Diversity in Health Using America’s Health Rankings® to Monitor Disparities Oakland, CA; March 14, 2013

America’s Health Rankings ® A Comprehensive Assessment of the Nation’s Health Longest running annual assessment of our nation’s health on a state-by-state basis Identifies the driving health trends of the nation Provides insights into the national health challenges on the horizon Evolved from a source of information to a robust, interactive tool that urges all populations and communities to act Under the editorial control of a scientific advisory committee that is based out of the University of North Carolina Chapel Hill Gillings School of Public Health Published by United Health Foundation, the American Public Health Association and Partnership for Prevention

Measures of Health Behaviors Smoking Binge Drinking Obesity High School Graduation Sedentary Lifestyle Community & Environment Violent Crime Occupational Fatalities Infectious Disease Children in Poverty Air Pollution Policy Lack of Health Insurance Public Health Funding Immunization Coverage Clinical Care Low Birthweight Primary Care Physicians Preventable Hospitalizations Health Outcomes Poor Mental Health Days Poor Physical Health Days Geographic Disparities Infant Mortality Diabetes Cardiovascular Deaths Cancer Deaths Premature Death

National discussion of disparities 4 Home Page Click 1 Click 2

National level discussion 5

State discussion  Print and web state summaries 6

Included metric  Outcomes section  Added in 2004 Edition 7

Distinct component: Geographic Disparity

State profiles 9 Click 1 Click 2 Click 3

State Profile 10 Smoking Obesity Sedentary Lifestyle Infant Mortality

Next? Unified Disparity Metric 11  Prevalence of Obesity Disparity in Rates  (highest rate – state rate) National Rate BRFSS, 2009 / 2010; BMI >= 30

Unified Disparity Measure 12  Prevalence of smoking Disparity in Rates  (highest rate – state rate) National Rate

Challenges Measuring Disparities  Insufficient sample size in some sub-groups with small populations may mask existing disparities  Lack of a uniform definition  Lack of universal disparity measure 13

Contact Info Tom Eckstein Arundel Street Consulting, Inc