By Ted Burnham
Via: NPR


How healthy is your county?

To see how the place where you live stacks up against the rest of the U.S., check out the latest County Health Rankings, an annual report comparing health trends for more than 3,000 counties, plus the District of Columbia.

The rankings are produced by the University of Wisconsin and the Robert Wood Johnson Foundation. You can drill down to look at, among other things, which areas have the highest and lowest education rates and income levels as well access to medical care and healthful foods.

Researchers say healthier counties have lower rates when it comes to things like smoking, physical inactivity, teen births, unemployment and violent crime — but they are no more likely than unhealthy counties to have lower rates of obesity, excessive drinking or greater access to better food options.

“The County Health Rankings show us that much of what influences our health happens outside of the doctor’s office. In fact, where we live, learn, work and play has a big role in determining how healthy we are and how long we live,” Risa Lavizzo-Mourey, president and CEO of RWJF, says in a press release. (The foundation provides financial support for NPR.)

Check out the map above showing the density of fast-food restaurants. There are 30 counties where 100 percent of the restaurants are fast-food, but in many of these cases there are only one or two restaurants in the county, Dr. Bridget Booske Catlin, deputy director of the study and senior scientist at the University of Wisconsin Population Health Institute, writes in an email to Shots.

Among counties with more than 10 restaurants, these five counties had the most fast-food places — (in descending order) Scott County in Tennessee, Fayette County in Indiana, Letcher County in Kentucky, Charlton County in Georgia and Sanpete County in Utah. Perhaps not surprisingly, all of these counties were in the bottom half of overall health rankings within their respective states, according to Booske Catlin.

Compare that with this map showing premature death (darker spots indicate a higher incidence) and you can see where there’s overlap.

The researchers also found these regional health trends:

     • Northern states have the highest rates of excessive drinking.

     • Southern states have the highest rates of children living in poverty, teenage births, sexually transmitted infections.

     • Unemployment is lowest in states in the Northeast, Midwest and central plains.

     • Deaths from motor vehicle accidents are lowest in the Northeast and upper Midwest.

By Peggy Lowe
via npr.org


Recruiting doctors to live and work in rural America is a chronic problem. Most health centers try to attract workers with big salaries and expensive homes.

Shots previously reported that one center in Maine was trying to lure medical students to the countryside for their final two years with the hope that they stick around.

The Ashland Health Clinic, a tiny hospital in southwest Kansas, is trying a different tack — a reverse-recruitment model. It’s called mission-focused medicine, and it’s based on serving problems most commonly found in third-world countries.

Ashland, population 855, sits about a five-hour drive south of Kansas City. It’s one of the last outposts on the Kansas open range, where buffalo still really roam along the rolling, dusty plains. There’s no gas station, unless you count the pump at the farmer’s co-op that uses dial-up for credit card approval. The nearest Starbucks is 160 miles away.

The Ashland clinic has 24 beds. The next closest center is 50 miles north, in Dodge City. (Yeah, the same one from those old cowboy movies.)

So when Benjamin Anderson interviewed for the clinic’s CEO job in 2009, he says the board chairman was exceedingly blunt.

Anderson says the chairman told him, “Ben, our facilities are 55 years old. Our finances are challenged. Our morale is low. Turnover is up. We’ve been without an administrator for six months. We’ve been without a doctor for seven or eight months. We really need this facility in this community. And if we don’t have this facility, we’ll lose our school. And if we don’t have our hospital and our school, this will become a ghost town very quickly.”

That pitch clicked for Anderson. He gave up his physician recruiter job in Dallas and moved with his wife out here to become Ashland’s new CEO.

“I’ve always had to have a job that matters,” he says. “I have to have a position that I know it’s not just a paycheck.”

Anderson is now well known on Ashland’s Main Street. But he knew he needed doctors for the hospital to succeed, and he knew he had to offer something different than the thousands of small towns he was competing with.

