County Local Health Improvement Plan (LHIP) Update Presentation to the Community Health Advisory Committee Daniel Coulter, MPH, Health Planner daniel.coulter@maryland.gov 443-245-3767 January 15, 2015 Healthy People. Healthy Community. Healthy Future.
Overview LHIP Background LHIP Priorities Summary of Activities Data Summary Future Directions Healthy People. Healthy Community. Healthy Future.
LHIP Background State Health Improvement Process (SHIP) Launched in Sept. 2011 CHAC chosen to serve as County s Local Health Improvement Coalition (LHIC) County Local Health Improvement Plan (LHIP) released in Jan. 2012 County Community Health Needs Assessment (CHNA) released in May 2013 LHIP update presented to CHAC in July 2013 Healthy People. Healthy Community. Healthy Future.
LHIP Priorities Priority 1: Substance Abuse: Prescription Drugs/ Pain Management Priority 2: Mental/Behavioral Health: Access to Treatment Priority 3: Substance Abuse Prevention Priority 4: Child Abuse Priority 5: Childhood Obesity: Physical Activity Healthy People. Healthy Community. Healthy Future.
Priority 1 Update: Substance Abuse: Prescription Drugs/ Pain Management 2013 Substance Abuse Assessment Local Overdose Fatality Review Team (LOFRT) Overdose Response Program Drug Take Back Events MD Prescription Drug Monitoring Program Provider Education Healthy People. Healthy Community. Healthy Future.
Priority 3 Update: Substance Abuse Prevention Substance Abuse Assessment DAAC Plan Anonymous People Screenings Engagement of Governance Newspaper Series Educational Materials Substance Abuse Prevention Forums Healthy People. Healthy Community. Healthy Future.
Priority 1 & 3 SHIP Data 35 Drug- Induced Death Rate per 100,000 Population 30 26.7 29.2 25 23.0 21.8 20 15 13.5 12.6 12.4 12.7 10 5 0 SHIP 2011 (2007-2009) SHIP 2012 (2008-2010) SHIP 2013 (2009-2011) SHIP 2014 (2010-2012) HP 2020 Goal: 11.3 MD 2014 Goal: 12.4 Source: DHMH Vital Statistics Administration (VSA)
Priority 1 & 3 SHIP Data Baltimore City Caroline Allegany Harford Baltimore County Calvert Wicomico Anne Arundel Washington Carroll Charles Frederick Saint Mary's Howard Prince George's Montgomery Drug- Induced Death Rate County Comparison 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 SHIP 2014 (2010-2012) data MD 2014 Goal: 12.4 29.2
Priority 1 & 3 SHIP Data 2500 2000 ED Visits for Addictions- Related Conditions per 100,000 Population 2088.6 2179.0 2018.4 1500 1000 1149.8 1515.2 1275.6 1445.2 1521.8 500 0 SHIP 2011 (2010) SHIP 2012 (2011) SHIP 2013 (2012) SHIP 2014 (2013) MD 2014 Goal: 1092.3 Source: Health Services Cost Review Commission (HSCRC)
Priority 1 & 3 SHIP Data ED Visits for Addictions- Related Conditions County Comparison Baltimore City Wicomico Dorchester Saint Mary's Washington Worcester Somerset Anne Arundel Harford Kent Talbot Allegany Baltimore County Caroline Charles Frederick Calvert Carroll Queen Anne's Garrett Prince George's Howard Montgomery 2018.4 MD 2014 Goal: 1092.3 0 1000 2000 3000 4000 5000 6000 SHIP 2014 (2013) data
Additional Substance Abuse Data Queen Anne's Carroll St. Mary's Anne Arundel Worcester Calvert Garrett Frederick Caroline Baltimore City Talbot Harford Baltimore Allegany Washington Kent Howard Dorchester Montgomery Charles Wicomico Somerset Prince George's Percentage of Adults Reporting Excessive Drinking in the Last 30 Days 18% Top U.S. Performers: 10% 0% 5% 10% 15% 20% 25% County Health Rankings 2014 (2006-2012) data
Additional Substance Abuse Data Substance Use Among High School Students Alcohol/ Drug Use Percentage of students who had at least one drink of alcohol on one or more of the past 30 days 37.5% 31.2% Percentage of students who had five or more drinks of alcohol in a row, that is, within a couple of hours, on one or more of the past 30 days 23.0% 17.0% Percentage of students who used marijuana one or more times during their life 41.9% 35.9% Percentage of students who used marijuana one or more times during the past 30 days 23.9% 19.8% Percentage of students who used any form of cocaine, including powder, crack, or freebase one or more times during their life 6.5% 6.5% Percentage of students who sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints or sprays to get high one or more times during their life 9.1% 10.4% Source: Youth Risk Behavior Survey (YRBS), 2013
