Creating the Future of CDC for the 21 st Century

1. Creating the Future of CDC for the 21st Century Dixie Snider, Jr., MD, MPH Deputy Director of Public Health Science Centers for Disease Control and Prevention AcademyHealth CDC Research Agenda Session San Diego, CA June 7, 2004

2. CDC’s Futures InitiativeHeath Protection for the 21st Century Input Ideas Implementation Impact • Outside-in • Interactive • Driven by data • Focused on customers • Strategic direction first, then structure & processes

3. Ideas…New Strategies! • Achieve health impact and reduce health disparities for customers (people whose health we protect) • alignment (strategy, goals, & action) • performance measurement and improvement • integration across organizational units • marketing • Lead the Nation’s public health system • Expand public health research as the foundation for all our work • Expand global health impact • Support the world’s best workforce and maximize our effectiveness & accountability

4. CDC’s Futures InitiativeWhy Change? Emerging Public Health Threats Human Genome Globalization Aging Society Changing Demographics Rising Health Care Costs Aging Workforce Information Technology Public Health Infrastructure

5. Increase in Health Expenditures • Health expenditures as percent of GDP projected to increase from 14.9% (2002) to 18.4% (2013) • Per capita health spending in the US is highest in the world, yet we still rank behind 47 countries in life expectancy Source: The New York Times Magazine

6. Health Status • U.S. life expectancy is 2.5 years shorter than in Western Europe and Canada, and more than 3 years shorter than in Japan • Obesity and obesity-related health risks cost the U.S. an estimated $125B per year • The U.S. ranks 28th in the world in infant mortality

7. . . . But Few People Turn to CDC for Health Information “I do not rememberhearing about health or disease info that came from the CDC in the past year” “I tried to get info about health or disease from the CDC in the past year” CDC as a source of health information CDC Has a Perception of High Trust/ Reliability . . . % of respondents saying “Yes” “CDC is one of the first places I would turn to for reliable health information” “One of the health information sources I trust the most is the CDC” Source: Porter Novelli

8. Where are people looking? % of Internet Users Who Have Searched for Information from: HealthPortals Govt. Agencies Non-ProfitOrgs. Doctors’Offices/ Hospital Sites/Health Centers Pharma-ceuticalWebsites ScientificRetrievalSystems OnlineNewsletters Universities ChatRooms Source: Harris Poll (2003)

9. NIH vs CDC Budget NIH $Billion CDC Source: CDC, NIH

10. Strategic Imperatives • Health Impact • Customers • Public health system • Public health research • Global health • Efficiency, effectiveness & accountability

11. Health Protection Goals • Health Promotion & Prevention of Disease, Injury, and Disability: All people will achieve their optimal lifespan with the best possible quality of health in every stage of life. • Preparedness: People in all communities will be protected from infectious, environmental, and terrorist threats.

12. Preparedness Goals People will benefit from state-of-the art detection, investigation, and containment of infectious, terrorism, and environmental threats. The government public health, health care delivery, business, educational sectors and other sectors of the health system will be integrated to protect people from infectious, environmental, and terrorist threats.

13. Health promotion and prevention of disease, injury, and disability by life-stage Infant Child Teen Adult Senior

14. Life-stage Goals [Draft] Infant: By 2015, the United States is one of five countries with the highest rates of infant survival (Baseline 28th, 1999) Children: By 2015, mortality is reduced 20%, saving an additional 800 lives per year (NCHS Baseline). Adolescents: By 2015, at least 95% of adolescents practice behaviors which protect them from illness and injury now and in the future. (NHIS baseline) Adults: By 2015, at least 90% of adults have a healthy weight (NHANES baseline) Seniors: By 2015, average lifespan of older Americans is increased by 2 years

15. Organizational Design Principles • Strategy and goals derive from population health assessments (“customers’ health”) to achieve health impact • Strategy and goals drive agency’s priorities and allocations • Emphasis on research and innovation • Health protection “marketing” • Consolidation of business & other cross-cutting services

16. CDC’s History

17. Office of Global Health Office of Executive Secretariat Office of Program Planning and Evaluation CDC Washington Office Department of Health and Human ServicesCenters for Disease Control and Prevention (CDC) Office of the Chief Operating Officer Office of Women’s Health Office of Health and Safety Office of the Director Office of Equal Employment Opportunity Office of Minority Health Office of Communication Office of Genomics and Disease Prevention Office of Science Policy and Technology Transfer National Center on Birth Defects & Developmental Disabilities National Center for Chronic Disease Prevention & Health Promotion National Center for Environmental Health National Center for Health Statistics National Center for Infectious Diseases National Center for Injury Prevention and Control National Center for HIV, STD, and TB Prevention National Institute for Occupational Safety and Health Epidemiology Program Office National Immunizations Program Public Health Practice Program Office

18. CustomersPeople whose health we want to improve Alliances Channels Partners Stakeholders Public Health Systems Business Education Health Care Delivery Federal Agencies Coordinating Center for Health Information and Services National Center for Health Marketing National Center for Public Health Informatics National Center for Health Statistics Coordinating Center for Infectious Diseases NCID, NCHSTP, NIP Coordinating Center for Health Promotion NCCDPHP, NCBDDD, Genomics Coordinating Center for EIO NCEH/ATSDR NCIPC, NIOSH Office of Global Health Office for Terrorism Preparedness & Emergency Response Executive Leadership Team Management Council Executive Board Strategy and Innovation Chief of Science Chief of Public Health Improvement Human Capital Management Office of the Chief of Staff Director Office of the Chief Operating Officer CDC Washington

19. Changing CDC Strategic imperatives Health Impact Goals Organization Design Internal and External Communications Recognition & Rewards Business Process Redesign Leader Accountability Employee Education

20. CDC’s Futures Initiative • • Clearly articulated and measured • • Segmented customer approach • • Strong partner network • • Revitalized state & local health departments • • Media, business, health care delivery, schools, communities

21. CDC’s Futures Initiative

22. CDC’s Futures Initiative

23. Futures Initiative: Improving Health Impact