It’s Hot Outside! Reducing Heat-Related Illness

Card-5-5x8-5-Its-Hot-Out-07-15-16-EmailReducing Heat-Related Illness in Older Adults

As the temperature goes up, so do the risks of getting sick from being too hot. Temperatures as low as 75 F can contribute to heat-related illness, particularly among those who are active and for some people with special needs. Temperatures inside can also be much higher than temperatures outside, especially if homes are not air conditioned or well managed for maximum cooling.

TIP: During an extreme heat event, check on at-risk friends, family, neighbors, employees, and others at least twice a day.

Early in 2015, the Public Health Council received funding from the Climate and Health Program of the NH Division of Public Health Services to generate an Upper Valley Climate and Health Adaptation Plan. The plan, CLIMATE+HEALTH, was published in November 2015 with help from the Upper Valley Lake Sunapee Regional Planning Commission, Dartmouth-Hitchcock, and members of the Upper Valley Adaptation Workgroup. CLIMATE+HEALTH identifies increasing exposure to extreme heat and severe weather events as priority issues in the Upper Valley region. People involved in developing the plan also determined the elderly and lower income populations would be the most affected by a climate change-related event.

The Heat and Older Adults Pilot Project is the second concrete activity to emerge from the CLIMATE+HEALTH plan. The first was Climate Change Impacts to Health: A Community Forum hosted on March 30, 2016, by members of the Upper Valley Adaptation Workgroup.

Heat and Older Adults Pilot Project

For the Heat and Older Adults Pilot Project, the PHC partnered with Grafton County Senior Citizens Council, Plainfield Caring Neighbors, and the Upper Valley Ambulance Service.  “Caregivers” in these organizations provide education, outreach, and resources to older adults who may be at risk for heat-related illness during very hot weather. These organizations agreed to help evaluate this pilot phase. Based on results and feedback from our partners, we hope to make the project more widely available by next summer. We also plan to expand our target groups to include people with chronic health conditions or disabilities, people who work outdoors, and athletes and people who exercise.

Grant funds from the NH Climate and Heat Program paid for the development of a Toolkit used to train people who interact with older adults, especially those who are more isolated. The people trained can be volunteers, service providers, family members, or anyone who provides companionship to an older person. We call them the “caregivers”. The Toolkit contains important information that you can download and use today:

As of July 27, 2016, the materials in the Toolkit are available to anyone in the Upper Valley who would like to use them. You can download Toolkit materials here or contact Alice Ely for hard copies.  You may also request information cards, magnets, and tumblers which were designed as handout materials for distribution to older adults, though quantities are limited.

To learn more about the effects of extreme heat, visit:

US Centers for Disease Control and Prevention, Extreme Heat

NH Climate and Health Program

NH Environmental Public Health Tracking Program

VT Climate Change Adaptation Program

“Serve Local” with Upper Valley Strong

Dan-xxx-Faye-Kinley-Nan copy After Tropical Storm Irene, temporary Long-Term Recovery Committees popped up all across the state to help coordinate support for flood victims, and Upper Valley Strong (UVS) was one. When a localized flood hit the Upper Valley again in 2013, UVS immediately jumped in to coordinate relief efforts and support volunteers and homeowners. UVS aligned with Two Rivers-Ottauquechee Regional Commission (TRORC) as well as the Upper Valley Lake Sunapee Regional Planning Commission (UVLSRPC) to obtain disaster-related information and create a cohesive approach to response and recovery. Staff and committee members already had the relationships and local knowledge to quickly gather resources – from shovels and wheelbarrows to dig out, to new appliances for residents, and volunteers to assist. The disaster relief and recovery processes were efficient and fast, largely because UVS was already in place.

It was clear to UVS that the region needed a permanent group in place to maintain relationships, coordinate resources, and hit the ground running when a disaster happened. And so, UVS became Vermont’s first Community Organization Active in Disaster (COAD). COADs are growing in popularity across the Unites States. These voluntary groups consist of nonprofits, corporations, faith-based groups, and other organizations that can play a role in disaster recovery. COADs help coordinate local resources, oversee individual recovery, and support volunteers. They also coordinate efforts with other local, state, and federal organizations during an emergency.

