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Wisconsin Department of Health ServicesJanuary 2014 P-00522U
Healthiest Wisconsin 2020 Baseline and Health Disparities Report
Socioeconomic Status
SOCIOECONOMIC STATUS
Background• Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities
Report • Key points
Data• Demographic and socioeconomic data• Access to health care• Overall health and mental health• Risk behaviors• Chronic disease outcomes• Reproductive and sexual health
References
Links to additional reports and resources
Contacts
Chapter Outline
Chapter outline
2
SOCIOECONOMIC STATUS
Report Overview
• This chapter is part of a larger report created by the Wisconsin Department of Health Services to track the progress on objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf
• The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included.
• Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations.
• Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf
Report overview
3
SOCIOECONOMIC STATUS
Report Format
Full Report• Format: PDF • Intended use: reference document
Chapters• Format: Annotated PowerPoint slide set• Intended uses: presentations to
– Decision-makers– Service providers– Community leaders– The public
Sample annotated slide
Report overview
4
SOCIOECONOMIC STATUS
Report Outline
Executive Summary
Section 1: Introduction
Section 2: Demographic overview
Section 3: Health focus areas
Section 4: Infrastructure focus areas
Section 5: Data summaries by population
Section 6: Technical notes
Report overview
5
SOCIOECONOMIC STATUS
Report Outline: Detail
Section 3: Health focus areas
• Alcohol and other drug use• Chronic disease prevention and management• Communicable diseases• Environmental and occupational health• Healthy growth and development• Injury and violence• Mental health• Nutrition and healthy foods• Oral health• Physical activity• Reproductive and sexual health• Tobacco use and exposure
Section 4: Infrastructure focus areas• Access to health services
Report overview
6
SOCIOECONOMIC STATUS
Report Outline: Detail
Section 5: Data summaries by population
Racial/ethnic minority populationso American Indianso Asianso Blackso Hispanics
People of lower socioeconomic status People with disabilities Lesbian, gay, bisexual, and transgender populations Geography
Report overview
7
SOCIOECONOMIC STATUS
Data notes
• Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf
• The 95% confidence intervals are denoted by error bars. Where
confidence intervals do not overlap, as shown in the example on
the right, differences are statistically significant. Larger confidence
intervals may indicate less reliable estimates that should be
interpreted with caution.
• Population estimates that are considered unreliable are excluded.
• Misclassification of racial/ethnic groups may affect the accuracy of rates.
• Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.
Report overview
8
SOCIOECONOMIC STATUS
Factors that influence health
Social determinants
of health
Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach
Report overview
9
SOCIOECONOMIC STATUS
Key Points
• The poverty rate in Wisconsin increased from 2006 to 2010.
• Education and income are correlated. The higher the level of education in a population, the higher the level of income, for both males and females.
• On average, Black, Hispanic, and American Indian adults in Wisconsin have lower levels of education and income compared to White and Asian adults. Differences within groups, particularly Asians, may be masked by aggregate data.
Key points
10
Access to health care
SOCIOECONOMIC STATUS
Key Points:
• Compared to adults with higher levels of education and income, adults with lower levels of education have:
– Less access to health and dental care, higher utilization of the emergency room, lower rates of prenatal care, and lower rates of cancer screening.
– Higher rates of risk behaviors including binge drinking, obesity, and tobacco use and exposure.
– Higher rates of poor physical and mental health.
– Higher rates of chronic diseases such as asthma, diabetes, heart disease, high cholesterol and blood pressure, stroke, and arthritis.
Key points
11
SOCIOECONOMIC STATUS
Demographic data
12
SOCIOECONOMIC STATUS
Source: American Community Survey, 2006-2010.
Poverty rate (percent living below the federal poverty level), Wisconsin, 2006-2010
2006 2007 2008 2009 2010
-5%
0%
5%
10%
15%
20%
Demographic and socioeconomic data
13
SOCIOECONOMIC STATUS
Percent of the population living in poverty, by county, Wisconsin, 2006-2010
Source: American Community Survey, 2006-2010.
Percent living in poverty
4.4% - 7.2%
7.3% - 11%
11.1% - 16.4%
16.5% - 31.6%
14
Demographic and socioeconomic data
SOCIOECONOMIC STATUS
Median household income by race/ethnicity, Wisconsin, 2008-2010
Source: American Community Survey, 2008-2010.
