Post on 11-Jan-2016
THE COUNTY HEALTH RANKINGS & ROADMAPS: FROM DATA TO ACTIONJulie A. Willems Van Dijk RN, PhD
Deputy Director, County Health RoadmapsUniversity of Wisconsin Population Health Institute
December 4, 2013
County Health Rankings & Roadmaps is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.
www.countyhealthrankings.org
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ACKNOWLEDGEMENTS‣ Robert Wood Johnson Foundation– Including Abbey Cofsky, Joe Marx, Michelle Larkin, Jim Marks,
Naima Wong
‣Wisconsin County Health Rankings & Roadmaps Team– Including Bridget Catlin, Patrick Remington, Amanda Jovaag, Kitty
Jerome, Alison Bergum, Kate Konkle, Karen Odegaard, Jan O’Neill, Kirstin Siemering
‣Our Partners– Including Burness Communications, Community Catalyst, United
Way Worldwide, NACo, NBCH, ASTHO, NACCHO, NNPHI, Dartmouth Institute, CDC, NCHS
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TODAY’S OUTLINE
‣What Creates Health?
‣Exploring the County Health Rankings & Detroit’s State of Population Health Report
‣Moving to Action
‣Discussion
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TWO VIEWPOINTS
Today’s Health
Health Outcomes
Tomorrow’s Health
Health Factors
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‣Reflect important aspects of population health that can be improved
‣Valid, reliable, recognized and used by others
‣Available at the county-level
‣Available for free or low cost
‣As up-to-date as possible
‣ Fewer measures better than more
HOW ARE MEASURES SELECTED?
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FOCUS AREA MEASURE DATA SOURCEMORTALITY (50%) Premature Death (50%)
(Years of Potential Life Lost)National Center for Health Statistics
MORBIDITY (50%) Low Birthweight (20%)
Poor or Fair Health (10%)
Poor Physical Health Days (10%)
Poor Mental Health Days (10%)
National Center for Health Statistics
Behavioral Risk Factor Surveillance System
HEALTH OUTCOMES
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FOCUS AREA MEASURE DATA SOURCETOBACCO USE (10%)
Adult Smoking (10%) Behavioral Risk Factor Surveillance System
DIET AND EXERCISE (10%)
Obesity (7.5%)
Physical Inactivity (2.5%)
National Center for Chronic Disease Prevention and Health Promotion
ALCOHOL USE (5%)
Excessive Drinking (2.5%)
Motor Vehicle Crash Death Rate (2.5%)
Behavioral Risk Factor Surveillance System
National Center for Health Statistics
SEXUAL ACTIVITY (5%)
Teen Birth Rate (2.5%)
Sexually Transmitted Infections (Chlamydia Rate) (2.5%)
National Center for Health Statistics
National Center for Hepatitis, HIV, STD, and TB Prevention
HEALTH BEHAVIORS
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FOCUS AREA MEASURE DATA SOURCEACCESS TO CARE (10%)
Uninsured (5%)
Primary Care Physicians (3%)
Dentists (2%)
Small Area Health Insurance Estimates
Health Resources & Services Administration
Health Resources & Services Administration
QUALITY OF CARE (10%)
Preventable Hospital Stays (5%)
Diabetic Screening (2.5%)
Mammography Screening (2.5%)
Dartmouth Institute: Dartmouth Atlas Project, Medicare Claims Data
CLINICAL CARE
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FOCUS AREA MEASURE DATA SOURCEEDUCATION (10%)
High School Graduation (5%)
Some College (5%)
States provided H.S. graduation data
American Community Survey
EMPLOYMENT (10%)
Unemployment (10%) US Bureau of Labor Statistics
INCOME (10%) Children in Poverty (10%) Small Area Income and Poverty Estimates
FAMILY AND SOCIAL SUPPORT (5%)
Inadequate Social Support (2.5%)
Single-Parent Households (2.5%)
Behavioral Risk Factor Surveillance System
American Community Survey
COMMUNITY SAFETY (5%) Violent Crime (5%)
Uniform Crime Reporting, Federal Bureau of Investigation
SOCIAL AND ECONOMIC FACTORS
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PHYSICAL ENVIRONMENT
Focus Area Measure Data SourceENVIRONMENTAL QUALITY (4%)
Daily Fine Particulate Matter (2%)
Drinking Water Safety (2%)
CDC WONDER Environmental data, NASA Applied Sciences Program/Public Health Program
Safe Drinking Water Information System
BUILT ENVIRONMENT (6%)
Limited Access to Healthy Foods (2%)
Fast Food Restaurants (2%)
Access to Recreational Facilities (2%)
Food Environment Atlas
County Business Patterns
County Business Patterns
14www.countyhealthrankings.org
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21http://www.cdc.gov/about/grand-rounds/archives/2010/download/GR-021810.pdf
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State of Population Health Report, Page 9
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State of Population Health Report, Page 8
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State of Population Health Report, Page 15
30www.countyhealthrankings.org/what-works-for-health
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SOCIAL ECOLOGICAL MODEL (MCELROY, BIBEAU, STECKLER, & GLANZ, 1988)
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ObesityIndividual Weight reduction
Exercise programs
Family/Interpersonal Family nutrition classesActive family challenge
Institutional Healthy nutritional choicesCompetitive pricingActivity challengesPoint of decision prompts
Community Bike and walking trails Safe Routes to School
Policy Taxes on sugar-sweetened beveragesCommunity development financing for healthy food outlets
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‣A model of health and action to guide your process
‣Tools and guidance that can be used by both public health and hospitals to work together
‣Community of learning
‣Stories and examples of how other communities have advanced their journey towards health
HOW CAN THIS BE HELPFUL TO MY COMMUNITY?
