Oakwood Healthcare Community Health Needs Assessment Indicators

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POPULATION Sub-Category Education Socioeconomic Violence High School High School Dropouts Graduation Rate (Percent) Some College Births to Unmarried Women Children in Poverty Children in Singleparent Households Individuals Living Below Poverty Level Individuals Who Report Being Disabled Unemployment Rate Violent Crime Rate Homicides Confirmed Victims of Abuse and/or Neglect, Ages 0-17 (Rate) 82% 5.0% 54% 41.0% 25% 31% 16.0% 8.7% 274 4.7 9.0 74% 11.1% 64% 41.3% 25% 33% 18.0% 23.7% 10.3% 497 6.2 14.3 69% 14.7% 57% 55.2% 38% 47% 26.1% 12.6% 1,146 21.0 10.3 Monroe 80% 9.5% 59% 36.3% 18% 26% 12.1% 26.4% 9.7% 248 2.0 9.7 Co ex 21.6% 27.8% 18.8% 70.0% 45.9% 28.2% 11.0% Heights 28.3% 79.3% Garden 37.4% 48.4% 38.3% 56.8% 45.2% ( sources and the National for Education Statistics) A for Educational Performance Information (CEPI) (American Survey, 5- year estimates) Department of, Vital (Small Area Income and Poverty Estimates) (American Survey, 5- year estimates) U.S. Census Bureau, Census 2000 Supplementary Survey, 2001 Supplementary Survey, 2002 through 2011 American Survey BRFSS (Bureau of Labor Statistics) (Uniform Crime Reporting, Federal Bureau of Investigation) FBI Crime in the Department United s of Human Services, Children's Protective Services Data Department of FBI Crime in the United s Source varies by - High school graduation (percent of ninth grade cohort that graduates in 4 years) 2011 students in the four-year cohort who have not graduated and either have left school permanently or whose whereabouts are unknown. The percent is based on the cohort 2007-2011 Some college (Percent of adults aged 25-44 years with some postsecondary education) 2010 live births to unwed mothers. The percent is based on total live births. 2011 Children in poverty (percent of children under age 18 in poverty) 2007-2011 Percent of children that live in single-parent household 2011 share of all people who live in families with incomes below the federal poverty level. The adults who reported being limited in any activities because of physical, mental, or emotional problems, or reported that they required use of special equipment (such as a cane, a wheelchair, a special bed, or a special telephone) due to a health problem. 2011 Unemployment rate (percent of population age 16+ unemployed) Violent crime rate per population 2011 2011 Confirmed Victims of Abuse and/or Neglect, Ages 0-17 per 1,000 children ages 0-17 Page 1 of 11 v.11

Sub-Category Status HEALTH OUTCOMES Leading Hospital Discharges (MI) Monroe Co ex Heights Garden Poor or Fair General Fair or Poor Average Number of Unhealthy Days in Past Month Poor Physical Heart Disease Injury & Poisoning Infectious & Parasitic Diseases Psychoses Cancer (Malignant Neoplasms) Osteo-arthrosis & Allied Disorders Cerebro-vascular Pneumonia Disease 17.0% 3.8 14.0% 14.6% 3.5 10.8% 140.0 103.9 54.3 48.5 40.0 39.6 34.8 34.3 18.0% 3.8 174.2 121.9 69.7 56.5 45.1 29.3 39.0 42.1 14.0% 13.1% 3.5 8.0% 165.5 113.9 52.4 55.9 38.7 44.1 40.8 39.3 13.7% 9.7% 162.2 109.8 55.5 55.0 42.6 35.6 40.0 37.8 24.7% 14.4% 168.0 122.4 79.8 51.4 42.8 17.1 32.6 42.5 2005-2011 Percent of adults reporting fair or poor health (ageadjusted) reported that their health, in general, was either fair or poor. 2005-2011 Poor physical health days (average number in past 30 days) The reported 14 or more days, out of the previous 30, on which their physical health was not good, which includes physical illness and injury 2010 2010 2010 2010 2010 2010 2010 2010 Page 2 of 11 v.11

