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Join the conversation now: #HHSDataFest Advancing Social Determinants of Health with Let’s Get Healthy California and California Open Data Intiatives Karen L. Smith, Director and State Health Officer, CDPH Matt Willis, Rx Safe Marin Debra S. Oto-Kent, Walk with Friends Eric G. Handler, WasteNotOC
86

Open DataFest III - 3.14.16 - Day One Afternoon Sessions

Jan 12, 2017

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Page 1: Open DataFest III - 3.14.16 - Day One Afternoon Sessions

Join the conversation now: #HHSDataFest

Advancing Social Determinants of Health with Let’s Get Healthy California and California Open Data Intiatives

Karen L. Smith, Director and State Health Officer, CDPH

Matt Willis, Rx Safe Marin

Debra S. Oto-Kent, Walk with Friends

Eric G. Handler, WasteNotOC

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Rethinking Health

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Rank state/territory Overall

1 Japan 82.73

2 Switzerland 81.81

3 Hong Kong 81.61

4 Australia 81.44

5 Italy 81.37

6 Iceland 81.28

7 France (metropol.) 80.95

8 Sweden 80.88

9 Israel 80.69

10 Singapore 80.60

11 Canada 80.54

12 Spain 80.48

13 Norway 80.45

14 Austria 80.24

15 Netherlands 80.20

16 New Zealand 80.13

17 Martinique ( France) 80.07

18 Macau 80.03

19 South Korea 80.00

20 Germany 79.85

Rank state/territory Overall

21 Belgium 79.77

22 Ireland 79.68

23 United Kingdom 79.53

24 Greece 79.52

25 Channel Islands ( UK) 79.51

26= Luxembourg 79.39

26= Guadeloupe ( France) 79.39

28 Finland 79.34

29= Cyprus 78.94

29= U.S. Virgin Islands ( US) 78.94

31 Costa Rica 78.87

32 Malta 78.80

33 Puerto Rico ( US) 78.70

34 Chile 78.65

35= Portugal 78.59

35= Slovenia 78.59

37 Cuba 78.50

38 Denmark 78.25

39 Taiwan 78.19

40 United States 77.97

41 Qatar 77.88

What do we know?Overall health isn’t determined by how much we spend.

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Life expectancy in California by race/ethnicity2006-2008

What do we know?Health is not distributed evenly in US.

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Health

Behaviors

30-40%

Underlying

Determinants

of Health

20-50%

Medical

Care

10-20%

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“Behavioral risk factors”

People’s behavior is shaped by the real life choices and opportunities available to them where they live, work, learn, and play.

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Choices?

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Neighborhood Conditions

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“It is necessary that properties shall continue to be occupied by the same social and racial

groups”- Federal Housing Administration Underwriting Manual 1938 in recommending racially

restrictive covenants.

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Social Determinates of Health

Conditions in the social, physical, and economic environment in which

people are born, live, work, and age. They consist of policies, programs

and institutions and other aspects of the social structure, including the

government and private sectors, as well as community factors.”

Healthy People 2020: An Opportunity to Address Societal Determinants of Health in the U.S., Objectives for 2020, July 11, 2010

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“Health equity is achieving the highest level of health for all people.”

Everyone should have the opportunity to make the choices that allow them to live a long, healthy life, regardless of their income, education or ethnic background.

Sources: Virginia Department of Public Health RWJF: Vulnerable Populations Portfolio

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Measuring health

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Indicators of Health

• Mortality rates

• Diseases

• Disability

• Medical care

• DALYs

• QALY

• Risk behaviors

• Poverty rates

• Educational attainment

• Incarceration rates

• Environmental toxins

• Built environment

• Food insecurity

• etc

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Infant MortalityData Source

birth certificate

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New tools

• Open data

• Geocoding

• Mapping

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Recipients as of Oct 2006.

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High school grads: 90%Unemployment: 4%

Poverty: 7%Home ownership: 64%

Non-White: 49%

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High school grads: 81%Unemployment: 6%

Poverty: 10%Home ownership: 52%

Non-White: 59%

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High school grads: 65%Unemployment: 12%

Poverty: 25%Home ownership: 38%

Non-White: 89%

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Life Expectancy—Oakland Flats and Hills (2000-2003)

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Alameda County

50

55

60

65

70

75

80

85

90

95

100

0% 10% 20% 30% 40% 50% 60%

Poverty Rate

Lif

e E

xp

ecta

ncy (

Years

)

San Francisco County

50

55

60

65

70

75

80

85

90

95

100

0% 10% 20% 30% 40% 50% 60%

Poverty Rate

Lif

e E

xp

ecta

ncy (

Years

)

Contra Costa County

50

55

60

65

70

75

80

85

90

95

100

0% 10% 20% 30% 40% 50% 60%

Poverty Rate

Lif

e E

xpecta

ncy (

Years)

Tract Poverty vs. Life

Expectancy

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Let’s get Healthy California

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The Guiding Questions

What will it look like if California is

the healthiest State in the

Nation?

