poverty and health in tennessee trha2018pdf.pdfcollege in ten years based on parents’ education...
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Poverty and Health
Randy Wykoff, MD, MPH & TM and
Kate Beatty, PhD, MPH
College of Public Health
East Tennessee State University
In Tennessee
The “Man on the Street” would probably tell us that Life Expectancy in the United State is:
1) The longest it has ever been; and
2) The longest in the world;
The Health Status of the United States
47.3
77
0
10
20
30
40
50
60
70
80
90
1900 1950 2000
Life Expectancy Change in the 20th Century
78.978.7 78.6
75
75.5
76
76.5
77
77.5
78
78.5
79
79.5
80
2014 2015 2016
Life Expectancy Change in the Last Three Years
In 2017, for Life Expectancy
the United States Ranks:
37th Behind---
Monaco, Japan, Singapore, San Marino, Iceland, Andorra, Guernsey, Switzerland, South Korea, Israel, Luxembourg, Australia, Italy, Sweden,
France, Norway, Liechtenstein, Jersey, Canada, Spain, Austria, Netherlands, Bermuda, New Zealand, Cayman Islands, Isle of Man,
Belgium, Finland, Ireland, Germany, United Kingdom, Greece, Malta, Taiwan, {European Union}, and Turks and Caicos
Life Expectancy
CIA Factbook 2017
Life Expectancy: All 222 Countries in the World: Male and Female
45.00
50.00
55.00
60.00
65.00
70.00
75.00
80.00
85.00
90.00
Internation Male Life Expectancy International Female Life Expectancy
81
76
1 Minnesota 5555
2 California 5647
3 New York 5701
4 Connecticut 5771
5 New Jersey 5875
6 Massachusetts 5970
7 Hawaii 6031
8 Washington 6096
9 Colorado 6113
10 Vermont 6326
11 Iowa 6333
12 Utah 6399
13 Wisconsin 6437
14 Oregon 6507
15 Rhode Island 6516
16 New Hampshire 6572
17 Nebraska 6592
18 Idaho 6599
19 Virginia 6696
20 Illinois 6825
21 Maryland 7113
22 Maine 7144
23 Texas 7175
UNITED STATES 721424 North Dakota 7225
25 Arizona 7246
26 Kansas 7380
27 Florida 7412
28 Pennsylvania 7541
29 South Dakota 7627
30 Nevada 7729
31 Michigan 7853
32 Delaware 7871
33 North Carolina 7889
34 Wyoming 8130
35 Georgia 8185
36 Montana 8229
37 Alaska 8342
38 Indiana 8471
39 Ohio 8492
40 Missouri 8558
41 New Mexico 8913
42 South Carolina 9131
43 Tennessee 9467
44 Oklahoma 9951
45 Arkansas 9972
46 Louisiana 10003
47 Kentucky 10042
48 Alabama 10321
49 West Virginia 10478
50 Mississippi 10950
America’s Health Rankings 2017: http://www.americashealthrankings.org
Premature (Early) Death Rates:
United States 2017
America’s Health Rankings 2017: http://www.americashealthrankings.org
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12000
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
Premature (Early) Death Rates:
United States 2017
USA
TENN
The Premature Death Rate in Tennessee is 31.2% Higher Than the National Rate
• Tennessee ranks 43rd (and is 31.2% worse than the National rate). . . .
• In the Nation that ranks 37th in the world . . .
Premature Death Rate in Tennessee
Early LifeExperiences
Education
Income
Work
Housing
Community
Race and Ethnicity
Economy
SanitationBehaviorAccess
A Quick History of Understanding “Health” . . .
