Healthy People 2010 Focus Area 1:

Access to Quality Health Services

Progress ReviewJune 15, 2006

1-1. Health insurance coverage1-2. Health insurance coverage for clinical preventive services *1-3. Counseling about health behaviors

Clinical Preventive Care Emergency Services

Primary Care

Long-Term Care & Rehabilitative Services

1-10. Difficulty or delay in getting emergency care1-11. Rapid pre-hospital emergency care1-12. Toll-free number for poison control centers1-13. Trauma care systems1-14. Pediatric guidelines & protocols

1-4. Source of ongoing care1-5. Usual primary care provider1-6. Difficulty or delay in getting care1-7. Core competencies in health provider training1-8. Racial/ethnic representation in health professions1-9. Hospitalizations for ambulatory care-sensitive conditions

1-15. Access to long-term care services1-16. Pressure ulcers among nursing home residents Proposed for deletion*

Improving Getting worse

Little or no change Baseline onlyTarget met

Mixed progress

Status of Access to Quality Health Services Objectives

1-12. Toll-free number for poison control centers

TargetMet

BaselineData

Obtained

Modified at Midcourse*

1-3. Counseling about health behaviors

1-7. Core competencies in health provider training

1-11. Rapid pre-hospital emergency care

1-13. Trauma care systems

1-15. Access to long-term care services

Progress: Three quarters of objectives and subobjectives with data beyond the baseline year are moving toward their targets.

Status of Access to Quality Health Services Objectives

* Midcourse modifications are proposed and are subject to final approval by HHS.

Asi

an

Nat

ive

Haw

aiia

n or

oth

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Isla

nder

His

pani

c or

Lat

ino

Whi

te, n

ot H

ispa

nic

Fem

ale

Mal

e

Nea

r poo

r

Mid

dle/

high

inco

me

Urb

an o

r met

ropo

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Pers

ons w

ith d

isab

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s

Health insurance: < 65 years(1997, 2004) B B B B B

Source of ongoing care: all ages (1998, 2004) B B B B

Source of ongoing care: 18+ years (1998, 2004) B B B B

Usual primary care provider (1996, 2003) B B B

Delays or difficulties in obtaining needed health care (1996, 2001) B B B B

Poor

Bla

ck, n

ot H

ispa

nic

B

Population characteristicsDisability

Pers

ons w

ithou

t dis

abili

ties

B

B

B

Rur

al o

r non

met

ropo

litan

B

1-1.

Gender

1-5.

1-6.

1-4a.

Population-based objectives

Race and ethnicity

Two

or m

ore

race

s

LocationIncome

Am

eric

an In

dian

or

Ala

ska

Nat

ive

1-4c.

Objectives with Changes in Disparity Since the Baseline

Note: Disparities are measured relative to the group with the best rate. Changes in disparity since the baseline, indicated by arrows, are between 10 and 49 percentage points and statistically significant at the 0.05 level. Data are not shown for objectives with insufficient data or for objectives with no change in disparity since the baseline for any of the characteristics shown.

Characteristic not selected for this objective.=

Increase in disparity=

Decrease in disparity=

B = Group with the best (most favorable) rate.

Clinical Preventive Care

Emergency Services

Primary Care

Long-Term Care & Rehabilitative Services

Highlighted Objectives

1-1. Health insurance coverage1-3. Counseling about health behaviors

1-13. Trauma care systems

1-15. Access to long-term care services

Improving Getting worse

Little or no change Baseline onlyTarget met

Mixed progress

1-5. Usual primary care provider1-6. Difficulty or delay in getting care1-8. Racial/ethnic representation in health professions1-9. Hospitalizations for ambulatory care-sensitive conditions

Nearpoor

50

Percent

2010 Target

70

60

80

90

100

Obj. 1-1I = 95% confidence interval. † Preliminary data for January – September 2005. Source: National Health Interview Survey, CDC, NCHS.

