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HealthBeat<br />

<strong>MIAMI</strong>-<strong>DADE</strong> <strong>COUNTY</strong> <strong>HEALTH</strong> <strong>DEPARTMENT</strong> <strong>SPRING</strong> <strong>2004</strong><br />

NATIONAL<br />

<strong>HEALTH</strong><br />

PUBLIC<br />

WEEK<br />

PAGE 8<br />

M D C H D C E L E B R A T E S<br />

B L A C K<br />

H I S T O R Y<br />

M O N T H<br />

PAGEAGE 9<br />

V O L U N T E E R S<br />

A N E W<br />

I N<br />

T H E<br />

P AGE<br />

AGE 13<br />

C L I N I C<br />

K E Y S<br />

13


Jeb Bush<br />

GOVERNOR<br />

Toni Jennings<br />

LIEUTENANT GOVERNOR<br />

John O. Agwunobi, M.D. M.B.A.<br />

SECRETARY, FLORIDA <strong>DEPARTMENT</strong> OF <strong>HEALTH</strong><br />

Bonita J. Sorensen, M.D. M.B.A.<br />

DEPUTY STATE <strong>HEALTH</strong> OFFICER<br />

Annie R. Neasman, R.N, M.S.<br />

DEPUTY SECRETARY FOR <strong>HEALTH</strong><br />

S ENIOR<br />

Lillian Rivera, R.N., M.S.N.<br />

ADMINISTRATOR<br />

Nancy Humbert, M.S.N., A.R.N.P.<br />

DEPUTY ADMINISTRATOR<br />

Eleni D. Sfakianaki, M.D., M.S.P.H.<br />

MEDICAL EXECUTIVE DIRECTOR<br />

JoAnne Kroesen, A.R.N.P., M.S.N., M.S.<br />

C.H.N. CONSULTANT, DIRECTOR, OFFICE OF ORGANIZATIONAL<br />

DEVELOPMENT<br />

Denise West, R.D., L.D./N, .M.P.H.<br />

DIRECTOR, WIC & NUTRITION<br />

Sandra Smith, R.N., B.S.N.<br />

ASSISTANT C.H.N. DIRECTOR, SPECIAL IMMUNIZATIONS PROGRAM<br />

Morton Laitner, Esq.<br />

CHIEF LEGAL COUNSEL<br />

Samir Elmir, P.E., M.S.<br />

ADMINISTRATOR, OFFICE OF ENVIRONMENTAL <strong>HEALTH</strong><br />

Richard Strait, M.B.A.<br />

PROGRAM ADMINISTRATOR<br />

Olga Connor, B.A.<br />

DIRECTOR, OFFICE OF PUBLIC <strong>HEALTH</strong> INFORMATION,<br />

LEGISLATIVE & COMMUNITY AFFAIRS<br />

Marie-Carole Desrosiers, M.D.<br />

DIRECTOR, TB CONTROL PROGRAM<br />

Evelyn Ullah, B.S.N., M.S.W.<br />

DIRECTOR, HIV/AIDS<br />

Thomas Burns, M.P.H.<br />

PROGRAM MANAGER, STD<br />

Fermin Leguen, MD, MPH<br />

DIRECTOR / EPIDEMIOLOGY & DISEASE CONTROL<br />

Alicia Reyes-Perez, R.N., B.S.N.<br />

REGISTERED NURSE CONSULTANT, DIRECTOR, SCHOOL <strong>HEALTH</strong><br />

PROGRAM<br />

Maurice Darden<br />

MANAGER, VITAL RECORDS<br />

Onelia Fajardo, M.P.H., DR, B.A.<br />

DIRECTOR, REFUGEE <strong>HEALTH</strong> ASSESSMENT PROGRAM<br />

Paula Schimpf, M.S.N., A.R.N.P.<br />

ASSISTANT CHN DIRECTOR, WOMEN’S <strong>HEALTH</strong> PROGRAM<br />

Martha Hernandez, M.P.A., R.H.I.A., L.H.R.M.<br />

SENIOR MANAGEMENT ANALYST / RISK MANAGEMENT PROGRAM<br />

Lee Fletcher, M.H.S.A.<br />

GENERAL SERVICES MANAGER<br />

L EADERS<br />

Geneva Riley<br />

SENIOR PERSONNEL MANAGER, HUMAN RESOURCES<br />

Message from our Administrator,<br />

LILLIAN RIVERA, RN, MSN<br />

It seems that December 2003 was just yesterday<br />

when I was writing my column to wish you the<br />

Season's Greetings and congratulate you for the<br />

excellent year that was coming to an end. The first<br />

quarter of the year is gone. They say time flies when<br />

you enjoy what you do, and I believe that is true. We<br />

are so immersed in doing well in all the things we do<br />

that we barely realize how fast our hours go.<br />

Beginning in <strong>2004</strong>, with the organization and culmination<br />

of the Step-Up, Florida event, we showcased<br />

the many options that our residents and visitors have to live a healthier<br />

lifestyle. The Miami-Dade County Health Department showed its validity in<br />

mobilizing and inspiring our community to pursue healthier lifestyles. There<br />

was great participation from the Miami-Dade County Public School students,<br />

and even Sebastian, the University of Miami mascot participated by<br />

Kayaking along the South Miami Senior High students.<br />

There are many other interesting things going on. Senior Leaders are<br />

attending professional training at the Department of Health in Tallahassee<br />

to enhance their skills and to be able to provide more support to the staff.<br />

