Dover – The Delaware Department of Health and Social Services (DHSS) announced progress in the battle against cancer in the first state. The DHSS Cancer Incidence and Mortality report for the years 2005-2009 is the most comprehensive cancer data report in the state.  And, the most recent data demonstrate that Delaware continues to make progress in fighting cancer, particularly cancer mortality.

In the 1990s, Delaware had the second highest cancer mortality in the country. Under the leadership of the Delaware Cancer Consortium and numerous health partners, that number has dropped significantly since then. In last year’s report (from years 2003-2007), Delaware was ranked 12 and now the state ranking has fallen further to 14.

“Delaware is making progress by focusing on a three-pronged strategy: prevention, screening and treatment,” said Governor Jack Markell. “But the fight is far from over. We cannot be satisfied until we end cancer altogether.”

DHSS Secretary Rita Landgraf praised the coordinated work of the Delaware Cancer Consortium, the Delaware Health Fund Advisory Committee, the Governor’s Council on Health Promotion and Disease Prevention and others in informing and educating Delawareans on preventing disease by making better lifestyle choices.

“A main message today is the importance of prevention and to remind people there are things they can do to reduce their cancer risk,” said DHSS Cabinet Secretary Rita Landgraf. “One of the simplest changes anyone can make is quitting smoking. Lung cancer is responsible for an astonishing 30 percent of Delaware’s cancer deaths and this simple step could save your life.”

Dr. Karyl Rattay, Director of the Division of Public Health, highlighted the importance of reducing additional behavior risk factors: obesity, poor diet, inactivity, alcohol abuse, and exposure to UV light—all which can increase cancer risk.

“The cancer data are encouraging, but if we want to reduce the overall incidence of all cancers and further lower mortality, we all must focus on the things we can control, our lifestyle,” said Dr. Rattay. “An easy to remember healthy lifestyle slogan is ‘5-2-1 Almost None’: five or more fruits or vegetables daily, no more than two hours of recreational screen time, one hour of total physical activity a day and almost no sugary beverages. Research shows lifestyle improvements matter.”

Delaware made progress in incidence or mortality in several areas:

• INCIDENCE RATES – Important incidence declines were seen for several cancers: including ovary, larynx, colon, cervix, esophagus, stomach and Hodgkin lymphoma —all of which experienced a larger drop than the nation.
• COLORECTAL CANCER – For the first time, colorectal cancer incidence was significantly lower among African Americans in Delaware than nationally; for both sexes combined; and for females. In the 10-year period, Delaware’s colorectal cancer mortality rate decreased 28.9 percent, compared to 22.7 percent nationally. This improvement in mortality is attributable to greater awareness of the necessity of colorectal screenings, and the provision of them through the Screening for Life program.
• RACIAL DISPARITY CLOSED IN SCREENINGS: Delaware became the first state in the country to end a racial disparity for colorectal screening. In 2010, a higher percentage of African-American Delawareans were screened (74.9 percent) than whites (74 percent). Delaware’s colorectal incidence rate declined 22.6 percent, while the U.S. rate declined 16.6 percent. In Delaware, the greatest improvement in incidence was made among African-American females (30.4 percent decline).
• FEMALE BREAST CANCER – Thanks to the improvement in the early detection of breast cancer, the decline in the breast cancer death rate for all Delaware women (29 percent) was over 50 percent greater than the decline nationally (19 percent) over the 10-year period. Delaware women ranked second (tied with two other states) nationally in the prevalence of women 40 and older who have had a mammogram within the past two years (81.4 percent). Between the two periods, there was a 9 percent decrease in breast cancer incidence among white females.
• MAJOR IMPROVEMENTS IN MORTALITY– Nine cancer types have shown considerable improvements in mortality (over the past 10 rolling five-year time periods):

o cervix (54.3 percent decline),

o prostate (35.0 percent),

o colon and rectum (29.0 percent),

o female breast (29.0 percent),

o stomach (25.5 percent),

o oral cavity and pharynx (25.2 percent),

o esophagus (23.7 percent)

o larynx (22.0 percent), and

o Non-Hodgkin lymphoma (22.2 percent).

