Blog & News
Social Vulnerability Index in Minnesota: Community and Uninsured Profile Interactive Map Updated with SVI, MNsure Regions, and More
July 02, 2024:SHADAC has made some exciting updates to our resource, “Minnesota’s Community and Uninsured Profile.” This profile, created with funding from the Blue Cross and Blue Shield of Minnesota Foundation, was designed to provide accessible information to policymakers and community members alike on Minnesota uninsured people and populations.
Along with updating the profile with 2022 American Community Survey data, researchers have also updated and added to the interactive map of Minnesota that allows users to visually explore the information & data, including information on Minnesotan communities' social vulnerability index. Our hope is that this update will make it even easier for people to:
- Explore the varied communities in the state
- Evaluate community needs
- Monitor equity initiatives, and
- Inform strategic planning
Let’s take a look at the major updates we’ve made to both the profile and its accompanying interactive map:
1. Social Vulnerability Index (SVI) Added to Interactive Map at the Zip Code Level
SHADAC Researchers have added Social Vulnerability Index (SVI) ratings to the Minnesota Community and Uninsured Profile Interactive Map. What is SVI, though, and what does it mean for communities in Minnesota and beyond?
Social Vulnerability is defined by the Centers for Disease Control and Prevention (CDC) as, “the demographic and socioeconomic factors (such as poverty, lack of access to transportation, and crowded housing) that adversely affect communities that encounter hazards and other community-level stressors.” In short, it represents how vulnerable a community is to stressors, whether that’s a natural stressor (like a tornado or hurricane, for example) or human-caused (like a chemical spill, for example).
The Social Vulnerability Index (SVI) quantifies an area’s social vulnerability, assigning a numerical value that allows for comparison of different locations (counties, zip codes, etc.) to understand how different communities may respond to or be affected by hazards and stressors.
The index measures vulnerability based on four overall factors: socioeconomic status (including insurance status, educational status, housing costs, employment, poverty level), household characteristics (like age composition, English language proficiency, etc.), racial & ethnic minority status, and housing type & transportation (like multi-unit structures, mobile homes, access or lack of access to vehicle, public transit, overcrowding, etc.).
This SVI information now lives on the BCBS Minnesota Community and Uninsured Profile’s Interactive Map – users can click on each zip code area on the map revealing that area’s SVI along with other data such as rate of uninsured, population, and more. Find the map here or click on the image of the map.
2. Every Geographic Layer Now Clickable with Basic Stats
Before the latest update, users were only able to click on Zip Code Tabulation Areas (ZCTAs). Now, researchers have made it possible for users to click on various geographic layers. Along with ZCTAs, users can now click to get basic data (population, number of uninsured, and rate of uninsured) by:
- County
- Economic development region
- House district
- Senate district
- MNsure region
- And more
This allows users to view data in a larger variety of ways and view increasingly specific data in a more easily accessible way.
3. Toggle Other Relevant Factors
Researchers also updated the feature allowing users to toggle relevant indicators on the map such as:
- Native American reservation locations & names
- Hospitals
- Schools
- County seat
- And more
These relevant factors can have large impacts on that area’s overall community makeup and social vulnerability. For example, a geographic area that is close in proximity to multiple hospitals may be less socially vulnerable than a rural area that has no hospitals close by.
4. Profile Updated with Latest Available Data
Along with these key updates to the profile’s accompanying interactive map, researchers also recently updated the profile itself with 2022 American Community Survey data. Learn more about the data update in this blog post.
Start Using the Interactive Map to Learn About Minnesota’s Varied Communities
Understanding communities’ needs begins with understanding those communities and the people within them.
The Minnesota Community and Uninsured Profile was created to help people better understand the many diverse communities within the state. It provides users with important data and information that is accessible, specific, and relevant. Its accompanying interactive map puts that data and information into a clear visual space, helping users understand how geographic location impacts communities and their needs throughout the state.
Ready to learn more about the diversity of Minnesotan communities? Start exploring the interactive map here, and check out the full profile at this link.
Blog & News
Changes to Child and Adult Core Sets to Advance Equity (SHVS Cross-Post)
July 02, 2024:The following Expert Perspective (EP) is cross-posted from State Health & Value Strategies. Authors: Elizabeth Lukanen and Lacey Hartman, SHADAC
Original posting date June 7, 2024. Find the original post here on the SHVS website.
The Child and Adult Core Sets were established to measure the quality of care for Medicaid and Children’s Health Insurance Program (CHIP) enrollees, nationally and at the state level, based on a uniform set of measures. The goal of the Core Sets is to monitor performance and improve the quality of healthcare. Starting in fiscal year (FY) 2025, states will be required to report a subset of Child and Adult Core Set measures (see Table 1) by race and ethnicity, sex, and geography.
By requiring data disaggregation for key populations of interest, policymakers, advocates and researchers will have a new tool to measure, monitor and inform policies and practices that focus on health equity.
