TRENDS in The Human Condition on Cape Cod (2005–to-2007)

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TRENDSin

The Human Condition on Cape Cod

(2005–to-2007)Presented By:

Warren Smith, Data AnalystSteve Brown, Community Coordinator

Barnstable County Dept. of Human Services

June 26, 2008

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Outline1. Research Questions (a review)

2. Top Household Problems/Challenges (a review)

3. Top Barriers to Service Access (a review)

4. The “Most Needy” Defined (a review)– Most Needy’s Top Household Problems & Service Barriers (a review)

5. Trends Among Most Needy Households: (new!)

– Changes in Reports of Problems & Barriers (prevalence)• Positive Changes• Negative Changes

– Changes in Seriousness of Problems & Barriers• Positive Changes• Negative Changes

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Research Questions

1. What Are The Human Needs?2. How Serious Are The Human Needs?3. Who Are The Needy?

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Survey History (a review)

• 1995: Original The Human Condition

• 2001: The Human Condition – 2001• Cape Cod Community Survey: (4-Years)

– 2004: Monitoring The Human Condition– 2005: Monitoring The Human Condition– 2006: Monitoring The Human Condition– 2007: Monitoring The Human Condition

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Household Problems: Overall

Figure 5.3.1 Top Household Issues

11%

12%

13%

14%

18%

22%

23%

23%

25%

26%

30%

33%

0% 5% 10% 15% 20% 25% 30% 35%

Experiencing an Alcohol and/or Drug Problem

Seriously Overweight Person(s) in Household

Inadequate Opportunities To Learn New Skills or For Work Advancement

Not Able To Afford Nutritious Food

Not Being Able To Afford Legal Help

Not Always Having Enough Money For Food

Not Enough Money To Pay For Housing

Paying For or Getting Dental Insurance

Inadequate Money To Pay Doctor, Dentist, or Buy Prescriptions

Unable To Afford Recreational Activities

A Lot of Depression in Household

A Lot of Anxiety or Stress in Household

Percent of Households Reporting Issue as Minor-to-Major Problem

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Service Barriers: Overall Figure 5.3.2 Top Barriers To Service Access

28%

29%

30%

31%

32%

36%

43%

46%

48%

49%

20% 25% 30% 35% 40% 45% 50%

Insurance Not Accepted For Services

Hours of Services Were NotConvenient

Lack of Information On Where To GoFor Services

Lack of Transportation

Unable To Take Time Away FromWork To Go To Services

Services Located Too Far Away

Paying Insurance Deductible/Co-Payment

Cost of Taking Time Away FromWork

Service(s) Not Accepting NewPatients/Clients

Could Not Afford Fees or Costs ForServices

Percent of Households Viewing Service Access Barrier as Moderately-to-Extremely Serious*(* Percent of Those Households Where Any Help Was Sought)

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Cape Cod’s “Most Needy”

Includes:

19% of Households26% of Adults (18+)

30% of Young People (0-17)

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Who Are “Most Needy”

• Compared to Overall Cape Cod Sample:– Problems and Service Barriers:

• 2.5x to 3x Times More Households Report Problems/Barriers

also,• 2.5x to 3x Times More Seriousness Reported

• Thumbnail Sketch:– Very low income, mostly “working poor,” young

families, renters, single parents, minorities, in poorer health, receive financial assistance, live in Hyannis, Yarmouth, Harwich, or Falmouth.

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Household Problems of The “Most Needy” (a review)

Figure 5.3.3 Top Household Issues- Most Needy Households -

26%

45%

47%

56%

62%

65%

74%

75%

76%

81%

83%

86%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Adult Substance Abuse (alcohol, drugs, etc.)

Paying for a Mental Health Counselor











Percent of Most Needy Households Reporting Issue as Minor-to-Major Problem

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Service Barriers of The “Most Needy” (a review)

Figure 5.3.4 Top Barriers To Service Access - Most Needy Households -

38%

41%

45%

45%

46%

49%

53%

57%

59%

75%

20% 30% 40% 50% 60% 70% 80%

Hours of Services Were Not Convenient

Lacked Information on AvailableServices



Unable To Take Time Away From WorkTo Go To Services




Cost of Taking Time Away From Work


Percent of Most Needy Households Viewing Service Access Barrier asModerately-to-Extremely Serious*

(* Percent of Those Most Needy Households Where Any Help Was Sought)

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TRENDS (New!)

Over Period 2005-to-2007(Latest 3 Years of MTHC Surveys)

What’s Changed? What’s Changing?

