Beaufort County Discharges - Beaufort Memorial Hospital

Transcription

Beaufort Memorial HOSPITAL
Community Health Needs Assessment
September 2013
TABLE OF CONTENTS
EXECUTIVE SUMMARY……………………………………………………………………………………………………PAGE 3
Overview, Service Area, Demographics
Health Status & System Responsiveness
Concluding Comments
COMMUNITY HEALTH NEEDS ASSESSMENT……………………………………………………………………PAGE 5
Introduction
Beaufort Memorial Hospital Service Area, Map 1
DEMOGRAPHIC OVERVIEW…………………………………………………………………………………………….PAGE 7
Population, Tables 1-3
Economics, Tables 4-5
COMMUNITY & PUBLIC HEALTH INVOLVEMENT…………………………………………………………….PAGE 10
Community Input – Together for Beaufort County
Human Services Alliance Organizational Chart, Figure 1, Table 6
Community Input – Office of Research and Statistics
Infant Morbidity & Mortality Data, Tables 7-10
Childhood Morbidity & Mortality, Tables 11-12
Adult Morbidity, Tables 13-14
Adult Mortality, Tables 15-18
BEAUFORT COUNTY DISCHARGES…………………………………………………………………………………..PAGE 20
Beaufort County Discharges by Hospital, Table 19
SERVICE LINE OUTMIGRATIONPAGE 20
Tables 20-22
BEAUFORT COUNTY PHYSICIAN RESOURCES…………………………………………………………………..PAGE 24
Table 23
Summary
SURVEY ASSESSMENT PROCESS & METHODOLOGY…………………………………………………………PAGE 26
Community Health Needs Survey
Table 24, Graph 1 & 2
Focus Groups
MOBILIZING ACTION THROUGH PLANNING & PARTNERSHIPS (MAPP)……………………………PAGE 30
Prioritization Process
Data Sources, Table 25
Methods, Table 26
Results
COMMUNITY HEALTH RESOURCE INVENTORY………………………………………………………………..PAGE 33
Table 27
Identification of Needs, BMH Involvement, & Resources Addressing Need, Table 28
SOURCES…………………………………………………………………………………………………………………………PAGE 44
CHNA WORK GROUP……………………………………………………………………………………………………….PAGE 45
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List of Tables
TABLE 1
Population for Beaufort & Jasper Counties
PAGE 7
TABLE 2
Population by Age for Beaufort County
PAGE 8
TABLE 3
Percent Population by Age for Beaufort County
PAGE 8
TABLE 4
Summary of Demographics & Economic Indicators
PAGE 9
TABLE 5
Selected Poverty Statistics
PAGE 9
TABLE 6
Together for Beaufort County
PAGE 12
TABLE 7
Percent of Babies Born with Less than Adequate Prenatal Care
PAGE 13
TABLE 8
Percent of Babies Born with Low Birth Weight
PAGE 13
TABLE 9
Percent of Babies Born to Mothers Age 15-19
PAGE 14
TABLE 10
Infant Mortality
PAGE 14
TABLE 11
Weight Status for Students
PAGE 14
TABLE 12
Leading Causes of Death Ages 1-14
PAGE 15
TABLE 13
Selected Morbidity Data
PAGE 16
TABLE 14
Selected Data on Chronic Disease & Health Service
PAGE 17
TABLE 15
PAGE 18
TABLE 16
PAGE 18
TABLE 17
PAGE 18
TABLE 18
Leading Causes of Death Ages 65+
PAGE 19
TABLE 19
Beaufort County Discharges by Hospital
PAGE 20
TABLE 20
Beaufort County Inpatient Discharges for Select Hospitals
PAGE 21
TABLE 21
Beaufort County Surgical Patient Discharges
PAGE 22
TABLE 22
Beaufort County Medical Patient Discharges
PAGE 23
TABLE 23
Physician Hospital Affiliation by Specialty
PAGE 24
TABLE 24
Sites for Community Health Needs Survey
PAGE 26
TABLE 25
Data Sources for the BMH CHNA
PAGE 31
TABLE 26
Prioritization of Health Needs
PAGE 32
TABLE 27
Community Health Resource Inventory
PAGE 33
TABLE 28
Identification of Needs, BMH Involvement, & Resources
PAGE 42
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Beaufort Memorial HOSPITAL
Our Mission:
To deliver superior health care services to our patients
and to improve the health of our community.
Executive Summary
Overview
Beaufort Memorial Hospital (BMH) is a 197 bed non-profit community hospital located in Beaufort SC and the
largest hospital between Charleston and Savannah GA. Beaufort is the second oldest city in South Carolina and is
among the fastest growing areas of the state. It is part of the economic, cultural, and recreational hub of a large,
growing region that encompasses parts of the Georgia and South Carolina coasts. It is located 75 miles south of
Charleston, SC, 55 miles north of Savannah, GA, and 40 miles from Hilton Head, SC.
The hospital, established in May 1944 with 25 beds, was the first hospital in the area. Over time it has grown to
encompass a medical staff of more than 150 board-certified physicians, a 14-bed inpatient psychiatric unit, and
the Keyserling Cancer Center, home to the region’s only linear-accelerator. Beaufort Memorial Hospital is
accredited by The Joint Commission and since 2000, it’s vascular and cancer services have been affiliated with
Duke Medicine, bringing some of the latest technology and clinical trial involvement to the region’s Lowcountry
residents.
Service Area
Over 80% of Beaufort Memorial Hospital’s patients reside in Beaufort County, and 58% of them predominantly
in a 4 zip code area contiguous to the hospital. The importance of BMH to its surrounding rural communities is
reflected in patient origin data. Over 40% of Jasper County hospitalizations and 25% of Hampton County
hospitalizations occur at BMH. As a major tourist destination, vacationers and out-of-state residents are also a
source of patients.
Demographics
Beaufort County is ranked as one of the healthiest counties in South Carolina. However, both its demographics
and health status indicators are heavily influenced by affluent and healthy retirees that reside in Hilton Head, 25
miles south of the Broad River. Nearly 30% of those residing in Hilton Head are over aged 65 and have a median
household income above $67,000 compared to the City of Beaufort, where 15.5% of the residents are over 65
and the median household income is a more modest $49,063. The lack of affluence within the City of Beaufort is
also reflected in poverty statistics, where 15% of the people have incomes below poverty level and nearly 23%
of the population is uninsured. It is this latter area from which BMH draws the majority of its patients.
Health Status & System Responsiveness
Statistically, Beaufort County ranks well on health outcomes when compared to other South Carolina counties.
Overall, its residents are healthier, with higher percentages of women receiving adequate prenatal care and
lower infant mortality rates. Strides in reducing disparities have been made in these two areas, although low3
birth weight babies continue to be an area of concern for African American births. Overall its adult morbidity
and mortality rates also compared favorably, with a lower prevalence of diabetes and hypertension and lower
mortality rates from cardiovascular disease and cancer. However, significant disparities continue to exist
between African American and Caucasians demonstrated by earlier onset of disease, greater utilization of the
BMH Emergency Department, and slightly longer lengths of stay. It should be noted that information on the
health status of the Latino community was unavailable due to the small sample size surveyed. In most instances
there were fewer than 50 people surveyed and data was suppressed to preserve confidentiality. As this
population grows in prominence and data becomes available, information specific to the Latino community may
be included in future CHNAs.
Beaufort County has achieved top rankings in health outcomes and health factors and has a resident population
that makes use of preventive health measures; however, there are very definitive areas of concern where
intervention is needed to circumvent future increases in morbidity and mortality, especially from preventable
causes. Prevention, early detection, and early intervention - keystones of public health, will continue to be vital
components of the health care system in order to achieve reductions in costs, morbidity, and mortality.
Over the decades, BMH has grown in its capacity and in the complement of services available to the community.
Physician recruitment and additions to service line offerings have been important additions to meeting the
needs of a growing and aging population. As new technology and procedures have become safe and available,
BMH has pursued these offerings, permitting its residents to obtain a more comprehensive level of care close to
home and family.
Concluding Comments
The future adequacy of a cost effective health care delivery system within the City of Beaufort and its immediate
areas lies largely within the purview of BMH. With a growing percentage of uninsured, shifts and reductions in
reimbursement at both the Federal and State levels, and a constrained supply of primary care providers, staying
steady at the helm will be a challenge for BMH. In keeping with these challenges, the strategies and
implementation plan which evolved from this assessment process attempts to balance the community’s
identified priorities with endeavors that are fiscally sound and in keeping with BMH’s strong stewardship within
Beaufort County. The depth and breadth of BMH’s involvement in community coalitions positions it well to
continue to affect change at all levels. With public health’s growing focus on “population health management”,
BMH’s leadership will continue to be called upon; and its position of importance as a resource to the
Lowcountry’ s array of health and human service agencies will likely provide ample opportunities for BMH to
fulfill its mission.
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Community Health Needs Assessment
Introduction
Beaufort Memorial Hospital (BMH) is a 197 bed non-profit community hospital located in Beaufort, SC and the
largest hospital between Charleston and Savannah. The hospital, established in May 1944 with 25 beds, was the
first hospital in the area. Over time it has grown to encompass a medical staff of more than 150 board-certified
specialists, a 14-bed inpatient psychiatric unit, and the Keyserling Cancer Center, home to the region’s only
linear-accelerator. Beaufort Memorial Hospital is accredited by The Joint Commission and since 2000, it’s
vascular and cancer services have been affiliated with Duke Medicine, bringing some of the latest technology
and clinical trial involvement to the region’s Lowcountry residents.
As with any Community Health Needs Assessment (CHNA), the characteristics of the population to be served
provide the parameters for the complement of services that are needed to best meet the health and wellness
requirements of the community. A cross-functional team was established by BMH to ensure that a broad
spectrum of stakeholders was represented. This team included representatives from the LifeFit Community
Health Department, the South Carolina Department of Health and Environmental Control, and AccessHealth
Lowcountry.
This assessment will review sociodemographic data, pertinent public health statistics, including morbidity and
mortality data, and lastly, discuss the results of a recent survey that addressed the public’s perception of the
community’s health needs. It will conclude with the identification of specific goals and strategies for BMH to
undertake in ensuring it is responsive to the needs of its community.
Beaufort Memorial Hospital Service Area
Beaufort Memorial Hospital’s patients predominantly reside in Beaufort County, with smaller percentages
coming from the outlying areas of Jasper and Hampton Counties. As a tourist destination, out-of-state residents
are also a source of patients for BMH. Nearly 70 patients per month are from out-of-state locations, excluding
the bordering states of Georgia and North Carolina. However, for the purposes of this document, focus will be
on Beaufort County, where over 80% of BMH’s patients reside. County-level information is the most accessible
and offers the most reliability given the smaller population that comprises the actual BMH service area.
With respect to Beaufort County, Fiscal Year 2011 Patient Origin Data indicated that 58% of BMH’s inpatients
reside in 29906, 29902, 29920, and 29907. Geographically, these areas are the City of Beaufort, Town of Port
Royal, St. Helena and Lady’s Islands. The secondary service area, from which 22% of the patients originate,
includes the towns of Ridgeland, Port Royal, Yemassee, Bluffton, and the zip code area known as Seabrook. Map
1 displays the primary, secondary, and tertiary areas served by BMH.
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Map 1: Beaufort Memorial Hospital Service Area
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Demographic Overview
Population
Beaufort is the second oldest city in South Carolina and is part of the economic, cultural, and recreational hub of
the large, growing region that encompasses parts of the Georgia and South Carolina coasts. It is located 75 miles
south of Charleston, SC, 55 miles north of Savannah, GA, and 40 miles from Hilton Head, SC. Beaufort County is
among the fastest growing areas in the State. Currently, the U.S. Census Bureau estimates that 164,684 people
reside in Beaufort County, a 34% increase in residents since the 2000 census. Much of this growth has been in
Bluffton, Port Royal, and Hilton Head. Bluffton and Hilton Head are both towns in the southern portion of the
county. Bluffton has had particularly aggressive growth, increasing from approximately 1,200 people in 2000 to
over 12,000 residents in 2010. In comparison, Hilton Head’s 9.5% increase is more modest. Port Royal, with a
town limit slightly less than a mile from Beaufort Memorial Hospital, has also had substantial population growth
during the past decade. This burgeoning area is a significant source of patients for BMH’s acute care,
outpatient, primary, and specialty care medical services.
