community area health & resource inventory

Transcription

1 Health Status Index Series Volume XIX Number I community area health & resource inventory data from 27 Richard M. Daley Mayor Bechara Choucair, MD Commissioner

2 Community Area Health & Resource Inventory Girma Woldemichael, Sc.D. Dana M. Harper, B.S. Sheri B. Cohen, M.P.H. Sandra D. Thomas, M.D., M.S. Kirsti A. Bocskay, Ph.D., M.P.H. Julie Y. Morita, M.D. Copyright Information All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated. Suggested Citation Woldemichael G, Harper DM, Cohen SB, Thomas SD, Bocskay KA, Morita JY. Community Area Health & Resource Inventory. Health Status Index Series Vol. XIX No. I Chicago, Illinois: Chicago Department of Public Health Office of Epidemiology, 211.

3 ERRATA This page list errors that were identified in the May 4, 211 release of the Community Area Health & Resource Inventory (CAHRI). All errors listed have been updated in this release of the CAHRI. p. 44, Liver disease and cirrhosis deaths reported for Montclare (Community Area 18) should read. p. 156, Liver disease and cirrhosis deaths reported for Mount Greenwood (Community Area 74) should read. p. 154, The Chronic Disease Deaths table for Washington Heights (Community Area 73) was replaced with the table below. chronic disease deaths number rate 1-yr change Heart Disease Stroke 2 * -- Lower Respiratory Disease 13 * -- Diabetes Mellitus 11 * -- Liver Disease and Cirrhosis 2 * -- Alzheimer s Disease 6 * --

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5 PREFACE Chicago was divided into 75 community areas based upon social, cultural and geographic factors more than 7 years ago by a research committee at the University of Chicago. Two additional community areas have been added since 196. Although the community areas no longer necessarily represent the boundaries of modern Chicago neighborhoods, health and healthcare resource information at the community area level is useful to many community-based organizations, planners, hospitals, universities, and other groups. The first edition of the Community Area Health Inventory was published in 1993 by the Chicago Department of Public Health (CDPH) Office of Planning, Policy and Resource Development. The report was then expanded into two volumes by the Office of Epidemiology in In 25, the Community Area Health Inventory significantly changed in organization and content, incorporated revised racial/ethnic categories, added more meaningful socioeconomic indicators and arranged the expanded number of health measures in a more relevant way. The latest installment of this report has been retitled to reflect the addition of healthcare resource data, and shortened to only one volume. Information on healthcare resources are presented by community area and, for some data, by region. Chicago s community areas can be grouped into seven regions: North, Northwest, Central, West, South, Southwest, and Far South. These regional areas, adapted in part from the work of the Chicago Department of Planning (currently known as the Chicago Department of Housing and Economic Development), were developed by CDPH s Office of Policy & Planning to facilitate geographic analysis of safety net healthcare resources. The Community Area Health and Resource Inventory report now also includes hospitalization data and updated methodologies for 1-year trend analyses of health measures. As Census 21 data was not available when this report was being compiled, population (age, sex and race/ethnicity) and socioeconomic data is not included. This report contains community area level data on the following topics: 27 health measures, including: infant, child and maternal health; disabilities (for year 2); mortality due to cancer, chronic disease and unnatural causes; hospitalizations; and infectious disease cases and deaths. 2 medically needy population (by region as well), 27 healthcare resource information including hospital capacity and utilization, and safety net provider utilization, and Current information on safety net provider locations throughout the City of Chicago (by region as well). The Community Area Health & Resource Inventory summarizes data from many sources and represents the cumulative effort of the Offices of Epidemiology and Policy & Planning, the Division of STI/HIV, and the Communicable Disease, Lead Poisoning Prevention and Tuberculosis Programs. We hope that this report will prove helpful in developing effective interventions for improving the health and well-being of Chicagoans.

6 CONTENTS Methods...1 Definitions of Measures...4 Health & Healthcare Resource Profiles...7 Appendix...165

7 METHODS OVERVIEW This report contains two pages for Chicago and each of its 77 community areas. The first page presents data on mortality, infectious disease, hospitalizations, disabilities, and infant, child and maternal health for the geographic area. Health information is presented for 27 with 1997 serving as a historical reference point. The second page presents data on the medically needy population in the community area and region in 2, hospital capacity and utilization and safety net provider utilization in 27, and locations of safety net providers in the community area as of February 211. DATA REPORTING CRITERIA The guidelines for data release and cell suppression used by CDPH try to balance data accessibility with privacy concerns and confidence in the stability of the estimates that we publish. Rates and percents based on 2 or fewer events can vary widely just by random chance even when there is no meaningful statistical difference between measurements. Rare events occurring in large populations do not usually allow for the identification of individuals, but reporting small cell sizes for population subgroups increases the risk of breaching confidentiality. The guidelines for cell suppression used in this report (adapted from the Massachusetts Department of Public Health) are based on both the numerator (event) and denominator (population or group size) values, except for Tuberculosis, Hepatitis C, Chlamydia, Gonorrhea, Syphilis and AIDS events and rates. See Table 1 for specific reporting conditions. The Division of STI/HIV, Tuberculosis and Communicable Disease Programs have a separate confidentiality standard whereby counts and rates for less than 5 events are suppressed. As such, for fewer than 5 events, counts will be reported as < 5 and rates suppressed. An age-adjusted mortality rate will be suppressed when the total number of events is 2 or less. Percentages and rates (not ageadjusted) based on 2 events or less will be reported along with a warning to use caution when making interpretations based on these rates. Percentages and rates (not age-adjusted) based on fewer than 5 events will be suppressed. If 1997 and/or 27 rates/percents are suppressed, 1-YR CHANGE will not be calculated, and will be indicated by --. POPULATION DENOMINATORS The population denominators for calculating 1997 and 27 rates/percentages for all health measures, except for Lead Screening, are projections based on 199 and 2 census data and 27 population projections were calculated using the following formulas: 1. Average annual rate of change (AARC) = (Population 2 - Population 199 )/1 2. Projected Population = 1997 Population (7*AARC) 3. Projected Population = 27 Population 2 + (7*AARC) This projection method requires two assumptions: (1) the rate of population change occurs evenly over time, and (2) the rate of change for is the same as The population denominators for calculating 1997 Lead Screening percentages are from the 199 census, and 27 Lead Screening percentages are from the 2 census. TABLE 1. CONDITIONS FOR REPORTING DATA REPORTED Population > 29 AND Number of events < Population 1 Population 29 AND Number of events = 1 Population 29 AND Population - Number of events > 5 Population < 1 AND Number of events = NOT REPORTED 1 Population 29 AND Population - Number of events 5 Population < 1 AND 1 Number of events 9 Health Status Index Series Vol XIX No I, pg. 1

