Definition

A composite health equity measure by geography, grounded in methods used by Gopal K. Singh for the Area Deprivation Index (ADI). The 99 Utah Small Areas are distributed across five HII groups: Very low HII (score <80.00), Low HII (score 80.00-94.99.), Average HII (score 95.00-104.99), High HII (score 105.00-119.99), and Very high HII (score > or = 120.00).

Numerator

N/A

Denominator

N/A

Data Interpretation Issues

Important limitations of the Utah HII to consider include: (a) some small areas might have a high HII because of their large and transient college student populations, (b) within areas with average and low HII, there may be clusters of underserved and underresourced communities such as American Indian Tribes or other underserved groups, (c) some communities are more geographically granular or span multiple geographical units, and (d) geographical unit limitations such as some ZIP Codes cross county boundaries, ZIP Codes in BRFSS may not exactly correspond to ZIP Code Tabulation Areas (ZCTAs) in ACS, and ZIP Codes were developed for mail routes and not geographic designations.

Why Is This Important?

The Utah HII is an innovative, data-driven, and practical way to advance health equity and inform efforts to reduce, in a more efficient and effective way, the burden of health disparities in diseases and health conditions in specific geographic areas. The 2022 Utah HII ranges from 58.53 to 152.80. The Utah HII gives a score to each Utah Small Area. Based on their score, Utah Small Areas are categorized into five groups: very low, low, average, high, and very high. The higher the group, the more improvements the area may need. To integrate a health equity approach, strategies, and interventions in all geographic areas must consider all the populations who live in the area. For areas with high and very high HII, strategies and interventions should include supportive activities to address the barriers that the populations who live in the area may face during implementation. These supportive activities may take the form of policies, processes, and practices to address the social determinants of health and to mitigate the inequities (processes) that result in disparities (outcomes). A full report on the 2022 Utah HII can be found here: [https://healthequity.utah.gov/wp-content/uploads/Utah-HII-2022-Update.pdf.]

How Are We Doing?

According to 2016-2020 data, more than one-third (40%) of the 99 Small Areas have a high or very high HII: [[br]] *Very low HII: 19 Small Areas *Low HII: 19 Small Areas *Average HII: 21 Small Areas *High HII: 26 Small Areas *Very high HII: 14 Small Areas [[br]] From the 2017 Utah HII to the 2022 Utah HII, most small areas (60%) did not change HII group. However, 1% improved 2 levels, 14% improved 1 level, and 26% declined 1 level.

What Is Being Done?

The Utah Department of Health and Human Services (DHHS) uses the HII to inform work to address health disparities and advance health equity. [[br]] * The DHHS Office of Health Equity has used the HII to produce the report [https://healthequity.utah.gov/wp-content/uploads/HealthDisparitiesbyUtahStateLegislativeDistrict2019 Health Disparities by Utah State Legislative District]. * The UDOH Bureau of Health Promotion is using the HII to understand and address health disparities in chronic disease. * The DHHS Division of Population Health is using the HII to understand and address health disparities in chronic and infectious diseases and has integrated it into the [https://dhhs.utah.gov/utahhpi/ Utah Healthy Places Index]. * The DHHS Office of Primary Care and Rural Health has created [https://ruralhealth.health.utah.gov/https-ruralhealth-health-utah-gov-utah-state-profile/health-improvement-index/ interactive maps with the HII].

Health Program Information

The DHHS Office of Health Equity's (OHE) vision is for all people to have a fair opportunity at reaching their highest health potential given that health is crucial for well-being, longevity, and economic and social mobility. The OHE's mission is to advance health equity and reduce health disparities in Utah. Contact {{style color:#003366 healthequity@utah.gov}} for more information.

Data Notes

The Utah Health Improvement Index (HII) is not a measure of health per se, but instead measures a combination of social and economic conditions that may affect health outcomes. The 2022 Utah HII ranges from 58.53 to 152.80. The Utah HII gives a score to each Utah Small Area. Based on their score, Utah Small Areas are categorized into five groups: very low, low, average, high, and very high. The higher the group, the more improvements the area may need. For more information on the 2022 Utah HII methodology, see [https://ibis.utah.gov/ibisph-view/pdf/resource/HII_UT_methodology_2022.pdf].

References and community resources

References: * Braveman, P, Arkin, E, Orleans, T, Proctor, D, & Plough, A. (2017). What is Health Equity? Robert Wood Johnson Foundation. * Utah Department of Health and Human Services (2022). [https://healthequity.utah.gov/wp-content/uploads/Utah-HII-2022-Update.pdf Utah Health Improvement Index?2022 update]. Salt Lake City, UT. * Office of Health Disparities (2018). [http://health.utah.gov/disparities/data/ohd/UtahHII.pdf The Utah Health Improvement Index]. Salt Lake City, UT: Utah Department of Health. * Singh, GK. Area deprivation and widening inequalities in US mortality, 1969-1998. American Journal of Public Health. 2003; 93(7); 1137-1143. More information about Utah Small Areas can be found at [https://ibis.health.utah.gov/pdf/resource/UtahSmallAreaInfo.pdf]