Committee Meeting April 16, 2018 Exploring Equity through Data - - PowerPoint PPT Presentation

Destination 2027 Steering Committee Meeting

April 16, 2018

AGENDA April 16th

th 2018

2018

• Exploring Equity through Data
• Health Equity Definition
• Local Public Health System - Key Findings
• Wrap-Up and Next Steps

Exploring Equity through Data

Reuben K. Varghese MD MPH Abby Raphael and Tricia Rodgers Destination 2027 Co-Chairs

Activity

• Partner up with someone different (new or want to know better)
• You have about 15 minutes to wander around to review the 4 data

points on posters (any order is fine) - there are 2 sets (one on each end of the room) to lessen the crowding

• Use the handout to capture your discussions as you peruse the data
• At 3:25, return to seats for a large group discussion

Exploring Equity through Data – discussion questions to explore with your partner

• What strikes you about this data?
• Does it relate to your work?
• In what ways does it show up in your work?
• In what ways does it show up in Arlington?
• What do you know about these populations?
• Do you have ideas on what may contribute to what you are seeing?

Exploring Equity through Data – Larger Group Discussion

Abby Raphael and Tricia Rodgers Destination 2027 Co-Chairs

Life Expectancy At Birth, 2009-2013

Data Source: Northern Virginia Health Foundation

8 17 5

2 4 6 8 10 12 14 16 18 All Black or African American White

Percent of Children in Poverty, Arlington County

Data Source: 2018 County Health Rankings, Virginia

Percent

13 12 33 3

5 10 15 20 25 30 35 Overall Black or African American Hispanic White

Teen Birth Rate (Per 1,000 Arlington Females Ages 15-19 Years)

Birth Rate Per 1,000 Females 15-19 Years

Data Source: 2018 County Health Rankings, Virginia

3,200 6,500 2,500 3,100

1,000 2,000 3,000 4,000 5,000 6,000 7,000 Overall Black or African American Hispanic White

Years of Potential Life Lost Before Age 75 Years (Per 100,000 Arlington Population)

YPLL Before Age 75 Years Per 100,000 Population

Data Source: 2018 County Health Rankings, Virginia

Health Equity Definition

Reuben K. Varghese MD MPH Abby Raphael and Tricia Rodgers Destination 2027 Co-Chairs

Health Equity Definition Share your views on Health Equity: – What does health equity mean to you? – What might a 30-second elevator speech sound like? – Can we agree on RWJF definition?

Table Discussion

"Everyone has a fair and just

• pportunity to be as healthy as

possible."

• Robert Wood Johnson Foundation

2017 Local Public Health System Assessment (LPHSA)

Destination 2027 Team – ACPHD Staff

Community Health Improvement Process

Information Gathering Strategic Issue Area Development Implementation Plan Actions

• Monitoring and

Evaluating

Information Gathering

Assessment Community Perspective Purpose Community Themes and Strengths Perceptions of people who live, work and play in Arlington What is important to community? What are community strengths, health issues, areas for improving quality of life? Community Health Status Population-based status and outcomes (health, well-being, social determinants) How healthy is community? What parts of our community experience different/worse health? Local Public Health System Performance System capacity and performance to deliver essential public health services What parts of our system perform well? What does system need to improve? Forces of Change Opportunities and threats to improving health in Arlington – can be political, economic, legal, policy, social, technological, environmental, scientific, ethical What forces are present that improve or worsen Arlington's health or opportunities for improving health? February March April

• Feb. - April

What is the Arlington Local Public Health System? ALL OF US

What does the Local Public Health System Evaluate?

LPHSA Key Findings

Core Function (3)

• Assessment
• Policy Development
• Assurance

Essential Service (10) Model Standards (30) Performance Measures (108)

LPHSA Process & Results

Performance Importance Top 5 and Top 1 Model Standard(s)

Result Categories for LPHSA Model Standards

Quadrant A High Importance Low Performance Quadrant B High Importance High Performance Quadrant C Low Importance Low Performance Quadrant D Low Importance High Performance

I P I P I P I P

I Importance P Performance

Result Categories for LPHSA Model Standards

Quadrant A High Importance Low Performance Quadrant B High Importance High Performance Quadrant C Low Importance Low Performance Quadrant D Low Importance High Performance

Performance- 2007 and 2017 LPHSA Among Top-Tiered Model Standards

Model Standards 2007 Performance Score 2017 Performance Score Change in Score from 2007-2017 Final Tier in 2017 LPHSA Process

