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Home My WebLink About2022-12-12 CHC PacketAgenda Community Health Commission City Of Edina, Minnesota Community Room - Edina City Hall Monday, December 12, 2022 6:30 PM I.Call To Order II.Roll Call III.Approval Of Meeting Agenda IV.Approval Of Meeting Minutes A.Minutes: Community Health Commission, November 14, 2022 V.Community Comment During "Community Comment," the Board/Commission will invite residents to share relevant issues or concerns. Individuals must limit their comments to three minutes. The Chair may limit the number of speakers on the same issue in the interest of time and topic. Generally speaking, items that are elsewhere on tonight's agenda may not be addressed during Community Comment. Individuals should not expect the Chair or Board/Commission Members to respond to their comments tonight. Instead, the Board/Commission might refer the matter to sta% for consideration at a future meeting. VI.Reports/Recommendations A.ANSR - MN Presentation - Smoke Free Multi-Unit Property Information VII.Chair And Member Comments A.Opioid Stakeholder Group Update VIII.Sta/ Comments A.Current Attendance IX.Adjournment The City of Edina wants all residents to be comfortable being part of the public process. If you need assistance in the way of hearing ampli4cation, an interpreter, large-print documents or something else, please call 952-927-8861 72 hours in advance of the meeting. MINUTES Community Health Commission November 14, 2022 at 6:30 PM City Hall, Community Room I.Call To Order II.Roll Call Present: Philip King-Lowe, Greg Wright, Julia Selleys, Nick Mattison, Matt Giljahn, Mary Absolon, Michael Wood, Tracy Nelson, Ben Hykes, Jay Shapiro. III.Approval Of Meeting Agenda Motion by Greg Wright to approve meeting agenda. Seconded by Nick Mattison. Motion Carried. IV.Approval Of Meeting Minutes A.Minutes: Community Health Commission, October 10,2022 Motion by Tracy Nelson to approve October 10, 2022 meeting minutes. Seconded by Greg Wright . Motion Carried. V.Community Comment VI.Reports/Recommendations A.Subcommittee Updates VII.Chair And Member Comments Discussion: How will newly elected City Council members be made aware of previous Commission work and recommendations? Do new City Council members have issues they would like Commission to work on? Potential recreational cannabis legislation, City role in regulation and communication to public. Do we have a communication template we use for communicating these kind of changes? Should we? VIII.Staff Comments Association of Non-Smokers Minnesota will be presenting in December and January on possible smoke free multi-unit housing policies. IX.Adjournment Motion by Nick Mattison to Motion. Seconded by Greg Wright . Motion Carried. Date: December 12, 2022 Agenda Item #: VI.A. To:Community Health Commission Item Type: Other From:Jackie Siewert & Kara Skahen - ANSR-MN Item Activity: Subject:ANSR - MN Presentation - Smoke Free Multi-Unit Property Information Information CITY OF EDINA 4801 West 50th Street Edina, MN 55424 www.edinamn.gov ACTION REQUESTED: INTRODUCTION: Presentation from Association of Non-Smokers - MN regarding possible programs/regulations to reduce exposure to smoking in multi-unit properties. ATTACHMENTS: Description ANSR Presentation Edina Multi-Unit Housing Survey - Smoke-Free Health Equity and Smoke-Free Housing December 12, 2022 Jackie SiewertLive Smoke Free — Kara SkahenLive Smoke Free — Rachel CallananPublic Health Law Center — Kate EbertBloomington Public Health This presentation is funded by a Commercial Tobacco-Free Communities grant from the Minnesota Department of Health. SHIP Background Statewide Health Improvement Partnership (SHIP) supports community-driven solutions to expand opportunities for •active living, •healthy eating and •commercial tobacco-free living Helping all people in Minnesota prevent chronic diseases including cancer, heart disease, stroke and type 2 diabetes. Focus on Policy, Systems, and Environmental changes Edina MUH Efforts •In 2018, a Renter Survey was conducted in Edina which surveyed over 400 residents living in Multi-unit housing •Face-to-face meetings with property managers to share survey results, discuss policy changes and offer technical assistance •Ongoing technical assistance available to all properties (tenants and management) including: •policy consultation, resident engagement strategies, signage, sample communication pieces, educational resources, cessation resources and more •Creation of educational materials including a video series •Facilitation of nationwide advisory committees to guide state model policy •Dissemination of research findings at national conferences •Support Policy, System and Environmental changes that promote living conditions that are free from secondhand smoke exposure. The home is the primary source of exposure for children in America. About Live Smoke Free ●Program of the Association for Nonsmokers - Minnesota ●Member of the Minnesota Multi-Housing Association (MHA) Vision A world where everyone has access to a safe, clean, smoke-free home Mission Protect all residents from exposure to harmful second and thirdhand smoke in their homes. Goal Increase smoke-free home opportunities for all people, especially those disproportionately impacted by second and thirdhand smoke exposure. Land Acknowledgement We recognize that Live Smoke Free is located within the traditional homelands of the Dakota people, and that the land we currently occupy comes with a legacy of genocide and trauma caused by U.S. law and policy applied to American Indians. How We Do Our Work •Assist property owners, managers, and homeowners' associations with the adoption, implementation and maintenance of equitable smoke-free housing policies. •Support residents who are exposed to secondhand or thirdhand smoke in their homes. •Educate and engage decision-makers to adopt smoke-free housing policies at the property, local, state, and federal levels. Assistance Available For Housing Providers: •Promotion, free signage* and materials •Compliance and enforcement consultation •Sample documents •Policy reminder letter •Violation notice •Resident survey •Linking residents with free cessation resources •Resident meetings For Renters: •Assistance in finding solutions to secondhand smoke problems in their home Visit us at www.mnsmokefreehousing.org LiveSmokeFree LiveSmokeFreeMN Agenda •The benefits of smoke-free housing •Health disparities related to secondhand smoke exposure •Smoke-free housing in Edina •Free tobacco cessation/treatment resources Smoke-Free Housing is a Growing Trend •Minnesota •In 2007 we knew of 50 properties in MN with a smoke-free policy •How many are there today? 