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Connecting Health and Wellness to Career Development and Beyond: Center Life to Community Living

Connecting Health and Wellness to Career Development and Beyond: Center Life to Community Living. Medical Priorities in the Health and Wellness Program John Kulig, MD, MPH Principal Medical Consultant. Health & Wellness Program Goals.

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Connecting Health and Wellness to Career Development and Beyond: Center Life to Community Living

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  1. Connecting Health and Wellness to Career Development and Beyond: Center Life to Community Living Medical Priorities in the Health and Wellness Program John Kulig, MD, MPH Principal Medical Consultant

  2. Health & Wellness Program Goals • Develop a model health and wellness program for Job Corps • Require the setting of health and wellness goals for all students enrolled in Job Corps • Implement case management for Job Corps students with chronic illness and/or disability

  3. Medical Program Goals • Implement case management for all Job Corps students with chronic illness • Launch a center-based asthma management initiative in 2005 • Strengthen the Job Corps Tobacco Use Prevention Program (TUPP) • Strengthen the Job Corps Weight Improvement Program (WIP)

  4. US Mortality: ages 15-19 years, 2002 Deaths% • Accidents (unintentional injuries) 7,137 52% • Assault (homicide) 1,892 14% • Intentional self-harm (suicide) 1,513 11% _______________________________________________ Total 10,542 77%

  5. Years of Potential Life Lost (YPLL) Before Age 75, United States, 2002 YPLL% • Accidents (unintentional injuries) 2,931,56515% • Assault (homicide) 940,781 5% • Intentional self-harm (suicide) 749,521 4% _________________________________________________________________________ Total 4,621,867 24%

  6. Mortality in Job Corps PY01 to PY04 (1st 45 weeks) – 82 deaths • Unintentional injury 32/82 39% • Homicide 18/82 22% • Medical 15/82 18% • Suicide 10/82 12% • Drugs/alcohol 4/82 5% • Unknown 3/82 4%

  7. Mortality in Job Corps PY01 to PY04 (1st 45 weeks) – 82 deaths • Unintentional injury 32/82 39% • Homicide 18/82 22% • Medical 15/82 18% • Suicide 10/82 12% • Drugs/alcohol 4/82 5% • Unknown 3/82 4%

  8. Medical Mortality in Job Corps PY01 to PY04 (1st 45 weeks) – 15 deaths • Cardiac disease 4 • Asthma 3 • Meningitis 2 • Seizure disorder 1 • Sickle cell disease 1 • Bronchopneumonia 1 • Blood disorder 1 • Pulmonary embolism 1 • Complication of surgery 1

  9. Mortality in Job Corps PY01 to PY04 (1st 45 weeks) – 82 deaths Male* 61/82 74% Female 21/82 26% Off Center 68/82 83% On Center 14/82 17% *Male deaths in PY0424/27 89%

  10. Actual causes of death: US population, total, 2000 RankCause# deaths% total 1st tobacco 435,000 18.1 2nd diet/inactivity 365,000 15.2 3rd alcohol consumption 85,000 3.5 6th motor vehicles 43,000 1.8 7th firearms 29,000 1.2 8th sexual behavior 20,000 0.8 9th illicit drug use 17,000 0.7 Ref: Mokdad AH et al. JAMA 291:1238 Mar 10, 2004; rev Jan 19, 2005

  11. Prevalence of cigarette smoking,US high schools, 2004 GradeLifetime30 dayDaily 8th 28% 9% 4% 10th 41% 16% 8% 12th 53% 25% 16% Ref: 2004 MTF

  12. Smoking affects employability!

  13. bladder cancer cervical cancer esophageal cancer gastric cancer laryngeal cancer leukemia lung cancer oral cancer pancreatic cancer renal cancer Surgeon General’s Report: 2004 “The evidence is sufficient to infer a causal relationship between smoking and . . .”

  14. aortic aneurysm atherosclerosis stroke coronary heart disease COPD pneumonia impaired lung growth in childhood and adolescence early onset of declining lung function in late adolescence respiratory symptoms in childhood and adolescence Surgeon General’s Report: 2004 “The evidence is sufficient to infer a causal relationship between smoking and . . .”

  15. Morbidity in Job Corps Tobacco Use on Center and off Center

  16. Obesity Trends* Among U.S. AdultsBRFSS, 1991-2002 1991 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) 2002 No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

  17. Morbidity Associated with Obesity • type 2 diabetes mellitus • hypertension • hyperlipidemia • cardiovascular disease • osteoarthritis • gallbladder disease • sleep apnea • breast and colon cancer

  18. Morbidity in Job Corps Overweight and Inactivity: Pilot Study Results Grafton Job Corps Center – Winter 2004

  19. Medical Program Goals • Implement case management for all Job Corps students with chronic illness • Launch a center-based asthma management initiative in 2005 • Strengthen the Job Corps Tobacco Use Prevention Program (TUPP) • Strengthen the Job Corps Weight Improvement Program (WIP)

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