Table 1: Core Set Measures Subject to Stratification (10 Measures in Total)
Child Core Set Measures (7 of 27 measures) |
|||
Measure Name |
National Quality Forum (NQF) # |
Measure Steward |
Data Collection Method |
Well-Child Visits in the First 30 Months of Life (W30-CH) |
1392 |
National Committee for Quality Assurance (NCQA) |
Administrative |
Child and Adolescent Well-Care Visits (WCV–CH) |
1516 |
NCQA |
Administrative |
Oral Evaluation, Dental Services (OEV-CH) |
2517 |
Dental Quality Alliance (DQA) (American Dental Association) |
Administrative |
Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17 (FUH-CH) |
576 |
NCQA |
Administrative |
Prenatal and Postpartum Care Up to Age 20 (PPC2-CH) |
1517* |
NCQA |
Administrative or hybrid |
Live Births Weighing Less Than 2,500 Grams (LBW–CH) – CMS calculates on behalf of states |
1382 |
Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) |
State vital records |
Low-Risk Cesarean Delivery (LRCD-CH) – |
Not applicable |
CDC/NCHS |
State vital records |
Adult Core Set Behavioral Health Measures (3 of 11 measures) |
|||
Measure Name |
NQF # |
Measure Steward |
Data Collection Method |
Initiation and Engagement of Substance Use Disorder Treatment (IET-AD) |
0004 |
NCQA |
Administrative or electronic health record |
Follow-Up After Emergency Department Visit for Substance Use: Age 18 and Older (FUA-AD) |
3488 |
NCQA |
Administrative |
Follow-Up After Hospitalization for Mental Illness: Ages 18 and older (FUH-AD) |
0576 |
NCQA |
Administrative |
*No longer endorsed by NQF.
States will be required to stratify these mandatory measures using the following categories:
- Race and ethnicity: Using the newly released 2024 Revisions to the Office of Management and Budget’s Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity. Minimum categories include:
- American Indian or Alaska Native
- Asian
- Black or African American
- Hispanic or Latino
- Middle Eastern or North African
- Native Hawaiian or Pacific Islander
- White
- Sex: Defined as biologic sex, using the 2011 HHS Implementation Guidance on Data Collection Standards for Race, Ethnicity, Sex, Primary Language, and Disability Status. Categories include:
- Male
- Female
- Geography: Using the core-based statistical area (CBSA), which are county-based statistical areas defined by large population areas, as a minimum standard. Those categories include:
- Metropolitan statistical area (population core of 50,000 or more)
- Micropolitan statistical area (population core of 10,000 to 49,999)
- Outside Core Based statistical area
Background and Context
Every year, the Secretary of the U.S. Department of Health and Human Services is required to review and update the Child and Adult Core Sets. This review is designed to detect measurement gaps and to identify and recommend revisions to improve and strengthen the Core Sets. This review is led by a workgroup that includes input from a variety of stakeholders including states, managed care plans, healthcare providers, and quality experts. In response to the annual review process, state reporting of these measures has evolved and starting in FY 2024, reporting of the Child Core Set and the Core Set of behavioral health measures for adults enrolled in Medicaid became mandatory.
Over time, the Core Sets have been specifically recognized as a critical tool to monitor health disparities. Increasing stratification of the measures is a priority area for the Centers for Medicare & Medicaid Services (CMS) and in guidance released in 2022, CMS explicitly encouraged states to “use Core Set data to identify disparities in care and to develop targeted quality improvement efforts to advance health equity.”
During the review of the 2025 Core Set Measures, the Core Set review workgroup discussed using stratified Core Sets data to advance health equity. Workgroup members who represent state and enrollee perspectives both highlighted the importance of disaggregation for assessing member experience and monitoring equity while also acknowledging the challenges inherent to data collection and reporting. In response to this discussion, the following challenges and considerations were highlighted in the final FY 2025 recommendations report:
- Data on enrollee demographics is of variable quality, with missing and unknown data (enrollees who don’t provide data and related hesitancy).
- Administrative burden to collect this information.
- Political considerations for how the data are collected and reported (balancing state legislative agendas compared to CMS requirements).
- Technical challenges, such as having multiple conflicting sources of data.
- Misalignment of reporting stratification categories with other federal and state program requirements.
- Need to engage enrollees in the collection and use of these data.
- Need for technical assistance to states to meet the new reporting requirements.
Despite these challenges, there was consensus among the workgroup about the importance of stratification, which aligned with the new requirement that 10 measures be reported by race and ethnicity, sex, and geography. Specifically, for FY 2025 reporting, states will be required to report stratified data for the seven Child Core Set measures listed above in Table 1 (25% of the 27 measures) and three of the Adult Core Set behavioral health measures (25% of 11 behavioral health measures).
Required stratification of additional measures will increase over time and the intent is that all eligible mandatory Core Set measures will be disaggregated by FY 2028. States have the option of reporting stratified data for all measures starting in FY 2025.
People’s experience of health inequities based on race and ethnicity, sexual orientation, gender identity, geography, immigration status, and other factors, is a longstanding and pervasive problem that is deeply rooted in discrimination and structural racism. The Medicaid program, through its policy, financial, and programmatic levers, is uniquely situated to address the health inequities experienced by the program’s diverse population of enrollees. Key to these efforts is the availability of comparable state programmatic and performance data to identify and track progress.
For this reason, the move toward disaggregated Core Sets data by race and ethnicity, sex, and geography is an important step to improve the monitoring of health care access and quality for Medicaid enrollees, to further identify where disparities exist and to develop and evaluate quality improvement efforts. However, this is a small step that needs to expand to identify other groups that have been economically and socially marginalized such as those with a disability, individuals who identify as lesbian, gay, bisexual, transgender, queer, intersex, or outside the gender binary (LGBTQI+), and those with limited English proficiency.
In addition to expanding data disaggregation to include a broader range of groups, it will also be important to provide states with the necessary resources and technical assistance to analyze and report these data in an accurate and comparable way. As was also noted in comments to the workgroup, enrollee engagement in the collection and use of these data is also key for advancing health equity. Community engagement is a way to establish and build trust and to develop interventions informed by the lived experience of Medicaid enrollees.
Finally, it will be critical to provide states, providers, and community partners with the resources and tools necessary to ensure that timely action is taken to actually address, and not just report on, systemic inequities.
Want to stay informed on the latest data collection practices, survey updates, and more? Sign up for our monthly newsletter here, and find health equity resources here on the SHVS site.
Blog & News
Telehealth Visit Data, ACEs Data, Opioid Sales, and More Updated on State Health Compare
June 06, 2024:National Survey of Children’s Health Data (NSCH)
Adverse Childhood Experiences
National Health Interview Survey Data (NHIS)
Made Changes to Medical Drugs (NHIS)
Trouble Paying Medical Bills (NHIS)
Had Emergency Department Visit (NHIS)
Had Telehealth Visit (NHIS)
Had Usual Source of Medical Care (NHIS)
Had General Doctor or Provider Visit (NHIS)
Drug Enforcement Administration ARCOS Data
Sales of Opioid Painkillers
Data from the Bureau of Labor Statistics
Unemployment Rate
Stay Up to Date with the Latest Data
Other Related Reading:
Publication
Perceptions and Opinions Relating to Cannabis in Minnesota
Using data from the National Survey on Drug Use and Health (NSDUH), this brief explores people’s perceptions and opinions related to cannabis and cannabis use prior to its 2023 legalization in Minnesota. The brief begins with an overview of the context of cannabis policy and use in the United States before moving into analysis of perceptions on cannabis prior to legalization. Specifically, researchers analyzed respondents’ opinions on:
- How easy or hard it would be to obtain cannabis
- Perceived risk associated with smoking cannabis
- Disapproval (or lack thereof) of cannabis use by adults (age 18+) and youth (age 12-17)
Researchers from the University of Minnesota School of Public Health’s State Health Access Data Assistance Center (SHADAC) and Cannabis Research Center (CRC) present data on these three topics for Minnesota specifically and for the U.S. as a whole.
Examining data prior to legalization helps both researchers and the public understand Minnesota’s perceptions and attitudes surrounding cannabis before policy changes – then, as we move forward, we can compare this to post-policy data to understand what has changed, what hasn’t changed, and, hopefully, begin to answer common questions regarding cannabis use and legalization.
Will cannabis use increase with legalization? Will increased consumption lead to greater public health harms? Will rates of use increase for youth? Will perceived risk of use decrease with legalization?
“The answer [to these questions] may depend, in part, on whether the changing legal status of cannabis also changes social norms and people’s perceptions about cannabis, such as reducing social stigma associated with cannabis use,” says SHADAC and CRC Researcher Colin Planalp.
The data in this brief are intended to provide information to Minnesota policymakers as they set up the state’s regulatory framework surrounding cannabis. It also aims to give Minnesotans helpful information as they navigate the new choices that come with the lifting of decades of cannabis prohibition.
Continued research and monitoring of these and other issues will be crucial as cannabis policy, attitudes, and social norms evolve. Examining and understanding these opinions and perceptions can potentially reveal hints at how the cannabis landscape may change as a result of legalization.
Read the brief in full here. Additionally, SHADAC and the CRC authored a companion brief using the same survey data to examine the potential public health implications of cannabis policy in Minnesota. You can find that brief here.
Interested in learning more about cannabis policy in Minnesota, substance use, and related topics? Check out the following resources:
- SHADAC blog accompanying this brief - “Measuring Perceptions and Opinions on Cannabis Use in Minnesota”
- Brief on the United States Opioid Crisis – “Opioid Crisis in the Pandemic Era”
- Cannabis Research Center Website
- Explore data on the topic of substance use, alcohol-involved deaths, and more on State Health Compare