18
2011– 2013 Community Health Needs Assessment
2011– 2013 Community Health Needs Assessment
I am pleased to present Advocate Trinity Hospital’s Community Health Needs Assessment. Our mission is to meet the health needs of the individuals, families and communities we serve. In support of our mission, we have conducted this community needs assessment to serve as a resource to the community.
Trinity Hospital has a long standing commitment to the community which spans for over 110 years. This commitment has grown and evolved through years of service and thoughtful consideration of our communities’ most pressing health needs. To determine the community health needs, our outreach team begins with a well planned and comprehensive needs assessment. Every three years, we collect key data to strategically plan and provide outreach programs and services where they are most needed and where we can make a measurable impact.
By partnering with key community leaders within local, state and national organizations, we can enhance our effectiveness to create strong, dynamic systems that support the health of our community. Trinity Hospital has several health programs developed to address the unique health needs of our community. These programs include the Ladies Night Health Seminars, the Men’s Health Education Events, the Senior Breakfast Seminars, the Partners for Faith & Health Network Collaborative, congregationally-based health education, and a number of health screening programs.
Whether seeking care through Trinity Hospital, other Advocate sites of care or through the broader community, we hope this report provides valuable information that can be used to achieve positive health outcomes.
I encourage individuals, families and community members to become partners in addressing their health needs. At the end of the report, please find a link to connect with us to express any feedback and ideas.
Jonathan R. Bruss President Advocate Trinity Hospital
I. Introduction 2
2 Mission
2 Values
2 Philosophy
3 MVP Integrated
II. Executive Summary 3
III. CHNA Process & Timeline 4
5 CHNA Councils Review Data & Set Priorities
5 Trinity Hospital’s Community Health Council Members
IV. Community Definition 6
6 Service Area
6 Age
7 Race and Ethnicity
7 Poverty
8 Health Resources
V. Data Sources 10
10 Links to Selected Data
10 Information Gaps
VI. CHNA Findings 11
VII. Health Need Priorities 13
13 Prioritization Process
13 Health Needs Selected to Address
14 Health Needs Not Selected to Address
VIII. Overview of Planned Program Interventions 14
IX. Vehicle for Community Feedback 15
Table of Contents
2
I. Introduction Advocate Trinity Hospital is one of eleven hospitals in the Advocate Health Care system. Advocate Health Care is the largest health system in Illinois and one of the largest healthcare providers in the Midwest. It operates more than 250 sites of care, including 11 acute care hospitals, the state’s largest integrated children’s network, five Level I trauma centers (the state’s highest designation for trauma care), two Level II trauma centers, one of the area’s largest home healthcare companies and one of the region’s largest medical groups. Advocate Health Care also trains more primary care physicians and residents at its four teaching hospitals than any other health system in the state.
Advocate is a faith-based, not-for-profit system, deeply rooted in its health system affiliations with the Evangelical Lutheran Church in America and the United Church of Christ. In January 1995, these two faith-based, values-driven organizations, joined together to establish Advocate Health Care. A common mission, values and philosophy (MVP) were developed from the similar mission-oriented histories of both organizations.
Mission Advocate’s mission is to serve the health needs of individuals, families and communities through a wholistic philosophy rooted in the fundamental understanding of human beings as created in the image of God.
Advocate’s mission permeates all areas of its healing ministry. Advocate Health Care holds its employees, management and Board of Directors accountable to living five core values that guide behavior consistent with its mission.
ValuesThe five values of Advocate Health Care serve as an internal compass to guide relationships and actions: Equality, Compassion, Excellence, Partnership and Stewardship.
• Equality – We affirm the worth and spiritual freedom of each person and treat all people with respect, integrity and dignity.
• Compassion – We embrace the whole person and respond to emotional, ethical and spiritual concerns, as well as physical needs in our commitment to unselfishly care for others.
• Excellence – We empower people to continually improve the outcomes of our service, to advance quality and to increase innovation and openness to new ideas.
• Partnership – We collaborate as employees, physicians, volunteers and community leaders to utilize the talents and creativity of all persons.
• Stewardship – We are responsible and accountable for all that we are, have and do.
PhilosophyAdvocate’s philosophy is to provide wholistic care. This philosophy means Advocate understands people have physical, emotional and spiritual needs, and their relationship to God, themselves, their families and society are vital to health and healing. The philosophy of Advocate is grounded in the principles of human ecology, faith and community-based health care. Through its actions, Advocate affirms the following principles.
