12/22/2015 Wisconsin Local Health Departments An Overview of Wisconsin Local Health Departments

12/22/2015 Sawyer Bayfield Douglas Burnett Wash- burn Ashland Iron Vilas Price Oneida Forest Florence Marinette PolkBarron Rusk Taylor Lincoln Langlade Meno- minee Oconto Shawno Marathon Clark Wood Portage Waupaca Outa- gamie Door Brown Kewaee Mani- towoc Fond du Lac Adams Waushara Juneau St. Croix Pierce Dunn Chippewa Eau Claire Pepin Buffalo Tremp- ealeau Jackson Monroe La Crosse Winne- bago Calu- met Sheboygan Vernon Crawford Rich- land Sauk Marq- uette Columbia Dodge Wash- ington Oe Mil Waukesha Jefferson Dane Iowa Grant Lafayette Green Rock Walworth Racine Kenosha Gr. Lake Burnett 92 Local Health Departments 71 County 21 City or Village Adams Juneau Crawford Rich- land Sauk Columbia Dodge Dane Iowa Grant Lafayette Green Rock Wisconsin Local Health Departments

12/22/2015 Population Range 2008 – pop WI = 5,617,744 4, ,870 Wisconsin Local Health Departments

12/22/2015 Operating Budgets 2007 – WI - LHD Survey $24,679,918 $94,121 Wisconsin Local Health Departments

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12/22/2015 Health Costs in Wisconsin l TOTAL (2007 Lewin group report) $42.3 Billion l PUBLIC HEALTH ( LHD Survey) $150.1 Million Local Health Departments Account for Only 0.4% Local Health Departments Account for Only 0.4% of Wisconsin’s Health Costs of Wisconsin’s Health Costs

12/22/2015 Wisconsin Local Health Departments Prevention Primary Primary Secondary Secondary Tertiary Tertiary

12/22/2015 Wisconsin Local Health Departments Primary prevention Includes actions to protect against disease and disability, such as: - getting immunizations - ensuring the supply of safe drinking water In addition, Primary Prevention can include general action to promote health such as: - Health promotion - Healthy lifestyle - Good nutrition and hygiene - adequate exercise and rest

12/22/2015 Wisconsin Local Health Departments The goal of secondary prevention is to identify and detect disease in its earliest stages. Examples are: - Colorectal screening - Mammograms Another goal of secondary prevention is to prevent the spread of communicable diseases (illnesses that can be transmitted from one person to another).

12/22/2015 Wisconsin Local Health Departments Tertiary prevention programs aim to: Tertiary prevention programs aim to: ä Improve the quality of life for people with various diseases by limiting complications and disabilities ä Reducing the severity and progression of disease, and providing rehabilitation ä Tertiary prevention involves actual treatment for the disease and is conducted primarily by health care practitioners, rather than public health agencies.

12/22/2015 Wisconsin Local Health Departments Population Health Population-based public health services – Interventions aimed at disease prevention and health promotion that affect an entire population and extend beyond medical treatment by targeting underlying risk, such as tobacco, drug, and alcohol use; diet and sedentary lifestyles; and environmental factors.

12/22/2015 For Every Dollar Invested in: ä as much as $80 in treatment cost for dental caries for one child. (CDC, An Ounce of Prevention, 1999) ä Water Fluoridation saves as much as $80 in treatment cost for dental caries for one child. (CDC, An Ounce of Prevention, 1999) ä ä Influenza Vaccination saves $30 to $60 in hospitalization costs for an older adult (CDC) ä ä Measles, Mumps, Rubella vaccination saves $16.34 in direct medical costs (CDC) ä ä Diphtheria, Pertussis, Tetanus (DPT) vaccination saves $6.21 in direct medical costs (CDC) ä ä Family Planning Services saves $4.40 in public funds for averting medical, welfare and nutritional costs. (Healthy Minnesotans 2004)

12/22/2015 For Every Dollar Invested in: ä ä Chickenpox Vaccination saves up to $5.40 in parent productivity losses and medical costs (CDC) ä ä WIC services for pregnant women saves $ $4.21 in Medical Assistant funds for a mother and her newborn. (Nat’l Ass. Of WIC Directors) ä ä Tobacco prevention saves $3.00 in direct health care costs. (ANSR Action Alert 2003)

12/22/2015 Voluntary Accreditation of Local and State Health Departments The goal of the national public health accreditation program is to improve and protect the health of the public by advancing the quality and performance of all health departments in the country – state, local, territorial and tribal. The goal of the national public health accreditation program is to improve and protect the health of the public by advancing the quality and performance of all health departments in the country – state, local, territorial and tribal. Accreditation means demonstrated accountability and improved quality. Nationally, public health accreditation means that people across the country can expect the same quality of public health programs and services no matter where they live. Accreditation means demonstrated accountability and improved quality. Nationally, public health accreditation means that people across the country can expect the same quality of public health programs and services no matter where they live.

12/22/2015 Healthiest WI 2020 ä ä Healthiest Wisconsin 2020: Everyone Living Better, Longer represents the third decade of statewide community health improvement planning designed to benefit the health of everyone in Wisconsin and the communities in which we live, play, work and learn.

