SHIP: The Statewide Health Improvement Program

Healthy kidsHealthy communities

Cause of Death, Minnesota 2010 Number of Deaths

Cancer 9599

Heart Disease 7144

Stroke 2154

Unintentional injuries 2087

Chronic lower respiratory disease 2012

Alzheimer’s Disease 1450

Diabetes 1036

Nephritis 895

Suicide 599

Influenza/pneumonia 591

What is SHIP?SHIP works to reduce chronic diseases such as heart disease, cancer and diabetes

Source: Mokdad et al, JAMA 2004 March 10; 291 (10):1238-45 U.S. 2000

The “Real” Causes of Death: U.S. estimate, 2000

Number of Deaths Percentage

Tobacco 435,000 18%

Diet/activity 365,000 15%

Alcohol 85,000 4%

Microbial agents 75,000 3%

Toxic agents 55,000 2%

Firearms 29,000 1%

Sexual behavior 20,000 <1%

Motor vehicles 43,000 <1%

Illicit use of drugs 17,000 <1%

What is SHIP?It does this through prevention—reducing the behaviors that lead to chronic disease

Percent of Minnesota Adults Obese (BRFSS)

Health in Minnesota

• Nearly 2/3 of adults are overweight or obese

• Only one out of four adults eats enough fruits and vegetables

• Only slightly more than half of Minnesota adults get at least a moderate level of exercise.

Obesity is epidemic in Minnesota

Percent of Minnesota Adult Current Smokers (BRFSS)

Health in Minnesota

• 15% of adults smoke, and many others are subjected to secondhand smoke.

• In high school, over a quarter of students used tobacco in the past 30 days.

• Nearly one in five high school students (18.1%) smoked cigarettes

Tobacco continues to be a problem

Health in Minnesota

Health Care Spending in Minnesota from 1996-2008

All contributing to health care costs that are out of control

$2.9 billion in annual medical costs (2007)Tobacco

Obesity $2.8 billionestimated annual financial burden (2006)

Health in MinnesotaThe financial burden on Minnesota is enormous

Source: Center for Disease Control and Prevention, University of California at San Francisco, Institute for the Future, thanks to Dakota SHIP

Minnesota spends annually per-capita:•Almost $7000 health care•Less than $4 on SHIP the first 2 yrs

Health in MinnesotaYet prevention is a tiny percent of health spending

• The goal of SHIP:– The goal of the Statewide Health Improvement Program

(SHIP) is to help Minnesotans live longer, healthier, better lives by preventing risk factors that lead to chronic disease.

How SHIP WorksThe solution: prevent chronic disease and thereby reduce health care spending

How SHIP WorksThe SHIP model: improving health by increasing opportunities for healthy choices

Increased opportunities for physical activity, nutritious food, and tobacco- free living…

…means more people get physical activity, better nutrition, and less tobacco exposure…

…leading to Improved health…

…lowering health care costs, and improving quality of life.

Keys to success•Local control

– Local communities select from a menu strategies what will work best for them.

•Strong partnerships– New community partnerships with not only local public health and

tribal grantees, but also with businesses, farmers, schools, community groups, chambers of commerce, hospitals, health plans, city planners, county boards, tribal officials and more.

•Evidence-based strategies– Built on best practices from the Centers for Disease Control and

Prevention and other public health leaders.

How SHIP Works

Keys to success (continued)•Sustainability

– Efforts that lead to long-lasting change, not programs that end and things go back to the way they were before.

•Strong evaluation– Always seeking to improve by understanding what is working, gaging

health outcomes and measuring cost savings.

How SHIP Works

MDH gathered a menu of strategies for local communities to choose from•Strategies that work on a community-wide scale rather than on an individual level, for example:

– Rather than tell kids about good nutrition, work with schools to serve more locally grown produce.

– Rather than tell people to get more physical activity, help employers build opportunities into the day.

– Rather than tell students to avoid second-hand smoke, help college campuses to become smoke-free.

How SHIP Works

Making an Impact in the work place•Healthier food

– Providing or improving access to healthy foods in cafeteria and in catering, as well as establishing workplace policies and programs that promote and support breastfeeding for working mothers.