Additional Substance Abuse Data Substance Use Among High School Students Alcohol/ Drug Use Percentage of students who used heroin one or more times during their life 4.5% 4.9% Percentage of students who used methamphetamines one or more times during their life 4.1% 5.0% Percentage of students who used ecstasy one or more times during their life 7.4% 8.3% Percentage of students who took steroid pills or shots without a doctor's prescription one or more times during their life 3.9% 5.1% Percentage of students who have taken a prescription drug (such as OxyContin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor's prescription one or more times during their life 15.7% 15.2% Percentage of students who used a needle to inject any illegal drug into their body one or more times during their life 3.6% 3.9% Percentage of students who were offered, sold, or given an illegal drug by someone on school property during the past 12 months 25.6% 29.1% Source: Youth Risk Behavior Survey (YRBS), 2013
Priority 2 Update: Mental/Behavioral Health: Access to Treatment Mental Health Needs Assessment and Annual Plan Eastern Shore Mobile Crisis (ESMC) Emergency Room & Hospital Intervention Project Crisis Intervention Team Telepsychiatry Program Behavioral Health Integration in Pediatric Primary Care (B-HIPP) Resource Directory Healthy People. Healthy Community. Healthy Future.
Priority 2 SHIP Data 12000 ED Visits Related to Mental Health Disorders per 100,000 Population 10000 9715.4 10272.8 8695.7 8000 6864.9 6000 4000 2792.2 3256.3 3564.8 3375.1 2000 0 SHIP 2011 (2010) SHIP 2012 (2011) SHIP 2013 (2012) SHIP 2014 (2013) MD 2014 Goal: 2652.6 Source: Health Services Cost Review Commission (HSCRC)
Priority 2 SHIP Data Dorchester Washington Saint Mary's Garrett Worcester Baltimore City Wicomico Somerset Caroline Allegany Anne Arundel Talbot Frederick Carroll Kent Harford Charles Baltimore County Queen Anne's Calvert Howard Montgomery Prince George's ED Visits Related to Mental Health Disorders County Comparison MD 2014 Goal: 2652.6 8695.7 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 SHIP 2014 (2013) data
Priority 2 SHIP Data Suicide Rate per 100,000 Population 18 17.1 16 14 13.7 12.6 14.4 12 10 8 9.6 8.7 9.4 9.5 6 4 2 0 SHIP 2011 (2009) SHIP 2012 (2010) SHIP 2013 (2011) SHIP 2014 (2012) HP 2020 Goal: 10.2 MD 2014 Goal: 9.1 Source: DHMH Vital Statistics Administration (VSA)
Priority 2 SHIP Data 350 Hospitalizations Due to Alzheimer's and Other Dementias per 100,000 Population 300 250 289.1 276.9 270.5 242.9 254.2 232.2 200 150 192.7 191.3 100 50 0 SHIP 2011 (2010) SHIP 2012 (2011) SHIP 2013 (2012) SHIP 2014 (2013) MD 2014 Goal: 274.6 Source: Health Services Cost Review Commission (HSCRC)
Additional Mental/ Behavioral Health Data 30.00% 25.00% Percentage of Population With a Disability 24.90% 20.00% 17.40% 15.00% 10.00% 5.00% 7.80% 10.64% 4.90% 6.24% 0.00% Physical Disability Mental Disability Physical, Mental, or Emotional Disabilities Sources: Behavioral Risk Factor Surveillance System (BRFSS) 2007 data, U.S. Census, American Community Survey 2005-2007 data
Additional Mental/ Behavioral Health Data Somerset Caroline Baltimore City Harford Allegany Washington Garrett Calvert Baltimore Worcester Wicomico Kent Carroll Queen Anne's Frederick Anne Arundel Talbot Prince George's Dorchester St. Mary's Charles Montgomery Howard Average Number of Mentally Unhealthy Days per 30 Day Period 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 County Health Rankings 2014 (2006-2012) data Source: CDC, Behavioral Risk Factor Surveillance System (BRFSS) 3.9 Top U.S. Performers: 2.4 days
Additional Mental/ Behavioral Health Data 83.5% 83.0% 82.5% 82.0% 81.5% 81.0% 80.5% 80.0% 79.5% 79.0% 78.5% Percentage of Adults Receiving Sufficient Social- Emotional Support 80.1% 82.8% Source: Behavioral Risk Factor Surveillance System (BRFSS) 2005-2010 data
Additional Mental/ Behavioral Health Data Caroline Garrett Queen Anne's Prince George's Charles St. Mary's Harford Somerset Calvert Anne Arundel Worcester Allegany Carroll Frederick Kent Washington Wicomico Dorchester Baltimore Howard Montgomery Talbot Baltimore City Ratio of Mental Health Providers to Population 869:1 0 500 1000 1500 2000 2500 3000 3500 County Health Rankings 2014(2013) data County is designated as a mental health professional shortage area (MHPSA).
