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From its start as a locally owned, non-profit hospital 110 years ago, Lancaster General has been dedicated to advancing the health and quality of life of the individuals and communities we serve by providing superior healthcare that demonstrates community benefit.

Lancaster General looks outside its walls to collaborate with individuals, organizations and agencies to proactively address issues that affect health.

As Lancaster County’s healthcare leader and a steward of community resources, we carefully evaluate and track program outcomes, measure effectiveness, reduce duplication of services and set direction to align our programs with state and national goals.

Using federal reports like Healthy People 2010, which recognizes and establishes national health goals, as well as state and local reports and a community advisory committee, we identify healthcare needs to address in Lancaster County.

While we strive to address all healthcare issues in our community, from prenatal education to care for seniors, certain issues are of particular concern in our community. We’ve identified these three areas as priorities:

• Overweight and Obesity • Tobacco Use • Domestic Violence

Following is an outline of how we dedicate our resources to promote awareness and action around these priority issues. Overweight and Obesity

According to the Centers for Disease Control (CDC), obesity in the United States has risen at an epidemic rate during the past 20 years.

In fact, 60 percent of Lancaster County adults are overweight, according to information from the 2003 Measure Up Lancaster report. One of the national health objectives outlined in Healthy People 2010 is to reduce the prevalence of obesity among adults to less than 15 percent by 2010.

For adults, “overweight” is defined by the National Institutes of Health as having a Body Mass Index (BMI) of 25 or greater. Obesity is indicated by a BMI of 30 or greater. While BMI is a useful screening tool, it is not a definite measure of who is overweight and obese.

Statistics on overweight children are also alarming. During the past 20 years, the number of obese children in the United States has doubled to one in five. In Pennsylvania, more than 17 percent of youth ages 10-12 are overweight, three percentage points above the national average of 14 percent.

In response to the alarming trend of overweight adults and youth, Lancaster General researched dozens of weight loss programs to identify those that could help make a positive effect on our community.

L.E.A.R.N., which stands for Lifestyle, Exercise, Attitude, Relationships and Nutrition, is one of the most thoroughly tested lifestyle change programs available for weight management.

Developed 22 years ago by Kelly Brownell, PhD, the 10-week program addresses reading and understanding food labels, smart food shopping, dining out strategies, behavior modification to recognize and change unhealthy eating patterns, nutrition education and eating a balanced diet.

For children and teens, Lancaster General offers Shapedown, a comprehensive, family-inclusive program for weight management.

Designed by the University of California, San Francisco School of Medicine faculty, Shapedown has been selected by the American Medical Association as an exemplary health promotion program and has received the award of excellence in consumer education from the National Food and Drug Administration.

The keys to any weight management program are diet and exercise. According to the 2003 Measure Up Lancaster report, only 46 percent of Lancaster County residents exercise regularly. Lancaster General works to help all individuals maintain a regular exercise routine through programs such as:

Over 50 & Fit walking program at the Health CampusOver 50 & Fit is a walking and exercise club for people over age 50. It meets weekly at the Lancaster General Health Campus.

Heart Healthy Yoga, Yoga for Breast Cancer Survivors and Yoga for New Mothers provides the benefits of a yoga class with modifications for medical conditions. Qigong and Tai Chi, offered at the Wellness Center, help improve flexibility and mobility for those dealing with chronic illness.

Pregnancy Plunge, offered in conjunction with the Lancaster Family YMCA, and Maternal Motion, offered in partnership with the YWCA of Lancaster, provide exercise and instruction for expectant mothers.

Through Lancaster General Cardiac Rehabilitation and Physical Rehabilitation, patients who have undergone treatment for disease can ease back into an exercise routine with the help of our trained staff.

Additionally, Lancaster General partners with other organizations to provide opportunities for physical activity while supporting important community causes. Last year we sponsored the American Heart Association Heart Walk, American Cancer Society’s Relay for Life, Diabetes Walk for a Cure, the YWCA Race Against Racism and helped initiate Lancaster Movers & Shapers.

Tobacco Use
According to the state Department of Health, one of every five Lancaster County residents dies from a tobacco-related illness.

