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Ten Outstanding Achievements in Arkansas Public Health: First Decade of the 21 st Century Joseph Bates, MD, MS Arkansas Department of Health.

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Presentation on theme: "Ten Outstanding Achievements in Arkansas Public Health: First Decade of the 21 st Century Joseph Bates, MD, MS Arkansas Department of Health."— Presentation transcript:

1 Ten Outstanding Achievements in Arkansas Public Health: First Decade of the 21 st Century Joseph Bates, MD, MS Arkansas Department of Health

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3 Past and Projected Female and Male Life Expectancy at Birth, United States, 1900-2050 Life Expectancy at Birth Years of Life Year Female Male

4 Life Expectancy For Countries Country Life Expectancy (Yrs) Rank Andorra 83.5 1 Japan 82.0 4 Sweden 80.6 8 Australia 80.6 9 France 80.5 11 Canada 80.3 14 Spain 79.8 20 United Kingdom 78.7 37 U.S. 78.0 45 Country Life Expectancy (Yrs) Rank Andorra 83.5 1 Japan 82.0 4 Sweden 80.6 8 Australia 80.6 9 France 80.5 11 Canada 80.3 14 Spain 79.8 20 United Kingdom 78.7 37 U.S. 78.0 45

5 Comparison of International Infant Mortality Rate: 2000 Deaths per 1,000 Live Births Singapore Hong Kong Japan Sweden Norway Finland Spain Chech Republic Germany Italy France Austria Belgium Switzerland Netherlands Northern Ireland Australia Denmark Canada Israel Portugal England & Wales Scotland Greece Ireland New Zealand United States Cuba 2.5 3.0 3.2 3.4 3.8 3.9 4.1 4.4 4.5 4.8 4.9 5.1 5.2 5.3 5.4 5.5 5.6 5.7 6.1 6.2 6.3 6.9 7.2

6 Leading Causes of Death U.S. Heart Disease 710,760 Malignant Neoplasm 553,091 Cerebrovascular Disease 167,661 Chronic Lower Respiratory Disease 122,009 Unintentional Injuries 97,900 Diabetes Mellitus 69,301 Influenza and Pneumonia 65,313 Alzheimer Disease 49,558 Nephritis, Nephrotic Synd., Nephrosis 37,251 Septicemia 31,224 Heart Disease 710,760 Malignant Neoplasm 553,091 Cerebrovascular Disease 167,661 Chronic Lower Respiratory Disease 122,009 Unintentional Injuries 97,900 Diabetes Mellitus 69,301 Influenza and Pneumonia 65,313 Alzheimer Disease 49,558 Nephritis, Nephrotic Synd., Nephrosis 37,251 Septicemia 31,224

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8 Top Ten Public Health Achievements 2000-2010 1 Coalition for a Healthier Arkansas Today (CHART) Plan: The Tobacco Master Settlement Agreement 2 Reduction of Adult and Youth Tobacco Use 3 Passage of the Clean Air Act 4 Hometown Health Improvement 5 School Influenza Immunization Program 6 Expansion of the Newborn Screening Program 7 Act 1220 to Combat Childhood Obesity 8 New Public Health Laboratory 9 Public Health Preparedness 10 Statewide Trauma System

9 Key Programs Funded by CHART Funding for support of biological research at UAMS, ASU, UAF and UAPB Funding for support of biological research at UAMS, ASU, UAF and UAPB Funding to create research buildings and the College of Public Health building Funding to create research buildings and the College of Public Health building Funding for COPH operations Funding for COPH operations Funding For Aging Centers Funding For Aging Centers Funding for Minority Health Commission Funding for Minority Health Commission Funding for AHEC at Helena Funding for AHEC at Helena Funding for tobacco prevention and cessation Funding for tobacco prevention and cessation

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12 Cigarette Packs Sold Per Adult (2001 – 2007)

13 Reduction of Adult and Youth Tobacco Use Youth smoking rate decreases to under 20 percent Youth smoking rate decreases to under 20 percent Adult smoking rate steadily declines Adult smoking rate steadily declines Per capita consumption of cigarettes steadily decreases Per capita consumption of cigarettes steadily decreases 105,000 fewer Arkansans smoke compared to 2002 105,000 fewer Arkansans smoke compared to 2002 21,500 fewer high school students smoke 21,500 fewer high school students smoke More than $1 billion in lifetime healthcare savings More than $1 billion in lifetime healthcare savings Reduction of Adult and Youth Tobacco Use

14 Passage of the Clean Indoor Air Act Smoking permitted in almost all public buildings Smoking permitted in almost all public buildings Advocates organize to ban smoking Advocates organize to ban smoking Some exemptions for smoking only by adults Some exemptions for smoking only by adults Clean Indoor Air Act takes effect July 21, 2006 Clean Indoor Air Act takes effect July 21, 2006 Arkansas one of 18 states to prohibit smoking Arkansas one of 18 states to prohibit smoking Passage of the Clean Indoor Air Act

