Upload
jennis
View
32
Download
2
Embed Size (px)
DESCRIPTION
Charlotte/Sarasota County Health Status Review & Recommendations. Zac Bielling Peace River Regional Medical Center Jack Lagrace Fawcett Memorial Hospital. Lindsey Cooke Charlotte Regional Medical Center Shreeta Quantano Sarasota Memorial Hospital. AGENDA. Purpose - PowerPoint PPT Presentation
Citation preview
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
AGENDAAGENDA PurposePurpose Overview of Health IssuesOverview of Health Issues StatisticsStatistics
Access to CareAccess to Care ObesityObesity Mental HealthMental Health
RecommendationsRecommendations Next StepsNext Steps
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
AGENDAAGENDA PurposePurpose Overview of Health IssuesOverview of Health Issues StatisticsStatistics
Access to CareAccess to Care ObesityObesity Mental HealthMental Health
RecommendationsRecommendations Next StepsNext Steps
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
AGENDAAGENDA PurposePurpose Overview of Health IssuesOverview of Health Issues StatisticsStatistics
Access to CareAccess to Care ObesityObesity Mental HealthMental Health
RecommendationsRecommendations Next StepsNext Steps
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
Recommendations: Access to CareRecommendations: Access to CareModels Models
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
Recommendations: Access to CareRecommendations: Access to CareModels Models
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
AGENDAAGENDA PurposePurpose Overview of Health IssuesOverview of Health Issues StatisticsStatistics
Access to CareAccess to Care ObesityObesity Mental HealthMental Health
RecommendationsRecommendations Next StepsNext Steps
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