March was designated as Nutrition Month and I would like to recognize<br />

WIC and Nutrition Director, Denise West, and her exceptional staff that has<br />

won the 2003 5 A Day National Excellence Award.<br />

I would like also to commend our social workers for their hard work and<br />

commitment to the many people they serve and help in Miami-Dade<br />

County. Our social workers are a key component for the department's<br />

functions and we are proud of their work and dedication.<br />

We celebrated Black History through the organization, and enjoyed the<br />

tour around the County that provided us with the history of the black community<br />

and its many contributions to the Miami-Dade County community.<br />

Our planning committee is actively preparing to welcome all of the<br />

County Health Department Directors and Administrators to Miami where<br />

their quarterly conference will be held. As part of the activities, we will be<br />

having a farewell retirement dinner for Ms. Annie R. Neasman, RN, MS,<br />

Deputy Secretary for Health/State Director of Public Health Nursing.<br />

I want to mention also the recent celebration of the National Public<br />

Health week and how proud we carry our compromise of promoting safe<br />

and healthy lifestyles and preventing the spread of disease, as well as the<br />

other things we do to keep our community healthy and safe.<br />

March 30 was National Doctor's Day. Congratulations to all the doctors<br />

that work in our Department for their dedication to public health and the<br />

many physicians in our community that provide medical care through the<br />

Volunteer Health Care Provider Program.<br />

We have definitely engaged and are looking at the Malcolm Baldrige criteria<br />

for performance excellence and we are taking active steps to train our<br />

organization with the criteria.<br />

We have many other events and challenges ahead, so I invite you all to<br />

continue our journey of excellence because our community needs us and<br />

we have vowed to do our best to keep Miami-Dade County healthy and<br />

continue to work towards our vision.<br />

2<br />

HealthBeat


Table of<br />

Contents<br />

ADMINISTRATOR’S MESSAGE<br />

PAGE 2<br />

DR. DESROSIERS RECEIVES AWARD<br />

PAGE 3<br />

DR. SFAKIANAKI TO CHAIR<br />

COMMITTEE<br />

PAGE 4<br />

THE REFUGEE <strong>HEALTH</strong> PROGRAM IS<br />

COLLECTING HONORS<br />

PAGE 5<br />

STEP UP, FLORIDA<br />

PAGE 6, 7<br />

NATIONAL PUBLIC <strong>HEALTH</strong> WEEK<br />

PAGE 8<br />

BLACK HISTORY MONTH<br />

PAGE 9, 10<br />

WOMEN AND CORONARY HEART<br />

DISEASE<br />

PAGE 11, 12<br />

DR. DESROSIERS RECEIVES AWARD<br />

The Florida Department of Health, Bureau of Tuberculosis and<br />

Refugee Health recognized Dr. Marie-Carole Desrosiers as TB<br />

Program Manager / Coordinator of the Year 2003 for her outstanding<br />

dedication and support of the Florida TB and Refugee Health<br />

Program. The award was presented to Dr. Desrosiers by MDCHD’s<br />

Administrator Lillian Rivera. In the picture, Dr. Desrosiers is accompanied<br />

by Rivera and Nancy Humbert, MDCHD’s Deputy<br />

Administrator.<br />

VOLUNTEERS: SOMETHING GOOD IS<br />

HAPPENING IN THE KEYS<br />

PAGE 13<br />

CONSORTIUM FOR A <strong>HEALTH</strong>IER<br />

<strong>MIAMI</strong>-<strong>DADE</strong><br />

PAGE 14<br />

COVER: A GROUP OF <strong>MIAMI</strong>-<strong>DADE</strong> <strong>COUNTY</strong> <strong>HEALTH</strong><br />

