MEMORIAL HERMANN — TEXAS MEDICAL CENTER · overall population health is the Community Benefit...

2019 Community Health Needs Assessment

MEMORIAL HERMANN — TEXAS MEDICAL CENTER

HEALTHINSURANCE

Board Approved June 27, 2019

MemorialHermann–TexasMedicalCenterCHNA20192

Table of Contents Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Introduction&Purpose...............................................................................................................................4SummaryofFindings...................................................................................................................................4PrioritizedAreas..........................................................................................................................................5

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 MemorialHermann–TexasMedicalCenter...............................................................................................6

Vision.......................................................................................................................................................6MissionStatement...................................................................................................................................6MemorialHermannHealthSystem.........................................................................................................6MemorialHermann–TexasMedicalCenterServiceArea.......................................................................7

Consultants..................................................................................................................................................8

Evaluation of Progress Since Prior CHNA .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 PriorityHealthNeedsandImpactfromPriorCHNA....................................................................................9

Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Overview....................................................................................................................................................11SecondaryDataSources&Analysis...........................................................................................................11

SecondaryDataScoring.........................................................................................................................11DisparitiesAnalysis................................................................................................................................12

PrimaryDataMethods&Analysis.............................................................................................................12CommunitySurvey.................................................................................................................................12KeyInformantInterviews.......................................................................................................................14

DataConsiderations...................................................................................................................................16Race/EthnicGroupings..........................................................................................................................17ZipCodesandZipCodeTabulationAreas..............................................................................................17

Prioritization..............................................................................................................................................17PrioritizationProcess.............................................................................................................................17

Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Population..................................................................................................................................................20

Age.........................................................................................................................................................21Race/Ethnicity........................................................................................................................................22Language...............................................................................................................................................24

SocialandEconomicDeterminantsofHealth............................................................................................25Income...................................................................................................................................................25Poverty...................................................................................................................................................26FoodInsecurity......................................................................................................................................28Unemployment......................................................................................................................................29Education...............................................................................................................................................30Transportation.......................................................................................................................................32SocioNeedsIndex®.................................................................................................................................34

Data Synthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Priorit ized Signif icant Health Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 PrioritizationResults..................................................................................................................................47AccesstoHealthcare..................................................................................................................................47


EmotionalWell-Being................................................................................................................................58FoodasHealth...........................................................................................................................................63ExerciseIsMedicine...................................................................................................................................70

Non-Prioritized Significant Health Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 OlderAdultsandAging..............................................................................................................................75Cancers......................................................................................................................................................76Education...................................................................................................................................................77Transportation...........................................................................................................................................78Children’sHealth.......................................................................................................................................80Economy....................................................................................................................................................81

Other Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 BarrierstoCare..........................................................................................................................................83Disparities..................................................................................................................................................83

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 AppendixA:EvaluationSincePriorCHNA.................................................................................................87AppendixB.SecondaryDataMethodology.............................................................................................106AppendixC.PrimaryDataMethodology.................................................................................................276AppendixD.PrioritizationTool................................................................................................................291AppendixE.CommunityResources.........................................................................................................294


Executive Summary

Introduction & Purpose MemorialHermann-TexasMedicalCenter(MHTMC)ispleasedtopresentits2019CommunityHealthNeedsAssessment(CHNA).ThisCHNAreportprovidesanoverviewoftheprocessandmethodsusedtoidentifyandprioritizesignificanthealthneedsacrossMemorialHermannHealthSystem’sregionalservicearea(includingMHTMC),asfederallyrequiredbytheAffordableCareAct.MemorialHermannHealthSystempartneredwithConduentHealthyCommunitiesInstitute(HCI)toconducttheCHNAfor13facilities:

• MemorialHermannKatyHospital• MemorialHermannMemorialCityMedicalCenter• MemorialHermannGreaterHeightsHospital• MemorialHermannNortheastHospital• MemorialHermannSoutheastHospital• MemorialHermannSugarLandHospital• MemorialHermannSouthwestHospital• MemorialHermannTheWoodlandsMedicalCenter• MemorialHermannRehabilitationHospital–Katy• MemorialHermann–TexasMedicalCenter• TIRRMemorialHermann• MemorialHermannSurgicalHospitalKingwood• MemorialHermannSurgicalHospitalFirstColony

ThepurposeofthisCHNAistoofferacomprehensiveunderstandingofthehealthneedsinMHTMC’sserviceareaandguidethehospital’splanningeffortstoaddressthoseneeds.Specialattentionhasbeengiventotheneedsofvulnerablepopulations,unmethealthneedsorgapsinservices,andinputfromthecommunity.TostandardizeeffortsacrosstheMemorialHermannHealthSystemandincreasethepotentialforimpactingtophealthneedsinthegreaterHoustonregion,communityhealthneedswereassessedandprioritizedataregional/systemlevel.Findingsfromthisreportwillbeusedtoidentifyanddevelopeffortstoimprovethehealthandqualityoflifeofresidentsinthecommunity.

Summary of Findings TheCHNAfindingsinthisreportresultfromtheanalysisofanextensivesetofsecondarydata(over100indicatorsfromnationalandstatedatasources)andprimarydatacollectedfromcommunityleaders,non-healthprofessionals,andorganizationsservingthecommunityatlarge,vulnerablepopulations,and/orpopulationswithunmethealthneeds.Throughanexaminationoftheprimaryandsecondarydata,thefollowingtophealthneedswereidentified:


Priorit ized Areas InMarch2019,stakeholdersfromthe13hospitalfacilitiesintheMemorialHermannHealthSystemcompletedasurveytoprioritizethesignificanthealthissues,basedoncriteriaincludinghealthimpactandriskaswellasconsiderationofMemorialHermann’sstrategicfocus.Thefollowingfourtopicswereidentifiedasprioritiestoaddress:

MHTMCwilldevelopstrategiestoaddresstheseprioritiesinits2019ImplementationStrategy.

MemorialHermannHealthSystem’sSignificantHealthNeeds•AccesstoHealthServices•Cancers•Children’sHealth•Diabetes•Economy

•Education•FoodInsecurity•HeartDisease/Stroke•LackofHealthInsurance•Low-Income/Underserved

•MentalHealth•Obesity•OlderAdults/Aging•SubstanceAbuse•Transportation

MemorialHermannHealthSystem’sCHNAPriorities• AccesstoHealthcare• EmotionalWell-Being• ExerciseIsMedicine• FoodasHealth


Introduction

Memorial Hermann – Texas Medical Center Foundedin1925,MemorialHermann-TexasMedicalCenteristheprimaryteachinghospitalfortheMcGovernMedicalSchoolatUTHealth.MemorialHermann-TMCprovidesleading-edgecareinheart,neuroscience,orthopedics,women'shealth,generalsurgery,organtransplantationandmuchmoreintheir692-bedfacility.AsoneofonlytwocertifiedLevelItraumacentersinthegreaterHoustonarea,thehospitalprovides24/7emergencyandtraumacare.MemorialHermannLifeFlight®providesemergencyrescuewithina150-mileradius.MemorialHermann-TMCisalsohometoChildren’sMemorialHermannHospital.A342-bed,womenandchildren’shospitalservingthecommunityforover30years,Children’sMHistheprimaryteachinghospitalforthepediatricobstetrics/gynecologyprogramsatMcGovernMedicalSchoolatUTHealthandis oneofthecountry’slargestpediatrichospitalswithrenownedprogramsinneurosciences,trauma,orthopedics,cardiaccare,andtransplantation.StrengtheningorthopedicandspineservicesintheGreaterHoustonareawitha64-bedfacilityisMemorialHermannOrthopedic&SpineHospital(HOSH),operatingunderMemorialHermann-TMC’slicense.AlsooperatingunderMemorialHermann-TMC’slicenseisMemorialHermannCypressHospital.MemorialHermannCypressHospitalbringsexpertiseandtopmedicalspecialiststotheCypressandNorthwestHoustonarea.Offeringadvancedmedicalequipmentandstate-of-the-arttechnologyintheir80-bedfacilitytoaddressthecommunity’shealthcareneeds,rangingfromroutineoutpatientvisitstocomplexinpatientprocedures.

Vision MemorialHermannwillbethepreeminenthealthsystemintheU.S.byadvancingthehealthofthoseweservethroughtrustedpartnershipswithphysicians,employeesandotherstodeliverthebestpossiblehealthsolutionswhilerelentlesslypursuingqualityandvalue.

Mission Statement MemorialHermannisanot-for-profit,community-owned,healthcaresystemwithspiritualvalues,dedicatedtoprovidinghighqualityhealthservicesinordertoimprovethehealthofthepeopleinSoutheastTexas.

Memorial Hermann Health System Oneofthelargestnot-for-profithealthsystemsinthenation,MemorialHermannHealthSystemisanintegratedsystemwithanexceptionalaffiliatedmedicalstaffandmorethan26,000employees.GovernedbyaBoardofcommunitymembers,theSystemservicesSoutheastTexasandtheGreaterHoustoncommunitywithmorethan300caredeliverysitesincluding19hospitals;thecountry’sbusiestLevel1traumacenter;anacademicmedicalcenteraffiliatedwithMcGovernMedicalSchoolatUTHealth;oneofthenation’stoprehabilitationandresearchhospitals;andnumerousspecialtyprogramsandservices.MemorialHermannhasbeenatrustedhealthcareresourceformorethan110yearsandasGreaterHouston’sonlyfull-service,clinicallyintegratedhealthsystem,wecontinuetoidentifyandmeetourregion’shealthcareneeds.AmongourdiverseportfolioisLifeFlight,thelargestandbusiestairambulanceserviceintheUnitedStates;theMemorialHermannPhysician


Network,MHMD,oneofthelargest,mostadvanced,andclinicallyintegratedphysicianorganizationsinthecountry;and,theMemorialHermannAccountableCareOrganization,operatingacaredeliverymodelthatgeneratesbetteroutcomesatlowercoststoconsumers,whileprovidingresidentsoftheGreaterHoustonareabroadaccesstohealthinsurancethroughtheMemorialHermannHealthInsuranceCompany.Specialtiesspanburntreatment,cancer,children’shealth,diabetesandendocrinology,digestivehealth,ear,noseandthroat,heartandvascular,lymphedema,neurosurgery,neurology,stroke,nutrition,ophthalmology,orthopedics,physicalandoccupationaltherapy,rehabilitation,roboticsurgery,sleepstudies,transplant,weightloss,women’shealth,maternityandwoundcare.SupportingtheSysteminitsimpactonoverallpopulationhealthistheCommunityBenefitCorporation.Atamarketshareof26.1%inthe‘expanded’greaterHoustonareaof12counties,ourvisionisthatMemorialHermannwillbeapreeminentintegratedhealthsystemintheU.S.byadvancingthehealthofthoseweserve.

Memorial Hermann – Texas Medical Center Service Area SinceMHTMCservesalargenumberofcitiesandtowns,thescopeofthisCHNAhasbeennarrowedtoreportingdataprimarilyatthecountylevel.TheserviceareaforMHTMCincludestwelvecountiesinTexas:Austin,Brazoria,Chambers,FortBend,Galveston,Harris,Liberty,Montgomery,SanJacinto,Walker,Waller,andWharton.ThegeographicboundariesoftheserviceareaareshowninFigure1.

Figure1.MHTMCServiceArea


Consultants MemorialHermannHealthSystemcommissionedConduentHealthyCommunitiesInstitute(HCI)toconductits2019CommunityHealthNeedsAssessment.HCIworkswithclientsacrossthenationtodrivecommunityhealthoutcomesbyassessingneeds,developingfocusedstrategies,identifyingappropriateinterventionprograms,establishingmonitoringsystems,andimplementingperformanceevaluationprocesses.TolearnmoreaboutConduentHealthyCommunitiesInstitute,pleasevisithttps://www.conduent.com/community-population-health.


Evaluation of Progress Since Prior CHNA TheCHNAprocessshouldbeviewedasathree-yearcycle.AnimportantpartofthatcycleisrevisitingtheprogressmadeonprioritytopicsfrompreviousCHNAs.Byreviewingtheactionstakentoaddresspriorityareasandevaluatingtheimpactoftheseactionsinthecommunity,anorganizationcanbetterfocusandtargetitseffortsduringthenextCHNAcycle.

Priority Health Needs and Impact from Prior CHNA MHTMC’slastCHNAwasconductedin2016.ThepriorityareasinFY16-18were:

• HealthyLiving:Encourageandfosterhealthylifestylesthrougheducation,awarenessandearlydetectiontopreventillness.

• HealthcareAccess:Improvecommunityknowledgeabouthealthcareaccesspointsandreduceperceivedbarrierstocare.

• BehavioralHealth:Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.

EachoftheabovehealthtopicscorrelateswellwiththeprioritiesidentifiedforthecurrentCHNA(detailedbelow);thusMHTMCwillbebuildinguponeffortsofpreviousyears.Adetailed

Figure2.CHNAProcess

AnalyzeData&

CommunityInput

PrioritizeHealthNeeds

CHNAReport&

ImplementationStrategy

Implement

EvaluateActionsTaken 3Year

Cycle


tabledescribingthestrategies/actionstepsandindicatorsofsuccessforeachoftheprecedingpriorityhealthtopicscanbefoundinAppendixA.MHTMC’sprecedingCHNAwasmadeavailabletothepublicviathewebsiteandcommunityfeedbackdirectedtoMemorialHermann’sCommunityBenefitDepartment:http://www.memorialhermann.org/locations/texas-medical-center/community-health-needs-assessment-tmc/.NocommentsorfeedbackwerereceivedontheprecedingCHNAatthetimethisreportwaswritten.


Methodology

Overview Twotypesofdatawereusedinthisassessment:primaryandsecondarydata.Primarydataaredatathathavebeencollectedforthepurposesofthiscommunityassessment.Primarydatawereobtainedthroughacommunitysurveyandkeyinformantinterviews.Secondarydataarehealthindicatordatathathavealreadybeencollectedbypublicsourcessuchasgovernmenthealthdepartments.Eachtypeofdatawasanalyzedusingauniquemethodology.FindingswereorganizedbyhealthtopicsandthensynthesizedforacomprehensiveoverviewofthehealthneedsinMHTMC’sservicearea.

Secondary Data Sources & Analysis SecondarydatausedforthisassessmentwerecollectedandanalyzedfromHCI’scommunityindicatordatabase.Thisdatabase,maintainedbyresearchersandanalystsatHCI,includesover100communityindicatorsfromatleast15stateandnationaldatasources.HCIcarefullyevaluatessourcesbasedonthefollowingthreecriteria:thesourcehasavalidatedmethodologyfordatacollectionandanalysis;thesourcehasscheduled,regularpublicationoffindings;andthesourcehasdatavaluesforsmallgeographicareasorpopulations.

Secondary Data Scoring HCI’sDataScoringTool®wasusedtosystematicallysummarizemultiplecomparisonsinordertorankindicatorsbasedonhighestneed.Foreachindicator,thecommunityvaluewascomparedtoadistributionofTexasandUScounties,stateandnationalvalues,HealthyPeople2020,andsignificanttrendswerenoted.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariesbyindicatorandisdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.Thecomparisonscoresweresummarizedforeachindicator,andindicatorswerethengroupedintotopicareasforasystematicrankingofcommunityhealthneeds.PleaseseeAppendixBforfurtherdetailsonthequantitativedatascoringmethodologyaswellassecondarydatascoringresults.

Figure3.SummaryofTopicScoringAnalysis


Disparit ies Analysis Whenagivenindicatorhasdataavailableforsubgroupslikerace/ethnicity,ageorgender–andvaluesforthesesubgroupsincludeconfidenceintervals–significantdifferencesbetweenthesubgroups’valueandtheoverallvaluecanbedetermined.Asignificantdifferenceisdefinedastwovalueswithnon-overlappingconfidenceintervals.Onlysignificantdifferencesinwhichthevalueforasubgroupisworsethantheoverallvalueareidentified.Confidenceintervalsarenotavailableforallindicators.Inthesecases,therearenotenoughdatatodetermineiftwovaluesaresignificantlydifferentfromeachother.

Primary Data Methods & Analysis CommunityinputforMemorialHermannHealthSystemwascollectedtoexpandupontheinformationgatheredfromthesecondarydata.PrimarydatausedinthisassessmentconsistedofacommunitysurveyinEnglishandSpanishaswellaskeyinformantinterviews.SeeAppendixCforthesurveyandinterviewquestions.

Community Survey Inputfromcommunityresidentswascollectedthroughanonlinesurvey.Thissurveyconsistedof11questionsrelatedtotophealthneedsinthecommunity,individuals’perceptionoftheiroverallhealth,andweeklyexercisehabits.ThecommunitysurveywasdistributedonlinethroughSurveyMonkey®fromOctober23rdthroughNovember27thof2018.ThesurveywasmadeavailableinbothEnglishandSpanish.PapersurveyswerealsomadeavailableandanswerstothepapersurveywereenteredintotheSurveyMonkeytool.Atotalof285responseswerecollected.ResultsinthisreportarebasedontheserviceareaforMemorialHermannHealthSystem.Thiswasaconveniencesample,whichmeansresultsmaybevulnerabletoselectionbiasandmakethefindingslessgeneralizabletothepopulationasawhole.

Table1.CommunitySurveyOutreachCommunityEvent DescriptionStepHealthEvent–MoodyPark,77009

CommunityeventhostedbyMemorialHermannprovidingparkactivation,walkingtours,Zumbainstruction,and(throughapartnershipwithHoustonFoodBank)fooddistributiontolow-income,at-risk,andmostlyuninsuredresidents.

StepHealthEvent–CastilloPark,77009

CommunityeventhostedbyMemorialHermannprovidingparkactivation,walkingtours,Zumbainstruction,and(throughapartnershipwithHoustonFoodBank)fooddistributiontolow-income,at-risk,andmostlyuninsuredresidents.

MemorialHermannHealthCentersforSchools

10school-basedhealthclinicsin5schooldistricts(74schools)inHarrisandFortBendCounties,providingmedical,mentalhealth,anddentalcare,alongwithnutrition,navigation,andsummerbootcampprogramstouninsuredandunderinsuredchildrenthroughouttheGreaterHoustonarea.

WestOremYMCA,77085

Acommunity-centeredorganizationthatbringspeopletogethertobridgethegapsincommunityneeds(underservedresidents),nurturesresidents’potentialtolearn,grow,andthrive,andmobilizesthelocalcommunitytoeffectlasting,meaningfulchange.

SpringBranchCommunity

AFederallyQualifiedHealthCenter(FQHC)providingquality,affordablehealthcareservicestotheunderservedanduninsuredcommunitiesofSpring


Therace/ethnicitymake-upofsurveyrespondentsisshowninFigure4.ThelargestproportionofrespondentsidentifiedasHispanic/Latino(47.2%),22.4%asWhite,20.8%asBlack/AfricanAmerican,andtheremaining9.6%ofrespondentsasAsian/PacificIslander,OtherandNativeAmerican.

HealthCenter,77080

BranchandWestHouston.

WesleyCommunityCenter,77009

Amulti-purposesocialserviceagencyprovidingresidentsofHouston:short-termrent,utility,andfoodassistancetopreventhomelessnessandmaintainfamilyfinancialstability;acareerandpersonalfinancialservicecenter;andEarlyHeadStart,achilddevelopmentprogramservinginfantstotoddlerstopromoteschoolreadiness.

CompleteCommunities,Houston

PrograminitiatedbytheMayorofHoustoninfivecommunities-allhistoricallyunder-resourced,eachwithabaselevelofcommunityinvolvementandsupport,andwithdiversepopulations.Theprogramisdesignedtoenhanceaccesstoqualityaffordablehomes,jobs,well-maintainedparksandgreenspace,improvedstreetsandsidewalks,grocerystoresandotherretail,goodschoolsandtransitoptions.Communities:AcresHomes[77018,77088,77091],Gulfton[77056,77057,77081],NearNorthside[77009,77022,77026],SecondWard[77003,77011,77020],andThirdWard[77003,77004,77204].

HealthyLivingMatters

AHouston/HarrisCountyChildhoodObesityCollaborative-Acollaborativeofmulti-sectorleadersthatpromotepolicyaimedatsystem-levelandenvironmentalchangetoreducetheincidenceofchildhoodobesity.Prioritycommunitieswereselectedduetothelackofaccesstohealthyfoodoptionsandopportunitiestoengageinphysicalactivityaswellasfortheircommunityassetsandreadinessforchange.PriorityCommunities:CityofPasadena[77058,77059,77502,77503,77504,77505,77506,77507,77536,77571,77586],NearNorthside[77009,77022,77026],andFifthWard/KashmereGardens[77020,77026,and77028]

GreaterNorthsideHealthCollaborative

Non-profitcollaborativewhosegoalistoexpandactivelivingresourcesandincreaseaccesstoqualityhealthcareandhealthyfoodbypromotingresidentleadershipandcivicparticipation.


Figure4.SurveyRespondentsbyRace/Ethnicity

Surveyrespondentswereaskedtoselecttopissuesmostaffectingthecommunity’squalityoflife.AsshowninFigure5,themajorityofrespondentsidentifiedDiabetes,Obesity/Overweight,SubstanceAbuse,andMentalHealth&MentalDisordersastopissuesinthecommunity.

Figure5.TopIssuesAffectingQualityofLife(Survey)

Key Informant Interviews Communityinputwasalsocollectedthroughkeyinformantinterviews.

MemorialHermannHealthSystemjoinedwiththeEpiscopalHealthFoundation(EHF)intheirkeyinformantinterviewinitiativesupportingfourGreaterHoustonareahospitalsystemsinpreparingtheircommunityhealthneedsassessments.ThecollaboratinghospitalsofthisinitiativeincludeMemorialHermann,CHISt.Luke’sHealth,HoustonMethodist,andTexasChildren’s(Table2).Throughthispartnership,atotalof53interviewswereconductedwith

47.20%

22.40%

20.80%

4.80%3.60% 1.20%

Hispanic

White

AfricanAmerican

Asian/PacificIslander

Other

NativeAmerican

10%10%13%13%14%

17%23%26%26%

35%51%54%

64%69%

SexualHealthOralhealth

TeenagePregnancyReproductiveHealth

OtherRespiratory/LungDiseaseInjuries,Violence&Safety

ElderCareHeartDisease&Stroke

CancersMentalHealth&MentalDisorders

SubstanceAbuseObesity/Overweight

Diabetes


stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Communityleaderswithspecificexperienceworkingwithprioritypopulations,suchaswomen,children,peopleofcolor,thedisabled,andmore,werealsointerviewed.

Table2.MemorialHermannCollaborativePartners

Intotal,64keyinformantinterviewswereconductedbyphonefromAugustthroughNovember2018;53keyinformantinterviewswereconductedthroughthecollaborativeand11interviewswereconductedbyHCI.Intervieweeswhowereaskedtoparticipatewererecognizedashavingexpertiseinpublichealth,specialknowledgeofcommunityhealthneedsand/orrepresentedthebroadinterestofthecommunityservedbythehospital,and/orcouldspeaktotheneedsofmedicallyunderservedorvulnerablepopulations.Effortsweremadetoidentifyintervieweesworkinginand/orknowledgeableaboutthecountiesinMemorialHermannHealthSystem’sservicearea.AsseeninTable3,someintervieweeswereidentifiedwithknowledgeofmultiplecounties.

Table3.KeyInformantsbyCountyCounty KeyInformantsAustin IncludedinMultipleCountiesBrazoria 3Chambers 2

EpiscopalHealthFoundation’smissionistoadvancetheKingdomofGodwithspecificfocusonhumanhealthandwell-beingthroughgrants,research,andinitiativesinsupportoftheworkoftheDiocese,spanning57counties.Throughinformedaction,collaboration,empowerment,stewardship,transparency,andaccountabilitythefoundationstrivesforthetransformationofhumanlivesandorganizationswithcompassionforthepoorandpowerless.

CHISt.Luke’sHealth,apartofCatholicHealthInitiatives(CHI),oneofthenation’slargesthealthsystems,isdedicatedtoamissionofenhancingcommunityhealththroughhigh-quality,cost-effectivecare.Throughpartnershipswithphysiciansandcommunitypartners,CHISt.Luke’sHealthservesGreaterHoustonwithitscommitmenttoexcellenceandcompassionincaringforthewholepersonwhilecreatinghealthiercommunities.

HoustonMethodistisanonprofithealthcareorganizationservingGreaterHouston,dedicatedtoexcellenceinresearch,education,andpatientcare.HoustonMethodistbringscompassionandspiritualitytoallitsendeavorstohelpmeetthehealthneedsofthecommunitythroughthesystem’sICAREvalues:integrity,compassion,accountability,respect,andexcellence.

TexasChildren’sHospitalisanot-for-profitorganizationwhosemissionistocreateahealthierfutureforchildrenandwomenthroughoutGreaterHoustonandtheglobalcommunitybyleadinginpatientcare,education,andresearch.TexasChildren’siscommittedtocreatingahealthycommunityforchildrenbyprovidingthebestpediatriccarepossible,throughgroundbreakingresearchandemphasisoneducation,whilealsoofferingafullcontinuumoffamily-centeredcareforwomen,fromobstetricstowell-womancare.


County KeyInformantsFortBend 10Galveston 7Harris 28Liberty 1Montgomery 4SanJacinto IncludedinMultipleCountiesWalker IncludedinMultipleCountiesWaller 2Wharton 2MultipleCounties* 5Total 64

Interviewsweretranscribedandanalyzedusingthequalitativeanalytictool,Dedoose1.Interviewexcerptswerecodedbyrelevanttopicareasandkeyhealththemes.Threeapproacheswereusedtoassesstherelativeimportanceoftheneedsdiscussedintheseinterviews.Theseapproachesincluded:thefrequencybywhichahealthtopicwasdiscussedacrossallinterviews;thefrequencybywhichatopicwasdescribedbythekeyinformantasabarrier/challenge;andthefrequencybywhichatopicwasmentionedperinterviewee.

Data Considerations Severallimitationsofdatashouldbeconsideredwhenreviewingthefindingspresentedinthisreport.Althoughthetopicsbywhichdataareorganizedcoverawiderangeofhealthandhealth-relatedareas,dataavailabilityvariesbyhealthtopic.Sometopicscontainarobustsetofsecondarydataindicators,whileothersmayhavealimitednumberofindicatorsorlimitedsubpopulationscoveredbythosespecificindicators.Datascoresrepresenttherelativecommunityhealthneedaccordingtothesecondarydataforeachtopicandshouldnotbeconsideredtobeacomprehensiveresultontheirown.Inaddition,thesescoresreflectthesecondarydataresultsforthepopulationasawhole,anddonotrepresentthehealthorsocioeconomicneedthatismuchgreaterforsomesubpopulations.Moreover,manyofthesecondarydataindicatorsincludedinthefindingsarecollectedbysurvey,andthoughspecificmethodsareusedtobestrepresentthepopulationatlarge,thesemeasuresaresubjecttoinstability,especiallyforsmallerpopulations.TheIndexofDisparityisalsolimitedbydataavailability,whereindicatordatavariesbasedonthepopulationgroupsandserviceareasbeinganalyzed.

1DedooseVersion8.0.35,webapplicationformanaging,analyzing,andpresentingqualitativeandmixedmethodresearchdata(2018).LosAngeles,CA:SocioCulturalResearchConsultants,LLCwww.dedoose.com

*Five(5)oftheKeyInformantInterviewsrepresented2ormorecounties,including:Austin,Brazoria,Chambers,FortBend,Galveston,Harris,Liberty,Montgomery,SanJacinto,Walker,Waller,andWhartoncounties.


Race/Ethnic Groupings

Thesecondarydatapresentedinthisreportderivefrommultiplesources,whichmaypresentraceandethnicitydatausingdissimilarnomenclature.Forconsistencywithdatasourcesthroughoutthereport,subpopulationdatamayusedifferenttermstodescribethesameorsimilargroupsofcommunitymembers.

Zip Codes and Zip Code Tabulation Areas

ThisreportpresentsbothZIPCodeandZIPCodeTabulationArea(ZCTA)data.ZIPorZoneImprovementPlanCodeswerecreatedbytheU.S.PostalServicetoimprovemaildeliveryservice.Theyarebasedonpostalroutes,whichfactorindelivery-area,mailvolumeandgeographiclocation.Theyarenotdesignedtobeusedforstatisticalreportingandmaychangefrequently.SomeZIPCodesmayonlyincludeP.O.boxesorcoverlargeunpopulatedareas.ZCTAsorZIPCodeTabulationAreaswerecreatedbytheU.S.CensusBureauandaregeneralizedrepresentationsofZIPCodesthathavebeenassignedtocensusblocks.Therefore,ZCTAsarerepresentativeofgeographiclocationsofpopulatedareas.Inmostcases,theZCTAwillbethesameasitsZIPCode.ZCTAswillnotnecessarilyexistforZIPCodeareaswithonlybusinesses,singleormultipleaddresses,orforlargeunpopulatedareas.SinceZCTAsarebasedonthemostrecentCensusdata,theyaremorestablethanZIPCodesanddonotchangeasfrequently.DemographicsforthisreportaresourcedfromtheUnitedStatesCensusBureau,whichpresentsZCTAestimates.TablesandfiguresintheDemographicssectionofthisreportreferenceZIPCodesintitle(forpurposesoffamiliarity)butshowvaluesofZCTAs.DatafromothersourcesisrepresentativebyZIPCodesandarelabeledassuch.

Priorit ization Inordertofocuseffortsonasmallernumberofthemostsignificantcommunityissues,sixteenrepresentativesfromtheMemorialHermannHealthSystem(oneormorerepresentingeachfacility)participatedinanonlineprioritizationprocesstoprioritizethefifteensignificanthealthneedsidentifiedthroughthesecondaryandprimarydataanalyses.Theprioritizedhealthneedswillbeunderconsiderationforthedevelopmentofanimplementationplanthatwilladdresssomeofthecommunity’smostpressinghealthissues.

Priorit ization Process Toprioritizesignificanthealthneeds,MemorialHermannstakeholdersparticipatedinanonlinewebinaronMarch7,2019toreviewdatasynthesisresultsfollowedbycompletionofaprioritizationmatrixlistingsignificanthealthneedsandfourcriteriabywhichtorateeachneed.Participantsscoredeachneedforeachofthecriteriaonascalefrom1-5,with1meaningtherespondentstronglydisagreesto5meaningtherespondentstronglyagreesthatthehealthneedmeetsthecriterion.Respondentswerealsoabletoselect“Don’tKnow/Unsure”foreachhealthneed.Thecriteriaforprioritizationincludedtowhatextentanissue:

• Impactsmanypeopleinthecommunity• Significantlyimpactssubgroupsinthecommunity(gender,race/ethnicity,LGBTQ,etc.)


• Hasinadequateexistingresourcesinthecommunity• Hashighriskfordiseaseordeath

CompletionoftheprioritizationmatrixinAppendixDresultedinnumericalscoresforeachhealthneedthatcorrespondedtohowwelleachhealthneedmetthecriteriaforprioritization.Thescoreswererankedfromhighesttolowest(Table4).

Table4.ResultsfromMemorialHermannPrioritizationMatrixSignificantHealthNeed Impacton

CommunityImpactonSubgroups

InadequateResources

HighRisk AverageScore

Obesity(Exercise,NutritionandWeight)

4.69 4.00 3.19 4.50 4.09

MentalHealth 4.44 3.44 4.50 3.75 4.03Diabetes 4.50 4.00 3.25 4.19 3.98LackofHealthInsurance 4.31 4.19 3.38 4.00 3.97Low-Income/Underserved

4.19 4.19 3.44 4.00 3.95

HeartDisease/Stroke 4.44 3.82 2.81 4.44 3.88SubstanceAbuse 3.56 3.88 3.63 4.19 3.81AccesstoHealthServices

4.00 3.94 3.25 3.88 3.77

OlderAdultsandAging 4.38 3.81 3.13 3.75 3.76FoodInsecurity 3.88 4.00 3.44 3.50 3.70Cancers 4.19 3.19 3.00 4.31 3.67Education 3.88 3.81 3.00 3.13 3.45Transportation 4.00 3.88 2.81 3.00 3.42Children'sHealth 4.00 3.50 3.00 3.19 3.42Economy 3.31 3.31 2.69 2.88 3.05Inadditiontoratingeachneedinthematrix,prioritizationparticipantswereaskedtoratethelevelofimportanceofMemorialHermann’s4strategicpillars.

1. ImprovingAccesstoHealthcarethroughprogramming,education,andsocialservicesupport;

2. AddressingEmotionalWell-being(mentalandbehavioralhealth)throughinnovativeaccesspoints;

3. PromotingtheimportanceofahealthydietthroughscreeningandcreatingaccesstonutritiousFoodasHealth;and,

4. FosteringimprovedhealththroughExerciseIsMedicinewithculturallyappropriateactivities.

EachoftheseintersectingpillarsconnecttoeachotherthroughvariouspointsinMemorialHermannprogramsandinitiativesadvancingthehealthofourcommunities(Figure6).


Figure6.MemorialHermann’sFourPillarsforCommunityHealth

Over93%ofparticipantsrespondedthatthe4pillarswereimportantorveryimportant.TheMemorialHermannCommunityBenefitteamreviewedthesefindings,andtakingintoaccountthealignmentoftopneedswithMemorialHermann’sstrategicfocusareas,adecisionwasmadetointegrate:

• LackofHealthInsurance,Low-Income/Underserved,andAccesstoHealthServicesintoPillar1:AccesstoHealthcare

• MentalHealthandSubstanceAbuseintoPillar2:EmotionalWell-Being• Diabetes,FoodInsecurityandHeartDisease/StrokeintoPillar3:FoodasHealth• Obesity(Exercise,NutritionandWeight)intoPillar4:ExerciseIsMedicine

Throughthissystem-wideprioritizationprocess,thefollowingfourprioritiesforMemorialHermannHealthSystemare:

• AccesstoHealthcare(addressingAccesstoHealthServices,LackofHealthInsurance,andLow-Income/Underserved)

• EmotionalWellbeing(addressingMentalHealthandSubstanceAbuse)• FoodasHealth(addressingDiabetes,FoodInsecurity,andHeartDisease/Stroke)• ExerciseIsMedicine(addressingObesity)

ThesefourhealthtopicswillbeexploredfurtherinordertounderstandhowfindingsfromthesecondaryandprimarydataanalysesresultedineachissuebeingahighpriorityhealthneedforMemorialHermannHealthSystem.


Demographics ThefollowingsectionexploresthedemographicprofileofMHTMC’sservicearea,includingthefollowing12counties:Austin,Brazoria,Chambers,FortBend,Galveston,Harris,Liberty,Montgomery,SanJacinto,Walker,Waller,andWharton.Thedemographicsofacommunitysignificantlyimpactitshealthprofile.Differentrace/ethnic,age,andsocioeconomicgroupshaveuniqueneedsandrequiredifferentapproachestohealthimprovementefforts.AlldemographicestimatesaresourcedfromtheU.S.CensusBureau’s2013-2017AmericanCommunitySurveyunlessotherwiseindicated.Sincethefacilityservesall12countiesintheregion,demographicsfiguresinthissectionshowinformationonallcounties.

Population AccordingtotheU.S.CensusBureau’s2013-2017AmericanCommunitySurvey,the12countiesinMHTMC’sserviceareahadpopulationsrangingfrom28,270to4,652,980.Figure7illustratesthepopulationsizebycounty.ThemostpopulouscountyinMHTMC’sserviceareaisHarrisCounty(over4.6millionresidents),whiletheleastpopulousisSanJacintoCounty(28,270residents).

Figure7.PopulationbyCounty


Age Figure8showsthepopulationwithinMHTMC’sserviceareathatisunder18yearsold.Asshown,28%ofChambersCounty’spopulationandnearly28%ofFortBendCounty’spopulationisunder18.Chambers,FortBend,Harris,Brazoria,Montgomery,andWhartoncountiesallhavehigherproportionsofresidentsunder18comparedtoboththestateandnationalvalues(26%and22.6%,respectively).At15.3%,WalkerCountyhasthelowestproportionofresidentsundertheageof18.

Figure8.PopulationUnder18

AsshowninFigure9,fivecountieshavesmallerproportionsofolderadultscomparedtoTexas(12.3%):Brazoria,Chambers,FortBend,Harris,andWallercounties.NinecountieshavesmallerproportionscomparedtotheU.S.(15.6%);all,butAustin,SanJacintoandWhartoncounties.InHarrisCounty,10.2%ofthepopulationisover65yearsold,whichisthelowestproportionintheregion;inSanJacintoCounty,21.4%ofresidentsareover65,whichisthehighestproportionintheregion.

24.1%26.7%

28.0%27.7%

24.5%26.9%26.0%26.5%

21.7%

15.3%

24.3%26.1%26.0%

22.6%

0%

5%

10%

15%

20%

25%

30%


Figure9.PopulationOver65

Figure10showsthatHarrisCountyhasalargerproportionofresidentsunder5yearsold(7.7%)comparedtoTexasandtheU.S.(7.2%and6.1%,respectively).Comparedtothestateandnationalvalues,WalkerandSanJacintocountieshavelowerproportionsofresidentsunder5(4.5%and5.5%,respectively).

Figure10.PopulationUnder5

Race/Ethnicity Theraceandethnicitycompositionofapopulationisimportantinplanningforfuturecommunityneeds,particularlyforschools,businesses,communitycenters,healthcareand

18.6%

11.5%11.4%10.6%

13.8%

10.2%

12.8%12.9%

21.4%

12.7%11.8%

16.7%

12.3%

15.6%

0%

5%

10%

15%

20%

25%

6.2%7.1% 7.0% 7.1%

6.5%

7.7%7.2% 6.9%

5.5%

4.5%

6.6% 6.9%7.2%

6.1%

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%


childcare.Raceandethnicitydataarealsousefulforidentifyingandunderstandingdisparitiesinhousing,employment,income,andpoverty.Figure11,Figure12,Figure13,andFigure14showtheracialcompositionofresidentsacrossalltwelvecountieswithinMHTMC’sservicearea.In11ofthe12counties,thelargestproportionofresidentsidentifyasWhite,non-Hispanic(rangingbetween34.4%and74.9%ofthepopulation).HarrisCountyistheonlycountyintheserviceareawithalargerproportionofresidentsidentifyingasHispanicorLatino(42.2%)comparedtoWhite,non-Hispanicresidents(30.6%).Inaddition,over10%ofresidentsidentifyasBlackorAfricanAmericanin8ofthe12counties.Also,over5%ofresidentsidentifyasAsianin3ofthe12counties(Brazoria,FortBendandHarriscounties).

