Conference on Social Inequality and Health

Partners in Austin Transforming Health P A T H Presenta6on by Conference on Social Inequality and Health Shannon Jones, III, Director, Aus6n / Travis County Health and Human Services Priscilla A. Hale, allgo Marva Overton, Alliance for African American Health in Central Texas Kellee Coleman, Mama Sana/Vibrant Woman Paula X. Rojas, Mama Sana/Vibrant Woman

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Austin/Travis County Health and Human Services Department Age-adjusted Mortality Rates for Seven Leading Causes of Death by Race/Ethnicity, Travis County, 2009-2011 Cancer Heart Disease Cause of Death Accidents Stroke Lung Disease Rate per 100,000 Alzheimer s Diabetes 0 50 100 150 200 Hispanic, all races Black, non-hispanic White, non-hispanic Data Source: Center for Health Statistics, Texas Department of State Health Services

Austin/Travis County Health and Human Services Department Age-adjusted Mortality Rates by Race/Ethnicity, Travis County, 1999-2011 1,200 1,000 Rate per 100,000 800 600 400 200 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 YEAR White, non-hispanic Black, non-hispanic Hispanic, all races Data Source: Center for Health Statistics, Texas Department of State Health Services

Austin/Travis County Health and Human Services Department Cardiovascular Disease by Race/Ethnicity for Travis County & Texas, 2008-2012 10.0 8.0 Percent 6.0 4.0 2.0 Travis County Texas Travis County Texas Travis County Texas 0.0 White, non-hispanic Black, non-hispanic Hispanic, all races Race/Ethnicity Data Source: Texas Behavioral Risk Factor Surveillance System (BRFSS) 2011-2012

18 Austin/Travis County Health and Human Services Department Diabetes Prevalence by Race Ethnicity, Travis County - Texas 2011-2012 16 14 12 Travis County Percent 10 8 6 4 2 Travis County Texas Travis County Texas Travis County Texas Texas 0 White, non-hispanic Black, non-hispanic Race/Ethnicity Hispanic, all races Data Source: Texas Behavioral Risk Factor Surveillance System (BRFSS) 2011-2012

Austin/Travis County Health and Human Services Department Infant Mortality Rates by Race Ethnicity, for 2010 for Travis County, Texas and United States 14 12 Deaths per 1,000 Live Births 10 8 6 4 5.2 11.46 5.24 5.5 11.4 5.5 3.7 11.5 6 2 0 United Stated Texas Travis County White, non-hispanic Black, non-hispanic Hispanic, all races

Austin/Travis County Health and Human Services Department Prevalence Rates for Persons Living with HIV/AIDS by Race/Ethnicity, Austin Transitional Grant Area, 2006-2012 900.0 800.0 700.0 Rates per 100,000 600.0 500.0 400.0 300.0 200.0 100.0 0.0 x x x x x x x 2006 2007 2008 2009 2010 2011 2012 Source: Texas Department of State Health Services, ehars Year Black Hispanic White X Other

Austin/Travis County Health and Human Services Department Comparison of Population and Persons Living with HIV, Travis County, 2013 60% 50% 50.3% 45.6% Percentage 40% 30% 20% 22.3% 33.5% 31% 10% 8% 8.1% 0% White, non Hispanic Black, non Hispanic Hispanic 1% Other Race/Ethnicity Population Persons Living with HIV

Prevalence Rates, of African Americans Living with HIV/AIDS, Texas TGAs & EMAs, 2006-2012 1300 Rates per 100,000 1100 900 700 500 967.1 796.4 726.7 505.8 391.6 998.3 831.5 740.1 520.1 409.7 1044.5 875.7 737.5 544.6 422.9 1082.9 917.5 749.4 568.2 453.9 1177.8 1132.6 1143.9 962.3 753.7 607.1 466.4 1011.2 784.9 674.9 540.8 957.4 811.7 630.5 554.2 300 100 2006 2007 2008 2009 2010 2011 2012 Year X Houston Dallas Fort Worth San Antonio Austin Source: Texas Department of State Health Services, ehars

Prevalence Rates, of Hispanics Living with HIV/AIDS, Texas TGAs & EMAs, 2006-2012 300 280 260 240 Rates per 100,000 220 200 180 160 140 120 100 2006 2007 2008 2009 2010 2011 2012 Year X Houston Dallas Fort Worth San Antonio Austin Source: Texas Department of State Health Services, ehars

Austin/Travis County Health and Human Services Department Age Adjusted All Cause Mortality Rate by Year 2000 Census Tract Travis County 2004-2008 78654 78641 78645 78726 78727 MOPAC 78728 78660 SH 130 78615 Mortality Rate per 100,000 78669 351.4 747.99 748.0 1449.9 78620 1450.0 2199.9 2200.0 5671.5 Zip Code Boundary 78738 78734 78736 78737 78732 78730 78733 78735 78739 US 290 78749 78748 78652 All Cause Mortality Rate for Travis County 2004-2008 is 747.4 per 100,000 78750 78746 78745 78759 78731 78703 78704 78747 78757 78610 78758 78702 78741 78744 78752 BEN WHITE US 183 78723 78721 78753 78719 78742 78754 US 290 78724 78725 78617 SH 71 78653 130 This map has been produced for: 78621 Age Adjusted to the 2000 Standard Population Data Source: US Census Bureau 2000 Census SF1, ESRI US Zip Codes, and Texas Department of State Health Services Center for Health Statistics Death Data 2004 2008. Data as of January 17. 2013 This map has been produced by the Austin/ Travis County Health and Human Services Department for the sole purpose of geographic reference. No warranty is made by the City of Austin regarding specific accuracy or completeness. A/TC HHSD Epidemiology & Health Statistics Unit "Instructional Use Only." No warranty is made regarding its accuracy, completeness, or relevance.

