2015 Colorado Health Report Card.pdf

8/9/2019 2015 Colorado Health Report Card.pdf

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THE 2015 COLORADO

www.ColoradoHealth.org/ReportCard #COHRC


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For detailed data on eachof the Health Report Card’s

38 indicators and methodology, visit

www.ColoradoHealth.org/ReportCard

Join the Conversation

#COHRC

On the Cover

Students enjoy burrito dayat Bella Romero Academyin Greeley. Food from localfarms is used in many mealsprovided in Weld CountySchool District 6.

Four generations of the Ewingfamily, (clockwise from left:Wayne, Christopher, Lisa andMadelyne), enjoy a tie-dyeevent put on by the EdgewaterNaturally Occurring RetirementCommunity.

Caitlin Johnson carries abucket of freshly picked okraat the Las Animas communitygarden. Produce from thegarden helps feed manymembers of the community,from school children to seniors.

Children help to celebrate thesigning of two bills in June2014 supported by LiveWellColorado to promote healthyeating and active living.

A young mother and her sonparticipate in a Mommy &Me Yoga class put on by theWellness Initiative at FlorenceCrittenton High School inDenver.

The Healthy Living Program – created by the University of Colorado Department of Pediatrics,Section of Nutrition – helps families take action for their health and wellness. The program’scurriculum includes parenting classes, activities that promote active living and cooking classes thathighlight food preparation and healthy eating.

LiveWell photo by Tanya Wheeler-Berliner; Other photos by Brian Clark


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Colorado is making slow but steady progresstoward becoming a straight-A state whenit comes to health. Still, many vulnerableColoradans are having a tougher timemaking the grade.

The 2015 Colorado Health Report Card –the ninth annual health report card presentedby the Colorado Health Foundation – showsimprovement in a number of areas. But italso reveals significant disparities in health

depending on race, ethnicity and income.

Colorado’s latest grades, based on 38 health-related indicators, also highlight the struggleto give our state’s youngest residents a healthyhead start:

• Seniors inched up, posting an A-compared with last year’s B+.

• Adults also did a bit better, climbingfrom a B to a B+.

• Teens stayed the same at a B.

• Colorado’s babies and childrenboth earned C’s – the same as last year.

This presents Colorado with the challengeof focusing on the health of our babies andchildren.

The Health Report Card’s underlyingdata illuminate stark differences basedon socio-economic factors.

For instance, while Colorado’s adults have thenation’s lowest obesity rate at 21.9 percent,adults with annual incomes below $10,000have an obesity rate of 29.2 percent – morethan seven percentage points higher thanthe state average. And Hispanic children

between the ages of 10 and 17 have anobesity rate of 15.5 percent, nearly doublethe 8.7 percent rate of white children.

For the first time, the Colorado HealthFoundation and its Health Report Cardpartner, the Colorado Health Institute, will usethe new data to inform an ongoing series ofin-depth reports throughout 2015. As partof this series, the data will be broken downgeographically, giving communities a better

idea of their own health grades.

Our goal is for the Health Report Cardto support efforts to make Colorado thehealthiest state, providing evidence that showswhere we are making progress as well aswhere are we are falling behind.

Slow But Steady

THE 2015 COLORADO

Colorado Getting Healthier, ButHealth Report Card Reveals Disparities


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Shopperscheck out theocal produceelection at

a farmer’smarket inCañon City.

hoto byMichael Rieger


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Last Report Card: C/24


Last Report Card: B/15


Last Report Card: B+/12

Grade:

Grade:

Grade:

Grade:

Grade:

Rank:

Rank:

Rank:

Rank:

Rank:

C

C

B

B+

A-

24

24

16

13

10

The GradesHealthy

Beginnings

HealthyChildren

Healthy Adolescents

Healthy

Adults

Healthy Aging


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Healthy BeginningsMany Colorado babies are getting a

better start on a healthy life, particularlywhen it comes to their mothers receivingprenatal care. Still, no Healthy Beginnings indicators rank better than 14th in thenation.

