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A snapshot of the New Hampshire ’ s Health profile

A snapshot of the New Hampshire ’ s Health profile. Jose Thier Montero, MD Director Division of Public Health Services NH-DHHS. Today’s Presentation. Current use of data How do we measure? Report structure “Responding” to present and future needs. NH Health Ranking.

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A snapshot of the New Hampshire ’ s Health profile

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  1. A snapshot of the New Hampshire’s Health profile Jose Thier Montero, MD Director Division of Public Health Services NH-DHHS

  2. Today’s Presentation • Current use of data • How do we measure? • Report structure • “Responding” to present and future needs

  3. NH Health Ranking Source: http://www.americashealthrankings.org/SiteFiles/Reports/AHR%202011Edition.pdf

  4. NH Determinants Source: http://www.americashealthrankings.org/SiteFiles/Reports/AHR%202011Edition.pdf

  5. NH Health Outcomes Source: http://www.americashealthrankings.org/SiteFiles/Reports/AHR%202011Edition.pdf

  6. So…. How do we measure? • What do we measure? • Health? Disease? Access to services? Cost? Who? What? When? • Who is measuring? • Who is reporting?

  7. Who Lives here? Who are we supposed to serve? • General demographics • Population segments • Market segmentation

  8. 2007 Age-Adjusted Estimates of the Percentage of Adults† with Diagnosed Diabetes in New Hampshire

  9. What should we do ?

  10. Why do we need to talk about health equality? Do we all have an equal chance to health? Health is seen in modern societies as a universal human aspiration as well as a basic human need. In the XXI century we compare and judge societies, rich or poor, by the quality of its population's health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantage due to ill-health. Health equity is central to this premise To improve health equity we need to go beyond the immediate causes of disease Social Determinants of Health Several groups have attempted to look at the “What to do” and others at “How to do it” WHO Commission on Social Determinants of Health

  11. What is Health equity? Equity is an ethical principle; it also is consonant with and closely related to human rights principles. The definition of equity shall support operationalisation of the right to the highest attainable standard of health as indicated by the health status of the most socially advantaged group. Assessing health equity requires comparing health and its social determinants between more and less advantaged social groups. These comparisons are essential to assess whether national and international policies are leading toward or away from greater social justice in health Source: Braveman P & Gruskin S. acll J Epidemiol Community Health 2003;57:254-258 doi:10.1136/jech.57.4.254

  12. How to define Health Equity? For the purposes of measurement and operationalisation, equity in health is the absence of systematic disparities in health (or in the major social determinants of health) between groups with different levels of underlying social advantage/disadvantage—that is, wealth, power, or prestige. Inequities in health systematically put groups of people who are already socially disadvantaged (for example, by virtue of being poor, female, and/or members of a disenfranchised racial, ethnic, or religious group) at further disadvantage with respect to their health; health is essential to wellbeing and to overcoming other effects of social disadvantage. Source: B Braveman, et acll J Epidemiol Community Health 2003;57:254-258 doi:10.1136/jech.57.4.254

  13. The average life expectancy in the US rose 30 years in the last century 25 of these years are due to advances in public health (not in medical care) Value of Public Health

  14. DPHS Vision The New Hampshire Division of Public Health Services is committed to being a responsive, expert, leadership organization that promotes optimal health and well being for all people in New Hampshire and protects them from illness and injury. Our first responsibility is to serve the public – individuals, families, communities and organizations – by delivering high quality, evidence-based services. We believe that quality health services should be available, accessible, affordable and culturally competent

  15. 10 Essential Public Health Services

  16. Improvement work with public health systems partners • 2005 Conducted the NPHPS • Developed Strategic Priorities • Workgroups • Public Health Improvement Services Council –enacted in statute 2007 to oversee public health improvement

