Wayne H. Giles, MD, MS

DirectorDivision of Population Health

August 8, 2012

Coordinated Chronic Disease Prevention and Health Promotion

Program:

National Center for Chronic Disease Prevention and Health Promotion

Division of Population Health

Growing Challenges

Chronic Diseases and Related Risk Factors

Actual Causes of Death†

United States, 2000

0 5 10 15 20

Tobacco

Poor diet/Physical inactivity

Alcohol consumption

Microbial agents

Toxic agents

Firearms

Sexual behavior

Motor vehicles

Illicit drug use

Percentage (of all deaths)

* Minino AM, Murphy SL, Xu J, Kochanek KD. Deaths: Final data for 2008. National vital statistics reports; vol 59 no 10. Hyattsville, MD: National Center for Health Statistics. 2011.

† Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238-1246.

Percentage (of all deaths)

Heart Disease

Cancer

Chronic lower respiratory diseases

Unintentional Injuries

Diabetes

Alzheimer’s disease

Pneumonia/influenza

Kidney Disease

Stroke

Leading Causes of Death†

United States, 2008

Disabilities

• Arthritis – is the number one cause of disability

• Stroke – has left 1 million Americans with disabilities

• Heart Disease – the leading cause of premature, permanent disability in the U.S. workforce

• Oral Health – one in five adults have active tooth decay that needs treatment

Achieving Healthy States: The Power of WE …

• Public health • Schools• YMCA’s• Non profit

organizations• Businesses• Hospitals • Elected officials• School

superintendents• Oral health care

professionals• Local aging

centers/senior centers

• Recreation and park departments

• State health departments

• City Planners• Redevelopment

agencies• Transportation

agencies • Faith based

organizations• Philanthropic leaders• Community leaders • Health plans• Foundations• Many more……

IOM Report: Released Jan. 31, 2012

“Enhancing quality of life for individuals with chronic disease has not been given the attention it needs by health systems and public health programs…”

IOM Recommendations:

States should develop comprehensive chronic disease plans that include community based efforts

CDC should explore HIAP approach with HIAs as a promising practice

Evaluations of CDC’s funded CD programs should include QOL and functional status

Working in Four Key Domains

EPIDEMIOLOGY &

SURVEILLANCE

ENVIRONMENTAL APPROACHES

HEALTH SYSTEMS

COMMUNITY-CLINICAL LINKAGES

The Coordinated Chronic Disease

Program?

Funds to States – Chronic Disease

Ensure that every state has a strong foundation

Maximize the reach of categorical programs by leveraging shared basic services

Work collaboratively across chronic disease conditions and risk factors to most effectively meet population health needs, especially for populations with greatest burden

Improve CDC’s assistance to state health departments

• Reduced administrative costs • Increased program investments• Flexibility • Shared services• Coordinated TA from CDC

What will we see?

Information on Awards

Average award $730,000

First year of a 3-year cooperative agreement FY 2011 – FY 2013

Supplement completes 5 year period of co-operative agreement 901 (which funds diabetes & tobacco)

2011-13 Timeline for CCDP

Awards to 58 grantees• Sept,

2011

Develop state CD plan & comm plan

• Aug 24, 2012

Implement management & leadership plan • Oct. 26, 2012

Establish capacity to implement strategies• July 26,

2013

What States Are Doing

I. Develop a state chronic disease plan & engage statewide partners (Aug. 24, 2012) – plan should:

be driven through collaboration with a broad range of statewide partners, including non traditional partnersengage all major categorical programs at the state health department, including key categorical partnersinclude analysis and identification of priority “big steps” that can affect multiple conditions – of interest to multiple partners

What States Are Doing

II. Assessment & management plan for leadership in CD prevention (assessment Oct. 26, 2012) – plan should address:

LeadershipOrganizational designCommunicationCapacity to achieve changes in 4 key domainsCapacity to provide TA to communities

What States Are Doing

III. Build capacity and achieve changes in 4 key domains

Epidemiology and surveillance

Environmental approaches

Health systems interventions

Community-clinical linkages

How Might This Affect Us?

What will remain the same? Current Cancer Division project officers will remain in DCPC Current project officers will monitor FOA activities.

What will change? Regional teams will be coordinated by DPH staff Increased opportunities for linkages and support across

programs More consistent messaging and TA

State Health Department of the Future

Highly skilled chronic disease staff in every state

Strong surveillance data documenting the burden and reach of the categorical programs

Robust evaluation capacity Informed policy makers who understand the

burden of chronic disease and the need to scale up effective interventions

State residents who understand and support the need to address chronic disease

Efforts to address heart disease, diabetes, cancer, nutrition, physical activity, arthritis are accelerating

Thank you