Non-infectious Chronic DiseasesNon-infectious Chronic Diseases Control & Prevention in Zhabei DistrictControl & Prevention in Zhabei District

Jane XiongZhabei District CDC, Shanghai, China

Aug 29,2006

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Brief Introduction of Myself (1)Brief Introduction of Myself (1)

Jane XiongJane Xiong

Shanghai Zhabei CDCShanghai Zhabei CDC

2002.4- Community Disease Management2002.4- Community Disease Management

1997.7-2002.4 Anti-epidemic 1997.7-2002.4 Anti-epidemic

2004 M.S. , Epidemiology, Fudan University2004 M.S. , Epidemiology, Fudan University

1997 B.M. , Preventive medicine, Fudan University 1997 B.M. , Preventive medicine, Fudan University

(formerly Shanghai Medical University)(formerly Shanghai Medical University)

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Brief Introduction of Myself (2)Brief Introduction of Myself (2)

Researching on policy supporting for disease control and prevention in community

Researching on how the general team in community health service(CHS) provide rapid, economic, sustained service for residents

Designing the model community's chronic diseases’ standardized and comprehensive management

Designing health promotion for all people in community, developing suitable intervention measures

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Brief Introduction of Myself (3)Brief Introduction of Myself (3)

Surveilling and managing infectious disease in community

Responsible for AIDS defending program, attending program planning, implementing and evaluating

Constructing HIV primary screening lab of Zhabei District

Drafting " Medium and long-term plans of AIDS defending in Zhabei district (2001-2015) "

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Brief Introduction of Zhabei DistrictBrief Introduction of Zhabei District

Northern of central ShanghaiNorthern of central Shanghai

29.18 sq. Km.29.18 sq. Km.

8 communities8 communities

800,000 residents 800,000 residents

150,000 floating people150,000 floating people

≥ ≥ 60 Ages is 19.7%60 Ages is 19.7%

Life expectancy 80.72

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The Order of Death Causes in Zhabei The Order of Death Causes in Zhabei (2000-2005)(2000-2005)

ORDER

2000 2001 2002 2003 2004 2005

CAUSE ％ CAUSE ％ CAUSE ％ CAUSE ％ CAUSE ％ CAUSE ％

1 　 38.97 　 36.57 　 36.49 　 39.45 　 39.10 　 40.33

2 　 28.47 　 29.39 　 29.12 　 28.13 　 28.84 　 28.53

3 　 9.54 　 11.16 　 11.81 　 10.58 　 9.93 　 10.79

4 　 5.33 　 5.13 　 5.19 　 5.13 　 5.19 　 4.64

5 　 3.75 　 4.31 　 4.08 　 4.41 　 4.16 　 3.38

6 　 2.20 　 2.37 　 2.58 　 2.24 　 2.90 　 2.63

7 　 2.20 　 1.94 　 2.14 　 1.94 　 1.40 　 1.55

8 　 2.02 　 1.57 　 1.09 　 0.70 　 1.31 　 1.06

9 　 0.97 　 0.76 　 0.98 　 1.08 　 0.96 　 0.85

10 　 0.60 　 0.71 　 0.64 　 0.77 　 0.77 　 0.82

　　　　　

endocrinopathy

poisonings and injuries

respiratory system

cancer

circulatory system

　　　　　

neuropathy

urogenital disease

infectious disease and verminosis

digestive system

lunacy

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The Death Rate of Leading Diseases in Zhabei The Death Rate of Leading Diseases in Zhabei (1955-2005)(1955-2005)

0

50

100

150

200

250

300

350

ci rcul atorysystem tumor

respi ratorysystem poi soni ngs andi nj ur i es endocr i nopathy

1960 70 80 90 2000 YEAR

DEATH RATE(1/100,000)

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The Incidence Rate of Main Cancers in Zhabei The Incidence Rate of Main Cancers in Zhabei

(2003)(2003)

ORDER

MALE　 FEMALE

1 lung cancer 87.23 breast cancer 59.41

2stomach

cancer48.37 lung cancer 39.42

3 liver cancer 33.27stomach

cancer28.56

4 colon cancer 26.84 colon cancer 28.28

5 rectum cancer 21.53 rectum cancer 14.85

1/100,000

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Network of Chronic Diseases Control & Prevention

