1. Health Disparities for Hawaii County Health Conference August 13, Sharon H. Vitousek, M.D. North Hawaii Outcomes Project

2. Health Disparities - Hawaii County
Health Outcomes
Higher Death rates
All causes
Heart disease
Stroke
Overall cancer
Infant Mortality
Traffic-related
Suicide
Lower life expectancy
Higher teen birth rates
Higher confirmed child abuse rates
Higher self-reported fair/poor health status

3. Health Disparities - Hawaii County Health Outcomes

5. Can we make this the same as others just Hawaii county and state no data table under pls – OK

7. PLS insert infant mortality - OK

14. Health Disparities - Hawaii County
Geographic
– Hawaii County
Economic
higher death rates with lower income
Education
Higher death rates with lower education
Ethnic: Genetic & Cultural, Socioeconomic
Higher CVD death rates --Hawaiian, Filipino
Lower cancer screening rates– Hawaiian
Lower rates of control - diabetes & blood pressure

15. Health Disparities - Hawaii County
Why?
Can you please insert a ggraph for the indicators in yello??

16. Framework for Population Health Institute of Medicine
Social and Physical Environment
Social, Economic & Physical Environment
(Socioeconomic Determinants)
Health-Related Behaviors
Health Systems
(Access to Care & Quality)
Population
Health Outcomes

17. Health Disparities - Hawaii County
Social and Economic Determinants
Higher unemployment
Lower income per capita
Higher % population living under 200% of federal poverty
More children living in poverty
Higher income inequality

20. Higher % population living under 200% of federal poverty

23. Health Disparities - Hawaii County
Health Related Behaviors
Smoking
Binge drinking
(Obesity)
(Adults getting no exercise)

24. Smoking

26. Can you mke this the same take out north hawaii? - OK

27. Activity

28. Health Disparities - Hawaii County
 Health Systems
Access:
Higher uninsured
Lower ratio of physicians per 1,000 population
Higher percent of population without a personal doctor
Lower percent of female population receiving prenatal care
Utilization & Cost:
Higher acute care hospitalizations per 1,000 population
Quality:

32. Consequences of Inadequate Access to Primary Healthcare
Source: Institute of Health Improvement, John Wasson, M.D. 32

33. Consequences of Inadequate Access
Delayed Care & Increased suffering
Higher ER utilization
Higher hospital utilization
Increased costs
Less focus on Prevention- Life style
Less recommended screening
Poorer outcomes

34. Improving Population Health -- How?
Socioeconomic Determinants
Economic Development
Health sector: policy & planning
Education/ Science sector
Energy sector
Health-Related Behaviors
Environmental AND Individual Strategies
Smoking cessation, physical activity, nutrition
Identifying and addressing problem drinking
Health Systems
Primary Care Workforce Development
Grow our own, Policy, Broader Team, Redesign care delivery, Engage community
Improved
Population
Health Outcomes

35. Consequences of Improved Access
Timely Care & Decreased suffering
Lower ER utilization
Lower hospital utilization
Decreased costs
More focus on prevention & life style
More recommended screening
Better outcomes & Quality of Life
Improved productivity/business environment
Improved community wellbeing