<strong>DEPARTMENT</strong>’S EMPLOYEES DURING THE STEP UP,<br />

FLORIDA EVENT.<br />

Miami-Dade County Health Department<br />

Recipient of the 2002 Governor’s<br />

Sterling Award for Excellence<br />

TOYS FOR CHILDREN<br />

MDCHD employees donated last December more than<br />

100 toys that were distributed to children at Jackson<br />

Memorial Hospital on Christmas Day. The toy drive was<br />

organized by the office of MDCHD’s Administrator Lillian<br />

Rivera.<br />

3<br />

HealthBeat


Dr. Sfakianaki to Chair Commitee of National Group<br />

Dr. Eleni Sfakianaki, Medical Executive Director of<br />

the Miami-Dade County Health Department (MDCHD),<br />

was recently appointed chair of the National<br />

Association of County and City Health Officials'<br />

(NACCHO) Community Health and<br />

Prevention Advisory Committee.<br />

NACCHO is a national nonprofit<br />

organization representing local public<br />

health agencies. NACCHO provides<br />

education, information, research, and Dr. Sfakianaki<br />

technical assistance to local health<br />

departments and facilitates partnerships among local,<br />

state, and federal agencies in order to promote and<br />

strengthen public health.<br />

NACCHO's Community Health and Prevention<br />

Advisory Committee's mission is to advocate for and<br />

facilitate the implementation of innovative and comprehensive<br />

community health and prevention policies and<br />

practices on the national and local level.<br />

"I believe NACCHO appointed me to chair this committee<br />

because of my background and experience in<br />

public health and community health," said Dr. Sfakianaki.<br />

Dr. Sfakianaki has been with the MDCHD for 14 years.<br />

In addition to her work at the MDCHD, she was recently<br />

appointed to the Advisory Board of the Anne E. Dyson<br />

Community Pediatrics Training Initiative at the University<br />

of Miami School of Medicine, a program that prepares<br />

pediatricians in the area of population-based health and<br />

public health. Dr. Sfakianaki also teaches graduate<br />

courses in public health at the University of Miami.<br />

Mort Laitner Inspires FIU Students With a Lecture<br />

Mort Laitner, MDCHD's Chief<br />

Legal Counsel has something to<br />

share and he did it recently in the<br />

best possible way: lecturing an audience<br />

of students that are still determining<br />

their career goals.<br />

Laitner was recently invited to lecture<br />

at FIU by professor William<br />

Brookman, who also works as an<br />

Environmental Health Supervisor at<br />

Monroe County Health Department.<br />

"I explained to them the basics<br />

and importance of the legal aspects<br />

of public health and they were very<br />

receptive about it," said Laitner, who<br />

had the time to highlight a field exercise<br />

conducted last year by the<br />

MDCHD and other local institutions<br />

to prepare the community in coping<br />

with a possible outbreak of biological<br />

agents.<br />

Laitner also told the students<br />

about the different programs within<br />

our Department and their efforts to<br />

have a healthy community in Miami-<br />

Dade County.<br />

After the lecture, professor<br />

Brookman wrote an e-mail saying:<br />

“Mort, I wanted to thank you very<br />

much on behalf of the students. You<br />

made quite an impression on them.<br />

Most are still determining their<br />

career goals and you made the legal<br />

aspects of public health come alive."<br />

4<br />

HealthBeat<br />

Mort Laitner played a key role in organizing the<br />

Smallpox Field Exercise that took place last<br />

October.


The Refugee Health Program is Collecting Honors<br />

The Miami-Dade County<br />

Refugee Health<br />

Assessment Program was<br />

recognized "for outstanding<br />

dedication and support of<br />

the Florida TB/Refugee<br />

Program." Program<br />

Director, Dr. Onelia Fajardo<br />

and Clinical Supervisor,<br />

Gina Bispham accepted a<br />

plaque on behalf of the<br />

program at the Refugee<br />

Health Conference in<br />

Tallahassee on December<br />

16-18, 2003.<br />

The program was also<br />

one of three finalists in the<br />

Institutions or Programs<br />

category of the Health Care<br />

Heroes Awards. The<br />

awards are given by the<br />

Greater Miami Chamber of<br />

Commerce to recognize<br />

dedication and excellence<br />

in the health care field.<br />

Talking about this great<br />

achievement, Dr. Fajardo<br />

said: "We, at the MDCHD<br />

Refugee Program are honored<br />

by the nomination and<br />

extremely grateful. Our<br />

team success reflects your<br />

continued support and the<br />

great leadership we have."<br />

Top: A group picture<br />

of the Refugee Health<br />

Program employees.<br />

Below: Dr. Onelia<br />

Fajardo and Gina<br />

Bispham hold the<br />

plaque they received<br />

in Tallahassee.<br />

5<br />

HealthBeat


StepUp, FLORIDA<br />

On Our Way to Healthy Living!<br />

“IN OUR <strong>COUNTY</strong> THIS EVENT WA<br />

AND VISITORS THAT THEY CA<br />

FOR <strong>HEALTH</strong>IER<br />

Warming up before the walk.<br />

MDCHD employees get ready to start the event at the West Perrine Clinic.<br />

Deputy Secretary for Health Annie<br />

Neasman joined the Miami-Dade<br />

County Health Department, local partners<br />

and citizens for "Step Up,<br />

Florida - on our way to healthy living!,"<br />

activities as part of the<br />

statewide event promoting physical<br />

activity and healthy lifestyles. This<br />

event showcased the numerous<br />

opportunities that Florida offers its citizens<br />

and visitors to be physically<br />

active.<br />

In Miami-Dade County, the event<br />

took place February 2-4.<br />

Miami-Dade County Health<br />

Department's Administrator Lillian<br />

Rivera and Deputy Administrator<br />

Nancy Humbert joined employees<br />

and representatives from other local<br />

organizations to participate in different<br />

activities throughout our county to<br />

promote healthy lifestyles.<br />

“In our county this event was aimed<br />

at telling residents and visitors that<br />

they can find here many options for<br />

healthier lyfestyles,” Rivera said.<br />

Participants carried the "fitness<br />

flag" along the East coast on Miami-<br />

Dade's beaches and three public<br />

schools joined the fitness celebration<br />

by showcasing their physical education<br />

programs. South Point<br />

6<br />

HealthBeat


Left to right: Dr. Jayne Greenberg, from Miami-Dade County Public Schools, a student,<br />