Compared with last year’s Health ReportCard, a greater proportion of mothersreceived timely prenatal care, enough to

move Colorado up nine places to 18th.And a slightly lower percentage of momssmoked during the late stages of theirpregnancies.

Colorado improved in infant mortalitysince last year, with 5.9 deaths for each1,000 live births, down from 6.2 deaths

per 1,000, pushing Colorado from 25th

to 20th.

However, a declining immunizationrate for toddlers dropped Colorado12 places to 30th. And Coloradocontinues to struggle with low-weightbirths, which research indicates resultsin more neurological and developmentaldisabilities.

The Health Report Card revealswidespread income, racial and ethnicdisparities in each Healthy Beginnings indicator. The mortality rate of blacknewborns, for instance, is 12.7 per 1,000more than two times the mortality rate ofwhite babies.

Health IndicatorRank Among

StatesRank Last

Year

15.4 percent of women received initial prenatal carelater than the first trimester or not at all. 18 27

92.2 percent of women abstained from cigarettesmoking during the last three months of pregnancy. 14 12

8.8 percent of babies were born with a low birth weight(less than 5 pounds, 8 ounces). 40 37Colorado’s infant mortality rate was

5.9 infant deaths per 1,000 live births. 20 2569.2 percent of preschool-age children received

all recommended doses of six key vaccines. 30 18


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Prenatal CareAll expectant mothers coveredby public or private insurancehave prenatal care benefits,thanks to new federal mandatesfor essential health benefitsrequired of all qualified healthplans. And many states areexpanding the reach of theirprenatal care programs evenfurther. One compelling modelis a Maternity Care Home,which augments traditional

l h b d

Program to Study:North Carolina’s Pregnancy Medical Home (PMH) mode

North Carolina launched the PMH for Medicaid enrollee

in 2009. Providers receive incentive payments forcompleting standardized risk screenings, postpartum visitand performing more vaginal deliveries than cesareansections.1 Early findings are promising. Eight hundred ofthe state’s 1,000 obstetricians have signed up. And 70percent of the women who were screened were found tohave high-risk pregnancies, alerting the integrated careteams to provide additional supports and services.

In Colorado:

C l d d M C H


Average Grade: Average Rank:C 24

Note: Immunization data are for toddlers 19-35 months old

The rate of pregnant womenreceiving late prenatal careor none at all is falling.

2007

2008

2009

Policies That Could Improve Colorado’s Grade

22.7%

20.7%

19.2%

17.8%

15.4%

2010

2011

more babies would be born to motherswho received timely prenatal care.

But if Coloradoranked No.1instead of 18th

2011

75.8%2012

71.7%2013

69.2%

In other news, thepercentage of parentsgetting recommendedimmunizations for theirtoddlers is dropping.

Good News Bad News


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Healthy ChildrenColorado isn’t at the head of the class

when it comes to creating a healthyfoundation for its children.

All children need access to affordableand adequate health care, which startswith health insurance. Children withoutinsurance often face unmet health needsthat take a financial and physical toll.

Colorado, however, ranks 37th for

coverage of children. But efforts to addressthe problem are beginning to pay off. Thepercentage of children without coveragedropped from 12.6 percent in 2008 to7.1 percent in 2013, outpacing otherstates and improving Colorado’s rankingon this indicator.


States

Rank La

Year

7.1 percent of children were not covered byprivate or public health insurance. 37 37

21.6 percent of children lived in families with incomesbelow the federal poverty level. 14 19

55.3 percent of children had a medical home that isaccessible, continuous, comprehensive, family-centered,

coordinated, and compassionate.35 35

77.6 percent of children saw a dentist forpreventive dental care in the past 12 months. 29 29

67.6 percent of school-age children participated in vigorousphysical activity for four or more days per week. 24 24

10.9 percent of children were obese. 5 5

Colorado ranks an enviable fifth for

childhood obesity. Even so, nearly 11 percenof children are obese. The state’s childrenrank near the middle of the pack for physicaactivity at 24th, although the percentagewho are active has been steadily increasing.

