AHR 2018 Senior Report MN Full

Minnesota 2018 SENIOR REPORT
Minnesota
OVERALL - SENIOR RANK: 4 CHANGE:  3
DETERMINANTS RANK: 7
OUTCOMES RANK: 1
1
ST R E N GT H S H I G H L I G H TS
10
High percentage of able-bodied In the past year, home health care

20
seniors workers decreased 4% from 268.3
Rank
30 Low prevalence of food insecurity to 257.9 aides per 1,000 adults

High home health care worker aged 75+
40
rate In the past year, food insecurity
50
‘13 ‘14 ‘15 ‘16 ‘17 ‘18
decreased 7% from 10.2% to 9.5%
Edition Year CHALLENGES of adults aged 60+
In the past year, excessive
Rank Based On: Weighted High prevalence of excessive
drinking increased 28% from 7.2%
sum of the number of drinking
standard deviations each core
to 9.2% of adults aged 65+
Low SNAP enrollment
measure is from the national In the past year, early deaths
average
Low prevalence of seniors with a
decreased 3% from 1,542 to 1,498
dedicated provider
deaths per 100,000 adults aged
65-74
In the past ive years, obesity
increased 21% from 23.7% to
28.6% of adults aged 65+
In the past two years, four- or ive-
star rated nursing home beds
increased 14% from 52.0% to
59.5% of certi ied nursing home
beds
WEBSITE: www.health.state.mn.us
Page 1 of 10
Measure Rating 2018 Value 2018 Rank

BEHAVIORS
Dental Visit (Percentage of adults aged 65+) +++++ 76.1% 2
Excessive Drinking (Percentage of adults aged 65+) + 9.2% 48
Obesity (Percentage of adults aged 65+) +++ 28.6% 24
Pain Management (Percentage of adults aged 65+ with arthritis) ++++ 56.0% 15
Physical Inactivity (Percentage of adults aged 65+ in fair or better health) ++++ 24.9% 11
Smoking (Percentage of adults aged 65+) ++++ 8.1% 16
Behaviors * (All Behaviors-Seniors) ++++ 0.085 14
COMMUNITY & ENVIRONMENT
Nursing Home Quality (Percentage of beds rated four- or ive-stars) +++++ 59.5% 8
Poverty (Percentage of adults aged 65+) +++++ 7.2% 7
Volunteerism (Percentage of adults aged 65+) +++++ 36.8% 2
Community & Environment - Macro * (Community & Environment - Macro - Seniors) +++++ 0.139 1
Community Support (Dollars per adult aged 60+ in poverty) +++ $434 28
Food Insecurity (Percentage of adults aged 60+) +++++ 9.5% 3
Home-delivered Meals (Meals per 100 adults aged 60+ with independent living di iculty) ++ 8.6 31
Community & Environment - Micro * (Community & Environment - Micro - Seniors) ++++ 0.037 16
Community & Environment Total * (All Community & Environment measures-Seniors) +++++ 0.176 8
POLICY
Geriatrician Shortfall (Percentage of geriatricians needed) ++++ 56.6% 11
Health Care Associated Infection (HAI) Policies (Percentage of policies in place) +++ 50.0% 23
Low-care Nursing Home Residents (Percentage of residents) ++ 15.2% 40
Prescription Drug Coverage (Percentage of Medicare enrollees aged 65+) +++++ 89% 1
SNAP Reach (Participants per 100 adults aged 60+ living in poverty) ++ 56.3 36
Policy * (All Policy measures-Senior) ++++ 0.001 18
CLINICAL CARE
Dedicated Health Care Provider (Percentage of adults aged 65+) + 90.3% 46
Diabetes Management (Percentage of Medicare enrollees aged 65 to 75) ++ 75.2% 36
Flu Vaccine (Percentage of adults aged 65+) +++++ 62.9% 10
Health Screenings (Percentage of seniors with recommended screenings) +++++ 78.2% 5
Home Health Care (Number of workers per 1,000 adults aged 75+) +++++ 257.9 2
Hospice Care (Percentage of Medicare decedents aged 65+) +++ 50.6% 26
Hospital Deaths (Percentage of Medicare decedents aged 65+) ++++ 19.5% 19
Hospital Readmissions (Percentage of hospitalized Medicare enrollees aged 65+) ++++ 14.3% 19
Preventable Hospitalizations (Discharges per 1,000 Medicare enrollees aged 65+) +++++ 36.6 10
Clinical Care * (All Clinical Care measures--Seniors) +++++ 0.060 10
ALL DETERMINANTS
All Determinants * (All Determinants) +++++ 0.321 7
OUTCOMES
Able-bodied (Percentage of adults aged 65+) +++++ 68.7% 4
Early Death (Deaths per 100,000 adults aged 65 to 74) +++++ 1,498 5
Falls (Percentage of adults aged 65+) ++++ 28.2% 12
Frequent Mental Distress (Percentage of adults aged 65+) +++++ 5.1% 3
High Health Status-Senior (Percentage of adults aged 65+) +++++ 48.4% 4
Hip Fractures (Hospitalizations per 1,000 Medicare enrollees aged 65+) +++++ 5.0 8
ICU Use (Percentage of Medicare decedents aged 65+) +++++ 6.0% 6
Teeth Extractions (Percentage of adults aged 65+) +++++ 10.3% 6
All Outcomes * (All Outcomes) +++++ 0.288 1
RATING RANK OVERALL
+++++ 1 – 10 Overall * (Overall) +++++ 0.609 4
++++ 11 – 20
+++ 21 – 30
* Value indicates z score. Negative scores are below US value; positive scores are above US value. For complete de initions of measures
++ 31 – 40
+ 41 – 50
including data sources and years, see "Appendix: Core Measures".
• Data Unavailable
SU P P L E M E N TA L M E ASU R E S

