Florida Department of Health- Hillsborough County ...

Florida Department of HealthHillsborough County

Community Health Assessment 2015/2016

Mission To protect, promote, and improve the health of all people in Florida through integrated state, county, and community efforts.

Vision To be the healthiest state in the nation.

Values (ICARE) Innovation ? We search for creative solutions and manage resources wisely. Collaboration ? We use teamwork to achieve common goals and solve problems. Accountability ? We perform with integrity and respect. Responsiveness ? We achieve our mission by serving our customers and engaging our partners. Excellence ? We promote quality outcomes through learning and continuous performance improvement.

Principles Honesty, Fairness, Devotion, Courage, and Excellence

This report is available at the Florida Department of Health?Hillsborough County website at:

TABLE OF CONTENTS

LIST OF TABLES ............................................................................................................................................3

LIST OF FIGURES...........................................................................................................................................4

ACKNOWLEDGEMENTS ..............................................................................................................................5

EXECUTIVE SUMMARY ................................................................................................................................7

COMMUNITY HEALTH ASSESSMENT PROCESS OVERVIEW .......................................................9

MAPP MODEL.......................................................................................................................... 9 HOSPITAL AND HEALTH CENTER COLLABORATION .....................................................................10 STATISTICS AND MEASUREMENT ..............................................................................................12

COMMUNITY HEALTH STATUS ASSESSMENT................................................................................ 13

METHODS ...............................................................................................................................13 RESULTS ................................................................................................................................13

Demographic and Socio?Economic Characteristics............................................................13 Health Status ......................................................................................................................26

County Health Rankings..................................................................................................26 Infant Health....................................................................................................................33 Adult Health.....................................................................................................................34 Health Disparities ............................................................................................................39 DISCUSSION ............................................................................................................................44

COMMUNITY THEMES AND STRENGTHS ASSESSMENT ............................................................ 46

METHODS ...............................................................................................................................46 RESULTS ................................................................................................................................47

Community Survey .............................................................................................................47 Focus Groups .....................................................................................................................62 Key Informant Interviews ....................................................................................................63 DISCUSSION ............................................................................................................................65

FORCES OF CHANGE ASSESSMENT.................................................................................................. 68

METHODS ...............................................................................................................................68 RESULTS ................................................................................................................................68 DISCUSSION ............................................................................................................................68

LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT .......................................................................... 70

METHODS ...............................................................................................................................70 RESULTS ................................................................................................................................71 DISCUSSION ............................................................................................................................72

IDENTIFYING STRATEGIC ISSUES ....................................................................................................... 73

STRATEGIZING MEETING OVERVIEW .........................................................................................73 COLLABORATIVE PRIORITIES ....................................................................................................73

AVAILABLE RESOURCES/ASSETS INVENTORY............................................................................. 75

Florida Department of Health ? Hillsborough County 1

Community Health Assessment 2015/2016

PRIORITY AREAS ........................................................................................................................................ 77 CONCLUSION AND NEXT STEPS .......................................................................................................... 88 REFERENCES............................................................................................................................................... 89 APPENDICES ................................................................................................................................................ 90

APPENDIX A. HEALTHY HILLSBOROUGH MEMBERS AND MEETING DATES ....................................90 APPENDIX B. COMMUNITY SURVEY INSTRUMENT .......................................................................97 APPENDIX C. FOCUS GROUP INSTRUMENT ..............................................................................106 APPENDIX D. KEY INFORMANT INTERVIEW INSTRUMENT ...........................................................107 APPENDIX E. STRATEGIZING MEETING FINAL REPORT .............................................................108