But challenges remain:

• INCIDENCE RATES – Compared to 10 years earlier, Delaware’s 2005-2009 overall cancer incidence rates were the same as 1995-1999. In 2005-2009, Delaware’s incidence rates for cancers of the colon, lung, prostate, thyroid, bladder, uterus and skin (malignant melanoma) were significantly higher than the U.S. rate. The cancers with dramatic incidence rate increases in Delaware and nationally during the 10-year period are: liver, thyroid, kidney and skin (malignant melanoma).
• LUNG CANCER – Lung cancer continues to play an enormous role in Delaware’s overall cancer burden. In 2005-2009, lung cancer accounted for 15.2 percent of all newly diagnosed cancer cases and 30.3 percent of all cancer deaths in Delaware.
• FEMALE BREAST CANCER – Breast cancer incidence among African-American women increased 4.6 percent. African-American women did have a significantly lower death rate then the U.S. (22.6 per 100,000 compared 31.6 per 100,000 nationwide).
• PROSTATE CANCER – Most likely because of a greater prevalence of prostate cancer screening in Delaware compared with the rest of the country, Delaware’s incidence rate increased 5 percent over the past 10 years, compared with a 10.7 percent decrease nationally. The burden disproportionately affects African-American men in Delaware and the nation. Delaware’s 2005-2009 incidence rates were 80 percent higher for African Americans than for whites.

By law, the Delaware Division of Public Health analyzes cancer rates by census tracts. Of Delaware’s 214 census tracts, the overall cancer incidence rates were not significantly different from the state’s average rate in 189 tracts. The overall cancer incidence rate was statistically significantly higher than Delaware’s average 2005-2009 incidence rate in nine census tracts; and in 16 census tracts, it was significantly lower. The rates between census tracts may differ for a variety of reasons including a clustering of lifestyle behaviors such as smoking, unhealthy eating and lack of physical activity; environmental or occupational exposure to chemicals or a lack of such exposure; access to health care, including screenings; and chance or random variation. And, also calculation can be impacted by the inherent instability of rates due to small numbers of cancer cases and small populations in certain census tracts.

The 2005-2009 cancer data report is posted on DPH’s website at this address: http://www.dhss.delaware.gov/dhss/dph/dpc/cancer.html. DPH will arrange presentations about cancer rates, risks and prevention methods for community groups who call 302-744-1040.

For information on quitting smoking, call toll-free:1-866-409-1858. To learn if you qualify for free cancer screenings or treatment, call the Delaware Helpline 2-1-1.

*Data are presented as five-year rolling averages to reduce the impact that short-term fluctuations may have due to the small size of Delaware’s population.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

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(Wilmington)–Delaware advanced 21 slots on the national Gallup Healthways Well-being Index from ranking 47 in 2011 to 26 in 2012.  The state rankings are based upon the 1,000 phone interviews in which respondents were asked about their emotional and physical health, work environment, healthy behavior, life evaluation, and access to basic needs like food, shelter, healthcare, and a safe and satisfying place to live.

“This positive ranking reflects the progress we are making through the collaboration of our public, private and non-profit partners across the state,” Gov. Jack Markell said. “The state is supporting many efforts to help people manage their health. This includes building a community-based mental health system, creating more walking and biking trails, and tobacco-free state-owned buildings and campuses. While we are each responsible for our own healthy behaviors, the state is working to support people in making healthy choices.”

“This improved ranking is so heartening to see,” said Rita Landgraf, Secretary of the Department of Health and Social Services. “Feeling better about yourself — physically, mentally and emotionally — is one of the keys to wellness and good health. So many partners across the state are working with us to improve everything from our mental health system to cancer rates, from obesity rates to chronic disease rates. While we have made progress – and this ranking confirms that– there are still many more challenges ahead. With our partners, our goal is to create a culture of health and wellness among all Delawareans.”

Many states’ rankings remained consistent with previous years but Delaware was among a few states with a significant change.  According to the data from the report, Delaware’s rankings advanced so dramatically because citizens reported improvements across all measures, with particularly big improvements in life evaluation and emotional health.  There were also encouraging increases in physical health, healthy behaviors, work environment, and basic access to food, shelter and health care.

“At Public Health it is particularly exciting to see the jump in people reporting better physical health and better health behaviors, “said Dr. Karyl Rattay, Delaware Division of Public Health  (DPH) Director.  “Ninety percent of the factors that impact people’s health are outside their actual health care.  That people are reporting better health and appear to be making better health choices is a goal at DPH and a development we are committed to sustaining over time.”

The physical health measure is determined by asking respondents about their body mass index, disease burden, sick days, physical pain, daily energy, history of disease and daily health experiences.  The healthy behaviors measure is lifestyle habits with established relationships to health outcomes.

