Healthcare Admin

HE007: Disease Distribution and Management

Short Answer Submission Form

Your Name: Olufunmilayo Adeleke

Your E-Mail Address: [email protected]

Instructions

Write your responses where it reads “Enter your response here.” Write as much as needed to satisfy the requirements indicated. Each item contains the rubric which will be used to evaluate your responses.

Short Answer 1

You are a healthcare administrator in a hospital and are contributing to a community health needs assessment (CHNA) for your county. Visit http://www.cdc.gov/brfss/brfssprevalence/ , and complete the following: Note: Detailed instructions for the use of this site, titled “Instructions for SMART: BRFSS City and County Data,” is available in the Assessment materials, if needed.

1. From the pull-down menu, select the criteria for the desired health risk data, select MMSA: AL- Tuscaloosa, Year: 2012, and Category: Chronic Health Indicators.

2. Click on the questions to view the prevalence of each chronic disease. For example, to view the prevalence rate of heart attacks among Tuscaloosa residents, click on “Ever told you had a heart attack (myocardial infarction)?” to discover that 3.6% of Tuscaloosa residents report ever having suffered from a heart attack.

3. After viewing the data for each of the Chronic Health Indicators, scroll down and click on Overweight and Obesity (BMI) and then Weight Classification by Body Mass Index (BMI) to view obesity rates for Tuscaloosa.

4. Now, compare the prevalence of each chronic disease in Tuscaloosa to the prevalence in Alabama.

Based on the information you analyzed, respond to the following prompts:

· Identify 10 indicators to measure public health that you would use to develop a holistic picture of the health of the community in Tuscaloosa. Describe what each indicator measures, and justify its necessity for the CHNA. You should use a mix of socio-economic, disease, and clinical indicators. (2–3 sentences for each indicator)

· Explain how three stakeholders should be involved to ensure the entire spectrum of community needs is considered. (1–2 pages)

Your Response

Indicators Comment by Seyra Hughes: Please include specifics. You need to quantify your work.

Observing trends in disease burden such as chronic diseases like asthma and diabetes. The incidence of asthma in Tuscaloosa was higher than the overall incidence in Alabama and hence the need to address it. Comment by Seyra Hughes: Specifcally, what is the incidence? Why do you think it needs attention. It is important to share details.

Body Mass Index (BMI) measures the weight of an individual relative to the height. In 2012, there were more obese people in Tuscaloosa than the overall number in Alabama; this information will help to determine the cardiovascular health of this community (Centers for Disease Control and Prevention, 2015).

Healthcare access is about the medical infrastructure available in the form of hospitals, human resources like healthcare workers and insurance policy. It’s an important consideration when determining whether the community accesses medical care.

Disability status is a measure of productivity of the community in question, the rate of disability in Tuscaloosa was higher in 2012 than the overall rate in Alabama.

Mortality rate determines the number of deaths over a certain period of time. Looking at infant mortality rate can help the health administrators make informed decisions.

Employment status determines income and source of livelihood. A community with the high unemployment rate is likely to experience more health problems due to poor insurance coverage.

Women’s health can give the overall picture because of the role that women play in bringing up children and caring for the family. When women are sick, the community is also sick.

Alcohol and tobacco consumption measures the risk of the community towards diseases associated with abuse of these two drugs. The high rate of lung cancer may be associated with tobacco use.

Education status measures literacy levels of the community which will help the health administrator determine the best approach to addressing their health needs. An educated community is a healthy community.

Leadership and government will influence resources utilization. A government that cares about her citizens will establish policies that benefit the community.

Stakeholders

The first stakeholder is the leadership; state governments have a role to play in ensuring their citizens get the best available care necessary. Local leaders like mayors and other advocates of the community should commit themselves to identifying the needs of the community that they serve so that they can petition the relevant agencies. Communities need to elect only those leaders with their interest at heart. Many state agencies all over the United States have been put in place to work closely with the community so as to identify the problems that people face and come up with solutions.

A second key stakeholder is the community itself. For any health regulation to work, the community has to be involved. Even collection of data in order to observe the health trends must involve the community. Communities play a big role during epidemics and other disease outbreaks with a potential to spread to other places. Community members participate in public gatherings where key health matters are addressed. Community members can help in bringing development through donating lands for construction of health facilities that will serve them. On top of this, participation in voluntary services such as cleaning the environment in the fight against vector-borne diseases.

