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A New Challenge for State Health Departments

Posted By Jean O’Connor, JD, DrPH, FACHE, Thursday, October 19, 2017
It is an honor to serve as board president this year. NACDD has contributed so much to my professional growth and development over the past four years. I look forward to giving back and helping to raise awareness about the value that NACDD brings to its Members, partners, and the general public.
 

Each year for the past three years, NACDD’s President’s Challenge has empowered the board president to highlight and engage Members in a significant opportunity in our field.

Last year, Mehul Dalal, MD, MSc, MHS, chronic disease director of Connecticut, challenged us to think about how we can “Learn, Lead, and Thrive,” through improving our management practices and supporting professional development growth in our departments. Namvar Zohoori, MD, MPH, PhD, director of the Center for Health Advancement at the Arkansas Department of Health, led our first President’s Challenge in 2016, inviting us to examine health equity’s importance in underpinning all of our efforts to reduce the burden of chronic disease.

This year, I am pleased to invite you to find ways to share and to promote innovative population health improvement models. To do that, you will be asked to identify and recognize at least one innovative model for population health improvement and chronic disease prevention in your community.

While hospitals, payors, and health care providers consider a more limited definition of “population” by focusing on the panel of patients they serve, we tend to view outcomes on a more geographical or societal basis. However, our end goal of improved health is the same, and we are using many of the same techniques and approaches to improving population health to accomplish our objectives.

While lately, it seems that the public immediately thinks of hospitals and payors when they think of population health improvement, now in my fourth year on the Board, I know that so much of that leadership is quietly coming from chronic disease programs across the country. You are doing the heavy lifting to build partnerships and change policies with hospitals and healthcare providers, employers, education, housing, transportation, and communities to improve health outcomes—both clinical outcomes and outcomes driven by the social determinants of health.

We should embrace this chance to build collaboration with other programmatic areas in public health – such as immunization, injury, and environmental health – and provide a platform for chronic disease professionals to be leaders in this area as they connect with their peers.

There are many ways you can contribute to this challenge:
  • Submit your ideas and examples to be featured in our new podcast series, “Innovations in Population Health” to publications@chronicdisease.org
  • Contribute success stories on innovative models in population health to PublicHealthSuccess.org.
  • Engage in social media efforts to raise awareness of your activities in population health, using #pophealthworks
  • Follow NACDD’s social media channels (Facebook.org/chronicdiseasedirectors and Twitter.com/NACDDInfo) to hear more about professional development opportunities on this subject
  • Hold at least one partner meeting to discuss how you can replicate successful population health models in your community
Through this year’s Challenge, along with sharing knowledge about what is working with each other, we have the ability to tell our story and build recognition about the role of NACDD and chronic disease directors in population health improvement. I am honored to begin this journey with you. 

If you need a little inspiration on how to get started on building innovative partnerships in health, take a look at NACDD’s two new podcasts from this year’s invitational Chronic Disease Academy:

As always, I look forward to sharing our experiences and learning together. Thank you for all you do for the public’s health.
 
Jean O’Connor, JD, DrPH, FACHE
Board President 2017-2018
National Association of Chronic Disease Directors

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NACDD Releases Podcasts from 2017 Chronic Disease Academy Plenaries

Posted By Dr. Mehul Dalal, Thursday, October 19, 2017
Updated: Thursday, October 12, 2017

NACDD’s vision is to “lead and influence the ways  chronic  disease  prevention and control  shapes the  future  health  landscape.” Each year, the Chronic Disease Academy is a special opportunity for chronic disease directors and their staff to learn innovative new approaches and concepts in our field so they can take these practices back to the field with them. This year’s Academy particularly inspired, motivated, and educated me on ways we can communicate about the value of the work that we do in public health. I was pleased to see  so many other attendees also energized and invigorated by the experience.

 

For those who couldn’t attend the Academy, for the first time ever, we have made the plenaries available via podcast:

After you’ve listened to these powerful speakers, I challenge you to take the next, hard step and translate the themes and information they shared into your own practice. There is no doubt that translating new knowledge into practice requires initiative, leadership, and great communication. Beyond that, in our hyper-paced world, I often find the missing ingredient in knowledge translation is reflection. 

 

So, I encourage you to block out some time on your schedule and reflect on areas that piqued your interest during the Academy and consider how they might integrate, even in a small way, into your work practices. This is a small way to keep the learning alive and, importantly, make it stick. 

