Community Health Needs Assessment Prepared for THE MOUNT SINAI HOSPITAL By VERITÉ HEALTHCARE CONSULTING, LLC December 31, 2017 ABOUT VERITÉ HEALTHCARE CONSULTING Verité Healthcare Consulting, LLC (Verité) was founded in May 2006 and is located in Alexandria, Virginia. The firm serves clients throughout the United States as a resource that helps health care providers conduct Community Health Needs Assessments and develop Implementation Strategies to address significant health needs. Verité has conducted more than 50 needs assessments for hospitals, health systems, and community partnerships nationally since 2010. The firm also helps hospitals, hospital associations, and policy makers with community benefit reporting, program infrastructure, compliance, and community benefit-related policy and guidelines development. Verité is a recognized national thought leader in community benefit and Community Health Needs Assessments. The community health needs assessment prepared for the Mount Sinai Hospital was directed by the firm’s Vice President with an associate supporting the work. The firm’s senior staff hold graduate degrees in relevant fields. More information on the firm and its qualifications can be found at www.VeriteConsulting.com. The Mount Sinai Hospital 1 Community Health Needs Assessment TABLE OF CONTENTS ABOUT VERITÉ HEALTHCARE CONSULTING ................................................................................................ 1 TABLE OF CONTENTS ............................................................................................................................................ 2 EXECUTIVE SUMMARY ......................................................................................................................................... 4 INTRODUCTION .......................................................................................................................................................... 4 OBJECTIVES AND METHODOLOGY .................................................................................................................. 5 REGULATORY REQUIREMENTS ................................................................................................................................... 5 METHODOLOGY ......................................................................................................................................................... 6 Collaborating Organizations ............................................................................................................................ 7 Information Gaps .............................................................................................................................................. 7 SIGNIFICANT COMMUNITY HEALTH NEEDS ................................................................................................. 8 Aging Population .............................................................................................................................................. 8 Access to Mental Health Care and Poor Mental Health Status ........................................................................ 9 Access to Primary Health Care Services by Individuals with Limited Resources ............................................. 9 Chronic Diseases and Contributing Lifestyle Factors .................................................................................... 10 Environmental Determinants of Health .......................................................................................................... 10 Homelessness .................................................................................................................................................. 11 Navigating a Changing Health Care Provider Environment .......................................................................... 11 Poverty, Financial Hardship, and Basic Needs Insecurity ............................................................................. 12 Safe and Affordable Housing .......................................................................................................................... 12 Socio-Economic, Racial, Cultural, Ethnic, and Linguistic Barriers to Care .................................................. 13 Substance Abuse .............................................................................................................................................. 13 CHNA DATA AND ANALYSIS .............................................................................................................................. 14 DEFINITION OF COMMUNITY ASSESSED ...................................................................................................... 15 SECONDARY DATA ASSESSMENT .................................................................................................................... 19 DEMOGRAPHICS ....................................................................................................................................................... 19 ECONOMIC INDICATORS ........................................................................................................................................... 31 People in Poverty ............................................................................................................................................ 31 Household Income ........................................................................................................................................... 33 Unemployment Rate ........................................................................................................................................ 35 Insurance Status .............................................................................................................................................. 38 Crime............................................................................................................................................................... 43 Housing and Homelessness ............................................................................................................................. 45 State of New York and New York City Budget Trends ..................................................................................... 48 LOCAL HEALTH STATUS AND ACCESS INDICATORS ................................................................................................. 57 County Health Rankings ................................................................................................................................. 57 New York State Department of Health ............................................................................................................ 62 Youth Risk Behavior Survey ............................................................................................................................ 81 New York Prevention Agenda 2013-2017 ....................................................................................................... 83 New York City Community Health Survey ...................................................................................................... 87 AMBULATORY CARE SENSITIVE CONDITIONS .......................................................................................................... 95 Borough/Neighborhood-Level Analysis .......................................................................................................... 95 ACSC Conditions Analysis .............................................................................................................................. 97 COMMUNITY NEED INDEX™ AND FOOD DESERTS ................................................................................................... 98 Dignity Health Community Need Index .......................................................................................................... 98 Food Deserts (Lack of Access to Nutritious and Affordable Food) .............................................................. 100 MEDICALLY UNDERSERVED AREAS AND POPULATIONS ........................................................................................ 101 HEALTH PROFESSIONAL SHORTAGE AREAS ........................................................................................................... 103 DESCRIPTION OF OTHER FACILITIES AND RESOURCES WITHIN THE COMMUNITY .................................................. 107 FINDINGS OF OTHER RECENT COMMUNITY HEALTH NEEDS ASSESSMENTS........................................................... 113 PRIMARY DATA ASSESSMENT ........................................................................................................................ 114 SUMMARY OF INTERVIEW FINDINGS ...................................................................................................................... 114 ISSUES IDENTIFIED BY INTERVIEW PARTICIPANTS ................................................................................................. 115 ORGANIZATIONS PROVIDING COMMUNITY INPUT .................................................................................................. 119 The Mount Sinai Hospital 2 Community Health Needs Assessment SOURCES ................................................................................................................................................................ 120 APPENDIX - ACTIONS TAKEN SINCE PREVIOUS CHNA ........................................................................... 123 The Mount Sinai Hospital 3 Community