The fall season is famous for fabulous foliage and back-to-school frenzy. It is also the perfect time to change your health outlook and approach. To fully enjoy the autumn air and season, learn more about protecting yourself and your family from the flu, coping with allergies, focusing on fitness, preparing for temperature changes, and more.

Protection from the Flu

As kids and teachers head back to the classroom they encounter new germs which they could end up bringing home. Besides guarding against run-of-the-mill cold and flu germs, this year parents and guardians also have to be on the look-out for H1N1 (swine flu). According to the Centers for Disease Control and Prevention (CDC), so far, with 2009 H1N1 flu, the largest number of cases has been in people between the ages of 5 and 24-years-old. Visit http://www.flu.gov/ for more information about the flu or http://www.flu.gov/h1n1resourcekit.html to access resources specific to H1N1.

Families, students, and school staff can keep from getting sick with the flu by practicing good hand hygiene-washing their hands often with soap and water, especially after coughing or sneezing, or using alcohol-based hand cleaners; practicing respiratory etiquette by covering your mouth and nose with a tissue when you cough or sneeze; and staying home if you're sick, the CDC says.

Remind children, that although sharing is nice, it would be best if they did not share food, snacks or personal health items with other children or accept such items from their classmates.

Another way to protect yourself and your family from the flu is to get vaccinated, in other words get a "flu shot." The CDC says that October through December is the best time to get vaccinated. To find a flu vaccination in New Jersey, visit the New Jersey Department of Health and Senior Services (NJDHSS) Web site.

Also check with your primary care physician and employer-free or low-cost vaccinations may be available at a designated time. Healthfirst Medicare Plan members do not require a referral to obtain an influenza or pneumococcal vaccine. Additionally, there is no copayment for receiving the influenza or pneumonia vaccines. According to Medicare.gov, influenza is most common in the U.S. from December to April, so it's best to get the flu shot from October through mid-November. The vaccine begins to protect you after 1 to 2 weeks.

According to the NJDHSS, the following people should get a flu shot:

• Everyone who wants to reduce the risk of catching influenza;
• Adults age 50 and over (especially those over 65);
• All children from age 6 months to 18 years
• All persons age 19 to 49 years with chronic medical conditions, including heart disease, pulmonary disorders (including asthma), diabetes, kidney disease, hemoglobinopathies, and compromised immune systems (HIV or immunosuppressive therapy);
• People with conditions that can cause breathing problems (such as cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders);
• Pregnant women;
• All residents of nursing homes and chronic-care facilities;
• Caregivers and household members of infants younger than 6 months (babies can get the flu at this age, but are too young for a flu shot);
• All close contacts of high-risk groups listed above, such as household members and persons providing home care; and
• All health care workers.

No matter the season, overall wellness is important for pregnant women, children and teens. Healthfirst has a variety of programs available to help make healthy living a priority, including:

• Healthy Mom/Healthy Baby - Pregnant women can get information about caring for themselves and their child before and after birth. Find out about prenatal care, fetal development, nutrition, pre-term labor, vaccinations and more.
• Immuni-Kids - Focuses on keeping young members' immunizations, well-care visits and Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services on track. Through the program, you'll receive reminders for your child's doctor's appointments, and information on topics such as lead poisoning and injury prevention.
• Healthy Teen - Help your teen stay on a healthy track for life. This program focuses on member education about prevention, screenings and teen development.

Avoiding Autumn Allergies

As the leaves begin to fall and the temperature drops, many people notice that their allergies increase or change. Outdoor allergies (also called "seasonal allergic rhinitis" [SAR], "hay fever," or "nasal" allergies) occur when allergens that are commonly found outdoors are inhaled into the nose and the lungs causing allergic reactions, the Asthma and Allergy Foundation of America (AAFA) says. Ragweed is the most common outdoor allergen during fall, according to the American Academy of Allergy Asthma and Immunology (AAAI), and is most prevalent throughout the Northeast, South and Midwest through October. The AAAI recommends the following tips to lessen or avoid allergy symptoms:

• Keep windows closed to keep pollen from drifting into your home. Use the air conditioner, which filters, cools and dries air;
• Stay indoors when pollen counts are highest, typically between 10 a.m. and 4 p.m.;
• Check daily pollen counts for your area;
• Change your clothing after time spent outdoors and avoid drying laundry outside; and
• Sleep well by taking a shower before bed to wash away pollen that's accumulated on or near your head - and will otherwise wind up on your pillow.

