2012 Community Health Assessment Report - Alexian Brothers

2012 PRC Community Health Needs Assessment Report Alexian Brothers Medical Center Primary & Secondary Service Areas

Sponsored by

ALEXIAN BROTHERS MEDICAL CENTER In Collaboration With Metropolitan Chicago Healthcare Council (MCHC)

Professional Research Consultants, Inc. 11326 “P” Street  Omaha, Nebraska 68137-2316 (800) 428-7455  www.prconline.com  2012-1141-02  © PRC, 2012.

Table Of Contents INTRODUCTION

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Project Overview ................................................................................................... 6 Project Goals Methodology

6 6

Summary Of Assessment Findings .................................................................... 14 Areas Of Opportunity For Community Health Improvement Top Community Health Concerns Among Community Key Informants Summary Tables

SELF-REPORTED HEALTH STATUS

14 15 15

33

Physical Health Status ......................................................................................... 34 Self-Reported Health Status Activity Limitations

34 36

Mental Health & Mental Disorders .................................................................... 39 Mental Health Status Depression Stress Sleep Suicide Emotional Health Children & ADD/ADHD Mental Health Treatment

DEATH, DISEASE & CHRONIC CONDITIONS

40 41 43 45 46 47 48 49

55

Leading Causes of Death .................................................................................... 56 Distribution of Leading Causes of Death Age-Adjusted Death Rates for Selected Causes

56 56

Cardiovascular Disease ....................................................................................... 59 Age-Adjusted Heart Disease & Stroke Deaths Prevalence of Heart Disease & Stroke Cardiovascular Risk Factors

59 62 67

Cancer ................................................................................................................... 75 Age-Adjusted Cancer Deaths Prevalence of Cancer Cancer Screenings

75 77 79

Respiratory Disease ............................................................................................. 86 Age-Adjusted Respiratory Disease Deaths Prevalence of Respiratory Conditions

87 89

Injury & Violence ................................................................................................. 93 Leading Causes of Accidental Death Unintentional Injury Intentional Injury (Violence) Family Violence

93 94 101 106

Diabetes .............................................................................................................. 111 Age-Adjusted Diabetes Deaths Prevalence of Diabetes Diabetes Treatment

111 112 114

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Alzheimer’s Disease .......................................................................................... 115 Kidney Disease ................................................................................................... 118 Age-Adjusted Kidney Disease Deaths Prevalence of Kidney Disease

118 119

Sickle-Cell Anemia ............................................................................................. 120 Potentially Disabling Conditions ..................................................................... 121 Arthritis, Osteoporosis, & Chronic Pain Vision & Hearing Impairment

INFECTIOUS DISEASE

121 125

127

Influenza & Pneumonia Vaccination ................................................................ 128 Flu Vaccinations Pneumonia Vaccination

128 129

Tuberculosis........................................................................................................ 131 HIV ....................................................................................................................... 133 Age-Adjusted HIV/AIDS Deaths HIV Testing

133 134

Sexually Transmitted Diseases ......................................................................... 135 Gonorrhea Syphilis Chlamydia Hepatitis B Vaccination Safe Sexual Practices

BIRTHS

136 137 138 139 140

143

Prenatal Care ...................................................................................................... 144 Birth Outcomes & Risks ..................................................................................... 147 Low-Weight Births Infant Mortality Births to Unwed Mothers Births to Teen Mothers

MODIFIABLE HEALTH RISKS

147 148 149 150

153

Actual Causes Of Death..................................................................................... 154 Nutrition ............................................................................................................. 155 Daily Recommendation of Fruits/Vegetables Affordability of Fresh Produce Health Advice About Diet & Nutrition

156 157 158

Physical Activity ................................................................................................. 159 Level of Activity at Work Leisure-Time Physical Activity Activity Levels Accessing Safe and Affordable Places for Exercise Health Advice About Physical Activity & Exercise Children’s Screen Time

160 161 162 164 165 166

Weight Status ..................................................................................................... 169 Adult Weight Status Weight Management Childhood Overweight & Obesity

169 173 175

Substance Abuse ................................................................................................ 177 Age-Adjusted Cirrhosis/Liver Disease Deaths

