DRAFT February 26, 2018 CHSA Topic Areas Results from the 2018 Community Health Status Assessment have been summarized into a scorecard on page 2. A more detailed technical report for the entire CHSA process is forthcoming. To further summarize results, indicators were combined based on the following topic areas from Healthy People 2020: Social Determinants of Health o Economic Stability o Education o Health and Health Care (Access to Care) o Neighborhood and Built Environment o Social and Community Context Health-Related Quality of Life and Well-Being Cancers Diabetes Heart Disease and Stroke Other Chronic Diseases Nutrition and Weight Status Physical Activity Disability and Health Environmental Health Family Planning Maternal, Infant and Child Health HIV Sexually Transmitted Diseases Immunization and Infectious Diseases Injury and Violence Prevention Mental Health and Mental Disorders Oral Health Tobacco Use Substance Abuse T F Report Layout - How to Read the Results Below is the template that describes how the topic areas are summarized using indicators compiled from data sources listed on page 4. In each section below, you will see a brief description of what is provided for disparities, progress, benchmarks, and indicators. subgroups with identified disparities for that topic are listed. A subgroup is flagged when its result is at least 10% worse than the other groups; disparities that are at least twice the value of the best result within each group are also identified in the detailed tables in appendix. : the number of indicators are tallied to show the number making progress, getting worse, no change or there were no trends to evaluate progress; the update value needs to be over 1.0% different from the baseline to be identified as a change (improving or worsening); changes less than or equal to 1.0% are reported as no change. R all indicators compiled in assessment are listed separately when space allowed, or within categories when a large number were used. D Indicator Description: A : REPORT LAYOUT DESCRIPTION OF CONTENTS Health and Well-Being TOPIC Overall Assessment stated Population subgroups with Any Healthy People 2020 or All indicators used to assess the health and well-being topic are here- based on trends (both a measured disparities in the County Health Rankings listed here baseline and an update) majority of the indicators are Comparisons are reported When the number of indicators prevents each being listed measured for indicators reported here Healthy People Targets applied to separately, categories are reported that refer to each indicator Assessment categories for When disparities could not Arlington results - Target Met, within the category progress include Improving, be assessed, the symbol is a Improving, Worsening, or no Worsening, No Change and white circle assessment made No Trend County Health Rankings describe Total number of indicators top ranking and low ranking assessed are reported as well results for Arlington KEY: Bad No Change/Mixed Results Good No Assessment Page 1 of 10
February 26, 2018 Destination 2027 Community Health Status Assessment Summary of Results for, and Benchmark Comparisons to Healthy People 2020 and County Health Rankings The summary results are provided below, followed by more detailed descriptions for each topic area following data sources: TOPIC AREA # Indicators DISPARITY PROGRESS BENCHMARK 1. Social Determinants: Health and Healthcare 16 2. Social Determinants: Economic Stability 12 3. Social Determinants: Education 4 4. Social Determinants: Neighborhood and Built Environment 5. Social Determinants: Social and Community Context 6. Health-Related Quality of Life and Well- Being 7. Cancers 20 8. Diabetes 3 9. Heart Disease and Stroke 9 10. Other Chronic Diseases 8 11. Nutrition and Weight Status 7 12. Physical Activity 4 13. Disability and Health 7 14. Environmental Health 2 15. Family Planning 3 16. Maternal, Infant, and Child Health 9 17. HIV 3 10 7 15 18. Sexually Transmitted Diseases 3 19. Immunizations and Infectious Diseases 13 20. Injury and Violence Prevention 12 21. Mental Health and Mental Disorders 7 22. Oral Health 1 23. Tobacco Use 10 24. Substance Abuse 26 25. Demographics 7 TOTAL 218 KEY: Bad No Change/Mixed Results Good No Assessment Page 2 of 10
