Richland Public Health
2017 Annual Report
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Since 1910
Dedicated to making Richland County a safer & healthier place to live and work for all ages.
Solid Dependable Proven
What is Public Health?
Public Health is the science of protecting and improving the health of people and their communities. This work is achieved by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases.
Public health professionals try to prevent problems from happening or recurring through implementing educational programs, recommending policies, administering services and conducting research—in contrast to clinical professionals like doctors and nurses, who focus primarily on treating individuals after they become sick or injured. Public health also works to limit health disparities. A large part of public health is promoting healthcare equity, quality and accessibility.
Overall, public health is concerned with protecting the health of entire populations. These populations can be as small as a local neighborhood, or as big as an entire country or region of the world.
Martin Tremmel
Health Commissioner
Kevin Van Meter
Fiscal Operations
Rick Grega
HR, Legal, & IT
Dr. Daniel Burwell
Medical Director
Board of Health
The Board of Health plans or authorizes activities benefiting the department’s purpose.
Terms are for five years; there is no term limit. Board meetings are normally the third Monday of the month at 6 p.m. at 555 Lexington Avenue. January and February’s board meeting is held on the fourth Monday of the month. Meetings are open to the public and the agenda includes an opportunity for public comment.
Barbara Cinadr, RN
Board Member
Thelda Dillon
Board Member
Robert Exten, MD
Board Member
Michael Keith
Board Member
John Leech, DDS
Board Member
Matthew Maiyer, RPh
Board Member
Della Phelps
Vice-President
Steven Phillips, DVM
Board Member
Dave Remy
Board Member
Jean Swartz
Board Member
Ary van Harlingen
President
Violet Wetzel
Board Member
District Advisory Council
2018 Members
How We Are Organized to
Prevent, Promote, and Protect
Environmental Health
Often working behind the scenes, Environmental Health employees protect the health of Richland County citizens by ensuring safe water, inspecting food services, and protecting against environmental hazards.
Public Health Nursing
In our Clinic and out in the field, Public Health Nurses are the face of Richland Public Health. Multiple wellness programs have our Nurses in Schools and in communities throughout the County.
Administration
Health Commissioner, Human Resources, Legal, and IT, and Fiscal Operations.
Community Health & Prevention Sciences
Community outreach with services focused on fact-based programs to promote and improve health of individuals and communities. Also the communication and publicity arm of Richland Public Health.
WIC Services
One of the best ideas the “Fed” has ever had and a proven champion of health. Women, Infants, and Children promotes breastfeeding and healthy food options for prenatal and postpartum women & children to age five.
Richland Public Health
Office of Vital Statistics
Online Birth Certificates
Birth Certificates
Death Certificates
Burial Permits
Births in Richland County, 2017
Births in Richland County include live births in the City of Shelby as well as non-hospital deliveries. Of the 1,171 births, 190 were at OhioHealth-Shelby and 86 were non-hospital deliveries. 745 births (64%) were “repeat” births (2nd or more births). 575 births (49%) were to unmarried mothers. Births to unmarried mothers were the second highest percentage since records began in 1993. However, that figure does not take into account births to couples within cohabitation unions.*
* Data indicates that more than half (58 percent) of all non-marital births in 2006-2010 occurred within cohabiting unions. (National Health Statistics Report, April 12, 2012, CDC/U.S. Department of Health and Human Services).
Teen Births
There were 108 total teen births. That is the second lowest percentage (9%) since records began in 1993. 19% of teen births were to minority race mothers. Four of the teen mothers were married.
- 14 Years Old (3) 3%
- 15 Years Old (2) 2%
- 16 Years Old (7) 6%
- 17 Years Old (12) 11%
- 18 Years Old (32) 30%
- 19 Years Old (52) 48%
Office of Vital Statistics
Cause of Death, Richland County 2017
%
Heart Disease
%
Strokes
37
%
Kidney Disease
51
%
Cancer
Accidents
%
All other Causes
%
Lung Diseases
%
Alzheimer’s/ Dementia
%
Accidents
80% of accidental deaths were due to accidental drug overdose (mostly opioids). Falls, traffic crashes, and “other” accounted for the rest.
