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Ten Outstanding Achievements in Arkansas Public Health: First Decade of the 21 st Century

Ten Outstanding Achievements in Arkansas Public Health: First Decade of the 21 st Century. Joseph Bates, MD, MS Arkansas Department of Health. Past and Projected Female and Male Life Expectancy at Birth, United States, 1900-2050. Life Expectancy at Birth. Female.

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Ten Outstanding Achievements in Arkansas Public Health: First Decade of the 21 st Century

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  1. Ten Outstanding Achievementsin Arkansas Public Health:First Decade of the 21st Century Joseph Bates, MD, MS Arkansas Department of Health

  2. Past and Projected Female and Male Life Expectancy at Birth, United States, 1900-2050 Life Expectancy at Birth Female Years of Life Male Year

  3. Life Expectancy For Countries Country Life Expectancy (Yrs)Rank Andorra 83.5 1 Japan 82.0 4 Sweden 80.6 8 Australia 80.6 9 France 80.5 11 Canada 80.3 14 Spain 79.8 20 United Kingdom 78.7 37 U.S. 78.0 45

  4. Comparison of International Infant Mortality Rate: 2000 2.5 Singapore Hong Kong Japan Sweden Norway Finland Spain Chech Republic Germany Italy France Austria Belgium Switzerland Netherlands Northern Ireland Australia Denmark Canada Israel Portugal England & Wales Scotland Greece Ireland New Zealand United States Cuba 3.0 3.2 3.4 3.8 3.8 3.9 4.1 4.4 4.5 4.5 4.8 4.8 4.9 5.1 5.1 5.2 5.3 5.3 5.4 5.5 5.6 5.7 6.1 6.2 6.3 6.9 7.2 Deaths per 1,000 Live Births

  5. Leading Causes of Death U.S. Heart Disease 710,760 Malignant Neoplasm 553,091 Cerebrovascular Disease 167,661 Chronic Lower Respiratory Disease 122,009 Unintentional Injuries 97,900 Diabetes Mellitus 69,301 Influenza and Pneumonia 65,313 Alzheimer Disease 49,558 Nephritis, Nephrotic Synd., Nephrosis37,251 Septicemia 31,224

  6. Top Ten Public Health Achievements2000-2010 1Coalition for a Healthier Arkansas Today (CHART) Plan: The Tobacco Master Settlement Agreement 2 Reduction of Adult and Youth Tobacco Use 3 Passage of the Clean Air Act 4 Hometown Health Improvement 5 School Influenza Immunization Program 6 Expansion of the Newborn Screening Program 7 Act 1220 to Combat Childhood Obesity 8 New Public Health Laboratory 9 Public Health Preparedness 10 Statewide Trauma System

  7. Key Programs Funded by CHART • Funding for support of biological research at UAMS, ASU, UAF and UAPB • Funding to create research buildings and the College of Public Health building • Funding for COPH operations • Funding For Aging Centers • Funding for Minority Health Commission • Funding for AHEC at Helena • Funding for tobacco prevention and cessation

  8. Cigarette Packs Sold Per Adult (2001 – 2007)

  9. Reduction of Adult and Youth Tobacco Use • Youth smoking rate decreases to under 20 percent • Adult smoking rate steadily declines • Per capita consumption of cigarettes steadily decreases • 105,000 fewer Arkansans smoke compared to 2002 • 21,500 fewer high school students smoke • More than $1 billion in lifetime healthcare savings Reduction of Adult and Youth Tobacco Use

  10. Passage of the Clean Indoor Air Act • Smoking permitted in almost all public buildings • Advocates organize to ban smoking • Some exemptions for smoking only by adults • Clean Indoor Air Act takes effect July 21, 2006 • Arkansas one of 18 states to prohibit smoking Passage of the Clean Indoor Air Act

  11. Passage of the Clean Indoor Air Act • No evidence to support that businesses suffer • Compliance very good • ADH educates public • More people quit smoking • Health benefits from reduced exposure to toxins in tobacco smoke • Positive effect on healthcare costs and worker productivity Passage of the Clean Indoor Air Act

  12. Hometown Health Improvement • Health solutions must come directly from hometowns • 73 Hometown Health Improvement (HHI) coalitions • HHI first piloted in 1998 Hometown Health Improvement

  13. Hometown Health Improvement • Community focus, local control, data-based decision making, local/state partnerships • County health units provide leadership and organized system • Reduction in preventable illnesses and injuries, coordination of community health services and improved health and quality of life Hometown Health Improvement

  14. 2009 Influenza Immunizations in Public Schools • ADH, Department of Education, school districts statewide providing seasonal vaccination clinics • Planning adjusted to provide seasonal and H1N1 vaccine • 345,088 doses of seasonal and H1N1 vaccine 2009 Influenza Immunizations in Public Schools

  15. Expansion of the Newborn Screening Program • Babies born each year with harmful/even fatal conditions • Fed guidelines recommend screening for 29 core conditions • ADH, UAMS, Arkansas Children’s Hospital, Arkansas March of Dimes, Arkansas Hospital Association • Expand screening from 7 to 29 conditions Expansion of the Newborn Screening Program

  16. Expansion of the Newborn Screening Program Results match expectations based on national figures ADH laboratory performs more than 300,000 screenings yearly Additional years of screening needed to fully evaluate impact For families, program is a life saver Expansion of the Newborn Screening Program