Deputy Secretary for Health Annie Neasman, MDCHD Administrator Lillian<br />

Rivera and Deputy Administrator Nancy Humbert.<br />

Gina Bispham, Wanda Williams and Denise West walk<br />

along US1.<br />

S AIMED AT TELLING RESIDENTS<br />

N FIND HERE MANY OPTIONS<br />

LYFESTYLES”<br />

Lillian Rivera<br />

MDCHD Administrator<br />

Elementary students participated in<br />

jump rope activities and Miami Beach<br />

Senior High students worked out in<br />

the school's fitness center which<br />

includes a rock climbing wall.<br />

Nautilus Middle School students had<br />

a tennis match, utilizing the shared<br />

facilities of the city park.<br />

At Crandon Park, in Key Biscayne,<br />

Sebastian, the University of Miami<br />

Mascot and students from Miami-<br />

Dade County Public Schools participated<br />

in a kayaking event. The students<br />

are part of a joined sports venture<br />

between the Miami-Dade County<br />

Public Schools and the Miami-Dade<br />

County Parks and Recreation<br />

Department. The group included students<br />

with disabilities who participate<br />

in kayaking activities all yearlong.<br />

At the end of the day, a closing<br />

event was held at Mercy’s Hospital<br />

with the participation of MDCHD´s<br />

employees and the leadership of our<br />

Department. Annie Neasman, Deputy<br />

Secretary for Health, John E.<br />

Matuska, CEO of Mercy’s Hospital<br />

and Dallas Manuel, from the office of<br />

Commissioner Dennis C. Moss also<br />

attended the event.<br />

Miami Beach Senior High students work out in the school's fitness center.<br />

From left to right: Annie Neasman, John E. Matuska, Barbara Adkison, Karen<br />

Weller, Pascale Jean, Lillian Rivera and Dallas Manuel, from the office of<br />

Commissioner Dennis Moss.<br />

7<br />

HealthBeat


National Public Health Week: “Eliminating Health Disparities”<br />

The Miami-Dade County Health Department (MDCHD) kicked off National Public<br />

Health Week with an event for employees and community partners at Corporate<br />

Park. MDCHD Administrator, Lillian Rivera hosted the event, which focused on living<br />

a healthier lifestyle.<br />

Also, included was a proclamation from Mayor Alex Penelas, Commissioner<br />

Barbara Carey-Shuler and Commissioner Jimmy Morales proclaiming April 5 - 12<br />

as National Public Health Week in Miami-Dade County.<br />

A presentation by Denise West, Director of the WIC and Nutrition program<br />

focused on the Department's award winning 5 A Day activities. Pascale Jean,<br />

Worksite Wellness Coordinator taught the group how to determine serving sizes<br />

for our meals.<br />

The keynote speaker for the day was Dr. Spencer Baron. Dr. Baron, the chiropractic<br />

physician to the Dolphins and the Marlins gave an exciting and informative<br />

presentation called, "A Day in the Life of Bad Habits." The presentation focused<br />

on things we do in our everyday life that can cause injury and what can be done to<br />

prevent such injuries.<br />

In a letter published in The Miami Herald in April, MDCHD Administrator Lillian<br />

Rivera wrote about the National Public Health Week: “This year's theme is<br />

''Eliminating Health Disparities.'' The department is working to close the gap in<br />

health indicators in our community. One of the ways is by building two new health<br />

centers. The first is in West Perrine. The first phase of construction is almost complete.<br />

The second center is in Little Haiti and is in the final phase of securing construction<br />

permits. Also, our Special Immunization Van will cover ''pockets of need''<br />

in the county.<br />

“The health department continues bio-preparedness efforts and has implemented<br />

a systems approach for a unified response to acts of domestic terrorism involving<br />

biological weapons of mass destruction. We are the lead agency in all inci-<br />