• We believe each person is created in the image of God.
• We respect, include and serve people without regard to race, religion, age, disability, gender, sexual orientation or socio-economic status.
• We seek to assure the spiritual freedom of all persons.
• We extend our concerns for the whole person to our patients, employees, physicians, volunteers, trustees and their families.
• We address clinical, business, corporate and social-ethical issues from a faith perspective and assist individuals, families and professionals in the resolution of these issues.
• We are guided by the principles of justice in addressing our social responsibility as a corporate citizen in this society.
3
• We are responsible and accountable in the spirit of stewardship for all the resources under our management to assure the accomplishment of our Mission.
• We believe in effective collaboration with those individuals and entities interested in addressing the health care needs of our region.
MVP IntegratedAdvocate’s MVP is integrated into every aspect of the organization, strengthening its cultural foundation. The MVP calls for Advocate to extend its services into the community to address access to care issues and to improve the health and well-being of the people in those communities.
As an Advocate hospital, Advocate Trinity Hospital embraces the system MVP as its own.
Advocate Trinity Hospital (Trinity Hospital) is a 193-bed not-for-profit healthcare facility located in Chicago, Illinois. Trinity Hospital offers a full range of inpatient and outpatient services as well as a variety of community outreach programs. The hospital has provided residents in Southeast Chicago with outstanding clinical outcomes and compassionate care for more than 115 years. Trinity Hospital treats more than 90,000 patients each year, giving them access to more than 350 physicians with expertise in more than 50 specialties. This includes advanced heart attack care, primary stroke care, an oncology center and an array of surgical specialties not found in most community hospitals.
II. Executive Summary Trinity Hospital is viewed by the community as a leader in health promotion within its primary and secondary service areas, i.e., total service area (TSA). The hospital provides community programs such as the First Place for Health education events, the Ladies Night Health Seminars, the Men’s Health education events, the Partners for Faith and Health Network Collaborative, as well as a number of preventive health screening programs including HIV and Hepatitis C testing services. This leadership role can also be attributed to its long history of providing quality health care to the community, clinical integration programs, an information technology platform and its ability to leverage relationships with community partners. However, there remain significant health challenges which must be addressed to improve the health of the community.
The community health needs assessment (CHNA) report, conducted by Trinity Hospital’s Community Health Council, describes the health needs of the community and identifies resources both within and outside the hospital to address the identified needs. The Council’s mission is to “Identify community health needs and improve the health of the community through collaboration by promoting healthy lifestyles and early detection of disease processes that focus on obesity, heart disease/stroke and asthma.”
This report provides a description of the CHNA process which covers Community Health Council activities conducted from years 2011 through 2013. The report includes a definition of the defined community, the demographics and a summary of key findings regarding the health status of the community. The report also includes the prioritized health needs as determined by the Council and an overview of planned interventions to address the prioritized health needs. Data sources include the 2004 and 2011 Community Area Health and Resource Inventory which also includes 2004 Behavioral Risk Factor Surveillance System data and a website link therein, and the 2009 Professional Research Consultants, Inc., Community Health Inventory. Additional data was gathered using the 2010 City of Chicago, Healthy Chicago Plan and A Profile of Health and Health Resources within Chicago’s 77 Communities, Northwestern University Feinberg School of Medicine, Center for Healthcare Equity/Institute for Healthcare Studies, 2011 Report.
Key Findings
Trinity Hospital serves a predominantly African American (81%) community within Southeast Chicago, however, there is a fast growing Hispanic (10%) population concentrated within four communities in the Southeast side community. Heart disease and cancer are ranked either first or second as the top causes of morbidity and mortality among the 20 communities in the total service area. The population within the total service area is expected to decrease by 5% over the next 10 years, however, the fastest growing constituents are senior citizens.
43
Although poverty and lack of health insurance are the main drivers of health disparities nationwide, recent studies have shown that African-Americans with health insurance utilize health care at a greater rate and intensity than their insured Caucasian counterparts. The poverty rate within Trinity Hospital’s primary service area is 20% which is comparable to the City of Chicago’s average of 21.4%. The poverty rate in the secondary service area is 30%, which is twice that of the state and national averages.
