Health Equity

Health Protection…

CDC MissionCDC Mission

To promote health and quality of lifeTo promote health and quality of lifeby preventing and controlling disease,by preventing and controlling disease,injury, and disabilityinjury, and disability

Healthy People inEvery Stage of Life

Healthy People inHealthy Places

Healthy People in aHealthy World

People Prepared forEmerging Health Threats

Health Protection GoalsHealth Protection Goals

Goals and Strategic SubgoalsGoals and Strategic Subgoals

Health PromotionHealth ProtectionHealth Diplomacy

WorkplaceCommunitiesHomesTravel &

RecreationHealthcare

SettingsSchoolsInstitutions

Infants & Toddlers

ChildrenAdolescentsAdultsOlder Adults

Healthy People Healthy People During Every Stage During Every Stage

of Lifeof Life

Healthy People in Healthy People in Healthy PlacesHealthy Places

People Prepared for People Prepared for Emerging Health Emerging Health

ThreatsThreats

Healthy People in a Healthy People in a Healthy WorldHealthy World

PreventDetect & Report InvestigateControlRecoverImprove

Health Protection: Urgent Challenges Health Protection: Urgent Challenges RNC 2004 Aug 04

West Nile

VirusAug-Nov

02

Space Shuttle

Columbia Disaster

Feb 03

SARS Mar-Aug 03

Monkey Pox

June-Aug 03

Northeast Blackout

Aug 03

California Wildfires

Oct-Nov 03

Ricin TularemiaAnthrax Oct-Nov 03

BSE Dec 03

Avian InfluenzaJan-Mar 04

Guam Typhoon

Feb 04

Ricin Domestic Response

Feb 04

G8 Summit

June 04

2004 Summer Olympics

June 04

DNC 2004 July 04

Hurricanes (Charley, Frances,

Ivan, Jean)

Aug-Oct 04

West Nile Virus Aug-Nov 04

Influenza Vaccine

Shortage Oct 04

Tsunami

Dec 04World Trade Center

Sept2001

AnthraxAttacks

Oct-Nov 01

Influenza Sept 03

Hurricane IsabelSept 03

Hurricane KatrinaAug. 05

Marburg VirusMar 05

Hurricane Rita

Sept. 05

HurricaneWilma

Oct 04

E.ColiNov 06

Climate Change

Hurricane IsabelSept 03

TBMay ‘07

Health Protection – Urgent RealitiesHealth Protection – Urgent Realities

• Having goals allows CDC to analyze, harmonize, Having goals allows CDC to analyze, harmonize, and improve its portfolio of activities and and improve its portfolio of activities and investmentsinvestments

• The goals process willThe goals process will– identify public health investments identify public health investments – support better partnerships and collaborationssupport better partnerships and collaborations– enhance marketing and communication of enhance marketing and communication of

agency prioritiesagency priorities– inform scientific and programmatic agendasinform scientific and programmatic agendas– improve the design and delivery of improve the design and delivery of

interventionsinterventions

Advantages of Having GoalsAdvantages of Having Goals

Characteristics of CDC’s GoalsCharacteristics of CDC’s Goals

CDC’s Health Protection GoalsCDC’s Health Protection Goals• Complement and support the nation’s Complement and support the nation’s Healthy Healthy

People 2010 goalsPeople 2010 goals• Will be achieved in cooperation with numerous Will be achieved in cooperation with numerous

national, state, and local partnersnational, state, and local partners• Include research and discovery necessary for Include research and discovery necessary for

long-term health impactlong-term health impact• Prioritize CDC’s efforts to reduce health problems Prioritize CDC’s efforts to reduce health problems

that affect certain populations, especially that affect certain populations, especially vulnerable groupsvulnerable groups

Why we are doing this? Why we are doing this?

