Volume 9 Issue 3

Inside This Issue:

Community Health Assessment
The Immunization Van
Test Palm Beach County
Shopping Matters
Oh no, Mosquitoes!
and more
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The Pulse

From the Director

We continue to work toward improving the health of all residents
and visitors to our great county. Whether it is access to care,
reviewing initiatives or educating on preventive measures, your
Health Department is proud to be your champion.
Recently, in the interest of providing long term sustainable
primary care for adults and children, the Health Care District
of Palm Beach County Board of Commissioners unanimously
approved transitioning these services at the Health Centers
under their management. In addition, the Palm Beach County
Board of County Commissioners has agreed with the transition.
The Health Department will remain in the centers providing
Public Health Services like immunizations, maternity, WIC,
family planning and HIV/AIDS. Much work continues to be
done including application for Health Resources and Services
Administration (HRSA) funding and Federally Qualified Health
Center designation to the Health Care District. At this time there
is no set timetable for completion, as each phase of the transition
is meticulously reviewed, written and approved.
The Florida Department of Health in conjunction with its
County Health Departments has launched its revised System for
Tuberculosis Care. This new approach assures all persons with TB
are able to receive treatment and through heightened surveillance
the number of cases throughout the State will continue to be
reduced. Palm Beach County Health Department will continue
to be a leader in this new system of TB care.
The Community and School Health Division recently completed
the Community Health Assessment in conjunction with the
Health Council of Southeast Florida and numerous other county
wide partners. This Assessment will be used to identify unmet
health care and human service needs and bring together partners
to create interventions that will benefit the residents of Palm
Beach County. I am proud to say that the Health Department
is taking the lead in this initiative and I am optimistic that it will
make Palm Beach County an even better place to live.
Another initiative we have undertaken is the elimination of HIV/
AIDS in the county. Our TEST PALM BEACH COUNTY
campaign has brought all of the organizations charged with
identifying and assisting people with HIV/AIDS together with
one common goal of eliminating the disease in this generation.
Exciting news was the endorsement by the Palm Beach County
Medical Society to have all physicians, and medical providers in
the county ask one simple question; Have you been tested for
HIV? This simple encouragement will help in early diagnosis,
get people into care and in time reduce the spread. For years
contracting HIV was considered a death sentence. Today, the
only sentence being issued is the death of the virus itself.

With school approaching

its a good time to remind
all that vaccines have
proven to be very effective
in eliminating many
childhood diseases like
Measles, Mumps, Rubella,
Chickenpox, Tetanus,
Pertussis (Whooping
Cough), and even polio.
All school aged children
should have their shots up to date and be ready for a happy and
healthy school year.

Alina Alonso, M.D.

Director
Palm Beach County Health Department
Champions for the Healthiest Community in the Nation.

inside this issue....

From The Director..................................................................2
Community Health Assessment.............................................3
New Child Care Facility Rule for Safety.................................3
The Immunization Van Out On the Streets.............................4
Test Palm Beach County Kick-off ..........................................5
World Hepatitis Day Event......................................................6
Mosquitoes.............................................................................6
Shopping Matters...................................................................7
Always Ready.........................................................................7

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Volume 9 Issue 3

Palm Beach County Community

Health Assessment
In 2012, the Palm Beach County Health Department engaged the Health Council of Southeast Florida to facilitate
a process to develop a comprehensive, county-wide Community Health Assessment (CHA). This assessment is
a result of the effort, participation, and contributions of a cross section of health and human service organizations,
community leaders and stakeholders that came together around the commitment to improve services for the
betterment of the community.
This community health assessment gives us the opportunity to:

Assess the populations health status

Highlight areas of unmet need

Present the communitys perspectives

Provide suggestions for possible interventions

Highlight recommendations that policymakers might consider when setting new policy goals and objectives for health improvement
activities
The report includes secondary data from national, state and local sources. It also includes primary data that encompasses the communitys
perspective. Based on analysis of the CHA, a community team will develop and implement a Community Health Improvement Plan. Key
findings include:

One quarter of the residents in Palm Beach county are 62 years or older

Just over 14% of the population in the county is at or below the poverty level

73.3% of births are to mothers who have received prenatal care in the first trimester

The rate of repeat births to mothers in the 15-17 age groups was slightly higher in Palm Beach (10.9%) than in Florida (9.0%)

Low birth weight in the county is at 8.9 , compared to Floridas 8.7%, and the Healthy People 2020 target of 7.8%

