Charlotte/Sarasota County Health Status Review & Recommendations

11

Charlotte/Sarasota County Charlotte/Sarasota County Health Status Health Status

Review & RecommendationsReview & Recommendations

Zac BiellingZac BiellingPeace River Regional Peace River Regional

Medical CenterMedical Center

Jack LagraceJack LagraceFawcett Memorial HospitalFawcett Memorial Hospital

Lindsey Cooke Lindsey Cooke Charlotte Regional Charlotte Regional

Medical CenterMedical Center

Shreeta Quantano Shreeta Quantano Sarasota Memorial Sarasota Memorial

HospitalHospital

22

AGENDAAGENDA PurposePurpose Overview of Health IssuesOverview of Health Issues StatisticsStatistics

Access to CareAccess to Care ObesityObesity Mental HealthMental Health

RecommendationsRecommendations Next StepsNext Steps

33

PurposePurpose

Provide insight to critical health issues affecting Provide insight to critical health issues affecting Charlotte and Sarasota CountiesCharlotte and Sarasota Counties

Offer recommendations that will ultimately Offer recommendations that will ultimately improve the health of the community by:improve the health of the community by: Increasing access to healthcare resourcesIncreasing access to healthcare resources Better focus on prevention and health education for Better focus on prevention and health education for

chronic illnesseschronic illnesses Prevent unnecessary ER visits and hospitalizationsPrevent unnecessary ER visits and hospitalizations

44




55

Overview of Health IssuesOverview of Health Issues Residents of Sarasota and Charlotte counties suffer Residents of Sarasota and Charlotte counties suffer

from:from: Barriers to access careBarriers to access care

• Lack of coverage and public awareness of available healthcare Lack of coverage and public awareness of available healthcare resourcesresources

• Insufficient supply of physicians caring for the growing number of Insufficient supply of physicians caring for the growing number of under and un-insured residents, as well as those on Medicaidunder and un-insured residents, as well as those on Medicaid

High prevalence of chronic diseases linked to inadequate High prevalence of chronic diseases linked to inadequate nutrition and sedentary lifestylesnutrition and sedentary lifestyles• These behaviors are initiated at younger ages where there is a lack These behaviors are initiated at younger ages where there is a lack

of resources to counteract these trends (i.e. lack of school-based of resources to counteract these trends (i.e. lack of school-based programs that encourage physical activity and proper nutrition)programs that encourage physical activity and proper nutrition)

Increasing rate of mental illness Increasing rate of mental illness • High and growing rate of mental health-related issues (i.e. intentional High and growing rate of mental health-related issues (i.e. intentional

injuries, hospitalizations). These disorders often are undiagnosed and injuries, hospitalizations). These disorders often are undiagnosed and untreated. There is a lack of resources to support counter-acting untreated. There is a lack of resources to support counter-acting these trends.these trends.

66




77

Statistics: Access to CareStatistics: Access to CareHealth coverage:

Charlotte county: 21.8% Sarasota county: 18.1% Florida: 18.7%

CHIP Health Survey findings:: 14% of all respondents report someone in family used ER for non emergent

care 32.6% of those who used ER for non emergent care did so because doctor

was closed 81% indicate not knowing of any clinics that treat the uninsured (2006,

Sarasota County Survey) 64.3% reported they were not aware of community programs to help become

healthier (2006) 41% indicated they did not have a dental exam or receive dental hygiene in

the past year due to cost Fewer than 10 physicians are providing services to more than 45% of the

Medicaid population in Sarasota County

Florida Health Insurance Study, 2004

88

Statistics: Obesity RelatedStatistics: Obesity Related

Interesting facts about AmericaInteresting facts about America Obesity is less prevalent in Charlotte and Sarasota Obesity is less prevalent in Charlotte and Sarasota

counties, although currently trending toward Florida counties, although currently trending toward Florida and US levelsand US levels

Approximately 1 in 4 people do not exercise regularlyApproximately 1 in 4 people do not exercise regularly 75% of the population does not consume appropriate 75% of the population does not consume appropriate

levels of fruits and vegetableslevels of fruits and vegetables

CHILDREN vs. ADULTSCHILDREN vs. ADULTS Florida United States

Percent Children Overweight

14% 15%

Percent Adults Overweight

58.2% 58.5%

99

Statistics: ObesityStatistics: Obesity

Hospitalizations due to: (per 100,000 population)

