LIJ Health System Community

Transcription

The North Shore- LIJ Health System
Community Service Plan 2013-2016
Office of Community and Public Health
1. The North Shore-LIJ Mission Statement:
The North Shore-Long Island Jewish Health System (referred to as NSLIJ or “the System”) strives to
improve the health of the communities it serves and is committed to providing the highest quality clinical
care; educating the current and future generations of health care professionals; searching for new
advances in medicine through the conduct of bio-medical research; promoting health education; and
caring for the entire community regardless of the ability to pay.
2. Definition and brief description of community served.
The Community Service Plan service areas for the North Shore-LIJ Health System were determined by
using the counties in which the health system facilities are located for local health planning. With a
service area of more than seven million people, North Shore–LIJ Health System encompasses hospitals in
the following counties: Nassau County (Franklin Hospital, Glen Cove Hospital, North Shore University
Hospital, Plainview Hospital, and Syosset Hospital); New York County (Lenox Hill Hospital); Queens
County (Forest Hills Hospital, Long Island Jewish Hospital, Steven and Alexandra Cohen Children's
Medical Center of New York, and Zucker Hillside Hospital); Richmond County (Staten Island University
Hospital); and Suffolk County (Huntington Hospital, Southside Hospital, and South Oaks Hospital). The
sections below describe the community it serves based on the 5 counties that encompass the health
system’s service area.
Nassau County Demographics
Nassau County has a population of 1,339,532 people with an age distribution of 23% 0-17 years, 33% 184 years, 29% 45-69 years, and 15% 65+ years. The county’s racial distribution is 65% white, 15%
Hispanic, 10% black, 8% Asian and 2% other. The average household income is $124,742 with a mean
household income of $95,823 and a per capita income of $42,307. The estimated poverty rate is 5.2% and
14% of the population is defined as low income. Forty-one percent of the population 25 years and older
has attained a Bachelor’s Degree or higher, while 11% has less than a high school diploma. The home
ownership rate is 82%. Certain communities within the county have income, education, and home
ownership rates significantly below the county average and also experience higher rates of health
disparities and racial diversity. These select communities are Freeport, Glen Cove, Elmont, Hempstead,
Inwood, Long Beach, Roosevelt, Uniondale, and Westbury.
New York County Demographics
New York County has a population of 1,577,412 people, with an age distribution of 15% 0-17 years, 48%
18-44 years, 24% 45-64 years, and 13% 65+ years. The county’s racial distribution is 48% white, 25%
Hispanic, 13% Black, 11% Asian, and 3% other. The average household income is $127,411, with a
median household income of $67,204 and a per capita income of $61,290. The estimated poverty rate is
17.6%. Fifty-seven percent of the population 25 years and older has attained a Bachelor’s Degree or
higher, while 14.9% has less than a high school diploma. The home ownership rate is 22.7%. Certain
communities within the county have income and education rates significantly below the county average,
and also experience higher rates of health disparities and racial diversity. These select communities are
South Battery Park, East Harlem, Hell Gate, Audobon, Lincolnton, Colonial Park, Peter Stuyvesant, and
Hamilton Grange.
Queens County Demographics
Queens County has a population of 2,235,260 people, with an age distribution of 20% 0-17 years, 41%
2 Hispanic, 18% Black, 23% Asian, and 4% other. The average household income is $72,324, with a
median household income of $56,406 and a per capita income of $26,234. The estimated poverty rate is
13.7%. Twenty-nine percent of the population 25 years and older has attained a Bachelor’s Degree or
higher, while 19.9% has less than a high school diploma. The home ownership rate is 44.9%. Certain
Fort Totten, Far Rockaway, Rockaway Beach, Jamaica, Arverne, South Ozone Park, Rochdale Village,
and St. Albans.
Richmond County Demographics
Richmond County has a population of 468,727 people, with an age distribution of 23% 0-17 years, 36%
Hispanic, 10% Black, 7% Asian, and 2% other. The average household income is $88,221, with a median
household income of $72,752 and a per capita income of $31,267. The estimated poverty rate is 13.7%.
Twenty-nine percent of the population 25 years and older has attained a Bachelor’s Degree or higher,
while 12.6% has less than a high school diploma. The home ownership rate is 69.8%. Certain
Mariner’s Harbor, Stapleton, St. George, and Port Richmond.
Suffolk County Demographics
Suffolk County has a population of 1,486,873 people with an age distribution of 24% 0-17 years, 34% 184 years, 28% 45-69 years, and 14% 65+ years. The county’s racial distribution is 72% white, 16%
Hispanic, 7% Black, 3% Asian and 2% other. The average household income is $107,305 with a mean
household income of $87,187 and a per capita income of $36,588. The estimated poverty rate is 5.7%.
Thirty-two percent of the population 25 years and older has attained a Bachelor’s Degree or higher while
10% has less than a high school diploma. The home ownership rate is 80%. Certain communities within
the county have income, education, and home ownership rates significantly below the county average and
also experience higher rates of health disparities and racial diversity. These select communities are
Amityville, Wyandanch, Smithtown, Islandia, Ronkonkoma, Port Jefferson Station, Selden, Coram,
Medford, Bellport, Brookhaven, Patchogue, Ridge, Mastic, Mastic Beach, Riverhead, Laurel and
Greenport.
3. Public Participation (a,b,c)
The North Shore-LIJ Health System employed a multi-sector approach to engage a diverse group
of participants to provide input in the Community Health Needs Assessment. The health system
collaborated with community based organizations with a focus on those representing communities with
health disparities, local health departments, businesses, insurance companies, local health coalitions,
health care providers, academia, government agencies including transportation, housing and mental health
and individual community members. The sections below describe the unique public participation
strategies and input for each of the counties within the NSLIJ service area.
Nassau County
The CHA/CHIP committee determined that in addition to census, hospitalization and vital
statistics data, the assessment should include the “voice of the community” (e.g. the community’s
perception of need) (see attachment I for CHNA meeting participants and dates). The group agreed that
quantitative and qualitative data should be collected from community organizations and the population-atlarge. Two subcommittees - Community-Based Organizations and Community-Wide Survey - were
formed with representation from the five not-for-profit hospitals, academic partners and the Nassau
County Department of Health.
3 I. Key Informant Interviews with Community-Based Organizations
The Community-Based Organizations (CBO) subcommittee was charged with conducting key
informant interviews with Nassau County’s health and human services providers. The subcommittee met
on January 25, 2013 to develop a list of key community organizations, a pre-interview questionnaire and a
CBO interview guide.
A list of community organizations was compiled based upon recommendations from both the
CBO subcommittee and the larger CHA/CHIP committee. Emphasis was placed on groups that addressed
one or more of the following populations: minorities/medically underserved, seniors, women’s/children’s
services, special populations and individuals with disease-specific conditions.
Next, the subcommittee developed a pre-interview questionnaire. The pre-interview
questionnaire would be used to provide background information (e.g. type of services provided,
demographics of persons served) prior to the in-person CBO interviews.
The qualitative CBO interview guide included questions with added prompts regarding New York
State’s Five Prevention Agenda Priorities; significant health problems in the CBO’s communities;
barriers to care; quality of care; current health services; and recommendations for improving services.
Finally, a specific interviewer was assigned to each CBO. The interviewers were comprised of
representatives from the hospitals, the academic partners and the county health department. Interviewers
were responsible for all contact with their assigned CBO. This included initial phone contact (i.e. obtain
name of organizational representative and agreement to participate), e-mail contact to complete the preinterview questions and an in-person interview at the CBO.
Interviewers were also required to participate in a training session to ensure consistency across
the interviewing process. This training was provided on February 6, 2012, by an Assistant Professor of
Preventive Medicine in the Divisions of Evaluative Services and Community Health at Stony Brook
University. As a result of the training, modifications were made to the interview guide. A copy of the
final CBO interview guide is included in Attachment II. The group agreed that all interviews should be
audio recorded and transcribed. Transcription duties were shared among the hospitals and health
department.
Staff from the Nassau County Department of Health interviewed three potential consultants to
conduct the qualitative analysis of the key informant interviews. With input from an academic partner, a
doctoral candidate in Public Health at CUNY Graduate Center was selected. The hospitals contracted
with and paid for the consultant. The consultant coded the key informant transcripts using Atlas TI
software. Coding reliability was tested and an analysis was conducted to identify emergent themes. A
total of 17 key informant interviews were included in the analysis. The list of participating CBOs is
included in Attachment II.
The consultant’s findings were presented to the CHA/CHIP committee on May 15, 2013. The
findings are summarized below. See Attachment II
Chronic Disease
Chronic disease was overwhelmingly reported as the most pressing health problem, with 50%
ranking it as the #1 health priority. The most commonly mentioned chronic diseases were diabetes, heart
disease and cancer. Obesity was seen as the most important risk factor for chronic conditions and
preventing obesity among youth, especially among minority populations, was a strong theme. Other
issues included: coordination of care for persons, especially the elderly, with multiple co-morbidities;
prevalence of smoking among the mentally ill population; and the need for more time and money to be
allocated to prevention efforts.
Mental Health and Substance Abuse
The CBOs noted an increase in the prevalence of mental health issues across all age groups and
inadequate resources to address these issues, especially among the senior population. County residents
4 are delaying or not seeking mental health treatment due to the stigma associated with receiving services.
Pain medication abuse is an increasing problem. Post-Hurricane Sandy, there has been an increase in
both substance abuse and mental health problems.
Healthy & Safe Environment
Common themes included: poor diets, access to healthy food, lack of nutritional information and
lack of exercise options for minority and low socio-economic groups. Other problems faced by low
socio-economic, minority and immigrant populations were an increase in unsafe living environments (e.g.
mold) due to Hurricane Sandy and environmental justice issues (e.g. water quality, built environment,
outdoor air quality).
Healthy Women, Infants & Children
Issues raised by the CBOs included: lack of childcare funding for low-income workers,
underutilization of health services by pregnant teens and older women and lack of awareness of the
importance of prenatal care among high-risk populations.
HIV, STD, Vaccine Preventable Diseases
There is limited funding for HIV awareness, screening and prevention. Strict eligibility
requirements for HIV treatment coverage present a barrier to care.
Other Health Issues Identified
The following barriers to health care were identified: inadequate public transportation in the
county; language barriers for non-English speaking persons seeking quality health services; lack of
awareness of available health resources (e.g. need to update 211 information banks); undocumented
immigrant populations not accessing health care services due to fear of being reported and LGBT
populations not accessing care due to fear of being treated differently. Other themes included: the need
for more in-home health and mental health services for home-bound seniors; heavy reliance on
emergency rooms for primary care; and the need for women to play a larger role in helping men access
needed health services.
II. Individual Community Member Survey
The Nassau County Hospitals and the Nassau County Department of Health collaborated in
developing a community-wide survey (see attachment III). The team agreed that the use of a uniform
survey distributed widely throughout communities in Nassau County would help ascertain the health
perceptions and key concerns of residents, as well as identify service needs and barriers to care.
The format of the survey was derived from a template that was tested and used by one of the participating
hospitals (St. Francis) in prior years. Criteria for developing key questions and multiple choice responses
included Prevention Agenda priorities, goals and barriers to health, strategies, and demographic
information. Health literate terminology was used to ensure clear communication. The survey was
distributed through Survey Monkey, hospital outreach programs, public libraries, NCDOH Programs and
County Agencies, and other outlets such as faith-based organizations, community centers, and social
media.
Individuals were asked to identify up to three main health concerns from a selected list of
answers. The purpose of highlighting three was to enable the team to establish a focused group of
priorities. Questions were designed to determine the individual perceptions regarding the biggest ongoing
health concerns in their community, their personal health concerns, and what they considered as barriers
to treatment. Additionally, they were asked to identify what they feel is most needed to improve the
health of the community, including health screenings and educational resources. The last question asked
where the respondents get most of their health information; respondents were asked to “check all that
apply.”
Demographic information was collected, asking respondents to identify the location where they received
the survey, their sex, age, and zip codes for where they work and live. All surveys were anonymous, and
offered in English and Spanish. Completed forms were sent to the Nassau County Department of Health
5 for analysis. Descriptive quantitative data analysis was conducted by inputting answers into Survey
Monkey, downloading them into Excel and determining frequencies/percentages.
A convenience sample was used to administer the survey. The survey was distributed in as many
locations as possible in an effort to gain a representation of the Nassau County population. It reached a
broad spectrum of community residents from many zip codes. According to 2010 US Census estimates,
19% of Nassau County’s population reside in select communities. Out of 1070 surveys returned, 25.8%
were from select communities, indicating that there was proportionate representation from populations
with health disparities. The survey results were shared with the CHA/CHIP committee on May 15, 2013.
The findings are summarized below (see Attachment IV).
Responses were analyzed according to two separate populations: Nassau County and select
communities. The select communities are those designated by the Nassau County Department of Health
as having health disparities. Women were the primary respondents, accounting for 72.4% from Nassau
County and 79.1% from select communities.
Blood pressure and diabetes screenings were cited at the top priorities in the
educational/screening category. Routine well visits were important in both populations; however,
exercise and physical activity ranked higher for Nassau County (26.85%) than the select communities
(19.3%).
The top three ongoing health concerns in the Nassau County population were cancer, obesity and
diabetes. Percentages in this category ranged from 33% to 44%. Select communities highlighted diabetes,
drug and alcohol abuse, and cancer, with percentages ranging from 37.2% to 40.5%.
Cancer was ranked as the biggest personal health concern for individuals in both populations (35.6% in
Nassau County and 37.2% select communities). Other personal health concerns included heart disease
and stroke, women’s health and diabetes.
The survey results indicate that the public is concerned about disease management and
prevention, as well as affordable access to quality health care. The significance of obesity was also
revealed; healthier food choices were requested, as well as exercise programs and more diabetes
screenings. Substance abuse was also cited as a significant health issue.
As a result, the following priorities emerged: to increase access to high quality chronic disease
preventive care and management; to reduce obesity in children and adults; to address the issue of
substance abuse.
Job opportunities, and clean air and water were cited as being significant criteria in both
populations for health improvement. However, weight loss programs ranked as more important
proportionately to Nassau County (30%) than to the select communities (25.8%). Other health issues that
were identified included mental health/depression/suicide, and women’s and children’s wellness.
However, the differences between these were marginal – ranging between 18% and 21%.
The top concerns for barriers to medical treatment were the same in both populations: no insurance, lack
of ability to pay deductibles and co-pays, and fear – i.e., not ready to face or discuss health issues. It
should also be noted that individuals cited that they feel people don’t understand the need to see a doctor.
New York County
The Lenox Hill Hospital (LHH) Community Health Needs Assessment (CHNA) committee
(LHHCHNA) (see attachment I) determined that in addition to census, hospitalization and vital statistics
data, the assessment should include the “voice of the community” (e.g. the community’s perception of
need). The group agreed that qualitative data should be collected from a diverse group of community
organizations that serve the population-at-large as well as those communities with health disparities.
Community partners and the New York City Department of Health and Mental Hygiene were invited to
participate in the CHNA process. A CHNA survey was developed and distributed to the group in the
Spring of 2013 and a Manhattan Take Care New York Listening Session was held on April 21, 2013.
6 A. Community-Based Entity CHNA Survey
A list of community organizations was compiled based upon recommendations from the LHH
CHNA Committee. This group included 20 entities: 4 schools, 6 government agencies, and 10
community-based organizations. Emphasis was placed on groups that addressed one or more of the
following populations: minorities/underserved, seniors, women’s/children’s services, special populations
and individuals with disease-specific conditions.
The committee used a survey based on a template from the Nassau County Community Based
Organization Informant Interview for creating the survey questionnaire (see attachment V). The survey
included a description of the population served by the entity, services provided, questions regarding New
York State’s Five Prevention Agenda Priorities; significant health problems in the CBO’s communities;
barriers to care; quality of care; current health services; recommendations for improving services and
collaboration opportunities. The survey was distributed in electronic survey (SurveyMonkey) formats. A
personalized invite was sent by email with the SurveyMonkey link to other community partners in April
2013 with follow up email invites in May 2013. The survey collection closed June 14, 2013 with a 40%
response rate (see attachment V for survey respondents). The sections below describe the survey results.
Chronic Disease
Chronic disease was overwhelmingly reported as the most pressing health problem, ranking as the
#1 health priority of the 5 New York State (NYS) Prevention Agenda Priorities. The most commonly
mentioned chronic diseases were heart disease/stroke, diabetes and asthma. Obesity was seen as the most
important risk factor for chronic conditions and obesity prevention for youth. Healthier food choices,
recreational opportunities, safe places to walk and play and weight loss resources were identified as
priority health improvement strategies. Nutrition, physical activity, chronic disease education programs,
health screenings and drug/alcohol prevention were also chosen as needed services for the community.
The entities listed that their clients utilize the following services: nutrition counseling, access to healthy
foods (i.e. teaching gardens), chronic disease management/medical referrals, CPR/first aid, community
and worksite wellness, and health programs and screenings. However, there are gaps in the availability of
and access to these resources and services.
Common themes included in this 2nd chosen priority included a concern for safety in the
environment, and environmental hazards that may lead to injury and chronic disease. Community health
strategies most needed to address these issues were safe places to walk and play, safe child care options,
and clean air and water.
Promoting mental health and preventing substance abuse was the 3nd highest NYS Prevention
Agenda Priority chosen. Drug and alcohol prevention services were identified as the second most needed
resource to improve the health of the community. The respondents noted an increase in the prevalence of
mental health issues across all age groups and inadequate resources to address these issues. Residents may
not seek mental health treatment due to lack of insurance and the stigma/fear associated with receiving
services.
This was the 4th NYS Prevention Agenda Priority chosen. Child and women’s health and wellness
were identified as significant community health concerns. Access to wellness programs, prenatal care,
safe childcare options, safe places to play and community understanding of the importance of routine well
care medical visits were identified as needed community health improvement strategies.
This was the lowest ranking NYS Prevention Agenda Priority area. Recommended community
health improvement services were HIV/STD screenings and immunization programs.
The following barriers to health care were identified: language and cultural sensitivity barriers for
non-English speaking persons seeking quality health services; health access related to insurance and
7 ability to pay co-payments and deductibles; and fear and/or lack of understanding of when to seek
medical care.
B. Manhattan Island Take Care New York Listening Session
The Lenox Hill Hospital and the New York City Department of Health and Mental Hygiene
(NYCDOHMH) collaborated in a county-wide community health needs assessment listening session
focused on the NYCDOHMH Take Care New York Priority Areas (see attachment VI) on April 24, 2013.
Public invitations were sent via email to NYCDOH Take Care New York Partners and Lenox Hill
community partners, and were posted in public areas. Forty-five community members and organizations
which included community based organizations, schools, health care providers, labor groups, and
government agencies participated in the session. (see attachment I).
Individuals were asked to prioritize health concerns from a list of Take Care New York Priority
areas, identify gaps in services and resources related to these areas and discuss areas for collaboration on
these issues. Stakeholder feedback was captured via listening session and 3 survey instruments were
disseminated during and after the listening session to maximize opportunities to elicit feedback:
1. Note cards: During the listening session, attendees were provided with note cards to share their
questions/comments, indicate their interest in receiving additional information about specific TCNY
areas, and provide their contact information if they wished to be connected with organizations sharing
similar interests (see attachment VI).
2. Evaluation form: At the completion of the listening session, attendees were provided with a brief
evaluation form to assess their satisfaction with the session. (see attachment VI).
3. Post-session survey: Following the listening session, attendees were sent a web-based survey to assess
familiarity with TCNY and interest in TCNY priority areas, health department resources, TCNY
partnership, and health department facilitation of inter-agency collaboration (see attachment VI).
The top 5 Manhattan Priority Areas where chosen as follows: active living, healthy eating,
tobacco free living, reduce alcohol and substance abuse, and healthy indoor and outdoor air.
1. Promote Mental Health
• Provision of mental health training to non-mental health professionals working with high
risk populations
• Promotion of smoking cessation among individuals with mental illness
• Treatment of trauma and psychological distress and prevention of mental illness among
youth
2. Active Living
• Access to spaces and programs that promote physical activity
• Connection of opportunities for physical activity
3. Healthy Eating
• Promotion of access of healthy foods in restaurants and bodegas
• Provision of programs that teach adults and youth how to prepare healthy, affordable
meals
• Enhancement of access to healthy foods for low income New Yorkers
• Public support of Health Bucks program
4. Child & Adolescent Health
• Early childhood intervention and prevention of special needs for youth in high risk
communities
• Promotion of adolescent mental health and prevention of unplanned pregnancy to
prevent high school dropout
5. Healthy Indoor & Outdoor Air
• Collaboration with other city agencies to improve the environment
8 Queens County
The Forest Hills Hospital and Long Island Jewish Medical Center Community Health Needs
Assessment (CHNA) committees determined that in addition to census, hospitalization and vital statistics
data, the assessment should include the “voice of the community” (i.e. the community’s perception of
need). The group agreed that qualitative data should be collected from a diverse group of community
organizations that serve the population at large, as well as those communities with health disparities and a
Queens NYCDOHMH Take Care New York Listening Session was planned.
Queens Take Care New York Listening Session
Forest Hills Hospital, Long Island Jewish Medical Center and the New York City Department of Health
and Mental Hygiene (NYCDOHMH) collaborated in a county-wide community health needs assessment
listening session focused on the NYCDOHMH Take Care New York Priority Areas ( see attachment VII)
on May 14, 2013. Public invitations were sent via email to NYCDOHMH Take Care New York Partners,
Forest Hills Hospital and Long Island Jewish Medical Center community partners and were posted in
public areas. Thirty three participants including 4 government agencies (excluding NYCDOHMH staff),
1 labor group, 13 health organizations/providers, 7 community-based organizations and 8 general public
members participated in the session (see attachment I).
areas, identify gaps in services and resources related to these areas, and discuss areas for collaboration on
these issues. Stakeholder feedback was captured via listening session, and 3 survey instruments were
disseminated during and after the listening session, to maximize opportunities to elicit feedback. The
three survey instruments were:
1. Note cards: During the listening session, attendees were provided with note cards to share their
similar interests (see attachment VII).
2. Evaluation form: At the completion of the listening session, attendees were provided with a brief
evaluation form to assess their satisfaction with the session (see attachment VII).
familiarity with an interest in TCNY priority areas, health department resources, TCNY partnership, and
health department facilitation of inter-agency collaboration (see attachment VII).
The top 7 Queens Priority Areas were chosen as follows: mental health, active living, healthy eating,
child and adolescent health, healthy indoor and outdoor air, HIV prevention, and tobacco free living.
Promote Mental Health recommended health improvement strategies were:
• Quantification of children’s mental health problems
• Increased collaboration among CBOs, medical health providers and metal health
providers
Active living recommended health improvement strategies were:
• Creation of physical activity opportunities in schools
• Promotion of physical activity by primary care providers
Healthy Eating recommended health improvement strategies were:
• Raise awareness of hunger and food insecurity issues
• Promotion of access to healthy foods
• Promote education on how to prepare healthy, affordable meals
• Enhancement of access to healthy foods for low income New Yorkers
9 Child & Adolescent Health recommended health improvement strategies were:
• Prevention and treatment of pediatric obesity
Healthy Indoor & Outdoor Air recommended health improvement strategies were:
• Implementation of smoke free New York City Housing Authority housing
HIV and STD Prevention recommended strategies were:
• Reduce stigma of NYC branded condoms
Tobacco-Free Living recommended health improvement strategies were:
• Reduction of youth access to tobacco products
• Provision of tobacco cessation counseling training to case managers
• Provide smoke free housing education to families
Richmond County
The Staten Island University Hospital (SIH) Community Health Needs Assessment committee
determined that in addition to census, hospitalization and vital statistics data, the assessment should
include the “voice of the community” (e.g. the community’s perception of need) ( see attachment I). The
group agreed that qualitative data should be collected from a diverse group of community organizations
that serve the population-at-large as well as those communities with health disparities. The longstanding
SIUH Community Advisory Board as well as other community partners and the New York City
Department of Health and Mental Hygiene were invited to participate in the community health needs
assessment (CHNA) process. This group included 61 entities: 6 schools, 6 government agencies, and 49
community-based organizations. A CHNA survey was developed and distributed to the group in the
Spring of 2013 and a Staten Island Take Care New York Listening Session was held on May 7, 2013.
A. Community-Based Entity CHNA Survey
A list of community organizations was compiled based upon recommendations from the SIUH
CHNA Committee and the SIUH Community Advisory Board. Emphasis was placed on groups that
addressed one or more of the following populations: minorities/underserved, seniors, women’s/children’s
services, special populations and individuals with disease-specific conditions.
Organization Informant Interview for creating the survey questionnaire (see attachment VIII). The survey
collaboration opportunities.
The survey was distributed in paper and electronic survey (SurveyMonkey) formats. The paper
survey was distributed to the SIUH Community Advisory Board in March 2013. A personalized invite
was sent by email with the SurveyMonkey link to other community partners in April 2013 with follow up
email invites in May 2013. The survey collection closed June 14, 2013 with a 31% response rate (see
attachment VIII for survey respondents). The sections below describe the survey results.
Chronic Disease
Chronic disease was overwhelmingly reported as the most pressing health problem, ranking as the
mentioned chronic diseases were diabetes, heart disease and cancer. Obesity was seen as the most
important risk factor for chronic conditions and along with preventing obesity among youth, especially
among minority populations. Healthier food choices, recreational opportunities and weight loss resources
were identified as priority health improvement strategies. Nutrition, physical activity, chronic disease
education programs and health screenings were also chosen as needed services for the community. The
entities listed that their clients utilize the following services: access to healthy foods, chronic disease
management/medical referrals; community wellness and health programs and screenings but there are
gaps in the availability of and access to these resources and services.
10 Mental Health and Substance Abuse
Agenda Priority chosen. Drug and alcohol rehabilitation serves were identified as the second most
needed resource to improve the health of the community. The respondents noted an increase in the
prevalence of mental health issues across all age groups and inadequate resources to address these issues.
County residents are delaying or not seeking mental health treatment due to lack of insurance and the
stigma/fear associated with receiving services. Pain medication abuse is an increasing problem. PostHurricane Sandy, there has been an increase in both substance abuse and mental health problems.
This was the 3rd NYS Prevention Agenda Priority chosen. Child and women’s health and
wellness were identified as community health concerns. Access to wellness programs and community
understanding of the importance of routine well care medical visits were identified as needed community
health improvement strategies.
Common themes included in this 4th priority included a concern for safety in the environment and
environmental hazards that may lead to chronic disease such as cancers. Community health strategies
most needed to address these issues were smoking cessation resources, safe child care options, safe places
to walk and play, and clean air and water.
The following barriers to health care were identified: language and cultural sensitivity barriers for
non-English speaking persons seeking quality health services; health access related to insurance and
ability to pay co-payments and deductibles; fear and/or lack of understanding of when to seek medical
care; and inadequate public transportation in the county.
B. Staten Island Take Care New York Listening Session
The SIUH and the New York City Department of Health and Mental Hygiene (NYCDOHMH)
collaborated in a county-wide community health needs assessment listening session focused on the
NYCDOHMH Take Care New York Priority Areas ( see attachment IX) on May 7, 2013. Public
invitations were sent via email to NYCDOHMH Take Care New York Partners and SIUH community
partners and were posted in public areas. Thirty eight community members and organizations which
included community based organizations, schools, health care providers, labor groups, and government
agencies participated in the session. (see attachment I).
areas, identify gaps in services and resources related to these areas and discuss areas for collaboration on
these issues. Stakeholder feedback was captured via listening session and 3 survey instruments were
disseminated during and after the listening session to maximize opportunities to elicit feedback:
1. Note cards : During the listening session, attendees were provided with note cards to share their
similar interests ( see attachment x).
2. Evaluation form: at the completion of the listening session, attendees were provided with a brief
evaluation form to assess their satisfaction with the session. (see attachment x).
familiarity with TCNY and interest in TCNY priority areas, health department resources, TCNY
partnership, and health department facilitation of inter-agency collaboration ( see attachment x).
11 The top 5 Staten Island Priority Areas where chosen as follows: active living, healthy eating,
tobacco free living, reduce alcohol and substance abuse, and healthy indoor and outdoor air.
Active living recommended health improvement strategies were:
• Promote usage of parks & playgrounds
• Increase advertisements that promote walking & mileage
• Strategies for adults to increase exercise
Healthy Eating recommended health improvement strategies were:
• Educate bodega owners on fresh fruits & vegetables
• Improve healthier food choices in vending machines
• Replicate proven weight-loss programs
Tobacco-Free Living recommended health improvement strategies were:
• Increase prevention messages to children & adolescents
• Provide smoking cessation point of service options
Reduce Alcohol & Substance Abuse recommended health improvement strategies were:
• Halt the closing of substance abuse & detox centers on the island
Healthy Indoor & Outdoor Air recommended health improvement strategies were:
• Increase information on the quality of air after Hurricane Sandy
Suffolk County
The CHA/CHIP committee determined that in addition to census, hospitalization and vital
statistics data, the assessment should include the “voice of the community” (e.g. the community’s
perception of need)( see attachment I for CHNA meeting participants and dates). The group agreed that
qualitative data should be collected from community organizations and the population-at-large. A
subcommittee - Community-Based Organizations Survey Committee - was formed with representation
from the not-for-profit hospitals, academic partners, Nassau Suffolk Hospital Council and the Suffolk
County Department of Health Services (SCDOH).
I. Community-Based Entity CHNA Survey
A list of community organizations was compiled based upon recommendations from the
CHA/CHIP Committee. Emphasis was placed on groups that addressed one or more of the following
populations: minorities/underserved, seniors, women’s/children’s services, special populations and
individuals with disease-specific conditions.
Organization Informant Interview for creating the survey questionnaire (see attachment X). The survey
collaboration opportunities.
The survey was distributed in paper and electronic survey (SurveyMonkey) formats. A
personalized invite was sent by email with the SurveyMonkey link to community entities in April 2013
with follow up email invites in May 2013. In addition, individual committee members outreached to their
partner community entities to increase survey participation. The survey collection closed June 14, 2013.
There were 102 respondents comprised of 18 community based organizations, 10 educational
organizations, 8 government agencies, 9 hospital/health organizations and 42 other organizations (see
attachment X for survey respondents). The sections below describe the survey results.
Health of the Community Rating
The entities were asked to rate the health of the community they serve. The responses were that
1% was very healthy, 21% were healthy, 58% were somewhat healthy, 17% were unhealthy and 3% were
very unhealthy.
Chronic Disease
12 Chronic disease was overwhelmingly reported as the most pressing health problem, ranking as the
mentioned chronic diseases were cancer, diabetes and heart disease. Obesity and nutrition/eating habits
were seen as the most important risk factors for chronic conditions. Quality and accessible care for the
elderly was also cited as an important health problem in the county. Access to healthier food, farmers
markets and weight loss resources were identified as priority health improvement strategies. Nutrition,
physical activity, chronic disease education programs, especially for diabetes, and health screenings were
also chosen as needed services for the community. The entities listed that their clients utilize the
following services: access to healthy foods, chronic disease management/medical referrals; community
wellness and health programs and screenings but there are gaps in the availability of and access to these
resources and services.
Agenda Priority chosen. Drug and alcohol rehabilitation serves were identified as the second most
needed resource to improve the health of the community. The respondents noted an increase in the
prevalence of mental health issues across all age groups and inadequate resources to address these issues.
Pain medication abuse is an increasing problem. Post-Hurricane Sandy, there has been an increase in
both substance abuse and mental health problems.
This was the 3rd NYS Prevention Agenda Priority chosen. Women’s health and wellness were
identified as community health concerns. Access to wellness programs and health screenings were
identified as needed community health improvement strategies.
Common themes included in this 4th priority included a concern for safety in the environment and
environmental hazards that may lead to injury in the elderly population. Community health strategies
most needed to address these issues were exercise/physical activity programs, health screening and
education programs.
The following barriers to health care were identified: health access related to insurance and ability to pay
co-payments and deductibles and inadequate public transportation in the county.
Nassau, Queens and Suffolk Mental Health Community Based Entity Survey
In order to assess the community’s mental health and substance abuse needs, staff from the Office
of Community Health, South Oaks Hospital (SOH) and Zucker Hillside Hospital (ZHH) formed a
committee to collect primary data from organizations that provide metal health and substance abuse
services with a focus on those serving at risk and diverse communities. Organizations were identified by
the Long Island Behavioral Health Management BHO Advisory Committee as well as the staff from SOH
and ZHH. This group included 47 entities: 6 government agencies, 20 community-based organizations
and 21 health care organizations/providers. The committee used a survey based on a template from the
Nassau County Community Based Organization Informant Interview for creating the survey questionnaire
but modified it to focus on behavioral health and substance abuse issues (see attachment XII). The survey
included a description of the population served by the entity, services provided, and questions regarding
New York State’s Five Prevention Agenda Priorities; significant health problems in the CBO’s
communities; barriers to care; quality of care; current health services; recommendations for improving
services; and collaboration opportunities.
The survey was distributed in electronic survey (SurveyMonkey) formats. A personalized invite
was sent by email with the SurveyMonkey link to other community partners in April 2013 with follow up
13 email invites in May 2013. The survey collection closed June 14, 2013 with a 45% response rate (see
attachment XII for survey respondents). The sections below describe the survey results.
Promoting mental health and prevent substance abuse was the highest NYS Prevention Agenda
Priority chosen. However, chronic disease and obesity were also cited as major health concerns for this
population. The top health improvement strategies identified were: drug and alcohol rehabilitation
programs; mental health services; job opportunities; smoking cessation; weight loss; healthier food
choices and transportation. Affordable housing for this population was also cited. The top health
screenings and education needs identified were mental health and substance abuse screenings, especially
integrating screenings into routine medical care and chronic disease. The barriers identified to accessing
mental health and substance abuse services were: lack of availability of mental health providers; inability
to pay visit co-pays and insurance deductibles; lack of insurance; lack of transportation; and fear/lack of
understanding the need to seek mental health services. To address the barriers and/or gaps in mental
health services the following strategies were identified:
 Improve access to services through insurance, ambulatory clinics, referral mechanisms
