Transcript New Jersey Department of Health and Senior Services
HEALTHY NEW JERSEY 2010
NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES Rose Marie Martin. MPH Research Scientist, NJDHSS, Division of Aids Prevention and Control JULY 2003
What is Healthy New Jersey 2010?
New Jersey’s health promotion and disease prevention initiative
Proposes year 2010 targets for 150 measurable health objectives
What is Healthy New Jersey 2010?
Provides comprehensive tracking of NJ residents’ health
Will be updated at least twice to measure progress
There are brief updates each year in the annual health statistics report
ORGANIZED INTO HEALTH AREAS
WHO WE ARE
OVERALL HEALTH STATUS
ACCESS TO HEALTH CARE
FUNDAMENTALS OF GOOD HEALTH
ORGANIZED INTO HEALTH AREAS (CONTINUED)
PREVENTING AND REDUCING MAJOR DISEASES
STRENGTHENING PUBLIC HEALTH CAPACITY
APPENDICES
FUNDAMENTALS OF GOOD HEALTH:
ENVIRONMENTAL HEALTH
HEALTHY MOTHERS & YOUNG CHILDREN
HEALTHY BEHAVIORS - ADOLESCENTS
HEALTHY BEHAVIORS - ADULTS
OCCUPATIONAL HEALTH AND SAFETY
UNINTENTIONAL INJURY
PRESERVING GOOD HEALTH FOR SENIORS
PREVENTING AND REDUCING MAJOR DISEASES
HEART DISEASE AND STROKE DIABETES CANCER HIV/AIDS MENTAL HEALTH ADDICTIONS ASTHMA INFECTIOUS DISEASES SEXUALLY TRANSMITTED DISEASES
DEVELOPMENT OF HNJ2010
AN INTER-DEPARTMENTAL WORK GROUP DEVELOPED THE ORIGINAL DRAFT THREE PUBLIC MEETINGS WERE HELD TO SEEK INPUT WRITTEN COMMENTS WERE SOLICITED FROM HEALTH PROFESSIONALS AND THE PUBLIC
Framework of Healthy New Jersey 2010
Two overarching goals: - Increase health-related quality and years of life - Eliminate health disparities based on race/ethnicity
These goals are identical in HNJ2010 and HP2010
New Jersey’s Diversity: A Public Health Challenge for 2010
Population (2000) Population Density (2000) (persons/square mile) Median Age (2000) New Jersey 8,414,350 1,134.4
36.7
United States 281,421,906 79.6
35.3
Percentage Age > 65 Years (2000) 13.2 12.4
Age > 85 Years (2000) 1.6 1.5 Percentage of Population Male/Female (2000) 48.5/51.5 49.1/50.9
Percentage of Population Below Poverty Level (2000) 8.5
Percentage of School/aged Related Children Below Poverty Level (2000) 10.5
12.4
15.4
Percentage of Live Births to Females Aged 10-17 Years (1997) 3.0 4.9
New Jersey’s Diversity (cont.)
Number of Counties Number of Local Health Departments Racial Distribution of Population (2000) Percentage White non-Hispanic Percentage Black non-Hispanic Percentage Asian/PI non-Hisp Percentage non-Hispanic Other Percentage Hispanic Educational Attainment (2000) (Age > 25 Years) High School Graduate or More Completed Bachelor’s Degree or More 21 113 3,136 2,918 66.0
69.1
13.0 12.1
5.7
3.7
1.9
13.3
2.5
12.5
82.1
29.8
80.4
24.4
Healthy Life Expectancy at Birth in Years New Jersey, 1996-1998 80 70 60 50 40 30 20 10 0 69.6
67.1
55.2
53.9
66.3
White femalesWhite males Black femalesBlack males Total
Target Setting
Healthy New Jersey indicators identify specific, measurable targets and preferred endpoints
5 major health areas - Overall Health Status - Access to Health Care - Fundamentals of Good Health - Preventing and Reducing Major Diseases - Strengthening Public Health Capacity
RACIAL DISPARITY IN HEALTH OUTCOMES
The Debate - Balance strong community support to eliminate disparities against community’s support for realistic, achievable targets for 2010 - Recognize multiple factors contributing to disparities
The Decision - Two targets
1. Narrows the gap (target) based on trend data, scientific/medical knowledge and current activities
2. Eliminates the gap (Preferred 2010 endpoint) in most cases
How can Healthy New Jersey 2010 be used?
