Baltimore County Department of Health

Baltimore County Department of Health

2014-2015 Community Health Needs Assessment

Healthy people living, working and playing in Baltimore County

2014-2015 BALTIMORE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT

ACKNOWLEDGEMENTS

This Community Health Needs Assessment (CHNA) represents the culmination of work completed by multiple individuals and groups during the past year beginning July 2014. The Baltimore County Department of Health (BCDH) would specifically like to thank members of the Community Assessment Team who provided their time and knowledge throughout the entirety of this process. The CHNA was made possible with the support of Gregory Wm. Branch, M.D., MBA, CPE, FACP, Director of Baltimore County Health and Human Services and team members:

Elise Andrews Bonita Cody, DDS Laura Culbertson, R.N., MSN Andre Davis Patricia Isennock, MS, BSN, NEA-BC, N-BC, MCHES Ellen Kobler Della Leister, R.N. Ruth Lucas

Lisa Pearson, LCSW-C Don Schlimm Aimee Bollinger-Smith, LCSW-C

Deborah Somerville, R.N., MPH Sue Vaeth

Mary Viggiani, LCSW-C Kim Ward

Baltimore County Department of Health Baltimore County Department of Health Baltimore County Department of Health Baltimore County Police Department MedStar Franklin Square Medical Center

Baltimore County Office of Communications Baltimore County Department of Health St. Stephens AME Church, Office of Management and Technology Chase Brexton Baltimore County Local Management Board Baltimore County Department of Social Services Baltimore County Public Schools Maryland Department of Health and Mental Hygiene Baltimore County Department of Health Baltimore County Police Department

The BCDH would also like to extend its gratitude to all of the focus group's participants, key leaders and informants, and community members who provided information used in the development of this assessment. Additionally, the BCDH would like to recognize Ascendient Healthcare Advisors for its efforts in directing this process and developing the content of this BCDH Community Health Needs Assessment.

ACKNOWLEDGEMENTS

2014-2015 BALTIMORE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT

MISSION To promote health and prevent disease through education, advocacy, linkage to resources and treatment to improve the quality of life for Baltimore County residents VISION Healthy people living, working and playing in Baltimore County LEADERSHIP Kevin Kamenetz Baltimore County Executive Gregory Wm. Branch, M.D., MBA, CPE, FACP Director, Baltimore County Department of Health and Human Services

This assessment was supported by a grant from the Maryland Hospital Association.

ACKNOWLEDGEMENTS

TABLE OF CONTENTS

INTRODUCTION ........................................................................................................................ 1 CHAPTER 1 METHODOLOGY .......................................................................................... 12

Study Design ............................................................................................................................12 Study Limitations ....................................................................................................................12 CHAPTER 2 HEALTH NEED PRIORITIZATION PROCESS ........................................ 14 Process Overview ....................................................................................................................14 Underlying Influential Factors ..............................................................................................15 CHAPTER 3 COUNTY PRIORITY HEALTH NEED AREAS......................................... 18 Priority Need: Implications of Health Disparities on Population Sub-groups ..............18 Priority Need: Impact of Mental and Behavioral Health/Drug Use on Health ............29 Priority Need: Management of Cardiovascular Health/Diabetes/Hypertension ........33 Priority Need: Health Effects of Obesity..............................................................................36 CHAPTER 4 SIGNIFICANT AREAS OF NEED DISPARITY ......................................... 38 District-level Disparities .........................................................................................................39

District 1 ................................................................................................................................40 District 2 ................................................................................................................................42 District 3 ................................................................................................................................44 District 4 ................................................................................................................................46 District 5 ................................................................................................................................48 District 6 ................................................................................................................................50 District 7 ................................................................................................................................52 District Summary.................................................................................................................54 Population Sub-group Disparities ........................................................................................55 Racial Disparities .................................................................................................................55 Ethnic Disparities.................................................................................................................56 Age Disparities.....................................................................................................................57

Disabled Population Disparities........................................................................................60 Homeless Population Disparities ......................................................................................61 CHAPTER 5 NEXT STEPS ................................................................................................... 63 APPENDICES ............................................................................................................................. 64 APPENDIX 1 DEMOGRAPHIC DATA ............................................................................. 65 Total Population ......................................................................................................................66 Age .............................................................................................................................................66 Gender .......................................................................................................................................75 Race and Ethnicity...................................................................................................................79 APPENDIX 2 SOCIOECONOMIC DATA ......................................................................... 85 Income Level ............................................................................................................................85 Poverty ......................................................................................................................................87 Unemployment ........................................................................................................................88 Community Need Index.........................................................................................................88 APPENDIX 3 HEALTH DATA/MEASURES ................................................................... 93 Health Status ? County Health Rankings ............................................................................93 Maryland State Health Improvement Process (SHIP) .....................................................100 APPENDIX 4 DETAILED QUALITATIVE FINDINGS ................................................. 117 Community Survey Questionnaire and Findings ............................................................117 Key Leaders Survey Questionnaire and Findings ............................................................133 Telephone Survey Questionnaire and Findings ...............................................................139 Focus Group Questionnaire and Findings ........................................................................156 APPENDIX 5 SUMMARY OF QUANTITATIVE AND QUALITIVE FINDINGS ..... 159

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