creating the future of cdc for the 21 st century

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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century

Creating the Future of CDC Creating the Future of CDC for the 21for the 21stst Century Century

Dixie Snider, Jr., MD, MPHDixie Snider, Jr., MD, MPHDeputy Director of Public Health ScienceDeputy Director of Public Health Science

Centers for Disease Control and PreventionCenters for Disease Control and Prevention

AcademyHealth CDC Research Agenda Session AcademyHealth CDC Research Agenda Session San Diego, CASan Diego, CAJune 7, 2004June 7, 2004

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CDC’s Futures InitiativeCDC’s Futures InitiativeHeath Protection for the 21Heath Protection for the 21stst Century Century

InputInput

IdeasIdeas

ImplementationImplementation

ImpactImpact• Outside-in Outside-in • InteractiveInteractive• Driven by data Driven by data • Focused on customers Focused on customers • Strategic direction first, Strategic direction first,

then structure & processesthen structure & processes

• Outside-in Outside-in • InteractiveInteractive• Driven by data Driven by data • Focused on customers Focused on customers • Strategic direction first, Strategic direction first,

then structure & processesthen structure & processes

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Ideas…New Strategies! Ideas…New Strategies! • Achieve Achieve health impacthealth impact and reduce and reduce health health

disparitiesdisparities for for customerscustomers (people whose (people whose health we protect) health we protect) – alignment (strategy, goals, & action)alignment (strategy, goals, & action)– performance measurement and performance measurement and

improvementimprovement– integration across organizational units integration across organizational units – marketingmarketing

• Lead the Nation’s Lead the Nation’s public health systempublic health system• Expand Expand public health researchpublic health research as the as the

foundation for all our work foundation for all our work • Expand Expand global healthglobal health impact impact • Support the world’s best Support the world’s best workforceworkforce and and

maximize our maximize our effectiveness & accountabilityeffectiveness & accountability

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CDC’s Futures InitiativeCDC’s Futures Initiative

Why Change?Why Change?

Emerging Public Health ThreatsEmerging Public Health Threats

Aging SocietyGlobalization

Public Health InfrastructurePublic Health InfrastructurePublic Health InfrastructurePublic Health Infrastructure

Changing DemographicsChanging DemographicsChanging DemographicsChanging Demographics

Rising Health Care Costs Aging Workforce

Information Technology

Human Genome

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Increase in Health ExpendituresIncrease in Health Expenditures

• Health expenditures as percent of Health expenditures as percent of GDP projected to increase from GDP projected to increase from 14.9% (2002) to 18.4% (2013)14.9% (2002) to 18.4% (2013)

• Per capita health spending in the US Per capita health spending in the US is highest in the world, yet we still is highest in the world, yet we still rank behind 47 countries in life rank behind 47 countries in life expectancyexpectancy

Source: The New York Times Magazine

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Health StatusHealth Status

• U.S. life expectancy is 2.5 years U.S. life expectancy is 2.5 years shorter than in Western Europe and shorter than in Western Europe and Canada, and more than 3 years Canada, and more than 3 years shorter than in Japanshorter than in Japan

• Obesity and obesity-related health Obesity and obesity-related health risks cost the U.S. an estimated risks cost the U.S. an estimated $125B per year$125B per year

• The U.S. ranks 28th in the world in The U.S. ranks 28th in the world in infant mortalityinfant mortality

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CDC as a source of health informationCDC as a source of health information

56%54%

0%

10%

20%

30%

40%

50%

60%

CDC Has a Perception of High Trust/ CDC Has a Perception of High Trust/ Reliability . . . Reliability . . .

“CDC is one of the first places I would turn to for reliable

health information”

% o

f re

spo

nd

ents

say

ing

“Y

es”

“One of the health information

sources I trust the most is the CDC”

. . . But Few People Turn to CDC for Health Information

43%

6%

0%

10%

20%

30%

40%

50%

60%

“I do not remember hearing about health or disease info that

came from the CDC in the past year”

“I tried to get info about health or

disease from the CDC in the past year”

Source: Porter Novelli

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Where are people looking?Where are people looking?

64%

31%

24% 23%21%

15%13%

10%

5%

0%

10%

20%

30%

40%

50%

60%

70%

HealthPortals

Govt. Agencies

% of Internet Users Who Have Searched for Information from:% of Internet Users Who Have Searched for Information from:

Doctors’Offices/

Hospital Sites/Health

Centers

Pharma-ceutical

Websites

Non-ProfitOrgs.

