1. Health Disparities in Hawaii County Japanese Chamber of Commerce January 25, 2012 Sharon H. Vitousek, M.D. North Hawaii Outcomes Project, www.nhop.org Hawaii Island Healthcare Alliance www.hawaiihealthcarealliance.orgwww.nhop.org

2. Health Disparities in Hawaii County What impact on business? What is the role of business ? Benefits of improvement to business

3. Health Disparities - Hawaii Count y Population Health Outcomes Higher Death rates –All causes –Heart disease –Stroke –Overall cancer –Infant Mortality –Suicide –Traffic-related Lower life expectancy Higher teen birth rates Higher confirmed child abuse rates

14. Health Disparities - Hawaii County Why?

15. Institute of Medicine Framework for Population Health Social and Physical Environment Social, Economic & Physical Environment (Socioeconomic Determinants) Health-Related Behaviors Health Systems (Access to Care) Population Health Outcomes

22. Health Disparities - Hawaii County Health Related Behaviors  Smoking- 15 % vs 10% state Obesity- (Binge drinking) (Adults no exercise)

27. Health Disparities - Hawaii County Health Systems Access to care: Higher uninsured  Lower ratio of physicians per 1,000 population Higher percent of population without a personal doctor Lower percent mothers receiving prenatal care Utilization & Cost: Higher acute care hospitalizations per 1,000 population Quality:

29. Consequences of Primary Care Shortage Source: Institute of Health Improvement, John Wasson, M.D.

30. Consequences of Primary Care Shortage Delayed Care & Increased suffering Higher ER utilization Higher hospital utilization Increased costs Less focus on Prevention- Life style Less screening- Cancer & Depression Poorer outcomes

32. Improving Population Health -- How? Socioeconomic Determinants Economic Development Health sector: policy change & planning Education & Science sectors- TMT Energy sector Health-Related Behaviors Environmental AND Individual Strategies Smoking cessation, physical activity, Identifying and addressing problem drinking, & depression Health Systems Primary Care Workforce Development Grow our own docs, Policy change, BEACON: Redesign care through Collaboration, Technology & Engagement Improved Population Health Outcomes

33. Economic Development of the Healthcare Sector Why – 3 rd largest employer in Hawaii County –Largest employer in many rural communities –Economic Multiplier effect of physicians~ 5 to 1 –Good for business & community How –Work force development & policy change What Business can do

34. Hawaii County Employees DBED Nov 2011 Employment sector# of Employees 1. Government12,000 2. Retail trade8,000 3. Healthcare/social assistance6,900 4. Accommodations5,500 5. Food service and drinking places 5,200

35. Hawaii Island Healthcare Alliance Island wide, voluntary, collaborative group of stakeholders Goal: Improve health & healthcare in Hawaii County by increasing healthcare workforce & improving financial sustainability of providers Endorses: –Growing own providers - Residency Hilo, –Broader primary care team –Collaboration to align policy efforts, Friends of the Future is 501(c )(3) Fiscal Agent

36. What Business Can Do Engage Employees in Healthy Lifestyles Advocate for: –Development of the Health Sector/Workforce –Funding UH Family Practice Residency - Hilo Technical Assistance for planning, finance –Serve on healthcare boards or committees –Join Hawaii Island Healthcare Alliance Demonstrate for Residency Program - Hilo – Small donations to show community support

37. Benefits of Health Workforce Development Improved Access –Timely Care & Decreased suffering –Lower hospital/ER utilization More prevention & life style improvements More recommended screenings Decreased costs Economic stimulation- job creation Better outcomes & Quality of Life Improved productivity/business environment

38. Hawaii Island Healthcare Alliance www.hawaiihealthcarealliance.org vitousek@nhop.org