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Archived Messages

Messages from State Health Officer Dr. Thomas M. Miller

Taking Small Steps for Big Changes

The American Public Health Association celebrates the first full week in April as National Public Health Week each year. For this year, the association has recommended walking as a perfect way to celebrate. Not only is walking fun and free, it is healthy and promotes physical activity for people of all ages.

Walking is a great means of gaining health benefits. Walking requires no special skills, nor does it require a health club membership or expensive equipment.

Starting a walking program takes initiative, and staying with it takes commitment. If you are just starting a walking program, walk at a comfortable pace and work on gradually increasing your pace and distance. After you have eased into a daily walk routine, step it up to a higher intensity workout.

You may want to track your progress by keeping a record of how many steps you take, the distance you walk, and the length of time it takes to walk that distance. Records can help you compare where you started with how your status has improved. Record these numbers in a walking journal or log them in a spreadsheet or a physical activity app. You may also want to use a device such as a pedometer or a wearable fitness tracker to calculate steps and distance. This can serve as a source of inspiration.

Make walking pleasurable. These are some suggestions:

  • Walk with family, friends, or neighbors.
  • Walk alone, if that is your preference.
  • Walk to music.
  • Take several different routes in safe, well-lighted locations.

Tips for the workplace:

  • Take a brisk walk for 10 minutes before eating lunch.
  • Walk instead of driving to lunch.
  • Replace coffee breaks with walking breaks.
  • Hold a "walking meeting" with a colleague to discuss business.

Combine walking with shopping:

  • Park at least 10 spaces from the store entrance.
  • Take a lap around the mall or shopping center each time you go there.
  • Meet friends for a walking club session or an evening stroll.

Most significantly, make walking a habit. Once you take that first step, you are on the way to an important destination — better health. Small steps do result in big changes.

Thomas M. Miller, M.D.
State Health Officer

(April 2017)

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Social Workers Are Key Members of the Public Health Team

During March, National Social Work Month, the Alabama Department of Public Health celebrates the crucial role public health social workers play in our mission to protect health and improve lives. Anyone may need the expertise of a skilled social worker at some time in his or her life.  We salute our department’s approximately 200 social workers who are so important to our community and state.

Public health social workers focus on identifying children, families, the elderly and physically and intellectually disabled adults who have needs. Social workers provide intervention services to help clients discover ways of meeting their needs and preventing future problems. They serve as members of a multidisciplinary team of professionals who are skilled in using social work values, knowledge, and community resources to promote positive health outcomes, while respecting personal choice and promoting the health and well-being of individuals, groups, and communities in Alabama. Public health social workers act as liaisons that educate and advocate for changes to improve poor outcomes related to social determinants of health.

Three levels of prevention are central to public health social work practice:

  • Preventing disease and adverse conditions (physical, emotional, behavioral) from ever occurring by promoting healthy behaviors, prevention activities, and protective measures.
  • Promoting early diagnosis and treatment to minimize the effects of illness.
  • Working to rehabilitate or restore clients to improved functioning after the onset of a disease or condition.

Social workers provide direct service to a multitude of Alabamians in a variety of public health settings and programs, including the following:

  • Adolescent Abstinence Education
  • Alabama Personal Responsibility Education Program (APREP)
  • Diabetes Self-education
  • Children’s Health Insurance Program (ALL Kids)
  • Early Head Start
  • HIV Care Coordination
  • Home Health
  • Licensure and Certification
  • Maternity Care Coordination
  • Metabolic Care Coordination
  • Newborn Hearing Screenings
  • Patient First
  • Plan First
  • Prenatal Education
  • Sexually Transmitted Diseases
  • Suicide Prevention
  • Telehealth
  • Tuberculosis Control
  • Wisewoman

In addition, public health social workers deploy to help people overcome natural disasters such as hurricanes. We salute those valued members of our public health team who inspire individuals and families to make a positive difference by providing essential support and encouragement to the people of Alabama.

