Post on 05-Jan-2016
1
Metrowest Massachusetts Regional Health Dialogue
Massachusetts Department of Public Health
June 21, 2007
2
Goals for holding regional dialogues
• Introduce new DPH leadership
• Present latest health data on your particular region
• Talk with residents and providers about data and identify areas of need
• Gather feedback to inform process of setting DPH priorities
3
Goals of New DPH leadership
• Use data and community input to set new priorities & reshape the Department
• Rely on science and evidence-based process to guide the work
• Strengthen ties with and support for local health and local agencies
• Increase resources to and visibility of public health in Massachusetts
4
Timetable
• Hold 8 regional dialogues with comprehensive data review and identification of key health concerns (by July)
• Identify short list of top priorities by end of August
• Hold second round of community dialogues to discuss action plans/results by end of calendar year
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Socio-Demographics Indicators and Health Care
Access
6
WesternRegion Central
Region
SoutheastRegion
Metro WestRegion
NortheastRegion
BostonRegion
Executive Office of Healthand Human Services Regions
Western Region
Central Region
North East Region
Metro West Region
South East Region
Boston Region
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A few comments about the limitations of this presentation
• A regional analysis has its drawbacks• Variability within a region – urban vs.
rural/suburban (i.e. Cambridge vs. the rest of the region)
• Variability by sub-population – race matters, poverty matters
• Our data don’t reflect all the important health indicators
8
STOW
DOVER
MILLIS
LINCOLN
LITTLETON CARLISLE
SHERBORN
PLAINVILLE
COHASSET
SOUTHBOROUGH
BOXBOROUGHACTON
SHARON
SUDBURY
CONCORD
HINGHAMHOPKINTON
CANTON
NATICK
WALPOLE
NORWELL
QUINCY
NEWTON
WESTON
FRAMINGHAM
WRENTHAM
MILTON
SCITUATEHOLLISTON
NORFOLK
MEDFIELD
LEXINGTON
FOXBOROUGH
BEDFORD
WALTHAM
MARLBOROUGH
HUDSON
ASHLAND
NEEDHAM
WAYLAND
WEYMOUTH
WOBURN
WESTBOROUGH
WILMINGTON
BRAINTREE
DEDHAM
NORTHBOROUGH
NORWOODRANDOLPH
WESTWOOD
BURLINGTON
WELLESLEY
CAMBRIDGE
MAYNARD
HULL
BELMONT
WINCHESTER
ARLINGTON
SOMERVILLE
WATERTOWN
BROOKLINE
Population in Communities Metrowest Region: 2005
Largest:Cambridge
101,529
Smallest:Sherborn
4,220
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
Population> 10,000
9
Race and Ethnic Breakdown of PopulationMetrowest Region and Massachusetts: 2005
Black* 6.0%
Hispanic 7.9%
White* 81.0%
Asian* 4.9%
Amer. Indian* 0.2%
Amer. Indian* 0.2%
Asian* 7.8%
White* 83.8%
Black* 4.3%
Hispanic 3.9%
Metrowest Massachusetts
* Non-Hispanics
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
Total Population: 1,488,582 Total Population: 6,349,097
10
Black* 14.9%
Hispanic 8.2%
Asian* 15.3%
Amer. Indian* 0.3%
White* 61.3%
Asian*20.8%
Hispanic2.7%
Black*3.2%
White*73.2%
Amer. Indian*0.2%
Race and Ethnic Breakdown of PopulationCambridge and Quincy : 2005
Cambridge
* Non-Hispanics
Quincy
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
Total Population: 101,529 Total Population: 90,458
11
White* 74.2%
Amer. Indian* 0.2%
Black* 5.8%
Hispanic 12.4%
Asian* 7.4%
Race and Ethnic Breakdown of PopulationSomerville and Framingham: 2005
Framingham
* Non-Hispanics
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
Total Population: 65,652
Asian*8.9%
Hispanic10.1%
Black*8.4% White*
72.4%
Amer. Indian*0.2%
Somerville
Total Population: 75,372
12
Population by Age Group Metrowest Region and Massachusetts: 2005
Ages Cambridge Quincy Somerville Framingham Metro west
Region
MA Total
0-19 years
19.1% 19.5% 18.4% 23.5% 24.4% 25.5%
20-24 years
15.4% 6.5% 12.7% 6.4% 5.9% 6.7%
25-44 years
36.0% 32.9% 39.3% 32.1% 29.5% 29.4%
45-64 years
20.2% 25.2% 19.0% 25.1% 26.6% 25.3%
65+ years
9.3% 15.9% 10.6% 12.9% 13.6% 13.3%
Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology Program
13Socio-Demographic IndicatorsMetrowest Region and Massachusetts:
2000Cambridge Quincy Somerville Framingham Metro
west Region
MA
Per Capita Income
$31,156 $26,001 $23,628 $27,758 $34,341 $25,952
Those living below 100% poverty
12.9% 7.3% 12.5% 8.1% 5.3% 9.3%
Less than a High School Educ.