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Better Care for Individuals

Better Health for Populations

Lower Costs

National Strategy for Quality (2011), National Prevention Strategy (2011), California County Health Rankings,

Commonwealth Fund on Local Health System Performance

Reviewed National and State Reports

Informed Development of Priorities, Goals and Targets

Health Equity Focus

Foundation to the Process

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Indicators

• 39 Indicators• 10 Year targets

Report Issued December 2012

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Data

Innovation &

Communication

Website

- Public reporting- Interaction & collaborative engagement

- Promising interventions- Moving the needle- Stakeholder participation

LGHC: Three Core Components

- Data structure & visualization

- Data stories & analysis

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Let’s Get Healthy CaliforniaWebsite

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Let’s Get Healthy CaliforniaInnovation Conference

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Innovations Finalists

• Rx Safe MarinMatt Willis, MD, MPH, Public Health Officer, Marin County

• Walk with FriendsDebra S. Oto-Kent, MPH, Founder, Executive Director, Health Education Council

• WasteNotOCEric G. Handler MD, MPH, Health Officer, Deputy Agency Director,Health Care Agency

2016 Innovations Conference

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RxSafe Marin: Using Data to Mobilize a Community Coalition

Matt Willis, MD MPHPublic Health OfficerMarin County

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What can we do as a community to prevent prescription drug misuse and

abuse and save lives?

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Comprehensive Approach

Prevention

Education

Surveillance

Monitoring

Diversion Control

Law Enforcement

Treatment

Recovery

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Community Based Prevention

Action Team

Data Collection and Monitoring

Action Team

Law Enforcement Action Team

Intervention, Treatment and Recovery

Action Team

Steering Committee: Data, Messaging, Policy

Representatives from: Marin County Office of Education, Marin County

Prescription Drug Abuse Task Force, Healthy Marin Partnerships

Backbone Support: HHS

Prescribers and Pharmacists

Action Team

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Strategic Goal for Data Action Team

• Problem: An Epidemic Without a Surveillance System

• Vision: Marin County will have county-wide relevant data on prescription drug misuse and abuse

• Develop a report card with 5-10 key data elements to track prospectively

• Engage community in selection of indicators of greatest relevance

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1. Consulted with federal, state, and other local jurisdictions

2. Contacted local agencies to determine available county-specific data

3. Compiled data and presented potential indicators• “Why this matters”

• Results

• Data source

4. Stakeholders voted on which indicators to include in the report card

Steps for Choosing Report Card Indicators

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Resources

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Example of Potential Indicator: Opioid-Related Emergency

Department Visits

Why this matters:The Centers for Disease Control and Prevention (CDC) reports that drug misuse and abuse causes almost three million emergency department (ED) visits annually. More than half of these are related to pharmaceuticals. Compared to deaths, non fatal ED visits are a more frequent and more sensitive indicator of community burden of opioid related harm.

Results:

Indicator 2006 2007 2008 2009 2010 2011 2012 2013

Non-Fatal Opioid-

Related Emergency

Department Visits

198 222 289 300 295 344 471 352

Data Source:Office of Statewide Health Planning & Development (OSHPD). Emergency Department Data. Prepared by California Department of Public Health, Safe and Active Communities Branch

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State Data Sources

• Emergency Department visits

•Hospitalizations

Office of Statewide Health Planning and Development (OSHPD)

•Controlled substance Prescription

California Department of Justice/ Controlled Substance Utilization Review and Evaluation System

(CURES)

•Drug poisoningsVital Statistics

• Treatment admissionsCalifornia Outcomes Measurement

System (CalOMS) Treatment

Agency Type

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Local Data Sources

•Drug possessionsOffice of the District Attorney (DA)

• Safely disposed Prescription Medications

Environmental Health Services (EHS)/

Drug Enforcement Agency (DEA)

•Naloxone doses administered

Emergency Medical Services (EMS)

Agency Type

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Report Card Draft

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• The Public as Data Consumers• Infographics

• Social Math

• Website

• Social Media

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Stay connected!

www.RxSafeMarin.org

Facebook.com/[email protected]

THANK YOU!

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“There is nothing new about poverty. What

is new is that we now have the techniques and the resources to get rid of poverty. The

real question is whether we have the will.”

-Martin Luther King Jr.

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• 12.7% of households are food insecure

• There are 349,690 people living with food insecurity

• 1 in 5 children face food insecurity

Source: (Feeding America. Map the Meal Gap 2013.)

