Appendices for the Maternal Infant and Early Childhood Home Visiting (MIEHCV) Needs Assessment for Washington DC September 2020

Prepared by: Georgetown University Center for Child and Human Development

Prepared for: District of Columbia Department of Health Child and Adolescent Health Division Child, Adolescent, School Health Bureau Community Health Administration 899 North Capitol Street, NE Washington, DC 20002

September 20, 2020

Copy for HRSA Review and Comment Only Do Not Disseminate Without Permission

Table of Contents for Appendices Appendix 1: Defining At-Risk Communities Appendix #1a………………………………………………………………………………………………………….3 Appendix #1b………………………………………………………………………………………………………….4 Appendix #1c………………………………………………………………………………………………………….6 Appendix #1d……………………………………………………………………………………………………..…..7 Appendix #1e……………………………………………………………………………………………………….…8 Appendix #1f………………………………………………………………………………………………………….9 Appendix #1g…………………………………………………………………………………………………….….11 Appendix 2: Home Visiting Capacity Assessment Appendix #2a……………………………………………………………………………………………………….12 Appendix #2b……………………………………………………………………………………………………….18 Appendix #2c……………………………………………………………………………………………………….20 Appendix 3: SUD/MH Capacity Assessment Appendix #3a……………………………………………………………………………………………………….22 Appendix #3b………………………………………………………………………………………………….……26 Appendix #3c……………………………………………………………………………………………………….30 Appendix 4: Interim Findings from the American Community Survey …………………….…………..32

Appendix 1: Defining At-Risk Communities

Appendix #1a: Original HRSA/UIC Domains and Indicators

Domain Indicator Indicator Definition Alignment with statute Year definition of at-risk communities Socioeconomic Status (SES) Poverty % population living below %100 FPL Poverty 2013-2017

Unemployment Unemployed percent of the civilian labor force Unemployment 2017

HS Dropout % of 16-19 year olds not enrolled in school with no high High school dropouts 2013-2017 school diploma % of 16-19 year olds not enrolled in school with no high 2013-2017 school diploma % of 16-19 year olds not enrolled in school with no high N/A at ward level school diploma Income Inequality Gini Coefficient N/A Adverse Perinatal Outcomes Preterm Birth % live births <37 weeks Premature birth, low-birth 2014 weight infants, and infant mortality, including infant death due to neglect or other indicators of at-risk prenatal, maternal, newborn, or child health Low Birth Weight % live births <2500 g Premature birth, low-birth 2014 weight infants, and infant mortality, including infant death due to neglect or other indicators of at-risk prenatal, maternal, newborn, or child health Substance Abuse Alcohol Prevalence rate: Binge alcohol use in past month Substance abuse 2012-2014 Marijuana Prevalence rate: Marijuana use in past month 2014-2016 Illicit Drugs Prevalence rate: Use of illicit drugs, excluding Marijuana, 2012-2014 in past month Pain Relievers Prevalence rate: Nonmedical use of pain medication in 2012-2014 past year Crime Crime Reports # reported crimes/1000 residents Crime 2018

Juvenile Arrests # crime arrests ages 0-17/100,000 juveniles aged 0-17, 2015 Child Maltreatment Child Maltreatment Rate of maltreatment victims aged <1-17 per 1,000 child Child maltreatment 2016 (aged <1-17) residents

Appendix #1b: Health Planning Neighborhoods by Number, Name and Ward

Health Health Planning Ward # Planning Neighborhood Name Neighborhood # 1 16th St Heights 4 2 Adams Morgan 1 3 Historic Anacostia 8 4 Bellevue 8 5 Brightwood 4 6 Brightwood Park 4 7 Brentwood 5 8 Barnaby Woods 4 9 Capitol Hill 6 10 U St/ Pleasant 1 11 Cathedral Heights 3 12 Eastland Gardens 7 13 Chevy Chase 3 14 Chinatown 2 15 Columbia Heights 1 16 Congress 8 Heights/Shipley 17 Douglass 8 18 Twining 7 19 Forest Hills 3 20 Fort Dupont 7 21 Fort Lincoln/Gateway 5 22 Tenleytown 3 23 Georgetown East 2 24 Hill East 6 25 Naylor/Hillcrest 7 26 Kingman Park 6 27 Lincoln Heights 7 28 Logan Circle/Shaw 6 29 Lincoln Park 6 30 Marshall Heights 7 31 South Columbia 1 Heights

32 Woodbridge 5 33 Mount Pleasant 1 34 Union Station 5 35 Washington Highlands 8 36 Kent/Palisades 3 37 Petworth 4 38 Michigan Park 5 39 Lamont Riggs 4 40 Saint Elizabeth's 8 41 Shepherd Park 4 42 Georgetown 2 43 DC Medical Center 5 44 GWU/ National Mall 2 45 Stadium Armory 7 46 Naval Station & Air 8 Force 47 Trinidad 5 48 Edgewood 5 49 Bloomingdale 5 50 Southwest/Waterfront 6 51 Woodley Park 3

Appendix #1c Sources and Indicators of Ward-Level Data for HRSA-defined Domains Domain Indicator Indicator Definition Year Source % total population living below %100 FPL % all women in DC living below %100 FPL % all children <5 years living below %100 Poverty FPL % all single mothers with children <5years living below %100 FPL % of unemployed females 16 and older in American Community Socioeconomic DC 2016 Unemployment Survey Status (SES) % of unemployed females 16 and older

with children through the age of 6y in DC % of females without a High School Diploma Education % of 16-19 year old females not enrolled in school Income Number of DC households with <$25,000 Inequality % of DC households with <$25,000 Preterm Birth % live births <37 weeks Low Adverse Perinatal % live births <2500g DC Health Report Birthweight 2016 Outcomes Infant # all infant deaths/1,000 live births Mortality # all 18-44 years female alcohol use/1,000 Alcohol females aged 18-44 years # all 18-44 years female marijuana Marijuana use/1,000 females aged 18-44 years # all 18-44 years female illicit DC Department of Substance Abuse 2016 Illicit Drugs drugs(excluding marijuana) use/1,000 Behavioral Health females aged 18-44 years # all 18-44 years female Nonmedical use of Pain Relievers pain medication/1,000 females aged 18-44 years Crime Reports # reported crimes/1,000 residents DC Metropolitan Police Crime # all adult females 18 and older 2016 Female Arrests Department arrests/1,000 females aged 18 and older Rate of maltreatment victims aged <1-17 per 1,000 child (aged <1-17) residents Child Child Rate of neglect only victims aged <1-17 DC Child and Family 2016 Maltreatment Maltreatment per 1,000 child (aged <1-17) residents Services Agency Rate of abuse only victims aged <1-17 per 1,000 child (aged <1-17) residents # all 18-44 years female use of mental DC Department of Mental Health Mental health health services/1,000 females aged 18-44 2016 Behavioral Health years

Appendix #1d

Sources and Indicators Available at the Health Planning Neighborhood Level Domain Indicator Indicator Definition Year Source % total population living below %100 FPL % all women in DC living below %100 FPL % all children <5 years living below %100 Poverty FPL % all single mothers with children <5years living below %100 FPL % of unemployed females 16 and older in Socioeconomic DC 2016 American Community Unemployment Status (SES) % of unemployed females 16 and older Survey with children through the age of 6y in DC % of females without a High School Diploma Education % of 16-19 year old females not enrolled in school Income Number of DC households with <$25,000 Inequality % of DC households with <$25,000 % live births <37 weeks % of mothers with previous preterm births Preterm Birth % of mothers without prenatal care who had a preterm birth Adverse Perinatal % live births <2500g 2016 Low DC Health Vital Statistics Outcomes % of mothers without prenatal care who Birthweight had a low birthweight birth Infant # all infant deaths/1,000 live births Mortality NICU % of NICU admissions % of women who did smoke prior to pregnancy Substance Abuse Tobacco Use 2016 DC Health Vital Statistics % of women who did smoke during pregnancy Rate of maltreatment victims aged <1-17 per 1,000 child (aged <1-17) residents Child Child Rate of neglect only victims aged <1-17 DC Child and Family 2016 Maltreatment Maltreatment per 1,000 child (aged <1-17) residents Services Agency Rate of abuse only victims aged <1-17 per 1,000 child (aged <1-17) residents

