2005: A Mona Lisa Year in Public Health

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2005 A Mona Lisa Year in Public Health

• Leadership North Carolina
• Pinehurst, North Carolina
• February 2, 2006

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(No Transcript)
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Public Health Priorities

• Building Preparedness and Response
• Preventing/Controlling Chronic Disease
• Eliminating Health Disparities
• Developing a Coordinated School Health Program
• Strengthening the Public Health Infrastructure

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Priority 1Building Preparedness in Response
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Aerial view NC Field Hospital, Waveland, MS
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NC Public HealthWhat was our mission?

• Surveillance and reporting to CDC and MSDH
• Daily meetings with MSDH, CDC, and USPHS
• Outbreak Investigation
• Evaluate environmental hazards
• Infection control recommendations
• Hospital Safety Officer
• Logistical and administrative support
• Shelter Management

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Mecklenburg County Shelterpeak census 750 -
800people served 2,500 - 3,000open 17
daysWake County Shelterpeople served
590Open 3 weeks
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Enhanced Surveillance SystemNC DETECT - Database

• Poison Control Centers
• Hospitals - NCHESS
• Piedmont Wildlife Center
• Pre-hospital Medical Information
• College of Veterinary Medicine
• People Expertise
• State, Regional, Local
• Hospital Epidemiologists (10)

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NCHESS

• 113 hospitals
• first time all hospitals required to report
• first time common data set
• first near real-time monitoring
• every 12 hours
• partnership with
• UNC School of Medicine
• NC Hospital Association

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Pandemic Flu Planning

• Worldwide
• 133 human cases
• 63 deaths
• 5 countries
• Projected for NC
• 1.1 million outpatient visits
• 5,600 deaths
• 25,000 hospitalizations
• Updates to the Plan

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Annual Influenza VaccinationNational Solutions

• Create manufacturers incentives
• Switch to cell based technology
• Research dose-stretching strategies
• Control vaccine through the federal, state, local
  public health system
• Build routine adult immunization infrastructure
• State Innovation

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Priority 2Preventing and Controlling
Chronic Disease
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Tobacco Tax Increase

• Current tax is 30 cents
• Increasing on July 1, 2006
• 35 cents
• National average is 91.7 cents

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• 1-800-QUIT-NOW
• North Carolina Tobacco Use Quitline
• Funding N.C. Health and Wellness Trust Fund
  and
• N.C. Tobacco Prevention and Control Branch
• Toll-free number 1-800-QUIT-NOW (784-8669)
• TTY 1-877-777-6534
• 800 AM Midnight / 7 days a week
• All North Carolina residents youth and adult
• Proactive Tobacco cessation specialists can
• call tobacco users back
• Multilingual
• www.quitlinenc.com for more information

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Smoke Free Environments

• 78 of work sites prohibit smoking
• 35 of restaurants are smoke-free
• 63 tobacco free school districts
• 30 tobacco free hospitals
• 76 local health departments tobacco free (indoor)
• 100 Prisons

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Controlled Substances Monitoring System Fatal
Unintentional and Suicide Poisonings in North
Carolina 1997-2004
Source NC State Center for Health Statistics,
Death Certificates, 1997-2004.
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Obesity Prevention

• Published Move More School Guidelines
• New Vending Machine Laws in Schools
• New Community Funding from Health Wellness
  Trust
• Department Wellness Initiative

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Priority 3Eliminating Health Disparities
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Increasing Poverty in a Growing State

• 5th fastest growth rate in country
• Poverty Rate for 2004
• 16,000 for family of 3
• 15 families with young children in 2000
• 21.2 families with young children in 2004
• Uninsured in North Carolina -
• 14.6 in 2000 up to 17.5 in 2004

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Increasing Diversity

• Latinos
• 600,913 in NC 7 of population
• account for 27.5 of population growth in NC
• account for 57 of growth in public schools
• Hmong and Russian Populations

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Eliminating Health Disparities

• HIV/AIDS Eliminated wait list for ADAP
• Centralized Pharmacy
• 1 million additional ADAP funds
• 250,000 Interpreters funds
• 2 million one-time funding for community grants
• Office of Minority Healthy and Eliminating Health
  Disparities
• Progress in Syphilis Elimination

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HIV Infection

• New HIV Disease Reports - Males
• 2000 66
• 2004 72
• Increase in Case Rates 2000 - 2003
• North Carolina - 55
• U.S. - 6
• Proportion of Black Persons Living with AIDS
• 6th Highest Nationally

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Child Maltreatment

• Children assessed (1999 -2004) 9 ?
• (113,557 - 03 - 04)
• Children substantiated (1999 -2004) 15?
• (27,310 - 03-04)
• 51 Child homicides in 2004
• 31 were child abuse homicides
• 48 increase over 5 years

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Child Maltreatment Leadership Team

• Recommendations
• Focus on Prevention
• Creation of a Leadership Team
• Strategies
• Universal Solution
• Selected Strategies
• Indicated Strategies

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Infant Mortality Rates 1975 - 2004
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Teen Pregnancy
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Child Death Rates in North Carolina 1989 - 2004
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Oral Health in NC

