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Edge of Amazing: Health & Well-being Monitor 2018 Results

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Edge of Amazing: Health & Well-being Monitor 2018 Results

  1. 1. Snohomish County 2018 State of Health & Well-being
  2. 2. Individual view: Healthcare spikes just before death Source: Robert Fogel, U. Chicago / AEI Forecasting the Cost of U.S. Healthcare, 2009
  3. 3. Source: Paul Fishbeck, Carnegie Mellon University, 2009 But others don’t experience the U.S. pattern.
  4. 4. AND most “high-cost patients” are not at end of life. • They come in waves. • In any given year, only 11% of highest- cost patients are in their final year of life. • 49% are having a discrete high-cost medical episode. • 62% won’t be in the top 5% next year.* Source: AHRQ/HHS, 2011; adjusted to include nursing home population (NCHS, 2013); *NIHCM Foundation 2012.
  5. 5. These cycles of healthcare & cost repeat many times over a lifetime.
  6. 6. Cycle of Healthcare We must disrupt the cycle itself. © 2017 Scott Forslund/ Providence Institute for a Healthier Community All Rights Reserved
  7. 7. Framework for Strategic Focus Outpatient Care Acute / In-patient Care Community Care – Social Determinants ©2017ScottForslund/ProvidenceInstituteforaHealthierCommunityAllRightsReserved Q1: Optimizing Well- Being Community Partnerships Q2: Managing Risk Community/ Healthcare Partnerships Acute Care Q3: Recovery & Reconnection Community/ Healthcare Partnerships Q4: Optimizing Well-Being Community Partnerships
  8. 8. Central Questions of PIHC’s Health & Well-being Monitor™ How do our county residents define their health & well- being? What resonates for them? What factors do residents find important to health & well-being? How satisfied are they with their own health &well- being? 8
  9. 9. Physical Health Emotional Health Learning & Growth Financial Security Relationships Community Access: Health Information Access: Medical Care Access: Transportation Eating Patterns Physical Activity Neighborhood Safety Housing Quality Access: Healthy Food Neighborhood: Physical Condition Meaningful Work Sense of Belonging to a Community Participation: Community Events Workplace Atmosphere Control Over Life Events Outlook on Life Sense of Purpose & Meaning Treatment by Others Racial or Ethnic Discrimination Our community defined health/wellbeing 24 ways
  10. 10. Security & Basic Needs: from the TotalHEALTH™ 7 30% of county respondents lack at least 1 basic need. Education accounted for about half.
  11. 11. #1 Factor- Personal Impact: Relationships with Family and Friends
  12. 12. 24 attributes map to Six Dimensions of Health & Well-being… …creating our roadmap to population health
  13. 13. Tailored Community HWB Monitor™ • A snapshot of your own community health & well-being • Benchmarks to compare to the county or similar communities • Insights into focus areas for improvement • Access to hyperlocal tools & resources • A way to monitor progress over time Countywide HWB Monitor Goal: • A standard measure of health & well- being for our county • Defined by our residents • Monitor & report changes annually • Unprecedented local insights • Help Snohomish County flourish A standard for health & well-being available to all
  14. 14. Core4™ Index: Down slightly in 2018 **Significant decline
  15. 15. Core4™ predicts poor physical health days
  16. 16. Core4™ predicts poor mental health days
  17. 17. Core4™ predicts debilitating health days
  18. 18. 2018 Core4™ Health & Well-being Index: “C” Scale: 0...1…2...3…4...5…6…7..8...9...10 2018: 75% 2017: 77% Flourishing ”A” Moderate-Good ”B-C” Struggling ”F” Challenged ”D”
  19. 19. Measuring ‘Can Do’ Bandura SeeToplineQuestionsQ18,Q8c When it comes to improving my health I could be doing … I could have a significant influence on decisions being made in my community 26% 25%49%