Appendix #1e

List of Final (Limited) Indicator Definitions Used During Simplified Method Analysis

Domain Indicator Indicator Definition Poverty % all women in DC living below %100 FPL % of unemployed females 16 and older with children through the age Unemployment Socioeconomic of 6y in DC Status (SES) Education % of females without a High School Diploma Income % of DC households with <$25,000 Inequality Preterm Birth % live births <37 weeks Low % live births <2500g Adverse Perinatal Birthweight Outcomes Infant # all infant deaths/1,000 live births Mortality NICU % of NICU admissions Alcohol # all 18-44 years female alcohol use/1,000 females aged 18-44 years # all 18-44 years female marijuana use/1,000 females aged 18-44 Marijuana years # all 18-44 years female illicit drugs(excluding marijuana) use/1,000 Substance Abuse Illicit Drugs females aged 18-44 years # all 18-44 years female Nonmedical use of pain medication/1,000 Pain Relievers females aged 18-44 years Tobacco Use % of women who did smoke prior to pregnancy Crime Reports # reported crimes/1,000 residents Crime # all adult females 18 and older arrests/1,000 females aged 18 and Female Arrests older Child Child Rate of neglect only victims aged <1-17 per 1,000 child (aged <1-17) Maltreatment Maltreatment residents # all 18-44 years female use of mental health services/1,000 females Mental Health Mental health aged 18-44 years

Appendix #1f

Insert from PDF: various outcomes from formulas (2 pages)

Appendix #1g

Insert from PDF COI definitions

Appendix 2: Home Visiting Capacity Assessment

Appendix #2a

2019 Home Visiting Program Survey Final Questions

Please fill out the following: . . First, Last Name: ______. Organization Name: ______. Current Role: ______. Contact Email: ______

Please select the model implemented by the program you manage (check all that apply) Attachment and Biobehavioral Catch-Up (ABC) Intervention Child First Early Head Start-Home-Based Option (EHS-HBO) Early Intervention Program for Adolescent Mothers Family Check-Up for Children Family Connects Family Spirit Health Access Nurturing Development Services (HANDS) Program Healthy Beginnings Healthy Families America (HFA) Home Instruction for Parents of Preschool Youngsters (HIPPY) Maternal Early Childhood Sustained Home-Visiting Program (MECSH) Minding the Baby Nurse Family Partnership (NFP) Parents as Teachers (PAT) Play and Learning Strategies (PALS) - Infants SafeCare Augmented Other Home Visiting Model: ______

Which populations are served by this program? (check all that apply) High risk Low-income Adolescent mothers Pregnant women Single parent Parents with intellectual disabilities Victims of abuse/domestic violence Families with infants Families with children 0-3 years Families with children 3-5 years Families/children with maltreatment history Families with substance abuse history Other: ______

Which of these is the primary target population of your program? o High risk o Low-income o Adolescent mothers o Pregnant women o Single parent o Parents with intellectual disabilities o Victims of abuse/domestic violence o Families with infants o Families with children 0-3 years o Families with children 3-5 years o Families/children with maltreatment history o Families with substance abuse history o Other: ______

In which languages was your program able to provide services in the last program year? (check all that apply) Amharic English Spanish Other please list: ______

Which parts of the District does this home visiting program serve? (check all that apply) Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 Ward 6 Ward 7 Ward 8

Where did the majority of the home visiting cases reside, in the last program year? o Ward 1 o Ward 2 o Ward 3 o Ward 4 o Ward 5 o Ward 6 o Ward 7 o Ward 8 o More than one ward: ______o Do not collect these data

Where does the funding for this home visiting program come from? (check all that apply) Federal agency provides funding directly to our organization (i.e., Early Head Start) DC Health provides funding for our program Another DC government agency provides funding for our program Philanthropy provides funding for our home visiting program Other source please list: ______

(If DC Health was chosen this would appear) You chose DC Health, please check all the sources of funding that apply: Federal Local Do not know/Unsure

(If another DC government agency was chosen this would appear) What specific DC government agency (not including DC Health) provides funding for your program? ______

Sources of that DC government agency funding are (check all that apply): Federal Local Do not know/Unsure

How many home visiting staff were hired in the most recently completed program year? o None o 1-5 employees o 6-10 employees o 11-15 employees o 16+ employees

How many employees are currently employed by this program? o 1-5 employees o 6-10 employees o 11-15 employees o 16+ employees

Do supervisors also carry a caseload of home visiting clients? o Yes o No

(IF yes) What percent of their time is dedicated to supervision? ______

How many staff does your program employ in each of the following categories?

Full-Time Part-Time Number of Family Support Workers Number of Supervisors Number of Outreach Workers Other please list: ______

What is the average length of employment among current program staff? o Less than 1 year o 1-5 years o 6-10 years o More than 10 years o Unknown

How many employees left the organization in the most recently completed program year? o None o 1-5 employees o 6-10 employees o 11-15 employees o 16+ employees

Why did they leave? (check all that apply) Accepted internal promotion Dismissed due to performance concerns Felt burned out Laid off due to organizational factors (for example: loss of funding or organizational restructuring) Lateral move to another position outside of organization Position of advancement outside of organization Relocated to DMV area Returning to school Unknown Other, please describe: ______

What is the average caseload for family support workers, whose sole responsibility is home visiting, in the most recently completed program year? ______

How many of these family support workers can one full-time supervisor support? ______

Fam/Child Does this program measure caseloads by family or by child? o Child o Family o Both

(IF Child or Both) How many children received services in the most recently completed program year? ______

(IF Family or Both) How many families received services in the most recently completed program year? ______

Is your program's capacity measured at a point in time or annually? o Point in time o Annually o Both

(IF Annually or Both) What is the annually funded enrollment capacity? ______

(IF Point in time or Both) What is the point in time funded enrollment capacity? ______

(IF Annually or Both) AnnCapMeasure What is the annually funded enrollment capacity? (Please specify children or families) ______

(IF Point in time or Both) What is the point in time funded enrollment capacity? (Please specify children or families) ______

Please take this moment to write any closing thoughts or additional information you want to share, about your experiences with home visiting in DC. ______

Would you be willing to participate in an interview, conducted by the Georgetown University's evaluation team, to share more details about home visiting services provided by your organization? o Yes o No

(IF Yes) Thank you! Please list your name and contact information and a member of the Georgetown University Team will be in contact with you.

Name: ______Email: ______Phone Number: ______

Appendix #2b

Home Visiting Program Inventory (Data Provided by Programs through Survey)

Number of Funded Area cases that Number Site Name Program Name Funders Enrollment Served received of Staff Capacity services

Bright Federal 64 children point in Parents as Teachers Wards 102 children 1-5 Beginnings (PAT) Funding time 1-8 employees Early Head Start Federal 56 children; 56 Wards 56 children; 1-5 CentroNía Home-Based Funding families annually 1-8 56 families employees Option Community 75 families annually; Wards Family Life Nurturing Skills for Private; CFSA 20 families point in 5-8 108 families 1-5 Services Families time employees DC Health Wards Community of (Federal and 55 families point in Parents as Teachers 5, 7, 8 Unknown 1-5 Hope Local); time (PAT)* employees Philanthropy Generation Parents as Teachers Philanthropy 30 families annually Wards 20 families 1-5 Hope (PAT) 1-8 employees Georgetown University Parenting Support Center for Child DC Health 40 families point in Ward 8 1-5 Program (promising Unknown and Human (Local) time employees Development practice model) (GUCCHD) 52 children; Healthy Babies 53 children; Healthy Families Philanthropy unknown families Wards 1-5 Project, Inc 62 families America (HFA) point in time 1-8 employees

DC Health 16+ Mamatoto Wards Mothers Rising (Local); DCHF 300 families 280 families employees Village 4-8 Home Visiting (Local); annually; 80 Philanthropy;

MCO families point in Contracts time Federal Martha's Table Parents as Teachers Funding; 97 families annually Wards 40 families 6-10 (PAT)* Philanthropy 7, 8 employees 160 families DC Health Wards 1, Parents as Teachers annually; 20 6-10 (Federal and 2, 4, 5, 94 families (PAT)* families point in employees Local) time 7, 8

Mary's Center DC Health 16+ Healthy Families 65 families point in Wards (Federal and 166 families employees America (HFA)* time 1- 8 Local) Father Child 1-5 CFSA 50 families point in Wards Attachment 43 families employees (Federal) time 1- 8 Program Early Head Start- Federal Wards Rosemount 77 children; 6-10 Home-Based Funding; Unknown 1- 8 Center 77 families employees Option (EHS-HBO) Philanthropy 140 children and Home Instruction 1-5 The Family Philanthropy; families annually; 18 children; for Parents of Wards 1, employees Place CFSA (Local) 20 cases point in 17 families Preschool 4, 5 Youngsters (HIPPY) time United Parents as Teachers Federal Planning 72 children annually Wards 1, Unknown 6-10 (PAT) Funding Organization 4, 5, 7 employees

Notes: for BBI and UPO, programs are implementing the EHS-HBO using the PAT curriculum; an asterisk indicates that the program is listed as an affiliate on the PAT and/or HFA national model websites; Community of Hope did not complete a survey for their HFA program. All data on number of children and families served were later confirmed and corrected by DC Action for Children as part of the preparation for the HV Council Annual Report.

