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Plan for Collaborating on a Harford County Community Health Improvement Plan. Community Health Improvement Plan (CHIP) Coalition Steering Committee November 2011. Today’s Agenda. Rationale for a community health needs assessment and improvement plan Proposed approach for the planning process

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Plan for collaborating on a harford county community health improvement plan

Plan for Collaborating on a Harford County Community Health Improvement Plan

Community Health Improvement Plan (CHIP) Coalition Steering Committee

November 2011


Today s agenda
Today’s Agenda Improvement Plan

  • Rationale for a community health needs assessment and improvement plan

  • Proposed approach for the planning process

  • Broad-brush review of Harford County health data and priorities

  • Next steps


Who says we need a plan for improving the community s health
Who Says We Need a Plan for Improving the Community’s Health?

  • CHNA – For Hospitals

    • Federal health care reform, as well as Federal and State requirements, mandate community health needs assessment (CHNA).

  • SHIP – For State Health Departments

    • Maryland’s Health Care Reform Coordinating Council reaffirms the importance of a State Health Improvement Process (SHIP).

  • LHIP – For Local Health Departments

    • National public health accreditation requires a Local Health Improvement Plan (LHIP).


What s required
What’s Required? Health?

Local Health Departments

State Health Improvement Process (SHIP) obligations requiring a Local Health Improvement Coalition (LHIC) and Action Plan

Obesity Prevention Task Force report due to the County Council

Public Health Accreditation Board (PHAB) prerequisite

Hospitals

State community benefits report to HSCRC

Federal IRS Form 990 Schedule H

New federal health care reform requirements for Community Health Needs Assessment (CHNA)



Can we build on harford county efforts
Can We Build on Harford County Efforts? Health?

Federal Health Care Reform Requirements

Hospital CHNA Mandates

LHD SHIP

Mandates

COMMUNITY HEALTH IMPROVEMENT PLAN

Healthy Harford Activities


A common vision and mission
A Common Vision and Mission? Health?

VISION

To make Harford County the healthiest community in Maryland

MISSION

To protect, promote and improve the health, safety and environment of the residents of Harford County through community assessment, education, collaboration and assurance of services


What is a public health planning process
What is a Public Health Planning Process? Health?

MAPP

  • MAPP = Mobilizing for Action through Planning & Partnerships

  • Developed by NACCHO & CDC in 2001

  • Consists of 4 assessments:

    • Quantitative data review

    • Qualitative data review

    • Internal review

    • External review


How can we get started
How Can We Get Started? Health?

One Approach

  • Present the quantitative data we currently have to community audiences

  • Then solicit reaction, including qualitative feedback

  • In order to engage in a discussion about strengths, weaknesses, opportunities & threats

  • To gain consensus on priorities, goals, strategies & action steps




Infant mortality rates harford county maryland 2001 05 to 2006 10
Infant Mortality Rates Health?Harford County & Maryland2001-05 to 2006-10

Source: Maryland Vital Statistics


Infant mortality rates harford county by race 2000 04 to 2005 09
Infant Mortality Rates Health?Harford County, By Race2000-04 to 2005-09

Source: Maryland Vital Statistics



Low birthweight rates harford county maryland 2000 04 to 2005 09
Low Birthweight Rates Health?Harford County & Maryland2000-04 to 2005-09

Source: Maryland Vital Statistics


Low birthweight rates harford county by race 2004 vs 2009
Low Birthweight Rates Health?Harford County, By Race2004 vs. 2009

Source: Maryland Vital Statistics


Teen birth rates harford county maryland 2004 vs 2009
Teen Birth Rates Health?Harford County & Maryland2004 vs. 2009

Source: Maryland Vital Statistics


Teen birth rates harford county by race 2004 vs 2009
Teen Birth Rates Health?Harford County, By Race2004 vs. 2009

Source: Maryland Vital Statistics


1 st trimester prenatal care rates harford county maryland 2004 06 to 2007 09
1 Health?st Trimester Prenatal Care RatesHarford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


1 st trimester prenatal care rates harford county by race 2004 vs 2009
1 Health?st Trimester Prenatal Care RatesHarford County, By Race2004 vs. 2009

Source: Maryland Vital Statistics




Top 10 causes of death maryland 2010
Top 10 Causes of Death . . .Maryland, 2010


Top 7 causes of death harford county 2009
Top 7 Causes of Death . . .Harford County, 2009

450

433

136

99

59

43

41


Heart disease mortality rates harford county maryland 2004 06 to 2007 09
Heart Disease Mortality Rates . . .Harford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


Heart disease mortality rates harford county by race 2004 06 to 2007 09
Heart Disease Mortality Rates . . .Harford County, By Race2004-06 to 2007-09

Source: Maryland Vital Statistics


Cancer mortality rates harford county maryland 2004 06 to 2007 09
Cancer Mortality Rates . . .Harford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


Cancer mortality rates harford county by race 2004 06 to 2007 09
Cancer Mortality Rates . . .Harford County, By Race2004-06 to 2007-09

Source: Maryland Vital Statistics


Stroke mortality rates harford county maryland 2004 06 to 2007 09
Stroke Mortality Rates . . .Harford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


Stroke mortality rates harford county by race 2004 06 to 2007 09
Stroke Mortality Rates . . .Harford County, By Race2004-06 to 2007-09