Family Income Level

Persons Under Age 65 with Health Insurance, by Income and Age, 2004

0 Poor Middle/high

10-14 15-19 20-24

Age

1997 2004

Total 25-64

2005 †

Obj. 1-1I = 95% confidence interval.Note: The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories are for persons who reported only one racial group.Source: National Health Interview Survey, NCHS, CDC.

Percent

2010 Target

American Indian/Alaska Native

Asian Native Hawaiian/

Pacific Islander

1999 2004

Persons Under Age 65 with Health Insurance, by Race/Ethnicity

Black White Hispanic

50

70

60

80

90

100

0

Percent 18-24 yrs.

50

60

70

† Among adults who currently smoke. ‡ Among adults who currently report risky drinking behavior. I = 95% confidence interval.* Data for persons 75 years and older are statistically unreliable and are suppressed. Note: Data exclude adults who did not have a health care visit in the past year. Source: National Health Interview Survey, CDC, NCHS.

25-44 yrs.

Adults Counseled by Their Provider about Health Behaviors, by Age

Group, 2001

0

45-64 yrs. 65-74 yrs.

40

30

20

10

8075+ yrs.

Obj. 1-3 a-d

PhysicalActivity

Diet & Nutrition

Smoking Cessation†

Risky Drinking‡

*

2010 Target

BlackNative Hawaiian

0Percent

2010Target

4020

Total

Female

Hispanic

Male

Asian

60 80 100

Obj. 1-5

Persons with a Usual Primary Care Provider, 2003

Note: The American Indian category includes Alaska Natives. The Native Hawaiian category includes Pacific Islanders.The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ.

Less than high schoolHigh school

At least some college

American Indian

White

With activity limitationsWithout activity limitations

0Percent

2010 Target

105

Total

White

Female

Hispanic

Male

Asian/Pacific Islander

15 20 25

Persons Experiencing Difficulties or Delays in Obtaining Needed Care,

2001

Note: The American Indian category includes Alaska Natives. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ.

PoorNear poor

Middle/high income

American Indian

Black

With activity limitationsWithout activity limitations

Obj. 1-6

Decrease desired

Obj. 1-8 a,c,d

Note: Data are based on graduates from schools of public health, dentistry, pharmacy, and medicine. The 2010 targets are based on the U.S. Bureau of Census projections of the proportion of persons in each racial/ethnic group in the U.S. population in the year 2000.The Asian/Pacific Islander group has exceeded its target of 4% and is not shown. Source: Bureau of Health Professions, HRSA.

Percent

American Indian/Alaska Native

1996-1997 2003-2004

Racial and Ethnic Groups Underrepresented in Health

Professions

10

15

0 Black orAfrican

AmericanHispanic or

Latino

5

2010 Target

SOURCE: Healthcare Cost and Utilization Project, AHRQ.

Hospitalizations for Uncontrolled Diabetes among Persons Aged 18-64

Years

Total MedicaidFemale Male Private UninsuredGender Insurance Status

Admissions per 10,000 population

Obj. 1-9b

1996 2003

0

20

10

30

402010 Target

Decrease desired

D.C.

States With Processes to Monitor andEvaluate Trauma System Outcomes,

2002

Obj. 1-13hSource: Federal Trauma-EMS Systems Program Survey, HRSA.

Legislated system & defined process (23)

No system & no defined process (21)

Non-legislated system & defined process (7)

Native Hawaiian

*

0Age-Adjusted Percent

2010 Target

5

Total

Hispanic

Asian

15 20 25

Obj. 1-15a

Persons Age 65 and Over without Access to Needed Home Health Care,

2001

* Data are statistically unreliable and are suppressed. = 95% confidence interval. MSA: Metropolitan Statistical Area. Note: Data are age adjusted to the 2000 standard population. The American Indian category includes Alaska Natives. The black and white categories exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons are defined as needing home health care services if they require assistance with personal care needs or routine care needs. Source: National Health Interview Survey, CDC, NCHS.

American Indian

Black

Within MSAOutside MSA

White

**

PoorNear poor

Middle/high income

10

Decrease desired

Progress review data and slides

are available on the web at:

http://www.cdc.gov/nchs/hphome.htm