Appendix #2c

2019 Home Visiting Program Interview Final Guide

What is the name of your Home Visiting Program?

1. Please tell me about the communities your program serves. a. Can you tell me more about these communities and their needs.

2. How long has your program been offering services? a. Please share how your program’s funding history has impacted your program’s ability to serve children and families.

3. Please describe your program’s current: i. Recruitment strategies? ii. Enrollment strategies? iii. Engagement strategies? 4. What is working for your program’s current: i. Recruitment strategies? ii. Enrollment strategies?/ Does your program maintain a waitlist? iii. Engagement strategies? 5. What challenges does your program experience with its current: i. Recruitment strategies? ii. Enrollment strategies? iii. Engagement strategies? (i.e. how does this impact your program’s retention rate?)

6. Does your program maintain a waitlist? If so, are you informing families of other home visiting programs available?

7. Thinking about women planning or expecting children and those women with young children, does your home visiting program ask questions about mental health or substance use formally/informally? a. If yes, does your program treat women who indicate mental health or substance use concerns or are they referred to other programs in the district? i. If referred out, which agency are referrals typically made to?

8. Please describe your organization’s home visiting model/curriculum. How did you select it?

9. Please share how your program tailors services to meet the specific needs of the community (i.e. service dosage, types of services provided/activities). a. What has it been like to follow the model’s/curriculum implementation guidelines for the communities you serve? b. What changes have you had to make to fit the population you serve? c. What are the challenges with tailoring services?

10. How does your program gather feedback from families about their experiences in your program?

a. How does your program incorporate that feedback? b. What, if anything, makes incorporating feedback challenging?

11. What are the characteristics of a strong home visitor in your program?

12. What training does newly hired staff receive? Are there any other on-going professional development opportunities? a. What resources does the staff need in order to be successful?

13. How do you retain staff within your agency?

14. What procedures are in place to encourage a smooth transition from home visitor to home visitor for children and families? a. What are common challenges in this process?

15. What resources does the program need in order to be successful?

16. Is there anything else you would like to share about your home visiting program?

Appendix 3: SUD/MH Capacity Assessment

Appendix #3a

Substance Use Disorder Treatment and Counseling Agencies Survey Final Questions

Agency name: ______

Do you have multiple program sites? o Yes o No

How many program sites does your agency have throughout the District? o 2 o 3 o 4 o 5 o 6 o 7+

Which parts of the District does this agency serve? (check all that apply) Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 Ward 6 Ward 7 Ward 8 Other please list: ______

Do you consent to have this agency and program sites labeled on a DC map of available substance use/mental health providers? o Yes o No

Which populations are served by this agency? (check all that apply) Pregnant women Women with children 0-5 years Adult Males Other please list: ______

In which languages was this agency able to provide services in the last year? (check all that apply) Amharic English Spanish Other please list: ______

How many employees are currently employed by this agency? o 1-5 employees o 6-10 employees o 11-15 employees o 16+ employees

Where does the funding for this agency come from? (check all that apply) Federal agency provides funding directly to our agency DC Department of Behavioral Health provides funding for our agency Another DC government agency provides funding for our agency Philanthropy provides funding for our agency Insurance Plans Do not know/Unsure Other source please list: ______

(IF Insurance) What insurance plans does this agency accept? (check all that apply) Aetna AmeriHealth Beacon CareFirst Cigna DC Medicaid HSCSN (Health Services for Children with Special Needs) Medicare MedStar TRICARE Trusted Health Care United Health Care Do not know/Unsure Other: ______

What type of services does this agency primarily offer? o Substance Use Disorder o Mental Health o Both o Other, please list: ______

Overall, how many people have received these services in the past year? o None o less than 20 people o 21-40 people o 41-60 people o 61-80 people o 91+ people o Do not know/Unsure

Does this agency have a waitlist for its Substance Use program(s)? o Yes o No o Do not know/Unsure

(IF Yes) How many of those people on the Substance Use programs waitlist(s) are pregnant women and women with children younger than 6 years? o 1-5 people o 6-10 people o 11-15 people o 16-20 people o 21+ people o Do not know/Unsure

Does this agency have a waitlist for its Mental Health program(s)? o Yes o No o Do not know/Unsure

(IF Yes) How many of those people on the Mental Health programs waitlist(s) are pregnant women and women with children younger than 6 years? o 1-5 people o 6-10 people o 11-15 people o 16-20 people o 21+ people o Do not know/Unsure

What is the average length of Substance Use treatment, in months, at this agency for pregnant women and women with children younger than 6 years? ______

What is the average length of Mental Health treatment, in months, at this agency for pregnant women and women with children younger than 6 years? ______

Please share any other information you would like the Georgetown Team to know: ______

Would you be willing to be contacted by the Georgetown University Team to share more about the services this agency provides? o Yes o No

Thank you for your willingness to participate! Please list the following information and a member of the Georgetown University Team will be in contact with you soon.

First, Last Name: ______Job Title: ______Contact Phone: ______Contact Email: ______At least 2 dates you are available: ______

Appendix #3b

Substance Use Disorder Treatment and Counseling Services Inventory

Number Average of length of Number Number Area people Number Primary Language Agency Name Funders substance Population Served on of Sites Served that of Staff Services Used use Waitlist received treatment services Ascension Providence Substance Outpatient Behavioral Wards 5, 11-15 Use and English; 1 Insurance Varies Unknown Adult males/females No waitlist Health and Addiction 7, 8 employees Mental Spanish Services Health DC Department of Substance Behavioral Health Behavioral Pregnant women; Women Minimum 12 Wards 16+ Use and Group Washington DC 1 Health; 91+ people with children 0-5 years; Unknown English months 1-8 employees Mental Treatment Center Insurance; Self Adult males/women Pay Health DC Department of 6 months Substance Behavioral Pregnant women; Women co- Wards 16+ Use and Clarks Inn at 1 Health; 91+ people with children 0-5 years; No waitlist English occurrence 1-8 employees Mental Samaritan Inns Philanthropy; Adult women treatment Health Grants; Rent DC Department of Behavioral 61-80 1-5 Substance 1 6 months Ward 5 Adult males/females No waitlist English Calvary Healthcare Health; people employees Use Philanthropy Federal Agency; DC Department of Behavioral Pregnant women; Women Health; Another Wards 16+ Mental English; Catholic Charities 1 Unknown 91+ people with children 0-5 years; Unknown DC Government 1-8 employees Health Spanish Agency; Adult males/females Philanthropy; Insurance Federal Agency; DC Department of Pregnant women; Women Amharic; Substance Behavioral with Children 0-5 years; English; Community Wards 16+ Use and 2 Health; Another Unknown 91+ people Adult males/females; No waitlist Spanish; Connections 1-8 employees Mental DC Government LGBTQI+; Youth; Translation Health Agency; Children Available Insurance

