Ways To Reduce OC Child Poverty: A “Comprehensive Holistic Approach”

ORANGE COUNTY – More than 4,600 children in Orange County were living in poverty in 2001, according to census data. That was almost 18 percent of the total number of children living in the County at the time. A decade later, more than 2,300 additional children were living in poverty.

Dr. Colleen Bridger, Director of the Orange County Health Department, said poverty remains one of the biggest, yet least acknowledged issues in our area.

She discussed possible ways to reduce child poverty at a County Board of Health meeting Wednesday night. Bridger explained that Orange County’s child poverty rate is on trend with the majority of other counties.

“Like in a lot of aggregate statistics, we look better than the State average. The challenge is that we still have families who are living in abject poverty in Orange County, and sometimes aggregate statistics can mask that,” Bridger said.

She added, “When you go back to the stereotype for Orange County, you hear that for example we have the lowest unemployment rate. So people, I think, make the next logical step to say ‘Well, if we have the lowest unemployment rate, then our poverty numbers must not be matching other areas in the State.’ That is just not the case.”

The Health Department’s analysis indicated that there are six prevalent pockets of poverty throughout our area, encompassing 21 of the 29 schools in Orange County.

Many poverty indicators, such as the number of children enrolled in Medicaid and the number of students on free or reduced lunch, have increased in the last five years, both countywide and also in both Chapel Hill-Carrboro City Schools and Orange County schools.

As of 2011, more than 7,000 children in the county, or 25 percent, were enrolled in Medicaid. More than 30 percent of students enrolled in both school districts received free or reduced lunch.

Long-term Impacts of Child Poverty

Children living in poverty, Bridger explained, are much more likely to experience “adverse childhood events.” Examples include abuse, neglect or a general category of household dysfunction.

“The reason that this is important is because when children are exposed to an adverse childhood event, it structurally affects their brain,” Bridger said.

Research shows that the more adverse events a child experiences will increase the likelihood for chronic diseases, mental health problems, and behaviors that lead to teen pregnancy or the contraction of sexually transmitted diseases.

“Those adverse childhood events are extremely linked to adult public health outcomes that we really want to see changed,” she said.

Possible Solutions

While poverty cannot be eliminated immediately, Bridger said that there are ways to address the problem now and prevent future difficulties in our local children’s lives.

“A county government cannot fix poverty. What we can do, however, is mitigate the effects of poverty on children. The only way to do that is through an extremely comprehensive holistic approach.”

The Harlem Children’s Zone Project was launched in New York City and promotes positive environments for area children. Bridger said she hopes to launch a program like that here in Orange County.

“One of the biggest successes that it [the Harlem Children’s Zone Project] showed relatively quickly is that it literally eliminated the racial disparity in math and reading for children in elementary school,” Bridger said.

Durham has a similar program already up and running, called the East Durham Children’s Initiative

As part of her larger goal to implement a program like the Harlem’s Children’s Zone project in Orange County, Bridger will recommend several initiatives at next month’s Board of Health meeting.

A component of her proposal is to create a new program manager position to focus on a community dealing with childhood poverty in our area.


Highest Weekly Flu Death Total Reported In NC, Death Toll Rises To 44

ORANGE COUNTY – Eleven people have died from flu-related complications last week in North Carolina, the highest weekly total so far this flu season, according to figures released Thursday from the State Department of Health and Human Services.

Forty-four people in the State have died from influenza since flu season began in October of last year.

Pam McCall, Director of Personal Health Services for the Orange County Health Department, said peak flu season is upon us.

“This does correlate with what it was like last year. This past week in 2013 also registered the highest number of flu deaths [so far for the 2012-2013 flu season].”

The number of cases typically increases in January and February, though she added that in 2013, there were flu deaths reported as late as May.

McCall added that the number of deaths is not unusual at this stage of the flu season.

“Last year at this time, there were 41 total deaths reported, and right now, we are at 44 so it is a little higher. This flu season, the difference is the age ranges [who are being affected]. Last year, the older adults made up a majority of the flu deaths. This year, it is in that 25-64 age range.”

Typical seasonal flus tend to impact very young children with underdeveloped immune systems or the elderly who have weakened immune systems.

But for the 2013-2014 flu season, 19 of the total number of deaths have occurred among adults aged 25 to 49, followed by people aged 50 to 64, with 14 deaths.

Some good news is that the number of new flu cases reported by UNC Hospitals has dropped significantly.