Planning resource: - State and local health agencies - Private health organizations-providers, community based organizations, consumer groups, advocacy groups Educational resource - Provides health status for New Jersey residents
HEALTHY NJ 2010 Infrastructure and the Internet
HNJ 2010 in print and on the Web Provides specific references to data sources Provides descriptions of data sources Links to departmental databases Interdecade updates - not only data updates, but also programmatic initiatives. Will recognize community members (Future) Web - link to HP2010 and other states’ activities related to 2010 objectives
Web page: www.state.nj.us/health/chs/hnj.htm
Update Healthy New Jersey 2000 - Second Update and Review Assessment of progress made toward achieving the State's health objectives for 2000. Healthy New Jersey 2010 State Health Issues Opinion Survey 1999 Results of a public opinion poll conducted by the Eagleton Institute regarding New Jersey residents' views on health issues.
Healthy New Jersey 2010 (June 2001) Volume I (PDF 828K) Healthy New Jersey 2010 (June 2001) Volume II (PDF 766K) Baseline data for the State's health objectives for 2010.
SOURCES OF DATA FOR HEALTHY NEW JERSEY 2010
Healthy New Jersey 2010 Data Sources by Number of Objectives Tracked Data System/Source
Vital Statistics System – Mortality Behavioral Risk Factor Surveillance System Vital Statistics System – Natality NJDHSS Office Of Local Health UB-92 Hospital Discharge File New Jersey Department of Environmental Protection NJDHSS Communicable Disease Service Sexually Transmitted Diseases Management Information System NJDHSS Aids Registry NJDHSS Long Term Care Systems Development Minimum Data Set NJDHSS Occupational Disease and Injury Services NJDHSS Communities That Care Middle School Survey NJDHSS Cancer Registry NJDHSS Consumer And Environmental Health New Jersey Department of Human Services, Division of Mental Health Services New Jersey Department of Education, Division of Academic Programs and Standards HEDIS U.S. Bureau of the Census Current Population Survey
Number of Objectives Tracked*
31 1/ 23 10 7 6 5 5 5 5 4 4 4 4 4 3 3 2
Healthy New Jersey 2010 Data Sources by Number of Objectives Tracked (con’t)
NJDHSS Lead Surveillance System 2 New Jersey Department of Law and Public Safety NJDHSS Family Health Services NJDHSS Communicable Disease Service NETSS NJDHSS Communicable Disease Service Tuberculosis Information System (TIMS) NJDHSS Health Information Steering Committee NJDHSS WIC Program CDC Immunization Survey NJDHSS New Jersey Immunization Information System NJDHSS TBI Surveillance System NJDHSS Survey of Child Bearing Women NJDHSS Division of Consumer Support Trans-Atlantic Renal Council New Jersey Department of Law and Public Safety Division of Highway Traffic Safety New Jersey Institute of Technology NJDHSS Emergency Room Data File** NJDHSS Office of Information Technology Services NJDHSS Center for Health Statistics 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 29 objectives tracked through the state’s single cause of death file and two through the multiple cause of-death file.
* Preliminary count. Includes sources of data for tracking developmental objectives.
