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Introduction

COMMUNITY HEALTH ASSESSMENT

Prepared by:

HealtheConnectionsHealthPlanning

November 2013

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Community Health Assessment

TABLE OF CONTENTS

Demographics and Social Determinants ........................................... Appendix 1

Healthy Infants and Toddlers ............................................................ Appendix 2

Healthy Children................................................................................ Appendix 3

Healthy Adolescents ......................................................................... Appendix 4

Healthy Adults .................................................................................. Appendix 5

Healthy Older Adults ........................................................................ Appendix 6

Healthy Environments ...................................................................... Appendix 7

Economic Development ................................................................... Appendix 8

Community Health Improvement Plan ............................................ Appendix 9

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Introduction

Organizing for Results New York State Guidance In the fall of 2012, the New York State Department of Health required all local Public Health Depart-ments in the state to produce a Community Health Improvement Plan in keeping with the goals identi-fied in the Prevention Agenda 2013. Local health departments were mandated to work with local hos-pitals as well as other area partners to complete a Community Health Assessment that includes a Com-munity Health Improvement Plan for 2013-2017. In the past, community health improvement activi-ties conducted by local health departments were described in the Municipal Public Health Services Plan (MPHSP). In 2013, the local health department Community Health Assessment, while still a re-quirement for state aid funding, is no longer part of the MPHSP. For 2013-2015, hospitals were asked by NYS to complete a Community Service Plan that mirrors the Community Health Needs Assessment and Improvement Strategy required for nonprofit hospitals in the Patient Protection and Affordable Care Act. Hospitals will also need to report on the costs associat-ed with the community health improvement services they implement to the IRS.

A Call to Action New York State’s health assessment and health improvement plan, Prevention Agenda 2013-2017, was approved by the Public Health and Health Planning Council in December 2012 and released by Gover-nor Cuomo and Commissioner Shah in April 2013. It is a call to action to health care providers, health plans, schools, employers, governmental and non-governmental agencies and businesses to collabo-rate at the community level to identify local health priorities and plan and implement a strategy for local health improvement that will contribute to improving the health status of New Yorkers through increased emphasis on prevention. The Plan identifies five priorities for improving the health of all New Yorkers and asks communities to work together to address them. The five Prevention Agenda priorities for 2013-2017 are:

Prevent Chronic Diseases Promote a Healthy and Safe Environment Promote Healthy Women, Infants and Children Promote Mental Health and Prevent Substance Abuse Prevent HIV, STIs and Vaccine Preventable Diseases

Collaborative Approach Collaboration is an essential element for improving population health in communities and in the State as a whole. No single entity provides public health services in Madison County, and all entities make important contributions to the local health system. Community health improvement is a systematic effort that must be sustained over time. The process involves an ongoing collaborative, community-wide effort to assess applicable data to:

identify, analyze, and address health problems, inventory community assets and resources, identify community perceptions, develop and implement coordinated strategies, develop measurable health objectives and indicators, identify accountable entities and cultivate community ownership of the process.

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Steering Committee In October 2012 the Madison County Public Health Department convened a group of community lead-ers including representatives from state and local government, county department directors, the not-for-profit sector, advocates, the business community, academia and health insurance companies to provide direction and oversight to the planning process. This group met several times over the course of a year, completing its work in October of 2013. See Appendix 9 for a listing of Steering Committee members.

Advisory Groups The Madison County Board of Health selected a “Life Stage” format based on materials produced by the U.S. Centers for Disease Control and Prevention (CDC). The Life Stages are:

Infants & Toddlers (birth to age 3) Children (ages 4 to 11) Adolescents & Teens (ages 12 to 19) Adults (ages 20 to 49) Older Adults & Seniors (aged 50 and older)

Additional volunteers representative of service providers and other experts in the community were invited to join Advisory Groups specific to each Life Stage. The Life Stage Advisory Groups met three times (February or March, June and September) with e-mail and telephone contact between meetings. See Appendix 9 for a listing of Life Stage Advisory Group members.

Strategic Health Directives In 2012, the Madison County Board of Health identified three overarching Strategic Health Directives to guide and direct health prevention across multiple settings and advances our efforts to build a healthier Madison County: Healthy Care, Healthy Behaviors and Health Environment. Together the directives provide a framework for achieving health protection and health equity across all stages of life and a guide for the community health assessment process. Healthy Care: Our goal is to ensure access to and receipt of recommended quality, effective, evidence-based preventive and health care services and information for individuals at each stage of life. The provision of evidence-based health care services is essential for improving and enhancing physical, oral and mental health. Preventive services have proven to be both effective and cost-saving through decade of practice and research and can be supported and reinforced by community prevention efforts that have the potential to reach large numbers of people. Primary and preventive care means having a regular primary care provider who provides integrated, accessible health care services. This includes providing local, sustainable access to primary and preven-tive health care that is economically beneficial to our network of providers and our community in gen-eral. Healthy care also includes chronic disease management, which in the clinical setting is an organized, proactive, multi-component, patient-centered approach to health care delivery that involves all mem-bers of a defined population who have specific disease. Care is focused on, and integrated across the spectrum of the disease and its complications, the prevention of co-morbid conditions, and relevant aspects of the delivery system.