Figure11.Race/EthnicitybyCounty(Austin,Brazoria,andChambers)

Figure12.Race/EthnicitybyCounty(FortBend,Galveston,andHarris)


Figure13.Race/EthnicitybyCounty(Liberty,Montgomery,andSanJacinto)

Figure14.Race/EthnicitybyCounty(Walker,Waller,andWharton)

Language Languageisanimportantfactortoconsiderforoutreacheffortsinordertoensurethatcommunitymembersareawareofavailableprogramsandservices.

Figure15.LanguageOtherthanEnglishSpokenatHome

20.2%

26.0%

18.2%

38.4%

20.1%

43.7%

18.9%21.0%

10.5%

16.5%

26.1% 24.6%

35.3%

21.3%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


Figure15showstheproportionofresidentswhospeakalanguageotherthanEnglishathome.Approximately38%ofresidentsinFortBendCountyandalmost44%ofresidentsinHarrisCountyspeakalanguageotherthanEnglishascomparedto35.3%inTexasand21.3%intheU.S.Thisisanimportantconsiderationfortheeffectivenessofservicesandoutreachefforts,whichmaybemoreeffectiveifconductedinlanguagesotherthanEnglishalone.

Table5.LanguageOtherthanEnglishSpokenatHome:TrendOverTimeCounty 2014 2015 2016 2017Austin 19.8% 19.9% 20.1% 20.2%Brazoria 25.9% 25.8% 25.9% 26.0%Chambers 18.4% 19.7% 19.1% 18.2%FortBend 38.1% 38.2% 38.4% 38.4%Galveston 19.5% 20.0% 20.2% 20.1%Harris 42.9% 43.1% 43.4% 43.7%Liberty 17.1% 17.7% 18.5% 18.9%Montgomery 19.3% 19.5% 20.0% 21.0%SanJacinto 8.9% 9.6% 10.7% 10.5%Walker 15.4% 16.2% 16.6% 16.5%Waller 24.8% 24.3% 24.6% 26.1%Wharton 26.1% 26.4% 25.0% 24.6%Texas 34.9% 35.0% 35.2% 35.3%UnitedStates 20.9% 21.0% 21.1% 21.3%

AmericanCommunitySurvey,2013-2017

AsshowninTable5,theproportionofresidentswhospeakalanguageotherthanEnglishathomehasremainedrelativelyconsistentbetween2014and2017.Mostcountiesexperiencedaslightincreaseovertime,exceptforChambersandWhartoncounties.SanJacintoCountyhasthelowestproportionacrosstheservicearea,withonly10.5%ofitsresidentsspeakingalanguageotherthanEnglishathome.

Social and Economic Determinants of Health Thissectionexplorestheeconomic,environmental,andsocialdeterminantsofhealthinMHTMC’sservicearea.Socialdeterminantsaretheconditionsinwhichpeopleareborn,grow,work,live,andage,andthewidersetofforcesandsystemsshapingtheconditionsofdailylife.

Income Medianhouseholdincomereflectstherelativeaffluenceandprosperityofanarea.Areaswithhighermedianhouseholdincomesarelikelytohaveagreatershareofeducatedresidentsandlowerunemploymentrates.Figure16comparesthemedianhouseholdincomevaluesforall12countiesinMHTMC’sserviceareatothemedianhouseholdincomevalueforTexasandtheU.S.($57,051and$57,652,respectively).FortBendCounty’smedianhouseholdincomeof$93,645isthehighestofthe12counties,whileWalkerCounty’smedianhouseholdincomeof$41,456isthelowest.HarrisCounty’smedianhouseholdincome($57,791)issimilartothestateandnationalvalues.


Figure16.MedianHouseholdIncome

Table6showsthetrendinmedianhouseholdincomeforallcountieswithinMHTMC’sservicearea.All,butonecountyexperiencedanincreaseinmedianhouseholdincomebetween2014and2017.SanJacintoCountyistheonlyexception,decreasingfrom$46,969to$43,421.

Table6.MedianHouseholdIncome:TrendOverTimeCounty 2014 2015 2016 2017Austin $54,603 $53,687 $56,681 $62,614Brazoria $69,092 $69,749 $72,006 $76,426Chambers $72,239 $70,544 $70,396 $74,368FortBend $86,407 $89,152 $91,152 $93,645Galveston $61,744 $62,313 $63,064 $65,702Harris $53,822 $54,457 $55,584 $57,791Liberty $47,722 $48,729 $49,655 $48,344Montgomery $68,840 $68,838 $70,805 $74,323SanJacinto $46,969 $43,029 $44,878 $43,421Walker $38,903 $37,666 $40,090 $41,456Waller $50,939 $51,348 $53,508 $53,506Wharton $41,992 $45,176 $46,445 $50,145Texas $53,482 $53,889 $54,727 $57,051UnitedStates $52,576 $53,207 $55,322 $57,652


Poverty FederalpovertythresholdsareseteveryyearbytheCensusBureauandvarybysizeoffamilyandagesoffamilymembers.Ahighpovertyrateisbothacauseandaconsequenceofpooreconomicconditions.

$62,614

$76,426$74,368

$93,645

$65,702$57,791

$48,344

$74,323

$43,421 $41,456

$53,506 $50,145$57,051$57,652

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

$90,000

$100,000


Figure17showstheproportionofresidentslivingbelowthepovertylevelinall12countiesofMHTMC’sserviceareacomparedtothestateofTexasandtheU.S.(16%and14.6%,respectively).ThepercentageofresidentslivingbelowthepovertylevelinWalkerCountyis24.3%,whichisthreetimesgreaterthanthatofFortBendCounty(8.1%).ThecountiesofHarris(16.8%),Liberty(16.2%),SanJacinto(17.2%),Waller(18%),andWharton(17.5%)alsostandout,withvaluesgreaterthanthestateandU.S.

Figure17.PeopleLivingBelowPovertyLevel

Table7showstheproportionofresidentslivingbelowthepovertylevelbyrace/ethnicity.PovertyratesforHispanic/Latinoresidentswerethehighestoutofalltherace/ethnicitygroupsin7ofthe12counties.PovertyrateswerethehighestforBlack/AfricanAmericanresidentsin3counties(Galveston,WalkerandWallercounties)andforAsianresidentsin2counties(LibertyandWhartoncounties).White,non-Hispanicresidentsdidnothavehigherpovertyratescomparedtootherrace/ethnicitygroupsinanyofthecounties.

13.4%

9.9%

12.9%

8.1%

13.9%

16.8%16.2%

10.3%

17.2%

24.3%

18.0%17.5%16.0%

14.6%

0%

5%

10%

15%

20%

25%

30%


Table7.PeopleLivingBelowPovertyLevelbyRace/EthnicityCounty White,non-

HispanicBlackorAfricanAmerican

Asian HispanicorLatino

Austin 5.9% 27.2% 0.0% 27.7%Brazoria 7.7% 10.2% 3.3% 15.1%Chambers 8.7% 11.5% 21.2% 27.0%FortBend 3.8% 9.4% 5.9% 14.8%Galveston 8.2% 23.6% 11.4% 23.2%Harris 7.0% 21.8% 11.4% 22.6%Liberty 12.4% 15.5% 33.8% 27.2%Montgomery 6.7% 13.1% 5.6% 21.5%SanJacinto 14.5% 24.1% 0.0% 27.9%Walker 19.3% 34.2% 28.1% 29.9%Waller 7.3% 35.7% 15.7% 22.1%Wharton 7.2% 37.2% 42.1% 22.2%Texas 8.8% 21.4% 10.6% 23.0%U.S. 10.3% 25.2% 11.9% 22.2%

AmericanCommunitySurvey,2013-2017Table8revealsthechangeinratesofpeoplelivingbelowpovertylevelacross4timeperiods.MirroringthetrendsforthestateofTexasandtheU.S.asawhole,mostofthecountiesinMHTMC’sserviceareaexhibitedadeclineinpovertyratesovertime.ExceptionsincludeAustin,ChambersandGalvestoncounties,whichallexperiencedarelativeincreaseintheirpovertyrate.

Table8.PeopleLivingBelowPovertyLevel:TrendOverTimeCounty 2010-2014 2011-2015 2012-2016 2013-2017Austin 10.2% 11.5% 14.5% 13.4%Brazoria 11.2% 11.2% 10.5% 9.9%Chambers 10.9% 10.6% 11.7% 12.9%FortBend 8.7% 8.2% 8.2% 8.1%Galveston 13.5% 13.9% 13.6% 13.9%Harris 18.4% 18.0% 17.4% 16.8%Liberty 18.3% 17.6% 17.3% 16.2%Montgomery 12.3% 12.0% 11.0% 10.3%SanJacinto 20.2% 20.2% 17.2% 17.2%Walker 25.4% 25.8% 24.0% 24.3%Waller 19.3% 18.2% 19.0% 18.0%Wharton 18.2% 17.6% 17.7% 17.5%Texas 17.7% 17.3% 16.7% 16.0%UnitedStates 15.6% 15.5% 15.1% 14.6%


Food Insecurity TheSupplementalNutritionAssistanceProgram(SNAP)isafederalassistanceprogramthatprovideslow-incomefamilieswithelectronicbenefittransfers(EBTs)thatcanbeusedto


purchasefood.Thegoaloftheprogramistoincreasefoodsecurityandreducehungerbyincreasingaccesstonutritiousfood.Table9showsthepercentageofhouseholdswithchildrenthatparticipateinSNAPinthe12countieswithinMHTMC’sservicearea.Over75%ofthehouseholdswithchildreninChambersCountyreceiveSNAP.FortBend(73.5%)andHarris(67.7%)countiesalsohavevaluesgreaterthanthestateofTexas(64.3%).SanJacintoCountyhasthelowestproportionofhouseholdswithchildrenreceivingSNAPintheservicearea(49.8%).

Table9.HouseholdswithChildrenReceivingSNAP

County HouseholdswithChildrenReceivingSNAP

Austin 58.3%Brazoria 63.1%Chambers 75.7%FortBend 73.5%Galveston 59.9%Harris 67.7%Liberty 57.4%Montgomery 61.7%SanJacinto 49.8%Walker 60.3%Waller 58.7%Wharton 61.3%Texas 64.3%


Unemployment Theunemploymentrateisakeyindicatorofthelocaleconomy.Unemploymentoccurswhenlocalbusinessesarenotabletosupplyenoughappropriatejobsforlocalemployeesand/orwhenthelaborforceisnotabletosupplyappropriateskillstoemployers.Ahighrateofunemploymenthaspersonalandsocietaleffects.Duringperiodsofunemployment,individualsarelikelytofeelsevereeconomicstrainandmentalstress.Unemploymentisalsorelatedtoaccesstohealthcare,asmanyindividualsreceivehealthinsurancethroughtheiremployer.Ahighunemploymentrateplacesstrainonfinancialsupportsystems,asunemployedpersonsqualifyforunemploymentbenefitsandfoodstampprograms.Table10displaystherateofunemploymentinthe12countiesofMHTMC’sserviceareabetweenMay2017andNovember2018.Inall12counties,theunemploymentrateexhibitedadecreaseduringthetimeperiod.InNovember2018,theFortBendCountyratewasequivalenttothestateandtheU.S.(3.5%)whiletherateinAustin,MontgomeryandWhartoncountieswerelower.However,theunemploymentratesinBrazoria,Chambers,Galveston,Harris,Liberty,SanJacinto,Walker,andWallercountiesremainedhigherthanTexasandtheU.S.


Table10.UnemploymentRateperCounty(U.S.BureauofLaborStatistics,2017-2018)County May2017 November

2017May2018 November

2018Austin 4.7% 3.5% 3.5% 3.2%Brazoria 5.3% 4.6% 4.4% 3.9%Chambers 6.6% 5.7% 5.3% 4.5%FortBend 4.8% 4.0% 3.9% 3.5%Galveston 5.3% 4.6% 4.5% 4.1%Harris 5.1% 4.3% 4.3% 3.8%Liberty 7.3% 6.0% 5.7% 5.0%Montgomery 4.6% 3.7% 3.6% 3.4%SanJacinto 5.8% 5.0% 4.7% 4.5%Walker 4.6% 4.0% 4.1% 3.7%Waller 5.0% 4.3% 4.0% 3.8%Wharton 4.5% 4.0% 3.5% 3.3%Texas 4.4% 3.7% 3.7% 3.5%UnitedStates 4.1% 3.9% 3.6% 3.5%


Education Graduatingfromhighschoolisanimportantpersonalachievementandisessentialforanindividual’ssocialandeconomicadvancement.Graduationratescanalsobeanimportantindicatoroftheperformanceofaneducationalsystem.Havingabachelor’sdegreeopensupcareeropportunitiesinavarietyoffieldsandisoftenaprerequisiteforhigher-payingjobs.Figure18displaystheproportionofresidentsinall12countieswithinMHTMC’sserviceareawhoare25yearsandolderwithatleastahighschooldegree.Nearly90%ofresidents25yearsandolderinFortBendandGalvestoncountieshaveatleastahighschooldegreecomparedto77.1%inLibertyCounty.WallerandWhartoncountiesalsohaverateslowerthan80%,comparedtoTexas(82.8%)andtheU.S.(87.3%).


Figure18.People25+withaHighSchoolDegreeorHigher

Figure19showstheproportionofresidentsinthe12countiesofMHTMC’sserviceareawhoare25yearsandolderwithabachelor’sdegreeorhigher.Withnearly46%ofresidents25andolderhavingabachelor’sdegree,FortBendCountyhasaneconomicadvantagecomparedtotheother11countiesinMHTMC’sservicearea,thestate(28.7%),andtheU.S.(30.9%).Theproportionofresidents25andolderwithabachelor’sdegreeinMontgomeryCounty(33.7%)isalsohigherthanthestateandtheU.S.Ontheotherhand,theproportionofresidents25andolderwithabachelor’sdegreeforLibertyCounty(9.3%)andSanJacintoCounty(10.1%)areapproximatelythreetimeslower.

Figure19.People25+withaBachelor'sDegreeorHigher

82.2%

87.5%85.8%

89.7%88.0%

80.5%

77.1%

87.6%

82.9%83.6%

78.3%78.9%

82.8%

87.3%

70%72%74%76%78%80%82%84%86%88%90%92%

22.3%

29.7%

20.5%

45.7%

29.5%30.5%

9.3%

33.7%

10.1%

20.3%19.2%15.0%

28.7%30.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


Table11andTable12displaytheeducationalattainmentindicatorsforresidents25yearsandolderacross4timeperiodsforMHTMC’sservicearea.Forhighschooldegreeattainment,mostcountiesexhibitedanincreaseovertime.ThenotableexceptionswereAustinandWallercounties,whichdecreasedslightlyacrossthefourtimeperiods.Forattainmentofabachelor’sdegree,11ofthe12countiessawmodestimprovementsaswell.ThesolecountythatshowedadecreaseovertimewasSanJacintoCounty(from12.3%to10.1%).

Table11.People25+withaHighSchoolDegreeorHigher:TrendOverTimeCounty 2010-2014 2011-2015 2012-2016 2013-2017Austin 86.0% 84.4% 82.4% 82.2%Brazoria 85.5% 86.0% 86.7% 87.5%Chambers 84.0% 83.1% 83.8% 85.8%FortBend 88.5% 88.9% 89.2% 89.7%Galveston 87.4% 87.5% 87.6% 88.0%Harris 79.1% 79.6% 80.2% 80.5%Liberty 76.6% 76.2% 76.2% 77.1%Montgomery 86.4% 86.3% 86.8% 87.6%SanJacinto 81.0% 81.5% 82.8% 82.9%Walker 82.9% 81.9% 82.6% 83.6%Waller 79.4% 78.1% 78.4% 78.3%Wharton 75.7% 76.5% 78.0% 78.9%


Table12.People25+withaBachelor'sDegreeorHigher:TrendOverTimeCounty 2010-2014 2011-2015 2012-2016 2013-2017Austin 19.5% 20.1% 21.0% 22.3%Brazoria 27.9% 28.6% 28.7% 29.7%Chambers 18.8% 18.7% 21.1% 20.5%FortBend 42.3% 43.7% 44.6% 45.7%Galveston 28.3% 29.3% 28.9% 29.5%Harris 29.0% 29.5% 30.1% 30.5%Liberty 8.8% 9.6% 10.0% 9.3%Montgomery 31.7% 32.2% 33.0% 33.7%SanJacinto 12.3% 11.4% 10.0% 10.1%Walker 18.4% 18.9% 19.5% 20.3%Waller 18.4% 18.8% 18.7% 19.2%Wharton 13.8% 14.1% 14.5% 15.0%


Transportation Therearenumerouswaysinwhichtransportationmayinfluencecommunityhealth.Publictransportationoffersmobility,particularlytopeoplewithoutcars.Transitcanhelpbridgethespatialdividebetweenpeopleandjobs,services,andtrainingopportunities.Publictransportationalsoreducesfuelconsumption,minimizesairpollution,andrelievestrafficcongestion.Walkingtoworkhelpsprotecttheenvironment,whilealsoprovidingthebenefitofdailyexercise.


Figure20.HouseholdsWithoutaVehicle

Figure20showsthepercentageofhouseholdswithoutavehicleforthe12countiesinMHTMC’sserviceare.Asshown,WhartonCountyhasthegreatestproportionofhouseholdswithoutavehicle(6.5%)whileFortBendCountyhasthesmallestproportion(2.4%).


Table13.ModesofCommuting

CountyCommutebyWalking

CommutebyBiking

CommutebyDrivingAlone

CommutebyPublicTransportation

Austin 1.9% 0.0% 81.6% 0.1%Brazoria 0.8% 0.0% 86.3% 0.2%Chambers 0.9% 0.0% 88.9% 0.2%FortBend 0.5% 0.1% 82.0% 1.6%Galveston 2.0% 0.6% 80.9% 0.9%Harris 1.5% 0.3% 79.3% 2.7%Liberty 1.0% 0.3% 88.9% 0.3%Montgomery 0.9% 0.2% 82.1% 1.2%SanJacinto 1.1% 0.0% 80.1% 0.0%Walker 3.9% 0.1% 82.0% 0.1%Waller 3.9% 0.2% 78.7% 0.9%Wharton 0.5% 0.1% 84.4% 0.4%Texas 1.6% 0.3% 80.5% 1.5%

AmericanCommunitySurvey,2013-2017Table13displaysthedifferentmodesofcommutingusedbyresidentsacrossthe12countiesofMHTMC’sservicearea.Inallcounties,themajorityofresidentscommutebydrivingalone,between78.7%and88.9%.WalkerandWallercountieshavethelargestproportionofresidentswhocommutebywalking(both3.9%).Relativelyfewpeoplecommutebybiking;lessthan1%usethismethodofcommutingineachofthecounties.AgreaterproportionofresidentsinFortBend,Harris,andMontgomerycountiesusepublictransportation(1.6%,2.7%and1.2%,respectively)ascomparedtotheothercountiesintheservicearea.

SocioNeeds Index® ConduentHealthyCommunitiesInstitutedevelopedtheSocioNeedsIndex®toeasilycomparemultiplesocioeconomicfactorsacrossgeographies.Thisindexincorporatesestimatesforsixdifferentsocialandeconomicdeterminantsofhealth–income,poverty,unemployment,occupation,educationalattainment,andlinguisticbarriers–thatareassociatedwithpoorhealthoutcomesincludingpreventablehospitalizationsandprematuredeath.Countiesareassignedanindexvaluefrom0(lowneed)to100(highneed),basedonhowthosecountiescomparetoothersintheU.S.


Figure21.SocioNeedsIndexbyCounty

AsshowninFigure21,thereisawiderangeinSocioNeedsIndexvaluesacrossthe12countieswithinMHTMC’sservicearea.FortBendCountyhasthelowestSocioNeedsIndexvalue(2.8)andWhartonCountyhasthehighestvalue(75.7).TwocountieshaveSocioNeedsIndexvaluesbelow10(FortBendandMontgomerycounties)andfivecountieshavevaluesabove50(Harris,Waller,SanJacinto,Liberty,andWhartoncounties).Figure22showsSocioNeedsIndexvaluesbrokendownbyzipcode.Eachzipcodeisrankedfrom1(lowneed)to5(highneed)toidentifytherelativelevelofneedintheservicearea.Zipcodeswithpopulationsunder300personsareexcluded.Thetenzipcodeswiththehighestsocioeconomicneedinclude:77011,77060,77093,77020,77039,77076,77036,77026,77037,and77506(allwithinHarrisCounty).


Figure22.SocioNeedsIndexbyZipCode


Data Synthesis Allformsofdatahavetheirownstrengthsandlimitations.TogainacomprehensiveunderstandingofthesignificanthealthneedsforMemorialHermannHealthSystem,thefindingsfromboththeprimarydataandthesecondarydatawerecomparedandstudiedtogether.Thesecondarydata,keyinformantinterviewsandcommunitysurveyweretreatedasthreeseparatesourcesofdata.Thesecondarydatawereanalyzedusingdatascoring,whichidentifiedhealthareasofneedbasedonthevaluesofindicatorsforeachtopicarea(AppendixB).ThefollowingtablesdisplaythedatascoresforHealthandQualityofLifeTopicsforAustin,Brazoria,Chambers,FortBend,Galveston,Harris,Liberty,Montgomery,SanJacinto,Walker,Waller,andWhartoncounties.

Table14.AustinCountyTopicScoresTopic ScoreAccesstoHealthServices 1.97Transportation 1.77HeartDisease&Stroke 1.69Maternal,Fetal&InfantHealth 1.67Education 1.48MentalHealth&MentalDisorders 1.48Exercise,Nutrition,&Weight 1.45Immunizations&InfectiousDiseases 1.43SocialEnvironment 1.42Children'sHealth 1.40OlderAdults&Aging 1.40Economy 1.32Environment 1.26OtherChronicDiseases 1.26RespiratoryDiseases 1.26Cancer 1.20Wellness&Lifestyle 1.18MortalityData 1.07Prevention&Safety 0.99Women'sHealth 0.94PublicSafety 0.81SubstanceAbuse 0.81

Table15.BrazoriaCountyTopicScores

Topic ScoreTransportation 2.11HeartDisease&Stroke 1.80OlderAdults&Aging 1.56Exercise,Nutrition,&Weight 1.53PublicSafety 1.46


Topic ScoreAccesstoHealthServices 1.42Immunizations&InfectiousDiseases 1.41MentalHealth&MentalDisorders 1.37Environment 1.36OtherChronicDiseases 1.31RespiratoryDiseases 1.28SubstanceAbuse 1.28Children'sHealth 1.23Cancer 1.21MortalityData 1.16Maternal,Fetal&InfantHealth 1.12Prevention&Safety 1.11SocialEnvironment 1.10Women'sHealth 1.10Wellness&Lifestyle 1.06Economy 1.04Men'sHealth 1.01Education 0.96

Table16.ChambersCountyTopicScores

Topic ScoreCancer 2.11Transportation 2.06AccesstoHealthServices 2.04RespiratoryDiseases 1.94HeartDisease&Stroke 1.90MortalityData 1.71OlderAdults&Aging 1.70Exercise,Nutrition,&Weight 1.65MentalHealth&MentalDisorders 1.65Environment 1.52SocialEnvironment 1.37Immunizations&InfectiousDiseases 1.36SubstanceAbuse 1.35Children'sHealth 1.33Education 1.32Maternal,Fetal&InfantHealth 1.31Wellness&Lifestyle 1.21Economy 1.20OtherChronicDiseases 1.15Prevention&Safety 1.04PublicSafety 0.89

Table17.FortBendCountyTopicScores

Topic Score


Topic ScoreTransportation 1.83Immunizations&InfectiousDiseases 1.47Exercise,Nutrition,&Weight 1.45OtherChronicDiseases 1.44PublicSafety 1.37HeartDisease&Stroke 1.32Environment 1.27SubstanceAbuse 1.24Maternal,Fetal&InfantHealth 1.23OlderAdults&Aging 1.19AccesstoHealthServices 1.18Children'sHealth 1.15SocialEnvironment 1.03MentalHealth&MentalDisorders 0.95Economy 0.91Education 0.83Prevention&Safety 0.78Men'sHealth 0.75Women'sHealth 0.71Wellness&Lifestyle 0.68RespiratoryDiseases 0.63MortalityData 0.61Cancer 0.53

Table18.GalvestonCountyTopicScores

Topic ScoreHeartDisease&Stroke 1.86OtherChronicDiseases 1.72Men'sHealth 1.71Transportation 1.69OlderAdults&Aging 1.62Wellness&Lifestyle 1.61Children'sHealth 1.58Immunizations&InfectiousDiseases 1.58SubstanceAbuse 1.55Exercise,Nutrition,&Weight 1.50MentalHealth&MentalDisorders 1.50PublicSafety 1.48Cancer 1.45MortalityData 1.45Environment 1.44Maternal,Fetal&InfantHealth 1.44RespiratoryDiseases 1.41Economy 1.34AccesstoHealthServices 1.32


Topic ScoreSocialEnvironment 1.32Women'sHealth 1.28Prevention&Safety 1.19Education 1.13

Table19.HarrisCountyTopicScores

Topic ScoreTransportation 1.82Women'sHealth 1.81Immunizations&InfectiousDiseases 1.78OtherChronicDiseases 1.78PublicSafety 1.65Maternal,Fetal&InfantHealth 1.64Prevention&Safety 1.58SocialEnvironment 1.58Education 1.56Economy 1.55HeartDisease&Stroke 1.54Children'sHealth 1.52OlderAdults&Aging 1.50AccesstoHealthServices 1.48Exercise,Nutrition,&Weight 1.48Wellness&Lifestyle 1.42Men'sHealth 1.38Diabetes 1.34Environment 1.34SubstanceAbuse 1.33Cancer 1.31MortalityData 1.29MentalHealth&MentalDisorders 1.26RespiratoryDiseases 0.99

Table20.LibertyCountyTopicScores

Topic ScoreTransportation 2.28RespiratoryDiseases 2.25AccesstoHealthServices 2.08HeartDisease&Stroke 2.08MentalHealth&MentalDisorders 1.98OlderAdults&Aging 1.95Women'sHealth 1.89Education 1.88OtherChronicDiseases 1.85MortalityData 1.83Exercise,Nutrition,&Weight 1.81


Topic ScorePrevention&Safety 1.76Wellness&Lifestyle 1.76Cancer 1.75Economy 1.75Maternal,Fetal&InfantHealth 1.71Children'sHealth 1.70SocialEnvironment 1.66Immunizations&InfectiousDiseases 1.56Environment 1.46PublicSafety 1.46Men'sHealth 1.32SubstanceAbuse 1.08

Table21.MontgomeryCountyTopicScores

Topic ScoreTransportation 1.93HeartDisease&Stroke 1.65AccesstoHealthServices 1.56OtherChronicDiseases 1.52Exercise,Nutrition,&Weight 1.50SubstanceAbuse 1.49Children'sHealth 1.37OlderAdults&Aging 1.36Women'sHealth 1.35PublicSafety 1.33Environment 1.32Immunizations&InfectiousDiseases 1.32MentalHealth&MentalDisorders 1.31Education 1.11SocialEnvironment 1.10RespiratoryDiseases 1.08Cancer 1.06Economy 1.04MortalityData 1.00Men'sHealth 0.95Wellness&Lifestyle 0.93Prevention&Safety 0.85Maternal,Fetal&InfantHealth 0.83

Table22.SanJacintoCountyTopicScores

Topic ScoreAccesstoHealthServices 2.31RespiratoryDiseases 2.13HeartDisease&Stroke 2.03Transportation 2.02


Topic ScoreMentalHealth&MentalDisorders 2.01OlderAdults&Aging 1.96Education 1.86Wellness&Lifestyle 1.81PublicSafety 1.78Economy 1.70OtherChronicDiseases 1.70Prevention&Safety 1.67Women'sHealth 1.66Children'sHealth 1.65Maternal,Fetal&InfantHealth 1.63Exercise,Nutrition,&Weight 1.61MortalityData 1.61Cancer 1.59SocialEnvironment 1.58Immunizations&InfectiousDiseases 1.36Environment 1.34Men'sHealth 1.29SubstanceAbuse 1.26

Table23.WalkerCountyTopicScores

Topic ScoreEconomy 1.80Wellness&Lifestyle 1.80HeartDisease&Stroke 1.76PublicSafety 1.74AccesstoHealthServices 1.73SocialEnvironment 1.69RespiratoryDiseases 1.64OlderAdults&Aging 1.58Exercise,Nutrition,&Weight 1.57Education 1.55SubstanceAbuse 1.55Women'sHealth 1.53Children'sHealth 1.47Men'sHealth 1.47Environment 1.46MentalHealth&MentalDisorders 1.43Immunizations&InfectiousDiseases 1.38Transportation 1.35Cancer 1.33OtherChronicDiseases 1.31Maternal,Fetal&InfantHealth 1.21MortalityData 1.20Prevention&Safety 0.91


Table24.WallerCountyTopicScores

Topic ScoreAccesstoHealthServices 2.38HeartDisease&Stroke 2.01Prevention&Safety 1.93Education 1.75Economy 1.71Wellness&Lifestyle 1.69Exercise,Nutrition,&Weight 1.65Environment 1.62OlderAdults&Aging 1.61SocialEnvironment 1.60OtherChronicDiseases 1.54Transportation 1.51Women'sHealth 1.47MentalHealth&MentalDisorders 1.46Children'sHealth 1.42RespiratoryDiseases 1.26MortalityData 1.23Immunizations&InfectiousDiseases 1.19Maternal,Fetal&InfantHealth 1.02SubstanceAbuse 0.99Cancer 0.88PublicSafety 0.80

Table25.WhartonCountyTopicScores

Topic ScoreHeartDisease&Stroke 2.22Maternal,Fetal&InfantHealth 2.17AccesstoHealthServices 1.96Women'sHealth 1.92Children'sHealth 1.83OlderAdults&Aging 1.82Wellness&Lifestyle 1.81Education 1.68Transportation 1.66OtherChronicDiseases 1.65SocialEnvironment 1.65MortalityData 1.60MentalHealth&MentalDisorders 1.57PublicSafety 1.57Exercise,Nutrition,&Weight 1.56Economy 1.54Cancer 1.35Environment 1.35


Topic ScoreImmunizations&InfectiousDiseases 1.33Prevention&Safety 1.27RespiratoryDiseases 1.08Men'sHealth 1.01SubstanceAbuse 0.79

Thismethodologywasappliedtoeachofthe12countieswithinMemorialHermannHealthSystem’sprimaryserviceareaandthendatascorescalculatedfortheregioninordertodeterminesignificanthealthneedsacrossthesystem.Table26liststheresultingdatascoresforHealth&QualityofLifeTopicAreas.

Table26.MemorialHermannRegionTopicScoresTopic ScoreTransportation 1.84HeartDisease&Stroke 1.82AccesstoHealthServices 1.79OlderAdults&Aging 1.60Exercise,Nutrition,&Weight 1.56OtherChronicDiseases 1.52MentalHealth&MentalDisorders 1.50Children'sHealth 1.47Immunizations&InfectiousDiseases 1.43Education 1.43Women'sHealth 1.42SocialEnvironment 1.42Wellness&Lifestyle 1.41Maternal,Fetal&InfantHealth 1.41RespiratoryDiseases 1.41Economy 1.41Environment 1.40PublicSafety 1.36Cancer 1.31Prevention&Safety 1.26SubstanceAbuse 1.23Men'sHealth 1.21

Theanalysisofkeyinformantinterviewsoccurredusingthequalitativesoftware:Dedoose1.Forthecommunitysurvey,HCIperformedasimplereviewandanalysistoidentifytophealthneeds.Overall,eachmethodproducedindividualresultsthatrepresentthecommunityinputinthisreport.Thisconsolidatedinputleadstotheprioritizedheathneedsinthisreport.ThistriangulatedapproachisshowninFigure23.


Figure23.VisualofDataSynthesisApproach

TheteamusedthetriangulatedapproachtoidentifysignificanthealthneedsforMemorialHermannHealthSystem.Figure24displaystheresultsofthissynthesis.Formanyofthehealthtopicsevidenceofneedwaspresentacrossmultipledatasources,includingObesity,MentalHealth,AccesstoHealthServices,Transportation,andUninsured.Forotherhealthtopicstheevidencewaspresentinjustonesourceofdata,howeveritshouldbenotedthatthismaybereflectiveofthestrengthandlimitationsofeachtypeofdatathatwasconsideredinthisprocess.

SignificantHealthNeeds

HealthIndicatorData

(DataScoringAnalysis)

KeyInformantInterviews(Thematic

CodingAnalysis)CommunitySurvey

(ThematicAnalysis)


Figure24.DataSynthesisResults


Priorit ized Signif icant Health Needs

Priorit ization Results Uponcompletionoftheonlineprioritizationsurvey,fourhealthareaswereidentifiedforsubsequentimplementationplanningbyMemorialHermannHealthSystem.Thesefourhealthprioritiesare:AccesstoCare,EmotionalWell-Being,ExerciseIsMedicine,andFoodasHealth.ThefollowingsectionwilldivedeeperintoeachofthesehealthtopicsinordertounderstandhowfindingsfromthesecondaryandprimarydataledtoeachhealthtopicbecomingapriorityhealthissueforMemorialHermannHealthSystem.Foreachprioritizedhealthneed,keyissuesaresummarized;secondarydatascoresarenotedforindicatorsofconcern;andcommunityinputisdescribed.

Access to Healthcare

Secondary Data AccesstoHealthServices,LackofInsuranceandLow-Income/UnderservedwereidentifiedassignificantneedsforMemorialHermannHealthSystem.AccesstoHealthServiceswasamongthetop5highest-rankingtopicsinthesecondarydatascoringresultsforAustin,Chambers,Liberty,Montgomery,SanJacinto,Walker,Waller,andWhartoncounties.AsshowninTable27,thereareseveralindicatorsrelatedtoAccesstoHealthServiceswithdatascoresequaltoorgreaterthan2.TheproportionofAdultsUnabletoSeeADoctorisanindicatorofconcernforHarrisCounty,at22.1%comparedtotheproportioninTexas(18.3%)andtheU.S.(12.1%).InWallerCounty,over28%ofadultsdonothavehealthinsurance.DentistRateisanindicatorofconcernforChambers,SanJacintoandWallercounties,withvaluesof5,4and16dentistsper100,000population,respectively,comparedto66.3inHarrisCounty.MentalHealthProviderRateisaconcerningindicatorfor9outof12countiesintheservicearea.Non-PhysicianPrimaryCareProviderRateisconcerningforAustin,Liberty,SanJacinto,andWallercounties,whilePrimaryCareProviderRateisanindicatorofneedfor7outof12countiesintheservicearea.

KeyIssues:• Rangeofbarriers,includingtransportation,accesstospecialtycare,lackofawareness,and

fearorstigma• Lackofhealthinsurance• Lowincomeandvulnerablegroups

SecondaryDataScoringMethodologyForeachindicator,eachcountyinMHTMC’sserviceareawasassignedascorebasedonitscomparisontoothercommunities,whetherhealthtargetshavebeenmet,andthetrendoftheindicatorvalueovertime.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariedbyindicatorandwasdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.PleaseseeAppendixBforfurtherinformationonHCIDataScoringmethodology.


Additionally,inWallerCounty,therearealmost24%ofpersonswithouthealthinsurance,whichistwiceasmuchasFortBend’svalue.

Table27.SecondaryDataScoringResults:AccesstoHealthServices

AdultsUnabletoAffordtoSeea

Doctor[10](2015)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

--- --- --- --- --- 22.1% --- --- --- --- --- ---

--- --- --- --- --- 2 --- --- --- --- --- ---

[10]TexasBehavioralRiskFactorSurveillanceSystem

AdultswithHealth

Insurance:18-64[9](2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

78.3% 82.0% 81.6% 85.4% 81.3% 74.7% 75.0% 79.7% 74.6% 79.7% 71.5% 74.2%

1.64 1.47 1.47 0.92 1.47 1.75 1.75 1.47 1.75 1.25 2.14 1.75

[9]SmallAreaHealthInsuranceEstimates

ChildrenwithHealth

Insurance[9](2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

89.3% 91.3% 90.0% 93.3% 91.4% 89.4% 88.7% 90.2% 88.5% 89.4% 86.6% 87.7%

1.58 1.14 1.53 0.97 1.36 1.81 1.81 1.53 1.81 1.81 1.97 1.97


DentistRate[4](2016)

dentists/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

37 52.2 5 51.8 42.8 66.3 26.9 45.5 4 43.4 16 45.5

1.89 1.17 2.61 1.17 1.5 0.5 1.83 1.56 2.61 1.56 2.5 1.56


[4]CountyHealthRankings

MentalHealthProviderRate[4](2017)

providers/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

26.9 56.5 17.5 59.8 95.9 103.7 14.7 69.4 7 47.6 33.9 33.5

2.44 2 2.67 2.11 1.78 1.44 2.61 2 2.83 1.89 2.44 2.44


Non-PhysicianPrimaryCare

ProviderRate[4](2017)

providers/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

37 44.3 47.6 52.2 77.4 72.2 39.2 55 7 40.6 4 50.3

2.22 1.67 1.67 1.67 0.67 1 2 1.67 2.83 1.83 2.83 1.89


PersonswithHealth

Insurance[9](2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

81.7% 85.0% 84.3% 88.0% 84.3% 79.3% 79.4% 83.1% 78.5% 82.1% 76.1% 78.5%

1.64 1.25 1.47 1.08 1.47 1.75 1.75 1.47 1.97 1.42 2.14 1.75


PrimaryCare

ProviderRate[4](2015)

providers/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

23.7 65.3 10.3 80.3 71.7 57.2 23.9 61.8 15 31.1 10.3 41

2.39 1.22 2.83 0.33 1 1.61 2.83 1.22 2.39 2.33 2.61 2.33



WhenconsideringAccesstoHealthServices,itisimportanttotakeintoaccounttheeconomyandhowfinancialbarriersimpactcommunityresidents’abilitytoaccesscare.EconomyrosetothetopofthesecondarydatascoringresultsforWalkerCountyandwasthefifthhighest-rankingtopicforWallerCounty.AsshowninTable28,thereareseveraleconomicindicatorswithdatascoresequaltoorgreaterthan2acrosstheservicearea.ChildFoodInsecurityRateisconcerningforAustin,Liberty,SanJacinto,Waller,andWhartoncountieswithproportionsrangingbetween24%and26%.ChildrenLivingBelowPovertyLevelisconcerningforAustinandWhartoncountieswithproportionsover25%.InHarrisandWhartoncounties,over14%offamiliesarelivingbelowthepovertylevel.Inhalfoftheserviceareacounties,anotherindicatortonoteisFemalePopulation16+inCivilianLaborForce,whileFoodInsecurityRateisanindicatorwithscoreequaltoorgreaterthan2in7of12counties.HomeownerVacancyRateisconcerningforGalveston,WalkerandWallercounties.HomeownershipislowerinGalveston,HarrisandWalkercountiescomparedtoothercountiesintheservicearea.MedianHouseholdGrossRentisrelativelyhighin5outof12counties(Brazoria,FortBend,Galveston,Harris,andMontgomerycounties).MedianHouseholdIncomeislowerinSanJacintoandWalkercounties($44,878and$40,090,respectively,comparedto$91,152inFortBendCounty).MedianHousingUnitValueisanindicatorofconcernforSanJacintoCounty.In7of12counties,MedianMonthlyOwnerCostsforHouseholdswithoutaMortgageisaconcerningindicator.In5of12counties,anotherindicatortonoteisMortgagedOwnersMedianMonthlyHouseholdCosts.InChambersandWhartoncounties,People65+LivingBelowPovertyLevelisaconcerningindicatorwithover12%ofresidents65yearsandolderlivingbelowthepovertylevel.InSanJacintoCounty,57.5%ofpeopleareliving200%abovethepovertylevelcomparedto79.4%inFortBendCounty.PeopleLivingBelowPovertyLevelisconcerningforWalkerandWallercounties(24%and19%,respectively).PerCapitaIncomeisbelow$23,000inSanJacintoandWalkercounties.PersonswithDisabilityLivinginPovertyisanindicatorofconcernforSanJacintoandWallercounties.Population16+inCivilianLaborForceisconcerningforLiberty,SanJacintoandWalkercounties.Harris,LibertyandWallercountieshaveSevereHousingProblems(20.9%,18.5%and22.4%,respectively).TheproportionofSNAPCertifiedStoresisconcerninginBrazoria,Galveston,Harris,andWallercounties.In5of12counties,anindicatortonoteisStudentsEligiblefortheFreeLunchProgram.TotalEmploymentChangeisanindicatorofconcernforAustinandLibertycounties.UnemployedWorkersinCivilianLaborForceisconcerningfor7of12counties.