Priority 4 Update: Child Abuse Strengthening Families Program Darkness to Light: Stewards of Children Training Identification of Crisis Lines Anti- Bullying Educational Materials Pinwheels for Prevention Campaign (planned for April, 2015) Healthy People. Healthy Community. Healthy Future.
Priority 4 SHIP Data Child Maltreatment Rate per 1,000 Children Under the Age of 18 25 20 18.4 20.1 16.5 15 10 9.3 10.2 9.2 5 0 SHIP 2012 (2011) SHIP 2013 (2012) SHIP 2014 (2013) HP 2020 Goal: 8.5 MD 2014 Goal: 4.8 Source: Department of Human Resources (DHR)
Priority 4 SHIP Data Worcester Dorchester Allegany Somerset Baltimore City Washington Caroline Talbot Kent Wicomico Calvert Harford Frederick Baltimore County Charles Prince George's Garrett Saint Mary's Anne Arundel Queen Anne's Montgomery Carroll Howard Child Maltreatment Rate County Comparison 16.5 0 5 10 15 20 25 30 35 SHIP 2014 (2013) data Source: Department of Human Resources (DHR) MD 2014 Goal: 4.8
Additional Child Abuse Data 8 Out of Home Placement Rate per 1,000 Children Under 18 7 6 5 6.9 5.8 6.5 5.2 5.9 5.0 5.4 5.4 4.8 6.0 4 3 2 1 0 2009 2010 2011 2012 2013 Source: Dept. of Human Resources, SSA StateStat Jurisdiction Data, 2009-2013.
Priority 5 Update: Childhood Obesity: Physical Activity Community Transformation Grant Just a Minute School Program Other School Based Physical Fitness Activities Expansion of CCPS Breakfast Program Updated Nutrition Standards for CCPS Healthy People. Healthy Community. Healthy Future.
Priority 5 SHIP Data 16 Percentage of Children and Adolescents Who Are Obese 14 12 13.4 12.7 11.9 11.6 11.7 12.1 11 13.2 10 8 6 4 2 0 SHIP 2011 (2008) SHIP 2012 (2010) Ship 2012 (2010- high school) HP 2020 Goal: 16.1 MD 2014 Goal 11.3 Source: Youth Tobacco Survey (MYTS) SHIP 2014 (2013- high school)
Priority 5 SHIP Data Somerset Dorchester Kent Garrett Caroline Baltimore City Prince George's Allegany Charles Anne Arundel Wicomico Baltimore County Washington Worcester Harford Calvert Frederick Carroll Saint Mary's Talbot Queen Anne's Montgomery Howard Children and Adolescents Who Are Obese County Comparison 13.2% 0 2 4 6 8 10 12 14 16 18 20 SHIP 2014 (2013 high school) data Source: Youth Tobacco Survey (MYTS) MD 2014 Goal: 11.3
Priority 5 SHIP Data 53 52 Percentage of Population That is Physically Active 51.8% 51 50 49 48 48.7% 48.0% 48.3% 47 46 SHIP 2012 (2011) SHIP 2013 (2012) SHIP 2014 (2013) 2011-2013 HP 2020 Goal: 47.9 MD 2014 Goal 49.8 Source: DHMH Behavioral Risk Factor Surveillance System (BRFSS)
Priority 5 SHIP Data Percentage of Population That is Physically Active County Comparison Talbot Saint Mary's Montgomery Frederick Worcester Howard Charles Anne Arundel Prince George's Carroll Wicomico Harford Allegany Kent Garrett Baltimore County Calvert Washington Queen Anne's Baltimore City Dorchester Somerset Caroline 48.3% MD 2014 Goal: 49.8% 0 10 20 30 40 50 60 SHIP County 2011-2013 data Source: DHMH Behavioral Risk Factor Surveillance System (BRFSS)
Additional Childhood Obesity Data Nutrition Among High School Students Nutrition MD Percentage of students who ate fruits and vegetables five or more times per day during the past seven days 14.5% 20.1% Percentage of students who ate fruits or drank 100% fruit juices less than two times per day during the past seven days 25.7% 31.9% Percentage of students who ate vegetables less than three times per day during the past seven days 9.8% 13.8% Percentage of students who drank soda one or more times per day during the past seven days 21.1% 18.0% Percentage of students who ate breakfast on all of the past seven days 33.4% 33.0% Percentage of students who ate breakfast on none of the past seven days 13.8% 15.7% Source: Youth Risk Behavioral Survey (YRBS), 2013
