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Senior Report 2017 Community & Behaviors Environment

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Senior Report 2017 Community & Behaviors Environment A call to action for individuals and their communities Senior Report 2017 Community & Behaviors Environment Health Outcomes Policy Clinical Care America’s Health Rankings® and America’s Health Rankings® Senior Report were built upon the World Health Organization definition of health: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Our model reflects that determinants of health directly influence health outcomes, with determinants accounting for three-quarters and outcomes accounting for one-quarter of each state’s overall score and ranking. Four categories of determinants are included in our model of health: Behaviors, Community & Environment, Policy and Clinical Care. 2 AMERICA’S HEALTH RANKINGS® SENIOR REPORT www.AmericasHealthRankings.org State Rankings on Senior Health America’s Health Rankings Senior Report o ers a comprehensive analysis of senior population health on a national and state-by-state basis across 34 measures of senior health. WA VT NH MT ND ME OR MN MA ID SD WI NY WY MI RI PA NE IA CT NV OH UT IL IN CA CO NJ VA KS MO KY DE NC TN MD AZ OK NM AR SC DC MS AL GA LA WV AK TX FL HI RANK: 1 to 10 11 to 20 21 to 30 31 to 40 41 to 50 Not Ranked The States with the Biggest The HEALTHIEST States OPPORTUNITIES FOR IMPROVEMENT 1 2 3 50 49 48 MINNESOTA UTAH HAWAII MISSISSIPPI KENTUCKY OKLAHOMA For more information please visit us at AmericasHealthRankings.org AMERICA’S HEALTH RANKINGS® SENIOR REPORT www.AmericasHealthRankings.org 1 America’s Health Rankings® Senior Report Executive Summary The 2017 America’s Health Rankings® Senior Nationally, clinical care measures — hospital Report provides a comprehensive analysis of readmissions, preventable hospitalizations, senior population health on a national and hospital deaths and hospice care use — have state-by-state basis across 34 measures of improved since the first Senior Report was senior health. This report’s model is based on published in 2013. In many cases, these the historical America’s Health Rankings model are promising trends that reflect consistent of health and was adapted in 2013 for the improvements each year from 2013 to 2017. senior population under the guidance of an Improvements were also made in the outcome advisory group of experts in the fields of aging measures intensive care unit (ICU) use and hip and senior health. The 2017 edition marks the fracture hospitalizations. fifth publication of this meaningful report, which continues to serve as a benchmark In the past year: of senior health for individuals, community leaders, policymakers, media and public • Preventable hospitalizations decreased 7 health professionals. percent from 53.8 to 49.9 discharges per 1,000 Medicare enrollees, continuing a four- year decline. Successes and Challenges in Senior Health Since the 2013 edition: In this year’s report, we observed national • Hospital readmissions decreased 7 percent, improvements in several clinical care from 15.9 percent to 14.8 percent of measures, and challenges in community & hospitalized Medicare enrollees. environment measures related to nutrition and access to healthy foods. Notably, the • Hospital deaths decreased 30 percent from premature death rate among seniors increased 30.1 percent to 21.0 percent and hospice care in the past year after three consecutive years use increased 42 percent from 36.7 percent of decline, a trend that mirrors the trajectory to 52.0 percent of chronically ill Medicare of years of potential life lost before age 75 in decedents aged 65 years and older. the general population, as was reported in the December 2016 release of America’s Health • ICU use in the last six months of life decreased Rankings Annual Report. 9 percent from 15.2 percent to 13.8 percent of Medicare decedents aged 65 years and older. • The hip fracture hospitalization rate decreased 21 percent from 7.3 to 5.8 hospitalizations per 1,000 Medicare enrollees, continuing a four- year decline. 2 AMERICA’S HEALTH RANKINGS® SENIOR REPORT www.AmericasHealthRankings.org As a nation, obesity, nutrition and access to Mississippi ranks 50th this year. The state healthy food remain challenges for seniors. also held this ranking in the first two years of Obesity and food insecurity both increased, the Senior Report. Kentucky (49th), Oklahoma while Supplemental Nutrition Assistance (48th), Louisiana (47th) and Arkansas (46th) Program (SNAP) reach and community support round out the bottom five states, representing expenditures decreased. the states with the greatest opportunities for improvement. In the past year: California made the greatest improvement in rank in one year, rising 12 spots from 28th • Obesity prevalence rose to 27.6 percent to 16th. South Dakota also made great strides of adults aged 65 years and older in 2017, this year, rising 10 spots from 25th to 15th. representing a five-year