Infant mortality is lower in White individuals (4.7 per 1,000) than in Black or other races (7.2 per 1,000)

61.3% of adults in the county are overweight or obese

Heart disease is the leading cause of death in the county (26.4%) followed by cancer (24.1%)

Lung cancer caused more than 25% of the deaths due to cancer in 2010
The complete 2012 Palm Beach County Community Health Assessment can be accessed on the Palm Beach County Health Departments
website at www.pbchd.com

Rule Revision: Licensed Child Care Facilities

The Palm Beach County Board of County
Commissioners (sitting as the Child Care
Facilities Board) in August 2011 approved
a new requirement for child safety alarm
devices in vehicles used by child care
centers that carry 6 or more passengers.
This rule is the first of its kind in Florida
for protecting the children of Palm Beach
County.

The new rule states:

On or after September 1, 2012, all vehicles

used by or on behalf of the child care facility
for the transportation of children and that
are designed to transport six (6) or more
passengers must be equipped with a child
safety alarm device that prompts the driver
to inspect the vehicle for children upon
vehicle shut off. The device must be properly

maintained in working order at all times to

ensure the safety of children. The safety
alarm must also be used in conjunction with
other requirements described in Palm Beach
County Rules and Regulations Governing
Child Care Facilities which states: The driver
or the staff member who conducts the walk
through inspection as required must sign the
transportation log to verify that all children
have exited the vehicle.
The alarms add an additional layer of
protection to ensure that no child is left
unattended on the way to or from a child
care facility. Following the rules requiring
constant adult supervision coupled with the
proper use of alarms can prevent needless
tragedy, said Health Department Director
Alina Alonso, M.D.

Licensed providers were eligible for

reimbursement of $150 towards the cost
of the safety alarms through the Childrens
Services Council of Palm Beach County.
To date, over 100 facilities have taken
advantage of the program.
In addition, when transporting children,
staff to child ratios must be maintained at
all times. The driver may be included in the
staff to child ratio, however, when infants are
being transported, there must be at least
one other staff member in the vehicle who
can see and hear all the children. At no time
shall the driver alone transport infants or
children under 5 years of age.
The complete rules and regulations can be
reviewed online at http://www.pbchd.com/
env/child_care/child_care_facilities.html

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The Pulse

ON THE ROAD SAVING LIVES

theyre thinking about than actually experiencing any kind
of discomfort when they actually get the shots.
Information about vaccines and school requirements
are posted online at www.PBCHD.com and click on
Immunizations.
The
Immunization Van
makes three to five stops each
week year round, making sure children in Palm Beach
County have easy access to protection from illnesses
like Chickenpox, Diphtheria, Mumps, Measles, Rubella,
Whooping Cough and others. PBCHD Community
Health Nursing Consultant Debbie Hogan, R.N., says
the van program was created in 1995 with a donation
from the Kiwanis Club. Since then, the van travels all
over Palm Beach County so uninsured kids can receive
these life-saving preventive shots. Vaccines actually
prevent diseases that have either caused death or severe
disability in children, Hogan said, Now kids can avoid
contracting up to 14 different diseases they never have
to experience the risks of those illnesses and can stay
healthy.

With the start of the school year, the Immunization Van

and our Health Centers are very busy helping parents of
students meet immunization requirements.
Palm Beach County Health Department Health Centers
offer vaccination services. School physicals and wellness
exams are also available for a flat rate of $35.00.
The 2012-2013 school year now requires Eleventh grade
students to have proof of a Varicella (Chickenpox) vaccine.
Seventh, Eighth, Ninth and Tenth graders will need proof
of a Tetanus/Diphtheria/Pertussis (Tdap) Booster and all
students should have received other vaccines like Mumps,
Measles, Rubella, Hepatitis B, Polio and their form 680 on
file as proof of receipt.
There is no charge for immunizations for children who meet
qualifications through 18 years old. Information can be
obtained by calling 561-840-4568 or 1-800-810-1225

The busiest time for the van is August when the back
to school rush is on. Thats when waiting until the last
minute can mean longer waits for parents and children.
PBCHD Senior Community Health Nurse Sherry Phillips
says procrastination is just human nature and every year
lots of families wait until the week before school starts to
get the required immunizations. People dont realize if
theyre pressed for time and wait until the last minute and
everybody else has waited until the last minute too, then
it takes more time to get the job done because youre
waiting in very long lines. Phillips adds the delays are
unnecessary if people plan ahead, and take advantage
of the slower times of the year. If you wait until August,
youre waiting for many hours, when you could have
come in February or March and it would be over with.
But is the discomfort of getting vaccinated harder on kids
or the parents who watch?
Phillips says the mind often seems to make it worse than
the reality, Once kids get the first vaccine they say, Are
you done? Is that it? Is that all there is? Then they realize
its not that big of a deal. Its more in their mind what

Monique Martin watches as her son Rodney receives vaccinations aboard the Immunization Van.