Shanghai CDC

Zhabei CDC

Planning and organizingInstruction and training

Quality controlStatistic analysis

& evaluation

System of CHS

Chronic Diseases Control & Prevention

in Communities

Hospitals level 2 or 3

DistrictHealth Bureau

Chronic Diseases Registering & Reporting

Other DepartmentsConcerned

Cooperation

DistrictGovernment

Professional guidance

Administration Management

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Center for Community Health Service (CHS)

Workstation of CHS

System of CHS in Zhabei DistrictSystem of CHS in Zhabei District

CommunityGovernment

Other departments

NGOs

Cooperation

Cooperation

Prevention & ControlHealth CarePrimary Medical TreatmentHandicapped HealingHealth PromotionFamily Planning Guiding

director

¥8→30per capita

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Work Station of CHS in Zhabei DistrictWork Station of CHS in Zhabei District

1 Offer health service to 10,000-20,000

CHS general team

General practitioners

Public healthpractitioner

Community nurses

Wal

k 15

-20

Min

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The Strong Points of General Teams The Strong Points of General Teams Convenient shorten the service radius

Advantageous to organize suitable, effective health promotion giving chronic disease patients continuous service

Economic the elementary medicine has kept in community, and the

expenditure is lower The system of CHS has provided a good

platform for community chronic disease prevention, control and management

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Our Works of Chronic Diseases Control & Prevention

What to do?

How to do? Information Garthering and Patients Finding

Health promotion

Patient Management

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Information Gathering and Patient RegisteringInformation Gathering and Patient Registering

Risk factors

High risk people

Patients

Community diagnosis

health records

Surveillance

Intervention strategy

Following-up

Epidemiology

Free medical

examination

Other ways

Clinic Screening

System of CHSReporting

Quality controlAnalysis

Evaluation

Zhabei CDC

Feedback

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Quality controlAnalysis

Evaluation

Cancer Finding and Registering

Hospitals level 2 or 3 in zhabei

Inputing information & reporting to CDC

Zhabei CDC

Prevention&health care section

In-patient DepartmentOut-patient DepartmentEmergency Department

Filling in Cancer ReportCards of New Patients

Information DepartmentAssistant Department

(CT/Pathology/…)Other Department

Cooperation

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Information Interchange with other CDC

Health Services for Cancer Patients in Communities

Zhabei CDC CDC of Other 18 Districts

Shanghai CDC

Interchange the Cancer Report Cards by Patients’ Address

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Public Health InterventionPublic Health Intervention

Policy intervention

Education intervention

Improve environmentsupporting ability

Health screening Biologic

prevention

Detect earlierBiologic Barrier

Idea changed

Health belief & behavior

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Intervention (1)Intervention (1)

The theme of Cancer control and prevention Week 1999~2005

2006 Proper diet, cancer prevention 2005 Health life, cancer prevention 2004 Delivering cancer prevention knowledge to communities 2003 Detect earlier, diagnose earlier and treat earlier 2002 Health life says “no” to cancer 2001 Preventing cancer scientifically and treating standardly 2000 Preventing cancer correctly 1999 Cancer can be prevented and cured

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Intervention(2)Intervention(2)

CounselingCounseling

LectureLecturePosterPoster

PamphletPamphlet

Cancer Week(4.15-21) Activity

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Intervention(3)Intervention(3)

Diabetes boardDiabetes board

““I Know My Own blood Pressure”I Know My Own blood Pressure”

Community Sports MeetingCommunity Sports Meeting

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Intervention(4)Intervention(4)

Measuring blood pressure for every patient aged≥35 when he/she goes to hospital for the first time every year

Strictly implementing the policy made by shanghai health bureau

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Intervention(5)Intervention(5)

Organizing a professional union Professional training Keeping from physical & mental

pressure Instructing family members

offering help to patients

The 1st Cancer Helping Center in Shanghai

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Intervention(6)Intervention(6)

The Diabetic Club

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Patient ManagementPatient Management

General teams of CHS

Different level managementfrom diagnosis to death

Chronic disease management system

Quality controlProfessional guiding

Statistic analysis& evaluation

feedback

Genera

l m

anagem

ent

Fam

ily sickb

ed

Hosp

ice

Hospital Level 2 or 3

deteriorating mending

Zhabei CDC

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My goal in EHIBMy goal in EHIB

To know the model about community disease control &

prevention in U.S.A

To make some progress on community health

promotion’s planning, practicing and evaluation

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`Thank you!Thank you!