The five leading causes of death within Trinity Hospital’s total service area are heart disease, cancer, stroke, accidents and diabetes. Asthma has a significant presence in the community and is the second leading cause of hospitalization. Access to care is an issue within Trinity Hospital’s total service area due to a lack of primary care and an increase in violent crime. Violent crime limits the ability of people to seek out services, engage in prevention programs, and decreases safety and quality of life in the community.
Trinity Hospital’s priority health needs, as identified by the Council, are to focus its prevention efforts on obesity, heart disease/stroke and asthma. The Council established four goals and objectives to improve the health of the community:
• Goal 1: Develop and support initiatives that provide education to prevent obesity, heart disease/stroke and asthma and its related risk factors.
• Goal 2: Develop collaborative relationships that leverage resources and enhance access to outreach services for obesity, heart disease/stoke and asthma within the total service area.
• Goal 3: Optimize community outreach strategies of Trinity Hospital by enhancing the infrastructure and process to assess and prioritize the needs of the community within the total service area.
• Goal 4: Continue to provide community health outreach and education to support hospital service lines (oncology, cardiology, respiratory, etc.).
III. CHNA Process & Timeline In 2011, Trinity Hospital and nine other Advocate Health Care hospitals convened a hospital-specific, hospital-based Community Health Council to conduct a comprehensive community health needs assessment (CHNA). The following chart describes the vision for a three-year process that when completed would result in the hospital’s having met the CHNA requirements of the Patient Protection and Affordable Care Act (PPACA).
Long Term Goal – Vision
Phase 1 (2011)Site teams assess data, prioritize needs
and establish plans.
Phase II (2012)Strengthen assessment through
community engagement.
Phase III (2013)Assessment process in place to address needs
and direct programming support, and metrics introduced to measure impact of programming.
5
CHNA Councils Review Data & Set PrioritiesIn support of this vision and in alignment with Advocate Health Care’s standardized approach, Trinity Hospital convened a Community Health Council to conduct its comprehensive CHNA. This Council was chaired by the hospital’s community health leader and comprised of representatives from the executive team, public affairs and marketing, mission and spiritual care, and business development and strategy. Community members serving on the hospital’s Governing Council were also recruited as active participants in the Community Health Council. Additional Trinity Hospital staff and community representatives were added as the process evolved to fill in any Community Health Council gaps in expertise. The titles and affiliations of the Community Health Council’s members are provided below.
Trinity Hospital’s Community Health Council Members• State Representative 33rd District, Illinois General Assembly
• Program Supervisor, Metropolitan Family Services
• Public Health Administrator, Chicago Department of Public Health
• Administrator Professional Services, South Shore Hospital
• Physician, Associates in Nephrology
• Retired Chicago Public Schools Educator, Community Representative
• Retired Healthcare Administrator, Chicago Department of Public Health, Community Representative
• Community Relations Specialist, Blue Cross Blue Shield of Illinois
• Manager, Community Health Promotion, Trinity Hospital
• Manager, Finance, Trinity Hospital
• Manager, Planning, Trinity Hospital
• VP, Mission and Spiritual Care, Trinity Hospital
• Account Manager, Ackers Packaging/Member, Trinity Hospital Governing Council
• Owner, A-Design Studio/Member, Trinity Hospital Governing Council
• Founder, TEECH Foundation/Member, Trinity Hospital Governing Council
• Advanced Practice Nurse, Surgery, Trinity Hospital
• Advanced Practice Nurse, Medical, Trinity Hospital
• Coordinator Health Education, Emergency Department, Trinity Hospital
The hospital’s Community Health Council members attended two CHNA workshops hosted by the Advocate system that were designed to launch the process by educating them on how to conduct an assessment and how to find reliable data sources. Using both primary and secondary community health data, the team identified the total service area’s key health needs and then employed a priority-setting process to determine key health needs on which to focus. This process included an examination of both Trinity Hospital’s and the community’s issues/challenges and assets, and discussions with external key informants to determine the potential for partnerships with other organizations and for sharing resources to address community need.
Trinity Hospital’s CHNA results and selected priorities were shared with its Governing Council during each of the first two years of the three-year process, with full endorsement of Trinity Hospital’s community health plan by its Governing Council on November 26, 2013.
