Harvey county council of state governments kansas collaborative meeting november 15 2006
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Harvey County Council of State Governments Kansas Collaborative Meeting November 15, 2006. Paula F. Marmet, MS, RD, Director Office of Health Promotion KS Department of Health & Environment. OHP Mission.

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Harvey County Council of State Governments Kansas Collaborative Meeting November 15, 2006

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Harvey county council of state governments kansas collaborative meeting november 15 2006

Harvey CountyCouncil of State GovernmentsKansas Collaborative MeetingNovember 15, 2006

Paula F. Marmet, MS, RD, Director

Office of Health Promotion

KS Department of Health & Environment


Ohp mission

OHP Mission

Through partnership with the people of Kansas, the Office of Health Promotion promotes healthy behaviors, policies and environmental changes that improve quality of life and prevent chronic disease, injury and premature death for all.


Office of health promotion

Cardiovascular Health

Diabetes

Arthritis

Cancer

Tobacco Use Prevention

Health Risk Behavior Surveillance (BRFSS)

Intentional Injury

Unintentional Injury

Nutrition

Physical Activity

Obesity

Office of Health Promotion


Harvey county council of state governments kansas collaborative meeting november 15 2006

Heart Disease

Cancer

Stroke

Chronic Lower Respiratory Disease

Unintentional injuries

Diabetes

Pneumonia / influenza

Alzheimer’s disease

Kidney disease

0

5

10

15

20

25

30

35

Percentage (of all deaths)

H Health Problems in the U.S.Problems in the U.S.

Actual Causes of Death†

United States, 2000

Leading Causes of Death*

United States, 2000

Tobacco

Diet / Physical Inactivity

Alcohol consumption

Microbial agents

(e.g., influenza, pneumonia)

Toxic agents

(e.g., pollutants, asbestos)

Motor vehicles

Firearms

Sexual behavior

Illicit drug use

Percentage (of all deaths)

*Minino AM, Arias E, Kochanek KD, Murphy SL, Smith BL. Deaths: final data for 2000. National Vital Statistics Reports 2002; 50(15):1-20.

†Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291 (10): 1238-1246. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Correction: Actual Causes of Death in the United States, 2000. JAMA. 2005;293 (3): 293.


Hk2010 process

HK2010 Process

  • Steering Committee reviewed the 22 focus areas of Healthy People 2010

  • Identified recurring themes

  • Selected cross cutting priorities

  • Convened Action Groups

  • Selected 5 specific areas for immediate action


Harvey county council of state governments kansas collaborative meeting november 15 2006

Reducing/Eliminating Health

Disparities

Three Cross

Cutting

Priorities

System Interventions to Address

Social Determinants of Health

Early Disease Prevention, Risk

Identification and Intervention for

Women, Children and Adolescents


Healthy kansans 2010

Healthy Kansans 2010

  • Goal: To markedly improve the 10 leading health indicators

    • Physical Activity

    • Overweight & Obesity

    • Tobacco Use

    • Substance Abuse

    • Responsible Sexual Behavior

    • Mental Health

    • Injury and Violence

    • Environmental Quality

    • Immunization

    • Access to Health Care


Actions for immediate action

Actions for Immediate Action

  • Tobacco Use Prevention

  • Disparities Data

  • Cultural Competency

  • Overweight and Obesity

  • Access to quality health care


Costs of tobacco use in kansas

Costs of Tobacco Use in Kansas

  • Single most preventable cause of death-4,000 deaths per year

  • $724 million health care costs $180.4 million Medicaid program

  • $547 per household residents’ tax burden

  • $811 million smoking caused productivity losses

  • 550 Ks kids become regular smokers each month

  • 50,000 kids alive today will die from tobacco related disease


Cost of obesity in kansas

Cost of Obesity in Kansas

  • $657 million in direct medical costs (5.5%)

  • $138 million in Medicare Costs (6.4%)

  • $143 million in Medicaid expenditures (10.2%)

  • By 2020, 1 in every 4 dollars spent on health care will be to treat obesity related disease


Costs of injury in kansas

Costs of Injury in Kansas

$4.06 billion total expenditure (medical and indirect costs)

$1.43 billion fatal injuries (35%)

$920 million hospitalized injuries (23%)

$1.71 billion for non-hospitalized injury (42%)

Motor vehicle is leading cause of death from injury: Total economic burden in 2000 was almost $1.9 billion ($701 /every adult and child in the state. (NHTSA)


Harvey county council of state governments kansas collaborative meeting november 15 2006

No Data <10% 10%–14%

Obesity Trends Among U.S. AdultsBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Source: Centers for Disease Control and prevention.


