Plan for collaborating on a harford county community health improvement plan
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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

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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

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

  • Next steps


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?

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)


Are We Duplicating or Streamlining Efforts?


Can We Build on Harford County Efforts?

Federal Health Care Reform Requirements

Hospital CHNA Mandates

LHD SHIP

Mandates

COMMUNITY HEALTH IMPROVEMENT PLAN

Healthy Harford Activities


A Common Vision and Mission?

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?

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?

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


First, Quick Facts About Our Community


Let’s start at the beginning . . .

PREGNANCY DATA


Infant Mortality RatesHarford County & Maryland2001-05 to 2006-10

Source: Maryland Vital Statistics


Infant Mortality RatesHarford County, By Race2000-04 to 2005-09

Source: Maryland Vital Statistics


Top 7 Leading Causes of Infant DeathMaryland, 2010


Low Birthweight RatesHarford County & Maryland2000-04 to 2005-09

Source: Maryland Vital Statistics


Low Birthweight RatesHarford County, By Race2004 vs. 2009

Source: Maryland Vital Statistics


Teen Birth RatesHarford County & Maryland2004 vs. 2009

Source: Maryland Vital Statistics


Teen Birth RatesHarford County, By Race2004 vs. 2009

Source: Maryland Vital Statistics


1st Trimester Prenatal Care RatesHarford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


1st Trimester Prenatal Care RatesHarford County, By Race2004 vs. 2009

Source: Maryland Vital Statistics


For pregnancy outcomes, Harford County ranks better than the State, but health disparities exist


Let’s move on to conditions that affect us over the years . . .

CHRONIC DISEASE DATA


Top 10 Causes of DeathMaryland, 2010


Top 7 Causes of DeathHarford County, 2009

450

433

136

99

59

43

41


Heart Disease Mortality RatesHarford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


Heart Disease Mortality RatesHarford County, By Race2004-06 to 2007-09

Source: Maryland Vital Statistics


Cancer Mortality RatesHarford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


Cancer Mortality RatesHarford County, By Race2004-06 to 2007-09

Source: Maryland Vital Statistics


Stroke Mortality RatesHarford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


Stroke Mortality RatesHarford County, By Race2004-06 to 2007-09

Source: Maryland Vital Statistics


COPD Mortality RatesHarford County & Maryland2004-06 to 2007-09

Source: Maryland Vital Statistics


COPD Mortality RatesHarford County, By Race2000-07 to 2004-09

Source: Maryland Vital Statistics


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 . . .

LIFESTYLE DATA


Leading Actual Causes of DeathUnited States, 2000

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


Adult Smoking RatesHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Adult Smoking RatesHarford County2010 CHAP & BRFSS Data


Adult Cigarette Smoking RatesHarford County & Maryland2000 to 2010

Source: CDC Behavioral Risk Factor Surveillance System


Youth Tobacco Use RatesHarford County & Maryland2000 to 2010

Source: Maryland Youth Tobacco Survey


Secondhand Smoke Exposure RatesHarford County & Maryland, 2008

Source: CDC Behavioral Risk Factor Surveillance System


Adult Obesity/Overweight RatesHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Adult Obesity/Overweight RatesHarford County2010 CHAP & BRFSS Data


Physical Activity Rates*Harford County & Maryland2005-07 to 2008-10

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

Source: CDC Behavioral Risk Factor Surveillance System


Physical Activity RatesHarford 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 & 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 RatesHarford 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


In lifestyle choices, Harford County ranks worse than or even with the State


And what about access to health care . . .

ACCESS DATA


% Who Could Not Afford to See M.D.Harford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Adult Influenza Vaccination RatesHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Childhood Influenza Vaccination RatesCounty Leaders, 2010

Source: CDC Behavioral Risk Factor Surveillance System


Anxiety Disorder RatesHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Binge Drinking RatesHarford County & Maryland2005-07 to 2008-10

Source: CDC Behavioral Risk Factor Surveillance System


Population to Provider RatiosHarford County & Maryland

Source: Maryland Primary Care Office, DHMH


Primary Care & Dental Care Shortage Areas in Harford County, 2010


With access to care, Harford County has specialty area needs


Now, putting the pieces together . . .

COMPOSITE DATA


SHIP


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


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


Do the data suggest common themes for determining Harford County health priorities?


Next Steps?

  • 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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