Our children’s health is not likely toimprove without addressing income-related disparities. More than 20 percentof Colorado’s children live in families that

struggle financially.The economic divide is especially strikingwhen it comes to medical homes. Andchildren in families below the poverty lineare least likely to be physically active orreceive preventive dental care.


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Physical Activity

Two of three Colorado kids get a ride to school– a missed opportunity for them to be active.2 Safe routes to walk or bike to school, along withpolicies and regulations that promote efforts to getstudents out of cars, could encourage the state’sstudents to be more physically active.

Program to Study: Maine’s Safe Routes to SchoolMaine, which has a similar rural-urban breakdownto Colorado, ranks third in the nation for youthphysical activity. More than 73 percent of childrenparticipate in vigorous activity four or more daysper week and nearly three of four walk or biketo school.3 To promote traffic safety, Maine’slegislature regulated the roles and authority ofschool crossing guards in 2007, requiring uniformhand motions and hand-held traffic signs.4 The

M ll h l d d

In Colorado:

Colorado lacks some components ofMaine’s statewide laws promotingactive transit safety, particularly as theypertain to crossing guards and speedzones around schools. The ColoradoDepartment of Transportation’s (CDOT)Safe Routes to School program isunable to fully meet demand to fundinfrastructure improvements and safetyeducation initiatives in local schools andcommunities.

Since 2005, CDOT has allocated $125million in federal funding for 705 localSafe Routes projects. That federal fundinhas expired, and the program is at risk.Colorado’s legislature passed Senate Bil14-1301 in 2014 directing $700,000

f d h f


Average Grade: Average Rank:C 24


exercise at least 20 minutes four times aweek, nowhere near the recommended hour-a-day of exercise for all kids.

Three of four kidsare receivingpreventivedental care.But children infinancially strugglingfamilies are less likely toreceive preventive dental care

And only

2of3 0-99% FPL

70.2%100-199% FPL

200-399% FPL 400%+ FPL

72.7%

80.3% 82.4%

77.6%2013

10%More than

of children are obese.

Colorado children

FPL = Federal Poverty Level


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StatesRank La

Year

11.6 percent of adolescents are not covered by privateor public health insurance. 41 38

15.8 percent of adolescents live in families with incomesbelow the federal poverty level. 12 22

92.3 percent of adolescents ate vegetables one or more timesduring the past seven days. 41 N/A*

49.1 percent of adolescents participated in vigorous physical activityon five or more of the past seven days. 13 4

16.6 percent of adolescents had five or more drinks of alcoholin a row on one or more of the past 30 days. 17 3010.7 percent of adolescents smoked cigarettes

on one or more of the past 30 days. 10 2024.3 percent of adolescents felt so sad or hopeless almost every dayfor two consecutive weeks during the past 12 months

that they stopped doing some usual activities. 9 46.6 percent of adolescents attempted suicide one or more times

during the past 12 months. 7 723.3 percent of adolescents were sexually active in the past three months. 1 14Among students who had sexual intercourse during the past three months,

63.7 percent reported using a condom during last sexual intercourse. 3 1

T f ili (25 4 bi h h 1 000 f l ) 23

Healthy AdolescentsMany of Colorado’s teens struggle with theirmental health. In 2013, nearly one of four saidthey felt so sad for two consecutive weeks in thepast year that they stopped their usual activities,an increase from 2011. More than 6.5 percentsaid they had attempted suicide in the past year.Among Hispanic teens, the rate was 7.8 percent.

Physical activity can be improved. WhileColorado teens rank 13th on this indicator,only about half of teens participated in vigorousexercise for an hour or more at least five times aweek.

More favorable trends are emerging in thesafer sex and teen pregnancy categories, likely

resulting from several statewide efforts to curteen pregnancy.

Fewer than one of four Colorado teens say thare sexually active, the nation’s lowest rate.And of the teens who are having sex, most sthey use condoms, earning the nation’s No. ranking.

