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Show PUBLIC HEALTH REPORT CARD* Overview America's Public Health Report Card combines a comprehensive examination of health indicators into a condensed, easy-to-read table in which each state is placed in a particular quartile based upon a combination of measures (Table 102). The statistics provided in the table allow comparison among the 50 states and the District of Columbia. If data are not available for a state in a particular area or sub-category, that state receives the lowest ranking, which limits the meaningfulness of the comparison. The quartile range indicates which overall place the state occupies in each category presented. The first quartile is the top 12 states in a category. The second quartile is the next 13 states, the third - the next 13 states, and the fourth quartile - the bottom 13 states. One limitation of the America's Public Health Report Card is that the same years are not used for all the indicators presented. For instance, statistics for the indicator Unsafe Drinking Water of the category Healthy Environment are from a 1986 source, whereas statistics for the Work-related Injury indicator of that same category are from a 1990 source. (The year of the source material is listed next to the indicator in Table 102. Note also that the date for the statistic is the date at which the measure was taken. Often, the source material was published later). The 1992 America's Public Health Report Card is the most recent version published. Several of the indicators used in this report card deserve explanation. The following descriptions of indicators were taken from the appendix of the Report Card. Medical Care Access Medical Care Access means eliminating inequities and discrimination to ensure that all citizens get the medical care they need-including treatment for emergencies and serious illnesses, but also basic examinations and preventive care. Utah ranks in the second quartile of this category. More trend and analyses of several of these indicators are available in the Health Care Costs, Access, and Quality section of the Review. Population Uninsured measures the percentage of population under 65 years of age without health insurance. Primary Care Physicians per Capita measures the number of primary care physicians per 10,000 civilian population, including doctors of medicine in patient care, office-based general practice and family practice, internal medicine, and pediatrics. Adequate Prenatal Care measures the percentage of women enrolling in first trimester prenatal care. Population Without Access to Primary Care measures the percentage of population designated by the Department of Health and Human Services as living in areas underserved by physicians. An underserved population is one which does not have primary medical care within reasonable economic and geographical bounds. Ratio of Medicaid Recipients to Poor People measures the total number of Medicaid recipients in a state divided by the number of people in the state who live under the poverty line. Lastly, the indicator Medicaid Spending per Capita measures the total dollars spent on Medicaid divided by the state's population. Healthy Environment Environmental factors can either enhance personal health or contribute to poor health outcomes. According to the Report Card, Utah does not compare well with other states in the healthful environment category (Table 101). Utah's ranking in pollution, unsafe drinking water, and fluoridated water are near the bottom compared to other states. Utah ranks in the fourth quartile, or in the lowest 13 states. Pollution Standard Index is measured by the Environmental Protection Agency. The EPA monitors pollutants such as ozone, carbon monoxide, sulfur dioxide, nitrogen dioxide, and fine particulate matter. Utah ranks 44th in the nation in the pollution standard index score. This may result from the pollution of automobiles, heavy industry, and oil refineries which can be trapped in Utah's populous valleys until storms blow it away. Unsafe Drinking Water is measured by the percentage of people who drink from a water source which is in violation of the Safe Drinking Water Acts of 1974 and 1986. Utah ranks the 49th lowest state in the nation in the proportion of people who are drinking unsafe water. The drinking water data are taken from a report provided by the National Wildlife Federation Fund, which uses information obtained from the Environmental Protection Agency. When the Report Card was published, the Utah Department of Environmental Quality offered additional information about the data used: * (a) the violations are largely due to certain failures to 1 Utah Department of Health, Division of Environmental Health, Bureau of Drinking Water/Sanitation (1988, Oct.). Memorandum to Suzanne Dandoy from Kenneth H. Bousefield regarding "National Wildlife Federation Fund Charges of Inadequate Enforcement of Drinking Water Standards." 74 PUBLIC HEALTH |