Transcript Catching the Polictical Bug

Catching the Political Bug:
Moving the Needle on Public
Health Issues
Alec Stone, MA, MPA
Health Policy Director
ONS Congress 2015
Orlando Florida
Public Awareness Campaigns Successes in the 20th Century
CDC Identifies 10 Public Health Achievements of First Decade of 21st Century
Vaccine-Preventable Diseases: A number of new vaccines were introduced during the first decade of the 21st century. Two of the most significant were the pneumococcal conjugate vaccine, which has prevented an
estimated 211,000 serious pneumococcal infections and 13,000 deaths and the rotavirus vaccine, which now prevents an estimated 40,000-60,000 rotavirus hospitalizations each year. Other achievements included record
low reported cases of hepatitis A, hepatitis B, and chicken pox. A recent economic analysis indicates that vaccinating each child born in the United States in a given year with the current childhood immunization schedule could
prevent approximately 42,000 deaths and 20 million cases of disease.
Prevention and Control of Infectious Diseases: The first decade of the 21st century saw a 30 percent reduction in reported tuberculosis cases in the United States and a 58 percent decline in central line-associated
bloodstream infections. A central line is a tube that a doctor usually places in a large vein of a patient's neck or chest to give important medical treatment. When not put in correctly or kept clean, central lines can become a
freeway for germs to enter the body and cause serious bloodstream infections. These infections can be deadly. Other achievements included improvements in lab techniques and technology that made it easier to identify
contaminated foods more rapidly and accurately to help control the spread of foodborne illness outbreaks. Broader HIV screening recommendations led to an increase in the number of people getting earlier HIV diagnosis,
which provided them earlier access to live-saving treatment and care. The development of a blood donor test to screen for West Nile Virus has identified an estimated 3,000 potentially infected U.S. blood donations, removing
them from the blood supply.
Tobacco Control: The number of states with comprehensive smoke-free laws grew from zero in 2000 to 25 states and D.C. in 2010. In 2009, a new federal cigarette tax took effect, bringing the combined federal and average
state excise tax for cigarettes to $2.21 per pack, an increase of 76 cents per pack since 2000. By 2010, FDA had banned flavored cigarettes, established restrictions on youth access to tobacco products, and proposed larger,
more effective graphic warning labels. Smoking still results in an economic burden, including medical costs and lost productivity, of approximately $193 billion per year.
Maternal and Infant Health: The past decade has seen significant reductions in babies born with birth defects such as spina bifida. This is due largely to folic acid fortification of cereal grain products in the United States as well
as public health campaigns encouraging women of childbearing age to make sure they get the recommended amounts of folic acid. These efforts have led to a 36 percent reduction in babies born with neural tube defects.
Motor Vehicle Safety: From 2000 to 2009, the death rate related to motor vehicle travel went from 14.9 per 100,000 people to 11 per 100,000. The injury rate fell from 1,130 per 100,000 people to 722. The decade also saw
a decline of 49 percent in pedestrian deaths among children, and a 58 percent decline in the number of bicyclist deaths. These achievements are likely the result of improved safety of vehicles and roadways, and safer
behavior on the part of both motorists and pedestrians as a result of strong seat belt, child safety seat and other regulations.
Cardiovascular Disease Prevention: Heart disease and stroke are still among the nation's leading killers. However, deaths from both diseases have declined over the past decade, continuing a trend that began in the early
1900s for stroke and the 1960s for heart disease. These declines in deaths are mainly due to lower smoking rates as well as improvements in treatment, medications and quality of care, which has led to reductions in major
risk factors for heart disease and stroke, such as uncontrolled high blood pressure and high cholesterol.
Occupational Safety: The United States has seen significant improvements in working conditions and the risk of workplace-associated injuries during the past decade. Examples of these improvements include patient lifting
guidance for U.S. health care workers that has reduced, by 35 percent, back injuries among these workers, a comprehensive childhood agricultural injury prevention initiative, which has resulted in a 56 percent decline in farm
injury rates among young people, and reductions in deaths among crab fisherman from overturned fishing vessels as the result of a U.S. Coast Guard initiative to correct stability hazards.