Colorado’s teen birth rate is nearly half whatwas in 2005, an important success. Even sobetter progress has been made in wealthiercounties. Douglas County, for example, has

a teen fertility rate of 4.6 births per 1,000compared with 41.3 births per 1,000 inPueblo County.


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50

43.4 42.537.6 33.4 28.9 25.4

40

30

20

10

02007 20102008 20112009 2012

high schoolstudents

struggles withdepression,

with teen girlstwice as likely

as boys to

report feelingdepressed.

1 of 4

Teen Mental Health

Program to Study:Massachusetts Child Psychiatry Access Project (MCPAP)

This program teaches pediatricians strategies for assessingmental health conditions and helps them connect their patientswith community-based mental health services. The psychiatristsand psychotherapists consult by telephone with pediatriciansto answer questions or to coordinate face-to-face assessmentswith adolescents who have more serious conditions. MCPAP,with funding from the state Department of Mental Health andsome insurance reimbursements, has expanded over the past10 years. Best practices such as training pediatric primarycare providers, age-appropriate mental health screenings,and collaboration between primary care providers and mentalh l h f l h b d fi d 5 6

In Colorado:

The Colorado Psychiatric Accessand Consultation for Kids (C-PAClaunched in 2013 and has helpe

more than 136,000 kids.7 Earlyresults show that providers use thconsultation hotline to coordinatecare for patients who needspecialist treatment. Colorado alsseeks to accelerate coordinationof physical and mental health caras part of the $65 million StateInnovation Model (SIM) grant,which the federal government

d D b 2014


Teen birth rates declined between 2007 and 2012*


Average Grade: Average Rank:B 16

New Hampshirehas the lowest

teen birth rate at

13.8*Births per 1,000 teenage females

Colorado is amothe 10 worst state

for adolescent heainsurance coverag

(ages 13-17).

No. 1Massachusetts

No. 41 Colorado No. 50 Te

1.4%

11.6% 17.3%

**Uninsured data gathered before importantprovisions of the Affordable Care Act went into e


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Healthy AdultsAdults in Colorado improved from a B to a B+ this

year. This progress reflects small improvementsacross key health indicators, including medical

homes, physical activity and mental health.Colorado adults are No. 1 in the nation on threeimportant health indicators – physical activity,obesity and diabetes – and rank second forhypertension. These interconnected measuresreflect the state’s active lifestyle. Still, financiallydisadvantaged Coloradans are disproportionatelyaffected by diabetes and obesity. Diabetesrates, for example, are more than three timeshigher among adults with annual incomes below

$10,000 compared with Coloradans making morethan $75,000 annually.

A closer look at the rates behind someof the top performances shows room forimprovement. For example, nearly one of

five adults didn’t participate in any physicalactivity in the past month. And Colorado’sobesity rate, while the lowest in the nation,has been inching steadily higher. Nearlythree of 10 (29.2 percent) of Colorado’slowest-income adults are obese, sevenpercentage points above the state average.

Two lifestyle indicators leave Colorado’sadults in the wake of other states. Almost

20 percent of adults smoke cigarettes andthe state ranks 37th for binge drinking.


StatesRank Last

Year

18.5 percent of working-age adults are not covered byprivate or public health insurance. 25 25

72.5 percent of adults had one (or more) person(s) they think of as their personal doctor or health care provider.

2630

19.2 percent of adults consumed five or more fruits and/or vegetablesper day within the past month. 8 12

83.2 percent of adults participated in any physical activitywithin the past month. 1 5

21.9 percent of adults were obese. 1 119.4 percent of adults smoked cigarettes. 15 13

21.2 percent of adults binge drank (males having five or more drinkson one occasion, females having four or more drinkson one occasion) in the past month. 37 38

14.0 percent of adults reported that their mental healthwas not good eight or more days in the past month. 12 18

4.5 percent of adults reported that they were diagnosed with diabetes. 1 820.2 percent of adults reported that they were diagnosed

with high blood pressure. 2 2


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Adult obesity ratesare on the rise, climbing19 percent in seven years. In 2013, about

690,000 people were obese.

