Prince George’s County Fire/EMS Wellness and Fitness Training December 2007 – CRS 40

Prince George’s County Fire/EMSPrince George’s County Fire/EMSWellness and Fitness TrainingWellness and Fitness Training

December 2007 – CRS 40December 2007 – CRS 40

““Wellness & Fitness For Life” Wellness & Fitness For Life”

Unacceptable Unacceptable Average Life ExpectancyAverage Life Expectancy

6666

ProblemsProblems

Adjusting to “Abnormal Culture” vs. “Normal World”

The National and Departmental “Cultural Attitude” Towards Wellness and Fitness

Health Care System Policy and ProcedureFailure Rate of ProgramsAlcoholism/substance abuseAddictive/Extreme behaviorsPsychological Stress of the public safety officerPhysiological Stress of the public safety officerDepartmental Bureaucracy Organizational and Individual WorkloadRecruitment and Hiring ProcessEconomics

Public Safety Public Safety Typical Personality Typical Personality ProfileProfile

– PerfectionistPerfectionist– Driven to succeedDriven to succeed– Willing to work long and irregular hoursWilling to work long and irregular hours– Ideals of individual service and sacrificeIdeals of individual service and sacrifice– Independent/ self reliantIndependent/ self reliant– Tendency to be a “risk taker”Tendency to be a “risk taker”– ““Adrenalin Junkies”Adrenalin Junkies”

““Wellness” - DefinedWellness” - Defined

SpiritualSpiritual

CareerCareer

FinancialFinancial SocialSocial

FamilyFamily

EmotionalEmotional

PhysicalPhysical

DimensionsOf

Wellness

DimensionsOf

Wellness

““Tip of the Spear”Tip of the Spear”

Health risk factors:Health risk factors:

Uncontrollable factorsUncontrollable factors

- Increasing age- Increasing age- Sex (gender)- Sex (gender)- Hereditary (including race)- Hereditary (including race)

Controllable and/or treatable by changing lifestyle or medicineControllable and/or treatable by changing lifestyle or medicine

- Abnormal lipid profile (Cholesterol)- Abnormal lipid profile (Cholesterol)- Hypertension - Hypertension

- Obesity (Increase BMI, - Obesity (Increase BMI, >>30 lbs overweight)30 lbs overweight) - Sedentary lifestyle - Sedentary lifestyle - Smoking- Smoking

- Diabetes- Diabetes - Poor nutrition- Poor nutrition

Cardiac Risk Factor ProfileCardiac Risk Factor ProfileAmerican College of Sports Medicine Risk StratificationAmerican College of Sports Medicine Risk Stratification

The Risk FactorsThe Risk Factors

• AgeAge • Family Cardiac History Family Cardiac History • *Abnormal Cholesterol Levels*Abnormal Cholesterol Levels • *High Blood Pressure *High Blood Pressure • *Obesity *Obesity • *Sedentary Lifestyles *Sedentary Lifestyles • *Smoking *Smoking • *Diabetes*Diabetes

*Identified as primary risk factors by American Heart Association*Identified as primary risk factors by American Heart Association

ControllableControllable

Risk Factor AgeRisk Factor Age

Defining CriteriaDefining Criteria

-Male > 45 years old-Male > 45 years old

-Female > 55 years old-Female > 55 years old

Risk Factor Family HistoryRisk Factor Family History

Defining CriteriaDefining Criteria

--Male = Heart attack or sudden death before age Male = Heart attack or sudden death before age 5555 of father, brother, or son. of father, brother, or son.

-Female = Heart attack or sudden death before age -Female = Heart attack or sudden death before age 6565 of mother, sister or daughter. of mother, sister or daughter.

Risk Factor Risk Factor Hyper-CholesterolemiaHyper-Cholesterolemia

Defining CriteriaDefining Criteria-Total serum cholesterol is -Total serum cholesterol is > 200 mg/dL> 200 mg/dL

-HDL (high density lipid) “good” cholesterol is <-HDL (high density lipid) “good” cholesterol is < 40 mg/dL 40 mg/dL

-LDL (low density lipid) “bad” cholesterol is -LDL (low density lipid) “bad” cholesterol is > 130 mg/dL> 130 mg/dL

-Currently on cholesterol medication. -Currently on cholesterol medication.