15 No evidence to support that businesses suffer No evidence to support that businesses suffer Compliance very good Compliance very good ADH educates public ADH educates public More people quit smoking More people quit smoking Health benefits from reduced exposure to toxins in tobacco smoke Health benefits from reduced exposure to toxins in tobacco smoke Positive effect on healthcare costs and worker productivity Positive effect on healthcare costs and worker productivity Passage of the Clean Indoor Air Act

16 Hometown Health Improvement Health solutions must come directly from hometowns Health solutions must come directly from hometowns 73 Hometown Health Improvement (HHI) coalitions 73 Hometown Health Improvement (HHI) coalitions HHI first piloted in 1998 HHI first piloted in 1998 Hometown Health Improvement

17 Community focus, local control, data-based decision making, local/state partnerships Community focus, local control, data-based decision making, local/state partnerships County health units provide leadership and organized system County health units provide leadership and organized system Reduction in preventable illnesses and injuries, coordination of community health services and improved health and quality of life Reduction in preventable illnesses and injuries, coordination of community health services and improved health and quality of life Hometown Health Improvement

18 2009 Influenza Immunizations in Public Schools ADH, Department of Education, school districts statewide providing seasonal vaccination clinics ADH, Department of Education, school districts statewide providing seasonal vaccination clinics Planning adjusted to provide seasonal and H1N1 vaccine Planning adjusted to provide seasonal and H1N1 vaccine 345,088 doses of seasonal and H1N1 vaccine 345,088 doses of seasonal and H1N1 vaccine 2009 Influenza Immunizations in Public Schools

19 Expansion of the Newborn Screening Program Babies born each year with harmful/even fatal conditions Babies born each year with harmful/even fatal conditions Fed guidelines recommend screening for 29 core conditions Fed guidelines recommend screening for 29 core conditions ADH, UAMS, Arkansas Children’s Hospital, Arkansas March of Dimes, Arkansas Hospital Association ADH, UAMS, Arkansas Children’s Hospital, Arkansas March of Dimes, Arkansas Hospital Association Expand screening from 7 to 29 conditions Expand screening from 7 to 29 conditions Expansion of the Newborn Screening Program

20 Results match expectations based on national figures Results match expectations based on national figures ADH laboratory performs more than 300,000 screenings yearly ADH laboratory performs more than 300,000 screenings yearly Additional years of screening needed to fully evaluate impact Additional years of screening needed to fully evaluate impact For families, program is a life saver For families, program is a life saver Expansion of the Newborn Screening Program

21 Cystic FibrosisFound 10 cases Congenital Adrenal HyperplasiaFound 3 cases Biotinidase DeficiencyFound 1 case Amino Acid DisordersFound 4 cases Fatty Acid Oxidation DefectsFound 4 cases Organic AcidemiasFound no case

22 Act 1220 of 2003 to Combat Childhood Obesity Act 1220 of 2003 Act 1220 of 2003 Limits vending and ala carte items Limits vending and ala carte items Child Health Advisory Committee Child Health Advisory Committee Standards and policy recommendations for healthier foods and physical activity Standards and policy recommendations for healthier foods and physical activity Act 1220 of 2003 to Combat Childhood Obesity

23 Schools measure Body Mass Index Schools measure Body Mass Index School reforms most ambitious in nation School reforms most ambitious in nation 38 percent of Arkansas children overweight or at risk 38 percent of Arkansas children overweight or at risk Efforts holding line on progression of epidemic* Efforts holding line on progression of epidemic* *ACHI, Assessment of Childhood and Adolescent Obesity in Arkansas: Online State Report (Year 5) Act 1220 of 2003 to Combat Childhood Obesity

24 Arkansas Public Health Laboratory

25 Construction starts 2004 and building dedicated 2006 Construction starts 2004 and building dedicated 2006 Costs $24.6 million and provides approximately 80,000 square feet Costs $24.6 million and provides approximately 80,000 square feet 5,000-square-foot embedded level 3 bio-safety lab 5,000-square-foot embedded level 3 bio-safety lab Lab performs more than 800,000 tests yearly Lab performs more than 800,000 tests yearly Arkansas Public Health Laboratory

26 Infectious diseases, food borne illnesses, and potential for chemical and biological terrorism Infectious diseases, food borne illnesses, and potential for chemical and biological terrorism Arkansas needs state-of-the art, fully certified laboratory Arkansas needs state-of-the art, fully certified laboratory Legislation to create laboratory funded with bond issue financed by fees Legislation to create laboratory funded with bond issue financed by fees Arkansas Public Health Laboratory

27 Public Health Preparedness ADH lead to coordinate health and medical response ADH lead to coordinate health and medical response Public Health Preparedness and Emergency Response Branch Public Health Preparedness and Emergency Response Branch Strategic National Stockpile Strategic National Stockpile Cache of medical supplies and pharmaceuticals Cache of medical supplies and pharmaceuticals Plans for mass dispensing of medications Plans for mass dispensing of medications Plan tested in mass flu clinics Plan tested in mass flu clinics Public Health Preparedness

