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Join the conversation now: #HHSDataFest
Advancing Social Determinants of Health with Let’s Get Healthy California
and Cali...
Rethinking Health
Rank state/territory Overall
1 Japan 82.73
2 Switzerland 81.81
3 Hong Kong 81.61
4 Australia 81.44
5 Italy 81.37
6 Iceland...
Life expectancy in
California
by race/ethnicity
2006-2008
What do we know?
Health is not distributed evenly in
US.
Health
Behaviors
30-40%
Underlying
Determinants
of Health
20-50%
Medical
Care
10-20%
“Behavioral risk factors”
People’s behavior is shaped by the real life choices and
opportunities available to them where t...
Choices?
Neighborhood Conditions
“It is necessary that properties shall continue to
be occupied by the same social and racial
groups”- Federal Housing Admi...
Social Determinates of Health
Conditions in the social, physical, and economic environment in which
people are born, live,...
“Health equity is achieving the highest level of health for all
people.”
Everyone should have the opportunity to make the
...
Measuring health
Indicators of Health
• Mortality rates
• Diseases
• Disability
• Medical care
• DALYs
• QALY
• Risk behaviors
• Poverty ra...
Infant Mortality
Data Source
birth certificate
New tools
• Open data
• Geocoding
• Mapping
Recipients as of Oct 2006.
High school grads: 90%
Unemployment: 4%
Poverty: 7%
Home ownership: 64%
Non-White: 49%
High school grads: 81%
Unemployment: 6%
Poverty: 10%
Home ownership: 52%
Non-White: 59%
High school grads: 65%
Unemployment: 12%
Poverty: 25%
Home ownership: 38%
Non-White: 89%
Life Expectancy—
Oakland Flats and Hills (2000-2003)
Alameda County
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
LifeExpectancy(Years)
San Francis...
Let’s get Healthy California
The Guiding Questions
What will it look
like if California is
the healthiest
State in the
Nation?
Better Care for
Individuals
Better Health for
Populations
Lower Costs
National Strategy for Quality (2011), National Preve...
Indicators
• 39 Indicators
• 10 Year targets
Report Issued December 2012
Data
Innovation
&
Communication
Website
- Public reporting
- Interaction & collaborative engagement
- Promising interventi...
Let’s Get Healthy California
Website
Let’s Get Healthy California
Innovation Conference
Innovations Finalists
• Rx Safe Marin
Matt Willis, MD, MPH, Public Health Officer,
Marin County
• Walk with Friends
Debra ...
RxSafe Marin:
Using Data to Mobilize a
Community Coalition
Matt Willis, MD MPH
Public Health Officer
Marin County
What can we do as a community to
prevent prescription drug misuse and
abuse and save lives?
Comprehensive Approach
Prevention
Education
Surveillance
Monitoring
Diversion
Control
Law
Enforcement
Treatment
Recovery
Community Based
Prevention
Action Team
Data Collection and
Monitoring
Action Team
Law Enforcement Action
Team
Intervention...
Strategic Goal for Data Action Team
• Problem: An Epidemic Without a Surveillance System
• Vision: Marin County will have ...
1. Consulted with federal, state, and other local jurisdictions
2. Contacted local agencies to determine available county-...
Resources
Example of Potential Indicator: Opioid-Related Emergency
Department Visits
Why this matters:
The Centers for Disease Contr...
State Data Sources
• Emergency Department
visits
• Hospitalizations
Office of Statewide Health Planning
and Development (O...
Local Data Sources
• Drug possessionsOffice of the District Attorney (DA)
• Safely disposed
Prescription
Medications
Envir...
Report Card Draft
Beyond the PDF: Livestories
• The Public as Data
Consumers
• Infographics
• Social Math
• Website
• Social Media
Stay connected!
www.RxSafeMarin.org
Facebook.com/RxSafeMarin
RxSafeMarin@gmail.com
THANK YOU!
“There is nothing new about poverty. What
is new is that we now have the techniques
and the resources to get rid of povert...
• 12.7% of households are food insecure
• There are 349,690 people living with food
insecurity
• 1 in 5 children face food...
Child Poverty Rates in California Counties
County or County Group Child Poverty Rate (%) County or County Group Child Pove...
Food Recovery
Educate restaurants and grocery stores on the
Good Samaritan Act to increase food
donations.
