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Obesity clusters within the Empire Health Foundation Region. Joe Campo, MPH Healthcare Research Group Office of Financial Management. background- problem statement. background – the maps. Washington State. ZIP code areas habitable areas state/federal areas.

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Obesity clusters within the Empire Health Foundation Region


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    1. Obesity clusterswithin the Empire Health Foundation Region Joe Campo, MPH Healthcare Research Group Office of Financial Management

    2. background- problem statement

    3. background – the maps Washington State • ZIP code areas • habitable areas • state/federal areas Obesity clusters within the Empire Health Foundation Region November 2011

    4. background – the maps Washington State • ZIP code areas • habitable areas • state/federal areas • one dot equals 20 persons ages 18+ Obesity clusters within the Empire Health Foundation Region November 2011

    5. background – the problem 2003-2005 • percent obese by ZIP code area • <15 • 15-19 • 20-24 • 25-29 • 30+ • one dot equals 20 persons ages 18+ • BRFSS, DOH Obesity clusters within the Empire Health Foundation Region November 2011

    6. background – the problem 2008-2010 • percent obese by ZIP code area • <15 • 15-19 • 20-24 • 25-29 • 30+ • one dot equals 20 persons ages 18+ • BRFSS, DOH Obesity clusters within the Empire Health Foundation Region November 2011

    7. background – the focus 2008-2010 • percent obese by ZIP code area • <15 • 15-19 • 20-24 • 25-29 • 30+ • one dot equals 20 persons ages 18+ • BRFSS, DOH Obesity clusters within the Empire Health Foundation Region November 2011

    8. background – the focus Empire Health Foundation Region Obesity clusters within the Empire Health Foundation Region November 2011

    9. Behavioral Risk Factor Surveillance System (2003-2010) background – large area comparisons Obesity clusters within the Empire Health Foundation Region November 2011

    10. Behavioral Risk Factor Surveillance System (2003-2010) background – large area comparisons EHF’s percent obese Obesity clusters within the Empire Health Foundation Region November 2011

    11. Behavioral Risk Factor Surveillance System (2003-2010) background – county comparisons Obesity clusters within the Empire Health Foundation Region November 2011

    12. Behavioral Risk Factor Surveillance System (2003-2010) background – county comparisons Obesity clusters within the Empire Health Foundation Region November 2011

    13. Behavioral Risk Factor Surveillance System (2003-2010) background – county comparisons Obesity clusters within the Empire Health Foundation Region November 2011

    14. Behavioral Risk Factor Surveillance System (2003-2010) background – county comparisons Obesity clusters within the Empire Health Foundation Region November 2011

    15. Behavioral Risk Factor Surveillance System (2003-2010) background – county comparisons Obesity clusters within the Empire Health Foundation Region November 2011

    16. Behavioral Risk Factor Surveillance System (2003-2010) background – county comparisons Obesity clusters within the Empire Health Foundation Region November 2011

    17. Behavioral Risk Factor Surveillance System (2003-2010) trends – percent obese from 2003-2010 Pend Oreille Lincoln Ferry Adams Stevens Whitman Spokane Obesity clusters within the Empire Health Foundation Region November 2011

    18. Behavioral Risk Factor Surveillance System (2003-2010) trends – percent obese from 2003-2010 Pend Oreille Lincoln Ferry Adams Stevens Whitman Spokane + 2.9% per year + 3.5% per year Obesity clusters within the Empire Health Foundation Region November 2011

    19. background – geographic variations 2008-2010 • percent obese by ZIP code area • <15 • 15-19 • 20-24 • 25-29 • 30+ • one dot equals 20 persons ages 18+ • BRFSS, DOH Obesity clusters within the Empire Health Foundation Region November 2011

    20. background – geographic variations 2008-2010 Obesity clusters within the Empire Health Foundation Region November 2011

    21. background – sources and methods • data sources • brfss • inpatient hospitalizations • chars & oregon • births and deaths • zip-code population • cost-to-charge ratios • modified retail food ...environment index • healthy youth survey • tools • head-banging • weighted two-dimensional median-based smoothing algorithm • spatial scan statistic • joinpoint regression analyzes varying models to test if a change in trend is statistically significant. Obesity clusters within the Empire Health Foundation Region November 2011

    22. Behavioral Risk Factor Surveillance System (2003-2010) high & low obesity clusters 2003-2010 combined 2006-2010 combined 2003-2010 space-time Obesity clusters within the Empire Health Foundation Region November 2011

    23. Behavioral Risk Factor Surveillance System (2003-2010) high & low obesity clusters 2003-2010 combined 2006-2010 combined 2003-2010 space-time primary primary primary 2003-06 Obesity clusters within the Empire Health Foundation Region November 2011

    24. Behavioral Risk Factor Surveillance System (2003-2010) high & low obesity clusters 2003-2010 combined 2006-2010 combined 2003-2010 space-time RR=0.7 RR=0.7 RR=0.7 Obesity clusters within the Empire Health Foundation Region November 2011

    25. Behavioral Risk Factor Surveillance System (2003-2010) high & low obesity clusters 2003-2010 combined 2006-2010 combined 2003-2010 space-time RR= 1.4 2007-08 RR= 1.3 RR= 1.3 Obesity clusters within the Empire Health Foundation Region November 2011

    26. Behavioral Risk Factor Surveillance System (2003-2010) high & low obesity clusters 2003-2010 combined 2006-2010 combined 2003-2010 space-time RR=1.4 2007-09 RR=1.3 RR=1.4 Obesity clusters within the Empire Health Foundation Region November 2011

