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2018 Community Health Assessment Report Scott County & Muscatine County, Iowa Rock Island County, Illinois

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2018 Community Health Assessment Report Scott County & Muscatine County, Iowa Rock Island County, Illinois 2018 Community Health Assessment Report Scott County & Muscatine County, Iowa Rock Island County, Illinois Study Sponsored by: Community Health Care, Inc. Genesis Health System Muscatine County Board of Health Quad City Health Initiative Rock Island County Health Department Scott County Health Department UnityPoint Health – Trinity Funded by: Genesis Health System UnityPoint Health – Trinity Prepared by: Professional Research Consultants, Inc. 11326 P Street Omaha, NE 68137-2316 www.PRCCustomResearch.com 2017-0858-02 FINAL © September 2018 COMMUNITY HEALTH ASSESSMENT Table of Contents Introduction 9 Preface 10 Project Goals 10 Acknowledgments 11 Methodology 13 Summary of Findings 22 Significant Health Needs of the Community 22 Summary of Qualitative Community Health Assessment Findings 24 Summary Tables 25 Community Description 46 Population Characteristics 47 Total Population 47 Urban/Rural Population 49 Age 50 Race & Ethnicity 52 Linguistic Isolation 55 Social Determinants of Health 57 Poverty 57 Education 60 Employment 61 Housing Issues 62 Food Insecurity 68 Social Services 70 Health Literacy 72 Problems Facing Families in the Community 75 Health Disparities 76 Social Determinant Risk & Health 76 Income & Health 77 General Health Status 78 Overall Health Status 79 Mental Health 81 Evaluation of Mental Health Status 82 Depression 83 Stress 85 Suicide 87 Mental Health Treatment 90 2 COMMUNITY HEALTH ASSESSMENT Perceived Ease of Obtaining Mental Health Services 94 Death, Disease, & Chronic Conditions 96 Leading Causes of Hospital Visits 97 Inpatient Hospitalizations 97 Emergency Department Visits 99 Hospital Readmissions 101 Leading Causes of Death 103 Distribution of Deaths by Cause 103 Age-Adjusted Death Rates for Selected Causes 103 Cardiovascular Disease 105 Age-Adjusted Heart Disease & Stroke Deaths 105 Prevalence of Heart Disease & Stroke 108 Cardiovascular Risk Factors 110 Cancer 116 Age-Adjusted Cancer Deaths 116 Cancer Incidence 118 Prevalence of Cancer 120 Cancer Screenings 123 Respiratory Disease 128 Age-Adjusted Respiratory Disease Deaths 129 Prevalence of Respiratory Disease 131 Injury & Violence 135 Unintentional Injury 135 Intentional Injury (Violence) 141 Diabetes 146 Age-Adjusted Diabetes Deaths 146 Prevalence of Diabetes 148 Alzheimer’s Disease 150 Age-Adjusted Alzheimer’s Disease Deaths 150 Kidney Disease 152 Age-Adjusted Kidney Disease Deaths 152 Prevalence of Kidney Disease 153 Infectious Disease 155 Influenza & Pneumonia Vaccination 156 Flu Vaccination 156 Pneumonia Vaccination 157 HIV 158 HIV Prevalence 159 3 COMMUNITY HEALTH ASSESSMENT Sexually Transmitted Diseases 161 Chlamydia & Gonorrhea 161 Births 163 Prenatal Care 164 Lack of Timely Prenatal Care 164 Perceived Ease of Obtaining Prenatal/Postnatal Care 165 Birth Outcomes & Risks 167 Low-Weight Births 167 Infant Mortality 168 Perceptions of Childhood Vaccinations 169 Family Planning 171 Births to Teen Mothers 171 Modifiable Health Risks 173 Nutrition 174 Daily Recommendation of Fruits/Vegetables 175 Access to Fresh Produce 177 Physical Activity 179 Leisure-Time Physical Activity 179 Activity Levels 181 Access to Physical Activity 184 Use of Local Trails for Exercise 185 Weight Status 187 Adult Weight Status 187 Children’s Weight Status 191 Substance Abuse 194 Age-Adjusted Cirrhosis/Liver Disease Deaths 194 Alcohol Use 196 Age-Adjusted Unintentional Drug-Related Deaths 197 Illicit Drug Use 199 Negative Effects of Substance Abuse 200 Perceived Ease of Obtaining Substance Abuse Services 203 Tobacco Use 205 Cigarette Smoking 205 Other Tobacco Use 208 4 COMMUNITY HEALTH ASSESSMENT Access to Health Services 211 Health Insurance Coverage 212 Type of Healthcare Coverage 212 Lack of Health Insurance Coverage 212 Difficulties Accessing Healthcare 214 Difficulties Accessing Services 214 Barriers to Healthcare Access 215 Perceived Ease of Accessing Local Healthcare Services 219 Outmigration for Care 224 Primary Care Services 226 Access to Primary Care 226 Specific Source of Ongoing Care 227 Utilization of Primary Care Services 231 Emergency Room Utilization 233 Oral Health 235 Particular Place Used for Dental Care 235 Dental Insurance 237 Dental Care 239 Perceived Ease of Accessing Local Dental Services 241 Local Resources 244 Number-One Health Concern in the Area 245 Perceptions of Local Healthcare Services 246 Healthcare Resources & Facilities 248 Hospitals & Federally Qualified Health Centers (FQHCs) 248 Health Professional Shortage Areas (HPSAs) 249 Appendices 250 Appendix A: Quad Cities Qualitative Community Health Assessment 251 Introduction 252 Quad Cities Community Themes and Strengths Assessment 254 Community Themes and Strengths Assessment 255 Introduction 255 Purpose 255 Methods 255 Results 256 Themes 256 Acknowledgements 256 Table 1: Community Themes and Strengths Participants 257 5 COMMUNITY HEALTH ASSESSMENT Exhibits 258 Exhibit 1: Focus Group Questions and Responses 258 Figure 1: Health Related Phrases 259 Figure 2: Sex/Gender of Target Population 259 Figure 3: Race/Ethnicity of Participants 260 Figure 4: Race/Ethnicity as Percentage 260 Table 2: Average Age and Number of Participants by Target Focus Group 261 Table 3: What Is Your Favorite Aspect About Living in the Community? 