October 18, 2012 Division of Public Health - Public Health Orientation 10:30 A.M. – 11:30 A.M.

1. Healthiest Wisconsin 2020: Everyone Living Better, Longer October 18, 2012 Division of Public Health - Public Health Orientation 10:30 A.M. – 11:30 A.M. Madison, Wisconsin Margaret Schmelzer, MS, RN State Health Plan Director, Public Health Nursing Director Wisconsin Department of Health Services, Division of Public Health Michele Green, RN, Masters Candidate University of Wisconsin – Milwaukee, College of Nursing

2. 2 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

3. A View From the PartnersEssential Elements for Success Source: DePablo M, Abraham B, 2009 3 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

4. What is HW2020? Flexible public health agenda designed by many to be implemented by all from 2010 – 2020. Systematic approach designed to: Align policies and systems. Contain health care costs. Improve health outcomes. 4 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

5. What is HW2020? A “call to action” to work together to improve health where we live, grow, work, learn, and play. 5 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

6. Intent of HW2020 Fulfill the statutory requirement to the Wisconsin Department of Health Services to produce a public health agenda at least every ten years Wisconsin Statute, Chapter 250.07 (1)(a) Provide an agreed upon framework to work together to assure conditions in which people can be healthy and members of healthy, safe, and resilient families and communities. 6 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

7. Brief History Healthier People in Wisconsin: A Public Health Agenda for the Year 2000 Healthiest Wisconsin 2010: A Partnership Plan to Improve the Health of the Public Healthiest Wisconsin 2020: Everyone Living Better, Longer 7 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

8. Strategic Processes Strategic planning Science and evidence with wisdom of community Quality Improvement Collaborative diverse partnerships 8 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

9. 9 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

10. Who are the HW2020 Partners? 10 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

11. HW2020 Overview and Key Features Framework Focus areas and objectives Review front page of HW2020 web site Profiles Implementation Plan Evidence- and science-based practices Endorsement form Links to national and federal sources 11 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

12. HW2020 Framework Vision Mission Values Goal 1 Goal 2 Focus Areas and Objectives CrosscuttingHealthInfrastructure Outcomes 12 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

13. HW2020 Framework Vision Everyone Living Better, Longer Mission Assure conditions in which people can be healthy and members of healthy, safe and resilient families and communities 13 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

14. Values / Principles Shared Accountability Alignment Collaboration Community Assets Evidence Fairness Infrastructure Justice Leverage Performance Improvement Prevention Science Shared Leadership 14 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

15. Goals Improve health across the life span Eliminate health disparities and achieve health equity 15 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

16. Focus Areas and Objectives 23 Focus Areas Each Focus Area has 2-3 objectives Each objective is directly tied to one of the two HW2020 goals The Focus Areas and objectives span 3 categories: Crosscutting Health Infrastructure 16 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

17. Crosscutting Focus Areas (2) Focus Area CategoriesRequires Systems Thinking andKeeping Your Eyes on All Three Categories Infrastructure Focus Areas (9) Health Focus Areas (12) 17 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

18. Focus Areas12 Health Focus Areas Adequate, appropriate and safe food and nutrition Alcohol and other drug use Chronic disease prevention and management Communicable disease prevention / control Environmental and occupational health Healthy growth and development Injury and violence Mental health Oral health Physical Activity Reproductive and sexual health Tobacco use and exposure 18 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

19. Focus Areas9 Infrastructure Areas Access to high-quality health services Collaborative partnerships for community health improvement Diverse, sufficient, and competent workforce that promotes and protects health Emergency preparedness, response, and recovery Equitable, adequate, and stable public health funding Health literacy Public health capacity and quality Public health research and evaluation Systems to manage and share health information and knowledge 19 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

20. Focus Area Objectives2 Crosscutting Focus Areas Eliminate health disparities Social, educational, and economic factors that impact health 20 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

21. Crosscutting Focus Areas (2) Focus Area CategoriesRequires Systems Thinking andKeeping Your Eyes on All Three Categories Infrastructure Focus Areas (9) Health Focus Areas (12) 21 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

22. Consider . . . “None of us expect to act on more than a tiny corner of the great complexity. But in our interrelated society, itself part of an uncompromising independent world, we have to think about the whole complexity in order to act relevantly on any part of it.” Source: Harlan Cleveland: The Knowledge Executive, 1989 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

23. Aligning Policies and Systems for Better Health Health Across the Life Span Eliminate Health Disparities and Achieve Health Equity Reduced Mortality, Morbidity, and Disability Health Outcomes Health Behaviors and Skills Social, Economic and Educational Factors Health Services and Systems Physical Environment Health Factors or Determinants Policies and Programs Adapted with modifications from University of Wisconsin School of Medicine and Public Health, “Mobilizing Action Toward Community Health, County Health Rankings,” accessed at http://www.counthealthrankings.org/about-project/background 23 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

24. Social Environment Physical Environment Genetic Endowment Individual Response Behavior Biology Health &Function Health Care Disease Well-Being Prosperity Determinants of Health Model R.G. Evans and G.L. Stoddart, 1990, Predicting Health, Consuming Health Care, Social Science Medicine 31:1347-1363, with permission from Elsevier Science Ltd., Kidlington, United Kingdom http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

25. Determinants of Health Individual-level health education efforts Health Outcomes Determinants of Health Health-supporting systems Healthy environments Employment Education Housing Income http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

26. Determinants of Health Individual-level health education efforts Determinants of Health Inadequate systems Health Outcomes Unhealthy environments Unemployment Lack of education Poor Housing Poverty http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

