2016 prc community health needs assessment · 2018. 12. 6. · prc community health needs...
TRANSCRIPT
2016 PRC Community Health Needs Assessment
Prepared for:
Logansport Memorial Hospital
By Professional Research Consultants, Inc.
Cass County, Indiana
PRC Community Health Needs Assessment
Customized Local Health Survey
• 750 surveys across Cass County
• Conducted via landline and cell phones
• Targets health status, experience, behaviors
Secondary Data
• County-level data
• Census data, vital statistics, other health-related data
Online Key Informant Survey
• Community stakeholder input (116 participants) — physicians, public health, other health providers, social services, community leaders
• Based on their experiences, the populations they serve
The PRC Community
Health Needs
Assessment consists of
both primary and
secondary data.
BENCHMARKING
• Previous Survey Data
• PRC National Health
Survey
• Indiana BRFSS data
• Healthy People 2020
targets
• National vital
statistics data
3
PRC Community Health Needs Assessment Cass County, Indiana
Population Survey
Total sample size gives an
excellent overall maximum
confidence interval of ± 3.6%.
Population & Survey Sample Characteristics
(Cass County, 2016)
48.4
%
51.6
%
37.3
%
44.1
%
18.5
%
80.9
%
8.3%
10.8
%
41.8
%
48.0
%
52.0
%
37.7
%
43.6
%
18.7
%
81.0
%
8.4%
10.6
%
41.1
%
0%
20%
40%
60%
80%
100%
Men Women 18 to 39 40 to 64 65+ White Hispanic Other <200%FPL
Actual Population
Weighted Survey SampleOver 125 survey items.
Many questions can be
trended to previous
(2013) survey.
4
PRC Community Health Needs Assessment Cass County, Indiana
Presentation
• Represents just a fraction of the data collected through this assessment.
• Primarily focuses on areas of need ("Areas of Opportunity"); however, there were many positive findings for the area as well.
• Will allow for Q&A at the end.
Prioritization
• Following the data presentation, you will be asked to rank health issues along various criteria to inform the prioritization process.
Today’s Activities
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
13 Areas of Opportunity
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
7
PRC Community Health Needs Assessment Cass County, Indiana
Self-Reported Health Status (Cass County, 2016)
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 5]
Notes: ● Asked of all respondents.
Excellent 12.8%
Very Good 35.0%
Good 33.4%
Fair 14.2%
Poor 4.6%
Would you say that in general your health is:
Excellent, Very Good, Good, Fair or Poor?
Excellent/Very Good = 48.8%
Good = 33.4%
Fair/Poor = 18.8%
8
PRC Community Health Needs Assessment Cass County, Indiana
Experience “Fair” or “Poor” Overall Health
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 5]
● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control
and Prevention (CDC): 2014 Indiana data.
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
12.5%
18.8%
2013 2016
Cass County
18.8% 18.9% 18.3%
Cass County Indiana US
0%
20%
40%
60%
80%
100%
Cass County similar to IN & US. Significantly higher than 2013 findings
9
PRC Community Health Needs Assessment Cass County, Indiana
Experience “Fair” or “Poor” Overall Health (Cass County, 2016)
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 5]
Notes: ● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households
with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.
16.7% 20.7%
8.5%
24.6% 26.4% 26.6%
13.3% 18.8%
Men Women 18 to 39 40 to 64 65+ LowIncome
Mid/HighIncome
Cass County
0%
20%
40%
60%
80%
100%
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
11
PRC Community Health Needs Assessment Cass County, Indiana
Healthcare Insurance Coverage (Among Adults Age 18-64; Cass County, 2016)
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 190]
Notes: ● Reflects respondents age 18 to 64.
Insured, Employer-Based 60.4%
Insured, Self-Purchase 7.6%
Insured, Unknown Type 1.2%
Medicaid 8.8%
Medicare 5.4%
VA/Military 4.2%
Medicaid & Medicare 1.0%
Other Gov't Coverage 0.7%
No Insurance/ Self-Pay 10.7%
Private Insurance = 69.2%
Gov’t-Sponsored = 20.1%
Uninsured = 10.7% (similar to US)
12
PRC Community Health Needs Assessment Cass County, Indiana
Lack of Healthcare Insurance Coverage (Among Adults Age 18-64)
Healthy People 2020 Target = 0.0% (Universal Coverage)
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 190]
● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control
and Prevention (CDC): 2014 Indiana data.
