Transcript Dr. Currier`s Presentation at the 2011 Healthcare Forum

The Pulse of Madison County:
HEALTHCARE FORUM 2011
May 4, 2011
Mary Currier, MD, MPH
Mississippi State Department of Health
Outline
• County rankings
• County and state statistics
• Prevention:
– Benefits
– Target behaviors
University of
Wisconsin
Population Health
Institute. County
Health Rankings
2011.
Accessible at
www.countyhealth
rankings.org.
County Health Rankings
Mississippi
County Health Rankings
Mississippi
County Health Rankings
Madison County, Mississippi
Madison
County
Error Margin
National
Benchmark*
Mississippi
Health Outcomes
7
27
Mortality
Premature death
Rank (of
81)
10,786
10,054-11,518
5,564
11,030
2
Morbidity
Poor or fair health
16%
14-18%
10%
22%
1 (tied)
Poor physical health days
2.9
2.4-3.3
2.6
4.1
2
Poor mental health days
2.8
2.3-3.2
2.3
4.2
2
11.6%
26 (tied
with two
others)
Low birthweight
10.8%
10.1-11.4%
6.0%
County Health Rankings
Madison County, Mississippi
Madison
County
Error Margin
National
Benchmark*
Mississippi
Rank (of 81)
Health Factors
1
Health Behaviors
1
Adult smoking
16%
13-19%
15%
24%
2 (tied)
Adult obesity
30%
26-34%
25%
34%
2
Excessive drinking
12%
9-14%
8%
11%
48 (tied with
seven others)
16-24
12
32
2 (tied )
83
728
29
22
65
5
Motor vehicle crash
20
death rate
Sexually
transmitted
infections
583
Teen birth rate
43
40-46
County Health Rankings
Madison County, Mississippi
Madison
County
Error
Margin
National
Benchmark*
Mississippi
Rank (of 81)
Health Factors
1
Clinical Care
1
Uninsured
adults
21%
13%
24%
13 (tied with
nine others)
Primary care
providers
446:1
631:1
1,155:1
2
Preventable
hospital stays
68
64-73
52
100
5 (tied with
two others)
Diabetic
screening
82%
71-92%
89%
78%
22 (tied with
six others)
Mammography
screening
67%
57-77%
74%
56%
3
18-25%
County Health Rankings
Madison County, Mississippi
Madison
County
Error Margin
National
Benchmark*
Mississippi
Rank (of 81)
Health Factors
1
Social & Economic Factors
4
High school
graduation
70%
92%
64%
5 (tied with
nine others
Some college
71%
68%
53%
2
Unemployment
6.9%
6.7-7.1%
5.3%
9.6%
3
Children in
poverty
18%
14-22%
11%
30%
3
Inadequate
social support
16%
13-19%
14%
25%
2 (tied)
Single-parent
households
31%
20%
44%
5 (tied with
two others)
Homicide rate
11
1
10
50 (tied with
six others)
8-14
County Health Rankings
Madison County, Mississippi
Madison
County
Error
Margin
National
Benchmark*
Mississippi
Rank (of 81)
Health Factors
1
Physical Environment
2
Air pollutionparticulate matter
days
0
0
1
1
Air pollutionozone days
2
0
3
71 (tied)
Access to healthy
foods
80%
92%
58%
18 (tied)
Access to
recreational
facilities
16
17
7
2
Physical Inactivity
US, 2008*
*BRFSS data
Physical Inactivity*
Madison Co. 26.0%
Mississippi 32.3%
US
23.8%
*A person is considered physically inactive if during the past month, other than a
regular job, he or she did not participate in any physical activities or exercises such as
running, calisthenics, golf, gardening, or walking for exercise.
Obesity
US by County, 2008*
* BRFSS data
Obesity, Mississippi by County
2008*
Madison Co. 29.9%
Mississippi 35.4%
US
27.2%
*BRFSS data
Diabetes, US by County, 2008*
*BRFSS data
Diabetes, Mississippi by County, 2008*
Madison Co. 10.6%
Mississippi 11.6%
US
8.3%
*BRFSS data
Chart 1
Health’s links to GDP
Poor health reduces GDP per capita by reducing both labor
productivity and the relative size of the labor force.
