Rhode Island’s Health ─ 2012

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Rhode Island’s Health ─ 2012. Michael Fine, MD Director of Health. The Healthy People 2010 Perspective. Healthy People 2010 Indicators: Physical Activity Overweight and Obesity Tobacco Use Substance Abuse Responsible Sexual Behavior Mental Health Injury and Violence - PowerPoint PPT Presentation

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Rhode Island’s Health ─ 2012

Michael Fine, MDDirector of Health

The Healthy People 2010Perspective

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Adults who engage in moderate physical activity 30+ mins / day

Healthy People 2010

Physical Activity - Adults

0

20

40

60

2001 2005 2009

Year of Survey (BRFSS)

Pe

rce

nt

RI

US

HP 2010 Target: 30%

Teens who engage in physical activity 60+ mins / 5 days

Healthy People 2010

Physical Activity - Teens

0

10

20

30

40

50

2005 2009

Year of Survey (YRBS)

Pe

rce

nt

RI

US

HP 2010 Target: 85%

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Adults who are obese

Healthy People 2010

Overweight and Obesity - Adults

0

5

10

15

20

25

30

2000 2005 2010

Year of Survey (BRFSS)

Pe

rce

nt

RI

US

HP 2010 Target: 15%

Teens who are overweight or obese

Healthy People 2010

Overweight and Obesity - Teens

0

5

10

15

20

25

30

35

2000 2005 2010

Year of Survey (YRBS)

Pe

rce

nt

RI

US

HP 2010 Target: 5%

Adults who consume 5+ servings of fruits and vegetables / day

Healthy People 2010

Overweight and Obesity - Adults

0

5

10

15

20

25

30

35

2000 2005 2009

Year of Survey (BRFSS)

Pe

rce

nt

RI

US

HP 2010 Target: 50%

Teens who consume 5+ servings of fruits and vegetables / day

Healthy People 2010

Overweight and Obesity - Teens

0

5

10

15

20

25

30

2000 2005 2009

Year of Survey (YRBS)

Pe

rce

nt

RI

US

HP 2010 Target: 50%

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Adults who currently smoke cigarettes

Healthy People 2010

Tobacco Use - Adults

0

5

10

15

20

25

2000 2005 2010

Year of Survey (BRFSS)

Pe

rce

nt

RI

US

HP 2010 Target: 12%

Teens who currently smoke cigarettes

Healthy People 2010

Tobacco Use - Teens

0

5

10

15

20

25

30

2001 2005 2009

Year of Survey (YRBS)

Pe

rce

nt

RI

US

HP 2010 Target: 16%

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Adults who engaged in binge drinking in the past 30 days

Healthy People 2010

Substance Abuse - Adults

0

5

10

15

20

2001 2006 2010

Year of Survey (BRFSS)

Pe

rce

nt

RI

US

HP 2010 Target: 6%

Teens who report alcohol use in the past 30 days

Healthy People 2010

Substance Abuse - Teens

0

10

20

30

40

50

60

2001 2006 2009

Year of Survey (YRBS)

Pe

rce

nt

RI

US

HP 2010 Target: 11%

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Teens who never engaged in sexual intercourse, or did not engage in sexual intercourse in the past 30 days,

or who used a condom at last sexual intercourse

Healthy People 2010

Responsible Sexual Behavior - Teens

0

20

40

60

80

100

2001 2005 2009

Year of Survey (YRBS)

Pe

rce

nt

RI

US

HP 2010 Target: 90%

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Suicides per 100,000 population per year

Healthy People 2010

Mental Health - All Ages

0

5

10

15

2000 2005 2009

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

HP 2010 Target: 5 per 100,000

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Fatalities caused by car crashes per 100,000 population per year

Healthy People 2010

Injury and Violence - All Ages

0

2

4

6

8

10

1997 2007

Year of Death

De

ath

s p

er

10

0,0

00

RI

HP 2010 Target: 9.2 per 100,000

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Adult non-smokers exposed to second-hand smoke

Healthy People 2010

Environmental Quality - Adults

0

5

10

15

20

2004 2008

Year of Survey (BRFSS)

Pe

rce

nt

RI

HP 2010 Target: 45%

Children with elevated lead levels

Healthy People 2010

Environmental Quality - Children

0

2

4

6

8

10

2000 2009

Year of Observation

Pe

rce

nt

RI

HP 2010 Target: 0%

Homes tested for radon

Healthy People 2010

Environmental Quality - All Ages

0

5

10

15

2000 2008

Year of Testing

Pe

rce

nt

HP 2010 Target: 20%

Persons infected by food borne Campylobacter

Healthy People 2010

Environmental Quality - All Ages

0

5

10

15

20

2002 2010

Year of Observation

Pe

rce

nt

RI

HP 2010 Target: 12.3%

Persons infected by food borne Salmonella

Healthy People 2010

Environmental Quality - All Ages

0

5

10

15

20

2002 2010

Year of Observation

Pe

rce

nt

RI

HP 2010 Target: 6.8%

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Adults ages 65+ vaccinated for influenza in the past year

Healthy People 2010

Immunization - Ages 65+

0

20

40

60

80

100

2001 2005 2010

Year of Survey (BRFSS)

Pe

rce

nt

RI

US

HP 2010 Target: 90%

• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care

Rhode Island’s Health

Changes and Comparisons

Adults with health insurance

Healthy People 2010

Access to Health Care - Adults

0

20

40

60

80

100

2000 2005 2010

Year of Survey (BRFSS)