and providers.
 Increase integration of mental health screening/referrals/awareness in other medical care
providers.
 Increase availability of residential services, supervised group housing, and
affordable/stable/permanent housing.
 Improve public transportation services.
The participating organizations could address the barriers and gaps they identified by offering assistance
in the following areas: advocacy, community education and awareness, education and integration with
health care providers, expansion of services, grant seeking, and transportation.
4. Assessment and Selection of Public Health Priorities.
I. Primary and Secondary Health Data Analysis
Since the NSLIJ service area includes Nassau, New York, Queens, Richmond, Staten Island and
Suffolk counties, individualized primary and secondary community health data collection, assessment
and NYSDOH Priority Agenda Item selection was performed by county and/or region. The primary data
collection and analysis was described in question 3. The secondary data analysis based on the NYSDOH
Priority Agenda Items for each county is described in the following sections.
Nassau County
In January 2013, preliminary community health assessment data was presented (see Attachment
XIII) by the NCDOH comparing Nassau County, NYS, and selected communities within Nassau County
in order to further identify and compare rates of age/ethnicity/race distribution, diseases of the
cardiovascular system (including stroke), diseases of the respiratory system, diabetes and liver disease,
injuries, unintentional injury, intentional injury, cancer, communicable diseases, mortality, and
pregnancy/perinatal outcomes. These select communities are Freeport, Glen Cove, Elmont, Hempstead,
Inwood, Long Beach, Roosevelt, Uniondale, and Westbury. Sources of information included SPARCS
data (2008-2010), NYSDOH Vital Statistics, NYS Cancer Registry and the NYSDOH Surveillance
System. Data were age-adjusted (direct standardization of rates) based on 2000 U.S. standard population.
A mapping of Prevention Quality Indicators (PQIs) quintiles was used as part of the health data analysis.
PQIs are a set of measures that can be used with hospital inpatient discharge data to identify quality of
care for "ambulatory care sensitive conditions." These are conditions for which quality community health
and outpatient care can potentially prevent the need for hospitalization or for which early intervention can
prevent complications or more severe disease. The PQIs are population based and adjusted for covariates.
Even though these indicators are based on hospital inpatient data, they provide insight into the community
14 health care system or services outside the hospital setting. With high-quality, population health and
community-based primary care, hospitalization for these illnesses often can be avoided. Although other
factors outside the direct control of the health care system, such as poor environmental conditions or lack
of patient adherence to treatment recommendations, can result in hospitalization, the PQIs provide a good
starting point for assessing quality of health services in the community.
Chronic Disease
To assess chronic disease prevalence in Nassau County, the county prevalence is compared to
New York State (NYS) and national prevalence and in relation to the 2013-2017 NYS Prevention Agenda
Objectives (NYSPAO). In addition, communities within the county that have higher prevalence rates than
the county average have been identified.
Coronary heart disease and congestive heart failure hospitalizations were worse than the NYS
average but slightly below the NYSPAO. Cerebrovascular (Stroke) disease mortality was significantly
better than the state and national averages and achieved the NYSPAO. Circulatory PQIs had the highest
rates in select communities and Bethpage, Bayville, and East Norwich. The highest hypertension PQIs
were found in the select communities.
Diabetes prevalence rates in Nassau County were 5.9%, significantly lower than the NYS average
of 10.4% but still above the NYSPAO of 5.7%. The diabetes short term complication rate was also better
than the NYS average and achieved the NYSPAO for people age 18+ years. Obesity rates for adults
(BMI>30) were 16%, below the NYS average of 24% but still above the NYSPAO of 15%. Elementary,
middle school and high school students had a 17% obesity rate. However, Nassau children 2-4 years
enrolled in the WIC program had obesity rates of 22%, above the NYS average of 14% and the NYSPAO
of 11%. Diabetes PQIs had the highest rates in select communities and Bayville and Manhasset.
Breast (68.1%) and cervical cancer (52.2%) early stage diagnosis rates were higher than the US
and NYS averages, but below the NYSPAO. The highest female breast cancer rates were located in the
communities of Bayville, East Norwich, Mill Neck, Old Bethpage and Great Neck. Prostate cancer rates
were highest in Albertson, Cedarhurst, East Rockaway, Long Beach Mill Neck, Valley Stream and
Woodmere. Lung Cancer incidence for men and women per 100,000 respectively were 63.7 and 56.3.
Male incidence was below NYS (75.8) but above the NYSPAO of 62%. Female incidence was above
NYS (53.9) and above the NYSPAO of 41%. Cigarette smoking rates for adults in Nassau County were
10.1%, below the NYS average of 18.1% and the NYSPAO of 12%. Chronic Obstructive Pulmonary
Disease adult hospitalizations per 10,000 in Nassau County were 36.5,below the NYS average of 41.3,
but above NYSPAO of 31.The select communities had a higher rate of COPD. Nassau County adult
asthma hospitalization rates were below the NYS average but the asthma rates in the select communities
were double the rates of the rest of the county.
Lifestyle data including nutrition and physical activity are major factors in the prevention and
management of chronic disease. Approximately 77% of Nassau County adults report that they are
engaged in some type of leisure time physical activity which is above the NYS rate (73%) but below the
NYSPAO target of 80%. Although the Nassau County rate is approaching the NYSPAO target, 1 out of 4
residents are inactive. Twenty-eight percent of county residents report that they eat 5 or more fruits and
vegetables per day. This is above the NYS average (26.8) but below the NYSPAO target (33%).
Healthy Safe Environment
To assess preventable injury prevalence in Nassau County, the county prevalence is compared to
the county average have been identified. Fall related hospitalizations for Nassau residents age 65+ years
(per 10,000) were 235, higher than the NYS rate of 198 and well above the NYSPAO target of 155. The
highest rates where present in Glen Cove, Locust Valley, Oyster Bay, Woodbury, Plainview, Jericho,
Hicksville, Lynbrook, Atlantic Beach and Great Neck. Sixty-eight percent of the patients were female.
Traumatic brain Injury admission rates including those resulting from alcohol related motor vehicle
injuries were above the NYS rate.
15 Healthy Women, Infants and Children
To assess the prevalence conditions related to the health of women, infants and children in Nassau
County, the county prevalence is compared to New York State (NYS) and national prevalence and in
relation to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). In reviewing Nassau County
health birth-related statistics, several data points were above the NYS rate and below the NYSPAO.
These were the percent of women enrolled in WIC with first trimester prenatal care (79% versus NYS
rate of 85%), and Cesarean sections (41% versus NYS 34%). Women receiving late or no prenatal care
were 3% for the county but the following communities had increased rates: Woodbury, Westbury,
Hempstead, Freeport, Uniondale, Roosevelt, Lynbrook, Valley Stream and Inwood. Low birth weight
rates were also elevated in many of the above communities. Pregnant women enrolled in WIC had a prepregnancy weight identified as overweight at a rate of 31% versus a NYS rate of 26%. In addition, the
pre-pregnancy obesity rate of pregnant women enrolled in WIC was 22% greater than 1 in 5. The percent
of obese children (ages 2-4years) enrolled in WIC was 31% versus a NYS rate of 26%. Anemia and
underweight in the pediatric WIC population was also above the NYS rate. Breastfeeding rates of mothers
in the WIC program were above the state average (40%) at 46%.
To assess the prevalence of metal health disorders and substance abuse in Nassau County, the
county prevalence is compared to New York State (NYS) and national prevalence and in relation to the
2013-2017 NYS Prevention Agenda Objectives (NYSPAO). Although the suicide rate (per 100,000) for
Nassau County was 5.4, lower than the NYS rate (7.5), it was still above the NYSPAO of 4.8. The
percent of Nassau County adults reporting 14 or more days with poor health in the last month was 9.6%
compared to NYS (7.5%) and above the NYSPAO of 7.8%. PQI data for mental health emergency
department visits showed increased rates in the following communities: Glen Cove, Locust Valley,
Syosset, Hempstead, Uniondale, Roosevelt, Freeport, East Rockaway, Oceanside, Long Beach and
Inwood. Nassau County’s rate of binge drinking is 20%, above NYS (19%) and the NYSPAO of 13.4%.
Drug related Nassau County hospitalizations were 19.6 %, below both NYS (25.7%) and NYSPAO
(26%). PQI data for substance abuse emergency department visits showed increased rates in the
following communities: Glen Cove, Locust Valley, Bayville, Mineola, Hempstead, West Hempstead,
Roosevelt, East Rockaway, Oceanside, Long Beach, Island Park and Inwood.
HIV, STDs. Vaccine-Preventable Diseases & Health Care-Associated Infections
To assess the prevalence of HIV, STDs. Vaccine-Preventable Diseases & Health Care-Associated
Infections in Nassau County, the county prevalence is compared to New York State (NYS) and national
prevalence and in relation to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). Nassau
County’s newly diagnosed HIV case rate (per 100,000) was 8, significantly below the NYS rate (19) and
NYSPAO (23). The Nassau County Gonorrhea case rate (per 100,000) was 28, lower than NYS (94) but
above NYSPAO (19). The tuberculosis case rate (per 100,000) for Nassau County was 3.2, below NYS
(4.9) but above NYSPAO (1). Nassau County case rates for chlamydia and pelvic inflammatory disease
hospitalizations were also below the NYS rate. Communicable disease rates for Tuberculosis,
syphilis, gonorrhea and chlamydia are all higher in selected communities compared to all of
Nassau County.
New York County
Community health assessment data was analyzed comparing New York County, NYS, and selected
communities within New York County in order to further identify and compare rates of age/ethnicity/race
distribution, diseases of the cardiovascular system (including stroke), diseases of the respiratory system,
diabetes and liver disease, injuries, unintentional injury, intentional injury, cancer, communicable
diseases, mortality, and pregnancy/perinatal outcomes. These select communities are South Battery Park,
East Harlem, Hell Gate, Audobon, Lincolnton, Colonial Park, Peter Stuyvesant, and Hamilton Grange.
16 Sources of information included SPARCS data (2008-2010), NYSDOH Vital Statistics, the NYS Cancer
Registry, and the NYSDOH Surveillance System.
A mapping of Prevention Quality Indicators (PQIs) quintiles was used as part of the health data
analysis. PQIs are a set of measures that can be used with hospital inpatient discharge data to identify
quality of care for "ambulatory care sensitive conditions." These are conditions for which quality
community health and outpatient care can potentially prevent the need for hospitalization, or for which
early intervention can prevent complications or more severe disease. The PQIs are population based and
adjusted for covariates. Even though these indicators are based on hospital inpatient data, they provide
insight into the community health care system and services outside the hospital setting. With high-quality
population health and community-based primary care, hospitalization for these illnesses can often be
avoided. Although other factors outside the direct control of the health care system can result in
hospitalization, such as poor environmental conditions or lack of patient adherence to treatment
recommendations, the PQIs provide a good starting point for assessing quality of health services in the
community.
Chronic Disease
To assess chronic disease prevalence in New York County, the county prevalence is compared to
New York State (NYS) and national prevalence, and to the 2013-2017 NYS Prevention Agenda
Coronary heart disease and congestive heart failure hospitalizations in New York County (36.5
and 33.0 per 10,000 respectively) were both lower than the NYS averages (43.8 and 40.1), and achieved
the NYSPAOs (48.0 and 33.0). Cerebrovascular (stroke) disease mortality (19.9 per 100,000) was
significantly lower than the state and national averages (27.5 and 39.0 respectively), and achieved the
NYSPAO (24.0). Circulatory PQIs had the highest rates in the select communities and in Inwood. When
analyzed by race and ethnicity, Blacks in New York County had the highest CHI rates of hospitalizations
for overall heart disease, cerebrovascular disease, and heart disease mortality, all of which were
approximately double the rates for whites. Blacks and Hispanics had the highest CHI rates for coronary
heart disease and congestive heart failure hospitalizations, with the rate for the latter twice as high as
whites for Hispanics, and four times as high for Blacks.
Diabetes prevalence rates in New York County were 6.1%, lower than the NYS average of 10.4%
and just above the NYSPAO of 5.7%. The diabetes short term complication rate for both 6-17 years and
18+ years of age was better than the NYS average, and close to the NYSPAO. Obesity rates for adults
(BMI>30) were 8.4% below the NYS average of 24.5%, but still above the NYSPAO of 15%. Children 24 years of age enrolled in the WIC program had obesity rates of 0.4% below the NYS average of 13.1%,
and 1.1% above the NYSPAO of 11.6%. Diabetes PQIs had the highest rates in the select communities,
Morningside Heights, and College. When analyzed by race and ethnicity, Blacks and Hispanics had
elevated CHI rates of diabetes hospitalizations. Diabetes mortality was highest in Blacks.
Breast cancer early stage diagnosis rates (66.6%) were higher than the NYS average and the US
average; the rates were significantly lower than the NYSPAO. Cervical cancer early stage diagnosis rates
(47%) were higher than the NYS average (42.0%) and equal to the US average (47.0%), but below the
NYSPAO (65%). The highest female breast cancer rates were found in Wall Street and Church Street.
Prostate cancer rates were highest in Lincolnton and Bowling Green. Lung Cancer incidence for men and
women respectively were 61.9 and 46.8 per 100,000. Male incidence was below NYS (75.8) and the
NYSPAO (62). Female incidence was also below NYS (53.9) but above the NYSPAO (41). CHI showed
that Blacks had the highest rates of lung cancer incidence, colorectal cancer mortality, and female breast
cancer mortality. Cigarette smoking rates for adults in New York County were 4.3% below the NYS
average of 18.1%, but above the NYSPAO of 12%. Chronic Obstructive Pulmonary Disease adult
hospitalizations per 10,000 in New York County were 34.2 (7.1 below the NYS average of 41.3), only
slightly above the NYSPAO of 31.The select communities had a higher rate of COPD, as well as College
and Morningside Heights. New York County adult asthma hospitalization rates (25.7 per 10,000) were
17 above the NYS average (19.3), but the asthma rates in the select communities were in the third and fourth
quartile compared to the county-wide rate. CHI showed that Blacks and Hispanics had elevated rates of
asthma and chronic lower respiratory disease hospitalizations, at approximately four times the rate for
whites.
management of chronic disease. Approximately 80.2% of New York County adults report that they are
engaged in some type of leisure time physical activity, which is above the NYS rate (73.7%) and the
NYSPAO target of 80%. Still, nearly 20% of residents are inactive. 13.6% of county residents report that
they eat 5 or more fruits and vegetables per day. This is well below the NYS average (26.8%) and the
NYSPAO target (33%).
To assess preventable injury prevalence in New York County, the county prevalence is compared
to New York State (NYS) and national prevalence, and to the 2013-2017 NYS Prevention Agenda
the county average have been identified. Fall related hospitalizations for New York County residents age
65+ years were 199.9 (per 10,000), higher than the NYS rate of 198.3 and the NYSPAO target of 155.
Healthy Women, Infants and Children
To assess the prevalence of conditions related to the health of women, infants and children in
New York County, the county prevalence is compared to New York State (NYS) and national prevalence,
and to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). In New York County, the percent
of women receiving first trimester prenatal care was higher than NYS and lower than the NYSPAO
(78.1% versus NYS rate of 73.2% and NYSPAO of 90%). The rate of low-birthweight births was slightly
more than those for NYS and US (8.2%), and higher than the 5% NYSPAO. Overall infant mortality was
4.1 (per 1,000 live births), lower than NYS and achieving the NYSPAO. Increased rates of women
receiving late or no prenatal care occurred in Midtown, Peck Slip, Hell Gate, East Harlem, Lincolnton,
College, and Roosevelt Island. Blacks and Hispanics had reduced rates of receiving first trimester prenatal
care, with only 57.6% of Blacks and 63.9% of Hispanics receiving adequate prenatal care. The percent of
obese children (ages 2-4years) enrolled in WIC was 12.7% versus a NYS rate of 13.1%and NYSPAO of
11.6%. Breastfeeding rates of mothers in the WIC program at 6 months were above the state average
(38.8%) at 41.9%.
To assess the prevalence of metal health disorders and substance abuse in New York County, the
county prevalence is compared to New York State (NYS) and national prevalence, and to the 2013-2017
NYS Prevention Agenda Objectives (NYSPAO). Although the suicide rate for New York County was 5.7
(per 100,000), lower than the NYS rate (7.5), it was still above the NYSPAO of 4.8. The percent of New
York County adults reporting 14 or more days with poor mental health in the last month was 8.9%
compared to 11.2% for NYS, and was above the NYSPAO of 7.8%. PQI data for mental health
emergency department visits showed increased rates in the select communities, as well as Herald Square,
Murray Hill, and Manhattanville. New York County’s rate of binge drinking is 2.3% below NYS
(19.6%), and 3.9% above the NYSPAO of 13.4%. Drug related New York County hospitalizations were
42.5 (per 10,000), higher than both NYS (25.7) and NYSPAO (26.0). PQI data for substance abuse
emergency department visits showed increased rates in the following communities: Lincolnton, Murray
Hill, Herald Square, East Harlem, Hell Gate, Cooper, Colonial Park, Midtown, and College. CHI showed
that Blacks and Hispanics had an elevated rate of drug-related hospitalizations, with the rate for Blacks at
eight times the rate for whites. Whites also had a higher suicide mortality rate than Blacks or Hispanics.
To assess the prevalence of HIV, STDs, Vaccine-Preventable Diseases & Health Care-Associated
Infections in New York County, the county prevalence is compared to New York State (NYS) and
national prevalence, and to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). The New
York County newly diagnosed HIV case rate (per 100,000) was 58.2, far higher than the NYS rate (19.5)
18 and NYSPAO (23.0). The New York County gonorrhea case rate (per 100,000) was 157.5, higher than
NYS (94.3) and far above NYSPAO (19.0). The tuberculosis case rate (per 100,000) for New York
County was 7.5, above NYS (4.9) and NYSPAO (1.0).
Queens County
Community health assessment data was analyzed comparing Queens County, NYS, and selected
communities within Queens County in order to further identify and compare rates of age/ethnicity/race
distribution, diseases of the cardiovascular system (including stroke), diseases of the respiratory system,
diabetes and liver disease, injuries, unintentional injury, intentional injury, cancer, communicable
diseases, mortality, and pregnancy/perinatal outcomes. These select communities are Fort Totten, Far
Rockaway, Rockaway Beach, Jamaica, Arverne, South Ozone Park, Rochdale Village, and St. Albans.
Sources of information included SPARCS data (2008-2010), NYSDOH Vital Statistics, the NYS Cancer
Registry, and the NYSDOH Surveillance System.
community.
Chronic Disease
To assess chronic disease prevalence in Queens County, the county prevalence is compared to
Coronary heart disease hospitalizations in Queens County (50.9 per 10,000) were higher than the
NYS average (43.8), while hospitalizations for congestive heart failure (34.9) were lower than the NYS
average (40.1). Both rates were only slightly greater than the NYSPAO (33.0). Cerebrovascular (stroke)
disease mortality for Queens County was significantly lower than the state and national averages
(respectively, 17.6, 27.5, and 39.0 per 10,000), and achieved the NYSPAO (24.0). Circulatory PQIs had
the highest rates in the select communities, Springfield Gardens, and Richmond Hills. The highest
hypertension PQIs were found in the select communities, Springfield Gardens, Rosedale, Hollis, and
Queens Village. CHI showed that Blacks had elevated rates of hospitalization for cerebrovascular disease
and congestive heart failure.
Diabetes prevalence rates in Queens County were 11%, only slightly higher than the NYS
average of 10.4% but well beyond the NYSPAO of 5.7%. The diabetes short term complication rates for
both 6-17 years and 18+ years of age (2.4 and 4.4 per 10,000 respectively) were better than the NYS
averages (3.0 and 5.8), and close to the NYSPAOs (2.3 and 3.9). Obesity rates for adults (BMI>30) were
3.9% below the NYS average of 24.5%, but still above the NYSPAO of 15%. Children 2-4 years of age
enrolled in the WIC program had obesity rates of 2.4% above the NYS average of 13.1%, and 3.9% above
the NYSPAO of 11.6%. Diabetes PQIs had the highest rates in select communities, Queens Village,
Springfield Gardens, and Astoria. When analyzed by race and ethnicity, Blacks had the highest CHI rates
of diabetes hospitalizations.
19 Breast cancer early stage diagnosis rates (60.9%) were lower than the NYS average and only
slightly higher than the US average; the rates were significantly lower than the NYSPAO. Cervical cancer
early stage diagnosis rates (50%) were higher than the US and NYS average, but below the NYSPAO.
The highest female breast cancer rates were found in Central Queens and Rockaway. Prostate cancer rates
were highest in Southeast Queens, Rockaway, and Jamaica. Lung Cancer incidence for men and women
respectively were 60.9 and 39.0 per 100,000. Male incidence was below NYS (75.8) and the NYSPAO
(62). Female incidence was also below NYS (53.9) and the NYSPAO (41). Cigarette smoking rates for
adults in Queens County were 2.6% below the NYS average of 18.1%, but above the NYSPAO of 12%.
Chronic Obstructive Pulmonary Disease adult hospitalizations per 10,000 in Queens County were 31.4
below the NYS average of 41.3, and only slightly above the NYSPAO of 31.The select communities had
a higher rate of COPD, as well as Astoria and East Elmhurst. Queens County adult asthma hospitalization
rates were similar to the NYS average, but the asthma rates in the select communities were in the third
and fourth quartile compared to the county-wide rate. CHI showed that Blacks had elevated rates of
hospitalizations for asthma and chronic lower respiratory disease.
management of chronic disease. Approximately 71.9% of Queens County adults report that they are
engaged in some type of leisure time physical activity, which is below the NYS rate (73.7%) and the
NYSPAO target of 80%. Although the Queens County rate is approaching the NYSPAO target, nearly
30% of residents are inactive. 6.8% of county residents report that they eat 5 or more fruits and vegetables
per day. This is well below the NYS average (26.8%) and the NYSPAO target (33%).
To assess preventable injury prevalence in Queens County, the county prevalence is compared to
the county average have been identified. Fall related hospitalizations for Queens residents age 65+ years
were 177.2 (per 10,000), lower than the NYS rate of 198.3 but above the NYSPAO target of 155.
Traumatic brain injury admission rates within the county were approximately the same as NYS rates, and
brain injuries resulting from alcohol related motor vehicle injuries were well below the NYS rate.
Queens County, the county prevalence is compared to New York State (NYS) and national prevalence,
and to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). In Queens County, the percent of
women receiving first trimester prenatal care was lower than both NYS and the NYSPAO (70.2% versus
NYS rate of 73.2% and NYSPAO of 90%). The rate of low-birthweight births was identical to those for
NYS and US (8.2%), but higher than the 5% NYSPAO. Overall infant mortality was 4.3 (per 1,000 live
births), lower than NYS and achieving the NYSPAO. Women receiving late or no prenatal care were 11%
for the county, but the following communities had increased rates: Astoria, Jamaica, Long Island City,
Elmhurst, Corona, Woodside, Jackson Heights, and East Elmhurst. When analyzed by race and ethnicity,
Blacks and Hispanics had lower CHI rates of receiving first trimester prenatal care, with only 56.8% and
64.6% respectively receiving adequate prenatal care. The percent of obese children (ages 2-4years)
enrolled in WIC was 15.5% versus a NYS rate of 13.1%and NYSPAO of 11.6%. Breastfeeding rates of
mothers in the WIC program at 6 months were above the state average (38.8%) at 47.9%.
To assess the prevalence of metal health disorders and substance abuse in Queens County, the
NYS Prevention Agenda Objectives (NYSPAO). Although the suicide rate for Queens County was 5.2
(per 100,000), lower than the NYS rate (7.5), it was still above the NYSPAO of 4.8. The percent of
Queens County adults reporting 14 or more days with poor mental health in the last month was 7.2%
compared to 11.2% for NYS, and met the NYSPAO of 7.8%. PQI data for mental health emergency
20 department visits showed increased rates in the select communities, as well as Glen Oaks, Long Island
City, and Rockaway Park. Queens County’s rate of binge drinking is 8.1% below NYS (19.6%), and
1.9% below the NYSPAO of 13.4%. Drug related Queens County hospitalizations were 14.5 (per
10,000), below both NYS (25.7) and NYSPAO (26.0). PQI data for substance abuse emergency
department visits showed increased rates in the following communities: North Shore Towers, Jamaica,
Richmond Hill, Far Rockaway, Rockaway Park, and Rockaway Beach. CHI data indicated that Blacks
and whites had drug-related hospitalization rates of about two times those for Hispanics. Whites had a
higher suicide mortality rate than Blacks or Hispanics.
Infections in Queens County, the county prevalence is compared to New York State (NYS) and national
prevalence, and to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). The Queens County
newly diagnosed HIV case rate (per 100,000) was 25.9, higher than the NYS rate (19.5) and NYSPAO
(23.0). The Queens County gonorrhea case rate (per 100,000) was 82.4, lower than NYS (94.3) but far
above NYSPAO (19.0). The tuberculosis case rate (per 100,000) for Queens County was 12.0, above
NYS (4.9) and NYSPAO (1.0).
Richmond County
Community health assessment data was analyzed comparing Richmond County, NYS, and
selected communities within Richmond County in order to further identify and compare rates of
age/ethnicity/race distribution, diseases of the cardiovascular system (including stroke), diseases of the
respiratory system, diabetes and liver disease, injuries, unintentional injury, intentional injury, cancer,
communicable diseases, mortality, and pregnancy/perinatal outcomes. These select communities are
Mariner’s Harbor, Stapleton, St. George, and Port Richmond. Sources of information included SPARCS
data (2008-2010), NYSDOH Vital Statistics, the NYS Cancer Registry, and the NYSDOH
community.
Chronic Disease
To assess chronic disease prevalence in Richmond County, the county prevalence is compared to
Coronary heart disease hospitalizations in Richmond County (52.6 per 10,000) were higher than
the NYS average (43.8) and the NYSPAO (48.0), while hospitalizations for congestive heart failure (31.1
per 10,000) were lower than the NYS average (40.1) and achieved the NYSPAO (33.0). Cerebrovascular
(stroke) disease mortality was significantly lower than the state and national averages (respectively, 14.8,
27.5, and 39.0) and achieved the NYSPAO (24.0). Circulatory PQIs and hypertension PQIs had the
highest rates in Mariner’s Harbor and Stapleton. CHI showed that Hispanics had elevated CHI rates of
cerebrovascular disease mortality, while Blacks had nearly twice the rate of hospitalizations as whites and
Hispanics. Blacks also had elevated rates of congestive heart failure hospitalizations, at 39.7 (per 10,000).
21 Diabetes prevalence rates in Richmond County were 8.5%, lower than the NYS average of 10.4%
but above the NYSPAO of 5.7%. The diabetes short term complication rates for both 6-17 years and 18+
years of age was better than the NYS averages (respectively, 2.1 and 4.2 per 10,000 vs. 3.0 and 5.8), and
close to the NYSPAO (2.3 and 3.9). Obesity rates for adults (BMI>30) were 26.6%, above the NYS
average of 24.5% and well above the NYSPAO of 15%. Children 2-4 years of age enrolled in the WIC
program had obesity rates of 4.6% above the NYS average of 13.1%, and 6.1% above the NYSPAO of
11.6%. Diabetes PQIs had the highest rates in Mariner’s Harbor and St. George. When analyzed by race
and ethnicity, Blacks and Hispanics had elevated CHI rates of diabetes mortality, with Blacks possessing
the highest rate for diabetes hospitalizations.
Breast cancer early stage diagnosis rates (65.4%) were slightly higher than the NYS and US
averages (64.8% and 60%), and were significantly lower than the NYSPAO (80%). Cervical cancer early
stage diagnosis rates (49.4%) were higher than the US and NYS averages (42.0% and 47.0%), but below
the NYSPAO (65%). The highest female breast cancer rates were found in Great Kills and Eltingtonville.
Prostate cancer rates were highest in Mariner’s Harbor. Lung Cancer incidence for men and women
respectively were 79.6 and 57.3 per 100,000. Male incidence was above NYS (75.8) and the NYSPAO
(62.0). Female incidence was also above NYS (53.9) and the NYSPAO (41). CHI data showed that
whites had elevated rates of lung cancer incidence when compared to Blacks and Hispanics. Chronic
Obstructive Pulmonary Disease adult hospitalizations per 10,000 in Richmond County were 44.5, above
the NYS average of 41.3, and above the NYSPAO of 31.0. Mariner’s Harbor, Port Richmond, and
Stapleton had the highest rates of COPD. Richmond County asthma hospitalization rates were slightly
higher than but similar to the NYS average. CHI data showed that Hispanics and Blacks had elevated
rates of asthma hospitalizations, at approximately two and three times the rate of whites respectively.
management of chronic disease. Approximately 70.2% of Richmond County adults report that they are
engaged in some type of leisure time physical activity, which is below the NYS rate (73.7%) and the
NYSPAO target of 80%. Although the Richmond County rate is approaching the NYSPAO target, nearly
30% of residents are inactive. Ten percent of county residents report that they eat 5 or more fruits and
vegetables per day. This is well below the NYS average (26.8%) and the NYSPAO target (33%).
To assess preventable injury prevalence in Richmond County, the county prevalence is compared
to New York State (NYS) and national prevalence, and to the 2013-2017 NYS Prevention Agenda
Objectives (NYSPAO). Fall related hospitalizations for Richmond County residents age 65+ years were
193.2 (per 10,000), lower than the NYS rate of 198.3 but above the NYSPAO target of 155.
Richmond County, the county prevalence is compared to New York State (NYS) and national prevalence,
and to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). In Richmond County, the percent
of women receiving first trimester prenatal care was higher than the NYS rate and lower than the
NYSPAO (81.7% versus NYS rate of 73.2% and NYSPAO of 90%). The rate of low-birthweight births
was nearly identical to those for NYS and US (8.2%), but higher than the 5% NYSPAO. Overall infant
mortality was 4.6 (per 1,000 live births), lower than NYS and within 0.1 of the NYSPAO. Women
receiving late or no prenatal care were highest in Port Richmond, Mariner’s Harbor, and St. George. CHI
data showed that Blacks had elevated rates of low birthweight births. Blacks and Hispanics had low CHI
rates of adequate prenatal care. The percent of obese children (ages 2-4years) enrolled in WIC was 17.7%
versus a NYS rate of 13.1% and NYSPAO of 11.6%. Breastfeeding rates of mothers in the WIC program
at 6 months were above the state average (38.8%) at 39.4%.
To assess the prevalence of metal health disorders and substance abuse in Richmond County, the
NYS Prevention Agenda Objectives (NYSPAO). Although the suicide rate for Richmond County was 4.9
22 (per 100,000), lower than the NYS rate (7.5), it was still above the NYSPAO of 4.8. The percent of
Richmond County adults reporting 14 or more days with poor mental health in the last month was 6.3%
compared to 11.2% for NYS, and met the NYSPAO of 7.8%. PQI data for mental health emergency
department admissions showed increased rates in St. George, Rosebank, and West New Brighton.
Richmond County’s rate of binge drinking is 5.2% below NYS (19.6%), and 1.0% above the NYSPAO of
13.4%. Drug related Richmond County hospitalizations were 43.9 (per 10,000), above both NYS (25.7)
and NYSPAO (26.0). PQI data for substance abuse emergency department visits showed increased rates
in Rosebank, New Dorp, and Tottenville. CHI data indicated that Blacks and whites had drug-related
hospitalization rates of about two times those for Hispanics. Statistics were unstable or unavailable for
suicide mortality in Blacks and Hispanics.
Infections in Richmond County, the county prevalence is compared to New York State (NYS) and
national prevalence, and to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). The
Richmond County newly diagnosed HIV case rate (per 100,000) was 12.1, lower than the NYS rate (19.5)
and NYSPAO (23.0). The Richmond County gonorrhea case rate (per 100,000) was 43.3, lower than
NYS (94.3) but far above NYSPAO (19.0). The tuberculosis case rate (per 100,000) for Richmond
County was 3.7, lower than NYS (4.9) but higher than NYSPAO (1.0).
Suffolk County
In April 2013, community health assessment data was presented (see attachment XIV) by the
Suffolk County Department of Health Services using the NYSDOH Community Health Indicator (CHI)
Reports identifying Suffolk County residents prevalence of health indicator groupings in order to further
identify and compare rates of age/ethnicity/race distribution, diseases of the cardiovascular system
(including stroke), diseases of the respiratory system, diabetes and liver disease, injuries, unintentional
injury, intentional injury, cancer, communicable diseases, mortality, and pregnancy/perinatal outcomes.
Selected communities within Suffolk County with higher rates of health disparities were determined by
income, education, and home ownership rates and racial diversity. These select communities are
Amityville, Wyandanch, Smithtown, Islandia, Ronkonkoma, Port Jefferson Station, Selden, Coram,
Medford, Bellport, Brookhaven, Patchogue, Ridge, Mastic, Mastic Beach, Riverhead, Laurel and
Greenport. Sources of information included SPARCS data (2008-2010), NYSDOH Vital Statistics, NYS
Cancer Registry and the NYSDOH Surveillance System.
community.
Chronic Disease
To assess chronic disease prevalence in Suffolk County, the county prevalence is compared to
23 Cardiovascular disease/coronary heart disease, stroke and hypertension were in the 4th quartile of
the Community Health Indicator. Suffolk County coronary heart disease hospitalization rates (57 per
10,000) were worse than the NYS average (44) and above the NYSPAO (48). Congestive heart failure
hospitalizations followed the same pattern. When analyzed by race and ethnicity, the CHI rates were
higher in Hispanic and Black populations for heart disease and cerebrovascular hospitalizations. Blacks
had the highest CHI rates for stroke, coronary heart disease mortality and congestive heart failure
mortality. Hispanics had the highest CHI rates for cardiovascular and cerebrovascular disease
hospitalizations. Cerebrovascular (Stroke) disease mortality was significantly better than the state and
national averages and achieved the NYSPAO. The highest Circulation PQIs were found in the select
communities listed above.
Diabetes prevalence rates in Suffolk County were 9%, lower than the NYS average of 10.4% but
still above the NYSPAO of 5.7%. The diabetes short term complication rate was also better than the NYS
average and achieved the NYSPAO for people age 18+ years. When analyzed by race and ethnicity, the
CHI rates for diabetes hospitalizations were elevated in Blacks and Hispanics. Diabetes mortality was
highest in Blacks. Obesity rates for adults (BMI>30) were 21%, below the NYS average of 24%, but still
above the NYSPAO of 15%. Elementary, middle school and high school students were in the 3rd and 4th
quartiles for percent overweight and percent obese for the CHI. However, Suffolk children 2-4 years
enrolled in the WIC program had obesity rates of 22%, above the NYS average of 14% and the NYSPAO
of 11%. Diabetes PQIs had the highest rates in select communities.
Breast (62%) and colorectal cancer (46%) early stage diagnosis rates were higher than the US and
NYS average but below the NYSPAO. CHI show that Blacks had higher colorectal cancer and female
breast cancer mortality and the lowest percent early stage of earlier diagnosis. Cervical cancer early stage
diagnosis rates (47.3%) were higher than NYS and US rates but below the NYSPAO (50%). The highest
female breast cancer rates are in the communities of Oakdale, Orient and West Hampton. Prostate cancer
rates were highest in Mt. Sinai, E. Moriches, Laurel, Peconic and West Hampton. Lung Cancer incidence
for men and women per 100,000 respectively were 79.9 and 69.3. Male incidence was above NYS (75.8)
and the NYSPAO of 62%. Female incidence was above NYS (53.9) and above the NYSPAO of 41%.
Cigarette smoking rates for adults in Suffolk County were 17.7%, below the NYS average of 18.1% and
above the NYSPAO of 12%. Chronic Obstructive Pulmonary Disease adult hospitalizations per 10,000 in
Suffolk County were 40.6, above the NYS average of 41.3 and the NYSPAO of 31.The select
communities had a higher rate of COPD. Suffolk County adult asthma hospitalization rates were below
the NYS average but the asthma rates in the select communities were higher the rates of the rest of the
county.
management of chronic disease. Approximately 77% of Suffolk County adults report that they are
engaged in some type of leisure time physical activity which is above the NYS rate (73%) but below the
NYSPAO target of 80%. Although the Suffolk County rate is approaching the NYSPAO target,
approximately 1 out of 4 residents are inactive. Twenty-eight percent of county residents report that they
eat 5 or more fruits and vegetables per day. This is above the NYS average (26.8) but below the
NYSPAO target (33%).
To assess preventable injury prevalence in Suffolk County, the county prevalence is compared to
the county average have been identified. Fall related hospitalizations for Suffolk residents age 65+ years
(per 10,000) were 224, higher than the NYS rate of 198 and well above the NYSPAO target of 155. CHI
show that Hispanics had the highest incidence of unintentional injury and fall hospitalizations. The
highest rates where present in Huntington, Melville, West Islip, Hauppauge, St. James, Stonybrook,
Centereach, Port Jefferson Station, Medford, Yaphank, Brookhaven, Center Moriches, Oakdale, Sayville,
Southside, Greenport and Shelter Island. Sixty-eight percent of the patients were female. Traumatic brain
24 Injury admission rates including those resulting from alcohol related motor vehicle injuries were above
the NYS rate.
To assess the prevalence conditions related to the health of women, infants and children in Suffolk
County, the county prevalence is compared to New York State (NYS) and national prevalence and in
relation to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). The percent of women
enrolled in WIC with first trimester prenatal care was on par with NYS at 73%, but below the NYSPAO
(90%). Blacks and Hispanic groups had the lowest rates (57%) as well as the lowest percent of adequate
prenatal care (48 and 50% respectively). Women receiving late or no prenatal care were 4% for the
county but the following communities had increased rates: Copiague, Amityville, Lindenhurst, W.
Babylon, Wyandanch, Deer Park, Bay Shore, Brentwood, Central Islip, Medford, Bellport, Riverhead and
Greenport. Low birth weight rates were also elevated in many of the above communities. Pregnant
women enrolled in WIC had a pre-pregnancy weight identified as overweight at a rate of 8.6% versus a
NYS rate of 15.4%. In addition, the pre-pregnancy obesity rate of pregnant women enrolled in WIC was
26%, greater than 1 in 4. The percent of obese children (ages 2-4years) enrolled in WIC was 20%, versus
a NYS rate of 13%. Underweight in the pediatric WIC population was also above the NYS rate.
Breastfeeding rates of mothers in the WIC program were on par with the NYS average (39%) but below
the NYSPAO of 50%.
To assess the prevalence of metal health disorders and substance abuse in Suffolk County, the
county prevalence is compared to New York State (NYS) and national prevalence and in relation to the
2013-2017 NYS Prevention Agenda Objectives (NYSPAO). Although the suicide rate (per 100,000) for
Suffolk County was 6.8, and lower the NYS rate (7.5), it was still above the NYSPAO of 4.8. The
percent of Suffolk County adults reporting 14 or more days with poor health in the last month was 13%
compared to NYS (11%) and above the NYSPAO of 7.8%. Whites had the highest rate of drug related
hospitalizations and both Blacks and Whites had double the suicide rate (7.2 and 6.8 respectively) than
Hispanics (3.3). PQI data for mental health emergency department visits showed increased rates in the
following communities: Huntington, Greenlawn, E. Northport, Port Jefferson, Port Jefferson Station,
Coram, Patchogue, Ridge, Brookhaven, Mastic, Mastic Beach, Moriches and the North Fork. Suffolk
County’s rate of binge drinking is 20%, above NYS (19%) and the NYSPAO of 13.4%. Drug related
Suffolk County hospitalizations were on par with the NYS (26%) and NYSPAO. PQI data for substance
abuse emergency department visits showed increased rates in the following communities: Ronkonkoma,
Bohemia, Oakdale, Holtsville, Ridge, Mastic Beach, Mastic, Shirley, Center Moriches, Riverhead and the
North Fork.
To assess the prevalence of HIV, STDs. Vaccine-Preventable Diseases & Health Care-Associated
Infections in Suffolk County, the county prevalence is compared to New York State (NYS) and national
prevalence and in relation to the 2013-2017 NYS Prevention Agenda Objectives (NYSPAO). Suffolk
County newly diagnosed HIV case rate (per 100,000) was 7.3, significantly below the NYS rate (19) and
NYSPAO (23). The Suffolk County Gonorrhea case rate (per 100,000) was 29, lower than NYS (94) but
above NYSPAO (19). Tuberculosis case rate (per 100,000) for Suffolk County was 3.4, below NYS (4.9)
and the NYSPAO (1).
II. Identified Health Priorities
As a result of the primary and secondary data analysis the following health priorities emerged as pressing
community health issues based on county:
Nassau County:
 Chronic disease, especially in at risk and diverse communities
 Obesity
25 



