Jackson Park Hospital Community Health Needs Assessment (CHNA) March 2018 – Data and Community Input Report Table of Contents I. Introduction 3 A. Overview of Jackson Park Hospital 3 B. Defining Community for the CHNA 3 C. Community Health Needs Assessment Methods/Process 6 II. Health Status in the Community – Health Indicator Data 7 A. Social, Economic, and Structural Determinants of Health 7 B. Behavioral Health – Mental Health and Substance Use 19 C. Chronic Disease 24 D. Access to Care 39 III. Health Status in the Community – Community & Stakeholder Input 46 A. Community Focus Groups 46 B. Key Informant Interviews 49 IV. Health Status in the Community – Maps of Community Resources 51 V. Summary of Jackson Park Hospital’s Community Health 60 Implementation Activities – 2015-2018 A. Senior Healthcare Program 60 B. Community Partnerships and Outreach 61 C. Outpatient Services 62 D. In Development – Substance Abuse Program 63 Appendix A. Written Comments from Focus Group Participants 63 Appendix B. Focus Group Questions 64 2 I. Introduction A. Overview of Jackson Park Hospital Jackson Park Hospital & Medical Center is a 256-bed short-term comprehensive acute care facility serving the south side of Chicago for nearly 100 years. The hospital offers full medical, surgical, obstetric, psychiatric, and medical stabilization (detox) services as well as medical sub-specialties including cardiology, pulmonary, gastrointestinal disease, renal, orthopedics, ENT, ophthalmology, infectious disease, HIV, hematology/oncology and geriatrics. Quality ambulatory care is provided onsite through the family medicine center and senior health center. The hospital also provides medical education and training through its family medicine residency program and several affiliated medical schools. Approximately 80 percent of the hospital's patients are covered by Medicare and Medicaid. Jackson Park Hospital’s mission is to provide compassionate and high quality healthcare service to meet the needs of the patients and communities we serve. We believe that all human beings possess intrinsic value. We will strive to ensure: (a) our operations will be patient-centered; (b) all patients will be treated with dignity and respect; (c) patients' rights will be honored. We will serve anyone in need of healthcare regardless of race, color, religion, gender, national origin, disability, age, or ability to pay. We believe in high levels of ethical and professional conduct. We believe in operating in an efficient and effective manner in order to thrive as a viable community healthcare provider. B. Defining Community for the Community Health Needs Assessment (CHNA) Jackson Park Hospital’s primary service area encompasses nine zip codes corresponding to 20 community areas in the City of Chicago.1 Figure 1 is a map of the hospital’s service area and list of communities in the service area. The total population in these zip codes is 481,995; nearly a quarter (23.8%) of the residents are under 18, while 14.8% are over the age of 65. 1 83.7% of the population is Black, 11.3% is White, and 1.3% is Asian, with a small percentage identifying with other racial groups, and 8.4% of the population identifies as Hispanic/Latino. 1 In the communities that make up Jackson Park Hospital’s service area, life expectancy ranges from 68 to 81 years of age, with almost all of the community areas having a life expectancy lower than the Chicago average of 77 years of age (Figure 2 and 3). The leading causes of death in these communities are heart disease and cancer. 1 American Community Survey, 2010-2014 3 Figure 1. Jackson Park Hospital Service Area Map and List of Community Areas Jackson Park Hospital’s service area covers nine zip codes corresponding to 20 community areas in Chicago. The communities in Jackson Park Hospital’s service area are: South Shore, Greater Grand Crossing, Chatham, Burnside, Avalon Park, Washington Park, Hyde Park, Woodlawn, Calumet Heights, South Chicago, South Deering, East Side, Washington Heights, Auburn Gresham, Roseland, West Pullman, Pullman, Riverdale, Englewood, and West Englewood. 60649 Zip Codes and Community Areas in Jackson Park Hospital’s Service Area Zip Code Community Areas 60649 South Shore 60619 Greater Grand Crossing, Chatham, Burnside, Avalon Park 60615 Hyde Park 60637 Washington Park, Hyde Park, Woodlawn 60617 Calumet Heights, South Chicago, South Deering, East Side 60620 Washington Heights, Auburn Gresham 60628 Roseland, West Pullman, Pullman, Riverdale 60621 Englewood 60636 West Englewood 4 Figures 2 and 3. Life Expectancy, 2015 81 78 77 75 75 74 74 72 72 72 72 72 73 73 73 71 71 69 70 70 68 Data Source: Illinois Department of Public Health, Death Certificate, US Census. Two-year estimates. 