boris d. lushniak, md, mph radm, usphs deputy surgeon general department of health and human...
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Boris D. Lushniak, MD, MPH RADM, USPHS
Deputy Surgeon General
Department of Health and Human Services
Office of the Surgeon Generalof the
United States of America
DISCLOSURE OF CONFLICTS OF INTEREST
Boris D. Lushniak, MD, MPH
I do not have any relevant financial relationships with any commercial interests
No off-label discussion of drugs or devicesWork supported by US Government
(DHHS, PHS, FDA, CDC/NIOSH)
The United States Public Health Service
• Who we are• What we do
Seven Uniformed Services of the United States
DOD
Armed
Military
Non-DOD
Non-Armed
Can Be Militarized
Non-DOD
Armed
Military
(HHS)
(DOC)
(DHS)
The Surgeon General is the Commander of the USPHS Commissioned Corps
The USPHS Commissioned Corps
Regina M. Benjamin, MD, MBAVADM, USPHS18th Surgeon General
Protecting, promoting, and advancing the health and safety of the nation
The Mission of the Commissioned Corps
US Public Health Service Mission
As America’s uniformed service of public health professionals, the Commissioned Corps achieves this mission through:
• Leadership and excellence in public health practice
• The advancement of public health science • Rapid and effective response to public health
needs
The United States Public Health Service
1798 Act provided care for sick and injured merchant seamen (loose hospital network)1870 Marine Hospital Service (national system)1871 Supervising Surgeon (later Surgeon General)
Dr. John Maynard Woodworth1878 Quarantine functions (smallpox, yellow fever, cholera)1889 Legislation creating Commissioned Corps 1891 Immigrant services1902 Public Health and Marine Hospital Service1912 Public Health Service (with broadened powers)
A Proud History
From Ellis Island… …To tribal landsAcross America… …Around the World
1918
Categories of Commissioned Corps Officers
• Over 6,500 officers in 800 locations, worldwide• 11 Professional Categories
• Medical• Dental• Nursing• Pharmacy• Scientist• Health Services• Engineer• Therapist• Veterinarian• Dietitian• Environmental Health
US Duty Stations
Federal Agencies Utilizing Commissioned Corps Officers
(Not all agencies and programs are represented)
• Combat overweight epidemic• Target Obesity
Public Health & Prevention Missions of the Surgeon General: Overweight & Obesity
Public Health & Prevention Missions of the Surgeon General
• Smoking• Underage Drinking
Public Health & Prevention Missions of the Surgeon General: Deep Vein Thrombosis & Healthy Homes
Best DVT Prevention Practices Promoting Healthy Homes
Public Health & Prevention Missions: Healthy Youth for a Healthy Future
• National Outreach Campaign- Encourage healthy eating habits- Help kids stay active- Promote healthy choices- Local roundtables with non-traditional partners
Faith-based organizationsBusinessesChambers of Commerce
- Recognition of “Community Champions”
The Surgeon General’s Vision for a Healthy and Fit Nation
Major Actions of OSG
A Report of the Surgeon General How Tobacco Smoke Causes Disease
The Biology and Behavioral Basis for Smoking-Attributable Disease
December 9, 2010
Major Actions of OSG
The Surgeon General’s Call to Action to Support Breastfeeding 2011
January 20, 2011
Upcoming Actions• March 8, 2012 – release of “Preventing
Tobacco Use Among Youth and Young Adults” (Washington DC)
• Other OSG initiatives – prescription drug misuse in teens, youth violence
• Let’s Move campaign• Million Hearts Hearts campaign
– Prevent 1 million heart attacks and strokes in 5 years
– Aspirin, Blood Pressure, Cholesterol, Smoking– www.millionhearts.hhs.gov
The science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.– CEA Winslow, 1920
Public Health
10 Great Public Health Achievements-US 1900-1999
VaccinationMotor-vehicle safetySafer workplacesControl of infectious diseasesDecline in deaths from heart disease and
stroke
Safer and healthier foodsHealthier mothers and babiesFamily planningFluoridation of waterRecognition of tobacco as a health hazard
MMWR 1999 Apr 2;48(12):241-3.