 

For me, Ian Galloway’s talk exemplified a topic where some reflection and discussion is a must.  The pay-for-success area is innovative. And should the example of hypertension in Canada that he shared pan out, the pay for success model  could potentially be disruptive in terms of how we do business. What if we really could construct agreements to sustainably pay for real health outcomes (instead of “deliverables”)? As stewards of public resources, why wouldn’t we?

 

Good learning experiences enhance both your skills and motivation, but perhaps great learning experiences also can destabilize us. Charles Brown’s talk  on social justice was poignant, not only because it was deeply personal, but because for many it revealed our own complacency, perhaps even complicity, in perpetuating unjust systems. The  discomfort in this knowledge is not easy to bear, though I suspect that many of us will do better to take the harder path and reflect on that discomfort rather than  to ignore it.

 

I hope you will take some time out to listen to these podcasts from our Chronic Disease Academy and share them with your colleagues. Shaping the future of the chronic disease prevention and health promotion starts with us and how we can improve upon and refine our work each day.

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NACDD’s Third Annual Walkability Action Institute Brings Interdisciplinary Teams Together

Posted By Margaret G. Ritchie, Tuesday, August 8, 2017

In early April, the Centers for Disease Control and Prevention (CDC) and the National Association of Chronic Disease Directors (NACDD) hosted the third annual Walkability Action Institute (WAI) in Decatur, Georgia. During the four-day action institute, renowned faculty taught attendees about macro-level policy, system, and environmental (PSE) changes that prevent chronic diseases by promoting active transportation and more walkable communities.

Through a competitive application process, officials from public health, planning, transportation, elected officials, and other representatives were selected to create 10, cross-disciplinary, Metropolitan Planning Organization (MPO) teams. In 2017, teams came from areas such as: Cleveland, Tennessee; Corridor (Cedar Rapids), Iowa; Flint, Michigan; Oahu, Hawaii; and Puget Sound region, Washington.

During a three-year period, 32 teams have been selected from 23 states to participate in the WAI project. After WAI, the teams participated in ongoing, virtual, community of practice groups (CoP). Through these virtual CoP groups, teams received technical assistance and were able to learn and share their implementation strategies.

NACDD currently receives progress reports from team leads that track the program’s outcomes and estimate reach for active transportation accomplishments. To date, teams from WAI have enabled more than 117 improvements impacting more than 13.6 million people. Collectively, WAI participants have leveraged $13,843,000 to implement and sustain walkability efforts.

According to public health planning and transportation consultant Mark Fenton, NACDD’s WAI demonstrates the ideal balance between effective policy development and its implications for the built environment.

“I think the brilliance of these [NACDD] gatherings is that we bring in interdisciplinary teams,” said Fenton. “NACDD is working to get teams that include someone from the regional planning agency, someone from transportation engineering, an elected official, a public health official. Your team has to have those four different disciplines, plus many of the teams bring one or two additional people from the world of advocacy.”

Streets that have been redesigned to be more walkable help support active living by removing transportation barriers and encouraging chronic disease prevention.

Ian Lockwood, P.E., a livable transportation engineer for Toole Design Group and a speaker at WAI, said that walking is fundamental to human beings because it used to be the common dominator that linked transportation and planning. Chronic diseases and obesity existed then, but they are more prevalent today due to the lack of daily physical activity.

“By getting back to that [to the basics], we can help people live healthier lifestyles. But we can also create better cities, and less carbon footprints, spend less on infrastructure, have a better economy, and have leftover money for other things,” Lockwood said.

Danielle Schaeffner, environmental change specialist for the Chronic Disease Prevention and Health Promotion Division of the Hawaii Department of Health, knew that WAI was an opportunity to bring interdisciplinary teams together, but had never attended one in person until this year.

“There is a lot of really great momentum around walkability in Honolulu County right now, and we got sent the opportunity [to attend WAI]… After reviewing it, we realized we had a good base for that multi-sector approach … we thought this [WAI] would be a great way to build our capacity,” Schaeffner said.

Following the WAI, Schaeffner and her team will identify next steps for walkability actions in the Oahu region, and define opportunities to collaborate among other nontraditional partners in Hawaii. “I think there is just a wealth of creativity, passion, and knowledge [from the WAI meeting] that I am really happy to go back to Honolulu with,” she said.

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How Your Voice is Heard: The Mechanics of NACDD National Advocacy

Posted By Mehul Dalal, M.D., Wednesday, July 5, 2017
By: Mehul Dalal, M.D., president, NACDD Board of Directors and chronic disease director at the Connecticut Department of Public Health.
 