For further information on how each measured was determined or for more Delaware data:

http://cdn1.hubspot.com/hub/162029/WBI2012/Delaware_2012_State_Report.pdf

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

The Delaware Division of Public Health (DPH) reminds Delawareans of the importance of observing the following guidelines during and after a flood:

Safe Drinking Water
If you are advised to boil your drinking water, heat water at the highest possible temperature so that it bubbles constantly (a rolling boil). Continue to boil water for one minute, and then let it cool. Store in clean, covered containers. Residents can also disinfect water using household bleach. Add 1/8 teaspoon (or 8 drops) of regular, unscented, liquid household bleach for each gallon of water. Stir it well and let it stand for 30 minutes before using it. Bottled water is another safe alternative.

Food Safety
Do not eat any food that may have come into contact with flood water. Food containers with screw-caps, snap lids, pull tops, and crimped caps are not considered waterproof. Also, discard cardboard juice/milk/baby formula boxes and home canned foods if they have come in contact with flood water. Discard canned foods with swelling, leakage, punctures, holes, fractures, extensive deep rusting, or dents that prevent normal stacking or opening.

Power Failure
Do not rely on appearance or odor of food; use a freezer thermometer. If the freezer thermometer reads 40 degrees F or below, the food is safe and may be refrozen. If the food still contains ice crystals or is 40 degrees F or below, it is safe to refreeze or cook. Perishable food such as meat, poultry, seafood, milk, and eggs not kept adequately refrigerated or frozen may cause illness, even when thoroughly cooked. Keeping refrigerator and freezer doors closed as much as possible will keep food cold for about 4 hours. A full freezer will keep the temperature for approximately 48 hours (24 hours if it is half full) if the door remains closed. Discard any perishable food (such as meat, poultry, fish, eggs or leftovers) that has been above 40 degrees F for two hours or more. Buy dry or block ice to keep the refrigerator as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18-cubic foot fully-stocked freezer cold for two days.

If you plan to eat refrigerated or frozen meat, poultry, fish or eggs while at safe temperatures, cook the food thoroughly to the proper temperature to kill bacteria. Wash fruits and vegetables with water from a safe source before eating.

For bottle feeding infants, use prepared, canned baby formula that requires no added water. When using concentrated or powdered formulas, prepare with bottled water if the local water source is potentially contaminated.

Clean Up
Floodwaters can dislodge tanks, drums, pipes and equipment which may contain hazardous materials such as pesticides or propane. Do not attempt to move unidentified dislodged containers without first contacting the local fire department or hazardous materials team. Wash skin that may have been exposed to pesticides and other hazardous chemicals frequently and thoroughly. Call the poison control center for additional instructions.

Wear protective gear and clothing, such as heavy shoes or boots, work gloves and safety glasses or goggles to help avoid accidental puncture wounds, cuts, abrasions, eye injuries and chemical exposure. Wear a hard hat when working under structures and trees. Select cool clothing that is cotton and tightly knit; long-sleeved shirts and full-length pants are recommended.

Assure proper ventilation when using fuel-burning equipment. Fuel-burning devices in closed areas pose a great risk of carbon monoxide poisoning. Provide plenty of ventilation when using a gas-powered pump for flooded basements or a gas-powered generator for electricity. Install and maintain carbon monoxide detectors.

Turn off the main gas valve at the meter if you smell leaking gas. Do not turn on lights or use torches or lanterns since they can ignite the gas. Leave the premises immediately and notify the gas company or the fire department.
Thoroughly wash countertops with soap and water, using hot water if available. Rinse, and then sanitize by applying a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of water. Allow to air dry.

Mold
Open doors and windows or use blowers to force fresh air into flooded spaces. Extract excess water. Once water is removed, close doors and windows, run dehumidifiers and empty the water pan frequently.

After water has been pumped from the basement, shovel out the mud and debris while it is still moist. Hose down walls to remove as much silt as possible before it dries. Floors and walls may need sanitizing, particularly if sewage has entered the basement. Scrub walls and floors with a 10 percent bleach solution or other comparable commercially available disinfectant.

Oil stains in basements caused by overturned or damaged oil tanks may be a problem following flooding. Call a professional to remove oil residue.