• CDC and all of our organizational components CDC and all of our organizational components are better positioned to support our collective are better positioned to support our collective work to improve our impact on healthwork to improve our impact on health

• Greater opportunities to collaborate and work Greater opportunities to collaborate and work with our partners with our partners

• Enables a much more powerful Congressional Enables a much more powerful Congressional Strategy to defend and support public healthStrategy to defend and support public health

• Creates a more durable platform to introduce Creates a more durable platform to introduce CDC to the incoming USG executive CDC to the incoming USG executive administration in late 2008, early 2009administration in late 2008, early 2009

Drives us toward “A Healthiest Nation”

Access To Quality Health Care

IndicatorGoal HP

2010 US NYS

% of adults with health care coverage** 100% 85.5% (2006) 86.5% (2006)

% of adults with regular health provider** 96% 80% (2006) 85.0% (2006)

% of adults who have seen a dentist in the past year**

83.0% 70.3% (2006) 71.8% (2006)

Early stage cancer diagnosis: Breast Cervical Colorectal

  63% 53% 40% (1996-2003)

64% 52% 40% (2000-2004)

Tobacco Use

Indicator Goal HP 2010 US NYS

% cigarette smoking in adolescents(past month) 16.0% 23.0% (2005) 16.3% (2006)

% cigarette smoking in adults 12% 20.1% (2006) 18.2% (2006)

COPD hospitalizations among adults 18 + years (per 10,000)

  23.0 (2004) 41.8 (2004-2006)

Lung cancer incidence (per 100,000) Male Female   85.3 54.2 (2004) 82.2 * 53.9 * (2000-2004)

New York State: The Healthiest StateNew York State: The Healthiest State

CDC: Next steps to make it CDC: Next steps to make it actionableactionable

• AccountabilityAccountability– Is the portfolio of activities effective as a Is the portfolio of activities effective as a

set of projects across the organization to set of projects across the organization to achieve the Goal? achieve the Goal?

– Are we having an impact on health? Are we having an impact on health? – What is needed to be effective or to What is needed to be effective or to

improve this effort? improve this effort?

CDC: Next steps to make it CDC: Next steps to make it actionableactionable

• MeasurementMeasurement– Moving out of measuring disease status Moving out of measuring disease status

into measuring health status.into measuring health status.

• Individual actionIndividual action– ““I understand what we are going to do with I understand what we are going to do with

Goals”Goals”– ““I see the next steps”I see the next steps”– ““I know my role”I know my role”

Moving Goals into Actionable Moving Goals into Actionable ItemsItems

• Green Hospital projectGreen Hospital project– Combination of environmental interests, Combination of environmental interests,

patient safety, satisfaction and quantifying patient safety, satisfaction and quantifying costscosts

– Large, complex database Large, complex database – Effect of Effect of

• Single rooms, sunlight on early discharges, Single rooms, sunlight on early discharges, reduced infections and patient satisfactionreduced infections and patient satisfaction

• Use of environmentally friendly cleaning Use of environmentally friendly cleaning agents agents

• Staging shift changes for nursing staffStaging shift changes for nursing staff

Community Partners: Making it Community Partners: Making it actionableactionable

• Walmart’s Personal Sustainability ProjectWalmart’s Personal Sustainability Project– educate associates on sustainability to educate associates on sustainability to

improve their health and well being, foster improve their health and well being, foster widespread community engagement widespread community engagement

– Participation in the project is voluntary. Participation in the project is voluntary. Associates create their own PSPs and adopt Associates create their own PSPs and adopt a pledge to improve their bodies, their a pledge to improve their bodies, their families, or their community. families, or their community.

Individually: making it actionableIndividually: making it actionable

• Nano-practicesNano-practices– Bike to work. – Park in the spot that’s farthest from where

you’re going. – Change your incandescent light bulbs to

compact fluorescents.– Care for a park.

For More InformationFor More Information

Learn more about CDC’s Health Learn more about CDC’s Health Protection Goals through our Internet Protection Goals through our Internet

site:site:

www.cdc.gov/goalswww.cdc.gov/goals

Healthy/Mothers/Healthy Babies/Healthy Children

IndicatorGoal HP

2010 US NYS

% early prenatal care (1st trimester) 90.0% 83.9% (2005)

75.4% (2005)

% low birthweight births (<2500 grams) 5.0% 8.2% (2005)

8.3% (2005)

Infant mortality (per 1,000 live births)** 4.5 6.9 (2005)

5.8 (2005)

Increase % of 2 year old children who receive recommended vaccines (4 DTaP, 3 polio, 1 MMR, 3 Hib, 3 HepB)