White Black Hispanic Asian American Indian$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$53,000 $27,400 $36,800 $53,600 $35,000
Me
dia
n h
ou
se
ho
ld in
co
me
15
Demographic and socioeconomic data
SOCIOECONOMIC STATUS
Male Female$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$22,171 $14,398$32,589 $21,797$39,618 $26,803$54,480 $36,727$71,312 $51,782
Less than high school graduate Completed high school Some college Bachelor's degree Graduate or professional degree
Median earnings in the previous 12 months, adults ages 25 and older, by sex and educational attainment, Wisconsin, 2010
Source: American Community Survey, 2010. 16
Demographic and socioeconomic data
SOCIOECONOMIC STATUS
Educational attainment of adults ages 25 and older, by race/ethnicity, Wisconsin, 2008-2010
Source: American Community Survey, 2008-2010.
Less than high school High school diploma/GED Bachelor/graduate degree0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
9% 34% 27%21% 34% 14%40% 28% 11%18% 17% 46%17% 32% 11%
White Black
Hispanic Asian
American Indian
17
Demographic and socioeconomic data
SOCIOECONOMIC STATUS
Educational attainment of Wisconsin adults, ages 25 and older, by level of urbanization, 2007-2011
Source: American Community Survey, 2007-2011.
Less than high school High school graduate to some col-lege
College graduate or more0%
10%
20%
30%
40%
50%
60%
70%
15% 51% 34%9% 56% 36%12% 62% 27%
Milwaukee County
Smaller-metropolitan counties
Non-metropolitan counties
18
Demographic and socioeconomic data
SOCIOECONOMIC STATUS
Income distribution among Wisconsin adults by level of urbanization, 2007-2011
Source: American Community Survey, 2007-2011.
Low income (<$25,000) Middle income ($25,000-$74,999)
High income ($75,000+)0%
10%
20%
30%
40%
50%
60%
29% 45% 26%20% 45% 35%26% 51% 24%
Milwaukee CountySmaller metropolitan countiesNon-metropolitan counties
19
Demographic and socioeconomic data
SOCIOECONOMIC STATUS
Rate of living with a disability, Wisconsin adults ages 18-64, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline only dataset
Living with a disability0%
10%
20%
30%
40%
50%
60%
70%
44% 20% 13%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
20
Demographic and socioeconomic data
SOCIOECONOMIC STATUS
Access to health care
21
SOCIOECONOMIC STATUS
Lack of health insurance coverage among Wisconsin adults ages 18-64, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
No health insurance coverage, ages 18-640%
10%
20%
30%
40%
50%
60%
34% 16%
4%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
Access to health care
22
SOCIOECONOMIC STATUS
Public health insurance coverage and inadequacy of health insurance among children ages 6-17, by highest education level of adult in household, Wisconsin, 2011-2012
Source: 2011-2012 National Survey of Children's Health.
Public insurance Current insurance not adequate0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
57% 26%61% 28%26% 24%
Less than high school educationHigh school graduateMore than high school education
Access to health care
23
SOCIOECONOMIC STATUS
Age-adjusted rate of use of and barriers to health care among Wisconsin adults, by household income, 2008-2011
Did not have a doctor's visit in past year
Do not have a personal doctor Unable to obtain medical care due to cost
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
36% 22% 27%35% 17% 13%31% 12%2%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Access to health care
24
SOCIOECONOMIC STATUS
Lack of routine preventive medical and dental care and unmet medical and dental needs among children, by poverty status, Wisconsin, 2011-2012
Source: 2011-2012 National Survey of Children's Health.Note: Estimates were not available for all groups. FPL is the Federal Poverty Level, based on household size and income.
Access to health care
Did not receive both routine preven-tive medical and dental care visits dur-
ing the past 12 months
Had one or more unmet dental and medical needs during the past 12
months
0%
10%
20%
30%
40%
50%
60%
70%
51% 13%38% 8%28%4%
0.201
0-99% FPL
100-199% FPL
200-399% FPL
400% FPL or higher
25
SOCIOECONOMIC STATUS
Lack of access to care within a medical home among children, by poverty status, Wisconsin, 2011-2012
Source: 2011-2012 National Survey of Children's Health.Note: FPL is the Federal Poverty Level, based on household size and income.
