Hawaii County Community Health Needs Assessment — November 2015 — 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 1.1.1 Healthcare Association of Hawaii ........................................................... 1 1.1.2 Member Hospitals ................................................................................. 1 1.1.3 Advisory Committee ............................................................................... 1 1.1.4 Consultants ........................................................................................... 3 1.2 About the Hospital ...................................................................................... 4 1.2.1 Hospital Community Benefit Team and Goals ....................................... 4 1.2.2 Definition of Community + Map ........................................................... 4 2 Selected Priority Areas ...................................................................................... 5 3 Evaluation of Progress since Prior CHNA ......................................................... 6 3.1 Impact since Prior CHNA ............................................................................ 6 3.2 Community Feedback on Prior CHNA or Implementation Strategy ............ 6 4 Methods ............................................................................................................ 7 4.1 Quantitative Data Sources and Analysis ....................................................... 7 4.1.1 Race/Ethnicity Disparities .................................................................... 8 4.1.2 Preventable Hospitalization Rates ........................................................ 8 4.1.3 Shortage Area Maps ............................................................................. 8 4.1.4 External Data Reports .......................................................................... 8 4.2 Qualitative Data Collection and Analysis .................................................... 8 4.3 Prioritization ............................................................................................. 9 4.4 Data Considerations ................................................................................... 9 5 Demographics ................................................................................................. 11 5.1 Population ................................................................................................. 11 5.1.1 Age ....................................................................................................... 11 5.1.2 Racial/Ethnic Diversity ........................................................................ 12 5.2 Social and Economic Determinants of Health ........................................... 14 5.2.1 Income ................................................................................................ 14 5.2.2 Poverty ................................................................................................ 14 5.2.3 Education ............................................................................................ 14 5.2.4 SocioNeeds Index® .............................................................................. 15 6 Findings .......................................................................................................... 16 Note to the Reader ............................................................................................. 19 6.1 Access to Care ............................................................................................ 21 6.1.1 Access to Health Services ..................................................................... 21 6.1.2 Mental Health ...................................................................................... 23 i 6.1.3 Oral Health ......................................................................................... 24 6.1.4 Economy ............................................................................................. 25 6.1.5 Transportation .................................................................................... 25 6.2 Chronic Diseases ....................................................................................... 27 6.2.1 Exercise, Nutrition & Weight ............................................................... 27 6.2.2 Diabetes and Kidney Disease ............................................................. 28 6.2.3 Heart Disease & Stroke ...................................................................... 29 6.2.4 Arthritis ............................................................................................. 30 6.2.5 Cancer ................................................................................................ 30 6.3 Environmental Health & Respiratory Diseases .......................................... 32 6.3.1 Environment ....................................................................................... 32 6.3.2 Respiratory Diseases ........................................................................... 32 6.4 Mental Health & Health Risk Behaviors ................................................... 34 6.4.1 Mental Health & Mental Disorders ..................................................... 34 6.4.2 Substance Abuse ................................................................................. 35 6.4.3 Wellness & Lifestyle ............................................................................ 37 6.4.4 Prevention & Safety ............................................................................ 37 6.4.5 Immunizations & Infectious Diseases ................................................ 39 6.5 Women’s, Infant, & Reproductive Health ................................................. 40 6.5.1 Maternal, Fetal, & Infant Health ......................................................... 40 6.5.2 Family Planning and Teen Sexual Health ............................................ 41 6.5.3 Women’s Health ................................................................................. 42 7 A Closer Look at Highly Impacted Populations ............................................... 43 7.1 Children, Teens, & Adolescents ................................................................. 43 7.1.1 Access to Care ..................................................................................... 43 7.1.2 Oral Health ......................................................................................... 43 7.1.3 Disabilities .......................................................................................... 43 7.1.4 Nutrition & Physical Activity ............................................................... 44 7.1.5 Asthma ............................................................................................... 44 7.1.6 Mental Health & Substance Abuse ...................................................... 44 7.1.7 Prevention and Safety ......................................................................... 44 7.1.8 Teen Pregnancy and Sexual Health ..................................................... 44 7.2 Older Adults ............................................................................................. 44 7.2.1 Access to Care ..................................................................................... 44 7.2.2 Chronic Diseases ................................................................................. 45 7.2.3 Safety .................................................................................................. 45 7.2.4 Social Environment ............................................................................. 45 7.3 Low-Income Population ........................................................................... 46 7.4 Rural Communities .................................................................................. 46 7.5 People with Disabilities ............................................................................. 47 7.6 Homeless Population................................................................................. 47 7.7 People from Micronesian Regions ............................................................ 48 7.8 Disparities by Race/Ethnic Groups ........................................................... 49 8 Conclusion ...................................................................................................... 52 ii iii Tables Table 5.1: Population Density and Change ................................................................................ 11 Table 6.1: Secondary Data Scoring for Health Topic Areas ....................................................... 18 Table 6.2: Secondary Data Scoring for Quality of Life Topic Areas ............................................ 18 Table 6.3: Providers per 100,000 Residents ............................................................................... 21 Table 6.4: Adult Oral Health .......................................................................................................