Pa. ranks 25th for senior health Annual health rankings report positive trends nationwide

PHILADEPHIA - Pennsylvania ranked 25th for senior health this year, according to the third edition of United Health Foundation's America's Health Rankings Senior Report: A Call to Action for Individuals and Their Communities.

Nationwide, the report shows positive trends for senior health, especially for those measures that look at whether seniors are getting the right care in a setting of their choice.

Seniors are experiencing lower hospital readmission rates and preventable hospitalization rates compared to last year, while hospice care use and the number of home health care workers have increased.

"United Health Foundation's America's Health Rankings Senior Report is a vital tool for understanding where we, as a state, are making strides in senior health and where key challenges for Pennsylvania's seniors remain," said Dr. Jerry Frank, chief medical officer, UnitedHealthcare of Pennsylvania.

"With America's senior population poised to double by 2050, we must continue to invest in programs and solutions that address our seniors' health needs and help them live the best lives they possibly can."

The report finds that Pennsylvania has its share of strengths and challenges.

Strengths

• High community-support expenditures: Pennsylvania spends an average of $1,917 per adult aged 65 and older living in poverty to support senior programs that address personal care, transportation, meals and other needs.

• Low percentage of low-care nursing home residents: Many low-care nursing home residents do not need the full suite of services offered by nursing homes, and would be capable of living in their own homes with the help of community aid programs such as Meals on Wheels.

In Pennsylvania, only 6 percent of nursing home residents are low-care, the fifth lowest rate in the nation, which indicates that older adults have the support programs they need to remain independent.

• Low geriatrician shortfall: With an aging baby boomer population, the number of geriatricians needed is growing dramatically.

The shortfall of geriatricians in Pennsylvania is 46.4 percent of the minimum number needed, the sixth lowest shortfall among the states.

Challenges

• High prevalence of obesity: 30.1 percent of Pennsylvania adults aged 65 and older are obese, which means that Pennsylvania ranks 45th among the states.

Obesity predisposes older adults to chronic diseases such as heart disease, diabetes, stroke, certain cancers and joint pain.

• High prevalence of physical inactivity: 36.7 percent of senior adults in Pennsylvania report doing no physical activity or exercise in the last 30 days.

Physical inactivity increases the risk of cardiovascular disease, diabetes, obesity, falls, depression and premature death.

• Low percentage of quality nursing home beds: In Pennsylvania, only 35.3 percent of nursing home beds are rated at 4- or 5-star levels.

Quality nursing home practices can largely prevent hospitalizations related to falls, pressure ulcers, urinary incontinence, malnutrition and dehydration.

Vermont healthiest state for seniors

According to the report, Vermont is the healthiest state for seniors, rising from fourth place last year. New Hampshire ranks second, improving one spot from last year. Minnesota fell to third after being ranked first for two years in a row, while Hawaii (4) and Utah (5) round out the top five states.

Louisiana ranks 50th as the least healthy state for older adults, followed by Mississippi (49), Kentucky (48), Arkansas (47) and Oklahoma (46).

Report highlights improvements

The report shows that nationwide seniors are improving in key care trends, particularly in metrics that examine whether seniors are getting the right care in the setting of their choice, pointing to a health system that may be working better for seniors.

Key findings include:

• Preventable hospitalizations dropped 8.6 percent, from 64.9 percent of discharges for Medicare beneficiaries last year to 59.3 percent of discharges in 2015. The decrease marks an 11 percent decline in preventable hospitalizations since the 2013 edition.

• More seniors are spending their last days in the setting they prefer. Hospice care which can be delivered in a home setting increased from 47.5 percent to 50.6 percent of decedents aged 65 and older, while hospital deaths decreased from 25 percent to 22.8 percent of decedents.

Hospice care rose 38 percent since the report's inception in 2013.

• The number of home health care workers increased 9.3 percent compared to last year, which may indicate that home care is an increasingly accessible option for today's seniors.

• More seniors received the flu vaccine compared to last year, rising from 60.1 percent of seniors in 2014 to 62.8 percent this year. Seniors are particularly susceptible to flu and flu-related complications, making it vital that they receive the vaccine each year.

• Seniors are reporting feeling better. The findings showed a 4.8 percent increase in self-reported high health status to 41.8 percent this year, contributing to a 9 percent increase over the past two years.

"It is heartening to see seniors' health is improving, but our societal challenge remains finding ways to encourage more seniors to be more active," said Rhonda Randall, D.O., senior adviser to United Health Foundation, and chief medical officer and executive vice president, UnitedHealthcare Retiree Solutions.

"Strong community support is an essential part of promoting positive health among seniors. We must work together across states, communities and our own families to encourage all seniors to find ways to be as active as they're able to be."

Unhealthy behaviors pose long-term

challenges

After showing promising improvements in last year's edition, physical inactivity rates increased in 2015; one-third of seniors (33.1 percent) did not get any physical activity or exercise outside of work, marking a 15.3 percent increase from the previous year (28.7 percent). Other worrisome trends for senior health include:

• 37.6 percent of seniors have four or more chronic conditions;

• 26.7 percent of seniors are obese;

• 8.7 percent of seniors smoke; and

• 16.1 percent of seniors have had all of their teeth removed due to tooth decay or gum disease.

In addition, despite promising gains in end-of-life care metrics, community support spending per capita for seniors support that helps older adults stay in their homes has declined by 23.9 percent in the past two years.

"Progress in key metrics such as preventable hospitalizations and hospice care show that more seniors are aging comfortably and receiving preferred types of support a trend that not only benefits our health care system but helps ensure seniors' well-being at each step of the aging process," said Reed Tuckson, M.D., senior medical adviser to United Health Foundation.

"We are excited to be making progress toward strong, personalized care for all seniors and look forward to seeing continued momentum in this area."

To see the state rankings in full, visit: www.americashealthrankings.org/senior.