Institute of Social and Economic Research, UAA Page 1 The Role of Social and Economic Research in Public Health Fran Ulmer 3/14/2006

Institute of Social and Economic Research, UAA Page 2 Goals of health research Improve health of the population Improve efficiency of health care system Make health care more affordable Expand access to health care Understand ingredients of community wellness and environmental health Prevent accidents and high risk behavior Many more

Institute of Social and Economic Research, UAA Page 3 Many UAA Programs College of Health and Social Welfare Institute for Circumpolar Health Studies Center for Rural Health Center for Alcohol and Addiction Studies Center for Human Development Justice Center WAMI/Biomedical Program Biological Sciences Environment and Natural Resources Institute Geology, anthropology, sociology, psychology, nursing, journalism and public communication

Institute of Social and Economic Research, UAA Page 4 Institute for Circumpolar Health Studies Program evaluation to help providers improve their programs Injury prevention Alcohol addiction and inhalant abuse Climate change/human health (Carl Hild) Specifics like studying traffic patterns and pediatric asthma, diesel exhaust effects (Mary Ellen Gordian)

Institute of Social and Economic Research, UAA Page 5 ISER Evaluations, like dental health aide program in rural Alaska Economics of telehealth/ANTHC Community control of alcohol (Matt Berman) Rural sanitation programs (Sharman Haley) NIOSH aircraft safety study (Lexi Hill) Cost of health care in Alaska

Institute of Social and Economic Research, UAA Page 6 ISER Mission ISER enhances the well-being of Alaskans and others, through non-partisan research that helps people understand social and economic systems and supports informed public and private decision-making. ISER pursues it mission by Focusing attention on critical economic and social issues in Alaska, the Arctic, and similar regions; Engaging in basic and applied research leading to better understanding of those issues; and Disseminating knowledge through publications, community involvement, public service, and teaching.

Institute of Social and Economic Research, UAA Page 7 The Institute of Social and Economic Research was established by the Alaska Legislature in ISER is part of the College of Business and Public Policy at UAA. It has a core staff of about 30 faculty members, research associates, and support personnel. Roughly one-third of its budget is from university money and two thirds from grants and contracts. ISER staff members not only do research but also teach undergraduate and graduate courses. ISER maintains the state's largest economic database and forecasts population and employment growth. All of ISER's research findings are published and are available at UAA or online at

Institute of Social and Economic Research, UAA Page 8 Alaska $5 Billion Health-Care Bill— Who’s Paying? by Mark Foster and Scott Goldsmith

Institute of Social and Economic Research, UAA Page 9 Organization of Presentation Alaska Health-care spending in 2005 Changes in spending since 1991 Health-care Coverage High-and Low-Cost Patients Are We Healthier Alaska/U.S. Cost Comparisons What’s Driving Costs? What do we do to improve health care in Alaska?

Institute of Social and Economic Research, UAA Page 10 Alaska Health Care Spending

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Institute of Social and Economic Research, UAA Page 12 How much is $5.3 billion in Alaska in FY2005 Total K-12 Spending, All Sources, $1.3 B Total Employment Wages, $11.8B

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Institute of Social and Economic Research, UAA Page 15 Changes in Alaska Health Care Spending

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Institute of Social and Economic Research, UAA Page 19 Health Coverage in Alaska

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Institute of Social and Economic Research, UAA Page 25 Employee/Employer Contributions to Health Insurance Premiums, Selected States Source: 2003 MEPS Data – Private Firm Family Coverage Premiums Employee Contribution % Employer Contribution % Alaska17%83% Wyoming20%80% Washington22%78% Oregon24%76% Minnesota25%75% Hawaii26%74% Montana28%72% Arizona30%70% #1 #49 #17 #27 #6 #10 #19 #38

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Institute of Social and Economic Research, UAA Page 28 High Cost & Low Cost Patients

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Institute of Social and Economic Research, UAA Page 30 Are Alaskans Healthier?

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Institute of Social and Economic Research, UAA Page 32 Water and Sewer Substantial investments in rural Alaska Approximately 50% to 75% of villages Will the trend continue?

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Institute of Social and Economic Research, UAA Page 35 Does water and sewer investment improve health? 24% of infants in villages with minimal water services are hospitalized for pneumonia (11 times the national average). Alaska low service vs. high service regions comparison: 3 times incidence of pneumonia and influenza Authors:Troy Ritter and Tom Hennessy (Centers for Disease Control and ANTHC) ADN 2/27/06

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Institute of Social and Economic Research, UAA Page 37 Alaska – U.S. Cost Comparisons

Institute of Social and Economic Research, UAA Page 38 Medical/Surgical & Dental Procedures

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Institute of Social and Economic Research, UAA Page 44 What is driving long term health care spending increases The Economics of Health & Health Care, Folland, Goodman, Stano, 4 th Edition (2004), Chapter 8, Extrapolating from Rand Analysis of U.S. Health Care Expenditure Growth, 1945 – c.1990

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Institute of Social and Economic Research, UAA Page 46 How do we improve health care in Alaska?

Institute of Social and Economic Research, UAA Page 47 Challenge: identify the issue, the funding, the talent to do research that can improve the health care delivery system and provide the research results in a format and a forum that will make a difference!

Institute of Social and Economic Research, UAA Page 48 Approaches for the future Research Data and analysis Alternative programs/other jurisdictions Legislation/administration Innovation Partnerships/collaboration Community awareness/information Prevention

Institute of Social and Economic Research, UAA Page 49 Initiatives Commonwealth North Health Roundtable DHSS insurance coverage study Legislation Information: UAA Health research think tank: HeaRTT United Way: community assessment/indicators AK Collaborative on Health& the Environment Healthy Alaskans 2010 (DHSS targets) Others?

Institute of Social and Economic Research, UAA Page 50 What can you do? The role of the University The role health care providers The role of community leaders The role of employers The role of individuals