One of five adults had hypertension,up from last year.

One of four adults didn’t havea regular source of care.

2006 2013

18.4% 21.9%

13Last Report Card: B/15

Average Grade: Average Rank:B+ 13

Coloradoadults are But sometimes #1is not good enough

And ...

Preventing Diabetes and Hypertension

Program to Study: The Hawaii Diabetes Plan

In 2010, Hawaii ranked 25th nationally for diabetes,with 6.2 percent of adults diagnosed with the condition.With a growing population of pre-diabetics, Hawaiiestimated the direct medical cost of diabetes at $964million. This financial burden prompted the HawaiiDepartment of Health to launch the Hawaii DiabetesPlan in 2010.8 To support this effort, the HealthyHawaii Initiative is a health promotion effort designedto increase opportunities for physical activity at school,at work, and in the community. Step it Up Hawaiiencourages adults to walk 30 minutes a day. Targetedlifestyle interventions, which mainly focus on physicalactivity, are aimed at reducing the risk of developingdiabetes. Hawaii has improved its rank to 10thnationwide for diabetes.


In Colorado:

Colorado is expanding its DiabetesPrevention Program, a healthy lifestyleinitiative that encourages 150 minutesof physical activity per week.9 Thisevidence-based program is coveredby some private insurers, including

UnitedHealthcare, Kaiser Permanenteand Anthem Blue Cross Blue Shield.Colorado Medicaid, however, doesnot cover this program, even thoughmany clients are low-income adultswho are most likely to be at riskfor diabetes. If Colorado’s publicinsurance programs opted in, morepeople would have coverage forpreventive measures against diabetes.

F o r P hy si c a l Ac t i v i t y , O b e si t y a nd D i a b e t e s

# 1


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Healthy AgingColorado’s seniors are managing to stayfairly healthy as they grow older, a good

thing considering that the state’s 65-and-olderpopulation is expected to more than triple to1.5 million by 2040.10

The Health Report Card reveals that olderadults are healthier than in years past. Theirgrade rose from a B+ last year to an A-.Improving in the area of medical homeswas one reason for this change. Coloradoalso outpaced other states in reducing thepercentage of older adults who reported

limited activity due to poor physical or mentalhealth.

Older Coloradans do well when it comes tostaying active. They rank second in physicalactivity, with more than three of four seniorssaying they exercise. Colorado’s low rate of

activity limitations – physical or mental healthconditions that inhibit activity – ranks fifth, up

from 17th a year earlier.Relatively high marks are reported forphysical and mental health. Only about 18percent of Colorado seniors report being inpoor physical health, earning a rank of 13th,and fewer than eight percent report poormental health, for an 11th-place ranking.

Financially struggling seniors, however,aren’t faring as well. Nearly half of thosewith annual incomes below $10,000reported poor physical health, more thanthree times the rate of seniors earning morethan $75,000 a year. Seniors with annualincomes between $10,000 and $15,000reported the highest rate of poor mentalhealth, at 15.7 percent.


StatesRank Last

Year

94.6 percent of older adults have one (or more) person(s)they think of as their personal doctor or health care provider. 19 28

53.9 percent of older adults have had a flu shot during the past12 months and have had a pneumonia vaccination. 7 8

76.1 percent of older adults participated in any physical activityin the past 30 days. 2 1

18.2 percent of older adults reported that their physical health wasnot good eight or more days in the past month. 13 7

7.7 percent of older adults reported that their mental health was notgood eight or more days in the past month. 11 8

19.6 percent of older adults reported eight or more days of limitedactivity in the past month due to poor physical or mental health. 5 17


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Long-Term Services and Supports (LTSS)

