Chronic disease prevention
Download
1 / 70

Chronic Disease Prevention - PowerPoint PPT Presentation


  • 199 Views
  • Uploaded on

Chronic Disease Prevention. November 20, 2008. Objectives. Background: Setting the Stage Status of Chronic Diseases in San Diego Evidenced-based Best Practices HHSA Chronic Disease Prevention Model. Setting the Stage. Why Chronic Disease?. Why Chronic Disease?.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Chronic Disease Prevention' - akiva


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Chronic disease prevention

Chronic Disease Prevention

November 20, 2008


Objectives
Objectives

  • Background: Setting the Stage

  • Status of Chronic Diseases in San Diego

  • Evidenced-based Best Practices

  • HHSA Chronic Disease Prevention Model


Setting the stage

Setting the Stage

Why Chronic Disease?


Why chronic disease
Why Chronic Disease?

  • California Conference for Local Public Health Officers (CCHLO)

    • Chronic Disease Conference

    • Spurred Idea to develop CC Agency for Agency

      • Two meeting held to date to develop an inventory of Agency Chronic Disease activities

    • SPOS came to PHS to conduct a “Focused Dialogue”

    • Chronic Disease was chosen


What is chronic disease
What Is Chronic Disease?

  • According the U.S. National Center for Health Statistics, is a disease that lasts 3 months or more.

  • Cannot be prevented by vaccines or cured by medications.

  • Caused by health damaging behaviors - particularly tobacco use, lack of physical activity, and poor eating habits.

  • Is the leading cause of death and disability in the United States.

  • Accounts for 7 of the 10 U.S. leading cause of death.


Why should we care
Why Should We Care?

  • Chronic diseases are prevalent, preventable and costly!

  • Cause extended pain and suffering, associated with decreased quality of life for millions.

  • Treatment for seven chronic diseases including cancers, mental illnesses, heart disease, lung conditions, hypertension, stroke, and diabetes ran to nearly $280 billion in 2003; now estimated to be to $1.3 trillion per year.

  • Prevention programs are highly cost-effective


Top 10 causes of mortality in san diego county
Top 10 Causes of Mortality in San Diego County

= Chronic Diseases

Rates are per 100,000 population.

Source: State of California, Department of Public Health, Center for Health Statistics, Vital Statistics Section, Death Statistical Master Files



Physical activity by gender

PA and Nutrition Trends

Physical Activity by Gender

Percent

Nutrition by Gender

Men

Women


Healthcare cost in california and san diego
Healthcare Cost in California and San Diego

  • $130 Billion spent (treatment and lost productivity) by California in 2003

  • $4.3 Billion in SD County (not including lung cancer treatment)


3 four 50
3 – FOUR – 50

3 RISK FACTORS

(Tobacco Use, Poor Diet, Lack of Physical Activity)

4 CHRONIC DISEASES

(Heart Disease/Stroke, Type 2 Diabetes, Respiratory Disease, Cancer)

50% of DEATH


Status of chronic diseases in san diego

Status of Chronic Diseases in San Diego

What Are the Statistics?


LIFE EXPECTANCY TRENDS

San Diego County vs United States, 2000-2006

*2006 U.S. data are preliminary


San diego county population by race ethnicity 2007
San Diego County Populationby Race/Ethnicity, 2007

  • 3 million

    people

  • Racial/Ethnic

    groups from

    around the

    world.

  • Over 100

    languages

Asian 9.4%

N=292,251

Hawaiian/Pacific Islander 0.4%

N=13,144

American Indian 0.5 %

N=15,946

Black 5.4%

N=166,486

Hispanic 29.3%

N=906,898

White 51.6%

N=1,597,847

Source: SANDAG, San Diego County 2007 Population Estimates


San diego county population by race ethnicity census 1990 vs 2000 vs 2007
San Diego County Populationby Race/Ethnicity, Census 1990 vs. 2000 vs. 2007

  • Between

  • 1990 & 2000:

  • The population of Hispanics and Asian increased

  • The population of Whites and Blacks decreased

Percent

Source: SANDAG, San Diego County 1990, 2000 Census, and 2007 Population estimates


All cancer deaths by race ethnicity 2005
All Cancer Deathsby Race/Ethnicity, 2005

Cancer is the

second leading

cause of death

for San Diego

County

San Diego County Overall Rate, 2005: 163.1 / 100,000

HP 2010 Goal: 159.9

Note: All rates are adjusted to 2000 Standard U.S. Population.

Source: California Death Statistical Master File; SANDAG January 1, Population Estimates.


Selected cancer deaths by race ethnicity 2005
Selected Cancer Deathsby Race/Ethnicity, 2005

HP 2010 Goal

Note: All rates are adjusted to 2000 Standard U.S. Population.

Source: California Death Statistical Master File; SANDAG January 1, Population Estimates.


Coronary heart disease and stroke deaths by race ethnicity 2005
Coronary Heart Disease and Stroke Deathsby Race/Ethnicity, 2005

Blacks have the

highest rate of

coronary heart

disease deaths

and stroke deaths

compared to

other racial and

ethnic groups.

