Honolulu County Community Health Needs Assessment and Implementation Plan Report February 28, 2013 Updated March 2017 Table of Contents Executive Summary .............................................................................................................................. 5 Introduction .................................................................................................................................................. 5 Approach ....................................................................................................................................................... 5 Data Sources and Methods ........................................................................................................................... 5 Areas of Need ................................................................................................................................................ 6 Selected Priority Areas .................................................................................................................................. 7 Note to the Reader ....................................................................................................................................... 9 1 Introduction .................................................................................................................................. 10 1.1 Summary of CHNA Report Objectives and context ........................................................................ 10 1.1.1 Healthcare Association of Hawaii ........................................................................................... 10 1.1.2 Member Hospitals ................................................................................................................... 10 1.1.3 Advisory Committee ................................................................................................................ 10 1.1.4 Consultants ............................................................................................................................. 11 1.2 Hospital Community Benefit Team and Goals ................................................................................ 12 1.2.1 Definition of Community + Map .............................................................................................. 18 2 Methods .......................................................................................................................................... 20 2.1 Core Indicator Summary ................................................................................................................. 20 2.1.1 Data Sources ........................................................................................................................... 20 2.1.2 Comparisons: Analytic Approach ............................................................................................ 20 2.1.3 Indicator and Topic Area Scoring ............................................................................................ 21 2.1.4 Shortage Area Maps ............................................................................................................... 21 2.1.5 Hospitalization Rates .............................................................................................................. 22 2.2 Key Informant Interviews ................................................................................................................ 22 2.3 Community Survey .......................................................................................................................... 24 3 Community Health Needs Assessment Findings .............................................................. 25 3.1 Demographics ................................................................................................................................. 25 3.1.1 Population ............................................................................................................................... 25 3.1.2 Economy .................................................................................................................................. 27 3.1.3 Education ................................................................................................................................ 27 3.2 Overview of Needs Assessment ...................................................................................................... 28 3.2.1 Access to Health Services ........................................................................................................ 32 3.2.2 Cancer ..................................................................................................................................... 33 3.2.3 Diabetes .................................................................................................................................. 34 3.2.4 Disabilities ............................................................................................................................... 36 3.2.5 Economy .................................................................................................................................. 38 3.2.6 Education ................................................................................................................................ 39 3.2.7 Environment ............................................................................................................................ 40 3.2.8 Exercise, Nutrition & Weight ................................................................................................... 40 3.2.9 Family Planning ....................................................................................................................... 42 3.2.10 Heart Disease & Stroke ........................................................................................................... 43 3.2.11 Immunizations & Infectious Diseases ...................................................................................... 45 3.2.12 Injury Prevention & Safety ...................................................................................................... 47 3.2.13 Maternal, Fetal & Infant Health .............................................................................................. 48 3.2.14 Mental Health & Mental Disorders ......................................................................................... 50 2 3.2.15 Older Adults & Aging ............................................................................................................... 52 3.2.16 Oral Health .............................................................................................................................. 54 3.2.17 Respiratory Diseases ............................................................................................................... 55 3.2.18 Social Environment .................................................................................................................. 57 3.2.19 Substance Abuse & Lifestyle .................................................................................................... 58 3.2.20 Transportation ........................................................................................................................ 60 4 Community Health Needs Summary ..................................................................................... 61 4.1 Findings/Conclusions ...................................................................................................................... 61 4.1.1 Disparities Highlights .............................................................................................................. 63 4.1.2 Identified Data Gaps ............................................................................................................... 64 4.1.3 Limitations and Other Considerations ..................................................................................... 65 5 Selected Priority Areas .............................................................................................................. 67 6 Feedback, Questions or Comments? ..................................................................................... 70 Appendix A: HCI Provided Data ...................................................................................................... 71 About HCI Provided Data ............................................................................................................................ 71 Framework for Indicator/Data and Topic Selection ................................................................................... 71 Core Indicator Data Summary: Analytic Approach and Scoring Methodology ........................................... 71 Core Indicator Data ..................................................................................................................................... 75 Appendix B: Hospitalization Data ................................................................................................. 86 Hospital Service Areas ................................................................................................................................. 86 Hospitalization Rates .................................................................................................................................. 86 Appendix C: Key Informant Interview Participants ................................................................ 95 Completed Interviews 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