Snap Shot:  Health of the Region  2021

 

Snap shot: Health of the Region 2021  provides you with information that will help you be part of the healthcare conversation.  Taken together, the selected indicators reflect the overall health of the region and the efficiency and efficacy of U.S. health systems.

 

In order to achieve improvement in healthcare we need to get a snap shot of current state of the health of individuals, communities and our nation that can serve as a base on which to build. Reliable, timely data is crucial for an objective presentation of a given medical situation, not just to help the diagnosis, but also to decide on a course of treatment and monitor results. Data is crucial for transparency and accountability, the foundations of our democracy. The challenge with data is to agree upon what is important and relevant. It is not possible to have meaningful outcomes if the data is difficult to understand, unreliable and inconsistent and understood differently by the various stakeholders. Data is not an opinion; it is usually reproducible and verifiable.

 

Data is a tool for more informed decision-making about, not a decision itself. Data is crucial for scientific advancement, and in the policy arena crucial for comparison of options. Of course data, numbers can be manipulated to serve particular interests. It is nearly impossible to accurately project the future status of complex systems such as economics, human body, etc... The challenge is to present the information in a simplified manner that allows for utilization into the meaningful discussion and decision-making. Clarifying terms and concepts that are central to proper decision-making need to be aired and critically reviewed. Having an agreed upon base of data, or a way to challenge the data, will elevate the discussion to a more productive level, a more deliberative conversation built on respect rather than fear and that allows for problem solving. 

 

The snap shot section is divided into the following categories: 

 

  

Health and Healthcare Core Measures (Combination of the IOM Committee and US Health  Status )

 

HEALTH OUTCOMES 

 

1. Life expectancy:  Life expectancy is a validated, readily available, and easily understandable measure for a critical health concept. Because life expectancy depends on a full range of individual and community influences on health—from cancer to homicide—it represents an inclusive, high-level measure for health.

 

Maternal mortality 

Life expectancy at birth • (number of years that a newborn is expected to live if current mortality rates continue to apply). Steady increase in years of quality life for all Americans.

Infant mortality • (deaths of infants aged under 1 year per 1,000 live births)

Life expectancy at age 65 • (number of years of life remaining to a person at age 65 if current mortality rates continue to apply)

Violence and Injury related mortality • (age-adjusted mortality rates due to intentional and unintentional injuries)

 

2. Well-being: Well-being captures the subjective dimensions of health related to quality of life. Furthermore, levels of well-being often predict utilization of and satisfaction with health care. Self reported well-being is a reliable indicator

 

Self-reported health status • (percentage of adults reporting fair or poor health)

Unhealthy days physical and mental • (mean number of physically or mentally unhealthy days in past 30 days)

Chronic disease prevalence • (percentage of adults reporting one or more of six chronic diseases [diabetes, cardiovascular disease, chronic obstructive pulmonary disease, asthma, cancer, and arthritis]) Multiple chronic conditions

Serious psychological distress • (percentage of adults with serious psychological distress as indicated by a score of > 13 on the K6 scale, with scores ranging from 0-24) Depression

 

HEALTH-RELATED BEHAVIORS 

 

3. Overweight and obesity: More than two-thirds of Americans are overweight or obese, a fact that has causes and consequences that extend beyond the health system—including socioeconomic, cultural, political, and lifestyle factors.

 

Healthy eating patterns: Nutrition • (percentage of adults with a good diet [conformance to federal dietary guidance] as indicated by a score of > 80 on the Healthy Eating Index)

Obesity • (percentage of adults with a body mass index > 30)

Activity levels: Physical Activity • (percentage of adults meeting the recommendation for moderate physical activity [at least 5 days a week for 30 minutes a day of moderate intensity activity or at least 3 days a week for 20 minutes a day of vigorous intensity activity])

 

4. Addictive behavior: Addiction, including to nicotine, alcohol, and other drugs, is prevalent in the United States, representing a complex challenge for the health system, communities, and families. Every year, substance abuse and addiction cost the country more than $500 billion

 

Tobacco use: Smoking • (percentage of adults who have smoked > 100 cigarettes in their lifetime and who currently smoke some days or every day)

Alcohol dependence/ misuse: Excessive Drinking • (percentage of adults consuming four [women] or five [men] or more drinks on one occasion and/or consuming more than an average of one [women] or two [men] drinks per day during the past 30 days)

Drug dependence/illicit use

 

5. Unintended pregnancy: Unintended pregnancy, a significant challenge for both individual and community health, is a measure that aggregates a variety of social, behavioral, cultural, and health factors— particularly women’s knowledge about and access to tools for family planning.

