Murray Sagsveen State Health Officer North Dakota Department of Health

CHEMISTRY Myra Kosse ENVIRONMENTAL ENGINEERING Dana Mount MUNICIPAL FACILITIES Jack Long WASTE MANAGEMENT Neil Knatterud WATER QUALITY Dennis Fewless ENVIRONMENTAL HEALTH SECTION Francis Schwindt STATE HEALTH OFFICER Murray G. Sagsveen ADVISORY COUNCIL Jim Brosseau, M.D. Julie Blehm, M.D. Dennis Wolf, M.D. GOVERNOR Edward T. Schafer North Dakota Department of Health February 1, 1998

State Health Council Howard C. Anderson Chairman Health Care Industry Turtle Lake, ND Gary Riffe Vice Chairman Health Care Industry Jamestown, ND Darlene Rinn Secretary Consumer Minot, ND Ronald A. Anderson Consumer Keene, ND Jim Brosseau, M.D. Health Care Industry Grand Forks, ND Lowell Herfindahl Health Care Industry Tioga, ND Linda Nelson Consumer Casselton, ND Clifford R. Porter Energy Industry Bismarck, ND Joel Smith Manufacturing/Processing Industry Fargo, ND Carmen Toman Consumer Grand Forks, ND Lori Wightman Consumer Fargo, ND

Advisory Council  James D. Brosseau, M.D. Internal Medicine Altru Health Systems, Grand Forks, ND  Julie A. Blehm, M.D. Internal Medicine Medical Arts Clinic, P.C., Minot, ND  Dennis E. Wolf, M.D. Family Practice Great Plains Clinic, Dickinson, ND

Mission Statement We, as public employees, are dedicated to the goal of assuring that North Dakota is a healthy place to live and to the belief that each person should have an equal opportunity to enjoy good health. To accomplish this mission, we are committed to the promotion of healthy lifestyles, protection and enhancement of the environment and provision of quality health care services for the people of North Dakota.

Vital Signs On an average day in North Dakota:  23.5 babies are born, 5.5 of them are born out of wedlock and 2 are born to teenage mothers  16 people die, 5 of them from heart disease and 3.75 from cancer  13 people get married and 6 people get divorced Source: ND Dept. of Health, Vital Records

Vital Signs In an average week:  1.2 infants die  1.4 children between ages 1 and 19 die  1.5 people commit suicide  3 people die from diabetes  4 people die from influenza and pneumonia  4.4 people die as a result of accidents Source: ND Dept. of Health, Vital Records

Vital Signs In an average month:  1 person younger than age 20 commits suicide  2.7 people die as a result of some type of accident  is the average age at death Source: ND Dept. of Health, Vital Records

Resident Live Births North Dakota ~ Source: ND Dept. of Health, Vital Records **Estimate **

Urban-Rural Population Distribution North Dakota, Source: U.S. Bureau of the Census

Population Distribution North Dakota Source: U.S. Bureau of the Census

Expenditures by Section July 1, 1995 through June 30, 1997 Total Expenditures = $65.6 Million Source: ND Dept. of Health, Administrative Services

Sections of the North Dakota Department of Health  Administrative Services  Preventive Health  Environmental Health  Health Resources

Administrative Services Section The Administrative Services Section provides support services to all divisions of the North Dakota Department of Health and assists in coordinating department activities. Administrative Services Section

Office of Statistical Services:  Collects data about the health of North Dakotans  Conducts research about North Dakotans’ health and use of health care services  Produces reports for external and internal audiences and  Conducts health policy research Administrative Services Section

The Crime Lab Division is responding to the growing problem of illegal drug use. Number of Forensic cases opened:  4,445 in 1997  4,022 in 1996  3,900 in 1995 Administrative Services Section

Preventive Health Section The goal of the Preventive Health Section is to promote good health and prevent illness and disease.

The Maternal and Child Health Division works to improve the health of:  Women  Infants and children  Adolescents Preventive Health Section

The Disease Control Division deals with:  Disease outbreaks  Immunizations  Sexually transmitted diseases  Injury prevention  Chronic diseases Preventive Health Section

The Health Promotion and Education Division educates North Dakotans about:  Cancer prevention and control  Tobacco prevention and control  Cardiovascular disease  Healthy lifestyles for school-age children Preventive Health Section

The Food and Lodging Division protects public health through licensure and inspection of:  Restaurants and bars  Hotels and motels  Mobile home parks  Campgrounds Preventive Health Section  Bed and breakfasts  Retail food stores  Meat markets and  Bakeries

The Microbiology Division provides diagnostic and referral services:  Conducts testing for many exotic diseases and emerging infections and  Serves as the state lab for FDA dairy and EPA water bacteriological testing programs Preventive Health Section

Local Public Health Units 24 single and multi-county health departments provide the following services:  Maternal and child health programs  Health promotion  Communicable disease programs  Spousal and child abuse programs  School health screening and education  Environmental health programs  Home health visits Preventive Health Section

Burleigh Oliver Dunn Slope Bowman Billings Golden Valley Stark Hettinger Adams Sioux Grant Mercer Morton Mountrail Williams McKenzie Divide Burke McHenry McLean Ward Renville Bottineau Kidder Dickey Emmons McIntosh Stutsman Logan La Moure Sargent Richland Barnes Ransom Cass Ramsey Eddy Wells Sheridan Foster Rolette Pierce Benson Towner Nelson Steele Griggs Traill Grand Forks Cavalier Walsh Pembina Multi County Health District Single County Health District City/County Health Department Single County Health Department None January 1999 Local Public Health Units Preventive Health Section City/County Health District

Environmental Health Section The goal of the Environmental Health Section is to safeguard the quality of North Dakota’s air, land and water resources.