Decreased consumption of and access to healthy foods
Decreased physical activity and access to safe recreational areas
Mental health and substance abuse
Access to healthcare
New York County
 Obesity
 Decreased consumption of and access to healthy foods
 Decreased physical activity and access to safe recreational areas
 Mental health and substance abuse
 Access to healthcare
 Healthy indoor and outdoor air
 Language and cultural sensitivity
Queens County
 Obesity
 Healthy indoor and outdoor air/ tobacco free living
Richmond County
 Obesity
 Healthy indoor and outdoor air/ tobacco free living
 Language and cultural sensitivity
Suffolk County
 Obesity
Nassau, Queens and Suffolk Mental Health
 Increased alcohol and drug Abuse
 Increased prevalence of mental health disorders especially depression and suicide
 Obesity
26 

Tobacco use
Access to healthcare
III. Collaborative Process and Criteria for Prioritizing NYSDOH Priority Agenda Items
The North Shore LIJ Health System (NSLIJ) began the Community Health Needs Assessment
(CHNA) process in January 2013. As an integrated health care system, the Office of Community and
Public Health was the lead corporate office that planned, coordinated and reported the CHNA in
collaboration with internal and external stakeholders for NSLIJ. Health system stakeholders included
senior leadership, the Committee on Community Health of the NSLIJ Board of Trustees, executive
directors and staff of NSLIJ hospitals, Office of Planning, Office of Government and Community Affairs
and corporate service lines (see attachment I). External stakeholders included representatives from
county health departments, area hospitals, academia, business, government agencies and community
based organizations with an emphasis on those who serve communities with health disparities (see
attachment I). A series of internal and external stakeholder meetings were held to discuss the process
including: the CHNA methodology; recruitment of community, academic and government partners;
secondary data analysis; primary data collection from external stakeholders; evaluation of primary data;
identification of health system and community resources; identification of NYSDOH Priority Agenda
items and development of the implementation plan. The Committee on Community Health of the NSLIJ
Board of Trustees was updated on the CHNA process during its quarterly meetings, provided feedback on
the process including the section of the NYSDOH Priority Agenda items and approved the recommended
NYSDOH Priority Agenda items and the implementation plan for the NSLIJHS as the governing body of
community health of the NSLIJHS Board of Trustees.
The NYSDOH Priority Agenda Items were selected based on the following criteria adapted from the
Catholic Health Association Assessing and Addressing Community Health Needs Manual:
1. Magnitude- The magnitude of the problem as it relates to the number of community members
impacted by the issue.
2. Severity- The severity of the problem which is determined by the risk of morbidity and mortality
associated with the problem.
3. Historical trends- The prevalence of the issue over time.
4. Alignment of the problem with the organization’s strengths and priorities.
5. Impact of the problem on vulnerable populations.
6. Importance of the problem to the community.
7. Existing resources addressing the problem.
8. Relationship of the problem to other community issues.
9. Feasibility of change and the availability of evidence-based approaches.
10. Value of immediate intervention versus any delay, especially for long-term or complex threats.
A discussion and debate approach was utilized to identify Priority Agenda Items. Health system, county
and regional priority-setting groups comprised of representatives from internal and external CHNA
stakeholders met to discuss the needs identified in the primary and secondary data analysis, and applied
the criteria listed above to these needs to identify priorities. Priority-setting group consensus on Priority
Agenda Items and focus areas was reached. The priority-setting groups then proceeded to validate the
priorities chosen to confirm that the needs identified are the needs that should be addressed by presenting
the process used for setting priorities and conclusions to internal and external stakeholders. These
stakeholders included community-based organizations, academic public health experts, health system and
facility community health staff, and other key stakeholders.
27 IV. NSLIJHS NYSDOH Priority Agenda Items
To improve the health of the community, the NSLIJHS, as a result of the CHNA process described
previously and approved by the Committee on Community Health of the NSLIJ Board of Trustees, has
selected the following Priority Agenda Item and focus areas for the service area of the health system:
PRIORITY AREA: Prevent Chronic Disease
• FOCUS AREA: Reduce obesity in children & adults
• Create community environments that promote & support healthy food and beverage
choices & physical activity
• Prevent childhood obesity through early child care & schools
• Expand the role of health care, health service providers, & insurers in obesity prevention
• Expand the role of public & private employers in obesity prevention
• FOCUS AREA: Increase access to high-quality chronic disease preventive care & management in
both clinical & community settings
• Increase screening rates for cardiovascular disease, diabetes, & breast/cervical/colorectal
cancers, especially among disparate populations
• Promote use of evidence-based care to manage chronic diseases
• Promote culturally relevant chronic disease self-management education
Integration of mental health awareness & screening
To address the mental health needs identified by the CHNA process, the South Oaks Hospital and Zucker
Hillside Hospital will focus on the following Priority Agenda Item and focus areas:
PRIORITY AREA: Promote Mental Health & Prevent Substance Abuse
• FOCUS AREA: Promote Mental, Emotional, & Behavioral Health
• Promote mental, emotional, & behavioral well-being in communities
• FOCUS AREA: Strengthen Infrastructure Across Systems
• Support collaboration among professionals working in fields of mental, emotional, and
behavioral health promotion & chronic disease prevention, treatment, and recovery
• Strengthen infrastructure for mental, emotional, and behavioral health promotion &
mental, emotional, and behavioral disorder prevention
5. Three Year Plan of Action
North Shore LIJ Health System (NSLIJ) Implementation Plan 2013‐2017 PRIORITY AREA: Prevent Chronic Diseases: Increase access to high quality chronic disease preventive care and management in both clinical and community settings
GOALS: Increase screening rates for cardiovascular disease, diabetes and breast, cervical and colorectal cancers, especially among disparate populations. Promote culturally relevant chronic disease self‐management education. Prevent initiation of tobacco use by New York youth and young adults, especially among low 28 socioeconomic status (SES) populations. Promote tobacco use cessation, especially among low SES populations and those with poor mental health. Eliminate exposure to secondhand smoke. PERFORMANCE MEASURES Short Term Indicators Source Frequency
By December 31, 2014, increase public awareness of chronic disease prevention through utilization of media channels by 15% from 2013 NSLIJHS public relations data. By December 31, 2014, increase the percentage of adults participating in screenings from disparate communities by 15% from 2013 community benefit data. By December 31, 2014, increase the percentage of adults participating in chronic self disease management programs by 30% from 2013 OCPH data. Public Relations media stats Annual Community Benefit reporting Annual Long Term Indicators Annual Office of Community and Public Health (OCPH) data Center for Tobacco Annual Control(CTC) Data; EMR data OCPH; NYSDOH,NYCDOMH tobacco control data Source Frequency
By December 31, 2017, increase the percentage of adults 18 years of age and older who had a test for high blood sugar, diabetes , cholesterol, blood pressure and BMI within the past three years 3% from 58.8% (2011) to 61.7%. By December 31, 2017, increase by at least 5% the percentage of adults with arthritis, asthma, cardiovascular disease, or diabetes who have taken a course or class to learn how to manage their condition. By December 31, 2017, decrease the prevalence of any tobacco use (cigarettes, cigars, smokeless tobacco) by high school age students by 30% from 21.2% (2010) to 15.0%. By December 31, 2017, decrease the prevalence of cigarette smoking by adults ages 18‐24 years by 17% from 21.6% (2011) to 18%. By December 31, 2017, decrease the prevalence of cigarette smoking by adults ages 18 years and older:  By 17% from 18.1% to 15.0% among all adults.  By 28% from 27.8% (2011) to 20.0% among adults with income less than $25,000.  By 17% from 29% (2011) to 24% among adults who report poor NYS Behavioral Risk Factor Surveillance System [BRFSS] BRFSS; annual measure, (beginning 2013) NYS Behavioral Risk Factor Surveillance System [BRFSS]; NY Adult Tobacco Survey; NYS Youth Tobacco Survey; Community Activity Tracking, CAT By December 31, 2014, increase provider compliance with 5A’s (chart review) tobacco cessation counseling by 5%. By December 31, 2014, increase in volume of electronic medical record for tobacco counseling by 5%. By December 31, 2014, increase in number of smoke free housing unit by 500 units. By December 31, 2014, increase in number of organizations with voluntary smoke free outdoor air policies by 3.
Bi‐
Annually Annually Annually Bi‐
Annually Annually 29 mental health. By December 31, 2017, decrease the percentage of adults who report being exposed to secondhand smoke during the past 7 days by 10%. By December 31, 2017, increase the number of Local Housing Authorities that adopt a tobacco‐free policy for all housing units by 10%.
By December 31, 2017, increase the integration of cessation curriculum into CTC data health provider training by 5%. Activity: Raise public awareness of the Short‐term metrics monitoring impact of healthy lifestyle behaviors on prevention of Chronic Disease Develop campaign signage / brochures / # Campaign materials created PSA in collaboration with community Track # community members enrolled in wellness partners. programs.
Track scope /reach of hospital based media channels Incorporate wellness messaging into hospital publications, website and patient Track scope /reach of community based media channels. education media channels. Track number of community based earned media Identify additional community based media channels with community partners credited. for ongoing promotion of campaign (i.e. LTE, OpEd, etc). Partner in the development and launch of Track # of hits to Long Island Health Collaborative Wellness Site. the Long Island Health Collaborative, a partnership between the Nassau and Suffolk County hospitals, departments of health, Nassau Suffolk Hospital Council and community based organizations (CBO), media campaign and website. Activity: Target community health Short‐ term metrics screenings to communities with high prevalence of Preventable Quality Indicators and needs based on the Community Health Needs Assessment (CHNA) Track # screenings in health disparate communities Use CHNA data to identify communities or community participants from health disparate with high disease prevalence rates communities using resident zip codes reported as a especially communities with other socio‐
percentage of all health screenings. economic risk factors. Track # screenings in health disparate communities Collaborate with CBOs in high need or community participants from health disparate communities who serve high risk communities with community partners reported as a population and hold health screenings at community sites and provide health access percentage of all health screenings and food assistance programs services at # of community members screened and/or enrolled screenings. in health access and food assistance programs. Analysis of demographic, health screening results Create a data base for community health and navigation follow‐up data. screenings to facilitate referrals and follow‐up care navigation. Annually NSLIJHS Facility System wide System wide System wide Nassau &Suffolk County Facilities System wide System wide System wide 30 Create/Expand chronic disease management support groups at hospital and community sites. Activity: Provide access to community‐
based chronic disease self management programs with a focus on health disparate populations. Track number and origin of referrals to and participants in chronic disease support groups. System wide Short‐ term metrics Implement the evidence‐based Chronic Disease Self‐Management Program (Better Choices, Better Health® Workshop). Implement the evidence‐based National Diabetes Prevention Program (DPPP). Analyze Pre‐ Post and 3 month validated knowledge, behavior assessments, participant demographic data and disease outcomes. Analyze Pre‐ Post and 3 month validated knowledge, behavior assessments, participant demographic data and disease outcomes. Track number of referrals from community based organizations Track patients and community members at risk for diabetes referred to community DPPPs. Short‐ term metrics System wide Establish clinical‐community linkages that connect patients/community members to self‐management education and community resources. Activity: Implement a multi‐media Tobacco Control Campaign across the service area. Develop campaign signage / brochures / PSA in collaboration with community partners. Incorporate Tobacco Control messaging into hospital publications, website and patient education media channels. Identify additional community based media channels with community partners for ongoing promotion of campaign. Identify additional community based media channels with community partners for ongoing promotion of campaign (i.e. LTE, OpEd, etc). Incorporate use of NYS Quit Line and CTC community programming into media messaging. Expand community cessation programs in collaboration with CTC and DOH as needed. Activity: Increase the number of providers utilizing best practice guidelines to support patient education re: smoking cessation. Participate in New York City Smoke Free Hospital Campaign. Educate hospital providers on evidence Southside Hospital System wide # Campaign materials created Track # community members enrolled in cessation programs. Track scope /reach of hospital based media channels. Track scope /reach of community based media channels. Track number of community based earned media. System wide Track number of calls to Quit line. System wide Track number community members in smoking cessation classes. Short‐ term metrics System wide Track level of achievement (Bronze through Gold) with associated program metrics. New York City Facilities System Track # of trainings, sites, participants. System wide System wide System wide 31 based best practices – the “5A’s” (ask, advise, assess, assist and arrange): 1)Provide in‐depth training on smoking cessation protocols to hospital and community based providers 2)Educate providers during hospital grand rounds or regularly scheduled series 3)Assure electronic medical record roll‐out includes best practice protocols 4)Educate providers on the availability of the new Medicare tobacco cessation counseling code 5) Collaborate with academic partners on the integration of the 5A’s into NYS Nursing School curriculum 6)Work with the Hofstra Medical School curriculum committee to integrate best practice protocols into medical school curriculum and practicum’s Promote the integration of the 5A’s into electronic medical records and provider education curriculums. Activity: Maintenance of effort for employee non‐smoking initiatives Increase the number of NSLIJHS employees pledging to remain tobacco free. Increase employee accessing tobacco cessation medications. Promotion of Smoke Free Campus Initiatives. Track Results of TC Performance Improvement Project. Track Grand Rounds ‐ increase in knowledge & intent to change behavior. Track # Protocols integrated Survey of participants’ satisfaction with program, knowledge, and intent to change practice behavior. Track #planning meetings scheduled with nursing schools. Track # planning meetings scheduled to discuss curriculum. wide Track annual Facility specific EMR tobacco use screening, counseling and referral data. Track activity with academic partners in curriculum development and tobacco cessation education Short‐ term metrics System wide Track employee pledge data from NSLIJ Human resources Benefit Department System wide Track employee pledge data from NSLIJ Human resources Benefit Department Track implementation of Smoke Free Campus signage and compliance System wide System wide 32 PRIORITY AREA Preventing Chronic Diseases: Reduce Obesity in Children and Adults GOALS: Create community environments and initiatives that promote and support healthy food and beverage choices and physical activity. Promote school‐based healthy eating and physical activity programs Promote breast feeding. Expand the role of health care and health service providers in obesity prevention. Expand the role of NSLIJHS in promoting employee obesity prevention. PERFORMANCE MEASURES Short Term Indicators Source Frequency
By December 31, 2014, increase public awareness of obesity prevention through utilization of media channels by 15% from 2013 Public Relations data. By December 31, 2014, increase the percentage of adults participating in walking activities disparate communities by 15% from 2013 LIHC data. Public Relations media stats Annually LIHC website and LIHC Wellness Survey data By December 31, 2014, increase the percentage of seniors participating in OCPH Stepping on Stepping On Program by 15% from 2013 OCPH data. Data By December 31, 2014, increase the percentage of newborns being Facility Latch On discharged on breastfeeding by 10% from 2013 data. and Baby Friendly Hospital metrics By December 31, 2014, increase the screening, identification and treatment CCMC Pediatric rates of pediatric primary care providers during well child visits by 30% or to Prevention in reach 95%. Primary Care Settings Chart audit data By December 31, 2014, increase the number of employees pledging to HR Employee complete health risk assessments and viewing wellness videos by 10%. Wellness Pledge data By December 31, 2014, increase the number of employees pledging to HR Employee complete health risk assessments and viewing wellness videos by 10%. Wellness Pledge data By December 31, 2014, increase the number of healthy food and beverage OCPH vending vending items by 10%. audits Long Term Indicators Source By December 31, 2017, reduce the percentage of children who are obese:  By 5% from 13.1% (2010) to 12.4% among WIC children (ages 2‐4 years).  By 5% from 17.6% (2010‐12) to 16.7% among public school children Statewide reported to the Student Weight Status Category Reporting system.  By 5% from 20.7% (2010‐11) to 19.7% among public school Annually Annually Annually Annually Annually Annually Bi‐Annually Frequency NYS Pediatric and Annually Pregnancy Nutrition Surveillance System [PedNSS]; NYS Student Weight Status Category 33 children in New York City represented in the NYC Fitnessgram. By December 31, 2017, reduce the percentage of adults ages 18 years and older who are obese:  By 5% from 24.5% (2011) to 23.2% among all adults.  By 5% from 26.8% (2011) to 25.4% among adults with an annual household income of < $25,000.  By 10% from 34.9% (2011) to 31.4% among adults with disabilities. By 2017, increase the percentage of infants born in NYS hospitals who are exclusively breastfed during the birth hospitalization by 10% from 43.7% (2010) to 48.1%. Reporting; NYC Fitnessgram; BRFSS Annually BRFSS Bureau of Biometrics and Biostatistics, NYSDOH; NYC Office of Vital Records, NYC DOHMH BRFSS By December 31, 2017, increase the percentage of adults ages 18 years and older who participate in leisure‐time physical activity:  By 5% from 73.7% (2011) to 77.4% among all adults.  By 10% from 59.0% (2011) to 65.0% among adults with less than a high school education.  By 10% from 49.9% (2011) to 54.9% among adults with disabilities. Activity: Raise public awareness of the impact Short‐term metrics monitoring of healthy lifestyle behaviors on prevention of Obesity. # Campaign materials created. Develop campaign signage / brochures / PSA in Track # community members enrolled in collaboration with community partners. wellness programs. Promote and utilize NYCDOHMH obesity prevention media campaign materials through Track # media placements and community facility media channels. reach. Pool purchased media credits for PSAs through Track # Long Island Health Collaborative the Long Island Health Collaborative. media outreach data. Incorporate wellness messaging into hospital publications, website and patient education media channels. Identify additional community based media channels with community partners for ongoing promotion of campaign (i.e. LTE, OpEd, etc). Track scope /reach of hospital based media channels. Track scope /reach of community based media channels. Track # of community based earned media . Annually Annually NSLIJHS Facility System wide NYC Facilities Nassau and Suffolk County Facilities System wide System wide 34 Partner in the development and launch of the Long Island Health Collaborative Website a partnership between the Nassau and Suffolk County hospitals, departments of health, Nassau Suffolk Hospital Council and community based organizations (CBO). Activity: Increase community member increased physical activity and healthy eating including school‐based healthy eating and physical activity programs. Promote and support community walking groups and fundraising walks with the Long Island Health Collaborative. Implement the evidenced‐based Chronic Disease Self‐Management Program (Better Choices, Better Health® Workshop). Implement the evidenced‐based National Diabetes Prevention Program (DPPP). Expand senior evidence‐based Stepping On falls prevention program focusing on daily strength and balance exercises. Track # of hits to Long Island Health Collaborative Wellness Site.
Nassau &Suffolk County Facilities Short‐term metrics monitoring Track hits and usage of LIHC website, number of walking groups, community participation in walking groups. Analyze Pre‐ Post and 3 month validated knowledge, behavior assessments, participant demographic data and disease outcomes. Analyze Pre‐ Post and 3 month validated knowledge, behavior assessments, participant demographic data and disease outcomes. OCPH Stepping On pre, post and 3 month evaluation data. Nassau and Suffolk Facilities System wide Provide evidence‐based “Healthier Tomorrows” Healthier Tomorrow’s Program outcome data. obesity management program in partnership with the YMCA at their facilities. Kohl’s Kares for Kids Program data Expand school‐based obesity prevention programs focusing on increasing physical activity and healthy eating. Host Farmer’s Markets for community member and employees. Activity: Expand the role of health care and health service providers in obesity prevention. Initiate a “Health Walking Prescription” program beginning in adult primary care settings. Expand the NYSDOH Prevention of Obesity in Primary Care (POPC) settings that increases pediatric primary care provider screening, identification and treatment of pediatric patients at well child care visits. Activity: Promote breast feeding in birthing hospitals. Facility Dietary metrics on market utilization and OCPH market utilization data. Short‐term metrics monitoring Track usage in Primary Care Setting. Southside Hospital Manhattan, Queens. Nassau and Suffolk Facilities Huntington Southside Cohen Children’s Medical Center System wide POPC chart audit data. System wide CCMC Short‐term metrics monitoring 35 Participate in NYSDOH Latch On Program and Baby Friendly Hospital Programs. Track # of bottles of formula distributed to healthy newborns in the hospital each month (Latch On NYC indicator) Track Baby‐Friendly USA Evaluation Criteria Track # of families provided prenatal breastfeeding education Track # babies discharged that are being solely and primarily breast fed. Activity: Expand the role of NSLIJHS in promoting employee obesity prevention. Increase the number of employees pledging to complete health risk assessments and viewing wellness videos. Expand employee wellness healthy eating initiatives specifically vending machine options. Short‐term metrics monitoring Staten Island University Hospital, Long Island Jewish Medical Center, North Shore University Hospital, Forest Hills Hospital, Huntington Hospital Track HR Benefits data System wide Bi‐annual OCPH vending audits System wide 36 PRIORITY AREA Promote Mental Health and Prevent Substance Abuse GOALS: Promote mental, emotional and behavioral (MEB) well‐being in communities Prevent underage drinking, non‐medical use of prescription pain relievers drugs by youth, and excessive alcohol consumption by adults Prevent and reduce occurrence of mental, emotional and behavioral disorders among youth and adults. Prevent suicides among youth and adults. Reduce tobacco use among adults who report poor mental health. Support collaboration among leaders, professionals and community members working in MEB health promotion, substance abuse and other MEB disorders and chronic disease prevention, treatment and recovery. Strengthen infrastructure for MEB health promotion and MEB disorder prevention. PERFORMANCE MEASURES Short Term Indicators Source
Frequency
By December 31, 2014, increase the number of mental health providers trained in tobacco cessation by 15% from 2013 CTC data. By December 31, 2014, increase provider compliance with 5A’s (chart review) by 5% using CTC data. By December 31, 2014, increase in volume of electronic medical record for tobacco counseling by 5%.
By December 31, 2014, expand the reach of BRAVE program by 5%. CTC data CTC Data Annually Annually EMR data Annually BRAVE Program Data By December 31, 2014, expand the reach of Prevention Resource Prevention Center program by 2 additional coalitions (1%). Resource Center Data By December 31, 2014, increase the medication collection totals by DEA data 10%. By December 31, 2014, increase the number of Outpatient home SOH data visits by 3%. Long Term Indicators Source Annually Annually By December 31, 2017, reduce the percentage of adult New Yorkers reporting 14 or more days with poor mental health in the last month by 10% to no more than 10.1%. (Baseline: 11.1%, 2011) By December 31, 2017, reduce the number of youth grades 9‐12 who felt sad or hopeless by 10% to no more than 22.4%. (Baseline: 24.9 %, 2011) By December 31, 2017, reduce the percentage of youth ages 12‐17 years reporting the use of non‐medical use of painkillers. (Baseline: 5.26% 2009‐2010, NSDUH, Target: 4.73%) By December 31, 2017, reduce suicide attempts by New York adolescents (youth grades 9 to 12) who attempted suicide one or more times in the past year by 10% to no more than 6.4%. BRFSS YRBS Annually NSDUH Annually YRBS Annually Annually Annually Annually 37 (Baseline: 7.1 suicide attempts per 100, 2011 YRBS) By December 31, 2017, reduce the age‐adjusted suicide mortality Bureau of rate by 10% to 5.9 per 100,000. (Baseline: 6.6 per 100,000, Bureau Biometrics of Biometrics 2007‐2009) By December 31, 2017, reduce the prevalence of cigarette smoking NY Adult Tobacco Survey among adults who report poor mental health by 15% from 31.2% in 2011 to 26.5%. (Baseline: 31.2%, 2011) County Data By December 31, 2017, identify indicator data and establish baseline targets for data required to plan and monitor county‐
level, strengths‐based efforts that promote MEB health and prevent substance abuse and other MEB disorders.  Identify specific roles different sectors (e.g., governmental and nongovernmental) and key initiatives (e.g., Health Reform) have in contributing toward MEB health promotion and MEB disorder prevention in New York State.
 Collaborate with researchers and practitioners to develop and disseminate a compendium of evidence‐based interventions and policies that promote MEB health and prevent MEB disorders.  Strengthen training and technical assistance of primary care physicians, MEB health workforce and community leaders in evidence‐based, including cultural sensitivity training, approaches to MEB disorder prevention and mental health promotion. Activity: Prevent suicides among Short‐ term metrics youth and adults. Expand Bully Reduction/Anti‐Violence Track schools participating. Education (BRAVE) School‐based Track system changes in bully reduction Program. policies in schools. Expand utilization of the Rosen Track center utilization data. Family Wellness Center evidence‐
based treatment and resources by Iraq and Afghanistan war veterans impacted by post‐traumatic stress disorder, traumatic brain injury and associated behavioral health issues as well as 911 first responders. Activity: Promote mental, emotional Short‐ term metrics and behavioral (MEB) well‐being in communities Expand utilization of the Unified: Track center utilization data. Behavioral Health Center for Military Veterans and Their Families evidence‐
based treatment and resources by military personnel, veterans, and Annually Annually Annually Zucker Hillside Hospital South Oaks Hospital Zucker Hillside Hospital South Oaks Hospital Zucker Hillside Hospital South Oaks Hospital 38 their families, including children. Expand the reach of the Prevention Resource Center facilitating partnerships among schools, communities, and prevention providers to promote evidence‐based strategies to decrease the prevalence of alcohol, drug use, and problem gambling in Suffolk County communities. Expand the visits of Mental Health Worker in Primary Care Provider’s office setting Expand Child & Adolescent Clinic home visits. Identify specific roles different sectors (e.g. governmental and nongovernmental) and key initiatives (e.g. Health Reform) have in contributing toward MEB health promotion and MEB disorder prevention in Nassau, queens and Suffolk Counties. Collaborate with researchers and practitioners to develop and disseminate a compendium of evidence‐based interventions and policies that promote MEB health and prevent MEB disorders. Strengthen training and technical assistance of primary care physicians, MEB health workforce and community leaders in evidence‐
based, including cultural sensitivity training, approaches to MEB disorder prevention and mental health promotion. Track # partnerships, programs and participants. Track substance abuse and gambling behavioral change outcomes. South Oaks Hospital Track all of the visits in Child & Adol clinic (COBS) and compare admission rate of Clinic vs. Home Visits vs. PCP Office setting. Track all of the visits in Child & Adol clinic (COBS) and compare admission rate of Clinic vs. Home Visits vs. PCP Office setting. Inventory of organizations with MEB in scope of services. Identify partners for coalition for MEB health promotion. Form coalition for MEB health promotion. South Oaks Hospital Inventory evidence‐based programs that promote MEB health and prevent MEB disorders. Identify 1 program. Seek opportunities for research. Zucker Hillside Hospital South Oaks Hospital Identify primary care practices. Track # of trainings, sites, participants Track Grand Rounds ‐ increase in knowledge & intent to change behavior. Track protocols integrated. Survey of participants’ satisfaction with program, knowledge, and intent to change practice behavior. Short‐term metrics monitoring Zucker Hillside Hospital South Oaks Hospital System‐wide Activity: Reduce tobacco use among adults who report poor mental health through community tobacco control awareness campaign Identify additional community based Track scope /reach of community based media channels with community media channels.
partners for ongoing promotion of South Oaks Hospital Zucker Hillside Hospital South Oaks Hospital System wide Zucker Hillside Hospital 39 campaign. Identify additional community based media channels with community partners for ongoing promotion of campaign ( i.e. LTE, OpEd, etc). Incorporate use of NYS Quit Line and CTC community programming into media messaging. Track # of community based earned media. Track # of calls to Quit line. Expand community cessation programs in collaboration with CTC and DOH as needed. Track # community members in smoking cessation classes. Activity : Increase the number of providers utilizing best practice guidelines to support patient education re: smoking cessation. Educate hospital providers on evidence based best practices – the “5A’s” (ask, advise, assess, assist and arrange): 1)Provide in‐depth training on smoking cessation protocols to hospital and community based providers 2)Educate providers during hospital grand rounds or regularly scheduled series 3)Assure electronic medical record roll‐out includes best practice protocols 4)Educate providers on the availability of the new Medicare tobacco cessation counseling code 5) Collaborate with academic partners on the integration of the 5A’s into NYS Nursing School curriculum 6)Work with the Hofstra Medical School curriculum committee to integrate best practice protocols into medical school curriculum and practicum’s Promote the integration of the 5A’s into electronic medical records and provider education curriculums. Short‐ term metrics Track # of trainings, sites, participants Track results of TC Performance Improvement Project. Track Grand Rounds ‐ increase in knowledge & intent to change behavior. Track protocols integrated. Survey of participants’ satisfaction with program, knowledge, and intent to change practice behavior. Track planning meetings scheduled with nursing schools. Track planning meetings scheduled to discuss curriculum. South Oaks Hospital System wide Zucker Hillside Hospital South Oaks Hospital System wide Zucker Hillside Hospital South Oaks Hospital System wide Zucker Hillside Hospital South Oaks Hospital System wide Zucker Hillside Hospital South Oaks Hospital Track # of trainings, sites, participants. System wide Track results of TC Performance Improvement Zucker Hillside Project. Hospital 40 Track annual Facility specific EMR tobacco use screening, counseling and referral data. Track activity with academic partners in curriculum development and tobacco cessation education. Activity :Maintenance of effort for employee non‐smoking initiatives Increase the number of NSLIJHS employees pledging to remain tobacco free. Track Grand Rounds ‐ increase in knowledge & intent to change behavior. Track protocols integrated. Survey of participants’ satisfaction with program, knowledge, and intent to change practice behavior. Track planning meetings scheduled with nursing schools. Track planning meetings scheduled to discuss curriculum. Track annual Facility specific EMR tobacco use screening, counseling and referral data. Track activity with academic partners in curriculum development and tobacco cessation education South Oaks Hospital Short‐ term metrics Track employee pledge data from NSLIJ Human resources Benefit Department. System wide Zucker Hillside Hospital South Oaks Hospital System wide Zucker Hillside Hospital South Oaks Hospital System wide Zucker Hillside Hospital South Oaks Hospital Increase employee accessing tobacco cessation medications. Track employee pledge data from NSLIJ Human resources Benefit Department. Promote Smoke Free Campus Initiatives. Track implementation of Smoke Free Campus signage and compliance. Activity: Prevent underage drinking, non‐medical use of prescription pain relievers drugs by youth, and excessive alcohol consumption by adults. Participate in US Department of Drug Enforcement Drug Take Back Days Short‐ term metrics # pounds of drugs received. # sites. Reach of marketing efforts. System wide Zucker Hillside Hospital South Oaks Hospital System wide Zucker Hillside Hospital South Oaks Hospital 6. Dissemination of the Plan to the public.
The Community Service Plans are displayed on and downloadable from the North ShoreLIJ Health System web site in a consumer-friendly brochure format, which can be found through
www.northshorelij.com (in the “About Us”/ “Community Service Plans” section). The CSP is
disseminated via the web site (external and internal northshorelij.com websites) and distributed
41 to hospitals executives and board members. A published version of the CSP is distributed to the
public, as requested.
7. Brief description of the process that will be used to maintain engagement with local
partners over the next # years of the Community Service Plan and the process that will be
used to track progress and make mid course corrections.
The NSLIJ health system has a history of active engagement and coalition work with community
partners as it relates to improving population health. We will continue to maintain these active
partnerships (see attachment I). In an effort to continue establishing relationships, coalition building and
expanding existing coalition capacity, NSLIJ has involved our partners in the CHNA process and has
included this collaborative work in our implementation plan (see question 5 response).
An example of how NSLIJ has leveraged the CHNA process is the formation of the Long Island
Health Collaborative (LIHC). The LIHC is a bi-county (Nassau and Suffolk County) coalition comprised
of hospitals, county health departments, health and welfare organizations, businesses and academia
working together to improve the health of all Long Islanders. Initially 2 separate CHNA workgroups were
formed to collaborate on the CHNA process. As each work group collected and analyzed primary and
secondary data and inventoried community resources (see attachment XV), both the Nassau and Suffolk
county workgroups independently achieved consensus on this NYSDOH Priority Agenda item and focus
areas:
• FOCUS AREA: Reduce obesity in children & adults
• FOCUS AREA: Increase access to high-quality chronic disease preventive care & management in
both clinical & community settings
It became apparent that since both workgroups shared similar goals and several workgroup members, a
regional approach leveraging both counties’ resources would greatly impact the health of Long Island
residents. Subsequently, the LIHC was established. The goals of the LIHC are to promote health
programming, public outreach and policy development related to the identified priority and focus areas.
The LICH has produced a logo which will be used for branding; has reached consensus on promoting
walking as an obesity/chronic disease prevention and treatment strategy; is developing a media campaign;
is creating a webpage that will be used for education and community resource linkages; and is developing
an evaluation metric for health programming. The LICH will continue to collaborate on these initiatives
during the community service plan 2014-2017cycle.
In New York City, NSLIJ has joined the Partnership for a Healthier NY (PHNY). The PHNY is a
population health initiative focused on decreasing alcohol and tobacco use, healthy eating, and active
living. Each borough has partnerships comprised of health department, hospital, business, government
and community based organizations that focus on evidence-based community health initiatives and policy
changes. This coalition will continue fostering the engagement of community partners.
42 NSLIJHS Community Service Plan Attachments
I.
NSLIJHS CHNA NSLIJHS CHNA Internal CHNA Committees, Community Partners
and Community Health Meetings by County
II.
NSLIJHS Nassau County Key Informant Interview Analysis
III.
NSLIJHS Nassau County Individual Community Member Survey
IV.
NSLIJHS Nassau County Community Member Survey Results
V.
NSLIJHS Lenox Hill Hospital Community-based CHNA Survey and Results
VI.
NSLIJHS Manhattan Take Care New York Listening Session
VII.
NSLIJHS Queens Take Care New York Listening Session
VIII.
NSLIJHS Staten Island University Hospital Community-based CHNA Survey and
Results
IX.
NSLIJHS Staten Island Take Care New York Listening Session
X.
NSLIJHS Suffolk County Community-based Organization CHNA Survey and Results
XI.
NSLIJHS Suffolk County Community-based Organization CHNA Survey Participants
XII.
NSLIJHS Nassau, Queens and Suffolk Mental Health Community-based Entity Survey
and Results
XIII.
NSLIJHS Nassau County Community Health Assessment Data
XIV. NSLIJHS Suffolk County Community Health Assessment Data
XV.
NSLIJHS Nassau and Suffolk Counties Resource Inventory
Attachment I: NSLIJHS CHNA Internal
CHNA Committees, Community Partners
and Community Health Meetings by County
NSLIJ Board of Trustees Committee on Community Health
NSLIJ Office of Community and Public Health
Jenifer Mieres, SVP, Office of Community and Public Health, Office of Community and Public
Health
Amit Powar, Vice President, Office of Community and Public Health Nancy Copperman,
Director of Public Health Initiatives, Office of Community and Public Health
Lisa Burch, Director of Sustainability and Social Responsibility, Office of Community and Public
Health
Rosemarie Ennis, Corporate Director of Community Education & Health, Office of Community and
Public Health
Christine Essig, Director of Community Benefit, Office of Community and Public Health
Barbara Felker, Vice President of Diversity & Inclusion, Office of Community and Public Health
Ji Im, Director of Community Benefit, North Shore-LIJ Health System
Jennifer Ludwin, Health Educator, North Shore-LIJ Office of Community and Public Health
Ji Im, Director of Community Benefit, North Shore-LIJ Health System
Jennifer Ludwin, Health Educator, North Shore-LIJ Office of Community and Public Health
Jerrold Hirsch, Vice President, Planning, North Shore-LIJ Health System
Stephanie Kubow, Project Manager, System Planning, North Shore-LIJ Health System
Melissa Strugatz, Analyst, System Planning, North Shore-LIJ Health System
Forest Hills CHNA Committee
Rita Miercia, Executive Director, Forest Hills Hospital
Brian O’Neill, Assistant Executive Director, Forest Hills Hospital
Gerard Brogan, Medical Director, Forest Hills Hospital
Theodore Lehman, Director, Community Services
Franklin Hospital CHNA Committee
Catherine Hottendorf, Executive Director, Franklin Hospital
Ed Cox, Director of Nutrition and Patient Relations, Franklin Hospital
1 Helen White, Manager of Community Relations, Franklin Hospitals
Patrick Mack, Coordinator Community Relations
Lenox Hill Hospital CHNA Committee
Dennis Connors, Executive Director, Lenox Hill Hospital
John Gupta, Executive Director MEETH
Peg Butler, Director. Community Outreach, Lenox Hill Hospital
Plainview/Syosset Hill Hospital CHNA Committee
Michael Fener, Executive Director, Plainview Hospital
Jim Baker, Director of Service Excellence and Community Relations, Plainview Hospital
Nicole Santora, Community Relations Liaison
Jaclyn Marino , Community Relations Liaison
LIJMC CHNA Committee
Chantal Weinhold, Executive Director, LIJMC
Joel Shulman, Executive Director, Zucker Hillside Hospital
Kevin McGeachy, Executive Director, Cohen Children’s Medical Center
Kevin Dwyer. SVP, Senior Development Officer, Zucker Hillside Hospital
Debbie Riccardi, Director, Community Outreach, Cohen Children’s Medical Center
Tricia Scarlata, Director Marketing and Community Outreach, LIJMC
South Oaks Hospital