  17. Results of Newborn Screening 1st Year Cystic Fibrosis Found 10 cases Congenital Adrenal Hyperplasia Found 3 cases Biotinidase Deficiency Found 1 case Amino Acid Disorders Found 4 cases Fatty Acid Oxidation Defects Found 4 cases Organic Acidemias Found no case

  18. Act 1220 of 2003 to Combat Childhood Obesity • Act 1220 of 2003 • Limits vending and ala carte items • Child Health Advisory Committee • Standards and policy recommendations for healthier foods and physical activity Act 1220 of 2003 to Combat Childhood Obesity

  19. Act 1220 of 2003 to Combat Childhood Obesity • Schools measure Body Mass Index • School reforms most ambitious in nation • 38 percent of Arkansas children overweight or at risk • Efforts holding line on progression of epidemic* *ACHI, Assessment of Childhood and Adolescent Obesity in Arkansas: Online State Report (Year 5) Act 1220 of 2003 to Combat Childhood Obesity

  20. Arkansas Public Health Laboratory

  21. Arkansas Public Health Laboratory • Construction starts 2004 and building dedicated 2006 • Costs $24.6 million and provides approximately 80,000 square feet • 5,000-square-foot embedded level 3 bio-safety lab • Lab performs more than 800,000 tests yearly Arkansas Public Health Laboratory

  22. Arkansas Public Health Laboratory • Infectious diseases, food borne illnesses, and potential for chemical and biological terrorism • Arkansas needs state-of-the art, fully certified laboratory • Legislation to create laboratory funded with bond issue financed by fees Arkansas Public Health Laboratory

  23. Public Health Preparedness • ADH lead to coordinate health and medical response • Public Health Preparedness and Emergency Response Branch • Strategic National Stockpile • Cache of medical supplies and pharmaceuticals • Plans for mass dispensing of medications • Plan tested in mass flu clinics Public Health Preparedness

  24. Public Health Preparedness • Health Alert Network (HAN) • Emergency Operations Center (EOC) • ADH integrated with state and federal partners. • Responds to numerous emergencies and disasters Public Health Preparedness

  25. THE PROBLEM Injury is the leading cause of death of Arkansans ages 1 – 44 Injury fatality rate is 30% higher than national average (70% higher for motor vehicle accidents) In 2008, Arkansas had the worst system of emergency care in the nation (study by American College of Emergency Physicians) Arkansas was one of three states without a trauma system and the only state without a designated trauma center

  26. Statewide Trauma System: A System Saving Lives • 1993- Trauma Advisory Council • 2008- statewide computer-based network • 2009- tobacco tax initiative • Four levels of resources and care standards • March 2011 – 7 out of 73 designated trauma centers Statewide Trauma System: A System Saving Lives

  27. Three-Pronged LegislativeSolution - 2009 1. Trauma System Act (Act 393) – funded by state’s tobacco tax Victims of traumatic injuries will be transported to definitive care in the shortest possible time. Projected annual savings: 168 lives and $193 million

  28. Three-Pronged LegislativeSolution - 2009 2. Primary seat belt law (Act 394) Law enforcement can stop drivers for not wearing a seat belt when this is the only violation observed Projected annual savings: 32 lives and $37 million

  29. Seat Belt Use Arkansas and US: 2002-2010 Percent Seat Belt Use

  30. Three-Pronged LegislativeSolution - 2009 3. Graduated drivers license law (Act 308) Provides for longer supervised driving periods for young drivers, restrictions on cell phone use and texting, and restricted late night driving Projected annual savings: 6 lives and $7 million

  31. Arkansas Trauma Call Center(ATCC) Contract signed with Metropolitan Emergency Medical Services (MEMS) in Little Rock to serve as the ATCC ATCC went “live” on January 3, 2011 (hospital-to-hospital transfers only) - full implementation expected by May 31, 2011 when ambulances receive trauma radios

  32. Trauma Registry Is operational statewide and is in early stages of recording and tracking individual cases of traumatic injury from inception through all phases of treatment 23 hospitals currently participating with over 1,200 records entered

  33. Dashboard • Computer database that provides up-to-the minute status information to the participating acute care hospitals in Arkansas. • Information is necessary for rapid transfer of patient to the most appropriate care facility.

  34. How Were These Goals Achieved • Strategic Planning with input from many external partners. • Strong support from Governor Huckabee (CHART Clean Air Act) and Governor Beebe (Trauma System and School Influenza Immunization) • Leadership from the Speaker of the House, Hershel Cleveland (Public Health Laboratory and Act 1220)

  35. How Were These Goals Achieved • Strong grass roots support as a result of work of Hometown Health organizations and local public health workers. • Strong support from the Arkansas Center for Health Improvement and the State Surgeon General

  36. Organization of the Year Award “The College of Professional Studies at UALR has chosen the Arkansas Department of Health as our Organization of the Year. Each year we select an organization that embodies the professionalism and high standards we hope that all our programs produce. This is the first time we have chosen a state agency. We are proud of the impact that the Arkansas Department of Health is making on the health of Arkansans.” Angela Brenton Dean, College of Professional Studies University of Arkansas at Little Rock

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