Our Health Begins with: The Michigan Health and Wellness 4 x 4 Plan

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1 Our Health Begis with: The Michiga Health ad Welless 4 x 4 Pla J U N E

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5 Table of Cotets Itroductio... 1 Ackowledgemets... 2 Public Health Crisis - A Call to Actio... 3 Compoets of the 4 x 4 Tool... 4 Strategies ad Goals Parterig Orgaizatios Appedix A Suggested Coalitio Strategies Appedix B Suggested Worksite Welless Strategies Appedix C Overweight ad Obesity Dashboard Appedix D Obesity CDC Model 24 Appedix E Natioal Highlights Appedix F Combatig Obesity i Michiga 2012 (Uiversity White Paper) Appedix G Obesity Summit Report November 8, 2011

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7 Itroductio Goveror Rick Syder helped shape the State s visio durig his Health ad Welless Message o September 14, Our visio is for Michigaders to be healthy, productive idividuals, livig i commuities that support health ad welless, with ready access to a affordable, perso-cetered, ad commuity-based system of care. Goveror Syder made reducig obesity a priority, which he has placed o the Michiga Dashboard. I his 2011 ad 2012 State of the State addresses, the Goveror reiterated the importace of persoal resposibility i our quest for healthier idividuals ad commuities. The Michiga 4 x 4 cocept, which he uveiled i his Health ad Welless message this past fall, is oe tool people ca use to attai health. Goveror Syder believes i the power of prevetio ad the impact welless iitiatives ca have o our health as idividuals, commuities, busiesses, ad as a state. The goal of the Michiga Health ad Welless 4 x 4 Pla is for every Michigader to adopt health as a persoal core value. The pla describes the approach that the State of Michiga will udertake i addressig welless ad obesity. Cetral to the pla is the 4 x 4 tool which ca be used to maitai ad/or attai health. The 4 x 4 tool recommeds the practice of four healthy behaviors ad keepig four health measures i cotrol. The four healthy behaviors are: maitai a healthy diet, egage i regular exercise, get a aual physical exam, ad avoid all tobacco use. The four measures are body mass idex (BMI), blood pressure, cholesterol level, ad blood sugar/glucose level. The facts poit to Michiga havig a public health crisis whe it comes to obesity ad chroic illesses. Thirty-two percet of adults are obese (BMI greater tha 30) ad 17 percet of youth are obese. Obesity is the root cause of most chroic illesses. Therefore, the Michiga Health ad Welless 4 x 4 Pla focuses much of its efforts o addressig obesity. Addressig obesity will help Michigaders cotrol blood pressure, cholesterol ad blood sugar/glucose levels which altogether will greatly reduce chroic illesses i our populatio. Implemetatio of this pla will require a collaborative approach amog state, tribal ad local govermets; busiesses, idustry ad other private sector parters; schools ad commuity orgaizatios; ad idividuals ad families. Through these parterships we ca improve health by creatig healthy commuities, expadig prevetio activities ad empowerig people to make healthy choices ad adopt health as a persoal core value. The pla uses priciples from the social ecological model where itervetios for idividuals ad the eviromet are used. Strategies i the pla iclude: a multimedia campaig, deploymet of coalitios, ad exteral parterships to help the coalitios implemet the pla. The Michiga Health ad Welless 4 x 4 Pla Jue

8 Ackowledgemets Over the past several moths, we have worked with a group of experts from the Uiversity of Michiga, Michiga State Uiversity, ad Waye State Uiversity, as well as a Obesity Steerig Committee comprised of experts to idetify strategies to address this issue. I September 2011, the Michiga Departmet of Commuity Health (MDCH) held a Obesity Summit atteded by early 500 participats from aroud the state to idetify key priority strategies that we should implemet i Michiga. This pla was developed with the iput ad guidace of umerous commuity, healthcare, busiess, educatio, ad academic experts across the state. Special recogitio goes to these experts, as well as staff from MDCH for sharig their kowledge, time ad experiece to develop a pla that, if adopted, will result i the reductio of obesity ad a healthier Michiga. We are grateful for everyoe s passio ad commitmet to advace this importat issue, ad to help Michiga residets achieve a healthier lifestyle. 2 The Michiga Health ad Welless 4 x 4 Pla Jue 2012

