As part of a 2013 NCACC Annual Conference workshop on the Affordable Care Act, Pitt County Health Director Dr. John Morrow discusses the impact of the Act on North Carolina county public health.

1. ACA and County
Public Health
John H. Morrow, MD, MPH
Pitt County Health Director
NCACC
August 24, 2013

2. U.S. Health Crisis
Compared with 16 other
comparable nations we have the
worst life expectancy. The gap is
increasing.
US Spends nearly twice as much
as other nations. 19.6% of our GDP
by 2021.

3. North Carolina Crisis
Based on overall health status,
NC currently ranks 33rd out of
50 U.S. States.
Some NC counties have third
world health status.

4. Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults
BRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%

5. Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults
BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%

6. Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults
BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%

7. Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults
BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%

8. Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults
BRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

9. Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults
BRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

10. Crisis not just Health
Jobs
Economy
National Security

11. Triple Aim
Improved quality
Improved value
Improved population health

12. Population Health
Determinants
Healthcare accounts for only 10-
15%.
Other factors include health
behaviors, education and
socioeconomic status.

14. Affordable Care Act
Requires non-profit
hospitals to conduct a
Community Health Needs
Assessment every 3
years.

15. CMMS Innovations
Accountable Care
Organizations (ACO)
Other payment and care
models.

16. Prevention and Public
Health Fund
Community
Transformation Grants

17. Websites
CDC.gov
Americasranking.org
Countyhealthrankings.org
Schs.nc.us