1. ERIN RAY PASCARETTI EPIDEMIOLOGIST PUTNAM COUNTY DEPARTMENT OF HEALTH Data Review

2. Community Health Assessment & Community Health Improvement Plan Description of the community being assessed  Demographics  Health Status Identification of main health challenges Summary of assets and resources Method for distribution to community Identification of at least 2 priorities Goals and objectives Individuals and Organizations involved Outcome and process measures Strategies and Best Practices

3. Data Sources Partners

4. Prevention Agenda.

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6. Prevention Agenda – Health Disparities Socio-economic Gender Race/Ethnicity Geography Age Other

7. Prevention Agenda – Health Status & Disparities Indicator Data Years Putnam County New York State NYS 2017 Objective l. Percentage of premature death (before age 65 years) 2008- 2010 24.424.321.8 2. Ratio of Black non-Hispanics to White non-Hispanics 1.56+2.121.87 3.Ratio of Hispanics to White non-Hispanics 2.062.141.86 4. Age-adjusted preventable hospitalizations rate per 10,000 - Ages 18+ years 2008- 2010 116.9155.0133.3 5. Ratio of Black non-Hispanics to White non-Hispanics 0.792.091.85 6.Ratio of Hispanics to White non-Hispanics 0.51.51.38 7. Percentage of adults with health insurance -Ages 18-64 years 2010 87.8 (86.6- 89.0) 83.1 (82.9- 83.3) 100 8. Age-adjusted percentage of adults who have a regular health care provider - Ages 18+ years 2008- 2009 91.1 (86.8- 95.3) 83.0 (80.4- 85.5) 90.8

8. Prevention Agenda – Healthy & Safe Environment Indicator Data YearsPutnam County New York State NYS 2017 Objective 9. Rate of hospitalizations due to falls per 10,000 - Ages 65+ years2008-2010 183.5204.6Maintain 10. Rate of emergency department visits due to falls per 10,000 - Ages 1-4 years 2008-2010 541.1476.8429.1 11.Assault-related hospitalization rate per 10,000 2008-2010 1.44.84.3 12. Ratio of Black non-Hispanics to White non-Hispanics s7.436.69 13.Ratio of Hispanics to White non-Hispanics 1.77+3.062.75 14. Ratio of low income ZIP codes to non-low income ZIP codes 0.00+3.252.92 15. Rate of occupational injuries treated in ED per 10,000 adolescents - Ages 15-19 years2008-2010 43.936.733.0 16. Percentage of population that lives in a jurisdiction that adopted the Climate Smart Communities pledge 20120.0*26.732.0 17. Percentage of commuters who use alternate modes of transportation 1 2007-2011 22.644.649.2 18. Percentage of population with low-income and low access to a supermarket or large grocery store 20105.42.52.24 19. Percentage of homes in Healthy Neighborhood Program that have fewer asthma triggers during the home revisits 2008-2011 NA12.920 20. Percentage of residents served by community water systems with optimally fluoridated water 20120.0*71.478.5

9. Prevention Agenda – Chronic Disease Indicator Data YearsPutnam County New York State NYS 2017 Objective 21.Percentage of adults who are obese 2008-200925.8 (21.3-30.3) 23.2 (21.2- 25.3) 23.2 22. Percentage of children and adolescents who are obese2010-2012 17.217.6 NYC: 19.7 ROS: 16.7 23.Percentage of cigarette smoking among adults 2008-2009 13.0 ( 9.9-16.1) 16.8 (15.1- 18.6) 15.0 24. Percentage of adults who receive a colorectal cancer screening based on the most recent guidelines - Ages 50-75 years 2008-200970.6 (64.6-75.9) 66.3 (63.5- 69.1) 71.4 25. Asthma emergency department visit rate per 10,000 2008-2010 28.483.775.1 26. Asthma emergency department visit rate per 10,000 - Ages 0-4 years 2008-2010 58.0221.4196.5 27. Age-adjusted heart attack hospitalization rate per 10,000 201014.815.514.0 28. Rate of hospitalizations for short-term complications of diabetes per 10,000 - Ages 6- 17 years 2008-2010 1.4*3.23.06 29. Rate of hospitalizations for short-term complications of diabetes per 10,000 - Ages 18+ years 2008-2010 2.85.64.86