10.5% 14.8% 19.4% 12.9% 9.0% 15.2%
Speak language other than English at home
31.2% 23.8% 35.6% 29.2% 21.9% 18.7%
Foreign born 25.9% 20.0% 29.3% 21.2% 12.1% 12.2%
Unemployed 3.6% 5.2% 4.0% 4.1% 4.2% 5.1%
Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology Program
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Birth Indicators
15
Infant Mortality Rates by EOHHS Region Massachusetts: 2003-2005
4.8 4.9
4.0**4.7
5.6 5.45.7
0
1
2
3
4
5
6
7
8
9
10
Western Central Northeast Metrowest Southeast Boston MA
Infa
nt
De
ath
s
pe
r 1
,00
0 L
ive
Bir
ths
Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology Program
Infant Mortality Rate: deaths of infants less than one year of age per 1000 live births
Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better
16
4.2
7.3
4.1
1.7
4.04.13.0
4.9
7.0
11.2
0
2
4
6
8
10
12
White non-Hispanic
Black non-Hispanic
Hispanic Asian Overall
Infa
nt
dea
ths
per
1,0
00 l
ive
bir
ths Metrowest
Massachusetts
Infant Mortality Rates by Race/Ethnicity Metrowest Region and Massachusetts: 2003-2005
NA= Calculations based on less than 5 events are excluded
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
* Statistically Significantly different from state (p ≤.05)
17
21.7
35.1
13.0**
8.3**
0
5
10
15
20
25
30
35
40
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Bir
ths
pe
r 1
,00
0
wo
me
n a
ge
s 1
5-1
9
Teen Birth RateMetrowest Region and Massachusetts: 1990-2005
Massachusetts
Metrowest Region
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
Teen birth rates are number of births to women ages 15-19 per 1000 females ages 15-19.
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
18
Public Source of Prenatal Care Payment byMetrowest Cities and Massachusetts: 2003-2005
32.6
17.2
33.0
36.6
17.0
40.7
0
15
30
45
Cambridge Quincy Framingham Somerville Metrowest MA
Pe
rce
nt
of
Pu
bli
c P
ay
me
nt
Bir
ths
(%
)
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
Statistically different from state (p ≤.05)– Red (*) Statistically higher than state- Green (**) statistically lower than state
**
*
*
Public: Government programs including Commonhealth, Healthy Start, Medicaid/MassHealth, and free care
**
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Leading Causes of Death
20Leading Causes of Death
Metrowest Region and Massachusetts:2005
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
MassachusettsN=53,776
Heart Disease
13,248 24.6%
Cancer
13,159 24.5%
Stroke 2,979 5.5%
Chronic Lower Respiratory Disease (formerly COPD)
2,643 4.9%
Influenza and pneumonia 1,932 3.6%
Unintentional Injuries 1,883 3.5%
Alzheimer's 1,635 3.0%
Nephritis 1,403 2.6%
Diabetes 1,271 2.4%
Septicemia
982 1.8%
Metrowest RegionN=11,437
Cancer
2,881 25.2%
Heart Disease
2,771 24.2%
Stroke
656 5.7%
Chronic Lower Respiratory Disease (formerly COPD)
541 4.7%
Influenza and pneumonia
423 3.7%
Unintentional Injuries
344 3.0%
Alzheimer's
341 3.0%
Nephritis
302 2.6%
Diabetes
265 2.3%
Septicemia
221 1.9%
21
Chronic Disease Outcomes and Overweight/Obesity
22Adults who are Overweight1 by EOHHS Region, Massachusetts:
1995 & 2005
57.8
49.5 45.7
43.5 44.6
50.2
35.7
45.1
52.057.5
60.8
55.952.6
56.1
0
10
20
30
40
50
60
70
Western Central Northeast MetroWest
Southeast Boston MA
Per
cen
t
1995 2005
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), Health Survey Program
1 Obesity: BMI greater than or equal to 25
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
23
Hospital Discharge Rates for Hypertension by Metrowest Cities and Massachusetts: 2003-2005
38.731.0
73.6
32.4
60.4
40.9
65.3
0
25
50
75
100
Cambridge Quincy Norwood Sharon Randolph Metrowest MA
Dis
char
ges
p
er 1
00,0
00
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
**
*
**
Age-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database
24Hospital Discharge Rate for Hypertension
