Early Disease Prevention Women, Children and Adolescents Healthy Kansans 2010 Reducing/Eliminating Health & Disease Disparities Systems Interventions to Impact the Social Determinants of Health Reviewing Progress Towards

Actual Causes of Death † Tobacco Poor diet/lack of exercise Alcohol Infectious agents Pollutants/toxins Firearms Sexual behavior Motor vehicles Illicit drug use Causes of Death United States 2000 Leading Causes of Death* Percentage (of all deaths) Heart Disease Cancer Chronic lower respiratory disease Unintentional Injuries Pneumonia/influenza Diabetes Alzheimer’s disease Kidney Disease Stroke Percentage (of all deaths) *Minino AM, Arias E, Kochanek KD, Murphy SL, Smith BL. Deaths: final data for National Vital Statistics Reports 2002; 50(15):1-20. † Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, JAMA. 2004;291 (10):

Source: KDHE, Bureau of Public Health Informatics, Kansas Vital Statistics Rates are age-adjusted to the 2000 U.S. Standard Population ICD10 code ranges for leading causes provided by the National Center for Health Statistics Leading-causes are ranked according to the age-adjusted mortality rate in 2008 Age-adjusted Mortality Rates for 10 Leading Causes of Death in Kansas

Leading Causes of Death by Age-Group in Kansas 2008 Source: Kansas Department of Health and Environment, Bureau of Public Health Informatics, Kansas Annual Summary of Vital Statistics 2008; 102; Figure 33

Healthy Kansans 2010 Cross Cutting Issue #1 Assure access to health care and preventive services for children and parents Integration of efforts to affect-whole child’s emotional and social well-being Promotion, development and adoption of healthy lifestyles Early disease prevention, risk identification and intervention for women, children and adolescents *Kansas Department of Health and Environment, Bureau of Health Promotion, Healthy Kansans 2010 Final Report 2006; Accessed online at

Percent of Pregnant Kansas Women Beginning Prenatal Care in the First Trimester Percent of Pregnant Women Source: Kansas Information for Communities- Bureau of Public Health Informatics- Kansas Department of Health and Environment Pregnant Women HP2010= Healthy People 2010 *Change in reporting – Question added to Kansas Birth Certificate % KS Pregnant Women 90% HP 2010 Target

Percent of Kansas Adults (65+ years) and Children (19-35 months) Not Receiving Recommended Immunizations Percent of Adults & Children Adult Source: KDHE, Kansas BRFSS Adults defined as those 65 years and older. Recommended immunizations for influenza and pneumococcal. Child Source: National Immunization Survey. Children defined as those months. Recommended 4:3:1:3:3 immunization series HP2010= Healthy People % KS 10% Adult Influenza HP 2010 Target Child 4:3:1:3:3 20% HP 2010 Target 18% KS 33% KS 10% Adult Pneumococcal HP 2010 Target

Percent of Uninsured Kansas Adults (18 years & older) and Children (under 18 years) Percent of Adults & Children Adult Source: KDHE, Kansas BRFSS Adults defined as those 18 years and older. Child Source: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplements HP2010= Healthy People % KS 0% Adult HP 2010 Target 11% KS 0% Children HP 2010 Target

Percentage of Kansas Adults (18 years & older), Adolescents (grades 9-12) & Children (<5 Years) Who are Obese Percentage of Adult, Adolescent & WIC Children Adult Source: KDHE, Kansas Behavior Risk Factor Surveillance System Obesity among adults defined as body mass index (BMI) > 30 Adolescent Source: 2005 & 2007 Kansas Coordinated School Health, Youth Risk Behavior Survey- Overweight (obesity) among adolescents defined as >= 95th percentile for BMI, by age and sex *Adult defined as Kansans aged 18 and older *Adolescent defined as those in grades 9-12 * HP2010= Healthy People 2010 WIC Source: Data from 2008 KS PedNSS Table 18C *WIC defined as children aged <5 years meeting WIC participation guidelines % KS 15% Adults HP 2010 Target Adolescents WIC Children HP 2010 Target 5% HP 2010 Target 11% KS 5% 12% KS

Source: Kansas Observational Study Adult Survey, National Highway Traffic and Safety Administration (NHTSA) Kansas Observational Study Child Survey, NHTSA Observed Safety Belt Usage Rates among Kansas Children and Adults Adults Buckle Up 77% KS 92% HP 2010 Target Children 0-4 Buckle Up 100% HP 2010 Target 96% KS

18% KS 12% Adults who smoke HP 2010 Target 21% KS 16% Adolescents who smoke HP 2010 Target Percentage of Adult & Adolescent Percentage of Kansas Adults (18 years & older) & Adolescents (grades 9-12) Who Currently Smoke Cigarettes Adult Source: KDHE, Kansas Behavior Risk Factor Surveillance System Adolescent Source: 2000 & 2002 KDHE, Youth Tobacco Survey Grades 9-12, 2005 and 2007 Kansas Coordinated School Health, Youth Risk Behavior Survey Grades 9-12 Adult defined as Kansans aged 18 and older Adolescent defined as those in grades 9-12 HP2010= Healthy People