From left to right: Paula Schimpf, Arelis Valero, Lillian Rivera,<br />

Barbara Adkison, Karen Weller and Pascale Jean.<br />

dents involving biological terrorism. To protect first-responders, the<br />

Vaccinate Florida plan was implemented, and hundreds were inoculated<br />

against smallpox,” wrote Rivera in her letter to The Herald.<br />

CONTRIBUTING WRITER: BARBARA ADKISON<br />

Suzzane Johnson, Dr. Spencer Baron and<br />

Olga Connor.<br />

Employees of MDCHD participated in the<br />

National Public Health Week.<br />

From left to right, Marylin Rey, from the<br />

office of Mayor Alex Penelas, Lillian Rivera<br />

and Olga Connor.<br />

MDCHD Celebrates National Doctor’s Day<br />

The Florida Department of Health (DOH)<br />

recognized March 30 as National Doctor's<br />

Day, a date held to celebrate the nation's<br />

physicians and their dedication to the<br />

physical well being of their patients, communities,<br />

and country.<br />

Florida joined the nation in applauding<br />

these physicians who strive each day to<br />

treat the sick, discover new cures, prevent<br />

illness and set benchmarks for future<br />

excellence in public health.<br />

“Doctor's individual and shared efforts<br />

make an immeasurable contribution to the<br />

people of our state,” Florida DOH<br />

Secretary John O. Agwunobi, M.D., M.B.A.<br />

said. “ We offer our thanks to these physicians<br />

for striving each day to uphold outstanding<br />

public health in Florida.”<br />

“Congratulations to all the doctors that<br />

work in our Department for their dedication<br />

to public health and the many physicians in<br />

our community that provide medical care<br />

through the Volunteer Health Care Provider<br />

Program,” said Lillian Rivera, MDCHD<br />

Administrator.<br />

Many of these physicians provide medical<br />

care on a voluntary basis to uninsured<br />

individuals through<br />

the Volunteer<br />

Health Care<br />

Provider<br />

Program.<br />

Established in<br />

1992 as part of<br />

the Florida<br />

Legislature's “Access to Health Care Act,”<br />

the program is designed to recruit and<br />

retain qualified volunteers in order to<br />

increase access to health care for<br />

Floridians. With this program, the Florida<br />

Department of Health partners with over<br />

19,000 volunteers to provide primary and<br />

specialty health care, as well as preventive<br />

mental, dental, tertiary, and hospitalization<br />

services; yet many volunteers are still<br />

needed for a range of positions including<br />

administration, computer specialists, photographers,<br />

medical professionals, and<br />

specialized practitioners.<br />

National Doctor's Day has been held<br />

annually since 1933 when Eudora Brown<br />

Almond introduced the idea to commemorate<br />

Dr. Crawford Long's landmark use of<br />

general anesthesia in surgery nearly one<br />

hundred years prior. Since then, the<br />

United States House of Representatives<br />

adopted a resolution in 1958 to memorialize<br />

Doctor's Day, and in 1990 a resolution<br />

was signed by then-President George<br />

Bush to designate March 30 as “National<br />

Doctor's Day.”<br />

8<br />

HealthBeat


M D C H D C e l e b r a t e s B l a c k H i s t o r y M<br />

The tours highlighted<br />

the vibrant and rich<br />

history of African-<br />

Americans in<br />

South Florida.<br />

Did you know that Billie<br />

Holiday, the great singer of jazz<br />

and blues, was one of the most<br />

notorious tenants of the<br />

Georgette's Team Room, a 13-<br />

room house built in 1940 in<br />

Miami's Northwest area<br />

That is just one of the many<br />

interesting things we learned as<br />

part of the Black History Tours<br />

program, launched by the<br />

Miami-Dade Transit Agency in<br />

1994 to make residents and visitors<br />

acquainted with landmarks<br />

in Miami's historical Black communities.<br />

Dozens of Miami-Dade<br />

County Health Department<br />

employees participated last<br />

February in these free tours<br />

that highlighted the vibrant<br />

and rich history of African-<br />

Americans in South Florida.<br />

Places like Charlotte Jane<br />

Cemetery, in Coconut Grove,<br />

the Lyric Theater, the Greater<br />

Bethel AME Church and the<br />

Chapman House, in<br />

Overtown, and The<br />

Wall, in Liberty City,<br />

are some of the<br />

sites the excursion<br />

features.<br />

Those who did<br />

the tour this year<br />

could also visit the Georgette's<br />

Tea Room and the Lincoln<br />

Memorial Park Cemetery, in the<br />

Brownsville area. The<br />

Georgette's Team Room, built<br />

by Georgette Scott Campbell,<br />

was once a secluded getaway<br />

for Black celebrities seeking a<br />

relaxing atmosphere away from<br />

Overtown.<br />

One interesting place was the<br />

Dorsey House, home of Dana<br />

Albert Dorsey, Miami's first<br />

Black millionaire. Dorsey started<br />

as a carpenter and became<br />

a millionaire by buying land,<br />

building houses and renting<br />

them to Blacks.<br />

Another piece of history featured<br />

on the tours is the Greater<br />

Bethel AME Church. It was built<br />

in 1896 and today it's the oldest<br />

continuing all-Black congregation<br />

in Miami.<br />

The Black History Month was<br />

also celebrated by MDCHD's<br />

employees with a luncheon at<br />

Miami International Commerce<br />

Center, where the entire third<br />

floor was decorated with works<br />

of art, pictures and posters.<br />

Kathy Malone and Beverly<br />

Miles coordinated all the Black<br />

History Events.<br />

One of the purposes of this<br />

year's Black History Month<br />

observance was to educate<br />

employees on the African-<br />

Americans' contributions to<br />

society. In that regard, a "tell-astory"<br />

fashion show highlighted<br />