10. Prevention Agenda – HIV/STD, Vaccine Preventable Indicator Data YearsPutnam CountyNew York State NYS 2017 Objective 30. Percentage of children with 4:3:1:3:3:1:4 immunization series - Ages 19-35 months 3 201141.247.6 31. Percentage of adolescent females with 3-dose HPV immunization - Ages 13-17 years 201115.726.05 32. Age-adjusted percentage of adults with flu immunization - Ages 65+ years 2008-200977.9 (70.2-85.7) 75.0 (71.5- 78.5) 66.2 33.Newly diagnosed HIV case rate per 100,000 2008-2010 5.721.614.7 34. Difference in rates (Black and White) of new HIV diagnoses s59.445.7 35. Difference in rates (Hispanic and White) of new HIV diagnoses s31.122.3 36. Gonorrhea case rate per 100,000 women - Ages 15-44 years 201039.9*203.4183.1 37. Gonorrhea case rate per 100,000 men - Ages 15-44 years 201016.1*221.7199.5 38. Chlamydia case rate per 100,000 women -Ages 15-44 years 2010421.91619.81,458 39. Primary and secondary syphilis case rate per 100,000 males 20100*11.210.1 40. Primary and secondary syphilis case rate per 100,000 females 20100*0.50.4

11. Prevention Agenda – Maternal Child Health Indicator Data YearsPutnam CountyNew York StateNYS 2017 Objective 41.Percentage of preterm births 2008-2010 11.012.010.2 45. Percentage of infants exclusively breastfed in the hospital2008-2010 62.642.548.1 49.Maternal mortality rate per 100,000 births 2008-2010 s23.321.0 50. Percentage of children who have had the recommended number of well child visits in government sponsored insurance programs 4 201174.969.976.9 54. Percentage of children with any kind of health insurance - Ages 0-19 years 2010 95.8 (94.8-96.8) 94.9 (94.5- 95.3) 100 55. Percentage of third-grade children with evidence of untreated tooth decay2009-201119.8 (15.8-23.8) 24.0 (22.6- 25.4) 21.6 57. Adolescent pregnancy rate per 1,000 females -Ages 15-17 years2008-2010 5.031.125.6 60. Percentage of unintended pregnancy among live births 201114.226.724.2 64. Percentage of women with health coverage -Ages 18-64 years 2010 90.1 (88.6-91.6) 86.1 (85.8- 86.4) 100 65. Percentage of live births that occur within 24 months of a previous pregnancy2008-2010 18.218.017.0

12. Prevention Agenda – Mental Health Substance Abuse Indicator Data Years Putnam County New York State NYS 2017 Objective 66. Age-adjusted percentage of adults with poor mental health for 14 or more days in the last month 2008- 2009 9.5 (6.6- 12.5) 10.2 (8.7 - 11.7) 10.1 67. Age-adjusted percentage of adult binge drinking during the past month 2008- 2009 19.8 (14.7- 24.8) 18.1 (16.1- 20.2) 18.4 68.Age-adjusted suicide death rate per 100,000 2008- 2010 6.47.15.9

13. Community Asset Survey All Residents (work or live) All Ages Advertised  Newspaper  Online  PHC and County Employees  Free Media  County Website 340 Responses

14. Community Asset Survey - Strengths of Community

15. Other Comments Great Snow Removal Proximity to NYC Quiet Rural Vigorous Probation Services

16. Community Asset Survey - Focus Areas

17. Other Comments Affordable gyms like YMCA After School Programs Dog Friendly Parks Eliminate Duplicative Services Enforce Immigration Laws Lower Property Taxes Lower School Taxes Litter Removal More Drug Enforcement More Environmental Forums More Shopping Safe Housing for Sex Offenders Smaller Government

18. Community Asset Survey - Health Issues

19. Other Comments Adult Protection Alcohol Abuse Education Cancer Support Functional Medicine Gun Safety Hospice Palliative Care Services on Western Side Substance Abuse Education Tetanus Shots for Laborers

20. County Health Rankings Population based health  Health Outcomes  Health Factors  Policies & Programs Ranked within State National & State data Priority is to raise awareness

21. County Health Rankings – Priority Areas Premature Death Perception of health, physical health, and mental health Obesity and physical inactivity Excessive drinking Uninsured Primary care physician & Dentist ratio Daily fine particulate matter Limited access to healthy foods

22. Many Voices One Valley Telephone Survey  Landline  Cell ~300 Residents Third Survey Focus  Living in Region  Working in Region  Priorities for Future  Quality of Healthcare

23. Many Voices One Valley – Priority Areas

24. What Now? Pick priority areas Identify strengths and weaknesses Create Goals and Objectives Assess and Measure Monitor over five years