The COVID-19 pandemic has consumed public health for most of 2020; however, the work towards health improvement in general remains. This annual report summarizes information regarding the progress towards goals and objectives in Virginia’s State Health Improvement Plan, known as the Plan for Well-Being. This report does not provide a comprehensive review of the COVID-19 response, which is summarized independently in the Commissioner’s Report delivered to the Board of Health during its December 2020 meeting.

The Plan for Well-Being outlines a path for improving the health and well-being of Virginians through four aims, 13 goals, and 29 measures. Virginia’s Plan for Well-Being lays out the foundation for giving everyone a chance to live healthy life by: (1) Factoring health into policy decisions related to education, employment, housing, transportation, land use, economic development, and public safety; (2) Investing in the health, education, and development of Virginia’s children; (3) Promoting a culture of health through preventive actions; and (4) Creating a connected system of healthcare. The measure of success is that the percent of adults in Virginia who report positive well-being increases.

The 2020 Annual Report indicates the updated figure for each measure in The Plan, with the most current data available. In some instances, this report also includes additional analysis of metrics, to better understand any disparities or trends in subpopulations. The accompanying technical document provides detail on values, data sources, and descriptions of each measure. Notably, many of the data sources for The Plan have a natural lag and are data from years prior to 2020.

Of the 29 measures, when compared to baseline measures reported in 2016, 15 show improvement, although at different degrees. Of these, three measures (Disability-Free Life Expectancy, Percent of High School Graduates Enrolled in an Institution of Higher Learning, and Teen Pregnancy Rates) have exceeded the goal that was originally set forth in The Plan. The remaining 14 measures persist as areas of needed focus, in that they have evidenced little to no change, or in some cases, have decreased further away from the intended goal. Some measures show fluctuating trend; the below categorization reflects comparison from the 2016 baseline to 2020 values.

Improving Measures:

• Percent of High School Graduates Enrolled in an Institution of Higher Education within 16 months after graduation*

• Percent of Cost Burdened Households

• Consumer Opportunity: Townsend Material Deprivation Index

• Percent of Health Districts that Have Established a Collaborative Community Health Planning Process

• Pregnancies Per 1,000 Females Ages 15-19 years old

• Black Infant Deaths Per 1,000 Black Live Births

• Percent of Households That Are Food Insecure for Some Part of the Year

• Percent of Adults Who Currently Use Tobacco

• Percent of Adolescent Girls Who Receive Two Doses of HPV Vaccine

• Percent of Adolescent Boys Who Receive Two Doses of HPV Vaccine

• Percent of Adults Who Receive an Annual Influenza Vaccine

• Average Years of Disability Free Life Expectancy

• Percent of Healthcare Providers Who Have Implemented a Certified Electronic Health Record

• Number of Entities Connected through Connect Virginia, HIE, and The Electronic HIE and the National eHealth exchange

• Percent of hospitals that meet the State Goal for Prevention of Hospital-Onset Clostridium difficile Infections

Areas of Needed Improvement (Little to no change or moving away from the goal):

• Percent of Adults Who Report Positive Well Being

• Economic Opportunity Index: Gini Income Inequality Index

• Percent of Children who do not meet the PALS-K Benchmark

• Percent of Third-Graders who pass the Standards of Learning Reading Assessment

• Percent of Adults Who Did Not Participate in Any Physical Activity During the Past 30 days

• Percent of Adults who are Overweight or Obese

• Percent of Adults Who Receive a Colorectal Cancer Screening

• Percent of Adults who Report at least one Adverse Childhood Experience (ACE)

• Percent of Adults who have a regular health care provider

• Rate of Avoidable Hospital Stays for Ambulatory Care Sensitive Conditions

• Rate of Avoidable Deaths from Heart Disease, Stroke or Hypertensive Disease

• Rate of Mental Health and Substance Use Disorder Hospitalizations

• Percent of Adults Who Report Having 1+ Days of Poor Health that kept them from doing their usual activities

• Number of local health districts that have an electronic health record (EHR)

*Italicized measures are those that had no data available for the 2020 update. Trend was assessed based on the last available data.