** Data source under development.
I.3 Healthy New Jersey 2010 Objectives Using BRFSS As Measurement 2002 BRFSS Questionnaire Objective Number Chapter Overall Health Status Statement of Objective % of persons 18+ reporting good, very good or excellent health I.4 2.3 Overall Health Status Days able to do usual activities within past 30 days, population 18+ Access to Health Care % of adults who report they have a source of primary care 2.4 3D.1 3D.2 3D.3 3D.4 3F.2 3G.2 3G.3 Access to Health Care % of 18+* who visit a dentist or dental clinic each year Healthy Behaviors – % 18+ eating at least 5 daily servings of Adults Healthy Behaviors Adults – Healthy Behaviors – fruits & vegetables (inc. legumes) % 18+ who are overweight but not obese % 18+ who are obese Adults Healthy Behaviors – Adults % 18+ who participated in frequent, leisure time physical activity during the past month Unintentional Injury Preserving Good Health for Seniors Preserving Good Health for Seniors % 18+ who use seat belts in automobiles % non-institutionalized 65+ reporting fair or poor health status % non-institutionalized 65+ who have ever had pneumococcal vaccination Core Core Core Core Core Core Core Core Location in BRFSS Module 6, Q.3, Quality of Life (Converse) Core Module 4, Physical Activity
3G.4
4A.3
4B.5
4B.8
4C.2
4C.5
4C.10
4E.1
4F.5
4F.6
Preserving Good Health for Seniors Heart Disease and Stroke Diabetes Diabetes Cancer Cancer Cancer Mental Health Addictions Addictions % non-institutionalized 65+ who had influenza vaccination < past 12 months % 18% who have had their blood cholesterol checked by a health professional < 5 years % 18+ with diagnosed diabetes who have had a dilated eye exam < 1 year % 18+ with diagnosed diabetes who report having a glycosylated hemoglobin measurement at least once a year % females 40+ who had a clinical breast exam & mammogram < 2 years % females 18+ with intact cervix uteri who had Pap test < 2 years % 50+ who had a fecal occult blood test < 1 year and/or have ever had sigmoidoscopy Average number of days < past 30 when mental health was good Prevalence of cigarette smoking among 18+ % 18+ who consumed 5+ alcoholic drinks per occasion, one+ time < month Core Module 3, Cholesterol Awareness, Q’s 1 and 2 Module 1, Diabetes, Q. 10 Module 1, Diabetes, Q. 8 Core Core Core (includes colonoscopy) Module 5, Mental Health, Q.2
(converse) Core Core *Total population = dentate population + edentulous patients Revised 10/17/01
WHAT IS AN OBJECTIVE?
FORMAT FOR A MEASURABLE HEALTH OBJECTIVE
:
1. WHAT CHANGE (IMPROVEMENT) WILL OCCUR?
2. WITHIN WHAT POPULATION AND AT WHAT RATE WILL THE CHANGE OCCUR?
3. WHAT IS THE TARGET DATE FOR THE EXPECTED CHANGE?
EACH OBJECTIVE HAS FOR THE TOTAL POPULATION AND EACH SUB-POPULATION:
BASELINE DATA FROM THE MOST RECENTLY AVAILABLE YEAR
TARGET AND PERCENT CHANGE
PREFERRED 2010 ENDPOINT AND PERCENT CHANGE
STATEMENT OF A TYPICAL OBJECTIVE FROM HNJ2000: INCREASE IMMUNIZATION LEVELS FOR MEASLES (RUBEOLA) IN CHILDREN BY AGE TWO TO 90.0 PERCENT BY 2000
A RELATED OBJECTIVE EXPANDED TO COVER OTHER IMMUNIZATIONS WAS INCLUDED IN HEALTHY NEW JERSEY 2010: BY 2010 INCREASE THE PERCENTAGE OF TWO YEAR OLD CHILDREN RECEIVING DTaP, POLIO, MMR, HiB, AND HEPATITIS B VACCINES, SEPARATELY AND AS PART OF THE 4-3-1 SERIES TO 90.0 PERCENT ALL CHILDREN <= AGE 2 - 90.0% MCO ENROLLEES <= AGE 2 - 90.0 %
