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Probe
THE

Quarterly Newsletter of the Oregon Public Health Association Summer 2005

Public health director eager to share (your) vision


BY TERRY HAMMOND director for Arlington County. She was
working closely with police and fire units

N ew Public Health Director Susan


Allan is happily getting her feet wet
in Oregon. From her corner office with a
there during the 9/11 crisis.
Allan returns easily to the Pacific
Northwest, having been raised in the Tri-
beautiful, rainswept view of the city Cities area in Washington state.
beyond the bridges of the Willamette
River, Allan is barely moved in, and
appears more intent on garnering informa-
What are the stories you
tion from her visitor than in propounding
her own grand vision. need to tell?
Yet, her vision is the key, fundamen-
tally the reason she exists in the newly Now in Oregon, how will this new
created position as chief and spokes- health authority move us? Character-
person for public health in the state. Last istically, Allan answers right away, with
year, between sessions, legislators raised precision and a soft-spoken intensity,
Director Susan Allan MD JD MPH
the issue whether Oregon needs a fixing on a question in turn.
centralized public health authority with “What are the stories you need to what we want to achieve, and more to the
its own voice, independent of the Depart- tell?” point, how we aim to do it.
ment of Human Services. Evidently, short Here is the kernel of the director’s By now, probably no one needs to tell
of creating a new department, Allan is message to public health workers in us the state infrastructure is a mess, but
intended to solve the demand for Oregon. During the next 6 months, Allan hearing a sober assessment of Oregon
leadership (cf., The Probe, Spring 2004). will continue visiting county health from a new arrival is a little chilling. In
Arriving in mid-March from Arlington, departments, and continue seeking public health, virtually all funding comes
Virginia, home of the Pentagon, Allan was partners and her bearings in the state from the feds, and Oregon ranks near the
recruited, highly credentialed (physician, public health apparatus, sharing her bottom among the 50 states in commit-
lawyer, top schools, experienced admini- desire to communicate. Basically, that ment to funding public health.
strator), from her position as public health asks all of us to dust off our visions of (continued on page 2)

OPHA Mission
• Protect and promote the health INSIDE: Childhood Obesity Summit Food
of all Oregon residents fight in legislature Review of school soda
• Educate and support public
health workers contracts OPHA update Housing health
• Advocate for just and equitable OCHIN medical records more ...
health policies
2 The Probe

OREGON PUBLIC HEALTH ASSOCIATION


ANNUAL MEMBERSHIP MEETING AND CONFERENCE
You can help us
spread the word
Emerging Issues in Public Health
Please consider distributing
October 6-7, 2005 The Probe to colleagues and
Oregon State University in Corvallis friends interested in Oregon
For conference information check the OPHA website in August public health. With office
www.oregonpublichealth.org technology, the best way to
We invite you to submit proposals for the conference. achieve a magazine format is
Slots are available for 45-min. and 60-min. presentations. by double-sided copying, with
Contact Tom Engle (tengle@teleport.com or tom.r.engle@state.or.us)
two automated staples on the
left side.
Everyone deserves a safe and stable home
T he Community Alliance of Tenants
is receiving an increasing number of
Tenants concerned about potential
health hazards can utilize the following

Probe
THE
calls from tenants about environmental resources.
health issues in their homes, especially • American Lung Association’s
mold. During our building based organi- Master Home Environmentalist program,
zing in large multifamily apartment to ask for an assessment (503-924-4094
buildings in Portland and Gresham, we ext. 18)
have also seen countless environmental TERRY HAMMOND Editor
• LeadLine at 503-731-4500, for
health hazards, most of them violations
concerns about lead MARJORIE MCGEE Communication
of Portland’s city code or Oregon
Landlord/Tenant Act. • Neighborhood Inspections Program Chair
As a result, CAT is exploring ways to (503-823-7306), if a landlord in Portland
better enforce habitability laws and is not making necessary repairs News published in The Probe aims to
improve laws and policies to ensure safer • CAT Renters’ Rights Hotline (503-
provide information. Views expressed in
housing for low-income tenants. One 288-0130), for all Oregon tenants to learn
method is to document lead or mold levels about rights as a renter this newsletter do not necessarily
in homes. - SARAH BUCKLEY represent the views of OPHA members

Director targets three strategic priorities or its board of directors.


