Areas of Responsibility

1. Areas of Responsibility • Assess Individual and Community Needs for • Plan Strategies, Interventions and Programs • Implement Strategies, Interventions and Programs • Conduct Evaluation and Research related to Health Education • Administer Health Education Strategies, Interventions and Programs. • Serve as a Health Education Resource Person • Communicate and Advocate for Health and Health Education

2. What was the CUP Project ?

3. Level Of Practice • Entry Level < 5 years of practice (Undergrad/Graduate) • Advanced 1 Level > 5 years of practice (Undergrad/Graduate) • Advanced 2 Level (Doctorate & > 5 years of practice)

4. Using the Competency-Based Framework for Health Education • The Health Education Student / Health Educator • College and University Faculty • Health Education Employers • Credentialing / Policy Makers and Funding Agencies • Health Professionals

5. Health Educator Survey • Conducted August 2009 • Conducted via Surveymonkey • 40% of the 341 health educators based in health departments participated (140 responses) • Regional responses ranged 22%-51%

7. Years Worked as HE • Average 8.7 years; Median 6 years • Range 0-31 years • 31% <3 years • 16% >20 years

8. Health Educator Skills • Assess individual & community needs 77% • Plan interventions 91% • Implement interventions 91% • Evaluate interventions & conduct research 55% • Manage others implementing interventions 52% • Serve as resource: find accurate sources of health information and respond to requests for information 88% • Communicate & advocate for health 83%

9. Role in LHD Accreditation • Accreditation coordinator • On accreditation preparation team • Collect documentation for: • Assessment • Data • Community collaboration • Outreach • Media • Policy advocacy • Staff development • Patient satisfaction surveys • Community resource guide • Patient education review

10. Revenue Generated • Average $111,228; Median $25,000 • Range 0 - $1.8 million • 40% responded $50,000+

11. Value of Health Educators Most important roles: • Build relationships within the community, recruit new partners to public health 97% • Assess community needs and present data in meaningful way 72% • Speak to groups, develop targeted messages, and present info in interesting way 71% • Are the face of the health department in community 61%

12. Value of Health Educators “Health educators are the glue connecting communities with the health department and encouraging collaborative community health projects. “HEs have the ability to enhance [others’] opinion of the health department’s value.”

13. Value of Health Educators “We have a wide variety of skills that coworkers constantly want to use.” “Our strengths are in designing programs, developing accurate messages, engaging populations, using data to guide our decisions, and evaluating [whether] an intervention is achieving a desired outcome.”

14. Value of Health Educators “Our true value is mobilizing and organizing communities and individuals around public health issues.” “We have the ability to build political support for public health in the community.”

15. Challenges Facing HEs: Turnover Turnover: • 67% respondents said someone in their health department had left in past 18 mo • 164 HEs had left in last 18 mo – that’s 48% of workforce

16. Recruitment & Retention Issues Top factors: • Salary 29% • Benefits 27% • Being able to focus on HE duties, not assigned wide variety of ad-hoc tasks 21% • Flexible work hours 16%

17. Challenges Facing HEs “If the job classifications at OSP have not been reviewed since before most current health educators were born, that probably indicates a need to review them again.”

18. Challenges Facing HEs “I tell people I am a Health Educator and no one ever knows what that is...”

19. Challenges Facing HEs: Salaries “Health educator salaries used to be on a par with school teachers.” “I’ve been at the health department for 20 years. I’m leaving to go into the schools, getting a $10,000 raise, and working 10 months instead of 12.”

20. Challenges Facing HEs: Many Hats “We continue to be very poorly paid for our knowledge, experience, and ‘other’ hats we are forced to wear.” “Being a Health Educator means that there are many hats to be worn, but I will always find an outfit to coordinate!”

21. Challenges Facing HEs “Health educators in large counties who concentrate in only one or two areas are getting much larger salaries than those of us [in rural areas] who are often concentrating in a half a dozen or more areas.”

22. Opportunities • Accreditation • Community Health Assessment • NC 2020 Health Objectives • Health Reform

23. Health Education: The National Picture

24. US Standard Occupational Classification (SOC) definition of a health educator • is one who: “promotes, maintains, and improves individual and community health by assisting individuals and communities to adopt healthy behaviors. They collect and analyze data to identify community needs prior to planning, implementing, monitoring, and evaluating programs designed to encourage healthy lifestyles, policies, and environments. May also serve as a resource to assist individuals, other professionals, or the community, and may administer fiscal resources for health education programs."

