evidence based practice

By: Kelly & Suyash

Life expectancy would grow by leaps and bounds if green vegetables smelled as good as bacon. 

~Doug Larson

IMA: Infant Mortality Awareness

A Systematic Approach to Health Improvement:

Healthy People 2010 is about improving health of individual, communities, and of the Nation.

The Healthy People 2010 goals and objectives cannot by themselves improve the health status of the Nation.

Instead, they need to be recognized as part of a larger, systematic approach to health improvement.

This systematic approach to health improvement is composed of four key elements:

GoalsObjectivesDeterminants of HealthHealth aspects

Healthy People 2010 Goals Goal 1:

Increase Quality and Years of Healthy LifeLife ExpectancyQuality of LifeAchieving a Longer and Healthier Life—the

Healthy People Perspective

Goal 2: Eliminate Health Disparities

 Gender Race and Ethnicity Income and Education Disability Geographic Location  Sexual Orientation

 Healthy People 2010 is firmly dedicated to the principle that—regardless of age, gender, race or ethnicity, income, education, geographic location, disability, and sexual orientation—every person in every community across the Nation deserves equal access to comprehensive, culturally competent, community-based health care systems that are committed to serving the needs of the individual and promoting community health.

ObjectivesThe Nation’s progress in achieving the two goals

of Healthy People 2010 will be monitored through 467 objectives in 28 focus areas.

Many objectives focus on interventions designed to reduce or eliminate illness, disability, and premature death among individuals and communities.

Others focus on broader issues, such as improving access to quality health care, strengthening public health services, and improving the availability and dissemination of health-related information.

Each objective has a target for specific improvements to be achieved by the year 2010

Healthy People 2010Focus Areas1.  Access to Quality Health Services.2.  Arthritis, Osteoporosis, and Chronic

Back Conditions3.  Cancer4.  Chronic Kidney Disease5.  Diabetes6.  Disability and Secondary Conditions7.  Educational and Community-Based

Programs

Healthy People 2010Focus Areas8. Environmental Health9.  Family Planning10. Food Safety11. Health Communication12. Heart Disease and Stroke13. HIV

Healthy People 2010Focus Areas14. Immunization and Infectious

Diseases15. Injury and Violence Prevention16. Maternal, Infant, and Child Health17.  Medical Product Safety18.  Mental Health and Mental Disorders19.  Nutrition and Overweight20.  Occupational Safety and Health21.  Oral Health

Healthy People 2010Focus Areas22.  Physical Activity and Fitness23.  Public Health Infrastructure24.  Respiratory Diseases25.  Sexually Transmitted Diseases26.  Substance Abuse27.  Tobacco Use28.  Vision and Hearing

Determinants of Health

Individual biology and behaviors influence health through their interaction with each other and with the individual’s social and physical environments.

Policies and interventions can improve health by targeting factors related to individuals and their environments, including access to quality health care.

Access to quality health care. Expanding access to quality health care is important to eliminate health disparities and to increase the quality and years of healthy life for all people living in the United States.

Health Status

To understand the health status of a population, it is essential to monitor and evaluate the consequences of the determinants of health.

description of the health of the total population, using information representative of most people living in this country.

Health status can be measured by birth and death rates, life expectancy, quality of life, morbidity from specific diseases, risk factors, use of ambulatory care and inpatient care, accessibility of health personnel and facilities, financing of health care, health insurance coverage, and many other factors.

Determinants of health

Health statusHealth status can be measured by:

birth and death rates,

life expectancy,

quality of life,

morbidity from specific diseases,

risk factors,

Health Status

use of ambulatory care and inpatient care,

accessibility of health personnel and facilities,

financing of health care,

health insurance coverage,

and many other factors.

Health Status The information used to report health status

comes from a variety of sources, including birth and death records; hospital discharge data; and health information collected from health care records, personal interviews, physical examinations, and telephone surveys.

These measures are monitored on an annual basis in the United States and are reported in a variety of publications, including Health, United States and Healthy People Reviews

Health Status:

These measures are monitored on an annual basis in the United States and are reported in a variety of publications, including Health, United States and Healthy People Reviews

The leading causes of death are used frequently to describe the health status of the Nation.