    27. Behavioral Risk Factor Surveillance System (2003-2010) high & low obesity clusters 2003-2010 combined 2006-2010 combined 2003-2010 space-time RR=1.2 RR=1.7 2009 RR= 1.4 Obesity clusters within the Empire Health Foundation Region November 2011

    28. Behavioral Risk Factor Surveillance System (2003-2010) high & low obesity clusters 2003-2010 combined Obesity clusters within the Empire Health Foundation Region November 2011

    29. Behavioral Risk Factor Surveillance System (2003-2010) high & low obesity clusters 2003-2010 combined Colville Springdale Deer Park Spokane City Davenport Cheney Ritzville Othello Obesity clusters within the Empire Health Foundation Region November 2011

    30. Behavioral Risk Factor Surveillance System (2003-2010) high & low obesity clusters 2003-2010 combined North Spokane City Lincoln/ Stevens South Spokane County Adams Obesity clusters within the Empire Health Foundation Region November 2011

    31. Behavioral Risk Factor Surveillance System (2003-2010) percent obese within high & low clusters Obesity clusters within the Empire Health Foundation Region November 2011

    32. Behavioral Risk Factor Surveillance System (2003-2010)percent obese within high & low clusters EHF’s % obese w/ 95% ci Obesity clusters within the Empire Health Foundation Region November 2011

    33. Behavioral Risk Factor Surveillance System (2003-2010)percent obese within high & low clusters Washington State’s % obese w/ 95% ci Obesity clusters within the Empire Health Foundation Region November 2011

    34. Behavioral Risk Factor Surveillance System (2003-2010)percent obese within high & low clusters EHF’s % obese w/ 95% ci Obesity clusters within the Empire Health Foundation Region November 2011

    35. Behavioral Risk Factor Surveillance System (2003-2010) population by weight groupings EHF’s % obese Obesity clusters within the Empire Health Foundation Region November 2011

    36. Behavioral Risk Factor Surveillance System (2003-2010) trends – percent obese from 2003-2010 South Spokane County North Spokane City Lincoln/ Stevens Adams Obesity clusters within the Empire Health Foundation Region November 2011

    37. Behavioral Risk Factor Surveillance System (2003-2010) trends – percent obese from 2003-2010 South Spokane County North Spokane City Lincoln/ Stevens Adams EHF trend + 2.6% per year Obesity clusters within the Empire Health Foundation Region November 2011

    38. Behavioral Risk Factor Surveillance System (2003-2010) trends – percent obese from 2003-2010 South Spokane County North Spokane City Lincoln/ Stevens Adams EHF trend + 2.6% per year + 4.4% Obesity clusters within the Empire Health Foundation Region November 2011

    39. Behavioral Risk Factor Surveillance System (2003-2010) trends – percent obese from 2003-2010 South Spokane County North Spokane City Lincoln/ Stevens Adams + 7.0% EHF trend + 2.6% per year ns Obesity clusters within the Empire Health Foundation Region November 2011

    40. Behavioral Risk Factor Surveillance System (2003-2010) trends – percent obese from 2003-2010 South Spokane County North Spokane City Lincoln/ Stevens Adams ns EHF trend + 2.6% per year Obesity clusters within the Empire Health Foundation Region November 2011

    41. Behavioral Risk Factor Surveillance System (2003-2010) trends – percent obese from 2003-2010 South Spokane County North Spokane City Lincoln/ Stevens Adams ns EHF trend + 2.6% per year Obesity clusters within the Empire Health Foundation Region November 2011

    42. Behavioral Risk Factor Surveillance System (2003-2010) summary of obesity rates • There are pronounced geographic variations in obesity rates • Compared to the nation, the EHF obesity rate is lower; compared to the state, it is higher • Within EHF Region, Adams County has the highest obesity rate; Spokane and Whitman have the lowest • Only Spokane &Whitman show a trend in their obesity rates: upwards • Small area clusters may differ, but there is a general concordance • For 2003-2010, three high and one low obesity clusters are seen • Only the low obesity South Spokane area has a trend: upwards • There is also a increasing trend seen in the EHF Region as a whole Obesity clusters within the Empire Health Foundation Region November 2011

    43. Key findings: Hospitalizations Age-adjusted patient day rates, trends and costs

    44. Washington & Oregon inpatient discharge data (2005-2009)diabetes (any diagnoses) age-adjusted patient day rates per 100,000 persons Obesity clusters within the Empire Health Foundation Region November 2011

    45. Washington & Oregon inpatient discharge data (2005-2009)diabetes (primary diagnosis) age-adjusted patient day rates per 100,000 persons Obesity clusters within the Empire Health Foundation Region November 2011

    46. Washington & Oregon inpatient discharge data (2005-2009)low-extremity amputations w/ diabetes age-adjusted patient day rates per 100,000 persons Obesity clusters within the Empire Health Foundation Region November 2011

    47. Washington & Oregon inpatient discharge data (2005-2009)diabetes long-term complications age-adjusted patient day rates per 100,000 persons Obesity clusters within the Empire Health Foundation Region November 2011

    48. Washington & Oregon inpatient discharge data (2005-2009)diabetes short-term complications age-adjusted patient day rates per 100,000 persons Obesity clusters within the Empire Health Foundation Region November 2011

    49. Washington & Oregon inpatient discharge data (2005-2009)uncontrolled diabetes age-adjusted patient day rates per 100,000 persons Obesity clusters within the Empire Health Foundation Region November 2011

    50. Washington & Oregon inpatient discharge data (2005-2009)coronary artery disease age-adjusted patient day rates per 100,000 persons Obesity clusters within the Empire Health Foundation Region November 2011