Charlotte County

Sarasota County

Florida U.S.*

Diabetes 2785.9 1992.6 2180.9 1708.4

Congestive Heart Failure

582.9 450.1 427.3 369.7

Cellulitis 123.9 110.8 134.2 129.5

Hypertension 150.0 107.8 135.3 167.6 Source: CHIP Project, Health Profile for Sarasota and Charlotte Counties, 2002 data *U.S. is 2001 Data

• In the United States alone, the combined direct and indirect costs of obesity were estimated to be $123 billion in 2001.1

1 Hossain, P (2007).Obesity and diabetes in the developing world — A growing challenge. The New England Journal of Medicine. 356, 213-215.

Hospitalizations related to ObesityHospitalizations related to Obesity

1010

Statistics: Mental HealthStatistics: Mental HealthCause of Cause of

DeathDeathRankRank Number Number

of of Deaths Deaths 2004 2004 (Raw)(Raw)

Percent Percent of Total of Total DeathsDeaths

2004 2004 Crude Crude Death Death RateRate

2004 2004 Age-Age-

adjusted adjusted Death Death RateRate

Percent Percent change change

from from 2003 - 2003 - 20042004

Male to Male to Female Female RatioRatio

Black to Black to White White RatioRatio

Hispanic Hispanic to Non-to Non-

Hispanic Hispanic WhiteWhite

Intentional Intentional Self-harm Self-harm (suicide)(suicide)

1111 32,43932,439 1.41.4 11.011.0 10.910.9 +.9+.9 4.04.0 .4.4 .5.5

Source: CDC/NCHS, 2004 Mortality Data. Death rates on annual basis per 100,00. Age-adjusted rates per 100,000.

Age GroupAge Group

Cause Cause of of

DeathDeath

Total # Total # of of

DeathsDeaths

10-1410-14

RawRaw

(%)(%)

15-1915-19

RawRaw

(%)(%)

20-2420-24

RawRaw

(%)(%)

25-3425-34

RawRaw

(%)(%)

35-4435-44

RawRaw

(%)(%)

45-5445-54

RawRaw

(%)(%)

55-6455-64

RawRaw

(%)(%)

65-7465-74

RawRaw

(%)(%)

75-8475-84

RawRaw

(%)(%)

85+85+

RawRaw

(%)(%)

SuicideSuicide 2,3082,308 1919

(.82)(.82)

8282

(3.5)(3.5)

124124

(5.4)(5.4)

293293

(12.7)(12.7)

430430

(18.6)(18.6)

520520

(22.5)(22.5)

339339

(14.7)(14.7)

199199

(8.6)(8.6)

196196

(8.5)(8.5)

104104

(4.5)(4.5)

Source: Florida Department of Health, 2005 Resident Deaths.

1111

Statistics: Mental HealthStatistics: Mental HealthCountyCounty 2003 – 5 Average 2003 – 5 Average

Number of DeathsNumber of Deaths2003 – 5 Average 2003 – 5 Average Number of Total Number of Total

PopulationPopulation

Age-Adjusted 3-yr Age-Adjusted 3-yr Death RateDeath Rate

State TotalState Total 2,3282,328 17,598,68817,598,688 12.612.6

CharlotteCharlotte 3030 154,886154,886 19.119.1

SarasotaSarasota 6161 360,334360,334 16.116.1

While hospitalization data (hospitalizations due to depressive While hospitalization data (hospitalizations due to depressive disorders and psychoses) have steadily declined for Charlotte and disorders and psychoses) have steadily declined for Charlotte and Sarasota counties, rates are believed to reflect both missed Sarasota counties, rates are believed to reflect both missed diagnosis and limited availability of psychiatric bedsdiagnosis and limited availability of psychiatric beds

It is estimated that one in five Americans suffer from moderate to It is estimated that one in five Americans suffer from moderate to severe mental illness, but do not seek treatment due to continuing severe mental illness, but do not seek treatment due to continuing social stigmasocial stigma

1212

Statistics: Mental HealthStatistics: Mental Health

County-level trends reflects increasing age-adjusted death rate for

suicide

1313




1414

Recommendations: Access to CareRecommendations: Access to CareModels Models

1. Sarasota County’s Health Care Access1. Sarasota County’s Health Care Access• Potential framework and foundation for Potential framework and foundation for

