Healthy People 2020—overview and correctional care insights

1. Healthy People 2020—overview and correctional care insights NCCHC Updates in Correctional Health Care April 24-27, 2010 Nashville, TN

2. Susan M. Tiona, M.D.,CCHP Kit Carson Correctional Facility PO Box 309 Burlington, CO 80807 719-346-9450 care4cons@gmail.com www.care4cons.com

3. What is Healthy People?

4. Healthy People 2020 Vision A society in which all people live long, healthy lives.

5. Healthy People 2020 Mission

6. Healthy People 2020 Overarching Goals

7. Healthy People 2020 Topic Areas

8. Healthy People 2020 Topic Areas

9. Healthy People 2020 Topic Areas

10. Healthy People 2020 Topic Areas

11. Sources of Data for Healthy People 2020 Objectives • National Health and Nutrition Examination Survey (NHANES), CDC, NCHS (National Center for Health Statistics); www.cdc.gov/nchs/nhanes.htm • National Health Interview Survey (NHIS), CDC, NCHS; www.cdc.gov/nchs/nhis.htm • National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS; www.cdc.gov/nchs/ahcd.htm • Medical Expenditure Panel Survey (MEPS), AHRQ (Agency for Healthcare Research and Quality);www.meps.ahrq.gov • United States Renal Data System, NIH, NIDDK; (National Institute of Diabetes and Digestive and Kidney Diseases); www.usrds.org

12. Healthy People 2020 Objectives Focus on some key objectives with correctional care applications…

13. Arthritis, Osteoporosis, and Chronic Back Conditions • Reduce the mean level of joint pain among adults with doctor-diagnosed arthritis • Reduce the proportion of adults with doctor-diagnosed arthritis who experience a limitation in activity due to arthritis or joint symptoms • Increase the proportion of adults with doctor-diagnosed arthritis who receive health care provider counseling— • For weight reduction among overweight and obese persons • For physical activity or exercise

14. Arthritis, Osteoporosis and Chronic Back Conditions (cont…) • Increase the proportion of adults with chronic joint symptoms who have seen a health care provider for their symptoms • Increase the proportion of adults with doctor-diagnosed arthritis who have had effective, evidence-based arthritis education as an integral part of the management of their condition • Reduce activity limitation due to chronic back conditions

15. Chronic Kidney Disease • Increase the proportion of persons with diabetes and chronic kidney disease who receive recommended medical evaluation (serum creatinine, microalbumin, HgA1C, lipids, eye exams) • Increase the proportion of persons with diabetes and CKD who receive recommended medical treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs).

16. Chronic Kidney Disease (cont…) • Improve cardiovascular care in persons with chronic kidney disease • Reduce the percentage of persons with CKD who have elevated blood pressure (Target <130/80) • Reduce the percentage of persons with CKD who have elevated lipid levels • Increase the percentage of persons with CKD who know that they have impaired renal function

17. Diabetes • Increase the proportion of persons with diagnosed diabetes who receive formal diabetes education • Increase the proportion of adults with diabetes whose condition has been diagnosed • Increase the proportion of persons with diabetes who obtain an annual urinary microalbumin measurement • Increase the proportion of adults with diabetes who have a HgA1C measurement at least twice year

18. Diabetes (cont…) • Increase the proportion of adults with diabetes who have an annual dilated eye exam, at least an annual foot exam, and at least an annual dental exam • Improve glycemic control among the population with diagnosed diabetes • Reduce the proportion with A1C value >9% • Increase the proportion with A1C value <7% • Increase the proportion of diabetics whose blood pressure is under control (Target < 130/80)

19. Diabetes (cont…) • Improve lipid control among diabetics • Increase the proportion of people with IFG, “pre-diabetes,” or multiple diabetes risk factors that are engaged in diabetes prevention behaviors • Increase the proportion of the high-risk, overweight population reporting a physically active lifestyle • Increase the proportion of the high-risk, overweight population who report intentionally losing weight in the previous year

20. Health Communication and Health IT • Increase the proportion of persons who report that their health care providers have satisfactory communication skills • Increase the proportion of persons who report that their health care provider always listens carefully to them • Increase the proportion of persons who report that their health care provider always explains things so that they can understand them • Increase the proportion of persons who report that their health care provider always shows respect for what they have to say • Increase the proportion of persons who report that their health care provider always spends enough time with them