(from page 1) field workers to pool ideas on how best
Money is not the only problem. The to advance. Thinking out loud, she takes
goal of creating a data warehouse to
incorporate health-related records from
aim at three points.
1. Shape and influence federal pri-
Give us your news!
various state agencies – viewed as a boon orities according to local needs and We invite you to send stories, news
for epidemiology and health promotion – interests. and graphics. Submission dates:
faces huge obstacles in cost, administra- 2. Conduct an explicit discussion of ISSUE STORY DEADLINE
tion, and value, and in Allan’s words, is Oregon priorities in order to direct federal Winter Dec 21
not likely to happen anytime soon. funds to real needs, such as, for example, Spring Mar 21
Meanwhile, the public financing of avian flu, chemical spills, and emergency Summer Jun 21
personal health care in the widely re- response to earthquakes. Fall Sep 21
nowned Oregon Health Plan, whatever 3. Get appropriate support from the for publication on the 10th of
sparks of inspiration remain, is simply state to develop a robust, integrated January, April, July, and October
dead. system of public health information and
In this environment, with little com- response. Contact editor at terryh@pdx.edu
mand over resources, Allan is relying To get there, the jump start is dialogue, Oregon Public Health Association
upon “intelligent discussion” among endeavoring to create new norms in a
818 SW 3rd Ave, #1201, Ptd 97204
leaders, administrators, researchers, and continuing conversation.
Summer 2005 3

Allies pledge to fight childhood obesity


A FAT Report from the National Governor’s Association
CHILDHOOD OBESITY SUMMIT

ISSUE agreed that the epidemic of childhood


obesity requires multiple strategies at
a 20-year period, estimated hospital costs
related to childhood obesity more than
local and state levels. tripled: $35 million in 1979-1981, compared
The first objective at the local level is to $127 million in 1997-1999 (in constant
to coordinate health at school. Competi- 2001 dollars, see reference on p. 6).
BY ROBIN STANTON tive foods and school vending was a Childhood obesity is also a contributing
OPHA NUTRITION SECTION primary topic of discussion. Most parti- factor to increased school costs due to
cipants seemed to support establishing absenteeism and low academic achieve-

I had the pleasure of being invited to


speak at the National Governor’s
Association Childhood Obesity Summit,
minimum nutrition standards for the sale
of competitive foods on campus.
The national Child Nutrition Re-
ment scores.
Childhood obesity is a timely issue,
making the covers of such diverse
June 22-24. Participants included primarily authorization Act requires that Local magazines as Newsweek, Fortune, U.S.
health and education policy advisors to Education Agencies establish a local News & World Report, and The State
state governors, health officers, legisla-
tors, and other invited guests.
Increasing rates of childhood obesity “It is something we
is an issue facing all states. The incoming
chair of the National Governor’s Associa- absolutely have to address”
tion is Gov. Mike Huckabee from Arkansas NGA Chair Gov. Mike Huckabee
(who grew up in the same town as former
President Clinton). Huckabee has been
instrumental in creating policies that wellness policy by the beginning of the
promote healthy lifestyles. 2006-07 school year. The act is expected
Gov. Huckabee will spearhead a to encourage coordinated efforts in
Healthy America Initiative, with three school districts.
pillars – one being childhood obesity. He Schools are not the only place to
intends to challenge governors across the address childhood obesity, but if schools
country to tackle childhood obesity. are not on board we won’t make a dent in
Gov. Huckabee is joining forces with the alarming upward trend. Over 53 million
the Clinton Foundation, in alliance with children and youth attend school every
the American Heart Association. The day. Combining students, faculty, and
foundation is making a long-term commit- staff, well over 20% of the U.S. population
ment that focuses on three initiatives. works in a school.
• Engage the food and restaurant Many states have taken positive steps
Education Standard. Gov. Huckabee
industry to improve and promote health- by requiring school health councils,
provides a disquieting view:
ier options. increasing the ratio of school nurses to
“We’ve got a nation whose kids are
• Work with schools and community students, or requiring recess. Three top
truly in an epidemic of obesity. Fifteen
groups to enhance nutrition and physical choices were identified as policy strate-
years ago, Arkansas Children’s Hospital
activity, both in school and after school. gies in state intitiatives.
had never seen a case of type-2 diabetes
• Mobilize communities to create a • Coordinate and integrate efforts in a pre-teen. Today, they see eight or ten
healthier environment via a media cam- across state agencies and with non- of those kids a week, and diagnose them,
paign “For kids, and by kids,” using governmental organizations. which means that these are kids who by
youth role models to promote healthy • Utilize state and local data for their twenties have vision problems, will
lifestyles. decisionmaking and policy. have a heart attack by the time they’re
The summit addressed school-based • Support the development of school thirty, will be on full kidney dialysis before
policies, influence of the built envi- health councils. they’re forty, and will never live to see a
ronment, promotional strategies for The most startling information about fiftieth birthday … It is something we
nutrition and physical activity, tools, and childhood obesity is its economic impact. absolutely have to address.”
collaboration. There was no question that Obesity is driving chronic conditions,
schools play a critical role. It was also which is driving healthcare costs. During Robin.w.Stanton@state.or.us
4 The Probe

