Community Health Assessment North Country Hospital Service Area

Transcription

1 Community Health Assessment North Country Hospital Service Area The North Country Hospital (NCH) service area (HSA) includes most of Orleans County (OC) and the northern section of Essex County (EC) in Vermont s Northeast Kingdom. This encompasses 22 communities with a total population of approximately 28,500. These communities are scattered over a large geographic area, separated by numerous hills or mountains and many lakes. Newport, with a population of 5005 is the largest community, and Westmore is the smallest, with a population of 306. Demographics: Socioeconomic Status / Education Level Indicator US VT OC EC % Under Federal Poverty Level (2009) % Adults age 25+ Without High School Education ( ) % Adults age 25+ With Bachelor s Degree or Higher ( ) Median Household Income ($) (2009) 50,221 51,219 39,914 34,407 Per Capita Income in Past 12 Months ($) ( ) 27,041 27,036 20,391 19,873 % Unemployment (February 2011) *Increase the % of adults with health insurance (VT Goal = 100%) (Red font indicates data is statistically worse than state) Source: * Source: VT Blueprint for Health, 2009 Annual Report, January 2010)

2 Socioeconomic Status & Education Level (Source: ) Percent Under Federal Poverty Level Median Household Income Previous Most Recent ,000 50,000 40,000 30,000 Previous 52,029 52,111 50,221 Most Recent ,219 39,184 39,914 38,799 34, , ,000 0 US VT OC EC - US VT OC EC 30 Percent Adults Age 25+ without High School Eucation Previous Most Recent-'05-'09 Percent Adults Age 25+ with Bachelor's Degree or Higher Previous Most Recent-'05-' US VT OC EC 0 US VT OC EC 2

3 Age Distribution (Source: VT Population Estimates) Orleans and Essex Counties have a slightly smaller population of working age, and a slightly greater aging population than VT as a whole. Orleans Co. Age Distribution <18 yrs yrs. 65+ yrs. Essex Co. Age Distribution <18 yrs yrs. 65+ yrs. 62% 17% 63% 18% 21% 19% VT - Age Distribution < 18 yrs yrs. 65+ yrs. 66% 14% 20% 3

4 Race / Ethnicity of Orleans and Essex Counties as compared to Vermont (Source: Population Census) Ethnicity / Race - Orleans County Ethnicity / Race - Essex County 0.5% 0.3% 0.6% 1.1% 0.3% 0.6% 0.3% 0.9% 97.5% 97.9% White Black Native American Asian Hispanic / Latino White Black Native American Asian Hispanic / Latino Ethnicity /Race - Vermont 1.0% 0.4% 1.3% 1.5% 95.8% White Black Native American Asian Hispanic /Latino 4

5 Health Status Indicators Statistically better than statewide; Statistically worse than statewide (For most indicators, data is by county; OC = Orleans County; EC = Essex County) (Source: The Health Status of Vermonters, 2008) (Unless otherwise noted by *, data is for combined years ) Maternal / Child Health (Data is by Hospital Service Area -HSA) Indicator VT Goal Statewide NCH Births NCH HSA Decrease the % of low birth weight births ( < 5.5 lbs) * Increase % pregnant women who received first trimester prenatal care (NCH ranks 1 st in the state for this time period.) * Increase % of pregnant women who receive early & adequate prenatal care (Based on the Adequacy of Prenatal Care Utilization Index Developed by Milton Kotelchuck, PhD, MPH) (NCH ranks 1 st in the state for this time period.) * Decrease the % women using tobacco during pregnancy (Individual hospital rates range from 13% to 32% for this time period.) N/A (NCH ranks 4 th in the state for this time period.) * Increase the % of mothers who smoked but quit before 4 th month (Range statewide is 0 to 58%) N/A * Decrease the % of women who are overweight before pregnancy (BMI > 26) (Range statewide is 34% to 52%) N/A * Increase the % mothers who are breastfeeding infant (Range statewide is 71% to 91%) N/A **Decrease pregnancies among adolescent females aged (per 1,000) * Data is for year ending 9/30/2010. Source: VT Dept. of Health, Div. of Health Surveillance, Public Health Statistics, Jan ** Data is for , for NCH Service Area; Health Status of Vermonters,