Charlotte CountyCharlotte County

2. Hillsborough County Healthcare Plan, FL2. Hillsborough County Healthcare Plan, FL

3. Project Access, Dallas, TX3. Project Access, Dallas, TX

1515

1. 1. Sarasota County Health Care AccessSarasota County Health Care Access Target uninsured residents at or below 200% FPLTarget uninsured residents at or below 200% FPL Universal referral system and patient information Universal referral system and patient information

among network providersamong network providers Establish volunteer health care provider network Establish volunteer health care provider network Case management services for uninsured patientsCase management services for uninsured patients

Reduce unnecessary ED utilization/avoidable hospitalizationReduce unnecessary ED utilization/avoidable hospitalization Increase access to low/no cost medications for Increase access to low/no cost medications for

uninsureduninsured

Recommendations: Access to CareRecommendations: Access to CareModelsModels

Primary objective of enhancing community’s awareness regarding availability of healthcare resources for uninsured

1616

22. . Hillsborough County Healthcare PlanHillsborough County Healthcare Plan Comprehensive managed care plan for uninsured Comprehensive managed care plan for uninsured

with incomes up to 100% FPLwith incomes up to 100% FPL Competitive contracts with providers and enrollees Competitive contracts with providers and enrollees

are integrated into systemare integrated into system Funding support via state authorized sales tax (1/2 Funding support via state authorized sales tax (1/2

cent sales tax and later reduced to ¼ cent) cent sales tax and later reduced to ¼ cent)

OutcomesOutcomes:: Reduced per patient costs by 65%Reduced per patient costs by 65% Estimated savings of $100 million over 10 yearsEstimated savings of $100 million over 10 years

$10 million Emergency care, $90 million medical $10 million Emergency care, $90 million medical expensesexpenses

Reduced hospital admission rates for chronic diseasesReduced hospital admission rates for chronic diseases


Strong emphasis on early intervention and health education

1717

3. 3. Project Access, Dallas, TXProject Access, Dallas, TX Developed in 2001, Dallas County Medical Society and Developed in 2001, Dallas County Medical Society and

community partnerscommunity partners Provides care for uninsured up to 200% FPLProvides care for uninsured up to 200% FPL Physicians, hospitals, and other providers care for a set Physicians, hospitals, and other providers care for a set

number of patients/yearnumber of patients/year

OutcomesOutcomes:: FY 2005 ED direct and indirect cost savings $553,375FY 2005 ED direct and indirect cost savings $553,375 PAD patients visit ED 61% less and spend 75% less days in PAD patients visit ED 61% less and spend 75% less days in

hospital post-enrollmenthospital post-enrollment Enrollees visited ED 1.8/year before enrolling, 0.7/year post-Enrollees visited ED 1.8/year before enrolling, 0.7/year post-

enrollmentenrollment FY 2005 total hospital savings by avoided uncompensated FY 2005 total hospital savings by avoided uncompensated

utilization estimated at $3,059 per enrollee/yearutilization estimated at $3,059 per enrollee/year


1818

Recommendations: ObesityRecommendations: Obesity

Partner with Key Stakeholders for Partner with Key Stakeholders for Prevention StrategiesPrevention Strategies

Collaborate with Local Schools and Collaborate with Local Schools and Community AgenciesCommunity Agencies

Develop Childhood Obesity Prevention Develop Childhood Obesity Prevention StrategiesStrategies

Research Funding for Prevention Research Funding for Prevention StrategiesStrategies

Financing Childhood Obesity Prevention Programs: Federal Funding Sources and Other Strategies by The Finance Project September 2004

1919

Recommendations: Obesity -Recommendations: Obesity -Stakeholders & StrategiesStakeholders & Strategies

Key StakeholdersKey Stakeholders

Childhood Obesity Prevention StrategiesChildhood Obesity Prevention Strategies Encouraging Healthy LifestylesEncouraging Healthy Lifestyles Providing Fitness and Nutrition EducationProviding Fitness and Nutrition Education Ensuring Access to Safe EnvironmentsEnsuring Access to Safe Environments Ensuring Access to Adequate Amounts of Healthy Ensuring Access to Adequate Amounts of Healthy

FoodFoodFinancing Childhood Obesity Prevention Programs: Federal Funding Sources and Other Strategies by The Finance Project September 2004

• ParentsParents • SchoolsSchools• CommunitiesCommunities • GovernmentGovernment• Health Care ProvidersHealth Care Providers