by Race/EthnicityMetrowest Region Massachusetts: 2003-2005
26 28
176
143
66
89
3322
0
20
40
60
80
100
120
140
160
180
200
Metrowest Region Massachusetts
Dis
ch
arg
es
pe
r 1
00
,00
0
White non-Hispanic Black non-Hispanic
Hispanic Asian non-Hispanic
Age-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
**
25
Heart Disease Mortality Rateby Metrowest Cities and Massachusetts: 2003-2005
185.7 182.5
231.2
161.6 159.8
0
50
100
150
200
250
Cambridge Quincy Randolph Metrowest Massachusetts
Dea
ths
per
100
,000
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
**
*
**
Age-adjusted to the 2000 US standard population
26
Prevalence of Diabetes Massachusetts: 1994-2005
3.8
5.6
6.46.25.8
5.6
5.8
4.9
4.3
4.7
3.8
0
1
2
3
4
5
6
7
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Per
cen
t
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), Health Survey Program
27
Diabetes Hospital Discharges by Metrowest Cities and Massachusetts: 2003-2005
133
178
136
169178
186
111
0
25
50
75
100
125
150
175
200
Cambridge Quincy Weymouth Randolph Norwood Metrowest MA
Dis
ch
arg
es
pe
r 1
00
,00
0
Age-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database
* *
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
*
**
*
28Diabetes Hospital Discharge Rate by Race/Ethnicity
Metrowest Region Massachusetts: 2003-2005
368
114105
301
151
242
4530
0
50
100
150
200
250
300
350
400
Metrowest Region Massachusetts
Dis
char
ges
p
er 1
00,0
00
White non-Hispanic Black non-Hispanic
Hispanic Asian non-Hispanic
Age-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database
**
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
**
**
**
29
Cancer
30
139.8 138.9135.3127.8
146.7134.9139.6
0
50
100
150
200
Western Central Northeast MetroWest
Southeast Boston MA
Cas
es p
er 1
00,0
00 p
op
ula
tio
n
Age-adjusted to the 2000 US standard population. Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Cancer Registry
***
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
Incidence Rates for Invasive Female Breast Cancer by EOHHS Region,
Massachusetts: 1999-2003
31Women Ages 40+ who have had a mammography in Past 2 Years by EOHHS Region
Massachusetts: 2005
82.0 84.187.183.486.9 83.0 80.1
0
20
40
60
80
100
Western Central Northeast MetroWest
Southeast Boston MA
Per
cen
t
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Health Survey Program
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
32Incidence Rates for Invasive Lung Cancer by EOHHS Region, Massachusetts: 1999-2003
72.076.7
67.2 69.965.1
77.777.5
0
25
50
75
100
Western Central Northeast MetroWest
Southeast Boston MA
Cas
es p
er 1
00,0
00 p
op
ula
tio
n
Age-adjusted to the 2000 US standard population. Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Cancer Registry
*
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
*** *
**
33
Adults who Currently Smoke by EOHHS Region, Massachusetts: 2005
20.418.1
12.4
18.318.821.2
19.5
0
5
10
15
20
25
30
Western Central Northeast MetroWest
Southeast Boston MA
Per
cen
t
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Health Survey Program
**
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
34
Substance Abuse
35Substance Abuse Admissions-
Alcohol Primary Substance by Metrowest Cities, Massachusetts: 2005
661
404
925
710785
306
820
0
100
200
300
400
500
600
700
800
900
1000
Cambridge Quincy Dedham Westborough Framingham Metrowest MA
Cru
de
rate
per
100
,000
Source: Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2005.
*
**
Statistically different from state (p ≤.05)– Red (*) Statistically higher than state- Green (**) statistically lower than state
*
*
**
36Substance Abuse Admissions-
Cocaine Primary Substance by Metrowest Cities, Massachusetts: 2005
62
85
173
2334
0
25
50
75
100
125
150
175
200
Cambridge Quincy Dedham Metrowest MA
Cru
de
rate
per
100
,000
Source: Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2005.