65
IV. Community Definition Service AreaThe Community Health Council (CHC) sets the direction for the community health initiatives within Trinity Hospital’s total service area. For planning purposes, the Council defines the community as the hospital’s primary and secondary service areas as defined by the following zip codes: 60617, 60619, 60620, 60628, 60643, 60649 (primary), 60409, 60621, 60633, 60636, 60637, 60827 (secondary). The community consists of a total population of 586,271, spanning 12 zip codes, including 20 community areas as defined by the City of Chicago Department of Planning.
Trinity Hospital’s community lies within Cook County and the Chicago city limits with the exception of Calumet City, Illinois, zip code 60827, which lies just south of the Chicago city limit. Exhibit I represents a map of the primary and secondary service areas, described as the total service area (TSA), for Trinity Hospital.
Exhibit 1 – Trinity Hospital Total Service Area Map
Non-Advocate Hospital
AgeAccording to the 2012 U.S. Census, the median age in Trinity Hospital’s primary service area is 35 with the largest population between the ages of 18-44. This age group, however, is expected to decline and the 65+ population is expected to increase. The communities with the largest population are Chatham, Avalon Park, Calumet Heights, Roseland, and Great Grand Crossing.
Trinity Hospital’s secondary service area mirrors the primary service area with a median age of 32.4. A decline is projected in all age groups with the exception of the 65+ age group, which is expected to increase. The communities within the secondary service area with the largest aging populations are West Englewood, Washington Heights, Morgan Park, Calumet City and Hegewisch. Expected growth of the senior population in these communities may present opportunities for Trinity to engage in senior health promotion and programs. Exhibit 2 depicts 2012 actual data versus 2017 projected population over a period of five years.
7
250,000
200,000
150,000
100,000
50,000
0Ages 0-17 Ages 18-44 Ages 45-64 Ages 65+
Current 151,737 202,497 147,881 84,256Projected 144,379 200,177 142,474 90,377
Po
pu
lati
on
Exhibit 2 – 2012 Actual vs. 2017 Projected Population by Age for Trinity Hospital’s Total Service Area
Source: U.S. Census 2012
Race and EthnicityThe population in Trinity Hospital’s total service area is 81 percent African American, 10 percent Hispanic, 8 percent White and 2 percent Asian. Although the overall population has declined between 2000 and 2012, the Hispanic population has increased within the primary service area. According to data reviewed by community, the Hispanic population is primarily located in four specific communities (Eastside, South Chicago, South Deering and Hegewisch).
PovertyThe average poverty rate in Trinity Hospital’s primary service area is 20.4 percent which is higher than state (13.1 percent) and national poverty levels (14.3 percent). The average poverty level rate in Trinity Hospital’s secondary service area is 28.6 percent—more than twice the state and national poverty level rates. In Trinity Hospital’s total service area, poverty rate trends increase as the age of the population decreases. Research has demonstrated that poverty and disease are linked. Poorer communities exhibit higher mortality and morbidity rates, and increased health needs than less poverty stricken communities. This presents Trinity Hospital with multiple opportunities to engage in health promotion activities that address community health disparities pertinent to improving the population’s health status.
8
Exhibit 3 – Community Characteristics Comparing Trinity Hospital’s Primary and Secondary Service Area with State and National Data
CharacteristicsPrimary
Service AreaSecondary
Service AreaChicago State
Total Population 385,472 200,899 2.7M 12.8M
% African American 82% 80% 33% 15%
% Hispanic 12% 7% 27% 12%
% White 4% 12% 32% 72%
% Asian 2% 1% 5% 1%
Median Age 34.6 32.4 32.0 34.2
Median Income $33,943 $32,201 $46,820 $56,377
Poverty Rate 20.4% 28.6% 21.4% 13.1%
Source: U.S. Census Bureau, A Profile of Health and Health Resources within Chicago’s 77 Communities. Northwestern University Feinberg School of Medicine, Center for Healthcare Equity/Institute for Healthcare Studies, 2011
Health Resources Trinity Hospital’s total service area is served by a variety of health resources. These resources, however, are limited and do not meet the total population’s demand for health services. A large number of people in the community seek health services outside of Trinity Hospital’s total service area. This is due to the lack of primary care access points and the lack of tertiary care, which provides highly specialized medical/advanced level care, including trauma care and complex surgical procedures or treatments. Health resources in the area include a variety of safety net providers, such as community hospitals, free community clinics, federally qualified health centers, school-based health centers, county-based health centers, city-based health centers, as well as private primary care facilities. Exhibit 4 shows the various types of health service providers and their locations within Trinity Hospital’s total service area.
