South Florida Hospital News
Tuesday November 24, 2020
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November 2020 - Volume 17 - Issue 5
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Healthy People 2030 vs. The State of Florida: How to Get There from Here

Just last month, the federal Department of Health and Human Services came out with its blueprint for public health action: Healthy People 2030. Healthy People 2030 contains 355 science-based health status objectives which have been categorized under five classifications: health conditions, health behaviors, populations, settings and systems, and social determinants of health. 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. For now, we’ll 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 doesn’t show a very rosy picture for Florida.)
 
There are four organizations which have recently rated Florida’s health status performance as compared to all other states: (1) The Commonwealth Fund, a private foundation whose mission is to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable including low-income people, the uninsured, and people of color; (2) The United Health Foundation, a not-for profit, private foundation established by the UnitedHealth Group and dedicated to improving health and health care; (3) U.S. News & World Report, a multi-platform publisher of news and information, which includes authoritative rankings in a variety of categories, including a ranking of the Best States for Health Care; and (4) WalletHub, a private company owned by Evolution Finance which conducted a review of the best and worst states for health care.
 
Here is Florida’s health status ranking as reported by these four different agencies:
 
Reporting Organization                Date of Publication          Florida Ranking (out of 50 states)
1. Commonwealth Fund                   August 2020                                 41
2. United Health Foundation         December 2019                               33
3. U.S. News & World Report                2019                                        29
4. WalletHub                                    August 2020                                  37
 
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 Florida—always 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. 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.
- Address avoidable use of healthcare facilities and resultant cost of care. Florida health systems need to do a better job of population health management and eliminating duplicative and unnecessary care.
- Improve funding for public health. Florida consistently ranks among the lowest states for public health expenditures per 100,000 people. 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 Florida’s population swells and ages, the provider-to-population ratios continue to deteriorate. 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. But we need policies which support healthy behaviors: elimination of food deserts, early nutritional and physical education in public schools, adequate emotional and mental health support, and social support structures to benefit the entire community.
 
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.

Calvin Glidewell is President and CEO of inspirEx Healthcare Strategies.

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