The Role of Social and Economic Research in Public Health Fran Ulmer 3/14/2006

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The Role of Social and Economic Research in
Public Health Fran Ulmer 3/14/2006
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Goals of health research

• Improve health of the population
• Improve efficiency of health care system
• Make health care more affordable
• Expand access to health care
• Understand ingredients of community wellness and
  environmental health
• Prevent accidents and high risk behavior
• Many more

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Many UAA Programs

• College of Health and Social Welfare
• Institute for Circumpolar Health Studies
• Center for Rural Health
• Center for Alcohol and Addiction Studies
• Center for Human Development
• Justice Center
• WAMI/Biomedical Program
• Biological Sciences
• Environment and Natural Resources Institute
• Geology, anthropology, sociology, psychology,
• nursing, journalism and public communication

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Institute for Circumpolar Health Studies

• Program evaluation to help providers improve
  their programs
• Injury prevention
• Alcohol addiction and inhalant abuse
• Climate change/human health (Carl Hild)
• Specifics like studying traffic patterns and
  pediatric asthma, diesel exhaust effects (Mary
  Ellen Gordian)

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ISER

• Evaluations, like dental health aide program in
  rural Alaska
• Economics of telehealth/ANTHC
• Community control of alcohol (Matt Berman)
• Rural sanitation programs (Sharman Haley)
• NIOSH aircraft safety study (Lexi Hill)
• Cost of health care in Alaska

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ISER Mission

• ISER enhances the well-being of Alaskans and
  others, through non-partisan research that helps
  people understand social and economic systems and
  supports informed public and private
  decision-making.
• ISER pursues it mission by
• Focusing attention on critical economic and
  social issues in Alaska , the Arctic , and
  similar regions
• Engaging in basic and applied research leading to
  better understanding of those issues and
• Disseminating knowledge through publications,
  community involvement, public service, and
  teaching.

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• The Institute of Social and Economic Research was
  established by the Alaska Legislature in 1961.
• ISER is part of the College of Business and
  Public Policy at UAA. It has a core staff of
  about 30 faculty members, research associates,
  and support personnel. Roughly one-third of its
  budget is from university money and two thirds
  from grants and contracts. ISER staff members not
  only do research but also teach undergraduate and
  graduate courses.
• ISER maintains the state's largest economic
  database and forecasts population and employment
  growth. All of ISER's research findings are
  published and are available at UAA or online at
  
  
  www.iser.uaa.alaska.edu

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Alaska 5 Billion Health-Care BillWhos
Paying? by Mark Foster and Scott Goldsmith
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Organization of Presentation

• Alaska Health-care spending in 2005
• Changes in spending since 1991
• Health-care Coverage
• High-and Low-Cost Patients
• Are We Healthier
• Alaska/U.S. Cost Comparisons
• Whats Driving Costs?
• What do we do to improve health care in Alaska?

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Alaska Health Care Spending
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How much is 5.3 billion in Alaska in FY2005

• Total K-12 Spending, All Sources, 1.3 B

• Total Employment Wages, 11.8B

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Changes in Alaska Health Care Spending1991-2005
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Health Coverage in Alaska
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Employee/Employer Contributions to Health
Insurance Premiums, Selected States
Employee Contribution Employer Contribution
Alaska 17 83
Wyoming 20 80
Washington 22 78
Oregon 24 76
Minnesota 25 75
Hawaii 26 74
Montana 28 72
Arizona 30 70
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6
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Source 2003 MEPS Data Private Firm Family
Coverage Premiums
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High Cost Low Cost Patients
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Are Alaskans Healthier?1990-2005
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Water and Sewer

• Substantial investments in rural Alaska
• Approximately 50 to 75 of villages
• Will the trend continue?

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Does water and sewer investment improve health?

• 24 of infants in villages with minimal water
  services are hospitalized for pneumonia (11 times
  the national average).
• Alaska low service vs. high service regions
  comparison 3 times incidence of pneumonia and
  influenza
• AuthorsTroy Ritter and Tom Hennessy (Centers for
  Disease Control and ANTHC) ADN 2/27/06

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Alaska U.S. Cost Comparisons
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Medical/Surgical Dental Procedures
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What is driving long term health care spending
increases
The Economics of Health Health Care, Folland,
Goodman, Stano, 4th Edition (2004), Chapter 8,
Extrapolating from Rand Analysis of U.S. Health
Care Expenditure Growth, 1945 c.1990
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How do we improve health care in Alaska?
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Challenge identify the issue, the funding, the
talent to do research that can improve the health
care delivery system and provide the research
results in a format and a forum that will make a
difference!
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Approaches for the future

• Research
• Data and analysis
• Alternative programs/other jurisdictions
• Legislation/administration
• Innovation
• Partnerships/collaboration
• Community awareness/information
• Prevention

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Initiatives

• Commonwealth North Health Roundtable
• DHSS insurance coverage study
• Legislation
• Information www.arctichealth.org
• UAA Health research think tank HeaRTT
• United Way community assessment/indicators
• AK Collaborative on Health the Environment
• Healthy Alaskans 2010 (DHSS targets)
• Others?

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What can you do?

• The role of the University
• The role health care providers
• The role of community leaders
• The role of employers
• The role of individuals