92% of Minnesotans have voluntary smoke-free home rules. •Nationally and internationally •All public housing buildings in the United States have a smoke-free policy •240 members of an online global coalition •76 municipalities in California have laws that prohibit smoking in 100% of private units of rental multi-unit housing properties 5,250+ smoke-free properties in MN Benefits of Smoke-Free Housing Healthier living Market advantages Reduced cleaning costs Reduced fire risk Reduced legal liability Fewer complaints Potential insurance savings Eliminates sealing/ventilation costs Secondhand Smoke is Deadly Source: The Health Consequences of Smoking – 50 Years of Progress: A Report of the Surgeon General – Atlanta, GA.: U.S. Department of Health and Human Services, CDC, Office on Smoking and Health, 2014. •Secondhand smoke contains over 7,000 chemicals and at least 70 are toxic •U.S. Surgeon General: There is no risk-free level of exposure •Each year in the United States, SHS exposure contributes to approximately 400 deaths in infants and 41,000 deaths among adults who do not smoke. Secondhand Smoke Drifts Secondhand Smoke Exposure Source: Nguyen, Gomez, Homa, King. Tobacco use, secondhand smoke, and smoke-free homes rules in multiunit housing. AJPM. 2016;51(5):682-92. •1 in 4 people in the U.S. live in multi-unit housing •Approximately 1 in 3 residents of multi-unit housing are involuntarily exposed to secondhand smoke in their home Thirdhand Smoke •Toxic tobacco residue that sticks to surfaces and objects •Exposure occurs via: •Absorption •Inhalation •Ingestion •Can remain in a multi-unit building for a long time – months to years How Much More Does it Cost to Turn Over a Smoke-Damaged Unit? 2-3x more on average up to 7x more according to some estimates "On average a smoked-in condo unit sells for about $60,000 less than a non-smoked-in unit." -Dawnn Willette, Edina Realty (2015) E-Cigarette Aerosol is not Harmless https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html E-Cigarettes continued •Still a growing problem – especially among youth •Included in Minnesota’s Clean Indoor Air law as of August 1, 2019 •Smoking, including e-cigarettes, is prohibited in common areas of rental apartment buildings •E-cigarette risks •Explosion, fire •EVALI (e-cigarette or vaping product use-associated lung injury) •Poisoning (children and pets) •Can cause confusion with smoke-free policy Smoke is Smoke •Secondhand marijuana smoke exposure can cause lung irritation, asthma attacks, and exacerbate respiratory health problems •Particulate levels from secondhand marijuana smoke are even higher than particulate levels from secondhand tobacco smoke (Ott, 2021) COVID-19 and Smoking •Cigarette smoke can keep the immune system from working right and cause heart and lung diseases.2 •A person who smokes is more likely to get very sick from COVID-19.5 •The COVID-19 pandemic showed us how important lung health and the policies that protect it are https://www.health.state.mn.us/communities/tobacco/quitting/index.html#q1 ADD FIRE SLIDE Health DisparitiesHealth Disparities in SHS Exposure Shastri et al., 2021 National Health and Nutrition Examination Survey Data 1999-2012 •Giveaways and free samples to entice those of low SES •E.g. provided free cigarettes in public housing complexes, soup kitchens, and homeless shelters (Apollonio et al., 2005) Tobacco Industry Targeting of Low SES Populations Smoke-Free Housing in Edina There are 92 Edina MUH properties in ANSR’s internal database ●50 have a smoke-free policy (54%) ●42 do not have a smoke-free policy (that we know of)(46%) Smoke-Free Housing in Edina •Renter occupied •Governed by landlord •46 known smoke-free rental properties in Edina* •Owner occupied (some units may be renter occupied) •Governed by homeowners’ association (HOA), usually through an elected board •4 known smoke-free CICs in Edina* Multi-Unit Rental Properties Common Interest Communities (Condos, Townhomes, Co-ops) *These policies were voluntarily adopted and many were supported by Bloomington Public Health and ANSR with funding from the Statewide Health Improvement Partnership * There are likely more 2018 Edina Renter Survey Surveyed 458 renters (51% response rate) at: •Heritage Court/Premier Properties, LLC •Oaks Lincoln/Oaks Properties, LLC •Ponds of Edina/KCS Property Management •Oaks Braemar/Oaks Properties, LLC •The Durham/RMK Management •York Plaza/Stuart Company Key Findings from 2018 Edina Renter Survey Smoke-Free Home Rules don’t allow smoking in their units Exposure to SHS are exposed to SHS in their home Key Findings from 2018 Edina Renter Survey Support for Smoke-Free Building Policy support a smoke-free building policy Support for Citywide Smoke-Free Housing Ordinance support a citywide smoke-free housing related ordinance Smoke-Free Policy Enforcement Effective Equitable Helping Residents Reduce or Quit Smoking Nearly 7 out of 10 people who smoke want to quit. Research shows that smoke-free policies help people quit. Reduces disparities in tobacco use and secondhand exposure among: •People with low socioeconomic status (and renters) •People with behavioral health conditions and substance use disorders •LGBTQ+ people •American Indian people •Black and African American people Free quit smoking support for Minnesotans •www.QuitPartnerMN.com •1-800-QUIT-NOW Free support available •Nicotine replacement therapy •Text messages •Emails •Coaching Specialized resources for teens, American Indians, those with mental illness, and pregnant people Free Quit Support from Quit PartnerTM “The only means of effectively eliminating the health risk associated with indoor exposure is to ban smoking activity.” - American Society for Heating, Refrigerating, and Air-Conditioning Engineers Levels of Smoke-Free Housing Policy FEDERAL STATE COUNTY CITY COMPANY/ORG BUILDING/PROPERTY PUBLIC HEALTH LAW CENTER LEGAL TECHNICAL ASSISTANCE 37 Legal Research Policy Development, Implementation, Defense Publications Trainings Direct Representation Lobby 12/5/2022 SMOKE-FREE MULTI-UNIT HOUSING KEY LEGAL TAKE-AWAYS 38 •Smoking is not a legally protected activity or right •Persons who smoke are not a protected category of people •Equity considerations https://www.publichealthlawcenter.org/sites/default/files/resources/N o-Constitutional-Right-Smoke-Toke-2019.pdf SMOKE-FREE MULTI-UNIT HOUSING Public Policy (laws) •Federal (HUD Rule) •State law •Local ordinance Policies for Individual Properties (voluntary) •Multi-unit rental •Common interest communities (condominiums) 39 COMPREHENSIVE VOLUNTARY POLICY RESOURCES PUBLIC POLICY APPROACHES FEDERAL, STATE, AND LOCAL LAWS 41 •Affordable or subsidized housing—HUD Rule •State/Local Smoke-Free/Clean Indoor Air Laws –Comprehensive (100% units and grounds) –Partial –Disclosure requirements PUBLIC POLICY APPROACHES