2020

Recommendations: Obesity - Recommendations: Obesity - SchoolsSchools

Nutrition and Eating BehaviorsNutrition and Eating Behaviors Ensure all school meals meet dietary guidelinesEnsure all school meals meet dietary guidelines Develop, implement and evaluate pilot programs to Develop, implement and evaluate pilot programs to

expand school meal fundingexpand school meal funding Remove junk food from vending machines and limit Remove junk food from vending machines and limit

availability of machines during school hoursavailability of machines during school hours Physical ActivityPhysical Activity

Intramural and interscholastic sports programsIntramural and interscholastic sports programs Partnering with local community centers forPartnering with local community centers for after schoolafter school

and summer programsand summer programs Incorporate nutritional lessons into gym class lesson Incorporate nutritional lessons into gym class lesson

plansplansKoplan, J and IOM Committee on Progress in Preventing Childhood Obesity, Preventing Childhood Obesity: Health in Balance, Overview and Next Steps

2121

Recommendations:Recommendations:Mental HealthMental Health

Partner with Key Stakeholders for Mental Health Partner with Key Stakeholders for Mental Health Prevention StrategiesPrevention Strategies

Charlotte and Sarasota County Department’s of HealthCharlotte and Sarasota County Department’s of Health Florida Department of Children and FamiliesFlorida Department of Children and Families Senior Friendship CentersSenior Friendship Centers Parents, Family MembersParents, Family Members SchoolsSchools Media OutletsMedia Outlets

Develop Depression and Mental Health Prevention Develop Depression and Mental Health Prevention StrategiesStrategies

Research/Develop Mental Health Funding PathwaysResearch/Develop Mental Health Funding Pathways

2222

Recommendations:Recommendations:Mental Health - StrategiesMental Health - Strategies

Target: All agesTarget: All ages Strategy Objective: Ensuring treatment of Strategy Objective: Ensuring treatment of

mental health disorders – Community Based mental health disorders – Community Based PharmaciesPharmacies• Forge strategic partnerships with pharmaceutical Forge strategic partnerships with pharmaceutical

companiescompanies• Streamline enrollment/application process for Streamline enrollment/application process for

medicationmedication• Ensure adherence to treatment protocolEnsure adherence to treatment protocol• Reduce/eliminate financial barriersReduce/eliminate financial barriers

2323

Recommendations:Recommendations:Mental Health - StrategiesMental Health - Strategies

Targeted Population: ElderlyTargeted Population: Elderly Strategy Objective: Reduce feelings of social Strategy Objective: Reduce feelings of social

isolation and encourage maintenance of isolation and encourage maintenance of active lifestylesactive lifestyles

Best Practice Model: PEARLS (CDC-PRC Best Practice Model: PEARLS (CDC-PRC Sponsored Initiative)Sponsored Initiative)• Home-based depression sessionsHome-based depression sessions• Initiate senior-centered exercise programsInitiate senior-centered exercise programs

2424

Recommendations: Recommendations: Mental Health - StrategiesMental Health - Strategies

Targeted Population: YouthTargeted Population: Youth Strategy Objective: Implement school-based Strategy Objective: Implement school-based

mental health promotion programsmental health promotion programs• Promote social/emotional competenciesPromote social/emotional competencies• Emphasize development of positive characterEmphasize development of positive character• Emphasize skills and attitudes consistent with Emphasize skills and attitudes consistent with

positive lifestylespositive lifestyles

2525

Recommendations: Mental Health Recommendations: Mental Health – Funding Pathways– Funding Pathways

Substance Abuse and Mental Health Substance Abuse and Mental Health Services Administration Services Administration Provides funding opportunities to improve the Provides funding opportunities to improve the

quality and availability of mental health quality and availability of mental health servicesservices

Florida statewide initiative to transform the Florida statewide initiative to transform the publicly funded mental health systempublicly funded mental health system Florida’s Mental Health TransformationFlorida’s Mental Health Transformation

• Consumer and family-driven systemConsumer and family-driven system

2626




2727

Next Steps: Access to CareNext Steps: Access to CareCase Study Common Themes:1. Volunteer healthcare provider network

2. Case management services

-Cross agency case management (JaxCare)

3. Collaboration of several groups essential to leveraging resources

County objectives should focus on expanding Sarasota Health Care Access program while developing a viable plan for Charlotte County