6 Immunization and Infectious Disease Increase the % of children under age 6 who have two or more vaccinations recorded in the VT Immunization Registry *Increase the % of kindergarteners who are fully immunized Increase the % of non-institutionalized adults age 65+ who receive annual influenza immunizations Increase the % of non-institutionalized adults age 65+ who have ever been vaccinated against pneumococcal diseases Decrease pneumonia/ influenza hospitalizations among adults age 65+ (rate per 10,000) **Decrease the number of sexually transmitted infections (Reported as actual number of cases for the year 2010 for Orleans and Essex Counties combined) Chlamydia Gonorrhea 58 <5 Syphilis <5 0 *Data is for Source: VT Agency of Human Services, Community Profiles, March ** Data is for Source: VT Department of Health, Center for Health Statistics. Youth Health or Risk Behaviors Decrease the % of youth who engage in binge drinking Decrease the % of youth who use alcohol before age Decrease the % of youth in grades 9-12 who are overweight or obese (BMI > 95 th percentile for age) Increase the % of youth in grades 9-12 that engage in 30 minutes of moderate physical activity, 5+ times / week * Decrease the % of students in grades 9-12 who have ever smoked * Decrease the % of students in grades 9-12 who smoked in the past 30 days * Decrease the % of students in grades 9-12 who have used chewing tobacco in the past 30 days * Source: VT Dept. of Health, VT Youth Risk Behavior Survey,

7 Adult Health or Risk Behaviors Decrease the % of adults (age 20+) who are obese (BMI 30+) Increase the % of adults (age 18+) who engage in regular physical activity (30 minutes of moderate physical activity 5+ times / week) Decrease the % of adults (age18+) who smoke cigarettes *Decrease the % of adult binge drinking *Source: VT Dept. of Health, Adult Behavioral Risk Factor Surveillance, Binge drinking is defined as: 5 or more alcoholic drinks on one occasion, at least once in the past 30 days. Diseases / Disorders (Listed alphabetically) Arthritis (N/A = not available) Increase the % of adults with chronic joint symptoms who have seen a healthcare provider for their symptoms Increase the % of adults with doctor-diagnosed arthritis who receive healthcare provider counseling on physical activity or exercise N/A Cancer: Breast Cancer, Cervical Cancer, Colon Cancer Increase % of women 40+ who have had a mammogram in the preceding 2 yrs Increase % of women 18+ who have had a Pap test in the preceding 3 yrs Increase % of adults 50+ who have had a fecal occult blood test in the preceding 2 yrs Increase % of adults 50+ who have ever had a sigmoidoscopy or colonoscopy

8 Diabetes (N/A =not available) Decrease diabetes-related deaths (per 100,000 people) Decrease hospitalization rates for uncontrolled diabetes among adults yrs (per 10,000) Increase % of adults with diabetes receiving diabetes education Increase % of adults with diabetes who have an annual dilated eye exam N/A Increase % of adults with diabetes who have an A1C measurement at least twice/ year N/A Increase % of adults with diabetes who have at least an annual foot exam N/A Heart Disease and Stroke Decrease coronary heart disease deaths (per 100,000 ) Decrease stroke deaths (per 10,000) N/A Decrease the % of adults with high blood pressure Increase the % of adults who have had their blood cholesterol checked within the preceding 5 yrs Mental Health Reduce suicide deaths - Actual numbers for Actual numbers for Actual numbers for Reduce suicide attempts (%) by youth in grades 9-12 (Data is for 2005 only) 1% 2% 2% N/A 8

9 Respiratory Diseases (COPD= Chronic Obstructive Pulmonary Disease) Decrease COPD deaths among people 45 and older (per 100,000) *Decrease asthma emergency department visits, ages 0-17 (per 10,000) N/A N/A *Decrease asthma emergency department visits, ages (per 10,000) N/A N/A *Decrease asthma emergency department visits, ages 65+ (per 10,000) N/A N/A *Decrease asthma hospitalizations ( all ages; per 10,000) N/A Increase the % of adults with asthma who receive written asthma management plans from their health care provider N/A Sources: *VT Dept. of Health, Asthma Data Report, Sept. 2010, for NCH HSA, from Hospital Discharge Data for ; VT Dept. of Health, VT Asthma Plan, December