SMOKE FREE/CLEAN INDOOR AIR LAWS 42 Minnesota Clean Indoor Air Act: (Minn. Stat. § § 144.411 to 144.417) –Common areas of multiunit rental housing –Comprehensive definition of “smoking” •Including use of e-cigarettes and marijuana –Allows local jurisdictions to enact stronger local ordinances (including smoke-free multiunit housing!) PUBLIC POLICY APPROACHES LOCAL ORDINANCES 43 •Units, common areas, outdoor areas, entire property (California jurisdictions) •Rental and common interest communities (California jurisdictions) U.S. Laws for 100% Smokefree Multi-Unit Housing (no-smoke.org) COMPREHENSIVE SMOKE-FREE HOUSING POLICY MODEL ORDINANCE FOR MINNESOTA 12/5/2022 44 •Comprehensive definition of smoking –Tobacco, marijuana/cannabis, e-cigarettes •Covers all MUH establishments –Apartments, condominiums, new/existing •Prohibits smoking in 100% of individual units, including balconies and patios; •Prohibits smoking in indoor common areas •Prohibits smoking in outdoor common areas (e.g., pool areas, patios, play areas, etc.); •Prohibits designated smoking areas*** •Equitable enforcement structure to support housing stability for all residents COMING SOON! PUBLIC HEALTH LAW CENTER RESOURCES 12/5/2022 45www.publichealthlawcenter.org CONTACT US 46 651.290.7506 Rachel.Callanan@mitchellhamline.edu www.publichealthlawcenter.org @phealthlawctr facebook.com/publichealthlawcenter 12/5/2022 Jackie Siewert Program Director, Live Smoke Free jackie@ansrmn.org 651-646-3005 Q&A City of Edina Multi-Unit Housing Resident Survey September 2018 ACKNOWLEDGEMENT This report was made possible through funding from the Statewide Health Improvement Partnership, Minnesota Department of Health and the collaboration of: City of Edina Health Commission Bloomington Public Health Association for Non-smokers Minnesota: Live Smoke Free Program Minnesota Department of Health Office of Statewide Health Improvement Initiatives Evaluation and Research Unit WE WISH TO THANK THE FOLLOWING PROPERTIES FOR THEIR SUPPORT OF THIS PROJECT Heritage Court/Premier Properties, LLC Oaks Lincoln/Oaks Properties, LLC Ponds of Edina/KCS Property Management Oaks Braemar/Oaks Properties, LLC The Durham/RMK Management York Plaza/Stuart Company 1 TABLE OF CONTENTS Executive Summary ...................................................................................................................................... 2 Background ................................................................................................................................................... 3 Scope of the Issue ......................................................................................................................................... 3 City of Edina profile ..................................................................................................................................... 4 Methodology ................................................................................................................................................. 4 Highlights from comparison of smoke-free vs. smoking-allowed properties ............................................... 6 Key findings .................................................................................................................................................. 9 Next Steps ................................................................................................................................................... 11 Appendix ..................................................................................................................................................... 12  Survey Results  Resident letter  Resident survey cover letter  Resident survey 2 EXECUTIVE SUMMARY The multi-unit housing resident survey was conducted to learn about smoking in apartments, and what residents think about secondhand smoke and smoke-free building policies. In early 2018, Bloomington Public Health (BPH) and the Association for Non-Smokers (ANSR) Minnesota’s Live Smoke Free program administered a survey to residents in to two types of multi-unit housing properties in the City of Edina: those with a smoke-free policy (i.e. smoking of tobacco is not allowed anywhere indoors) and those with a smoking-allowed policy. Questions included: o Basic demographics o Whether residents allowed smoking in their units o Frequency of secondhand smoke exposure o Any smoking behavior changes as a result of or following a building-wide smoke-free policy o Support for a smoke-free property policy o Support for citywide ordinance around smoking in multi-unit housing  Residents from smoke-free properties were asked to provide details about rules in place for tobacco smoking.  When asked about smoking behavior, all residents had the option to indicate when a question didn’t apply to them because they were nonsmoking or no one in their household smoked.  Surveys were available in English only. A total of 893 surveys were distributed and 458 were returned representing a 51% return rate. Individual return rates were as follows: Smoke-Free Properties: 50% return rate  Oaks Lincoln 48%  Oaks Braemer 50%  York Plaza 51% Smoking-allowed properties: 54% return rate  Heritage 58%  The Ponds, 59%  The Durham 52% 3 Key findings include:  Majority of all respondents (97%) don’t allow smoking in their units even with a smoking-allowed policy present.  Majority of respondents surveyed (94%) support a smoke-free building-wide policy.  Despite 97% of all respondents not allowing the smoking of tobacco products in their units, (99% in smoke-free vs 93% in smoking-allowed properties), 46% of these respondents are still exposed to secondhand smoke from all buildings. This includes 39% in smoke-free vs. 64% in smoking-allowed buildings.  Negative health impact of secondhand smoke exposure were reported by 8% of respondents.  