Community Health Needs Assessment 2019 Executive Summary · • Mental Health & Substance Abuse •...

2019 Community Health Needs Assessment Executive Summary

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Community Health Needs Assessment

2019

Executive Summary


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Table of Contents

1. Introduction ......................................................................... 2

2. Thank You to Our Community Partners ............................. 3

3. Evaluation of 2016 CHNA .................................................. 6

4. Methodology ...................................................................... 7

5. Demographics In Our Region ............................................ 8

6. Critical Health Needs ......................................................... 9

7. Available Resources ........................................................ 27

8. Next Steps ....................................................................... 29


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Introduction About This Report

A Community Health Needs Assessment (CHNA) helps to:

• gauge the health status of a community

• guide development and implementation of strategies to create a healthier community

• promote collaboration among local agencies and

• provide data to evaluate outcomes and impact of efforts to improve population health.

Facilitated by Strategy Solutions, Inc., the St. Clair Hospital CHNA follows best practices as outlined by the Association for Community Health Improvement, a division of the American Hospital Association, and ensures compliance with Internal Revenue Service (IRS) guidelines. The process has taken into account input from those who represent the broad interests of the communities served by St. Clair including those with knowledge of public health, the medically underserved, and populations with chronic disease. On March 11, 2019, the St. Clair CHNA Community Benefit Committee met to review the primary and secondary data collected through the needs assessment process and discussed the relevant identified needs and issues present in the Hospital’s service area. The committee completed a prioritization exercise evaluating each identified need against four criteria. On June 10, 2019, the CHNA Community Benefit Committee reconvened to review the results of the prioritization exercise and select the priority areas for the Implementation Plan.

Report Service Area

For this assessment, the community is defined as the geography included

on the map below. St. Clair’s service area covers Southern and Western

Allegheny County and Northern Washington County, represented as

Regions 1-6 for outreach purposes. Regions 1 and 2 make up our primary

service area. The service area map depicting the ZIP codes serviced by the

Hospital is shown in the map below.


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Thank You to Our Community Partners

St. Clair Hospital is committed to providing exceptional patient safety, clinical outcomes, patient satisfaction and value to continue to meet the needs of our community. We offer special thanks to the representatives of the CHNA Community Benefit Committee and to the 343 citizens and stakeholder participants of the focus groups, interviews, and community and intercept surveys who generously gave their time and input to provide insight and guidance to the process. Listed below are the Community Benefit Committee members and a group of community leaders and experts who also participated in the CHNA process.

CHNA Community Benefit Committee Members


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St. Clair Hospital CHNA Stakeholders


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Community Partners


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Evaluation of 2016 CHNA

We Are Making a Difference


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Methodology

This assessment is intentionally designed to frame health status in the context of “factors that impact health” to better inform the community as we seek to leverage resources and investments that will improve the health of the community. Data from numerous qualitative and quantitative sources were used to validate the findings, using the data CHNA methodology outlined below.

Source: St. Clair Health Primary and Secondary Data Collection, Strategy Solutions, Inc. 2019

This blend of data create a full and vibrant picture of the health and wellness of the St. Clair communities, the issues residents face, and what they have accomplished since the most recent CHNA. Individual data sources are cited with data presented.


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Demographics In Our Region Our Community

When looking at our service area we have a slightly higher female population (51.5%). The majority of our residents are White, Non-Hispanic (87.7%), 6.2% are Black/African American and 3.3% are Asian. The remaining 2.8% of our population identify as other or two or more races. Just under one-third (29.0%) of our residents have a high school diploma or equivalent as their highest level of educational attainment. One in four residents (25.2%) has some college education, completed tech school or have an associate degree. Over a third (39.8%) have a bachelor’s degree or greater. Very few (6.0%) do not have a high school high school diploma. Approximately half (49.4%) of our residents are married. Of those eligible to enter our workforce (age 16+), 62.7% are employed and of those employed the highest percentage (68.8%) are working in white collar occupations. As we continue to strengthen our support for the residents we serve, it is important to be

mindful of the unique demographics that make up our community.

