county health rankings 2016: measures and new features

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www.countyhealthrankings.org

COUNTY HEALTH RANKINGS 2016: MEASURES AND NEW FEATURES

Amanda Jovaag Kate Konkle

February 29, 2016

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ACKNOWLEDGEMENTS

‣ Robert Wood Johnson Foundation

– Including Andrea Ducas, Michelle Larkin, Jim Marks, Joe Marx, Amy Slonim, Don Schwarz, Katie Wehr

‣ Wisconsin County Health Rankings & Roadmaps Team

– Including Bridget Catlin, Julie Willems Van Dijk, Matt Rodock, Kathryn Hatchell, Hyojun Park, Elizabeth Pollock, Paige Andrews, Marjory Givens, Keith Gennuso

‣ Our Partners

– Including Burness, NNPHI, Dartmouth Institute, CDC, NCHS

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County Health Rankings & Roadmaps Background

What’s New for 2016?

2016 Measures and data changes

2016 New additional measures

Wrap‐Up; Q & A

OUTLINE

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COUNTY HEALTH RANKINGS: 2 RANKINGS

Today’s Health

Health Outcomes

Tomorrow’s Health

Health Factors

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Wrap‐Up; Q & A

OUTLINE

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Improved feature–Our Approach

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New feature–Access to Measure Details from Our Approach

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Revised County Snapshot—with Ranked and Additional measures

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Created with Haiku Deck

New feature–Show areas of strength

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New feature–Compare counties across states

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Wrap‐Up; Q & A

OUTLINE

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‣ Reflects aspects of population health in our model that can be improved

‣ Communicable

‣ Fewer measures are better than more

‣ Emerging health issue

‣ Closer alignment with intended topic

‣ Aligned with other metric initiatives (e.g., America’s Health Rankings)

‣ Advance efforts to address health equity

HOW ARE MEASURES SELECTED?

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‣ Available at the county level

‣ From data sources that are valid, reliable, and recognized

‣ Measures that have been tested and used by others

‣ Data available for nearly all counties nationwide

‣ Short time lag (recently available within the past 3‐5 years)

‣ Collected regularly and publicly available

‣ Rankable

HOW ARE MEASURES SELECTED?

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FOCUS AREA MEASURE DATA SOURCE YEARS

LENGTH OF LIFE (50%)

Premature Death (50%)(Years Of Potential Life Lost)

National Center for Health Statistics 2011‐2013

QUALITY OF LIFE (50%)

Poor or Fair Health (10%)

Poor Physical Health Days (10%)

Poor Mental Health Days (10%)

Behavioral Risk Factor Surveillance System (BRFSS)

2014

Low Birthweight (20%) National Center for Health Statistics 2007‐2013

HEALTH OUTCOMES

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FOCUS AREA MEASURE DATA SOURCE YEARS

TOBACCO USE (10%)

Adult Smoking (10%) BRFSS 2014

DIET AND EXERCISE (10%)

Adult Obesity (5%)

Food Environment Index (2%)

Physical Inactivity (2%)

Access To Exercise Opportunities (1%)

CDC Diabetes Interactive Atlas

USDA & Feeding America

CDC Diabetes Interactive Atlas

Delorme & ESRI

2012

2013

2012

2012 & 2013

ALCOHOL USE (5%)

Excessive Drinking (2.5%)

Alcohol‐impaired Driving Deaths (2.5%)

BRFSS

Fatality Analysis Reporting System

2014

2010‐2014

SEXUAL ACTIVITY (5%)

Sexually Transmitted Infections (2.5%)

Teen Births (2.5%)

National Center for Hepatitis, HIV, STD, and TB Prevention

National Center for Health Statistics

2013

2007‐2013

HEALTH BEHAVIORS

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FOCUS AREA MEASURE DATA SOURCE YEARSACCESS TO CARE (10%)

Uninsured (5%)

Primary Care Physicians (3%)

Dentists (1%)

Mental Health Providers (1%)

Small Area Health Insurance Estimates

Area Health Resource File/American Medical AssociationArea Health Resource File/National Provider Identification FileCMS, National Provider Identification

2013

2013

2014

2015

QUALITY OF CARE (10%)

Preventable Hospital Stays (5%)

Diabetic Monitoring (2.5%)

Mammography Screening (2.5%)

Dartmouth Institute: Dartmouth Atlas of Health Care, Medicare Claims Data

2013

CLINICAL CARE

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FOCUS AREA MEASURE DATA SOURCE YEARSEDUCATION (10%)

High School Graduation (5%)Some College (5%)

National Center For Education Statistics

American Community Survey

2013‐2014

2010‐2014

EMPLOYMENT (10%)