the lives and work of many<br />

influential African-American and<br />

their contribution.<br />

9<br />

HealthBeat


o n t h W i t h T o u r s a n d F e s t i v i t i e s<br />

Donald Young, Ethel Lewis and Clementine McCray.<br />

Kathy Malone was one of the organizers.<br />

Beverly Miles (left) and two employees of Miami-Dade Metro<br />

Transit System.<br />

One of the purposes of this<br />

year's Black History Month<br />

observance was to educate<br />

employees on the African-<br />

Americans' contributions<br />

to society.<br />

Dozens of employees attended the cultural event.<br />

10<br />

HealthBeat


Women and Coronary Heart Disea<br />

ELENI D.<br />

SFAKIANAKI,<br />

M.D., M.S.P.H.<br />

MDCHD Medical<br />

Executive<br />

Director<br />

Coronary heart disease -<br />

part of the overall classification<br />

of Cardiovascular<br />

Diseases (CVD)- continues<br />

to be the leading cause of<br />

death in the United States,<br />

and in many other developed<br />

nations. Death rates<br />

from CVD have been going<br />

down over the last several<br />

decades. However, despite<br />

an overall reduction, the rate<br />

of decline is less for women<br />

than for men. In terms of<br />

total deaths, in every year<br />

since 1984, CVD has claimed the lives of more<br />

females than males. And the gap between male<br />

and female deaths is wide, as the graph below<br />

shows:<br />

It is estimated that one in two women will eventually die<br />

Misperceptions still exist that CVD is not a real<br />

problem for women. Many people still believe<br />

that "heart disease is a man's disease."<br />

However, the harsh reality is that:<br />

Cardiovascular diseases cause about a<br />

death a minute among women, claiming more<br />

than one half million female lives every year.<br />

That is more lives than the next 7 causes of<br />

death in women combined.<br />

It is estimated that one in two women will<br />

eventually die of heart disease or stroke, compared<br />

with one in 25 who will eventually die of<br />

breast cancer.<br />

Starting at age 75, the prevalence of CVD<br />

among women is higher than that among men.<br />

Nearly two thirds of women who die suddenly<br />

have no previously recognized symptoms.<br />

CVD is a particularly important problem<br />

among minority women. The death rate due to<br />

CVD is 69 percent higher in black women than in<br />

white women.<br />

The good news is that, according to the<br />

literature, overwhelming evidence suggests<br />

that CVD can be prevented to a large<br />

extent in both men and women. As we<br />

know, several factors raise the risk of heart<br />

disease. These include:<br />

Increasing age<br />

Gender<br />

Heredity and race<br />

High blood cholesterol<br />

High blood pressure<br />

Tobacco smoke<br />

Physical inactivity<br />

Obesity or overweight and<br />

Diabetes.<br />

Addressing these factors and effectively<br />

modifying or controlling them, can substantially<br />

reduce the risk for CVD. Of course,<br />

some of these factors, namely the first<br />

three ones, cannot be modified: we cannot<br />

turn the clock back nor can we change our<br />

gender and our family history. However,<br />

both men and women can do a lot to modify<br />

or control the other risk factors: high<br />

blood cholesterol, high blood pressure,<br />

tobacco smoke, physical inactivity, obesity<br />

or overweight and diabetes.<br />

11<br />

HealthBeat


e - New Guidelines for Prevention<br />

f heart disease or stroke.<br />

In the majority of people, simple lifestyle<br />

changes can have dramatic results in terms<br />

of reducing the risk for CVD, and are recommended<br />

to all individuals. When it<br />

comes to more drastic interventions however,<br />

and specifically addressing women, no<br />

clear guidance had been available until<br />

very recently. In fact, on February 4th the<br />

American Heart Association announced<br />

new guidelines for preventing heart disease<br />

and stroke in women according to a<br />

woman's individual cardiovascular health.<br />

The guidelines are based on the highestquality<br />

evidence from all the available<br />

research related to CVD prevention, and<br />

represent a major collaborative effort by the<br />

American Heart Association and 11 other<br />

professional and governmental co-sponsoring<br />

organizations.<br />

According to the new recommendations,<br />

the aggressiveness of treatment should be<br />

linked to the level of risk a woman has of<br />

having a heart attack in the next 10 years.<br />

Levels of risk are established using a standardized<br />

scoring method developed by the<br />

Framingham Heart Study. Low risk means<br />

a woman has a less than 10 percent<br />

chance of having a heart attack in the next 10<br />

years, intermediate risk is a 10 to 20 percent<br />

chance, and high risk is a greater than 20 percent<br />

chance.<br />

In addition to categorizing the levels of risk,<br />

the new guidelines classified the prevention<br />

measures, both lifestyle and medical, based on<br />

the strength of the recommendation for each<br />

level of risk. Details of the various classes will<br />

not be discussed here, except to mention that<br />

these new guidelines provide advice on what not<br />

to do in addition to telling us what to do. To that<br />

end, certain interventions were labeled Class III,<br />

indicating that such interventions are either not<br />

useful or could be harmful, or both. The following<br />

is a simplified summary of the types of intervention<br />

according to levels of risk:<br />

High-Risk Women (>20% risk of having a<br />

heart attack in the next 10 years)<br />

Recommended intervention:<br />

Smoking cessation<br />

Physical activity/cardiac rehabilitation<br />

Diet therapy<br />