9 Public Health Crisis - A Call to Actio Michiga has a public health crisis. I 1995, 18% of the adult populatio was obese. By 2010, the obesity prevalece i our populatio had icreased to 32%. If the tide is ot chaged, the percet of obesity i our populatio will reach 50% by Obesity is a root cause of most chroic illesses. Therefore, it is the role ad obligatio of Public Health to iform ad educate Michigaders about this threat to their health just as it does whe there is a threat of pademics ad epidemics. The Problem: A Public Health Crisis (>18 years of age) Obese: BMI >30 Overweight: BMI >25 <29.9 Not Obese or Overweight: BMI <24.9 Source: BRFSS Survey, 2011 The cosequeces of obesity are Type 2 diabetes, heart disease, arthritis, stroke, ad demetia. Curretly i Michiga, 2.5 millio adults ad 400,000 childre are obese, may of whom already show sigs of chroic illesses. Uecessary sufferig is beig caused by obesity, which is maily drive by sedetary lifestyles ad uhealthy eatig habits. Impact o Michiga s people ad its ecoomy Lead to chroic illesses: Type 2 diabetes, heart disease, arthritis stroke, cacers, demetia. 2.5 Millio Obese adults Uecessary sufferig ad uecessary health care expeditures i billios.4 Millio Obese Childre Accordig to the CDC, 75% of total health care expeditures are associated with treatig chroic diseases. If Michigaders reduce their BMI rates to lower levels ad achieve a improved status of health, the state could save over $13 billio aually i uecessary health care costs. By 2018 $12.5 B Results i lack of productivity ad precludes ivestmet i more productive areas. Note: Per CDC 75% of $2.2 Trillio U.S. health care spedig goes to treat chroic coditios. The Michiga Health ad Welless 4 x 4 Pla Jue

10 Compoets of the 4 x 4 Tool Prevetig or maagig chroic diseases is the top health challege of the 21st cetury. Seve out of 10 deaths each year are from chroic diseases. More tha 75% of healthcare spedig (i Michiga ad the U.S.) is for people with chroic diseases icludig heart disease, stroke, cacer, diabetes, kidey disease, ad demetia. Leadig a healthy lifestyle ca greatly reduce the risk of developig chroic diseases. Two-thirds of premature deaths i the U.S. are due to poor utritio, lack of physical activity, ad tobacco use. Prevetio measures such as appropriate screeig ad cotrol of risk factors are importat steps to save lives, reduce disability, ad lower healthcare costs. PRACTICE FOUR KEY HEALTHY BEHAVIORS 4 1. Maitai a Healthy Diet Research shows that healthy eatig cotributes greatly to oe s overall health, as well as maitaiig a healthy body weight. As described i the Dietary Guidelies for Americas, eatig healthy meas cosumig a variety of utritious foods ad beverages. The guidelies iclude vegetables, fruits, low- ad fat-free dairy products ad whole grais. The guidelies also iclude limitig itake of saturated fats, added sugars, ad sodium; keepig tras-fat itake as low as possible; ad balacig caloric itake with calories bured to maage body weight. 2. Egage i Regular Exercise Reductio of sedetary lifestyle ad icreased regular physical activity are importat cotributors to health. Regular physical activity helps to achieve ad maitai a healthy weight while cotributig to the health of boes, joits, ad muscles. It ca also reduce feeligs of axiety ad depressio. Eve though the beefits of physical activity are apparet, less tha half of adults i Michiga egage i physical activity regularly at least 150 miutes (2.5 hours) of moderate itesity physical activity a week, such as brisk walkig, bikig or swimmig. Childre ad adolescets should get 60 miutes of physical activity per day. The America Academy of Pediatrics also recommeds less tha 2 hours of media time per day (televisio, computer, movies, ad video games). 3. Get a Aual Physical Examiatio Receivig a aual physical is a good way to remai proactive about oe s health ad welless. There are may beefits to havig a aual physical exam, icludig earlier diagosis ad treatmet of existig health issues ad prevetio of future problems. Regular physical exams also provide a variety of screeigs depedet o age, health ad family history ad lifestyle choices. By gettig the right health services, screeigs, ad treatmets, Michigaders icrease their chaces for livig loger ad healthier lives. Idividuals also should discuss with their health professioal the status of their four health measures (BMI, cholesterol, blood sugar, blood pressure) ad develop goals for maitaiig or attaiig desired levels for each measure. 4. Avoid All Tobacco Use ad Exposure Tobacco use is the leadig cause of premature ad prevetable death i the Uited States. Avoidig all tobacco use, which icludes cigarettes, cigars, smokeless tobacco, pipes ad hookahs, ad elimiatig exposure to secodhad smoke, ca greatly reduce the risk of developig heart disease, cacers, pulmoary disease, periodotal disease, asthma ad other diseases. While Michiga has decreased smokig i the populatio over the last 50 years from 46% to 18%, we still have 15,000 aual deaths related to smokig. The Michiga Health ad Welless 4 x 4 Pla Jue 2012

