Health : Food companies and urgent interventions

 We asked food companies to meet these targets this their sales weighted averages. so far 28 companies represented both package food companies and restaurant companies have committed to meeting at leas tone of our sodium reduction targets.

This includes food giant, such as Unilever, Kraft, camp-bell's,and major restaurant chains including subway and Starbucks. now i'll turn to our clinical initiative. our main approach is what we call the primary care information project. the goal of this project is to improve the quality of care through health information technology. this project we have developed with a vendor, prevention oriented electronic health record, and employed it to more than 3,000 providers serving 3 million patients. key prevention systems of this health record include clinical decision support system which gives alert to providers about the services needed that are actionable.

That is they lead a specific responses of the providers. and the ability to generate condition-specific list of patients in need of specific care such as blood pressure control. in addition, the providers get quality dashboards, they can use track performance and compare it to their peers. transfer performance of hypertension and blood pressure is controlled shown here compared to peer providers in gray. and percent of patients whose smoking status over time is shown here. in this case compared to the meaningful youth target in green.

It also presents automatic recommendations. in this case, improving the percent of patients with testing. providers receive these dashboards by e-mail with the link of the health department website, which has information on all of the measures included in the dashboards. we're tracking the information for services across all pcip providers and trends are positive. we have seen as you can see here increases over time and the percent of eligible pashs receiving aspirin, the percentage of patients with hypertension whose blood pressure is controlled and the percent of smokers receiving smoker cessation intervention. what is the impact of all of these actions stand on cardiovascular disease?during the time period we've seen substantial decreases immortality from cardiovascular disease in new york city. including 33% decrease and a 16% decrease in cerebral vascular disease mortality. i can't say to a degree this which it caused the change butit certainly is encouraging. over the same time period life expectancy at birth in new york city has been increasing and increasing faster in the u. s.  asa whole. in 2009 expect taps si in new york city was . 4 years higher than it was nationally.

Now, this slide shows life expectancy at age 40. unlike life expectancy at birth this measure reflects improvement of mortality in older adults. this measure also substantially outpaced in the united states,especially in the last five years. in summary, new york city, our efforts to address cardiovascular disease are showing signs of success. the interventions we use are characteristics of implementation on a mass scale which is what we need because cardiovascular disease is so common. let me just finish with a thought that mass disease require massive remedies. thank you very much.