Food Distributi...
Targeting the cities of Anaheim and Orange
253 tons (390,000 meals)
of newly recovered food
Updated 10/31/15
Screening Tool to Determine
Level of Food Insecurity
• “Within the past 12 months we worried whether our food would run
ou...
Interactive Google Pantry Map of Orange County
Join the conversation now: #HHSDataFest
Interactive Activity: Enhancing Incentives for State and Local
Government to Use D...
Creating Person Centered Services
and Coordinating the San Diego Region
Achieving Community Health
John Ohanian, President...
The Complex Community that We Live in…
• 4,261 square miles (larger than 21 U.S.
States; same size as Connecticut)
• 5th l...
Building
Better
Health
Living
Safely
Thriving
BEHAVIORS DISEASES PERCENT
Leadto
Resultin
Morethan
No Physical Activity
Poor Diet
Tobacco Use
Cancer
Heart Disease & Stro...
Areas of
Influence
Definition Top 10 Indicators
Enjoying good health and
expecting to live a full life
• Life Expectancy
•...
The County of San Diego’s ConnectWellSD will enrich the lives of individuals and families
through collaboration.
ConnectWe...
It all begins with one person, one family
Housing/Shelter
TransportationHealthcare
Food
Assistance
Financial
Assistance
Connecting San Diego Healthcare
Lab Companies
Health Plans
Home Health
Nursing Homes
EMS
Public Health
Agencies
Behavioral...
Connecting Service Providers
Public Benefits
Housing
Health Benefits
Military / Veteran
Services
Meals
Community Services
...
Regional Information Exchange
Cross-Sector –
Vertical insights across social,
health and government
sectors
Community-wide...
Regional Information Exchange virtually integrates with its participants to enable the automation of secure,
private, flow...
Without restrictions
from copyright,
patents or other
mechanisms
Freely available for
everyone
to use
Movement towards Ope...
Challenges and Roadmap to Success
Trust and Relationships
Interoperability
Privacy and Consent
Training and
Re-training
What do you think?
Achieving Community Health
John Ohanian, President & CEO, 2-1-1 San Diego/Imperial
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
Open DataFest III - 3.14.16 - Day One Afternoon Sessions
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Open DataFest III - 3.14.16 - Day One Afternoon Sessions

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Slide presentations delivered during the afternoon sessions of Day One of the California Statewide Health and Human Services Open DataFest - March 14 - 15, 2016, Sacramento, CA

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Open DataFest III - 3.14.16 - Day One Afternoon Sessions

  1. 1. Join the conversation now: #HHSDataFest Advancing Social Determinants of Health with Let’s Get Healthy California and California Open Data Intiatives Karen L. Smith, Director and State Health Officer, CDPH Matt Willis, Rx Safe Marin Debra S. Oto-Kent, Walk with Friends Eric G. Handler, WasteNotOC
  2. 2. Rethinking Health
  3. 3. Rank state/territory Overall 1 Japan 82.73 2 Switzerland 81.81 3 Hong Kong 81.61 4 Australia 81.44 5 Italy 81.37 6 Iceland 81.28 7 France (metropol.) 80.95 8 Sweden 80.88 9 Israel 80.69 10 Singapore 80.60 11 Canada 80.54 12 Spain 80.48 13 Norway 80.45 14 Austria 80.24 15 Netherlands 80.20 16 New Zealand 80.13 17 Martinique ( France) 80.07 18 Macau 80.03 19 South Korea 80.00 20 Germany 79.85 Rank state/territory Overall 21 Belgium 79.77 22 Ireland 79.68 23 United Kingdom 79.53 24 Greece 79.52 25 Channel Islands ( UK) 79.51 26= Luxembourg 79.39 26= Guadeloupe ( France) 79.39 28 Finland 79.34 29= Cyprus 78.94 29= U.S. Virgin Islands ( US) 78.94 31 Costa Rica 78.87 32 Malta 78.80 33 Puerto Rico ( US) 78.70 34 Chile 78.65 35= Portugal 78.59 35= Slovenia 78.59 37 Cuba 78.50 38 Denmark 78.25 39 Taiwan 78.19 40 United States 77.97 41 Qatar 77.88 What do we know? Overall health isn’t determined by how much we spend.
  4. 4. Life expectancy in California by race/ethnicity 2006-2008 What do we know? Health is not distributed evenly in US.
