LET S USE OUR BRAINS TO INSPIRE HEALTHY ACTS

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1 LET S USE OUR BRAINS TO INSPIRE HEALTHY ACTS Joe Thompson, MD, MPH President and CEO, ACHI Professor, UAMS Colleges of Medicine and Public Health

2 OUR MISSION, VISION & VALUES MISSION ACHI s mission is to be a catalyst for improving the health of Arkansans through evidence-based research, public issue advocacy, and collaborative program development. VISION ACHI s vision is to be a trusted health policy leader committed to innovations that improve the health of Arkansans. VALUES ACHI s values are trust, innovation, initiative, and commitment.

3 OUR PRIORITIES

4 STROKE STATISTICS IN THE UNITED STATES oleading cause of long-term disability o5 th leading cause of death ocost estimated at $34 billion per year for healthcare, medications, and missed work oapproximately 795,000 stroke events each year o (7,484 people in Arkansas had strokes in 2014)

5 STROKE MORTALITY RATE BY STATE (2017) Age-Adjusted Death Rates (per 100,000 population) ARKANSAS: o 7 th highest stroke death rate in U.S. (43.8 per 100,000) in 2017 o 1,612 deaths from stroke in 2017 o Stroke was the 4 th leading cause of death in Arkansas in 2016 Source:

6 PERCENTAGE OF ADULT ARKANSANS WITH LEADING RISK FACTORS FOR STROKE ohypertension: >50% odiabetes: 12% ohyperlipidemia: 37% osmoking: 26% Source:

7 ARKANSAS HEALTH RANKINGS (2017) o7 th highest adult obesity rate o1 st among states reporting for high school obesity o9 th highest for diabetes o3 rd highest for hypertension Source: The State of Obesity. A report from Trust for America s Health and the Robert Wood Johnson Foundation.

8 TRADITIONAL STROKE RISK FACTORS INTERSTROKE study Population-attributable risk for common risk factors Risk Factor Population- Attributable Risk, % 99% CI Hypertension 34.6 ( ) Smoking 18.9 ( ) Waist-to-hip ratio (tertile 2 vs tertile 1) 26.5 ( ) Dietary risk score (tertile 2 vs tertile 1) 18.8 ( ) Regular physical activity 28.5 ( ) Diabetes 5.0 ( ) Alcohol intake 3.8 ( ) Cardiac causes (Atrial fibrillation) 6.7 ( ) Ratio of apolipoprotein B to A ( ) (tertile 2 vs tertile 1) Psychological factors Stress 4.6 ( ) Depression 5.2 ( ) *For the protective factor of physical activity, the population-attributable risks are provided for individuals who do not participate in regular physical activity. Source: O'Donnell MJ et al. Lancet 2010; available at:

9 PROPORTIONAL CONTRIBUTION TO PREMATURE DEATH Source: McGinnis JM, Williams-Russo P, Knickman JR. The case for more active policy attention to health promotion. Health Aff (Millwood) 2002;21:78-93

10 CLINICAL AND PUBLIC HEALTH PROGRESS EACH CONTRIBUTED ABOUT HALF TO THE 50% REDUCTION IN HEART DISEASE DEATHS, U.S., % Risk factor reductions = ~50% 25% 24% 20% Clinical interventions = ~50% 20% 15% 10% 12% 11% 10% 9% 12% 5% 5% 5% 0% -5% -10% -15% -8% -10% Ford ES, et al. NEJM 2007;356(23): HTN, Hypertension, BP, Blood pressure, BMI, Body mass index

11 STROKE PATHWAY Genetics Physical inactivity, diet, alcohol, smoking Hypertension, obesity, diabetes, hyperlipidemia, cardiac disease Healthcare access quality, compliance, literacy Stroke

12 Age-adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults Obesity (BMI 30 kg/m 2 ) No Data <14.0% 14.0% 17.9% 18.0% 21.9% 22.0% 25.9% > 26.0% Diabetes No Data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% >9.0% CDC s Division of Diabetes Translation. United States Surveillance System available at

13 ADULT OBESITY RATE BY STATE (2017) Source: Trust for America s Health:

14 OBESITY PREVALENCE IN OECD COUNTRIES; TOP & BOTTOM RANKING U.S. STATES Source: America s Health Rankings, United Health Foundation A call to action for individuals and their communities Annual Report 2017.

15 OBESITY PREVALENCE IN U.S. STATES AND ALL ARKANSAS COUNTIES Source: America s Health Rankings, United Health Foundation A call to action for individuals and their communities Annual Report 2017 ; County Health Rankings, Health Factors Adult obesity in Arkansas 2017.

16 Healthy Active Arkansas 10-Year Plan Overarching goal: Increase the percentage of adults, adolescents, and children at a healthy weight Reducing BMI of Arkansans by only 5% will: - Prevent thousands of cases of diabetes, stroke, coronary heart disease, hypertension, and cancer - Lead to savings of more than $2B in 10 years

17 Healthy Active Arkansas Launched by Gov. Asa Hutchinson in 2015 Operations and Communications Teams Board of Directors AFMC Arkansas Blue Cross Blue Shield Arkansas Center for Health Improvement Arkansas Children s Hospital Arkansas Coalition for Obesity Prevention Board of Directors, cont. Arkansas Department of Health Arkansas Department of Human Services Arkansas Minority Health Commission Arkansas Surgeon General Baptist Health CHI St. Vincent Delta Dental of Arkansas Governor s Office University of Arkansas for Medical Sciences (UAMS) Winthrop Rockefeller Institute

18 Healthy Active Arkansas Priority Areas 1. Physical & Built Environment 2. Nutrition Standards in Government, Institutions & Private Sector 3. Nutrition Standards in Schools Childcare Through College 4. Physical Education & Activity in Schools Childcare Through College 5. Healthy Worksites 6. Access to Healthy Foods 7. Sugar-Sweetened Beverage Reduction 8. Breastfeeding 9. Public Marketing Campaign

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