8 At the time that this report was prepared, data from the 21 U.S. census had not been released. When the 21 census redistricting summary file was released in February 211, it indicated a 6.9% decrease in the Chicago population (a decrease of 2,418 individuals). Based on these data, sixty of the 77 community areas have experienced population loss. This suggests that the method used to project the 27 population for this report likely resulted in overestimates of the population of many community areas as well as Chicago as a whole. The rates, age-adjusted rates, and percents we present for 27 differ from what would be calculated using the 21 census counts. CAUSE OF DEATH DETERMINATION All deaths are registered using death certificates. Death certificates are processed and analyzed by a standardized system that is used in most countries throughout the world, the International Classification of Diseases (ICD). On the death certificate, the certifier (a physician, coroner or medical examiner) enters information about the causes and circumstances of death in a specific sequence. When received by the vital statistics office, the listed causes are placed in standard categories, and the underlying cause of death is then determined. Underlying cause of death is not necessarily the first medical condition listed on the death certificate. All of the information on the certificate is examined systematically, using classification rules, to determine the most appropriate underlying cause of death. The system is periodically revised to reflect advances in medical knowledge and public health priorities. The ninth revision, ICD-9, Health Status Index Series Vol XIX No I, pg. 2 was used for deaths in the United States for twenty years, The ICD-1 is the most recent update, and is being used for US deaths starting from There are important differences between ICD-1 and its predecessor, ICD-9, including the following: The number of detailed categories has nearly doubled. Important changes in some of the rules for classifying underlying cause of death. Therefore, even with the same information being recorded on the death certificate, a death can be attributed to a different underlying cause of death. Due to these differences, mortality rates based on data classified under ICD-1 cannot be directly compared to ICD-9. In order to compare mortality statistics based on deaths classified by ICD-9 to ICD-1, a comparability ratio can be applied to counts and rates. Ratios were determined by a comparability study conducted by the National Center for Health Statistics. The causes of death and corresponding comparability ratios used in this publications are listed in Table 2. HOSPITALIZATIONS The data presented in the Community Area Health & Resource Inventory reflect estimated hospital discharges reported from Illinois hospitals and licensed ambulatory surgery centers to the Illinois Health Care Cost Containment Council (until 21) and the Illinois Department of Public Health (IDPH). Hospitalization discharge data can be used as a proxy for disease incidence, but with noted limitations. Hospital discharges, not individual patients, are recorded. Moreover, discharges may poorly measure some conditions because only those severe cases in which hospitaliza- tion is required are included in the database. Additionally, hospital discharges are stratified by resident zip codes, not community areas. Therefore, hospital discharges by community area were estimated using a methodology developed by MCIC (Metro Chicago Information Center). The rate of hospital discharges in a given patient zip code were assumed to be uniform within a given zip code. MCIC provided data on what percentage of a zip code population belonged to a given community area and what zip codes were in each community area. These percentages were applied at random to all of the records pertaining to a given zip code in order to redefine the geography of patient residences as community areas. Finally, the records assigned to each community area were pooled and analyzed to obtain the community area-based estimate. TABLE 2. CAUSE OF DEATH COMPARABILITY RATIOS CAUSE OF DEATH COMPARABILITY RATIO HIV/AIDS Infl uenza and Pneumonia.7144 All-cancers 1.93 Breast Cancer 1.73 Colon Cancer.9988 Lung Cancer.991 Prostate Cancer Accidents Homicide 1.2 Suicide.9834 Heart Disease.9976 Stroke 1.52 Lower Respiratory Disease Diabetes Mellitus Liver Disease and Cirrhosis Alzheimer s Disease

9 INFECTIOUS DISEASES The numbers and rates for infectious diseases that are required to be reported are always subject to variations in reporting and detection, since health care providers are not always compliant with reporting requirements and persons affected by these illnesses do not always seek medical care. TEN YEAR TREND ANALYSIS Percent change in rates or percents 1997 to 27 are calculated (1-YR CHANGE) using the following formula: [(rate 27 - rate 1997 )/rate 1997 ]*1 [(percent 27 - percent 1997 )/percent 1997 ]*1 A + sign indicates an increase over time, - a decrease. In the Community Area Health & Resource Inventory, rates for causes of death, all cause mortality and hospital discharges are age adjusted, which is explained in the next section. Confidence interval testing is used to determine if changes in age-adjusted rates between 1997 and 27 are significant at the.1 level, which is indicated in the tables. 9% confidence intervals (CI) are calculated for each measure using the following formulas: SE = R/( N) 9% CI = R ± (1.645*SE) where SE = standard error, R = age-adjusted rate and N = number of events (deaths or discharges). A statistically significant change is considered to have occurred if the point estimate of the 1997 age-adjusted rate is not within the 9% confidence interval for the corresponding 27 age-adjusted rate. For all other measures, Chi-square testing is used to determine if changes in rates/ percentages between 1997 and 27 are significant at the.1 level, which is indicated in the tables. Poisson regression in a log-linear model is utilized with independent variables: year, community area and population, and the dependent variable: number of events (e.g., birth, infectious disease case). AGE-ADJUSTED RATE CALCULATIONS Age adjustment is a technique that is used to make it easier to interpret differences in disease rates between different populations. Most important health conditions vary with age. The populations in different community areas vary in their age composition. Similarly, the population in the same geographic area varies in its age composition over time. When comparing rates of death and hospital discharges, we would like to be able to separate differences that are due to potentially modifiable risk factors from differences that are due to age. With direct age adjustment, a reference or standard population is identified, and weights are assigned to age-specific groups based on their representation in the standard population. All of the weights add up to 1. The age adjusted rate for a population is a weighted average of the age group specific rates for the population, using the weights derived from the standard population. TABLE 3. AGE-ADJUSTMENT WEIGHTS FOR YEAR 2 STANDARD POPULATION AGE (YEARS) WEIGHT Health Status Index Series Vol XIX No I, pg. 3 Age adjusted rates that are derived using the same standard population can be compared to each other, but they CANNOT be compared to age adjusted rates using different standard populations. Age adjusted rates are summary statistics for comparisons, and NOT actual rates - they cannot be applied to a specific population to get the actual number of events that occurred in that population. The projected U.S. population for the year 2 is currently used as the reference (standard) population for age adjustment by CDPH. This makes our data consistent with reports issued by all agencies within the U.S. Department of Health and Human Services, which uniformly adopted the projected U.S. population for year 2 as their standard for age adjustment for health events or deaths occurring in 1999 or later. The age-adjustment weights used in this publication are listed in Table 3. GENERAL LIMITATIONS This report is intended as a resource for advocates, providers, planners, and others. It is descriptive and is not intended to serve as a causal analysis. For example, if a community has a high cancer mortality rate, this may not be caused by characteristics of the community. Answering these questions would require further investigation. For some measures, such as breast cancer mortality, which are based on relatively few events at the community area level, other limitations must be considered. These rates are subject to substantial random variability.