For the week of January 19 through January 25, they were 41 lab-confirmed influenza cases compared to 82 the preceding week.

“That too seems to indicate that we have reached the peak of the season so far since we have had a dramatic drop at UNC Hospitals, at least in the number of cases. It does look like the numbers are going down overall in the State,” she said.

It is not too late for people to get their annual flu shot, but McCall said it does take two weeks after inoculation for the antibodies to develop in your body and become effective. The Center for Disease Control recommends that people six months and older get vaccinated for the flu.

McCall said if you do come down with the flu, the antiviral medication TAMIFLU® can reduce the severity and duration of symptoms.

The flu vaccine is offered at the Orange County Health Department. To find other locations where the vaccine is administered, click here.


Norovirus Outbreaks Flare Up Across NC, But Not Orange County

ORANGE COUNTY - Officials from the Orange County Health Department say that a Norovirus outbreak has not moved into our area, though outbreaks have flared up across the state.

Pam McCall, Personal Health Services Director for the Orange County Health Department, explains that Norovirus is a highly contagious gastrointestinal illness which is most common during the winter months. Outbreaks have been reported in Alamance, Henderson, Burke, and Beaufort Counties, according to the Associated Press.

“It is not a fun illness to have, but it is pretty self-limiting and usually goes away in one to three days,” McCall says.

The symptoms include nausea, vomiting, diarrhea, and possibly stomach cramping. Some people may also have fever, chills, headache, muscle aches and a general sense of tiredness. The illness begins suddenly, and the infected person may feel very sick. There are no specific medications to treat Norovirus.

“It can be dangerous for people who have their immune system compromised because they can become dehydrated. That is the main danger with people who have some kind of underlying medical condition. The elderly and young children are probably the most at-risk for that,” McCall says.

Norovirus is present in the stools and vomit of sick people during illness and for a few days after they recover.

People can get sick through direct contact with a person who has the virus, by touching contaminated surfaces, or by eating food or drinking liquids that have been contaminated with the virus.

McCall says the most effective way to prevent the spread of the Norovius is through hand washing.

“Some of these waterless hand sanitizers are not effective against the Norovirus, so you really need to use soap and warm water and vigorously wash your hands after you go to the bathroom and before you prepare food,” McCall says. ”If you do have a diarrheal illness like this, do not prepare food for other people up until 48 hours after the symptoms resolve.”

Epidemiologist Nicole Lee, of the N.C. Department of Health and Human Services Department, says that there are several illnesses that must be reported to the health department in accordance with state laws. Lee says that individual cases of the Norovirus are not required to be reported, but outbreaks of the virus are.

“It really is more of a state-wide issue where we would want people to know to stay home if you are ill. We get reports of people who are symptomatic, and what we are seeing is that there are outbreaks from November to April. We are starting to get reports in various counties,” Lee says.

Many commonly used disinfectants are not effective against Norovirus. McCall recommends cleaning with a diluted bleach solution to disinfect surfaces after an episode of the illness.

Public health experts recommend the following measures to protect yourself and your family from Norovirus:

  • Clean up vomit and diarrhea immediately.
  • Do not prepare food for others to eat while you are sick and for at least 48 hours afterward.
  • Even after symptoms are gone, wash your hands frequently, especially after going to the bathroom.
  • Remember that you can spread the virus for days, and sometimes weeks, after the illness ends.

Flu Causes 3 Deaths In North Carolina

ORANGE COUNTY - Three North Carolinians have died from the flu, according to State health officials, marking the first deaths of the annual flu season.

The North Carolina Department of Health and Human Services said Tuesday that the patients were from Eastern North Carolina, the Triad region, and the Charlotte area. They were middle-aged adults who were at increased risk for influenza complications due to underlying medical conditions.

Pam McCall, Director of Personal Health Services for the Orange County Health Department, said that flu season runs from September until around March. The number of cases typically peaks in January or February.

McCall said it is not too late for people to get their annual flu shot.

“It does take two weeks for the shot to become effective and for the antibodies to develop in your body,” McCall said. ”The flu season is continuing, and we are getting reports of more positive flu tests, so people should go ahead and get the shot now. It is really the only way to prevent the flu.”

The Center for Disease Control recommends that people six months and older get vaccinated for the flu.

“People who are elderly, children under age two, pregnant women, and people with chronic medical conditions are more susceptible to the complications of the flu,” McCall said. “So if they got the flu, it may lead to something more serious.”