Schedule future meetings with exemplary organizations for benchmarking

Charlotte County restructure Access to Care Task Force and seek future Lower Income Funding support and other grant opportunities

2828

Next Steps: ObesityNext Steps: Obesity

Meeting with School SuperintendentsMeeting with School Superintendents Vending Machines with Healthy Food Options Vending Machines with Healthy Food Options

& Limited Accessibility& Limited Accessibility Healthy Cafeteria OptionsHealthy Cafeteria Options Increased Physical Activity at each grade Increased Physical Activity at each grade

levellevel Meeting with Local Community CentersMeeting with Local Community Centers Educate parents and facilitate healthy Educate parents and facilitate healthy

lifestyleslifestyles

2929

Next Steps: Mental HealthNext Steps: Mental Health Increase awareness of mental health Increase awareness of mental health

illness/reduce stigmaillness/reduce stigma Eliminating Barriers Initiative – Pilot Program with Eliminating Barriers Initiative – Pilot Program with

Florida participationFlorida participation Involves various stakeholders and increases Involves various stakeholders and increases

awareness of mental health issues and resourcesawareness of mental health issues and resources Meet with Community Organizations Meet with Community Organizations

Develop community based pharmaciesDevelop community based pharmacies Develop more mental health outreach programsDevelop more mental health outreach programs

Meet with School Superintendents Meet with School Superintendents Discuss implementation of school-based mental Discuss implementation of school-based mental

health promotion programshealth promotion programs

3030

THANK YOUTHANK YOU

QUESTIONS?QUESTIONS?

3131

ReferencesReferencesBehavioral Risk Factor Surveillance System, 2001Behavioral Risk Factor Surveillance System, 2001

Behavioral Risk Factors Telephone Survey 2002 from Health Planning Council of Southwest Florida Behavioral Risk Factors Telephone Survey 2002 from Health Planning Council of Southwest Florida http://www.hpcswf.com/PlanningProjects.asphttp://www.hpcswf.com/PlanningProjects.asp

Community Health Improvement Partnership. Health profile for Sarasota and Charlotte Counties. Community Health Improvement Partnership. Health profile for Sarasota and Charlotte Counties. 2003 and 2004.2003 and 2004.

Community Health Improvement Partnership. Summary of best practices. 2006Community Health Improvement Partnership. Summary of best practices. 2006

Elimination of Barriers Initiative – Modules and toolkits to reduce mental health stigmaElimination of Barriers Initiative – Modules and toolkits to reduce mental health stigmahttp://http://www.dcf.state.fl.us/mentalhealth/ebi/index.shtmlwww.dcf.state.fl.us/mentalhealth/ebi/index.shtml

Florida Health Insurance Study. 2004Florida Health Insurance Study. 2004

Health Planning Council of Southwest Florida. Accessed Health Planning Council of Southwest Florida. Accessed http://www.hpcswf.com/PlanningProjects.asp July, 2007http://www.hpcswf.com/PlanningProjects.asp July, 2007

U.S. Census Bureau, State and County Quick FactsU.S. Census Bureau, State and County Quick Facts

3232

AppendixAppendix

3333

PercentPercent Charlotte Charlotte SarasotaSarasota FloridaFlorida

SmokeSmoke 18.3%18.3% 19.6%19.6% 22.2%22.2%

Drink heavilyDrink heavily 15.0%15.0% 9.9%9.9% 14.7%14.7%

High blood High blood pressurepressure

38.2%38.2% 30.4%30.4% 27.7%27.7%

High cholesterolHigh cholesterol 46.5%46.5% 37.8%37.8% 35.2%35.2%

DiabetesDiabetes 8.4%8.4% 7.7%7.7% 8.2%8.2%

OverweightOverweight 35.6%35.6% 39.5%39.5% 35.7%35.7%

ObeseObese 27.8%27.8% 16.9%16.9% 22.3%22.3%

Behavioral Risk Factors Telephone Survey, 2002Behavioral Risk Factors Telephone Survey, 2002

Health Planning Council of Southwest Florida

Appendix AAppendix A

3434

Appendix BAppendix B

DiagnosisDiagnosis CharlotteCharlotte Area 8Area 811 FloridaFloridaCHF rate/100,000 (age 18+)CHF rate/100,000 (age 18+) 765.2765.2 620.4620.4 577.8577.8

