Virginia's Plan For Well-Being - Well-Being Healthy, Connected Communities - Virginia Center for Health ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
1
Draft
Virginia’s Plan For Well-Being
2016-2020
Well-Being
System of Health Care Preventive Actions
Strong
Start for
Children
Healthy, Connected Communities
2
Letter to be developed
3
Table of Contents
VISION: WELL-BEING FOR ALL VIRGINIANS
AIM 1 » Healthy, Connected Communities ....................................... p. 7
GOAL 1.1 Virginia’s Families Maintain Economic Stability.............................................. 9
GOAL 1.2 Virginia’s Communities Collaborate to Improve the Population’s Health 11
AIM 2 » Strong Start for Children ................................................................ 12
GOAL 2.1 Virginians Plan Their Pregnancies ........................................................................ 13
GOAL 2.2 Virginia’s Children are Prepared to Succeed in Kindergarten ................... 15
GOAL 2.3 The Racial Disparity in Virginia’s Infant Mortality Rate is Eliminated ..... 17
AIM 3 » Preventive Actions ................................................................................. 19
GOAL 3.1 Virginians Follow a Healthy Diet and Live Actively ....................................... 21
GOAL 3.2 Virginia Prevents Nicotine Dependency ............................................................ 24
GOAL 3.3 Virginians Are Protected Against Vaccine-Preventable Diseases ........... 25
GOAL 3.4 In Virginia, Cancers Are Prevented or Diagnosed at the Earliest Stage
Possible .......................................................................................................................... 27
GOAL 3.5 Virginians Have Lifelong Wellness ....................................................................... 29
AIM 4 » System of Health Care ...................................................................... 30
GOAL 4.1 Virginia Has a Strong Primary Care System Linked to Behavioral Health
Care, Oral Health Care, and Community Support Systems ........................ 32
GOAL 4.2 Virginia’s Health IT System Connects People, Services and Information to
Support Optimal Health Outcomes ..................................................................... 35
GOAL 4.3 Health Care-Associated Infections in Virginia are Prevented and
Controlled ...................................................................................................................... 37
4
5
VISION: WELL-BEING FOR ALL VIRGINIANS
VIRGINIANS LIVE LONGER, HEALTHIER coming together to review local and state level
lives today than ever before. Medical care is data that reflect the health of the community.
only part of the reason. Health begins where Examining trends and variation among subsets
Virginians live, work, and play. Virginia’s of the population can assist the state and
economy paves the way for its communities communities in analyzing health outcomes
to create conditions for people to be healthy. and identifying priority issues to address.
Disinfecting drinking water, vaccinating
Virginia’s Plan for Well-Being lays out the foun-
people, controlling mosquitos and rodents,
dation for giving everyone a chance to live a
and tracking contagious illnesses keep once
healthy life: (1) Factoring health into policy
common diseases like measles and polio at
decisions related to education, employment,
bay. Passing laws to make transportation safer
housing, transportation, land use, economic
and to protect workers reduces injuries.
development, and public safety; (2) Investing
The definition of well-being is “a state in the health, education, and development of
characterized by health, happiness, and Virginia’s children; (3) Promoting a culture of
prosperity”. It is valuable as a population health through preventive actions; and
outcome measure because it reflects how (4) Creating a connected system of health
Virginians perceive their life is going. Well- care. The plan highlights specific goals and
being is dependent on having good physical strategies on which communities can focus
and emotional health. Social circumstances, so the state can make measureable health
financial resources, and community factors improvement by 2020. Virginia’s Plan for
also play important roles. Well-Being is a call to action for all Virginians
to work together to make Virginia the health-
The opportunity for health begins with
iest state in the nation. Improving well-be-
our families, neighborhoods, schools and
ing can lower health care costs and increase
jobs. There are striking differences in health
productivity, ultimately enhancing Virginia’s
within and between communities in Virginia.
competitiveness and resiliency.
Uncovering the root causes of health
inequities in Virginia’s neighborhoods Measure of Success
and working together to improve the
conditions needed for people to Percent of adults
be healthy will improve in Virginia who
well-being for all report positive
well-being increas-
Virginians.
