HEALTH ASSESSMENT FINDINGS
Fall/ Winter 2011 Final report Sept. 2011
Assessment Tactics • 200+ studies reviewed for best practices • 300+ indicators researched • 627 stakeholder surveys completed • 934 affected population surveys completed
• Focus groups – 2 with stakeholders – 8-10 with affected populations
• Affected population intercept surveys
Affected Population Survey Constituencies
Health Highlights
Idaho Health Districts
Affected Population Survey Findings: Health Which three of the following statements describe best what you and your family need to live healthy and productive lives?
Affected Population Focus Group Concerns • Lack of affordable health insurance major concern across all groups – Those w/ limited income but ineligible for Medicaid / Medicare particularly frustrated – Concern with getting and keeping health insurance coverage not only for their children but for themselves as well. – Frustrations with restrictive Medicaid criteria – Finding providers who accept Medicaid or public insurance. – High costs of medical care that insurance does not cover – Jobs that do not offer health insurance or very minimal benefits
Affected Population Focus Group Concerns • Transportation barriers
• Frustration at lack of case management and fragmentation of care • Cost of basic care (and out of pocket costs) were major concern • Need better access to: – – – –
Dental care Mental health care Substance abuse services Follow-up care after medical visits
Idaho Refugee Population • From 1/01/2000 to 1/01/2010 6,720 refugees resettled in Idaho
• Adults with minor children
• All refugees that arrive in Boise receive: – Resettlement and Placement (R&P) – Social Security card – Food stamps – Case Management
• Adults with no children
– Medicaid for up to 1 year (eligible for recertification)
– Refugee Medical Assistance for 8 months
• Medical screenings prior to and after resettlement for all
Idaho Refugee Population • Barriers to health – Language (58% less likely to have health care visit) – Lack of social support – Mental health – Culturally different medical experiences and expectations
Indicators of Concern: Access to Care Indicator
U.S.
Idaho
Children with medical home
58%
56%
Adults with regular primary care physician
82%
72%
Residents living in Primary Care Professional Shortage Area
12%
17%
Residents living in Mental Health Provider Shortage Area
19%
62%
Residents living in Oral Health Provider Shortage Area
10%
17%
Children Receiving Preventive Medical/Dental Care
71%
60% ID ranks 51st
Uninsured adults
15%
17%
Uninsured children
9%
11%
Dental coverage much worse in Dist. 3
% of Adults and Children Without Health Insurance
Worsening trend since 2008
U.S. Census Bureau, 2009
% of Uninsured Individuals by Household Income
U.S. Census Bureau, 2009
% of Uninsured by Ethnicity, 2009
U.S. Census Bureau, 2009
Indicators: Health Outcomes Indicators
U.S. 50th Percentile
Idaho
Ada
Canyon
Premature Death (years potential life lost)
8149
6422
5371
7037
Poor or Fair Health
16%
14%
11%
17%
Avg. # poor physical health days in past month
3.7
3.5
2.9
3.9
Avg. # poor mental health days in past month
3.4
3.3
3.2
3.5
Low birthweight babies (<5.5 lbs)
7.8%
6.6%
6.8%
6.2%
County Health Rankings, 2011
Indicators: Health Factors U.S. 50th Percentile
Idaho
Ada
Canyon
Adult smoking
22%
18%
16%
19%
Adult obesity
29%
26%
22%
30%
Excessive drinking
15%
15%
17%
14%
Motor vehicle crash death rate
23
20
12
19
Sexually transmitted infections
215
280
348
353
Teen birth rate
46
40
31
72
19%
20%
16%
23%
Primary care provider ratio
1274:1
1036:1
716:1
1841:1
Preventable hospital stays
80
50
40
47
Diabetes management (HbA1c)
83%
81%
82%
82%
Mammography screening
63%
61%
67%
61%
Indicators
Uninsured adults
County Health Rankings, 2011
Indicators: Social & Economic Factors U.S. 50th Percentile
Idaho
Ada
Canyon
High school graduation
79%
80%
85%
65%
Some college
52%
61%
71%
51%
Children in poverty
20%
16%
11%
19%
