RADM Kerry Paige Nesseler Chief Nurse Officer, USPHS Director, Office of Global Health Affairs

1. 2012 USPHS Scientific and Training Symposium“National Prevention Strategy: Nurses Contributing to the Advancement of the Nation’s Health” RADM Kerry Paige Nesseler Chief Nurse Officer, USPHS Director, Office of Global Health Affairs Department of Health and Human Services Health Resources and Services Administration 21 June 2012

2. Outline • Global & Domestic Burden of Disease • Non-Communicable Diseases (NCDs)/Chronic Diseases • Affordable Care Act and Nursing • National Prevention Strategy • Federal PHS Nursing Strategic Plan • Commissioned Corps Nurse Officers Demographics • Division of Commissioned Corps Personnel and Readiness (DCCPR)

3. UN/WHO High-level Meetings • United Nations High-level Meeting on Prevention and Control of Non-Communicable Diseases • Held on 19-20 September 2011 • Only the 2nd such meeting on a disease (2001: HIV) • 133 country delegations spoke in the plenary – including 34 heads of state • Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases • includes strong call for partnership working, including with the health sector • WHO Global Forum for Government Chief Nursing and Midwifery Officers (GCNMO) Meeting – held on 17-18 May 2012 • Forum on Non-Communicable Diseases • Over 100 Chief Nurse Officers from around the world in attendance

4. 1990 2020 Communicable diseases Chronic disease Injuries Global burden of disease Source: Harvard School of Public Health

5. 10 facts about NCDs • Chronic Disease is responsible for 60%of all deaths worldwide – 35 million people died from chronic disease in 2005 • 80%of chronic disease deaths occur in low- and middle-income countries • Almost halfof chronic disease deaths occur in people below age 70 • Around the world, chronic disease affects women and men equally • The major risk factors for chronic disease are an unhealthy diet, physical inactivityand tobacco use

6. 10 facts about NCDs (Cont’d) • Without action, 17 million people will die prematurely this year from a NCD • 1 billion adults are overweight – without action, this figure will surpass 1.5 billion by 2015 • 22 million children under five years old are overweight • Tobacco use causes at least 5 million deaths each year • If the major risk factors for chronic disease were eliminated, at least 80%of heart disease, stroke and type 2 diabetes would be prevented; and 40%of cancer would be prevented Source: WHO, Preventing Chronic Disease: A Vital Investment, October 2005.

7. Age-standardized mortality from chronic disease* * i.e. deaths per 100,000 population Source: WHO, http://who.int/whois/whostat/EN_WHS08_Table1_Mort.pdf

9. Prevalence of overweight and obesity in adults (%) Source: http://www.who.int/gho/publications/world_health_statistics/EN_WHS2011_Full.pdf

10. Prevalence of diabetes Source: http://www.who.int/diabetes/facts/world_figures/en/index.html

11. Risk of developing type 2 diabetes, relative to BMI Study of 84,941 U.S. nurses 16-year follow-up Obesity’s impact on health Slide 14

12. Physical inactivity (%) No data available for Uganda and Switzerland Source: http://www.who.int/gho/publications/world_health_statistics/EN_WHS2011_Full.pdf

13. The impact of physical activity Physical activity reduces the risk of: • Breast cancer by approximately 20–40% among those who do vigorous physical activity for 30–60 minutes on 5 days each week; • Colon cancer: the most active people are at 30% lower risk than the least fit; • Strokeby 25–30% among active individuals; • Coronary heart disease: physically inactive people can have as much as twice the risk; • Diabetesby 30–50%; • Plus benefits for musculoskeletalandmental health.

14. Benefits of five-a-day Five servings of fruit and vegetables each day reduces the risk of: • Cardiovascular disease by 28%* • Type 2 diabetes by 24%** • Some gastrointestinal cancers by 20%*** Sources: * H.-C. Hung 2005 (J Nat Cancer Ins) ** F.B. Hu 2001 (New Eng J Med) *** WHO 2003

15. The question is “What can we do?”

16. It turns out we know exactly what to do: Prevention works! It’s simple, affordable and effective

17. Why nurses? If the millions of nurses in a thousand different places articulate the same ideas and convictions..... and come together as one force they could act as a powerhouse for change. Dr Haefden Mahler, WHO Director General (1985)

18. Affordable Care Act (ACA) & Nursing “After a year of striving, after a year of debate, after a historic vote, health care reform is no longer an unmet promise. It is the law of the land.” -- President Obama 23 March 2010 18

19. National Prevention Strategy

20. Vision Working together to improve the health and quality of life for individuals, families, and communities by moving the nation from a focus on sickness and disease to one based on prevention and wellness.

