Community Health Needs Assessment Findings & Selection of Health Priorities January 17, 2019 Daniel Coulter, MPH Jean-Marie Kelly, MPH
Community Health Needs Assessment (CHNA)- Purpose: • Examination of the health status of Cecil County residents to identify key health issues and assets available to address health issues. • Provides the basis for the development of a Community Health Improvement Plan (CHIP). ▫ This 3- year plan includes health priorities for the County and strategies to address health priorities.
Benefits of the CHNA & CHIP • Comprehensive health information • Justification of resource allocation • Coordination and collaboration • Strengthened partnerships • Identified strengths and weaknesses • Benchmark and baseline data for performance improvement
Community Health Needs Assessment- Methods • Community Health Survey ▫ Online survey open to all Cecil County adult residents ▫ Questions related to Demographics, Community Health, Quality of Life, and Access to Health Services • Focus Groups ▫ Vulnerable populations in Cecil County. • Key Informant Interviews • Review of Secondary Data ▫ U.S. Census, MD Vital Statistics, MD SHIP, MD BRFSS, MD YRBS, County Health Rankings, etc.
Community Health Needs Assessment- Selection of Health Priorities • Community Health Survey participants were asked to select the 3 most important health issues in Cecil County. • The top 15 identified health issues (selected by survey respondents) are displayed on slide 11. ▫ Secondary data included in this presentation is organized related to these categories. • Following the presentation of data, CHAC members will be asked to vote on their top 3 priorities to be included in the CHIP for FY20- FY22. (Up to 5 will be included) ▫ This information will be reviewed by the CHNA steering committee to determine the final priorities.
Community Health Needs Assessment- Selection of Health Priorities • Members should vote on health priorities based on: ▫ Size: Number of persons affected, taking into account variance from benchmark data and targets. ▫ Seriousness: Degree to which the problem leads to death, disability, and impairs one’s quality of life. ▫ Trends: Whether or not the health problem is getting better or worse in the community over time. ▫ Equity: Degree to which specific groups are affected by a problem. ▫ Intervention: Any existing multi-level public health strategies proven to be effective in addressing the problem. ▫ Feasibility: Ability of organization or individuals to reasonably combat the problem given available resources. Related to the amount of control and knowledge (influence) organization(s) have on the issue. ▫ Value: The importance of the problem to the community (based on Community Health Survey results). ▫ Consequences of Inaction: Risks associated with exacerbation of problem if not addressed at the earliest opportunity. ▫ Social Determinant/ Root Cause: Whether or not a problem is a root cause or social determinant of health that impacts one or more health issues.
Community Health Needs Assessment- Next Steps • The CHNA steering committee will review the 5 priorities selected at this meeting and set final priorities to be addressed in the CHIP. • An email will be sent out to the group announcing final priorities and you will be invited to select one or more work groups to join and develop a strategic plan to address prioritized health issues. • The CHNA and CHIP will be finalized by June 30, 2019 and we will begin work on the CHIP on July 1.
Community Health Survey Results- Demographics A total of 1403 individuals completed the Community Health Survey.
Community Health Survey Results- Demographics Gender Male 18.6% Female 81.2% Other 0.1% Race Alone or in Combination with One or More Other Race White 95.3% Black or African American 2.9% Asian 0.6% American Indian or Alaskan Native 1.2% Native Hawaiian or Other Pacific Islander 0.0% Some Other Race 2.1% Ethnicity Hispanic, Latino, or Spanish Origin 2.4% Marital Status Married 64.6% Divorced 15.6% Widowed 4.7% Separated 2.2% Never Married 13.0%
Community Health Survey Results- Demographics
Community Health Survey Results- Most Important Health Issues Rank Health Issue % Respondents 1 Substance Abuse 75.3% 2 Mental Health 37.7% 3 Homelessness 32.9% 4 Access to Health Services 18.9% 5 Poverty 15.7% 6 Obesity 14.2% 7 Affordable Housing 13.9% 8 Child Abuse and Neglect 13.5% 9 Dental Health 10.9% 10 Cancer 10.7% 11 Violent Crime 7.9% 12 Unemployment 6.8% 13 Childhood Trauma 5.9% 14 Educational Attainment 5.6% 15 Diabetes 5.0% *Survey respondents were asked to select their top 3 health issues.