10 Health Status Index Series Vol XIX No I, pg. 4 DEFINITIONS OF MEASURES HEALTH MEASURES Caesarean Section The annual number and percent of births to resident mothers who were delivered by Caesarean section. Source: IDPH Division of Vital Records Causes of Death The annual number of resident deaths and the age adjusted annual death rate per 1, population are given for each of the indicated causes of death. The specific causes of death listed here are not exhaustive. Breast cancer rates are for females and males. For each community area, the causes are grouped into 4 categories: infectious disease, cancer, unnatural and chronic disease. The causes of death and corresponding ICD-9 and ICD-1 codes are listed in Table 4. Source: IDPH Division of Vital Records Disabilities Blind/Deaf: Non-institutionalized, civilian persons aged 5 and older with a long-lasting condition such as: blindness, deafness, or a severe vision or hearing impairment. Physical: A condition that substantially limits one or more basic physical activities like walking, climbing stairs, reaching, lifting or carrying. Mental: A condition that makes it difficult to learn, remember, or concentrate. Requires Care: A condition that makes it difficult to dress, bathe, get around inside the home. Home-Bound: A condition that makes it difficult to go outside the home alone to shop or visit a doctor s office. Unable to Work: A condition that makes it difficult to work at a job or business, refers only to persons between the ages of 16 and 64. These categories are NOT mutually exclusive. Source: United States Census (Year 2) Fertility The annual number of births and fertility rate, defined as the number of births per 1 women of child-bearing age (15-44) in the geographic area. Source: IDPH Division of Vital Records First Trimester Prenatal Care The annual number and percent of births to pregnant women residing in Chicago receiving prenatal care in the first trimester. Source: IDPH Division of Vital Records Hospitalizations The estimated, annual number of resident hospitalization discharges and rate per 1, population are given for each of the indicated primary diagnoses. The specific primary diagnoses listed here are not exhaustive. Hospitalization discharge rates are for all ages. The primary diagnosis and corresponding ICD-9- CM codes are listed in Table 5. Source: IDPH TABLE 4. CAUSE OF DEATH ICD-9 AND ICD-1 CODES CAUSE ICD-9 CODES ICD-1 CODES HIV/AIDS B2-B24 Infl uenza and Pneumonia J1-J18 All-cancers C-C97 Breast Cancer C5 Colon Cancer* C18-C21 Lung Cancer 162 C33-C34 Prostate Cancer 185 C61 Accidents E8-E869, E88-E929 V1-X59, Y85-Y86 Homicide E96-E969 X85-Y9, Y87.1 Suicide E95-E959 X6-X84, Y87. Heart Disease , 42, 44, Stroke , I-I9, I11, I13, I2-I51 I6-I69 Lower Respiratory Disease , 496 J4-J47 Diabetes Mellitus 25 E1-E14 Liver Disease and Cirrhosis 571 K7, K73-K74 Alzheimer s Disease 331. G3 *Includes cancers of the rectum and anus Includes cancers of the trachea and bronchus TABLE 5. PRIMARY DIAGNOSIS ICD-9-CM CODES CAUSE ICD-9-CM CODES Alcohol and Substance Abuse , All Other Mental Health 29, , Asthma 493 Congestive Heart Failure 428, 42.1, 42.11, Diabetes 25

11 Infant Mortality The annual number and rate of deaths of resident infants (younger than one year of age). The rate is the number of infant deaths per 1, live births to mothers residing in the geographic area. Source: IDPH Division of Vital Records Infectious Diseases (Reportable) Reportable diseases are those that are mandated by state law to be tabulated and reported to the appropriate health authority, in this case CDPH. The infectious, reportable conditions selected for this report are: AIDS Chlamydia Gonorrhea Hepatitis C Syphilis (primary and secondary) Tuberculosis The annual number of cases and incidence rates per 1, population are given for all conditions except for Hepatitis C, which reflect the number of individuals with Hepatitis C positive test results registered for the first time by CDPH in 27. Hepatitis C and Syphilis data are not available for None of the rates are age-adjusted. Sources: CDPH Division of STI/HIV, Tuberculosis & Communicable Disease Programs Lead Screening Screened is the number and percent of resident children age 6 and younger with at least one lead screening. Elevated is the number and percent of resident children screened with a blood lead level higher than 9 micrograms per deciliter. If a child was screened more than once, only one elevated screening is reported here. Source: CDPH Lead Poisoning Prevention Program Premature Birth The annual number and percent of resident births with less than 37 completed weeks in the womb. Source: IDPH Division of Vital Records Very Low Birthweight The annual number and percent of resident births weighing less than 15 grams (3.25 pounds). Source: IDPH Division of Vital Records HEALTHCARE RESOURCE MEASURES Average Occupancy Rate Measure of inpatient health facility s occupied beds, determined by dividing average daily census by the calculated capacity. Average daily census is the average number of inpatients receiving service on any given day over a 12- month period. The calculated capacity is the number of beds set up and staffed (See Beds Staffed). Source: IDPH Annual Hospital Questionnaire Beds Licensed Number of beds recognized and licensed by IDPH. Source: IDPH Annual Hospital Questionnaire Beds Staffed Number of beds/stations set up and staffed on a particular day (October 1). Source: IDPH Annual Hospital Questionnaire Emergency Department Visits The number of visits to a hospital s emergency and/or trauma unit. Source: IDPH Annual Hospital Questionnaire Health Status Index Series Vol XIX No I, pg. 5 Encounters Provided The number of patient encounters with a physician or mid-level provider (nurse practitioner, physician s assistant or certified nurse midwife). Sources: CDPH Office of Policy & Planning, Illinois Department of Human Services Facility Types Hospitals provide acute care and general services. (Other types of hospitals, e.g., rehabilitation, mental health, etc., are excluded.) CDPH Health Centers provide comprehensive primary care services in an ambulatory setting (i.e., not hospital-based) and are operated by CDPH. Cook County Health Centers (located in Chicago) provide comprehensive primary care services in an ambulatory setting and are operated by the Cook County Health & Hospitals System. (general population) provide comprehensive primary care services to vulnerable populations with limited health coverage (e.g., uninsured, Medicaid recipients, etc.). Some may provide oral health services. (special populations) provide comprehensive primary care services to vulnerable populations with limited health coverage and focus their care on special populations (e.g., specific race/ethnic groups, sexual orientation, health condition, age, gender, etc.). Some may provide oral health services.

