america’s health rankings ® what does it tell us about the state of our health? alliance for...
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America’s Health Rankings ® What Does It Tell Us
About the State of Our Health?Alliance for Health Insurers
September 9, 2014
America’s Health Rankings® - Annual Report
A Comprehensive Assessment of the Nation’s Health
• Longest running annual assessment of our nation’s health on a state-by-state basis
• Report identifies the driving health trends of the nation
• Report provides insights into the national health challenges on the horizon
• Report has evolved from a source of information to a robust, interactive tool that urges all populations and communities to act
• Under the editorial control of a scientific advisory committee based out of the University of North Carolina Chapel Hill Gillings School of Global Public Health
• Published by United Health Foundation, the American Public Health Association and Partnership for Prevention
• 25th Edition will be released December 2014
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America’s Health Rankings® - Senior Report
A Comprehensive Assessment of Senior Health
2nd edition, updates the data we gathered for the 2013 inaugural report.
Offers a comprehensive analysis of senior health on a national and state-by-state basis across 34 measures of senior health.
Report seeks to promote discussion around the health of Americans 65 years and older while driving communities, governments, stakeholders and individuals to take action to improve senior health.
In compiling the report, researchers worked with a panel of leading public health scholars.
Report draws data from more than 12 government agencies and leading research organizations, including the U.S. Department of Health and Human Services, the U.S. Department of Commerce, the U.S. Department of Labor, The Dartmouth Atlas Project, the National Foundation to End Senior Hunger and the Commonwealth Fund.
Model, Metrics and Methodology
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Measures of Health – AnnualBehaviors• Smoking• Binge Drinking• Drug Deaths• Obesity• Physical Inactivity• High School Graduation
Community & Environment• Violent Crime• Occupational Fatalities• Infectious Disease (Salmonella,
Pertussis and Chlamydia)• Children in Poverty• Air Pollution
Public & Health Policies• Lack of Health Insurance• Public Health Funding• Immunization—Children• Immunization—Adults
Clinical Care• Low Birthweight Infants• Primary Care Physicians• Dentists• Preventable Hospitalizations
Health Outcomes• Diabetes• Poor Mental Health Days
• Poor Physical Health Days• Disparity in Health Status• Infant Mortality• Cardiovascular Deaths• Cancer Deaths• Premature Death
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Behaviors- Smoking- Chronic Drinking- Obesity- Underweight- Physical Inactivity- Dental Visits- Pain ManagementCommunity – Macro- Poverty- Volunteerism- Quality Nursing HomesCommunity – Micro- Social Support- Food Insecurity- Community SupportPolicy- Low-Care Nursing Home
Residents- Prescription Drug Coverage- Geriatrician Shortfall
Clinical Care- Dedicated Health Care Provider- Recommended Hospital Care- Flu Vaccine- Health Screenings- Diabetes Management- Home Health Care- Preventable Hospitalizations- Hospital Readmissions- Hospice Care- Hospital Deaths
Outcomes- ICU Usage- Falls- Hip Fractures- Health Status- Able-Bodied- Premature Death- Teeth Extractions- Mental Health Days
Measures of Health – Senior
Ranking Model Construction
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Behaviors• Smoking• Binge Drinking• Drug Deaths• Obesity• Physical Inactivity• High School Graduation
Community & Environment• Violent Crime• Occupational Fatalities• Infectious Disease (Salmonella,
Pertussis and Chlamydia)• Children in Poverty• Air Pollution
Public & Health Policies• Lack of Health Insurance• Public Health Funding• Immunization—Children• Immunization—Adults
Clinical Care• Low Birthweight Infants• Primary Care Physicians• Dentists• Preventable Hospitalizations
Health Outcomes• Diabetes• Poor Mental Health Days
• Poor Physical Health Days• Disparity in Health Status• Infant Mortality• Cardiovascular Deaths• Cancer Deaths• Premature Death
2. Normalize using a z-score
3. Eliminate outliers
4. M
ultip
le b
y w
eigh
ts
5. Sum weighted scores
6. R
ank
amon
g st
ates
1. Gather data
What Does It Tell Us About the Health of Each State?
