# Presentation: 307837

## OFFICE OF THE CHIEF FOR PUBLIC HEALTH PRACTICE

- Mission: “to advance achievement of CDC’s Health Protection goals through science-based, practice-oriented standards , policies and legal tools.”
- Striving towards  overall “*Excellence in Practice to Performance*” as a means to better health outcomes.

## Foci of Interest

- Performance Standards and Measuring Results of Performance Accreditation
- Community Strategic Planning and Action
- Best Practices
- Legal Tools and Analysis of legal interventions
- Public Health Systems Research
- Translation of Science into Practice

## continued

- Workforce/Leadership Development
- Public Health Practice Council
- Health System Leadership
- Enhancing the results of International, State, Local, Tribal and Territorial PH networks
- State Management Officials

## PUBLIC HEALTH PRACTICE COUNCIL

- An opportunity for us to seek common understanding of and solutions for important practice-related issues
- A forum for a coordinated, enterprise-wide approach to addressing practice issues
- A facilitation towards shared leadership of public health practice, communication about and strategic contribution re: the practice.

## A “Glimpse” Into Local PH

- Stephanie Bailey
- Office of the Chief for Public Health Practice
- 12/08/06

## THREE PICTURES

- One you are most familiar with
- 			and.......
- Two that you may not be.

## Health Protection: Urgent Threats 

***E-Coli***
**Outbreak**
- Sept-Oct 2006

**RNC 2004 **
**Aug  04**

|  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |

**California **
**Wildfires **
**Oct-Nov 03**

**Ricin ****Tularemia****Anthrax **
**Oct-Nov 03**

**Avian **
**Influenza**
**Jan-Mar 04**

**DNC 2004 **
**July 04**

**Hurricanes (Charley, Frances, Ivan, Jean)   ****  **
**Aug-Oct 04 **

- Health Protection: Urgent Threats

**Marburg Virus**
**Mar 05-Sept 05**

*CDC – Protecting People’s Health*

**Notes:**
CDC has been operating in emergency mode 28 times in the past 5 years.  (and in some major ways this has affected you: smallpox clinics, anthrax detection, SARS protocols, etc)
Over the last five years, we all have faced unprecedented threats to health and safety. (Tsunami, Hurricanes Katrina & Rita, SARS, West Nile Virus...)
But we can combat these successfully. We can reduce disparities. And we can protect the nation’s health and economic security. But we can do this only if bold steps are taken to rebalance the current investment portfolio. 
Health protection must be prioritized—through preparedness; health promotion; and disease, injury, and disability prevention—at least as much as disease treatment is prioritized, and these actions must occur now.
Moreover, health protection research also must be prioritized to create a solid evidence-based foundation for the policies, programs, and practices necessary for success—at least as much as biomedical research is prioritized.

## The first ‘unknown’ to you

- The Stories of our Children
- Data:2004

## Raphael, age 10, 4th Grade

- Mother incarcerated
- “waited all day to talk to mentor, wanting only to tell her about seeing his sister being shot the night before”
- Expelled at end of school year because someone said something about his mother

**Notes:**
Let me talk about cost in a different way by presenting to you the stories of our children.  While this is Nashville’s 2004 data, it is my sense that you and any US city would have similar ones.

In our neighborhoods.........

## Renaldo, age 11, 6th grade

- Mother killed at age 6
- Father lives in East Tennessee
- 3 cousins in household

## Amanda, age 8

- Mother on disability
- Old brother, age 17, in jail
- Older sister, age 15, pregnant
- All three children have separate dad

## Christopher, age 12, 5th grade

- 1 of 6 children
- Father on disability
- Suspended 2  x week, in school, for anger
- All brothers expelled from school
- 2 older/2 younger

## Kenny, age 12, 4th grade

- 1 of 6 children
- Father incarcerated

## Thomas, Kindergarten

- Crack baby
- Kicked out of school for attacking teacher

## Courtney, age 5, Kindergarten

- Mother incarcerated
- Aunt raising 7 children, none are hers

## Keisha, age 6, 1st grade

- Dad incarcerated
- 5 siblings, older teenage sister has a baby

## Jarvis

- Age six, first grade
- Two older brothers, ages 16 and 17
- Lives with aunt because both parents incarcerated on drug charges
- October 2005, placed back in first grade...............