12 School-based Health Centers operate in schools and provide comprehensive primary care services to students. Services may also be offered to school faculty, staff, family members of students and community members. Some may provide oral health services. Free Health Centers provide primary care services at no cost. A few sites offer comprehensive services, while most provide only basic care. Many have limited hours. Services may be focused on specific populations, including: homeless, children, specific ethnic or religious groups, etc. Oral Health Care Centers provide oral health care services to vulnerable populations with limited health coverage. Sources: CDPH Office of Policy & Planning, Chicago Community Oral Health Forum, IDPH Annual Hospital Questionnaire Health Status Index Series Vol XIX No I, pg. 6 Inpatient Admissions Number of patients accepted for inpatient service during a 12 month period. Source: IDPH Annual Hospital Questionnaire Medically Needy The number of persons who are less than 65 years of age and under 2% of poverty. Source: United States Census (Year 2) Number of Sites The number of safety net health centers operating in 27. Sources: CDPH Office of Policy & Planning, Illinois Department of Human Services Number Reporting The number of safety net health centers that provided data to CDPH for the 27 CDPH Community Health Center Report or the Illinois Department of Human Services 27 School Health Center Report. Sources: CDPH Office of Policy & Planning, Illinois Department of Human Services Outpatient Visits The number of outpatient visits provided by a hospital, including visits provided on the hospital campus and off-site facilities. Source: IDPH Annual Hospital Questionnaire Patients Seen The number of unduplicated patients seen at each safety net health center. Sources: CDPH Office of Policy & Planning, Illinois Department of Human Services Safety Net Health Centers Health centers that deliver health care to underserved populations (uninsured, Medicaid and other vulnerable populations) for free, at a lowcost or a sliding fee scale. Source: CDPH Office of Policy & Planning

13 HEALTH & HEALTHCARE RESOURCE PROFILES

14 Health Status Index Series Vol XIX No I, pg HEALTH MEASURES CHICAGO BIRTHS 46,254 BIRTHS, FERTILITY RATE OF 64.9 PER 1, 11.6% DECREASE FROM 1997 INFANT AND CHILD HEALTH RATE/PCT 1-YR CHANGE Very Low Birthweight (P) Premature Birth (P) 5, Infant Mortality (R) Lead Screening Screened (P) 15, Elevated (P) 2, MATERNAL HEALTH 1-YR CHANGE First Trimester Prenatal Care 35, Cesarean Section 12, DISABILITIES (2 CENSUS) Blind/Deaf 84, Physical 217, Mental 132,951 5 Requires Care 86, Home-Bound 274, Unable to Work 287,94 15 ALL CAUSE MORTALITY 19,824 DEATHS, RATE OF PER 1,, 15.7% DECREASE FROM 1997 CANCER DEATHS All Cancers 4, Breast Colon Lung 1, Prostate CHRONIC DISEASE DEATHS Heart Disease 5, Stroke 1, Lower Respiratory Disease Diabetes Mellitus Liver Disease and Cirrhosis Alzheimer s Disease UNNATURAL CAUSES OF DEATH Accidents Homicide Suicide HOSPITALIZATIONS Alcohol and Substance Abuse 19, All Other Mental Health 34,953 1, Asthma 7, Congestive Heart Failure 13, Diabetes 7, Total Hospitalizations 425,593 15, INFECTIOUS DISEASES HIV/AIDS Deaths AIDS Cases Chlamydia Cases 22, Gonorrhea Cases 9, Syphilis Cases ND Infl uenza and Pneumonia Deaths Tuberculosis Cases Hepatitis C Cases 1, ND *Rate or percent suppressed because count is < 5 (or < 21 for age-adjusted rates). Use caution when interpreting data based on 2 or fewer events, the rate/percent is unreliable. See Methods section for more information. Signifi cant difference (.1 level) Community area hospitalization discharges are estimates derived from zip codes. See Methods section for more information. If rate/percent suppressed for 27 and/or 1997, then 1-YR CHANGE is indicated by --. ND = No Data, data not collected in 1997 to calculate 1-YR CHANGE; P = Percent; R = Rate.

