TABLE OF CONTENTS EXECUTIVE SUMMARY ............................................................................................................ 1 Introduction ................................................................................................................................. 1 Patient Care.............................................................................................................................. 1 Research ................................................................................................................................... 2 Education ................................................................................................................................. 3 Community Definition ................................................................................................................ 4 Significant Community Health Needs......................................................................................... 5 OBJECTIVES AND METHODOLOGY ....................................................................................... 7 Regulatory Requirements ............................................................................................................ 7 Methodology ............................................................................................................................... 8 Collaborating Organizations .................................................................................................... 8 Data Sources ............................................................................................................................ 9 Information Gaps ..................................................................................................................... 9 DATA AND ANALYSIS ............................................................................................................. 10 Definition of Community Assessed .......................................................................................... 10 Secondary Data Summary ......................................................................................................... 15 Demographics ........................................................................................................................ 15 Economic Indicators .............................................................................................................. 16 Health Status and Access Indicators ...................................................................................... 17 Ambulatory Care Sensitive Conditions ................................................................................. 21 Community Need Index......................................................................................................... 22 Food Deserts .......................................................................................................................... 23 Medically Underserved Areas and Populations ..................................................................... 23 Health Professional Shortage Areas ...................................................................................... 24 Relevant Findings of Other CHNAs ...................................................................................... 24 Primary Data Summary ............................................................................................................. 25 SIGNIFICANT COMMUNITY HEALTH NEEDS .................................................................... 28 Prioritization Process................................................................................................................. 28 Access to Affordable Health Care ......................................................................................... 28 Chronic Diseases and Other Health Conditions .................................................................... 28 Economic Development and Community Conditions ........................................................... 31 Health Professions Education and Research ......................................................................... 31 Healthcare for the Elderly ...................................................................................................... 32 Wellness................................................................................................................................. 33 OTHER FACILITIES AND RESOURCES IN THE COMMUNITY ......................................... 34 Federally Qualified Health Centers ....................................................................................... 34 Hospitals ................................................................................................................................ 34 Other Community Resources................................................................................................. 35 APPENDIX A – CONSULTANT QUALIFICATIONS .............................................................. 36 APPENDIX B – LOCAL NEIGHBORHOODS COMMUNITY SECONDARY DATA ASSESSMENT ............................................................................................................................. 37 Community Assessed ................................................................................................................ 37 Demographics............................................................................................................................ 37 Economic indicators .................................................................................................................. 42 People in Poverty ................................................................................................................... 42 Eligibility for the National School Lunch Program............................................................... 45 Unemployment ...................................................................................................................... 46 Insurance Status ..................................................................................................................... 47 Ohio Medicaid Expansion ..................................................................................................... 48 Crime ..................................................................................................................................... 49 Health Status and Access Indicators ......................................................................................... 49 County Health Rankings ........................................................................................................ 49 Community Health Status Indicators ..................................................................................... 54 Ohio Department of Health ................................................................................................... 56 Behavioral Risk Factor Surveillance System ........................................................................ 60 Ambulatory Care Sensitive Conditions ..................................................................................... 62 Community Need IndexTM and Food Deserts ........................................................................... 65 Dignity Health Community Need Index ................................................................................ 65 Food Deserts .......................................................................................................................... 67 Medically Underserved Areas and Populations ........................................................................ 69 Health Professional Shortage Areas .......................................................................................... 70 Findings of Other Community Health Needs Assessments ...................................................... 73 APPENDIX C – 7-COUNTY COMMUNITY SECONDARY DATA ASSESSMENT ............. 75 Community Assessed ................................................................................................................ 75 Demographics............................................................................................................................ 75 Economic indicators .................................................................................................................. 81 People in Poverty ................................................................................................................... 81 Unemployment ...................................................................................................................... 83 Insurance Status ..................................................................................................................... 84 Crime ..................................................................................................................................... 84 Health Status and Access Indicators ......................................................................................... 85 County Health Rankings ........................................................................................................ 85 Community Health Status Indicators ..................................................................................... 90 Ohio Department of Health ................................................................................................... 92 Behavioral Risk Factor Surveillance System .......................................................................