Sharon Moffatt, RN BSN MSN Association of State and Territorial Health Officials January 12, 2011

Transcription

1 Sharon Moffatt, RN BSN MSN Association of State and Territorial Health Officials January 12, 2011

2 ASTHO From Micronesia to Alaska and Across the U.S. to the Virgin Islands

3

4 Comprehensive Well Woman Visits across the Lifespan Address Health Equity by linking expertise of public health and primary care Support Preventive Services Delivered in a Comprehensive System of Care Model Review and Update Process Based on The Guide for Community Preventative Services

5 Scope of Preventative Services for Women

6 Preconception Health Folic Acid Healthy Weight Smoke cessation Sodium intake Family Planning Breastfeeding support Interconception Care Health pregnancy intervals Women of Childbearing Age Clearly stated periodicity of wellness visits at all ages Priority focus to behavioral health screenings and early interventions Women in pre through post menopause

7 Environmental and the Workplace Occupational health exposures Breast feeding in the workplace Domestic Violence Assessment and counseling for intimate partner violence Substance Abuse Screening, Brief Intervention, Referral and Treatment: SAMHSA model Mental Health Caregiver stress

8 Scope of Preventative Services for Women

9 Target Preventive Services to address serious health disparities Race Ethnicity Poverty Education Other social determinants of health Target Services & Screenings African American women are 2.4 times more likely to have a stroke compared to Caucasians 45% of African American women have CVD compared to 32% Caucasians Examples of Disparities 9

10 17 percent of women reported not receiving a mammogram within the past two years 29 percent of Asian/Pacific Islander older women reported not receiving mammography screening within the past two years Examples of Disparities 5 year survival rate for breast cancer for African American women was 77% compared to 90% for Caucasians Examples of Disparities

11 Clinical expertise Trusted health authority Identify high risk patients Link to specialists Address issues of health literacy Community outreach Develop a diverse health care workforce Identify barriers to access care Cost Transportation Cultural acceptance Primary Care Public Health

12 Services and screenings to fill gaps in preventive services for women

13 Women receive health screenings and services in multiple settings beyond the primary care office WIC Public Health STD clinics Public Health Family Planning Clinics Safety Net clinics 23.7 Million Women are enrolled annually in Women, Infant and Children (WIC) 85% of women in WIC are % of pregnant women in WIC are 17 or younger

14 Assessment of current delivery system Identification of gaps in services Identification of high risk women and linkages to access care Coordination of health information Health Information Exchange

15 Linking women to medical home is a critical service which needs to be part of the recommended women preventive services Payer support for this linkage and coordination across a comprehensive system of care with assure improved Access to Care Deliver of recommended preventive services

16 Model to Coordinate Regular Updates on the Guidelines

17 Independent public health and prevention experts Liaisons to Taskforce Coordination with the US Preventative Clinical Services Taskforce

18 Comprehensive Well Woman Visits across the Lifespan Address Health Equity by linking expertise of public health and primary care Support Preventive Services Delivered in a Comprehensive System of Care Model Review and Update Process Based on The Guide for Community Preventative Services

19 Association of State and Territorial Health Officials

20 The Guide to Community Preventative Services: Bright Futures, American Academy of Pediatrics, American Heart Association. Health Equities: Advocacy. National Stroke Association. African American and Stroke. Behavioral Risk Factor Surveillance System, 50 states and the District of Columbia, Center for Disease Control

21 Montgomery DL, Splett PL. Economic Benefit of Breast-Feeding Infants Enrolled in WIC. Journal of the American Dietetic Association. 1997; 97: Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and 6 months later. Bertha K. Madras et al. Drug and Alcohol Dependence, Volume 99, Issues 1-3, 1 January 2009, Pages National Women s Health Information Center.