Guide to improving health value

Evidence for what works

HPIO’s 2017 Health Value Dashboard™ finds that Ohio ranks 46 out of 50 states and D.C. on health value, a composite measure of population health outcomes and healthcare spending. This means that Ohioans are living less healthy lives and spending more on health care than people in most other states.

This resource page provides information about where to find evidence-informed strategies proven to address many of the challenges identified in the Dashboard.

State health improvement plan (SHIP)

• 2017-2019 state health improvement plan (Ohio Department of Health): Released by the Governor’s Office of Health Transformation and the Ohio Department of Health in February 2017, the SHIP is a strategic menu of priorities, outcome objectives and evidence-based strategies designed to address three of Ohio’s greatest health challenges: mental health and addiction, chronic disease, and maternal and infant health.

State policy options fact sheets

Each HPIO fact sheet briefly summarizes outcomes and healthcare costs related to specific health challenges identified in the 2017 Health Value Dashboard. The fact sheets also identify strategies most likely to improve health and decrease disparities based on the strongest-available evidence, describe the extent to which each strategy is currently being implemented in Ohio and offer policy options for implementing or expanding the strategies.

• Reduce tobacco use and secondhand smoke exposure 
• Increase food security and access to healthy food 

Addiction Evidence Project

Launched in December 2017, the HPIO Addiction Evidence Project provides policymakers and other stakeholders with information needed to evaluate Ohio’s policy response to the opiate crisis, and accelerate and continually improve strategies to address substance use disorders in a comprehensive, effective and efficient way.

Recommendations to reduce infant mortality

A New Approach to Reduce Infant Mortality and Achieve Equity, prepared by HPIO for the Legislative Service Commission in 2017, provides 127 specific recommendations to address infant mortality by improving housing, transportation, education and employment.

Evidence-based policymaking overview resources

• Navigating sources of evidence: A guide to effective prevention strategies:  This HPIO policy brief defines “evidence-based prevention” and provides guidance on how to find the best-available sources of evidence for what works to prevent Ohio’s greatest health challenges.
• Results First: A project of the Pew Charitable Trusts and the MacArthur Foundation, the Results First initiative provides state governments with tools to conduct cost-benefit analyses. The analysis model and technical assistance help state leaders to identify which programs work and which do not, and to calculate potential returns on investment of funding alternative programs.
• How states engage in evidence-based policymaking: A national assessment: This report from the Pew-MacArthur Results First initiative identifies specific actions states can take to incorporate research findings into their decisions.

Tools for benefit-cost analysis

• Washington State Institute for Public Policy (WSIPP): Literature reviews and benefit-cost analyses on education, behavioral health, public health and criminal justice programs. WSIPP was created by the Washington state legislature to conduct non-partisan research. Although the data used to calculate the benefit-to-cost ratios is specific to Washington state, the analysis and literature reviews on this website can provide general guidance to other states.
• Community Health Advisor: Interactive tool from the Health Partners Institute that estimates the impact of specific strategies on medical costs and health outcomes. Addresses smoking, physical activity and cardiovascular disease.

Recommended sources of evidence: Comprehensive range of health topics

• What Works for Health: Evidence registry from the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. Addresses a wide range of health issues, including the social, economic and physical environments. Indicates which strategies are likely to reduce health disparities.
• Hi-5 (Health Impact in 5 years): S. Centers for Disease Control and Prevention (CDC) recommendations for non-clinical interventions that have evidence reporting: 1) positive health impacts, 2) results within five years, and 3) cost effectiveness and/or cost savings over the lifetime of the population or earlier.
• 6/18 (Accelerating Evidence into Action): CDC recommendations for traditional and innovative clinical interventions proven to improve health outcomes and control healthcare costs
• The Guide to Community Preventive Services (Community Guide): Systematic reviews from the CDC. Includes strategies that reduce health inequities.
• Agency for Healthcare Research and Quality (AHRQ) Innovations Exchange: Research reviews on a wide range of medical conditions and clinical risk factors.

See HPIO’s Navigating sources of evidence brief for additional sources.

Recommended sources of evidence: Mental health and addiction

• Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health: Includes inventory of evidence-based prevention programs and policies (see Appendix B).
• Office of Juvenile Justice and Delinquency Prevention Model Programs Guide (OJJDP): Evidence registry that addresses child welfare, juvenile justice and substance abuse.
• Washington State Institute for Public Policy (WSIPP): Literature reviews and benefit-cost analyses on children’s mental health, substance abuse, adult mental health, and public health and prevention.

Mental health and addiction are also addressed in the recommended sources in the comprehensive range of health topics section above.

Recommended sources of evidence: Chronic disease

• Community Health Improvement Navigator Database of Interventions: Evidence registry from the CDC that includes strategies related to tobacco use, physical activity, nutrition and other chronic disease risk factors.
• Nutrition Evidence Library: Systematic reviews on specific nutrition topics from the U.S. Department of Agriculture (USDA).

Chronic disease is also addressed in the recommended sources in the comprehensive range of health topics section above.

Recommended sources of evidence: Maternal and infant health

• Forging a comprehensive initiative to improve birth outcomes and reduce infant mortality: Policy and program options for state planning: Compendium of strategies from the Association of Maternal and Child Health programs

Maternal and infant health is also addressed in the recommended sources for comprehensive range of health topics section above.

Recommended sources of evidence: Social determinants of health

• Results First Clearinghouse Database: Clearinghouse that aggregates and rates evidence of effectiveness from several other registries. Topics include child welfare, social policy, criminal justice and education.
• Top Tier Evidence: Systematic reviews on early childhood, education, employment/training, housing/homelessness and other topics.

Social determinants of health are also addressed in the recommended sources in the comprehensive range of health topics section above.

• Results First Clearinghouse Database: Clearinghouse that aggregates and rates evidence of effectiveness from several other registries. Topics include child welfare, social policy, criminal justice and education.
• Top Tier Evidence: Systematic reviews on early childhood, education, employment/training, housing/homelessness and other topics.

Social determinants of health are also addressed in the recommended sources in the comprehensive range of health topics section above.

Additional tools for local community health improvement planners

2017-2019 state health improvement plan community strategy and indictor toolkits

• Mental health and addiction
• Chronic disease
• Maternal and infant health

HPIO evidence inventories

• Tobacco use and secondhand smoke exposure
• Food security and access to healthy food
• Physical activity

Resources for improving public health and prevention

• Beyond Medical Care: HPIO policy brief and series of fact sheets describing emerging policy opportunities to advance prevention and improve health value in Ohio
• Improving population health planning in Ohio: Report prepared for the Ohio Department of Health, Ohio Department of Medicaid and Governor’s Office of Health Transformation to provide recommendations to strengthen Ohio’s population health planning and implementation infrastructure.