Sub-Category HEALTH OUTCOMES (continued) Conditions/Diseases Monroe Co ex Heights Garden Cancer (all causes) Incidence Breast Cancer Incidence Colon Cancer Incidence Lung Cancer Incidence Adults Reporting Diagnosed with Diabetes Adults Reporting Adults Reporting Diagnosed Diagnosed with Coronary Heart Hypertension Disease or Angina Adults Reporting Diagnosed with Stroke Any Cardiovascular Disease Currently Have Asthma 116.2 44.4 65.1 468.9 121.9 44.5 69.5 9.5% 29.8% 4.8% 2.8% 8.9% 10.1% 31.5% 506.7 65.9 51.4 83.4 31.1% 336.8 8.8% 31.4% 4.0% 3.1% 9.8% 8.8% 46.4% 587.3 9.1% 5.0% 2.8% 8.9% 10.3% 31.5% 564.0 14.4% 4.4% 4.7% 10.9% 12.6% 30.6% BRFSS (CDC, PHSPO) Arthritis CDC 2009 Ageadjusted rate per 2008 Breast Cancer Rate per 2009 Colon Cancer Rate per 2009 Lung Cancer Rate per The reported that they were ever told by a doctor that they have diabetes. 2009 Percent of Among Among adults that report having been all adults, the proportion who all adults, the proportion who Among all adults, The diagnosed with had ever been told had ever been told the proportion who high blood by a doctor that by a doctor that had ever been told reported that they pressure they had angina or they had a stroke by a doctor that were ever told by coronary heart disease they had a heart attack, coronary heart disease or a stroke. a doctor, nurse, or other health care professional that they had asthma. Among all adults, the proportion who reported ever being told by a health care professional that they had some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. Page 3 of 11 v.11

Sub-Category HEALTH OUTCOMES (continued) Maternal Monroe Co ex Heights Garden Infant Mortality Infant Deaths, All (per 1,000 live births) Infant Mortality by Race: White Non- Hispanic Infant Mortality by Race: Infant Mortality by Black Non- Race: Hispanic Hispanic Births to Mothers w/ Late or No Prenatal Care (New Birth Certificate) Births w/ Less than Adequate Pre-natal Care (New Birth Certificate) Births to Mothers Who Smoked During Pregnancy (New Birth Certificate) Births to Mothers Who Are Foreign Born Births to Mothers with No Diploma or GED Medicaid Paid Births Low Birth Weight Low Birth Weight Very Low Birth Weight Preterm Births 6.1 6.7 5.6 13.1 5.5 23.0% 8.10% 8.3% 1.4% 12.0% 7.3 7.6 5.9 14.7 7.1 4.0% 29.6% 19.0% 11.6% 15.9% 44.8% 8.5% 8.4% 1.6% 10.1% 10.2 10.3 6.1 15.2 6.1 6.5% 34.1% 16.3% 16.5% 23.7% 46.4% 10.7% 10.6% 2.4% 11.7% 6.1 5.8 5.7 5.9% 32.6% 22.4% 2.9% 12.5% 40.1% 6.8% 7.2% 1.1% 7.8% 10.2 14.4 4.4 2.2% 22.3% 9.7% 28.7% 4.3% 24.9% 8.1% 8.6% 12.3 7.4% 41.3% 21.4% 10.0% 20.3% 63.2% 13.3% 14.3% 7.9 3.8% 30.2% 19.3% 12.9% 13.4% 42.3% 9.4% 10.8% 8.3 1.9% 15.2% 17.3% 6.1% 7.4% 26.6% 6.7% 8.3% 6.9 8.3% 31.2% 7.2% 27.1% 23.4% 61.4% 7.3% 8.4% 3.9 5.5% 27.8% 15.3% 34.5% 12.1% 49.9% 8.1% 8.2% 14.4 7.1% 42.9% 15.5% 11.6% 34.6% 48.1% 13.3% 14.3% 3.2% 26.5% 26.2% 5.1% 8.5% 37.6% 7.1% 9.8% 4.6 4.0% 21.5% 29.1% 13.6% 24.9% 57.5% 8.1% 9.7% 6.4 2.5% 18.5% 20.2% 7.5% 9.9% 38.5% 6.6% 7.8% 6.8 3.7% 23.5% 26.9% 5.7% 18.2% 60.7% 10.8% 11.6% 9.4 2.5% 17.7% 26.3% 2.2% 11.4% 51.9% 7.8% 9.3%, Vital Linked Birth/Infant Death Data Set Linked Birth/Infant Death Data Set Linked Birth/Infant Death Data Set Linked Birth/Infant Death Data Set Department of, Vital Department of, Vital Department of, Vital, Vital, Vital, Vital, Vital (NCHS) Status s (CHSI), Vital CDC CDC CDC CDC KidsCount Data KidsCount Data KidsCount Data HHS Status s KidsCount Data 2010 Infant 2006-2008 Rate 2006-2008 Rate 2006-2008 Rate 2006-2008 Rate Deaths include of all infant deaths of all infant deaths of all infant deaths of all infant deaths deaths of infants (within 1 year) (within 1 year) (within 1 year) (within 1 year) up to one year of age. The rate is the number per 1,000 live births 2011 2010 2011 2011 2010/2011 2010 Paid 2010 percent of births per total live births; single year Babies who weigh less than 2,500 grams (approximately 5 lb. 8 oz.) at birth are considered lowbirth weight occurrences. 2004-2010 2009 2010 percent total live births with less than 37 weeks of gestation Page 4 of 11 v.11

