4Key Priorities Promoting healthy lifestyles and behaviors Putting PREVENTION FirstPromoting healthy lifestyles and behaviorsEmergency Preparedness and ResponsePandemic Flu preparednessAll-Hazards preparednessEliminating Disparities in healthRacialEthnicEconomicThe KEY PRIORITIES of the Surgeon General arePrevention….Preparedness… (whether Natural or Man-Made Disasters,Or being prepared for a Pandemic…..and Eliminating Health Disparities.When you mention health disparities, most people think in terms of racialOr ethnic differences. But one of the greatest predictors of poor health is POVERTY.
5LEADING CAUSES OF DEATH HEART DISEASECANCERHIV/AIDSINFLUENZAUNINTENTIONAL INJURY
6HEART DISEASE BEHAVIOR Tobacco UseDietObesityPhysical ActivityAlcoholdiets high in saturated fats and cholesterol, which raise blood cholesterol levelsand promote atherosclerosis. High salt or sodium in the diet causesraised blood pressure levels. Obesity is excess body fat.It is linked to higher LDL (bad) cholesterolExcessive alcohol use leads to an increase in blood pressure, and increasesthe risk for heart disease
7Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% %–14%
8Obesity Trends* Among U.S. Adults BRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)No Data <10% %–14% %–19% %–24% %–29% ≥30%
9The FactsOver the past THREE decades, obesity has more than TRIPLED among children and adolescents, rising from 5% to 17%.
10The Facts Currently, 1 in 3 American children is overweight or obese. The National Survey of Children's Health, Overweight and Physical Activity Among Children: A Portrait of States and the Nation 2005; HRSA,Health,United States, U.S. Department of Health and Human Services,Centers for Disease Control and Prevention, National Center forHealth Statistics, 2007.
11The FactsOver the past THREE decades, obesity has more than TRIPLED among children and adolescents, rising from 5% to 17%.
12The Costs There are major health effects Obesity is estimated to cause:112,000 DEATHS/year in the US1 in 3 children born in 2000 are destined todevelop diabetes in their lifetime
13This is more than health… The CostsThis is more than health…It affects our human capital, our economic growth, our communities, our neighborhoods, our national security.
14The economic consequences are staggering The CostsThe economic consequences are staggeringObese adults incur an estimated $1,429 more in health care costs than their normal weight peers
15The Costs The economic consequences are staggering Adult obesity related health care costs:$147 BillionChildhood obesity related health care costs:$3 Billion
16Social Determinants of Health (SHD) The World Health Organization has 2 Definitions.SDH are complex, integrated, and overlapping social structures and economic systems that include social environment, physical environment, and health services. SDH are influenced by policies and are shaped by money, power, and resources.SDH are circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. SDH are shaped by economic, social, and political forces.
17Key Terms Health Disparity Health Equity Health Inequity Specific types of health differences that is closely linked with social and economic disadvantagesHealth EquityDHHS definition: valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparitiesHealth InequityNegative health outcomes that are a result of social and economical injusticesOther key terms
18Social Determinants of Health 3 Categories of Social Determinants of HealthSocial environment (i.e. discrimination, income, education)Physical environment (i.e. buildings, spaces, and transportation)Health Services (i.e. access and quality care)These 3 categories are beyond the individual’s control but affects the individual’s environment.
19SOCIAL DETERMINANTS OF MENTAL HEALTH, WORKING DEFINITION Income inequalityFood securityHousing qualitySocial StatusViolenceEducationEmployment ConditionsSocial ExclusionPolitical disadvantageCultural NormsDiscriminationLiteracySocial determinants of mental health means those elements of social structure most closely SHOWN TO AFFECT HEALTH AND ILLNESS, including at a minimum,
20HEALTHY AND SAFE COMMUNITY ENVIRONMENTS Health and Wellness are influenced by the places in which people live, learn, pray, and play.Communities, including homes, schools, public spaces, and work sites can be transformedto support well-being. Healthy and safe community environments include those withclean air, water, affordable and secure housing, sustainable and economically vitalneighborhoods (transportation, good schools), and supportive structures(violence free places to be active, access to healthy foods.