Program to Study:Minnesota’s Aging and Disabilities Resource Center Program

Minnesota has developed a seamless system to connect adults with

disabilities and seniors to services and supports such as housing andhome-delivered meals. State legislation passed in 2009 directedMinnesota’s Board of Aging to allocate federal, state and local fundsto develop an Aging and Disabilities Resource Center program tocoordinate all LTSS.11 The Resource Center provides a searchablewebsite as well as phone and in-person assistance to providers, seniorsand family members seeking information, resources and support. Thefree services are available statewide. A 2012 survey found that morethan 87 percent of users said they would recommend the service.12

In Colorado:

Colorado kicked off a yearlong planning andstakeholder engagementprocess in October 2014 with

the goal of creating a moreperson-centered, streamlinedapproach to accessing LTSS.As Colorado shores up thisarea, stakeholders shouldkeep in mind the successof Minnesota’s model forcoordinating informationin a central hub.

Last Report Card: B+/12

Average Grade: Average Rank:A- 10


Annual Income Poor Health

$$75K 13.4%

Colorado seniors fall short of

the Healthy People 2020 targetof all seniors having a regular

source of medical care.

Low-income seniors are more likely

to experience poor physical health.

And only

of seniors got a flu shotand pneumonia vaccine

in the past year.

53.9%94.6%


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Imagine that the other 49states are Colorado’s peerswhen it comes to healthylifestyles. Some states set thehealth bar high. Utah and

Massachusetts, for example,each ranks first on five of the38 health indicators. Andwhile Colorado may not bethe valedictorian, we are aclose runner-up, earning atop ranking on four healthindicators.

But even states at the topof the class have room forimprovement. Colorado willnot become a true leader inhealth until all Coloradansare earning an A, regardless of race, ethnicity,economic status or where they live.

Colorado is not a high achiever on child andadolescent poverty indicators. Black andHispanic children under 13 are significantlymore likely to be living in poverty comparedwith white children in Colorado. About 11percent of white children were in families withincomes below the poverty level – $23,550for a family of four – in 2013, while thepercentage for Hispanic children was about38 percent. Nearly half of black children werein this category.

Achieving good health can be challenging forColoradans living in poverty. Adults earningless than $10,000 per year, for example, are

three times more likely to report poor mentalhealth than adults with annual incomes of$75,000 or more.

Disparities data on all indicators are availableat www.ColoradoHealth.org/ReportCard.

16 Colorado Health Report Card

Many Coloradans Face Barriers to Healthy Lifestyle

Percentage of Children Below Poverty Level,Ages 0-12, Colorado, 2013

Poor Mental Health, Adults 18-64, Colo

Colorado’s Grade Over TimIt’s also important to understand how our grades habeen trending over time. Are Coloradans becominghealthier?

A look back at Colorado’s grades on the first fullHealth Report Card in 2007 reveals that we aremaking strides in some areas but falling behind inothers.

Colorado has shown great improvement on the teefertility indicator. Since the 2007 Health ReportCard, births to teen moms plummeted from a rate o43.9 per 1,000 to 25.4 per 1,000. Over that timeColorado invested in public health efforts to curbteen pregnancy by making it easier for lower-incomwomen to access effective contraception.

Immunization rates for toddlers between 19 and35 months showed the least progress and, in fact,declined. This Health Report Card shows that 69.2percent of toddlers received the recommendedvaccination series, down from 80.3 percent on the2007 report. Colorado allows personal exemptionschool-based immunization requirements for parent


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The Health Report Card also provides insights intohow different areas of health interact. Is obesity, forexample, related to nutrition? Is there a connectionbetween fruit and vegetable consumption andhypertension or diabetes rates?

Data from the past four Health Report Cards showthat obesity, hypertension and nutrition indicatorstrack closely. For example, a smaller proportion ofColorado adults are consuming five or more servingsof fruit and vegetables per day since the 2011Health Report Card, while a higher percentage reporthaving hypertension. These trends echo researchdocumenting the positive relationship between ahealthy diet and better health.