  20. 20. Measuring ‘Can Do’ Bandura SeeToplineQuestionsQ18,Q8c 19K 24K 13K 100K 81K 168K 71K 71K 173K 19K 37K 52K 216K 209K 406K 315K349K57K 109K HWB Index: 37% HWB Index: 67% HWB Index: 84% HWB Index: 97%
  21. 21. Measuring ‘Can Do’ Bandura SeeToplineQuestionsQ18,Q8c Getting By: 100K Getting Traction 305K Getting There 316K Getting Kudos: 108K Negative: Struggling to Challenged Positive: Good to Flourishing NO MORE CAN DO MORE
  22. 22. The Can-Do Progression GETTING BY 12% / 100,000 people GETTING TRACTION 37% / 305,000 people GETTING THERE 38% / 316,000 people GETTING KUDOS 13% / 109,000 people GIVING BACK HWB Index: 59% HWB Index: 65% HWB Index: 86% HWB Index: 91% HWB Index: 97%
  23. 23. Measuring ‘Can Do’ Bandura SeeToplineQuestionsQ18,Q8c Getting By: 100K Getting Traction 305K Getting There 316K Getting Kudos: 108K Struggling to Challenged Good to Flourishing NO MORE CAN DO MORE
  24. 24. Snohomish County ‘18 Highlights: Six Dimensions of Health™
  25. 25. Measuring ‘Can Do’: Getting BY: BETTY Bandura SeeToplineQuestionsQ18,Q8c Getting By: 100K Struggling to Challenged Good to Flourishing NO MORE CAN DO MORE
  26. 26. Measuring ‘Can Do’: Getting By / “Betty” HWB Index: 47% (F) “Struggling” Age: 57 years old (62% >55) Race: Caucasian (10% POC vs. 19% pop) Gender: 57% female Relationships: • Single, living alone (87% no kids) • Relationship difficulties (40%) • Isolated, not part of community (52%) • No sense of community efficacy (55%) Mental/emotional/spiritual: • Struggling emotionally (52%) • 3+ poor mental health days/mo (53%) Neighborhood & Environment • Very dissatisfied (41%, 2x population) • 0 exercise days/week (30%, 2x pop) Work/Learning & Growth: • Education: High School (77% no college) • Low income, $ insecure (66% <$25k/pc) • Part-time job, troubles (46%) • No sense of opps for growth (40%) Security/Basic Needs: • Housing concerns, Food insecurity (42%) • Social Needs (42% with 1+ SDOH needs) Physical Health: • Not happy with physical health (65%) • Chronic medical condition (55%) • 3+ poor health days/month • Sedentary; no exercise • <7 hours sleep most days (4x pop avg) “Just Getting By”: 100K people (12% of county), predominantly Everett, Marysville, Arlington/northeast
  27. 27. Measuring ‘Can Do’: Getting Traction: TRACY Bandura SeeToplineQuestionsQ18,Q8c Getting Traction 305K Struggling to Challenged Good to Flourishing NO MORE CAN DO MORE
  28. 28. Measuring ‘Can Do’: Getting Traction/ “Tracy” HWB Index: 64% “D” Challenged Age: 29 (#2nd Millennials cohort @ 30%) Race: Caucasian (13% POC vs. 19% pop) Gender: 57% female Relationships: • Married, 2 kids (35% couples/kids) • Relationship OK (25% excel vs. 45%) • Not community connected - yet (56%) • Lowest community efficacy (63% no) Mental/emotional/spiritual: • Emotional challenges (41%) • Struggle w/ purpose (72% “no/some”) • 3+ poor mental health days/mo (52%) Neighborhood & Environment • OK (41% Unhappy, 2x population) Work/Learning & Growth: • Education: HS, college (like pop overall) • Low income, $ insecure (44% <$25k/pc) • Risk of job loss (17%; 2x population) • Sees opps for growth (43% positive) Security/Basic Needs: • High Social Needs (40%; @ 2x overall population) • ~Education, transportation, job Physical Health: • Highest phys hlth dissatisfaction (70%) • Risk of Chronic medical condition (42%) • 1+ poor health days/month (63%) • Workout 1-3 days/wk (53%) • <7 hours sleep 1-3 days/wk (39%) “Getting Traction”: 305K people (37% of county), predominantly Everett, Monroe-east, Lake Stevens/Granite, Marysville
  29. 29. Measuring ‘Can Do’: Getting There: TED Bandura SeeToplineQuestionsQ18,Q8c Getting There 316K Struggling to Challenged Good to Flourishing NO MORE CAN DO MORE
