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Health Status Workgroup. February 16, 2011. Overview. Health status portion of MUA only We have developed a 4 var Social Deprivation Index Related it to direct health status measures There is movement toward belief that SDI plus a direct health measure is appropriate
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Health Status Workgroup February 16, 2011
Overview • Health status portion of MUA only • We have • developed a 4 var Social Deprivation Index • Related it to direct health status measures • There is movement toward belief that SDI plus a direct health measure is appropriate • Used county and PCSAs to demonstrate; no rec on rational service area
Big Picture • SDI4 can be calculated across the nation at local level • This is identifying areas at risk of poor health • Then considering direct measures of health • This allows for a check of actual outcomes
SDI 4—Robert Graham Center • 4 variables • Weights from research; vars from 2000 Census, unemployment 2007 Claritas • 100 pct poverty: 51% • Unemployment rate: 30% • % persons less than high school: 12% • % households with single parent 10%
SDI Calculation • Place areas (county or PCSA) into deciles • Multiply decile (1, 2,…10) by weight • Sum index
Example • Assume a county in fifth decile on all 4 • 5 x .51=2.55 • 5 x .30=1.50 • 5 x .12=0.60 • 5 x .10=.50 • Sum of score =5.15
Does SDI4 correlate with health outcomes? • Yes, there is a consistent relationship in which the worst decile is ‘sicker’ than the best using a variety of measures • Correlations are not perfect which is one reason for including direct measures of health
Direct Measures of Health Status • County: standardized mortality ratio; % fair/poor health status; Life expectancy at birth; unhealthy days; low birth weight • PCSA: Diabetes & hypertension prevalence; self reported disability; Ambulatory care sensitive conditions; IMR
SDI4 • We looked at a variety of variables, these 4 strongly capture the risk of poor health outcomes, and they are available at small units of geography (flexibility regardless of rational service area chosen) • Other variables that could be included may be included under accessibility and/or ability to pay