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Oct 1

Healthy People 2030 vs. The State of Florida: How to Get There from Here: SF STAT! – South Florida Hospital News

By: Calvin Glidewell

President/CEO

inspirEx Healthcare Strategies

cglidewell@inspirexhealthcare.com

Just last month, the federal government came out with its once-in-a-decade blueprint for public health action: Healthy People 2030. A Healthy People report has been published every decade since 1980 and is coordinated by the Office of Disease Prevention and Health Promotion within the federal Department of Health and Human Services. Healthy People 2030 establishes five overarching goals and contains 355 science-based health status objectives with measurable target initiatives. These objectives reflect high priority public health issues. This decades plan has a particular emphasis on identifying and addressing social determinants of health and on achieving well-being, defined as how people think, feel, and function, and how they evaluate their lives as a whole.

The five overarching goals within the Healthy People 2030 framework are:

Attain healthy, thriving lives and well-being, free of preventable disease, disability, injury and premature death.

Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being for all.

Create social, physical, and economic environments that promote attaining full potential for health and well-being for all.

Promote healthy development, healthy behaviors, and well-being across all life stages.

Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.

The 355 core objectives in the plan have been categorized under five classifications: health conditions, health behaviors, populations, settings and systems, and social determinants of health. As you might expect from these classifications, the objectives include health status targets and tools for actions that should be adopted by individuals, by providers and health systems, by businesses, and by public-private partnership initiatives to achieve optimal health.

Eventually, the Healthy People 2030 plan will identify state-specific data points that will show baseline performance as well as targeted improvements for each state within each indicator. At the present time, however, the state-specific data is still being formulated and tabulated by the National Center for Health Statistics. Its a fair question to ask how we in Florida are doing in identifying and addressing these public health priorities, but until the federal government comes up with its state-specific performance data, well have to rely on other commercially-available published studies showing the relative performance of each state in achieving optimal health. (Spoiler Alert: Unfortunately, the data we do have doesnt show a very rosy picture for Florida.)

Healthcare executives are used to ratings by outside organizations. In the hospital industry, there are several regulatory and independent agencies rendering their opinions on hospital quality and safetyCMS Star ratings, Leapfrog, HealthGrades, U.S. News & World Report, IBM Watson Health, and more. Likewise, there are several independent ratings and comparisons of health status by state. And, like hospital ratings, these studies, which are conducted by a variety of independent organizations, dont always examine the same data sets, often develop their own unique approaches to measuring health status, use different ratings methodologies, report on a diverse set of indicators, and frequently have different results.

These are the four organizations which have recently rated Floridas health status performance as compared to all other states.

Here is Floridas health status ranking as reported by these four different agencies:

Reporting Organization Date of Publication Florida Ranking (out of 50 states)

1.Commonwealth FundAugust 202041

2.United Health FoundationDecember 201933

3.U.S. News & World Report201929

4.WalletHub August 2020 37

As mentioned, each study is slightly different in its approach, methodology, and outcome. Unfortunately, though, the results in aggregate tend to show a dismal picture for the state of Floridaalways in the lower half and usually in the lower quartile of comparative state performance with regard to health status. A closer analysis of the disparate factors affecting health status performance leads to a few inescapable conclusions and recommendations for policy-makers, public health officials, healthcare administrators, businesses, and individuals.

Improve access to care. To achieve better health, Floridians need better access to preventative, diagnostic and therapeutic care. Florida has begun its journey to improve access by expanding the scope of practice for Advanced Practice Nurses and for pharmacists and by loosening telehealth restrictions to better serve rural communities, but the state still has a long way to go. In particular, the policy decision not to expand Medicaid to low-income adults authorized by the Affordable Care Act consistently lands Florida among the worst-performing states in the nation for access to care.

Eliminate disparities in care. Florida still has a significant difference in healthcare utilization rates and clinical outcomes between white Floridians and Black or Hispanic Floridians and between rural and urban communities. Changing this paradigm will require concerted efforts by policymakers and health systems to address social determinants of health and to educate low-income Floridians about health literacy and available resources. In addition, lawmakers should consider additional incentives for providers to practice in rural and underserved communities.

Address avoidable use of healthcare facilities and resultant cost of care. Florida health systems need to do a better job of population health management, including dedicating the right resources to managing non-institutional care, identifying duplicative diagnostic tests and unnecessary care, and instituting appropriate interventions to reduce preventable ED visits and readmissions. This will also require empowering patients with more education and information about their health conditions and creating greater interoperability of electronic health record platforms.

Improve funding for public health. Florida consistently ranks among the lowest states for public health expenditures per 100,000 people. With its racial and ethnic diversity, weather-related risks, and an age mix skewing toward older adults, Florida policymakers should ensure that there are adequate resources for health equity initiatives, disaster response efforts, chronic disease management, and emerging public health threats.

Address the growing scarcity of adequate providers. As Floridas population swells and ages, the provider-to-population ratios continue to deteriorate. Legislators should consider scholarships and loan forgiveness programs for health care providers, particularly for mental health and primary care providers. In addition, health systems should periodically evaluate their recruitment and retention efforts to continually be able to attract and maintain a dedicated and high-quality workforce.

Create broad-based nutritional and exercise programs to minimize inactivity, obesity, and diabetes. Individual behavior is often the most difficult domain to legislate, monitor, and manage. Florida is blessed with an amazing cultural diversity, an abundance of natural resources, and plenty of opportunities for recreational activities. The raw materials for creating healthy lifestyles are already present within our state, but natural resources in and of themselves are not enough. State and community leaders will need to go further with concerted and focused efforts to eliminate food deserts, to provide early education in public schools on the importance of proper nutrition and exercise, to guarantee adequate emotional and mental health support for citizens, to encourage social support structures to benefit the entire community, and to promote spirituality and well-being for all Floridians.

Thanks to the framework and recommendations provided by the Healthy People 2030 initiative, there is a clear pathway to improving the health status of Floridians. Not easy, but clear. We need political will, leadership commitment, allocation of sufficient resources, development of fresh collaborations with private and nonprofit business partners, and an unwavering resolve to lead the way in America to becoming the healthiest state in the nation.

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Healthy People 2030 vs. The State of Florida: How to Get There from Here: SF STAT! - South Florida Hospital News

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