Rhode Island’s Health ─ 2012 Michael Fine, MD Director of Health

The Healthy People 2010 Perspective

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Adults who engage in moderate physical activity 30+ mins / day Healthy People 2010 Physical Activity - Adults HP 2010 Target: 30%

Teens who engage in physical activity 60+ mins / 5 days Healthy People 2010 Physical Activity - Teens HP 2010 Target: 85%

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Adults who are obese Healthy People 2010 Overweight and Obesity - Adults HP 2010 Target: 15%

Teens who are overweight or obese Healthy People 2010 Overweight and Obesity - Teens HP 2010 Target: 5%

Adults who consume 5+ servings of fruits and vegetables / day Healthy People 2010 Overweight and Obesity - Adults HP 2010 Target: 50%

Teens who consume 5+ servings of fruits and vegetables / day Healthy People 2010 Overweight and Obesity - Teens HP 2010 Target: 50%

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Adults who currently smoke cigarettes Healthy People 2010 Tobacco Use - Adults HP 2010 Target: 12%

Teens who currently smoke cigarettes Healthy People 2010 Tobacco Use - Teens HP 2010 Target: 16%

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Adults who engaged in binge drinking in the past 30 days Healthy People 2010 Substance Abuse - Adults HP 2010 Target: 6%

Teens who report alcohol use in the past 30 days Healthy People 2010 Substance Abuse - Teens HP 2010 Target: 11%

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Teens who never engaged in sexual intercourse, or did not engage in sexual intercourse in the past 30 days, or who used a condom at last sexual intercourse Healthy People 2010 Responsible Sexual Behavior - Teens HP 2010 Target: 90%

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Suicides per 100,000 population per year Healthy People 2010 Mental Health - All Ages HP 2010 Target: 5 per 100,000

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Fatalities caused by car crashes per 100,000 population per year Healthy People 2010 Injury and Violence - All Ages HP 2010 Target: 9.2 per 100,000

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Adult non-smokers exposed to second-hand smoke Healthy People 2010 Environmental Quality - Adults HP 2010 Target: 45%

Children with elevated lead levels Healthy People 2010 Environmental Quality - Children HP 2010 Target: 0%

Homes tested for radon Healthy People 2010 Environmental Quality - All Ages HP 2010 Target: 20%

Persons infected by food borne Campylobacter Healthy People 2010 Environmental Quality - All Ages HP 2010 Target: 12.3%

Persons infected by food borne Salmonella Healthy People 2010 Environmental Quality - All Ages HP 2010 Target: 6.8%

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Adults ages 65+ vaccinated for influenza in the past year Healthy People 2010 Immunization - Ages 65+ HP 2010 Target: 90%

Healthy People 2010 Indicators: –Physical Activity –Overweight and Obesity –Tobacco Use –Substance Abuse –Responsible Sexual Behavior –Mental Health –Injury and Violence –Environmental Quality –Immunization –Access to Health Care Rhode Island’s Health Changes and Comparisons

Adults with health insurance Healthy People 2010 Access to Health Care - Adults HP 2010 Target: 100%

Adults with a specific source of ongoing health care Healthy People 2010 Access to Health Care - Adults HP 2010 Target: 96%

Pregnant women who receive first trimester care Healthy People 2010 Access to Health Care - Females HP 2010 Target: 90%

Pregnant women who receive adequate prenatal care Healthy People 2010 Access to Health Care - Adults HP 2010 Target: 90%

Adults who used oral health care in the past year Healthy People 2010 Access to Health Care - Adults HP 2010 Target: 56%

Adult women who received a Pap test in the past 3 years Healthy People 2010 Access to Health Care - Adults HP 2010 Target: 90%

Women ages 40+ who received a mammogram in the past 3 years Healthy People 2010 Access to Health Care - Adults HP 2010 Target: 70%

Another Perspective

Four Additional Indicators: –Premature Death –Financial Cost –Days of Lost Work and School –Social Capital Rhode Island’s Health Notable Trends

Four Perspectives: –Premature Death –Financial Cost –Days of Lost Work and School –Social Capital Rhode Island’s Health Disease Burden

Note: Average YPLL per total deaths under age 65; data represent deaths in What Causes Premature Death? Potential Years of Life Lost Top Ten Causes of Premature Death

Potential Years of Life Lost Unintentional Injury

Potential Years of Life Lost Cancer

Potential Years of Life Lost Heart Disease

Potential Years of Life Lost Perinatal Conditions (RI only)

Potential Years of Life Lost Suicide

Potential Years of Life Lost Homicide

Potential Years of Life Lost Birth Defects

Potential Years of Life Lost Liver Disease

Potential Years of Life Lost Stroke

Potential Years of Life Lost Diabetes

Four Perspectives: –Premature Death –Financial Cost –Days of Lost Work and School –Social Capital Rhode Island’s Health Disease Burden

Financial Cost Health Care Expenditures per Capita 2009

Financial Cost % Growth in Health Care Expenditures % growth from 1980 through 2009

Financial Cost Distribution of Health Care Expenditures 2009

Four Perspectives: –Premature Death –Financial Cost –Days of Lost Work and School –Social Capital Rhode Island’s Health Disease Burden

We are working to measure days of lost work and school attributable to illness and injury. Days of Lost Work and School

Four Perspectives: –Premature Death –Financial Cost –Days of Lost Work and School –Social Capital Rhode Island’s Health Disease Burden

“The central premise of social capital is that social networks have value. Social capital refers to the collective value of all “social networks” (who people know) and the inclinations that arise from these networks to do things for each other (‘norms of reciprocity’).” Social Capital The Concept From

Social capital indicators include: –Club meetings attended last year –Community projects worked on last year –Times entertained at home last year –Times volunteered last year –Time visiting friends –Etc. Social capital indicators may be used to construct a “social cap- ital index,” to estimate social capital in a group or a locale. Social Capital Indicators of Social Capital From

Min: Max: Mean: Std Dev: RI Value: Social Capital “Social Capital Index” (by State) From States with high scores - Vermont South Dakota North Dakota1.71

Michael Fine, MD Director of Health