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Item B: Lane County Community Health Assessment Plan
ECC UGENE ITY OUNCIL AIS GENDA TEM UMMARY Work Session: Lane County Community Health Assessment Action Plan Meeting Date: July 22, 2013 Agenda Item Number: B Department: Library, Recreation and Cultural Services Staff Contacts: Renee Grube www.eugene-or.gov Contact Telephone Numbers: 541-682-5067 ISSUE STATEMENT This work session will provide an overview of the Lane County Community Health Assessment and Community Health Improvement Plan. BACKGROUND Lane County Public Health, Trillium Community Health Plans, PeaceHealth Oregon West, the United Way of Lane County, and Lane County residents have been engaged in a community health assessment and community health improvement planning process. Non-profit hospitals (PeaceHealth) and Coordinated Care Organizations in Oregon (Trillium) are both required, through federal and state legislations, to engage with public health in parallel processes to assess health needs in the community and develop a plan to collaboratively address those needs. Additionally, Lane County Public Health is required to complete a similar process in order to meet the requirements for national accreditation as a Public Health Department. Due to the similar requirements, the three entities and the United Way of Lane County decided to pursue the processes together. As a team, they completed one community health assessment process and developed one collaborative plan for how they will work together with community members to improve the health of Lane County residents. This work session will provide an overview of their findings. RELATED CITY POLICIES Effective, Accountable Municipal Government: A government that works openly, collaboratively, and fairly with the community to achieve measureable and positive outcomes and provide effective, efficient services. Sustainable Development: A community that meets its present environmental, economic and social needs without compromising the ability of future generations to meet their own needs. S:\CMO\2013 Council Agendas\M130722\S130722B.doc COUNCIL OPTIONS No options are provided; this item is for information only. CITY MANAGER’S RECOMMENDATION No recommendation is suggested; this item is for information only. SUGGESTED MOTION No suggested motion; this item is for information only. ATTACHMENTS A. Community Health Assessment B. Community Health Improvement Plan FOR MORE INFORMATION Staff Contacts: Renee Grube Telephone: 541-682-5067 Staff E-Mail: renee.l.grube@ci.eugene.or.us S:\CMO\2013 Council Agendas\M130722\S130722B.doc Lane County Community Health Assessment 7TVMRK:IVWMSR %'SPPEFSVEXMZI4VSNIGXFIX[IIR0ERI'SYRX]4YFPMG,IEPXL4IEGI,IEPXL3VIKSR;IWX 8VMPPMYQ''3ERH9RMXIH;E]SJ0ERI'SYRX] 0ERI'SYRX]'SQQYRMX],IEPXL%WWIWWQIRX Lane County Community Health Assessment 7TVMRK:IVWMSR Overview 0ERI'SYRX]4YFPMG,IEPXL4IEGI,IEPXL3VIKSR;IWXERH8VMPPMYQ 3VKERM^EXMSRPEYRGLIHEGSQTVILIRWMZIGSQQYRMX]LIEPXLEWWIWWQIRXERHTPERRMRKTVSGIWWMRWTVMRK 9RHIVXEOIRMRGSPPEFSVEXMSR[MXLQER] GSQQYRMX]TEVXRIVWXLISZIVEPPKSEPSJXLMW[SVO [EWXSMHIRXMJ]OI]TVMSVMX]EVIEW[LIVIXLI GSQQYRMX]GERXEOIEGXMSRXSMQTVSZISZIVEPP MAPP Method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teering Committee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ummary of Findings Community Health Status (IWTMXIKSSHTL]WMGEPLIEPXL0ERI'SYRX]VIWMHIRXWEVIQYGLQSVIPMOIP]XSI\TIVMIRGITSSV QIRXEPLIEPXLERHWYFWXERGIEFYWIMWWYIWXLERXLIVIWXSJ3VIKSRSVXLIREXMSR 'SWXVIQEMRWEWMKRMJMGERXFEVVMIVXSEGGIWWJSVQER]VIWMHIRXW 8SFEGGSYWIEQSRKTVIKRERX[SQIRLEWMRGVIEWIHMRVIGIRX]IEVWERHMWEQENSVGSRGIVRJSVXLI LIEPXLSJFSXLQSXLIVERHGLMPH 'LMPHLSSHZEGGMREXMSRVEXIWMR0ERI'SYRX]EVIXSSPS[XSIJJIGXMZIP]TVSXIGXEKEMRWXWSQI GSQQYRMGEFPIHMWIEWIWPMOITIVXYWWMWERHQIEWPIW Forces of Change and Community Themes 'IVXEMRGSQQYRMXMIWMR0ERI'SYRX]LEZIEWMKRMJMGERXP]SPHIVTSTYPEXMSRXLERXLIVIWXSJXLI GSYRX]WXEXIREXMSR 0ERI'SYRX]MWKVS[MRKQSVIIXLRMGEPP]HMZIVWI[MXLERMRGVIEWMRK,MWTERMGTSTYPEXMSR -RGSQQYRMX]JSVYQWVIWMHIRXWMHIRXMJMIHFILEZMSVEPLIEPXLXSFEGGSYWISFIWMX]ERHHMEFIXIWEW XLIQSWXTVIWWMRKRIIHWMR0ERI'SYRX] -RGVIEWIHEGGIWWXSSVEPLIEPXLGEVI[EWMHIRXMJMIHF]FSXLGSRWYQIVWERHTVSZMHIVWEWETVMSVMX] (YIXSFYHKIXEV]GSRWXVEMRXWERHXLIIGSRSQMGHS[RXYVR0ERI'SYRX]ERHSXLIVGSQQYRMX] WIVZMGITVSZMHIVWLEZIFIIRJSVGIHXSGYXFEGOSRWIVZMGIW Priority Areas for Community Health Improvement %HZERGIERH-QTVSZI,IEPXL)UYMX] 4VIZIRXERH6IHYGI8SFEGGS9WI 7PS[XLI-RGVIEWISJ3FIWMX] 4VIZIRXERH6IHYGI7YFWXERGI%FYWIERH1IRXEP-PPRIWW -QTVSZI%GGIWWXS,IEPXL'EVI 7YQQEV]SJ*MRHMRKW 0ERI'SYRX]'SQQYRMX],IEPXL%WWIWWQIRX Overview of CHA Process Narrative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iagram of Key Partners 3ZIVZMI[SJ',%4VSGIWW 0ERI'SYRX]'SQQYRMX],IEPXL%WWIWWQIRX Method 8LIEWWIWWQIRXTVSGIWWYXMPM^IHF]XLI0ERI'SYRX]TEVXRIVWLMT[EWEHETXIHJVSQXLIREXMSREP 1SFMPM^MRKJSV%GXMSRXLVSYKL4PERRMRKERH4EVXRIVWLMTW 1%44 QSHIPERIZMHIRGIFEWIH GSQQYRMX][MHIWXVEXIKMGTPERRMRKTVSGIWWJSVMQTVSZMRKGSQQYRMX]LIEPXL1%44[EWHIZIPSTIH F]XLI2EXMSREP%WWSGMEXMSRSJ'SYRX]ERH'MX],IEPXL3JJMGMEPW 2%'',3 MRSVHIVXSLIPT GSQQYRMXMIWMQTVSZILIEPXLXLVSYKLGSPPEFSVEXMZIGSQQYRMX]HVMZIRWXVEXIKMGTPERRMRK 6EXLIVXLERJSGYWMRKSRQIHMGEPLIEPXLSYXGSQIWERHMRHMGEXSVWXSEWWIWWGSQQYRMX]LIEPXL1%44 XEOIWEGSQTVILIRWMZIETTVSEGLSJPSSOMRKEXXLIQ]VMEHJEGXSVWXLEXEJJIGXMRHMZMHYEPJEQMP]ERH GSQQYRMX]LIEPXL8LVSYKLEWIVMIWSJHMJJIVIRXEWWIWWQIRXWXLI0ERI'SYRX],IEPXL%WWIWWQIRX XIEQPSSOIHEXHEXEXLEXEHHVIWWIHUYEPMX]SJPMJIWSGMSIGSRSQMGJEGXSVWW]WXIQWERHTSPMG]PIZIP MRJVEWXVYGXYVIEW[IPPEWXVEHMXMSREPTL]WMGEPERHQIRXEPLIEPXLMRHMGEXSVW&]GSRWMHIVMRKWYGL[MHI VERKMRKMRJSVQEXMSRXLI0ERI'SYRX],IEPXL%WWIWWQIRXKMZIWEJYPPTMGXYVISJLIEPXLMRSYV GSQQYRMX] 1%44MRGPYHIWJSYVHMJJIVIRXGSQQYRMX]EWWIWWQIRXW XLI'SQQYRMX],IEPXL7XEXYW%WWIWWQIRX PSSOMRKEXHEXE XLI'SQQYRMX]8LIQIWERH7XVIRKXLW%WWIWWQIRX WYVZI]WOI]MRJSVQERX MRXIVZMI[WERHGSRZIVWEXMSRW[MXLXLIGSQQYRMX] XLI*SVGIWSJ'LERKI%WWIWWQIRX MHIRXMJ]MRKXLI FVSEHJSVGIWXLEX[SYPHLIPTSVLMRHIVXLIMQTPIQIRXEXMSRSJE'SQQYRMX],IEPXL-QTVSZIQIRX 4PER ERHE0SGEP4YFPMG,IEPXL7]WXIQ%WWIWWQIRX EWWIWWIWXLIGETEGMX]SJXLIIRXMVIGSQQYRMX] TYFPMGLIEPXLW]WXIQ 8SHEXI0ERI'SYRX]LEWGSQTPIXIHXLIJMVWXX[SEWWIWWQIRXW%W[IHIZIPST XLIEGXMSRTPERXSMQTPIQIRXXLI'SQQYRMX],IEPXL-QTVSZIQIRX4PERXLI*SVGIWSJ'LERKIERH 0SGEP4YFPMG,IEPXL7]WXIQ%WWIWWQIRXW[MPPFIGSQTPIXIHERHEHHIHXSXLMWVITSVXEWEREHHIRHYQ Community Presentations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emographics of Lane County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Number % Good to Excellent 11 30.5 Fair Medium Moderate 6 16.7 Better than Other Places 9 25 Depends on SES 10 27.8 TOTAL 36 100 Q: Why do you think it has improved, declined, or stayed the same? Number % Social Determinants Total 37 64.9 Employment 16 28.0 Poverty/Access to Healthcare1119.3 Child Mistreatment 4 7.0 Education 3 5.3 Affordable Housing 3 5.3 Behavioral Risk Factors Total 814.0 Obesity 3 5.3 Stress 2 3.5 Alcohol/drug/Mental Health 2 3.5 Positive Comments Total 7 12.3 Smoking Bans 1 1.8 Improved Behavioral Risks 1 1.8 Fewer in hazardous jobs 1 1.8 Access improved 1 1.8 More social cohesion 1 1.8 New hospital 1 1.8 Air quality improved 1 1.8 Other Factors Total 5 8.8 Infant Mortality 2 3.5 Air Quality still bad 1 1.8 Hard to implement change 1 1.8 'SQQYRMX]8LIQIWERH7XVIRKXLW%WWIWWQIRX 0ERI'SYRX]'SQQYRMX],IEPXL%WWIWWQIRX Loss of sense of community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hat barriers, if any, exist to improving health and quality of life in Lane County? Number % Income/Employment 21 30.4 Lack of access to & knowledge for healthy practices; lack of resources for policy changes thereof1014.5 Access to healthcare 9 13.0 Education 8 11.6 Affordable housing 5 7.2 Transportation 4 5.8 Lack of funding for services 4 5.8 Drug Abuse 3 4.3 Elderly & Disabled Srvs. 2 2.9 Rural/isolated 2 2.9 Non-English speaking 1 1.4 Community Survey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nited Way Community Conversations 9RMXIH;E]SJ0ERI'SYRX] 