Percent of Women Reporting Smoking During Pregnancy by Age Group Kansas 2008 Source: Kansas Department of Health and Environment, Bureau of Public Health Informatics, Kansas Information for Communities (KIC), Birth Records. Accessed online

Kansas Department of Health and Environment Impacting Healthy Kansans 2010 Policy to support early intervention

Healthy Kansans 2010 Cross Cutting Issue #2 Invest in community capacity building, utilizing self- identified community assets to promote planning, implementation, and evaluation of community-based interventions, which address health disparities Develop a coordinated, statewide strategy regarding collection, dissemination and utilization of health data and promote participatory evaluation practices Promote cultural sensitivity, specificity, and competency through adoption of policies and actions at multiple levels, including professional, organizational, and system Reduce/Eliminate health and disease disparities *Kansas Department of Health and Environment, Bureau of Health Promotion, Healthy Kansans 2010 Final Report 2006; Accessed online at

Healthy Kansans 2010 Cross Cutting Issue #3 Access to care Cardiovascular risk factors Prevention and Wellness System interventions to address social determinants in health *Kansas Department of Health and Environment, Bureau of Health Promotion, Healthy Kansans 2010 Final Report 2006; Accessed online at

Age-Adjusted Prevalence of Selected Risk Factors Among Kansas Adults 18 Years and Older by Race Source: KDHE, 2008 Kansas Behavioral Risk Factor Surveillance System Rates are age-adjusted to the 2000 U.S. Standard Population Obese is defined as Body Mass Index ≥ 30 Kg/m^2 *Depression estimates are for 2006 and 2008 Target 20% Target 12% Target 50% Target 15% Target 16%

Percentage of Kansas Adults 18 Years Reporting No Leisure Physical Activity in the Past Month 2008 Source: KDHE, 2008 Kansas Behavioral Risk Factor Surveillance System

Percentage of Kansas Adults 18 Years with Diagnosed Depression 2008 Source: KDHE, 2008 Kansas Behavioral Risk Factor Surveillance System

Percentage of Kansas Adults 18 Years with Diagnosed Depression by County Population Density Category 2008 Source: KDHE, 2008 Kansas Behavioral Risk Factor Surveillance System Population density categories determined based on 2000 census populations. Rural: Less than 40 persons per square mile. Urban: 40 or more persons per square mile.

Percentage of Kansas Adults 18 Years with No Leisure Physical Activity in the Past Month by County Population Density Category 2008 Source: KDHE, 2008 Kansas Behavioral Risk Factor Surveillance System Population density categories determined based on 2000 census populations. Rural: Less than 40 persons per square mile. Urban: 40 or more persons per square mile.

Age-Adjusted Prevalence of Hypertension Among Kansas Adults (18 Years & Older) by Annual Household Income and Race/Ethnicity Source: KDHE, , Kansas Behavioral Risk Factor Surveillance System Rates are age-adjusted to the 2000 U.S. Standard Population

Kansas Department of Health and Environment Impacting Healthy Kansans 2010 Policy to support reducing/eliminating health & disease disparities

Kansas Department of Health and Environment Impacting Healthy Kansans 2010 Policy to support reducing/eliminating health & disease disparities

Birth Death Child Senior Adolescent Adult *Social Connections *Education*Housing/Neighborhood*Income*Access Water Conditions *Nutrition *Physical Activity Navigation Equipment *Oral Health The River of Life: Equipping Kansans for Lifetime Good Health *Insurance Prenatal Care Behavior During Pregnancy Immunization Sexual Behavior Tobacco Use Cancer Obesity Diabetes Sexual Behavior Arthritis *Education Source: 2009 KDHE, Bureau of Health Promotion

Quality Water Conditions Navigation Equipment- Oars of Health Many Social Connections Living Income Access to Care The River of Life: Equipping Kansans for Lifetime Good Health Quality Housing/Neighborhood Many Educational Opportunities Quality Prenatal Care No Risky Behaviors During Pregnancy Complete/timely Immunizations No Tobacco Use Reduced Risk Heart Disease Reduced Risk Obesity Reduced Risk Diabetes Reduced Risk Cancer Reduced Risk Arthritis Good Nutrition Health Education Insurance Source: 2009 KDHE, Bureau of Health Promotion

Poor Water Conditions Few Social Connections Few Educational Opportunities Poor Housing/Neighborhood Low Income Little Access to Care No/Poor Prenatal Care Risky Behaviors During Pregnancy No/late Immunizations Increased Risk Tobacco Use Increased Risk Heart Disease Increased Risk Obesity Increased Risk Diabetes Increased Risk Cancer Increased Risk Arthritis The River of Life: Equipping Kansans for Lifetime Good Health Navigation Equipment Begins to Fail- Oars of Health Health Education Good Nutrition Insurance Source: 2009 KDHE, Bureau of Health Promotion