in health matters, place matters -the health opportunity ......dec 15, 2016 · to identify hoi...
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In Health Matters, Place Matters -The Health Opportunity Index
(HOI)
Virginia Department of HealthOffice of Health Equity
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Identifying the Problem
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5
10
15
20
25
30
35
40
45
50
Teen
Bir
th R
ate
Hig
h Bl
ood
Pres
sure
Vege
tabl
es
Disp
arit
y in
Hea
lth
Stat
us
Diab
etes
Stro
ke
Lack
of
Hea
lth
Insu
ranc
e
Card
iova
scul
ar D
eath
s
Infa
nt M
orta
lity
Frui
ts
Prim
ary
Care
Phy
sici
ans
Canc
er D
eath
s
Chol
este
rol C
heck
Low
Bir
thw
eigh
t
Obe
sity
Phys
ical
Inac
tivi
ty
Exce
ssiv
e Dr
inki
ng
Hig
h Sc
hool
Gra
duat
ion
Smok
ing
Air
Pollu
tion
Une
mpl
oym
ent
Annu
al
Hig
h Ch
oles
tero
l
Prem
atur
e De
ath
Suic
ide
Hig
h H
ealt
h St
atus
Prev
enta
ble
Hos
pita
lizat
ions
Infe
ctio
us D
isea
se
Child
ren
in P
over
ty
Drug
Dea
ths
Poor
Phy
sica
l Hea
lth
Days
Poor
Men
tal H
ealt
h Da
ys
Viol
ent
Crim
e
Source: American Health Rankings by United Health Foundation Released 12/15/16
America’s Health RankingsUnited Health Foundation Scorecard
Overall Ranking = 19th
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HEALTH OUTPUT – RACIAL/ETHNIC
The State of Population Health
Source: Dr. Edward Ehlinger, Minnesota Commissioner of Health2016 President’s Challenge for the Association of State and Territorial Health Officials (ASTHO)
Opportunity Differences Geographic
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5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
Poverty Below 50 Poverty Below 100Poverty Below 125Poverty Below 150Poverty Below 185Poverty Below 200
Rural
Urban
Virgina
Gap @ 200
Gap @ 150 FPL
Gap @ 125 FPL
Gap @ 100 FPL
Poverty Gradient (Rural & Urban) in Virginia
Opportunity Differences Racial/Ethnic
All White Black
Hispanic or Latino Origin Asian
American Indian and Alaska Native
Native Hawaiian and Other Pacific Islander
Unemployment Rate (2015 Q3) 4.5% 3.4% 8.3% 5.2% NR NR NR
Education: On-Time Graduation Rate (2015) 90.5% 92.9% 86.3% 84% 95.6% 87.9% 94.4%Poverty: Less than 50% FPL 5.2% 4.2% 9.2% 6.4% 3.8% 7% 7.4%Poverty: Less than 100% FPL 11.4% 9.2% 20.1% 15.8% 8.3% 13.9% 11%Poverty: Less than 125% FPL 15.2% 12.3% 25.7% 21.4% 11.3% 18.7% 13.6%
Source: EPI analysis of Bureau of Labor Statistics Local Area Unemployment Statistics (LAUS) data and Current Population Survey (CPS) data;Virginia Department of Education State-level Cohort Report, Class of 2015; U.S. Census Bureau, 2010-2014 American Community Survey 5-Year Estimates.
