A New Measure of Community Health: Findings From the Healthy Aging Data Reports.

Abstract

The purpose of this study was to develop a multidimensional measure of community healthy aging that is more nuanced than existing measures. The social-ecological framework guided this analysis of the latent structure of community prevalence rates of chronic diseases and functional impairments. The sample was 471 communities in Massachusetts (n = 319) and New Hampshire (n = 152). Data were drawn from publicly available healthy aging data reports for both states. Community prevalence rates for 45 chronic conditions, rates of mortality, and Medicare service utilization were estimated with the 2014-2015 Centers for Medicare & Medicaid Services (CMS) Medicare Beneficiary Summary Files and used in factor analyses to explore the latent structure of community healthy aging. Results revealed a multidimensional structure composed of 4 latent population health components: serious complex chronic disease, indolent chronic disease, physical disability, and psychological disability. We found that while lower community socioeconomic status is a major determinant of all 4 components of population health, it is predictably associated with higher levels of serious complex chronic disease and physical disability and yet surprisingly with lower levels of indolent chronic disease and psychological disability. The 4-dimensional model provides a more nuanced measure of community healthy aging than mortality rate, and it identifies community health disparities that otherwise may go undetected. Understanding the multiple levels that influence community healthy aging may reveal new interventions or programs to improve it and allow policymakers or other stakeholders to more accurately tailor interventions to match the conditions of need.