Measuring Community Health:

What the data from Spartanburg tell us

Kathleen Brady, PhDUniversity of South Carolina Upstate

September 10, 2015

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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.

Stakeholders

Six Indicator Areas

1. Education

2. Economy

3. Public Health

4. Natural Environment

5. Social Environment

6. Civic Health

Good Data

Three Rules:

Integrity

Context

Comprehensiveness

• Validity – measures what it says it measures

• Reliability – consistent over time

• Comparative – peer geographies or groups

• Trend – changes over time

• Paint the whole picture

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Why Health Research ?

We measure it because it is important

Leading Indicators

• Birth Outcomes• Overweight and Obesity• Access to Health Care• Behavioral Health• Tobacco Use

RTBH Priorities

1. Improving Access to Care

2. Reducing Childhood Obesity

3. Improving Birth Outcomes

4. Reducing Tobacco Use

5. Improving Behavioral Health Access

And….

Secondary Indicators• 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

• Education• Poverty• Air Quality / Toxic Exposure

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What do our local data tell us?

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 Obesity64% 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 do we do with the research?

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.