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Visualization of the impact of all measures on rankings
Color indicates above or below norm
Size indicates magnitude of impact
For WI: http://www.americashealthrankings.org/WI/obesity?tabname=coremeasureimpact
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Core Measure Impact
Disparity Maps
Disparity by gender, age, race/ethnicity, education, income and urbanicity
Rates for smoking, physical inactivity, obesity, diabetes and high health status
Population affected in these subpopulations.
For Obesity in WI: http://www.americashealthrankings.org//WI/obesity?tabname=disparities
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Trends
Trends for each individual metric over time are displayed for the state and for the country.
For obesity in WI: http://www.americashealthrankings.org/WI/obesity?tabname=trendstate
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State Summary Ranks for all metrics
Disparities discussion
http:
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/WI
Health in the Wisconsin & the United States
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America’s Health Rankings - Annual
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Hawaii has taken the title of healthiest state.
Americans made considerable progress in their overall health in 2013, driven by improvements in more than two-thirds of our health measures.
While we should celebrate the gains we made, a key challenge will be maintaining momentum.
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Change in Rank
1990 1995 2000 2005 2010
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Wisconsin - Overall
Ove
rall
Rank
Wisconsin varies year to year The overall trend is a slow decline Implication: Population health is not improving in
Wisconsin as fast as in other states.
1990 1995 2000 2005 20100
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Wisconsin - Smoking
Edition
Perc
ent o
f Pop
ulati
on
2012/2013 Editions used revised BRFSS Methodol-ogy
America’s Health Rankings Top National Trends
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In the US, smoking has declined in the last year from 21.2 percent of the adult population to 19.6 percent.
Wisconsin
US
Wisconsin rates are typically slightly higher than US rates for smoking.
1990 1995 2000 2005 20100
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Wisconsin - Obesity
Edition
Perc
ent o
f Pop
ulati
onAmerica’s Health Rankings Top National Trends
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In the US, obesity has leveled off, shifting from 27.8 percent of adult population to 27.6 percent of the adult population – consistent with other surveys.
US
Wisconsin
2012/2013 Editions used revised BRFSS Methodology
Wisconsin trends bear watching closely. New data has WI at 29.8 %, slightly above US median of 29.4%.
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Binge Drinking Wisconsin has highest binge
drinking rate.– 25.2 percent of population age 18+
are binge drinkers.– Among a cluster of high prevalence
states in the upper Mississippi valley.
http://www.americashealthrankings.org/WI/binge
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Pertussis Wisconsin ranked 49th for incidence
of pertussis has a high prevalence of pertussis compared to neighboring states.
– 21.0 cases per 100,000 population.– high prevalence of pertussis
compared to neighboring states.
http://www.americashealthrankings.org/WI/pertussis
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Immunization - Children Wisconsin does have a strong child
immunization program– 75.2 percent of children receive
recommended doses of DTaP, polio, MMR Hib, hepatitis B, varicella and PCV vaccines by age 19 to 35 months.
– Ranked 6th
– high prevalence of pertussis compared to neighboring states.
Adolescent immunization rate was 67.2 percent, a rank of 16th.
http://www.americashealthrankings.org/WI/immunize
http://www.americashealthrankings.org/WI/immunize_teens
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High School Graduation Wisconsin has the second highest
high school graduation rate– 91.1 percent of incoming freshman
graduate within 4 years.– IL is considerable less (81.9%) and
MN is slightly less (88.2%)
http://www.americashealthrankings.org/WI/graduation
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Senior Health Across the U.S. This year’s senior report reveals some encouraging data related to
senior health:– Seniors are significantly more active than last year.
• In the US, Physical inactivity decreased from 30.3 percent to 28.7 percent of seniors. In Wisconsin, it decreased from 33.8 percent to 30.2 percent of seniors.
– More seniors than last year are pursuing preferred options for end-of-life care.
