Key Public Health Indicators

This passage aims to make a brief comparison the public health systems of Louisiana and Washington based on several key public health indicators. In our analysis, we choose 3 indicators in each category: health status, resources and risk factors for measuring the differences. We select the indicators not only based on their importance in public health, but also on whether they can be integrated into a comprehensive reflection public health conditions. And based on these, we find 3 meaningful differences in the public health systems of two states for further analysis.

We use the data (America's Health Rankings, 2016) to make our comparison. The reason for choosing this dataset is that it offers reliable and comprehensive public health data

by the state with well-defined measurement for indicators. As well it shows how much these indicators affect the health ranks of states, helping us find indicators causing important differences. We find that, in general, there is an obvious gap between Louisiana and Washington in public health condition.

1. Health Status. The three indicators of health status we choose are diabetes, cancer deaths and poor mental health days. Diabetes is an indicator of the prevalence of a common chronic disease; cancer deaths monitor the death rate of a common chronic disease, and poor mental health days indicates mental health condition of the population.
1a. Diabetes. It is measured by “Yes” responses to the question of “Have you ever been told by a doctor that you have diabetes?” In Louisiana, 11.3% adults have diabetes, and in Washington, 8.9% adults have diabetes.
1b. Cancer Deaths. In Louisiana, 217.9 deaths per 100,000 population happen due to all kinds of cancer, while 182.8 deaths per 100,000 populations happen for the same reason.
1c. Poor Mental Health Days. The measurement is the number of days in last 30 days the adults self-reported their mental health was not good. In Louisiana, people have 3.9 poor mental health days on average, and in Washington, people have 3.7 poor mental health days.

2. Resources. Three indicators of resources are health insurance, immunization, and dentists. Health insurance give a financial access for health service; immunization gives a primary prevention for people; practitioners such as dentists offer specialized services in diagnosis and treatment.
2a. Health Insurance. 15.7% of the population in Louisiana reported that they have no health insurance privately, through their employers or government. In Washington, the ratio of lacking health insurance is only 11.6%.
2b.

Immunization. It is measured by combined average z-score of the percentage of adolescents of age 13 to 17 years who have received 1 dose of Tdap since the age of 10 years, 1 dose of meningococcal conjugate vaccine, and 3 doses of HPV. Louisiana gets 0.655 in this area and Washington gets 0.287.

2c. Dentists. Among every 100,000 population, there are 48 practicing dentists in Louisiana and 71 practicing dentists in Washington.

3. Risk Characters. The three indicators of risk characters are smoking, obesity and children in poverty. All the three factors are closely related to multiple diseases. And they reflect factors of habits, lifestyle, and social status among the population, respectively.

3a. Smoking. It is measured by self-report as smoking at least 100 cigarettes in their lifetime and currently smoke. There are 24% of the population of Louisiana are smokers compared with the ratio of 15.3% in Washington.

3b. Obesity. The measurement of obesity is the self-report with a body mass index (BMI) of 30.0 or higher in adults. In this measurement Louisiana has 34.9% of the population in obesity, while Washington has 27.3% of the population in

obesity.
3c. Children in Poverty. The measurement is that young people who are under 18 years old live in households are at or below the poverty threshold. 33.7% of young people in Louisiana are in this condition, twice as much as the ratio of 16.8% in Washington.

The Difference in Public Health Systems.

To focus on the important differences between public health systems between Louisiana and Washington, we choose the indicator in which the two states have the most disparity from each category: 1a. Diabetes, 2b. Immunization and 3c. Children in Poverty.

In Louisiana, 11.3% adults have diabetes, 27% higher than the ratio of 8.9% in Washington. It may partly due to the higher obesity in Louisiana. The higher prevalence of diabetes needs more doctors, medicine and other health resources for costly third prevention, so it is a heavy burden to public health in Louisiana in a long time. To fill the gap in the future, Louisiana can put more resource into primary prevention, such as promoting healthy lifestyle projects (in diets and exercise) in the community.

As well, Louisiana has 33.7% children in poverty, twice more than the ratio of 16.8% in Washington. This social risk factor has both direct negative effects on health, such as lacking financial access to health service, and indirect negative effects, such as lack of education in health and unhealthy lifestyle. And both effects are important obstacles to primary prevention. To reduce the effects of the gap needs not only the extension of public services but also reforms in economic and social policy for more benefits to the poor in

Louisiana.
However, Louisiana does a better job in immunization, with 0.655 z-score, as 2.3 times high as the 0.287 of Washington in adolescent immunization coverage. It indicates that the population of Louisiana get a better primary prevention from infectious diseases, and have a lower risk of falling into epidemic disaster. As a state with a dense population, Washington should invests more in coverage of immunization and prepare better for prevention of epidemics for its public health system.

In conclusion, although most public health conditions in Louisiana are not as satisfying as Washington, there are indicators like immunization shows that Louisiana has abilities to do a better job in its primary prevention. We hope that more focus and comprehensive resources in primary prevention from public health, economics, and social policy can help Louisiana reduce the gap between it and Washington in public health system.