Preventing Chronic Disease | Monitoring Progress in Population Health: Trends in Premature Death Rates - CDC

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Preventing Chronic Disease | Monitoring Progress in Population Health: Trends in Premature Death Rates - CDC

Monitoring Progress in Population Health: Trends in Premature Death Rates

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• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Table

Patrick L. Remington, MD, MPH; Bridget B. Catlin, PhD; David A. Kindig, MD, PhD

Suggested citation for this article: Remington PL, Catlin BB, Kindig DA. Monitoring Progress in Population Health: Trends in Premature Death Rates. Prev Chronic Dis 2013;10:130210. DOI: http://dx.doi.org/10.5888/pcd10.130210.

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Abstract

Introduction
Trends in population health outcomes can be monitored to evaluate the performance of population health systems at the national, state, and local levels. The objective of this study was to compare and contrast 4 measures for assessing progress in population health improvement by using age-adjusted premature death rates as a summary measure of the overall health outcomes in the United States and in all 50 states.

Methods
To evaluate the performance of statewide population health systems during the past 20 years, we used 4 measures of age-adjusted premature (< 75 years of age) death rates: current rates (2009), baseline trends (1990s), follow-up trends (2000s), and changes in trends from baseline to the follow-up periods (ie, “bending the curve”).

Results
Current premature death rates varied by approximately twofold, with the lowest rate in Minnesota (268 deaths per 100,000) and the highest rate in Mississippi (482 deaths per 100,000). Rates improved the most in New York during the baseline period (−3.05% per year) and in New Jersey during the follow-up period (−2.87% per year), whereas Oklahoma ranked last in trends during both periods (−0.30%/y, baseline; +0.18%/y, follow-up). Trends improved the most in Connecticut, bending the curve downward by −1.03%; trends worsened the most in New Mexico, bending the curve upward by 1.21%.

Discussion
Current premature death rates, recent trends, and changes in trends vary by state in the United States. Policy makers can use these measures to evaluate the long-term population health impact of broad health care, behavioral, social, and economic investments in population health.

Author Information

Corresponding Author: Patrick L. Remington, MD, MPH, Population Health Institute, Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 4263 Health Science Learning Center, 750 Highland Ave, Madison, WI 53705. Telephone: 608-263-1745. E-mail:plreming@wisc.edu.

Author Affiliations: Bridget B. Catlin, David A. Kindig, Population Health Institute, Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

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References

1. Keppel K, Pamuk E, Lynch J, Carter-Pokras O, Kim Insun, Mays V, et al. Methodological issues in measuring health disparities. National Center for Health Statistics. Vital Health Stat 2 2005;141:1–16. PubMed
2. Remington PL, Booske BC. Measuring the health of communities — how and why? J Public Health Manag Pract 2011;17(5):397–400. CrossRefPubMed
3. World Health Organization. The World Health Report 2000. Health systems: improving performance. Geneva (CH): World Health Organization; 2000.
4. Nolte E, McKee M. Measuring the health of nations: analysis of mortality amenable to health care. BMJ 2003;327(7424):1129–33. CrossRefPubMed
5. Kelley ET, Arispe I, Holmes J. Beyond the initial indicators: lessons from the OECD Health Care Quality Indicators Project and the US National Healthcare Quality Report. Int J Qual Health Care 2006;18(Suppl 1):45–51. CrossRef PubMed
6. United Health Foundation. America’s health: state health ranking. http://www.americashealthrankings.org/2010/2010Edition.aspx. Accessed November 13, 2012.
7. University of Wisconsin Population Health Institute. County health rankings. www.countyhealthrankings.org. Accessed March 14, 2013.
8. Jemal A, Ward E, Hao Y, Thun M. Trends in the leading causes of death in the United States, 1970-2002. JAMA 2005;294(10):1255–9. CrossRefPubMed
9. Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed mortality files. CDC WONDER online database. http://wonder.cdc.gov. Accessed March 14, 2013.
10. Krieger N, Rehkopf DH, Chen JT, Waterman PD, Marcelli E, Kennedy M. The fall and rise of US inequities in premature mortality: 1960-2002. PLoS Med 2008;5(2):e46. CrossRef PubMed
11. Canadian Institute for Health Information. Health indicators 2012. https://secure.cihi.ca/free_products/health_indicators_2012_en.pdf. Accessed August 15, 2013.
12. Clegg LX, Hankey BF, Tiwari R, Feuer EJ, Edwards BK. Estimating average annual per cent change in trend analysis. Stat Med 2009;28(29):3670–82.CrossRef PubMed
13. Peppard PE, Kindig DA, Dranger E, Jovaag A, Remington PL. Ranking community health status to stimulate discussion of local public health issues: the Wisconsin County Health Rankings. Am J Public Health 2008;98(2):209–12. CrossRef PubMed
14. Rohan AM, Booske BC, Remington PL. Using the Wisconsin County Health Rankings to catalyze community health improvement. J Public Health Manag Pract 2009;15(1):24–32. CrossRef PubMed
15. Antos J, Bertko J, Chernew M, Cutler D, Goldman D, McClellan M, et al. Bending the curve: effective steps to address long-term healthcare spending growth. Am J Manag Care 2009;15(10):676–80. PubMed
16. Mokdad AH, Remington PL. Measuring health behaviors in populations. Prev Chronic Dis 2010;7(4):A75. PubMed
17. Parrish RG. Measuring population health outcomes. Prev Chronic Dis 2010;7(4):A71. PubMed
18. Newburn VH, Remington PL, Peppard PE. A method to guide community planning and evaluation efforts in tobacco control using data on smoking during pregnancy. Tob Control 2003;12(2):161–7. CrossRef PubMed
19. Kindig DA, Booske BC, Remington PL. Mobilizing Action Toward Community Health (MATCH): metrics, incentives, and partnerships for population health. Prev Chronic Dis 2010;7(4):A68. PubMed