Virginia Department of Health – Virginia Health Opportunity Index

The Virginia Health Opportunity Index (HOI) website uses interactive dashboards to make the HOI accessible, interesting and easy to understand. The dashboards offer a variety of perspectives for viewing the HOI, including multiple geographic levels and profiles. We encourage you to explore the many pathways the dashboards provide to understand the Social Determinants of Health (SDOH) in your community. This post provides a guide for the many buttons, maps and pop-ups in the Counties dashboards.

The Health Opportunity Landscape Dashboard

The Health Opportunity Landscape dashboard allows you to see where your county stands in relation to other counties in Virginia in the HOI and its four profiles. The dashboard consists of three parts: the map in the upper left corner, rankings in the upper right corner, and visualization scales in the lower part of the dashboard.

Using the Map

County Rankings-Hovering — Hovering over a county in the map highlights it in the scale visualizations in the bottom portion of the dashboard.

The map shows Virginia’s 134 counties and independent cities colored by Local Health District (LHD). Hover the cursor over a locality in the map
to highlight it in the visualization scales. Hovering the cursor over the map area also reveals a map toolkit on the left side of the map. You can use this tool to zoom in, zoom out, or to return to the “home” view. Hover
over the right arrow at the bottom to reveal advanced zooming and selection tools. You can use these tools to zoom into specific areas of the map or to select groups of localities. To pan the map, click and hold the left mouse button. This will allow you to “grab” the map and move it around in the frame.

The Rankings

Click on a locality to select it and reveal it rank in the HOI and its four profiles in the upper right corner. Selecting a locality affects all sections of the dashboard. Hold the <ctrl> key or use the advanced selection tool to select multiple localities. Clicking on a selected locality clears the selection. Alternatively, use the Local Health District dropdown at the top of the rankings to select all of the localities in a LHD. To clear a selected LHD, return this dropdown to “(All)”. When multiple localities are selected the rankings boxes show the median rank of the selected localities. If an odd number of localities are selected this is the middle locality in the rankings. If an even number of counties are selected this is the halfway point between the two most central localities.

Rankings Three Rivers — The median rankings for Three Rivers Health District. Since Three Rivers has an even number of localities the rankings are the midpoint between the two center-most localities. For instance, the Economic Profile rank of 99 is the midpoint between Westmoreland County (93) and Mecklenburg County (105).

The Visualization Scales

The charts at the bottom of the map show the distribution of the localities in the HOI and its four profiles. Each locality is represented by an outline of its shape, and is shaded by opportunity level (very high, high, average, low & very low). Hover over a locality in any of the charts to highlight it in each of the other charts and in the map. Hovering over a locality also reveals a “tooltip” which includes additional details on opportunity level and ranking. Click on a locality to select it or <Ctrl>+click to select multiple localities. The map will zoom in on selected localities.

Ranking Charts Three Rivers — With the Three Rivers Health District selected you can see the median ranking of its localities and the distribution of individual localities along the visualization scale. Hover over an individual locality to see its ranking.

A Closer Look

By scrolling down to the next dashboard you can view the HOI and its profiles at the census tract level. Click on the radio buttons in the upper left hand corner to scroll through the HOI and its four profiles. To select individual localities or groups of localities, use the check box list to the left of the map. Before selecting, deselect the “All” check box to clear the selections. The map will zoom to the selected entities. Alternatively, you may use the map toolkit as described above.

County CT View Richmond city — The Economic Opportunity Profile for Census Tracts in Richmond City. The Economic Opportunity Profile is selected using the radio buttons in the upper left. Richmond City is selected using the check box list to the left of the map.

The Virginia Health Opportunity Index (HOI) is a resource that could be used in a variety of ways. This blog post describes how we use it with the Conrad-30 program to bring qualified physicians to some of the most underserved areas of Virginia.

