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Rhode Island’s Health ─ 2012. Michael Fine, MD Director of Health. The Healthy People 2010 Perspective. Healthy People 2010 Indicators: Physical Activity Overweight and Obesity Tobacco Use Substance Abuse Responsible Sexual Behavior Mental Health Injury and Violence - PowerPoint PPT Presentation
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Rhode Island’s Health ─ 2012
Michael Fine, MDDirector of Health
The Healthy People 2010Perspective
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Adults who engage in moderate physical activity 30+ mins / day
Healthy People 2010
Physical Activity - Adults
0
20
40
60
2001 2005 2009
Year of Survey (BRFSS)
Pe
rce
nt
RI
US
HP 2010 Target: 30%
Teens who engage in physical activity 60+ mins / 5 days
Healthy People 2010
Physical Activity - Teens
0
10
20
30
40
50
2005 2009
Year of Survey (YRBS)
Pe
rce
nt
RI
US
HP 2010 Target: 85%
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Adults who are obese
Healthy People 2010
Overweight and Obesity - Adults
0
5
10
15
20
25
30
2000 2005 2010
Year of Survey (BRFSS)
Pe
rce
nt
RI
US
HP 2010 Target: 15%
Teens who are overweight or obese
Healthy People 2010
Overweight and Obesity - Teens
0
5
10
15
20
25
30
35
2000 2005 2010
Year of Survey (YRBS)
Pe
rce
nt
RI
US
HP 2010 Target: 5%
Adults who consume 5+ servings of fruits and vegetables / day
Healthy People 2010
Overweight and Obesity - Adults
0
5
10
15
20
25
30
35
2000 2005 2009
Year of Survey (BRFSS)
Pe
rce
nt
RI
US
HP 2010 Target: 50%
Teens who consume 5+ servings of fruits and vegetables / day
Healthy People 2010
Overweight and Obesity - Teens
0
5
10
15
20
25
30
2000 2005 2009
Year of Survey (YRBS)
Pe
rce
nt
RI
US
HP 2010 Target: 50%
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Adults who currently smoke cigarettes
Healthy People 2010
Tobacco Use - Adults
0
5
10
15
20
25
2000 2005 2010
Year of Survey (BRFSS)
Pe
rce
nt
RI
US
HP 2010 Target: 12%
Teens who currently smoke cigarettes
Healthy People 2010
Tobacco Use - Teens
0
5
10
15
20
25
30
2001 2005 2009
Year of Survey (YRBS)
Pe
rce
nt
RI
US
HP 2010 Target: 16%
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Adults who engaged in binge drinking in the past 30 days
Healthy People 2010
Substance Abuse - Adults
0
5
10
15
20
2001 2006 2010
Year of Survey (BRFSS)
Pe
rce
nt
RI
US
HP 2010 Target: 6%
Teens who report alcohol use in the past 30 days
Healthy People 2010
Substance Abuse - Teens
0
10
20
30
40
50
60
2001 2006 2009
Year of Survey (YRBS)
Pe
rce
nt
RI
US
HP 2010 Target: 11%
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Teens who never engaged in sexual intercourse, or did not engage in sexual intercourse in the past 30 days,
or who used a condom at last sexual intercourse
Healthy People 2010
Responsible Sexual Behavior - Teens
0
20
40
60
80
100
2001 2005 2009
Year of Survey (YRBS)
Pe
rce
nt
RI
US
HP 2010 Target: 90%
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Suicides per 100,000 population per year
Healthy People 2010
Mental Health - All Ages
0
5
10
15
2000 2005 2009
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
HP 2010 Target: 5 per 100,000
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Fatalities caused by car crashes per 100,000 population per year
Healthy People 2010
Injury and Violence - All Ages
0
2
4
6
8
10
1997 2007
Year of Death
De
ath
s p
er
10
0,0
00
RI
HP 2010 Target: 9.2 per 100,000
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Adult non-smokers exposed to second-hand smoke
Healthy People 2010
Environmental Quality - Adults
0
5
10
15
20
2004 2008
Year of Survey (BRFSS)
Pe
rce
nt
RI
HP 2010 Target: 45%
Children with elevated lead levels
Healthy People 2010
Environmental Quality - Children
0
2
4
6
8
10
2000 2009
Year of Observation
Pe
rce
nt
RI
HP 2010 Target: 0%
Homes tested for radon
Healthy People 2010
Environmental Quality - All Ages
0
5
10
15
2000 2008
Year of Testing
Pe
rce
nt
HP 2010 Target: 20%
Persons infected by food borne Campylobacter
Healthy People 2010
Environmental Quality - All Ages
0
5
10
15
20
2002 2010
Year of Observation
Pe
rce
nt
RI
HP 2010 Target: 12.3%
Persons infected by food borne Salmonella
Healthy People 2010
Environmental Quality - All Ages
0
5
10
15
20
2002 2010
Year of Observation
Pe
rce
nt
RI
HP 2010 Target: 6.8%
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Adults ages 65+ vaccinated for influenza in the past year
Healthy People 2010
Immunization - Ages 65+
0
20
40
60
80
100
2001 2005 2010
Year of Survey (BRFSS)
Pe
rce
nt
RI
US
HP 2010 Target: 90%
• Healthy People 2010 Indicators:– Physical Activity– Overweight and Obesity– Tobacco Use– Substance Abuse– Responsible Sexual Behavior– Mental Health– Injury and Violence– Environmental Quality– Immunization– Access to Health Care
Rhode Island’s Health
Changes and Comparisons
Adults with health insurance
Healthy People 2010
Access to Health Care - Adults
0
20
40
60
80
100
2000 2005 2010
Year of Survey (BRFSS)
Pe
rce
nt
RI
US
HP 2010 Target: 100%
Adults with a specific source of ongoing health care
Healthy People 2010
Access to Health Care - Adults
0
20
40
60
80
100
