Non-infectious Chronic Diseases Control & Prevention in Zhabei District

1. Non-infectious Chronic DiseasesControl & Prevention in Zhabei District Jane Xiong Zhabei District CDC, Shanghai, China Aug 29,2006

2. Brief Introduction of Myself (1) • Jane Xiong • Shanghai Zhabei CDC • 2002.4- Community Disease Management 1997.7-2002.4 Anti-epidemic • 2004 M.S. , Epidemiology, Fudan University 1997 B.M. , Preventive medicine, Fudan University (formerly Shanghai Medical University)

3. Brief Introduction of Myself (2) • Researching on policy supporting for disease control and prevention in community • Researching on how the general team in community health service(CHS) provide rapid, economic, sustained service for residents • Designing the model community's chronic diseases’ standardized and comprehensive management • Designing health promotion for all people in community, developing suitable intervention measures

4. Brief Introduction of Myself (3) • Surveilling and managing infectious disease in community • Responsible for AIDS defending program, attending program planning, implementing and evaluating • Constructing HIV primary screening lab of Zhabei District • Drafting " Medium and long-term plans of AIDS defending in Zhabei district (2001-2015) "

5. Brief Introduction of Zhabei District • Northern of central Shanghai • 29.18 sq. Km. • 8 communities • 800,000 residents 150,000 floating people • ≥ 60 Ages is 19.7% • Life expectancy 80.72

6. The Order of Death Causes in Zhabei (2000-2005) circulatory system lunacy cancer digestive system respiratory system infectious disease and verminosis poisonings and injuries urogenital disease endocrinopathy neuropathy

7. The Death Rate of Leading Diseases in Zhabei (1955-2005) DEATH RATE(1/100,000) 1960 70 80 90 2000 YEAR

8. The Incidence Rate of Main Cancers in Zhabei (2003) 1/100,000

9. Professional guidance Administration Management Network of Chronic Diseases Control & Prevention District Government District Health Bureau Shanghai CDC Planning and organizing Instruction and training Quality control Statistic analysis & evaluation Other Departments Concerned Zhabei CDC Cooperation Hospitals level 2 or 3 System of CHS Chronic Diseases Registering & Reporting Chronic Diseases Control & Prevention in Communities

10. Center for Community Health Service (CHS) Workstation of CHS System of CHS in Zhabei District Prevention & Control Health Care Primary Medical Treatment Handicapped Healing Health Promotion Family Planning Guiding ¥8→30 per capita director Community Government Other departments Cooperation NGOs Cooperation

11. Work Station of CHS in Zhabei District CHS general team Walk 15-20 Min General practitioners Public health practitioner Community nurses 1 Offer health service to 10,000-20,000

12. The Strong Points of General Teams • Convenient shorten the service radius • Advantageous to organize suitable, effective health promotion giving chronic disease patients continuous service • Economic the elementary medicine has kept in community, and the expenditure is lower The system of CHS has provided a good platform for community chronic disease prevention, control and management

13. What to do? How to do? Information Garthering and Patients Finding Health promotion Patient Management Our Works of Chronic Diseases Control & Prevention

14. Community diagnosis Surveillance health records Information Gathering and Patient Registering Epidemiology Risk factors Quality control Analysis Evaluation Following-up Clinic Screening High risk people Free medical examination Patients Other ways Reporting Zhabei CDC System of CHS Feedback Intervention strategy

15. Cancer Finding and Registering Quality control Analysis Evaluation Zhabei CDC Prevention&health care section Inputing information & reporting to CDC In-patient Department Out-patient Department Emergency Department Filling in Cancer Report Cards of New Patients Hospitals level 2 or 3 in zhabei Information Department Assistant Department (CT/Pathology/…) Other Department Cooperation

16. Information Interchange with other CDC Shanghai CDC Zhabei CDC CDC of Other 18 Districts Interchange the Cancer Report Cards by Patients’ Address Health Services for Cancer Patients in Communities

17. Public Health Intervention Policy intervention Health screening Biologic prevention Education intervention Improve environment supporting ability Detect earlier Biologic Barrier Health belief & behavior Idea changed

18. Intervention (1) • 2006 Proper diet, cancer prevention • 2005 Health life, cancer prevention • 2004 Delivering cancer prevention knowledge to communities • 2003 Detect earlier, diagnose earlier and treat earlier • 2002 Health life says “no” to cancer • 2001 Preventing cancer scientifically and treating standardly • 2000 Preventing cancer correctly • 1999 Cancer can be prevented and cured The theme of Cancer control and prevention Week 1999~2005

19. Intervention(2) Cancer Week(4.15-21) Activity Poster Lecture Counseling Pamphlet

20. Intervention(3) Diabetes board Community Sports Meeting “I Know My Own blood Pressure”

21. Intervention(4) Strictly implementing the policy made by shanghai health bureau Measuring blood pressure for every patient aged≥35 when he/she goes to hospital for the first time every year

22. Intervention(5) The 1st Cancer Helping Center in Shanghai • Organizing a professional union • Professional training • Keeping from physical & mental pressure • Instructing family members offering help to patients

23. Intervention(6) The Diabetic Club

24. Patient Management Hospital Level 2 or 3 mending deteriorating feedback General teams of CHS Zhabei CDC Different level management from diagnosis to death Quality control Professional guiding Statistic analysis& evaluation Chronic disease management system Hospice Family sickbed General management

25. My goal in EHIB • To know the model about community disease control & prevention in U.S.A • To make some progress on community health promotion’s planning, practicing and evaluation

26. ` Thank you!