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Impact of Public Health Infrastructure

Focus Area 23: Public Health Infrastructure Progress Review Richard J. Klein National Center for Health Statistics April 16, 2008. Impact of Public Health Infrastructure. Public Health Infrastructure--the resources needed to deliver essential public health services to every community.

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Impact of Public Health Infrastructure

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  1. Focus Area 23:Public Health InfrastructureProgress ReviewRichard J. KleinNational Center for Health StatisticsApril 16, 2008

  2. Impact of Public Health Infrastructure Public Health Infrastructure--the resources needed to deliver essential public health services to every community Public Health Response Laboratory Practice Essential Capabilities Epidemic Investigation Surveillance Workforce Capacity & Competency Information & Data Systems Organizational & Systems Capacity Basic Infrastructure SOURCE: Public Health Foundation

  3. Highlighted Objectives Information & data systems 23-2. Access to information on health indicators 23-4. Data for all population groups 23-6. Objectives tracked at least every three years 23-7. Data release within one year of collection Workforce capacity & competency 23-11. Performance standards Organizational & systems capacity • 23-12. Health improvement plans • a. Tribal • b. State • c. Local • d. Local linked to state Improving Little or no progress* Baseline only No data Note: *Percent of targeted progress achieved is between -10% and 10%.

  4. Examples of Access to Information on Health Indicators Federal Tribal State Local 13.1 Community Health Profile (Minnesota, Michigan, and Wisconsin Tribal Communities, Great Lakes EpiCenter) SOURCE: CDC, NCHS Obj. 23-2

  5. Community Health Status Indicators (CHSI) • Mission: provide information on community health • More than 200 measures for each of the 3,141 U.S. counties • Peer counties based on population density, population size, poverty rate, and age distribution • Healthy People 2010 targets shown where applicable • Cooperative effort • Federal: Health Resources Services Administration, Centers for Disease Control and Prevention, National Library of Medicine • Foundations: Public Health Foundation and Robert Wood Johnson funds • Endorsed broadly Obj. 23-2

  6. CHSI Peer Counties Anne Arundel County Prince William County Obj. 23-2

  7. CHSI Peer Counties Lower than peer counties (median) Higher than peer counties (median) Obj. 23-2

  8. Minimum Template for Population-Based Objectives Race: Socioeconomic Status: American Indian or Alaska Native only Family Income Level Asian or Pacific Islander only Asian only Poor Native Hawaiian or Other Pacific Islander only Near poor Black or African American only Middle/high income White only 2 or more races American Indian or Alaska Native; White or Black or African American; White Hispanic origin and race:Education Level Hispanic or Latino Not Hispanic or Latino Less than high school Black or African American High school graduate White At least some college Gender: Female Male Source: Healthy People 2010, November 2000 Obj. 23-4

  9. Data Quality and Completeness Increase desired Percent Baseline 2007 2010 Target: 100 100 80 65 60 49 40 26 20 0 Data for all pop groups Tracked at least every three years Released w/in 1 year of collection Note: Baseline for 23-4 and 23-6 is 2004; 23-7 baseline is 2000. SOURCE: DATA2010, Health Promotion Statistics Branch, NCHS Obj. 23-4, 23-6, & 23-7

  10. Use of National Public Health Performance Standards: State Public Health Systems Increase desired Number 2010 Target: 35 Six percent (n=1) of the 18 states that used the Public Health Performance Standards in 2007 met the standards. 18 9 2004 2007 Note: The PHPS are used by local and state public health systems as a tool in comprehensive health improvement initiatives, bioterrorism preparedness planning and other efforts. PHPS are considered to be a benchmark for public health practice. SOURCE: National Public Health Performance Standards Program, CDC, Office of the Chief of Public Health Practice. Obj. 23-11a

  11. Use of National Public Health Performance Standards: Local Public Health Systems Increase desired 2004 2010 Targets = 50 LPHS that participate in the PHPS program LPHS that do not participate in the PHPS program 12% N=273 36% N=98 Public Health Performance Standards Met Public Health Performance Standards not met N = 2,315 LPHS N = 273 LPHS 2007 LPHS that participate in the PHPS program LPHS that do not participate in the PHPS program 46% N=214 20% N=469 Public Health Performance Standards Met Public Health Performance Standards not met N = 2,315 LPHS N = 469 LPHS Note: The PHPS are used by local and state public health systems as a tool in comprehensive health improvement initiatives, bioterrorism preparedness planning and other efforts. PHPS are considered to be a benchmark for public health practice. SOURCE: National Public Health Performance Standards Program, CDC, Office of the Chief of Public Health Practice. Obj. 23-11b and d

  12. Implementation of a Health Improvement Plan: State and Local Health Agencies Increase desired Percent 2010 Targets: TBD 56 54 37 States with a Health Improvement Plan (2007) Local Agencies with a Health Improvement Plan (2005) Local Plans linked with State Health Improvement Plans (2005) Note: The Healthy People 2010 target will be determined by the Healthy People 2010 Steering Committee, at a later date. SOURCE: State, Association of State and Territorial Health Officials (ASTHO) and Local, National Profile of Local Health Departments (NACCHO) Obj. 23-12b-d

  13. Public Health Infrastructure Objectives Target met Improving Little or no progress* Information and data systems Organizational & systems capacity 23-2. Access to information on health indicators 23-3. Geocoding in major health data systems 23-4. Data for all population groups 23-6. Objectives tracked at least every three years 23-7. Data release within one year of collection 23-12. Health improvement plan a. Tribal b. States c. Local d. Local linked to State 23-13. Public health laboratory services a–k. 23-14. Epidemiology services a. formal training b.Tribes c. States d. Local 23-15. Evaluation of public health laws a. Turning Point b. Emergency Powers 23-17. Population-based prevention research Workforce capacity & competency 23-8. Core competencies in job descriptions a. Tribal b. Local 23-9. Core competencies: public health curricula 23-10. Continuing education a. Tribal b. State c. Local 23-11. Performance standards used a. State b. Local 23-11. Performance standards met c. State d. Local Getting worse Baseline only No data Objectives 23-1, 23-5, and 23-16 were deleted at the Healthy People 2010 Midcourse Review in 2005. Note: *Percent of targeted progress achieved is between -10% and 10%.

  14. Summary • All retained objectives are at least partially measurable • Access to information on health indicators available at national, Tribal, state, and county level • Data timeliness and completeness improved • Participation in the National Public Health Performance Standards Program improved for state and local public health systems. • Tribal data collection improving – challenges remain • Future: Developing and refining PHI measurement in Healthy People 2020

  15. Acknowledgements • Tamyra Carroll Garcia • Public Health Analyst • CDC/National Center for Health Statistics • tuc6@cdc.gov • Susan Schneider • Public Health Analyst • CDC/National Center for Health Statistics • sah4@cdc.gov • Contributors: • Nakki Price, CDC/OCPHP Beverly Smith, HRSA • Liza Corso, CDC/OCPHP Christopher Barrett, HHS/ODPHP • Joan Cioffi, CDC/OWCD Ellis Davis, HHS/ODPHP • Elizabeth Jackson, CDC/NCHS Jeff Pearcy, CDC/NCHS

  16. Progress review data and slides are available on the web at: http://www.cdc.gov/nchs/hphome.htm

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