**Note: Negative Risk factor if HDL is > **Note: Negative Risk factor if HDL is > 60 mg/dL60 mg/dL****

Good, Bad, and Ugly CholesterolGood, Bad, and Ugly Cholesterol

“GOOD”

High Density Lipids (HDL)

Good, Bad, and Ugly CholesterolGood, Bad, and Ugly Cholesterol

“Bad”

Low Density Lipids (LDL)

Good, Bad, and Ugly CholesterolGood, Bad, and Ugly Cholesterol

“Ugly” Total Cholesterol > 200

High Density Lipids (HDL) < 40

Coronary Risk Ratio > 5.0

Good, Bad, and Ugly CholesterolGood, Bad, and Ugly Cholesterol

“Ideal” Total Cholesterol < 200

High Density Lipids (HDL) > 40

Coronary Risk Ratio < 5.0

**Negative Risk factor if HDL is > **Negative Risk factor if HDL is > 60**60**

Risk Factor HypertensionRisk Factor Hypertension

Defining CriteriaDefining Criteria

--Systolic blood pressure Systolic blood pressure >> 140 mmHg 140 mmHg

-Diastolic -Diastolic >> 90 mmHg 90 mmHg

-Confirmed on at least two separate readings.-Confirmed on at least two separate readings.

-Currently on high blood pressure medication. -Currently on high blood pressure medication.

What are High Blood Pressure Risks?What are High Blood Pressure Risks?

Likelihood of cardiovascular event by Likelihood of cardiovascular event by the chronic hypertensive numbers……the chronic hypertensive numbers……

115/75…………………………….Normal115/75…………………………….Normal

135/85……………………………. 3X135/85……………………………. 3X

155/95……………………………. 4X155/95……………………………. 4X

175/105………………………….. 8X175/105………………………….. 8X

*National Heart, Lung & Blood Institute*National Heart, Lung & Blood Institute

Risk Factor ObesityRisk Factor Obesity

Defining CriteriaDefining Criteria

--Body Mass Index Body Mass Index >> 30 30 ~ 30lbs over ideal weight~ 30lbs over ideal weight

-Male waist girth -Male waist girth >> 40 inches40 inches -Female waist girth -Female waist girth >> 35 inches35 inches

*Use clinical judgment when evaluating obesity and BMI*Use clinical judgment when evaluating obesity and BMI

ObesityObesity CAN CAUSECAN CAUSE Premature deathPremature death Cardiovascular DiseaseCardiovascular Disease High Blood PressureHigh Blood Pressure OsteoarthritisOsteoarthritis Some CancersSome Cancers DiabetesDiabetes

Sedentary lifestyle

Hypertension

Smoking

Diabetes

Poor nutrition

Abnormal lipid profile

(Cholesterol)

Obesity

PATTERNPATTERNSS

Obesity Trends Among U.S. Adults Obesity Trends Among U.S. Adults between 1985 and 2006between 1985 and 2006

Obesity Trends Among U.S. Adults Obesity Trends Among U.S. Adults between 1985 and 2006between 1985 and 2006

Source of the data:Source of the data:The data shown in these maps were collected The data shown in these maps were collected through CDC’s Behavioral Risk Factor Surveillance through CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Each year, state health System (BRFSS). Each year, state health departments use standard procedures to collect departments use standard procedures to collect data through a series of monthly telephone data through a series of monthly telephone interviews with U.S. adults.interviews with U.S. adults.Prevalence estimates generated for the maps Prevalence estimates generated for the maps may vary slightly from those generated for the may vary slightly from those generated for the states by BRFSS (http://aps.nccd.cdc.gov/brfss) as states by BRFSS (http://aps.nccd.cdc.gov/brfss) as slightly different analytic methods are used.slightly different analytic methods are used.