Table28.SecondaryDataScoringResults:Economy

ChildFoodInsecurityRate[5](2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

24.2% 20.1% 21.6% 19.1% 22.4% 23.5% 26.0% 21.2% 25.1% 24.7% 24.0% 24.1%

2.17 1 1.39 0.67 1.33 1.67 2.17 1.17 2.06 1.83 2.06 2.06

[5]FeedingAmerica

ChildrenLivingBelowPovertyLevel[1]

(2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

25.3% 13.2% 13.7% 11.2% 19.2% 26.0% 23.3% 14.8% 19.7% 23.4% 25.1% 28.6%

2.33 0.39 0.5 0.39 1.11 1.67 1.39 0.17 0.89 1.56 1.89 2.28

[1]AmericanCommunitySurvey

FamiliesLivingBelowPovertyLevel[1]

(2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

11.2% 7.9% 7.7% 6.4% 10.2% 14.4% 12.4% 8.3% 11.7% 13.4% 12.0% 14.4%

1.44 0.56 0.61 0.39 1.11 2.06 1.72 0.56 1.22 1.67 1.17 2.06


FemalePopulation

16+inCivilian

LaborForce[1](2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

54.4% 58.9% 46.4% 59.3% 58.1% 59.8% 39.5% 53.6% 43.7% 49.5% 50.6% 53.0%

1.78 1.33 2.61 1.17 1.5 0.94 2.83 2 2.61 2.44 2.06 1.78


FoodInsecurityRate[5](2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

15.8% 14.5% 15.2% 14.8% 17.0% 16.6% 18.7% 14.6% 18.7% 23.3% 19.2% 15.3%

2.06 1.33 1.72 1.56 2 2.06 2.39 1.33 2.39 2.39 2.39 1.72

[5]FeedingAmerica


HomeownerVacancyRate[1]

(2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

1.6% 1.6% 1.4% 1.1% 2.7% 1.5% 1.2% 1.2% 2.1% 3.2% 2.0% 0.9%

0.89 0.89 0.72 0.17 2.28 0.67 0.61 0.17 1.83 2.67 2.28 0.5


Homeownership[1]

(2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

63.5% 64.3% 72.3% 74.4% 54.7% 49.6% 64.8% 65.6% 62.7% 44.5% 59.6% 58.4%

0.56 0.83 0.61 0.39 2.17 2.44 0.83 0.61 0.56 2.61 1.06 1.22


HouseholdswithCashPublic

AssistanceIncome[1](2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

1.5% 0.8% 0.9% 1.1% 1.0% 1.5% 1.9% 1.1% 1.8% 1.8% 0.9% 0.9%

1.11 0.17 0.56 0.56 0.56 0.89 1.61 0.56 1.39 1.61 0.56 0.78


Low-IncomeandLow

AccesstoaGroceryStore[17](2015)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

3.5% 6.9% 5.2% 7.1% 7.8% 6.3% 7.7% 5.9% 2.9% 12.3% 11.3% 6.8%

1 1.5 1.17 1.5 1.5 1.33 1.5 1.33 1 1.83 1.83 1.5

[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas

MedianHouseholdGrossRent[1](2012-

2016)dollars

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

852 951 867 1252 941 937 801 1077 697 809 825 699

1.53 2.25 1.58 2.58 2.08 2.08 1.42 2.58 0.92 1.58 1.53 1.03



MedianHouseholdIncome[1](2012-2016)

dollars

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

56681 72006 70396 91152 63064 55584 49655 70805 44878 40090 53508 46445

0.72 0.17 0.83 0.17 0.39 0.5 1.33 0.39 2.28 2.22 1.17 1.67


MedianHousingUnitValue[1]

(2012-2016)dollars

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

1643

00

1571

00

1587

00

2176

00

1611

00

1456

00

8910

0

1900

00

8800

0

1236

00

1538

00

1070

00

1.14 0.92 0.92 0.42 0.92 1.08 1.75 0.58 2.19 1.64 1.08 1.58


MedianMonthly

OwnerCostsfor

HouseholdswithoutaMortgage[1](2012-

2016)dollars

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

448 490 501 712 523 534 414 531 396 433 494 416

1.58 2.03 2.25 2.36 2.58 2.14 1.08 2.58 0.75 1.69 2.03 1.14


MortgagedOwnersMedianMonthlyHouseholdCosts[1]

(2012-2016)dollars

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

1512 1645 1549 1884 1648 1504 1160 1635 1111 1281 1435 1204

2.03 2.14 1.81 2.25 2.14 1.81 0.97 2.19 1.08 1.36 1.58 1.19


People65+LivingBelowPovertyLevel[1]

(2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

7.6% 8.7% 12.1% 6.9% 8.0% 11.3% 10.6% 7.7% 10.8% 7.2% 4.9% 14.5%

0.56 0.89 2.17 0.39 0.72 1.89 1.94 0.78 1.72 0.39 0.17 2.39



PeopleLiving200%

AbovePovertyLevel[1]

(2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

68.2% 75.0% 71.7% 79.4% 70.7% 61.6% 60.5% 73.0% 57.5% 56.7% 59.3% 57.2%

1.11 0.39 1 0.17 0.56 1.33 1.72 0.56 2.11 1.89 1.67 1.89


PeopleLivingBelowPovertyLevel[1]

(2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

14.5% 10.5% 11.7% 8.2% 13.6% 17.4% 17.3% 11.0% 17.2% 24.0% 19.0% 17.7%

1.33 0.39 0.61 0.39 1.11 1.67 1.67 0.17 1.89 2.39 2.06 1.89


PerCapitaIncome[1](2012-2016)

dollars

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

28351 31180 29729 37134 32756 29850 22065 35912 22563 16419 23338 23245

0.67 0.33 1.11 0.17 0.33 0.5 1.83 0.17 2.28 2.5 1.83 1.83


PersonswithDisabilityLivingin

Poverty[1](2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

--- 19.4% --- 16.2% 22.7% 22.9% 28.0% 17.9% --- 26.0% --- ---

--- 0.64 --- 0.64 0.97 0.97 1.81 0.86 --- 1.31 --- ---


PersonswithDisabilityLivingin

Poverty(5-year)[1]

(2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

24.0% 21.8% 17.7% 15.6% 23.2% 25.4% 28.4% 19.1% 31.6% 23.6% 30.5% 27.3%

1.08 0.92 0.75 0.75 1.08 1.42 1.92 0.75 2.25 1.08 2.08 1.58



Population16+inCivilian

LaborForce[1](2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

62.1% 64.6% 59.2% 66.9% 64.2% 68.3% 51.3% 63.7% 52.7% 39.3% 60.5% 61.5%

1.44 1.17 1.61 1.17 1.33 0.94 2.83 1.5 2.67 2.61 1.39 1.44

[1]AmericanCommunitySurveyRentersSpending

30%orMoreof

HouseholdIncomeonRent[1]

(2012-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

42.3% 36.1% 28.2% 40.1% 45.6% 46.8% 35.1% 39.4% 43.2% 43.8% 46.8% 29.9%

1.44 0.67 0.78 1.06 1.5 1.5 0.72 1.06 1.61 1.33 1.83 0.33


SevereHousing

Problems[4](2010-2014)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

12.3% 14.6% 11.0% 14.8% 16.3% 20.9% 18.5% 16.0% 15.3% 18.3% 22.4% 15.3%

0.72 1.5 0.39 1.06 1.06 2.39 2.11 1.28 1.28 1.72 2.61 1.17


SNAPCertifiedStores[17](2016)stores/1,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

0.9 0.5 0.6 0.4 0.7 0.6 0.8 0.5 0.7 0.6 0.6 0.9

1.22 2 1.89 1.89 2.11 2.11 1.78 1.89 1.78 1.89 2.11 1.22


StudentsEligiblefortheFreeLunch

Program[8](2015-2016)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

42.9% 38.5% 28.2% 26.7% 40.5% 58.2% 55.5% 35.1% 59.6% 49.0% 65.8% 59.4%

0.83 0.5 0.39 0.17 0.72 2.22 2.11 0.56 2.39 1.56 2.39 2.5

[8]NationalCenterforEducationStatistics


TotalEmploymentChange[16](2014-2015)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

-0.7% 3.6% 11.6% 6.2% 3.9% 2.4% -3.7% 3.5% 4.0% 4.1% 3.2% 1.7%

2.17 0.67 0.5 0.5 0.5 1.67 2.5 1 0.5 0.5 1.17 1.83

[16]U.S.Census-CountyBusinessPatterns

UnemployedWorkersinCivilian

LaborForce[15](July2018)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

3.7% 4.7% 5.6% 4.1% 4.7% 4.4% 6.1% 3.8% 4.9% 4.7% 4.8% 4.0%

1.28 2.44 2.61 1.78 2.44 1.94 2.61 1.28 2.44 2.44 2.44 1.44

[15]U.S.BureauofLaborStatistics

Primary Data Duringthekeyinformantinterviewprocess,AccesstoHealthServiceswasdiscussedover160timesandwasraisedbyparticipantsalmost50timesinrelationtobarriersorchallengestoachievinghealthinthecommunity.Theprimarythemesrelatedtobarriersorchallengeswerelimitationstoprocuringspecialtycareservices,transportationtoservicesandhoursofoperation.Inadditiontotheprimarythemes,twoadditionalbarriersorchallengesstoodoutaskeyfactorsimpactingaccesstohealthcareservices,lackofknowledgeandstigmaorfearpreventingpeoplefromseekingcare.Theissuethatinterviewparticipantsweremostconcernedwithwaspatientsbeingabletoaccessfollowupcarewithspecialtycareproviders.Multipleparticipantsraisedconcernsthatevenifpatientsareabletoaccesspreventativeorprimarycareservices,theymaynotbeabletoaccesstheappropriatefollowupcarewithaspecialtycareprovider.Someparticipantsraisedthisconcernincontextofpatientsnotlivingnearaspecialistandothersraisedincontextofpatientsnotbeingabletoaffordthecostoffollowupcare.“…specialtycareisahugeproblem.Theyhavespecialistshereinthecounty,buttryingtohelpourCoastalpatientsgetintoseespecialistsorjustpeopleoutinthecommunitytryingtoseespecialists,ifthey'renotinsured,andtheydon'thaveprivatefundstopayforit,theyjustdon'tgetthatcare.Andweseethatinthepublichealthprograms.”“Wecantakecareofhelpingthemcontroltheirdiabetes,andkeeptheirbloodpressureincheck,andwecantreatthemforthatcommoncold,wecanprovidethatannualpapsmearforthewomanandprovidethatmammogram,butit'swhenthepersonexperiencessomethingofamoresignificantissue—saytheyhaveagallbladderattack,ortheyhaveahernia—thatisjustaresourcethatwesimplydon'thave.Orsomeoneneedstoseeanorthopedicsurgeon.Wetrytotakecareofthemthebestthatwecaninthesettingthatwehave,butthatisahugebarrierthatwefacewithourpatients,orthatourpatientsface.


So,whathappensisitbecomesanurgentsituation,andtheyendupintheemergencyroom,andthey'regivensurgeryonanemergencybasis.”Aconcernbroughtupbyafewparticipants,thatforseriouschronicconditions,patientswouldultimatelyendupseekingcarefromemergencyservicesinstead.Anothercommonconcernraisedbyinterviewparticipants,wastransportationtoservicesandhoursofoperationofserviceslimitingpatients’accesstocare.Participantsdescribedhowthesefactorsdeterminewhetherpatientsdecidetotakeofffromworkandseekservicesinthefirstplace.“Iwouldthinkthatourlower-incomefolks,itdefinitelybecomesmoreofachallengeforthem,whenyoudon’thavefacilitiesthatarelocatedclose-byinproximity.”Afewparticipantsdescribedthemanyservicesandresourcesthatareavailabletothecommunitybutthatmanymaynotbeawarehowtheycanaccessorbenefitfromthem.Oneparticipantdescribedresourcesbeingconcentratedincertaingeographicareasandmoreremotelocationsnotbeingwellconnectedorknowledgeableabouthowtheymayalsobenefitfromtheseresources.Participantsdescribedthepotentialformorecollaborationandpartnershiptoconnectcommunitiestooneanother.“Iwouldlovetoseesomebodyfromthepublicassistance,andI’lljustcallitMedicaid,orthepublicbenefits,maybehaveanofficeinsidethehospital.Thatwouldbephenomenal.I’veworkedinadifferentstateasahospitalsocialworkerpreviously,andtherewassomeonefromapublicassistance,fromtheDepartmentofHumanHealthandWelfareServicesinthehospital,andthatpersonwasabletoconnectthepeopletherewithemergencyMedicaid,withMedicaid,whichalsohelpsthehospital.Havetheirbillspaidandwhatnot,andmaybeitwouldcutdownonoutsourcingandsomeofthecollectionsandwhatnot.Ithinkthatthatwouldbewonderful,wouldbetohavesomeonefromthestatepublicbenefitsprogramhousedinsidethehospital.”Severalparticipantsdescribedadown-turninpeopleseekingpreventativecareserviceandhypothesizedthatoneofthefactorsmayberelatedtotheimmigrantcommunityintheregionexperiencingfearorstigmarelatedtohavingtoshowidentificationorproofofcitizenship.“EventhoughweattheHealthDistrictdonotaskforproofofimmigrationstatus,peopledon'tunderstandthat,particularlysincewe'reagovernmentagency,andit'sbeenarealchallengetogetsomeofthesefolkstocomeinforservices.”Therewerealmost80referencestotheuninsuredpopulationinthekeyinformantinterviewsandlackofhealthinsurancewasraisedasabarrierorchallengetoachievinghealthinthecommunity19times.Lackofhealthinsurancewasmostoftenbroughtupincontextofpatientshavinglimitedfinancialresourcesandafactortonotaccessinghealthcareservices.Participantsdiscussedpatientsnothavingtheabilitytopayfeesformultipleappointmentco-paysornotseekingcareduetocompetingfinancialpriorities.Whilehealthcareservicesmaybeavailableinthecommunity,forthosewhoarelackinghealthinsurance,accessinghealthcareservicesisnotnecessarilyanoption.Lackofhealthinsurancecreatesaparticularchallengeforthosewhorequirespecialtycareservices.


“Ithinkthosearethebiggesttwo—access,again,withthemajorityofouradultpopulationbeinguninsured,havingthemtrytofindaproviderthat,again,willtakeslidingfeescale,orreducedrates.Oncethey'reabletoaccessthoseservices,thenitbecomesamatterofpayingforthethingsthatareneeded.Thepatientcomesinandwediagnosethemwithdiabetes,thencomesthecostofmedications,andifthatpatientisneedingspecialtycareoutsideofthescopeofprimarycare,accesstospecialists.”Participantsbroughtupissuesrelatedtolowincomeorgroupswhomaybeunderservedinthecommunity115timesduringthekeyinformantinterviewprocess.Particulargroupsthatparticipantsfeltmayexperienceaddedchallengesaccessinghealthcareservicesincludedtheimmigrantpopulation,individualswithdisabilities,familieswithyoungchildren,andtheelderly.Severalparticipantsraisedfeesrelatedtoco-paysoroutofpocketexpensesasabarriertopatientsseekinginitialpreventativeservicesorongoingtreatmentforchronicconditions.Participantsidentifiedseveralgroupstheyfeltwereunderservedinthecommunity.Multipleparticipantsdiscussedtheuniqueandspecificchallengeswithprovidingculturallyappropriatecareforadiverseandrecentimmigrantpopulationinthecommunity.Participantsfeltthatfamilieswithyoungchildrenandtheelderlypopulationareparticularlyvulnerablegroupsinthecommunitythatexperiencebarriersandchallengesaccessinghealthcareservices.Specifically,participantsdiscussedthesegroupsexperiencinghighlevelsofpovertyplacingthemathigherriskforpoorhealthoutcomes.“Mostofthemareextremelylowincomeandtheyfallinthosecategorieswherewehaveasignificantnumberofelderlydisabled,singlemomsandtheirchildren,sovulnerablefolkshereinHouston.”

Emotional Well-Being

Secondary Data MentalHealthandSubstanceAbusewereidentifiedassignificantneedsforMemorialHermannHealthSystem.MentalHealth&MentalDisorderswasthefifthhighest-rankingtopicinthesecondarydatascoringresultsforbothLibertyandSanJacintocounties.AsshowninTable29,thereareseveralindicatorsrelatedtoMentalHealth&MentalDisorderswithdatascoresequaltoorgreaterthan2forcertaincounties.Age-AdjustedDeathRateduetoAlzheimer’sDiseaseisaconcernforChambersandLibertycounties,withvaluesof42.3%and38.5%,respectively.Age-AdjustedDeathRateduetoSuicideisanindicatortonotefor9outof12countiesintheservicearea.Alzheimer’sDiseaseorDementiaintheMedicarePopulationisconcerningforChambersandGalvestoncounties(12.2%and11.1%,respectively).DepressionintheMedicarePopulationisanindicatorofconcernforGalvestonandSanJacintocounties(18.2%and18.8%,respectively).MentalHealthProviderRateisconcerningfor9of12counties,withtheaverage

KeyIssues:• Mentalhealthaspartofoverallhealth• Needformorebehavioralhealthservicesandproviders,andservicestosupportlocal

communities• Alcoholandsubstanceabuse• Alzheimer’sanddementia


numberofpoormentalhealthdaysbeinganindicatorofneedforSanJacintoCountyspecifically(justunder4daysonaverageinthepast30days).

Table29.SecondaryDataScoringResults:MentalHealth&MentalDisordersAge-AdjustedDeathRatedueto

Alzheimer'sDisease[12](2010-2014)deaths/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

22.8 26 42.3 20.6 21.4 17.9 38.5 18.8 15.5 17.9 16.8 16.8

1.25 1.08 2.14 0.64 0.42 0.64 2.36 0.64 0.64 0.42 0.64 0.86

[12]TexasDepartmentofStateHealthServices

Age-AdjustedDeathRatedueto

Suicide[12](2010-2014)deaths/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

16.6 12.4 15.1 7.3 12.9 10.3 14 14.6 14.6 14.9 15.8 13.8

2.17 2 2.17 0.94 1.67 0.94 2.28 2.28 2.06 2.17 2.28 2.17


Alzheimer'sDiseaseorDementia:MedicarePopulation[3](2015)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

9.9% 10.7% 12.2% 10.2% 11.1% 11.4% 10.9% 10.7% 11.0% 10.4% 10.5% 11.4%

1 1.67 2.28 1.33 2.11 1.89 1.67 1.67 1.94 1.39 1.78 1.89

[3]CentersforMedicare&MedicaidServices

Depression:MedicarePopulation[3](2015)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

14.4% 15.5% 14.3% 12.2% 18.2% 14.8% 17.5% 15.9% 18.8% 15.3% 14.6% 13.6%

1 1.5 0.67 0.61 2.33 0.94 1.94 1.28 2.61 1.33 0.94 0.61


FrequentMental

Distress[4](2016)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

10.9% 9.9% 10.5% 9.0% 10.7% 11.2% 11.8% 10.2% 12.2% 11.6% 11.3% 12.0%


1.17 0.67 0.67 0.5 0.83 1.17 1.5 0.67 1.83 1.33 1.17 1.5


MentalHealth

ProviderRate[4](2017)providers/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

26.9 56.5 17.5 59.8 95.9 103.7 14.7 69.4 7 47.6 33.9 33.5

2.44 2 2.67 2.11 1.78 1.44 2.61 2 2.83 1.89 2.44 2.44


PoorMentalHealth:5+Days[10](2016)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

--- --- --- --- --- 80.0% --- --- --- --- --- ---

--- --- --- --- --- 1.53 --- --- --- --- --- ---


PoorMentalHealth:Average

NumberofDays[4]

(2016)Days

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

3.6 3.2 3.5 3 3.5 3.7 3.8 3.3 3.9 3.7 3.5 3.8

1.33 0.67 1 0.5 1.33 1.5 1.5 0.67 2.17 1.5 1 1.5


SubstanceAbuseisanothertopicofconcernintheservicearea.AdultswhoDrinkExcessivelyisconcerningforChambers,Montgomery,Walker,andWallercounties(rangingbetween20%and21%).TheproportionofAlcohol-ImpairedDrivingDeathsishighinBrazoria,FortBend,Harris,Montgomery,SanJacinto,andWalkercounties.LiquorStoreDensityisanindicatorwithdatascoregreaterthan2forChambersCounty.

Table30.SecondaryDataScoringResults:SubstanceAbuse

AdultswhoDrink

Excessively[4](2012-2016)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

18.3% 19.4% 20.9% 18.3% 18.8% 18.1% 19.4% 21.0% 17.0% 20.0% 20.5% 17.0%

1.5 1.67 2.17 1.5 1.5 1.5 1.67 2.17 0.83 2.17 2.17 0.83



Alcohol-ImpairedDriving

Deaths[4](2012-2016)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

18.2% 34.3% 17.7% 36.0% 31.8% 37.8% 21.8% 32.9% 40.4% 36.4% 21.8% 27.8%

0.33 2.22 0.56 2 1.67 2.17 0.72 2.06 2.39 2.67 0.5 1.22


DeathRateduetoDrugPoisoning[4](2012-2016)deaths/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

5.6 8.1 8.6 5.6 15.6 10.2 12.9 10.6 13.4 5.3 8.9 7

0.5 0.64 0.42 0.86 1.58 1.19 1.31 1.08 1.42 0.75 0.81 0.5


LiquorStoreDensity[16]

(2015)stores/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

6.8 2.3 12.9 5.2 8.7 6.3 3.8 6.3 3.6 5.7 2.1 4.8

0.89 0.61 2.28 0.61 1.44 0.89 0.61 0.67 0.39 0.61 0.5 0.61

[16]U.S.Census-CountyBusinessPatterns

Primary Data Approximately50%ofcommunitysurveyrespondentscitedMentalHealthasoneofthetopissuesmostaffectingthequalityoflifeintheircommunityand52%ofrespondentsnotedSubstanceAbuse.Ininterviewswithkeyinformants,MentalHealthwasdiscussed113timesandwasraisedbyparticipants33timesasaneedsorconcernforthehealthofthecommunity.TheprimarythemesrelatedtoMentalHealthweretreatingmentalhealthaspartofoverallhealth,addressbehavioralhealthinschool,needforbehavioralhealthprovidersandservicesandolderadultswithAlzheimer’sanddementia.Someparticipantsdiscussedarecentshiftincaredeliveryandthecontinuedneedtoaddressmentalhealthaspartofaperson’stotalhealthsimilarlytohowchronicdiseaseismanaged.Oneparticularlyvulnerablepopulationthatwouldbenefitfromabroaderapproachtotreatment,inclusiveofmentalhealth,isthehomelesspopulation.Severalparticipantsbroughtupissuesregardinganeedformorebehavioralhealthprovidersandservicesinthecommunity.


“Wehereseeahugegapinmentalhealth,there’sjustnotalotofsupportiveservicesformentalhealth,andwe’reseeingthattoreallyhitouryoungadults,ouradultswhoareintheir20s.WeseealotofpeoplehavingalotofPTSDorevenhavingapsychoticbreak,andweonlyhaveoneagencythatwouldsupportsomebodymaybewithoutinsurancethat’shavingmentalhealthissues,whichiscausingsomuchtraumaforthemfromthatpointforward.Iwouldsayoneofthehugeindicatorsforuswouldbementalhealth,it’shugeforus.”“(…)Ithinkthereneedstobemoreworkaroundfundingforbehavioralhealthbutalsofundingforrecruitingandtrainingtherapistsandbehavioralhealthspecialiststoaddresssubstanceabuse,anxiety,depressionandsuicidality.”Ofparticularconcernforsomeparticipantsistheneedtohavementalhealthservicesthatwillsupportlocalcommunitieshavingexperiencedtraumaticevents.“AndIthinkmentalhealthisanotherconcern.Especiallywhenyou'retalkingaboutHarvey,therecoveryeffortsthere.ThiscommunityalsohadtheSanteFe[school]shooting,soIthinkthatmentalhealthhastobeupthereaswell,fromastandpointofconcerns.”Oneparticipantobservedrecentincreasesandchangeswithinthelocalpopulation.Fromtheparticipant’sperspective,thereshouldbemoreprogramsorservicestoaddressthegrowingneedforaddressingmentalhealthinthecommunity.Anotherparticipantsuggestedsolutionsforaddressingtheneedformorebehavioralhealthprovidersinthecommunitysuchasexpandingresidencyprogramsforpsychiatristsanddevelopingcomprehensivetelemedicineprogramstoprovideservicesmoreefficiently.Furthermore,participantsrecommendedaddressingbehavioralhealthwithyoungerpopulationsintheschools.Schoolsthatprovidebehavioralhealthservicesthroughtelemedicinehavebeenreceivedwellinthecommunityandtheperceptionisthattheyareeffective.Someparticipantsbelievethattheseprogramsshouldbeexpandedandavailableacrossthecommunity.“We’realsolookingtobringinsomenon-profitorganizationsworkingintheschoolsettingofcommunityschools,BoysandGirlsClub,also,lookingatworkingwithourmentalhealthtaskforcesandthementalhealthdeputies.”“There[are]thementalhealthunitsthathavegoneoutintotheschools.They'renotschool-basedbutthat’sthevenuetheywilldrivetowiththeirmobileunits.Theyhaveabigimpact.They'reseeingthousandsofkids.They’vedonesometelemedicinewithmentalhealth,behavioralhealth,withsomeofthehighschools.FromwhatI’veheard,(…)it’sbeenprettyeffectiveandwellreceived.”AchallengethathealthcareprovidersidentifiedforthemedicalcommunityisadequatelyaddressingdementiaandAlzheimer’swithinthegeriatricpopulation.“Dementia’saterminalillness.(…)Muchmoreneedstobedonewithhealthcaresystemsaroundroutinescreeningandidentificationofitasanissue.(…)So,thatisthefirstthingthatneedstohappen.Then


thereneedstobeanunderstandingthattherearethings–therearemedicationsthatcanbehelpfultothesystemsofthedementia.(…)Butyoucanaffectitbyaddressingsomeofthesymptoms.”SubstanceAbusewasdiscussed55timesandwasraisedbyparticipants15timesasaneedorconcernforthehealthofthecommunity.MultipleuniquethemesemergedfromthekeyinformantinterviewsrelatedtoSubstanceAbuse:fundingfortreatmentprograms,invisibilityofalcoholism,overcomingstigmaofseekingtreatment,andemergingshiftsinoutreachmodels.Participantsidentifiedfundingforprogramsandavailabilityofservicesforthosewhomaynotbeabletoaffordtreatmentout-of-pocketasissuesthecommunityisfacingtoaddresssubstanceabuse.Oneparticipantdiscussedthedifficultyofmakingaconnectionbetweenthejailsystemandthehealthcaresystemforthosestrugglingwithsubstanceabuseissues.“Westilldealdailywithalotofdruguseinourcounty,and(…)alotoffolksthatcometoourjailsystemarebeingarrestedondrugoffenses,andthatcontinuestobeachallengetogetthesepeoplewheretheyneedtobe,fromahealthcarestandpoint,especiallymentalhealth,andIthinkthisgoesforanycountyinthestateofTexas.”Oneparticipantraisedalcoholabusespecificallyasanissueinthecommunitythatdoesnotgettheamountofattentionofothersubstanceabusetopicsbutmayinfactbeimpactingalargerproportionofthepopulationandconnectedtomanyotherhealthissues.Multipleparticipantsidentifiedculturalstigmaasabarrierforthosewhomaybenefitfromseekingtreatment.Stigmaorfearmaybeuniqueandvaryfrompopulationtopopulationinthecommunity.“Withsubstanceabuse,it’scultureandstigma.Nobodygoestosubstanceabusetreatmentontheirown.Theymaynotbeadjudicatedbutsomeoneisreally,reallypushingthem,familymember,boss.Noonegoestotreatmentifthey’renotunderduress.”Afewparticipantsdescribeduniqueapproachestooutreachandsubstanceabusetreatmentinthecommunitythatwouldsupportremovingbarriersforpeoplehavingtotakethefirststepontheirown.“Forinstance,it’sprettynew,butthere’saninitiativethat’scalledtheHeroesProjectthat’slookingatoverdoses,sowhenanoverdosehappens,they’resendingateamtotheER.So,it’sgotapeersupportspecialist,theEMPisinvolved–buttheyactuallygointotheERandtheydoaninterventiontheretotrytohelpwithlinkagetotreatmentsothatwecanassistthepatients.”

Food as Health

KeyIssues:• Foodinsecurityandlimitedaccesstohealthyfoods• Diabetesandheartdiseaselinkedtosocioeconomicfactors• Sedentarylifestyleanddrivingculture• Fooddeserts


Secondary Data ThetopicsofDiabetesandHeartDisease&Strokeemergedassignificanthealthneeds.HeartDisease&StrokerosetothetopofthesecondarydatascoringresultsforMemorialHermannHealthSystemandwasinthetop5highest-rankingtopicsinthesecondarydatascoringresultsforAustin,Brazoria,Chambers,Galveston,Liberty,Montgomery,SanJacinto,Walker,Waller,andWhartoncounties.Table31displaysdiabetesindicatorsforthetwelvecountiesintheservicearea.Asshown,DiabetesintheMedicarePopulationreceivedascoregreaterthan2forBrazoria,FortBend,Liberty,SanJacinto,Waller,andWhartoncounties.

Table31.SecondaryDataScoringResults:Diabetes

Age-AdjustedDeathRateduetoDiabetes[12](2010-

2014)deaths/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

16.3 15.1 14.7 13 17.5 20.2 19.4 13.4 21.1 22.7 20.6 29.2

-- -- -- -- -- 0.92 -- -- -- -- -- --


Diabetes:MedicarePopulation[3](2015)percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

25.0% 29.4% 28.3% 30.8% 27.8% 28.1% 31.4% 24.8% 31.3% 28.3% 29.6% 30.3%

0.67 2.5 1.72 2.22 1.78 1.67 2.83 0.94 2.83 1.94 2.06 2.28


AsshowninTable32,additionalindicatorsofconcerninclude:Age-AdjustedDeathRateduetoCerebrovascularDisease(WalkerandWhartoncounties);Age-AdjustedDeathRateduetoHeartDisease(Chambers,LibertyandSanJacintocounties);AtrialFibrillationintheMedicarePopulation(in7of12counties);HeartFailureintheMedicarePopulation(in8of12counties);HyperlipidemiaintheMedicarePopulation(Austin,FortBendandLibertycounties);HypertensionintheMedicarePopulation(SanJacinto,WallerandWhartoncounties);andIschemicHeartDiseaseintheMedicarePopulation(in5of12counties).StrokeintheMedicarePopulationisaveryconcerningindicatorforall12countiesintheservicearea,withindicatorscoresallgreaterthan2.


Table32.SecondaryDataScoringResults:HeartDisease&StrokeAge-Adjusted

DeathRateduetoCerebrovascularDisease(Stroke)[12](2010-2014)deaths/100,000

populationAu

stin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

36.7 38.6 38.2 35.4 44.4 41.5 41.1 38.5 35.9 55.5 38.3 47.7

0.86 1.25 1.19 0.64 1.75 1.42 1.75 1.25 0.64 2.08 1.08 2.36


Age-AdjustedDeathRateduetoHeartDisease

[12](2010-2014)deaths/100,000

population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

176.7 173 194.7 135 170.7 167.6 257.6 173.2 201.5 160.2 194.8 179.6

1.25 1.08 2.19 0.42 0.92 0.92 2.14 1.25 2.08 0.75 1.75 1.47


AtrialFibrillation:Medicare

Population[3](2015)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

8.7% 8.0% 8.5% 6.9% 8.0% 7.3% 8.2% 8.8% 7.8% 8.1% 8.4% 8.8%

2.28 1.78 2.28 0.94 1.78 1.5 2 2.44 1.78 2.11 2.17 2.44


HeartFailure:Medicare


Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

15.1%

16.6%

19.5%

13.9%

17.6%

16.0%

20.4%

14.6%

20.6%

16.8%

17.5%

19.1%

1.56 2.11 2.22 1.06 2.44 1.89 2.39 1.22 2.5 2 2.44 2.33


Hyperlipidemia:Medicare


Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

46.8%

44.9%

42.2%

46.6%

42.0%

43.2%

46.0%

46.3%

47.5%

42.7%

46.1%

47.6%

2.17 1.78 1.17 2.17 1.5 1.44 2 1.94 1.94 1.44 1.94 1.89


Hypertension:Medicare


Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

59.6%

59.3%

58.5%

57.1%

59.2%

55.5%

60.4%

56.0%

61.9%

58.3%

61.6%

65.3%


1.94 1.94 1.72 1.61 1.94 1.22 1.83 1.61 2.33 1.78 2.06 2.61


IschemicHeartDisease:Medicare


Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

26.9%

31.0%

35.0%

28.0%

29.2%

28.8%

33.2%

28.6%

34.4%

30.2%

31.0%

32.8%

1.22 1.83 2.39 1.22 1.72 1.33 2 1.17 2.39 1.67 2.06 2.33


Stroke:MedicarePopulation[3](2015)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

4.7% 5.1% 4.6% 4.7% 5.6% 5.2% 5.8% 4.6% 5.3% 4.8% 6.0% 4.8%

2.28 2.61 2.06 2.5 2.83 2.61 2.5 2.28 2.61 2.28 2.61 2.28

[3]CentersforMedicare&MedicaidServicesTable33revealsfood-relatedindicatorsofconcern(withscoresequaltoorgreaterthan2),including:ChildFoodInsecurityRate(in5of12counties);FastFoodRestaurantDensity(WhartonCounty);FoodEnvironmentIndex(WalkerandWallercounties);FoodInsecurityRate(in7of12counties);GroceryStoreDensity(BrazoriaandWallercounties);HouseholdswithNoCarandLowAccesstoaGroceryStore(SanJacintoCounty);andSNAPCertifiedStores(Brazoria,Galveston,Harris,andWallercounties).

Table33.SecondaryDataScoringResults:Nutrition

ChildFoodInsecurityRate

[5](2016)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

24.2%

20.1%

21.6%

19.1%

22.4%

23.5%

26.0%

21.2%

25.1%

24.7%

24.0%

24.1%

2.17 1 1.39 0.67 1.33 1.67 2.17 1.17 2.06 1.83 2.06 2.06

[5]FeedingAmerica

ChildrenwithLowAccesstoa

GroceryStore[17](2015)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

2.5% 6.2% 5.3% 7.4% 8.1% 5.4% 4.3% 5.6% 1.8% 4.1% 1.9% 4.8%

1.17 1.67 1.5 1.83 1.83 1.5 1.33 1.67 1 1.33 1 1.5



FastFoodRestaurantDensity[17]

(2014)restaurants/

1,000populationAu

stin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

0.5 0.6 0.7 0.6 0.7 0.7 0.5 0.6 0.1 0.5 0.4 0.8

1.22 1.44 1.78 1.33 1.67 1.67 1.33 1.5 1 1.44 1.17 2.11


FoodEnvironment

Index[4](2018)

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

7.7 7.5 7.6 7.4 6.9 7.2 6.6 7.5 6.9 5.3 6.3 7.4

0.72 1.22 1.06 1.22 1.56 1 1.72 1.22 1.67 2.39 2.11 1


FoodInsecurityRate[5](2016)

Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

15.8%

14.5%

15.2%

14.8%

17.0%

16.6%

18.7%

14.6%

18.7%

23.3%

19.2%

15.3%

2.06 1.33 1.72 1.56 2 2.06 2.39 1.33 2.39 2.39 2.39 1.72

[5]FeedingAmerica

GroceryStoreDensity[17](2014)stores/

1,000population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

0.2 0.1 0.1 0.1 0.2 0.2 0.1 0.1 0.2 0.1 0.1 0.2

1.39 2 1.94 1.83 1.39 1.5 1.94 1.83 1.39 1.83 2 1.5


HouseholdswithNoCarandLowAccesstoa


Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

2.4% 1.5% 1.8% 1.1% 1.4% 0.9% 3.4% 1.5% 4.9% 1.5% 2.8% 2.9%

1.5 1 1.33 1 1 1 1.83 1.17 2 1.17 1.67 1.67



Low-IncomeandLowAccesstoaGroceryStore[17](2015)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

3.5% 6.9% 5.2% 7.1% 7.8% 6.3% 7.7% 5.9% 2.9% 12.3%

11.3% 6.8%

1 1.5 1.17 1.5 1.5 1.33 1.5 1.33 1 1.83 1.83 1.5


People65+withLowAccesstoaGroceryStore[17](2015)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

2.4% 2.2% 1.8% 1.9% 3.5% 1.4% 2.2% 2.5% 1.3% 3.0% 0.8% 1.8%

1.33 1.33 1.17 1.17 1.67 1 1.33 1.33 1 1.5 1 1.17


SNAPCertifiedStores[17](2016)stores/1,000population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

0.9 0.5 0.6 0.4 0.7 0.6 0.8 0.5 0.7 0.6 0.6 0.9

1.22 2 1.89 1.89 2.11 2.11 1.78 1.89 1.78 1.89 2.11 1.22


Primary Data Food-relatedtopicsemergedinthecommunityinputgatheredthroughthesurveyandkeyinformantinterviews.FoodInsecurity,FoodProgramsandFoodKnowledgeissueswerediscussedover170timesduringthekeyinformantinterviewsandwereraisedbyparticipants34timesinrelationtobarriersorchallengestoachievinghealthinthecommunity.Theprimarythemesrelatedtobarriersorchallengesthatemergedintheinterviewswereaccesstohealthyfoodsandaffordability,knowledgegapsandlimitedfoodfamiliarityandprogramlimitations.Themostcommonissueraisedbykeyinformantparticipantsrelatedtofoodinsecuritywascommunitymembersnotbeingabletoaccesshealthyfoodsintheircommunity.Multipleparticipantsbelievedthatinmanycommunities,healthyfoodoptionswerenotavailabletopeoplewithinafive-mileradiusfromtheirhomeorwork.Participantsdescribed‘fooddeserts’asatopissueaffectinghealthinthecommunityandhowlimitedaccesstohealthyfoodsalsowascloselyassociatedwithpeoplealsobeingnotbeingabletoaffordhealthyfoods.


