Social Determinants of Health Disparities: The CT Health Index .


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Wellbeing Equity Index. A precise, recognizable proof, evaluation and estimation of social determinants that prompt wellbeing disparitiesSocial DeterminantsComponentsIndicatorsCoreComplementaryData Sources. Monetary Security/Financial Resources. Wage. Riches/Assets. Neediness. PublicAssistance.
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Social Determinants of Health Disparities: The CT Health Index Connecticut Association of Directors of Health October 2006

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Health Equity Index A orderly, recognizable proof, evaluation and estimation of social determinants that prompt to wellbeing incongruities Social Determinants Components Indicators Core Complementary Data Sources

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Economic Security/Financial Resources Income Wealth/Assets Poverty Public Assistance Access to Capital Media Value-Owner Occupied Homes Land/Building Assessed Value Sales Prices Average # of Vehicles % Households Below Poverty % Individuals with Income <50% Poverty % Children <18 in Poverty Concentration of Poverty Approval Rates-Home Purchase Mortgages # of Home Purchase Mortgages Median Household Income Rate per Household-TFA Food stamps SAGA US Census/Claritas US Census/Claritas Local Tax Assessor US Census/Claritas Department of Social Services Home Mortgage Disclosure Act

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Social Determinants Set of Ten Social Determinants Economic Security & Financial Resources Livelihood Security & Employment Opportunity School Readiness & Educational Attainment Environmental Quality Civic Involvement & Political Access Availability & Utilization of Quality Health Care Health Adequate, Affordable & Safe Housing Community Safety & Security Transportation

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Components An arrangement of components that include the separate Social Determinants Examples Economic Security & Financial Resources Income Wealth/Assets Poverty Public Assistance Access to Capital

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Indicators An estimation used to portray the state of a populace bunch on a particular trademark or occasion. Pointer Selection Criteria Core Indicators Proxy Measures Complementary Indicators

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Types of Indicators: Core Indicators The arrangement of markers utilized as a part of the SDHEI for which reference focuses and estimation scales have been created and scoring will be connected

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Types of Indicators: Core Indicators Social Determinant: Economic Security & Financial Resources Component: Wealth/Assets Indicators: Median Value for Specified Owner-involved Housing Land/Building Assessed Values Sales Prices of Existing Homes Average Number of Automobiles Available by Household

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Types of Indicators: Core Indicators Social Determinant: Economic Security & Financial Resources Component: Access to Capital Indicators: Approval Rate of Home Purchase Mortgage Loan Applications Number of Home Purchase Mortgage Loan Applications Median Dollar Amount of Home Purchase Mortgage Loans Originated Over Two Years

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Types of Indicators: Proxy Measures A remain in measure used to inexact a real condition, result or occasion when an immediate measure is not achievable to information accumulation, time or asset requirements.

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Types of Indicators: Proxy Measures Examples Access to Quality Health Care Insurance Coverage-"Self pay" code as essential payor source-CHIME Rates of Ambulatory Care Sensitive Hospitalizations-CHIME Access to Capital Approval rate home buy contract credit applications-HMDA Area Business Capacity/Economic Development Percent of all organizations more than four years of age

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Indicator Construct Indicator Data Source Data Source Reference Point Rate Percentage Mean Median Six Point Measurement Scale Numerator Denominator Indicator Score

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Indicator Construct –Example US Census-Claritas Median Household Income Hartford: $24,820 Meriden: $43,237 Wethersfield: $53,289 Farmington: $67,073 Fairfield: $83,512 Darien: $146,755 CT Median HH Income $60,538 0-$20,000 $20,001-40,000 $40,001-60,000 $60,001-80,000 $80,001-100,000 $100,001+ Hartford-2 Meriden-3 Wethersfield-3 Farmington-4 Fairfield-5 Darien-6

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Framework of Analysis Demographic and wellbeing result measures against which SDHEI discoveries will be examined: Health Outcomes: occurrence or predominance rates for mortality and determined infections Demographic: race/ethnicity; sex; age; place of habitation; class (instructive fulfillment, wage

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Summary: Accomplishments to Date SDHEI Methodology Common Meanings for Critical Concepts Systematic Methodology Identification of Measures of Disparities Method of Tying SDHEI Findings to Health Outcomes and Demographics Method of Pre-testing the SDHEI Instrument 16 Neighborhoods-Hartford 4 Zip Codes-West Hartford

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Summary: Accomplishments to Date Instrument Development Identified Core Indicators Acquired Datasets Computed Formulas Developed Reference Points and Measurement Scales

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Summary: Accomplishments to Date Instrument Pre-Testing Acquired Municipal Data from Target Cities Calculated Indicator Scores for Neighborhoods

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Next Steps: Instrument Development Using SPSS Exploratory Statistical Analysis of SDHEI as a Measurement Tool Descriptive Statistics [means, middle, mode, fluctuation, percentages] Inferential Statistics [t-tests, pearson connections, ANOVAs] Multivariate Statistics [regression, DFA]

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Next Steps: SDHEI Relationship to Health Outcomes Work with DPH to Identify Availability of Health Outcome Data Compile Health Outcome Data by Neighborhood Test Strength and Direction of the Correlations Between SDHEI and the Measures of Health Outcomes

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Next Steps: SDHEI Relationship to Demographics Test Strength and Direction of the Correlations Between SDHEI and Demographic Variables

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Types of Indicators: Complementary Indicators Measures used to bolster facilitate, inside and out examination of issues raised by the HEI Based on precise perception, and overview and subjective research Observations, recognitions, portrayals

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Complementary Indicators Urban Environment/Sanitation Nutrition/Life Style Natural Environment Political Access & Power Social Cohesion Stress Community Organization Work Environment Public Transit

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Examples of Complementary Indicators Urban Environment – Physical Aspects of the Neighborhood Amount of civil uses for foundation Parks and measure of open space accessible for recreational utilize Nutrition/Life Style Supermarkets per capita Billboards publicizing alcohol or cigarettes Transportation Availability of open transportation Political Access and Power Racial/sex representation in chose office Social Cohesion Quality of social connections/bolster arrange Social control

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