2017 Febr ebruary 28, 2018 Co Communit ity Presentatio ion Ot Ottawa Co County Fi Fillm lmor ore Co Comple lex
Today’s Agenda Welcome Study Findings 2015 CHIP Progress 2018 CHIP Launch 2.0
Background & Methods
What is is a a CHNA? A community health needs assessment is a o systematic examination of the health status indicators for Ottawa County o used to identify key problems and assets o to develop strategies to address our health needs and identified issues o essential ingredients: community engagement and collaborative participation Public Health Accreditation Board (PHAB)
This is stu tudy What is a CHNA? ed 3 3 rep produced eports ts Our Opportunity o Work together o Dig deeper o Ensure sustainability o Monitor change over time o Target limited resources miOttawa.org/healt lthdata
Who we heard fr from in in 2017 10 91 489 1,318
Data Coll llection Area
The Assessment Process Key stakeholder Population data interviews BRFS YAS Rankings Key informant Underserved feedback surveys synthesize the data learn the data t ell the story… Household Survey C OMMUNITY CHNA A SSESSMENT
Health Landscape
Our health, our story ry Ottawa ranks #1 in MI Ottawa ranks #1 in MI o Ottawa ranks #1 in MI o o MI ranks 35 out of 50 Economy still a concern Economy is a concern o o o More are insured Lack health insurance o o Health care cost, Impact of new ACA o o complexity & lack of Single female-headed o coordination families in poverty Alzheimer’s disease o Alzheimer’s disease o Alcohol use high o Alcohol use high o Obesity and ↓ F/V o Obesity and ↓ F/V o impact all groups impact all groups Disparities persist o Health outcomes and o Mental health & income/education o suicide Mental health o 2011 2014 2017 12
Our health, our story… • With 3 hospitals, several low to no fee health clinics and hundreds of providers, health care is accessible to most • Caring, giving and philanthropic with a str trong col olla laborative sp spiri irit among people and organizations • Community of faith with strong schools • Solid economy and safe neighborhoods • Offers outdoor spaces that invite activity “In sum, Ottawa County possesses all of the social and community characteristics that distinguish a community as healthy .” - Ottawa County CHNA 2017
How We e Compare to Others Health Status Indicators Risk Behavior Indicators Ottawa MI US Ottawa MI US General Health Fair/Poor 12.6% 17.7% 16.4% No Leisure Time Physical 23.4% 25.5% -- Activity Poor Physical Health 10.0% 13.0% -- (14+ days) Adequate Fruit and Vegetable 17.6% 14.9% -- Consumption (5 or more/day) Poor Mental Health (14+ days) 8.8% 11.9% -- Consumes Fruits <1 time/day 31.5% 39.7% 39.7% Activity Limitation (14+ days) 7.6% 8.8% -- Consumes Vegetables <1 21.4% 24.7% 22.1% Disability 20.9% 25.1% -- time/day Obese 29.9% 31.2% 29.9% Current Cigarette Smoking 17.6% 20.7% 17.1% Overweight 33.3% 34.9% 35.3% Former Cigarette Smoking 19.5% 26.7% 25.3% Healthy Weight 35.9% 32.4% 32.9% Binge Drinking 14.1% 18.5% 16.9% No Health Care Coverage Heavy Drinking 5.7% 6.5% 6.5% 9.2% 12.0% 12.3% (18-64) No Personal Health Care 12.4% 14.8% 21.6% Provider No Health Care Access Due to 7.4% 12.7% 12.0% Cost = Ottawa County is best = Ottawa County is worst 14
How We Compare to Others Clinical Preventive Practices Chronic Conditions Ottawa MI US Ottawa MI US No Routine Checkup in Past Arthritis 19.4% 30.0% 25.8% 18.7% 28.0% 29.1% Year Depression 17.1% 19.7% 17.4% No Dental Visit in Past Year 18.4% -- 33.6% Lifetime Asthma 12.7% 15.7% 14.0% Had Flu Vaccine in Past Year 70.8% 57.7% 58.6% Diabetes 9.8% 10.7% 10.8% (65+ Only) Current Asthma 8.7% 10.2% 9.3% Ever Had Pneumonia Vaccine 72.9% 72.8% 73.4% (65+ Only) Skin Cancer 6.3% 6.1% 5.9% Other Cancer 4.8% 7.0% 6.7% COPD 4.0% 7.7% 6.3% Heart Attack 3.7% 4.7% 4.4% Angina/CHD 3.3% 4.6% 4.1% Stroke 1.7% 3.3% 3.1% = Ottawa County is best = Ottawa County is worst 15
How We e Compare to Ourselves Health Status Indicators Risk Behavior Indicators 2011 2014 2017 2011 2014 2017 General Health Fair/Poor 9.9%% 10.5% 12.6% No Leisure Time Physical 12.7% 20.5% 23.4% Activity Poor Physical Health 8.1% 6.1% 10.0% Adequate Fruit and (14+ days) Vegetable Consumption -- 29.50% 17.6% Poor Mental Health 8.6% 8.6% 8.8% (5 or more/day) (14+ days) Consumes Fruits Activity Limitation -- 20.6% 31.5% 5.1% 5.7% 7.6% <1 time/day (14+ days) Consumes Vegetables Disability 22.2% -- 20.9% -- 17.1% 21.4% <1 time/day Obese 25.8% 23.9% 29.9% Current Cigarette Smoking 17.2% 18.6% 17.6% Overweight 36.7% 35.3% 33.3% Former Cigarette Smoking 24.5% 22.6% 19.5% Healthy Weight 36.3% 37.7% 35.9% Binge Drinking 20.3% 19.3% 14.1% No Health Care Coverage 12.6% 9.3% 9.2% Heavy Drinking 7.5% 6.5% 5.7% (18-64) No Personal Health Care 12.0% 11.4% 12.4% Provider No Health Care Access Due -- 9.8% 7.4% to Cost Confidence in Navigating -- 81.3% 84.4% the Health Care System Medication/Treatment for = better/improved Mild to Severe -- 25.8% 53.5% = worse Psychological Distress 16