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“Statistically Significant” Changes

• What Does This Mean?Statistically Significance (p-value)

“One could say that the statistical significance of a result tells us something about the degree to which the result is “true” … For example. A p-value of .05 . . . indicates that there is a 5% probability that [a trend] ….. is a “fluke.” StatSoft. Inc. 1984-2003, Elementary Concepts in Statistics, http://www.scansoft.com/textbook/

There are no absolutes in statistics! (Warren Smith)

We contract significance testing out to an expert;

Dr. Sonia Sheffield, Ph.D. Professional, with over 20 years of public and private sector experience in statistical analysis. Worked with us since 1994.

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Household Problem TrendsSpecial Figure 5.3.3 Top Household Issues

- Most Needy Households -

26%

45%

47%

56%

62%

65%

74%

75%

76%

81%

83%

86%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Adult Substance Abuse (alcohol, drugs, etc.)

Paying for a Mental Health Counselor











Percent of Most Needy Households Reporting Issue as Minor-to-Major Problem

Red = Stat. Sig. INCREASEGray = No Stat. Sig. ChangeGreen (dots) = Stat. Sig. DECREASE

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Service Barrier TrendsSpecial Figure 5.3.4 Top Barriers To Service Access

- Most Needy Households -

38%

41%

45%

45%

46%

49%

53%

57%

59%

75%

20% 30% 40% 50% 60% 70% 80%

Hours of Services Were NotConvenient

Lacked Information on AvailableServices



Unable To Take Time Away FromWork To Go To Services




Cost of Taking Time Away FromWork


Percent of Most Needy Households Viewing Service Access Barrier asModerately-to-Extremely Serious*

(* Percent of Those Most Needy Households Where Any Help Was Sought)

Red = Stat. Sig. INCREASEGray = No Stat. Sig. ChangeGreen (dots) = Stat. Sig. DECREASE

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Among The Most Needy

Prevalence(i.e., Changes in Proportion of Households Reporting Problem or Barrier to Service)

How Widespread is the Problem or Barrier?

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Significant Prevalence Changes

• “Not Enough Money to Pay For Housing”

. +45% since 2005

• “Not Always Having Enough Money for Food”

. +40% since 2005

• “Not Being Able to Afford Recreational Activities”

. +12% since 2005

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“A Lot of Anxiety or Stress in Household”

. +3% since 2005

. +31% since 2006 (↑↑) - recently

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• “Not Able to Afford Nutritious Food”

. +46% since 2005

• “Inadequate Opportunities to Learn New Skills or

For Work Advancement”

. +28% since 2005

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Significant Prevalence Changes• “Not Able to Find or Afford After-School Child Care”

. +85% since 2005

• “Not Able to Find or Afford Child Day Care”. +67% since 2005

• “Immigration Status or Visa Dispute”. +54% since 2005

. - 53% since 2006 (↓↓) - recently

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• “Not Able to Find Appropriate Senior (65+) Housing”. +33% since 2005

. - 47% since 2006 (↓↓) - recently

• “Seriously Overweight Person(s) in Household”. +7% UP slightly since 2005 . – 30% DOWN since 2006 (↓↓) - recently

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• “Could Not Afford Fees or Costs for Service” (as Service Barrier)

. +23% since 2005

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GOOD NEWS!!! Prevalence Decreased

• “Insurance Not Accepted for Services” (as Service Barrier)

. - 18% since 2005

. - 25% since 2006 (↓↓) - recently

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Seriousness(i.e., Changes in Seriousness Reported)

How Serious is the Problem or Barrier?

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Significant Seriousness Changes

• “Not Always Having Enough Money for Food”

. +50% since 2005

• “Not Enough Money To Pay For Housing”

. +47% since 2005

• “Not Able to Afford Legal Help”

. +39% since 2005

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• “Not Being Able to Afford Recreational Activities”

. +37% since 2005

• “A Lot of Anxiety or Stress in Household”

. +2% since 2005

. +33% since 2006 (↑↑) - recently

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• “Not Able to Afford Nutritious Food” . +62% since 2005

• “Inadequate Opportunities to Learn New Skills or For Work Advancement”

. +45% since 2005

• “Paying For a Mental Health Counselor” . +30% since 2005

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• “Not Able to Find or Afford After-School Child Care”. +86% since 2005

• “Immigration Status or Visa Issues”. +81% since 2005

. - 50% since 2006 (↓↓) - recently

• “Not Able to Find or Afford Child Day Care”. +80% since 2005

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• “Not Able to Find Appropriate Senior (65+) Housing” . +44% since 2005 . - 55% since 2006 (↓↓) - recently

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• “Lack of Transportation” (as Service Barrier)

. +56% since 2005

• “Services Not in Appropriate Place or Part of Town” (as Service Barrier)