7.2 Assure Linkage 56.3 50.0

 -6.3

1

2.2 Emergency Response

Not in 2007 LPHSA

100.0

n/a

2

4.2 Community Partnerships 25.0 50.0

 25.0

2

9.1 Evaluation of Population Health 56.3 50.0

 -6.3

2

2.1 Identification/Surveillance 58.3 91.7

 33.3

3

3.2 Health Communication 66.7 25.0

 -41.7

3

4.1 Constituency Development 43.8 50.0

 6.3

3

5.4 Emergency Plan 100.0 100.0

= 0.0

3

LPHSA Work Session: Large Group Discussion

Facilitators: Destination 2027 Team – ACPHD Staff

Reviewing LPHSA Key Findings - Discussion

• What do the following mean to you (how would you

describe them):

• Assuring Linkages
• Community Partnerships
• Evaluation of Population Health
• Investigation and Response to Public Health Threats and

Emergencies

Reviewing LPHSA Key Findings - Discussion

• Who is working in these areas?
• Assuring Linkages
• Community Partnerships
• Evaluation of Population Health
• Investigation and Response to Public Health Threats and Emergencies
• What forces of change or status quo might present either an
• pportunity or challenge to improving in these performance areas?
• (Time permitting) What needs to improve in these areas?

Wrap-Up

Next meeting will be Monday May 21st – 3:00 pm to 5:30 pm Refreshments at 2:30 pm

To prepare for our May 2018 Meeting

• Continue the health equity

conversation with others – look for another data point coming to your inbox

• Practice your elevator speech or

start to create a new one and try it out on colleagues, neighbors, friends

END OF PRESENTATION

2018 County Health Rankings: Health Outcomes

2018 County Health Rankings: Health Factors

Information Gathering

Assessment Community Perspective Purpose Community Themes and Strengths Perceptions of people who live, work and play in Arlington What is important to community? What are community strengths, health issues, areas for improving quality of life? Community Health Status Population-based status and outcomes (health, well-being, social determinants) How healthy is community? What parts of our community experience different/worse health? Local Public Health System Performance System capacity and performance to deliver essential public health services What parts of our system perform well? What does system need to improve? Forces of Change Opportunities and threats to improving health in Arlington – can be political, economic, legal, policy, social, technological, environmental, scientific, ethical What forces are present that improve or worsen Arlington's health or opportunities for improving health? + -

Integrating information across assessments: Stringing the Beads

Assessment Bead

CTSA CHSA LPHSA FOC

Issue (Theme) CTSA CHSA LPHSA FOC Mental Health Dental Health Better Collaboration Access to care + -

• +

+

• +

+ +

TO BE AS IS

People must agree on the current situation as it really is. People must agree on a cogent vision of the future they desire. People must agree on how to break out of the AS IS and chart an irreversible course toward the TO BE.

STAKE STRATEGY ENVIRONMENT

CORE PRIME

People must agree on what’s happening around them, which they’re unable to affect, but which will affect them. People must agree on what’s at stake if they stay where they are and don’t change.

Ground Rules

• Stay present (phones on vibrate/silent, limit side

conversations)

• Speak one at a time
• Be open to new ideas, welcome all perspectives
• Step up / step back
• Allow the facilitator to move the conversation along
• Not all the information will be available we will decide on the

best available information

• Come prepared to participate

Framework for Evaluating Data

Colleen Ryan Smith

Homework Guid ide – Guide to review assessment reports

 List Key Findings You Identify in Assessment 

For each key finding, is there a disparity (health inequity)? If yes, move on to step 3. If no, stop here and start the next issue- this issue is completed.

 What are the specific groups that are impacted by this disparity? 

How does the current environment either support or present challenges or barriers to systems change?



What fundamentally needs to change in the system (or systems) to move towards health equity?

CHSA results include:

Provides a variety of health and well-being topics.

To look at trends on various topics of health and well-being that can describe a community in a population health model.

Describe all of Arlington as well as its specific groups that have different experiences from the

• verall population

To characterize issue areas and specific populations where there are

• pportunities to improve our health

and well-being.

Measures Arlington results against other local, state, and federal goals and targets to improve our health

Are Arlington's experiences similar to

• ther counties, all of Virginia, the U.S?