Bacterial Pneumonia/100,000 Bacterial Pneumonia/100,000 (total population)(total population)

434.3434.3 364.5364.5 333.3333.3

COPD/100,000 (age 18+)COPD/100,000 (age 18+) 367.0367.0 295.8295.8 281.3281.3

Perforated Appendix /1,000 Perforated Appendix /1,000 abdomen w/ appendicitisabdomen w/ appendicitis

321.7321.7 339.4339.4 291.2291.2

Adult Asthma rateAdult Asthma rate 246.5246.5 11.111.1 134.7134.7

Top Five Avoidable Hospital Admissions rates, Charlotte CountyTop Five Avoidable Hospital Admissions rates, Charlotte County

1 Area 8 represents data for the seven SW Florida Counties: Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota

3535

Appendix CAppendix C

DiagnosisDiagnosis SarasotaSarasota Area 8Area 811 FloridaFloridaCHF Admissions CHF Admissions

Rate/100,000 (age 18+)Rate/100,000 (age 18+)1400.51400.5 620.4620.4 577.8577.8

COPD/100,000 (age 18+)COPD/100,000 (age 18+) 492.9492.9 295.8295.8 287.3287.3

Bacterial Pneumonia/100,000 Bacterial Pneumonia/100,000 (total population)(total population)

635.6635.6 364.5364.5 333.3333.3

Perforated Appendix /1,000 Perforated Appendix /1,000 abdomen w/ appendicitisabdomen w/ appendicitis

465.6465.6 339.4339.4 291.2291.2

Angina without Procedure Angina without Procedure admission rate/100,000admission rate/100,000

364.9364.9 45.245.2 39.739.7

Top Five Avoidable Hospital Admissions rates, Sarasota CountyTop Five Avoidable Hospital Admissions rates, Sarasota County

1 Area 8 represents data for the seven SW Florida Counties: Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota

3636

Appendix DAppendix D

Charlotte County Sarasota County State of Florida

Caucasian 88.8%88.8% 87.5%87.5% 62.1%62.1%

African-American 5.3%5.3% 4.5%4.5% 15.7%15.7%

American Indian/Alaska Natives

0.2%0.2% 0.2%0.2% 0.4%0.4%

Asian 1.1%1.1% 1.1%1.1% 2.1%2.1%

Native Hawaiian/Pacific Islander

0.0%0.0% 0.0%0.0% 0.1%0.1%

Hispanic 4.2%4.2% 6.3%6.3% 19.5%19.5%

Source: U.S. Census Bureau, State and County Quick Facts

Obesity Census DataObesity Census Data

3737

Appendix EAppendix E

Non-Non-Hispanic Hispanic

WhiteWhite

Non-Non-Hispanic Hispanic

BlackBlack

HispanicHispanic AsianAsian Native Native AmericanAmerican

Pacific Pacific IslanderIslander

OverweightOverweight

(BMI (BMI ≥ 25)≥ 25)

39.2%39.2% 39.5%39.5% 42.2%42.2% 32.8%32.8% 35.1%35.1% 40.8%40.8%

ObeseObese

(BMI (BMI ≥ 30)≥ 30)

21.8%21.8% 34.8%34.8% 28.3%28.3% 4.8%4.8% 34.3%34.3% 33.0%33.0%

BMI (Mean)BMI (Mean) 26.826.8 28.728.7 27.927.9 24.024.0 28.528.5 27.827.8

Sample Sample SizeSize

129,116129,116 12,56112,561 12,15312,153 3,0713,071 2,2992,299 626626

Source: 2001 BRFSS, Behavioral Risk Factor Surveillance System

Prevalence of Overweight and Obese by EthnicityPrevalence of Overweight and Obese by Ethnicity

3838

Appendix FAppendix FObesity and DiabetesObesity and Diabetes

OVERALLOVERALL Charlotte County Sarasota County State of Florida

Percent Overweight

35.6% 39.5% 35.1%

Percent Obese 21.8% 16.9% 22.3%

Percent with Diabetes

8.4% 8.2% 7.7%

1 Behavioral Risk Factors Telephone Survey 2002 from Health Planning Council of Southwest Florida http://www.hpcswf.com/PlanningProjects.asp

• Prevalence of diabetes is increasing due to the escalation of the overweight and obese population.2

• More than 1.1 billion adults worldwide are overweight, and 312 million of those are obese. 2

2 Hossain, P (2007).Obesity and diabetes in the developing world — A growing challenge. The New England Journal of Medicine. 356, 213-215.

