Intentionally Designing Health & Well-Being in Eastern Virginia Marissa J. Levine, MD MPH State Health Commissioner
Intentional Design: A Population Health Approach 2
Key Points/Assumptions • Health and well-being matter to all people in Virginia • Dealing with the burden of disease and breaking the cycle of debilitating disease must be addressed simultaneously • Community-led, data-driven, focused solutions are the ideal • Leadership efforts should intentionally facilitate the development and/or maintenance of these community efforts and be aligned for efficiency and impact
Relative Contribution of Factors that Affect Health Genetics Clinical Social and Care Economic Factors Environment Health Behaviors Source: McGinnis et al, The Case for More active Policy Attention to Health Promotion, Health Affairs , 21, no. 2 (2002): 78-93
Health Status Assessment Data-driven Redefine decision Health making and feedback Strong Start for All Children Build Create a Prevention System of Everywhere Healthcare HEALTHY CONNECTED COMMUNITY
http://www.virginiawellbeing.com
Virginia’s Plan for Well Being Metrics Percent of Adults Who Report Positive Well-Being HEALTHY, CONNECTED COMMUNITIES STRONG START FOR CHILDREN • • H.S. Grads Enrolled in Higher Ed Teen Pregnancy Rate • • Cost-Burdened Households Kindergarteners Not Meeting PALS-K Benchmark • • Consumer Opportunity Index Third Graders Passing Reading SOL • • Economic Opportunity Index Infant Mortality Rate by Race • Districts with Collaborative Improvement Processes SYSTEM OF HEALTH CARE • Adults With A Regular Health-care Provider • PREVENTIVE ACTIONS Avoidable Cardiovascular Disease Deaths • • Adults Not Participating In Physical Activity Mental Health and Substance Abuse • Adults Who Are Overweight or Obese Hospitalizations • • Households That Are Food Insecure Avoidable Hospital Stays • • Adults Using Tobacco Adults Whose Poor Health Kept Them from Usual • Adults Vaccinated Against Influenza Activities • • Adolescents Vaccinated Against HPV Providers With Electronic Health Records • • Adults Screened for Colorectal Cancer Health Districts With EHRs • • Percent of Adults With Adverse Childhood Entities Connected to the Health Information Experiences Exchange • • Disability-free Life Expectancy Hospitals Meeting State Goal for Prevention of C. difficile Infections
Population Health Data Framework State Virginia’s Plan Data for Well-Being Regional Regional Regional Regional Data Data Data Data Community Health Local Local Local Local Local Local Local Local Assessment Data Data Data Data Data Data Data Data in Every District Drivers Drivers Drivers Drivers
Aim 1: Healthy, Connected Communities
Health Opportunity Index Educational Attainment Population Access to Care Density EPA Environmental Spatial Hazards Segregation Walkability HOI Population Churning Food Access Material Deprivation Employment Job Participation Access Affordability of Housing and Income Diversity Transportation
Community Health Services • Network of Health Districts & Local Health Departments Data Source: Virginia Department of Health, Health Planning Districts. 13
Aim 2: Strong Start for Children
Life Course Theory HEALTH OUTCOMES PGY= Pregnancy Source: William Hollinshead, Trajectories and MCH Checkpoints, 2007
Quintiles Page 17
Aim 3: Preventive Actions
Health Impact Assessment (HIA) A systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and the distribution of those effects within the population. HIA provides recommendations on monitoring and managing those effects. National Research Council, Improving Health in the United States: The Role of Health Impact Assessment, 2011.
HIA Answers the Question... • “ How would this new development/project affect people’s health?’. HIA Toolkit Available at: http://www.vdh.virginia.gov/healthpolicy/healthequity /hia/index.htm
Aim 4: System of Health Care
* Per 100,000 Population ages 18 years and older
* Per 100,000 Population ages 18 years and older
http://www.virginiawellbeing.com
Summary and Questions
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