“Wehaveareallylargecounty.(…)Thewestdoesn’tcatertotheeastveryeasilyandviceversa.(…)Onceyougetoffofthatinterstate,youstartgettingintotheeastcountyandwestcountyyou’llgomilesandmilesandmileswithoutgrocerystores,sotherearefooddesertsinourcommunity.”

“Ithinktheneighborhoodconditionscanbebarrierstohealthylivingaswell.[In]someoftheneighborhoods,iftheydon’thaveacar,theyareonabus,thenthereisnomarket.Theremightbeadollarstorethathassomefoodsavailable,butthereareneighborhoodsthatdonothavehealthyfoodchoices,theyhaveaneighborhoodlittlestore,and7-Eleventypeofthings...”

“Thenwerealizedweneededtodosomethingfortheparents,sowecreatedanexerciseprogramforthemintheeveningaswellasthatRecipeforSuccesstonotonlycomeintotheschoolbutcomeintotheparkandrecreationcentertohelptheparentswithnutritionalmealsandthenwerealizedthattherewasn’tagrocerystorenear.Therewereseveralmom-and-popstores,soweworkedwiththemomandpopstorestodevelopahealthiervarietyoffoodsforthecommunity.”

Participantsalsodiscussedtheimbalanceofhealthyfoodoptionsforthosecommunitieswithlowerhousingpricesandingeneral,loweraverageincomes.Oneparticipantdescribedthelinkbetweenpeoplehavingtoworkmultiplejobsandhavingtimetoshopforandpreparehealthyfoods.“Wehaveagrocerystoreoneverycornerbutnoteverycornerinthepoorneighborhoods.It’sbeenmypersonalexperiencethateatinghealthyisexpensive.Itcostsmoremoneytobuyhealthyfruitsandvegetablesandmorehealthyfood,ingeneralthanitdoestobuyfoodthat’snotsohealthy,that’shighfat,highcarb,highsugar….Itcostsmoremoney.Ittakeslongertoprepare.Whenyouhaveamomandadadoreitherandthey’retryingtohandletwojobs,ifnotthree.They’vegotkidsofvaryingages.Themechanicsofshoppingandpreparingmealsisprobablyanactivitythatgetsletgo.” Someparticipantshaddirectexperiencewitheducatingthecommunityabouthealthyfoodsandeating.Theseparticipantssharedthatsomecommunitymembershavelimitedknowledgeoffreshfruitsandvegetablesandwouldbenefitfromearlyeducationforparentsandchildreninschools.

“Andthereareplaceswhichwearereallyconcernedabout,whichiseastofI45wherethere’sthisfoodinsecurity,fooddesert,andallotherproblemsthatarehappening,andwe’reseeingincreasingincidenceofchildobesityinthoseareas,andthosezipcodes.Sodefinitelyeducationisthekey.Itstartsfromprobablyprenatalcareofmom,anditgoesontoschool.”

InMemorialHermann’scommunitysurvey,67%ofrespondentsselectedDiabetesasoneofthetopissuesmostaffectingthequalityoflifeintheircommunity.Duringkeyinformantinterviews,Diabeteswasdiscussed64timesandwasraisedbyparticipants32timesasahealthneedorconcerninthecommunity.ForthoseparticipantswhoraisedDiabetesasatophealthissueinthecommunity,uniquethemesemergedregardinghowdiabetesisimpactingspecificgroupsinthecommunityandthewayasedentarylifestyleimpactsdiabetes.MultipleparticipantsattributedthesurgeinobesityanddiabetesingeneralintheU.S.toashifttoamoresedentarylifestylewhileothersspecificallyidentifiedthelocalclimateanddrivingcultureaskeyfactorsleadingtoanincreaseinsedentarylifestylesimpactingtheregion.


HeartDisease&Strokewasdiscussed34timesduringthekeyinformantinterviewsandwasraisedbyparticipants16timesasahealthneedorconcerninthecommunity.ForthoseparticipantswhoraisedHeartDisease&Strokeasatophealthissueinthecommunity,theuniquethemesthatemergedintheinterviewswerechronicdiseaseriskrelatedtosocioeconomicstatusandchallengeswithmanagingheart-relatedconditions.“Youhavesomanycommunitiesthatarefooddesertsso,ofcourse,Ithinkweareallatriskforthingslikediabetesandhypertension,obesity,stroke–but,Ithinkinadditiontothat,thosethataremostarealreadymarginalized.Peoplewhoarelowincome.Lowsocioeconomicstatus.So,education,andallofthoseindicatorsareprobablyevenmoreatriskforchronicdiseasesthansomeone,forexample,whohasaccesstocareandinsurance.So,theyprobablyaredoublyatrisk.”

Exercise Is Medicine

Secondary Data Exercise,Nutrition&Weightwasinthetop5highest-rankingtopicsfromthesecondarydatascoringresultsforBrazoria,FortBendandMontgomerycounties,andwasthefifthhighest-rankingtopicforMemorialHermannHealthSystemoverall.AsshowninTable34,indicatorsofconcernrelatedtoexercisespecificallyinclude:AccesstoExerciseOpportunities(inAustin,Chambers,Liberty,andWallercounties)andWorkersWhoWalktoWork(in9of12counties).

Table34.SecondaryDataScoringResults:Exercise,Nutrition&Weight

AccesstoExerciseOpportunities[4](2018)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

66.2%

79.0%

58.8%

83.8%

88.1%

90.4%

59.5%

82.7%

74.5%

77.9%

45.2%

75.2%

2 1.33 2.17 0.83 0.83 0.67 2.17 1 1.67 1.33 2.33 1.5


Adults(18+Years)WhoAreObese[10](2016)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

-- -- -- -- -- 32.0%

-- -- -- -- -- --

-- -- -- -- -- 1.67 -- -- -- -- -- --

KeyIssues:• Obesityandconvenienceoffastfood• Walkabilityofcommunities• Safetyofoutdoorspacesandplacestoexercise• School-basedprograms



ChildFoodInsecurityRate

[5](2016)PercentAu

stin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

24.2%

20.1%

21.6%

19.1%

22.4%

23.5%

26.0%

21.2%

25.1%

24.7%

24.0%

24.1%

2.17 1 1.39 0.67 1.33 1.67 2.17 1.17 2.06 1.83 2.06 2.06

[5]FeedingAmerica

ChildrenwithLowAccesstoa


Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

2.5% 6.2% 5.3% 7.4% 8.1% 5.4% 4.3% 5.6% 1.8% 4.1% 1.9% 4.8%

1.17 1.67 1.5 1.83 1.83 1.5 1.33 1.67 1 1.33 1 1.5


FastFoodRestaurantDensity[17]

(2014)restaurants/

1,000population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

0.5 0.6 0.7 0.6 0.7 0.7 0.5 0.6 0.1 0.5 0.4 0.8

1.22 1.44 1.78 1.33 1.67 1.67 1.33 1.5 1 1.44 1.17 2.11


FoodEnvironment

Index[4](2018)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

7.7 7.5 7.6 7.4 6.9 7.2 6.6 7.5 6.9 5.3 6.3 7.4

0.72 1.22 1.06 1.22 1.56 1 1.72 1.22 1.67 2.39 2.11 1


FoodInsecurityRate[5](2016)

Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

15.8%

14.5%

15.2%

14.8%

17.0%

16.6%

18.7%

14.6%

18.7%

23.3%

19.2%

15.3%

2.06 1.33 1.72 1.56 2 2.06 2.39 1.33 2.39 2.39 2.39 1.72

[5]FeedingAmerica


GroceryStoreDensity[17](2014)stores/

1,000populationAu

stin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

0.2 0.1 0.1 0.1 0.2 0.2 0.1 0.1 0.2 0.1 0.1 0.2

1.39 2 1.94 1.83 1.39 1.5 1.94 1.83 1.39 1.83 2 1.5


HouseholdswithNoCarandLowAccesstoa


Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

2.4% 1.5% 1.8% 1.1% 1.4% 0.9% 3.4% 1.5% 4.9% 1.5% 2.8% 2.9%

1.5 1 1.33 1 1 1 1.83 1.17 2 1.17 1.67 1.67


Low-IncomeandLowAccesstoaGroceryStore[17](2015)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

3.5% 6.9% 5.2% 7.1% 7.8% 6.3% 7.7% 5.9% 2.9% 12.3%

11.3% 6.8%

1 1.5 1.17 1.5 1.5 1.33 1.5 1.33 1 1.83 1.83 1.5


People65+withLowAccesstoaGroceryStore[17](2015)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

2.4% 2.2% 1.8% 1.9% 3.5% 1.4% 2.2% 2.5% 1.3% 3.0% 0.8% 1.8%

1.33 1.33 1.17 1.17 1.67 1 1.33 1.33 1 1.5 1 1.17


RecreationandFitnessFacilities

[17](2014)facilities/1,000population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

0.1 0.1 0 0.1 0.1 0.1 0 0.1 0 0 0 0.1

0.89 1.33 1.78 1.33 1.17 1.33 1.67 1.33 1.67 1.5 1.78 1.06



SNAPCertifiedStores[17](2016)stores/1,000population

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

0.9 0.5 0.6 0.4 0.7 0.6 0.8 0.5 0.7 0.6 0.6 0.9

1.22 2 1.89 1.89 2.11 2.11 1.78 1.89 1.78 1.89 2.11 1.22


WorkerswhoWalktoWork[1]

(2012-2016)Percent

Austin

Brazoria

Cham

bers

FortBen

d

Galveston

Harris

Libe

rty

Mon

tgom

ery

San

Jacinto

Walker

Waller

Wha

rton

1.7% 0.8% 0.7% 0.6% 2.0% 1.5% 1.0% 1.0% 1.4% 4.7% 4.7% 1.1%

2.11 2.78 2.78 2.67 1.56 2.17 2.67 2.78 2.44 0.22 0.22 2.56


Primary Data Over60%ofMemorialHermann’scommunitysurveyrespondentsnotedObesityasatopissueaffectingthequalityoflifeintheircommunity.Inkeyinformantinterviews,Exercise,Nutrition&Weightwasdiscussedalmost170timesandwasraisedbyparticipants42timesasaneedorconcernforachievinghealthinthecommunity.TheprimarybarriersrelatedtoExercise,Nutrition&Weightidentifiedbyparticipantswerewalkability,accesstosafeoutdoorspacesandprogrammingthatmaynotmeettheneedsofcommunitiesfacingfinanciallimitations,andtheconvenienceofunhealthyfoods.Participantsalsodiscussedaneedtodevelopnutritionalprogrammingforyouthintheschools.Severalparticipantsdiscussedbarrierstohealthylifestylechangesanddescribedcommunitieswheresidewalksarelimitedorpedestrianpathwaysarenotavailable.Theabilityforcommunitymemberstomakesmallshiftsintheirdailylives,suchaswalkingregularly,maybemorefeasiblethanundertakinganexerciseregimen.Thelimitationsofpedestrianpathwaysandsaferwalkingspacespreventthoseinsomesectionsofthecommunityfrommakingtheseshifts.Forindividualswhomaynotbeabletoaffordgymmembershipsnorattendclassesduetoworkschedules,outdooractivitiesandfitnessareasofferafreealternative.Participantsfeltthatinmanyneighborhoods,theseoutdoorspacesarenotavailableduetodisrepairorunsafeenvironments.“Andfortheactivitypartofit,it'salsoanaccessfactorforalotofpeople.Whenwedidoursurvey,oneoftheresponseswehad[wasthat]peoplecouldn'taffordgymmemberships,andtheymaynothaveasafeplacetoexerciseintheircommunities,iftheyliveinahighercrimearea,thekidsdon'tgooutside,theystayinthehousewheretheirparentsfeelthatthey'resafe.”


“Ithinkthebuiltenvironmentishuge,too.Ifyouliveoutinaplannedcommunity,theyusuallyhavewalkingtrails,ortheyhaveaprettyfountainareaforyoutowalkaroundit.Theyhavethoselittleexercisethingsthatyoustoponpartwayaroundthetrailandyoudoyourlittlepush-upsandyoursit-upsandyourpull-ups(…)Yougointothesepoorerareasandthere'snosidewalks.There'snolightsatnight.There'sapark—it'sallrustedequipment.”Participantsalsodescribedprogramsandfacilitiesthatareeitherlimitedorlacking.Theseprogramsincludedfreeexerciseprogramswithchildcareoptions,youthsportsleaguesandrecessintheschoolsandfreeorlow-costoptionsforair-conditionedfacilitiesduringtimesoftheyearwhentheweatherdoesnotpermitoutdooractivities.“InpoorareasofHouston,there’sjustnotalotofparks.There'snolittleleague,andthere'snosoccerleagues,andso,there'snotalotofrecessintheschools.There'sjustnot—thecultureamongthekidsisjustnotbeingcreatedaroundphysicalactivity.”Achallengethatseveralparticipantsraisedistheconvenienceandlowcostofunhealthyfoods.Forfamiliesthatmayhavefinancialortimelimitations,theconvenienceofinexpensive,lesshealthyfoodsisdifficulttocontendagainst.“Wehavethebigchaingrocerystoreshereinthecommunity,butalotoftimes,becauseourpopulationislimitedwithfunds,thebadfoodsaretheonesthatarethecheapestandmostaccessible,sotheygoinandbuythecheapest/fastestthingtheycanget.”Keyinformantsalsodiscussedtheopportunitytobringexerciseandnutritionprogramsintoschoolstoaddresschildhoodobesityandalsohelpwithstudents’overallperformance.“WhenwelaunchedtheCANDOproject,itwas(…)toaddresschildhoodobesity.Wewerelookingatphysicalactivity,wewerelookingatprovidinghealthyfoodandthenutritionguidelinesandthatsortofthing.Welookedatdoingitthroughschoolsandweactuallyidentifiedthreeschoolsthatwewouldworkwithandactuallyendupwithonethatwecouldreallydosomethingwith.”“…theprincipalandtheleadershipoftheschoolsweresofocusedontestscores.Wecanconvincethemthattestscoreswouldbeimprovediftheirstudentshadahealthydietandphysicalactivity,intermsofconnectingthedots.”


Non-Prioritized Significant Health Needs Thefollowingadditionalsignificanthealthneedsemergedfromareviewoftheprimaryandsecondarydata.Withtheneedtofocusontheprioritizedhealthneedsdescribedabove,thesetopicsarenotspecificallyprioritizedeffortsinthe2019-2022ImplementationStrategy.However,duetotheinterrelationshipsofsocialdeterminantneedsmanyoftheseareasfall,tangentially,withintheprioritizedhealthneedsandwillbeaddressedthroughtheupstreameffortsoftheprioritizedhealthneeds.Additionally,manyofthemareaddressedwithinongoingprogramsandservices.Examplesoftheseeffortsareprovidedbelowbytopicarea.

Older Adults and Aging

Secondary Data ThesecondarydatascoringresultsrevealedthetopicofOlderAdultsandAgingasasignificanthealthneed.OlderAdultsandAgingwaswithinthetop5highest-rankingtopicsforBrazoriaandGalvestoncountiesandwithinthetop6highest-rankingtopicsforChambers,Liberty,SanJacinto,andWhartoncounties.AlthoughOlderAdultsandAgingwasnotoneofthehighest-rankingsecondarydatascoringtopicsforAustinCounty,thereare4indicatorsofconcern(withscoresequaltoorgreaterthan2).Thetopicwasahigh-rankingoneforBrazoriaCounty,withconcerningindicators:Stroke,Diabetes,ChronicKidneyDisease,andHeartFailure(allintheMedicarePopulation).OlderAdultsandAgingwasalsoahigh-rankingtopicforChambersCountyandthereare8indicatorswithscoresgreaterthan2,includingPeople65+LivingBelowPovertyLevel.Thetopicwasnothigh-rankingforFortBendCounty;however,indicatorsofconcernincludeStroke,Diabetes,ChronicKidneyDisease,andHyperlipidemia(allintheMedicarePopulation).Thetopicwasthefifthhighest-rankingtopicforGalvestonCountyandconcerningindicatorsinclude:ChronicKidneyDisease,Stroke,HeartFailure,Depression,andAlzheimer’sDiseaseorDementia(allintheMedicarePopulation).Althoughnotahigh-rankingtopicinHarrisCounty’ssecondarydatascoringresults,indicatorsofnoteinclude:ChronicKidneyDiseaseandStroke(bothintheMedicarePopulation)aswellasAge-AdjustedDeathRateduetoFalls.ForLibertyCounty,OlderAdultsandAgingwasthesixthhighest-rankingtopicandthereare10indicatorswithscoresequaltoorgreaterthan2(mostintheMedicarePopulation).ForMontgomeryCounty,thereareafewindicatorstonote(allintheMedicarePopulation):AtrialFibrillation,StrokeandChronicKidneyDisease.OlderAdultsandAgingrankedsixthinSanJacinto’ssecondarydatascoringresultsandthereare9indicatorswithscoresabove2,outofwhichsevenareequaltoorgreaterthan2.5andallofwhicharewithintheMedicarePopulation.ForWalkerCounty,thereare5indicatorswithscoresequaltoorgreaterthan2.WallerCountyhas8concerningindicatorsrelatedtoOlderAdultsandAging.WhartonCountyhas10indicatorsequaltoorgreaterthan2,includingPeople65+LivingBelowPovertyLevel(withhighdisparities)andPeople65+LivingAlone.

Primary Data KeyinformantsandstakeholdersdiscussedOlderAdultsandAging.Over62%ofparticipantsinMemorialHermannHealthSystem’sprioritizationprocesscitedOlderAdultsasoneofthe


groupsmostaffectedbypoorhealthoutcomes.Interviewswithkeyinformantsnotedthegrowingpopulationofolderadultsandneedsrelatedtospecializedcare,financialassistanceandoutreach.Participantsalsomentionedexistingseniorprogramsandservices.“…[W]earegoingtowatchtheliteraldoublingofthenumberofAmericansovertheageof65inthenext25years.Everyday,betweennowand2030,dayafterday,10,000Americanswillturn65,sowearewatchinganextraordinaryexpansionofchallengesofaging.(…)[M]oreandmoreAmericansaregoingtobegettingold,socaringforthismassiveincreaseintheagingpopulationisgoingtobeoneofthegreatchallengesIthink.”“UTMBhasaseniorcitizens’center,andtheyhaveaninstituteforlife-longlearning,wheretheyofferalotofinformationalandeducationalclassesforseniors.”

Efforts MemorialHermannHealthSystemincludestwofreestandingRehabilitationHospitals(TIRRandKaty)aswellasaseniorlivingfacility(UniversityPlace),featuringindependentliving,personalassistanceservices,andaseparate,butattached,nursingcenter.Additionalcommunityoutreachincludeshealtheducationon:Alzheimer’sdisease,DiscountedDiabetesEducation,Education/outreachforSeniors,InjuryPrevention,FallPrevention,andsupportgroupsforvariouspopulations,including:Alzheimer’s,Amputees,Cardiacpatients,Chronicdisease,Diabetics,Grief,Parkinson’sdisease,Stroke,Survivorship,andmore.

Cancers

Secondary Data Cancerwasthehighest-rankingtopicforChambersCounty.Althoughitdidnotrankhighfortheothercountiesintheservicearea,therearecertainindicatorstonote.ProstateCancerIncidenceRatewasaconcerningindicatorforAustinCounty(withscoreabove2).ChambersCountyhas5indicatorsofconcern(thefirstfourwithscoresof2.78):Age-AdjustedDeathRateduetoCancer,Age-AdjustedDeathRateduetoColorectalCancer,Age-AdjustedDeathRateduetoLungCancer,ColorectalCancerIncidenceRate,andLungandBronchusCancerIncidenceRate.InGalvestonCounty,indicatorswithscoresgreaterthan2include:Age-AdjustedDeathRateduetoProstateCancer,Age-AdjustedDeathRateduetoColorectalCancer,andAge-AdjustedDeathRateduetoCancer.InHarrisCounty,twoconcerningindicatorsareCervicalCancerIncidenceRateandAge-AdjustedDeathRateduetoBreastCancer(bothwithindicatorscoresabove2).LibertyCountyhas6indicatorswithscoresgreaterthan2:Age-AdjustedDeathRateduetoLungCancer,OralCavityandPharynxCancerIncidenceRate,CervicalCancerIncidenceRate,Age-AdjustedDeathRateduetoCancer,LungandBronchusCancerIncidenceRate,andAge-AdjustedDeathRateduetoColorectalCancer.SanJacintoCountyhas5concerningindicators:Age-AdjustedDeathRateduetoCancer,Age-AdjustedDeathRateduetoLungCancer,Age-AdjustedDeathRateduetoBreastCancer,OralCavityandPharynxCancerIncidenceRate,andLungandBronchusCancerIncidenceRate.WalkerCountyhasoneindicatorwithscoreabove2:CervicalCancerIncidenceRate.WhartonCountyhas4indicatorstonote:


Age-AdjustedDeathRateduetoBreastCancer,ColorectalCancerIncidenceRate,Age-AdjustedDeathRateduetoColorectalCancer,andCervicalCancerIncidenceRate.

Primary Data InMemorialHermann’scommunitysurvey,overonethirdofrespondentsnotedCancerasatopissueaffectingthequalityoflifeintheircommunity.Interviewswithkeyinformantsrevealedtheimportanceofearlydetectionandmakingcancerscreeningservicesandspecialtycareavailableandaccessible(e.g.,telehealth,mobilemammography).

Efforts AsleadingprovidersofcancertreatmentinHouston,MemorialHermannCancerCentersarecommittedtocancertreatment,prevention,andresearch.Theirbroadgeographicalcoveragemakescancertreatmentextremelyaccessibleandconvenienttowherepatientsliveorwork.AlleightMemorialHermannCancerCentersareapprovedbytheAmericanCollegeofSurgeonsCommissiononCancer(ACoSCoC);only25percentofhospitalsacrossthecountryhavereceivedthisspecialrecognition.Withguaranteedaccesstocomprehensivecare,collaborativeteamapproachforcoordinatingthebestavailabletreatmentoptions,state-of-the-artequipmentandservices,educationandsupport,andlifelongpatientfollow-upthroughtheCancerRegistry,patientsareabletoaccessafullmenuoftherapiesandtreatmentoptions.Additionaloutreachincludeseducationandsupportgroupsforcancerpatients:Art,Self-guidedArtTherapy,Lymphedema,BrestCancer,OncologyNutritionTherapy,StressRelief,LookGoodFeelBetter,Yoga,Meditation,andHealthyEatingAdvices.

Education

Secondary Data Educationwasthefourthhighest-rankingtopicinthesecondarydatascoringresultsforWallerCounty.People25+withaHighSchoolDegreeorHigherisanindicatorscoringabove2forWallerCounty.AlthoughEducationdidnotrankashighforothercountiesintheservicearea,thereareindicatorstonote.LibertyCountyhastwoindicatorswithscoresabove2andadisparityexistsforPeople25+withaHighSchoolDegreeorHigher.SanJacintoCountyhas2indicatorstonote,oneofwhichisPeople25+withaBachelor’sDegreeorHigher;ahighdisparityexistsforBlackorAfricanAmericanresidentsaswellasHispanicorLatinoresidents.TheStudent-to-TeacherRatioisanindicatorofconcernforGalvestonandWalkercounties.WhartonCountyhasoneindicatorwithscoreabove2:People25+withaBachelor’sDegreeorHigher;moreover,therearedisparitiesforcertainrace/ethnicitygroups.

Primary Data Duringkeyinformantinterviews,thetopicofEducationcameupfrequentlyandinrelationtodifferentfocusareasandtargetaudiences,includingchildren,generalcommunitymembersaswellasproviders.Thelinkbetweenindividuals’levelofeducationandqualityoflifewasemphasized.Keyinformantsrecommendedfindingopportunitiestoexpandtheavailabilityofeducation(relatedtohealthandnon-healthtopics)aswellasintegratinghealtheducationintoexistingactivitiesinbothclinicalandnon-clinicalsettings,suchasschoolsandchurches.Key


informantsnotedthateducation(forexample,relatedtohealthyeating)mustbeprovidedtobothchildrenandadultsinorderfortheinformationtobeappliedsuccessfully.Opportunitieswerealsopointedouttoeducatehealthcareproviders(andprovidecontinuingeducation)onavailablecommunitylinkagesandresourcesandonhowtoinitiateconversationswithpatientsregardingdifferenthealthtopics.“Ithinkitcomesdowntoeducationbecauseprobably75%ofourdiagnoseddiabetesaretype2diabetes,andthatissomethingthatwithproperdiet,properexercise,andeducationthatmanypatientscanovercome,andsowehaveworked,andwecontinuetoprovide(…)thepropereducation.”“Wewanttogointodifferentgroupsandeducatethemonwhattheyshouldbedoingorshouldn’tbedoing.(…)Ithinkeducationisahugecomponentbutwe’vegottofigureouthowtointegratethat.Theeducation,withouttheintegrationintosomebody’slifestyle,doesn’tdothemanygood.”“Thekidsdoreceiveeducationinschool,butthatdoesn’tnecessarilygobackhometotheirparents,nordotheylistentotheirchildrenwhentheydobringitup…”“…itisthewholefamily.Themommightbetheonewho'scooking,andthekidsareeating,dad'sbuyingfastfood—itinvolveseverybody.”

Efforts MemorialHermannoperatestenHealthCentersforSchools,establishedin1996,offeringaccesstoprimarymedical,dentalandmentalhealthservicestounderservedchildrenat82schoolsintheGreaterHoustonArea.Researchshowsthatschool-basedhealthcentersincreaseeducationalsuccessbyprovidingmedicalandmentalhealthcarethatallowsstudentstostayinschoolandlearn.Theprimarygoaloftheprogramistokeepchildrenhealthyandfeelingwellsothattheystayinschoolandcanperformwellacademically,creatingafoundationforabrighterfuture.Byprovidingimprovedaccesstohealthcaretoat-riskchildrenacrosstheregion,MemorialHermannhasdemonstratedsuccessincreatinghealthieroutcomesforkids,includingimprovementsintheirphysicalhealth,theirmentalwellbeing,andeventheirattendancerateatschool.

Transportation

Secondary Data TransportationrosetothetopofthesecondarydatascoringresultsforBrazoria,FortBend,Harris,LibertyandMontgomerycountiesandwasthesecondhighest-rankingtopicforbothAustinandChamberscounties.Transportationwasthefourthhighest-rankingtopicforGalvestonandSanJacintocounties.AustinCountyhas4indicatorswithscoresgreaterthan2.BrazoriaandChamberscountieseachhave5indicatorsofconcern(includingsomedisparitiesinBrazoriaCounty).FortBendhas3indicatorswithscoresabove2.Thereare2transportationindicatorsofconcernforGalvestonCounty.HarrisCountyhas3indicatorsofconcern,includingSoloDriverswithaLongCommute,MeanTravelTimetoWork,andWorkerswhoWalktoWork(andsomedisparitiesrelatedtorace/ethnicityandage).LibertyCountyhas5indicatorswithscoresabove2anddisparitiesfor


certainrace/ethnicitygroups.MontgomeryCountyhas4indicatorsofconcern:WorkerswhoWalktoWork,MeanTravelTimetoWork,SoloDriverswithaLongCommute,andWorkerswhoDriveAlonetoWork.Thereare5indicatorsofconcernforSanJacintoCountyaswell.WorkersCommutingbyPublicTransportationisanindicatorofconcernforWalkerCounty,withanindicatorscoregreaterthan2.InWallerCounty,MeanTravelTimetoWorkandSoloDriverswithaLongCommuteareindicatorstoobserve.WhartonCountyhas3indicatorstonote:WorkerswhoWalktoWork,WorkerswhoDriveAlonetoWork,andWorkersCommutingbyPublicTransportation.

Primary Data ParticipantsraisedthetopicofTransportation59timesinrelationtobarriersorchallengestoachievinghealthinthecommunity–morethananyothertopic.KeyinformantsrepeatedlynotedthattheHoustonregionhassignificanttransportationissues(includingavailability,accessibility)thatimpactcommunitymembers’abilitytoaccesshealthprogramsandservices,andnotedthechallengesofresidentslivinginruralcounties.Inadditiontolimitedoptionsforpublictransportation,travelcostandtimewerebroughtup.Moreover,forcertainpopulations,likeolderadultsorpeoplewithdisabilities,publictransportationisnotafeasibleoption.“Thisremarkablespread-outcity,thesizeofMassachusetts,istheGreaterHoustonMetropolitanArea.(…)Thisisnotacityandasuburbanymore,it’sametropolitanregionwitheighttotencentersofactivitythatarelargerthandowntownSanDiego,spreadoutoverthismassivearea,butgettingfromoneplacetoanotherisanincreasingchallenge.Povertyalsomeansinadequatetransportation,wehavenoreallygoodtransitsystembecauseit’salmostimpossibletodevelopagoodtransitsystemforacitysolackingindensityandsospreadoutasHoustonis.Wehaven’tsolvedthatproblem,andalotofthehealthcareissuescomebecausepeople[are]withoutacartryingtogettoahospital,ortohealthcare…”“Houstonisreallyspreadout(…)anditcangofromcitytoruralveryquickly.Thefamiliesintheruralcommunitiesthatreallyarewithina20-mileradiusofthecity,soreallystillwithintheHoustonaddress,Ithinkthattransportationforthemisahugebarrier.That’satoughone,becauseHoustonissobig,anditcangoquicklytorural,veryquickly,andyourzipcodeisstillreflectingHouston.”“…weliveinaruralcommunityandthelackoftransportationtogetfromoneplacetoanotherisverydifficult.”“YouandIhavecars,butnoteverybodyhasacar,andthebussystemhereiscomplicatedsoifyouaretryingtogofromoneendoftowntothenext,itmighttakeyoutwoorthreebuses.Transportationcanbeanissue.”“Forsomeindividualsthatdon’thavetransportation,usuallyit’sahugechallenge.(…)wedopartnerwithColoradoValleyTransitAuthority,andtheycanprovidetransportationservices.Again,thechallengeismakingsurepeopleareevenawareofthat,thattheyknowabouttheprogram,thattheyknowwhotocalltoarrangethattransportation.”

Efforts MemorialHermannprovidesbusandtaxitokensasrequiredfordischargeandcontinuityofcareneeds.


OneMemorialHermannstrategicefforttonotonlyprovidetherightcareattherighttimeintherightplace,butalsoprovidetheopportunitytoaccesshelp/careviathetelephoneistheMemorialHermannNurseHealthLine.Establishedin2014,theNurseHealthLineisafreetelephoneserviceforGreaterHoustonresidentswhoareexperiencingahealthconcernandareunsureofwhattodoorwheretogo.Experienced,bilingualnursesusetheirtrainingandexpertisetoconductassessmentsbyphone,andareavailabletoanswercalls24hoursaday,sevendayaweekforanyresidentlivinginHarrisorsurroundingcounties.Theyhelpcallersdecidewhenandwheretogoformedicalcareandassistwithsocialservicereferralsandtransportationneeds.

Children’s Health

Secondary Data Children’sHealthwasthefifthhighest-rankingtopicinWhartonCounty’ssecondarydatascoringresults,butdidnotrankashighfortheothercountiesintheservicearea.InWhartonCounty,anindicatortonoteisChildFoodInsecurityRate.Whilethetopicwasnothigh-rankinginthesecondarydatascoringresultsformostcountiesintheservicearea,ChildFoodInsecurityRateisaconcerningindicatorforAustin,Liberty,SanJacinto,andWallercounties.

Primary Data WhendiscussingChildren’sHealth,keyinformantspointedoutspecificissuessuchaschildhoodobesity,accesstoservices,childcare,andbeinguninsured.Someparticipantsadvisedeffortstoengagechildren,familiesandcommunitiesmorecomprehensively.“AlotofpeoplewontgotoaFQHCtogettheirkidimmunizedbecauseit’sahugedoctorvisitthatrequiresalotofpaperworkandtime/effort.”“Texasranksverylowindollarsspentonhealthforchildren.Weranklowinourranking,generally,inchildren’shealth.We’renotputtingenoughmoneyandresourcesintoit.Ithinkweneedtoshiftourattentionand(…)givemoreattentiontochildren’shealthandhowimportantitisforearlychildhooddevelopmentandforbraindevelopmentandongoinghealthintherestoftheirlives.Iwouldsayputthatasapriority.Putchildren’shealthasapriority.Notjustsayingtheearlyyears,notjustsayingzerotofivebutalsothroughoutearlyadolescence,pre-adolescence,earlyadolescenceandintotheteens.”

Efforts Children'sMemorialHermannHospital,licensedunderMemorialHermannTexasMedicalCenter,wasfoundedin1986andistheprimaryteachinghospitalforthepediatricandobstetrics/gynecologyprogramsatTheUniversityofTexasMedicalSchoolatHouston.Children'sMemorialHermannofferscareinmorethanthirtypediatricandwomen'srelatedspecialtiesincludingthelatestadvancesinmaternal-fetalmedicineandneonatalcriticalcareservices,andrenownedprogramsinpediatrictrauma,neurosciences,pulmonologyandcardiaccare.Morethan37,000childrencometoChildren'sMemorialHermannHospitaleachyear.InadditiontoMemorialHermann’sschool-basedhealtheffortsdescribedabove,MemorialHermannisanon-goingfinancialcollaboratorwithChildrenatRisk,a501non-profit


organizationthatdriveschangeforchildrenthroughresearch,education,andinfluencingpublicpolicy.

Economy

Secondary Data Economywasthehighest-rankingtopicforWalkerCounty;thereare9concerningindicatorsforWalkerCounty,includingseveralwithhighdisparities.Economywasalsothefifthhighest-rankingtopicforWallerCounty,whichhas11indicatorswithscoresgreaterthan2andhighdisparitiesexistingforthemeasurePeopleLivingBelowPovertyLevel.AlthoughEconomydidnotrankashighforothercountiesintheservicearea,thereareindicatorstonote.Thereare5indicatorsequaltoorgreaterthan2inAustinandBrazoriacounties(withdisparitiesforChildrenLivingBelowPovertyLevelinAustinCounty).ChambersCountyhas4indicatorswithscoresabove2,includingPeople65+LivingBelowPovertyLevel(andadisparityforHispanicorLatinoresidents).FortBendhas3economicindicatorsofconcern.BothGalvestonandHarriscountieshave8concerningindicatorsrelatedtoEconomy;moreover,inHarrisCountyrace/ethnicitydisparitiesexistforFamiliesLivingBelowPovertyLevel.Thereare8indicatorswithscoresabove2forLibertyCounty.MontgomeryCountyhas4indicatorstonote(withscoresequaltoorgreaterthan2).SanJacintohas11indicatorswithscoresgreaterthan2andtherearedisparitiesforcertainrace/ethnicitygroups.WhartonCountyhas5economicindicatorswithscoresgreaterthan2.

Primary Data Keyinformantsdiscussedfoodinsecurityandfooddesertsasfactorsrelatedtopoorhealthoutcomes.Theypointedoutthat,althoughindividualsmightunderstandthateatinghealthyfoodsisrecommended,theymaynothaveaccesstogrocerystoresorbeabletoaffordhealthierfoodoptions.Keyinformantsnotedtheimportanceofaddressingsocioeconomicbarrierstoimprovehealthandwellbeing.OneparticipantnotedthatwhilemanyresidentscommutetoHoustonforemployment,someopportunitiesareemergingwithlargeremployersalongUS-290andInterstate-10freeways.ExistingprogramsandservicesforuninsuredandpoorcommunitymemberswerementionedalongwitheventssuchastheAnnualPovertySummit.“(…)That’samatterofmoney.Youcaneducate[a]womanalldaylong,butifshe’sgotacoupleofkidstofeedandshecanfeedthemallforsevendollarsasopposedto25,she’sgoingtogotoMcDonald’s.”“Ithinkinsomeofthelowerincomeneighborhoods,theoptionsforbuyingfoodarelimitedanddonotofferalotofhealthychoices,andthatalotoftimehealthierfoodcostsmore.Andsotheabilitytoeasilygetandaffordhealthyfood,whetheryou’reeatingathomeoreatingout,arejustmorelimitedforsomepeopleandinsomeneighborhoods…”

Efforts It’sadauntingtaskinaregionlikeGreaterHouston,whichhasanestimated7millionpeopleandoneofthehighestratesofuninsuredandunderinsuredinthecountry.ButMemorialHermannbelievesthatwecanONLYimpactthehealthofourcommunity,andthehealthof


individuals,byfocusingonthemultipledeterminantsofhealththatplaythegreatestroleininfluencingaperson’soverallhealthandwellbeing.


Other Findings Criticalcomponentsinassessingtheneedsofacommunityareidentifyingbarriersanddisparitiesinhealthcare.Theidentificationofbarriersanddisparitieshelpsinformandfocusstrategiesforaddressingprioritizedhealthneeds.ThefollowingsectionoutlinesbarriersacrossMemorialHermannHealthSystemanddisparitiesastheypertaintoMHTMC’sservicearea.

Barriers to Care Communityinputrevealedawiderangeofbarrierstocareandwellbeing.Asdiscussedintheprevioussection,transportationwasthemostfrequentlycitedbarrierinthecommunity,followedbyotherbarrierssuchasaccesstohealthservices,healthyfoodandexerciseoptions,lowincome,andfoodinsecurity.Overall,thesecondaryandprimarydataconfirmedthatsocioeconomicfactorsimpactcommunitymembers’abilitytoachievegoodhealth.“Manythingscomebacktopovertyandlackofdisposableincome.”Keyinformantsdescribedtheinfluenceofsocialdeterminantsofhealth(includingincome,poverty,language,education,employment)onhealthoutcomes.Participantsdiscussedtheimportanceofaddressingsocialandeconomicfactorstogetattherootcausesofpoorhealthandwellbeing.“Ithinkyouhavetounderstandthatalotoffolksworkfrompaychecktopaycheck,soiftheyactuallyendupatoneofthesemedicalcentersandtheyrequireathirtydollarcopayortendollarsorfifteendollars,thenthey’renotgoingtohaveit.So,they’regoingtowalkawayuntiltheydohavethatmoneyandthatcouldbemonthslater.So,iftheyaresick,they’rejustgoingtobecomesicker.So,that’soneofthebigbarriers.”