Noise and confusion seem to be the baseline operating conditions in Washington these days, but I wanted to share with you the ways that NACDD is breaking through that noise, on your behalf, so that your voice can be heard and your constituents better served. During the last few months, I’ve had the privilege of representing our work to key Washington stakeholders. Although the federal commitment to chronic disease prevention and health promotion remains uncertain, NACDD is working strategically to protect funding for our work, relying on the following principles:
 
NACDD employs an inclusive and bipartisan approach. Through our strategic partnership with Cornerstone Government Affairs, our messages are heard (and resonate) on both sides of the aisle.
 
NACDD works diligently to align messages with partner organizations, harnessing the power of consistent messaging across multiple advocacy groups.
 
NACDD commits to relationship building with our Washington contacts, serving as a credible and trusted source of information on chronic disease prevention and control, and health promotion.
 
Because of the way we advocate and align with our partners, we have seen a few important successes occur recently.
 
While a myriad of voices were competing for the limited attention and time of legislators in key committee roles, NACDD has been working strategically and diligently to build value relationships with key legislative staffers.
 
This targeted approach helped to ensure that NACDD was one of only about two dozen organizations selected to testify before the House Labor HHS appropriations subcommittee, which provides and oversees CDC funding. I had the honor of delivering our testimony to that subcommittee, and thanks to the government relations team that crafted an inclusive, compelling, and bipartisan message, our testimony was received positively by both Chairman Tom Cole (R) and Ranking member Rosa Delauro (D). 
 
In May, at CDC’s request, NACDD hosted a national partners’ meeting to review the president’s budget proposal for the National Center for Chronic Disease Prevention and Health Promotion. Major national organizations including ASTHO, NACCHO, the American Diabetes Association, the American Cancer Society, the American Heart Association, and Y-USA were part of the meeting. As the group discussed a plan for a collective response to the budget proposal, it was clear that the NACDD-Cornerstone partnership was vital to informing a collaborative, calibrated, and strategic response.  As result of that meeting, NACDD led a sign-on letter addressed to the House and Senate appropriations subcommittee, which garnered almost 300 signatures. The letter was characterized by a positive tone, demonstrating strong alignment among diverse partners.
 
Your work matters to every day Americans and to our country’s future. I am honored to serve on your behalf to share your successes with our nation’s leaders. And we will continue to make the case on the Hill that chronic disease prevention and control and health promotion are critical tools to promoting a strong and thriving nation.

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NACDD’s Health Equity Council Launches New Health Equity Tool

Posted By Louise Square, Wednesday, May 3, 2017
Updated: Monday, May 1, 2017

By: Louise Square
Project Lead, Moving to Institutional Equity: A Tool to Address Racial Equity for Public Health Practitioners

Last week, NACDD’s Health Equity Council launched “Moving to Institutional Equity: A Tool to Address Racial Equity for Public Health Practitioners.” In public health, institutional racism creates many problems for minorities that contribute to health disparities and inequities. Our new tool has been designed to tackle institutional racism by identifying policies that have resulted in negative outcomes for minorities.

Institutional racism can be subtle and difficult to identify because it often has the benefit of being a policy or procedure that is long practiced. However, we must start conversations about racial equity in our communities of practice if we are ever to identify and address the root causes of health disparities in our nation.

NACDD created the “Moving to Institutional Equity” tool to help users recognize institutional racism by moving through a series of worksheets that give step-by-step directions to identify potentially racist policies and/or procedures and then to explore opportunities to change the outcomes.

Primarily through our HEC, NACDD has worked to speak to many difficult issues in an ongoing effort to achieve health equity and to improve health outcomes. Our initiatives aim to move systematically through the factors known as social determinants of health and provide resources to address them. Some of our work includes community action guides to address high school dropout rates, neighborhood segregation, and food deserts.

NACDD believes that, if regularly implemented, the “Moving to Institutional Equity” tool will help create a culture that recognizes equity as a core value of the workplace. State health departments can be role models in this effort by having our organizations reflect the communities we serve and by working to improve population health and advance health equity.

I would like to issue a special thanks to the HEC members for their hard work and dedication on this publication: Gail Brandt, Washington State Department of Health; Cheryl Farmer, Washington State Department of Health; Janet Kiley, formerly of the Michigan Department of Health and Human Services; Vivian Lasley-Bibbs, Kentucky Department of Public Health; Marisa New, Oklahoma State Department of Health; Holly Nickel, formerly of the Michigan Department of Health and Human Services; Robyn Taylor, Ohio Department of Health; Steven Owens, NACDD consultant; and Tiffany Pertillar, NACDD consultant.