Inadequate social support
19%
17%
14%
19%
Single-parent households
29%
23%
22%
25%
3
3
2
5
Indicators
Homicide rate County Health Rankings, 2011
Indicators: Physical Environment â&#x20AC;&#x201C; Health Factors U.S. 50th Percentile
Idaho
Ada
Canyon
Air pollution -- particulate matter days*
0
10
17
3
Air pollution -- ozone days*
0
2
9
0
50%
52%
81%
90%
8
10
12
2
Indicators
Access to healthy foods Recreational facilities per 100,000
* Interestingly, asthma rates declined across the board and are below the national rate; big declines in districts 3/4 County Health Rankings, 2011
Percentage of Overweight & Obese Adults, 2009 Overweight rate up slightly in Dist. 3; down slightly in Dist. 4; no improvement at state level Obesity fairly stable; worse in Dist. 3
County Health Rankings
Youth Overweight and Obesity, 2009
Centers for Disease Control & Prevention, Youth Risk Behavior Survey
Percentage of Students Not Meeting Recommended Physical Activity Level, 2009
NOTE: Idaho was ranked #1 (best) for percent of high school students who did not meet the recommended physical activity level in 2009
Commonwealth Fund State Data Center
% of Youth Consuming 5 Servings Fruits/Veggies per Day (2009)
Percentage of Population with Diabetes, 2010
Up from 4.9% in 2000
Rate trending up overall
CDC BRFSS Data
Teen Birth Rate per 1,000 Teen pregnancies in Idaho have declined over past decade; however, the trend has been rising in Canyon County
County Health Rankings
Prenatal Care Begun in First Trimester 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Prenatal care: % starting in first trimester
U.S.
Idaho
CANYON
ADA
83%
71.50%
64.30%
78.40%
Trend: % of Children Immunized Rates vary by source, but National Immunization Survey reports rates for Idaho children 19-35 months of age improved from lowest in the nation to national average in 2009
Americaâ&#x20AC;&#x2122;s Health Rankings
Substance Abuse • Among Idaho adults seeking substance abuse treatment in 2009, – – – – –
28% were for marijuana 25% for alcohol only 23% were for amphetamines 5% for opiates 14% were for alcohol in addition to other drugs
• Adolescent abuse of prescription drugs has been rising over past 5 years • Illicit drug use rates fell in District 4, but rose in District 3 SAMHSA
Age-Adjusted Suicide Rates, 2009
Idaho Vital Statistics
Idaho Youth Suicide Intentions and Behaviors
Youth Risk Behavioral Survey, 2009
Suicide Facts •
Idaho’s suicide rate ranks 10th highest in the nation
•
Recent years have shown an increasing trend (14% increase from 2007 to 2008)
•
In Idaho, most at risk are: – – – –
Teenage males (age 15-17) Elderly males (age 75+) Working age males (age 18-64) Native American teenage males
•
Suicide is 2nd leading cause of death for adolescents and young adults in Idaho
•
In 2009, 58% of Idaho suicides involved a firearm
•
Many suicides can be prevented by ensuring people are aware of warning signs, risk factors and protective factors – Idaho does not currently operate a suicide hotline (identified gap)
Idaho Suicide Prevention Council and Suicide Prevention Action Network
Domestic Violence Indicators (2009)
• 11,670 domestic violence calls to Idaho hotline • 6,183 incidents of intimate partner violence • 1,114 incidents of forcible rape • 1,634 reported child abuse victims
Disease-Specific Indicator Comparison Highlights FAVORABLE COMPARED TO NATIONAL DATA
UNFAVORABLE COMPARED TO NATIONAL DATA
• Asthma • Cancer mortality • Heart disease & stroke mortality • Trauma death rates
• • • • •
Mammography rates Colorectal screening rates Melanoma mortality Suicide rate STDs
Next Steps for United Way • Finalize & distribute assessment report – Full report & condensed executive summary report
• Prioritize needs with input from Vision Councils, Board and stakeholders • Collaborate & align funding with partner agencies to “move the needle” on prioritized indicators • Seek innovative models to address priority needs
Questions