Federal Agency; DC Department of Behavioral American 61-80 16+ Mental 5 Health; Another Varies Wards 5, Deaf adult males/females No waitlist Sign Deaf Reach Inc. people employees Health DC Government 7, 8 Language Agency; Service Contracts Pregnant women; Adults DC Department of 40+ 16+ Mental Family Solutions 1 12 months Ward 6 males/females/children No waitlist English Behavioral Health people employees Health 6+ Pregnant women; Women Family Wellness DC Department of None Wards 7, 40+ with children 0-5 years; 16+ Mental 1 No waitlist English Center Behavioral Health Specified 8 people Adult males/females; employees Health Youth DC Department of Wards Pregnant women; Adult 16+ Substance Harbor Light Center 1 28 days 91+ people No waitlist English Behavioral Health 1-8 males/females; Homeless employees Use DC Department of Substance Behavioral Pregnant women; Women Substance Use – No. Amharic; Hillcrest Children and Health; Another Wards with children 0-5 years; 16+ Use and 3 24 months 91+ people Mental English; Family Center DC Government 1-8 Adult males/females; employees Mental Health - Spanish Agency; Youth Health Insurance; Grants Yes DC Department of Holy Comforter-St. Families; Adult Behavioral None None 6-10 None None None Cyprian Community 1 Ward 6 males/females; HIV Aids Health; Specified Specified employees Specified Specified Specified Action Group Philanthropy Clients KINARA Health Care Pregnant women; Adult 16+ Mental English; 1 Insurance Varies Ward 4 91+ people No waitlist Services males/females employees Health Spanish Pregnant women; Women Kolmac Outpatient Insurance; Self with children 0-5 years; 16+ Substance 1 6-9 months Ward 2 91+ people No waitlist English Recovery Centers Pay Adult males/females/ employees Use LGBTQI+ Federal Agency; Substance DC Department of Pregnant women; Women Substance Use – No. Behavioral Wards 1, with children 0-5 years; 16+ Use and English; LA:YC 3 12 months 91+ people Mental Health; 4, 8 Adult males/females; employees Mental Spanish Health - Philanthropy; Youth 12-25 years Health Insurance Yes DC Department of Behavioral Wards Pregnant women; Adult 16+ Mental McClendon Center 3 Health; 60 months 91+ people No waitlist English Philanthropy; 1-8 males/females employees Health Insurance

New Hope Health DC Department of 40+ Youth; Adults 16+ Mental 1 6 months Ward 8 No waitlist English Services Behavioral Health people males/females employees Health 28

DC Department of Behavioral None None Pathways to Housing 1 Health; DHS; Wards 16+ None None None Specified Specified Adult males/females DC Philanthropy; 1-8 employees Specified Specified Specified Insurance

DC Department of Women with children 0-5 Wards 16+ Mental PSI Services Inc. 2 Behavioral 24 months 91+ people years; Adult No waitlist English 5-8 employees Health Health; Insurance males/females Federal Agency; Pregnant women; Adult 16+ Substance Substance RAP, Inc. 1 DC Department of 28 days Ward 5 91+ people English Behavioral Health males/females employees Use - Yes Use Substance Safe Haven Outreach DC Department of Up to 1.5 Wards Pregnant women; Adult 16+ Use and 1 91+ people No waitlist English Ministry, Inc. Behavioral Health months 1-8 males/females employees Mental Health DC Department of Substance Behavioral Pregnant women; Women 16+ Use and English; So Others Might Eat Health; DHS; Varies Wards 91+ people with children 0-5 years; No waitlist 7+ employees Mental Spanish Philanthropy; 1-8 Adult males; LGBTQI+ Health Insurance Pregnant women; Women Total Family Care DC Department of Wards 40+ 11-15 Mental 1 12 months with children 0-5 years; No waitlist English Coalition Behavioral Health 4-8 people employees Health Adult males; LGBTQI+ DC Department of Behavioral Wards Umbrella Therapeutic 3 Health; Another Varies 91+ people Adult males/females; 16+ Mental English; 7-8 No waitlist Services DC Government Youth; Children employees Health Spanish Agency DC Department of None 7+ Behavioral 91+ people 16+ None None None Volunteers of America Specified Ward 4 Adult males Health; Unknown employees Specified Specified Specified Substance Women with children 0-5 Whitman-Walker Wards 40+ 16+ Use and 7+ None Specified Varies years; Adult Unknown English Health 1-8 people employees Mental males/females/ LGBTQI+ Health Federal Agency; DC Department of Behavioral Wards 1, 16+ Mental Woodley House, Inc. 1 Varies 91+ people Adult males/females No waitlist English Health; 3-5, 7, 8 employees Health Philanthropy; Insurance

Appendix #3c

SUD/MH Interview Guide “We are interested in hearing about your program’s mental health/substance use services and supports for pregnant women and women with small children.”

1. How long have you been at this agency? a. Can you briefly tell me about this agency? 2. What are the substance use/mental health services offered by your agency for pregnant women and women with young children? a. What are the levels of care? Inpatient, outpatient services, community support, group therapy b. Can women bring their young children to inpatient services? 3. How is your agency responding to the COVID-19 global emergency? 4. How do women typically enroll in services provided by your program? a. Probe if it is the same for pregnant women and women who bring in their young children 5. Where are women being referred from to your agency? a. Where do you refer women, pregnant women, and women with small children who may need mental health/substance use or additional/higher levels of support? 6. What are the challenges of enrolling and retaining women in services? 7. Does your program offer any support to address these challenges? Think around transportation, language, location of services, etc. 8. What prevents your agency from offering more (i.e. high levels of care, women-specific services) for pregnant women and women with young children? 9. Which substances are most commonly used/abused by adult women, pregnant women, and women with small children that you serve? 10. What changes have you noticed in the past 2-5 years in drugs used/abused by pregnant women and mothers with young children? 11. What are 2-3 recommendations that you would suggest to improve (or start offering) services for pregnant women or women with young children to address their need? 12. Is there anything else you would like to share about the substance use/mental health treatment services available for pregnant women and women with small children in DC?

DC-MIECHV Updated Needs Assessment:

Interim Findings from the American Community Survey (2016)

April 2020 He

Prepared by: Alexander Zeymo & Dr. Nawar Shara MedStar Health Research Institute (MHRI); Indra Amaro Gómez & Dr. Deborah F. Perry Georgetown University Center for Child and Human Development (GUCCHD)

Introduction As a recipient of federal home visiting dollars under the Maternal Infant and Early Childhood Home Visiting (MIECHV) program, DC Health is working with the Georgetown University Center for Child and Human Development (GUCCHD), to plan, coordinate, analyze, and synthesize data for the federally-required 2019-2020 needs assessment.

The updated MIECHV needs assessment is an essential element to ensure that states and territories are understanding and building capacity to address the numerous needs of families living in at-risk communities. The federal Maternal and Child Health Bureau (MCHB) worked with other federal and state partners to develop and disseminate detailed guidance on how the updated needs assessment should be conducted, and this was published in a Supplemental Information Request (SIR) on January 3, 2019 (Human Resources Services Administration, 2019). The SIR outlines four necessary components: 1) identify at-risk communities, 2) understand the current capacity for home visiting services through the District, 3) identify the current services available for pregnant women and families with young children who may benefit from substance use disorder (SUD) treatment and/or counseling services, and 4) To coordinate with and take into account requirements in other needs assessments and evaluations like Title V, Head Start, and Title II.

For each state and Washington DC, the Human Resources Services Administration (HRSA) provided data for six domains at the Ward/District level. There were concerns, however, that relying solely on data aggregated at the Ward-level in DC would masks emerging areas where vulnerable families may benefit from home visiting services. Additionally, the data provided by HRSA reported on data from different timeframes (varying from 2012 to 2018). Working with DC Health, the methodology for identifying at risk communities was refined.

This document provides interim findings for the foundational analyses for the first component which is to identify DC at-risk communities. The Team obtained publicly available information to map at the Ward and Health Planning Neighborhood level1 (HPN). The 2016 socio economic metrics chosen to map aligned with the first needs assessment the GUCCHD team conducted for DC Health in 2016. These metrics fall in line with those provided in the SIR by HRSA but go into more detail by looking at specific populations that are the recipients of home visiting services (i.e., pregnant women and women with young children).