Unemployment (10%) US Bureau of Labor Statistics 2014

INCOME (10%) Children In Poverty (7.5%)

Income Inequality (2.5%)

Small Area Income And Poverty Estimates


2014

2010‐2014

FAMILY AND SOCIAL SUPPORT (5%)

Single‐parent Households (2.5%)Social Associations (2.5%)


County Business Patterns

2010‐2014

2013

COMMUNITY SAFETY (5%)

Violent Crime (2.5%)

Injury Deaths (2.5%)

Uniform Crime Reporting, Federal Bureau of InvestigationCDC WONDER

2010‐2012

2009‐2013

SOCIAL AND ECONOMIC FACTORS

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FOCUS AREA

MEASURE DATA SOURCE YEARS

AIR & WATER QUALITY (5%)

Air Pollution – Particulate Matter (2.5%)

Drinking Water Violations (2.5%)

CDC WONDER Environmental data, NASA Applied Sciences Program/Public Health Program

Safe Drinking Water Information System

2011

FY2013‐2014

HOUSING & TRANSIT (5%)

Severe Housing Problems (2%)

Driving Alone To Work (2%)

Long Commute – Driving Alone (1%)

Comprehensive Housing Affordability Strategy (CHAS) dataAmerican Community Survey


2008‐2012

2010‐2014

2010‐2014

PHYSICAL ENVIRONMENT

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BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) MEASURES

‣ Ranked measures:

– Poor or fair health

– Poor physical health days

– Poor mental health days

– Adult smoking

– Excessive drinking

‣ Additional measures

– Frequent physical distress

– Frequent mental distress

– Insufficient sleep

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BRFSS MEASURES

‣Why are we seeing these changes?

– Change in measure over time

– Inclusion of cell phone respondents

– Modeling

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Wrap‐Up; Q & A

OUTLINE

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ADDITIONAL MEASURES – HEALTH OUTCOMES

Health Outcomes

Premature age‐adjusted mortality

Child mortality

Infant mortality

Frequent physical distress

Frequent mental distress

Diabetes prevalence

HIV prevalence

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ADDITIONAL MEASURES – HEALTH FACTORS

Health Behaviors

Food insecurity

Limited access to healthy foods

Drug overdose deaths

Drug overdose deaths ‐modeled

Motor vehicle crash deaths

Insufficient sleep

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ADDITIONAL MEASURES – HEALTH FACTORS

Clinical Care Uninsured adults

Uninsured children

Health care costs

Other primary care providers

Social and Economic Factors

Median household income

Children eligible for free lunch

Residential segregation ‐ black/white

Residential segregation ‐ non‐white/white

Homicides

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NEW ADDITIONAL MEASURES

‣ Health outcomes

– Frequent physical distress

– Frequent mental distress

‣ Health factors

– Drug overdose deaths – modeled

– Residential segregation – black/white

– Residential segregation – non‐white/white

– Insufficient sleep

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FREQUENT MENTAL AND PHYSICAL DISTRESS

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DRUG OVERDOSES ‐MODELED

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RESIDENTIAL SEGREGATION

Why does it matter?

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‣ A county with 100 residents

– 50 black

– 50 white

‣ In this example, 30 out of 50 or 60% of residents (either black or white) would have to move in order for both neighborhoods to have equivalent distributions.

RESIDENTIAL SEGREGATION

40 black residents

10 white residents

10 black residents

40 white residents

40 black residents

40 white residents

10 black residents

10 white residents

Index=60 (Highly segregated)

Neighborhood 2

Neighborhood 1

Index=0 (Complete integration)

30 whites

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INSUFFICIENT SLEEPMap of SUFFICIENT SLEEP

Behavioral Risk Factor Surveillance System, United States, 2014

Liu Y, Wheaton AG, Chapman DP, Cunningham TJ, Lu H, Croft JB. Prevalence of Healthy Sleep Duration among Adults —United States, 2014. MMWR Morb Mortal Wkly Rep 2016;65:137–141. DOI: http://dx.doi.org/10.15585/mmwr.mm6506a1

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Wrap‐Up; Q & A

OUTLINE

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UPCOMING WEBINARS

March 8

Community Engagement for Health Equity,

Racial & Social Justice

April 5

County Health Rankings & Roadmaps 101 and

Website Tour

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STAYING CONNECTED

e‐Newsletter: [email protected]

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Amanda Jovaag, MSCounty Health Rankings Data LeadUniversity of Wisconsin Population Health Institutewww.countyhealthrankings.org

THANK YOU!

Documents

county health rankings 2016: measures and new features