9
Exhibit 4 – Healthcare Resources within Trinity Hospital’s Total Service Area
Name of Facility Type of Facility Location (Service Area)
Trinity Hospital Hospital Calumet Heights (primary)
Jackson Park Hospital Hospital South Shore (primary)
Roseland Community Hospital Hospital Roseland (primary)
St. Bernard Hospital Hospital Englewood (secondary)
South Shore Hospital Hospital South Chicago (primary)
La Rabida Children’s Hospital Hospital South Shore (primary)
University of Chicago Hospital Hospital Woodlawn (secondary)
Cook County Health Clinics (2 sites)
County ClinicEnglewood (secondary)Woodlawn (secondary)
Chicago Department of Health Centers (2 sites)
City ClinicRoseland (primary)Englewood (secondary)
Miles Square Health Center Community Health Center (FQHC) South Shore (primary)
Access Community Health Centers (3 sites)
Community Health Center (FQHC)
South Shore (primary)Greater Grand Crossing (primary)Auburn Gresham (secondary)
Chicago Family Health Centers (4 sites)
Community Health Center (FQHC)
Roseland (primary)Eastside (primary)Pullman (primary)South Chicago (primary)
Aunt Martha’s Healthcare Network
Community Health Center (FQHC) Hegewisch (secondary)
TCA Healthcare Community Health Center (FQHC) Riverdale (secondary)
Community Health Free Care Community Health Center (FQHC) Englewood (secondary)
Beloved Community Health Center
Community Health Center (FQHC) Englewood (secondary)
Christian Community Health Center (2 sites)
Community Health Center (FQHC)Morgan Park (secondary)Washington Heights (secondary)
School-based Health Centers (4 sites)
School-Based Health Centers
Riverdale (secondary)South Shore (primary)West Englewood (secondary)Auburn Gresham (secondary)
Source: 2011 Community Area Health and Resource Inventory from the Chicago Department of Public Health
109
V. Data SourcesSeveral sources of data were used in the community needs assessment. Primary data was obtained from the 2009 Professional Research Consultants, Inc., (PRC) Community Health Survey. The PRC Community Health Survey consisted of a telephonic survey of 2,200 households in Cook (Chicago), Will and DuPage counties that solicited information on 131 items that were compared with state and national benchmarked primary and secondary data. Another key source utilized to conduct a secondary data analysis was the 2004 and 2011 Community Area Health and Resource Inventory Reports from the Chicago Department of Public Health. The Community Area Health & Resource Inventory reports summarize data from many sources and represent the cumulative effort of the Offices of Epidemiology and Policy & Planning, the Division of Sexually Transmitted Infections/Human Immunodeficiency Virus, and the Communicable Disease, Lead Poisoning Prevention and Tuberculosis Programs within the Chicago Department of Public Health. The reports include hospitalization data and updated methodologies for 10-year trend analyses of health measures. The reports contain community level data on the following topics:
• 2000 medically needy population (by region);
• 2004 Behavioral Risk Factor Surveillance System;
• 2007 health measures, including: infant, child and maternal health; disabilities (for year 2000); mortality due to cancer, chronic disease and unnatural causes; hospitalizations; and infectious disease cases and deaths;
• 2007 healthcare resource information including hospital capacity and utilization, and safety net provider utilization; and
• Current information on safety net provider locations throughout the City of Chicago (by region).
Other data sources reviewed include the 2010 City of Chicago, Healthy Chicago Plan created by the City of Chicago and A Profile of Health and Health Resources within Chicago’s 77 Communities, Northwestern University Feinberg School of Medicine, Center for Healthcare Equity/Institute for Healthcare Studies, 2011 Report.
Links to Selected DataVarious data sources discussed in this report can be accessed through the following links:
Reports from City of Chicago http://www.cityofchicago.org/city/en/depts/cdph/provdrs/pol_plan_report.html (click here)
Community Area Health Inventory Report http://www.cityofchicago.org/content/dam/city/depts/cdph/statistics_and_reports/SR_CAHRI08052011.pdf (click here)
Feinberg School of Medicine http://chicagohealth77.org/uploads/Chicago-Health-Resources-Report-2011-0811.pdf (click here)
Hospital specific admission and discharge data was also reviewed which allowed the Council to capture disease specific health information relevant to the defined community. The Council also conducted informational interviews with key informant community stakeholders and community organizations within the service area. Through key informant interviews, the Council was able to confirm growing trends in health needs that supported the data reviewed from primary and secondary data sources in areas such as obesity, heart disease/stroke and cancer prevalence.
