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

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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  1. Harvey CountyCouncil of State GovernmentsKansas Collaborative MeetingNovember 15, 2006 Paula F. Marmet, MS, RD, Director Office of Health Promotion KS Department of Health & Environment

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. Actions for Immediate Action • Tobacco Use Prevention • Disparities Data • Cultural Competency • Overweight and Obesity • Access to quality health care

  9. 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

  10. 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

  11. 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)

  12. 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.

  13. 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.

  14. 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.

  15. Obesity Trends Among U.S. AdultsBRFSS, 2004 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Source: Centers for Disease Control and prevention.

  16. 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.

  17. 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.

  18. 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)

  19. Trends for Overweight Prevalence among Children & Adolescents – United States, 1963-2000. Source: NHANES - 1963-65 through 1999-02.

  20. 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.

  21. Smoking trends in Kansas

  22. 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

  23. 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

  24. 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

  25. 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

  26. Injury Prevention • $1 spent on smoke alarms saves $69 • $1 spent on bike helmets saves $29 • $1 spent on child safety seats saves $32

  27. Governor’s Healthy KansasAgenda • Tobacco Use Prevention • Increase Physical Activity • Improve Nutrition • Children in Schools • Adults in the Workplace • Seniors where they live

  28. 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.

  29. Farmers' Market June 2006

  30. Farmers' Market June 2006

  31. 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

  32. 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

  33. Kansas DPCP and HDSP Collaboration Quality of Care Project

  34. 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

  35. Diabetes Project Organization Demographics • 66 funded organizations • 90 sites statewide • 350 participating health professionals • 50% of Kansas’ counties represented • Diverse organizations participating

  36. 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

  37. 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

  38. 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?

  39. First Year Outcomes Organizations Checking Yes on the Quarterly Office Self-Assessment Form

  40. First Year Outcomes Cont’d…. Organizations Checking Yes on the Quarterly Office Self-Assessment Form

  41. First Year Outcomes Cont’d…. Organizations Checking Yes on the Quarterly Office Self-Assessment Form

  42. First Year Outcomes Cont’d…. Organizations Checking Yes on the Quarterly Office Self-Assessment Form

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