## Jackie, age 12, 4th grade

- Family has been put out of MDHA
- Was in room when uncle was shot
- Has been raped
- WHEN SHE GROWS UP.... ...............she wants to be a doctor

## Social Costs of This Disparity

- 	 - Incarceration
- Handicaps
- Violence, truancy, suspensions
- Mixed families
- Failure (academic)
- Needing and/or wanting attention
- Lack of tools
- Adult indifference
- Low self-esteem

**Notes:**
Can you afford this? ......still?

## The second ‘unknown’ picture to you

- What funding streams (and policies) look like at the local (and state) level

## Resource Flow

- Children

**Notes:**
The financing of the community issues t least from PH’s view is not easily accessed, sustainable nor in abundance.  For example.....

## Resource Flow (HCFA)

- Children

## Resource Flow  (HRSA)

- Children

- CMS

- State Funds

- Substance
- Abuse
- Agency

- Department
- of Health

- MEDICAID

- Mental
- Health
- Agency

- Family
- Planning

- Community
- Organizations

- Clinics

- Department
- of Health

- CHC

- Substance
- Abuse

- CDC

- SAMHSA

- OPHS

- State Family
- Planning
- Agency

- HRSA

## Resource Flow (CDC)

- Children

- Resource Flow** **(CDC)

## Resource Flow (SAMHSA)

- Children

## Resource Flow (OPHS)

- Children

## Resource Flow (STATE FUNDS)

- Children

## Resource Flow

- Children

## The venue for making it happen everyday.....

- MCOs

- Federal
- Agencies

- Non-profits

- Mental Health

- HSR Institutions

- Civic Groups

- CHCs

- Schools of Public Health/ Universities

- Hospitals

- EMS

- State Health Department

- Neighborhood Associations

- Tribal Health

- Schools

- Police

- Fire

- Insurers

- Environmental Health

- The venue for making it happen everyday.....

- Gov’t Depts

- Faith Orgs

- Professional Sports

- Media

- Advocates

**Notes:**
Through the Council’s process and YOUR leadership as well as partner efforts, PHSR will be seen as a critical component of “doing business” (protecting and improving health not to mention reducing injuries) and be used by all agencies and organizations, to some extent, that comprise the public health system.  

A Public Health System is Complex
This illustration has been referred to as “the eggs” or “the web” – it is a cluttered representation of the complexity of a public health system and examples of organizations and groups that make up the system network.  

As you can see, there are many partners and groups represented who contribute to health and delivery of the EPHS. These include:

Healthcare providers like hospitals, physicians, community health centers, mental health,  labs, nursing homes and others who provide preventive, curative, and rehabilitative care.
Public safety such as police, fire and EMS.  Their work is focused on preventing and coping with injury and other emergency health situations.
Human Service and Charity Organizations such as food banks, public assistance agencies, transportation providers, and others that assist people to access healthcare and receive other health-enhancing services.
Education and Youth Development Organizations like schools, faith institutions, youth centers, and others groups that assist with informing, educating, and preparing children to make informed decisions and act responsively regarding health and other life choices and to be productive contributors in the community.   
Recreation and Arts-related Organizations who contribute to the physical and mental well-being of the community and those that live, work and play in it.
Economic and Philanthropic Organizations such as employers, community development and zoning boards, United Way, community and business foundations that provide resources necessary for individuals and organizations to survive and thrive in the community.

## A “Glimpse” Into Local PH Practice

- Stephanie Bailey
- Office of the Chief for Public Health Practice
- 12/08/06