21Let’s Move!"The physical and emotional health of an entire generation and the economic health and security of our nation is at stake."- First Lady Michelle Obama at the Let’s Move! launch on February 9, 2010Let’s Move! is a comprehensive initiative, launched by the First Lady, dedicated to solving the problem of obesity within a generation so that kids born today will grow up healthier and able to pursue their dreams.
23The ProcessThe Domestic Policy Council produced an extensive report outlining the science and proposing the direction for solving the problem of childhood obesityAs part of this effort, President Barack Obama established the first-ever Task Force on Childhood Obesity to develop and implement an inter-agency plan that details a coordinated strategy, identifies key benchmarks, and outlines an action plan to end the problem of childhood obesity within a generation. The goal of the action plan is to reduce the childhood obesity rate to just five percent by 2030 – the same rate before childhood obesity first began to rise in the late 1970s. In total, the report presents a series of 70 specific recommendations, many of which can be implemented right away.
24Five Pillars of Let’s Move! Creating a healthy start for childrenEmpowering parents and caregiversProviding healthy foods in schoolsImproving access to healthy, affordable foodsIncreasing physical activity
25Creating a Healthy Start for Children Get Kids MovingReduce Screen TimeMake Nutrition FunOffer Healthier BeveragesSupport Infant FeedingLet’s Move! in the Clinic
26Empowering Parents and Caregivers Balancing Calories ● Enjoy your food, but eat less. ● Avoid oversized portions. Foods to Increase ● Make half your plate fruits and vegetables. ● Make at least half your grains whole grains. ● Switch to fat-free or low-fat (1%) milk. Foods to Reduce ● Compare sodium in foods like soup, bread, and frozen meals ― and choose the foods with lower numbers. ● Drink water instead of sugary drinks.
27Providing Healthy Foods in Schools Healthy, Hunger Free Kids ActHealthierUS School ChallengeChefs Move to SchoolsThe Healthy, Hunger-Free Kids Act of 2010 authorizes funding for federal school meal and child nutrition programs and increases access to healthy food for low-income children. Improves Nutrition and Focuses on Reducing Childhood ObesityGives USDA the authority to set nutritional standards for all foods regularly sold in schools during the school day, including vending machines, the “a la carte” lunch lines, and school stores. Helps communities establish local farm to school networks, create school gardens, and ensures that more local foods are used in the school setting.The HealthierUS School Challenge (HUSSC) is a voluntary initiative established in 2004 to recognize those schools participating in the National School Lunch Program that have created healthier school environments through promotion of nutrition and physical activity. In February 2010, First Lady Michelle Obama introduced Let’s Move!, incorporating the HealthierUS School Challenge into her campaign to raise a healthier generation of kids. At that time, monetary incentive awards became available for each HUSSC award level: Bronze, Silver, Gold, and Gold Award of Distinction.Chefs across the country are answering Mrs. Obama's call to get involved with their local schools as part of the Chefs Move to Schools initiative, run through the U.S. Department of Agriculture. The First Lady is calling on chefs to get involved by adopting a school and working with teachers, parents, school nutritionists and administrators to help educate children and show that nutrition can be fun.
28Let’s Move Salad Bars Provide salad bars to schools across the country Any K-12 school or district participating in Natl. School Lunch ProgramVisit ww.saladbars2schools.org to learn more and complete an application.Superintendant, Principal, and Nutrition Service Director approval.Any K-12 school or school district participating in the National School Lunch Program is eligible to apply for a salad bar. Schools who have received Healthier US School Challenge Awards from USDA have top priority.
29HealthierUS School Challenge And, the newly revamped and relaunched Presidential Council on Fitness Sports and Nutrition that has gotten commitment from organizations to recruit one million children and their families to participate in PALA!HealthierUS School Challenge
31Let’s Move Museums and Gardens With their impressive reach and great potential for impact, museums and gardens can launch community efforts to fight childhood obesity using interactive exhibits, outdoor spaces, gardens and programs that encourage families to eat healthy foods and increase physical activity.