The vaccine protects against various strains of flu virus circulating this year, including H1N1. It is available in nasal spray and shot form.

“I really would encourage everyone to get an annual flu vaccine, and in addition to that, to use the other precautions such as hand washing, staying home when you are sick, and covering your cough.”

McCall said the flu vaccine is offered at the Orange County Health Department. To find other locations where the vaccine is administered, click here.


Durham Child Dies Of Possible Meningitis; Health Official On The Deadly Illness

CHAPEL HILL – A 5-year-old child died Wednesday in Durham due to a probable case of bacterial meningitis, according to health officials. The disease is rare and can be deadly if not caught early.

A spokesman for the Durham County Department of Public Health told multiple news outlets that the case was under investigation. Nine classmates of the infected child, who attend Mount Zion Christian Academy, were being treated with preventive antibiotics.

Susan Rankin, the communicable disease coordinator for Orange County Health Department, explained that meningitis is a disease caused by the inflammation of the protective membranes covering the brain and spinal cord, known as the meninges.

“The most common is viral meningitis, which is caused by a virus. [Another type is] bacterial which can be cause by several different types of bacteria,” Rankin said.

Meningitis may develop in response to a number of causes, usually bacteria or viruses, but can also be caused by physical injury, cancer, or certain drugs, according to the Center for Disease Control.

Rankin said that bacterial meningitis is not an airborne illness and is not spread through casual contact.

“It is transmitted in secretions such as saliva or nasal secretions, like when people have a runny nose—you’ll be infected through contact like that.”

The average onset of bacterial meningitis is three to seven days, though it depends on what kind of bacteria caused it. Symptoms include fever, headache, a stiff neck and trouble thinking.

“A parent should take their child to the doctor if they are demonstrating any of those symptoms and let the doctor know that they were in contact to meningitis,” Rankin said.

Rankin said that the last case of bacterial meningitis reported in OrangeCounty occurred sometime in mid 2000’s.

“In the United States, about 4,100 people a year become sick with some sort of bacterial meningitis, and that is across the whole United States. There are about 500 deaths per year.”

Several childhood vaccines prevent variations of bacterial meningitis.

The severity of the illness and the treatment for meningitis differ depending on the cause. That’s why it is important to target the specific cause of meningitis.


Spotting Heart Problems in High School Athletes

Photo Courtesy: Getty Images

CHAPEL HILL – As the summer draws to a close, high school student athletes are gearing up for competition once again. However, the recent tragic deaths of student athletes related to undetected cardiac conditions, including a high school football player in North Carolina last month, have prompted schools to focus on preventing these tragic events.

Scarlett Steinert, Coordinator of Healthful Living & Athletics for the Chapel Hill Carrboro City Schools, says the CHCCS have policies and procedures in place to help spot warning signs of cardiac problems before the student athlete can take to the field or court.

“At the high school level, we are really making sure we’re looking at those physicals. We are talking to kids about any problems that they may be having. Things that our athletic directors and coaches are really good at honing in on are things that add to different kinds of health issues like stress,” Steinert says, adding, “The most important thing I think that we have done here in Chapel Hill/Carrboro City Schools is that we have full time trainers in our high schools, and our trainers talk to our students and educate them about current issues.”

The system also follows guidelines set forth by the North Carolina High School Athletic Association. Steinart says a student has to undergo and pass one physical every year, with a physical form that is mandated statewide.

“Really what to look for is if there are any changes in the athlete. If you’ve never had headaches and you have a headache, it is important to seek medical attention, and also let mom or dad know that this is happening, or letting a trainer or letting your doctor know,” Steinart says.

Steinart also suggests that student athletes have a family physician who are familiar with their medical history.

Evan Raines, a sixteen-year-old junior defensive end from Fayetteville, collapsed on the football practice field on August 3 and later died. The Fayetteville Observer reported that Raines’ father said hospital officials told him his son died of cardiac arrest, though questions still surround his death.

Ronald Rouse, a teenager from South Carolina, died of cardiac arrhythmia suddenly during his homecoming football game last October. He was a week short of his 18th birthday.

Dr. Julie Monoco, Medical Director for the Orange County Health Department, says that incidents like this make it critical for children to have a sports physical, which is more thorough than just a well child check. She says all children who are physically active, not just high school student athletes, are encouraged to have a thorough physical annually.