Bob Detor, CEO, South Oaks Hospital
Patricia Porter, CFO, South Oaks Hospital
Mary Jeanne Corea, Director of Community Relations, South Oaks Hospital
Christine Moran, Vice President of Behavioral Health Services, South Oaks Hospital
Gerard M. Kaiser, Vice President of Senior Services, South Oaks Hospital
Kristie Golden, Vice President, South Oaks Hospital
Staten Island University Hospital
2 Anthony Ferreri, Regional Executive Director, Staten Island University Hospital
Robert Blake, Associate Vice President, Planning, Staten Island University Hopsital
Christine Hollie, Associate Vice President, Operations, Staten Island University Hospital
Huntington Hospital
Kevin Lawlor, Executive Director
Julie Robinson-Tinque, Director Public Affairs
Glen Cove Hospital
Susan Kwiatek, Executive Director, Glen Cove Hospital
Christine Reynolds, Nurse Educator Community Outreach, Glen Cove Hospital
North Shore University Hospital
Susan Sommerville, Executive Director
Joe Leggio, Manager, Marketing and Communication
Southside Hosptial
Donna Moravick, Executive Director
Edward Fraser, Director Community Relations
3 1
Queens Community Partner
Organizations
AAFE (Asian Americans for
Equality)
Asociacion de Mujeres
Progresistas
Asthma Coalition of Queens
BASTA/MRNY
CCNS WIC program Woodside
& Jamaica
CHHAYA
Children's Aid Society
Chinese-American Planning
Council, Inc
City College of NY
Focus Area
Tobacco
Active Living
Tobacco
Tobacco
Healthy Eating
Tobacco
Alcohol
Tobacco
Active Living
Coalition for Asian American
Children and families
Healthy Eating /
Active Living
Cornell University
Healthy Eating
Cornell University Cooperative
Extension
Healthy Eating /
Active Living
Cultural Collaborative of Jamaica
DOE PS11/ PS 122
First Baptist Church of Corona,
Inc.
Grameen Health Innovations
Greater Ridgewood Youth
Council
Harvest Home Farmer's Market,
Inc.
Active Living
Alcohol
Healthy Eating /
Alcohol
Healthy Eating
Jackson Heights Green Alliance
Active Living
Healthy Eating /
Active Living /
Smoke-Free
Healthy Eating
Healthy Eating
Active Living
Healthy
Eating/Active
Living
Active Living
Latin Women in Action
MinKwon Center for Community
Action (formerly YKASEC)
Tobacco
Alcohol
Alcohol
Alcohol
Alcohol
Alcohol
Healthy Eating /
Active Living
Poderosas
Public Health Solutions
Queens Botanical Garden Intergenerational Community
Garden
Queens Library Health Link
Queens Museum of Art
Queens Pomonok Library /
Cancer Action Council
Queens Smoke Free Coalition
Recycle a Bicycle
Safe Space
The Corona Self Help Center
Alcohol
Healthy Eating
Transportation Alternatives
United Healthcare Community
Plan
We Bike
Healthy Eating /
Active Living
Tobacco
Plaza del Sol Urban Health
Center
Healthy Eating
Immigrant Movement
International
Korean Community Service
(KCS)
NYC DOE PS 78/PS 166
NYCDOE - SAPIS / Newtown
H.S.
NYCDOE - SAPIS / PS 92Q
PAIHS
The Lesbian, Gay, Bisexual &
Transgender Community Center
Healthy Eating /
Active Living
Kalusugan Coalition, Inc.
Kalusugan Coalition, Inc.
Kindaw
NYC DOE - SAPIS / Office of
Safety and Youth Development
Active Living
Health Care Education Project
Jacob A. Riis Neighborhood
Settlement House
North Shore Long Island Jewish
Tobacco Control Center
North Shore-LIJ Health System
Woodside on the Move, Inc.
Healthy Eating
Tobacco
Active Living
Tobacco
Tobacco
Active Living
Healthy Eating
Alcohol
Tobacco
Active Living
Health &
Wellness
Active Living
Healthy Eating /
Active Living
Tobacco
4 2
New York County Take Care New York
Listening Session Participants
ACS
Bailey House
Center for Independence of the Disabled, NY
City Harvest
Columbia University
Community Healthcare Network
Cornell Cooperative Extension/Hunter Student
CUNY School of Public Health
CUNY SPH
Department of Transportation
Fund for the Public Health of New York
Harlem DPHO
Health Advocate
Kiker Marcom Group, LLC
Lenox Hill
Mental Health Association of New York City
Morris Heights Health Center
Northern Manhattan Perinatal Partnership, Inc
NYU
Palladia Org
Partnership for a Healthier NYC
PCIP
Sabree Education
Settlement Health
Touro COP Student
Univ. of Medicine & Dentistry of NJ
Visiting Nurse Service of NY
WellCare
West Side Campaign Against Hunger
YWCA of Brooklyn
3
Richmond County Take Care New York
Alliance for Lupus Research
American Cancer Society
Assist Tobacco Cessation Center
City Harvest
Community Health Action of Staten Island
FPHNY (Board Member of SIPCW)
Greater New York Hospital Association
Health Education on Wheels
Health Plus Amerigroup
IlluminArt Productions
National Autism Association Holistic Health
Counselor
NS-LIJ Health System- Staten Island University
Hospital
NYSNA
Partnership for a Healthier NYC
Richmond University Medical Center
SIPCW
Sky Light Center
Special Ed Teacher
Staten Island Slim Down
Staten Island Smoke-Free Partnership
Support Center Online
Touro College
VNSNY/SIPCW
5 4
Queens County Take Care New York
Asthma Coalition of Queens
Catholic Charities
Citizens' Commitee for Children of New York,
Inc.
Creedmoor Psychiatric Center
Ecuadorian International Center
Emblem Health
Goodwill Industries
H.E. Corona Senior Center
Healthcare Education Project
HealthPlus AmeriGroup
Help/PSI, Inc.
Joseph P. Addabbo Health Center
New York Downtown Hospital
Northshore LIJ (Forest Hills)
NYC DOC
NYC DOT
Queens Smoke-Free Partnership
Safe Space
Steinway Wellness & Recovery Center
The Partnership for a Healthier NYC
TransCanada - Ravenswood Power Plant
VNSNY Choice Health Plans
Hospital Governance and Community
Advisory Boards
North Shore - LIJ Committee on Community
Health
Glen Cove Hospital Community Advisory
Board
Southside Hospital Advisory Board
Huntington Hospital Advisory Board
Tobacco Action Coalition Key Stakeholders
American Cancer Society – Eastern Division
American Heart Association
American Lung Association of the Northeast
Association of School-based Prevention,
Intervention, Resource and Education
Professionals
Babylon Village Youth Project
Clubhouse of Suffolk
Cornell Cooperative Extension of Suffolk
County
Diabetes Resource Coalition of Long Island
Eastern Suffolk BOCES
Good Samaritan Hospital
Long Beach Medical Center – F.A.C.T.S.
Long Island Lesbian Cancer Initiative (LILCI)
Manhasset Community CASA
Nassau County Department of Health
Nassau County Department of Drug and Alcohol
Addiction
Nassau-Suffolk Hospital Council
New York State Department of Health
NSLIJ’s Center for Tobacco Control
NYS Public Health Association – L.I. Region
South Nassau Communities Hospital
Stony Brook University Hospital
Stony Brook University Student Health Services
Students Against Destructive Decisions (SADD)
Suffolk Coalition to Prevent Alcohol and Drug
Dependencies (PADD)
Suffolk County Alcohol and Substance Abuse
Services
Suffolk County Department of Health Services
Suffolk County Perinatal Coalition
Western Suffolk BOCES
Winthrop University Hospital
YMCA Family Services
6 5
New York City Falls Coalition
NYC Department of Health and Mental Hygiene
NYC Department for the Aging
NYC Health and Hospitals Corporation
NYC Mayor's Office for People with Disabilities
NYC Human Resources Administration
New York Academy of Medicine
Visiting Nurse Service of New York
United Hospital Fund
AARP - NY
Brookdale Center for Healthy Aging and
Longevity
VISIONS
Tuoro College of Pharmacy
St. John's College of Pharmacy
North Shore LIJ
NYU School of Dentistry
Mt. Sinai - Dept of Geriatrics
Columbia Mailman School of Public Health
New York State Department of Health and
Local Health Departments
(SCDHS)
(NCDOH)
New York City Department of Health and
Mental Hygiene (NYCDHMH)
6
Hospital Associations
Hospital Association of New York State
(HANYS)
Greater New York Hospital Association
(GNYHA)
Nassau Suffolk Hospital Council (NSHC)
Area Hospitals
Brookhaven Memorial Hospital Medical Center
Eastern Long Island Hospital
John T. Mather Memorial Hospital
Long Beach Medical Center
Mercy Medical Center
New Island Hospital
Peconic Bay Medical Center
St. Catherine of Siena Medical Center
St. Charles Rehabilitation Hospital
St. Francis Hospital
Southampton Hospital
South Nassau Communities Hospital
Stony Brook University Medical Center
Winthrop Hospital
Professional Organizations
American Association of Retired Persons
(AARP)
American Lung Association
Communities Putting Prevention to Work –
Tobacco NYC DOHMH
7 Community Based Organizations &
Community Members
Central Queens Y
Cross Island YMCA
Chinese Planning Council
Dominican Sisters Family Health Service
Ridgewood YMCA
Samuel Field Y
Tobacco Action Coalition (TAC)
NYC Coalition for a Smoke Free City
North Shore - LIJ sponsored Naturally
Occurring Retirement Communities (NORCs)
Deepdale CARES (Queens)
Huntington (Suffolk)
Plainview-Old Bethpage CARES (Nassau)
Plainview-Old Bethpage WOW (Nassau)
NORC WOW (Queens)
Project Independence (Nassau)
Queens SNAP Senior Center
Queens Interagency Council
Queens Quits
Queens Smoke Free Partnership
7
New York City Coalition for a Smoke Free
City
Citywide partners
Campaign for Tobacco Free Kids
NYC Cessation Centers
Community based organizations
Faith based organizations
Health facilities
Other community groups dedicated to decreased
tobacco use
Borough Smoke-Free Partnerships
Queens Smoke Free Partnership
Manhattan Smoke Free Partnership
Bronx Smoke Free Partnership
Brooklyn Smoke Free Partnership
Colleges and Universities
Hofstra University School of Education, Health,
and Human Services
St. Joseph’s College Nursing
Long Island University-C.W. Post Campus
Adelphi University
SUNY Farmingdale
Queensboro Community College
Molloy College
8 New York County Community Health Meetings
Date
Meeting Description
Notes
01/18/13
Greater NY Hospital Association6
Community Health Forum: conference
call
02/20/13
Community Health Forum meeting
02/27/13
Coalition for a Smoke Free NYC7
Quarterly Meeting
03/08/13
Briefing on Community Health Needs
Assessment
04/24/13
NYCDOHMH Take Care New York2
Planning Meeting
04/30/13
New York City Falls Prevention Coalition5
Policy Sub-Committee Conference Call
05/09/13
call
05/09/13
Emergency responders, Falls survey,
Policy Sub-Committee update, US
Preventive Services Task Force
05/14/13
Listening Session
05/17/13
call
06/13/13
Quarterly Meeting
07/12/13
08/08/13
Falls Prevention Awareness Day,
Grants/Projects
09/04/13
call
09/23/13
Latino/Hispanic Health Equity Initiative
NY Regional Forum
09/27/13
call
10/18/13
call
11/17/13 New York City Falls Prevention Coalition5
2
See corresponding table for members.
5
See corresponding table above for members.
6
7
9 Queens County Community Health Meetings
Date
Description
Notes
01/18/13
call
02/20/13
02/27/13
Quarterly Meeting
03/05/13
CTG Partnership for a Healthier New York1
Neighborhood Contractors Orientation
03/08/13
Briefing on Community Health Needs
Assessment
03/19/13
Queens New York Neighborhood Contractors
Meeting
03/26/13
Queens New York Neighborhood Contractor
Call
04/24/13
Planning Meeting
05/09/13
call
05/14/13
Listening Session
05/17/13
call
06/12/13
Queens New York Neighborhood Contractors
Meeting
06/13/13
Quarterly Meeting
06/24/13
Partnership for a Healthier NYC1
Queens Contractor Call
07/12/13
08/16/13
Partnership for a Healthier NYC1
Queens Contractor Training Call
09/04/13
call
09/27/13
call
10/18/13
call
1
6
7
4
10 Richmond County Community Health Meetings
Date
Description
01/18/13
Community Health Forum: conference call
02/20/13
02/27/13
Quarterly Meeting
03/08/13
6
Greater NY Hospital Association
Notes
Briefing on Community Health Needs Assessment
03/19/13
Community Advisory Board
Meeting (regarding NYSDOH
Prevention Agenda and results of
community health needs
assessment)
Rosemarie Dressler, Director, Community Outreach
Relations, Staten Island University Hospital
Michael McBrearty, Outreach Coordinator, Staten
Island University Hospital
Anna Pallotti, SIUH Auxiliary
Sally Ann Esposito Browne, SI school system,
Teacher and Parkinson foundation
Kathleen Carney-Kielty, Program Coordinator, Staten
Wanda Cordes, First Central Baptist Church
Adenike Coyle, Nurse, First Central Baptist Church
Ray Diaz, Senior Program Manager, NYCHA
Queens/Staten Island Community Operations
Maureen Fisher, Director of Health Programs, JCC of
Staten Island
Nicholas DiBenedetto, Director of Business
Development, Primary Care Ambulance
Boris Natenzon, President & CEO, Nates Pharmacy
Daniel Lebowitz, Account Manager, Primary Care
Ambulance
Cilina Ramsey, Language, Health Literacy and
Diversity Coordinator, Staten Island University
Hospital
Tanya Shaw, Office of Strategic Planning, Staten
Bob Blake, Associate Vice President, Planning, Staten
Michael Carr, Community Outreach Coordinator,
Kerry Gillespie, Director, Complementary Medicine,
Maureen Gonzalez, Pediatric Nutritionist, Staten
04/24/13
NYCDOHMH Take Care New
York3
Planning Meeting
05/09/13
05/14/13
NYCDOHMH Take Care New
York3
Listening Session
11 05/17/13
06/13/13
Quarterly Meeting
07/12/13
09/04/13
09/27/13
6
10/18/13 Greater NY Hospital Association
6
7
3
12 Nassau County Community Health Meetings
Meeting
Date
01/15/13
Location
Nassau County
Department of
Health
(NCDOH)
Organization
South Nassau
Communities
Hospital
North Shore
LIJ Health
System
NCDOH
Adelphi
University
Mercy Hospital
St. Francis
Hospital
Long Beach
Medical Center
Catholic Health
Services
Winthrop
University
Hospital
Nu Health
Sudden Infant
& Child Death
Resource
Center,
Stonybrook
University
Medical Center
Representative
Gina Kearney, Director, Community
Education
Nancy Copperman, Director, Public
Health Initiatives
Ji Im, Director, Community Benefit
Stephanie Kubow, Mgr. Office of
Planning
Katheryne Small, Office of Planning
Melissa Strugatz, Office of Planning
Lawrence Eisenstein, Health
Commissioner
Tavora Buchman, Director, Division
of Quality Improvement,
Epidemiology and Research
Celina Cabello, Epidemiologist
Carolyn Mc Cummings,
Skye Ostreicher, Intern
Phil Alcabes, Professor of Public
Health
Director of the MPH Program
Type of
Participant
Hospital
Hospital
DOH
Academic
Beth Hammerman, Director of
Planning and Community Health
Hospital
Lashieka Hunter, Staff Writer
Hospital
Cindy Casson, Special Projects
Hospital
Juliana McCabe, CHS Public &
External Affairs
Karen Tripmacher, Assistant Director,
Community Relations & Special
Projects
Denise Portalatin, Manager,
Community Outreach
Barbara Marcinek, Quality
Assurance Coordinator
Shelley Afleh
Hospital
Hospital
FQHC
Hospital
13 01/25/13
Community
Based
Organization
Informant
Interview
Sub
Committee
NCDOH
St. Francis
Hospital
Sue Palo, Director, Rehabilitation &
Community Services
Hospital
NCDOH
Laura Bush
Leslie Maddison
DOH
Hospital
Nancy Copperman ,Director, Public
Health Initiatives
Hospital
Long Beach
Medical Center
North Shore
LIJ Health
System
Adelphi
University
Hofstra
University
South Nassau
Communities
Hospital
Gabrielle Pergin
Academic
Academic
Hospital
01/25/13
Community
Member
Heath
Needs
Survey subCommittee
Phillip Alcabes, Professor of Public
Health
Martine Hackett, Associate Professor,
Graduate Director, Master of Public
Health and Master of Science in
Community, Health Programs Hofstra
University
NCDOH
DOH
NCDOH
North Shore
LIJ Health
System
St. Francis
Hospital
Health Initiatives
Jennifer Ludwin, Health Educator
Ji Im, Director, Community Benefit
Pam Cruz-Ford, Manager,
Community Health Promotion
Programs, Emergency Cardiac Care
Hospital
Hospital
14 Programs, Marketing & Conference
Management
South Nassau
Communities
Hospital
Long Beach
Medical Center
Winthrop
University
Hospital
Hofstra
University
02/11/13
Informant
Interview
Training
NCDOH
Long Beach
Medical Center
North Shore
LIJ Health
System
Adelphi
University
Hofstra
University
Winthrop
University
Hospital
NCDOH
SUNY
Stonybrook
05/15/13
NCDOH
Health
Data
NCDOH
St. Francis
Hospital
Education
Hospital
Hospital
Projects
Hospital
Leslie Madison
Academic
Hospital
Nancy Copperman, Dir, Public
Health Initiatives
Lori Ginsberg, Coordinator, Public
Health Initiatives
Health
University
Projects
Carolyn Mc Cummings,
Amy Singh, Assistant Professor of
Preventive Medicine in the Divisions
of Evaluative Services and
Community Health at Stony Brook
University.
Pam Cruz-Ford, Manager,
Community Health Promotion
Programs, Emergency Cardiac Care
Programs, Marketing & Conference
Hospital
Academic
Academic
Hospital
DOH
Academic
Hospital
15 Management
Analysis
and Key
Informant
Interview
Analysis
Winthrop
University
Hospital
Catholic Health
Services
Long Beach
Medical Center
Nu Health
Family Health
Centers
South Nassau
Communities
Hospital
St. Joseph
Hofstra
University
Adelphi
University
NCDOH
Mercy Hospital
05/15/13
NCDOH
Nassau-Suffolk
Hospital
Council
North Shore
LIJ Health
System
The Long
Island GLBT
Projects
Christine Hendriks, CHS Vice
President
Public and External Affairs
Hospital
Hospital
Hospital
Barbara Marcinek, Quality
Assurance Coordinator
FQHC
Gabrielle Pareja
Hospital
Carol Foley, Project Manager/Supply
Chain Liaison
University
Health
Tony Samuel
Laura Buch
Planning and Community Health
Elisa Gerber, Public Relations,
Marketing and Events Coordinator
Janine Logan ,Director,
Communications
Health Initiatives
Robert Vitelli, Chief Operating
Officer
Hospital
Academic
Academic
DOH
Hospital
Hospital
Association
Hospital
Community
Based
16 NCDOH
Health
Data
Analysis
and Key
Informant
Interview
Analysis
Services
Network (Gay,
Lesbian,
Bisexual,
Transgender)
Nassau County
Lions Club
Foundation
Jewish
Association
Serving the
Aging (JASA)–
Long Beach
Services
Town of North
HempsteadProject
Independence
Planned
Parenthood Of
Nassau County
United Way of
Long Island
Nassau County
Perinatal
Services
Network
FEGS Health
& Human
Services
(Federation of
Employment
and Guidance
Services)
Mental Health
Association of
Nassau County
FEGS Health
& Human
Services
(Federation of
Employment
and Guidance
Services)
Positive Space
Organization
Kerri O’Neill, Director of Programs
Fred Rieger, Secretary
Community
Based
Organization
Gloria Lebeaux, Director, Senior
Services
Community
Based
Organization
1.
Paula Uhl, Deputy
Commissioner Department of
Services for the Aging
2.
Kristina Lew
Government
Jennifer Raytory
Community
Based
Organization
Georgette Beal, Senior Vice
President, HIV/AIDS Grant
Management
Debra Ross
Community
Based
Organization
Angelis Davila, Director
Community
Based
Organization
Kathy Rosemann
Lori Hardoon, Project Director
Community
Based
Organization
Lisa Harris, Director Project Hope
Community
Based
Organization
Dwight Reynolds, Care Coordinator
Community
Based
Organization
17 Sustainable
Long Island
Amy Engel , Executive Director
Janice Moynihan, Community
Planner / Educational Program
Coordinator
Health Initiatives, North Shore-LIJ
Health System
Jerzy Eisenberg-Guyot, Public Health
Associate, Centers for Disease
Control and Prevention
Celina Cabello, Epidemiologist,
NCDOH
Epidemiology and Research, NCDOH
Community
Based
Organization
Chris Hendriks, Vice President,
Catholic Health Services of LI
Marilyn Fabbricante, Director, St.
Charles Hospital
07/30/13
Long
Island
Health
Collaborat
ive
Meeting
Gabrielle Pareja, South Nassau
Communities Hospital
NSHC Office in
Hauppauge
Colleen Valdini, Manager, Public and
External Affairs, Good Samaritan
Hospital
Jennifer Ludwin, Health Educator,
Marsha Kenny, Director of Public
Affairs & Marketing, Southampton
Hospital
Philip Alcabes, Professor of Public
Health, Adelphi University
Stanford Guan,SCDOH
Tina Graziose, Health Enhancement
Director, YMCA of LI
Erin Healy, Director of Population
Health, Stony Brook University
Hospital
18 Zahrine Bajwa, Association Team
Coordinator, Cornell Cooperative
Extension of Suffolk County
Janine Logan, Director of
Communications, Nassau-Suffolk
Hospital Council
Pat Kiernan, Vice President,
Foundation / Community Relations,
Laurel Breen, Associate Professor, St.
Joseph’s College
Dr. James Tomarken, Suffolk County
Health Services (SCDHS)
Commissioner
Karyn Kirschbaum, School Health
Policy Specialist, Western Suffolk
BOCES – Healthy Schools NY
Samantha Vigliotta, Director of
Donor Relations, Peconic Bay
Medical Center
Kelly Miloski, Peconic Bay Medical
Center
Projects, Winthrop University
Hospital
Chris Banks, Vice President of
Development and External Relations,
Brookhaven Memorial Hospital
Medical Center
Lisa Benz Scott, Director, Program in
Public Health, Stony Brook
University, School of Public Health
Cindy Casson, Special Projects, Long
Beach Medical Center
Grace Kelly-McGovern, Public
Relations Director, SCDOH
19 09/18/13
NSHC Office in
Hauppauge
Chris Banks, Vice President of
Development and External Relations,
Brookhaven Memorial Hospital
Medical Center
Joseph’s College
NCDOH
Carolann Foley, Director Materials
Management/Purchasing, St. Joseph
Hospital
Planning and Community Health,
Mercy Medical Center
Pat Kiernan, Vice President,
Foundation / Community Relations,
Stephanie Kubow, Manager, Office of
Planning, North Shore-LIJ Health
System
Jennifer Ludwin, Health Educator,
Linda Mermelstein, Physician,
SCDOH
Heather Reynolds, Director of
Community Relations/Volunteer
Services, St Catherine of Siena
Medical Center
Hospital
Samantha Vigliotta, Director of
Donor Relations, Peconic Bay
Medical Center
Stuart Vincent, Director of Public
Relations, Mather Hospital
20 Nancy Copperman, Director, Public
Health System
Charles Hospital
Yvonne Spreckels, Director,
Community Relations, Stony Brook
University Hospital
Stanford Guan (SCDOH)
Hospital Council
Philip Alcabes, Professor of Public
Health, Adelphi University
10/29/13
NSHC Office in
Hauppauge
Lori Andrade, Chief Operations
Officer, Health and Welfare Council
Georgette Beal, Senior Vice President
of HIV/AIDS Grants Management,
United Way Long Island
Joseph’s College
Health System
Carolann Foley, Project
Manager/Supply Chain Liaison, St.
Joseph’s Hospital
Pam Ford, Manager, Community
Health Promotion Programs,
Emergency Cardiac Care Programs,
Marketing & Conference
Management, St. Francis Hospital
Kristie Golden, Department
Administrator, Department of
Psychiatry & Behavioral Science,
Education, South Nassau
Communities Hospital
21 Stephanie Kubow, Manager, Office of
Planning, North Shore-LIJ Health
System
Ann Little, Director, Asthma
Coalition of Long Island
Sue Palo (St. Francis Hospital)
Gabrielle Pareja (South Nassau
Comm Hospital)
Heather Reynolds, Director of
Community Relations/Volunteer
Services, St Catherine of Siena
Medical Center
James Tomarken, Commissioner,
Suffolk County Department of Health
Services
Anderson Torres, CEO, Hispanic
Counseling Center
Pat Kiernan, Vice President of
Development, East Long Island
Hospital
Marsha Kenny, Director of Public
Affairs & Marketing, Southampton
Hospital
Charles Hospital
Stuart Vincent, Director of Public
Relations, Mather Hospital
Teresa Maestre, Coordinator,
Hispanic Counseling Center
Juliet Frodella, Director of
Community Care and Senior Options
and Solutions, Eastern Long Island
Hospital
NCDOH
Zahrine Bajwa, Association Team
Coordinator, Cornell Cooperative Ext.
Hospital
Colleen Lindblad, Assistant Director
of Finance and Budget, NuHealth,
Nassau University Medical Center
22 Karen Tripmacher, Assistant Director,
Projects, Winthrop University
Hospital
Hospital Council
23 Suffolk County Community Health Meetings
Date
Description
02/14/13
Long Island
Health
Collaborative
04/11/13
Long Island
Health
Collaborative
Attendees
Notes
Discussion of community
and population health
survey, statistical sources,
and formation of a survey
sub-group
Survey results, identification
of prevention agenda priority
areas
Chris Banks, Vice President of Development
and External Relations, Brookhaven
Memorial Hospital Medical Center
Nancy Copperman, Director, Public Health
Initiatives, North Shore-LIJ Health System
Jane Corrarino, Director of Grants
Development, Coordination, and
Biostatistical Unit, SCDOH
Juliet Frodella, Director of Community Care
and Senior Options and Solutions, Eastern
Long Island Hospital
04/29/13
Long Island
Health
Collaborative
Pat Kiernan, Vice President, Foundation /
Community Relations, Eastern Long Island
Hospital
Jennifer Ludwin, Health Educator, North
Shore-LIJ Health System
Robert Ross, Vice President of Community
and Government Relations, Southampton
Hospital
Yvonne Spreckels, Director, Community
Relations, Stony Brook University Hospital
James Tomarken, Commissioner, Suffolk
County Department of Health Services
Samantha Vigliotta, Director of Donor
Relations, Peconic Bay Medical Center
Stuart Vincent, Director of Public Relations,
Mather Hospital
Janine Logan, Director of Communications,
Jennifer LoGiudice, Assistant Vice
President, External Affairs and Strategic
Initiatives, St. Catherine of Siena Med
Center
Discussion of collaboration
with community based
organizations regarding
specific health priority areas
24 Marilyn Fabbricante, Director, St. Charles
Hospital
Chris Hendriks, Vice President, Catholic
Health Services of LI
Sharon DiSunno, VP Quality Management,
Heather Reynolds, Director of Community
Relations/Volunteer Services, St Catherine
of Siena Medical Center
Mather Hospital
Eileen Knauer, Regional Vice President &
Executive Director, YMCA of LI
05/30/13
Long Island
Health
Collaborative
Patricia Gremillion-Burdge, School Health
Policy Specialist, Western Suffolk BOCES
Susan Kessler, Program Administrator,
Entering into the coalition
building phase, needs and
assets assessment, and
conversation with relevant
stakeholders
Marilyn Fabbricante, Director, St. Charles
Hospital
Joseph’s College
Lisa Benz Scott, Director, Program in Public
Health, Stony Brook University, School of
Public Health
Assistant Vice President, Development &
Public Affairs, Good Samaritan Hospital
Medical Center
Hospital
25 Ann Little, Director, Asthma Coalition of
Long Island
Stanford Guan (SC Health Dept)
Demetrios Kadenas, Chief Development
Officer, Peconic Bay Medical Center
Kristie Golden, Department Administrator,
Department of Psychiatry & Behavioral
Science, Stony Brook University Hospital
Hospital
06/25/13
Long Island
Health
Collaborative
Ann Little, Director, Asthma Coalition of
Long Island
Dr. James Tomarken (SCDOH);
Development and
distribution of Strategy Maps
– Obesity,
Treatment/Management of
Chronic Diseases, and
Mental Health
Tracy Teague, MPH Program, Adelphi
University
Philip Alcabes, Professor of Public Health,
Adelphi University
External Affairs, Good Samaritan Hospital
26 Sharon DiSunno, VP Quality Management,
Coordinator, Cornell Cooperative Extension
of Suffolk County
07/30/13
Long Island
Health
Collaborative
Jerzy Eisenberg-Guyot, Public Health
Associate, Centers for Disease Control and
Prevention
Celina Cabello, Epidemiologist, NCDOH
Tavora Buchman, Director, Division of
Quality Improvement, Epidemiology and
Research, NCDOH
Hospital
Gabrielle Pareja, South Nassau Communities
Hospital
Marsha Kenny, Director of Public Affairs &
Marketing, Southampton Hospital
Adelphi University
Stanford Guan,SCDOH
Erin Healy, Director of Population Health,
Coordinator, Cornell Cooperative Extension
of Suffolk County
Hospital
Joseph’s College
Development of a universal
metric tool in partnership
with Stony Brook University
27 Dr. James Tomarken, Suffolk County Health
Services (SCDHS) Commissioner
Karyn Kirschbaum, School Health Policy
Specialist, Western Suffolk BOCES –
Healthy Schools NY
Kelly Miloski, Peconic Bay Medical Center
Community Relations & Special Projects,
Public Health
Cindy Casson, Special Projects, Long Beach
Medical Center
Grace Kelly-McGovern, Public Relations
Director, SCDOH
Public Health
Joseph’s College
Research, NCDOH
09/18/13
Long Island
Health
Collaborative
Carolann Foley, Director Materials
Management/Purchasing, St. Joseph Hospital
Beth Hammerman, Director of Planning and
Community Health, Mercy Medical Center
Hospital
Healthy Schools NY
Planning, North Shore-LIJ Health System
Conversations with the
Chronic Disease Bureau,
establishing State-level
priorities
28 Jennifer Ludwin, Health Educator, North
Linda Mermelstein, Physician, SCDOH
Mather Hospital
Hospital
10/29/13
Long Island
Health
Collaborative
Adelphi University
Lori Andrade, Chief Operations Officer,
Health and Welfare Council
Georgette Beal, Senior Vice President of
HIV/AIDS Grants Management, United Way
Long Island
Joseph’s College
Research, NCDOH
Carolann Foley, Project Manager/Supply
Chain Liaison, St. Joseph’s Hospital
Pam Ford, Manager, Community Health
Promotion Programs, Emergency Cardiac
Care Programs, Marketing & Conference
Management, St. Francis Hospital
Kristie Golden, Department Administrator,
Department of Psychiatry & Behavioral
Science, Stony Brook University Hospital
Education, South Nassau Communities
Finalizing and piloting the
universal metric tool to
measure pre- and postprogram behavior and
knowledge change, with a
focus on understanding of
health status and lifestyle
29 Hospital
Healthy Schools NY
Planning, North Shore-LIJ Health System
Ann Little, Director, Asthma Coalition of
Long Island
Sue Palo (St. Francis Hospital)
Gabrielle Pareja (South Nassau Comm
Hospital)
James Tomarken, Commissioner, Suffolk
County Department of Health Services
Anderson Torres, CEO, Hispanic Counseling
Center
Pat Kiernan, Vice President of Development,
East Long Island Hospital
Marsha Kenny, Director of Public Affairs &
Marketing, Southampton Hospital
Hospital
Mather Hospital
Teresa Maestre, Coordinator, Hispanic
Counseling Center
Coordinator, Cornell Cooperative Ext.
Colleen Lindblad, Assistant Director of
Finance and Budget, NuHealth, Nassau
University Medical Center
Community Relations & Special Projects,
Public Health
30 HEALTH NEEDS ASSESSMENT:
NASSAU COUNTY
County-Hospital Collaboration
Nassau County Department of Health, Catholic Health Services, Long Beach Memorial Hospital, North
Shore – LIJ Health System, South Nassau Communities Hospital, and Winthrop Hospital
Consulting Services Provided by Jessica B. Steier, MPH, DPH Candidate
May 2013
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Nassau County Health Needs Assessment
May 2013
I.
II.
III.
IV.
Introduction
Methodology
Participating Organizations
Key Findings from the Assessment
A. Prevention Agenda Priorities
1. Prevent Chronic Disease
2. Promote a Healthy and Safe Environment
3. Promote Healthy Women, Infants, and Children
4. Promote Mental Health and Substance Abuse
5. Prevent HIV, STDs, Vaccine Preventable Diseases, and Healthcare
Associated Infections
B. Other Issues Identified
C. Recommendations to Improve Services and Programs
Health Services Offered by Participating Organizations
Appendix
V.
VI.
I. Introduction
Nassau County represents a dichotomy, as its residents represent some of the healthiest and
sickest in the nation. Health disparities exist within and between townships of varying
socioeconomic composition. There are also differences in health status based on race and
ethnicity. For example, infant mortality, cancer mortality and homicide rates are much higher
for blacks than whites. Latinos have higher rates of teen pregnancies, tuberculosis and
deaths from injuries. The causes of these disparities are numerous and complex, and include
differences in income, education, housing, access to health care, as well as racism. Reducing
or eliminating these disparities is one of the most important national and local public health
goals.
This report will identify the priorities, goals and opportunities for improvement as conveyed
by leaders of healthcare organizations across Nassau County. Data from this report will be
used to reduce health disparities among Nassau County residents and improve the healthcare
received by the community.
II. Methodology
Together, the Nassau County Department of Health and Nassau County Hospitals conducted
a Community Health Assessment. Key-informant interviews were conducted with health
organization leaders to identify pressing health needs in the community in the hopes of
developing strategies to meet them. Upon providing consent to be interviewed, participants
were asked open-ended questions about their organization and the population they serve.
Participants were asked to identify the biggest health problems in their community and
prioritize health issues to be addressed. Additionally, they were asked to describe the factors
that affect the health care the community receives, namely demographic factors such as age,
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JB Steier
gender, race/ethnicity, socioeconomic status and financial security, and language barriers.
Participants were asked to describe the health resources their community utilizes in relation
to specific health problems and identify barriers to, or gaps in, resources provided. Lastly,
participants were asked to identify ways they feel their organization might improve services
and programs for the community they serve.
Interviews were recorded and transcribed. Qualitative data analysis was conducted using
Atlas TI software to identify prevalent themes and emergent themes in responses. The data
presented here represent common themes discussed by participants of this study, focusing
on the strengths and weaknesses of health services provided to Nassau County residents.
Please see Appendix A for the interview guide in its entirety.
A pre-interview survey was conducted to collect basic information about the services
provided by the organizations and their target populations. A summary of this data is
provided in Section V.
III. Participating Organizations
Below is a list of the organizations who participated in the Community Health Assessment,
and the role of the key informants interviewed:
Syosset, NY
American Diabetes
Association
Melville, NY
Plainview, NY
Catholic Charities
Hicksville, NY
Circulo de la Hispanidad
Long Beach, NY
FEGS
Hempstead, NY
Health and Welfare Council
of Long Island
Hempstead, NY
Island Harvest
Mineola, NY
Jewish Association Serving
the Aging (JASA)
Long Beach, NY
LI GLBT
Garden City, NY
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1. Director of Patient and Family Services
1. Director, Long Island Operations
1. Regional Vice President – Field Operations
1.
2.
1.
2.
1.
2.
3.
1.
Director of Development and Communications
Developer, Information and Referral
Executive Director
Chief Director of Services and Operations
Senior Director
Director of HIV Services
Vice President, Long Island Operations
President and CEO
1. SNAP Outreach Coordinator
1. Director, Long Beach Services
1. Chief Operating Officer and Director of
Development for the Long Island GLBT Services
Network
Long Island Council of
Churches
Hempstead, NY
Mental Health Association
Of Nassau County
Glen Cove, NY
Perinatal Services Network
Uniondale, NY
Planned Parenthood
Hempstead, NY
Massapequa, NY
Glen Cove, NY
Project Independence
Roslyn Heights, NY
Sustainable Long Island
Farmingdale, NY
United Way
Deer Park, NY
1. Director
2. Nassau County Coordinator
1. Director of Special Projects
1. Coordinator
1. Senior Vice President for Health
Services, Planned Parenthood of Nassau County
1. Deputy Commissioner
2. Senior Citizen program Development Specialist
1. Executive Director
1. Senior Vice President for HIV AIDS Grants
Management
IV. Key Findings
A. Prevention Agenda Priorities
1. Prevent Chronic Disease
*Participants overwhelmingly reported chronic disease as one of the most pressing
health problems; 76.4% of organizations feel it is a priority; 50% feel it is the #1 health
priority.
The health burden of overweight and obesity-related diseases and
conditions, such as diabetes and heart disease, is increasing significantly.
“Unattended diabetes [is a major health issue]. Where I think people have not taken
care of it at an earlier age and so now we’re dealing with the results, which is poor
ambulation, or inability to ambulate. These people are homebound a lot earlier than
they probably would have to be, because of diabetes that wasn’t responded to.” -JASA
Promoting healthy living among youth should be a top priority, especially in
minority populations with a high prevalence of obesity.
“Obesity in the Hispanic community is terrible. [There is obesity throughout the
lifecycle], but seeing it in the kids there’s so much you could do around prevention and
education. I can tell you some kids who come to my programs, they are now 35 years
old almost. Now they are men, fathers, and they have a lot of issues with diabetes.
They went from childhood, they were just obese and then became diabetic and this and
that.” -Circulo
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Management of multiple co-morbidities and coordination of care is a
problem, especially among older populations.
“The problem with people who are older is that they don’t have one health problem.
All of them are dealing with a complexity of multiple health problems and they’re
taking… I think the problem isn’t one specific health problem, it’s the coordination of
services to people that are taking 15 medications. And you have 5 doctors, and you
have a physical therapist, and then have a nurse, you have so many different
disciplines and I think the coordination of services, with now, of course the problem on
Medicare managed care, and the lack of finances and the inability to retain home
care.” -JASA
“Our population has a tremendous amount of comorbidities, and our [patients with]
end-stage renal disease not only have diabetes but could have started off with
alcoholism and substance abuse, and we have a lot of patients with Hepatitis C, and
even though it may not be a primary diagnosis for us, we have people in my program
with HIV also.” –FEGS
Time and money should be allocated for prevention rather than solely on
treatment.
“We’re not funded to do prevention; it’s really underfunded, particularly in Nassau
County… It makes no sense because in the long run, it costs a lot less to prevent than it
does to treat… And I can say that with most chronic illnesses, if care is available, and
accessible to a person, you can mitigate some of the problems with diabetes, with
congestive heart failure, because…they don’t have to get to the point of end stage renal
disease if they’re treated in a correct way, even some of your minor cardiac issues don’t
have to get to end stage disease if they’re treated in a better more on time with the
care coordination.” –FEGS
Certain chronic conditions limit food choices which is problematic for lower
SES people who cannot afford higher quality foods.
“I would say diabetes [is a major issue] and I would also say anything having to do
with cholesterol, because that’s not something that you can get something off the shelf
to deal with. And people come for food they say ‘I need sodium-free food,’ the
diabetics need no-sugar added. Those are the people that we see the most that have
those issues that we are not able to accommodate their disease. They have to shop
differently and they can’t afford to and they search pantries and they’re not finding the
foods that they need and then they go over a certain amount of visits because they’re
eating things that’s causing their disease to act up more than normal then what do they
do. So I would say that’s a rising problem.” –LI Council of Churches
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JB Steier
Smoking continues to be highly prevalent among the mentally ill population.
“We also look at the impact of smoking…Our population, there’s a high correlation
between schizophrenia and smoking. Many people that come to us do smoke. People
live hard lives in a hospital or facility, or have undergone years of homelessness, so
when you add it all up, our population dies 25 years early.” –Mental Health Association
2. Promote a Healthy and Safe Environment
Poor diets among minority and low SES populations is due, in part, to cultural
norms.
“Santo Dominicans, they eat “corpa pushas” it’s like corn and you put inside cheese or
meat or whatever. But is like pizza. Do you eat pizza everyday and put on cheese that
is processed with no nutrients whatsoever and a little bit of tomato sauce that is from
the can and do you eat this very often? I saw this with one of the girls last year. And
it was very much cultural.” –Cirulo
More outreach to low SES and minority populations is needed to provide
education about nutrition and healthy food practices.
“A big piece we are trying to do around that level is change is educating parents about
how to handle your children who say they are finicky eaters and they don’t want to eat.
The parents then stop serving them vegetables or broccoli and then they are given
foods that are really not that nutritious and high in fat and carbs. And now, Chef has
been really trying to work with families to let people know - keep introducing it. If they
say ‘no,’ find out why… And, we see some positive elements in just getting the parents
on board. Because the parents don’t know necessarily what to do. They see their kids
and want to make sure they’re eating, so instead of trying the vegetables or fruits
they’ll push the other kinds of foods. We see a lot of it.” -Circulo
Food deserts exist in low SES neighborhoods; there is a need for increased
access to nutritious food options to reduce food insecurity.
“People don’t have access [to healthy foods]… Without the Farmers Market, generally
the people in those communities don’t have a car and they can’t go to a supermarket
easily. It’s giving them only access to the local bodega or you know corner quick you
know convenience store; high sodium, high fat, not good healthy choices, no fresh
produce, or very limited choices.” – Sustainable LI
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JB Steier
Hurricane Sandy has increased cases of unsafe living environments (ie. mold)
particularly among low SES, minority, and immigrant populations
“In the wake of Hurricane Sandy, we’re going to see some serious health issues
emerge, everything from mold that hasn’t been properly remediated, and people
rebuilding their homes because of that, to the waste that washed up because of breech
in Reynold’s channel, to the people that have on their property all kinds of things like oil
spills and gas leaks and all those things, raw sewage, washed up onto these properties,
and we’re going to see some serious public health issues. And what we’re seeing now,
since a lot of the disaster case managers have come over to me, because a lot of the
people had chronic illnesses that exacerbated under the disaster, and we are seeing
more and more people who are identifying those mental and physical illness that might
have flew under the radar who are now coming into our programs.” –FEGS
Environmental justice issues are prevalent among low SES housing such as
water quality, the built environment, and outdoor air quality.
“From our environmental justice work we do see much, much higher rates with Asthma,
in some of the environmentally disadvantaged areas..We go by New York State
[designated] Potential Environmental Justice Areas, and for instance Roosevelt has
much, much higher rates of asthma than other parts of the state. And so we key in on
that and we try to do Environmental Justice Education and Awareness because that’s an
area that the people in the community should be aware of. So I would say certainly
Asthma, and certainly cancer as far as the environmental justice issues. Some of them
are living in houses with mold, they still have asbestos, they still have lead.” –
Sustainable LI
Lower socioeconomic populations may not have access to safe spaces to
exercise and stay active.
“I think the exercise [is another problem]. A lot of our families, first I’ll talk about
Hempstead, after dark, people are not wanting to go outside. There’s limited areas for
them to play or families are coming home late so they’re stuck in apartments. For Long