21. Priorities Source: National Vital Statistics Report, CDC, 2008 Tobacco Free Living Preventing Drug Abuse and Excessive Alcohol Use Healthy Eating Active Living Mental and Emotional Well-being Reproductive and Sexual Health Injury and Violence Free Living

22. Draft Model: PHS Nursing Strategic Plan

23. Mission/Vision: PHS Nursing Strategic Plan • Draft Vision: • “Health outcomes are optimal and health disparities are eliminated for all people through the promotion of wellness and disease prevention efforts” • Draft Mission: • “To enhance and improve health and safety outcomes through leadership, education and research by providing exceptional culturally competent holistic nursing services to all people”

24. Values: PHS Nursing Strategic Plan • Draft Values: COMMITMENT EDUCATIONRESEARCHLEADERSHIPCOMPASSION EXCELLENCEINTEGRITY NURSING

25. Goals/Objectives: PHS Nursing Strategic Plan (Cont’d) • The goals and objectives illustrated in the strategy is a mirrored reflection of how the USPHS Federal Nursing community is committed to address health outcomes in the below identified priority areas selected in alignment with the National Prevention Strategy. • The task force identified these health priorities as part of a prioritization exercise.

26. Implementation strategy: PHS Nursing Strategic Plan • The next phase is to communicate and implement the plan and the strategy to all PHS nurses. • A smaller team has been formed to address this strategy under the leadership of CDR Amy Webb. • Steps of implementation strategy include: Conducting an assessment of PHS nursing support activities aligned to plan, sharing best practices, educational modules, web posting of the HHS campaigns such as my plate.gov. • Core to the success of the plan will be the utilization of the Federal Public Health Leadership Network, PHS N-PAC, PHS Nursing Strategic Planning task force and all of you as key stakeholders.

27. Public Health Service Nursing Strategic Plan: Acknowledgements

28. Commissioned Corps Nurse Officers Demographics

33. Division of Commissioned Corps Personnel and Readiness (DCCPR)

34. Division of Commissioned Corps Personnel and Readiness (DCCPR) • Federal Register Notice Process • On 21 May 2012, the Federal Register Notice process has officially established DCCPR within the Office of the Surgeon General • Consolidation of four former Offices: • Office of Force Readiness and Deployment (OFRD) • Office of Commissioned Corps Operations (OCCO) • Office of Commissioned Corps Force Management (OCCFM) • Office of Reserve Affairs (ORA)

35. Office of the Surgeon General: Accountability Structure Note: Absence of MAB and Compensation under DCCPR

36. Statutory • Responsibilities • (42 USCA §204a) • Statutory Administration • of the Corps • (42 USCA §216) • Immediate Office of the Director

37. DRAFT DCCPR Vision-Mission DCCPR Vision The principal Division that provides an essential, valued and accountable cadre of U.S. PHS Commissioned Corps Officers to serve HHS and its partners to protect, promote and advance the health and safety of the nation. DCCPR Mission Efficiently recruit, commission, develop, manage, deploy, support and retire a resilient cadre of Regular and Ready Reserve officers of the Commissioned Corps through personnel, policy development and operational activities to effectively support routine and emergent missions. The Division will enhance and strengthen the Corps as an asset to the Department, Agencies and partners.

38. Commissioned Corps Five Pillars • Five pillars to identify the need for new Corps applicants. These position pillars include: • Assignment to underserved and vulnerable populations. • Assignment is in a hardship location (or difficult-to-recruit position) where there is significant unmet need for qualified professionals. • Assignment requires individual to be available for rapid deployment – domestic or international – at the direction of the agency head (as distinguished from deployment for natural disaster or international response) or requires availability to perform duties 24/7, including when on leave. • Assignment requires regular engagement with other uniformed services. • Assignment does not meet criteria 1-4 but cannot be filled without the Commissioned Corps and will address an important public health need.

39. Thank you to all PHS Nurses for your dedicated service!

40. Contact Information Kerry Paige Nesseler, M.S., R.N. Assistant Surgeon General Chief Nurse Officer, USPHS Director, Office of Global Health Affairs Department of Health and Human Services Health Resources and Services Administration Phone: (301) 443-2741 Fax:  (301) 443-2870 Email: KNesseler@hrsa.gov