Information Gaps Information gaps were identified in Riverdale and Calumet City, which lie outside the City of Chicago city limits. While the City of Chicago provides specific community level detailed data for all communities within city limits, the same level of comparative data is not available for Calumet City or Riverdale. Gaps in information also arise because of variations between reports, e.g., some reports for specific indicators use county level or city level data versus reports that provide data at the zip code and community level. The Cook County Health Department and the City of Chicago Department of Public Health house a rich array of useful data and community reports that are easily accessible and posted on each respective website. Data points are available at the zip code, community and census tract levels.
11
VI. CHNA FindingsThis summary of CHNA findings is intended to provide some context for planning efforts, rather than comprehensive information on every relevant health indicator. This section provides an overview of the health status of people living in Trinity Hospital’s total service area.
The community health surveys provide data for the leading causes of death and hospitalization in Trinity Hospital’s total service area. The Behavioral Risk Factor Surveillance System (BRFSS) report represents local data gathered on health behaviors or risk factors related to the leading causes of death in each community. This data in combination with the community health surveys provides a road map for the identification of the most pressing health needs in the total service area.
The ten leading causes of death in Trinity Hospital’s total service area are:
1. Heart Disease
2. Cancer (All Types)
3. Stroke
4. Accidents
5. Diabetes Mellitus
6. Homicide
7. Lower Respiratory Disease
8. Alzheimer Disease
9. Liver Disease and Cirrhosis
10. Suicide
Source: 2011 Community Area Health and Resource Inventory from the Chicago Department of Public Health – Data from 2007
The five leading causes of hospitalization in Trinity Hospital’s total service area are:
1. Alcohol and Substance Abuse
2. All Other Mental Health
3. Asthma
4. Congestive Heart Failure
5. Diabetes
Source: 2011 Community Area Health and Resource Inventory from the Chicago Department of Public Health – Data from 2007
In 2011, the three leading causes of death—heart disease, cancer and stroke—accounted for approximately 56 percent or 2,758 of the deaths in Trinity Hospital’s service area. Notably, the two leading causes of deaths (heart disease and cancer) together account for (50 percent) half of all deaths. The death rate for heart disease is nearly 17 percent higher than the Chicago rate, while the cancer rate is over 50 percent higher than the Chicago rate in Trinity Hospital’s total service area.
Additionally, the average stroke rate within the Trinity Hospital service area communities of Englewood, West Englewood and Grand Crossing is 80 per 100,000 people, approximately 53 percent higher than the Chicago and state stroke rates. The data also shows that cancer is the leading cause of death followed by heart disease and stroke for the communities of Chatham, Avalon Park, Roseland, Pullman, South Deering, East Side, West Englewood, Englewood and Hegewisch.
12
BRFSS data identified the following risk factors and behaviors:
1. Obesity
2. Non-Daily Fruit Consumption
3. No Exercise in Past Month
4. Never Had a Cholesterol Check
5. Told Blood Pressure High More Than Once
6. Currently Smoking
7. Never Had a Clinical Breast Exam
8. Not Having a Health Plan
9. Binge Drinking
Source: 2011 Community Area Health and Resource Inventory from the Chicago Department
of Public Health (2011)
According to the risk factor surveillance data, obesity and non-daily fruit consumption ranked the highest of risk factors in Trinity Hospital’s total service area. Over 70 percent of respondents were obese and 50 percent of respondents indicated not having daily fruit consumption. Forty-five percent of the respondents never had their cholesterol checked and 35 percent had no exercise in the past month. The risk factor surveillance data also indicated that 35 percent of respondents were without a health plan. Three community areas reported an especially high score for a single risk factor. The Eastside community, which is primarily Hispanic (68 percent,) reported a high incidence of never having a clinical breast exam while the communities of Hegewisch and Morgan Park reported a high incidence of having been identified with high blood pressure more than once.
