Deputy Director for Public Health Services · Deputy Director for Public Health Services. ... -...

Public Health in the First Decade of the 21st CenturyPublic Health in the First Decade of the 21st CenturyPhiladelphia, PA March 24, 2004

Ed Thompson, MD, MPHEd Thompson, MD, MPHDeputy Director for Public Health Services

Centers for Disease Control and Prevention

ANTHRAXANTHRAX

West Nile Virus 1999

West Nile Virus 2000

West Nile Virus 2001

West Nile Virus 2002

9100 cases 222 deathsAs of January 21, 2004

1971U.S. civilian vaccination stopped

200338,257 civilians vaccinated

1971U.S. civilian vaccination stopped

200338,257 civilians vaccinated

(as of 8/8/03)

8437 cases worldwide

813 deaths

8437 cases worldwide

813 deaths

33 U.S. cases No Deaths33 U.S. cases No Deaths( plus 159 “suspect” cases)

PUBLIC HEALTHPUBLIC HEALTH

PUBLIC HEALTHPUBLIC HEALTH

72 total U.S. cases

37 lab-confirmed

35 suspect/probable

72 total U.S. cases

37 lab-confirmed

35 suspect/probable

Fak Has Kilu Shot Demand Rises Sharply

Vicious flu strain hits nation early

In Colorado, Flu Outbrelled at Least 5 Children

Shortage of Flu Shots Prompts RationingVaccine Being Reserved For Highest-Risk Patients

PUBLIC HEALTHPUBLIC HEALTH

Whatgoesaround

Whatgoesaround

ComesaroundComesaround

Old Public Health ThreatsOld Public Health Threats

The MicrobeThe MicrobeMalariaMalaria

Plasmodium Plasmodium vivaxvivax

The VectorThe Vector

New Public Health ThreatsNew Public Health Threats

The VectorThe Vector“Travel from a SARS affected area & having “Travel from a SARS affected area & having

an exposure to a person infected with an exposure to a person infected with SARS”SARS”

The MicrobeThe MicrobeCoronavirusCoronavirus, SARS, SARS--CoVCoV

A new, severe respiratory A new, severe respiratory illness that has been reported illness that has been reported

worldwide. worldwide.

“They fancied themselves free, and no one will ever be free so long as there are pestilences.”

- Albert Camus, The Plague

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs overweight for 5’4” woman)

No Data <10% 10%-14% 15%-19% 20%-24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 1990

No Data <10% 10%-14% 15%-19% 20%-24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 1991

No Data <10% 10%-14% 15%-19% 20%-24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 1993

No Data <10% 10%-14% 15%-19% 20%-24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 1995

No Data <10% 10%-14% 15%-19% 20%-24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 1997

No Data <10% 10%-14% 15%-19% 20%-24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 1999

No Data <10% 10%-14% 15%-19% 20%-24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2000

No Data <10% 10%-14% 15%-19% 20%-24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2001

(*BMI ≥30, or ~ 30 lbs overweight for 5’4” woman)

No Data <10% 10%-14% 15%-19% 20%-24% ≥25%

Blood Lead Levels in the U.S. Population 1976–1999NHANES II, III, 99+

1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000

Year

18

2

4

6

8

10

12

14

16

Blo

od L

ead

Lev

els (

mg/

dL)

0

2.7 2.0

unleadedgasoline

Introduced1979

leadpaintBan1976

can solderphase-out

Begins1978

lead &copperRule1991

cansolderends1992

leadedgas

ends1996

The New Normal

The New Normal

Preparedness and Response to EmergenciesPreparedness and Response to Emergencies

ANDAND

Protection of Health from Predictable ThreatsProtection of Health from Predictable Threats

The New Normal

Preparedness and Response to EmergenciesPreparedness and Response to Emergencies

AND

Protection of Health from Predictable ThreatsProtection of Health from Predictable Threats

