Upload
michael-kerr
View
505
Download
2
Embed Size (px)
Citation preview
Join the conversation now: #HHSDataFest
Advancing Social Determinants of Health with Let’s Get Healthy California and California Open Data Intiatives
Karen L. Smith, Director and State Health Officer, CDPH
Matt Willis, Rx Safe Marin
Debra S. Oto-Kent, Walk with Friends
Eric G. Handler, WasteNotOC
Rank state/territory Overall
1 Japan 82.73
2 Switzerland 81.81
3 Hong Kong 81.61
4 Australia 81.44
5 Italy 81.37
6 Iceland 81.28
7 France (metropol.) 80.95
8 Sweden 80.88
9 Israel 80.69
10 Singapore 80.60
11 Canada 80.54
12 Spain 80.48
13 Norway 80.45
14 Austria 80.24
15 Netherlands 80.20
16 New Zealand 80.13
17 Martinique ( France) 80.07
18 Macau 80.03
19 South Korea 80.00
20 Germany 79.85
Rank state/territory Overall
21 Belgium 79.77
22 Ireland 79.68
23 United Kingdom 79.53
24 Greece 79.52
25 Channel Islands ( UK) 79.51
26= Luxembourg 79.39
26= Guadeloupe ( France) 79.39
28 Finland 79.34
29= Cyprus 78.94
29= U.S. Virgin Islands ( US) 78.94
31 Costa Rica 78.87
32 Malta 78.80
33 Puerto Rico ( US) 78.70
34 Chile 78.65
35= Portugal 78.59
35= Slovenia 78.59
37 Cuba 78.50
38 Denmark 78.25
39 Taiwan 78.19
40 United States 77.97
41 Qatar 77.88
What do we know?Overall health isn’t determined by how much we spend.
Life expectancy in California by race/ethnicity2006-2008
What do we know?Health is not distributed evenly in US.
“Behavioral risk factors”
People’s behavior is shaped by the real life choices and opportunities available to them where they live, work, learn, and play.
“It is necessary that properties shall continue to be occupied by the same social and racial
groups”- Federal Housing Administration Underwriting Manual 1938 in recommending racially
restrictive covenants.
Social Determinates of Health
Conditions in the social, physical, and economic environment in which
people are born, live, work, and age. They consist of policies, programs
and institutions and other aspects of the social structure, including the
government and private sectors, as well as community factors.”
Healthy People 2020: An Opportunity to Address Societal Determinants of Health in the U.S., Objectives for 2020, July 11, 2010
“Health equity is achieving the highest level of health for all people.”
Everyone should have the opportunity to make the choices that allow them to live a long, healthy life, regardless of their income, education or ethnic background.
Sources: Virginia Department of Public Health RWJF: Vulnerable Populations Portfolio
Indicators of Health
• Mortality rates
• Diseases
• Disability
• Medical care
• DALYs
• QALY
• Risk behaviors
• Poverty rates
• Educational attainment
• Incarceration rates
• Environmental toxins
• Built environment
• Food insecurity
• etc
Alameda County
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
Lif
e E
xp
ecta
ncy (
Years
)
San Francisco County
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
Lif
e E
xp
ecta
ncy (
Years
)
Contra Costa County
50
55
60
65
70
75
80
85
90
95
100
0% 10% 20% 30% 40% 50% 60%
Poverty Rate
Lif
e E
xpecta
ncy (
Years)
Tract Poverty vs. Life
Expectancy
Better Care for Individuals
Better Health for Populations
Lower Costs
National Strategy for Quality (2011), National Prevention Strategy (2011), California County Health Rankings,
Commonwealth Fund on Local Health System Performance
Reviewed National and State Reports
Informed Development of Priorities, Goals and Targets
Health Equity Focus
Foundation to the Process
Data
Innovation &
Communication
Website
- Public reporting- Interaction & collaborative engagement
- Promising interventions- Moving the needle- Stakeholder participation
LGHC: Three Core Components
- Data structure & visualization
- Data stories & analysis
Innovations Finalists
• Rx Safe MarinMatt Willis, MD, MPH, Public Health Officer, Marin County
• Walk with FriendsDebra S. Oto-Kent, MPH, Founder, Executive Director, Health Education Council
• WasteNotOCEric G. Handler MD, MPH, Health Officer, Deputy Agency Director,Health Care Agency
2016 Innovations Conference