178

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Prevalence of Liver Disease High-Risk Alcohol Use Age-Adjusted Drug-Induced Deaths Illicit Drug Use Substance Abuse Treatment

179 179 183 185 186

Tobacco Use ........................................................................................................ 190 Cigarette Smoking Other Tobacco Use

ACCESS TO HEALTH SERVICES

190 195

198

Health Insurance Coverage ............................................................................... 199 Type of Healthcare Coverage Lack of Health Insurance Coverage

199 200

Difficulties Accessing Healthcare .................................................................... 204 Difficulties Accessing Services Barriers to Healthcare Access Deferring Healthcare Services Accessing Healthcare for Children

204 205 211 212

Primary Care Services ........................................................................................ 220 Specific Source of Ongoing Care Utilization of Primary Care Services

220 222

Emergency Room Utilization ............................................................................ 224 Oral Health ......................................................................................................... 225 Dental Care Dental Insurance

226 228

Vision Care ......................................................................................................... 230

HEALTH EDUCATION & OUTREACH

231

Healthcare Information Sources ...................................................................... 232 Participation in Health Promotion Events ...................................................... 233

PERCEPTIONS OF LOCAL HEALTHCARE

236

Perceptions of Local Healthcare Services........................................................ 237 Other Issues ........................................................................................................ 239 Collaboration Need for Specialists Senior Population Adolescent Males

239 242 244 244

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INTRODUCTION The PRC Community Health Assessment is a systematic, data-driven approach to determining the health status, behaviors and needs of our community residents.

5

Project Overview Project Goals This Community Health Assessment is a systematic, data-driven approach to determining the health status, behaviors and needs of residents in the service area of Alexian Brothers Medical Center. Subsequently, this information may be used to formulate strategies to improve community health and wellness. A PRC Community Health Assessment provides information so that communities may identify issues of greatest concern and decide to commit resources to those areas, thereby making the greatest possible impact on community health status. This Community Health Assessment will serve as a tool toward reaching three basic goals: 

To improve residents’ health status, increase their life spans, and elevate their overall quality of life. A healthy community is not only one where its residents suffer little from physical and mental illness, but also one where its residents enjoy a high quality of life.



To reduce the health disparities among residents. By gathering demographic information along with health status and behavior data, it will be possible to identify population segments that are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals may then be developed to combat some of the socio-economic factors which have historically had a negative impact on residents’ health.



To increase accessibility to preventive services for all community residents. More accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating the quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care.

This study is a follow-up to similar assessments conducted in 2002, 2006 and 2009. Like the 2009 assessment, this study was conducted in conjunction with a large-scale assessment of the Chicago metropolitan area facilitated by the Metropolitan Chicago Healthcare Council (MCHC).

Methodology This assessment incorporates data from primary research (the 2012 PRC Community Health Survey) and secondary research (vital statistics and other existing data). It also allows for trending and comparison to benchmark data at the regional, state and national levels.

2012 PRC Community Health Survey Survey Instrument The survey instrument used for this study is based largely on the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to health promotion and disease prevention

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objectives and other recognized health issues. Many questions in this survey allow for comparison with data collected locally in 2002, 2006 and 2009, as well as to current measures collected throughout the Chicago metropolitan area (“MCHC Region”). Community Defined for This Assessment The study area for this effort, referred to as the “Total Service Area” or “TSA” for the purposes of this study, includes the Primary Service Area and Secondary Service Area of Alexian Brothers Medical Center, defined at the ZIP Code level. Included residential ZIP Codes are outlined below.

