The cost and quality of health care, as well as access to care and health outcomes, continue to vary widely among states according to the Commonwealth Fund Commission on a High Performance Health System’s second state scorecard. The report, Aiming Higher: Results from the 2009 State Scorecard on Health System Performance, is a follow-up to the Commission’s 2007 State Scorecard report; ranking states on 38 indicators in the areas of access, prevention/treatment quality, avoidable hospital use and costs, healthy lives, and equity.
To improve the health of communities and the general population, an array of health reformers, states and businesses alike are all looking to a range of prevention measures such as chronic disease management, alcohol and smoking cessation, and obesity programs. The hope is that these measures will also improve value and control costs.
Where we live, learn, work and play can have an enormous influence on our health and well being. Yet millions of working men and women and their families face almost insurmountable barriers to better health on a daily basis. Many of these hurdles can’t be cleared simply by choosing a healthy path. For example, many inner city and rural families have virtually no access to healthful foods. Many neighborhoods are unsafe for walking, let alone exercise. Children who do not receive high-quality services and education run a higher risk of becoming less healthy adults.
Community health centers (CHCs) play a key role in the U.S. health care safety net. They provide primary health care and other health services for medically underserved populations, including 1 in 8 Medicaid beneficiaries, 1 in 7 uninsured persons, 1 in 3 people in poverty, 1 in 10 minorities, and 1 in 9 rural Americans.
The recent deaths of two children due to preventable dental conditions focused attention on the importance of improving access to dental coverage for low-income Americans. With SCHIP reauthorization on the horizon and the chance that elements of last year’s vetoed SCHIP proposal—which included provisions for dental care—may be revived, oral health issues are front and center.
The U.S. health care system is often touted as a model for the rest of the world. We are clearly a leader in costs, but how well are we performing in return for our high investment? How do we do compare to benchmarks of achievable performance? And is performance getting better?
Vaccines are among the greatest triumphs of medical science over illness and disease in the past half-century. In the United States, vaccine use has virtually eradicated smallpox and polio and has drastically reduced the incidence of the dangerous—and formerly common—childhood illnesses measles, mumps and rubella.
In 2003, the Trust for America’s Health released a report on state preparedness in the age of bioterrorism. The study found that despite nearly $2 billion in federal funding, state public health systems were insufficiently prepared to handle a bioterrorist attack.
With nearly 130 million people obese or overweight, America is truly facing an epidemic. The proportion of Americans who are overweight or obese rose to 64 percent of the population in 2000 from 60 percent in 1990. Moreover, nearly 17 percent of preventable deaths in 2000 were attributable to poor eating habits and sedentary lifestyles, up from 14 percent in 1990, according to the Journal of the American Medical Association.
September 11 and subsequent anthrax attacks demonstrated clearly that our public health system was not prepared to cope with a large-scale emergency. Congress responded by appropriating $1.8 billion to help states and communities better prepare. Another $1.12 billion is contained in the omnibus appropriations bill for 2004 awaiting final action.
Despite significant state and federal efforts to cover kids, including the State Children’s Health Insurance Program, 9.2 million Americans under the age of 19 (12.1 percent of all Americans) went without health insurance in 2001, according to the U.S. Census Bureau. Such a lack of coverage can have serious clinical and financial consequences for children and their parents, such as children not receiving critical preventative care, including immunizations. At the same time, even children with coverage don’t necessarily receive high quality care. To cite one example, immunization rates for children two or younger in 2000 were below the Childhood Immunization Initiative’s goal of at least 90 percent.