In Health Matters, Place Matters - The Health Opportunity Index (HOI) Virginia Department of Health Office of Health Equity

Transcription

1 In Health Matters, Place Matters - The Health Opportunity Index (HOI) Virginia Department of Health Office of Health Equity 1

2 Identifying the Problem

3 America s Health Rankings United Health Foundation Scorecard Overall Ranking = 19 th Teen Birth Rate High Blood Pressure Vegetables Disparity in Health Status Diabetes Stroke Lack of Health Insurance Cardiovascular Deaths Infant Mortality Fruits Primary Care Physicians Cancer Deaths Cholesterol Check Low Birthweight Obesity Physical Inactivity Excessive Drinking High School Graduation Smoking Air Pollution Unemployment Annual High Cholesterol Premature Death Suicide Source: American Health Rankings by United Health Foundation Released 12/15/16 High Health Status Preventable Hospitalizations 3 Infectious Disease Children in Poverty Drug Deaths Poor Physical Health Days Poor Mental Health Days Violent Crime

4 HEALTH OUTPUT RACIAL/ETHNIC

5 The State of Population Health

6 Source: Dr. Edward Ehlinger, Minnesota Commissioner of Health 2016 President s Challenge for the Association of State and Territorial Health Officials (ASTHO)

7 Opportunity Differences Geographic Poverty Gradient (Rural & Urban) in Virginia FPL 125 FPL 150 FPL Rural Urban Virgina Poverty Below 50 Poverty Below 100 Poverty Below 125 Poverty Below 150 Poverty Below 185 Poverty Below 200

8 Opportunity Differences Racial/Ethnic All White Black Hispanic or Latino Origin Asian American Indian and Alaska Native Native Hawaiian and Other Pacific Islander Unemployment Rate (2015 Q3) 4.5% 3.4% 8.3% 5.2% NR NR NR Education: On-Time Graduation Rate (2015) 90.5% 92.9% 86.3% 84% 95.6% 87.9% 94.4% Poverty: Less than 50% FPL 5.2% 4.2% 9.2% 6.4% 3.8% 7% 7.4% Poverty: Less than 100% FPL 11.4% 9.2% 20.1% 15.8% 8.3% 13.9% 11% Poverty: Less than 125% FPL 15.2% 12.3% 25.7% 21.4% 11.3% 18.7% 13.6% Source: EPI analysis of Bureau of Labor Statistics Local Area Unemployment Statistics (LAUS) data and Current Population Survey (CPS) data; Virginia Department of Education State-level Cohort Report, Class of 2015; U.S. Census Bureau, American Community Survey 5- Year Estimates.

9 Identifying the Means to a Solution

10 America s Health Rankings United Health Foundation Scorecard Overall Ranking = 1 st Teen Birth Rate High Blood Pressure Vegetables Disparity in Health Status Diabetes Stroke Lack of Health Insurance Cardiovascular Deaths Infant Mortality Fruits Primary Care Physicians Cancer Deaths Cholesterol Check Low Birthweight Obesity Physical Inactivity Excessive Drinking High School Graduation Smoking Air Pollution Unemployment Annual High Cholesterol Premature Death Suicide High Health Status Source: Adapted from American Health Rankings by United Health Foundation Released 12/15/16 Preventable Hospitalizations Infectious Disease 10 Children in Poverty Drug Deaths Poor Physical Health Days Poor Mental Health Days Violent Crime

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12 VIRGINIA STATE HEALTH IMPROVEMENT PLAN

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14 Source: King County (WA) Equity and Social Justice Annual Report December

15 DESIGN AND METHODS

16 Health Opportunity Index Identifies areas and populations that are most vulnerable to adverse health outcomes based on the Social Determinants of Health 16

17 Healthy People 2020: Five Elements of SDOH 17

18 Health Opportunity Index Access to Care Educational Attainment Population Density EPA Environmental Hazards Spatial Segregation Walkability HOI Population Churning Food Access Material Deprivation Employment Access Job Participation Affordability of Housing and Transportation Income Diversity 18

19 Geographic Level Can Mask Detail 19

20 Structure 30+ Variables 13 Indicators 4 Profiles 1 Health Opportunity Index 20

21 Selecting Indicators 1. Identified by Local Health Departments & Stakeholders as important. 2. Linked to health outcomes in academic literature. 3. Actionable (e.g., segregation vs race) 4. Consistent, quality data for all Census Tracts in Virginia.

22 Health Opportunity Index Community Environmental Profile Consumer Opportunity Profile Economic Opportunity Profile Wellness Disparity Profile 22

23 Community Environmental Profile Air Quality Index (EPA) Neurological Risk Population Churning Index Inflow Mobility Population- Weighted Density Walkability Index Density Cancer Risk On-road Pollution Respiration Risk Outflow Mobility Diversity (Landuse) Design (Connecti vity) Non-road Distance to Transit Non-point 23

24 Consumer Opportunity Profile Affordability Index Education Index Food Accessibility Index Material Deprivation Index Housing Cost Avg. Years of Schooling % Low Income Unemployment Transportation Costs % Low Access to Major Grocery Store Autoless Homes Average Income Distance to Grocery Store Home Ownership Overcrowding 24

25 Economic Opportunity Profile Employment Access Index Income Inequality Index Job Participation Index Number of Jobs Gini Coefficient % of Working Age Population in the Labor Force Distance to Jobs 25

26 Wellness Disparity Profile Access to Care Index Segregation Index % Uninsured Race/Ethnicity Primary Care Physician FTEs within 30 miles Population Spatial Influence Weighting 26

27 Uses of the HOI To show that place matters when it comes to health To identify the impact of social determinants of health on statewide health landscape To identify HOI indicators that are most influential on local health To learn from communities with good health despite adverse HOI indicators To build collaboration across all sectors to promote health equity 27

28 DISPARITIES & THE HOI

29 Monotonicity of HOI Life Expectancy at Birth Disability Free Life Expectancy 29

30 Monotonicity of HOI Infant Mortality Low Birth Weight 30

31 Predictive Analytics for Low Birth Weight (Low HOI) 31

32 Predictive Analytics for Low Birth Weight (High HOI) 32

33 Three River Health District HOI Affordability FoodAccess RacialDissimilarities Education Walkability HealthCare Accessibility AirQuality PopChurning PopDensity Townsend Deprivation IncomeEquality Job Participation Employment Accessibility

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35 Rural/Urban Disparities Rural-Urban Commuting Areas

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37 Health Opportunity Index Urban Areas Rural Areas

38 Profiles

39 For more information please contact: Adrienne McFadden, MD, JD Justin Crow, MPA Rexford Anson-Dwamena, MPH 39