ABMC Primary Service Area

ABMC Secondary Service Area

60007 Elk Grove Village

60004 Arlington Heights

60010 Barrington

60005 Arlington Heights

60018 Des Plaines

60008 Rolling Meadows

60056 Mount Prospect

60016 Des Plaines

60067 Palatine

60047 Lake Zurich

60101 Addison

60074 Palatine

60103 Bartlett

60089 Buffalo Grove

60106 Bensenville

60090 Wheeling

60107 Streamwood

60126 Elmhurst

60108 Bloomingdale

60137 Glen Ellyn

60120 Elgin

60148 Lombard

60133 Hanover Park

60157 Medinah

60139 Glendale Heights

60181 Villa Park

60143 Itasca

60185 West Chicago

60172 Roselle

60187 Wheaton

60173 Schaumburg

60188 Carol Stream

60191 Wood Dale

60634 Chicago

60193 Schaumburg

60707 Elmwood Park

60194 Schaumburg 60195 Schaumburg The following map provides a geographic description.

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paste map

Sample Approach & Design

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A precise and carefully executed methodology is critical in asserting the validity of the results gathered in the 2012 PRC Community Health Survey. Thus, to ensure the best representation of the population surveyed, a telephone interview methodology was employed. The primary advantages of telephone interviewing are timeliness, efficiency and random-selection capabilities. The sample design used for this effort consisted of a stratified random sample of 1,001 individuals aged 18 and older, including 496 in the Primary Service Area (PSA) and 505 in the Secondary Service Area (SSA). These include 737 interviews conducted as part of the larger metropolitan-area MCHC study, as well as 265 additional interviews requested by Alexian Brothers Medical Center; note that certain questions were asked only of the “oversampled” 265 respondents. Once these data were collected, the sample was weighted in proportion to the actual population distribution at the ZIP Code level so that estimates reflect the area as a whole. All administration of the surveys, data collection and data analysis was conducted by Professional Research Consultants, Inc. (PRC). Sampling Error For statistical purposes, the maximum rate of error associated with a sample size of 1,001 respondents is ±3.1% at the 95 percent level of confidence. The confidence interval for each sub-area (PSA and SSA) is ±4.4%.

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Expected Error Ranges for a Sample of 1,001 Respondents at the 95 Percent Level of Confidence ±3.5 ±3.0 ±2.5 ±2.0 ±1.5 ±1.0 ±0.5 ±0.0 0% Note: Examples:

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

● The "response rate" (the percentage of a population giving a particular response) determines the error rate associated with that response. A "95 percent level of confidence" indicates that responses would fall within the expected error range on 95 out of 100 trials. ● If 10% of the sample of 1,001 respondents answered a certain question with a "yes," it can be asserted that between 8.1% and 11.9% (10% ± 1.9%) of the total population would offer this response. ● If 50% of respondents said "yes," one could be certain with a 95 percent level of confidence that between 46.9% and 53.1% (50% ± 3.1%) of the total population would respond "yes" if asked this question.

Sample Characteristics To accurately represent the population studied, PRC strives to minimize bias through application of a proven telephone methodology and random-selection techniques. And, while this random sampling of the population produces a highly representative sample, it is a common and preferred practice to “weight” the raw data to improve this representativeness even further. This is accomplished by adjusting the results of a random sample to match the demographic characteristics of the population surveyed (poststratification), so as to eliminate any naturally occurring bias. Specifically, once the raw data are gathered, respondents are examined by key demographic characteristics (namely gender, age, race, ethnicity, and poverty status) and a statistical application package applies weighting variables that produce a sample which more closely matches the population for these characteristics. Thus, while the integrity of each individual’s responses is maintained, one respondent’s responses may contribute to the whole the same weight as, for example, 1.1 respondents. Another respondent, whose demographic characteristics may have been slightly oversampled, may contribute the same weight as 0.9 respondents. The following chart outlines the characteristics of the final weighted sample for key demographic variables, compared to actual population characteristics revealed in census data. [Note that the sample consisted solely of area residents aged 18 and older; data on children were given by proxy by the person most responsible for that child’s healthcare needs, and these children are not represented demographically in this chart.]

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Population & Sample Characteristics (Total Service Area, 2012)

Weighted Survey Sample 70.5%

16.8%

16.9%

11.0%

13.0%

16.5%

20%

15.4%

15.2%

47.2%

46.6%

37.4%

40%

38.2%

51.5%

51.3%

48.5%

60%

48.7%

80%

14.8%

Actual Population

74.2%

100%

0%

Men Sources:

Women

18 to 39

40 to 64

65+

White

Hispanic

Other