So he came up with a novel plan. He offers potential candidates eight weeks off to do missionary work overseas. Because he’s found that a doctor who is willing to sleep on a cot in the Amazon or treat earthquake victims in Haiti is ready to serve in rural Kansas. He calls it mission-focused medicine.

“When you recruit a mission-focused provider, they want to see the ghettos,” he says. “They want to know that there’s no Spanish-speaking provider in more than a one-hour drive. They want to see houses that are falling down, widows that are uncared for. They want to know that there’s need and that by them coming there, they would fill a disparity that would otherwise not be filled. So we reversed it.”

It worked. Last July, Dr. Dan Shuman and his family moved here from the Austin, Texas, area. The difference between here and all the other needy areas was his ability to continue his missionary work in Haiti and Mexico during his eight weeks off. But Shuman says Ashland’s own challenges were equally attractive.

“When you’re primary focus is sort of a mission-based focus, when you get into things in order to try to relieve suffering or work toward eliminating disparities,” Shuman says, “then you want to know about those things. It’s appealing to see opportunities.”

Studies suggest that finding primary care providers in rural areas is at crisis levels. More medical students are specializing, so general practitioners are very hard to find. And those who can deal with the lower pay and isolation in rural areas? Even harder. So Anderson raised the bar by shooting for a higher cause. At every staff meeting, he’s part cheerleader, part chaplain.

Indeed, things are looking up for Ashland. In addition to Shuman, Anderson has recruited a nursing director. And that doc who slept on the cot in the Amazon was recently in Ashland for interviews.

Peggy Lowe is a reporter for Harvest Public Media.

via The Baltimore Sun


Baltimore Inner Harbor from Federal Hill – photo by ktylerconk on Flickr

Frustrated by Maryland’s high rate of health disparities, state leaders are proposing a new attack — one more commonly associated with economic development. Gov. Martin O’Malley’s 2012-2013 budget will include funding to create Health Enterprise Zones, where doctors and community groups in areas with large health disparities, such as Baltimore, could add medical and support services for minorities. Tax credits and other financial incentives would be available to spur interest.

The plan is designed to save lives and healthcare dollars, according to Lt. Gov. Anthony G. Brown, who last summer formed a work group on disparities led by Dr. E. Albert Reece, dean of the University of Maryland School of Medicine.

“Maryland has world-class hospitals, top medical schools and one of the highest rates of primary-care physicians per capita, and yet we continue to see disparities in health care and outcomes among Maryland’s racial and ethnic communities. It’s clear that a lack of access to primary care in many communities is a significant factor driving these disparities,” Brown said, adding that funding is in the governor’s budget proposal, which has yet to be released.

According to state and national data, the disparities are many: In Maryland, the infant mortality rate among blacks is almost three times that for whites, the incidence of new HIV infections among blacks is almost 12 times that of whites, and Hispanics are more than four times as likely not to have health insurance as whites. Moreover, nearly twice as many African-Americans suffer from diabetes as whites, and hospital admission rates were three times higher for blacks with asthma and 41/2 times as high for blacks with hypertension. Treating such illnesses is costly, according to the work group, which cited data showing nearly $230 billion in direct medical costs could have been saved from 2003 to 2006 if there were no racial and ethnic health disparities.

The proposed program would work something like economic enterprise zones, where businesses receive subsidies to create jobs and activity in certain areas. The health zones program would be a pilot, available in two or three geographic areas. New and existing primary-care practitioners could receive loan assistance repayment; income, property or hiring tax credits; and assistance in installing health information and other technology. Subsidies would be capped, likely in the tens of thousands of dollars. Local health departments might get involved in recruiting participants.

Brown said he would push to expand the program statewide if it proves successful in a couple of years — not a given, considering the logistical and cultural complexity of the problems. For example, residents of some neighborhoods don’t have easy access to grocery stores that sell fresh fruit and vegetables, or don’t visit the doctor until there is an emergency. Reece said many groups have tackled disparities, but the work group wanted to focus its attention on chronic diseases responsible for 80 percent of health costs. They drilled down to a few key maladies that often have “ripple” effects. They include diabetes, hypertension and asthma.