AND

Chronic diseases

Environmental threats

Injury

The New Normal

The New NormalThe New Normal

The Old Normal That Ain’t Gonna ChangeThe Old Normal That Ain’t Gonna Change

The American Public Health System

STATE

STATE

LOCAL

LOCAL

FEDERAL

FEDERAL

The American Public Health System

STATE

STATE

LOCAL

LOCAL

FEDERAL

FEDERAL

The American Public Health System

STATE

STATE

LOCAL

LOCAL

FEDERAL

FEDERAL

The New NormalThe New Normal

The Old Normal That Ain’t Gonna ChangeThe Old Normal That Ain’t Gonna Change

The New NormalThe New Normal

The Old Normal That Ain’t Gonna ChangeThe Old Normal That Ain’t Gonna Change

The Imperative for CDC to ChangeThe Imperative for CDC to Change

CDC’s Futures InitiativeCDC’s Futures InitiativeIdeas…Input…Implementation…ImpactIdeas…Input…Implementation…Impact

Why Change?Why Change?Why Change?

By modernizing its strategy, CDC can enhance its overall impact on the health status of the public.

CDC must work to sustain our reputation as the premier public health agency within HHS.

By modernizing its By modernizing its strategy, CDC can enhance strategy, CDC can enhance its overall impact on the its overall impact on the health status of the public. health status of the public.

CDC must work to sustain CDC must work to sustain our reputation as the our reputation as the premier public health premier public health agency within HHS.agency within HHS.

Aging population

Increasing diversity

Escalating health costs

Changes in access to health care services

Health disparities

Global threats

Terrorism

Epidemic effects of chronic diseases

Aging population

Increasing diversity

Escalating health costs

Changes in access to health care services

Health disparities

Global threats

Terrorism

Epidemic effects of chronic diseases

Ready for Challenges of the 21st Century

Ready for Challenges of Ready for Challenges of the 21the 21stst CenturyCentury

New Strategic GoalsNew Strategic GoalsNew Strategic Goals

Preparedness: All communities will be protected from infectious, environmental, and terrorist threats.

Health promotion and prevention of disease, injury, and disability: All people will achieve their optimal lifespan with the best possible quality of health in every stage of life.

Preparedness: All communities will be : All communities will be protected from infectious, environmental, protected from infectious, environmental, and terrorist threats.and terrorist threats.

Health promotion and prevention of disease, injury, and disability:: All All people will achieve their optimal lifespan people will achieve their optimal lifespan with the best possible quality of health in with the best possible quality of health in every stage of life.every stage of life.

Strategic ImperativesStrategic ImperativesStrategic Imperatives

Customer-focus

Public Health Research

Leadership for the nation’s health system

Increased focus on Global Health

Effectiveness and Accountability

CustomerCustomer--focus focus

Public Health ResearchPublic Health Research

Leadership for the nation’s health system Leadership for the nation’s health system

Increased focus on Global HealthIncreased focus on Global Health

Effectiveness and AccountabilityEffectiveness and Accountability

ImplementationImplementationImplementationCommunication

TeamCommunicationCommunication

TeamTeam

Strategic Imperatives

Teams

Strategic Strategic Imperatives Imperatives

TeamsTeams

Health ProtectionGoals Team

Health ProtectionHealth ProtectionGoals TeamGoals Team

Business Practices Team

Business Business Practices TeamPractices Team

OrganizationalDesign Team

OrganizationalOrganizationalDesign TeamDesign Team

Health Protection Impact!

Health Protection Health Protection Impact!Impact!

CommunicateCommunicateCommunicate

Check Futures Updates at the Futures Initiative Internet Web site: www.cdc.gov/futures

Contribute your questions and comments at futuresgroup@cdc.gov.

Check Futures Updates at Check Futures Updates at the Futures Initiative the Futures Initiative Internet Web site: Internet Web site: www.cdc.gov/futures

Contribute your questions Contribute your questions and comments at and comments at futuresgroup@cdc.gov.

www.CDC.govwww.CDC.gov