3939

Appendix GAppendix GBarriers to Establishing a Volunteer Physician NetworkBarriers to Establishing a Volunteer Physician Network

Physician perspectives:Physician perspectives: Too many referrals, too few volunteersToo many referrals, too few volunteers Concerns for malpractice litigationConcerns for malpractice litigation Not equitable among community providersNot equitable among community providers Other services not available to patientsOther services not available to patients Lack of patient responsibilityLack of patient responsibility Low appreciation/recognitionLow appreciation/recognition Inconsistent Administrative SupportInconsistent Administrative Support

4040

Appendix HAppendix HPotential Solutions to Establishing a Volunteer NetworkPotential Solutions to Establishing a Volunteer Network

Equitable distribution of referrals to physiciansEquitable distribution of referrals to physicians Malpractice immunity (Access to Healthcare Act)Malpractice immunity (Access to Healthcare Act) Shared community responsibilityShared community responsibility Access to prescriptions for patients in specialty Access to prescriptions for patients in specialty

carecare Increased patient responsibilityIncreased patient responsibility Recognition of professionRecognition of profession Consistent Administrative SupportConsistent Administrative Support

4141

Appendix IAppendix IRecommendations: Obesity - SchoolsRecommendations: Obesity - Schools

Healthy Schools – Nutrition and Eating Healthy Schools – Nutrition and Eating BehaviorsBehaviors Develop and implement nutritional standards for all Develop and implement nutritional standards for all

food and beverages sold or servedfood and beverages sold or served Ensure all school meals meet dietary guidelinesEnsure all school meals meet dietary guidelines Develop, implement and evaluate pilot programs to Develop, implement and evaluate pilot programs to

expand school meal fundingexpand school meal funding Remove junk food from vending machines and limit Remove junk food from vending machines and limit

availability of machines during school hoursavailability of machines during school hours Provide more nutritious options for school Provide more nutritious options for school

luncheslunches

Koplan, J and IOM Committee on Progress in Preventing Childhood Obesity, Preventing Childhood Obesity: Health in Balance, Overview and Next Steps

4242

Appendix JAppendix JObesity - Examples of FundingObesity - Examples of Funding

Strategy Programs

Promoting Healthy Lifestyles*Targeting Obesity

State Nutrition and Physical Activity Programs to Prevent Obesity and Related Chronic Diseases and Prevention and Treatment of Childhood Obesity in Primary Care;

Promoting Healthy LifestylesTarget Special Populations

Health Disparities in Minority Health Grant Program; Children, Youth and Families at Risk State Strengthening Projects; Community Programs to Improve Minority Health

Promoting Healthy LifestylesGeneral Health and Wellness

Preventive Health and Health Services Block Grant

Promoting Healthy LifestylesPhysical Fitness

Carol M. White Physical Education Program; National Youth Sports Program Fund; After School Program with a Focus on Fitness

Fitness and Nutrition Education Team Nutrition Training Grant Program; 21st Century Community Learning Center Block Grant

Parental Involvement Even Start Program: State Agency Block Grant

Access to Safe Environments Community Development Block Grant Entitlement Communities Program

Access to Adequate Amounts of Healthy Food National School Lunch Program; National School Breakfast Program; Summer Food Service Program; Child and Adult Care Food Program; Food Stamps; Community Food Projects

*Currently Florida receives funding for the Florida Diabetes Prevention and Control Program (DPCP) since 1996

4343

Appendix KAppendix KRecommendations: Obesity – SchoolsRecommendations: Obesity – Schools

Healthy Schools – Physical ActivityHealthy Schools – Physical Activity Intramural and interscholastic sports Intramural and interscholastic sports

programsprograms• After school use of school facilitiesAfter school use of school facilities• Use of schools as community centersUse of schools as community centers

Partnering with local community centers for Partnering with local community centers for after school and summer programsafter school and summer programs

Incorporate nutritional lessons into gym class Incorporate nutritional lessons into gym class lesson planslesson plans

Koplan, J and IOM Committee on Progress in Preventing Childhood Obesity, Preventing Childhood Obesity: Health in Balance, Overview and Next Steps

Documents

Charlotte/Sarasota County Health Status Review & Recommendations