25

20

15

10

5

0

Children

Adolescen

Adults

2007 2008 2009 2010 2011 2012 2013 2015*

Percentage of Coloradans Without Health Insurance

Colorado Adults and Healthy Living

Report Card Year

P e r c e n t a g e

Health: It’s All Connected

Progress Report: Uninsured Rates DecliningProviding children with opportunities for a healthylife can help build the foundation for lifelonghealth and create a state in which children thriveand grow into healthy, productive adults.

A close look at uninsured data across the lifestages reveals strong progress on this indicatorsince the 2007 Health Report Card.

Children below the age of 13 saw the mostdramatic decline, posting a 50 percent dropfrom 14.1 percent to 7.1 percent without healthinsurance.

25

20

15

10

5

0

P e r c e n

t a g e

2011 20132012 2015*

Report Card Year

Obesity Hypertension Fruit & VegetableConsumption

Uninsured rates for adolescents also went down,falling from 14.1 percent to 11.6 percent. Duringthis time, Colorado expanded eligibility for the CHealth Plan Plus (CHP+) and enacted other policithat made it easier for families to enroll their childin public insurance programs.

Colorado adults saw small improvements on this

indicator, with uninsured rates dropping just overone percentage point. But major provisions of theAffordable Care Act went into effect in 2014,after the latest uninsured data were collected,so we expect to see a better grade on the 2016Health Report Card.

* In order to align the Health Report Card with the year of its release, the dates skipped from 2013 to 2015.


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MethodologyThe Colorado Health Report Card’s 38 healthindicators are presented through five life stages.

Because the data come from many sources,the age ranges for some indicators vary withina life stage. Detailed information about the

data, including the ages, years and sources,can be found in the data workbooks atwww.ColoradoHealth.org/ReportCard.

• Healthy Beginnings: All indicators are forpregnant moms or newborns, with theexception of immunization data, which are forchildren between 19 and 35 months.

• Healthy Children: Insurance and povertyindicators include all children under age 13while medical home and preventive dental

indicators are for all children through 18 years.Physical activity data are for kids betweensix and 17, while obesity data are for thosebetween 10 and 17.

• Healthy Adolescents: All data are for teensbetween 13 and 17, with the exception ofteen fertility, which is for teen girls between15 and 17.

• Healthy Adults: All data are for adults between18 and 64.

• Healthy Aging: All data are for seniors65 and older.

There is a change this year in the Health ReportCard title. The titles of previous reports reflected the

year in which data were compiled. In order to alignthe Health Report Card with the year of its release,instead of lagging by a year, we skipped from2013 to 2015.

Data SourcesThe indicators selected for the Health Report Cardcome from eight data sources. The data are themost recent available for all states.

1. Centers for Disease Control and Prevention. BehavioralRisk Factor Surveillance System (BRFSS), 2013.

2. Centers for Disease Control and Prevention, NationalCenter of Health Statistics. National Survey of Children’sHealth, 2011-12.

3. Centers for Disease Control and Prevention. NationaImmunization Survey, 2013.

4. Centers for Disease Control and Prevention. NationaVital Statistics System, 2010-2012.

5. Centers for Disease Control and Prevention, Office oAdolescent and School Health. Youth Risk BehaviorSurvey, 2013.

6. Centers for Disease Control and Prevention. PregnanRisk Assessment Monitoring System, 2011.

7. Colorado Department of Public Health and EnvironmColorado Department of Human Services Office ofBehavioral Health, Colorado Department of Educatioand University of Colorado Denver. Healthy KidsColorado Survey, 2013.13

8. United States Census Bureau. American Community

Survey, 2013.

RankingThe indicators selected for the 2015 HealthReport Card are reported consistently acrossstates, allowing Colorado’s performance to beranked relative to other states. For each indicathe best-performing state is ranked first. Anadjusted rank was calculated for indicators witfewer than 50 states reporting data. In caseswhere states had the same value for an indicatthey were listed randomly.

GradingA grade was assigned to each life stage basedon Colorado’s average rank for all indicators ithat life stage. The grades were assigned usingthe ranks and letter grades shown in the tablebelow.

