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Sarah LindeSarah Linde--Feucht, M.D.Feucht, M.D.

Captain, US Public Health ServiceCaptain, US Public Health Service

Office of Disease Prevention and Health PromotionOffice of Disease Prevention and Health Promotion

US Department of Health and Human ServicesUS Department of Health and Human Services

National Wellness Summit forNational Wellness Summit for

People with Mental IllnessesPeople with Mental Illnesses

September 17September 17--18, 200718, 2007

Defining Wellness:Defining Wellness:

Key Principles,Key Principles,Elements, and BarriersElements, and Barriers

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Some Thoughts Before We StartSome Thoughts Before We Start

� ³Our health always seems much more

valuable after we lose it.´  ± anonymous

� ³A good objective of leadership is to help

those who are doing poorly to do well and

to help those who are doing well to do even better.´ - anonymous

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Objectives

� Define Wellness

� Identify Key Principles and

Elements of Wellness� Identify Key Barriers to Wellness

� Identify Department of Health and

Human Services initiatives� Do this in 15 minutes!

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What is Wellness?

� The quality or state of being ingood health,

especially as an actively soughtgoal

� No Health without Mental HealthLancet. 2007 Sep 8;370(9590):859-77

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Key Elements and Principles

� Elements

� Mental

� Physical

� Spiritual

� Principles

� Function

� R elationships

� Adaptability

� Coping

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Key Barriers or Challenges

� Lack of awareness

 ± Mental health is essential to wellness

 ± Individual wellness contributes to

community wellness

� Time

 ± Finding balance

� Money ± Budgets for mental versus physical health

 ± Budgets for prevention versus treatment

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What is HHS Doing?

� Recognizes the Need for a Focus on

Prevention

� HHS has a number of initiatives to

promote the development of healthy

children and adults

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Need for Focus on Prevention� Chronic diseases account for 75% of the $1.4 trillion

spent on healthcare

� Chronic diseases account for 2/3 of years lost due topremature death

� 40% of deaths caused by modifiable behaviors

� Greater return on investment from prevention thantreatment

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Factors Contributing to

Early Mortality

Behavior 

40%

Genetics

30%

Medical Care

10%

Environment

20%

McGinnis, et al., Health Affairs; 21(2), 2002

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Health Care CostsHealth Care Costs

Public

Health and

Preventive

Measures

5%

Curative

Medicine

95%

McGinnis, et al., Health Affairs; 21(2), 2002

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HHS Initiatives - HealthierUS� National effort to improve lives, prevent

and reduce cost of disease, and

promote community health and wellness

� Four components: ± Be physically active

 ± Eat a nutritious diet ± Get preventive screenings ± Make healthy choices

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HHS Initiatives ± 

Steps to a HealthierUS� Supports evidence-based community

programs and interventions focused on

reducing the burden of chronic diseasesand related risk behaviors

� Programs work to guide States andcommunities toward improving health

status� www.healthierus.gov/steps

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HHS Initiatives ± Small Step:

Be a Player, Play an Hour a Day� Ad campaign using SHREK  to encourage

kids to get physical activity for an hour a day

� Nutrition information, activities and gamesdesigned for kids

� SmallSteps education program developed in

 partnership with Scholastic� is designed to

help 2nd, 3rd, and 4th grade students buildLanguage Arts and Math skills as they learn

about health and fitness

� www.smallstep.gov

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HHS Initiatives ± 

Guide to Clinical Preventive Services

� R ecommendations on clinical preventive

services including screening tests,

counseling, immunizations, and preventive medications

� Sponsored since 1998 by theAgency for 

Healthcare R esearch and Quality

� http://www.ahrq.gov/clinic

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HHS Initiatives ± 

Guide to Community Preventive Services

� Evidence-based recommendations for 

 programs and policies to promote population health.

� Centers for Disease Control and

Prevention� http://www.thecommunityguide.org/

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HHS Initiatives ± 

Dietary Guidelines� Science-based advice for 

ages 2+ to promote health,prevent chronic disease

� Basis for all Federal nutritionpolicy and programs

� Jointly released byHHS/USDA

� http://www.health.gov/

DietaryGuidelines/

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HHS Initiatives ± 

Physical Activity Guidelines

� Science-based

recommendations on the

latest knowledge aboutactivity and health

� will be issued in late 2008

� http://www.health.gov/

PAguidelines/

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HHS Initiatives -

Prevention Health InformationNational HealthInformation Center

�  A health information referralservice in Spanish and English

� Connects health professionalsand consumers withorganizations to provide healthinformation

� Database contains descriptionsof health-related organizations

� Produces annual directories:

Federal Health InformationCenters and Clearinghouses,National Health Observances,and Toll-free Numbers for Health Information

� http://www.health.gov/nhic/

healthfinder.gov�  An award-winning Federal Web

site for consumers�  A key resource for finding the

best government and nonprofithealth and human servicesinformation on the Internet.