%
Suicides
%
Flu & Pnuemonia
Richland Public Health
Community Health & Prevention Sciences
Community Health and Preventive Sciences (CHPS) is the art and science of studying and assessing community health needs. This involves organizing and provisioning comprehensive community health services and doing the work of educating and developing health care programs. The objective of that work is promoting health and preventing diseases. We are committed to reducing the leading preventable causes of illness, disability, and death – and to promoting community health – in Richland County.
PROGRAMS
- AARP Senior Driver Class
- Advertising & Public Relations
- Bike Loan Program at Libraries
- Bike Loop in Mansfield
- Bike to Work Week
- Blood Pressure Kits at Libraries
- Child Car Seat Program (OBB)
- Communities Preventing Chronic Disease
- Community Fairs and Resources
- Creating Healthy Communities
- Diabetes & Heart Health Education
- Just Walk Richland
- Monthly Health Report Newsletter
- Public Information Officers
- Social Media/Website
- Walking Maps
- Weather Safety Information
Julie Chaya
Director CH&PS
I’m Julie Chaya, Director of Community Health and Prevention Sciences at Richland Public Health. Our Division changed our name from Health Promotion/Education in January of 2018 to better reflect what we do here. Our staff is dedicated to improving health and health care among diverse populations through research, learning, and community partnerships. We are engaged in research and community health activities across the lifespan from maternal-child health to long-term care. Call any of our Health Educators if you have questions about what we can do for you.
American Idol Runner-Up
Ohio Native, Singer/Songwriter
Crystal Bowersox Concert
Brenna, who also has Type 1 diabetes, asked Crystal how she controls her diabetes. Crystal encouraged other kids in the room to support those with diabetes and told them to believe in themselves and they could do anything.
Later that evening, Bowersox performed at a sold-out concert at Richland Academy of the Arts.
Community Health & Prevention Sciences
Child Passenger Safety
It’s hard to dispute the fact that children are safer in Child Passenger Seats than adult seat belts, but many of us can remember when the only safety device we had in the car was our mother’s forearm. Reed Richmond, Richland Public Health’s CPS Tech and a member of the CHPS staff, can remember those days, too. As a new grandfather, he’s kind of passionate about getting kids in the right seat and the right place.
Last year, he assisted in 59 new seat installs through the Ohio Buckles Buckeyes program and assisted families with 42 other CPS checks.
For more information about the OBB Program or if you’d like to have your install checked, call Reed at 419-774-4726.
Community Health & Prevention Sciences
Biking Programs
When Mansfield City Council approved the creation of a 5.7 mile Inner City Bike Loop, Richland Public Health’s Communities Preventing Chronic Disease grant stepped up to provide painting for the route. Our Health Educators didn’t stop there. During Bike Month in May, Richland Public Health sponsors a “Bike to Work” day. We have “getting to know” rides in rural and city environments. We sponsor advertising to get the word out about the health and environmental benefits of riding a bike instead of using a car. In 2018, residents in Lexington and Butler will have a chance to borrow bikes from their Public Library. Get out and ride it, Richland!
Community Health & Prevention Sciences
Just Walk Richland
Just Walk Richland is a movement that encourages whole health walking in Richland County. These walking groups are open to all in Richland County and include walks on urban city streets, residential neighborhood streets, the Richland B&O trail, and rustic hiking trails. Just Walk Richland opens the invitation to individuals to walk for their own interests, whether that is for physical, mental or social benefits. Whatever your reason, Just Walk Richland! Connect with us on Meetup
Community Health & Prevention Sciences
Hike for Health
Speaking of walking, for 18 years, Richland Public Health has promoted the Hike for Health as a healthy form of fun exercise in Ohio’s great outdoors. The science behind exercise and health is irrefutable. But lately there has been more research proving that reconnecting with nature is good for your health, too. Since its start at Malabar State Farm Park in February, the Hike has added an October date and a new location: Gorman Nature Center. For more information about the Hikes, call 419-774-4761
Community Health & Prevention Sciences
Blood Pressure Cuffs
Through the Communities Preventing Chronic Disease (CPCD) grant, Richland Public Health (RPH) began a project to expand residents’ access and ability to self-monitor their blood pressure. RPH collaborated with the county’s library systems and the District 5 Area Agency on Aging to create a kit containing a blood pressure monitor/cuff, instructions, educational material about blood pressure, and a blood pressure tracking card. At all libraries in the county, patrons are able to check out a kit for two weeks at a time and keep the resources that are supplied in the kits at no cost. There is also a kit at the District 5 Area Agency on Aging for onsite usage. The libraries and RPH continue to work collaboratively to maintain the kits.
