Why Policy, Systems and Environmental Change?

New Jersey ‘s Mission: Develop and implement the

Blueprint for Healthy Aging in New Jersey

By Roslyn Council, NJDHSS

Healthy Communities in NJHealthy Communities in NJ

• Creating a better tomorrow through one Creating a better tomorrow through one community at a time.community at a time.

• Assist local public health offices in disparate Assist local public health offices in disparate communities in Southern New Jersey. communities in Southern New Jersey.

• Help identify effective evidence based Help identify effective evidence based strategies in public health that are strategies in public health that are

appropriate for the needs of their individual appropriate for the needs of their individual countiescounties

Southern Areas of ConcentrationSouthern Areas of Concentration

Atlantic CountyAtlantic CountyCamden CountyCamden CountyCumberland CountyCumberland CountySalem CountySalem County

How did we get Buy-in? How did we get Buy-in?

The Office of Public Health Infrastructure (OPHI)The Office of Public Health Infrastructure (OPHI)

provides leadership, guidance resources and provides leadership, guidance resources and technical assistance for MAPP (Mobilizing for technical assistance for MAPP (Mobilizing for Action through Planning and Partnerships) a Action through Planning and Partnerships) a county-based public health partnerships which county-based public health partnerships which they generated the first county-wide Community they generated the first county-wide Community Health Improvement Plan (CHIP) and begun to Health Improvement Plan (CHIP) and begun to implement strategies to address the priorities implement strategies to address the priorities identified in the CHIPs .identified in the CHIPs .

Why these counties ?Why these counties ?

High % of Persons with limited High % of Persons with limited incomes.incomes.

High % of individuals without Health High % of individuals without Health Insurance or limited coverage.Insurance or limited coverage.

High % of disabled persons and those High % of disabled persons and those of racial/ethnic minority populations.of racial/ethnic minority populations.

These are individuals who are at high-These are individuals who are at high-risk for chronic diseases.risk for chronic diseases.

CHIP-Priorities:CHIP-Priorities:

A “Healthier Community” A “Healthier Community” Improving Chronic DiseasesImproving Chronic Diseases Develop and execute evidence based Develop and execute evidence based

interventions proven to reduce the interventions proven to reduce the burden of disease among individuals. burden of disease among individuals.

New Jersey Funding New Jersey Funding

The Federal Budget The Federal Budget has been decreased has been decreased nationally.nationally.

State Funding for State Funding for local health local health departments departments decreased decreased significantly.significantly.

Challenge 1: How Do County Health Departments meet Program Priorities With Decrease Budget?

Challenge 1: How Do County Health Departments meet Program Priorities With Decrease Budget?

PartnershipPartnership Collaboration Collaboration NetworkingNetworking Creating An Alliance for Creating An Alliance for

policy, systems & policy, systems & environmental changesenvironmental changes

Challenge 2: Benefits of Policy, Systems & Environmental Change? Challenge 2: Benefits of Policy, Systems & Environmental Change?

Increase Impact of larger community/environmentIncrease Impact of larger community/environment More effective & efficient delivery of servicesMore effective & efficient delivery of services Innovative IdeasInnovative Ideas New and broader issues without the sole responsibility for New and broader issues without the sole responsibility for

developing solutionsdeveloping solutions Elimination of Duplication of ServicesElimination of Duplication of Services Improved CommunicationsImproved Communications Improved Public ImageImproved Public Image Better Needs Assessment Better Needs Assessment Increase availability of FundingIncrease availability of Funding Increased availability of combining resourcesIncreased availability of combining resources Consistency of informationConsistency of information SustainabilitySustainability

Partnerships/StakeholdersPartnerships/Stakeholders

..New Jersey Department of Health and Senior New Jersey Department of Health and Senior Services (NJDHSS) Services (NJDHSS)

Division of Aging and Community Services Division of Aging and Community Services (DACS)(DACS)

Office of Public Health Infrastructure ( OPH) Office of Public Health Infrastructure ( OPH) Chronic Disease Prevention and Control Chronic Disease Prevention and Control

(CDPC)(CDPC)Local Health Departments/ Health OfficersLocal Health Departments/ Health OfficersSouthern Jersey Family Medical Center Southern Jersey Family Medical Center

(SJFMC)(SJFMC)Area Health Education Centers (AHEC)Area Health Education Centers (AHEC)

County MAPP CoordinatorsCounty MAPP CoordinatorsMinority communities and faith based Minority communities and faith based

organizations.organizations.

