Posts Tagged ‘chronic disease’

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Show Your Love

February 14th, 2013

Valentine’s Day isn’t just a day of romance, flowers and candy.  The CDC Preconception Health and Health Care Initiative launched a campaign asking all women of childbearing age to Show Your Love by taking good care of themselves.  It’s a national initiative to educate women and couples on the importance of preconception health. Preconception health refers to a woman’s health during the years she can have a child.  A mother’s health before she gets pregnant can affect the health of her baby.  

Women who’d like to become pregnant are urged to “Show Your Love” to your future baby by adopting healthy behaviors now.   Women who are not planning a pregnancy now are encouraged to “Show Your Love” to themselves so they’ll be healthy and have a fulfilling future.  About half of all pregnancies in our country are unplanned, which increases the chances of having a poor birth outcome such as preterm birth, low birth weight, high birth weight, or stillbirth.  Many women become pregnant when they’re not in the best health or while engaging in behaviors that could harm a pregnant woman or her baby.  It makes sense to be healthy at all stages of life. 

The Show Your Love website includes posters, educational videos, TV PSAs and health checklists for use by health care providers and community partners who want to educate the women and couples they work with about the importance of preconception health.  Preconception health is impacted by a number of health issues addressed by various ADHS programs – chronic disease, oral health, nutrition, physical activity, smoking, STD’s, immunizations and mental health.  The Bureau of Women’s and Children’s Health website includes additional preconception health tools. Also, please feel free to email the Bureau at: preconceptionhealth@azdhs.gov .

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Tobacco Use & the Target Market

November 15th, 2012

One of the things you learn in business school is the importance of using the concept of a “target market” as a core of your business marketing plan.  That’s what we do when it comes to tobacco cessation.  We examine our tobacco surveillance data and look at demographic patterns for target populations and look for the leverage points to develop our interventions.  Since 50% of tobacco products are purchased by folks with a mental illness and/or chronic disease- this demographic is a key focus of our tobacco prevention strategies. 

We’ve been working hard for the last 3 years to make inroads into this target population with some pretty good success.  Our folks in the Division of Behavioral health and our Bureau of Tobacco and Chronic Disease and ASHLine have trained clinical behavioral health staff on how to get folks into smoking cessation (quit) services-  establishing systemic change within the behavioral health system for cessation services- moving Arizona toward being tobacco free.  This involves assessing every single patient at every single visit in our behavioral health system for tobacco use and providing them the opportunity to be referred for tobacco cessation coaching.  Since our initial efforts 3 years ago- ASHLine referrals from behavioral health locations have skyrocketed.  

The ASHLine referral development team is focusing training new nurse practitioners at Magellan’s Integrated Home Health on ASHLine Ask, Advice, Refer protocol & nicotine replacement therapy prescription guidelines.  Additionally, our Tobacco and Chronic Disease team submitted a manuscript to the CDC’s online journal Preventing Chronic Disease which describes the success of our interventions and illustrating how the behavioral health population is using cessation services and quitting tobacco at the same rate as the general population.

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Worksite Wellness- a Critical Public Health Lever

September 21st, 2012

Chronic diseases like heart disease, cancer, stroke, and diabetes cause 70% of deaths in the US these days… absorbing 75% of the $2.5T spent on annual medical care costs.  When it comes to employee healthcare expenses- the indirect costs of poor health like absenteeism, disability, and reduced work output can be several times higher than direct medical costs.  In fact, productivity losses from health problems cost employers $1,685 per employee per year! 

One of the provisions in the Affordable Care Act includes incentives for employers to implement worksite wellness programs to help them keep their workforce healthier.  When done well (using evidence-based and best practices) worksite health programs have a 3:1 payoff.  Like the odds? 

The Affordable Care Act contains some elements that will make worksite wellness programs more common and robust over the next couple of years.  There are basically 2 kinds of worksite wellness programs.  I’ll call them Wellness and Wellness Lite.  A “Wellness Lite” program doesn’t require a participant to meet any standard related to health status to receive a reward.  For example…  a wellness program could include a gym membership or tobacco cessation program but doesn’t require participants to actually lose weight or quit smoking.  

A Wellness program requires people to meet a health status standard to get a reward.  For example- an employer could ask employees to certify that they haven’t smoked during the previous year.  Enrollees who don’t could be assessed an annual surcharge of  20% of cost of the employee’s health insurance coverage.  Rewards may be in the form of premium discounts or rebates, lower cost-sharing requirements, waiving a surcharge, etc. Under the Affordable Care Act, wellness program rewards can be as high as 30% of the cost of the employee health plan- potentially going to 50% in the future.  

