Health of the State Kelli T. Wells, MD Statewide Medical Director - PowerPoint PPT Presentation

Health of the State Kelli T. Wells, MD Statewide Medical Director Florida Department of Health

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA FLORIDA • Estimated population 21,000,000 • 116 million tourists in 2017 • 12 international airports • 14 deep water ports • More than 2.8 million students enrolled in school • More than 5 million seniors • 6 million campers annually • 1000 people move to Florida daily 2

~ ~ LIFE COURSE Concept Broad sodaL economic:, culnnl &erwronmental conditions. Global. natlonaL state & local pollcles. HEALTH EQUITY &ACCESS TO HEALTH SERVICES. LIYII-. &working conditions. Social, famllv & community netlNOrk. • zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA R • ..ii, ill 3

State Health Improvement Plan (SHIP) 2017-2021 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Florida State Health • Set state health priorities Improvement Plan • Address priorities from a comprehensive, multi-agency system perspective • Improve efficiency, effectiveness and performance of the public health system 4

SHIP Steering Committee ■ Agency for Health Care Administration ■ Florida Department of Environmental Protection ■ Feeding Florida ■ Florida Department of Health ■ Florida American Indian ■ Florida Department of Health Advisory Council Juvenile Justice ■ Florida Association of ■ Florida Department of Transportation Community Health Centers ■ Florida Institute for ■ Florida Association Health Innovation of Health Planning Agencies, Inc. ■ Florida State University ■ Florida Chamber Foundation ■ Office of Attorney General ■ Florida Department of Agriculture and Consumer ■ United Way of Florida Services ■ University of Florida ■ Florida Department of ■ VISIT Florida Children and Families ■ Florida Department of Economic Opportunity ■ Florida Department of Education 5 5

SHIP Priority Areas • Health Equity • Maternal and Child Health • Immunizations • Injury, Safety and Violence • Healthy Weight, Nutrition and Physical Activity • Behavioral Health • STDs and Other Infectious Diseases • Chronic Diseases and Conditions 6

Immunizations: Goals GOALS: 1. Increase access to immunizations for infants and pregnant women 2. Increase access to immunizations for vaccine preventable disease in children and teens 7 State Health Improvement Plan

Immunizations: Strategies Increase Access for Infants and Pregnant Women 1. Increase the rate of infants who receive Hepatitis B vaccine within 3 days of birth 2. Increase the rate of pregnant women who receive the annual seasonal influenza vaccine 8 State Health Improvement Plan

Immunizations: Strategies Increase Access for Children and Teens 1. Increase the percentage of 2 year olds who are fully immunized for childhood vaccine preventable disease 2. Increase teen male and female rates of completion of first dose of HPV vaccine 9 State Health Improvement Plan

Vaccine Preventable Disease zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA • Resurgence of diseases previously controlled • Preventable morbidity and mortality • Disparities • Multifocal strategies and interventions required 10

~ ~ Getting to Goal: State Data Vaccine-Preventab le Disease Surveill ance __ 11 . • zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA A. p, il lOll ,. __ Summary . .....,__,i,,g_...,... _________ _ _..,. ______ • --•U•-- ........ . -- .......... -------....--- ______ __ ____________ ,._ • rt-..-2-...._,... • .:r.. ........ -- ._.._......_.,_.,.._ .... ~•---•-• ---J •....--- .... u , ,.a-..., _ _.,.........., .. ~., _ _..._ ... .,,.., .... • ---- · ~---~------....., .,:::.. ..... _ ~--·--·-- - 1111 ....... . ,... ___ . ---•-••--U--- ... n_..-~_,.,.._..,...,....,._.,,,...r-. __ __,_ • ::=.....,_.....,....,....._. ___ ___ ... _"""'_ ,,..._ ___ .. _~_._....,_ ... ____ 1111111111 11 ..... _ - . llllil_,__...._.,~-- .. -- ..... ---"""- ..... .. . .I •. ....,_ ... - ...... ··-- ........ c-._ .. ____ ..._ . ""-""-J--1 • ~_,.,..._,........,._ .. u.,._..._ M-.i--•-""--•11-----.....- ............. ).~lllnt,lll,9ton ' 11.,...,,...1.»1a _ ... -~_,11£1.....,.....,..,,...,u.:t1'1-- ..._ _____ _ :ino:~ _..., ________ ..,__.......,._DA11Uo11t..a.••-•--t.1!01J ..,.,.. __ ........ _....,.....,__IJ'o_......,..._.....,.._01'"1111 -~-------.--- _____ 11

