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Rural NH County Health Rankings. Mobilizing Action Toward Community Health (MATCH). County Health Rankings – catalyst or cornerstone of a bigger effort “Call to Action” Collaboration between Robert Wood Johnson Foundation and University of Wisconsin Population Health Department
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Mobilizing Action Toward Community Health (MATCH) • County Health Rankings – catalyst or cornerstone of a bigger effort • “Call to Action” • Collaboration between Robert Wood Johnson Foundation and University of Wisconsin Population Health Department • Results in actions to improve overall community health
Data Sources • Centers for Disease Control and Prevention (CDC): • Behavioral Risk Factor Surveillance System (BRFSS), • National Center for Health Statistics, • National Center for Chronic Disease Prevention and Health Promotion (Division of Diabetes Translation), • National Center for Hepatitis, HIV, STD, and TB Prevention • Environmental Protection Agency (EPA) Collaboration • Health Resources and Services Administration (Area Resource File) • Decennial Census and American Community Survey, Census/Current Population Survey: • Small Area Health Insurance Estimates and Income and Poverty Estimates, and • Census County and Zip Code Business Patterns • Federal Bureau of Investigation (Uniform Crime Reporting) • Medicare claims/The Dartmouth Institute • National Center for Education Statistics
Population Health Model • Health outcomes - measures of length and quality of life • Health factors - behaviors, clinical care, social and economic factors, and the physical environment.
Health Outcomes • Mortality • Premature Death • Morbidity • Health-related Quality of Life • Birth Outcomes
Health Behaviors Tobacco Use Diet and Exercise Unsafe Sex Alcohol Use Physical Environment Environmental Quality Built Environment Clinical Care Access to Care Quality of Care Social and Economic Factors Education Employment Income Family and Social Support Community Safety Health Factors
State Rankings United States
Prominent Finding • Healthier counties are urban/suburban, whereas least health counties are mostly rural • About half (48%) of the 50 healthiest counties are urban or suburban counties • Most (84%) of the 50 least healthy counties are rural.
Coos Health Outcomes * 90th percentile, i.e., only 10% are betterNote: Blank values reflect unreliable or missing data
Coos Health Factors: Health Behaviors * 90th percentile, i.e., only 10% are betterNote: Blank values reflect unreliable or missing data
Coos Health Factors: Clinical Care * 90th percentile, i.e., only 10% are betterNote: Blank values reflect unreliable or missing data
Coos Health Factors: Social & Economic Factors * 90th percentile, i.e., only 10% are betterNote: Blank values reflect unreliable or missing data
Coos Health Factors: Physical Environment * 90th percentile, i.e., only 10% are betterNote: Blank values reflect unreliable or missing data
Health As An ‘Economic Engine’ • Health Becomes A Form Of Capital • Health Expenditures Become Investments
Microeconomics of Health • Directly increases • the number of working years • the productivity of each year of work, • Indirectly enhances • education, • personal, family, and business income
Economic Loss To Business From Illness • Absenteeism – 2 million FTEs per year • ¼ of workers – 1 workday/month either absent from work or exhibit reduced productivity at work • Depression – average of 5.6 lost hours productivity/week • Cost to employers of $44 billion per year • Pain – productivity loss of over $61 billion per year • Employee Turnover – pre-employment history of a single hospitalization due to a chronic illness is associated with a 20% increase • high replacement costs • loss of the benefits of long-term experience
Overall Economic Impact • Chronic conditions cost to employers • exceeded $1 trillion in 2003 • may reach $5.7 trillion by 2030 • Improvements in survival and health in the United States from 1970 to 1999 increased the value from the output of the formal labor force by as much as 8%.
Macroeconomic • Increase • Internal investment • External investment • Alter the long-term demographics of a population
Investments • Internal • Increasing savings that provide financial capital for investment • External • Better population health encourages outside investment, technology transfer, and access to global markets • Poor health conditions raise concerns about the capability of the local workforce to meet the needs of investors
Non-healthcare Determinants Of Health • Medical care is a relatively minor contributor to overall health • More potent influences on health include: • increasing health-promoting personal behaviors, • reducing environmental health hazards, and • improving basic social systems that facilitate health. • Education • Link between health and economic development • Unhealthy children • Not prepared for school • Miss more school • Attend school fewer years • Learn less when in school • Community-based and participatory processes • directly involve the region's citizens in the debate, research, policy design, and evaluation of any interventions
Health = Economic Growth Historical studies have found that half of the overall economic growth in the United States during the last century may be associated with improvements in population health.
New Hampshire Health Employment • 3rd in average annual employment (12.8% of total) - 2008 • 27.7% (14,999 jobs) average annual increase 2000 - 2008 • 2nd in average annual wages (13.8% of total) 2008 • 82.1% ($1.5 billion) average annual health care wage increase 2000 – 2008
Next Steps • Pick Priorities • Implement Strategies • Evaluate Efforts • Assess Needs and Resources • Find Programs and Policies that Work
County Health Rankings • Where we live, learn, work, and play influences how healthy we are and how long we live. • Purpose - “Call to action” for state and local health departments to develop broad-based solutions with others in their community so all residents can be healthy.
