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Wisconsin Department of Health Services January 2014 P-00522V Healthiest Wisconsin 2020 Baseline and Health Disparities Report People with Disabilities.

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Presentation on theme: "Wisconsin Department of Health Services January 2014 P-00522V Healthiest Wisconsin 2020 Baseline and Health Disparities Report People with Disabilities."— Presentation transcript:

1 Wisconsin Department of Health Services January 2014 P-00522V Healthiest Wisconsin 2020 Baseline and Health Disparities Report People with Disabilities

2 PEOPLE WITH DISABILITIES Background Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report Context Key points Data Demographic and socioeconomic data Access to and use of health care services Risk behaviors and health outcomes References Links to additional reports and resources Contacts Chapter Outline Chapter outline 2

3 PEOPLE WITH DISABILITIES Report Overview This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included. Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations. Technical notes are available at: Report overview 3

4 PEOPLE WITH DISABILITIES Report Format Full Report Format: PDF Intended use: reference document Chapters Format: Annotated PowerPoint slide set Intended uses: presentations to –Decision-makers –Service providers –Community leaders –The public Sample annotated slide Report overview 4

5 PEOPLE WITH DISABILITIES Report Outline Executive Summary Section 1: Introduction Section 2: Demographic overview Section 3: Health focus areas Section 4: Infrastructure focus areas Section 5: Data summaries by population Section 6: Technical notes Report overview 5

6 PEOPLE WITH DISABILITIES Report Outline: Detail Section 3: Health focus areas Alcohol and other drug use Chronic disease prevention and management Communicable diseases Environmental and occupational health Healthy growth and development Injury and violence Mental health Nutrition and healthy foods Oral health Physical activity Reproductive and sexual health Tobacco use and exposure Section 4: Infrastructure focus areas Access to health services Report overview 6

7 PEOPLE WITH DISABILITIES Report Outline: Detail Section 5: Data summaries by population Racial/ethnic minority populations o American Indians o Asians o Blacks o Hispanics People of lower socioeconomic status People with disabilities Lesbian, gay, bisexual, and transgender populations Geography Report overview 7

8 PEOPLE WITH DISABILITIES Data notes Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: The 95% confidence intervals are denoted by error bars. Where confidence intervals do not overlap, as shown in the example on the right, differences are statistically significant. Larger confidence intervals may indicate less reliable estimates that should be interpreted with caution. Population estimates that are considered unreliable are excluded. Misclassification of racial/ethnic groups may affect the accuracy of rates. Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non- Hispanic. Report overview 8

9 PEOPLE WITH DISABILITIES Factors that influence health Social determinants of health Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, Report overview 9

10 PEOPLE WITH DISABILITIES People with disabilities: context Summary 10 Healthiest Wisconsin 2020 focuses on the elimination of health disparities. For the first time, people with disabilities are included in the plan as a population that experiences significant disparities in health and health care access. People with disabilities can be healthy and well; however, many face social, structural and environmental barriers that restrict participation in daily activities and/or access to care. Gaining a better understanding of these barriers can assist public health, health care providers, and the public in reducing health disparities for people with disabilities.

11 PEOPLE WITH DISABILITIES Key Points: Adults with disabilities One in six (16%) adults ages and 28% of adults ages 65 and older in Wisconsin are living with a disability. Compared to people without a disability, adults with a disability are more likely to: –Be low-income. –Have less access to health care. –Report higher health risk factors such as tobacco use, secondhand smoke exposure, obesity, and obesity-related chronic conditions. The presence of a chronic condition, such as diabetes or asthma, may be the reason some people report having a disability. Key points 11

12 PEOPLE WITH DISABILITIES Source: National Survey of Childrens Health, 2011/2012. Key Points: Children and youth with special health care needs (CYSHCN) About 22% of Wisconsin children have a special health care need. Compared to children and youth without a special health care need, CYSHCN: –Have more unmet medical/dental needs and more difficulty getting specialty care, despite being more likely to have a medical home and to receive preventive care. –Have two or more adverse childhood experiences (ACEs). –Have lower school attendance and engagement. Parents of CYSHCN are: –More likely than other parents to be stressed and to have their work life affected by childcare issues. 12 Key points

