Overview of Community Transformation Grant

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1 Overview of Community Transformation Grant CTG Leadership Team Meeting August 29, 2012

2 Causes of Death Cause of Death Number of Deaths Heart disease 599,413 Cancer 567,628 Stroke 128,842 Chronic lower respiratory disease 137,353 Unintentional injuries 118,021 Diabetes 68,705 Influenza/pneumonia 53,692 Alzheimer s 79,003 Influenza and Pneumonia 53,692 U.S. data. Source: Centers for Disease Control and Prevention

3 Real Causes of Death The Real Causes of Death Number of Deaths Percentage Tobacco 435,000 18% Diet/activity 365,000 15% Alcohol 85,000 4% Microbial agents 75,000 3% Toxic agents 55,000 2% Firearms 29,000 1% Sexual behavior 20,000 <1% Motor vehicles 43,000 <1% Illicit use of drugs 17,000 <1% U.S. data. Source: Mokdad et al, JAMA 2004 March 10; 291 (10): U.S. 2000

4 Obesity Trends in Minnesota Percent of Minnesota Adults Obese (BRFSS)

5 Minnesota Tobacco Use Trends Percent of Minnesota Adult Current Smokers (BRFSS)

6 MN Health Care Cost Trends Health Care Spending in Minnesota from

7 Health Care in Minnesota Costs of tobacco and obesity in Minnesota Tobacco $2.9 billion in annual medical costs (2007) Obesity $2.8 billion estimated annual financial burden (2006)

8 Health Care in Minnesota Minnesota spends annually per-capita: Almost $7,000 health care Less than $4 on SHIP Source: Center for Disease Control and Prevention, University of California at San Francisco, Institute for the Future, thanks to Dakota SHIP

10 What efforts lead us to CTG? 1. Steps to a Healthier MN 2. Statewide Health Improvement Program - SHIP 3. Communities Putting Prevention to Work 4. Community Transformation Grant

11 SHIP Overview Goal of SHIP as part of Minnesota s health reform Support Minnesotans to live longer, healthier lives by reducing risk factors that lead to chronic disease. Prevent or delay onset of chronic diseases Contain spiraling costs associated with treating chronic diseases

12 SHIP Overview SHIP works to make it so that People have greater access to healthy foods More communities are biking and walking friendly More children have healthy food in their schools and child care More public areas are tobacco-free Therefore fewer Minnesotans will suffer from the burden of chronic disease

13 SHIP Overview Keys to success Strategies are evidence-based Population-based versus individual-based Sustainable through partnerships Strong evaluation

14 SHIP Overview First two years, All 87 MN counties and 9 of 11 tribal communities. Hundreds of businesses, schools, non-profits, health care organizations and others involved. 90%+ of funding went directly to local communities via tribal and local public health agencies Tribal Grantees Leech Lake with partners: Mille Lacs, Bois Forte, Grand Portage, White Earth, Fond du Lac, Red Lake Upper Sioux Lower Sioux

15 SHIP Strategies Strong school partnerships Farm to School: 367 schools serving more than 200,000 students Smoking cessation services: 33 post-secondary Tobacco-free campuses: 31 post-secondary schools Increased physical activity: 46 schools Safe Routes to School:117 schools serving at least 77,000 students

17 SHIP Strategies Strong school partnerships Farm to School: 367 schools serving more than 200,000 students Smoking cessation services: 33 post-secondary Tobacco-free campuses: 31 post-secondary schools Increased physical activity: 46 schools Safe Routes to School:117 schools serving at least 77,000 students

19 Results from the First Two Years SHIP made an impact in communities More biking and walking: projects in 255 cities Nutrition: 544 child care sites have serving approximately 8564 children Increased physical activity: 902 child care sites serving over 20,000 children Farmers markets: up 61 percent Tobacco-free parks policies:6 cities Smoke free policies: 227 apartment buildings

21 Results from the First Two Years SHIP made an impact in communities More biking and walking: projects in 255 cities Nutrition: 544 child care sites have serving approximately 8564 children Increased physical activity: 902 child care sites serving over 20,000 children Farmers markets: up 61 percent Tobacco-free parks policies:6 cities Smoke free policies: 227 apartment buildings

23 Results from the First Two Years Working with our heath care partners Approximately 60 clinics are now assessing and discussing patient risk behaviors and referring patients to community resources 73 health care institutions are now working to support breastfeeding