27. Source: Centers for Disease Control and Prevention http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

28. Tool Box • Focus Area Profiles • Evidence Based Sources • Additional Resources • National Prevention Strategy • Leading Health Indicators for the Nation http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

29. Evidence-Based ResourcesEssential for effective actions Healthy People 2020 – U.S. Department of Health and Human Services http://healthypeople.gov/2020/topicsobjectives2020/default.aspx National Partnership for Action – U.S. Department of Health and Human Services - Office of Minority Health http://minorityhealth.hhs.gov/npa/files/Plans/Toolkit/NPA_Toolkit.pdf http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

30. Evidence-Based ResourcesEssential for effective actions Area Health Education Centers (AHEC) – Informed Caring http://www.informedcaring.org/Home.aspx What Works: Policies and Programs to Improve Wisconsin’s Health http://whatworksforhealth.wisc.edu/ http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

31. Evidence-Based ResourcesEssential for effective actions The Community Guide – U.S. Centers for Disease Control and Prevention http://www.thecommunityguide.org/index.html U.S. Preventive Health Services Task Force http://www.uspreventiveservicestaskforce.org/ http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

32. Additional Resources National Prevention Strategy, Office of the U.S. Surgeon General (2011) http://www.healthcare.gov/prevention/nphpphc/strategy/report.pdf Leading Health Indicators, Healthy People 2020, U.S. http://healthypeople.gov/2020/LHI/default.aspx http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

33. Local Community Health Improvement Plans All Wisconsin local health departments are required by state law to develop a community health improvement plan (CHIP). Healthiest Wisconsin 2020 links directly to local community health improvement plans and Healthy People 2020. Contact your local health department and get involved and help make a difference. http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

34. Endorsement FormIt takes the work of many to improve the health of all Review and complete the form available at the HW2020 web site (see Spotlight Box) http://www.dhs.wisconsin.gov/hw2020/index.htm • Become a champion • Share leadership and accountability for the public’s health • Non-binding http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

35. Focus Area ProfilesThe launching point for collective action / impact • Each Focus Area Profile contains • Definition (scope) of the focus area • Importance • Wisconsin data highlights • Objectives • Indicators • Data sources • Evidence- or science-based actions* • References Note: Profiles will be updated as science / practice change http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

36. Reduce disease, injury and adverse health conditions due to risky behaviors Reduce preventable illness and disability Reduce preventable death Align policies and systems for better health Eliminate disparities Achieve health equity Balance policies and actions based on all 4 drivers of health FrameworkHealth and Systems Outcomes 36 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

37. Implementation http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

38. HW2020 Action ModelTaking Action, Making a Difference Assess strengths needs & resources Evaluate & report results Engage community partners Healthy People in Healthy Wisconsin Communities Implement strategies Select priorities & align to HW2020 Find / use programs & policies that work 38 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

39. Monitoring and Reporting Progress Wisconsin Public Health Council is charged with reporting and monitoring the state health plan Other features of monitoring and reporting are under development in the Wisconsin Department of Health Services. See: HW2010 Data Report: Tracking a Decade’s Progress: Summary Data for Healthiest Wisconsin 2010 (January 2012) http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

40. Contact Information Web Link: http://dhs.wisconsin.gov/hw2020/ HW2020 Mailbox: DHSHW2020@dhs.wisconsin.gov Margaret Schmelzer, MS, RN State Health Plan Director Director of Public Health Nursing Division of Public Health Wisconsin Department of Health Services Voice: 608-266-0877 Email: margareto.schmelzer@dhs.wisconsin.gov http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

41. 41 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

42. Supplemental Data Slides The slides that follow provide a “snapshot / tip of the iceberg” view of Wisconsin health. These slides highlight many but not all of the 23 Focus Areas. Learn More and Become Engaged in HW2020 Go to the HW2020 web site, review the main plan and review the focus area profiles that interest you. Ask your agency / organization to submit a HW2020 Endorsement Form and become a HW2020 Champion. http://www.dhs.wisconsin.gov/hw2020/index.htm http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

43. Health of Wisconsin Source: University of Wisconsin, School of Medicine and Public Health, 2010

44. ObesityWhy do we need HW2020? Wisconsin’s 3rd Graders Source: WI-DHS, Oral Health/ BMI Surveillance Project, 2008 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

45. ObesityWhy do we need HW2020? Wisconsin’s Adults $1,400 Annual increase in health care costs for every obese adult Source: Wisconsin Department of Health Services, Web-published Nutrition Profile, 2010 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

46. TobaccoWhy do we need HW2020? Source: Wisconsin Department of Health Services, Tobacco Control Program http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

47. TobaccoWhy do we need HW2020? Youth Tobacco Survey: High School and Middle School Smoking Rates: 2000 - 2010 Source: Wisconsin Department of Health Services, Tobacco Control Program http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

48. Alcohol & Other Drug Use Why do we need HW2020? 50th Wisconsin’s rank for current alcohol use, binge drinking, and heavy drinking among adults 41% High school students who currently use alcohol 8th highest Binge drinking among youth Source: United Health Foundation, 2011; Wisconsin Department of Health Services, 2010 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

49. Bars vs. Grocery StoresPlace Matters! Source: WI Division of Mental Health and Substance Abuse, 2011 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov

50. Chronic DiseaseWhy do we need HW2020? Risk Factors: The Epidemic of Chronic Disease in Wisconsin Source: Wisconsin Department of Health Services, Bureau of Community Health Promotion, 2012 http://www.dhs.wisconsin.gov/hw2020/index.htm Mailbox: dhshw2020@dhs.wisconsin.gov