Transcript 1. 2007 Governor`s Public Health Conference Presentation: New

Healthy Kansans 2010:
New Frontiers in Public Health
Howard Rodenberg MD MPH
Director, KDHE Division of Health
and State Health Officer
Governor’s 2007 Public Health Conference
First Official Public Health Body in
Kansas:
Kansas State Board, 1885
State and Local Boards of Health
Chapter 129, Laws 1885
An Act to create a State and local boards of health, and to regulate the
practice of medicine in the State of Kansas.
Sec 4. The state board of health shall supervise the
health interests of the people of this state….
U.S. and Kansas in 1880
• 1880 U.S. Vital Statistics showed…
– Nation struggling with infectious, preventable
diseases
– More than one in ten infants died before their
first birthday
– 9 out of the top 10 ten causes of death were
infectious diseases
• There were no official vital statistic records
for Kansas in 1880 (no data)
Table 1. United States Leading Causes of Death, 1880
Number of Deaths
(Registered States)
Percent of Known
Causes of Death
Consumption
(Tuberculosis)
91,270
13.1%
Pneumonia
63,053
9.1%
Diphtheria
38,143
5.5%
Heart disease
26,068
3.8%
Cholera infantum
24,983
3.6%
Typhoid fever
22,854
3.3%
Malarial fever
20,231
2.9%
Croup
17,966
2.6%
Convulsions
17,844
2.6%
Scarlet fever
16,388
2.4%
Cause
Actions of First State Board of
Health focused on…
• Setting up appropriate systems and tools to allow them to
identify health problems, track improvements, and set priorities
– Created first vital statistics forms, which included marriage, birth, stillbirth, death, and vaccination forms
• Promoting prevention policies – specifically, sanitation and
hygiene
– Included rules for appropriate sewer drainage, keeping water supplies
clean, quarantining infectious diseases, disinfecting areas where disease
had been present, and vaccination
Today
• Things have changed in 125 years!
• Chronic disease are the new frontier
• Have enjoyed rapid advancements in medical
technologies, pharmaceuticals but these have not
solved the chronic disease problem
• Many chronic diseases share common risk factors
• Behavioral changes are key to reducing premature
death
• Chronic diseases present complex, long-term
challenge
United States Leading Causes of Death, 2002
Cause
% All Deaths
Heart Disease
28.5%
Cancer
22.8%
Stroke
6.7%
Chronic Lower Respiratory Disease
5.1%
Unintentional Injury
4.4%
Diabetes
3.0%
Pneumonia / Influenza
2.7%
Alzheimer’s Disease
2.4%
Kidney Disease
1.7%
United States Actual Causes of Death, 2000
Cause
% All Deaths
Tobacco
18.1%
Diet / Physical Activity
15.2%
Alcohol Consumption
3.5%
Microbial Agents (e.g., influenza, pneumonia)
3.1%
Toxic Agents (e.g., pollutants, asbestos)
2.3%
Motor Vehicles
1.8%
Firearms
1.2%
Sexual Behavior
0.8%
Illicit Drug Use
0.7%
Discovering a Healthier Future:
Healthy Kansans 2010
• Derived from CDC Healthy People 2010
Project
• Sets national goals for health and healthrelated behaviors
• Rankings vs. goals
• Where does Kansas rate now?
10 Leading Health Indicators
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Physical Activity
Overweight and Obesity
Tobacco Use
Substance Abuse
Responsible Sexual Behavior
Mental Health
Injury and Violence
Environmental Quality
Immunization
Access to Health Care
Healthy People/Kansans 2010: 10 Leading Health Indicators
Objective
Kansas Rate
HP2010 Goal
Increase the proportion of adolescents who engage in vigorous
physical activity that promotes cardiorespiratory fitness 3 or more
days per week for 20 or more minutes per occasion.
70%
(2005 KS Youth Risk Behavior Surveillance System, grades
9-12)
85%
(grades 9-12)
Increase the proportion of adults who engage regularly, preferably
daily, in moderate physical activity for at least 30 minutes per day.
38%
(2005 KS BRFSS)
50%
Reduce the proportion of children and adolescents who are
overweight or obese.
11%
( ages 12-18, 2002 KS Youth Tobacco Survey)
5%
(ages 12-19)
Reduce the proportion of adults who are obese.
24%
(2005 KS BRFSS)
15%
Reduce cigarette smoking by adolescents
21%
(2005 KS Youth Risk Behavior Surveillance Survey)
16%
(grades 9-12)
Reduce cigarette smoking by adults
18%
(2005 KS BRFSS)
12%
Physical Activity
Overweight and Obesity
Tobacco Use
Substance Abuse
Healthy People: Increase the proportion of adolescents not using
alcohol or any illicit drugs during the past 30 days
6th,
o
8th,
6th,
10th,
8th,
69%
and
graders reported not using alcohol at
least once in the past 30 days
12th
91%
and
graders reported not using marijuana
at least once in the past 30 days
10th,
12th
( 2005 Kansas Communities That Care Survey Youth
Survey)
89%
Healthy People/Kansans 2010: 10 Leading Health Indicators
Objective
Kansas Rate
HP2010 Goal
Reduce the proportion of adults engaging in binge drinking of
alcoholic beverages during the past month.