COLLECTION OF DATA FOR FIRST UPDATE TO HNJ2010
PLANNED FOR COMPLETION IN LATE 2003
TARGETS, PREFERRED 2010 ENDPOINTS AND BASELINES WILL HAVE TO BE ADJUSTED, IN SOME CASES
DATA SOURCES FOR DEVELOPMENTAL OBJECTIVES WILL NEED TO BE IDENTIFIED
SELECTED HIGHLIGHTS FROM THE FINAL UPDATE TO HEALTHY NEW JERSEY 2000
MEASURING PROGRESS TOWARD HEALTHY NEW JERSEY 2000 TARGETS
Progress Quotient = most recent value - baseline value x 100 year 2000 target - baseline value
FINAL STATUS FOR OBJECTIVES RELATED TO BIRTHS TO ADOLESCENTS HEALTHY NEW JERSEY 2000 BIRTH RATE TO TOTAL FEMALES 10-14 YEARS BIRTH RATE TO MINORITY FEMALES 10-14 YEARS BIRTH RATE TO TOTAL FEMALES 15-19 YEARS BIRTH RATE TO MINORITY FEMALES 15-19 ADOLESCENT FEMALES WHO RECEIVE FAMILY PLANNING SERVICES % TARGETED IMPROVEMENT ACHIEVED
FINAL STATUS FOR OBJECTIVES RELATED TO SUBSTANCE USE BY ADOLESCENTS HEALTHY NEW JERSEY 2000 % HIGH SCHOOL STUDENTS CURRENTLY SMOKING CIGARETTES % HIGH SCHOOL STUDENTS WHO USED ALCOHOL IN THE PAST 30 DAYS % HIGH SCHOOL STUDENTS WHO USED MARIJUANA IN THE PAST 30 DAYS % HIGH SCHOOL STUDENTS WHO USED COCAINE IN THE PAST 30 DAYS -400 -300 -200 -100 0 % TARGETED IMPROVEMENT ACHIEVED 100
FINAL STATUS FOR OBJECTIVES RELATED TO INJURIES IN ADOLESCENTS HEALTHY NEW JERSEY 2000 DEATH RATE IN 15-19 YEAR OLDS CAUSED BY MOTOR VEHICLE INJURIES SUICIDE DEATH RATE IN WHITE MALES 15-19 HOMICIDE DEATH RATE IN MINORITY MALES 15-19 ALCOHOL-RELATED MOTOR VEHICLE DEATH RATE IN 15-19 YEAR OLDS 0 200 400 600 800 % TARGETED IMPROVEMENT ACHIEVED 1000
FINAL STATUS FOR OBJECTIVES TO PREVENT, DETECT AND CONTROL CANCER HEALTHY NEW JERSEY 2000 1000 HEALTHY NEW JERSEY 2000 2.9
19 TOTAL POPULATION 1.7
37 FEMALE BREAST CANCER DEATH RATE - 50-64 YEAR OLDS FEMALE BREAST CANCER DEATH RATE - 65+ YEAR OLDS .5
43 86 AGE-ADJUSTED TOTAL LUNG CANCER DEATH RATE - NOT CALCULATED AGE-ADJUSTED LUNG CANCER DEATH RATE- MINORITY MALES 3.1
82 SMOKING PREVALENCE IN ADULTS 20+ .4
SMOKING PREVEALENCE IN HIGH SCHOOL STUDENTS 9.6
AVERAGE DAILY SERVINGS OF FRUITS AND VEGETABLES AGE-ADJUSTED TOTAL CERVICAL CANCER DEATH RATE AGE-ADJUSTED MINORITY CERVICAL CANCER DEATH RATE CERVICAL CANCER DEATH RATE IN WOMEN 65+ 90 .3
56 .3
23 25 19 % WOMEN WHO HAD A PAP SMEAR IN THE PAST TWO YEARS % MINORITY WOMEN WHO HAD A PAP SMEAR IN THE PAST TWO YEARS % WOMEN 65+ WHO HAD A PAP SMEAR IN THE PAST TWO YEARS 4.6
800 600 D VE IE CH A NT ME VE RO 400 MP D I TE GE AR 200 % T 0 8.7
-2 6.2
-1 9.1
-3 -200
4Ai. AGE-ADJUSTED FEMALE BREAST CANCER DEATH RATE NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVE 0 1990 5 10 15 20 25 30 SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS YEAR 1995 YEAR 2000 OBJECTIVE 2000
4Aii. FEMALE BREAST CANCER DEATH RATES BY AGE NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVES DEATH RATE - FEMALES 65 & OVER 100 120 140 160 180 0 1990 20 40 60 80 DEATH RATE - FEMALES 50-64 SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS YEAR 1995 YEAR 2000 OBJECTIVE - FEMALES 65 & OVER YEAR 2000 OBJECTIVE - FEMALES 50-64 2000
60 70 80 90 100 30 40 50 0 1991 10 20 4B. WOMEN AGED 40 AND OVER WHO RECEIVED A CLINICAL BREAST EXAMINATION AND A MAMMOGRAM WITHIN THE PAST YEAR NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVE 1994 1997 2000 YEAR 2000 OBJECTIVE