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AHS-1]
Notes: ● Asked of all respondents under the age of 65.
Cass County
10.7%
18.0%
10.1%
Cass County Indiana US
0%
20%
40%
60%
80%
100%
13.6% 10.7%
2013 2016
Low income residents are more likely to be uninsured.
13
PRC Community Health Needs Assessment Cass County, Indiana
Barriers to Access Have
Prevented Medical Care in the Past Year
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 7-13]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
10.8
%
8.4%
9.7%
7.5%
8.0%
3.4%
13.5
%
12.9
%
12.6
%
12.0
%
11.8
%
5.1%
0.7%
Getting aDr Appointment
Cost(Doctor Visit)
Cost(Prescriptions)
InconvenientOffice Hours
Findinga Doctor
Lack ofTransportation
Language/Culture
0%
20%
40%
60%
80%
100%
Cass County 2013 Cass County 2016
n/a
Significantly
higher than
US (9.5%).
Significantly
higher than
US (8.7%).
14
PRC Community Health Needs Assessment Cass County, Indiana
Experienced Difficulties or Delays of Some Kind
in Receiving Needed Healthcare in the Past Year (Cass County, 2016)
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 194]
Notes: ● Asked of all respondents.
● Represents the percentage of respondents experiencing one or more barriers to accessing healthcare in the past 12 months.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households
with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.
28.0%
46.0%
39.0% 39.6%
29.2%
47.0%
34.3% 37.4% 35.0%
Men Women 18 to 39 40 to 64 65+ LowIncome
Mid/HighIncome
Cass County US
0%
20%
40%
60%
80%
100%
Higher than previous findings (28.3%).
15
PRC Community Health Needs Assessment Cass County, Indiana
Skipped or Reduced Prescription Doses in
Order to Stretch Prescriptions and Save Money
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 14]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
Cass County
13.7% 10.2%
Cass County US
0%
20%
40%
60%
80%
100%
9.5% 13.7%
2013 2016
16
PRC Community Health Needs Assessment Cass County, Indiana
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 138]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents with children 0 to 17 in the household.
Child Has Visited a Physician
for a Routine Checkup in the Past Year (Among Parents of Children 0-17)
79.3% 78.5% 79.0%
89.3%
Cass CountyChildren 0-12
Cass CountyChildren 13-17
Cass County US
0%
20%
40%
60%
80%
100%
Have Visited a Physician for a Checkup in
the Past Year
72.2%
65.1% 70.5%
Cass County Indiana US
0%
20%
40%
60%
80%
100%
17
PRC Community Health Needs Assessment Cass County, Indiana
Have Used a Hospital
Emergency Room More Than Once in the Past Year
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 22-23]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
Cass County
9.4% 8.5%
Cass County US
0%
20%
40%
60%
80%
100%
Used the ER because:
• Emergency Situation = 69.3%
• Weekend/After Hours = 24.8%
• Access Problems = 4.4%
5.8% 9.4%
2013 2016
The Primary Care Physician ratio is also
significantly worse for Cass County
compared to Indiana and the US.
18
PRC Community Health Needs Assessment Cass County, Indiana
70.7% 73.8%
2013 2016
Child Has Visited a Dentist or Dental Clinic Within the Past Year (Among Parents of Children Age 2-17)
Healthy People 2020 Target = 49.0% or Higher
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 141]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective OH-7]
Notes: ● Asked of all respondents with children age 2 through 17.
Cass County
64.8%
93.3%
73.8%
90.7%
Cass CountyChildren 2-12
Cass CountyChildren 13-17
Cass County US
0%
20%
40%
60%
80%
100%
Adults: 66.6% (similar to US)
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
20
PRC Community Health Needs Assessment Cass County, Indiana
Leading Causes of Death (Cass County, 2012-2014)
Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance
and Informatics. Data extracted May 2016.
Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
● CLRD is chronic lower respiratory disease.
Heart Disease 24.8%
Cancer 22.2%
CLRD 8.3% Stroke 4.7%
Diabetes Mellitus 4.6%
Unintentional Injuries 4.1%
Alzheimer's Disease 3.2%
Other Conditions 28.1%
#2
Age-adjusted death rates are worse than
IN & US for cancer overall, as well as
leading sites (lung, breast, colorectal).
21
PRC Community Health Needs Assessment Cass County, Indiana
Cancer Incidence Rates by Site (Annual Average Age-Adjusted Incidence per 100,000 Population, 2008-2012)
Sources: ● State Cancer Profiles.
● Retrieved April 2016 from Community Commons at http://www.chna.org.
Notes: ● This indicator reports the age adjusted incidence rate (cases per 100,000 population per year) of cancers, adjusted to 2000 US standard population age groups
(under age 1, 1-4, 5-9, ..., 80-84, 85 and older). This indicator is relevant because cancer is a leading cause of death and it is important to identify cancers
separately to better target interventions.
114.0 106.3
84.0
42.7
108.9 119.0
75.2
45.1
131.7 123.0
63.7
41.9
Prostate Cancer Female Breast Cancer Lung Cancer Colon/Rectal Cancer
0
25
50
75
100
125
150Cass County Indiana US
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 151]
● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control
and Prevention (CDC): 2014 Indiana data.
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective C-17]
Notes: ● Reflects female respondents 50-74.
82.9%
72.4%
80.3%
CassCounty
Indiana US
0%
20%
40%
60%
80%
100%
Mammogram
in Past 2 Yrs (Among Women Age 50-74)
Healthy People 2020 Target = 81.1% or Higher
72.2% 78.0%
84.8%
CassCounty
Indiana US
0%
20%
40%
60%
80%
100%
Pap Test
in Past 3 Yrs (Among Women Age 21-65)
Healthy People 2020 Target = 93.0% or Higher
Sigmoid/Colonoscopy
Ever (Among Adults Age 50+)
68.9% 61.6%
74.5%
CassCounty
Indiana US
0%
20%
40%
60%
80%
100%
Better
than
2013
findings
Better
than
2013
findings
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
24
PRC Community Health Needs Assessment Cass County, Indiana
Kidney Disease: Age-Adjusted Mortality (2012-2014 Annual Average Deaths per 100,000 Population)
Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and
Informatics. Data extracted May 2016.
Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population.
14.3
18.0
13.2
Cass County Indiana US
0
2
4
6
8
10
12
14
16
18
20
Kidney disease mortality has significantly
decreased in the past decade.
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
26
PRC Community Health Needs Assessment Cass County, Indiana
Diabetes: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population)
Healthy People 2020 Target = 20.5 or Lower (Adjusted)
Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and
Informatics. Data extracted May 2016.
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective D-3]
Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population.
● The Healthy People 2020 target for Diabetes is adjusted to account for only diabetes mellitus coded deaths.
2005-2007 2006-2008 2007-2009 2008-2010 2009-2011 2010-2012 2011-2013 2012-2014
Cass County 36.3 36.8 30.4 24.4 22.9 30.7 36.8 36.3
Indiana 25.5 24.8 24.2 23.9 24.1 24.7 25.9 25.5
US 23.8 22.8 21.9 21.3 21.1 21.2 21.3 21.1
0
5
10
15
20
25
30
35
40
27
PRC Community Health Needs Assessment Cass County, Indiana
Prevalence of Diabetes (Cass County, 2016)
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 158]
Notes: ● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households
with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.
● Excludes gestational diabetes (occurring only during pregnancy).
14.7% 14.3%
5.0%
17.9%
25.5%
17.4% 13.9% 14.5% 14.5%
Men Women 18 to 39 40 to 64 65+ LowIncome
Mid/HighIncome
Cass County US
0%
20%
40%
60%
80%
100%
Another 6.9% of adults report
that they have been
diagnosed with “pre-diabetes”
or “borderline” diabetes.