Empty Calories for Schools


When you water down a nutrition bill,
is there any nutrition left?
BY KARI MCFARLAN
• Replace the sale of soda, candy and state senate 18 to 12, while Republicans
fried pastry with more nutritious held the house 33 to 27. Like so many
D uring the 2005 legislative session,
instead of taking action to prevent
childhood obesity, the Oregon senate
beverages and snack foods.
• Limit the serving size and the fat and
bills under these conditions, SB 860 died
in committee in the opposite chamber.
passed a bill full of empty calories. Concerns about forced standards are
sugar content of snack foods.
Advocates worked for legislation to understandable, admitted Nancy Becker
establish statewide nutritional standards • Remove advertisements for candy and RD, a registered dieti-
for foods and beverages sold in schools, soda from the surfaces of vending cian and ONPA
but the senate passed a bill that imposes machines. member
no changes in foods and beverages, and As the political process moved
directs local schools to establish guide- forward, SB560 was opposed by school
lines on their own. and industry lobbyists, and the votes
Just like the sodas and high-fat, high- could not be mustered to move the bill
sugar snacks widely available in schools, out of the Education and Workforce
the legislation may look appealing on the committee.
surface, but has no real substance. Advocates then turned to SB860,
The Oregon Nutrition Policy Alliance which focused on a smaller number of
(ONPA) believes legislators missed an snacks and beverages. After weeks of
opportunity to take an important step in intense opposition from food and
addressing the childhood obesity epi- beverage lobbyists, such as the Soft
demic. ONPA is a network of health, Drink Association and Grocery
nutrition, education, and policy profes- Manufacturers of America, SB860 was
sionals working together to promote diluted to remove any reference to any
policy to increase healthy nutrition and food or beverage prohibitions. The bill,
physical activity among Oregonians. in its final form, simply mandates each
“We came to the legislature asking local school district to establish wellness
them to help make the healthy choice the polices and guidelines.
easy choice for all of Oregon’s school In the end, the senate passed a
children. As an alliance of diverse marshmallow of a bill that makes no
members, we worked hard to develop improvements to school food, but leaves
reasonable nutritional standards for local school districts in the position of
foods. Now the senate is telling local developing solutions on their own. in-
districts they must reinvent the wheel,” Ironically, these new state wellness volved with
said Noelle Dobson, founding member of policies are already mandated under the lobbying efforts
Upstream Public Health, a public health federal Child Nutrition Reauthorization for the bills. On the
advocacy organization based in Portland Act of 2004. By the time the contents of other hand, the alternative of doing
and member of ONPA. this totally revised bill trickled down to nothing is itself harmful, and the conse-
ONPA rallied behind SB560. The bill the senate floor, health and education quences too familiar.
established statewide nutrition standards advocates were dry-mouthed. Instead of “Schools with committed staff and
for all foods sold in schools outside the leading a local, collaborative effort to parent volunteers may develop good
federal meal programs, and the elimination improve public health for Oregon’s wellness policies, “Becker said, “but other
of foods of minimal nutritional value children and youth, state senators simply schools will get left behind. All Oregon
(FMNV) such as soda pop, candy, and adopted federal standards and felt students deserve access to healthy foods
fried pastries. satisfied. in schools.”
Key components of statewide nutri- Divided government may account for Each of Oregon’s 198 local school
tion standards that would protect all the trepidation. In 2005, the power districts are expected to have a wellness
Oregon students include the following. fiefdoms were stark. Democrats held the (continued on page 6)
Summer 2005 5
New Oregon report School Soda Contracts:
Soda contracts in schools: A Sample Review of
Contracts in Oregon Public
Who really benefits? School Districts, 2004