13 PEOPLE WITH DISABILITIES Adults living with a disability 13

14 PEOPLE WITH DISABILITIES Demographic characteristics 14

15 PEOPLE WITH DISABILITIES Percent of adults with disabilities by age group, Wisconsin, Sources: American Community Survey, ; Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); landline-cellphone combined dataset. Demographic and socioeconomic data 15

16 PEOPLE WITH DISABILITIES Percent of Wisconsin adults ages with disabilities, by race/ethnicity, Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. 16 Demographic and socioeconomic data

17 PEOPLE WITH DISABILITIES Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); landline-only dataset. 17 Demographic and socioeconomic data Percent of Wisconsin adults ages with disabilities, by income level,

18 PEOPLE WITH DISABILITIES Access to health care and health status 18

19 PEOPLE WITH DISABILITIES Use of and barriers to health care among Wisconsin adults ages 18-64, by disability status, Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset. Access to health care 19

20 PEOPLE WITH DISABILITIES Rates of fair or poor health by disability status, Wisconsin adults ages 18-64, Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset Note: Health status questions only asked Health status 20

21 PEOPLE WITH DISABILITIES Health risk factors and outcomes 21

22 PEOPLE WITH DISABILITIES Rate of physical inactivity among Wisconsin adults, by disability status, Physical activity Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset. 22

23 PEOPLE WITH DISABILITIES Rates of overweight and obesity by disability status, Wisconsin adults ages 18-64, Nutrition Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset. 23

24 PEOPLE WITH DISABILITIES Rates of diabetes by disability status, Wisconsin adults ages 18-64, Chronic diseases Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset. Note: Diabetes excludes women who were diagnosed during pregnancy, and does not differentiate between type 1 and type 2 diabetes. Prediabetes question was only asked in years

25 PEOPLE WITH DISABILITIES Rates of high cholesterol and blood pressure by disability status, Wisconsin adults ages 18-64, 2009 and 2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset. 25 Chronic diseases

26 PEOPLE WITH DISABILITIES Rates of binge drinking and heavy drinking by disability status, Wisconsin adults ages 18-64, Alcohol and other drug use 26 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset.

27 PEOPLE WITH DISABILITIES Rate of Adverse Childhood Experiences (ACEs) by disability status, Wisconsin adults ages 18-64, Mental health 27 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset.

28 PEOPLE WITH DISABILITIES Rates of insufficient sleep and emotional support by disability status, Wisconsin adults ages 18-64, Mental health 28 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset.

29 PEOPLE WITH DISABILITIES Rates of tooth removal and dental visits in the past year, by disability status, Wisconsin adults ages 18-64, Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); landline-only dataset. Note: Tooth removal question asked in 2008, 2010, and Dentist visit question asked in 2008 and Oral health

30 PEOPLE WITH DISABILITIES Smoking status among Wisconsin adults ages 18-64, by disability status, Tobacco use and exposure Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset. Note: Menthol question was asked in 2009 and 2010; smokeless tobacco question was asked in

31 PEOPLE WITH DISABILITIES Secondhand smoke exposure among Wisconsin adults ages 18-64, by disability status, Tobacco use and exposure Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset. Note: Smoking at work question was only asked in 2009 and

32 PEOPLE WITH DISABILITIES HIV testing and risk behaviors among Wisconsin adults ages 18-64, by disability status, Reproductive and sexual health Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); land-line only dataset. 32

33 PEOPLE WITH DISABILITIES Rates of influenza and pneumonia vaccination among older adults (ages 65+) in Wisconsin, by disability status, Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); landline-only dataset. Immunization among older adults 33

34 PEOPLE WITH DISABILITIES Children and Youth with Special Health Care Needs (CYSHCN) 34

35 PEOPLE WITH DISABILITIES Percentage of children with special health care needs, Wisconsin and the United States, Source: National Survey of Childrens Health, Demographics 35

36 PEOPLE WITH DISABILITIES Percentage of children with special health care needs, by age, Wisconsin, Source: National Survey of Childrens Health, Demographics 36

37 PEOPLE WITH DISABILITIES Percentage of children with oral health needs, by disability status, Wisconsin, Oral health 37 Source: National Survey of Childrens Health,

38 PEOPLE WITH DISABILITIES Percentage of children ages 10-17, who are obese, by disability status, Wisconsin, Nutrition 38 Source: National Survey of Childrens Health,

