Commonwealth Conversations: Public Health

Violence: A Serious -- and Preventable -- Issue for Massachusetts

This is the newest post in the "Health of Massachusetts" series, a comprehensive new report from the Massachusetts Department of Public Health.

Chapter thirteen of the “Health of Massachusetts” explores violence in Massachusetts, including bullying, sexual assaults, intimate partner violence, and child and elder abuse.  Data and statistics around these issues can be difficult to capture; many assaults go unreported to medical personnel and police, even when a physical injury occurs.

Regardless of how we count assaults, deaths and injuries are only the tip of the iceberg in terms of how violence affects us. The hidden effects of assaults and threats can include psychological consequences that affect quality of life and physical health. Violence can also negatively impact society through financial and property damage costs, reduced worker productivity, and a sense of fear and dread that can contribute to sedentary lifestyles and social isolation.

The good news is that violence is preventable. The more we learn about factors that increase or reduce the likelihood of violence – known as risk and protective factors – the greater the probability of putting effective prevention strategies into place.

To learn more about how common the problem is, who is most affected, mental and physical health outcomes, and risks associated with violence, visit our website at www.mass.gov/dph/healthofmassachusetts.

El suicidio y las lesiones auto inferidas en Massachusetts

Posted by:
Jordan Coriza, Department of Public Health

Jordan is the Director of Ethnic Media Engagement for the Department.

Esta es la entrega más reciente de la serie de blogs que destacan capítulos importantes del informe Health of Massachusetts (La salud de Massachusetts), un reporte nuevo y amplio publicado por el Departamento de Salud Pública de Massachusetts (DPH).

El suicidio es un tema de salud pública importante y prevenible. Pese a que el término “suicidio” se refiere a aquellos actos en los que la persona deliberadamente se quita la vida, debemos reconocer el impacto de las lesiones auto inferidas no mortales, tales como los intentos de suicidio o los cortes o quemaduras intencionales.

El Programa de Prevención del Suicidio del DPH se empeña en reducir el número de suicidios e intentos de suicidio en Massachusetts. El programa echa mano de una serie de estrategias de prevención recomendadas por el National Suicide Prevention Plan (Plan Nacional de Prevención del Suicidio), dentro de las cuales podemos destacar el aumento de la concientización pública sobre el tema, reducir del estigma de aquéllos que buscan ayuda profesional, pruebas de detección para la depresión, capacitación y destrezas para los profesionales del ramo de la salud mental, abuso de sustancias y demás áreas de la salud, reunir información y capacitación para el público general, así como ofrecer servicios familiares y comunitarios posteriores a un suicidio.

El impacto de un suicidio es enorme. Los expertos estiman que por cada suicidio quedan seis seres queridos que se enfrentan al dolor de haber perdido a un familiar o amigo cercano. Junto a la tristeza que le sigue a cualquier muerte, la mayoría de los sobrevivientes sufre de culpa, es decir, el sentimiento de “tal vez pude haber hecho algo” para prevenir este suicidio.

Para obtener más información sobre el tema, diríjase a www.mass.gov/dph/healthofmassachusetts o el sitio web del Programa de Prevención del Suicidio.

Suicídio e ferimentos auto-infligidos em Massachusetts

Posted by:
Jordan Coriza, Department of Public Health

Jordan is the Director of Ethnic Media Engagement for the Department.

Esta é a entrega mais recente da série de blogs destacando diferentes capítulos do Health of Massachusetts (O Estado de Saúde de Massachusetts), um novo relatório completo do Departamento de Saúde Pública de Massachusetts (DPH).

O suicídio é um problema de saúde pública importante e evitável. Apesar do termo “suicídio” se referir aos atos em que a pessoa deliberadamente tira a própria vida, é importante reconhecer o impacto dos ferimentos auto-infligidos, tais como as tentativas de suicídio ou cortes e queimaduras intencionados.

O Programa de Prevenção do Suicídio do DPH está empenhado em reduzir o número de suicídios e tentativas de suicídio em Massachusetts. O programa emprega uma série de estratégias de prevenção recomendadas pelo National Suicide Prevention Plan (Plano Nacional de Prevenção de Suicídios), entre as quais podemos destacar o aumento da conscientização do público sobre este assunto, a redução do estigma de quem procura ajuda profissional, testes de rastreio de depressão, treinamentos para os profissionais do ramo da saúde mental, dependência de substancias químicas e outras áreas de saúde, treinamento de abertura para o público em geral, assim como oferecer serviços posteriores a uma ocorrência de suicídio para familiares e membros da comunidade.

O impacto de um suicídio é enorme. Os especialistas dão a seguinte estimativa: por cada suicídio, seis pessoas ficam para lidar com a dor da perda do seu ente querido. Além da tristeza associada a qualquer morte, a maioria dos sobreviventes se sente culpada, achando que poderia “ter feito alguma coisa” para evitar o acontecido.

Para obter mais informações sobre este assunto, confira www.mass.gov/dph/healthofmassachusetts ou DPH Suicide Prevention.

The Impact of Suicide and Self-Inflicted Injury in Massachusetts

This is the latest in a series of posts highlighting a chapter from the "Health of Massachusetts", a comprehensive new report from the Massachusetts Department of Public Health (MDPH).

