UF Health Jacksonville

2019

UF HEALTH JACKSONVILLE

COMMUNITY HEALTH NEEDS ASSESSMENT

Table of Contents

Table of Figures ....................................................................................................................... 4

Introduction and Purpose ........................................................................................................ 6

Jacksonville Nonprofit Hospital Partnership ......................................................................................... 6 Collaborative Projects .......................................................................................................................................... 6

UF Health Jacksonville ......................................................................................................................... 8 Executive Statement ............................................................................................................................................ 8 About the Hospital ............................................................................................................................................... 8

Consultants.......................................................................................................................................... 9

Executive Summary ............................................................................................................... 11

Service Area ....................................................................................................................................................... 11 Methods for Identifying Community Health Needs ............................................................................ 12

Primary Data ...................................................................................................................................................... 13 Secondary Data .................................................................................................................................................. 13 Summary of Findings ......................................................................................................................... 14 Prioritized Areas ................................................................................................................................ 15 Conclusion ......................................................................................................................................... 16

About this CHNA.................................................................................................................... 17

UF Health Jacksonville and UF Health North's Service Area ................................................................ 17 Evaluation of Progress Since Prior CHNA ............................................................................................ 18

Priority Health Needs from Preceding CHNA ....................................................................................................18 Community Feedback from Preceding CHNA and Implementation Plan...........................................................18

Methodology......................................................................................................................... 18

Overview ........................................................................................................................................... 18 Primary Data Methods and Analysis................................................................................................... 19

Key Informant Interviews...................................................................................................................................19 Focus Groups......................................................................................................................................................20 Community Survey ............................................................................................................................................. 21 Secondary Data Methods and Analysis............................................................................................... 22 Secondary Data Scoring ..................................................................................................................................... 23 Index of Disparity ............................................................................................................................................... 25 External Data Reports ........................................................................................................................................ 25 Data Synthesis Method ...................................................................................................................... 25 Data Considerations........................................................................................................................... 27 Race/Ethnic Groupings.......................................................................................................................................27 ZIP Codes and ZIP Code Tabulation Areas..........................................................................................................28 Prioritization...................................................................................................................................... 28

Demographics and Community Context................................................................................. 29

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Population ......................................................................................................................................... 29

Age .................................................................................................................................................... 30

Race/Ethnicity ................................................................................................................................... 31

Language Spoken at Home ................................................................................................................. 34

Veterans ............................................................................................................................................ 34

Disabilities ......................................................................................................................................... 35

Social and Economic Determinants of Health ..................................................................................... 36 Income & Poverty............................................................................................................................................... 36 Education ........................................................................................................................................................... 43

SocioNeeds Index............................................................................................................................... 45

Prioritized Significant Health Needs....................................................................................... 46

Access................................................................................................................................................ 47 Access to Health Services...................................................................................................................................47 Access to Proper Nutrition ................................................................................................................................. 51 Access to Safe and Affordable Housing..............................................................................................................53

Behavioral Health [Mental Health & Substance Abuse] ...................................................................... 54 Secondary Data .................................................................................................................................................. 54 Primary Data ...................................................................................................................................................... 58

Poverty .............................................................................................................................................. 59 Secondary Data .................................................................................................................................................. 60 Primary Data ...................................................................................................................................................... 65

Obesity & Physical Activity................................................................................................................. 66 Secondary Data .................................................................................................................................................. 67 Primary Data ...................................................................................................................................................... 70

Maternal, Fetal & Infant Health ......................................................................................................... 70 Secondary Data .................................................................................................................................................. 71 Primary Data ...................................................................................................................................................... 72

Cancer ............................................................................................................................................... 73 Secondary Data .................................................................................................................................................. 73 Primary Data ...................................................................................................................................................... 78

Vulnerable Populations...................................................................................................................... 78 African-Americans .............................................................................................................................................. 78 Children .............................................................................................................................................................. 80 Hispanic/Latinx................................................................................................................................................... 81 Homeless ............................................................................................................................................................ 82 Lesbian, Gay, Bisexual, Transgender, Queer or Questioning (LGBTQ)...............................................................82 Low-Income........................................................................................................................................................ 83 Older Adults ....................................................................................................................................................... 84 Persons with Disabilities .................................................................................................................................... 87 Veterans ............................................................................................................................................................. 88

Other Significant Health Needs.............................................................................................. 89

Diabetes ............................................................................................................................................ 90

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Heart Disease..................................................................................................................................... 90 Social Environment ............................................................................................................................ 93 Respiratory Diseases .......................................................................................................................... 96 Sexual Health..................................................................................................................................... 98 Built Environment & Safety.............................................................................................................. 100

Conclusion ........................................................................................................................... 103 Appendix A. Prior CHNA Impact Report and Comments ....................................................... 104 Appendix B. Primary Data ................................................................................................... 111

