The Pulse of Madison County: HEALTHCARE FORUM 2011 May 4, 2011 Mary Currier, MD, MPH Mississippi State Department of Health

Outline County rankings County and state statistics Prevention: – Benefits – Target behaviors

University of Wisconsin Population Health Institute. County Health Rankings Accessible at rankings.org. rankings.org

County Health Rankings Mississippi

County Health Rankings Madison County, Mississippi Madison County Error Margin National Benchmark* Mississippi Rank (of 81) Health Outcomes7 Mortality 27 Premature death10,78610,054-11,5185,56411,030 Morbidity 2 Poor or fair health16%14-18%10%22% 1 (tied) Poor physical health days Poor mental health days Low birthweight10.8% %6.0%11.6% 26 (tied with two others)

County Health Rankings Madison County, Mississippi Madison County Error Margin National Benchmark* Mississippi Rank (of 81) Health Factors1 Health Behaviors1 Adult smoking16%13-19%15%24% 2 (tied) Adult obesity30%26-34%25%34% 2 Excessive drinking12%9-14%8%11% 48 (tied with seven others) Motor vehicle crash death rate (tied ) Sexually transmitted infections Teen birth rate

County Health Rankings Madison County, Mississippi Madison County Error Margin National Benchmark* Mississippi Rank (of 81) Health Factors1 Clinical Care1 Uninsured adults 21%18-25%13%24% 13 (tied with nine others) Primary care providers 446:1 631:11,155:1 2 Preventable hospital stays (tied with two others) Diabetic screening 82%71-92%89%78% 22 (tied with six others) Mammography screening 67%57-77%74%56% 3

Madison County Error Margin National Benchmark* Mississippi Rank (of 81) Health Factors 1 Social & Economic Factors4 High school graduation 70% 92%64% 5 (tied with nine others Some college71% 68%53% 2 Unemployment6.9% %5.3%9.6% 3 Children in poverty 18%14-22%11%30% 3 Inadequate social support 16%13-19%14%25% 2 (tied) Single-parent households 31% 20%44% 5 (tied with two others) Homicide rate (tied with six others) County Health Rankings Madison County, Mississippi

Madison County Error Margin National Benchmark* Mississippi Rank (of 81) Health Factors1 Physical Environment2 Air pollution- particulate matter days Air pollution- ozone days (tied) Access to healthy foods 80% 92%58% 18 (tied) Access to recreational facilities County Health Rankings Madison County, Mississippi

Physical Inactivity US, 2008* *BRFSS data

Physical Inactivity* Madison Co. 26.0% Mississippi 32.3% US 23.8% *A person is considered physically inactive if during the past month, other than a regular job, he or she did not participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise.

Obesity US by County, 2008* * BRFSS data

Obesity, Mississippi by County 2008* Madison Co. 29.9% Mississippi 35.4% US 27.2% *BRFSS data

Diabetes, US by County, 2008* *BRFSS data

Diabetes, Mississippi by County, 2008* Madison Co. 10.6% Mississippi 11.6% US 8.3% *BRFSS data

Health Consequences of Obesity Coronary heart disease Type 2 diabetes Cancers (endometrial, breast, and colon) Hypertension (high blood pressure) Dyslipidemia (for example, high total cholesterol or high levels of triglycerides) Stroke Liver and Gallbladder disease Sleep apnea and respiratory problems Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint) Gynecological problems (abnormal menses, infertility)

Why Should Employers Care? The Cost of Obesity is High: In 2008, the annual healthcare cost of obesity in the US was estimated to be as high as 147 billion dollars a year, double the amount a decade ago (28). Annual medical expenses for the obese are estimated to be 42 percent higher than for a person of a healthy weight (28).  Workplace obesity prevention programs may be an effective way for employers, including local governments, to reduce obesity, lower health care costs, lower absenteeism, and increase employee productivity.

Settings for the Prevention and Treatment of Obesity Medical Settings Home School Work Site Community

Why Should Employers Get Involved? Potential benefits to employers: Reduces cost for chronic diseases Decreases absenteeism Reduces employee turnover Improves worker satisfaction Demonstrates concern for your employees Improves morale

Why Should Employers Get Involved? Potential benefits to your employees: Ensures greater productivity Reduces absenteeism Improves fitness and health Provides social opportunity and source of support within the workplace

Target Behaviors for Change CDC focuses on six target behaviors for the prevention of obesity and other chronic diseases 1.Increase physical activity 2.Increase consumption of fruits and vegetables 3.Increase breastfeeding initiation, duration, and exclusivity 4.Decrease consumption of sugar sweetened beverages 5.Decrease consumption of high energy dense, nutrient poor, foods 6.Decrease television viewing (screen time)

Employer Health Strategies* Health Impact Insurance Health Fairs & Assessments Disease Management Workplace Health Policies Community Health & Wellness *Paul Jarris, MD, Director of ASTHO

Policies and Environmental Strategies Vending machines and cafeteria – healthy options – fewer unhealthy options Point of decision prompts – reminders at the elevators to take the stairs Time allowed for walking – and a convenient place to do so Make the healthy choice the easy choice

“….it’s not about looking at healthcare as a cost for someone else to manage, but rather health as an investment that they need to leverage.” “…the health of nations will impact the wealth of nations. In fact, good health is good business.” Loeppke, R. (2008), “The value of health and the power of prevention”, International Journal of Workplace Health Management, vol. 1. No. 2, pp

Resources for Implementing Strategies and Measures and Monitoring Performance CDC’s Recommended Community Strategies and Measurements to Prevent Obesity in the United States, July, A detailed Implementation and Measurement Guide to assist local governments, states, and policy makers in implementing the CDC recommended strategies and reporting on the associated measurements: uide.pdf uide.pdf CDC’s obesity cost calculator Measures incorporated into ICMA’s Center for Performance Measurement system:

Other Resources for Prevention hite_papers/Obesity_in_Workforce_Brief Obesity in Workforce action/employers-and-businesses Recommendations for cost effective prevention CDC Healthier Worksite Initiative CDC Nutrition, physical activity and obesity website