Karen Timberlake, Director, UW Population Health Institute

1. Wisconsin Women’s Health Foundation
The Gathering
November 13, 2012
Karen Timberlake
Director, UW Population Health Institute

3.  How healthy are we as a country and as a
state?
 What matters to improving health?
 What’s working to improve the health of
individuals and communities?
 What can you do?

4.  Thegoal: “Everyone living better
longer.”
◦ Length of life, quality of life, health disparities
 Prevention (when possible) is better
than cure
 It’s easier to be healthy when you
live, work, learn, play in a “healthy
place”
4

5. Country Rankings
1.00–2.33
2.34–4.66
4.67–7.00
AUS CAN GER NETH NZ UK US
OVERALL RANKING (2010) 3 6 4 1 5 2 7
Quality Care 4 7 5 2 1 3 6
Effective Care 2 7 6 3 5 1 4
Safe Care 6 5 3 1 4 2 7
Coordinated Care 4 5 7 2 1 3 6
Patient-Centered Care 2 5 3 6 1 7 4
Access 6.5 5 3 1 4 2 6.5
Cost-Related Problem 6 3.5 3.5 2 5 1 7
Timeliness of Care 6 7 2 1 3 4 5
Efficiency 2 6 5 3 4 1 7
Equity 4 5 3 1 6 2 7
Long, Healthy, Productive Lives 1 2 3 4 5 6 7
Health Expenditures/Capita, 2007 $3,357 $3,895 $3,588 $3,837* $2,454 $2,992 $7,290
Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity).
Source: Calculated by The Commonwealth Fund based on 2007 International Health Policy Survey; 2008 International
Health Policy Survey of Sicker Adults; 2009 International Health Policy Survey of Primary Care Physicians;
Commonwealth Fund Commission on a High Performance Health System National Scorecard; and Organization for
Economic Cooperation and Development, OECD Health Data, 2009 (Paris: OECD, Nov. 2009).

6. Source: Muennig and Glied, Health Affairs 29, No. 11 (2010)

7.  US spends more on health care than any other
industrialized nation and yet we trail all
developed nations in length and healthiness of
life
 What should we do to improve health?
 Co-chairs:
◦ Mark McClellan, former head of CMS under President
George W. Bush
◦ Alice Rivlin, former head of OMB under President Bill
Clinton
http://www.commissiononhealth.org/AboutUs.aspx

8.  Become a smoke-free nation
 Ensure that all children have high quality early
developmental support
 Create public-private partnerships to open and
sustain full-service grocery stores in
communities without access to healthful foods
 Require all schools (K-12) to include time for all
children to by physically active every day
http://www.commissiononhealth.org/AboutUs.aspx

9.  Develop a “health impact” rating for housing
and infrastructure projects; create incentives
for healthier infrastructure development
 Ensure that decision-makers in all sectors
have the evidence they need to build health
into public and private policies and practices
http://www.commissiononhealth.org/AboutUs.aspx

10.  4 of 5 physicians say
unmet social needs are
directly leading to worse
health
 4 of 5 physicians say
patients’ social needs are
as important as their
medical conditions
 4 of 5 physicians are not
confident of their ability to
address social needs
 Physicians would like to
write prescriptions for
fitness, nutrition,
transportation assistance,
employment, adult
education, housing
http://www.rwjf.org/files/research/RWJFPhysiciansSurveyExecutiveSummary.pdf

12. HEALTH MORTALITY (LENGTH OF LIFE): 50%
OUTCOMES MORBIDITY (QUALITY OF LIFE): 50%
Tobacco use
Diet & exercise
HEALTH BEHAVIORS (30%)
Alcohol use
Sexual activity
Access to care
CLINICAL CARE (20%)
Quality of care
HEALTH
FACTORS Education
Employment
SOCIAL & ECONOMIC FACTORS Income
(40%)
Family & social support
Community safety
POLICIES & Environmental quality
PROGRAMS PHYSICAL ENVIRONMENT (10%)
Built environment
County Health Rankings model © 2012 UWPHI

13.  Where you live matters to your health.
 There are many factors that influence health.
 Improving health is everyone’s responsibility
and we all -- businesses, health care
providers, government, consumers, and
community leaders -- need to work together
to find solutions.

14.  Because health depends upon, and is
influenced by, the entire community, all
sectors need each other’s participation and
expertise to make progress.
 While personal responsibility is important
when it comes to health, it must also be
linked to a larger discussion about how policy
change can make healthy choices easy
choices.