Cognitive Di iculty (Percentage of adults aged 65+ ) +++++ 6.2% 2
Depression (Percentage of adults aged 65+) ++++ 12.3% 16
Education (Percentage of adults aged 65+ ) +++ 27.5% 23
Minnesota
Multiple Chronic Conditions (Percentage of Medicare enrollees aged 65+) +++++
Overuse--Mammography (Percentage of female Medicare enrollees aged 75+) +++
28.7%
24.1%
2018 SENIOR
10
27
REPORT
Overuse--PSA Test (Percentage of male Medicare enrollees aged 75+) +++++ 10.5% 3
Poor Mental Health Days (Mean number of days) +++++ 1.7 4
Risk of Social Isolation (Percentile of mean z scores for six social isolation risk factors in adults 65+) +++++ 6 4
RATING RANK
+++++ 1 – 10 Suicide (Deaths per 100,000 adults aged 65+) +++++ 11.5 6
++++ 11 – 20
+++ 21 – 30
++ 31 – 40 • Data Unavailable
+ 41 – 50
Page 2 of 10
Dental Visit - Seniors Teeth Extractions - Seniors
76.1% 10.3%
SINCE 2017, DENTAL VISIT* SINCE 2017, TEETH EXTRACTIONS*
INCREASED 0.7% FROM 75.6% TO DECREASED 1.9% FROM 10.5% TO
76.1% 10.3%
* Percentage of adults aged 65+ * Percentage of adults aged 65+
Home Health Care Nursing Home Quality
257.9 59.5%
SINCE 2017, HOME HEALTH CARE * SINCE 2017, NURSING HOME
DECREASED 3.9% FROM 268.3 TO QUALITY* INCREASED 8.2% FROM
257.9 55.0% TO 59.5%
* Number of workers per 1,000 adults aged * Percentage of beds rated four- or ive-stars
75+
Food Insecurity - Seniors Suicide - Senior
9.5% 11.5
SINCE 2017, FOOD INSECURITY* SINCE 2017, SUICIDE* DECREASED
DECREASED 6.9% FROM 10.2% TO 4.2% FROM 12.0 TO 11.5
9.5% * Deaths per 100,000 adults aged 65+
* Percentage of adults aged 60+
Top 5 States
1: UTAH 2: HAWAII 3: NEW HAMPSHIRE 4: MINNESOTA 5: COLORADO
Page 3 of 10
Smoking - Seniors
10.0
Range of Values for all States MN Value
9.0
Percentage of adults aged 65+
8.0
7.0 GENDER
6.0
Female
5.0
Male
4.0
0.0 5.0 10.0 15.0 20.0 25.0
3.0
2.0 Percentage of adults aged 65+
1.0 RACE/ETHNICITY
0.0
‘13 ‘14 ‘15 ‘16 ‘17 ‘18 White
Edition Year
0.0 5.0 10.0 15.0 20.0 25.0
Percentage of adults aged 65 and older who are Percentage of adults aged 65+
smokers (reported smoking at least 100 cigarettes in
URBANICITY
their lifetime and currently smoke every or some
days)
Rural
Suburban
Urban
Minnesota United States 0.0 5.0 10.0 15.0 20.0 25.0