This group of very dedicated public health practitioners comes from different races, and backgrounds. As we crafted this tool together, we found that we benefited from each other’s passion, experience, and knowledge.

From that process, we learned that we will be most successful in our efforts to improve equity if we begin within our own departments and areas of influence. The “Moving to Institutional Equity” tool is designed to guide us on that journey. The Health Equity Council plans to implement a pilot for the tool this summer. Please be on the lookout for more information soon. If you have questions, the Health Equity Council is here to help. You can contact Gail Brandt or myself. We look forward to working with you.

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NACDD School Health Publication Focuses on Opportunities for School, Hospital Partnership

Posted By Margaret G. Ritchie, Tuesday, December 20, 2016
Updated: Monday, December 19, 2016

Millions of children are living with a diagnosis of a chronic health condition, and many of these children require management during the school day. According to the National Survey of Children’s Health, 2011-2012, an estimated 15.9 percent of children ages 6 to 11 and 17.5 percent of children ages 12 to 17 have at least one chronic health condition. 

NACDD recently announced a new publication related to this important topic of management of chronic health conditions in schools, titled “Opportunities for School and Hospital Partnership in the Management of Chronic Health Conditions: An Issue Brief for Health Departments that Integrates Community Health Needs Assessment Requirements for Non-profit Hospitals Under the Affordable Care Act, Medicaid Initiatives, and Additional Opportunities.” The issue brief was authored by Amanda Martinez, Consultant, per a NACDD project funded by the CDC School Health Branch and had support from Rachelle Chiang, Senior Consultant for School Health. 

From August 2015 to February 2016, Martinez conducted research including a review of resources and interviews with 30 stakeholders to inform the publication’s development. Select stakeholders reviewed some or the entire draft document at later dates. A few states served in an advisory capacity.

Martinez drew from efforts aimed at enhancing the integration of health care and public health in partnership with other sectors, along with her past experience in hospital and school settings, to help guide the publication content. In an interview, Martinez said that more needed to be done to raise awareness of chronic health conditions students may have and how these conditions can affect both health and education outcomes – schools are critical to improved public health because they are a part of the community and play a strong role in providing school health and nursing services to meet the management and care needs of these students. 

According to Martinez, many hospitals want to prioritize children’s health needs. But due to other rising priorities, hospitals and schools may not have had opportunities to work together. The CHNA is a partnership opportunity that can give a strategic framework and strength to implement new or existing activities.

The publication highlights strengthened relationships between schools and hospitals as a strategy to more effectively achieve integrated service delivery for students with chronic health conditions and example partnerships from across the country. It features specific strategies and resources for state health departments and their education department partners to facilitate success of school and hospital partnership at the local level.

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Healthy Holiday Living: Eating Out

Posted By Margaret G. Ritchie, Thursday, December 8, 2016
Updated: Tuesday, November 8, 2016

Follow these eat right tips when you are dining out during the holiday season:

  1. If you can, choose restaurants with healthier menu options and order those options.
  2.  Try out a vegetarian option, such as a grilled vegetable Panini or wrap with fresh vegetables and hummus. Avoid vegetarian options that are overloaded with cheese (lots of calories and fat).
  3.  Order a salad with the dressing on the side. Watch out for main dish salads with a lot of cheese or fried meats and toppings. Ask for less cheese and grilled meats.
  4.  Opt for grilled meat, fish, and poultry rather than fried.
  5.  Order the smallest sandwich. Skip anything called “double.” Go for the 6-inch sub rather than the foot-long option. Ask if whole wheat is an option for buns and bread.
  6.  Opt for fresh vegetables, fresh fruit, or low-fat yogurt as side dishes.
  7.  Order broth-based vegetable or bean soup rather than creamy soups.
  8.  Choose sugar-free drinks, such as water (best choice!), unsweetened tea, coffee, or diet soda.

These tips are provided by the American Diabetes Association. 

Tags:  eating out while traveling  healthy choices  Healthy eating  healthy holidays  Holidays  traveling 

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The Gift of Giving

Posted By Margaret G. Ritchie, Tuesday, December 6, 2016

When you think about the holiday season, spending time with your family and shopping may be a few of your priorities in the coming weeks. Or maybe you’re helping plan a holiday party at your place of employment. The holiday season though can be so much more.

There are ways that you, your family or your coworkers can help promote awareness, inclusivity and giving during the holiday season.

Below are some events around Atlanta that you can partake in.