During the physical, she says doctors will ask a series of questions to determine if the child has a pre-existing condition. Symptoms such as significant shortness of breath, dizziness and/or chest pain are immediate red flags of a heart condition and will often require further testing.

“We do specific screening questions for the patient to risk-stratify the patient’s cardiac-related issues,” Monoco says. “The main thing that we want to rule out is something called Idiopathic Hypertrophic Cardiomyopathy.”

Monoco explains that condition causes a thickening of the heart muscle wall.

“That affects about one in 500 adults. Most of the time it isn’t an issue and is usually more prevalent in males versus females. It tends to become more of a problem in athletes who play high intensity sports such as basketball and football,” Monaco says.



Who’s Enforcing Orange County’s Smoking Ban?

CHAPEL HILL- Orange County’s new ordinance banning smoking in public places comes with a $25 fine for violators, but officials say it’s more about empowerment than enforcement.

“We are not going to take an active role in enforcing that,” says Sergeant Bryan Walker, spokesman for the Chapel Hill Police Department. “That would all be down to the Orange County Department of Health.”

The smoking ban took full effect on July 1, following a six month educational campaign by the county health department.

The ban covers all outdoor locations owned by the towns or county, including sidewalks, bus stops and parks, as well as indoor locations that are open to the general public.

Stacy Shelp, communications manager with the Orange County Health Department, says the aim of the ban is to educate people about the dangers of second-hand smoke and to encourage smokers to quit.

She says the ban should make it easier for people to ask others to put out their cigarettes. 

“It is word-of-mouth, it is grassroots, it is empowering people to be able to say something, which is what this rule is really all about,” says Shelp. “It’s letting people know its OK to say, ‘I’m sorry, I don’t know if you know, but smoking is not allowed here any more.’”

The Town of Carrboro has posted no smoking signs, while Chapel Hill has installed signs reminding residents to breathe.

But nearly a month into the ban, many remain unaware of the new law, so the health department has organized a Smoking Response Team to target public areas that smokers frequent.

Shelp says the response team visited Franklin Street last week and plans to move into Carrboro by the end of this week.

“They just walk up and down and when they see people smoking they go up and say, ‘I’m not sure that you’re aware we have a smoke-free policy here in Orange County now.’ Just letting people know and asking them to put their cigarettes out. It was very effective. That group on Friday talked to more than 100 people.”

The team is made up of health department employees and volunteers. Shelp says the response so far has been positive.

“I went out and people were for the most part very friendly. We got a lot of people saying ‘I’m completely supportive of the rule,’ or ‘No, I didn’t know but I think it’s great.’”

The health department is expanding its educational campaign to include more signage as well as advertising on local buses, but ultimately, Shelp says enforcement of the ban will come down to concerned citizens.

“It’s all of our air and we should be free to breathe it free of second-hand smoke,” says Shelp. “It’s been exciting to hear how many people are appreciative and now feel much better about being able to say that to somebody that they see smoking around them.”

The health department offers an online complaint form where you can report smoking ban violations, as well as resources for those looking to kick the habit, including free nicotine replacement therapy.

You can learn more about Orange County’s public smoking ban here.


Orange County Recognized for Measles Prevention

HILLSBOROUGH – Your local Orange County health department has been recognized by the NC Division of Public Health/Communicable Disease Branch for “Best Practice in an Outbreak Response Associated with the Spring 2013 Measles Outbreak.”

Community health services supervisor at the Orange County health department, Judy Butler, says the county’s effective response was rooted in its quick action after cases were discovered.

“It’s not something that you can let lie on your desk for a couple of days and then start working on it,” Butler says.

During the spread, 25 quarantine and isolation orders were given by the county, and eight cases of measles infection were confirmed.

“This is the largest number of quarantine and isolation orders we’ve had to issue in quite some time,” Butler says. “One reason for that is that measles is highly infectious.”

All of the measles cases in this incident were traced back to exposure in Stokes County.



July 1 Brings Health Changes And Flooding

CHAPEL HILL - On the first of the month, Orange County faced two significant changes – more than five inches of water causing flood damage, along with the enforcement of the Smoke-Free Public Places Rule. WCHL’s Aaron Keck sat down with Dr. Colleen Bridger, the Director of the Orange County Health Department to discuss the Health Department’s role in both of the impacts of flooding and the smoking ban on Orange County residents.

After the devastating storm on Sunday, the Orange County Health Department sent two nurses to the Red Cross’ shelter that night.  Monday morning, the Health Department focused on restaurants and pools, restoring sanitation and safety, so they can re-open as quickly as possible.

