2018 Cuyahoga County Community Health Assessment/Chna
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2018 Cuyahoga County Community HealthAssessment A Community Health Needs Assessment The Center for Health Affairs 2018 CUYAHOGA COUNTY COMMUNITY HEALTH ASSESSMENT/CHNA 2018 Cuyahoga County Community Health Assessment A Community Health Needs Assessment Acknowledgements The 2018 Cuyahoga County Community Health Assessment represents an exciting collaboration between Case Western Reserve University School of Medicine, the Cleveland Department of Public Health, the Cuyahoga County Board of Health, the Health Improvement Partnership‐Cuyahoga, The Center for Health Affairs, and University Hospitals to conduct a joint assessment of the health of the Cuyahoga County community. Additional organizations provided input that guided the content and format of this assessment. These organizations include: the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County, Asian Services In Action, Inc., Better Health Partnership, The Center for Community Solutions, Cleveland Clinic, the Cleveland Foundation, Cypress Research Group, the Health Policy Institute of Ohio, ideastream, MetroHealth, the Ohio Department of Health, Southwest General Health Center, St. Vincent Charity Medical Center and United Way of Greater Cleveland. Key Authors/Contributors Brian Adams, University Hospitals Bedford/Richmond Medical Centers Terry Allan, Cuyahoga County Board of Health Chesley Cheatham, University Hospitals Cleveland Medical Center Patricia Cirillo, PhD, Cypress Research Group Karen Cook, MetroHealth Kirstin Craciun, The Center for Health Affairs Lorice Dakdduk, University Hospitals Beachwood Rehabilitation Hospital Kevin Edwards, MD, University Hospitals and Case Western Reserve University Michele Fancher, The Center for Health Affairs Elizabeth Fiordalis, Cleveland Clinic Paul Forthofer, University Hospitals St. John Medical Center Merle Gordon, Cleveland Department of Public Health Heidi Gullett, MD, MPH, Case Western Reserve University School of Medicine Martha Halko, Cuyahoga County Board of Health Rita Horwitz, Better Health Partnership Becky Karns, Cuyahoga County Board of Health Chris Kippes, Cuyahoga County Board of Health LouAnn Marx, University Hospitals Ahuja Medical Center Adam Nation, Cleveland Department of Public Health Danielle Price, University Hospitals Bartlomiej Rog, MD, MPH, University Hospitals and Case Western Reserve University Maryann Salib, DO, MPH, University Hospitals and Case Western Reserve University Nichelle Shaw, Cuyahoga County Board of Health Kurt Stange, MD, PhD, Case Western Reserve University School of Medicine Ann Stahlheber, Cuyahoga County Board of Health 1 CUYAHOGA COUNTY COMMUNITY HEALTH ASSESSMENT/CHNA 2018 Robyn Strosaker, MD, FAAP, University Hospitals Cleveland Medical Center Mary Beth Talerico, University Hospitals Parma Medical Center Bob Waitkus, Cleveland Clinic Kathryn Wesolowski, University Hospitals Rainbow Babies & Children’s Hospital Suggested report citation: 2018 Cuyahoga County Community Health Assessment / 2018 Community Health Needs Assessment Adopted by University Hospitals on September 27, 2018. Electronic Access This publication can be accessed electronically at http://hipcuyahoga.org/2018cha/ or http://clevelandhealth.org/network/health/cleveland_health_statistics.php or http://www.uhhospitals.org/about/community‐benefit/community‐health‐needs‐assessment. We welcome comments and feedback on ways to improve this document in future editions. We can be reached at 216‐309‐ CHIP(2447) or [email protected] Written Comments University Hospitals solicited feedback on its 2015 Community Health Needs Assessments (CHNAs), which are posted on its website, but did not receive any comments. Individuals are encouraged to submit written comments on the current joint Community Health Needs Assessment (CHNA) to [email protected]. These comments provide additional information to hospital facilities regarding the broad interests of the community and help to inform future CHNAs and implementation strategies. 2 2018 CUYAHOGA COUNTY COMMUNITY HEALTH ASSESSMENT/CHNA Table of Contents: 2018 Cuyahoga County Community Health Assessment Acknowledgements .....................................................................................................................1 Table of Contents ........................................................................................................................3 1. Introduction .............................................................................................................................6 2. Executive Summary .................................................................................................................9 3. Process and Methods ..............................................................................................................15 4. Overview of Community Stakeholder Input ..........................................................................18 5. County Profile: Key Indicators ...............................................................................................25 A. Demographic Characteristics ................................................................................................26 B. Hospital Patients Served. 29 Hospital Discharges...……………………………………………………………………………………….……………………..29 Hospitalization Levels, Trends………………………………………………………………………………………………...30 Primary and Secondary Diagnoses, All Ages…….……………………………………………………………………..36 Primary and Secondary Diagnoses, Under 18 Only………………………………………………………………….54 C. Socioeconomic Indicators .....................................................................................................58 Unemployment ............................................................................................................................ 60 Uninsured ..................................................................................................................................... 63 Average Life Expectancy .............................................................................................................. 66 Residents Below Poverty Level .................................................................................................... 68 High School Diploma .................................................................................................................... 71 D. Health Resource Availability .................................................................................................73 Ambulatory Care Sensitive Discharges . .. .75 Preventable Hospitals Stays Indicators ........................................................................................ 81 Licensed Primary Care Physicians ................................................................................................ 82 Federally Qualified Health Centers and Medically Underserved Areas ....................................... 83 E. Quality of Life .......................................................................................................................85 Food Desert Areas ........................................................................................................................ 87 Homicide Rate .............................................................................................................................. 90 Recreational Facilities Rate .......................................................................................................... 94 F. Behavioral Risk Factors ..........................................................................................................95 Obesity ......................................................................................................................................... 97 Tobacco Use ................................................................................................................................. 100 Fruit and Vegetable Consumption ............................................................................................... 103 Illegal Drug Use ............................................................................................................................ 106 Physical Activity ........................................................................................................................... 107 G. Environmental Health Indicators ..........................................................................................110 3 CUYAHOGA COUNTY COMMUNITY HEALTH ASSESSMENT/CHNA 2018 Childhood Lead Poisoning ............................................................................................................ 112 EPA Air Quality Standards ............................................................................................................ 113 Unhealthy Air Quality .................................................................................................................. 114 Houses Built Prior to 1950 ........................................................................................................... 117 Foodborne Disease ...................................................................................................................... 118 H. Social and Mental Health ......................................................................................................120 Child Abuse .................................................................................................................................. 122 Violent Crime ..............................................................................................................................