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CDC Director Shares Insights on Improved Public Health

Thursday, July 18, 2013 - Campus News -

The factors impacting public health the most in this country are often hiding in plain sight.
That was a key message shared by the director of the Centers for Disease Control and Prevention as he addressed a packed auditorium at the University of Oklahoma Health Sciences Center in Oklahoma City.
Tom Frieden, M.D., M.P.H., shared his insights as he delivered the Edward N. Brandt Memorial Lecture. The lecture is part of Public Health Grand Rounds sponsored by the OU College of Public Health and OU Medicine.
"There are so many things that are hiding in plain sight and it is the job of those of us who work in health and public health to bring those things to the fore in ways that will promote health," Frieden said. "Promoting health is not particularly complicated. It is about maximizing health, reducing preventable suffering - reducing preventable illness, injury, disability and death."
He pointed out that many answers to the health problems facing Americans are literally staring us in the face if we will just examine the data. 
"Often, we don't see what is most apparent or most striking in front of us because we almost take it for granted, but we are living in the midst of a huge increase in cardiovascular morbidity and mortality," he said. "If you look over the scope of time, even if you correct for age, there's been a big increase in heart disease and stroke. It is by far the leading cause of death in this country. It is by far the leading cause of preventable death in this country; and it is by far the leading cause of health disparities in this country."
Frieden said that is why the CDC, with a range of public and private partners, launched The Million Hearts campaign 18 months ago.  It is a campaign aimed at preventing a million heart attacks and strokes over the next five years through community prevention in the form of better tobacco control, sodium reduction and trans fat elimination, as well as through clinical prevention measures including a focus by clinicians on what he termed the ‘ABCS' – aspirin, blood pressure, cholesterol and smoking cessation.
"Those four areas can save more lives than any other areas in health care," Frieden said. "That doesn't mean we don't improve all over; but in those four areas, we can make a huge difference."
The problems are clearly evident when one examines the various facts and figures related to preventable illness, injury, disability and death; but Frieden said so too are the solutions. For example, when evaluating health systems that show the greatest improvements, one often finds similarities.
Frieden offered blood pressure as an example.  While it is estimated that some 67 million people in this country have high blood pressure, it is controlled in fewer than half (47%) of those. Yet, some systems have been able to achieve much higher levels of control. In examining health systems with blood pressure control in 80 to 90 percent of patients, Frieden said some common denominators emerge. First, they had focused quality measures.
"Providing quality feedback monthly improves outcomes in a year," he said.
Next, they had solid health information systems.  Frieden noted that electronic medical records may not be a solution alone but they are definitely an important component. 
Finally, team-based care was another common factor in successful blood pressure control among patients.
"We know it is not only important to have information, it is important to have people who can act on it," Frieden said.
Smoking cessation is one area where the data shows intervention is making a difference. With a new tobacco tax, expanded smoke-free laws, hard-hitting anti-smoking ad campaigns, Frieden said the numbers on smoking are beginning to move. He pointed to preliminary national data just out that shows a rapid decrease in smoking over the past four years with about 4.5 million fewer smokers today than in 2009.
To view Frieden's presentation in its entirety, visit:

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