Creating the Future of CDC
st
for the 21 Century
Dixie Snider, Jr., MD, MPH
Deputy Director of Public Health Science
Centers for Disease Control and Prevention
AcademyHealth CDC Research Agenda Session
San Diego, CA
June 7, 2004
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
CDC’s Futures Initiative
Heath Protection for the 21st Century
Input
Ideas
Implementation
•
•
•
•
•
Outside-in
Interactive
Driven by data
Focused on customers
Strategic direction first,
then structure & processes
Impact
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Ideas…New Strategies!
• Achieve health impact and reduce health
disparities for customers (people whose health we
protect)
– alignment (strategy, goals, & action)
– performance measurement and improvement
– integration across organizational units
– marketing
• Lead the Nation’s public health system
• Expand public health research as the foundation
for all our work
• Expand global health impact
• Support the world’s best workforce and maximize
our effectiveness & accountability
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
CDC’s Futures Initiative
Why Change?
Emerging Public Health Threats
Globalization
Human
Genome
Aging Society
Changing
Demographics
Rising Health
Care Costs
Aging Workforce
Public Health
Infrastructure
Information Technology
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Increase in Health Expenditures
• Health expenditures as percent of GDP
projected to increase from 14.9% (2002)
to 18.4% (2013)
• Per capita health spending in the US is
highest in the world, yet we still rank
behind 47 countries in life expectancy
Source: The New York Times Magazine
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Health Status
• U.S. life expectancy is 2.5 years shorter
than in Western Europe and Canada, and
more than 3 years shorter than in Japan
• Obesity and obesity-related health risks
cost the U.S. an estimated $125B per
year
• The U.S. ranks 28th in the world in infant
mortality
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
CDC as a source of health information
CDC Has a Perception of High
Trust/ Reliability . . .
60%
. . . But Few People Turn to CDC
for Health Information
60%
56%
% of respondents saying “Yes”
54%
50%
50%
43%
40%
40%
30%
30%
20%
20%
10%
10%
0%
“CDC is one of the
first places I would
turn to for reliable
health information”
“One of the health
information
sources I trust the
most is the CDC”
0%
6%
“I do not remember
hearing about health
or disease info that
came from the CDC in
the past year”
“I tried to get info
about health or
disease from the CDC
in the past year”
Source: Porter Novelli
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Where are people looking?
% of Internet Users Who Have Searched for Information
from:
70%
64%
60%
50%
40%
31%
30%
24%
23%
21%
20%
15%
13%
10%
10%
5%
0%
Health
Portals
Govt.
Agencies
Source: Harris Poll (2003)
NonProfit
Orgs.
Doctors’
Offices/
Hospital
Sites/
Health
Centers
Pharmaceutical
Websites
Scientific
Retrieval
Systems
Online
Universities
Newsletters
Chat
Rooms
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
NIH vs CDC Budget
30
NIH
25
$Billion
20
15
CDC
10
5
0
1960
Source: CDC, NIH
1970
1980
1990
2000
2004
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Strategic Imperatives
• Health Impact
• Customers
• Public health system
• Public health research
• Global health
• Efficiency, effectiveness & accountability
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Health Protection Goals
• Health Promotion & Prevention of Disease, Injury,
and Disability:
All people will achieve their optimal lifespan with the
best possible quality of health in every stage of life.
• Preparedness:
People in all communities will be protected from
infectious, environmental, and terrorist threats.
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Preparedness Goals
People will benefit from state-of-the art detection, investigation, and
containment of infectious, terrorism, and environmental threats.
The government public health, health care delivery, business, educational
sectors and other sectors of the health system will be integrated to
protect people from infectious, environmental, and terrorist threats.
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Health promotion and prevention of disease,
injury, and disability by life-stage
Infant
Child
Teen
Adult
Senior
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Life-stage Goals [Draft]
Infant: By 2015, the United States is one of five countries with the
highest rates of infant survival (Baseline 28th, 1999)
Children: By 2015, mortality is reduced 20%, saving an additional 800
lives per year (NCHS Baseline).
Adolescents: By 2015, at least 95% of adolescents practice
behaviors which protect them from illness and injury now and in the
future. (NHIS baseline)
Adults: By 2015, at least 90% of adults have a healthy weight
(NHANES baseline)
Seniors: By 2015, average lifespan of older Americans is increased
by 2 years
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Organizational Design Principles
• Strategy and goals derive from population
health assessments (“customers’ health”)
to achieve health impact
• Strategy and goals drive agency’s priorities
and allocations
• Emphasis on research and innovation
• Health protection “marketing”
• Consolidation of business & other crosscutting services
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
CDC’s History
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Department of Health and Human Services
Centers for Disease Control and Prevention (CDC)
CDC Washington Office
Office of the Chief
Operating Officer
Office of Global Health
Office of Women’s Health
Office of Program Planning
and Evaluation
Office of Health and Safety
Office of the Director
Office of Executive Secretariat
Office of Equal Employment
Opportunity
Office of Minority Health
Office of Communication
Office of Genomics and
Disease Prevention
Office of Science Policy and
Technology Transfer
National Center
on Birth Defects &
Developmental
Disabilities
National Center for
Chronic Disease
Prevention &
Health Promotion
National Center for
Environmental
Health
Epidemiology
Program
Office
National Center
for Health
Statistics
National Center
for Infectious
Diseases
National
Immunizations
Program
National Center
for Injury
Prevention and
Control
National Center
for HIV, STD, and
TB Prevention
National Institute
for Occupational
Safety and Health
Public Health
Practice
Program Office
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Customers
People whose health we want to improve
Alliances
Public Health
Systems
Channels
Business
Education
Health Care
Delivery
Federal
Agencies
Coordinating Center for Health Information and Services
National
Center for Health
Marketing
Coordinating Center
for Infectious Diseases
NCID, NCHSTP, NIP
Coordinating
Center for
Health Promotion
National Center
for
Public Health
Informatics
Coordinating
Center for EIO
NCCDPHP, NCBDDD,
Genomics
Management Council
Strategy and
Innovation
National Center for
Health Statistics
Office
of Global Health
NCEH/ATSDR
NCIPC, NIOSH
Office for Terrorism
Preparedness &
Emergency Response
Executive Board
Executive Leadership Team
Chief of
Science
Chief of Public
Health Improvement
Office of the
Chief of Staff
Director
Human Capital
Management
Office of the Chief
Operating Officer
CDC Washington
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Changing CDC
Strategic
imperatives
Internal and
External
Communications
Health Impact
Goals
Recognition
& Rewards
Business
Process
Redesign
Organization
Design
Leader
Accountability
Employee
Education
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
CDC’s Futures Initiative
FROM
TO
• No overall measure of success
• Lack of customer
segmentation
• Clearly articulated and
measured
• Segmented customer
approach
• Limited partner capacity
(state and local health
depts)
• Strong partner network
• Revitalized state & local
health departments
• Media, business, health
care delivery, schools,
communities
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
CDC’s Futures Initiative
FROM
TO
• Primary focus on Infectious
Disease and Preparedness
• Primary focus on Infectious
Disease, Preparedness and
Prevention
• Disease specific, fragmented
approach to global
• Comprehensive integrated
global approach
• Inefficient work processes
• Efficient work processes
• Silos/organization
• Integrated organization
(maintaining specialization)
• Focus on process
• Focus on impact
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
CDC’s Futures Initiative
FROM
TO
• Minimal applied research
• Strong applied research
• Fragmented approach to
customers/partners
• Integrated approach to
customers/partners
• Difficult to do business with
• Easy to do business with
(standard of good gov’t)
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
Futures Initiative: Improving Health
Impact
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM