Culture of Health Think Tank: Elderly in North Dakota

Elderly in North Dakota: Statistics 2014: ND population = 739,482 Persons 65+ years = 105,998 (14.2%) Persons 85+ years = 17,959 (2.2%) 48.5% of people 60+ living in rural areas (2010 Census) > 1 in 3 over 65 years has one or more disabilities Disparity: 51% American Indian vs. 33.9% White 2025: 65+ years expected to be 18% of population https://agid.acl.gov/StateProfiles/Profile/Pre/?id=36&topic=0&years=2014 http://www.ndcompass.org/aging/#.WTa_jTawfcu Not sure what this is showing but could be interesting? Does anyone know? Part F. Persons Served/Service – Units https://agid.acl.gov/StateProfiles/Profile/Pre/?id=36&topic=0&years=2014

UND Medical School Biennial Report Figure 1.3. Age of people in North Dakota compared with U.S. in 2015. Reprinted from Fourth biennial report: Health issues for the state of North Dakota (p. 5), by Molmen, D., et al. Retrieved from http://www.med.und.edu/biennial-report/_files/docs/fourth-biennial-report.pdf   There are more North Dakotans 85 and older compared with the U.S. population (tied for fourth highest). North Dakota compared with the U.S. has 1.2 times the population age 85 and older. There are fewer North Dakotans between the ages of 40 to 64 and 65 to 84 relative to the U.S. population

UND Medical School Biennial Report The average age for the state has increased from 33 years in 1980 to over 37 years in 2010 (about two years every 10-year census). This trend is projected to increase as the baby boomer population ages. Rural North Dakotans are older than either micropolitan or metropolitan North Dakotans. This was true in all four census periods (1980, 1990, 2000, and 2010). Figure 1.4. Average age of North Dakota residents from 1980 to 2010 by metropolitan, micropolitan (large rural), and rural counties. Reprinted from Fourth biennial report: Health issues for the state of North Dakota (p. 5), by Molmen, D., et al. Retrieved from http://www.med.und.edu/biennial-report/_files/docs/fourth-biennial-report.pdf

UND Medical School Biennial Report show the progression of population change for people age 65 and older at four census periods (1980, 1990, 2000, and 2010). There has been a continual increase in the proportion of older adults in the rural counties. In 2010, the eight counties with 27% or more of their population age 65 or older were all rural; in fact, they are some of the most remote counties because all are classified as frontier Reprinted from Fourth biennial report: Health issues for the state of North Dakota (p. 10), by Molmen, D., et al. Retrieved from http://www.med.und.edu/biennial-report/_files/docs/fourth-biennial-report.pdf

County Health Rankings Measure current health Project future health Health Outcomes Length of life Quality of life Health Factors Health behaviors Clinical care Social and economic factors Physical environment

County Health Rankings: Health Outcomes North Dakota Length of Life (age adjusted) Premature death 6,600 Quality of Life (age adjusted) Poor or fair health 13% Poor physical health days 3 Poor mental health days 3.3 I skipped low birthweight since we are elderly subgroup http://www.countyhealthrankings.org/app/north-dakota/2017/compare/snapshot

County Health Rankings: Health Factors North Dakota Health Behaviors Adult smoking 19% Adult obesity 31% Food environment index (0-10 scale) 8.4 Physical inactivity 23% Access to exercise opportunities 66% Excessive drinking 25% Alcohol-impaired driving deaths 47% Chose measures that may be related and most pertinent to age with our subgroup. http://www.countyhealthrankings.org/app/north-dakota/2017/compare/snapshot

County Health Rankings: Health Factors North Dakota Clinical Care Primary care physicians 1280 : 1 Dentists 1630 : 1 Mental health providers 640 : 1 Preventable hospital stays 46 Diabetes monitoring 87% Mammography screening 69% http://www.countyhealthrankings.org/app/north-dakota/2017/overview

Healthy People 2020 Injury and Violence Prevention (IVP-23.2): Prevent an increase in fall-related deaths among adults aged 65 and older Mental Health and Mental Disorders (MHMD-4.2): Reduce the proportion of adults aged 18 and older who experience major depressive episodes MHMD-9.2: Increase the proportion of adults aged 18 and older with major depressive episodes who receive treatment Older Adults (OA-2.1): Increase the proportion of males aged 65 years and older who are up to date on core set of clinical preventive services OA-2.2: Increase the proportion of females aged 65 and older who are up to date on core set of clinical preventive services Respiratory Diseases (RD-10): Reduce deaths from COPD among adults https://www.healthypeople.gov/2020/data-search/

North Dakota Department of Health Indicator Dashboard Indicators include: state versions of Healthy People 2020 goals Health Improvement Plan Agency-specific Not searchable by age http://www.ndhealth.gov/StrategicPlanning/

AARP Livability Index livability score customizable Housing Neighborhood Transportation Environment Health Engagement Opportunity customizable https://livabilityindex.aarp.org/

North Dakota Compass: Aging Overview Ideas at Work Initiatives and collaborations Evidence based strategies http://www.ndcompass.org/aging/#.WS3Dh6qwcdU

North Dakota Long Term Care Association Professional and advocacy organization Assisted living Basic care Nursing facilities 14,000 professionals 14,000 frail elderly and disabled cared for annually Affiliate of the American Health Care Association and National Center for Assisted Living ND Culture Change Coalition http://www.ndltca.org/resources/helpful-links/ ND Culture Change Coalition - embraces the strengths and individuality of the elders they serve

North Dakota Family Caregiver Support & Services Study Spouses/partners Children Other family members Neighbors Friends Providing 58 million unpaid hours Transportation Personal care Financial management Grocery shopping And MORE! Worth $860 million p. 2 of report

North Dakota Family Caregiver Support & Services Study 5 aims Key conclusions and recommendations https://www.ag.ndsu.edu/aging/documents/nd-family-caregiver-supports-and-services-study

References AARP. (n.d.). AARP livability index. Retrieved from https://livabilityindex.aarp.org/ Administration of Community Living. (2017). Profile of state OAA programs: North Dakota. Retrieved from https://agid.acl.gov/StateProfiles/Profile/Pre/?id=36&topic=0&years=2014 County Health Rankings. (2017). North Dakota health gaps report. Retrieved from http://www.countyhealthrankings.org/app/north-dakota/2017/overview North Dakota Compass. (2017). Aging. Retrieved from http://www.ndcompass.org/aging/#.WS3Dh6qwcdU North Dakota Department of Health. (2011). Building a Healthy North Dakota. Retrieved from http://home.healthynd.org/ North Dakota Department of Health. (2013). Health indicator tracking dashboard overview. Retrieved from http://www.ndhealth.gov/StrategicPlanning/ North Dakota Long Term Care Association. (2015). Helpful links. Retrieved from http://www.ndltca.org/resources/helpful-links/ Strommen, J., Fuller, H., Sanders, G., Elliott, D., Callahan, K., & Raguse, E. (2016). North Dakota family caregiver supports and services study. Retrieved from https://www.ag.ndsu.edu/aging/documents/nd-family-caregiver-supports-and-services-study U.S. Department of Health and Human Services. (2017). Healthy people 2020: Data 2020. Retrieved from https://www.healthypeople.gov/2020/data-search/ Molmen, D., Wynne, J., Anderson, M. D., Arnold, T. F., Tinguely, S., Delmore, L.,…Koebele, C. M. (2017). Fourth biennial report: Health issues for the state of North Dakota. Retrieved from http://www.med.und.edu/biennial-report/_files/docs/fourth-biennial-report.pdf