11 KNOW YOUR FOUR KEY HEALTH MEASURES 1. Body Mass Idex (BMI) BMI, or Body Mass Idex, is a measure of body fat based o height ad weight. A healthy adult BMI falls withi a rage of A BMI betwee 25 ad 29.9 is cosidered overweight. Those with a BMI of 30 or greater are classified as obese. Maitaiig a BMI withi the healthy rage ca reduce blood pressure, cholesterol, blood glucose ad lower your risk for heart disease, stroke, cacer, diabetes ad kidey disease. BMI values for childre are expressed i percetiles to cotrol for differeces i body sizes due to geder ad age. The percetile idicates the relative positio of the child s BMI umber amog childre of the same geder ad age. A child with a BMI percetile betwee 5% ad 84% is cosidered to be at a healthy weight; 85% - 94% is cosidered overweight ad above the 95th percetile is cosidered obese. Lowerig BMI ca have dramatic health beefits icludig reducig risk of developig Type 2 diabetes by more tha 50% ad substatially reducig the risk of heart disease ad cacer if moderate reductio of BMI (5 to 10%) is achieved. 2. Blood Pressure Healthy blood pressure is a key to heart health. Ucotrolled high blood pressure icreases your risk of heart attack, stroke ad kidey disease. A blood pressure of less tha 120/80 is cosidered healthy or ormal. A blood pressure betwee /80-89 is cosidered prehypertesio ; ad a blood pressure of 140/90 or above is cosidered hypertesio. 3. Cholesterol Level High cholesterol is a direct cotributor to cardiovascular disease, which ca lead to stroke ad heart attacks. To decrease risk for cardiovascular disease total blood cholesterol should be kept below 200. A blood cholesterol level of is cosidered mildly high, while a blood cholesterol level of 240 or greater is cosidered high. 4. Blood Glucose Level Blood glucose levels measure the amout of a type of glucose i your blood. It is importat to kow this measure because icreased blood glucose levels ca be a predictor of diabetes. Fastig blood glucose levels should be below 100mg/dl. The Michiga Health ad Welless 4 x 4 Pla Jue

12 STRATEGIES AND GOALS Each of the strategies listed below will icorporate iformatio for idividuals ad orgaizatios o adoptio of the 4 x 4 pla as part of their activities. Maitai a Healthy Diet Egage i Regular Exercise Get a Aual Physical Examiatio Avoid All Tobacco Use ad Exposure Body Mass Idex (BMI) Blood Pressure Cholesterol Level Blood Sugar/Glucose Level A. Develop multimedia public awareess campaig to reduce obesity ad promote a social movemet ecouragig every Michigader to adopt health as a persoal core value through promotio of the 4 x 4 Pla. B. Deploy 46 commuity coalitios throughout Michiga to support implemetatio of the 4 x 4 Pla. C. Egage parters throughout Michiga to help coalitios implemet the 4 x 4 Pla. Employers Trade ad other professioal orgaizatios Educatio system Departmets of state govermet D. Withi the Michiga Departmet of Commuity Health create the ifrastructure to support 4 x 4 Pla implemetatio eergizig the local coalitios, ad parters. E. 6 Seek fudig to fiace the pla for a projected first-year cost of $18.25 millio. The Michiga Health ad Welless 4 x 4 Pla Jue 2012

