2019 Greenwich Hospital Community Health Needs Assessment and CHIP

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2019 Greenwich Hospital Community Health Needs Assessment and CHIP 2019 Greater Greenwich Region Greenwich Hospital Collaborative Community Health Needs Assessment and Implementation Strategies By the Greenwich Community Health Improvement Partnership and Council of Community Services This document is a special section of the Fairfield County Community Wellbeing Index 2019, a core program of DataHaven (ctdatahaven.org), in partnership with Fairfield County’s Community Foundation and a Community Health Needs Assessment for the towns served by all Fairfield County hospitals including Greenwich Hospital 1 ABOUT THIS REPORT This document is a special section of the Fairfield County Community Wellbeing Index 2019 (Appendix A), a comprehensive report about Fairfield County and the towns within it. The Community Wellbeing Index was produced by DataHaven in partnership with Fairfield County’s Community Foundation and many other regional partners, including the Greenwich Community Health Improvement Partnership and the Council of Community Services, coalitions both serving towns in the Greater Greenwich Region. This document serves as the Community Health Needs Assessment for the Greater Greenwich Region served by Greenwich Hospital (Greenwich, CT and Mamaroneck, Port Chester, Rye Brook and Rye Town, NY). The Community Health Needs Assessment documents the process that GCHIP / CCS used to conduct the regional health assessment and health improvement activities. You may find the full Community Wellbeing Index attached to this section, or posted on the DataHaven, Fairfield County’s Community Foundation, Greenwich Hospital, or any of the town health department websites. The Community Health Needs Assessment and Community Health Improvement Plan were approved by the Greenwich Hospital Board of Trustees on June 18, 2019. 2 TABLE OF CONTENTS I. EXECUTIVE SUMMARY II. INTRODUCTION A. OVERVIEW B. ADVISORY STRUCTURE AND PROCESS C. PURPOSE AND COMMUNITY SERVED III. METHODS A. SOCIAL DETERMINANTS OF HEALTH FRAMEWORK B. DATA COLLECTION METHODS – COMMUNITY INPUT i. QUANTITATIVE DATA 1. REVIEWING EXISTING SECONDARY DATA 2. 2018 DATAHAVEN COMMUNITY WELLBEING SURVEY ii. QUALITATIVE DATA 1. COMMUNITY CONVERSATIONS 2. KEY INFORMANT SURVEYS iii. ANALYSES iv. LIMITATIONS IV. FINDINGS A. 2019 FAIRFIELD COUNTY COMMUNITY WELLBEING INDEX B. REGIONAL COMMUNITY CONVERSATIONS C. KEY INFORMANT SURVEYS V. COMMUNITY ENGAGEMENT VI. PRIORITIZATION OF HEALTH ISSUES A. 2016 COMMUNITY HEALTH IMPROVEMENT PLAN PROGRESS-TO-DATE B. 2019 PRIORITIZATION OF HEALTH ISSUES VII. COMMUNITY HEALTH IMPROVEMENT PLAN A. OVERVIEW OF THE COMMUNITY HEALTH IMPROVEMENT PROCESS B. DEVELOPMENT OF THE 2019 COMMUNITY HEALTH IMPROVEMENT STRATEGIC COMPONENTS C. PLANNING FOR ACTION AND MONITORING PROGRESS D. COMMUNITY HEALTH IMPROVEMENT PLAN i. GREENWICH COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP | COUNCIL OF COMMUNITY SERVICES ii. GREENWICH HOSPITAL VIII. COMMUNITY RESOURCES 3 IX. APPENDICES A. FAIRFIELD COUNTY COMMUNITY WELLBEING INDEX 2019 B. GREENWICH COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP AND COUNCIL OF COMMUNITY SERVICES MEMBERS C. HOW TO SEARCH FOR A SERVICE USING THE 2-1-1 DATABASE 4 I. EXECUTIVE SUMMARY INTRODUCTION Understanding the current health status of a community a necessary first step towards identifying priorities for future planning and funding, existing strengths and assets on which to build, and areas for further collaboration and coordination across organizations, institutions, and community groups. To this end, the Greenwich Community Health Improvement Partnership (GCHIP) and the Council of Community Services (CCS) – two local coalitions (‘the Coalitions’) comprised of Greenwich Hospital, local departments of public health, federally qualified health centers, and numerous community and non- profit organizations serving the Greater Greenwich region as fully set forth in Appendix B, are leading a comprehensive regional Community Health Needs Assessment (CHNA) effort. This effort is comprised of two main elements: • Assessment – identifies the health-related needs in the Greater Greenwich area using primary and secondary data. • Implementation Plan– determines and prioritizes the significant health needs of the community identified through the CHNA, overarching goals, and specific strategies to implement across the service area resulting in a Community Health Improvement Plan (CHIP). This report details the findings of the CHNA conducted from January 2018 – April 2019. During this process, the following goals were achieved: the current health status of the Greater Greenwich region was examined and compared to state indicators and goals; current health priorities among residents and key stakeholders were explored; and, community strengths, resources, and