Sub-Category MI Top 5 Causes of Death INJURY & DEATH Injury & Death Monroe Co ex Heights Garden Heart Disease Overall Cancer Death Rate Death Rate Chronic Lower Respiratory Disease (CLRD) Death Rate Stroke Death Rate Unintentional Injury Death Rate Premature Death Motor Vehicle Crash Mortality Fatal Injuries Rate 197.2 174.2 43.2 40.2 38.2 8,025 58.6 22.0 210.0 183.2 46.2 40.9 35.9 7,254 60.1 10.9 269.1 204.9 43.9 43.8 38.6 10,263 71 10 202.0 188.5 48.7 39.9 36.3 6,696 53 12 National Vital Statistics System- Mortality National Vital Statistics System- Mortality National Vital Statistics System- Mortality National Vital Statistics System- Mortality National Vital Statistics System- Mortality (NCHS) s (NCHS) CDC CDC CDC CDC CDC CDC Heart disease deaths (per, age adjusted) Overall cancer death rate (per, age adjusted) Chronic lower respiratory disease (CLRD) deaths (per, age adjusted) Stroke deaths (per, age adjusted) Injury deaths, unintentional (per, age adjusted) Premature death (years of potential life lost before age 75 per pop) 2010 Injury Rate per Page 5 of 11 v.11

HEALTH BEHAVIORS Sub-Category Obesity Rate Activity Nutrition Tobacco Monroe Co ex Heights Garden Adult Obesity National for Chronic Disease Prevention and Promotion Children and Adolescents Considered Obese Physical Inactivity No Exercise Percent Consuming Less than 5 Fruits & Vegetables per Day Adult Smoking Adolescents Who Smoked Cigarettes in the Past 30 Days 30% 13.0% 28.0% 21.0% 18.1% 32% 11.9% 24.3% 23.6% 77.4% 19.7% 14.0% 34% 28.6% 74.8% 22.0% 35% 27.0% 16.2% 77.7% 16.4% 23.7% 19.5% 22.7% 34.5% 24.5% 4.8% Youth Risk Behavior Surveillance System (YRBSS) s s (CDC, (CDC, NCHS) NCHS) Youth Risk Behavior Surveillance System (YRBSS) CDC YRBSS CDC CDC CDC YRBSS 2009 Adult obesity 2012 Survey high (percent of adults school students that report a BMI who were >= 95th >= 30) percentile for body mass index, based on sex- and agespecific reference data from the 2000 CDC growth charts) 2010 18+ who report no exercise in past month 2009 The reported that they had ever smoked at least 100 cigarettes (five packs) in their life and that they smoke cigarettes now, either every day or on some days 2007-2008 Page 6 of 11 v.11