35Let’s Move! Faith and Communities How we’re doing it…The First Lady is calling on mayors and elected officials across the country to join her Let’s Move! campaign. Let’s Move Cities, Towns, and Counties engages mayors and other municipal leaders in the campaign to solve the problem of childhood obesity within a generation.Once an elected official signs up as a prospective Let’s Move City or a Let’s Move Town or a Let's Move County, he or she will have the option of choosing at least one significant action to take over the following twelve months in each of the four pillar areas.Giving Parents and Caregivers the Tools They Need to Make Healthy Choices in Early ChildhoodImproving Nutrition in SchoolsIncreasing Physical Activity OpportunitiesMaking Healthy Food Affordable & Accessiblethe Let’s Move Toolkit for Faith-based and Neighborhood Organizations. It provides creative ideas and helpful tips for congregations and communities that want to promote healthy eating and fitness, and respond to hunger. Community gardensLet’s Move! Faith and Communities
39The Affordable Care Act In Addition to Coverage, Quality, and Cost… Unique Opportunities for PreventionIn March 2010, Congress passed and the President signed into law the Affordable Care Act. While the Affordable Care Act strives to increase access to affordable health coverage, it is important to note that the Affordable Care Act is more than just about insurance coverage.It is a unique opportunity to bring prevention to the forefront of our efforts to improve the health of Americans.
40Priorities Tobacco Free Living Preventing Drug Abuse and Excessive Alcohol UseHealthy EatingActive LivingMental and Emotional Well-beingReproductive and Sexual HealthInjury and Violence Free LivingThe Priorities of the National Prevention Strategy are designed to improve health and wellness for the entire U.S. population.Each Priority area in the Strategy provides evidence-based recommendations that are most likely to reduce the burden of the leading causes of preventable death and major illness.The following slides will outline the sections and components that are included in the Strategy for each Strategic Direction and Priority chapter.Source: National Vital Statistics Report, CDC, 2008
41Recommendations (Example) Active LivingEncourage community design and development that supports physical activity.Promote and strengthen school and early learning policies and programs that increase physical activity.Facilitate access to safe, accessible, and affordable places for physical activity.Support workplace policies and programs that increase physical activity.Assess physical activity levels and provide education, counseling, and referrals.The National Prevention Strategy identifies recommended policy, program, and systems approaches for each Strategic Direction and Priority. This slide includes the recommendations for the priority, Active Living.All recommendations are based on recent scientific evidence. References of the scientific base is provided as an Appendix in the Strategy.Along with the recommendations, projects are highlighted to show how communities have advanced prevention and provide examples for others to consider ways in which they too can take action.An example of a Project Highlight included in the Strategy is “Safe Routes to School (SRTS)”Community leaders, schools, and parents across the U.S. are encouraging more children, including children with disabilities, to walk and bicycle to schoolSRTS programs improve safety and accessibility as well as reduce traffic and air pollution in the vicinity of schoolsAs a result, these programs help make bicycling and walking to school a safer and more appealing transportation choice, thus encouraging a healthy and active lifestyle from an early age
42Actions (Example) Federal Government will…. Promote the development of transportation options and systems that encourage active transportation and accommodate diverse needs.Support adoption of active living principles in community design, such as mixed land use, compact design, and inclusion of safe and accessible parks and green space.Support coordinated, comprehensive, and multicomponent programs and policies to encourage physical activity and physical education, especially in schools and early learning centers.The Strategy identifies actions that the Federal government will take to promote health and wellness.This section identifies actions that the National Prevention Council departments and agencies will take to guide the implementation of the Strategy.The statements represent both new and existing initiatives.Note: The examples in the slide are from the Active Living chapter.
43HUD-DOT-EPA - HHS Sustainable Communities Partnership Mobility Matters WorkshopNovember 5, 2010We are honored to be here today to talk with you about the joint effort between EPA,HUD, and DOT to support livable and sustainable communities.Sustainable communities revitalize neighborhoods, efficiently use resources to grow in a“smart” way, and offer a variety of housing and transportation choices.