Well-Being es (metric under
This begins with development)
System of Health Care Preventive Actions
the community Strong
Start for
Children
Healthy, Connected Communities
6
VIRGINIAN’S PLAN FOR WELL-BEING MEASURES
VISION Goal 2.2: VIRGINIA’S CHILDREN ARE PREPARED
TO SUCCEED IN KINDERGARTEN
By 2020, the percent of adults who report positive By 2020, the percent of children in Virginia who
well-being increases (metric under development) do not meet the PALS K benchmarks in the fall
of kindergarten and require literacy interventions
AIM 1 » Healthy, Connected Communities decreases from 12.7% to 12.2%
Goal 1.1: VIRGINIA’S FAMILIES MAINTAIN By 2020, the percent of third graders in Virginia who
ECONOMIC STABILITY pass the Standards of Learning third grade reading
assessment increases from 69% to 80%
By 2020, the percent of Virginia high school
graduates enrolled in an institute of higher education
within 16 months after graduation increases from
Goal 2.3: THE RACIAL DISPARITY IN VIRGINIA’S
70.9% to 75.0% INFANT MORTALITY RATE IS ELIMINATED
By 2020, the percent of cost-burdened households in By 2020, Virginia’s Black Infant Mortality Rate equals
Virginia (more than 30% of monthly income spent on the White Infant Mortality Rate
housing costs) decreases from 31.4% to 29.0%
By 2020, the Consumer Opportunity Index score in
Virginia increases from 81.8% to 83.7% AIM 3 » Preventive Actions
By 2020, the Economic Opportunity Index Score in Goal 3.1: VIRGINIANS FOLLOW A HEALTHY DIET
Virginia increases from 70.7% to 73.7% AND LIVE ACTIVELY
By 2020, the percent of Virginia adults who did not
Goal 1.2: VIRGINIA’S COMMUNITIES participate in any physical activity during the past 30
COLLABORATE TO IMPROVE THE days decreases from 23.5% to 20.0%
POPULATION’S HEALTH
By 2020, the percent of Virginia adults who are
By 2020, the percent of Virginia health planning overweight or obese decreases from 64.7% to 63.0%
districts that have established an on-going
By 2020, the percent of Virginia households that are
collaborative community health planning process
food insecure for some part of the year decreases
increases from 43% to 100%
from 11.9% to 10.0%
AIM 2 » Strong Start for Children Goal 3.2: VIRGINIA PREVENTS NICOTINE
DEPENDENCY
Goal 2.1: VIRGINIANS PLAN THEIR PREGNANCIES
By 2020, the percent of adults aged 18 years and
By 2020, Virginia’s teen pregnancy rate decreases older in Virginia who report using tobacco decreases
from 27.9 to 25.1 pregnancies per 1,000 females ages from 21.9% to 12.0%
15 to 19 years
7
VIRGINIAN’S PLAN FOR WELL-BEING MEASURES
Goal 3.3: VIRGINIANS ARE PROTECTED AGAINST By 2020, the rate of avoidable deaths from heart
VACCINE-PREVENTABLE DISEASES disease, stroke, or hypertensive disease in Virginia
decreases from 46.76 to 40.00 per 100,000 persons
By 2020, the percent of adults in Virginia
who receive an annual influenza vaccine By 2020, the rate of mental health and substance use
increases from 48.2% to 70% disorder hospitalizations in Virginia decreases from
884.1 to 825.0 per 100,000 persons
By 2020, the percent of girls aged 13-17 in Virginia
who receive three doses of HPV vaccine increases By 2020, the percent of adults in Virginia who report
from 35.9% to 80% having one or more days of poor health that kept
them from doing their usual activities decreases from
By 2020, the percent of boys aged 13-17 in Virginia 19.5% to 18.0%
who receive three doses of HPV vaccine increases
from 22.5% to 80%
Goal 4.2: VIRGINIA’S HEALTH IT SYSTEM
CONNECTS PEOPLE, SERVICES,
Goal 3.4: CANCERS ARE PREVENTED OR AND INFORMATION TO SUPPORT
DIAGNOSED AT THE EARLIEST STAGE POSSIBLE OPTIMAL HEALTH OUTCOMES
By 2020, the percent of adults aged 50 to 75 By 2020, the percent of health-care providers in
years in Virginia who receive colorectal cancer Virginia who have implemented a certified electronic
screening increases from 69.1% to 85.0% health record increases from 70.6% to 90.0%
By 2020, the number of entities in Virginia connected
through Connect Virginia HIE Inc., the electronic
Goal 3.5: VIRGINIANS HAVE LIFE-LONG
WELLNESS health information exchange, and the national
e-Health Exchange increases from 3,800 to 7,600
By 2020, the average years of disability-
free life expectancy for Virginians increases By 2020, the number of Virginia’s local health
from 66.1 years to 67.3 years districts that have electronic health records and
connect to community providers through Connect
Virginia increases from 0 to 35
AIM 4 » System of Health Care
Goal 4.1: VIRGINIA HAS A STRONG PRIMARY Goal 4.3: HEALTH CARE-ASSOCIATED
CARE SYSTEM LINKED TO BEHAVIORAL INFECTIONS ARE PREVENTED AND
HEALTH CARE, ORAL HEALTH CARE, AND CONTROLLED IN VIRGINIA
COMMUNITY SUPPORT SYSTEMS
By 2020, the percentage of hospitals in
By 2020, the percent of adults in Virginia Virginia meeting the state goal for prevention
who have a regular health care provider of hospital-onset Clostridium difficile
increases from 69.3% to 85.0% infections increases from 36% to 100%
By 2020, the rate of avoidable hospital stays for
ambulatory care sensitive conditions in Virginia
decreases from 1,294 to 1,100 per 100,000 persons
8
AIM 1: HEALTHY, CONNECTED COMMUNITIES
WHERE VIRGINIANS LIVE AFFECTS The Virginia Department of Health has
their health. Feeling safe, supported, and developed a Health Opportunity Index
connected to family, neighborhood, and (HOI) to help communities understand
the community is critical for well-being. the factors that lead to health so they
Place matters: the conditions in which can work to improve health outcomes for
people live, work, and play shape their everyone. The HOI is a composite measure
health. For example, having safe, clean of the “social determinants of health”,
parks provides Virginians with recreational factors that relate to a community’s
opportunities. This supports active living, well-being and the health status of its
which results in improved physical and population. It is comprised of 13 indices in
emotional health. Conditions that foster four categories:
well-being include:
Environment: (1) Air quality;
○ Safe, walkable neighborhoods (2) Population density; (3) Population
churning; (4) Walkability
○ Accessible public transportation
○ Access to health care Consumer Opportunity:
(1) Affordability; (2) Education; (3) Food
○ Employment opportunities with safe
accessibility; (4) Material deprivation
working conditions
○ Quality educational systems Economic Opportunity:
(1) Employment; (2) Income
○ Spaces for social gatherings and inequality; (3) Job participation
physical activity
Wellness: (1) Segregation;
○ Clean air and water
(2) Access to care
Improving environmental and social
conditions at the neighborhood level The HOI is calibrated with life expectancy,
provides greater opportunity for all disability-adjusted life expectancy, and
Virginians to be healthy. Communities low birth weight measures, and is strongly
can improve health by considering predictive of key health outcomes. The
implications to health when developing HOI provides communities with a tool to
policies and systems related to education, identify areas and populations that are most
employment, housing, transportation, vulnerable, giving Virginia an opportunity to
land use, economic development, and develop strategic, targeted approaches to
public safety. improve health and well-being.