CDPCCDPC Funding to Provide:CDPCCDPC Funding to Provide:

Mini-grants will be given to the Mini-grants will be given to the county Public Health Officers county Public Health Officers /Health Depts. and Community /Health Depts. and Community Health Improvement Plan (CHIP) Health Improvement Plan (CHIP) teams for evidence based trainings teams for evidence based trainings regarding the top five (5) identified regarding the top five (5) identified health issues for their counties .health issues for their counties .

Implement evidence based Chronic Implement evidence based Chronic Disease Self – Management Disease Self – Management Program (CDSM)- “Take Control Program (CDSM)- “Take Control Of Your Health”Of Your Health”

Chronic Disease Self – Management Program

(CDSM)- “Take Control Of Your Health”Chronic Disease Self – Management Program

(CDSM)- “Take Control Of Your Health”

The Chronic Disease Self-Management Program is a workshop The Chronic Disease Self-Management Program is a workshop where people with different chronic diseases attend together. It where people with different chronic diseases attend together. It teaches the skills needed in the day-to-day management of teaches the skills needed in the day-to-day management of treatment and to maintain and/or increase life’s activities .treatment and to maintain and/or increase life’s activities .

This program is from Stanford University and is what is called This program is from Stanford University and is what is called “evidence based”, which means it has been proven beneficial “evidence based”, which means it has been proven beneficial again and again in a wide variety of populations. It is offered in again and again in a wide variety of populations. It is offered in 40 states and 19 different countries 40 states and 19 different countries

Issue OrientedIssue Oriented StructuredStructured Focused to Act on Specific Goals/OutcomesFocused to Act on Specific Goals/Outcomes

Chronic Disease Self – Management Program (CDSM)- “Take Control Of Your Health” in NJ

Chronic Disease Self – Management Program (CDSM)- “Take Control Of Your Health” in NJ

Managed through the DHSS-Division of Aging and Managed through the DHSS-Division of Aging and Community Services (DACS)Community Services (DACS)

TODAY for CDSMP: Programs delivered in 19 of 21 counties. 1,585 participants 85 Master Trainers 343 Peer Leaders

Today for DSMP 20 Master Trainers in 12 counties 1 Peer Leader Several DSM Workshops planned

CDSMP Reach to Minority PopulationsCDSMP Reach to Minority Populations

Minority48% White

52%

In 2007, only 6% were non-white.

As of January 2010, 48% from minority

communities.

Diverse Populations Reached CDSMPDiverse Populations Reached CDSMP

Ethnicity

Native American

4%

Asian17%

African American

47%

Hispanic23%

Other9%

Pacific Islander.3%

N=766

CDSMP-OutcomeCDSMP-Outcome

How currently manage disease

85.2%

33.2%

51.3%

75.4%

60.2%

19.3%

0%

20%

40%

60%

80%

100%

See myphysician

Follow diet Exerciseregularly

Takemedicine asprescribed

Prayer Non-traditional

% o

f Peo

ple

What People Say:What People Say:

As a master trainer I now As a master trainer I now live healthier and teach live healthier and teach others to live a healthier lifeothers to live a healthier life

Teaching others to be leaders Teaching others to be leaders of their own health is what it of their own health is what it is all about.is all about.

It is responsibility and It is responsibility and commitmentcommitment

What Does the Future Hold for NJCEED?What Does the Future Hold for NJCEED?

CDPC has integrated CDSMP CDPC has integrated CDSMP into policy, environmental and into policy, environmental and health system change initiatives health system change initiatives for diabetes, heart disease and for diabetes, heart disease and stroke.stroke. CDPC DPCP is integrating CDPC DPCP is integrating

the Stanford Diabetes Self the Stanford Diabetes Self Management Program Management Program (DSMP) into our health (DSMP) into our health systems initiatives.systems initiatives.

The CDPC Diabetes The CDPC Diabetes Prevention and Control Prevention and Control Program have been trained Program have been trained in both.in both.