25. Federal US Labor Statistics • Nationally more than 62,000 health educators • 50% work in health care and social assistance • An additional 20% work in State and local government. Media wage nationally: $44,000 Range: $26,210 - $78,260 Median for state government: $33,000

26. Health ______ ReformWhere We* Stand • America spends more than $2 trillion annually on health care, more than any other nation. • Yet in Estimated Life Expectancy #50United States -- 78.1 years. • Worse than Bosnia (#45) and one slot above Albania. * Which We?

27. Currency-- Timeliness “We need to invest in prevention and wellness that help Americans live longer, healthier lives.  We know this saves money.  If we can help somebody control obesity, they are less likely to get diabetes.  And if they are less likely to get diabetes that means that we are going to be saving a whole lot of money in hospital costs.”  Full statement:  http://www.whitehouse.gov/the_press_office/Remarks-of-the-President-in-an-Online-Town-Hall-on-Health-Care-Reform/ President Obama July 1, 2009

28. http://www.hhs.gov/recovery/programs/cdc/chronicdisease.html

29. “...investing $10 per person in these projects could yield annual health care savings of as much as $16 billion within five years.” ROI $5.61 for every $1 in prevention Trust For America’s Health 10 Top Priorities For a National Prevention Strategy

30. Promote Disease Prevention. Combat the Obesity Epidemic. Prevent Tobacco Use and Exposure. Prevent & Control Infectious Disease. Prepare for Health Emergencies. Recognize Relationship Health & Economic Competitiveness. Safeguard the Food Supply. Plan for Seniors’ Health Care. Improve the Health of Low Income & Minority Communities. Reduce Environmental Threats. Trust for America’s Health 10 Top Priorities for a National Prevention Strategy: http://healthyamericans.org/pages/?id=126

31. How Congressional Budget Office Scores Prevention "Benjamin Franklin once famously remarked, "An ounce of prevention is worth a pound of cure." Unfortunately, what this means is often, according to the CBO, an ounce of prevention isn't worth anything at all." --James Marks, Senior Vice President and Director of the Health Group, Robert Wood Johnson Foundation

32. For every $1 invested on: • Water fluoridation saves $38 in dental restorative treatment. • Preconception care for women with diabetes,reduces health costs by up to $5.19. • Arthritis self-help programs saves $4.10 on physician visits. • Pap tests for low-income women saves $5.90 on medical care costs. http://www.healtheducationadvocate.org/factsheets/

33. Addressing Teen Pregnancy • Nationally 31-33% of pregnant teens graduate on time. • NC Adolescent Parenting Program in ’06-’07 enrolled 785 teens from 31 Counties. • Only 35 (4%) of them dropped out of school. Expected Dropouts = 526 Actual Dropouts = 35 Additional graduates = 491 491 X $10K = $4.9M http://tppi.its.state.nc.us/info/tppi.htm

34. http://ayp.ncpublicschools.org/2008/app/cgrdisag/ 2008 Four-Year Cohort Graduation Rates by Student Subgroup (DPI 2008) Up from 63% ’01* =7,683 more grads 7,683* @ +$10K per Year = +$76.8 Million per Year Up from 55% ’01* =2,434 more grads 2,434* @ +$10K per Year =$24.3 Million per Year *U.S. Department of Education, National Center for Education Statistics, Common Core of Data (CCD), “Local Education Agency Universe Dropout and Completion Data File: School Year 2000–01

35. Coalition of National HealthEducation Organizations* Support prevention and wellness provisions; ensure they are included in health reform legislation. Support the development and expansion of the Public Health Workforce; ensure health educators are included. Ensure health educators are included as a key component of community health teams and medical/dental homes. *March 6-8, 2010 –13thAnnual Advocacy Summit, Washington, DC.

36. NC Opportunities for Health Education Tell Your Story – to local, state & national policy makers. Help Others tell theirs. Engage Partners Using State & National Evidence-based Tools. Join support & contribute to national & state health education organizations’ policy efforts. Use NC SOPHE chapter ties into national chapter Advocacy Tool Kit Linked Strategic Plans

37. …merely scoring costs in the short term and not determining the value of health in the long term has helped us have the most expensive medical care in the world with a shorter life span than all our competitors… Looking toward prevention allows to us to think about getting health at a good value...and to me that's a good idea. Help Create the Community in Which You Want to Live --James Marks, Senior Vice President and Director of the Health Group, Robert Wood Johnson Foundation

38. Q & A • What have you seen or heard in this session that strikes you? • What steps do you need to take to get there?