Beach, you’ve got some of that, but you have a little more flexibility. Still, people are in
basements and so forth. I think exercise is a big component for everybody… I would
say that here in Long Beach, finances affects exercise. Some of the families that have
limited income they are not in the soccer programs. They don’t have the resources for
travel soccer. We ran Long Beach soccer team. If they have to travel all over Long
Island, some parents can’t take children all over Long Island – children can’t
participate.” -Circulo
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JB Steier
3. Promote Healthy Women, Infants, and Children
The lack of funding for childcare has negative consequences for low-income
workers who are unable to afford daycare services.
“The reduction in funding for daycare for low-income people [is a problem]. They just
eliminated hundreds and hundreds of slots for these kids, and these are working class
parents who cannot afford high cost daycare who are losing slots in these subsidized
programs…These people, how can they work if they don’t have safe and effective child
care for their children? You take that away and they’re going to be put in unsafe
situations because they have no choice, or they’re going to not be able to work.” –
Perinatal Network
Pregnant teenagers underutilize healthcare services despite the availability
of resources.
When asked how age affects healthcare received: “The only group I can think of is
[pregnant teenagers]. It’s very complicated. They left the house, or their parents sent
them out, and they don’t have any idea about how important it is to keep [up with]
their medical [care]. I think that population is affected because they do not use the
resources available…there’s a lot of resources here in Nassau, but that specific
population you have to reach out to them and bring them in.” - Perinatal Services
Network
Older women do not seek out preventative health services.
“I really wonder how many women, we’re talking about very older women, even ever
go see an OB/GYN. I have a feeling that many, not most of them, haven’t even gone
for a pap smear, ever. Because, generationally, they just didn’t do it. And to try to
encourage women, older women, to take care of themselves, is a big deal. We get this
a lot. We say to them, go get a pap smear, go get tested. And they’ll say, we’ve never
been to a gynecologist. We give them a look, like, what? But, no, so just in terms of
getting the right kind of medical care is a big deal. Even for that. So in terms of that
kind of women’s health, certainly.” –JASA
There is a lack of awareness of the importance of prenatal care among highrisk populations.
*Especially among the African American population
“In Nassau County, the high risk population is the African Americans, it’s the one who
still has a high percent of infant mortality, prematurity, and low-birth weight babies.”
-Perinatal Services Network
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4. Promote Mental Health and Substance Abuse
There has been an increase in the prevalence of mental health issues across
all age groups with insufficient resources to care.
“We have more kids with autism and more young adults who are bipolar and more
people in their 20s who are schizophrenics and more older adults that we’re seeing with
bipolar disorder, schizophrenia, long term depression, major depression, who, you
know, it was either unresolved, or even if it is, who are not able to address some of
these issues independently. And we’re seeing much more of that. It was never, years
ago, that you saw this many older people with major mental illnesses that came our
way. These are people just living in the community, many of them on medication for it,
but you know, it does interfere with your ability to address other issues. A lot, a lot of
it. A lot of bipolar, a lot of schizophrenia.” –JASA
Stigma associated with mental health services causes people to delay
treatment or not seek services at all.
*Especially among the Hispanic population
“One [of the biggest health problems] has a lot to do with just mental health services
partly because there is a stigma around it and people not really wanting to say that
they need mental health services. But for many reasons, I think that is a very big thing
that we find people are in need of and don’t necessarily always know how to access.”
–United Way
There has been an increase in substance abuse and mental health issues
post-Hurricane Sandy.
“In Long Beach especially, a huge amount of the population, of the immigrant Hispanic
population they lost their homes, they’re living with family or neighbors, or they’re in
like sort of temporary housing. We are seeing a huge problem with domestic violence
and drug dependency… mental health, stress, anxiety, and drug use. So all of that was
exasperated because of everything that they lost.” – Sustainable LI
Pain medication abuse is an increasing problem.
“We see a lot of pain medication. A lot. There’s a lot of pain medication that’s being
prescribed. I mean, they go to five doctors, you can ask five doctors for a prescription
for pain and if they’re not really good doctors, or they don’t know the client, they will
just give them a prescription. So now they have five prescriptions for Oxycotin, how
wonderful. It’s big, big with older people. Pain medication abuse is big, we see it a lot.
We see some alcohol, we don’t see as much, but we do see some. But we do see a lot
of prescription medication abuse. And misuse. People don’t understand what to take.
They don’t remember what to take. If they’re self-administering and there’s dementia,
they’re going to take two instead of one. They’re going to forget that they took it.
Again, that’s where you need some kind of supervision.” –JASA
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JB Steier
There is a lack of senior mental health services.
“There’s been a huge lack [of senior mental health services]. I would like to see that
mentioned and addressed. We as advocates talked a few years ago that the baby boom
generation started turning 65 in 2011. We urged the system to think about it, and they
didn’t respond… What you’re going to have are two groups of people. One with severe
mental illness who are aging and dying, and other individuals who as they age will face
challenges of their own and become depressed. We know there’s a huge lack of
geriatric mental health specialists in the area. There’s a lack of residential services.
That’s a challenge for us. Even the people we serve with age, and maybe start to use a
walker or cane whatever, and have mental health challenges, the residential system is
not equipped to handle these individuals, there are steps, not enough staff, people
wetting the bed… we’re not equipped to deal with that.” –Mental Health Association
5. Prevent HIV, STDs, Vaccine Preventable Diseases, and Healthcare Associated
Infections
Funding for HIV awareness, screening, and prevention is limited.
“If the Department Of Health is looking for programs that would have a prevention bend to
them, or reduction, mitigation bend to them, clearly HIV AIDS is always at the top of the list,
because we can prevent that disease. Nassau County actually had a pretty big [HIV
prevention advocate], Dr. Pollack was her name, she ran a pretty big STD, HIV prevention
program a couple of years ago. Money was tight and I don’t think that’s still there. They did
STD screenings, got out the prevention methods; there isn’t a lot out there. We distribute
condoms, we give prevention methods, but we’re not funded to do that. We have another
program funded that’s supposed to identify people with AIDS out in the community, and
know their status, and you can’t just go up to someone and say ‘do you know your status?’
And, ‘you want to get tested?’ So we distribute condoms and information using peers, and in
that exchange, we solicit people, we attempt to get them tested if they don’t know their
status. –FEGS
“Based on the number and relevance of the number of gay and bisexual men impacted by
HIV/AIDS, I think Long Island, I mean we would like to offer a much broader and more
comprehensive range of continuum of HIV prevention and supportive services. We’re starting
but there’s a lot more to be done for people.” –LI GLBT
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Strict eligibility requirements for HIV treatment coverage presents a barrier to
care.
“Generally when somebody is newly testing HIV positive, they are referred to a medical
provider, it’s kind of built into the system. People get information pretty quickly. We get most
of our referrals from the actual medical providers that someone is coming and seeking
treatment for HIV and AIDS, it’s a pretty solid infrastructure. The problem is that not
everyone is eligible for Ryan White. They used to just have to be HIV positive and there
would be a plethora of services to support them. And now, they have to basically be poor
and on Medicaid. If they’re trying to pull themselves up and out of the system, or if they
were never in that system to begin with, they’re out of luck…the services are no longer there
for them. They can access the medical provider through their private insurance if they have
it, or they can use something called “ADAP” which is the age drug assistance program, but a
lot of the social supports are no longer available for them, and that’s a problem.” –FEGS
B. Other Issues Identified
Inadequate public transportation system on Long Island is a barrier to accessing
care.
“Accessibility, getting transportation in Long Island and Nassau County is a nightmare. Even
though we have a system called “Able Ride” just accessing Able Ride, sometimes it’s better to
bang your head into a wall because you make the appointment, you have to know in
advance to make the appointment, then you sit and wait until they pick you up. They also
don’t leave the car so if you have mobility issues and you can’t get to the car… and then if
you have a compromised immune system, you’re often times sitting in a van with multiple
people who may have an active virus, or the flu, and you’re taking your life in your hands
often times when you go to the doctor that way.” –FEGS
“Getting to the actual treatment [is a major barrier to care]. Because some patients can be
going for radiation every day, and to rely on family members to take them every single day,
most family members are also working. So how are they going to get to those appointments?
That’s something we have seen a lot. Same thing with chemo therapy they can be there
every few weeks, some being every day, but generally every few weeks. But it’s a family
member that has to take them.” –American Cancer Society
A growing segment of the population does not speak English fluently, affecting
the quality of care provided due to poor communication.
“Our primary issue is going to be language barriers, because we can put some services in
Spanish, we also have a very large Persian community, and we do have a social worker part
time dealing with Farsi speaking seniors in that community, but those are two of many many
languages spoken in the town of north Hempstead so we recognize there are communities
we are not able to reach just yet.” –Project Independence
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There is a lack of awareness of health resources available among health care
providers and consumers. Need to streamline and update current information
banks (211).
“I think really getting information out there to people and having it in all different places… I
think they’re so overwhelmed they don’t know what to do. It’s just like you know they need a
sounding board to be like ‘where do I go from here?’… I think having access to places, to
people who can really explain services is critical.” –Catholic Charities
“[Health care can be improved through] more education…sending people into the
communities and, we as the ADA can go in there and educate them on diabetes and
prevention and give them literature, but we don’t have the education to know as far as, you
know, ‘this program is available for you’ and ‘these resources are available for you so you can
contact the Nassau County Department of Health’ or ‘they’ll provide these resources.’ So I
think to let people know the resources that are available for them if they are having issues
affording their medications or treatments.” –American Diabetes Association
There is a need for in-home services (both physical and mental health services)
for elderly populations who are unable to travel to receive care.
“The other thing is mental health services tend to be expecting the person to come to us, but
with seniors that are homebound don’t come out. So what we recommend now is an “act
team model” where a psychiatrist social worker will go out, they’ve used it for difficult
consumers, they have an act team for seniors… we’re concerned about the older community
where they’re not getting any care. So I’d like to see seniors mentioned.” –Mental Health
Association
“Just having an aide [is a major issue]. Being able to able to afford one. Being able to stay
in their home as long as possible. There is not an older person, or any person in this world,
who wants to be put into a nursing home. I don’t care who you are. They can advertise it
from here to doomsday and they can be beautiful, but everyone wants to stay in their own
home, for as long as possible. And the only way most of these people are going to be able
to stay home is with some assistance. And Medicare covers a very, very short period of time
for homecare. So, after that, we have an issue. How are we going to provide home care?
We provide some homecare that’s funded through NYS, but it’s very limited. Our funding
keeps getting cut. So we have people, we have wait lists. And we’re only giving it to people
3 ½ hours every other week. And it’s just housekeeping. We also provide 20 hours of
personal care a week. But, people are on wait lists. And what do you do on weekends?
What do you do at night? Family members are stressed beyond belief and do not have
anything left. Don’t have the money, don’t have the patience, don’t have the resources to be
able to now take care of their older adults. They’re not going to be able to put them in their
homes, especially now after what’s happened (referring to Hurricane Sandy and devastation
in Long Beach). So, it’s a crisis, it’s a homecare crisis in my opinion. And we get a call every
day. We must get 10 calls a day asking us how do we get an aide. Who do we call. Who’s
going to pay for it. Every day.” -JASA
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Patients are unable to navigate the system and are unsure how and where to
obtain care. There is a need for case managers or patient navigators.
“When there is a service available that helps them navigate the healthcare system is one of
the primary things people look for. There’s a lot of confusion because we all know how
fragmented the medical and healthcare system is… people don’t know who to turn to or how
to access these programs, people don’t know what’s out there.” –FEGS
There is a heavy reliance on emergency room for primary care.
“I think the community utilizes, unfortunately, the emergency room in too many instances. I
think that there has been a better job in Nassau County with the clinics becoming federally
qualified health clinics, that there is an attempt to provide much more comprehensive service
delivery for the populations in these settings. I think people utilize stand-alone doctors they
may pay out of pocket for. I think they may utilize some of the quick stop clinics within
pharmacies and where we’re seeing that sort of pop up. That’s a way that I think people
meet some of the needs that aren’t met comprehensively.” –Health and Welfare Council of LI
Undocumented immigrant populations are afraid to access healthcare out of fear
of being reported; delay healthcare until they reach emergency status.
“We see a huge problem with the undocumented, because they’re afraid to go for care
unless they’re dying or really injured, which is awful. I mean, they’re afraid. And so we will
say to people ‘You have to get help, your cough isn’t good’ or ‘you are truly sick,’ there’s a
big problem in some of these communities that they’re afraid that they’ll be shipped out or
whatever. I mean, it’s never spoken. It’s all unspoken, but they just say ‘I can’t’. So that’s a
problem.” –Sustainable LI
Men do not access needed medical attention or preventive health screening;
women play a large role in their husbands’ healthcare.
“I think the men go to the doctor actually because their wives make appointments for them.
So do I think the men are out there saying ‘Oh let me go?” No. Years ago [we had
information that read:] ‘the AHA: how to take care of your husband.’ That was the focus, you
know. Or women would know what their husband’s numbers are and they had no idea what
theirs were.” –American Heart Association
“There’s more women who will reach out for the support services for like the outreach to
recovery, which is our breast cancer one-on-one support group. We had a group that was
called Man to Man for prostate cancer survivors, it did not do well at all. A lot of men are not
out there requesting the support. It’s usually significant other or family that’s looking for the
support for them. Not a lot of men reach out on their own.” –American Cancer Society
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The LGBT population struggles to access healthcare out of fear that they will be
treated differently.
“That’s a challenge because there’s been a history of bad, negative, and stigmatizing
experiences that LGBT people have had with, um, health and other medical personnel. If
they haven’t, there’s- I guess there’s the assumption that they will or that they don’t know
how to be quote unquote ‘out’ with a healthcare professional. Even though a lot of
healthcare professionals today are actually eager to better serve the LGBT community,
there’s still that- that lack of understanding or- or really the fear that someone will be
treated, uh, in a bad way. That is compounded by the fact that there are different health
disparities in the LGBT community.” –LI GLBT
C. Recommendations to Improve Services and Programs
Need for increased collaboration and partnerships among hospitals and
community based organizations.
“I think, first and foremost, and this is not like rocket science, coordination and collaboration
amongst the different entities [will remove barriers to care]. So, when we talk about health
from a physical and a mental perspective and a preventive perspective, the health care
institutions need to be working in partnership with community based organizations in a very
different way, because as we look at the Affordable Care Act and how we’re moving care into
the community, hospitals have to be able to get patients to care that works for them. Even
when we talk about public health issues, I think it’s the same thing, there needs to be
integration of schools, hospitals, non-profit organizations to make sure that there’s an
educational component that gets out to individuals so that they’re clear on what some of the
risk factors may be, where they can go to access services and then we can look at where
some of those gaps are.” –Health and Welfare Council of LI
“I really would like to see it more coordination and collaboration with people…It would be
nice to see that as a region we’re really taking care of some of the people with lower income
because everyone sees us as a very affluent area and for that reason they tend to not
allocate that many resources. But we’re also not coming together as one voice, really
identifying what the problems are and advocating for them in a coordinated way. I think
that’s where we need to go long term if we’re truly going to address issues. All of their city
issues are slowly creeping here and we’re not monitoring the impact that it’s having on
everyone else. But its going to happen and it is happening.” –United Way
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JB Steier
Increased community outreach and education campaigns available in other
languages (especially Spanish).
“[Health education is needed] especially, you know, in a lot of the immigrant [populations]. I
think a lot of them are afraid to seek help and education. So I think that’s a big one. And
again I just think education. I think that people don’t understand the major effects that
diabetes can have on you if you don’t manage it. Diabetes can, you know, you can manage
it and live a healthy lifestyle, but if you don’t manage it, that’s where you’re going to see
these very severe complications. And I think that a lot of these communities - they don’t
understand the severe complications and they don’t take care of themselves.”
–American Diabetes Association
Health promotion events and programs should be held at night and on weekends
to allow people who work to attend.
“A big issue is hours of operation. So people who work during the da, need things on the
weekends, or in the evenings, or even before they go to work maybe. So, that’s always an
issue I think with people getting the time. The time and the hours of operation.”
–Island Harvest
Use of technology to communicate with people regarding healthcare issues and
services.
“I think now everything is kind of going digital. So I think more information that we can
digitally have access to, the better. Any kind [of digital media]. Even like through social
media, through websites, through texting is a good one. I think they were exploring how we
could, because for SNAP you have to recertify every 6 months to a year potentially
depending on your household. So it’s usually 6 months. So there’s a lot of, what they call
churning. So people will not recertify and then they will have to end up reapplying and it
creates more of a back log. People miss out on their benefits and it’s like a vicious cycle. So,
texting alerts or something like ‘Did you recertify?’ or ‘Did you send in your paperwork?’ you
know it would probably be easier and prevent that. But, I don’t think that technology has
caught up quite yet with that one. But it would be nice in the future. I mean, texting is a
great one. I think anything on Facebook or YouTube or, you know, web advertising. Anything
like that.” – Island Harvest
Outreach events should be hosted at community centers and places of worship to
increase attendance and participation.
“Put things in more than one language, try to host meetings at the community centers, or
senior centers or whatever is actually in that community, and be really clear that there is no
cost and be really clear that they won’t be asked for anything. It’s just, I think that you are
dealing with people that have been sort of conditioned to be wary, and that it’s important
that they’re clear why you want to help and that there is nothing required of them.” –
Sustainable LI
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JB Steier
Patient education should emphasize prevention versus treatment, with a focus on
healthy lifestyles (eating healthy and exercising).
“I think a lot of people still don’t know that 80% of heart disease can be prevented through
exercise, eating healthy, stop smoking, know your numbers, know your BP, know your
Glucose. I think it’s still educating the people to make simple small choices. Healthier choices
that will then reduce all their risk factors. So I think it’s really getting people to know what
their risk factors are.” –American Heart Association
There should be increased communication across organizations to ensure visibility
of programs and resources available.
“Health department and hospitals could much more clearly communicate information about
the availability of free and cheap services. That would be a good start. I realize that they
have the same problem that every non-profit does, that no one is paying them to do this.
The Council for Non-profits recently started emailing this information, and no other agency
has this information. They don’t know which programs exist. And they change all the time.
You can print up a brochure of all services, but 6 months later, it changes because funding
runs dry… We let people know. If they would let us know, it would help to let other people
know. Our prelude goes out to about 125 people; our newsletter goes out to 5,000 people.
We reach out. We let people know. If more came in, there would be less problems. I think
other organizations could do the same. If you can establish an email list, it ought to be easy
to push out that information on a regular basis. Every healthcare provider should be able to
integrate this into normal communications. Every hospital ought to have a newsletter that
gives information at least to say what they’re doing themselves. I’m not expecting people to
do things they’re not getting paid for, but if they’re already doing something, you ought to
communicate it better. Almost any organization can use their resources to communicate
better I think. It would probably help to raise money in the end.” –LI Council of Churches
A taskforce with members from various organizations would be helpful to
brainstorm additional ideas and solutions.
“If there was any kind of a task force, we would certainly be willing to sit on a task force to
come up with some concrete, practical applications. The agency always wants to on the
forefront of advocacy, whether it’s advocating at the political level, coming up with, of
course, if we had more funding to provide more home health care, more home delivered
meals, we would continue.” -JASA
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JB Steier
Increased patient navigation and case management services would break down
barriers to care.
“I think utilizing some of our very effective case management models and having these
concepts of health navigators or people who can really help to remove barriers, like with care
coordinators. Some of the things they’re implementing under the new health home model will
definitely help where it needs to be expanded out to people. I think we need to bring health
more to the forefront through media campaigns, ad campaigns to talk about the importance
of people’s health; not just physical health but also mental health to remove some of the
barriers around that and just make it more accessible. And also using that opportunity to
really educate people, some series, some forums that are easy to get to, held at libraries, to
really just educated people on what does all of this mean, to erase some of the
misconceptions about whats going on with the ACA, I think more education for people on
how to utilize and maximize what they’re getting out of the healthcare system will be
important.” –United Way
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JB Steier
V. Health Services Provided by Participating Organizations
American Cancer
Society
Syosset, NY
1. Research projects for cancer prevention
2. Education
3. Advocacy
4. Patient and Family Services
5. Prevention and detection program including screenings
6. Free wig programs
7. Cosmetology Classes as a support programs
8. Wellness programs and one-on–one support services (free
patient navigator)
9. Transportation to treatment centers
American Diabetes
Association
Melville, NY
1. Funds for Research
2. Education
3. Programs that provide Glucose testing, Cholesterol
Screenings, Mammograms
4. Advocacy
5. Health Fairs and Speaking Engagements to educate and
fundraise
6. Educate on Prevention
7. Educational Events
“Tour de Cure”: Annual bike ride
Step Up for Diabetes Walk
Father of the Year Event Gala
Diabetes Expo and Feria de Salud
“Stop Diabetes at Work: Employee wellness program
“Living with Type 2 Diabetes”: Newly diagnosed individual
receives informational literature, advice, etc. to assist
them
“Stay with Schools” program
Partner with JDRF (Juvenile Diabetes Research)
American Heart
Association
Plainview, NY
1.
2.
3.
4.
5.
6.
7.
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JB Steier
Education through church programs
Awareness of Cardio Vascular Disease
Research
Grants
Advocacy
Referrals
“Power to End Stroke”
Targets African Americans and Hispanics
Educate them to be aware of their numbers and eating
habits
8. Program “Jump Rope for Hearts”
Through schools
Catholic Charities
Hicksville, NY
Educational and fundraising
9. “Go Red for Women” dinner in Queens
1. Chemical Dependence Services
2. Commodity Supplemental food programs
3.HIV & AIDS services
4. Housing for seniors and people with physical disabilities
5. Immigrant services; mental health outpatient and residential
6. Nutrition Outreach Education Project (food stamps
enrollment)
7. Regina maternity services; residential maternity program
8. Community residences for people with developmental
disabilities
9. Senior Clubs
10. Meals on Wheels
11. Senior Case Management
12. WIC Program
13. Dental Services
14. “Para Social Ministry”
15. Congregant senior meals
Circulo de la
Hispanidad
Long Beach, NY
1. Health Fairs
2. Screenings and blood pressure checks
3. Mammogram bus
4. Long Beach soccer team
5. Programs in area of Domestic Violence
6. HIV/AIDS services
7. Housing Services
8. Education and youth service
9. Mental health services
10. Alcohol and substance abuse prevention services
11. Preventive Education
FEGS
Hempstead, NY
1. Partners in Dignity (PID)/ Nursing Home Transition and
Diversion Medicaid Waiver (NHTD)
2. Care coordination
3 Medical Navigation
4. Information and Referral
5. Advocacy
6. Benefits/entitlement and insurance counseling
7. Individual, group, and family counseling
8. Volunteer services
9. Spiritual care and bereavement counseling
10. Professional and community education
11. Positive Space Program
Mental health counseling
Substance abuse recovery readiness counseling
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JB Steier
Early intervention services
Medical case management services
HOPWA housing and supportive housing services for
HIV+ women
Mental health counseling to the LGBT, non HIV
community
Health and Welfare
Council of Long Island
Hempstead, NY
1.
2.
3.
4.
5.
6.
Island Harvest
Mineola, NY
1. Food bank
2. 500 member agencies that assist in food bank, food
distribution
3. Two mobile food pantries
Operation Hope (veterans)- delivers one month supply of
food
Senior Mobile Food Pantry- provides groceries on a
weekly basis to low income senior housing facilities
4. Kids Weekend Backpack Program
Provides packs of food to children who receive free or
reduced price lunches
Can apply to receive meals to take home for the weekend
5. Summer food program
Provide free lunches to children over the summer
6. SNAP Outreach (Supplemental Nutrition Assistance Program)
Walk through process of applying for food stamps
Outreach and application assistance
7. Advocacy Programs including MICAH (Mobilized Interfaith
Coalition Against Hunger)
8. Community Resource Exchange (Community Guides)
Allows them to refer clients to other agencies
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JB Steier
Research and public policy
Advocacy and education
Regional Planning
Access to health care
Nutritional security services
Economic stability services
Jewish Association
Serving the Aging
(JASA)
Long Beach, NY
LI GLBT
Garden City, NY
1. Case management
2. Information and referral
3. Counseling services
5. Congregate Nutrition Programs
6. Home delivered meals for frail and homebound clients
7. Medical transportation
8. Cultural arts and recreation programs
9. Homecare services
10. Emergency financial assistance
11. Family and caregiver support programs
12. Legal and elder abuse services
13. Adult protective and community guardian services
14. Community outreach and education
15. Contract with DSS to work as community guardians for all
adults above age 18
16. Provide homecare services and housing for low to moderate
income elderly persons
1. Support Services/ Support Groups/ Help Line
2. Mental Health Counseling Services
3. Anti-Bullying Services and “Safe School Initiative”
4. Community Education and Training Programs
Delivers 275-300 workshops and trainings each year to
students, teacher, and health human service providers,
social workers, counselors
5. HIV Services Unit
Confidential rapid HIV testing, STD screens
6. Preventive Education
7. Community Centers in Bay Shore and Garden City
8. School Awareness Campaign in conjunction with National
Coming Out Day
Long Island Council of
Churches
Hempstead, NY
1. Prescription Assistance
2. Provide Insulin if needed for Diabetics
3. Food Bank
4. Community Share Gardens- grow produce to share with local
pantry
Mental Health
Association
Glen Cove, NY
1. Personal recovery-oriented rehabilitation services
2. Adult residential services for people with a mental health
diagnosis
3. Hospital Discharge Coordination for children
4. Consumer link peer-to-peer services
5. Financial management
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JB Steier
6. Health home care management
7. Crisis respite for families of children with mental health
diagnoses
8. Residential program for children and young adults with
autism
9. Medicaid service coordination for consumers with
developmental disabilities
10. In-home respite for developmentally disabled consumers
11. Education and training for mental health professionals and
substance abuse workers
12. Advocacy for people of all ages with mental illnesses, and
for the people who love them
13. Community outreach and education
14. Veterans Services, promoting wellness for Long Island
veterans and their families
15. Information & Referral 365-day-a-year HELPline
16. Compeer volunteer mentor program
17. Family support services
18. The Players volunteer theater troupe
Perinatal Services
Network
Uniondale, NY
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JB Steier
1. Health providers, mental health and social support services
for pregnant women.
2. Partner with the mental health system in Nassau County,
Mental Health Association; want to engage in more clinics,
mental health clinics
3. Family resource guide
5. Dental Services
6. WIC Program
7. Prenatal care and delivery
8. Case management
9. Early intervention
10. Shelters for pregnant women
11. Advocacy
12. Enrollment in HMO
13. Visiting nurses
Planned Parenthood
Hempstead, NY
Massapequa, NY
Glen Cove, NY
1.
2.
3.
4.
5.
6.
7.
8.
Project Independence
Roslyn Heights, NY
1. Assist seniors to age in place, safely
2. Human services, health, mental health
3. Programming
4. Nursing
5. Social work
6. Connect seniors with available services in community
7. 311 Town Stat Program
8. Psychological assessments
9. Member of Geriatric Mental Health Alliance
10. Medical transportation
1. Community organizing
2. Public Participation
3. Facilitation for Brownfield redevelopment
4. Recovery and revitalization after Hurricane Sandy
5. Farmers markets
6. Annual conference and fundraisers
7. Economic development
8. Environmental justice surveillance and services
Sustainable Long
Island
Farmingdale, NY
United Way
Deer Park, NY
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JB Steier
Maternal and child health services
HIV and sexual health education
HPV vaccines
Education service
Testing vans
Transportation hubs
Community health fairs
Offer flu shots and minimal care that their PAs can provide
1. Administrative agent to those who are HIV Positive
2. Provide Financial Assistance to agencies that provide
healthcare services, mental health, and substance abuse
education
3. Fund agencies in high need areas
4. Ryan White HIV and AIDS Services
Serve low income individuals who do not have insurance
5. Work with AIDAP programs to insure individuals and have
services for veterans
6. Case Management
7. Housing Services
8. “Youth Build”
Individuals who have not completed high school and do
not have a GED and give them Green energy job training
9. 211 Long Island
Connect people to resources if they are in need of
housing or health care
VI. Appendix
KEY INFORMANT INTERVIEW for THE COMMUNITY HEALTH ASSESSMENT
Together, Nassau County Department of Health and Nassau County Hospitals are conducting
a Community Health Assessment. Today we are trying to get your expert opinion about the
health in the community that your organization serves. When we ask a question about the
community, we are talking about the community in which your organization serves.
Answering the following questions will assist us in identifying the most pressing health needs
in your community, and developing strategies to meet them. Please share your opinion with
us by answering the following questions. Your participation is voluntary, and your responses
are confidential. With your permission, this interview will be recorded and transcribed.
Information from all interviews will be aggregated and reported in a Community Health
Assessment. If after this interview you have questions or concerns, you may contact the
Nassau County Department of Health at 516-227-9408. Do I have your permission? Thank
you. Begin recording
Thank you for already completing some basic information about your organization. I
would like to expand on it a bit.
1. Please describe your organization? {Ask the following if still needed after pre survey}
a. Describe your role in the organization
b. What specific services does your organization provide? {Ask for explanation if not
obvious}
c. Who is the target population?
d. Describe services your organization provides to minority populations
e. …to low-income
f. …to uninsured
g. …to other specific populations?
2. Please identify some of the biggest health problems in the community you serve? {Leave
this as open ended, probing for specificity, then follow-up with question 3}.
Hand the informant the list of priorities with focus areas to review and consider.
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JB Steier
NYS DOH has identified 5 health issues that health communities could address :
1)Chronic Disease, 2) Healthy and Safe Environment, 3) Healthy Women, Infants and
Children 4) Mental Health and Substance Abuse, 5) HIV, STD, Vaccine Preventable
Diseases.
3. Of these issues, which are priorities for your community?
a. Which of these issues are priorities for minority populations you serve?
b. … low income?
c. …uninsured?
d. …other specific populations?
4. Many
a.
b.
c.
d.
e.
factors affect the health care community members receive
How does age affect the health care received by the community you serve?
How does gender affect the health care they receive?
In what way do race and/or ethnicity affect the health care they receive?
How does financial security affect the quality of health care they receive?
Describe how language affects the health care they receive?
5. Please describe resources (i.e. health services, community education programs,
screenings, etc.) that your community uses in relation to the health problems you
have identified.
a. How often do they access these services?
b. Where do they access these services?
c. Would you describe any gaps in resources related to these problems?
6. What keeps people in the community you serve from receiving the resources needed
to address these issues? Please give an example.{Ideas could include:
transportation, issues of insurance, religion/cultural difference, fear, doctor availability,
etc}
7. How can these barriers be addressed?
a. In what way can services be improved?
b. What additional services are needed in the community you serve?
c. What strategies do you recommend for overcoming these barriers?
8. Previously, you described how your community utilizes resources related to the biggest
health needs. Please describe other resources/services your community uses.
9. What additional services or programs are needed to improve the community’s health?
25
JB Steier
10. How would you and your organization like to help improve services and programs for the
community you serve? {Look to build partnerships and elicit ideas}
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JB Steier
Atachment III. Nassau County Individual Community Member Survey
COMMUNITY HEALTH ASSESSMENT SURVEY
Your opinion is important to us!
The purpose of this survey is to get your opinion about health issues that are important in your community.
Together, the Nassau County Department of Health and Nassau County hospitals will use the results of this
survey and other information to help target health programs in your community. Please complete only one
survey per adult 18 years or older. If you have any questions, please contact us at (516) 227-9408. Your
survey responses are anonymous. Thank you for your participation.
1. What are the biggest ongoing health concerns in your COMMUNITY? (Please check up to 3)
Asthma/lung disease
Heart disease & stroke
Safety
Cancer
Child health & wellness
Diabetes
Drugs & alcohol abuse
Environmental hazards
HIV/AIDS & Sexually
Transmitted Diseases (STDs)
Mental health/
depression/suicide
Obesity/weight loss issues
Vaccine preventable
diseases
Women’s health & wellness
Other (please specify)
________________
2. What are the biggest ongoing health concerns for YOU? (Please check up to 3)
Asthma/lung Disease
Environmental hazards
Safety
Cancer
Vaccine preventable diseases
Child health & wellness
Diabetes
HIV/AIDS & STDs
Mental health/
Drug & alcohol abuse
depression/suicide
________________
3. What prevents people in your community from getting medical treatment? (Please check up to 3)
Lack of availability of
Unable to pay coCultural/religious beliefs
doctors
pays/deductibles
Don’t know how to find doctors
Don’t understand need to see
a doctor
Language barriers
There are no barriers
No insurance
Fear (e.g. not ready to
face/discuss health problem)
Transportation
__________________
4. Which of the following is MOST needed to improve the health of your community? (Please check up to 3)
Clean air & water
Mental health services
Smoking cessation programs
Drug & alcohol rehabilitation
Recreation facilities
services
Healthier food choices
Safe childcare options
Safe places to walk/play
Job opportunities
Safe worksites
Transportation
Weight loss programs
_________________
PAGE 1 of 2
5. What health screenings or education/information services are needed in your community? (Please check up to 3)
Blood pressure
Eating disorders
Mental health/depression
Nutrition
Cancer
Emergency preparedness
Prenatal care
Suicide prevention
Cholesterol
Exercise/physical activity
Dental screenings
Heart disease
Diabetes
HIV/AIDS & STDs
Vaccination/immunizations
Disease outbreak information
Importance of routine well
checkups
Other (please specify) _________
Drug and alcohol
6. Where do you and your family get most of your health information? (Check all that apply)
Doctor/health professional
Library
Television
Family or friends
Newspaper/magazines
Health Department
Radio
Worksite
Hospital
Religious organization
Internet
School/college
____________
For statistical purposes only, please complete the following:
Location where you received this survey: _________________
What is your sex:
Male
Female
What is your age:_______________
ZIP code or Town where you live: _________________
ZIP code or Town where you work: ___________
What race do you consider yourself?
White/Caucasian
Black/African American
Native American
Multi-racial
Asian/Pacific
Other (please specify) _________________
Islander
Are you Hispanic or Latino?
Yes
No
What is your highest level of education?
K-8 grade
Technical school
Graduate school
Some high school
Some college
Doctorate
High school graduate
College graduate