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Healthy Behaviors: Our goal is to support individuals at each stage of life in making healthy choices. This area of focus includes: healthy eating and healthy weight, active living, tobacco free living, pre-venting substance abuse and excessive alcohol use, injury free living, infection free living, and mental and emotional well-being. The development and progression of many chronic diseases are linked to unhealthy behaviors, particularly cigarette smoking and use of other tobacco products, poor diet, and lack of exercise. Healthy Environments: Our goal is to create and sustain social and physical environments that are ac-cessible; that support health, safety, and quality of life for individuals at each stage of life. This area of focus includes: natural environments, built environments, social capital and public well-being. Many elements of our communities affect health directly and also influence health-related choices. A healthy community environment can help make healthy choices easy and affordable. Avail-ability of resources to meet daily needs, community structure and design, and the natural environment are some of the factors that influence individual and community health.

Economic Development - Health Care Simultaneous to the state-wide development of the Prevention Agenda 2013, the Madison County Board of Supervisors was engaged in a multi-faceted economic development planning process which culminated in the Madison County Economic Development Plan approved in February 2013. The Health Improvement Planning Report for Madison County completed by the Public Health Department in October 2009 included a section on the economic benefits of both the improved health of residents and expanding opportunities for the healthcare sector. Building upon these two documents, the Steer-ing Committee approved a Health Care Economic Development component within the Community Health Improvement Plan which is in addition to, and not required by, the expectations of the NYSDOH. Several elected, business, hospital, insurance, academic and not-for-profit leaders were invited to serve on an Economic Development Advisory Group which met twice and provided significant input toward the Madison County Community Health Improvement Plan. See Appendix 8 for a listing of Economic Development Advisory Group members.

Prioritization and Emphasis This Madison County Community Health Assessment, the Madison County Community Health Improve-ment Plan (Appendix 9) and the affiliated Community Service Plans developed by Community Memori-al Hospital and Oneida Healthcare focus on priority areas. These priority areas were identified through the year-long collaborative and participatory processes of the Advisory Groups and the Steering Com-mittee. Within each section of this report, longer narratives and additional charts are provided regard-ing issues identified by the Advisory Groups through review of available data, as significant for Madison County. Areas with less interest or concern may only be included in the Indicator Table at the end of each section, or not mentioned at all. Guidance from the NYSDOH requires two goals, one of which must address a health disparity issue. Given the excellent and diverse input from the Advisory Groups, the Steering Committee chose not to limit the plan to two goals. The Madison County Community Health Improvement Plan includes six goals with strategies and action steps, several of which address economic status and geographic isola-tion as health disparities.

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The health priorities for Madison County were organized into a three-tier framework: Tier I priorities represent the highest priorities for the community Advisory Groups and the Steering Committee. Determination was based on data, anecdotal knowledge of the issue, current community resources available to address the issue, and the community’s ability to make an impact and “move the needle” during the next four years. Additional criteria used to select the top tier priorities were areas of focus that spanned the life stages. The Tier II priority was selected because of the correlation between adequate prenatal care and both short-term health outcomes and long-term health outcomes that span the life stages. Additionally, supporting pre-conception and intra-conception is important in keeping those individuals of child bear-ing age healthy. Tier III priorities emerged from the discussions of the economic development Advisory Group and healthy environment related issues that were confirmed by the Steering Committee as important is-sues to include in the Community Health Improvement Plan. Tier III priorities include a description of overarching goals, lead agencies, and strategies. Resident Engagement

The Community Health Assessment is about us – you and I, our neighbors, our co-workers, our friends - the residents of Madison County. Our behaviors and choices determine the figures in the charts and graphs. The Community Health Improvement Plan is also about us. We have the opportunity to be-come part of a movement to improve health and wellness.

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For Report Information please contact:

Madison County Department of Health

www.healthymadisoncounty.org © 2013

Madison County Department of Health

PO Box 605 • Wampsville, NY 13163

Tel: 315‐366‐2361 • Fax: 315‐366‐2697

health@madisoncounty.ny.gov

For Report Information please contact:

Madison County Department of Health

www.healthymadisoncounty.org © 2013

Madison County Department of Health

PO Box 605 • Wampsville, NY 13163

Tel: 315‐366‐2361 • Fax: 315‐366‐2697

health@madisoncounty.ny.gov