Health Status Workgroup

February 16, 2011

Overview

• Health status portion of MUA only• We have – developed a 4 var Social Deprivation Index– Related it to direct health status measures

• There is movement toward belief that SDI plus a direct health measure is appropriate

• Used county and PCSAs to demonstrate; no rec on rational service area

Big Picture

• SDI4 can be calculated across the nation at local level– This is identifying areas at risk of poor health

• Then considering direct measures of health– This allows for a check of actual outcomes

SDI 4—Robert Graham Center

• 4 variables• Weights from research; vars from 2000

Census, unemployment 2007 Claritas– 100 pct poverty: 51%– Unemployment rate: 30%– % persons less than high school: 12%– % households with single parent 10%

SDI Calculation

• Place areas (county or PCSA) into deciles • Multiply decile (1, 2,…10) by weight• Sum index

Example

• Assume a county in fifth decile on all 4– 5 x .51=2.55– 5 x .30=1.50– 5 x .12=0.60– 5 x .10=.50

• Sum of score =5.15

Does SDI4 correlate with health outcomes?

• Yes, there is a consistent relationship in which the worst decile is ‘sicker’ than the best using a variety of measures

• Correlations are not perfect which is one reason for including direct measures of health

Direct Measures of Health Status

• County: standardized mortality ratio; % fair/poor health status; Life expectancy at birth; unhealthy days; low birth weight

• PCSA: Diabetes & hypertension prevalence; self reported disability; Ambulatory care sensitive conditions; IMR

SDI4

• We looked at a variety of variables, these 4 strongly capture the risk of poor health outcomes, and they are available at small units of geography (flexibility regardless of rational service area chosen)

• Other variables that could be included may be included under accessibility and/or ability to pay