Oregon Public Health Data: What’s in it for CCOs? Katrina Hedberg, MD, MPH Health Officer & State Epidemiologist March 10, 2014

Public Health Division 2 Broad Public Health Priorities Substance use: tobacco, alcohol, drug overdose Obesity: physical activity, nutrition Health Equity: low income, racial/ ethnic disparities

Public Health Division 3 Overview Oregon’s “State Health Profile” Public health data sources Public health priority areas SIM public health surveillance activities

Public Health Division 4 State Health Profile Published in 2012, updated in population health indicators Array: social context, diseases, behaviors, healthcare access, disparities

Public Health Division 5 Population Health Definitions Public Health View –Defined by time, place, person –Indicators at community level Health Care Delivery (Clinical View) –Panel of patients: eligible, enrolled –Patients with specific conditions or utilization

Public Health Division 6 Traditional Public Health Data: Population Health Assessment Vital Records: Birth, death, abortion Disease Reporting –Communicable diseases; Cancer Population-based surveys –Behavior Risk Factor Surveillance System –Oregon Healthy Teens

Public Health Division 7 Care Coordination/ Service Delivery Service receipt: –Vaccines; WIC; C-care; Home visiting; HIV care Hospital discharge data All payer/ all claims data Electronic Health Records: –health information exchange

Public Health Division 8 Mortality

Public Health Division 9 Causes of Death & Premature Death, 2011

Public Health Division 10 Mortality by Race/ Ethnicity

Public Health Division 11 Teen Births

Teen Pregnancy (15-17 yrs)

Teen Pregnancy Rates by Race / Ethnicity, 2010

Public Health Division 14 Reportable Diseases

Public Health Division 15 Pertussis Incidence, Oregon

Public Health Division 16 Chlamydia incidence

Public Health Division 17 Oregon syphilis cases number

Public Health Division 18 Oregon syphilis cases number >50% of MSM cases were HIV+

Public Health Division 19 Cancer cases and deaths Oregon women, 2010

Public Health Division 20 Cancer cases and deaths Oregon men, 2010

Chronic Conditions by SES percent

Public Health Division 22 Health Risk Behaviors

Public Health Division 23 Behaviors that Kill Oregonians

Public Health Division 24 Tobacco

Public Health Division 25 Cigarette smoking prevalence

Percentage of Adults who Smoke Oregon 2012 Source: Oregon Behavioral Risk Factor Surveillance System

Public Health Division 27 Percent of Adults Who Smoke by Health Insurance, 2012 Source: Oregon Behavioral Risk Factor Surveillance System

Public Health Division 28 Smoking Prevalence by SES Oregon BRFSS Low SES Not Low SES 44 % 37% 19 % 13% Low SES Higher SES

Public Health Division 29 Obesity: Diet / Physical Activity

Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Public Health Division 33 Obesity Trends* Among U.S. Adults BRFSS, 2009 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Public Health Division

35 Obesity in Oregon Adults and 8th Graders Source: Oregon BRFSS and Oregon Healthy Teens Survey New BRFSS weighting method began in 2010.

Public Health Division 36 Percentage of Obese Adults by Health Insurance, 2012 Source: Oregon Behavioral Risk Factor Surveillance System

Public Health Division 37 Oregon Diabetes Prevalence New BRFSS weighting method began in 2010.

Oregon Teens Exercising >60 min/ day, >5 days per week, 2013 Source: Oregon Healthy Teens

Public Health Division 39 Alcohol

Public Health Division 40 Alcohol-related deaths, by age group, Oregon, 2011Alcohol-related deaths, by age group, Oregon, 2011Alcohol-related deaths, by age group, Oregon, 2011Alcohol-related deaths, by age group, Oregon, 2011

Public Health Division 41 Binge Drinking in Adults by Age; Oregon, 2011

Public Health Division 42 Community Health Interventions

Public Health Division 44 Tobacco Control: Community Interventions Limit access Vending machines Placement of cigarettes Cost: taxes Smoke-free Air Policies Media

Quit Line Counseling Nicotine replacement therapy Link to benefits from health insurance Public Health Division

46

Public Health Division 47 Physical Activity Policies Zoning/ Design (e.g. sidewalks) Green space Mass transit Public education / school PE classes Gasoline tax/transit subsidies

Public Health Division

49 Healthy Diet Policies Access –Vending machines (work / school) Availability of choice –Restaurant / store locations Public Education –Menu labeling Cost –Tax sugar-sweetened beverages / fast food –Price incentives / subsidies for healthy foods

Public Health Division 50 Alcohol Policies Dram shop liability Limiting hours of sale Regulate alcohol outlet density Increase price Enhanced enforcement prohibiting sales to minors Public Health Division

51 SIM Activities

Public Health Division 52 SIM Funds for PH Surveillance Analysis of state health profile by –CCO region –Race/ ethnicity Medicaid BRFSS (baseline) Analytic tool (OPHAT) –For community health assessment analyses 52

Questions? Public Health Division