(vs. 5.7% nationwide)
28
PRC Community Health Needs Assessment Cass County, Indiana
Perceptions of Diabetes
as a Problem in the Community (Key Informants, 2016)
Sources: ● PRC Online Key Informant Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
45.1% 32.4% 9.8% 12.7%
Major Problem Moderate Problem Minor Problem No Problem At All
Top Reasons for "Major Problem" Responses:
• Lifestyle
• Health Education
• Affordable Care/Services
Ranked
#4
among key informants
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
30
PRC Community Health Needs Assessment Cass County, Indiana
Teen Birth Rate (Births to Women Age 15-19 Per 1,000 Female Population Age 15-19, 2006-2012)
Sources: ● Centers for Disease Control and Prevention, National Vital Statistics System. Accessed using CDC WONDER.
● Retrieved April 2016 from Community Commons at http://www.chna.org.
Notes: ● This indicator reports the rate of total births to women under the age of 15 - 19 per 1,000 female population age 15 - 19. This indicator is relevant because in many
cases, teen parents have unique social, economic, and health support services. Additionally, high rates of teen pregnancy may indicate the prevalence of unsafe
sex practices.
49.0
38.9 36.6
Cass County Indiana US
0
20
40
60
80
31
PRC Community Health Needs Assessment Cass County, Indiana
Teen Birth Rate (Births to Women Age 15-19 Per 1,000 Female Population Age 15-19;
Cass County by Race/Ethnicity, 2006-2012)
Sources: ● Centers for Disease Control and Prevention, National Vital Statistics System. Accessed using CDC WONDER.
● Retrieved April 2016 from Community Commons at http://www.chna.org.
Notes: ● This indicator reports the rate of total births to women under the age of 15-19 per 1,000 female population age 15-19. This indicator is relevant because in many
cases, teen parents have unique social, economic, and health support services. Additionally, high rates of teen pregnancy may indicate the prevalence of unsafe
sex practices.
41.9
33.5
24.6
97.9
64.6 62.0
49.0
38.9 36.6
Cass County Indiana US
0
20
40
60
80
100
120White (Non-Hispanic) Hispanic/Latina All Races/Ethnicities
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
33
PRC Community Health Needs Assessment Cass County, Indiana
Leading Causes of Death (Cass County, 2012-2014)
Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance
and Informatics. Data extracted May 2016.
Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
● CLRD is chronic lower respiratory disease.
Heart Disease 24.8%
Cancer 22.2%
CLRD 8.3% Stroke 4.7% Diabetes Mellitus 4.6%
Unintentional Injuries 4.1%
Alzheimer's Disease 3.2%
Other Conditions 28.1%
#1
#4
Stroke prevalence much higher
than IN & US.
34
PRC Community Health Needs Assessment Cass County, Indiana
Prevalence of High Blood Pressure (Cass County, 2016)
Healthy People 2020 Target = 26.9% or Lower
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 147]
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-5.1]
Notes: ● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households
with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.
46.7% 44.4%
21.2%
52.8%
77.1%
51.4%
44.1% 45.5%
36.5%
Men Women 18 to 39 40 to 64 65+ LowIncome
Mid/HighIncome
Cass County US
0%
20%
40%
60%
80%
100%
91.7% of adults with multiple HBP readings
are taking action to help control their levels
(such as medication, diet, and/or exercise).
35
PRC Community Health Needs Assessment Cass County, Indiana
90.0% 86.6%
2013 2016
Present One or More Cardiovascular Risks or Behaviors
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 149]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
● Cardiovascular risk is defined as exhibiting one or more of the following: 1) no leisure-time physical activity; 2) regular/occasional cigarette smoking; 3) hypertension;
4) high blood cholesterol; and/or 5) being overweight/obese.
Cass County
86.6% 83.0%
Cass County US
0%
20%
40%
60%
80%
100%
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
37
PRC Community Health Needs Assessment Cass County, Indiana
Select Injury Death Rates (By Cause of Death; Annual Average Deaths per 100,000 Population)
Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and
Informatics. Data extracted May 2016.