9
Foundational Goals for Creating Healthy, ○ Virginians are prepared to respond to
Connected Communities manmade and natural disasters
○ Virginians receive a quality education ○ Virginians have access to quality
emergency medical services
○ Virginians complete job training or
college after high school ○ Virginians are protected from fires
○ Virginians live in housing they can ○ Virginians are protected from crime
afford
○ Virginia’s public transportation
○ Virginia’s families maintain economic systems provide access to and from
stability geographically isolated areas
○ Virginians are socially engaged ○ Virginia businesses partner with the
community to address environmental
○ Virginians have access to clean air and
and social drivers of workforce health
water
○ Virginia’s communities collaborate to
○ Virginians have access to safe food
improve the population’s health
During 2016-2020, Virginia is focusing attention on these foundational goals:
1.1 Virginia’s families maintain economic stability
1.2 Virginia’s communities collaborate to improve the population’s health
Health Opportunity Index (HOI) — The HOI is a composity measure comprising 13 indices
that reflect a broad array of social determinants of health
10
AIM 1: HEALTHY, CONNECTED COMMUNITIES
2020 FOCUS GOALS
GOAL 1.1: VIRGINIA’S FAMILIES
MAINTAIN ECONOMIC STABILITY
Health and poverty are inextricably
linked; ill health not only affects the poor
disproportionately, it is also associated
with lower income.1 Virginia is perennially
one of the wealthiest states in the nation.
Unfortunately, a wealth gap prevents
some Virginians from experiencing ○ Develop school policies to assess
equitable opportunities for optimal health and address physical, social, and
and longevity. Reducing poverty and environmental health barriers that
maintaining economic stability are vital to impede learning
keeping all Virginians well. An education
that prepares Virginians for today’s job ○ Expand training and work-linked
market provides increased opportunity learning opportunities for youth
for employment, which in turn improves ○ Support opportunities for mid-career
access to stable housing, healthy food, retraining
transportation, and health care. Strategic
investments in the physical and social ○ Build affordable housing, and
infrastructure as well as investments in rehabilitate existing affordable housing
educational resources are important for to accommodate low-income families
sustained economic stability.
Strategies Key Community Partners
Community Organizations
○ Provide alternative pathways to
Community Planners
graduation and post-secondary
Economic Development
training for disconnected youth and Agencies
those with special needs Educators
Elected Officials
○ Develop and use early warning
Employers
systems to prevent failure and help at-
Families
risk students
Justice System11 Measures of Success
12
AIM 1: HEALTHY, CONNECTED COMMUNITIES
2020 FOCUS GOALS
Goal 1.2: VIRGINIA’S COMMUNITIES Strategies
COLLABORATE TO IMPROVE THE
○ Establish collaborative health
POPULATION’S HEALTH
assessment and strategic health
Adopting a collaborative community improvement planning processes
approach to health assessment and throughout the Commonwealth that
planning supports population-level health include public health, health care
systems, and community partners
improvement. Both state and community-
level assessments are valuable to identify ○ Align health system community benefit
opportunities to achieve and maintain programs with community health
well-being in the Commonwealth. This improvement plans
process involves bringing together people ○ Enhance data systems and public
from many sectors of the community to health information technology to
review data; identify priorities; develop collect, manage, track, analyze, and
goals and measurable objectives; and report state and county-level data for
use in health assessments
recommend evidence-based policies,
programs, and actions for the community
Key Community Partners
to pursue. The assessments include social,
Community Organizations
economic, and environmental data, such
Educators
as the number of mothers who did not Elected Officials
graduate from high school, in addition to Employers
health outcome data, like the number of Families
people who have lung cancer. Health-Care Providers
Hospital Systems
State and community health improvement Local Governments
plans can be a catalyst for empowering Public
community action. They can be shared Public Health
with elected officials, the health
Measure of Success
care community, governmental and
community-based agencies, and the
public. The information can foster the
allocation of resources to areas that will
maximize benefits to the collective health
of the community.13
AIM 2: STRONG START FOR CHILDREN
A CHILD’S HEALTH IS AFFECTED BY ○ Virginians are as healthy as possible
biological influences, including nutrition, before becoming pregnant
illness, and each parent’s health, as well ○ Pregnant women in Virginia receive
as environmental influences, including recommended prenatal care services
education and quality health and social
○ Virginia mothers breastfeed
services.2 Compared to children without
chronic health problems, children with ○ Virginia parents practice positive
chronic health problems have a greater parenting
risk of having poorer health outcomes ○ Virginia fathers are engaged in family
and lower job status as adults.3,4 Health- planning, health, parenting, and child
related factors affect school performance, development-focused activities
and in turn academic success is associated
○ Virginia infants and children are not
with health outcomes during childhood and
exposed to secondhand smoke
later in adulthood.5 Investing in programs
that lead to improved health for Virginia’s ○ Virginia’s children are prepared to
children benefits everyone and reduces succeed in kindergarten
long-term costs to the Commonwealth.6 ○ Virginia’s adolescents choose not to
engage in behaviors that put their
Foundational Goals for Giving
well-being at risk
Children a Strong Start
○ The racial disparity in Virginia’s infant
○ Virginians plan their pregnancies mortality rate is eliminated
During 2016-2020, Virginia is focusing attention on these foundational goals:
2.1 Virginians plan their pregnancies
2.2 Virginia’s children are prepared to succeed in kindergarten
2.3 The racial disparity in Virginia’s infant mortality rate is eliminated14
AIM 2: STRONG START FOR CHILDREN
2020 FOCUS GOALS
Goal 2.1: VIRGINIANS PLAN THEIR
PREGNANCIES
Comprehensive family planning and
preconception health lead to improved
birth outcomes, which are associated with
better health and cognition as children
mature. Family planning services include
providing education and contraception.