Majority of respondents (91% in smoke-free properties and 90% in smoking-allowed properties) indicated they would support a multi-unit housing smoking related citywide ordinance. BACKGROUND The City of Edina has been a leader in reducing resident exposure to secondhand smoke and protecting youth from tobacco products. In 2017, Edina was the first city in the state to set a high standard for the sale of cigarettes and tobacco products to young adults under the age of 21 by passing a Tobacco 21 ordinance. This ordinance increased the tobacco sale age from 18 to 21. The City of Edina also protects its residents from secondhand smoke by prohibiting smoking in public parks and recreational spaces. In February 2018, at the request of the Edina Health Commission, Bloomington Public Health (BPH) and the Association for Non-Smokers Minnesota (ANSR) Live Smoke Free program began outreaching to select multi-unit properties (both smoking prohibited and permitted) asking to survey residents on the topic of smoke-free housing. The goal of the survey was to learn about smoking in apartments, and what residents think about secondhand smoke and smoke-free building policies. Bloomington Public Health (BPH) has long supported programs, partnerships and policies that cultivate healthy, active communities. We collaborate with communities, schools, worksites and healthcare providers to reduce the risk of chronic disease by targeting poor nutrition, physical inactivity and tobacco use for those who live and work in the City of Edina. SCOPE OF THE ISSUE Research strongly demonstrates an association between tobacco use and chronic disease risk factors. Scientific knowledge about the health effects of tobacco use has increased greatly since 4 the first Surgeon General’s report on tobacco was released in 1964.1 Since the publication of that report, more than 20 million Americans have died because of smoking.2 The harmful effects of tobacco do not end with the user. The US Surgeon General has concluded that there is no risk- free level of exposure to secondhand smoke. Since 1964, 2.5 million deaths have occurred among nonsmokers who died from diseases caused or exacerbated by secondhand smoke exposure. Secondhand smoke causes heart disease, lung cancer, and stroke in adults and can cause a number of health problems in infants, children, and older adults including asthma, Type II diabetes, hypertension, high cholesterol, and obesity. An estimated 58 million Americans remain exposed to secondhand smoke each year. The home is the primary source of secondhand smoke exposure for children, and multi-unit housing residents are particularly vulnerable to involuntary exposure in their homes.3 Many factors influence tobacco use. Risk factors include race/ethnicity, age, education, and socioeconomic status. Significant disparities in tobacco use exist geographically; such disparities typically result from differences among states in smoke- free protections, tobacco prices, and program funding for tobacco control.3 Tobacco use is the largest preventable cause of death and disease in the United States. Each year, approximately 480,000 Americans die from tobacco-related illnesses. Further, more than 16 million Americans suffer from at least one disease caused by smoking.4 CITY OF EDINA PROFILE The City of Edina is located in the metro region of the state. The city’s population is estimated to be 49,976 in 2016.5 Of this population it is estimated that 42,489 (85%) are non-Hispanic White, 1,092 (2.2%) are African American, 1,516 (3%) are Hispanic, and 3,521 (7%) are Asian.6 The City of Edina is estimated to contain 21,325 occupied housing units in 2016.7 Less than a third of those units, 5,915, are occupied by households renting. It is estimated that households that are White (not Hispanic) own 94.4 percent of the owner-occupied housing units and rent 75.3 percent of the renter-occupied housing units. There are significant racial differences in household occupancy based on ownership or rental status. METHODOLOGY The project team, including the City of Edina Community Health Administrator, staff from Bloomington Public Health, Association for Non-smokers Minnesota: Live Smoke Free Program and the Minnesota Department of Health met in December 2017 and January 2018. The project team determined criteria for who to survey and developed survey questions over two meetings. 1 DHHS Publication No. (CDC) 89-8411 2 DHHS Office on Smoking and Health, January 2014 3 Healthy People 2020 4 DHHS Office on Smoking and Health 5 2012-2016 American Community Survey 5-Year Estimates Table S0101 6 2012-2016 American Community Survey 5-Year Estimates Table B03002 7 2012-2016 American Community Survey 5-Year Estimates Table S2502 5 Bloomington Public Health maintains a list of all multi-unit properties in Edina which includes information about their smoking policies, number of units and if available, the number of residents residing in those properties. Although the exact number of smoke-free properties is unknown, our best data shows 47% of 53 properties contacted report having adopted a smoke- free policy. A map was created using ArcMap in ArcGIS version 10.5 to visualize the geographic distribution of multi-unit properties with and without smoking policies in Edina. The project team then prioritized the 53 multi-unit properties based on their geographic distribution, smoking policy type and number of residents to ensure the selected properties provided the best representation of the city and then narrowed the selection to six. The property managers of the six properties were contacted to ascertain their interest in participating in the survey process. Of the initial six properties selected, four agreed to allow for the survey to occur and provide assistance with the survey. The two properties that declined were replaced by two other properties from the original pool of 53. Property managers distributed paper copies of the survey with instructions for completion to all households (one survey per unit). Residents received written instructions to return completed surveys in a sealed envelope to the on-site manager or management office at which time they would receive a $10 gift card. Property managers received a $50 gift card for their role in survey dissemination and collection.8 Decisions regarding timeframe for survey distribution and collection were left to property managers and what they felt was the best time to achieve the highest return rate. In most cases, that meant surveys were distributed toward the end of the month and returned the first of the month when rents were due. The average length of time from survey distribution to collection was 7-14 days and occurred between April 2018 and July 2018. Paper survey results were compiled by ANSR and entered into Survey Monkey. All survey data was analyzed by BPH in Statistical Package for Social Services (SPSS) version 24. 8 Gift cards were purchased from retailer that did not sell tobacco products. 6 HIGHLIGHTS FROM COMPARISON OF SMOKE-FREE VS. SMOKING-ALLOWED PROPERTIES Demographics of survey respondents by property type Smoke-free properties N=287 Smoking-allowed properties N=168  It is estimated that the demographic makeup of renter in Edina include 75% non- Hispanic White, 14% Asian, 4% African American, 4% Hispanic and 4% some other race9.  The three smoke-free properties surveyed are similar demographically to renters in Edina.  The three smoking-allowed properties surveyed are demographically more diverse than renters in Edina. 9 2012-2016 American Community Survey 5-Year Estimates Table S2502 Note due to rounding, totals are greater than 100. 