The Massachusetts Report Card

Report Card Working Group of the MA-HDC 06.22.09

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The Massachusetts Report Card

Measuring Our Progress Toward the Elimination of Racial, Ethnic, and Linguistic Disparities in Health

Health Disparities Council Meeting June 22, 2009


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Massachusetts Report Card Working Group(Participating Members)

Mary Crotty, MNA Sherry Dong, Tufts Joe-Ann Fergus, MNA Pam Jones, BPHC Georgia Simpson May, DPH Joel Weissman, EHS (advisor)


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Today’s Agenda

Report Card Working Group Update The MA Report Card

Purpose Our Framework Key Concepts Report Card Structure

Indicators Exercise Next Steps


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Report Card Working Group Update

Working group meetings were held on June 2, and June 16 Process reviewed and goals set for moving forward The next meeting is Scheduled for July 22

Report Card Group members also met with staff from the AGs office on June 11 (Maura Healey and Lois Johnson) The goal of this meeting was to explore the concept of how or

if existing policies and laws may contribute to or help to alleviate disparities.

Per the suggestion of Rep. Rushing at the last council meeting, the report card group emailed out a request for input to the council members.

The report card group is seeking input from council members regarding the model and content of the report card.

MA Report Card: Purpose Identify priority health, social, and policy

indicators for Massachusetts.

Create a systematic approach to tracking our progress, over time, in reducing racial, ethnic, and linguistic disparities.

Provide the residents of the Commonwealth with useable information on the health and wellness of Massachusetts.


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MA Framework for Addressing Health Disparities

Societal/Policy Factors

Access to Health Care

Personal Health Behaviors

Extent and Quality of Health Care and Outcomes

Individual FactorsCommunity Factors

Institutional Transformation

Version 3+: 6/18/09


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Key Concepts for Developing a MA Report Card

I. Racial, Ethnic & Linguistic Health Disparities

II. Not a Static Document Periodic Updates Parking Lot

III. Report Card Structure Health and Social Statistics vs. Social Policy Formatting

IV. Selection Criteria for Indicators


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Key Concept III: Report Card Structure

Health Status Indicator Morbidity (prevalence/incidence of illness) Mortality (death rate)

Contributory Factors Associated with the Indicator 1. Health Care Utilization

Access and quality2. Social Determinants

Basic needs, social well-being, community attributes (including environmental)

3. Personal Practices/Individual Factors

Report Card Structure, cont.

4. Social Policy Levers Civil Rights (“obvious” discrimination) Other policies, laws, etc that appear to be race neutral but may

affect the health of racial-ethnic minorities disproportionately Zoning / restrictive ordinances Mortgage and foreclosure policies and practices Medicaid rates resulting in poor access/low quality Workplace health and inspections, e.g., nail salons, auto

body shops, taxi drivers


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KIS MIV

Keep It Simple, Make It Visual


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King County, WA


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King County, WA


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Formatting Considerations

Content Length Resources

Stop for Discussion


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676

1564 1524

235

783

227

2080

841

2276

1038

0

500

1000

1500

2000

White Black Hispanic Asian MA

Ra

te p

er

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0,0

00

ED Visits Hospitalizations

Source: MDPH, Bureau of Health Information, Statistics, Research and Evaluation, Health Survey Program

Example: Age-Adjusted Asthma ED Visits and Hospitalizations by Race/Ethnicity 2003-2005


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What do we want to know? What can we measure?Can we intervene and where? Are there policy implications?

_______________________________________

• % who need inhalers who do not have them• % living in substandard housing• % living in areas with poor air quality• Educational level• Household income

The rate of asthma ED visits and hospitalization may be a proxy for other health care access issues

• timely access to ambulatory services

Use the Example to Build Our Report Card


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Example, cont.

Asthma Related ED Visits by R/E (MA: 1,038/100,000)

Contributory Factors Associated with the Indicator 1. Health Care Utilization

a. ______2. Social Determinants

a. ______3. Personal Practices/Individual Factors4. Social Policy Levers

a. Medicaid Reimbursement

b. Environmental Hazards

Black: 2,276/100,000Hispanic: 2,080/100,000

Asian: 227/100,000White: 841/100,000


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IndicatorsWhat do we want to know?

Selection Criteria What’s been identified What needs to be included Prioritize


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Key Concept IV: Indicator Selection Criteria

Availability of Data (Measures and Statistics) Known Instances of Disparities Size of Disparities Amenable to intervention

an indicator we can influence an area we can adjust to impact the indicator can identify an area(s) in the system to apply an

intervention(s) that will change the indicator Presence of Policies which would impact disparity (Social

Policies)


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Our Indicators

Review “Proposed Indicators and Ranking” Document

What we haveWhat else do we want to know

Stop for Discussion


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Let’s Prioritize

Write In Missing Indicators Ranking of Indicators

On a Scale of 1 (Low) to 5 (High)


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MA Report Card, Next Steps

Compile Format Present a Mock-up of a MA Report Card


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Thank You!

The Massachusetts Report Card

Documents

Transcript of The Massachusetts Report Card