These services help families have children
when they are financially, emotionally, and
physically ready. Publicly-supported family ○ Educate women and men about
planning services prevent an estimated the effectiveness of contraceptive
1.3 million unintended pregnancies a year methods and increase access to the
in the United States. The trend toward most effective methods
having smaller families and waiting at
least 24 months between pregnancies ○ Expand access to and use of
has contributed to better health of infants preconception health services
and children.7 Preconception health
services for females and males include
health screenings, counseling, and clinical Key Community Partners
services that enable them to become as
Community Organizations
healthy as possible before pregnancy.8
Faith-based Communities
Families
Strategies
Federally Qualified Health Centers
○ Increase access to quality family Health-Care Providers
planning services for all women of
Health Insurers
child-bearing age
Public Health
○ Expand evidence-based programs that
Schools
promote healthy relationships
Social Services15 Measure of Success
16
AIM 2: STRONG START FOR CHILDREN
2020 FOCUS GOALS
Goal 2.2: VIRGINIA’S CHILDREN ○ Increase the number of providers and
ARE PREPARED TO SUCCEED IN educators who screen for adverse
KINDERGARTEN childhood events (ACEs) and are
trained in using a trauma-informed
Succeeding or failing in school affects approach to care
a child’s well-being, self-esteem, and
motivation. Being developmentally ready ○ Expand programs that help families
to learn and participate in classroom affected by ACEs, toxic stress,
activities not only sets the stage for the domestic violence, mental illness, and
kindergarten year but can have lifelong substance abuse create safe, stable,
influence on well-being. According to and nurturing environments
a report by the University of Virginia’s
○ Expand programs that teach
Curry School of Education, one out
positive parenting and help parents
of three children in Virginia is not
fully engage with their children in
prepared to succeed in literacy, math,
productive ways
self-regulation, and/or social skills at
the beginning of kindergarten. The ○ Increase opportunities for fathers to be
report finds that “children who enter engaged in programs and services for
kindergarten behind their peers rarely their children
catch up; instead, the achievement
gap widens over time.”9 Investing in
programs to prepare children to succeed
in school prevents them from falling Key Community Partners
behind and dropping out of high school.
Businesses
Strategies Childcare Providers
○ Increase developmental screening for Community Organizations
childhood milestones and delays
Educators
○ Increase enrollment of three to five Families
year-old children in early childhood
Health-Care Providers
education programs that include
quality educational components that Public Health
address literacy, numeracy, cognitive
Social Services
development, socio-emotional
development, and motor skills17 Measures of Success
18
AIM 2: STRONG START FOR CHILDREN
2020 FOCUS GOALS
Goal 2.3: THE RACIAL DISPARITY IN ○ Eliminate early elective deliveries
VIRGINIA’S INFANT MORTALITY RATE
○ Expand outreach to pregnant women
IS ELIMINATED
and increase the number of group
The Commonwealth has made significant prenatal care classes
progress in helping its infants thrive; ○ Implement policies that support
however, some communities have worse women and their families in
outcomes than others. If the rate at which breastfeeding for at least six months
black infants and white infants died were
equal, Virginia would have the lowest ○ Expand home visiting and family
infant mortality rate in the country. Giving support programs
everyone a chance to live a healthy
life benefits not only those currently
disadvantaged but the whole community.
Key Community Partners
Closing this gap requires addressing the
root causes of disparities throughout Community Organizations
life. To achieve equity, all sectors of the Educators
community—from policy makers to Elected Officials
grassroots community organizations to
Families
community members—must work together.
Federally Qualified Health Centers
Health-Care Providers
Strategies Health Insurers
○ Form neighborhood collaboratives Hospital Association
co-led by community members in Medical Societies
under-resourced communities to Mental Health Providers
identify obstacles and develop plans Public Health
to address the root causes of health
Social Services
inequities
○ Increase the number of providers
who screen postpartum women for
depression and provide or refer for
treatment19 Measure of Success
20 20
AIM 3: PREVENTIVE ACTIONS
A CULTURE OF HEALTH AND WELLNESS services “at about half the recommended
is built on preventive actions. Virginia rate”.10 This results in complex, advanced
can substantially decrease the burden disease that is more costly to treat.
of disease and reduce health care
Personal behaviors that prevent disease in-
spending by creating conditions that
clude not using tobacco; eating appropri-
lead to health. Communities, health care
ately-sized portions; daily dental flossing;
systems, and individuals all have a role
practicing safe sex; exercising regularly;
to play. For example, reversing Virginia’s
and taking medicines as prescribed.
high prevalence of obesity will require
(1) community design and policies that
promote healthy eating and active living; Foundational Goals for Preventive
(2) clinical interventions and education; Actions
and (3) individual behavior modification.
