Health Outcomes in the SSHVS Population Study. Loretta R Cain, MPH, PhD The University of Chicago

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1 Health Outcomes in the SSHVS Population Study Loretta R Cain, MPH, PhD The University of Chicago

2 Background Objective measures to assess status of prevalent health conditions are needed to identify: Diagnosed disease Undiagnosed disease Pre-disease Undiagnosed and pre-disease states are important opportunities for intervention to improve health trajectories and reduce cost and disease burden in the population Objective measures carry more weight than self-report with health professionals and policymakers 2

3 Analytic Methods and Results 3

4 Hypertension Hypertension Categories No Hypertension If self-reported, physician diagnosed hypertension = No hypertension AND Systolic blood pressure < 120 mmhg and Diastolic blood pressure < 80 mmhg Pre-Hypertension Systolic blood pressure 120 mmhg and <140 mmhg and Diastolic blood pressure 80 mmhg and < 90 mmhg Diagnosed Hypertension If self-reported, physician diagnosed hypertension = Hypertension Undiagnosed Hypertension If self-reported, physician diagnosed hypertension = No hypertension AND Systolic blood pressure 140 mmhg or Diastolic blood pressure 90 mmhg NHLBI. (n.d.) What are High Blood Pressure and Prehypertension. Retrieved from 4

5 Population Study Health Outcomes: Hypertension (n=264) 14% 15% 21% 1-NO HYPERTENSION 2-PRE-HYPERTENSION 3-DIAGNOSED HYPERTENSION 4-UNDIAGNOSED HYPERTENSION 50% 5

6 90.0% 80.0% 70.0% 60.0% 50.0% Hypertension Distribution by Age Group (n=264) 51.8% 84.4% 40.0% 30.0% 20.0% 20.9% 31.9% 29.7% 17.6% 15.8% 17.2% 15.2% 10.0% 5.4% 4.8% 5.4% 0.0% Ages Ages Ages NO HYPERTENSION 2-PRE-HYPERTENSION 3-DIAGNOSED HYPERTENSION 4-UNDIAGNOSED HYPERTENSION 6

7 60.0% 50.0% Hypertension Distribution by Gender (n = 264) 47.4% 51.7% 40.0% 30.0% 20.0% 14.1% 23.0% 15.5% 16.7% 19.0% 12.6% 10.0% 0.0% Male 1-NO HYPERTENSION 3-DIAGNOSED HYPERTENSION 2-PRE-HYPERTENSION Female 4-UNDIAGNOSED HYPERTENSION 7

8 Diabetes Mellitus Diabetes Mellitus Categories No Diabetes If self-reported, physician diagnosed diabetes = No Diabetes AND HbA1c < 5.7% Pre-Diabetes HbA1c 5.7% - 6.4% Diagnosed Diabetes If self-reported, physician diagnosed diabetes = Diabetes Undiagnosed Diabetes If self-reported, physician diagnosed diabetes = No Diabetes AND HbA1c 6.5% NLM. (2014) A1c Test. Retrieved from 8

9 Population Study Health Outcomes: Diabetes (n=246) 7% 18% 51% 1-NO DIABETES 2-PRE-DIABETES 3-DIAGNOSED DIABETES 4-UNDIAGNOSED DIABETES 24% 9

10 70.0% 60.0% 59.8% Diabetes Distribution by Age Group (n=246) 50.0% 40.0% 45.0% 41.4% 30.0% 20.0% 10.0% 0.0% 28.1% 28.5% 23.5% 22.3% 22.7% 9.5% 10.0% 7.2% 2.0% Ages Ages Ages NO DIABETES 2-PRE-DIABETES 3-DIAGNOSED DIABETES 4-UNDIAGNOSED DIABETES 10

11 60.0% 50.0% 51.5% Diabetes Distribution by Gender (n=246) 49.7% 40.0% 30.0% 20.0% 22.3% 19.2% 25.8% 17.8% 10.0% 6.9% 6.6% 0.0% Male Female 1-NO DIABETES 2-PRE-DIABETES 3-DIAGNOSED DIABETES 4-UNDIAGNOSED DIABETES 11

12 Body Mass Index BMI = weight (lb) / [height (in)] 2 x 703 NHLBI. (2014). Assessing Your Weight and Health Risk. Retrieved from 12

13 Population Study Health Outcomes: BMI (n = 255) 0% 17% UNDERWEIGHT NORMAL 53% 30% OVERWEIGHT OBESE 13

14 60.0% 50.0% BMI Distribution by Age Group (n=255) 55.1% 50.0% 52.9% 40.0% 30.0% 28.3% 29.7% 31.2% 20.0% 16.7% 19.5% 16.0% 10.0% 0.0% Ages Ages Ages 65+ UNDERWEIGHT NORMAL OVERWEIGHT OBESE 14

15 70.0% BMI Distribution by Gender (n=255) 60.0% 58.3% 50.0% 45.9% 40.0% 35.0% 30.0% 25.2% 20.0% 18.5% 16.5% 10.0% 0.0% 0.6% 0.0% Male Female UNDERWEIGHT NORMAL OVERWEIGHT OBESE 15

16 Depression No Depression If self-reported, physician diagnosed depression = No Depression Depression If self-reported, physician diagnosed depression = Depression 16

17 Population Study Health Outcomes: Self-Reported Depression (n = 267) 20% Yes No 80% 17

18 90.0% 80.0% Depression Distribution by Age Group (n = 267) 80.4% 80.1% 80.7% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 19.6% 19.8% 19.3% 10.0% 0.0% Ages Ages Ages 65+ DEPRESSION NO DEPRESSION 18

19 90.0% 80.0% Depression Distribution by Gender (n = 267) 80.2% 80.5% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 19.8% 19.5% 10.0% 0.0% Male DEPRESSION NO DEPRESSION Female 19

20 Conclusions Interpret the findings Hypertension (64%) Diabetes Mellitus (25%) BMI (53%) Burden of pre-disease Pre-hypertension (21%) Pre-diabetes (24%) Overweight (30%) Limitations Generalizability Recall Bias 20

21 Next Steps Today s workshop give us the opportunity to compare findings with NYC HANES data. What would we expect? Primary data collection at a population level is costly. Difficult to find funders who want to pay for these data in these communities. Is there a lower cost way to generate accurate estimates for disease and pre-disease in the population? Abel Kho and NYC Macroscope projects are going to help us answer this question 21

Know Your Number Aggregate Report Single Analysis Compared to National Averages

Know Your Number Aggregate Report Single Analysis Compared to National s Client: Study Population: 2242 Population: 3,000 Date Range: 04/20/07-08/08/07 Version of Report: V6.2 Page 2 Study Population Demographics