AUTHOR: NICOLA PINSON JD


BY KARI MCFARLAN of that pocket money goes directly to soft CONSULTANT: KATIE GAETJENS JD MSW
drink companies.
Available online (2005):

A nalysis of contracts between Oregon


public school districts and soda
companies suggests that Oregonians
Margo Wootan, director of nutrition
policy at the Center for Science in the
Public Interest, based in Washington, DC,
www.communityhealthpartnership.org/
images/pages/soda_report/
full_report.pdf
may want to take a closer look at the value summarized the significant picture
Community Health Partnership
of these agreements, according to a report produced by the new study. 522 SW 5th Avenue, Suite 200
released in “The report clearly demonstrates that Portland, OR 97204
April by funds from vending machines aren’t 503-416-1449
philanthropic donations from soft drink www.communityhealthpartnership.org
companies to schools. The money comes
out of children’s and parents’ pockets.” “The incidence of childhood obesity
The report, School Soda Contracts: has tripled in the last few decades,” Roger
A Sample Review of Contracts in Oregon Cone, director of the Center for the Study
Public School Districts, 2004, has been of Weight Regulation and Associated
well-presented, well-quoted in the news, Disorders at Oregon Health and Science
and heavily blogged since its release. University, affirmed – giving official
State epidemiologist Mel Kohn has sanction to a fact also emphasized by
begun emphasizing its importance in Oregon Public Health Director Susan
his recent presentations. Allan in presentations with a series of
Among key report findings: maps over time in slides, growing steadily
darker with the trend toward obesity in
• Vendors gain exclusive advertising
Oregon and throughout the USA.
rights to promote and increase the sale
“In some populations in the U.S., the
of products in schools;
incidence of type-2 diabetes in children
• Contracts are far more lucrative for has increased tenfold,” Cone said.
vendors than they are for school Given these conditions, Dr. Cone is
districts; not shy about his position on nutrition in
schools, whether promulgated in state
• Contract lengths range from 3 to 15
guidelines or in locally directed wellness
years (avg 9 years).
programs as recently mandated by the
Considering the comparatively small legislature (see story p. 4).
amounts paid to schools by vendors, “It is the responsibility of parents,
Community Oregon communities may want to rethink local school boards, and legislators to
Health Partner- the merits of allowing soda companies to insure that schools don’t exacerbate this
ship, a Portland-based market and advertise brand products in public health epidemic by serving
nonprofit organization committed to schools. unhealthy foods and beverages to
improving the health of Oregonians. If the fundamental purpose of the children,” Cone said.
At first glance, contracts may appear contracts is to generate money for The Soda Contract report is spurring
lucrative – generating thousands or underfunded school activities, the debate, both locally and nationally, about
millions of dollars in vendor payments question must be asked whether these the merits of school soda contracts. Mary
and sales, plus noncash benefits – all agreements are truly contributing to that Lou Hennrich, CHP executive director, and
providing a steady stream of funding to goal. The Soda Contract report provides Nicola Pinson, author of the report,
keep important school activities afloat. the numbers to begin judging the matter presented the study findings at the
The reality appears quite different. explicitly. A favorable alternative, once we National Network of Public Health
According to CHP’s findings, most of the stop and think about it, might be to plainly Institutes annual conference in May.
money generated for schools comes from fund schools appropriately without Plans are underway to present again at
students purchasing beverages; and most gambling on our children’s health. (continued on page 6)
6 The Probe

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Food fight in legislature ruled by laissez-faire


