1. Non-infectious Chronic Diseases Control & Prevention in Zhabei District Jane Xiong Zhabei District CDC, Shanghai, China Aug 29,2006

2. 2 Brief Introduction of Myself (1) Jane Xiong Jane Xiong Shanghai Zhabei CDC Shanghai Zhabei CDC 2002.4- Community Disease Management 2002.4- Community Disease Management 1997.7-2002.4 Anti-epidemic 1997.7-2002.4 Anti-epidemic 2004 M.S., Epidemiology, Fudan University 2004 M.S., Epidemiology, Fudan University 1997 B.M., Preventive medicine, Fudan University 1997 B.M., Preventive medicine, Fudan University (formerly Shanghai Medical University) (formerly Shanghai Medical University)

3. 3 Brief Introduction of Myself (2)  Researching on policy supporting for disease control and prevention in community  Researching on how the general team in community health service(CHS) provide rapid, economic, sustained service for residents  Designing the model community's chronic diseases’ standardized and comprehensive management  Designing health promotion for all people in community, developing suitable intervention measures

4. 4 Brief Introduction of Myself (3)  Surveilling and managing infectious disease in community  Responsible for AIDS defending program, attending program planning, implementing and evaluating  Constructing HIV primary screening lab of Zhabei District  Drafting " Medium and long-term plans of AIDS defending in Zhabei district (2001-2015) "

5. 5 Brief Introduction of Zhabei District Northern of central Shanghai Northern of central Shanghai 29.18 sq. Km. 29.18 sq. Km. 8 communities 8 communities 800,000 residents 800,000 residents 150,000 floating people 150,000 floating people ≥ 60 Ages is 19.7% ≥ 60 Ages is 19.7% Life expectancy 80.72

6. 6 The Order of Death Causes in Zhabei (2000-2005) ORDE R 200020012002200320042005 CAUSE ％ ％ ％ ％ ％ ％ 1 38.97 36.57 36.49 39.45 39.10 40.33 2 28.47 29.39 29.12 28.13 28.84 28.53 3 9.54 11.16 11.81 10.58 9.93 10.79 4 5.33 5.13 5.19 5.13 5.19 4.64 5 3.75 4.31 4.08 4.41 4.16 3.38 6 2.20 2.37 2.58 2.24 2.90 2.63 7 2.20 1.94 2.14 1.94 1.40 1.55 8 2.02 1.57 1.09 0.70 1.31 1.06 9 0.97 0.76 0.98 1.08 0.96 0.85 10 0.60 0.71 0.64 0.77 0.82 endocrinopathy poisonings and injuries respiratory system cancer circulatory system neuropathy urogenital disease infectious disease and verminosis digestive system lunacy

7. 7 The Death Rate of Leading Diseases in Zhabei (1955-2005) 1960 70 80 90 2000 YEAR DEATH RATE(1/100,000)

8. 8 The Incidence Rate of Main Cancers in Zhabei (2003) ORDE R MALE FEMALE 1lung cancer87.23breast cancer59.41 2stomach cancer48.37lung cancer39.42 3liver cancer33.27stomach cancer28.56 4colon cancer26.84colon cancer28.28 5rectum cancer21.53rectum cancer14.85 1/100,000

9. 9 Network of Chronic Diseases Control & Prevention Shanghai CDC Zhabei CDC Planning and organizing Instruction and training Quality control Statistic analysis & evaluation System of CHS Chronic Diseases Control & Prevention in Communities Hospitals level 2 or 3 District Health Bureau Chronic Diseases Registering & Reporting Other Departments Concerned Cooperation District Government Professional guidance Administration Management

10. 10 Center for Community Health Service (CHS) Workstation of CHS System of CHS in Zhabei District Community Government Other departments NGOs Cooperation Prevention & Control Health Care Primary Medical Treatment Handicapped Healing Health Promotion Family Planning Guiding director ¥8→30 per capita

11. 11 Work Station of CHS in Zhabei District 1 Offer health service to 10,000-20,000 CHS general team General practitioners Public health practitioner Community nurses Walk 15-20 Min

12. 12 The Strong Points of General Teams  Convenient shorten the service radius  Advantageous to organize suitable, effective health promotion giving chronic disease patients continuous service  Economic the elementary medicine has kept in community, and the expenditure is lower The system of CHS has provided a good platform for community chronic disease prevention, control and management

13. 13 Our Works of Chronic Diseases Control & Prevention  What to do?  How to do? Information Garthering and Patients Finding Health promotion Patient Management

14. 14 Information Gathering and Patient Registering Risk factors High risk people Patients Community diagnosis health records Surveillance Intervention strategy Following-up Epidemiology Free medical examination Other ways Clinic Screening System of CHS Reporting Quality control Analysis Evaluation Zhabei CDC Feedback

15. 15 Quality control Analysis Evaluation Cancer Finding and Registering Hospitals level 2 or 3 in zhabei Inputing information & reporting to CDC Zhabei CDC Prevention&health care section In-patient Department Out-patient Department Emergency Department Filling in Cancer Report Cards of New Patients Information Department Assistant Department (CT/Pathology/…) Other Department Cooperation

16. 16 Information Interchange with other CDC Health Services for Cancer Patients in Communities Zhabei CDC CDC of Other 18 Districts Shanghai CDC Interchange the Cancer Report Cards by Patients’ Address

17. 17 Public Health Intervention Policy interventionEducation intervention Improve environment supporting ability Health screening Biologic prevention Detect earlier Biologic Barrier Idea changed Health belief & behavior

18. 18 Intervention (1) The theme of Cancer control and prevention Week 1999~2005  2006 Proper diet, cancer prevention  2005 Health life, cancer prevention  2004 Delivering cancer prevention knowledge to communities  2003 Detect earlier, diagnose earlier and treat earlier  2002 Health life says “no” to cancer  2001 Preventing cancer scientifically and treating standardly  2000 Preventing cancer correctly  1999 Cancer can be prevented and cured

19. 19 Intervention(2) Counseling Lecture Poster Pamphlet Cancer Week(4.15-21) Activity

20. 20 Intervention(3) Diabetes board “I Know My Own blood Pressure” Community Sports Meeting

21. 21 Intervention(4) Measuring blood pressure for every patient aged≥35 when he/she goes to hospital for the first time every year Strictly implementing the policy made by shanghai health bureau

22. 22 Intervention(5)  Organizing a professional union  Professional training  Keeping from physical & mental pressure  Instructing family members offering help to patients The 1st Cancer Helping Center in Shanghai

23. 23 Intervention(6) The Diabetic Club

24. 24 Patient Management General teams of CHS Different level management from diagnosis to death Chronic disease management system Quality control Professional guiding Statistic analysis& evaluation feedback General management Family sickbed Hospice Hospital Level 2 or 3 deteriorating mending Zhabei CDC

25. 25 My goal in EHIB  To know the model about community disease control & prevention in U.S.A  To make some progress on community health promotion’s planning, practicing and evaluation

26. 26 ` Thank you!