Our AZ Healthy Worksites web page provides businesses with information and tools to help them develop and implement an effective worksite wellness program.  For example, the Program Design page lists the eight steps for developing, implementing, and evaluating a comprehensive worksite program.  We’ve also contracted with the Arizona Small Business Association &  Viridian Health Management to develop a new toolkit for AZ businesses.  Viridian and the Arizona Small Business Association will teach businesses how to do effective wellness programs, understand their own particular issues/data, and develop effective strategies.  In all, our contract tasks the team to train 500 AZ employers.   Finally- the CDC is jumping into the fray with a variety of resources, which you can see at their worksite wellness hub website.  

 

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Posted in Affordable Care Act, Prevention

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Arizona’s New Chronic Disease Strategic Plan

September 10th, 2012

I’m happy to share our new Arizona Chronic Disease Strategic Plan.  This past year, our team from the Bureau of Tobacco & Chronic Disease worked with community partners from across the state on a new guiding document for chronic disease prevention and health promotion.  This strategic plan will be used by ADHS, county health departments, and community partners to advance chronic disease policies, systems and environmental change in the areas of where we work, live, learn, and get care.  At the same time, this plan will also help align activities around the CDC’s Chronic Disease Prevention and Health Promotion Four Domains.  

Funded through the CDC Coordinated Chronic Disease Program- the new plan identifies ways in which our partners can maximize the impact in the areas of heart disease, cancer, diabetes, obesity and tobacco.  The strategic plan includes a matrix of evidence-based strategies which can be used by the public health community..  and it provides clear direction for advancing nationally recognized recommended or promising evidence-based practices.  Congratulations and thank you to the many community partners and health department staff who contributed to the development of new plan.

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Outstanding Dietitians

July 10th, 2012

Registered Dietitians are on the front lines of our battle against obesity.  They work everyday to help people understand the importance of balancing diet and exercise – not necessarily an easy task in this junk-food, drive-thru world.  Some of them are really good at it – including our own Adrienne Udarbe and Maricopa County’s Trudes Rodriquez.  The Arizona Academy of Nutrition and Dietetics recognized their work at its annual meeting in June.

Adrienne was honored as the Emerging Dietetics Leader for 2012. Her work in the Champions for Change -Communities Putting Prevention to Work project demonstrated her leadership in mobilizing community networks to create sustainable changes to support healthy eating and active living throughout Arizona. She also represents the Arizona Academy as the Let’s Move Coordinator for Arizona and is known for the creativity and enthusiasm she brings to her work in the field of dietetics.

Trudes Rodriquez from tTrudes Rodrigues & Lynn Laddhe Maricopa County Department of Public Health was chosen as the Recognized Young Dietitian of the Year for the Academy’s Central District. Trudes is the Coordinator for the WIC Dietetic Internship and led the Coma Bien, Estar Bien Supermarket Program in collaboration with Food City stores. She also directed the county’s Women Together for Health Program that empowered women to make positive changes through nutrition and physical activity to prevent chronic disease. Since becoming an RD, Trudes has also earned an MBA, achieved certification in Adult Weight Management, has become a personal fitness trainer, breastfeeding counselor, and eating coach. 

True public health professionals.

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Wellness!

June 14th, 2012

I’m excited to announce that we have 32 teams signed up for the ADHS Worksite Wellness Stair Climb Challenge.  Stair climbing and other physical activities have so many health benefits including decreasing your risk of developing a chronic disease, improving your mental health and mood, and it increases your chances of living longer.  So, Get Your Climb On!

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ADHS Receives Award to Participate in National Quality Improvement Demonstration Initiative

March 15th, 2012

We just received a new grant award from the Association of State and Territorial Health Officials to participate in the Robert Wood Johnson Foundation’s National Quality Improvement Demonstration Initiative!  Arizona was only one of only 5 states with a successful application.  This is great for Arizona for a number of reasons.  

First, it’ll help prepare our agency for national accreditation as a state public health agency.  The grant will fund a quality improvement project that is a collaboration of Women’s & Children’s Health, Chronic Disease, and Environmental Health.  Key public health staff will go through a quality improvement process to review and standardize home safety assessment and referral protocols between ADHS- funded programs.  Conducting continuous quality improvement is a focus of accreditation, so this is a fabulous opportunity to learn by doing!  