Tobacco use is a major contributing factor in heart disease, lung disease, stroke and cancer. Second-hand smoke also is associated with Sudden Infant Death Syndrome (SIDS), asthma and chronic respiratory infections in children.

Lancaster General is one of the organizers of the Tobacco-Free Coalition of Lancaster County, a group dedicated to decreasing tobacco use, and illness and death related to tobacco use in our community. The coalition is the governing body of the Pennsylvania Tobacco Settlement Funds which are overseen by the Lancaster County Drug & Alcohol Commission.

Twelve percent of the Tobacco Settlement Funds must be used directly for tobacco prevention and cessation programs. Lancaster General has worked closely with this coalition to identify needs and provide programs aimed at making Lancaster a tobacco-free community.

LifeSkills education helps children resist tobacco, alcohol and drugsRecognizing that a lifetime of tobacco use often begins during adolescent years, Lancaster General implemented LifeSkills in 2002. Touted by the CDC as a “best practice program” for preventing youth from starting to smoke, LifeSkills is taught in eight Lancaster County school districts and seven private schools by Lancaster General staff.

Adults who smoke can receive help in quitting through Freedom from Smoking at Lancaster General, a seven-session class that provides support and education for those interested in kicking the habit. Participants who successfully quit are rewarded for their efforts with a refund of their program fee. In addition, Lancaster General Hospital and Women & Babies Hospital started one-on-one counseling for patients who want to stop smoking.

Using our relationship with the physician community, Lancaster General helped increase the number of clinicians who routinely counsel smokers to quit, increase quitting attempts and rates and reduce the number of individuals who are regularly exposed to tobacco smoke by providing training through Clean Air. The Clean Air program is adapted from the Clean Air for Healthy Children program, which reflects the CDC best practices and the Agency for Healthcare Research and Quality guidelines.

Domestic Violence
An overwhelming amount of domestic violence goes unreported, even though it can reach into many areas relating to quality of life.

Victims of domestic violence are at greater risk for poverty, homelessness, quitting school and becoming part of an ongoing cycle of violence.

As a member of the Lancaster Coalition Against Family Violence, Lancaster General works with the medical community, social service agencies, the faith community, schools, shelters and others to provide training to recognize domestic violence and provide assistance.

We trained our staff and physicians to recognize the signs of domestic violence and to properly, and sensitively, intervene to help victims.

Posters and resource cards, printed by Lancaster General, hang in Lancaster General facilities, as well as hundreds of locations throughout the county where domestic violence victims can discreetly access them. Materials are available by calling the Wellness Center at (717) 544-3138.

As a member of the Sexual Assault Forensic Examiner (SAFE) program with the YWCA and the county District Attorney’s office, Lancaster General provides specially trained nurses who are on-call 24 hours a day, as well as a private waiting and examination area to aid in evidence collection and care of sexual assault survivors.

We also continued our partnership with pediatrician Cathy Hoshauer, MD, for a child sexual assault center on the pediatric unit of Lancaster General Hospital, which provides a child-friendly atmosphere in which children can be examined and treated.

Exposure to violence in early life can produce changes in brain chemistry and function that appear to be permanent. It is a risk factor for many later problems, including teen violence, self-mutilation and general lack of impulse control. It affects the involved child’s ability to learn and to become a productive citizen, increases demands on social services and schools and can affect the quality of life for the entire community.

The Nurse-Family Partnership program helps new mothers develop proper parenting skillsAs part of Healthy Beginnings Plus and the Nurse-Family Partnership, specially trained Lancaster General nurses reinforce positive parenting skills during a child’s early years and support new mothers in caring for their child.

An Ongoing Commitment
We are thankful for the many community partners that help us address community needs surrounding these important areas. There are numerous other areas where we work, side by side with hundreds of people in organizations and associations throughout the county who share our passion for creating a healthier community.

Our annual community health report, due out in early 2005, details the ongoing work in improving our community’s health. To receive a copy of the annual report or to learn more about Lancaster General community health initiatives, log onto www.LancasterGeneral.org or contact Alice Yoder, Director of Community Health, (717) 544-3283, amyoder@LancasterGeneral.org.