AverageRank

LetterGrade

1-3 A+

4-6 A

7-10 A-

11-13 B+

14-16 B

17-20 B-

21-23 C+

24-26 C

AverageRank

LetterGrad

18 Colorado Health Report Card

27-30 C-

31-33 D+

34-36 D

37-40 D-

41-43 F+

44-46 F

47-50 F-


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1 Community Care North Carolina. (2011). “Module 15: The Pregnancy Medical Home.”http://commonwealth.communitycarenc.org/toolkit/15/Module_15_Pregnancy%20Home%20Module.pdf,http://www.dhcs.ca.gov/services/calendar/Documents/Corry.pdf

2 Colorado Department of Public Health and Environment, Center for Health and Environmental Data,Health Statistics and Evaluation Branch. (2013). “Colorado’s Child Health Survey.”http://www.chd.dphe.state.co.us/Resources/mchdata/2013CHS.pdf

3 State of Maine. (2013). “Safe Routes to School & Bicycle and Pedestrian Safety Education Programs –Yearly Report.” http://www.maine.gov/mdot/bikeped/docs/srts/SRTSBPSAnnualReport2012-2013-2.pdf

4 123rd Maine State Legislature. “An Act to Promote School Zone Safety.” (2007).http://www.mainelegislature.org/legis/bills/bills_123rd/billpdfs/HP09380.pdf

5 Dube, N. (2013). “Massachusetts Child Psychiatry Access Project.”http://www.cga.ct.gov/2013/rpt/2013-R-0011.htm

6 Massachusetts Child Psychiatry Access Project. (2014). “Connecting Primary Care With Child Psychiatry.”http://www.mcpap.com/

7 Center for Improving Value in Health Care. (2014). “Spotlight on Innovation: Investing in the Future:C-PACK and Colorado’s Kids.”http://www.civhc.org/News-Events/News/Spotlight-on-Innovation--Investing-in-the-Future--.aspx/

8 The Hawaii State Department of Health Community Health Division. (2010). “Hawaii Diabetes Plan 2010:Guiding the Collaborative Efforts of Partners.” http://health.hawaii.gov/diabetes/files/2013/10/2010plan.

9 American Diabetes Association. (2014). “Colorado Diabetes Prevention Program.”http://www.diabetes.org/in-my-community/local-offices/denver-colorado/colorado-diabetes-prevention.html

10 Colorado Demography Office. Population Projections by Age and Gender. Accessed January 20, 2015.https://dola.colorado.gov/demog_webapps/pagParameters.jsf

11 The Office of the Revisor of Statues. (2014). “2014 Minnesota Statues.”https://www.revisor.mn.gov/statutes/?id=256.975

12 Minnesota Board on Aging. (2013). “MN Aging and Disability Resource Center (ADRC): Progress, Challengesand Lessons Learned.” http://nasuad.org/sites/nasuad/files/HIHCBS(Jean%20Wood)%20MBA%20ADRC%2presentation%20for%20hawaii.pdf

13 The Healthy Kids Colorado Survey has replaced the Youth Risk Behavior Survey as the source for most Coloradadolescent health data. In addition, the nutrition indicator is now vegetable rather than fruit consumption.

Health Indicators Endnotes


20/20

www.ColoradoHealth.org/ReportCard

www.ColoradoHealthInstitute.org

501 South Cherry Street, Suite 1100 • Denver, Colorado 80246

Phone: 303.953.3600 • Twitter: @COHealthFDN • Web: www.ColoradoHealth.org

303 E. 17th Avenue, Suite 930 • Denver, Colorado 80203

Phone: 303.831.4200 • Twitter: @COHealthInst

Contributing Members

Natalie Triedman

Deborah GoekenBrian Clark

Jessica Fern

Sara Schmitt

Cliff Foster

Contributing Members

Jaclyn Lensen

Leslie Chadwick

Kyle Legleiter

Kaye BoekeKindle Morell

Taryn Fort

2015 Colorado Health Report Card.pdf

Documents

Transcript of 2015 Colorado Health Report Card.pdf