Higher fertility
and
child mortality
Higher
dependency ratio
Labor force reduced
by mortality and early
retirement
Lower
GDP
per capita
New evidence
coupled with a
wider
perspective
suggest sizable
Child fitness
Child
malnutrition
Reduced schooling
and impaired
cognitive capacity
Reduced labor
productivity
Adult fitness
and
malnutrition
Reduced access to
natural resources and
global economy
economic returns
to better health
Reduced investment
in physical capital
Source: Ruger, Jennier Prah, Dean T. Jamison, and David E. Bloom, 2001,
“Health and the Economy,” page 619 in International Public Health, edited by
Michael H. Merson, Robert E. Black, and Anne J. Mills (Sudbury,
Massachusetts: Jones and Barlett).
Bloom, Canning and Davidson 2004
http://www.imf.org/external/pubs/ft/fandd/2004/03/pdf/bloom.pdf
Health Consequences of Obesity
• Coronary heart disease
• Type 2 diabetes
• Cancers (endometrial,
breast, and colon)
• Hypertension (high blood
pressure)
• Dyslipidemia (for example,
high total cholesterol or
high levels of triglycerides)
• Stroke
• Liver and Gallbladder disease
• Sleep apnea and respiratory
problems
• Osteoarthritis (a degeneration
of cartilage and its underlying
bone within a joint)
• Gynecological problems
(abnormal menses, infertility)
Why Should Employers Care?
The Cost of Obesity is High:
• In 2008, the annual healthcare cost of obesity in the US was
estimated to be as high as 147 billion dollars a year, double the
amount a decade ago (28).
• Annual medical expenses for the obese are estimated to be 42
percent higher than for a person of a healthy weight (28).
 Workplace obesity prevention programs may be an effective way for
employers, including local governments, to reduce obesity, lower health
care costs, lower absenteeism, and increase employee productivity.
Settings for the Prevention and
Treatment of Obesity
•
•
•
•
•
Medical Settings
Home
School
Work Site
Community
Why Should Employers Get Involved?
Potential benefits to employers:
•
•
•
•
•
•
Reduces cost for chronic diseases
Decreases absenteeism
Reduces employee turnover
Improves worker satisfaction
Demonstrates concern for your employees
Improves morale
Why Should Employers Get Involved?
Potential benefits to your employees:
•
•
•
•
Ensures greater productivity
Reduces absenteeism
Improves fitness and health
Provides social opportunity and
source of support within the
workplace
Target Behaviors for Change
CDC focuses on six target behaviors for the
prevention of obesity and other chronic diseases
1. Increase physical activity
2. Increase consumption of fruits and vegetables
3. Increase breastfeeding initiation, duration, and
exclusivity
4. Decrease consumption of sugar sweetened
beverages
5. Decrease consumption of high energy dense,
nutrient poor, foods
6. Decrease television viewing (screen time)
Employer Health Strategies*
Health Impact
Health Fairs
Disease
&
Insurance Assessments Management
*Paul Jarris, MD, Director of ASTHO
Workplace
Health
Policies
Community
Health &
Wellness
Policies and Environmental Strategies
• Vending machines and cafeteria – healthy options
– fewer unhealthy options
• Point of decision prompts – reminders at the
elevators to take the stairs
• Time allowed for walking – and a convenient place
to do so
• Make the healthy choice the easy choice
“….it’s not about looking at healthcare as a cost for
someone else to manage, but rather health as an
investment that they need to leverage.”
“…the health of nations will impact the wealth of
nations. In fact, good health is good business.”
Loeppke, R. (2008), “The value of health and the power of prevention”,
International Journal of Workplace Health Management, vol. 1. No. 2, pp. 95-108.
Resources for Implementing Strategies and Measures
and Monitoring Performance
• CDC’s Recommended Community Strategies and Measurements
to Prevent Obesity in the United States, July, 2009
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5807a1.htm
• A detailed Implementation and Measurement Guide to assist
local governments, states, and policy makers in implementing the
CDC recommended strategies and reporting on the associated
measurements:
http://www.cdc.gov/obesity/downloads/community_strategies_g
uide.pdf
• CDC’s obesity cost calculator
http://www.cdc.gov/leanworks/costcalculator/index.html
• Measures incorporated into ICMA’s Center for Performance
Measurement system: http://www.icma.org/performance
Other Resources for Prevention
http://thomsonreuters.com/content/healthcare/pdf/w
hite_papers/Obesity_in_Workforce_Brief
Obesity in Workforce
http://www.countyhealthrankings.org/takeaction/employers-and-businesses
Recommendations for cost effective prevention
http://www.cdc.gov/nccdphp/dnpao/hwi/index.htm
CDC Healthier Worksite Initiative
http://www.cdc.gov/WinnableBattles/Obesity/ CDC
Nutrition, physical activity and obesity website