Public Health US 2009
6.22 infant deaths per 1000 live births (45)78.11 life expectancy in years (49)Health care expenditure
– 17.6 % GDP (1)– $2.5 trillion – $8160 per person
Core Public Health FunctionsAssessment and monitoring of the health of
communities and populations at risk – identify health problems and priorities - surveillance
The formulation of public policies – designed to solve identified local and national health
problems and prioritiesAssure that all populations have access to
appropriate and cost-effective care– including health promotion and disease prevention
services– evaluation of the effectiveness of that care
Healthy Peoplewww.healthypeople.gov
Developed in 1979 by the Department of Health and Human Services
Science-based, 10 year national objectives For promoting health and preventing diseaseIncludes a vision, mission, goals, focus areas,
criteria, objectives and action plans for achieving the targets
Healthy People 2020
Launched Dec 2010 600 objectives, 1300 measures Each objective has a reliable data source, a
baseline measure, and a target for specific improvements
www.healthypeople.gov/HP2020
Healthy People 2020Implementation Framework
MAP-IT– Mobilize -- partnerships– Assess – needs and assets– Plan – clear objectives and concrete steps– Implement – workplan, POC, communication plan– Track – evaluate and track progress
Using Healthy People to make the case for funding
www.healthypeople.gov/HP2020
The Affordable Care Act
Unique Opportunities for Prevention
National Prevention Council
Bureau of Indian Affairs Department of Labor
Corporation for National and Community Service
Department of Transportation
Department of Agriculture Department of Veterans Affairs
Department of Defense Environmental Protection Agency
Department of Education Federal Trade Commission
Department of Health and Human Services
Office of Management and Budget
Department of Homeland Security Office of National Drug Control Policy
Department of Housing and Urban Development
White House Domestic Policy Council
Department of Justice
Advisory Group
17 non-federal members
Statutory Role:
– Develop policy and program recommendations
– Advise National Prevention Council on prevention and health promotion practices
National Prevention Strategy
Extensive stakeholder and public input
Aligns and focuses prevention and health promotion efforts with existing evidence base
Supports national plans
Vision
Working together to improve the health and
quality of life for individuals, families, and
communities by moving the nation from a focus
on sickness and disease to one based on
prevention and wellness.
National Prevention Strategy
Healthy and Safe Community Environments
• Clean air and water
• Affordable and secure housing
• Sustainable and economically vital neighborhoods
• Make healthy choices easy and affordable
Clinical and Community Preventive Services
• Evidence-based preventive services are effective
• Preventive services can be delivered in communities
• Preventive services can be reinforced by community-based prevention, policies, and programs
• Community programs can promote the use of clinical preventive service (e.g., transportation, child care, patient navigation issues)
Empowered People
• People are empowered when they have the knowledge, resources ability, and motivation to identify and make healthy choices
• When people are empowered, they are able to take an active role in improving their health, supporting their families and friends in making healthy choices, and leading community change
Elimination of Health Disparities
• Health outcomes vary widely based on race, ethnicity, socio-economic status, and other social factors
• Disparities are often linked to social, economic or environmental disadvantage
• Health disparities are not intractable and can be reduced or eliminated with focused commitment and effort
Priorities
Tobacco Free Living
Preventing Drug Abuse and Excessive Alcohol Use
Healthy Eating
Active Living
Mental and Emotional Well-being
Reproductive and Sexual Health
Injury and Violence Free Living
Source: National Vital Statistics Report, CDC, 2008
Federal Implementation
Provide coordination and ongoing leadership at the Federal level, and among all Federal departments
Establish processes for continual public input
Establish specific and measureable agency-specific actions to address recommendations
Monitor and track federal actions
Annual Status Report
Optimal Implementation
What’s Next
Regional meetingsExecute and coordinate NPS actions
across Council agenciesEncourage partners to create and
execute their own NPS action plans Monitor and track progress Share successes!
For more information go to:
www.healthcare.gov/nationalpreventioncouncil
Contact the National Prevention Council at:
Boris Lushniak, M.D., M.P.H.RADM, USPHSDeputy Surgeon [email protected]
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