States have been involved in public health since the yellow fever, small pox, and cholera epidemics of the late 18th and early 19th century. At that time, State health initiatives focused on quarantine measures and efforts to improve water supply and sanitation infrastructure. After the discovery of antibiotics in the mid-1900s, States became increasingly involved in control of communicable disease and, over time, delivery of health care services.
Today, States and other stakeholders are focused on chronic disease, preventive care, and equitable care to improve State and national population health. The 2010 State Snapshots kick starts that process by providing data and resources that States, policymakers, researchers, and clinicians can use to design and target interventions that ensure patients receive the high-quality care needed to make their lives better.
Overall, States are seeing improvements in health care quality, but disparities for their minority and low-income residents persist. Because we track the same core measures over time, we can also see some improvements in selected areas, so we know that improvement is possible. While every State was in the top 10 percent for at least some measures (benchmark States), States in the New England and Pacific census divisions were benchmark States more often. New England States performed best on preventive care and acute treatment, while western States did best on outcomes of care.
States also varied in quality of care for certain clinical conditions. For example, Connecticut and Florida ranked highest in cancer care; Massachusetts and California in maternal and child health care; and Nebraska, New Hampshire, and Wisconsin in care for respiratory diseases.
By identifying areas needing improvement, each State can target areas for intervention. Each State can also link directly from the interactive Web-based 2010 State Snapshots to AHRQ's Health Care Innovations Exchange to find innovations that have improved care in areas States are seeking to improve. For example, Maryland is weak in diabetes care. Maryland researchers, clinicians, or policymakers can look in the Exchange under diabetes to find that nurse-led visits, monthly text messages, and community coalitions are innovative ways to improve diabetes care for particular groups. They can also find diabetes-related tools such as a diabetes eye exam report or health coach toolkit.
Once stakeholders have the "big picture" of who their State residents are and how the State is performing on individual care measures, they can accelerate the speed that care is improved and disparities are reduced.
Carolyn M. Clancy, M.D.