ScientificRetrievalSystems

OnlineNewsletters

Universities ChatRooms

Source: Harris Poll (2003)

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NIH vs CDC BudgetNIH vs CDC Budget

0

5

10

15

20

25

30

1960 1970 1980 1990 2000 2004

$B

illi

on

Source: CDC, NIH

NIH

CDC

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Strategic ImperativesStrategic Imperatives

• Health ImpactHealth Impact

• CustomersCustomers

• Public health systemPublic health system

• Public health research Public health research

• Global health Global health

• Efficiency, effectiveness & Efficiency, effectiveness & accountabilityaccountability

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Health Protection GoalsHealth Protection Goals

• Health Promotion & Prevention of Disease, Health Promotion & Prevention of Disease, Injury, and Disability:Injury, and Disability: All people will achieve their optimal lifespan All people will achieve their optimal lifespan with the best possible quality of health in every with the best possible quality of health in every stage of life. stage of life.

• PreparednessPreparedness:: People in all communities will be protected from People in all communities will be protected from infectious, environmental, and terrorist threats.infectious, environmental, and terrorist threats.

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People will benefit from state-of-the art detection, investigation, and People will benefit from state-of-the art detection, investigation, and containment of infectious, terrorism, and environmental threats.containment of infectious, terrorism, and environmental threats.

The government public health, health care delivery, business, The government public health, health care delivery, business, educational sectors and other sectors of the health system will be educational sectors and other sectors of the health system will be integrated to protect people from infectious, environmental, and terrorist integrated to protect people from infectious, environmental, and terrorist threats.threats.

Preparedness GoalsPreparedness Goals

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Health promotion and prevention of disease, Health promotion and prevention of disease, injury, and disability by life-stageinjury, and disability by life-stage

InfantInfant ChildChild TeenTeen AdultAdult SeniorSenior

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Infant: By 2015, the United States is one of five countries with the Infant: By 2015, the United States is one of five countries with the highest rates of infant survival (Baseline 28th, 1999)highest rates of infant survival (Baseline 28th, 1999)

Adolescents: By 2015, at least 95% of adolescents practice Adolescents: By 2015, at least 95% of adolescents practice behaviors which protect them from illness and injury now and in the behaviors which protect them from illness and injury now and in the future. (NHIS baseline)future. (NHIS baseline)

Seniors: By 2015, average lifespan of older Americans is increased Seniors: By 2015, average lifespan of older Americans is increased by 2 years by 2 years

Life-stage Goals [Draft]Life-stage Goals [Draft]

Children: By 2015, mortality is reduced 20%, saving an additional 800 Children: By 2015, mortality is reduced 20%, saving an additional 800 lives per year (NCHS Baseline).lives per year (NCHS Baseline).

Adults: By 2015, at least 90% of adults have a healthy weight Adults: By 2015, at least 90% of adults have a healthy weight (NHANES baseline)(NHANES baseline)

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Organizational Design PrinciplesOrganizational Design Principles

• Strategy and goals derive from Strategy and goals derive from population health assessments population health assessments (“customers’ health”) to achieve (“customers’ health”) to achieve health impacthealth impact

• Strategy and goals drive agency’s Strategy and goals drive agency’s priorities and allocations priorities and allocations

• Emphasis on research and innovation Emphasis on research and innovation • Health protection “marketing” Health protection “marketing” • Consolidation of business & other Consolidation of business & other

cross-cutting servicescross-cutting services

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CDC’s HistoryCDC’s History

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Epidemiology Program

Office

National Immunizations

Program

Public Health Practice

Program Office

National Center on Birth Defects &

Developmental Disabilities

National Center for Chronic

Disease Prevention &

Health Promotion

National Center for Environmental

Health

National Center for Health Statistics

National Center for Infectious

Diseases

National Center for Injury

Prevention and Control

National Center for HIV, STD, and

TB Prevention

National Institute for Occupational Safety and Health

Office of the Director

Office of Global Health

CDC Washington Office

Office of Program Planning and Evaluation

Office of Women’s Health

Office of Health and Safety

Office of Equal Employment Opportunity

Office of Executive Secretariat

Office of Minority Health

Office of Science Policy and Technology Transfer

Office of Communication

Office of the Chief Operating Officer

Office of Genomics and Disease Prevention

Department of Health and Human ServicesDepartment of Health and Human ServicesCenters for Disease Control and Prevention (CDC)Centers for Disease Control and Prevention (CDC)

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Coordinating Center for Health Information and Services