13 STRATEGIES AND GOALS A. Develop multimedia public awareess campaig to promote a social movemet to reduce obesity ad ecourage every Michigader to adopt health as a persoal core value through promotio of the 4 x 4 Pla. 1. Alert Michigaders of obesity crisis that will result i chroic diseases, uaffordable costs, ad losses i productivity ad vitality. 2. Coduct Cosumer Perceptio Survey to guide developmet of the multimedia campaig. 3. Provide a marketig umbrella for the campaig with broad public recogitio. Desig campaig utilizig TV, radio, prit, website ad social media. 4. Develop messages appropriate for populatio at large ad culturally sesitive messages related to race ad ethicity. 5. Redevelop the existig Michiga Health ad Welless state website to cotiue persoal goal trackig ad risk assessmet, ad access to evidece-based tools ad resources for adoptio of the 4 x 4 Pla. 6. Promote free, low-cost, self-maagemet tools, such as electroic calorie couters, pedometers, health trackig tools, combied with smart techology. 7. Post to welless website a referral bak of Michiga-based worksite welless experts ad compaies for use by employers. 8. Post to welless website a referral bak of Michiga-based worksite welless experts ad compaies for idividuals to use. 9. Create sectio i welless website for Michigaders to self-report preferred techiques for weight loss ad welless; use trackig system for followig ad rewardig most followed practices. 10. Documet stories about persos who lose sigificat weight or sigificatly improve health measures; reward them as 4 x 4 Champios. 11. Iclude small measurable steps that idividuals ca take to improve healthy eatig ad physical activity. 12. Develop Goveror s Awards for Best Practices ad recogitio programs for idividuals, employers, state restaurats, busiesses, schools, state departmets, ad other orgaizatios that adopt the 4 x 4 health ad welless philosophy. B. Deploy 46 commuity coalitios throughout Michiga to support implemetatio of the 4 x 4 Pla. 1. Develop guidelies to support coalitios ad set expectatios with pay for performace system. 2. Establish coalitios of sufficiet size ad leadership structure to have sigificat impact i commuities. The Michiga Health ad Welless 4 x 4 Pla Jue

14 C. 3. Eter ito cotractual agreemets with local health departmets, Tribes ad/or other suitable agecies to lead coalitios i the adoptio of the 4 x 4 Pla, icludig creatig eviromets that support healthy behaviors. 4. Implemet commuity assessmets ad develop actio plas that support healthy behaviors (see Appedix A for suggested evidece-based coalitio strategies). 5. Develop roles for legislators to work with coalitios i their respective commuities. 6. Egage leadership of commuity coalitios with statewide professioal ad trade orgaizatios (e.g., Michiga Health & Hospital Associatio, Michiga Osteopathic Associatio, Michiga State Medical Society, restaurat ad grocer associatios, busiess associatios) ad departmets of state govermet. Egage parters throughout Michiga to help coalitios implemet the 4 x 4 Pla. 1. Employers a. Ecourage employers to assess their worksites by usig the Desigig Health Eviromets at Work assessmet tool ad develop actio pla cosistet with fidigs (www.michiga.gov/healthymichiga...click o Busiesses). b. Provide guidace for the developmet of worksite eviromets that ecourage ad support healthy eatig, physical activity ad the adoptio of the 4 x 4 Pla. (See Appedix B for suggested cotet of worksite welless programs.) c. Develop referral process for Michiga-based compaies that provide worksite welless programs for employers seekig this assistace. d. Work with employers ad health plas to ecourage adoptio of health isurace products that icetivize adoptio of the 4 x 4 Pla. e. Develop recogitio ad award system for employers that successfully implemet the 4 x 4 Pla. 2. Trade ad Professioal Orgaizatios a. Hospital, medical associatios, health cliics (MHA, MSMS, MOA, Michiga Primary Care Cosortium, Michiga Primary Care Associatio, Michiga Chapter of America Academy of Pediatrics): 1. Ecourage local hospitals ad all health care providers to provide every patiet with his/her 4 health measures, plus offer discussio about the 4 healthy behaviors, if desired by patiet. 2. Ecourage healthcare professioals to provide educatio, couselig ad referrals to commuity resources to help idividuals with their 4 healthy behaviors ad 4 health measures. 3. Icorporate the 4 x 4 Pla ito their electroic health record system for health maagemet ad ease of distributio to patiets. 4. Promote the recordig of BMI ito Michiga Care Improvemet Registry (MCIR) for childre. b. Health Isurers (Blue Cross Blue Shield of Michiga, Michiga Associatio of Health Plas, other carriers, third party admiistrators): 1. Offer products to health care purchasers that iclude icetives to practice the 4 healthy behaviors ad 4 health measures. 2. Offer products to health care purchasers that provide value-based purchasig. 3. Promote i health pla s welless programs the adoptio of health as a persoal core value, ad the adoptio of the 4 x 4 tool. 8 The Michiga Health ad Welless 4 x 4 Pla Jue 2012

