Evidence-Based Healthy Aging

1. Evidence-Based Healthy Aging Building Community Partnerships for Health June Simmons Partners in Care Foundation

2. The Move to Evidence-Based Health Promotion • The shift to health – from health care • The new demographics of health • The Chronic Care Model

3. Nationwide Statistics:Opportunity for Impact • 50% of Americans have a chronic condition • 25% have multiple chronic conditions. • 7 of 10 deaths in US each year due to chronic disease • 7% of Medicaid population but 54% of costs • 80% of health care costs go to 20% of patients -- those with chronic diseases

4. Chronic Illness in California • Largest and most diverse state: • 38 million residents • 3.9 million residents ages 65+ (10%)1 • 62% of all older people report having 2+ chronic conditions2,3 • 58% of older Californians have some type of arthritis4 • 14.8% of CA seniors suffer from diabetes5 • 30% of the state’s elderly minorities are diabetic5 • Heart disease accounts for 29% of the state’s deaths6 1 CDC. Population Estimate 2006. 2Yen I, Trupin L, Yelin E. The relationship between health and employment. San Francisco, CA: Institute for Health Policy Studies; 2001. 3 Partnership for Solutions. Chronic conditions: Making the case for ongoing care. Baltimore, MD: Johns Hopkins University; 2002. 4 Lund LE. Prevalence of Arthritis in California Counties, 2001: Center for Health Statistics; December 2003. 5 Lund LE. Prevalence of Diabetes in California Counties: 2003 Update: Center for Health Statistics; February 2005. 6 CDC. Chronic diseases: The leading causes of death California. CDC. Available at: http://www.cdc.gov/nccd php/publications/factsheet/chronicDisease/California.ntml. Accessed 8/1, 2006.

5. Californians Age 65 and Over

6. The Chronic Care Model

7. New leadership from AoA and NCOA • Development of New Evidence-Based Health Promotion Models • Transformation of the Aging Network • What is Evidence-Based

8. Available Programs

9. Framework for Partnerships • A New Vision is Being Crafted • Health Care Providers do not have to solve the problem of chronic disease alone • There are powerful, proven programs available • New strategies are being developed and tested to take these new programs to scale

10. Core Program: Stanford Chronic Disease Self Management • Peer-led, 2-hour sessions for 6 weeks • Any chronic disease • Focus on goals and action plans • Techniques to deal with problems such as frustration, fatigue, pain and isolation • Appropriate exercise for maintaining and improving strength, flexibility, and endurance • Appropriate use of medications • Communicating effectively with family, friends, and health professionals • Nutrition • How to evaluate new treatments.

11. Effectiveness of CDSMP • After 12 months, significant improvement in: • Amount of exercise (ROM & aerobic), • Cognitive symptom management • Communication with physicians • Self-efficacy – Confidence in coping • Health status (fatigue, shortness of breath, pain, role function, depression, health distress) • Utilization: • Emergency department (ED) visits • Physician visits • Hospital days • Spanish version available; Effective among minorities

12. State Programs Funded by US Admin. on Aging & Nat’l. Council on Aging • Arkansas • Arizona • California • Colorado • Connecticut • Florida • Hawaii • Idaho • Illinois • Indiana • Iowa • Maine • Maryland • Massachusetts • Michigan • Minnesota • New Jersey • New York • North Carolina • Ohio • Oklahoma • Oregon • Rhode Island • South Carolina • Texas • Washington • Wisconsin

13. Interests Align Around Evidence-Based Prevention Programs • Health care cost savings in programs that improve quality of life • CMS working with AoA at national level – Move senior centers from recreation to wellness • Aging Departments working with Public Health at state level – Fall prevention, flu, etc. • Locally, health care and aging/disability service providers pursuing goal of individual responsibility and empowerment in self-care

14. Many Strategies Being Developed and Tested • How can we reach real scale • Tobacco is a good example of the model of change • How do we engage people in this change? • Physicians are proven most powerful referral source

15. California as an example • 3.9 million older adults • Chronic disease summary • Strategies to reach evolving • Want to build a “distribution system” that is scalable and sustainable

16. Target Sectors For ADOPTION/ENGAGEMENT

17. Physicians & Older Adult Education Programs • New Partnerships to identify and engage older adults • Physician practices a location where many elders are seen • Physicians can identify those with chronic conditions • Physician referral is the most powerful tool

18. Role of Physicians – Beyond Referral • Emphasize patient responsibility • Empower the patient – You CAN do it! • Know the resources • Write the prescription – for all chronic conditions • Follow-up encouragement • What changes did you make? Physician is the most powerful influence in patients signing up for and completing the 6-week program

19. Sustainable Sources of Support • Community Colleges and K-12 offer free non-credit education to older adults • Paid for attendance • Can add new curricula • Have marketing in place • Teach in community settings

20. Promoting Health and Preventing Decline – the New Imperative • Quality of life is at stake • The health dollar is at stake • With new knowledge and methods, we must transform community understanding • Mobilize the population to rise to the challenge • Take on the leadership