2016 Community Health Needs Assessment and Wellness Plan

Transcription

1 2016 Community Health Needs Assessment and Wellness Plan Washington County Hospital and Medical Group In collaboration with Washington County Health Department and the Community IPLAN Team A Collaborative Approach to Improving Population Health in Washington County

2 TABLE OF CONTENTS Process.. 2 Population.. 2 Community Demographics.. 3 Washington County Hospital Statistics County Health Rankings 5 Washington County Hospital (WCH) Community Assessment Survey Washington County Health Department (WCHD) Survey Strategies to Decrease Risk and Promote Health and Wellness 16 1

3 PROCESS Washington County Hospital and Medical Group (WCH) and the Washington County Health Department (WCHD) share the same vision of improving the health of our community. The mission of the hospital is to forge partnerships to improve the health of our community through service excellence. The mission of the health department is to prevent and control disease in order to ensure the optimal health status of the community. In the past, Washington County Hospital and Medical Group has employed many different methods to assess the health needs of the area it serves and has adjusted its services to meet those identified needs. As a district hospital, Washington County Hospital and Medical Group believes that it is important to partner with other local resources to assess community health issues and work collaboratively to improve the health of our residents. Assessing community health needs through a review of available health data and discussion with area healthcare partners, community leaders, and representatives of the many groups served by the hospital and the health department, give Washington County Hospital and Medical Group and its health care partners the opportunity to identify and address the area s most pressing health care needs. WCH, WCHD and the community IPLANteam are working collaboratively to complete this assessment and plan with hopes of making a greater impact on our population health. The hospital chose to work collaboratively with local healthcare providers, the WCHD and the community I-PLAN team to complete the assessment rather than using a consultant as had been past practice. Once the assessment of county data, state and national statistics was completed, a health assessment survey was distributed to a wide segment of residents throughout Washington County to self report their perception of wellness and their personal health activities. This data, coupled with that acquired by the WCHD thru IPLAN serve to provide a health risk assessment to aid in the development of a roadmap to wellness for our community. POPULATION For the purposes of this Community Health Assessment and Plan, WCH defined its primary service area and population as Washington County. The hospital s and health department populations include all who receive care or services without regard to insurance coverage or eligibility for assistance. The Community Health Needs Assessment will serve as a guide for planning and implementation of health care initiatives that will allow the hospital and its partners to best serve the emerging health needs of Washington County. 2

4 COMMUNITY The geographic assessment area includes the entire county of Washington, which covers 562 square miles in rural south central Illinois. The county includes the following cities/villages: Addieville, Ashley, Du Bois, Hoyleton Irvington, Nashville, New Minden, Oakdale Okawville, Radom, Richview, Venedy, Wamac This geographic area definition of community is well-suited to Washington County Hospital and Medical Group, a designated critical access hospital providing basic, primary care through inpatient care, ancillary services, clinics, and specialty clinics to residents of a rural area. 3

5 2016 WASHINGTON COUNTY HOSPITAL SERVICES & STATISTICS AND ECONOMIC IMPACT HOSPITAL SERVICES HOSPITAL STATISTICS Acute Care/Swing Bed Hospital Total Acute/Swing Beds: 22 Long Term Care Program Total Long Term Care Beds: 28 Emergency Department 24/7 Medical/Swing Admissions: 186 Medical Group/RHC Outpatient Visits: 22,307 Surgery Medical Group Visits: 7975 Laboratory Employees on Staff: 160 Imaging Full-time Medical Staff: 7 Physical Therapy ED Medical Staff: 5 Occupational Therapy Specialty Medical Staff: 10 Speech Therapy Auxiliary Members: 75 Cardiac Rehab Therapy Respiratory Therapy Outpatient Nursing/Infusion Clinic Specialty Clinics ECONOMIC IMPACT FOR COMMUNITY Washington County Hospital invests in the health of our community in many ways. We provide essential medical services 24 hours a day, 365 days a year. We provide a variety of innovative, preventive and community services that improve the health of our citizens. An increasingly important way Washington County Hospital keeps our community healthy is by supporting our local and state economy. We are a vigorous economic engine for our community and for Illinois. The hospital employs full time equivalents (FTEs) and has a total payroll of $8,586,477. Hospital payroll expenditures serve as an important economic stimulus, creating and supporting jobs throughout the local and state economies. Dollars earned by Washington County Hospital employees and spent on groceries, clothing, mortgage payments, rent, etc., generate more than $19,607,000 in economic activity and create an additional 187 jobs for the local and state economy. (source: 2016 Illinois Health and Hospital Association) 4