9;0' WXEJJERHZSPYRXIIVWLEZIGSRHYGXIHHS^IRWSJ'SQQYRMX] 'SRZIVWEXMSRWEGVSWWXLI'SYRX]SZIVXLIPEWXX[S]IEVW'SQQYRMX]'SRZIVWEXMSRWEQSHIP 'SQQYRMX]8LIQIWERH7XVIRKXLW%WWIWWQIRX 0ERI'SYRX]'SQQYRMX],IEPXL%WWIWWQIRX HIZIPSTIHF]XLI,EV[SSH-RWXMXYXIEVIJEGMPMXEXSVPIHHMWGYWWMSRW[MXLGSQQYRMX]QIQFIVWJVSQ ZEVMSYW[EPOWSJPMJI 9;0'WXEJJERHZSPYRXIIVWLEZILSWXIHWIZIVEP'SQQYRMX]'SRZIVWEXMSRWJSGYWIHSRLIEPXLERH [IPPRIWWMRSYVGSQQYRMX]SZIVXLIPEWXWM\QSRXLW8LIWI'SRZIVWEXMSRWMRGPYHIHWTIEOMRK[MXL GSQQYRMX]QIQFIVWJVSQPS[MRGSQILSYWMRKJVSQEGVSWWXLIGSYRX]GSQQYRMX]QIQFIVWJVSQ *PSVIRGIERH7TERMWLWTIEOMRKGSQQYRMX]QIQFIVWJVSQ'SXXEKI+VSZIERH'VIW[IPP8LITYVTSWI SJXLIGSRZIVWEXMSRW[EWXSMRJSVQXLI'SQQYRMX],IEPXL2IIHW%WWIWWQIRXERH-QTVSZIQIRX4PER EFSYXXLIEWTMVEXMSRWERHGSRGIVRWSJHMJJIVIRXKVSYTWMRXLIGSQQYRMX]VIKEVHMRKLIEPXLERH [IPPRIWW 'SQQYRMX]8LIQIWERH7XVIRKXLW%WWIWWQIRX Lane County's Healthy Future Version 1.0 A Plan for Empowering the Community A Community Health Improvement Plan for Lane County, Oregon April 2013 Prepared by Jennifer Jordan, MPH LIME UNITED Tri I Ii U M Pei. ffle :lth Community Health Plan" United Way of Lane County Lane County Public Health TABLE OF CONTENTS Acknowledgements ...... ............................... ...........................Page 3 Executive Summary ................................ ............................... Page 4 Background & Introduction / Framework ............. ..........................Page 7 Health Priority One: Health Equity .... ........... ...........................Page 10 Health Priority Two: Tobacco ....................... ...........................Page 16 Health Priority Three: Obesity ...................... ...........................Page 26 Health Priority Four: Substance Abuse and Behavioral Health........ Page 34 Health Priority Five: Access to Health Care ...... ..........................Page 43 Conclusion................ ............................... ...........................Page 49 pj ACKNOWLEDGEMENTS Many individuals representing public, private and nonprofit groups worked on the Lane County's Healthy Future Version 1.0, Lane County's community health improvement plan. Their time, dedication and efforts are greatly appreciated. The following is a list of key contributors: • . Lindsey Adkission, Community Health Analyst, Lane County Public Health • James Boyle, PeaceHealth, Senior Analyst, PeaceHealth Oregon West • Anne Celovsky, AmeriCorps VISTA Volunteer, Lane County Public Health • Mardel Chinburg, Lane County Public Health Advisory Committee Member & University of North Carolina Practicum Student with Lane County Public Health • Chelsea Clinton, MS, MPA Health Program Specialist, United Way of Lane County /100% Access Coalition • Jody Corona, Health Facilities Planning & Development, Consultant for PeaceHealth • Tara DeVee, Trillium Community Advisory Committee • Jennifer Jordan, MPH, Senior Community Health Analyst, Lane County Public Health • Rick Kincade, MD, PeaceHealth, Network V.P. for Medical Affairs • Patrick Luedtke, MD, MPH, Public Health Officer, Lane County Public Health • Mary Anne McMurren, Administrator, PeaceHealth, Cottage Grove Hospital representing the Cottage Grove Community • David Parker, Chair, Trillium Community Advisory Committee • Dan Reece, LCSW, PeaceHealth, Peace Health Manager Network of Care • Ellen Severson, MPH, Community Health Analyst, Lane County Public Health /Trillium Community Health Plans • Rick Yecny, CEO, PeaceHealth, Peace Harbor Hospital, representing the Florence area community • Lane County Public Health Prevention Team • Lane County Community Members r Lane County, Oregon Executive Summary WELCOME TO LANE COUNTY'S HEALTHY FUTURE! Lane County has a strong foundation as a healthy community built around abundant natural resources, collaboration across organizations, hardworking residents, caring neighbors, and innovation. We are proud of these assets, but we know there is still much work to be done. Even though there has been decades of