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State Health Improvement Process (SHIP)

Chronic Disease Tools
1. Obesity is driving reduced life expectancy and poor health in Maryland.  Expand opportunities for Active Living in your communities. CDC’s Community Guide has recommendations for policies and programs to increase active living .
2. There are also resources for adolescents, early childhood, and people with disabilities who are more likely to be overweight than those without disabilities.
3. Maryland's Comprehensive Cancer Control Plan is a resource for all Marylanders on cancer control topics and a method to encourage communities to work together to control cancer by: reducing risk, early detection, improving treatment, and enhancing survivorship. Many cancers can be successfully treated if caught early. Implement recommended ways to promote cancer screening. Take the Health Check, a quick and easy, interactive questionnaire, and instantly get a personalized health action plan. Use these interactive tools, quizzes, and videos to learn more about ways to lower your risk for cancer or find it early.
4. Make sure every school in your community implements school wellness policies and programs to ensure that children and youth get the physical activity and nutrition they need. This U.S. Department of Agriculture (USDA) and CDC sponsored clearinghouse can assist school districts with developing local wellness policies for physical activity and nutrition, and provides tools and resources for implementation, and un-reviewed sample policies.
5. Expand access to smoking cessation resources.  Check out the Maryland Resource Center for Quitting Use and Initiation of Tobacco and CDC recommendations for how to reduce smoking in your community.
6. Legal approaches to tobacco control can be very effective.  The University of Maryland Legal Resource Center for Tobacco Regulation, Litigation & Advocacy is dedicated to providing legal support to communities, community groups, employers, local governments, and State legislators and agencies interested in reducing the negative health consequences of tobacco use.

Also - The Public Health Law Network provides information and technical assistance on Tobacco Control.
7. Workplace Wellness Programs are helping to control employee health risks and health care costs, reduce absenteeism, reduce injuries, and improve quality of life. Look at CDC’s Guidelines to make your worksite health supporting and consider joining Healthiest Maryland Businesses.
8. Excessive alcohol use is a leading cause of preventable death among all age groups. Implement policies that facilitate the provision of Screening, Behavioral Intervention, and Referral to Treatment (SBIRT) or offer alcohol or substance abuse counseling in clinical care or employee assistance programs.
9. Alcohol screening and brief intervention in trauma centers has been shown to decrease alcohol-related trauma recidivism by up to 50%. Information is available to develop programs for hospital-based implementation of alcohol screening and brief intervention. These programs could also be utilized in other healthcare settings.
10. Depression is under-diagnosed and treated in Maryland and the cause of many bad health outcomes for the depressed persons and their families. See the Community Guide for ways you can expand access to depression screening and treatment and the National Prevention and Health Promotion Strategy p. 48-50 for proven approaches to expanding access to mental health services. 
11. Alzheimer's causes a number of changes in the brain and body that may affect safety, including changes in judgment, abstract thinking, sense of time/place and behavior. Taking measures to ensure safety at all times can help prevent injuries, and it can help people with dementia feel relaxed and less overwhelmed. Use the tips and resources in this link to assess safety needs.
12. Youth Tobacco Use is usually initiated during adolescence. More than 80% of adult smokers begin smoking before 18 years of age. Implement mass-media campaigns, school-based tobacco-use prevention policies and programs, community interventions, and higher costs for tobacco products through excise taxes. See this link for educational resources and materials.
13. Numerous factors contribute to the rate of heart disease deaths across the state of Maryland. In order to improve health outcomes and prevent deaths from heart disease, the American Heart Association provides resources to encompass each healthy behavior factor that can lead to heart disease. Review the nutrition center recommendations, physical activity guidelines, weight management options, stress management tools, and smoking cessation programs available in the Get Healthy section of the website. Improve overall health to prevent and treat heart and other devastating chronic diseases.

Faith-based tools have proven to be effective in decreasing prevalence and treating heart disease and other related symptoms. The National Heart Lung and Blood Institute provides a faith-based activities toolkit containing ideas and resources to conduct activities to promote The Heart Truth. Background information about the campaign along with promotional and educational tools and information for speakers are available here.
14. Emergency department visits for diabetes problems signal that this chronic disease is not being well managed. Makes sure that providers and patients alike are aware of and practice evidence based guidelines to prevent and control diabetes. 
15. The Pulmonary Hypertension Association provides resources about living with hypertension and how to manage daily living through exercise, diet and nutrition and by utilizing patient -to-patient support services. These tools can be found here. Information is available for patients of all ages, caregivers, medical professionals, and community members.

Low Salt Diets are key to improving health and fighting risk factors of hypertension. This change in diet can be achieved by using the DASH method: “Dietary Approaches to Stop Hypertension”. An excellent resource for developing an eating plan can be found by visiting the National Heart Lung and Blood Institute’s website.
16. Educate Before You Medicate is a resource that focuses on education in prescription drug use. This resource offers guides for providers, parents, and educators to talk about drug abuse. Tools for consumers to participate in healthy prescription drug practices are also available here.

The Maryland Poison Center offers poisoning triage, treatment, education, and prevention services to all Marylanders. Education is one of the many determinants of drug-induced deaths and is available to the public and health professionals by visiting this website. 24 hour emergency assistance can also be found by contacting their toll free hotline at 1-800-222-1222.
17. Exercise is Medicine is a solution to one of the greatest public health problems of the 21st century. This program is focused on encouraging primary care physicians and other health care providers to include exercise when designing treatment plans for patients. The belief is that exercise and physical activity are integral to the prevention and treatment of chronic disease and should be assessed as a regular part of traditional medical care. Visit Exercise is Medicine online to support the initiative, receive program updates, and download an Action and Promotion Guide. Tips, tools, and ideas for planning local events or activities are also available through this program’s website.

Physical inactivity is a fast-growing public health problem and contributes to a variety of chronic conditions and devastating health complications including obesity, heart disease, diabetes, hypertension, cancer, depression, anxiety, arthritis, and osteoporosis. Tackle any of these issues by Getting Fit
(Functionally Integrated Training”). The custom designed program along with desire, determination, and motivation will provide tools to shed unwanted weight and battle chronic health concerns. Click here to get more information about this program and the potential health benefits in can provide.