○ Virginians follow a healthy diet and
Policy makers can create the conditions live actively
that support the healthy choice becoming ○ Virginia prevents nicotine
the easy choice. Fluoridating drinking dependency
water, developing walkable communities,
and prohibiting smoking in public ○ Virginia conducts comprehensive
buildings are actions that prevent disease. surveillance and investigation of
diseases
Clinical interventions that promote health
○ Virginians are protected against
include vaccination, cancer screenings,
vaccine-preventable diseases
treatment for high blood pressure,
dental cleanings, and early identification ○ Virginians are free from sexually
and treatment of persons addicted to transmitted infections
substances. According to the Centers for
○ Virginia prevents and controls animal
Disease Control and Prevention (CDC),
diseases from spreading to people (for
Americans receive preventive health
example, rabies and bird flu)21
○ In Virginia, injuries are prevented ○ In Virginia, cancers are prevented
or diagnosed at the earliest stage
○ Virginians have good oral health
possible
○ Virginians have access to, can afford,
○ Virginians have lifelong wellness
and receive preventive clinical services
During 2016-2020, Virginia is focusing attention on these foundational goals:
3.1 Virginians follow a healthy diet and live actively
3.2 Virginia prevents nicotine dependency
3.3 Virginians are protected against vaccine-preventable diseases
3.4 In Virginia, cancers are prevented or diagnosed at the earliest stage possible
3.5 Virginians have lifelong wellness22
AIM 3: PREVENTIVE ACTIONS
2020 FOCUS GOALS
Goal 3.1: VIRGINIANS FOLLOW A injury. Factors that positively contribute
HEALTHY DIET AND LIVE ACTIVELY to physical activity levels include higher
income, enjoyment of exercise, and social
Following a healthy diet and living support from peers and family. Factors
actively have long-term health benefits. that discourage adequate physical activity
Maintaining a healthy weight is associated include a low income, lack of time, rural
with improved quality of life and residency, and obesity.
reduced risk of cardiovascular disease,
diabetes, dementia, cancer, liver disease, Policies can be created and
and arthritis. Obesity results from a neighborhoods can be designed to
combination of factors: genetics; behavior; support healthy eating and active living.
education; access to nutritious food; an People make decisions based on their
environment that supports active living; environment; for example, a person may
and food marketing and promotion.11 choose not to take a walk because there
are no sidewalks. Creating opportunities
A nutritious diet includes balancing in the community, child care, school, and
the number of calories consumed with workplace settings can make it easier
the number of calories the body uses. to engage in physical activity and eat a
It is necessary for optimal growth and healthy diet.
development of children.12 Healthy
eating is associated with improved
thinking, memory, and mood among Key Community Partners
school children.13 The inability to afford Businesses
enough food for an active, healthy life is
Childcare Providers
associated with poor health outcomes
Community Organizations
among children, adults, and the elderly.14
Community Planners
Living an active lifestyle supports
Economic Development Agencies
wellness, improves mood, and reduces
Educators
chronic disease. Among children, it
alleviates depression, decreases body Farmers
fat, creates stronger bones, and is even Families
associated with better grades in school.15 Health-Care Providers
Among older adults, physical activity Public Health
lowers the risk of falls, a leading cause of23
Strategies ○ Create parks, recreation facilities or
open space in all neighborhoods
○ Integrate health planning into local and
regional comprehensive planning ○ Increase access to healthy and
affordable foods in all neighborhoods
○ Adopt community designs that
support active living, including ○ Implement organizational and
concentrated mixed use development programmatic nutrition standards and
and bicycle- and pedestrian-friendly policies
communities ○ Expand programs and services to
○ Expand opportunities during and eliminate childhood hunger
after school for children to get healthy ○ Help people recognize and make
meals and the recommended amount healthy food and beverage choices
of daily physical activity
○ Increase the number of evidence-
based employee wellness programs24
Measures of Success25
AIM 3: PREVENTIVE ACTIONS
2020 FOCUS GOALS
Goal 3.2: VIRGINIA PREVENTS
NICOTINE DEPENDENCY Key Community Partners
Academic Partners
According to the CDC, “tobacco use is the
single most preventable cause of death Businesses
and disease in the United States.”16 The Elected Officials
Campaign for Tobacco Free Kids reports
Faith-based Communities
that health care costs in Virginia directly
caused by smoking are $3.11 billion a Health-Care Providers
year.17 Smoking is associated with heart Health Insurers
disease, stroke, chronic lung disease,
Public Health
diabetes, bone disease, and many types
of cancer. Tobacco accounts for 30% of all School Districts
cancer deaths. Secondhand smoke causes
heart disease, stroke, and lung cancer. It
affects the health of infants and children
by increasing the risk for asthma attacks,
respiratory and ear infections, and Sudden
Measure of Success
Infant Death Syndrome.18, 19
Strategies
○ Establish smoke-free policies and
social norms
○ Promote tobacco cessation and
support tobacco users in quitting
○ Prevent initiation of tobacco use26
AIM 3: PREVENTIVE ACTIONS
2020 FOCUS GOALS
Goal 3.3: VIRGINIANS ARE
PROTECTED AGAINST VACCINE- Key Community Partners
PREVENTABLE DISEASES
Families
Virginians who receive their Federally Qualified Health
recommended vaccines protect Centers
themselves from illness and protect others
Health-Care Providers
by decreasing the spread of disease.