progress in reducing disease and early death, tobacco use continues to be the leading preventable cause of death and disease in Lane County; obesity and diabetes affect more people every year; rates of substance abuse and poor mental health are of serious concern; and access to health care remains a challenge for many. Additionally, health inequities persist for communities of color, low- income populations, sexual minorities, and others. These are complex challenges. Addressing them successfully requires resources, effort, innovation and participation from everyone. Actual Causes of Death in Oregon* Tobacco Diet /Activity Patterns Alcohol Toxic Agents Microbial Agents Motor Vehicles Firearms Sexual Behavior Illicit Use of Drugs Number of Deaths 4 0 2000 4000 6000 8000 *Risk factors or the actual reasons people die. For example, tobacco smoking is the most common actual cause of death from lung cancer. These data are crucial for monitoring the reasons why people die and for targeting where, when, and how health resources should be expended to reduce morbidity and early mortality. This Lane County wide community health improvement plan is the product of a collaborative effort by Lane County community members, Lane County Public Health, PeaceHealth, Trillium Community Health Plans (Lane County's Coordinated Care Organization coordinating health care for local Medicaid beneficiaries), and the United Way of Lane County. In order to collaboratively develop this community health improvement plan, the team led an extensive community health assessment and community health improvement planning process over the last year (May 2012 -April 2013). Please see the companion document, Lane County's Community Health Assessment Version 1.0, for further details on the process and data collected. Based on the review of local public health data, it was found that there are more similarities than differences in the health of Lane County residents and that of the rest of the state. For this reason, and in order to align efforts at the state and local level to increase impact, the local team has worked to closely match our community health improvement plan priorities and strategies with those included in the State of Oregon's health improvement plan. We would like to thank the state's community health improvement planning team for their leadership in this work. In addition to aligning priority areas and strategies, much of the background language for each of the five health priority areas in this plan was pulled directly from the State of Oregon's Health Improvement Plan (The 2012 Oregon's Healthy Future, Version 1.0; A Plan for Empowering Communities).. We would also like to credit the state team for the work they have done in drafting that and other language we have borrowed from their plan. Based upon the review of local community health data from a variety of sources, these five priority areas are offered to focus the attention and work of policy- makers and public, private and nonprofits organizations over the course of the implementation of this three year plan (July 2013 — June 2016): 1. Advance and Improve Health Equity 2. Prevent and Reduce Tobacco Use 3. Slow the Increase of Obesity 4. Prevent and Reduce Substance Abuse and Mental Illness 5. Improve Access to Health Care These priorities were chosen based on which accomplishments would offer the greatest improvements in lifelong health, advance health equity, and promote equal access to conditions 5 that allow people to be healthy. This plan outlines improvement strategies that will address each of these priorities and allow us to advance toward our vision. While this plan outlines key areas for action over the next 3 years, Lane County's Healthy Future Version 1.0 is a living dynamic document. While the priorities are clear, the details of the means of addressing them will be further developed and evolve and grow over time. We envision a Lane County where everyone