Transcript Slide 1

Preventing Heart Disease and
Stroke Through Policy, Systems, and
Environmental Change at the State &
Local Level
Jill Birnbaum, JD
American Heart Association
Vice President, State
Advocacy & Public Health
April 11, 2011
Why Policy, Systems, and Environmental Change?
The policies, systems, and environments around us
shape the pattern of our lives and have a profound
impact on our health
Changing policies, systems, and environments to help
make healthy choices easy, safe, and affordable will
improve community health
Example
•In New York City, smoke-free workplace policies, tobacco pricing
strategies, and hard-hitting media campaigns have resulted in
350,000 fewer adult smokers, a decline in the city’s adult
smoking rate from 21.6% in 2002 to 15.8% in 2008, and over
115,000 premature deaths prevented
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A Framework for Public Health Action:
The Health Impact Pyramid
Interventions focusing
on lower levels of the
pyramid tend to be
more effective
because they reach
broader segments of
society and require
less individual effort.
Implementing
interventions at each
of the levels can
achieve the maximum
possible sustained
public health benefit.
Frieden TR. A framework for public health action. Am J Public Health. 2010;100(4):590–595
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Policy, Systems and Environmental Change at AHA
Obesity Prevention
• Require Quality Physical Education with Minimum Standards in Schools
Elementary, middle school and high school
• Support Physical Activity and Healthy Eating in the School Environment
° Competitive Foods/school lunch program
° Coordinated school health/health education
• Support Physical Activity and Healthy Eating in the Community Environment
° Menu labeling
° Banning trans fat (schools and restaurants)
° Sodium reduction
° Procurement
° Built environment
° Food deserts
° Sugar-sweetened beverage reduction
° Safe routes to school
° Pre-school physical activity and nutrition
° Worksite wellness
°
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Policy, Systems and Environmental Change at AHA
Tobacco Control
•Increase Excise Taxes
•Establish Smokefree Laws
•Support Tobacco Control Programs
Quality & Availability of Care
•Implementation of Health Reform
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Health insurance exchanges
°
Preventative Benefits
°
Medicaid
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Policy, Systems and Environmental Change at AHA
Acute Cardiovascular Care
•SCA/OHCA
° AEDs,
CPR
° Regionalization of Care
•STEMI/Stroke
° Regionalization of Care
Surveillance/Monitoring
•Funding
•Pre-hospital Data Collection
•Registries
•State Health Examination Surveys
Funding for Heart Disease & Stroke Research and Programs
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Communities Putting Prevention to Work
Created by HHS, supported by CDC
Total: $650 million/2 years (ARRA)
Focused on tobacco and obesity
Four Components
•Cities
° 44
communities ($372.8 million) (ARRA)
° 10
communities ($31 million) (ACA)
•States ($50 million)
•National Media Initiative ($28.1 million)
•Leveraging National Partners ($10 million)
Examples of Funded Communities
COMMUNITY
TOTAL
OBESITY
TOBACCO
Boston
$12.5 million
$6.4 million
$6.1 million
Cherokee Nation
$2.1 million
$1 million
$1.1 million
San Diego County
$16.1 million
$16.1 million
Jefferson County, Alabama
$13.3 million
$6.3 million
$7 million
Los Angeles County
$32.1 million
$15.9 million
$16.2 million
New York City
$25.4 million
$15.5 million
$15.6 million
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CPPW Funded Communities
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Examples of Strategies
San Diego County, California – Population: 3,001,072
• Establish a San Diego-based food distribution center, link local food demand to supply, and
increase access to healthy foods, especially in high-need areas
• Enhance school wellness and before- and after-school physical activity policies to create
healthier school environments
Jefferson County, Alabama – Population: 659,503
• Incorporate smart growth policies into land use plans, develop a greenway master plan to
improve physical activity
• Require that fresh produce be provided in child care centers, schools, and after-school
programs. and encourage grocery stores and public markets to move into “food deserts.”
• Support jurisdiction-wide 100% smoke-free air policies, require removal of tobacco products
from all pharmacies, and support coverage of tobacco cessation services through worksite
health policies.
Cherokee Nation, Oklahoma – Population: 260,628
• Limit unhealthy food options in schools, implement a farm-to-school program, and work to
increase physical education in schools.
• Increase access to cessation services and support jurisdiction-wide 100% smoke-free air
policies that extend coverage to areas currently not covered under 24/7 tobacco-free policies
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How To Get Involved
CPPW
• http://www.cdc.gov/CommunitiesPuttingPreventiontoWork/
AHA
• Advocacy Staff
• You’re the Cure
http://www.yourethecure.org/
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