Mississippi Association of GrantmakersMississippi Association of Grantmakers
January 9, 2015January 9, 2015
Heart Disease Death Rate - MississippiHeart Disease Death Rate - Mississippi
Rank Among States
2012 - of 502012 - 1st of 50
(1= highest )
Source: National Center for Health Statistics
Alabama– 2ndAlabama – 2nd
Accident Death Rate – MississippiAccident Death Rate – Mississippi
(unintentional injury)(unintentional injury)
Rank Among States
2012 - of 502012 - 5th of 50
(1= highest )
Source: National Center for Health Statistics
West Virginia – 1stWest Virginia – 1st
New Mexico – 2ndNew Mexico – 2nd
Kentucky – 3rdKentucky – 3rd
Oklahoma – 4thOklahoma – 4th
Motor Vehicle Accident DeathRate – MississippiMotor Vehicle Accident DeathRate – Mississippi
Rank Among States
2012 - of 502012 - 1st of 50
(1= highest )
Source: National Center for Health Statistics
Cancer Death Rate - MississippiCancer Death Rate - Mississippi
Rank Among States
2012 - 2nd of 502012 - 2nd of 50
(1= highest )
Source: National Center for Health Statistics
Kentucky- 1stKentucky - 1st
Adult American Smokers - 2013Adult American Smokers - 2013
U.S. Adults
19.0%
Smokers
Adult Mississippi Smokers - 2013Adult Mississippi Smokers - 2013
Non-Smokers
24.8%
Smokers
Source: CDC: Behavioral Risk Factor Surveillance System (BRFSS)
Adult Smoking Rate - MississippiAdult Smoking Rate - Mississippi
Rank Among States
2013 -4th* of 502013 -4 th* of 50
(1= highest )
Source: CDC: Behavioral Risk Factor Surveillance System (BRFSS)
West Virginia 1stWest Virginia 1st
Kentucky 2ndKentucky 2nd
Arkansas – 3rdArkansas – 3rd
MS Public SchoolsCurrent Smokers, 1998 – 2012*MS Public SchoolsCurrent Smokers, 1998 – 2012*
*Mississippi Youth Tobacco Survey
MS Public SchoolsCurrent Smokers, 1998 - 2012MS Public SchoolsCurrent Smokers, 1998 - 2012
35.1%35.1%
Obesity, United States - 2013 Obesity, United States - 2013
Obesity, United States - 2013 Obesity, United States - 2013
29.4%29.4%
21.3%21.3%
Source: Behavioral Risk Factor Surveillance System, CDC
35.1%35.1%
34.6%34.6%
7
4
8#
10
11
8
1
State Rank, Obesity - 2013State Rank, Obesity - 2013
State Rank, Obesity - 2013State Rank, Obesity - 2013
Top TenTop Ten
Source: Behavioral Risk Factor Surveillance System, CDC
* = tied
5
6
3
9
7
4
10
11
8
1
Obesity, US, 2013Obesity, US, 2013
States with >30% ObesityStates with >30% Obesity
Obesity, US, 2013Obesity, US, 2013
States with >30% ObesityStates with >30% Obesity
Source: Behavioral Risk Factor Surveillance System, CDC
5
6
3
9
9.7%9.7%
Adults with Diagnosed Diabetes - 2012Adults with Diagnosed Diabetes - 2012
12.5%
13.0%
7.0%
3*
State Rank, Diagnosed Diabetes - 2012State Rank, Diagnosed Diabetes - 2012
State Rank, Diagnosed Diabetes - 2012State Rank, Diagnosed Diabetes - 2012
Top Ten States
* = tied
2
1
5
7
8
3*
10
6
9
3*
State Rank, Diagnosed Diabetes - 2012State Rank, Diagnosed Diabetes - 2012
State Rank, Diagnosed Diabetes - 2012State Rank, Diagnosed Diabetes - 2012
States With >10% Diabetes
* = tied
2
1
5
7
8
3*
10
6
9
Infant Mortality Rate - MississippiInfant Mortality Rate - Mississippi
Rank Among States
2012 -2nd of 502012 - 2nd of 50
(1= highest )
Source: National Center for Health Statistics, Deaths: Final Data for 2010.