Sub-Category HEALTH BEHAVIORS (continued) Alcohol/Drug Abuse Driving Sexual Monroe Co ex Heights Garden Adults Engaging in Binge Drinking During the Past 30 Days Illicit Drug Use Prescription Drug Marijuana Use (non-medical) Use Drove Motor Vehicle After Drinking Seatbelt Use Births to Teens Under Age 20 HIV Prevalence Sexually Transmitted Infection Incidence Rate 15.0% 8.9% 6.9% 2.7% 34.0% 315 16.6% 9.5% 7.5% 5.7% 2.7% 88.3% 9.9% 163.9 500 17.0% 13.6% 417.5 1,162 22.2% 9.6% 7.1% 5.7% 3.3% 91.3% 9.8% 44.8 206 18.4% 3.7% 89.3% 12.1% 1.5% 88.8% 3.2% 15.1% 8.9% Substance Abuse and Mental Services Admin (SAMHSA) Substance Abuse and Mental Services Admin (SAMHSA) Substance Abuse and Mental Services Admin (SAMHSA) 5.1% 5.0% 6.5% 20.6% 5.7% 12.6% 7.7% 11.4% 10.7%, Vital (National for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention) (National for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention) The reported consuming five or more drinks per occasion at least once in the previous month Southeast Alliance 2010 (), 2009 (MI), 2004-2002 (Out- Co, Monroe Co) SAMHSA National Study on Drug Use & (NSDUH). SEMCA utilizes NSDUH southeastern substate region to estimate Out- and Monroe counties Southeast Alliance 2010 (), 2009 (MI), 2004-2002 (Out- Co, Monroe Co) SAMHSA National Study on Drug Use & (NSDUH). SEMCA utilizes NSDUH southeastern substate region to estimate Out- and Monroe counties Southeast Alliance 2010 (), 2009 (MI), 2004-2002 (Out- Co, Monroe Co) SAMHSA National Study on Drug Use & (NSDUH). SEMCA utilizes NSDUH southeastern substate region to estimate Out- and Monroe counties Proportion of reported that they had driven when they d had too much to drink at least once in the previous month. 2008 and 2010 The reported always using a seatbelt when driving or riding in a car 2010 percent of live births to teens under age 20 2009 Number of Recorded persons living with HIV 2010 Sexually transmitted infections (Chlamydia rate per population) Page 7 of 11 v.11

Sub-Category MENTAL HEALTH Mental Monroe Co ex Heights Garden Population to Mental Provider Ratio Poor Mental Days Suicide Rate Inadequate Social Support Lack of Social and Emotional Support Life Satisfaction 11.8 19% 2826:1 10.6% 11.9 20% 7.1% 6.3% 4642:1 10.7 26% 8939:1 3.8% 10.9 23% 10.1% 4.5% 11.9% 6.8% 6.6% 13.3% 13.7% 10.6% (HRSA Area Resource File) NVSS-M (CDC, NCHS) CDC 2011-2012 Ratio of population to mental health providers Poor Mental on at Least 14 Days in the Past month Number of deaths due to suicides per 2005-2010 Inadequate social support (percent of adults without social/emotional support) The reported either Rarely or Never to the following question: How often do you get the social and emotional support you need? The reported either Dissatisfied or Very Dissatisfied to the following question: In general, how satisfied are you with your life? Page 8 of 11 v.11

