Healthiest Wisconsin 2020:Healthiest Wisconsin 2020:Everyone Living Better LongerEveryone Living Better Longer

Karen E. TimberlakeKaren E. TimberlakeSecretarySecretaryWisconsin Department of Health ServicesWisconsin Department of Health Services

Real Talk for Real Action:Real Talk for Real Action:Getting Together for a Healthier WisconsinGetting Together for a Healthier Wisconsin

January 29, 2009January 29, 2009

Purpose of a State Health PlanPurpose of a State Health Plan

Develop an agreed-upon plan that provides Develop an agreed-upon plan that provides

strategic direction and aligns the resources to the strategic direction and aligns the resources to the

vision and goals. vision and goals.

The 2010 goals were:The 2010 goals were:

– Protect the health and safety of the publicProtect the health and safety of the public

– Eliminate health disparities (move toward equity in 2020)Eliminate health disparities (move toward equity in 2020)

– Transform Wisconsin’s public health systemTransform Wisconsin’s public health system

By focusing on…By focusing on…

HW 2010 Health PrioritiesHW 2010 Health PrioritiesAccess to Primary and Preventive Health ServicesAccess to Primary and Preventive Health Services

Adequate and Appropriate NutritionAdequate and Appropriate Nutrition

Alcohol and Other Substance Use and AddictionAlcohol and Other Substance Use and Addiction

Environmental and Occupational Health HazardsEnvironmental and Occupational Health Hazards

Existing, Emerging and Re-emerging Communicable Existing, Emerging and Re-emerging Communicable

DiseasesDiseases

High Risk Sexual BehaviorHigh Risk Sexual Behavior

Intentional and Unintentional Injuries and ViolenceIntentional and Unintentional Injuries and Violence

Mental Health and Mental DisordersMental Health and Mental Disorders

Overweight, obesity, and lack of physical activityOverweight, obesity, and lack of physical activity

Social and Economic Factors that Influence HealthSocial and Economic Factors that Influence Health

Tobacco use and exposureTobacco use and exposure

HW 2010 Infrastructure PrioritiesHW 2010 Infrastructure Priorities

Integrated electronic data and information Integrated electronic data and information systemssystems

Community health improvement processes Community health improvement processes and plansand plans

Coordination of state and local public health Coordination of state and local public health system partnershipssystem partnerships

Sufficient, competent workforceSufficient, competent workforce

Equitable, adequate, and stable financing Equitable, adequate, and stable financing

Decreasing Trends in Youth Decreasing Trends in Youth Smoking in WisconsinSmoking in Wisconsin

High school smoking rates decreased 37% from High school smoking rates decreased 37% from

1 in 3 youth in 2000 to 1 in 5 youth in 2008 1 in 3 youth in 2000 to 1 in 5 youth in 2008

Middle school smoking rates decreased from Middle school smoking rates decreased from

12% in 2000 to 4.3% in 200812% in 2000 to 4.3% in 2008

Significant decrease in the number of Wisconsin Significant decrease in the number of Wisconsin

retailers selling tobacco to minorsretailers selling tobacco to minors

Decline in Adults Smoking RatesDecline in Adults Smoking RatesAdult smoking rate in Wisconsin is at its lowest point ever Adult smoking rate in Wisconsin is at its lowest point ever

Wisconsin’s rate has dropped below the national averageWisconsin’s rate has dropped below the national average

45 million fewer packs of cigarettes were sold after introduction of 45 million fewer packs of cigarettes were sold after introduction of $1/pack tax increase in 2007$1/pack tax increase in 2007

There have been 39,000 to the Wisconsin Tobacco quit line in 2008There have been 39,000 to the Wisconsin Tobacco quit line in 2008

0

5

1 0

1 5

2 0

2 5

2 0 0 0 2 0 0 1 2 0 0 2 2 0 0 3 2 0 0 4 2 0 0 5 2 0 0 6 2 0 0 7

W I

U S

Per

cent

Adult Smoking Prevalence 2000 - 2007

The Burden of Tobacco in The Burden of Tobacco in WisconsinWisconsin

Tobacco use contributes to Tobacco use contributes to

over 8,000 deaths annuallyover 8,000 deaths annually

$3 billion in health care and $3 billion in health care and

productivity costs annuallyproductivity costs annually

$276 million spent on $276 million spent on

marketing and advertising marketing and advertising

by the tobacco industryby the tobacco industry

Challenges Ahead:Challenges Ahead: Advocating for a Advocating for a Smoke-Free WisconsinSmoke-Free Wisconsin