Saw
Saw it advertised… really nice to be able to check this out at the library! Very useful and I was able to give my healthcare provider a 2-week snapshot of my blood pressure! Anonymous, Survey Response
In Richland County, Ohio, the incidence of diagnosed high blood pressure has increased to affect 40% of the adult population, thus surpassing both the statewide (34%) and nationwide (31%) incidence. In 2016, heart disease and stroke accounted for 28% of deaths in Richland County. The program allows for blood pressure monitors to be accessible to any resident in Richland County over the age of 18. Because it is a free resource, people who may be unable to purchase their own monitors or would otherwise rely on a single reading from their health care providers now have the opportunity to use a kit at home. Checking a kit out of the library creates opportunities for more frequent and consistent readings, thus allowing users to learn about blood pressure issues sooner than if they were to wait until a physician visit. This program also allows people to take their blood pressure in the comfort and privacy of their own homes, which is not the case with most of the other free public blood pressure monitors. This is the Prevention Science behind Community Health.
I had been feeling ill recently and wasn’t sure what it was, I just knew I felt “not right.” I thought it may be my BP, but wasn’t sure. I checked out the BP kit, and this actually saved my life… had I not been able to borrow it from the library, I may have not known until it was too late. Anonymous, Survey Response
The program launched in April 2016 and over a 21-month period, the blood pressure kits have been checked out a total of 292 times. Due to one library’s long wait lists and high demand, an additional kit was added nine months into the program, bringing the total number of available kits to 21 across 10 libraries.
This collaborative effort was chosen by The Public Health National Center for Innovations as one of its Cross-Sector Partnership Innovations.
2017 Use Data
Finding Richland Public Health Online
Page Views
Original Visits
By Department
Environmental Health
Vital Statistics
WIC
Public Health Clinic
Public Health Nursing
CH&PS (HPE)
Most Visited Service
Food Services
Plumbing, Commercial
Immunizations
Sewage Treatment
Birth & Death Statistics
Just Walk Richland
Mosquito Spraying
WIC Car Seat Program
By Device
%
%
%
YouTube
Richland Public Health
Environmental Health Division
Environmental Health is the branch of public health that focuses on the relationships between people and their environment; promotes human health and well-being; and fosters healthy and safe communities. Environmental Health is a key part of any comprehensive public health system. The field works to advance policies and programs to reduce chemical and other environmental exposures in air, water, soil, and food in order to protect people and provide communities with healthier environments.
American Public Health Association
Programs with most inspections, investigations, and consultations.
- Food Services 29%
- Plumbing Commercial 23%
- All Other 22%
- All Other 12%
- Sewage Treatment 9%
- Vector Control 6%
| Contacts | 2017 |
| Campgrounds | 67 |
| Food | 3,158 |
| Emergency Preparedness | 10 |
| Housing | 7 |
| Indoor Air Quality | 48 |
| Institutions | 5 |
| Lead | 19 |
| Environmental Health Nuisance | 91 |
| Environmental Health Other | 63 |
| Plumbing – Commercial | 2,515 |
| Plumbing – Residential | 1,299 |
| Private Water Systems | 632 |
| Public Swimming Pools/Spas | 237 |
| Rabies | 640 |
| Schools | 126 |
| Sewage Treatment Systems | 943 |
| Site Assessment | 22 |
| Solid Waste | 309 |
| Tattoo & Body Piercing Facilities | 115 |
| Vector Control | 694 |
| Totals All Contacts | 11,000 |
*Inspections, investigations and consultations
Joe Harrod
Director Environmental Health
I’m Joe Harrod, Director of Environmental Health at Richland Public Health. In the Environmental Health Division we help protect the health and well-being of the residents of Richland County. We do this by providing education and enforcing public health-related laws during our routine inspections. This helps prevent diseases and make environments safe in restaurants, private water systems, schools, and businesses. The next few pages will give you some insight into what we do in Environmental Health.