• Decay Rates in preschoolers have increased
  slightly
• Decay Rates in permanent teeth have leveled off
• Untreated Decay most significant in Latinos (38)
• Sealants in 5th Graders ?
• Safety Net Clinics ?
• Dentist treating Medicaid ? 20 to 24
• 450 medical practices - varnish, education,
  referrals

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Implemented Family Planning

• 61 pregnancies to low income women are unplanned
• Only 39 of NC low income women currently
  receive FP services
• Enrollment of 6,405 participants 1/01/06

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Priority 4Developing a Coordinated School
Health Program
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Disparity in Education

• 3rd grade proficiency (1998 -2003) 30.0
• 8th grade proficiency (1998 -2003) 11.9
• SAT scores (1990 -2003) 25.3
• Black Males 50 Drop out rate
• Drop Outs Represent 85 of juveniles in court
  Represent 75 of inmates
• Black Males 12 of population
  60 of prison population

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Education PaysLearning and Earning

• Week Year
• Less than high school 404 21,008
• High school diploma 576 29,952
• Some college/AA degree 664 34,528
• Bachelors degree 902 47,216
• Advanced degree 1,142 59,384

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Developing a Coordinated School Health Program

• 1) Family and Community Involvement
• 2) Comprehensive School Health Education
• 3) Physical Education
• 4) School Health Services 11593
• 5) School Nutrition Services
• 6) Counseling, Psychological Social Services
• 7) Healthy School Environment
• 8) Health Promotion for School Personnel

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100 Child and Family Teams

• Nurses/Social Workers
• 20 School Systems Low Performing
• Governors Office Commitment to the Year Two
  Nurses

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Priority 5Strengthening the Public Health
Infrastructure
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Accreditation
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Incubators1 million dollars

• Primary Care
• 600,000 Community Health Grants

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Top 25 Questions

• Genomics and Personal Health?
• Feasibility of an HIV Vaccine?
• How can human life span be extended?
• Journal of Science

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What are the Ten Challenges for 2006 and
Beyond?
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Challenge Readying Children for School

• Over 10,000 children on Early Intervention
  waiting list
• Consideration of Eligibility Changes
• 5 million ongoing, but more is needed

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Challenge Universal Vaccination of Children

• 2001 2005
• 391.06 465.16
• Paying for New Vaccines
• Prevnar HPV
• Menactra Rotovirus
• Dtap Booster Zoster
• Thimerosal Issue

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Challenge Leaving Tobacco Use Behind

• DHHS Policy as a Pacesetter
• All State and Local Buildings
• Tobacco Free Communities
• Increase the Tobacco Tax
• Public Awareness Campaigns
• Marketing the Quitline
• Success in Teen Tobacco Use

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Challenge Eating Smart Moving More

• Sedentary Lifestyles of NC Adults
• CDC Findings in 2004
• 1 Kentucky 26.2
• 2 - Louisiana 22.6
• 3 - North Carolina 22.5

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NC Adults Reporting Sedentary Lifestyles

• 16.9 in 2001
• 22.5 in 2003 33
• NC Adults Getting Recommended Levels of Physical
  Activity
• 42.3 in 2001
• 37.6 in 2003 11
• Steepest Decline of Any State

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Challenge Reversing the HIV/AIDS Epidemic

• HIV Prevention
• General Population
• Targeted to Minority Men
• Targeted to positives
• Harm Reduction - Needle Exchange
• Raise ADAP Eligibility

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Challenge Replacing Critical Facilities

• State Laboratory of Public Health
• and
• NC Medical Examiners Office
• 100 Million

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Challenge Delivering on Technology Promises

• HIS
• Implementation to begin in 06
• NEDSS
• Implementation Rollout Jan 06 - July 07
• Immunization Registry
• Two Way Interface - 06

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ChallengeProtecting Health in a Growing State

• Improvement Permits
• Well Protection
• Health Goals
• Managing Sludge
• Animal Control

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Challenge Securing Financial Resources

• Assuring Sound Medicaid Policy
• Seeking Other Financial Support
• Managing Reduced Federal Funds
• Preventive Block Grant
• Maternal Child Health Block Grant
• Preparedness Funding
• State Appropriations

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Challenge Reconvening the Public Health Task
Force 2006

• Eliminating Health Disparities
• Strengthening the Infrastructure
• Filling in Service Gaps

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Challenge Capitalizing on Knowledge Management

• Healthy Carolinians Midcourse Review
• 110 Objectives set for 2010
• Six targets have been achieved
• Forty one objectives are moving in the right
  direction
• Sixteen are moving in the wrong direction
• www.healthycarolinians.org

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www.unitedhealthfoundation.org
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PRIZM Marketing Database

• Seven of the 66 segments high in NC
• Mixed ethnicity, but predominately white
• Elementary to high school education
• Blue collar, service and farm jobs
• Rural, small town locations
• Represent almost 25 of NCs population

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Ten Dang Good Reasons to live in North Carolina
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1 Reason The Best Public Health
Partnerships MONA LISA SMILES
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Public Health Foundation

• Either we are all protected
• or we are all at risk.