Access to health care
Children who do not receive coordinated, ongoing, comprehensive care withi...0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
55% 35% 30% 24%
0-99% FPL
100-199% FPL
200-399% FPL
400% FPL or higher
26
SOCIOECONOMIC STATUS
Emergency room utilization among Wisconsin residents, by poverty status, 2008-2010
Source: Wisconsin Department of Health Services, Family Health Survey, 2008-2010.
Treated in emergency room during past year0%
5%
10%
15%
20%
25%
30%
35%
40%
27% 18% 13%
Poor (<100% FPL)
Near-poor (100-199% FPL)
Not poor (200% FPL or more)
Access to health care
27
SOCIOECONOMIC STATUS
Percentage of births to mothers who received prenatal care during the first trimester, by maternal education level, Wisconsin, 2010
Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident birth certificates.
Prenatal care during first trimester0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
70% 80% 88% 93%
Some high schoolHigh school graduateSome collegeCollege graduate
Healthy growth and development
28
SOCIOECONOMIC STATUS
Health risk factors
29
SOCIOECONOMIC STATUS
Vaccination coverage with selected vaccines among adolescents ages 13-17, by federal poverty level (FPL), Wisconsin and the United States, 2011
Access to health care
Source: National Immunization Survey for Teens, 2011.Note: * To protect against tetanus, diphtheria, and pertussis. ** To protect against meningococcal disease.
At or above FPL
Below FPL At or above FPL
Below FPL
Tdap ≥ 1 MenACWY
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
91% 81% 73% 81%80% 74% 71% 69%
WisconsinU.S.
Per
cen
t
30
SOCIOECONOMIC STATUS
Rates of influenza and pneumonia vaccination among older adults (ages 65+) in Wisconsin, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Access to health care
Flu vaccination in past 12 months Ever received pneumonia vaccination0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
60% 69%68% 73%73% 65%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
31
SOCIOECONOMIC STATUS
Age-adjusted rates of binge drinking and heavy drinking among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Binge drinking Heavy drinking0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
19% 8%25% 9%27% 9%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
Alcohol and other drug use
32
SOCIOECONOMIC STATUS
Age-adjusted rate of low vegetable consumption among Wisconsin adults, by education level, 2009
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Data from 2009 only.
Nutrition
33
Less than two servings of vegetables per day
-5%
0%
5%
10%
15%
20%
25%
30%
16% 8% 4%
Less than high school
High school graduate to some college
College graduate or more
SOCIOECONOMIC STATUS
Breastfeeding initiation by maternal income, Wisconsin, 2009-2011
Source: Wisconsin PRAMS, 2009-2011. Division of Public Health, Department of Health Services.
Initiated breastfeeding0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
73% 82% 88%
<$10,000$10,000 - $49,999$50,000+
34
Nutrition
SOCIOECONOMIC STATUS
Age-adjusted rate of physical inactivity among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset
Did not participate in any physical activity in past month, other than at job
-10%
0%
10%
20%
30%
40%
50%
60%
37% 24% 16%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
Physical activity
35
SOCIOECONOMIC STATUS
Age-adjusted rates of tooth removal and dental visits in the past year among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Tooth removal question asked in 2008, 2010, and 2011. Dentist visit question asked in 2008 and 2010.
Had at least 1 permanent tooth removed Did not visit dentist within past year0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
60% 52%39% 28%26% 17%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
Oral health
36
SOCIOECONOMIC STATUS
Rates of HIV testing and age-adjusted risk behaviors among Wisconsin adults, by household income, 2008-2011
Reproductive and sexual health
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Testing rates are not age-adjusted; rates of exposure to high-risk situations are age-adjusted.
Ever been tested for HIV Ever been in any HIV high-risk situations0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
43%
7%
31%3%
33%2%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
37
SOCIOECONOMIC STATUS
Age-adjusted rates of smoking among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Tobacco use and exposure
Current smoker0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
38% 24% 12%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
38
SOCIOECONOMIC STATUS
Rates of secondhand smoke exposure among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: The “smoking at work” question was only asked in 2009 and 2010.