“We decided to identify … areas where we thought we could make an effective impact within a reasonable time frame,” he said. The health enterprise zones approach is unique, he believes. Work group members got the idea from a similar program built around children’s needs in the community of Harlem in New York City. Program applicants are likely to come predominantly from rural and urban area where disparities are most pronounced.

In Baltimore, studies show a 20-year gap in life expectancy between upper-income, predominantly white neighborhoods and poorer, predominantly minority neighborhoods. Recently, city health department officials began working with community leaders in 55 neighborhoods to identify the most pressing health needs and develop plans to tackle them. The state’s zones would complement these efforts, Reece said. His work group also proposed other elements to promote health and track outcomes.

The group suggested Health Innovation Prizes with small financial rewards and public recognition for individuals and groups that improve health and well-being in their community. The group also recommended tracking disparity data for programs that already exist for primary care physicians and hospitals. Incentives and penalties assessed through these programs could eventually be linked to disparities.

Reece said the prize and the enterprise zones are two things Maryland can do now to help reduce disparities in a few key geographic and health areas. If legislation to create the zones is passed during the current legislative session, the details will be worked out by the state Department of Health and Mental Hygiene.
Already, Dr. Joshua M. Sharfstein, department secretary, supports the move: “The creation of Health Enterprise Zones will help communities target resources to have the most powerful impact.”

meredith.cohn@baltsun.com

via Sociological Images
by Gwen Sharp

If you’re looking for basic global demographic information, World Health Rankings provides a great overview, using World Health Organization, World Bank, UNESCO, and other data. The website allows you to select a country, then provides a detailed breakdown of many demographic details, such as population pyramids (you can select different years in the past, or look at predictions for the future), leading causes of death, etc. Here’s the 2010 population pyramid for the U.S.:


You can also easily access all the age pyramids here. The 2020 projections for Brazil show the changing demographics due to the dramatic decrease in the fertility rate, which Lisa posted about this weekend:


There’s an interactive map of the top 15 causes of death in the U.S., allowing you to look at variations by county. Here’s the map of deaths due to heart disease, with Clark County, Nevada, highlighted:


You can also look at life expectancy for different nations for every decade between 1960 and 20101 [sic], a “real-time” clock that tracks global deaths (you can look at how many have died in the last year or month, or you can click “now” and reset the clock and watch as the clock estimate how many people die of various causes of death worldwide), and maps showing the prevalence of various causes of death around the world. Lots of neat representations of rather depressing information.

Also, as I wrote this post I realized that now every time I see a population pyramid of the U.S., Community‘s song “Baby Boomer Santa” is going to play through my head.

Hans Roling, the charismatic statistician, explains 200 years of economic development and global health in under 5 minutes in this clip from The Joy of Stats, a one-hour documentary from the BBC. If you aren’t already tired of PowerPoint, you will definitely have presentation-envy after watching this engaging and fascinating dance with data.

The Joy of Stats, a one-hour documentary, explores the growing importance of statistics:

[W]ithout statistics we are cast adrift on an ocean of confusion, but armed with stats
we can take control of our lives, hold our rulers to account and see the world as it really is. What’s more, Hans concludes, we can now collect and analyse such huge quantities of data
and at such speeds that scientific method itself seems to be changing.

From the description, it sounds like they’ll touch on Crimespotting by Stamen, Google Translation, among other data-driven projects. Whatever they cover, it’s bound to be interesting with Rosling at the front.

Check out the this clip of Rosling presenting world development in the context of income versus lifespan. The material is more or less the same as his TED talk, but this time around, the motion chart isn’t projected on a screen. The data is CGI’d into the air where Rosling can pluck and grasp at points as he highlights the significance of specific points in history.

via Flowingdata