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-13.1, IVP-23.1]
Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population.
14.6
7.4
11.4
5.5
10.6
8.1
Motor Vehicle Accidents (2010-14)HP2020 Goal = 12.4 or Lower
Falls (2005-14)HP2020 Goal = 7.2 or Lower
0
2
4
6
8
10
12
14
16Cass County Indiana US
38
PRC Community Health Needs Assessment Cass County, Indiana
Fell One or More Times in the Past Year (Among Respondents Age 45 and Older)
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 125-126]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of those respondents age 45 and older.
33.6% 28.2%
Cass County US
0%
20%
40%
60%
80%
100%
Of these adults, 38.4% were
injured as the result of a fall.
39
PRC Community Health Needs Assessment Cass County, Indiana
Have a Firearm Kept in
or Around the Home
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 51, 159-160]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
● In this case, firearms include pistols, shotguns, rifles, and other types of guns; this does not include starter pistols, BB guns, or guns that cannot fire.
52.5%
33.8%
Cass County US
0%
20%
40%
60%
80%
100% Households With
Children: 53.0%
(vs. 31.0% nationwide)
44.9%
52.5%
2013 2016
Firearm-related mortality is significantly
lower than state and nation.
Cass County
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
41
PRC Community Health Needs Assessment Cass County, Indiana
Experience “Fair” or “Poor” Mental Health (Cass County, 2016)
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 116]
Notes: ● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households
with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.
7.8% 13.8% 14.0%
10.3% 6.8%
22.4%
4.9% 11.0%
15.5%
Men Women 18 to 39 40 to 64 65+ LowIncome
Mid/HighIncome
Cass County US
0%
20%
40%
60%
80%
100%
Would you say that in general your mental health is:
Excellent, Very Good, Good, Fair or Poor?
42
PRC Community Health Needs Assessment Cass County, Indiana
Have Experienced Symptoms of Chronic Depression
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 117]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
● Chronic depression includes periods of two or more years during which the respondent felt depressed or sad on most days, even if (s)he felt okay sometimes.
Cass County
28.8% 29.9%
Cass County US
0%
20%
40%
60%
80%
100%
22.8% 28.8%
2013 2016
43
PRC Community Health Needs Assessment Cass County, Indiana
Mental Health Treatment
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 120-121]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Reflects the total sample of respondents.
22.0%
13.2%
27.4%
13.6%
Ever Sought Help for aMental or Emotional Problem
Currently Taking Medication/Receiving Mental Health Treatment
0%
20%
40%
60%
80%
100%
Cass County US
44
PRC Community Health Needs Assessment Cass County, Indiana
Perceptions of Mental Health
as a Problem in the Community (Key Informants, 2016)
Sources: ● PRC Online Key Informant Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
43.5% 38.0% 7.4% 11.1%
Major Problem Moderate Problem Minor Problem No Problem At All
Top Reasons for "Major Problem" Responses: • Access to Care/Services • Disease Management • Access to Providers • Denial/Stigma
Ranked
#5
among key informants
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
46
PRC Community Health Needs Assessment Cass County, Indiana
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 176-177]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control
and Prevention (CDC): 2014 Indiana data.
Notes: ● Based on reported heights and weights, asked of all respondents.
● The definition of overweight is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 25.0,
regardless of gender. The definition for obesity is a BMI greater than or equal to 30.0.
72.3% 66.4% 65.2%
Cass County Indiana US
0%
20%
40%
60%
80%
100%
Prevalence of Total Overweight (Percent of Adults With a Body Mass
Index of 25.0 or Higher)
39.0% 32.7% 33.4%
Cass County Indiana US
0%
20%
40%
60%
80%
100%
Prevalence of Obesity (Percent of Adults With a Body Mass Index of
30.0 or Higher) Healthy People 2020 Target = 30.5% or Lower
47
PRC Community Health Needs Assessment Cass County, Indiana
Prevalence of Obesity (Percent of Adults With a BMI of 30.0 or Higher; Cass County, 2016)
Healthy People 2020 Target = 30.5% or Lower
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 176] ● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-9] Notes: ● Based on reported heights and weights, asked of all respondents. ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● The definition of obesity is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 30.0, regardless of gender.