Disparit ies Significantcommunityhealthdisparitiesareassessedinboththeprimaryandsecondarydatacollectionprocesses.ThefollowingtablesidentifythenumberofsecondarydatahealthindicatorswithahealthdisparityforMHTMC’sservicearea.SeeAppendixBforthespecificindicatorswithsignificantdisparities.

Table35.NumberofHealthDisparitiesIdentifiedinSecondaryDataAnalysis(Austin,Brazoria,Chambers,FortBend)

AustinCounty BrazoriaCounty ChambersCounty FortBendCountyHispanicorLatino(6)BlackorAfricanAmerican(4)OtherRace(4)

HispanicorLatino(6)OtherRace(6)

HispanicorLatino(4)AmericanIndianorAlaskaNative(3)OtherRace(3)

HispanicorLatino(7)OtherRace(7)BlackorAfricanAmerican(6)White(4)

Male(1) Male(5) N/A Male(5)<6yearsofage(1)65+yearsofage(1)

65+yearsofage(2) 6-11yearsofage(1) 65+yearsofage(2)


Table36.NumberofHealthDisparitiesIdentifiedinSecondaryDataAnalysis(Galveston,Harris,Liberty,Montgomery)

Table37.NumberofHealthDisparitiesIdentifiedinSecondaryDataAnalysis(SanJacinto,Walker,Waller,Wharton)

GeographicdisparitieswereidentifiedusingtheSocioNeedsIndex.AsshownearlierinFigure21,thereisawiderangeinSocioNeedsIndexvaluesacrossthe12countieswithinMHTMC’sservicearea.FortBendCountyhasthelowestSocioNeedsIndexvalue(2.8)andWhartonCountyhasthehighestvalue(75.7).TwocountieshaveSocioNeedsIndexvaluesbelow10(FortBendandMontgomerycounties)andfivecountieshavevaluesabove50(Harris,Waller,SanJacinto,Liberty,andWhartoncounties).Figure22displayedthetenzipcodeswiththehighestsocioeconomicneed:77011,77060,77093,77020,77039,77076,77036,77026,77037,and77506(allwithinHarrisCounty).

GalvestonCounty HarrisCounty LibertyCounty MontgomeryCountyBlackorAfricanAmerican(12)OtherRace(6)HispanicorLatino(5)

BlackorAfricanAmerican(13)White(8)HispanicorLatino(8)OtherRace(7)AmericanIndianorAlaskaNative(6)

HispanicorLatino(5) OtherRace(8)BlackorAfricanAmerican(6)HispanicorLatino(6)AmericanIndianorAlaskaNative(3)TwoorMoreRaces(3)

Male(5) Male(10)Female(3)

Male(4) Male(5)

60-64yearsofage(2)65+yearsofage(2)

<6yearsofage(2)25-44yearsofage(2)45-64yearsofage(2)65+yearsofage(2)

45-54yearsofage(1) <6yearsofage(1)65+yearsofage(1)

SanJacintoCounty WalkerCounty WallerCounty WhartonCountyAsian(5)HispanicorLatino(3)BlackorAfricanAmerican(2)

BlackorAfricanAmerican(7)OtherRace(3)

BlackorAfricanAmerican(6)OtherRace(3)HispanicorLatino(3)

BlackorAfricanAmerican(7)OtherRace(4)

N/A N/A N/A N/A18-24yearsofage(1)45-54yearsofage(1)

55-59yearsofage(2) 60-64yearsofage(2) <6yearsofage(1)6-11yearsofage(1)65+yearsofage(1)


Conclusion TheCommunityHealthNeedsAssessmentforMHTMCutilizedacomprehensivesetofsecondarydataindicatorstomeasurethehealthandqualityoflifeneedsforMHTMC’sservicearea.Furthermore,thisassessmentwasinformedbyinputfromknowledgeableanddiverseindividualsrepresentingthebroadinterestsofthecommunity.MemorialHermann’ssystem-wideprioritizationprocessresultedinfourfocusareasorpillars:AccesstoHealthcare,EmotionalWell-Being,FoodasHealth,andExerciseIsMedicine.MHTMCwillreviewtheseprioritiesmorecloselyduringtheImplementationStrategydevelopmentprocessanddesignaplanforaddressingthesepillarsmovingforward.Inaddition,MHTMCinvitesyourfeedbackonthisCHNAreporttohelpinformthenextCommunityHealthNeedsAssessmentprocess.Ifyouhaveanyfeedbackorremarks,pleasesendthemto:[email protected].


Appendix

Appendix A: Evaluation Since Prior CHNA

Appendix B. Secondary Data Methodology

Secondary Data Sources

Secondary Data Scoring

Data Scoring Results

Appendix C. Primary Data Methodology

Community Input Participants

Key Informant Interview Questionnaire (Episcopal Health Foundation)

Key Informant Interview Questionnaire (Conduent Healthy Communities Institute)

Community Survey (English)

Community Survey (Spanish)

Appendix D. Priorit ization Tool

Priorit ization Survey

Appendix E. Community Resources


AppendixA.MHTMCImpactReport

EvaluationSincePriorCHNAPriority1:HealthyLiving

Priority1: HealthyLiving

Goal1:Providecommunitymemberswiththenecessaryinformationandresourcestomakeinformedchoicesforsustainedhealthyliving.

EarlyDetectionandScreeningObjective1.1: Decreasemortalityinthecommunity,especiallyforvulnerablepopulations,throughprevention,earlydetectionandscreeningofkeyrisk

factorsOutcomeIndicators:

AnnualBaselineYear1 Year2 FY2020

Target• Totalnumberofcommunitymemberseducatedthroughprograms 5,308 8,847 4641 5,838• Numberoffreechildsafetyseatsdistributed 100 81 74 150




• NumberofEmergencyRoom(ER)patientsscreenedfor(HepatitisCandHumanImmunodeficiencyVirus(HepCandHIV) 5,354

7982-HIV5,510–HEPC

WedoperformroutinescreeningforHIVintheEDforpatientsaged18-65whoareabletooptout.Were-startedtheprograminlate2017.2017tested=2366Jan2018-May2018=2411Total:4777WepreviouslyperformedHCVscreeningthroughagrantfromGileadPharmaceuticalsbutnotatthistime.

5,621




• Percentofpatientstestedfor(HepCandHIV)referredfortherapy 1.68%

100%ofpatientstestedforHepCandHIVreferred

fortherapy

Percentagesarecalculatedusingtotalpositives,nottotaltestsdonesincethatwouldleadtoverysmallpercentagesandwedon’trefernegativeresultstotherapy.21.1%HIVpatientsreferredtotherapy63.2%HIVpatientsfoundtoalreadybeincareandreceivingtherapy84.3%HIVpatientsintotalreceivingtherapyfordiagnosis.15.7%HIVpatientsnotreceivinganyformoftherapy

1.68%




• Numberofresearchstudiesrelatedtoprevention,earlydetection,orscreening 26 48 45 29• Numberofstudysubjectsenrolled 1,798 Noactivestudies 156 1,977

Strategies:Year1Notes Year2Notes Timeline:

Year1,2,31.1.1: ImplementLiveYourDREAMS,amulti-level,varyingintensityapproach,injurypreventionprogramto

includecommunity,classroomandhospital-basededucationandtraining.Collaborationwithcommunitypartnersre:trafficsafety(GraduatedDriversLicensing,increaseseatbeltuse,reduceimpairedanddistracteddrivingamongteens)

1,2,3

1.1.2: Coordinatechildsafetyseatdistributionandeducationprogramforlowincomefamilies 1,2,31.1.3: ProvideinfantsafetycurriculumtoUniversityofTexas(UT)SchoolofNursingstudentsintheNewborn

andNewParentCareprogramtoeducatepregnantandparentingteenstoincreasepreventativebehaviors(topicsinclude:Safesleep,watersafety,childpassengersafety,PeriodofPurpleshakenbabysyndrome/braintrauma,crying,postpartumdepression,nutrition,etc.)

SchoolofNursingrequest

toredirectprogram

2,3

1.1.4: TestERpatientsforHIVandHEPCforearlyidentificationandimmediatetreatment 1,2,31.1.5: Continueeducationandoutreachrelatedtostrokepreventionandearlydetectionbyconductingthe

following:• monthlyStrokeSupportGroup• highlightStrokeMonthinMayeveryyear-educatingemployeesandpatientsonhowtoquicklyidentifyandrespondtostroke

• createanddistributeStrokePreventionBrochures;• providefinancialsupporttoStompOutStroke(acommunityeventfocusedonstrokeeducation,screening,andprevention)

• hosthealthycookingclasses,freetothecommunity,topromotebrainhealth(withMonicaPopeandFoodasMedicine)

• HostYatsuDay–aStrokeContinuingMedicalEducationeventforhealthcareproviders

1,2,3

1.1.6: Continuetosupportresearchactivitiestodecreasemortalitythroughprevention,earlydetection,andscreeningofkeyriskfactors

1,2,3

Monitoring/EvaluationApproach:• Participationlistsforeducationprograms• Rosterandreleasedsignedforcarseats• Releasefromparentsonhelmetdistribution/inventorylevels• Clinicalresearchdatabase• DocumentationthroughHepCandHIVgrantprogram.




PotentialPartners:• TexasDepartmentofTransportation,DepartmentofStateHealthServices(DSHS)• ChildFatalityReviewTeam,ChildrenatRisk• Localhighschools• SouthEastTexasRegionalAdvisoryCouncil(SETRAC),Governor’sEMS&TraumaAdvisoryCouncil(GETAC• SafeKidsGreaterHouston• UTSchoolofNursing• CommunitypartnersforTrafficSafety(WatchURBAC,HoustonFireDepartment(HFD),DepartmentofPublicSafety(DPS),

Krysta’sKaringAngels,MothersAgainstDrunkDriving(MADD),StateFarm,etc.)


ObesityPreventionObjective1.2: SupporteffortsoflocalcommunitypartnersinpreventingorreducingobesityinadultsandchildrenOutcomeIndicators:

AnnualBaseline Year1 Year2 FY2020Target

• Numberofeventssupported 0 PlannedforFY19 2


Year1,2,31.2.1: Providefinancialsupportand/orstaffingforeventshostedbycommunitypartnersthatprovide

educationandoutreachinreducingorpreventingobesityPlannedforFY19 PlannedforFY19 2,3

Monitoring/EvaluationApproach:• Feedbackfromcommunitypartners

PotentialPartners:• ChildrenatRisk• HoustonFoodBank• UnitedStatesDepartmentofAgriculture(USDA)• CentersofDiseaseControl(CDC)• TexasDepartmentofAgriculture• TexasMedicaid/Children’sHealthInsuranceProgram(CHIP)programs


AccesstoHealthyFoodObjective1.3: SupporteffortsofMHsystemandlocalcommunitypartnersinimprovingthecommunity’saccesstohealthyfoodOutcomeIndicators: AnnualBaseline Year1 Year1 FY2020Target

• NumberofERpatientsscreenedforfoodinsecurityviatheERNavigationprogram

1,881 3081 2524 1,881

• Numberofcommunityhealthworker(CHW)referralstocommunityfoodpantriesviatheERNavigationprogram

189 524 792 189

• NumberofERNavigationprogramsupportedcommunityeventshostedbylocalpartners

0(tobedeterminedinY1)

0 20 2


Year1,2,31.3.1: ContinuetoparticipateintheMHERNavigationprograminwhichparticipantsarescreenedforfood

insecurityandreferredtofoodpantriesifnecessary(See2.4.2) 1,2,3

1.3.2: Collectfoodtosupportfoodpantriesorspecialeventshostedbycommunitypartners. Specialeventsassociatedwithfoodpantriesprovidedatthesystemlevel

FoodDrivediscontinued

1,2,3

Monitoring/EvaluationApproach:• PatientactivitydocumentedandreportedwithintheERNavigationelectronicrecordsystem• Recordofeventsattended

PotentialPartners:• HoustonFoodBank• UnitedWay• GreaterGraceOutreachChurch• GulfCoastCommunityServicesAssociation,Inc.• InterfaithMinistries• LeonelCastilloCommunityCenter• DePelchinChildren’sServices• MemorialHermannCommunityBenefitProgram


Timefor/SafetyDuringPhysicalActivityObjective1.4: Increaseeducationandresources/toolstopromotesafetyduringphysicalactivityOutcomeIndicators:


• Totalnumberofcommunitymemberseducatedthroughprograms 1,180 625 PlannedforFY19 1,298


Year1,2,31.4.1: Providecommunityeducationoutreachtoelementarygradestudentshighlightingbicyclehelmetsafety.

Hostannualeventre:injurypreventionforelementarygradestudents Programdidnot

occurduetolackoffunding

2,3

1.4.2: ProvideeducationonsafetyandpreventiontopicstoBoyScoutsaspartofearningtheirsafetymeritbadge

PlannedforYearFY19

PlannedforYearFY19

2,3

1.4.3: Providecommunityeducationoutreachandtrainingprogramforparentsonwatersportssafety,heat,andproperhydration

PlannedforFY19 PlannedforYearFY19

2,3

1.4.4: Provideexerciseinstructionworkshopsforteensatlocalhighschools PlannedforFY19 PlannedforYearFY19 2,3

Monitoring/EvaluationApproach:• Signedreleasesforhelmets• Attendancerosters

PotentialPartners:• BoyScoutsofAmerica• Houston-GalvestonAreaCouncil(H-GAC)• GreaterHoustonOffRoadBikingAssociation• YMCAofHouston,HarrisCountyAquaticProgram• TexasDrowningAlliance,USASwimmingfoundation• HoustonIndependentPoolandSpaAssociation


ChronicDiseaseManagementObjective1.5: Connectcommunitymemberstoappropriateresourcesandcaresettingstofacilitatechronicdiseasemanagement.OutcomeIndicators:


• Numberofhospital'sassociatedcounties'callstoNurseHealthLine(Brazoria,FortBend,Harris,Liberty,andMatagorda) 32,698 32,907 34,459 32,698

• 30-dayall-causereadmissionrate(excludingtraumapatients) 6.70% 6.65 6.08% 5%Strategies: Year1Notes Year2Notes Timeline:

Year1,2,31.5.1: Providea24/7freeresourceviatheNurseHealthLinethatcommunitymembers(uninsuredandinsured)

withintheMemorialHermannHealthSystem(MHHS)communitycancalltodiscusstheirhealthconcerns,receiverecommendationsontheappropriatesettingforcare,andgetconnectedtoappropriateresources(See2.1.1and2.4.1)

1,2,3

Monitoring/EvaluationApproach:• ReportfromtheNurseHealthLineinTMCcommunity• Hospitalreadmissiondatafromcostaccountingsystem

PotentialPartners:• MemorialHermannCareManagement• MemorialHermannCommunityBenefitCorporation


Priority2:AccesstoHealthCare

Priority2: HealthCareAccess

Goal2:Improvehealthcareaccesstoprovidebetterhealthoutcomes.

AvailabilityofPrimaryCareandSpecialtyProvidersObjective2.1: EnsureavailabilityofprimarycareandspecialtyproviderstomaintainLevelOneTraumaCenterstatusOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target

• Numberofhospital'sassociatedcounties'callstoNurseHealthLine(Brazoria,FortBend,Harris,Liberty,andMatagorda) 32,698

32,907 34,45932,698

• Percentageofinpatientandobservationpatientsdischargedbyhospitalistservice

13.5% 13.35% 7.7% 15%

• Numberoftraumadiverthours 223 34hours 14.5hours 200• Numberoftransferdenialsduetocapacitybecauseservicesnotavailable 105 88 194 84


Year1,2,32.1.1: Providea24/7freeresourceviatheNurseHealthLinethatcommunitymembers(uninsuredand

insured)withintheMHHScommunitycancalltodiscusstheirhealthconcerns,receiverecommendationsontheappropriatesettingforcare,andgetconnectedtoappropriateresources(See1.5.1and2.4.1)

1,2,3

2.1.2: PartnerwithMemorialHermannMedicalGroup(MHMG)toincreasethenumberofprimarycarephysiciansintheregionaffiliatedwithMHHS.Includessuccessionplanningandplacementtofillvacanciesbasedonvolume/openings.

12candidateswereinterviewedandplacedaroundtheTMCmarketin

FY17

1


Priority2: HealthCareAccess

Goal2:Improvehealthcareaccesstoprovidebetterhealthoutcomes.

2.1.3: MaintainagreementswithUTandotherprivatepracticephysicianstoensureadequatenumberofspecialtyprovidersrelatedtoLevelItraumastatusservingunderanduninsuredpopulations

WerenewedtheFY17Annual

FundingAgreement(AFA)toensurepropersupporttoUniversityofTexasforourTraumaProgram.We’ve

continuedtommetandmaintaintheguidelinesofthe

AmericanCollegeofSurgeonsforourLevel1TraumaDesignation

WerenewedtheFY17Annual

FundingAgreement(AFA)toensurepropersupporttoUniversityofTexasforourTraumaProgram.We’vecontinuedtomeetandmaintaintheguidelinesofthe

AmericanCollegeofSurgeonsforourLevel1TraumaDesignation

1

Monitoring/EvaluationApproach:• Hospitalfinancialaccountingbydischargingphysician• Traumadatabaseofdiversionhours• SystemTransferCenter• Alegis

PotentialPartners:• UniversityofTexasHealthScienceCenteratHouston• MemorialHermannMedicalGroup


HealthInsuranceCoverageandCostsObjective2.2: Educatepatientsaboutand/orhelpthemtoacquirehealthcareinsurancetoensureneedsareaddressed,coverageiscontinuous,and

benefitsareoptimizedOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target

• NumberofClassDPrescriptionsprovidedtotheLamarandAliefSchoolBasedHealthCenters

1,324 1141 1065 1,324

• Numberoflengthofstayoutliers(outliers-overthetotalchargethresholddefinedbyMedicare) 1,704

3,500forallTMC,1896foradult,753forchildren

3,627forallTMC,1122forchildren,58fortranscare

1,534

• 30-dayall-causereadmissionrate(excludingtraumapatients) 6.70% 8.9% 10.4% 5%• Numberofcaseconversionsfromunfundedtofunded 5,600 3,981 3154 6,160

Strategies: Timeline:Year1,2,3

2.2.1: ProvideClassDPrescriptionstotheLamarandAliefSchoolBasedHealthCentersinsupportofprimarymedicalcareprovidedtouninsuredchildrenandteensatnocost 1,2,3

2.2.2: Financialcounselingteamworkswithinpatientsregardingoptionsre:HealthExchange,COBRA,CountyIndigent,CrimeVictim;alsohaveonsiteMedicaidworkersandfacilitateMedicaidapplications 1

Monitoring/EvaluationApproach:• Patientexperiencescoresre:coordinationofcare• Percentageofpatientsclassifiedas“SelfPay”• Hospitalcasemanagementlengthofstayoutlierreport• Hospitalcasemanagementcaseconversionreport

PotentialPartners:• TexasDSHS• CentersofMedicare&MedicaidServices(CMS)• MemorialHermannCommunityBenefitCorporation


TransportationObjective2.3: Ensurepatientsaretransportedtothenextlevelofcareortotheirfinaldestinationinatimely,safe,andcost-effectiveamannerOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target

• Costofsubsidizedtransportation $597,000 $745,009 $887,434 $597,000


Year1,2,32.3.1: ParticipateinsystemrelationshipwithAmericanMedicalResponse(AMR)ambulancecompany

andYellowCabtotriagetransportationoptionsbasedonpatientneeds(insurancebenefitorsubsidizedbyTMC)

1,2,3

2.3.2: ProvideLifeFlightorotherplaneprogramsfreeofchargetotransportlongdistancepatients 1,2,32.3.3: ProvidebustokensforGreyhoundanddischargehome 1,2,3

Monitoring/EvaluationApproach:• CaseManagementnon-resourcefundcostcenter

PotentialPartners:• AMRAmbulance• YellowCab• GreyhoundBus


HealthCareNavigationObjective2.4.: ConnectuninsuredpatientswithoutaprimarycareproviderwhoaccesstheERforloweracuityconditionswithamedicalhomeOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target

• Numberofhospital'sassociatedcounties'callstoNurseHealthLine(Brazoria,FortBend,Harris,Liberty,andMatagorda)

32,698 32,907 34,459 32,698

• NumberofpatientsenrolledintheERNavigationProgram 2063 2929 2337 2063• NumberofERNavigationpatientencounters 4275 7784 6343 4275• NumberofERNavigationreferralstocommunityresources 3426 5605 4856 3426• NumberofERNavigationscheduledappointments 380 292 171 380

Strategies: Year1Notes Year2Notes Timeline:Year1,2,3

2.4.1: Providea24/7freeresourceviatheNurseHealthLinethatcommunitymembers(uninsuredandinsured)withintheMHHScommunitycancalltodiscusstheirhealthconcerns,receiverecommendationsontheappropriatesettingforcare,andgetconnectedtoappropriateresources(See1.5.1and2.1.1)

1,2,3

2.4.2 ContinuetoparticipateintheMHERNavigationprograminwhichpatientsarereferredtoamedicalhome(See1.3.1)

1,2,3

Monitoring/EvaluationApproach:• PatientactivitydocumentedandreportedwithintheERNavigationelectronicrecordsystem

PotentialPartners:• MemorialHermannCommunityBenefitCorporation• MemorialHermannCareManagement• CentralCareCommunityHealthCenter• LegacyCommunityHealthCenter• MemorialHermannCommunityBenefitCorporation


Priority3:BehavioralHealthThefollowingtablesprovidestrategiesandoutcomeindicatorsthatreflectanMHHSsystem-wideapproachtoBehavioralHealth.DataisnotspecifictoMHTexasMedicalCenterbuttothecommunityatlargewiththeexceptionofreductioninERencountersthatresultinapsychiatricinpatientstaythroughlinkageswithanetworkofbehavioralpartners.

Priority3: BehavioralHealth

Goal3: Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.

Objective3.1: Createnontraditionalaccesspointsaroundthecommunity(crisis/ambulatory,acutecare,andcommunity-basedchroniccaremanagement),andlinkthosewhoneedservicestopermanentprovidersandresourcesinthecommunity

OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target• DecreaseinnumberofERencountersthatresultinpsychiatricinpatient

stay1146 1,213 1,135 1089

5%reductionofbaseline

• DecreaseinnumberofERencountersthatresultinpsychiatricinpatientstay-Children’s

30 19 18 29

• DecreaseinnumberofERencountersthatresultinpsychiatricinpatientstay-Hermann

173 180 115 164

• NumberofMemorialHermannCrisisClinic(MHCC)totalvisits 5,400 5,590 5,154 5%overbaseline• NumberofPsychiatricResponseCareManagementtotalvisits 1,200 1,103 1,259 5%overbaseline


Year1,2,33.1.1: Providementalhealthassessment,care,andlinkagetoservicesinanacutecaresetting,24x7

atChildren’sandHermannAnuptickinacutecarevolumeoverthepastfiscalyearhascontributedtoahighernumberofpsychiatrictransfersoverall.

Anincreaseinacutecarevolumeandnumberofacutecaresitesoverthepastfiscalyearhavecontributedtoahighernumberof

psychiatrictransfersoverall.

1,2,3




3.1.2: Createnontraditionalcommunityaccesstopsychiatricprovidersforindividualsexperiencingamentalhealthcrisis.ClinicalSocialWorkersconnectthetargetpopulationtoon-goingbehavioralhealthcare

Recruitingmentalhealthproviders

willingtocommittoanon-traditionalscheduleremainsachallenge.Continuingthisurgentcaremodeloftreatmentremainsapriority,duetolimitedmentalhealth

treatmentaccessinthecommunity

1,2,3

3.1.3: Engageindividualswithachronicmentalillnessandworktomaintainengagementwithtreatmentandstabilityinthecommunityviaenrollmentincommunity-basedmentalhealthcasemanagementprogram

Staffingissuesimpededyearonetarget.Identifyingappropriatelylicensedclinicianswillingtoconsideracareerthatiscommunitybasedwiththerequirementofmakinghomevisitsandworkingnon–traditionalhoursisanongoingchallenge.

CaseManagerspartnerwiththeirclientstoidentifyspecificrecoverygoalsandutilizeevidence-basedpracticesto

facilitateclientachievement.Wecontinuetopartnerwithcommunity

providerstoaddressthementalhealth

needsoftheGreaterHoustonCommunity.

1,2,3

Monitoring/EvaluationApproach:• EMR/registrationsystem(trackandtrenddaily,weekly,monthly)

PotentialPartners:• Systemacutecarecampuses• MemorialHermanMedicalGroup• Networkofpublicandprivateproviders


Objective3.2: Reducestigmainordertopromotementalwellnessandimprovecommunityawarenessthatmentalhealthispartofphysicalhealthandoverallwell-being

OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target• Numberofpresentations/educationalsessionsforhealthcareprofessionals

withinMHHS50sessionsperyear 63 71 5%increaseover

baseline• Numberofpresentations/educationalsessionsforcorporations 5 7 8 5%overbaseline• TrainingonAcuteCareConcepts-systemnurseresidentprogram 15trainings

(45hourstotal/3hourseach)*

18

9 15trainings(45hourstotal/3hourseach)*

• TrainingonChiefMedicalOfficer(CMO)Roundtable-system-wide 1training(2hours)* 0 4 1training(2hours)**Totaltimeincludestrainingmaterialdevelopmentandimplementation 531.6


Year1,2,33.2.1: ProvidementalhealtheducationsessionswithintheMHhealthsystemfornursesand

physicians 1,2,3

3.2.2: WorkwithemployersolutionsgrouptoprovideeducationandtrainingwithcorporationsonMHtopics(stress,post-traumaticstressdisorder)

1,2,3

Monitoring/EvaluationApproach:• Requestsforpresentationsandsessionstrackedviacalendar/excel

PotentialPartners:• Systemacutecarecampuses• SystemMarketingandCommunications• Employersolutionsgroup


Objective3.3: Qualityofmentalhealthandsubstanceabuseservices:access,link,andpracticeutilizingevidence-basedpracticetopromoteoverallwellness

OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target• NumberofMemorialHermannCrisisClinicfollow-upspostdischargewith

clinicpatients7,716 6,431 5,154 5%overbaseline

• PsychiatricResponseCaseManagementreductioninsystemERutilization 54.4% 53.0% 50% 5%increaseoverbaseline


Year1,2,33.3.1: Socialworkersfollow-upwithdischargedpatientsandtheirfamiliestoassesswell-being

andconnectthemtocommunityresourcesThegoalistocontinuetoeducatethecommunity,includingotherhealthsystems,aboutthecrisiscliniclevelofcaresothatwhensomeoneisexperiencingamentalhealthcrisisorneedsimmediateaccesstoabehavioralhealthprovider,theclinicwillbetheidentifiedreferralsource.

TheSystemhasseenanoverallincreaseinpatientacuitywithcomplexphysicaland

behavioralhealthneedsrequiringhigherlevelsofcare.TheCrisisClinicandPsychResponseCaseManagement

Programscontinuetomeettheneedsofpatientswithbehavioralhealthconditionsbyproviding

immediateaccesstoamentalhealth

provider.

1,2,3




3.3.2: PsychiatricResponseCaseManagementProgramutilizesevidence-basedpracticeinterventions(motivationalinterviewing,MHFirstAid,CAMS,etc.)toreduceERutilizationforprogramenrollees

CaseManagerscontinuetopartnerwithcommunity

agenciesinanefforttoconnectprogram

enrolleestoresourcesfor

ongoingwellness.Programclinicianscontinuetouseevidence-based

practiceinterventionsto

reduceERutilizationandimprovequality

oflife.

1,2,3

Monitoring/EvaluationApproach:• Socialworklogs(Excelspreadsheet)

PotentialPartners:• Systemacutecarecampuses• Community-basedclinicalproviders• Networkofpublicandprivateproviders

MemorialHermann–TexasMedicalCenterCHNA2019 106

Appendix B. Secondary Data Methodology

Secondary Data Sources Themainsourceforthesecondarydata,ordatathathavebeenpreviouslycollected,isthecommunityindicatordatabasemaintainedbyConduentHealthyCommunitiesInstitute.ThefollowingisalistofbothlocalandnationalsourcesusedinMemorialHermann-TexasMedicalCenter’sCommunityHealthNeedsAssessment.

Austin County 1. AmericanCommunitySurvey2. CentersforMedicare&MedicaidServices3. CountyHealthRankings4. FeedingAmerica5. InstituteforHealthMetricsandEvaluation6. NationalCancerInstitute7. NationalCenterforEducationStatistics8. SmallAreaHealthInsuranceEstimates9. TexasDepartmentofFamilyandProtectiveServices10. TexasDepartmentofStateHealthServices11. TexasEducationAgency12. TexasSecretaryofState13. U.S.BureauofLaborStatistics14. U.S.Census-CountyBusinessPatterns15. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas16. U.S.EnvironmentalProtectionAgency

Brazoria County 1. AmericanCommunitySurvey2. AmericanLungAssociation3. CentersforMedicare&MedicaidServices4. CountyHealthRankings5. FeedingAmerica6. InstituteforHealthMetricsandEvaluation7. NationalCancerInstitute8. NationalCenterforEducationStatistics9. SmallAreaHealthInsuranceEstimates10. TexasDepartmentofFamilyandProtectiveServices11. TexasDepartmentofStateHealthServices12. TexasEducationAgency13. TexasSecretaryofState14. U.S.BureauofLaborStatistics15. U.S.Census-CountyBusinessPatterns16. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas


17. U.S.EnvironmentalProtectionAgency

Chambers County 1. AmericanCommunitySurvey2. CentersforMedicare&MedicaidServices3. CountyHealthRankings4. FeedingAmerica5. InstituteforHealthMetricsandEvaluation6. NationalCancerInstitute7. NationalCenterforEducationStatistics8. SmallAreaHealthInsuranceEstimates9. TexasDepartmentofFamilyandProtectiveServices10. TexasDepartmentofStateHealthServices11. TexasEducationAgency12. TexasSecretaryofState13. U.S.BureauofLaborStatistics14. U.S.Census-CountyBusinessPatterns15. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas16. U.S.EnvironmentalProtectionAgency

Fort Bend County 1. AmericanCommunitySurvey2. CentersforMedicare&MedicaidServices3. CountyHealthRankings4. FeedingAmerica5. InstituteforHealthMetricsandEvaluation6. NationalCancerInstitute7. NationalCenterforEducationStatistics8. SmallAreaHealthInsuranceEstimates9. TexasDepartmentofFamilyandProtectiveServices10. TexasDepartmentofStateHealthServices11. TexasEducationAgency12. TexasSecretaryofState13. U.S.BureauofLaborStatistics14. U.S.Census-CountyBusinessPatterns15. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas16. U.S.EnvironmentalProtectionAgency

Galveston County 1. AmericanCommunitySurvey2. AmericanLungAssociation3. CentersforMedicare&MedicaidServices4. CountyHealthRankings5. FeedingAmerica6. InstituteforHealthMetricsandEvaluation


7. NationalCancerInstitute8. NationalCenterforEducationStatistics9. SmallAreaHealthInsuranceEstimates10. TexasDepartmentofFamilyandProtectiveServices11. TexasDepartmentofStateHealthServices12. TexasEducationAgency13. TexasSecretaryofState14. U.S.BureauofLaborStatistics15. U.S.Census-CountyBusinessPatterns16. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas17. U.S.EnvironmentalProtectionAgency

Harris County 1. AmericanCommunitySurvey2. AmericanLungAssociation3. CentersforMedicare&MedicaidServices4. CountyHealthRankings5. FeedingAmerica6. InstituteforHealthMetricsandEvaluation7. NationalCancerInstitute8. NationalCenterforEducationStatistics9. SmallAreaHealthInsuranceEstimates10. TexasBehavioralRiskFactorSurveillanceSystem11. TexasDepartmentofFamilyandProtectiveServices12. TexasDepartmentofStateHealthServices13. TexasEducationAgency14. TexasSecretaryofState15. U.S.BureauofLaborStatistics16. U.S.Census-CountyBusinessPatterns17. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas18. U.S.EnvironmentalProtectionAgency

Liberty County 1. AmericanCommunitySurvey2. CentersforMedicare&MedicaidServices3. CountyHealthRankings4. FeedingAmerica5. InstituteforHealthMetricsandEvaluation6. NationalCancerInstitute7. NationalCenterforEducationStatistics8. SmallAreaHealthInsuranceEstimates9. TexasDepartmentofFamilyandProtectiveServices10. TexasDepartmentofStateHealthServices11. TexasEducationAgency


12. TexasSecretaryofState13. U.S.BureauofLaborStatistics14. U.S.Census-CountyBusinessPatterns15. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas16. U.S.EnvironmentalProtectionAgency

Montgomery County 1. AmericanCommunitySurvey2. AmericanLungAssociation3. CentersforMedicare&MedicaidServices4. CountyHealthRankings5. FeedingAmerica6. InstituteforHealthMetricsandEvaluation7. NationalCancerInstitute8. NationalCenterforEducationStatistics9. SmallAreaHealthInsuranceEstimates10. TexasDepartmentofFamilyandProtectiveServices11. TexasDepartmentofStateHealthServices12. TexasEducationAgency13. TexasSecretaryofState14. U.S.BureauofLaborStatistics15. U.S.Census-CountyBusinessPatterns16. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas17. U.S.EnvironmentalProtectionAgency

San Jacinto County 1. CentersforMedicare&MedicaidServices2. AmericanCommunitySurvey3. CountyHealthRankings4. FeedingAmerica5. InstituteforHealthMetricsandEvaluation6. NationalCancerInstitute7. NationalCenterforEducationStatistics8. SmallAreaHealthInsuranceEstimates9. TexasDepartmentofFamilyandProtectiveServices10. TexasDepartmentofStateHealthServices11. TexasEducationAgency12. TexasSecretaryofState13. U.S.BureauofLaborStatistics14. U.S.Census-CountyBusinessPatterns15. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas

Walker County 1. AmericanCommunitySurvey2. CentersforMedicare&MedicaidServices


3. CountyHealthRankings4. FeedingAmerica5. InstituteforHealthMetricsandEvaluation6. NationalCancerInstitute7. NationalCenterforEducationStatistics8. SmallAreaHealthInsuranceEstimates9. TexasDepartmentofFamilyandProtectiveServices10. TexasDepartmentofStateHealthServices11. TexasEducationAgency12. TexasSecretaryofState13. U.S.BureauofLaborStatistics14. U.S.Census-CountyBusinessPatterns15. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas16. U.S.EnvironmentalProtectionAgency

Waller County 1. AmericanCommunitySurvey2. CentersforMedicare&MedicaidServices3. CountyHealthRankings4. FeedingAmerica5. InstituteforHealthMetricsandEvaluation6. NationalCancerInstitute7. NationalCenterforEducationStatistics8. SmallAreaHealthInsuranceEstimates9. TexasDepartmentofFamilyandProtectiveServices10. TexasDepartmentofStateHealthServices11. TexasEducationAgency12. TexasSecretaryofState13. U.S.BureauofLaborStatistics14. U.S.Census-CountyBusinessPatterns15. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas16. U.S.EnvironmentalProtectionAgency

Wharton County 1. AmericanCommunitySurvey2. CentersforMedicare&MedicaidServices3. CountyHealthRankings4. FeedingAmerica5. InstituteforHealthMetricsandEvaluation6. NationalCancerInstitute7. NationalCenterforEducationStatistics8. SmallAreaHealthInsuranceEstimates9. TexasDepartmentofFamilyandProtectiveServices10. TexasDepartmentofStateHealthServices


11. TexasEducationAgency12. TexasSecretaryofState13. U.S.BureauofLaborStatistics14. U.S.Census-CountyBusinessPatterns15. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas


Secondary Data Scoring

Datascoringisdoneinthreestages:

Foreachindicator,eachcountyinMemorialHermann-TexasMedicalCenter’sserviceareaisassignedascorebasedonitscomparisontoothercommunities,whetherhealthtargetshavebeenmet,andthetrendoftheindicatorvalueovertime.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariesbyindicatorandisdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.

Indicatorsarecategorizedintotopicareasandeachtopicareareceivesascore.Indicatorsmaybecategorizedinmorethanonetopicarea.Topicscoresaredeterminedbythecomparisonsofallindicatorswithinthetopic.

ComparisontoaDistributionofCountyValues:WithinStateandNation

Foreaseofinterpretationandanalysis,indicatordataontheCommunityDashboardisvisuallyrepresentedasagreen-yellow-redgaugeshowinghowthecommunityisfaringagainstadistributionofcountiesinthestateortheUnitedStates.Adistributioniscreatedbytakingallcountyvalueswithinthestateornation,orderingthemfromlowtohigh,anddividingthemintothreegroups(green,yellow,red)basedontheirorder.Indicatorswiththepoorestcomparisons(“inthered”)scoredhigh,whereasindicatorswithgoodcomparisons(“inthegreen”)scoredlow.

Comparisons • Quantitatively

score all possible comparisons

Indicators • Summarize

comparison scores for each indicator

Topics • Summarize

indicator scores by topic area


ComparisontoValues:State,National,andTargets

Eachcountyiscomparedtothestatevalue,thenationalvalue,andtargetvalues.Targetvaluesincludethenation-wideHealthyPeople2020(HP2020)goals.HealthyPeople2020goalsarenationalobjectivesforimprovingthehealthofthenationsetbytheDepartmentofHealthandHumanServices’(DHHS)HealthyPeopleInitiative.Forallvaluecomparisons,thescoringdependsonwhetherthecountyvalueisbetterorworsethanthecomparisonvalue,aswellashowclosethecountyvalueistothetargetvalue.

TrendOverTime

TheMann-Kendallstatisticaltestfortrendwasusedtoassesswhetherthecountyvalueisincreasingovertimeordecreasingovertime,andwhetherthetrendisstatisticallysignificant.Thetrendcomparisonusesthefourmostrecentcomparablevaluesforthecounty,andstatisticalsignificanceisdeterminedatthe90%confidencelevel.Foreachindicatorwithvaluesavailableforfourtimeperiods,scoringwasdeterminedbydirectionofthetrendandstatisticalsignificance.

