Working with Iowans building a culture of conservation, Program Summary, November 2008

Over 94% of Iowa ’ s land is held in private ownership, and the programs of the Iowa Department of Agriculture and Land Stewardship Division of Soil Conservation (IDALS-DSC) have been established to work with these landowners. Over 90% of the landscape is used for agricultural production so much of our focus is in rural communities, but we haven’t overlooked the importance of land management in urban areas. It is crucial to understanding of both conservation and hydrology issues, that what happens on the landscape has immense consequences to the environmental health of our state and the quality of life we enjoy. IDALS-DSC is striving to integrate our programs with other agencies and local concerns to improve water and local concerns to improve water and soil quality throughout the state and nation.

Social and medical vulnerability factors of emergency department frequent users in a universal health insurance system

Objectifs - Identifier les facteurs de vulnérabilité sociaux et médicaux associés au recours multiple aux consultations des urgences. - Déterminer si les patients à recours multiple sont plus à même de combiner ces facteurs dans un système d'assurance universelle. Méthode Il s'agit d'une étude cas-contrôle rétrospective basée sur l'étude de dossiers médico-administratifs comparant des échantillons randomisés de patients à recours multiple à des patients n'appartenant pas à cette catégorie, au sein des urgences du Centre Hospitalier Universitaire Vaudois et de la Policlinique Médicale Universitaire de Lausanne. Les auteurs ont défini les patients à recours multiple comme comptabilisant au moins quatre consultations aux urgences durant les douze mois précédents. Les patients adultes (>18 ans) ayant consulté les urgences entre avril 2008 et mars 2009 (période d'étude) étaient inclus ; ceux quittant les urgences sans décharge médicale étaient exclus. Pour chaque patient, le premier dossier d'urgence informatisé inclus dans la période d'étude était sélectionné pour l'extraction des données. Outre les variables démographiques de base, les variables d'intérêt comprennent des caractéristiques sociales (emploi, type de résidence) et médicales (diagnostic principal aux urgences). Les facteurs sociaux et médicaux significatifs ont été utilisés dans la construction d'un modèle de régression logistique, afin de déterminer les facteurs associés avec le recours multiple aux urgences. De plus, la combinaison des facteurs sociaux et médicaux a été étudiée. Résultats Au total, 359/Γ591 patients à recours multiple et 360/34'263 contrôles ont été sélectionnés. Les patients à recours multiple représentaient moins d'un vingtième de tous les patients des urgences (4.4%), mais engendraient 12.1% de toutes les consultations (5'813/48'117), avec un record de 73 consultations. Aucune différence en termes d'âge ou de genre n'est apparue, mais davantage de patients à recours multiples étaient d'une nationalité autre que suisse ou européenne (n=117 [32.6%] vs n=83 [23.1%], p=0.003). L'analyse multivariée a montré que les facteurs de vulnérabilité sociaux et médicaux les plus fortement associés au recours multiple aux urgences étaient : être sous tutelle (Odds ratio [OR] ajusté = 15.8; intervalle de confiance [IC] à 95% = 1.7 à 147.3), habiter plus proche des urgences (OR ajusté = 4.6; IC95% = 2.8 à 7.6), être non assuré (OR ajusté = 2.5; IC95% = 1.1 à 5.8), être sans emploi ou dépendant de l'aide sociale (OR ajusté = 2.1; IC95% = 1.3 à 3.4), le nombre d'hospitalisations psychiatriques (OR ajusté = 4.6; IC95% = 1.5 à 14.1), ainsi que le recours à au moins cinq départements cliniques différents durant une période de douze mois (OR ajusté = 4.5; IC95% = 2.5 à 8.1). Le fait de comptabiliser deux sur quatre facteurs sociaux augmente la vraisemblance du recours multiple aux urgences (OR ajusté = 5.4; IC95% = 2.9 à 9.9) ; des résultats similaires ont été trouvés pour les facteurs médicaux (OR ajusté = 7.9; IC95% = 4.6 à 13.4). La combinaison de facteurs sociaux et médicaux est fortement associée au recours multiple aux urgences, puisque les patients à recours multiple étaient dix fois plus à même d'en comptabiliser trois d'entre eux (sur un total de huit facteurs, IC95% = 5.1 à 19.6). Conclusion Les patients à recours multiple aux urgences représentent une proportion modérée des consultations aux urgences du Centre Hospitalier Universitaire Vaudois et de la Policlinique Médicale Universitaire de Lausanne. Les facteurs de vulnérabilité sociaux et médicaux sont associés au recours multiple aux urgences. En outre, les patients à recours multiple sont plus à même de combiner les vulnérabilités sociale et médicale que les autres. Des stratégies basées sur le case management pourraient améliorer la prise en charge des patients à recours multiple avec leurs vulnérabilités afin de prévenir les inégalités dans le système de soins ainsi que les coûts relatifs.