RxSafe Marin: Using Data to Mobilize a Community Coalition
Matt Willis, MD MPHPublic Health OfficerMarin County
Comprehensive Approach
Prevention
Education
Surveillance
Monitoring
Diversion Control
Law Enforcement
Treatment
Recovery
Community Based Prevention
Action Team
Data Collection and Monitoring
Action Team
Law Enforcement Action Team
Intervention, Treatment and Recovery
Action Team
Steering Committee: Data, Messaging, Policy
Representatives from: Marin County Office of Education, Marin County
Prescription Drug Abuse Task Force, Healthy Marin Partnerships
Backbone Support: HHS
Prescribers and Pharmacists
Action Team
Strategic Goal for Data Action Team
• Problem: An Epidemic Without a Surveillance System
• Vision: Marin County will have county-wide relevant data on prescription drug misuse and abuse
• Develop a report card with 5-10 key data elements to track prospectively
• Engage community in selection of indicators of greatest relevance
1. Consulted with federal, state, and other local jurisdictions
2. Contacted local agencies to determine available county-specific data
3. Compiled data and presented potential indicators• “Why this matters”
• Results
• Data source
4. Stakeholders voted on which indicators to include in the report card
Steps for Choosing Report Card Indicators
Example of Potential Indicator: Opioid-Related Emergency
Department Visits
Why this matters:The Centers for Disease Control and Prevention (CDC) reports that drug misuse and abuse causes almost three million emergency department (ED) visits annually. More than half of these are related to pharmaceuticals. Compared to deaths, non fatal ED visits are a more frequent and more sensitive indicator of community burden of opioid related harm.
Results:
Indicator 2006 2007 2008 2009 2010 2011 2012 2013
Non-Fatal Opioid-
Related Emergency
Department Visits
198 222 289 300 295 344 471 352
Data Source:Office of Statewide Health Planning & Development (OSHPD). Emergency Department Data. Prepared by California Department of Public Health, Safe and Active Communities Branch
State Data Sources
• Emergency Department visits
•Hospitalizations
Office of Statewide Health Planning and Development (OSHPD)
•Controlled substance Prescription
California Department of Justice/ Controlled Substance Utilization Review and Evaluation System
(CURES)
•Drug poisoningsVital Statistics
• Treatment admissionsCalifornia Outcomes Measurement
System (CalOMS) Treatment
Agency Type
Local Data Sources
•Drug possessionsOffice of the District Attorney (DA)
• Safely disposed Prescription Medications
Environmental Health Services (EHS)/
Drug Enforcement Agency (DEA)
•Naloxone doses administered
Emergency Medical Services (EMS)
Agency Type
Beyond the PDF: Livestories
“There is nothing new about poverty. What
is new is that we now have the techniques and the resources to get rid of poverty. The
real question is whether we have the will.”
-Martin Luther King Jr.
• 12.7% of households are food insecure
• There are 349,690 people living with food insecurity
• 1 in 5 children face food insecurity
Source: (Feeding America. Map the Meal Gap 2013.)
Food Insecurity Statistics
Orange County
Child Poverty Rates in California CountiesCounty or County Group Child Poverty Rate (%) County or County Group Child Poverty Rate (%)
Merced 40.6 Colusa, Glenn, Tehama, Trinity 21.7
Fresno 36.4 Shasta 21.7
Tulare 36.3 Yolo 21.3
Lake, Mendocino 35.2 Solano 20.8
Kern 35 San Diego 19.6
Imperial 32.7 San Luis Obispo 19.2
Stanislaus 32.4 Santa Barbara 19
Madera 30.7 Orange 18.4
Del Norte, Lassen, Modoc, Siskiyou, 29 Ventura 16.8
Kings 28.7 Sonoma 16.1
Butte 26,4 Alameda 15.8
Los Angeles 26.3 Contra Costa 15.6
Sutter, Yubs 26 San Francisco 15.4
San Joaquin 25.2 Santa Cruz 14.3
Sacramento 25.2 El Dorado 14.2
Humboldt 24.7 Nevada, Plumas, Sierra 12.7
San Bernardino 24.6 Santa Clara 12.2
Alpine, Amador, Calaveras, Inyo, Mariposa, Mono, Tuolumne 22.6 Marin 10.5
Riverside 22.1 Placer 9.7
Monterey, San Benito 22 San Mateo 8.6
Napa 21.9
Food RecoveryEducate restaurants and grocery stores on the Good Samaritan Act to increase food donations.