MissingValues

Indicatorscoresarecalculatedusingthecomparisonscores,availabilityofwhichdependsonthedatasource.Ifthecomparisontypeispossibleforanadequateproportionofindicatorsonthecommunitydashboard,itwillbeincludedintheindicatorscore.Afterexclusionofcomparisontypeswithinadequateavailability,allmissingcomparisonsaresubstitutedwithaneutralscoreforthepurposesofcalculatingtheindicator’sweightedaverage.Wheninformationisunknownduetolackofcomparabledata,theneutralvalueassumesthatthemissingcomparisonscoreisneithergoodnorbad.

IndicatorScoring

Indicatorscoresarecalculatedasaweightedaverageofallincludedcomparisonscores.Ifnoneoftheincludedcomparisontypesarepossibleforanindicator,noscoreiscalculatedandtheindicatorisexcludedfromthedatascoringresults.

TopicScoring

Indicatorscoresareaveragedbytopicareatocalculatetopicscores.Eachindicatormaybeincludedinuptothreetopicareasifappropriate.Resultingscoresrangefrom0-3,whereahigherscoreindicatesagreaterlevelofneedasevidencedbythedata.Atopicscoreisonlycalculatedifitincludesatleastthreeindicators.


Data Scoring Results ThefollowingtableslisteachindicatorbytopicareaforeachofthecountiesinMemorialHermann-TexasMedicalCenter’sservicearea.SecondarydataforthisreportareuptodateasofNovember2,2018.


Austin County

SCORE ACCESS TO HEALTH SERVICES UNITS

AUSTIN COUNTY HP2020 TEXAS U.S.

MEASUREMENT PERIOD HIGH DISPARITY* Source

2.44 Mental Health Provider Rate providers/ 100,000

population 26.9 98.8 214.3 2017 3

2.39 Primary Care Provider Rate providers/ 100,000

population 23.7 59.9 75.5 2015 3

2.22 Non-Physician Primary Care Provider Rate

providers/ 100,000 population 37 66.8 81.2 2017 3

1.89 Dentist Rate dentists/ 100,000

population 37 55.9 67.4 2016 3

1.64 Adults with Health Insurance: 18-64 percent 78.3 100 77.4 2016 8

1.64 Persons with Health Insurance percent 81.7 100 81.4 2016 8

1.58 Children with Health Insurance percent 89.3 100 90.3 2016 8

SCORE CANCER UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


2.06 Prostate Cancer Incidence Rate cases/ 100,000

males 114.1 95.4 109 2011-2015 6

1.94 Cancer: Medicare Population percent 7.6 7.1 7.8 2015 2

1.94 Colorectal Cancer Incidence Rate cases/ 100,000

population 42.1 39.9 38.1 39.2 2011-2015 6

1.67 Age-Adjusted Death Rate due to Colorectal Cancer

deaths/ 100,000 population 15.3 14.5 14.4 14.5 2011-2015 6

1.22 Oral Cavity and Pharynx Cancer Incidence Rate

cases/ 100,000 population 11.3 10.9 11.6 2011-2015 6

1.00 Age-Adjusted Death Rate due to Lung Cancer

deaths/ 100,000 population 39.9 45.5 39 43.4 2011-2015 6

0.75 Age-Adjusted Death Rate due to Breast Cancer

deaths/ 100,000 females 18.3 20.7 20.2 20.9 2011-2015 6


0.72 All Cancer Incidence Rate cases/ 100,000

population 377.7 401.3 441.2 2011-2015 6

0.67 Age-Adjusted Death Rate due to Cancer


0.67 Lung and Bronchus Cancer Incidence Rate


0.56 Breast Cancer Incidence Rate cases/ 100,000

females 94 111.7 124.7 2011-2015 6

SCORE CHILDREN'S HEALTH UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


2.17 Child Food Insecurity Rate percent 24.2 23 17.9 2016 4


1.17 Children with Low Access to a Grocery Store percent 2.5 2015 15

0.67 Substantiated Child Abuse Rate cases/ 1,000

children 2.1 8.5 2017 9

SCORE ECONOMY UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


2.33 Children Living Below Poverty Level percent 25.3 23.9 21.2 2012-2016

Hispanic or Latino, Other 1


2.17 Total Employment Change percent -0.7 3.2 2.5 2014-2015 14

2.06 Food Insecurity Rate percent 15.8 15.4 12.9 2016 4

2.03 Mortgaged Owners Median Monthly Household Costs dollars 1512 1444 1491 2012-2016 1

1.78 Female Population 16+ in Civilian Labor Force percent 54.4 57.7 58.3 2012-2016 1

1.58 Median Monthly Owner Costs for Households without a Mortgage dollars 448 467 462 2012-2016 1


1.53 Median Household Gross Rent dollars 852 911 949 2012-2016 1

1.44 Families Living Below Poverty Level percent 11.2 13 11 2012-2016


1.44 Population 16+ in Civilian Labor Force percent 62.1 64.2 63.1 2012-2016 1

1.44 Renters Spending 30% or More of Household Income on Rent percent 42.3 48 47.3 2012-2016 1

1.33 People Living Below Poverty Level percent 14.5 16.7 15.1 2012-2016

<6 Black or African American, Hispanic

or Latino, Other 1

1.28 Unemployed Workers in Civilian Labor Force percent 3.7 4 4.1 July 2018 13

1.22 SNAP Certified Stores stores/ 1,000

population 0.9 2016 15

1.14 Median Housing Unit Value dollars 164300 142700 184700 2012-2016 1

1.11 Households with Cash Public Assistance Income percent 1.5 1.6 2.7 2012-2016 1

1.11 People Living 200% Above Poverty Level percent 68.2 62.8 66.4 2012-2016 1

1.08 Persons with Disability Living in Poverty (5-year) percent 24 25.1 27.6 2012-2016 1

1.00 Low-Income and Low Access to a Grocery Store percent 3.5 2015 15

0.89 Homeowner Vacancy Rate percent 1.6 1.6 1.8 2012-2016 1

0.83 Students Eligible for the Free Lunch Program percent 42.9 52.9 42.6 2015-2016 7

0.72 Median Household Income dollars 56681 54727 55322 2012-2016 Black or African

American 1

0.72 Severe Housing Problems percent 12.3 18.3 18.8 2010-2014 3

0.67 Per Capita Income dollars 28351 27828 29829 2012-2016

Black or African American, Hispanic

or Latino, Other, Two or More Races 1

0.56 Homeownership percent 63.5 55 55.9 2012-2016 1


0.56 People 65+ Living Below Poverty Level percent 7.6 10.8 9.3 2012-2016 1

SCORE EDUCATION UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


1.81 Infants Born to Mothers with <12 Years Education percent 22.1 21.6 15.9 2013 10

1.61 People 25+ with a High School Degree or Higher percent 82.4 82.3 87 2012-2016

65+ Hispanic or Latino 1

1.50 People 25+ with a Bachelor's Degree or Higher percent 21 28.1 30.3 2012-2016


or Latino 1

1.28 Student-to-Teacher Ratio students/ teacher 14 15.4 17.7 2015-2016 7

1.22 High School Drop Out Rate percent 0.9 2 2016 11

SCORE ENVIRONMENT UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


2.17 Houses Built Prior to 1950 percent 17.6 7.4 18.2 2012-2016 1

2.00 Access to Exercise Opportunities percent 66.2 80.6 83.1 2018 3

1.61 Recognized Carcinogens Released into Air pounds 21 2017 16

1.50 Farmers Market Density markets/ 1,000

population 0 2016 15

1.50 Households with No Car and Low Access to a Grocery Store percent 2.4 2015 15

1.39 Grocery Store Density stores/ 1,000


1.39 PBT Released pounds 21 2017 16

1.33 People 65+ with Low Access to a Grocery Store percent 2.4 2015 15


1.22 Fast Food Restaurant Density restaurants/ 1,000






0.89 Liquor Store Density stores/ 100,000

population 6.8 6.8 10.5 2015 14

0.89 Recreation and Fitness Facilities facilities/ 1,000


0.75 Drinking Water Violations percent 0 6.6 FY 2013-14 3

0.72 Food Environment Index 7.7 6 7.7 2018 3


SCORE EXERCISE, NUTRITION, & WEIGHT UNITS




2.11 Workers who Walk to Work percent 1.7 3.1 1.6 2.8 2012-2016 1



















SCORE HEART DISEASE & STROKE UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


2.28 Atrial Fibrillation: Medicare Population percent 8.7 7.4 8.1 2015 2

2.28 Stroke: Medicare Population percent 4.7 4.5 4 2015 2

2.17 Hyperlipidemia: Medicare Population percent 46.8 46.1 44.6 2015 2

1.94 Hypertension: Medicare Population percent 59.6 57.5 55 2015 2

1.56 Heart Failure: Medicare Population percent 15.1 15.5 13.5 2015 2

1.25 Age-Adjusted Death Rate due to Heart Disease

deaths/ 100,000 population 176.7 173 171.9 2010-2014 10

1.22 Ischemic Heart Disease: Medicare Population percent 26.9 28.8 26.5 2015 2

0.86 Age-Adjusted Death Rate due to Cerebrovascular Disease (Stroke)


SCORE IMMUNIZATIONS & INFECTIOUS DISEASES UNITS




1.83 Age-Adjusted Death Rate due to Influenza and Pneumonia

deaths/ 100,000 population 16.1 14.2 15.2 2010-2014 10

1.61 Tuberculosis Incidence Rate cases/ 100,000

population 2.1 1 4.5 2013-2017 10

1.39 HIV Diagnosis Rate cases/ 100,000

population 10.1 16.1 2016 10

1.28 Chlamydia Incidence Rate cases/ 100,000

population 238.4 511.6 2017 10

1.28 Syphilis Incidence Rate cases/ 100,000

population 3.4 40.6 2017 10

1.17 Gonorrhea Incidence Rate cases/ 100,000

population 73.9 160.2 2017 10

SCORE MATERNAL, FETAL & INFANT HEALTH UNITS



2.31 Preterm Births percent 14.8 9.4 12 11.4 2013 10

1.97 Mothers who Received Early Prenatal Care percent 55.2 77.9 59.2 74.2 2013 10


1.75 Babies with Low Birth Weight percent 8.2 7.8 8.3 8 2013 10

1.69 Teen Births percent 3.6 2.8 4.3 2014 10

0.47 Infant Mortality Rate deaths/ 1,000 live

births 3 6 5.8 6 2013 10

SCORE MENTAL HEALTH & MENTAL DISORDERS UNITS




population 26.9 98.8 214.3 2017 3

2.17 Age-Adjusted Death Rate due to Suicide


1.33 Poor Mental Health: Average Number of Days days 3.6 3.4 3.8 2016 3


1.25 Age-Adjusted Death Rate due to Alzheimer's Disease


1.17 Frequent Mental Distress percent 10.9 10.6 15 2016 3

1.00 Alzheimer's Disease or Dementia: Medicare Population percent 9.9 11.7 9.9 2015 2

1.00 Depression: Medicare Population percent 14.4 17 16.7 2015 2

SCORE OLDER ADULTS & AGING UNITS AUSTIN COUNTY HP2020 TEXAS U.S.





2.00

Rheumatoid Arthritis or Osteoarthritis: Medicare Population percent 32.2 31.6 30 2015 2





1.28 COPD: Medicare Population percent 10.5 11.1 11.2 2015 2




1.17 Asthma: Medicare Population percent 7.3 8.2 8.2 2015 2


1.17 People 65+ Living Alone percent 25.2 23.9 26.4 2012-2016 1


1.00 Chronic Kidney Disease: Medicare Population percent 15.2 19.9 18.1 2015 2


0.78 Osteoporosis: Medicare Population percent 4.7 6.5 6 2015 2

0.67 Diabetes: Medicare Population percent 25 28.2 26.5 2015 2


SCORE OTHER CHRONIC DISEASES UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


2.00




SCORE PREVENTION & SAFETY UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


1.75 Age-Adjusted Death Rate due to Unintentional Injuries



0.50 Death Rate due to Drug Poisoning deaths/ 100,000

population 5.6 9.4 12.4 2006-2012 3

SCORE PUBLIC SAFETY UNITS AUSTIN COUNTY HP2020 TEXAS U.S.



1.44 Violent Crime Rate crimes/ 100,000

population 240.1 407.6 2012-2014 3


children 2.1 8.5 2017 9

0.33 Alcohol-Impaired Driving Deaths percent 18.2 28.3 29.3 2012-2016 3

SCORE RESPIRATORY DISEASES UNITS AUSTIN COUNTY HP2020 TEXAS U.S.





population 2.1 1 4.5 2013-2017 10







SCORE SOCIAL ENVIRONMENT UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


2.61 Mean Travel Time to Work minutes 30.3 25.9 26.1 2012-2016 Male 1









65+ Hispanic or Latino 1



1.50 People 25+ with a Bachelor's Degree or Higher percent 21 28.1 30.3 2012-2016


or Latino 1



<6 Black or African American, Hispanic

or Latino, Other 1

1.33 Voter Turnout: Presidential Election percent 63.7 58.8 2016 12

1.17 Linguistic Isolation percent 3.5 7.9 4.5 2012-2016 1



0.83 Single-Parent Households percent 29 33.3 33.6 2012-2016 1


American 1





children 2.1 8.5 2017 9


SCORE SUBSTANCE ABUSE UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


1.50 Adults who Drink Excessively percent 18.3 25.4 19.4 18 2016 3

0.89 Liquor Store Density stores/ 100,000 6.8 6.8 10.5 2015 14


population


population 5.6 9.4 12.4 2006-2012 3


SCORE TRANSPORTATION UNITS AUSTIN COUNTY HP2020 TEXAS U.S.



2.44 Solo Drivers with a Long Commute percent 39.6 36.9 34.7 2012-2016 3

2.17 Workers Commuting by Public Transportation percent 0.1 5.5 1.5 5.1 2012-2016 1



1.00 Workers who Drive Alone to Work percent 79.5 80.3 76.4 2012-2016 1

0.56 Households without a Vehicle percent 4 5.6 9 2012-2016 1

SCORE WELLNESS & LIFESTYLE UNITS AUSTIN COUNTY HP2020 TEXAS U.S.


1.50 Life Expectancy for Females years 80.4 80.8 81.5 2014 5

1.50 Self-Reported General Health Assessment: Poor or Fair percent 16.9 18.2 16 2016 3

1.39 Life Expectancy for Males years 76 76.2 76.7 2014 5

1.00 Poor Physical Health: Average Number of Days days 3.4 3.5 3.7 2016 3

0.83 Frequent Physical Distress percent 10.6 10.8 15 2016 3

0.83 Insufficient Sleep percent 30.2 32.7 38 2016 3


SCORE WOMEN'S HEALTH UNITS AUSTIN COUNTY HP2020 TEXAS U.S.




deaths/ 100,000 females 18.3 20.7 20.2 20.9 2011-2015 6


females 94 111.7 124.7 2011-2015 6


Brazoria County


BRAZORIA COUNTY HP2020 TEXAS U.S.



population 56.5 98.8 214.3 2017 4


providers/ 100,000 population 44.3 66.8 81.2 2017 4

1.47 Adults with Health Insurance: 18-64 percent 82 100 77.4 2016 9

1.25 Persons with Health Insurance percent 85 100 81.4 2016 9


population 65.3 59.9 75.5 2015 4


population 52.2 55.9 67.4 2016 4


SCORE CANCER UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.



population 42.5 39.9 38.1 39.2 2011-2015 7









deaths/ 100,000 population 167.5 161.4 156.4 163.5 2011-2015 Male 7


population 410.4 401.3 441.2 2011-2015 7


males 98.5 95.4 109 2011-2015 7



deaths/ 100,000 females 20.1 20.7 20.2 20.9 2011-2015 7


females 106.7 111.7 124.7 2011-2015 7



0.69 Cervical Cancer Incidence Rate cases/ 100,000

females 6.9 7.3 9.2 7.5 2011-2015 7

0.42 Age-Adjusted Death Rate due to Prostate Cancer

deaths/ 100,000 males 17.2 21.8 18.1 19.5 2011-2015 7

SCORE CHILDREN'S HEALTH UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.





children 6.4 8.5 2017 10


SCORE ECONOMY UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.
















0.92 Persons with Disability Living in Poverty (5-year) percent 21.8 25.1 27.6 2012-2016 1


0.89 People 65+ Living Below Poverty Level percent 8.7 10.8 9.3 2012-2016 Hispanic or Latino 1



0.67 Total Employment Change percent 3.6 3.2 2.5 2014-2015 15

0.64 Persons with Disability Living in Poverty percent 19.4 24.2 26.6 2016 1






or Latino, Other 1

0.39 People Living 200% Above Poverty Level percent 75 62.8 66.4 2012-2016 1


18-24, 6-11 Hispanic or Latino,

Other 1



American Indian or Alaska Native,

Hispanic or Latino, Other, Two or More

Races 1


0.17 Median Household Income dollars 72006 54727 55322 2012-2016 Hispanic or Latino,

Other 1

SCORE EDUCATION UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.


1.50 Student-to-Teacher Ratio students/ teacher 16 15.4 17.7 2015-2016 8


1.00 People 25+ with a High School Degree or Higher percent 86.7 82.3 87 2012-2016 65+ 1

0.67 People 25+ with a Bachelor's Degree or Higher percent 28.7 28.1 30.3 2012-2016

65+ American Indian or Alaska

Native, Other 1


SCORE ENVIRONMENT UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.






1.75 Annual Ozone Air Quality grade F 2014-2016 2









1.42 Drinking Water Violations percent 4.4 6.6 FY 2013-14 4

1.33 Access to Exercise Opportunities percent 79 80.6 83.1 2018 4








population 2.3 6.8 10.5 2015 15

















1.33 Access to Exercise Opportunities percent 79 80.6 83.1 2018 4








SCORE HEART DISEASE & STROKE UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.





1.83 Ischemic Heart Disease: Medicare Population percent 31 28.8 26.5 2015 3

1.78 Atrial Fibrillation: Medicare Population percent 8 7.4 8.1 2015 3






deaths/ 100,000 population 173 173 171.9 2010-2014 Male 11





population 16 40.6 2017 11


population 10.7 16.1 2016 11


population 392.3 511.6 2017 11


population 2.7 1 4.5 2013-2017 11


population 84.7 160.2 2017 11


deaths/ 100,000 population 13 14.2 15.2 2010-2014 11







1.17 Babies with Very Low Birth Weight percent 1.4 1.4 1.4 1.4 2013 11



births 3.9 6 5.8 6 2013 11



SCORE MEN'S HEALTH UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.


1.44 Life Expectancy for Males years 76.1 76.2 76.7 2014 6


males 98.5 95.4 109 2011-2015 7


deaths/ 100,000 males 17.2 21.8 18.1 19.5 2011-2015 7





deaths/ 100,000 population 12.4 10.2 11.7 12.5 2010-2014 Male White 11


population 56.5 98.8 214.3 2017 4







SCORE OLDER ADULTS & AGING UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.



2.50 Diabetes: Medicare Population percent 29.4 28.2 26.5 2015 3












1.33 Age-Adjusted Death Rate due to Falls



1.11









SCORE OTHER CHRONIC DISEASES UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.



1.11



SCORE PREVENTION & SAFETY UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.






deaths/ 100,000 population 38.1 36.4 37.6 39.2 2010-2014 Male White 11


population 8.1 9.8 16.9 2014-2016 4

SCORE PUBLIC SAFETY UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.




children 6.4 8.5 2017 10


population 175 407.6 2012-2014 4

SCORE RESPIRATORY DISEASES UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.



1.50 Lung and Bronchus Cancer cases/ 100,000 60.4 53.1 60.2 2011-2015 7


Incidence Rate population


population 2.7 1 4.5 2013-2017 11






SCORE SOCIAL ENVIRONMENT UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.







1.28 Linguistic Isolation percent 4 7.9 4.5 2012-2016 1





children 6.4 8.5 2017 10







65+ American Indian or Alaska

Native, Other 1




or Latino, Other 1


18-24, 6-11 Hispanic or Latino,

Other 1


American Indian or Alaska Native,

Hispanic or Latino, Other, Two or More

Races 1

0.17 Median Household Income dollars 72006 54727 55322 2012-2016 Hispanic or Latino,

Other 1

0.17 Single-Parent Households percent 25.3 33.3 33.6 2012-2016 1

SCORE SUBSTANCE ABUSE UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.





population 8.1 9.8 16.9 2014-2016 4


population 2.3 6.8 10.5 2015 15

SCORE TRANSPORTATION UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.





2.67 Workers who Drive Alone to Work percent 86.9 80.3 76.4 2012-2016 55-59 Black or

African American 1




0.61 Households without a Vehicle percent 3.4 5.6 9 2012-2016 1

SCORE WELLNESS & LIFESTYLE UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.








SCORE WOMEN'S HEALTH UNITS BRAZORIA COUNTY HP2020 TEXAS U.S.




deaths/ 100,000 females 20.1 20.7 20.2 20.9 2011-2015 7

1.06 Breast Cancer Incidence Rate cases/ 100,000 106.7 111.7 124.7 2011-2015 7


females


females 6.9 7.3 9.2 7.5 2011-2015 7

Chambers County


CHAMBERS COUNTY HP2020 TEXAS U.S.



population 10.3 59.9 75.5 2015 3


population 17.5 98.8 214.3 2017 3


population 5 55.9 67.4 2016 3



1.53 Children with Health Insurance percent 90 100 90.3 2016 8



SCORE CANCER UNITS CHAMBERS

COUNTY HP2020 TEXAS U.S. MEASUREMENT

PERIOD HIGH DISPARITY* Source








population 49.4 39.9 38.1 39.2 2011-2015 6




cases/ 100,000 population 13 10.9 11.6 2011-2015 6



females 116.1 111.7 124.7 2011-2015 6



population 428.7 401.3 441.2 2011-2015 6


males 90.1 95.4 109 2011-2015 6

SCORE CHILDREN'S HEALTH UNITS CHAMBERS



1.53 Children with Health Insurance percent 90 100 90.3 2016 8




children 5.9 8.5 2017 9

SCORE ECONOMY UNITS CHAMBERS





2.25

Median Monthly Owner Costs for Households without a Mortgage dollars 501 467 462 2012-2016 1











1.11 Per Capita Income dollars 29729 27828 29829 2012-2016 Hispanic or Latino,

Other 1



0.83 Median Household Income dollars 70396 54727 55322 2012-2016

American Indian or Alaska Native, Black or African

American 1





American Indian or Alaska Native 1



6-11 American Indian or Alaska

Native 1


0.50 Children Living Below Poverty Level percent 13.7 23.9 21.2 2012-2016 Other 1


0.39 Severe Housing Problems percent 11 18.3 18.8 2010-2014 3



SCORE EDUCATION UNITS CHAMBERS





1.61 People 25+ with a High School Degree or Higher percent 83.8 82.3 87 2012-2016 Hispanic or Latino 1

1.39 Student-to-Teacher Ratio students/ teacher 14.6 15.4 17.7 2015-2016 7



SCORE ENVIRONMENT UNITS CHAMBERS




population 12.9 6.8 10.5 2015 14


2.08 Drinking Water Violations percent 17 6.6 FY 2013-14 3
















SCORE HEART DISEASE & STROKE UNITS CHAMBERS







deaths/ 100,000 population 194.7 173 171.9 2010-2014 10













population 2 1 4.5 2013-2017 10


population 5 16.1 2016 10


population 12.1 40.6 2017 10


population 115.8 511.6 2017 10


population 21.7 160.2 2017 10










births 2.2 6 5.8 6 2013 10





population 17.5 98.8 214.3 2017 3










SCORE OLDER ADULTS & AGING UNITS CHAMBERS
















1.67 Chronic Kidney Disease: percent 17.7 19.9 18.1 2015 2


Medicare Population




1.17




SCORE OTHER CHRONIC DISEASES UNITS CHAMBERS




1.17



SCORE PREVENTION & SAFETY UNITS CHAMBERS





0.42 Death Rate due to Drug Poisoning




SCORE PUBLIC SAFETY UNITS CHAMBERS




population 255.9 407.6 2012-2014 3


children 5.9 8.5 2017 9


SCORE RESPIRATORY DISEASES UNITS CHAMBERS











population 2 1 4.5 2013-2017 10


SCORE SOCIAL ENVIRONMENT UNITS CHAMBERS





2.39 Mean Travel Time to Work minutes 29.2 25.9 26.1 2012-2016 1

2.25

Median Monthly Owner Costs for Households without a Mortgage dollars 501 467 462 2012-2016 1






1.61 People 25+ with a High School Degree or Higher percent 83.8 82.3 87 2012-2016 Hispanic or Latino 1




1.11 Per Capita Income dollars 29729 27828 29829 2012-2016 Hispanic or Latino,

Other 1




children 5.9 8.5 2017 9


American Indian or Alaska Native, Black or African

American 1




Native 1

0.50 Children Living Below Poverty Level percent 13.7 23.9 21.2 2012-2016 Other 1



SCORE SUBSTANCE ABUSE UNITS CHAMBERS





population 12.9 6.8 10.5 2015 14



0.42 Death Rate due to Drug Poisoning


SCORE TRANSPORTATION UNITS CHAMBERS





2.50 Workers Commuting by Public Transportation percent 0 5.5 1.5 5.1 2012-2016 1


2.33 Workers who Drive Alone to Work percent 87.8 80.3 76.4 2012-2016 Asian 1


0.61 Households without a Vehicle x 2.6 5.6 9 2012-2016 1

SCORE WELLNESS & LIFESTYLE UNITS CHAMBERS





1.17 Insufficient Sleep percent 32 32.7 38 2016 3




Fort Bend County

SCORE ACCESS TO HEALTH SERVICES UNITS FORT BEND




population 59.8 98.8 214.3 2017 3




population 51.8 55.9 67.4 2016 3





population 80.3 59.9 75.5 2015 3

SCORE CANCER UNITS FORT BEND





males 103.8 95.4 109 2011-2015 6


females 114.7 111.7 124.7 2011-2015 6


cases/ 100,000 population 10 10.9 11.6 2011-2015 6


population 367.6 401.3 441.2 2011-2015 6


deaths/ 100,000 females 18.1 20.7 20.2 20.9 2011-2015 6


females 6.4 7.3 9.2 7.5 2011-2015 6


deaths/ 100,000 males 14.6 21.8 18.1 19.5 2011-2015 6











population 34 39.9 38.1 39.2 2011-2015 6

SCORE CHILDREN'S HEALTH UNITS FORT BEND





children 3.5 8.5 2017 9



SCORE ECONOMY UNITS FORT BEND


























0.39 Homeownership percent 74.4 55 55.9 2012-2016

1

0.39 People 65+ Living Below Poverty Level percent 6.9 10.8 9.3 2012-2016



Hispanic or Latino, Other, <6, 6-11, 12-

17, 18-24 1

0.17 Homeowner Vacancy Rate percent 1.1 1.6 1.8 2012-2016

1



or Latino, Other 1

0.17 People Living 200% Above Poverty Level percent 79.4 62.8 66.4 2012-2016

1




0.17 Students Eligible for the Free Lunch Program percent 26.7 52.9 42.6 2015-2016

7


SCORE EDUCATION UNITS FORT BEND



1.67 Student-to-Teacher Ratio students/ teacher 16.5 15.4 17.7 2015-2016

7

1.00 High School Drop Out Rate percent 1.1 2 2016

11


0.42 Infants Born to Mothers with <12 Years Education percent 9.2 21.6 15.9 2013

10


Black or African American, Other,

Two or More Races, Female, 65+ 1

SCORE ENVIRONMENT UNITS FORT BEND

























population 5.2 6.8 10.5 2015 14



FORT BEND COUNTY HP2020 TEXAS U.S.


2.67 Workers who Walk to Work percent 0.6 3.1 1.6 2.8 2012-2016 25-44 1




















SCORE HEART DISEASE & STROKE UNITS FORT BEND












deaths/ 100,000 population 135 173 171.9 2010-2014 Black, White, Male 10





population 373.5 511.6 2017

10


population 93 160.2 2017

10


population 19 40.6 2017

10


population 3.7 1 4.5 2013-2017

10


population 9.2 16.1 2016

10



deaths/ 100,000 population 13.6 14.2 15.2 2010-2014

10









births 4.3 6 5.8 6 2013 10


0.42 Teen Births percent 1 2.8 4.3 2014 10

SCORE MEN'S HEALTH UNITS FORT BEND




males 103.8 95.4 109 2011-2015

6

0.50 Life Expectancy for Males years 80.1 76.2 76.7 2014

5


deaths/ 100,000 males 14.6 21.8 18.1 19.5 2011-2015

6





population 59.8 98.8 214.3 2017

3

1.33 Alzheimer's Disease or Dementia: Medicare Population percent 10.2 11.7 9.9 2015

2


deaths/ 100,000 population 7.3 10.2 11.7 12.5 2010-2014 White, Male 10



deaths/ 100,000 population 20.6 26.6 24.5 2010-2014 White 10


0.50 Frequent Mental Distress percent 9 10.6 15 2016 3

0.50 Poor Mental Health: Average Number of Days days 3 3.4 3.8 2016 3

SCORE OLDER ADULTS & AGING UNITS FORT BEND



2.50 Stroke: Medicare Population percent 4.7 4.5 4 2015

2






1.56 Osteoporosis: Medicare Population percent 6 6.5 6 2015 2







deaths/ 100,000 population 6 7.2 7.4 8.3 2010-2014 10


deaths/ 100,000 population 20.6 26.6 24.5 2010-2014 White 10




0.61






SCORE OTHER CHRONIC DISEASES UNITS FORT BEND



2.17 Chronic Kidney Disease: Medicare Population percent 19.2 19.9 18.1 2015

2

1.56 Osteoporosis: Medicare Population percent 6 6.5 6 2015

2

0.61

Rheumatoid Arthritis or Osteoarthritis: Medicare Population percent 26.1 31.6 30 2015

2

SCORE PREVENTION & SAFETY UNITS FORT BEND



1.06 Severe Housing Problems percent 14.8 18.3 18.8 2010-2014

3


population 5.6 9.8 16.9 2014-2016

3


deaths/ 100,000 population 6 7.2 7.4 8.3 2010-2014

10



SCORE PUBLIC SAFETY UNITS FORT BEND



2.00 Alcohol-Impaired Driving Deaths percent 36 28.3 29.3 2012-2016 3

1.11 Substantiated Child Abuse Rate cases/ 1,000 3.5 8.5 2017 9


children


population 261.5 407.6 2012-2014 3

SCORE RESPIRATORY DISEASES UNITS FORT BEND




population 3.7 1 4.5 2013-2017 10









SCORE SOCIAL ENVIRONMENT UNITS FORT BEND











children 3.5 8.5 2017 9










0.39 Homeownership percent 74.4 55 55.9 2012-2016

1

0.39 People 65+ Living Alone percent 15.2 23.9 26.4 2012-2016

1


Hispanic or Latino, Other, <6, 6-11, 12-

17, 18-24 1



or Latino, Other 1


Black or African American, Other,

Two or More Races, Female, 65+ 1




SCORE SUBSTANCE ABUSE UNITS FORT BEND



2.00 Alcohol-Impaired Driving Deaths percent 36 28.3 29.3 2012-2016 3



population 5.6 9.8 16.9 2014-2016 3


population 5.2 6.8 10.5 2015 14


SCORE TRANSPORTATION UNITS FORT BEND




2.83 Solo Drivers with a Long Commute percent 57.5 36.9 34.7 2012-2016

3

2.67 Workers who Walk to Work percent 0.6 3.1 1.6 2.8 2012-2016 25-44 1

1.94 Workers who Drive Alone to Work percent 82.3 80.3 76.4 2012-2016 Black or African American, 20-44 1

1.06 Workers Commuting by Public Transportation percent 1.7 5.5 1.5 5.1 2012-2016 Hispanic or Latino 1

1.00 Households with No Car and Low Access to a Grocery Store percent 1.1 2015

15

0.50 Households without a Vehicle percent 2.7 5.6 9 2012-2016

1

SCORE WELLNESS & LIFESTYLE UNITS FORT BEND







0.50 Life Expectancy for Males years 80.1 76.2 76.7 2014

5

0.50 Poor Physical Health: Average Number of Days days 2.9 3.5 3.7 2016

3

SCORE WOMEN'S HEALTH UNITS FORT BEND




females 114.7 111.7 124.7 2011-2015 6



deaths/ 100,000 females 18.1 20.7 20.2 20.9 2011-2015 6



females 6.4 7.3 9.2 7.5 2011-2015 6


Galveston County


GALVESTON COUNTY HP2020 TEXAS U.S.



population 95.9 98.8 214.3 2017 4


population 42.8 55.9 67.4 2016 4





population 71.7 59.9 75.5 2015 4



SCORE CANCER UNITS GALVESTON




deaths/ 100,000 males 22.5 21.8 18.1 19.5 2011-2015 7




deaths/ 100,000 population 189 161.4 156.4 163.5 2011-2015 Male Black 7





deaths/ 100,000 females 21.2 20.7 20.2 20.9 2011-2015 7







males 99.8 95.4 109 2011-2015 7


population 403 401.3 441.2 2011-2015 7


females 7.8 7.3 9.2 7.5 2011-2015 7


females 110.1 111.7 124.7 2011-2015 7


population 35.4 39.9 38.1 39.2 2011-2015 7

SCORE CHILDREN'S HEALTH UNITS GALVESTON





children 9.5 8.5 2017 10



SCORE ECONOMY UNITS GALVESTON








2.11 SNAP Certified Stores stores/ 1,000 0.7 2016 16


population


2.00 Food Insecurity Rate percent 17 15.4 12.9 2016 5








or Latino, Other 1



or Latino, Other 1


12-17, 18-24, 6-11, <6 Black or African American, Hispanic

or Latino, Other 1





0.72 People 65+ Living Below Poverty Level percent 8 10.8 9.3 2012-2016

Black or African American 1



0.56 Households with Cash Public Assistance Income percent 1 1.6 2.7 2012-2016 1





or Latino, Other 1




SCORE EDUCATION UNITS GALVESTON






65+ Black or African American, Other 1



65+ Black or African American 1

SCORE ENVIRONMENT UNITS GALVESTON
















population 8.7 6.8 10.5 2015 15






1.25 Annual Particle Pollution grade A 2014-2016 2












2.00 Food Insecurity Rate percent 17 15.4 12.9 2016 5







1.56 Workers who Walk to Work percent 2 3.1 1.6 2.8 2012-2016 55-59, 60-64 1











SCORE HEART DISEASE & STROKE UNITS GALVESTON








deaths/ 100,000 population 44.4 34.8 42 37.3 2010-2014 Black 11



1.50 Hyperlipidemia: Medicare Population percent 42 46.1 44.6 2015 3


deaths/ 100,000 population 170.7 173 171.9 2010-2014 Male Black 11





population 491.3 511.6 2017 11


population 132.8 160.2 2017 11


population 13.7 16.1 2016 11


population 23.3 40.6 2017 11




population 3.1 1 4.5 2013-2017 11








births 5.6 6 5.8 6 2013 11





SCORE MEN'S HEALTH UNITS GALVESTON




deaths/ 100,000 males 22.5 21.8 18.1 19.5 2011-2015 7



males 99.8 95.4 109 2011-2015 7







population 95.9 98.8 214.3 2017 4







SCORE OLDER ADULTS & AGING UNITS GALVESTON



2.83 Chronic Kidney Disease: Medicare percent 21.9 19.9 18.1 2015 3


Population












1.50 Hyperlipidemia: Medicare Population percent 42 46.1 44.6 2015 3

1.44







0.72 People 65+ Living Below Poverty Level percent 8 10.8 9.3 2012-2016





SCORE OTHER CHRONIC DISEASES UNITS GALVESTON




1.44



SCORE PREVENTION & SAFETY UNITS GALVESTON




population 15.6 9.8 16.9 2014-2016 4






SCORE PUBLIC SAFETY UNITS GALVESTON




children 9.5 8.5 2017 10



population 261.1 407.6 2012-2014 4


SCORE RESPIRATORY DISEASES UNITS GALVESTON









population 3.1 1 4.5 2013-2017 11




SCORE SOCIAL ENVIRONMENT UNITS GALVESTON









children 9.5 8.5 2017 10









or Latino, Other 1



or Latino, Other 1




65+ Black or African American, Other 1



65+ Black or African American 1




or Latino, Other 1




SCORE SUBSTANCE ABUSE UNITS GALVESTON





population 15.6 9.8 16.9 2014-2016 4



population 8.7 6.8 10.5 2015 15


SCORE TRANSPORTATION UNITS GALVESTON






1.56 Workers who Walk to Work percent 2 3.1 1.6 2.8 2012-2016 55-59, 60-64 1

1.39 Households without a Vehicle percent 6 5.6 9 2012-2016 1


1.00 Workers who Drive Alone to Work percent 80 80.3 76.4 2012-2016 60-64 White, non-

Hispanic 1

SCORE WELLNESS & LIFESTYLE UNITS GALVESTON









SCORE WOMEN'S HEALTH UNITS GALVESTON






deaths/ 100,000 females 21.2 20.7 20.2 20.9 2011-2015 7


females 7.8 7.3 9.2 7.5 2011-2015 7


females 110.1 111.7 124.7 2011-2015 7

Harris County

SCORE ACCESS TO HEALTH SERVICES UNITS HARRIS



2.00 Adults Unable to Afford to See a Doctor percent 22.1 18.3 12.1 2015 10





population 57.2 59.9 75.5 2015 4


population 103.7 98.8 214.3 2017 4




population 66.3 55.9 67.4 2016 4

SCORE CANCER UNITS HARRIS




females 11 7.3 9.2 7.5 2011-2015

7


deaths/ 100,000 females 23.2 20.7 20.2 20.9 2011-2015 Black 7



1.58 Colon Cancer Screening: Sigmoidoscopy or Colonoscopy percent 57.6 62.3 2016 10


deaths/ 100,000 males 19.8 21.8 18.1 19.5 2011-2015 7


females 113.2 111.7 124.7 2011-2015 7


males 102.5 95.4 109 2011-2015 7




population 402.6 401.3 441.2 2011-2015 7


deaths/ 100,000 population 157.8 161.4 156.4 163.5 2011-2015 Black, Male 7


population 38.8 39.9 38.1 39.2 2011-2015 7







SCORE CHILDREN'S HEALTH UNITS HARRIS







children 5.4 8.5 2017 11

SCORE DIABETES UNITS HARRIS



1.67 Diabetes: Medicare Population percent 28.1 28.2 26.5 2015

3


1.44 Adults with Diabetes percent 10.2 11.2 10.5 2016

10

0.92 Age-Adjusted Death Rate due to Diabetes

deaths/ 100,000 population 20.2 21.7 21.2 2010-2014 Black, Hispanic, Male 12

SCORE ECONOMY UNITS HARRIS








population 0.6 2016

17

2.08 Median Household Gross Rent dollars 937 911 949 2012-2016

1


American Indian or Alaska Native, Black or African American, Hispanic or Latino,

Other 1




Asian, Black or African American, Hispanic or Latino, Other, Female, 75+ 1

1.81 Mortgaged Owners Median Monthly Household Costs dollars 1504 1444 1491 2012-2016

1

1.67 Child Food Insecurity Rate percent 23.5 23 17.9 2016

5

1.67 Children Living Below Poverty Level percent 26 23.9 21.2 2012-2016


Other, <6 1

1.67 People Living Below Poverty Level percent 17.4 16.7 15.1 2012-2016 American Indian or 1


Alaska Native, Black or African American, Hispanic or Latino,

Other, Female, <6, 6-11, 12-17, 18-24














Other 1


American Indian or Alaska Native, Black or African American, Hispanic or Latino, Native Hawaiian or

Other Pacific Islander, Other, Two

or More Races 1


SCORE EDUCATION UNITS HARRIS



1.92 Infants Born to Mothers with <12 Years Education percent 27.5 21.6 15.9 2013

12

1.89 Student-to-Teacher Ratio students/ teacher 16.4 15.4 17.7 2015-2016

8

1.67 High School Drop Out Rate percent 2.6 2 2016

13


Male, 35-44, 45-64, 65+ 1


American Indian or Alaska Native, Black or African American, Native Hawaiian or

Other Pacific Islander, Other, 45-

64, 65+ 1

SCORE ENVIRONMENT UNITS HARRIS







1.69 Annual Particle Pollution grade C 2014-2016 2



















population 6.3 6.8 10.5 2015 16




HARRIS COUNTY HP2020 TEXAS U.S.