� links to carefully selectedinformation and Web sites fromover 1,500 health-relatedorganizations.

� http://healthfinder.gov/

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HHS Initiatives ± 

Prevention Scholarship� Provides opportunities for 

professional growth anddevelopment in both prevention

policy and medical education[e.g., The Luther TerryFellowship]

� Educates and trains Preventive

Medicine Residents, medicalstudents, emerging leaders, andpublic health interns

� Office of Disease Prevention andHealth Promotion

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Healthy People 2010Healthy People 2010�� A comprehensive set of tenA comprehensive set of ten--yearyear

national health objectivesnational health objectives

�� A framework for public healthA framework for public healthpriorities and actionspriorities and actions

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Healthy PeopleHealthy People --

Management by ObjectiveManagement by Objective

� Identifies individual steps and targets

necessary to achieve common goals� Establishes measurement standards

� Assumes programmatic efforts will be more

effective when specific objectives areestablished and progress is measurable

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Healthy People 2010Healthy People 2010 -- GoalsGoals

�� Increase quality andIncrease quality andyears of healthy lifeyears of healthy life

�� Eliminate healthEliminate healthdisparitiesdisparities

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HP 2010HP 2010 ±  ± Focus AreasFocus Areas� Access to Quality Health

Services� Arthritis, Osteoporosis, and

Chronic Back Conditions

� Cancer

� Chronic Kidney Disease

� Diabetes

� Disability and SecondaryConditions

� Educational and CommunityBased Programs

� Environmental Health

� Family Planning

� Food Safety

� Health Communication

� Heart Disease and Stroke

� HIV

� Immunizations and Infectious

Disease

� Injury and Violence

Prevention� Maternal, Infant, and Child

Health

� Medical Product Safety

� Mental Health and MentalDisorders

� Nutrition and Overweight� Occupational Safety and

Health

� Oral Health

� Physical Fitness and Activity

� Public Health Infrastructure

� Respiratory Diseases� Sexually Transmitted

Diseases

� Substance Abuse

� Tobacco Use

� Vision and Hearing

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HP 2010 FA 18 Mental Health andHP 2010 FA 18 Mental Health and

Mental DisordersMental DisordersGoal: Improve mental health and ensure accessGoal: Improve mental health and ensure accessto appropriate quality mental health servicesto appropriate quality mental health services

Objectives (select examples):Objectives (select examples):

1818--1. Reduce the suicide rate1. Reduce the suicide rate1818--2. Reduce the rate of suicide attempts by2. Reduce the rate of suicide attempts by

adolescentsadolescents

1818--3. Increase the proportion of homeless3. Increase the proportion of homeless

adults with mental health problems whoadults with mental health problems whoreceive mental health servicesreceive mental health services

1818--9. Increase the proportion of adults with9. Increase the proportion of adults withmental disorders who receive treatmentmental disorders who receive treatment

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Healthy People 2010Healthy People 2010 ±  ± 

Leading Health IndicatorsLeading Health Indicators�� Physical activityPhysical activity

�� Overweight andOverweight and

obesityobesity

�� Tobacco useTobacco use

�� Substance abuseSubstance abuse

�� Responsible sexualResponsible sexualbehaviorbehavior

�� Mental healthMental health

�� Injury and violenceInjury and violence

�� EnvironmentalEnvironmental

qualityquality

�� ImmunizationImmunization

�� Access to health careAccess to health care

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Healthy People 2010:Healthy People 2010:

Integration into Public Health AgendaIntegration into Public Health Agenda

Federal: Public Health Service Grant

Announcements must support

Healthy People Objectives

States: virtually all have used HP 2010

to design their own action plans

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Healthy People 2020� 2007, 2008, 2009

 ± Development of framework andobjectives

 ± Continued public input� 2009

 ± Framework released

� 2010

 ± Final 2020 objectives released

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