February 26, 2018 Destination 2027 Community Health Status Assessment Summary of Results for, and Benchmark Comparisons to Healthy People 2020 and County Health Rankings Mixed Results 5 Cannot Be Assessed 3 16 Cannot Be Assessed No 3 Change 2 Worsening 9 Cannot Be Assessed 10 DISPARITIES PROGRESS Improving 10 BENCHMARKS Mixed Results 2 Did Not Meet 3 Met 9 19 of the 24 topic areas have indicators with results for specific subgroups - such as age, race/ethnicity, gender/ gender identity, poverty status, educational attainment 16 of the 19 topic areas that have subgroup results show disparities between subgroups 3 topic areas show mixed results 21 of the 24 topic areas have indicators with both a baseline value and update value to measure progress 10 of the 21 topic areas that measure progress show indicators improving; 9 topic areas with progress measured show worsening trends 2 topic areas show mixed results/no change 14 of the 24 topic areas have indicators that can be benchmarked to Healthy People 2020 and/or County Health Rankings 9 of the 14 topic areas that have benchmark comparisons show indicators improving; 3 topic areas with benchmarking show results not meeting benchmark comparisons 2 topic areas showed mixed results/no change in their indicators with benchmarks Page 3 of 10
February 26, 2018 CHSA Data Sources Destination 2027 Community Health Status Assessment Summary of Results for, and Benchmark Comparisons to Healthy People 2020 and County Health Rankings Arlington Economic Independence Division (EID) Arlington Public Schools (APS) Arlington Youth Risk Survey CDC Behavioral Risk Factor Surveillance System (BRFSS) CDC Diabetes Interactive Atlas CDC National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) CDC National Center for Health Statistics (NCHS) CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) CDC National Environmental Public Health Tracking Network (NEPHTN) CDC NCCDPHP - National Diabetes Surveillance System CDC WONDER - Environmental Data CDC WONDER - Mortality CDC WONDER - Natality CDC WONDER Fatal Accident Reporting System (FARS) - Mortality Centers for Medicaid and Medicare Services, National Provider Identifier (CMS/NPI) Comprehensive Housing Affordability Strategy (CHAS) County Business Patterns Dartmouth Atlas Federal Bureau of Investigation, Uniform Crime Reporting System (FBI/UCRS) HRSA Area Resource File (ARF) Institute for Health Metrics Evaluation (IHME) Map the Meal Gap NIH National Cancer Institute (NCI) - Surveillance, Epidemiology, and End Results (SEER) Northern Virginia Health Foundation and Virginia Commonwealth University - Getting Ahead: The Uneven Opportunity Landscape in Northern Virginia OneSource Global Business Browser, Delorme map data, ESRI, & US Census Tigerline Files Safe Drinking Water Information System U.S. Census, American Community Survey (ACS) U.S. Census, Small Area Health Insurance Estimates (ACS-SAHIE) U.S. Census, Small Area Income and Poverty Estimates (SAIPE) U.S. Department of Agriculture (USDA), Food Environment Index (FEI) Virginia Behavioral Risk Factor Surveillance System Virginia Department of Education (VDE) Virginia Department of Health (VDH) Data Portal Virginia Department of Social Services (VDSS) Virginia Electronic Disease Surveillance System (VEDSS) Page 4 of 10
February 26, 2018 Social Determinants: Health and Healthcare Male American Indian/Alaska Native, Native Hawaiian or Other Pacific Islander Children, Adults MIXED - WORSENING 5 Improving 7 Worsening 4 No Trend TOTAL: 16 Indicators Social Determinants: Economic Stability Moving toward HP2020 Target for Health insurance coverage Best CHR rankings for preventable hospital stays (#2), people without health coverage (#3) Worst CHR rankings for screening (mammography and diabetic screening) Female American Indian/Alaska Native, Native Hawaiian or Other Pacific Islander Children, Young Adults Low Income, Not Low Income MIXED -WORSENING 3 Improving 7 Worsening 2 No Change TOTAL: 12 Indicators Social Determinants: Education Best CHR rankings for poverty(#1), unemployment (#1) Worst CHR ranking for housing (#76) Asian, Black/ African American, American Indian/Alaska Native, Native Hawaiian or Other Pacific Islander Older Adults In poverty IMPROVING 4 Improving TOTAL: 4 Indicators Social Determinants: Neighborhood