Health Screenings

Lack of health screenings is a health problem for Mahoning County because a significant proportion of residents fail to meet the guidelines for appropriate utilization of screening tests recommended in Healthy People 2000 or by other appropriate medical experts, such as the American Academy of Family Physicians and the American Cancer Society. Some common screenings and their associated chronic health problems are:

• Regular Physical Exams—Smoking, Obesity, Diabetes
• Mammograms—Breast Cancer
• Pap Smears—Cervical Cancer
• Prostate Cancer Screenings—Prostate Cancer
• Colorectal Cancer Screenings—Colorectal Cancer
• High Cholesterol Screenings—Cardiovascular Problems
• High Blood Pressure Screenings—Cardiovascular Problems and Dementia

Health Screenings provide prevention and early detection of chronic diseases and are more efficient in addressing disease than treatment, therefore reinforcing the Commission's avid focus on wellness. Lack of health screenings causes a higher risk for chronic disease, disability, and mortality. This table shows the prevalence of these risk factors (expressed as percent of population) in Mahoning County and Ohio along with the Healthy People 2000 goals:

	MC	OH	HP*
No cholesterol screening (5 yrs.)	25.9	38.5	25
Females 40+ no mammogram	19.5	28.0	20
Females 40+ no mammogram (2 yrs.)	29.5	40.0	40
Adults 40+ no digital rectal exam (1 yr.)	66.2	66.5	60
Adults 50+ no proctoscopic exam	63.5	73.0	60
Females 18+ no PAP test	4.1	6.9	5
Females 18+ no PAP test (3 yrs.)	18.7	20.9	15
Adults who had regular physical exams	NA	74.0	91

* MC = Mahoning County   OH = Ohio   HP = Healthy People 2000 goal

Focus groups of primary care physicians, health care organizations, and the general public were used to gain an understanding of why people do or do not undergo appropriate health screenings. Nearly 60 organizations were surveyed to compile information about existing community resources for health screenings.

Goals

• Increase knowledge and awareness of health screenings.
• Improve availability of screenings, as well as access.

Objectives

Reduce the percentage of:

• Adults who don't have regular physical exams to no more than 9%.
• Adults who haven't had a cholesterol screening in the past five years to no more than 25%.
• Females over age 40 who never had a mammogram to no more than 20%.
• Females over age 40 who haven't had a mammogram in the past two years to no more than 40%.
• Adults over age 40 who haven't had a digital rectal exam in the past year to no more than 60%.
• Adults over age 50 who have never had a proctoscopic exam to no more than 60%.
• Females over age 18 who have never had a pap test to no more than 5%.
• Females over age 18 who haven't had a pap test in the past three years to no more than 15%.

Recommended Frequency Schedule

Health Screening Type	Ages 20-40	Ages 40-50	Ages over 50
Physical Exam	1-2 years	1-2 years	Annually
Blood Pressure	Every exam or 2 years	Every exam or 2 years	Every exam or 2 years
Cholesterol Blood Test	3-5 years	3-5 years	3-5 years
Pap Test	Annually	Annually	Annually
Mammography		Annually	Annually
Breast Self-Exam	Monthly	Monthly	Monthly
Professional Breast Exam	1-2 years	1-2 years	1-2 years
	*** Starting at age 30
Digital Rectal Exam		***Discuss with Provider
Stool Blood Test			Annually
Sigmoidoscopy			3-5 years

Strategies

• Increase media attention to health screening importance by promoting regular newspaper column dedication to local endeavors. The committee recommends that these articles be written by local citizens and that the Mahoning County Medical Society lends its influence and expertise to accomplish this goal.
• Establish and coordinate local organizations to communicate opportunities for health screenings through utilization of the existing community calendar, similar to the one Help Hotline uses, which indicates the critical information for various health screening activities. The committee suggests that the Mahoning County Board of Health (MCBOH) should act as coordinator of this project and that Help Hotline, United Way, YWCA, and YMCA should be active participants and resources for input and distribution. As part of this objective, there should be efforts to use the Internet MCBOH Webpage to communicate all health-screening offerings.
• Inform local primary care physicians and their patients of the importance of health screenings by distributing the "American Heart Association Box" and the U.S. Department of Health and Human Services' "Put Prevention into Practice" and other appropriate materials in local physician's offices, select businesses, and other designated areas. The committee proposes that the accompanying materials would be similar to the ones used by pediatricians at various clinics and private offices to indicate proper health screenings and other health care interventions at various stages of an individual's life.
• Recruit influential area individuals and organizations to stress the importance of health screenings with Leadership Mahoning Valley support.
• Encourage the importance of health screenings throughout the school curricula including elementary, junior high, high school, and YSU by using YSU School of Nursing and local organizations. The committee targets Northeast Ohio Teacher's Day and "Teach the Teachers" as ways to approach this strategy in conjunction with Leadership Mahoning Valley.

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