Table 1: Population for Beaufort & Jasper Counties
Area
Beaufort County
Beaufort City
Bluffton Town
Hilton Head Island
Port Royal
Jasper County
2000 Census
120,937
12,950
1,275
33,862
3,950
20,678
2010 Census
162,233
12,361
12,530
37,099
10,678
24,777
Percent Change
34.15%
-4.55%
882.75%
9.56%
170.33%
19.82%
Source: Low Country Council of Governments, Planning Department, October 2011
Current population projections for Beaufort County continue the trajectory observed in Table 1. In fact, a review
of population projections pre- and post- the 2010 census depicted an overall population estimate for 2015 of
175,990 (up from an original estimate of 170,640) and a revised projection for 2020 of 215,300 people, up from
the previous projection of 185,220, suggesting a 14.2% change between 2010 and 2020. Unfortunately,
population projections by city and town were not available at the time this document was authored.
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Although the demand for health services will certainly be influenced by this population growth, the
configuration of services needed, will also be influenced by the age and sex composition of the population.
Population changes by age category for Beaufort County are displayed in Table 2.
Table 2: Population by Age for Beaufort County, 2000 & 2010
Beaufort County
Under 5 years
5 to 9 years
10 to 14 years
15 to 19 years
20 to 24 years
25 to 34 years
35 to 44 years
45 to 54 years
55 to 59 years
60 to 64 years
65 to 74 years
75 to 84 years
85 years +
2000 Census
2010 Census
Percent Change
8,110
8,033
7,747
8,722
10,002
16,434
16,433
14,019
6,397
6,286
11,329
5,913
1,512
10,960
9,566
8,553
9,956
11,756
20,137
17,534
18,580
9,886
12,273
20,137
9,698
3,197
35.1%
19.1%
10.4%
14.1%
17.5%
22.5%
6.7%
32.5%
54.5%
95.2%
77.7%
64.0%
111.4%
Source: U.S. Census Bureau (2000), (2010)
Beaufort’s pre-school aged population is comparable to the state’s, its adult (18-64) population is lower (57.8%
compared to 62.8%), and the traditional “senior citizen” population, those over 65, is significantly higher (21.4%
versus 14.1%). These age demographics are influenced by the retirement communities in Hilton Head, and
surrounding areas. Table 3, below provides some insight into the age composition of the denser population
centers within Beaufort County.
Table 3: Percent Population by Age for Beaufort County& Minor Civil Divisions (MCDs)
Age Category
<18
18-24
25-44
45-64
65+
Median Age
Co. - Beaufort
23.0
12.0
27.2
22.1
15.5
City - Beaufort
21.6
19.5
28.9
17.8
12.2
Bluffton
28.9
6.8
35.5
21.5
7.3
Hilton Head
17.3
6.9
24.5
27.3
24.1
Port Royal
22.9
14.6
34.2
17.3
11.0
36
30
32.7
46
30
Source: U.S. Census Bureau (2010)
Age demographics are an important variable in the planning of future services and potential delivery sites for
BMH. Bluffton and Port Royal, each high growth areas, have significant proportions of youth (<18) and young
adults (aged 25-44). Hilton Head, also a projected growth area, is home to a significant proportion of seniors
(65+), with nearly a quarter of its population being over age 65.
Economics
Beaufort County is considered one of the most desirable places to live within South Carolina. It often ranks
among the highest counties in both economic and public health indices. Yet, the presence of a significant
number of affluent retirement communities masks the economic disparities that can be found in the area. If we
were to look only at the City of Beaufort’s demographics, which is the population that composes BMH’s primary
service area, a slightly different picture emerges. The City experienced a 4.5% decline in population between
2000 and 2010 compared to the aggressive growth seen elsewhere in the region. The City of Beaufort has
8
slightly more children under age 5 (7.7%) compared to the county (6.5%) and the proportion of the over 65
population (15.5%) is more in-line with the State, (13.7%) rather than the county, which is influenced by the
older population of Hilton Head. This skewing is also seen in economic data. The City of Beaufort has a higher
level of poverty (15% vs. 10.5%), a lower median household income ($49,063 vs. $55,286) and median value of
owner-occupied housing units ($222,100 vs. $290,900). The Town of Port Royal, just a half mile away from
Beaufort Memorial Hospital, is a more affordable community for housing. The median value of an owneroccupied home is almost $30,000 lower than the City of Beaufort, $57,000 lower than the Town of Bluffton, and
a $100,000 lower than Beaufort County as a whole. These individual contrasts to the aggregate data are
particularly important to BMH, since the City of Beaufort and the Town of Port Royal are the top two sources of
inpatients for the hospital. Table 4 summarizes a number of the significant economic indicators for Beaufort
County and its minor civil divisions (MCDs).
Table 4: Summary of Demographic and Economic Indicators for Beaufort County & MCDs
Census Data Item
Population Change 2000-2010
Persons < age 5
Persons aged 65 and over
Foreign Born persons, % 2006-2010
High School Graduates, % persons 25+
% persons 25+ with Bachelor’s or higher
Median value of owner-occupied housing
unit
Median HH income
Persons below poverty level % 2006-10
South
Carolina
15.3%
6.5%
13.7%
4.7%
83.0%
24.0%
Beaufort
County
34.15%
6.5%
21.4%
9.6%
90.6%
37.4%
City of
Beaufort
-4.55%
7.7%
15.5%
4.5%
88.8%
37.9%
Port
Royal
170.33%
7.5%
5.3%
6.2%
92.3%
31.0%
Hilton
Head
9.56%
4.6%
28.8%
15.0%
91.8%
50.7%
Bluffton
882.75%
9.3%
7.3%
19.2%
89.1%
32.6%
$134,100
$290,900
$222,100
192,700
$500,800
$240,800
$43,939
16.4%
$55,286
10.5%
$49,063
15.0%
$44,619
6.6%
$67,629
8.9%
$55,699
15.3%
Source: http://quickfacts.census.gov
Table 5 provides more specific information about the growing level of poverty among children and families in
Beaufort County. Overall, there was a 13% increase in children and families living in poverty, so by 2010, nearly
a quarter of the children residing in Beaufort County are residing in poverty. As discussed in the 2012 Together
for Beaufort County Annual Report, children living in poverty are at a disadvantage for future opportunities.
These disadvantages include greater infant mortality, lower birth weight, lack of early childhood care,
inadequate housing, inadequate healthy food, and eventually lower scores on math and reading tests. This
disadvantage can be seen in the review of morbidity and mortality statistics relevant to childhood in the
following section.
Table 5: Selected Poverty Statistics for Beaufort County& South Carolina, 2010
Percent Below Poverty Level
Children
Families
Persons Below Poverty Level
2010
23%
8.7%
12%
Beaufort County
Change from 2000
15.7%
11.5%
13%
South Carolina
2010
24.4%
12.9%
17.1%
Source: U.S. Census Bureau (2000), (2010)
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Community & Public Health Involvement
Beaufort Memorial Hospital is fortunate to be located within a county that has a robust configuration of health
and human services agencies with a lengthy history of interagency collaboration. BMH and its employees have a
track-record of providing technical support and leadership to innumerable organizations. One of the major
commitments has been the hospital’s participation in the Together for Beaufort County initiative, with
employees participating on 7 of the coalitions. A historical overview and description of this important publicprivate partnership follows.
Community Input - Together for Beaufort County
In 2004 a group of Beaufort County leaders introduced a community indicators project called "Together for
Beaufort County” (T4BC). This initiative is sponsored by the Beaufort County Human Services Alliance and is an
initiative that allows all Beaufort County residents to work together to improve the County’s quality-of-life. The
Alliance initially engaged a consultant to develop a series of indicators that would permit the monitoring of
progress as the identified issues were addressed.
Operational definitions of four strategic goals, each with four complementary objectives, and baseline data for
measurement of the objectives were delineated. The four strategic goals were:

Strategic Goal One:
Together we will, with our Lowcountry neighbors, build an economy that supports a sustainable qualityof-life.

Strategic Goal Two:
Together we will break the cycle of illiteracy by exceeding national education standards.

Strategic Goal Three:
We will break the cycles of poverty that impact children, elderly and the working poor.

Strategic Goal Four:
Together we will balance growth in a manner that promotes and protects the health of our residents.
Figure 1 (next page) displays these four goals and the associated coalitions.
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Figure 1: Human Service Alliance Organizational Chart
11
The sharing of this information established a common ground for public, private, and nonprofit leaders to
engage the public in a dialogue about how to work together to address these and other related issues.
Additionally, it fostered collaborations among public, private, nonprofit and faith organizations to address gaps
in services, build efficiencies, gain understanding, and address the collective responsibilities to the community
shared by the human service sector.
A 2009 Interim Report highlighted the actions taken by local community groups to improve Beaufort County’s
quality-of-life. In 2011, the Alliance contracted with University of South Carolina Beaufort to evaluate the
progress made toward achieving the original T4BC quality-of-life objectives and present the findings at a series
of public forums. Goals 3 and 4 are most closely interrelated to BMH’s mission as a non-profit, communitybased hospital. Table 6 displays BMH’s representation on the T4BC coalitions.
Table 6: Together for Beaufort County Coalitions & BMH Membership
GOAL 1: ECONOMY
Lowcountry VITA Coalition
Affordable Child Care Cost Coalition
Lowcountry Affordable Housing Coalition
GOAL 2: EDUCATION
Early Childhood Coalition
Business-Education Partnership
Partners for Adult Literacy
GOAL 3: POVERTY
Community Services Organization
Coalition for Aging in Place
Reducing Adolescent Pregnancy Alliance
Adequacy of Prenatal Care Coalition
GOAL 4: HEALTH
Eat Smart Move More Lowcountry
AccessHealth Lowcountry
Mental Health Access Coalition
Water Quality Coalition
BMH Membership
X
X
X
X
X
X
X
Source: Beaufort Memorial Hospital (2012)
Community Input – Office of Research and Statistics
A community’s health is traditionally measured by an assortment of health status indicators, particularly
morbidity and mortality data. In general, Beaufort County ranks among the healthiest of South Carolina’s
counties. Among the state’s 40 counties, as listed in County Health Rankings: 2012 South Carolina, Beaufort
County ranked 1st in health outcomes for both morbidity and mortality. It also ranked 1st in health factors, a
summary ranking that was based on health behaviors, clinical care, social and economic, and environmental
factors. Among these four factors, Beaufort ranked 1st in health behaviors, 7th in clinical care, 6th in social and
economic factors, and 1st in physical environment.
Health factors included indices such as smoking, diet and exercise, alcohol use (binge drinking and motor vehicle
accidents, and risky sex behavior (teen pregnancy and chlamydia rate). Clinical care was derived from measures
of access to care and quality of care. Access to care was impacted by the 31,000 residents in Beaufort County
who are uninsured and the number of primary care providers in the area. In terms of socioeconomic factors,
education, employment, income, family and social support and community safety statistics were all factored
into the composite score. Lastly, the physical environment was measured through air pollution data, access to
healthy food, and liquor store density.
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Beaufort County’s ranking as the healthiest county in South Carolina is laudable. However, just as aspects of the
demographical information were influenced by Hilton Head Island, such is the case with morbidity and mortality
data. Additionally, this “healthy’ ranking must be tempered by South Carolina’s national ranking as 49th in
diabetes; 42nd in obesity, high blood pressure, and high cholesterol, and 31st in cardiac disease. What follows is a
review of key morbidity and mortality information for the children and adults of Beaufort County.
Infant Morbidity & Mortality Data
In 2006, a group of Beaufort County leaders initiated a community indicators project. Four goals and four
objectives for each goal were identified as priorities. Among the three goals was Strategic Goal Three – Poverty.
Four objectives were identified as critical to reducing the impact poverty had on current and future generations
of Beaufort County residents. Among the four objectives were three related to infants and teens. The first
addressed the adequacy of prenatal care. As can be seen in Table 7, Beaufort County had a greater percentage
of children born to mothers who had not received adequate prenatal care compared to the state. As a result of
the focus on this health outcome indicator, an approximate 50% reduction was made in improving the
percentage of mothers receiving adequate prenatal care. Although there was a significant reduction for white
babies, babies born to black mothers also experienced a substantial improvement in mothers obtaining prenatal
care.
