Brown County Health Department & City of De Pere Health Department

1. Brown County Health Department & City of De Pere Health Department Community Health Improvement Process Overview

2. Core Functions of Public Health 1988 Institute of Medicine Report • Assessment • Policy Development • Assurance

3. Public Health Essential Services • Monitor health status to identify community health problems. • Diagnose and investigate health problems and health hazards in the community. • Inform, educate, and empower people about health issues. • Mobilize community partnerships to identify and solve health problems. • Develop policies and plans that support individual and community health efforts.

4. Public Health Essential Services • Enforce laws and regulations that protect health and ensure safety. • Link people to needed health services and assure the provision of health care when otherwise unavailable. • Assure a competent public health and personal healthcare workforce. • Evaluate effectiveness, accessibility, and quality of personal and population-based health services. • Research for new insights and innovative solutions to health problems.

5. What is a Community Health Improvement Process (CHIP) Assess community assets, gaps and resources Create a community health plan to address health priorities Mobilize community resources to implement health plan

6. Required Services of Local Health Departments Wisconsin State Statute 251.05(3)(c) Involve key policymakers and the general public in determining and developing a community health improvement plan that includes actions to implement the services and functions specified under s. 250.03 (1) (L). Assessment to be completed every five years.

7. Healthcare System Partners Patient Protection & Affordable Care Act Every three year assessment requirement Improved health of the population

8. Why do a community health assessment . . . • Forms and strengthens partnerships • Shares community responsibility • Increases community awareness of the population’s health • Integrates isolated efforts • Works to prevent duplication of efforts • Develops community specific strategies

9. History of Assessment in Brown County • Initial assessment in 1995 • “Healthier Brown County 2000”

10. History: Community Health Assessment • Teen Pregnancy Prevention • Part of adolescent parenting coalition • Tobacco-free • Regional coalition housed in Outagamie County • Cardiovascular health • Efforts throughout county

11. Who participated. . . Representatives of the community Knowledge of the community: assets, resources, and health needs Interest and commitment to create a healthier community

12. The How. . . • Steering Committee Formed • Community Partners brought together to examine data • Identify gaps and resources • Identify priority focus areas • Develop a health plan to address priority concerns • Present the health plan to the community

15. Areas Reviewed • Health Focus Areas • All twelve areas reviewed • Overarching Focus Areas • Both areas reviewed • Infrastructure Focus Areas • Emergency Preparedness area reviewed

16. Priority Matrix

17. Questions

18. Oral Health

19. Healthiest Wisconsin 2020 Objectives 1. By 2020, assure access to ongoing oral health education and comprehensive preventions, screening, and early interventions, and treatment of dental disease in order to promote healthy behaviors and improve and maintain oral health.

20. Healthiest Wisconsin 2020 Objectives 2. By 2020, assure appropriate access to effective and adequate oral health delivery systems, utilizing a diverse and adequate workforce, for populations of differing races, ethnicities, sexual identities, and orientations, gender identities, and educational or economic status and those with disabilities.

21. Data Categories • Fluoridation of water supply • Dental sealants • Caries Experience and untreated decay • Adult tooth loss d/t decay or disease • Oral and pharyngeal cancer • Dental visits • Medicaid utilization rate • Dental workforce

22. Percent of Population on Community Water Systems Who Have Access to Optimally Fluoridated Water Brown County: 98% Wisconsin: 90%

23. Wisconsin Sealant Programs, 2009-2010 Wisconsin Seal-A-Smile: ~6300 children received sealants 51% 3rd graders with sealants Seal Brown County: 1013 children received sealants Participating schools/groups: Boys & Girls Club, Danz , students from De Pere Schools (at Howe Dental Room), East High School, Edison Middle School, Eisenhower, Fort Howard, Howe, Jefferson, Nicolet, Oneida Nation School

28. Percentage of Wisconsin Adults with Tooth Loss Due to Decay/Gum Disease, BRFSS 2004, 2006 & 2008 Brown County: 32.1% Wisconsin: 40% Source: Wisconsin Department of Health Services, Behavioral Risk Factor Surveillance System

31. Source: 2008 WCHR Full Report

32. Percentage of Medicaid Members Receiving a Dental Service, 2008/2009 Wisconsin: 25% Brown County: 20.1% # Medicaid Dentists: 102 # MA Members: 7,309 Members per Dentist: 72

33. Federally Designated Dental Health Professional Shortage Areas City of Green Bay

34. Wisconsin Dentists by County

36. Questions

37. Adequate, Appropriate & Safe Food & Nutrition

38. Adequate, Appropriate & Safe Food & NutritionHealthiest Wisconsin 2020 Objectives 1. By 2020, people in Wisconsin will eat more nutritious foods and drink more nutritious beverages through increased access to fruits and vegetables, decreased access to sugar-sweetened beverages and other less nutritious foods, and supported, sustained breastfeeding.

39. Adequate, Appropriate & Safe Food & NutritionHealthiest Wisconsin 2020 Objectives 2. By 2020, all people will have ready access to sufficient nutritious, high-quality, affordable foods and beverages.

40. Adequate, Appropriate & Safe Food & NutritionHealthiest Wisconsin 2020 Objectives 3. By 2020, Wisconsin will reduce disparities in obesity rates for populations of differing races, ethnicities, sexual identification and orientations, gender identities, and educational or economic status.

41. Data categories • Fruit/Vegetable consumption • Beverage consumption • Breastfeeding rates • Fast food/Grocery store/Farmers market access • Food insecurity levels • Food assistance utilization • Obesity rates

42. Percentage of Adults in Wisconsin Report of 0-5 Servings of Fruits and Vegetables Consumed per Day Source: Health Counts in Wisconsin. Wisconsin Behavioral Risk Factor Survey. DHS.

43. Percentage of Adults in Wisconsin Report of 0-5 Servings of Fruits and Vegetables Consumed per Day, 2001-2007 WI overall = 77.2% WI range = 64% – 86.3% Brown County = 78.3% Brown County rank = 42/72 Source: 2008 WCHR Full Report

44. Percentage of Adults in Wisconsin Report of 5 or more Servings of Fruits and Vegetables Consumed per Day 1996-2009 24% 23% 22% 22% Source: Health Counts in Wisconsin. Wisconsin Behavioral Risk Factor Survey. DHS.

45. Percent of Wisconsin Students in Grades 9-12 Who Consumed 5 or More Servings of Fruits and Vegetables Per Day in the Past 7 Days - 2009 Source: 2009 Wisconsin Youth Risk Behavior Survey. Wisconsin Department of Public Instruction.

46. Percent of Wisconsin Students in Grades 9-12 Who Consumed 3 or More Glasses per Day of Milk in the Past 7 Days-2009 Source: 2009 Wisconsin Youth Risk Behavior Survey. Wisconsin Department of Public Instruction.

47. Percent of Wisconsin Students in Grades 9-12 Who Drank a Glass, Can, or Bottle of Soda per Day in the Past 7 Days - 2009 Source: 2009Wisconsin Youth Risk Behavior Survey. Wisconsin Department of Public Instruction.

48. Source: ROSIE WIC database; Accessed 10/1/10

49. Source: ROSIE WIC database; Accessed 10/1/10

50. Farmers Markets per 100,000 population, 2008 - 2009 Wisconsin = 3.2 / 100,000 Brown County = 2.9 / 100,000 Source: Food Environment Atlas; Located @ http://maps.ers.usda.gov/FoodAtlas/foodenv5.aspx