Transcript Public Health Prioritization Process Community Presentation
Welcome to the Pueblo City-County Health Department
Thank you for being here today!
Restrooms are located by the elevators This is a tobacco-free campus. Thank you for not using tobacco on Health Department grounds We are a green building; green plastic bins in the back of the room are available for recycling In case of an emergency, please exit the building using the stairs at the front or back of the building
Agenda
Introduction/Purpose of Meeting (15 minutes) Community Process to Determine Priorities (15 minutes) Overview of Public Health Priorities: statistics, capacity, possible strategies (60 minutes) Community Input (30 minutes) Break (10 minutes) Rank Public Health Priorities (30 minutes) Next Steps (10 minutes)
Process to Narrow Down Priorities
PUEBLO COMMUNITY HEALTH ASSESSMENT
Mission of Pueblo Community Health Assessment
Pursuant to the Colorado Public Health Reauthorization Act –Colorado counties are required to complete a comprehensive community health assessment. To that end, Pueblo City-County Health Department is tasked to partner with various county-wide organizations and individuals to complete a community health assessment. The purpose of the assessment is to assist Pueblo in deciding what its community health priorities are for the next 5 years and what strategies will be used by various public health organizations and partners to improve the overall health of Pueblo residents. * Based on geography of Pueblo County
Contributions to Health Assessment Process
PCCHD Community Health Assessment Team Internal (CHATI) Members: Heather Maio Chad Wolgram Jenna Ward Julie Kuhn Lynn Procell Kim Whittington Sarah Joseph Shylo Dennison Community Health Assessment Steering Committee Members Donald Moore Mary Gunn Randy Evetts Angela Jensen Tony LaCombe John LeFebre Charlotte Yianokopolus-Veatch Cindy Lau Kirsten Taylor Michelle DesLauriers Barb Mettler
Steps of the Community Health Assessment
1) Community Health Assessment & Status Report (Data collection based on health indicators; strengths; & weaknesses) 2) Capacity Assessment & Report (Who is doing what & how well?) 3) Prioritization process of public health issues for community 4) Community Health Improvement Plan (Priorities identified and responsibilities assigned) 5) Strategic Plan for Pueblo City County Health Department
Top 8 Priorities
*In alphabetical order Cardiovascular Disease Communicable/Infectious disease prevention Diabetes Lack of providers/Access to care Mental health Obesity (adult and childhood) Poverty Teen Pregnancy/Unintended pregnancy
Cardiovascular Disease
Rate of Cardiovascular Disease 1200
Hospital Discharge for CVD, 2009
1000 1074.2 per 100,000 Pueblo County 800 600 961.8 per 100,000 Colorado 400 200 26% of all deaths caused by Heart Disease in Pueblo Disparities Minority populations have greater disparities for CVD 0 M aj or ca rd io va sc ula r d ise as e Dis ea Isc se he s o m f t ic he (co he ro na ar ry t ) h ea rt dis ea se s C er He eb ro ar t fa va sc ilu ula re r d ise as es /s tro ke Pueblo Colorado
Cardiovascular Disease
Evidence based strategies Comprehensive strategies to reduce blood pressure ( http://www.bmj.com/content/326/7404/1419.short
) Ensure screenings for high risk individuals ( http://www.bmj.com/content/326/7404/1419.short
)
Communicable/Infectious Disease
Influenza (flu) Pueblo County: 33 influenza-associated hospitalizations 2010-2011 Colorado average: 20.9 Disparities Elderly Infants Immune-compromised individuals Tuberculosis Pueblo County: 1.9 cases per 100,000 Colorado: 2.3 cases per 100,000 Disparities Prison and homeless populations
Communicable/Infectious Disease
The Rate of Positive Chlamydia Cases Reported in 15 24 Year-Olds per 100,000
4000 3500 3000 2500 2000 1500 1000 500 0 Pueblo Colorado Females Males Disparities 18-24 year olds Minority females Those with multiple partners Drug users
