Finding HOPE

A national initiative hopes to spark a dialogue on improving healthy living opportunities for all Americans

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You can’t put a price tag on good health, but you can put some numbers together on how many lives could be improved if there could be more equitable health expectations in the United States.

All things being equal:

  • 95 percent of Americans would report good mental health, which translates to an additional 289,910 Virginians;
  • 97 percent of children would live in a healthy environment, including 144,011 more in Virginia; and
  • The infant mortality rate would drop to 2.4 per 1,000 live births, meaning 17,000 more infants would live through their first year of life, including 501 in Virginia.

Those are some of the findings of the Health Opportunity and Equity Initiative, which was released today. HOPE is a project led by the National Collaborative for Health Equity, working with Virginia Commonwealth University’s Center on Society and Health and the Texas Health Institute, with funding through the Robert Wood Johnson Foundation. The project has been conducted over three years, according to Steve Woolf, director of the Center on Society and Health and a professor in the Department of Family Medicine and Population Health.

It’s a national report that is also broken down by states and the District of Columbia, and further delineated by factors including race and ethnicity, level of education attained, and social and economic status. The study looked at factors, including self reports of good or excellent health in adults, premature mortality, low birth weight, livable income, and affordable housing. The researchers say this is the first national study of its kind to break down the numbers by race, income and ethnicity. That provides a way to study a particular group’s benchmarks across each state. That can help, because results can be radically different in bordering states, says Woolf.

For example the premature mortality rate of African-Americans in Virginia is 491.3 per 100,000, while the rate for African-Americans living in West Virginia is 705.8, and it’s 780.4 for black residents of D.C., the highest rate in the nation.

Differences in demographics account for some health inequalities, but it’s also a matter of policies in each state. Woolf notes that the differences have become more noticeable over the decades since the 1980s, when the federal government began shifting more policy responsibilities to states.

“The health of an American didn’t vary much at one time,” he says, but we’ve begun to see very different outcomes as time has passed.

“The good news is that we can create better opportunities for all Americans, especially the most vulnerable among us, by expanding health equity,” according to the report.

The study has taken a positive focus, emphasizing what’s working and what can be done over “nagging,” says Woolf.

“We really wanted to take a positive frame for this and move away from the negative messaging,” he says.

HOPE also sets goals in each category that are attainable and based on what’s already being achieved in certain groups in the nation. For example, there’s a target of 5 percent of American adults reporting poor mental health, based on statistics reported on college graduates in Iowa, Minnesota, North Dakota, South Dakota and Wisconsin.

“What that shows is that those results are achievable, so other states can try to figure out what choices they made that they can explore,” says Woolf.

The impact of meeting the target could be profound. Looking at statistics for Virginia, about 10.2 percent of adults report poor mental health currently, so that number would need to be halved to meet the goal, representing about 300,000 adults. The commonwealth ranks 18th overall in the United States.

Regarding adult health, the state ranks 18th, with 52.7 percent of adults reporting good or excellent health. That breaks down to 55.9 percent of white residents, 43.1 percent of blacks, 44.1 of Hispanics,, 57.3 Asians and 48.7 multiracial residents. By education attainment, 69.5 percent of Virginians with a college degree reported good or excellent health, while 25.4 percent of those with less than a high school degree reported good health. The HOPE goal is 75 percent for a state. If that was met, 1.2 million more Virginians would consider themselves in good or excellent health.

The state was ninth in households with a livable income, which is considered a household income at 250 percent or more of the federal poverty level. That level was attained by 76.3 percent of Asian households, 74.2 percent of white households, 68.4 percent of multiracial households, 59.2 of Native American households, 55.6 of black households and 55.3 of Hispanic households. Overall 69.6 percent of households met the livable income standard.

Each state has gaps. “There is no state that has its work done,” Woolf says. Some are better than others, but every part of the country can do better.”

Woolf notes that the financial investments needed to try to reach the goals would net improvements in health, but also would improve social mobility and other factors that are good for economic development and help people rise from poverty.

“We know it’s possible in America to get those rates,” he says. “We can make a big difference if we can close these gaps.”

Coming Into Focus

The structure of the merger of Bon Secours with Mercy Health is beginning to take shape, with the creation of a governmental structure and the naming of a CEO.

The names of Bon Secours facilities will remain the same for now, but beginning this fall, the facilities will operate as part of a merged system that will be known as Bon Secours Mercy Health. The CEO and president of the merged operation is John M. Starcher Jr., current president and CEO of Mercy Health, according to a joint release. The merger was announced in February.

Bon Secours Mercy Health will be led by a board of directors, with Chris Allen to serve as the board chair. Allen is the current chair of the Bon Secours Board of Trustees. The head of the current Mercy board, Katherine Vestal, will be vice chair of the merged board. Bon Secours Mercy Health Ministries will have canonical oversight for the system and will be chaired by Sister Pat Eck, current chair of Bon Secours Ministries, according to the release.

The merged entity will have 57,000 employees and will be the fifth largest Catholic health care system in the United States.