10 Data Added as a Result of Analysis Team Discussion & Review General Population Data Population Numbers and Percentage of Total OC OC as % of State EC EC as % of State VT Population ,741 27, % 6, % Source: (2010 census) Health Care Access Item VT OC EC Primary Care: Do you have 1 person you think of as your personal doctor or health care provider? % of Respondents Was there a time in the past 12 months when you needed to see a doctor, but could not because of the cost? % of Respondents Source: VT Dept of Health, Behavioral Risk Factor Surveillance System, Percentage of Patients with Medicare or Medicaid as Primary Source of Payment % of patients served by North Country Practices, Oct through June 2011, that have Medicare as primary source of payment 38% % of patients served by North Country Practices, Oct through June 2011, that have Medicaid as primary source of payment 28% Source: Central Billing Department, NCH, July 6, This is an unduplicated count. This includes all North Country Practices, except NC Psychiatry. 10

11 Disability Item VT OC EC Are you limited in any way in any activities because of physical, mental, or emotional problems? % of Respondents Do you now have any health problem that requires you to use special equipment, such as a cane, wheelchair, special bed or special telephone? % of Respondents Source: VT Dept of Health, Behavioral Risk Factor Surveillance System, Arthritis Item VT OC EC Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. % of Respondents Source: VT Dept of Health, Behavioral Risk Factor Surveillance System, 11

12 Cancer Most commonly diagnosed cancers in males and females, VT & US, number & percentage of new cases / year, Cancer Site US Males VT Males US Females VT Females ( Number) and percentage of total new cases Prostate (16,010) 30% (493) 29% Breast (15,713) 31% (475) 31% Lung (7,199) 13% (242) 14% (6,264) 12% (179) 12% Colon & Rectum (5,517) 10% (172) 10% (5,413) 10% (164) 11% Bladder (3,712) 7% (120) 7% Uterus (2,968) 6% (110) 7% Melanoma of Skin (2,751) 5% (96) 6% (2,176) 4% (84) 5% Other Sites (14,527) 27% (558) 32% (14,170) 28% (522) 34% Source: Living with Cancer in VT, April, 2009, VT Dept. of Health, Cancer Deaths by Site Most common causes of cancer deaths in males and females, VT & US, number & percentage of deaths / year, Cancer Site US Males VT Males US Females VT Females (Number) and percentage of total cancer deaths Lung (78,317) 32% (189) 30% (59,609) 26% (140) 24% Prostate (24,656) 10% (69) 11% Breast (35,083) 15% (97) 16% Colon & Rectum (24,064) 10% (62) 10% (23,897) 10% (68) 11% Pancreas (12,919) 5% (31) 5% (13,230) 6% (30) 5% Leukemia (10,793) 4% Non-Hodgkin s Lymphoma (30) 5% Ovary (13,027) 6% (31) 5% Other Sites (70,115) 28% (251) 40% (60,664) 26% (228) 38% Source: Living with Cancer in VT, April, 2009, VT Dept. of Health, Note: Per the above source, relative to the number of people living in each county, the number of cancer survivors is consistent throughout the state. 12

13 10 Leading Causes of Death -- VT, Orleans County, Essex County, 2008 Number and Percentage of all Deaths for State and County, 2008 VT # VT % OC # OC % EC # EC % Total Deaths by Number and Percentage of Total 5, % % % 10 Leading Causes of Death by Number and Percent of Total for VT & by County Malignant Neoplasms (cancer) 1, % % 15 25% Diseases of the Heart 1, % % % Chronic Lower Respiratory Diseases (COPD, Emphysema and others) % % % Accidents % % 3 5.0% Cerebrovascular Disease (Stroke) % % 0 0 Alzheimer s Disease % % 1 1.7% Diabetes Mellitus % 5 1.7% 1 1.7% Intentional Self-harm (Suicide) % 5 1.7% 1 1.7% Influenza & Pneumonia % 4 1.4% 0 0 Parkinson s Disease % 2 0.7% 0 0 (Note: Essex County had 7 deaths (11.7% of all deaths) categorized in All Other Diseases. This is similar to VT and OC.) Source: VT Department of Health, Vital Statistics, 2008 VT Resident Deaths 13