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The Massachusetts Report Card. Measuring Our Progress Toward the Elimination of Racial, Ethnic, and Linguistic Disparities in Health Health Disparities Council Meeting June 22, 2009. Massachusetts Report Card Working Group (Participating Members). Mary Crotty, MNA Sherry Dong, Tufts

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The Massachusetts Report Card

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The massachusetts report card

The Massachusetts Report Card

Measuring Our Progress Toward the Elimination of Racial, Ethnic, and Linguistic Disparities in Health

Health Disparities Council Meeting June 22, 2009

Report Card Working Group of the MA-HDC 06.22.09


Massachusetts report card working group participating members

Massachusetts Report Card Working Group(Participating Members)

  • Mary Crotty, MNA

  • Sherry Dong, Tufts

  • Joe-Ann Fergus, MNA

  • Pam Jones, BPHC

  • Georgia Simpson May, DPH

  • Joel Weissman, EHS (advisor)

Report Card Working Group of the MA-HDC 06.22.09


Today s agenda

Today’s Agenda

  • Report Card Working Group Update

  • The MA Report Card

    • Purpose

    • Our Framework

    • Key Concepts

    • Report Card Structure

  • Indicators Exercise

  • Next Steps

Report Card Working Group of the MA-HDC 06.22.09


Report card working group update

Report Card Working Group Update

  • Working group meetings were held on June 2, and June 16

    • Process reviewed and goals set for moving forward

    • The next meeting is Scheduled for July 22

  • Report Card Group members also met with staff from the AGs office on June 11 (Maura Healey and Lois Johnson)

    • The goal of this meeting was to explore the concept of how or if existing policies and laws may contribute to or help to alleviate disparities.

  • Per the suggestion of Rep. Rushing at the last council meeting, the report card group emailed out a request for input to the council members.

  • The report card group is seeking input from council members regarding the model and content of the report card.

Report Card Working Group of the MA-HDC 06.22.09


Ma report card purpose

MA Report Card: Purpose

  • Identify priority health, social, and policy indicators for Massachusetts.

  • Create a systematic approach to tracking our progress, over time, in reducing racial, ethnic, and linguistic disparities.

  • Provide the residents of the Commonwealth with useable information on the health and wellness of Massachusetts.

Report Card Working Group of the MA-HDC 06.22.09


Ma framework for addressing health disparities

Access to Health Care

Societal/Policy Factors

Individual Factors

Community Factors

Extent and Quality of Health Care and Outcomes

Institutional Transformation

Personal Health Behaviors

Version 3+: 6/18/09

MA Framework for Addressing Health Disparities

Report Card Working Group of the MA-HDC 06.22.09


Key concepts for developing a ma report card

Key Concepts for Developing a MA Report Card

  • Racial, Ethnic & Linguistic Health Disparities

  • Not a Static Document

    • Periodic Updates

    • Parking Lot

  • Report Card Structure

    • Health and Social Statistics vs. Social Policy

    • Formatting

  • Selection Criteria for Indicators

Report Card Working Group of the MA-HDC 06.22.09


The massachusetts report card

Report Card Working Group of the MA-HDC 06.22.09


Key concept iii report card structure

Key Concept III: Report Card Structure

Health Status Indicator

  • Morbidity (prevalence/incidence of illness)

  • Mortality (death rate)

    Contributory Factors Associated with the Indicator

  • Health Care Utilization

    • Access and quality

  • Social Determinants

    • Basic needs, social well-being, community attributes (including environmental)

  • Personal Practices/Individual Factors

Report Card Working Group of the MA-HDC 06.22.09


Report card structure cont

Report Card Structure, cont.

  • Social Policy Levers

  • Civil Rights (“obvious” discrimination)

  • Other policies, laws, etc that appear to be race neutral but may affect the health of racial-ethnic minorities disproportionately

    • Zoning / restrictive ordinances

    • Mortgage and foreclosure policies and practices

    • Medicaid rates resulting in poor access/low quality

    • Workplace health and inspections, e.g., nail salons, auto body shops, taxi drivers

Report Card Working Group of the MA-HDC 06.22.09


Kis miv

KIS MIV

Keep It Simple, Make It Visual

Report Card Working Group of the MA-HDC 06.22.09


King county wa

King County, WA

Report Card Working Group of the MA-HDC 06.22.09


The massachusetts report card

King County, WA

Report Card Working Group of the MA-HDC 06.22.09


Formatting considerations

Formatting Considerations

  • Content

  • Length

  • Resources

Stop for Discussion

Report Card Working Group of the MA-HDC 06.22.09


The massachusetts report card

Example: Age-Adjusted Asthma ED Visits and Hospitalizations by Race/Ethnicity 2003-2005

Source: MDPH, Bureau of Health Information, Statistics, Research and Evaluation, Health Survey Program

Report Card Working Group of the MA-HDC 06.22.09


The massachusetts report card

Use the Example to Build Our Report Card

  • What do we want to know? What can we measure?

  • Can we intervene and where? Are there policy

  • implications?

  • _______________________________________

    • % who need inhalers who do not have them

    • % living in substandard housing

    • % living in areas with poor air quality

    • Educational level

    • Household income

  • The rate of asthma ED visits and hospitalization may be a

  • proxy for other health care access issues

    • timely access to ambulatory services

Report Card Working Group of the MA-HDC 06.22.09


The massachusetts report card

Example, cont.

Asthma Related ED Visits by R/E(MA: 1,038/100,000)

Contributory Factors Associated with the Indicator

  • Health Care Utilization

    • ______

  • Social Determinants

    • ______

  • Personal Practices/Individual Factors

  • Social Policy Levers

    • Medicaid Reimbursement

    • Environmental Hazards

  • Report Card Working Group of the MA-HDC 06.22.09


    Indicators what do we want to know

    IndicatorsWhat do we want to know?

    • Selection Criteria

    • What’s been identified

    • What needs to be included

    • Prioritize

    Report Card Working Group of the MA-HDC 06.22.09


    Key concept iv indicator selection criteria

    Key Concept IV: Indicator Selection Criteria

    • Availability of Data (Measures and Statistics)

    • Known Instances of Disparities

    • Size of Disparities

    • Amenable to intervention

      • an indicator we can influence

      • an area we can adjust to impact the indicator

      • can identify an area(s) in the system to apply an intervention(s) that will change the indicator

    • Presence of Policies which would impact disparity (Social Policies)

    Report Card Working Group of the MA-HDC 06.22.09


    Our indicators

    Our Indicators

    Review “Proposed Indicators and Ranking” Document

    • What we have

    • What else do we want to know

    Stop for Discussion

    Report Card Working Group of the MA-HDC 06.22.09


    Let s prioritize

    Let’s Prioritize

    • Write In Missing Indicators

    • Ranking of Indicators

      • On a Scale of 1 (Low) to 5 (High)

    Report Card Working Group of the MA-HDC 06.22.09


    Ma report card next steps

    MA Report Card, Next Steps

    • Compile

    • Format

    • Present a Mock-up of a MA Report Card

    Report Card Working Group of the MA-HDC 06.22.09


    The massachusetts report card

    Thank You!

    Report Card Working Group of the MA-HDC 06.22.09


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