ACCESS TO CARE Sub-Category Insurance Coverage / Cost Primary Care Dental Care Care Mgmt Percent Uninsured Percent Uninsured Children (<17) Monroe Co ex Heights Garden (Small Area Insurance Estimates) Care Access due to Cost Primary Care Physicians per Population Population to Primary Care Physician Ratio Dentists per Population Population to Dentist Ratio Dental Visits in Past Year Preventable Hospital Stays 2,596:1 3,630:1 79.00 15.1% 4.5% 13.4% 89.6 1,271:1 62.9 1,626:1 73.8% 69.75 4.8% 90.3 1,551:1 54.2 1,863:1 87.8 11.6% 3.7% 10.2% 38.8 2,666:1 32.9 3,069:1 73.4% 85.5 13.5% 13.2% 77.1% 26.1% 22.2% 57.1% Area Resource File (HRSA, (HRSA BHPr) Area Resource File) Area Resource File (HRSA, BHPr) (HRSA Area Resource (Dartmouth Atlas File) of Care) CDC CDC No Coverage Among those aged 18-64 years 2010 The adult s who reported that in the past 12 months there was a time when they needed to see a doctor but could not due to the cost 2010 Rate of primary care providers (PCP) per 2011-2012 Population to Primary Care Physicians 2010 Number of total professionally active dentists per population 2011-2012 a The proportion of reported that they had visited a dentist or dental clinic for any reason in the previous year. 2010 Preventable hospital stays (rate per 1,000 Medicare enrollees) Page 9 of 11 v.11

PREVENTION Sub-Category Screenings Vaccines Colorectal Screening Diabetic Screening Monroe Co ex Heights Garden (Dartmouth Atlas of Care) Mammography Screening Prostate Cancer Screening Among Men Aged 50 and Older Pap Smear No Routine Checkup in Past Year HIV Screening Flu Vaccine 65+ Pneumonia Vaccine 65+ Ever had Pneumonia Vaccine Adults 65 Years and Older 70.6% 84% 63.0% 64.5% 86% 54.6% 59.0% 79.3% 32.3% 37.8% 67.5% 67.8% 67.1% 66.1% 81.0% 60.0% 77.4% 63.7% 67.8% 56.7% 77.0% 52.7% 43.9% 80.0% 30.8% 32.7% 73.0% 63.7% 62.8% 54.9% 65.6% 79.2% 32.2% 37.7% 70.1% 60.0% 48.4% 56.0% 74.9% 27.3% 62.9% 50.9% s (CDC, NCHS) s (CDC, NCHS) CDC CDC Colorectal Screening Among Adults 50 years and Older 2010 Diabetic screening (percent of diabetics that receive HbA1c screening) Breast Cancer screening Among Women Age 40 and Older Among men aged 50 years and older, the proportion who reported having a PSA in the past year. Cervical Cancer Screening Among women Aged 18 Years and Older a The reported that they did not have a routine checkup in the past year. 2008-2009 HIV Testing among adults Aged 18-65 Years 2010 Respondents age 65+ who report influenza vaccination 2010 Respondents age 65+ who report influenza vaccination Among adults aged 65 years and older, the proportion who reported that they had a flu vaccine, either by an injection in the arm or sprayed in the nose during the past 12 months Page 10 of 11 v.11

ENVIRONMENT Sub-Category Recreation/Nutrition/Access to Foods Transportation Air Quality/Pollution Number of Recreational & Fitness Facilities Monroe Co ex Heights Garden ( Business Patterns) Fast Food Limited Access to Restaurants y Foods Students Eligible for Free Lunch % of Households with No Vehicle Available Daily Particulate Matter Days 7.6 45% 8% 9.3% 11.0 9 49% 6% 48.1% 7.8% 9.9 Air Pollution Ozone Days 7.0 55.0% 4.0% 56.0% 13.5% 12.0 4 9.0 51.0% 30.0% 5.0% 12.3 0 ( (DA Business Food Environment (National Patterns) Atlas) for Education Statistics) 21.0% 4.0% 14.0% 8.0% 10.0% 10.0% 6.0% 5.0% 8.0% American Survey/ Starfish CHNA (CDC WONDER) PHASE (CDC, EPA) U.S. Census Bureau CDC 2010 Access to recreational facilities (rate per population) 2010 Fast food 2012 Limited restaurants access to health (percent of all foods (percent of restaurants that population who are fast food) lives in poverty and more than 1 or 10 miles from a grocery store) 2011 2011 American Survey 1- Year Estimates (, ); 2009 American Survey via Starfish/Demographics Now () 2008 Average daily amount of fine particulate matter in micrograms per cubic meter (PM2.5) 2006 The number of days per year that air quality in a county was over the National Ambient Air Quality d for ozone Page 11 of 11 v.11