gaps were identified in order to assist the coalitions and community partners in establishing top health priorities as well as programming and implementation strategies to achieve these priorities. METHODS The coalitions adopted the Association for Community Health Improvement’s (ACHI) Community Health Assessment Framework to guide the CHNA and to ensure that involved hospitals comply with Internal Revenue Service regulations for charitable hospitals and those of the local health departments pursuing voluntary accreditation through the Public Health Accreditation Board. Specifically, the CHNA defines health in the broadest sense and recognizes that numerous factors at multiple levels impact a community’s health – from lifestyle behaviors to clinical care to social and economic factors to the physical environment. This larger framework of the social determinants of health guided the overarching process. Data Collection Methods Quantitative and qualitative data were collected and reviewed throughout the CHNA process. Secondary data sources included, but were not limited to, the U.S. Census, U.S. Bureau of Labor Statistics, Centers for Disease Control and Prevention, state public health departments, Connecticut Health Information Management Exchange (CHIME), as well as local organizations and agencies. Types of data included vital statistics based on birth and death records. In addition, the Coalitions partnered with DataHaven and, in part, sponsored the 2018 DataHaven Community Wellbeing Survey (CWS), hired Health Equity Solutions to conduct community conversations in the Greater Greenwich Region, worked with the Yale School of Public Health Student Consulting Group to conduct and later analyze Key Informant Surveys, and a student Practicum Team also from the Yale School of Public Health to identify community resources. 5 KEY FINDINGS The following section provides a brief overview of the key findings from the community health needs assessment for the Greater Greenwich Region. This includes overall demographics, social and physical environment, health outcomes and findings as they relate to the top three health priorities that were selected for action planning at a regional level: Healthy Lifestyles, Access to Care and Behavioral Health. These focus areas will be addressed through a Social Determinants of Health lens. Demographics Numerous factors are associated with the health of a community including what resources and services are available as well as who lives in the community. While individual characteristics such as age, gender, race and ethnicity have an impact on people’s health, the distribution of these characteristics across a community is also critically important and can affect the number and type of services and resources available. • Population. The Greater Greenwich Region has a population of about 175,000. • Age Distribution. The median age for both the population of Greenwich and all New York State areas are higher than the state of CT as a whole; however, Port Chester Village has a median age that is about four years lower than the CT state average of 40.8. • Racial and Ethnic Diversity. The towns in the region vary dramatically in terms of their racial and ethnic composition. Greenwich and the New York State areas (excluding Port Chester Village) are close to 80% White and 10% Hispanic. By contrast, Port Chester Village is about one third White and two-thirds Hispanic. Social and Physical Environment Income and poverty are closely connected to health outcomes. A higher income makes it easier to live in a safe neighborhood with good schools and many recreational opportunities. Higher wage earners are better able to buy medical insurance and medical care, purchase nutritious foods and obtain quality child care than those earning lower wages. Lower income communities have higher rates of asthma, diabetes and heart disease. Those with lower incomes also generally experience lower life expectancies. • Income and Poverty. In 2014, there were wide gaps in Median Household income rates for the Greater Greenwich Region ($125,567), Fairfield County ($83,163), and Connecticut ($69,899). The widest gap is found between Greenwich ($135,528) and Port Chester Village ($60,141). The 2019 Community Index shows that income gaps have continued to widen over time. • Educational Attainment. In 2014, the proportion of residents in the Greater Greenwich Region with a college degree or higher (60%) was greater than that of the state overall (37%) and Fairfield County (45%). Only 21% of Port Chester Village adults had a college degree or higher, compared to 66% of Greenwich adults. The educational attainment rate in 2017 is similar to what it was in 2014. 6 Health Outcomes Health outcomes and risk factors related to chronic disease, mental health and substance abuse, mortality and morbidity
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