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State Health Compare: State-Level Data Resources on Measures of Health Equity (Part Two - Health Behaviors, Health Outcomes, Social and Economic Factors)
February 10, 2022:Health equity and social determinants of health (SDOH) are rapidly growing fields of public health research. SHADAC researchers believe that making strides toward achieving health equity depends equally on better understanding health disparities as well as on making concerted, measurable efforts toward reducing avoidable differences in populations’ health outcomes.
This blog, the second in a two-part series, provides a high-level overview of a range of state-level measures currently housed on SHADAC’s online data tool, State Health Compare, which may help states understand and track trends across indicators of health equity, such as health behaviors, health outcomes, and social and economic factors.
Health Behaviors
Achieving health equity across the nation means ensuring equal opportunities for individuals to live healthy lives, and part of this goal includes addressing disparities in social determinants of health such as drinking or smoking, as well as guaranteeing access to care and treatment for these behaviors.
Adult Smoking (2005-2010, 2011-2020)*
This measure shows the percent of adults who reported smoking, defined as adults who have smoked 100 or more cigarettes in their lifetime and who currently smoke some days or every day. The measure is broken down by race/ethnicity and educational attainment. Related Resource: SHADAC researchers used data from the Behavioral Risk Factor Surveillance System (BRFSS) to produce analyses focused on several different health behaviors, including Adult Smoking and E-cigarette Use in the United States. This blog, part of a spotlight series including binge drinking and obesity, looks at national and state-level rates at which adults with different racial/ethnic backgrounds smoke and vape in 2018 and 2017.
Adult E-Cigarette Use (2016-2020)
This measure shows the percent of adults who reported currently using e-cigarettes some days or every day. The measure is broken down by age, race/ethnicity and educational attainment. Related Resource: SHADAC researchers used data from the Behavioral Risk Factor Surveillance System (BRFSS) to produce analyses focused on several different health behaviors, including Adult Smoking and E-cigarette Use in the United States. This blog, part of a spotlight series including binge drinking and obesity, looks at national and state-level rates at which adults with different racial/ethnic backgrounds smoke and vape in 2018 and 2017.
Adult Binge Drinking (2005-2010, 2011-2020)*
This measure shows the percent of adults who reported binge drinking, defined as having on one occasion, four or more drinks for women or five or more drinks for men. The measure is broken down by race/ethnicity and educational attainment. Related Resource: SHADAC researchers used data from the Behavioral Risk Factor Surveillance System (BRFSS) to produce analyses focused on several different health behaviors, including Adult Smoking and E-cigarette Use in the United States. This blog, part of a spotlight series including smoking/e-cigarette use and obesity, looks at national and state-level rates at which adults with different racial/ethnic backgrounds smoke and vape in 2018 and 2017.
Health Outcomes
Closing the persistent gaps in health outcomes (e.g., higher rates of preventable conditions, disease prevalence, or premature death) between certain populations or geographic regions is an important step toward health equity.
Health Status (2005-2017, 2017-2020)*
Specifically, this measure on State Health Compare shows the percent of the adult population who report being in either poor or fair health. Estimate breakdowns are available by education level and race and ethnicity.
Adult Unhealthy Days (2011-2020)
Data users can examine this measure in a variety of ways. Overall, the measure captures the average composite number of days in the past 30 days that an adult’s mental or physical health was not good. Users can also individually examine the average number of mentally and physically unhealthy days in the past 30 days. Additionally, for each variation of this measure, users can make comparisons by age, health insurance coverage type, disability status, educational attainment, household income categories, and race and ethnicity are all available. Related Resource: Combining several years of data (2018-2020) from the Behavioral Risk Factor Surveillance System (BRFSS), SHADAC researchers produced one-page infographics that show how all 50 states and D.C. compare to the U.S. average in measures of people’s self-reported physical and mental health, and how people’s physical and mental health varies depending on their race and ethnicity, level of income, and age within each state.