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Volume 9 Issue 3

TEST PALM BEACH COUNTY

CAMPAIGN UNDERWAY!
Together we can end the spread of HIV in our
lifetime, said Alina Alonso, M.D., at a recent
information session at the Palm Beach County
Medical Society, asking
all clinicians to encourage
patients to be tested for the
HIV virus.
In Palm Beach County
close to 8,000 people
are living with HIV/AIDS
because of treatment
and early diagnosis.
However, with the number of new cases each
year it is estimated that another 800 people are
carrying the virus yet they are totally unaware. With
a greater number of clinicians asking the simple
question Have you had an HIV test? - the number
of unaware cases can be greatly reduced. Today,
being infected is no longer a death sentence
because with counseling and treatment an individual
can live a long healthy life, and at the same time
eliminate the spread of the disease.
According to panelist and physician Maureen
Whelihan, M.D.,Doctors need to be open to discuss
any and all STDs with their patients. I have yet
to talk with a member of the Palm Beach County
Medical Society who hasnt encountered one of
these diseases in their practice. Dr. Whelihan
added that with more testing and advice available
the management of the disease will be better served.

years. Jose Menajovsky, M.D., an

infectious disease physician with
an emphasis on HIV Management
said, I treat about 1,000 HIV
patients each year in my practice.
We need to eradicate the stigma
attached to people with HIV and treat
their disease like any other chronic disease. Dr.
Menajovsky cited the example of two other chronic
diseases like hypertension and diabetes. Neither
can be cured, but with early detection and treatment
these can be managed. People openly discuss
other chronic diseases and the
same should be true of HIV, said
Dr. Menajovsky.
Dr. Alonso added, A good way for
a physician to ask about testing is
to create a rapport with the patient
and not be judgmental. Dr. Alonso
added, We want everyone, not just
clinicians, to be able to discuss this
disease as openly as any other and
help get those who need it into managed care.
Co-infections should also be considered according
to Dr. Whelihan. Im seeing many over the age
65 who have become more sexually active. I get
a few giggles when talking with this age group but,
its important for them to know that they need to
be aware of other diseases like HPV, Chlamydia,
Gonorrhea and HIV.
Test Palm Beach County is the latest effort to remind
all to include an HIV test the next time they have a
physical or other medical exam.

The State of Florida leads the country in testing

for HIV and it is the goal of the state to reduce the
number of undiagnosed to 10% in the next two
(L to R) Rob Scott, Dr. Maureen Whelihan, Dr. Alina Alonso, Dr. Jose Menajovsky & Metris Batts.
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The Pulse

BABY BOOMERS AT RISK

World Hepatitis Day
is marked to increase
the awareness and
understanding of
viral Hepatitis and
the diseases that it
causes. It provides an
opportunity to focus
on specific actions
such as: Strengthening
prevention; screening;
and control of viral
Hepatitis and its related
diseases.

Hepatitis viruses A, B and C can cause acute and chronic infection

and inflammation of the liver leading to cirrhosis and liver cancer.
These viruses constitute a major global health risk with around 240
million people being chronically infected with Hepatitis B and around
150 million people being chronically infected with Hepatitis C.
The Centers for Disease Control and Prevention reported that the
Hepatitis C virus (HCV) now kills more Americans annually than HIV,
the virus that causes AIDS. Most of the deaths occur in middle age
adults. About 3% of these baby boomers (age 45-65) are infected. And
about half of the people do not know they have the virus.
Despite its
staggering toll on
health, Hepatitis
remains a group of
diseases that are
largely unknown,
undiagnosed and
untreated. This
years theme is Its
closer than you
think.

Daniel Anaya gets screened for Hepatitis exposure by Health

Department staff at the World Hepatitis Day event.