  1. Sleighbells on the Square – The 16th annual Sleighbells on the Square 5K/1K/Tot Trot will take place on the Marietta Square in Marietta on Saturday, Dec. 10. Sponsored by the Cobb County Bar Association, the festive event will help raise money for the Cobb Children’s Emergency Fund. The money raised from the event will support households in Cobb County facing financial emergencies or crises.
  2. 2016 YCR “Casino Royale” – Roll up your sleeves and take a gamble during the Young Council’s “Casino Royale” on Wednesday, Dec. 14, at The Ivy Buckhead. Proceeds from the even will benefit Andee’s Army – a charity which provides financial assistance to families of children receiving medical treatment or care for non-traumatic, acquired brain injuries.
  3. Reflection 25 for Charity – You can walk 1 or 25 miles with “Blind” Pete from Georgia Obstacle Racers and Mud Runners in Lawrenceville on Saturday, Dec. 17. All funds raised during the event will be donated to More Heart Than Scars, I Am Adaptive and Operation Enduring Warrior.

NACDD encourages YOU to find a charity event in your area or volunteer. Take some time this holiday season to really give back to your community.  

Tags:  Charity  hol  National Association of Chronic Disease Directors  Nonprofits 

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Healthy Holiday Living: Fast Food Choices

Posted By Margaret G. Ritchie, Thursday, December 1, 2016
Updated: Monday, November 7, 2016

 

It is possible to make wise choices and eat a fairly healthy meal if you order carefully while you are traveling during the holiday season.

 

  1. Instead of french fries or onion rings, order healthy side items—vegetables and fruits such as salads, apple slices, and carrots.
  2. Select from the restaurant’s healthy menu, if available. Most chains have their menu online.
  3. Order the smallest sandwich on the menu.
  4. Ask for grilled chicken instead of fried chicken in sandwiches, wraps, and salads.
  5. Ask for sandwiches without mayonnaise, sauces, and cheese.
  6. Opt for low-fat or low-calorie sauces and dressings such as mustard, fat-free salad dressing, salsa, or barbecue sauce.
  7. Order a main course salad, but be careful. Sometimes salads with a lot of high-fat meats and cheese actually have more calories than a cheeseburger. When it comes to salad dressing, a little can go a long way, so use the smallest amount possible.
  8. Choose lean meats or veggies for subs; try the turkey or grilled chicken breast sub instead of a meatball sub.
  9. For subs, ask that some of the bread be scooped out before it’s assembled and pile on fresh veggies.
  10. Choose sugar-free drinks, such as water (best choice!), unsweetened tea, coffee, or diet soda.

These tips are provided by the American Diabetes Association. 

Tags:  healthy choices  Healthy eating  healthy holidays  holiday season  traveling 

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NACDD Supports Healthy Aging in Recognition of National Alzheimer’s Disease and Awareness Month and Family Caregivers Month

Posted By Margaret G. Ritchie, Tuesday, November 22, 2016
Updated: Friday, November 4, 2016

November is National Alzheimer’s Disease and Awareness Month and Family Caregivers Month. Alzheimer’s disease and other forms of dementia can be disruptive to daily life for many individuals and their families. Healthy aging, which NACDD promotes through numerous chronic disease prevention projects, supports a healthy brain and better quality of life for older adults and their caregivers.  

According to the World Health Organization, more than 40 million people worldwide were living with dementia in 2015. Factors for dementia include: age, family history, and genetic susceptibility genes; at this time, there are no interventions that definitively prevent, treat or cure Alzheimer’s disease. 

NACDD contributed to efforts to improve brain health and support healthy aging as a member of the project committee for The Health Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013-2018, from the Alzheimer’s Association and Centers for Disease Control and Prevention. NACDD served as an advisory group member for the report, The State of Aging and Health in America 2013


NACDD’s funding agreement with the Centers for Disease Control and Prevention allowed NACDD to engage in strategic activities with states to address Alzheimer’s disease and other dementias in recent years.  

The Healthy Brain Initiative state projects implemented beginning in 2015 are highlighted in a series of state reports. A 2008 NACDD survey, NACDD helped the Association determine the needs, priorities and activities of the state health departments related to aging. NACDD found that physical activity; falls prevention; diabetes; cancer prevention and control; and heart disease and stroke prevention were among state health departments’ concerns. 

Learn more about NACDD’s health aging projects, find data on self-reported memory loss from 22 states and view a variety of additional resources and reports on health aging on NACDD’s website

Tags:  Alzheimer's disease  caregivers  dementia  Healthy aging  healthy brain  National Alzheimer’s Disease and Awareness Month a 

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