When data from the risk factor surveillance report is coupled with the health status profile, the emerging trends indicate the need for community-based prevention and education programs in heart disease, obesity, cancer prevention, physical activity and nutrition education. Specific communities, such as Eastside, show the need for culturally and linguistically appropriate bilingual education focused on breast cancer prevention. The Hegewisch and Morgan Park communities can benefit from stroke and hypertension focused prevention programs.
According to the 2009 PRC Community Health Survey, access to care is an issue in Trinity Hospital’s total service area. The report indicated that 32 percent of people surveyed had difficulty getting a primary care appointment compared to 18 percent of all people surveyed in the tri-county (Cook, Will and DuPage) zip codes. Another 25 percent of people surveyed in the service area could not afford medications. There was increased use of hospital-based clinics versus individual physician offices for primary care in Trinity Hospital’s total service area as well.
Another factor that limits access to care is an increase in violent crime in the community. Crime and violence are known to limit the ability of people to seek out services, engage in prevention programs such as walking or outdoor exercise, and experience overall quality of life. In Trinity Hospital’s total service area, 14 percent of people surveyed have been a victim of violent crime compared to the tri-county zip codes overall, which indicated only six percent of the people have been a victim of violent crime. The PRC survey also showed an increase in physical violence while the Community Area Health Inventory conducted by the Chicago Department of Public Health indicated that homicide was the 6th leading cause of death in Trinity Hospital’s total service area.
Although Trinity Hospital’s total service area demonstrates several major health issues and community concerns, there are also community assets. The hospital has developed strong partnerships with local service, health and community organizations that can be utilized to bring more resources to assist in maintaining the health of the community. Several federally qualified health centers and a newly developed free health clinic within the community help to improve access to care for low-income individuals. Also present are community service organizations and community coalitions that Trinity Hospital partners with to bring free health
13
education and other services, such as health screenings and health education lectures, to the community. Through community partnerships, Trinity Hospital is able to provide and support needed services in the communities served.
(Note: All data and website links within this document were verified as of December 15, 2013.)
VII. Health Need PrioritiesPrioritization Process
After studying and analyzing the data, Trinity Hospital’s Community Health Council consolidated the list of most significant health needs as indicated below:
1. Heart Disease/Stroke and Obesity
2. Cancer
3. Asthma
4. Accidents
5. Homicide
The Community Health Council ranked the most significant community health needs using the following criteria.
• Most prevalent health needs identified based on highest mortality rates.
• Highest incidence of disease in the community.
• Highest incidence of diagnosis from hospital admissions and discharges.
• Availability of resources involving community partnerships and existing relationships that provide the opportunity to work collaboratively in addressing health needs.
• Availability of current resources that can be utilized to plan and implement programs.
The Council compared the rankings identified for each notable health indicator by community and total service area. These rankings were also compared to the top rankings of Trinity Hospital’s admissions and discharges by disease specific area or service lines. The top health needs identified by the Council include heart disease/stroke, obesity and asthma.
Health Needs Selected to Address
Heart Disease/Stroke and ObesityTrinity Hospital’s total service area data indicates a heart disease, cancer and stroke death rate of 56 percent, a heart disease death rate that is 17 percent higher than the Chicago rate and a stroke death rate that is 66 percent higher than the Chicago rate in some communities. High rates of obesity (70 percent) exist within the total service area as compared to the Chicago rate of 58 percent and the state rate of 56 percent. These disparities indicate the need to provide prevention programs that offer behavior modification for nutrition and physical activity. The Council agreed that the root cause of obesity involves lack of exercise and poor eating habits, and that these preventable risk factors significantly impact heart disease and stroke. Therefore it was agreed that implementing a prevention program targeting obesity will also address heart disease and stroke prevention and education in the community. Trinity Hospital plans to address the key health issues of heart disease and stroke by conducting outreach activities with heart disease/stroke risk assessments, providing linkage to care through referrals to primary care sites and other community partners, and conducting outreach programs such as the Active for Your Health and First Place 4 Health Healthy Lifestyle Education programs.
The Active for Your Health and First Place 4 Health Programs are behavior modification programs that provide local residents with the health education and support they need to improve their health, practice healthy behaviors and incorporate regular physical activity in their everyday lives. The programs provide community-based interventions to reduce heart disease and stroke.
13 14
AsthmaAsthma was also chosen as a priority area to address due to its prevalence in the community. According to hospital inpatient encounters, asthma was among the top 15 diagnoses seen in the emergency department. Asthma also ranks 3rd in prevalence for hospitalizations in the health inventory report. To address the needs identified regarding asthma, planning began in 2011 for the development of an asthma management community outreach program to be implemented in 2013.