Service Area Demographics

Source: Claritas-Pop-Facts Premier, 2019, Environics Analytics


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Critical Health Needs Our 2019 Community Health Needs Assessment was designed to explore data from numerous qualitative and quantitative sources. The process used to identify community needs followed a triangulation method of data interpretation. This allowed us to identify key needs and issues through secondary data that were then validated by our community through our primary research. Recognizing that much of our secondary data are limited to the county level or multiple county regions, it was imperative to our process that we included the voice of our community. It is understood that not all of the needs represented in the county data were found to exist in the communities we serve. For the purposes of our assessment, we looked at needs under the following broad categories:

• Access to Quality Health Services

• Chronic Disease & Cancer

• Physical Activity & Falls

• Mental Health & Substance Abuse

• Healthy Environment & Conditions

• Healthy Women, Mothers, Babies and Children

• Infectious Disease

The data were presented on June 10, 2019 and the Community Benefit Committee of the Board of Directors determined that the Hospital would focus its efforts over the next three years on addressing the following:

• Access to Quality Health Services (Healthy Women, Mothers, Babies and Children included) • Chronic Disease & Cancer • Mental Health & Substance Abuse • Healthy Environment & Conditions (Healthy Women, Mothers, Babies and Children included)

Community needs are identified by secondary data and then supported by the voice of our local community. Data will be displayed to highlight some of the key areas of opportunity within our community based on the secondary data. We will then highlight the specific needs that are unique to our primary service area that our community participants have identified.


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Secondary data that are highlighted are indicators where the county is either different when compared to the state or Healthy People 2020 Goal or has an unfavorable trend over time for years data are available. For purposes of this assessment, anything less than 3 percent or point difference is considered comparable and not noted. Indicators that are improving or better compared to the state, nation and Healthy People 2020 Goal are also not noted in this summary. All the data compiled for our CHNA can be found in our complete data analysis.

The following icons appear next to the community input to indicate the primary data source the information was obtained through.


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Access to Quality Health Services What The Data Say

Why this is important: People who are unable to afford to see a doctor may not receive the proper medical services when they need them. This can

lead to missed diagnoses, untreated conditions, and adverse health outcomes. People who cannot afford to see a doctor are less likely to get routine

checkups and screenings. When they become ill, they generally delay seeking treatment until the condition is more advanced and therefore more

difficult and costly to treat. Maintaining regular contact with a health care provider is especially difficult for low-income people, who are less likely to

have health insurance. This often results in emergency room visits, which raises overall costs and impacts the continuity of care.

Source: Department of Health Informatics, Behavioral Risk Factor Surveillance System Data,

Pennsylvania Department of Health, 2015-2017.

When compared to the state the following needs exist in Allegheny and Washington Counties:

• Adults who are uninsured

• Adults who are without a primary care provider

• Cost as a barrier to care


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What The Community Says

Intercept Survey Respondents experienced the following barriers when accessing care:

• Cost of Co-Pay (71.4%)

• Cost of Medical Care (57.1%)

• Cost of Medication (57.1%)

• Transportation (14.3%)

Focus Group Participants identified the following barriers community members experienced when accessing care:

• Lack of Health Insurance

• Language Barriers

• Cost of Care

• Transportation

• Limited Hours of Service

Stakeholders identified the following barriers community members experienced when accessing care:

• Cost of Care

• Transportation

Community Survey Respondents experienced the following barriers when accessing care:

• Appointment Times (20.5%)

• Insurance Limitations (12.0%)

• Cost (10.8%)

• Distance (6.6%)

• Transportation (6.0%)


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Chronic Disease & Cancer

What The Data Say

Why this is important: Few things impact your life more than a serious health problem. Chronic diseases, including heart disease, stroke and diabetes, as

well as cancer affect the health of millions of people and cost billions of dollars in medical expenses every year.

Lifestyle choices – such as not smoking, maintaining a healthy weight and being physically active – can help prevent some of the most common chronic

diseases and some types of cancer. Regular health screenings can often discover chronic conditions and cancers early when treatment is more likely to

be successful.

Sources: Department of Health Informatics, Pennsylvania Department of Health, 2011-2016

Department of Health Informatics, Behavioral Risk Factor Surveillance System Data, Pennsylvania

Department of Health, 2015-2017.


• Heart Related Conditions

• Cardiovascular Disease

• Diabetes

• Lyme Disease

• Healthy Weight


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Department of Health Informatics, Behavioral Risk Factor Surveillance System Data, Pennsylvania Department of Health, 2015-2017.


• Leukemia

• Oral Cavity and Pharynx Cancer

• Prostate Cancer

• Female Breast Cancer

• Bronchus and Lung Cancer

• Colorectal Cancer


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Community Survey Respondents identified the following chronic diseases as problems in our community:

• Cancer (33.3%)

• Obesity (29.4%)

• Heart Disease (28.5%)

• High Blood Pressure (20.2%)

• Diabetes (15.4%)

• Intercept Survey Respondents are personally experiencing the following:

• High Blood Pressure (75.0%)

• Obesity (61.5%)

• High Cholesterol (60.0%)

• Diabetes (53.3%)

• Heart Disease (36.4%)

Focus Group Participants commented on the following:

• Lot of individuals with Cancer

• Large elderly population with a variety of medical conditions

Stakeholders commented on the following:

• High rates of hypertension put individuals at risk for Stroke and Cardiovascular Disease

• Need to focus on disease prevention


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Physical Activity & Falls

What The Data Say

Why this is important: Adults who are sedentary are at an increased risk of many serious health conditions. These conditions include obesity, heart

disease, diabetes, colon cancer, and high blood pressure. In addition, physical activity improves mood and promotes healthy sleep patterns.