To commemorate
World Hepatitis Day, the Palm Beach County Health Department
held an event in July with Hepatitis testing, education and vaccines
for Hepatitis B at the Northeast Health Center. Numerous residents
attended to learn about the different forms of Hepatitis, how it is
transmitted, who is at risk and the various methods of prevention and
treatment. STD and HIV screenings were also offered. 19 vaccines
were given to individuals at high risk for liver failure.

Health Department Director Alina Alonso, M.D., says, Hepatitis

infection symptoms can present many years after exposure. Thats
why its so important to get screened and begin a treatment program to
prevent serious and permanent liver damage.

For more
information visit the
Palm Beach County Health Department online at www.pbchd.com

The Palm Beach County Health Department is advising residents

and visitors to remain diligent in mosquito prevention after a horse in
Wellington was confirmed in June to have Eastern Equine Encephalitis
Virus (EEEV) and one sentinel chicken tested positive in August for the
presence of St. Louis Encephalitis Virus (SLEV). Earlier this summer,
Palm Beach County Mosquito Control reported Culiseta melanura
mosquitoes were caught in traps monitored to determine mosquito
counts and species. It is this mosquito that carries the EEEV and not
generally found in South Florida.

Dr. Mary Echols, a veterinarian who oversees arbovirus activities for

the Health Department said, Normally we see EEE in horses that
have traveled out of the area and were infected prior to returning to
our county. However, this case was in an unvaccinated horse that had
not traveled out of the county, so this is the first locally acquired case
of this EEE virus this year. Echols continued, The sentinel chicken
program was first established in 1978 throughout Florida. This early
warning system is vital to help make the public aware of the presence
of mosquito-borne illnesses and the importance of mosquito-borne
disease prevention. The last positive result for the presence of St.
Louis Encephalitis in Palm Beach County was in 2001.

The rainy season can signal an increase in mosquito populations.

Residents and visitors need to take precautions to prevent mosquito
bites and eliminate mosquito friendly breeding places around their
homes by remembering to Drain and Cover, said Health Department
Director Alina Alonso, M.D.

Drain any standing water around your home as even the
smallest container can be a breeding ground for mosquitoes.

Check doors and window screens and repair any holes or tears.

Cover yourself with light weight clothing that has long sleeves,
wear long pants and socks and use an insect repellent following

the manufacturers recommendation.

Eastern Equine Encephalitis and St. Louis Encephalitis are rare

diseases in Palm Beach County that is carried from infected birds and
spread by mosquitoes.
The Department of Agriculture is advising horse owners to have their
animals vaccinations and boosters up to date. EEE and West Nile
infection are preventable in horses that are vaccinated. There is no
EEEV or SLEV vaccine for humans. For further information log on to
the links below:
www.pbchd.com
www.cdc.gov www.freshfromflorida.com/ai/

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Volume 9 Issue 3

PBCHD NUTRITIONISTS HELP SHOPPERS

ALL OVER THE COUNTY
The Comprehensive Nutrition Program recently sponsored Shopping
Matters for Adults grocery store tours during the month of March.
Shopping Matters is a program supported by the national nonprofit
Share Our Strength. Share Our Strength invests in community
organizations to help end childhood hunger. The Palm Beach County
Health Department was awarded a mini grant to run the grocery
shopping tours to teach low-income adults how to get the most
nutrition for their food dollars. With the support of the Governors
Council for Community Health Partnerships, clients who participated
in the tours received a reusable grocery bag, a calculator to figure
out the unit pricing of fruits and vegetables along with handouts and
recipes. Clients were
also rewarded with a gift
card to purchase healthy
foods. Shopping bags
were filled with fresh
fruits and vegetables
with the help of Palm
Beach County Health
Department Volunteer
Health Services.
Shopping Matters teaches adults how to buy fruits and vegetables
on a budget, compare unit prices, read food labels and identify whole
grain foods. The hands-on grocery store tour was a lot of fun for
the clients as well as the registered and licensed dietitians that led
the tours. Delray Beach Health Center held the first tour and it was a
memorable experience. Liliane Laurent hosted the multi-cultural tour
at the Monterrey Supermarket in both English and Creole. Laurent
said, The grocery store tour brought the clients from being strangers
to becoming friends. Nutritionist Shana Bayder led a tour at Publix
that focused on fresh, frozen and canned fruits and vegetables, as well
as whole grains, beans and low-fat dairy. The store manager helped
teach the lesson on unit pricing. One client commented how smart
shopping is healthy and can save money, The Shopping Matters
booklet is helpful. It showed me what fruits and veggies are cheaper
because they are in season.