Table 7: Percent of Babies Born with Less than Adequate Prenatal Care, Beaufort County, 2006-2010
Year
2006
2007
2008
2009
2010
All
59.0
49.4
44.6
34.7
30.0
White
58.9
48.6
43.8
32.0
28.6
Black
58.8
50.7
45.6
43.1
34.3
SC - All
37.8
36.2
35.4
33.6
31.9
Source: National KIDS COUNT Program, Children’s Trust of South Carolina
Another indicator of the effects of poverty on newborns is the percentage of low birth weight babies. Low birth
weight, that is babies who are born weighing less than 5.8 pounds, can be a precursor to immediate acute
conditions including respiratory distress syndrome, birth defects, and health issues that arise later in life, such as
high blood pressure, diabetes, and heart disease. The data presented in Table 8 indicate that the percent of low
birth weight babies in Beaufort County has been increasing over the past few years. This trend is observable in
both white and black populations. Although it has increased among white babies, it is a significantly greater
problem within the black community. The number of black babies born with low birth weight is nearly 2.5 times
higher than for the white population. It is also significantly higher than the State rate (16.1 versus 9.9),
respectively.
Table 8: Percent of Babies Born with Low Birth Weight, Beaufort County, 2006-2010
Year
2006
2007
2008
2009
2010
All
7.9
7.7
9.4
9.0
9.1
White
5.3
6.1
7.6
7.7
6.8
Black
15.0
12.8
14.4
12.1
16.1
SC - All
10.1
10.2
9.9
10.0
9.9
Teenage pregnancy is the third indicator of poor health outcomes for babies. As can be seen in Table 9, there
appears to be a downward trend within both South Carolina and Beaufort County. Since 2006, the percent of
babies born to teenage mothers has decreased almost 10% in the state and 7% in the county. However, this
overall downward trend masks the increase in teenage pregnancy that has occurred in the black teenage
population within Beaufort County. Contrary to the decrease observed in babies born to white teenage
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mothers, there was a significant increase in the percentage of black teen mothers during 2007-2009, over 10%
higher for each of those years than in 2006. The most recent statistic available, 2010, yielded an approximate 8%
decline from 2009.
Table 9: Percent of Babies Born to Mothers Age 15-19, 2006-2010
Year
2006
2007
2008
2009
2010
All
50.7
54.3
46.6
50.2
43.2
White
50.5
49.6
37.6
44.5
37.7
Black
52.2
62.3
62.8
63.6
56.0
SC – All
53.0
53.6
53.0
49.0
42.6
In terms of general indices of infant health, the infant mortality rate is a universal measure utilized to compare
the health of babies both globally, between countries, and provincially, between states or communities. Overall,
there is a downward trajectory in infant mortality for Beaufort County. Since 2006, the infant mortality rate has
declined from 8.1 per 1,000 live births to 3.8 per 1000 live births. This decline, although occurring for both
white and black infants, has been more pronounced for black infants, declining from 13.4 per 1000 live births to
3.9 per 1000 live births in 2010.
Table 10: Infant Mortality Rate per 1000 Live births, Beaufort County, 2006-2010
Year
2006
2007
2008
2009
2010
All Infants
8.1
7.3
4.7
3.2
3.8
White Infants
5.9
4.1
3.0
2.5
3.8
Black Infants
13.4
18.3
9.8
5.6
3.9
SC – All Infants
8.4
8.5
8.0
7.1
7.4
Childhood Risk Factors & Mortality
During fall 2008, 2009, and 2010, the Eat Smart, Move More Lowcountry Coalition undertook the task of
measuring the Body Mass index (BMI) of 3rd, 5th and 8th grade students in Beaufort County. Overall, in 2008, 97%
of 3rd graders, 96% of 5th graders, and 83% of 8th graders were measured. During 2010, 91% of the 3rd graders,
90.4% of the 5th graders, and 83.8% of the 8th graders were measured. The result of this study, that childhood
obesity is a severe problem in Beaufort County, was disturbing.
Table 11: Weight Status for Students in Beaufort County Schools, 2008 & 2010
Grade
3
5
8
Underweight
2008
2010
3.2
3.8
3.0
2.2
1.6
2.2
Weight Status
Normal Range
Overweight
2008
2010
2008
2010
59.6
58.7
16.9
17.1
57.5
58.8
17.6
17.4
59.5
58.8
18.4
17.3
Obese
2008
20.3
21.9
20.4
2010
20.4
21.6
21.7
Source: Beaufort County, South Carolina, 3rd, 5th, & 8th Grade Students Body Mass Index, fall 2008, Fall 2010
As seen in Table 11, in both 2008 and 2010, nearly 40% of the children attending Beaufort County Schools were
overweight or obese. This was particularly notable among lower socioeconomic status (SES) households.
Differences among the BMI measures were found between male and female students, among different SES
levels, and between white, African American, and Hispanic children. These studies led to a goal to reduce the
percentage of overweight/obese residents and the percentage of diabetes, hypertension, heart disease, and
stroke by 2012.
14
The leading causes of death for children in Beaufort County are displayed in Table 12. Overall, the mortality rate
for children 1-14 in Beaufort County is identical to the rate for South Carolina. What is notable for the 20082010 periods is that deaths due to malignant neoplasms were almost double the South Carolina rate. However,
given the small number of deaths involved, a 5-year or 10-year rate is more appropriate for comparative
purposes.
Table 12: Leading Causes of Death Ages 1-14 in Beaufort County, 2008-2010
Cause of Death
(ICD-9 Codes)
All Causes
Malignant Neoplasms (Cancer)(C00-C97)
Accidents (V01-X59, Y85-Y86)
Homicide (X85-Y09, Y87.1)
All Other Causes
Number
Percent
Rate/100,000
SC Rate/100,000
17
4
3
3
7
100
23.5
17.6
17.6
41.2
0.6
14.7
11.0
11.0
25.8
0.6
7.9
20.8
5.1
18.3
Source: Community Health Needs Assessment Toolkit, South Carolina Hospital Association, 2012
The second rate that is notable is the deaths due to homicide. Again, this rate is double the state rate for 20082010. As with malignant neoplasms, the small number of deaths involved during the 3-year period, in essence 1
death per year may or may not be indicative of a broader societal problem.
Adult Morbidity
The Community Health Status Indicators Project, as compiled by the U.S. Department of Health and Human
Services, provides information on average life expectancy, utilization of adult preventive services, and risk
factors for premature death. The average life expectancy in Beaufort County for 2009 was estimated to be 78.9
years. This compares favorably to the U.S. median of 75.1 years, and the range among counties that are
considered peers of Beaufort (75.1 – 79.). This same report indicated that based on the information included in
the CDC’s Behavioral Risk Factor Surveillance System for years 2000-2006, 86% of women over age 18 residing
in Beaufort County obtained a pap smear, 85.7% of women over age 50 received a mammogram, and 50% of
persons aged 50 and over obtained a colonoscopy/sigmoidoscopy. Of the senior citizen population, 70.8% of
those over aged 65 received a pneumonia vaccine and 68.4% had a flu vaccine. Beaufort County’s residents
exceeded state percentages for these preventive measures in all categories except colonoscopy/sigmoidoscopy.
Table 13 (next page) reviews a number of other indicators of morbidity. In general, Beaufort County residents
fare better than their state counterparts. However, Beaufort lags behind national benchmarks for excessive
drinking and the number of uninsured. Both of these issues were ranked among the top health problems in
Beaufort County on a survey conducted for this needs assessment. Alcohol abuse ranked second on a list of
unhealthy behaviors.
15
Table 13: Selected Morbidity Data for Beaufort County, 2011-2013
HEALTH
OUTCOMES
MORBIDITY
Poor or Fair
Health
Poor Physical
Health Days
Poor Mental
Health Days
HEALTH
BEHAVIORS
Adult Smoking
Adult Obesity
Physical Inactivity
Excessive Drinking
CLINICAL CARE
Uninsured
Primary Care MDs
Dentists
Diabetic Screen
Mammography
2011
2012
2013
Beaufort
Co.
SC
Nat’l
Benchmark
Beaufort
Co.
SC
Nat’l
Benchmark
Beaufort
County
SC
Nat’l
Benchmark
9%
16%
10%
10%
16%
10%
10%
16%
10%
2.6
3.6
2.6
2.7
3.7
2.6
2.7
3.6
2.6
3.0
3.6
2.3
3.0
3.6
2.3
2.9
3.6
2.3
19%
20%
*
20%
22%
30%
*
15%
15%
25%
*
8%
19%
21%
18%
20%
22%
31%
28%
14%
14%
25%
21%
8%
16%
21%
18%
19%
21%
31%
28%
14%
13%
25%
21%
7%
27%
1,290:1
*
84%
75%
21%
1,202:1
*
81%
65%
13%
631:1
*
89%
74%
20%
1,290:1
*
83%
75%
19%
1,202:1
*
83%
70%
11%
631:1
*
89%
74%
23%
1,552:1
1,129:1
85%
77%
20%
1,545:1
2,229:1
85%
69%
11%
1,067:1
1,516:1
90%
73%
Source: http://www.countyhealthrankings.org
* Indicates data was not available
Yet, as we have previously seen, the statistical information available at the county level frequently masks the
disparities found in vulnerable populations. Information provided by the South Carolina Hospital Association
included hospital and emergency room data for selected chronic diseases by race. The contrast between the
white and black population is startling. As seen in Table 14 (next page), black patients with an inpatient stay or
Emergency Department (ED) visit for hypertension, heart disease, stroke or diabetes tend to be younger than
their white patients. In fact, they are 10 - 20 years younger and consistently spend one more day hospitalized.
16
Table 14: Selected Data on Chronic Disease Conditions & Health Service Utilization, 2011
Disease Category
Hypertension
Prevalence
Crude hospitalization rate/100,000
Average Length of Stay
Median Age of Patient
Crude ED visit rate/100,000
Heart Disease
Prevalence
Stroke
Prevalence
Diabetes
Prevalence
Chronic Lower Respiratory Disease
Prevalence
South Carolina
Beaufort Co.
Beaufort County by Race
White
Black
36.4%
73
4
58
290
53
35.4%
112
5
61
313
59
35
3
67
190
72
209
4
60
750
53
4.3%
1,127
5
68
97
63
4.8%
898
4
71
134
69
819
4
74
131
71
1,148
5
64
117
58
3.7%
310
5
69
97
67
3.8%
210
4
74
134
73
199
4
76
131
75
224
5
65
117
61
12.1%
203
5
52
289
53
11.6%
145
5
54
217
54
71
4
56
95
62
398
6
52
236
54
Not available
342
5
63
954
38
Not available
253
5
69
528
35
221
4
74
273
47
356
6
54
1,381
25
Source: South Carolina Department of Health and Environmental Control, 2011
Adult Mortality
Age-specific mortality information, by cause, for the three-year period of 2008-2010 was provided by the South
Carolina Hospital Association (SCHA) as part of the Community Health Needs Assessment Toolkit that was
distributed to member hospitals. Tables 15-18 display this data for Beaufort County and South Carolina. Caution
should be used in reviewing this data due to the small number of deaths in some categories. Mortality rates are
often unstable when they are based on fewer than 20 deaths, and are unreliable for drawing any conclusions.
17
Table 15: Leading Causes of Death for Ages 15-24 in Beaufort County & South Carolina, 2008-2010
Cause of Death
(ICD-9 Codes)
All Causes
Suicide (X60-X84, Y87.0)
Homicide (X85-Y09, Y87.1)
All Other Causes
Number
Percent
Rate/100,000
Beaufort Co.
Rate/100,000
South Carolina
47
24
9
4
10
100
51.1
19.1
8.5
21.3
2.2
112.2
42.1
18.7
46.8
2.7
132.6
34.6
38.7
35.6
Source: Community Health Needs Assessment Toolkit, SCHA 2012
Table 15 provides data for 15-24 year olds. As can be seen, the overall mortality rate is slightly lower than the
state’s. However, when we look at the causes, the suicide rate of 42.1 per 100,000 is higher than the state.
Additionally, it accounts for almost one-fifth of the deaths during the three-year time period, second only to
accidents. The presence of two military bases, the Marine Corps Recruit Depot on Parris Island and the Marine
Corps Air Station within Beaufort County might account for the higher suicide rate.
Table 16: Leading Causes of Death for Ages 25-44 in Beaufort County & South Carolina. 2008-2010
Cause of Death
(ICD-9 Codes)
All Causes
Malignant Neoplasms (Cancer)(C00-C97)
Diseases of the Heart (I-I09, I11, I13, I20-I51)
All Other Causes
Number
Percent
Rate/100,000
Beaufort Co.