44Partnership MissionTo coordinate our policies, programs, and resources to help urban, suburban, and rural areas and regions to build sustainable communities, and to make sustainable communities the leading style of development in the United States.The U.S. population is projected to grow from 307 million this year to about439 million in 2050 – about a 40% increase. To support this population,an estimated 89 million homes and 190 billion square feet of new offices,institutions, stores, and other buildings will be need to be built.This growth presents an opportunity for us to do things in a different way than we havein the past. The partnership between EPA, HUD, and DOT is about creating sustainablecommunities and the need to change our pattern of development if we want to be ableto meet current and future environmental and economic needs.
45Livable Communities Can Provide Transportation Options Livable communities provide a variety of transportation options for their residents.Developing safe, reliable and economical transportation choices makes it easier for folksto get to the places where they live, work and play.It also decreases household transportation costs, improves air quality,reduces greenhouse gas emissions, and promotes public health.
46Livable Communities Can Provide Housing Options Livable communities also have a variety of housing options for their residents. Promotingmixed-use housing choices including affordable housing, increases people’s connectednessto their communities and supports inclusive communities that provide opportunities forpeople to interact together.Expanding location and energy efficient housing choices for people of all ages, incomes,races and ethnicities increases mobility and lowers the combined cost of housing andtransportation.
47Livable Communities Can Provide Options That Best Fit Their Citizens’ Needs Overall, livable communities have a diversity of housing, transportation, recreation, businessoptions that best fit the needs of their residents. By developing healthy, safe andwalkable neighborhoods through such strategies as transit oriented, mixed-use developmentand land recycling, communities can increase their livability and connectedness.The HUD-DOT EPA Partnership is focused on targeting federal funding to supportcommunity efforts to develop sustainable strategies that enhance the unique characteristicsof their communities and meet the needs of their residents.
48Environmental and Social Benefits of Sustainable Communities Reduced Emissions and Improved Air QualityReduced Water Demand and Water ImpactsReclaimed Abandoned and Hazardous LandsMore Walkable, Healthier NeighborhoodsEnhanced Quality of Life and Strengthened Social FabricWhere you live affects how you get around, and how you get around often affects whereyou live. Both decisions affect our environment and the quality of our communities.If we are smarter about how we grow, we can make America’s big cities,small towns and rural communities become healthier, safer, and more vibrant.
49Partnership Project – Iowa City Iowa City’s Riverfront Crossings District is led by EPA with assistance from FTA, FHWA, HUD, and Iowa Department of Natural Resources.Iowa City has requested assistance in transforming a 10-square block area south of their downtown that presently consists of brownfield properties into an urban park and high density mixed use neighborhoodThis project is building on a previous EPA-led project that provided assistance for redeveloping areas impacted by flooding in 2008.This project is part of the Brownfields Partnership pilot program led by EPA.It builds upon a previous EPA-led project that provided development assistancefor areas of Iowa City impacted by the 2008 floods.The project is focused on developing a conceptual plan for transforming a 10-blockarea in Iowa City called the Riverfront Crossings District.FTA, FHWA, HUD, and IDNR are joining in the effort to help the city develop the planand identify housing, transportation and redevelopment opportunities in the District.
50Partnership Project – Iowa City EPA is in the process of accessing urban design experts to develop a conceptual plan for the area.The revitalized District will become a Smart Growth urban neighborhood that will emphasize walkablility and the use of public transit.It will provide a mix of uses including affordable housing, ground floor retail and office space, pedestrian-oriented streetscapes, entertainment and recreational facilities, and public open space including trails and other amenities along the Iowa River.Currently, EPA is in the process of working with a contractor to develop the conceptualdesign plan for the area that emphasizes mixed uses, walkability, and revitalization.The plan will provide a mix of uses including affordable housing, ground floor retailand office space, pedestrian-oriented streetscapes, entertainment and recreational facilities,and public open space including trails and other amenities along the Iowa River.After the plan is developed, the Partners will work with the city to identify potentialfederal resources available to help support implementation of the plan.
51There’s more to be done… For the FIRST time ever, the current generation is on track to have a shorter lifespan than their parents.Progress has been made, but more needs to be done.YOUR generation will drive those changes and make the decision to live healthier lifestyles.
52Let’s Move.Adopt the national standards and encourage others to do the same