15 ACCESS Doctors Medical 27 HEALTHCARE RESOURCES CHICAGO HOSPITAL CAPACITY AND UTILIZATION Hospitals 31 Beds Licensed 11,46 Beds Staffed 8,137 Inpatient Admissions 412,243 Outpatient Visits 5,74,323 Emergency Department Visits 1,117,321 Average Occupancy Rate 71 SAFETY NET HEALTH CENTER UTILIZATION FACILITY TYPE MEDICALLY NEEDY (2 CENSUS) REGION North 136, Northwest 164, West 271, Central 21, South 154, Southwest 199, Far South 95, All 1,42, OF SITES CDPH Health Centers 7 Cook County Health Centers 9 (general population) 69 (special populations) 16 School-based Health Centers 26 Free Health Centers 11 REPORTING PATIENTS SEEN ENCOUNTERS PROVIDED All ,173 1,612,322 NORTHWEST n Health Status Index Series Vol XIX No I, pg. 9 v WEST v v SOUTHWEST For a complete listing of all safety net providers and addresses, please see the Appendix for an alphabetical listing by type. ) n n ) v! n ) n ) n v ) ) n! ) v ) n ) v ) ) ) ) ) v v ) n ) v v! v n v! n n v ) v ) n v v v n n v n! v n! n n v! n n! n ) n! n v v n! v! n v! ) FAR SOUTH n NORTH v v! SAFETY NET PROVIDERS (AS OF FEBRUARY 211) CDPH Health Centers Cook County Health Centers (General Population) (Special Populations) n School-Based Health Centers Free Health Centers Oral Health Care Centers Hospitals CENTRAL n v n v SOUTH v!

16 27 HEALTH MEASURES Health Status Index Series Vol XIX No I, pg. 1 COMMUNITY AREA 1: ROGERS PARK BIRTHS 912 BIRTHS, FERTILITY RATE OF 55 PER 1, 24.1% DECREASE FROM 1997 ALL CAUSE MORTALITY 376 DEATHS, RATE OF PER 1,, 25.4% DECREASE FROM 1997 HOSPITALIZATIONS Alcohol and Substance Abuse INFECTIOUS DISEASES All Other Mental Health 1,175 2, INFANT AND CHILD HEALTH CANCER DEATHS Asthma RATE/PCT 1-YR CHANGE Congestive Heart Failure Very Low Birthweight (P) All Cancers Diabetes Premature Birth (P) Breast 11 * -- Total Hospitalizations 9,42 19, Infant Mortality (R) Colon 6 * -- Lead Screening Lung 12 * -- Screened (P) 1, Prostate 3 * -- Elevated (P) CHRONIC DISEASE DEATHS HIV/AIDS Deaths 6 * -- AIDS Cases MATERNAL HEALTH Chlamydia Cases YR CHANGE Heart Disease Gonorrhea Cases First Trimester Stroke 15 * -- Prenatal Care Syphilis Cases ND Lower Respiratory Disease 18 * -- Cesarean Section Infl uenza and Diabetes Mellitus 14 * -- Pneumonia Deaths Liver Disease and Cirrhosis 5 * -- Tuberculosis Cases DISABILITIES (2 CENSUS) Alzheimer s Disease 5 * -- Hepatitis C Cases ND Blind/Deaf 1, UNNATURAL CAUSES OF DEATH Physical 3, Mental 3, Accidents 16 * -- Requires Care 1, Homicide 3 * -- Home-Bound 6, Suicide 9 * -- Unable to Work 7, *Rate or percent suppressed because count is < 5 (or < 21 for age-adjusted rates). Use caution when interpreting data based on 2 or fewer events, the rate/percent is unreliable. See Methods section for more information. Signifi cant difference (.1 level) Community area hospitalization discharges are estimates derived from zip codes. See Methods section for more information. If rate/percent suppressed for 27 and/or 1997, then 1-YR CHANGE is indicated by --. ND = No Data, data not collected in 1997 to calculate 1-YR CHANGE; P = Percent; R = Rate.

17 ASHLAND 27 HEALTHCARE RESOURCES COMMUNITY AREA 1: ROGERS PARK HOSPITAL CAPACITY AND UTILIZATION FACILITY LICENSED STAFFED INPATIENT ADMISSIONS OUTPATIENT EMERGENCY DEPARTMENT AVERAGE OCCUPANCY RATE No hospitals SAFETY NET HEALTH CENTER UTILIZATION FACILITY TYPE OF SITES CDPH Health Centers Cook County Health Centers (general population) 1 (special populations) School-based Health Centers 1 Free Health Centers REPORTING PATIENTS SEEN ENCOUNTERS PROVIDED Total 2 8,32 17,935 MEDICALLY NEEDY (2 CENSUS) COMMUNITY AREA 1 27, NORTH REGION 136, DAMEN ACCESS St. Francis ROGERS HOWARD CLARK ACCESS Rogers Park ASHLAND PRATT Sullivan ) TOUHY n DEVON HOWARD SHERIDAN SAFETY NET PROVIDERS (AS OF FEBRUARY 211) CDPH Health Centers Cook County Health Centers (General Population) (Special Populations) n School-Based Health Centers Free Health Centers Oral Health Care Centers v Hospitals If there are No hospitals in a community area, then LICENSED, STAFFED, INPATIENT ADMISSIONS, OUTPATIENT, EMERGENCY DEPARTMENT and AVER- AGE OCCUPANCY RATE are indicated by --. If of health centers REPORTING is < 2, then PATIENTS SEEN and ENCOUNTERS PROVIDED are suppressed and indicated by --. If of health centers RE- PORTING is, then PATIENTS SEEN and ENCOUNTERS PROVIDED are indicated by --. Health Status Index Series Vol XIX No I, pg. 11 For a complete listing of all safety net providers and addresses, please see the Appendix for an alphabetical listing by type.

