Steps to a HealthierFLPinellas County

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Steps to a HealthierFL-Pinellas County
Claude M. Dharamraj, MD, MPH Assistant
Director Pinellas County Health Department
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Leading Causes of Death Pinellas County, 2004
COPD Chronic Obstructive Pulmonary Disease
CLDC Chronic Liver Disease Cirrhosis
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Half of All Deaths in the U.S. Can Be Attributed
to These Categories
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Heart
Disease

Heart
Heart


Disease

Disease
Cancers
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Cancers

Cancers

Diabetes

Heart
All Injuries

Respiratory
Diabetes
Disease

Respiratory

Disease

Cancers

Disease

Infant

All Injuries

HIV/AIDS

Infant
Deaths
Infant
Infant

Deaths

Deaths

Deaths
Diet/Activity
Alcohol Use
Tobacco Use
Other
Source McGinnis, J.M. Foege, W.H. (1993)
Actual causes of deaths in the United States JAMA
., 270(18), 2207
2212.
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Steps to a HealthierFL-Pinellas County Grant
Purpose

• Reduce burden of 3 chronic diseases
• Diabetes
• Obesity
• Asthma
• By targeting 3 risk behaviors
• Poor Nutrition
• Lack of Physical Activity
• Tobacco Use and Exposure

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Steps to a HealthierFL Pinellas County Grant

• HHS and CDC
• 1 million for 2003
• 2 million per year for 2004-2008
• Public-private partnership
• Includes school system
• Began funding 9/22/2003
• 230 Original applicants

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Year One Steps Awardees Representing 23
Communities
State-coordinated Small Cities/Rural
Communities WA 4 counties AZ 3
counties CO 4 counties NY 4 counties
Tribes/Tribal Entities Intertribal Council Of
Michigan
Large Cities/Urban Communities Seattle-King
County, WA Salinas-Monterey County,
CA Austin-Travis County, TX New Orleans, LA St.
Petersburg-Pinellas County, FL Boston,
MA Philadelphia, PA
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Steps to a HealthierFL-Pinellas County
Intervention Area (IA)Total population -
310,81758 schools - 57,900 Students
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Obesity
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Obesity Trends Among U.S. AdultsBRFSS, 1985
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1986
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1987
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1988
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1989
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1990
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1991
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1992
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1993
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1994
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1995
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1996
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1997
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1998
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 1999
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 2000
(BMI 30, or 30 lbs overweight for 5 4
person)
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Obesity Trends Among U.S. AdultsBRFSS, 2001
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2002
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2003
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. AdultsBRFSS, 2004
(BMI 30, or 30 lbs overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
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Adults Overweight or Obese
Source 2002 BRFSS
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Diabetes
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AADR for Diabetes Mellitus
Age-adjusted death rate per 100,000 pop. Source
Florida DOH CHARTS
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Adults who have been told by a health
professional that they have DM
Source 2002 BRFSS
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Diabetes Cost

• Pinellas County, 2003
• Over 1,600 hospitalized
• Cost 36.2 million

AHCA 2003
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Asthma
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AADR for COPD
Age-adjusted death rate per 100,000 pop. Source
Florida DOH CHARTS
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Adults who ever had asthma
Source 2002 BRFSS
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Asthma Cost

• Pinellas County, 2003
• Over 500 hospitalized
• Cost 7 million

AHCA 2003
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Behavioral Risks
Adults
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Adults who currently smoke
Source 2002 BRFSS
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Adults who mostly sit or stand at job
Source 2002 BRFSS
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Adults with no leisure time activity
Source 2002 BRFSS
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Adults with no regular moderate physical
activity
Source 2002 BRFSS
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Adults eating lt 5-A-Dayfruits and vegetables
Source 2002 BRFSS
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Behavioral Risks
Youth
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Pinellas students (IA) overweight by BMI Testing
Source FitnessGram Data 2005
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Consume at least 2 fruits daily

• Pinellas High School Students
• 15.8

2005 YRBS (IA)
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Watch gt 2 hour of TV on school nights

• Pinellas H.S. Students
• 58.9
• Pinellas M. S. Students
• 87.8

2005 YRBS (IA) 2003 YRBS
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No strenuous physical activity in last 7 days