15. www.countyhealthrankings.org 15
HEALTH OUTCOMES – MORBIDITY AND MORTALITY
‣ Top 5
– St. Croix
– Ozaukee
– Taylor
– Iowa
– Vernon
‣ Bottom 5
– Jackson
– Adams
– Milwaukee
– Marquette
– Menominee 15

16. www.countyhealthrankings.org 16
HEALTH FACTORS – BEHAVIORS, CLINICAL CARE,
SOCIAL/ECONOMIC FACTORS, PHYSICAL ENVIRONMENT
‣ Top 5
– Ozaukee
– Waukesha
– Dane
– La Crosse
– Pierce
‣ Bottom 5
– Racine
– Juneau
– Adams
– Milwaukee
– Menominee

17.  Which states
have the best
adult
smoking
rates?
 Some
counties in
WI are as low
as 13% -
others as
high as 29%
- what’s the
difference?

18.  Binge + heavy
drinking
 4 drinks for
women, 5
drinks for men
on a single
occasion
 1 drink for
women, two
drinks per day
for men, on
average

19.  For how
many days
during the
past 30 was
your mental
health not
good?
 Considering:
stress,
depression,
problems
with
emotions

20. 20

21. 21

22. 22

23. 23

25. 25

26. 26

27. 27

28. 28

29. 29

30. 30

37.  What aspects of life outside of a hospital or
clinic support or hinder health?
◦ Health begins where we
live, learn, work, worship, play
 What can you do to support improvement in
those conditions?
 Who else can have an impact?
 How can you help get others to the table?

39.  Health care
 Public health
 Foundations (including community foundations)
 United Way
 Chambers of Commerce
 Rotary/Civic organizations
 Large employers
 Churches/faith organizations
 Schools
 City planning/local government
 Community non-profits
 ______________________?

40. http://whatworksforhealth.wisc.edu/index.asp
www.countyhealthrankings.org/what-works-for-health

42.  What’s the goal?
◦ School readiness for all Brown County children,
starting with at-risk families
 Who’s involved?
◦ United Way
◦ Hospitals
◦ Early childhood
◦ County human services
◦ Elected officials
◦ Private sector business leaders

43.  What have they accomplished?
◦ Last year, over 1100 first time parents received
Welcome Baby Visits in the hospital, and 320
families were connected with further services
 How have they done it?
◦ Central coordinating agency
◦ Clear metrics and means of tracking
◦ Commitment among participants to common
strategies
◦ Found an evidence-based model and adapted it
slightly to their needs

44.  What’s the Goal?
◦ Improve success for Menominee children in school
◦ Address health challenges for Menominee children
and families, starting with childhood obesity

45.  Who’s Involved?
◦ Schools
◦ Health clinic
◦ College of Menominee Nation
◦ Local health department
 What have they accomplished?
◦ Mapped community assets against County Health
Rankings indicators
◦ Chose childhood obesity as a priority
◦ Developed 90 day action plans to improve physical
environment to promote health

46.  How have they done it?
◦ Created a shared understanding that neither health
nor school performance can be improved in a
vacuum—root causes are common to both
◦ Leadership
◦ Data
◦ Models of action

47.  Opportunities to improve health, not just
healthcare, exist in your “day jobs” and in
your communities
 Tools, resources, models exist to help
 Your experiences, networks, connections are
important
 Think of yourselves as leaders with important
knowledge and social capital who can make a
real difference

48. From the Juneau County Community Health Needs Assessment:
Everyone needs to make a concerted effort to help
populations become healthier. Efforts to change people’s
behavior cannot be viewed as “oh it’s just the doctors, or
health department’s or etc., responsibility.” We all need to
put our reputations and names on the line and support
one another to increase the credibility of what we are
trying to do and help support the change we hope to
accomplish with our population.
In addition, we cannot rely on others totally for making
referrals for residents who need services and resources;
we need to educate and empower the consumer.
48

49.  Wisconsin Partnership Program, UW School of
Medicine and Public Health
 The Robert Wood Johnson Foundation and the
County Health Rankings & Roadmaps team

50. ktimberlake@wisc.edu
County Health Rankings & Roadmaps
http://www.countyhealthrankings.org/
UW Population Health Institute
http://uwphi.pophealth.wisc.edu/