39 PEOPLE WITH DISABILITIES Percentage of children ages 6-17 who missed school because of illness or injury, by disability status, Wisconsin, Missed school 39 Source: National Survey of Childrens Health,

40 PEOPLE WITH DISABILITIES Percentage of children with parents who report usually or always feeling stressed from parenting and parents who have had to cut back hours or quit a job because of child care issues 40 Mental health Source: National Survey of Childrens Health,

41 PEOPLE WITH DISABILITIES Percentage of children ages 6-17 covered by public health insurance and whose health insurance (public and/or private) was inadequate, by disability status, Wisconsin, Access to health care 41 Source: National Survey of Childrens Health,

42 PEOPLE WITH DISABILITIES Percentage of children who saw health care providers for preventive medical and dental care during the past 12 months, Wisconsin, Access to health care Source: National Survey of Childrens Health,

43 PEOPLE WITH DISABILITIES Percentage of children who have a medical home and percentage of children who have problems getting specialist care, by disability status, Wisconsin, Access to health care Source: National Survey of Childrens Health,

44 PEOPLE WITH DISABILITIES Percentage of children who live with someone who uses tobacco and are exposed to secondhand smoke at home, by disability status, Wisconsin, Tobacco use and exposure 44 Source: National Survey of Childrens Health,

45 PEOPLE WITH DISABILITIES Percentage of children who had two or more adverse childhood experiences (ACEs), by disability status, Wisconsin, Mental health 45 Source: National Survey of Childrens Health,

46 PEOPLE WITH DISABILITIES References 1.University of Wisconsin Population Health Institute. County Health Rankings, Center for Urban Population Health. Milwaukee Health Report, LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies. 20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf 20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf 4.Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057– Wisconsin Department of Health Services (DHS). Healthiest Wisconsin Where in health is disability? Public health practices to include people with disabilities, 2012: rounds/archives/2012/December2012.htmhttp://www.cdc.gov/about/grand- rounds/archives/2012/December2012.htm National Survey of Childrens Health, Sampling and Survey Administration, Child and Adolescent Health Measurement Initiative (2012): administration.pdf administration.pdf 46 References

47 PEOPLE WITH DISABILITIES 8.U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans Midcourse Report: Strategies to Increase Physical Activity Among Youth: 9.CDC. Overweight and obesity among people with disabilities CDC. Alcohol Use and Health. use.htmhttp://www.cdc.gov/alcohol/fact-sheets/alcohol- use.htm 11.CDC. Adverse Childhood Experience Study. 12.CDC. Insufficient sleep is a public health epidemic CDC. Health-related quality of life: Well-being concepts CDC. Smoking and Tobacco Use: Secondhand Smoke Facts. acts/index.htm acts/index.htm 15.Health Resources and Services Administration (HRSA). 2009/10 NS-CSHCN: Health Conditions and Functional Difficulties. Data Resource Center: 16.HRSA. Fast Facts: 2011/12 National Survey of Childrens Health References

48 PEOPLE WITH DISABILITIES 17.Child and Adolescent Health Measurement Initiative (2002). Approaches to Identifying Children and Adults with Special Health Care Needs HRSA. Children with Special Health Care Needs in Context: A Portrait of States and the Nation Felitti, et al., (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine - May 1998 (Vol. 14, Issue 4, Pages ). 48 References

49 PEOPLE WITH DISABILITIES Links to additional reports and resources Wisconsin Department of Health Services (DHS): Disabilities and Impairments, Children and Youth with Special Health Care Needs Program, Centers for Disease Control and Prevention (CDC) Disability and Health Data System, National Survey of Children with Special Health Care Needs, Families with Special Needs, University of Wisconsin-Madison, Waisman Center 49 References

50 PEOPLE WITH DISABILITIES Contacts Bureau of Community Health Promotion Division of Public Health Department of Health Services Sharon Fleischfresser, MD, MPH Medical Director Children and Youth with Special Health Care Needs Program Elizabeth Oftedahl, MPH CYSHCN Epidemiologist Maternal and Child Health Program Family Health Section Jessica Seay, MPH State Systems Development Initiative Coordinator Maternal and Child Health Program Family Health Section 50 Contacts


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