(from page 4) policies that promote physical activity
U.S. Public Health Service (2001). The
policy in place by September 2006. ONPA and improve the nutritional environment
surgeon general’s call to action to
anticipates working with local school at schools, we’ll go back to the Legislature prevent and decrease overweight and
districts to improve food offerings, and ‘older but wiser’ in 2007!” obesity. Available online:
continue to advocate for statewide www.surgeongeneral.gov/topics/
standards that guarantee protection for obesity/calltoaction/CalltoAction.pdf
all of Oregon’s school children.
Community Health Partnership, a Wang G & Dietz WH (2002). Economic
burden of obesity in youths aged 6 to
founding organization of ONPA, is
17 years: 1979-1999. Pediatrics,
developing resource materials and as- 109(5), 81 (6 p.)
sembling experienced trainers to work
Community Health Partnership study
with parents and advocates throughout
Oregon to educate and empower them to School soda contracts questionable
develop comprehensive wellness policies (from page 5)
and nutrition standards for their children. the National Association of County and Health Care in Schools, called the Soda
Mary Lou Hennrich, executive director of City Health Officials conference in July. Contract report “uniquely insightful” as
Community Health Partnership, member Locally, CHP will present to the Portland it “clearly demonstrates the limited benefit
of ONPA, and lifetime member of OPHA, State University graduate public health created by these agreements at the
expressed the enduring commitment felt program, in addition to other public expense of children’s health.” Like other
by many. forums to engage Oregonians in dialogue readers, Lear concluded: “As com-
“Community Health Partnership will about the contracts and the broader munities, we need to develop more
work with other advocates to assist local school nutrition environment. effective ways of raising school funds.
school districts in creating a wellness From Washington, DC, Julia Graham Students should not be asked to fund
policy. If local districts don’t come up with Lear, director of the Center for Health & their education with soda.”
Summer 2005 7
President’s message
Activities show OPHA on upward trajectory
BYJAN WALLINDER • The board approved a request by • Jan Wallinder represented OPHA at
OPHA PRESIDENT Marjorie McGee and Willi Horner- the Affiliate President Elect meeting at
Johnson to create a Disability Section. APHA in early June, where we heard plans

T he location and dates for the fall


annual meeting are set. Mark your
calendars: Oct. 6 & 7 at Oregon State
Ten members have expressed interest in
participating. The section purposes are
to (a) assess gaps and barriers in health
for a major grant proposal to support
affiliates, and lobbying in Congress. Jan
visited the offices of Sen. Smith and Rep.
University in Corvallis. Tom Engle and care for people with disabilities in Oregon, Hooley to request they support full
the planning committee are developing a (b) conduct a networking lecture series funding of CDC and HRSA, and Kids First
terrific agenda. Watch your e-mail for to bring together people with disabilities legislation for children’s health care, and
more information later this summer. and healthcare professionals, and (c) public health preparedness workforce
policy guidance and advocacy. training.
Here is a quick rundown of other news
from the last quarter. There have been several opportunities for The board has continued to focus on
OPHA visibility during the last quarter. operations the past 3 months. Following
• With the help of Ebony Williams at are a couple items for general attention.
Community Health Partnership, we have • With fellow public health organiza-
a current membership list and soon will tions, OPHA supported a reception for • In addition to educational sessions,
be able to do renewal notices. Susan Allan, new director of Public Health the upcoming annual meeting will include
at the Department of Human Services (see OPHA awards and board elections. The
• Marjorie McGee continues to update story p. 1). Nominations Committee is seeking candi-
the OPHA webpage with upcoming dates for president elect and board
OPHA and community events, and • OPHA had a table display in the lobby positions. Interested persons, contact
information from sections and commit- of the Portland State Office Building exdirector@oregonpublichealth.org
tees. Check out the new look online: during Public Health Week.
www.oregonpublichealth.org • The Community Health Education/
• OPHA co-sponsored a symposium, Health Promotion section has not been
• Mitch Haas, affiliate representative to “Public Health in the 21 st Century: active for the past year. The board and
the Governing Council, participated with Promoting an Understanding of the recent section chair Rosa Martinez are
other state affiliates in our region Importance of Genomics in Public Health seeking interested OPHA members to
(Washington, Alaska, and Idaho) to Practice,” with the Oregon MPH and help reactivate the section. We will survey
develop a letter of inquiry to the Paul Oregon Genetics programs. The symposi- former section members this summer to
Allen Grant Foundation, asking for public um offered MPH students an opportunity evaluate strategies for the future. A
health infrastructure support. Although to present posters, and network with section organizing meeting for CHE/HP
we were not asked to proceed with a full organizations and community agencies. will be included at the fall conference in
application, the process helped us OPHA was represented with a table October. Interested persons, contact
identify some administrative support display and raffled a basket of goodies exdirector@oregonpublichealth.org
issues, and also recognize common needs donated by the Adolescent Risky
of all four of the state affiliates. Behavior section.