and Built Environment Asian, Black/ African American, American Indian/Alaska Native, Some Other Race Adolescents/Young Adults, Older Adults MIXED -IMPROVING 6 Improving 3 Worsening 1 No Change TOTAL: 10 Indicators Best CHR rankings for access to exercise opportunities (#1), Food environment Index (#7) Coverage: Uninsured population Providers: Dentists (Ratio), Primary Care Physicians (Ratio), Mental Health Providers (Ratio) Preventable Hospital Stays Screening: Diabetic Monitoring (% Receiving HbA1c), Mammography screening Health Care Costs ($) (Price-adjusted Medicare reimbursements per enrollee) Access: No routine check up in past 2 years, no personal doctor or health care provider, adults that did not see a doctor because of cost Medical Assistance: Number of recipients/households, reimbursement $ for Arlington Residents Income Inequality Ratio APS Students with Free and Reduced Meals (FARMS) Benefits Number of Arlington residents/households receiving SNAP benefits Housing: Severe Housing Problems, households receiving Housing Grants, Housing Choice Vouchers Poverty: Children 50%FPL, 100% FPL, 125% FPL Unemployment: Percent of population 16 years and older that are unemployed Percent of population 25 years and older with less than a high school diploma or GED Percent of population 25 years and older with at least a bachelor's degree or higher Percent of population 25 years and older with at least a high school diploma or GED Percent of 9th Grade Students that Attained High School Graduation within 4 Years (4-Year Graduation Rate) Parks and Rec: Access to Recreational Facilities, Population living within a half mile of a park, Access to Exercise Opportunities (% with access) Air Quality: Ozone (Air Quality) above Regulatory Standard, Annual Particulate Matter (PM) 2.5 Commute: labor force that drives alone to work, takes public transportation to work, and labor force that carpools to work Food Insecurity: Food Environment Index Page 5 of 10
February 26, 2018 Social Determinants: Social and Community Context While data on population subgroups unavailable for these indicators; however due to poor results on residential segregation, lack of diversity across multiple non-white racial ethnic groups is documented. MIXED 4 Improving 3 Worsening TOTAL: 7 Indicators Best CHR rankings for injury deaths (#3), unemployment (#1) Worst CHR ranking for residential segregation (black/white: #111, nonwhite/white: #94) and social associations (#65) Health-Related Quality of Life and Well-Being Male, Female, Transgender, Not Sure (Questioning) White Non-Hispanic, Hispanic Low-income 8 th, 10 th, 12 th graders Cancers Males Black/African American, White Non-Hispanic Older Adults Diabetes NO SUBGROUP TO ASSESS DISPARITIES MIXED 4 Improving 1 Worsening 1 No Change 9 No Trend TOTAL: 15 Indicators IMPROVING 1 4 No Change 5 No Trend TOTAL: 20 Indicators MIXED 1 Worsening 1 No Trend TOTAL: 3 Indicators Best CHR rankings for frequent physical distress (#1), poor or fair health (#3), poor physical health days (#3) and Years of Potential Life Lost (YPLL) (#2) Residential segregation: black/white, non-white/white Injury Death Rate Violent Crime Rate Social Associations Limited English Proficiency Students using electronic device to connect socially Students Bullied, Bullied on School Property Insufficient Sleep Poor or Fair Health, Poor Mental Health, Poor Physical Health, Frequent Physical Distress All Causes Mortality Life Expectancy, Premature Deaths (YPLL) All Cancers Mortality; Cancer mortality by type (Leukemia, Non-Hodgkins Lymphoma, Liver and Bile Duct, Pancreatic, Lung and Bronchus, Female Breast, Bladder, Brain and Other Nervous System, Colon and Rectal, Throat, Kidney and Renal, Skin, Female Ovarian, Male Prostate, Stomach, and Female Uteran) Adults that reported ever being diagnosed with any cancer, with skin cancer Adults that reported ever being diagnosed with diabetes Diabetes Hospitalization Rate (age-adjusted per 100,000) Page 6 of 10