2000 2006
Year of Survey (BRFSS)
Pe
rce
nt
RI
HP 2010 Target: 96%
Pregnant women who receive first trimester care
Healthy People 2010
Access to Health Care - Females
0
20
40
60
80
100
2000 2010
Year of Survey (BRFSS)
Pe
rce
nt
RI
HP 2010 Target: 90%
Pregnant women who receive adequate prenatal care
Healthy People 2010
Access to Health Care - Adults
0
20
40
60
80
100
2000 2010
Year of Observation
Pe
rce
nt
RI
HP 2010 Target: 90%
Adults who used oral health care in the past year
Healthy People 2010
Access to Health Care - Adults
0
20
40
60
80
100
1998 2010
Year of Survey (BRFSS)
Pe
rce
nt
RI
HP 2010 Target: 56%
Adult women who received a Pap test in the past 3 years
Healthy People 2010
Access to Health Care - Adults
0
20
40
60
80
100
2000 2006 2010
Year of Survey (BRFSS)
Pe
rce
nt
RI
US
HP 2010 Target: 90%
Women ages 40+ who received a mammogram in the past 3 years
Healthy People 2010
Access to Health Care - Adults
0
20
40
60
80
100
2000 2006 2010
Year of Survey (BRFSS)
Pe
rce
nt
RI
US
HP 2010 Target: 70%
AnotherPerspective
• Four Additional Indicators:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital
Rhode Island’s Health
Notable Trends
• Four Perspectives:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital
Rhode Island’s Health
Disease Burden
Note: Average YPLL per total deaths under age 65; data represent deaths in 2007.
What Causes Premature Death?
Potential Years of Life Lost
Top Ten Causes of Premature Death
Potential Years of Life Lost
Unintentional Injury
0
10
20
30
40
50
60
70
69 72 75 78 81 84 87 90 93 96 99 02 05 08
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
Potential Years of Life Lost
Cancer
0
50
100
150
200
250
300
69 72 75 78 81 84 87 90 93 96 99 02 05 08
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
Potential Years of Life Lost
Heart Disease
0
100
200
300
400
500
600
69 72 75 78 81 84 87 90 93 96 99 02 05 08
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
Potential Years of Life Lost
Perinatal Conditions (RI only)
0
1
2
3
4
5
6
7
8
9
90 92 94 96 98 00 02 04 06 08 10
Year of Death
De
ath
s p
er
1,0
00
Postneonatal
Neonatal
Potential Years of Life Lost
Suicide
0
2
4
6
8
10
12
14
16
69 72 75 78 81 84 87 90 93 96 99 02 05 08
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
Potential Years of Life Lost
Homicide
0
2
4
6
8
10
12
69 72 75 78 81 84 87 90 93 96 99 02 05 08
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
Potential Years of Life Lost
Birth Defects
0
2
4
6
8
10
12
69 72 75 78 81 84 87 90 93 96 99 02 05 08
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
Potential Years of Life Lost
Liver Disease
0
5
10
15
20
25
69 72 75 78 81 84 87 90 93 96 99 02 05 08
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
Potential Years of Life Lost
Stroke
0
20
40
60
80
100
120
140
160
180
69 72 75 78 81 84 87 90 93 96 99 02 05 08
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
Potential Years of Life Lost
Diabetes
0
5
10
15
20
25
30
35
40
69 72 75 78 81 84 87 90 93 96 99 02 05 08
Year of Death
De
ath
s p
er
10
0,0
00
RI
US
• Four Perspectives:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital
Rhode Island’s Health
Disease Burden
Financial CostHealth Care Expenditures per Capita
$6,815
$8,309
$0
$2,000
$4,000
$6,000
$8,000
$10,000
Do
llar
s p
er C
apit
a
RI
US
2009
Financial Cost% Growth in Health Care Expenditures
5.3
6.0
0.0
2.0
4.0
6.0
8.0
10.0
Pe
rce
nt
Gro
wth
pe
r C
ap
ita
RI
US
% growth from 1980 through 2009
Financial CostDistribution of Health Care Expenditures
0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40
Hospital Care
Physician & Oth Professional Svcs
Rx Drugs & Oth Medical Nondurables
Nursing Home Care
Dental Services
Home Health Care
Medical Durables
Oth Health, Residential, & Personal Care
Hea
lth C
are
Ser
vice
Percent of Total Health Care Expenditure
RI
US
2009
• Four Perspectives:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital
Rhode Island’s Health
Disease Burden
• We are working to measure days of lost work and school attributable to illness and injury.
Days of Lost Work and School
• Four Perspectives:– Premature Death– Financial Cost– Days of Lost Work and School– Social Capital
Rhode Island’s Health
Disease Burden
• “The central premise of social capital is that social networks have value. Social capital refers to the collective value of all “social networks” (who people know) and the inclinations that arise from these networks to do things for each other (‘norms of reciprocity’).”
Social Capital
The Concept
From
• Social capital indicators include:– Club meetings attended last year– Community projects worked on last year– Times entertained at home last year– Times volunteered last year– Time visiting friends– Etc.
• Social capital indicators may be used to construct a “social cap-ital index,” to estimate social capital in a group or a locale.
Social Capital
Indicators of Social Capital
From
• Min:• Max:• Mean:• Std Dev:• RI Value:
Social Capital
“Social Capital Index” (by State)
From-1.431.710.020.78
-0.06
• States with high scores- Vermont 1.42- South Dakota 1.69- North Dakota 1.71
Michael Fine, MDDirector of Healthwww.health.ri.gov