15 c. Wholesale ad retail food compaies (Associated Food ad Petroleum Dealers, Michiga Grocers Associatio), food producers: 1. Promote program s adoptio of cosistet messagig, promietly displayed, about the 4 x 4 Pla. 2. Promote foods with less salt, sugar, uhealthy fats. d. Restaurat Associatios (Michiga Restaurat Associatio, Michiga Associatio of Food Producers): 1. Ecourage Michiga restaurats to post meus olie alog with utritioal cotet ad iformatio. 2. Ecourage restaurats to iclude calorie iformatio o their meus as well as social media codig wheever possible to assist customers with smart tools to obtai other utritio iformatio. 3. Ecourage restaurats to offer bite-size desserts. 4. Iclude refereces to the 4 x 4 Pla o meus. 5. Work with uiversity researchers to offer appropriate cotet of sugar, sodium, ad healthy fat levels i foods. e. Busiess Associatios (Small Busiess Associatio of Michiga, Michiga Chamber of Commerce): 1. Ecourage small ad large busiesses to offer worksite welless programs for their employees. 2. Ecourage busiess associatios to develop ad ecourage implemetatio of worksite welless program for its members i collaboratio with worksite welless expert. f. Paret-Teacher Associatios ad Pricipal Associatios: 1. Provide materials for parets, teachers ad school childre about the 4 x 4 Pla ad strategies that ca lead to adoptio of healthy behaviors. 2. Hoor schools that promote the 4 x 4 Pla i effective ways. 3. Work with school system ad Michiga Departmet of Educatio to promote healthy eatig ad physical activity practices. g. Weight Maagemet Programs (Weight Watchers, Medical Weight Loss Cliic, hospital based cliics, O Target Livig, other atioal weight loss Michiga-based frachises): 1. Promote the 4 x 4 Pla i promotioal materials icludig promiet sigage o site i exchage for promotio o welless website. h. Physical Activity Programs (YMCA): 1. Establish a statewide 4 x 4 health ad welless program affordable for everyoe, icludig low-icome idividuals. 2. Review Michiga s playgrouds ad establish collaborative for developmet. The Michiga Health ad Welless 4 x 4 Pla Jue

16 i. Work with Michiga s uiversities ad colleges, trade associatios ad professioal sports teams so that sports teams (males ad females) adopt ad promote the 4 x 4 Pla. 1. Promote 4 x 4 Pla with commuity colleges, colleges, uiversities, ad professioal sports teams to egage players to be role models for geeral studet populatio ad commuity. 2. Egage commuity colleges, colleges ad uiversities to ecourage studets to adopt healthy behaviors. 3. Educatio System 4. a. Ecourage all school systems to adopt healthy food offerigs, healthy behaviors, physical activity programs, ad discuss with studets the meaig of health as a persoal core value. b. State Departmets of Educatio ad Commuity Health will cotiue to work with schools o iitiatives listed o pages 10 ad 12. Departmets of State Govermet a. The Office of the State Employer: 1. Ecourage each state departmet to ecourage employees to achieve the goals of the 4 x 4 Pla. 2. Egage i collective bargaiig for health isurace products for state employees that icetivize their adoptio of the 4 x 4 Pla. 3. Develop policies for use by state departmets ad agecies that provide appropriate space ad break time for breastfeedig employees. Commuicate those policies as well as the availability of ay support programs ad/or educatioal materials to employees. 4. Ecourage adoptio of stadards for healthy food ad beverages where offered osite ad at meetigs. 5. Establish Goveror s Michiga Health ad Welless 4 x 4 Awards for state agecies that achieve excellece criteria. 6. Provide guidace to state departmets ad agecies o schedulig alteratives, uses for state-owed or leased facilities, ad appropriate employee group activities related to the 4 x 4 goals ad objectives. b. The Michiga Departmet of Educatio: 1. Implemet Michiga Nutritio Stadards i school districts, campus wide, where food is offered or sold. 2. Cotiue to work with MDCH to develop resources as research emerges ad as districts idetify specific eeds to supplemet the Michiga Nutritio Stadards Toolkit that was released i November Develop a State Board of Educatio model policy for Comprehesive School Physical Activity Programs that iclude physical educatio as the corerstoe ad physical activity durig the school day, before school ad after school. 4. Revise idicators to reflect obesity best practices i the Early Childhood Stadards of Quality ad Michiga s Quality Improvemet Ratig System ad implemet evidece-based facility level itervetios. 5. Create a Goveror s Award for schools that attai excellece i health ad welless practices. 6. Collaborate to joitly admiister the Michiga Model for Health program with MDCH to implemet ad evaluate effective K-12 health educatio curriculum. 10 The Michiga Health ad Welless 4 x 4 Pla Jue 2012

17 7. Cotiue to joitly admiister the Child ad Adolescet Health Ceter (CAHC) Program with MDCH to implemet obesity prevetio ad treatmet strategies i a cliical settig. c. The Departmet of Agriculture ad Rural Developmet: 1. Stregthe the farm-to-school etwork. 2. Collaborate o Pure Michiga FIT (Feedig Ifats ad Toddlers, 0-5). Begiig i 2012, state agecies (MDCH, Departmets of Huma Services ad Educatio) will collaborate with state ad local parters to pilot a utritio educatio program, aimed at teachig parets ad caregivers of babies, toddlers ad preschoolers the iformatio they eed to raise healthy, happy childre ad tackle childhood obesity i our state. Other parters iclude: Michiga Grocers Associatio, Michiga Fitess Foudatio, ad Michiga Health ad Hospital Associatio. 3. Work o establishig Food Hubs: a. Lik agriculture ad cosumers b. Icrease access c. Allow for utritio traiig d. Request for Proposal for 5 pilot sites e. Establish best practices d. The Departmet of Trasportatio: 1. Cotiue to promote the Michiga Safe Routes to School Program, a effort desiged to icrease safety ad ecourage more studets to walk ad bike to school daily. 2. Work with the Complete Streets Advisory Coucil ad the State Trasportatio Commissio to develop ad commuicate a complete streets policy for Michiga. Complete streets are roadways plaed, desiged ad costructed to provide appropriate access to all legal users i a maer that promotes safe ad efficiet movemet of people ad goods whether by car, truck, trasit, assistive device, foot or bicycle. 3. Work with the Complete Streets Advisory Coucil ad the State Trasportatio Commissio to idetify model local policies for complete streets. Michiga curretly leads the atio i the umber of commuities that have adopted complete streets policies. 4. Cotiue to use a cotext sesitive approach to project developmet, workig with commuities ad stakeholders to develop complete streets where appropriate, cost effective ad i keepig with the cotext ad fuctio of the roadway. 5. Give cosideratio to commuities that have passed Complete Streets policies i rewardig federal Trasportatio Ehacemet program grats. e. The Departmet of Huma Services: 1. Develop utritio stadards, physical activity requiremets ad scree-time limits to the Licesig Rules for Family ad Group Child Care Homes. The Michiga Health ad Welless 4 x 4 Pla Jue

18 2. Expad the Double Up Food Bucks program. 3. Implemet utritio educatio through SNAP-ED program. f. The Departmet of Natural Resources: 1. Work with schools to provide educators the tools, traiig, ad resources they eed to brig the eviromet ito their classrooms ad their studets ito the eviromet. 2. Promote Project WILD, part of the No Child Left Iside iitiative, as a preschool through 12th grade evirometal ad coservatio educatio program, emphasizig awareess, appreciatio ad uderstadig of wildlife ad atural resources ad the importace of beig active outdoors. 3. Promote physical fitess ad healthy outdoor lifestyles as part of DNR s Recreatio 101 programs at state parks ad other locatios. g. Michiga Ecoomic Developmet Corporatio: 1. Cosider promotig the statewide campaig as a PureMichiga campaig to promote welless associated with the 4 x 4 Pla. 2. Establish promotioal opportuities with trade orgaizatios ad restaurats that adopt the 4 x 4 Pla. h. Ecourage each state departmet to assess their eatig ad physical activity eviromets ad policies ad to implemet appropriate chages. D. Withi the Michiga Departmet of Commuity Health create the ifrastructure to support 4 x 4 Pla implemetatio, eergizig the local coalitios, ad parters. 1. Establish admiistrative ad programmatic ifrastructure at MDCH to coordiate pla ad support implemetatio by all public ad private stakeholders of the Michiga 4 x 4 Pla. 2. Assist other state agecies to support ad implemet the 4 x 4 Pla. 3. Ehace Medicaid services to icorporate 4 x 4 Pla activities for erollees. 4. Establish a Steerig Committee cosistig of leaders from stakeholder groups ad state agecies to guide ad moitor implemetatio ad idetify state policy priorities. 5. Maage local coalitios, icludig provisio of techical assistace ad traiigs. 6. Create public awareess ad public relatios campaig (Strategy A). 7. Develop toolkits ad ehace resources for schools, childcare settigs, worksites, healthcare facilities ad commuities that iclude priority strategies ad itervetios. 8. Cotiue to implemet programs that focus o improvig healthy eatig ad icreasig physical activity i childcare, schools, commuities ad faith-based orgaizatios. 9. Collaborate with the Ifat Mortality state pla o strategies that relate to healthy lifestyle ad obesity reductio. 10. Develop valid methods to estimate weight of commuity residets at baselie ad at ed of each year of the five-year obesity pla. 12 The Michiga Health ad Welless 4 x 4 Pla Jue 2012

