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I. PUBLIC HEALTH OVERVIEW

Overview Public Health System DSHS Advisory Council May 5, 2005 Nick Curry, M.D., MPH, Deputy Commissioner Prevention, Preparedness & Regulatory Services. I. PUBLIC HEALTH OVERVIEW.

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I. PUBLIC HEALTH OVERVIEW

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  1. OverviewPublic Health System DSHS Advisory Council May 5, 2005Nick Curry, M.D., MPH, Deputy CommissionerPrevention, Preparedness & Regulatory Services

  2. I. PUBLIC HEALTH OVERVIEW

  3. PUBLIC HEALTH: Science and art of working in communities to promote health, prevent disease and injury, and prolong quality life.

  4. A Public Health Model:Sound Mind, Sound Body DSHS consolidation promotes the use of the public health model to integrate public health, mental health and substance abuse.

  5. Core Public Health Functions Assessment Assurance Policy Development

  6. Core Public Health Functions • Assessment: Monitor and assess health in communities and populations to identify problems and establish priorities. • Policy Development: Formulate health policies in cooperation with government and community leaders to address problems and priorities. • Assurance: Work to assure that communities and populations have appropriate and cost-effective health services, including disease prevention and health promotion services.

  7. Essential Public Health Services • Monitor the health status of individuals in the community to identify community health problems. • Diagnose and investigate community health problems and community health hazards. • Inform, educate, and empower the community with respect to health issues. • Mobilize community partnerships in identifying and solving community health problems. • Develop policies and plans that support individual and community efforts to improve health.

  8. Essential Public Health Services • Enforce laws and rules that protect the public health and ensure safety in accordance with those laws and rules. • Link individuals who have a need for community and personal health services to appropriate community and private providers. • Ensure a competent workforce for the provision of essential public health services. • Research new insights and innovative solutions to community health problems.

  9. Essential Public Health Services • Evaluate the effectiveness, accessibility, and quality of personal and population-based health services in a community.

  10. Leading Causes of Death–1900 Source: Achievements in Public Health, 1900-1999: Control of Infectious Diseases. MMWR, July 30, 1999.

  11. * Percentage (of all deaths) Causes of Death in United States – 2000 Leading Causes of Death* Heart Disease Cancer Stroke Chronic lower respiratory disease Unintentional Injuries Diabetes Pneumonia/influenza Alzheimer’s disease Kidney disease

  12. 10 Greatest Public Health Achievements1900-2000 • Vaccination • Motor vehicle safety • Safer workplaces • Control of infectious diseases • Reduction in heart disease and stroke fatalities • Safer, healthier foods • Healthier mothers & babies • Family planning • Fluoridated drinking water • Understanding tobacco use as a health hazard

  13. Increased Life Expectancy Increased years due to public health measures: 25 Increased years due to medical care advances: 5 Source: Centers for Disease Control and Prevention (CDC).

  14. 2002 Health Care Spending

  15. Health Care =Public Health + Medical Care Public Health Medical Care

  16. Two Guiding Public Health Principles Prevention Evidence-based strategies & interventions

  17. Causes of Death in United States – 2000 Actual Causes of Death† Leading Causes of Death* Heart Disease Tobacco Poor diet/lack of exercise Cancer Alcohol Stroke Chronic lower respiratory disease Infectious agents Unintentional Injuries Pollutants/toxins Diabetes Firearms Sexualbehavior Pneumonia/influenza Alzheimer’s disease Motor vehicles Illicit drug use Kidney Disease Percentage (of all deaths) Percentage (of all deaths) Sources: * National Center for Health Statistics. Mortality Report. Hyattsville, MD: US Department of Health and Human Services; 2002 † Adapted from McGinnis Foege, updated by Mokdad et. al.

  18. Is There a Public Health Solution? 1900: Population-based, public health efforts won battle against infectious killers 2000: Can population-based public health efforts win the battle against chronic diseases?

