Where is Maines Public Health

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Where is MainesPublic Health?

• Dora Anne Mills, MD, MPH
• Director, Maine CDC/DHHS

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What direction are we going in?
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Where is Mainecompared with the nation?
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What are our major challenges?
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What are our successes?
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How do we know?

• Healthy Maine 2010Longer and Healthier Lives
  for All
• State Health PlanMaine is the Healthiest State
  inthe Nation

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Access to Quality Health Care, Disease
Prevention, andHealth Promotion

• GOAL
• Improve access to comprehensive, high-quality
  health care services and effective prevention
  interventions.

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DevelopmentalIncrease the number of communities
in Maine that have a community health promotion
program that addresses multiple Healthy Maine
2010 focus areas.
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DevelopmentalIncrease the number of geographic
areas in Maine that have a health improvement
plan linked to Healthy Maine 2010 goals and
objectives.
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DevelopmentalIncrease the number of dental
providers located in designated Dental Health
Professional Shortage Areas where
Medicaid-eligible individuals are able to receive
dental care.
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Summary Report CardAccess

• Making Progress
• Increasing Access to Primary Care Providers
• Increasing Access to Health Insurance
• Decreasing Proportion of Children WithDental
  Decay
• No Progress or Wrong Direction

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Chronic Disease

• GOAL
• Reduce the number of new cases as well as improve
  early detection and treatment of chronic disease.

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Diabetes
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Replace w/Jennys slide
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Long Term Benchmarks Be the 1 State
DRAFT
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Long Term Benchmarks Be the 1 State
DRAFT
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Summary Report CardDiabetes

• Making Progress
• No Progress or Wrong Direction
• Adult Diabetics Taking Classes (40 have
  nevertaken a class!)
• Adult Diabetics Having Had Eye Exam (27 havenot
  had one within one year!)
• Adult Diabetics Having Had HgA1c (22 have
  nothad within one year!)
• Diabetes Rates Incidence and Death

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Asthma and COPD
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Long Term Benchmarks Be the 1 State
DRAFT
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Summary Report CardAsthma COPD

• Making Progress
• Surveillance Systems for Asthma
• COPD Deaths
• No Progress or Wrong Direction
• Proportion of Maine Children and Adults with
  Asthma
• Asthma Hospitalizations

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Cardiovascular Disease
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Long Term Benchmarks Be the 1 State
DRAFT
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Long Term Benchmarks Be the 1 State
DRAFT
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Summary Report CardCardiovascular Disease

• Making Progress
• Stroke and Heart Disease Deaths
• Cholesterol and Blood Pressure Checks
• No Progress or Wrong Direction

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Cancer
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Long Term Benchmarks Be the 1 State
Age-Adjusted Invasive Cancer Incidence Rate
43rd out of 45 states and DC. Data not
available for AR, VA, TN, SD, MS, WY.
DRAFT
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Long Term Benchmarks Be the 1 State
DRAFT
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Summary Report CardCancer

• Making Progress
• Cancer Incidence and Death Rates
• Screenable Cancer Diagnosed in Earlier Stages
• Colon Cancer Screening
• Pap Smears
• No Progress or Wrong Direction
• Mammogram Rates
• Skin Cancer Protective Measures

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EnvironmentalHealth

• GOAL
• Promote health for all througha healthy
  environment.

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Trends in Number of Children with Elevated Blood
Lead Levels1997 - 2004
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Summary Report CardEnvironmental Health

• Making Progress
• Unhealthy Ozone Days
• Fish Guidelines
• Childhood Lead Poisoning
• Private Well Water Testing
• No Progress or Wrong Direction

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Family Planning andPerinatal Health

• GOAL
• Improve pregnancy planning and spacing, prevent
  unintended pregnancy, and improve the health of
  women and infants.

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Summary Report CardFamily Planning Perinatal
Health

• Making Progress
• Teen Pregnancy
• No Progress or Wrong Direction
• Infant Mortality

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Infectious Disease and Immunization

• GOAL
• Prevent disease, disability, and deathfrom
  infectious diseases, including vaccine-preventable
  diseases.

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Summary Report CardInfectious Disease
Immunization

• Making Progress
• No Progress or Wrong Direction
• Flu Shots for Seniors
• Vaccination Rates Among 2-Year Olds
• Tuberculosis
• Food Borne Pathogens
• HIV/STDs

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Injury

• GOAL
• Reduce injuries, disabilities,and deaths due to
  unintentionalinjuries, suicide, and violence.

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Summary Report CardInjury

• Making Progress
• Child Abuse
• No Progress or Wrong Direction
• Motor Vehicle Crashes
• Deaths Due to Falls Among Seniors
• Assault Injury Hospitalizations
• Safety Belt Usage

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Mental Health

• GOAL
• Improve mental health andensure access to
  appropriate,quality mental health services.

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Maine BRFSS Data,1999-200414,250 respondents

• Now thinking about your mental health, which
  includes stress, depression, and problems with
  emotions, for how many days during the past 30
  days was your mental health not good?
• No Mental Distress 68.5 N9761
• Frequent Mental Distress (FMD) 14 days or more
  10.4 N1489

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0 Days Mental DistressCompared to 14 or More Days
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0 Days Mental DistressCompared to 14 or More Days
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Frequent Mental Distress, Maine
1999-2004(1999-2004 BRFSS)
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Long Term Benchmarks Be the 1 State
DRAFT
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Summary Report CardMental Health

• Making Progress
• No Progress or Wrong Direction
• Self-Inflicted Injuries
• Co-occurring Health Challenges
• Days of Frequent Mental Distress

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Occupational Health

• GOAL
• Promote the health and safety ofpeople at work
  through preventionand early intervention.

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Summary Report CardOccupational Health

• Making Progress
• Work-Related Deaths
• No Progress or Wrong Direction
• Occupational Injuries

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Physical Activityand Nutrition

• GOAL
• Improve health, fitness, andquality of life
  through daily physical activity and good
  nutrition.

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Summary Report CardPhysical Activity and
Nutrition

• Making Progress
• Adult Physical Activity
• Adult Fruits and Vegetables
• No Progress or Wrong Direction
• Youth TV Watching
• Youth Physical Activity
• Youth Fruits and Vegetables
• Youth and Adult Overweight

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Substance Abuse

• GOAL
• Reduce substance abuse, including tobacco use and
  exposure to secondhand smoke, to protect the
  health, safety, and quality of life for all,
  especially children.

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Summary Report CardSubstance Abuse

• Making Progress
• Youth Marijuana Use
• Youth and Adult Cigarette Smoking
• Tobacco Consumption
• Pregnant Women Smoking
• No Progress or Wrong Direction
• Adult Binge Drinking
• Youth Heroin Use

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Great Tobacco Successes,But Challenges Remain!
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November, 1996Maine 1 for Young Adult Smoking

• 1995 34
• 2004 36

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43 of smokers with children have no rules on
smokingin their home.
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So, how is public healthdoing in Maine?
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• Overarching Goals
• Healthy Maine 2010 Longer and Healthier Lives
  for All
• Maine State Health Plan Maine is the Healthiest
  State in the Nation

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Some Major Cross-CuttingPublic Health
Challengesin Maine
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Ongoing Work on Public Health Infrastructure
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Disparities
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Even our successes show great challenges with
disparities40 of the uninsured smoke20 of
the insured smoke