America’s Health Rankings ® Senior Report: A Call to Action for Individuals and Their Communities May 29, 2012

2 Today’s Agenda  Introduction  Senior Health in the U.S.  Methodology and Senior Health Rankings  What We Can Do  Discussion

3 America’s Health Rankings ® Senior Report A Comprehensive Assessment of Senior Health  Offers a comprehensive analysis of senior health on a national and state-by-state basis across 34 measures of senior health  Report seeks to promote discussion around the health of Americans 65 years and older while driving communities, governments, stakeholders and individuals to take action to improve senior health  In compiling the report, researchers worked with a panel of leading public health scholars  Report draws data from more than 12 government agencies and leading research organizations, including the U.S. Department of Health and Human Services, the U.S. Department of Commerce, the U.S. Department of Labor, The Dartmouth Atlas Project, the National Foundation to End Senior Hunger and the Commonwealth Fund

Senior Health in the United States 4

Key National Takeaways  Rapid growth of senior population (53 percent increase from 2015 to 2030)  The 2012 America’s Health Rankings® found Americans are living longer but sicker lives  About 80 percent of seniors are living with one chronic condition, while 50 percent of seniors have at least two chronic conditions  More obese individuals moving into age group  Low health status of individuals moving into age group –Nationally, the self-reported health status of the middle-aged population has decreased slightly from 1995 to 2010, with 1.7 percent fewer adults aged 50 to 64 reporting very good or excellent health

6 Senior Health Across the U.S. The Senior Report takes a holistic look at senior health and reveals a mixed picture of health from state-to-state, particularly among the following key measures:  Obesity: –Obesity affects 25.3% of U.S. adults 65 and older, according to the Senior report –Obesity rates among those aged 50 to 64 years increased 7.5 percent from 1995 to 2010, indicating that the next wave of seniors is at even higher risk than today’s seniors for obesity –A 2008 Health Affairs study estimated that the U.S. spends $147 billion on obesity or obesity- related health issues for the entire U.S. population –The prevalence of obesity among seniors varies from a low of 16.9 percent in Hawaii and 18.1 percent in Nevada to a high of 29.3 percent in Alaska and 29.5 percent in Michigan  Physical Inactivity: –Just under one-third (30.3 percent) of seniors in fair or better health report doing no physical activity or exercise (such as walking, gardening, jogging, calisthenics or golf) –The prevalence of physical inactivity among seniors ranges from a low of 20.5 percent in Colorado and 21.3 percent in California to a high of 41.2 percent in West Virginia and 41.3 percent in Tennessee

7 Senior Health Across the U.S., Cont.  Poverty –The report finds that 9.3 percent of U.S. adults aged 65 and older live at or below the poverty threshold –The percentage of seniors living at or below the poverty threshold ranges from a low of 5.1 percent in Alaska and 6.2 percent in Utah to a high of 12.3 percent in New Mexico and 13.5 percent in Mississippi  Low-Care Nursing Home Residents –This measure looks at the percentage of nursing home residents who might be able to live in an alternate environment with community support –The report finds that 12.2 percent of nursing home residents nationwide might be able to live in an alternate environment –The percentage of low-care nursing home residents ranges from a low of 1.1 percent of nursing home residents in Maine and 4.7 percent in Hawaii to a high of 25.0 percent in Oklahoma and 26.7 percent in Illinois

Report Contents and State Rankings 8

9 Model Behaviors -Smoking -Chronic Drinking -Obesity -Underweight -Physical Inactivity -Dental Visits -Pain Management Community – Macro -Poverty -Volunteerism -Highly Rated Nursing Homes Community – Micro -Social Support -Food Insecurity -Community Support Policy -Low-Care Nursing Home Residents -Creditable Drug Coverage -Geriatrician Shortfall Clinical Care -Dedicated Health Care Worker -Recommended Hospital Care -Flu Vaccine -Health Screenings -Diabetes Management -Home Health Care -Preventable Hospitalizations -Hospital Readmissions -Hospice Care -Hospital Deaths Outcomes -ICU Usage -Falls -Hip Fractures -Health Status -Able-Bodied -Premature Death -Teeth Extractions -Mental Health Days

10 Senior Rankings 1Minnesota 2Vermont 3New Hampshire 4Massachusetts 5Iowa 6Hawaii 7Connecticut 8Colorado 9Utah 10Maryland 11North Dakota 12Delaware 13Maine 14Nebraska 15Oregon 16Washington 17Pennsylvania 18Kansas 19South Dakota 20Wisconsin 21Virginia 22Arizona 23New York 24Idaho 25California 26Michigan 27New Jersey 28Ohio 29North Carolina 30Florida 31Rhode Island 32Indiana 33Missouri 34Wyoming 35Montana 36South Carolina 37Illinois 38New Mexico 39Texas 40Alaska 41Tennessee 42Nevada 43Georgia 44Alabama 45Kentucky 46Arkansas 47West Virginia 48Louisiana 49Oklahoma 50Mississippi

Commentaries  Senior Report – Working Together to Care for an Aging Nation Jennie Chin Hansen, RN, MSN, FAAN, CEO of the American Geriatrics Society  Preparing for the Future as Millions of Baby Boomers Continue to Age Gail Gibson Hunt, President and CEO, National Alliance for Caregiving  Rx for Health – Invest in America’s Senior Centers to Promote Health and Prevent Disease James Firman, EdD, President and CEO; Richard Birkel, PhD, Senior Vice President, National Council on Aging  Senior Hunger: A National Problem, A Local Problem Enid A. Borden, Founder, President and CEO; Margaret B. Ingraham, Executive Vice President, National Foundation to End Senior Hunger  The Environment of Care: A Community’s Journey to Become America’s Healthiest Hometown Elliot Sussman, MD, MBA, Chairman; Joseph Hildner, MD, Chief Medical Officer, The Villages Health; Stephen Klasko, MD, MBA, CEO, USF Health and Dean, Morsani College of Medicine 11

12 State Summary Ranks for all metrics Strengths and Challenges 4 to 6 highlights Disparities discussion

13 Infographics

A Call to Action 14

15 How to Put the Rankings to Use  Use America’s Health Rankings ® Senior Report as a news hook to discuss strengths/challenges of your and other states and to highlight programs and activities geared toward seniors  Use the Rankings to help people understand the importance of key interventions  Help promote the America’s Health Rankings ® “take action” library and your own websites and programs to translate knowledge into action  Direct inquiries to resources on AmericasHealthRankings.org. These include PDF and e-book versions of the Senior Report, state-specific infographics, custom-report tools, and Spanish- language content  Leverage successful models and advocate for change as individuals, a community and public health professionals  United Health Foundation is committed to being a part of the solution, providing a full array of tools to help empower your missions to improve public health

Thank You! Shelly Espinosa (general) Scott Weier (media) Learn More: Contact americashealthrankings.org Tom Eckstein (data) Sarah Milder (data)