Download Pennsylvania - National Association of Chronic Disease

Chronic Disease Directors
Preventive Health and Health Services Block Grant
Proposed Elimination Impact Assessment
Pennsylvania
Total Reported: $3,141,548
Safe and Healthy Communities: $419,158
Potential Alternative
Funding Source
If yes, Source
Amount
Categorical Funding
Available?
Is it sufficient to replace
PHHSBG funds?
Population Impacted
Immediate Implications
Long-term Implications
No
No
According to the 2012 BRFSS survey found that 23% of
Pennsylvania adults had no leisure time physical activity in the
past month; 21% of Pennsylvania adults were current smokers
and 62% of Pennsylvania adults aged 18 and above were
overweight and 29% were obese. Grants to five
county/municipal health departments serving approximately
9,649,908 adults.
Elimination of the sole source of funds to five
county/municipal health departments to address the links
between violence, healthy eating and physical activity; reduce
injuries through local policy and community-based activities;
create easy access to parks, spaces to play and healthy
affordable foods; sustain food systems that promote health; and
improve land use, zoning and community design to enhance
health and safety.
Inability to achieve Healthy People 2020 objectives. A serious
implication is increased healthcare costs, both direct and
indirect, that are attributed to chronic disease risk factors.
According to the Center for Disease Control and Prevention,
chronic diseases affect almost 50% of Americans and account
for 7 of the 10 leading causes of death in the United States.
Chronic diseases and conditions such as heart disease, stroke,
diabetes, cancer, obesity, and arthritis cause suffering and
limitations to daily functioning. This program provides a
community driven approach to addressing preventable health
risk factors for these chronic diseases.
Heart Disease and Stroke Prevention: $513,137
Potential Alternative
Funding Source
If yes, Source
Amount
Categorical Funding
Available?
Is it sufficient to replace
PHHSBG funds?
Population Impacted
Immediate Implications
Long-term Implications
Tuberculosis: $189,030
Potential Alternative
Funding Source
If yes, Source
Amount
Categorical Funding
Available?
Is it sufficient to replace
PHHSBG funds?
Population Impacted
No
No
All Pennsylvanians, with particular impact on disparate
population groups (i.e., ethnic/racial minorities, low
socioeconomic individuals) Heart disease and stroke are the
leading and third leading causes of death, respectively, among
both men and women, claiming the lives of 31,643
Pennsylvanians in 2011. Approximately 24.9% of all deaths in
Pennsylvania are from these leading killers.
Elimination the following programs: The Pennsylvania
Academy of Family Physicians Foundation (PAFPF) to
implement the cardiovascular component of the Pennsylvania
Primary Care Coalition’s “Improving Performance in Practice”
(IPIP) program, which improves the delivery of preventive
health care and self-management programs to persons with/at
risk of heart disease or stroke.
A 12-13 point reduction in blood pressure can reduce the risk
of heart attack by 21% and stroke risk by 37%.
In 2009, direct and indirect costs associated with heart disease
and stroke in Pennsylvania were estimated at approximately
$27.2 billion. The estimated total direct and indirect cost of
heart disease and stroke has increased by approximately $4.3
billion annually between 2005 and 2009.
No
No
Statewide impact. Tuberculosis (TB) is spread from person to
person through the air when an infectious individual talks,
laughs or sings. Therefore, although there are segments of the
population that have been identified as high risk, anyone can
Immediate Implications
become infected if exposed. TB disproportionally affects
minorities and other under-served populations. Most TB
patients do not have any medical coverage and cannot get care
outside the public health system for their disease
. TB laboratory testing services will be impacted if there is the
Elimination of PHHSBG fund. It will severely limit the ability
to provide TB testing thus impacting patient care. A cut by
60% would allow us to perform only 675 tests a year,
eliminating of 1,012 lab tests per year.
Long-term Implications
Injury Prevention: $668,493
Potential Alternative
Funding Source
If yes, Source
Amount
Categorical Funding
Available?
Is it sufficient to replace
PHHSBG funds?
Population Impacted
Immediate Implications
Long-term Implications
No
No
All 12 million Pennsylvania residents, all races/ethnicities,
males and females, rural and urban residents, and all ages.
Elimination of funding to 5 county and municipal health
departments (Cities of Allentown and York; county health
departments in Chester, Erie and Montgomery Counties).