24 Results from the First Two Years Healthier employees = savings for employers Worksite wellness initiatives: 870 employers reaching over 138,000 employees Tobacco-free grounds: 21 worksites Increasing physical activity: 47 employers Improved food options available to staff: 90 employers

25 SHIP SHIP funding is $15 million for FY (through June 30, 2013) 18 SHIP grantees covering 55 counties and cities and one tribal community

26 National health reform context Affordable Care Act (ACA) Prevention and Public Health Fund of ACA Administered by the Centers for Disease Control and Prevention (CDC) Community Transformation Grant (CTG): Prevention focus of national health reform

27 CTG Goals: Improve health of the nation by improving weight and reducing tobacco use and exposure Control health care spending through reductions in risk factors for chronic disease

28 CTG Funding: 5-year grants awarded competitively to 61 states and communities, totaling $103 million Transforming communities: $1/per capita MDH grant award is $3.6 million/year

29 CTG Guiding principles: Maximize health impact through prevention Improve health equity Expand evidence-base for policy, systems and environmental changes that improve health

30 CTG Strategic directions: 1. Tobacco-free living 2. Active living and healthy eating 3. Clinical preventive services 4. Social and emotional wellness 5. Healthy and safe physical environments

31 Requires dual approach CTG Targeted efforts focused on health disparities Statewide impact

32 CTG Focus on health disparities: Rural Poverty Smoking rates Obesity rates Chronic disease burden

33 CTG Funding: MDH award is $3.6 million per year Requirements of a state grantee: At least 50% to community efforts At least 37% to rural and frontier counties

34 CTG Three levels of MDH CTG efforts: 1. Local grants 2. Regional-level systems 3. State-level coordination

35 Level 1: Local grants Selection criteria: SHIP grantees Criteria identifying highest need Rural and Frontier areas: counties and tribal land Poverty Smoking and obesity rates Chronic disease burden County Health Rankings Site visits to assess capacities and partnerships

42 Tobacco use in rural communities More likely to smoke cigarettes Higher rates of smokeless tobacco use More likely exposed to secondhand smoke Less access to cessation programs Social and personal acceptance of tobacco use

43 Level 1: Local grants Grantees selected: North County-Polk- Mahnomen-Norman Clay-Wilkin-Becker-Otter Tail Leech Lake Morrison-Todd-Wadena-Cass Carlton-Cook-Lake-St. Louis- Aitkin-Itasca-Koochiching

44 Level 2: Regional-level systems Active living: Regional Development Commissions Healthy eating: Regional food councils Clinical services: Regional Learning Collaboratives Tobacco-free living: County, multi-county and regional approaches

45 Level 2: Regional-level systems Minnesota Regional Development Commissions Regional Sustainable development Partnerships Regional Learning Collaboratives Regional offices of American Lung Association

46 Level 2: Regional-level systems Minnesota Regional Development Commissions Regional Sustainable development Partnerships Regional Learning Collaboratives Regional offices of American Lung Association

47 Level 3: State-level coordination Active living: State policies Administrative functions Healthy eating: State food charter Clinical services: Community measures Reimbursement Tobacco-free living: State coordination and policies

48 Level 3: State-level coordination Overall grants management Coordination with SHIP Training and technical assistance Evaluation Communications

49 Level 3: State-level coordination MDH/Hennepin County collaboration plan: Leadership Team membership MN Food Charter Clinical reimbursement demo pilot Smoke-free foster care

50 Health improvement benefits Over time, these benefits should be realized: Increased access to physical activity, healthy foods, and smoke-free environments Increased economic activity from jobs attributable to SHIP and CTG Increased productivity from improved worker health Decreased health care costs from reduced health risk behaviors and chronic diseases

51 Web links: CTG SHIP Chris Kimber, MS, RD, PAPHS Office of Statewide Health Improvement Initiatives

52 Making connections Break into small groups Discuss other local and regional health improvement initiatives see next slide Note taker for each group

53 Making connections Discussion question: What is happening within your communities and regions that might have a linkage with CTG?

Healthy Communities Grant Application Form

Healthy Communities Grant Application Form Crow Wing Energized along with the Statewide Health Improvement Program (SHIP) is working to help community members of Crow Wing County live longer, healthier