Public Health

1. Public Health Jason Drenning Ashley Eckes Jessica Eliazar Jessica Elliott

2. What is Public Health? • Public health is concerned with threats to the overall health of a community based on population health analysis • "Health care matters to all of us some of the time, public health matters to all of us all of the time“ - C. Everett Koop

3. Public Health Objectives • The focus of a public health intervention is to prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviors • Modern public health is concerned with addressing determinants of health across a population, rather than advocating for individual behavior change. • Our health is affected by many factors including where we live, genetics, our income, our educational status and our social relationships - "social determinants of health"

4. Facets of Public Health • Epidemiology • Environmental Health • Social & Behavioral Sciences • Biostatistics • Occupational Health

5. Smoking Obesity Stress Management Physical Fitness Nutrition HIV/AIDS Substance Abuse Depression Mental Health Heart Disease Maternal/Infant Health Diabetes Important Public Health Issues

6. Early Interventions • The Romans understood that the proper disposal of human waste was a necessary to the health of communities in urban areas. • The Chinese developed the practice of variolation following a smallpox outbreak around 1000 BC. • An individual without the disease could become immune by inhaling the dried crusts that formed around lesions of infected individuals.

7. Vaccinations Motor Vehicle Safety Workplace Safety Control of Infectious Diseases Decline in deaths from stroke and heart disease Safer and healthier foods Healthier mothers and babies Family planning Fluoridation of drinking water Recognition of tobacco use as a health hazard 10 Great Public Health Achievements

8. Public Health Today • The developing world remains plagued by largely preventable infectious diseases, exacerbated by malnutrition and poverty. • Infectious diseases such as SARS, have made their way from China to Canada and the United States; • Public health challenges also include the ongoing social, economic and health disasters related to the 2005 Tsunami and Hurricane Katrina in 2006

9. Health People 2010 • Provides a framework of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats • Goal 1: Increase Quality and Years of Healthy Life • Goal 2: Eliminate Health Disparities http://www.healthypeople.gov/

10. Impact of Public Health • The dramatic achievements of Public Health in the 20th century have improved our quality of life: an increase in life expectancy, world wide reduction in infant and child mortality, and the elimination or reduction of many communicable diseases. • Since 1900, the average life expectancy for Americans has increased by about 30 years. Over twenty-five of the 30 years can be accredited to public health initiatives, while medical advances account for less than 4 years.

11. Public Health Bills • Large Scope • Broad • American Public Health Association Priorities • Rebuilding the Public Health Infrastructure • Ensuring Access to Health Care • Eliminating Health Disparities • Prevention • Reducing Health Care Costs

12. Obesity • National Health Problem • Contributes to diabetes, cardio-vascular disease, and cancer • Disproportionately affects poor, blacks, and American Indians • Increasing the fastest in children • Importance of Prevention

13. Impact on Public Health • Health Care Costs and Expenditures • Directly associated • According to a recent study, obesity-related medical expenditures in Florida total over $3.9 billion (FDOH, 2005) • Over half of the costs being financed by Medicare and Medicaid (FDOH, 2005). • Indirectly associated • Management of diabetes and secondary diseases • Costs of disability on economy

14. Previous Bills • Healthy Lifestyles and Prevention American Act or HeLP America Act (2004) • The purpose is to improve the health of Americans and minimize health care costs by restructuring the Nation's health care system towards prevention, wellness, and self care. • Urban and Rural Disease Prevention and Health Promotion Act of 2003 • To provide assistance for the development of indoor disease prevention and health promotion centers in urban and rural areas throughout the United States. • Right Start Act of 2003 • To improve early learning opportunities and promote preparedness by increasing the availability of Head Start programs, to increase the availability and affordability of quality child care, to reduce child hunger and encourage healthy eating habits, to facilitate parental involvement, and for other purposes.