PROGRESS DISPARITIES BENCHMARKS

CHSA – In Indicator Topic Areas

• Social Determinants of Health
• Economic Stability
• Education
• Health and Health Care (Access to Care)
• Neighborhood and Built Environment
• Social and Community Context
• Health-Related Quality of Life and Well-Being
• Cancers
• Diabetes
• Heart Disease and Stroke
• Other Chronic Diseases
• Nutrition and Weight Status
• Physical Activity
• Disability and Health
• Environmental Health
• Family Planning
• Maternal, Infant and Child Health
• HIV
• Sexually Transmitted Diseases
• Immunization and Infectious Diseases
• Injury and Violence Prevention
• Mental Health and Mental Disorders
• Oral Health
• Tobacco Use
• Substance Abuse

CHSA Scorecard- By the Numbers

• 218 Indicators provided

results for 24 Topic Areas

• 16 topic areas

demonstrated disparities in:

• gender/gender identity
• age/ school grade
• race
• ethnicity
• poverty status/income level
• educational attainment

Improving 10 Worsening 9 No Change 2 Cannot Be Assessed 3

PROGRESS

Disparities 16 Mixed Results 5 Cannot Be Assessed 3

DISPARITIES

Met 9 Did Not Meet 3 Mixed Results 2 Cannot Be Assessed 10

BENCHMARKS

CHSA Disparity Assessment by Population Groups

GENDER IDENTITY

85 55 3 2 2 17 37 33 30 45 11 16 94 94 160 160

0% 20% 40% 60% 80% 100% Female Male Transgender Not Sure Best Result Minor Disparity Major Disparity No Data to Assess

AGE

45 16 37 16 4 31 34 49 16 38 29 24 146 116 111 122

0% 20% 40% 60% 80% 100% Infants/Children Young Adults Adults Older Adults Best Result Minor Disparity Major Disparity No Data to Assess

Total Number of Indicators: 211

CHSA Disparity Assessment by Population Groups

RACE

9 1 38 2 49 6 41 7 19 3 13 32 42 3 28 4 31 31

119 200 126 202 118 142 0% 20% 40% 60% 80% 100% African American or Black American Indian or Alaska Native Asian Native Hawaiian or Other Pacific Islander White Some Other Race Best Result Minor Disparity Major Disparity No Data to Assess

HISPANIC ORIGIN

10 14 31 2 38 4 132 191

0% 20% 40% 60% 80% 100% Hispanic Not Hispanic Best Result Minor Disparity Major Disparity No Data to Assess

Total Number of Indicators: 211

CHSA Disparity Assessment by Population Groups

Socio Economic Status

2 7 13 4 3 11 4 2 3 4 3

206 190 190 202 0% 50% 100% In Poverty Less than $50K annual Income More than $50K Annual Income Less than High School Education Best Result Minor Disparity Major Disparity No Data to Assess

Other Subgroups

1 211 210 0% 20% 40% 60% 80% 100% Uninsured Persons with Disabilities Best Result Minor Disparity Major Disparity No Data to Assess

Total Number of Indicators: 211

Data Walk Activity

*According to the 2018 CHSA, there were 137 teen births (15-19 yrs) in Arlington County for 2013-2015 combined (3 years), or 46 teen births annually.

(Arlington Rank = 4) (Arlington Rank = 4)

(Arlington Rank = 2) (Arlington Rank = 1)

http://www.countyhealthrankings.org/app/virginia/ 2018/rankings/arlington/county/outcomes/overall/ snapshot

2018 County Health Rankings

8 3 3 1 1 2 2 2 2 2 3 3 1 3 3 4

1 2 3 4 5 6 7 8 9 10

2011 2012 2013 2014 2015 2016 2017 2018

Rank out of 39 Health Districts Year

Arlington's County Health Ranking for Health Factors and Health Outcomes

Health Factors Health Outcomes

(Arlington Rank = 3)

8% of Arlington children are living in poverty…

CHSA Work Session: Small Group Discussion

Small Group Discussion Questions:

When looking at the data what groups of people appear to be impacted most frequently (e.g. older adults, African American or Black, Less than high school education level) ? What topic areas those groups show up (e.g. economic stability, injury and violence prevention, chronic diseases)? What was surprising or unexpected about the information you found in the report about disparities, progress or benchmarks? What social determinants, systems, policies, and practices (upstream) may contribute to (or reinforce) disparities? / What are the upstream factors contributing to the downstream disparities we observed among these data sets? What are the forces of change with regard to these issues making things better/worse? (consider the following: political, economic, legal, policy, social, technological, environmental, scientific, ethical at the local, state, and national level)?