19 11. Expad studet-led approach to empower youth to improve their ow health by implemetig positive chages i schools i partership with Uited Dairy Idustry of Michiga ad the Fuel Up to Play 60 program. 12. Moitor, evaluate ad report the success of coalitio strategies. 13. Aggressively pursue grat fudig to support implemetatio of the 4 x 4 Pla. 14. Expad MICR s capabilities ad promote its adoptio amog the healthcare commuity. a. Provide access to the MCIR BMI Growth Module for childre 0 to 18 years that icludes cliical decisio support tools to empower physicias to provide quality care reflected i atioal guidelies. b. Build a iterface from MCIR to Electroic Health Records. c. Expad MCIR to iclude a BMI Health Module for adults. 15. Work with Commissio for the Blid to offer healthy optios i their cocessios at all state buildigs. E. Seek fudig to fiace the pla for a projected first year cost of $18.25 millio. Our ability to implemet these strategies will deped upo the availability of resources. The Michiga Health ad Welless 4 x 4 Pla Jue

20 PARTNERING ORGANIZATIONS 14 America Cacer Society MI Departmet of Natural Resources America Heart Associatio MI Departmet of Trasportatio Associated Food & Petroleum Dealers MI Ecoomic Developmet Corporatio Blue Cross Blue Shield of Michiga MI Evirometal Coucil CHASS Ceter, Ic. MI Fitess Foudatio Childre s Health Iitiative Program MI Food Policy Coucil Coalitio of MI Orgaizatios of Nursig MI Food Processors Associatio Commuicatios & Research, Ic. MI Goveror s Office Comprehesive School Health Coordiator s Associatio of MI MI Grocers Associatio Cosulate of Mexico MI Health & Hospital Associatio Daialle Karmaos Work It Out MI Health Policy Forum Detroit Waye Couty Health Authority MI Osteopathic Associatio Diabetes Parters i Actio Coalitio MI Office of the State Employer Early Childhood Ivestmet Corporatio MI Paret Teacher Associatio Greater Detroit Area Health Coucil MI Peer Review Orgaizatio Greater Flit Health Coalitio MI Primary Care Associatio Greater Lasig Africa America Health Istitute MI Public Health Istitute Health ad Welless Foudatio MI Restaurat Associatio HealthMedia, Ic. MI Soft Drik Associatio Healthy Kids, Healthy Michiga MI State Medical Society Hery Ford Health System Michiga State Uiversity Istitute for Black Family Developmet MI Towships Associatio Iter-Tribal Coucil of Michiga MI Welless Coucil Lasig Latio Health Alliace mynutratek M.O.O.V.E. Detroit Natioal Kidey Foudatio of MI MI Academy of Family Physicias O Target Livig MI Associatio of Broadcasters Public Sector Cosultats MI Associatio of Food Producers School Commuity Health Alliace of MI MI Associatio of Health Plas Small Busiess Associatio of MI MI Associatio of Local Public Health Sparrow Health System MI Busiess ad Professioal Associatio Spectrum Health MI Chamber of Commerce State Alliace of MI YMCAs MI Chapter America Academy of Pediatrics Uited Dairy Idustry of MI MI Associatio of Chiropractors UitedHealthcare Commuity Pla MI Departmet of Agriculture & Rural Developmet Uiversity of Michiga MI Departmet of Commuity Health W.K. Kellogg Foudatio MI Departmet of Educatio Waye State Uiversity MI Departmet of Huma Services Weight Watchers The Michiga Health ad Welless 4 x 4 Pla Jue 2012

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