Many of Wisconsin’s border states are smoke free

Wisconsin’s Culture of DrinkingWisconsin’s Culture of Drinking

Underage DrinkingUnderage Drinking49% of high school students have tried alcohol 49% of high school students have tried alcohol 39% of 21 and under drink 39% of 21 and under drink

69% of the WI adult population drink69% of the WI adult population drink23% of adults admit to binge drinking23% of adults admit to binge drinking26% of WI adults admit to driving under 26% of WI adults admit to driving under the influence in the past year the influence in the past year (HHS)(HHS)

More than 42,000 convicted of drunk More than 42,000 convicted of drunk driving in 2007 driving in 2007 (WI DOT)(WI DOT)

The Costs of Alcohol in WisconsinThe Costs of Alcohol in Wisconsin

$5 billion each year in alcohol-related costs$5 billion each year in alcohol-related costs

$523 million in alcohol related $523 million in alcohol related hospitalizations in 2006hospitalizations in 2006337 killed, 5,500 injured in alcohol related 337 killed, 5,500 injured in alcohol related traffic accidents in 2007 traffic accidents in 2007 (Wi DOT)(Wi DOT)

Approx. 47% of all fatal crashes due to alcohol Approx. 47% of all fatal crashes due to alcohol (WI DOT)(WI DOT)

Exceeds deaths caused by speedingExceeds deaths caused by speeding

Responding to Alcohol AbuseResponding to Alcohol AbuseAlliance for Wisconsin Youth: oversees Alliance for Wisconsin Youth: oversees five regional prevention centers five regional prevention centers

More than 100 local coalitions are members of More than 100 local coalitions are members of Alliance for Wisconsin YouthAlliance for Wisconsin Youth

$2.3 million in grants for community $2.3 million in grants for community evidence-based substance abuse servicesevidence-based substance abuse services

BadgerCare +: preventative services for BadgerCare +: preventative services for pregnant mothers at risk of abusing pregnant mothers at risk of abusing alcohol or drugsalcohol or drugs

Wisconsin’s Obesity CrisisWisconsin’s Obesity Crisis

62.8% adults overweight or obese62.8% adults overweight or obese

25% of high school students at risk 25% of high school students at risk

29.2% of 2-4 year olds participating in WIC 29.2% of 2-4 year olds participating in WIC program at riskprogram at risk

Cost to Wisconsin = $1.5 billion annuallyCost to Wisconsin = $1.5 billion annually$626 million from Medicaid and Medicare for $626 million from Medicaid and Medicare for obesity-related medical costsobesity-related medical costs

Reducing Obesity in WisconsinReducing Obesity in Wisconsin

DHS & WI Partnership for Activity and Nutrition DHS & WI Partnership for Activity and Nutrition (WI PAN) working to create environments and (WI PAN) working to create environments and enable healthier food choices and physical enable healthier food choices and physical activity activity

Public Transportation Public Transportation – Increase exerciseIncrease exercise– Reduce obesity, diabetes, heart disease and injuriesReduce obesity, diabetes, heart disease and injuries AND ALSOAND ALSO– Increase community socializingIncrease community socializing– Reduce petroleum dependenceReduce petroleum dependence

Infant Mortality in WisconsinInfant Mortality in Wisconsin

In spite of declines in teen pregnancy and In spite of declines in teen pregnancy and rates of smoking while pregnant, infant rates of smoking while pregnant, infant mortality has barely budged in the last mortality has barely budged in the last decade:decade:

1997 6.5 deaths per 1,000 1997 6.5 deaths per 1,000 2007 6.4 deaths per 1,000 2007 6.4 deaths per 1,000

Infant mortality rates have decreased for Infant mortality rates have decreased for Whites, Latinos and Native Americans but Whites, Latinos and Native Americans but increasedincreased for African Americans for African Americans

African American Infant Mortality African American Infant Mortality Rates IncreasingRates Increasing

1997 African American infant mortality rate: 1997 African American infant mortality rate:

13.4 deaths per 1,00013.4 deaths per 1,000

2007 African American infant mortality rate: 2007 African American infant mortality rate:

14.5 deaths per 1,00014.5 deaths per 1,000

Meanwhile:Meanwhile:– American Indian infant mortality has dropped from American Indian infant mortality has dropped from