February 26, 2018 Heart Disease and Stroke Males Black/African American White Non-Hispanic MIXED-IMPROVING 5 Improving 1 Worsening 3 No Trend Other Chronic Diseases Males Adults, Older Adults TOTAL: 9 Indicators WORSENING 3 Worsening 5 No Trend TOTAL: 8 Indicators Nutrition and Weight Status Males, Females Asian, Black or African American 8 th, 10 th, 12 th grades Low Income Physical Activity IMPROVING 6 No Trend TOTAL: 7 Indicators Best ranking in CHR for adult obesity (#1) Males, Not Sure, Transgender Some Other Race 8 th, 10 th, 12 th Grades Low Income MIXED-IMPROVING 3 No Trend TOTAL: 4 Indicators Heart Disease Mortality, Stroke Mortality Adults ever diagnosed with heart attack, angina or coronary heart disease, stroke Cardiovascular Disease Hospitalization Rate, Heart Disease Hospitalization Rate, Hypertension Hospitalization Rate, Stroke Hospitalization Rate Adults ever diagnosed with arthritis Adults currently with asthma Adults ever with asthma Adults ever with COPD, emphysema or chronic bronchitis Adults ever with kidney disease Arthritis Hospitalization Rate Asthma Hospitalization Rate Chronic Obstructive Pulmonary Disease Hospitalization Rate Students that are overweight or obese Students that are overweight Students that are obese Adult Obesity Adults that are obese Adults that are overweight Adults that are overweight or obese Best ranking in CHR for adult physical inactivity (#1) Students who watched 3 or more hours per school day Students who played video games on a school day Adult Physical Inactivity Adults that reported no physical activity in past 30 days Page 7 of 10
February 26, 2018 Disability and Health Black or African American, White, American Indian or Alaska Native, Asian alone, Native Hawaiian or other Pacific Islander alone, Two/more races Non-Hispanic Adults, Older Adults Environmental Health No subgroups available to assess disparities Family Planning Males, Transgender, Not Sure Black/African American, Some Other Race, White 8 th. 10 th, and 12 th Grades WORSENING 7 Worsening TOTAL: 7 Indicators MIXED-IMPROVING 1 No Change TOTAL: 2 Indicators NO TRENDS 3 No Trend TOTAL: 3 Indicators Maternal, Infant and Child Health Black or African American, Asian Teen, Young Adult mothers Less than High School Education NO TRENDS 9 No Trend TOTAL: 9 Indicators Percent of population with a disability Percent of population with a vision difficulty Percent of population with a ambulatory difficulty Percent of population with a hearing difficulty Percent of population with a self-care difficulty Percent of population with a independent living difficulty Percent of population with a cognitive difficulty Average daily levels of PM2.5 Drinking Water Violations (Yes/No) Students who have had sexual intercourse Students who had sexual intercourse for the first time before age 13 years Students who used a condom and birth control pills at last sexual intercourse Met HP2020 Targets for low birthweight and very low birthweight births Met HP2020 Targets for preterm births, extremely preterm births and moderate to late preterm births Need 3.6% improvement to reach HP2020 Target for births to mothers with early prenatal care (Target=77.9%) Low birthweight births (under 2,500 grams) Very low birthweight births (under 1,500 grams) Births to mothers with early prenatal care (1st trimester) Births to mothers with prenatal care in 2nd trimester Births to mothers with late (3rd trimester) or no prenatal care Preterm births (gestational age less than 37 weeks) Extremely preterm births (under 28 weeks) Very preterm births (28-31 weeks) Moderate to late preterm births (32-36 weeks) Page 8 of 10
February 26, 2018 HIV No data available to assess disparities by race/ethnicity subgroups Older Adults IMPROVING 2 Improving 1 No Trend TOTAL: 3 Indicators Sexually Transmitted Diseases No subgroups available to assess disparities WORSENING 3 Worsening TOTAL: 3 Indicators Worst CHR ranking for HIV Prevalence (#119) Immunizations and Infectious Diseases Males Black/African American, White Young Adults, Adults MIXED- WORSENING 5 Improving 6 Worsening 2 No Trend TOTAL: 13 Indicators Injury and Violence Prevention Transgender, Not Sure, Males Black/African American, Some Other Race, White 6 th, 8 th, 10 th, 12 th Grades WORSENING, BUT missing trends for all but 1 indicator 1 Worsening 11 No Trend TOTAL: 12 Indicators HP2020 making progress on TB Incidence but need to reduce from 5.4 to 1.0 (81% reduction) to meet Target Need to reduce the percent of students in physical fight in past month from 17.8% to 16.0% to achieve 10-percent improvement HIV Prevalence