Thomas M. Miller, M.D.
State Health Officer

(March 2017)

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Pregnant Women: Avoid Drug Use

Substance abuse or misuse during pregnancy has many serious consequences. During pregnancy, everything an expectant mother consumes has an effect on her growing fetus. That is why it is so important that women who want to have a healthy baby avoid using drugs.

Illegal drugs such as marijuana, cocaine, heroin, and methamphetamines are not the only substances that are harmful to fetal development. Using tobacco, alcohol, and non-prescribed drugs increases the chances of birth defects, premature babies, underweight babies, and stillborn births.

Smoking during pregnancy is a risk factor for poor birth outcomes. Statistics indicate that pregnant mothers who smoke risk major pregnancy complications and babies of mothers who smoke while pregnant are three times more likely to die from sudden unexplained infant deaths than infants of nonsmoking mothers.1

Being around smoke is also harmful for infants and children. According to the Centers for Disease Control and Prevention, among the many health problems associated with secondhand smoke are more frequent and severe asthma attacks, respiratory infections, and ear infections in children. In 2015, 10.4 percent of all live births in Alabama were to mothers who smoked during pregnancy.2

There is no safe level of alcohol consumption during pregnancy, because drinking alcohol can harm a baby’s developing brain and other organs. Alcohol use by the mother is the leading cause of mental retardation and developmental delays in children. While most mothers may realize that drinking during pregnancy can have detrimental effects on their babies, 6.9 percent of adult mothers in Alabama admit to drinking alcohol while pregnant.3

Illicit drug use during pregnancy can cause long-term health problems for both mother and child. The number of delivering mothers using or dependent on opiates rose nearly five-fold from 2000 to 2012, when an estimated 21,732 infants were born with Neonatal Abstinence Syndrome (NAS) in the U.S.4

NAS is a group of problems that can occur in newborns exposed to prescription painkillers and other drugs while in the womb. NAS affected one baby born every 25 minutes in 2012. Newborns with a diagnosis of NAS stayed in the hospital for an average of 16.9 days, compared to 2.1 days for other newborns. Pregnant women who use cocaine are at risk of preterm labor and their infants are at an increased risk for compromised neurological development. Opioids, methamphetamines, and methadone are the emerging drugs of choice for many women in Alabama.

Furthermore, intravenous drug users and their children are at particular risk for contracting a host of diseases including Hepatitis B and Human Immunodeficiency Virus, the virus that causes AIDS.5

Staying clear of all forms of substance abuse before, during, and after birth and getting good prenatal care are the best ways to have a strong and healthy baby. If a woman uses any form of drugs, she should talk with her doctor to get the help she needs to quit.

Helpful information is available for pregnant women on this website. As an example, a free mobile information service, text4baby, provides pregnant women and new mothers tips to guide them through their pregnancy and the baby’s first year. Women who sign up for the service will receive free text messages each week, timed to their due date or baby’s date of birth.

Check this website at adph.org/perinatal for additional information.

The sooner a woman breaks the substance abuse habit, the better it will be for both her and her baby.

Thomas M. Miller, M.D.
State Health Officer

(February 2017)

1 State and Regional Perinatal Advisory Committees and the Bureau of Family Health Services, Alabama Department of Public Health, Alabama Perinatal Health Act Annual Progress Report for Fiscal Year 2016 and Plan for Fiscal Year 2017, page 9.
2 Ibid., page 9.
3 Ibid., page 10.
4 Ibid., page 10.

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Make It Your Resolution to Quit in 2017

The new year is a great time to resolve to quit smoking. Cigarettes damage your lungs, your blood vessels, and cells throughout your body. Tobacco use is the leading cause of preventable death in the U.S., yet one in five Alabamians still smokes.

  • In Alabama, 8,600 people die annually from tobacco use.1
  • Almost one-third of cancer deaths in Alabama are attributable to smoking.1
  • More than 60 percent of Alabamians who smoke said they tried to quit at least once during the past year.2

Quitting smoking is a personal decision, and the majority of smokers want to quit. Many people want to quit to enjoy better health, and to protect and set a good example for their children. Within 20 minutes of quitting, heart rate and blood pressure drop. After three months, circulation improves and lung function increases. There are no negative aspects to quitting tobacco.

