July 2023 – Page 2 – AZ Public Health Association

July 10, 2023July 14, 2023

Will Humble Climate Change, Injury Prevention, Public Health, Wills Blog

Maricopa County Heat Surveillance Report: Persons Experiencing Homelessness, Men without a College Education at Highest Risk for Heat Exposure Death

This week is shaping up to set a record for the most number of consecutive days with temperatures over 110F. The lower Sonoran desert temps are forecast to be in the 112-117 range each day this week, and the National Weather Service believes there’s a 10% chance we could have multiple days over 120F mid-week.

See the Area Forecast Discussion from the National Weather Service

Environmental heat is by far the deadliest weather phenomena with far more mortality than floods, cold, and lightning combined. It’s not even close. As one of the hottest places on Earth, our Arizona deserts are among the more lethal places weatherwise.

As part of their efforts to mitigate bad outcomes from heat exposure, the Maricopa County Department of Public Health has been conducting public health surveillance to inform policy interventions at the county and city level.

MCDPH published their newest report last month which had some important findings:

View Maricopa County Public Health’s Environmental Heat Mortality Surveillance Report

425 heat-associated deaths occurred during 2022 in Maricopa County, a 25% increase from 2021.
Individuals experiencing homelessness make up the largest proportion of heat-associated deaths in 2022. Among deaths where the living situation is known, people experiencing homelessness are accounting for an increasingly large share of all heat-associated deaths in recent years.
Maricopa County found 283 deaths involving substance use, representing over 2/3 of all heat-associated deaths recorded in 2022. Note: Methamphetamine was involved in 90% of heat-associated deaths involving drug use. Methamphetamine was a contributing factor or main cause of death in 53% of all heat-associated deaths.
Fifty-eight percent (58%) of all heat-associated deaths occur in July.
Males accounted for more than 80% of heat-associated deaths in 2022. Two-thirds (66%) of all heat-associated deaths occurred among individuals aged 50 years or older.
60% of heat-associated deaths occurred among non-Hispanic White individuals, however African Americans (7.4%) and American Indians (3.6%) are overrepresented among heat deaths.
More than 66% of adult decedents did not attend any post-secondary schooling, among all heat-associated deaths with known educational background. Note: Perhaps this is a marker for people with outdoor occupations and those experiencing homelessness.
The majority of outdoor heat-associated deaths occurred in an Urban Area in 2022. 70% of outdoor heat deaths and over half of all overall heat-associated deaths occurred in an Urban Area within Maricopa County throughout the year.
All indoor heat-associated deaths in 2022 occurred in uncooled environments. Among indoor deaths where an AC unit was present, the unit was non-functioning in 78% of cases. In 2022, 42% of indoor deaths were among females, despite females making up less than 20% of the overall heat deaths for the year.

View Maricopa County Public Health’s Environmental Heat Mortality Surveillance Report

July 9, 2023July 8, 2023

Will Humble Community Health Workers, Wills Blog

HRSA Grant via the ASU College of Health Solutions Offering Stipends to Train up to 200 New Community Health Workers

ASU’s College of Health Solutions just received a $3M grant from the federal Health Resources and Services Administration to train 200 community health workers in Arizona over the next two years starting in August.

Applicants must have a high school diploma or equivalent and be U.S. citizens or legal permanent residents. Those selected will receive a $7,500 stipend to complete the two-semesters program, which requires about 10 – 15 hours a week of online training.

After completing the program, newly minted community health workers will be matched with a community organization to participate in a 480-hour internship or a 2,000-hour apprenticeship. Community health workers who complete the 2,000-hour apprenticeship qualify for an additional $7,500 grant.

Want to be a community health worker? Apply for ASU program by July 31 (azcentral.com)

College of Health Solutions | Arizona State University

July 8, 2023July 9, 2023

Will Humble Community Health Workers, Injury Prevention, Public Health, Reproductive Health, Wills Blog

Public Health Journalism this Week: Nonfeasance at the AZ Industrial Commission During the Ducey era, Contraceptive Dispensing, Community Health Workers

ADOSH under Gov. Ducey did not protect Arizona workers: Here’s how (azcentral.com)

Editorial Note: This article discloses major shortcomings in the Arizona Industrial Commissions duties to protect workers in Arizona during the Ducey Administration and cries out for leadership changes at the Commission. Thankfully the Commission is due for a major audit later this year from the Arizona Auditor General (Lindsey Perry Director). It would make sense to make those leadership changes before the Audit begins.

The Arizona Industrial Commissioners serve 5-year terms and can be terminated due to inefficiency, neglect of duty, malfeasance, misfeasance or nonfeasance in office: ARS 23-101. The Director of the Commission serves at the pleasure of the Governor: ARS 23-108.

The current Director, Mr. James Ashley, was appointed to the Commission by Governor Ducey in 2015. Prior to his he had little professional experience in the field, having worked as a district director for former Congressman John Shadegg and deputy chief for former Congressman Ben Quayle. Makes one wonder whether the Senate was paying any attention at all to vetting Director nominees during the Ducey administration.

Women can obtain birth control pills from pharmacist starting this week with some conditions | Arizona Capitol Times (azcapitoltimes.com)

Most Arizona pregnancy-related deaths preventable | Arizona Capitol Times (azcapitoltimes.com)

COVID-19 pandemic in Arizona exacerbates a mental health care crisis (azcentral.com)

How to become a community health worker through this ASU program (azcentral.com)

ASU looking to train community health workers (abc15.com)

July 6, 2023July 7, 2023

Will Humble Reproductive Health, Wills Blog

Az Pharmacists Can Now Dispense Contraceptives w/o a Physician Prescription

Back in 2021 the state legislature passed, and the governor signed a bill giving pharmacists the ability to dispense oral and other contraceptives that currently require a prescription to fill.