34.4%
43.7%
36.5%
45.1%
30.7%
48.7%
37.8% 39.0%
Men Women 18 to 39 40 to 64 65+ LowIncome
Mid/HighIncome
Cass County
0%
20%
40%
60%
80%
100%
The prevalence of obesity has significantly
increased since 2013 (31.4%).
48
PRC Community Health Needs Assessment Cass County, Indiana
Child Obesity Prevalence (Children Age 5-17 Who Are Obese; BMI in the 95th Percentile or Higher)
Healthy People 2020 Target = 14.5% or Lower
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 180]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-10.4]
Notes: ● Asked of all respondents with children age 5-17 at home.
● Obesity among children is determined by children’s Body Mass Index status equal to or above the 95th percentile of US growth charts by gender and age.
● *Interpret with caution as sample size is small (<50).
Cass County
20.3%
9.5%
Cass County US
0%
20%
40%
60%
80%
100%
16.4% 20.3%
2013 2016
49
PRC Community Health Needs Assessment Cass County, Indiana
44.0%
27.6%
46.8%
31.6%
22.5%
39.7%
31.2% 35.5%
30.2%
Men Women 18 to 39 40 to 64 65+ LowIncome
Mid/HighIncome
Cass County US
0%
20%
40%
60%
80%
100%
Had Seven or More
Sugar-Sweetened Beverages in the Past Week (Cass County, 2016)
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 212]
Notes: ● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households
with defined poverty status up to incomes just above the FPL, earning up to twice the poverty threshold; “Mid/High Income” includes households with incomes at
200% or more of the federal poverty level.
50
PRC Community Health Needs Assessment Cass County, Indiana
No Leisure-Time Physical Activity in the Past Month (Cass County, 2016)
Healthy People 2020 Target = 32.6% or Lower
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 106]
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective PA-1]
Notes: ● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households
with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.
20.2% 22.4% 17.5%
21.8%
28.3% 31.7%
18.0% 21.4%
27.9%
Men Women 18 to 39 40 to 64 65+ LowIncome
Mid/HighIncome
Cass County US
0%
20%
40%
60%
80%
100%
Significant improvement seen since 2013.
51
PRC Community Health Needs Assessment Cass County, Indiana
Perceptions of Nutrition, Physical Activity, and Weight
as a Problem in the Community (Key Informants, 2016)
Sources: ● PRC Online Key Informant Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
50.5% 28.8% 8.1% 12.6%
Major Problem Moderate Problem Minor Problem No Problem At All
Top Reasons for "Major Problem" Responses:
• Obesity
• Access to Healthful Foods
• Lifestyle
Ranked
#2
among key informants
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
53
PRC Community Health Needs Assessment Cass County, Indiana
Prevalence of Potentially Disabling Conditions
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 28, 161-162]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AOCBC-10]
Notes: ● The sciatica indicator reflects the total sample of respondents; the arthritis and osteoporosis columns reflect adults age 50+.
37.6%
10.5%
19.5%
32.0%
8.7%
19.4%
Arthritis/Rheumatism (50+) Osteoporosis (50+)HP2020 Objective = 5.3% or Lower
Sciatica/Chronic Back Pain (18+)
0%
20%
40%
60%
80%
100%
Cass County US
54
PRC Community Health Needs Assessment Cass County, Indiana
Prevalence of Blindness/Deafness
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 25-26]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease
Control and Prevention (CDC): 2014 Indiana data.
Notes: ● Reflects the total sample of respondents.
5.2%
11.6% 7.3% 8.6%
Blindness/Trouble Seeing Even With Glasses Deafness/Trouble Hearing
0%
20%
40%
60%
80%
100%
Cass County US
Indiana = 4.5%
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
56
PRC Community Health Needs Assessment Cass County, Indiana
CLRD: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population)
Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and
Informatics. Data extracted May 2016.
Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population.
● CLRD is chronic lower respiratory disease.
2005-2007 2006-2008 2007-2009 2008-2010 2009-2011 2010-2012 2011-2013 2012-2014
Cass County 49.1 55.7 52.1 54.9 48.4 57.8 55.5 66.6
Indiana 51.7 52.8 54.3 56.3 56.2 56.2 57.3 56.0
US 42.1 42.4 42.9 43.2 42.5 42.1 42.0 41.4
0
10
20
30
40
50
60
70
57
PRC Community Health Needs Assessment Cass County, Indiana
Prevalence of
Chronic Obstructive Pulmonary Disease (COPD)
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 24] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2014 Indiana data. ● 2015 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Includes those having ever suffered from or been diagnosed with COPD or chronic obstructive pulmonary disease, including bronchitis or emphysema. ● In prior data, the term “chronic lung disease” was used, which also included bronchitis or emphysema.
Cass County
11.1% 8.7% 9.5%
Cass County Indiana US
0%
20%
40%
60%
80%
100%
7.2% 11.1%
2013 2016
58
PRC Community Health Needs Assessment Cass County, Indiana
75.6%
57.2%
2013 2016
Older Adults: Have Had a Flu Vaccination in the Past Year (Among Adults Age 65+)
Healthy People 2020 Target = 70.0% or Higher
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 163-164] ● 2015 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2014 Indiana data. ● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IID-12.12] Notes: ● Reflects respondents 65 and older. ● “High-Risk” includes adults age 18 to 64 who have been diagnosed with heart disease, diabetes or respiratory disease. ● Includes FluMist as a form of vaccination.
Cass County
57.2% 56.3% 58.9%
Cass County Indiana US
0%
20%
40%
60%
80%
100%
High-Risk Adults = 46.1%
(HP2020 Goal = 70%)
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
60
PRC Community Health Needs Assessment Cass County, Indiana
Excessive Drinkers (Cass County, 2016)
Healthy People 2020 Target = 25.4% or Lower
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 189]
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-15]
Notes: ● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households
with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.
● Excessive drinking reflects the number of persons aged 18 years and over who drank more than two drinks per day on average (for men) or more than one drink
per day on average (for women) OR who drank 5 or more drinks during a single occasion (for men) or 4 or more drinks during a single occasion (for women) during
the past 30 days.
27.8%
11.9%
25.3% 20.3%
6.4%
23.7% 21.2% 19.4% 22.2%
Men Women 18 to 39 40 to 64 65+ LowIncome
Mid/HighIncome
Cass County US
0%
20%
40%
60%
80%
100%
Excessive drinking has increased
significantly since 2013.
61
PRC Community Health Needs Assessment Cass County, Indiana
Have Ever Sought Professional Help
for an Alcohol/Drug-Related Problem
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 68]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
Cass County
2.0% 4.1%
Cass County US
0%
20%
40%
60%
80%
100%
3.4% 2.0%
2013 2016
28.9% report their life has been
negatively affected by substance abuse.
62
PRC Community Health Needs Assessment Cass County, Indiana
Perceptions of Substance Abuse
as a Problem in the Community (Key Informants, 2016)
Sources: ● PRC Online Key Informant Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
60.6% 27.5%
4.6%
7.3%
Major Problem Moderate Problem Minor Problem No Problem At All
Top Reasons for "Major Problem" Responses: • Access to Care/Services • Denial/Stigma • Prevalence/Incidence Most problematic substance mentioned: Methamphetamines, heroin & alcohol
Ranked
#1
among key informants
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
64
PRC Community Health Needs Assessment Cass County, Indiana
Member of Household Smokes at Home
Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 58, 184]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
● “Smokes at home” refers to someone smoking cigarettes, cigars, or a pipe in the home an average of four or more times per week in the past month.
Cass County
16.0% 10.2%
Cass County US
0%
20%
40%
60%
80%
100%
Households with children
exposed to smoke in the
home: 10.1%
17.0% 16.0%
2013 2016
16.4% of respondents report current
smoking (similar to US and 2013 findings).
