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2019 Community Health Needs Assessment Report

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2019 Community Health Needs Assessment Report 2019 Community Health Needs Assessment Report Staunton, Waynesboro & Augusta County, Virginia Prepared for: By: PRC, Inc. 11326 P Street Omaha, NE 68137-2316 www.PRCCustomResearch.com 2019-0070-02 © June 2019 PRC, Inc. COMMUNITY HEALTH NEEDS ASSESSMENT Table of Contents Introduction 6 Project Overview 7 Project Goals 7 Methodology 8 IRS Form 990, Schedule H Compliance 15 Summary of Findings 16 Significant Health Needs of the Community 16 Summary Tables: Comparisons With Benchmark Data 21 Summary of Key Informant Perceptions 40 Community Description 41 Population Characteristics 42 Total Population 42 Urban/Rural Population 44 Age 45 Race & Ethnicity 47 Linguistic Isolation 49 Social Determinants of Health 50 Income 50 Education 53 Employment 54 Housing 55 Transportation 59 Food Access 60 Health Literacy 63 General Health Status 65 Overall Health Status 66 Mental Health 68 Mental Health Status 69 Depression 71 Stress 73 Suicide 74 Mental Health Treatment 75 Key Informant Input: Mental Health 78 Death, Disease & Chronic Conditions 82 Leading Causes of Death 83 PRC, Inc. 2 2 COMMUNITY HEALTH NEEDS ASSESSMENT Distribution of Deaths by Cause 83 Age-Adjusted Death Rates for Selected Causes 83 Cardiovascular Disease 85 Age-Adjusted Heart Disease & Stroke Deaths 85 Prevalence of Heart Disease & Stroke 88 Cardiovascular Risk Factors 89 Key Informant Input: Heart Disease & Stroke 93 Cancer 95 Age-Adjusted Cancer Deaths 95 Cancer Incidence 97 Prevalence of Cancer 97 Cancer Screenings 99 Key Informant Input: Cancer 101 Respiratory Disease 103 Age-Adjusted Respiratory Disease Deaths 104 Influenza & Pneumonia Vaccination 106 Prevalence of Respiratory Disease 107 Key Informant Input: Respiratory Disease 109 Injury & Violence 110 Unintentional Injury 110 Intentional Injury (Violence) 114 Key Informant Input: Injury & Violence 118 Diabetes 119 Age-Adjusted Diabetes Deaths 119 Prevalence of Diabetes 121 Key Informant Input: Diabetes 122 Kidney Disease 125 Age-Adjusted Kidney Disease Deaths 125 Prevalence of Kidney Disease 126 Key Informant Input: Kidney Disease 127 Potentially Disabling Conditions 128 Multiple Chronic Conditions 128 Activity Limitations 129 Arthritis, Osteoporosis & Chronic Back Conditions 131 Alzheimer’s Disease 133 Caregiving 138 Immunization & Infectious Diseases 139 Key Informant Input: Immunization & Infectious Diseases 139 PRC, Inc. 3 3 COMMUNITY HEALTH NEEDS ASSESSMENT Births 140 Birth Outcomes & Risks 141 Low-Weight Births 141 Infant Mortality 142 Key Informant Input: Infant & Child Health 143 Family Planning 144 Births to Adolescent Mothers 144 Key Informant Input: Family Planning 145 Modifiable Health Risks 147 Nutrition 148 Daily Recommendation of Fruits/Vegetables 149 Sugar-Sweetened Beverages 150 Physical Activity 152 Leisure-Time Physical Activity 153 Activity Levels 153 Access to Physical Activity 156 Neighborhood Attributes 156 Weight Status 160 Adult Weight Status 160 Children’s Weight Status 163 Key Informant Input: Nutrition, Physical Activity & Weight 165 Sleep 168 Substance Abuse 170 Age-Adjusted Cirrhosis/Liver Disease Deaths 170 Alcohol Use 172 Age-Adjusted Unintentional Drug-Related Deaths 173 Illicit Drug Use 175 Alcohol & Drug Treatment 177 Personal Impact from Substance Abuse 177 Key Informant Input: Substance Abuse 179 Tobacco Use 183 Cigarette Smoking 183 Other Tobacco Use 186 Key Informant Input: Tobacco Use 189 Sexual Health 191 HIV 191 Sexually Transmitted Diseases 194 PRC, Inc. 4 4 COMMUNITY HEALTH NEEDS ASSESSMENT Access to Health Services 197 Health Insurance Coverage 198 Type of Healthcare Coverage 198 Lack of Health Insurance Coverage 198 Difficulties Accessing Healthcare 200 Difficulties Accessing Services 200 Barriers to Healthcare Access 201 Accessing Healthcare for Children 202 Key Informant Input: Access to Healthcare Services 203 Primary Care Services 207 Access to Primary Care 207 Specific Source of Ongoing Care 208 Utilization of Primary Care Services 208 Emergency Room Utilization 211 Oral Health 212 Dental Insurance 212 Dental Care 213 Key Informant Input: Oral Health 215 Vision Care 217 Local Resources 218 Perceptions of Local Healthcare Services 219 Healthcare Resources & Facilities 221 Federally Qualified Health Centers (FQHCs) 221 Resources Available to Address the Significant Health Needs 222 Appendix 227 Evaluation of Past Activities 228 PRC, Inc. 5 5 Introduction COMMUNITY HEALTH NEEDS ASSESSMENT Project Overview Project Goals This Community Health Needs Assessment, a follow-up to a similar study conducted in 