6 2016 County Health Rankings for Illinois Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. County Health Rankings Health Gaps Report Many factors contribute to the health of our community. Washington County ranks 23 rd out of 102 counties for healthy outcomes. This graphic demonstrates the different health factors that can ultimately impact our personal health outcomes. 5

7 WASHINGTON COUNTY DEMOGRAPHICS Census Washington County State of Illinois Population 14,337 12,880,580 % below 18 years of age 20.7% 23.2% % 65 and older 18.4% 13.9% % Non-Hispanic African American 0.8% 14.2% % American Indian and Alaska Native 0.1% 0.6% % Asian 0.4% 5.3% % Native Hawaiian/Other Pacific 0.1% 0.1% Islander % Hispanic 1.6% 16.7% % Non-Hispanic White 96.2% 62.3% % not proficient in English 0% 5% % Female 49.9% 50.9% % Rural 73.6% 11.5% SOCIAL & ECONOMIC FACTORS: STATE RANK 7/102 Washington County State of Illinois High school graduation 83% 83% Some College 71% 67% Unemployment 4.9% 7.1% Children in poverty 13% 20% Income inequality: Ratio of income at the 80 th percentile to income at the th percentile Children in single-parent households 27% 32% Social associations: includes civic organizations, sports groups, political and professional organizations. Number of associations per 10,000 population Violent crime: number of reported violent crime offenses per 100, population Injury deaths: deaths due to injury per 100,000 population

8 HEALTH BEHAVIORS: STATE RANK 26/102 Washington County State of Illinois Adult smoking 15% 17% Adult obesity 31% 27% Food Environment index: an index of factors that contribute to a healthy food environment, 0 (worst) to 10 (best) Physical inactivity 27% 22% Access to exercise opportunities 46% 89% Excessive drinking 21% 21% Alcohol-impaired driving deaths 33% 36% HEALTH OUTCOMES/QUALITY OF LIFE: STATE RANK 14/102 Washington County State of Illinois Poor or fair health 12% 17% Poor physical health days Poor mental health days Low birth weight 7% 8% CLINICAL CARE: STATE RANK 38/102 Washington County State of Illinois Uninsured 10% 15% Primary care physicians 3610:1 1240:1 Dentists 3580:1 1410:1 Mental health providers 1590:1 560:1 Mammography screening 67% 65% Diabetic monitoring 83% 86% 7

9 2016 WCH COMMUNITY ASSESSMENT SURVEY RESULTS Surveys were returned by 225 individuals from a variety of local groups including churches and civic groups within our county. The surveys addressed some basic demographic statistics, wellness activities, health-related prevention activities and included a section for the community s assessment of health and healthcare access within Washington County. The 225 individuals are within these demographic categories and the data provided was self-reported by them. EMPLOYMENT 3 2 EDUCATION Full-time Retired Part-time Unemployed College High School Some High School AGE GENDER Male Female 8

10 WELLNESS ACTIVITIES: SELF REPORTED Smoker 52 Drink Alcohol regularly YES NO WELLNESS ACTIVITIES: SELF REPORTED Eat fast foods 2 or more times per week Drink 5 or more sugary drinks per week More than 25 pounds overweight YES NO 9

11 WELLNESS ACTIVITIES: SELF REPORTED Exercise 4 or more times per week Eat 5 or more servings of fruit/vegetables daily YES NO Flu shot HEALTH RELATED PREVENTION ACTIVITIES IN LAST 12 MONTHS: SELF REPORTED Mammogram (females) Cholesteral Colonoscopy within 10 yrs YES NO 10

