1. HEALTHY NEW JERSEY 2010 NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES Rose Marie Martin. MPH Research Scientist, NJDHSS, Division of Aids Prevention and Control JULY 2003

2. What is Healthy New Jersey 2010? n New Jersey’s health promotion and disease prevention initiative n Proposes year 2010 targets for 150 measurable health objectives

3. What is Healthy New Jersey 2010? n Provides comprehensive tracking of NJ residents’ health n Will be updated at least twice to measure progress n There are brief updates each year in the annual health statistics report

4. ORGANIZED INTO HEALTH AREAS u WHO WE ARE u OVERALL HEALTH STATUS u ACCESS TO HEALTH CARE u FUNDAMENTALS OF GOOD HEALTH

5. ORGANIZED INTO HEALTH AREAS (CONTINUED) u PREVENTING AND REDUCING MAJOR DISEASES u STRENGTHENING PUBLIC HEALTH CAPACITY u APPENDICES

6. FUNDAMENTALS OF GOOD HEALTH:  ENVIRONMENTAL HEALTH  HEALTHY MOTHERS & YOUNG CHILDREN  HEALTHY BEHAVIORS - ADOLESCENTS  HEALTHY BEHAVIORS - ADULTS  OCCUPATIONAL HEALTH AND SAFETY  UNINTENTIONAL INJURY  PRESERVING GOOD HEALTH FOR SENIORS

7. PREVENTING AND REDUCING MAJOR DISEASES  HEART DISEASE AND STROKE  DIABETES  CANCER  HIV/AIDS  MENTAL HEALTH  ADDICTIONS  ASTHMA  INFECTIOUS DISEASES  SEXUALLY TRANSMITTED DISEASES

8. DEVELOPMENT OF HNJ2010 AN INTER-DEPARTMENTAL WORK GROUP DEVELOPED THE ORIGINAL DRAFT THREE PUBLIC MEETINGS WERE HELD TO SEEK INPUT WRITTEN COMMENTS WERE SOLICITED FROM HEALTH PROFESSIONALS AND THE PUBLIC

9. Framework of Healthy New Jersey 2010 n Two overarching goals: - Increase health-related quality and years of life of life - Eliminate health disparities based on race/ethnicity race/ethnicity n These goals are identical in HNJ2010 and  HP2010  HP2010

10. New Jersey’s Diversity: A Public Health Challenge for 2010 New Jersey United States Population (2000) 8,414,350 281,421,906 Population Density (2000) (persons/square mile) 1,134.4 79.6 Median Age (2000) 36.7 35.3 Percentage Age > 65 Years (2000) 13.2 12.4 Age > 85 Years (2000) 1.6 1.5 Percentage of Population Male/Female (2000) 48.5/51.5 49.1/50.9 Percentage of Population Below Poverty Level (2000) 8.5 12.4 Percentage of School/aged Related Children Below Poverty Level (2000) 10.5 15.4 Percentage of Live Births to Females Aged 10-17 Years (1997) 3.0 4.9

11. New Jersey’s Diversity (cont.) Number of Counties 21 3,136 Number of Local Health Departments1132,918 Racial Distribution of Population (2000) Percentage White non-Hispanic66.0 69.1 Percentage Black non-Hispanic13.0 12.1 Percentage Asian/PI non-Hisp 5.7 3.7 Percentage non-Hispanic Other 1.9 2.5 Percentage Hispanic 13.3 12.5 Educational Attainment (2000) (Age > 25 Years) (Age > 25 Years) High School Graduate or More 82.1 80.4 High School Graduate or More 82.1 80.4 Completed Bachelor’s Degree Completed Bachelor’s Degree or More 29.8 24.4 or More 29.8 24.4

12. 69.6 Healthy Life Expectancy at Birth in Years New Jersey, 1996-1998 55.2 53.9 66.3 0 10 20 30 40 50 60 70 80 White femalesWhite malesBlack femalesBlack malesTotal 67.1