80% 80.6% (2006)

83.5% (2006)

% of children with at least one lead screening by age 36 months     77% (NYS excl. NYC) (2002 birth cohort)

Prevalence of tooth decay in 3rd grade children 42% 53.0% (2004)

54.1% (2004)

Pregnancy rate among females aged 15-17 years** (per 1,000) 43.0 44.4 (2002)

36.5 (2005)

Physical Activity/Nutrition

Indicator Goal HP 2010 US NYS

% of overweight/obese children in grades: 2-4 Years (WIC) K 2 4 7 10   14.8% (2004) 15.5% (2005)

% of adults who are obese (BMI>30)** 15.0% 25.1% (2006) 22.9% (2006)

% of adults engaged in some type of leisure time physical activity 80.0% 77.4% (2006) 74.0% (2006)

% of WIC moms breastfeeding at 6 months   50% 23.4% (2004) 39.5% (2005)

Unintentional Injury

Indicator Goal HP 2010 US NYS

Unintentional injury mortality (per 100,000) hospitalizations (per 10,000)

17.1 39.1* (2005) 19.9 * 59.3 * (2003-2005)

Motor vehicle crash related mortality (per 100,000) 8.0 15.2 * (2005)

7.7 * (2003-2005)

Pedestrian injury Hospitalizations (per 10,000)     2.0 (2004-2006)

Fall related hospitalizations age 65+ years (per 10,000)     206.3 (2004-2006)

Healthy Environment

Indicator

Goal HP

2010 US NYS

Incidence of children <72 months with confirmed blood lead level> = 10ug/dl (per 100 children tested)

0.0   1.7 (2001-2003) (Rate for NYS Excluding NYC)

Asthma related hospitalizations (per 10,000)** Total Ages 0-17 years

17.3 16.6 *(2005) 22.6 (2003)

22.2 * 34.1 (2003-2005)

Work related hospitalizations (per 10,000 employed persons aged 16+ years)

    15.3 (2003-2005)

Elevated blood lead levels (>25 ug/dl) per 100,000 employed persons age 16+ years

0.0   6.4 (2003-2005)

Chronic Disease

Indicator Goal HP 2010 US NYS

Diabetes prevalence in adults 2.5% (includes children)

7.5% (2006)

7.6% (2006)

Diabetes short-term complication hospitalization rate (per 10,000) Age 6-17 years Age 18+ years

  2.9 5.5 (2004)

3.1 5.2 (2005-2006)

Coronary heart disease hospitalizations (per 10,000)     63.7 * (2003-2005)

Congestive heart failure hospitalization rate per 10,000 (ages 18+ years)

  48.9 (2004)

44.3 (2005-2006)

Cerebrovascular (Stroke) disease mortality (per 100,000) 50 46.6 * (2005)

32.6 * (2003-2005)

Infectious Disease

IndicatorGoal HP

2010 US NYS

HIV infection rate (per 100,000) - 18.5 (2006) 25.5 (2003-2005)

Gonorrhea case rate (per 100,000)   120.9 (2006) 90.7 (2006)

Tuberculosis cases (per 100,000) 1.0 4.4 (2007) 7.2 (2003-2005)

Bacterial pneumonia hospitalization rate per 10,000 (ages 18+ years)

  41.8 (2004) 38.1 (2005-2006)

% of adults 65+ years with immunizations - flu shot past year - ever pneumonia

90% 90% 69.6% 66.9% (2006)

64.7% 61.0% (2006)

Community Preparedness

Indicator Goal HP 2010 US NYS

% population living within jurisdiction with state-approved emergency preparedness plans

    100% (2007)

Mental Health/Substance Abuse

IndicatorGoal HP

2010 US NYS

Suicide mortality rate (per 100,000) 4.8 10.9 * (2005) 6.0 * (2003-2005)

% adults reporting 14 or more days with poor mental health in last month

    10.4% (2003-2005)

% binge drinking past 30 days (5 + drinks in a row) in adults 13.4% 15.4% (2006) 15.8% (2006)

Drug-related hospitalizations (per 10,000)     34.6 * (2003-2005)