The GUCCHD team partnered with the MedStar Health Research Institute (MHRI) team to create, organize, and finalize 24 maps. These maps were created using R programming and used indicators from the 2016 American Community Survey data. The informative titles of each map list the number or average rate of DC as a whole for comparison purposes of each Ward or HPN. These titles also correspond to a second section of the document that has Tables illustrating the actual values for each HPN. There are corresponding tables that rank the Ward and HPN-level included in the interim findings document.

These tables and maps are being shared for use by DC Health teams planning the Title V Needs Assessment as well as other internal uses. They will be included in the final DC MIECHV Needs Assessment report to be completed July 2020.

1 The Health Planning Neighborhoods (HPNs) were developed from the Proximal Neighborhood Groups (PNGs) used in the Health Equity Report: District of Columbia 2018 report (District of Colombia Department of Health, 2019). However, the HPNs used in this document were modified by DC Health to more accurately connect US Census tracts to current DC neighborhoods. There are 51 different HPNs used throughout this document each assigned a number based on a similar order assigned to the PNGs.

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Table of Contents

Introduction ...... 2 Total Population in DC ...... 5 Total Population in DC Under Age 5 ...... 7 Poverty Rate for Total Population in DC ...... 9 Poverty Rate for All Women in DC ...... 11 Poverty Rate for All Children Under Age 5 in DC ...... 13 Poverty Rate for All Women with Children Under Age 5 in DC ...... 15 Number of All DC Households with Income below $25,000...... 17 Rate for All DC Households with Income below $25,000...... 19 Unemployment Rate for All Women in DC ...... 21 Unemployment Rate for All Women with Children Through the Age 5 in DC ...... 23 Rate for All Women in DC without a High School Diploma ...... 25 Rate for All 16 to 19-year-old Women in DC Not Enrolled in School ...... 27 Appendix: Health Planning Neighborhood Tables (Ranked) ...... 29 Table 1b: In 2016, 639,009 residents were living in DC...... 29 Table 2b: In 2016, 43,607 children under the age of 5 were living in DC, which constituted 6.8% of the total population...... 30 Table 3b: On average, 18.6% of all DC residents lived below the federal poverty line (2016). . 31 Table 4b: On average, 19.7% of all women living in DC had incomes below the federal poverty line (2016)...... 32 Table 5b: The average poverty rate for children under the age of five living in DC was 25.8% in 2016...... 33 Table 6b: The average poverty rate for all single mothers with children under the age of five in DC was 27.3% in 2016...... 34 Table 7b: In 2016, 60,134 of DC households were living below the federal poverty line...... 35 Table 7d: In 2016, the average poverty rate for households in DC was 22.4%...... 36 Table 8b: The average unemployment rate for all DC women was 8.3% in 2016, compared to the District wide average of 8.7%...... 37 Table 9b: The average unemployment rate for all DC women with children through the age of five was 9.4% in 2016...... 38 Table 10b: On average, 5.4% of all women in DC had not received a High School diploma in 2016...... 39 Table 11b: On average, 20.5% of all 16 to 19-year-old women living in DC were not enrolled in school (2016)...... 40 References ...... 41

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Total Population in DC

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Total Population in DC Under Age 5

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Poverty Rate for Total Population in DC

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Poverty Rate for All Women in DC

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Poverty Rate for All Children Under Age 5 in DC

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Poverty Rate for All Women with Children Under Age 5 in DC

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Number of All DC Households with Income below $25,000.

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Rate for All DC Households with Income below $25,000.

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Unemployment Rate for All Women in DC

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Unemployment Rate for All Women with Children Through the Age 5 in DC

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Rate for All Women in DC without a High School Diploma

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Rate for All 16 to 19-year-old Women in DC Not Enrolled in School

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Appendix: Health Planning Neighborhood Tables (Ranked) Table 1b: In 2016, 639,009 residents were living in DC. Quartile Health Planning Neighborhoods Total DC Population 1 Logan Circle/Shaw (28) 27,783 1 Columbia Heights (15) 24,358 1 Adams Morgan (2) 23,165 1 Kent/Palisades (36) 20,118 1 U St/Pleasant (10) 19,632 1 Chinatown (14) 19,445 1 Cathedral Heights (11) 18,581 1 16th St Heights (1) 18,548 1 Tenleytown (22) 17,889 1 Twining (18) 16,859 1 Southwest/Waterfront (50) 16,851 1 Naylor/Hillcrest (25) 16,817 2 Brightwood (5) 16,761 2 Bellevue (4) 16,686 2 Trinidad (47) 16,527 2 Marshall Heights (30) 16,259 2 Kingman Park (26) 15,640 2 Petworth (37) 15,163 2 Union Station (34) 14,897 2 GWU (44) 14,868 2 Lincoln Heights (27) 14,863 2 Georgetown East (23) 14,534 2 Bloomindale (49) 14,296 2 Michigan Park (38) 14,252 2 Fort Dupont (20) 14,170 Median Woodley Park (51) 12,981 3 Mount Pleasant (33) 12,232 3 Historic Anacostia (3) 11,406 3 Forest Hills (19) 11,197 3 South Columbia Heights (31) 10,982 3 Douglass (17) 10,871 3 Brightwood Park (6) 10,736 3 Capitol Hill (9) 10,436 3 Lamont Riggs (39) 10,387 3 Hill East (24) 10,199 3 Brentwood (7) 9,825 3 Eastland Gardens (12) 9,763 3 Congress Heights/Shipley (16) 9,047 4 Woodbridge (32) 8,730 4 Fort Lincoln/Gateway (21) 8,570 4 Georgetown (42) 8,150 4 Edgewood (48) 7,721 4 Shepherd Park (41) 7,720 4 Saint Elizabeth’s (40) 7,040 4 Chevy Chase (13) 6,590 4 Barnaby Woods (8) 6,268 4 Washington Highlands (35) 5,807 4 Naval Station & Airforce Base (46) 4,680 4 Lincoln Park (29) 4,184 4 Stadium Armory (45) 2,803 4 DC Medical Center (43) 1,722

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Table 2b: In 2016, 43,607 children under the age of 5 were living in DC, which constituted 6.8% of the total population.

Quartile Health Planning Neighborhoods Total DC Population Under Age 5 1 Kingman Park (26) 1,722 1 Bellevue (4) 1,704 1 Marshall Heights (30) 1,553 1 Naylor/Hillcrest (25) 1,530 1 Lincoln Heights (27) 1,465 1 Brightwood (5) 1,462 1 Historic Anacostia (3) 1,459 1 16th St Heights (1) 1,369 1 Tenleytown (22) 1,318 1 Michigan Park (38) 1,242 1 Columbia Heights (15) 1,207 1 Mount Pleasant (33) 1,179 2 Logan Circle/Shaw (28) 1,174 2 Trinidad (47) 1,141 2 Fort Dupont (20) 1,123 2 Eastland Gardens (12) 1,115 2 Petworth (37) 1,060 2 Naval Station & Airforce Base (46) 972 2 Cathedral Heights (11) 959 2 Twining (18) 941 2 Union Station (34) 916 2 Brentwood (7) 901 2 Douglass (17) 899 2 Adams Morgan (2) 836 2 Congress Heights/Shipley (16) 829 Median Hill East (24) 824 3 Southwest/Waterfront (50) 808 3 Chinatown (14) 793 3 U St/Pleasant (10) 770 3 Kent/Palisades (36) 759 3 Fort Lincoln/Gateway (21) 736 3 South Columbia Heights (31) 724 3 Capitol Hill (9) 675 3 Woodbridge (32) 646 3 Edgewood (48) 638 3 Chevy Chase (13) 633 3 Woodley Park (51) 623 3 Georgetown East (23) 589 4 Washington Highlands (35) 585 4 Lamont Riggs (39) 584 4 Bloomindale (49) 561 4 Brightwood Park (6) 507 4 Shepherd Park (41) 460 4 Forest Hills (19) 425 4 Saint Elizabeth’s (40) 374 4 Lincoln Park (29) 308 4 Barnaby Woods (8) 191 4 GWU (44) 137 4 Georgetown (42) 122 4 DC Medical Center (43) 47 4 Stadium Armory (45) 12