San Diego County Overall:

CHD Rate - 128.4 / 100,000

Stroke Rate – 41.3 / 100,000

HP 2010 Goal CHD: 166.0

HP 2010 Goal Stroke: 48.0

Note: All rates are adjusted to 2000 Standard U.S. Population.

Source: California Death Statistical Master File; SANDAG January 1, Population Estimates.


Diabetes by Race/Ethnicity

Prevalence of Diabetes Among Adults 2005*

% High School Students Overweight 2005

Hospital

Admissions 2005

Deaths (underlying)2005

R/E

Black

White

Hispanic

Asian/Other

69.0

16.6

33.5

21.2

10.7

7.7

18.4

7.4

6.6

5.1

6.5

7.2

303.5

87.1

236.0

87.6

* - Percentage of adults who were ever diagnosed with diabetes

Source: Youth Risk Behavior Survey (YRBS), San Diego City Schools; California Office of Statewide Planning and Development;SANDAG January 1, Population Estimates; California Health Interview Survey (CHIS), California Department of Health Services, Death Statistical Master File.


Diabetes mortality
Diabetes Mortality

Among the top 53 U.S. City/County jurisdictions

San Diego County:

  • Ranked 52 in 1990

  • Ranked 46 in 2004

  • Ranked 8th in the highest rate of change between 1990 and 2004

Source: NACCHO 53 Big Cities Health Inventory, 2007

Note: Ranking scheme - 1 being worst and 53 being best


Diabetes mortality among san diego county residents 2000 2005
Diabetes Mortality Among San Diego County Residents, 2000-2005

Deaths and Age-adjusted Rates

HP2010

= 45


Diabetes hospitalizations among san diego county residents 2001 2005
Diabetes Hospitalizations Among San Diego County Residents, 2001-2005

Number and Age-adjusted Rates


Diabetes hospitalizations among san diego county residents 2001 20051
Diabetes Hospitalizations Among San Diego County Residents, 2001-2005

By Race/EthnicityNumber and Age-adjusted Rates


Overweight & Obese Adults* 2001-2005by Race/Ethnicity, 2005

HP 2010 Goal

Unhealthy weight

(BMI>25): 40%

Obesity (BMI >30): 15%

* as Defined by Body Mass Index (BMI)

Source: 2005 California Health Interview Survey (CHIS)


Asthma in san diego county by race ethnicity
Asthma in San Diego County 2001-2005by Race/Ethnicity

Average Annual Number of Deaths

2002-2004

Estimated Prevalence

Among Children 2005

Hospitalization Rate, 2005

Race/Ethnicity

Black

White

Hispanic

Asian/Other

13.8*

9.6

12.4

11.7

204.7

59.3

74.9

62.6

3

18

3

4

Source: 2005 California Health Interview Survey (CHIS), California Office of Statewide Planning and Development;SANDAG January 1, Population Estimates. California Department of Health Services, Death Statistical Master File

* - These results for Blacks reflect 2003 data results since sample size for Blacks in 2005 was statistically unreliable.


Selected Health Indicators* 2001-2005

San Diego County, CA, & US, HP2010

Healthy People 2010 Goal

San Diego County

Indicator

CA

U.S.

  • Infant Mortality

  • Adults reporting poor/fair health

  • Incidence of AIDS

  • CHD Deaths

  • Suicides

  • F. Breast Cancer Deaths

  • Unintentional Injury Deaths

4.6

14.4%

14.0

144.4

10.5

22.9

28.8

4.5

None

1.0

166.05.0

22.3

5.3

16.0%

11.8

162.8

8.5

24.1

30.5

7.0

14.0%

15.0

159.6

10.7

26.0

37.7

The numbers above reflect either rates or percentages

* - These data reflect the most current comparable data


Evidence based best practices

Evidence-based Best Practices 2001-2005

Do They Work?


Direction from the national level
Direction from 2001-2005the National Level

Federal Government Agencies

United States Department of Agriculture

United States Surgeon General

Centers for Disease Control


“Healthy places are those 2001-2005designed and built to improve the quality of life for all people who live, work, worship, learn, and play within their borders -- where every person is free to make choices amid a variety of healthy, available, accessible, and affordable options.”

CDC’s “Designing & Building Healthy Places”


Direction from the National Level 2001-2005

Leading Public Health Organizations

National Association of County and City Health Officials

National Task Force on Community Preventive Services

Robert Wood Johnson Foundation

Kaiser Permanente

American Planning Association (funded by CDC)


Public 2001-2005

California Conference of Local Health Officers

California Department of Public Health

Governor's Obesity Prevention Plan

Private

The California Endowment

Strategic Alliance

Direction from the State Level


Best Practices and Promising Interventions 2001-2005

  • Healthy Community Improvements

  • Healthy Community Development

  • Healthy Community Plans & Policies


1 healthy community improvements
1. Healthy Community Improvements 2001-2005

Best Practices and Promising Interventions

Partnering with communities and cities to improve existing physical and social conditions that prevent physical activity and healthy eating


Healthy community improvements
Healthy Community Improvements 2001-2005

Safe and healthy routes to schools, parks, healthy foods, seniors

Traffic calming, improve street crossings

Installing/improving sidewalks & bike paths

Community gardens

School/community joint use agreements


Safe and Healthy Routes to Schools and Parks, Healthy Foods, Seniors

AARP

- assessments

- advocates


From abandoned lots to community gardens… Seniors

Create gardens for culturally appropriate foods reflective of the community.