The third key stakeholder is the health personnel in the form of doctors, nurses, dentists, pharmacists and other health workers. They serve to offer direction in understanding disease trends and formulating the necessary steps that need to be taken in order to solve the problems faced. Doctors have supported communities through many programs over the years, one such program advocated by World Health Organization is Doctors without Borders, a partnership that has helped overcome many disease outbreaks all over the world.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 1: Analyze community health needs using public health and clinical data.
Learning Objective 1.1: Analyze indicators to measure public health.	Analysis of indicators to measure public health is missing.	Response analyzes fewer than 10 indicators to measure public health. Indicators are not appropriate to measure public health.	Response accurately and thoroughly analyzes 10 indicators to measure public health and justifies its necessity for the CHNA. Response represents a diverse mix of socio-economic, demographic, disease, and clinical indicators.	Demonstrates the same level of achievement as “2,” plus the following: Response includes a logical rationale on why each indicator was chosen.
Learning Objective 1.2: Explain how stakeholders should be involved to ensure that community needs are considered.	Explanation of which stakeholders should be consulted is missing.	Response vaguely explains how stakeholders should be involved to ensure that the entire spectrum of the community needs is considered or includes fewer than three stakeholders.	Response accurately and thoroughly explains how at least three logical stakeholders that should be involved to ensure that the entire spectrum of community needs is considered.	Demonstrates the same level of achievement as “2,” plus the following: Response explains how to engage the three stakeholders to get their input for the CHNA.

Short Answer 2

Visit the “CHNA Map Gallery” ( http://assessment.communitycommons.org/CHNA/MapGallery.aspx ) to respond to the following prompts. Note: Detailed instructions for the use of this site, titled “Instructions for CHNA Map Gallery,” are available in the Assessment materials, if needed.

Each rectangle on the screen links to a map of a different indicator, grouped into demographic measures, social and economic factors, the physical environment, health behaviors, clinical care, and health outcomes categories. Hover over the rectangle to view each indicator or view the label listed directly below the rectangle.

1. Click on a relevant map. In order to view data specific to the questions in this Assessment, type Santa Fe, NM into the box labeled “Enter a location” in the upper right-hand corner.

2. Using the box labeled Map Layers on the right side of the screen, you can view the data in different ways. For example, click Label to view the numerical value for the indicator displayed on the map.

3. Return to the Map Gallery tab to view a broad array of socio-demographic and health indicators.

Based on the information you analyzed, respond to the following prompts:

· Describe Santa Fe, New Mexico using the following five gallery categories: demographic measures, social and economic factors, the physical environment, health behaviors, and clinical care. Select at least three indicators per category. (1–2 pages)

· Using the health outcomes category, describe the prevalence of two infectious diseases and two chronic diseases in Santa Fe, New Mexico. (1 paragraph)

Your Response

Social Demographic factors The population of Hispanic origin is the highest at almost 50 % followed by that of whites at 45%. . The next thing is education level; those with a higher degree are the majority at 49% followed closely by higher diploma at 38% . This level of education will have a great effect on health standards of the people of Santa Fe. Educational attainment is higher in females for all levels in Santa Fe. However, almost equal numbers of male and females enrolled in college and universities in Santa Fe as compared to New Mexico where this ratio is the same . About age, females are more than males in all categories. Nevertheless, the median age group of between 40-454 has more males than females . The physical environment involves the landscape in general and could include mountains, rivers, lakes and other natural components. For the recreational and gym facilities, the distribution was varied, but on average, bars and drinking places were topping the list as per 2014 . The park facilities were also differently distributed, and remarkable differences existed between Santa Fe and New Mexico. Other parameters included the accessibility to a park and recreational centers. In the matter of health behaviors, disease trends seemed to be different among various counties with maternal health showing the greatest disparity. Healthcare access was also highlighted with notable variations in the distribution of physicians and dentists; this has a significant impact on the delivery of quality medical care especially to minority populations . Other things that stood out were chronic conditions with cardiovascular diseases being the most frequent; health measure need to be taken to address this trend . Diabetes and arthritis also showed considerably high rates when compared to New Mexico and this impacts on the people of Santa very negatively because they have to spend more time seeking medical attention . Health outcomes The infectious condition widely affecting people of Santa and most common in New Mexico was Clostridium botulinum while the chronic conditions most prevalent were asthma, arthritis and cardiovascular diseases . These conditions need to be addressed to ensure that there are no health disparities that disadvantage the people of Santa Fe.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 1: Analyze community health needs using public health and clinical data.

