1. Healthiest Wisconsin 2010: A Partnership Plan to Improve the Health of the Public A Report of the State Health Plan Committee February 9, 2007

2. Healthiest Wisconsin 2010 Progress Report and Policy Recommendations to the Wisconsin Public Health Council Presented for the State Health Plan Committee by: Mary Jo Baisch, Ph.D., RN Gary Hollander, Ph.D.

3. Charge to the State Health Plan Committee Charge to the State Health Plan Committee Make recommendations to the PHC on the priorities and strategies to achieve the Council’s goals related to Healthiest Wisconsin 2010 by: è Monitoring, evaluating, and communicating progress toward and away from achieving the state health plan. è Championing the achievement of the state health plan. è Promoting broad-based ownership for achieving the state health plan.

4. Focus of Today’s Progress Report Provide recommendations to support a public health system transformation related to: èGeneral needs for the transformation. èEquitable, adequate, and stable funding and financing. èIntegrated electronic data and information systems. Provide status reports and policy recommendations for three statewide health priorities: èAdequate and appropriate nutrition.  Obesity, overweight, and lack of physical activity. èT obacco use and exposure.

5. Evaluation Model Healthiest Wisconsin 2010

6. InfrastructurePriorities HealthPriorities Statewide Health and Infrastructure Priorities

7. Overarching Needs Healthiest Wisconsin 2010 èAdequately and equitably fund the state health plan priorities.  Collect data in ways that are timely, locally based, and accurate. èEliminate health disparities. èAssure that primary prevention is a lead strategy.

8. Policy Actions and Recommendations To Support the Transformation of Wisconsin’s Public Health System Healthiest Wisconsin 2010 Goal 3: Transform Wisconsin’s PH System

9. èDetermine what is acceptable and what is optimal for the health of Wisconsin. èDefine concrete indicators to measure the five infrastructure (system) priorities. èDevelop a social marketing campaign about the public health system. èExamine the public health system across the rural- urban continuum. Actions and Recommendations: Public Health System Transformation

10. èAccept and adopt the transformation report presented by the State Health Plan Committee. èEstablish a “commissioned” study group to develop strategies for financing and integrated data priorities in 2007 and defer work on the other three infrastructure priorities until 2008. èBrief Governor Jim Doyle on the State Health Plan and the Committee’s recommendations. èDisseminate the findings widely. Actions and Recommendations Public Health System Transformation

11. Adequate and Appropriate Nutrition Issues and Current and Emerging Disparities

12. Adequate and Appropriate Nutrition Consider... è Poor nutrition is costly for Wisconsin è The estimated annual cost of heart disease is $5.2 billion. è Low birth weight babies are 50% less likely to do well in school.

13. Adequate and Appropriate Nutrition Consider... èThere was an increase in the percent of Wisconsin mothers who breastfed their infants since 2000. èIncreases were most marked among WIC infants with increases of 9-20 percent in minority populations. èHealth improvement is tied to the availability of public health nutritionists, yet only one health department has its nutritionists dedicated to “general public health nutrition.”

14. Adequate and Appropriate Nutrition Consider the health disparities... è9 percent of Wisconsin residents are food insecure è1/3 are households of single, low income mothers. è1/4 are disabled persons. èNearly 50 % of WIC households are food insecure. èBlack/African Americans experience food insecurity three times that of the white population.

15. Obesity, Overweight, Lack of Physical Activity Issues and Current and Emerging Disparities

16. Obesity, Overweight, Lack of Physical Activity Consider... èWisconsin residents live in environments that promote obesity. èReversing the trends for overweight and obesity requires the commitment and involvement of all sectors (government, the public, private, nonprofit, and voluntary). èThe Wisconsin Nutrition and Physical Activity Plan is a science-based framework to reduce obesity.

17. Obesity, Overweight, and Lack of Physical Activity Consider the health disparities... èChildren and adolescents are on a trend for the worse when it comes to overweight and obesity. èPercent of children ages 2-4 in WIC who are overweight is increasing. èAsian high school students are less likely to report regular moderate physical activity. èThe proportion of obese adults was higher among Black/African American and American Indian populations.

18. Policy Actions To Improve Nutrition/Physical Activity and Prevent Obesity and Overweight Recommendations and Policy Actions

19. Policy Actions To Improve Nutrition/Physical Activity and Prevent Obesity and Overweight èPromote awareness of food security issues. èEndorse implementation of the Wisconsin Nutrition and Physical Activity Plan. èAdvocate for policies that improve nutrition and reduce obesity.

20. Policy Actions To Improve Nutrition/Physical Activity and Prevent Obesity and Overweight Specifically advocate for: Funding to assure that public health nutrition education and epidemiology services are available in each local health department throughout Wisconsin.

21. Policy Actions To Improve Nutrition/Physical Activity and Prevent Obesity and Overweight èAccess to food and wellness programs. èHealth insurance coverage for prevention, assessment, and management of overweight and obesity. èExpansion of worksite wellness programs. èSchool nutrition programs: èAdoption of K-12 standards for nutrition and physical education. èSchool wellness policies in every school that include goals for nutrition education, physical activity, and guidelines for food and beverages.

22. Policy Actions To Improve Nutrition/Physical Activity and Prevent Obesity and Overweight Support a policy agenda that promotes: è food security è breastfeeding è access to wellness facilities è bike trails è food assistance programs è other nutrition improvement programs

23. Tobacco Use and Exposure Issues and Current and Emerging Disparities

24. Tobacco Use and Exposure èTobacco causes 5 million deaths worldwide èThe health and economic toll for Wisconsin is significant: èOver 8,000 died from smoking; of these, 7,215 died from directly related causes and 853 died from indirect causes. èOver $2.16 billion in direct health care costs is paid annually in Wisconsin.

25. Tobacco Use and Exposure èComprehensive tobacco control programs work. èTobacco use among middle school youth decreased from 16 percent in 2000 to 13 percent in the year 2004. èSmoking among young adults decreased from 40 percent in 2000 to 25 percent in the year 2005. Consider...

26. Tobacco Use and Exposure Consider the health disparities... èSmoking rates among pregnant women with a college education are less than 4 percent but great than 30 percent among pregnant women without a high school degree. èDisparities exist for ethnic minorities and those living in poverty. èAmerican Indian and Hispanic middle school youth reported the highest rate of tobacco use.

27. Tobacco Use and Exposure Consider the health disparities... èBlack African Americans have the highest rate of exposure due to smoking in their homes. èDisparities exist for ethnic minorities and those living in poverty.  Wisconsin has emerged as a national leader in addressing tobacco-related disparities. èCigarette smoking is highly prevalent among American Indians.

28. Recommendations and Policy Actions Tobacco Use and Exposure

29. Policy Actions To Improve Tobacco Use and Exposure èSupport a comprehensive prevention and control program: èPrevent young people from initiating tobacco use. èPromote quitting. èEliminate non-smokers’ exposure. èEliminate disparities of use among different populations. èEndorse the $1.25 per pack cigarette tax increase.

30. Discussion Debate Decisions Healthiest Wisconsin 2010

31. Taking action to transform the public’s health Healthiest Wisconsin 2010