Virginia benefits from high childhood Hospital Systems
immunization rates. However, in two other Health Insurers
areas, it lags behind. While the percent
Medical Societies
of adults receiving an annual flu vaccine
has increased, it is still below the national Public Health
goal. The area of most concern, however,
is a low rate of adolescent vaccinations ○ Educate Virginians about the
that prevent meningococcal meningitis effectiveness of HPV vaccination in
and cancers caused by the Human preventing HPV-associated cancers
Papillomavirus (HPV).
○ Increase the number of adolescents
who receive well visits in patient-
Strategies
centered medical homes
○ Use patient registries to identify ○ Establish policies to ensure health-
patients due for vaccination and send care providers receive annual influenza
them reminders vaccine
○ Evaluate data from the Vaccines for
Children program and target outreach
to providers who have the opportunity
to improve vaccination rates
○ Evaluate data from the Virginia
Immunization Information System to
assess immunization coverage and
develop targeted interventions to
address gaps27 Measures of Success
28
AIM 3: PREVENTIVE ACTIONS
2020 FOCUS GOALS
Goal 3.4: CANCERS ARE PREVENTED
OR DIAGNOSED AT THE EARLIEST Key Community Partners
STAGE POSSIBLE Community Organizations
Cancer is the leading cause of death for Employers
Virginians. It is caused by changes to Families
the genes that lead to the uncontrolled
Federally Qualified Health
growth of specific cells in the body. There
Centers
are many types of cancer, and the risks
associated with each type vary. Preventive Health Care Providers
actions can keep some cancers from Health Insurers
developing. These include not using
Hospital Systems
tobacco, minimizing alcohol consumption,
and vaccination against HPV and Hepatitis Lay Health Workers
B. In some cases, when cancer does Medical Societies
form, it can be identified early through
Public Health
evidence-based screenings, resulting in
better treatment options and outcomes.
settings to support people in seeking
recommended cancer screenings
Strategies
○ Implement evidence-based strategies
○ Increase tobacco prevention and
to reduce structural barriers to cancer
cessation programs
screenings
○ Increase percent of medical practices
○ Implement provider assessment and
that implement evidence-based
feedback interventions to increase
client reminder systems to increase
cancer screenings
recommended cancer screenings for
patients
○ Increase the number of providers,
lay health advisors, and volunteers
trained in health literacy to provide
one-on-one education in medical,
community, worksite, and household29 Measure of Success
30
AIM 3: PREVENTIVE ACTIONS
2020 FOCUS GOALS
Goal 3.5: VIRGINIANS HAVE LIFE-
LONG WELLNESS
Nearly one out of every eight Virginians
today is 65 or older. In two decades,
almost one in every five will be. Preventive
actions and support systems can result Key Community Partners
in people living in their own home and Academic Partners
community safely, independently, and
Adult Daycare Providers
comfortably, regardless of age, income, or
ability level. Area Agencies on Aging
Faith-based Communities
Strategies
Businesses
○ Encourage construction of safe, Families
congregate and retirement housing for Health-Care Providers
the aging population
Hospital Systems
○ Increase access to internet usage for Nursing Homes
aging Virginians Public Health
○ Increase the number of fitness and Senior Centers
physical therapy facilities that promote
senior fitness
○ Develop a statewide senior falls
prevention program
○ Implement community-wide value-
neutral programs to support Virginians
in planning in advance for future
healthcare choices31 Measure of Success
32
AIM 4: SYSTEM OF HEALTH CARE
VIRGINIA IS HOME TO EXCELLENT found that 40% of Americans were “very
providers and hospitals that deliver state- worried” about “having to pay more for
of-the-art health care services. However, their health care or health insurance”.20
like the rest of the United States, many The challenge for Virginia is to improve
health measures, including patient health care quality by providing care that
outcomes and quality, lag behind other is safe, effective, patient-centered, timely,
developed countries. Health care spending efficient, and equitable while controlling
in the United States is the highest in the health care spending.
world and continues to increase. Increased
Meeting this challenge is difficult because
longevity, and chronic health problems
health care is delivered across many
place new demands on the utilization of
disparate and independent settings
medical services and medical technology
and by many providers. The average
and contribute to higher spending.
Medicare beneficiary with chronic
The leading category of health care illness in the U.S. sees an average of 13
spending in Virginia is hospitalization. physicians a year.21 The Commonwealth
Many hospital stays can be avoided Fund Commission challenged health care
through prevention and primary care. systems to improve performance by 2020.
In Virginia in 2013, there were 1,294 Strategies include making patient’s clinical
avoidable hospital stays for every 100,000 information available at the point of care
people. The rate ranges significantly through shared electronic health records
across Virginia, from 233 to 6,934 per and actively coordinating care across
100,000. A Kaiser Family Foundation poll providers and settings.2233
Foundational Goals for a System of ○ Virginians obtain, process, and
Health Care understand basic health information
and services needed to make
○ Health care in Virginia is affordable to appropriate health decisions
families and businesses
○ Virginia’s health IT system connects
○ Virginia assures adequate regulation of people, services, and information to
health care facilities support optimal health outcomes
○ Virginia has a strong primary care ○ All health care professionals in Virginia
system linked to behavioral health are licensed and/or certified
care, oral health care, and community
support systems ○ Health care-associated infections are
prevented and controlled in Virginia
2020 FOCUS GOALS
4.1 Virginia has a strong primary care system linked to behavioral health care,
oral health care, and community support systems
4.2 Virginia’s health IT system connects people, services, and information to
support optimal health outcomes
4.3 Health care-associated infections are prevented and controlled in Virginia34
AIM 4: SYSTEM OF HEALTH CARE
2020 FOCUS GOALS
Goal 4.1: VIRGINIA HAS A STRONG improve population health can lead to
PRIMARY CARE SYSTEM LINKED TO improved delivery systems and better
BEHAVIORAL HEALTH CARE, ORAL coordination of care across settings.