Learning Objective 1.3: Describe the socio-demographic characteristics of specific communities.	Description of socio-demographic characteristics is missing.	Description of socio-demographic characteristics is inaccurate or incomplete.	Response accurately and thoroughly describes the socio-demographic characteristics (i.e., demographic measures, social and economic factors, the physical environment, health behaviors, clinical care, and health outcomes) of Santa Fe.	Demonstrates the same level of achievement as “2,” plus the following: Response accurately describes additional data such as insurance status, community safety, access to a healthy lifestyle, and access to healthcare services.
Learning Objective 1.4: Describe the prevalence of infectious and chronic diseases in a specific community.	Description of the prevalence of diseases is missing.	Response is inaccurate or describes fewer than two chronic and two infectious diseases.	Response accurately describes the prevalence of two chronic and two infectious diseases in Santa Fe.	Demonstrates the same level of achievement as “2,” plus the following: Response accurately compares and contrasts indicators based on the data provided.

Short Answer 3

Use this link, http://cni.chw-interactive.org/ , to obtain the Community Needs Index (CNI) of Santa Fe to the two neighboring cities of Edgewood and La Cueva. Calculate the index using Dignity Health’s Community Needs Index’s (CNI) methods.

Note: Detailed instructions for the use of these tools, titled “Instructions for CHNA Map Gallery,” are available in the Assessment Materials, if needed.

1. Click on Launch CNI. Download Google Chrome following the prompts, if needed (free).

2. Select New Mexico (Step 1), then select Santa Fe (Step 2). Then, click Draw Map. The tool will show the CNI results for Santa Fe.

3. Click on Show More Search Options. When the map appears, click on Click here to generate report to view the CNI for each Santa Fe ZIP code.

4. Repeat steps 2 and 3 for Edgewood and La Cueva CNI to compare the cities and ZIP codes.

5. Click on Click here to generate report to compare the CNI for each zip code for Santa Fe, Edgewood, and La Cueva.

Based on the information you analyzed, respond to the following:

· Compare the CNIs of Santa Fe to the two neighboring cities of Edgewood and La Cueva, and explain what this tells you about the level of need and access to resources in Santa Fe. (2 paragraphs)

Your Response

The Community Need Indices varies between the three cities which helps to show the variations in their health needs. La Cueva has the highest need at a median community need index of 4 while Santa Fe follows with a community need index of 3.1; Edgewood has the lowest community need index with a median community need index score of 2.6 . This information suggests that when compared to neighboring cities, Santa Fe is in between or rather the situation in Santa Fe is not as bad as in La Cueva. The community health need score of Santa Fe and that of Edgewood are almost the same, i.e., they are in the same need bracket. This would mean that measure being taken in Edgewood to lower the median community need index score, need also be applied in Santa Fe.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 1: Analyze community health needs using public health and clinical data.

Learning Objective 1.5: Compare Community Needs Indexes (CNIs) between multiple cities.

Comparison of CNI scores is missing.

Comparison of CNI scores is inaccurate or incomplete.

Response clearly explains relevant similarities and differences between three neighboring cities, including information about CNI scores and level of need.

Demonstrates the same level of achievement as “2,” plus the following: Response examines the methodology of CNI scores and makes the connection to the social determinants of health.