18 Health Status Index Series Vol XIX No I, pg HEALTH MEASURES COMMUNITY AREA 2: WEST RIDGE BIRTHS 1,262 BIRTHS, FERTILITY RATE OF 76.3 PER 1, 7.4% INCREASE FROM 1997 INFANT AND CHILD HEALTH RATE/PCT 1-YR CHANGE Very Low Birthweight (P) Premature Birth (P) Infant Mortality (R) Lead Screening Screened (P) 2, Elevated (P) MATERNAL HEALTH 1-YR CHANGE First Trimester Prenatal Care Cesarean Section DISABILITIES (2 CENSUS) Blind/Deaf 2, Physical 5, Mental 3,44 5 Requires Care 2, Home-Bound 7, Unable to Work 7, ALL CAUSE MORTALITY 527 DEATHS, RATE OF PER 1,, 25.7% DECREASE FROM 1997 CANCER DEATHS All Cancers Breast 1 * -- Colon 2 * -- Lung Prostate 5 * -- CHRONIC DISEASE DEATHS Heart Disease Stroke Lower Respiratory Disease 16 * -- Diabetes Mellitus Liver Disease and Cirrhosis 4 * -- Alzheimer s Disease 7 * -- UNNATURAL CAUSES OF DEATH Accidents 2 * -- Homicide 6 * -- Suicide 5 * -- HOSPITALIZATIONS Alcohol and Substance Abuse All Other Mental Health Asthma Congestive Heart Failure Diabetes Total Hospitalizations 8,675 11, INFECTIOUS DISEASES HIV/AIDS Deaths 3 * -- AIDS Cases Chlamydia Cases Gonorrhea Cases Syphilis Cases ND Infl uenza and Pneumonia Deaths Tuberculosis Cases Hepatitis C Cases ND *Rate or percent suppressed because count is < 5 (or < 21 for age-adjusted rates). Use caution when interpreting data based on 2 or fewer events, the rate/percent is unreliable. See Methods section for more information. Signifi cant difference (.1 level) Community area hospitalization discharges are estimates derived from zip codes. See Methods section for more information. If rate/percent suppressed for 27 and/or 1997, then 1-YR CHANGE is indicated by --. ND = No Data, data not collected in 1997 to calculate 1-YR CHANGE; P = Percent; R = Rate.

19 KEDZIE 27 HEALTHCARE RESOURCES COMMUNITY AREA 2: WEST RIDGE HOSPITAL CAPACITY AND UTILIZATION FACILITY SAFETY NET HEALTH CENTER UTILIZATION FACILITY TYPE LICENSED STAFFED OF SITES CDPH Health Centers Cook County Health Centers (general population) 1 (special populations) 1 School-based Health Centers Free Health Centers 2 REPORTING INPATIENT ADMISSIONS PATIENTS SEEN ENCOUNTERS PROVIDED Total 4 7,776 2,958 OUTPATIENT EMERGENCY DEPARTMENT AVERAGE OCCUPANCY RATE No hospitals The ARK CALIFORNIA TOUHY PRATT DEVON WESTERN Heartland Rogers Park DAMEN ACCESS St. Francis MEDICALLY NEEDY (2 CENSUS) COMMUNITY AREA 2 21, NORTH REGION 136, SAFETY NET PROVIDERS (AS OF FEBRUARY 211) CDPH Health Centers Cook County Health Centers PETERSON ACCESS Peterson New Life Volunteering Asian Family ) DAMEN (General Population) n (Special Populations) School-Based Health Centers Free Health Centers Goldie's LINCOLN BRYN MAWR Oral Health Care Centers v Hospitals If there are No hospitals in a community area, then LICENSED, STAFFED, INPATIENT ADMISSIONS, OUTPATIENT, EMERGENCY DEPARTMENT and AVER- AGE OCCUPANCY RATE are indicated by --. If of health centers REPORTING is < 2, then PATIENTS SEEN and ENCOUNTERS PROVIDED are suppressed and indicated by --. If of health centers RE- PORTING is, then PATIENTS SEEN and ENCOUNTERS PROVIDED are indicated by --. Health Status Index Series Vol XIX No I, pg. 13 For a complete listing of all safety net providers and addresses, please see the Appendix for an alphabetical listing by type.

20 Health Status Index Series Vol XIX No I, pg HEALTH MEASURES COMMUNITY AREA 3: UPTOWN BIRTHS 768 BIRTHS, FERTILITY RATE OF 48.7 PER 1, 22.9% DECREASE FROM 1997 INFANT AND CHILD HEALTH RATE/PCT 1-YR CHANGE Very Low Birthweight (P) Premature Birth (P) Infant Mortality (R) 4 * -- Lead Screening Screened (P) 1, Elevated (P) MATERNAL HEALTH 1-YR CHANGE First Trimester Prenatal Care Cesarean Section DISABILITIES (2 CENSUS) Blind/Deaf 1, Physical 5, Mental 4, Requires Care 2, Home-Bound 6, Unable to Work 7, ALL CAUSE MORTALITY 527 DEATHS, RATE OF PER 1,, 25.9% DECREASE FROM 1997 CANCER DEATHS All Cancers Breast 4 * -- Colon 1 * -- Lung 19 * -- Prostate 4 * -- CHRONIC DISEASE DEATHS Heart Disease Stroke Lower Respiratory Disease 17 * -- Diabetes Mellitus 2 * -- Liver Disease and Cirrhosis 8 * -- Alzheimer s Disease 9 * -- UNNATURAL CAUSES OF DEATH Accidents 16 * -- Homicide 3 * -- Suicide 7 * -- HOSPITALIZATIONS Alcohol and Substance Abuse All Other Mental Health 2,4 2, Asthma Congestive Heart Failure Diabetes Total Hospitalizations 1,134 17, INFECTIOUS DISEASES HIV/AIDS Deaths 15 * -- AIDS Cases Chlamydia Cases Gonorrhea Cases Syphilis Cases ND Infl uenza and Pneumonia Deaths Tuberculosis Cases Hepatitis C Cases ND *Rate or percent suppressed because count is < 5 (or < 21 for age-adjusted rates). Use caution when interpreting data based on 2 or fewer events, the rate/percent is unreliable. See Methods section for more information. Signifi cant difference (.1 level) Community area hospitalization discharges are estimates derived from zip codes. See Methods section for more information. If rate/percent suppressed for 27 and/or 1997, then 1-YR CHANGE is indicated by --. ND = No Data, data not collected in 1997 to calculate 1-YR CHANGE; P = Percent; R = Rate.

