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An interactive lead case study by Susan Buchanan, MD, Linda Forst, MD, MPH, and Anne Evens, MS.

Welcome to Immu-News, the Immunization Initiatives listserv, a monthly resource for the community of participants in this project. For now, this is post-only listserv (in other words, you will get only one e-mail per month in your mailbox, instead of floods of daily discussions) but we hope to evolve into a more interactive form, something that will truly be of service to you as each of you searches for ways to improve your ability to record and access immunization data, to increase immunizations provided to your clients, and thus to improve the health of your community.

Our topic for this month is introduced by Dr. Jennie McLaurin, MCN’s Migrant Health Specialist and the Project Director for the Immunization Initiative. We include examples and a source for patient-held immunization records, and two articles on the topic. Please feel free to send responses, comments, thoughts, and ideas to the listserv administrator at kath@healthletter.com. If you send comments, we will follow up with your responses and ideas in the next listserv.

Immu-News is also pleased to feature Grounded in Practice, highlights from the real world clinics participating in Immunization Initiatives. We begin with San Benito Health Foundation in Hollister, CA. We invite you to send suggestions, stories, examples of things that have worked to improve immunization practices in your clinic. Send your ideas to kath@healthletter.com

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Our June topic is IIS or Immunzaion Registries. Between August and October of 2008, immunization initiative staff at MCN conducted structured interviews with all State Immunization Coordinators or their designated contact persons in an effort to identify state programs that address the immunization needs. In response to the question “does your state have an electronic immunization registry?” we found that 42 states have registries, six states are in the process of implementing them, and two states do not have registries. Out of 42 states with registries, 37 are in both public and private settings and 31 are “birth to death” registries, including both children and adults. To view report, go to: http://www.migrantclinician.org/toolsource/resource/interviews-state-programs-addressing-immunization-needs.html

We offer three articles that discuss the progress of using immunization registries to improve recording and access of immunization data. Click on the links below to access the full articles.

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Our May topic is “What Do Migrants from Mexico, Central and South America Think About Immunization?” MCN has conducted several focus groups in recent years on this topic, and we share with you, in two papers, what we learned in these focus groups.

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California Department of Public Health offers numerous bilingual educational materials regarding childhood lead poisoning prevention.

The Occupational Lead Poisoning Prevention Program (OLPPP) is a program in the California Department of Public Health that helps employers, workers, and others prevent lead poisoning in workers.

U.S. Department of Housing and Urban Development lead information

Lead information from National Institute of Environmental Health Sciences

Lead is a toxic metal that was used for many years in products found in and around our homes. Lead also can be emitted into the air from motor vehicles and industrial sources, and lead can enter drinking water from plumbing materials. Lead may cause a range of health effects, from behavioral problems and learning disabilities, to seizures and death. Children six years old and under are most at risk.

To access information on a specific state or local area, click on the map or scroll down and pick the state or local name from the list provided.

Approximately 250,000 U.S. children aged 1-5 years have blood lead levels greater than 10 micrograms of lead per deciliter of blood, the level at which CDC recommends public health actions be initiated. Lead poisoning can affect nearly every system in the body. Because lead poisoning often occurs with no obvious symptoms, it frequently goes unrecognized. CDC’s Childhood Lead Poisoning Prevention Program is committed to the Healthy People goal of eliminating elevated blood lead levels in children by 2010.

Migrant Health Promotions (MHP) and MCN have jointly sponsored a series of webcasts on promotora programs in migrant health. This link takes you to a list of these webcasts which are archived and can be viewed at a convenient time for you.

The Immunization Initiative at MCN promotes improving childhood, adolescent, and adult immunization coverage levels among migrant and other mobile underserved populations. During the course of the initiative, anecdotal and documented evidence of an increase in the Hispanic indigenous population in United States and outside California surfaced from various sources. A separate initiative emerged, to design and develop a piece of educational material specifically for this population. This article, published in Streamline (March-April, 2009) discusses this initiative.

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Mexican-made “lead-free” bean pots contain high levels of toxic metal.

A resource from SAGE in English and Spanish. A reminder to cover your mouth when you cough or sneeze to prevent sickness from spreading. Prints legal size.

Sage Words developed a pandemic flu brochure specifically for a small clinic on the Navajo Reservation. Though the illustrations are targeted towards this population, it is available in English and Spanish, and the information is general. It includes preventative measures, and is for low-literacy users. It’s designed to be easily photocopied or printed from computers and is available to anyone who might find it appropriate to use.