1% 11%4% 79% 4% 2% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 1% 34% 8% 53% 4% 1% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 7 Smoking rules set by respondents for their apartment Smoke-free properties N=289 Smoking-allowed properties N=167  Housing cost was ranked first followed by proximity to work or school second and a smoke-free policy third as what tenants considered when selecting a place to live by respondents from both smoking-allowed and smoke- free properties. o Overall, 71% of all respondents surveyed indicated a smoke-free policy was in their top three consideration when selecting a place to live. Top considerations from respondents in smoke-free properties when considering housing Rank 1 2 3 Percent citing in their Top 3 Housing Cost 72% 19% 6% 97% Proximity to work/school 10% 44% 26% 80% Smoke-Free Policy 13% 35% 28% 75% Transportation 1% 10% 24% 35% Good school district 9% 7% 15% 31% 1% 99% Yes, smoking is allowed in my unit No, smoking is not allowed in my unit 7% 93% Yes, smoking is allowed in my unit No, smoking is not allowed in my unit 8 Top considerations from respondents in smoking-allowed properties when considering housing Rank 1 2 3 Percent citing in their Top 3 Housing Cost 75% 16% 5% 96% Proximity to work/school 12% 35% 32% 79% Smoke-Free Policy 12% 26% 26% 64% Good school district 11% 19% 10% 40% Transportation 1% 15% 24% 40% 9 KEY FINDINGS  Majority of all respondents don’t allow smoking in their unit even with a smoking- allowed policy present. Respondents that do not allow smoking of tobacco in their units by property tobacco policy type  Several respondents who didn’t allow smoking in their unit indicated they had secondhand smoke exposure Respondents secondhand smoke exposure in their apartment who do not allow smoking of tobacco in their apartment by property tobacco policy type  Majority of respondents surveyed support a smoke-free property policy 97% 99% 93% 0%10%20%30%40%50%60%70%80%90%100% All respondents Smoke-free properties Smoking-allowed properties 46% 39% 64% 0%10%20%30%40%50%60%70% All respondents Smoke-free properties Smoking-allowed properties 10 Respondents support for smoke-free property by property tobacco policy type  Majority of respondents indicated they would support a multi-unit housing smoking related citywide ordinance Respondents support for citywide smoke free ordinance for apartments by property tobacco policy type 93% 95% 91% 0%10%20%30%40%50%60%70%80%90%100% All respondents Smoke-free properties Smoking-allowed properties 90% 90% 91% 0%10%20%30%40%50%60%70%80%90%100% All respondents Smoke-free properties Smoking-allowed properties 11 NEXT STEPS Upon survey completion and analysis, BPH and ANSR conducted face-to-face meetings with property managers to share property-specific results, discuss policy changes and offer technical assistance. For those properties with existing smoke-free policies, technical assistance was provided to strengthen policy compliance in the form of consultation, policy review, recommending strategies to increase resident engagement, and provision of tools like signage and a resident letter which shared survey findings and reinforced policy specifics and enforcement protocol. For first-time policy adopters, technical assistance provided included educational resources (e.g., an FAQ document that addressed common questions residents may have as to why the property is going smoke-free, how the policy will benefit residents, and an explanation of policy enforcement, etc.); sample implementation tools (e.g., a resident letter template that shared survey findings, the hazards of secondhand smoke, fire risk, and details about the new smoke-free policy, a sample lease addendum, etc.); cessation resources for residents; and ongoing consultation. With the completion of the final report, BPH staff will meet with City of Edina staff to review the findings and evaluate the options for city policies. Our findings highlight the importance of smoke-free policies to help protect all residents, especially youth and those with low income status, from secondhand smoke exposure. 12 APPENDIX 13 SURVEY RESULTS BPH distributed a total of 893 surveys, and 457 were returned representing a 51% return rate. In smoke-free multi-unit properties, 580 surveys were distributed and 289 surveys were returned (50%). In smoking-allowed multi-unit properties, 313 surveys were distributed and 169 surveys were returned (54%). Five multi-unit properties had an individual return rate of 50% or greater. Demographics Race and Ethnicity. N=434  It is estimated that the demographic makeup of renter in Edina include 75% non- Hispanic White, 14% Asian, 4% African American, 4% Hispanic and 4% some other race10.  The three smoke-free properties surveyed are similar demographically to renters in Edina.  The three smoking-allowed properties surveyed are demographically more diverse than renters in Edina. Race and ethnicity for all respondents 10 2012-2016 American Community Survey 5-Year Estimates Table S2502 Note due to rounding, totals are greater than 100. 1% 19% 5% 70% 4% 1% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 14 Race and ethnicity for respondents by property tobacco policy type Smoke-free properties N=287 Smoking-allowed properties N=168  Of respondents to this survey, more respondents of color reside in smoking-allowed properties compared to smoke-free. This could be due to costs, amenities, and other factors. Age. N= 456Age ranges for all respondents 1% 11%4% 79% 4% 2% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 1% 34% 8% 53% 4% 1% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 7% 51%12% 30% 18-25 26-55 56-65 Over 65 15 Age ranges for respondents by property tobacco policy type Smoke-free properties N=288 Smoking-allowed properties N=168  Renters over 65 were more represented in responses from smoking-allowed properties. A larger young adult population (18-25) was observed among respondents of smoking- allowed properties. Income. N= 437  The median income for households in Edina is estimated to be $91,84711.  The median of the respondents is within the $55,000 to $79,000 category, lower than the median income for Edina households. 