12 The 225 WCH survey respondents ranked their perception of the top health problems in our county and the top 5 health care service needs of our community. MOST IMPORTANT HEALTH PROBLEMS IN OUR COUNTY Obesity Cancer Heart Disease Substance Abuse Alzheimer's Mental Illness TOP 5 HEALTH CARE SERVICES IN NEED OF STRENGTHENING Substance Abuse Mental Illness Alzheimer's Cancer Care Specialty Care 11

13 2016 WASHINGTON COUNTY HEALTH DEPARTMENT SURVEY 66% are overweight/ with 30% being classified as obese 63% report eating fast food at least 1-2 times per week 34% have elevated cholesterol 38% have high blood pressure (hypertension) 9.4% are diabetic 24% are smokers 64% of adults have had a colonoscopy in the past 10 years 24% report exercising 4 or more times per week 28% report eating 5 or more fruits and vegetables daily 20% of adults in the county are at risk for binge drinking 40% of sophomores & 53% of seniors in HS report using substances in the past 30 days Based on these survey results, the health department has identified four priority health conditions to focus improvement activities. These same four conditions were also identified in the top five health concerns on the hospital s community assessment. 12

14 CARDIOVASCULAR DISEASE Washington County has 1.55 times greater incidence rate for heart disease than the state. The mortality rate for Washington County was 2 times greater than that of the state. According to Healthy People 2020, heart disease is the leading cause of death and stroke is the third leading cause of death in the United States. The major goal is to improve cardiovascular health and quality of life through prevention, early detection and treatment of risk factors for heart attack and stroke. The most important risk factors for heart disease and stroke that people can control are: 1) high blood pressure, 2) high cholesterol, 3) cigarette smoking, 4) diabetes, 5) poor nutrition and lack of physical activity, and 6) overweight and obesity. While controlling these risk factors for heart disease and stroke remains a challenge, as any lifestyle change is difficult, the risk of Americans developing and dying from cardiovascular disease would be greatly reduced if improvements were made in reducing these risk factors. CANCER Overall cancer rates in Washington County are below the state average but some specific cancers are higher. Colon and rectal cancers are higher for males and females within the county than the state average. Prostate cancer rates are also higher in the county. Lung cancer rates are only slightly higher for men than the state average, as are non-hodkins lymphoma cases. According to Healthy People 2020, cancer is the leading cause of death in the United States. Through cancer research, detection, and treatment progress, there has been a decline in the incidence of new cases of cancer and in the death rate for all cancers. The major goal for Healthy People 2020 is to reduce the number of new cancer cases and decrease the illness, disability, and death caused by cancer. The objectives stress the importance of promoting evidence-based screening for cervical, colorectal, and breast cancer by measuring the use of the screening tests available. Risk factors for cancer that can be prevented include: 1) use of tobacco products, 2) physical inactivity and poor nutrition, 3) obesity, and 4) ultraviolet light exposure. Cervical cancer can be prevented by getting vaccinated against human papillomavirus and liver cancer can be prevented by vaccination for the hepatitis B virus. Screening for early detection include: mammograms for breast cancer, Pap tests for cervical cancer, and fecal occult blood testing, sigmoidoscopy or colonoscopy for colorectal cancer. 13

