2016 Community Health Needs Assessment

2016 Community Health Needs Assessment

Bergen County, New Jersey

Prepared for: The Community Health Improvement Partnership of Bergen County

Bergen County Department of Health Services Christian Healthcare Center/Ramapo Ridge Psychiatric Hospital Englewood Hospital and Medical Center Hackensack University Medical Center Hackensack University Medical Center at Pascack Valley Holy Name Medical Center The Valley Hospital

Prepared by: Professional Research Consultants, Inc. 11326 P Street Omaha, NE 68136-2316

2015-0991-02 ? October 2016

COMMUNITY HEALTH NEEDS ASSESSMENT

Table of Contents

Introduction

7

Project Overview

8

Project Goals

8

Methodology

9

Summary of Findings

17

Significant Health Needs of the Community

17

Summary Tables: Comparisons With Benchmark Data

21

Community Description

42

Population Characteristics

43

Total Population

43

Urban/Rural Population

45

Age

46

Race & Ethnicity

48

Linguistic Isolation

50

Social Determinants of Health

52

Poverty

52

Education

55

Employment

56

Housing Insecurity

56

Food Insecurity

58

High-Need Areas

60

General Health Status

63

Overall Health Status

64

Evaluation of Health Status

64

Activity Limitations

66

Caregiving

68

Mental Health

70

Evaluation of Mental Health Status

70

Depression

72

Stress

74

Suicide

75

Mental Health Treatment

76

Key Informant Input: Mental Health

78

2

COMMUNITY HEALTH NEEDS ASSESSMENT

Death, Disease & Chronic Conditions

81

Leading Causes of Death

82

Distribution of Deaths by Cause

82

Age-Adjusted Death Rates for Selected Causes

82

Cardiovascular Disease

84

Age-Adjusted Heart Disease & Stroke Deaths

84

Prevalence of Heart Disease & Stroke

87

Cardiovascular Risk Factors

89

Key Informant Input: Heart Disease & Stroke

96

Cancer

98

Age-Adjusted Cancer Deaths

98

Cancer Incidence

101

Prevalence of Cancer

102

Cancer Screenings

104

Key Informant Input: Cancer

109

Respiratory Disease

112

Age-Adjusted Respiratory Disease Deaths

113

Key Informant Input: Respiratory Disease

116

Injury & Violence

118

Unintentional Injury

118

Intentional Injury (Violence)

124

Key Informant Input: Injury & Violence

130

Diabetes

131

Age-Adjusted Diabetes Deaths

131

Prevalence of Diabetes

133

Key Informant Input: Diabetes

135

Alzheimer's Disease

137

Age-Adjusted Alzheimer's Disease Deaths

137

Progressive Confusion/Memory Loss

138

Key Informant Input: Dementias, Including Alzheimer's Disease

139

Kidney Disease

141

Age-Adjusted Kidney Disease Deaths

141

Prevalence of Kidney Disease

142

Key Informant Input: Chronic Kidney Disease

143

Septicemia

144

3

COMMUNITY HEALTH NEEDS ASSESSMENT

Potentially Disabling Conditions Arthritis, Osteoporosis, & Chronic Back Conditions Key Informant Input: Arthritis, Osteoporosis & Chronic Back Conditions Vision & Hearing Impairment Key Informant Input: Vision & Hearing

Infectious Disease

Influenza & Pneumonia Vaccination Flu Vaccinations Pneumonia Vaccination

HIV Age-Adjusted HIV/AIDS Deaths HIV Prevalence HIV Testing Key Informant Input: HIV/AIDS

Sexually Transmitted Diseases Chlamydia & Gonorrhea Safe Sexual Practices Key Informant Input: Sexually Transmitted Diseases

Immunization & Infectious Diseases Key Informant Input: Immunization & Infectious Diseases

Births

Birth Outcomes & Risks Infant Mortality Key Informant Input: Infant & Child Health

