The Massachusetts Report Card

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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

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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)

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Todays 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.

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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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MA Framework for Addressing Health Disparities
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Key Concepts for Developing a MA Report Card

• Racial, Ethnic Linguistic Health Disparities
• Not a Static Document
• Periodic Updates
• Parking Lot
• Report Card Structure
• Health and Social Statistics vs. Social Policy
• Formatting
• Selection Criteria for Indicators

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(No Transcript)
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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
• Health Care Utilization
• Access and quality
• Social Determinants
• Basic needs, social well-being, community
  attributes (including environmental)
• Personal Practices/Individual Factors

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Report Card Structure, cont.

• 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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KIS MIV

• Keep It Simple, Make It Visual

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King County, WA
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King County, WA
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Formatting Considerations

• Content
• Length
• Resources

Stop for Discussion
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Example Age-Adjusted Asthma ED Visits and
Hospitalizations by Race/Ethnicity 2003-2005
Source MDPH, Bureau of Health Information,
Statistics, Research and Evaluation, Health
Survey Program
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Use the Example to Build Our Report Card

• 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

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Example, cont.

• Asthma Related ED Visits by R/E (MA
  1,038/100,000)
• Contributory Factors Associated with the
  Indicator
• Health Care Utilization
• ______
• Social Determinants
• ______
• Personal Practices/Individual Factors
• Social Policy Levers
• Medicaid Reimbursement
• Environmental Hazards

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IndicatorsWhat do we want to know?

• Selection Criteria
• Whats 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 have
• What else do we want to know

Stop for Discussion
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Lets 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

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• Thank You!