AN EQUITABLE, HEALTHY AND SAFE DALLAS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT 2016 Dallas County Community Health Needs Assessment 1 | P a g e CREDITS This report would not have been possible without the support of many organizations and individuals throughout the Dallas area. Dallas County Health and Human Services and Parkland Health & Hospital System provided leadership throughout the process, most especially Sue Pickens, Gail Seaman, Chris Nwoko, Brad Walsh, Greg Eastin and Zach Thompson. The organizations that participated on the Community Health Needs Assessment PHI Workgroup for Dallas County included: Adapt Community Solutions Dallas-Fort Worth Hospital Council North Dallas Shared Ministries Dallas-Fort Worth Hospital Council AIDS Arms North Texas Food Bank Education and Research Foundation American Heart Association Dallas Independent School District Presbyterian Hospital Dallas Women’s Foundation Serve West Dallas Baylor Scott & White Health Desoto Independent School District Smiley Dentistry DFW Area Health Education Center Southern Methodist University Center buildingcommunityWORKSHOP (AHEC) for Research and Evaluation Children’s Health (including the Texas Department of State Health Health & Wellness Alliance for Environmental Protection Agency Services Children & Charting the Course) Texas HHSC – Center for Elimination of City of Dallas Housing Federal Reserve Bank of Dallas Disproportionality and Disparities City of Dallas WIC Program Foremost Family Health Centers Texas Health Resources City of Garland Health Department Green Oaks Texas Hunger Initiative CitySquare Hatcher Station COPC Advisory Board Texas Scottish Rite Hospital The Diabetes Health and Wellness CNM Connect Hispanic Chamber of Commerce Institute at Juanita J Craft Recreation Center Injury Prevention Center of Greater Community Council of Greater Dallas United Way of Metropolitan Dallas Dallas Commit2 Los Barrios Unidos Community Clinic University of North Texas University of Texas – Southwestern Dallas County Criminal Justice Methodist Dallas Medical Center Medical Center and University Hospital Dallas County Health & Human University of Texas at Dallas, Institute MetroCare Services for Population Research Urban Communities (formerly Urban Dallas County Medical Society Mission East FQHC League) Dallas County Sheriff’s Department National Kidney Foundation YMCA of Metropolitan Dallas Research and Project Management provided by Dallas County Community Health Needs Assessment 2 | P a g e TABLE OF CONTENTS Credits ................................................................................................................................................ 2 Table of Figures ...................................................................................................................................... 6 Table of Tables ........................................................................................................................................ 8 Executive Summary ............................................................................................................................ 9 Background ..................................................................................................................................... 9 Vision .............................................................................................................................................. 9 Top Five Health Issues ................................................................................................................... 10 Call to Action: Goals and Strategies .............................................................................................. 10 Introduction ...................................................................................................................................... 12 Methodology .................................................................................................................................... 13 Partnership Development ................................................................................................................. 14 Dallas County and Its Communities ................................................................................................... 14 Visioning Sessions ............................................................................................................................. 16 Community Strengths and Themes Assessment ............................................................................... 18 Who is the Leader? ........................................................................................................................ 18 Priority Health Issues ..................................................................................................................... 18 Strengths ...................................................................................................................................... 18 Weaknesses .................................................................................................................................. 19 Barriers .......................................................................................................................................... 19 Unmet Needs ................................................................................................................................ 20 Leadership .................................................................................................................................... 20 Innovative Approaches .................................................................................................................. 21 Community Health Status ................................................................................................................. 21 Immunizations .............................................................................................................................. 39 Communicable Diseases................................................................................................................ 44 Asthma and Respiratory Diseases ................................................................................................. 48 Cancer ........................................................................................................................................... 49 Diabetes ........................................................................................................................................ 53 Heart Disease and Stroke .............................................................................................................. 55 Preventable Hospitalizations ......................................................................................................... 57 Dallas County Community Health Needs Assessment 3 | P a g e Maternal-Fetal Health ................................................................................................................... 58 Behavioral Health – Mental Health and Substance Use Disorders ................................................. 65 Violence and Injuries ..................................................................................................................... 66 Environmental Health Factors ....................................................................................................... 68 Public Health System Assessment .................................................................................................... 69 Comparison to Peer Counties ........................................................................................................ 70 Forces of Change .............................................................................................................................. 72 Healthcare Coverage ..................................................................................................................... 73 Poverty .......................................................................................................................................... 75 Economic Development in Traditionally Poverty-Stricken Communities ...................................... 76 1115 Waiver .................................................................................................................................... 77 Behavioral Health System Changes ................................................................................................ 77 Strategic Issues: Top 5 Health Issues Impacting Dallas County Residents ............................................. 78 Behavioral Health .............................................................................................................................. 78 Why Behavioral Health? ................................................................................................................ 79 Health Access .................................................................................................................................... 80 Why Health Access? ...................................................................................................................... 80 Older Adults and Aging Population ................................................................................................... 81 Why Older Adults and Aging Population? ...................................................................................... 81 Community Coordination and Care Partners ....................................................................................