11/12/2014

Lai Sze Tso 1 and Guowei Yu 2 1. Carman and Ann Adams Department of Pediatrics Prevention Research Center, Wayne State University School of Medicine, Detroit, Michigan, 48201, USA ([email protected])

2. Northwest University for Nationalities, West of China Institute of Environmental Health, 1 Xibei Xincun, ChengGuan District, Lanzhou, Gansu, 730030, China ([email protected] ) APHA 2014: Session 4024. Health in All Policies (HiAP) Public Health Approaches Tuesday Nov 18: 8:30 am -10:30 am Image from http://www.bridgetochina.org.hk/our-work/bridge-projects/gansu-province/sancha-village/

Presenter Disclosure

Lai Sze Tso, Phd

The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 month:

“No relationships to disclose”

American Public Health Association Annual Meeting, 2014.

Maiji in China

Image from http://www.tre ehugger.com/ clean- technology/chi nas-green- walls-losing- the-battle- against- encroaching- deserts.html

Tso and Yu, P-2 APHA 2014

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Minqin County Maiji in Gansu

Jingtai District, Baiyun County Images from http://www.colorsmagazine.com/stories/magazine/84/story/living-off-the-sand

Image from http://www.panoramio.com/photo_explorer#view=photo&position=28&w ith_photo_id=62252872&order=date_desc&user=2828767

Image from http://www.panoramio.com/photo_explorer#view=photo&position=29&with_photo_id=62252866&order=date_desc&user=2828767

Maiji District, Tianshui County Tso and Yu, P-3 http://w ww.china.org.cn/travel/cultural_relics/2012-05/30/content_25864444_2.htm Image from http://mapcarta.com/25631408 [ 连霍高速天水段©云横秦岭 Copyright: 云横秦岭] http://www.bridgetochina.org.hk/our-work/bridge-projects/gansu-province/sancha-village/ APHA 2014

Health in All Policies: Gansu Case Study

• Goal 1: monitor health & well-being in rural communities • Goal 2: identify target diseases & causes of death (policy changes) • Comprehensive Grade Index, (GI) • Combined weighted data from 3 prevalent indices: (1) Infectious Diseases Monitoring System (2) Causes of Death Monitoring System (3) New-Rural Cooperative Medical System • Assessed GI against each of single evaluation index Tso and Yu, P-4 APHA 2014

Multiple Evaluations of Indices (1)

Single-measure evaluations: • Incidence of Infection [A], Mortality Rate [B], & Hospital Admission Rate [C]

Complex-measure evaluations: • Life expectancy [D] • Index of life lost [E] • Potential years of life lost (YPLL) [F] • Cause eliminated life expectancy (CELE) [G] • Potential value years of life lost (VYPLL) [H] • Potential family years of life lost (FYPLL) [ I ] • Per capital medical expenses [ J ] Tso and Yu, P-5 APHA 2014

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Multiple Evaluations of Indices (2)

基于疾病与健康监测系统的农村居民健康状况评价指标体系 目标层

Evaluating Rural Residents’ Health using Disease Monitoring Target & the New-Rural Cooperative Medical System Assessments

准则层 健康状况 健康结局 Normal Single Measure Complex Measure Assessment Health Conditions Health Outcomes of Factors

发病 死亡 住院 平均 早死 潜在 去死 潜在 潜在 人均 要素层 率 率 率 期望 指数 寿命 因期 价值 家庭 医疗 寿命 损失 望寿 损失 损失 费用 年 命 年 年 Key [A] [B] [C] Assessments [D] [E] [F] [G] [H] [ I ] [ J ] of Factors

Tso and Yu, P-6 APHA 2014

Defining Diseases & Causes of Death

• Infectious diseases: viral hepatitis, tuberculosis, influenza, bacterial dysentery, and infectious diarrhea • Mortality index: cerebrovascular disease, ischemic heart disease, high blood pressure, emphysema, and stomach cancer • YPLL index: traffic accident, cerebrovascular disease, ischemic heart disease, suicide, and high blood pressure • CELE index: cerebrovascular disease, ischemic heart disease, high blood pressure, traffic accident, and stomach cancer • Index of life lost: birth asphyxia, premature birth, hemorrhagic disease of newborn, congenital pneumonia, and neonatal respiratory distress • FYPLL: traffic accident, suicide, cerebrovascular disease, ischemic heart disease, and high blood pressure Tso and Yu, P-7 APHA 2014

Meeting Goals -- Targets for Policy:

To Improve community well-being, policies should reduce -- •Traffic accidents •Cerebral vascular disease •Ischemic heart disease •Hypertension •Stomach cancer

Tso and Yu, P-8 APHA 2014

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