Additional Childhood Obesity Data Physical Activity Among High School Students Physical Activity MD Percentage of students who were physically active for a total of at least 60 minutes per day on five or more of the past seven days 42.5% 40.1% Percentage of students who were physically active for a total of at least 60 minutes per day on 0 of the past seven days 16.2% 18.0% Percentage of students who attended physical education (PE) classes on one or more days in an average week when they were in school 35.2% 39.1% Percentage of students who attended physical education (PE) classes daily in an average week when they were in school 27.6% 18.2% Source: Youth Risk Behavioral Survey (YRBS), 2013
Additional Childhood Obesity Data Montgomery Baltimore City Prince George's Howard Baltimore Harford Anne Arundel Frederick Carroll Worcester Washington Charles Allegany Wicomico Calvert Dorchester Talbot Garrett St. Mary's Kent Caroline Somerset Queen Anne's Percentage of Population With Adequate Access to Locations for Physical Activity 79% Top U.S. Performers: 85% 0% 20% 40% 60% 80% 100% 120% County Health Rankings 2014 (2010 & 2012) data Sources: OneSource Global Business Browser, Delorme map data, ESRI, & US Census Tigerline Files
Additional Childhood Obesity Data Queen Anne's Howard Frederick Carroll Talbot St. Mary's Montgomery Kent Harford Garrett Charles Caroline Calvert Baltimore Anne Arundel Worcester Wicomico Washington Prince George's Dorchester Allegany Somerset Baltimore City Food Environment Index 9/10 0 2 4 6 8 10 County is a top U.S. Performer. Access to Healthy Food: 95% Food Security: 90% County Health Rankings 2014 (2011 (MtMG) & 2010 (USDA)) data Source: USDA Food Environment Atlas, Map the Meal Gap from Feeding America
Future Directions Short Term: FY 14 LHIP Annual Report Revision of LHIP Setting New Objectives through FY16 Collecting more data Formally adding Chronic Disease to the Plan Access to Care Workgroup Healthy People. Healthy Community. Healthy Future.
Future Directions Long Term: The next Community Health Needs Assessment is planned to begin during Q4 of FY15. Union Hospital must complete the CHNA and Community Benefit Implementation Plan by June 30, 2016 The CHNA will inform the creation of new health priorities and LHIP for County. The priorities and objectives in the LHIP and the Implementation Plan should align. Healthy People. Healthy Community. Healthy Future.
Important Links County Community Health Needs Assessment: https://uhcc.thehcn.net/content/sites/uhcc/uhcc_chna_report_fy12-fy13.pdf County Local Health Improvement Plan: http://www.cecilcountyhealth.org/ccdhxx/pdf/lhic%20memo%20attachment%20ceci l%20county%20final_2.pdf County Substance Abuse Assessment: http://wrangler.websitewelcome.com/~hdadmin/1221/wp- content/uploads/2013/08/-county-substance-abuse-assessment-report- FINAL.pdf State Health Improvement Process: http://cecil.md.networkofcare.org/ph/ Community Benefit Implementation Plan, UHCC: https://www.uhcc.com/getattachment/about/community-benefit/uhcc-cbip_fy13- FY14.pdf.aspx Healthy People. Healthy Community. Healthy Future.