13. Target Setting n Healthy New Jersey indicators identify specific, measurable targets and preferred endpoints n 5 major health areas - Overall Health Status - Access to Health Care - Fundamentals of Good Health - Preventing and Reducing Major Diseases - Strengthening Public Health Capacity

14. RACIAL DISPARITY IN HEALTH OUTCOMES n The Debate - Balance strong community support to eliminate disparities against community’s support for realistic, achievable targets for 2010 - Recognize multiple factors contributing to disparities n The Decision - Two targets F 1. Narrows the gap (target) based on trend data, scientific/medical knowledge and current activities scientific/medical knowledge and current activities F 2. Eliminates the gap (Preferred 2010 endpoint) in most cases

15. How can Healthy New Jersey 2010 be used? n Planning resource: - State and local health agencies - Private health organizations-providers, community based organizations, consumer groups, advocacy groups n Educational resource - Provides health status for New Jersey residents residents

16. HEALTHY NJ 2010 Infrastructure and the Internet n HNJ 2010 in print and on the Web n Provides specific references to data sources n Provides descriptions of data sources n Links to departmental databases n Interdecade updates - not only data updates, but also programmatic initiatives. Will recognize community members n (Future) Web - link to HP2010 and other states’ activities related to 2010 objectives

17. Web page: www.state.nj.us/health/chs/hnj.htm Update Healthy New Jersey 2000 - Second Update and Review Assessment of progress made toward achieving the State's health objectives for 2000. Healthy New Jersey 2010 State Health Issues Opinion Survey 1999 Results of a public opinion poll conducted by the Eagleton Institute regarding New Jersey residents' views on health issues. Healthy New Jersey 2010 (June 2001) Volume I (PDF 828K) Healthy New Jersey 2010 (June 2001) Volume II (PDF 766K) Baseline data for the State's health objectives for 2010.

18. SOURCES OF DATA FOR HEALTHY NEW JERSEY 2010

23. WHAT IS AN OBJECTIVE?

24. FORMAT FOR A MEASURABLE HEALTH OBJECTIVE: 1. WHAT CHANGE (IMPROVEMENT) WILL OCCUR? 2. WITHIN WHAT POPULATION AND AT WHAT RATE WILL THE AND AT WHAT RATE WILL THE CHANGE OCCUR? CHANGE OCCUR? 3. WHAT IS THE TARGET DATE FOR THE EXPECTED CHANGE? FOR THE EXPECTED CHANGE?

25. EACH OBJECTIVE HAS FOR THE TOTAL POPULATION AND EACH SUB-POPULATION: n BASELINE DATA FROM THE MOST RECENTLY AVAILABLE YEAR n TARGET AND PERCENT CHANGE n PREFERRED 2010 ENDPOINT AND PERCENT CHANGE

26. STATEMENT OF A TYPICAL OBJECTIVE FROM HNJ2000: INCREASE IMMUNIZATION LEVELS FOR MEASLES (RUBEOLA) IN CHILDREN BY AGE TWO TO 90.0 PERCENT BY 2000

27. A RELATED OBJECTIVE EXPANDED TO COVER OTHER IMMUNIZATIONS WAS INCLUDED IN HEALTHY NEW JERSEY 2010: BY 2010 INCREASE THE PERCENTAGE OF TWO YEAR OLD CHILDREN RECEIVING DTaP, POLIO, MMR, HiB, AND HEPATITIS B VACCINES, SEPARATELY AND AS PART OF THE 4-3-1 SERIES TO 90.0 PERCENT ALL CHILDREN <= AGE 2 - 90.0% ALL CHILDREN <= AGE 2 - 90.0% MCO ENROLLEES <= AGE 2 - 90.0%

28. COLLECTION OF DATA FOR FIRST UPDATE TO HNJ2010 n PLANNED FOR COMPLETION IN LATE 2003 n TARGETS, PREFERRED 2010 ENDPOINTS AND BASELINES WILL HAVE TO BE ADJUSTED, IN SOME CASES n DATA SOURCES FOR DEVELOPMENTAL OBJECTIVES WILL NEED TO BE IDENTIFIED