UVS is unique in its alignment with the Regional Planning Commisions of both the New Hampshire and Vermont regions within the Upper Valley. Though these relationships present challenges in terms of establishing consistent funding between disasters and coordinating local operations during an emergency, UVS believes that partnering with our region’s RPCs makes disaster response more sustainable and effective. Perhaps most importantly, COADs offer disaster case management, which is required for people to receive money from organizations like the Vermont Disaster Relief Fund. “The value contributed to the community by COADs such as Upper Valley Strong during disaster recovery cannot be overstated” says Wesley Miller, the Upper Valley’s Public Health Emergency Preparedness Coordinator.

In many ways, their name speaks for itselfDan – Upper Valley Strong is an organization that capitalizes on the inherent strengths of our communities to help people recover following a disaster. They not only support local agencies like the Upper Valley Haven, COVER, SEVCA and the Upper Valley Housing Coalition, but also train and mobilize a strong contingent of dedicated volunteers. According to Miller, “without the dedication and spirit of community shown by these volunteers, the crushing effects of disaster events would weigh on community members for a significantly longer period of time.  Upper Valley Strong has a long history and demonstrated capacity to support our local communities during these most challenging  times.”

UVS trainings provide volunteers with information about how to conduct themselves safely and effectively on disaster sites. These programs are available to corporations, groups, and anyone interested in learning more about helping their neighbors in times of disaster. As one UVS volunteer from Hypertherm, Pete Twarog, spoke about in a recent interview, we all see far off disasters on the news every day, but it is difficult to have a direct impact even when we feel drawn to help. What UVS works to instill is a “serve local” mentality. “Help out your neighbor. Your neighbor may be the next person who needs you, so be ready,” Twarog says. To learn more about how you can be ready to lend a hand when your community needs you, contact Upper Valley Strong, and check out their training promotion video.


Major Updates to Website

TheNHHealthCost New Hampshire Insurance Department recently announced major consumer-oriented updates to its nationally recognized health cost transparency website, NH residents can use the website to search and compare the cost estimates of medical and dental procedures and retail prescription drug costs. Medical care can be costly, and most people may not know what they will need to pay until they receive a bill in the mail. Services can also vary by hundreds or even thousands of dollars, depending on the facility and insurance company. NH HealthCost is a helpful resource for people who want to make more informed decisions about how to manage their health care dollars.

NH HealthCost includes:

  • 67 medical procedure cost estimates, including X-rays, physical therapy, lab tests, and more.
  • 16 dental procedure cost estimates, including cleanings, X-rays, fillings, and more.
  • 65 retail prescription costs for generic and brand name drugs
  • Searchable quality measures for NH hospitals, including patient experience, infection prevention, and more.
  • Guide to Health Insurance, to answer your questions about finding a plan, using insurance, and managing your costs.

A major new component of the updated website is quality of care data. This new section of the website offers a convenient way to view nationally available quality data on local health care facilities, such as infection rates, patient experience, and readmissions. Knowing more about the cost and quality of care means that patients can have a better understanding of the medical services they can expect to receive before their appointment.

For those who are new to health insurance or want to learn more, the website now includes a “Guide to Health Insurance.” The guide features commonly asked questions about getting health insurance, navigating the insurance system, and how to manage costs. The guide is also interactive. Users can submit their own questions and give feedback.

NH HealthCost, which was created by the NH Insurance Department in 2007, uses actual anonymous paid health insurance claims data, collected from the state’s insurers, to show cost estimates for health care procedures at facilities across the state. The website allows people to see the total costs of their procedures, including physician fees, lab fees, and facility fees, based on their insurance company, deductible, and co-insurance. Uninsured NH residents can also see how much they will need to pay out-of-pocket for medical costs.

New Hampshire is considered a national leader in health care transparency. In 2015, it was the only state in the country to earn an A on a national report card on access to health care prices, issued by the Catalyst for Payment Reform and Health Care Incentives Institute. The report card cited NH HealthCost as “a prime example of a price transparency website built with consumers in mind.”

The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. For more information, visit

Representatives of NH Health Cost will provide an overview of the website at the PHC meeting on June 17, 2016. That meeting will be held from 9 to 11 am at Hypertherm, 71 Heater Road.

Report on Climate and Health Forum

cloverFollowing up on the Upper Valley Adaptation Workgroup’s recent Climate Change Impacts to Health Forum, the Valley News reported on the productive discussion and information sharing that took place during the evening.

Though the event began with education around how the climate is changing in our region, presenter Erich Osterberg, a climatologist at Dartmouth College, encouraged attendees not to get lost in the statistics. He emphasized that seemingly small temperature and precipitation changes can have lasting impacts on the environment and on the health of those living in the Upper Valley. The forum, as Rich Jurgens of the Valley News reported, was convened “not to debate the reality of climate change, but to prepare for it.”