Report on Impacts and Costs of the Iowa Low-Income Weatherization Program, 2001

This report summarizes state and utility low-income weatherization program activity for households weatherized to completion during calendar year 2001. The report includes state, utility, and agency summaries of calendar year 2001 spending and impacts by measure, end-use, and fuel.

Report on Impacts and Costs of the Iowa Low-Income Weatherization Program: Executive Summary 2001

This report summarizes state and utility low-income weatherization program activity for households weatherized to completion during calendar year 2001. The report includes state, utility, and agency summaries of calendar year 2001 spending and impacts by measure, end-use, and fuel.

Report on Impacts and Costs of the Iowa Low-Income Weatherization Program: Executive Summary 2001

This report summarizes state and utility low-income weatherization program activity for households weatherized to completion during calendar year 2001. The report includes state, utility, and agency summaries of calendar year 2001 spending and impacts by measure, end-use, and fuel.

Report on Impacts and Costs of the Iowa Low-Income Weatherization Program: Executive Summary 2003

This report summarizes state and utility low-income weatherization program activity for households weatherized to completion during calendar year 2001. The report includes state, utility, and agency summaries of calendar year 2001 spending and impacts by measure, end-use, and fuel.

F-1 Food Assistance Program State Summary, August 2009

The Food Assistance Monthly Participation Report is a monthly summary of Food Assistance program participation, Statewide and for each Iowa county. Breakouts are reported for participants also in the FIP program, those only receiving Food Assistance, and those that are receiving economic assistance under other programs (primarily Medicaid). This report may also be known as the F-1 Report.

A-1A Supplemental Security Income Program, August 2009

A-1A - Supplemental Security Income Program

A-1 Monthly Public Assistance Statistical Report Family Investment Program, August 2009

A-1 - Monthly Public Assistance Statistical Report Family Investment Program

Report on Impacts and Costs of the Iowa Low-Income Weatherization Program, 2003

This report summarizes state and utility low-income weatherization program activity for households weatherized to completion during calendar year 2003. The report includes state, utility, and agency summaries of calendar year 2003 spending and impacts by measure, end-use, and fuel. The base data consisted of statewide program tracking databases of spending and measure installations for households completed during the calendar year 2003..

Report on Impacts and Costs of the Iowa Low-Income Weatherization Program, 2004

This report summarizes state and utility low-income weatherization program activity for dwellings weatherized to completion during calendar year 2004. The report includes state, utility, and agency summaries of calendar year 2004 spending and impacts by measure, end-use, and fuel. The base data consisted of statewide program tracking databases of spending and measure installations maintained by the Iowa Department of Community Action Agencies.

Report on Impacts and Costs of the Iowa Low-Income Weatherization Program, 2005

This report summarizes state and utility low-income weatherization program activity for dwellings weatherized to completion during calendar year 2005. The report includes state, utility, and agency summaries of calendar year 2005 spending and impacts by measure, end-use, and fuel. The base data consisted of statewide program tracking databases of spending and measure installations maintained by the Iowa Department of Community Action Agencies.

Report on Impacts and Costs of the Iowa Low-Income Weatherization Program, 2006

This report summarizes state and utility low-income weatherization program activity for dwellings weatherized to completion during calendar year 2006. The report includes state, utility, and agency summaries of calendar year 2006 spending and impacts by measure, end-use, and fuel. The base data consisted of statewide program tracking databases of spending and measure installations maintained by the Iowa Department of Community Action Agencies.

Report on Impacts and Costs of the Iowa Low-Income Weatherization Program, 2007

This report summarizes state and utility low-income weatherization program activity for dwellings weatherized to completion during calendar year 2007. The report includes state, utility, and agency summaries of calendar year 2007 spending and impacts by measure, end-use, and fuel. The base data consisted of statewide program tracking databases of spending and measure installations maintained by the Iowa Department of Community Action Agencies.