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Middlesex Hospital Community Health Needs Assessment

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MIDDLESEX HEALTH Middlesex Hospital Community Health Needs Assessment REPORT FOR YEAR ENDING SEPTEMBER 30, 2019 ACKNOWLEDGEMENTS Author: Catherine Rees, MPH, Director, Community Benefit, Middlesex Health Many thanks to the following for their participation and input: Contributors: Amber Kapoor, MPH, Health Education and Grants Coordinator, Middlesex Health Cancer Center; Robyn L. Martin, B.S. Public Health, Epidemiology Technician, Infection Prevention and Community Benefit Coordinator, Community Benefit, Middlesex Health; Catherine Martin, Community Benefit Intern, Middlesex Health. Mark Abraham, Executive Director, DataHaven, for assistance with the 2018 DataHaven Community Wellbeing Survey and ChimeData Study. The members of the Middlesex Health Community Health Needs Assessment Advisory Committee: • Reverend Robyn Anderson, Director, • Sheila Daniels, Co-Chair Patient & Family Ministerial Health Fellowship Advisory Council, Middlesex Health PFAC • Wesley Bell, RS, MS, MPH, Director of Health, • Kevin Elak, R.S., Public Health Manager, Cromwell Health Department Middletown Health Department • Monica Belyea, MPH, RD, Program Planner, • Mary Emerling, RN, MPA, Middletown School Opportunity Knocks for Middletown’s Young Health Supervisor, Middletown Public Schools Children, Family Advocacy Maternal Child • Ann Faust, Executive Director, Coalition to End Health, Middlesex Health Homelessness • Ed Bonilla, Vice President of Community • Margaret Flinter, APRN, PhD, c-FNP, FAAN, Impact, Middlesex United Way FAANP, Senior Vice President and Clinical • Sherry Carlson, BSN, RN, Public Health Nurse, Director, Community Health Center, Inc. Connecticut River Area Health District • Rosa Flores, Unit Secretary and Cardiac • Louis Carta, MA, Community Health Educator, Monitor Technician, Public Health Intern, Middletown Health Department Middlesex Health • Heather Chandor, Vice Presdent of Operations, • Joseph Havlicek, MD, Director of Health, Middlesex YMCA Middletown Health Department • Katharine Conroy, MPH, Marketing & Analytics • Yvette Highsmith-Francis, Vice President, Coordinator, Middlesex Health Eastern Region, Community Health Center, Inc. Continued ACKNOWLEDGEMENTS Middlesex Health Community Health Needs Assessment Advisory Committee Members Continued: • Faith M. Jackson, Director of Equal Opportunity • William Milardo Jr, RS, Assistant Health & Diversity Management & Veterans Service Director and Sanitarian, Durham Health Contact Representative, City of Middletown Department and President, Middlesex County Branch • Sarah Moore, MBA, Director of Development, NAACP Middlesex Health • Michael Kalinowski, MD, Primary Care • Salvatore Nesci, R.S., Public Health Physician and Community Health Advocate Coordinator, Cromwell Health Department • Amber Kapoor, MPH, Health Education • Margaret O’Hagan-Lynch, Division Director and Grants Coordinator, Cancer Center, Addiction Services, Connecticut Valley Hospital Middlesex Health • Judy Omphroy, Health Committee Chair, • Hebe Kudisch, Chief Program Officer, Middlesex County NAACP Branch & Columbus House, Inc. Applications Analyst, ITS Applications Revenue • Rebecca Lemanski, Director, Middletown Cycle, Middlesex Health Works! & Director, Community Resilience • Dan Osborne, LCSW, Chief Executive Officer, Collaborative Gilead Community Services, Inc. • Veronica Mansfield, DNP,APRN, AE-C,CCM, • Catherine Rees, MPH, Director, Community Manager of Clinical Practice, Center for Benefit, Middlesex Health Chronic Care Management, Middlesex Health • Terri Savino, DNP, RN, CPHQ, CPXP, • Robyn L. Martin, B.S. Public Health, Manager, Patient Experience and Service Epidemiology Technician, Infection Prevention Excellence, Quality Improvement, Middlesex and Community Benefit Coordinator, Health Community Benefit, Middlesex Health • Thayer Talbott, Vice President, Programs & • Catherine Martin, Community Benefit Intern, Operations, Community Foundation of Middlesex Health Middlesex County • Kit McKinnon MBA, BSN RN, CDE, CCM, • Gary Wallace, Captain, Investigative Services NE-BC, Manager of Clinical Operations, Division Commander, Middletown Police Center for Chronic Care Management, Department & Middlesex Health Board Middlesex Health of Directors • Russell S. Melmed, MPH, Director of Health, Chatham Health District Please contact Catherine Rees with any questions at 860-358-3034, [email protected]. EXECUTIVE SUMMARY Middlesex Health is dedicated to improving the health, well-being and quality of life of the communities we serve. Conducting a community health needs assessment (CHNA) ensures that the most pressing health and health-related needs of a defined community are identified and subsequently addressed. By collecting and analyzing a variety of data sources specific to our geographic area, a comprehensive picture of our community’s health status is formed. This process enables the identification of unmet needs, gaps and barriers to optimal health, well-being and health equity. While the Internal Revenue Code 501(r)(3), as set forth by the Patient Protection and Affordable Care Act, requires not-for-profit hospitals to perform a community health needs assessment every three taxable years with input from persons representing the broad interests of the community, conducting a CHNA is a best practice for improving community health, quality of life and advancing health equity. The intent of this CHNA is not only to serve as a tool for guiding Middlesex Health’s planning, but also to be a useful resource for our community partners and the general public. Middlesex Health continues to use its CHNA as a vehicle for examining how the influencers of health outcomes - social determinants of health and health disparities - can have profound health and well-being implications resulting in poorer health outcomes and reduced quality of life for some. Assessing and addressing the systems and drivers that contribute to certain groups experiencing diminished health and quality of life is needed to close the gap of perpetual and widespread health disparities. The significant health and health-related issues that have been identified through the process of conducting this CHNA include chronic disease, mental health, substance use disorder, social determinants of health issues, at-risk populations, and health disparities. Middlesex Health will use the findings of this CHNA to prioritize the significant health and health-related needs in order to inform the CHNA implementation strategy, also required by 501(r)(3). The implementation strategy will include the actions Middlesex Health intends to take to address the most prominent health and health-related needs identified in the CHNA, including an intentional focus on promoting health equity. Middlesex Health remains grateful for its continued collaboration with our community partners that share a commitment to improving the health, well-being, and quality of life for our community members. We look forward to using the findings of this CHNA to further the work of these multisector partnerships by responding to identified needs and continuing to support community health improvement and advance health equity. Middlesex Health Community Health Needs Assessment 2019 i TABLE OF CONTENTS Executive Summary ………………………………………………………………………………….. i Part I: Introduction and Background ……………………………………………………………………….. 1 About Middlesex Health and Middlesex Hospital ……………………………………….. 1 Comments from Most Recently Conducted CHNA …………………………………….. 1 Input from Persons Representing the Community ……………………………………… 1 Overview of Process and Methods Used to Conduct CHNA ………………………….. 2 DataHaven ChimeData Study Town Level Companion Report ………………………. 2 Middlesex Health Cancer Center CHNA ………………………………………………... 2 Limitations ………………………………………………………………………………….. 3 Next Steps ……………………………………………………………………………………………. 4 Actions Since 2016 CHNA ………………………………… ………………………………………. 5 Significant Health & Health-Related Needs ………………………………………………………. 10 Definition of the Community Served ………………………………………………………………. 11 Population ………………………………………………………………………………….. 12 Age Distribution ……………………………………………………………………………. 12 Population Projections Age 65 and Over ……………………………………………….. 14 Race and Hispanic or Latino Origin ……………………………………………………… 15 Veteran Status ……………………………………………………………………………… 16 Life Expectancy & Mortality ………………………………………………………………. 17 Process and Methods Used to Conduct CHNA ………………………………………………….. 18 DataHaven 2018 Community Wellbeing Survey ……………………………………….. 18 DataHaven ChimeData Study ……………………………………………………………. 20 Key Informant Survey ……………………………………………………………………... 21 Social Determinants of Health …………………………………………………………………….... 22 Median Household Income ……………………………………………………………….. 23 Financial Insecurity ………………………………………………………………………… 24 Poverty Status ……………………………………………………………………………… 26 Employment Status ………………………………………………………………………… 28 The ALICE Population …………………………………………………………………….. 28 Education Level …………………………………………………………………………….. 30 Housing ……………………………………………………………………………………... 31 Homelessness ……………………………………………………………………………… 33 Living Environment ………………………………………………………………………… 35 Transportation ………………………………………………………………………………. 41 Food Insecurity ……………………………………………………………………………… 42 TABLE OF CONTENTS continued Access to Health Care Services ………………………………………………………….. 45 SDOH Impact on Community Health and Well-Being ………………………………….. 54 2-1-1 CT Service Requests ……………………………………………………………….. 57 CMS Accountable Heath Communities Initiative………………………………………... 61 Health Equity …………………………………………………………………………………………. 63 Partnerships
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