  5. 5. Health Behaviors 30-40% Underlying Determinants of Health 20-50% Medical Care 10-20%
  6. 6. “Behavioral risk factors” People’s behavior is shaped by the real life choices and opportunities available to them where they live, work, learn, and play.
  7. 7. Choices?
  8. 8. Neighborhood Conditions
  9. 9. “It is necessary that properties shall continue to be occupied by the same social and racial groups”- Federal Housing Administration Underwriting Manual 1938 in recommending racially restrictive covenants.
  10. 10. Social Determinates of Health Conditions in the social, physical, and economic environment in which people are born, live, work, and age. They consist of policies, programs and institutions and other aspects of the social structure, including the government and private sectors, as well as community factors.” Healthy People 2020: An Opportunity to Address Societal Determinants of Health in the U.S., Objectives for 2020, July 11, 2010
  11. 11. “Health equity is achieving the highest level of health for all people.” Everyone should have the opportunity to make the choices that allow them to live a long, healthy life, regardless of their income, education or ethnic background. Sources: Virginia Department of Public Health RWJF: Vulnerable Populations Portfolio
  12. 12. Measuring health
  13. 13. Indicators of Health • Mortality rates • Diseases • Disability • Medical care • DALYs • QALY • Risk behaviors • Poverty rates • Educational attainment • Incarceration rates • Environmental toxins • Built environment • Food insecurity • etc
  14. 14. Infant Mortality Data Source birth certificate
  15. 15. New tools • Open data • Geocoding • Mapping
  16. 16. Recipients as of Oct 2006.
  17. 17. High school grads: 90% Unemployment: 4% Poverty: 7% Home ownership: 64% Non-White: 49%
  18. 18. High school grads: 81% Unemployment: 6% Poverty: 10% Home ownership: 52% Non-White: 59%
  19. 19. High school grads: 65% Unemployment: 12% Poverty: 25% Home ownership: 38% Non-White: 89%
  20. 20. Life Expectancy— Oakland Flats and Hills (2000-2003)
  21. 21. Alameda County 50 55 60 65 70 75 80 85 90 95 100 0% 10% 20% 30% 40% 50% 60% Poverty Rate LifeExpectancy(Years) San Francisco County 50 55 60 65 70 75 80 85 90 95 100 0% 10% 20% 30% 40% 50% 60% Poverty Rate LifeExpectancy(Years) Contra Costa County 50 55 60 65 70 75 80 85 90 95 100 0% 10% 20% 30% 40% 50% 60% Poverty Rate LifeExpectancy(Years) Tract Poverty vs. Life Expectancy
  22. 22. Let’s get Healthy California
  23. 23. The Guiding Questions What will it look like if California is the healthiest State in the Nation?
  24. 24. Better Care for Individuals Better Health for Populations Lower Costs National Strategy for Quality (2011), National Prevention Strategy (2011), California County Health Rankings, Commonwealth Fund on Local Health System Performance Reviewed National and State Reports Informed Development of Priorities, Goals and Targets Health Equity Focus Foundation to the Process
  25. 25. Indicators • 39 Indicators • 10 Year targets Report Issued December 2012
  26. 26. Data Innovation & Communication Website - Public reporting - Interaction & collaborative engagement - Promising interventions - Moving the needle - Stakeholder participation LGHC: Three Core Components - Data structure & visualization - Data stories & analysis
  27. 27. Let’s Get Healthy California Website
  28. 28. Let’s Get Healthy California Innovation Conference
  29. 29. Innovations Finalists • Rx Safe Marin Matt Willis, MD, MPH, Public Health Officer, Marin County • Walk with Friends Debra S. Oto-Kent, MPH, Founder, Executive Director, Health Education Council • WasteNotOC Eric G. Handler MD, MPH, Health Officer, Deputy Agency Director, Health Care Agency 2016 Innovations Conference
  30. 30. RxSafe Marin: Using Data to Mobilize a Community Coalition Matt Willis, MD MPH Public Health Officer Marin County
  31. 31. What can we do as a community to prevent prescription drug misuse and abuse and save lives?