Trinity Hospital will expand the current intervention programs for healthy lifestyle education and implement an asthma management education program to impact the prioritized health needs. The hospital has identified community partners that will help to provide additional outreach to the community. Several community partners that the hospital works with include Chicago Family Health Center, Aunt Martha’s Healthcare Network, and the Chicago Department of Public Health. These organizations are well known in the community for improving access to care for the underserved and uninsured. The organizations also actively engage in many prevention activities within the community.
Health Needs Not Selected to Address The key health issues that have been identified and not specifically targeted in Trinity’s Community Health Improvement Plan are cancer, accidents and homicide. Trinity Hospital is addressing the cancer care needs of the community through its establishment of a new Oncology Center, a Cancer Care Committee and ongoing community outreach programs dedicated to the early detection of cancer in the communities served. The Oncology Center’s programs are structured to facilitate a multidisciplinary environment while providing minimally invasive procedures and advanced surgical intervention to treat cancer. The Oncology Center includes advanced diagnostics, imaging services, interventional radiology and an infusion center. The purpose of the Cancer Committee is to develop, approve and implement the strategic plans, goals and objectives for Trinity’s cancer programs and provides oversight for ongoing programs and outreach services. The committee ensures that community outreach plans reflect the cancer experience at Trinity Hospital and addresses the defined community needs. Representatives on the committee include community outreach organizations such as the American Cancer Society and Trinity Hospital’s community outreach department.
Trinity Hospital continually assesses whether additional prevention strategies are needed within the community and works in support of its community partners to address needs such as accidents and homicide. Community partners specifically addressing these needs include organizations such as the Neighborhood Chicago Alternative Policing Strategy (CAPS) Chicago Police Department. The police department is working within the community to address these needs and Trinity Hospital partners with them to support their activities such as the National Night Out event. The National Night Out event is designed to increase awareness about police and community partnerships or programs that educate communities regarding violence prevention, drug prevention, town watch, neighborhood watch and other anti-crime efforts.
VIII. Overview of Planned Program InterventionsTrinity Hospital is a vital part of the community, serving the health needs of individuals, families and communities with a wholistic philosophy of care. The hospital’s dedication to expanding its partnerships has resulted in a network of more than 80 community organizations, key leaders, elected officials and the faith community to implement and enhance community outreach programs. The hospital works with over 45 churches to implement the Partners for Faith and Health Outreach program which includes health screenings, health fairs and programs such as the healthy lifestyle behavior modification programs “Active for Your Health” and “First Place 4 Health” that teach healthy living principles.
15
The Active for Your Health and First Place 4 Health Programs are behavior modification programs that provide local residents with the health education and support they need to improve their health, practice healthy behaviors and incorporate regular physical activity in their everyday lives. The programs provide community-based interventions to reduce heart disease and stroke by providing:
• Health education workshops related to cardiovascular health improvement and heart disease prevention
• Physical fitness awareness education designed to increase physical activity and encourage basic lifestyle changes
Program goals are to improve the cardiovascular health and overall fitness of the community by reducing the controllable risk factors associated with heart disease, stroke and diabetes. Primary goals are to:
• Increase the knowledge of risks factors associated with heart disease by providing health education workshops to community residents; and
• Increase the physical fitness level of the community by developing healthy lifestyle changes and positive behavior toward physical fitness.
Trinity Hospital also works with grassroots community organizations and neighborhood groups to address the health needs and community concerns that impact the community it serves. In addition to outreach services provided, Trinity Hospital implements a number of community education programs that are offered onsite at the hospital. These educational programs include lectures, seminars and support group meetings for congestive heart failure, diabetes education, heart risk assessments and senior breakfast club lectures covering a range of topics pertinent to senior health.
IX. Vehicle for Community FeedbackThank you for reading this CHNA Report. If you would like to provide comments to us related to the contents of this report, please click on the link below.
http://www.advocatehealth.com/chnareportfeedback
If you experience any issues with the link to our feedback form or have any other questions, please click below to send an email to us at:
A paper copy of this report may be requested by contacting the hospital’s Public Affairs and Marketing department.
2320 East 93rd Street Chicago, Illinois 60617
773.967.2000 advocatehealth.com/trin