• In the US, the use of hospice care increased from 36.7 percent to 47.5 percent of decedents aged 65 and older. In Wisconsin, 34.5 percent to 47.2 percent.
• In the US, Hospital deaths decreased from 30.1 percent to 25.0 percent of decedents aged 65 and older. In Wisconsin, 25.0 percent to 20.9 percent.
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Senior Health Across the U.S. This year’s senior report reveals some encouraging data related to senior
health: (cont.)– More seniors than last year are avoiding preventable hospitalizations.
• In the US, the percentage decreased from 66.6 to 64.9 admissions per 1,000 Medicare beneficiaries. In Wisconsin, it is much lower with a smaller decline; 55.3 to 55.0 admissions.
– Nursing home quality improved in the past year.• In the US, the percentage increased from 42.0 percent to 46.8 percent of
beds rated 4 or 5 stars. In Wisconsin, it is higher than the national average and it increased from 50.3 to 53.3 percent rated 4 or 5 stars.
State Rankings
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America’s Health Rankings Overall Ranking
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2013 RANK (1-50) STATE Overall
47 Alabama -0.82225 Alaska 0.27528 Arizona 0.0249 Arkansas -0.89321 California 0.318 Colorado 0.5657 Connecticut 0.649
31 Delaware -0.09733 Florida -0.2138 Georgia -0.3151 Hawaii 0.919
12 Idaho 0.44230 Illinois -0.09641 Indiana -0.48718 Iowa 0.31727 Kansas 0.12245 Kentucky -0.71648 Louisiana -0.84416 Maine 0.36624 Maryland 0.2764 Massachusetts 0.725
34 Michigan -0.2183 Minnesota 0.731
50 Mississippi -0.89439 Missouri -0.37323 Montana 0.277
2013 RANK (1-50) STATE Overall
11 Nebraska 0.4637 Nevada -0.2945 New Hampshire 0.703
10 New Jersey 0.53132 New Mexico -0.17515 New York 0.3735 North Carolina -0.2479 North Dakota 0.557
40 Ohio -0.40744 Oklahoma -0.66613 Oregon 0.42629 Pennsylvania -0.02219 Rhode Island 0.31743 South Carolina -0.63522 South Dakota 0.28442 Tennessee -0.57936 Texas -0.256 Utah 0.6952 Vermont 0.868
26 Virginia 0.25914 Washington 0.40346 West Virginia -0.72720 Wisconsin 0.31317 Wyoming 0.355
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Senior RankingsState Rank
1 Minnesota2 Hawaii3 New Hampshire4 Vermont5 Massachusetts6 Colorado7 Utah8 Oregon9 Delaware10 Wisconsin11 Maryland12 Connecticut13 Iowa14 Maine15 Washington16 Nebraska17 Kansas18 California19 North Dakota20 Michigan21 Virginia22 Pennsylvania23 Arizona24 New Jersey25 Idaho
State Rank26 Rhode Island27 South Dakota28 Florida29 North Carolina30 Montana31 Ohio32 New York33 Wyoming34 South Carolina35 Illinois36 Alaska37 Indiana38 New Mexico39 Missouri40 Georgia41 Texas42 Nevada43 Tennessee44 Alabama45 West Virginia46 Arkansas47 Oklahoma48 Kentucky49 Louisiana50 Mississippi
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Five Steps to Take Action1
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1. Click on “Take Action”2. Select Annual or Senior3. Select Measure to Improve4. Click on “View”5. Select your action from list
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25th Edition of America’s Health Rankings
Celebrate 25 years of tracking the population health of each state.
Scheduled to be released in December, 2014 Feature perspectives on public health from
public health thought leaders
Thank You!
Foundation
Shelly Espinosa
952-936-1889
Media RelationsScott Weier
Follow us on Twitter: http://twitter.com/ahr_rankings
Follow us on Facebook: www.facebook.com/AmericasHealthRankings
Visit our website: www.AmericasHealthRankings.org
DataTom Eckstein
DataSarah Milder