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Table 3b: On average, 18.6% of all DC residents lived below the federal poverty line (2016). Poverty Rate for Total DC Quartile Health Planning Neighborhoods Population 1 Stadium Armory (45) 59.2% 1 Saint Elizabeth’s (40) 46.2% 1 Georgetown (42) 43.6% 1 Washington Highlands (35) 40.1% 1 Congress Heights/Shipley (16) 39.9% 1 Historic Anacostia (3) 39.1% 1 Naylor/Hillcrest (25) 38.9% 1 Bellevue (4) 38.5% 1 Douglass (17) 36.4% 1 Eastland Gardens (12) 36.2% 1 Trinidad (47) 30.7% 1 Marshall Heights (30) 29.2% 2 Edgewood (48) 27.5% 2 Lincoln Heights (27) 26.1% 2 Fort Dupont (20) 24.6% 2 GWU (44) 23.7% 2 DC Medical Center (43) 22.8% 2 Twining (18) 20.8% 2 Fort Lincoln/Gateway (21) 18.8% 2 Chinatown (14) 18.2% 2 Southwest/Waterfront (50) 17.3% 2 Cathedral Heights (11) 17.2% 2 Columbia Heights (15) 16.9% 2 U St/Pleasant (10) 16.4% 2 Brentwood (7) 15.6% Median Hill East (24) 14.9% 3 South Columbia Heights (31) 14.9% 3 Mount Pleasant (33) 13.8% 3 Brightwood (5) 13.6% 3 Shepherd Park (41) 12.3% 3 Logan Circle/Shaw (28) 11.9% 3 Petworth (37) 11.9% 3 Bloomindale (49) 11.5% 3 Lamont Riggs (39) 11.5% 3 16th St Heights (1) 11.4% 3 Brightwood Park (6) 11.3% 3 Kingman Park (26) 11.2% 3 Kent/Palisades (36) 10.2% 4 Michigan Park (38) 10.0% 4 Georgetown East (23) 9.4% 4 Union Station (34) 8.7% 4 Woodbridge (32) 8.4% 4 Forest Hills (19) 7.8% 4 Chevy Chase (13) 7.7% 4 Capitol Hill (9) 6.8% 4 Woodley Park (51) 6.5% 4 Adams Morgan (2) 6.5% 4 Lincoln Park (29) 4.9% 4 Tenleytown (22) 4.4% 4 Naval Station & Airforce Base (46) 3.6% 4 Barnaby Woods (8) 3.4%

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Table 4b: On average, 19.7% of all women living in DC had incomes below the federal poverty line (2016). Quartile Health Planning Neighborhoods Poverty Rate for All DC Women 1 Stadium Armory (45) 81.7% 1 Georgetown (42) 53.6% 1 Saint Elizabeth’s (40) 46.1% 1 Naylor/Hillcrest (25) 41.8% 1 Bellevue (4) 41.6% 1 Historic Anacostia (3) 41.6% 1 Congress Heights/Shipley (16) 41.1% 1 Washington Highlands (35) 39.4% 1 Douglass (17) 37.3% 1 Eastland Gardens (12) 36.1% 1 Edgewood (48) 30.5% 1 Trinidad (47) 30.4% 2 Marshall Heights (30) 30.1% 2 Lincoln Heights (27) 26.8% 2 DC Medical Center (43) 25.1% 2 GWU (44) 23.8% 2 Fort Dupont (20) 23.7% 2 Twining (18) 21.7% 2 Chinatown (14) 20.4% 2 Southwest/Waterfront (50) 18.9% 2 Columbia Heights (15) 18.8% 2 Fort Lincoln/Gateway (21) 18.4% 2 U St/Pleasant (10) 18.2% 2 South Columbia Heights (31) 18.0% 2 Brentwood (7) 16.7% Median Hill East (24) 15.9% 3 Cathedral Heights (11) 14.5% 3 16th St Heights (1) 13.8% 3 Petworth (37) 13.8% 3 Shepherd Park (41) 13.4% 3 Mount Pleasant (33) 13.3% 3 Brightwood (5) 13.0% 3 Logan Circle/Shaw (28) 12.8% 3 Lamont Riggs (39) 12.5% 3 Brightwood Park (6) 12.1% 3 Kingman Park (26) 12.0% 3 Bloomindale (49) 10.3% 3 Chevy Chase (13) 10.2% 4 Union Station (34) 9.7% 4 Georgetown East (23) 9.1% 4 Kent/Palisades (36) 9.0% 4 Michigan Park (38) 8.9% 4 Forest Hills (19) 8.6% 4 Adams Morgan (2) 7.4% 4 Capitol Hill (9) 7.4% 4 Woodley Park (51) 7.2% 4 Woodbridge (32) 6.0% 4 Lincoln Park (29) 5.4% 4 Tenleytown (22) 5.3% 4 Naval Station & Airforce Base (46) 5.2% 4 Barnaby Woods (8) 4.3%

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Table 5b: The average poverty rate for children under the age of five living in DC was 25.8% in 2016.

Poverty Rate for All DC Children Quartile Health Planning Neighborhood Name Under Age 5 1 Washington Highlands (35) 73.6% 1 Saint Elizabeth’s (40) 66.5% 1 Bellevue (4) 63.9% 1 Eastland Gardens (12) 55.2% 1 Naylor/Hillcrest (25) 52.8% 1 Historic Anacostia (3) 50.8% 1 Congress Heights/Shipley (16) 50.1% 1 Douglass (17) 38.4% 1 Lincoln Heights (27) 37.8% 1 Marshall Heights (30) 35.3% 1 Trinidad (47) 29.0% 1 Twining (18) 27.8% 2 Columbia Heights (15) 26.6% 2 U St/Pleasant (10) 25.4% 2 Mount Pleasant (33) 23.5% 2 Edgewood (48) 23.2% 2 Fort Dupont (20) 23.2% 2 SW/Waterfront (50) 17.1% 2 Chinatown (14) 16.3% 2 Lamont Riggs (39) 16.0% 2 Brightwood (5) 14.2% 2 Brentwood (7) 13.9% 2 Bloomingdale (49) 9.5% 2 Hill East (24) 9.3% 2 Petworth (37) 8.9% Median 16th ST Heights (1) 7.5% 3 Kingman Park (26) 7.5% 3 Shephard Park (41) 6.9% 3 Forest Hills (19) 6.7% 3 South Columbia Heights (31) 6.1% 3 Michigan Park (38) 5.0% 3 Brightwood Park (6) 5.0% 3 Logan Circle/Shaw (28) 4.6% 3 Naval Station & Air Force (46) 4.0% 3 Cathedral Heights (11) 2.6% 3 Woodbridge (32) 2.6% 3 Union Station (34) 1.5% 3 Adams Morgan (2) 0.0% 4 Georgetown East (23) 0.0% 4 Georgetown (42) 0.0% 4 GWU/National Mall (44) 0.0% 4 Tenleytown (22) 0.0% 4 Kent/Palisades (36) 0.0% 4 Woodley Park (51) 0.0% 4 Barnaby Woods (8) 0.0% 4 Fort Lincoln/Gateway (21) 0.0% 4 DC Medical Center (43) 0.0% 4 Capitol Hill (9) 0.0% 4 Lincoln Park (29) 0.0% 4 Chevy Chase (13) 0.0% 4 Stadium Armory (45) N/A

