Healthy People 2010 Focus Area 1: Access to Quality Health Services Progress Review June 15, 2006

1-1. Health insurance coverage 1-2. Health insurance coverage for clinical preventive services * 1-3. Counseling about health behaviors Clinical Preventive CareEmergency Services Primary Care Long-Term Care & Rehabilitative Services Difficulty or delay in getting emergency care Rapid pre-hospital emergency care Toll-free number for poison control centers Trauma care systems Pediatric guidelines & protocols 1-4. Source of ongoing care 1-5. Usual primary care provider 1-6. Difficulty or delay in getting care 1-7. Core competencies in health provider training 1-8. Racial/ethnic representation in health professions 1-9. Hospitalizations for ambulatory care-sensitive conditions Access to long-term care services Pressure ulcers among nursing home residents Proposed for deletion * ImprovingGetting worseLittle or no changeBaseline onlyTarget metMixed progress Status of Access to Quality Health Services Objectives

1-12. Toll-free number for poison control centers Target Met Baseline Data Obtained Modified at Midcourse* 1-3. Counseling about health behaviors 1-7. Core competencies in health provider training Rapid pre-hospital emergency care Trauma care systems Access to long-term care services Progress: Three quarters of objectives and subobjectives with data beyond the baseline year are moving toward their targets. Status of Access to Quality Health Services Objectives * Midcourse modifications are proposed and are subject to final approval by HHS.

Objectives with Changes in Disparity Since the Baseline Note: Disparities are measured relative to the group with the best rate. Changes in disparity since the baseline, indicated by arrows, are between 10 and 49 percentage points and statistically significant at the 0.05 level. Data are not shown for objectives with insufficient data or for objectives with no change in disparity since the baseline for any of the characteristics shown. Characteristic not selected for this objective.= Increase in disparity= Decrease in disparity = B = Group with the best (most favorable) rate.

Clinical Preventive Care Emergency Services Primary Care Long-Term Care & Rehabilitative Services Highlighted Objectives 1-1. Health insurance coverage 1-3. Counseling about health behaviors Trauma care systems Access to long-term care services ImprovingGetting worseLittle or no changeBaseline onlyTarget metMixed progress 1-5. Usual primary care provider 1-6. Difficulty or delay in getting care 1-8. Racial/ethnic representation in health professions 1-9. Hospitalizations for ambulatory care-sensitive conditions

Near poor 50 Percent 2010 Target Obj. 1-1 I = 95% confidence interval. † Preliminary data for January – September Source: National Health Interview Survey, CDC, NCHS. Family Income Level Persons Under Age 65 with Health Insurance, by Income and Age, Poor Middle/ high Age Total †

Obj. 1-1 I = 95% confidence interval. Note: The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Source: National Health Interview Survey, NCHS, CDC. Percent 2010 Target American Indian/ Alaska Native Asian Native Hawaiian/ Pacific Islander Persons Under Age 65 with Health Insurance, by Race/Ethnicity Black White Hispanic

Percent yrs † Among adults who currently smoke. ‡ Among adults who currently report risky drinking behavior. I = 95% confidence interval. * Data for persons 75 years and older are statistically unreliable and are suppressed. Note: Data exclude adults who did not have a health care visit in the past year. Source: National Health Interview Survey, CDC, NCHS yrs. Adults Counseled by Their Provider about Health Behaviors, by Age Group, yrs yrs yrs. Obj. 1-3 a-d Physical Activity Diet & Nutrition Smoking Cessation † Risky Drinking ‡ * 2010 Target

Black Native Hawaiian 0 Percent 2010 Target 4020 Total Female Hispanic Male Asian Obj. 1-5 Persons with a Usual Primary Care Provider, 2003 Note: The American Indian category includes Alaska Natives. The Native Hawaiian category includes Pacific Islanders. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ. Less than high school High school At least some college American Indian White With activity limitations Without activity limitations

0 Percent 2010 Target 105 Total White Female Hispanic Male Asian/Pacific Islander Persons Experiencing Difficulties or Delays in Obtaining Needed Care, 2001 Note: The American Indian category includes Alaska Natives. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ. Poor Near poor Middle/high income American Indian Black With activity limitations Without activity limitations Obj. 1-6 Decrease desired

Obj. 1-8 a,c,d Note: Data are based on graduates from schools of public health, dentistry, pharmacy, and medicine. The 2010 targets are based on the U.S. Bureau of Census projections of the proportion of persons in each racial/ethnic group in the U.S. population in the year The Asian/Pacific Islander group has exceeded its target of 4% and is not shown. Source: Bureau of Health Professions, HRSA. Percent American Indian/ Alaska Native Racial and Ethnic Groups Underrepresented in Health Professions Black or African American Hispanic or Latino Target

SOURCE: Healthcare Cost and Utilization Project, AHRQ. Hospitalizations for Uncontrolled Diabetes among Persons Aged Years Total Medicaid FemaleMalePrivateUninsured Gender Insurance Status Admissions per 10,000 population Obj. 1-9b TargetDecrease desired

D.C. States With Processes to Monitor and Evaluate Trauma System Outcomes, 2002 Obj. 1-13h Source: Federal Trauma-EMS Systems Program Survey, HRSA. Legislated system & defined process (23) No system & no defined process (21) Non-legislated system & defined process (7)

Native Hawaiian * 0 Age-Adjusted Percent 2010 Target 5 Total Hispanic Asian Obj. 1-15a Persons Age 65 and Over without Access to Needed Home Health Care, 2001 * Data are statistically unreliable and are suppressed. = 95% confidence interval. MSA: Metropolitan Statistical Area. Note: Data are age adjusted to the 2000 standard population. The American Indian category includes Alaska Natives. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons are defined as needing home health care services if they require assistance with personal care needs or routine care needs. Source: National Health Interview Survey, CDC, NCHS. American Indian Black Within MSA Outside MSA White * * Poor Near poor Middle/high income 10 Decrease desired

Progress review data and slides are available on the web at: