Walsh, Elliot
Research Dissemination Coordinator

e wals0421@umn.edu

Disability Health Care Data and Information: Resources from SHADAC

• Unfair treatment in health care settings, at work, or when applying for public benefits
• Adults with disabilities are more likely to live in poverty compared to adults with no disability
• People with a disability often have increased medical expenses, with a study from the National Disability Institute estimating that a U.S. household containing an adult with a disability must spend an estimated 28% more income to obtain the same standard of living as a household with no disability
• Those with disabilities have twice the risk of developing chronic health conditions like depression, diabetes, asthma, and poor oral health

Federal Survey Sample Size Analysis: Disability, Language, and Sexual Orientation and Gender Identity

• People who indicated sexual orientation or gender identity (SOGI)
• People with language access needs, and
• People with disabilities

Collection of Self-Reported Disability Data in Medicaid Applications: A Fifty-State Review of the Current Landscape (SHVS Brief)

States are likely undercounting the number of people with disabilities in their Medicaid programs. While some people with disabilities are covered by Medicaid as a result of disability- related eligibility, little is known about people with disabilities who are eligible on the basis of income or other factors. 

 

This State Health and Value Strategies (SHVS) Brief authored by SHADAC researchers Emily Zylla and Elizabeth Lukanen provides an overview of current disability data collection standards, including information on how states are collecting self-reported disability information on Medicaid applications. SHADAC researchers reviewed paper Medicaid applications for all 50 states and the District of Columbia alongside online applications for 36 states and the District of Columbia. 

 

Understanding and collecting better demographic data about the types of disabilities Medicaid enrollees experience can help us both identify any existing inequities and tailor possible solutions and resources appropriately. Read the brief in full here.

State Health Compare Disability Breakdowns

On SHADAC’s State Health Compare tool, users are able to examine a number of different measures related to health and health care at the state level. A number of these measures can be broken down by demographic categories, including by disability status, including:

• Health Insurance Coverage Type
• Broadband Internet Access
• Adult Unhealthy Days
• Unaffordable Rents

Data disaggregation such as this can help in identifying differences, trends, and similarities between different groups and demographics. See an example of what you can do with this data below, where we breakdown the measure ‘Adult Unhealthy Days’ by Disability Status.

Explore all of the measures including each of their available breakdowns at this link.

Housing Affordability Matters: Unaffordable Rents Infographics Updated with 2022 Data

Using data from the American Community Survey (ACS) in the ‘Unaffordable Rents’ measure on State Health Compare, we created a blog plus six accompanying infographics containing information on the connection between affordable housing and health. Within these publications, we included specific information on housing affordability for households with a person with a disability alongside all rental households to understand any differences in unaffordable rents between demographic groups.

 

For example, in the United States as a whole, 47.3% of rental households had unaffordable rents in 2022. In rental households that include a person that has a disability, that jumps to 54% had unaffordable rents in 2022. 

 

These resources also present data on other demographic groups including Medicaid enrollees, people of color, and household incomes less than 25,000 annually.

 

 

You can find each of the infographics created for the US and five individual states along with an explanatory blog on the topic here.

Minnesota Community and Uninsured Profile

This resource, originally funded by the Blue Cross Blue Shield of Minnesota Foundation, provides users with a tool that provides rates and counts of uninsured Minnesotans at various levels (ZIP code, county, MNSure rating area, state, etc.). The profile then can provide further breakdowns by a number of demographic factors, including by age, income, educational attainment, and disability status.  

 

Explore the profile here.

 

While this profile currently represents communities and uninsured populations from the single state of Minnesota, SHADAC researchers can provide additional technical assistance, profile customization, and analysis to other organizations and groups upon request.

 

If you or your organization is interested in working with this profile, or creating one relevant to you or your needs, don’t hesitate to reach out at shadac@umn.edu or on our contact page here.

Stay Informed on Disability Health Data Resources and Information

The resources and products above represent just some of the work SHADAC is doing that we hope can help advance health equity. Examining different demographic groups, identities, and experiences helps researchers, policymakers, and other stakeholders understand the challenges and barriers different people face – and, hopefully, use that information to tailor health equity work towards those differing needs in the future. 

 

You can stay up to date on our latest releases and updates by following us on LinkedIn, or by signing up for our newsletter.

 

Continue your journey to understand health disparities and health equity with the following products:

• Medicaid Equity Monitoring Tool Project
• LGBT Health Equity: Sexual Orientation and Gender Identity Data Resources from SHADAC
• Provider Discrimination by Sexual Orientation Among Cisgender and Transgender/Nonbinary Adults in Minnesota

Walsh, Elliot
Research Dissemination Coordinator

e wals0421@umn.edu

LGBT Health Equity: Sexual Orientation and Gender Identity Data Resources and Information from SHADAC

• Less likely to have health insurance coverage 
• Less likely to have a regular health care provider
• More likely to delay care
• More likely to report poor quality care and unfair treatment from providers

Sexual Orientation and Gender Identity Data: New and Updated Information on Federal Guidance and Medicaid Data Collection Practices (SHVS Brief) 

State Health Compare: Explore Health Data with SOGI Data Breakdowns

• Adults Who Forgo Needed Medical Care Due to Cost
• Adult Smoking
• Adult Excessive Alcohol Consumption
• Adult E-Cigarette Use
• Chronic Disease Prevalence
• Adult Unhealthy Days
• Activities Limited Due to Health Difficulty
• Adults with No Personal Doctor
• Adult Cancer Screenings
• Adult Flu Vaccinations

Gender Based Discrimination in Health Care by Gender Identity in Minnesota

• Over half (57.1%) of trans and non-binary people reported forgone care—more than double the overall average of 26.2%
• Nearly one-third of trans and non-binary adults had low confidence in getting necessary health care—compared to the overall average of 11.8%

Examining Discrimination and Health Care Access by Sexual Orientation in Minnesota

• Both lesbian/gay and bisexual/pansexual people were more likely to report barriers to health care access
• Bisexual/pansexual people were more likely to report having low confidence in the ability to get needed health care
• Both lesbian/gay or bisexual/pansexual people had significantly higher rates of forgone care

SHADAC Response to 2023 Request for Comments on American Community Survey SOGI Questions

Stay Up to Date on the Latest in SOGI and LGBT Health Data

• Medicaid Equity Monitoring Tool Project
• Affordable Housing and Health: Unaffordable Rents Infographics
• Collection of Self-Reported Disability Data in Medicaid Applications: A Fifty-State Review of the Current Landscape (SHVS Brief)

Walsh, Elliot
Liu, Grace

Social Vulnerability Index in Minnesota: Community and Uninsured Profile Interactive Map Updated with SVI, MNsure Regions, and More

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.

Hartman, Lacey
Lukanen, Elizabeth

Changes to Child and Adult Core Sets to Advance Equity (SHVS Cross-Post)

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.

Walsh, Elliot
Research Dissemination Coordinator

e wals0421@umn.edu

Telehealth Visit Data, ACEs Data, Opioid Sales, and More Updated on State Health Compare

National Survey of Children’s Health Data (NSCH)

Adverse Childhood Experiences

Adverse Childhood Experiences (ACEs) are traumatic events that occur during childhood, and include physical and emotional abuse, neglect, and household dysfunction, amongst others. These experiences can have long-term impacts on health and wellness long after childhood.

National Health Interview Survey Data (NHIS)

Made Changes to Medical Drugs (NHIS)

‘Made Changes to Medical Drugs’ is defined as the rate of individuals who made changes to medical drugs because of cost during the past twelve months by age for the civilian non-institutionalized population. Asking a medical provider to switch to a cheaper medication, taking less medication than prescribed, skipping dosages, using alternative therapies as a replacement, and delaying refills are all examples of how someone could make changes to medical drugs due to cost. Making changes such as these can have negative impacts on both short- and long-term health.

Trouble Paying Medical Bills (NHIS)

This measure tracks the percentage of people who had trouble paying off their medical bills in the last year. Like the ‘Made Changes to Medical Drugs’ measure, this can help understand and track health care affordability in the United States. This is especially relevant as the United States has some of the highest health care costs in the world.

Had Emergency Department Visit (NHIS)

Visits to the Emergency Department (ED) (also called the Emergency Room) are often costly and, in a surprisingly large number of cases, preventable. It’s estimated that between 13% and 27% of ED visits could be managed in primary care offices, clinics, and/or urgent care centers. 

Had Telehealth Visit (NHIS)

Telehealth, also called telemedicine, can expand access to care for many individuals and communities. Telehealth services conducted by phone or by video allow individuals to be connected with a health professional when they cannot get an in-person appointment, cannot safely leave their home, or lack transportation to get to an appointment, among a number of other reasons. Access to telehealth was expanded during the COVID-19 pandemic and has remained a popular way to access care.

Had Usual Source of Medical Care (NHIS)

When individuals do not have a usual source of medical care, health outcomes can be affected. For example, individuals may not seek care when they have a medical issue, which can result in delayed diagnosis of disease, worsening health conditions, etc. Lacking a usual source of care also means that people may miss out on preventative services and/or recommended screenings (like cancer screenings). They may also seek care in an Emergency Department, which we discussed earlier as being more costly and inefficient for both patients and health professionals.

Had General Doctor or Provider Visit (NHIS)

Utilization of health care services with a general doctor or provider is an important health-related behavior – seeing a general doctor allows individuals to obtain information about their health status, receive preventative services & screenings, maintain (or improve) their health and well-being, and respond to health problems with guidance from a professional health care provider. Seeing a provider can also form a relationship between patient and doctor/provider, where the doctor knows and monitors the patient over time.

Drug Enforcement Administration ARCOS Data

Sales of Opioid Painkillers

The Opioid Epidemic in the United States is widespread and destructive - since 2000, the annual number of overdose deaths from any kind of drug in the U.S. has multiplied nearly six times over, rising from 17,500 to over 106,000 people in 2021. Opioids caused a majority of these deaths, including both legal drugs and illicit drugs like heroin and fentanyl.

Data from the Bureau of Labor Statistics

Unemployment Rate

During the COVID-19 pandemic, the unemployment rate in the United States peaked at 14.8% in April 2020, which is the highest unemployment rate since 1948 (when unemployment data collection first began). 

Stay Up to Date with the Latest Data

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