Cancer Prevention: Improvements in screening techniques along with strong cancer screening recommendations have led to improved screening rates and a reduction in deaths of 2–3 percent per year from colorectal, breast
and cervical cancer. In addition, the creation of the National Breast and Cervical Cancer Early Detection Program has reduced disparities by providing breast and cervical cancer screenings to uninsured women.
Childhood Lead Poisoning Prevention: By 2010, 23 states had comprehensive lead poisoning prevention laws compared to just five states in 1990. Enforcement of these statutes, along with federal laws that reduce hazards in
the highest risk housing, has significantly reduced the prevalence of lead poisoning. The percentage of children aged 1 to 5 years with elevated blood lead levels has declined significantly going from 88.2 percent in 1980 to
under 1 percent in 2008.
Improved Public Health Preparedness and Response: There has been much progress made since September 11, 2001 expanding the capacity of the public health system to respond to public health emergencies and disease
outbreaks. The first decade of the 21st century also saw improvements in laboratory response for identifying and reporting disease outbreaks. In addition, influenza vaccination, along with other public health measures taken
during the 2009 outbreak of H1N1, prevented an estimated 5–10 million cases, 30,000 hospitalizations, and 1,500 deaths. The decade also saw the percentage of state public health agencies that were prepared to
use Strategic National Stockpile (SNS) material increasing from 70 percent to 98 percent. SNS has large quantities of medicine and medical supplies to protect the American public if there is a public health emergency (such as
terrorist attack, flu outbreak or earthquake) severe enough to cause local supplies to run out.
CDC’s 5 Health Achievements in 2014
Tips From Former Smokers campaign, A CDC study published this year in The Lancet shows that an estimated 1.6
million smokers attempted to quit smoking and more than 200,000 did immediately following the three-month “Tips
From Former Smokers” (Tips) national ad campaign in 2012.
Listeria & Advanced Molecular Detection, Listeria ranks third as a cause of death from major foodborne germs in
the US and sickens about 1,600 people each year. Because it can be so deadly, CDC has increasingly focused on
better ways to track and trace Listeria outbreaks.
Million Hearts® CDC released a Vital Signs in 2013 showing that at least 200,000 deaths each year from heart
disease in the US could be prevented through changes by individuals, such as stopping smoking, more physical
activity, and less salt in the diet; community changes to create safe places to exercise and smoke-free areas;
improvements in managing high blood pressure, high cholesterol, and diabetes; and improvement in acute care,
secondary prevention, and rehabilitation.
Healthcare-Associated Infections (HAI) On any given day, about 1 in every 20 hospitalized patients has an infection
caused by receiving medical care. These infections cost the U.S. healthcare system billions of dollars and can present
patients with devastating emotional, financial, and medical consequences.
Celebrating 10 Years of PEPFAR CDC and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)
commemorate a decade of success in fighting global HIV/AIDS. Today, there is extraordinary progress in reducing
new HIV infections and providing life-saving care and treatment to those living with HIV/AIDS.
CDC’s 5 Health Threats in 2015
• Antibiotic Resistance & Advanced Molecular Detection: Coping with
untreatable infections in The End of the Antibiotic Era
• Prescription Drug Abuse and Overdose: Reducing the number of
misuse, abuse or overdose amidst a growing epidemic
• Global Health Security: Securing our global health borders knowing
that disease can spread nearly anywhere within 24 hours
• HPV: Preventing cancer in the U.S. by vaccinating preteens and teens
• Polio: Coming together to end polio once and for all
Cancer
• Cancer is the name given to a collection of related diseases. In all types of
cancer, some of the body’s cells begin to divide without stopping and
spread into surrounding tissues. Cancer can start almost anywhere in the
human body, which is made up of trillions of cells. Normally, human cells
grow and divide to form new cells as the body needs them. When cells
grow old or become damaged, they die, and new cells take their place.
• When cancer develops, however, this orderly process breaks down. As cells
become more and more abnormal, old or damaged cells survive when they
should die, and new cells form when they are not needed. These extra cells
can divide without stopping and may form growths called tumors. Many
cancers form solid tumors, which are masses of tissue. Cancers of the
blood, such as leukemias, generally do not form solid tumors.