28 Health Alert Network (HAN) Health Alert Network (HAN) Emergency Operations Center (EOC) Emergency Operations Center (EOC) ADH integrated with state and federal partners. ADH integrated with state and federal partners. Responds to numerous emergencies and disasters Responds to numerous emergencies and disasters Public Health Preparedness

29 THE PROBLEM ● Injury is the leading cause of death of Arkansans ages 1 – 44 ages 1 – 44 ● Injury fatality rate is 30% higher than national average (70% higher for motor vehicle accidents) average (70% higher for motor vehicle accidents) ● In 2008, Arkansas had the worst system of emergency care in the nation (study by American emergency care in the nation (study by American College of Emergency Physicians) College of Emergency Physicians) ● Arkansas was one of three states without a trauma system and the only state without a designated system and the only state without a designated trauma center trauma center

30 Statewide Trauma System: A System Saving Lives 1993- Trauma Advisory Council 1993- Trauma Advisory Council 2008- statewide computer- based network 2008- statewide computer- based network 2009- tobacco tax initiative 2009- tobacco tax initiative Four levels of resources and care standards Four levels of resources and care standards March 2011 – 7 out of 73 designated trauma centers March 2011 – 7 out of 73 designated trauma centers Statewide Trauma System: A System Saving Lives

31 Three-Pronged Legislative Solution - 2009 1. Trauma System Act (Act 393) – funded by state’s tobacco tax 1. Trauma System Act (Act 393) – funded by state’s tobacco tax Victims of traumatic injuries will be transported to definitive care in the shortest possible time. Victims of traumatic injuries will be transported to definitive care in the shortest possible time. Projected annual savings: Projected annual savings: 168 lives and $193 million 168 lives and $193 million

32 Three-Pronged Legislative Solution - 2009 2. Primary seat belt law (Act 394) 2. Primary seat belt law (Act 394) Law enforcement can stop drivers for not wearing a seat belt when this is the only violation observed Projected annual savings: Projected annual savings: 32 lives and $37 million 32 lives and $37 million

33 Percent Seat Belt Use

34 Three-Pronged Legislative Solution - 2009 3. Graduated drivers license law (Act 308) Provides for longer supervised driving periods for young drivers, restrictions on cell phone use and texting, and restricted late night driving Projected annual savings: Projected annual savings: 6 lives and $7 million 6 lives and $7 million

35 Arkansas Trauma Call Center (ATCC) Contract signed with Metropolitan Emergency Medical Services (MEMS) in Little Rock to serve as the ATCC Contract signed with Metropolitan Emergency Medical Services (MEMS) in Little Rock to serve as the ATCC ATCC went “live” on January 3, 2011 (hospital-to- hospital transfers only) - full implementation expected by May 31, 2011 when ambulances receive trauma radios ATCC went “live” on January 3, 2011 (hospital-to- hospital transfers only) - full implementation expected by May 31, 2011 when ambulances receive trauma radios

36 Trauma Registry Is operational statewide and is in early stages of recording and tracking individual cases of traumatic injury from inception through all phases of treatment Is operational statewide and is in early stages of recording and tracking individual cases of traumatic injury from inception through all phases of treatment 23 hospitals currently participating with over 1,200 records entered 23 hospitals currently participating with over 1,200 records entered

37 Dashboard Computer database that provides up-to-the minute status information to the participating acute care hospitals in Arkansas. Computer database that provides up-to-the minute status information to the participating acute care hospitals in Arkansas. Information is necessary for rapid transfer Information is necessary for rapid transfer of patient to the most appropriate care facility. of patient to the most appropriate care facility.

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41 How Were These Goals Achieved Strategic Planning with input from many external partners. Strategic Planning with input from many external partners. Strong support from Governor Huckabee (CHART Clean Air Act) and Governor Beebe (Trauma System and School Influenza Immunization) Strong support from Governor Huckabee (CHART Clean Air Act) and Governor Beebe (Trauma System and School Influenza Immunization) Leadership from the Speaker of the House, Hershel Cleveland (Public Health Laboratory and Act 1220) Leadership from the Speaker of the House, Hershel Cleveland (Public Health Laboratory and Act 1220)

42 How Were These Goals Achieved Strong grass roots support as a result of work of Hometown Health organizations and local public health workers. Strong grass roots support as a result of work of Hometown Health organizations and local public health workers. Strong support from the Arkansas Center for Health Improvement and the State Surgeon General Strong support from the Arkansas Center for Health Improvement and the State Surgeon General

43 Organization of the Year Award “The College of Professional Studies at UALR has chosen the Arkansas Department of Health as our Organization of the Year. Each year we select an organization that embodies the professionalism and high standards we hope that all our programs produce. This is the first time we have chosen a state agency. We are proud of the impact that the Arkansas Department of Health is making on the health of Arkansans.” Angela Brenton Angela Brenton Dean, College of Professional Studies University of Arkansas at Little Rock


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