Straub Medical Center Community Health Needs Assessment — March 2016 — Produced by Table of Contents Executive Summary ............................................................................................... vi Introduction ....................................................................................................... vi Summary of Findings ......................................................................................... vi Selected Priority Areas .................................................................................... viii 1 Introduction ...................................................................................................... 1 1.1 Summary of CHNA Report Objectives and Context ...................................... 1 1.2 About the Hospital ....................................................................................... 1 1.2.1 Definition of Community + Map ........................................................... 2 1.2.2 Hawai‘i Pacific Health .......................................................................... 2 1.3 Healthcare Association of Hawaii ............................................................... 2 1.3.1 Member Hospitals................................................................................. 3 1.4 Advisory Committee ................................................................................... 3 1.5 Consultants ................................................................................................. 4 1.5.1 Healthy Communities Institute ............................................................. 4 1.5.2 Storyline Consulting .............................................................................. 5 2 Selected Priority Areas ..................................................................................... 6 3 Evaluation of Progress since Prior CHNA .......................................................... 7 3.1 Impact since Prior CHNA ............................................................................. 7 3.2 Community Feedback on Prior CHNA or Implementation Strategy ........... 11 4 Methods .......................................................................................................... 12 4.1 Quantitative Data Sources and Analysis..................................................... 12 4.1.1 Race/Ethnicity Disparities ................................................................... 12 4.1.2 Preventable Hospitalization Rates ....................................................... 13 4.1.3 Shortage Area Maps ............................................................................ 13 4.1.4 External Data Reports ......................................................................... 13 4.2 Qualitative Data Collection and Analysis ................................................... 13 4.3 Prioritization ............................................................................................ 14 4.4 Data Considerations .................................................................................. 15 5 Demographics ................................................................................................. 16 5.1 Population ................................................................................................. 16 5.1.1 Age ....................................................................................................... 16 5.1.2 Racial/Ethnic Diversity ........................................................................ 17 5.2 Social and Economic Determinants of Health ........................................... 19 5.2.1 Income ................................................................................................ 19 5.2.2 Poverty ................................................................................................ 19 5.2.3 Education ........................................................................................... 20 5.2.4 SocioNeeds Index® ............................................................................. 20 6 Findings .......................................................................................................... 22 Note to the Reader ............................................................................................. 25 6.1 Access to Care ............................................................................................ 27 i 6.1.1 Access to Health Services ..................................................................... 27 6.1.2 Mental Health ..................................................................................... 29 6.1.3 Oral Health .......................................................................................... 31 6.1.4 Economy ............................................................................................. 32 6.2 Chronic Diseases ....................................................................................... 33 6.2.1 Exercise, Nutrition & Weight ............................................................... 33 6.2.2 Diabetes ............................................................................................. 34 6.2.3 Heart Disease & Stroke ...................................................................... 36 6.2.4 Renal Disease ...................................................................................... 37 6.2.5 Cancer ................................................................................................ 38 6.3 Environmental Health & Respiratory Diseases ......................................... 39 6.3.1 Environment ...................................................................................... 39 6.3.2 Respiratory Diseases .......................................................................... 39 6.4 Mental Health & Health Risk Behaviors .................................................... 41 6.4.1 Mental Health & Mental Disorders ...................................................... 41 6.4.2 Substance Abuse ................................................................................ 42 6.4.3 Wellness & Lifestyle ............................................................................ 45 6.4.4 Prevention & Safety ............................................................................ 45 6.4.5 Immunizations & Infectious Diseases ................................................ 46 6.5 Women’s, Infant & Reproductive Health ................................................... 47 6.5.1 Maternal, Fetal & Infant Health ........................................................... 47 6.5.2 Family Planning ................................................................................. 48 6.5.3 Women’s Health ................................................................................. 48 7 A Closer Look at Highly Impacted Populations ............................................... 49 7.1 Children, Teens and Adolescents .............................................................. 49 7.1.1 Access to Care ..................................................................................... 49 7.1.2 Chronic Health Issues ......................................................................... 50 7.1.3 Health Education ................................................................................ 50 7.1.4 Mental Health ..................................................................................... 50 7.1.5 Mortality ............................................................................................. 50 7.1.6 Nutrition and Physical Activity ............................................................ 51 7.1.7 Oral Health .......................................................................................... 51 7.1.8 Substance Abuse and Substance-Free Environments .......................... 51 7.1.9 Teen Sexual Health .............................................................................. 51 7.2 Older Adults .............................................................................................. 52 7.2.1 Access to Care ...................................................................................... 52 7.2.2 Chronic Diseases ................................................................................. 52 7.3 Low-Income Population ............................................................................ 53 7.4 Rural Communities ................................................................................... 53 7.5 People with Disabilities ............................................................................. 53 7.6 Homeless Population................................................................................. 55 7.7 People from Micronesian Regions ............................................................. 56 7.8 Disparities by Race/Ethnic Groups ............................................................ 56 8 Conclusion ...................................................................................................... 59 ii iii Tables Table 5.1: Population Density and Change ...............................................................................16 Table 5.2: Zip Codes with Highest Socioeconomic Need ..........................................................21 Table 6.1: Secondary Data Scoring for Health Topic Areas.......................................................24 Table 6.2: Secondary Data Scoring for Quality of Life Topic Areas ...........................................24 Table 6.3: Providers per 100,000