15 ALCOHOL AND SUBSTANCE ABUSE (ADULTS AND YOUTH) Excessive alcohol use is reported at 28% for adults in Washington County vs a state average of 20% and a national average of 17%. But perhaps the more sobering statistic involves our youth. 23% of sophomores and 32% of seniors report binge drinking in the past two weeks (Youth Risk Behavior Survey 2014) According to Healthy People 2020, in 2005, it was estimated that 22 million Americans have a drug or alcohol problem, but approximately 95% of these people are not aware of their problem. Of those who are aware, attempts to obtain treatment are often unsuccessful. These facts emphasize the importance of increasing prevention efforts and improving access to treatment for substance abuse. The effects of substance abuse involve, not only the individual, but also the family and the community. Many social, physical, mental, and public health problems relate to substance abuse, including: teenage pregnancy, HIV/AIDS, STDs, domestic violence, child abuse, motor vehicle crashes, physical fights, crime, homicide, and suicide. Substance abuse is one of the most complex public health issues due to the social attitudes, political, and legal responses to the use and abuse of alcohol and drugs. Additionally, The Centers for Medicare & Medicaid Services (CMS) announced startling figures in 2016 for Opioid use in the country: Nationally: 5.32%, State of Illinois: 4.64%, Washington County (zip code 62263): 3.2%. DEMENTIA/MENTAL HEALTH Death certificates from Washington County reviewed over the past 4 years reveal that dementia is listed as a leading significant health history for the majority of elderly deaths. According to Healthy People 2020, Dementia was the 6 th leading cause of death in 2013 according to death certificate data. In people over 70 years of age, the prevalence of dementia was 15% in the United States in Costs related to care of dementia patients are estimated to range between $159 and $215 billion. Dementia eventually affects the individual s ability to manage their own medications, take care of financial matters, drive a car, avoid physical injury, maintain appropriate social relationships, and perform activities of daily living. 14

16 Illinois Health Gaps Report 15

17 WCH STRATEGIES TO HELP DECREASE RISK FACTORS AND PROMOTE HEALTH AND WELLNESS CARDIOVASCULAR DISEASE Publish a Wellness Resource Booklet to help identify available resources that promote a healthy lifestyle. Provide community education via the Brown Bag Luncheon Series, promoting medication accuracy and understanding the importance of taking medications as prescribed. Focus on providing specialized chronic care management for patients with 2 or more chronic diseases Continue to provide meeting space for Yoga classes and Weight Watcher s at the hospital Promote Cardiac Rehab services including those available to spouses of impacted patients Encourage healthy eating with the Eat Fit program which is designed to assist participants with sodium control in their diet. Regular sessions are held to provide education and support in shopping, meal planning, identification of sources of sodium in the diet and ways to make substitutions for healthier choices. ContinueDiabetic Self-Management program led by a nurse practitioner: These insurance covered education and support meetings are held monthly to provide new information, share information among participants and provide individual support. Enforce the Smoke-Free ordinances and expand smoke free areas. Support the efforts of the WCHD in reducing risk factors for cardiovascular disease. CANCER Educate affected patients and their families to the importance of health eating Provide screening medical services: Mammograms: including final results for diagnostic mammography before leaving the hospital PSA: prostate lab test to provide early detection of cancer Colonoscopy: recommended every 10 years or more often if family history exists Promote preventative care HPV: vaccine that prevents cervical cancers Support the efforts of the WCHD in reducing risk factors related to cancer 16

18 ALCOHOL AND SUBSTANCE ABUSE (ADULTS AND YOUTH) Participate in MacKenna s Broken Hearts, a bi-annual disaster drill involving high school students intended to drive home the devastating effects of drug and alcohol use. Advocate for the Opioid Control Summits (State, region and county)- focuses on ways we can all Make an Impact in the fight against prescription opioid and heroin abuse. Address 2014 Youth Risk Behavior Summaries for Washington County 14% of 10 th graders and 33% of 12 th graders in Washington County have driven under the influence compared to state percentages of 7% and 18% respectively Advance the work being performed by the Alcohol and Substance Abuse Coalitionto create strategic plans for alcohol, tobacco and other drug prevention. Community Education Support the efforts of the WCHD to prevent substance use/abuse for adults and youth DEMENTIA/MENTAL HEALTH Foster community awareness of prevention, diagnosis, and treatment options for dementia and other mental health conditions Promote Telepsych services which are offered weekly at Washington County Hospital. A board certified psychiatrist provides video face to face visits with patients and their families to aid in the management of mental health issues. Encourage use of pediatric and adolescence psychiatric care which is provided by a Nurse Practitioner within the Rural Health Clinic Recommend the Human Service Center in Okawville which provides counseling programs for individuals needing the following: Psychiatric Services Community Support Services DUI Services Counseling Services Substance Use Services Children First Support the efforts of the WCHD for the prevention and early diagnosis and management of dementia and other mental health disorders 17