261 Table 4: What Do You See as the Biggest Health Concern in Your Community? 262 Table 5: What Do You Think Could Address Your Health Concerns? 264 Table 6: What Barriers Exist That Might Keep This From Happening? 265 Table 7: What Could Address Those Barriers? 267 Table 8: What Are Some Assets In Your Community That Support Improved Health? 268 Table 9: What Would You Like to See In Our Community In The Next 5-10 Years? 269 Table 10: Is There Anything Else You’d Like To Say About What Could Make Your Community Healthier? 270 Table 11: What Are The Top Three Daily Living Stresses In YOUR Life? 270 Table 12: What Are The Top Three Daily Things That Bring YOU Joy? 272 Exhibit 2: Survey Questions and Responses 275 Figure 5: Zip Code of Residence (n=274) 275 Figure 6: Proportion of Respondents by Gender (n=201) 276 Figure 7: Proportion of Respondents by Age (n=195) 277 Figure 8: Proportion of Respondents by Race/Ethnicity (n=210) 278 Figure 9: Proportion of Respondents by Annual Household Income (n=162) 279 Figure 10: Proportion of Respondents by Number of People in Household (n = 186) 280 Figure 11: Proportion of Respondents by Highest Education Level (n=217) 281 Figure 12: Level of Community Health (n=237) 282 Figure 13. Factors that Contribute to a Healthy Community (n=237) 283 Figure 14: Leading Health Problems (n=237) 284 Figure 15: Leading Safety Problems (n=237) 285 Figure 16: Level of Personal Health (n=237) 286 Figure 17: Number of Days Unable to Work or Perform Daily Activities Due to Illness 287 Figure 18: Community Assets (n=237) 288 Figure 19: Method of Payment for Health Care Services (n=237) 289 Figure 20: Ability to Access Health Care Services (n=237) 290 Figure 21: Type of Health Care Services Received Outside of Community (n=237) 290 Figure 22: Reasons for Receiving Health Care Services Outside of Community (n=237) 291 Figure 23: Mental Health Services Needed by Individual or Family Members (n=237) 292 Figure 24: Social Service Benefits Needed by Individual or Family Members (n=237) 293 Figure 25: Ability to Access Services in Community (n=144) 293 Figure 26: Ability to Receive Benefits in Community (n=166) 294 Figure 27: Top Three Daily Things that Bring You Joy (n=237) 295 Figure 28: Top Three Daily Stressors (n=237) 295 Quad Cities Local Public Health System Assessment 297 Local Public Health System Assessment 298 Introduction 298 Purpose 298 Methods 298 Table 13: Essential Public Health Services 299 Results 301 Themes 301 Table 14: Suggested Focus Areas 303 6 COMMUNITY HEALTH ASSESSMENT Acknowledgements 303 Table 15: Local Public Health System Assessment Participants 304 Exhibits 305 Exhibit 3: LPHS - Jelly Bean Diagram 305 Exhibit 4: LPHSA Subcommittee Meeting Agendas 306 Exhibit 5: Essential Service Ratings 308 Table 16: Combined Essential Service Activity Levels 308 Figure 29: Essential Services Activity Level Comparison 308 Table 17: Essential Services Overall Consensus Results - Subcommittee Meeting 309 Exhibit 6: SWOT Analysis Discussion Results 311 Table 18: Essential Services 1 & 2 SWOT Analysis 311 Table 19: Essential Services 3 & 4 SWOT Analysis 312 Table 20: Essential Services 5 & 6 SWOT Analysis 313 Table 21: Essential Services 7 & 8 SWOT Analysis 314 Table 22: Essential Services 9 & 10 SWOT Analysis 315 Quad Cities Forces of Change Assessment 316 Forces of Change Assessment 317 Introduction 317 Purpose 317 Methods 317 Results 319 Table 23: Identified Forces of Change 319 Table 24: Rankings of Forces Categories 327 Table 25: Forces of Change Ranked as a “Top 3” Force 328 Themes 329 Acknowledgements 329 Table 26: Forces of Change Assessment Participants 329 Exhibits 330 Exhibit 7: Forces of Change Meeting Agenda 330 Exhibit 8: Forces of Change Note Sheet 331 Exhibit 9: Forces of Change Follow-Up Survey 332 Appendix B: Muscatine Community Health Assessment 333 Introduction 334 Muscatine Community Themes and Strengths Assessment 336 Community Themes and Strengths Assessment 337 Purpose 337 Method 337 Results 337 Muscatine Local Public Health System Assessment 339 Local Public Health System Assessment 340 Purpose 340 Table 1: Essential Public Health Services 340 Method 340 Results 341 7 COMMUNITY HEALTH ASSESSMENT Muscatine Forces of Change Assessment 342 Forces of Change Assessment 343 Purpose 343 Method 343 Results 343 Acknowledgements
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