1. Measuring Community Health: What the data from Spartanburg tell us Kathleen Brady, PhD University of South Carolina Upstate September 10, 2015

2. To Edit Footer: VIEW>HEADER FOOTER The mission of the Metropolitan Studies Institute is to support research efforts between USC Upstate and the community that enhance relationships, promote the reciprocal flow of information and ideas, assist community and economic development, and increase the strategic use of the University’s scholarship and outreach capabilities.

3. Stakeholders

5. Six Indicator Areas 1.Education 2.Economy 3.Public Health 4.Natural Environment 5.Social Environment 6.Civic Health

6. Good Data Three Rules: Integrity Context Comprehensiveness Validity – measures what it says it measures Reliability – consistent over time Comparative – peer geographies or groups Trend – changes over time Paint the whole picture

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12. We measure it because it is important Leading Indicators Birth Outcomes Overweight and Obesity Access to Health Care Behavioral Health Tobacco Use RTBH Priorities 1.Improving Access to Care 2.Reducing Childhood Obesity 3.Improving Birth Outcomes 4.Reducing Tobacco Use 5.Improving Behavioral Health Access

13. And…. Secondary Indicators Teen Pregnancy and Childbearing Immunizations Teen Risk Behavior and Attitudes Chronic Diseases Cancer Diabetes Heart Disease and Stroke Breast Feeding Sexually Transmitted Infections Health Disparities and Inequities Mortality Crosscutting Indicators Education Poverty Air Quality / Toxic Exposure

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15. Access to Care Approximately 48,666 residents of Spartanburg County are uninsured (17.0% of all residents and 24.2% of residents age 18-64 in 2013) 17% of Spartanburg County residents were unable to see a doctor because they could not afford to (SC BRFSS 2010) In 2012 SRHS and Mary Black Hospital provided: care to 41,241 self-pay / indigent patients in the ED who were not admitted to inpatient treatment ($61 million) care to an additional 2,102 self-pay indigent patients who were admitted ($66.3 million)

17. High Utilizers of the ED FY 2013-2014 (4+ visits)

19. ED dental data for uninsured

20. Behavioral Health At SRHS in 2012, there were 9,456 visits to the ED by uninsured patients for behavioral health conditions. This was the #1 diagnosis in the ED in 2012. 5,910 individuals Total Charges $41,622,647 Average Charge $4,402

23. Overweight and Obesity 64% of Spartanburg County adults are overweight or obese 34% of Spartanburg County children are overweight or obese Obese individuals have 30% to 50% more chronic health conditions than individuals who smoke or drink heavily Medical costs in South Carolina related to obesity exceed $1 billion annually Overweight or obese children, Spartanburg County (2013-2014): 1st graders: 31.5% 3rd graders: 34.4% 5th graders: 37.8%

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25. What we know and what works Prevention and Wellness are largely a function of policy, systems, and environmental change Modifying the environment to make healthy choices practical and available (“make the healthy choice the easy choice”) Implementing healthy policies Ensuring adequate systems of care Raise awareness, implement policies and the norm will change Knowledge is a very poor predictor of behavior! (at least when it comes to health behavior)

26. Local Data-Informed Initiatives Partners for Active Living B-cycle Complete Streets Hub City Farmers’ Market Mobile Market Trails Childhood Obesity Initiatives Smoking ordinances

31. Wellville goals OBESITY PREVENTION We will reduce obesity by creating a healthier community through better nutrition and active living. CARE FOR THE UNINSURED We will increase access to care for the uninsured by removing physical and social barriers to quality healthcare. HEALTH FOR THE INSURED We will maximize health for the insured by creating innovative ways to streamline primary and preventive care. KINDERGARTEN READINESS We will improve kindergarten readiness by ensuring that children birth through age 5 have access to quality early childhood education. COMMUNITY PRIDE We will build community pride by increasing social connections that engage more citizens to express love for where they live, work, and play.