Leading Causes of Death, 1997 1900

Application of Healthy People 2010

“The public health approach to eliminating disparities in health”, American Journal of Public Health, David Satcher, MD, PhD, and Eve J. Higginbotham, MD 2008(march)

Reducing & Eliminating Disparities in healthTwo successful programsPublic health approach

The issue of disparitiesDisparities in health among different racial, ethnic, and

socioeconomic groups in the U.S. : A serious threat Access to quality health care : Accounts for only 15-20

% of the variation in morbidity and mortalityOther determinants of health : Environment, biology,

genetics, and human behaviorHealth promotion & Disease prevention: Cost

effective, more humaneA public health-oriented strategy : Successful in the

long term

Problems and GoalsHealth disparities among minorities : Higher infant

mortality, premature death rates & disease burden, lower quality of health care

A goal of Healthy People 2010 : The president and surgeon general first announced a

national goal of eliminating disparities in health (1998).

The goal remained a national concernThe Institute of Medicine report Unequal Treatment:

Confronting Racial and Ethnic Disparities in Health Care

A public health framework for health disparitiesPhysical and social environments20-25 % of the variations in morbidity and mortalityExposed to severe violence, toxic waste Nature & human-made disasters Biology and geneticsGenetics : 20-25% of variations in morbidity and

mortalityHuman behavior :Lifestyle practices : More than 40% of variations in health

outcomes

The Action for Healthy Kids Program Former surgeon General David Satcher and First lady

Laura Bush started the Action for Healthy Kids program in 2002.

The goal of the initial conference: Follow on The Surgeon General’s Call to Action in Prevent and Reduce Overweight and Obesity (2001)

A nationwide program to fight obesity : Potential role of schools in combating obesity

All 50 states and the District of Columbia had Action for Healthy Kids programs

The Action for Healthy Kids Program Schools: Appropriate settings53 million children attend school each dayProvide opportunities for children to improve their lives

and futuresProvide the opportunity for children to adopt healthy

lifestyles of nutrition and fitnessChildren who ate breakfast and were physically fit :

Performed better on standardized exams, attended school more regularly, and concentrated on their work better

Children who were overweight and obese: Higher prevalence of depression and school absenteeism

The Action for Healthy Kids Program Schools & Districts: Enhancing the content, frequency, and quality of their

physical education programs Developing model nutrition programs : Changing the

content of vending machines & altering school mealsA major boost : Congress passed the Wellness Act of

2004Reaching out to parents and communitiesAction for Healthy Kids reports: More than 70 % of school districts: Developed policiesMinority and lower socio-economic-status children in

public schools

The 100 Black Men Health Challenge Started in 2002 with the Atlanta chapter of 100 Black

Men African American men: Being ill and dying before the

age of 70 even in higher socioeconomic groupsThe 100 Black Men America Inc: Organization of professional men who are of higher

socioeconomic status Committed to mentoring, tutoring, and supporting

children & their families in lower socio-economic communities

Encouraging children to succeed academicallyGuaranteeing scholarships for college

The 100 Black Men Health Challenge The success of this program is documented in Project

Success: Doing the Right Thing for the Right Reason Widely touted in the mediaConcern was first with the members of 100 Black

Men themselvesSuffered highly from health disparities, especially in

cardiovascular disease, diabetes, and cancer

The 100 Black Men Health Challenge Three Major personal health goals:Regular physical activity and good nutritionSmoking cessation program Regularly visiting a primary care provider: screened quarterly

for weight, nutrition, physical activity, and prostate healthSuccessful program :Interventions targeting African American menIncorporating healthy lifestyle modeling and education for

their menteesImprove their community environments and support

opportunities for healthy lifestyles

Healthy Kids & The 100 Black Men health ChallengeReduce disparities and risk factors & improve

learning among childrenThe Action for Healthy Kids program: Implemented

nationallyThe 100 Black Men health Challenge:Ultimately, to the more than 100 chapters nationwide Strong support and funding for the national

leadership of 100 Black Men

Population-Based Prevention Effective in reducing disparitiesPopulation-based prevention: Less than 3% of health

budget Treating diseases & complications: More than 90% Available to all populationsLeaders who care enough, know enough, will do

enough, and are persistent enough

Reference:

www.healthypeople.govwww.actionforhealthykids.orgwww.100blackmen.orgDavid Satcher, EveJ. Higginbotham. (2008).

The public Health Approach to Eliminating Disparities in Health. American Journal of Public Health. 98(3), 400-404.

Activities:

What are the goals of systematic approach to health improvement?

Goal 1: Increase Quality and Years of Healthy Life

Goal 2: Eliminate Health Disparities

How many focus areas and objectives are there in Healthy People 2010?

467 objectives in 28 focus areas.