According to the AAFA, some 10 to 20 percent of Americans begin to suffer from ragweed allergy, or hay fever. If you are unsure if you have allergies or are seeking medicine to treat your symptoms, speak with your primary care provider. Your provider might recommend seeing an allergist for further testing.

Healthfirst's Asthma Care Management Program provides members with up-to-date asthma educational materials and resources to help them better manage their asthma. The program is conducted in collaboration with the New York City Department of Health's (DOH) "Asthma Initiative," and has been recognized by DOH as a model program.

Focus on Fitness

As the weather cools down, many people find themselves anxious to get outside and get moving. To many, fall is the perfect time for outdoor sports and activities. So why not use the 2009 fall season to focus on your fitness?

Touch football, soccer and running are all popular outdoor sports in the fall. Check with your local athletic associations to find out when fall leagues start up. Fall is also peak marathon season - visit marathonguide.com to find a race near you. If you're not into racing, but still want that group momentum, consider joining the New Jersey Road Runner's Club this fall. Fitness isn't just about exercise-it's also about eating healthy food. As we shift into autumn, you'll find that different fruits and vegetables will taste more flavorful because they are "in season." Don't miss out on enjoying these healthy and tasty treats. According to FoodFit.com, some of the best vegetables during the fall season are beans, beets, broccoli, cauliflower, sweet potatoes and watercress; and some of the best fruits are apples, bananas, clementines, grapes, oranges and pears.

Healthfirst members should inquire about our Pediatric Obesity Program to learn more about annual Body Mass Index (BMI) assessment, basics on good nutrition and guidelines for physical activity for children. Your provider may also inform you about some related community events which focus on health and fitness.

This fall could also be the perfect opportunity for you to kick an unhealthy habit, such as smoking. Tobacco has been linked to lung cancer and other deadly chronic diseases. Healthfirst members should talk to their primary care provider to access resources to help fight tobacco addiction. NYS Medicaid covers both prescription and nonprescription smoking cessation aids. If you need help or want to find a local quit smoking program, call 311 or NY State Smoker's Quitline at 1-866-NY-QUITS (1-866-697-8487).

Fight Fall Fatigue

Although the fall air is crisp and refreshing, you may find yourself feeling a bit fatigued or worn out as we change our clocks on November 1 for daylight savings. We'll be setting our clocks back, which means an extra hour of sleep to many people, but for others the disruption to their sleep schedule can be daunting. The National Sleep Foundation offers these tips to help ease the adjustment to standard time:

• Maintain your regular bedtime Saturday night, when clocks move back, and awaken at your regular time on Sunday morning. This can give you an "extra" hour of sleep the next morning and help reduce your sleep debt;
• Block out light and keep your sleeping area dark. Standard time causes the sun to rise about an hour earlier. This can impact sleep, especially for people accustomed to awakening before or around sunrise. The light itself can disturb sleep, so it is always best to sleep in a darkened room;
• Increase the light when you wake up. Light has an alerting affect that may help you wake up. It will also help adjust your biological clock to the "new" sleep schedule;
• Difficulty adjusting to the time change? Staying awake at night or sleeping until your desired wake-up time may be helped by gradually moving bedtime and awakening later by 15 minutes every one to two days.

Coping with the Cold

Sooner than you expect, the cool air will turn into cold air. Be sure you're ready for the drop in temperature by bringing your winter clothes out of storage, picking them up from the dry cleaner, or bringing all your warmer clothes to the front of your closet. Consider carrying a light sweater or jacket with you as we move further into the fall season-you never know when that first frost might happen.

As the temperatures cool down, you may also have to confront an uncomfortable dryness in the air. According to the Asthma and Allergy Foundation of America, dry wind, cold air, or sudden changes in weather can sometimes bring on an asthma episode for those suffering from the chronic condition. Use a scarf or wrap to protect your mouth and nose from the harsh air. Although you can't change the air outside, you can change the air inside your home. Some people find that adding a humidifier to their indoor environment helps alleviate dryness and improve air quality. Be sure to discuss the use of a humidifier with your primary care physician before purchasing one.

While you are working on improving the air quality in your home, be sure to check your carbon monoxide detector. The CDC recommends checking or replacing carbon monoxide batteries twice a year when you change the time on your clocks each spring and fall. Also, for smoke alarms that use regular alkaline batteries, replace the batteries at least annually, perhaps when you change the time on your clocks for daylight savings. Test alarms monthly to ensure they work properly.