1. Key Informant Interview Questions.............................................................................................. 111 2. Organizations Participating in Key Informant Interviews .............................................................. 112 3. Focus Group Discussion Questions ............................................................................................... 112 4. Completed Focus Groups.............................................................................................................. 113 5. Community Survey Questionnaire ................................................................................................ 113

Appendix C. Secondary Data................................................................................................ 122

1. Secondary Data Sources ............................................................................................................... 122 2. Secondary Data Scoring Detailed Methodology ............................................................................ 125

Comparison to a Distribution of County Values: Within State and Nation......................................................125 Comparison to Values: State, National and Targets ........................................................................................126 Trend Over Time .............................................................................................................................................. 126 Missing Values..................................................................................................................................................126 Indicator Scoring .............................................................................................................................................. 126 Topic Scoring .................................................................................................................................................... 126 3. Secondary Data Scores ................................................................................................................. 127 Duval County .................................................................................................................................................... 127

Appendix D. Community Resources ..................................................................................... 149

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Table of Figures

FIGURE 1. MAP OF UF HEALTH JACKSONVILLE AND UF HEALTH NORTH

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FIGURE 2. MAP OF DUVAL COUNTY SERVICE AREA

12

FIGURE 3. MAP OF UF HEALTH JACKSONVILLE AND UF HEALTH NORTH

17

FIGURE 4. COMMON THEMES FROM KEY INFORMANT INTERVIEWS

19

FIGURE 5. COMMON THEMES FROM FOCUS GROUPS

20

FIGURE 6. MOST PRESSING HEALTH NEEDS ACCORDING TO SURVEY PARTICIPANTS

21

FIGURE 7. MOST IMPACTFUL CONDITIONS OF LIFE ACCORDING TO SURVEY PARTICIPANTS

22

FIGURE 8. INDICATOR SCORE RANGE

23

FIGURE 9. SUMMARY OF TOPIC SCORING ANALYSIS

24

FIGURE 10. VISUAL REPRESENTATION OF SYNTHESIS OF PRIMARY AND SECONDARY DATA

26

FIGURE 11. POPULATION PER ZIP CODE, 2012-2016

30

FIGURE 12: POPULATION BY AGE, 2012-2016

31

FIGURE 13: POPULATION BY RACE/ETHNICITY, 2012-2016

32

FIGURE 14: POPULATION AGED 5+ SPEAKING LANGUAGE OTHER THAN ENGLISH AT HOME, 2012-2016

34

FIGURE 15: VETERAN POPULATION, 2012-2016

35

FIGURE 16: PERSONS WITH A DISABILITY, 2012-2016

35

FIGURE 17: MEDIAN HOUSEHOLD INCOME, 2012-2016

36

FIGURE 18: MEDIAN HOUSEHOLD INCOME PER COUNTY: PAST 4 TIME PERIODS

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FIGURE 19. MEDIAN HOUSEHOLD INCOME BY ZIP CODE, 2012-2016

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FIGURE 20: PEOPLE LIVING BELOW POVERTY LEVEL, 2012-2016

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FIGURE 21: PEOPLE LIVING BELOW POVERTY LEVEL: PAST 4 TIME PERIODS

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FIGURE 22: PEOPLE LIVING BELOW POVERTY LEVEL BY RACE/ETHNICITY, 2012-2016

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FIGURE 23: WHITE, NON-HISPANIC POPULATION LIVING BELOW POVERTY LEVEL: PAST 4 TIME PERIODS

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FIGURE 24. BLACK OR AFRICAN-AMERICAN POPULATION LIVING BELOW POVERTY LEVEL BY COUNTY (2012-2016) 41

FIGURE 25: BLACK OR AFRICAN-AMERICAN POPULATION LIVING BELOW POVERTY LEVEL: PAST 4 TIME PERIODS 42

FIGURE 26: HISPANIC OR LATINO POPULATION LIVING BELOW POVERTY LEVEL: PAST 4 TIME PERIODS

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FIGURE 27. PEOPLE LIVING BELOW POVERTY LEVEL BY ZIP CODE, 2012-2016

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FIGURE 28: POPULATION AGED 25+ WITH A HIGH SCHOOL DEGREE OR HIGHER, 2012-2016

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FIGURE 29: POPULATION AGED 25+ WITH A HIGH SCHOOL DEGREE OR HIGHER: PAST 4 TIME PERIODS

44

FIGURE 30. HIGH SCHOOL DEGREE ATTAINMENT BY ZIP CODE, 2012-2016

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FIGURE 31. SOCIONEEDS INDEX FOR UF HEALTH JACKSONVILLE AND UF HEALTH NORTH'S SERVICE AREA (ZIP CODE) 46

FIGURE 31. RELATED FACTORS TO ACCESS

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FIGURE 33. HIV INCIDENCE RATE & AIDS DIAGNOSIS RATE (CASES PER 100,000 POPULATION)

79

FIGURE 34. PERSONS WITH A DISABILITY, 2012-2016

88

FIGURE 35. VETERAN POPULATION, 2012-2016

89

FIGURE 36. INDICATOR SCORE RANGE

125

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