Public Health 3.0 in Boston Monica Valdes Lupi, JD, MPH Executive - - PowerPoint PPT Presentation
Public Health 3.0 in Boston Monica Valdes Lupi, JD, MPH Executive Director Boston Public Health Commission October 31, 2016 Agenda Career path Key health indicators Importance of partnerships and collaboration Strategic
October 31, 2016 Monica Valdes Lupi, JD, MPH Executive Director Boston Public Health Commission
Career path Key health indicators Importance of partnerships and collaboration Strategic priorities and Public Health 3.0 Discussion
#1 best tasting tap water #1 best access to healthcare #1 city for active living #3 city for sports #3 on walkable cities list #6 on best places to go to college
#1 in income inequality (& the gap is growing!) #3 in highest average rent #9 on the list of most segregated cities #10 on the list of poorest cities
% of Population Categorized as Black
Heart Disease Hospitalizations per 1,000 Population Asthma Hospitalizations per 1,000 Population
SOURCE: Inpatient Hospital Discharge Database, Massachusetts Center for Health Information and Analysis, 2010 DATA ANALYSIS: Boston Public Health Commission Research and Evaluation Office
Prevention Treatment and recovery support Access to care
Public health
Opportunities: MassHealth
1.
Strong leadership and workforce: Chief Health Strategist
2.
Strategic partnerships: cross- sector
3.
Flexible and sustainable funding: blending/braiding/recapturing/re- investing
4.
Timely and locally relevant data, metrics, and analytics: actionable
5.
Foundational infrastructure: public health accreditation
Community Initiatives
HelpSteps Breathe Easy at Home
Homeless Services
HUES to Home: High
Health Impact Assessment: Boston Living Wage Ordinance
Enacted in 1998 to ensure city contractor
employees earn hourly wage that family of four can live on or above the poverty line
Goal to attach millions of dollars in city
contracts to some benefit for employees of the contracted companies
Applies to firms with city service contracts
hourly employees
Current wage = $14.11 per hour
Source: Boston Office of Workforce Development, 2015
Safe Routes to School – Boston Safe Routes to School Tobacco Control – Tobacco 21 Access to Clean Syringes – AHOPE
Three year-initiative to increase walking funded
School level (n=18 in year 2)
‘Wellness champions’ coordinate school efforts Pedestrian safety module required in PE class Walk-to-School Days and other special events Communication with parents, faculty and staff
Dec 2015: adopted this policy
Tobacco control efforts in Boston
Among Boston high school students, the
rate of cigarette use declined from 15.3% in 2005 to 7.9% in 2013. National average is 15.7%.
State legislation pending before the
Timeline of activities
1993: Legislature allowed for 10 needle
exchanges to be created around the state, dependent on local approval.
Local opposition blocked implementation of
new needle exchanges, so up until 2016, there were only 5 needle exchanges in MA.
2006: decriminalized possession and
allowed for the over-the-counter sale of syringes at all pharmacies in the state but access to clean syringes remains challenging.
2016: Legislature lifted the “cap” and
amended language around local approval.
In MA, HIV prevention efforts with IDUs have
Decrease in HIV prevalence largely attributed to
Huge accomplishment, given the state of the HIV
Home Improvement Loans and Grants: Lead, Prevention Wellness Trust Fund Water Fluoridation: Promotion of drinking tap H20; advocacy
Provided landlords with free Moderate Risk Deleading (MRD) training
which helps significantly reduce the overall costs of eliminating lead in their rental properties.
Conducted healthy home visit and assessments. Provided Section 8 landlords with window guards for their tenants with
small children through HUD Healthy Section 8 & Affordable Housing Project.
Provided IPM kits through the DND/BPHC Healthy Homes Integration
Project.
Through PWTF, referrals made to senior repair programs to receive home
modifications to prevent falls.
Community water fluoridation adds a controlled
Boston has fluoridated water from an excellent
Efforts to promote tap water consumption are a
Benefits of fluoride Decrease sugary drink intake Environmental benefit of fewer discarded drink
containers
Let’s Get Healthy, Boston! collaboration with NEU School of Pharmacy students and faculty on ReThinkDrinkNEU
Encourages NEU community to “rethink” consumption of sugary beverages and switch to water
Pharmacy students have promoted 190 filtered water stations on campus and advocated for the inclusion of their locations on the NUGo app.
Pharmacy students had outreach displays at Earth Day, Sustainability Day, and Bouvé Health Day
Collected input from 375 individuals
about additional placement locations for water stations.
Distributed 300 water bottles with
ReThinkDrink NEU logos
Monica Valdes Lupi, JD, MPH Executive Director mvaldeslupi@bphc.org 617.534.5264
11.9 19.4 8.6 16.4 0.0 5.0 10.0 15.0 20.0 25.0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Deaths Ages 12+ per 100,000 Population
Unintentional Heroin/Opioid Overdose Mortality Boston Residents, 2002-2013
n=767 (64 per year avg.)
TOTAL Deaths 2012: 62 2013: 81 2014: 87
Safe Routes to School – Boston Safe Routes to School Motorcycle Injury Prevention – Vision Zero Tobacco Control – Tobacco 21 Access to Clean Syringes – AHOPE
VISION ZERO BOSTON: Mayor J. Walsh’s plan to eliminate fatal and serious crashes in Boston by 2030 includes reducing speed limits, building safer streets, and engaging Bostonians by providing resources to reduce distracted and impaired driving.
BPHC Injury Prevention Program, Emergency Medical Services and Chronic Disease Division working with the Boston Transportation Department and the Boston City Council to lower the default speed limit in the City of Boston from 30 mph to 25
expected to take effect on January 1, 2017. This comes after Boston and other municipalities worked with the state legislature to give municipalities control over setting default speed limits.
Driving at 25 mph allows drivers and pedestrians more time to see each other making crashes unlikely to occur but in the event they do occur are less likely to cause serious injury or death. Reducing the default speed limit to 25 mph will help make Boston safer for all people walking, driving, and bicycling.
Integrated HIV/HCV/STD testing, and referral to treatment Overdose prevention and education + naloxone distribution Primary care and behavioral health referrals Patient navigation when accessing medical care HIV medical case management Referral to substance use treatment: detox, CSS, TSS, aftercare,
MAT
On average, AHOPE places 3-4 people in treatment every day
Housing search + advocacy Mental health Legal assistance On-site medical care, wound care
Hepatitis C (HCV):
substantial increase in HCV infection among youth in MA
that may be a marker for the future direction of the HIV epidemic.
HCV diagnoses between 15 -24 age group increased by 74%
between 2002 and 2009.
Overdose:
Between 2000 (338) and 2014 (1256), overdoses increased
by 227%.
Education of medical and social service providers is
We need to ensure stigma surrounding injection drug
Home Improvement Loans and Grants: Lead, PWTF, Home visiting with DND Water Fluoridation: Promotion of drinking tap H20; advocacy
BPHC helped BPS draft the most comprehensive
Discussion of tap water benefits included in trainings
Give free water pitchers as incentives
BPHC changes
Eliminated purchased water coolers in favor of filtered
piped tap water stations
Recently distributed free re-usable water bottles to all
employees
The Story of Boston’s Tap Water: Started from the
Test the Tap Soda Free Summer Challenge