SOURCE: NEW JERSEY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM
4C. AGE-ADJUSTED LUNG CANCER DEATH RATES, TOTAL AND MINORITY MALES NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVES 0 1990 YEAR 1995 2000 YEAR 2000 OBJECTIVE - MINORITY MALES 10 DEATH RATE - MINORITY MALES 20 30 YEAR 2000 OBJECTIVE - TOTAL DEATH RATE - TOTAL 40 50 60 70 80 SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS
20 25 30 35 40 45 5 10 15 0 4Dii. PREVALENCE OF CIGARETTE USE* AMONG HIGH SCHOOL STUDENTS NEW JERSEY, 1989-1998 AND YEAR 2000 OBJECTIVE 1989 1992 1995 1998 2000
YEAR 2000 OBJECTIVE SOURCE: SURVEY REPORTS -"DRUG AND ALCOHOL USE AMONG NEW JERSEY HIGH SCHOOL STUDENTS" *INCLUDES THOSE WHO SMOKE ON OCCASION AS WELL AS REGULAR SMOKERS
4Di. PERSONS AGED 20 AND OVER WHO ARE CURRENTLY SMOKING CIGARETTES NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVE 2000 0 1991 5 10 15 20 25
SOURCE: BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM
1995
YEAR 2000 OBJECTIVE
4E. AGE-ADJUSTED COLORECTAL CANCER DEATH RATE NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVE 1990 0 16 18 2 4 6 12 14 8 10 SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS YEAR 1995 ORIGINAL YEAR 2000 OBJECTIVE 2000 REVISED YEAR 2000 OBJECTIVE
4F. AVERAGE DAILY SERVINGS OF FRUITS AND VEGETABLES* IN THE POPULATION AGED 18 AND OVER NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVE 2 3 0 1991 1 1994 4 5 6 SOURCE: NEW JERSEY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM * NOT INCLUDING FRENCH FRIES, FRIED POTATOES OR POTATO CHIPS 1997 YEAR 2000 OBJECTIVE 2000
4Gi. AGE-ADJUSTED CERVICAL CANCER DEATH RATES NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVES 6 7 2 3 4 5 0 1990 1 MINORITY TOTAL YEAR 1995 YEAR 2000 OBJECTIVE-MINORITY SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES, CENTER FOR HEALTH STATISTICS 2000 YEAR 2000 OBJECTIVE-TOTAL
4Gii. CERVICAL CANCER DEATH RATE, AGED 65 AND OVER NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVE YEAR 1995 0 1990 2 4 6 8 10 12 SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS YEAR 2000 OBJECTIVE 2000
4H. WOMEN WITH UTERINE CERVIX WHO HAVE HAD A PAP SMEAR DURING THE PAST TWO YEARS NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVES 10 20 30 0 1991 1994 TOTAL MINORITY 65+ YEAR 2000 OBJECTIVE - TOTAL & MINORITY 1997 40 50 60 70 80 90 SOURCE: NEW JERSEY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM NOTE: MINORITY YEAR 2000 OBJECTIVE WAS REVISED 12/03/93 FROM 80% TO 85% YEAR 2000 OBJECTIVE WOMEN AGED 65+ 2000
4Hi. WOMEN WITH UTERINE CERVIX WHO HAVE HAD A PAP SMEAR DURING THE PAST TWO YEARS, BY RACE NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVES MINORITY 0 1991 10 1994 1997 20 30 40 50 60 70 80 90 SOURCE: NEW JERSEY BEHAIORAL RISK FACTOR SURVEILLANCE SYSTEM NOTE: MINORITY YEAR 2000 OBJECTIVE WAS REVISED 12/03/93 FROM 80% TO 85% 2000
4Hii. WOMEN 65+ WITH UTERINE CERVIX WHO HAVE HAD A PAP SMEAR DURING THE PAST TWO YEARS NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVES 2000 20 30 40 0 1991 10 50 60 70 80 1994 1997 YEAR 2000 OBJECTIVE SOURCE: NEW JERSEY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM NOTE: MINORITY YEAR 2000 OBJECTIVE WAS REVISED 12/03/93 FROM 80% TO 85%