2016, is a systematic, data-driven approach to determining the health status, behaviors, and needs of residents in the service area of Augusta Health. Subsequently, this information may be used to inform decisions and guide efforts to improve community health and wellness. A Community Health Needs Assessment provides information so that communities may identify issues of greatest concern and decide to commit resources to those areas, thereby making the greatest possible impact on community health status. This Community Health Needs Assessment will serve as a tool toward reaching three basic goals: • To improve residents’ health status, increase their life spans, and elevate their overall quality of life. A healthy community is not only one where its residents suffer little from physical and mental illness, but also one where its residents enjoy a high quality of life. • To reduce the health disparities among residents. By gathering demographic information along with health status and behavior data, it will be possible to identify population segments that are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals may then be developed to combat some of the socio-economic factors that historically have had a negative impact on residents’ health. • To increase accessibility to preventive services for all community residents. More accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating the quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care. This assessment was conducted on behalf of Augusta Health by PRC, Inc. PRC is a nationally recognized healthcare consulting firm with extensive experience conducting Community Health Needs Assessments in hundreds of communities across the United States since 1994. PRC, Inc. 77 COMMUNITY HEALTH NEEDS ASSESSMENT Methodology This assessment incorporates data from both quantitative and qualitative sources. Quantitative data input includes primary research (the PRC Community Health Survey) and secondary research (vital statistics and other existing health-related data); these quantitative components allow for trending and comparison to benchmark data at the state and national levels. Qualitative data input includes primary research gathered through an Online Key Informant Survey. PRC Community Health Survey Survey Instrument The survey instrument used for this study is based largely on the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to health promotion and disease prevention objectives and other recognized health issues. The final survey instrument was developed by Augusta Health and PRC and is similar to the previous survey used in the region, allowing for data trending. Community Defined for This Assessment The study area for the survey effort (referred to as the “Total Area” in this report) is defined as each of the residential ZIP Codes comprising Staunton, Waynesboro, and Augusta County in Virginia. This community definition, illustrated in the following map, represents the hospital’s primary service area and includes those ZIP Codes from which 79% of the hospital’s admissions are derived. PRC, Inc. 88 COMMUNITY HEALTH NEEDS ASSESSMENT Sample Approach & Design A precise and carefully executed methodology is critical in asserting the validity of the results gathered in the PRC Community Health Survey. Thus, to ensure the best representation of the population surveyed a mixed-mode methodology was implemented. This included surveys conducted via telephone (landline and cell phone) as well as through online questionnaires. The sample design used for this effort consisted of a stratified random sample of 601 individuals age 18 and older in the Total Area, including 151 in Staunton, 150 in Waynesboro, and 300 in surrounding Augusta County. Once the interviews were completed, these were weighted in proportion to the actual population distribution so as to appropriately represent the Total Area as a whole. All administration of the surveys, data collection, and data analysis was conducted by PRC. For statistical purposes, the maximum rate of error associated with a sample size of 601 respondents is ±4.0% at the 95 percent confidence level. Expected Error Ranges for a Sample of 601 Respondents at the 95 Percent Level of Confidence ±4.5 ±4.0 ±3.5 ±3.0 ±2.5 ±2.0 ±1.5 ±1.0 ±0.5 ±0.0 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Note: The "response rate" (the percentage of a population giving a particular response) determines the error rate associated with that response. A "95 percent level of confidence" indicates that responses would fall within the expected error range on 95 out of 100 trials. Examples: If 10% of the sample of 601 respondents answered
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