29. SELECTED HIGHLIGHTS FROM THE FINAL UPDATE TO HEALTHY NEW JERSEY 2000

30. MEASURING PROGRESS TOWARD HEALTHY NEW JERSEY 2000 TARGETS Progress Quotient = most recent value - baseline value x 100 year 2000 target - baseline value

31. FINAL STATUS FOR OBJECTIVES RELATED TO BIRTHS TO ADOLESCENTS HEALTHY NEW JERSEY 2000 BIRTH RATE TO TOTAL FEMALES 10-14 YEARS BIRTH RATE TO MINORITY FEMALES 10-14 YEARS BIRTH RATE TO TOTAL FEMALES 15-19 YEARS BIRTH RATE TO MINORITY FEMALES 15-19 ADOLESCENT FEMALES WHO RECEIVE FAMILY PLANNING SERVICES

32. FINAL STATUS FOR OBJECTIVES RELATED TO SUBSTANCE USE BY ADOLESCENTS HEALTHY NEW JERSEY 2000 % HIGH SCHOOL STUDENTS CURRENTLY SMOKING CIGARETTES % HIGH SCHOOL STUDENTS WHO USED ALCOHOL IN THE PAST 30 DAYS % HIGH SCHOOL STUDENTS WHO USED MARIJUANA IN THE PAST 30 DAYS % HIGH SCHOOL STUDENTS WHO USED COCAINE IN THE PAST 30 DAYS

33. FINAL STATUS FOR OBJECTIVES RELATED TO INJURIES IN ADOLESCENTS HEALTHY NEW JERSEY 2000 DEATH RATE IN 15-19 YEAR OLDS CAUSED BY MOTOR VEHICLE INJURIES SUICIDE DEATH RATE IN WHITE MALES 15-19 HOMICIDE DEATH RATE IN MINORITY MALES 15-19 ALCOHOL-RELATED MOTOR VEHICLE DEATH RATE IN 15-19 YEAR OLDS

34. FINAL STATUS FOR ACCESS TO PREVENTIVE AND PRIMARY CARE OBJECTIVES HEALTHY NEW JERSEY 2000 FEMALE BREAST CANCER DEATH RATE - TOTAL POPULATION FEMALE BREAST CANCER DEATH RATE - 50-64 YEAR OLDS FEMALE BREAST CANCER DEATH RATE - 65+ YEAR OLDS % 40+ WOMEN WITH MAMMOGRAM & CBE WITHIN PAST YEAR AGE-ADJUSTED TOTAL LUNG CANCER DEATH RATE - NOT CALCULATED AGE-ADJUSTED LUNG CANCER DEATH RATE- MINORITY MALES SMOKING PREVALENCE IN ADULTS 20+ SMOKING PREVEALENCE IN HIGH SCHOOL STUDENTS AGE-ADJUSTED TOTAL CERVICAL CANCER DEATH RATE FINAL STATUS FOR OBJECTIVES TO PREVENT, DETECT AND CONTROL CANCER HEALTHY NEW JERSEY 2000 AVERAGE DAILY SERVINGS OF FRUITS AND VEGETABLES AGE-ADJUSTED MINORITY CERVICAL CANCER DEATH RATE CERVICAL CANCER DEATH RATE IN WOMEN 65+ % WOMEN WHO HAD A PAP SMEAR IN THE PAST TWO YEARS AGE-ADJUSTED TOTAL COLORECTAL CANCER DEATH RATE % MINORITY WOMEN WHO HAD A PAP SMEAR IN THE PAST TWO YEARS % WOMEN 65+ WHO HAD A PAP SMEAR IN THE PAST TWO YEARS

35. 4Ai. AGE-ADJUSTED FEMALE BREAST CANCER DEATH RATE NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVE SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS YEAR 2000 OBJECTIVE

36. 4Aii. FEMALE BREAST CANCER DEATH RATES BY AGE NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVES SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS DEATH RATE - FEMALES 65 & OVER DEATH RATE - FEMALES 50-64 YEAR 2000 OBJECTIVE - FEMALES 65 & OVER YEAR 2000 OBJECTIVE - FEMALES 50-64