EHS issues environmental permits for:  Wastewater discharges (800 facilities)  Air Pollution (900 facilities)  Hazardous wastes (9 facilities)  Solid waste (14 municipal, 25 industrial and special)  Feedlots (900 facilities) Environmental Health Section

Other EHS Programs  Drinking water (600 systems)  Radiation Control (80 radioactive licenses and 750 X-ray)  Underground storage tanks (3,450 tanks)  Revolving loan programs  Wastewater treatment - $6.5 million per year  Drinking water - $24 million the first two years  Groundwater quality Environmental Health Section

Chemistry Lab  Organic analysis (man-made components, such as pesticides)  Inorganic analysis (naturally occurring compounds, such as fertilizer) Environmental Health Section

The Division of Health Facilities works to: assure that services are consistent with accepted standards of practice and that building structures meet established requirements. Health Resources

The Division of Health Facilities monitors:  Buildings  Equipment and  Services to people Health Resources

Emergency Health Services The Division of Emergency Health Services is the lead agency for North Dakota’s Emergency Medical Services (EMS) System. Health Resources

Current Issues  Tobacco legislation  Teen suicide  Access to health care services in rural North Dakota  Partnership between the North Dakota Department of Health and local public health departments  Shaken Baby Syndrome Spring 1998

Source: ND Dept. of Health, Health Resources Section

Source: ND Dept. of Health, Health Resources Section and Office of Statistical Services

                                              Burleigh Oliver Dunn Slope Bowman Billings Golden Valley Stark Hettinger Adams Sioux Grant Mercer Morton Mountrail Williams McKenzie Divide Burke McHenry McLean Ward Renville Bottineau Kidder Dickey Emmons McIntosh Stutsman Logan La Moure Sargent Richland Barnes Ransom Cass Ramsey Eddy Wells Sheridan Foster Rolette Pierce Benson Towner Nelson Steele Griggs Traill Grand Forks Cavalier Walsh Pembina Hospitals North Dakota ~ 1999 Source: ND Dept. of Health, Health Resources Section

Total Population North Dakota ~ Source: U.S. Bureau of the Census

Population Age 65 and Over North Dakota ~ Source: U.S. Bureau of the Census

Population Age 65 and Over North Dakota Vs United States Source: U.S. Bureau of the Census

Coronary Heart Disease Risk Factors for Coronary Heart Disease High blood pressure Smoking High fat diet Sedentary lifestyle Excessive alcohol use Male and Female Coronary Heart Disease Death Rates  Age-adjusted death rate per 100,000 North Dakotans * Source: ND Dept. of Health, Vital Records

Lung Cancer Male and Female Lung Cancer Death Rates *Age-adjusted death rate per 100,000 North Dakotans * Risk Factors for Lung Cancer  Smoking  Environmental tobacco smoke  Exposure to radon decay products, asbestos or ionizing radiation Source: ND Dept. of Health, Vital Records

Diabetes Death Rate* All Races *Diabetes as an underlying and contributing cause. **Age-adjusted death rate per 100,000 North Dakotans ** Source: ND Dept. of Health, Vital Records

Diabetes Death Rate* Native Americans *Diabetes as an underlying and contributing cause. **Age-adjusted death rate per 100,000 North Dakotans ** Source: ND Dept. of Health, Vital Records

Diabetes Risk Factors for Diabetes  Overweight (20 percent or more above ideal weight)  Family history of diabetes  Personal history of diabetes during pregnancy  Member of an ethnic group with high prevalence of diabetes

North Dakota Community Hospitals Admissions: Source: Office of National Health Statistics in HCFA Office of Actuary

North Dakota Community Hospitals Outpatient Visits: Source: Office of National Health Statistics in HCFA Office of Actuary

Source: Federal Reserve Bank of Minneapolis (

Burleigh Oliver Dunn Slope Bowman Billings Golden Valley Stark Hettinger Adams Sioux Grant Mercer Morton Mountrail Williams McKenzie Divide Burke McHenry McLean Ward Renville Bottineau Kidder Dickey Emmons McIntosh Stutsman Logan La Moure Sargent Richland Barnes Ransom Cass Ramsey Eddy Wells Sheridan Foster Rolette Pierce Benson Towner Nelson Steele Griggs Traill Grand Forks Cavalier Walsh Pembina Counties with Greatest Population Loss Counties with Greatest Populaiton Gain %24.5% 11.1% 16.8% 17.4% 15.7% 11.3%21.1% 13.7% 17.3% 16.3% 15.1% 14.5% 1.3% 11.3% 5.4% 13.6%.7% 11.2% 3.7% 4.5% 11.5% North Dakota Population Statistics Source: North Dakota Census Data Center Counties with Greatest Population Loss Counties with Greatest Population Gain % 14%

Nursing Facility Residents by Age ND vs US ~ 1995 Sources: US: National Center for Health Statistics National Nursing Home Survey ND: ND Department of Human Services

Department of Health General Fund 1987 to 2001 $8,000,000 $10,000,000 $12,000,000 $14,000,000 $16,000,000 Biennium General Fund Appropriations General Fund $11,972,221$11,902,613$14,109,924$13,655,186$14,366,079$14,934,440$14,456,

General Funding for Key Programs

Summary of FTEs 1987 to 2001 Biennium Number of FTEs

Register of Deeds Mitigation Project Document Microfilm Digital Storage

General Funds Allocated to Local Health Units

94% 96% 98% 100% 102% 104% 106% 108% Biennium Comparison of General Funds through Biennia 100% 97% 102% 106% 102% Percentage Change from