21 RACINE 27 HEALTHCARE RESOURCES COMMUNITY AREA 3: UPTOWN HOSPITAL CAPACITY AND UTILIZATION FACILITY LICENSED STAFFED INPATIENT ADMISSIONS OUTPATIENT EMERGENCY DEPARTMENT AVERAGE OCCUPANCY RATE Methodist Hospital of Chicago ,995 12,698 4, Thorek Hospital and Medical Center , ,235 11, Weiss Memorial Hospital , ,431 22, SAFETY NET HEALTH CENTER UTILIZATION FACILITY TYPE OF SITES CDPH Health Centers 1 Cook County Health Centers 1 (general population) 2 (special populations) 3 School-based Health Centers 1 Free Health Centers REPORTING PATIENTS SEEN ENCOUNTERS PROVIDED Total 8 3, ,2 Methodist ASHLAND v CLARK FOSTER Near North Uptown MONTROSE Heartland Uptown ) Heartland Wilson McCormick LAWRENCE Uplift n )! LSD FOSTER AV v CDPH Uptown LSD LAWRENCE AV Weiss LAKE SHORE SAFETY NET PROVIDERS (AS OF FEBRUARY 211) CDPH Health Centers Cook County Health Centers (General Population) (Special Populations) n School-Based Health Centers Free Health Centers Oral Health Care Centers v Hospitals CLARENDON SHERIDAN LAKE SHORE MEDICALLY NEEDY (2 CENSUS) COMMUNITY AREA 3 25, NORTH REGION 136, Lake View n IRVING PARK Howard Brown ) American Indian ) v Thorek If there are No hospitals in a community area, then LICENSED, STAFFED, INPATIENT ADMISSIONS, OUTPATIENT, EMERGENCY DEPARTMENT and AVER- AGE OCCUPANCY RATE are indicated by --. If of health centers REPORTING is < 2, then PATIENTS SEEN and ENCOUNTERS PROVIDED are suppressed and indicated by --. If of health centers RE- PORTING is, then PATIENTS SEEN and ENCOUNTERS PROVIDED are indicated by --. Health Status Index Series Vol XIX No I, pg. 15 For a complete listing of all safety net providers and addresses, please see the Appendix for an alphabetical listing by type.

22 Health Status Index Series Vol XIX No I, pg HEALTH MEASURES COMMUNITY AREA 4: LINCOLN SQUARE BIRTHS 59 BIRTHS, FERTILITY RATE OF 47.8 PER 1, 23.6% DECREASE FROM 1997 INFANT AND CHILD HEALTH RATE/PCT 1-YR CHANGE Very Low Birthweight (P) Premature Birth (P) Infant Mortality (R) 3 * -- Lead Screening Screened (P) Elevated (P) MATERNAL HEALTH 1-YR CHANGE First Trimester Prenatal Care Cesarean Section DISABILITIES (2 CENSUS) Blind/Deaf 1, Physical 2, Mental 1, Requires Care Home-Bound 3, Unable to Work 4, ALL CAUSE MORTALITY 231 DEATHS, RATE OF PER 1,, 21% DECREASE FROM 1997 CANCER DEATHS All Cancers Breast 5 * -- Colon 3 * -- Lung 17 * -- Prostate 4 * -- CHRONIC DISEASE DEATHS Heart Disease Stroke 15 * -- Lower Respiratory Disease 7 * -- Diabetes Mellitus 7 * -- Liver Disease and Cirrhosis 5 * -- Alzheimer s Disease 2 * -- UNNATURAL CAUSES OF DEATH Accidents 7 * -- Homicide 2 * -- Suicide 2 * -- HOSPITALIZATIONS Alcohol and Substance Abuse All Other Mental Health 494 1, Asthma Congestive Heart Failure Diabetes Total Hospitalizations 4,91 12, INFECTIOUS DISEASES HIV/AIDS Deaths 5 * -- AIDS Cases Chlamydia Cases Gonorrhea Cases Syphilis Cases ND Infl uenza and Pneumonia Deaths 11 * -- Tuberculosis Cases Hepatitis C Cases ND *Rate or percent suppressed because count is < 5 (or < 21 for age-adjusted rates). Use caution when interpreting data based on 2 or fewer events, the rate/percent is unreliable. See Methods section for more information. Signifi cant difference (.1 level) Community area hospitalization discharges are estimates derived from zip codes. See Methods section for more information. If rate/percent suppressed for 27 and/or 1997, then 1-YR CHANGE is indicated by --. ND = No Data, data not collected in 1997 to calculate 1-YR CHANGE; P = Percent; R = Rate.

23 27 HEALTHCARE RESOURCES COMMUNITY AREA 4: LINCOLN SQUARE HOSPITAL CAPACITY AND UTILIZATION FACILITY LICENSED STAFFED INPATIENT ADMISSIONS OUTPATIENT EMERGENCY DEPARTMENT AVERAGE OCCUPANCY RATE Swedish Covenant Hospital , ,52 41, SAFETY NET HEALTH CENTER UTILIZATION FACILITY TYPE OF SITES CDPH Health Centers Cook County Health Centers (general population) (special populations) 1 School-based Health Centers 1 Free Health Centers ACCESS Peterson Goldie's BRYN MAWR CALIFORNIA Swedish Covenant v New Life Volunteering LINCOLN FOSTER ) WESTERN Amundsen n BRYN MAWR DAMEN REPORTING PATIENTS SEEN ENCOUNTERS PROVIDED Total 2 2,26 8,7 rie Helping ands LAWRENCE Heartland Lincoln Sq MEDICALLY NEEDY (2 CENSUS) COMMUNITY AREA 4 11, NORTH REGION 136, SAFETY NET PROVIDERS (AS OF FEBRUARY 211) CDPH Health Centers Cook County Health Centers LINCOLN MONTROSE Erie Teen ) (General Population) (Special Populations) n School-Based Health Centers Free Health Centers Oral Health Care Centers v Hospitals If there are No hospitals in a community area, then LICENSED, STAFFED, INPATIENT ADMISSIONS, OUTPATIENT, EMERGENCY DEPARTMENT and AVER- AGE OCCUPANCY RATE are indicated by --. If of health centers REPORTING is < 2, then PATIENTS SEEN and ENCOUNTERS PROVIDED are suppressed and indicated by --. If of health centers RE- PORTING is, then PATIENTS SEEN and ENCOUNTERS PROVIDED are indicated by --. Health Status Index Series Vol XIX No I, pg. 17 For a complete listing of all safety net providers and addresses, please see the Appendix for an alphabetical listing by type.

