Indiana Chronic Disease Plan Chronic Disease Advisory Group Meeting March 24, 2016

Welcome and Introductions: Tell Us About Yourself Name Organizational Affiliation

Agenda for Today Where We Have Been Where Indiana’s Health Challenges Are Today Where We Are Going and Hopes for the Future How We Hope to Get There with Your Help

Where We Have Been History of Chronic Disease Planning in Indiana Purpose of New Chronic Disease Planning

Indiana Chronic Disease Plans To reduce the cancer burden in Indiana through the development, implementation, and evaluation of a comprehensive cancer control plan that addresses cancers across the continuum from prevention through palliation. The mission of the Cardiovascular and Diabetes Coalition of Indiana (CADI) is to reduce the burden of diabetes, cardiovascular disease and stroke in Indiana. The mission of Indiana Healthy Weight Initiative is to enhance the health and quality of life of Hoosiers by promoting good nutrition, regular physical activity, and a healthy weight through policy, environment, and lifestyle change. The Indiana Joint Asthma Coalition (InJAC) is a voluntary network of people and organizations who work to reduce the burden of asthma on people living in Indiana.

Indiana’s Health Challenges “Only about 20% of health is impacted by medical care. The rest is due to the food we eat, air we breathe, our physical activity, education level, genetics, and the many circumstances influencing choices we make about our behaviors.” – Social Determinants of Health, CDC

Indiana’s Health Challenges The top three leading causes of death for Indiana men and women are: Heart Disease Cancer Chronic lower respiratory infections According to the United Health Foundation, Indiana’s biggest challenges or leading causes of poor health are: Low per capita public health funding High prevalence of smoking High levels of air pollution Low levels of physical activity Childhood poverty For these causes of death and poor health, long standing disparities exist by Race, Gender, Social Economic Status and County of Residence.

Obesity Hoosier adult obesity is at 32% (44th in USA) (CDC 2013) Obesity is a risk factor for a variety of chronic conditions including: Diabetes Hypertension High Cholesterol Stroke Heart Disease Certain Cancers Arthritis

Heart Disease, Stroke and Diabetes Heart Disease is the leading cause of death for Hoosiers, and Stroke is the 4th leading cause 33% of all Indiana adults reported having high blood pressure Nearly 40% of all Indiana adults reported having high cholesterol Diabetes is the 7th Leading Cause of Death of Indiana Residents Nearly 500,000 Indiana have diabetes while nearly 290,000 have prediabetes. Diabetes is a major cause of heart disease and stroke. Diabetes is the leading cause of kidney failure, non-traumatic lower-limb amputations, and new cases of blindness among adults.

Cancer 22% of all deaths in Indiana in 2014 had cancer as an underlying cause (Indiana 2014 mortality data)

Cancer Indiana trails behind the US median in all of the following categories:

Asthma Every 5 days, 1 person dies from asthma in Indiana (ISDH DAT 2014 and Indiana Mortality Report 2013) Approximately 1 out of 10 children are diagnosed with asthma. Multi-Racial adults have the highest prevalence rate at 20.2% (nationwide) (CDC 2011) 510,000 people in Indiana currently have asthma (ISDH DAT 2014) 33.6% of adults and 44.7% of children missed at least 1 day of work/school in the past 12 months due to asthma (2011-2012 CDC and ISDH DAT) 10.3% of adults and 8.0% of children in Indiana have asthma (ISDH DAT 2014)

Where We Are Going and Hopes for the Future Collective Impact Common agenda Shared measurement systems Mutually reinforcing activities Continuous communication Backbone support organizations Revitalization of the Chronic Disease Advisory Group (CDAG)

How We Hope To Get There with Your Help Chronic Disease Planning Process and CDAG Plan Philosophy: Culture of Health Plan Framework : CDC Four Domains

Culture of Health Framework Quality of Partnerships Investment in Collaboration Policies that Support Collaboration Mindsets and Expectations Civic Engagement Sense of Community Built Environment Social and Economic Environment Policy and Governance Access Balance and Integration Consumer Experience Individual and Community Well Being Managed Chronic Disease Reduced Health care Costs

Making Health a Shared Value Mindsets and Expectations Civic Engagement Sense of Community

Fostering Cross-Sector Collaboration Quality of Partnerships Investment in Collaboration Policies that Support Collaboration

Creating Healthier Communities Built Environment Social and Economic Environment Policy and Governance

Strengthening Integration of Health Services Access Balance and Integration Consumer Experience

Outcomes and Measures Individual and Community Well Being Managed Chronic Disease Reduced Health care Costs

Chronic Disease Prevention System

Four Domains Questions for the group: Do these four domains capture the scope of Chronic Disease in Indiana and potential collaboration points? Should we consider adding additional domains?

Domain 1: Epidemiology and Surveillance Track chronic diseases, risk factors and share the information Monitor social and environmental factors that influence health Conduct surveillance of health care preventive services Leverage health information technology Questions for the group: What are some of the current gaps in data collection and utilization in Indiana? How can we improve statewide epidemiology and surveillance efforts? Are there current examples of collaborations in Indiana around epidemiology and surveillance efforts that we should be aware of?

Domain 2: Environmental Approaches Create policies that change the context and make healthier lives easier Change social and physical environments that make healthy choices: Easier Safer Cheaper More convenient Questions for the group: What are some of the current gaps for built environment in Indiana? How can we improve statewide built environment, social and economic efforts? Are there current examples of collaborations in Indiana around built environment, social and economic efforts that we should be aware of?

Domain 3: Healthcare System Interventions Increase the use and improve the quality of clinical and other preventive services Create interventions to increase access to and build demand for quality preventive services Questions for the group: How can we improve the quality of preventive services? What sort of interventions can be implemented to increase access and build demand for preventive services? Are there current examples of collaborations in Indiana around healthcare system interventions that we should be aware of?

Domain 4: Community Programs Linked to Clinical Services Increase the use of effective community interventions Establish partnerships with hospitals and health care providers Encourage a broader spectrum of health care workers to help people manage their health Use outreach and education to more fully engage the public Questions for the group: How can we communicate with and establish partnerships with hospitals and health care providers? What can we do to more fully engage the public?

Next Steps Next Meetings Needs from the Group Questions and Closing Comments