Heartland Health 2020 Population Health Unnatural Causes Vignette

Heartland Health

2020 Population HealthUnnatural Causes Vignette

Heartland HealthStrategic Plan Update 2008

“It is unreasonable to expect that people will change their behavior easily when so many forces in the social, culture and physical environment conspire against such change.”

The Institute of Medicine


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Social Determinants(Poverty, economics, education, access…)


A Mom’s Education, A Baby’s Chance of Survival

Babies born to mothers who did not finish high school are nearly twice as likely to die before their first birthday as babies born to college graduates.


Less Education, Worse Health

Compared with college graduates, adults who have not finished high school are more than four times as likely to be in poor or fair health.

Persistent Gaps in Health Behaviors: Smoking

Education disparities in cigarette smoking have persisted over decades and the gaps between college graduates and those with less education appears to have widened.

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Strategic Plan Update 2008

Parents’ Income, A Child’s Chances for Health

Children in poor families are about seven times as likely to be in poor or fair health as children in the highest-income families.

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Lower Income, More Chronic Illness

Nearly one in every three poor adults has their activity limited by chronic illness, compared with fewer than one in 10 adults in the highest-income group.

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Lower Income Is Linked With Worse Health

Diabetes is twice as common among poor adults as among those in the highest-income group. The prevalence of heart disease is nearly 50 percent higher among poor adults than among adults in the highest-income group.

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The High Economic Stakes of Health Disparities

If Americans who have not completed college experienced the lower death rates and better health status of college graduates, these improvements would translate into potential gains of $1.007 trillion annually.

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Lifestyle and Chronic Disease

Ten-Year Review – Greater St. Joseph Behavior Risk Factor Survey

Locally, individuals with a lower level of education experience higher incidence of high blood pressure; overall the high blood pressure rate is higher than the U.S. rate.

The rate of smoking as increased locally among all populations, but more significantly among low income individuals; and overall is higher than the U.S. rate.



The rate of persons reporting any physical activity in the past month has remained fairly stable; however, this is a 30 point difference of low to high income.


The rate of obesity has increased locally among all populations, but more significantly among low income individuals; and overall is higher than the U.S. diabetes rate.


Uninsured

• Missouri = 14.7%

• USA = 15.3 %

• NWMO Region = Average 14.8%

• PSA/SSA counties 8.3% - 22.4%

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Financially Vulnerable(underinsured)

Medium House Income

• USA = $49,280

• MO = $44,767

Only 2 counties in PSA/SSA meet Missouri median income rate, 0 above USA rate

“Nearly 1/3 of service area are financially vulnerable”


Education

Bachelor degrees or higher

• USA = 24.4%

• Missouri = 21.6%

• PSA/SSA counties – only 2 counties meet Missouri rate, 0 at USA rate


Youth Health Issues

• Youth Poverty– Transience/Mobility– Youth Obesity/Physical Activity

• Abuse/Neglect– Leads to mental health issues and current shortage

of mental health services

• Obesity– Nutrition– Physical Activity


Senior Health Issues

• Chronic health issues

• Transportation

• Need for physical activity

• Poverty

• Preventative health care

• Information and referral

Wellness Connections 6 Year Results

Risk Factors present at HRS Screening

2001 2007 % Improvement

Blood Glucose 26% 5% 520%

Stress 34% 9% 377%

Blood Pressure 25% 11% 227%

Dietary Fat 67% 39% 71%

Tobacco 8% 6% 33%

Fruit/Veg 92% 73% 26%

Exercise 65% 56% 16%

Heartland Health employee Wellness Connections members measured in 2001 and again in 2007 (same employees) demonstrated significant reduction of health risk factors e.g. stress and exercise. These concepts are promoted in the market and community.


What works

Near Term Population Health• Aggressive and comprehensive care management

(both medical and social) • Wellness education and promotion with self and

group management• Local/regional partnerships addressing targeted

populations

• Lifestyle Medicine – “How daily lifestyle practices and habits impact short-term and long-term health and quality of life”.


What works

Long Term Population Health– Change from “medicalization” of social problems

to integrated planning and development that address root causes in:• Social Determinates (poverty, education …)• Lifestyle and Chronic Disease• Built Environment

Do the right thing for human well being.

Documents

Heartland Health 2020 Population Health Unnatural Causes Vignette