11 2012-2016 American Community Survey 5-Year Estimates Table S1903 8% 44% 14% 34% 18-25 26-55 56-65 Over 65 4% 64% 8% 23% 18-25 26-55 56-65 Over 65 16 Income reported by all respondents Income reported by respondents by property tobacco policy type Smoke-free properties N=276 Smoking-allowed properties N=161 6% 11% 21% 25% 17% 21% 0% 5% 10% 15% 20% 25% 30% $23,000 or less $23,001-$39,000 $39,001-$55,000 $55,001-$79,000 $79,001-$100,000 More than $100,000 6% 13% 23%23% 15% 21% 0% 5% 10% 15% 20% 25% 30% $23,000 or less $23,001-$39,000 $39,001-$55,000 $55,001-$79,000 $79,001-$100,000 More than $100,000 6% 8% 17% 27% 21%21% 0% 5% 10% 15% 20% 25% 30% $23,000 or less $23,001-$39,000 $39,001-$55,000 $55,001-$79,000 $79,001-$100,000 More than $100,000 17 The apartment that you live in Tenure in apartment by property tobacco policy type Smoke-free properties N=287 Smoking-allowed properties N=169 Children under 18 present in all respondents apartment N=458 29% 47% 12% 12%Less than 1 year 1-5 years 6-10 years More than 10 years 25% 54% 10% 12% Less than 1 year 1-5 years 6-10 years More than 10 years 78% 22% No Yes 18 Children under 18 living in respondent’s apartment by property tobacco policy type Smoke-free properties N=289 Smoking-allowed properties N=169 Adults over 65 present in respondents apartment for all respondents n=455 84% 16% No Yes 69% 31% No Yes 67% 33% No Yes 19 Adults over 65 present in respondents apartment by property tobacco policy type Smoke-free properties N=288 Smoking-allowed properties N=167 Apartment unit smoking rules and exposure Respondents smoking rules for their apartment by property tobacco policy type Smoke-free properties N=289 Smoking-allowed properties N=167  A small percentage of respondents (7%) indicated they allowed smoking in their units on smoking-allowed properties.  A small percentage of respondents (1%) indicated they smoked/allowed smoking in their units on smoke-free properties. 64% 37% No Yes 72% 28% No Yes 1% 99% Yes, smoking is allowed in my unit No, smoking is not allowed in my unit 7% 93% Yes, smoking is allowed in my unit No, smoking is not allowed in my unit 20 Secondhand smoke exposure (SHS) for respondents who don’t allow smoking in unit by property tobacco policy type12 Smoke-free properties N=286 Smoking-allowed properties N=156  In smoke-free properties, 39% of respondents who don’t allow smoking in their units indicated secondhand smoke exposure. In smoking-allowed units, 56% of respondents indicated exposure.  Despite not allowing smoking in their units, respondents are still largely exposed to secondhand smoke potentially due to smoking in shared areas, adjacent units, and/or outdoor areas that seep into individual units. 12 A few respondents who allow smoking in their individual units also smelled smoke from other units. These responses have been eliminated from this ‘secondhand smoke’ exposure analysis. 2% 9%11% 17% 61% 0% 10% 20% 30% 40% 50% 60% 70% Everyday A few times a week A few times a month A few times a year Not at all 7% 15%17%17% 44% 0% 10% 20% 30% 40% 50% Everyday A few times a week A few times a month A few times a year Not at all 21 Willing to Use designated smoking areas. N=458  When asked whether they would use a designated smoking area if provided, 81% of all respondents indicated that the question didn’t apply to them because they did not smoke Respondents willing to use designated smoking area for all respondents Respondents willing to use designated smoking area by property tobacco policy type for all respondents Smoke-free properties N=289 Smoking-allowed properties N=169  From smoke-free properties, 81% were nonsmoking compared to 79% of respondents in smoking-allowed properties. 81% 7% 13% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% I do not smoke Yes No 81% 7%11% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% I do not smoke Yes No 79% 6% 15% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% I do not smoke Yes No 22 Secondhand smoke (SHS) exposure for residents who indicated they were non-smokers. N=369  Half (50%) of the 81% of residents who indicated they were nonsmoking (when asked if they would be willing to use designated smoking areas) reported secondhand smoke exposure. Secondhand smoke exposure (SHS) for all respondents who indicated they were non-smokers. Secondhand smoke exposure (SHS) for respondents who indicated they were non-smokers by property tobacco policy type Smoke-free properties N=235 Smoking-allowed properties N=134 5% 13%14%18% 50% 0% 10% 20% 30% 40% 50% 60% Everyday A few times a week A few times a month A few times a year Not at all 3% 10%13%17% 57% 0% 10% 20% 30% 40% 50% 60% Everyday A few times a week A few times a month A few times a year Not at all 9% 18%17%19% 37% 0% 5% 10% 15% 20% 25% 30% 35% 40% Everyday A few times a week A few times a month A few times a year Not at all 23  Despite living in a smoke-free building, 43% of nonsmoking respondents indicated secondhand smoke exposure. In smoking-allowed buildings, 63% of nonsmoking respondents indicated exposure. Respondents with secondhand smoke exposure who reported tobacco smoke nuisance to landlord by property tobacco policy type Smoke-free properties N=114 Smoking-allowed properties N=96  In smoke-free properties, 68% of respondents who indicated secondhand smoke exposure did not report it to their landlord. In smoking-allowed properties, 78% of respondents exposed did not report.  Of the respondents who reported secondhand smoke exposure, those with more frequent exposure indicated they reported it to their landlord; o 91% of respondents with at least weekly secondhand smoke exposure in smoke- free properties reported secondhand smoke exposure to their landlord compared to 69% of respondents in smoking-allowed properties.  Some respondents that didn’t report smelling secondhand smoke in their apartment, reported secondhand smoke exposure to their landlord; 5% in smoke free properties vs. 3% in smoking-allowed. Reasons respondents provided for not reporting smoke  Respondents who smelled smoke but didn’t report it in smoke-free properties provided reasons including; o Had no idea it was a smoke-free property o Could not pinpoint exact source of smoke o Smoke was too infrequent or didn’t bother them enough to report it  Major reasons for not reporting in smoking-allowed properties included; 43% 48% 22% 13% 5% 0% 20% 40% 60% Everyday A few times a week A few times a month A few times a year Not at all 54% 15% 26% 17% 3% 0% 20% 40% 60% Everyday A few times a week A few times a month A few times a year Not at all 24 o Problem was insignificant o Property allowed smoking, management wouldn’t do anything o Others have already reported it o They had countermeasures  In smoke-free properties, 17% percent of all respondents had countermeasures for the smoke, compared to 28% of all respondents in smoking-allowed buildings. o This percentage includes respondents who indicated they had no secondhand smoke exposure. o Countermeasures included laundry and cleaning supplies, air purifiers, odor absorbers and door/window seals. Most respondents selected using multiple countermeasures. Respondents’ perceptions of the follow-up frequency on smoking violation or nuisance reported to landlord  In smoke-free properties; o Twelve out of 37 (32%) respondents who reported smoke (including a few who didn’t indicate exposure) indicated that landlord responded to smoke complaints always or most of the time. o Twenty out of 247 (8%) respondents didn’t report smoke but indicated that landlord responded always or most of the time to smoke complaints.  