NYS Prevention Agenda 2013-2018: Progress Toward Becoming the Healthiest State June 2, 2017 Presentation to the NYS Oral Health Coalition Sylvia Pirani, Director, Office of Public Health Practice
Prevention Agenda 2013-2018 Goal is improved health status of New Yorkers and reduction in health disparities through increased emphasis on prevention. Call to action to broad range of stakeholders to collaborate at the community level to assess local health status and needs; identify local health priorities; and plan, implement and evaluate strategies for local health improvement. Incorporated into NYS Health Care Reform Efforts (DSRIP, SIM, PHIPs) 2
Steered by Ad Hoc Leadership Group Collaborative effort led by committee appointed by Public Health and Health Planning Council, including leaders from Healthcare, Business, Academia, CBOs, Local Health Departments, and other State Agencies including OMH and OASAS. Final Priorities based on active participation from members of committee and stakeholder feedback. 3
Five Prevention Agenda Priorities 1. Prevent chronic diseases 2. Promote a healthy and safe environment 3. Promote healthy women, infants and children 4. Promote mental health and prevent substance abuse 5. Prevent HIV, sexually transmitted diseases, vaccine-preventable diseases and healthcare associated infections 4
Prevention Agenda 2013-2018 Prevention Agenda Dashboard measures progress on 96 statewide outcome indicators, including reductions in health disparities. As of December 2016: 34 indicators show progress (28 with significant improvement) Preventable Hospitalizations Rate Asthma Related Hospitalizations Tobacco Use 51 not met and staying the same 11 not met and going in wrong direction 5 3 Progress on 96 Prevention Agenda Indicators 8 1 7 Improved Worsened Unchanged No Data 3 11 2 3 8 7 4 2 8 4 12 7 1 https://health.ny.gov/preventionagendadashboard Improve Health Status Promote a Healthy and and Reduce Health Safe Environment Disparities Prevent Chronic Disease Prevent HIV/STDs, Vaccine Preventable Diseases and HAI's Promote Healthy Women, Infants, and Children Promote Mental Health and Prevent Substance Abuse 5
Promote Healthy Women Infants and Children Focus Area: Child Health Goal: Reduce prevalence of dental caries among NYS children Objectives: By December 31, 2018: reduce the prevalence of tooth decay among NYS children by at least 10%. increase the proportion of NYS children who have protective dental sealants by at least 10%. increase the proportion of NYS children who receive regular dental care by at least 10%. increase the percentage of NYS population receiving fluoridated water by 10%. strengthen systems to improve the oral health of people with special health needs. 6
Interventions by Health Impact for Oral Health Increasing Individual Effort Needed Increasing Population Impact Counseling & Education Clinical Interventions Long-Lasting Protective Interventions Changing the Context to Make Individuals Default Decisions Healthy Improve education increase marketing on oral health Integrate oral health preventive practices into pediatric primary care Require dental exams as part of school and head start examinations Maintain and expand fluoridation; promote healthy school lunch and prohibit vending machines Socio-economic Factors Poverty, education, dental health insurance Frieden T., A Framework for Public Health Action: The Health Impact Pyramid. American Journal of Public Health. 2010; 100(4): 590-595 7
Prevention Agenda 2013-2018 Oral Health Objectives https://health.ny.gov/preventionagendadashboard 8
Percentage of NYS Medicaid Enrollees ages 2-20 with at least one preventive dental visit within the last year https://www.health.ny.gov/statistics/chac/general/g119_999.htm 9
2016-2018 Community Health Improvement Planning Cycle 127 plans received by 58 LHDs and 167 Hospitals
Percent 100 Priority Areas chosen by local health departments and hospitals, December 2016 99 98 % % 90 80 83 % 70 72% 60 50 40 30 20 24 % 29 % 10 10 % 7 % 10 % 0 Prevent Chronic Diseases Promote a Healthy and Safe Environment Promote Healthy Women, Infants and Children LHD Hospitals Promote Mental Health and Prevent Substance Abuse 0 % Prevent HIV/STDs, VPDs and HAIs LHD n=57 Hospitals n=166 LHD n=6 Hospitals n=12 LHD n=14 Hospitals n=48 LHD n=48 Hospitals n=121 LHD n=0 Hospitals n=17 TOTALS: LHD n=58 Hospitals n=167 NOTE: Organizations often indicated working in more than one priority area 11
Percent 90 80 Promote Healthy Women, Infants, and Children focus areas among local health departments and hospitals, December 2016 86 % 79 % 70 60 50 40 30 20 29 % 21 % 25 % 10 12 % 0 LHD n=14 Hospitals n=48 Maternal and Infant Health Child Health Reproductive, Preconception and Inter-Conception Health LHD Hospitals NOTE: Organizations often indicated working in more than one focus area in each of their chosen priority areas 12
Percent 100 Promote a Healthy and Safe Environment focus areas among local health departments and hospitals, December 2016 100 % (n=6) 90 92 % (n=11) 80 70 60 50 40 30 25 % (n=1) 20 10 9 % (n=1) 0 Air Quality Water Quality Built Environment Injury Prevention LHD n=6 Hospitals n=12 LHD Hospitals NOTE: Organizations often indicated working in more than one focus area in each of their chosen priority areas 13
Percent 90 Preventing Chronic Disease focus areas among local health departments and hospitals, December 2016 80 70 82 % 67 % 74 % 69 % 60 50 40 30 33 % 30 % 20 10 0 LHD n=57 Hospitals n=166 Reduce obesity in children and adults NOTE: Organizations often indicated working in more than one focus area in each of their chosen priority areas Reduce illness, disability and death related to tobacco use and secondhand smoke exposure LHD Hospitals Increase access to high quality chronic disease preventive care and management in both clinical and community settings 14
Percent Promote Healthy Women, Infants, Children Goals, December 2016 45 43% 43% 40 39% 35 35% 30 29% 25 21% 20 15 14% 10 7% 8% 8% LHD n=14 Hospitals n=48 5 0 Reduce premature births Increase the proportion of NYS babies breastfed NOTE: Organizations often indicated working in more than one focus area in each of their chosen priority areas 2% Reduce the rate of maternal deaths LHD Increase proportion of children who receive comprehensive wellchild-care Hospital Reduce the prevalence of dental caries among NYS children Prevention of unintended and adolescent pregnancy 15
May 12, 2017 16 Digging deeper into reports 8 organizations indicate working to reduce dental caries 4 LHDs 4 Hospitals Interventions/strategies include: Integrate oral health preventive practices, such as fluoride varnish, into pediatric primary care n=3 LHDs n=2 hospitals Integrate oral health messages across all providers and programs that serve children including child care, WIC and home visiting n=1 LHD n=1 hospital 16
May 12, 2017 17 NYS Health Improvement Plans Prevention Agenda 2008-2012 -10 Priorities - Focused on Prevention and Access to Health Care -Fostered local collaboration -Implementation of Local Action Plans Challenging -5 Priorities Prevention Agenda 2013-2018 -Focus on Health Disparities and Social Determinants through Health Pyramid lens -Broad based state and local involvement in development of goals, priorities, action plans -Implementation of evidence based actions -Dashboard to visualize results -Alignment with health care reform - Focus on Health Across all Policies and Healthy Aging Prevention Agenda 3.0 2019-2024 17
May 12, 2017 18 Questions? https://www.health.ny.gov/prevention/prevention_agenda/2013-2017/ prevention@health.ny.gov 18