Injury
Genetics
Bureau of Labor Statistics: www.bls.gov/newsrelease/cfoi.t05.htm
0
2
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14
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
Fatal Occupational Injuries: 2015 and 2016
USA
TENN
The Occupational Fatality Rate in Tennessee is 14% Higher Than the National Rate
America’s Health Rankings 2017: http://www.americashealthrankings.org
0
50
100
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300
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
Primary Care Physicians Per 100,000
USA
TENN
The Rate of Primary Care Physicians in Tennessee is 92.5% of the National Rate
America’s Health Rankings 2017: http://www.americashealthrankings.org
0
5
10
15
20
25
30
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
Prevalence of Smoking: Adults
USA
TENN
The Adult Smoking Rate in Tennessee is 29% Higher Than the National Rate
America’s Health Rankings 2017: http://www.americashealthrankings.org
0
5
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40
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
Prevalence of Obesity: Adults
USA
TENN
The Adult Obesity Rate in Tennessee is 16.4% Higher Than the National Rate
America’s Health Rankings 2017: http://www.americashealthrankings.org
0
5
10
15
20
25
30
35
40
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
Drug Deaths Per 100,000 Population
USA
TENN
The Drug Overdose Death Rate in Tennessee is 36% Higher Than the National Rate
Estimated Death Rates for Drug PoisoningsBy County: 1999 - 2014
0
5
10
15
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30
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45
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
Adults with a College Degree or More
US States by Educational Attainment: Wikipedia: https://en.wikipedia.org/wiki/List_of_U.S._states_by_educational_attainment
USA
TENN
The Percent of Adults in Tennessee Who Have a College Degree or More is 16.5%
Lower Than the National Rate
40
42
44
46
48
50
52
54
56
58
60
Men Women
Less than HS
High School
Some College
College+
Life Expectancy at Age 25 by Educational
Achievement
Education Matters for Health: Robert Wood Johnson Foundation. September, 2009
6.8 yrs 5.1 yrs
Percent of High School Sophomores Who Complete
College in Ten Years Based on Parents’ Education Level
5.913.3
25.7
49.4
65.473.3
0
10
20
30
40
50
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70
80
Education Matters for Health: Robert Wood Johnson Foundation. September, 2009
America’s Health Rankings 2017: http://www.americashealthrankings.org
0
5
10
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30
35
1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829303132333435363738394041424344454647484950
Children Living in Poverty
USA
TENN
The Percent of Children Living in Poverty in Tennessee is 22% Higher Than the National Rate
0
50000
100000
150000
200000
250000
PoorestFifth
2ndPoorest
Fifth
MiddleFifth
2ndRichest
Fifth
RichestFifth
1967
1976
1986
1996
2006
2016
Selected Measures of Household Income
Disparities: 1967 – 2016
2016: Ratio = 16.5:1
48% INCREASE
1967: Ratio = 11.4:1
Income and Poverty in the United States, 2016. U.S. Census Bureau https://www.census.gov/content/dam/Census/library/publications/2017/demo/P60-259.pdf
Tennessee County Designation by Income
53331
31006
0
10000
20000
30000
40000
50000
60000
Richest Fifth Second Fifth Third Fifth Fourth Fifth Poorest Fifth
People living in Tennessee poorest fifth of counties make only 58% of those living in the
richest fifth of counties.
Median Household Income: Tennessee:
By Quintile (19 Counties Each)
7844
11390
0
2000
4000
6000
8000
10000
12000
Richest Fifth Second Fifth Third Fifth Fourth Fifth Poorest Fifth
The Premature Death Rate is 45% higher in Tennessee’s poorest counties
Premature Mortality (YPLL) Tennessee:
By Income Quintile (19 Counties Each)
We need to work together to enhance economic
opportunity and improve educational achievement;
We need to work together to encourage healthier
behaviors, especially related to diet, exercise, smoking
and substance abuse; and
We need to work together to assure access to health
care, especially primary care, mental health and
preventive services;
What Can We Do To Improve Health
in the United States?
Randy Wykoff, MD, MPH & TM
Professor and Dean
College of Public Health
East Tennessee State University
(423) 439-4243
Please Feel Free to Contact Me. . .