Can We Become Healthier Than Minnesota?

Real Talk for Real Action Conference

January 30 2009

David Kindig University of Wisconsin School of Medicine and Public Health/Population Health InstituteCarried out under a grant from the Wisconsin

Partnership Program

OUR COMPETITION AT #17 (down from #12 last year)

IN AMERICA’S HEALTH RANKINGS

Hawaii (#2) and Utah (#5) are,

well, not like us…

But Minnesota (#4),

Vermont (#1), and

Massachusetts (#9)???

OVERALL HEALTH RANKING

1990 2003 2008

VERMONT 16 4 1

MINN 1 1 4

WISC 4 14 17

PERCENT UNINSURED

2003 2008

VERMONT 9.7 10.7

MINNESOTA 7.8 8.8

WISCONSIN 8.4 8.5

ADULT SMOKNG RATES

2003 2008

VERMONT 21.1 17.6

MINNESOTA 21.7 16.5

WISCONSIN 23.3 19.6

PREVALENCE OF OBESITY

2003 2008

VERMONT 18.9 21.9

MINNESOTA 22.3 26.0

WISCONSIN 21.6 25.3

PERCENT BINGE DRINKING

2003 2008

VERMONT 16.1 17.3

MINNESOTA 20.4 16.0

WISCONSIN 25.3 23.8

CHILDREN IN POVERTY

2003 2008

VERMONT 12.2 10.9

MINNESOTA 8.4 13.7

WISCONSIN 12.0 15.7

AIR POLLUTION

2003 2008

VERMONT 10.1 9.5

MINNESOTA 11.8 9.9

WISCONSIN 12.4 13.3

HEALTH CARE COSTS

• PER CAPITA EXPENDITURES??

• % INCREASE IN EXPENDITURES?

• ACCEPTABLE RANGE OF REGIONAL

VARIATION?

STRONG MEASURES, SOLID PARTNERSHIPS, REAL RESOURCES

“What is required is a coordinated effort across determinants between the public and private sectors, as well as financial resources and incentives to make it work”.

Population %Excess deaths %

City of Milwaukee

570,547 11% 1330 28%

Rural Counties (n=52)

1,576,804 32% 1612 34%

Urban Counties (n=20)

2,841,084 57% 1840 38%

TOTAL 4,988,435 100% 4782 100%

Distribution of population and excess deaths in Wisconsin

*Values are annual averages based on data from AIM (1993-2002) and WISH (1995-2004)*Rural/urban definitions are based on those used by the Wisconsin Office of Rural Health

MY PROPOSED HEALTHY WISCONSIN 2020 OVERALL GOALS

• MOVE FROM B- TO B+…SOLIDLY INTO THE TOP TEN…AND THEREFORE MAKE A SERIOUS CHALLENGE TO MINNESOTA

• MOVE FROM D TO C IN HEALTH DISPARITIES..A COMMITMENT TO MORE FAIRNESS IN OUR STATE

Dialogues on Key Strategies to Improve our Health • Track A: Improving our health behaviors

– Room E: Physical activity, nutrition, and obesity– Room F: Alcohol use and addiction

• Track B: Mix of prevention and treatment– Room G: Health care quality and costs– Room H: Access to needed care

• Track C: Healthier social and economic climate– Room I: Remedying racial disparities– Room J: Improving the health of Milwaukee