BusinessBusinessBusinessBusinessPublic Health Public Health SystemsSystems

Public Health Public Health SystemsSystems

Health Care Health Care DeliveryDelivery

Health Care Health Care DeliveryDelivery

Federal Federal AgenciesAgenciesFederal Federal

AgenciesAgenciesEducationEducationEducationEducation

NationalNationalCenter for Health Center for Health

MarketingMarketing

NationalNationalCenter for Health Center for Health

MarketingMarketing

National Center National Center forfor

Public HealthPublic HealthInformaticsInformatics

National Center National Center forfor

Public HealthPublic HealthInformaticsInformatics

National Center forNational Center forHealth StatisticsHealth Statistics

National Center forNational Center forHealth StatisticsHealth Statistics

Coordinating Center Coordinating Center for Infectious Diseasesfor Infectious Diseases

NCID, NCHSTP, NIPNCID, NCHSTP, NIP

Coordinating Center Coordinating Center for Infectious Diseasesfor Infectious Diseases

NCID, NCHSTP, NIPNCID, NCHSTP, NIP

Coordinating Coordinating Center for Center for

Health PromotionHealth PromotionNCCDPHP, NCBDDD, NCCDPHP, NCBDDD,

GenomicsGenomics

Coordinating Coordinating Center for Center for

Health PromotionHealth PromotionNCCDPHP, NCBDDD, NCCDPHP, NCBDDD,

GenomicsGenomics

Coordinating Coordinating Center for EIO Center for EIO

NCEH/ATSDRNCEH/ATSDR

NCIPC, NIOSHNCIPC, NIOSH

Coordinating Coordinating Center for EIO Center for EIO

NCEH/ATSDRNCEH/ATSDR

NCIPC, NIOSHNCIPC, NIOSH

Office Office of Global Healthof Global Health

Office Office of Global Healthof Global Health

Office for TerrorismOffice for TerrorismPreparedness & Preparedness &

Emergency ResponseEmergency Response

Office for TerrorismOffice for TerrorismPreparedness & Preparedness &

Emergency ResponseEmergency Response

Strategy andStrategy and InnovationInnovation

Strategy andStrategy and InnovationInnovation

Chief of Chief of ScienceScienceChief of Chief of ScienceScience

Chief of PublicChief of PublicHealth ImprovementHealth Improvement

Chief of PublicChief of PublicHealth ImprovementHealth Improvement

Human CapitalHuman CapitalManagementManagement

Human CapitalHuman CapitalManagementManagement

CustomersCustomersPeople whose health we want to improvePeople whose health we want to improve

Executive Leadership TeamManagement Council Executive Board

Partners Alliances Stakeholders

Office of the Chief Office of the Chief Operating OfficerOperating Officer

Office of the Chief Office of the Chief Operating OfficerOperating Officer

Office of the Office of the Chief of StaffChief of StaffOffice of the Office of the Chief of StaffChief of Staff

CDC WashingtonCDC WashingtonCDC WashingtonCDC Washington

DirectorDirectorDirectorDirector

Channels

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Changing CDCChanging CDC

Strategic imperatives

Health Impact Goals

Organization Design

Employee Education

Internal and External

Communications

Leader Accountability

Recognition& Rewards

Business Process

Redesign

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FROMFROM TOTO

• • No overall measure of No overall measure of successsuccess

• • Lack of customer Lack of customer segmentationsegmentation

•• Limited partner capacity Limited partner capacity (state and local health (state and local health depts)depts)

CDC’s Futures Initiative

• • Clearly articulated and Clearly articulated and measured measured

•• Segmented customer Segmented customer approachapproach

•• Strong partner networkStrong partner network•• Revitalized state & Revitalized state & local health local health departmentsdepartments•• Media, business, Media, business, health care delivery, health care delivery, schools, communitiesschools, communities

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FROMFROM TOTO

•• Primary focus on Infectious Primary focus on Infectious Disease and PreparednessDisease and Preparedness

•• Disease specific, fragmented Disease specific, fragmented approach to globalapproach to global

•• Inefficient work processesInefficient work processes

•• Silos/organizationSilos/organization

•• Focus on processFocus on process

•• Primary focus on Primary focus on Infectious Disease, Infectious Disease, Preparedness and Preparedness and PreventionPrevention

•• Comprehensive integrated Comprehensive integrated global approachglobal approach

•• Efficient work processesEfficient work processes

• • Integrated organization Integrated organization (maintaining (maintaining specialization)specialization)

•• Focus on impactFocus on impact


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FROMFROM TOTO

•• Minimal applied researchMinimal applied research

•• Fragmented approach to Fragmented approach to customers/partnerscustomers/partners

•• Difficult to do business withDifficult to do business with

• • Strong applied researchStrong applied research

•• Integrated approach to Integrated approach to customers/partnerscustomers/partners

•• Easy to do business with Easy to do business with (standard of good gov’t)(standard of good gov’t)


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Futures Initiative: Improving Health Futures Initiative: Improving Health ImpactImpact

creating the future of cdc for the 21 st century

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