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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 InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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 InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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 Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
CDC’s HistoryCDC’s History
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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
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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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CDC’s Futures InitiativeCDC’s Futures InitiativeCreating the Future of CDC for the 21Creating the Future of CDC for the 21stst Century Century
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
CDC’s Futures Initiative
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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
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)
CDC’s Futures Initiative
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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
Futures Initiative: Improving Health Futures Initiative: Improving Health ImpactImpact