PAGE A2, KEIZERTIMES, JUNE 15, 2018
Marion County looks at public health with new lens
By ERIC A. HOWALD
Of the Keizertimes
Disclosure: The author of this
article was one of the participants
in the workgroup at the center of
the story.
When thinking about sub-
stance abuse in Marion Coun-
ty, what is the fi rst substance
that comes to mind? Heroin,
opiates, alcohol, marijuana, to-
bacco, methamphetamine …
the choices feel endless.
For a group of about 50
local community leaders asked
to participate in a workgroup
at the Keizer Civic Center
Thursday, May 31, the answer
was either alcohol or opioids.
However, the responses were
based only on perceptions.
Answering that question
with certainty, and then
developing an approach to
solving it, is the task ahead for
the Marion County Public
Health Division (MCPHD)
of the Marion County Health
& Human Services. And the
work is just getting underway.
With funding either fl at
or shrinking to tackle public
health problems, program
administrators, led by Program
Manager Kerryann Bouska,
are rethinking how to address
substance abuse issues with
wide-ranging
effects
on
society.
In the past, public health
offi cials were reliant on
donors with specifi c agendas
and tasked with developing
programs that catered to the
needs of specifi c populations or
mitigated risks. Despite good
intentions, new information
and shifting goalposts often
left the same programs in
the lurch when the money
dried up or a new donor was
secured with a different set of
priorities.
Agencies like MCPHD
are combatting those forces
with new emphases, different
tactics, and a bigger goal.
In contrast to past efforts,
A new dook at pubdic headth
Rather than addressing the issues of individuads and smadd
groups, the Marion County Pubdic Headth Division is dooking
at the environmentad infl uences deading to substance abuse
and addressing those through pubdic podicy.
ENVIRONMENTAL INFLUENCES INCLUDE:
Retail Availability
Social Availability
Community/Cultural Norms
Promotional Campaigns
Price
which focused on getting a
program in place to care for
specifi c subgroups, evaluating
its effectiveness and then
looking at how the approaches
to such problems might be
altered for greater benefi ts.
MCPHD is using a Strategic
Prevention Framework that
puts the emphasis on assessing
needs, system capacities and
planning before execution.
This is why such a large
group was put together to
begin investigating substance
Law Enforcement
Individual factors
abuse problems in Marion
County. With representatives
from K-12 schools, colleges
and
universities,
health
professionals, media, law
enforcement and numerous
other agencies, MCPHD
tapped into a large array of
perceptions within the local
community. Even though
opioids and alcohol rose
to the top as the leading
problems, participants were
also asked where they would
look for data to back up their
assertions. Suggestions ran the
gamut from student wellness
surveys to police reports and
hospital intake data.
Once the actual leading
problem is identifi ed, the next
step will be to look at what
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environmental
infl uences
might contribute to the
problem. That step will take
into
consideration
retail
availability, social availability,
community and cultural
norms, promotional aspects,
law enforcement, prices and
factors affecting individual
factors.
The goal of the second
phase
is
to
identify
environmental factors that
could be addressed through
public policy. For example,
one of the most effective
public health initiatives in U.S.
history was raising the age of
alcohol consumption from 18
to 21. Doing so lead to lesser
rates of alcoholism and fewer
alcohol-related deaths among
youth.
Such steps fall under the
umbrella of harm reduction.
Rather than seeking to
prohibit or put in place
outright bans, public policy
was enacted to reduce harm to
some of the most vulnerable
segments of the population.
In an example closer to home,
the community in Hood
River, Ore., recently set out to
combat the public perception
of the city as a party town –
an image bolstered by data
revealing it had the highest per
capita sales and consumption
of alcohol in the state.
Rather than looking to
close down bars, breweries,
cideries and other outlets,
public
offi cials
engaged
owners who increased training
for bartenders, servers, security
and event coordinators; asked
for commitments from local
law enforcement agencies
to enforce liquor laws; and
reworked event licenses based
on the behavior of the licensee
and community expectations.
As a result, public perception
is changing.
The end goal of all this
investigation and planning is
to arrive at policy solutions
with the potential to change
an entire population – by
raising the standards of the
community – rather than
risk and prevention needs of
individuals.
It is a different lens to look
through than what's come
before, but the results have the
potential to be more surprising
and, potentially, benefi cial.