Elimination of funding to Safe Kids Pennsylvania to support
training and technical assistance to community-based affiliates
Injury is a serious public health problem in Pennsylvania and
in the nation because of its impact on health, including
premature death, disability and the burden on the health care
system. In 2011, unintentional injury was the leading cause of
death among children and adults ages one through 44, both in
Pennsylvania and on the national level. In the same year,
unintentional injuries ranked as the fifth leading cause of death
overall for Pennsylvanians, contributing to 6.062 unintentional
injury deaths.
Sexual Assault-Rape Prevention: $284,015
Potential Alternative
Funding Source
No
If yes, Source
Amount
Categorical Funding
Available?
Is it sufficient to replace
PHHSBG funds?
Population Impacted
Immediate Implications
Long-term Implications
Yes
No
Residents age 12 and over, all races/ethnicities, urban and rural
residents, and males and females.
Elimination of 11,250 direct service hours. Direct service
includes crisis intervention, counseling, advocacy and
accompaniment services, and the 24-hour advertised toll-free
hot line service for all 67 counties by rape crisis centers.
Inability to provide services to the increasing number of
victims reporting sexual assault. Rape or attempted rape leads
to a variety of physical and mental health problems that
increase medical, productivity, and quality of life costs for the
total population.
Nutrition and Physical Activity Programs: $717,287
Potential Alternative
Funding Source
If yes, Source
Amount
Categorical Funding
Available?
Is it sufficient to replace
PHHSBG funds?
Population Impacted
Immediate Implications
No
No
Adults and children, with particular impact on disparate
population groups (i.e., higher prevalence of obesity, low
socioeconomic individuals). Poor nutrition and physical
inactivity are two main contributors to obesity, the risk factor
with greatest prevalence in PA. PA has the 20th highest
prevalence of obesity and is an epidemic with 32% of 35+ year
olds obese and 18% of high school students obese during the
2010-2011 school year (BRFSS 2011 & Growth Screen
Program 10-11). In 2010-2011, 34% of school aged children in
grades K-12 were either overweight or obese, and of that, 17%
were obese. There were 729,538 children <5 years old enrolled
in various Early Childhood Education (ECE) programs during
the 2011-2012 school year. Of those, 140,533 were in school
districts with either high or moderately high educational and
family risk factors.
Asthma is the leading cause for hospitalizations amongst
Long-term Implications
children. We are targeting children ages 2-16 living near the
City of Philadelphia with poorly controlled asthma.Elimination
the following programs:
Nutrition & Physical Activity: Creation of healthier nutrition
environments and comprehensive school physical activity
programs 15 school districts, 81 schools with an estimated
41,229 students. The Educating Physicians in their
Communities (EPIC) – Pediatric Obesity, which provides
pediatric and family practice teams with education, tools and
resources for the prevention, evaluation and treatment of
pediatric obesity, reaching approximately 1,551,455 children
by June 30, 2014. The Healthy Corner Store Initiative to
provide access to healthier food retail, reaching a minimum of
798,076 adults and children. WalkWorks, increasing safe
walking routes and social supports, via walking groups,
reaching approximately 206,211 adults and children.
Oral Health Program: $125,289
Potential Alternative
Funding Source
If yes, Source
Amount
Categorical Funding
Available?
Is it sufficient to replace
PHHSBG funds?
Population Impacted
Immediate Implications
No
No
All Pennsylvanians, but especially children from low-income
families who are less likely to receive private dental care.
Programs generally target schools by using the percentage of
children eligible for federal free or reduced-cost lunch
programs.
School based dental sealant programs, like that funded by the
PHHSBG, is recommended by the Task Force on Community
Preventive Services, CDC and the ADA, as an effective way to
prevent tooth decay and tooth pain that can affect learning.
Tooth decay (dental caries) affects children in the United
States more than any other chronic infectious disease.
Untreated tooth decay causes pain and infections that may lead
to problems; such as eating, speaking, playing, and learning.
Tooth decay and other oral diseases that can affect children are
preventable. According to CDC, the combination of dental
sealants and fluoride has the potential to nearly eliminate tooth
decay in school-age children.
Long-term Implications
Administration: $225,139
Potential Alternative
Funding Source
If yes, Source
Amount
Categorical Funding
Available?
Is it sufficient to replace
PHHSBG funds?
Population Impacted
Immediate Implications
Long-term Implications
No
No
All Pennsylvanians, as administrative resources are necessary
for carrying out statewide chronic disease and injury
prevention program activities and services.
Lack of administrative infrastructure for prevention
programming of public health programs.