EDUCATION
Smoking is the leading cause of preventable death in the United
States. It is estimated that there are 4.2 million smokers aged 65 Less Than High
and older in the nation. Smoking damages nearly every organ in School
the body and causes diseases such as cataracts, respiratory High School Grad
disease, heart disease, stroke and cancer. It is also associated Some College
with accelerated cognitive decline, dementia and early cognitive College Grad
impairment. Cessation, even in senior smokers, can have 0.0 5.0 10.0 15.0 20.0 25.0
profound bene its on current health and long-term outcomes.
For example, the risk of dying of lung cancer drops by half 10
INCOME
years after cessation.
Less Than $25,000
$25-$49,999
$50-$74,999
$75,000 or More
0.0 5.0 10.0 15.0 20.0 25.0

Data suppression rules are as de ined by the original source.
Race and ethnicity populations are as de ined by the original source.
Page 4 of 10
Obesity - Seniors
30.0
28.0
26.0
24.0
22.0 GENDER
20.0
18.0
Female
16.0
14.0 Male
12.0
10.0 10.0 18.0 26.0 34.0 42.0 50.0
8.0
4.0
RACE/ETHNICITY
2.0
0.0
‘13 ‘14 ‘15 ‘16 ‘17 ‘18 White
Edition Year
10.0 18.0 26.0 34.0 42.0 50.0
Percentage of adults aged 65 and older with a body Percentage of adults aged 65+
mass index of 30.0 or higher based on reported
URBANICITY
height and weight
Rural
Suburban
Urban
Minnesota United States
10.0 18.0 26.0 34.0 42.0 50.0

Obesity is the leading cause of preventable life-years lost among
EDUCATION
Americans — surpassing tobacco use, high blood pressure and
high cholesterol. There is a stronger relationship between Less Than High
School
obesity and mortality risk among older age groups. Adults with
High School Grad
obesity, compared with adults at a healthy weight, are at a
Some College
higher risk of developing serious health conditions including
College Grad
cognitive decline, chronic conditions and certain cancers.
Contributing factors for obesity include behaviors such as poor 10.0 18.0 26.0 34.0 42.0 50.0
diet and physical inactivity, social and physical environments, Percentage of adults aged 65+
genetics and medical history. Growing evidence illustrates the INCOME
importance of the built environment and community design in
promoting a healthy lifestyle. Less Than $25,000
$25-$49,999
$50-$74,999
$75,000 or More
10.0 18.0 26.0 34.0 42.0 50.0

Page 5 of 10
Physical Inactivity - Seniors
35.0
Percentage of adults aged 65+ in f air or

30.0
25.0 GENDER
better he alth
20.0 Female
Male
15.0
5.0 18.0 31.0 44.0 57.0 70.0
10.0
Percentage of adults aged 65+ in fair or better
5.0
health
0.0 RACE/ETHNICITY
‘13 ‘14 ‘15 ‘16 ‘17 ‘18
Edition Year
White
5.0 18.0 31.0 44.0 57.0 70.0

Percentage of adults aged 65 and older in fair or
better health who reported doing no physical activity Percentage of adults aged 65+ in fair or better
or exercise other than their regular job in the past 30
health
days
URBANICITY
Rural
Suburban
Urban
5.0 18.0 31.0 44.0 57.0 70.0

Physical activity is an integral part of healthy aging. The Centers
for Disease Control and Prevention estimate that only 16 percent health
of adults aged 65 and older met aerobic and muscle- EDUCATION
strengthening guidelines in 2011 — the lowest of any age group.
Physical inactivity increases the risk of cardiovascular disease, Less Than High
School
cancer, diabetes, hypertension, obesity and premature death.
High School Grad
Increasing physical activity, especially from an absence,
Some College
prevents and helps manage numerous chronic diseases. Even
College Grad
moderate increases in physical activity can greatly reduce risk of
adverse health outcomes. Growing evidence illustrates the 5.0 18.0 31.0 44.0 57.0 70.0
importance of the built environment and community design to Percentage of adults aged 65+ in fair or better
promote physical activity for seniors. health
INCOME
Less Than $25,000