How We Compare to Ourselves Clinical Preventive Practices Chronic Conditions 2011 2014 2017 2011 2014 2017 No Routine Checkup in Past Arthritis 23.2% 18.3% 19.4% 26.2% 19.9% 18.7% Year Depression 18.8% -- 17.1% No Dental Visit in Past Year 21.6% 21.2% 18.4% Anxiety 14.8% -- 15.0% Had Flu Vaccine in Past Year 67.9% 72.1% 70.8% Lifetime Asthma 13.5% 11.9% 12.7% (65+ Only) Diabetes 7.3% 7.8% 9.8% Ever Had Pneumonia 70.9% 66.9% 72.9% Vaccine (65+ Only) Current Asthma 8.4% 6.5% 8.7% Skin Cancer 7.3% 4.7% 6.3% Other Cancer 5.3% 5.4% 4.8% COPD -- 3.0% 4.0% Heart Attack 2.1% 2.1% 3.7% Angina/CHD 3.0% 2.9% 3.3% Stroke 1.2% 2.1% 1.7% = better/improved = worse 17
Top Reported Health Concerns “The most important health Depression & Anxiety problem in the community is:” 1. Obesity 2. Drug abuse 3. “We need better resources and Obesity 1 in 5 support for difficult issues ” 91 Cancer 1 in 8 Health care costs/lack of affordable health 1 in 9 care Mental health 1. Alcohol/drugs/ 1 in 11 Substance Use/Opioids 2. substance abuse Obesity 3. Lifestyle choices (diet, “Behavioral health is still 1 in 11 smoking, lack of exercise) very underserved ” 10 Mental health 1 in 16 18 Source: BRFS – Q1.1: What do you feel is the most important health problem in your community today? (n=1,221)
New for 2017
New to this is CHNA Adverse Childhood Experiences study 11 11 questions women 18 18-44 44 Maternal and Child Health Report ch child ildren en 0-17 17 1 1 in in 20 20 Adult suicidal thinking and attempts 1 in 1 in 4 Chronic pain & use of Rx pain meds 6% vs 6% vs 14% 14% Vaping (adults and youth) 1 in in 13 13 Food insufficiency 1 in in 5 Health literacy not ot con onfi fiden ent 50% 50% of “obese” Weight control receiv ived no o advic ice
ACEs Overv rview Ottawa County ACE Study ACEs are adverse ch child ildhood exp xperie iences es or tr traumatic even ents ts such as abuse, Ottawa MI US neglect or family dysfunction. 29.6% Emotional abuse o The 1 st ACE study was conducted with 17,000 adults between 1995-1997 14.6% Physical abuse o ACEs are common across all populations 7.8% Sexual abuse o ACEs cluster 22.0% Separated or divorced parents o ACEs have a dos ose-response e rel elationship ip with many health, social 19.5% & behavioral outcomes Household substance abuse o ACEs help us to understand how 17.5% Household mental illness Ottawa County residents are impacted by things that happen in 12.8% childhood Intimate partner violence o ACEs can be prevented 7.9% Incarcerated household member
How Common are ACEs? 14% 14% 15% 38% 41% 47% OTTAWA MICHIGAN UNITED STATES 39% 45% 47% ZERO ONE to THREE FOUR or more
Prevalence of f 4+ ACEs 14% Age Education 18-24 < High School 14.3% 18.2% 25-34 High School Grad 20.0% 14.4% 35-44 19.5% Some College 19.5% 47% OTTAWA 45-54 13.9% College Grad 7.8% 55-64 13.9% HH Income 65-74 3.8% <$20,000 24.2% 39% 75+ $20,000-$34,999 3.4% 23.7% Gender $35,000-$49,999 14.3% Male $50,000-$74,999 11.3% 12.9% Female 16.8% $75,000+ 7.2% Race/Ethnicity Section White 14.0% Northwest 16.9% Non-White 15.0% Northeast 15.5% Poverty Level Central 16.2% Below Poverty Line 24.7% Southwest 12.5% Above Poverty Line 13.5% Southeast 12.3% N=1,157. *Among all adults, the proportion who reported ever experiencing four or more of the eleven adverse childhood experiences by age 18.
Im Impact of f ACEs 41% Obesity 26% Chronic pain Disability Smoker Depression Heavy drinker Suicide attempt 0 ACEs 1-3 ACEs 4+ ACEs
Im Impact of f ACEs 49% Obesity 19% Chronic pain Disability Smoker Depression Heavy drinker Suicide attempt 0 ACEs 1-3 ACEs 4+ ACEs
Im Impact of f ACEs 41% Obesity Chronic pain Disability 15% Smoker Depression Heavy drinker Suicide attempt 0 ACEs 1-3 ACEs 4+ ACEs
Im Impact of f ACEs 33% Obesity Chronic pain Disability Smoker 10% Depression Heavy drinker Suicide attempt 0 ACEs 1-3 ACEs 4+ ACEs
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