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My Approach to Public HealthULYEE  CHOE,  D.O.

ASSOCIATE  PROFESSOR,  USF  MORSANI COLLEGE  OF  MEDICINE

DIRECTOR,  FLORIDA  DEPARTMENT  OF  HEALTH   IN  PINELLAS

Background

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Who We Are

Our MissionTo Protect

To Promote

Improve the Health of Residents and Visitors

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ICARE ValuesInnovation

Collaboration

Accountability

Responsiveness

Excellence

DOH‐Pinellas: 2016‐2017Employee – 649.15 FTEs

Budget ‐ $52,068,198

Services ‐ > 1.4 million

CU4

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CU4 Choe, Ulyee, 9/21/2017

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2016 Sources of Funding

Locations

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Boca Ciega High School924 58th Street SouthSt. Petersburg, FL 33707Phone: 893-2780

Pinellas Park High Clinic 

6305 118th Ave N

Largo, FL 33773

Phone: 538‐7410

Largo High Clinic 

410 Missouri Ave North

Largo ‐ 33770

Phone: 588‐3758

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ServicesMaternal and Child Health (MCH)

WIC

Dental Health/ Dental Sealants

School Health

Refugee Health

Immunizations

Infectious Disease◦ TB◦ STI◦ HIV

Birth and Death Certificates

Tobacco Prevention

Environmental Health◦ Healthy beaches◦ Swimming pool inspections◦ Biomedical Waste

Primary Care/ Health Care for the Homeless

School‐based Clinics

Family Planning

Health Promotions

Health equity

Public Health Preparedness

Breast and Cervical Cancer Screening

Refugee Health

Please visit:

pinellas.floridahealth.gov

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My ApproachInnovation

Collaboration

Impactful Changes

Innovation

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Sexually Transmitted InfectionsAnnual new infections (incidence) = 20 million

Total Infections (prevalence) = 110 million

Total Medical Costs = $16 billion

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Contributing FactorsNot getting STI testing or treatment

Unprotected Sex

Multiple Partners

Increased Social Media to Meet New Partners?

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Reported STD’s in Public/ Private Sector

41%

59%

2007

Public

Private

23%

77%

2014*

STI InterventionsSTI Results Texting

Internet Partner Notification

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STI Result TextingUpon agreement, staff obtains  (DH3203) for testing and cell phone text results including cell number and provider

With a positive Lab, a text message is then generated by STD staff in the PRISM

Client given informational card regarding text message

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Internet Partner Notification

To confidentially contact and bring to treatment known and suspected sex and needle‐sharing partners of reportable STDs, including HIV, using Internet email addresses and mobile dating applications (apps).

Internet Partner NotificationGrindr

Adam4Adam

Tinder

Jack’d

Scruff

Plenty of Fish

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Collaboration

Opioid EpidemicMore than one person in Pinellas dies every other day from opioid abuse and misuse

208 opioid‐related deaths in 2016

2,529 overdose transports by EMS/ Fire Administration

Increase in synthetic opioids

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Post Mortem Drug Identifications2005‐2016

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 20152016

Projected

Heroin (6‐MAM) 10 6 12 10 9 3 1 2 4 7 14 20

Fentanyl 30 34 21 39 27 22 21 19 26 41 64 110

Oxycodone 82 113 181 205 241 312 325 201 95 99 72 90

0

50

100

150

200

250

300

350

Heroin, Fentanyl Analogs, and Oxycodone

Heroin (6‐MAM) Fentanyl Oxycodone

Fentanyl analogs identifications in post mortem case currently exceed both oxycodone and heroin

Demographic Information

59%

41%

Sex

Male Female

96%

4%

1%

Race

White Black Other

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OD Transports June 23, 2016 – June 22, 2017

Opioid Deaths2016 (Jan‐Dec)

Based on Injury Location,Not Death Location(191 of 204 points mapped)

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CollaborationDCF

DOH‐Pinellas

Operation Par

Pinellas County Human Services

Pinellas BCC

Juvenile Welfare Board

States Attorney

USF – St. Pete

Poison Control

Medical Examiners

Gulf Coast Jewish Family Community Services

City of St. Petersburg

Bayfront Health

Baycare Health

Pinellas County Sheriff

Pinellas County EMS/ Safety

Alliance for Global Narcotics Training

Community Health Centers

Suncoast Center

Catholic Charities

Pinellas Homeless Leadership Board

PACE

Healthy Start Coalition

Pinellas County Medical Association

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Impactful Changes

ObesityMore than 1 out of every 3 kids were overweight or obese

70% chance of becoming overweight or obese adults

27% of young Americans are too overweight to serve in the military

By 2030, 60% of all adults in the United States will be obese

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Partnerships to Improve Community Health120 Pinellas County Schools locations with Healthy School Team

58 Early learning centers in Pinellas County have created new policies and made fitness/ nutrition changes to improve the health of preschoolers

15 Recreation centers used Fun Bites initiative

25 Park and trail locations with Bottle‐refilling water stations

18 Bike Fix‐It Stations added to parks and trails

15 Fitness Zones

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•Product

•Price

•Placement

•Promotion

Internet Partner Notification

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Health in All PoliciesStrategy to ensure that leaders are informed about the health consequences of various policy options

Acknowledges that social determinants of health have a profound effect on how healthy we will be over the course of our lives

Decisions about issues like food access, housing, transportation, education have a direct impact on health

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Questions?