12%
(2005 KS BRFSS)
6%
55%
(Abstinence only - 2005 KS Youth Risk Behavior
Surveillance System, grades 9-12)
95%
(includes abstinence or
condom use if sexually
active)
No Kansas data available that is directly comparable to the
HP2010 target
50%
Reduce deaths caused by motor vehicle crashes
17.5 deaths per 100,000 population
(2004 Vital Statistics, KDHE)
9.2 deaths per 100,000
population
Reduce homicides
4.3 homicides per 100,000 population
(2004 KS Vital Statistics)
3.0 homicides per 100,000
population
0%
(EPA Aerometric Information Retrieval System)
0%
84%
(4:3:1:3:3 series - 2005 National Immunization Survey
80%
(4:3:1:3:3 series)
Responsible Sexual Behavior
Increase the proportion of adolescents who abstain from sexual
intercourse
Mental Health
Increase the proportion of adults with recognized depression who
receive treatment
Injury and Violence
Environmental Quality
Reduce the proportion of persons exposed to air that does not meet
the U.S. Environmental Protection Agency’s health-based standards
for ozone.
Immunization
HP2010 Objective: Increase the proportion of young children who
are fully immunized (4:3:1:3:3 series)
Healthy People/Kansans 2010: 10 Leading Health Indicators
Objective
Kansas Rate
HP2010 Goal
Increase the proportion of noninstitutionalized adults aged 65 years
and older who are vaccinated annually against influenza.
66%
(2005 KS BRFSS)
90%
67%
(2005 KS BRFSS)
90%
Increase the proportion of persons with health insurance.
87%
(2005 KS BRFSS)
100%
Increase the proportion of persons who have a specific source of
ongoing primary care.
84%
(2005 KS BRFSS)
96%
Increase the proportion of pregnant women who begin prenatal care
in the first trimester of pregnancy.
87%
(2004 Vital Statistics, KDHE)
90%
Increase the proportion of adults aged 65 years and older ever
vaccinated against pneumococcal disease.
Access to Health Care
Healthy Kansans 2010 Focus Areas
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Maternal Infant Child Health
Oral Health
Hearing
HIV & STD
Family Planning
Arthritis
Childhood & Adult
Immunization
Disability
Environmental Health
Nutrition & Overweight
Respiratory Health
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Occupation Health
Vision
Heart Disease & Stroke
Diabetes
Mental Health
Substance Abuse
Injury and Violence
Cancer
Tobacco
Chronic Kidney Disease
Public Health Infrastructure
Access to Care
Physical Activity & Fitness
The HK2010 Process
Priority Areas:
• Reducing and Eliminating Health Disparities
• System Interventions to Address Social
Determinants of Health
• Early Disease Prevention, Risk Identification
and Intervention for Women, Children and
Adolescents
HK2010: A Closer Look
• The HK2010 recommendations focus on
systematic changes to improve health and reduce
premature death
• Recommendations continue to stress the
importance of the core public health services such
as vaccinations and clean water
• A growing emphasis on addressing chronic disease
and the role these conditions play in premature
death and quality of life issues
The Wheels in Motion
• Since 2000, a 19% drop in youth smokers in Kansas; 20% drop
in the number of adult smokers
• Creation of the Governor’s Council on Fitness
• Creation of the Child Health Advisory Council
• Improved childhood immunization rates
• “Don’t Let the Flu Bug U” campaign
• Health care reform efforts mention role of wellness
• Multiple bills related to tobacco use prevention, clean indoor air,
safety belt usage, and childhood obesity were proposed during
the 2007 Kansas legislative session
• Governor’s Healthy Kansas Program…take the pledge!
The Wheels in Motion
Chronic Disease Risk Reduction
Grants
November 2006 Fiscal Yr‘07
Cheyenne Rawlins
Decatur
Norton
Phillips
Smith
Jewell
Osborne
Mitchell
Republic Washington Marshall
Nemaha Brown Doniphan
Cloud
Sherman
Thomas
Sheridan Graham
Rooks
Clay
Pottawatomie
Ottawa
Wallace
Gove
Logan
Trego
Russell
Ellis
Riley
Lincoln
Dickinson
Saline
Greeley
Wichita Scott
Lane
Ness
Rush
Jefferson Leavenworth
Wyandotte
Shawnee
Geary
Douglas Johnson
Wabaunsee
Osage
Morris
Ellsworth
Atchison
Jackson
Lyon
Barton
Franklin
Miam i
Marion
Rice
McPherson
Chase
Coffey
Pawnee
Finney
Hamilton
Hodgeman
Anderson
Linn
Stafford
Reno
Kearney
Harvey
Gray
Ford
Stanton
LEGEND
Seward
Wilson
Clark
Meade
Level A - Grants less
than $15,000
Clean Indoor Air
Ordinance Passed
Bourbon
Butler
Kingman
Grant
Stevens
Sedgwick
Pratt
Haskell
Kiowa
Morton
Woodson Allen
Greenwood
Edwards
Comanche
Barber
Harper
Neosho
Elk
Sum ner
Cowley
Crawford
Montgomery
Chautauqua
Level B - Grants more than
$15,000 based on community
need
Cherokee
Labette
Level C - Grants more than $15,000 to achieve
comprehensive tobacco funding level
(including funding from other sources)
Clean Indoor Air
Ordinance Proposed or
Discussed
• To date, 18 communities in Kansas have passed Clean
Indoor Air Ordinances
Looking Ahead
• Partner to implement HK2010 at the local
level
• Reduce the impact chronic disease has on
the state of Kansas through HK2010
recommendations
• Continue to find ways to address health
disparities
To boldly go where no state
has gone before!