2016 Community Health Assessment Table of Contents Introduction ........................................................... 4 Children and Youth with Special Health About Seattle Children’s ........................................................... 6 Care Needs and Chronic Conditions ............... 26 Opportunities for Better Health ............................................. 6 Overview of Children and Youth with Special Health Care Needs/Chronic Conditions ............................26 Working Together Toward Healthier Communities .........7 Care Coordination ......................................................................26 Methods ...................................................................8 Adolescent Transition ...............................................................28 Design ............................................................................................... 8 Childhood Asthma .....................................................................30 Data Sources .................................................................................. 8 Childhood Diabetes ....................................................................31 Limitations ....................................................................................... 9 Cancer ..............................................................................................31 Transplant ......................................................................................33 Definition of Community ...................................10 Heart Disease ...............................................................................33 What We Heard from the Community – Community Assets and Resources include: ....................34 Key Findings ..........................................................11 Opportunities ...............................................................................37 Basic Needs ....................................................................................11 Cultural Competency ..................................................................11 Access to Care, Use of Clinical Preventive Services and Oral Health .............. 38 Community Input and Inclusiveness ...................................12 Access to Care .............................................................................38 Health Insurance Coverage, Health Literacy and Navigating Healthcare Services ............................................12 Incomplete Vaccinations ........................................................ 40 Community Assets and Resources ......................................12 Oral Healthcare .......................................................................... 40 Community Input ........................................................................41 Community Social and Economic Context ..... 13 Community Assets and Resources .....................................42 Overview of Washington State and King County ..........13 Opportunities ...............................................................................46 King County Demographics....................................................14 Poverty Improves ........................................................................14 Mental and Behavioral Health .......................... 47 Housing Affordability ................................................................16 Depression ....................................................................................47 Stark Disparities by Place, Race and Income ................... 17 Substance Abuse and Chemical Dependency ...............48 Employment and Income .........................................................19 Autism .............................................................................................50 Education and Early Childhood Development ...............20 Community Input .......................................................................50 Foster Care ....................................................................................21 Community Assets and Resources ......................................51 LGBTQ Youth.................................................................................21 Opportunities ...............................................................................53 Rural Washington ........................................................................21 Maternal and Child Health ................................ 54 Seattle Children’s Patient Demographics.........................23 Infant Mortality ............................................................................54 Life Expectancy and Leading Causes of Early and Adequate Prenatal Care ......................................55 Death and Hospitalization ................................ 23 Low Birth Weight .......................................................................56 Life Expectancy ..........................................................................23 Community Input .......................................................................56 Leading Causes of Death ........................................................23 Community Assets and Resources .....................................56 Leading Causes of Hospitalization ......................................25 Opportunities ...............................................................................57 2 Community Health Assessment 2016 Preventable Causes of Death ........................... 58 Obesity, Physical Activity and Nutrition ...........................58 Community Input .......................................................................66 Community Assets and Resources .....................................67 Opportunities ...............................................................................68 Violence and Injury Prevention ....................... 70 Intentional Injuries ......................................................................70 Unintentional Injuries ................................................................ 72 Community Input .......................................................................77 Community Assets and Resources include: ....................77 Opportunities ...............................................................................79 Appendix A: Methods ........................................80 Identification of Health Needs and Selection of Indicators ...................................................................................... 80 Description of the Data .............................................................81 Community Input ........................................................................81 Review of Existing Reports ....................................................84 Evidence-based Practices ......................................................85 Limitations .....................................................................................85 Appendix B: Report Structure ......................... 86 Appendix C: Data for Report Indicators ........ 88 Appendix D: Evaluation of Our Community Benefit Implementation Plan 2013-16 ....................................................... 104 Background ................................................................................104 Summary ......................................................................................104 Results ...........................................................................................104 Looking Forward ......................................................................108 Seattle Children’s Community Benefit Implementation Plan 2013-2016 Progress Report ....................... Inside back cover Community Health Assessment 2016 3 Introduction At Seattle Children’s, our commitment to adolescent populations, as well as community caring for the community is our passion, input, and to include data and information our duty, and our privilege. We serve as the about the WAMI region when available. pediatric and adolescent medical center for This report provides qualitative and quantitative the largest landmass of any children’s hospital information about: in the country, which includes Washington, • A Description of Our Community: Seattle Alaska, Montana and Idaho (the WAMI region). Children’s serves the WAMI region, with We reach beyond our hospital every day the majority of our patients located in King to provide programs and services to make County, WA. children, teens and families safer and healthier in the communities where they live, based on • Life Expectancy and Leading Causes of identified community needs. Death and Hospitalization: Life expectancy in King County neighborhoods can vary The Patient Protection and Affordable Care Act by up to 10 years. Injuries are the leading (ACA) requires non-profit hospitals to conduct causes of death among children, teens and a Community Health Needs Assessment young adults in King County and throughout (CHNA) every three years to understand the Washington state. The leading causes of most significant needs impeding health in hospitalizations for children and teens are their area and examine ways to address them. asthma and injuries. At Seattle Children’s we call this process a Community Health Assessment (CHA), and • The following identified health needs: intentionally drop the word “needs” from our Children with special healthcare needs and report. We do this purposefully because the chronic conditions (CSHCN) communities that we serve are so much more Access to care