Rate/100,000
South Carolina
134
48
20
11
55
100
35.8
14.9
8.2
41
3.8
134.7
56.1
30.9
154.4
5.5
153.6
67.2
81.8
196.4
Source: Community Health Needs Assessment Toolkit, SCHA 2012
In terms of young adults, the overall mortality rate for the 25-44 year old age group is lower than South
Carolina’s, 3.8/100,000 compared to 5.5/100,000. It is also consistently lower, as seen in Table 16, in the leading
causes of death for this age group.
Table 17: Leading Causes of Death for Ages 45-64 in Beaufort County & South Carolina, 2008-2010
Cause of Death
(ICD-9 Codes)
All Causes
Malignant Neoplasms (Cancer) (C00-C97)
All Other Causes
Number
Percent
Rate/100,000
Beaufort Co.
Rate/100,000
South Carolina
596
220
105
39
232
100
36.9
17.6
6.5
38.9
15.6
576.3
275
102.2
607.7
23.5
717.5
537.1
165.6
923.6
Source: South Carolina Hospital Association, Community Health Needs Assessment Toolkit (2012)
The overall mortality rate for middle-agers, those 45-64, is significantly lower than the South Carolina rate, as
are the rates for the leading causes of death. The age-specific mortality rate, as seen in Table 17, for Beaufort
County is 15.6/100,000 compared to 23.5/100,000 for South Carolina as a whole.
18
Table 18: Leading Causes of Death for Ages 65+ in Beaufort County & South Carolina, 2008-2010
Cause of Death
(ICD-9 Codes)
All Causes
Malignant Neoplasms (Cancer) (C00-C97)
Alzheimer’s (G30)
All Other Causes
Number
Percent
Rate/100,000
Beaufort Co.
Rate/100,000
South Carolina
2,767
716
568
182
1,301
100
25.9
20.5
6.6
47
88.6
2291.4
1817.8
582.5
4163.6
135.0
2910.1
3179.4
727.2
6656.9
Source: South Carolina Hospital Association, Community Health Needs Assessment Toolkit (2012)
The last age group considered is senior citizens, typically defined as those people aged 65 and over. The
mortality rate for this group (88.6/100,000) is also lower than the state’s (135.0/100,000), as seen in Table 18.
19
Beaufort County Discharges
Limited data was available relative to patient origin by hospital, given its proprietary nature. However, the
South Carolina Department of Health and Environmental Control, Office of Research and Statistics (ORS)
provided some general information on patient discharges by county and hospital.
Table 19 displays information on the total number of non-military discharges in Beaufort County during 2010
and 2011 for each of the three Beaufort County hospitals: BMH, Coastal Carolina Hospital, and Hilton Head
Hospital. BMH captures over 50% of the inpatient discharges attributable to Beaufort County residents.
Excluded from this data are inpatient days at the Naval Hospital Beaufort, which serves all active duty and
retired Navy and Marine Corps personnel, and all military dependents residing in the Beaufort area.
Table 19: Beaufort County Discharges by Hospital*
Beaufort Memorial Hospital
Coastal Carolina Hospital
Hilton Head Hospital
Other
Total
2010
8,146
484
3,894
1,803
14,327
Total Discharges
2011**
8,743
694
3,923
317
13,677
Source: South Carolina, Office of Research and Statistics
**Discharges from GA and NC hospitals are not included for 2011.
% Discharge
2010
2011
56.8%
63.9%
3.3%
5.0%
27.2%
28.7%
12.6
2.3
100%
100%
*Excludes newborns
Service Line Outmigration
During 2011, approximately 2,777 Beaufort County residents were hospitalized outside their county of
residence, referred to as “outmigration”. Discharges from the neighboring states of Georgia and North Carolina
were not yet included. However, of the 2,777 discharges, 61% were hospitalized in Charleston County, 25% in
Jasper County, 10% in Greenville County, and approximately 4% scattered throughout 16 other counties in South
Carolina (SC). By comparison, in 2010 which includes out-of-state discharges in North Carolina and Georgia,
there were 4,330 Beaufort County residents discharged from short-term general hospitals located outside the
county. The greatest percentage of these discharges (45%) were from facilities in Georgia, followed by 36% in
Charleston, 11% percent in Jasper County, 3.6% in Greenville County and 2.4% in North Carolina. The remainder
of out-of-county discharges (3%) was distributed over 17 other SC counties. It should be noted, that additional
information related to inpatient discharges from facilities within Georgia was not within the public domain.
Access to this data requires the signing of a data agreement with the Georgia Department of Community Health.
Once the agreement has been approved, the data can be purchased or viewed in person at their Atlanta office.
Patient origin data for non-federal, SC acute care facilities was available through ORS. This information provided
information on acute care discharges, by hospital, by county of residence. For example, during 2010, MUSC had
a total of 31,840 discharges, of which, 1,357 were from Beaufort County residents. Each hospital in the ORS
data base was reviewed for Beaufort County discharges. In addition, information on discharges by service
category was available. Table 20 (next page), displays these discharges by service category for the
preponderance of out-of-county discharges derived from Beaufort County residents. As can be seen, the
greatest number of out-of-county discharges was from MUSC. In terms of service category, during 2010 and
2011, over 60% of the MUSC discharges were for surgical procedures. Smaller percentages were observed for
other service categories: 15-20% for medical, 8% pediatric, and 6% obstetrics. Psychiatric discharges almost
doubled between 2010 and 2011, from 2.7% to 4.9%. That may have been related to the departure of a
Beaufort-area psychiatrist.
20
The second greatest migration was to Greenville Memorial Hospital, followed by Roper Hospital, and Bon
Secours, St. Francis Xavier, both located in Charleston.
Table 20: Beaufort County Inpatient Discharges* for Select Hospitals by Service Category, 2010 & 2011
Hospital
No. Patients
Obstetrics
Surgical
Medical
Pediatric
Psychiatric
2010
2011
2010
2011
2010
2011
2010
2011
2010
2011
2010
2011
1357
1479
87
98
914
912
210
278
110
125
36
66
Greenville Memorial
140
263
22
47
73
117
27
66
17
26
1
7
Roper Hospital
100
103
0
0
80
84
20
19
0
0
0
0
Bon Secours, St.Fran.
51
53
6
3
40
43
5
5
0
0
0
2
Palmetto - Richland
32
17
1
0
15
7
14
6
1
0
1
4
Trident Medical
25
38
0
1
22
30
3
7
0
0
0
0
East Cooper Med. Ctr.
17
21
2
1
15
18
0
4
0
1
0
1
Palmetto - Baptist
10
10
0
2
6
3
2
2
0
0
2
3
1732
1984
118
152
1165
1214
281
387
128
152
40
83
MUSC
Other
TOTAL
Source: SC Budget and Control, Office of Research and Statistics, 2010 & 2011
*Excludes newborns
There is some additional outmigration to other hospitals throughout South Carolina; however, the discharges at
these facilities were less than 10. It should also be noted, that discharges from Coastal Carolina and Hilton Head
Hospitals were not included in this table, since both hospitals have a presence in Beaufort County and the data
was specific to discharges outside the patient’s county of residence.
Further examination of medical and surgical patient discharges was conducted. Table 21 (next page) displays
the outmigration for surgical discharges by procedure category. The greatest number of discharges was for
cardiovascular procedures, followed by orthopedics. Interesting to note, is the increase in vascular/cardiac
procedures performed at Greenville Memorial Hospital, which nearly tripled between 2010 and 2011. Increases
at Greenville Memorial Hospital also occurred in abdominal, orthopedic, and plastic surgeries. Differences
between the two calendar years were also observed for MUSC. Although there was little change in the total
number of surgical procedures performed at MUSC, percentage-wise the charges are notable. Significant
declines occurred in Vascular/Cardiac (10%), Abdominal (18%) and Thyroid/thymus procedures (36%). Increases
occurred in the Nervous System (28%), Plastic Surgery (111%), Breast (67%), and Other (27%) categories.
In part, BMH has addressed the outmigration of cardiac services by changes in its service line offerings. A CON
application to perform cardiac procedures on patients presenting with an ST elevated myocardial infarction was
recently approved. This newly licensed service went “live” June 1, 2013. A further decline in the outmigration of
vascular and cardiac procedures is likely to be observed in forthcoming years.
21
Table 21: Beaufort County Surgical Patient Discharges* for Select Hospitals, 2010 & 2011
Surgical Category
MUSC
Vascular/Cardiac
Abdominal
Appendectomy
Cholecystectomy
Hernia
Orthopedics
Nervous System
Urological
Thoracic
Gynecological
Thyroid/Thymus
Otolaryngology
Tonsils & Adenoids
Plastic Surgery
Breast
Ophthalmology
Proctology
Other
Oral/Maxillary
Dental
2010
302
146
0
3
2
107
64
49
48
28
42
29
3
9
9
6
4
55
4
4
2011
275
120
0
5
1
112
82
51
54
29
27
35
5
19
15
1
1
70
10
0
TOTAL
914
912
Greenville
2010
2011
13
35
16
23
1
2
2
0
0
0
12
19
11
10
5
5
4
6
0
6
0
0
2
1
0
0
0
8
0
0
0
1
1
0
6
0
0
1
0
0
73
117
Roper
2010
52
3
0
0
0
21
1
0
0
2
0
0
0
0
0
0
0
1
0
0
2011
54
4
0
3
0
14
1
0
2
1
0
0
0
0
0
0
0
5
0
0
80
84
St. Francis Xavier
2010
2011
0
1
1
4
0
0
0
0
0
0
28
25
6
5
3
2
1
2
0
1
0
1
0
1
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
40
43
* Excludes newborns
22
Table 22 displays 2010 and 2011 medical discharges for Beaufort County residents. As can be seen, there is far
less outmigration for medical conditions. Although the majority of these discharges were from MUSC, a
significant increase can be observed for Greenville Memorial Hospital. This increase from 20 to 65 discharges
was primarily attributable to discharges in the “Symptoms/Ill-Defined” and “Circulatory System” medical
categories.
Table 22: Beaufort County Medical Patient Discharges* for Select Hospitals, 2010 & 2011
Medical Category
MUSC
Circulatory System
Accidents/Poisoning/Violence
Digestive System
Symptoms/Ill-Defined
Nervous System
Special Conditions
Neoplasms (includes cancer)
Respiratory System
Endocrine/Metabolic System
Muscular/Skeletal System
Infection/Parasitic Diseases
Diseases of the Blood
Congenital Anomalies
Genitourinary System
Skin/Subcutaneous Tissue
2010
58
35
20
21
18
8
13
7
8
8
5
5
2
2
0
2011
59
51
13
19
16
32
17
16
7
7
9
16
1
12
3
TOTAL
210
278
Greenville
2010
2011
2
27
5
9
4
4
2
3
1
1
3
7
1
1
6
7
1
0
0
0
1
1
1
1
0
0
0
3
0
1
1
27
65
Roper
2010
6
0
0
0
1
8
2
1
0
0
1
0
0
0
1
2011
3
0
0
1
0
11
1
2
0
0
1
0
0
0
0
20
19
*Excludes newborns
In conclusion, BMH will continue to observe the outmigration of Beaufort County residents for medical and
surgical services. As Beaufort County continues to grow and as new technology evolves, it is expected that the
hospital will continue to enhance and shape its services lines to best meet the needs of the community.
23
Beaufort County Physician Resources
Beaufort County has three distinct medical communities, with the locus of practices conforming to the
respective hospital services areas of Beaufort Memorial Hospital, Coastal Carolina Hospital, and Hilton Head
Regional Healthcare. Table 23 displays the number of physicians on staff at each of the three hospitals. The
listing has not been adjusted for cross-privileges nor does it reflect full-time-equivalents (FTEs).
Table 23: Physician Hospital Affiliation by Specialty, 2012-2013
Physician Specialty
Cardiology
Dermatology
Emergency Medicine
Family Medicine
Gastroenterology
General Surgery
Gynecology
Hematology
Hospitalists
Internal Medicine
Interventional Radiology
Neurology
Nephrology
Obstetrics & Gynecology
Oncology
Ophthalmology
Otolaryngology (ENT)
Orthopaedics
Pediatrics
Plastic & Reconstructive Surgery
Psychiatry
Pulmonology, Critical Care
Radiation Oncology
Urology
Vascular Surgery
Beaufort Memorial
Hospital
5
2
20
12
7
5
2
2
19
14
6
3
13
9
3
4
4
9
16
2
5
1
2
3
1
Coastal Community
Hospital*
4
1
5
6
2
2
4
1
Not listed
6
Not listed
1
4
0
1
2
0
7
1
1
Not listed
1
Not listed
2
1
Hilton Head Regional
Hospital*
4
4
8
3
3
5
See Obstetrics
1
4
6
Not listed
2
1
7
1
5
2
6
8
2
1
3
1
4
1
*Physician count has not been adjusted for cross-privileges between the two Tenant-owned facilities.
