Healthiest Wisconsin 2020: Everyone Living Better Longer Karen E. Timberlake Secretary Wisconsin Department of Health Services Real Talk for Real Action: Getting Together for a Healthier Wisconsin January 29, 2009

Purpose of a State Health Plan Develop an agreed-upon plan that provides strategic direction and aligns the resources to the vision and goals. The 2010 goals were: The 2010 goals were: –Protect the health and safety of the public –Eliminate health disparities (move toward equity in 2020) –Transform Wisconsin’s public health system By focusing on…

HW 2010 Health Priorities Access to Primary and Preventive Health Services Adequate and Appropriate Nutrition Alcohol and Other Substance Use and Addiction Environmental and Occupational Health Hazards Existing, Emerging and Re-emerging Communicable Diseases High Risk Sexual Behavior Intentional and Unintentional Injuries and Violence Mental Health and Mental Disorders Overweight, obesity, and lack of physical activity Social and Economic Factors that Influence Health Tobacco use and exposure

HW 2010 Infrastructure Priorities Integrated electronic data and information systems Community health improvement processes and plans Coordination of state and local public health system partnerships Sufficient, competent workforce Equitable, adequate, and stable financing

Decreasing Trends in Youth Smoking in Wisconsin High school smoking rates decreased 37% from 1 in 3 youth in 2000 to 1 in 5 youth in 2008 Middle school smoking rates decreased from 12% in 2000 to 4.3% in 2008 Significant decrease in the number of Wisconsin retailers selling tobacco to minors

Decline in Adults Smoking Rates Adult smoking rate in Wisconsin is at its lowest point ever Wisconsin’s rate has dropped below the national average 45 million fewer packs of cigarettes were sold after introduction of $1/pack tax increase in 2007 There have been 39,000 to the Wisconsin Tobacco quit line in 2008 Percent Adult Smoking Prevalence

The Burden of Tobacco in Wisconsin Tobacco use contributes to over 8,000 deaths annually $3 billion in health care and productivity costs annually $276 million spent on marketing and advertising by the tobacco industry

Challenges Ahead: Advocating for a Smoke-Free Wisconsin Many of Wisconsin’s border states are smoke free

Wisconsin’s Culture of Drinking Underage Drinking 49% of high school students have tried alcohol 39% of 21 and under drink 69% of the WI adult population drink 23% of adults admit to binge drinking 26% of WI adults admit to driving under the influence in the past year (HHS) More than 42,000 convicted of drunk driving in 2007 (WI DOT)

The Costs of Alcohol in Wisconsin $5 billion each year in alcohol-related costs $523 million in alcohol related hospitalizations in killed, 5,500 injured in alcohol related traffic accidents in 2007 (Wi DOT) Approx. 47% of all fatal crashes due to alcohol (WI DOT) Exceeds deaths caused by speeding

Responding to Alcohol Abuse Alliance for Wisconsin Youth: oversees five regional prevention centers More than 100 local coalitions are members of Alliance for Wisconsin Youth $2.3 million in grants for community evidence-based substance abuse services BadgerCare +: preventative services for pregnant mothers at risk of abusing alcohol or drugs

Wisconsin’s Obesity Crisis 62.8% adults overweight or obese 25% of high school students at risk 29.2% of 2-4 year olds participating in WIC program at risk Cost to Wisconsin = $1.5 billion annually $626 million from Medicaid and Medicare for obesity-related medical costs

Reducing Obesity in Wisconsin DHS & WI Partnership for Activity and Nutrition (WI PAN) working to create environments and enable healthier food choices and physical activity Public Transportation –Increase exercise –Reduce obesity, diabetes, heart disease and injuries AND ALSO AND ALSO –Increase community socializing –Reduce petroleum dependence

Infant Mortality in Wisconsin In spite of declines in teen pregnancy and rates of smoking while pregnant, infant mortality has barely budged in the last decade: deaths per 1, deaths per 1, deaths per 1,000 Infant mortality rates have decreased for Whites, Latinos and Native Americans but increased for African Americans

African American Infant Mortality Rates Increasing 1997 African American infant mortality rate: 13.4 deaths per 1, African American infant mortality rate: 14.5 deaths per 1,000 Meanwhile: –American Indian infant mortality has dropped from 15.4 to 9.5 between –The Hispanic/Latino infant mortality rate declined from 10.3 in 1997 to 6.4 for 2007

Reducing Infant Mortality P4P initiative in Medicaid managed care –identifies highest risk women –employs evidence-based practices –includes accountability and outcome measures Critical community-based initiatives for improving birth outcomes Hands on approaches such as: –home visits, smoking cessation and creating safe sleep environments Improving educational attainment, job opportunities, life course approach

Looking Forward: HW 2020 Build on the Strengths of HW2010 Expand partnerships Learn from Evaluations and Data UW research on “Making Wisconsin the Healthiest State” Create a collaboration of Public Health Partners Not just a government public health plan Align the work of the Partners with the priorities and strategies of the State Health Plan

Broad Goals of HW 2020 Improved health across lifespan Improved health equity Everyone living better longer

Health Outcome Focus Areas Adequate, appropriate, and safe food and nutrition Chronic disease prevention and management Communicable disease prevention and control Environmental and occupational health Healthy growth and development Mental health Oral health Physical activity Reproductive and sexual health Tobacco use and exposure Unhealthy alcohol and drug use Violence and injury prevention

Reduced disease, injury, and impairment Healthy, safe and resilient communities, families and individuals Effective policies and systems aligned for better health Infrastructure Focus Areas Access to quality health services Collaborative partnerships for community health improvement Diverse, sufficient, competent workforce that promotes and protects health Equitable, adequate, stable public health funding Public health capacity and quality Public health research and evaluation Systems to manage and share health information and knowledge Health Focus Areas Health Focus Areas Adequate, appropriate, and safe food and nutrition Chronic disease prevention and management Communicable disease prevention and control Environmental and occupational health Healthy growth and development Mental health Oral health Physical activity Reproductive and sexual health Tobacco use and exposure Unhealthy alcohol and drug use Violence and injury prevention Intermediate Targets Metrics to be determined Intermediate/short-term Disease, injury, disability rates Others, e.g., birthweight Healthiest Wisconsin 2020 Improve health across lifespan Achieve health equity DRAFT revised 1/23/09 Strategic Leadership Team WI Division of Public Health Overarching Focus Area Social, economic, and educational factors including health literacy Productivity Prosperity Participation Well-being Long Term Goals Metrics to be determined Length of life, e.g., average of life expectancy, infant mortality (by race/ethnicity) Quality of life Health equity

Healthiest States Project and Healthiest Wisconsin 2020 Both emphasize –social relationships –physical environment –behaviors –in addition to health services Both envision an all-sectors approach Both emphasize evidence-based approaches Both focus on outcomes