Short Answer 4

Explain the relationship between the social determinants of health and the burden of disease. (1–2 paragraphs)

Your Response

Social determinants of health are things like demographics which involve population parameters like age, sex, level of education, number of births, number of deaths, disease trends, among other things. One key determinant to the burden of disease is population. When the population is high and social amenities like water, housing, schools and hospitals are overcrowded, this creates a strain in the fight against infectious diseases like tuberculosis, pneumonia and even viral diseases like influenza. The government and other relevant agencies need to compile the demography of the population with utmost accuracy to ensure that proper interpretations can be made and improvements done where necessary.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 2: Explain the relationship between the social determinants of health and the burden of disease.
Learning Objective 2.1: Explain the relationship between the social determinants of health and the burden of disease.	Explanation of the relationship between social determinants of health and the burden of disease is missing.	Explanation of the relationship between social determinants of health and the burden of disease is inaccurate or incomplete.	Response clearly explains the relationships between the social determinants of health and the burden of disease.	Demonstrates the same level of achievement as “2,” plus the following: Response effectively correlates social determinants of health to health outcomes and health equity.

Use the data presented in The Robert Wood Johnson Foundation’s interactive tool for sexually transmitted infections (STIs) in Virginia (2014) to answer items 5 through 7. The map can be accessed via this link:

http://www.countyhealthrankings.org/app/virginia/2014/measure/factors/45/map?sort=sc-2

Short Answer 5

Looking at the map, describe the geographic distribution of chlamydia in Virginia. Which county in Virginia has the highest rates and which has the lowest? Hint: click on the Data tab under the heading “Sexually Transmitted Infections” to view data by county. (1 paragraph)

Your Response

The geographical distribution of chlamydia in Virginia from the data in 2014 shows Norfolk city having the highest rate of chlamydia rate at 1358, Buchanan has the lowest rate at 55, however, a number of cities were not ranked, these include Bland and Highland . Most counties had a rate above 250 which is a very worrying number given the impact of this sexually transmitted disease on the citizens. This geographic distribution serves as a model of studying the trend of diseases and it should be incorporated in all other states within the United States.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.1: Use data to make comparisons about disease distribution.	Description of disease distribution is missing.	Description of disease distribution is either inaccurate or incomplete.	Response appropriately uses data to describe disease distribution, including information about highest and lowest rates.	Demonstrates the same level of achievement as “2,” plus the following: Response uses data to compare chlamydia rates with three additional counties.

Short Answer 6

Examine the trend data for Fairfax County. What does it tell you about changes over time in the county’s chlamydia rates? How have chlamydia rates changed over time in the state of Virginia as a whole? (1 paragraph)

Your Response

The rates in Fairfax county have gone up from a rate 448 in 2014 to 963 in 2015, in 2016, the rate dropped to 601 but went up to 621 in 2017 . In Virginia, this rate has decreased in some years for the period between 2017 and 2017; in 2014, this rate was 449 before it dropped to 427 in 2015, 2016 was the lowest at 407, however, it rose again to 436 on average all over Virginia. This data indicates that Fairfax county is not doing a great job in the fight against chlamydia infection; measures and policies need to be laid down to help lower this rate towards the state average.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.

Learning Objective 3.2: Interpret data to make inferences about changes in disease distribution.

Analysis of data about changes in disease distribution is missing.

Response describes data but makes inaccurate or incomplete inferences about changes in disease distribution.

Response appropriately analyzes data to make accurate inferences about changes in disease distribution.

Demonstrates the same level of achievement as “2,” plus the following: Response accurately analyzes chlamydia risk factors and health behaviors.

Learning Objective 3.3: Compare disease distribution at the local and state level.

Comparison of disease distribution at the local and state level is missing.

Comparison of disease distribution at the local and state level is inaccurate or incomplete.

Response compares general disease distribution trends at the local and state level.

Demonstrates the same level of achievement as “2,” plus the following: Response includes an accurate analysis and comparison of the changes in STI rates over time utilizing statistical data at the local, state, and national level.

Short Answer 7

Based on the morbidity rates and associated coloring on the map of Virginia, where would you deploy a mobile unit for STI screenings? Explain why and the significance of the color gradient. (1–2 paragraphs) Hint: click on Map tab under the heading “Sexually Transmitted Infections” to return to the original map, or click on the following link: http://www.countyhealthrankings.org/app/virginia/2014/measure/factors/45/map?sort=sc-2 .

Your Response

The southwestern part of Virginia was adversely affected, when one looks at the map it is no doubt the most suitable location for a screening center for sexually transmitted infections. The color gradient shows the regions mostly affected or rather where the rate of chlamydia is high. People in these regions could be engaging in risky sexual behavior, other possible factors could be population size of these counties and the economic activities. Another contributing factor is that most of these counties contain the major cities in Virginia.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.

