Paul Johnson, Director of the Institute for Fiscal Studies, gives an overview of how public spending is distributed and where health fits within the total spending picture.
Paul Johnson, Director of the Institute for Fiscal Studies, gives an overview of how public spending is distributed and where health fits within the total spending picture.
Ray Baxter from Kaiser Permanente's Community Benefit presented at the Bay Area Open Space Council's 2011 conference. More about the conference here: http://openspacecouncil.org/upload/page.php?pageid=53
Primary Health Care, Objectives, Principles and Policy DirectionsHealth and Labour
Presentation by Dr.Hans Kluge e.a., director of Health Systems, WHO-Euro at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
Ray Baxter from Kaiser Permanente's Community Benefit presented at the Bay Area Open Space Council's 2011 conference. More about the conference here: http://openspacecouncil.org/upload/page.php?pageid=53
Primary Health Care, Objectives, Principles and Policy DirectionsHealth and Labour
Presentation by Dr.Hans Kluge e.a., director of Health Systems, WHO-Euro at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
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A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
1. County Health Rankings & Roadmaps:
A healthier nation, county by county
Dec. 13, 2011
ACHIEVE Webinar
Karen Odegaard, MPH
Karen.Odegaard@match.wisc.edu
Community Engagement Specialist
UW Population Health Institute
27. Next Steps
Use the Rankings as a
Call to Action
Engage key partners
27
28. Key Messages
• Annual county health check-up
• Where we live matters to our health
• There are great disparities in health based on where we live
• Much of what influences our health happens outside of the
doctor’s office
• Health is everyone’s business
• We all need to work together
28
30. The County Health
Rankings & Roadmaps Team
• The Wisconsin Team
– Including Patrick Remington, Bridget Booske Catlin,
David Kindig, Julie Willems Van Dijk, Amanda Jovaag
• Robert Wood Johnson Foundation
– Including Abbey Cofsky, Brenda Henry, Michelle
Larkin, Jim Marks, Joe Marx, Pamela Russo
• Our Partners
– Including Burness Communications, CDC, NCHS,
ASTHO, NACCHO, NNPHI, Leah Devlin, Dartmouth
Institute, 11-member Metrics Advisory Group,
Roadmaps to Health Advisory Group, and Community
Catalyst
30
POLL: COUNTY AND STATEKEY POINTS- County Health Rankings & Roadmaps is a collaborative program between the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. - Rankings show that where we live, learn, work and play matters to our health. Much of what influences our health happens outside the doctor’s office – from access to healthy food or opportunities for physical activity to education and jobs.- Roadmaps showhow to take collective community action through programs and policies that will have the greatest impact.- The purpose of this presentation is to provide you with an general overview of County Health Rankings & Roadmaps.Before we begin I’d like to share with you why this work is so important to me.
By end of presentation you will know:Why we rankWhat we rankHow to use Rankings to take action[CLICK]So, let’s start with why we rank.
The Rankings serve as a call to action. The purpose of the County Health Rankings is to help ignite discussion and action at the local level regarding community health improvement. They do this by: Image source: Clip art
Simplifying complex data.Rankings are way to take number of different pieces data & simplify them.They provide a quick & easy snapshot of a community’s health. Help counties see where they are doing well and where they are not so they can make changes to improve health. Image source: http://multimedia.journalism.berkeley.edu/tutorials/intro-dataviz/
The County Health Rankings show us health is everyone’s business, because where we live, learn, work and play influences how healthy we are and how long we live. For example, having health insurance and quality medical care are important but access to healthy food, opportunities for physical activity, education, jobs, all have an even greater influence. Image sources (clockwise from top left): www.countyhealthrankings.org; Flickr Creative Commons: emurray; www.countyhealthrankings.org; Flickr Creative Commons: Old Shoe Woman; Flickr Creative Commons: reallyboring
Rankings serve as hook, get our attention. We’re competitive, like to know who’s winning, who’s not, who’s doing better than others. That hook generates media coverage. This is good because it helps people understand the health status of their community. It also provides an opportunity for people to tell the story of the many factors that affect health in a community.These are just a few places where you could find coverage about the 2011 Rankings.
Rankings add context. A number by itself doesn’t tell much. Rankings allow communities to compare themselves with others within their state. When we look at the state of Minnesota here, we can quickly see how counties compare with one another within the state. Counties can also compare to national benchmarks on individual measures.