Family Planning Births to Teen Mothers Key Informant Input: Family Planning

Modifiable Health Risks

Actual Causes of Death Nutrition

Daily Recommendation of Fruits/Vegetables Access to Fresh Produce Sugar-Sweetened Beverages Physical Activity Leisure-Time Physical Activity Activity Levels Access to Physical Activity

146 146 147 148 150

151

152 152 153 154 155 155 157 157 158 158 159 160 161 161

162

163 163 163 165 165 165

167

168 169 170 171 174 176 176 178 181

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COMMUNITY HEALTH NEEDS ASSESSMENT

Weight Status Adult Weight Status Children's Weight Status Key Informant Input: Nutrition, Physical Activity & Weight

Sleep Substance Abuse

Age-Adjusted Cirrhosis/Liver Disease Deaths Alcohol Use Age-Adjusted Drug-Induced Deaths Drug Use Alcohol & Drug Treatment Negative Effects of Substance Abuse Key Informant Input: Substance Abuse Tobacco Use Cigarette Smoking Other Tobacco Use Key Informant Input: Tobacco Use

Access to Health Services

Health Insurance Coverage Type of Healthcare Coverage Lack of Health Insurance Coverage

Difficulties Accessing Healthcare Difficulties Accessing Services Barriers to Healthcare Access Accessing Healthcare for Children Key Informant Input: Access to Healthcare Services

Health Literacy Understanding Health Information Completing Health Forms Population With Low Health Literacy

Primary Care Services Access to Primary Care Specific Source of Ongoing Care Utilization of Primary Care Services

Emergency Room Utilization Advance Directives

182 182 186 188 190 193 193 194 196 197 200 201 202 205 205 209 211

212

213 213 213 216 216 217 220 220 223 223 224 225 227 227 228 229 231 233

5

COMMUNITY HEALTH NEEDS ASSESSMENT

Oral Health Dental Insurance Dental Care Key Informant Input: Oral Health

Vision Care

Local Resources

Perceptions of Local Healthcare Services Healthcare Resources & Facilities

Hospitals & Federally Qualified Health Centers (FQHCs) Resources Available to Address the Significant Health Needs

Appendices

Appendix I: Peer County Comparisons Selected Data Charts County Health Rankings

Appendix II: Special Populations Health Needs of Korean Residents Health Needs of African American Residents

235 235 237 239 240

242

243 245 245 246

250

251 251 263 266 266 269

6

Introduction

COMMUNITY HEALTH NEEDS ASSESSMENT

Project Overview

Project Goals

This Community Health Needs Assessment is a systematic, data-driven approach to determining the health status, behaviors and needs of residents in Bergen County. Subsequently, this information may be used to inform decisions and guide efforts to improve community health and wellness. A Community Health Needs Assessment provides information so that communities may identify issues of greatest concern and decide to commit resources to those areas, thereby making the greatest possible impact on community health status. This Community Health Needs Assessment will serve as a tool toward reaching three basic goals:

To improve residents' health status, increase their life spans, and elevate their overall quality of life. A healthy community is not only one where its residents suffer little from physical and mental illness, but also one where its residents enjoy a high quality of life.

To reduce the health disparities among residents. By gathering demographic information along with health status and behavior data, it will be possible to identify population segments that are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals may then be developed to combat some of the socio-economic factors which have historically had a negative impact on residents' health.

To increase accessibility to preventive services for all community residents. More accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating the quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care.

This assessment was conducted on behalf of the Community Health Improvement Partnership of Bergen County by Professional Research Consultants, Inc. (PRC). PRC is a nationally recognized healthcare consulting firm with extensive experience conducting Community Health Needs Assessments such as this in hundreds of communities across the United States since 1994. Subsequent implementation planning for the county and hospital sponsors, based on the findings of this assessment, will be conducted with the assistance of Strategy Solutions, Inc., a consulting group with more than 20 years of experience in community health planning.

8

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