York County Community Health Needs Assessment Summary of Results Presented By: Lisa Lehman, Holleran Dr. David Polk, York College April 3, 2009

2 Methodology A total of 625 York County adults were interviewed by telephone to assess their health practices and health status. There was a 25% over-sampling in York City to allow for results to be tabulated for the city alone. Interviews were conducted between April 7 and May 9, 2008 with additional interviews in York City conducted in November of Each interview lasted approximately minutes.

3 Key Areas Examined General Health Status (Mental Health, Physical Health) Access to Care Chronic Disease (Diabetes, Cardiovascular Health, Cancer) Risky Behavior (Substance Abuse, Communicable Disease) Oral Health Immunizations Children’s Health Women’s Health Teen Risky Behaviors Crime, Violence, and Race Relations Environmental Health

4 General Health Status of York County Residents

5 Would you say in general that your health is…?

66 Community Health Status Indicators ( health.hhs.gov) Compared to Peer Counties Peer CountiesYork, PAChester, PA Hillsborough, NH Size408,801474,027401,291 Density % Below Poverty7.5%5.3%6.3% % %11.9%11.0% % White93.4%89.6%94.0%

77 Would you say in general that your health is…? % Fair or Poor (Median 17.1%; Peers 8.2%-14.4%)

88 Trends – Subjective Health Assessment Poor to fair health10%13%11% 16%

9 During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities? Respondents reporting 1 or more days of poor physical or mental health

10 Average Number of Unhealthy Days In Past Month (Median 6.0; Peers )

11 Exercise, Weight, & Nutrition

12 Body Mass Index (BMI) ***Scores are significantly different than the National and Pennsylvania comparison.

13 Do you now consider yourself to be overweight, underweight, or about average?

14 During the past month, other than your regular job, did you participate in any physical activities or exercises?

15 Access to Health Care

16 Do you have any kind of health care coverage?

17 About how long has it been since you last visited a doctor for a routine checkup? ***Scores are significantly different than the National and Pennsylvania comparison.

18 Was there a time in the past 12 months when your doctor prescribed medication to you that you did not access because of cost?

19 Trends – Access to Care Cost prevented seeing MD 8%6%5%8%12% No usual provider of care 10%12%11%10% No health insurance6%9% 13%9%

20 Oral Health

21 How long has it been since you last visited a dentist or dental clinic for any reason?

22 How many of your permanent teeth have been removed because of tooth decay or gum disease? **Scores are significantly different than the Pennsylvania comparison.

23 Disability

24 Are you limited in any way in any activities because of physical, mental, or emotional problems? ***Scores are significantly different than the National and Pennsylvania comparison.

25 Do you now have any health problem that requires you to use special equipment?

26 Alcohol Consumption

27 During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage? Respondents who had an alcoholic drink in the past 30 days ***Scores are significantly different than the National and Pennsylvania comparison.

28 On the days when you drank, about how many drinks did you drink on average? Respondents who had an alcoholic drink in the past 30 days

29 How many times during the past 30 days did you have 5 or more drinks on an occasion? Respondents who have had a drink in the past 30 days ***Scores are significantly different than the National and Pennsylvania comparison.

30 Trends – Behavioral Risks Currently smoke20%19%23%22%26% Binge drinking13%20%12%16%9%

31 Seniors & Immunizations

32 During the past 12 months, have you had a flu shot? Respondents age 65 and over

33 During the past 12 months, have you had a flu shot? ***Scores are significantly different than the National and Pennsylvania comparison.

34 Safety

35 How often do you use seat belts when you drive or ride in a car? **Scores are significantly different than the Pennsylvania comparison. ***Scores are significantly different than the National and Pennsylvania comparison.

36 Trends – Behavioral Risks Don’t always wear seatbelt 39%35%33%25%17%

37 How safe from crime do you consider your neighborhood to be?

38 Preventive Screenings

39 Have you ever had a mammogram? Females 40 and Over

40 Have you ever been told by a doctor, nurse, or other health professional that you had prostate cancer? Males 40 and Over

41 Have you ever used a home blood stool test? ***Scores are significantly different than the National and Pennsylvania comparison. Respondents 50 and Over

42 Have you ever had a sigmoidoscopy or colonoscopy?

43 Adult Preventive Services Used

44 Trends – Access to Screening and Preventative Services Dental exam last yearna75%82%75%70% Breast exam last year (40+)66%67%77%64%94% Flu shot last year27%36%34%43%40% Ever had mammogram (40+)78%87%na94%93% Mammogram last two years (50+) 59%60%81%74%87% Pap exam last year63%67%69%83%66%

45 HIV/AIDS

46 Have you ever been tested for HIV? ***Scores are significantly different than the National and Pennsylvania comparison. Respondents under 65 years

47 Emotional Health

48 How often do you receive the emotional support you need? ***Scores are significantly different than the National and Pennsylvania comparison.

49 In general, how satisfied are you with your life? **Scores are significantly different than the Pennsylvania comparison.

50 Has a doctor or other healthcare provider ever told you that you had an anxiety disorder? *Scores are significantly different than the National comparison.

51 Has a doctor or other healthcare provider ever told you that you have a depressive disorder? *Scores are significantly different than the National comparison.

52 Does your family experience any problems with children or teenagers having behavior or emotional problems?

53 Eye Care

54 When was the last time you had your eyes examined by any doctor or eye care provider? *Scores are significantly different than the National comparison. Cost was #1 reason for not having eyes examined

55 Household Issues

56 In the past 30 days, have you been concerned about having enough food for you or your family?

57 Does your family experience any problems living in an apartment or house that needs major repairs?

58 Does your family experience any problems in lacking money to pay for housing?

59 Does your family experience any problems in lacking money to pay the utility bills?

60 Public Health

61 How important is it that your community has a strong system of public health?

62 York City has an organized approach to address the health of the community

63 York County has an organized approach to address the health of the community

64 Another organization or agency serves my community’s public health needs Mentions: WellSpan, Red Cross, Office of Aging, Fire/Police, VNA, Church, Salvation Army

65 On a scale of 1-5, how effective do you think public health is in your community?

66 Birth Statistics

67 Birth Measures (%s) Compared to Peer Counties York, PA Chester, PA Hillsborough, NH US Low birth wt Premature births Births to women under Births to unmarried women No care first trimester

68 Infant Mortality (Rate – Deaths Under Age of 1/1000 Live Births) Compared to Peer Counties York, PA Chester, PA Hillsborough, NH US White Black na13.6 Hispanic

69 Preventable Disease

70 Risk Factors For Premature Death

71 Death Measures (Rate per 100,000) Compared to Peer Counties York, PA Chester, PA Hillsborough, NH US Breast cancer (female) Colon cancer Coronary heart disease Homicide Lung cancer Motor veh injuries Stroke Suicide Unintentional injury

72 Prioritizing Issues & Developing Goals

73 Sample goal statements: To improve the quality of chronic disease care in South Central Pennsylvania. To create a public health department to serve York County. To increase the number of York County children who are physically active. To promote improved health literacy practices in York County. To reduce the incidence of dental caries among York County children through prevention education and services. To increase access to oral health care for the uninsured and underinsured population of York County. To advocate for policies that increase access to oral health treatment and preventative services.