Community Health Needs Assessment Report Trenton, New Jersey July 2013 Submitted to: New Jersey Health Initiatives and Robert Wood Johnson Foundation Prepared by: Kalla Gervasio Trenton Community Health Needs Assessment Intern Carol McAloon, RN, MSN, NE-BC Trenton Community Health Needs Assessment Data Analyst 1 PARTNERSHIPS AND COLLABORATIONS Trenton Police Department 2 ACKNOWLEDGMENTS The Trenton Health Team offers its profound gratitude to the Robert Wood Johnson Foundation New Jersey Health Initiative for its generous commitment and support of the Trenton Community Health Needs Assessment. The Trenton Health Team gratefully acknowledges St. Francis Medical Center for its vision, commitment and leadership in driving the Trenton Community Health Needs Assessment effort while the Trenton Health Team was building and expanding its infrastructure. 3 TABLE OF CONTENTS PARTNERSHIPS AND COLLABORATIONS ....................................................................................................... 2 ACKNOWLEDGMENTS ................................................................................................................................... 3 TABLE OF CONTENTS ..................................................................................................................................... 4 EXECUTIVE SUMMARY .................................................................................................................................. 6 A SNAPSHOT OF TRENTON........................................................................................................................ 7 OVERVIEW OF EMERGING PRIORITIES IN THT’S CHNA ............................................................................. 7 THT’S INNOVATIVE APPROACH ................................................................................................................. 8 NEXT STEPS ............................................................................................................................................... 9 OTHER AREAS OF CONCERN ................................................................................................................... 10 LIMITATIONS OF THIS REPORT ................................................................................................................ 10 CHAPTER HIGHLIGHTS ............................................................................................................................. 11 HEALTH PRIORITY SPOTLIGHT: Obesity and Healthy Lifestyles .............................................................. 11 HEALTH PRIORITY SPOTLIGHT: Substance Abuse and Behavioral Health ............................................... 11 HEALTH PRIORITY SPOTLIGHT: Safety and Crime ................................................................................... 11 HEALTH PRIORITY SPOTLIGHT: Chronic Disease ..................................................................................... 12 HEALTH PRIORITY SPOTLIGHT: Health Literacy and Disparities .............................................................. 12 INTRODUCTION ........................................................................................................................................... 13 Purpose and Geographic Scope of the Trenton Community Health Needs Assessment ....................... 13 Advisory Structure and Methodology ..................................................................................................... 16 Social Determinants of Health Framework ............................................................................................. 18 SNAPSHOT OF TRENTON ............................................................................................................................. 20 Poverty .................................................................................................................................................... 20 Income ................................................................................................................................................ 21 Employment—Job Types .................................................................................................................... 22 Unemployment ................................................................................................................................... 23 Language Barriers ............................................................................................................................... 24 Housing and Homelessness ................................................................................................................ 25 Education ............................................................................................................................................ 28 Population ............................................................................................................................................... 28 4 Age Distribution ...................................................................................................................................... 30 Racial and Ethnic Diversity ...................................................................................................................... 31 EMERGING PRIORITIES ................................................................................................................................ 34 SAFETY AND CRIME ................................................................................................................................. 34 OBESITY AND HEALTHY LIFESTYLES......................................................................................................... 37 Finding Food in Trenton ...................................................................................................................... 38 Childhood Obesity ............................................................................................................................... 41 SUBSTANCE ABUSE AND BEHAVIORAL HEALTH ...................................................................................... 47 HEALTH LITERACY AND DISPARITIES ....................................................................................................... 49 CHRONIC DISEASES ................................................................................................................................. 50 Diabetes .............................................................................................................................................. 51 Cardiovascular Disease ....................................................................................................................... 52 Cancer ................................................................................................................................................. 53 OTHER AREAS OF CONCERN ....................................................................................................................... 54 RISKY BEHAVIORS .................................................................................................................................... 54 HIV/AIDS and Hepatitis C .................................................................................................................... 54 Sexually Transmitted Diseases ............................................................................................................ 55 Teen Pregnancy ................................................................................................................................... 55 Birth Outcomes ................................................................................................................................... 56 ENVIRONMENTAL ISSUES........................................................................................................................ 57 Transportation .................................................................................................................................... 57 Lead Poisoning .................................................................................................................................... 58 Asthma ................................................................................................................................................ 58 NEXT STEPS ................................................................................................................................................. 58 REFERENCES ................................................................................................................................................ 60 5 EXECUTIVE SUMMARY The Trenton Health Team (THT) has completed a comprehensive, data-informed Community Health Needs Assessment (CHNA), in which Trenton residents played a key role in identifying and articulating the city’s top health priorities. THT, a collaborative of the city’s two hospitals, St. Francis Medical Center and Capital Health; its only Federally Qualified Health Center, Henry J. Austin Health Center and the city government’s Department of Health & Human Services, has partnered with 29 community and social service agencies across Trenton in a new approach to develop one CHNA for the city as a whole. Organizations participating in the unified CHNA have committed to allocating resources to address the health needs as identified. CHNAs are not new. Across the nation, non-profit organizations create government-mandated CHNAs and Community Health Improvement Plans