Speaker 1: Thanks very much, everyone. Thank you. I'm Judy Monroe, Indiana State Health Commissioner, and this is my last day on the job. Driving in today, I was thinking about what a remarkable journey it's been. This five years has been transformative for me and my career, but I think for Indiana as well, for public health. One of the greatest joys in this job has been reaching out to the entire community and all sectors. We've worked with our school systems, Department of Education, with our business community, and with our faith community. After we raised the cigarette tax in 07, we clearly saw, and we have hard data to show that the consumption of cigarettes dropped 25%. I learned early on, and it became very clear to me, there are none of our big public health issues that we want to solve can be done by the health department alone. It can't be done by public health alone. It's been great to see how the system partners do want to work with us to make a difference. So it's meant a lot to me to work with the universities in Indiana. Purdue University, about four or five years ago, developed a health care technical assistance program. As we've been looking at trying to improve public health systems, it made sense to reach out to Purdue. It's very exciting how counties like Boone County have come together with their healthy coalitions or their partners to learn about quality improvement and how to apply that into public health. And as we've reached out to Purdue and used some of the high tech, it's worked very well for us. Would you please mark either A, B, C, D, or E and push send. The communities, as they learn about quality improvement, they begin to learn the tools that they can apply to improving a specific problem in their communities. Since the local public health system conducted a community health assessment, C for 60%, that's a consensus. As we see the expert from Purdue that comes in really as the teacher, taking a community group through teaching them quality improvement and how to apply it, they get that immediate data with the audience response system.

Speaker 2: We're finding that some of the counties that have gone through the assessment process a year or two ago, early on, and who have embraced that very strongly and tried to use the results of the assessment to improve, have done well in the county health rankings.

Speaker 1: I'm very excited about the county health rankings. I didn't realize how excited I would be until after they came out and we started having counties in Indiana that we really did not have as much interest in engaging in our quality improvement. And once they got their county health ranking, they were on the phone calling us saying, we want to be part of this. So that's been our message with our quality improvement project all along, is that the action's going to be at that county level. When we launched InShape Indiana, we knew we would need to have businesses at the table. The change of culture toward one of wellness from an economic standpoint. So we reached out to businesses early on and made it clear to them that we wanted them to be partners. Good morning, Gregory and Appel.

Speaker 3: One moment.

Speaker 1: Gregory and Appel is an example of a small company that was mobilized into action because of our worksite tax credit that was part of our cigarette tax increase in 2007. So they're a small company, and because of the tax credit, they've got a gym now. And we've seen that multiplied, I think, 150 times now around the state of small employers that have been mobilized into action to help their employees.

Speaker 4: At Gregory and Appel, we've instituted a comprehensive wellness plan that employees have received very well. Part of it is to get a tax credit. It's also to get employees up and moving, to get them up off their seats. Wait for me, Rhonda. Either counting their steps, or going on runs, or eating healthy, and it's a program where we really are encouraging people to live healthy lifestyles. Employees can earn $500 gift cards if they go through enough steps. You take a pedometer, and you count your steps for the day, and you simply plug it in to your computer at the office, and it uploads right onto the website.

Speaker 1: I think it's really exciting because when an employer takes steps to improve the health of their employees, it really does speak to the employees as we value you as a human being, not just as an employee, but we really value your health. Dr. Morales? Yeah.

Speaker 3: I'm going to go through these pictures and see if there's any that you don't want included. Oh, yeah.

Speaker 1: Great. Hey, we've had a busy five years. Yes, we have. A lot of memories. Thank you. There's Peyton and I. In June of 2009, I had the privilege of being with Peyton Manning when he and I and others launched Project 18, which is his initiative to battle childhood obesity.

Speaker 5: Healthy eating can be a tricky thing.

Speaker 1: He has a hospital named after him, a children's hospital, and they partnered with Ball State University and Marsh Supermarkets.

Speaker 5: See, you can have your cake and eat it, too, as long as you're also eating the foods that keep you fit and healthy.

Speaker 1: It's really fun to have the children come to the supermarket and understand where the healthy foods are in the supermarket, which aisles are the healthy ones, and having them engage with Marsh Supermarket employees.

Speaker 3: I'm Molly Ittenbach, a pharmacist at Marsh. I also give grocery store tours as part of the Project 18 program to teach children about making healthy choices. We are going to start off in the produce section, where they have the fruits and vegetables.

Speaker 1: What a great combination. And this is mobilized across the state.

Speaker 3: What are the two magic words?

Speaker 1: Classes that are now going into supermarkets and realizing how important food is to their health.

Speaker 3: One of the things that you can look for that give you a clue that something is going to be a good, healthy choice, maybe as compared to some other things, are these little tags that we've got in front of the pride and let's say Project 18 approved.

Speaker 1: Prevention is just, I think, the answer to so many of the questions that we have around health care and around the cost of health care. For me personally, it's been important because as a family doc, I've seen the end result of not having prevention. Let's go upstream and go to the primary prevention, which is really where public health can take the lead, should take the lead. Thank you.