*
**
*
Statistically different from state (p ≤.05)– Red (*) Statistically higher than state- Green (**) statistically lower than state
**
37
Opioid-Related Emergency Department Visit Ratesby Metrowest Cities and Massachusetts: 2005
188
134
298
240
189
277
0
100
200
300
400
Cambridge Quincy Somerville Weymouth Metrowest MA
Vis
its
per
100
,000
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
**
Age-adjusted to the 2000 US standard population
*
*
Statistically different from state (p ≤.05)– Red (*) Statistically higher than state- Green (**) statistically lower than state
*
38
Injury/Violence
39Emergency Department Visit Rates for Motor Vehicle-related Injuries by
Metrowest Cities and Massachusetts: 2003-2005
1465
956
2363
1204
1498
724
1660
0
500
1000
1500
2000
2500
Cambridge Quincy Framingham Norwood Randolph Metrowest MA
Vis
its
per
100
,000
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
**
*
Age-adjusted to the 2000 US standard population.Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Emergency Visits
*
**
**
40Hospitalization Rates for Fall-Related Injuries Persons Ages 65+ by EOHHS Region
Massachusetts: 2003-2005
2,024
2,333 2,254 2,311 2,2752146**
2443*
0
500
1000
1500
2000
2500
3000
Western Central Northeast Metro West Southeast Boston MassachusettsTotal
Ho
spit
al D
isch
arg
es p
er 1
00,0
00
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program
41
Infectious Diseases
42
Persons Living with HIV by Metrowest Cities and Massachusetts : 2005
133.2
386.1
203.4
352.6
247.1
0
50
100
150
200
250
300
350
400
450
Quincy Cambridge Somerville Metrowest MA
Per
son
s p
er 1
00,0
00
**
*
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
Source: MDPH, BCDC HIV/AIDS Files as of 09/01/06
*
**
Crude rates
43
138
1136
781
85
1028
370
0
200
400
600
800
1000
1200
Metrowest Region Massachusetts
Per
son
s p
er 1
00,0
00
White non-Hispanic Black non-HispanicHispanic
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
Persons Living with HIV by Race/Ethnicity Metrowest Region and Massachusetts : 2005
**
Source: MDPH, BCDC HIV/AIDS Files as of 09/01/06Crude rates
**
44
Asthma
45Pediatric Asthma Prevalence Among School Children, Grades K-8
by EOHHS Region Massachusetts: 2005-2006
10.5 10.69.4
10.1
12.7
9.8
13.0
0
5
10
15
20
Western Central Northeast MetroWest
Southeast Boston MA
Pe
rce
nt
Source: MDPH, Center for Environmental Health, Pediatric Asthma Surveillance (2005-2006)
**
** ****
Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state
46LAWRENCE1494.5
FRAMINGHAM1639.3
NORWOOD1823.2
Pediatric Asthma Emergency Visit Rates by TownsAmong Children Ages <5
Metrowest Region - Massachusetts 2004-2005
Emergency Visit Rates by Townsper 100,000
Significantly higher than state rate
Not different from state rate
Significantly lower than state rateTowns with less than 5 cases in the period were excluded.
Massachusetts State Total Rate: 1,136.2
Source: Division of Health Care Finance and Policy. Calendar Year 2005. Emergency Visits
47
Summary• The Metrowest region is a healthy place to live
• Residents of certain communities are affected disproportionately by health issues, including the following:Framingham: Access to private sources for prenatal care,
admissions for substance abuse, emergency visits by children ages <5 with asthma
Randolph: Hospitalizations for hypertension and diabetes, deaths to heart disease, emergency visits for motor vehicle injuries
Norwood: Hospitalizations for hypertension and diabetes, emergency visits for motor vehicle injuries and by children ages <5 with asthma
Quincy: Hospitalizations for diabetes, admissions for cocaine, emergency visits for opioid-related injuries
Somerville: Access to private sources for prenatal care, opioid-related emergency visits, persons living with HIV
Weymouth: Hospitalizations for diabetes, emergency visits for opioid-related injuries
Sharon: Hospitalizations for hypertensionCambridge: Persons living with HIV
48
The following groups of the Metrowest region, when compared with those at the state level, have higher rates of:Blacks & Latinos: emergency visits for
opioid-related injuries
Whites: incidence for female breast cancer; hospitalizations for persons ages 65+ due to fall injuries
Refugees: high TB rates; increased lead poisoning among children
Health Disparities
49
How Can You Access these Data?
• Hard Copies: (617) 624-5674
• TDD/TTY: (617) 624-6001
• DPH Website:
mass.gov/dph/bhsre/resep/resep.htm
• For other questions or suggestions:
Laura.Innis@state.ma.us, 617-624-6021
• For more detailed community data:
http://masschip.state.ma.us/
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Q/A