2.17 Workers who Walk to Work percent 1.5 3.1 1.6 2.8 2012-2016 White, non-Hispanic 1




1.67 Adults (18+ Years) Who Are Obese percent 32 30.5 33.6 29.9 2016 10




1.50 Adults who are Overweight or Obese percent 66.7 68.4 65.2 2016 10







1.42 Adult Fruit and Vegetable Consumption percent 18.7 17.2 2015 10








SCORE HEART DISEASE & STROKE UNITS HARRIS




1.89 Heart Failure: Medicare Population percent 16 15.5 13.5 2015 3




deaths/ 100,000 population 41.5 34.8 42 37.3 2010-2014 Black 12

1.33 Ischemic Heart Disease: Medicare Population percent 28.8 28.8 26.5 2015

3

1.22 Hypertension: Medicare Population percent 55.5 57.5 55 2015

3


deaths/ 100,000 population 167.6 173 171.9 2010-2014 Black, White, Male 12




2.33 Gonorrhea Incidence Rate cases/ 100,000 182.1 160.2 2017 12


population


population 59.3 40.6 2017 12


population 571.4 511.6 2017 12


population 6.6 1 4.5 2013-2017 12

1.78 Adults 65+ with Influenza Vaccination percent 57.2 57.3 58.6 2016 10


population 26.3 16.1 2016

12

1.17 Adults 65+ with Pneumonia Vaccination percent 73.5 90 71.3 73.4 2016

10


deaths/ 100,000 population 14 14.2 15.2 2010-2014 Black, Male 12





births 6.8 6 5.8 6 2013 12







SCORE MEN'S HEALTH UNITS HARRIS




deaths/ 100,000 males 19.8 21.8 18.1 19.5 2011-2015 7

1.33 Prostate Cancer Incidence Rate cases/ 100,000 102.5 95.4 109 2011-2015 7


males





1.89 Alzheimer's Disease or Dementia: Medicare Population percent 11.4 11.7 9.9 2015

3

1.53 Poor Mental Health: 5+ Days percent 80 81.5 2016

10



population 103.7 98.8 214.3 2017 4




0.94 Depression: Medicare Population percent 14.8 17 16.7 2015

3


deaths/ 100,000 population 17.9 26.6 24.5 2010-2014 White, Female 12

SCORE OLDER ADULTS & AGING UNITS HARRIS



2.67 Chronic Kidney Disease: Medicare Population percent 20.9 19.9 18.1 2015

3

2.61 Stroke: Medicare Population percent 5.2 4.5 4 2015

3





1.89 Heart Failure: Medicare Population percent 16 15.5 13.5 2015 3


Asian, Black or African American, Hispanic or Latino, 1


Other, Female, 75+









1.17 Adults 65+ with Pneumonia Vaccination percent 73.5 90 71.3 73.4 2016 10




0.94



deaths/ 100,000 population 17.9 26.6 24.5 2010-2014 White, Female 12

0.39 COPD: Medicare Population percent 9.6 11.1 11.2 2015

3

SCORE OTHER CHRONIC DISEASES UNITS HARRIS





0.94



SCORE PREVENTION & SAFETY UNITS HARRIS



2.39 Severe Housing Problems percent 20.9 18.3 18.8 2010-2014

4




population 10.2 9.8 16.9 2014-2016

4



SCORE PUBLIC SAFETY UNITS HARRIS





population 713.7 407.6 2012-2014 4


children 5.4 8.5 2017 11

SCORE RESPIRATORY DISEASES UNITS HARRIS




population 6.6 1 4.5 2013-2017 12


1.17 Adults 65+ with Pneumonia Vaccination percent 73.5 90 71.3 73.4 2016 10


deaths/ 100,000 population 14 14.2 15.2 2010-2014 Black, Male 12





0.33 Age-Adjusted Death Rate due to deaths/ 100,000 37.5 45.5 39 43.4 2011-2015 7


Lung Cancer population

SCORE SOCIAL ENVIRONMENT UNITS HARRIS









1.81 Mortgaged Owners Median Monthly Household Costs dollars 1504 1444 1491 2012-2016

1

1.75 Persons with Health Insurance percent 79.3 100 81.4 2016

9

1.67 Children Living Below Poverty Level percent 26 23.9 21.2 2012-2016


Other, <6 1


Male, 35-44, 45-64, 65+ 1



Other, Female, <6, 6-11, 12-17, 18-24 1





children 5.4 8.5 2017 11






American Indian or Alaska Native, Black or African American, Native Hawaiian or

Other Pacific Islander, Other, 45-

64, 65+ 1



Other 1


American Indian or Alaska Native, Black or African American, Hispanic or Latino, Native Hawaiian or

Other Pacific Islander, Other, Two

or More Races 1

SCORE SUBSTANCE ABUSE UNITS HARRIS





1.28

Adults (18+ Years) Reporting Binge Drinking Within the Last 12 months percent 16.6 24.2 17.9 16.9 2016 10


population 10.2 9.8 16.9 2014-2016 4

0.94 Adults who Smoke percent 12.1 12 14.3 17.1 2016 10


population 6.3 6.8 10.5 2015

16


SCORE TRANSPORTATION UNITS HARRIS



2.83 Solo Drivers with a Long Commute percent 45.8 36.9 34.7 2012-2016

4


2.17 Workers who Walk to Work percent 1.5 3.1 1.6 2.8 2012-2016 White, non-Hispanic 1

1.44 Workers who Drive Alone to Work percent 79.1 80.3 76.4 2012-2016 White, non-Hispanic,

25-44, 55-59 1

1.33 Households without a Vehicle percent 6.4 5.6 9 2012-2016

1

1.28 Workers Commuting by Public Transportation percent 2.8 5.5 1.5 5.1 2012-2016

Hispanic or Latino, Native Hawaiian or

Other Pacific Islander, Two or

More Races, White, non-Hispanic, Male,

25-44 1

1.00 Households with No Car and Low Access to a Grocery Store percent 0.9 2015

17

SCORE WELLNESS & LIFESTYLE UNITS HARRIS




1.75 Poor Physical Health: 5+ Days percent 80.6 81.5 2016 10



1.17 Frequent Physical Distress percent 11.5 10.8 15 2016

4

1.17 Poor Physical Health: Average Number of Days days 3.6 3.5 3.7 2016

4

1.06 Life Expectancy for Females years 81 80.8 81.5 2014

6

SCORE WOMEN'S HEALTH UNITS HARRIS





females 11 7.3 9.2 7.5 2011-2015 7


deaths/ 100,000 females 23.2 20.7 20.2 20.9 2011-2015 Black 7


females 113.2 111.7 124.7 2011-2015 7

1.06 Life Expectancy for Females years 81 80.8 81.5 2014 6


Liberty County


LIBERTY COUNTY HP2020 Texas U.S.



population 24 60 76 2015 3


population 15 99 214 2017 3


providers/ 100,000 population 39 67 81 2017 3


population 27 56 67 2016 3

1.81 Children with Health Insurance percent 88.7 100.0 90.3 2016 8

1.75 Adults with Health Insurance: 18-64 percent 75.0 100.0 77.4 2016 8

1.75 Persons with Health Insurance percent 79.4 100.0 81.4 2016 8

SCORE CANCER UNITS LIBERTY COUNTY HP2020 Texas U.S.







females 10.7 7.3 9.2 7.5 2011-2015 6








deaths/ 100,000 females 22.4 20.7 20.2 20.9 2011-2015 6

1.83 Colorectal Cancer Incidence Rate cases/ 100,000 41.5 39.9 38.1 39.2 2011-2015 6


population


deaths/ 100,000 males 21.1 21.8 18.1 19.5 2011-2015 6


population 401.0 401.3 441.2 2011-2015 6



females 98.4 111.7 124.7 2011-2015 6


males 75.0 95.4 109.0 2011-2015 6

SCORE CHILDREN'S HEALTH UNITS LIBERTY COUNTY HP2020 Texas U.S.


2.17 Child Food Insecurity Rate percent 26.0 23.0 17.9 2016 4



children 13.3 8.5 2017 9


SCORE ECONOMY UNITS LIBERTY COUNTY HP2020 Texas U.S.




2.61 Unemployed Workers in Civilian Labor Force percent 6.1 4.0 4.1 July 2018 13







1.94 People 65+ Living Below Poverty Level percent 10.6 10.8 9.3 2012-2016 Two or More Races 1




or Latino, Other 1





1.72 Families Living Below Poverty Level percent 12.4 13.0 11.0 2012-2016 Hispanic or Latino 1




Other Pacific Islander 1




1.39 Children Living Below Poverty Level percent 23.3 23.9 21.2 2012-2016 Hispanic or Latino 1



or Latino 1




0.83 Homeownership percent 64.8 55.0 55.9 2012-2016 1

0.72 Renters Spending 30% or More of Household Income on Rent percent 35.1 48.0 47.3 2012-2016 1


SCORE EDUCATION UNITS LIBERTY COUNTY HP2020 Texas U.S.


2.39 People 25+ with a Bachelor's Degree or Higher percent 10.0 28.1 30.3 2012-2016 1

2.06 People 25+ with a High School Degree or Higher percent 76.2 82.3 87.0 2012-2016 Other 1



1.22 High School Drop Out Rate percent 1.7 2.0 2016 11

SCORE ENVIRONMENT UNITS LIBERTY COUNTY HP2020 Texas U.S.










1.72 Food Environment Index 6.6 6.0 7.7 2018 3














population 3.8 6.8 10.5 2015 14

























SCORE HEART DISEASE & STROKE UNITS LIBERTY COUNTY HP2020 Texas U.S.


2.50 Stroke: Medicare Population percent 5.8 4.5 4.0 2015 2



deaths/ 100,000 population 257.6 173.0 171.9 2010-2014 Male 10




1.83 Hypertension: Medicare Population percent 60.4 57.5 55.0 2015 2










population 20.3 40.6 2017 10


population 369.4 511.6 2017 10


population 87.3 160.2 2017 10


population 2.0 1.0 4.5 2013-2017 10


population 3.7 16.1 2016 10




2.36 Preterm Births percent 13.5 9.4 12.0 11.4 2013 10



1.75 Babies with Low Birth Weight percent 8.2 7.8 8.3 8.0 2013 10



births 5.6 6.0 5.8 6.0 2013 10


SCORE MEN'S HEALTH UNITS LIBERTY COUNTY HP2020 Texas U.S.





deaths/ 100,000 males 21.1 21.8 18.1 19.5 2011-2015 6


males 75.0 95.4 109.0 2011-2015 6





population 15 99 214 2017 3





1.94 Depression: Medicare Population percent 17.5 17.0 16.7 2015 2


1.50 Frequent Mental Distress percent 11.8 10.6 15.0 2016 3


SCORE OLDER ADULTS & AGING UNITS LIBERTY COUNTY HP2020 Texas U.S.















1.94 People 65+ Living Below Poverty Level percent 10.6 10.8 9.3 2012-2016 Two or More Races 1





1.44 Osteoporosis: Medicare Population percent 5.8 6.5 6.0 2015 2

1.44

Rheumatoid Arthritis or Osteoarthritis: Medicare Population percent 30.1 31.6 30.0 2015 2




SCORE OTHER CHRONIC DISEASES UNITS LIBERTY COUNTY HP2020 Texas U.S.





1.44


SCORE PREVENTION & SAFETY UNITS LIBERTY COUNTY HP2020 Texas U.S.








population 12.9 9.8 16.9 2014-2016 3

SCORE PUBLIC SAFETY UNITS LIBERTY COUNTY HP2020 Texas U.S.



population 433.2 407.6 2012-2014 3


children 13.3 8.5 2017 9


SCORE RESPIRATORY DISEASES UNITS LIBERTY COUNTY HP2020 Texas U.S.












population 2.0 1.0 4.5 2013-2017 10

SCORE SOCIAL ENVIRONMENT UNITS LIBERTY COUNTY HP2020 Texas U.S.






2.39 People 25+ with a Bachelor's Degree or Higher percent 10.0 28.1 30.3 2012-2016 1




or Latino, Other 1





Other Pacific Islander 1


children 13.3 8.5 2017 9




American, Hispanic 1


or Latino








SCORE SUBSTANCE ABUSE UNITS LIBERTY COUNTY HP2020 Texas U.S.


1.67 Adults who Drink Excessively percent 19.4 25.4 19.4 18.0 2016 3


population 12.9 9.8 16.9 2014-2016 3



population 3.8 6.8 10.5 2015 14

SCORE TRANSPORTATION UNITS LIBERTY COUNTY HP2020 Texas U.S.


2.67 Workers who Drive Alone to Work percent 87.8 80.3 76.4 2012-2016


Native, Asian 1







1.50 Households without a Vehicle percent 5.5 5.6 9.0 2012-2016 1

SCORE WELLNESS & LIFESTYLE UNITS LIBERTY COUNTY HP2020 Texas U.S.




1.83 Self-Reported General Health Assessment: Poor or Fair percent 18.2 18.2 16.0 2016 3

1.50 Frequent Physical Distress percent 11.8 10.8 15.0 2016 3


1.17 Insufficient Sleep percent 32.7 32.7 38.0 2016 3

SCORE WOMEN'S HEALTH UNITS LIBERTY COUNTY HP2020 Texas U.S.



females 10.7 7.3 9.2 7.5 2011-2015 6



deaths/ 100,000 females 22.4 20.7 20.2 20.9 2011-2015 6


females 98.4 111.7 124.7 2011-2015 6


Montgomery County


MONTGOMERY COUNTY HP2020 Texas U.S.



population 69 99 214 2017 4




population 46 56 67 2016 4





population 62 60 76 2015 4

SCORE CANCER UNITS MONTGOMERY COUNTY HP2020 Texas U.S.




females 8.0 7.3 9.2 7.5 2011-2015 7




females 117.6 111.7 124.7 2011-2015 7


deaths/ 100,000 males 17.8 21.8 18.1 19.5 2011-2015 7


deaths/ 100,000 females 19.6 20.7 20.2 20.9 2011-2015 7




population 398.9 401.3 441.2 2011-2015 7







population 36.6 39.9 38.1 39.2 2011-2015 7


males 88.7 95.4 109.0 2011-2015 7



SCORE CHILDREN'S HEALTH UNITS MONTGOMERY COUNTY HP2020 Texas U.S.






children 5.5 8.5 2017 10

SCORE ECONOMY UNITS MONTGOMERY COUNTY HP2020 Texas U.S.




















or Latino, Other 1




0.56 Families Living Below Poverty Level percent 8.3 13.0 11.0 2012-2016


or Latino, Other 1






or Latino, Other, 1


Two or More Races






or Latino, Other 1



Other, Two or More Races 1

SCORE EDUCATION UNITS MONTGOMERY COUNTY HP2020 Texas U.S.



1.22 People 25+ with a High School Degree or Higher percent 86.8 82.3 87.0 2012-2016





25-34, 65+ American Indian or

Alaska Native, Other, Two or More

Races 1

SCORE ENVIRONMENT UNITS MONTGOMERY COUNTY HP2020 Texas U.S.
























population 6.3 6.8 10.5 2015 15

























SCORE HEART DISEASE & STROKE UNITS MONTGOMERY COUNTY HP2020 Texas U.S.










deaths/ 100,000 population 173.2 173.0 171.9 2010-2014 Male Black 11







population 13.1 40.6 2017 11


population 265.4 511.6 2017 11


population 7.7 16.1 2016 11


population 1.8 1.0 4.5 2013-2017 11


population 52.4 160.2 2017 11













births 4.5 6.0 5.8 6.0 2013 11


SCORE MEN'S HEALTH UNITS MONTGOMERY COUNTY HP2020 Texas U.S.



deaths/ 100,000 males 17.8 21.8 18.1 19.5 2011-2015 7



males 88.7 95.4 109.0 2011-2015 7







population 69 99 214 2017 4







SCORE OLDER ADULTS & AGING UNITS MONTGOMERY COUNTY HP2020 Texas U.S.












1.33










or Latino, Other 1







SCORE OTHER CHRONIC DISEASES UNITS MONTGOMERY COUNTY HP2020 Texas U.S.



1.33



SCORE PREVENTION & SAFETY UNITS MONTGOMERY COUNTY HP2020 Texas U.S.




population 10.6 9.8 16.9 2014-2016 4





SCORE PUBLIC SAFETY UNITS MONTGOMERY COUNTY HP2020 Texas U.S.




children 5.5 8.5 2017 10


population 171.2 407.6 2012-2014 4


SCORE RESPIRATORY DISEASES UNITS MONTGOMERY COUNTY HP2020 Texas U.S.




population 1.8 1.0 4.5 2013-2017 11








SCORE SOCIAL ENVIRONMENT UNITS MONTGOMERY COUNTY HP2020 Texas U.S.












children 5.5 8.5 2017 10













25-34, 65+ American Indian or

Alaska Native, Other, Two or More

Races 1





or Latino, Other 1



Other, Two or More Races 1

SCORE SUBSTANCE ABUSE UNITS MONTGOMERY COUNTY HP2020 Texas U.S.






population 10.6 9.8 16.9 2014-2016 4


population 6.3 6.8 10.5 2015 15

SCORE TRANSPORTATION UNITS MONTGOMERY COUNTY HP2020 Texas U.S.





2.17 Workers who Drive Alone to Work percent 81.5 80.3 76.4 2012-2016 1

1.67 Workers Commuting by Public Transportation percent 1.3 5.5 1.5 5.1 2012-2016 16-19, 20-24 Other 1



SCORE WELLNESS & LIFESTYLE UNITS MONTGOMERY COUNTY HP2020 Texas U.S.









SCORE WOMEN'S HEALTH UNITS MONTGOMERY COUNTY HP2020 Texas U.S.



females 8.0 7.3 9.2 7.5 2011-2015 7



females 117.6 111.7 124.7 2011-2015 7


deaths/ 100,000 females 19.6 20.7 20.2 20.9 2011-2015 7


San Jacinto County


SAN JACINTO COUNTY HP2020 Texas U.S.



population 7 99 214 2017 3




population 4 56 67 2016 3


population 15 60 76 2015 3




SCORE CANCER UNITS








deaths/ 100,000 females 26.7 20.7 20.2 20.9 2011-2015 6







population 427.1 401.3 441.2 2011-2015 6



deaths/ 100,000 males 19.3 21.8 18.1 19.5 2011-2015 6




males 79.3 95.4 109.0 2011-2015 6


population 35.3 39.9 38.1 39.2 2011-2015 6


females 93.2 111.7 124.7 2011-2015 6

SCORE CHILDREN'S HEALTH UNITS






children 12.6 8.5 2017 9


SCORE ECONOMY UNITS



2.67 Population 16+ in Civilian Labor Force percent 52.7 64.2 63.1 2012-2016 #N/A

2.61 Female Population 16+ in Civilian Labor Force percent 43.7 57.7 58.3 2012-2016 #N/A





2.28 Median Household Income dollars 44878 54727 55322 2012-2016 Asian #N/A


Asian, Hispanic or Latino, Two or More

Races #N/A

2.25 Persons with Disability Living in Poverty (5-year) percent 31.6 25.1 27.6 2012-2016 #N/A

2.19 Median Housing Unit Value dollars 88000 142700 184700 2012-2016 #N/A

2.11 People Living 200% Above Poverty Level percent 57.5 62.8 66.4 2012-2016 #N/A


1.89 People Living Below Poverty Level percent 17.2 16.7 15.1 2012-2016 18-24 Asian #N/A

1.83 Homeowner Vacancy Rate percent 2.1 1.6 1.8 2012-2016 #N/A




Black or African American #N/A

1.61 Renters Spending 30% or More of Household Income on Rent percent 43.2 48.0 47.3 2012-2016 #N/A

1.39 Households with Cash Public Assistance Income percent 1.8 1.6 2.7 2012-2016 #N/A


1.22 Families Living Below Poverty Level percent 11.7 13.0 11.0 2012-2016 Asian #N/A

1.08 Mortgaged Owners Median Monthly Household Costs dollars 1111 1444 1491 2012-2016 #N/A


0.92 Median Household Gross Rent dollars 697 911 949 2012-2016 #N/A

0.89 Children Living Below Poverty percent 19.7 23.9 21.2 2012-2016 #N/A


Level

0.75 Median Monthly Owner Costs for Households without a Mortgage dollars 396 467 462 2012-2016 #N/A

0.56 Homeownership percent 62.7 55.0 55.9 2012-2016 #N/A


SCORE EDUCATION UNITS





or Latino #N/A




1.17 People 25+ with a High School Degree or Higher percent 82.8 82.3 87.0 2012-2016 Hispanic or Latino #N/A

SCORE ENVIRONMENT UNITS






















0.61 Houses Built Prior to 1950 percent 4.7 7.4 18.2 2012-2016 #N/A


population 3.6 6.8 10.5 2015 14




2.44 Workers who Walk to Work percent 1.4 3.1 1.6 2.8 2012-2016 #N/A




















SCORE HEART DISEASE & STROKE UNITS


















population 2.9 1.0 4.5 2013-2017 10


population 106.1 160.2 2017 10


population 21.2 40.6 2017 10


population 14.4 16.1 2016 10


population 290.1 511.6 2017 10












births 3.7 6.0 5.8 6.0 2012 10


SCORE MEN'S HEALTH UNITS





deaths/ 100,000 males 19.3 21.8 18.1 19.5 2011-2015 6


males 79.3 95.4 109.0 2011-2015 6





population 7 99 214 2017 3









SCORE OLDER ADULTS & AGING UNITS


















Black or African American #N/A

1.56




0.78 People 65+ Living Alone percent 21.6 23.9 26.4 2012-2016 #N/A




SCORE OTHER CHRONIC DISEASES UNITS




1.56



SCORE PREVENTION & SAFETY UNITS






population 13.4 9.8 16.9 2014-2016 3


SCORE PUBLIC SAFETY UNITS





children 12.6 8.5 2017 9


population 246.9 407.6 2012-2014 3


SCORE RESPIRATORY DISEASES UNITS










population 2.9 1.0 4.5 2013-2017 10



SCORE SOCIAL ENVIRONMENT UNITS



2.67 Population 16+ in Civilian Labor Force percent 52.7 64.2 63.1 2012-2016 #N/A

2.61 Female Population 16+ in Civilian Labor Force percent 43.7 57.7 58.3 2012-2016 #N/A



or Latino #N/A

2.39 Mean Travel Time to Work minutes 40.1 25.9 26.1 2012-2016 #N/A

2.28 Median Household Income dollars 44878 54727 55322 2012-2016 Asian #N/A


Asian, Hispanic or Latino, Two or More

Races #N/A

2.19 Median Housing Unit Value dollars 88000 142700 184700 2012-2016 #N/A



1.89 People Living Below Poverty Level percent 17.2 16.7 15.1 2012-2016 18-24 Asian #N/A


children 12.6 8.5 2017 9


1.50 Single-Parent Households percent 33.1 33.3 33.6 2012-2016 #N/A

1.17 People 25+ with a High School Degree or Higher percent 82.8 82.3 87.0 2012-2016 Hispanic or Latino #N/A

1.08 Mortgaged Owners Median Monthly Household Costs dollars 1111 1444 1491 2012-2016 #N/A

0.94 Linguistic Isolation percent 1.4 7.9 4.5 2012-2016 #N/A

0.92 Median Household Gross Rent dollars 697 911 949 2012-2016 #N/A

0.89 Children Living Below Poverty Level percent 19.7 23.9 21.2 2012-2016 #N/A

0.78 People 65+ Living Alone percent 21.6 23.9 26.4 2012-2016 #N/A

0.75 Median Monthly Owner Costs for Households without a Mortgage dollars 396 467 462 2012-2016 #N/A

0.56 Homeownership percent 62.7 55.0 55.9 2012-2016 #N/A


SCORE SUBSTANCE ABUSE UNITS





population 13.4 9.8 16.9 2014-2016 3



population 3.6 6.8 10.5 2015 14


SCORE TRANSPORTATION UNITS



2.61 Workers Commuting by Public Transportation percent 0.0 5.5 1.5 5.1 2012-2016 #N/A

2.44 Workers who Walk to Work percent 1.4 3.1 1.6 2.8 2012-2016 #N/A

2.39 Mean Travel Time to Work minutes 40.1 25.9 26.1 2012-2016 #N/A



1.67 Workers who Drive Alone to Work percent 79.4 80.3 76.4 2012-2016


Native, Asian #N/A

0.89 Households without a Vehicle percent 5.1 5.6 9.0 2012-2016 #N/A

SCORE WELLNESS & LIFESTYLE UNITS










SCORE WOMEN'S HEALTH UNITS




deaths/ 100,000 females 26.7 20.7 20.2 20.9 2011-2015 6



females 93.2 111.7 124.7 2011-2015 6


Walker County


WALKER COUNTY HP2020 Texas U.S.



population 31 60 76 2015 3


population 48 99 214 2017 3





population 43 56 67 2016 3



SCORE CANCER UNITS WALKER COUNTY HP2020 Texas U.S.



females 16.8 7.3 9.2 7.7 2008-2012 6






deaths/ 100,000 males 19.2 21.8 18.1 19.5 2011-2015 6


females 117.7 111.7 124.7 2011-2015 6




population 39.8 39.9 38.1 39.2 2011-2015 6





population 414.9 401.3 441.2 2011-2015 6


males 99.7 95.4 109.0 2011-2015 6





deaths/ 100,000 females 17.7 20.7 20.2 20.9 2011-2015 6

SCORE CHILDREN'S HEALTH UNITS WALKER COUNTY HP2020 Texas U.S.






children 4.9 8.5 2017 9

SCORE ECONOMY UNITS WALKER COUNTY HP2020 Texas U.S.







or Latino, Other 1





2.39 People Living Below Poverty Level percent 24.0 16.7 15.1 2012-2016 18-24 Black or

African American 1


American 1























SCORE EDUCATION UNITS WALKER COUNTY HP2020 Texas U.S.





35-44 Black or African American 1


Black or African American, Other 1


SCORE ENVIRONMENT UNITS WALKER COUNTY HP2020 Texas U.S.
























population 5.7 6.8 10.5 2015 14
























0.22 Workers who Walk to Work percent 4.7 3.1 1.6 2.8 2012-2016 55-59 Other 1

SCORE HEART DISEASE & STROKE UNITS WALKER COUNTY HP2020 Texas U.S.

















population 798.7 511.6 2017 10


population 146.7 160.2 2017 10


population 34.6 40.6 2017 10


population 11.2 16.1 2016 10


population 0.0 1.0 4.5 2013-2017 10













births 1.6 6.0 5.8 6.0 2013 10

SCORE MEN'S HEALTH UNITS WALKER COUNTY HP2020 Texas U.S.





deaths/ 100,000 males 19.2 21.8 18.1 19.5 2011-2015 6


males 99.7 95.4 109.0 2011-2015 6







population 48 99 214 2017 3







SCORE OLDER ADULTS & AGING UNITS WALKER COUNTY HP2020 Texas U.S.













1.61











SCORE OTHER CHRONIC DISEASES UNITS WALKER COUNTY HP2020 Texas U.S.



1.61




SCORE PREVENTION & SAFETY UNITS WALKER COUNTY HP2020 Texas U.S.




population 5.3 9.4 13.9 2012-2014 3



SCORE PUBLIC SAFETY UNITS WALKER COUNTY HP2020 Texas U.S.




population 383.4 407.6 2012-2014 3


children 4.9 8.5 2017 9

SCORE RESPIRATORY DISEASES UNITS WALKER COUNTY HP2020 Texas U.S.









population 0.0 1.0 4.5 2013-2017 10




SCORE SOCIAL ENVIRONMENT UNITS WALKER COUNTY HP2020 Texas U.S.






or Latino, Other 1


2.39 People Living Below Poverty Level percent 24.0 16.7 15.1 2012-2016 18-24 Black or

African American 1


American 1










35-44 Black or African American 1








children 4.9 8.5 2017 9



SCORE SUBSTANCE ABUSE UNITS WALKER COUNTY HP2020 Texas U.S.





population 5.3 9.4 13.9 2012-2014 3


population 5.7 6.8 10.5 2015 14

SCORE TRANSPORTATION UNITS WALKER COUNTY HP2020 Texas U.S.




1.72 Workers who Drive Alone to Work percent 82.6 80.3 76.4 2012-2016 55-59 1




0.22 Workers who Walk to Work percent 4.7 3.1 1.6 2.8 2012-2016 55-59 Other 1


SCORE WELLNESS & LIFESTYLE UNITS WALKER COUNTY HP2020 Texas U.S.








SCORE WOMEN'S HEALTH UNITS WALKER COUNTY HP2020 Texas U.S.



females 16.8 7.3 9.2 7.7 2008-2012 6



females 117.7 111.7 124.7 2011-2015 6


deaths/ 100,000 females 17.7 20.7 20.2 20.9 2011-2015 6


Waller County


WALLER COUNTY HP2020 Texas U.S.





population 10 60 76 2015 3


population 16 56 67 2016 3


population 34 99 214 2017 3




SCORE CANCER UNITS WALLER COUNTY HP2020 Texas U.S.



deaths/ 100,000 females 21.2 20.7 20.2 20.9 2011-2015 6


females 109.8 111.7 124.7 2011-2015 6









population 371.0 401.3 441.2 2011-2015 6







males 85.5 95.4 109.0 2011-2015 6


population 30.2 39.9 38.1 39.2 2011-2015 6

SCORE CHILDREN'S HEALTH UNITS WALLER COUNTY HP2020 Texas U.S.






children 3.5 8.5 2017 9

SCORE ECONOMY UNITS WALLER COUNTY HP2020 Texas U.S.













2.06 People Living Below Poverty Level percent 19.0 16.7 15.1 2012-2016 18-24, 6-11 Black or

African American 1












1.17 Families Living Below Poverty Level percent 12.0 13.0 11.0 2012-2016 1


American Indian or Alaska Native, Black or African American,

Hispanic or Latino 1








SCORE EDUCATION UNITS WALLER COUNTY HP2020 Texas U.S.








SCORE ENVIRONMENT UNITS WALLER COUNTY HP2020 Texas U.S.

























population 2.1 6.8 10.5 2015 14























0.22 Workers who Walk to Work percent 4.7 3.1 1.6 2.8 2012-2016 45-54, 55-59, 60-64 1

SCORE HEART DISEASE & STROKE UNITS WALLER COUNTY HP2020 Texas U.S.









deaths/ 100,000 population 194.8 173.0 171.9 2010-2014 Black 10








population 15.6 40.6 2017 10


population 2.9 1.0 4.5 2013-2017 10


population 78.0 160.2 2017 10


population 306.0 511.6 2017 10


population 8.0 16.1 2016 10











births 5.1 6.0 5.8 6.0 2013 10






population 34 99 214 2017 3










SCORE OLDER ADULTS & AGING UNITS WALLER COUNTY HP2020 Texas U.S.

















1.06










SCORE OTHER CHRONIC DISEASES UNITS WALLER COUNTY HP2020 Texas U.S.



1.06



SCORE PREVENTION & SAFETY UNITS WALLER COUNTY HP2020 Texas U.S.









population 8.9 9.8 16.9 2014-2016 3

SCORE PUBLIC SAFETY UNITS WALLER COUNTY HP2020 Texas U.S.



population 273.0 407.6 2012-2014 3


children 3.5 8.5 2017 9


SCORE RESPIRATORY DISEASES UNITS WALLER COUNTY HP2020 Texas U.S.





population 2.9 1.0 4.5 2013-2017 10







SCORE SOCIAL ENVIRONMENT UNITS WALLER COUNTY HP2020 Texas U.S.








2.06 People Living Below Poverty Level percent 19.0 16.7 15.1 2012-2016 18-24, 6-11 Black or

African American 1













American Indian or Alaska Native, Black or African American,

Hispanic or Latino 1






children 3.5 8.5 2017 9



SCORE SUBSTANCE ABUSE UNITS WALLER COUNTY HP2020 Texas U.S.




population 8.9 9.8 16.9 2014-2016 3



population 2.1 6.8 10.5 2015 14

SCORE TRANSPORTATION UNITS WALLER COUNTY HP2020 Texas U.S.






1.22 Workers who Drive Alone to Work percent 78.1 80.3 76.4 2012-2016 60-64 1


0.22 Workers who Walk to Work percent 4.7 3.1 1.6 2.8 2012-2016 45-54, 55-59, 60-64 1

SCORE WELLNESS & LIFESTYLE UNITS WALLER COUNTY HP2020 Texas U.S.









SCORE WOMEN'S HEALTH UNITS WALLER COUNTY HP2020 Texas U.S.



deaths/ 100,000 females 21.2 20.7 20.2 20.9 2011-2015 6


females 109.8 111.7 124.7 2011-2015 6



Wharton County


WHARTON COUNTY HP2020 Texas U.S.



population 34 99 214 2017 3


population 41 60 76 2015 3







population 46 56 67 2016 3

SCORE CANCER UNITS WHARTON

COUNTY HP2020 Texas U.S. MEASUREMENT



deaths/ 100,000 females 25.7 20.7 20.2 20.9 2011-2015 6


population 50.5 39.9 38.1 39.2 2011-2015 6




females 18.3 7.3 9.4 7.8 2007-2011 6



population 406.8 401.3 441.2 2011-2015 6




deaths/ 100,000 males 19.1 21.8 18.1 19.5 2011-2015 6



females 101.5 111.7 124.7 2011-2015 6






males 85.7 95.4 109.0 2011-2015 6



SCORE CHILDREN'S HEALTH UNITS WHARTON






children 9.6 8.5 2017 9


SCORE ECONOMY UNITS WHARTON












1.89 People Living Below Poverty Level percent 17.7 16.7 15.1 2012-2016 6-11, <6 Black or African American 1










or Latino 1

















SCORE EDUCATION UNITS WHARTON






1.83 People 25+ with a High School Degree or Higher percent 78.0 82.3 87.0 2012-2016 65+ Other 1



SCORE ENVIRONMENT UNITS WHARTON
























population 4.8 6.8 10.5 2015 14
























SCORE HEART DISEASE & STROKE UNITS WHARTON


















population 145.3 160.2 2017 10




population 11.9 40.6 2017 10


population 336.0 511.6 2017 10


population 1.4 1.0 4.5 2013-2017 10


population 2.4 16.1 2016 10





births 9.4 6.0 5.8 6.0 2013 10







SCORE MEN'S HEALTH UNITS WHARTON






deaths/ 100,000 males 19.1 21.8 18.1 19.5 2011-2015 6


males 85.7 95.4 109.0 2011-2015 6





population 34 99 214 2017 3









SCORE MORTALITY DATA UNITS WHARTON




deaths/ 100,000 females 25.7 20.7 20.2 20.9 2011-2015 6


births 9.4 6.0 5.8 6.0 2013 10










1.75 Age-Adjusted Death Rate due to Diabetes










deaths/ 100,000 males 19.1 21.8 18.1 19.5 2011-2015 6




population 7.0 9.4 12.4 2006-2012 3



SCORE OLDER ADULTS & AGING UNITS WHARTON














2.00












SCORE OTHER CHRONIC DISEASES UNITS WHARTON





2.00



SCORE PREVENTION & SAFETY UNITS WHARTON







population 7.0 9.4 12.4 2006-2012 3

SCORE PUBLIC SAFETY UNITS WHARTON




children 9.6 8.5 2017 9


population 412.5 407.6 2012-2014 3


SCORE RESPIRATORY DISEASES UNITS WHARTON








population 1.4 1.0 4.5 2013-2017 10






SCORE SOCIAL ENVIRONMENT UNITS WHARTON








1.89 People Living Below Poverty Level percent 17.7 16.7 15.1 2012-2016 6-11, <6 Black or African American 1


1.83 People 25+ with a High School Degree or Higher percent 78.0 82.3 87.0 2012-2016 65+ Other 1







children 9.6 8.5 2017 9





or Latino 1










SCORE SUBSTANCE ABUSE UNITS WHARTON






population 4.8 6.8 10.5 2015 14


population 7.0 9.4 12.4 2006-2012 3

SCORE TRANSPORTATION UNITS WHARTON




2.28 Workers who Drive Alone to Work percent 84.0 80.3 76.4 2012-2016 Asian 1







SCORE WELLNESS & LIFESTYLE UNITS WHARTON









SCORE WOMEN'S HEALTH UNITS WHARTON




deaths/ 100,000 females 25.7 20.7 20.2 20.9 2011-2015 6


females 18.3 7.3 9.4 7.8 2007-2011 6



females 101.5 111.7 124.7 2011-2015 6


AppendixC.PrimaryDataMethodology

CommunityInputParticipantsAccessHealth(FQHC)(FortBendFamilyHealthCenter)AIDSFoundationofHoustonAssociationfortheAdvancementofMexicanAmericansAvenueCDCCatholicCharities-ArchdioceseofGalvestonCatholicCharities-FortBendChildAdvocatesofFortBendChildrenatRiskChristClinicCityofHouston,DepartmentofParksandRecreationCoastalAreaHealthEducationCenters(AHEC)CommunityHealthChoiceElCentrodeCorazonEpiscopalHealthFoundationFortBendCountyHealthandHumanServicesFortBendCountySheriff'sOfficeFortBendRegionalCouncilOnSubstanceAbuseFortBendSeniorsMealsonWheelsFortBendWomen'sCenterGalvestonCountyHealthDistrictGalvestonCountyMentalHealthDeputiesGreaterHoustonPartnershipGreaterHoustonWomen'sChamberofCommerce

GulfCoastMedicalFoundationHarrisCountyPublicHealthHealthcarefortheHomeless-HoustonHOPEClinic(FQHC)HoustonFoodBankHoustonHealthDepartmentHoustonHousingAuthorityHoustonIndependentSchoolDistrictInterfaithCommunityClinicKinderInstituteLegacyCommunityHealthLibertyCountySheriff'sOfficeLoneStarFamilyHealthCenterMidtownArtsandTheaterCenterHoustonMontgomeryCountyWomen'sCenterBaker-RipleyEarlyHeadStartPatientCareInterventionCenter(PCIC)PrairieViewA&MUniversitySantaMariaHostel,Inc.TheArcofFortBendCountyTheHarrisCenterforMentalHealthandIDD(formerlyMHMRA)TheRoseTheWomen'sHomeTri-CountyServicesBehavioralHealthcareUnitedWayofBrazoriaCountyUnitedWayofGreaterHoustonUnitedWayofHarrisandMontgomeryCountyWestChambersMedicalCenter(FQHC)YMCAofGreaterHouston


KeyInformantInterviewQuestionnaire(EpiscopalHealthFoundation)• Goodmorning/afternoon[NAMEOFINFORMANT].Mynameis[NAMEOFINTERVIEWER],

andIamwithHealthResourcesinAction,anon-profitpublichealthorganizationbasedinBoston.Thankyouforspeakingwithmetoday.

