Healthy People 2010 Focus Area 1: Access to Quality Health Services Progress Review June 15, 2006

1. Healthy People 2010 Focus Area 1:Access to Quality Health ServicesProgress ReviewJune 15, 2006

2. Status of Access to Quality Health Services Objectives Proposed for deletion * Target met Improving Little or no change Getting worse Mixed progress Baseline only Clinical Preventive Care Emergency Services 1-1. Health insurance coverage 1-2. Health insurance coverage for clinical preventive services * 1-3. Counseling about health behaviors 1-10. Difficulty or delay in getting emergency care 1-11. Rapid pre-hospital emergency care 1-12. Toll-free number for poison control centers 1-13. Trauma care systems 1-14. Pediatric guidelines & protocols Primary Care 1-4. Source of ongoing care 1-5. Usual primary care provider 1-6. Difficulty or delay in getting care 1-7. Core competencies in health provider training 1-8. Racial/ethnic representation in health professions 1-9. Hospitalizations for ambulatory care-sensitive conditions Long-Term Care & Rehabilitative Services 1-15. Access to long-term care services 1-16. Pressure ulcers among nursing home residents

3. Status of Access to Quality Health Services Objectives Modified at Midcourse* BaselineDataObtained Target Met 1-3. Counseling about health behaviors 1-7. Core competencies in health provider training 1-11. Rapid pre-hospital emergency care 1-13. Trauma care systems 1-12. Toll-free number for poison control centers 1-15. Access to long-term care services Progress: Three quarters of objectives and subobjectives with data beyond the baseline year are moving toward their targets. * Midcourse modifications are proposed and are subject to final approval by HHS.

4. Objectives with Changes in Disparity Since the Baseline = Group with the best (most favorable) rate. B = Increase in disparity = Decrease in disparity = Characteristic not selected for this objective. Note: Disparities are measured relative to the group with the best rate. Changes in disparity since the baseline, indicated by arrows, are between 10 and 49 percentage points and statistically significant at the 0.05 level. Data are not shown for objectives with insufficient data or for objectives with no change in disparity since the baseline for any of the characteristics shown.

5. Highlighted Objectives 1-1. Health insurance coverage 1-3. Counseling about health behaviors 1-5. Usual primary care provider 1-6. Difficulty or delay in getting care 1-8. Racial/ethnic representation in health professions 1-9. Hospitalizations for ambulatory care-sensitive conditions 1-13. Trauma care systems 1-15. Access to long-term care services Target met Improving Little or no change Getting worse Mixed progress Baseline only Clinical Preventive Care Primary Care Emergency Services Long-Term Care & Rehabilitative Services

6. Persons Under Age 65 with Health Insurance, by Income and Age, 2004 Percent 2005 † 1997 2004 100 2010 Target 90 80 70 60 50 0 Poor Nearpoor 25-64 Middle/high 10-14 15-19 20-24 Total Family Income Level Age I = 95% confidence interval. † Preliminary data for January – September 2005. Source: National Health Interview Survey, CDC, NCHS. Obj. 1-1

7. Persons Under Age 65 with Health Insurance, by Race/Ethnicity Percent 1999 2004 100 2010 Target 90 80 70 60 50 0 Hispanic White American Indian/Alaska Native Native Hawaiian/Pacific Islander Black Asian I = 95% confidence interval. Note: The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group. Source: National Health Interview Survey, NCHS, CDC. Obj. 1-1

8. Adults Counseled by Their Provider about Health Behaviors, by Age Group, 2001 2010 Target Percent 18-24 yrs. 25-44 yrs. 45-64 yrs. 65-74 yrs. 75+ yrs. 80 70 60 50 40 30 20 10 * 0 Smoking Cessation† PhysicalActivity Diet & Nutrition Risky Drinking‡ †Among adults who currently smoke. ‡ Among adults who currently report risky drinking behavior. I = 95% confidence interval. * Data for persons 75 years and older are statistically unreliable and are suppressed. Note: Data exclude adults who did not have a health care visit in the past year. Source: National Health Interview Survey, CDC, NCHS. Obj. 1-3 a-d

9. Persons with a Usual Primary Care Provider, 2003 Total 2010 Target American Indian Asian Native Hawaiian Black White Hispanic Female Male Less than high school High school At least some college With activity limitations Without activity limitations 0 20 40 60 80 100 Percent Note: The American Indian category includes Alaska Natives. The Native Hawaiian category includes Pacific Islanders.The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ. Obj. 1-5

10. Persons Experiencing Difficulties or Delays in Obtaining Needed Care, 2001 Decrease desired 2010 Target Total American Indian Asian/Pacific Islander Black White Hispanic Female Male Poor Near poor Middle/high income With activity limitations Without activity limitations 0 5 10 15 20 25 Percent Note: The American Indian category includes Alaska Natives. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ. Obj. 1-6

11. Racial and Ethnic Groups Underrepresented in Health Professions 2010 Target Percent 1996-1997 2003-2004 15 10 5 0 Black orAfrican American Hispanic orLatino American Indian/Alaska Native Note: Data are based on graduates from schools of public health, dentistry, pharmacy, and medicine. The 2010 targets are based on the U.S. Bureau of Census projections of the proportion of persons in each racial/ethnic group in the U.S. population in the year 2000.The Asian/Pacific Islander group has exceeded its target of 4% and is not shown. Source: Bureau of Health Professions, HRSA. Obj. 1-8 a,c,d

12. Hospitalizations for Uncontrolled Diabetes among Persons Aged 18-64 Years 2010 Target Decrease desired 1996 2003 Admissions per 10,000 population 40 30 20 10 0 Medicaid Female Male Private Uninsured Total Insurance Status Gender Obj. 1-9b SOURCE: Healthcare Cost and Utilization Project, AHRQ.

13. States With Processes to Monitor and Evaluate Trauma System Outcomes, 2002 Non-legislated system & defined process (7) Legislated system & defined process (23) No system & no defined process (21) D.C. Obj. 1-13h Source: Federal Trauma-EMS Systems Program Survey, HRSA.

14. Persons Age 65 and Over without Access to Needed Home Health Care, 2001 Decrease desired 2010 Target Total American Indian * * Asian * Native Hawaiian Black White Hispanic Poor Near poor Middle/high income Within MSA Outside MSA 0 5 15 20 25 10 Age-Adjusted Percent * Data are statistically unreliable and are suppressed. = 95% confidence interval. MSA: Metropolitan Statistical Area. Note: Data are age adjusted to the 2000 standard population. The American Indian category includes Alaska Natives. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons are defined as needing home health care services if they require assistance with personal care needs or routine care needs. Source: National Health Interview Survey, CDC, NCHS. Obj. 1-15a

15. Progress review data and slides are available on the web at: http://www.cdc.gov/nchs/hphome.htm