Environmental Health
Food Safety
The Food Safety Division at Richland Public Health licenses and routinely inspects food service operations (FSO), retail food establishments (RFE), temporary and mobile FSO/RSE, and vending facilities to ensure public health and safety. When a violation is found, the violation is thoroughly explained, corrective measures are taken, and education is given to the operators. Thanks to an ongoing working relationship between the Health Department’s Sanitarians and the food facility operators in Richland County, our community is protected against food-borne illnesses that may result from unsanitary working conditions, improper food handling, preparation, or storage, unsafe sources and improper cooking, holding or cooling temperatures.
Rob Bowers, Registered Sanitarian, doing a mobile food service inspection at a summer fair.
Environmental Health
Rabies & Animal Control
Rabies protection is one of the oldest public health programs. Rabies is an infectious viral disease that affects the nervous system of humans and other mammals. People get rabies from the bite of an animal with rabies (a rabid animal). Because rabies is a fatal disease, the goal of public health is to prevent and control the spread of rabies by conducting rabies investigations for every animal bite in the County. Working with several local veterinarians, Richland Public Health has helped sponsor a free rabies clinic in May for several years.
Dr. Henry Akers give a rabies shot at the Annual Free Rabies Clinic.
Environmental Health
Recreational Water
Richland Public Health licenses and inspects public swimming pools to minimize the risk of recreational water-borne illness and to reduce safety hazards resulting in accidents from improperly maintained pools. Public swimming pools include those located in apartments, hotels, motels, neighborhood associations, parks, health clubs, and other recreational establishments.
Environmental Health
Mosquito Control
Richland Public Health trapped a total of 18,308 mosquitoes in 2017. 491 pooled mosquito samples were tested for West Nile Virus (WNV) and 49 samples tested positive for WNV.
Richland Public Health provided 264.56 miles of treatment for adult mosquito control and a total of 55 gallons of adulticide was applied in Richland County.
Richland Public Health
Plumbing Division
Safe Water for All
Our State-Certified Plumbing Inspectors work with registered plumbers and homeowners to ensure all plumbing installations are in compliance with the Ohio Plumbing Code. Our Chief Plumbing Inspector teaches Plumbing Code CEU Classes for a six-county area.
Richland Public Health has residential and commercial jurisdiction in Richland County and Commercial Jurisdiction in Ashland, Crawford, Huron, Knox, and Morrow Counties.
Commercial
Residential
Private Water
Inspections & Consultations
Frank Brykalski
Chief Plumbing Inspector
Conducting a residential plumbing inspection is Plumbing Inspector Aaron Streng.
Public Health
Nursing & Clinic
Amy Schmidt
Director, Public Health Nursing
I’m Amy Schmidt, Director of Public Health Nursing at Richland Public Health. Public Health Nurses have the distinction of applying the values and philosophies of nursing and public health together in an effort to impact a community. They work at all levels of intervention with individuals, families, clinics and communities to promote the health of the community and the entire population. Public Health Nurses make a difference in their communities. They provide leadership and ground their work in science. They are conveners, collaborators, and advocates for a healthier community. They are skilled at bringing people together to make change happen in our communities.