The law didn’t take immediate effect because the AZ Board of Pharmacy needed to write rules outlining things pharmacists need to do in order to dispense without a prescription. Those rules were approved by the Governor’s Regulatory Review Council on Wednesday.

Today (Thursday) ADHS’ Chief Medical Officer for Public Health (Lisa Villarroel, MD MPH) iss ued a thorough Standing Order for the Self-administration of Hormonal Contraceptives, including the self-screening questionnaire… the final piece of the puzzle needed for pharmacists to dispense those kinds of contraceptives without an initial doctor visit or physician prescription.

View ADHS’ Standing Order and Self-screening Questionnaire

As with pretty much any public health intervention, there are benefits and risks. On the benefit side, the measure will improve community health and well-being by improving access, make it easier to space pregnancies (which improves maternal and child health).

On the risk side, there is a chance some women will skip annual checkups and screenings. There are also some medical conditions that put women at higher risk for side effects from oral contraceptives that could be missed under the new system, which is why the statute, and the Board of Pharmacy rules require that the pharmacist review the self-assessment before filling the order.

View the proposed rules: 4 AAC 23_March 21, 2023

View the Statute View ARS 32-1979.01

The Arizona Section of the American College of Obstetricians and Gynecologists supports the new law and the Board’s rules: See their Letter

“By implementing the 2021 legislation, these rules will improve access to these types of contraceptives, especially for low-income patients and those who live in rural areas. Self-administered hormonal contraception improves community health and well-being, reduces global maternal mortality, creates health benefits of pregnancy spacing for maternal and child health and allows for mothers to engage in economic self-sufficiency.”

Since 2012 ACOG has endorsed this model of access to hormonal contraception to minimize barriers to access. Studies have shown these medications can be safely dispensed using the health risk screening questionnaire that is required in the legislation and reflected in the rules— this will help women and their pharmacists determine which medication is right for them and what is safe based on their individual health history.”

AzPHA supported the 2021 bill that set this intervention in motion because we believed that the public health benefits of greater access outweigh the risks. We look forward to the ADHS self-assessment screening guidance and standing orders so this intervention can be implemented.

Arizona could begin giving expanded access to birth control in July (azcentral.com)

Pharmacists will be able to dispense birth control to women without prescriptions | Arizona Capitol Times (azcapitoltimes.com)

July 5, 2023July 6, 2023

Will Humble Climate Change, Wills Blog

APS Doubles Down on Coal & Sticking Us with the Tab: Send them Back to the Drawing Board

Arizona Public Service Company (APS) is asking the Arizona Corporation Commission for a rate increase that extracts $460 million more from captive ratepayers, a whopping 13.6% net increase on monthly bills.

We understand public utilities like APS have capital needs and variable costs that periodically require rate increases to ensure a reliable supply of energy and meet expected peak demands.

What we don’t understand is why APS is asking us to pay hundreds of millions more so they can continue to operate the inefficient coal fired Four Corners power plant into the next decade. Especially since there are cheaper and cleaner ways to serve the public that don’t carry the public health impacts such as increases in asthma and bronchitis that prolonged burning of fossil fuels does in communities.

Since the last rate case, APS has spent hundreds of millions of dollars in capital expenses, operations, and maintenance at the inefficient Four Corners Generating Station and Cholla Power Plant. Now the company is asking us to pony up hundreds of millions more to keep Four Corners running until 2031 even though it is no longer economical to run and more costly than clean energy alternatives.

With better planning, the utility could get cleaner energy sources with lower operating costs that would moderate this excessive rate increase request.

APS Doubles Down on Coal & Sticking Us with the Tab

Arizona Republic, June 27, 2023

APS could save ratepayers money, reduce pollution, and moderate their rate increase request by retiring the Four Corners Power Plant before 2031 and replacing it with lower-cost renewable energy. At a minimum, their plan should switch Four Corners to seasonal operations this year as APS originally promised.

APS’ rate increase should also include more investments in energy efficiency, which can also reduce customer bills and lessen the burden on people with low incomes. They should be doubling down on investing in energy efficiency technologies like incentives for buying programmable thermostats, increasing incentives to participate in time-varying rate plans that reduce peak load without removing home comfort, and incentives for people to install more efficient HVAC systems, refrigeration, pool pumps, and industrial motors.

We understand utilities like APS require periodic rate increases to plan for growth, meet customer needs, and accommodate peak loads. However, APS’ request focuses too much on expensive and dirtier energy sources and not enough on cheaper, cleaner solar and wind, and more energy efficiency.

We urge the Arizona Corporation Commission to ask APS to go back to the drawing board and come back with a more reasonable proposal that focuses more on cheaper renewable energy and better leverages energy efficiency.

Will Humble is executive director for the Arizona Public Health Association. Sandy Bahr is director of Sierra Club’s Grand Canyon (Arizona) Chapter. Reach them at [email protected] &[email protected] and on Twitter at @willhumble_az & @SLBahr

SUBMIT WRITTEN COMMENTS TO THE AZ CORPORATION COMMISSION DOCKET

Be sure to include the docket number at the top of your comments – Docket Number E-01345A-22-0144
Use the talking points listed below for your comments, plus include any specific reasons you are concerned about this rate case. Tell your story!
You can mail your comments to: Arizona Corporation Commission, Consumer Services Section, 1200 West Washington, Phoenix, AZ 85007
You can submit your comments electronically or ask us to drop them off for you.

To submit a public comment, go to https://efiling.azcc.gov/cases, Click on “Make A Public Comment in a Docket.” Complete your information and click “Submit.”

July 2, 2023July 2, 2023

Will Humble Uncategorized