Presentations following the climate overview by Osterberg included reports from Matt Cahillane of the Climate and Health Program in New Hampshire and Jared Ulmer of the Vermont Climate Change Adaptation Program, which outlined current efforts to build resilience to climate effects in the two states. Public Health Council Coordinator Alice Ely also presented the PHimage1C’s Climate and Health Adaptation Plan, and introduced a pilot project that will be run over the summer to begin to address the needs of older adults during extreme heat events. Older adults, who are especially vulnerable to heat related health issues, are a rapidly growing sector of the Upper Valley’s population. Ely says that the PHC hopes the pilot project will help establish strategies that will work for our region to inform future initiatives, and that it will begin to address a current need area at the same time.

The forum was attended by municipal leaders, emergency preparedness personnel, public health and medical professionals, social service providers and passionate community members. With several opportunities for audience members to give feedback and engage in discussion with presenters and each other, the forum was a tangible first step in building the community based networks that will be necessary to address  climate change impacts in the Upper Valley.

Upper Valley Trails – Inside and Out

trail1It’s beginning to feel a lot like spring time here in the Upper Valley! Though we’ve experienced fewer sub freezing days then last winter, the warmer temperatures and the first scents and sights of spring always feel like a refreshing beginning. But while the Upper Valley usually provides plenty of opportunities for winter recreation and May flowers will be popping up before we know it, this dreaded in between period – Mud Season – can often be a tricky time to enjoy the outdoors and get exercise.

Regardless of whether the ground outside is white, green or brown, it’s important for people of all ages to spend part of their day being physically active. Studies have shown that regular, moderate intensity exercise can maintain healthy weight, strengthen bones, reduce the risk of cancer, diabetes, and heart disease, improve mental health, and ultimately prolong life. The CDC recommends that adults get in 2 hours and 30 minutes per week of moderate intensity aerobic exercise, such as walking, and that they do an activity that works all the major muscle groups at least 2 times per week. The numbers may sound daunting, and with the busy lives we lead, it is no wonder that 4 out of 5 adults are not getting the recommended amount of physical activity.

Fortunately, in our region, there are lots of ways to get moving, even without a gym membership or fancy equipment. Our own neighborhoods are the perfect place to get fresh air and physical fitness, and the Upper Valley Trails Alliance can help you find a path to wellness that is right for you. Founded in 1999 after a multi-community needs assessment, UVTA “advocates for the use, maintenance, and development of trails in the Upper Valley through education, outreach and stewardship.” Put simply, the Upper Valley Trails Alliance wraps environmental preservation and appreciation into one bundle – helping you take advantage of our area’s natural resources to lead a healthy life style. UVTA compiles wonderful trail information for everyone, from experts to those who are just getting started. Their indoor walking paths are perfect for the days when sun sets before you can leave the office, or for times when its too chilly, icy or unpredictTrail Finder logo with round borderable to brave the outdoors. As the days get longer and the weather continues to warm, check out the Trail Finder. This comprehensive database of trails lets you search for routes by location, difficulty level, and activity. In fact, the trail finder is for far more than just walking. It can help you find fire tower hikes for you and the family, bike paths, and paddling routes – in the Upper Valley and beyond!

When you’re thinking about exercising outdoors this time of year, and when you are using trails in general, it’s always important to consider safety first. Make sure to tell someone where you are going if you are checking out a new trail. Bring warm layers and a headlamp – sometimes a route can take longer than you expect, and its important to be sure you can make it back safely. Check in with the Trail Manager, whose contact information can be found on the Trail Finder listing, to get up to date information about trail conditions. For avid and experienced trail users, the Upper Valley Trail Runners maintain an active Facebook page, with up to date trail conditions and advice about the types of shoes or equipment that are best for the current terrain. Don’t be intimidated by their enthusiasm for running long miles though – trails are for everyone, and with routes ranging from 0.2 (Pine Point Trail) to nearly 300 miles (the Appalachian Trail) the Trail Finder can certainly help you discover a path that’s right for you.

To learn more about the Upper Valley Trails Alliance, and their efforts to preserve and promote the use of our areas land resources, visit their website at As of March 7th, several outdoor trails in the Lebanon and Norwich are closed until the end of mud season to allow them to dry out, but check in with the Trail Managers for updates – and maybe give some of those indoor routes a try in the meantime!