NVSR Volume 61, Number 4, May 8, 2013
8.98.9
8.88.8
Infant Mortality, 2012 Infant Mortality, 2012
Deaths per 1000 Live BirthsDeaths per 1000 Live Births
6.06.0
Source: National Center for Health Statistics, Deaths: Final Data for 2012.
Mississippi Infant Mortality,by Year, 1997 - 2013Mississippi Infant Mortality,by Year, 1997 - 2013
*US IM 2010: 6.1
Mississippi Infant Mortality,by Year, 1997 - 2013Mississippi Infant Mortality,by Year, 1997 - 2013
*US IM 2010: 6.1
20052005
20042004
20032003
20022002
20012001
20002000
19991999
19981998
Infant Mortality – State Rank (1=worst)Infant Mortality – State Rank (1=worst)
20062006
20072007
20082008
■#1
20092009
20102010
20112011
20122012
Teen Birth Rate - MississippiTeen Birth Rate - Mississippi
Rank Among States
2012 -3rdof 502012 - 3rdof 50
(1= highest )
Source: National Center for Health Statistics, Births: Final Data for 2012 NVSR Volume 62, Number 9, December , 2013.http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_09.pdf
New Mexico – 1stNew Mexico – 1st
Oklahoma – 2ndOklahoma – 2nd
Infant Deaths by Age of MotherInfant Deaths by Age of Mother
Mississippi, 2013Mississippi, 2013
Mother Mother
20 & Older20 & Older
322 (86.3%)322 (86.3%)
TeenageTeenage
Mother Mother
50 (13.4%)50 (13.4%)
Total infant deaths, 373
Infant Deaths by BirthweightInfant Deaths by Birthweight
Mississippi, 2013Mississippi, 2013
Very Low Very Low
BirthweightBirthweight
183 (49.1%)183 (49.1%)
LowLow
BirthweightBirthweight
70 (18.7%)70 (18.7%)
NormalNormal
BirthweightBirthweight
119 (31.9%)119 (31.9%)
Total infant deaths, 373
Low Birthweight - MississippiLow Birthweight - Mississippi
Rank Among States
2012 -1st of 502012 - 1st of 50
(1= highest )
Source: National Center for Health Statistics, Births: Final Data for 2011. NVSR Volume 62, Number 1, June, 2013.http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_01_tables.pdf
Very Low Birthweight - MississippiVery Low Birthweight - Mississippi
Rank Among States
2012 -1st of 502012 - 1st of 50
(1= highest )
Source: National Center for Health Statistics, Births: Final Data for 2011. NVSR Volume 62, Number 1, June, 2013.
http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_01_tables.pdf
% of Total Births of Known Gestational Age
Year of Birth
Births by Gestational Age, by Year
Mississippi
% Early Term (37 – 38 Weeks) Deliveries,Mississippi, 2011 – 2014, by Quarter
Number of Reported Cases of HIV Disease,Mississippi, 2000 - 2013Number of Reported Cases of HIV Disease,Mississippi, 2000 - 2013
HIV Disease Reported by Race/Ethnicity,
Mississippi, 2013
Note. Data include persons with a diagnosis of HIV infection regardless of stage of disease at diagnosis.
a) Includes data from areas with confidential name-based HIV infection reporting since at least January 2006.Estimated numbers resulted from statistical adjustment that accounted for reporting delays, but not forincomplete reporting. Rates are per 100,000.