37. 4B. WOMEN AGED 40 AND OVER WHO RECEIVED A CLINICAL BREAST EXAMINATION AND A MAMMOGRAM WITHIN THE PAST YEAR NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVE SOURCE: NEW JERSEY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM YEAR 2000 OBJECTIVE

38. 4C. AGE-ADJUSTED LUNG CANCER DEATH RATES, TOTAL AND MINORITY MALES NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVES SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS YEAR 2000 OBJECTIVE - TOTAL DEATH RATE - MINORITY MALES DEATH RATE - TOTAL YEAR 2000 OBJECTIVE - MINORITY MALES

39. 4Dii. PREVALENCE OF CIGARETTE USE* AMONG HIGH SCHOOL STUDENTS NEW JERSEY, 1989-1998 AND YEAR 2000 OBJECTIVE SOURCE: SURVEY REPORTS -"DRUG AND ALCOHOL USE AMONG NEW JERSEY HIGH SCHOOL STUDENTS" *INCLUDES THOSE WHO SMOKE ON OCCASION AS WELL AS REGULAR SMOKERS YEAR 2000 OBJECTIVE

40. 4Di. PERSONS AGED 20 AND OVER WHO ARE CURRENTLY SMOKING CIGARETTES NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVE SOURCE: BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM YEAR 2000 OBJECTIVE

41. 4E. AGE-ADJUSTED COLORECTAL CANCER DEATH RATE NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVE SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS ORIGINAL YEAR 2000 OBJECTIVE REVISED YEAR 2000 OBJECTIVE

42. 4F. AVERAGE DAILY SERVINGS OF FRUITS AND VEGETABLES* IN THE POPULATION AGED 18 AND OVER NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVE SOURCE: NEW JERSEY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM * NOT INCLUDING FRENCH FRIES, FRIED POTATOES OR POTATO CHIPS YEAR 2000 OBJECTIVE

43. 4Gi. AGE-ADJUSTED CERVICAL CANCER DEATH RATES NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVES SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES, CENTER FOR HEALTH STATISTICS TOTAL YEAR 2000 OBJECTIVE-TOTAL MINORITY YEAR 2000 OBJECTIVE-MINORITY

44. 4Gii. CERVICAL CANCER DEATH RATE, AGED 65 AND OVER NEW JERSEY, 1990-1998 AND YEAR 2000 OBJECTIVE SOURCE: NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CENTER FOR HEALTH STATISTICS YEAR 2000 OBJECTIVE

45. 4H. WOMEN WITH UTERINE CERVIX WHO HAVE HAD A PAP SMEAR DURING THE PAST TWO YEARS NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVES SOURCE: NEW JERSEY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM NOTE: MINORITY YEAR 2000 OBJECTIVE WAS REVISED 12/03/93 FROM 80% TO 85% YEAR 2000 OBJECTIVE - TOTAL & MINORITY YEAR 2000 OBJECTIVE - WOMEN AGED 65+

46. 4Hi. WOMEN WITH UTERINE CERVIX WHO HAVE HAD A PAP SMEAR DURING THE PAST TWO YEARS, BY RACE NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVES SOURCE: NEW JERSEY BEHAIORAL RISK FACTOR SURVEILLANCE SYSTEM NOTE: MINORITY YEAR 2000 OBJECTIVE WAS REVISED 12/03/93 FROM 80% TO 85% YEAR 2000 OBJECTIVE - TOTAL & MINORITY

47. 4Hii. WOMEN 65+ WITH UTERINE CERVIX WHO HAVE HAD A PAP SMEAR DURING THE PAST TWO YEARS NEW JERSEY, 1991-2000 AND YEAR 2000 OBJECTIVES SOURCE: NEW JERSEY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM NOTE: MINORITY YEAR 2000 OBJECTIVE WAS REVISED 12/03/93 FROM 80% TO 85% YEAR 2000 OBJECTIVE