Food Insecurity Statistics

Orange County

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Child Poverty Rates in California CountiesCounty or County Group Child Poverty Rate (%) County or County Group Child Poverty Rate (%)

Merced 40.6 Colusa, Glenn, Tehama, Trinity 21.7

Fresno 36.4 Shasta 21.7

Tulare 36.3 Yolo 21.3

Lake, Mendocino 35.2 Solano 20.8

Kern 35 San Diego 19.6

Imperial 32.7 San Luis Obispo 19.2

Stanislaus 32.4 Santa Barbara 19

Madera 30.7 Orange 18.4

Del Norte, Lassen, Modoc, Siskiyou, 29 Ventura 16.8

Kings 28.7 Sonoma 16.1

Butte 26,4 Alameda 15.8

Los Angeles 26.3 Contra Costa 15.6

Sutter, Yubs 26 San Francisco 15.4

San Joaquin 25.2 Santa Cruz 14.3

Sacramento 25.2 El Dorado 14.2

Humboldt 24.7 Nevada, Plumas, Sierra 12.7

San Bernardino 24.6 Santa Clara 12.2

Alpine, Amador, Calaveras, Inyo, Mariposa, Mono, Tuolumne 22.6 Marin 10.5

Riverside 22.1 Placer 9.7

Monterey, San Benito 22 San Mateo 8.6

Napa 21.9

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Food RecoveryEducate restaurants and grocery stores on the Good Samaritan Act to increase food donations.

Food DistributionConnect those in need with pantries that provide wholesome food.

Identify those in needStart asking the questions if individuals are facing

food insecurity.

3-Pronged Approach

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Targeting the cities of Anaheim and Orange

253 tons (390,000 meals)of newly recovered food

Updated 10/31/15

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Screening Tool to DetermineLevel of Food Insecurity

• “Within the past 12 months we worried whether our food would run out before we got money to buy more”

Often True Sometimes True Never True

• “Within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.”

Often True Sometimes True Never True

Development and Validity of a 2-Item Screen to Identify Families at Risk: Pediatrics 2010;126;e26

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Interactive Google Pantry Map of Orange County

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Join the conversation now: #HHSDataFest

Interactive Activity: Enhancing Incentives for State and Local Government to Use Data More Effectively

Facilitator: Shell Culp, Chief Innovation Officer, Stewards of Change Institute

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Creating Person Centered Services and Coordinating the San Diego Region

Achieving Community Health

John Ohanian, President & CEO, 2-1-1 San Diego/Imperial

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The Complex Community that We Live in…

• 4,261 square miles (larger than 21 U.S.

States; same size as Connecticut)

• 5th largest U.S. County, 2nd largest in

CA

• 18 municipalities; 36 unincorporated

towns

• 18 tribal nations

• 42 school districts

• 2013 Estimates - 3.1 million population

• 48% White

• 32% Latino

• 11% Asian/PI

• 4.7% African American

• 0.5% American Indian

• Region is very diverse

• Over 100 languages

• Large military presence

• Largest refugee resettlement site in CA

• Busiest international border crossing in

the world (San Ysidro/MX)

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Building Better Health

Living Safely

Thriving

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BEHAVIORS DISEASES PERCENTL

ea

d t

o

Re

su

lt in

Mo

re t

ha

n

No Physical Activity

Poor Diet

Tobacco Use

Cancer

Heart Disease & Stroke

Type 2 Diabetes

Lung Disease

of Deaths

in San Diego

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Areas of Influence

Definition Top 10 Indicators

Enjoying good health and expecting to live a full life

• Life Expectancy• Quality of Life

Learning throughout the lifespan

• Education

Having enough resources for a quality life

• Unemployment Rate• Income

Living in a clean and safe neighborhood

• Security• Physical Environment• Built Environment

Helping each other to live well

• Vulnerable Population• Community Involvement

NG RESULTS

76

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The County of San Diego’s ConnectWellSD will enrich the lives of individuals and families through collaboration.

ConnectWellSD is implementing a person-centered service approach and a new technology system to link enterprise-wide customer data and service information.

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It all begins with one person, one family

Housing/Shelter

TransportationHealthcare

Food Assistance

Financial Assistance

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Connecting San Diego Healthcare

Lab CompaniesHealth Plans

Home Health

Nursing Homes

EMS

Public Health Agencies

Behavioral Health Providers

Schools

Patients and Caregivers

Community Health Centers

Pharmacies

Physician Practices

Hospitals

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Connecting Service Providers

Public Benefits

Housing

Health Benefits

Military / Veteran Services

Meals

Community ServicesUtility Assistance

Financial Literacy Programs

Crisis Services

Disaster Coordination

Aging Services

Childcare Transportation

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Regional Information Exchange

Cross-Sector –Vertical insights across social,

health and government sectors

Community-wide

Holistic

Easily Accessible

High volume

Community Backbone

Efficient

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Regional Information Exchange virtually integrates with its participants to enable the automation of secure, private, flow of information between regional service and healthcare providers to:

Greatly Enhance Care Coordination

Reduce the Cost to provide services

Improve theQuality of care

Achieve Improved Population Health

Regional Information Exchange Partnership

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Without restrictions from copyright, patents or other

mechanisms

Freely available for everyone

to use

Movement towards Open Data

Interoperability denotes the ability of diverse systems and organizations to work together (inter-operate). In this case, it is the ability to interoperate - or intermix - different datasets.

Open Data

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Challenges and Roadmap to Success

Trust and Relationships

Interoperability

Privacy and Consent

Training and Re-training

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What do you think?

Achieving Community Health

John Ohanian, President & CEO, 2-1-1 San Diego/Imperial