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Title-less Presentation

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Brita Roy

on 20 July 2015

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Personal Well-Being Index #4 and #6
Short Flourishing Scale
Social support
Social network size and quality (positive/negative)
Quality of relationships
Perceived loneliness




PROMIS Global Mental Health Measure (G02+G04+G05+G10)
PROMIS G10 (-)
HRQOL-4 #3
Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
PROMIS Pediatric SWB Item:
In the past 7 days, I...
Smiled a lot
Laughed a lot
Was in a good mood
2-item depression screen
# days work/school missed in the last 30 days for mental health
SCALE Intervention Targets:
Emerging Menu of Shared Strategies For Our Work Together
Based on our workgroup process, conversations, hundreds of action plans submitted by our members, a careful landscape analysis, the following strategies for our shared learning and action together is emerging. Each member of 100 Million, will, of course, decide what makes sense for them based on their understanding of themselves, their organization or community.
9 “whats”:
1. Address equity gaps (and think about equity more broadly) systematically.
• Support the development of communities of solution – partner with people experiencing inequities in a way that accompanies and unlocks their potential and solutions.
• Partner with faith-based communities to improve health and wellbeing
• Develop a conceptual framework and the capacity of health, health care and community organizations to improve equity.
• Use data to develop a more refined understanding of who is at risk of poor health outcomes and close these gaps systematically.
2. Help all kids have a great start in life (connected prenatal, perinatal, and infant health and wellbeing programs) with all the skills they (and their families) need to thrive, including:
• Positive peer support and connectedness
• Leadership skills
• Language skills
• Coping and resilience skills
• Job, education and microfinance skills
• Cradle to Career approaches in partnership with schools and local employers
3. Help veterans to thrive.
• Improve the high risk transition from active duty to civilan life to improve health and wellbeing.
• End veteran homelessness and support those who are newly housed in their physical, mental, social and spiritual health and wellbeing.
4. Grow the health, dignity and wellbeing of indigenous people and communities.
5. Address the social and behavioral determinants of health across health care, community and social services, with a special focus on vulnerable populations.
6. Make mental health everybody’s job (whole person) across the continuum of health care, community, public health and social services.
• Prevent the development of trauma and substance abuse, where possible.
1. Reduce community violence and incarceration rates among young men and women and help them reintegrate into the community.
2. Tobacco, opiates, alcohol – focus on communities with disparities
3. Stress management, coping, resilience, mindfulness, peacemaking skills taught in school/community
4. Support families proactively at high risk moments (birth, death, illness)
5. Create a more sustainable approach to work
• Create a continuum of mental health across health care and community.
• Integrate mental health into primary care and physical health into mental health delivery
• Shift policies to eliminate carve-outs of behavioral health
7. Improve access to primary health care for all.
8. Create the best possible wellbeing in the elder years and at the end of life.
• Have meaningful conversations about one’s decisions at the end of life.
• Earlier introduction of palliative care options.
9. Engage everyone in improving their own health.
• Empower people with the knowledge, tools, support and confidence to improve their own health.
• Make it easier for people to improve their own health (eg, remove barriers).

Community Social Well-Being Measures:
Social Cohesion
People in this neighborhood can be trusted
People in this neighborhood do not share the same values
This is a closely-knit neighborhood
People around here are willing to help their neighbors
Neighborhood disorder
Gallup-Healthways Community Domain
G-H Social domain
Access & Engagement
Ability to access appropriate systems (healthcare, education, social services, housing etc.)
Ability to engage in community (access to voting, volunteering, participation in social and/or political activities)
Affordability of services
High value (high quality, low cost)
Enumeration and quality of partnerships
Complementary partnerships across sectors (healthcare, public health, social services, etc.)
Policies that support collaboration
Life expectancy at birth (population from current life tables)
Life expectancy (individual model projections)
Years of potential life lost (YPLL)
Prevalence of overweight/obesity
STI prevalence/HIV prevalence
Prevalence of 10 most common chronic diseases
Infant mortality
Teen pregnancy rate
Premature birth rate
Rates of preventable infections and/or injuries
Prevalence of healthy behaviors
Smoking rates
Access to healthy foods
Child Opportunity Index Health & Environmental Opportunity Index
Vaccination rates (flu, childhood)
Exposure to traumatic events
Suicide rate
Psychological distress status
% Children never experienced an ACE
Depression rate
Addictive behavior
Opioid overdose rates
Incarceration rate
DUI rate
% individuals with inadequate social support
Sense of community index
% population who believe their health is interdependent with others in their community
Aging in place in communities
Level of social capital
Presence of senior villages
Residential segregation (Dissimilarity index - census)
Volunteer rate
Amount per GDP charitable donations
Investment in arts/cultural activities
Use of public libraries and museums
Job placement/unemployment rate/underemployment rate
Access to adult education and job training programs
High school graduation rate
Pre-school enrollment rate
Presence of and membership in community organizations
Presence of and membership in faith based organizations
Child Opportunity Index Social & Economic Opportunity Index
Child Opportunity Index Educational Opportunity Index
Gallup-Healthways Purpose domain
IOM Criteria for Core Measure Development
Criteria for core measures
• Importance for health
• Strength of linkage to progress
• Understandability of the measure
• Technical integrity
• Potential for broader system impact
• Utility at multiple levels
Criteria for the set
Systemic reach
Person meaningful
Utility at multiple levels