Richland
| Public Health Clinic | 2017 |
| General Health (new, revisit, sick) | 1,492 |
| Immunizations (includes TB) | 2,977 |
| Influenza Vaccine (Flu Shots) | 873 |
| Neighborhood Immunizations (visits) | 429 |
| International Travel (visits/consults) | 240 |
| Nurses Appointments | 252 |
| STD/HIV Testing | 217 |
| Total Visits | 6,480 |
For Clinic Appointments for child, adult, travel, and shingles vaccine as well as flu shots: call 419-774-4700. Walk-ins are welcome.
Public Health Nursing
BCMH
Special health care needs may be caused by a condition a child is born with or develops later. The condition is chronic in nature and will last longer than a year. Call a Public Health Nurse to see if your child’s condition is eligible: 419-774-4540.
Right: A BCMH child with her mother during a home visit.
Public Health Nursing
Newborn Home Visits
Richland Public Health provides a registered nurse from Public Health Nursing to visit your newborn child (up to eight weeks old) in your home. Our nurse will do an assessment of your child and help answer questions you may have. The nurse can also provide a reference to other community agencies for further assistance if needed.
Some families may also qualify for a free “Cribette” provided by a grant through “Cribs for Kids” and the Ohio Department of Health. Newborn home visits are a free service in a collaborative effort funded by the Richland County Youth and Family Council.
Call 419-774-4540 to schedule an appointment.
Left: Kristen Grove, RN, packs a Cribette as she prepares for a home visit.
Public Health Nursing
International Travel Services
sA public health nurse can provide immunizations for travel disease, travel advise to avoid discomfort and disease, documentation of immunizations, and helpful answers to your questions.
If you are going to places beyond North America, you need to know about serious health risks—especially where sanitation and medical conditions are poor. Diseases such as tetanus, diphtheria, polio, measles, meningitis, typhoid, hepatitis A, hepatitis B, yellow fever, malaria, influenza, Zika, and traveler’s diarrhea pose threats to the unprotected traveler.
Appointments are needed. Please call 419-774-4700 and ask for the International Travel Services program.
Clinic nurse Paula Musgrove talks with a client about her trip to China, where she will be living with a host family.
Public Health Nursing
Nurses in Schools
Richland Public Health provides public health nurses to 12 schools in Richland County. They also do hearing and vision screenings for additional schools.
Hearing screenings are one of many duties that public health nurses perform in schools.
Public Health Nursing
Safe Sleep Education
Several Public Health Nurses participated in an October video promoting the ABCs of Safe Sleep: Alone, on their Back, in a Crib, to prevent infant deaths
Emergency Preparedness, Planning & Response
Women, Infants, Children
WIC
SThe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is federally funded through the USDA. WIC’s mission is to provide supplemental foods, health care referrals, and nutritional information to income eligible pregnant, breastfeeding, postpartum women, and to infants and children up to age 5 who are at nutritional risk. WIC is the nation’s premier and most cost effective public health nutrition program. Currently, WIC serves 53 percent of all infants born in the United States.
2017 WIC Services
Ashland & Richland
- New Particpants 15%
- Recertifications 37%
- Other Contacts 48%
Recertifications
New Participants
Other Contacts
Total Contacts
Tina Picman
Director Richland-Ashland WIC
I’m Tina Picman, Director for the Richland/Ashland County WIC Program. I want to welcome you to WIC and its wonderful services. WIC helps young families learn about good nutrition, find health care, and purchase healthy foods available at local grocery stores. In June, 2017, WIC moved from the lower level of RPH to the upper level and is now co-located with the RPH clinic. You can come to your WIC appointment and get your children’s immunizations up-to-date all in one visit!
Ohio WIC Income Guidelines
Eligible Gross Income (before taxes
| Family Size | Annual | Monthly | Weekly |
| 1 | $22,311 | $1,860 | $430 |
| 2 | 30,044 | 2,504 | 578 |
| 3 | 37,777 | 4149 | 876 |
| 4 | 45,510 | 3,793 | 876 |
WIC
WIC also offers special classes just for kids. These classes include “Story Time” with the Library Lady, the ”Kids as Chefs“ cooking class, and Halloween and “Christmas with Santa” classes featuring nutritious snacks and crafts. Participating in WIC can be fun for the family!
