A Presentation of the Colorado Health Institute A profile of your community’s health May 4, 2009 CHI Webinar June 22, 2011

A Brief Introduction to CHI CHI is a trusted and leading source of credible health information for Colorado leaders. Our insight is used to: – Inform policy – Contribute to effective implementation – Support state efforts to improve health 2 AccessQualityValuePrevention

Introduction to Webinar How do I ask questions during the webinar? Recorded webinar and PowerPoint slides will be available after the webinar. Special thanks to the Colorado Health Foundation

Your presenter 4 Jeff Bontrager Director of Research on Coverage and Access Colorado Health Institute

Guiding questions for this presentation What health concerns do you hear in your communities? What determines health? What data and resources are available to help you understand your community’s health? 5

To start things off… …a question for you: What are the primary health concerns that you hear from people in your community? 6

Three resources discussed today 7

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Straw poll On a scale of 1 – 5, how would you rate the health of the residents in your community? 9 Poor Health Great Health What determines health?

10 Health Determinants Health behaviors (30% of determinants) Tobacco useDiet and exerciseAlcohol useHigh risk sexual behavior Clinical care (20% of determinants) Access to careQuality of care Social and economic factors (40% of determinants) EducationEmploymentIncomeFamily & social supportCommunity safety Physical environment (10% of determinants) Environmental qualityBuilt environment Source: University of Wisconsin Population Health Institute, 2010 County Health Rankings

HEALTH BEHAVIORS 11

Health Determinants Health behaviors (30% of determinants) Tobacco useDiet and exerciseAlcohol useHigh risk sexual behavior Clinical care (20% of determinants) Access to careQuality of care Social and economic factors (40% of determinants) EducationEmploymentIncomeFamily & social supportCommunity safety Physical environment (10% of determinants) Environmental qualityBuilt environment HEALTH BEHAVIORS 12

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Obesity Trends* Among U.S. Adults BRFSS 1985 Source: Behavioral Risk Factor Surveillance System, Centers for Disease Control and Prevention

Obesity Trends* Among U.S. Adults BRFSS 1986 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS 1987 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS 1988 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS 1989 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. Adults BRFSS 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. Adults BRFSS 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. Adults BRFSS 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. Adults BRFSS 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS 2002 No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. Adults BRFSS 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. Adults BRFSS 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. Adults BRFSS 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. Adults BRFSS 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. Adults BRFSS 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. Adults BRFSS 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. Adults BRFSS 2009 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

2010 Colorado rankings: Focus on physical activity 39 Health indicatorValue and rank School-age children who participated in vigorous physical activity for four or more days per week 64% 34 th Adolescents who participated in vigorous physical activity on three to five (or more) of the past seven days 47% 10 th Adults who participated in any physical activity within the past month 84% 4 th Older adults who participated in any physical activity in the past 30 days 75% 1 st Source: The Colorado Health Foundation, Grading Our Progress, 2011

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Smoking and obesity among Colorado adults, Source: Colorado Behavioral Risk Factor Surveillance System, Health Statistics Section, CDPHE

CLINICAL CARE 42

Health Determinants Health behaviors (30% of determinants) Tobacco useDiet and exerciseAlcohol useHigh risk sexual behavior Clinical care (20% of determinants) Access to careQuality of care Social and economic factors (40% of determinants) EducationEmploymentIncomeFamily & social supportCommunity safety Physical environment (10% of determinants) Environmental qualityBuilt environment CLINICAL CARE 43

Health insurance coverage For most people living in the U.S., health insurance provides the mechanism by which to gain access to health care… 44

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Access vs. coverage For most people living in the U.S., health insurance provides the mechanism by which to gain access to health care… 46 …however, Not everybody who has coverage, has access Not everybody who lacks coverage, lacks access

CHI inventory of safety net providers – Community and public hospital emergency departments – Community health centers (federally-qualified health centers) – Community-funded/community-based clinics and family practice residency programs – Rural health clinics – School-based health centers – Low-income dental clinics and public oral health programs – Community mental health centers – Migrant health centers – Local health departments 47

Safety Net Map

SOCIAL AND ECONOMIC FACTORS 49

Health Determinants Health behaviors (30% of determinants) Tobacco useDiet and exerciseAlcohol useHigh risk sexual behavior Clinical care (20% of determinants) Access to careQuality of care Social and economic factors (40% of determinants) EducationEmploymentIncomeFamily & social supportCommunity safety Physical environment (10% of determinants) Environmental qualityBuilt environment SOCIAL AND ECONOMIC FACTORS 50

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2011 COUNTY HEALTH RANKINGS 52 Robert Wood Johnson Foundation University of Wisconsin Population Health Institute

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AGING OF THE POPULATION 54

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Resources CHI Regional Profiles: profiles.aspx profiles.aspx 2010 Colorado Health Report Card: County Health Rankings: Colorado Department of Public Health and Environment: – Colorado Health Data: Bringing Health Home Learning Collaborative Webinars (hosted by Engaged Public) Colorado Household Survey: Colorado Demography Office: 57

Our next webinar The Colorado Health Insurance Exchange July 20 th from noon-1pm 58 Presenter: Joan Henneberry Planning Director of the Colorado Health Insurance Exchange Register at:

Contact Information Jeff Bontrager, MSPH Director of Research on Coverage and Access