• Are the measures actionable?
• Are the measures sensitive to interventions?
• Are the measures affected by population migration?
• Are the measures easily understood by collaborating organizations, policy makers, and the public?
• Is the meaning of an increase or decrease in a measure unambiguous?
• Do the measures stand alone or are they aggregated into an index or summary measure?
• Are the measures uniform across communities?
• To what extent do measures address disparities as well as overall burden?
• Can unintended consequences be tracked?

• Simple, sensitive, robust, credible, impartial, actionable, and reflective of community values
• Valid and reliable, easily understood, and accepted by those using them and being measured by them
• Useful over time and for specific geographic, membership, or demographically defined populations
• Verifiable independently from the entity being measured
• Politically acceptable
• Sensitive to change in response to factors that may influence population health during the time that inducement is offered
• Sensitive to the level and distribution of health in a population
• Responsive to demands for evidence of population health improvement by measuring large sample sizes

Healthier Lives
Sustainable, Equitable Well-Being
Personal Well-Being Index #8
Connor-Davidson Resilience Scale (25-items)
Brief Resilient Coping Scale (4 items)
Spiritual Health Scale 2011 (114 items!)
Subjective Well-Being (Diener Satisfaction with Life Scale)
Personal Well-Being Index (PWI) Q9: "How satisfied are you on a scale from 0-10 with your life as a whole?"
WHO 5 Overall Well-Being Index
Pediatric Well-Being Life Satisfaction:
Thinking about the past 4 weeks, I was happy with my life
Peds PROMIS Item:
Thinking about your life, indicate how much each statement is like you:
My life has purpose
PROMIS Global Physical Health Measure (G03+G06+G07+G08)
HRQOL-4 #1
HRQOL-4 #2
Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?
HRQOL Activity Limitations Module #1
Are you LIMITED in any way in any activities because of any impairment or health problem?
EU-SILC, Global Activity Limitation Indicator (GALI)
For at least the past 6 months, to what extent have you been limited because of a health problem in activities you usually do?
Charlson comorbidity index
Blood pressure, BMI
# days work/school missed due to physical health
Supporting Conditions
Chronic disease care and management
Exposure to violent crime
Violent crime rate
Gallup-Healthways Physical Domain
Green space
HRQOL-4, #4:
During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?
% of participants with Good physical health or better (PROMIS G03)
In the past 7 days, I felt very healthy (PROMIS Peds SWB)
% of participants with Good or better mental health (PROMIS G04)
PROMIS Pediatric SWB Item:
In the past 7 days, I felt happy.
PROMIS G05; Social support; SES measures
PROMIS Pediatric SWB Item:
Thinking about the past 4 weeks, I was happy with my friendships
Short Flourishing scale #1 - I lead a purposeful and meaningful life
Peds PROMIS Item:
Thinking about your life, indicate how much each statement is like you: My life has meaning
Optimal resource investments across sectors
Dollars spent on social services/human services relative to acute healthcare
Appropriate proportion of spending on each well-being domain
Smoking bans
Zoning laws
Sodium procurement
Soft-drink size restrictions
School lunch regulation
Vending machine policies
Helmet laws
Restorative justice policies
Mental health Medicaid coverage
Veterans mental health support
DUI rehab policies
Zoning laws
Housing laws
Desegregation policies
Education policies
Employment policies
Arts and cultural spending
Non-profit tax policies
PROMIS Global 02: In general, would you say your quality of life is [Excellent, Very Good, Good, Fair, or Poor] (% adults rate Good or better)
Cantril's Ladder
Please imagine a ladder with steps numbered from zero at the bottom to ten at the top. Suppose we say that the top of the ladder represents the best possible life for you and the bottom of the ladder represents the worst possible life for you.
On which step of the ladder do you feel you personally stand at the present time?
On which step do you think you will stand about five years from now?
Life Years
Change in cost (expenditures of health and social care)
Stratified by equity dimensions
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