1. Building a County Coalition to Transform Health for Women of Color and their Families Dr. Angela M. Wakhweya, MSc.Econ. Health Officer Anne Arundel County Department of Health Health Care Reform Conference for Women of Color Morgan State University September 8, 2012

2. The Local Context September 8, 2012 Anne Arundel County Department of Health2

3. Anne Arundel County ~ Who Are We? Anne ArundelMarylandU.S. Racial/Ethnic Breakdown: White72.4%54.7%63.7% Black15.2%29.0%12.2% Hispanic6.1%8.2%16.3% Asian3.4%5.5%4.7% Median Household Income (2010) *$79,843$69,193$50,221 Unemployment (January 2011) † 6.5%7.5%9.8% Uninsured Adults (2010) ¶ 10.3%12.9%17.8% Individuals Below Poverty (2010)6.8 %9.2%14.3% Area: 416 square miles Population 537,656 (2010) § Geography: Rural south county Rural south county Urban/suburban northern and mid-county Urban/suburban northern and mid-county § US Census, 2010; * American Community Survey, 2010; ¶ BRFSS, 2010; † Bureau of Labor Statistics, January 2011 3 Anne Arundel County Department of Health September 8, 2012

4. Geographic Disparities Anne Arundel County Department of Health Top Ten Zip Codes Five Leading Causes of Death, 2010 Crude Death Rate September 8, 20124

5. Anne Arundel County Department of Health Zip CodeNameCounty Region Deaths from Leading Causes, Ages 0-64 years Highest Crude Death Rate (per 100,000) 21225BrooklynNorthern26199.66 21060Glen Burnie EastNorthern48189.89 21061Glen Burnie WestNorthern80167.43 21401AnnapolisCentral37127.47 21122PasadenaNorthern67124.46 ZIP Codes with the highest death rate from the five leading causes, Ages 0-64 Geographic Disparities Five Leading Causes of Death for AA County (2010) 1. Heart Disease 4. Chronic Lower Respiratory Disease 2. Cancer 5. Diabetes 3. Stroke September 8, 20125

6. Geographic Disparities Anne Arundel County Department of Health 10 Leading ZIP Codes Medicaid Enrollment Rate* 2007-2011 September 8, 20126

7. Geographic Disparities 10 Leading ZIP Codes 2010 Hospital ED Visit Rate* Ages 5-18 Years Rate based on 2010 Census for Ages 5-18 Years September 8, 2012Anne Arundel County Department of Health7

8. *Crude rates per 100,000 population Gender and Race Disparities 2010 Hospital ED Visit Rates* September 8, 2012Anne Arundel County Department of Health8

9. Gender and Race Disparities 2010 Hospital ED Visits for Select Causes - 21225 Crude rates per 100,000 (all ages) Anne Arundel County Department of Health September 8, 20129

10. disparities Source: Maryland Health Services Cost Review Commission, 2010 Race Disparities by County September 8, 2012 Anne Arundel County Department of Health10

11. disparities Source: Maryland Health Services Cost Review Commission, 2010 Race Disparities by County September 8, 2012Anne Arundel County Department of Health11

12. Race Disparities - Weight September 8, 2012Anne Arundel County Department of Health12 Weight Status by Race for Anne Arundel County, 2007 Data source: Anne Arundel County Behavioral Risk Factor Survey, 2007

13. Towards A Healthy Weight! We are heading in the wrong direction! Percent of Obese Adults By Year for Anne Arundel County, Maryland, and the US Data source: National BRFSS Bend the obesity curve downwards A CALL TO ACTION! Anne Arundel County Department of Health

14. Healthy Anne Aruindel Coalition “A Ripple Effect” September 8, 2012Anne Arundel County Department of Health 14

15. Healthy Anne Arundel Coalition Structure Coalition Steering Committee Coalition Network Partnership for Children, Youth, & Families CBOs/FBOs/ Volunteers/ Community Reps School Health Advisory Council Drug and Alcohol Abuse Council County Board of Education County Detention and Corrections Facilities Department of Social Services Department of Aging and Disabilities County and City Recreation and Parks Mental Health Agency Arundel Community Development Services Anne Arundel County Public Schools County Agencies, Offices, Departments and Partners Examples Boards, Coalitions, Councils and Committees Examples Conquer Cancer Coalition FIMR and CFR Committees City Housing Authority & County Housing Commission County and City Police and Fire Department Large Employers & Businesses American Heart Association September 8, 2012Anne Arundel County Department of Health15

16. Healthy Anne Arundel Coalition Health Improvement Focus Areas  Obesity* ~ “Eat Healthier and Move More”  Mental Health & Substance Abuse* ~ Utilizing a “Four-Quadrant Framework”  Cancer and Tobacco Use Prevention  Dental Care  Sexual Health  Housing and Environmental Conditions  Maternal and Child Health *Designated Priority Areas Anne Arundel County Department of Health September 8, 201216

17. Steering Committee Promotion and Publicity Subcommittee Co-Occurring Disorders Steering Committee Community Health Needs Assessment Subcommittee Community Outreach Subcommittee Obesity Prevention Subcommittee Leadership and Finance Subcommittee Healthy Anne Arundel Coalition Implementation Structure September 8, 2012Anne Arundel County Department of Health17  Communicates with nearly 200 community and faith based organizations.  Assures that the Coalition’s activities are responsive to the needs of minorities in the County.  Assists other Coalition subcommittees in connecting with minority County residents.  Helps engage minority communities in the implementation of the Coalition’s Action Plan. Community Outreach Subcommittee

18. County Schools 79 Elementary Schools Enrollment: 36,759 19 Middle Schools Enrollment: 16,848 12 High Schools Enrollment: 22,696 142 Private Schools Enrollment: 15,038 Anne Arundel County Department of Health 300+ school health staff! September 8, 2012 18

19. ZIP CodeName # Elementary Schools # Middle Schools # High Schools # Private Schools* 21225Brooklyn3100 21060Glen Burnie East6104 21061Glen Burnie West9122 21401Annapolis51115 21122Pasadena8226 TOTAL316527 Anne Arundel County Department of Health Opportunity for School Based Partnerships * Not all private schools may be represented 19 September 8, 2012

20. Healthy Anne Arundel Coalition Reducing Health Disparities  The Coalition’s priorities reflect documented and evidence based health disparities  The Coalition’s broad-based membership assures that there is a vested interest in reducing health disparities across all sectors  The Community Outreach Subcommittee engages the County’s minority community in the implementation of the Coalition’s action plan and initiatives  “Generational shift” in health outcomes starts with our children and our youth! Anne Arundel County Department of Health20 September 8, 2012

21. Important Role of Local Public Health Departments in Health Care Reform – Transforming Care at the Local Level September 8, 2012 Anne Arundel County Department of Health 21

22. Key Role of LHDs  Utilize new public-private sector partnerships through the Coalition to improve health care outcomes and health disparities  Seek “navigator entity” status by positioning ourselves to respond to the RFP due late 2012  Provide public outreach and social marketing to inform, educate and empower communities  Assure access to services during public health transitions as part of our three core public health functions and ten essential services  Lead the local health improvement coalition process and ensure the community is aware and engaged! Anne Arundel County Department of Health21 September 8, 2012

23. Healthy Anne Arundel Coalition Contacts Laurie Fetterman, MSW Phone: 410-222-7203 Email: HDFETT00@aacounty.org www.HealthyAnneArundel.orgHealthyAnneArundel@aacounty.org 22 Anne Arundel County Department of Health September 8, 2012