12/22/2015 Healthiest Wisconsin 2020: Everyone Living Better, Longer represents the third decade of statewide community health improvement planning designed to benefit the health of everyone in Wisconsin and the communities in which we live, play, work and learn. Healthiest WI 2020

12/22/2015 GOALS: 1. Improve health across the life span. 2. Eliminate health disparities and achieve health equity Overarching Focus Areas: Health disparities Social, economic, and educational factors that influence health Alcohol and Drug Chronic Disease Communicable Disease Environmental and Occupational Growth and Development Injury and Violence Mental Health Nutrition Oral Health Physical Activity Reproductive and Sexual Tobacco Focus Areas Healthiest WI 2020 Vision

12/22/2015 Healthiest WI 2020 – Infrastructure Focus Areas ä Access to high quality health service ä Public Health capacity and quality ä Emergency preparedness, response and recovery ä Equitable, adequate, stable public health funding ä Systems to manage and share health information and knowledge ä Health literacy ä Collaborative partnerships for community health improvement ä Public health research and evaluation ä Diverse, sufficient and competent workforce that promotes and protects health

12/22/2015 What Does Public Health Do? ä Prevents epidemics and the spread of disease ä Protects against environmental hazards ä Promotes healthy behaviors ä Prevents injuries ä Responds to disasters ä Mobilizes communities for action ä Develops policies to promote health ä Monitors the health conditions of the population

12/22/2015 Communicable Disease Control ä Immunizations ä Investigation of Disease ä Education Health Focus Area Health Focus Area – Communicable disease prevention and control

12/22/2015 Measles and Mumps

12/22/2015 Tuberculin Skin Testing

12/22/2015 Early 1900’s--Board of Health Sign

12/22/2015 Chronic Disease Prevention and Control ä Cancer Control Programs ä Cardiovascular Disease ä Tobacco Prevention ä Nutrition and Alcohol ä Diabetes Control Health Focus Area - - Tobacco use and exposure - - Physical activity - - Chronic disease prevention and management - - Alcohol and other drug use - - Adequate, appropriate, and safe food and nutrition

12/22/2015 Wellness Programs and Health Education Health Focus Area – Health Focus Area – Physical Activity

12/22/2015 Injury Prevention Health Focus Area Health Focus Area - I njuries and violence - Childhood Injury Prevention Programs - Intentional Injuries and Violence - Gun Control Programs - Fall Prevention - Burns and Fire-related injury prevention - Motor Vehicle Injury Prevention

12/22/2015 Sharps Collection Program Health Focus Area - Health Focus Area - Injuries and violence - Communicable disease Prevention and Control

12/22/2015 Environmental Health ä Human Health Hazard Investigation ä Radon Testing and Education ä Emergency Response ä Water Testing ä Restaurant and Lodging Inspections ä Animal Bite Investigations Health Focus Area - - Environmental and occupational health - Communicable Disease Prevention and Control

12/22/2015 Swimming Pool and Beach Inspections Health Focus Area: - Communicable Disease Prevention, - Environmental and Occupational Health

12/22/2015 Reproductive/Perinatal Health ä Prenatal Care Coordination ä WIC ä Family Planning ä Sexually Transmitted Disease Clinics and Investigation of Cases Health Focus Area - Health Focus Area - R eproductive and sexual health - Adequate, appropriate, and safe food nutrition - Alcohol and other drug use - - Mental health Tobacco use and exposure Health growth and development

12/22/2015 Infant and Child Health ä ä 72,002 births in WI (2008 birth data) ä ä WIC ä ä Immunizations ä ä Health Check ä ä Visits to new moms ä ä Day Care Issues ä ä Child Abuse and Neglect Health Focus Area - - Oral health - Injury and violence - - Tobacco use and exposure - Adequate, appropriate, and safe food nutrition

12/22/2015 Adolescent Health Health Focus Area - - Tobacco use and exposure - - Alcohol and drug use - - Reproductive and sexual health - Physical Activity - Nutrition and Healthy Growth and development

12/22/2015 Public Health Preparedness Health Focus Area - - Communicable disease prevention and management - - Environmental and occupational health - - Mental health

12/22/2015 Oral Health Programs Health Focus Area - - Oral Health - - Tobacco use and Exposure - - Healthy growth and development

12/22/2015 Ten Leading Causes of Death in the United States CDC Data TuberculosisHeart Disease (34%) Pneumonia (11%)Cancer (29%) Diarrhea and EnteritisStroke (7%) Heart Disease (8%)COPD (6%) Kidney Disease (5%)Accidents/Injury (6%) Injuries (5%)Diabetes (4%) Stroke (5%)Alzheimer’s Cancer (4%)Influenza/Pneumonia (4%) BronchitisKidney Disease (2%) DiptheriaSepticemia

12/22/2015 Another way to think about how we make ourselves sick is by looking at this chart of lifestyle-related causes of death Table 2

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12/22/2015 Public Health Departments Improve the Health of the Public

12/22/2015 Wisconsin Local Health Departments “Public health departments are like the police and fire departments. They teach and practice prevention, but they are prepared to act in emergencies. While the public appreciates them most in emergencies, they are truly successful --and least noticed--when their prevention efforts work.” Larry Gilbertson