Source: 2012-2013 Physician Directory, Hilton Head Regional Healthcare, Directory of Physicians & Services,
05/12, Beaufort Memorial Hospital Medical Staff Services, September 2013.
As previously mentioned, in 2012, Beaufort County had a primary care physician to population ratio of 1,290:1
compared to a national benchmark of 631:1. This ratio includes family practitioners, internists, and pediatricians
yielding 38 active primary care practitioners affiliated with BMH. However, 40% of these physicians (n=15) are
pediatricians and the remaining 23 are geographically dispersed throughout the county, including Bluffton,
Lady’s Island, Port Royal, Sheldon, and St. Helena’s Island.
Federal Health Professional Shortage Area criteria require a 3500:1 or less ratio of population to primary care
physician, including family physicians, internists, pediatricians and obstetrician/gynecologists for geographic
designation as a shortage area. However, within this general definition, pockets of physician shortages exist
within the BMH’s secondary and tertiary service areas. This is particularly evident, if children (those age 18 and
under) and pediatricians are excluded from the ratio calculations. Beaufort County has an approximate ratio of
4107:1 when including only family physicians and internists. If adjusted for full-time equivalents, the ratio would
24
likely be higher. Compounding the primary care capacity issues of the area is a seasonal population of tourists
and migrants, both of whom have a strong presence in the summer months. Lastly, access to primary care is
also impeded by geographic barriers and the challenges faced by a rural population dependent upon private
transportation to obtain care.
Over the past several years, BMH has aggressively recruited physicians, particularly in primary care and
psychiatry. Successful recruitment has led to the establishment of Beaufort Memorial Bluffton Medical Services
and Lady’s Island Internal Medicine. With the greying of Baby Boomers and the projected population growth
BMH will be confronted with continued demand for primary care services and specialties best suited for the
treatment of chronic disease.
Summary
Overall, health status indicators for Beaufort County reflect a population that is somewhat healthier than the
rest of South Carolina. This appears to be in keeping with people’s perceptions. With only 10% of the
population rating their health as fair or poor, and even fewer experiencing poor physical health days (2.7%), and
poor mental health days (2.9%), this is compared to the rest of the state, where 16% reported poor or fair
health, 3.6 poor physical health days, and 3.6 poor mental health days. Beaufort’s indicators were more aligned
with national benchmarks (see Table 13).
Although Beaufort County has achieved top rankings in health outcomes and health factors and has a resident
population that makes use of preventive health measures, there are very definitive areas of concern where
intervention is needed to circumvent future increases in morbidity and mortality, especially from preventable
causes. In particular, the overweight and obese school-aged population is an area of great concern. Excessive
weight has been identified as a causal factor in the development of heart disease, diabetes, hypertension, and
stroke. This is of particular importance to the black community, given the higher hospitalization rates and
longer length of stays they experience.
The number of uninsured residents has also been identified as a variable that is impacting the health and
wellness of Beaufort County. The percent of uninsured in Beaufort County is double the national benchmark.
Access to health care is further compromised by constraints in primary care capacity and challenges in
overcoming geographic distance to obtain care. The limited access to primary care physicians may be a
contributing factor in the higher rates of Emergency Department utilization for hypertension, heart disease, and
stroke. Continued lack of access to adequate primary care will impede progress in reducing morbidity related to
chronic disease and could ultimately lead to premature death.
25
Survey Assessment Process & Methodology
The quantitative analysis identified several areas of emphasis for Beaufort Memorial Hospital’s community
wellness programming. Although the precision of vital statistic data can provide impartial guidance for the
hospital’s resources, it is also essential to understand and be responsive to the community’s perception of what
they believe are the major health needs.
Community Health Needs Survey
In keeping with BMH’s commitment to improve community health and promote wellness, a number of
convenience surveys were conducted to gather information about the community’s perception of the major
health problems and unhealthy behaviors in Beaufort County. A total of 349 residents were surveyed, spanning
from high school students to those over 65. Surveying opportunities were strategically chosen to ensure
inclusion of vulnerable populations, such as the medically underserved, low-income and minorities. Table 24 lists
the groups who were surveyed, the sample size, when the survey was conducted, and whether the surveys
included information representative of vulnerable populations.
Table 24: Sites for Community Health Needs Survey
Group
Community Wellness Breakfast
Together for Beaufort County CSO*
BMH Medical Career Group
Sheldon Township Community Support Partnership Coalition
Beaufort High School Health Occupations Students of America
Assoc.
Gullah Nurses Association
PASO’s Promotores – Human Services Outreach to the Latino
Community
Beaufort County Alliance for Human Services
The Link Church
St. Helena Baptist Church
Mount Carmel Baptist Church
Faith Memorial Baptist Church
Family Worship Center
Tabernacle Baptist Church
Grace Chapel AME
TOTAL
Survey
Location
Beaufort
Beaufort
Jasper Co.
Dale
Survey Date
Vulnerable
Population
11-2012
11-2012
12-2012
12-2012
Sample
Size
58
17
16
11
Beaufort
12-2012
27
Yes
St. Helena
Jasper Co. &
Bluffton
Beaufort
Beaufort
St. Helena
Dale
St. Helena
Northern
Beaufort
Beaufort
Beaufort
01-2013
10
Yes
01-2013
9
Yes
01-2013
02-2013
02-2013
02-2013
02-2013
47
25
25
23
23
02-2013
25
Yes
02-2013
02-2013
13
20
349
Yes
Yes
Source: Beaufort Memorial Hospital Community Health Needs Survey 2013
Yes
Yes
Yes
Yes
Yes
Yes
*Community Services Organization
Amazingly, the residences of the survey respondents corresponded exactly with BMH’s primary and secondary
service areas. Of the 349 people surveyed, 58% of the respondents resided in zip codes that comprise the
primary service area of BMH (58% of BMH patients) and 22% in the zip codes that comprise the secondary
service area (22% of BMH patients). Overall, the top three health problems, in descending order, were
obesity/overweight, lack of access to medical care, and cancer. Poverty, heart disease, and access to dental care
tied for the fourth ranked health problem. The top six unhealthy behaviors that were identified in the survey
results, as seen in Graph 2, in descending order, were being overweight, alcohol abuse, poor eating habits, drug
abuse, lack of exercise, and not going to a doctor for care. When the surveys are reviewed with respect to age
groups, some expected concerns arise. Results from the two teen groups that were surveyed reflected ageappropriate concerns and awareness of health issues prevalent in the community. These teens aged 18 or
26
under, ranked the top five health problems in Beaufort County as 1.)teenage pregnancy, 2.)diabetes, 3.)high
blood pressure, 4.)cancer, and 5.)sexually transmitted diseases. The top five unhealthy behaviors for this same
age group were 1.)having unsafe sex, 2.)drug abuse, 3.)alcohol abuse, 4.)being overweight, and 5.)not using seat
belts.
Graph 1
Top Health Problems in Beaufort County
Obesity/Overweight
Access to Medical Care
Cancer
Poverty
Heart Disease
Access to Dental Care
Substance Abuse
Unemployment
Mental Health
Teenage Pregnancy
High Cholesterol
Arthritis
Tobacco Use
Stroke
Domestic Violence
HIV/AIDS
0
50
100
150
200
Number of Responses
Source: Beaufort Memorial Hospital Community Health Needs Survey (2013)
27
Graph 2
Top Unhealthy Behaviors in Beaufort County
Being Overweight
Alcohol Abuse
Poor Eating Habits
Drug Abuse
Lack of Exercise
Not Going to A Doctor
Dropping Out of School
Unsafe Sex
Tobacco Use
Not Going to A Dentist
Violent Behavior
Distracted Driving
0
50
100
150
200
250
Number of Responses
Source: Beaufort Memorial Hospital Community Health Needs Survey (2013)
Focus Groups
In addition to the survey, information was gathered through several focus groups and interviews with key
informants in Beaufort County. These interviews and focus groups, including one with uninsured residents of
Hilton Head Island were conducted by Amy Martin, Dr.PH, Deputy Director, SC Rural Health Research Center,
from the University of South Carolina, Arnold School of Public Health. A focus group with breast cancer
survivors was conducted by Dixie Slichter, coordinator of the Paula Williams Memorial Breast Cancer Support
Group at Beaufort Memorial Hospital, and Brenda Hughes, Community Transformation Grant Coordinator,
Lowcountry Region, SC Department of Health and Environmental Control.
Dr. Martin’s results from the focus groups and interviews were included in a Health System’s Profile that was
conducted as a prerequisite to obtaining funding by The Duke Endowment (TDE) through the South Carolina
Hospital Association to implement an AccessHealth program. Three recommendations were made for
improvement to the local health care system. The first recommendation was for health care providers to
distribute an updated list of area health care resources. There was specific concern expressed by the patient
stakeholders that outdated brochures are not trusted. Recommendation two was for the health system to
consider the use of patient navigators, particularly for patients with multiple or complex medical problems.
Lastly, to “refer rather than reject”. The uninsured focus group participants would encourage health care
providers to refer uninsured patients to agencies or providers who will provide care rather than just say “no”.
The health issues that this group identified as the biggest priorities for Beaufort County were cancer, heart
disease and hypertension, diabetes, dental care, and mental health.
28
Sixteen(n=16) women, all members of the Paula Williams Memorial Breast Cancer Support Group sponsored by
Beaufort Memorial Hospital, participated in a focus group that inquired about their perception of what is
needed within the local public health system. The participants stated preventative measures relative to health
are not generally considered until diagnosis. This is the case for both patients and health care providers. The
concept of awareness was described as knowledge about chronic diseases, risk factors, treatment options, and
the relevance of family history as a risk factor in chronic diseases. Prevention was described as knowledge of
behaviors needed to be adopted in order to remain in an optimal state of health. Education is the understanding
of how to adopt healthy behaviors. Awareness, prevention and education are related but not one in the same.
The participants were very clear on these distinctions. The focus group feedback included statements that the
Local Public Health System (LPHS) does an adequate job in advertising services, special promotions and free
and/or low cost screenings but care should be taken to make sure advertising is targeted to underserved
communities. The women felt that a better job could be done with regard to promoting prevention, awareness
and education. Special efforts should also be made to reach underserved communities.
Probing was done to further the discussion of concerns with the local health system. Navigating the local health
care was identified as a challenge, unless there is someone within the system who is coordinating care.
Participants shared that, as patients, they need to understand that they can advocate for themselves. They must
also be equipped to do so. Lastly, the participants said that access to care is dependent upon location (i.e.
decreased access in Sheldon Township) and type of insurance (i.e. private vs. Medicare/Medicaid).
29
Mobilizing Action through Planning &
Partnerships (MAPP)
Prioritization Process
The first step in strategic planning is prioritization. Prioritizing issues allows the public health system and
community to direct resources, time and energy to those issues deemed most critical and practical to address. A
number of methodologies are available for this portion of the process including “Simplex”, “Nominal Group
Planning”, “Criteria Weighting”, and “Hanlon”. For the purpose of BMH’s Community Health Needs Assessment
(CHNA), the “Criteria Weighting” method was employed. Criteria weighting is more objective, offers numerical
ranking through a mathematical process, and allows for weighting criteria differently. As a first step, criteria are
established against which each issue is weighted. Consideration can be given to the magnitude of the problem,
the seriousness of the consequences resulting from the issue, and the ability to evaluate outcomes from
interventions. The relative significance of each criterion is assigned a value and these values are then utilized as
weights in the ranking process. The identified issues are then ranked in accordance with the criteria and given a
score, multiplied by the weight and given a “significance level”. The significance level is then utilized in ranking
of priorities.
Data was collected, analyzed and disseminated from a variety of sources. This data was then scored, based on
an evidence-based prioritization process similar to the one described above.
30
Data Sources
Table 25 provides a listing of the data sources utilized and/or collected.
Table 25: Data Sources for the BMH CHNA 2013
Source
South Carolina Hospital Association, BMH Community Needs
Assessment Toolkit (2011)
US Census Bureau (2010), (2000)
Children’s Trust of South Carolina, National KIDS COUNT
Program.