DRAFT Health Driver Diagram (High Level)Key
Outcome
Primary Drivers
Central to ourMission and Capabilities,High Control
Central to ourMission &SharedCapabilities, &Control
Alignedwith our Mission &Limited Capabilities &Control
ImprovedHealth
(As Measured by a Summary
Measure ofHealth)
Healthy LifestylesPreventive ServicesAcute CareChronic DiseaseEnd of LifeCross Cutting Issues
Tobacco Non-useActivityDiet/NutritionAppropriate Alcohol Use
AdvocacyOther Community Projects
AdvocacyOther Community Projects
EnvironmentalFactors
HealthBehaviors
HealthCare
Socio-economic Factors
Adult/Family Literacy
Early Childhood Development
Physical Activity
Nutritious Food/Drink
Livable Communities
Physical Environment
Socioeconomic
Lead and Other Chemicals
Health Literacy
Built Environments
Environmental Quality
Trained Workforce
Income
Family/Social Support
Family StabilityAging Population Services and
Caregiver Support
Parenting Skills
Safe Areas for Activity
Access to Healthy Food/Drink
Social Cohesion
Affordability
Dental Health
Housing
English Proficiency
2nd Hand Smoke
Employer/Employee Awareness
Utilities
Worker Availability/Readiness
Cultural Competence
April 16, 2010 - Version 4.0 Driver Diagram: Partial Inventory of Related HealthPartners Initiatives
Reduced Toxic Exposures
Financial Management
Mental Health Anti-Stigma Efforts for Mental Health and Chemical Dependency
Improved Work-Health Linkage
Cultural Understanding
Community Engagement
Provider Outreach to Community
Community Safety
Reduced Violence
Ready Transportation
Green Building Initiatives
Itasca Project efforts Food Shelf programsPirates of Carrot Bean: SHIP supportBreastfeeding video
Health Literacy workshops Project ReadSpeaking Together
Itasca Project efforts Tech Prep ConsortiumYouth Volunteer Program EBAN ExperienceEmployee education Health Career ScholarshipsTeachers in Healthcare Setting
Financial Fitness Program
Itasca Project efforts Food Shelf programsSPPS Health & Wellness Homes for All 2010EMACS SHIP supportRegions Financial Counseling
Project Read Baby Safety programBaby Clothes Breastfeeding video:Cell phone drives Shelter/Clinics partnersCornerstone conference
Itasca Project efforts Data/Research projectsEmployee education EBAN ExperiencePower to End Stroke
EMACS: Hovander House SHIP supportNAMI partnership East Metro Roundtable
Itasca Project efforts Food Shelf programsCSAs Farmers Market promoComplete Streets SHIP supportMN Environmental Fund County Volunteer Drivers
Smoke-Free Worksites SHIP support
MN Environmental Fund Environment Conservation
Related HealthPartners Initiatives
Employment
Education
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‣Annual prize
‣Honoring outstanding community efforts and partnerships
‣Winning communities receive a $25,000 cash prize
‣2014 winners will be announced and next round of applications will be released in June, 2014
ROADMAPS TO HEALTH PRIZE
Meet the six inaugural winners and learn more about how your community can apply at
www.countyhealthrankings.org/roadmaps/prize
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NEW ORLEANS
http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2013/02/new-orleans--louisiana--2013-
roadmaps-to-health-prize.html
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STAYING CONNECTED
e-Newsletter: chr@match.wisc.edu
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DISCUSSION
Julie Willems Van Dijk RN PhD
Deputy Director, County Health Rankings & Roadmaps
University of Wisconsin Population Health Institute
608-263-6731
willemsvandi@wisc.edu