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Closing the Gap: Reducing Disparities & Achieving Health Equity
 

Closing the Gap: Reducing Disparities & Achieving Health Equity

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  • State & federal sources
  • AA/H/L children =3x AI children =2x AA/AI/ H/L families 3x more likely to live in poverty Fed poverty guidelines= family of 4 <$22K/yr

Closing the Gap: Reducing Disparities & Achieving Health Equity Closing the Gap: Reducing Disparities & Achieving Health Equity Presentation Transcript

  • National Academy for State Health Policy’s 23 rd Annual State Health Policy Conference Session: Closing the Gap: Reducing Disparities & Achieving Health Equity October 4-6, 2010 Barbara Pullen-Smith, MPH, Director Office of Minority Health and Health Disparities Division of Public Health NC Department of Health and Human Services Healthy Communities. Every One Matters.
  • Scotland Guilford Rockingham Moore Anson Union Richmond Mecklenburg Cabarrus Stanly Surry Ashe Wilkes Yadkin Forsyth Stokes Davidson Randolph Rowan Lincoln Cleveland Gaston Iredell Caldwell Alexander Catawba Burke McDowell Buncombe Rutherford Polk Madison Yancey Watauga Cherokee Graham Clay Macon Jackson Swain Avery Davie Montgomery Mitchell Henderson Transylvania Haywood Wake Granville Person Orange Lee Hoke Robeson Columbus Brunswick Pender Bladen Sampson Duplin Onslow Jones Lenoir Wayne Johnston Harnett Carteret Craven Pamlico Beaufort Hyde Tyrrell Dare Gates Hertford Bertie Martin Pitt Greene Wilson Nash Franklin Warren Halifax Northampton Edgecombe Vance Durham Alamance Cumberland Washington Currituck Camden Pasquotank Perquimans Chowan New Hanover Chatham Caswell Alleghany North Carolina
    • Quick Facts:
    • 100 counties
    • @ 9.3 million residents
    • High School Grad @ 78%
    • Median income @$47,000
    • Poverty @ 15%
    • 1.7million uninsured
  • North Carolina Population Estimates 2008 Data Source: National Center for Health Statistics & US Census Bureau 2008 Bridged Population Estimates
  • NC Office of Minority Health and Health Disparities- Research and Data Tools- Population Specific Fact Sheets www.schs.state.nc.us/SCHS or www.ncminorityhealth.org
  • Racial and Ethnic Health Disparities in North Carolina REPORT CARD 2010 Office of Minority Health and Health Disparities And State Center for Health Statistics North Carolina Department of Health and Human Services
  • Health Disparities Report Card 2010 Update
    • State Center for Health Statistics
    • Vital Records: Mortality Data
    • Behavioral Risk Factor Surveillance System (BRFSS)
    • Youth Risk Behavior Survey (YRBSS)
    • Pregnancy Risk Assessment Monitoring System (PRAMS)
    • NC Nutrition and Physical Activity Surveillance System (NC-NPASS)
    • American Fact Finder
    • US Census Bureau:
    • American Community
    • Survey
    • HIV/AID Surveillance
    • CHAMPS
    • Hospital Data
    • National Center for Health Statistics
    • NC Cancer Registry
    Data Collection Sources Include:
  • Health Disparities Report Card 2010 Update Focus Areas
    • Social and economic well-being
    • Maternal and Infant Health
    • Adult Health
    • Communicable Diseases
    • Violence and Injuries
    • Child and Adolescent
    • Health
    • Risk Behaviors and
    • Health Promotion
  • Health Disparities Report Card Disparity Ratio and Grades
      • 0.0 - 0.5 = A
      • 0.6 - 1.0 = B
      • 1.1 - 1.9 = C
      • 2.0 - 2.9 = D
      • 3.0 or Greater = F
    • In cases where the minority rates are better than the white comparison rate, the disparity ratio was not utilized, and the grade is reported as an “A.”
          • Source: NC Division Public Health Epidemiology Team; NC OMHHD Research Associate;
            • NC State Center for Health Statistics
    Guidelines Used to Assign Grades : Guidelines Used to Assign Grades
  • 2004-2008 Grade D Grade D Grade A Grade B Any Rate Ratios that are >1.0 indicate a Disparity Gap. Here, African American and American Indian babies are more likely to die at a higher rate than Whites. Data Source: State Center for Health Statistics
  • AA Grade F AI Grade D Asian Grade C H/L Grade F AA Grade F AI Grade F Asian Grade C H/L Grade F % Children < 18yrs Living Below Poverty % of Families Living Below Poverty 3 out of 4 racial/ethnic groups have children that live in poverty at least 2.5 times more often than the majority white population.
  •  
  • Grade D Grade C Grade D Grade F Grade D Grade F Ove Any Rate Ratios that are >1.0 indicate that African Americans are more likely to die at a higher rate than Whites. Data Source: State Center for Health Statistics Grade D
  •  
  • Grade C Grade C Grade C Grade C Grade C Grade F Grade D Any Rate Ratios that are >1.0 indicate that American Indians are more likely to die at a higher rate than Whites. Data Source: State Center for Health Statistics
  • Grade B Grade C Grade D Grade D Any Rate Ratios that are >1.0 indicate that Hispanic/Latinos are more likely to die at a higher rate than Whites. Data Source: State Center for Health Statistics
  • Grade A Grade C Grade A Grade A Grade A Grade A Any Rate Ratios that are >1.0 indicate that Asians are more likely to die at a higher rate than Whites. Ratios of <= 1 indicate that Asian death rates are equal to, or below those of Whites. Data Source: State Center for Health Statistics
    • Prevention for the Health of North Carolina: Prevention Action Plan
        • www.nciom.org
    • NC Healthy Carolinians 2010 Plan ( 2020 State Plan in progress)
        • www.healthycarolinians.org
    • Health Policy
      • 1987 First Race/Ethnicity Data Reports –State Center for Health Statistics –updates approximately every 3 years www.schs.state.nc.us /SCHS
      • 2009 Legislation- Health Providers Required to Report Race/Ethnicity Data ( self-reported)
    • NC Department of Health and Human Services (DHHS) Call To Action To Eliminate Health Disparities)
        • www.ncminorityhealth.org
    North Carolina’s Response
  • North Carolina’s Response continued
    • Division of Public Health, DHHS (state level)
        • http://ncpublichealth.com
    • Public Health Departments (county level profiles)
        • www.healthycarolinians.org
    • Community Based, Non Traditional Agencies
        • www.ncminorityhealth.org
    • Health Care “Safety Nets” (examples)
        • Office of Rural Health & Community Care www.ncdhhs.gov/orhcc
        • NC Community Health Association www.ncchca.org
        • NC Association of Free Clinics www.ncfreeclinics.org
  • Eliminating Health Disparities Performance Measures
    • Health Disparities Trend Data
    • NC Health Carolinians Plan Targets
    • Local Public Health Departments Accreditation
    • Healthy Carolinians Partnerships Certification/Recertification Standards
    • NC Prevention Action Plan- 11 Priorities
    • Department of Health and Human Services
        • Performance indicators and reporting requirements
  • Systems Change = Key
    • Based on 3 Guiding Principles:
    • Integration
    • Investment
    • Accountability
  • On Behalf of the NC OMHHD Thank You for Being a Partner in the Fight to Eliminate Health Disparities! Office of Minority Health and Health Disparities Division of Public Health NC Department of Health and Human Services 1906 Mail Service Center Raleigh, NC 27699-1906 (919)707-5040 www.ncminorityhealth.org Healthy Communities. Every One Matters.