Community Health Rankings (2010)
Community Health Status Report (2010)
Community Health Survey ** (2012-2013)
County Health Rankings (2011-2013)
South Carolina Department of Health and Environmental
Control (2010)
Health System Profile Beaufort & Jasper Counties (2011)
Paula Williams Memorial Breast Cancer Support Group
(2012)
Low Country Council of Governments, Planning Department
(2011)
Together for Beaufort County Annual Report (2012)
Type
Demographics, patient origin, morbidity/mortality rates,
health status indicators
Demographics
Prenatal care and infant mortality statistics
Morbidity/mortality, risk factors, behavioral factors,
demographics, county rankings
Chronic disease rates, risk factors, mortality rates,
behavioral factors, environmental hazards
Health perceptions (i.e. risk factors, chronic disease, public
health system) at the community level
Morbidity/mortality, uninsured, provider ratios
Morbidity/mortality rates, risk factors, chronic disease rates,
demographics
Stakeholder & community focus groups: utilization of
services, access to care, health outcomes, indicators
Focus group: perceptions of local public health system
Economic indicators, health outcomes/indicators
Economy, environmental hazards, county goals/objectives,
health indicators
**Beaufort Memorial Hospital Community Health Survey (2012-2013) (See Table 24) was distributed at the
following locations: Community Wellness Breakfast, Together for Beaufort County CSO, BMH Medical Career
Group, Sheldon Township Community Support Partnership Coalition, Beaufort High School Health Occupations
Students of America Assoc., Gullah Nurses Association, PASO’s Promotores, Beaufort County Alliance for Human
Services, The Link Church, St. Helena Baptist Church, Mount Carmel Baptist Church, Faith Memorial Baptist
Church, Family Worship Center, Tabernacle Baptist Church, & Grace Chapel AME.
Methods
Data from the Community Health Survey was analyzed. This survey was used as the primary “driver” of the items
being scored to ensure the voice of the community is captured. The measures included health problems (access
to medical care, heart disease, high blood pressure, etc.) and health behaviors (diet, exercise, etc.).
Respondents were instructed to check-off what they considered to be the five most important health problems
and the five most important unhealthy behaviors in Beaufort County. Measures used in the survey were
grouped into categories, or constructs (i.e. chronic disease, obesity, access), as seen in Table 26. Categories were
named based on the data sources in Table 19. For example, “obesity” is a construct found in the majority of data
sources in Table 24. The categories were ranked based on the total number of responses received for each
measure. Scoring was based on three criteria: 1.) ability to evaluate outcomes of implemented strategies, 2.)
size, and 3.) seriousness of the health problem. Within each criterion, numerical ratings were assigned. For
example, to evaluate outcomes, scores are based on what data is available (anecdotal, baseline, trend). The size
of the health problem is based on the percentage of the population affected by a particular problem. To
evaluate the seriousness of a health problem, scores are based on the impact of a health problem (i.e. the
nature of the problem, does it cause long term illness, death rates, hospitalizations, economic and community
impact, etc.). The results of construct groupings and their respective rankings are in Table 26 (next page).
31
Table 26: Prioritization of Health Needs
Category
Chronic Disease
Obesity
Access
Poverty
Dental
Injury
Violence
Substance Abuse
Prenatal Care
Infectious Disease
Description
Hypertension, diabetes, heart disease,
stroke, cancer, high cholesterol, etc.
Being overweight/obese, exercise, eating
habits
Medical care, not going to doctor
Homelessness, unemployment, dropping out
of school
Access, not going to dentist
Firearm, suicide, distracted driving, seat
belts, car accidents
Child abuse, domestic violence, rape, youth
violence, violent behavior
Tobacco, alcohol, drugs
Infant death, teen pregnancy
STD’s, HIV/AIDS, immunizations, etc.
Rank/#
Responses**
Prioritization
Score
Ranking
575
52
1
474
50
2
224
48
3
205
30
7
170
25
9
168
30
6
165
32
5
86
64
32
33
19
24
4
10
8
** The number of responses is greater than the sample size due to the “check-off” nature of the surveys, in which
participants could respond to multiple questions.
Results
The top three health priorities identified through the ranking process were chronic disease, obesity, and access
to medical care. These three constructs were among the top five health issues identified in the community
survey: obesity/overweight, access to medical care, cancer, poverty, and heart disease. They are also reflected in
the top five unhealthy behaviors: being overweight, alcohol abuse, poor eating habits, drug abuse, and lack of
exercise. Although obesity is not, in and of itself, excessive compared to SC and national benchmark, it is a
precursor to other chronic diseases.
32
Community Health Resource Inventory
In accordance with the IRS proposed regulations governing the submission of a Community Health Needs
Assessment, an inventory of existing community resources available to address the needs identified in the CHNA
Survey was developed and is displayed in Table 27. Table 28, which follows on page 42, delineates the identified
needs, whether it is being addressed by Beaufort Memorial Hospital or other community resources.
Table 27: Community Health Resource Inventory
No.
Name of Resource
1.
AAA Carolinas Foundation for
Traffic Safety
2.
AccessHealth Lowcountry of
3.
Access Network
4.
Adequacy of Prenatal Care
Coalition of Together for
Beaufort County
5
Al-Anon Family Group
6.
Alcoholics Anonymous
7.
Beaufort and Jasper County
School Districts Wellness
Policies
8.
Beaufort and Jasper Counties
Sheriffs’ Offices
Description
One of the major issues the AAA Carolinas
Foundation for Traffic Safety is tackling is
texting while driving, with a strong focus on
teen drivers, a group who has grown up
continuously connected to cell phones and
computers. The AAA Carolinas Foundation for
Traffic Safety provides awards in an effort to
recognize those towns and cities that make a
strong effort to make our state’s roads safer.
Beaufort Memorial Hospital sponsors and
supports this program funded by The Duke
Endowment with technical assistance from the
SC Hospital Association to provide a primary
care medical home for uninsured adults. A two
year collaboration of planning among 18 health
and human service agencies including all area
hospitals led to the development and funding of
this program.
Care management for persons affected by HIVAIDS, their families, friends, care-partners,
emergency assistance for medication, housing,
utilities, nutrition, and transportation. Free
counseling and testing.
A number of concerned citizens and health
practitioners have worked together since 2006
to improve the two conditions which seem to
dramatically impact adequacy of prenatal care
rates: improving data collection methods and
education of minority populations.
The Al-Anon Family Groups are a fellowship of
relatives and friends of alcoholics who share
their experience, strength, and hope in order to
solve their common problems.
Alcoholics Anonymous® is a fellowship of men
and women who share their experience,
strength and hope with each other that they
may solve their common problem and help
others to recover from alcoholism. Beaufort
Memorial Hospital provides meeting space biweekly for AA meetings.
Policies passed in 2008 to assure improved
nutrition in school lunches and vending
machines plus recommendations relating to
physical activity.
Partners with the South Carolina Department of
Public Safety and law enforcement agencies
Population Served
North & South Carolina
Uninsured residents of Beaufort
and Jasper Counties ages 19-64
Residents of Beaufort, Colleton,
Hampton and Jasper counties
who have HIV-AIDS
Beaufort County
Beaufort County
Beaufort County
Public school students in
Beaufort and Jasper Counties in
grades 1 through 8
33
9.
Beaufort County Alcohol and
Drug Abuse Department
10.
Beaufort County Department
of Social Services
11.
Beaufort County Early
Childhood Coalition of
12.
Beaufort County Health
Department, SC DHEC
Lowcountry Region
Beaufort County School
District
13.
14.
Beaufort County Youth
Conference
15.
Beaufort Housing Authority
across the Palmetto State for the annual
seatbelt campaign observed during the
Memorial Day weekend. The effort and
enforcement focuses on the importance of using
a seatbelt while driving or riding in a vehicle.
The numbers from a recent survey by the
University of South Carolina and officials at the
SC Department of Public Safety credit
enforcement and public education efforts with a
90.5% seat belt usage rate.
Beaufort County Sheriff's Office Crime
Prevention Specialist is responsible for all
community and business crime prevention
initiatives within the jurisdiction of the Sheriff's
Office. This includes Neighborhood Watch
programs, community and business security
surveys, specific crime reduction strategies and
child safety programs. The Crime Prevention
Specialist provides law-related education and
awareness seminars relating to various topics
such as Identity Theft, Internet Safety, Robbery
Prevention, Drugs & Alcohol and Stranger
Danger.
A component of Beaufort County Government
established under South Carolina law to help
individuals and families troubled by alcohol,
tobacco or other drug related problems with
outpatient and prevention programs.
Provides foster care, protective services for
children and adults, medical services, adoption
and Adopt-A-Family program.
Priority issues include expanding family support
services; improving child care quality,
affordability and accessibility; improving and
expanding pre-literacy resources and services;
child health, safety and nutrition; and,
expanding child advocacy, volunteerism and
community support for young children.
Family planning, immunizations, STD testing, TB
testing and WIC prenatal resources, and
community health promotion.
The District has directed its efforts to tracking
and improving standardized test scores of
students’ from early childhood through college.
Also has a Wellness policy and Employee
Working Well Initiative.
The annual Youth Conference is a one day
educational event planned by teens for their
peers. It was developed and delivered by a
partnership of Carae's Lowcountry Modeling,
the Beaufort County Alcohol and Drug Abuse
Department, Department of Social Services,
Technical College of the Lowcountry, Beaufort
Memorial Hospital, the Boys & Girls Clubs of the
Lowcountry, several faith-based organizations
and area teenagers.
Beaufort Housing Authority – Housing provided
to those in need who meet eligibility guidelines.
Beaufort County
Beaufort County
Beaufort County
Beaufort County
Beaufort County
Beaufort County Youth
Beaufort County
34
16.
17.
Beaufort Jasper Economic
Opportunity Commission
Beaufort Jasper Hampton
Comprehensive Health
Services, Inc.
18.
Beaufort Marine Institute
19.
CHiP Mobile Wellness Van
20.
LifeFit Wellness Services
21.
Transitional Care Program
22.
Beaufort Women’s Center
23.
Better Choices, Better Health
24.
Blueprint for Change
25.
Bluffton Jasper Volunteers in
Direct assistance with utilities, emergency
heating/cooling, housing rehabilitation,
prescription medication assistance, rental
assistance, emergency assistance with food,
Youth Leadership Program, child and adult care
food program, Head Start and Early Head Start.
Federally Qualified Health Centers that offer
primary care, gynecology, obstetrics, pediatrics,
pharmacies, WIC, nutritional consultations,
mammography, migrant health programs and
Ryan White (HIV/AIDS) medical services.
Alternative education for juvenile offenders.
Court order by Department of Juvenile Justice.
The Community Health Improvement Program
(CHiP) van is a 40 foot healthcare mobile unit
that provides free and low cost screenings and
some immunizations to neighborhoods,
businesses, schools, churches, senior citizen
centers, and other organizations.
Community fitness facility, LifeFit Wellness
Center that focuses on disease management
and prevention through a case management
philosophy. Offers lab screenings and evaluation
of risk factors, customized exercise program,
group classes, access to a registered dietician
and discounted prices for massage therapy and
personal training. Community health education
activities including smoking cessation, prenatal
education, and cancer support groups are
coordinated through the LifeFit Wellness
Center. LifeFit also sponsors local fitness
events such as 5K races, LocoMotion, and Dance
For Your Health.
Provides coordination to ensure continuity of
care for patients with defined chronic diseases
when discharged from the hospital. Goals are to
assist in the transition from hospital to home,
provide patient education, medication, and
appropriate follow-up care. This program also
partners with local churches to provide free
blood pressure and weight screenings to quickly
identify exacerbations and prevent
hospitalizations.
Free pregnancy tests, confidential counseling,
adoption referral, support groups, birthing
education.
Chronic disease self-management program of SC
DHEC offers six week informational workshops.
Outpatient psychiatric and chemical
dependency counseling, assessment, individual
and group therapy, medication management,
psycho-therapy, professional interventions,
drug screenings, Life Coaching.
Free medical clinic in Bluffton that serves as
Poverty income guidelines.
Services available to Beaufort
and Jasper Counties
Eight health centers serve
children and adults on a sliding
fee scale in Beaufort, Jasper, and
Hampton Counties
Juvenile offenders from the State
of South Carolina
Residents and businesses of
Residents of Beaufort County;
scholarships are available
Inpatients of Beaufort Memorial
Hospital who have Congestive
Heart Failure, Chronic
Obstructive Pulmonary Disease
and Pneumonia. Patients may
reside in Beaufort, Jasper or
Hampton Counties.