Harvey county council of state governments kansas collaborative meeting november 15 2006

No Data <10% 10%–14% 15%–19%

Obesity Trends Among U.S. AdultsBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Source: Centers for Disease Control and prevention.


Harvey county council of state governments kansas collaborative meeting november 15 2006

Obesity* Trends Among U.S. AdultsBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: Centers for Disease Control and prevention.


Obesity trends among u s adults brfss 2004

Obesity Trends Among U.S. AdultsBRFSS, 2004

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Source: Centers for Disease Control and prevention.


Harvey county council of state governments kansas collaborative meeting november 15 2006

Obesity Prevalence among Kansas Adults by Age Groups, BRFSS 2005

Percent

Age in Years

Kansas Behavioral Risk Factor Surveillance System.

Obesity is defined as Body Mass Index  30 Kg/m2.


Obesity prevalence among kansas adults racial disparities brfss 2005

Obesity Prevalence among Kansas Adults - Racial Disparities, BRFSS 2005

Percent

Racial Groups

Kansas Behavioral Risk Factor Surveillance System.

Obesity is defined as Body Mass Index  30 Kg/m2.


Harvey county council of state governments kansas collaborative meeting november 15 2006

Obesity & Chronic Diseases Among Kansas Adults:

Prevalence and Trend of Diagnosed Diabetes and Obesity among Adults in Kansas, BRFSS 1992-2005

Prevalence of diabetes & obesity (%)

Year

1992-2004 Kansas Behavioral Risk Factor Surveillance System ,Office of Health Promotion, Kansas Department of Health and Environment; 1992-2004 Behavioral Risk Factor Surveillance System, Center for Disease Control and Prevention.

Note: Obesity is defined as Body Mass Index (BMI) of 30 or more.BMI = weight (kg)/height (m2)


Harvey county council of state governments kansas collaborative meeting november 15 2006

Trends for Overweight Prevalence among Children & Adolescents – United States, 1963-2000.

Source: NHANES - 1963-65 through 1999-02.


Harvey county council of state governments kansas collaborative meeting november 15 2006

Childhood Obesity in Kansas:

Kansas Students, Grades 6 – 12, YTS 2002-03

Kansas Students, Grades 9 – 12, YRBS 2005

Source: 2002-03 Kansas Youth Tobacco Survey; 2005 Kansas Youth Risk Behavioral Survey.


Harvey county council of state governments kansas collaborative meeting november 15 2006

Smoking trends in Kansas


Harvey county council of state governments kansas collaborative meeting november 15 2006

  • Promising Practices for Preventing Obesity:

  • Support Healthy Lifestyle

  • Breastfeeding

  • Adequate physical activity

  • Limited screen time

  • Achieving optimal level of fruit and vegetable consumption

  • Achieving Energy Balance

  • Source: Centers for Disease Prevention and Health Promotion


Harvey county council of state governments kansas collaborative meeting november 15 2006

  • Recommendations – Guide To Community Preventive Services:

  • Physical Activity

    • - Community wide campaigns.

    • - Point of decision prompts.

    • - Individually-adapted health behavior change.

    • - School-based physical education.

    • - Non-family social support.

    • - Creation &/or enhanced access to places for physical activity

    • combined with informational outreach (policy and

    • environmental changes to increase PA).

  • Source: The Guide to Community Preventive Services. www.thecommunityguide.org


Harvey county council of state governments kansas collaborative meeting november 15 2006

  • Nutrition

  • Multi-component nutrition interventions to improve knowledge/attitudes and consumption patterns and environments to enhance healthy food choices through:

  • - Educational components (such as classroom instruction by

  • teachers, integrating nutrition education across curricula,

  • peer training)

  • - Environmental components (such as school menus,classroom

  • snacks & special treats)

  • - Other components (such as physical activity, family

  • education & involvement, community involvement)

  • Source: The Guide to Community Preventive Services. www.thecommunityguide.org


Harvey county council of state governments kansas collaborative meeting november 15 2006

  • Tobacco Use Prevention & Control

  • Prevent tobacco use initiation.

  • Increase cessation efforts.

  • Reduce exposure to secondhand smoke.

  • Invest in Proven Practices

    Source: The Guide to Community Preventive Services. www.thecommunityguide.org


Injury prevention

Injury Prevention

  • $1 spent on smoke alarms saves $69

  • $1 spent on bike helmets saves $29

  • $1 spent on child safety seats saves $32


Governor s healthy kansas agenda

Governor’s Healthy KansasAgenda

  • Tobacco Use Prevention

  • Increase Physical Activity

  • Improve Nutrition

  • Children in Schools

  • Adults in the Workplace

  • Seniors where they live


Harvey county council of state governments kansas collaborative meeting november 15 2006

Helping to Create a Healthier Worksite

The Capitol Mid-Week

Farmers' Market

The Kansas Department of Health and Environment, Office of Health Promotion, and the Kansas Department of Commerce, Agricultural Marketing Division, announce the grand opening of the Capitol Mid-Week Farmers'Market on May 24th from 9 a.m. to 2 p.m.