Rankings report is starting point for discussion in communities, not ending point. Communities will want to dig into local data to further understand what’s going on in order to know where and how to take action.Image source: http://www.myparkingsign.com/
So, we know that the Rankings are intended to be a call to action, but what are the Rankings?
Let’s look at the thinking behind the County Health Rankings & Roadmaps. We gather population based data. All data for Rankings already collected somewhere else.We compute County Health Rankings & release them. Release attracts media attention.Local public health officers and other community leaders use County Health Rankings report as call to action for community.They bring together community members from wide variety of sectors to look further at community’s needs.Community members identify evidence informed health policies and programs that can be implemented locally.As a result, ultimately the health of the community improves.
The Rankings model looks at the multiple factors that influence health. It shows health outcomes in the green boxes, Health factors in the blue boxes and programs and policies. For each county, you will find twoRankings, one on Health Outcomes and one on Health Factors. We believe that there are two separate sets of messages to convey. One set addresses how healthy a county currently is and the other addresses how healthy a county might be in the future based on the many factors that influence health. If you’re looking for a single ranking of the “healthiest” counties, we use the health outcomes rank.So, let’s take a minute to WALK through the model in some detail. I am not going to dive too deeply into all 27 measures and their data sources, but I will show you how to find this information on our website.
We say Health Outcomes are “measures of today’s health.” We look at two types of health outcomes.1) how long people live (mortality) 2) how healthy people feel (morbidity). Each count for 50% of total Health Outcomes score for a county.“How long people live” is measured by premature death or more specifically, the years of potential life lost before age 75.“How healthy people feel” is drawn from four measures: three measures from the Behavioral Risk Factor Surveillance System (BRFSS) data that measure the health-related quality of life and low birthweight.Health outcomes are influenced by a variety of health factors.
We think of Health Factorsas “Tomorrow’s Health” (the blue boxes – health factors). These are factors that determine how long people live and quality of their lives. The blue boxes are the actionable things communities can work on now to help improve their future.
We look at four types of health factors: health behaviors, clinical care, social and economic, and physical environment factors. Within each factors, we look at some specific focus areas. In turn, each of these focus areas arebased on several measures. We’ll look at those specific measures a little more when we tour the Website, but for now we’re going to look at each health factor and its focus areas.Note – it is important to note, that while an important predictor of health, genetics is not a part of our model. Only things that are modifiable are a part of our model.
We look at four health behaviors: Tobacco use, Diet and Exercise, Unsafe Sex and Alcohol Use. Health behaviors account for 30 percent of the Health Factors rank.----------------------------------------------------------------------------------------------------------------------------------------------------------Health Behaviors Tobacco use (10%) What: Estimated percent of the adult population that currently smokes every day or “most days” and has smoked at least 100 cigarettes in their lifetime.Why: Measuring the prevalence of tobacco use in the population can alert communities to potential adverse health outcomes and can be valuable for assessing the need for cessation programs or the effectiveness of existing programs.Source: Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS)Diet & Exercise (10%)What: The percentage of the adult population (age 20 and older) that has a body mass index (BMI) greater than or equal to 30.Why: Obesity increases the risk for health conditions such as coronary heart disease, type 2 diabetes, cancer, hypertension, dyslipidemia, stroke, liver and gallbladder disease, sleep apnea and respiratory problems, and osteoarthritis.Source: National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, using multiple years of Behavioral Risk Factor Surveillance System (BRFSS) data. Unsafe Sex (5%) 2 measures: Chlamydia rate and teen birth rateChlamydia RateWhat: Chlamydia incidence (the number of new cases reported) per 100,000 population.Why: Chlamydia is the most common bacterial STI in North America and is one of the major causes of tubal infertility, ectopic pregnancy, pelvic inflammatory disease, and chronic pelvic pain.Source: CDC’s National Center for Hepatitis, HIV, STD, and TB PreventionTeen Birth RateWhat: Teen births are reported as the number of births per 1,000 female population, ages 15-19.Why: Teen pregnancy is associated with poor prenatal care and pre-term delivery. Pregnant teens are more likely than older women to receive late or no prenatal care, have gestational hypertension and anemia, and achieve poor maternal weight gain. They are also more likely to have a pre-term delivery and low birth weight, increasing the risk of child developmental delay, illness, and mortality.Source: National Vital Statistics System (NVSS) at the National Center for Health Statistics, part of the Centers for Disease Control and Prevention (CDC).Alcohol use (5%) 2 measures: Excessive drinking and motor vehicle crash death rateExcessive DrinkingWhat: The percent of the adult population that reports either binge drinking, defined as consuming more than 4 (women) or 5 (men) alcoholic beverages on a single occasion in the past 30 days, or heavy drinking, defined as drinking more than 1 (women) or 2 (men) drinks per day on average.Why: Excessive drinking is a risk factor for a number of adverse health outcomes such as alcohol poisoning, hypertension, acute myocardial infarction, sexually transmitted infections, unintended pregnancy, fetal alcohol syndrome, sudden infant death syndrome, suicide, interpersonal violence, and motor vehicle crashes.Source: National Center for Health Statistics using data was obtained from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS)Motor Vehicle Crash Death RateWhat: Motor vehicle crash deaths are measured as the crude mortality rate per 100,000 population due to on- or off-road accidents involving a motor vehicle.Why: A strong association has also been demonstrated between excessive drinking and alcohol-impaired driving, with approximately 17,000 Americans killed annually in alcohol-related motor vehicle crashesSource: National Center for Health Statistics (NCHS)
Clinical Care accounts for 20 percent of the Health Factors Rank. We look at two focus areas: Access to Care and Quality of Care. ------------------------------------------------------------------------------------------------------------------------------------------------------------Access to Care (10%) 2 measures: uninsured adults and primary care physiciansUninsured AdultsWhat: estimated percent of the adult population under age 65 that has no health insurance coverage.Why: Lack of health insurance coverage is a significant barrier to accessing needed health care.Source: Small Area Health Insurance Estimates from the U.S. Census Bureau provide annual estimates of the population without health insurance coverage for all U.S. states and their counties.Primary Care Physicians What: Primary care physicians include practicing physicians specializing in general practice medicine, family medicine, internal medicine, pediatrics, and obstetrics/gynecology. The measure represents the population per one provider..Why: Having access to care requires not only having financial coverage but also access to providers.Source: Health Resources and Services Administration’s Area Resource File (ARF) for 2009. The ARF data on practicing physicians come from the AMA Master File (2008), and the population estimates are from the U.S. Census Bureau’s 2008 population estimates.Quality of Care (10%)3 measures: Preventable hospital stays, diabetic screening, and mammography screeningPreventable Hospital StaysWhat: hospital discharge rate for ambulatory care-sensitive conditions per 1,000 Medicare enrollees.Why: Health Resources and Services Administration’s Area Resource File (ARF) for 2009. The ARF data on practicing physicians come from the AMA Master File (2008), and the population estimates are from the U.S. Census Bureau’s 2008 population estimates.Source: Dartmouth Atlas of Health Care using Medicare claims dataDiabetic ScreeningWhat: percent of diabetic Medicare patients whose blood sugar control was screened in the past year using a test of their glycated hemoglobin (HbA1c) levels.Why: Regular HbA1c screening among diabetic patients is considered the standard of care.Source: Dartmouth Atlas of Health Care using Medicare claims dataMammography ScreeningWhat: percent of female Medicare enrollees age 67-69 that had at least one mammogram over a two-year period.Why: Evidence suggests that mammography screening reduces breast cancer mortality, especially among older women. Source: Dartmouth Atlas of Health Care using Medicare claims data
Social and Economic Factors account for 40 percent of the Health Factors rank. It is the most significant determinant of health outcomes and it is also one of the key reasons we talk about Health being everyone’s business. We look at five focus areas: employment, , community safety , income, education, and family and social support.----------------------------------------------------------------------------------------------------------------------------------------------Employment (10%)UnemploymentWhat: the percent of the civilian labor force, age 16 and older, that is unemployed but seeking work.Why: Unemployment may lead to physical health responses ranging from self-reported physical illness to mortality, especially suicide. It has also been shown to lead to an increase in unhealthy behaviors related to alcohol and tobacco consumption, diet, exercise, and other health-related behaviors, which in turn can lead to increased risk for disease or mortalitySource: Bureau of Labor Statistics (BLS), Local Area Unemployment Statistics (LAUS)Community Safety (5%) Violent Crime or Homicide RateWhat? Violent Crime OR Homicide Rate (violent crime per 100K residents or homicide per 100K in select states)Why? High levels of violent crime compromise physical safety and psychological well-being. Crime rates can also deter residents from pursuing healthy behaviors such as exercising out-of-doors. Additionally, some evidence indicates that increased stress levels may contribute to obesity prevalence, even after controlling for diet and physical activity levels.Source: Some variation depending on state. FBI's Criminal Justice Information Services for violent crime rates and CDC’s National Center for Health Statistics National Vital Statistics System data from 2000-2006 for the homicide death rate.Income (10%) Children in Poverty What? Children in poverty is the percent of children under age 18 living below the Federal Poverty Line (FPL)Why? Poverty can result in negative health consequences, such as increased risk of mortality, increased prevalence of medical conditions and disease incidence, depression, intimate partner violence, and poor health behaviors. While negative health effects resulting from poverty are present at all ages, children in poverty greater morbidity and mortality due to an increased risk of accidental injury and lack of health care access. Children’s risk of poor health and premature mortality may also be increased due to the poor educational achievement associated with poverty. The children in poverty measure is highly correlated with overall poverty rates.Source: Small Area Income and Poverty Estimates (SAIPE) through the U.S. Census.Education (10%)2 measures: High school graduation and Some collegeHigh School GraduationWhat: the percent of a county’s ninth-grade cohort in public schools that graduates from high school in four years.Why: The relationship between more education and improved health outcomes is well known, with years of formal education correlating strongly with improved work and economic opportunities, reduced psychosocial stress, and healthier lifestyles.Source: Local Education Agency Universe Survey Dropout and Completion data and the Public Elementary/Secondary School Universe Survey dataSome CollegeWhat: the percent of the population age 25-44 with some post-secondary education, such as enrollment at vocational/technical schools, junior colleges, or four-year colleges. It includes individuals who pursued education following high school but did not receive a degree.Why: The relationship between higher education and improved health outcomes is well known, with years of formal education correlating strongly with improved work and economic opportunities, reduced psychosocial stress, and healthier lifestylesSource: American Community Survey (ACS).Family & Social Support (5%) 2 measures: Inadequate Social Support and Children in single-parent householdsInadequate Social SupportWhat: based on responses to the question: “How often do you get the social and emotional support you need?” The County Health Rankings reports the percent of the adult population that responds that they “never,” “rarely,” or “sometimes” get the support they need.Why: Poor family support, minimal contact with others, and limited involvement in community life are associated with increased morbidity and early mortality. Source: BRFSSSome CollegeWhat: percent of all children in family households that live in a household headed by a single parent (male or female householder with no spouse present).Why: Adults and children in single-parent households are both at risk for adverse health outcomes such as mental health problems (including substance abuse, depression, and suicide) and unhealthy behaviors such as smoking and excessive alcohol use.Source: American Community Survey (ACS).
The Physical Environment accounts for 10 percent of the Health Factors Rank. It looks at two focus areas:Environmental Quality and the Built Environment.--------------------------------------------------------------------------------------------------------Environmental Quality (5%) 2 measures: Air pollution – particulate matter days and Air pollution – ozone daysAir pollution – particulate matter daysWhat: the annual number of days that air quality was unhealthy for sensitive populations due to fine particulate matter (FPM, < 2.5 µm in diameter)Why: The relationship between elevated air pollution—particularly fine particulate matter and ozone—and compromised health has been well documented.Source: Public Health Air Surveillance Evaluation (PHASE) project, a collaborative effort between the Centers for Disease Control and Prevention (CDC) and the EPAAir pollution – Ozone DaysWhat: ozone measure represents the annual number of days that air quality was unhealthy for sensitive populations due to ozone levels.Why: The relationship between elevated air pollution—particularly fine particulate matter and ozone—and compromised health has been well documented. Source: Public Health Air Surveillance Evaluation (PHASE) project, a collaborative effort between the Centers for Disease Control and Prevention (CDC) and the EPA(Challenge: lack of air quality monitoring in communities. Solution = CDC & EPA developed air Q simulation models – estimate # days air Q poor for sensitive pops)Built Environment (5%)2 measures: Access to Healthy Foods and Access to Recreational FacilitiesAccess to Healthy FoodsWhat: Studies have linked the food environment to consumption of healthy food and overall health outcomes.Why: The relationship between elevated air pollution—particularly fine particulate matter and ozone—and compromised health has been well documented.Source: US Census Bureau’s Zip Code Business PatternsAccess to Recreational FacilitiesWhat: the number of recreational facilities per 100,000 population in a given county. Why: The availability of recreational facilities can influence individuals’ and communities’ choices to engage in physical activity. Source: United States Department of Agriculture (USDA) Food Environment Atlas, and is calculated using the most current County Business Patterns data set.Images: top: countyhealthrankings.org; bottom: Flickr Creative Commons: Natalie Maynor
So we can start to move back out the bigger picture view of the model. We know that these are the “actionable” things communities can work on now to help improve their future. That action comes through programs and policies.