Communicable/Infectious Disease
Evidence based strategies ( www.cdc.gov
) Increase vaccines with chart reminders, electronic health records, mailed/telephoned reminders Comprehensive education on preventing transmission Increase and encourage testing
Diabetes
5% of all deaths in Pueblo are caused by Diabetes Mellitus, Type II Evidence based strategies ( www.thecommunityguide.org
) Case management interventions to improve glycemic control Self-management education in community gathering places for adults with type 2 diabetes
Lack of Providers/Access to Care
% enrolled in Medicare and dual eligible in 2008-2009
12.40% 18.80% Pueblo Weld Mesa Colorado 17.10% 10.90% Disparities Low socioeconomic individuals Ethnic and minority populations
Lack of Providers/Access to Care
Evidence based strategies Ensuring eligible individuals are enrolled in available insurance programs (i.e. CHP+, Medicaid, etc.) Increase the number of physician assistants and nurse practitioners
Safety Net Provider Locations in Pueblo County, 2007 Type # of Clinics
Rural Health Clinics 0 and Emergency Departments Safety Net Dental Clinics Safety Net Mental Health Clinics School Based Health Centers Clinic Delivery Sites Other Primary Care Clinics ClinicNet Clinics Public Health Departments and Nursing Services that Provide Primary Care Services 2 1 3 1 1 5 5 0
Mental Health
Poor mental health days was highest at 31% for ages 18-24 in Pueblo County Disparities Greatest percentage of suicides occurred among non-Hispanic whites Highest race/ethnicity and age-specific rates were among American Indian/Alaska Native adolescents and young adults.
Parents who reported behavioral or mental health problems in children ages 1-14
27 26,5 26 25,5 25 24,5 24 Pueblo Colorado
Mental Health
Evidence based strategies Collaborative care for managing depressive disorders Home and clinic-based depression care management
Poor Mental Health Days, 2009
4 3,5 3 2,5 2 1,5 1 0,5 0 Pueblo Colorado National Benchmark
Obesity
15 10 5 0 35 30 25 20 Children Eating Fruits and Vegetables Pueblo County: 5.8% consumed five or more fruits and vegetables per day Colorado: 9.6%
Percent of Youth (ages 2-14) Overweight and Obese, 2007-2009 Percent of Overweight and Obese Adults, 2007 2009
70 60 50 Obese Overweight/Obese 40 30 20 10 0 Obese Overweight/Obese Pueblo Colorado HP 2020 objective Pueblo Colorado HP 2020 Objective
Obesity
Disparities Lower socioeconomic status and middle income (living in suburban areas without connectivity) Minority populations Evidence based strategies ( www.thecommunityguide.org
) Behavioral interventions to reduce screen time Multi-component coaching or counseling interventions to reduce weight and maintain weight loss Worksite wellness programs (trainings, policy/system changes)
$60 000 $50 000 $40 000 $30 000 $20 000 $10 000 $0
Poverty
Percent of Pueblo County Population in Poverty, 2009
30 25 20 15 10 5 0
Median Household Income, 2009
adult poverty child poverty Pueblo Colorado Pueblo Colorado
Poverty
Disparities Ethnic and Minority Populations Evidence based strategies Increase financial literacy ( http://www.practicalmoneyskills.com/foreducators/stat e_standards/process.php
) Improve graduation rates ( http://www.cdc.gov/PCD/issues/2007/oct/pdf/07_0 063.pdf
)
Teen/Unintended Pregnancy
Pueblo County: 55.6% unintended and 44.4% intended Pueblo County Hispanic population: 49.7% of pregnancies considered intended In 2009, 17% of all births in Pueblo County were to teens
Teen/Unintended Pregnancy
Disparities Lower socio-economic women Young women whose mothers were teen moms Hispanic teens Evidence based strategies ( www.thecommunityguide.org
) Youth development, behavioral interventions: interventions coordinated with community service to reduce sexual risk behaviors in adolescents Comprehensive risk reduction intervention for adolescents (abstinence as well as other scientifically proven prevention methods)