Suicide is a significant, and preventable, public health issue. While the term “suicide” refers to completed suicides, it is also important that we recognize the impact of nonfatal self-inflicted injuries such as suicide attempts or intentionally cutting or burning oneself.

The MDPH Suicide Prevention Program works to reduce the number of suicides and suicide attempts in the Commonwealth. The program employs prevention strategies recommended by the National Suicide Prevention Plan, which include increasing public awareness of suicide as a public health problem, reducing the stigma of help-seeking, depression screening, skills training for mental health, substance abuse and healthcare professionals, gatekeeper training for the general public and services for families and communities after a suicide occurs.

The impact of suicide is enormous. Experts estimate, very conservatively, that for every suicide there are six loved ones left behind to experience the complicated grief that follows. Along with the sadness that attends any death, most of these survivors also suffer from guilt, feeling that they could have “done something” to prevent the suicide.

You can learn more on our website at www.mass.gov/dph/healthofmassachusetts or by visiting the MDPH Suicide Prevention page.

Baby-Friendly Breastfeeding?

Posted by:
Meghan Morse, Department of Public Health

Meghan is the new State Breastfeeding Coordinator for DPH.

It’s that time of the year again; World Breastfeeding Week! World Breastfeeding Week, observed August 1-7, serves to celebrate and raise awareness of breastfeeding. This year the theme is “Just 10 Steps!: The Baby- Friendly Way” in honor of the Baby- Friendly Hospital Initiative. This initiative, which includes the “Ten Steps to Successful Breastfeeding”, began 20 years ago at the recommendation of the World Health Organization. So, what is this Baby-Friendly initiative and how does it help mothers overcome barriers to breastfeeding that they may experience in the hospital and in the first days of motherhood?

The Ten Steps to Successful Breastfeeding are listed below, but experts say that even beginning with just one step in a birth hospital has shown improvement in breastfeeding success among new moms.

Here are the ten steps:

1. Have a written breastfeeding policy that is regularly shared with all health care staff.

2. Train all health care staff in skills necessary to this policy into action.

3. Inform all pregnant women about the benefits and management of breastfeeding.

4. Help mothers begin breastfeeding within one hour of birth.

5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.

6. Give newborn infants no food or drink other than breastmilk, unless medically indicated.

7. Practice “rooming in”- allow mothers and infants to remain together 24 hours a day.

8. Encourage breastfeeding on cue.

9. Give no pacifiers or artificial nipples to breastfeeding infants.

10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

Since the Ten Steps were introduced 20 years ago, breastfeeding rates have improved significantly. But, not all maternity facilities observe these steps. To all the Moms out there, did you experience any of these procedures in your birth hospital? Did it help? If your hospital was Baby-Friendly, would it have helped your breastfeeding relationship? If you could add an 11th step for successful breastfeeding in the hospital, what would it be? We would love to hear from you!

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Lessons from “The Other Side of Massachusetts”

Posted by: David Morales, Commissioner, Division of Health Care Finance and Policy

About a month ago I began provider site visits across Massachusetts as a way to better understand health care system delivery issues, local market dynamics, challenges, and opportunities to integrated care and provider leadership visioning in an evolving health care marketplace.

Last week I spent some time with several providers in Western Mass. and got an up-close view of their innovative responses to reimbursement challenges, evolving patient utilization trends, and integrated care planning. A few key lessons merit pointing out:

• First, these providers recognize that they are employers –- often the largest employers in the area –- and that they are uniquely positioned to “nudge” consumers’ health care decisions toward complete, integrated, and lower cost care. By partnering with other area employers, these hospitals and physician groups are beginning to develop "purchasing networks" that collaborate with insurers to create low-cost, local-care plans for their employees. Their goal is twofold: lower the annual cost of care and premiums and develop innovative health care benefit plans that better meet the specific needs of their employees.

• Second, Massachusetts is a dynamic state and every area is very different. Western Mass. is confronting its own set of challenges and operates in a distinct labor market from the eastern part of the state. Small businesses make up the majority of their business leadership and employment base and as such there are fewer dedicated human resource managers to handle their health benefits. Providers operate in challenging market areas (including competition from Connecticut and New York) and must plan for geographic realities that are different from eastern Mass. In particular, recruiting a highly-skilled workforce to isolated community hospitals can be difficult.

• Third, these providers are not working in isolation: hospitals, physician groups, employers, and health plans are at the table, collectively redesigning a health care system that is rapidly evolving. From access to primary care and "wrap-around" care, to smarter insurance benefits that reward quality and prevention, every stakeholder is thoughtfully engaged and planning for a health care delivery system that is moving toward better coordination of care and where more must be done with less dollars.

Because there is no one “right” solution for mitigating health care costs and system redesign in Massachusetts, we must be thoughtful, cautious, and pragmatic as we redesign our strong, yet complex, health care delivery system. Western Mass. offers some simple yet smart principles for us to consider as we continue to better plan for system integration: employers (of all sizes) must play a critical and active role, solutions must be tailored to the market realities of the geographic area, and candid and ongoing cooperation from all stakeholders is essential.