Map Details - High Blood Pressure and Medication Adherence Among Medicaid Members and YMCA Lifestyle Change Programs

Impact Statement

This map highlights the existence of major geographic disparities in blood pressure medication adherence, even within the Medicaid population. The YMCA’s Blood Pressure Self-Management program is well positioned to address these disparities, and the Michigan Department of Health and Human Services will work with the YMCAs to strengthen the program and pilot group classes in areas of highest need.

This map was developed as a part of the GIS Capacity Building Project. Learn more about the project.

This map shows results of statistical significance testing of differences between county-level medication adherence rates for the combined 2015–2016 Michigan Medicaid population 18–64 years old. Berrien, Kalamazoo, Kent, Ingham, Wayne, Bay, Tuscola, Genesee, Saginaw, Shiawassee, and Ogemaw counties had statistically lower rates of medication adherence in comparison to all other counties. Washtenaw and Jackson counties and counties in the Traverse City area and the eastern Upper Peninsula had adherence rates comparable to all other counties. The map also shows the locations of YMCA lifestyle change programs, including the Diabetes Prevention Program (DPP) and Blood Pressure Self-Management (BPSM) program, in addition to locations that do not offer either program. The seven BPSM programs (Detroit, Ann Arbor, Adrian, Bay, Lansing, Grand Rapids, and Cadillac) are well matched to statistically lower or comparable counties. The 12 DPP programs are also mostly located in statistically lower or comparable counties. Neither program operates in the one YMCA location in Shiawassee County, and there are no YMCA locations in Saginaw, Tuscola, or Ogemaw counties.

Key Points

Major Findings

This map identifies counties that have low adherence to blood pressure medications in the Medicaid population, and where evidence-based lifestyle change programs are available. The map assesses how current program availability matches counties with low adherence rates.

How the map will be used, or has been used

The Michigan Department of Health and Human Services is working with the YMCAs to strengthen the program’s curriculum and pilot group classes. Efforts to improve the BPSM program will prioritize counties with the lowest adherence rates and work to expand availability to low-adherent counties without active programs.

ArcGIS, Excel, and SAS/SPSS

Michigan Medicaid Claims data; Michigan Open GIS data portal; State Alliance of Michigan YMCAs

Proportion of Days Covered calculations for each county; tests of statistical difference of county-level rates for each county relative to all other counties; geocoding of program locations.

Adrian Zeh, Evaluation Specialist, Michigan Department of Health and Human Services

Adrian Zeh, Michigan Department of Health and Human Services; accessed from the Centers for Disease Control and Prevention’s Chronic Disease GIS Exchange.

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