Kapi‘olani Medical Center for Women & Children Community Health Needs Assessment April 8, 2013 Table of Contents Executive Summary .............................................................................................................................. 5 Introduction .................................................................................................................................................. 5 Approach ....................................................................................................................................................... 5 Data Sources and Methods ........................................................................................................................... 5 Areas of Need ................................................................................................................................................ 6 Selected Priority Areas .................................................................................................................................. 8 Note to the Reader ....................................................................................................................................... 8 1 Introduction ..................................................................................................................................... 9 1.1 Summary of CHNA Report Objectives and context ............................................................................. 9 1.1.1 Healthcare Association of Hawaii ................................................................................................. 9 1.1.2 Kapiolani Medical Center for Women & Children ......................................................................... 9 1.1.3 Advisory Committee ................................................................................................................... 10 1.1.4 Consultants ................................................................................................................................. 11 1.2 Hospital Community Benefit Team and Goals ................................................................................... 11 1.2.1 Definition of Community + Map ................................................................................................. 12 2 Methods ........................................................................................................................................... 14 2.1 Core Indicator Summary .................................................................................................................... 14 2.1.1 Data Sources ............................................................................................................................... 14 2.1.2 Comparisons: Analytic Approach ................................................................................................ 14 2.1.3 Indicator and Topic Area Scoring ................................................................................................ 15 2.1.4 Shortage Area Maps ................................................................................................................... 15 2.2 Hospitalization Rates ......................................................................................................................... 16 2.3 Key Informant Interviews .................................................................................................................. 16 2.4 Community Survey ............................................................................................................................ 17 3 Community Health Needs Assessment Findings ............................................................... 19 3.1 Demographics .................................................................................................................................... 19 3.1.1 Population................................................................................................................................... 19 3.1.2 Economy ..................................................................................................................................... 22 3.1.3 Education .................................................................................................................................... 24 3.2 Overview of Needs Assessment ........................................................................................................ 25 3.2.1 Access to Health Services ............................................................................................................ 31 3.2.2 Cancer ......................................................................................................................................... 33 3.2.3 Diabetes ...................................................................................................................................... 35 3.2.4 Disabilities ................................................................................................................................... 38 3.2.5 Economy ..................................................................................................................................... 39 3.2.6 Education .................................................................................................................................... 40 3.2.7 Environment ............................................................................................................................... 42 3.2.8 Exercise, Nutrition & Weight ...................................................................................................... 42 3.2.9 Family Planning .......................................................................................................................... 44 3.2.10 Heart Disease & Stroke ............................................................................................................. 46 3.2.11 Immunizations & Infectious Diseases ....................................................................................... 48 3.2.12 Injury Prevention & Safety ........................................................................................................ 50 3.2.13 Maternal, Fetal & Infant Health ............................................................................................... 51 3.2.14 Mental Health & Mental Disorders .......................................................................................... 54 1 3.2.15 Older Adults & Aging ................................................................................................................ 56 3.2.16 Oral Health ............................................................................................................................... 58 3.2.17 Respiratory Diseases ................................................................................................................. 59 3.2.18 Social Environment ................................................................................................................... 61 3.2.19 Substance Abuse & Lifestyle ..................................................................................................... 64 3.2.20 Transportation .......................................................................................................................... 66 4 Community Health Needs Summary ...................................................................................... 67 4.1 Findings/Conclusions ......................................................................................................................... 67 4.1.1 Disparities Highlights .................................................................................................................. 69 4.1.2 Identified Data Gaps ................................................................................................................... 70 4.2 Limitations and Other Considerations ............................................................................................... 71 5 Selected Priority Areas ............................................................................................................... 73 Appendix A: HCI Provided Data ...................................................................................................... 74 About HCI Provided Data ............................................................................................................................ 74 Framework for Indicator/Data and Topic Selection ................................................................................... 74 Core Indicator Data Summary: Analytic Approach and Scoring Methodology ........................................... 74 Core Indicator Data ..................................................................................................................................... 78 Appendix B: Hospitalization Data ................................................................................................. 91 Hospitalization Rates .................................................................................................................................. 91 Appendix C: Key Informant Interview Guide and Participants ........................................... 94 Completed Interviews ................................................................................................................................. 94 Attempted Interviews ................................................................................................................................