Community Health Survey Results- Perceived Health of Community and Personal Health 0.2%
Community Health Survey Results- Quality of Life Quality of Life in Cecil County Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree Cecil County residents feel responsible for their community and take 12.1% 32.3% 35.9% 18.4% 1.3% pride in its accomplishments. Community partners work well together. 6.1% 19.8% 46.9% 24.2% 3.0% Cecil County has many different resources that enhance quality of life. 8.1% 27.3% 34.3% 28.4% 2.0% All Cecil County residents believe that they can make Cecil County a 15.3% 39.2% 30.5% 13.3% 1.6% better place to live. All individuals and groups have the opportunity to contribute to and 5.4% 15.6% 34.9% 39.2% 4.8% participate in Cecil County’s quality of life. Cecil County has networks of support for individuals and families during 9.1% 23.8% 36.8% 28.0% 2.3% times of stress and need. Cecil County is a safe place to live. 12.1% 30.7% 24.4% 30.6% 2.3% There is economic opportunity in Cecil County. 14.3% 33.3% 26.0% 24.3% 2.2% Cecil County is a good place to grow old. 16.5% 31.0% 30.0% 21.0% 1.6% Cecil County is a good place to raise children. 11.7% 24.4% 27.7% 33.4% 2.9% I am satisfied with the health care system in Cecil County. 15.3% 30.0% 23.4% 28.8% 2.5% I am satisfied with the quality of life in Cecil County. 10.4% 28.4% 22.5% 35.5% 3.2%
Community Health Survey Results- Health Literacy
Community Health Survey Results- Primary Source for Health Information
Community Health Survey Results- Access to Health Services Access to Health Services in Cecil County Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree Transportation for medical appointments is available to Cecil County 13.2% 19.5% 44.6% 19.2% 3.5% residents when needed. There are enough substance use disorder treatment providers in 30.8% 22.3% 26.8% 12.9% 7.3% Cecil County. There are enough mental health providers for children in Cecil 36.2% 26.6% 29.7% 6.3% 1.2% County. There are enough mental health providers for adults in Cecil County. 31.7% 29.3% 29.3% 8.2% 1.6% There are enough bilingual (Spanish-speaking, etc.) providers in Cecil 7.6% 12.2% 69.9% 7.5% 2.9% County. There are enough providers accepting Medicaid (Medical Assistance) 11.4% 18.0% 50.9% 15.2% 4.5% in Cecil County. Cecil County residents are able to see a dentist when needed. 11.9% 20.6% 22.0% 38.1% 7.4% Cecil County residents are able to see a medical specialist when 10.6% 28.4% 26.5% 31.1% 3.6% needed (e.g. heart, lung, skin, etc.). Cecil County residents are able to see a primary care provider 5.1% 17.1% 22.2% 45.8% 9.8% (Family Doctor, Pediatrician, Nurse Practitioner, Physician…
Community Health Survey Results- Barriers to Accessing Health Services Rank Most Significant Barriers % Respondents 1 Inability to Pay Out of Pocket Expenses 57.2% 2 Health Care Coverage Does Not Cover Needed Services 33.8% 3 Availability of Doctors or Other Providers/Appointments 30.4% 4 Time Limitations 25.9% 5 Basic Needs Not Met 25.6% 6 Lack of Transportation 22.9% 7 Lack of Dental Insurance 22.2% 8 Lack of Health Insurance 21.5% 9 Difficult to Understand/ Navigate Health Care System 18.7% 10 Lack of Trust in Medical Services 12.8% *Survey respondents were asked to select their top 3 barriers.
Community Health Survey Results- Populations Not Being Adequately Served Rank Population % Respondents 1 Uninsured/ Underinsured 43.7% 2 Homeless 43.1% 3 Low-Income/ Poor 41.9% 4 Seniors/ Aging/ Elderly 33.5% 5 Disabled 22.6% 6 Children/ Youth 20.5% 7 Young Adults 16.6% 8 None 14.4% 9 Other 11.1% 10 Black/ African American 7.1% 11 Hispanic/ Latino 5.9% *Survey respondents were asked to select all that apply.
Community Health Survey Results- Resources or Services Missing in Cecil County Rank Resource or Service % Respondents 1 Mental Health Services 50.2% 2 Free/ Low Cost Dental Care 46.8% 3 Substance Use Disorder Services 42.7% 4 Free/ Low Cost Medical Care 36.2% 5 Medical Specialists 31.0% 6 Transportation 29.9% 7 Prescription/ Medication Assistance 28.0% 8 Community and Family Outreach Programs 22.6% 9 Health Screenings 22.0% 10 Primary Care Providers 19.7% 11 Health Education 18.8% 12 Bilingual Services 11.7% *Survey respondents were asked to select all that apply.
CHNA Focus Groups & Interviews- Key Themes
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