Falls are a leading cause of unintentional injury and injury death. Falls commonly produce bruises, hip fractures, and head trauma. These injuries can

increase the risk of early death and can make it difficult for older adults to live independently. Most fatal falls occur among adults aged 65 or over.





• Fall Mortality

• Lack of Physical Activity


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Community Survey Respondents identified the following as problems in our community:

• Lack of Safe Places to Walk and Play (14.5%)

Intercept Survey Respondents identified Lack of Safe Places to Walk and Play (13.6%) as a

problem in the community.

86.4% of Intercept Survey Respondents are physically active for 30 minutes or more a few

times per week.

Focus Group Participants did not comment on this community health

need.

Stakeholders commented on the need for affordable exercise opportunities for our

seniors.


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Mental Health & Substance Abuse

What The Data Says


Why this is important: Psychological distress can affect all aspects of our lives. It is important to recognize and address potential psychological issues

before they become critical. Occasional down days are normal, but persistent mental/emotional health problems should be evaluated and treated by a

qualified professional.

Drinking alcohol has immediate physiological effects on all tissues of the body, including those in the brain. According to the Centers for Disease Control

and Prevention, excessive alcohol use, either in the form of heavy drinking, or binge drinking, can lead to increased risk of health problems, such as liver

disease and unintentional injuries.

Drug overdose deaths are the leading cause of injury death in the United States, with over 100 drug overdose deaths occurring every day. The death rate

due to drug overdose has been increasing over the last few decades.

Tobacco is the agent most responsible for avoidable illness and death in America today. Areas with a high smoking prevalence will also have greater

exposure to secondhand smoke for non-smokers, which can cause or exacerbate a wide range of adverse health effects such as cancer, respiratory

infections, and asthma.





• Mental and Behavioral Disorders Mortality

• Suicide Mortality

• Poor Mental Health Days

What The Data Say


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Department of Health Informatics, Behavioral Risk Factor Surveillance System Data,

Pennsylvania Department of Health, 2015-2017

Pennsylvania Youth Survey, 2017


• Adult and child alcohol consumption

• Adult and child tobacco use

• Drug induced mortality

• Youth drug use


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Community Survey Respondents identified the following:

• Mental Health as a top community problem (27.2%)

• Mental Health as a problem that did not exist 5 years ago (8.9%)

• Drug Abuse as a problem that did not exist 5 years ago (41.1%)

Intercept Survey Respondents have personally been affected by the following:

• Depression (46.2%)

• Mental Health (36.4%)


• A lack of providers in the community

• Distance to providers

• Challenges with insurance

• Increasing drug problem

• Stigma


• Although decreasing, opioids continue to be a problem in our community

• Depression and anxiety are prevalent in our community


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Healthy Environment & Conditions

What The Data Say

Why this is important: Food insecurity is an economic and social indicator of the health of a community. The U.S. Department of Agriculture

(USDA) defines food insecurity as limited or uncertain availability of nutritionally adequate foods or uncertain ability to acquire these foods in

socially acceptable ways. Poverty and unemployment are frequently predictors of food insecurity in the United States. Food insecurity is

associated with chronic health problems in adults including diabetes, heart disease, high blood pressure, hyperlipidemia, obesity, and mental

health issues including major depression.

Sources: Department of Health Informatics, Behavioral Risk Factor Surveillance System Data,

Pennsylvania Department of Health, 2015-2017.

County Health Rankings and Roadmaps, 2018


• Overall Health Status

• Food Insecurity


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Community Survey Respondents identified the following as problems in the community:

• Hunger (6.5%)

• Access to Healthy Food (5.6%)

• Access to Fresh Fruits and Vegetables (4.0%)

Intercept Survey Respondents identified Access to Food (4.6%) as a top

community problem.

82.6% Eat Fresh Fruits and Vegetables Daily


• There are a lot of students who receive free or reduced lunch

• Parents are unable to afford healthy foods

• Transportation can be a barrier to accessing a food pantry


• Seniors need access to affordable healthy foods

• Individuals living in poverty are unable to afford healthy food


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Healthy Women, Mothers, Babies & Children What The Data Say

Why this is important: Babies born to mothers who do not receive prenatal care are three times more likely to have a low birth weight and five

times more likely to die than those born to mothers who do get care. Early prenatal care allows women and their health care providers to identify

and, when possible, treat or correct health problems and health-compromising behaviors that can be particularly damaging during the initial

stages of fetal development.