NINR: Leading By Example
WHAT IS NURSING RESEARCH?
Nursing research develops knowledge to:
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Build the scientific foundation for clinical practice
Prevent disease and disability
Manage and eliminate symptoms caused by illness
Enhance end-of-life and palliative care
Public Awareness Campaign
The National Institute of Nursing Research (NINR), a part
of the National Institutes of Health, developed the
Palliative Care: Conversations Matter™ campaign to
raise awareness of pediatric palliative care and to help
health care professionals and patients discuss palliative
care earlier. It can be hard for health care professionals to
talk about palliative care with their patients—particularly
with children. Many patients and their families have
never heard of palliative care, and they are not aware
that it can give them extra support in dealing with a
serious illness. This is especially true when talking about
palliative care for children.
Outreach and Approach
The Palliative Care: Conversations Matter™ Customizable Tear-off Pad
This tear-off pad provides readily available tips, resources, and answers
to common questions about palliative care to help encourage
interactive discussions with patients and their families or caregivers.
Learn more about the tear-off pad and download the PDF.
The Palliative Care: Conversations Matter™ Campaign Videos
These informational video vignettes highlight the importance of
palliative care for pediatric patients and provide ideas about how to
start and manage a palliative care conversation with pediatric patients,
their parents or caregivers, and their families. Watch the three short
videos to get tips from NINR Director Dr. Patricia Grady and hear the
personal story of a mother’s experience with pediatric palliative care.
NIH Grants for EOL
NIH designated NINR as the lead institute for end-of-life research. NINR’s palliative and endof-life interdisciplinary research efforts apply behavioral, biological, and social science
strategies to address challenges for life-threatening illness and the caregivers.
NINR supports research that explores interventions to optimize patient and caregiver quality
of life across care settings and cultural contexts. NINR recognizes that high-quality, evidencebased palliative care is a critical component of maintaining quality of life at any stage of
illness, not just at the end of life. Specific research topics and activities include: relief of
pain, suffering, and distressing symptoms through effective palliative care; understanding
and facilitating decision making by patients, caregivers, and providers; and developing new
investigators in this area of science.
•Improve understanding of issues and choices underlying palliative and end-of-life care
•Develop bio-behavioral interventions in palliative care for the chronically ill across lifespan
•Develop strategies to minimize the physical and psychological burdens, and better
maintain the health of caregivers, particularly as the patient nears the end of life
•Determine impact of providers trained in palliative and EOL care on healthcare outcomes
•Create new communication strategies among clinicians, patients, families, and
communities to promote decision making regarding complex treatment and care options in
the face of life-threatening illness.
ONS Health Policy Agenda
ONS respectfully calls on the U.S. Congress and the Administration to:
• Promote and improve cancer symptom management and palliative care;
• Advance and ensure access to quality cancer prevention and care; and
• Bolster the nation’s nursing workforce to safeguard public health
Why Oncology Nurses?
Grassroots Advocacy
Grass Tops Influence
Expertise
Personal Stories
Constant Contact
Using Tools In Your Arsenal
Trusted Advisor
Calling Not A Career
One Person Can Make A Difference
References
• http://www.cdc.gov/about/history/tengpha.htm
• http://www.cdc.gov/media/releases/2011/p0519_publichealthachievements.html
• http://beta.congress.gov/bill/113th-congress/housebill/1339?q=%7B%22search%22%3A%5B%22HR+1339%22%5D%7D
• http://www.ninr.nih.gov/newsandinformation/conversationsmatter
• http://www.ninr.nih.gov/newsandinformation/conversationsmatter-providers
• http://www.hpna.org/DisplayPage.aspx?Title=Legislative%20Alert
• http://www2.ons.org/LAC/media/ons/docs/LAC/pdf/HealthPolicyAgendaJan2014.pdf
• http://www.ninr.nih.gov/researchandfunding/spotlight-on-end-of-life-research
• www.house.gov
• www.senate.gov
Contact Information
Alec Stone, MA, MPA
Health Policy Director
125 Enterprise Drive
Pittsburgh, PA 15275-1214
(412) 859-6401 office
(301) 661-1428 cell
[email protected]
@ONSAlec
www.ons.org/LAC