Genius Award nominations DISABILITY


A new OPHA section focusing on
For the fourth consecutive year, • Top prize, the Genius Award, $3,000 disability was approved on Apr. 15 by the
Community Health Partnership is board of directors. Ten charter members
calling for Genius Award nominations • Exceptional Achievement, $1,000
with and without disabilities, founded the
to honor outstanding Oregonians • Meritorious Service, $500 new section, including public health
working to improve public health. professionals, community members, and
Awards are presented to individuals to Nominees demonstrate innovation
and responsiveness, risk-taking and students.
share with a community health organiza- The first Disability section meeting
tion of their choice. boldness in forging collaborative
solutions to public health programs. will be held in late July. Interested OPHA
Nominations due by Aug. 15. members, please contact Marjorie McGee
Awards are presented at the annual Find detailed nomination criteria at (mcgeem@ohsu.edu) or Willi Horner-
Genius Award Breakfast on Oct. 21. www.communityhealthpartnership.org Johnson (hornerjo@ohsu.edu).
8 The Probe

OCHIN gets $1 million boost for medical records


T hanks to a $1 million grant from the
Kaiser Permanente Community Fund
at Northwest Health Foundation, the
quality health services for medically
underserved Oregonians,” said Thomas
Aschenbrener, Northwest Health Foun-
EMRs and organizing care in a different
and better way,” said Nancy Stevens,
director of Community Benefit Initiatives
Oregon Community Health Information dation president. “This is an exciting at Kaiser Permanente Northwest. “Kaiser
Network is undertaking an ambitious partnership – a chance to leverage Kaiser Permanente’s unique contribution to this
project to develop a state-of-the-art Permanente’s experience with EMR and effort is our experience with the identical
system of electronic medical records at practice management technology where software platform that OCHIN has
community health clinics in the Portland it’s needed most.” selected.
metropolitan area. The Northwest division of Kaiser For more information:
Founded in 2000, OCHIN is a collabo- Permanente is an ideal partner in this OCHIN
rative project of stakeholders, safety net endeavor, having pioneered the use of www.community-health.org.
health care providers, and CareOregon, information technology and electronic
charged first to design and implement a Northwest Health Foundation
medical records now being implemented
statewide data infrastructure that offers www.nwhf.org.
throughout the Kaiser system.
practice management software to safety “Our providers are very interested in Kaiser Permanente Community Fund
net community clinic partners. Electronic sharing what they’ve learned about www.nwhf.org/opportunities/kaiser.php.
capacity allows safety-net partners to
achieve greater efficiency in appointment
scheduling, resource utilization, and
Evaluators conference calls for proposals
financial functions. For more information, contact Kari Greene (971-673-0599; kari.greene@state.or.us)
To date, OCHIN has installed a The Oregon Program Evaluators
OREGON PROGRAM EVALUATORS NETWORK
common integrated practice management Network is calling for presentations for
system in 14 clinics, covering 85 sites from its annual fall conference. Submissions Ways of Knowing:
Seattle to Santa Cruz. are encouraged in a variety of disciplines Evaluation and Evidence
The second charge, addressed by the and professional settings, including
September 15-16, 2005
present grant, is to develop capacity for social service agencies, academia,
Oregon Convention Center
electronic medical records to improve the independent consultants, government Portland
quality of care. OCHIN expects to activate and private industry. Diversity topics are
its first EMR site this fall at Multnomah featured at the conference as part of • Professional development workshops
County’s North Portland Health Clinic. OPEN’s Diversity Initiative. (3 hrs) – by July 15
“OCHIN is improving access to Deadline for submissions: • Conference sessions (1 hr) – by Aug 1

JOIN the Oregon Public Health Association


and get in the stream of people and knowledge
helping to keep Oregon healthy
Select a membership type
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Please send form & check to OPHA • 818 SW 3rd Ave #1201 • Portland OR 97204 Nutrition Disability
e-mail: exdirector@oregonpublichealth.org • Tax ID: 93-6097025 Community health promotion and
Enjoy professional networking, information, and opportunities for leadership health education
www.oregonpublichealth.org Other interests _________________

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