Chronic-Disease-Prevention课件

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,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?,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,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,Rate,Rank 2004,Rank 2005,Cause of Death,2004,2005,1,1,Heart Disease,183.7,172.6,2,2,Cancer (any),166.3,163.1,3,3,Stroke,49.8,41.3,4,5,COPD/Chronic lower respiratory diseases,38.3,39.1,5,4,Alzheimers Disease,38.1,36,6,6,Unintentional injuries,28.6,28.5,7,7,Diabetes mellitus,19.1,21.1,8,8,Influenza & pneumonia,16.6,14.3,9,9,Suicide,10.4,9.9,10,10,Essential (primary) hypertension and hypertensive renal disease,9.1,9.4,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,= Chronic Diseases,Death by Risk Factors,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 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,*2006 U.S. data are preliminary,LIFE EXPECTANCY TRENDS,San Diego County vs United States, 2000-2006,San Diego County Population,by Race/Ethnicity, Census 1990 vs. 2000 vs. 2007,Source:,SANDAG, San Diego County 1990, 2000 Census, and 2007 Population estimates,Between,1990 & 2000:,The population of Hispanics and Asian increased,The population of Whites and Blacks decreased,Percent,All Cancer Deaths,by Race/Ethnicity, 2005,Note:,All rates are adjusted to 2000 Standard U.S. Population.,Source:,California Death Statistical Master File; SANDAG January 1, Population Estimates.,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,Coronary Heart Disease and Stroke Deaths,by Race/Ethnicity, 2005,Note:,All rates are adjusted to 2000 Standard U.S. Population.,Source:,California Death Statistical Master File; SANDAG January 1, Population Estimates.,Blacks have the,highest rate of,coronary heart,disease deaths,and stroke deaths,compared to,other racial and,ethnic groups.,HP 2010 Goal CHD: 166.0,HP 2010 Goal Stroke: 48.0,San Diego County Overall:,CHD Rate - 128.4 / 100,000,Stroke Rate 41.3 / 100,000,Diabetes,by Race/Ethnicity,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.,R/E,Hospital,Admissions 2005,Deaths (underlying)2005,Black,White,Hispanic,Asian/Other,69.0,16.6,33.5,21.2,303.5,87.1,236.0,87.6,10.7,7.7,18.4,7.4,% High School Students Overweight 2005,Prevalence of Diabetes Among Adults 2005*,6.6,5.1,6.5,7.2,* - Percentage of adults who were ever diagnosed with diabetes,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,Deaths and Age-adjusted Rates,HP2010,= 45,Diabetes Hospitalizations Among San Diego County Residents, 2001-2005,Number and Age-adjusted Rates,Overweight & Obese Adults*,by Race/Ethnicity, 2005,* as Defined by Body Mass Index (BMI),Source:,2005 California Health Interview Survey (CHIS),HP 2010 Goal,Obesity (BMI 30): 15%,Unhealthy weight,(BMI25): 40%,Asthma in San Diego County,by Race/Ethnicity,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.,Race/Ethnicity,Hospitalization Rate, 2005,Average Annual Number of Deaths,2002-2004,Black,White,Hispanic,Asian/Other,3,18,3,4,204.7,59.3,74.9,62.6,Estimated Prevalence,Among Children 2005,13.8*,9.6,12.4,11.7,Evidence-based Best Practices,Do They Work?,Direction from the National Level,Federal Government Agencies,United States Department of Agriculture,United States Surgeon General,Centers for Disease Control,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),Direction from the National Level,Public,California Conference of Local Health Officers,California Department of Public Health,Governors Obesity Prevention Plan,Private,The California Endowment,Strategic Alliance,Direction from the State Level,Best Practices and Promising Interventions,Healthy Community Improvements,Healthy Community Development,Healthy Community Plans & Policies,1. Healthy Community Improvements,Partnering with communities and cities to improve existing physical and social conditions that prevent physical activity and healthy eating,Best Practices and Promising Interventions,Healthy Community Improvements,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,Create gardens for culturally appropriate foods reflective of the community.,CX3 Projects,(Chula Vista & La Mesa),Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention,Strong Partnerships,Leadership Training,Youth & Mentors,Community Assessment,Advocacy,Outcomes,La Mesa,Chula Vista,$550,000 Safe Routes to School grant to improve sidewalk connectivity,Community “reclaimed” Lauderbach Park,2. Healthy Community Development,Promoting healthy development and redevelopment projects in neighborhoods,Best Practices and Promising Interventions,Healthy Community Development,Integrating “Healthy Places” design into the Development Review process,Redevelopment areas,Grocery stores in underserved areas,Facility design,Helping Communities get Developments Designed for “Health”,Trails and Trail Access Points,Eliminating Food Deserts,Attracting a Grocery Store into East Oakland, CA,Partners: East Oakland Diabetes Work Group, Alameda County Department of Public Health, Network for a Healthy California,3. Healthy Community Plans & Policies,Promoting healthy government, school and worksite policies and plans that support physical activity, healthy eating and tobacco-free environments,Best Practices and Promising Interventions,Healthy Community Plans & Policies,Land use & transportation planning,Affordable housing policies,Regional Food Systems & Urban Agriculture,Worksite Wellness policies,Government Wellness policies,School Wellness policies,City of Richmond General Plan Update,City of Richmond,Health and Wellness Element,Policy Framework,School Wellness Gardens,Classroom Garden Beds,Quad Area with Gardening,Healthier Vending Machines,Chronic Diease Model,Will it Work?,Individuals,Families,Neighborhoods,Policies and Laws,Socio-Ecological Model,Businesses,Environmental Approaches to Tobacco,:,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,Smoking Rates,Lung Cancer Death Rates,Percent,American Lung Association of California,Centers for Disease Control, National Cancer Institute, statecancerpro,Tobacco and Heart Attacks,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?,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,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,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 togetherwhether to advocate for change, cultivate a community garden, or provide services.,Why Place Matters: Environmental Strategies,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,$4.3 Billion Annually,*Social*,*Economic*,*Physical*,*Service*,50% of Deaths,Physical Activity,Tobacco,Nutrition,Heart Disease/Stroke,Type 2 Diabetes,Cancer,Respiratory Disease,Poor environments,a,Unhealthy behaviors,a,Chronic Diseases,Chronic Disease,environments,Adopting a new solution,Healthy environments,a,Healthy Behaviors,a,Disease Reduction,*Social*,*Economic*,Reduction in:,Heart Disease/Stroke,Type 2 Diabetes,Cancer,Respiratory Disease,*Physical*,*Service*,Creating Environments to Support Healthy Behaviors,Physical Activity,Tobacco,Nutrition,environments,Chronic Disease,QA & Comments,