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Table 6b: The average poverty rate for all single mothers with children under the age of five in DC was 27.3% in 2016. Poverty Rate for All DC Women Quartile Health Planning Neighborhoods with Children Under Age 5 1 Saint Elizabeth’s (40) 51.1% 1 Congress Heights/Shipley (16) 49.7% 1 Washington Highlands (35) 46.2% 1 Bellevue (4) 44.5% 1 Historic Anacostia (3) 43.8% 1 Naylor/Hillcrest (25) 43.2% 1 Douglass (17) 40.7% 1 Eastland Gardens (12) 38.6% 1 Chinatown (14) 37.7% 1 Columbia Heights (15) 35.1% 1 Trinidad (47) 34.4% 1 GWU (44) 33.4% 2 Marshall Heights (30) 32.0% 2 Naval Station & Airforce Base (46) 31.9% 2 Lincoln Heights (27) 29.2% 2 South Columbia Heights (31) 28.7% 2 Southwest/Waterfront (50) 26.2% 2 Hill East (24) 25.6% 2 Twining (18) 25.3% 2 Edgewood (48) 24.4% 2 Woodley Park (51) 23.4% 2 Brightwood Park (6) 22.9% 2 U St/Pleasant (10) 22.7% 2 Georgetown East (23) 22.0% Median Fort Dupont (20) 21.5% 3 Capitol Hill (9) 19.8% 3 Mount Pleasant (33) 18.9% 3 16th St Heights (1) 18.6% 3 Fort Lincoln/Gateway (21) 18.1% 3 Bloomindale (49) 17.3% 3 Shepherd Park (41) 17.2% 3 Kingman Park (26) 16.3% 3 Georgetown (42) 14.9% 3 Brightwood (5) 14.7% 3 Petworth (37) 13.6% 3 Cathedral Heights (11) 12.5% 3 Brentwood (7) 11.8% 4 Logan Circle/Shaw (28) 10.3% 4 Union Station (34) 9.2% 4 Kent/Palisades (36) 9.1% 4 Michigan Park (38) 8.9% 4 Lamont Riggs (39) 8.3% 4 Woodbridge (32) 6.8% 4 Adams Morgan (2) 5.7% 4 Forest Hills (19) 0.0% 4 Tenleytown (22) 0.0% 4 Barnaby Woods (8) 0.0% 4 DC Medical Center (43) 0.0% 4 Lincoln Park (29) 0.0% 4 Chevy Chase (13) 0.0% N/A Stadium Armory (45) N/A

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Table 7b: In 2016, 60,134 of DC households were living below the federal poverty line. Number of all DC Households with Quartile Health Planning Neighborhoods income <$25,000 1 Chinatown (14) 2,567 1 Naylor/Hillcrest (25) 2,564 1 Bellevue (4) 2,552 1 Trinidad (47) 2,496 1 Logan Circle/Shaw (28) 2,333 1 Fort Dupont (20) 2,327 1 Marshall Heights (30) 2,226 1 Twining (18) 2,181 1 Lincoln Heights (27) 2,017 1 Columbia Heights (15) 2,016 1 Historic Anacostia (3) 1,998 1 Eastland Gardens (12) 1,813 2 Southwest/Waterfront (50) 1,772 2 Cathedral Heights (11) 1,623 2 GWU (44) 1,613 2 Douglass (17) 1,580 2 Congress Heights/Shipley (16) 1,514 2 16th St Heights (1) 1,498 2 U St/Pleasant (10) 1,407 2 Brightwood (5) 1,357 2 Saint Elizabeth’s (40) 1,213 2 Fort Lincoln/Gateway (21) 1,205 2 Mount Pleasant (33) 1,163 2 Adams Morgan (2) 1,150 2 Edgewood (48) 1,099 Median Georgetown East (23) 1,031 3 Kingman Park (26) 1,011 3 Washington Highlands (35) 1,008 3 Bloomindale (49) 950 3 Lamont Riggs (39) 940 3 Brentwood (7) 923 3 Michigan Park (38) 873 3 Union Station (34) 838 3 Hill East (24) 823 3 Petworth (37) 800 3 Brightwood Park (6) 717 3 South Columbia Heights (31) 703 3 Forest Hills (19) 631 4 Kent/Palisades (36) 610 4 Woodley Park (51) 470 4 Tenleytown (22) 465 4 Woodbridge (32) 390 4 Chevy Chase (13) 361 4 Shepherd Park (41) 333 4 Capitol Hill (9) 306 4 Georgetown (42) 231 4 DC Medical Center (43) 210 4 Lincoln Park (29) 105 4 Barnaby Woods (8) 79 4 Naval Station & Airforce Base (46) 46 4 Stadium Armory (45) 0

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Table 7d: In 2016, the average poverty rate for households in DC was 22.4%. Rate of all DC Households with Quartile Health Planning Neighborhoods income < $25,000 1 Saint Elizabeth’s (40) 49.4% 1 Washington Highlands (35) 48.7% 1 Historic Anacostia (3) 47.3% 1 Eastland Gardens (12) 44.3% 1 Congress Heights/Shipley (16) 44.0% 1 Douglass (17) 41.4% 1 Bellevue (4) 40.9% 1 Fort Dupont (20) 38.6% 1 Naylor/Hillcrest (25) 37.6% 1 Trinidad (47) 37.0% 1 Lincoln Heights (27) 36.0% 1 Marshall Heights (30) 35.9% 2 Edgewood (48) 35.8% 2 Fort Lincoln/Gateway (21) 34.1% 2 Twining (18) 32.1% 2 GWU (44) 29.8% 2 DC Medical Center (43) 27.0% 2 Chinatown (14) 24.2% 2 Brentwood (7) 24.1% 2 Lamont Riggs (39) 22.9% 2 Mount Pleasant (33) 22.5% 2 16th St Heights (1) 21.7% 2 Columbia Heights (15) 21.2% 2 Brightwood (5) 20.9% 2 U St/Pleasant (10) 19.6% Median Michigan Park (38) 19.4% 3 Southwest/Waterfront (50) 18.5% 3 Hill East (24) 18.4% 3 Brightwood Park (6) 17.0% 3 Bloomindale (49) 16.5% 3 Petworth (37) 16.2% 3 Cathedral Heights (11) 16.2% 3 Kingman Park (26) 15.3% 3 South Columbia Heights (31) 15.0% 3 Logan Circle/Shaw (28) 15.0% 3 Georgetown (42) 14.6% 3 Woodbridge (32) 13.1% 3 Georgetown East (23) 12.6% 4 Union Station (34) 12.5% 4 Chevy Chase (13) 12.1% 4 Shepherd Park (41) 12.0% 4 Forest Hills (19) 9.8% 4 Kent/Palisades (36) 9.1% 4 Adams Morgan (2) 8.7% 4 Woodley Park (51) 7.4% 4 Capitol Hill (9) 6.6% 4 Tenleytown (22) 6.2% 4 Lincoln Park (29) 5.8% 4 Barnaby Woods (8) 3.9% 4 Naval Station & Airforce Base (46) 3.8% 4 Stadium Armory (45) 0.0%

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Table 8b: The average unemployment rate for all DC women was 8.3% in 2016, compared to the District wide average of 8.7%. Unemployment Rate for All DC Quartile Health Planning Neighborhoods Women 1 Stadium Armory (45) 92.1% 1 Washington Highlands (35) 25.7% 1 Congress Heights/Shipley (16) 25.0% 1 Bellevue (4) 24.3% 1 Douglass (17) 20.6% 1 Naylor/Hillcrest (25) 20.4% 1 Eastland Gardens (12) 20.0% 1 Fort Dupont (20) 18.0% 1 Marshall Heights (30) 17.5% 1 Lincoln Heights (27) 17.5% 1 Historic Anacostia (3) 16.9% 1 Saint Elizabeth’s (40) 15.5% 2 Twining (18) 14.1% 2 Lamont Riggs (39) 14.0% 2 Trinidad (47) 12.8% 2 Edgewood (48) 12.7% 2 Fort Lincoln/Gateway (21) 12.0% 2 Michigan Park (38) 11.6% 2 Petworth (37) 10.1% 2 Brentwood (7) 9.2% 2 Shepherd Park (41) 8.4% 2 South Columbia Heights (31) 8.2% 2 Southwest/Waterfront (50) 7.5% 2 Bloomindale (49) 7.4% 2 Hill East (24) 7.4% Median 16th St Heights (1) 7.2% 3 Columbia Heights (15) 6.9% 3 Brightwood (5) 6.8% 3 Kingman Park (26) 6.7% 3 Kent/Palisades (36) 6.1% 3 Chinatown (14) 5.8% 3 Brightwood Park (6) 4.9% 3 Woodbridge (32) 4.4% 3 Capitol Hill (9) 4.2% 3 Chevy Chase (13) 4.0% 3 Barnaby Woods (8) 3.9% 3 Mount Pleasant (33) 3.8% 3 Georgetown East (23) 3.4% 4 Adams Morgan (2) 3.4% 4 Naval Station & Airforce Base (46) 3.1% 4 Logan Circle/Shaw (28) 3.0% 4 U St/Pleasant (10) 3.0% 4 Union Station (34) 2.9% 4 Forest Hills (19) 2.7% 4 Cathedral Heights (11) 2.4% 4 Georgetown (42) 2.4% 4 Tenleytown (22) 2.4% 4 Lincoln Park (29) 2.4% 4 GWU (44) 2.3% 4 Woodley Park (51) 1.9% 4 DC Medical Center (43) 1.5%