Austin/Travis County Health and Human Services Department People Living with HIV in 2013 by Census Tract in Travis County MOPAC SH 130 US 290 130 Rate PLWH Per 1,000 Total Population US 290 BEN WHITE No cases reported Less than 1.0 1.0 3.9 4.0 7.9 8.0 11.9 12.0 and Higher US 183 SH 71 This map has been produced for: "Instructional Use Only." No warranty is made regarding its accuracy, completeness, or relevance.

Public and Private Community Gardens To date, community gardens have been primarily located in Central Aus9n neighborhoods. By expanding to underserved and suburban communi9es, more Aus9nites will have greater access to fresh produce, as well as green space that provides wildlife habitat. COA - Office of Sustainability State of the Food System Report April 2015

Areas of Austin with Limited Access to Fresh Food People who live in areas with few grocery stores and reduced access to fresh produce are more likely to go hungry and are more prone to dietary- related disease. Dark Green areas represent areas with limited access to fresh food. COA - Office of Sustainability State of the Food System Report April 2015

Farmers Markets Texas has the fewest farmers markets per capita in the country. Strategically increasing the number of markets and farmstands in neighborhoods with reduced access to fresh food would help address food insecurity, but logis9cal considera9ons such as hours and days of opera9on, loca9on, and consumer demand need to be considered and addressed to make par9cipa9on viable and profitable for farmers. COA - Office of Sustainability State of the Food System Report April 2015

Overview of community health improvement planning Community Health Assessment (CHA) was conducted to idengfy the health related needs and strengths of AusGn/Travis County. IdenGfied key themes and suggesgons from the community forums, interviews and focus groups. Community Health Improvement Plan (CHIP) is a long- term, systemagc effort to address public health problems on the basis of results of the community health assessment.

CHIP HEALTH PRIORITIES 1. Chronic Disease focus on Obesity 2. Built Environment focus on Access to Healthy Foods 3. Built Environment focus on Transporta6on 4. Access to Primary Care and Mental Health/ Behavioral Health Services focus on Naviga6ng the Healthcare System ü Cross- cupng issue: health educagon/health literacy

Update from the Health Equity Workgroup Priscilla A. Hale, allgo Marva Overton, Alliance for African American Health in Central Texas Kellee Coleman, Mama Sana/Vibrant Woman Paula X. Rojas, Mama Sana/Vibrant Woman Austin/Travis County Health and Human Services Department

Background Ø Stakeholder members allgo Alliance for African American Health in Central Texas Immigrant Rights Organizers (members formerly of the Austin Immigrant Rights Coalition) Mama Sana/Vibrant Woman City of Austin Health and Human Services Department staff Ø Stakeholders meet May-August (6 plus meetings) Ø Developed short term goals Ø Developed Community engagement process

Stakeholder Meetings During the stakeholder meetings the group agreed to initially focus on the following issue areas with specific program requirements. Ø Issue Areas v Chronic Disease for African American Community v (Diabetes, Cardiovascular disease, Sickle Cell Disease & HIV/AIDS) v Mental Health Access for Immigrant Communities v Maternal and Infant Health for Communities of Color v Sexual Health and Wellness (including HIV/AIDS) for LGTBQ Communities of Color Ø Programs requirements v Community based interventions v Culturally specific v Non-traditional and innovative

Community Engagement Process Ø Location v July 9 th Southeast Community Health and Wellness Center v July 18 th YMCA/City of Austin Rundberg Ø Community members present v 63 v 38 Ø Common themes for services v Community based v Culturally specific/relevant v Holistic approaches v Midwifery access v Peer supporters/educators v Accessibility issues (language, cultural, transportation and scheduling)

Question 1 What do you think about the four issue areas discussed? Ø Community members supported the four issue areas presented as high priorities Ø Many attendees shared personal experiences that reflected the priority areas

Question 2 In your opinion, what other areas should be included? Ø Crisis Intervention/Basic needs support Ø Elderly Ø Mental Health Ø Network of Community Health Workers Ø Social/Emotional Development Ø Youth

Question 3 Are there health programs that you have participated in that you felt were effective? Ø Characteristics of the programs that were effective included; community based, peer supported, accountability component, and accessible services (phone, location, language)

Recommendations Ø Program requirements v v v v Community based interventions Culturally specific Non-traditional, innovative Focuses on individual/groups that are disproportionally impacted (People of Color, Elderly, Immigrants, LGBT (Lesbian, Gay, Bisexual and Transgender) and Youth. Ø Issue Areas v v v v Chronic disease for African American Community o (Diabetes, Cardiovascular disease, Sickle Cell Disease & HIV/AIDS) Mental health Access for Immigrant Communities Maternal and Infant Health for Communities of Color Sexual Health and Wellness (including HIV/AIDS) for LGTB Communities of Color Funding requested: $1,050,000

Health Equity Working Group Overall Reflections Meaningful community engagement made a difference on mul6ple fronts. What is the differences between "community input" and meaningful community engagement? What are the implica6ons for the PATH conference on Social Inequality and Health?

Questions