Institute of Social and Economic Research, UAA Page 1 The Role of Social and Economic Research in Public Health Fran Ulmer 3/14/2006

Institute of Social and Economic Research, UAA

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The Role of Social and Economic Research in Public Health

Fran Ulmer 3/14/2006


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Goals of health research• Improve health of the population• Improve efficiency of health care system• Make health care more affordable• Expand access to health care• Understand ingredients of community

wellness and environmental health • Prevent accidents and high risk behavior• Many more


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Many UAA Programs• College of Health and Social Welfare• Institute for Circumpolar Health Studies• Center for Rural Health• Center for Alcohol and Addiction Studies• Center for Human Development• Justice Center• WAMI/Biomedical Program• Biological Sciences• Environment and Natural Resources Institute• Geology, anthropology, sociology, psychology, nursing, journalism and public communication


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Institute for Circumpolar Health Studies

• Program evaluation to help providers improve their programs

• Injury prevention• Alcohol addiction and inhalant abuse• Climate change/human health (Carl Hild)• Specifics like studying traffic patterns and

pediatric asthma, diesel exhaust effects (Mary Ellen Gordian)


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ISER• Evaluations, like dental health aide

program in rural Alaska• Economics of telehealth/ANTHC• Community control of alcohol (Matt

Berman)• Rural sanitation programs (Sharman

Haley)• NIOSH aircraft safety study (Lexi Hill)• Cost of health care in Alaska


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ISER Mission

• ISER enhances the well-being of Alaskans and others, through non-partisan research that helps people understand social and economic systems and supports informed public and private decision-making.

• ISER pursues it mission by• Focusing attention on critical economic and social

issues in Alaska , the Arctic , and similar regions; • Engaging in basic and applied research leading to better

understanding of those issues; and • Disseminating knowledge through publications,

community involvement, public service, and teaching.


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• The Institute of Social and Economic Research was established by the Alaska Legislature in 1961.

• ISER is part of the College of Business and Public Policy at UAA. It has a core staff of about 30 faculty members, research associates, and support personnel. Roughly one-third of its budget is from university money and two thirds from grants and contracts. ISER staff members not only do research but also teach undergraduate and graduate courses.

• ISER maintains the state's largest economic database and forecasts population and employment growth. All of ISER's research findings are published and are available at UAA or online at www.iser.uaa.alaska.edu


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Alaska $5 Billion Health-Care Bill—Who’s Paying?

by Mark Foster and Scott Goldsmith


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Organization of Presentation

• Alaska Health-care spending in 2005• Changes in spending since 1991• Health-care Coverage• High-and Low-Cost Patients• Are We Healthier• Alaska/U.S. Cost Comparisons• What’s Driving Costs?• What do we do to improve health care in Alaska?


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Alaska Health Care Spending


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How much is $5.3 billion in Alaska in FY2005

• Total K-12 Spending, All Sources, $1.3 B

• Total Employment Wages, $11.8B


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Changes in Alaska Health Care Spending

1991-2005


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Health Coverage in Alaska


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Employee/Employer Contributions to Health Insurance Premiums, Selected States

Source: 2003 MEPS Data – Private Firm Family Coverage Premiums

Employee Contribution %

Employer Contribution %

Alaska 17% 83%

Wyoming 20% 80%

Washington 22% 78%

Oregon 24% 76%

Minnesota 25% 75%

Hawaii 26% 74%

Montana 28% 72%

Arizona 30% 70%

#1

#49

#17

#27

#6

#10

#19

#38


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High Cost & Low Cost Patients


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Are Alaskans Healthier?1990-2005


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Water and Sewer

• Substantial investments in rural Alaska

• Approximately 50% to 75% of villages

• Will the trend continue?


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Does water and sewer investment improve health?

• 24% of infants in villages with minimal water services are hospitalized for pneumonia (11 times the national average).

• Alaska low service vs. high service regions comparison: 3 times incidence of pneumonia and influenza

• Authors:Troy Ritter and Tom Hennessy (Centers for Disease Control and ANTHC) ADN 2/27/06


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Alaska – U.S. Cost Comparisons


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Medical/Surgical & Dental Procedures


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What is driving long term health care spending increases

Drivers of Aggregate U.S. Health Care Expenditure Growth (post WWII)

570%

60%

70%

Insurance

Income

Technology

The Economics of Health & Health Care, Folland, Goodman, Stano, 4th Edition (2004), Chapter 8, Extrapolating from Rand Analysis of U.S. Health Care Expenditure Growth, 1945 – c.1990


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Factors Accounting for the Rise in Real U.S. Per Capita HealthSpending

Source: Exhibit 1: Factors Accounting for the Rise in Real U.S. Per Capita Health Spending, "The Rise in Health Care Spending andWhat To Do About It," Health Affairs, November/December 2005, Volume 24, Number 6

Rise in treateddisease prevalence

(Number of new cases- volume variance)

Rising population factors Obesity, stress, ozone

63 percent

Components Underlying Causes ExamplesEstimated percent ofgrowth in per capitahealth care spending

Changing treatmentthresholds

Innovation

Hypertension, diabetes,hyperlipidemia, osteoporosis

Pharmacologies, SSRIs,statins, rising income

Rise in spending fortreated cases

($ per treated case -price variance)

InnovationTreatment of low-birthweight

babies, heart attacks 37 percent


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How do we improve health care in Alaska?


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Challenge: identify the issue, the funding, the talent to do

research that can improve the health care delivery system

and provide the research results in a format and a forum

that will make a difference!


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Approaches for the future

• Research• Data and analysis• Alternative programs/other jurisdictions• Legislation/administration• Innovation• Partnerships/collaboration• Community awareness/information• Prevention


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Initiatives• Commonwealth North Health Roundtable• DHSS insurance coverage study• Legislation• Information: www.arctichealth.org• UAA Health research think tank: HeaRTT• United Way: community assessment/indicators• AK Collaborative on Health& the Environment• Healthy Alaskans 2010 (DHSS targets)• Others?


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What can you do?

• The role of the University

• The role health care providers

• The role of community leaders

• The role of employers

• The role of individuals

Documents

Institute of Social and Economic Research, UAA Page 1 The Role of Social and Economic Research in Public Health Fran Ulmer 3/14/2006