The Conrad-30 ProgramThe Conrad-30 Waiver Program is a great resource that brings high-quality foreign physicians to the Commonwealth. International Medical Graduates (IMGs) may complete their graduate medical or residency training in the United States using a J-1 Visa, which lets them remain in the United States during their studies.* However, after finishing school, they must return to their home country for two years before they may return to the U.S. Conrad-30 waives this requirement for a limited number of IMGs who agree to serve underserved populations. Conrad-30, named for the number of open slots per state, prioritizes primary care physicians (PCP), with most of the slots dedicated to PCPs working in Federally-designated shortage areas. Within those 30, each state is allotted 10 “flex slots” that gives flexibility in the specialty and work areas. Virginia allocates five discretionary slots to specific high priority specialties and work areas.

Identifying Target Areas

Virginia’s Conrad-30 Waiver Program is administered by the Virginia Department of Health – Office of Minority Health and Health Equity (VDH-OMHHE) health workforce division, led by Health Workforce Specialist, Olivette Burroughs. Olivette consults with stakeholders, including Virginia’s Primary Care Association (PCA), to identify specialties and areas of need.Stakeholder consultations are essential for this program, but it is equally important to have data to support discretionary selections. Working with Olivette, VDH-OMHHE’s data unit identified three data sources to guide the placement of discretionary Conrad-30 physicians:

Avoidable Hospital Stays (reported by Virginia Health Information): These are stays that could be avoided with high-quality medical care outside of the hospital, usually primary care. While not always avoidable, rates of these stays should decrease when quality health care is available and accessible within a community. Avoidable hospital stays are cataloged by condition, including composite groups such as lung conditions or chronic disease composites.
The Virginia Health Opportunity Index (HOI) 1.0: The first version of the Virginia HOI was released in 2010. Like its successor, it offered a broad examination of the opportunity Virginians have to live a long and healthy life, based on where they live.
Physician Full-Time Equivalency Units (FTEs): VDH-OMHHE’s data unit maintains an up-to-date database on physicians and other health professionals using data collected from the Virginia Department of Health Professions. The database includes specialty, work hours and other data.

These three sources identify vulnerable populations that could benefit from increased access to physicians. Since avoidable hospital stays are available at the county level, we aggregated Census Tract level estimates for the Virginia HOI and physician FTEs to the county level. Areas that scored lowest among these three sources and were identified as high need areas by Virginia’s PCA were selected for discretionary slots.

The Target Areas
Ultimately, three areas were identified as high priority for Pulmonologists, two for Obstetrician/Gynecologists and one for Primary Care. With the exception of one area in Southwest Virginia identified for Pulmonologists, all other identified areas were in Southside Virginia. While there is broad need for physician services across Virginia, these areas stood out based on their high rates of avoidable hospitalizations.Emporia and its surrounding counties, was a target area identified as high priority for all three specialists, while the Martinsville/Danville area was identified as a high priority target area for pulmonogists and OBGYNs. You can explore how these areas fare in the current version of the Health Opportunity Index using our county dashboards.

Pulmonologists:

Obstetrician/Gynecologists:

Primary Care:

The Results
Olivette is accepting applications for its Conrad-30 discretionary slots through August, 2016. Physicians who fill these positions in Virginia know that they will serve vulnerable populations with a demonstrated need for their services. If you are an interested physician (or know of an interested physician) please contact Olivette Burroughs (olivette.burroughs@vdh.virginia.gov).The Conrad-30 program demonstrates how the Virginia HOI, when used in conjunction with other data sources and stakeholder input, could help programs and policymakers target resources. Utilizing the Virginia HOI helps the Conrad-30 program ensure Virginians who face added barriers to better health based on where they live are considered in the analysis for physician placement. This sets a fair and adequate baseline of access to care for all regions of Virginia, and contributes to ongoing efforts to make Virginia the healthiest state in the nation.* International Medical Graduates are defined as individuals who are not U.S. citizens but are accepted to pursue graduate medical training or residency in the United States. They may use a J-1 Visa or a H-1B1 Visa.

Tag: Virginia Department of Health

Navigating the Counties Dashboards

Using the Virginia HOI to Bring Physicians to Virginia