HEALTH CARE, AND COMMUNITY
SUPPORT SYSTEMS
Strategies
A primary care provider is an important
○ Create Accountable Care Communities
point of entry into the complex health
throughout Virginia, groups of health-
care delivery system. This is especially
care providers and community
important for people living with chronic
partners that voluntarily coordinate
conditions like diabetes. As the number of
high quality care to ensure patients get
Virginians with chronic disease increases,
the right care at the right time; avoid
the need for patient-centered care
duplication of services; and prevent
coordination and programs to help them
medical errors
manage their medications and monitor
their illness increases. ○ Incentivize payment for healthcare that
leads to prevention and management
Untreated mental health disorders
of health and wellness rather than
and substance misuse and abuse have
episodic treatment of disease
serious impact on physical health and
are associated with the prevalence, ○ Improve access to comprehensive
progression, and outcome of some of primary care in patient-centered
today’s most pressing chronic diseases, medical homes
including diabetes, heart disease, and
○ For patients with complex conditions,
cancer. Integrating behavioral health
integrate primary care with behavioral
care, substance abuse prevention and
health care, substance abuse services,
treatment services, and primary care
and oral health care
services produces the best outcomes
and proves the most effective approach ○ Increase the number of Virginia-
to caring for people with complex health certified community behavioral health
care needs.23 clinics
Bringing together hospital systems, health ○ Expand telemedicine services in rural
care providers, insurers and community areas of Virginia
partners to develop shared strategies to35
Key Community Partners
Businesses
Community Organizations
Faith-based Communities
Federally Qualified Health Centers
Health-Care Providers
Hospital Systems
Public Health
○ Increase care coordination across ○ Promote drug-prescribing protocols in
providers and settings health care settings
○ Expand adoption of the community ○ In primary care and other settings,
health worker model by health care increase use of the Screening,
organizations Brief Intervention, Referral and
Treatment tool (an evidence-
○ Develop patient-centered health
based practice used to identify,
communications that have a positive
reduce, and prevent problematic
impact on health, health care, and
use, abuse, and dependence
health equity
on alcohol and illicit drugs)
○ Increase the number of providers
○ Increase the number of providers
who screen for nicotine use,
who screen for domestic violence
including smokeless tobacco
and refer victims to organizations
and e-cigarettes, and provide or
that can assist them
refer for cessation services
○ Educate Virginians about how to avoid
○ Expand access to and use of
wasteful or unnecessary medical tests,
community-based programs for
treatments and procedures
treatment of mental health disorders36
Measures of Success37
38
AIM 4: SYSTEM OF HEALTH CARE
2020 FOCUS GOALS
Goal 4.2: VIRGINIA’S HEALTH IT
SYSTEM CONNECTS PEOPLE, Key Community Partners
SERVICES, AND INFORMATION
Businesses
TO SUPPORT OPTIMAL HEALTH
OUTCOMES Elected Officials
Federally Qualified Health Centers
Virginians and their health-care providers
benefit from access to comprehensive, Free Clinics
secure, easily accessible health Health-Care Providers
information that can inform better
Health Insurers
decision making. Connect Virginia HIE,
Inc. is the Commonwealth’s health- Hospital Systems
information exchange designed to Public Health
promote collaboration and information
sharing between consumers, health-
○ Connect providers, hospitals, and
care providers, and purchasers of health
community partners through Connect
care services. Developing the capacity
Virginia HIE, Inc. to allow for statewide
to collect, analyze, and share population
health information exchange
health information provides the
opportunity for Virginia to create policies ○ Develop the capacity to create
and systems to bring about meaningful aggregated data reports through
health improvement for all Virginians. Connect Virginia HIE, Inc. that can be
used to analyze and track population
Strategies health measures
○ Adopt electronic health records in all ○ Enhance public and private
clinical and care coordination settings data systems and public health
information technology to collect,
○ Expand the use of specific disease
manage, track, analyze, and
registries and reports (for example,
report population health data
patients with hypertension) by medical
practices and hospital systems to ○ Support Health Information
evaluate and track patient outcomes Technology training
and develop targeted interventions to opportunities and jobs
improve patient outcomes39 Measures of Success
40
AIM 4: SYSTEM OF HEALTH CARE
2020 FOCUS GOALS
Goal 4.3: HEALTH CARE-ASSOCIATED
INFECTIONS ARE PREVENTED AND Key Community Partners
CONTROLLED IN VIRGINIA
Academic Partners
Developing systems to assure patient Businesses
safety has improved but remains an
Health-Care Providers
important goal in providing quality
care. Health care-associated infections Hospital Systems
(HAIs), those resulting from the receipt Insurers
of medical care in health care settings,
Public Health
are estimated to account for $28 to
$45 billion in direct health care costs
in the United States annually.24 When ○ Use antibiotics wisely to prevent
health care facilities employ evidence- bacteria from developing resistance to
based prevention strategies, HAIs the drugs that are used to treat them
can be prevented and controlled. For
○ Implement standard precautions in the
example, Clostridium difficile, a type
care of all patients in all health care
of bacteria that causes gastrointestinal
settings all of the time
illness, accounts for 12% of HAIs in
hospitals.25 Strategies to prevent spread ○ Use evidence-based methods to clean
include complying with hand hygiene medical equipment and the health care
guidelines, ensuring adequate cleaning environment
and disinfection of the environment, and
○ Collect, analyze, and use data to
prescribing antibiotics appropriately.