Adults that reported never being tested for HIV New HIV/AIDS Cases New Chlamydia Cases New Gonorrhea Cases New Syphilis (Total Early) Cases Immunizations: Adults with no pneumococcal vaccination, annual flu vaccination New Cases of Infectious Diseases: Campylobacter, Cryptosporidiosis, Giardiasis, Lyme Disease, Malaria, Pertussis, Salmonellosis, Shigellosis, Tuberculosis, and Varicella (Chickenpox) New Lead Cases (elevated blood levels) Injury: Unintentional Injury Mortality (Accidents), Students who rarely or never wore a bicycle helmet, who texted or e-mailed while driving a car, Adults that reported sometimes, seldom, or never wearing their seat belt Weapons: Students who carried a weapon in past month, carried a weapon in past month on school property, injured or threatened with a weapon on school property in past month Physical Fights: Students who were in a physical fight in past month, in a physical fight in past month on school property, in a physical fight and injured needing treatment in past year Dating Violence: Students physically hurt by someone they dated in the past year, Students who were forced to have sexual intercourse in past year Page 9 of 10
February 26, 2018 Mental Health and Mental Disorders Transgender, Not Sure, Females Black/African American, Some Other Race Low Income Oral Health Transgender, Not Sure Some Other Race 8 th Grade Tobacco Use WORSENING 2 Worsening 5 No Trend TOTAL: 7 Indicators NO TRENDS 1 No Trend TOTAL: 1 Indicator Best ranking in CHR for average number of poor mental health days for adults (#4) and for adults with frequent mental distress (#7) Transgender, Not Sure, Males Some Other Race 8 th, 10 th, 12 th Grades Substance Abuse IMPROVING - BUT ONLY Best ranking in CHR for adults 1 of the 10 indicators who are current smokers (#4) can be assessed 9 No Trend TOTAL: 10 Indicators Transgender, Not Sure Black/African American, White 8 th, 10 th, 12 th Grades Not Low Income MIXED-WORSENING 2 Worsening 23 No Trend TOTAL: 26 Indicators Best CHR rankings for Drug Poisoning/Overdose Deaths (#4) Worst CHR ranking for Adult Excessive Drinking (Last-#133) Students who considered attempting suicide in the past 12 months Students who made a plan to attempt suicide in the past 12 months Students who attempted suicide in the past 12 months Average Number of Poor Mental Health Days Adults with Frequent Mental Distress Adults with mental health not good 8+ days during past month Adults ever being diagnosed with a depressive disorder Students who saw a dentist for preventative care such as checkup, exam, teeth cleaning, or other dental work Initiation: Students who ever tried cigarette smoking, ever tried cigarette smoking for the first time before age 13 years Current Smoker: Students who currently smoke cigarettes, Adult smoking, Adults that reported being a current smoker Tobacco Sales: Students who currently smoke that usually obtained their own cigarettes by buying in a store or gas station in past month Vapor Products: Students who used vapor products in past month, who used vapor products in past month on school property Other Tobacco Use: Students who smoked cigars or cigarillos in the past 30 days, Students who used chewing tobacco, snuff, or dip in past month Drinking & Driving: Alcohol-impaired driving deaths, students who rode with someone driving under the influence of alcohol, students who drove under the influence of alcohol Alcohol: Adult Excessive Drinking, adult alcohol consumption, adult heavy alcohol consumption, adult binge drinking, students who ever drank alcohol, drank alcohol for first time before age 13 years, had at least one drink of alcohol in past month, who had 5+ drinks of alcohol in a row within hours, had alcohol on or near school property in past month, drank alcohol in past month and who usually obtained the alcohol they drank by someone giving it to them Marijuana: Students who have ever used marijuana, tried marijuana for the first time before age 13 years, ever used synthetic marijuana Illicit Drug Use: Drug poisoning/overdose deaths, students who have ever used cocaine, ecstasy, hallucinogenic drugs, heroin, methamphetamines, steroid pills, prescription drugs without a doctor's prescription, sniffed glue Students who were offered drugs near school property Page 10 of 10