1. Health Status Workgroup February 16, 2011

2. Overview Health status portion of MUA only We have – developed a 4 var Social Deprivation Index – Related it to direct health status measures There is movement toward belief that SDI plus a direct health measure is appropriate Used county and PCSAs to demonstrate; no rec on rational service area

3. Big Picture SDI4 can be calculated across the nation at local level – This is identifying areas at risk of poor health Then considering direct measures of health – This allows for a check of actual outcomes

4. SDI 4—Robert Graham Center 4 variables Weights from research; vars from 2000 Census, unemployment 2007 Claritas – 100 pct poverty: 51% – Unemployment rate: 30% – % persons less than high school: 12% – % households with single parent 10%

5. SDI Calculation Place areas (county or PCSA) into deciles Multiply decile (1, 2,…10) by weight Sum index

6. Example Assume a county in fifth decile on all 4 – 5 x.51=2.55 – 5 x.30=1.50 – 5 x.12=0.60 – 5 x.10=.50 Sum of score =5.15

7. Does SDI4 correlate with health outcomes? Yes, there is a consistent relationship in which the worst decile is ‘sicker’ than the best using a variety of measures Correlations are not perfect which is one reason for including direct measures of health

8. Direct Measures of Health Status County: standardized mortality ratio; % fair/poor health status; Life expectancy at birth; unhealthy days; low birth weight PCSA: Diabetes & hypertension prevalence; self reported disability; Ambulatory care sensitive conditions; IMR

9. SDI4 We looked at a variety of variables, these 4 strongly capture the risk of poor health outcomes, and they are available at small units of geography (flexibility regardless of rational service area chosen) Other variables that could be included may be included under accessibility and/or ability to pay