Report Card Working Group of the MA-HDC 06.22.09 1 The Massachusetts Report Card Measuring Our...
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Transcript of Report Card Working Group of the MA-HDC 06.22.09 1 The Massachusetts Report Card Measuring Our...
Report Card Working Group of the MA-HDC 06.22.09
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The Massachusetts Report Card
Measuring Our Progress Toward the Elimination of Racial, Ethnic, and Linguistic Disparities in Health
Health Disparities Council Meeting June 22, 2009
Report Card Working Group of the MA-HDC 06.22.09
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Massachusetts Report Card Working Group(Participating Members)
Mary Crotty, MNA Sherry Dong, Tufts Joe-Ann Fergus, MNA Pam Jones, BPHC Georgia Simpson May, DPH Joel Weissman, EHS (advisor)
Report Card Working Group of the MA-HDC 06.22.09
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Today’s Agenda
Report Card Working Group Update The MA Report Card
Purpose Our Framework Key Concepts Report Card Structure
Indicators Exercise Next Steps
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Report Card Working Group Update
Working group meetings were held on June 2, and June 16 Process reviewed and goals set for moving forward The next meeting is Scheduled for July 22
Report Card Group members also met with staff from the AGs office on June 11 (Maura Healey and Lois Johnson) The goal of this meeting was to explore the concept of how or
if existing policies and laws may contribute to or help to alleviate disparities.
Per the suggestion of Rep. Rushing at the last council meeting, the report card group emailed out a request for input to the council members.
The report card group is seeking input from council members regarding the model and content of the report card.
MA Report Card: Purpose Identify priority health, social, and policy
indicators for Massachusetts.
Create a systematic approach to tracking our progress, over time, in reducing racial, ethnic, and linguistic disparities.
Provide the residents of the Commonwealth with useable information on the health and wellness of Massachusetts.
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Report Card Working Group of the MA-HDC 06.22.09
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MA Framework for Addressing Health Disparities
Societal/Policy Factors
Access to Health Care
Personal Health Behaviors
Extent and Quality of Health Care and Outcomes
Individual FactorsCommunity Factors
Institutional Transformation
Version 3+: 6/18/09
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Key Concepts for Developing a MA Report Card
I. Racial, Ethnic & Linguistic Health Disparities
II. Not a Static Document Periodic Updates Parking Lot
III. Report Card Structure Health and Social Statistics vs. Social Policy Formatting
IV. Selection Criteria for Indicators
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Key Concept III: Report Card Structure
Health Status Indicator Morbidity (prevalence/incidence of illness) Mortality (death rate)
Contributory Factors Associated with the Indicator 1. Health Care Utilization
Access and quality2. Social Determinants
Basic needs, social well-being, community attributes (including environmental)
3. Personal Practices/Individual Factors
Report Card Structure, cont.
4. Social Policy Levers Civil Rights (“obvious” discrimination) Other policies, laws, etc that appear to be race neutral but may
affect the health of racial-ethnic minorities disproportionately Zoning / restrictive ordinances Mortgage and foreclosure policies and practices Medicaid rates resulting in poor access/low quality Workplace health and inspections, e.g., nail salons, auto
body shops, taxi drivers
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Formatting Considerations
Content Length Resources
Stop for Discussion
Report Card Working Group of the MA-HDC 06.22.09
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676
1564 1524
235
783
227
2080
841
2276
1038
0
500
1000
1500
2000
White Black Hispanic Asian MA
Ra
te p
er
10
0,0
00
ED Visits Hospitalizations
Source: MDPH, Bureau of Health Information, Statistics, Research and Evaluation, Health Survey Program
Example: Age-Adjusted Asthma ED Visits and Hospitalizations by Race/Ethnicity 2003-2005
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What do we want to know? What can we measure?Can we intervene and where? Are there policy implications?
_______________________________________
• % who need inhalers who do not have them• % living in substandard housing• % living in areas with poor air quality• Educational level• Household income
The rate of asthma ED visits and hospitalization may be a proxy for other health care access issues
• timely access to ambulatory services
Use the Example to Build Our Report Card
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Example, cont.
Asthma Related ED Visits by R/E (MA: 1,038/100,000)
Contributory Factors Associated with the Indicator 1. Health Care Utilization
a. ______2. Social Determinants
a. ______3. Personal Practices/Individual Factors4. Social Policy Levers
a. Medicaid Reimbursement
b. Environmental Hazards
Black: 2,276/100,000Hispanic: 2,080/100,000
Asian: 227/100,000White: 841/100,000
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IndicatorsWhat do we want to know?
Selection Criteria What’s been identified What needs to be included Prioritize
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Key Concept IV: Indicator Selection Criteria
Availability of Data (Measures and Statistics) Known Instances of Disparities Size of Disparities Amenable to intervention
an indicator we can influence an area we can adjust to impact the indicator can identify an area(s) in the system to apply an
intervention(s) that will change the indicator Presence of Policies which would impact disparity (Social
Policies)
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Our Indicators
Review “Proposed Indicators and Ranking” Document
What we haveWhat else do we want to know
Stop for Discussion
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Let’s Prioritize
Write In Missing Indicators Ranking of Indicators
On a Scale of 1 (Low) to 5 (High)
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MA Report Card, Next Steps
Compile Format Present a Mock-up of a MA Report Card