Another program helpful to WIC participants is the WIC Farmer’s Market Program. During the summer months, WIC provides a $20 coupon booklet that can be redeemed at approved farm markets for fresh, locally grown fruits, vegetables and herbs. It is a great way to support area farmers and serve your family fresh produce!
Ohio WIC introduced a new logo
for the State program, seen above.
Financial Information
Good Stewards of Public Funds
The Board of Health and Administration of Richland Public Health appreciate the trust of the citizens of Richland County in approving our Levies. We are very conscious of making every financial decision in the best interest of serving our citizens.
2017 Program Expenses
| Public Health Nursing | $2,177,604.28 |
| Environmental Health | 1,586,319.09 |
| CH&PS (Health Ed.) | 1,060,435.90 |
| WIC | 921,184.13 |
| Vital Statistics | 327,574.85 |
| TOTAL | $6,073,118.26 |
2018 Operating Budgets
| Payroll/Fringes | $4,434,147.63 |
| Operating Fees/Permits | 1,613,415.98 |
| Equipment/Building | 262,950.00 |
| Administrative | 140,000.00 |
| TOTAL | $6,073,118.26 |
Message from the Health Commissioner
Community Members,
In a word, the 2017 year-in-review would be regarded as PROGRESSIVE.
The WIC clinic staff settled into a new location area alongside our public health nursing clinic. The rationale for this move is to improve collaboration between the nutrition program, breastfeeding education, nursing services and immunizations as a one-stop for the convenience of our moms, dads, and babies.
The Division of Environmental Health was surveyed five times from various state regulatory agencies regarding the pool, food, water, and solid waste programs. The surveys are time-consuming; however, I am pleased to report our staff exceeded expectations. Each program remains in compliance with state regulations, and many areas are in the higher performance percentiles.
The wet spring and early summer weather produced many more mosquitoes than we can recall in recent years. The phone and email requests for trapping, surveillance, spraying and larvicide treatments kept our two college interns and our staff sanitarian busy all season. We appreciate everyone’s patience, especially when our staff drive by your home with a motorized fogging machine at 4:30 am. In short, we trapped 18,308 mosquitoes and became one of the first sites in Ohio to locate West Nile Virus positive mosquitoes.
Our vital statistics program utilizes a Google™ search engine, and more than half of our online birth certificate purchases are from out-of-state customers. It is an honor when our staff responds to a request from one of our citizens entering our armed forces, and we endeavor to complete such requests within one business day.
Public health nursing successfully vaccinated more than 4,000 of our residents for childhood, adolescent and adult immunizations, including our standard flu-clinics. It is unfortunate that this year’s influenza vaccine was not as effective as it has been in past years; however, it became clear to our disease surveillance staff that those having received the vaccine were much less ill than those who were not vaccinated. Sadly, four Ohio children died from complications due to influenza their children were not vaccinated. We cannot stress enough the importance of an annual flu shot early in the flu season (around late October) for ALL family members age 6-months and older without a history of adverse reaction.
The Community Health & Prevention Sciences (CHPS) division has taken its goals/objectives to another level. It would be difficult for a Richland County resident not to have seen/heard a billboard, poster, radio, newspaper, newsletter, or television advertisement where CHPS staff were actively promoting healthy diets, exercise/ walking/biking, cardiovascular health, diabetes prevention, local parks initiatives, community gardens, worksite wellness programs, and the like. It is with regular messaging that we encourage healthy choices and improve our overall health as a community. CHPS is continually working to make the healthy choice the easy choice. Please assist us in these efforts in any little way that you can – your heart will thank you for it!
It remains our privilege as public servants to exceed the expectations of our Richland County residents. Kindly let us know how we are doing – we welcome your feedback (our website has a satisfaction survey) and endeavor to remedy areas where we can improve.
In good health for 2018,
Martin J. Tremmel, RS, MPA, JD
Health Commisioner
Richland Public Health