 

Contraceptive use: Condom use • (proportion of youth in grades 9-12 who are sexually active and do not use condoms, placing them at risk for sexually transmitted infections)

 

6. Healthy communities: Individual health is a function of a wide range of socioeconomic and community factors, from infrastructure to social connections. Community health includes critical elements of health that fall outside the care system, such as housing, employment, and environmental factors.

 

Childhood poverty rate

Childhood asthma

Air quality index

Drinking water quality index

 

7. Preventive services: Preventive services (for example, screening for hearing loss or counseling for tobacco cessation) present a valuable opportunity for both improving health and reducing costs

 

Preventive services

Influenza immunization

Colorectal cancer screening

Breast cancer screening

 

Preventive services • (percentage of adults who are up-to-date with age-appropriate screening services and flu vaccination)

Childhood immunization • (percentage of children aged 19-35 months who are up-to-date with recommended immunizations)

 

HEALTH SYSTEMS 

 

8. Care access: A person’s ability to access care when needed is a critical precondition for a high quality health system. Factors that could hamper access to care include lack of health insurance, clinician shortages, lack of transportation, cultural and linguistic barriers, and physical limitations.

 

Usual source of care

Delay of needed care

Preventable hospitalizations • (hospitalization rate for ambulatory care-sensitive conditions)

Unmet medical, dental, and prescription drug needs • (percentage of [non-institutionalized] people who did not receive or delayed receiving needed medical services, dental services, or prescription drugs during the previous year)

 

9. Patient safety: Avoiding harm is among the principal responsibilities of the health care system, yet adverse outcomes are common. Ensuring patient safety will require a culture that prioritizes and assesses safety through a reliable index of organizational results.

 

Wrong-site surgery

Pressure ulcers

Medication reconciliation

 

10. Evidence-based care: Ensuring that patients receive care supported by scientific evidence for appropriateness and effectiveness is a central challenge for the health care system. Currently, an estimated one-third of U.S. health care expenditures do not contribute to improving health. Aggregating carefully selected and standardized clinical measures can provide a reliable composite index of system performance

 

Cardiovascular risk reduction

Hypertension control

Diabetes control composite

Heart attack therapy protocol

Stroke therapy protocol

Unnecessary care composite

 

11. Care match with patient goals: Systematically assessing each patient’s individual goals and perspectives ensures that the health care system is focusing on the aspects of care that matter most to patients.

 

Care match with patient goals

Patient experience

Shared decision making

End-of-life/advanced care planning

 

COST OF HEALTHCARE SERVICES

 

12. Personal spending burden: Care that is too expensive can limit access to care, lead people to avoid care, or prevent them from spending money in other areas of value to them—with far-reaching economic impacts.

 

Personal spending burden

Health care–related bankruptcies

 

13. Population spending burden: Health care spending consumes a large portion of the U.S. gross domestic product, dwarfing the health care spending of other nations. This burden can be measured at national, state, local, and institutional levels.

Health care expenditures • (per capita health care spending)

Insurance coverage • (percentage of adults without health coverage via insurance or entitlement)

 

Population spending burden

Total cost of care

Health care spending growth

 

14. Individual engagement: Given the effects of personal choices on health, as well as the increasing use of personal health devices, it is critical for individuals to be aware of their options and responsibilities in caring for their own health and that of their families and communities.

 

Involvement in health initiatives

 

15. Community engagement: Across the United States, communities have and utilize different levels of resources to support efforts to maintain and improve individual and family health—for example, addiction treatment programs, emergency medical facilities, and opportunities for social engagement.

 

Availability of healthy food

Walkability Community health benefit agenda