15.4 to 9.5 between 1985-2007.15.4 to 9.5 between 1985-2007.– The Hispanic/Latino infant mortality rate declined from The Hispanic/Latino infant mortality rate declined from

10.3 in 1997 to 6.4 for 200710.3 in 1997 to 6.4 for 2007

Reducing Infant MortalityReducing Infant MortalityP4P initiative in Medicaid managed care P4P initiative in Medicaid managed care – identifies highest risk womenidentifies highest risk women– employs evidence-based practicesemploys evidence-based practices– includes accountability and outcome measuresincludes accountability and outcome measures

Critical community-based initiatives for Critical community-based initiatives for improving birth outcomes improving birth outcomes Hands on approaches such as: Hands on approaches such as: – home visits, smoking cessation and creating safe home visits, smoking cessation and creating safe

sleep environmentssleep environments

Improving educational attainment, job Improving educational attainment, job opportunities, life course approachopportunities, life course approach

Looking Forward: HW 2020Looking Forward: HW 2020

Build on the Strengths of HW2010Build on the Strengths of HW2010

Expand partnerships Expand partnerships

Learn from Evaluations and DataLearn from Evaluations and DataUW research on “Making Wisconsin the Healthiest State”UW research on “Making Wisconsin the Healthiest State”

Create a collaboration of Public Health PartnersCreate a collaboration of Public Health PartnersNot just a government public health planNot just a government public health plan

Align the work of the Partners with the priorities Align the work of the Partners with the priorities and strategies of the State Health Planand strategies of the State Health Plan

Broad Goals of HW 2020Broad Goals of HW 2020

Improved health across lifespanImproved health across lifespan

Improved health equityImproved health equity

Everyone living better longerEveryone living better longer

Health Outcome Focus AreasHealth Outcome Focus Areas

Adequate, appropriate, and safe food and nutritionAdequate, appropriate, and safe food and nutritionChronic disease prevention and managementChronic disease prevention and managementCommunicable disease prevention and controlCommunicable disease prevention and controlEnvironmental and occupational healthEnvironmental and occupational healthHealthy growth and developmentHealthy growth and developmentMental healthMental healthOral healthOral healthPhysical activityPhysical activityReproductive and sexual healthReproductive and sexual healthTobacco use and exposureTobacco use and exposureUnhealthy alcohol and drug useUnhealthy alcohol and drug useViolence and injury prevention Violence and injury prevention

Reduced disease, injury,and

impairment

Healthy, safe and resilient

communities, families and individuals

Effective policies and

systems aligned for better

health

Infrastructure Focus AreasInfrastructure Focus Areas• Access to quality health services • Collaborative partnerships for

community health improvement• Diverse, sufficient, competent

workforce that promotes and protects health

• Equitable, adequate, stablepublic health funding

• Public health capacity and quality• Public health research and

evaluation• Systems to manage and share

health information and knowledge

Health Focus AreasHealth Focus Areas• Adequate, appropriate, and safe food and nutrition • Chronic disease prevention and

management• Communicable disease prevention

and control• Environmental and occupational

health• Healthy growth and development • Mental health• Oral health• Physical activity• Reproductive and sexual health• Tobacco use and exposure• Unhealthy alcohol and drug use• Violence and injury prevention

Intermediate TargetsIntermediate TargetsMetrics to be determined

Intermediate/short-term• Disease, injury, disability rates• Others, e.g., birthweight

Healthiest Wisconsin 2020

Improve health across

lifespan

Achievehealthequity

DRAFT revised 1/23/09Strategic Leadership TeamWI Division of Public Health

Overarching Focus AreaOverarching Focus AreaSocial, economic, and educational factors

including health literacy

ProductivityProsperity ParticipationWell-being

Long Term GoalsLong Term GoalsMetrics to be determined

• Length of life, e.g., average of life expectancy, infant mortality (by race/ethnicity)

• Quality of life• Health equity

Healthiest States Project and Healthiest States Project and Healthiest Wisconsin 2020Healthiest Wisconsin 2020

Both emphasize Both emphasize – social relationshipssocial relationships– physical environmentphysical environment– behaviors behaviors – in addition to health servicesin addition to health services

Both envision an all-sectors approachBoth envision an all-sectors approach

Both emphasize evidence-based approaches Both emphasize evidence-based approaches

Both focus on outcomesBoth focus on outcomes