Learning Objective 3.4: Use data to make recommendations to improve health outcomes.

Recommendations regarding the deployment of mobile units for STI screenings are missing.

Recommendations regarding the deployment of mobile units for STI screenings are incomplete or not supported by references to the data.

Response makes clear recommendations regarding the deployment of mobile units for STI screenings.

Demonstrates the same level of achievement as “2,” plus the following: Response uses data to thoroughly and accurately justify the recommendation.

Use the CDC map of “Diagnosed Diabetes Percentage, 2011” to answer the items 8 through 10:

http://www.cdc.gov/diabetes/atlas/countydata/atlas.html

Note: Detailed instructions for the use of these tools, titled “Instructions for CDC Diabetes Site,” are available in the Assessment Materials, if needed.

· Move cursor to 2011.

· Click on Select State button State Name California.

· Move cursor to 2010 to respond to questions.

· Return to the U.S. map view by clicking Select State Remove Filter.

· Move the cursor to each year referenced in the question prompt.

Short Answer 8

Describe the geographic distribution of diabetes in the United States in 2011. Then, select the state of California for the year 2010. Describe the distribution of diabetes in California. (1 paragraph)

Your Response

Diabetes is a chronic disease that is common in the United States. In 2011, the median percentage of people diagnosed with diabetes in the United States was 8.9% . In California, the rate was 8.6% in 2010 while the median of all the states was 8.3 . California had a lower limit of 8.1% and an upper limit of 9.1% in the year 2010 . Most cases of diabetes were reported in the southern states where the term “diabetes belt” was coined to refer to the states that had about 11% prevalence as compared to the national average of 8.9% .

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.5: Use data to describe disease distribution.	Description of disease distribution is missing.	Description of disease distribution is inaccurate or incomplete.	Response appropriately describes the geographic disease distribution using visual and directional geographic references with no statistics present.	Demonstrates the same level of achievement as “2,” plus the following: Response includes specific statistics to support Descriptions provided.

Short Answer 9

Examine the national maps of diabetes from 2004 through 2010. Describe the changes in diabetes prevalence/incidence over time in the United States. (1–2 paragraphs)

Your Response

Over this period, significant increase in prevalence has been reported probably due to poor policies aimed at controlling the disease. The median percentage for all the states had significantly increased for the period between 2004 and 2010, in 2004, the rate was 6.9% compared to 2010 when the rate was 8.3% . What is shocking to note is that this rate had increased for every single year between 2004 and 2010, this median percentage was 6.9, 7.3, 7.4, 7.8, 7.9, 8.0 and 8.3 respectively . This increasing incidence is something that should worry the government since studies show that most cases can be prevented as they are caused by modifiable risk factors such as obesity and sedentary lifestyle .

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.6: Analyze data to make inferences about changes in disease distribution.	Analysis of changes in disease distribution is missing.	Response makes inaccurate or incomplete inferences about prevalence/incidence of diabetes over time.	Response appropriately describes prevalence/incidence of diabetes over time.	Demonstrates the same level of achievement as “2,” plus the following: Response accurately identifies statistics for each year and any significant or unexpected changes in the data.

Short Answer 10

How do the rates of diabetes in California compare to the nation as a whole? (2–3 sentences)

Your Response

The incidence of diabetes in California for the period between 2004 and 2010 was even higher than the national average for the same years . It is only in 2010 that a fall in this rate was seen in California, the rate in 2010 was 8.6%, a fall from the previous year when the rate was 9.2 in California . Despite this fall in rate in 2010, the rate in California was still higher than the national average which was 8.3% in 2010 .

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.7: Use data to compare disease distribution at the local, state, and/or national level.	Usage of data to compare disease distribution at various levels is missing.	Usage of data to compare disease distribution at various levels is inaccurate or incomplete.	Response appropriately uses data to compare disease distribution at the state and national level.	Demonstrates the same level of achievement as “2,” plus the following: Response uses data to compare disease distribution by sex.

Use the “BRFSS Prevalence and Trends Data by State” (http://www.cdc.gov/brfss/brfssprevalence/) to answer the items 11 through 13.