2 Florida Department of Health ? Hillsborough County

Community Health Assessment 2015/2016

LIST OF TABLES

Table 1. Population of Hillsborough County and City Components..........................................14 Table 2. Population of Hillsborough County and Florida by Age (2015)...................................15 Table 3. Population of Hillsborough County and Florida by Age (2020)...................................15 Table 4. Household Type (2010) .............................................................................................17 Table 5. Nativity and Language Spoken at Home (2010?2014) ..............................................18 Table 6. Income Measures (2010?2014).................................................................................19 Table 7. Household Income Distribution (2010?2014).............................................................20 Table 8. Federal Poverty Guidelines (2015) ............................................................................21 Table 9. Colleges and Technical/Career Schools in Hillsborough County ...............................23 Table 10. Demographics of Arrestees (2014) ............................................................................26 Table 11. Summary of County Health Rankings ............................................................ 28 Table 12. Length and Quality of Life..........................................................................................28 Table 13. Health Behaviors .......................................................................................................30 Table 14. Clinical Care..............................................................................................................31 Table 15. Social and Economic Factors ....................................................................................32 Table 16. Physical Environment ................................................................................................33 Table 17. Infant Health Status (2010?2014)..............................................................................34 Table 18. Infant and Neonatal Death Rates (2010?2014) .........................................................34 Table 19. Adult Health Status (2013) ........................................................................................36 Table 20. Adult Screening Status (2013)...................................................................................36 Table 21. Age?Adjusted Cancer Incidence Rates per 100,000 Population (2010?2012)...........37 Table 22. Age?Adjusted Hospitalization Rates per 100,000 Population (2012?2014) ...............38 Table 23. Age?Adjusted Mortality Rates per 100,000 Population (2014)...................................39 Table 24. Health Disparities? Access to Care ...........................................................................40 Table 25. Health Disparities? Maternal and Child Health (2012?2014) .....................................41 Table 26. Health Disparities?Injuries and Injury?Related Deaths (2012?2014) .........................42 Table 27. Health Disparities? Causes of Death (2012?2014) ....................................................43 Table 28. Health Disparities? Modifiable Behaviors Leading to Premature Death (2013) ..........43 Table 29. Most Important Health Problem ................................................................................58 Table 30. Factors that Improve Quality of Life ..........................................................................59 Table 31. Most Important Risky Behaviors ...............................................................................60 Table 32. Trusted Source of Information ...................................................................................61 Table 33. Statements About Local Community..........................................................................62 Table 34. Most Important Health Issue .....................................................................................63 Table 35. Ranked Forces of Change.........................................................................................69 Table 36. Summary of LPHSA Results .....................................................................................71 Table 37. Strategic Health Issues..............................................................................................74 Table 38. Resources Available to Support Strategic Health Issues ...........................................75 Table 39. Resources Available to Support Strategic Health Issues ...........................................76 Table 40. Behavioral Health Priority Area Available Asset Inventory .........................................78 Table 41. Access to Care Priority Area Available Asset Inventory .............................................79 Table 42. Access to Care Priority Area Available Asset Inventory .............................................80 Table 43. Access to Care Priority Area Available Asset Inventory .............................................80 Table 44. Access to Care Priority Area Available Asset Inventory .............................................82 Table 45. Access to Care Priority Area Available Asset Inventory .............................................82 Table 46. Access to Care Priority Area Available Asset Inventory .............................................84 Table 47. Obesity Priority Available Asset Inventory .................................................................85

Florida Department of Health ? Hillsborough County 3

Community Health Assessment 2015/2016

LIST OF FIGURES

Figure 1. Four MAPP Assessments Flowchart ........................................................................10 Figure 2. Community Health Needs Assessment Alignment for Healthy Hillsborough

Steering Committee Members .................................................................................11 Figure 3. Location of Hillsborough County, Florida ..................................................................14 Figure 4. Population of Hillsborough County and Florida by Age.............................................16 Figure 5. Population by Race/Ethnicity....................................................................................16 Figure 6. Household Income in Hillsborough County (2010?2014)..........................................20 Figure 7. Percentage of the Population Living Below the Poverty Level (2010?2014) .............21 Figure 8. Educational Attainment for Persons 25 Years of Age and Older (2010?2014)..........22 Figure 9. Labor Force Participation (2010?2014) ....................................................................24 Figure 10. Six Month Average Unemployment Rate (2005?2015).............................................25 Figure 11. Employment by Industry (2010?2014)......................................................................25 Figure 12. Geographic Distribution of Survey Respondents ......................................................48 Figure 13. How Respondents Rate the Health of their Community............................................49 Figure 14. How Respondents Rate their Personal Health .........................................................49 Figure 15. Exercise Frequency .................................................................................................50 Figure 16. Smoking Frequency .................................................................................................51 Figure 17. Alcohol Consumption ...............................................................................................51 Figure 18. Sugary Drink Consumption ......................................................................................52 Figure 19. Respondents Who Have a Medical Provider ............................................................53 Figure 20. Time since Last Visit with Medical Provider ..............................................................54 Figure 21. Where Respondents Go for Medical Care by Race/Ethnicity....................................54 Figure 22. Where Respondents Go for Medical Care by Medical Provider ................................55 Figure 23. Respondents Who Did Not Get Needed Medical Care .............................................55 Figure 24. Reasons For Not Getting Medical Care ....................................................................56 Figure 25. How Respondents Paid for Medical Care .................................................................56 Figure 26. How Respondents Paid for Medical Care by Race and Ethnicity ..............................57 Figure 27. Reasons for No Health Insurance ............................................................................57 Figure 28. Healthy Hillsborough Collaborative Meeting .............................................................68 Figure 29. Essential Public Health Services and Core Functions ..............................................70 Figure 30. Ranked Ordered Performance Scores for Each Essential Service ...........................72 Figure 31. Meeting Participants Listing the Resources Available ..............................................75 Figure 32. Priority Areas of Focus .............................................................................................77