Food DistributionConnect those in need with pantries that provide wholesome food.
Identify those in needStart asking the questions if individuals are facing
food insecurity.
3-Pronged Approach
Targeting the cities of Anaheim and Orange
253 tons (390,000 meals)of newly recovered food
Updated 10/31/15
Screening Tool to DetermineLevel of Food Insecurity
• “Within the past 12 months we worried whether our food would run out before we got money to buy more”
Often True Sometimes True Never True
• “Within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.”
Often True Sometimes True Never True
Development and Validity of a 2-Item Screen to Identify Families at Risk: Pediatrics 2010;126;e26
Join the conversation now: #HHSDataFest
Interactive Activity: Enhancing Incentives for State and Local Government to Use Data More Effectively
Facilitator: Shell Culp, Chief Innovation Officer, Stewards of Change Institute
Creating Person Centered Services and Coordinating the San Diego Region
Achieving Community Health
John Ohanian, President & CEO, 2-1-1 San Diego/Imperial
The Complex Community that We Live in…
• 4,261 square miles (larger than 21 U.S.
States; same size as Connecticut)
• 5th largest U.S. County, 2nd largest in
CA
• 18 municipalities; 36 unincorporated
towns
• 18 tribal nations
• 42 school districts
• 2013 Estimates - 3.1 million population
• 48% White
• 32% Latino
• 11% Asian/PI
• 4.7% African American
• 0.5% American Indian
• Region is very diverse
• Over 100 languages
• Large military presence
• Largest refugee resettlement site in CA
• Busiest international border crossing in
the world (San Ysidro/MX)
BEHAVIORS DISEASES PERCENTL
ea
d t
o
Re
su
lt in
Mo
re t
ha
n
No Physical Activity
Poor Diet
Tobacco Use
Cancer
Heart Disease & Stroke
Type 2 Diabetes
Lung Disease
of Deaths
in San Diego
Areas of Influence
Definition Top 10 Indicators
Enjoying good health and expecting to live a full life
• Life Expectancy• Quality of Life
Learning throughout the lifespan
• Education
Having enough resources for a quality life
• Unemployment Rate• Income
Living in a clean and safe neighborhood
• Security• Physical Environment• Built Environment
Helping each other to live well
• Vulnerable Population• Community Involvement
NG RESULTS
76
The County of San Diego’s ConnectWellSD will enrich the lives of individuals and families through collaboration.
ConnectWellSD is implementing a person-centered service approach and a new technology system to link enterprise-wide customer data and service information.
It all begins with one person, one family
Housing/Shelter
TransportationHealthcare
Food Assistance
Financial Assistance
Connecting San Diego Healthcare
Lab CompaniesHealth Plans
Home Health
Nursing Homes
EMS
Public Health Agencies
Behavioral Health Providers
Schools
Patients and Caregivers
Community Health Centers
Pharmacies
Physician Practices
Hospitals
Connecting Service Providers
Public Benefits
Housing
Health Benefits
Military / Veteran Services
Meals
Community ServicesUtility Assistance
Financial Literacy Programs
Crisis Services
Disaster Coordination
Aging Services
Childcare Transportation
Regional Information Exchange
Cross-Sector –Vertical insights across social,
health and government sectors
Community-wide
Holistic
Easily Accessible
High volume
Community Backbone
Efficient
Regional Information Exchange virtually integrates with its participants to enable the automation of secure, private, flow of information between regional service and healthcare providers to:
Greatly Enhance Care Coordination
Reduce the Cost to provide services
Improve theQuality of care
Achieve Improved Population Health
Regional Information Exchange Partnership
Without restrictions from copyright, patents or other
mechanisms
Freely available for everyone
to use
Movement towards Open Data
Interoperability denotes the ability of diverse systems and organizations to work together (inter-operate). In this case, it is the ability to interoperate - or intermix - different datasets.
Open Data
Challenges and Roadmap to Success
Trust and Relationships
Interoperability
Privacy and Consent
Training and Re-training