  30. 30. Measuring ‘Can Do’: Getting There/ “Ted” HWB Index: 86% “B” Good Age: 39 (Highest Millennials cohort @ 32%) Race: African Amer (32% POC) Gender: 55% male Relationships: • Married, 1 child (73% couples/kids) • Excellent relationships (68% v. 45% pop) • Community connected - yet (65%) • Solid community efficacy (61%) Mental/emotional/spiritual: • Mental/emotionally stable (98% pos.) • Hi purpose/meaning (55% “fits exact”) • 0-1 poor mental health day/mo (56%=0) Neighborhood & Environment • Good (11% Unhappy, half county rate) Work/Learning & Growth: • Education: college grad (highest college/grad school rate @ 43%) • Good income, $ secure (48% >$100K/HH; 3% job worries) • Strong job satis (85% positive) • Strong learning/growth (56% “excell”) Security/Basic Needs: • Rare social needs (97% 0-1) Physical Health: • Satisfied (55% moderate; 45% highly) • No medical condition (80%) • Rare poor health days/mo (60%=0) • Workout 4-6+ days/wk (68%=4+) • <7 hours sleep most days/wk (70%) “Getting There”: 316K people (37% of county), predominantly Bothell, Edmonds, Snohomish
  31. 31. Measuring ‘Can Do’: Getting Kudos: KURT Bandura SeeToplineQuestionsQ18,Q8c Struggling to Challenged Good to Flourishing NO MORE CAN DO MORE Getting Kudos: 109K
  32. 32. Measuring ‘Can Do’: Getting Kudos/ “Kurt” HWB Index: 91% “A-” Flourishing Age: 54 (66% 35-64) Race: Caucasian (7% POC vs. 19% pop) Gender: 59% male Relationships: • Couple no kids home (49% - highest) • Relations thriving (76% excel vs. 45%) • Deep community (57% “exactly”) • Highest community efficacy (75% yes) Mental/emotional/spiritual: • Emotionally thriving (72%; 2x pop) • Hi life purpose/meaning (88% “exact”) • 0 poor mental health days/mo (71%) Neighborhood & Environment • Loves it (71%, 1.7x avg population) Work/Learning & Growth: • Education: Some college (44%, highest) • Income, $ insecure (49% >100k/PC) • No job fears (99%) • Hi growth potential (91% positive) Security/Basic Needs: • No basic/social Needs (98%) • Excellent healthcare access (87%) Physical Health: • Highly satisfied (64% ‘excel’) • No chronic medical condition (78%) • Fewest poor health days/mo (75%=0) • Workout near daily (45% daily; highest) • Most sleep (49%=7+ hrs daily; 75%=most days) “Getting Kudos”: 109K people (13% of county), predominantly Arlington, Lynnwood, Snohomish
  33. 33. What would make life better? * *
  34. 34. Discrimination: major rise in ‘18
  35. 35. Physical health • Chronic inflammation • High blood pressure* • Diabetes* • Declines in kidney function* • Increased breast cancer* • Heart disease* • Stroke* Mental/emotional well-being • Chronic stress • Mental health issues such as anxiety and depression in children • Loneliness** • Bereavement** • PTSD** • Dementia** Discrimination Rising: strongest biological impact on youth, life-time results *Franceschi & Campisi, 2014 **Slavich & Cole, 2013
  36. 36. Discrimination is poisoning our children.
  37. 37. Discrimination, Well-being, and Health “A threatening childhood and adolescent milieu indicates a need to be vigilant and on guard… …fosters calibration of the immune system to a hypersensitive mode. This early programming is predicted to: • foster vigilance and elevated inflammation through-out the life course. • amplify the effects of adult exposure to potentially racist events.” Source: Simons, Barr, Gibbons, October 2018
  38. 38. Discrimination, Well-being, and Health “A medical/public health model that restricts its focus to increasing socio-economic status and reducing health risk behaviors is likely to have little impact on the ill health of Black Americans.” Source: Simons, Barr, Gibbons, October 2018
  39. 39. • National Association for the Advancement of Colored People (NAACP) • Greater Trinity Academy & Church • Forest Park SDA Church • Latino Educational Training Institute • Community Health Center of Snohomish County • United Way Collaborative: Improving School Attendance for Families in Transition • Everett AMEN Clinic (medical & community) • Cascade Valley Health Foundation (Stilly Valley) • Interfaith • Everett Housing Authority • Providence Northwest Service Area Community HWBM – underway & exploring in 2018

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