Smoking allowed at home Exposed to others' smoke at home
Smoking permitted at work0%
10%
20%
30%
40%
50%
60%
39% 26% 19%26% 15% 15%13% 7% 8%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
Tobacco use and exposure
39
SOCIOECONOMIC STATUS
Age-adjusted rate of seat belt non-use and rate of fall-related injuries among Wisconsin adults, by household income, 2008, 2010, 2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Questions were asked in 2008, 2010, and 2011. Rates of seat belt use are age-adjusted; rates of fall-related injury are not age-adjusted but are limited to the population 45 and older.
Does not always wear a seat belt One or more fall-related injuries in past 3 months (ages 45+)
0%
10%
20%
30%
40%
50%
60%
22% 44%13% 29%10% 31%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
Injury and violence
40
SOCIOECONOMIC STATUS
Health Outcomes
41
SOCIOECONOMIC STATUS
Age-adjusted rates of physical health among Wisconsin adults by income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline only datasetNote: Physical health and limited activities questions were only asked in 2009-2011.
Fair or poor health Physical health not good on at least one day during past month
Of those with at least one day of poor health, percent whose poor
health limited usual activities on at least one day during past month
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
36% 58% 71%13% 37% 67%6%
26% 69%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
42
Physical health Nutrition
SOCIOECONOMIC STATUS
Age-adjusted rates of diabetes and prediabetes among Wisconsin adults, by household income, 2008-2011
Chronic diseases
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Diabetes excludes women who were diagnosed during pregnancy, and does not differentiate between type 1 and type 2 diabetes.
Ever been diagnosed with diabetes Ever been told you have prediabetes0%
5%
10%
15%
20%
25%
13% 9%7% 6%5% 5%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
43
SOCIOECONOMIC STATUS
Age-adjusted rates of heart attack and stroke among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Chronic diseases
Ever had a heart attack Ever had a stroke0%
5%
10%
7% 5%3% 2%3% 2%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
44
SOCIOECONOMIC STATUS
Age-adjusted rates of high cholesterol and high blood pressure among Wisconsin adults, by household income, 2009 and 2011
Ever been told you have high cholesterol Ever been diagnosed with high blood pressure0%
10%
20%
30%
40%
50%
60%
40% 36%32% 27%28% 22%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Questions only asked in 2009 and 2011.
45
Chronic diseases
SOCIOECONOMIC STATUS
Cancer screening among Wisconsin adults, by education level, 2008 and 2010
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Questions were only asked in 2008 and 2010.
No sigmoid/colonoscopy,
ages 50+
No PSA test in past two years, males ages 40+
No Pap test in past three years,
females ages 18+
No mammogram in past two
years, females ages 50+
0%
10%
20%
30%
40%
50%
60%
70%
80%
33% 50% 19% 22%28% 45% 9% 15%
Less than high school
High school graduate to some college
College graduate or more
46
Chronic diseases
SOCIOECONOMIC STATUS
Age-adjusted rate of arthritis among adults, and percent of those with arthritis whose activity is limited due to joint pain, by household income, 2009-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Arthritis question was asked in 2009-2011. Question about limited activity due to joint pain was asked in 2009 and 2011.
Ever been told you have some form of arthritis
Among those with arthritis, percent whose activity is limited due to joint pain
0%
10%
20%
30%
40%
50%
60%
70%
80%
36% 63%24% 36%21% 29%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
47
Chronic diseases
SOCIOECONOMIC STATUS
Age-adjusted rates of asthma among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Environmental health
Ever been told you have asthma Currently have asthma0%
5%
10%
15%
20%
25%
30%
22% 18%13% 9%10% 7%
Low income (<$20,000)Middle income ($20,000-$74,999)High income ($75,000+)
48
SOCIOECONOMIC STATUS
Percentage of lead poisoning (10 mcg/dL or greater) among tested children under age six, by Medicaid enrollment, Wisconsin, 2010
Source: Wisconsin Department of Health Services, Wisconsin Childhood Lead Poisoning Prevention Program (WCLPPP).
Percent with lead poisoning (≥10 µg/dL)
-0.5%
0.0%
0.5%
1.0%
1.5%
2.0%
0.7% 1.6%
Non-Medicaid enrolleesMedicaid enrollees
Environmental health
49
SOCIOECONOMIC STATUS
Age-adjusted rate of frequent mental distress among Wisconsin adults, by household income, 2009-2011
Frequent mental distress0%
5%
10%
15%
20%
25%
30%
35%
40%
24% 10% 4%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Question asked in 2009-2011.