Weight maintenance/reduction<br />

Blood pressure control<br />

Lipid control (statin therapy)<br />

Aspirin therapy<br />

Blood sugar control in diabetics<br />

Evaluate/treat depression<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

Omega 3 fatty-acid supplementation<br />

Folic acid supplementation<br />

Intermediate-risk women (10% to 20% risk)<br />

Recommended intervention:<br />

Smoking cessation<br />

Physical activity<br />

Heart-healthy diet<br />

Weight maintenance/reduction<br />

Blood pressure control<br />

Lipid control<br />

Aspirin therapy<br />

Lower-risk women (


Volunteers<br />

Something Good is Happening in the Keys<br />

Dr. Sanford Yankow prepares a medical procedure.<br />

Twelve volunteer physicians work at the clinic.<br />

Something good is happening in the Keys and it<br />

does not have anything to do with the flashy<br />

nightlife of Duval Street.<br />

We are talking about the recent opening of the<br />

Good Health Clinic, created by Dr. Sanford Yankow<br />

and Dr. Stanley Zuba in Tavernier Key to provide<br />

secondary and tertiary care to the uninsured indigent<br />

residents of the Upper Keys of Florida.<br />

The clinic staff includes 12 volunteer physicians<br />

in the fields of internal medicine, neurology, dermatology,<br />

gastroenterology and general surgery. Other<br />

medical services provided by the clinic are<br />

OB/GYN and pediatrics.<br />

The Good Health Clinic has established a partnership<br />

with the Mariners Hospital, a member of<br />

Baptist Health of South Florida.<br />

From left to right: Kay Cullen, Clinic Coordinator, Dr. Sanford Yankow, Clinic<br />

Director, Maria Ortega, from MDCHD and Jim Gustafson, Division Director,<br />

Pastoral Care Mariners Hospital.<br />

13<br />

HealthBeat


Consortium for a Healthier<br />

Miami-Dade Addresses<br />

Chronic Disease in<br />

Our Community<br />

"In 2001, chronic diseases<br />

accounted for six of the top ten<br />

leading causes of death in<br />

Florida. Of the 167,181 deaths<br />

that occurred in Florida, 71.2%<br />

were due to chronic disease."<br />

John O. Agwunobi, M.D., M.B.A.<br />

Secretary, Florida Department of<br />

Health<br />

Statistics for Miami-Dade coincide<br />

with those of the State with heart<br />

disease as the leading cause of<br />

death followed by cancer and<br />

stroke. As a community, we wanted<br />

to work together to reduce chronic<br />

disease in our community and<br />

formed the Consortium for a<br />

Healthier Miami-Dade (Consortium)<br />

in September 2003. Since that first<br />

meeting, membership has doubled<br />

and now includes over 50 organizations,<br />

businesses and government<br />

agencies.<br />

Healthy People 2010 serves as a<br />

guide to improve the health of people<br />

in the United States and<br />

includes a section related to chronic<br />

disease.<br />

The State of Florida Department<br />

of Health has set the statewide<br />

goals based upon Healthy People<br />

2010 addressing arthritis, cancer,<br />

diabetes, heart disease and stroke,<br />

nutrition and overweight, physical<br />

activity, tobacco use and epilepsy<br />

through health promotion and prevention<br />

of illness, disability and premature<br />

death. It is designed to<br />

reach two major goals, increase<br />

quality and years of healthy life and<br />

eliminate health disparities.<br />

The Consortium is<br />

working with the<br />

Health Council of<br />

South Florida on the<br />

Planned Approach to<br />

Community Health<br />

to promote disease<br />

prevention programs.<br />

Since addressing chronic diseases<br />

is a multifaceted issue, the<br />

Consortium members formed committees<br />

to address the priorities that<br />

the group has set. The committees,<br />

which meet regularly, are:<br />

1) School Based Issues<br />

The co-chairs are Carol Chong,<br />

RD, from Miami-Dade Public<br />

Schools and Begoña Calcerrada,<br />

from North Beach Coalition and<br />

publisher of Hola Amigos. The overall<br />

goal of this committee is to promote<br />

health and wellness in the<br />

schools<br />

2) Worksite Wellness<br />

The co-chairs are Santiago Leon,<br />

from ACC Hall Insurance Brokers<br />

and Dr. Donna Riley, from Miami-<br />

Dade Public Schools.<br />

The group decided on promoting<br />

healthy lifestyles through worksite<br />

activities by sharing information on<br />

best practices and by creating partnerships<br />

to implement worksite<br />

wellness activities.<br />

3) Health Promotion and Disease<br />

Prevention<br />

The co-chairs are Tori Gabriel,<br />

from Miami Heart Research<br />

Institute, Inc. and<br />

Peggy McLoughlin, from Jackson<br />

Health Systems. The group will<br />

address chronic disease through<br />

the promotion of a healthy lifestyle<br />

including good nutrition, regular<br />

physical activity and not using<br />

tobacco products.<br />

The Consortium is also working<br />

with the Health Council of South<br />

Florida on the Planned Approach to<br />

Community Health (PATCH) to promote<br />

disease prevention programs.<br />

The Consortium and committee<br />

chairs make up the steering committee<br />

that will help guide the<br />

PATCH process through the five<br />

phases. Upon completion, the community<br />

will have added information<br />

that will enable them to better identify<br />

and target priority health problems.<br />

The Consortium is open to all<br />

who are interested. For additional<br />

information or to participate in the<br />

Consortium, please call (786) 845-<br />

0335. A web site will be online<br />

soon.<br />

Contributing Writer: Barbara Adkison<br />

14<br />

HealthBeat


I N t he Spotlight<br />

CONGRATULATIONS, EMPLOYEES OF THE MONTH!<br />

Congratulations to the outstanding employees who were recognized for their exemplary<br />