Second, this serves as another example of how we’re implementing our Strategic Map.  This Quality Improvement Initiative fits perfectly with the strategic areas of developing and prioritizing resources to maximize results, as well as strengthen internal processes using continuous quality improvement.   

Third, it serves as an example of a successful grant application that was put together quickly with existing staff resources.   The grant announcement was issued in early December, with a due date of January 9.  You can imagine that putting a grant application together at this time of year was no small task.  We quickly assembled a team to consider applying; Sheila Sjolander came up with a concept for the grant, and the team finessed the concept to ensure it fit the intention and specifications in the grant guidance.   Credit goes to Toni Means, Tim Vaske, Diane Eckles, Bre Thomas, and Neelima Gabriel for their hard work pulling the application together.  Check out the original grant guidance and Arizona’s response on our Managing for Excellence webpage.

 

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Prevention and County Health

January 5th, 2012

Our prevention and county health folks will be spending more time working to help counties, schools, and communities to adopt policies that will reduce obesity, chronic disease and disparities.  One area of focus will be Border Health where the objectives include reducing motor vehicle accidents and substance abuse.  There will also be more going on around employee worksite wellness.

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What’s Preconception Health- and Why’s it Important?

November 7th, 2011

Being born too soon is the number one killer of infants in Arizona and in the nation.  Death rates from prematurity are declining but babies born too soon (before 37 weeks) often face medical, developmental and social challenges as they get older. More than 8,000 babies in Arizona were born too soon last year.   This week the March of Dimes released the 2011 Premature Birth Report Card that grades States on their premature birth rates.  While Arizona was average- there was good news related to the reduction in the percentage of uninsured women and the number of women who smoke.   

Some of the known factors impacting prematurity include having twins/triplets, having a chronic disease such as diabetes, high blood pressure, being obese, smoking, and alcohol or illegal drug use.  One of our main approaches to reducing prematurity rates is to improve the health of women before they get pregnant- called preconception health.   Prenatal care is still important- but poor health practices during pregnancy will usually trump good prenatal care.   

Our interventions include implementing evidence-based practices to get moms to stop smoking, improve physical activity and nutrition and behavioral health- and all are part of our Preconception Health Strategic Plan which includes Every Woman Arizona educational materials, grants to six local communities to implement preconception health strategies, and home visitation programs that address many of the factors that can lead to prematurity.  Our WIC program and clinics also work with young moms in their reproductive years to improve their health.  We also work with the Arizona March of Dimes and the Arizona Perinatal Trust to encourage hospitals to adopt policies designed to ensure that elective inductions aren’t approved before 39 weeks gestation.

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Multiple Chronic Conditions- an Expensive Public Health Threat

October 17th, 2011

I’ve written several pieces over the last few weeks highlighting our efforts to better integrate primary healthcare into the treatment plans for folks with mental illnesses- but the issue of providing better coordinated care for folks with multiple chronic medical conditions is really far bigger than this integration issue.  More than 25% of Americans have multiple chronic conditions like arthritis, asthma, chronic respiratory conditions, diabetes, heart disease, and high blood pressure.  Treating folks with multiple conditions is both complicated and expensive- and more coordinated efforts are a key to improving both.  In fact, 66% of all health care spending in the US goes toward caring for the 27% of folks with co-occurring chronic medical conditions. 

The US Department of Health and Human Services (HHS) knows full well that better care coordination for these folks is critical if the nation is going to do a better job of improving health care efficiency and containing costs.  There are a number of efforts underway to address these issues- many of which are summarized in a strategic framework document that HHS put out a few months ago called Multiple Chronic Conditions: A Strategic Framework.  The framework is just that- an outline of a strategy- and it includes a vision statement, goals, objectives, and discrete strategies to guide HHS in coordinating its efforts internally and collaborating with stakeholders externally. 

By the way, our tobacco & chronic disease team is leading the state’s efforts to help folks better manage their illness.  One of their tools is the Stanford Chronic Disease Self Management Program- which is an evidence-based program which empowers folks to recognize and address the factors which impact their chronic conditions.  Through Healthy Living, individuals can develop and implement personalized action plans, take ownership, and achieve improved health outcomes that are both manageable and sustainable.  Our team (under the leadership of Ramona Rusinak) and the Arizona Living Well Institute has identified this as a core element of its overall strategic direction.

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