Tuberculosis Case Rates, by year, MS vs US
Source Data: US data1976-2010 CDC
MS data 1976-2011 CDC, 2012, MSDH
![C:\Users\Mary.Currier\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\JNCB3R6P\MC900431611[2].png](data/images/img37.png)
![C:\Users\Mary.Currier\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\JNCB3R6P\MC900431611[2].png](data/images/img38.png)
Less than the national average rate for the first time since 2006
What do these health indicatorshave in commonWhat do these health indicatorshave in common
•High infant mortality
•High death rates from heart disease,cancer, injuries
•High rates of smoking and obesity
•Low rates of physical activity and healthyeating
Social Determinants of HealthSocial Determinants of Health
•Health is related to
–Education
–Economic stability
–Neighborhood and the built environment
–Health and health care
–Social and Community Context
Social Determinants of HealthSocial Determinants of Health
•Health is related to
–Education: high school graduation,enrollment in higher education, language andliteracy, early childhood education anddevelopment
–Economic stability: poverty, employment,food security, housing stability
Social Determinants of HealthSocial Determinants of Health
•Health is related to
–Neighborhood and the built environment:access to healthy foods, quality of housing,crime and violence, environmental conditions
–Health and health care–Health and health care: access to healthcare, access to primary care, health literacy
–Social and community context–Social and community context: socialcohesion, civic participation, perceptions ofdiscrimination and equity,incarceration/institutionalization
National Prevention StrategyNational Prevention Strategy
Economic Benefits of PreventingDiseaseEconomic Benefits of PreventingDisease
•Disease can cause significant economicburdens to the economy, families, andbusinesses through lost productivity andhealth care costs;
•Prevention can reduce significant economicburden of disease as well as improve thelength and quality of people’s lives;
•Prevention: can be cost-effective, reducehealth care costs, and improve productivity.
Economic Benefits of PreventingDiseaseEconomic Benefits of PreventingDisease
•Examples – lowering health care costs:
–A 5 percent reduction in the prevalence ofhypertension would save $25 billion in 5years.323
–Annual health care costs are $2,000 higherfor smokers, $1,400 higher for people who areobese, and $6,600 higher for those who havediabetes than for nonsmokers, people whoare not obese, or people do not havediabetes.324
Economic Benefits of PreventingDiseaseEconomic Benefits of PreventingDisease
•Examples – lowering health care costs:
–Increasing use of preventive services, including tobaccocessation screening, alcohol abuse screening and aspirinuse, to 90 percent of the recommended levels could save$3.7 billion annually in medical costs.326
–Medical costs are reduced by approximately $3.27 for everydollar spent on workplace wellness programs, according toa recent study.327
–For every HIV infection prevented, an estimated $355,000 issaved in the cost of providing lifetime HIV treatment.319
Economic Benefits of PreventingDiseaseEconomic Benefits of PreventingDisease
•Examples – increasing productivity:
–Asthma, high blood pressure, smoking, andobesity each reduce annual productivity bybetween $200 and $440 per person.333
–Workers with diabetes average two morework days absent per year than workerswithout diabetes.334
–Absenteeism costs are reduced byapproximately $2.73 for every dollar spent onworkplace wellness programs, according to arecent study.327
Direction of the Health DepartmentDirection of the Health Department
•History:
–Inside the clinic walls
–One patient at a time
•Include prevention in clinic interactions
–Safe sleep
–Smoking cessation
–Early elective deliveries
–Nutrition education, etc.
![C:\Users\Mary.Currier\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\K79G5CPL\medical-clinic[1].gif](data/images/img42.jpg)
Direction of the Health DepartmentDirection of the Health Department
•Move outside those clinic walls, back thecommunity
–Include non-traditional partners (but don’tleave the traditional partners behind)
–Promote health as a consideration in allpolicies
![C:\Users\Mary.Currier\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\K55RDQT7\3955992673_6edfe24666_z[1].jpg](data/images/img43.jpg)
![C:\Users\Mary.Currier\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.IE5\K79G5CPL\community[1].jpg](data/images/img44.jpg)
PartnersPartners
Traditional partners:
–health care providersand facilities,
–non-profit healthagencies
Plus:
–Schools
–Faith-Based Organizations
–Employers
–City planners,
–Elected officials
–Economic developmentgroups
–Any other organization thatis interested in improving thehealth and quality of life forMississippi residents
–All Mississippi residents
Direction of the Health DepartmentDirection of the Health Department
•Examples
–Mayors’ Health Councils
•Joint use agreements, smoke free air, sidewalks andstreet lights required, farmer’s markets
–Congregational nurses
•Health screenings, improved nutritional foods, safesleep education for families (grandmothers seem tobe important!), these congregations form a network
–Mississippi Perinatal Quality Collaborative
•Hospitals, providers, insurers, March of Dimes,public health working together to improve perinataloutcomes
The town of Arcola received donated land, a mini grant, and raisedfunds to begin a new children and adult softball league
Direction of the Health DepartmentDirection of the Health Department
•Examples
–Tobacco coalitions
•Increasing comprehensive smoke free airordinances in communities and counties statewide
–Assuring day care regulations are healthy
•Physical activity requirements
•Screen time
•Healthy meals and snacks
–Diabetes self management education –
•Group meetings to provide education and supportfor better diabetes control and prevention ofcomplications
healthy foods, an examplehealthy foods, an example
•Policy: assuring policies (e.g., tax policies, EBTcard policies, zoning, school nutrition policies)friendly to grocery stores, farmer’s markets, gasstations with a healthy food isle.
