December 2, 2013
The people of North Carolina are more likely to live in poverty, die due to preventable conditions and have higher rates of obesity and tobacco use than people in most other states. Therefore, it is no surprise that when comparing health indicators among the 50 states, our state historically has ranked in the bottom third.
In this context, some of the major North Carolina health funders and the N.C. Division of Public Health (NC DPH) asked the North Carolina Institute of Medicine (NCIOM ) to create a task force to develop a Prevention Action Plan for the state. The NCIOM was created by the N.C. General Assembly in 1983 to study important issues facing the state and develop workable solutions to those problems.
The task force included state and local policy makers, public health officials, health care professionals, and community and business leaders. In 2009, the group identified major preventable causes of death and disability in the state and evidence-informed strategies to address those risk factors. Two years later, NCIOM led the state’s efforts to develop the Healthy NC 2020 objectives. We involved more than 150 people from across the state to identify 40 key indicators of population health, which could be measured over time to assess the state’s progress in improving population health. In 2012, we worked with the NC DPH and other partners to develop a plan to implement evidence-based strategies to improve population health at the local level.
North Carolina has used the Prevention Action Plan and the Healthy NC 2020 report to compete successfully for federal funding to implement comprehensive prevention strategies and enhance the state’s data and tracking systems. Already, progress has been made on half of the 40 objectives.
Significant challenges remain. Funding for public health is limited. Historically, only 3 percent of national health care spending has focused on public health and prevention. It is therefore critical to focus our limited resources into evidence-based efforts that have the greatest likelihood of success.
At the same time, we must expand community- and state-level partnerships — such as the successful collaboration between North Carolina hospitals and local health departments — to improve population health. We can continue to improve the health of all North Carolinians, but only if all partners — government, health, insurance, academic, philanthropy, business and community leaders — work together to implement multifaceted strategies to address the major health risks affecting the people of our state.
—Pam Silberman, DrPH
Dr. Pam Silberman is president and chief executive officer of the N.C. Institute of Medicine and clinical professor of health policy and management at the Gillings School.
Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit sph.unc.edu/cph.