1 / 38

Daniel J Kruger, PhD University of Michigan Genesee County Health Department's

Daniel J Kruger, PhD University of Michigan Genesee County Health Department's Public Health Week Annual Conference 5 April 2011. The economic crisis and the health of Genesee County: Results from the 2009 Speak to Your Health! Community Survey. Mission of the PRC/MI.

gaston
Download Presentation

Daniel J Kruger, PhD University of Michigan Genesee County Health Department's

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Daniel J Kruger, PhD University of Michigan Genesee County Health Department's Public Health Week Annual Conference 5 April 2011 The economic crisis and the health of Genesee County: Results from the 2009 Speak to Your Health! Community Survey

  2. Mission of the PRC/MI To create and foster knowledge resulting in more effective public health programs and policies. The Center conducts community-based prevention research to improve health and prevent disease, especially focusing on populations with a disproportionate share of poor health outcomes.

  3. Support for the survey provided by: Centers of Disease Control and Prevention (CDC), U.S. Dept of Health and Human Services Genesee County Health Department Hurley Medical Center

  4. Speak to Your Health! Survey Committee Co-Chairs: • Daniel J. Kruger, UM-SPH • Suzanne Cupal, Genesee County Health Department Committee Members: • Shante Burke, GC Community Mental Health • Bettina Campbell, YOUR Center • Erin Conklin, Genesys Health System • E. Hill De Loney, Flint Odyssey House - HAC • Micki Juip, Hurley Medical Center • Susan Morrel-Samuels, UM-SPH • John Sonnega, UM-Flint • Arlene Sparks, GCCARD • Mark Valacak, Genesee County Health Officer

  5. Purpose of the Survey The survey was designed via collaborative process to: • Understand residents’ health-related behaviors and perceptions • Provide information for needs assessments and evaluations of projects • Identify community assets • Understand the associations between residents’ health-related behaviors and perceptions, social determinants, and health outcomes • Provide training opportunities • Develop a community health agenda that is widely disseminated and democratic

  6. Survey Methodology • Random sample of households in Genesee County • 20 residents per Census Tract in Flint • 10 residents per Census Tract outside of Flint • Telephone interviews conducted by the Michigan Public Health Institute • Adults ages 18 years and older • Final sample size = 1700 residents • 900 in Flint and 800 Out-County • Data analyses can be weighted to take into account sampling strategy and demographic distribution

  7. 2009 Survey Topics Physical and Mental Health Screening Mental Health Health Care Access, Coverage, Satisfaction, Trust Health Promoting Behaviors (nutrition, exercise, etc.) Health Adverse Behaviors (tobacco use, etc.) Spirituality, Religion, and Health Experiences of and Perceptions of Racism Financial health Violence, Crime, and Incarceration Perceptions of Neighborhood Conditions Sleep Quality Public Policy for Smoking Regulations

  8. Survey Strengths • Data can be used for needs assessment, planning, and assessing programs and interventions • Among the best local data available in Michigan on health and health behaviors • Results can be used to compare health status at various levels (City, County, State, National) • Geographic mapping of information can identify areas with certain assets or need

  9. Genesee County, Michigan

  10. Survey Respondents Selected by Census Tract

  11. Locations of Survey Respondents • Survey data can be mapped and analyzed at different geographical levels: • Census Tract • ZIP Code • School attendance area • City Ward • Etc.

  12. Community Utilization of Survey Data

  13. Fulfilling the Core Functions of Public Health

  14. The economic crisis and the health of Genesee County

  15. Economic Decline

  16. Economic Decline • Given recent economic trends, the partnership was interested in examining the impact of individual economic decline on health indicators in the 2009 survey wave.