This resource helps you address stigmatization by providing best practices for inhibiting and the actions to take when you encounter stigmatization when new infectious diseases and illness emerge.

Early in an outbreak, such as the 2009 H1N1 outbreak, groups of people, places, and animals can be singled out and will be at risk of being stigmatized by association with the threat this virus poses. Groups are stigmatized by an infectious disease when the risk of infection to others is not present or remote but the association of the risk is magnified by others for that population group, or place or animal.

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FIOB has a good presentation that they use to teach the general community about indigenous cultures. This PowerPoint could be used to teach staff about indigenous languages.

This organization, based in Woodburn, Oregon, has 3 community outreach workers and a receptionist in their office who speaks indigenous languages (Mixteco Alto and Mixteco Bajo). 

 

They utilize the following strategies to communicate with clients who speak indigenous languages:

1        Audio Materials: The Oregon Law Center puts important information and scenarios on tapes and CDs in indigenous languages for their clients

2        Radio: The employees at the Oregon Law Center who speak indigenous languages create radio ads for local Spanish language stations in indigenous languages.  They also participate on 2-3 radio shows per month. 

3        Presentations: They also do around 5 community presentations per month for workers (some of which are done in indigenous languages). 

4        Identifying and training interpreters for indigenous languages: They collaborate with the Oregon Judicial Department to provide training to become court interpreters for people who speak both an indigenous language and Spanish. 

 

Contact Information:

230 W. Hayes St.

Woodburn, OR 97071

Julie Samples juliesamps@yahoo.com

(503) 981-0336

1-800-973-9003

The recommendations provided in this report include specific action steps and new activities that will require additional funding and a renewed commitment by government and nongovernment organizations involved in domestic and international TB control efforts to be implemented effectively. The Federal TB Task Force will coordinate activities of various federal agencies and partner with state and local health departments, nonprofit and TB advocacy organizations in implementing this plan to control and prevent XDR TB in the United States and to contribute to global efforts in the fight against this emerging public health crisis.

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Oral health is one of HRSA's Special Projects of National Significance (SPNS). The SPNS Innovations in Oral Health Care Initiative funds 15 demonstration sites for up to five years to support organizations using innovative models of care to provide oral health care to HIV-positive, underserved populations in both urban and non-urban settings.

Medicaid is a significant source of financing for oral health services, particularly for children and adolescents. Almost universally, however, Medicaid programs identify access to dental care as a significant and persistent problem for persons with Medicaid.  Oral health status and access to dental services are issues for all populations served by Medicaid.  This document from HRSA discusses some of the most critical issues in improving oral health access through Medicaid.  

The National Network for Oral Health Access (NNOHA) is a nationwide network of dental providers who care for patients in Migrant, Homeless, and Community Health Centers. These providers understand that oral disease can affect a person's speech, appearance, health, and quality of life and that inadequate access to oral health services is a significant problem for low-income individuals.

Describes the adverse health effects of lead in workers with blood-lead levels of 5-10 ug/dL and recommend changing OSHA’s medical removal trigger of 60 ug/dL. 

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Founded by singer/songwriter Paul Simon and pediatrician/child advocate Irwin Redlener, MD in 1987, The Children's Health Fund (CHF) works nationally to develop health care programs for the nation's most medically underserved population - homeless and disadvantaged children. CHF brings medical care and essential services directly to underserved children in rural and urban communities via Mobile Medical clinics (doctor's offices on wheels) and fixed site clinics. Moreover, CHF has become a major national advocacy voice on behalf of all children, and has inspired special federal legislation designed to help create innovative Children's Health Projects throughout the United States. The Children's Health Fund's website contains a lot of useful information, which would undoubtedly benefit your audience. 

To provide easily accessible immunizations, reduce patient waiting time, and assure quality of service in provision of immunizations.

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Physician outreach efforts regarding West Nile Virus diagnosis. We have created a webinar that medical professionals can access for free. CME credits are part of the activity, which makes it even better. The webinar features Lyle Petersen, head of CDC’s vector-borne disease unit, along with Anne Kemptrup, from California Dept. of Public Health and Susan Little, executive director of the DEET Education Program. The program runs for one hour.

The AgriSafe Network Distance Learning Webinars aims to provide appropriate and timely training opportunities for Network members and affiliates. Through partnering with the National Rural Health Association and the Great Plains Center for Agricultural Health, the Network has been able to offer a series of fantastic speakers using the web-based Elluminate program.