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Table 9b: The average unemployment rate for all DC women with children through the age of five was 9.4% in 2016. Unemployment Rate for All DC Quartile Health Planning Neighborhoods Women with Children Through Age 5 1 Washington Highlands (35) 58.5% 1 Historic Anacostia (3) 32.3% 1 Congress Heights/Shipley (16) 29.7% 1 Lamont Riggs (39) 29.0% 1 Marshall Heights (30) 26.6% 1 Petworth (37) 24.8% 1 Twining (18) 22.5% 1 Lincoln Heights (27) 18.9% 1 Fort Dupont (20) 18.0% 1 Michigan Park (38) 17.7% 1 Saint Elizabeth’s (40) 16.7% 1 Brentwood (7) 16.2% 2 Eastland Gardens (12) 15.9% 2 Trinidad (47) 14.6% 2 Hill East (24) 12.8% 2 Columbia Heights (15) 11.0% 2 Bellevue (4) 10.9% 2 Southwest/Waterfront (50) 9.6% 2 16th St Heights (1) 9.1% 2 Mount Pleasant (33) 8.5% 2 Shepherd Park (41) 8.5% 2 Brightwood Park (6) 8.0% 2 Kingman Park (26) 7.0% 2 Edgewood (48) 7.0% 2 Naval Station & Airforce Base (46) 6.7% Median Cathedral Heights (11) 6.1% 3 Brightwood (5) 5.9% 3 Bloomindale (49) 4.5% 3 Logan Circle/Shaw (28) 3.8% 3 Adams Morgan (2) 3.8% 3 Woodbridge (32) 1.9% 3 Douglass (17) 1.5% 3 U St/Pleasant (10) 0.0% 3 South Columbia Heights (31) 0.0% 3 Georgetown East (23) 0.0% 3 Georgetown (42) 0.0% 3 GWU (44) 0.0% 3 Forest Hills (19) 0.0% 4 Tenleytown (22) 0.0% 4 Kent/Palisades (36) 0.0% 4 Woodley Park (51) 0.0% 4 Barnaby Woods (8) 0.0% 4 Fort Lincoln/Gateway (21) 0.0% 4 DC Medical Center (43) 0.0% 4 Capitol Hill (9) 0.0% 4 Lincoln Park (29) 0.0% 4 Union Station (34) 0.0% 4 Chinatown (14) 0.0% 4 Chevy Chase (13) 0.0% 4 Naylor/Hillcrest (25) 0.0% N/A Stadium Armory (45) N/A

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Table 10b: On average, 5.4% of all women in DC had not received a High School diploma in 2016. Rate for All DC Women without High Quartile Health Planning Neighborhoods School Diploma 1 Fort Dupont (20) 20.3% 1 Washington Highlands (35) 19.1% 1 Historic Anacostia (3) 18.6% 1 16th St Heights (1) 18.5% 1 Bellevue (4) 18.3% 1 Saint Elizabeth’s (40) 17.6% 1 Columbia Heights (15) 16.8% 1 Stadium Armory (45) 16.4% 1 Naylor/Hillcrest (25) 16.2% 1 Edgewood (48) 16.2% 1 Congress Heights/Shipley (16) 16.1% 1 Fort Lincoln/Gateway (21) 15.6% 2 Lincoln Heights (27) 15.1% 2 Mount Pleasant (33) 14.8% 2 Trinidad (47) 14.1% 2 Douglass (17) 13.6% 2 Eastland Gardens (12) 13.5% 2 Brentwood (7) 13.5% 2 Marshall Heights (30) 13.3% 2 Brightwood (5) 13.1% 2 Chinatown (14) 11.7% 2 Michigan Park (38) 11.0% 2 Petworth (37) 11.0% 2 Twining (18) 9.9% Median Brightwood Park (6) 9.3% 3 Southwest/Waterfront (50) 9.1% 3 Logan Circle/Shaw (28) 8.3% 3 South Columbia Heights (31) 8.1% 3 Bloomindale (49) 7.9% 3 Woodbridge (32) 6.7% 3 Hill East (24) 6.6% 3 Kingman Park (26) 6.0% 3 U St/Pleasant (10) 6.0% 3 Lamont Riggs (39) 5.3% 3 Adams Morgan (2) 5.0% 3 Shepherd Park (41) 4.4% 3 Chevy Chase (13) 4.2% 4 Union Station (34) 4.0% 4 Barnaby Woods (8) 3.8% 4 Woodley Park (51) 3.2% 4 DC Medical Center (43) 2.9% 4 Kent/Palisades (36) 2.1% 4 Cathedral Heights (11) 1.8% 4 Capitol Hill (9) 1.4% 4 Tenleytown (22) 1.1% 4 Forest Hills (19) 1.1% 4 Georgetown East (23) 1.0% 4 Lincoln Park (29) 0.6% 4 Georgetown (42) 0.6% 4 Naval Station & Airforce Base (46) 0.0% N/A GWU (44) N/A

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Table 11b: On average, 20.5% of all 16 to 19-year-old women living in DC were not enrolled in school (2016). Rate for All DC Women 16-19 Years Quartile Health Planning Neighborhoods Not Enrolled in School 1 Lincoln Park (29) 85.1% 1 Washington Highlands (35) 71.9% 1 Bellevue (4) 53.0% 1 Historic Anacostia (3) 46.7% 1 Kingman Park (26) 40.0% 1 Logan Circle/Shaw (28) 39.5% 1 Douglass (17) 38.3% 1 Chevy Chase (13) 37.0% 1 Naval Station & Airforce Base (46) 36.8% 1 Eastland Gardens (12) 35.0% 1 Petworth (37) 29.0% 1 Twining (18) 27.8% 1 Barnaby Woods (8) 27.6% 2 Congress Heights/Shipley (16) 26.4% 2 Southwest/Waterfront (50) 25.2% 2 Lamont Riggs (39) 23.8% 2 Columbia Heights (15) 21.0% 2 Chinatown (14) 19.8% 2 Lincoln Heights (27) 19.1% 2 Bloomindale (49) 14.5% 2 Brightwood Park (6) 13.3% 2 Hill East (24) 13.0% 2 Mount Pleasant (33) 11.9% 2 Marshall Heights (30) 11.1% Median Fort Dupont (20) 10.0% 3 Naylor/Hillcrest (25) 7.1% 3 South Columbia Heights (31) 6.5% 3 16th St Heights (1) 6.0% 3 Edgewood (48) 5.9% 3 Union Station (34) 5.8% 3 Michigan Park (38) 5.7% 3 Capitol Hill (9) 4.7% 3 Tenleytown (22) 4.5% 3 Saint Elizabeth’s (40) 4.4% 3 Trinidad (47) 3.5% 3 U St/Pleasant (10) 3.1% 3 Georgetown (42) 1.7% 4 Kent/Palisades (36) 0.7% 4 Adams Morgan (2) 0.0% 4 Georgetown East (23) 0.0% 4 GWU (44) 0.0% 4 Cathedral Heights (11) 0.0% 4 Forest Hills (19) 0.0% 4 Woodley Park (51) 0.0% 4 Brightwood (5) 0.0% 4 Shepherd Park (41) 0.0% 4 Brentwood (7) 0.0% 4 Fort Lincoln/Gateway (21) 0.0% 4 Woodbridge (32) 0.0% 4 Stadium Armory (45) 0.0% N/A DC Medical Center (43) N/A

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References

District of Colombia Department of Health. (2019). Health equity report: District of Columbia 2018. Washington, DC.

Human Resources Services Administration. (2019). Maternal, Infant, and Early Childhood Home Visiting Program: Supplemental Information Request (SIR) for the submission of the statewide needs assessment update. (OMB No. 0906-0038). Washington, DC.

US Census Bureau (2017). Narrative Profiles: Washington DC, 2013-2017 American Community Survey 5-year estimates. Retrieved from: https://www.census.gov/acs/www/data/data-tables-and-tools/narrative-profiles/2017/

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