  17. Economic Decline • Given recent economic trends, the partnership was interested in examining the impact of individual economic decline on health indicators in the 2009 survey wave. • Respondents were asked the extent to which they agreed with the statement: “My financial situation is much worse this year than it was in the previous year.”5) Strongly Agree4) Agree3) Neutral2) Disagree 1) Strongly Disagree

  18. Outcome Measures

  19. General and mental health items from the Behavioral Risk Factor Surveillance System: Outcome Measures

  20. General and mental health items from the Behavioral Risk Factor Surveillance System: 1. Would you say that in general your health is …2. Would you say that in general your mental or emotional health is … 5) Excellent 4) Very good 3) Good 2) Fair, or 1) Poor Outcome Measures

  21. General and mental health items from the Behavioral Risk Factor Surveillance System: 1. Would you say that in general your health is …2. Would you say that in general your mental or emotional health is … 5) Excellent 4) Very good 3) Good 2) Fair, or 1) Poor3. During the past 30 days, how many days did poor health keep you from doing your usual activities, such as self-care, work, or recreation? Outcome Measures

  22. General and mental health items from the Behavioral Risk Factor Surveillance System: 1. Would you say that in general your health is …2. Would you say that in general your mental or emotional health is … 5) Excellent 4) Very good 3) Good 2) Fair, or 1) Poor3. During the past 30 days, how many days did poor health keep you from doing your usual activities, such as self-care, work, or recreation? 4. During the past 30 days, how many days did poor mental or emotional health keep you from doing your usual activities, such as self-care, work, or recreation? Outcome Measures

  23. Outcome Measures

  24. Outcome Measures • BSI-18 depression subscale (α = .77, Derogatis, 2001). • During the past week, including today, please tell me how often you felt or thought the following way… …feeling lonely …feeling blue or sad …feeling no interest in things Response scale: Often, Fairly Often, Sometimes, Almost Never, or Never

  25. Outcome Measures • BSI-18 depression subscale (α = .77, Derogatis, 2001). • During the past week, including today, please tell me how often you felt or thought the following way… …feeling lonely …feeling blue or sad …feeling no interest in things • Stress level (α = .73, Cohen et al., 1983). • How often have you……been upset because of something that happened that you didn’t expect? …felt nervous and “stressed out”? …felt that you had so many problems that you could not deal with them? Response scale: Often, Fairly Often, Sometimes, Almost Never, or Never

  26. Other Predictors • Years of education • Income level (from series of items) • Age • Gender • Race (converted into White or non-White) • Stepwise linear regressions predicted health outcomes for the 733 participants with complete data.

  27. Demographic Descriptives

  28. Outcome Descriptives

  29. Results Beta values for significant predictors of health outcomes * indicates p < .05, ** indicates p < .01, *** indicates p < .001.

  30. Results • Higher incomes were associated with better reported status across all health outcomes. • Income was usually the strongest predictor. • Older ages were associated with better reported mental health outcomes. • Those with higher educational levels reported better overall health and better mental or emotional health. • Women reported more stress than men. • Financial decline predicted adverse health across all health outcomes.

  31. The degree of decline in which an individual’s financial situation was worse compared to the previous year, the greater degree to which they: • Rated their physical health more poorly • Had more days in the past month where poor physical health interfered with their usual activities • Rated their mental health more poorly • Had more days in the past month where poor mental health interfered with their usual activities • Reported experiencing • more stress • more depressive symptoms

  32. Conclusions • The degree to which the individual’s financial situation had worsened in the past year was significantly associated with poorer perceived general health and mental health as well as the extent to which poor general and mental health interfered with activities of daily living. • Economic decline influences health above and beyond the relationship with traditional socio-economic indicators such as educational attainment and current income. • Especially in a period of economic uncertainty, the awareness that individuals experiencing financial decline may be at risk for greater health concerns is highly beneficial to community partnerships seeking to improve community health.

  33. Survey Website www.sph.umich.edu/prc/

  34. Survey Website

  35. Survey Website

  36. Survey Website

  37. Thank You!!!To All Who Participated in the Speak to Your Health! Community Survey

  38. Questions? The economic crisis and the health of Genesee County: Results from the 2009 Speak to Your Health! Community Survey

More Related