Identifying the Means to a Solution
0
5
10
15
20
25
30
35
40
45
50
Teen
Bir
th R
ate
Hig
h Bl
ood
Pres
sure
Vege
tabl
es
Disp
arit
y in
Hea
lth
Stat
us
Diab
etes
Stro
ke
Lack
of
Hea
lth
Insu
ranc
e
Card
iova
scul
ar D
eath
s
Infa
nt M
orta
lity
Frui
ts
Prim
ary
Care
Phy
sici
ans
Canc
er D
eath
s
Chol
este
rol C
heck
Low
Bir
thw
eigh
t
Obe
sity
Phys
ical
Inac
tivi
ty
Exce
ssiv
e Dr
inki
ng
Hig
h Sc
hool
Gra
duat
ion
Smok
ing
Air
Pollu
tion
Une
mpl
oym
ent
Annu
al
Hig
h Ch
oles
tero
l
Prem
atur
e De
ath
Suic
ide
Hig
h H
ealt
h St
atus
Prev
enta
ble
Hos
pita
lizat
ions
Infe
ctio
us D
isea
se
Child
ren
in P
over
ty
Drug
Dea
ths
Poor
Phy
sica
l Hea
lth
Days
Poor
Men
tal H
ealt
h Da
ys
Viol
ent
Crim
e
Source: Adapted from American Health Rankings by United Health Foundation Released 12/15/16
America’s Health RankingsUnited Health Foundation Scorecard
Overall Ranking = 1st
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VIRGINIA STATE HEALTH IMPROVEMENT PLAN
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Source: King County (WA) Equity and Social Justice Annual Report December 2015
DESIGN AND METHODS
Health Opportunity Index
Identifies areas and populations that are most vulnerable to adverse health outcomes based on the Social
Determinants of Health
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Healthy People 2020:Five Elements of SDOH
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Educational Attainment
Population Density
Spatial Segregation
Material Deprivation
Population Churning
Job Participation
Income Diversity
Affordability of Housing and
Transportation
EPA Environmental
Hazards
Food Access
Walkability
Access to Care
Employment Access
HOI
Health Opportunity Index
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Geographic Level Can Mask Detail
Structure
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30+ Variables
13 Indicators
4 Profiles
1 Health Opportunity Index
Selecting Indicators
1. Identified by Local Health Departments & Stakeholders as important.
2. Linked to health outcomes in academic literature.
3. “Actionable” (e.g., segregation vs race)
4. Consistent, quality data for all Census Tracts in Virginia.
Health Opportunity Index
Community Environmental Profile
Economic Opportunity Profile
Consumer Opportunity Profile
Wellness Disparity Profile
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Air Quality Index (EPA)
Neurological Risk
Cancer Risk
Respiration Risk
On-road Pollution
Non-road
Non-point
Population Churning Index
Inflow Mobility
Outflow Mobility
Population-WeightedDensity
Walkability Index
Density
Diversity (Land-use)
Design (Connecti
vity)
Distance to Transit
Community Environmental Profile
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Consumer Opportunity Profile
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Affordability Index
Housing Cost
Transportation Costs
Average Income
Education Index
Avg. Years of Schooling
Food Accessibility
Index
% Low Income
% Low Access to Major Grocery Store
Distance to Grocery Store
Material Deprivation
Index
Unemployment
Autoless Homes
Home Ownership
Overcrowding
Economic Opportunity Profile
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Employment Access Index
Number of Jobs
Distance to Jobs
Income Inequality Index
Gini Coefficient
Job Participation Index
% of Working Age Population in the
Labor Force
Wellness Disparity Profile
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Access to Care Index
% Uninsured
Primary Care Physician FTEs within 30 miles
Segregation Index
Race/Ethnicity
Population
Spatial Influence Weighting
Uses of the HOI
To show that place matters when it comes to health To identify the impact of social determinants of health
on statewide health landscape To identify HOI indicators that are most influential on
local health To learn from communities with good health despite
adverse HOI indicators To build collaboration across all sectors to promote
health equity
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DISPARITIES & THE HOI
Monotonicity of HOI
Life Expectancy at BirthDisability Free Life
Expectancy
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Monotonicity of HOI
Infant Mortality Low Birth Weight
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Predictive Analytics for Low Birth Weight (Low HOI)
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Predictive Analytics for Low Birth Weight (High HOI)
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0.000 5.000 10.000 15.000 20.000 25.000 30.000
Employment Accessibility
Job Participation
IncomeEquality
Townsend Deprivation
PopDensity
PopChurning
AirQuality
HealthCare Accessibility
Walkability
Education
RacialDissimilarities
FoodAccess
Affordability
Three River Health District HOI
Rural/Urban Disparities
Rural-Urban Commuting Areas
Health Opportunity IndexUrban Areas Rural Areas
Profiles
For more informationplease contact:
Adrienne McFadden, MD, [email protected]
Justin Crow, [email protected]
Rexford Anson-Dwamena, [email protected]
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