5 C. Community Health Needs Assessment Methods/Process Jackson Park Hospital worked with the Illinois Public Health Institute (IPHI) to conduct this Community Health Needs Assessment (CHNA), using community health status data from approximately 20 publicly available sources that are accessible through the Chicago Health Atlas and Community Commons websites. IPHI also conducted two focus groups with community residents in March 2018 and three key informant interviews with staff leaders from Jackson Park Hospital. Jackson Park Hospital wrote up a summary of implementation activities completed since the 2015 CHNA. This CHNA was conducted to meet federal requirements and guidelines, including: clearly defining a community served by the hospital, and ensuring that defined community does not exclude low-income or vulnerable communities in proximity to the hospital; a clear description of the CHNA process and methods; community health needs; collaboration, including with public health experts; and a description of existing facilities and resources in the community; input from persons representing the broad needs of the community; opportunity for community comment on the CHNA and health needs in the community; posting the CHNA and making it available to the public; And, Jackson Park Hospital will adopt and submit an implementation strategy to the IRS within four-and-a-half months of posting this CHNA. 6 II. Health Status in the Community – Health Indicator Data A.Social, Economic, and Structural Determinants of Health Figures 4 and 5. Poverty: Percentage of households living below the poverty threshold, 2015 57% 45% 46% 34% 34% 34% 36% 36% 31% 26% 27% 28% 29% 24% 24% 19% 21% 21% 15% 18% 12% Data Source: US Census Bureau: American Community Survey. Five-year estimates. Household poverty rates range from 11.5% to 56.6% of households in the community areas served by Jackson Park Hospital, with the majority of community areas experiencing higher household poverty rates than the Chicago average of 18.9%. 7 Figures 6 and 7. Childhood Poverty: Percentage of children (under 18 years old) living below the poverty threshold, 2015 73% 55% 57% 57% 58% 50% 50% 53% 53% 42% 42% 45% 36% 37% 39% 39% 31% 24% 27% 20% 13% Data Source: U.S. Census Bureau: American Community Survey. Five-year estimates for community areas, one-year estimate for Chicago. Child poverty rates range from 13.1% to 73.3% in the community areas served by Jackson Park Hospital, with the majority of community areas experiencing higher child poverty rates than the Chicago average of 31.4%. 8 Figures 8 and 9. Unemployment: Percentage of adults aged 16 years and over in the civilian labor force who were unemployed, 2015 Riverdale 40.8% Englewood 36.0% West Englewood 34.8% Washington Park 31.8% Auburn Gresham 26.0% Roseland 25.3% South Deering 25.3% Greater Grand Crossing 24.9% West Pullman 24.8% Woodlawn 22.4% South Shore 22.4% Avalon Park 22.3% South Chicago 21.8% Burnside 21.5% Chatham 20.3% Washington Heights 19.7% Pullman 19.4% East Side 17.0% Calumet Heights 16.9% Chicago 9.5% Hyde Park 7.9% Data Source: Illinois Department of Public Health, Vital Statistics; US Census Bureau. Five-year estimates for community areas, one-year estimate for Chicago. The community areas in Jackson Park Hospital’s service area experience high rates of unemployment. Riverdale has the highest rate of unemployment(40.8%), while all community areas (except Hyde Park) have unemployment rates above the Chicago average of 9.5%. 9 Figure 10. Educational Attainment: Percentage of adults aged 25 years and older without a high school diploma or equivalency, 2015 East Side 29.8% Englewood 25.7% Riverdale 25.5% West Englewood 23.8% South Chicago 22.9% Burnside 21.3% South Deering 21.2% Washington Park 19.3% Auburn Gresham 17.5% Woodlawn 16.4% West Pullman 16.3% Chicago 15.9% Roseland 15.8% Greater Grand Crossing 14.9% Chatham 13.6% South Shore 13.4% Pullman 12.6% Calumet Heights 11.5% Avalon Park 11.5% Washington Heights 10.7% Hyde Park 3.3% Data Source: U.S. Census Bureau: American Community Survey. Five-year estimates for community areas, one-year estimate for Chicago. The number of adults without a high school diploma in these community areas ranges from nearly double the Chicago average percentage (East Side, 29.8%) to only 3.3% in Hyde Park. 10 Figure 11. Disability: Percentage of people with limitations in functioning (vision, hearing, mobility, and cognitive functioning) and self-care, 2015 Burnside 23.4% Calumet Heights 22.0% Chatham 18.0% West Englewood 17.6% Roseland 17.5% Avalon Park 16.8% Auburn Gresham 16.4% Washington Heights 16.3% South Chicago 15.9% Pullman 15.8% Englewood 15.7% Greater Grand Crossing 15.6% West Pullman 15.4% South Shore 15.2% South Deering 15.1% Woodlawn 15.1% Washington Park 15.0% East Side 10.6% Chicago 10.3% Riverdale 9.2% Hyde Park 9.1% Data Source: US Census Bureau: American Community Survey. Five-year estimates for community areas, one-year estimate for Chicago.