1. Can We Become Healthier Than Minnesota? Real Talk for Real Action Conference January 30 2009 David Kindig University of Wisconsin School of Medicine and Public Health/Population Health Institute Carried out under a grant from the Wisconsin Partnership Program

2. OUR COMPETITION AT #17 (down from #12 last year) IN AMERICA’S HEALTH RANKINGS Hawaii (#2) and Utah (#5) are, well, not like us… But Minnesota (#4), Vermont (#1), and Massachusetts (#9)???

3. OVERALL HEALTH RANKING 199020032008 VERMONT 16 4 1 MINN 1 1 4 WISC 4 14 17

4. PERCENT UNINSURED 2003 2008 VERMONT 9.7 10.7 MINNESOTA 7.8 8.8 WISCONSIN 8.4 8.5

5. ADULT SMOKNG RATES 2003 2008 VERMONT 21.1 17.6 MINNESOTA 21.7 16.5 WISCONSIN 23.3 19.6

6. PREVALENCE OF OBESITY 2003 2008 VERMONT 18.9 21.9 MINNESOTA 22.3 26.0 WISCONSIN 21.6 25.3

7. PERCENT BINGE DRINKING 2003 2008 VERMONT 16.1 17.3 MINNESOTA 20.4 16.0 WISCONSIN 25.3 23.8

8. CHILDREN IN POVERTY 2003 2008 VERMONT 12.2 10.9 MINNESOTA 8.4 13.7 WISCONSIN 12.0 15.7

9. AIR POLLUTION 2003 2008 VERMONT 10.1 9.5 MINNESOTA 11.8 9.9 WISCONSIN 12.4 13.3

10. HEALTH CARE COSTS PER CAPITA EXPENDITURES?? % INCREASE IN EXPENDITURES? ACCEPTABLE RANGE OF REGIONAL VARIATION?

16. STRONG MEASURES, SOLID PARTNERSHIPS, REAL RESOURCES “What is required is a coordinated effort across determinants between the public and private sectors, as well as financial resources and incentives to make it work”.

18. Population% Excess deaths% City of Milwaukee 570,547 11% 1330 28% Rural Counties (n=52) 1,576,80432%161234% Urban Counties (n=20) 2,841,08457%184038% TOTAL4,988,435100%4782100% Distribution of population and excess deaths in Wisconsin *Values are annual averages based on data from AIM (1993-2002) and WISH (1995-2004) *Rural/urban definitions are based on those used by the Wisconsin Office of Rural Health

19. MY PROPOSED HEALTHY WISCONSIN 2020 OVERALL GOALS MOVE FROM B- TO B+…SOLIDLY INTO THE TOP TEN…AND THEREFORE MAKE A SERIOUS CHALLENGE TO MINNESOTA MOVE FROM D TO C IN HEALTH DISPARITIES..A COMMITMENT TO MORE FAIRNESS IN OUR STATE

20. Dialogues on Key Strategies to Improve our Health Track A: Improving our health behaviors –Room E: Physical activity, nutrition, and obesity –Room F: Alcohol use and addiction Track B: Mix of prevention and treatment –Room G: Health care quality and costs –Room H: Access to needed care Track C: Healthier social and economic climate –Room I: Remedying racial disparities –Room J: Improving the health of Milwaukee