1. SHIP: The Statewide Health Improvement Program Healthy kids Healthy communities

2. Cause of Death, Minnesota 2010Number of Deaths Cancer9599 Heart Disease7144 Stroke2154 Unintentional injuries2087 Chronic lower respiratory disease2012 Alzheimers Disease1450 Diabetes1036 Nephritis895 Suicide599 Influenza/pneumonia591 What is SHIP? SHIP works to reduce chronic diseases such as heart disease, cancer and diabetes

3. Source: Mokdad et al, JAMA 2004 March 10; 291 (10):1238-45 U.S. 2000 The Real Causes of Death: U.S. estimate, 2000 Number of DeathsPercentage Tobacco435,00018% Diet/activity365,00015% Alcohol85,0004% Microbial agents75,0003% Toxic agents55,0002% Firearms29,0001% Sexual behavior20,000<1% Motor vehicles43,000<1% Illicit use of drugs17,000<1% What is SHIP? It does this through preventionreducing the behaviors that lead to chronic disease

4. Percent of Minnesota Adults Obese (BRFSS) Health in Minnesota Nearly 2/3 of adults are overweight or obese Only one out of four adults eats enough fruits and vegetables Only slightly more than half of Minnesota adults get at least a moderate level of exercise. Obesity is epidemic in Minnesota

5. Percent of Minnesota Adult Current Smokers (BRFSS) Health in Minnesota 15% of adults smoke, and many others are subjected to secondhand smoke. In high school, over a quarter of students used tobacco in the past 30 days. Nearly one in five high school students (18.1%) smoked cigarettes Tobacco continues to be a problem

6. Health in Minnesota Health Care Spending in Minnesota from 1996-2008 All contributing to health care costs that are out of control

7. $2.9 billion in annual medical costs (2007) Tobacco Obesity $2.8 billion estimated annual financial burden (2006) Health in Minnesota The financial burden on Minnesota is enormous

8. Source: Center for Disease Control and Prevention, University of California at San Francisco, Institute for the Future, thanks to Dakota SHIP Minnesota spends annually per-capita: Almost $7000 health care Less than $4 on SHIP the first 2 yrs Health in Minnesota Yet prevention is a tiny percent of health spending

9. The goal of SHIP: – The goal of the Statewide Health Improvement Program (SHIP) is to help Minnesotans live longer, healthier, better lives by preventing risk factors that lead to chronic disease. How SHIP Works The solution: prevent chronic disease and thereby reduce health care spending

10. How SHIP Works The SHIP model: improving health by increasing opportunities for healthy choices Increased opportunities for physical activity, nutritious food, and tobacco- free living… …means more people get physical activity, better nutrition, and less tobacco exposure… …leading to Improved health… …lowering health care costs, and improving quality of life.

11. Keys to success Local control – Local communities select from a menu strategies what will work best for them. Strong partnerships – New community partnerships with not only local public health and tribal grantees, but also with businesses, farmers, schools, community groups, chambers of commerce, hospitals, health plans, city planners, county boards, tribal officials and more. Evidence-based strategies – Built on best practices from the Centers for Disease Control and Prevention and other public health leaders. How SHIP Works

12. Keys to success (continued) Sustainability – Efforts that lead to long-lasting change, not programs that end and things go back to the way they were before. Strong evaluation – Always seeking to improve by understanding what is working, gaging health outcomes and measuring cost savings. How SHIP Works

13. MDH gathered a menu of strategies for local communities to choose from Strategies that work on a community-wide scale rather than on an individual level, for example: – Rather than tell kids about good nutrition, work with schools to serve more locally grown produce. – Rather than tell people to get more physical activity, help employers build opportunities into the day. – Rather than tell students to avoid second-hand smoke, help college campuses to become smoke-free. How SHIP Works

14. Making an Impact in the work place Healthier food – Providing or improving access to healthy foods in cafeteria and in catering, as well as establishing workplace policies and programs that promote and support breastfeeding for working mothers. Comprehensive tobacco-free worksite policies – Health plan coverage of tobacco cessation treatment, onsite support for and promotion of tobacco cessation treatment, and tobacco-free policies. Encouraging physical activity – Create active worksites by increasing opportunities for walking and biking and access to worksite recreation facilities. SHIP Strategies

15. Making an Impact in schools Healthy eating in schools – Breakfast promotion; healthy lunch and snacks, including classroom celebrations and incentives, fundraising, concessions and vending. Farm to School – Connect farmers with schools to provide fresh, local foods. Efforts may include school gardens to educate children and supplement food offerings. Safe Routes to School – Increase opportunities for non-motorized transportation such as walking and biking to- and from- school. SHIP Strategies

16. Making an Impact in schools (continued) Active school day – Encourage physical activity through active classrooms, active recess and physical education. Tobacco-free post-secondary campuses – Implement a tobacco-free policy to apply to students, staff and visitors on all post-secondary school grounds, in student housing and at all school sponsored events. SHIP Strategies

17. Making an Impact in health care Partnerships – Strengthen partnerships between local public health and tribal governments, health care facilities and clinics, health plans/payers and community-based organizations. Screening – Enhance methods for screening and documentation of Body Mass Index (BMI) and tobacco use and exposure. SHIP Strategies

18. Making an Impact in health care (continued) Technical assistance – Effective practices and approaches for addressing BMI status and tobacco use and exposure. Community resources – Offer resources addressing behaviors related to nutrition, physical activity and tobacco use and exposure. SHIP Strategies

19. Making an Impact in communities Active transportation – Increase opportunities for non-motorized transportation, such as walking and bicycling. Healthy food environment – Improve access to nutritious foods such as fruits and vegetables by increasing availability and affordability in grocery and corner stores, concession facilities and other food vendors, require calorie or nutrition labeling on menus, new farmers markets and facilitate the development of new community gardens and other small scale food production strategies. SHIP Strategies

20. Making an Impact in communities (continued) Active child care – Increase healthy eating and physical activity in licensed child care and pre-school settings. Smoke-free multi-unit housing – Implement voluntary smoke-free housing policies in multi-unit housing. Tobacco-free outdoor spaces – Implement tobacco-free policies for parks, playgrounds, beaches, zoos, fairs, and other recreational settings. SHIP Strategies

21. Results from the First Two Years A statewide effort for FY 2010-11 All 87 MN counties and 9 of 11 tribal communities Hundreds of businesses, schools, non-profits, health care organizations and others involved Tribal Grantees Leech Lake with partners: Mille Lacs, Bois Forte, Grand Portage, White Earth, Fond du Lac, Red Lake Upper Sioux Lower Sioux

22. Strong school partnerships Farm to School: 367 schools serving more than 200,000 students Safe Routes to School:117 schools serving at least 77,000 students Increased physical activity: 46 schools Smoking cessation services: 33 post-secondary Tobacco-free campuses: 31 post-secondary schools School nutrition staff trained to serve healthy meals: 75 percent of eligible districts Results from the First Two Years

23. Healthier employees--savings for employers Worksite wellness initiatives: 870 work sites reaching over 138,000 employees Tobacco-free grounds: 21 worksites Increasing physical activity: 47 employers Improved food options available to staff: 90 employers Results from the First Two Years

24. SHIP made an impact in communities More biking and walking: projects in 255 cities Nutrition: 544 child care sites serving approximately 8564 children Increased physical activity: 902 child care sites serving over 20,000 children Tobacco-free parks policies: 6 cities Smoke free policies: 227 apartment buildings Farmers markets: up 61 percent

25. Health Care built strong partnerships Counseling and referral: Approximately 60 clinics Support for breastfeeding: 73 health care institutions Results from the First Two Years

26. Moving forward SHIP for 2012-13 $15 million 70% cut No longer statewide 18 grantees funded 55 counties and cities and one tribal community

27. SHIP www.health.state.mn.us/ship/www.health.state.mn.us/ship/ Obesity Plan www.health.state.mn.us/obesitywww.health.state.mn.us/obesity CDC community guide www.thecommunityguide.orgwww.thecommunityguide.org Resources