$25-$49,999
$50-$74,999
$75,000 or More
5.0 18.0 31.0 44.0 57.0 70.0

health
Page 6 of 10
Frequent Mental Distress - Seniors
8.0
7.0
6.0
GENDER
5.0
Female
4.0
Male
3.0
0.0 4.0 8.0 12.0 16.0 20.0
2.0
1.0 RACE/ETHNICITY
0.0
‘13 ‘14 ‘15 ‘16 ‘17 ‘18 White
Edition Year
0.0 4.0 8.0 12.0 16.0 20.0
Percentage of adults aged 65 and older who reported Percentage of adults aged 65+
their mental health was not good 14 or more days in
URBANICITY
the past 30 days
Rural
Suburban
Urban
0.0 4.0 8.0 12.0 16.0 20.0

Frequent mental distress is characterized by 14 or more days of
EDUCATION
self-reported poor mental health in the past month and
emphasizes the burden of severe mental health issues in a Less Than High
School
population. Older adults with FMD are more likely to engage in
High School Grad
behaviors that contribute to poor health such as smoking,
Some College
physical inactivity and poor diet. Activity limitations due to
College Grad
physical, mental or emotional problems, as well as avoidance of
medical care due to cost are associated with frequent mental 0.0 4.0 8.0 12.0 16.0 20.0
distress among older adults. Chronic and severe mental health Percentage of adults aged 65+
episodes are treatable and may be preventable through simple, INCOME
cost-eﬀective and time-e icient screening procedures, early
interventions and quality care. Less Than $25,000
$25-$49,999
$50-$74,999
Seniors- $75,000 or
More
0.0 4.0 8.0 12.0 16.0 20.0

Page 7 of 10
Dedicated Health Care Provider - Seniors
100.0
90.0
80.0
70.0
GENDER
60.0
Female
50.0
Male
40.0
70.0 76.0 82.0 88.0 94.0 100.0
30.0
10.0 RACE/ETHNICITY
0.0
‘13 ‘14 ‘15 ‘16 ‘17 ‘18 Hispanic
Edition Year
White
Percentage of adults aged 65 and older who reported 70.0 76.0 82.0 88.0 94.0 100.0
having one or more people they think of as their
personal doctor or health care provider
URBANICITY
Rural
Suburban
Urban
70.0 76.0 82.0 88.0 94.0 100.0

Seniors with a dedicated health care provider are better
positioned to receive care that can prevent, detect and manage
EDUCATION
health conditions. Having a regular health care provider is
associated with lower health care costs, and improvements in Less Than High
School
overall health status and chronic care management. Adults
High School Grad
without a dedicated health care provider are more likely to visit
Some College
the emergency department for non-urgent or avoidable
College Grad
problems. An estimated $13.7 million was spent on emergency
department services for adults aged 65 and older in 2013. 70.0 76.0 82.0 88.0 94.0 100.0
Barriers to obtaining a dedicated health care provider include Percentage of adults aged 65+
limited access, inancial constraints, limited transportation and a INCOME
lack of knowledge of available services and providers.
Less Than $25,000
$25-$49,999
$50-$74,999
$75,000 or More
70.0 76.0 82.0 88.0 94.0 100.0

Page 8 of 10
Dental Visit - Seniors
80.0 Range of Values for all States MN Value

70.0
60.0 GENDER
50.0
Female
40.0 Male
30.0
20.0 35.0 50.0 65.0 80.0 95.0
20.0
10.0 RACE/ETHNICITY
0.0
‘13 ‘14 ‘15 ‘16 ‘17 ‘18 Hispanic
Edition Year
White
Percentage of adults aged 65 years and older who 20.0 35.0 50.0 65.0 80.0 95.0
reported visiting the dentist or dental clinic within the
past year (pre-2011 BRFSS methodology)
URBANICITY
Percentage of adults aged 65 and older who reported
Rural
visiting a dental health professional within the past
year Suburban
Urban
20.0 35.0 50.0 65.0 80.0 95.0
Minnesota United States Percentage of adults aged 65+

EDUCATION
Less Than High

Oral health naturally declines with age, and problems arise if School
routine care is not maintained. Poor oral health can have a large High School Grad
impact on quality of life by negatively aﬀecting the ability to Some College
chew, speak and interact socially, in addition to increasing the College Grad
risk for certain diseases such as diabetes and oral cancer. Most
20.0 35.0 50.0 65.0 80.0 95.0
individuals lose dental insurance coverage when they retire, and
Medicare generally does not cover dental care. This means the Percentage of adults aged 65+
majority of seniors pay out-of-pocket for most or all dental INCOME

expenses, which impacts dental care use. Older adults who use
Less Than $25,000
preventive dental care may reduce their dental bills and out-of-
$25-$49,999
pocket payments.
$50-$74,999
$75,000 or More
20.0 35.0 50.0 65.0 80.0 95.0