  32. 32. Comprehensive Approach Prevention Education Surveillance Monitoring Diversion Control Law Enforcement Treatment Recovery
  33. 33. Community Based Prevention Action Team Data Collection and Monitoring Action Team Law Enforcement Action Team Intervention, Treatment and Recovery Action Team Steering Committee: Data, Messaging, Policy Representatives from: Marin County Office of Education, Marin County Prescription Drug Abuse Task Force, Healthy Marin Partnerships Backbone Support: HHS Prescribers and Pharmacists Action Team
  34. 34. Strategic Goal for Data Action Team • Problem: An Epidemic Without a Surveillance System • Vision: Marin County will have county-wide relevant data on prescription drug misuse and abuse • Develop a report card with 5-10 key data elements to track prospectively • Engage community in selection of indicators of greatest relevance
  35. 35. 1. Consulted with federal, state, and other local jurisdictions 2. Contacted local agencies to determine available county-specific data 3. Compiled data and presented potential indicators • “Why this matters” • Results • Data source 4. Stakeholders voted on which indicators to include in the report card Steps for Choosing Report Card Indicators
  36. 36. Resources
  37. 37. Example of Potential Indicator: Opioid-Related Emergency Department Visits Why this matters: The Centers for Disease Control and Prevention (CDC) reports that drug misuse and abuse causes almost three million emergency department (ED) visits annually. More than half of these are related to pharmaceuticals. Compared to deaths, non fatal ED visits are a more frequent and more sensitive indicator of community burden of opioid related harm. Results: Indicator 2006 2007 2008 2009 2010 2011 2012 2013 Non-Fatal Opioid- Related Emergency Department Visits 198 222 289 300 295 344 471 352 Data Source: Office of Statewide Health Planning & Development (OSHPD). Emergency Department Data. Prepared by California Department of Public Health, Safe and Active Communities Branch
  38. 38. State Data Sources • Emergency Department visits • Hospitalizations Office of Statewide Health Planning and Development (OSHPD) • Controlled substance Prescription California Department of Justice/ Controlled Substance Utilization Review and Evaluation System (CURES) • Drug poisoningsVital Statistics • Treatment admissions California Outcomes Measurement System (CalOMS) Treatment Agency Type
  39. 39. Local Data Sources • Drug possessionsOffice of the District Attorney (DA) • Safely disposed Prescription Medications Environmental Health Services (EHS)/ Drug Enforcement Agency (DEA) • Naloxone doses administered Emergency Medical Services (EMS) Agency Type
  40. 40. Report Card Draft
  41. 41. Beyond the PDF: Livestories
  42. 42. • The Public as Data Consumers • Infographics • Social Math • Website • Social Media
  43. 43. Stay connected! www.RxSafeMarin.org Facebook.com/RxSafeMarin RxSafeMarin@gmail.com THANK YOU!
  44. 44. “There is nothing new about poverty. What is new is that we now have the techniques and the resources to get rid of poverty. The real question is whether we have the will.” -Martin Luther King Jr.
  45. 45. • 12.7% of households are food insecure • There are 349,690 people living with food insecurity • 1 in 5 children face food insecurity Source: (Feeding America. Map the Meal Gap 2013.) Food Insecurity Statistics Orange County
  46. 46. Child Poverty Rates in California Counties County or County Group Child Poverty Rate (%) County or County Group Child Poverty Rate (%) Merced 40.6 Colusa, Glenn, Tehama, Trinity 21.7 Fresno 36.4 Shasta 21.7 Tulare 36.3 Yolo 21.3 Lake, Mendocino 35.2 Solano 20.8 Kern 35 San Diego 19.6 Imperial 32.7 San Luis Obispo 19.2 Stanislaus 32.4 Santa Barbara 19 Madera 30.7 Orange 18.4 Del Norte, Lassen, Modoc, Siskiyou, 29 Ventura 16.8 Kings 28.7 Sonoma 16.1 Butte 26,4 Alameda 15.8 Los Angeles 26.3 Contra Costa 15.6 Sutter, Yubs 26 San Francisco 15.4 San Joaquin 25.2 Santa Cruz 14.3 Sacramento 25.2 El Dorado 14.2 Humboldt 24.7 Nevada, Plumas, Sierra 12.7 San Bernardino 24.6 Santa Clara 12.2 Alpine, Amador, Calaveras, Inyo, Mariposa, Mono, Tuolumne 22.6 Marin 10.5 Riverside 22.1 Placer 9.7 Monterey, San Benito 22 San Mateo 8.6 Napa 21.9
  47. 47. Food Recovery Educate restaurants and grocery stores on the Good Samaritan Act to increase food donations. Food Distribution Connect those in need with pantries that provide wholesome food. Identify those in need Start asking the questions if individuals are facing food insecurity. 3-Pronged Approach