engage healthcare providers in quality
improvement activities
Strategies
○ Increase knowledge and practice
○ Create a culture of safety in health of key prevention strategies for
care facilities that encourages the various HAIs across and within
effective communication between healthcare settings
health-care providers, patients,
○ Use health information systems to
and family members
reinforce clinical practices that improve
○ Perform hand hygiene frequently patient safety41 Measure of Success
42
REFERENCES
1. Organization, World Health (2002). Health, Econom- 14. Gunderson, C. Z. (2015). Food Insecurity and Health
ic Growth and Poverty Reduction: Prevalence Trends. Outcomes. Health Affairs, 1830-1839.
Geneva: World Health Organization.
15. MacLellan, D. D. (2098). Food Intake and Academic
2. Council, National Research (2004). Children’s Health, Performance Among Adolescents. Canadian Journal
the Nation’s Wealth: Assessing and Improving Child of Dietetic Practice and Research, 141-144.
Health. Washington DC: National Academies Press.
16. Fellows, J. T. (2002). Annual Smoking-Attributable
3. Case, A. F. (2005). The Lasting Impact of Childhood Mortality, Years of Potential Life Lost, and Economic
Health and Circumstance. Journal of Health Econom- Costs-United States, 1995-1999. Morbidity and Mor-
ics , 365-389. tality Weekly Report, 300-303.
4. Bhutta, A. C. (2002). Cognitive and Behavioral 17. Kids, Foundation for Tobacco Free (2015, Septem-
Outcomes of School-Aged Children Who Were Born ber 25). The Toll of Tobacco in Virginia. Retrieved
Pre-term: a Meta-Analysis. Journal of the American November 19, 2015, from Tobacco Free Kids: http://
Medical Association, 728-737. www.tobaccofreekids.org/facts_issues/toll_us/vir-
ginia
5. Health & Academics. (2015, September 1). Retrieved
October 1, 2015, from Adolescent and School Health: 18. Prevention, Centers for Disease Control and (2015,
http://www.cdc.gov/HealthyYouth/health_and_aca- October 1). Health Effects of Cigarette Smoking. Re-
demics/ trieved November 19, 2015, from Smoking & Tobacco
Use : http://www.cdc.gov/tobacco/data_statistics/
6. Early Childhood Mental Health. (n.d.). Retrieved Oc- fact_sheets/health_effects/effects_cig_smoking/
tober 16, 2015, from Center on the Developing Child:
http://developingchild.harvard.edu/science/deep- 19. Prevention, Centers for Disease Control and (2014,
dives/mental-health/ November 24). Health Effects of Secondhand
Smoke. Retrieved November 15, 2015, from Smok-
7. Div. of Reproductive Health, N. C. (1999, December ing & Tobacco Use : http://www.cdc.gov/tobacco/
3). Achievements in Public Health, 1900-1999: Family data_statistics/fact_sheets/secondhand_smoke/
Planning. Morbidity and Mortality Weekly Report, pp. health_effects/
1073-1080.
20. Foundation, K. F. (2012, May 1). How Much Does the
8. Information for Health Professionals Recommen- U.S. Spend on Health and How Has It Changed? Re-
dations. (2014, September 2). Retrieved October 3, trieved November 15, 2015, from Health Care Costs:
2015, from Preconception Health and Health Care: A Primer: http://kff.org/report-section/health-care-
http://www.cdc.gov/preconception/hcp/recommen- costs-a-primer-2012-report/
dations.html
21. Elhauge, E. (2010). The Fragmentation of US Health
9. Education, Curry School. (2014). The Virginia Kin- Care. Cambridge: Oxford University Press.
dergarten Readiness Project Executive Summary &
Legislative Report Fall 2014. Charlottesville: Universi- 22. Fund, The Commonwealth (2009). The Path to a
ty of Virginia. High Performance U.S. Health System. Common-
wealth Fund Commission on a High Performance
10. Preventive Health Care. (2013, June 12). Retrieved Health System.
November 5, 2015, from Gateway to Health Commu-
nication & Social Marketing Practice: http://www.cdc. 23. Administration, Substance Abuse and Mental Health
gov/healthcommunication/toolstemplates/entertain- Services (2015, July 2). Wellness Strategies. Re-
mented/tips/preventivehealth.html trieved November 19, 2015, from Wellness: http://
www.samhsa.gov/wellness/strategies
11. America’s Health Rankings. (2015). Retrieved No-
vember 10, 2015, from United Health Foundation: 24. Scott, R. (2009). The Direct Medical Costs of Health-
http://www.americashealthrankings.org/ care-Associated Infections in US Hospitals and the
Benefits of Prevention. Atlanta: Centers for Disease
12. United States Department of Agriculture. (2010). Di- Control and Prevention.
etary Guidelines Advisory Committee on the Dietary
Guidelines for Americans, 2010. Washington DC: 25. Lessa, F. (2015). Burden of Clostridium difficile in-
United States Department of Agriculture. fection in the United States. New England Journal of
Medicine, 825-834.
13. Hoyland, A. D. (2009). A Systematic Review of the
Effect of Breakfast on the Cognitive Performance
of Children and Adolescents. Nutrition Research
Reviews , 220-243.43
44
Virginia Department of Health
109 Governor Street
Richmond, VA 23219
804-864-7002
www.vdh.virginia.govYou can also read
