Coordinated Chronic Disease Prevention and Health Promotion Program:

1. Coordinated Chronic Disease Prevention and Health Promotion Program: Wayne H. Giles, MD, MS Director Division of Population Health August 8, 2012 National Center for Chronic Disease Prevention and Health Promotion Division of Population Health

2. Growing Challenges

3. Heart Disease Cancer Chroniclowerrespiratorydiseases Stroke UnintentionalInjuries Alzheimer’s disease Diabetes Pneumonia/influenza KidneyDisease Percentage (of all deaths) Chronic Diseases and Related Risk Factors Actual Causes of Death† United States, 2000 Leading Causes of Death† United States, 2008 Tobacco Poor diet/ Physical inactivity Alcohol consumption Microbial agents Toxic agents Motor vehicles Firearms Sexual behavior Illicit drug use 0 5 10 15 20 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.

4. 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

5. 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……

6. 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…”

7. 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

8. Working in Four Key Domains

9. The Coordinated Chronic Disease Program?

10. 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

11. Reduced administrative costs Increased program investments Flexibility Shared services Coordinated TA from CDC What will we see?

12. 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)

13. 2011-13 Timeline for CCDP

14. 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 partners engage all major categorical programs at the state health department, including key categorical partners include analysis and identification of priority “big steps” that can affect multiple conditions – of interest to multiple partners

15. What States Are Doing II. Assessment & management plan for leadership in CD prevention (assessment Oct. 26, 2012) – plan should address: Leadership Organizational design Communication Capacity to achieve changes in 4 key domains Capacity to provide TA to communities

16. 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

18. 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

19. 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

20. Thank you