  48. 48. Targeting the cities of Anaheim and Orange 253 tons (390,000 meals) of newly recovered food Updated 10/31/15
  49. 49. Screening Tool to Determine Level of Food Insecurity • “Within the past 12 months we worried whether our food would run out before we got money to buy more” Often True Sometimes True Never True • “Within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.” Often True Sometimes True Never True Development and Validity of a 2-Item Screen to Identify Families at Risk: Pediatrics 2010;126;e26
  50. 50. Interactive Google Pantry Map of Orange County
  51. 51. Join the conversation now: #HHSDataFest Interactive Activity: Enhancing Incentives for State and Local Government to Use Data More Effectively Facilitator: Shell Culp, Chief Innovation Officer, Stewards of Change Institute
  52. 52. Creating Person Centered Services and Coordinating the San Diego Region Achieving Community Health John Ohanian, President & CEO, 2-1-1 San Diego/Imperial
  53. 53. The Complex Community that We Live in… • 4,261 square miles (larger than 21 U.S. States; same size as Connecticut) • 5th largest U.S. County, 2nd largest in CA • 18 municipalities; 36 unincorporated towns • 18 tribal nations • 42 school districts • 2013 Estimates - 3.1 million population • 48% White • 32% Latino • 11% Asian/PI • 4.7% African American • 0.5% American Indian • Region is very diverse • Over 100 languages • Large military presence • Largest refugee resettlement site in CA • Busiest international border crossing in the world (San Ysidro/MX)
  54. 54. Building Better Health Living Safely Thriving
  55. 55. BEHAVIORS DISEASES PERCENT Leadto Resultin Morethan No Physical Activity Poor Diet Tobacco Use Cancer Heart Disease & Stroke Type 2 Diabetes Lung Disease of Deaths in San Diego
  56. 56. Areas of Influence Definition Top 10 Indicators Enjoying good health and expecting to live a full life • Life Expectancy • Quality of Life Learning throughout the lifespan • Education Having enough resources for a quality life • Unemployment Rate • Income Living in a clean and safe neighborhood • Security • Physical Environment • Built Environment Helping each other to live well • Vulnerable Population • Community Involvement N G R E S U L T S 7 6
  57. 57. The County of San Diego’s ConnectWellSD will enrich the lives of individuals and families through collaboration. ConnectWellSD is implementing a person-centered service approach and a new technology system to link enterprise-wide customer data and service information.
  58. 58. It all begins with one person, one family Housing/Shelter TransportationHealthcare Food Assistance Financial Assistance
  59. 59. Connecting San Diego Healthcare Lab Companies Health Plans Home Health Nursing Homes EMS Public Health Agencies Behavioral Health Providers Schools Patients and Caregivers Community Health Centers Pharmacies Physician Practices Hospitals
  60. 60. Connecting Service Providers Public Benefits Housing Health Benefits Military / Veteran Services Meals Community Services Utility Assistance Financial Literacy Programs Crisis Services Disaster Coordination Aging Services Childcare Transportation
  61. 61. Regional Information Exchange Cross-Sector – Vertical insights across social, health and government sectors Community-wide Holistic Easily Accessible High volume Community Backbone Efficient
  62. 62. Regional Information Exchange virtually integrates with its participants to enable the automation of secure, private, flow of information between regional service and healthcare providers to: Greatly Enhance Care Coordination Reduce the Cost to provide services Improve the Quality of care Achieve Improved Population Health Regional Information Exchange Partnership
  63. 63. Without restrictions from copyright, patents or other mechanisms Freely available for everyone to use Movement towards Open Data Interoperability denotes the ability of diverse systems and organizations to work together (inter-operate). In this case, it is the ability to interoperate - or intermix - different datasets. Open Data
  64. 64. Challenges and Roadmap to Success Trust and Relationships Interoperability Privacy and Consent Training and Re-training
  65. 65. What do you think? Achieving Community Health John Ohanian, President & CEO, 2-1-1 San Diego/Imperial

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