•Comprehensive tobacco-free worksite policies – Health plan coverage of tobacco cessation treatment, onsite support for and promotion

of tobacco cessation treatment, and tobacco-free policies.

•Encouraging physical activity – Create active worksites by increasing opportunities for walking and biking and access to

worksite recreation facilities.

SHIP Strategies

Making an Impact in schools•Healthy eating in schools

– Breakfast promotion; healthy lunch and snacks, including classroom celebrations and incentives, fundraising, concessions and vending.

•Farm to School– Connect farmers with schools to provide fresh, local foods. Efforts may include

school gardens to educate children and supplement food offerings.

•Safe Routes to School– Increase opportunities for non-motorized transportation such as walking and

biking to- and from- school.

SHIP Strategies

Making an Impact in schools (continued)•Active school day

– Encourage physical activity through active classrooms, active recess and physical education.

•Tobacco-free post-secondary campuses– Implement a tobacco-free policy to apply to students, staff and

visitors on all post-secondary school grounds, in student housing and at all school sponsored events.

SHIP Strategies

Making an Impact in health care•Partnerships

– Strengthen partnerships between local public health and tribal governments, health care facilities and clinics, health plans/payers and community-based organizations.

•Screening– Enhance methods for screening and documentation of Body Mass Index

(BMI) and tobacco use and exposure.

SHIP Strategies

Making an Impact in health care (continued)•Technical assistance

– Effective practices and approaches for addressing BMI status and tobacco use and exposure.

•Community resources – Offer resources addressing behaviors related to nutrition,

physical activity and tobacco use and exposure.

SHIP Strategies

Making an Impact in communities•Active transportation

– Increase opportunities for non-motorized transportation, such as walking and bicycling.

•Healthy food environment– Improve access to nutritious foods such as fruits and vegetables by increasing

availability and affordability in grocery and corner stores, concession facilities and other food vendors, require calorie or nutrition labeling on menus, new farmers markets and facilitate the development of new community gardens and other small scale food production strategies.

SHIP Strategies

Making an Impact in communities (continued)•Active child care

– Increase healthy eating and physical activity in licensed child care and pre-school settings.

•Smoke-free multi-unit housing– Implement voluntary smoke-free housing policies in multi-unit housing.

•Tobacco-free outdoor spaces– Implement tobacco-free policies for parks, playgrounds, beaches, zoos, fairs, and

other recreational settings.

SHIP Strategies

Results from the First Two YearsA statewide effort forFY 2010-11•All 87 MN counties and 9 of 11 tribal communities•Hundreds of businesses, schools, non-profits, health care organizations and others involved

Tribal Grantees

Leech Lake with partners: Mille Lacs, Bois Forte, Grand Portage, White Earth, Fond du Lac, Red Lake

Upper Sioux

Lower Sioux

Strong school partnerships•Farm to School: 367 schools serving more than 200,000 students •Safe Routes to School:117 schools serving at least 77,000 students •Increased physical activity: 46 schools •Smoking cessation services: 33 post-secondary •Tobacco-free campuses: 31 post-secondary schools •School nutrition staff trained to serve healthy meals: 75 percent of eligible districts

Results from the First Two Years

Healthier employees--savings for employers•Worksite wellness initiatives: 870 work sites reaching over 138,000 employees •Tobacco-free grounds: 21 worksites•Increasing physical activity: 47 employers •Improved food options available to staff: 90 employers

Results from the First Two Years

Results from the First Two YearsSHIP made an impact in communities•More biking and walking: projects in 255 cities •Nutrition: 544 child care sites serving approximately 8564 children•Increased physical activity: 902 child care sites serving over 20,000 children•Tobacco-free parks policies: 6 cities •Smoke free policies: 227 apartment buildings•Farmers markets: up 61 percent

Health Care built strong partnerships•Counseling and referral: Approximately 60 clinics •Support for breastfeeding: 73 health care institutions

Results from the First Two Years

Moving forwardSHIP for 2012-13 •$15 million•70% cut•No longer statewide•18 grantees funded 55 counties and cities and one tribal community

•SHIP www.health.state.mn.us/ship/ •Obesity Plan www.health.state.mn.us/obesity •CDC community guide www.thecommunityguide.org

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