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

2. Welcome and Introductions: Tell Us About Yourself
Name
Organizational Affiliation

3. 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

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

5. 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.

6. 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

7. 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.

8. 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

9. 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.

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

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

12. 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 ( CDC and ISDH DAT)
10.3% of adults and 8.0% of children in Indiana have asthma (ISDH DAT 2014)

13. 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)

14. 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

15. 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

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

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

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

19. Strengthening Integration of Health Services
Access
Balance and Integration
Consumer Experience

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

21. Chronic Disease Prevention System

22. 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?

23. 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?

24. 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?

25. 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?

26. 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?

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