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Community Health Needs Assessment Central Valley Region

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Community Health Needs Assessment Central Valley Region Community Health Needs Assessment Central Valley RegionRegion Central Valley, California EXCELLENCE THROUGH LEADERSHIP & COLLABORATION “Effective, efficient, safe, timely, patient centered, equitable and affordable.” www.hospitalcouncil.org 2019 Community Health Needs Assessment © 2019 Hospital Council of Northern & Central California Ms. Shauna Day, Regional Vice President—Central Valley and Central Coast 7225 N. First Street, Suite 105 Fresno, CA 93720 Phone: (559) 650-5694 With technical assistance from Laura Acosta, MPH HC2 Strategies, Inc. Jessica L.A. Jackson, MA, MPH Wildfire Graphics & Analytics, LLC Ad Lucem Consulting TABLE OF CONTENTS ACKNOWLEDGMENTS 5 EXECUTIVE SUMMARY 6 INTRODUCTION 9 HISTORY OF COMMUNITY HEALTH NEEDS ASSESSMENT 10 COMMUNITY PROFILE 11 Quick Community Facts 12 CHNA OVERVIEW 13 HEALTH INDICATORS 15 Social and Economic Factors 15 Health System 20 Public Health and Prevention 26 Physical Environment 30 VOICES FROM THE COMMUNITY 32 PRIORITIZATION OF HEALTH NEEDS 43 IDENTIFIED HEALTH NEEDS 43 REGIONAL EVALUATION 48 APPENDIX 50 Appendix A: Glossary of Terms 51 Appendix B: Sources Cited 54 Appendix C: Qualification of Consultants 54 Appendix D: Health Indicators Table 55 Appendix E: Description of Key Informants and Focus Groups 58 Appendix F: Key Informant Codebook and Frequencies 62 Appendix G: Focus Group Codebook and Frequencies 79 Appendix H: Survey Results 92 Appendix I: Community Resources 103 4 Acknowledgments ACKNOWLEDGMENTS This report was made possible through the financial contribution of 14 hospitals located in Central Valley, California and the Hospital Council of Northern and Central California's Community Benefits Workgroup. Under the leadership of Ms. Shauna Day, Regional Vice President, the committee collaborated with Ms. Laura Acosta of HC2 Strategies, Inc. to conduct key informant interviews, focus groups, and establish priority health needs for the 2019-2021 community health needs cycle. Additionally, the committee worked with Ms. Jessica L.A. Jackson of Wildfire Graphics & Analytics, LLC to gather health indicator data, analyze quantitative and qualitative data, and package the final report. Special thanks is also extended to the team at Ad Lucem Consulting for establishing the methdolodgy for ranking health need data, from key informant and focus group interviews. Ad Lucem also provided the overall rankings for the four-county region, found in this report. The analysis method and rankings were invaluable in providing 'at a glance' information for informed decision making. Many of the key health indicators presented in this report were collected from the Engagement Network CHNA report provided by Community Commons, which is managed by the Institute for People, Place, and Possibility, the Center for Applied Research and Environmental Systems (CARES), and the Community Initiatives Network. The data gathered from Community Commons ensured an efficient and accurate method to gathering data from numerous sources. Finally, we would like to thank our community members and organizations and all those who gave input for this report through key informant interviews and focus groups. Their perspectives ensure that we are taking into consideration the most vulnerable in our communities to better create initiatives, more meaningful partnerships, and strategic investments into our communities. Members of the Community Benefits Workgroup Listed in Alphabetical Order by Hospital • Rebecca Russell, Adventist Health—Central Valley Network • Sharon Spurgeon, Coalinga Regional Medical Center (Closed) • Alma Martinez, Community Medical Centers; Clovis Community Medical Center; Community Regional Medical Center; Fresno Heart and Surgical Hospital • Marie Sanchez, Kaiser Permanente—Fresno Service Area • John Tyndal, Kaweah Delta Health Care District • Sherrie Bakke, Madera Community Hospital • Karen Hoyt, San Joaquin Valley Rehabilitation Hospital • Ivonne Der Torosian, Saint Agnes Medical Center • Mary Jo Jacobson, San Joaquin Valley Rehabilitation Hospital • Kimberly Pryor-DeShazo, Sierra View Medical Center • Tim Curley, Valley Children's Healthcare 5 Executive Summary EXECUTIVE SUMMARY The Hospital Council of Northern and Central California is a nonprofit hospital and health system trade association established in 1961, representing 185 hospitals and health systems in 50 of California’s 58 counties—from Kern County to the Oregon border. The Hospital Council’s membership includes hospitals and health systems ranging from small, rural hospitals to large, urban medical centers, representing more than 37,000 licensed beds. Beginning in 2011, the Hospital Council of Northern and Central California initiated a four-county (Fresno, Kings, Madera, and Tulare) community health needs assessment (CHNA) process, working collaboratively with 15 hospitals across the Central Valley region. The 2019 report continues a tradition of collaboration and expands upon previous efforts through expanded data collection from important voices in our community. Participating hospitals in the 2019 Regional Community Health Needs Assessment include: Adventist Health Hanford Adventist Health Reedley Adventist Health Selma Clovis Community Medical Center Coalinga Regional Medical Center (Closed) Community Regional Medical Center (includes Community Behavioral Health Center) Kaiser Permanente, Fresno Service Area Kaweah Delta Health Care District Madera Community Hospital San Joaquin Valley Rehabilitation Hospital Sierra View Medical Center Saint Agnes Medical Center Tulare Regional Medical Center (Adventist Health oversees the operations of the hospital. Doors opened to the public October 15, 2018.) Valley Children’s Healthcare The CHNA represents our commitment to improving health outcomes in our community through rigorous assessment of health status in our region, incorporation of stakeholders’ perspectives, and adoption of related implementation strategies to address priority health needs. The CHNA is conducted not only to satisfy legal requirements, but also to partner for improved health outcomes. The goals of this assessment are to: • Engage public health and community stakeholders including low-income, minority, and other under served populations • Assess and understand the community’s health issues and needs • Understand the health behaviors, risk factors, and social determinants that impact health • Identify community resources and collaborate with community partners • Use findings to develop and adopt an implementation strategy based on the collective prioritized issues 6 Executive Summary Sources of Data Sources of data for this assessment included a mixture of secondary data and primary data. Secondary data sources include publicly reported state and nationally-recognized data sources such as Community Commons, California Department of Public Health, and County Health Rankings & Roadmaps. Primary data was collected through key informant interviews, focus groups, and an online survey. Key informants and focus groups were purposefully chosen to represent medically under served, low-income, or minority populations in our community. Their input provided insights on how to better direct our resources and form partnerships. The online survey was distributed to partner organizations that were not represented by key informants and advertised to the general public via a public service announcement hosted on Univision's Arriba Valle Central" show. Additionally written comments on the previous CHNA were solicited on each hospital's website using a unique link. To date no written comments were received. Top Needs Across the Region Top needs for the region were identified by creating potential health need scores using both quantitative (i.e., health indicators) and qualitative (i.e, key informant interviews, focus groups, and survey) data. First, qualitative data was coded and organized into themes that identified the main ideas being communicated. Next, the themes were organized into 13 categories representing overarching health and social needs. The number of mentions for each theme was counted, divided by the total number of mentions, and multiplied by 100 to find the percentage. The themes were then linked to quantitative health indicators and percentages for qualitative data, entered into a spreadsheet, and a formula was applied to assign points to each indicator. Point allocations indicated how far each indicator deviated from the state benchmark. Potential health need scores were calculated by finding the average of all the points within each theme. This process yielded potential health need scores, whereby the higher the score, the more pressing the need. The results are as follows: Rank Potential Health Need Description 1 CVD/Stroke Indicators related to cardiovascular disease. 2 Access to Care Indicators related to health care facilities, health care coverage, and primary care provider rate. 3 Asthma Indicators related to asthma prevalence, emergency department visits, hospitalizations, and mortality from chronic lower respiratory disease. 3 Economic Security Indicators related poverty, education, public assistance, and homelessness. 4 Climate and Health Indicators related to the air quality, water quality, and pollution. 5 Violence and Injury Prevention Indicators related unintentional injuries and violence. 6 Oral Health Indicators related to access to dentists 7 Obesity/HEAL/Diabetes Indicators related to obesity, diabetes, healthy eating, and active living. 8 Maternal and Infant Health Indicators related to prenatal
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