In smoking-allowed properties; o Six out of 23 (26%) respondents who reported smoke (including a few who didn’t indicate exposure) indicated that landlord responded to smoke complaints always or most of the time. o Nineteen out of 142 (13%) respondents didn’t report smoke but indicated that landlord responded always or most of the time to tobacco complaints. 25 Respondents’ knowledge of smoking policy by property tobacco policy type Smoke-free properties N=116 Smoking-allowed properties N=109  Many respondents, 173/289 (60%) in smoke-free properties and 60/169 (36%), in smoking-allowed properties selected multiple options which have been excluded from the above charts. Respondents’ perception of landlord’s policy enforcement. In smoke-free properties (N=281);  More than half (71%) of respondents indicated they didn’t know how landlord enforced policy.  Two percent of respondents didn’t think landlord enforced policy.  A few respondents (2%) indicated question didn’t apply because smoking was allowed in the building. In smoking-allowed properties (N=154);  More than half (51%) of respondents indicated they didn’t know how landlord enforced policy.  Three percent of respondents didn’t think landlord enforced policy.  Six percent indicated question didn’t apply because smoking was allowed in the building. 3% 19% 47% 3% 28% 0%20%40%60% Smoking is allowed in individual apartments but not in shared… Smoking is allowed in some outdoors areas Smoking is not allowed anywhere inside the building Smoking is not allowed anywhere outdoors Don’t know/not sure 20% 8% 29% 1% 41% 0%20%40%60% Smoking is allowed in individual apartments but not in shared… Smoking is allowed in some outdoors areas Smoking is not allowed anywhere inside the building Smoking is not allowed anywhere outdoors Don’t know/not sure 26 Health problems: Percent of respondents reporting a smoke related health problem  Of all respondents who responded (N=421), 36 of them (8%) indicated they believed they or a family member had a health problem due to secondhand smoke exposure. o This includes 22/288 (8%) of respondents from smoke-free properties and 14/169 (7%) of respondents from smoking-allowed properties.  Self-reported health problems include: o allergies o asthma o headaches o breathing problems o cancer Smoke-free policy experience and ordinance perception Smoking behavior change since being in a smoke free property In smoke-free properties (N=284);  All properties already have a no smoking policy.  Majority of respondents (86%) indicated question didn’t apply as no one living in my apartment smokes tobacco.  Other respondents responded as shown in graph above N=35. o Of these respondents, 31% indicated they had quit or tried to cut back due to smoke-free policy in place at their property. 11%9%11% 69% 0% 20% 40% 60% 80% Yes, quit smoking Yes, quit smoking cigarettes and now smoking e-cigarettes Yes, tried to quit or cut back smoking No, no changes in current smoking behavior 27 In smoking-allowed properties (N=165):  All properties have a smoking-allowed policy.  Three fourths (75%) of respondents indicated that no one living in my apartment smokes tobacco.  A few, 12% indicated that question didn’t apply since property didn’t have a smoke-free policy.  The remaining 13% of respondents indicated behavior changes: o The majority, 81% indicated no change to their smoking behavior. o Some indicated they quit smoking, 10% or tried to cut back on smoking, 10%. Property wide smoking policy N=359  Of all respondents who responded, 93% indicated they would support a property wide smoke-free policy. o This includes 95% in smoke-free and 91% in smoking-allowed properties o Only a few respondents (4%) in smoke-free properties indicated they opposed or strongly opposed a property-wide policy compared to 8% in smoking-allowed properties. Support for a property wide smoke-free policy by property tobacco policy type Smoke-free properties N=284 Smoking-allowed properties N=165 95% 5% 0% 20% 40% 60% 80% 100% Support or strongly support Oppose or strongly oppose 91% 8% 0% 20% 40% 60% 80% 100% Support or strongly support Oppose or strongly oppose 28 Citywide ordinance support N=359  Of all respondents who responded, 90% indicated they would support a city-wide smoke- free multi-unit housing ordinance. o This includes 90% in smoke-free and 91% in smoking-allowed properties. Support for city-wide smoke-free multi-unit housing ordinance by property tobacco policy type for all respondents Policy support by smoking behavior for all respondents  Note: Graphs show respondent who indicated they support or strongly support property-wide and citywide policies/ordinance 90% 90% 91% All respondents Smoke-free properties Smoking-allowed properties 50%55%60%65%70%75%80%85%90%95%100% All respondents Smoke-free properties Smoking-allowed properties 35% 71% 92% 82% 92% 0%20%40%60%80%100% Willing to use designated smoking area Supports buildingwide smoke free policy Supports a citywide smoke ordinance NonSmoker Smoker 29 Consideration used to make housing choices  Housing cost was ranked first followed by proximity to work or school second and a smoke-free policy third as what tenants considered when selecting a place to live by respondents from both smoking-allowed and smoke free properties. o Overall, 71% of all respondents surveyed indicated a smoke-free policy was in their top three considerations when selecting a place to live. Top considerations from respondents in smoke-free properties when considering housing Rank 1 2 3 Percent citing in their Top 3 Housing Cost 72% 19% 6% 97% Proximity to work/school 10% 44% 26% 80% Smoke-Free Policy 13% 35% 28% 75% Transportation 1% 10% 24% 35% Good school district 9% 7% 15% 31% Top considerations from respondents in smoking-allowed properties when considering housing Rank 1 2 3 Percent citing in their Top 3 Housing Cost 75% 16% 5% 96% Proximity to work/school 12% 35% 32% 79% Smoke-Free Policy 12% 26% 26% 64% Good school district 11% 19% 10% 40% Transportation 1% 15% 24% 40% 30 Sociodemographic Differences for all Respondents Secondhand smoke exposure (SHS) for respondents who indicated they did not allow smoking in their units N=442 55% 42% 46% 55% 35% 46% 42% 65% 46% 50% 43% 50% 44% 55% 46% 40% 51% 0%10%20%30%40%50%60%70% All Respondents More than $100,000 $79,001-$100,000 $55,001-$79,000 $39,001-$55,000 $23,001-$39,000 $23,000 or less Over 65 56-65 26-55 18-25 Hispanic or Latino White Black or African American Asian or Asian American Has Adults over 65 Has Children