15. Democratic View • More funding for physical education in public schools • Strengthening Title IX • Fighting against President Bush’s push to make the title weaker • Affordable Education and Accessible Health Care • Lowering obesity rates will in tern lower insurance costs • Expand funding

16. Republican View • Healthy America Initiative • Joint effort with governors both Democratic and Republican • Huckabee, Sanford • Napolitano, Scharzenegger, Vilsack, Bredsen • Raise Awareness of healthy behaviors and risks • “Do it yourself” solution • Put little money into regulation and education • The rest is up to the individual • Cost effective programs

17. Implications • To fix the obesity problem in America it will cost more before it costs less • Those that are already obese • Treatment – or prevention measure • Implementation • Is law the way to go with the obesity issue? • Governmental time frame is often to short • Make sure we don’t “blame the victim” • Encouraging good treatment • Requirements for surgery • Results of expert opinions and recommendations • Fast food lawsuits

18. Childhood Obesity Prevention Act • Rationale for Proposed Legislation • To encourage innovative state and community based activities to help reduce and prevent obesity among children. • Target Group • Elementary and Secondary School aged children.

19. Childhood Obesity Prevention Act • Primary Mechanisms • State and Local Wellness Projects • Commission on Prevention of Obesity • National Health and Physical Fitness Awards

20. State & Local Wellness Projects • State Wellness Project Grants • Award Grants to State Educational Agencies to fund projects related to the creation of nutrition and physical fitness programs targeting school aged children.

21. State & Local Wellness Projects • State Wellness Project Grants • Basic Program Activities: • Collect preliminary data on the State’s obesity prevalence. • Develop and implement school programs that enhance nutritional education and physical fitness programs. • Collaborate with Local Wellness Projects and public/private community-based organizations • Develop State Health Standards. • Report the program results.

22. State & Local Wellness Projects • Local Wellness Project Grants • Award Grants to Local Educational Agencies to fund projects to promote healthier eating habits and increase physical fitness within the community.

23. State & Local Wellness Projects • Local Wellness Project Grants • Basic Program Activities: • Provide a preliminary statement of the community’s needs and the project’s goals. • Promote local awareness of the impact of individual behaviors on health status. • Increase opportunities for physical fitness. • After-school activities, intramural sports, etc. • Provide support to school nutrition and physical fitness services • Training teachers and staff, providing educational materials, etc. • Report the program results.

24. Commission on Prevention of Obesity • Establishment and Purpose • Provide guidance on research, policy formation, and other activities of the Federal government relating to the prevention and treatment of obesity. • Oversight of State and Local Wellness Projects.

25. Commission on Prevention of Obesity • Commission Duties • Collect & review information from Wellness Projects • Provide Feedback • Share information on successful projects. • Create recommendations on a Federal response to obesity prevention and treatment • Develop standards for the receipt of the National Health & Physical Fitness Awards

26. Commission on Prevention of Obesity • Consultation • Representatives of State and local government • Educators • Community based organizations

27. Commission on Prevention of Obesity • Membership • HHS • Department of Agriculture • Department of Education • Center for Medicaid and Medicare Services • CDC • NIH • Private sector representatives • Public Health Organizations, Food Industry, Fitness Industry, etc.

28. Commission on Prevention of Obesity • Report • Every two years • Describe & evaluate current programs • State recommendations on a Federal response to obesity prevention and treatment • Address Healthy People 2010 objectives

29. National Health and Physical Fitness Awards • Program to recognize and award elementary & secondary schools with • Outstanding physical fitness and nutritional education programs • Demonstrated improvements in student fitness, nutritional awareness, and overall health

30. National Health and Physical Fitness Awards • Teacher Achievement Awards • Awarded to teachers, coaches, & other personnel for providing leadership within nutrition and physical fitness programs • Student Achievement Awards • Awarded to students that demonstrate improvements in nutrition awareness, levels of physical activity, and have shown overall health improvements

31. Childhood Obesity Prevention Act • Estimated Costs • State Wellness Project Grants • $500,000 per state grant; 20 state max: $10,000,000 • Local Wellness Project Grants • $200,000 per local grant; 100 max: $20,000,000 • Must award at least one to each state • Commission on Prevention of Obesity • $200,000 per year

32. Childhood Obesity Prevention Act • It's estimated that the obesity epidemic costs our nation $117 billion per year in direct health care costs and lost productivity (RWJF, 2007). • We must take action now to address this urgent national health threat.

33. Questions?