Health 3.0 Leadership Conference: Population Health in Detroit with David Law
POSTER TEMPLATE FOR HC DISPARITIES
1. Local and State:
• Division of Minority Health and Disparity Elimination
• Created to address health and fitness needs while promoting healthy
lifestyles for the state and local areas
• Council charged by Governor to serve as clearing house on information
on health and physical fitness
• Makes recommendations for legislation
• TN HR 11 (2011, adopted) - Recognizes February 4, 2011, as “National
Wear Red Day” and encourages all Tennesseans to educate themselves on
preventing cardiovascular disease.
• Tennessee Heart and Disease and Stroke Prevention Health Program
• Lessen the burden of disease through changes in policy and environment
• Count on ME: Heart Health is a Numbers Game
• Media campaign with suggestions for disease prevention and control for
African Americans and other minorities
National
• Affordable Care Act (ACA) requires new health plans to cover a number of
preventive services at no cost, including many that can help reduce risk of
cardiovascular disease
• Testing for high blood pressure and cholesterol.
• Counseling on the use of daily aspirin.
• Counseling and medication to quit smoking.
• Counseling on diet and weight loss and managing obesity.
• American medical association. (n.d.). Research Findings and Recommendations. Retrieved from http://www.ama-
assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/research-findings-recommendations.page
• HP2020 Objective Data Search | Healthy People 2020. (2015). Retrieved June 15, 2015, from
http://www.healthypeople.gov/2020/data-search/Search-the-Data?f%5B%5D=field_topic_area%3A3516&ci=0&se=0&pop=
• Interactive Atlas of Heart Disease and Stroke Tables. (2012). Retrieved from
http://nccd.cdc.gov/DHDSPAtlas/reports.aspx?state=TN&themeId=27
• Tennessee department of health. (2010, August). High blood pressure facts. Retrieved from
http://health.state.tn.us/factsheets.hypertension.htm
• Tennessee department of health. (2010, August). Cardiovascular disease. Retrieved from
http://health.state.tn.us/factsheets/cario.htm
• U.S census bureau. (2010). American factfinder - community facts. Retrieved from
http://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml
• U.S. department of health and human services. (2012). National healthcare disparities report (12-0006). Retrieved from
Agency for healthcare research and quality website: http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf.
• 2011 National Healthcare Disparities Report. (2014, October). Agency for Healthcare Research and Quality, Rockville, MD.
http://archive.ahrq.gov/research/findings/nhqrdr/nhdr11/index.html
• The Institute of Medicine recommends a multi-level strategy to eliminate health
disparities this includes:
• Informing everyone of the gap between racial and ethnic groups
• Increase healthcare providers’ awareness of disparities
• Increase the proportion of underrepresented racial and ethnic minorities among
health care professionals
• promote consistency of care through use of evidence-based guidelines
• Implement patient education programs to increase patient's knowledge
• Promoting healthy eating fitness programs that are free to the community.