Residents may participate in free
screenings through local
transitional care churches
Women of Beaufort and Jasper
Counties
Residents who have ongoing
health conditions in the
Beaufort, Jasper, Hampton, and
Colleton Lowcountry area
Children, adolescents, and adults
of Beaufort County
Residents who live or work in
35
Medicine Clinic
primary care medical home.
26.
Bluffton Self Help Inc.
27.
Child Abuse Prevention
Association – Open Arms
Shelter
28.
Child Car Seat Inspection
Stations
29.
Citizens Opposed to Domestic
Abuse
30.
Coastal Connections
Emergency financial assistance to
families/individuals in crisis situations with pastdue rents and utility bills, medications,
budgeting classes, children’s needs and other
requests on a case-by-case basis. Free donated
clothes and food.
Open Arms Shelter for abused and neglected
children ages birth to 21 years. Outreach
preventions such as character development,
anti-bullying programs, anger management
programs for children, child abuse awareness,
teen pregnancy prevention programs and
parenting groups.
Promotes the right seat, the right size, and the
right use. Certified technicians inspect child car
seats and demonstrate how to correctly install
and use it.
24-hour hotline, safe shelter for victims of
domestic violence, information and referral,
legal representation ad court advocacy, case
management, individual and group counseling,
children’s services, Batterer’s Program,
community education and volunteer program.
Offers temporary and permanent solutions to
employment needs.
31.
Coastal Empire Community
Mental Health Center
32.
Coastal South Tobacco
Coalition
33.
Collaborative Organization of
Services For Youth
34.
35.
Community Services
Organization of Beaufort
County Coalition of Together
for Beaufort County
Deep Well Project
36.
Dieticians and Nutritionists
Emergency and crisis intervention services,
mental health counseling and psychiatric
services, psychosocial rehabilitation, schoolbased mental health services, detention center
based services.
Community-based coalition developed in 2009
by county alcohol and drug abuse prevention
personnel to promote reduction in secondhand
smoke and smoke-free workplace ordinances in
the Lowcountry. Have conducted surveys,
petitioned town councils to pass ordinances,
and provided education materials for
physicians’ offices. Includes participation of
Beaufort Memorial Hospital, Naval Hospital
Beaufort and Marine health promotion and drug
demand resource departments.
Therapeutic treatment plan coordination for
youth service agencies serving Beaufort County.
More than 70 human services agencies who
serve residents in need regarding emergency
needs such as housing, food, clothing,
education, and healthcare.
Emergency assistance with food, rent, water
and utility bills, household furnishings for
families who suffer catastrophic loss,
transportation, home repairs, medicine,
clothing, childcare, and school supplies.
Registered dieticians are available for dietary
Bluffton (Beaufort County) or
Jasper County
Greater Bluffton area of Beaufort
County
Children ages 0-21. Serves
Beaufort, Jasper, Hampton,
Colleton, and Allendale Counties
Multiple stations are available to
Beaufort and Jasper County
residents
Victims of domestic abuse in
Beaufort, Colleton, Hampton,
and Jasper Counties
Beaufort, Allendale, Colleton,
Hampton, and Jasper Counties
Serves Beaufort, Colleton,
Hampton and Jasper Counties
Any Beaufort County resident,
birth to 21, referred by any state
agency. Serves the state of
South Carolina
Residents of Beaufort County
Anyone in need in Hilton Head,
Beaufort County
Residents of Beaufort, Colleton,
36
consultations on an outpatient basis through
Beaufort Jasper Hampton Comprehensive
Health Services and Beaufort Memorial
Hospital. Inpatient dietary services are available
at all three area hospitals.
160-bed inpatient treatment facility for alcohol
and other drug addictions.
37.
Earle E. Morris Alcohol/Drug
Addiction Treatment Center
38.
Eat Smart Move More
Lowcountry Coalition of
39.
Emergency Shelter after Dark
40.
Family Promise
41.
Farmers’ Markets
42.
Florence Crittenton Programs
of SC
43.
Good Neighbor Medical Clinic
of Beaufort
44.
Gullah Church Nurses
Association
45.
Help of Beaufort
Emergency assistance, food, clothing and
sometimes financial assistance.
46.
Hope Haven of the
Lowcountry
47.
Jasper County Department of
Social Services
24/7 rape crisis hotline, hospital/medical
accompaniment, court accompaniment,
counseling, forensic interview for alleged cases
of child sexual and severe physical abuse.
Provides foster care, protective services for
children and adults, group home licensing,
referrals for child support, emergency financial
services (utilities and medicine).
A countywide coalition organized in 2006 to
address obesity and chronic disease concerns in
Beaufort County. The Coalition has led to the
development of wellness policies for school
districts and held wellness conferences.
Purchased physical activity equipment for
elementary schools, and initiated formal
employee wellness initiatives regarding
nutrition, physical activity, and tobacco
cessation in multiple local businesses including a
university system and public school districts.
Annually gather BMI data on students in two
counties. Developing a network of community
gardens in order to improve food access for
vulnerable populations.
Call to gain assistance for shelter after dark for
individuals who are homeless.
Provides temporary shelter, family stability and
permanent housing solutions for homeless
families with children by mobilizing resources
from interfaith and secular communities.
Locally grown produce is offered to residents, to
encourage selecting healthy and nutritional
foods. Many markets participate in the SNAP
and WIC Farmers Market Nutrition program.
Residential program for single pregnant women
and teens provides medical, educational, and
counseling services.
Christian–based free clinic provides a primary
care medical home for adults up to 200%
Federal Poverty Level.
Provides basic life support certification,
conducts workshops in health education on
diabetes, nutrition, HIV/AIDS, hypertension,
breast cancer and other health related subjects.
Hampton and Jasper Counties
Any South Carolina resident
meeting diagnostic criteria for
substance dependency and
appropriate for admission
(patients screened)
Special populations in Beaufort
and Jasper Counties relating to
the coalition’s initiatives.
Anyone who is homeless in
Beaufort County
Beaufort County
Available in Beaufort, Bluffton,
St. Helena and Jasper County
All single pregnant women and
teens from across South Carolina
Serves uninsured Beaufort
County residents
Serves General Public of
(predominately African American
churches in Beaufort and Jasper
Counties)
Must be referred by the
Department of Social Services.
Serves Northern Beaufort County
Serves Beaufort, Jasper,
Hampton, Colleton, and
Allendale Counties
Serves anyone who lives in
Jasper County
37
49.
KidFest
49.
Lowcountry Area Coalition
50.
Med-I-Assist
51.
Medical University of South
Carolina College of Dental
Medicine
Mental Health Access Coalition
of Together for Beaufort
County
52.
53.
Mothers Against Drunk Driving
54.
National Domestic Violence
Hotline
55.
Neighborhood Outreach
Connection
56.
New Life Center Commission
on Alcohol & Other Drug
Abuse
Other Physical Activity
Resources
57.
58.
Palmetto Retailers Education
Program
Large one-day event held each spring to
celebrate Child Abuse Prevention Month and
Month of the Military Child. KidFest involves
60+ different community agencies and
businesses and provides an opportunity for
community families to learn about various
services available in the Beaufort area.
Formed with the assistance of the Internal
Revenue Service to expand the single largest
anti-poverty program offered by the federal
government – VITA, the Volunteer Income Tax
Assistance program.
A Patient Prescription Assistance Program
designed to assist patients who have no
prescription insurance coverage and are unable
to afford their prescription medication.
Offers dental care at fees based on the ability to
pay.
General Public of Beaufort
County
In an effort to increase the availability and
accessibility of mental health resources in our
community, this group has defined two
priorities: transportation and education.
Additional services include a Community Mental
Health Resource Guide and free suicide
prevention training for community members
and providers.
Mothers Against Drunk Driving – To support
victims/survivors of alcohol-related traffic
crashes, to educate and increase public
awareness regarding the problems of alcohol
and drug impaired drivers.
National Domestic Violence Hotline – Crisis
intervention, problem solving skills, support,
referrals.
Focuses on low income families from all major
ethnic groups. Identifies distressed
neighborhoods and offers assistance and
encouragement to struggling individuals and
families in low income neighborhoods with
education, healthcare, and workforce
development.
Outpatient treatment for addictions, prevention
programs, adolescent counseling, red ribbon
campaign, employee assistance programs.
Locally owned organizations that offer fitness
equipment and programs include Anytime
Fitness, City Fit, Earth Fit, the Omni, and the
YMCA of Beaufort County. The YMCA also
serves families. Walking trails are available at
several locations in Beaufort County, including
one on the BMH campus. Recently, a
pedestrian area was included on the new
McTeer Memorial Bridge that crosses the
Intercoastal waterway.
Program designed to modify the environment in
which tobacco products and alcoholic beverages
Beaufort County
General Public
Beaufort County
General Public
Beaufort and, Jasper, Colleton,
and Hampton Counties
Jasper, Hampton and Allendale
Counties
Residents of northern Beaufort
County (service area of Beaufort
Memorial Hospital)
South Carolina – provided as a
service of the Beaufort County
38
59.
Partnership for Adult Literacy
60.
PASOs Family and Community
Health Programs
61.
Penn Center – Early
intervention program
62.
Personal Services Branch,
Marine Corp Community
Services
Phoenix House
63.
64.
Pregnancy Center and Clinic of
the Low Country
65.
Project S.M.A.R.T.
(Success, Motivation And
Responsibility Training)
66.
Reduce Adolescent Pregnancy
Alliance
67.
Safe Haven
68.
St. Francis by the Sea Catholic
Church
Sheldon Township Community
Support Partnership
69.
are sold and consumed. The curriculum helps
reduce underage access to alcohol and tobacco
products in communities, while also lowering
the liability risks for businesses and their
employees. Provides managers and servers/
sellers with the knowledge and skills to comply
with established alcohol and tobacco policies,
and to avoid the potential consequences of
failing to comply with those policies.
Information includes alcohol and tobacco laws
and consequences, checking IDs, Fake IDs,
handling difficult situations, cutting off service,
and reducing liability of employees and
businesses.
Work group focused on increasing enrollment in
adult education and literacy programs.
Helps the Latino community and service
providers work together for strong and healthy
families. This is done through education,
support, and grassroots leadership
development.
Early intervention program concentrates on “at
risk” families with pre-school children and
focuses on education, health and social
development of the entire family unit.
Alcohol and Drug Abuse
Department
Information and referral, substance abuse,
family counseling, child and spouse abuse
reporting and case management.
Addresses the needs of persons living with
HIV/AIDs, especially those who are homeless or
without support systems. Onsite services
include HIV primary healthcare clinic, dental
clinic, housing, and education programs.
Free and low cost services for prenatal care up
to 16th week, testing for pregnancy and sexually
transmitted diseases, guidance, education,
support and parenting classes, infant
equipment.
Program is for first time non-violent juvenile
offenders (10-16 years old). It is designed to
equip at-risk juveniles with various skills and life
principles necessary for successful goal setting
and achievement.
Work Group implementing a variety of sciencebased strategies for reducing the number of
births to teenagers.
A shelter for families. Allows person/family to
stay 60 days to obtain self-sufficiency.
Services include assistance with rent, utilities,
food, and medicine
Grassroots coalition formed in 1998 by BMH
and SC DHEC Lowcountry region to address
educational and economic diversities in the
Sheldon Township of northern Beaufort County.
This group has received numerous grants which
Marine Corp services available to
enlisted, veterans, and
dependents
Beaufort, Jasper, Colleton, and
Hampton Counties
Beaufort County
Programs available to the
General Public of Beaufort
County
(National Historic District
Landmark)
Beaufort County
Beaufort County
State of South Carolina
Anyone in need in Beaufort
County
Residents of the Sheldon
Township, northern Beaufort
County (Census Tract #1)
39
70.
South Carolina Department of
Natural Resources
71.
South Carolina Office of Victim
Assistance
72.
Spanish Moss Trail
73.
State Seat Belt Law
74.
Stork’s Nest Program
75.
The Affordable Housing
Consortium
76.
The Benefit Bank of South
Carolina
77.
The Coalition for Aging in Place
of Together for Beaufort
County
have funded educational resources, leadership
development, and health promotion in local
area churches. The group was instrumental in
facilitating a bond issue leading to a new high
school with access to free technical college
courses, healthcare for local students, the
establishment of a local library branch, and an
expansion of a Head Start facility.
Hunter education program provides training on
the responsibility and ethics in the field, as well
as firearms safety.