Page 9 of 10
Trend: Food Insecurity - Seniors, Trend: Community Support, Minnesota, Trend: Volunteerism, Minnesota, United
Minnesota, United States United States States
16.0 600
40.0
Dollars per adult aged 60+ in poverty

550
Percentage of adults aged 6 0+

14.0 35.0
500
12.0 450 30.0
400
10.0
350 25.0
8.0
300 20.0
6.0 250
15.0
200
4.0
150 10.0
2.0 100
5.0
0.0 50
‘13 ‘14 ‘15 ‘16 ‘17 ‘18
0 0.0
Edition Y ear ‘13 ‘14 ‘15 ‘16 ‘17 ‘18 ‘13 ‘14 ‘15 ‘16 ‘17 ‘18
Edition Year Edition Year
Percentage of adults aged
60 and older who faced the Expenditures captured by the Percentage of adults aged 65
threat of hunger in the past Administration on Aging per and older who reported
12 months adult aged 60 and older living volunteering in the past 12
in poverty months

Minnesota United States Minnesota United States
Trend: Preventable Hospitalizations - Trend: Hospice Care, Minnesota, United Trend: Hospital Deaths, Minnesota,
Seniors, Minnesota, United States States United States
Discharges per 1,000 Medicar e enrollees
70.0 55.0
Percentage of Medicare decedents aged
Percentage of Medicare decedents aged

30.0
50.0
60.0
45.0
25.0
50.0 40.0
35.0
aged 65+
40.0
20.0
30.0
65+
65+
30.0 25.0 15.0
20.0
20.0
10.0
15.0
10.0 10.0 5.0
0.0 5.0
‘13 ‘14 ‘15 ‘16 ‘17 ‘18
0.0 0.0
Edition Y ear ‘13 ‘14 ‘15 ‘16 ‘17 ‘18 ‘13 ‘14 ‘15 ‘16 ‘17 ‘18
Edition Year Edition Year
Number of discharges for
ambulatory care-sensitive Percentage of Medicare Percentage of deaths
conditions per 1,000 decedents aged 65 and older occurring in a hospital among
Medicare enrollees aged 65 who were enrolled in hospice chronically ill Medicare
and older during the last six months of decedents aged 65 and older
life after diagnosis of a
condition with a high
Minnesota United States Minnesota United States
probability of death
Page 10 of 10

AHR 2018 Senior Report MN Full

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Minnesota 2018 SENIOR REPORT

High percentage of able-bodied In the past year, home health care

30 Low prevalence of food insecurity to 257.9 aides per 1,000 adults

Measure Rating 2018 Value 2018 Rank

Measure Rating 2018 Value 2018 Rank

Dental Visit - Seniors Teeth Extractions - Seniors

Home Health Care Nursing Home Quality

Food Insecurity - Seniors Suicide - Senior

1: UTAH 2: HAWAII 3: NEW HAMPSHIRE 4: MINNESOTA 5: COLORADO

Minnesota United States 0.0 5.0 10.0 15.0 20.0 25.0

Percentage of adults aged 65+

0.0 5.0 10.0 15.0 20.0 25.0

Percentage of adults aged 65+

Percentage of adults aged 65+

10.0 18.0 26.0 34.0 42.0 50.0

Percentage of adults aged 65+

Physical Inactivity - Seniors

Range of Values for all States MN Value

5.0 18.0 31.0 44.0 57.0 70.0

5.0 18.0 31.0 44.0 57.0 70.0

Less Than $25,000

5.0 18.0 31.0 44.0 57.0 70.0

Percentage of adults aged 65+ in fair or better

Frequent Mental Distress - Seniors

Percentage of adults aged 65+

0.0 4.0 8.0 12.0 16.0 20.0

Percentage of adults aged 65+

Dedicated Health Care Provider - Seniors

70.0 76.0 82.0 88.0 94.0 100.0

70.0 76.0 82.0 88.0 94.0 100.0

Percentage of adults aged 65+

Dental Visit - Seniors

80.0 Range of Values for all States MN Value

20.0 35.0 50.0 65.0 80.0 95.0

Minnesota United States Percentage of adults aged 65+

Less Than High

majority of seniors pay out-of-pocket for most or all dental INCOME

20.0 35.0 50.0 65.0 80.0 95.0

Percentage of adults aged 65+

Dollars per adult aged 60+ in poverty

Percentage of adults aged 65+

Minnesota United States

Percentage of Medicare decedents aged

Minnesota United States

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