Mental health
50
SOCIOECONOMIC STATUS
Age-adjusted rate of four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by household income, 2010 and 2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Question asked in 2010 and 2011.
Mental health
Four or more ACEs0%
5%
10%
15%
20%
25%
30%
35%
40%
30% 16% 10%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
51
SOCIOECONOMIC STATUS
Percentage of children who have experienced two or more adverse childhood experiences (ACEs), by federal poverty level (FPL), 2011-2012
Two or more adverse childhood experiences
-10%
0%
10%
20%
30%
40%
50%
60%
47% 30% 16% 9%
0 - 99% FPL100 - 199% FPL200 - 399% FPL400% FPL or higher
Source: 2011-2012 National Survey of Children’s Health .
Mental health
52
SOCIOECONOMIC STATUS
Age-adjusted rate of insufficient sleep and rate of poor emotional support among Wisconsin adults, by household income, 2008-2010
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Questions were not asked in 2011. Rates of insufficient sleep are age-adjusted; rates of poor emotional support are not age-adjusted.
Insufficient sleep Sometimes, rarely, or never receive emotional support0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
27% 35%20% 18%19% 7%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
Mental health
53
SOCIOECONOMIC STATUS
Age-adjusted rates of overweight and obesity among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Overweight or Obese Obese0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
70% 41%65% 29%60% 23%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
Nutrition
54
SOCIOECONOMIC STATUS
Percentage of low birthweight (<5.5 pounds) births, by maternal education, Wisconsin, 2008-2010
Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident birth certificates.
Healthy growth and development
Low birthweight0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
10.0% 8.1% 6.6% 5.5%
Some high school
High school graduate
Some college
College graduate
55
SOCIOECONOMIC STATUS
References1. University of Wisconsin Population Health Institute. County Health Rankings 2013.
http://www.countyhealthrankings.org/our-approach/
2. Center for Urban Population Health. Milwaukee Health Report 2011. http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf
3. LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies. Accessible at: http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf
4. Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057–1059. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/
5. Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020. http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf
6. United States Department of Health and Human Services (HHS). The 2011 HHS Poverty Guidelines. http://aspe.hhs.gov/poverty/11poverty.shtml
56
References
SOCIOECONOMIC STATUS
7. American Community Survey Glossary. http://
factfinder2.census.gov/help/en/american_factfinder_help.htm#glossary/glossary.htm
8. U.S. Census Bureau: http://blogs.census.gov/2010/09/23/income-vs-earnings/
9. Current Population Survey (CPS) Definitions. http://www.census.gov/cps/about/cpsdef.html
10. Centers for Disease Control and Prevention (CDC). Health Care: See Why Being Insured Matters. http://www.cdc.gov/features/vitalsigns/HealthcareAccess/
11. CDC. Regular Check-Ups Are Important. http://www.cdc.gov/family/checkup/
12. Data Resource Center for Child and Adolescent Health. Indicator details. http://www.childhealthdata.org/browse/survey/results?q=2507&r=1
13. RAND Corporation. The Evolving Role of Emergency Departments in the United States. http://www.rand.org/content/dam/rand/pubs/research_reports/RR200/RR280/RAND_RR280.pdf
14. CDC. During Pregnancy. http://www.cdc.gov/pregnancy/during.html
15. CDC. Preteen and Teen Vaccines. http://www.cdc.gov/vaccines/who/teens/for-parents.html
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References
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16. Centers for Medicare and Medicaid Services. Immunizations. http://www.cms.gov/Medicare/Prevention/Immunizations/index.html?redirect=/immunizations/
17. CDC. Alcohol Use and Health. http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
18. CDC. State Indicator Report on Fruits and Vegetables, 2013. http://www.cdc.gov/nutrition/downloads/State-Indicator-Report-Fruits-Vegetables-2013.pdf
19. U.S. Department of Agriculture. ChooseMyPlate.gov. http://www.choosemyplate.gov/food-groups/vegetables-amount.html
20. DHS, Wisconsin PRAMS. What Moms Tell Us: Breastfeeding (August 2012). http://www.dhs.wisconsin.gov/publications/p0/p00398.pdf