Policies & programs influence health factors which over time influence health outcomes. Some examples of what can be implemented at local level to make a difference include those that many of you are probably familiar with: Implement clean indoor air policiesProvide menu labeling or improve school food policiesInclude pedestrian/cycling in transportation master plansThey can also include:Creatingzoning for mixed use development to improve community safetyInvesting in work force development & job training programs, andExpanding access to high quality early childhood programsMore examples of Policies & Programs that work can be found on our web site.
This brings us back up to the big picture view of the Rankings model …There are two key things to remember about the Rankings model The County Health Rankings looks at the multiple factors that influence health outcomes and …2) Programs and policies determine:whether people are more or less likely to engage in risky behaviorsWhether people have access to quality clinical careEconomic and education statusHow socially connected people feelAnd important elements in their physical environments.
We know we use Rankings to raise awareness and as a call to action and that the Rankings are based on multiple factors that influence how long we live and how healthy we are … Now I’m going to spend some time talking about How to use the Rankings to take action … because it’s really how we use the Rankings to improve the health of our communities that makes them powerful.
POLL: CHR WEBSITE Let’s take a quick tour of the WebsiteWhen you go to the web site home page, you’ll see the U.S. & 5 main tabs:-> Our Approach-> Ranking Methods-> Action Steps-> Your StoriesTo get to your county, you can click on your state …
The Rankings are a call to action, but how do you take action? That’s where our Take Action Cycle comes in …
The work you’re doing through the Healthy Communities programs is closely aligned with the steps set out in the Take Action Cycle. Work Together – which sits at the top of our cycle aligns with the Commitment phase of the Community Change Process. Work Together sits at the top of the Take Action Cycle because it is integrated in all action steps. As communities work toward improved health outcomes, we encourage them to continually ask whether they have the right people at the table. We point to the sectors that you see at the center of the model as key partners to engage.Assess Needs & Resources aligns with the Assessment Phase of the Community Change Process. Pick Priorities and Find Programs & Policies that Work aligns with the Planning Phase … these steps help communities use the information gathered during assessment to focus their efforts and guides them toward evidence-informed programs and policies. Implement Strategies and Implementation focus on getting the programs and policies in place. The Take Action Cycle, like the Community Change Process, includes evaluation as a separate step or phase but notes that it should be woven throughout the process.We don’t want to reinvent the wheel … or the cycle. We want to build on the great work you’re already doing in your communities and we think the County Health Rankings and the Take Action Cycle can do that in a couple of ways: Use the Rankings to engage community members in the work you’re currently doing. Use the Rankings to expand the work your doing into other health factors within your community. Maybe you’ve been working on Tobacco or Diet & Exercise, but you know that Educational Outcomes are also a priority issue in your community … you can take the experience and partnerships you’ve created and begin working toward programs and policies that influence education … or whatever is a priority in your community.
Here are a few things that you can do in your community: Use the Rankings as a Call to Actiondevelop key messages about the Rankings for your communitywork with your local media to increase awareness of the many factors that contribute to the health of your community,Engage key partnersHealth is everyone’s business and all sectors must work together to improve health within a community. Use the Rankings to engage multiple & diverse partners to take action
As we get closer to the release of the 2012 Rankings we will have webinars specifically focused on preparing key messages for your communities. These are the key messages we’ve used in 2011 … hopefully you heard some of them today.
If you want to learn about those and other webinars, sign up for our e-Newsletter at www.countyhealthrankings.orgYou can also stay connected to us on Twitter, Facebook and You Tube.