Harvey county council of state governments kansas collaborative meeting november 15 2006

Farmers' Market June 2006


Harvey county council of state governments kansas collaborative meeting november 15 2006

Farmers' Market June 2006


Smoking cessation in pregnancy

Smoking Cessation in Pregnancy

  • 1-866-KanStop

  • 4,800 pregnant women smokers in KS

  • Neonatal health care costs due to smoking= $3.2 million

  • Medicaid = 11% of smoking caused health care costs in Kansas

  • Kansas Legislature allocated $250,000


Provider training

Provider Training

  • 5 A’s approach for tobacco cessation in a clinical setting

  • $500 educational stipend to set up system

  • $10 incentive for each PG referral to QL

  • Provide technical assistance and feedback to providers


Harvey county council of state governments kansas collaborative meeting november 15 2006

Kansas DPCP and HDSP

Collaboration

Quality of Care Project


Harvey county council of state governments kansas collaborative meeting november 15 2006

Background For Collaboration

  • CDEMS was developed for chronic disease management, not only for diabetes

  • DPCP has an established Quality of Care project (3 years and 66 organizations)

  • CVH team desired to address CVD quality of care issues

  • Tool to be used for identification of gaps in quality of care of chronic diseases

  • Anticipate improvement in patient outcomes

  • Tool to enhance and/or develop office protocols to improve the quality of care for patients with Diabetes and/or CVD


Harvey county council of state governments kansas collaborative meeting november 15 2006

Diabetes Project Organization Demographics

  • 66 funded organizations

  • 90 sites statewide

  • 350 participating health professionals

  • 50% of Kansas’ counties represented

  • Diverse organizations participating


Harvey county council of state governments kansas collaborative meeting november 15 2006

Kansas Diabetes Quality of Care Project Sites

Doniphan

Brown

Republic

Washington

Marshall

Nemaha

Cheyenne

Rawlins

Decatur

Norton

Phillips

Smith

Jewell

Atchison

Pottawatomie

Cloud

Leavenworth

Riley

Jackson

Clay

Sherman

Thomas

Sheridan

Graham

Rooks

Osborne

Mitchell

Jefferson

Geary

Ottawa

Lincoln

Shawnee

Waubaunsee

Dickinson

Douglas

Johnson

Wallace

Logan

Gove

Trego

Ellis

Russell

Saline

Ellsworth

Morris

Osage

Franklin

Miami

Rush

Greeley

Wichita

Scott

Lane

Ness

McPher-

Barton

son

Pawnee

Rice

Marion

Lyon

Anderson

Linn

Chase

Coffey

Hodgeman

Harvey

Stafford

Stafford

Hamilton

Kearney

Finney

Wood-

Edwards

Reno

Reno

son

Allen

Bourbon

Greenwood

Pratt

Sedgwick

Butler

Kingman

Gray

Ford

Kiowa

Stanton

Grant

Haskell

Wilson

Neosho

Crawford

Elk

Mont-

gomery

Morton

Stevens

Seward

Meade

Clark

Comanche

Barber

Harper

Sumner

Cowley

Chautauqua

Labette

Cherokee


Harvey county council of state governments kansas collaborative meeting november 15 2006

Organization Demographics – cont’d

Types of participating organizations:

  • Local Health Departments

  • Community Health Clinics

  • Safety Net Clinics

  • American Indian Health Clinic

  • Home Health Agencies

  • Hospital Affiliated Practices

  • Private Practices

  • Farmworker Program

  • Promotora Program


Harvey county council of state governments kansas collaborative meeting november 15 2006

CDEMS

Hard copy inserted

into patient’s chart

% of Patients Receiving

Vaccinations and

Foot Exams

Needs Improvement

Patient Data

Entered

Dr. updates

patient’s chart

How does it work?


Harvey county council of state governments kansas collaborative meeting november 15 2006

First Year Outcomes

Organizations Checking Yes on the Quarterly Office Self-Assessment Form


Harvey county council of state governments kansas collaborative meeting november 15 2006

First Year Outcomes Cont’d….

Organizations Checking Yes on the Quarterly Office Self-Assessment Form


Harvey county council of state governments kansas collaborative meeting november 15 2006

First Year Outcomes Cont’d….

Organizations Checking Yes on the Quarterly Office Self-Assessment Form


Harvey county council of state governments kansas collaborative meeting november 15 2006

First Year Outcomes Cont’d….

Organizations Checking Yes on the Quarterly Office Self-Assessment Form


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