Tidygeocoder is a package for the R programming language (R Core Team, 2021) that allows researchers and analysts to easily perform geocoding. Geocoding (also called "forward geocoding") is the process of obtaining geographic coordinates (longitude and latitude) from an address or a place name, while reverse geocoding is the process of obtaining an address or place name from geographic coordinates.
Humana, a large health care company, has set a goal of 20% improvement in health in the communities it serves by 2020. The metric chosen for the Bold Goal initiative was the HRQOL-4 version of the Centers for Disease Control and Prevention (CDC) Healthy Days survey. This paper presents the methods for measuring progress, reports results for the first year of tracking, and describes Humana's community-based interventions. Across 7 specially designated “Bold Goal” communities, mean unhealthy days declined from 10.98 in 2015 to 10.64 in 2016, which represented a 3.1% relative, or 0.34 absolute, decline. This compares with a 0.17 absolute unhealthy days decline in Humana's national population overall. The paper also describes how additional work identifying associations between social determinants of health (SDOH) and Healthy Days is influencing Humana's strategy. Lastly, a strategy of community engagement is illustrated through 2 case examples: San Antonio and Knoxville. In the San Antonio area, the community in which Humana has been involved the longest, unhealthy days dropped by 9.0% (−0.95 absolute) from a mean 10.52 to 9.57 unhealthy days. In Knoxville, one of the newer areas of engagement, mean unhealthy days declined by 4.8% (−0.61 absolute), representing declines in both physically and mentally unhealthy days. Overall, results are encouraging, and Humana expects declines to accelerate over time as initiatives are launched and scaled in Bold Goal communities.
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