Measuring Community Health:
What the data from Spartanburg tell us
Kathleen Brady, PhD
University of South Carolina
Upstate
September 10, 2015
The mission of the Metropolitan Studies Institute is to support research
efforts between USC Upstate and the community that enhance relationships,
promote the reciprocal flow of information and ideas, assist community and
economic development, and increase the strategic use of the University’s
scholarship and outreach capabilities.
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Stakeholders
Six Indicator Areas
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Education
Economy
Public Health
Natural Environment
Social Environment
Civic Health
Good Data
Three Rules:
Integrity
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Context
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Validity – measures what it says it
measures
Reliability – consistent over time
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Comparative – peer geographies or
groups
Trend – changes over time
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Paint the whole picture
Comprehensiveness
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We measure it because it is important
Leading Indicators
RTBH Priorities
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1. Improving Access to Care
2. Reducing Childhood
Obesity
3. Improving Birth Outcomes
4. Reducing Tobacco Use
5. Improving Behavioral
Health Access
Birth Outcomes
Overweight and Obesity
Access to Health Care
Behavioral Health
Tobacco Use
And….
Secondary Indicators
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Teen Pregnancy and Childbearing
Immunizations
Teen Risk Behavior and Attitudes
Chronic Diseases
Cancer
Diabetes
Heart Disease and Stroke
Breast Feeding
Sexually Transmitted Infections
Health Disparities and Inequities
Mortality
Crosscutting Indicators
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Education
Poverty
Air Quality / Toxic Exposure
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Access to Care
Approximately 48,666 residents of Spartanburg County are uninsured
(17.0% of all residents and 24.2% of residents age 18-64 in 2013)
17% of Spartanburg County residents were unable to see a doctor
because they could not afford to (SC BRFSS 2010)
In 2012 SRHS and Mary Black Hospital provided:
• care to 41,241 self-pay / indigent patients in the ED who were not
admitted to inpatient treatment ($61 million)
• care to an additional 2,102 self-pay indigent patients who were
admitted ($66.3 million)
High Utilizers of the ED FY 2013-2014 (4+ visits)
ED dental data for uninsured
Behavioral Health
At SRHS in 2012, there were 9,456 visits to the ED by
uninsured patients for behavioral health conditions.
This was the #1 diagnosis in the ED in 2012.
• 5,910 individuals
• Total Charges $41,622,647
• Average Charge $4,402
Overweight and Obesity
64% of Spartanburg County adults are overweight or obese
34% of Spartanburg County children are overweight or obese
Obese individuals have 30% to 50% more chronic health conditions than
individuals who smoke or drink heavily
Medical costs in South Carolina related to obesity exceed $1 billion annually
Overweight or obese children, Spartanburg County (2013-2014):
• 1st graders: 31.5%
• 3rd graders: 34.4%
• 5th graders: 37.8%
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What we know and what works
Prevention and Wellness are largely a function of policy, systems, and environmental change
Modifying the environment to make healthy choices practical and available (“make the healthy
choice the easy choice”)
Implementing healthy policies
Ensuring adequate systems of care
Raise awareness, implement policies and the norm will change
Knowledge is a very poor predictor of behavior!
(at least when it comes to health behavior)
Local Data-Informed Initiatives
Partners for Active Living
• B-cycle
• Complete Streets
Hub City Farmers’ Market
• Mobile Market
Trails
Childhood Obesity Initiatives
Smoking ordinances
Wellville goals
OBESITY PREVENTION
• We will reduce obesity by creating a healthier community through better nutrition and active
living.
CARE FOR THE UNINSURED
• We will increase access to care for the uninsured by removing physical and social barriers
to quality healthcare.
HEALTH FOR THE INSURED
• We will maximize health for the insured by creating innovative ways to streamline primary
and preventive care.
KINDERGARTEN READINESS
• We will improve kindergarten readiness by ensuring that children birth through age 5 have
access to quality early childhood education.
COMMUNITY PRIDE
• We will build community pride by increasing social connections that engage more citizens
to express love for where they live, work, and play.