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Health Disparities - Hawaii Count y

Health Disparities for Hawaii County Health Conference August 13, 2010 Sharon H. Vitousek, M.D. North Hawaii Outcomes Project www.nhop.org. Health Disparities - Hawaii Count y. Health Outcomes Higher Death rates All causes Heart disease Stroke Overall cancer Infant Mortality

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Health Disparities - Hawaii Count y

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  1. Health Disparities for Hawaii CountyHealth ConferenceAugust 13, 2010Sharon H. Vitousek, M.D.North Hawaii Outcomes Projectwww.nhop.org

  2. Health Disparities - Hawaii County Health Outcomes • Higher Death rates • All causes • Heart disease • Stroke • Overall cancer • Infant Mortality • Traffic-related • Suicide • Lower life expectancy • Higher teen birth rates • Higher confirmed child abuse rates • Higher self-reported fair/poor health status

  3. Health Disparities - Hawaii CountyHealth Outcomes

  4. Health Disparities - Hawaii County • Geographic – Hawaii County • Economic • higher death rates with lower income • Education • Higher death rates with lower education • Ethnic: Genetic & Cultural, Socioeconomic • Higher CVD death rates --Hawaiian, Filipino • Lower cancer screening rates– Hawaiian • Lower rates of control - diabetes & blood pressure

  5. Health Disparities - Hawaii County Why?

  6. Framework for Population Health Institute of Medicine Social and Physical Environment Social, Economic & Physical Environment (Socioeconomic Determinants) Population HealthOutcomes Health-Related Behaviors HealthSystems (Access to Care & Quality)

  7. Health Disparities - Hawaii County Social and Economic Determinants • Higher unemployment • Lower income per capita • Higher % population living under 200% of federal poverty • More children living in poverty • Higher income inequality

  8. Higher % population living under 200% of federal poverty

  9. Health Disparities - Hawaii County Health Related Behaviors • Smoking • Binge drinking • (Obesity) • (Adults getting no exercise)

  10. Smoking

  11. Activity

  12. Health Disparities - Hawaii County Health Systems Access: • Higher uninsured • Lower ratio of physicians per 1,000 population • Higher percent of population without a personal doctor • Lower percent of female population receiving prenatal care Utilization & Cost: • Higher acute care hospitalizations per 1,000 population Quality:

  13. Consequences of Inadequate Access to Primary Healthcare Source: Institute of Health Improvement, John Wasson, M.D.

  14. Consequences of Inadequate Access • Delayed Care & Increased suffering • Higher ER utilization • Higher hospital utilization • Increased costs • Less focus on Prevention- Life style • Less recommended screening • Poorer outcomes

  15. Improving Population Health -- How? • Socioeconomic Determinants • Economic Development • Health sector: policy change & planning • Education/ Science sectors • Energy sector Improved Population HealthOutcomes • Health-Related Behaviors • Environmental AND Individual Strategies • Smoking cessation, physical activity, improved access to fruits & vegetables • Identifying and addressing problem drinking • HealthSystems • Primary Care Workforce Development • Grow our own, Policy, Broader Team, Redesign care delivery, Engage community

  16. Consequences of Improved Access • Timely Care & Decreased suffering • Lower ER utilization • Lower hospital utilization • Decreased costs • More focus on prevention & life style • More recommended screening • Better outcomes & Quality of Life • Improved productivity/business environment • Improved community wellbeing

  17. Hawaii Island Healthcare Alliance • Island wide, voluntary, collaborative group of stakeholders • Goal to improve health & health care in Hawaii County by increasing healthcare workforce & financial sustainability of providers • Endorses: • Growing own providers, • Broader primary care team • Collaboration to align policy efforts, • Friends of the Future is 501(c )(3) Fiscal Agent

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