Nicotine found in tobacco products is addictive. The good news is that over-the-counter nicotine replacement therapy and counseling assistance are available at no charge through our Quitline. The Quitline helps smokers develop an individualized quit plan, offers coaching, and up to eight weeks of nicotine replacement therapy (NRT) patches, if the user is medically eligible and enrolled in a coaching program. NRT gives the body a little of the nicotine it craves without the harmful chemicals found in burning cigarettes.

Quitline services are available online at QuitNowAlabama.com and by calling 1-800-784-8669 from any Alabama area code. The Quitline schedules telephone coaching sessions at convenient times. If he or she is eligible for NRT, a package is mailed directly to the smoker’s home. Studies show the combination of coaching and medication increases the chances of being successful.

If you have resolved to make 2017 the year that you extinguish your smoking habit, please take your decision to stop seriously. Even if you have tried to quit before and failed, do not let past failures discourage you. On average, smokers try about four times before they quit permanently. Remember, quitting smoking is the single most important step you can take to protect your health and the health of your family. Follow through on your resolution and enjoy the rest of your life smoke free.

Thomas M. Miller, M.D.
State Health Officer

(January 2016)

1Campaign for Tobacco Free Kids

2 2016 Adult Tobacco Survey, conducted by the Institute for Social Science Research at the University of Alabama for the Centers for Disease Control and Prevention

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World AIDS Day Emphasizes Need for Awareness and Educational Efforts

World AIDS Day is held on December 1 each year. This observance is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV, and commemorate people who have died. World AIDS Day was the first ever global health day, held for the first time in 1988. This annual observance is important because it reminds the public that HIV has not gone away – there is still a vital need to raise awareness and improve education.

More than 1.2 million people in the United States and 13,000 people in Alabama are living with the HIV infection. Nationally, almost 1 in 8 HIV-positive persons are unaware of their infection. In Alabama, this figure is much higher as 1 in 6 people living with HIV are unaware of their infection and 1 in 5 HIV-positive gay and bisexual men who have sex with men are unaware of their status. Each year, between 600 and 700 people are newly diagnosed with HIV in Alabama.

The estimated number of recent HIV infections is highest among individuals aged 13-24 years, followed by individuals aged 25-34 years. This downward shift in the age distribution of Alabama’s recently infected HIV population indicates a need for increased prevention efforts targeting adolescents and young adults. The theme for 2016 is “Leadership. Commitment. Impact.”

The Alabama Department of Public Health just launched a comprehensive statewide social media campaign to bring awareness to this issue. This campaign, Start Talking Alabama, was created by the HIV/AIDS Prevention and Care Division to reach young gay men of color in Alabama. The goal of the campaign is to increase HIV awareness and decrease stigma by sharing prevention, testing, and treatment information and support.  The educational videos and webcast programs provide information and resources to reach adolescents and young adults between 15-29 years of age who are twice as likely to be infected with HIV as the average Alabama resident. Trends over the past decade show an alarming increase in the number of HIV infections among African American males in this age range reporting sex with another male.

KML AL is an app that the department has recently released that seeks to encourage individuals to "Know Your Status, Manage Your Health, and Live Your Best Life." It is an information source to help prevent the transmission of HIV/AIDS and to help those with HIV/AIDS in managing their disease. The app provides information on how HIV is transmitted, how to prevent HIV, how to get tested, and how to manage the disease.

The mission of the Division of HIV/AIDS Prevention and Care, in collaboration with community partners, is to reduce the incidence of HIV infections, to increase life expectancy for those infected, and to improve the quality of life for persons living with or affected by HIV. Alabama also has 16 partner organizations and clinics that are dedicated to providing treatment and support services for people living with HIV. Visit adph.org/aids for more information.

Thomas M. Miller, M.D.
State Health Officer

(December 2016)

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