Source of the data:Source of the data:The data shown in these maps were collected The data shown in these maps were collected through CDC’s Behavioral Risk Factor Surveillance through CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Each year, state health System (BRFSS). Each year, state health departments use standard procedures to collect departments use standard procedures to collect data through a series of monthly telephone data through a series of monthly telephone interviews with U.S. adults.interviews with U.S. adults.Prevalence estimates generated for the maps Prevalence estimates generated for the maps may vary slightly from those generated for the may vary slightly from those generated for the states by BRFSS (http://aps.nccd.cdc.gov/brfss) as states by BRFSS (http://aps.nccd.cdc.gov/brfss) as slightly different analytic methods are used.slightly different analytic methods are used.

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1986

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1987

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1988

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1989

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1991

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1992

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1993

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1994

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1996

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1997

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 1998

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 1999

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2000

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2001

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2002

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2004

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2005

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2006

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Risk Factor Risk Factor Sedentary LifestyleSedentary Lifestyle

Defining CriteriaDefining Criteria

--Persons Persons notnot participating in regular exercise participating in regular exercise program.program.

-Persons -Persons notnot accumulating accumulating 30 minutes30 minutes of of moderate physical activity at least moderate physical activity at least 4 – 7 days 4 – 7 days per weekper week..

Muscular StrengthThe ability to exert a maximal force at a given

speed in a single voluntary contraction.

Muscular EnduranceThe ability to exert a sub-maximal force for voluntary contractions or

one extended contraction.

Cardio-Pulmonary EnduranceThe ability of the heart and lungs to

deliver oxygen to working muscles for extended periods of time.

FlexibilityThe ability to have a range of motion at a joint

and/or spine.

Durable and Multi-Disciplined

Public Safety

Fitness

Risk Factor Risk Factor Tobacco UseTobacco Use

Defining CriteriaDefining Criteria

--Current tobacco user of any typeCurrent tobacco user of any type (cigarette, (cigarette, cigar, pipe, chewing tobacco)cigar, pipe, chewing tobacco)

-Tobacco user that has -Tobacco user that has quitquit within last 6 monthswithin last 6 months..

Risk Factor Risk Factor DiabetesDiabetes

Defining CriteriaDefining Criteria

-Physician diagnosed diabetes (insulin, diet -Physician diagnosed diabetes (insulin, diet or exercise controlled)or exercise controlled)

Is there something on your six?Is there something on your six?

S T R E S S

A Healthy Stress PatternA Healthy Stress Pattern

Excited

Relaxed Ah!

Uh Oh!Normal

A Unhealthy Stress PatternA Unhealthy Stress Pattern

Excited

Relaxed

Uh Oh!

Breakdown

Uh Oh!

Uh Oh!

Commonly Used Maladaptive Coping Techniques

Harder, Faster, BetterHarder, Faster, Better

Hyper-ActivityHyper-Activity

Impulsive and Reckless Impulsive and Reckless Behavior w/o ThoughtBehavior w/o Thought

Substance AbuseSubstance Abuse

S T R E S S

PURSUIT OF OUTSIDE INTERESTS/ HOBBIES

S T R E S S

DIETDIET

LongevityLongevityThe Centenarian Personality*The Centenarian Personality*

What can you learn from 100 year old people?What can you learn from 100 year old people?

SenseOf

Humor

SenseOf

Hope

Willing To

EngageHealthyCoping

Mechanisms

PracticesStress

Reduction

NoMajor

Illnesses

NotObese

Never Smoked

Centenarian>100 years

*Information taken from “Aging Smart…Aging Well” Monika White, PhD, President/CEO Center for Healthy Aging, March 2006

Take Home MessageTake Home Message

Take Home MessageTake Home Message

Take personal responsibility for your Wellness

Take Home MessageTake Home Message

Take personal responsibility for your WellnessAvail yourself of Proper Resources

Take Home MessageTake Home Message

Take personal responsibility for your wellnessAvail yourself of proper resourcesEstablish & practice good habits

FOR MOST OF US….

FOR MOST OF US….

CHANGE ISN’T EASY

Thanks

For questions & comments cdbussing@co.pg.md.us