“We have two primary roles,” says Bridger. “We provide nursing support to the Red Cross and the shelter. And then this morning the focus has been on the restaurants and pools that have been flooded. We have sent teams of restaurant inspectors to the areas that have been flooded to make sure the restaurant owners know how to clean up after a flood. Most of the pools have needed to be drained and refilled and start all over again.”

Monday, Orange County began enforcing the Smoke-Free Public Places Rule.

“It prohibits smoking indoors where the public is invited or allowed and outdoors in places that are either owned by Orange County or one of the municipalities that falls within Orange County,” says Bridger. “So for example, parks, sidewalks, bus stops, places like that.”

The Health Department is promoting this rule by posting signs inside and along the outside of about a dozen buses, on billboards, and in magazines. Bridger says mainly the Health Department is mainly focused on sharing ways and providing resources to quit smoking.

“We’re really trying to pair information about the fact that Orange County public places are smoke-free, but also, if you’re a smoker and you’d like to quit smoking, here are some resources for you to quit,” says Bridger.

Bridger hopes this rule will be practiced by the public, minimizing law enforcement. A citation costs a smoker $25, but she says the rule is mainly to encourage the public to quit smoking, not punishment.

“Essentially, we are hoping that this will be a grassroots enforcement process, where somebody next to somebody else smoking says, ‘Oh hey, did you hear that there’s a new rule. You’re not allowed to smoke here anymore,’” says Bridger. “We are really hoping to minimize any sort of law enforcement involvement in this process.”

She says the public showed a very positive response to the idea of the rule.

“We surveyed folks. We got 750 responses,” says Bridger. “Eighty-percent of those responses were, yes this is a good idea, please do it.”

Resources the Orange County Health Department provides include free nicotine replacement therapy for people involved in smoking cessation programs offered by the Health Department and the NC Quitline.

For any information on how to quit smoking, call the number for the Smoke-Free OC Hotline is (919)-245-2480.

To access the Orange County Health Department’s website, you can go to www.orangecountync.gov/health.


HYAA Baseball Attendees Possible Measles Exposure

CHAPEL HILL – The Orange County Health Department is reporting that people in attendance of two Hillsborough Youth Athletic Association baseball games last week may have been exposed to the measles.

The first game was on Friday, May 3, at 6:00 p.m. at the Cedar Grove Park—Field No. 2— in Cedar Grove, NC. The other game was at the Exchange Club Park in Hillsborough, NC on Saturday, May 4, at 4:30 p.m.

A person in attendance of those games “developed symptoms of measles” on Sunday, May 5. This would mean that they may have been contagious while at the games on Friday and Saturday.

Judy Butler, Community Health Services Supervisor for the OCHD, says it can be called a case of the measles. She says it’s still too early in the illness, though, to confirm the case through blood tests.

That’s brings the total number of known cases in Orange County to nine this year and 23 total in the state.

“The majority of the population would be protected by either already having had the illness or receiving the vaccine,” Butler said. “This was an outdoor, short-term setting so it would still be a low-risk exposure. Still we felt like we had to let people know.”

Measles is a viral illness that’s spread through respiratory droplets. Symptoms include fever, cough, runny nose, red eyes and a rash that begins on the head and moves down. Measles can be prevented by the combination MMR— the measles, mumps, and rubella— vaccine.

The earliest a child can be vaccinated is one year of age and then the second dose can be given 30 days later.

Butler says this person had been fully vaccinated and had no reason not to be in public. She’s says this was a rare case given the context.

“According to the Center For Disease Control, two doses of the vaccine given at the appropriate ages—which this person’s was— are greater than 99 percent effective.”

If you attended the games on May 3 or 4, the health department is warning to be alert for symptoms that could occur anytime between May 10 and May 25.

If you develop symptoms, Butler says to stay home and call your medical provider to be tested.

Before this outbreak, 2011 was the last time a measles case was reported in North Carolina and it was just one person.

“I haven’t dealt with measles in any form since 1988. This is a very unusual year for us,” Butler said.

Butler says this outbreak can be traced back to a case coming out of Stokes County in the western part of the state. She says all of the known cases in North Carolina are linked.

“There was someone who traveled to another country where they have measles,” she explained. “That person was not vaccinated. That person returned and then became ill will measles.”

WCHL will keep you updated on any new reports of measles cases in Orange County.