high. Pennsylvania and Alaska both dropped eight spots, now ranking 26th and 29th, respectively. • Food insecurity rose to 15.8 percent of adults aged 60 years and older. Improving the Health of • Community support funding for public Our Nation’s Seniors nutrition, transportation, and other social services for seniors aged 60 and older living With this report, United Health Foundation in poverty decreased 6 percent. equips stakeholders with five years of senior health and well-being data that encourages In the past two years, SNAP reach decreased continued conversations among policymakers, 7 percent from 75.2 percent to 70.1 percent of public health officials and community leaders, adults aged 60 years and older living in poverty. and drives action to promote better health for our nation’s seniors. As a nation, we have experienced impressive improvements in 2017 Senior Health Rankings critical areas of senior health since the launch of the first America’s Health Rankings Senior The Senior Report ranks each state across 26 Report in 2013. With this year’s report, we are measures of health determinants and eight reminded of persistent social and economic measures of health outcomes. The healthiest barriers to proper nutrition and access to states for seniors are spread throughout the healthy foods, and continued successes in United States, while the least-healthy states are measures of clinical care. clustered in the southern region. Minnesota ranks as the healthiest state for seniors this year. The state held the top spot in the first two years of the Senior Report. Utah improved to second, while Hawaii (third), Colorado (fourth) and New Hampshire (fifth) round out the top five states in 2017. AMERICA’S HEALTH RANKINGS® SENIOR REPORT www.AmericasHealthRankings.org 3 4 AMERICA’S HEALTH RANKINGS® SENIOR REPORT www.AmericasHealthRankings.org Contents Executive Summary 2 Introduction 6 Findings 8 State Rankings 8 Largest Changes in Ranking Since 2016 14 National Findings 16 Successes 16 Challenges 18 Core Measures 21 Supplemental Measures 66 State Summaries 70 Appendix 125 Core Measures Table 126 Supplemental Measures Table 129 Methodology 130 Model Development 132 2017 Senior Report Advisory Group 134 The Team 135 AMERICA’S HEALTH RANKINGS® SENIOR REPORT www.AmericasHealthRankings.org 5 Introduction According to the Administration on Aging, rankings were calculated as well as rankings 14.5 percent, or about one in every seven for each individual measure. Where available, Americans, was 65 years old or older in 2014. subpopulation data were analyzed to gain a This translates to 46.2 million seniors, a 28 clearer picture of health within each state. percent increase since 2004. This proportion of older adults is expected to grow to 21.7 Now in its fifth year, the report serves to: percent of the population by 2040. Not only will the next generation of seniors rapidly • Provide a benchmark for senior population grow in numbers, but according to last year’s health by state. State-level data allow America’s Health Rankings® Senior Report, the community leaders, public health officials next group of seniors are projected to have a and policymakers to monitor health trends higher prevalence of obesity and diabetes, and over time and to compare senior health a lower prevalence of high health status. The measures with other states and the nation. increasing number of older adults combined with the growing prevalence of obesity, • Stimulate discussion and action to diabetes and other chronic diseases threaten improve senior population health. The to create serious challenges for our health care report’s purpose is to kindle and continue system. In order to learn where and how to take to fuel dialogue and action among action to improve the health of current and individuals, community leaders, the media, future seniors, we assessed the current status policymakers and public health officials by of senior health in the fifth edition of America’s providing accurate, reliable and trustworthy Health Rankings Senior Report. information based on a holistic view of The report offers a comprehensive and health. convenient analysis of senior population health on a national and state-by-state basis. This year, America’s Health Rankings It includes 34 measures of health and well- Senior Report presents five years of senior being, all selected under the guidance of health data, allowing for the examination of an advisory group of experts in the fields national- and state-level trends. Each year we of aging and senior health. Comprehensive also present the strengths, challenges and highlights of every state to facilitate a shared discussion on improving senior population health. This report continues to build an informational foundation that creates awareness about senior health in every state 6 AMERICA’S HEALTH RANKINGS® SENIOR REPORT www.AmericasHealthRankings.org — the next and most vital step is to take action. Learn more about this report at www.
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