4 Florida Department of Health ? Hillsborough County

Community Health Assessment 2015/2016

ACKNOWLEDGEMENTS

The Florida Department of Health?Hillsborough County's 2015/2016 Community Health Assessment was developed by the Department's staff with the assistance of Legacy Consulting Group. Generous input was provided by a broad group of individuals representing the interests of the community, including the Healthy Hillsborough Steering Committee and Collaborative and the thousands of Hillsborough County residents and community members who took part in the community survey, key informant interviews and focus group sessions. We would like to acknowledge each of these individuals and thank them for their generosity, time and contributions.

The individuals listed below made major contributions to the planning and the completion of the health assessment and this report.

Healthy Hillsborough Steering Committee

Dr. Douglas Holt

DOH?Hillsborough

Dr. Leslene Gordon

DOH?Hillsborough

Daragh Gibson

DOH?Hillsborough

Dr. Ayesha Johnson

DOH?Hillsborough

Allison Nguyen

DOH?Hillsborough

Christina Bastone

BayCare Health System

Bob Costello

BayCare Health System

Keri Eisenbeis

BayCare Health System

Jan Baskin

Florida Hospital Carrollwood

Michelle Robey

Florida Hospital Tampa

Dr. Peter Bath

Florida Hospital West Florida Region

Mary Willis

Florida Hospital West Florida Region

Mary Jane Harrington

Tampa General Hospital

Tamika Powe

Tampa General Hospital

Jenna Davis

Moffitt Cancer Center

Cathy Grant

Moffitt Cancer Center

Edward Kucher

Tampa Family Health Centers

Karyn Glubis

Tampa Family Health Centers

Sonia Goodwin

Suncoast Community Health Centers

DOH ? Hillsborough Internal Work group

LeSonya Allen

Steve Huard

Jennifer Bellitera

Dr. Ayesha Johnson

Christina Ciereck

Lauren Krockta

Faye Coe

Cindy Morris

Steven Drake

Allison Nguyen

Daragh Gibson

Walter Niles

Dr. Leslene Gordon

Jim Roth

Eliot Gregos

Mike Wagner

Cindy Hardy

Jennifer Waskovich

Sophia Hector

Bonnie Watson

Dr. Douglas Holt

Florida Department of Health ? Hillsborough County 5

Community Health Assessment 2015/2016

DOH?Hillsborough Additional Support Staff Hilmarie Figueroa Eliot Gregos Dr. Ayesha Johnson (Product Team Lead) Dawn Krockta Noemi Padro Allyson Sison Douglas A. Zimmer

University of South Florida College of Public Health Interns: Freddy Cruz Kate LeGrand Tim Leighton Obianberi Manos Veronica Varela

Focus Group and Key Informant Interview Organizations Represented (Names of individual contributors in Appendix A): American Cancer Society Beth?El Farmworker Ministry Catholic Mobile Medical Services CDC of Tampa City of Joy C. O. G. I. C. Crisis Center Drug Abuse Comprehensive Coordinating Office (DACCO) Florida Blue Florida Department of Health?Hillsborough Haitian Association Healthy Start Coalition Hillsborough Area Regional Transit Authority (HART) Hillsborough County BOCC Hispanic Services Council Reach UP Redlands Christian Migrant Association (RCMA) Ruskin Seminole Tribe of Florida, Tampa Health St. James AME Church Tampa Tampa Bay Health Care Collaborative Tampa Bay United Way Tampa City Council, District 5 Tampa Family Health Centers Town `N Country Library University Area Community Development Corporation University of South Florida College of Public Health University of South Florida Bridge Clinic Wholesome Community Ministries

6 Florida Department of Health ? Hillsborough County

Community Health Assessment 2015/2016

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