24 Health Status Index Series Vol XIX No I, pg HEALTH MEASURES COMMUNITY AREA 5: NORTH CENTER BIRTHS 64 BIRTHS, FERTILITY RATE OF 64.2 PER 1, 25.7% INCREASE FROM 1997 INFANT AND CHILD HEALTH RATE/PCT 1-YR CHANGE Very Low Birthweight (P) 4 * -- Premature Birth (P) Infant Mortality (R) 3 * -- Lead Screening Screened (P) Elevated (P) 2 * -- MATERNAL HEALTH 1-YR CHANGE First Trimester Prenatal Care Cesarean Section DISABILITIES (2 CENSUS) Blind/Deaf Physical 1, Mental 1, Requires Care Home-Bound 2, Unable to Work 2,437 1 ALL CAUSE MORTALITY 14 DEATHS, RATE OF PER 1,,.3% INCREASE FROM 1997 CANCER DEATHS All Cancers Breast 1 * -- Colon 8 * -- Lung 12 * -- Prostate 1 * -- CHRONIC DISEASE DEATHS Heart Disease Stroke 11 * -- Lower Respiratory Disease 3 * -- Diabetes Mellitus 5 * -- Liver Disease and Cirrhosis 1 * -- Alzheimer s Disease 2 * -- UNNATURAL CAUSES OF DEATH Accidents 4 * -- Homicide * -- Suicide 3 * -- HOSPITALIZATIONS Alcohol and Substance Abuse All Other Mental Health Asthma Congestive Heart Failure Diabetes Total Hospitalizations 3,394 15, INFECTIOUS DISEASES HIV/AIDS Deaths 1 * -- AIDS Cases Chlamydia Cases Gonorrhea Cases Syphilis Cases ND Infl uenza and Pneumonia Deaths 1 * -- Tuberculosis Cases <5 * -- Hepatitis C Cases <5 * ND *Rate or percent suppressed because count is < 5 (or < 21 for age-adjusted rates). Use caution when interpreting data based on 2 or fewer events, the rate/percent is unreliable. See Methods section for more information. Signifi cant difference (.1 level) Community area hospitalization discharges are estimates derived from zip codes. See Methods section for more information. If rate/percent suppressed for 27 and/or 1997, then 1-YR CHANGE is indicated by --. ND = No Data, data not collected in 1997 to calculate 1-YR CHANGE; P = Percent; R = Rate.

25 27 HEALTHCARE RESOURCES COMMUNITY AREA 5: NORTH CENTER HOSPITAL CAPACITY AND UTILIZATION FACILITY LICENSED STAFFED INPATIENT ADMISSIONS OUTPATIENT EMERGENCY DEPARTMENT AVERAGE OCCUPANCY RATE No hospitals ) Mile Sq North Center SAFETY NET HEALTH CENTER UTILIZATION IRVING PARK LINCOLN FACILITY TYPE OF SITES CDPH Health Centers Cook County Health Centers (general population) (special populations) 1 School-based Health Centers Free Health Centers WESTERN DAMEN ADDISON REPORTING PATIENTS SEEN ENCOUNTERS PROVIDED Total BELMONT CLYBOURN MEDICALLY NEEDY (2 CENSUS) COMMUNITY AREA 5 6, NORTH REGION 136, SAFETY NET PROVIDERS (AS OF FEBRUARY 211) CDPH Health Centers Cook County Health Centers (General Population) (Special Populations) n School-Based Health Centers Free Health Centers Oral Health Care Centers v Hospitals DIVERSEY If there are No hospitals in a community area, then LICENSED, STAFFED, INPATIENT ADMISSIONS, OUTPATIENT, EMERGENCY DEPARTMENT and AVER- AGE OCCUPANCY RATE are indicated by --. If of health centers REPORTING is < 2, then PATIENTS SEEN and ENCOUNTERS PROVIDED are suppressed and indicated by --. If of health centers RE- PORTING is, then PATIENTS SEEN and ENCOUNTERS PROVIDED are indicated by --. Health Status Index Series Vol XIX No I, pg. 19 For a complete listing of all safety net providers and addresses, please see the Appendix for an alphabetical listing by type.

26 Health Status Index Series Vol XIX No I, pg HEALTH MEASURES COMMUNITY AREA 6: LAKE VIEW BIRTHS 1,174 BIRTHS, FERTILITY RATE OF 33.5 PER 1, 8.1% INCREASE FROM 1997 INFANT AND CHILD HEALTH RATE/PCT 1-YR CHANGE Very Low Birthweight (P) Premature Birth (P) Infant Mortality (R) 3 * -- Lead Screening Screened (P) Elevated (P) MATERNAL HEALTH 1-YR CHANGE First Trimester Prenatal Care Cesarean Section DISABILITIES (2 CENSUS) Blind/Deaf 2,2 2.2 Physical 4, Mental 2, Requires Care 1, Home-Bound 3, Unable to Work 5, ALL CAUSE MORTALITY 343 DEATHS, RATE OF 68.1 PER 1,, 34% DECREASE FROM 1997 CANCER DEATHS All Cancers Breast 6 * -- Colon 7 * -- Lung 19 * -- Prostate 6 * -- CHRONIC DISEASE DEATHS Heart Disease Stroke 18 * -- Lower Respiratory Disease 11 * -- Diabetes Mellitus 1 * -- Liver Disease and Cirrhosis 4 * -- Alzheimer s Disease 7 * -- UNNATURAL CAUSES OF DEATH Accidents Homicide 1 * -- Suicide 6 * -- HOSPITALIZATIONS Alcohol and Substance Abuse All Other Mental Health Asthma Congestive Heart Failure Diabetes Total Hospitalizations 9,31 17, INFECTIOUS DISEASES HIV/AIDS Deaths 2 * -- AIDS Cases Chlamydia Cases Gonorrhea Cases Syphilis Cases ND Infl uenza and Pneumonia Deaths 11 * -- Tuberculosis Cases Hepatitis C Cases ND *Rate or percent suppressed because count is < 5 (or < 21 for age-adjusted rates). Use caution when interpreting data based on 2 or fewer events, the rate/percent is unreliable. See Methods section for more information. Signifi cant difference (.1 level) Community area hospitalization discharges are estimates derived from zip codes. See Methods section for more information. If rate/percent suppressed for 27 and/or 1997, then 1-YR CHANGE is indicated by --. ND = No Data, data not collected in 1997 to calculate 1-YR CHANGE; P = Percent; R = Rate.