21. Heart Disease and Stroke • Increase the proportion of adults with high blood pressure whose blood pressure is under control • Increase the proportion of adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or high • Reduced the mean total blood cholesterol levels among adults • Reduce the proportion of adults with high total blood cholesterol levels • Increase the proportion of adults who have had their blood cholesterol checked within the preceding 5 years

22. Heart Disease and Stroke (cont…) • Increase the proportion of adults with pre-hypertension who meet the recommended guidelines for: • Body mass index • Saturated fat consumption • Sodium intake • Physical activity • Moderate alcohol consumption

23. Heart Disease and Stroke (cont…) • Increase the proportion of adults with hypertension who meet the recommended guidelines for: • Body mass index • Saturated fat consumption • Sodium intake • Physical activity • Moderate alcohol consumption • Increase the proportion of persons with coronary artery disease who have their LDL cholesterol level at or below recommended levels

24. Heart Disease and Stroke (cont…) • Increase the proportion of adults with elevated LDL cholesterol who have been advised by a health care provider to: • Eat fewer foods high in saturated fat or high in cholesterol • Control weight or lose weight • Increase physical activity or exercise • Take recommended medication • Increase the proportion of adults with elevated LDL cholesterol who meet the recommended guidelines for: • Healthy weight • Cholesterol-lowering diet • Physical activity

25. Nutrition and Weight Status • Increase the proportion of adults who are at a healthy weight • Reduce the proportion of adults who are obese • Reduce iron deficiency among females aged 12 to 49 years • Reduce iron deficiency among pregnant females • Reduce consumption of saturated fat and sodium in the population aged 2 and older • Increase the consumption of calcium in the population aged 2 and older

26. Nutrition and Weight Status (cont…) • Increase the proportion of physician office visits that include counseling or education related to nutrition or weight • Increase the proportion of primary care physicians who regularly measure the body mass index of their patients • Reduce consumption of calories from solid fats and added sugars in the population aged 2 years and older

27. Older Adults • Reduce the proportion of adults who have moderate to severe functional limitations • Increase the proportion of older adults with one or more chronic health problems who report confidence in managing their conditions • Increase the proportion of older adults with reduced physical or cognitive function who engage in light, moderate, or vigorous leisure-time physical activities

28. Physical Activity and Fitness • Reduce the proportion of adults who engage in no leisure-time physical activity • Increase the proportion of physician office visits for chronic health diseases or conditions that include counseling or education related to exercise

29. Physical Activity and Fitness (cont…) • Increase the proportion of adults that meet current Federal physical activity guidelines for aerobic physical activity and for muscle strength training • Increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity for at least 150 minutes/week or 75 minutes/week of vigorous intensity, or an equivalent combination • Increase the proportion of adults who perform muscle-strengthening activities on 2 or more days of the week

30. Respiratory Diseases • Reduce hospitalizations for asthma • Reduce hospital emergency department visits for asthma • Reduce activity limitations among persons with current asthma • Reduce the proportion of adults whose activity is limited due to chronic lung and breathing problems

31. Respiratory Diseases (cont…) • Increase the proportion of persons with current asthma who receive appropriate asthma care according to National Asthma Education and Prevention Program (NAEPP) guidelines. • Persons with current asthma who receive written asthma management plans from their health care provider • Persons with current asthma with prescribed inhalers who receive instruction on their use • Persons with current asthma who receive education about appropriate response to an asthma episode, including recognizing early signs and symptoms or monitoring peak flow results • Increase the proportion of persons with current asthma who do not use more than one canister of short-acting inhaled beta agonist per month

32. Correctional Care Insights for Healthy People 2020 How do we make it work?

33. Healthy Inmates 2020 Vision A correctional system in which all inmates have the opportunity for healthy living

34. Healthy Inmates 2020 Mission

35. Healthy Inmates 2020 Long Term Goals

36. Healthy Inmates 2020Focus Areas 1-5

37. Healthy Inmates 2020Focus Areas 6-10

38. Access to Health Services

39. Arthritis, Joint Pain, and Chronic Back Conditions

40. Chronic Kidney Disease

41. Diabetes

42. Diabetes

43. Health Communication

44. Heart Disease and Stroke

45. Heart Disease and Stroke

46. Heart Disease and Stroke

47. Nutrition, Weight and Exercise

48. Nutrition, Weight and Exercise

49. Nutrition, Weight and Exercise

50. Older inmates