Community Health Assessment

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Community Health Assessment

• Tompkins County, NY
• 20052010

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Purpose

• Describes the health of the community
• Basis for strategic planning
• Determine health priorities
• Data and technical assistance for researchers,
  community
• NYSDOH categorical grants
• Fulfills NYSDOH mandate

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CHA Structure
4
Structure

• Demographics
• Health Care environment
• CHA Core Indicators
• Data Analysis
• Resources
• Opportunities for Action
• Figures, Tables, Maps

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CHA Core Indicators

• Designated by NYSDOH
• Healthy People 2010 15 categories
• Article 6 references

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CHA Core Indicators (NYSDOH)
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Data Sources

• Community Health Assessment (CHA) Clearinghouse,
  NYSDOH
• NY Community Health Data Set
• County Health Indicator profiles
• CHA Indicators (CHAIs), NYSDOH
• 13 health topic areas
• U.S. Census Bureau

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Data Sources Local

• TC Health Department
• TC Planning Department
• TC Youth Services
• Health Planning Council
• County Office for the Aging
• Cayuga Medical Center
• COMPASS II

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Working with the data

• Working with small pops.
• Using 3-year averages

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Sampling Error
SMALL POPULATIONS
CHA p. 121 (Expanded BRFSS, 2003 - NYSDOH)
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Distorted Rates
SMALL POPULATIONS

• Maternal Mortality Rate /100,000 live births

Total maternal deaths Upstate, 2000-2002 20 Total
maternal deaths Tompkins, 2000-02 1
CHA p. 148 (NYS Vital Stats)
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Working with the data

• Working with small populations
• Using 3-year averages

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Evens out ups downs
3-YR AVERAGE
CHA p. 128 (TCHD Annual Report, 2001-2003)
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1 spike lasts 3 years
3-YR AVERAGE
Deaths in only 2 of 7 yrs
Yet, rate gt0 in 5 of 7 yrs
CHA p. 135 (NYS SPARCS data as of Aug. 2004)
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Numbers of Note

• Demographics

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Special Tab 137 (U.S. Census 2000)
Demographics

• Tompkins County Planning Department
• College students non-college students
• Long form question 8a at any time since
  February 1, 2000, has this person attended
  regular school or college?
• Yes for ages 17 years college student

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Population Transience
Demographics

• Over half of Tompkins 2000 pop. had lived in a
  different county 5 years earlier.
• One-fifth in a different state

CHA pp. 20, 31 (U.S. Census 2000 Residence in
1995 for the pop. 5 years and over.)
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Poverty (Individuals)
Demographics

• Tompkins individual poverty rate is the highest
  in the area.
• Excl. students, its close to the lowest.

CHA p. 34 (TC Planning Dept, Spec. Tab 137)
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Median Income
Demographics

• Tompkins median household income is below that
  of NYS
• Tompkins median family income gt NYS

CHA p. 33 (TC Planning Dept, Spec. Tab 137) 2000
Census SF-3 P77
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Numbers of Note

• Health Indicators

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Breast cancer incidence
Age adj. Rate /100,000 female residents, 1997-2001
CHA p. 68 (NYS Cancer Registry data as of Aug.
2004)
22
Breast cancer mortality
Crude Rate /100,000 female residents
CHA p. 67 (NYS Vital Statistics data as of Aug.
2004)
23
Colorectal cancer mortality
Age adj. Rate /100,000 residents, 1998-2002
CHA p. 71 (NYS Vital Statistics data as of Aug.
2004)
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Prostate Cancer

• Tompkins incidence rate is significantly higher
  than both NYS and Upstate (age-adj.)
• Mortality rates the only significant difference
  is for Tioga County(see chart, next slide)

CHA p. 74 (NYS Cancer Registry)
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Incidence rate
Prostate cancer
CHA p. 74 (NYS Cancer Registry)
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Incidence by ZIP
Prostate cancer expected
CHA p. 74 (NYS Cancer Registry)
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Expected by ZIP
Prostate cancer
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Late stage incidence
Prostate Cancer Expected incidence
CHA p. 75 (NYS Cancer Registry)
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Diabetes incidence
Expanded BRFSS, 2003
CHA p. 81 (NYSDOH Expanded BRFSS, 2003)
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Diabetes related hospitalizations
Rate /10,000 residents, 1998-2003
CHA p. 82 (SPARCS data as of Sep. 2004)
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Adult Diabetes in NYS
BRFSS Percent residents age 18
CHA p. 80 (NYS BRFSS as of Dec. 2004)
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Cardiovascular disease mortality
Average Age adj. Rate /100,000 residents,
2000-2002
CHA p. 101 (NYS Vital Statistics data as of Aug.
2004)
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Diseases of the heart Mortality
Crude Rate /100,000 residents
CHA p. 102 (NYS Vital Statistics)
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Birth Rate /1,000 females age 15-44
Family Planning
CHA p. 88 (NYS Vital Stats 2000-2002)
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Teens age 15-19
Births per 1,000 female residents

• Tompkins has the lowest teenage birth rates in
  the area.

CHA p. 88 (NYS Vital Stats 2000-2002)
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Births to mothers age 30-44 years
Percent of live births

• Almost half of Tompkins births are to mothers
  age 3044.

CHA p. 92 (NYS Vital Stats 2000-2002)
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Postneonatal Mortality (28 days1 yr.)
Average Rate per 1,000 Live Births
CHA p. 153 (NYS Vital Stats, 2000-2002)
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3-year average
Postneonatal Mortality (28 days1 year)
(Age 28 days1 yr)
CHA p. 155 (NYS Vital Stats as of Aug 2004)
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Infant Mortality (up to age 1 yr.)
Neonatal Postneonatal Infant
CHA p. 154 (NYS Vital Stats, 2000-2002)
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Child Immunization
Percent
CHA p. 123 (TCHD Annual Reports)
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Oral Health
Percent Tompkins County 3rd graders

• Caries
• Untreated caries
• Sealants
• Dental visit
• Insurance
• Flouride supp

CHA p. 173
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Suicides
Age. adj. Rate /100,000 residents
CHA p. 133 (NYS Vital Stats 2000-2002)
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Teen suicides
Age. adj. Rate /100,000 residents
CHA p. 134 (NYS SPARCS data as of Aug. 2004)
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Priorities
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Compass II

• Lack of specialty care
• Lack of affordable primary care
• Lack of money to pay for Rx and doctor visits
• Cost of health care premiums
• Poverty a critical problem

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TCHD

• Aging population and need for related services
• Emergency preparedness and response
• Emerging infectious disease
• Reduction in State financial support

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Commission for a Healthy CNY

• Access to dental care
• Obesity
• Access to mental health care
• Stroke medical management
• lt www.upstate.edu/healthycny gt

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Online access

• www.tompkins-co.org /wellness/cha05/

Theresa Lyczko tlyczko_at_tompkins-co.org Ted
Schiele tschiele_at_tompkins-co.org