Other (please specify) ________________
Do you currently have health insurance?
Yes
No
No, but I did at an earlier time/previous job
Do you have a smart phone?
Yes
No
Please return this completed survey to:
Division of Quality Improvement
106 Charles Lindbergh Blvd
Uniondale, NY 11553
Or you may fax completed survey to: 516-227-9503
PAGE 2 of 2
Attachment IV. Nassau County Individual Community Member Survey
Nassau County
Community Health Assessment
Community Member Survey
Spring 2013
Methodology
•
•
•
•
Survey
– Based on previous community heath surveys including NHANES and BRFSS
– 16 questions
– Survey data: services provided, target population, identify and prioritize pressing health
needs in community, barriers, resources, health improvement strategies
Identification of community member survey recipients
– Each Nassau County Hospital and NCDOH distributed survey to community members at
community events targeting :
– Various age groups
– Diversity of recipients
– Communities with health disparities
Distribution
– Paper and Electronic survey through SurveyMonkey
– Survey translated into Spanish
– Survey closed April 2013
Analysis
– Select Communities surveys based on zip code related to disease burden and analyzed
separately in addition to the total responses
Survey Respondents (Total = 1070)
Select Communities Surveyed (26% of Total Respondents)
11003 Elmont
11096 Inwood
11520 Freeport
11542 Glen Cove
11550 Hempstead
11553 Uniondale
11561 Long Beach
11575 Roosevelt
11590 Westbury
Age Distribution of Respondents
Total
18-29 yrs
17%
30-45yrs
24%
72% female
28% Male
65 yrs +
20%
46-64 yrs
39%
Select Communities
18-29 yrs
25%
30-45yrs
28%
79% Female
21% Male
65 yrs +
16%
46-64 yrs
31%
Respondent Racial Diversity
Total Respondents
* 16% Latino
Select Communities
Caucasion
Caucasion
Black
Black
Native
American
Native
American
Asian
Asian
*30% Latino
Educational Attainment
Total Respondents
K-8 grade
Select Communities
K-8 grade
Some HS
Some HS
HS grad
HS grad
Technical
school
Some college
Technical
school
Some college
College grad
College grad
Grad school
Doctorate
Other
Grad school
Doctorate
Other
What are the biggest ongoing health concerns for YOU ?
Total Responses
(select top 3 health concerns)
Cancer
Heart Disease & Stroke
Women's Health & Wellness
Obesity/Weight loss
Diabetes
Environmental Hazards
Safety
Asthma/lung disease
Mental health
Child health& wellness
Substance abuse
HIV/AIDS & STDs
Vaccine Preventable Diseases
Other
36
35
33
31
27
20
19
17
14
14
10
8
7
4
0
5
10
15
20
25
% respondents choosing health concern
30
35
40
What are the biggest ongoing health concerns for your community ?
Total Responses
Cancer
Obesity/Weight loss
Diabetes
Substance Abuse
Mental Health
Women's Health
Child Health& Wellness
Asthma & Lung disease
Safety
HIV/AIDS & STDs
Other
44
36
33
32
31
22
19
18
17
17
14
12
6
3
0
10
20
30
40
50
What are the biggest ongoing health concerns for YOU ?
Selected Communities Responses
Cancer
36
34
Diabetes
31
Obesity & Weight loss
30
Heart Disease
25
Safety
20
Child health& wellness
17
Asthma/lung disease
16
17
Mental Health
12
HIV/Aids & STDs
11
6
Other
3
0
5
10
15
20
25
30
35
40
What are the biggest ongoing health concerns for your community ?
Diabetes
40
Substance Abuse
38
Cancer
37
Obesity & Weight loss
32
HIV/Aids & STDs
24
23
Asthma/lung disease
22
Mental Health
20
Child Health & Wellness
20
18
Safety
18
12
6
0
5
10
15
20
25
30
35
40
45
Which of the following is MOST needed to improve
the health of your community ?
Total Responses
Healthier Food Choices
Job Opportunities
Clean Air & Water
Weight Loss Programs
Recreation Facilities
Mental Health
Safe Places to Play
Substance Abuse Services
Smoking Cessation Services
Safe Childcare Options
Transportation
Safe Worksites
Other
46
39
34
30
22
21
20
20
20
16
15
12
5
4
0
10
20
30
40
50
Which of the following is MOST needed to improve
the health of your community ?
Job Opportunities
Clean Air & Water
Substance Abuse Services
Safe Places to Play
Mental Health Services
Smoking Cessation Services
Transportation
Safe Worksites
Other
45
41
34
26
25
23
21
20
20
15
9
6
2
0
10
20
30
40
50
Where do community members you serve get most of their health information?
(Check all that apply) Total Responses
Doctor, Health Professional
Internet
Television
Family or Friends
Hospital
Library
Health Department
Newspaper
Worksite
School/College
Religious Organization
Other
77
48
37
34
17
13
11
10
9
8
3
3
0
20
40
60
80
% respondents identifying health information channel
100
Where do community members you serve get most of their health
information? (Check all that apply) Select Community Responses
Internet
Television
Family or Friends
Newspaper
Hospital
Health Department
Library
School/College
Worksite
Radio
Other
76
47
39
34
31
21
14
13
8
8
7
4
1
0
10
20
30
40
50
60
70
80
What health screenings or education/information services are needed in your
community? (select top 3 screenings or services) Total Responses
Diabetes
Blood Pressure
Exercise/Physical Activity
Importance of Routine Well Checkups
Cancer
Nutrition
Cholesterol
Drug & Alcohol
Mental Health, Depression
Emergency Prepardness
Heart Disease
Dental Screening
HIV/Aids & STDs
Disease Outbreak Info
Vaccinations, Immunizations
Suicide Prevention
Prenatal Care
Other
29
28
27
26
24
24
20
18
18
18
16
14
10
9
9
6
5
3
0
5
10
15
20
25
30
% respondents choosing screening or education/information service
35
What health screenings or education/information services are needed in your
community? (select top 3 screenings or services)
Blood Pressure
Diabetes
Drug & Alcohol
Cancer
Nutrition
Cholesterol
Nutrition
Exercise/Physical Activity
HIV/AIDs & STDs
Dental Screening
Emergency Preparedness
Mental Health
Disease Outbreak Info
Prenatal Care
Other
33
30
27
26
24
24
23
22
19
17
17
17
17
9
9
8
2
0
5
10
15
20
25
30
35
What prevents people in your community from getting medical treatment?
(select top 3 barriers) Total Responses
No Insurance
Unable to Pay Copays/Deductibles
Fear(i.e. not ready to face/discuss health)
Don't Understand Need to see MD
Language Barriers
Transportation
Don't Know How to Find MD
There are No Barriers
Lack of Availability of MDs
Cultural/Religious Beliefs
Other
58
43
42
28
16
16
13
11
10
8
4
0
10
20
30
40
% respondents identifying barrier to medical treatment
50
60
70
What prevents people in your community from getting medical treatment?
(select top 3 barriers) Selected Communities Responses
No Insurance
Fear(i.e. not ready to face/discuss health)
Language Barriers
Don't Understand Need to See MD
Transportation
Lack of Availability of MDs
Don't Know How to Find MDs
There Are No Barriers
Other
71
50
42
23
30
15
10
12
10
4
3
0
10
20
30
40
50
60
70
80
Do You currently have heath insurance?
Health Insurance
Total Responses
Select Communities
Yes
86%
83%
No
11%
15%
No, but I did have
insurance previously
3%
2%
Do you have a smart phone?
Health Insurance
Total Responses
Select Communities
Yes
54%
79%
No
46%
21%
Findings
CHRONIC DISEASE
• The top health concerns for all the respondents and the select
communities were chronic disease: Cancer, Heart Disease,
Stroke, Diabetes and Obesity.
• Select communities identified substance abuse as an additional
high priority health concern.
• Both the total respondents and the select communities
identified healthy food choices, recreational facilities, weight
loss programs, clean air and water and job opportunities as
items needed to improve the health of the community
• All respondents indicated that health screenings/educational
programs on chronic disease (esp diabetes, blood pressure),
importance of routine well care, nutrition and physical activity
were needed. Substance abuse was identified by selected
communities
Findings
Heath Information and Health Access
• All the respondents receive the majority of their health
information from health professionals, the internet, television
and family /friends.
• Barriers to health access included no insurance, inability to pay
copayments/deductibles, fear of discussing health issues and
lack of knowledge about the importance of routine medical care
• The selected communities also cited language barriers
• Over 50 % of the total respondents and 79% of the selected
community respondents had a smart phone.
Recommended 2014-2017 NYS Community Service Plan &
Community Health Needs Assessment Implementation Plan
Priority Selection
•
FOCUS AREA: Reduce obesity in children & adults
•
•
•
•
•
FOCUS AREA: Increase access to High-quality chronic disease preventive care &
management in both clinical & community settings
•
•
•
•
Create community environments that promote & support healthy food beverage choices &
physical activity
Prevent childhood obesity through early child care & schools
Expand the role of health care, health service providers, & insurers in obesity prevention
Expand the role of public & private employers in obesity prevention
Increase screening rates for cardiovascular disease, diabetes, & breast/cervical/colorectal
Promote use of evidence-based care to manage chronic diseases
Promote culturally relevant chronic disease self-management education
Attachment V. Lenox Hill Hospital Community-based CHNA Survey and
Results
Lenox Hill Hospital
Community Health Assessment CBO Survey
Methodology
•
•
•
Survey
– Based on Nassau County CHA community survey and informant interview script
– 20 questions
Identification of community-based organizations, hospitals, & government survey recipients
– Identified organizations in Lenox Hill Hospital’s service area based on:
– Age groups served
– Diversity of services provided
– Health disparities addressed
– 21 potential survey recipients identified: 4 schools, 5 government entities, and 12
community-based organizations
Distribution
– Electronic survey through SurveyMonkey
– Personalized invite by email in April 2013 with follow up email invites in May 2013
– Survey closed June 14, 2013
Community-based Organizations
92nd Street Y
Target Population: People of all ages & abilities residing in the upper east side of Manhattan
Services Provided: Wellness services; physical activity; education & educational outreach through the arts
Target Population: Multicultural communities & youth; reach extends throughout Metro NYC area
Services Provided: Youth & adult education
Lenox Hill Neighborhood House
Target Population: 1000 older adults living at home on the east side of Manhattan
Services Provided: 2 senior centers; homeless shelter; adult day program; & supportive housing for mentally ill
Park Avenue Women’s Shelter
Target Population: Mentally ill homeless women aged 45+
Services Provided: Medical & psychiatric care; social work; housing placement; harm reduction; referrals; & services
available on & off site
Safe Kids New York City
Target Population: Children under age 14, particularly those living in high risk NYC neighborhoods
Services Provided: Educational programs & materials to children, parents, & older adults; & safety devices
Government
Community Emergency Response Team- Upper East Side
Target Population: East side Manhattan from 72nd St. to 96th St.
Services Provided: Assistance to FDNY or NYPD in large emergencies
Manhattan Community Board 8
Target Population: Residents from 5th Ave. to East River; 59th St. to 96th St.
Services Provided: Makes recommendations on issues to elected officials & city agencies
Schools
Eleanor Roosevelt High School
Target Population: 9-12th grade adolescents
Services Provided: Education
Q 11 The NYS Prevention Plan for 2013-2017 identifies 5 priority areas with
related focus areas and goals. Please rank these health-related needs, 1 being
the highest priority to 5 being the lowest priority, for your community.
NYS Prevention Plan Priority Area
Average
Ranking
Preventing chronic disease. Examples: reduce obesity in children and adults,
reduce illness and disability related to tobacco use and second hand smoke, and increase
access to preventive care and health screenings.
3.88
Promoting a healthy and safe environment. Examples: reduce fall risk
among vulnerable populations, reduce occupational injury and illness, and violence
prevention.
3.50
Promote mental health and prevent substance abuse. Examples: prevent
underage drinking and non-medical use of prescription drugs, suicide prevention, and
mental health education and screening.
2.88
Promote healthy women, infants, and children. Examples: reduce
premature births and unplanned pregnancies, increase prevalence of breastfed babies,
and increase access to well child care.
Preventing HIV, sexually transmitted diseases, vaccine-preventable
diseases, and healthcare associated infections. Examples: improve
immunization rates, STD and HIV education, and access to testing and care.
2.75
2.00
Q 10 What are the biggest ongoing health concerns in your community?
50
37.5
37.5
Diabetes
25
Asthma, Lung Disease
12.5
Obesity, Weight Loss Issues
12.5
Cancer
0
Drugs & Alcohol Abuse
25
Mental Health, Depression, Suicide
25
12.5
Safety
12.5
HIV/AIDS & STDs
0
0
0
10
20
30
40
50
60
Q 12 Please describe resources (i.e. health services, community education
programs, screenings, etc.) that your community uses in relation to the health
problems you have identified.
Resources
Community Health Education
Programs
Phase III Cardiac Rehabilitation
CPR/First Aid
Physical Activities
Fit-Friendly Worksites
Referrals
Go Red For Women
Screenings
Nutrition Counseling
Teaching Gardens
Q 20 Where do community members you serve get most of their health
information? (Check all that apply)
Family or Friends
Hospital
Television
Newspapers, Magazines
Internet
School, College
Library
Radio
Health Department
Worksite
62.5
62.5
50
50
37.5
25
25
25
12.5
12.5
0
0
0
10
20
30
40
50
60
70
Q 15 Which of the following is MOST needed to improve the health of your
community? (select top 3 health improvement strategies)
Access to Healthcare*
Safe Places to Walk & Play
Drug & Alcohol Prevention*
Clean Air & Water
Drug & Alcohol Rehabilitation
Job Opportunities
Smoking Cessation Programs
Transportation
Safe Worksites
50
37.5
37.5
25
25
25
12.5
12.5
12.5
12.5
12.5
12.5
12.5
0
0
10
20
30
40
% respondents choosing health improvement strategy
*Free text write-in by multiple respondents
50
60
Q 16 What health screenings or education/information services are needed in
your community? (select top 3 screenings or services)
Nutrition
Exercise, Physical Activity
Disease Outbreak Information
Blood Pressure
Cholesterol
Diabetes
Heart Disease
Cancer
Dental Screenings
Prenatal Care
Drug & Alcohol
Suicide Prevention
HIV/AIDS & STDs
50
37.5
25
12.5
25
12.5
12.5
12.5
0
25
12.5
12.5
12.5
0
0
12.5
0
0
10
20
30
40
50
60
Q 17 What prevents people in your community from getting medical treatment?
(select top 3 barriers)
Don't Understand Need to See a Doctor
50
Fear (e.g. not ready to face/discuss health…
50
No Insurance
50
Don’t Know How to Find Doctors
25
12.5
Lack of Availability of Doctors
12.5
Unable to Pay Copays/Dedubtibles
12.5
Language Barriers
12.5
Transportation
0
0
0
10
20
30
40
50
60
Q 18 You previously identified barriers and gaps in resources/services
available to your community. Please explain in what way resources/services
can be improved and what additional services are needed.
Resources & Services
Collaboration
Health Education
Insurance & Access to Healthcare
Language & Cultural Sensitivity
Q 19 Please describe how your organization can specifically address some of
the additional service needs described in Q 18.
Strategies
Collaboration
Health Awareness & Education Programs
Take Care New York
(TCNY)
•
•
•
April 24, 2013 New York Department of Health and Mental
Hygiene held a Manhattan listening session to share the health
department’s new TCNY initiative and gather community feedback
Brought stakeholders together to discuss strategies and
interventions to improve health outcomes for all New Yorkers
Stakeholders:
• Community-based Organizations
• General Public
• Healthcare Providers
TCNY Listening Session Methodology
• Stakeholder feedback captured via listening session participation &
3 survey instruments
1. Notecards
• Stakeholders were provided notecards during listening session
• Notecards used to share questions, comments, interest in receiving
information, & provide contact information to connect with other
stakeholders
2. Evaluation Form
• Completed at end of listening session
• Assessed stakeholder satisfaction with listening session
3. Post-session Survey
• Stakeholders received web-based survey to assess familiarity with TCNY
and interest in health department resources, TCNY priority areas, TCNY
partnership, & health department facilitation of inter-agency
collaboration
Stakeholders
Stakeholder Type
Number in Attendance
9
General Public
22
Government Organizations
2
Healthcare Providers
12
Total in attendance: 45
TCNY Priority Areas
TCNY 2016 Priority Areas
1. Tobacco-Free Living
2. Healthy Eating
7. Reduce Alcohol & Substance Abuse
3. Active Living
8. Prevent & Treat Cancer
4. Heart Health
5. HIV Prevention
10. Quality Preventive Care
With a focus on child & adolescent health
TCNY Manhattan Priority Areas
Priority Area
Ranking
Promote Mental Health
1
Active Living
2
Healthy Eating
3
Child & Adolescent Health
4
Healthy Indoor & Outdoor Air
5
Findings
• Provision of mental health training to non-mental health
professionals working with high risk populations
• Promotion of smoking cessation among individuals with mental
illness
• Treatment of trauma and psychological distress and prevention
of mental illness among youth
Findings
2. Active Living
• Access to spaces and programs that promote physical activity
• Connection of opportunities for physical activity
3. Healthy Eating
• Promotion of access of healthy foods in restaurants and
bodegas
• Provision of programs that teach adults and youth how to
prepare healthy, affordable meals
• Enhancement of access to healthy foods for low income New
Yorkers
• Public support of Health Bucks program
Findings
4. Child & Adolescent Health
• Early childhood intervention and prevention of special needs for
youth in high risk communities
• Promotion of adolescent mental health and prevention of
unplanned pregnancy to prevent high school dropout
• Collaboration with other city agencies to improve the
environment
Stakeholder Resource Request
TCNY Priority Area
Resource Request
1) Healthy Eating/Active Living 1) Free services for healthy
eating & tobacco-free living
for organizations serving the
disabled population
2) Promote Mental Health
2) Screening materials &
trainings for teachers & other
non-mental health
professionals who work with
youth
3) Children & Youth
3) Contraception & mental
health services in high schoolbased health centers
4) Additional Request
4) Technology to enhance the
reach to all priority areas
Priority Area Comparison
Lenox Hill Hospital & TCNY
Lenox Hill Hospital Priorities
TNCY Priorities
1. Preventing Chronic Disease
2. Promoting A Healthy & Safe
Environment
2. Active Living
3. Promote Mental Health & Prevent 3. Healthy Eating
Substance Abuse
4. Promote Healthy Women, Infants, 4. Child & Adolescent Health
& Children
5. Preventing HIV, Sexually
Transmitted Diseases, VaccinePreventable Diseases, & Hospital
NewYorkCiityDepartmeentofHealth
handMentalHygiene
TakeCareN
T
NewYorkBo
orough‐WideeListeningSSessions
Manhattan
nListeningSeessionStakeh
holderFeedb
backSummaary–April24
4,2013
Table
e of Contentts I.
II.
III.
IV.
V.
VI.
VII.
VIII.
Background B
Methodolog
M
gy Demographi
D
ics a.
a Table 1 ‐ Stakeholde
er Attendancce Findings F
a.
a Table 2 –
– Stakeholde
er Feedback
b.
b Table 3 –
– Stakeholde
er Resource Requests Listening Ses
L
ssion Evaluaation a.
a Table 4 –
– On‐site evaaluation find
dings b.
b Table 5 –
– Familiarity with TCNY p
prior to sess ion c.
c Table 6 –
– Priority Are
eas of Intere
est d.
d Table 7 –
– Communityy Resource Interests
e.
e Table 8 ‐ Interest in P
Partnership
Appendix A A
– Feedback Notecard
Appendix B –
A
– On‐site Evvaluation Appendix C –
A
– Post‐Session Survey
1 2
2 2
2 2
2 3
3‐8 8
8‐11 1
12 1
13 1
14‐16 NewYorkCiityDepartmeentofHealth
handMentalHygiene
TakeCareN
T
NewYorkBo
Manhattan
holderFeedb
4,2013
I.
Background B
On April 24, 2013 the New
w York City D
Department o
of Health andd Mental Hyggiene held thee first of five borough h department’s new Takee Care New York (TCNY) initiative and gather listening sessions to sharre the health
community feedback. f
Co
ommunity‐based organizations, health care provideers, and the general publlic joined health department staff at the Huntter School of Public Heaalth in East H
Harlem to discuss strateegies and omes for all N
New Yorkers. Roger Hayees, Assistant C
Commissioneer of East interventionss to improve health outco
and Central H
Harlem District Public Heaalth Office, de
escribed the ccity’s TCNY p
plan and Dr. N
Nicholas Freudenberg, Distinguished
d Professor o
of Urban Public Health at H
Hunter Collegge, City Univeersity of New
w York (CUNYY), shared how CUNY is incorporating aspects of tthe city’s TCN
NY initiative too improve thee health of itss student bod
dy. II.
Methodolog
M
gy Stakeholder feedback was w
captured
d via listening session participation
n and three survey insttruments d during and aafter the liste
ening session to maximize opportunitiees to elicit feedback: disseminated
1. Note
ecards: during the listeniing session, attendees w
were provideed with noteecards to shaare their quesstions/comme
ents, indicate their intere
est in receivi ng additional information
n about specific TCNY areass, and provide their contact informatio
on if they wishhed to be con
nnected with organizations sharing similar interests (aattached in A
Appendix A).
2. Evalu
uation form: at the comp
pletion of the listening seession, atten
ndees were p
provided with
h a brief evalu
uation form to assess theirr satisfaction with the sesssion (attached
d in Appendixx B). 3. Post‐‐session surve
ey: following the listening session, atteendees were sent a web‐b
based survey to assess familiarity with TCNY and in
nterest in TCNY priorityy areas, health department resourcees, TCNY nership, and h
health departtment facilitation of inter‐‐agency collab
boration (attaached in Appeendix C). partn
III.
Demographi
D
ics Table 1. Ma
anhattan Listtening Sessiion Attendance Total Num
mber of Attendees 45 Stakeholder Type
e (N) aand % of Totaal Attendees
Co
ommunity‐Based Organization 9 (20%) He
ealth Care Pro
ovider 12 (27%) Go
overnment Organization*
2 (4%) Ge
eneral Public 22 (49%) *Governmen
nt organization attendees e
exclude healtth departmennt staff. 2 NewYorkCiityDepartmeentofHealth
handMentalHygiene
TakeCareN
T
NewYorkBo
Manhattan
holderFeedb
4,2013
IV.
Findings F
Over half of the session attendees a
represented he
ealth care prooviders and tthe general p
public, the m
majority if 1
which consisted of studen
nts.: Nearly 5
50% (22) of tthe attendee s participated
d in the discu
ussion, which
h focused on five TCNY priority areas, including: The prevalen
nt themes of tthe Manhattaan listening se
ession feedbaack included tthe followingg:  Mental Health:  Provision of m
P
mental health training to non‐mental heealth professionals who w
work with high
h risk groups. g
 Promotion of P
with mental illness. smoking cesssation amongg individuals w
 Treatment of T
trauma and p
psychologicall distress and prevention o
of mental illneess among ch
hildren & adolescents. a
 Activve Living  Access to spa
A
ces and progrrams that pro
omote physic al activity.  Connection of
C
f opportunitie
es for physicaal activity & hhealthy eatingg, such as gardening.  Healtthy Eating  Promotion of P
access to heaalthy foods in
n local restaurrants & bodeegas.  Provision of p
P
programs thatt teach adultss & children hhow to preparre healthy, afffordable meaals.  Enhancement
E
t of access to healthy food
ds for low incoome New Yorrkers.  Public suppor
P
rt of the Healtth Bucks proggram. d & Adolescen
nt Health  Child
 Early childhoo
E
od interventio
on and prevention of speccial needs for children in high risk comm
munities.  Promotion of P
adolescent m
mental health
h & preventio n of unplanneed pregnancies to preventt high school dropou
s
ut.  Healtthy Indoor & Outdoor Air  Collaboration
C
with other city agencies tto improve thhe environmeent.
1
22 of the 45 attendees werre recorded as providing feed
dback, questio ns, or suggestiions. 3 NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
ManhattanListeniingSessionStak
keholderFeedbacckSummary–A
April24,2013
Table 2. Stakeholder Feedbackk Take Care New
w York Priority Are
ea Corre
esponding Quotes
Coorresponding Feed
dback We need [mental h
health] screening materials and “W
traiinings for teacherrs and other non‐‐mental health professionalss who work with youth.” Mental Hea
alth Consider embbedding mental h
health prevention sccreening into oth
her priority areas of chroonic illness, such aas heart “Whatt you’re going to find with adolesccents is that theree disease, canccer and substancee abuse. is a lot of stigma witth mental health a
as there is with Patients withh chronic illness o
often have reprroductive health. They often don’tt want to talk to comorbid meental health issuees. parents about it and many times thee source of the Examine menntal health from aa trauma lens al health issues iss in the home anyyway. We need to
o so that childrren and families ccan be properly menta
look a
at the full range o
of mental health services without assessed andd treated. pareental consent”. Provide train ing to teachers, p
professors, “Plea
ase ensure that m
mental health supp
port services are employers onn the signs and syymptoms of what questions high o
on the agenda, particularly in ligh
ht of the fact thatt mental illnesss so they know w
to ask and ca n recognize when help is co‐morbidity is vvery high in this population.” needed. Adolescents ccan access reprod
ductive health services with out parental consent. Consider provision of m
mental health serrvices to adolescents i n the same way sso they can access psychiiatric and social sservices without pare ntal consent. 4 How does thee health departm
ment promote smoking cesssation among thee seriously and persistently m
mentally ill? NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
April24,2013
Take Care New
w York Priority Are
ea Active Living Healthy Eatting Corre
esponding Quotes
Coorresponding Feed
dback paign Against Hun
nger, we try to “At Westside Camp
consiider how much tim
me people are sp
pending inline for otherr city agencies. W
We know people’ss time is valuable and trry to give exercisee classes while they are waiting on
n line and people love it. People love do
oing yoga while waiting on linee. It is easy and lo
ow‐cost.” Consider parttnering with NYC
CHA to ensure there are moore places to play around NYCHA housing. Consider creaating more comm
munity gardens so New Yorkeers can learn about healthy eating and st ay active. Consider offeering the MATCHO
O (Moving “O
One thing we abso
olutely love is thee Health Bucks Action Througgh Community H
Health Prog
gram – anything that can replicate that model of Outreach) proogram to engagee and educate putting choice and ageency in the hands of New Yorkers iss parents/childdren in healthy eaating. useful.” “Myy children came h
home with so much information [from
m the MATCHO seession]. Now theyy eat vegetables, rea
ad labels, and I am
m looking forward
d to having my children participate again
n.” 5 How is the heealth departmentt addressing funding cuts tto physical activity and sports teams in schoools? NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
April24,2013
Take Care New
w York Priority Are
ea Child & Adole
escent Health Corre
esponding Quotes
Coorresponding Feed
dback “Brronx Knows is resp
ponsible for loweering HIV in the com
mmunity. Maybe iit’s time we take the lessons we learn
ned from campaig
gns that have beeen very effective and apply that knowleedge to the rest off the indicators?”” “[Off
ffer] contraceptio
on distribution in sschools, as teen preg
gnancy is a big cause [of high scho
ool dropout] and provvide this not just iin a handful of scchools, but in all schoo
ols across the city.. Mental health services in schoolss may a
also be a way of ffocusing those seervices to achievee th
he goal [of reducin
ng high school drropout rate”.” Consider focuusing on early chiildhood intervention and prevention o
of special needs in children, siimilar to the Firstt 2000 Days Campaign in East Harlem. How can the department replicate programs, su ch as Bronx Know
ws in other areas like carrdiovascular diseaase, asthma, unwanted preegnancy, etc.? Consider provviding mental health services and contraceeption in all schoo
ol‐based health centers in ordder to reduce higgh school dropout ratess. Healthy Indo
oor & Outdoor A
Air Additional Fee
edback Collaborate w
with other City aggencies to promote initiiatives that impro
ove the physical envirronment. “In so
ome of our schoo
ols and neighborh
hoods, more than half off the people who enter high schoo
ol don’t gradate o
or don’’t graduate on tim
me. Some of thosse are related to healtth problems, som
me aren’t, but theyy all have health co
onsequences. The difference in gra
aduation rates betweeen white, black, a
and Latino people is a big driver in
n thee large inequalitiees in health for th
hose groups. So redu
ucing that differen
nce in educationa
al achievements Consider reduucing high school dropout rates a TCNY goal, given that educational attainment iss a powerful influence on health. 6 NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
April24,2013
would
d help reduce thosse differences in h
health outcomes. I wo
onder if you’ve th
hought about add
ding that to the agenda and h
how would you do
o that?” Consider adddressing oral health in TCNY “The reason I came to
o this meeting is b
because I did not 2016. see o
oral health under any of those (TCN
NY) 10 priorities. For tthe last 25 years, if I see 15 patients in the day, 12 will ha
ave high blood prressure, cardiovasscular disease, orr diab
betes, and those cconditions are verry linked to oral healtth. How can we a
add oral health to
o one of these 10 prriority areas?” “Plea
ase consider moree health promotio
on programs thatt targ
get older adults an
nd increase awarreness on senior health
h issues (ie. glauccoma, medication
n adherence, fallss preevention, pneumo
onia, vaccination,, depression).” “W
We can promote h
healthy living witth community ga
atekeepers and reeally try to show more cultural compeetency by being p
part of their events throughout thee city, eespecially in comin
ng months. We n
need to work with
h com
mmunities and rea
ach more people by doing that.” 7 Consider incluuding a focus on older adult health in TCN
NY 2016. Promote TCN
NY and TCNY partners at community eevents in NYC thro
oughout the year and partticularly in the up
pcoming months. Show
w the health department’s cultural comppetency by particcipating in community eevents. NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
April24,2013
TTable 3. Stakeholder Resource
e Requests Take Care New Y
York Priority Are
ea Healthy Eating &
& Active Living Mental Health Children and Yo
outh Additional Resource Requests Free services for healthy eating and tobacco‐free living for oorganizations serrving the population. disabled p
Screeningg materials and trainings for teachers and other noon‐mental health professionals who workk with youth. Contracep
ption and mental health services in high school‐baased health centeers Technologgy to enhance the
e reach to all prio
ority areas. Contact lisst of all of the orgganizations/providers that attendded the listening ssession for collaborattion/resource shaaring. V.
Liste
ening Session Evvaluation TTable 4. On‐site
e Evaluation Fin
ndings (n=10)* Questions 1. Overall satisfaaction with this listening session. 2. The forum helped me learn mo
ore about Take C
Care New York (TC
CNY). 3. The presentattion and handoutts were informatiive. 4. Sufficient time
e was allocated for questions and answers. 5. The program w
was well planned
d and interactive.. Stakeho
older Average Raating 4
4.2
3.8
4.5
4.3
**Participants were asked to rate their agreement with tthe statements abo
ove on a scale of 1
1‐5: 1=Poor; 2+Fairr; 3=Good; 4=Very Good; 5=Excellent. TThe evaluation form
m is attached in Ap
ppendix B. 8 NewYorkCiityDepartmeentofHealth
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Table 5. Sesssion Attend
dees’ Familiaarity with TC
CNY Prior to
o the Listenin
ng Session (n=10)* *Survey attacched in Appendix C. Were you
u familiar with
w Take Care New Yoork (TCNY)) prior to
registerring for thiss listening seession?
1
4
Y
Yes
N
No
S
Somewhat
5
Table 6. TCN
NY Priority A
Areas of Inte
erest % of Attendees W
Working or Intterested in Workingg on the Topic 40% 60% 50% 40% 40% 90% 60% 30% 30% 60% TCNY Prioritty Areas Tobacco‐Fre
ee Living Healthy Eatting Active Living Heart Healtth HIV Preventtion Promote Mental Health Reduce Alco
ohol and Riskky Substance Use Prevent and
d Treat Cance
er Healthy Indoor and Outd
door Air Quality Prevventive Care 9 NewYorkCiityDepartmeentofHealth
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Table 7. Com
mmunity Re
esource Interests.* Nott Interested Somew
what Interestted In
nterested N Connection
n with local organizatio
ons working o
on similar health initiativess 0% 13%
88% 8 Facilitation
n of a cross‐
organizatio
onal website resource po
ortal 0% 0%
100% 10 Cross‐organ
nizational workshops or trainings 0% 0%
100% 10 Webinars featuring resources a
and local case
e studies 0% 20%
80% 10 Newsletterr articles 11% 22%
67% Information
nal briefs or fact sheets on key healtth issues 11% 0%
89% 9 Tool kits 0% 10%
90% 10 0% 25%
75% 8 11% 11%
78% 9 Social media assistance Communityy data to support pro
ogram developme
ent and partnership
p efforts 9 *Participantss were asked to rate their interest in the resources aabove, on a sccale of 1‐3: 1==Not Interestted; 2=Somewhatt Interested; 3
3=Interested.. 10 NewYorkCiityDepartmeentofHealth
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Table 8. Inte
erest in Take Care New York Partne
ership Would your comm
munity organ
nization, bu
usiness, heallth care proovider,
busin
ness, labor group
g
or faiith-basedorgganization b
be interesteed in
becom
ming a Takee Care New
w York partn
ner?
2
3
Yes
No
Already a TCNY Partnerr
Don't Know
w
1
4
11 NewYorkCiityDepartmeentofHealth
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VI.
Appendix A A
– Feedback Notecard 12 NewYorkCiityDepartmeentofHealth
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VII.
Appendix B –
A
– On‐site Evvaluation 13 NewYorkCiityDepartmeentofHealth
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VIII.
Appendix C. A
Post‐Sessio
on Survey 14 NewYorkCiityDepartmeentofHealth
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ListeningSesssionStakeholderFeedbaackSummaryy–May14,2
2013
Tablee of Contentts
I.
Background
B
d
2
II.
Methodolog
M
gy
2
III.
Demograph
D
hics
a.
a Table 1 - Stakeholdeer Attendancce
2
IV.
Findings
F
a.
a Table 2 – Stakeholdeer Feedback
b.
b Table 3 – Stakeholdeer Resource Requests
3
4-7
7
V.
Listening
L
Seession Evalu
uation
a.
a Table 4 – On-site evaaluation find
dings
8
VI.
Appendix
A
A – Feedback
k Notecard
9
VII.
Appendix
A
B – On-site Evaluation
E
10
VIII. Appendix
A
C – Post-Sesssion Survey
y
11-13
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I.
Background
B
d
On May 14, 2013 the New
w York City Department of Health andd Mental Hyggiene held thhe last of five borough
listening sesssions to sharre the health department’ss new Take C
Care New Y
York (TCNY)) initiative annd gather
community feedback.
f
Co
ommunity-baased organizaations, healthh care provideers, and the general public joined
health departtment staff att Queens Borrough Hall to
o discuss straategies and innterventions tthat would efffectively
promote heallthy lifestyless and lead to improved
i
heaalth outcomess for all New Yorkers. Caamellia Morteezazadeh,
Executive Director of Taake Care New
w York, desccribed the ciity’s TCNY pplan and com
mmunity stakkeholders
shared ideas of strategies and
a interventiions to impro
ove the healthh of New Yorkkers.
II.
Methodolog
M
gy
Stakeholder feedback
f
wass captured viaa listening sesssion participaation and threee survey insttruments disseminated
during and affter the listeniing session to
o maximize op
pportunities tto elicit feedbback:
1. Noteecards: during the listeniing session, attendees w
were provideed with noteecards to share their
questtions/commen
nts, indicatee their interesst in receivinng additional information about specifiic TCNY
areass, and providee their contacct information
n if they wishhed to be connnected with organizations sharing
simillar interests (aattached in Ap
ppendix A).
2. Evalu
uation form: at the comp
pletion of th
he listening ssession, attenndees were pprovided withh a brief
evalu
uation form to
o assess their satisfaction with
w the sessioon (attached iin Appendix B
B).
3. Post--session surveey: following
g the listening
g session, atteendees were sent a web-bbased survey to assess
familliarity with TCNY
T
and interest
i
in TCNY
T
prioritty areas, heaalth departmeent resourcess, TCNY
partn
nership, and health
h
departm
ment facilitation of inter-aggency collabooration (attachhed in Appenddix C).
III.
Demograph
D
hics
Table 1. Qu
ueens Listen
ning Session
n Attendancce.
Total Numb
ber of
Attendeees
33
Stakeholder Type
(N) aand % of Tottal Attendeess
Com
mmunity-Bassed Organizattion
7 (21%)
Lab
bor Group
1 (3%)
Gov
vernment Org
ganization
4 (12%)
Heaalth Care Prov
vider
113 (39%)
Gen
neral Public
8 (24%)
*Governmen
nt organization
n attendees ex
xclude health department sstaff.
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IV.
Findings
F
Of the 33 paarticipants wh
ho attended th
he Queens lisstening sessioon, over a thiird were heallth care proviiders and
more than a quarter repreesented the general
g
publicc. The majorrity (25) of thhe attendees engaged in aan active
ority areas.1
discussion off seven of TCNY’s ten prio
The prevalen
nt themes of th
he Queens listening session
n feedback inncluded the foollowing:
 Menttal Health:
 Quantification
Q
n of children’s mental heallth problems.
ve Living
 Activ
 Creation
C
of ph
hysical activitty opportunitiies in schoolss.
 Promotion
P
of physical activ
vity by primaary care proviiders.
 Healthy Eating
 Enhancement
E
of access to healthy
h
food.
 Education
E
on healthy cook
king.
 Child
d & Adolesceent Health
 Prevention/co
P
ontrol of child
dhood obesity
y.
 Healthy Indoor & Outdoor Air
I
on of smoke-ffree NYCHA
A housing.
 Implementatio
 HIV Prevention
R
stig
gma of NYC condoms.
c
 Reducing
ving
 Tobaacco-Free Liv
 Reduction
R
of youth access to tobacco.
 Provision
P
of tobacco cessattion counselin
ng training too case manageers.
1
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
QueensListenin
ngSessionStakeh
holderFeedback
kSummary–Maay14,2013
Table 2. Stakeh
holder Feedbacck
Take Care New
w York
Priority Arrea
Relevan
nt Quotes
Stakehold
der Questions or Feedback
Partnerr with more menttal health organizzations.
Consid
der quantifying chhildren’s mental hhealth problems iin
NYC.
Mental Hea
alth
“How
w about bringing physical
p
activity back
b
to
the schools? I have a seven year old kid
k in
schoo
ol, there's one gym
m period per weekk. Back
in th
he day it was every
ry day, we were able
a to
play after school. Thiis would do wond
ders to
help the [obessity] problem.”
Addresss the lack of phyysical activity in sschools.
Consid
der initiatives thatt promote the preescription of physsical
activity
y from health carre providers.to paatients
Active Liviing
now physicians sttarted prescribing
g fruits
“I kn
and
d vegetables. You must do 25 minu
utes of
phyysical activity 5 tiimes a week then come
back to
o see me.”
Healthy Eatting
“On
ne of the things we
w hear from our clients
c
all the time is that it’s much cheaper to eat
unhealthy.
u
If you could provide some
4 Raise awareness
a
on hunnger and food insecurity issues in N
New
York City.
C
NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
QueensListenin
ngSessionStakeh
holderFeedback
inno
ovative ways for people
p
to eat healthier;
[forr example], you can
c show clients how
h to
prep
pare meals with a hot plate and diffferent
wayss to prepare food.. It’s much easierr to buy
McDonalds dollar menu.”
Promote education on hhealthy cooking.
Consid
der working with restaurants to subbsidize healthier meal
optionss or smaller portiions.
Consid
der educating the public on nutritioon labeling.
“I kno
ow there’s a lot of labeling going on, but
with
hout the education
n component, eveen if it
says 1000
1
calories, peo
ople still think theey'll be
oka
ay.”
Promote initiatives thatt implement smokke-free housing inn
NYCH
HA housing.
Healthy Indo
oor &
Outdoor Air
A
Tobacco-Free Living
Consid
der repackaging thhe NYC condoms, as they are
stigmaatized by clients
on't see much in th
he goals about reeducing
“I do
yo
outh access to tob
bacco, I know theere’s
leg
gislation on the ta
able at the city cou
uncil.
5 Consid
der conducting sm
moke-free housingg outreach to fam
milies.
NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
QueensListenin
ngSessionStakeh
holderFeedback
We'rre working on thiis in Queens arou
und the
boro
ough but I want to
o get a sense of what
w
the
department iss looking to do.”
Provid
de tobacco cessatiion counseling traaining to case maanagers
workin
ng in public housiing.
“I just
j wanted to ad
dd one more thing
g with
heallthy homes. One of
o the things that would
be veery helpful in red
ducing tobacco usse, is to
look at the NYCHA ho
ousing. What can
n we do
from
m a city standpoin
nt? It’s hard to wo
ork on
outsiide voluntary land
dlords especially on low
inco
ome areas. They say-what
s
about th
he city
and NYCHA
N
housing?
? I think this wou
uld help
givve us momentum, especially in Queens.
Ma
anhattan has bettter development and
a a
population that will pa
ay more in rent to
o live in
smokke free housing. In
I Queens it’s harrder to
say if you want to livee in smoke free ho
ousing,
pay hig
gher rent.”
Additional Feed
dback
“C
Collaboration is important between
n the
organizations
o
because there aren't a lot of
resources flowin
ng into the area, so
s we
need to take advvantage of the serrvices
that are already
a
there.”
6 Facilitaate collaboration between commuunity partners so tthey
can shaare resources.
NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
QueensListenin
ngSessionStakeh
holderFeedback
“Seend people out to different organizzations
and explain wh
hat you're doing.”
”
Publiciize information reegarding Take Caare New York annd the
health department’s woork to community groups and at cittywide
public events.
“Therre are some Clean
n NYC Parks even
nts, and
wee sponsor an asth
hma day at the Jacob
Resetttlement House. TTCNY
T
should try to take
advantage of these events that are alrready
g citywide.”
happening
“We've been a membeer of TCNY since pretty
h the start, just lo
ooking at the list, I find
much
we'vee worked on 6 of the 10 [priority areas].
a
But nobody
n
ever asked
d. We would like to add
our info
i
to this, it’s ceertainly too late for
f the
past, but fro
om now on”.
ve tracking of TC
CNY partners’ woork on priority areeas of
Improv
interest.
T
Table 3. Stakeh
holder Resourcce Requests
Take Care New
w York
Priority Area
Tobacco-Free Liiving
Resource Requ
uests
Tobacco-cessatiion counseling traaining for case maanagers.
HIV Prevention
Rebranded NYC
C condoms.
7 NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
QueensListenin