Pe

rce

nt

RI

US

HP 2010 Target: 100%

Adults with a specific source of ongoing health care

Healthy People 2010

Access to Health Care - Adults

0

20

40

60

80

100

2000 2006

Year of Survey (BRFSS)

Pe

rce

nt

RI

HP 2010 Target: 96%

Pregnant women who receive first trimester care

Healthy People 2010

Access to Health Care - Females

0

20

40

60

80

100

2000 2010

Year of Survey (BRFSS)

Pe

rce

nt

RI

HP 2010 Target: 90%

Pregnant women who receive adequate prenatal care

Healthy People 2010

Access to Health Care - Adults

0

20

40

60

80

100

2000 2010

Year of Observation

Pe

rce

nt

RI

HP 2010 Target: 90%

Adults who used oral health care in the past year

Healthy People 2010

Access to Health Care - Adults

0

20

40

60

80

100

1998 2010

Year of Survey (BRFSS)

Pe

rce

nt

RI

HP 2010 Target: 56%

Adult women who received a Pap test in the past 3 years

Healthy People 2010

Access to Health Care - Adults

0

20

40

60

80

100

2000 2006 2010

Year of Survey (BRFSS)

Pe

rce

nt

RI

US

HP 2010 Target: 90%

Women ages 40+ who received a mammogram in the past 3 years

Healthy People 2010

Access to Health Care - Adults

0

20

40

60

80

100

2000 2006 2010

Year of Survey (BRFSS)

Pe

rce

nt

RI

US

HP 2010 Target: 70%

AnotherPerspective

• Four Additional Indicators:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital

Rhode Island’s Health

Notable Trends

• Four Perspectives:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital

Rhode Island’s Health

Disease Burden

Note: Average YPLL per total deaths under age 65; data represent deaths in 2007.

What Causes Premature Death?

Potential Years of Life Lost

Top Ten Causes of Premature Death

Potential Years of Life Lost

Unintentional Injury

0

10

20

30

40

50

60

70

69 72 75 78 81 84 87 90 93 96 99 02 05 08

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

Potential Years of Life Lost

Cancer

0

50

100

150

200

250

300

69 72 75 78 81 84 87 90 93 96 99 02 05 08

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

Potential Years of Life Lost

Heart Disease

0

100

200

300

400

500

600

69 72 75 78 81 84 87 90 93 96 99 02 05 08

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

Potential Years of Life Lost

Perinatal Conditions (RI only)

0

1

2

3

4

5

6

7

8

9

90 92 94 96 98 00 02 04 06 08 10

Year of Death

De

ath

s p

er

1,0

00

Postneonatal

Neonatal

Potential Years of Life Lost

Suicide

0

2

4

6

8

10

12

14

16

69 72 75 78 81 84 87 90 93 96 99 02 05 08

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

Potential Years of Life Lost

Homicide

0

2

4

6

8

10

12

69 72 75 78 81 84 87 90 93 96 99 02 05 08

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

Potential Years of Life Lost

Birth Defects

0

2

4

6

8

10

12

69 72 75 78 81 84 87 90 93 96 99 02 05 08

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

Potential Years of Life Lost

Liver Disease

0

5

10

15

20

25

69 72 75 78 81 84 87 90 93 96 99 02 05 08

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

Potential Years of Life Lost

Stroke

0

20

40

60

80

100

120

140

160

180

69 72 75 78 81 84 87 90 93 96 99 02 05 08

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

Potential Years of Life Lost

Diabetes

0

5

10

15

20

25

30

35

40

69 72 75 78 81 84 87 90 93 96 99 02 05 08

Year of Death

De

ath

s p

er

10

0,0

00

RI

US

• Four Perspectives:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital

Rhode Island’s Health

Disease Burden

Financial CostHealth Care Expenditures per Capita

$6,815

$8,309

$0

$2,000

$4,000

$6,000

$8,000

$10,000

Do

llar

s p

er C

apit

a

RI

US

2009

Financial Cost% Growth in Health Care Expenditures

5.3

6.0

0.0

2.0

4.0

6.0

8.0

10.0

Pe

rce

nt

Gro

wth

pe

r C

ap

ita

RI

US

% growth from 1980 through 2009

Financial CostDistribution of Health Care Expenditures

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40

Hospital Care

Physician & Oth Professional Svcs

Rx Drugs & Oth Medical Nondurables

Nursing Home Care

Dental Services

Home Health Care

Medical Durables

Oth Health, Residential, & Personal Care

Hea

lth C

are

Ser

vice

Percent of Total Health Care Expenditure

RI

US

2009

• Four Perspectives:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital

Rhode Island’s Health

Disease Burden

• We are working to measure days of lost work and school attributable to illness and injury.

Days of Lost Work and School

• Four Perspectives:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital

Rhode Island’s Health

Disease Burden

• “The central premise of social capital is that social networks have value. Social capital refers to the collective value of all “social networks” (who people know) and the inclinations that arise from these networks to do things for each other (‘norms of reciprocity’).”

Social Capital

The Concept

From

• Social capital indicators include:– Club meetings attended last year– Community projects worked on last year– Times entertained at home last year– Times volunteered last year– Time visiting friends– Etc.

• Social capital indicators may be used to construct a “social cap-ital index,” to estimate social capital in a group or a locale.

Social Capital

Indicators of Social Capital

From

• Min:• Max:• Mean:• Std Dev:• RI Value:

Social Capital

“Social Capital Index” (by State)

From-1.431.710.020.78

-0.06

• States with high scores- Vermont 1.42- South Dakota 1.69- North Dakota 1.71

Michael Fine, MDDirector of Healthwww.health.ri.gov

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