performance and professionalism for the months of December, January and February 2003. Our<br />

sincere thanks and gratitude for all the hard work you have put forth to make Miami-Dade County a<br />

healthy and safe community.<br />

DECEMBER JANUARY FEBRUARY<br />

Yainet Gómez<br />

XXXXXXXXXXXXXX<br />

Michael Cover<br />

XXXXXXXXXXX<br />

Karen Weller<br />

XXXXXXXXXXX<br />

The National Association of Social Workers (NASW) is celebrating 100 years of professional social<br />

work all over the United States this month. That is why we want to acknowledge the work of our social<br />

workers. Our social workers here at the Miami-Dade County Health Department work to expand choices<br />

and opportunities for all people, with emphasis on vulnerable, disadvantaged, oppressed, and<br />

exploited people and groups. We commend all of you for your numerous contribution to the department<br />

and surrounding Miami-Dade County.<br />

EMPLOYEE NEWS<br />

Annie Neasman will retire after more than 30 years of public health service<br />

Deputy Secretary for Health/State Director of Public Health<br />

Nursing, Ms. Annie R. Neasman, R.N. M.S., is retiring effective<br />

May 21, <strong>2004</strong>.<br />

The announcement was made by DOH Secretary John O.<br />

Agwunobi, M.D., M.B.A., who said: “Neasman is among<br />

Florida's renowned public health leaders, and I am extremely<br />

honored and humbled to have served along side her.’’<br />

“Ms. Neasman's leadership at the Florida Department of<br />

Health will be sorely missed. She has been instrumental in our<br />

quest to make our department the best in the nation.<br />

Although she will be leaving the department, Ms. Neasman's<br />

passion for public health remains; and, she will continue her<br />

public health leadership role in her community,’’ Agwunobi<br />

added.<br />

An activity is scheduled for Wednesday, April 7, <strong>2004</strong>, from<br />

9:30 a.m. to 11:30 a.m., in Room 301, Building 4052, Capital<br />

Circle Office Complex in Tallahassee, in celebration of Ms.<br />

Neasman's over 30 years of public health service to the state<br />

of Florida.<br />

Annie R. Neasman, Olga Connor and Sebastian, the UM<br />

mascot.<br />

15<br />

HealthBeat


Mission: A Healthy Community is the Heart of Public Health. Vision: To Be a A World-Class Public Health System.<br />

Miami-Dade County Health Department<br />

8175 N.W. 12 Street, Suite 437<br />

Miami, FL 33126<br />

Produced by the MDCHD Office of Public Health<br />

Information, Legislative and Community Affairs<br />

A RE CHRONIC DISEASES PREVENTABLE<br />

Chronic diseases impose<br />

an enormous financial and<br />

societal burden on the United<br />

States. According to the<br />

Centers for Disease Control<br />

and Prevention (CDC), chronic<br />

diseases today account for<br />

70% of the deaths of all<br />

Americans and 75% of this<br />

country’s annual health care<br />

costs.<br />

Unless we take steps now<br />

to deal effectively with chronic<br />

diseases, our nation is<br />

headed for a serious financial<br />

and quality-of-life crisis.<br />

Among the contributing factors<br />

to this crisis<br />

are the aging of our population;<br />

increases in obesity, particularly<br />

among adolescents;<br />

and the tragedy of tobacco<br />

addiction.<br />

No one speaks with more<br />

passion, conviction, and<br />

vision about the need to<br />

address this pending crisis<br />

than Dr. James Marks, director<br />

of the CDC’s National<br />

Center for Chronic Disease<br />

Prevention and Health<br />

Promotion. As he demonstrates<br />

so clearly in his presentation,<br />

"The Burden of<br />

Chronic Disease and the<br />

Physical<br />

activity is<br />

one of the<br />

many ways<br />

to prevent<br />

chronic<br />

diseases.<br />

Future of Public Health," public<br />

health prevention programs<br />

can, with real societal<br />

and political will, substantially<br />

reduce or even prevent the<br />

burden of many major chronic<br />

disease conditions.<br />

His presentation makes a<br />

strong case for moving from<br />

a palliative medical model to<br />

a prevention-based approach.<br />

He argues most persuasively<br />

that preventing chronic diseases<br />

can provide Americans<br />

with a better quality of life,<br />

reduce unnecessary medical<br />

costs and lost productivity,<br />

and strengthen our national<br />

economy.<br />

Funding for research and<br />

medical advances alone will<br />

alleviate neither the cost nor<br />

the suffering of individuals<br />

faced with a chronic disease.<br />

Without concomitant investments<br />

in public health prevention<br />

and control efforts to<br />

implement the prevention<br />

research results we already<br />

have, rising health care costs<br />

and preventable deaths will<br />

continue.<br />

This article was published on the<br />

website of the Centers for<br />

Disease Control and Prevention.

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