• Using handouts to get the word out and radio advertisements
SIX PRIORITIES
DEFINITION AND OVERVIEW OF
DISPARITIES
LEGISLATION
RECOMMENDATIONS TO END THE
DISPARITY
REFERENCES
SOCIAL AND OTHER DETERMINANTS OF HEALTH
PROMOTING EFFECTIVE PREVENTION AND
TREATMENT OF LEADING CAUSES OF MORTALITY,
STARTING WITH CARDIOVASCULAR (CV) DISEASE
National Healthcare Disparities Report 2011
Cost of cardiovascular disease $444.2 billion
Cost of heart failure $34.4 billion
Cost-effectiveness if hypertension screening $14,00-$35,00/QALY
Mortality of Cardiovascular disease is high with 779,367deaths
Incidence of heart attacks are 1.3 million
The NHQR track quality measures for preventing and treating CV disease
Cholesterol screening
ACE inhibitor or ARB for heart failure
Inpatient deaths following heart attack
Hospitalization for congestive heart failure
Timeliness of cardiac reperfusion for heart attacks
Discharge instructions for heart failure
Inpatient deaths from 2001 to 2008 with heart attack decreased significantly for each racial and ethnic and area of income group
In all years Blacks had lower inpatient mortality rates than Whites
Residents of the two lowest incomes had higher mortality rates
Ages 45-64 and 65 and over had higher rates of inpatient deaths
From 2004 to 2008 the overall rate of admissions for congetive heart failure decreased significantly overall
In all years Blacks had higher rates while APIs had lower rates of admissions
All years residents of the highest income neighborhood had lower rates than residents if the three lower income quartile neighborhoods
At current rates of improvements Whites could achieve the benchmark in u years, hispancis and APIs sooner than whites and blacks 14
years
Tennessee is in the Bottom 5 states for Chronic Disease Management
(2011 National Healthcare Disparities Report, 2014)
“A cheerful heart is good medicine, but a crushed spirit dries up the bones”. Proverbs
17:22
According to the National Healthcare Disparities
Report, 2011, there are six priorities
• Making Care Safer
• Ensuring Person and Family Centered Care
• Promoting Effective Communication and Care Coordination
• Promoting Effective Prevention and Treatment of Leading
Causes of Mortality (Starting with CV)
• Working with Communities to Promote Wide Use of Best
Practices To Enable Healthy Living
• Making Quality Care Affordable
• High school Graduates: 85.3% in Jackson TN vs 84.4% in state
• Median Household Income: $37,231 in Jackson vs $44,298 in state
• Below Poverty Level: 23.7% in Jackson vs 17.6% in state
• 18.4 % Madison County
• Percent without Health Insurance in 2012 under age 65 16.5% in Madison County
• Percent of total people without insurance in TN 2013: 10%
• US 14.4%
• 8th out of 50 states for heart disease deaths
(U.S census bureau, 2010)
Cardiovascular Disease Promoting Resolution of Disparities
Ashley York MSN, AGNP-C, WHNP-BC
Advisor: Dr. Denise Thornton Orr
• Making Care Safer- tracks safety within the hospital setting and examine healthcare-associated
infections, postoperative and other hospital complications, and preventable hospital deaths.
• Ensuring Person and Family Centered Care-ensure individual experiences with care in an office or
clinic setting, as well as during a hospital stay. Measures tracked include a focus on perceptions of
communication with providers and satisfaction with the physician-patient relationship
• Promoting Effective Communication and Care Coordination- presents data to assess the
performance of the U.S. health care system in coordinating care across providers or services. Care
coordination is measured, in part, using readmission measures as well as measures of success in
transitioning across health care settings.
• Promoting Effective Prevention and Treatment of Leading Causes of Mortality- examining
prevention, treatment, and outcomes for a range of conditions or population groups with a focus on
cardiovascular disease
• Working with Communities to Promote Wide Use of Best Practices To Enable Healthy Living- using
lifestyle modification, functional status preservation and rehabilitation, and supportive and palliative
care to help communities use best practices.
• Making Quality Care Affordable- how well the health care system promotes quality, affordable care,
and appropriate use of services. Emphasis is looked at overuse of health services, as measures
representing misuse or underuse overlap. Also looking at barriers to care, such as the U.S.
population that is uninsured, financial barriers to care experienced by the population with health
insurance, and people with a usual source of care.
(2011 National Healthcare Disparities Report., 2014)
• West Tennessee, 70 miles east of Memphis
• Part od Madison County
• Estimated 7th largest city in TN
• 13th highest crime rate in the United States
• Median Age: 34.4
• Population 2013: 67,685 with 12.7% 65 or older
• White: 49.2%
• Black 45.7%
• Hispanic 4.0%
• Asian 1.2%
Health Disparities That Are Changing Over Time
National Healthcare Disparities Report, 2011
JACKSON TENNEESSEE