Grover Lecture - By the Numbers
CHSP's Grover Lecturer Charts Ohio's Health by the Numbers
Kate Fox
Amy Rohling McGee began her 2015 Grover Lecture Series presentation on April 10 by citing some interesting Ohio "rankings":
"A year or so ago, the Atlantic published some research that showed that Ohioans curse more than any other state, and that we say 'please' and 'thank you' less than any other state. Recently, too, Estately put out some research that showed that Ohio was in the top quartile of states most likely to survive a zombie apocalypse. So there's a little bit of good news, I guess."
However, McGee moved quickly to discussing a ranking system that should matter to everyone. For two years McGee and her staff members have worked with an advisory group of nearly 100 public health stakeholders to develop the HPIO Health Value Dashboard, a report designed to measure Ohio's health-specifically, health outcomes and health care costs-against national averages and to identify areas of strength and weakness.
"We didn't want to replicate what other health data surveys* were already doing," McGee emphasized. "Instead, we asked ourselves, 'In terms of improving health and reducing costs in Ohio, what set of metrics could move us in the right direction?'"
Numbers
The advisory group identified 106 metrics out of thousands that would measure and rank the "health" of each state, and present them in a user-friendly format for policy makers and legislators. The result, published in print and online in December 2014 shows that, among other things, Ohio ranks No. 47 out of 50 states when it comes to health care value-the amount spent per capita compared to health outcomes.
"In other words," McGee said, "we are spending more and getting less." The report shows that Ohio ranks near the top in health insurance access and such environmental factors as safe drinking water and adequate housing, yet ranks near the bottom in addressing smoking (and secondhand smoke), diabetes, infant mortality, avoidable ER visits by Medicare recipients, drug treatment access and food insecurity.
*UnitedHealth Foundation's America's Health Rankings, the Commonwealth Fund's Health System Scorecards, the University of Wisconsin Population Health Institute's County Health Rankings, and the Kaiser Family Foundation's State Health Facts, among others (see page 15 of the 2014 Health Value Dashboard for a chart of how the report differs from the others).
The Significance
More important to McGee than the published rankings, though, are the avenues the report creates to address the gaps in Ohio's complex health care system.
"First, the report identifies areas to conduct further analysis on what we can do to address issues," she said. She cited the incidence of falls in the elderly population as an example: "If we see a high amount being spent on fall injuries and a lack of measures to address that, then that's a gap where all of us can step in with ideas."
It's not an easy discussion, considering the different perspectives of the patient, the medical care team, the insurance companies and various public health entities, but it's an essential conversation that needs to take place, according to McGee-which leads to the second avenue: involvement.
"The truth is that everyone involved in health care is going to experience policy-related issues at some point, and I wanted the Dashboard to represent, first, that health care policy makers and legislators are approachable-regular people who come from regular backgrounds, just like you and me-and second, that those in the health care field should feel empowered to contact these people with their ideas, concerns and solutions."
"It's important to emphasize that this project is a group effort," McGee continued, and though the Dashboard relies on analytics to present information, for McGee, its greater potential is to arm everyone touched by health care issues with accurate, impartial information and give them a way to become involved in health care decisions that ultimately affect all of us.
The Grover Lecture Series was endowed in the College of Health Sciences and Professions by Tad and Ann Grover in 2003 and brings an annual speaker to campus to discuss a health-related topic of interest to the college's faculty members and students.
Dashboard Highlights:
- Surprisingly, clinical care has less influence (20%) on a person's health than social and economic environment (40%) and individual health behaviors (30%). Yet it accounts for 95% of health care spending in Ohio.
- Ohio scores poorly on the national health scale primarily due to statistics tied to adult smoking, adult diabetes and infant mortality; child immunization percentages; the number of individuals 12 and over needing drug treatment and outdoor air quality in Ohio.
- Ohio ranks in the top 10-15 nationally for employee-sponsored health insurance coverage, safe drinking water and water fluoridation; adequate housing; and health department accreditation.
- Ohio reached the top 10 with only one ranking: safe drinking water. Worst rankings at 49 included health behaviors, Medicare spending and children exposed to second-hand smoke.