CX3 Projects Seniors(Chula Vista & La Mesa)Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention

Strong Partnerships

Leadership Training

Youth & Mentors

  • Community Assessment

  • Advocacy


2 healthy community development
2. Healthy Community Development Seniors

Best Practices and Promising Interventions

Promoting healthy development and redevelopment projects in neighborhoods


Healthy community development
Healthy Community Development Seniors

Integrating “Healthy Places” design into the Development Review process

Redevelopment areas

Grocery stores in underserved areas

Facility design




Eliminating Food Deserts… “Health”Attracting a Grocery Store into East Oakland, CA


Partners: East Oakland “Health”Diabetes Work Group, Alameda County Department of Public Health, Network for a Healthy California


3 healthy community plans policies
3. Healthy Community Plans & Policies “Health”

Best Practices and Promising Interventions

Promoting healthy government, school and worksite policies and plans that support physical activity, healthy eating and tobacco-free environments


Healthy community plans policies
Healthy Community Plans & Policies “Health”

Land use & transportation planning

Affordable housing policies

Regional Food Systems & Urban Agriculture

Worksite Wellness policies

Government Wellness policies

School Wellness policies



City of Richmond “Health”

Health and Wellness Element

Policy Framework

www.healthycommunitiesbydesign.org


School wellness gardens
School Wellness Gardens “Health”

Classroom Garden Beds

Quad Area with Gardening


Healthier vending machines
Healthier Vending Machines “Health”


Chronic diease model

Chronic Diease Model “Health”

Will it Work?


Socio-Ecological Model “Health”

Businesses

Neighborhoods

Policies and Laws

Individuals

Families


Environmental approaches to tobacco the california model
Environmental Approaches to Tobacco “Health”: The California Model

  • Prop. 99 Tobacco Tax Funds

  • Local Ordinances and State Legislation for Smoke-Free Environments

  • Massive Anti-Tobacco Campaign


California vs the us
California vs. The US “Health”

  • Smoking Rates

  • Lung Cancer Death Rates

Percent

American Lung Association of California

Centers for Disease Control, National Cancer Institute, statecancerprofiles.cancer.gov


Tobacco and heart attacks
Tobacco and Heart Attacks “Health”

  • Pueblo, Colorado

    • Decrease in heart attack rates by 28% after smoke-free ordinance

      • 399 HA pts in 1.5 yrs prior to ordinance, only 291 HA pts in 1.5 yrs after

  • Helena, Montana

    • Decrease in heart attack rates by 40% during first 6 months of smoke-free ordinance


Why act now
Why Act Now? “Health”

Chronic Disease Prevention is strategic:

  • Fundamental to reducing death and disability and improving community health

  • Critical to cutting health care costs

  • Experience to-date shows that strategies can be very cost-effective

  • Funding opportunities for strategies that focus on environmental change


At its foundation
At its Foundation… “Health”

Place Matters

Adopting the concept that neighborhood environmental factors all affect individual behaviors and health

From Policy Link and

The California Endowment


Why place matters environmental strategies
Why Place Matters: Environmental Strategies “Health”

  • Physical Environment

    • Safe parks; full-service grocery stores and farmers’ markets; safe, walkable streets; less truck and bus traffic; well-maintained housing; open spaces.

  • Social Environment

    • Strong social networks that bring neighbors together—whether to advocate for change, cultivate a community garden, or provide services.


Why place matters environmental strategies1
Why Place Matters: Environmental Strategies “Health”

  • Economic Environment

    • Commercial investment, jobs that take people out of poverty, businesses that provide healthy food options.

  • Service Environment

    • Access to quality healthcare services, public safety, and community support services.


Understanding the problem
Understanding the problem “Health”

50% of Deaths

environments

Tobacco

Chronic Disease

Nutrition

*Service*

*Physical*

Heart Disease/Stroke

Type 2 Diabetes

Cancer

Respiratory Disease

Physical Activity

$4.3 Billion Annually

*Economic*

*Social*

Poor environments a Unhealthy behaviors a Chronic Diseases


Adopting a new solution “Health”

Creating Environments to Support Healthy Behaviors

environments

Tobacco

Chronic Disease

Nutrition

*Service*

*Physical*

Reduction in:

Heart Disease/Stroke

Type 2 Diabetes

Cancer

Respiratory Disease

Physical Activity

*Economic*

*Social*

Healthy environments a Healthy Behaviors a Disease Reduction


Qa comments
QA & Comments “Health”


ad