Hollingsworth strives to fulfill state's health goals Protecting and improving the public well-being of South Dakotans are among the major goals of Secretary of Health Doneen Hollingsworth, who addressed the Dakota Hospital Association and Foundation Community Leadership Luncheon in Vermillion Nov. 1. by David Lias Improving public health.
Insuring access to quality health care services across South Dakota.
Improving the ability of South Dakota health care providers to respond to emerging public health issues and needs.
Those are the top three items on Doneen Hollingsworth's "to do" list.
Hollingsworth, the South Dakota secretary of health, was keynote speaker at the Dakota Hospital Association & Foundation Builders Club Community Leadership Luncheon held Nov. 1 at USD.
She is no stranger to Vermillion. Hollingsworth spent her youth here, was educated in the Vermillion's public elementary, middle and high schools and attended The University of South Dakota.
She was named the state's secretary of health in 1995.
Protecting and improving
For the past 18 months, the state health department has been focusing much of its efforts in attempting to reduce the number of state residents who smoke.
"Tobacco is a terrible problem in South Dakota. About 40 percent of South Dakota high school students smoke, about 22 percent of adults smoke, and 21 percent � one in five � of pregnant women in South Dakota smoke," Hollingsworth said. "Nationally, that is about 12 percent. And about half of Native Americans in South Dakota smoke."
The average smoker makes seven quit attempts before they are successful, she said. The state department of health hopes to help more smokers kick the habit by starting the South Dakota Quit Line, a toll-free telephone counseling service.
"What we're doing in South Dakota is very unique. We're combining the free telephone counseling with free tobacco cessation products," Hollingsworth said. "Our approach is cutting edge. Research shows that using that quit line alone doubles the chance of quitting. Using nicotine replacement products alone doubles the chance of quitting so we'd like to think that our program, by combining the quit line and the tobacco cessation products, is giving South Dakotans an optimal chance to quit."
She said that South Dakota's response has been "fantastic" to the quit line.
"There have been more calls to the South Dakota quit line than the Florida, Texas and Colorado quit lines combined," Hollingsworth said. "Over 9,000 individuals have called the South Dakota Quit Line since it started in January. We've averaged 1,400 calls a month since July. This is something we're really excited about."
In 2001, Gov. William Janklow asked the South Dakota Department of Health to organize a statewide diabetes screening effort.
"We started looking into this, and realized that no one had ever done anything like this on a statewide level. Like we usually do in South Dakota, we asked a lot of people for help, and we received lots of help," Hollingsworth said. "We received help from hospital systems, clinics, physicians, community groups and businesses."
In 2001, 31,536 South Dakotans were tested for blood glucose at 590 sites in 220 communities across the state.
Nearly 9 percent of the people who were tested had elevated levels and were referred to a medical provider. Approximately 25,000 people also had their blood pressure screened. About one-third of the people tested had elevated blood pressure levels.
"This year, the governor asked us to do it again," Hollingsworth said. "The numbers were so high last year that we knew there were still a lot of South Dakotans at risk for diabetes and didn't know it.
"In 2002, our focus has been quite different. We tried to take the screenings to places where people are, rather than organizing the screenings generally in medical facilities," she said. "This year, we've been to just about every type of event that has had a fairly large gathering of people � county fairs, the state fair, rodeos, art festivals, and the Sturgis Motorcycle Rally."
Through October 2002, the South Dakota Department of Health, through this cooperative effort, screened another 31,000 South Dakotans. The screenings will continue through December.
health care services
Making sure there is an adequate health care workforce in South Dakota is going to be a key issue in South Dakota's future, Hollingsworth said.
"One thing that USD, SDSU and the governor's office has worked on is helping to increase the number of training slots for nurses," she said. "We've created a tuition reimbursement program for nurses. And there are critical shortages in some other areas that will need to be addressed."
A recent study also shows that 8.1 percent of South Dakotans are underinsured.
"The concern is that this problem will grow worse. Health care costs will continue to rise, and employers are finding it more difficult to continue to cover their employees," Hollingsworth said.
This summer, the governor put together a 20-member health insurance task force. "They are looking at the issue; we'll be making some recommendations to Gov. Janklow," she said. "Before he established the task force, he spoke to both of the gubernatorial candidates, and they both expressed a keen interest in the issue and a willingness to continue working with this group."
The task force is focusing on the individual insurance market, and will recommend changes.
"It's a very complicated, very difficult issue," Hollingsworth said, "and we need to keep working on that."
South Dakota, along with the rest of nation, finds itself having to complete an urgent task of being able to respond to the threat of bioterrorism.
"Remember back a year ago," Hollingsworth said. "Five anthrax deaths really put the nation's public health system into a tailspin. As a department, as a state, I think we really did a pretty good job responding."
South Dakota trained, in a very short time, over 1,900 health care providers and first responders to deal with bioterrorism.
"Our bioterrorism Web site had thousands and thousands of hits," Hollingsworth said. "People were very interested, very concerned. In the month of October (2001) our bioterrorism staff took over 900 phone calls from the public."
Early in 2002, Congress passed sweeping legislation providing generous funding to states and local governments, first responders, health departments and emergency management.
"In the public health areas, there were unprecedented resources, and I think it was a testament to how serious the federal government was taking the need for preparedness, providing these funds to states very quickly," she said.
The South Dakota Health Department has received over $7.5 million for bioterrorism preparedness and planning.
"What we plan to do with that funding is strengthen our public health system, and make it a system that we use every day, not just if, heaven forbid, we have a smallpox outbreak, or another anthrax outbreak in this country," she said. "We want a system that will serve us well in the winter with routine influenza, or will help us in the summer when we had the West Nile cases."
She pictures physicians, hospitals, laboratories, and public health nurses using the state's health care system more easily on a daily basis as improvements are made.
"We will continue to provide specialized training for health care providers," Hollingsworth said. "We are also using our dollars to provide a mobile laboratory, that can handle very infectious agents with very minimal risk of spreading that disease. We learned how important timely lab results and responses were last fall.
"In a large geographic state like South Dakota, we need to have those mobile resources to take it where there might be an incident. What we also want to do is use that lab as training resource, and use it all around the state on a continual basis," Hollingsworth said.
The state health department is also working on "wiring" the state's health care system.
"We are developing a communication system, and it's redundant. It starts with mobile radios, and it goes all the way up to a system that's very similar to the Dakota Digital Network," she said. "We will be connecting all hospitals in South Dakota, clinics, physicians' offices, laboratories and ambulance services, mostly for communication."
A better communication system will enable better analysis of health trends in South Dakota, she said.
"We'll be able to get accurate, timely information back to the health care providers, and accurate, timely information back to the public. That's our goal," Hollingsworth said.
She believes the challenge for the future in public health is twofold: "As a department, we need to continue to strengthen our state's public health system to address the traditional responsibilities, such as childhood immunizations, health education and screenings, disease surveillance and intervention, and rural health care.
"We must also insure, because of the times we live in, adequate capacity and flexibility in the system to respond to new threats, such as bioterrorism, and emerging and reemerging infectious disease, such as West Nile virus and anthrax," Hollingsworth said.
She praised the Vermillion community for building a strong health care system.
"From a health department perspective, the Vermillion hospital system and the Sioux Valley system is one we can always count on," Hollingsworth said.