•Environment: assuring improved access tohealthy foods such as farmers’ marketsplacement, less access to vending machinesand school stores with junk food
•Systems: to include easy access toprevention/screening and nutritioneducation/healthy cooking education
MSDH must change with the timesto meet the needs of the state andimprove health.The Bower Foundation is helpingus do it!MSDH must change with the timesto meet the needs of the state andimprove health.The Bower Foundation is helpingus do it!
Thank youThank you
Funding Request for Infant Mortality ReductionPriority areasFunding Request for Infant Mortality ReductionPriority areas
•Preconception health – improving health beforepregnancy
•17 Hydroxyprogesterone (17 P) - access to weeklyhormone injection that decreases repeat pretermdeliveries
•Premature elective deliveries – reducing non-medicallyindicated deliveries before 39 weeks gestation
•Maternal smoking – smoking cessation and limitingsecondhand smoke exposure among pregnant women
•Safe sleep environment for infants - infants should sleepalone, in a crib, on their back, in a smoke freeenvironment
•Systems for risk based perinatal care – getting the momto the right place to deliver in the shortest amount of time
Funding Request for Infant Mortality ReductionFunding Request for Infant Mortality Reduction
•Address the target areas through
–Strengthening surveillance and data analysiscapacity
–Building capacity through training, publicprivate collaboration, and communityengagement
•Among health care providers
•Among policy makers at all levels (especiallyhomes, hospitals and communities)
•Among the public
Funding Request for Infant Mortality ReductionPriority areasFunding Request for Infant Mortality ReductionPriority areas
Fiscal Year 2016 Requested Increase
Purpose
Requested
Services: Maternity
Early Intervention
1,020,800
4,789,937
Infant Mortality Task Force Initiative
1,512,385
Admin: New Lab Support
Patient/Insurance Billing System
State MAGIC Fin. Fee Increase
560,000
1,000,000
551,214
Personnel: Pos/Reclass/Reallo/Benchmark
7,495,169
Phase I Underwood Building Renovation
SRF Match
5,200,000
1,800,000
Medicaid Patient Managed Care Reimb.
3,226,000
27,155,506
69
Public & Provider EducationPublic & Provider Education
SyphilisSyphilis
SyphilisSyphilis
TuberculosisTuberculosis
TuberculosisTuberculosis
HIV/AIDSHIV/AIDS
HIV/AIDSHIV/AIDS
ControlControl
70
SyphilisSyphilis
SyphilisSyphilis
TuberculosisTuberculosis
TuberculosisTuberculosis
HIV/AIDSHIV/AIDS
HIV/AIDSHIV/AIDS
ControlControl
Case/Contact InterventionCase/Contact Intervention
Rapid identification of cases
Intensive case interviews
Locate and evaluate contacts
often with limited locating information
Prevent contacts from transmitting
Rapid identification of cases
Intensive case interviews
Locate and evaluate contacts
often with limited locating information
Prevent contacts from transmitting
Your first line of defense.
FY 15 Budget $365 millionFY 15 Budget $365 million
Employees 2,208Employees 2,208
District Offices 9District Offices 9
County Offices 104County Offices 104
WIC Dist. Centers 95WIC Dist. Centers 95
Home Health Offices 0Home Health Offices 0
Mississippi State Department of Health
Public Health Accreditation
•Prerequisites for accreditation:
–State health assessment
–State health improvement plan
–MSDH strategic plan
10 Essential Public Health Services
School Immunization LawMiss. Code Ann. § 41-23-37
•Medical exemptions
•No religious exemptions (48 states allowthem)– declared unconstitutional by the MSSupreme Court
•Philosophical exemptions –(18 states havethem) – Many states with philosophicalexemptions now have more measles and morepertussis