• Aswementionedinourinterviewinvitation,theEpiscopalHealthFoundationis

coordinatinganinterviewinitiativetosupportfourGreaterHoustonareahospitalsystemsinpreparingtheircommunityhealthneedsassessments.ThecollaboratinghospitalsincludeCHISt.Luke’s,HoustonMethodistHospital,MemorialHermannHealthSystem,andTexasChildren’sHospital.

• Thepurposeofthisinterviewistogainagreaterunderstandingofthehealthstatusand

wellbeingofresidentsintheGreaterHoustonareaanddeterminehowthesehealthneedsarecurrentlybeingaddressed.Interviewslikethisonearebeingconductedwithabout70stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Wearealsointerviewingcommunityleaderswithspecificexperienceworkingwithprioritypopulationssuchaswomen,children,peopleofcolor,andthedisabledtonameafew.

• Weareinterestedinhearingpeople’sfeedbackontheneedsofthebroaderGreater

Houstoncommunityandthepopulationsyouworkwithasaleaderinyourcommunity.TheFoundationandthefourhospitalswelcomeyourcriticalfeedbackandsuggestionsforhealthimprovementactivitiesinthefuture.Yourhonestyduringtoday’sinterviewisencouragedandappreciated.

• Aswementionedinourinterviewinvitation,theinterviewwilllastbetween45minutesto

anhouranditwillberecorded.Afteralltheinterviewsarecompleted,HealthResourcesinActionwillprovideatranscriptofyourinterviewtothefourhospitalsforuseinpreparingtheircommunityhealthneedsassessmentreports.Eachhospitalwillkeepyourinterviewtranscriptconfidentialandaccessibleonlytotheteamthatispreparingthecommunityhealthneedsassessmentreport.HealthResourcesinActionwillalsobepreparingareportofthegeneralthemesthatemergeacrossalltheinterviewstohelpthehospitalspreparetheirreports.

• TheFoundationhasaskedHealthResourcesinActiontoaskallintervieweeshowtheywish

anyquotesfromtoday’sinterviewtobepresentedinreports.Therearethreeoptions.Quotesmaybepresentedanonymouslywithoutyournameororganization,presentedwithyournameandorganization,orpresentedwithonlythesectoryourepresent.Whichoptionwouldyouliketochoose?

• RECORDRESPONSEFROMINTERVIEWEE:rAnonymousrNameandorganizationrSector

• Thankyou.Wewillnoteyourchoiceinthetranscriptthatweprovidetothehospitals.


• IFTHERESPONDENTISUNSUREATTHETIMEOFTHEINTERVIEW:Ok,pleasefeelfreetothinkitoverandwewillfollowupwithyouforyourdecisionbeforewesendthetranscripttothehospitals.

• Doyouhaveanyquestionsbeforewebegin?BEGINRECORDINGTHEINTERVIEW

INTERVIEWQUESTIONNAIRE(55MINUTES)

NOTESTOINTERVIEWER:• INTERVIEWQUESTIONSMAYBEADDEDORTAILOREDTOMEETTHESPECIFIC

POSITION/ROLEOFTHEINTERVIEWEE• THEQUESTIONSINTHEINTERVIEWQUESTIONNAIREAREINTENDEDTOSERVEASAGUIDE,

NOTASCRIPTBACKGROUND(5MINUTES)• Canyoutellmealittlebitaboutyourroleatyourorganization/agency?

o Hasyourorganization/agencyeverpartneredwithanyofthefourhospitalsinvolvedinthissharedcommunityhealthneedsassessmentbefore?IFSO,PROBEINWHATCAPACITY/PROGRAM

• Howwouldyoudescribethecommunityyourepresent/thecommunityyourorganizationserves/theGreaterHoustonpopulationatlarge?Whataresomeofitsdefiningcharacteristicsintermsofdemographics?INTERVIEWER:ESTABLISHWHATTHEINFORMANTCONSIDERSTHECOMMUNITYTOBEFROMTHEIRPERSPECTIVE

COMMUNITYISSUES(20minutes)INTERVIEWER:VARYTHELABELOF‘COMMUNITY’BASEDONTHEINFORMANT’SBACKGROUNDANDHOWHEORSHEDESCRIBESTHECOMMUNITY;BESURETOPROBEONWOMEN’SANDCHILDREN’SISSUESTOENSUREWEADDRESSTHENEEDSOFTHECHILDREN’SHOSPITALSINALLQUESTIONSASRELEVANT• Thinkingaboutthestatusofthecommunitytoday,howwouldyouratetheoverallhealth

statusofresidentsonascaleof1to5with1beingpoorand5beingveryhealthy?

• Ifyouhadtopickyourtop3healthconcernsinthecommunity,whatwouldtheybe?PROBEIN-DEPTHBASEDONINFORMANTAREAOFEXPERTISE

o Whodoyouconsidertobethepopulationsinthecommunitymostvulnerableorat

riskfortheseconditions/issues?§ IFNOTYETMENTIONED,PROBESPECIFICALLYONPRIORITYPOPULATION

RELEVANTTOTHEINFORMANT’SEXPERTISE:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityfor[PRIORITYPOPULATION]?


§ FORINFORMANTSEXPERTISEWITHWOMENANDCHILDREN:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityforchildrenandtheirfamilies?Howaboutforwomen?

§ IFNOTYETDISCUSSED:Ofthetopthreeissuesyoumentioned,whichwould

yourankasyourtopissue?Howdoyouseethisissueaffectingcommunitymembers’dailylivesandtheirhealth?PROBEIN-DEPTHINSPECIFICFOCUSAREAS;MAYASKABOUTONEISSUEATTIMEANDFOCUSONPERSON’SAREAOFEXPERTISE.

• Fromyourexperience,whatareresidents’biggestbarrierstoaddressingthetop3health

issuesyouidentified?o PROBE:Socialdeterminantsofhealth?o PROBE:Barrierstoaccessingmedicalcare?o PROBE:Barrierstoaccessingpreventiveservicesorprograms?

FOCUSAREA:HEALTHYLIVING(5MINUTES)• I’dliketoaskyouaboutbarriersaffectinghealthylivingandthepreventionofobesity.

o Whataresomeofthebarrierstohealthyeatingandphysicalactivityamongthecommunitiesyouserve?

§ Whatpopulationsaremostaffectedbybarrierstohealthylivingandphysicalactivity?PROBEABOUTFOODINSECURITYANDACCESSTOSAFESPACESFORPHYSICALACTIVITY

o Whateffortsorprogramsareyouawareofthatpromotehealthyliving?PROBEABOUTHEALTHYLIVINGMATTERSCOLLABORATIVE

ACCESSTOHEALTHCAREANDPUBLICHEALTH/PREVENTIONSERVICES(15MINUTES)

• I’dliketoaskyouaboutaccesstohealthcareandsocialservicesinyourcommunity.

o Whatdoyouseeasthestrengthsofthehealthcareandsocialservicesinyourcommunity?

o Whatdoyouseeasitslimitations?• Whatchallenges/barriersdoresidentsinyourcommunityfaceinaccessinghealthcareand

socialservices?[PROBEINDEPTHFORBARRIERSTOCARE:INSURANCEISSUES,LANGUAGEBARRIERS,ACCESSTOHEALTHINFORMATION/HEALTHLITERACY,LACKOFTRANSPORTION,CHILDCARE,ETC.]

o Whatdoyouthinkneedstohappeninthecommunityyouservetohelpresidentsovercomeoraddressthesechallenges?

• Whatprograms,services,orpoliciesareyouawareofinthecommunitythataddressaccess

tohealthcareandsocialservices?

o Inyouropinion,howeffectivehavetheseprograms,services,orpoliciesbeenataddressingthehealthneedsofresidents?


o Whatprogram,services,orpoliciesarecurrentlynotavailablethatyouthinkshould

be?

IMPROVINGTHEHEALTHOFTHECOMMUNITY/RESIDENTS(10MINUTES)• Whatdoyouthinkneedstohappeninthecommunityyouservetohelpresidentsovercome

oraddressthechallengestheyfaceinbeingabletobehealthy?

• Earlierinthisinterview,youmentioned[TOPISSUE]asbeingyourtophealthpriorityforarearesidents.Whatdoyouthinkneedstobedonetoaddress[TOPISSUEHERE]?

o Whatdoyouthinkhospitalscandotoaddressthisissuethattheyaren’tdoingrightnow?Doyouhaveanysuggestionsabouthowhospitalscanbecreativeorworkoutsidetheirtraditionalroletoaddressthisissueandimprovecommunityhealth?

o Whatkindsofopportunitiesarecurrentlyouttherethatcanbeseizedupontoaddresstheseissues?Forexample,aretheresome“lowhangingfruit”–currentcollaborationsorinitiativesthatcanbestrengthenedorexpanded?

VISIONFORTHECOMMUNITY(5MINUTES)

• Thehospitalsinvolvedinthisinitiativewillbeplanningtheirstrategytoimprovethehealth

ofthecommunitiestheyserve.Whatadvicedoyouhaveforthegroupdevelopingtheplantoaddressthetophealthneedsyou’vementioned?

CLOSING(5MINUTES)

Thankyousomuchforyourtime.That’sitformyquestions.Isthereanythingelsethatyouwouldliketomentionthatwedidn’tdiscusstoday?AsImentioned,afteralloftheinterviewsarecompleted,wewillbesendingyourinterviewtranscriptstothefourhospitals.Eachhospitalwillmaketheircommunityhealthneedsassessmentreportspubliclyavailablewhentheyarecomplete.Ifyouhaveanyquestions,pleasefeelfreetoreachouttoJenniferMineoattheEpiscopalHealthFoundationwhoiscoordinatingthiseffortonbehalfofthefourhospitals.Thankyouagain.Haveagoodmorning/afternoon.


KeyInformantInterviewQuestionnaire(ConduentHealthyCommunitiesInstitute)Goodmorning/afternoon[NAMEOFINFORMANT].Mynameis[NAMEOFINTERVIEWER],andIamwithConduentHealthyCommunitiesInstitute.Mycolleague[name]isalsoontheline.WeareworkingwithMemorialHermannHealthSystemtoconductaCommunityHealthNeedsAssessment.• Thepurposeofthisinterviewistogainagreaterunderstandingofthehealthstatusand

wellbeingofresidentsintheGreaterHoustonareaanddeterminehowthesehealthneedsarecurrentlybeingaddressed.Interviewslikethisonearebeingconductedwithabout12stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Wearealsointerviewingcommunityleaderswithspecificexperienceworkingwithprioritypopulationssuchaswomen,children,peopleofcolor,andthedisabledtonameafew.

• Weareinterestedinhearingpeople’sfeedbackontheneedsofthecommunityandthe

populationsyouworkwithasaleaderinyourcommunity.MemorialHermannwelcomeyourcriticalfeedbackandsuggestionsforhealthimprovementactivitiesinthefuture.Yourhonestyduringtoday’sinterviewisencouragedandappreciated.

• Aswementionedinourinterviewinvitation,theinterviewwilllastbetween45minutesto

anhouranditwillberecorded.Afteralltheinterviewsarecompleted,wewillanalyzeandsummarizealltheinterviewstoincorporateintothecommunityhealthneedsassessmentreports.EachMHhospitalwillkeepyourinterviewtranscriptconfidentialandaccessibleonlytotheteamthatispreparingthecommunityhealthneedsassessmentreport.

• MemorialHermannhasaskedHCItoaskallintervieweeshowtheywishanyquotesfromtoday’sinterviewtobepresentedinreports.Therearethreeoptions.Quotesmaybepresentedanonymouslywithoutyournameororganization,presentedwithyournameandorganization,orpresentedwithonlythesectoryourepresent.

• Whichoptionwouldyouliketochoose?

• RECORDRESPONSEFROMINTERVIEWEE:rAnonymousrNameandorganizationrSector

• Thankyou.Wewillnoteyourchoiceinthetranscriptthatweprovidetothehospitals.

• IFTHERESPONDENTISUNSUREATTHETIMEOFTHEINTERVIEW:Ok,pleasefeelfreetothinkitoverandwewillfollowupwithyouforyourdecisionbeforewesendthetranscripttothehospitals.

• Doyouhaveanyquestionsbeforewebegin?BEGINRECORDINGTHEINTERVIEW


INTERVIEWQUESTIONNAIRE(55MINUTES)

NOTESTOINTERVIEWER:• INTERVIEWQUESTIONSMAYBEADDEDORTAILOREDTOMEETTHESPECIFIC

POSITION/ROLEOFTHEINTERVIEWEE• THEQUESTIONSINTHEINTERVIEWQUESTIONNAIREAREINTENDEDTOSERVEASAGUIDE,

NOTASCRIPTBACKGROUND(5MINUTES)• Canyoutellmealittlebitaboutyourroleatyourorganization?

o Hasyourorganization/agencyeverpartneredwithMH’scommunityhealthneedsassessmentbefore?IFSO,PROBEINWHATCAPACITY/PROGRAM

• Howwouldyoudescribethecommunityyourepresent/thecommunityyourorganizationserves?Whataresomeofitsdefiningcharacteristicsintermsofdemographics?INTERVIEWER:ESTABLISHWHATTHEINFORMANTCONSIDERSTHECOMMUNITYTOBEFROMTHEIRPERSPECTIVE

COMMUNITYISSUES(20minutes)INTERVIEWER:VARYTHELABELOF‘COMMUNITY’BASEDONTHEINFORMANT’SBACKGROUNDANDHOWHEORSHEDESCRIBESTHECOMMUNITY;BESURETOPROBEONWOMEN’SANDCHILDREN’SISSUESTOENSUREWEADDRESSTHENEEDSOFTHECHILDREN’SHOSPITALSINALLQUESTIONSASRELEVANT• Thinkingaboutthestatusofthecommunitytoday,howwouldyouratetheoverallhealth

statusofresidentsonascaleof1to5with1beingpoorand5beingveryhealthy?

• Ifyouhadtopickyourtop3healthconcernsinthecommunity,whatwouldtheybe?PROBEIN-DEPTHBASEDONINFORMANTAREAOFEXPERTISE

o Whodoyouconsidertobethepopulationsinthecommunitymostvulnerableorat

riskfortheseconditions/issues?§ IFNOTYETMENTIONED,PROBESPECIFICALLYONPRIORITYPOPULATION

RELEVANTTOTHEINFORMANT’SEXPERTISE:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityfor[PRIORITYPOPULATION]?

§ FORINFORMANTSEXPERTISEWITHWOMENANDCHILDREN:Whatdoyou

thinkarethemostpressinghealthconcernsinthecommunityforchildrenandtheirfamilies?Howaboutforwomen?

§ IFNOTYETDISCUSSED:Ofthetopthreeissuesyoumentioned,which

wouldyourankasyourtopissue?Howdoyouseethisissueaffecting


communitymembers’dailylivesandtheirhealth?PROBEIN-DEPTHINSPECIFICFOCUSAREAS;MAYASKABOUTONEISSUEATTIMEANDFOCUSONPERSON’SAREAOFEXPERTISE.

• Fromyourexperience,whatareresidents’biggestbarrierstoaddressingthetop3health

issuesyouidentified?o PROBE:Socialdeterminantsofhealth?o PROBE:Barrierstoaccessingmedicalcare?o PROBE:Barrierstoaccessingpreventiveservicesorprograms?

FOCUSAREA:HEALTHYLIVING(5MINUTES)• I’dliketoaskyouaboutbarriersaffectinghealthylivingandthepreventionofobesity.

o Whataresomeofthebarrierstohealthyeatingandphysicalactivityamongthecommunitiesyouserve?

§ Whatpopulationsaremostaffectedbythesebarrierstohealthylivingandphysicalactivity?PROBEABOUTFOODINSECURITYANDACCESSTOSAFESPACESFORPHYSICALACTIVITY

o Whateffortsorprogramsareyouawareofthatpromotehealthyliving?PROBEABOUTHEALTHYLIVINGMATTERSCOLLABORATIVE

ACCESSTOHEALTHCAREANDPUBLICHEALTH/PREVENTIONSERVICES(15MINUTES)

• I’dliketoaskyouaboutaccesstohealthcareandsocialservicesinyourcommunity.

o WhatAREthestrengthsofthehealthcareandsocialservicesinyourcommunity?

o Whataresomeoftheirlimitations?• Whatchallenges/barriersdoresidentsinyourcommunityfacewhenaccessinghealthcare

andsocialservices?[PROBEINDEPTHFORBARRIERSTOCARE:INSURANCEISSUES,LANGUAGEBARRIERS,ACCESSTOHEALTHINFORMATION/HEALTHLITERACY,LACKOFTRANSPORTION,CHILDCARE,ETC.]

o Whatdoyouthinkneedstohappeninthecommunitytohelpresidentsovercomeoraddressthesechallenges?

• Whatprograms,services,orpoliciesareyouawareofthataddressaccesstohealthcare

andsocialservices?

o Inyouropinion,howeffectivehavetheseprograms,services,orpoliciesbeenataddressingthehealthneedsofresidents?

o Whatprogram,services,orpoliciesnotavailablethatyouthinkshouldbe?

IMPROVINGTHEHEALTHOFTHECOMMUNITY/RESIDENTS(10MINUTES)


• Whatdoyouthinkneedstohappeninthecommunitytohelpresidentsovercomeoraddressthechallengestheyfaceinbeingabletobehealthy?

• Earlierinthisinterview,youmentioned[TOPISSUE]asbeingyourtophealthpriorityforarearesidents.Whatdoyouthinkneedstobedonetoaddress[TOPISSUEHERE]?

o Whatdoyouthinkhospitalscandotoaddressthisissuethattheyarenotdoingrightnow?

o Doyouhaveanysuggestionsabouthowhospitalscanbecreativeorworkoutsidetheirtraditionalroletoaddressthisissueandimprovecommunityhealth?

o Whatkindsofopportunitiesarecurrentlyouttherethatcanbeseizedupontoaddresstheseissues?Forexample,aretheresome“lowhangingfruit”–currentcollaborationsorinitiativesthatcanbestrengthenedorexpanded?

VISIONFORTHECOMMUNITY(5MINUTES)

• Thehospitalsinvolvedinthisinitiativewillbeplanningtheirstrategytoimprovethehealth

ofthecommunitiestheyserve.Whatadvicedoyouhaveforthegroupdevelopingtheplantoaddressthetophealthneedsyou’vementioned?

CLOSING(5MINUTES)

Thankyousomuchforyourtime.That’sitformyquestions.Isthereanythingelsethatyouwouldliketomentionthatwedidn’tdiscusstoday?AsImentioned,afteralloftheinterviewsarecompleted,wewillbesendingyourinterviewtranscriptstoMemorialHermann.Thecommunityhealthneedsassessmentreportswillbepubliclyavailablewhentheyarecomplete.Ifyouhaveanyquestions,pleasefeelfreetoreachouttoDeborahGanelinatMemorialHermannwhoiscoordinatingthiseffort.Thankyouagain.Haveagoodmorning/afternoon.


CommunitySurvey(English)MemorialHermannHealthSystemisconductingaCommunityHealthNeedsAssessmentfortheGreaterHoustonarea.ThisassessmentallowsMemorialHermanntobetterunderstandthehealthstatusandneedsofthecommunityandusetheknowledgegainedtoimplementprogramsthatwillbenefitthecommunity.Wecanbetterunderstandcommunityneedsbygatheringvoicesfromthecommunity.Thissurveyallowscommunitymemberslikeyoutotellusaboutwhatyoufeelareimportantissuesforyourcommunity.Weestimatethatitwilltakeabout5minutestocompletethissurvey.Thankyouverymuchforyourinputandyourtime!1. Pleaselookatthislistofcommunityissues.Inyouropinion,whatarethetop5issuesmost

affectingthequalityoflifeinyourcommunity?o Diabeteso Obesity/Overweighto Respiratory/LungDisease(asthma,COPD,etc.)o Cancerso MentalHealthandMentalDisorderso Injuries,ViolenceandSafetyo SubstanceAbuse(alcohol,tobacco,drugs,etc.)o OralHealtho HeartDiseaseandStrokeo SexualHealth(HIV/AIDS,STDs,etc.)o TeenagePregnancyo ElderCareo ReproductiveHealth(familyplanning)o Other(pleasespecify):______________________________

2. Howwouldyourateyourownpersonalhealth?

o Veryhealthyo Somewhathealthyo Unhealthyo Veryunhealthy

3. Abouthowmanytimesaweekdoyouexerciseorperformaphysicalactivitylikewalking,

running,bicycling,etc.?o Lessthan1timeaweeko 2-3timesaweeko 5ormoretimesaweeko Nevero Other(pleasespecify):______________________________


4. Whataresomeofthebarriersorchallengestoexercisingonaregularbasisforyou?o Noplacestoexerciseo Notimetoexerciseo Idon’tlikeexercisingo Feelunsafeexercisinginthecommunityo Noneofmyfriendsorfamilyexerciseo Nochildcareo Lackoffundstopayforgymorclasseso Notransportationo Other(pleasespecify):______________________________

5. Howmuchdoyouagreeordisagreewitheachofthestatementsbelow. Agree

stronglyAgree Disagree Disagree

stronglyTherearegoodparksforchildren,adultsandpeopleofallabilitiestoenjoyinmycommunity

Inthepast12months,IhadaproblemgettingthehealthcareIneededformeorafamilymemberfromanytypeofhealthcareprovider,dentist,pharmacy,orotherfacility

Idon’tknowwheretogetservicesformyselfwhenIamsad,depressedorneedsomeonetotalkto

IamconfidentIcangetanappointmentwhenIneedtoseemydoctorfairlyquickly

Ihaveaplacetoreceivemedicalcareotherthantheemergencyroom

Withinthepast12months,IworriedwhethermyfoodwouldrunoutbeforeIgotmoneytobuymore

Withinthepast12months,thefoodIboughtjustdidn’tlastandIdidn’thavemoneytogetmore

Therearemanyoptionsforhealthyandaffordablefoodinmycommunity

6. Hasyourdoctorevertoldyouthatyouhaveanyofthefollowing?(Markallthatapply)

o Highbloodpressureo Highcholesterolo Cancero Diabeteso Obesityo Asthmao Heartdiseaseo Other(pleasespecify):______________________________

Now,afewquestionssothatwecanseehowdifferenttypesofpeoplefeelaboutthequestionsasked.7. Zipcodewhereyoulive:______________________________8. Whatisyourage?______________________________


9. Whatisyourrace/ethnicity?o Whiteo Black/AfricanAmericano Hispanic/Latinoo Asian/PacificIslandero NativeAmericano Other(pleasespecify):______________________________

10. Whataretheagesofchildrenlivinginyourhousehold?

o 11andyoungero 12-18yearsoldo 18andoldero None

11. Whatkindofmedicalinsuranceorcoveragedoyouhave?

o Privateo Employer-sponsoredo Medicaido Medicareo Noneo Other(pleasespecify):______________________________

Thankyouforcompletingthissurvey!


CommunitySurvey(Spanish)MemorialHermannHealthSystemestárealizandounaEvaluacióndelasNecesidadesdeSaluddelaComunidadeneláreametropolitanadeHouston.EstaevaluaciónpermiteaMemorialHermann

comprendermejorelestadodesaludylasnecesidadesdelacomunidad,asícomousarlainformaciónobtenidaparaponerenprácticaprogramasquebeneficienalacomunidad.

1.Lealalistadeproblemasdelacomunidad.Ensuopinión¿cuálessonlos5problemasquemásafectanlacalidaddevidaensucomunidad?□ Diabetes□ Obesidad/sobrepeso□ Enfermedadesrespiratorias/pulmonares(asma,enfermedadpulmonarobstructivacrónica[EPOC],etc.)

□ Cáncer□ Saludmentalytrastornosmentales□ Lesiones,violenciayseguridad□ Drogodependencia(alcohol,tabaco,drogas,etc.)

□ Saludbucal□ Enfermedadescardíacasyaccidentescerebrovasculares

□ Saludsexual(VIH/sida,enfermedadesdetransmisiónsexual[ETS],etc.)

□ Embarazosdeadolescentes□ Cuidadodeancianos□ Saludreproductiva(planificaciónfamiliar)

□ Otros,(especifique):_________________________________________________________

2.¿Cómocalificaríasupropiasaludpersonal?□ Muybuena□ Bastantebuena

□ Mala□ Muymala

3.¿Aproximadamente,cuántasvecesporsemanahaceejerciciooalgunaactividadfísica,comocaminar,correr,andarenbicicleta,etc.?□ Menosde1vezporsemana□ De2a3vecesporsemana

□ 5omásvecesporsemana□ Nunca


4.¿Cuálessonalgunasdelasbarrerasodificultadesqueleimpidenhacerejercicioregularmente?□ Notengounlugardondehacerejercicio.□ Notengotiempoparahacerejercicio.□ Nomegustahacerejercicio.□ Nomesientoseguro/ahaciendoejercicioenmicomunidad.

□ Ningunodemisamigosofamiliareshacenejercicio.

□ Notengoconquiéndejaramishijosmientrashagoejercicio.

□ Notengodineroparapagarungimnasiooclases.

□ Notengoaccesoatransporte.


Calculamosqueletomaráunos5minutoscompletarestaencuesta.


5.¿Lehadichosumédicoalgunadelassiguientesafecciones?(Marquetodaslasopcionesquecorrespondan).□ Presiónarterialalta□ Colesterolalto□ Cáncer□ Diabetes

□ Obesidad□ Asma□ Enfermedadcardíaca


6.¿Enquémedidaestádeacuerdooendesacuerdoconcadaunadelassiguientesafirmaciones? Muyde

acuerdoDe

acuerdoEn

desacuerdoMuyen

desacuerdoEnmicomunidad,haybuenosparquesparaniños,adultosypersonascontodotipodecapacidadesparanuestrodisfrute.

Enlosúltimos12meses,tuveunproblemaparaobtenerelcuidadomédicoquenecesitabaparamíoparaunfamiliarporpartedecualquiertipodeproveedordecuidadodelasalud,dentista,farmaciauotrocentrosanitario.

Nosédóndeobtenerserviciosparamícuandoestoytriste,deprimido/a,onecesitohablarconalguien.

Séconseguridadquepuedoobtenerunacitaconmimédicoconciertarapidez.

Tengoamidisposiciónunlugarpararecibircuidadosmédicosquenoseaunasaladeemergencias.

Enlosúltimos12meses,mepreocupédesilacomidaseagotaríaantesdeobtenerdineroparacomprarmásalimentos.

Enlosúltimos12meses,losalimentosquecomprésimplementenoduraronlosuficienteynotuvedineroparacomprarmás.

Enmicomunidadhaymuchasopcionesparacompraralimentossaludablesyasequibles.

7.Códigopostaldesucasa:_________________________8.¿Cuántosañostiene?_________________9.¿Cuálessuraza/origenétnico?□ Blanco/a□ Negro/aoafroamericano/a□ Hispano/aolatino/a

□ Asiático/aoisleño/adelPacífico□ Indígenaamericano/a□ Otro/a,(especifique):______________

10.¿Cuántosañostienenlosniños/asquevivenensucasa?□ 11ymenos□ Entre12y18años

□ Másde18años□ Ninguno

Ahoraleharemosalgunaspreguntasparapodervercómosesientenlosdistintosgruposdepersonasacercadelaspreguntasquelehemoshecho.


11.¿Quétipodeseguromédicoocoberturatiene?□ Privado□ Patrocinadoporunempleador□ Medicaid

□ Medicare□ Ninguno□ Otro,(especifique):________


AppendixD.PrioritizationTool

PrioritizationSurveyThankyouforyourparticipationinthisprioritizationprocess.TheCommunityHealthNeedsAssessment(CHNA)processhasmultiplesteps.Afterthoroughresearchhasbeencompletedtoidentifythesignificanthealthneedsinthecommunity,thesesignificanthealthneedsmustbeprioritizedforfurtherstrategicplanningandimplementation.Prioritizationistheprocessofdeterminingthemostimportantorurgenthealthneedstoaddressincommunities.BelowisadiagramthatshowsthemethodsthatwereusedtoidentifykeyissuesacrossMemorialHermann’sserviceareas.Thesethreemethodsincluded:asecondarydatareview,acommunitysurveyandkeyinformantinterviews.Asyousee,someissuesrevealedthemselvesacrossmultiplemethods.Reviewingthisdiagrammayhelpyoucompletethissurvey.

1. Thefollowinghealthneedsarenotlistedbyorderofimportance.Foreachhealthneed,click

onthearrowonthedropdownboxandselectyouragreementwitheachstatement.Ifyouareonatabletorphone,pleasescrollallthewaytotherightforeachrow.

Theissueimpactsmanypeopleinmycommunity

Thisissuesignificantlyimpactssubgroups

Therearenotenoughexistingandadequateresourcesto

Thisissuehashighriskfordiseaseordeath


(subgroupsbyage,gender,race/ethnicity,LGBTQ,etc.)

addressthisissueinmycommunity

AccesstoHealthServices

HeartDiseaseandStroke

OlderAdultsandAging

Obesity(Exercise,NutritionandWeight)

Transportation MentalHealth Diabetes SubstanceAbuse Cancers LackofHealthInsurance

Education FoodInsecurity Low-Income/Underserved

Children’sHealth Economy 2. IndicatethelevelofimportancethatshouldbegiventowardseachofMemorialHermann’s

4Pillars.Keydefinitionsarelistedbelow.

NotImportant

SomewhatImportant

Important VeryImportant

NotSure

Accesstocare(includinghealthcareaccess,healthcareresourceawareness,healthcarenavigation/literacy)

Foodashealth(includingfoodinsecurity,foodprograms,foodknowledge)

Exerciseasmedicine(includingobesity,accesstoparks,safeplacestoexercise)

Emotionalwell-being(includingemotionalhealth,mentalhealth,substanceabuse)

Keydefinitions:Healthcarenavigation/literacy:needforeducationinnavigatinghealthsystemsFoodinsecurity:lackingreliableaccesstohealthyfoodoptions


Foodprograms:programs,effortsorservicesdesignedtoaddressfoodissuesFoodknowledge:one’sunderstandingofhealthyfoods3. Whoinyourcommunityismostaffectedbypoorhealthoutcomes?(Selectupto5)

o Lesbian,Gay,Bisexual,Transgender,QueerorQuestioning(LGBTQ)o OlderAdultso PersonswithDisabilities(cognitive,sensoryorphysicaldisability)o Racial/EthnicMinorityPopulationso Veteranso Immigrantsorotherundocumentedpersonso Personsexperiencinghomelessnessorprecariouslyhousedo OtherPopulations(pleasespecify):____________________________

4. Pleaseprovideyourname:__________________________________________

5. Pleaseprovideyouremailaddress:__________________________________________

6. Pleaseselectthename(s)ofthehealthcarefacilityorfacilitiesyourepresent.Youmay

choosemorethanone.o MemorialHermannKatyo MemorialHermannMemorialCityo MemorialHermannGreaterHeightso MemorialHermannNortheasto MemorialHermannSoutheasto MemorialHermannSugarLando MemorialHermannSouthwesto MemorialHermannTheWoodlandso KatyRehabo TexasMedicalCentero TIRRMemorialHermanno MemorialHermannSurgicalHospitalKingwoodo MemorialHermannSurgicalHospitalFirstColonyo MemorialHermannFirstColonyHospital(ER)o MemorialHermannTomballHospital(ER)o Other(pleasespecify):_____________________________

ThankyouforyourinputandparticipationintheCommunityHealthNeedsAssessmentprocess.


AppendixE.CommunityResourcesThefollowingisalistofcommunityresourcesmentionedbycommunityinputparticipants.2-1-1TexasA.C.TaylorHealthCenterAccessHealthAcresHomeHealthCenterAIDSFoundationHoustonAldineHealthCenterAmericanHeartAssociationAmericanRedCrossAmistadCommunityHealthCenterAreaAgencyonAgingAssociationfortheAdvancementofMexicanAmericansAvenue360Health&WellnessAvenueCDCBaker-RipleyBastropCommunityHealthCenterBaylorTeenHealthClinicBaysideClinicBaytownHealthCenterBeeBusyWellnessCenterBoatPeopleSOSBo'sPlaceBrighterBitesBrownsvilleCommunityHealthCenterBuffaloBayouPartnershipBurlesonFamilyMedicalCenterBVCAA-HealthPointCanDoHoustonCasadeAmigosHealthCenterCasaElBuenSamaritanoCatholicCharitiesoftheArchdioceseofGalveston-Houston-FortBendCentralCareCommunityHealthChambersCommunityHealthCenterCHISt.Luke'sHealthChildAdvocatesofFortBendChildrenatRiskChristClinicChristianCommunityServicesCenter(CCSC)CHRISTUSHealthSystemCitiesChangingDiabetesCityofHoustonCityofHouston,DepartmentofParksandRecreation

CityofPasadenaCoastalAreaHealthEducationCenters(AHEC)CommunityHealthChoiceCountyIndigentHealthCareProgramCovenantwithChristCommunityServiceCenterCypressHealthCenterDannyJacksonHealthCenterDentalHygieneClinicE.A."Squatty"LyonsHealthCenterElCentroDeCorazonElFrancoLeeHealthCenterEpiscopalHealthFoundationFamilyServices(GalvestonCounty)FortBendConnectFortBendCountyCollaborativeInformationSystemFortBendCountyHealthandHumanServicesFortBendCountySheriff'sOfficeFortBendRegionalCouncilOnSubstanceAbuseFortBendSeniorsMealsonWheelsFortBendWomen'sCenterGalvestonCountyHealthDistrictGalvestonCountyMentalHealthDeputiesGoHealthyHoustonTaskForceGoodRxGreaterHoustonPartnershipGreaterHoustonWomen'sChamberofCommerceGulfCoastCommunityServicesAssociationGulfCoastMedicalFoundationGulfgateHealthCenterHarmonyHouseRespiteCenterHarrisCenterCrisisLineHarrisCountyPublicHealthandEnvironmentalServices(HCPHES)HarrisCountyRidesHarrisCountySocialServicesHarrisHealthSystemHarvestGreen(Development)HEALInitiative


HealthCenterofSoutheastTexasHealthcarefortheHomeless-HoustonHealthyLivingMatters(HarrisCounty)HelpingHandsFoodPantryHOPEClinic(FQHC)HoustonFoodBankHoustonHealthDepartmentHoustonHousingAuthorityHoustonIndependentSchoolDistrictHoustonRyanWhitePlanningCouncilHoustonShifaSynottClinicHuntsvilleMemorialHospitalClinicIbnSinaFoundationIndiaHouseCharityClinicInterfaithCommunityClinicInterfaithMinistriesMealsonWheelsInterfaithofTheWoodlandsKinderInstituteLaNuevaCasaHealthCenterLegacyHealth(FQHC)LeonCountyCommunityHealthCenterLibertyCountySheriff'sOfficeLoneStarFamilyHeathCenter(FQHC)LongBranchHealthCenterLongTermRecoveryGroupLosBarriosUnidosCommunityClinicMagnoliaHealthCenterMamieGeorgeCommunityCenterMartinLutherKingJr.HealthCenterMedicalPlusSuppliesMEHOP-MatagordaEpiscopalHealthOutreachProgramMETHeadStartMethodistHospitalMetroliftMidtownArtsandTheaterCenterHoustonMontgomeryCountyFoodBankMontgomeryCountyWomen’sCenterNeighborhoodHealthCenterNorthwestAssistanceMinistry'sChildren'sClinicNorthwestHealthCenterNuestraClinicadelVallePatMcWatersHealthClinic-SecondMileMissionPatientCareInterventionCenter(PCIC)PearlandCommunityHealthCenterPediatric&AdolescentHealthCenter

PhysiciansatSugarCreekPlannedParenthoodPrairieViewA&MUniversityQuentinMeaseHospitalRegionalAssociationofGrantMakersRegionalMedicalCenterRobertCarrascoHealthClinicRSVPMedSpaSanJoseClinicSantaMariaHostel,Inc.SettegastHealthCenterSevaClinicCharityMedicalFacilityShelteringArmSeniorServicesDivisionofBakerRipleyShifaClinicSmithClinicSocialSecurityAdministrationSpringBranchCommunityHealthCenterSt.HopeFoundationSt.Vincent'sHouseStephenF.AustinCommunityHealthNetworkStrawberryHealthCenterTexanaBehavioralHealthTexasA&MAgriLifeExtensionServiceTexasChildren’sHospitalTexasMedicaidandCHIPMedicalTransportationProgramTheArcofFortBendCountyTheBeaconTheHarrisCenterforMentalHealthandIDD(formerlyMHMRA)TheRoseTheWomen'sHomeThomasStreetHealthCenterTOMAGWAClinicTri-CountyServicesBehavioralHealthcareUberHealthUnitedWayofBrazoriaCountyUnitedWayofGreaterHoustonUnitedWayProjectBlueprintUniversityofHouston-CollegeofOptometryUniversityofTexasHealth-DentalUniversityofTexasHealthServicesUniversityofTexasPhysiciansUrbanHarvestUTMB


ValbonaHealthCenterVCareClinicVecinoHealthCenterWestChambersMedicalCenter(FQHC)WestHoustonAssistanceMinistries(WHAM)WholeLifeServiceCenterWomen'sCareCenterWorkforceSolutionsYMCAofGreaterHouston

MEMORIAL HERMANN — TEXAS MEDICAL CENTER · overall population health is the Community Benefit...

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