in the community is empowered to participate in efforts to improve the lifelong health of all people in the community. Through this effort, we will work to raise awareness that working toward better health is not just the job of the individual. There are many things we can do at the community and organizational level to ensure that, when residents decide to live healthier, the systems and people around them support and encourage that decision. These changes to the environments where we live, learn, work, and play will make it easier for everyone in the community to achieve better health and improve health equity.. Background & Introduction/Framework Factors Socioeconomic Factors: The community health assessment and community health improvement team was encouraged by the level of community interest expressed in efforts that focus on the "social determinants of health ". Work in this area would fall into the bottom and most impactful level of the pyramid above — Socioeconomic Factors. Work in this area — e.g. poverty reduction, ensuring access to affordable housing, increasing formal educational attainment at the community level — has generally been outside the purview of public health interventions. The community health assessment and community health improvement plan leadership team looks forward to supporting and coordinating community efforts to engage in work in this area. Our top priority - advancing and improving health equity - an element in this work plan still at a very early stage of development, will be a place to focus work in this area. Work in each of the four.other priority areas will also be prioritized to focus community energy on efforts with the greatest potential to improve health equity. Changing the Context to Make Individuals' Default Decisions Healthy: The majority of the strategies in this plan focus on efforts to encourage public and organizational policy adoption and implementation here in Lane County. As depicted in the visual above developed by Dr. Thomas Frieden, MD, MPH, the Director of the U.S. Centers for Disease Control and Prevention (CDC), it is at the lower levels of the pyramid where we can expect the greatest impact for the effort exerted. This is true both in terms of the resources necessary to lead the intervention and on the impacted community members. According to CDC Director Dr. Thomas Frieden: "Public action and interventions represented by the base of the pyramid require less individual effort and have the greatest population impact .... . ... Interventions at the top tiers are designed to help individuals rather than entire populations, but they could theoretically have a large population impact if universally and effectively applied. In practice, however, even the best programs at the pyramid's higher levels achieve limited public health impact, largely because of their dependence on long -term individual behavior change "(A Framework for Public Health Action: The Health Impact Pyramid, American Journal of Public Health, April 2010, Vol 100, No 4, pages 590 -595). [A complete PDF of this article is available online free of charge. Because public health is inherently political, unless we build community understanding and support for work at the lower levels of the pyramid, we cannot expect to gain the level of support necessary to encourage the policy changes needed to get ahead of health problems of this complexity. It is not the intent of this plan to devalue or ignore the importance of working at all levels, in fact Dr. Frieden argues that implementing interventions at each of the levels can lead to maximum sustained impact. This plan instead works to direct limited community attention and resources to efforts where we can expect to achieve the greatest community health benefit. Interventions at the top of the pyramid are better understood and don't require as much leadership support to implement. 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