Note: Detailed instructions for the use of this web tool, titled “Instructions for BRFSS Prevalence and Trends Data by State” are available in the Assessment Materials, if needed.

Short Answer 11

What were the five most prevalent chronic diseases among the population of Alabama in 2012 based on the chronic health indicators listed?

Your Response

Arthritis, asthma, depression, COPD, and diabetes .

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 4: Analyze leading causes of death and disease in the United States.
Learning Objective 4.1: Identify top chronic diseases in specific populations.	Identification of top chronic diseases is missing.	Identification of top chronic diseases is inaccurate or incomplete.	Response accurately identifies the five most prevalent chronic diseases among the population in Alabama in 2012.	Demonstrates the same level of achievement as “2,” plus the following: Response includes a description of prevalence rates for the five most prevalent chronic conditions.

Short Answer 12

How do the rates for the five most prevalent chronic diseases among the population of Alabama in 2012 compare to the five most prevalent chronic diseases in Illinois in the same time period? (1–2 paragraphs)

Your Response

Arthritis, COPD, asthma, diabetes, and depression were still the most prevalent chronic diseases in Illinois in the year 2012, but the rate was lower in Illinois as compared to Alabama for the five most prevalent diseases . Arthritis topped both states with a rate of 33.9% in Alabama as compared to an incidence of 25.4% in Illinois . The incidence of diabetes followed closely with a rate of 12.3% in Alabama as compared to the rate of 9.4% in Illinois for the same period in the year 2012 .

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 4: Analyze leading causes of death and disease in the United States.
Learning Objective 4.2: Compare leading chronic diseases between the states.	Comparison of chronic diseases between the states is missing.	Comparison of chronic diseases between the states is incomplete or inaccurate.	Response describes chronic-disease prevalence for the leading five diseases in Illinois and Alabama.	Demonstrates the same level of achievement as “2,” plus the following: Response uses statistics to accurately analyze chronic disease prevalence in Alabama compared to Illinois.

Short Answer 13

Create a table comparing five chronic-disease indicators of your choice for 2012 in Alabama, Illinois, California, Florida, and Hawaii. (1/2 page) Note: You may not use diabetes (non-pregnancy related) or obesity indicators in response to this question.

Your Response

STATE(year 2012) Arthritis Diabetes Asthma COPD Depression Alabama 33.9% 12.3% 8.6% 9.9% 21.9% Illinois 25.4% 9.4% 8.5% 6% 15% California 22% 9.8% 8.8% 4.6% 11.7% Florida 26.4% 11.4% 8.2% 7.6% 16.9% Hawaii 20.03% 7.8% 8.9% 3.6% 11.5%

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations	3 Exceeds Expectations
Sub-Competency 4: Analyze leading causes of death and disease in the United States.

Learning Objective 4.3: Organize data using a table to compare leading chronic diseases between states.

Table or comparison is missing.

Table is incomplete or inaccurate.

Table accurately displays data comparing five chronic-disease indicators for 2012 in Alabama, Illinois, California, Florida, and Hawaii.

Demonstrates the same level of achievement as “2,” plus the following: Table includes a brief narrative that draws relevant conclusions regarding the disease burden as a whole among the five states.

References Centers For Disease Control and Prevention. (2011). Diagnosed Diabetes . Retrieved from Centers For Disease Control and Prevention: https://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html Centers for Disease Control and Prevention. (2015). BRFSS Prevalence & Trends Data. Retrieved from CDC: https://www.cdc.gov/brfss/brfssprevalence/ Community Commons. (2014). maps. Retrieved from Community Commons: https://maps.communitycommons.org/viewer/?action=open_map&id=46966 Robert Wood Johnson Foundation. (2014). Sexually transmitted infections. Retrieved from County Health Rankings: http://www.countyhealthrankings.org/app/virginia/2014/measure/factors/45/map?sort=sc-2 Truven Health Analytics, Coverage Estimates, The Nielson Company, & Community Need Index. (2017). Community Need Index. Retrieved from Dignity Health: http://cni.chw-interactive.org/ US Census Bureau. (2015, April 18). Race and Ethnicity in Santa Fe, New Mexico. Retrieved from Statistical Atlas: https://statisticalatlas.com/place/New-Mexico/Santa-Fe/Race-and-Ethnicity

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