Source: Maryland Vital Statistics


Copd mortality rates harford county maryland 2004 06 to 2007 09
COPD Mortality Rates . . .Harford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


Copd mortality rates harford county by race 2000 07 to 2004 09
COPD Mortality Rates . . .Harford County, By Race2000-07 to 2004-09

Source: Maryland Vital Statistics


For chronic disease outcomes harford county ranks worse than the state
For chronic disease outcomes, Harford County ranks worse than the State

Note: Rates are deaths per 100,000 population


Now let’s look at lifestyle choices . . . than the State

LIFESTYLE DATA


Leading actual causes of death united states 2000
Leading Actual Causes of Death than the StateUnited States, 2000

Source: Mokdad AH, et al, JAMA, Mar 2004


Adult smoking rates harford county maryland 2005 07 to 2008 10
Adult Smoking Rates than the StateHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Adult smoking rates harford county 2010 chap brfss data
Adult Smoking Rates than the StateHarford County2010 CHAP & BRFSS Data


Adult cigarette smoking rates harford county maryland 2000 to 2010
Adult Cigarette Smoking Rates than the StateHarford County & Maryland2000 to 2010

Source: CDC Behavioral Risk Factor Surveillance System


Youth tobacco use rates harford county maryland 2000 to 2010
Youth Tobacco Use Rates than the StateHarford County & Maryland2000 to 2010

Source: Maryland Youth Tobacco Survey


Secondhand smoke exposure rates harford county maryland 2008
Secondhand Smoke Exposure Rates than the StateHarford County & Maryland, 2008

Source: CDC Behavioral Risk Factor Surveillance System


Adult obesity overweight rates harford county maryland 2005 07 to 2008 10
Adult Obesity/Overweight Rates than the StateHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Adult obesity overweight rates harford county 2010 chap brfss data
Adult Obesity/Overweight Rates than the StateHarford County2010 CHAP & BRFSS Data


Physical activity rates harford county maryland 2005 07 to 2008 10
Physical Activity Rates* than the StateHarford County & Maryland2005-07 to 2008-10

* NOTE: Moderate activity 30 minutes/day, 5 days/week

Source: CDC Behavioral Risk Factor Surveillance System


Physical activity rates harford county 2010 chap brfss data
Physical Activity Rates than the StateHarford County2010 CHAP & BRFSS Data

NOTE: Moderate activity 30 minutes/day, 3 days/week

NOTE: Moderate activity 30 minutes/day, 5 days/week


Fruits vegetables intake rates harford county maryland 2005 07 to 2008 10
Fruits & Vegetables Intake Rates* than the StateHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System

* NOTE: 5 or more daily servings of fruits or vegetables


Fruits vegetables intake rates harford county 2010 chap brfss data
Fruits & Vegetables Intake Rates than the StateHarford County2010 CHAP & BRFSS Data

Fruits/Vegetables, 37.1%

Fruits, 18.3%

NOTE: 3 more daily servings of fruit and 3 more daily servings of vegetables



And what about access to health care . . . even with the State

ACCESS DATA


Who could not afford to see m d harford county maryland 2005 07 to 2008 10
% Who Could Not Afford to See M.D. even with the StateHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Adult influenza vaccination rates harford county maryland 2005 07 to 2008 10
Adult Influenza Vaccination Rates even with the StateHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Childhood influenza vaccination rates county leaders 2010
Childhood Influenza Vaccination Rates even with the StateCounty Leaders, 2010

Source: CDC Behavioral Risk Factor Surveillance System


Anxiety disorder rates harford county maryland 2005 07 to 2008 10
Anxiety Disorder Rates even with the StateHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Binge drinking rates harford county maryland 2005 07 to 2008 10
Binge Drinking Rates even with the StateHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Population to provider ratios harford county maryland
Population to Provider Ratios even with the StateHarford County & Maryland

Source: Maryland Primary Care Office, DHMH





SHIP 2010


Which of the 39 ship objectives does harford county rank worse than the state
Which of the 39 SHIP objectives does Harford County rank worse than the State?

  • Seasonal flu vaccination rate

  • Heart disease death rate

  • Cancer death rate

  • Adult tobacco use

  • Youth tobacco use

  • Behavioral health-related admissions to E.R.

  • Alzheimer’s-related admissions to the E.R.


County health rankings
County Health Rankings worse than the State?


Which of the 27 county health rankings objectives does harford county rank worse than the state
Which of the 27 County Health Rankings objectives does Harford County rank worse than the State?

  • Adult smoking

  • Adult obesity

  • Access to recreational facilities

  • Air pollution ozone days

  • Mammography screening

  • Motor vehicle crash death rate

  • Primary care physician availability

  • Preventable hospital stays

  • Poor mental health days

  • Poor physical health days

  • Unemployment



Next steps
Next Steps? County health priorities?

  • Agree that the Community Health Improvement Plan (CHIP) Coalition will serve as the unifying framework for Community Health Needs Assessment, Local Health Improvement Plan, and the Obesity Task Force efforts.

  • Finalize membership of the CHIP Steering Committee and the larger Coalition.

  • Preliminarily select 3 to 5 priority areas of focus and identify partners for leading those improvement efforts.

  • Solicit feedback from others in the community – via meetings, website communications, and other avenues.

  • Other thoughts?


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