eek 17 : . Apriill . 22-28, 2018 Summary Weekly State lnfl ll e111 za Adivity Smte in 1illlle n za a111 • i111 l!JBnm - tile· ln es s nu~ activit:y;:: lll actNity oon 1tii111ue:d w decrease and 1 •· In wee . 11 ., influenza an 1rema in ed at Dllllfllll lil 1l eve ls mr this m 1 ne @f itiihe se.BS.llll • Dam indica te in C ma acr"wi ty ~eaked .· week S il en • g E=e l:Jlfulilry . ~ 20 : 1. dlllri F o:r mon- e i:nfo:nm:a'tiio i ed ov,eral I. 'it is 'i •· Wlri i e activ ili'!t' tlas d'. pa,ge 2 • to drrwi liate at low l eve l s. 1t r owighobllt · 1tne s . Br - o tis in lori da . • l'#Jo ne . • ifluenza-8s.so1Jiated pediatric. deaths. ·. ·ere oo:nfii:mm ed j'n ee k 7. Bgh1t Pre om"111ately c·rcu Eati ng Stra"111 i ffl · rurassociated p i atr - de . · i!ii have been am ed so far i tim e 2017 -18 'inffl ma s ea son. • lileat'hs due · t0 pne m : • a a d · ifluenza .ere b~ experted levels • Th re e o!llltbreaks o · influ en za or I were r ie port ed nn w e.e 17: an t hre e Yl' ai.. Thus far. 4 96 o .· ea!G uf i - fl em:a and I ! labo ratory confiirrnati n of 'i -· For more i nform ai · 11 see p a_ge 6 • ha - ~ been reported since · e Sltart of e 201.1-18 . season. • Th e Ro · c1a D epart m ent uf ea ~h i sm · :cting e m1lm aooed suw.e Ila ce a im ens iv e- 'it r, rc u) pati:e ts d'.ged ~65ye ar s nfluenza and LI Outb rea ks laboramry-co rnied 'i ft e11La. care - Reported as of 4/'2Bll.018 17 ., fu . ca~ . were 1 rtile.d ; 370 cases hffil e b.B - repmted sim:ie "' In · r, February 1 201.8. n v aa:: mn if · 0111 sta1tus 1, e maj mity ( ~~ 1 ere "' Off 1t 235 cases Yi' 1JJ11 1 1 w cd at ed i m1 · ·· awials. . Of th e 366 ra s.es · · ei dical lm i mxi e. s i3JV . · iia . e ., · ~ortty ( 89%:) tili a -cl . ma. · lli g me · ca con diwio. ns.

~ ~ Influenza and Influenza-like Illness (ILI) Outbreaks 3 new outbreaks reported last week c::::J Week 17 Outbreaks (3) 5+ Outbreaks zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 0 Outbreaks 1-2 Outbreaks 3-4 Outbreaks 13

~ ~ ~ County Influenza Activity Level Week ending April 28, 2018 Activity {N} No Activity (16) Unknown (0) zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Mild Activity (46) Moderate Activity (5) Elevated Activity (0) 14

County Influenza Activity Trend Week ending April 28, 2018 Trend {N) .______.I Unknown (0) zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA -- Decreasing (38) __ I Plateau (26) I ncreasing (3) 15

- zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Emergency Department and Urgent Care Center Visits for ILI by Children ≤18 Years Old Data as of week 17 (ending April 28, 2018) 25 20 Percent of Visits 15 10 5 0 40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 Week 2014-15 2015-16 2016-17 2017-18 16

- zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Emergency Department and Urgent Care Center Visits for ILI by Pregnant Women Data as of week 17, 2018 (ending April 28, 2018) 120 100 Number of Visits 80 60 40 20 0 40 42 44 46 48 50 52 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 Week 2014 -15 2015- 16 2016-17 2017-18 17

Influenza-Associated Pediatric Deaths by Vaccination Status Week ending April 28, 2018 15 • zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 10 Count • Unvaccinated Vaccinated • Vaccination status unknown 5 0 2013-14 2014-15 2015-16 2016-17 2017-18 Influenza Season 18

Vaccine Preventab e Disease s • a ce . - Table of Conten~ •••••••••••• •••• •• • .. +........ .. ... 2 _rna .- 1 aSi n n s,· ·m n s · -, Jiffll s _ mm _ ry ............ ....... 11 of pe I ,l:j§ Mo .r Hlhly Activity Tr ends May 2017~A: pr. 2018 f,o,r nu _ • 1 • I • I 1 Va - - la I I (!1 1 00 'j!OUl'l , 0 1 mn ' . di MOf umps le,v, _ Is s , __ n d s comlSt _ nt and Apr P0'fl

Religious Exemptions 3.1%-5.9% zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA RE prevalence in children age 4-18 D 0.3%-1% • 1%-2% • 2%-3.1% • 20

Pertussis Cases April 2018 rate per 100,000 population, January-March D O.O CI County w i th ;?:1 case in April zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA D 0. 1- 0.2 • o.3 - o.s • o.9 - 1.7 21

Pertussis Vaccination History for Cases 30 25 Number of Cases 20 15 10 5 0 0-1 mo. 2-3 mo. 4-5 mo. 6-17 mo. 18 mo.-5 yrs. 6-11 yrs. 12-18 yrs. 19+ yrs. Age Group - - Too young for Under vaccinated Never vaccinated D vaccination - UTD on vaccination Unknown vaccination status