  19. Partnerships: A Key to AchievingA Culture of Health • Local, state & federal government • Local providers & health professionals • Hospitals & clinics, & professional associations • Universities, schools of public health, academic health science centers • Community-based organizations, nonprofits, foundations • EMS & first responders, medical examiners • Private sector

  20. II. HEALTH SERVICE REGIONS

  21. HEALTH SERVICE REGIONS • Regions created in 1970 • Eleven regions today • Mission: • To provide public health services in areas w/out local health departments • To carry out required state governmental functions and assist local health departments

  22. HEALTH SERVICE REGIONS Each Region Provides: • Direct services • Health promotion and disease prevention • Disease investigation and control • Consumer health services • Public health preparedness services • A single point of access for DSHS

  23. HEALTH SERVICE REGIONS Each Regional Office is led by a licensed physician with expertise in medicine & public health

  24. HEALTH SERVICE REGIONS 25% of Texans are not served by a local health department

  25. Population Served by Public Health Regions Indiana Vermont Hawaii N Dakota Delaware S Dakota Wyoming Maryland W Virginia Mississippi 2003 Texas Population, 22,118,500 Nevada Source: Center for Health Statistics, Population Estimates for Counties, 2003

  26. III. PREPAREDNESS

  27. Preparedness Overview DSHS is Texas lead for Health and Medical response Health and Medical response plan is Annex H of state emergency response plan DSHS must ensure coordination with regional and local response plans

  28. Bioterrorism Preparedness Priorities • Surveillance • Early detection • Rapid Response • Early Containment • Capacity building/sustaining

  29. Capacity Building • $60 million/year, 75% spent locally • 500 workers added in Texas since 9/11: Austin office, 8 regions and 48 local health departments • Laboratory Response Network (LRN) labs increased from 5 to 10 • Established 8 Epidemiological Response Teams across Texas • Expanded Health Alert Network (HAN) • Established partnerships with neighboring U.S states (4) and neighboring Mexican states (4)

  30. Strategic National Stockpile • A national repository of life-saving pharmaceuticals and medical materiel that will be delivered to the site of a chemical or biological terrorism event, or natural or technological disasters, in order to reduce morbidity and mortality.

  31. SNS Components • 12-hour Push Packages Vendor Managed Inventory • Vaccine • Chempack

  32. 12-Hour Push Package • Arrives in <12 hours • 50 tons • Pre-packed • Fills a jumbo jet • or multiple tractor • trailers • Broad spectrum support

  33. CHEMPACK Project • “Forward” placement of nerve agent antidotes • Qualifies for shelf life extension program • Two type of containers: • EMS container: for emergency responders - material packaged mostly in auto-injectors • hospital container: for hospital dispensing - multiuse vials for precision dosing and long term care.

  34. State/Local Responsibilities • Coordinate planning with regions, counties, and cities • Receive, store, stage • Distribute • Manage inventory • Protect operations

  35. U.S.-Mexico Border Region • 2 countries • 10 states • 14 sister cities • 12 million people Texas: 5 states, 7 sister cities, 6 million people

  36. U.S.-Mexico Border Region If this region were a state, it would… …rank last in access to health care. …rank 2nd in death rates from hepatitis. …rank 3rd in deaths related to diabetes. …rank as the 7th largest state.

  37. U.S.-Mexico Border is busiest in the world. Each year, more than 300 million people, 90 million cars, & 4.3 million trucks cross the border Laredo is home to the largest inland port in the US.

  38. Border Crossings More than half of all border crossings from Mexico to U.S occur into Texas. 52% Pedestrians 72% Trucks 89% Trains

  39. US Border State Health Officers Identify need for “vertical planning” with Sister Mexico States NM-TX-CHIH El Paso Juarez Presidio Ojinaga TX-COAH Del Rio Ciudad Acuna Eagle Pass Piedras Negras TX-NL-TAMPS Laredo Nuevo Laredo McAllen Reynosa Brownsville Matamoras

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