Nutritionist Marie Allsopp and therapist Michael Amberg hosted a

Shopping Matters tour in Riviera Beach. The participants were eight
clinic clients from their On the Weigh to a Better You weight loss
support group. One client said that she learned really how much
sodium is in prepackaged food and another client said that he learned
that buying domestic was important. The $10 Challenge was a
success as many of the clients used their gift cards to purchase fresh
fruits and vegetables on sale at the conclusion of the tour. Allsopp
noted, The tour lasted about two hours and was an excellent way for
the clients to put into practice the lessons learned from the ongoing
weight loss support group.
Nutritionist Donna Ward in Belle Glade had a youth group of Haitian
American teenagers who went on the tour at Winn Dixie. The girls
learned about unit pricing to stretch food dollars and how to select
healthier options by reading the food labels. Ward said, We had fun
trying to convince one participant to try a whole grain cereal instead of
the one she liked that has sugar as the first ingredient! Nutritionist Flor
Doylet in Lantana was able to take the Hispanic prenatal clients from
Healthy Mothers Healthy Babies Centering Program on the Shopping
Matters tour in Spanish. Nutritionist Lorna Dubinsky led the last tour at
Walmart in West Palm Beach. Participants had lots of questions and
were pulling products off the
shelves to ask questions about
the labels. Participants shared
cooking tips -- one shared how
she cooks frozen sliced okra
which costs 88 cents. At the
end of the tour Dubinsky said,
Everyone hugged each other
and the clients asked when will
we be going to the grocery store
again!
Clients will now look at grocery store products with a keener eye for
healthy and economical choices!

ALWAYS READY
In June, the Palm Beach County Health Department Office of Public Health Preparedness
participated in the St. Lucie Nuclear Power Plant exercise at John Prince Park in Lake
Worth. The exercise was designed to simulate response in the event an incident at the
nuclear power plant on Hutchinson Island. The Federal Emergency Management Agency
(FEMA) evaluated drill involved multiple first responder agencies, such as PBC Fire Rescue
and Hazmat teams, PBC Sheriffs Office, PBC Division of
Emergency Management, Health Care District of PBC, and
many other emergency response teams. Health Department
staff was responsible for aiding with the dispensing and
patient counseling for mock medication (actually Lifesaver
candies) given to the actor evacuees that participated in
the event. Environmental Health Strike Team staff aided with
vehicle monitoring. Exercises like this one are rehearsals for
real life emergencies that may occur.

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Services Provided

The Palm Beach County Health Department is a

service organization responsible for the health of
over a million residents in Palm Beach County.
The many and varied core programs include disease
prevention and control, environmental public health,
school health and health education. In addition, the
department shares responsibility for primary care of
the medically indigent population of the county with the
private sector by providing millions of services annually
through its seven health centers.
The Palm Beach County Health Department has served as
the model agency for the State of Florida and many other
states throughout the country. For over 60 years it has led
the way with innovative programs that include:

v Immunizations for children

v Parental education in child care from pregnancy
to birth and beyond
v Monitoring the land, air and water
v Monitoring and testing for potential epidemics

The future holds many unknowns, but your Health Department

will be there to serve your health needs.

HEALTH ACCESS DIVISION----------------------------------- (561) 671-4036

EPIDEMIOLOGY & COMMUNICABLE DISEASE------ (561) 671-4184
ENVIRONMENTAL PUBLIC HEALTH-----------------------------(561) 837-5900
COMMUNITY & SCHOOL HEALTH---------------------- (561) 671-4161
MATERNAL CHILD HEALTH----------------------------- (561) 671-4140
STD/TB---------------------------------------------------------- (561) 803-7362
IMMUNIZATIONS------------------------------------------- (561) 840-4568
NUTRITION SERVICES--------------------------------- (561) 671-4089
OFFICE OF EMERGENCY PREPAREDNESS
------------------------------------------------------------------ (561) 671-4014
PREVENTIVE MEDICINE/PUBLIC HEALTH
RESIDENCY PROGRAM-----------------------------(561) 837-5165
DENTAL PUBLIC HEALTH----------------------- (561) 837-5560
VITAL STATISTICS-------------------------------(561) 837-5841
WIC------------------------------------------ (561) 357-6007

APPOINTMENT LINE

1-855-GET-APPT (438-2778)
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