  17. New Hampshire Division of Public Health Services Strategic Map: 2011-2013 Demonstrate Measurable Improvements in Health and Well Being C A B D E Strengthen Approaches to Population Health Expand Public Health Education and Messaging Strengthen Public Health Infrastructure Improve the Effectiveness of Resource Allocation Strengthen Organizational Effectiveness and Adaptability Develop and Implement a Health Messaging Strategy Implement Cross- Program Integration to Increase Population Health Impact Ensure Access to Healthcare and Public Health Services Align Internal Resources to Support Strategic Goals Improve Intra-agency Communication at All Levels 1 Integrate Data Systems to Monitor Population Health Status Build an Internal Social Marketing Capacity Develop the Capacity to Meet the Future Health Workforce Needs Allocate Resources Externally to Support Strategic Goals Redesign Internal Contracting Process and Financial Management Structure 2 Position DPHS as Expert on Approaches to Population Health: Policy, Data, Practices Develop Key Communications Partnerships to Increase Impact Focus on Chronic Disease Prevention, Diagnosis, Treatment and Intervention Build the Internal Capacity to Support Strategic Resource Allocation Ensure Optimal Workforce Capacity 3 Make Strategic Use of Partnerships to Implement Population Health Approaches Continue to Prepare for and Respond to Public Health Threats Strengthen Organizational and Staff Resilience Evaluate Message Effectiveness and Make Needed Adjustments 4 Implement a Regional Public Health System Optimize the Performance of Key Business Processes 5 Color boxes denote priority tracks of work for year one. Similar colors are related focus areas and would be worked on together. Prepare for Accreditation of the State Health Department 6 Implement the Technology Required For Future Effectiveness 7 Develop and Implement a Public Health Performance Management System F

  18. Expected Outcomes Healthier population as defined by: Lower rates of obesity (currently at 35% in children) Lower rates of smoking (currently at 15% in adults, 19% in teens) Increased access to preventive health care Higher rates of immunizations Better health care quality (Evidence based, no adverse events) Disease care cost avoidance Population Informed and educated on health promotion and disease prevention Compliance with state and federal laws, rules and/or guidelines governing the terms and conditions of federal grantors, optimizes the federal revenue brought into the State

  19. Evidence-based Public Health DPHS promotes evidence-based public health, particularly through adoption of the Community Guide to form state health policy. NH worked with small businesses to implement employee-driven worksite wellness programs. Partnered with the Business & Industry Association, Health insurance companies to increase employer awareness of their workers’ health concerns and implement policy changes. 34

  20. Collaboration is Key • In its recent report, the Institute of Medicine (IOM) makes a clear statement that “collaboration between government and public private entities is critical for assuring the future health of the public.” • Thus, the work of public health is everyone's work as defined by “what we as a society do collectively to assure the conditions in which people can be healthy.”

  21. LHI is a framework to Support National Strategies

  22. Leading Health Indicators Access to Health Services Clinical Preventive Services Environmental Quality Injury and Violence Maternal, Infant, and Child Health Mental Health Nutrition, Physical Activity, and Obesity Oral Health Reproductive and Sexual Health Social Determinants Substance Abuse Tobacco 37

  23. New Hampshire DPHS direction Demonstrate Measurable Improvements in the Health and Well Being of NH Population People Leadership Processes Aim Staff Resources Information

  24. DPHS direction – how does it all fit? Aim

  25. DPHS direction – how does it all fit? Goals and objectives Mission, vision, values SHIP

  26. DPHS direction – how does it all fit? People Processes Leadership Aim Staff Resources Information

  27. Broad Goal: Reduce burden of chronic disease Specific goal: Reduce tobacco consumption DPHS objective: Reduce youth smoking prevalence to X% by 20YY Activities and performance indicators Youth media campaigns School outreach Helpline $ spent in 2009: $23,000 Television ads Radio ads Internet ads % Division goals DPHS 2012 target # DPHS 2015 goal # 2010 target 2000 2000 2010 2010 2000 2010 DPHS objective: Reduce maternal smoking prevalence to X% by 20YY Activities and performance indicators Provider education Direct outreach $ spent in 2010: $12,000 Providers with edu materials % Division goals DPHS 2012 target # # DPHS 2015 goal 2010 target 2000 2000 2010 2010 2000 2010

  28. We need to Work Together to Assure a Healthy Population

  29. Questions........

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