ngSessionStakeh
holderFeedback
V.
Listening Session Evaluation
T
Table 4. On-sitte Evaluation Findings
F
(N-24)*
Questions Stakeho
older Average Raating 1. Overall satisfaaction with this listening session. 4.3
2. The forum helped me learn mo
ore about Take C
Care New York (TC
CNY). 4.3
3. The presentattion and handoutts were informatiive. 4.1
4. Sufficient time
e was allocated for questions and answers. 4.2
5. The program w
was well planned
d and interactive.. 4.3
**Participants werre asked to rate th
heir agreement wiith the statementss above on a scalee of 1-5: 1=Poor;; 2+Fair; 3=Goodd; 4=Very Good;
55=Excellent. The evaluation form is attached in Ap
ppendix B.
D
Due to the small sample
s
size of 6 from
f
the online su
urvey (survey atttached in Append
dix C) there are noo results to displaay from the Queens online
ssurvey.
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VI.
Appendix
A
A:
A Feedback
k Notecard
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VII.
Appendix
A
B:
B On-site Ev
valuation
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VIII. Appendix
A
C – Post Sesssion Survey
y
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13 Attachment VIII. Staten Island University Hospital Community-based CHNA Survey and
Results
Methodology
•
•
•
Survey
– 20 questions
– SIUH Community Advisory Board
– SIUH community partners
– 61 potential survey recipients identified: 6 schools, 6 government entities, and 49
community-based organizations
Distribution
– Electronic survey through SurveyMonkey & paper copy of survey
– Personalized invite in person to Community Advisory Board in March 2013
– Personalized invite by email to community partners in April 2013 with follow up email
invites in May 2013
American Parkinson Disease Association
City Harvest
Community, Growth, and Opportunity, Inc.
Community Health Action of Staten Island
Eger Harbor House Inc., Assisted Living Program
Healthy Families Staten Island
Jewish Board of Family and Children’s Services
Staten Island Branch of the NAACP
Staten Island Children’s Home Intervention Program
Staten Island Partnership for Community Wellness (2)
Community Businesses
Nate’s Pharmacy
Government
New York City Housing Authority
Community Health Center of Richmond, Inc.
Primary Care Ambulance
Philanthropy
Service Auxiliary
Religious Organizations
First Central Baptist Church
Staten Island Hindu Temple, Inc.
related focus areas and goals.
Priority Score
Preventing chronic disease. Examples: reduce obesity in children and adults, reduce
illness and disability related to tobacco use and second hand smoke, and increase access to
preventive care and health screenings.
4.21
2.95
Promote healthy women, infants, and children. Examples: reduce premature
births and unplanned pregnancies, increase prevalence of breastfed babies, and increase
access to well child care.
Promoting a healthy and safe environment. Examples: reduce fall risk among
vulnerable populations, reduce occupational injury and illness, and violence prevention.
2.89
2.47
2.47
Drugs & Alcohol Abuse
Obesity, Weight Loss Issues
Diabetes
Cancer
Safety
HIV/AIDS & STDs
63.16
42.11
63.16
36.84
26.32
26.32
21.05
36.84
31.58
21.05
10.53
15.79
0
0
10
20
30
40
50
60
70
Resources
Access to Healthy Foods
Primary Care
Chronic Disease Management
Referrals
Community Health Programs
Screenings
Wellness
Family or Friends
Hospital
Internet
Television
Radio
Worksite
Health Department
School, College
Library
68.42
57.89
52.63
42.11
42.11
36.84
21.05
21.05
21.05
15.79
10.53
5.26
0
10
20
30
40
50
60
70
80
73.68
Drug & Alcohol Rehabilitation Services
47.37
42.11
42.11
Job Opportunities
36.84
36.84
Transportation
21.05
15.79
10.53
Safe Places to Walk , Play
10.53
Clean Air & Water
5.26
Safe Worksites
0
0
10
20
30
40
50
60
70
80
Drug & Alcohol
Nutrition
Blood Pressure
Cancer
Diabetes
Heart Disease
Cholesterol
HIV/AIDS & STDs
Dental Screenings
Disease Outbreak Information
Suicide Prevention
Prenatal Care
52.63
42.11
52.63
36.84
36.84
26.32
26.32
26.32
10.53
26.32
21.05
26.32
26.32
21.05
15.79
15.79
10.53
0
10
20
30
40
50
60
(select top 3 barriers to medical treatment)
No Insurance
73.68
Don't understand need to see a doctor
57.89
57.89
47.37
Transportation
31.58
26.32
Language Barriers
26.32
Don't Know How To Find Doctors
15.79
15.79
5.26
0
10
20
30
40
50
60
70
80
Language Access & Cultural Sensitivity*
Health Access
Health Education
Healthy Foods
Jobs
Transportation
*Identified by multiple respondents
Strategies
Collaboration
Health Awareness & Educational Programs
Take Care New York
•
•
•
May 7, 2013 New York Department of Health and Mental Hygiene
held a Staten Island listening session to share the health
department’s new TCNY initiative and gather community feedback
Brought stakeholders together to discuss strategies and
interventions to improve health outcomes for all New Yorkers
Stakeholders:
• Community-based Organizations
• General Public
• Healthcare Providers
Stakeholders
Stakeholder Type
Number in Attendance
5
Educational Organizations
3
Government Organizations
1
22
Labor Groups
2
Other
5
Total in attendance: 38
TCNY Priority Areas
TCNY 2016 Priority Areas
2. Healthy Eating
3. Active Living
8. Prevent & Treat Cancer
4. Heart Health
5. HIV Prevention
10. Quality Preventive Care
With a focus on child & adolescent health
TCNY Staten Island Priority Areas
Priority Area
Ranking
Active Living
1
Healthy Eating
2
Tobacco-Free Living
3
Reduce Alcohol & Substance
Abuse
4
Healthy Indoor & Outdoor Air
5
Findings
1. Active Living
• Promote usage of parks & playgrounds
• Increase advertisements that promote walking & mileage
• Strategies for adults to increase exercise
2. Healthy Eating
• Educate bodega owners on fresh fruits & vegetables
• Improve healthier food choices in vending machines
• Replicate proven weight-loss programs
Findings
• Increase prevention messages to children & adolescents
• Provide smoking cessation point of service options
• Halt the closing of substance abuse & detox centers on the
island
• Increase information on the quality of air after Hurricane Sandy
Stakeholder Resource Request
TCNY Priority Area
Resource Request
1) Promote Mental Health
1) Organizations would like to
partner with CBOs or hospitals
so that more people are aware
of services
2) General Feedback
2) DOHMH pamphlets &
literature have been unavailable
through 311. DOHMH should
provide more printed health
information in Spanish.
Priority Area Comparison
Staten Island University Hospital & TCNY
SIUH Priorities
TCNY Priorities
1. Preventing Chronic Disease
1. Active Living
2. Promote Mental Health & Prevent 2. Healthy Eating
Substance Abuse
3. Promote Healthy Women, Infants, 3. Tobacco-Free Living
& Children
4. Promoting A Healthy & Safe
Environment
4. Reduce Alcohol & Substance
Abuse
5. Preventing HIV, Sexually
Transmitted Diseases, VaccinePreventable Diseases, & Hospital
2014-2017 NYS Community Service Plan & Community Health
Needs Assessment Implementation Plan Priority Selection
•
FOCUS AREA: Reduce Obesity in Children & Adults
•
•
•
•
•
FOCUS AREA: Increase Access to high-quality chronic disease preventive care &
management in both clinical & community settings
•
•
•
•
Create community environments that promote & support healthy food beverage choices &
physical activity
Prevent childhood obesity through early child care & schools
Expand the role of health care, health service providers, & insurers in obesity prevention
Expand the role of public & private employers in obesity prevention
Increase screening rates for cardiovascular disease, diabetes, & breast/cervical/colorectal
Promote use of evidence-based care to manage chronic diseases
Promote culturally relevant chronic disease self-management education
NewYorkCiityDepartmeentofHealth
handMentalHygiene
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StatenIslandListeninggSessionStak
keholderFeeedbackSumm
mary–May7
7,2013
Table
e of Contentts I.
II.
III.
IV.
V.
VI.
VII.
VIII.
Background B
Methodolog
M
gy Demographi
D
ics a.
a Table 1 ‐ Stakeholde
er Attendancce Findings F
a.
a Table 2 –
– Stakeholde
er Feedback
b.
b Table 3 –
– Stakeholde
er Resource Requests Listening Ses
L
ssion Evaluaation a.
a Table 4 –
– On‐site evaaluation find
dings b.
b Table 5 –
– Familiarity with TCNY p
prior to sess ion c.
c Table 6 –
– Priority Are
eas of Intere
est d.
d Table 7 –
– Communityy Resource Interests
e.
e Table 8 ‐ Interest in P
Partnership
Appendix A A
– Feedback Notecard
Appendix B –
A
– On‐site Evvaluation Appendix C –
A
– Post‐Session Survey
1 2
2 2
2 2
2 3
3‐7 7
7‐10 1
11 1
12 1
13‐15 NewYorkCiityDepartmeentofHealth
handMentalHygiene
TakeCareN
T
NewYorkBo
mary–May7
7,2013
I.
Backkground On May 7, 20
013 the New York City Department of Health and M
Mental Hygien
ne held the ffourth of five borough listening sessions to sharre the health
h department’s new Takee Care New York (TCNY) initiative and gather community feedback. f
Co
ommunity‐based organizations, health care provideers, and the general publlic joined government representatives at the Visiting V
Nurse
e Service of N
New York Citty in Staten Island, NY to
o discuss nd interventio
ons that wou
uld effectively promote hhealthy lifestyyles and lead
d to improveed health strategies an
outcomes fo
or all New Yo
orkers. It was w convened
d by Ewel Naapier, Directo
or of Community Partnerships at DOHMH and Camellia Mo
ortezazadeh, Director of Take Care New
w York. Also p
present weree TCNY staff aand eight content expe
erts from DOH
HMH. II.
Methodology Stakeholder feedback was w
captured
d via listening session participation
n and three survey insttruments d during and aafter the liste
ening session to capture m
maximum feed
dback, listed b
below: disseminated
1. Notecards: durin
ng the listenin
ng session atttendees weree provided with notecards to further sh
hare their que
estions/comm
ments, interest in receivingg additional iinformation aabout specificc TCNY areas, and the opp
portunity to p
provide their contact inforrmation if th ey wished to
o be connecteed with organizations sharing similar in
nterests (attacched in Appendix A). mpletion of th
he listening ssession atten
ndees were p
provided with a brief 2. Evaluation form: at the com
evaluation form to assess their satisfaction
n with the listtening session
n (attached in
n Appendix B). 3. Postt‐session survvey: followingg the listeningg session atteendees were sent a web‐b
based survey to assess fam
miliarity with TTCNY and further interest in TCNY prioority areas, heealth departm
ment resourcces, TCNY parttnership, and
d health depaartment faciliitation of inteer‐agency co
ollaboration (attached in A
Appendix C). III.
Dem
mographics Table 1. Sta
aten Island LListening Sesssion Attend
dance. Total Num
mber of Attendees Stakkeholder Type
(N) and % of Totaal Attendees Co
ommunity‐Base
ed Organization 5 (13%) He
ealth Care Provvider 22 (58%) Go
overnment Orgganization 1 (3%) Ed
ducational Orgaanization 3 (8%) Labor Group Otther 2 (5%) 5 (13%)
38 *Governmen
nt organization attendees e
exclude healtth departmennt staff. 2 NewYorkCiityDepartmeentofHealth
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IV.
Findings The Staten Issland listeningg session inclu
uded 21 regisstered attenddees and 29 w
walk‐in particiipants. Of thee 50 participants w
who attended
d the Staten IIsland listenin
ng session, 244 engaged in aa wide‐rangin
ng and robustt 1
discussion th
hat directly orr indirectly co
overed all of TTCNY’s ten priiority areas. Many of thee discussions ccovered issues that allign with TCNY’s particularr focus on Chiildren and Addolescent Heaalth. The prevalen
nt themes of tthe Staten Islaand listening session feed back included
d the followin
ng:  Activve Living  Promote the u
P
usage of parkks and playgro
ounds.  Increase adve
ertisement that promotes walking and m
mileage markkers.  Strategies for adults to increase exercisse. S
 Healtthy Eating  Educate bode
E
ega owners on
n fresh fruits and vegetablles.  Improve healtthier food cho
oices in vending machiness. R
ven weight‐lo
oss programs.  Replicate prov
 Tobaacco‐Free Living  Increase prevention messaages to children and adoleescents.  Provide smok
P
king cessation
n point of servvice options.  Redu
uce Alcohol &
& Substance A
Abuse  Halt the closin
H
ng of substance abuse and
d detox centeers on the island.  Healtthy Indoor & Outdoor Air  Increase inforrmation on th
he quality of aair after Hurriicane Sandy
1
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
StatenIslandListeeningSessionStaakeholderFeedb
backSummary––May7,2013
TTable 2. Stakeholder Feedbackk Take Care New York Priority Area
a Relevant Quotes Active LLiving “Staten Island has the most cityy parks and theree’s ation accessibilityy to these parks. We public transporta
need to take ad
dvantage of that. Everywhere you go there’s a park, how can we get peo
ople to do school trips to the park? We have a lot of nice parks here”.. “There is a corrrelation between
n active living and
d healthy eating. II don’t see it with
h adults though, o
only with kids. I’ve never seen any med
dia campaigns ab
bout active living for a
adults. We should
d focus on promoting things that an avverage family can
n participate in likke a park day…once you get a family involved the effeects trickle down to ch
t
hildren and childrren influence peeers. I know there’s a ne
k
ew incentive with
h the bikes in the city, but I don’t see anything in SStaten Island”. SStakeholder Queestions or Feedbaack Re‐instituute mileage markkers on boardwalks, in parks, and in othher public spacess. Consider initiatives that offer family vouch
hers and babysittinng at health clubss and other placees where adults exeercise. Work witth the Parks Depaartment to promo
ote Active Living fam
mily days in the parks. Promote physical activity by renovating the playgrounnds at Staten Islaand’s many suppo
ortive housing ssites. Consider developing Stateen Island sugar sw
weetened beveragees awareness ads on how long it taakes to walk off a sugaar‐sweetened bevverage, but makee them borough sspecific (i.e. from
m Clove Lake to Stt. George). 4 orkCityDepartm
mentofHealthan
ndMentalHygieene
NewYo
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
Take Care New York Priority Are
ea Healthy Eating Relevant Quotes Stakeholder Qu
uestions or Feedb
back “How can the cityy assist or incentiivize bodegas to carry more fresh f
c
food”? “Healthier choicees in vending macchines are more costly, reducing t
c
the shared revenu
ue – and the incentive. Also, h
i
ealthy options do
on’t always have the same brand recog
s
gnition as unheallthy choices”. “At City Harvest, bodega owners ccan come to our workshop to lear
w
n how to get fressh produce into th
heir stores. Local food
s
d distribution and
d connect those stores with local f
s
farmers and grow
wers”. Educate bbodega owners on
n how to get fressh food in their stores. Link activee living & healthyy eating to workin
ng in communitty gardens. Use food ddistribution sites to distribute heaalth‐related materials from other CBOss and hospitals. Replicate initiatives such as the “Staten Islaand Slim Down” proogram. 5 NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
Take Care New
w York Priority Are
ea Tobacco‐Frree Living Relevant Quottes Stakeholder Q
Questions or Feed
dback “We need to hold
d people more acccountable for heealth issues. This isn’t rocket science, evveryone knows but people are stilll making the cho
oice smoking is bad b
to smoke. Addicttion is difficult. Th
here needs to be a
a rehab center speecific for smoking,, smoking is definitely a gatew
way drug. Peoplee who start out veery Consider m
more smoking prrevention messagges and young are more likely to smoke th
hroughout their campaign s to young people. The younger yyou start smoking
g whole life. We neeed to do more preventive, ratherr the more likely you are to continue into adulthood that complain ab
bout not enough ffunding”. “Staten Islan
nd was the last bo
orough to have a
a smoking cessatiion program in th
he city, but when you were able to han
nd someone someething at the poin
nt of service it was integral to gettin
ng people to quit””. Take Care New
w York Priority Are
ea Reduce Alcohol & Substance Abuse Relevant Quottes “Staten Island iis hardest hit in ssubstance abuse b
but they are closing detox centers an
nd units in the Sta
aten Island Hospita
al. We won’t know the impact for a while. We have tto be careful about closing these u
units that are so neecessary. I don’t kknow the city’s ro
ole surrounding h
hospitals for patieents and recoveryy”. 6 Stakeholder Q
Questions or Feed
dback NewYo
orkCityDepartm
mentofHealthan
ndMentalHygieene
TakeCa
areNewYorkB
Borough‐WideL
ListeningSessio
ons
Take Care New
w York Priority Are
ea Healthy Indoor &
& Outdoor Air Relevant Quotes “After Sandy, p
people are concerrned with qualityy of life and qualityy of air; they are sscared of mold an
nd outdoor air polluta
ants”. Stakeholder Q
Questions or Feed
dback Whatt are initiatives on
n air quality in Staten Island? TTable 3. Stakeholder Resource
e Requests Take Care New Y
York Priority Are
ea Promote Mental Health Resourrce Requests Organizations have bee
en doing a lot of eeducation to the community and w
would like to partner with CBOs pitals so that more people are aw
ware of the servicees that we have. or hosp
General Feedbacck DOHM
MH pamphlets and
d literature are offten unavailable tthrough 311. Thee Health Departm
ment should provide
e more health infformation printed
d in Spanish. V
V.
Listeningg Session Evaluation TTable 4. Staten Island Listeningg Session Onsite
e Evaluation Fin
ndings* (N=25)
Questions Stakeho
older Average Raating 1. Overall satisfaaction with this listening session. 4.2
2. The forum helped me learn mo
ore about Take C
Care New York (TC
CNY). 4.1
3. The presentattion and handoutts were informatiive. 3.9
4. Sufficient time
e was allocated for questions and answers. 4.3
5. The program w
was well planned
d and interactive.. 4.3
**Participants werre asked to rate ttheir agreement w
with the stateme
ents above on a sccale of 1‐5: 1=Pooor; 2=Fair; 3
3=Good; 4=Very G
Good; 5=Excellen
nt. The evaluation
n form is attached
d in Appendix B
handMentalHygiene
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Table 5. Sesssion Attend
dees’ Familiaarity with TC
CNY prior to
o the Listenin
ng Session.((N=6) *Survey attacched in Appendix C. Were
e you familiarr with Take Caare New Yorkk (TCNY) prio
or to registeriing for this listening sesssion?
16.70
0%
Yes
No
16.70%
Somew
what
66.70%
Table 6. TCN
NY Priority A
Areas of Inte
erest % of Attendees W
Working or Intterested in Workingg on the Topic 883.3% 666.7% 666.7% 333.3% 16.7% 16.7% 333.3% 333.3% 550.0% 550.0% TCNY Prioritty Areas Tobacco‐Fre
ee Living Healthy Eatting Active Living Heart Healtth HIV Preventtion Promote Mental Health Reduce Alco
ohol and Riskky Substance Use Prevent and
d Treat Cance
er Healthy Indoor and Outd
door Air Quality Prevventive Care 8 NewYorkCiityDepartmeentofHealth
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Table 7. Com
mmunity Re
esource Interests.* Not In
nterested Somewhatt Interested Intereested N/A N Connection
n with local organizatio
ons working on similar h
health initiatives 0% 16.7% 66.7%
16.7
7% 6 Facilitation
n of a cross‐
organizatio
onal resource portal 0% 0% 100% 0% 4 Cross‐organ
nizational Workshopss or Trainingss 0% 33.3% 66.7%
0% 6 Webinars featuring resources a
and local case
e studies 0% 0% 100% 0% 6 Newsletterr articles 0% 25% 75% 0% 4 Information
nal briefs or fact sheets on key health issue
es 0% 0% 100% 0% 5 Tool kits 0% 0% 100% 0% 6 Social media assistance 0% 16.7% 66.7%
16.7
7% 6 Communityy data to support pro
ogram developme
ent and partnership
p efforts 0% 0% 100% 0% 6 *Participantss were asked to rate their interest in the resources aabove, on a sccale of 1‐3: 1==Not Interestted; 2=Somewhatt Interested; 3
3=Interested.. 9 NewYorkCiityDepartmeentofHealth
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erest in Take Care New York Partne
ership Table 8. Inte
Would yo
our communiity organizatiion, business, health care provider, business,, labor group or faith‐base
ed organization be interessted in becomingg a Take Care
e New York?
Yes
No
I am already a TCNY partner
50%
50%
Don''t Know
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VI.
Appe
endix A Feedb
back Noteca rd 11 NewYorkCiityDepartmeentofHealth
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VII.
Appe
endix B 12 NewYorkCiityDepartmeentofHealth
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VIII.
endix C Appe
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15 Attachment X. Suffolk County Community-based Organization CHNA Survey and
Results
Suffolk County
Methodology
•
•
•
Survey
– 15 questions
needs in community, community health status, barriers, health improvement strategies
– Organizations identified as community partners in Suffolk County
Distribution
– Personalized invite by email in Spring 2013 with follow up email invites
– Survey closed June, 2013
Type of Respondent
Total
Business
3
Community-based
Organization
23
Educational Organization
13
Government
12
Hospital/Healthcare Provider
9
Other/Unknown*
42
TOTAL = 102
*Respondent did not provide information
Q 1 What are the biggest health problems for the people/community you
serve? (select top 5 health concerns)
Drug & Alcohol Abuse
52.9
38.2
Obesity, weight Loss Issues
49
Nutrition, Eating Habits
25.5
24.5
Smoking, Tobacco Use
Cancer
41.2
Diabetes
34.3
32.4
27.5
Care For The Elderly
43.1
Falls In The Elderly
13.7
12.7
Memory Loss
21.6
Teen Pregnancy
15.7
Premature Births
0
HIV/AIDS & STDs
11.8
10.8
9.8
10.8
10.8
Access To Vaccinations
Infections
Environmental Problems (water, pollution, air, etc)
Violence In Home, Guns, Murder, Rape, Other
Preventable Injuries
5.9
0
10
20
30
% respondents choosing health problem
40
50
60
Q 2 What would be most helpful to improve the health problems of the
people/community you serve? (select top 5 health concerns)
Health Education Programs
Drug & Alcohol Services
Affordable Housing
Health Screenings
Job Opportunities
Access To Healthier Food
Transportation
Home Care Options
Insurance Enrollment Programs
Clean Air & Water
Safer Places To Walk & Play
Parks & Recreation
Farmer's Markets
Safer Child Care Options
More Grocery Stores
Better Schools
Breastfeeding
Safer Work Places
43.1
42.2
40.2
38.2
38.2
34.3
32.4
30.4
29.4
28.4
20.6
14.7
14.7
13.7
11.8
9.8
4.9
3.9
2
2
0
10
20
30
40
50
Q 3 Do any people/communities you serve in Suffolk have problems getting
needed health care?
Health Care Access
22%
Yes
No
78%
Q 4 If you answered yes to Q 3, what do you think are the reasons?
No Insurance & Unable To Pay For Care
91.1
Unable To Pay Co-pays & Deductibles
75.9
Transportation
49.4
Language Barriers
32.9
Don't Understand Need To See Doctor
30.4
Fear (e.g. not ready to face/discuss health problem)
29.1
20.3
Don't Know How To Find Doctors
13.9
Cultural, Religious Beliefs
8.9
0
20
40
60
80
100
Q 5 What types of health screenings &/or services are needed to keep people
healthy in the community you serve? (select top 5 screenings/services)
43.9
41.5
Drug & Alcohol
Suicide Prevention
Blood Pressure
Cancer
Diabetes
Cholesterol
Heart Disease
Nutrition
Weight Loss Help
Eating Disorders
Routine Well Checkups
Dental Screenings
Quitting Smoking
Prenatal Care
HIV/AIDS & STDs
Disease Outbreak Prevention
Falls Prevention In Elderly
Memory Loss
7.3
42.7
42.7
37.8
32.9
18.3
36.6
30.5
25.6
14.6
34.1
31.7
22
8.5
14.6
9.8
13.4
4.9
12.2
8.5
0
10
20
30
40
% respondents choosing health screening or service
50
Q 6 What health issues do the people/community you serve need education
about? (select top 5 education topics)
47.6
Diabetes
Blood pressure
Heart Disease
Cholesterol
Cancer
Drug & Alcohol
Suicide Prevention
Nutrition
Eating Disorders
Routine Well Checkups
Quit Smoking
Dental Screenings
Prenatal Care
Disease Outbreak Prevention
Falls Prevention In Elderly
HIV/AIDS & STDs
34.1
29.3
28
24.4
46.3
43.9
9.8
40.2
32.9
12.2
31.7
26.8
20.7
12.2
15.9
9.8
14.6
14.6
8.5
0
10
20
30
% respondents choosing education topic
40
50
Family or Friends
Television
Internet
Hospital
Library
School, College
Worksite
Other Social Media
Church Group
Health Department
Radio
Facebook, Twitter
67.1
58.5
51.2
47.6
30.5
22
20.7
19.5
17.1
15.9
15.9
13.4
12.2
11
0
10
20
30
40
50
60
70
80
Q 8 What do you think makes a community healthy?
Healthy Community
Community Support & Unity
Knowledge of a Healthy
Lifestyle/Health Literacy
Education
Prevention Programs &
Services
Access to Affordable
Healthcare
Community Support Services
Access to Healthy &
Affordable Food
Policies Supporting Healthy
Lifestyles
Access to Quality & Affordable
Transportation
Housing
Collaboration Amongst
Recreation Areas
Jobs
Communication
Q 9 How would you rate the health of the people/community you serve?
70
61
60
50
40
30
22
20
13.4
10
3.7
1.2
0
Somewhat
Healthy
Healthy
Unhealthy
Very
Very Healthy
Unhealthy
% respondents choosing health rating
Q 13 Tell us about the populations your organization serves.
(Check all that apply)
90
80
70
60
50
40
30
20
10
0
83.3
78.8
77.3
68.2
62.1
21.2
% respondents choosing population served
16.7
Attachment XI: Suffolk County Community-Based Organization Survey
Participants
Tina Stone RN
Participant
Affiliation
William Floyd School district
Jennifer Dzvonar
North Brookhaven Chamber of Commerce
Dave Williams
Port Jefferson FD
Kathleen Brennan
President Port Jefferson Board of Ed.
Teresa Ergul RN
Debra Engelhardt
Moriches Elementary School
Comsewogue Public Library
April Ortiz
Suffolk County Department of Health
Claire McCarthy
Mary Alvar
J. O'Donnell
Gail Lynch-Bailey
thomas talbot
Karen A. Rade
Laura Giardino
Erma Gluck
Helen Crosson
Kathleen Johnson
William Floyd High School
William Floyd School District
William Floyd School District
The Longwood Alliance
Middle island civic association
Montauk Library
Suffolk county Dept. of health
Coram Civic Association
Cold Spring Harbor
Port Jefferson Ambulance
Jason Lazerus
Port Jefferson Volunteer Ambulance
Barbara Ransome
Greater Port Jefferson Chamber of Commerce
Ronnie Kreitzer
Three Village Meals on Wheels Inc.
Paula Klee Parish
Performance Solutions,
Inc/Womenonthemoveli.com
Tara D'Amato, Community Services Coordinator
Mastics Moriches Shirley Community Library
Lauren Nichols
Patchogue Medford Library
James Olney
Northport-East Northport Public Library
r. maggio
Rich Schlude
port jefferson free library
Miller Place Fire Dept
Patty Vorilas
Babylon Village Chamber of Commerce
Betsy Maniotis
Pastor Thomas Humphrey
Laurie Golan
SBPWN
Long Island Men's Center
Long Island Youth Mentoring
S. Kathleen Carberry
Robyn Berger-Gaston
The Learning Connection
FAmily Service League
Margaret Bakos
Stony Brook U School of Dental Medicine
SANDRA GIL
Patricia Carley
Matthew Ellwood
ann aboulafia
Mary Louise Cohen
SUFFOLK COUNTY DEPT. OF HEALTH
Sunrise Senior Living
Bay Shore Wellness Alliance
aboulafia & june cpas pc
William J. St. George
St.James Rehabilitation& Healthcare
Ted
mariusz borkowski
Janet Sklar
Nagengast
Bay Shore Wellness Alliance
ES BOCES @ Bay Shore UFSD
Nancy Hemendinger
Walter Ladick
Geogeine Bellando
Brookhaven Hospital
Katelin Thomas
Suffolk Project for AIDS Resource Coordination
(grant-funded program based out of Stony Brook
University)
Staci M. Spencer
Linda S Reich
Catherine Shannon
South Fork Comm. Health Init.
Catholic Charities
St. Catherine of Siena Med Center
Marian Russo
Village of Patchogue Community Development
Agency
Kathleen Valerio
Stony Brook University Health Education Office
CPO @ SHS
Ronald Kaplan
FEGS
Dorothy S. Lane, MD
Stony Brook University Medical Center
Joel Vetter
Suffolk OEM
Kathleen Burger
Suffolk County Community College - Brentwood
Campus
Martha Kahan
Marianne Zacharia
Nancy Olsen-Harbich
Connie Kraft
Jennifer Logiudice
Janine Logan
Eastern Suffollk BOCES
Cornell Cooperative Extension
St. Catherine of Siena Medical Center
Attachment XII. NSLIJHS Nassau, Queens and Suffolk Mental Health
Community-based Entity Survey and Results
South Oaks Hospital
&
Zucker Hillside Hospital
Community Health Needs Assessment CBO Survey
Methodology
•
•
•
Survey
– Tailored to mental health and substance abuse
– 23 questions
needs in community, barriers, resources, organization sustainability, health improvement
strategies
– Long Island Behavioral Health Management BHO Advisory Committee as of April, 2013
– Community-based organizations requested by ZHH
– 47 potential unique entity respondents: CBOs = 20; Hospitals = 21; Government = 6
Distribution
– Personalized invite by email in April 2013 with follow up email invites in May and June 2013
– Focus on CBOs for follow up email invites
Service Location Key
N = Nassau County Only
S = Suffolk County Only
LI = Island Wide
S
Concern for Independent Living, Inc.
N
Family and Children’s Association
S
Family Service League
LI
Long Island Behavioral Health Management (2)
LI
Long Island Recovery Association
N
Mental Health Association of Nassau County, Inc.
S
Mental Health Association in Suffolk County, Inc.
N
Mental Health Association PROS
N
NAMI Queens/Nassau
N
South Shore Association for Independent Living, Inc.
Government
N
Nassau County Office of Mental Health, Chemical Dependency, & Developmental Disabilities Services
LI
NYS Office of Mental Health
LI
NYS Office of Mental Health- LI Field Office
S
Suffolk County Department of Health, Division of Community Mental Hygiene
Hospitals
N
Franklin Hospital
S
John T. Mather Memorial Hospital
S
South Oaks Hospital (2)
S
Southside Hospital (2)
related focus areas and goals.
Priority Score
4.52
Preventing chronic disease. Examples: reduce obesity in children and adults, reduce
illness and disability related to tobacco use and second hand smoke, and increase access to
preventive care and health screenings.
Promoting a healthy and safe environment. Examples: reduce fall risk among
vulnerable populations, reduce occupational injury and illness, and violence prevention.
3.48
2.76
Promote healthy women, infants, and children. Examples: reduce premature
births and unplanned pregnancies, increase prevalence of breastfed babies, and increase
access to well child care.
2.19
2.05
Drug & Alcohol Abuse
Obesity & Weight Loss Issues
Diabetes
Asthma & Lung Disease
Cancer
Safety
HIV/AIDS & STDs
85.71
85.71
28.57
23.81
23.81
9.52
9.52
28.57
4.76
9.52
4.76
4.76
0
0
20
40
60
80
100
Resources
Examples
Community Education
Programs & Awareness
Healthcare providers, clinics
Counseling (Inpatient &
Outpatient)
Narcan
Housing
Referrals
Screenings
Support Groups
Local physicians
Family or Friends
Hospital
Internet
Television
Health Department
Radio
School, College
Worksite
Case Management*
Library
66.67
61.9
57.14
47.62
38.1
23.81
23.81
14.29
14.29
14.29
14.29
9.52
9.52
0
20
40
60
80
Drug & Alcohol Rehabilitation Programs
Job Opportunities
Transportation
Clean Air & Water
Safe Places to Walk & Play
Safe Worksites
Housing*
90.48
71.43
42.86
23.81
23.81
19.05
19.05
4.76
4.76
4.76
4.76
4.76
4.76
0
20
40
60
80
100
Drug & Alcohol
Suicide Prevention
Diabetes
Blood Pressure
Heart Disease
Cancer
HIV/AIDS & STDs
Cholesterol
Nutrition
Dental Screenings
Prenatal Care
71.43
61.9
42.86
38.1
19.05
14.29
9.52
4.76
14.29
14.29
14.29
19.05
9.52
4.76
9.52
0
10 20 30 40 50 60 70 80
Q 17 Of the following healthcare providers, who are people in the community
you serve most likely to turn to for initial help for mental health and/or
substance abuse concerns?
Community MH Agency, Alcohol & Drug Tx…
42.86
Hospital Emergency Room
38.1
Primary Care Provider
14.29
Private Therapist
4.76
AA or other support group
0
School Counselor
0
Urgent Care
0
0
10
20
30
40
50
% respondents identifying initial point of access for mental health & substance abuse services
Q 18 To what degree is your organization negatively impacted by current
service delivery regulations and policies of the state, county, or local
government?
60
50
47.62
42.86
40
30
Response selection (%)
20
9.52
10
0
Highly
Affected
Moderately
Affected
Minimally
Affected
Q 19 How fiscally sustainable do you feel your organization is under the
current funding structures?
Sustainability (%)
4.76
23.81
Highly Sustainable
Moderately
Sustainable
At Risk of Closing
71.43
52.38
Unable to Pay Co-pays/Deductibles
47.62
No Insurance
42.86
Transportation
42.86
28.57
Don't Understand Need to See a Doctor
28.57
Don't Know How to Find Doctors
9.52
Language Barriers
9.52
4.76
0
0
10
20
30
40
50
60
Housing- residential services, supervised housing, stable/permanent/affordable
housing
Improved Access to Services- insurance, ambulatory clinics, referral
mechanisms
Integration & Education of Other Healthcare Providers- co-occurring disorders,
primary care physicians
Providers- psychiatrists
Transportation- public transportation
Strategies
Advocacy
Community Education & Awareness
Education & Integration with Healthcare Providers
Expansion of Services
Grant Seeking
Transportation
2014-2017 NYS Community Service Plan & Community Health
Needs Assessment Implementation Plan Priority Selection
PRIORITY AREA: Promote Mental Health & Prevent Substance Abuse
•
FOCUS AREA: Promote Mental, Emotional, & Behavioral Health
•
•
FOCUS AREA: Prevent Substance Abuse & Other Mental, Emotional, & Behavioral
Health Disorders
•
•
•
•
•
Promote mental, emotional, & behavioral well-being in communities
Prevent underage drinking, non-medical use of prescription drugs by youth, & excessive
alcohol consumption by adults
Prevent & reduce occurrences of mental, emotional, & behavioral disorders among youth &
adults
Prevent suicides among youth & adults
Reduce tobacco use among adults who report poor mental health
FOCUS AREA: Strengthen Infrastructure Across Systems
•
•
Support collaboration among professionals working in fields of mental, emotional, behavioral
health promotion & chronic disease prevention, treatment, & recovery
Strengthen infrastructure for mental, emotional, & behavioral health promotion & mental,
emotional, & behavioral disorder prevention
Preliminary Data for the Nassau County Community Health Assessment
Methods
• Data Sources: SPARCS 2008‐2010, NYSDOH Vital Statistics, NYS Cancer Registry, NYSDOH Surveillance System, 2010 US Census
• Age Adjustment: Direct Standardization of Rates
– Based on 2000 US Standard Population
• Select Communities: Roosevelt, Long Beach, Westbury, Uniondale, Hempstead, Inwood, Elmont, Freeport, Glen Cove
• Significance testing was done using confidence intervals in line with NYS methods. Those statistically significant are noted by *
Demographics
Nassau County Population by Age and Sex
80+
70 to 79
60 to 69
Age Group
50 to 59
40 to 49
Female
30 to 39
Male
20 to 29
10 to 19
0 to 9
-9
-8
-7
Source: U.S. Census 2010
-6
-5
-4
-3
-2
-1
0
1
Percentage (%)
2
3
4
5
6
7
8
9
Percent Distribution of Race by Town/City, Nassau County, 2010
9.94
7.52
7.89
9.13
2.79
5.23
6.45
3.63
14.99
2.27
8.23
13.90
4.70
7.66
10.10
4.72
7.18
16.55
5.90
11.13
5.56
Other
API
Hempstead
79.30
71.56
68.28
Long Beach
Black
84.98
83.25
North Hempstead
Oyster Bay
74.20
72.98
Glen Cove
Nassau County
2010
Nassau County
2000
White
Percent Distribution of Hispanic Ethnicity by Town/City, Nassau County
30
27.86
Percentage of Hispanics in Town
25
20.00
20
17.39
15
14.58
14.10
12.80
12.85
11.50
10.00
9.80
10
7.48
5.10
5
0
Nassau
County
2010
Nassau Glen Cove Glen Cove Hempstead Hempstead
County
2010
2000
2010
2000
2000
Long
Beach
2010
Long
Beach
2000
North
North Oyster Bay Oyster Bay
Hempstead Hempstead 2010
2000
2010
2000
Age Distribution in Select Communities by Sex
Nassau County 2010
2.7
80+
5.1
4.3
70 to 79
5.8
8.5
60 to 69
Age Group (years)
50 to 59
40 to 49
30 to 39
20 to 29 10 to 19
0 to 9
9.6
12.8
13.5
14.4
14.7
Female
14.6
13.4
15.7
13.8
14.0
12.5
13.1
11.7
Percentage
Male
Race Distribution by Community
5.41
18.62
8.45
8.65
7.64
5.13
4.37
11.10
Race Percent
31.08
Other API
Black
White
80.96
72.81
46.42
Select Communities
Rest of County
Nassau County
Diseases of the Cardiovascular System
Average Rate of CVD Hospitalization (2008‐2010)
2250
2200
2150
Age Adjusted Rate (per 100,000)
2100
2050
2000
1950
1900
1850
1800
1750
1700
Source: NYS DOH SPARCS (2008‐2010)
Nassau *
NYS
NYSxNYC
Average Rate of Hospitalization for CVD by Age Nassau County (2008‐2010)
400
350
300
250
200
150
100
50
0
under1
1to4
5to14 15to24 25to29 30to34 35to39 40to44 45to49 50to54 55to59 60to64 65to69 70to74 75to79 80to84
Age Group (years)
85+
Average Hospitalization Rate for CVD by Sex Nassau County (2008‐2010)
3500
3000
Rate (per 100,000)
2500
2000
1500
1000
500
0
Male *
Female
Average Rate of Hospitalization for Diseases of the Heart (2008‐2010)
1550
1500
1450
1400
1350
1300
1250
1200
1150
Nassau*
NYS
NYSxNYC
Average Hospitalization Rate for Diseases of the Heart by Age Nassau County (2008‐2010)
250
200
150
100
50
0
under1
1to4
5to14 15to24 25to29 30to34 35to39 40to44 45to49 50to54 55to59 60to64 65to69 70to74 75to79 80to84
Age Group (years)
85+
Average Rate for Diseases of the Heart by Sex Nassau County (2008‐2010)
2500
Rate (per 100,000)
2000
1500
1000
500
0
Male *
Female
Average Rate of Stroke Hospitalization (2008‐2010)
400
350
300
250
200
150
100
50
0
Nassau
NYS
NYSxNYC
Average Rate of Hospitalization for Stroke by Age Nassau County(2008‐2010)
60
50
40
30
20
10
0
under1
1to4
5to14
15to24 25to29 30to34 35to39 40to44 45to49 50to54 55to59 60to64 65to69 70to74 75to79 80to84
Age Group (years)
85+
Average Hospitalization Rate for Stroke by Sex Nassau County (2008‐2010) 410
400
390
Rate (per 100,000)
380
370
360
350
340
330
Male *
Female
Diseases of the Respiratory System
Average Rate of COPD Hospitalization (2008‐2010)
450
400
350
300
250
200
150
100
50
0
Nassau *
NYS
NYSxNYC
Average Rate of Hospitalization for COPD by Community
Nassau County (2008‐2010)
600
500
Rate (per 100,000)
400
300
200
100
0
Select Communities *
Rest of County
Average Rate of Asthma Hospitalization (2008‐2010)
250
200
150
100
50
0
Nassau *
NYS
NYSxNYC
Average Rate of Hospitalization for Athsma by Community
300
250
Rate (per 100,000)
200
150
100
50
0
Rest of County
Diabetes and Liver Disease
Average Rate of Type 2 Diabetes Hospitalizations (2008‐2010)
180
160
140
120
100
80
60
40
20
0
Nassau *
NYS
NYSxNYC
Average Rate of Hospitalization for Type 2 Diabetes by Community
300
250
Rate (per 100,000)
200
150
100
50
0
Rest of County
Average Rate of Liver Disease Hospitalization (2008‐2010)
34
33
32
31
30
29
28
27
26
25
Nassau *
NYS
NYSxNYC
Average Rate of Hospitalization for Liver Disease by Community
60
50
Rate (per 100,000)
40
30
20
10
0
Rest of County
Injuries
Proportion of Average Injury Rates: Outpatient
by Type within Age Group in Nassau County (2008‐2010)
Submersion
Pedestrian
Fire/Flame
Bicycle
Respiratory Interference
Assault
Falls
MVA
Poisoning
Struck
self inflicted
Age Group (Years)
Unintentional Injury
Average Rate of MVA Related Injuries, Outpatient
(2008‐2010)
1200
1000
800
600
400
200
0
Nassau*
NYS
NYSxNYC
Average Rate of MVA Related Injuries by Community, Outpatient
1600
1400
1200
Rate (per 100,000)
1000
800
600
400
200
0
Rest of County
Average Rate of Respiratory Interference, Outpatient
(2008‐2010)
13.5
13
12.5
12
11.5
11
10.5
10
Nassau *
NYS
NYSxNYC
Average Rate of Respiratory Interference by Community, Outpatient
25
Rate (per 100,000)
20
15
10
5
0
Rest of County
Average Rate of Bicycle Injury, Outpatient
(2008‐2010)
25
20
15
10
5
0
Nassau
*
NYS
NYSxNYC
Average Rate of Bicycle Injury by Community, Outpatient
45
40
35
Rate (per 100,000)
30
25
20
15
10
5
0
Rest of County
Average Rate of Pedestrian Accidents, Outpatient
(2008‐2010)
80
70
60
50
40
30
20
10
0
Nassau *
NYS
NYSxNYC
Average Rate of Pedestrian Accidents by Community, Outpatient
120
100
Rate (per 100,000)
80
60
40
20
0
Rest of County
Average Rate of Submersion, Outpatient
(2008‐2010)
3.5
3
2.5
2
1.5
1
0.5
0
Nassau*
NYS
NYSxNYC
Intentional Injury
Average Rate of Assault Related Injuries, Outpatient
600
500
400
300
200
100
0
Nassau *
NYS
NYSxNYC
Average Rate of Assault Related Injuries by Community, Outpatient
600
500
Rate (per 100,000)
400
300
200
100
0
Rest of County
Average Rate of Self Inflicted Injury, Outpatient (2008‐2010)
90
80
70
60
50
40
30
20
10
0
Nassau *
NYS
NYSxNYC
Average Rate of Firearm Related Injuries, Outpatient
(2008‐2010)
6
5
4
3
2
1
0
Nassau *
NYS
NYSxNYC
Average Rate for Firearm Related Injury by Community, Outpatient Nassau County (2008‐2010)
4
3.5
3
Rate (per 100,000)
2.5
2
1.5
1
0.5
0
Rest of County
Cancer
All Invasive Malignant Tumors, 2005‐2009
700
Incidence
Age‐Adjusted Rate per 100,000 Population
600
500
400
Nassau County
Mortality
NYS
300
NYSxNYC
200
100
0
Males
Source: NYS Cancer Registry
Females
Males
Females
Cancer Incidence among Males by Cancer Site, 2005‐2009
200
Age‐Adjusted Rate per 100,000 Males
180
160
140
120
100
80
Nassau County
NYS
60
40
20
0
NYSxNYC
Cancer Incidence among Females by Cancer Site, 2005‐2009 160
Age‐Adjusted Rate per 100,000 Females
140
120
100
80
Nassau County
60
NYS
NYSxNYC
40
20
0
Cancer Mortality among Males by Cancer Site, 2005‐2009
70
Age‐Adjusted Rate per 100,000 Males
60
50
40
30
Nassau County
NYS
20
10
0
NYSxNYC
Cancer Mortality among Females by Cancer Site, 2005‐2009
45
Age‐Adjusted Rate per 100,000 Females
40
35
30
25
20
Nassau County
15
NYS
NYSxNYC
10
5
0
Communicable Diseases
8
Average Incidence Rate of Tuberculosis Nassau County (2008‐2010)
7
Rate per 100,000 Population
6
5
4
3
2
1
0
Source: NYS CDESS
Rest of County
Nassau County
30
Average Incidence Rate of Syphilis Nassau County (2008‐2010) 25
20
15
10
5
0
Source: NYS CDESS
Rest of County
Nasau County
Average Incidence Rate of Gonorrhea
90
80
70
60
50
40
30
20
10
0
Source: NYS CDESS
Rest of County
Nasau County
Average Incidence Rate of Chlamydia
600
500
400
300
200
100
0
Source: NYS CDESS
Rest of County
Nassau County
Mortality
250.0
Age‐Sex Adjusted Death Rates by Region, 2010
200.0
150.0
Diseases of the Heart
Malignant Neoplasms
100.0
50.0
0.0
New York State
Source: NYS Vital Statistics
NYSxNYC
Nassau
40.0
35.0
30.0
25.0
Chronic Lower Respiratory Disease
Cerebrovascular Disease
20.0
Total Accidents
Pneumonia
Diabetes Mellitus
15.0
10.0
5.0
0.0
New York State
NYSxNYC
Nassau
10.0
9.0
8.0
Rate per 100,000 Poplation
7.0
6.0
Suicide
Cirrhosis of the Liver
5.0
Homicide/Legal Intervention
AIDS
4.0
3.0
2.0
1.0
0.0
New York State
NYSxNYC
Nassau
Pregnancy and Perinatal Outcomes
Average Teen Pregnancy Rate
50
45
Teen Pregnancy Rate/ 1,000 females 15‐19 years
40
35
30
25
20
15
10
5
0
*
Source: NYSDOH Bureau of Biometrics and Health Statistics and NYC DOHMH, Bureau of Vital Statistics
Rest of County
Nassau County
Average Teen Birth Rate
35
Rate per 1,000 Female Population 15‐19
30
25
20
15
10
5
0
NYSDOH Bureau of Biometrics and Health Statistics and NYC DOHMH, Bureau of Vital Statistics
Rest of County
Nassau County
Percent Low Birth Weight (<2500 grams) by Community (2008‐2010)
9.5
Per 100 Live Births
9
8.5
8
7.5
7
Rest of County
Nassau County
Infant Mortality Rate by Community
Nassau County 2008‐2010
9
8
7
Rate/ 1,000 Live Births
6
5
4
3
2
1
0
Rest of County
Nassau County
Percent Recieving Late (3rd Trimester) or No Prenatal Care by Community
(2008‐2010)
6
5
Per 100 Live Births
4
3
2
1
0
Rest of County
Nassau County
Findings
• Major health disparities exist in Nassau County. These disproportionate health outcomes exist across:
– Age: Chronic Disease and Injury
– Sex: Chronic Disease
– Community: Communicable Disease, Injury, Chronic Disease and Perinatal Outcomes
Next Steps
• Waiting for additional vital statistics data
• Community Engagement Data
• Identify Priorities and Programs
Data Update
Selection of Priority Areas
Dr. Jane E. Corrarino
April 11, 2013





