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Lilian Peake, MD, MPHDirector of Public Health, SC DHEC

January 2018

Mission

Coordinate action on shared goals to improve the health

of ALL people in South Carolina.

Coalition of >60 executive leaders

from across the state

South Carolina Rural Health Action Plan

FACTORS THAT AFFECT HEALTH

High crime

No grocery store

No free recreation

Dilapidated housing

Challenged schools

Few jobs

Less opportunity

Factors Associated with County-level Mortality Rates

• Income

• College education

• Smoking rate

Children living below FPL and in single-parent households are more closely linked to premature mortality if they live in a low-income county than if they live in a high-income county

Source: Cheng ER, Kindig DA. Disparities in premature mortality between high- and low income US counties. Prev Chronic Dis 2012;9:110120. DOI: http://dx.doi.org/10.5888/pcd9.110120.

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High School Graduation and Median Earning in the Past 12 Months by Education

Nonfatal Child MaltreatmentRate per 1,000 population

HEALTH OUTCOMES

Teen BirthsRate per 1,000 females

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Preterm Birth by Race/Ethnicity

Infants Placed to Sleep on their Backs Exclusively

Obesity by Age GroupBreastfeeding Initiation and Duration of Exclusive Breastfeeding

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Adolescents Who Met Physical Activity Recommendations SC FitnessGram 2016-17

Smoking among High School Students

Secondhand Smoke Exposure in Homes or Vehicles among Adolescents

Sexually Transmitted Infections Age Distribution of STIs

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Leading Causes of Hospitalizations Among Children

Asthma Hospitalizations Among Children Under Five Years of AgeRate per 10,000 population

Adolescents Diagnosed with Major Depressive Episode in Past Year

Leading Causes of Injury Deaths by Age Group, Adolescent Seat Belt Use and Distracted Driving

State Health Improvement Plan

2018-2023

Priorities

Chronic Health Conditions

Behavioral Health

Resilient Children

Factors that Affect Health

Health Care Transformation

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Resilient Children - Safe and Supportive Environments

Goals

1. Integrated early childhood data system

2. Training for providers

3. Resources and activities to build resilience

4. Health homes and professional trauma services

Objectives• Decrease child maltreatment by 10% (Baseline 15.8

per 1,000)

• Increase high school graduation by 5% (Baseline

84.6%)

Coalition: Child Well-Being Coalition

Chronic Health Conditions –Healthy Lifestyles and Environments

Goals1. Partner coordination

2. Policies, systems and environments that support healthy eating and active, tobacco-free living

3. Screening, treatment and chronic disease self-management

4. Promote healthy lifestyle choices

Objectives• Decrease adult obesity by 5% (Baseline 33.2%) • Decrease adult smoking by 10% (Baseline 20.6%)• Decrease stroke deaths by 5% (Baseline 45.4 per

100,000)

Coalitions: SCaleDown, Diabetes Advisory Council, SC Tobacco-Free Collaborative

Behavioral Health – Sustainable System of Behavioral Health Care

Goals1. Access to clinical behavioral health services

2. School-based services

3. Crisis intervention and stabilization services

4. Interdisciplinary system for prevention and treatment of substance use disorders

Objectives• Decrease suicide by 5% (Baseline 15.7 per

100,000) • Decrease drug overdose deaths by 5% (Baseline

18.0 per 100,000)

Coalition: SC Behavioral Health Coalition

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Factors that Affect Health and Health Care Transformation

SC Rural Health Action Plan Recommendations1. Access to Health Care 2. Economic Development3. Education 4. Housing5. Cross-cutting Issues

• Infrastructure –Broadband,Social Services, Transportation

• Socio-economic Factors – Poverty, Racism, Sexism

Goals that Build on the Recommendations

1. Increase high quality non-traditional points of access to integrated health care for all ages

2. Improve health information, communications and consumer-informed decision making

3. Increase awareness of root causes of differences in health outcomes among groups of South Carolinians

Making it Work

• Strategies

• Bright Spots

• Links to Best Practices

• Assets

Resilient ChildrenAAP Resource: Leveraging Modifiable Resilience Factors in a Pediatric Clinic Setting

1. Train staff in trauma-informed care2. Screen -- ACEs, resilience, family functional capacity3. Team-based practice – education

• Group-based parenting education and support• Peer-based education and support

4. Medical home for children with ACEs• Customize to needs of family

5. Integrate behavioral health care services6. Community referrals – warm hand-offs

Source: http://pediatrics.aappublications.org/content/pediatrics/139/5/e20162569.full.pdf

It’s not until we start sitting down and working across

boundaries to see how we as a community can do

better that you start seeing the possibilities of how we

can share resources.”

- Renee Romberger, Spartanburg Regional Medical Center

Promote collaborative health

improvement process

Coalition response

Annual review of outcomes with state and local coalitions

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LiveHealthySC.com

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