1 Contents Disclaimer .............................................................................................................................................. 4 Acknowledgements ............................................................................................................................... 5 Project Management Team ............................................................................................................... 5 Project Support Team ....................................................................................................................... 5 Healthy Roanoke Valley .................................................................................................................... 5 Community Health Assessment Team (CHAT) ............................................................................... 6 CHAT Members and Area of Expertise ................................................................................................ 7 Executive Summary ............................................................................................................................... 8 Description of the Community ............................................................................................................. 9 Community Demographics ............................................................................................................... 9 Assessment Service Area .................................................................................................................. 10 Existing Resources ................................................................................................................................ 11 Carilion Medical Center ................................................................................................................... 11 Community Health Assessment Process ............................................................................................. 13 Methods ............................................................................................................................................ 13 Collaboration .................................................................................................................................... 13 Community Health Improvement Process ...................................................................................... 14 Step 1: Conduct Community Health Assessment ....................................................................... 14 Step 2: Strategic Planning ............................................................................................................. 14 Step 3: Implementation Strategy .................................................................................................. 15 Step 4: Program Implementation ................................................................................................. 15 Step 5: Evaluation ......................................................................................................................... 15 Data Collection ................................................................................................................................. 17 Community Health Survey (CHS):............................................................................................... 17 Focus Groups: ............................................................................................................................... 17 Stakeholder Survey: ...................................................................................................................... 18 Prioritization .................................................................................................................................... 18 Robert Wood Johnson Foundation Framework .............................................................................. 18 Target Population ............................................................................................................................. 19 Community Health Assessment Findings .......................................................................................... 20 Community Impact ............................................................................................................................. 23 2 Response Since the 2015 RVCHA .................................................................................................... 23 Success Measures ............................................................................................................................ 24 2018 Community Health Assessment Data ........................................................................................ 27 Primary Data and Community Engagement .................................................................................. 27 Stakeholder Survey Results ......................................................................................................... 27 Target Population Focus Group Results ..................................................................................... 34 Roanoke Valley Community Health Survey Results .................................................................. 43 Secondary Data ................................................................................................................................ 79 Demographics .............................................................................................................................. 80 Social and Economic Factors ...................................................................................................... 88 Health Behaviors ........................................................................................................................ 126 Clinical Care ................................................................................................................................ 133 Physical Environment................................................................................................................. 142 Health Outcomes / Health Status of the Population ................................................................ 144 Appendices ......................................................................................................................................... 157 Appendix 1: Community Health Improvement Process ............................................................... 157 Appendix 2: Gantt Chart ................................................................................................................ 158 Appendix 3: Community Health Need Prioritization .................................................................. 159 Appendix 4: Community Health Survey .......................................................................................160 Appendix 5: Healthy Roanoke Valley Strategic Framework 2016-2019 ....................................... 164 Appendix 6: Stakeholder Survey ...................................................................................................169 Appendix 7: Stakeholder Focus Group and Survey Locations ...................................................... 171 Appendix 8: Community Resource List ........................................................................................ 172 Community Resources Listed by Stakeholders ......................................................................... 172 Appendix 9: Cancer Community Health Survey .......................................................................... 177 Appendix 10: Links and References to Other Community Health Assessments and Data ....... 209 3 Disclaimer This document has been produced to benefit the community. Carilion Clinic encourages use of this report for planning purposes and is interested in learning of its utilization. Comments and questions are welcome and can be submitted to Carilion Clinic Community Health & Outreach at [email protected]. Members of the Project Management Team reviewed all documents prior to publication and provided critical edits. Every effort has been made to ensure the accuracy of the information presented in this report; however, accuracy cannot be guaranteed. Members of the Roanoke Valley Community Health Assessment Team cannot accept responsibility for any consequences that result from the use of any information presented in this report. 4 Acknowledgements Success of the 2018 Roanoke Valley Community Health Assessment (RVCHA) was due to the strong leadership and participation of its Project Management Team, the Project Support Team, members of Healthy Roanoke Valley, and the Community Health Assessment Team. Thank you to all of the community members who participated in the Community Health Survey and focus groups. Members of these teams included: Project Management Team Project Director: Shirley Holland, Carilion Clinic– VP Planning and Community Development Project Manager: Aaron Boush, Carilion Clinic– Community Health & Outreach Manager Project Manager: Amy Michals, Carilion Clinic– Community Health & Outreach Analyst Project Manager: Pat Young, United Way of Roanoke Valley– Director Family Health Strategies Project Support Team Carilion Clinic Community Health & Outreach Intern: Rohan Kaushal Carilion Clinic Community Health & Outreach Intern: Devki Patel Carilion Clinic Community Health & Outreach Intern: Emily Skywark Carilion Clinic Carilion Direct Virginia Medical Reserve Corps Volunteers: Victoria Cox, Spencer Ferguson, Benjamin