Breastfeeding is widely recognized as the single best way to feed infants. Breast milk has health benefits for both infants and mothers.

Breastfeeding improves the relationship between babies and mothers, and also improves the infant's immune system, resulting in fewer episodes

of infectious illness. In addition, breastfeeding lowers the risk of breast cancer and may lower the risk of ovarian cancer in mothers.

Source: Department of Health Informatics, Pennsylvania Department of Health, 2011-2016


• Breastfeeding Mothers

• Teen Live Birth Outcomes

• Mothers Receiving Prenatal Care

• Non-Smoking Mothers

• Mothers Receiving Medicaid Assistance


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Community Survey Respondents experience the following:

• Receive routine health care from a Gynecologist (39.3%)

• Have traveled outside of the community for pediatric health services (1.3%)

• Access to good childcare (9.8%)

Intercept Survey Respondents did not identify this community health need as

a top problem in the community.

Focus Group Participants did not discuss this community health

need.


• Childhood obesity is a problem

• High rates of infant mortality with a widening gap based on racial disparities


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Infectious Disease

What The Data Say

Why this is important: Infectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms

live in and on our bodies. They're normally harmless or even helpful, but under certain conditions, some organisms may cause disease. Some

infectious diseases can be passed from person to person. Some are transmitted by bites from insects or animals. And others are acquired by

ingesting contaminated food or water or being exposed to organisms in the environment. Many infectious diseases can be prevented by

vaccines.





• Sexually Transmitted Diseases

• HIV Testing


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Community Survey Respondents have received the following within the past year:

• Flu vaccination in the past year (78.6%)

• Pneumonia Vaccine (20.3%)

• Tetanus Booster (13.8%)

• Shingles Vaccine (8.8%)

Intercept Survey Respondents have personally been affected by the following:

• Flu (30.8%)

• Pneumonia (18.2%)

Focus Group Participants did not discuss this community

health need.

Stakeholders did not discuss this community health need.


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Available Resources Regional resources that are available in St. Clair’s service area to respond to the significant health needs of the community can be found in the United Way’s Southwest PA 2-1-1. The PA Southwest 2-1-1 is part of the national 2-1-1 Call Centers initiative that seeks to provide an easy-to-remember telephone number and web resource for finding health and human services– for everyday needs and in crisis situations. Residents can search the United Way’s vast database of services and providers to find the help they need. The Southwest Region includes Allegheny, Armstrong, Beaver, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Mercer, Somerset, Washington and Westmoreland counties. The table below shows the number of approximate resources available in Allegheny and Washington Counties as listed in United Way’s PA Southwest 2-1-1. For a complete listing of available services, please visit http://pa211sw.org/. Community Resources for Allegheny and Washington Counties

http://pa211sw.org/


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St. Clair Hospital Resources

Federally Qualified Health Centers

Hilltop Community Healthcare Center (412) 431-3520

Sto-Rox Neighborhood Family Health Council (412) 771-6462

West End Health Center (412) 921-7200

Information regarding services available at St. Clair

Hospital can be obtained by visiting our website,

www.stclair.org, and clicking on the Services tab.

http://www.stclair.org/

https://www.stclair.org/services/


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Next Steps

On June 10, 2019 the CHNA Community Benefit Committee determined that the Hospital would focus its efforts over the next three years on addressing the following:

• Access to Quality Health Services• Chronic Disease & Cancer• Mental Health & Substance Use• Healthy Environment & Conditions

Over the next several months this committee will work closely with Hospital leaders to identify the best approach to address the identified needs within each focus area. The committee will take into consideration the core competencies of the Hospital, availability of resources both internal and external to the Hospital, and ability to implement evidenced-based solutions to address an identified need.

While other important health issues were identified in the study such as lack of physical activity, falls, sexually transmitted diseases, dental disease and vaccination rates, the Hospital will look to our community partners and county agencies for their expertise in addressing these matters.

St. Clair is committed to serving the community through adherence to our mission, providing services that prevent disease and working to enhance the quality of life and well-being of those we serve. As we learned in our last 2016 CHNA, we can be more effective by aggressively focusing our efforts on fewer critical areas of need rather than trying to address many. We learned greater focus on fewer areas permits the Hospital’s staff to better evaluate the health need and begin to identify possible solutions for the communities we serve.

Community Health Needs Assessment 2019 Executive Summary · • Mental Health & Substance Abuse •...

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