. +34% since 2005

• “Could Not Afford Fees or Costs for Service” (as Service Barrier)

. +25% since 2005

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• “Lack of Information on Where to Go For Services” (as Service Barrier)

. +24% since 2005

• “Cost of Taking Time Away From Work”. +19% since 2005 (as Service Barrier)

• “Services Not Accepting New Patients/Clients” (as Service Barrier)

. +17% since 2005

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Good News! Seriousness Decreased

• “Seriously Overweight Person(s) in Household”

. - 30% DOWN since 2006 (↓↓) - recently

• “Hours of Services Are Not Convenient”

. - 17% since 2006 (as Service Barrier) (↓↓) recently

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SUMMARYIncreased: Since 2005

Prevalence Seriousness

“Not Being Able to Find or Afford After-School Child Care” + 85% +86%

“Immigration Status or Visa Dispute” +54% +81%

“Not Being Able to Find or Afford Child Day Care” + 67% +80%

“Not Able To Afford Nutritious Food” + 46% +62%

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SUMMARYIncreased: Since 2005 Prevalence Seriousness

“Lack of Transportation” (Service Barrier) - + 56%

“Not Always Having Enough Money for Food” + 40% +50%

“Not Having Enough Money to Pay for Housing” + 45% +47%

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“Inadequate Opportunities to Learn New

Skills or for Advancement at Work” + 28% + 45%

“Not Able to Find Appropriate

Senior (65+) Housing” +33% +44%

“Not Being Able to Afford Legal Help” - + 39%

“Paying For a Mental Health Counselor” - + 30%

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Prevalence Seriousness“Not Able to Afford Recreational Activities” + 12% + 37%

“Seriously Overweight Person(s) in Household” + 7% - “Having a Lot of Anxiety or Stress in Household” + 3% + 2%

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SUMMARYIncreased in BOTH Years: Since

2005 and Since 2006


“Having a Lot of Anxiety or Stress in

the Household” + 3% + 2% (since 2005)

+31% +33% (since 2006)

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SUMMARYDecreased: Prevalence Seriousness

“Not Able to Find Appropriate Senior (65+) Housing“ - 47% - 55% (since 2006)

“Immigration Status or Visa Dispute” - 53% - 50% (since 2006)

“Seriously Overweight Person(s) the Household” - 30% -30% (since 2006)

“Insurance Not Accepted For Services” - 25% - (since 2006)

- 18% - (since 2005) “Hours of Service Were Not Convenient” - - 17% (since 2006)

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Q & AWhat Surprised You?

What Themes Do You See?

What Patterns Emerge?

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Problems & Service BarriersThat Have NOT Changed Significantly

in PREVALENCEOver The Past 3 Years

(2005-2007)

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Prevalence(i.e., Changes in Proportion of Households Reporting Problem or Barrier to Service)

How Widespread is the Problem or Barrier?

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NOT Significant Prevalence Changes

“Discrimination (due to HIV, AIDS, TB, etc.)”

“Lack of Handicap Access” (as Service Barrier)

“Discrimination (due to Race, Age, Sexual Identity/Orientation etc.)”

“Discrimination Toward Mentally Ill Persons”

“Feelings of Discrimination” (as Service Barrier)

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“Lack of Transportation” (as Service Barrier)

“Lack of Information on Where to Go For Services” (as Service Barrier)

“Household Overcrowding”

“Hours of Services Are Not Convenient:” (as Service Barrier)


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“Hours of Services Are Not Convenient” (as Service Barrier)

“Paying For a Mental Health Counselor”

“Cost of Taking Time Away From Work” (as Service Barrier)

“Inadequate Money to Pay Doctor/Dentist, or to Buy Prescriptions”

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Problems & Service BarriersThat Have NOT Changed Significantly

in SERIOUSNESSOver The Past 3 Years

(2005-2007)

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Seriousness(i.e., Changes in Seriousness Reported)

How Serious is the Problem or Barrier?

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NOT Significant Seriousness Changes

“Discrimination (due to HIV, AIDS, TB, etc.)”

“Discrimination (due to Race, Age, Language, Sexual Orientation/Identity, etc)”

“Lack of Handicap Access” (as Service Barrier)

“Experiencing Physical Conflict in Household”

“Feelings of Discrimination” (as Service Barrier)


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NOT Significant Seriousness Changes

“Paying Insurance Deductibles/Co-Payment” (as Service Barrier)

“Inadequate Money to Pay Doctor, Dentist, or to Buy Prescription Med’s”

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TRENDS in The Human Condition on Cape Cod (2005–to-2007)

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