Connecting state and local government leaders
The Michigan Department of Health and Human Services recently launched a county-level social vulnerability index that officials can use to make data-driven decisions on how to efficiently spend opioid settlement funds.
Michigan’s health department developed a social vulnerability index to give county and local officials a comprehensive view of how substance use disorders affect their communities to inform equitable decisions on action steps, programming and planning to mitigate the opioid crisis.
The Michigan Substance Use Vulnerability Index, which scores counties on their susceptibility to substance use, is part of Michigan Department of Health and Human Services’ ’ plan to encourage officials to use data as they determine where to spend funds from a multistate settlement involving major pharmaceutical distributors McKesson, Cardinal Health and AmerisourceBergen.
Michigan is slated to receive $776 million over 18 years—50% of which is allocated for county and local government—to support opioid treatment and prevention efforts, MDHHS said in a Jan. 18 statement.
MI-SUVI, launched Jan. 18, considers 26 indicators including the number of treatment admissions, the percent of population within a 30- or 25-minute drive to treatment centers and the number of opioid prescriptions administered. Factoring in various data points “allows counties to tailor their efforts to their community,” said Rita Seith, the opioids and emerging drugs unit manager at MDHHS.
Historically, policymakers have considered overdose mortality data to guide substance use-related programs and planning, but that factor alone “doesn’t necessarily answer all of the questions that we need to answer,” Seith said. “If someone knows that fatalities went up or down, that doesn’t necessarily help figure out, ‘Well, what do I need to do about it?’” she said.
Seith said MDHHS officials pulled data from sources they already had access to, including Michigan’s emergency medical information system and the disease surveillance system, publicly available information such as the American Community Survey and outside partners. The agency also collaborated with stakeholders including analysts, prevention program managers, health workers and individuals with lived experience to provide feedback on potential indicators.
Epidemiologists then conducted statistical tests to identify the most relevant points to add in the index’s calculations to reduce duplicative data. “You wouldn’t want to include a dataset that tells you the number of doorbells per square mile and include the number of doorknobs per square mile,” Seith said. “You would want to pick one … because you can have a really long list of indicators and variables that weren’t telling you something different.”
Feedback was also valuable in designing the dashboard to ensure readability and a user-friendly design. “If people look at a report and don’t understand what we did or what we’re trying to say, then that report isn’t useful anymore,” Seith said. The tool incorporates dynamic text, color schemes and legends, displaying the same information in different formats so it is more accessible for a broad audience.
MDHHS plans to update the index every year as “substance vulnerability is not something that changes week to week,” Seith said. The agency is also exploring scaling the index to a ZIP code level so counties can more closely address vulnerabilities in their communities.
The index “can be used for conversation starting and inspiration within each county as they make decisions about how to spend the money that they have,” Seith said. “There’s no one size fits all technique to addressing substance use disorder.”