Activities Limited due to Health Difficulty (2005-2010, 2011-2020)*
Similar to the “Adult Unhealthy Days” measure, estimates for “Activities Limited due to Health Difficulty” show the average number of days in the previous 30 days when a person indicates their activities are limited due to mental or physical health difficulties.
Chronic Disease Prevalence (2005-2010, 2011-2018)*
This measure captures the percent of adults who reported having one or more common chronic conditions such as diabetes, cardiovascular disease, heart attack, stroke, or asthma. Comparisons across rates can be made by race/ethnicity and educational attainment.
Cancer Incidence (2000-2018)
Estimates for this measure provide an age-adjusted rate per 100,000 people of breast, cervical, lung and colorectal cancer occurrence, and can be viewed by race/ethnicity subcategories.
Premature Death (2000-2019)
This measure provides a composite estimate of the average number of years lost due to premature death (deaths that occur before the average age of death within a given population) prior to age 75. Estimates are available by race/ethnicity breakdowns.
Suicide Deaths (1999-2020)
Estimates for this measure provide the age-adjusted rate of suicide deaths per 100,000 people. The data are available to view by age, race/ethnicity, sex, method, and metropolitan status subcategories. Related Resource: For the past several years, SHADAC researchers have produced an annual report looking at the alarming trend of rising suicide deaths in the U.S. Particularly concerning is the accelerated rate at which suicide deaths have increased across the nation in recent years, as well as the steep increase in deaths for children age 10-14. SHADAC also held a webinar discussing this growing public health issue, highlighting concerning trends and variations in suicide deaths by a variety of breakdowns.
Social and Economic Factors
A number of factors, from social to structural and economic to educational, can significantly impact goals of health equity, as well as present serious roadblocks in achieving more equitable and ideal health outcomes.
Children Considered to be Poor (2008-2019)
This measure details the percent of children considered to be poor, as defined by falling below 100% of the Federal Poverty Guidelines (FPG) set to measure the minimum amount of total income that a family needs for food, clothing, transportation, shelter and other necessities. This measure can be broken down by race/ethnicity.
Unemployment Rate (2000-2020)
Estimates for this measure represent the percent of the civilian labor force (age 16 and older) that was unemployed in the past year. A person is considered “unemployed” if they do not have a job, have actively looked for work in the prior 4 weeks, and/or are currently available for work. Breakdowns for this measure are available by race/ethnicity. Related Resource: SHADAC researchers recently produced a new analysis examining unemployment by racial/ethnic breakdowns—an important lens for analyzing unemployment as a social determinant of health, with unemployment often varying widely across racial/ethnic categories.
Unaffordable Rents (2012-2019)
The Unaffordable Rents measure is a state- and national-level indicator of housing affordability that measures the percent of rental households that spent more than 30 percent of their household’s monthly income on rent. This measure is available to be broken down by a significant number of categories, including disability status, household income, Medicaid enrollment, metropolitan status, and race (white/non-white). Related Resource: An analysis by SHADAC looked at the percent of cost-burdened rental households in each state in 2017, examining unaffordable rents overall while also analyzing unaffordable rents among rental households. SHADAC researchers also created state infographics for the five states with the highest percentages of unaffordable rents among rental households that had a Medicaid enrollee.
Adverse Childhood Experiences (2016-2020)
A more recent measure on State Health Compare, adverse childhood experiences, or ACEs, provides an estimation of the percent of children who experience events between the ages of 0-17 that have the potential to leave lasting traumatic impressions, such as violence, abuse, or neglect; witnessing violence in the home or community; or having a family member attempt or die by suicide. ACEs also include experiencing pervasive conditions that undermine a child’s sense of safety and stability, such as growing up in a household with substance misuse, mental health problems, and instability due to parental separation or household members being in jail or prison. Users can make comparisons in rates by subcategories of age, health insurance coverage type, education levels, poverty levels, and race/ethnicity.
Notes
For a full overview of all available state-level measures, please visit the “Explore Data” page on State Health Compare, or take a look at our one-page guide to State Health Compare measures and their data sources.
All measures marked with an “*”: This indicates a break in series due to survey changes in either data processing or implementation methodology.