Helps with filing for compensation fund,
advocacy and support, referrals, training and
technical assistance. Benefits can be paid up to
$15,000 for medical costs, counseling costs, lost
wages or loss of support, burial/funeral costs.
Crime must have cause physical injury or
emotional trauma; victim must not have been
engaged in illegal activity.
Beaufort Memorial Hospital partnered with the
City of Beaufort to provide a rail trail pathway
for walking, biking, and jogging. The BMH Board
dedicated a portion of hospital property to the
City as the path provides a health-related
community benefit, especially as it will
eventually connect the existing wellness trail on
the Hospital's main campus to the Spanish Moss
Trail.
“Buckle Up South Carolina”. Under the law, a
law enforcement officer has the authority to
stop a driver if the officer has a clear and
unobstructed view of a driver or occupant of a
motor vehicle not wearing a safety belt or not
secured in a child restraint system.
A collaborative project of Zeta Phi Beta Sorority,
March of Dimes, and BMH to improve the
health of babies by preventing birth defects and
infant mortality through research, community
service, education, and advocacy. This incentive
program encourages pregnant women to
participate in prenatal education and receive
regular prenatal care to earn points that can be
spent on baby items.
Beaufort County’s Affordable Housing
Consortium is addressing the need to
accommodate workforce housing development
in high density areas.
The Benefit Bank of South Carolina is a program
of the South Carolina Office of Rural Health. It is
a web-based service which connects low and
moderate income families with the resources
for which they are eligible but currently unenrolled.
Work Group represents the federal
government’s efforts locally to restructure
services to the rapidly growing number of
seniors in a manner that preserves their quality
of life. It has adopted the Beacon Hill Village
General Public
Beaufort County
Beaufort County
Beaufort County
40
78.
The Farm Worker Health
Program
79.
United Way of the Lowcountry
Helpline and Palmetto Breeze
(Lowcountry Regional Transit
Authority).
80.
Urgent Care Centers
81.
Volunteers In Medicine Hilton
Head
82.
Youth Access To Tobacco
model which replaces the traditional practice of
placing seniors in assisted living communities
with one which gives them the resources to stay
in their own homes.
Beaufort Jasper Hampton Comprehensive
Health Services Leroy E. Browne Medical Center
on St. Helena Island is a federally funded
program that provides medical, dental and
social services.
These agencies sponsor a community Helpline
which provides referrals to local health and
human service agencies. An online directory of
community resources, including assistance for
healthcare, is maintained by both of these
agencies.
Private or franchised care centers that offer
daily primary care and some lab/imaging
services.
Provides free and low cost medical, dental and
mental health services to families and
individuals who otherwise have no access to
quality-driven healthcare. Services include
immunizations, physical exams, general
medicine, dental care and a wide variety of
specialized services.
Developed to monitor the levels of youth access
to tobacco products in the retail setting through
nationwide compliance checks, the project has
provided substantial additional benefits through
increases in the awareness and compliance of
tobacco merchants. The program has been
successful in reducing the access of underage
youth to purchasing tobacco products in retail
establishments in Beaufort County from 66.3%
in 1994 to 18% in 2010.
Migrant and seasonal farm
worker population in the
Beaufort, Jasper and Hampton
Counties
Helpline call center and website
serve Beaufort and Jasper
Counties at uwlowcountry.org or
palmettobreezetransit.com.
Facilities in northern Beaufort
County such as Doctors Care,
Doctors Express, and Lowcountry
Urgent Care that serve families
as a for-profit fee for service
healthcare entity.
Men, women and children who
live or work on Hilton Head and
Daufuskie Islands
Beaufort County
Source: United Way of the Lowcountry, www.palmettobreezetransit.com/BusinessDirectoryii.aspx, downloaded
3.6.2013. Beaufort Memorial Hospital, 2013.
BMH’s commitment to being an authentic community-based hospital is reflected through the leadership and
support it provides to community initiatives which foster the health and wellness of its service area and the
larger community. This commitment includes supporting the local government and local wellness coalitions in
their efforts to impact the health and wellness of the community, particularly with respect to social issues which
the hospital is not in a position to directly impact. Table 28 (next page) lists the needs that were identified
through the quantitative and qualitative sections of the CHNA. As required, indication is provided as to whether
a need is being “addressed” or “not addressed” by BMH. The third, and last column, inventories the resources
currently addressing the need. The numbers in parentheses correspond to the resource inventory provided in
Table 27.
41
Table 28: Identification of Needs, BMH Involvement, & Resources Addressing Need
Identified Need
Chronic Diseases
Addressed/Not
Addressed
by Hospital
Addressing
Obesity
Addressing
Access to Medical Care
Addressing
Prenatal Care
(infant death, teen pregnancy)
Addressing
Substance Abuse
(tobacco, alcohol, drugs)
Addressing
Explanation of Addressed/Unaddressed Need
(Item Number in Resource Inventory)
Beaufort Memorial Hospital CHiP Wellness Van (19)
Beaufort Memorial Hospital LifeFit Wellness Services (20)
Beaufort Memorial Hospital Transitional Care Program (21)
Better Choices, Better Health (23)
Eat Smart, Move More Lowcountry Coalition (38)
Gullah Church Nurses Association (44)
Other Physical Activity Resources (57)
Sheldon Township Community Support Partnership (69)
Beaufort & Jasper County School Districts Wellness Policies (7)
Dieticians and Nutritionists (36)
Eat Smart, Move More Lowcountry Coalition (38)
Farmers’ Markets (41)
Other Physical Activity Resources (57)
Spanish Moss Trail (72)
AccessHealth Lowcountry (2)
Beaufort Jasper Hampton Comprehensive Health Services (17)
Beaufort Memorial Hospital CHiP Mobile Wellness Van (19)
Bluffton Jasper Volunteers in Medicine Clinic (25)
Good Neighbor Medical Center (43)
Med-I-Assist (50)
The Benefits Bank (76)
The Farm Worker Health Program (78)
United Way of the Lowcountry Helpline & Palmetto Breeze (79)
Urgent Care Centers (80)
Volunteers in Medicine Hilton Head (81)
Adequacy of Prenatal Care Coalition (4)
Beaufort County Health Department, SC DHEC Lowcountry Region (12)
Beaufort Jasper Economic Opportunity Commission (16)
Beaufort Women’s Center (22)
Child Abuse Prevention Association (27)
Florence Crittenton Programs of SC (42)
PASOs Family & Community Health Programs (60)
Pregnancy Center & Clinic of the Low Country (64)
Reduce Adolescent Pregnancy Alliance (66)
Stork’s Nest Program (74)
Al-Anon Family Group (5)
Alcoholics Anonymous (6)
Beaufort County Alcohol and Drug Abuse Department (9)
Beaufort County Youth Conference (14)
Blueprint for Change (24)
Coastal Empire Community Mental Health Center (31)
Coastal South Tobacco Coalition (32)
Collaborative Organization of Services for Youth (33)
Earle E. Morris Alcohol/Drug Addiction Treatment Center (37)
Mental Health Access Coalition (52)
Mothers Against Drunk Driving (53)
New Life Center Commission on Alcohol & Other Drug Abuse (56)
Palmetto Retailers Education Program (58)
Personal Services Branch Marine Corp Community Services (62)
Youth Access To Tobacco (82)
42
Violence
(child abuse, domestic violence,
rape, youth violence, violent
behavior)
Not Addressing
Injury
(firearm, suicide, distracted
driving, seat belts, car
accidents)
Not Addressing
Poverty
(homelessness, unemployment,
dropping out of school)
Addressing
Infectious Disease
(STDs, HIV/AIDs,
Immunizations)
Addressing
Dental
(access, not going to the
dentist)
Addressing
Beaufort County Department of Social Services (10)
Beaufort County Early Childhood Coalition (11)
Beaufort Marine Institute (18)
Child Abuse Prevention Association (27)
Citizens Opposed to Domestic Abuse (29)
Hope Haven of the Lowcountry (46)
Jasper County Department of Social Services (47)
KidFest (49)
National Domestic Violence Hotline (54)
Penn Center – Early Intervention Program (61)
Personal Services Branch, Marine Corp Community Services (62)
Project S.M.A.R.T. (65)
AAA Carolinas Foundation for Traffic Safety (1)
Beaufort and Jasper Counties Sheriffs’ Offices (8)
Child Car Seat Inspection Stations (28)
Mothers Against Drunk Driving (53)
South Carolina Department of Natural Resources (70)
South Carolina Office of Victim Assistance (71)
State Seat Belt Law (73)
Beaufort County Early Childhood Coalition (11)
Beaufort County School District (13)
Beaufort Housing Authority (15)
Beaufort Jasper Economic Opportunity Commission (16)
Beaufort Marine Institute (18)
Bluffton Self Help Inc. (26)
Coastal Connections (30)
Community Services Organization of Beaufort County Coalition (34)
Deep Well Project (35)
Emergency Shelter after Dark (39)
Family Promise (40)
Help of Beaufort (45)
Lowcountry Area Coalition (49)
Neighborhood Outreach Connection (55)
Partnership for Adult Literacy (59)
Safe Haven (67)
St. Francis by the Sea Catholic Church (68)
The Affordable Housing Consortium (75)
The Coalition for Aging in Place (77)
Access Network (3)
Beaufort County Health Department, SC DHEC Lowcountry Region (12)
Beaufort Memorial Hospital CHiP Mobile Wellness Van (19)
Gullah Church Nurses Association (44)
Med-I-Assist (50)
Phoenix House (63)
Volunteers In Medicine Hilton Head (81)
AccessHealth Lowcountry (2)
Good Neighbor Medical Clinic (43)
Medical University of South Carolina College of Dental Medicine (51)
The Farm Worker Health Program (78)
Volunteers In Medicine Hilton Head (81)
43
Sources
Beaufort County, Beaufort County Alliance for Human Services, Together for Beaufort 2006-2009 Beaufort
County, South Carolina.
Beaufort County School District, Beaufort County, South Carolina, 3rd, 5th, and 8th Grade Students, Body Mass
Index (BMI) Report, Fall 2008.
Beaufort County School District, Beaufort County, South Carolina, 3rd, 5th, and 8th Grade Students, Body Mass
Index (BMI) Report, Fall 2010.
Beaufort Memorial Hospital, 2012-2013, Physician Directory.
Hilton Head Regional Healthcare, Directory of Physicians and Services, 05/12.
Lowcountry Council of Governments, Planning Department (October 2011). The people and the economy of the
Lowcountry: A demographic profile.
Martin, Amy (2011). Health Systems Profile for Beaufort, Jasper, and Hampton Counties. University of South
Carolina, Arnold School of Public Health.
Robert Wood Johnson Foundation, County Health Rankings and Roadmaps. Retrieved from
http://www.countyhealthrankings.org/.
S.C. Budget and Control Board, Office of Research & Statistics, Health & Demographics Section, Inpatient Patient
Origin for Select Service Categories, 2010.
S.C. Budget and Control Board, Office of Research & Statistics, Health & Demographics Section, Inpatient Patient
Origin for Select Service Categories, 2011.
S.C. Budget and Control Board, Office of Research & Statistics, Health & Demographics Section, Number and
Percent of Persons Hospitalized Outside Their County of Residence by County Where Services Occurred, , 2010.
S.C. Budget and Control Board, Office of Research & Statistics, Health & Demographics Section, Number and
Percent of Persons Hospitalized Outside Their County of Residence by County Where Services Occurred, 2011.
South Carolina Hospital Association, Community Health Needs Assessment Tool Kit, Beaufort Memorial Hospital,
2012.
U.S. Department of Commerce, United States Census Bureau, State & County QuickFacts, retrieved from:
http://quickfacts.census.gov.
U.S. Department of Health and Human Services, Community Health, Community Health Status Reports, Beaufort
County, 2009.
U.S. Department of Health and Human Services, Community Health, Community Health Status Reports, Jasper
County, 2009.
44
CHNA Work Group
Cynthia Coburn-Smith, MS, Manager, Community Health Improvement Program, LifeFit Wellness Services,
Mark Senn, PhD, Senior Director, LifeFit Wellness Services, Beaufort Memorial Hospital
Brenda Hughes, MPH, Community Transformation Grant Coordinator, Lowcountry Region,
SC Department of Health and Environmental Control
Deborah E. Slazyk, MHA, Director, AccessHealth Lowcountry
Dixie Slichter, LifeFit Community Health Specialist and Coordinator of the Paula Williams Memorial Breast
Cancer Support Group, Community Health Improvement Program, Beaufort Memorial Hospital
45

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