4/12/2013
Prevent Chronic Disease
Promote a Healthy and Safe
Environment
Promote Healthy Women, Infants and
Children
Promote Mental Health & Prevent
Substance Abuse
Prevent HIV, STDs, Vaccine
Preventable Diseases and Healthcare
1

Two priorities
◦ At least one address a disparity


Goals and objectives for each
Improvement strategies & performance
measures
◦ Measurable & time-framed targets over 5 years
◦ Evidence-based, or promising practices
◦ Current and new
4/12/2013
2

NYSDOH Community
Health Indicator Reports



















4/12/2013
15 Topic Areas
250 Health Indicators
Multiple Data Sets
Statewide, Regional, County
Graphs, Maps,
Quartile Rankings
Statistical Significance
Partnerships
Coalitions
Individuals
Community Survey
Cancer
CV Disease
Child & Adolescent
Health
Cirrhosis/DM
Communicable Disease
Family
Planning/Natality
HIV/AIDS/STIs
Injury







Maternal & Infant
Health
Obesity/Related
Occupational Health
Oral Health
Respiratory Disease
SES/General Health
Tobacco, Alcohol,
other Substance Abuse
Indicators
3

Cancer

◦ Most indicators 1st, 2nd Q
◦ Breast Cancer
◦ Asthma
 Incidence & Mortality

quartile
 Black/White Disparity in
mortality
 4th Q hospitalization rates
◦ Lead Screening
3rd/4th


 3rd Q hospitalization rates

Family
Planning/Natality
◦ All indicators 1st, 2nd, 3rd
Q
◦ Black/White IMR disparity

HIV/AIDS/STIs
◦ Most Indicators 2nd, 3rd Q
◦ Early Syphilis rate 4th Q
4/12/2013
◦ % elderly flu shots 3rd Q
 CV disease /Coronary
Heart Disease
 Stroke
 HTN

Cirrhosis/DM
◦ DM
Cardiovascular
◦ 4th Quartile
Hospitalization Rates:
Child/Adolescent

Maternal & Infant
◦ Most indicators 1st, 2nd,
3rd Q or non-significant
differences from NYS
◦ 4th Q for overweight WIC
enrollees
◦ 4th Q % Cesarean Section
 44.0 vs. 34.4 (27% excess)
4

Injury

◦ Suicide, self-inflicted,
Homicide
◦ 4th Q almost all age groups
◦ Age 65+
 1st, 2nd, 3rd Q

 14,000 per year
 Plus ED visits
Unintentional Injury
◦ Hospitalization rate
◦ Suffolk vs. NYS
 3rd, 4th Q all age groups
 83.5 vs. 77.5 (8% excess)
 3rd Q
 1,483 per year
 Age 75-84
 271.3 vs. 230.8 (17% excess)
◦ Health Disparities
 Age 85+
 Pedestrian & Bicycle
injuries
Injury
◦ MVA Mortality
 710.3 vs. 567.7 (25% excess)

 % overweight, not obese
 % overweight or obese
◦ Traumatic Brain Injury
Hospitalization


Occupational Health
◦ Most indicators 1st, 2nd,
3rd Q
Asthma
◦ Hospitalization rate 4th Q
all age groups
◦ 14.4 vs. 12.3 NYS
Obesity and Related
◦ 3rd & 4th Q all students
 3rd Q
 4,874/Year
 4th Q
(per 10,000)
 Age 65-74
◦ Mortality

Falls hospitalizations

Oral Health
 (12% excess)
 12,726/A
4/12/2013
5

Socio-Economic Status
and General Health

◦ Most indicators 1st Q
◦ No medical care because
of cost
◦ Drug-related
hospitalization rate
 3rd Q
 Age-adjusted
 3rd Q
 13.1 vs. 12.0 (9% excess)
◦ % Adults Smokers
 1st Q, better than NYS
◦ Poor mental health 14+
days in past month
◦ % Binge Drinkers
 20.7 vs. 19.8 (4% excess)
 4th Q
 13.1 vs. 10.9 (20% excess)

Cancer







CV Disease
Child & Adolescent
Health
Cirrhosis/DM
Family
Planning/Natality
HIV/AIDS/STIs
Respiratory Disease
◦ Asthma Hospitalization
rate
4/12/2013
Injuries
◦ Overall for Hospitalization
and Mortality
◦ Falls
◦ Breast

Tobacco, Alcohol,
Other Substances
 Age 65+
 Age 75+ (17-25% excess rate)
 TBI 4th Q

Maternal & Infant
◦ Obesity & C/S




Obesity/Related
Occupational Health
Oral Health
SES/General Health
◦ Mental health

Tobacco, Alcohol, other
Substance Abuse Indicators
6




Partnerships
Coalitions
Individuals
Community Survey
◦ Health Problems
◦ Ways to improve
◦ Access to care
 Reasons
◦ Health screenings/Svc
◦ Sources of information
◦ Ranking health of community








4/12/2013
Biggest health problems for
community
Most helpful strategies
Access to care? Reasons?
Health screenings/services needed
Health issues needing education
Where do people get health
information?
What makes a healthy community
Rating health of people/community
7

Health Problems
Cancer
Care for the elderly
Diabetes
Drugs & alcohol abuse
Preventable Injuries
Car crashes
Pedestrian injuries
Other
Mental health (including
depression & suicide)
Nutrition / eating habits

NSHC
27.3
54.5
58.2
32.7
38.2
25.5
49
21.6
16.4
18.2
34.5
14.5
34.5
9.1
3.6
0.0
0.0
41.2
43.1
34.3
52.9
32.4
5.9
Most Helpful to Improve Problems
SCDHS
NSHC
Access to healthier food
32.7
30.4
Affordable housing
14.5
38.2
5.5
42.2
Farmers markets
47.3
11.8
Health education programs
56.4
43.1
Health screenings
34.5
38.2
Weight loss programs
36.4
40.2
Drug & alcohol services
4/12/2013
SCDHS
8


Access to care
SCDHS
NSHC
Yes
67.3
78.4
No insurance and unable to pay for the care
58.2
91.1
Transportation
18.2
49.4
Unable to pay co-pays/deductibles
40.0
75.9
Health screenings or services
SCDHS
NSHC
32.7
42.7
9.1
42.7
Cholesterol (fats in the blood)
38.2
32.9
Diabetes
54.5
37.8
Drug and alcohol
18.2
43.9
Exercise/physical activity
36.4
36.6
23.6
41.5
Nutrition
52.7
30.5
Blood pressure
Cancer
4/12/2013
9


Health education need
SCDHS
NSHC
Diabetes
49.1
47.6
Drug and alcohol
12.7
46.3
40.0
43.9
Nutrition
54.5
40.2
Where health information is obtained
Doctor/health care
provider
SCDHS
NSHC
72.7
58.5
Family or friends
20.0
67.1
Health Department
23.6
51.2
Internet
50.9
12.2
Library
16.4
47.6
School or college
30.9
15.9
Very
Very Healthy
Unhealthy
1%
3%
Healthy
21%
Unhealthy
17%
Very Healthy
Healthy
Somewhat Healthy
Unhealthy
Somewhat
Very Unhealthy
Healthy
58%
4/12/2013
10
Selection of 2 Priority Areas
Disparity-related (1 or both)






◦ Goals & Measurable
Objectives
◦ Improvement Strategies
◦ Performance measures
◦ Time-framed targets
◦ Evidence-based
◦ Best Practice Interventions
◦ Build Community Capacity
◦ Inventory Community Assets
◦ Partnerships
Prevent Chronic Disease
Promote a Healthy and Safe
Environment
Promote Healthy Women,
Infants and Children
Promote Mental Health &
Prevent Substance Abuse
Prevent HIV, STDs, Vaccine
Preventable Diseases and
Healthcare Associated
Infections
Cancer
 Collaborative
 Coordinated








CV Disease
Child & Adolescent
Health
Cirrhosis/DM
Family
Planning/Natality
HIV/AIDS/STIs
Respiratory Disease
◦ Asthma Hospitalization
rate
4/12/2013
Injuries
◦ Overall for Hospitalization
and Mortality
◦ Falls
◦ Breast
 Age 65+
 Age 75+ (17-25% excess rate)
 TBI 4th Q

Maternal & Infant
◦ Obesity & C/S




Obesity/Related
Occupational Health
Oral Health
SES/General Health
◦ Mental health

Tobacco, Alcohol, other
Substance Abuse Indicators
11
A
Attachment XV. NSLIJHS Nassau and Suffolk Counties Resource 1 Inventory
ORGANIZATION
PROGRAM
B
C
DESCRIPTION
2
Healthier Families
3
Good Samaritan 4 Hospital
Good Sam University
SCSMC, Smithtown,NY
Bariatric webinar
Stroke/TIA Management
D
E
F
G
IS YOUR PROGRAM EVIDENCE TARGET POPULATION/ PRIORITY MEASURES/ METRIC
BASED?
AREA SERVED
(OBESITY, CHRONIC DISEASE, MENTAl HEALTH)
In partnership with Bay Shore school district, yes
we provide a 10‐week after school program to children ages 8 ‐12 which features supervised exercise sessions twice a week, plus a family oriented nutrition education session once per week.
Children ages 8 ‐ 12 obesity
with a BMI in the 95th percentile or above who are identified by Bay Shore school district staff. A series of monthly community health lectures on nutrition, weight loss and related topics
no
Adults 18 and over in the hospital's primary and secondary service Obesity, chronic Evaluation form measures relevance areas.
disease prevention of topic/speakers.
Educational lecture on bariatric surgery delivered via web‐based technology.
no
Primary and secondary stroke prevention is Yes, AHA/ASA Cllinical focus of this program
Guidelines for Mangement of Stroke & TIA
6
7
8
9
10
Obesity Prevention 12
Initiative
All patients assessed for obesity (BMI > 30)
13
14
Yes, SAMHSA, SBIRT model: substance
abuse and mental services adminstration
screening, brief intervention, referrel to
treatment
Adults 18 and over who are interested in learning about surgical Evaluation form measures relevance weight‐loss options.
Obesity
of topic/speakers.
Western Suffolk Prevention of GWTG Stroke Registry
County stroke/TIA through education and screenings
Age 18 and above with Obesity, Chronic BMI at least 25
Disease
% of patients referred to treamth that
enrolled in treatment
% of patients enrolled in treatment that
are losing and/or maintaining wt.
% of paitent enrolled in treatment whose BMI decreased to <25 (health weight)
22
23
24
25
26
no
monthly data submission
quarterly data submission
annual data submission
% of patients who are identified as obese at risk for obesity
20
21
Bariatric webinar
Post‐session.
monthly data submission
% of patients assessed for obesity/risk monthy for all metrics
% of patients who are provided with
education, resources and support
% of patiente who were referred to
treatment (WW, endocrinologist/
primary MD/YMCA
Educational lecture on bariatric surgery delivered via web‐based technology.
Each session.
for obesity utilizing a screening tool
15
16
17
18
19
HOW OFTEN EVALUATED?
Measure lifestyle changes and Beginning and end of 10 week educational improvement via pre‐ and session.
post‐program evaluations
Core Measure CMS monitoring
TJC submissions
NYS DOH Stroke Registry
11 SCMC, Smithtown, NY
H
Adults 18 and over who are interested in learning about surgical weight‐loss options.
Obesity
Evaluation form measures relevance of topic/speakers.
Post‐session.
A
B
C
D
Healthy Schools NY (HSNY)
Healthy Schools NY (HSNY) is a five year grant (July 2010 – March 2015) of the New York State Department of Health, Division of Chronic Disease Prevention. HSNY provides expertise and resources to school districts with a high rate of free and reduced lunch eligibility, to develop policies that increase opportunities for physical activity and establish healthful eating environments, outside of the school meals program. Coordinators work with school district personnel and shareholders in the community to assess school wellness policies, and identify improvement areas to revise or develop policy elements, regulations, and practices for physical activity and nutrition. Yes
28
29 Western Suffolk NY
The YMCA OF LONG ISLAND
Student Support Services Center
YMCA DIABETES PREVENTION PROGRAM Healthier Tomorrow
33
34
35
36
American Parkinson's 38 Disease Association
39 PBMC
G
H
Children and Wellness School Assessment tool, adolescents between Obesity and chronic WellSAT, developed by the Robert Ongoing assessment.
the ages of 3 and 18 disease prevention Wood Johnson Foundation and Rudd years old. Foundation.
Adults 18 and over, Pre‐diabetes
overweight with a BMI of greater than 25, at risk of developing type diabetes or have been diagnosed with prediabetes by a healthcare provider
weight, blood values
At the end of the 16 week session A youth weight management program designed to address youth obesity. The program Children age 9 to 16
Youth Obesity
weight
at the end of 15 week session
Those affected by eplipsy in our service area.
Chronic Disease
N/A
N/A
No
is designed to provide children with the tools
to adopt healthy eating habits and an active lifestyle.
Suffolk Epilepsy Support Epilepsy Support Group Provides encouragement, acceptance, Yes
Group
comfort, and empowerment.
37 PBMC
F
A program that helps those at high risk of Yes developing type 2 diabetes adopt and maintain healthy lifestyles by eating healthier, increasing physical activity and losing a modest amount of weight in order to reduce their chances of developing the disease. 30
31
32
E
Those undergoing bariatric surgery in our Obesity, Chronic service area.
Disease
Those affected by Parkinson's disease in our service area.
Chronic Disease
N/A
N/A
Parkinson's Support Group
New patients can get information as well as meet with patients who have already embarked on their weight loss journey.
Yes
Offers information, education, and resources for patients, families, and friends affected by this disease.
Yes
N/A
N/A
Stroke Support Group
You and your loved ones can understand the effects of a stroke and what can be done to maximize recovery and independence.
Yes
Those affected by Stroke in our service area.
N/A
N/A
Bariatric Surgery Support Group
The Greater Westhampton Chamber Joe Koziarz Memorial 5K Run/Walk
40 of Commerce
41 PBMC
Keep the Mind Strong
42 PBMC
Common Causes of Shoulder Pain
5k Run/Walk in Westhampton Beach. Health screenings will be available for the community.
No
Discussion on how to keep your brain healthy and active and how to prevent a decline in cognition.
Yes
Discussion on the common causes of shoulder pain and how physical therapy can help.
Yes
Chronic Disease
Those participating in the walk/run that would like to get screened for specific health concerns in Westhampton, NY and surrounding areas.
Chronic Disease
Those interested in keeping a healthy and active brain.
Chronic Disease
N/A
N/A
N/A
N/A
Those affects by shoulder pain.
N/A
N/A
Chronic Disease
A
43 PBMC
North Fork Breast 44 Health Coalition
45 Alcoholics Anonymous
46 Alcoholics Anonymous
B
C
PBMC Heart Health Volleyball Tournament Heart Healthy Volleyball Tournament.
North Fork Breast Health Coalition 5k Walk
Walk for breast cancer.
Alcoholics Anonymous Support group for alcoholics.
Live and Let Live AA Wednesday
Support group for alcoholics.
47 Overeaters Anonymous Overeaters Anonymous Support group for overeaters.
The Mental Health 48 Assoication
PBMC, Suffolk County Lions Diabetes Education program, 49 Project Fit
D
No
No
Yes
Yes
Yes
Riverhead Survivors of Incest Anonymous Support for those who have been involved in Group
incest.
Yes
Focused on preventive health care and works with hospitals to promote its programs which are aimed at reducing childhood obesity and increasing general Project Fit America
fitness.
Yes
50 Long Island 2 Day Walk Auction
LI2Day Walk Chinese Raise awareness and funding for the fight against breast cancer on Long Island.
51 CAPP, PBMC
Pre‐Prom Bash
Support a safe and substance free prom for No
the seniors of Riverhead High School.
Jamesport Fire Department Sound to Bay 5k and 10k Run
Run with PBMC health booth available for blood pressure/glucose checks and health advice
Jamesport Fire 52 Department
No
No
H
Obesity, Chronic Disease
N/A
N/A
Chronic Disease
N/A
N/A
Mental Health
N/A
N/A
Mental Health
Obesity, Mental Health
N/A
N/A
N/A
N/A
Those who have been involved in incest.
Mental Health
N/A
N/A
Children of the Riverhead School District and their families.
Reports
Quarterly N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Reports
Yearly
Those interested in supporting the fight against breast cancer.
Those suffering from alcoholism.
Those suffering from alcoholism.
Those suffering from compulsive eating.
Those who support the fight against breast cancer on Long Island Chronic Disease
Those attending the Riverhead High School prom and their families.
Mental Health
Spectators or participants of the race that wish to monitor Obesity, Chronic their health.
Disease
Yes
PBMC employees.
Reports
Yearly
Sophisticated robotic playform designed to expand the surgeon's capabilities and offer a state‐of ‐the‐art minimally invasive option for major surgery.
Yes
Those undergoing surgery.
Chronic Disease
N/A
N/A
A simple, quick CT screening Those wishing to monitor their health.
Chronic Disease
Reports
Monthly
Chronic Disease
Reports
Monthly
Chronic Disease
Reports
Monthly
Create awareness against heart disease in Go Red for Women
women.
Riverhead Rocks Triathlon fitness event.
54 Riverhead Rocks, PBMC Triathlon
Mindful Eating to Better Health
Seminar on how to eat healthier.
55 PBMC
PBMC Employee 8 Week Weight Loss Weekly presentations, nutrition handouts, Contest
raffles, & weigh‐ins for paticipants.
56 PBMC
58 PBMC
The da Vinci® Surgical System
PBMC Health Lung Cancer Screening Program
59 PBMC
Orthopedic Joint Replacement Intensive Specialized intensive program for patients Therapy Program
recovering from Joint Replacement Surgery
Ostomy Program
G
Yes
PBMC, Go Red for 60 PBMC
F
PBMC employees and the community who wish to advocate against heart disease Obesity, Chronic in women.
Disease
Those involved in the triathlon.
Obesity, Chronic PBMC employees.
Disease
53 Women
57 Intuitive Surgical
E
Those interested in physical activitiy and promoting a healthy heart.
Acute and rehabilitative needs for people with selected disorders of the gatrointenstinal, genitourinary and/or integumentary system.
No
No
Yes
Yes
Yes
Patients recovering from Joint Replacement Surgery
Patients who need care for gatrointestinal, genitouinary, and/or intengumentary disorders
A
B
C
D
E
F
G
H
Wound Care Program
Advanced‐technology wound care treatment in the comfort of patients' homes.
Yes
Home‐bound patients for whom it is advisable to alleviate the difficulties and dangers of trips to the hospital for wound‐
care services.
Chronic Disease
PBMC's Cary Grossman Center for Physical Speech and Language 62 Therapy
Programs
Provides diagnosis and treatment of a wide range of communication and swallowing conditions, including feeding and swallowing diorders, voice disorders, language disorders,
Yes
and cognition impairment.
Those suffering from a speech or language disorder or cognition impairment.
Mental Health
Reports
Monthly
PBMC, New York State Department of Health, Suffolk County Department of Health Services, The Greater The Cancer Services NYC Affiliate of Susan G. Program of Eastern 63 Komen for the cure.
Suffolk County
Men and women are screened and provided with further assistance for those whose screenings establish the need for additional care. Bi‐lingual navigators work to reduce barriers that prevent quality care. Assistance is offered to any one diagnosed with breast, cervical or colorectal cancer.
Yes
Those wishing to monitor their health or treat cancer.
Chronic Disease
Reports
Monthly
N/A
N/A
61 PBMC
64 PBMC
SCDHS
65
SCDHS
66
Staff nurses on hand to the community to give out information on medicine safety, PBMC Health community CPR, and a stroke awareness and Community Health Fair bloor pressure monitoring.
No
Diagnostic & Treatment Primary medical care services for individuals Throughout Suffolk, clinics Centers and families are provided to residents who located in Amityville, are patients of one of the county’s eight Brentwood, East Hampton, health centers, which are located throughout Greenlawn, Patchogue, the county
Riverhead, Shirley, Southampton, Wyandanch: 194,912 Visits; 51,532 d li t d ti t
Diabetes Education Education program administered through Total # of patients at health Program
health centers
centers diagnosed with all diabetes (GDM & DM)= 4,634
SCDHS
WIC Program
Provides supplemental foods, nutrition and health education plus health and human services referrals to low‐income pregnant, breastfeeding, postpartum women, infants and children up to 5 years of age who are at nutritional risk. Health and dietary information provided by a doctor, nurse, nutritionist, dietitian, or clinic / health care provider is used to determine nutritional risk
SCDHS
School Based Over 2500 teachers trained in schools Comprehensive Health throughout Suffolk since 2002
Education
Mental Health Clinics
Treatment services for mental health, substance abuse and those with mental retardation or developmental disabilities
The community
Chronic Disease
Obesity; Chronic Disease; Mental Health
Obesity
WIC sites located in Amityville, Obesity
Shirley, Riverhead, Brentwood, Coram, Southampton, Greenlawn, Wyandanch, Patchogue: 17,508 aver. monthly WIC Clients
67
68
SCDHS
69
SCDHS
70
Methadone Maintenance Treatment Programs
54 public school districts, 12 Obesity
BOCES sites, 5 private schools Clinics located in Brentwood, Farmingville, Riverhead
Provides assistance to individuals in need of Services provided in methadone treatment Huntington, Riverhead, Hauppauge
Mental Health
Mental Health
Reports
Monthly
A
B
C
D
E
SCDHS
Case Management CAMERA evaluates, determines eligibility High need consumers who have Mental Health
Evaluation Referral and and refers applications for case management not been successful in Assessment (CAMERA) and ACT Teams for persons with severe and traditional treatment settings
persistent mental illness. Case managers assist mental health consumers with accessing services that are needed to improve their quality of life, such as outpatient treatment, vocational services, disability benefits, housing and linkages to community supports. ACT Teams provide mental health treatment in the community for high need consumers who have not been successful in traditional treatment settings.
SCDHS
In order to be eligible for the Mental Health
Court Ordered Assisted Persons served by the AOT program are AOT program, an individual Outpatient Treatment deemed to be at risk of harm to self or (AOT)
others when noncompliant with psychiatric would have to meet the criteria treatment and/or medication. They are court‐set forth by Kendra's Law, section 9.60 of Mental Hygiene ordered to comply with an intensive treatment plan, consisting of an array of Law. mental health services including, but not limited to, case management, outpatient psychiatric services, and medication management services.
SCDHS
Children's Single Point of Access to Mental Health Management (SPOA)
SCDHS
Adult Single Point of Access For Mental Health Housing (SPA)
SCDHS
Diagnostic & Treatment Primary medical care services for individuals Throughout Suffolk, clinics Centers and families are provided to residents who located in Amityville, are patients of one of the county’s eight Brentwood, East Hampton, health centers, which are located throughout Greenlawn, Patchogue, the county
Riverhead, Shirley, Southampton, Wyandanch: 194,912 Visits; 51,532 d li t d ti t
Diabetes Education Education program administered through Total # of patients at health Program
health centers
centers diagnosed with all diabetes (GDM & DM)= 4,634
71
72
73
74
75
76
77
SCDHS
78
Coordinates high‐end mental health services Aged 5‐17 for children and youth with serious emotional disturbance (SED) and their families, offers a centralized, coordinated referral process using a universal referral form
Coordinates all referrals for adult mental Adults health housing in the community
SCDHS
WIC Program
Provides supplemental foods, nutrition and health education plus health and human services referrals to low‐income pregnant, breastfeeding, postpartum women, infants and children up to 5 years of age who are at nutritional risk. Health and dietary information provided by a doctor, nurse, nutritionist, dietitian, or clinic / health care provider is used to determine nutritional risk
SCDHS
School Based Over 2500 teachers trained in schools Comprehensive Health throughout Suffolk since 2002
Education
Mental Health
Mental Health
Obesity; Chronic Disease; Mental Health
Obesity
WIC sites located in Amityville, Obesity
Shirley, Riverhead, Brentwood, Coram, Southampton, Greenlawn, Wyandanch, Patchogue: 17,508 aver. monthly WIC Clients
79
80
54 public school districts, 12 Obesity
BOCES sites, 5 private schools F
G
H
A
B
C
D
Mental Health Clinics
Treatment services for mental health, substance abuse and those with mental retardation or developmental disabilities
SCDHS
Methadone Maintenance Treatment Programs
Case Management Evaluation Referral and Assessment (CAMERA)
Provides assistance to individuals in need of Services provided in Mental Health
methadone treatment Huntington, Riverhead, Hauppauge
CAMERA evaluates, determines eligibility High need consumers who have Mental Health
and refers applications for case management not been successful in and ACT Teams for persons with severe and traditional treatment settings
persistent mental illness. Case managers assist mental health consumers with accessing services that are needed to improve their quality of life, such as outpatient treatment, vocational services, disability benefits, housing and linkages to community supports. ACT Teams provide mental health treatment in the community for high need consumers who have not been successful in traditional treatment settings.
81
82
SCDHS
Clinics located in Brentwood, Farmingville, Riverhead
E
SCDHS
F
G
H
Mental Health
83
SCDHS
In order to be eligible for the Mental Health
Court Ordered Assisted Persons served by the AOT program are AOT program, an individual Outpatient Treatment deemed to be at risk of harm to self or (AOT)
others when noncompliant with psychiatric would have to meet the criteria treatment and/or medication. They are court‐set forth by Kendra's Law, ordered to comply with an intensive section 9.60 of Mental Hygiene Law. treatment plan, consisting of an array of mental health services including, but not limited to, case management, outpatient psychiatric services, and medication management services.
SCDHS
Children's Single Point of Access to Mental Health Management (SPOA)
SCDHS
Adult Single Point of Access For Mental Health Housing (SPA)
WSBOCES/SSSC
NYS Diabetes Prevention Program (DPP)
84
85
86
87
88
89
Coordinates high‐end mental health services Aged 5‐17 for children and youth with serious emotional disturbance (SED) and their families, offers a centralized, coordinated referral process using a universal referral form
Coordinates all referrals for adult mental Adults health housing in the community
Mental Health
Yes
Developed by CDC, the National Diabetes Prevention Program meets for 16 weeks in a group setting where personal lifestyle goals are set for each individual. Each one‐hour session will cover diet, exercise, and behavior modification to help participants develop lifelong skills for healthy living through step‐by‐step changes. 6 ‐ 8 post core sessions assist participants with maintaining their successes and staying on track.
Suffolk County adults obesity, chronic with prediabetes or disease
established risk factors for type 2 diabetes
Mental Health
Reduction and maintainance of individual weight loss by 5‐7% and participation in regular physical activity
ongoing ‐ A
B
C
D
E
F
G
H
WSBOCES/SSSC
NYS Diabetes Prevention Program (DPP)
Developed by CDC, the National Diabetes Yes
Prevention Program meets for 16 weeks in a group setting where personal lifestyle goals are set for each individual. Each one‐hour session will cover diet, exercise, and behavior modification to help participants develop lifelong skills for healthy living through step‐by‐step changes. 6 ‐ 8 post core sessions assist participants with maintaining their successes and staying on track.
Suffolk County adults obesity, chronic with prediabetes or disease
established risk factors for type 2 diabetes
Reduction and maintainance of individual weight loss by 5‐7% and participation in regular physical activity
ongoing ‐ SBU Childrens Hospital
Childrens EXPO
Asthma Booth, Education & screening
children 1‐21
Asthma
questionairre
1x/yr
St. Charles Hospital
Bariatric Support Group Open to the public ‐ this group is a monthly No
gathering of bariatric patients, post‐surgery, to discuss their progress and share successes
Morbidly obese individuals/north eastern shore of Suffolk County
Obsesity
Attendance taken, referalls provided
Quarterly
Morbidly obese patients who have undergone bariatric surgery/north eastern shore of Suffolk county Obesity
Quarterly
Annually
90
91
Yes, NIH asthma guidelines
92
93
94
95
Bariatric Post‐Op Nutritional Support Group
This group meets twice a month and is specifically for patients who have had bariatric surgery at St. Charles Hospital. Healthy eating, recipes, etc. are shared by professionals and clinicians.
Diabetes Education Center
6 Core Classes: Diabetes Overview, Nutrition Basics, Meal Planning, Preventing Complications, Coping with Diabetes, Follow‐
Up with additional classes such as Blood Glucose Monitoring, Eating Healthy, etc.
Yes
Individuals with and at high risk for Type II Diabetes
Chronic disease
98 St. Charles Hospital
Stroke Awareness
RN provides lectures within the community (civic organizations, clubs, senior centers, etc.) on stroke awareness including signs, symptons and what to do. Blood pressure screenings also included.
No
Individuals over age 60 Chronic disease
Healthy Sundays
Passport to Health Program
102
Pediatric Health Fair
Eastern Long Island Hospital (ELIH)
Diabetes Prevention Program (DPP)
103
Eastern Long Island 104 Hospital (ELIH)
No
Group of clinicians from St. Charles provide screenings to underserved individuals.
No
A series of health/wellness lectures offered free to the community
No
Free event for the community ‐ services provided include healthy snacks/healthy eating, sleep disorders, dental screening, immunization information, car seat safety and more.
No
Underserved and uninsured population
Any intrested individuals
Chronic disease and obesity
Attendance taken
Annually
Individuals served are registered with contact information. Screening results are documented.
Annually
Individuals are registered with contact information
Annually
Any intrested individuals
Individuals are registered with contact information
Annually
Lifestyle Coach for NYS Diabetes Prevention Yes: Developed by the CDC
Program provides support and guidance while delivering the nationally approved diabetes prevention program. 16 week program with 6‐8 months post core sessions
Pre‐diabetic adults over 18 years of age.
Obesity, chronic disease
Weight and activity as well as food intake
Chronic Disease
HbA1c control, Blood Pressure Control,
Eye Exam, Smoking and Tobacco Use and Cessation Treatment, Lipid Control, Nephropathy assessment, Foot Exam
One time Recognition
Working with the HANYS Diabetes Campaign National Committee for collaborative to assist physicians in utilizing Quality Assurance and monitoring of quality measures (NCQA) Diabetes established by NCQA for the treatment of Yes: National Committee for Recognition
diabetic patients
Quality Assurance
Patients with a diagnosis of diabetes for at least one year and are between the ages of 18 and 75. Following NCQA specified abstraction process for patient sample
pre‐screened, weekly X 16 weeks then monthly for 6‐8 months
A
B
Chronic Disease Self Management
Suicide Awareness
SafeTALK
C
D
Coordinate with the Suffolk County Retired and Senior Volunteer Program (RSVP) and the Town of Southold Senior Program to provide these living healthy workshops.
Yes: Stanford University
Collaborative group of hospital staff, community based organizations, professionals, and interested individuals to raise awareness about suicide risk and prevention.
No
Program offered through the Mental Health Yes
Association in Suffolk County
108
E
F
Number of Participants
N/A
All ages
Mental Health
N/A
N/A
General
Mental Health
N/A
N/A
Screening tools, patient satisfaction, multiple regulatory measuremenets.
Ongoing
109 Southampton Hospital
Weight Loss Support and Outreach Monthly meeting for weight loss patients No, although we encourage and open to the public, run by our bariatric new participants to follow up surgeon.
with the surgeon.
Living with Diabetes
Program led by certified Diabetes educator
Diabetics
Smoking Cessation
Maternity Classes
SBU (Stony Brook)I Department of Psychiatry
Thinner!
Mental Health ClinicaServices, Educationl and Research 116
North Shore LIJ Health 117 System
Yes
Monthly educational programs in partnerships with Southampton and Westhampton Libraries
No
Monthly program to promote realxation and stress‐rduction
No
6‐week program numerous times throughout the year
No
Series of 7 pre‐natal classes throughout the year
No
Weight loss program in Hospital Wellness Institute includes nutritional counseling, Pre‐ and post‐program exercise, motivation
evaluations
The Department of Psychiatry & Behavioral Yes
Sciences delivers a variety of mental health services in various clinical settings to all ages. Broad research is conducted by world renown researchers alongside a robust residency and fellowship programs. H
55 and older with ongoing chronic illness Chronic Disease
Those who have had bariatric surgery and adults over 18 who are obese
Obesity
Various programs (heal with massage, living with diabetes, balance with tai chi, kidney disease, menopause)
Healthy Mind Healthy Mood
G
Chronic Disease
Adults over 18
Chronic Disease
Stressed adults
Mental Health
Smokers of all ages
Chronic Disease
Mothers and families
CardioPulmonary patients and adults over 18 who want to chronic Disease, lose weight
obesity
Individuals of all ages Mental Health
with mental health and behaviroal difficullties.
Healthier Tomorrows
12 week Pediatric Weight Mgmt Program in partnership with the Great South Bay YMCA yes
Overweight and obese youth 8‐16 yrs
Chronic Disease
BMI
ongoing
Kohl's Cares For Kids Pediatric Obesity Prevention Program
Staff from Cohen Children's Medical Center partners with school districts which have a population of high percentage of free and reduced school lunch recipients to deliver nutrition and physical activity programs.
yes
elementary students
Chronic Disease
surveys of pa participation
ongoing
In partnership with the Great South Bay YMCA, a 16 week diabetes management program for community members with Diabetes Management diabetes including nutrition and disease Program
management education and physical activity yes
adults with diabetes
Chronic Disease
weight , BMI, physical activity ongoing
NYSDOH accident /trauma statistics
ongoing
Safe Kids
NSLIJHS is the NYS Director of Safe Kids, a childhood injury prevention organization. Partners include health facilities, business, cbos and government. Activities include automobile, water, bike, pedestrian safety for children and families
yes
infants, children, adolescents and their families
Chronic Disease
A
B
C
Train primary care providers to screen, NYSDOH Prevention of identify and treat youth for pediatric Pediatric Obesity in overweight/obesity through health system Primary Care Settings changes .
D
yes
E
youth 2‐18
F
Chronic Disease
G
chart reviews
H
ongoing
Cornell University Cooperative Extension 122 Suffolk
123
124
Assist low‐income families and youth acquire the knowledge, skills, attitudes and changed‐
behaviors necessary for nutritionally sound diets, contribute to their personal Expanded Food and development and improve the whole family Nutrition Education YES
diet and nutritional well being.
To improve the likelihood that persons Supplemental Nutrition eligible for the SNAP will make healthy food choices within a limited budget and choose Assistance Program Education (SNAP‐ED) physically active lifestyles consistent with the current Dietary Guidelines for Americans called Eat Smart in Yes
NewYork State (ESNY) and MyPlate.
Obesity prevention Low income adults and and wellness Youth Healthy eating Pre and post evaluation
On‐going ‐ Every Qtr internally and reports generated annually submitted to USDA SNAP and Snap Eligibles that includes women, youth, adults and Seniors. On‐going Reported annually to USDA
125
126
127
128
129
130 CCE and SCDOHS 131
132
Pre and Post evaluation
Obesity prevention ‐
to support parents and caregivers by providing education on nutrition, physical activity, and parenting practices that help families make healthy changes. HCHF Healthy Children focuses on the behaviors most likely to help Healthy Families children avoid unhealthy weight gain. YES
Low income parents and other caregivers are encouraged to promote healthy eating and active play and to shape the environments where children ages 3‐11 live, Collaboration for Healthy, Activity and learn, and play. During these early years, Nutrition in Children's influential adults are especially important role models and lifelong habits are Environments‐
developed.
YES
(CHANCE)
promote health of eligible low‐income, nutritionally at risk residents with nutrition education , enhance use of local produce . Farmers Market Promote Farmers markets as a component Nutrition Program of sustainable communities Creating Healthy Places to Live, Work, and Play is a NYS initiative to promote healthy lifestyles and prevent obesity and type 2 Creating Healthy Places diabetes.
Yes
Diabetes Self Management Housed in the Health centers under SCDOHS, Education provide Diabetes counseling and classes
YES
Families with young children Community Agencies
Low income WIC, Seniors obesity prevention Pre and Post evaluation created best practices
obesity prevention Process evaluation ‐ monthly logs
Program success is measured qualitatively as well as quantitatively. Program participants are observed enjoying the market as consumers even after their coupons are spent. Children at markets with their parents taste and enjoy new fruits and vegetables. Quantitative measures include the increasing number of Obesity Prevention farmers’ markets, vendors at markets, increase fresh fruits and redemption rate of FMNP Seasonal after summer season coupons and vegetables
ends Towns of Brookhaven , Riverhead, Babylon, Southampton
SCDOHS Centers eligibles
Chronic disease and Obesity prevention
case history on‐going A
John T. Mather 133 Memorial Hospital
B
Bariatric Center of Excellence
Palliative Medicine Program
138
D
The Bariatric Center of Excellence at Mather Hospital uses a multidisciplinary approach to the treatment of morbid obesity employing the latest laparoscopic surgery techniques and robotic surgery. In addition, the Center offers free seminars and support groups for individuals considering bariatric surgery, for those who have had the surgery and also for individuals at least five years post surgery who need to get back on track with their weight loss goals.
Yes
Palliative medicine is specialized care for patients with a serious illness that is both a philosophy of care and an organized, highly structured system for delivering care. The goal of palliative medicine is to prevent and relieve suffering and provide the best quality of life for people living with pain, complex symptoms and stresses of chronic illness. Yes
E
Morbidly obese individuals
F
Obesity
G
Symptoms managed, patient satisfaction
Mental Health Clinic
Yes
The Outpatient Chemical Dependency Clinic includes trained staff that ensures that each client is treated as an individual and addresses that client’s use/ abuse of alcohol and/or other substances as well as the other areas of their life affected by their chemical dependency. Following an assessment, the program offers individualized treatment for clients and their families; counseling; and a flexible schedule of services that enables Chemical Dependency clients to participate in treatment while they continue with their daily responsibilities. Yes
Clinic
Designed to stabilize acute psychiatric Outpatient Adult and symptoms, these programs provide an Adolescent Psychiatric alternative to inpatient hospitalization or Partial Hospitalization serve to decrease the length of stayu in an programs inpatient facility.
Yes
H
Program will conduct satisfaction surveys of patients and families. Program evaluates symptom managment, length of stay, use of health care proxies, decisions to forego invasive measures. Team includes a social worker. Appropriate at any age and at any stage of an illness.
Chronic Illness
Patients are evaluated post sugery through frequent follow‐
up meetings with a multidisciplinary team that includes a nutritionist. The team tracks a patient's progress on achieving his or her weight‐loss goal. In addition patients are Track patient outcomes from surgery encouraged to attend support through follow‐up.
groups. Adults and Adolescents Mental Health
Treatment plan reviews
Varies with patient treatment plan
Adults and Adolescents Mental Health
Treatment plan reviews
Adults and Adolescents Mental Health
Treatment plan reviewsd
The Clinic provides psychiatric evaluations and medication management for those patients who need such services. Each patient has a comprehensive treatment plan that coordinates all of the services being provided.
C

LIJ Health System Community

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