21. CDC: PRAMS and Breastfeeding. http://www.cdc.gov/prams/Breastfeeding.htm
22. Public Health Reports. Socioeconomic Status and Breastfeeding Initiation Among California Mothers. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497787/
23. CDC. Physical Activity. http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html
24. University of Wisconsin Population Health Institute. County Health Rankings, 2013. http://www.countyhealthrankings.org/our-approach
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25. CDC. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm
26. CDC. Smoking and Tobacco Use: Secondhand Smoke Facts. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/index.htm
27. CDC. Asthma. http://www.cdc.gov/asthma/faqs.htm
28. CDC. Adolescent and School Health: Asthma and Schools. http://www.cdc.gov/healthyyouth/asthma/index.htm
29. American Lung Association. Asthma and Children. http://www.lung.org/lung-disease/asthma/resources/facts-and-figures/asthma-children-fact-sheet.html
30. DHS. The Legacy of Lead: Report on Childhood Lead Poisoning in Wisconsin 2008. http://www.dhs.wisconsin.gov/lead/LegacyofLead/index.HTM
31. CDC. Self-Reported Frequent Mental Distress Among Adults --- United States, 1993—2001. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5341a1.htm
32. CDC. Adverse Childhood Experiences Study. http://www.cdc.gov/ace/
33. O’Connor C, Finkbiner C, & Watson L (2012). Adverse Childhood Experiences in Wisconsin: Findings from the 2010 Behavioral Risk Factor Survey. Madison, Wisconsin: Wisconsin Children’s Trust Fund and Child Abuse Prevention Fund of Children’s Hospital & Health System. http://wichildrenstrustfund.org/index.php?section=adverse-childhood
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34. CDC. The state of mental health in aging America. http://www.cdc.gov/aging/pdf/mental_health.pdf
35. CDC. Insufficient sleep is a public health epidemic. http://www.cdc.gov/features/dssleep/
36. CDC. Health-related quality of life: Well-being concepts. http://www.cdc.gov/hrqol/wellbeing.htm#four
37. CDC. About BMI for Adults. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#Definition
38. CDC. Is low birthweight a health problem? http://www.cdc.gov/pednss/how_to/interpret_data/case_studies/low_birthweight/what.htm
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References
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• Centers for Disease Control and Prevention —Social Determinants of Health http://www.cdc.gov/socialdeterminants/
• Policy Link: http://www.policylink.org/
• Robert Wood Johnson Foundation:
o How Does Employment or Unemployment Affect Health? http://www.rwjf.org/en/research-publications/find-rwjf-research/2012/12/how-does-employment--or-unemployment--affect-health-.html
o How Social Factors Shape Health: Income, Wealth, and Health http://www.rwjf.org/en/research-publications/find-rwjf-research/2011/04/how-social-factors-shape-health1.html
o Why Does Education Matter So Much to Health? http://www.rwjf.org/en/research-publications/find-rwjf-research/2012/12/why-does-education-matter-so-much-to-health-.html
Links to additional reports and resources
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Links
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• National Association of City and County Health Officials (NACCHO)—Health equity and social justice: http://www.naccho.org/topics/justice/
• Unnatural Causes: http://www.unnaturalcauses.org/
• UW Madison Population Health Institute: http://uwphi.pophealth.wisc.edu/
• World Health Organization Commission on Social Determinants of Health: http://www.who.int/social_determinants/en/
• Wisconsin Center for Health Equity: http://www.wche.org/
• Healthiest Wisconsin 2020 Crosscutting Focus Area: Social, Economic, and Educational Factors that Influence Health: http://www.wche.org/uploads/8/8/9/8/8898682/hw2020_see_profile_final_11.1.2013.pdf
• Centers for Disease Control and Prevention (CDC). Demographic status publications: http://www.cdc.gov/hrqol/pubs/demo_status/socioeconomic.htm
Links to additional reports and resources
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Links
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Contacts
Evelyn Cruz, Minority Health OfficerWisconsin Division of Public Health, Office of Policy and Practice AlignmentE-mail: Evelyn2.Cruz@dhs.wisconsin.gov
Karl Pearson, DemographerWisconsin Division of Public Health, Office of Health InformaticsE-mail: KarlT.Pearson@dhs.wisconsin.gov
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Contacts
Recommended