Under 18 31 32 33 34 35 36 Date: December 12, 2022 Agenda Item #: VII.A. To:Community Health Commission Item Type: Other From:Mary Absolon Item Activity: Subject:Opioid Stakeholder Group Update Information CITY OF EDINA 4801 West 50th Street Edina, MN 55424 www.edinamn.gov ACTION REQUESTED: INTRODUCTION: Presentation and other information from Opioid Settlement Funds stakeholder group meeting. ATTACHMENTS: Description Opioid Stakeholder Presentation Opioid Stakeholder Group Meeting Agenda: ●Welcome & Connect Activity ●Group Agreements ●Practical Vision Workshop ●Next Steps ●Lunch Facilitation designed by A.Crombie Huda Yusuf Jeff Giles Mary Absolon Julia Selleys Nick Kelley Jennifer Anderson Yussuf Shafie Nicole Mills Chelsey Eichen Mike Dobesh Hannah Hatch Ivan Nelson Pearl Evans Participants: What is Land Acknowledgement? A formal statement that recognizes and respects Indigenous people as traditional stewards of this land and the enduring relationship that exists between Indigenous people and their traditional territories. Why do we recognize the land? To honor and express gratitude and appreciation to those whose territory we reside on. It is important to understand the long-standing history that has brought us to reside on the land, and to understand our place in that history. Facilitation designed by A.Crombie Let’s Connect ❏Name ❏Organization ❏What technology created in the past 50 years (1972) that you can’t live without? Facilitation designed by A.Crombie Technology: the application of scientific knowledge to the practical aims of human life or to the change of the human environment. Please keep it to 20 seconds or less. Use simple language Be an active participant Group Agreements: Be curious Stay focused Take space, Make space Goals: ❏Reveal the hidden vision within the group; identify the group’s hopes and dreams. Facilitation designed by A.Crombie ❏For the group to take ownership of a common vision for the future. Practical Vision Workshop Question: What do we want to see in place in 3-5 years as a result of our actions? Your Mission: Determine how to allocate Opioid Settlement funds in Bloomington, Edina and Richfield. What a Practical Vision is . . . ●Shared–a single group product ●Practical–descriptive language of nouns and adjectives in the present tense ●Intentional–describing where you will be when you get there ●Familiar–clearer and deeper, but not different from what each individual had in mind before ●Inspiring–calling for participants to stretch a bit and take responsibility for the future ●Fatalistic–a projection of what is out there, waiting for us to catch up to it ●Subjective–a personal vision pushed on the group ●Whimsical–wishful thinking about what ought to be a goal ●Mechanical–it’s not a roadmap to goals ●Scenario building What it is NOT . . . CONTEXT WHAT : Visioning future collaborative opioid response work WHERE : WHEN: WHO: BUDGET: WHY : Designed by A. Crombie Historic lawsuits providing local communities with new, long range funding Cities of Bloomington, Richfield, and Edina Over the next 15+ years Stakeholders from various sectors including: treatment and recovery, first responders, public health, peer support workers, community members, schools, parents, youth prevention organizations, harm reduction and more Approx $150,000 per year for the first 5 years Approx $100,000 per year for the remaining 10-15 years ●2020 saw the highest combined total overdose deaths. ●Most involved substance= synthetic opioids ●Ages 15-34 had the greatest # of ER visits. TOP STRENGTHS: relationship building, education, connection to treatment and resources TOP NEEDS: funding, education, integration of community pov Survey sai d….. Let’s ImaĀine Designed by A. Crombie ❏Individually list 8-10 concrete elements of the vision that can be completed in the next 3-5 years. ❏Select 5 best ideas on your list by marking it with a star or check mark. Workshop Question: What do we want to see in place in 3-5 years as a result oÿ our actions? 1.Idea 2.Idea 3.Idea 4.Idea 5.Idea 6.Idea 7.Idea 8.Idea 9.Idea 10.Idea ❏In your small group, share your best ideas with each other. ❏Decide on the team’s top 8 ideas and . . . ★Write horizontally ★1 idea per card ★3-7 words per card ★Use a marker ★WRITE BIG Fully trained response staff–Narcan to wound care Responsible Collaboration Group by similar accomplishments Name cluster with a noun & 1-2 word adjectives “trained & dedicated opioid team” Comprehensive follow-up process to overdose events Harm reduction strategies (fentanyl test strips Coordinated response across stakeholders To be a “best practices” team Culturally aware response Culturally responsive approaches In 3-5 years, we want to see the ÿollowinĀ elements as a result oÿ our actions: Accessible & Community-based Prevention Strategies Access to free & culturally inclusive clubs & sports Youth education in schools Housing Investing in workforce training Community engagement events Community education (harm reduction) Easy Access to System No barriers to treatment Childcare (to support access to care) Housing (treatment onsite) Accessible health care & holistic response, mental health More available Narcan–nose (increase), needle Decrease stigma Relevant Data Driving Responses Access to relevant data Input on lived experiences Decrease death by 75-100% Sustainable Funding Plan Sustainable funding plan Engaging input with lived experiences Group by similar accomplishments Name cluster with a noun & 1-2 word adjectives “trained & dedicated opioid team” ParkinĀ Lot: ●Data on incarcerated individuals–access to treatment, untreated once enter (no services, prescription, relapse) ●Data by age segments ●Meet people with menu of resources before discharge at ED ●Linkage to Peer Recovery Services ●Info–local level about pre-existing program ●Role of legal community/partners Group by similar accomplishments Name cluster with a noun & 1-2 word adjectives “trained & dedicated opioid team” Resolve Which element is most clearest? ●Responsible Collaboration ●Accessible & Community-based Prevention Strategies Most exciting? ●Easy Access to system Next Steps ●Kate will send out an invite for doodle poll and will put together an agenda for the first bucket–Responsible Collaboration ●Action planning and coordinating space ●Collaboration piece ●Have a process in the workshop of who can do what ●Want to talk about more responsible action plans Recommendation: Workshop on identifying the obstacles that block your vision. Date: December 12, 2022 Agenda Item #: VIII.A. To:Community Health Commission Item Type: From:Jeff Brown, Community Health Administrator Item Activity: Subject:Current Attendance CITY OF EDINA 4801 West 50th Street Edina, MN 55424 www.edinamn.gov ACTION REQUESTED: INTRODUCTION: