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Newyork-Presbyterian Hospital Community Health Needs Assessment 2019-2021

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Newyork-Presbyterian Hospital Community Health Needs Assessment 2019-2021 NewYork-Presbyterian Hospital Community Health Needs Assessment 2019-2021 February 6, 2020 Table of Contents Executive Summary 3 Key Health Policy Impact 212 Introduction 14 Community Input 219 Acknowledgements 15 Public Health Department & Other Experts 221 Why a CHNA? 18 Input Solicited from Community Populations 222 About Us: NYPH 19 Other Community Feedback 235 CHNA Vision 20 Written Comments from Prior CHNA 252 Definition of Health 21 Prioritization of Significant Health Needs 253 Governance & Collaboration 22 Impact of Evaluation Strategies for Previously Conducted 258 CHNA – NYP Hospitals and NYP Lawrence CHNA Process 23 Appendix 282 Defining the Hospital Community 24 List of Data Indicators Utilized and Sources 283 Assessing the Health of the High Disparity NYC Communities 37 Gaps Limiting Ability to Assess the Community’s Health Needs 300 Data Review 43 Hanlon Method Description 301 Assessing the Health of the High Disparity non-NYC NYS DOH Prevention Agenda 2019-2024 302 Communities 153 Health of Older Adults in NYC Report Summary 306 Data Review 154 Community Health Needs Assessment Survey Demographics 310 Assessing the Health of the Westchester County 187 Focus Group Guide 313 Data Review 188 2 NYP Community Health Needs Questionnaire 317 Executive Summary NYP and NYPH NewYork-Presbyterian Hospital (NYPH) is ranked #1 in New York and #5 in the nation in U.S. News & World Report’s “Best Hospitals” survey. NYPH is the nation’s only hospital affiliated with two world-class medical schools, Weill Cornell Medicine and Columbia University Vagelos College of Physicians and Surgeons. Its 47,000 employees and affiliated physicians are dedicated to providing the highest quality, most compassionate care to New Yorkers and patients from across the country and around the world. NYPH provides more than $1 billion in benefits every year to the community. NewYork-Presbyterian Hospital is comprised of seven campuses located mainly within New York City. NYPH is part of NewYork-Presbyterian (NYP), one of the nation’s most comprehensive and integrated academic healthcare delivery systems. Founded nearly 250 years ago with the fundamental belief that every person deserves access to the very best care, NYP now includes NYPH with its seven campuses, the three Regional Hospitals consisting of NewYork-Presbyterian Queens, NewYork-Presbyterian Brooklyn Methodist Hospital, and NewYork-Presbyterian Hudson Valley Hospital, as well as more than 200 primary and specialty care clinics and medical groups, and an array of telemedicine services. NYPH and each of the Regional Hospitals conduct their own community health needs assessment and develop independent community service plans. 4 NewYork-Presbyterian Hospital CHNA Executive Summary Purpose: NewYork-Presbyterian (NYP) is deeply committed to the communities residing in the boroughs of New York City, Westchester County, and the surrounding areas. NYP delivers a range of innovative programs and services intended to educate and provide resources to prevent illness, maintain health, and improve the overall well-being of the community. NewYork-Presbyterian Hospital (NYPH) has completed this Community Health Needs Assessment (CHNA) in order to update its understanding of the needs of local community members and the conditions that influence their well-being, and to assemble a three-year plan to enhance community health in areas identified as high disparity neighborhoods. Governance and Engagement: The Division of Community & Population Health and the Office of Government & Community Relations partnered to develop an enterprise-wide CHNA process to promote community awareness and hospital alignment in order to maximize the impact to those who need it most. A Steering Committee comprised of NYP leadership, which included representation from NYPH, and campus leadership was key to providing insight, guidance, and making decisions that impacted the completion of the CHNA. 5 NewYork-Presbyterian Hospital CHNA Executive Summary Process: NYPH obtained broad community input regarding local health needs 2019 – 2021 Community Focus & Planning including the needs of medically underserved and low-income populations. Data collection included quantitative data for demographics, socioeconomic status, health, and social determinants as well as qualitative data from community questionnaires and focus groups which were analyzed to identify high disparity communities and a prioritization process ensuring integration with the Priority Areas of the 2019-2024 NYS Prevention Agenda. Premier, Inc. was engaged to partner with the NYPH team to complete the CHNA utilizing a transparent and collaborative manner. New York Prevention Agenda 2019-2024: Vision: New York is the Healthiest State for People of all Ages Priority Areas: 1. Prevent Chronic Diseases 2. Promote a Healthy and Safe Environment 3. Promote Healthy Women, Infants and Children 4. Promote Well-being and Prevent Mental and Substance Use Disorders 5. Prevent Communicable Diseases 6 NewYork-Presbyterian Hospital CHNA Executive Summary Prioritization Method: Socioeconomic Factors Premier, Inc. customized a prioritization model that utilized an approach inclusive of the Hanlon Method technique to quantify and compare indicators and identify significant community needs. The top quartile high disparity neighborhood data sets inclusive of social determinants of health, health outcomes, access, and utilization were Physical Environment analyzed to ensure a dynamic model for NYP. The model also included qualitative data sets to allow the voice of the community to play into the top priorities. Representatives from NYPH hospitals, NYP, Community Advisory Boards, and clinical and operational leadership participated throughout Health Behaviors the process. Community Health Think Tanks provided opportunities for participants to review summaries of quantitative and qualitative data in order to rank the top health issues. This process allowed the team to receive input as well as ensure complete understanding of the process and intent of the CHNA. Healthcare Access & Outcomes 7 NewYork-Presbyterian Hospital CHNA Executive Summary Prioritized Indicators: High Disparity Communities: The prioritization method allowed the NYPH team to narrow a vast An analysis of community health need and risk of high resource utilization amount of quantitative and qualitative data sets and define the highest was undertaken. High NYC disparity communities were identified by disparity community and health indicators impacting that community. calculating a need score consisting of a composite of 29 indicators, The top ten (10) indicators include: carefully selected, across five domains: demographics, income, insurance, access to care and New York State Department of Health Prevention Agenda Priorities. For geographies outside NYC, a ZIP code 1. Binge Drinking level Community Need Index was utilized. 2. Cancer Incidence - Lung Details of disparity and neighborhood are included in the complete CHNA. 3. Hospitalizations: Drug This analysis will be used within the prioritization model to strategically 4. Cancer Incidence - Prostate place initiatives to maximize community impact. 5. Diabetes Overall the higher disparity quartiles are illustrated below in red and orange. 6. HIV Non-NYC NYC 7. Physical Activity Counties 8. % of adults taking high blood pressure medication 9. Psychiatry 10. Cancer Incidence - All Sites 8 NewYork-Presbyterian Hospital Defined Community at a Glance Copyright © 2019 by Environics Analytics (EA). Source: ©Claritas, LLC 2019. The index is a measure of how similar or different the defined area is from the benchmark. Benchmark is New York State. 9 NewYork-Presbyterian Hospital – A Diverse Geography The NYPH community is diverse in its geography with the NYC NTAs At the same time NYPH must also serve a county population that is older, having a younger, more minority, but economically challenged less minority, less economically challenged and more likely to speak only population. The SDoH concerns are concentrated upon language, English, but that still has similar SDoH concerns such as food insecurity safety, food insecurity, high cost of housing and public transportation. and cost of living. There is still variance among counties for behavioral risk Behavioral risk factors such as smoking, drinking and consuming factors and health status that range from favorable to unfavorable. fruits and vegetables vary among the NTAs but are problematic for Complicating access to health care in the five counties can be the fewer those in high-disparity neighborhoods. number of physical health care locations than are currently available in NYC. New York City NTAs North-NYC Counties 4.8M YOUNGER ON 26.8% DID NOT 3.4M OLDER ON 10.7% DID NOT PEOPLE AVERAGE COMPLETE HIGH PEOPLE AVERAGE COMPLETE HIGH SCHOOL SCHOOL There are more than Is slightly older, 17.1% of There are more than NYS The high disparity NYC The five counties cover a Is slightly younger on NYC average of foreign the population is 65+, average of persons that community covers a geography of average, 11.2% of the born, non-English compared to NYC, 12.5% speak only English at geography of approximately 3.4M population is 65+, speaking, not and NYS 16.3% home and that graduated approximately 4.8M people compared to NYC, graduated from high from high school, but less people 12.5% school and unemployed unemployed 15.9% 26.4% 85.5% MINORITY 89.5% 6.2% FAMILIES BELOW 41.4% MINORITY UNINSURED LIVING IN POPULATION INSURED FEDERAL POVERTY POPULATION
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