Dale Brill: “But I feel fine, really.” Assessing the health of Florida’s health

health

No visit to the doctor’s office starts without a systematic review of indicators that signal the health of the patient. Once you make it past the waiting room door, the examination begins with height, weight, blood pressure, temperature, pulse and oxygen level – just for starters.

Similarly, six measures can be used to inform the initial evaluation of Florida’s aggregate healthcare system. Think of them as conversation starters rather than an exhaustive list. We can always perform more detailed tests later.

The first symptom of interest addresses our life span. Premature death captures the age of death for persons younger than 75. The raw number reflects the number of years of potential life lost prior to age 75 per 100,000 persons in a state’s population. The most recent report from the Centers for Disease Control and Prevention (CDC) shows Massachusetts leading the nation with only 5,345 years. In contrast, Florida ranks 25th with 7,116 years lost prematurely. About 10 years ago (as reported in 2004), Florida ranked 33rd. Things are improving, but we find ourselves in the middle of the national pack.

Tallies of the average number of self-reported poor physical and mental health days, also serve to shape our assessment of life in the Sunshine State. Those two measures reflect the number of days in the past 30 that adults said either their mental health or physical health was not good as recorded by the CDC’s Behavioral Risk Factor Surveillance System.

Physically, Floridians rank 44th while South Dakota, Minnesota, Nebraska, Hawaii and Iowa shape the top five. Florida ranks a tad higher at 42nd in the measure of reported poor mental health days. The same five states form the top five in this category but only South Dakota holds the same position for reported physical and mental health at No. 1. So much for sunshine as a magic elixir.

Two symptoms signal how well the state’s healthcare system is proactively addressing Florida’s health issues:

Preventable hospitalizations is the rate of discharges attributed to “ambulatory care-sensitive conditions” among the Medicare population. In other words, conditions that could have been treated with outpatient care. Florida ranks 30th in the 2014 report from the Dartmouth Atlas of Health Care. In 2004, Florida ranked 20th.

Public health funding is a measure of money spent per person on public health typically targeting preventive and education programs. Recall that an ounce of prevention is worth a pound of cure, although spending on public health is less than 2 percent of all healthcare spending. The U.S. average is $90 per person with Alaska ($218.51), Hawaii ($212.86) and New York ($149.24) taking the top three slots. Florida ($57.98) holds the 35th position, having fallen from 28th in the Trust for America’s Health report 10 years earlier.

Finally, comparing the lack of health insurance provides an indication of access to healthcare across states. According to a two-year average calculated by the Annual Social and Economic Supplement Bureau of the Current Population Survey, Florida ranked 48th nationally. This represents a decline from 42nd about 10 years prior. Both sets of rankings reflect comparisons made before full implementation of the Affordable Care Act.

Those symptoms hardly present enough information to make a diagnosis. Yet a prognosis of what will happen if nothing changes strongly suggests continued decline.

Before we perform more tests, it appears that the business office representative failed to ask the one diagnostic question you should have expected before we actually began talking about your health: Who is your insurance carrier?

Dale Brill is founder and obsessive thinker for Thinkspot Inc., a Florida-based consulting firm. He previously was chief marketing officer for VISIT FLORIDA under Gov. Jeb Bush, director of the Office of Tourism, Trade & Economic Development in the Gov. Charlie Crist administration and president of the Florida Chamber Foundation. You can reach Dale by e-mail at [email protected]

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