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November 12, 2008

NORC Health Indicators: Shifting from Reactive to Strategic Practice by Using Data to Improve the Health Status of Seniors. November 12, 2008. Presenters. Fredda Vladeck, Director, Aging In Place Initiative, United Hospital Fund fvladeck@uhfnyc.org Rebecca Segel, Program Manager,

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November 12, 2008

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  1. NORC Health Indicators: Shifting from Reactive to Strategic Practice by Using Data to Improve the Health Status of Seniors November 12, 2008

  2. Presenters Fredda Vladeck, Director, Aging In Place Initiative, United Hospital Fund fvladeck@uhfnyc.org Rebecca Segel, Program Manager, United Hospital Fund rsegel@uhfnyc.org Stephanie Pinder, Executive Director Lincoln Square Neighborhood Center, Inc. stpinder_lcsn@yahoo.com Mia Oberlink, Senior Research Associate Center for Home Care Policy & Research mia.oberlink@vnsny.org

  3. United Hospital Fund • New York City public charity, policy, and research center • Long history of fostering models and strategies to integrate health care and community-based social services • Established the Aging in Place Initiative in 1999 • Works with multiple partners • Programs • Funders: public and private • Researchers

  4. To Advance Aging in Place • Maximize the health and well-being of all older adults • Foster connections within the community • Empower older adults to assume new roles in the community

  5. Shifting from Reactive to Systematic Practice • Identify the issues • Quantify the problem • Set goals • Utilize “believable”, valid interventions • Measure the results

  6. NORCs and NORC Programs • NORC = Naturally Occurring Retirement Community: A multi-age community with a large concentration of older adults • NORC Supportive Service Programs • Community change model • Public-private partnerships of: • Housing/neighborhood organizations • Senior residents • Health and social service providers • Community stakeholders • Government agencies

  7. Community Health Chronic Care Model • Environment • Resources • Support Community Care Self Care NORC PROGRAM • Empowerment • Self-Advocacy • Lifestyle Choices Medical Care • Diagnosis • Treatment • Disease Management United Hospital Fund 2008

  8. Health Indicators Initiative Goal: To help NORC programs use evidence-based practice to maximize the health and well-being of seniors. • Three domains: • Access to Care • Prevention, Promotion, and Wellness • Management of Chronic Conditions

  9. Health Indicators Initiative Three Steps: • Baseline data collection to identify key health issues in the community • Implementation and measurement of targeted interventions • Resurvey and assessment of progress towards improving health status

  10. New York State-funded NORC Programs • 20 State-funded NORC Programs • Located in three regions • NYC- 9; Long Island- 4; Upstate- 7 • Administered 1,264 surveys

  11. Demographic Characteristics of the 20 State-funded NORC programs Note: Percentages may not add up to 100% due to rounding and/or missing information. Source: UHF-NYS Health Indicators in NORC Programs Project, 2007 Prepared by:

  12. Fair/Poor Health Status(Indicators Data compared to City, State, & National Data) Indicators New York City* New York State* USA* * Percentages are rounded to the nearest whole number. Source: NYC www.nyc.gov; NYS http://www.cdc.gov; US http://www.cdc.gov Source: UHF Health Indicators in NORC Programs Initiative, 2007-2008

  13. Health Status* by Region Aggregate (N=1,264) Long Island Programs (N=282) New York City Programs (N=695) Upstate Programs (N=287) Note: Percentages may not add up to 100% due to rounding and/or missing information. * People aged 60+ in 20 NYS NORC-SSPs were asked, “Would you say that in general your health is excellent, very good, good, fair, or poor?” Responses of “excellent,” “very good,” and “good” were combined into one category. Responses of “fair” and “poor” were combined into another category. Source: UHF-NYS Health Indicators in NORC Programs Project, 2007 Prepared by:

  14. Chronic Conditions* In NORC Programs, by Region % * People aged 60+ in 20 NYS NORC-SSPs were asked: “Has a doctor ever told you that you … “have diabetes?” “are overweight or obese?” “have heart disease?” ”have high blood pressure?” The percentages of people who said “yes” to each question are shown for the Group 2 Aggregate, and for three geographic groupings. Source: UHF-NYS Health Indicators in NORC Programs Project, 2007

  15. 10 or More Medications,* by Region Aggregate (N=1,264) Long Island Programs (N=282) New York City Programs (N=695) Upstate Programs (N=287) * People aged 60+ in 20 NORC-SSPs were asked, “How many prescription and non-prescription medications are you currently taking?” Source: UHF-NYS Health Indicators in NORC Programs Project, 2007 Prepared by:

  16. Physical Activity* by Region Aggregate (N=1,264) Long Island Programs (N=282) New York City Programs (N=695) Upstate Programs (N=287) Note: Percentages may not add up to 100% due to rounding and/or missing information. * People aged 60+ in 20 NORC-SSPs were asked two questions in order to estimate their level of physical activity. Level of physical activity: “Recommended level of activity” is defined as 1) light or moderate activity that causes light sweating or a light to moderate increase in breathing or heart rate and occurs five or more times per week for at least 30 minutes each time, and/or 2) vigorous activity that causes heavy sweating or large increases in breathing or heart rate and occurs three or more times per week for at least 20 minutes each time. People who engage in other combinations of the two types of physical activities described above are included in the category “some activity.” Those who do not engage in physical activity are included in the category “no activity.” Source: UHF-NYS Health Indicators in NORC Programs Project, 2007 Prepared by:

  17. Flu Shot and Pneumonia Shot * Percentages are rounded to the nearest whole number. Source: State of Aging and Health in America(2002) http://www.cdc.gov/aging/pdf/State_of_Aging_and_Health_in_America_2004.pdf Source: UHF Health Indicators in NORC Programs Initiative, 2007-2008

  18. Falls Note: Percentages may not add up to 100% due to rounding and/or missing information. Source: UHF-NYS Health Indicators in NORC Programs Project, 2007 Prepared by:

  19. Lincoln Square Neighborhood NORC • Home to 804 seniors • 500 seniors connected to the program • 253 seniors completed the survey • 20% White non-Hispanic • 33% Black non-Hispanic • 43% Hispanic • 51% rate their health fair/poor

  20. Diabetes: Prevalence and ControlN=253 Source: UHF Health Indicators Initiative 2008

  21. Health IndicatorsDiabetes: Selected Indicators Source: UHF Health Indicators Initiative 2008

  22. Health IndicatorsDiabetes: Selected Indicators Source: UHF Health Indicators Initiative 2008

  23. Using Data to Inform Practice • Understand community health risks • Introduce “standards of practice” to advance more strategic and targeted practice • Share findings with community to develop new partnerships and strengthen existing ones

  24. Design Considerations • Utility of the information • Easy to administer and enter data • Confidentiality maintained at the program • Quality assurance built in • Technical assistance provided in real time • Analysis and reports accessible and understandable

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