65
PRC Community Health Needs Assessment Cass County, Indiana
Other Tobacco Use
Sources: ● 2016 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 59-60]
● 2015 PRC National Health Survey, Professional Research Consultants, Inc.
● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control
and Prevention (CDC): 2014 Indiana data.
● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objectives TU-1.2, TU-1.3]
Notes: ● Reflects the total sample of respondents.
● Smokeless tobacco includes chewing tobacco or snuff.
4.4% 5.4% 3.6% 3.0%
CigarsHP2020 Goal = 0.2% or Lower
Smokeless TobaccoHP2020 Goal = 0.3% or Lower
0%
20%
40%
60%
80%
100%
Cass County US
Indiana = 4.3%
66
PRC Community Health Needs Assessment Cass County, Indiana
Perceptions of Tobacco Use
as a Problem in the Community (Key Informants, 2016)
Sources: ● PRC Online Key Informant Survey, Professional Research Consultants, Inc.
Notes: ● Asked of all respondents.
48.6% 29.0% 13.1% 9.3%
Major Problem Moderate Problem Minor Problem No Problem At All
Top Reasons for "Major Problem" Responses:
• Prevalence/Incidence
• Community Attitude
• Comorbidities
Ranked
#3
among key informants
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
General Health Status
Areas of Opportunity
► Access to Healthcare Services
► Cancer
► Chronic Kidney Disease
► Diabetes
► Family Planning
► Heart Disease & Stroke
► Injury & Violence
► Mental Health
► Nutrition, Physical Activity & Weight
► Potentially Disabling Conditions
► Respiratory Diseases
► Substance Abuse
► Tobacco Use
Q & A
Click to edit Master text styles
Prioritizing Health Needs
70
PRC Community Health Needs Assessment Cass County, Indiana
• Rate how much of a problem each issue is for our community. (i.e., How big is the problem?)
Scope & Severity
• Rate how much we are able to have a positive impact, either alone or
with community partners. (i.e., Can we make a difference?)
Ability to Impact
SCALE: Scope & Severity
❶ ↔ ❷ ↔ ❸ ↔ ❹ ↔ ❺ ↔ ❻ ↔ ❼ ↔ ❽ ↔ ❾ ↔ ❶⓿
EXTREMELY prevalent,
with very serious health
consequences
NOT very prevalent at
all, with only minimal
health consequences
Criteria
SCALE: Ability to Impact
❶ ↔ ❷ ↔ ❸ ↔ ❹ ↔ ❺ ↔ ❻ ↔ ❼ ↔ ❽ ↔ ❾ ↔ ❶⓿
GREAT ability to impact NO ability to impact
PRC Community Health Needs Assessment
Next Steps
Thank You!
73
PRC Community Health Needs Assessment Cass County, Indiana
Top-Ranked
Issues
Key Informants: Relative Position of
Health Topics as Problems in the Community
60.6%
50.5%
48.6%
45.1%
43.5%
31.1%
25.0%
24.5%
24.2%
21.6%
18.1%
16.8%
15.8%
9.8%
8.0%
7.1%
7.1%
5.6%
5.2%
4.1%
27.5%
28.8%
29.0%
32.4%
38.0%
38.7%
46.0%
27.4%
28.3%
43.3%
34.0%
35.6%
42.1%
34.8%
39.1%
33.3%
44.9%
16.7%
25.0%
29.6%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Substance Abuse
Nutrition, Physical Activity, and Weight
Tobacco Use
Diabetes
Mental Health
Cancer
Heart Disease and Stroke
Oral Health/Dental Care
Family Planning
Dementia/Alzheimer's Disease
Respiratory Diseases
Infant and Child Health
Access to Health Care Services
Sexually Transmitted Diseases
Chronic Kidney Disease
Injury and Violence
Arthritis/Osteoporosis/Back Conditions
HIV/AIDS
Hearing and Vision Problems
Immunization and Infectious Diseases
Major Problem Moderate Problem Minor Problem No Problem At All