• Pinellas H.S. Students
• 17.9
• Pinellas M. S. Students
• 16.4

2005 YRBS (IA) 2003 YRBS
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Current tobacco use(any kind)

• Pinellas Youth
• 22.5
• Florida Youth
• 19.1

Source 2002 FYTS
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Asthma in Youth

• Pinellas County
• 2002-03 School Year
• 5.1 students have asthma

Pinellas County Schools
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Healthy People 2010 Goals

• Reduce hospitalizations for asthma for persons
  less than 18 years
• Pinellas baseline 625
• Pinellas 2008 goal - 500
• HP 2010 Goal
• Reduce hospitalizations for asthma

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HP 2010 Nutrition

• Increase the of persons aged 2 years older who
  consume at least 2 fruits daily
• Pinellas baseline 19
• Pinellas 2008 goal 50
• HP 2010 goal 75

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HP 2010 Education

• Target schools will offer enhanced School Health
  Education through Pinellas Schools STEPS
• Pinellas 2008 goal 90

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Community Action Plan

• Divided into 2 sections
• School-based Interventions
• Community Interventions
• Focused on populations experiencing greater
  burden of chronic diseases
• Activities divided into 6 areas
• Nutrition/Obesity, Diabetes, Physical Activity,
  Tobacco, and Asthma

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Pinellas County Schools Steps Staff

• Peggy Johns, Supervisor
• (Pre K-12 Health Education)
• Lisa Ross, School Steps Coordinator
• Linda Steimel, Clerical Support
• Catherine Gerard, Nutrition Education
• Dolores McCoy, Nutrition Education

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School Action Plan

• Salad Bar Program
• FitnessGram
• Staff Pedometer Program
• Asthma Services
• Numerous Health Curricula Used In Class

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Healthy Interventions

• Healthy choices in vending machines
• The time interval between meals and students
  lunch schedule
• Increase healthy food choices
• Importance of physical education
• Curriculum incorporating health messages
• Sharing results of surveys with students

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Nutrition Interventions

• Nutrition classes in community sites and after
  school programs
• 5 A Day education for children

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Obesity Interventions

• PCS collaboration with
• Choose To Lose Weight Management
• (Bayfront Medical Center)
• Childrens Weight Management
• Parent adolescent conditioning training (YMCA)
• KidShapers (All Childrens Hospital)
• Nutrition Youth Team (4-H Club)
• BMI Chart Distribution (PinCHD)

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Physical Activity Interventions

• YMCA - Champion
• PE classes in community sites
• Walking programs
• - PCS Staff
• - Community
• Lunch Bunch Programs
• After School Programs

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Tobacco Interventions

• Health Department/American Lung Association -
  Champions
• Smoke-free car kits
• Students teach students
• Youth Advocates
• Smoking Cessation
• - Youth and Adults

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Diabetes Interventions

• Community-based organizations - Champion
• Diabetic self-management education
• Diabetes awareness
• Youth diabetes prevention class
• Diabetes assessment questionnaire
• Diabetes weight management program

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Asthma Interventions

• All Childrens Hospital - Champion
• Pediatric outreach care coordination
• Asthma Champion
• Training for Asthma certification
• Grand Rounds
• Asthma Website
• Asthma Resource Directory/Speakers Bureau

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Asthma Interventions

• ALA
• Asthma U Education Seminar for adults
• A is for Asthma
• Awareness in-service for pre and child care
  providers
• Health Department
• Indoor air quality assessment

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Take Steps for a Healthier Pinellas
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Steps Contacts

• Lisa Ross, Steps School Coordinator
• Lisa_Ross_at_places.pcsb.org
• Richard Curtin, Steps Project Manager
• Richard_Curtin_at_doh.state.fl.us
• Steps Direct Line
• Pinellas County Health Department (727)-820-4113

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Useful Websites

• http//www.pinellas.k12.fl.us/CI/STEPS/
• http//www.pinellaswellness.com/
• http//www.healthierus.gov/steps/
• http//www.nhlbi.nih.gov/
• http//www.5aday.com/

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Questions???