Dealing with garbage and sewage can be challenging. Beware that sewage can backflow through floor drains into basements. Clean with a disinfectant. Never mix ammonia and chlorine bleach, which produces poisonous chloramine gas. If flood waters cause storm sewers to back up, fecal bacteria can be extremely dangerous. If sewage overflows in your home, wait for water to recede, then clean and sanitize all affected surfaces with bleach as soon as possible. After coming into contact with sewage or floodwater, wash your hands well and use a brush to clean under fingernails.

Residents with questions about flood recovery can contact the Delaware Division of Public Health’s (DPH) Storm Recovery call center at 866-408-1899. The call center is scheduled to be open on Tuesday, October 30 at 12:00 p.m. (noon) to 4:30 p.m., and 9:00 a.m. to 4:30 p.m. on Wednesday, October 31 to Friday, November 2, 2012. Hours may be subject to change due to call volume and storm conditions. For updated call center hours, follow Twitter #SandyDe or #StormDE.

For fact sheets on flood preparedness and recovery, visit the DPH website at: www.dhss.delaware.gov/dhss/dph/floodhealthinfo.html.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

DHSS Press Release Date: October 27, 2012
DHSS-122-2012

Rita Landgraf, Secretary
Jill Fredel, Director of Communications
302-255-9047, Pager 302-357-7498
Email: jill.fredel@delaware.gov

The Delaware Division of Public Health announced today that it will open two medical needs shelters on Sunday, October 29, 2012 at noon Sunday at William Penn High School, 713 E. Basin Road, New Castle, and Cape Henlopen High School, 1250 Kings Highway, Lewes.

A partnership with the Delaware National Guard, the Medical Needs Shelters provide safe and temporary housing to individuals who require support with their medical needs. These shelters are for people who cannot be accommodated in regular shelters.

Individuals at the shelters can expect sleeping accommodations, food and trained medical staff who can assist with medical needs. Medical shelters cannot take the place of a hospital and are intended for those who have minor medical conditions that are stable and require daily assistance. Examples include assistance with medicine administration, changing wound dressings or helping the oxygen dependent.

Caregivers must accompany the individual to the Medical Needs Shelter. Items to bring include:

· Durable medical equipment and oxygen tanks;
· All medication and supplies;
· Personal items;
· Any special foods or liquids for dietary needs;
· Important documents such as phone numbers and insurance information.

Only service animals are allowed in the shelter. No other pets will be admitted. For further information, visit http://dhss.delaware.gov/dhss/dph/files/medneedspi.pdf. Emergency contact number is 1-888-295-5156.

Dr. Patrick Titus must meet stringent requirements for treating pain management patients

Secretary of State Jeffrey Bullock has signed an order to accept a consent decree setting forth numerous requirements that Dr. Patrick Titus must satisfy before he is allowed to resume prescribing controlled substances. Dr. Titus’ Controlled Substance Registration was suspended in December 2011 when it was alleged that he had been overprescribing controlled substances and ignoring evidence that some of his pain management patients were abusing or diverting the controlled substances.

Dr. Titus admitted that he needs additional training and education to safely and effectively prescribe controlled substances to chronic pain patients. He also admitted that controls to prevent diversion and abuse of controlled substances were inadequate and may have actually led to abuse.

“This is unfortunately another of an increasing number of cases involving lax prescribing practices that lead to diversion and abuse of potentially dangerous drugs,” said Secretary Bullock. “The effects of prescription drug abuse and diversion can be devastating to individuals, families and communities. It is imperative that physicians strictly adhere to standards for safely prescribing controlled substances.”

Among the terms of the consent agreement, Dr. Titus must fulfill extensive requirements before his registration will be reinstated. These include evidence that his practice is fully equipped to comply with regulations and guidelines set forth by the Delaware Board of Medical Licensure and Discipline, the Federation of State Medical Boards, the American Pain Society and the American Academy of Pain Medicine. Furthermore, Dr. Titus’s staff must undergo training on these regulations and guidelines and appropriate medical record keeping practices. He will be subject to random audits for the next two years.

Dr. Titus must also complete 12 hours of Continuing Medical Education (“CME”), in addition to those regularly required for license renewal (40 hours), on opioid prescription practices, treatment of chronic pain, or other related topics before his suspension will be lifted. For the next two years, Dr. Titus must take 6 additional CME hours on these topics each year.

When treating patients for chronic pain, Dr. Titus must require toxicology screens.  He may not treat any pain management patients longer than six months. Thereafter, he must refer each patient to a recognized pain management physician for re-evaluation.