Post on 25-May-2020
2019 Community Health Needs Assessment
MEMORIAL HERMANN NORTHEAST HOSPITAL
HEALTHINSURANCE
Board Approved June 27, 2019
MemorialHermannNortheastHospitalCHNA20192
Table of Contents Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Introduction&Purpose...............................................................................................................................4SummaryofFindings...................................................................................................................................4PrioritizedAreas..........................................................................................................................................5
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 MemorialHermannNortheastHospital......................................................................................................6
Vision.......................................................................................................................................................6MissionStatement...................................................................................................................................6MemorialHermannHealthSystem.........................................................................................................6MemorialHermannNortheastHospitalServiceArea.............................................................................7
Consultants..................................................................................................................................................8
Evaluation of Progress Since Prior CHNA .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 PriorityHealthNeedsandImpactfromPriorCHNA....................................................................................9
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Overview....................................................................................................................................................11SecondaryDataSources&Analysis...........................................................................................................11
SecondaryDataScoring.........................................................................................................................11DisparitiesAnalysis................................................................................................................................12
PrimaryDataMethods&Analysis.............................................................................................................12CommunitySurvey.................................................................................................................................12KeyInformantInterviews.......................................................................................................................14
DataConsiderations...................................................................................................................................16Race/EthnicGroupings..........................................................................................................................17ZipCodesandZipCodeTabulationAreas..............................................................................................17
Prioritization..............................................................................................................................................17PrioritizationProcess.............................................................................................................................17
Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Population..................................................................................................................................................20Age.............................................................................................................................................................21Race/Ethnicity............................................................................................................................................22Language....................................................................................................................................................24SocialandEconomicDeterminantsofHealth............................................................................................25
Income...................................................................................................................................................25Poverty...................................................................................................................................................27FoodInsecurity......................................................................................................................................30Unemployment......................................................................................................................................31Education...............................................................................................................................................32Transportation.......................................................................................................................................34SocioNeedsIndex®.................................................................................................................................37
Data Synthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Priorit ized Signif icant Health Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 PrioritizationResults..................................................................................................................................44AccesstoHealthcare..................................................................................................................................44
MemorialHermannNortheastHospitalCHNA20193
EmotionalWell-Being................................................................................................................................53FoodasHealth...........................................................................................................................................57ExerciseIsMedicine...................................................................................................................................63
Non-Prioritized Significant Health Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 OlderAdultsandAging..............................................................................................................................67Cancers......................................................................................................................................................68Education...................................................................................................................................................68Transportation...........................................................................................................................................69Children’sHealth.......................................................................................................................................70Economy....................................................................................................................................................71
Other Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 BarrierstoCare..........................................................................................................................................73Disparities..................................................................................................................................................73
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 AppendixA:EvaluationSincePriorCHNA.................................................................................................77AppendixB.SecondaryDataMethodology...............................................................................................95AppendixC.PrimaryDataMethodology.................................................................................................146AppendixD.PrioritizationTool................................................................................................................161AppendixE.CommunityResources.........................................................................................................164
MemorialHermannNortheastHospitalCHNA20194
Executive Summary
Introduction & Purpose MemorialHermannNortheastHospital(MHNortheast)ispleasedtopresentits2019CommunityHealthNeedsAssessment(CHNA).ThisCHNAreportprovidesanoverviewoftheprocessandmethodsusedtoidentifyandprioritizesignificanthealthneedsacrossMemorialHermannHealthSystem’sregionalservicearea(includingMHNortheast),asfederallyrequiredbytheAffordableCareAct.MemorialHermannHealthSystempartneredwithConduentHealthyCommunitiesInstitute(HCI)toconducttheCHNAfor13facilities:
• MemorialHermannKatyHospital• MemorialHermannMemorialCityMedicalCenter• MemorialHermannGreaterHeightsHospital• MemorialHermannNortheastHospital• MemorialHermannSoutheastHospital• MemorialHermannSugarLandHospital• MemorialHermannSouthwestHospital• MemorialHermannTheWoodlandsMedicalCenter• MemorialHermannRehabilitationHospital–Katy• MemorialHermann–TexasMedicalCenter• TIRRMemorialHermann• MemorialHermannSurgicalHospitalKingwood• MemorialHermannSurgicalHospitalFirstColony
ThepurposeofthisCHNAistoofferacomprehensiveunderstandingofthehealthneedsinMHNortheast’sserviceareaandguidethehospital’splanningeffortstoaddressthoseneeds.Specialattentionhasbeengiventotheneedsofvulnerablepopulations,unmethealthneedsorgapsinservices,andinputfromthecommunity.TostandardizeeffortsacrosstheMemorialHermannHealthSystemandincreasethepotentialforimpactingtophealthneedsinthegreaterHoustonregion,communityhealthneedswereassessedandprioritizedataregional/systemlevel.Findingsfromthisreportwillbeusedtoidentifyanddevelopeffortstoimprovethehealthandqualityoflifeofresidentsinthecommunity.
Summary of Findings TheCHNAfindingsinthisreportresultfromtheanalysisofanextensivesetofsecondarydata(over100indicatorsfromnationalandstatedatasources)andprimarydatacollectedfromcommunityleaders,non-healthprofessionals,andorganizationsservingthecommunityatlarge,vulnerablepopulations,and/orpopulationswithunmethealthneeds.Throughanexaminationoftheprimaryandsecondarydata,thefollowingtophealthneedswereidentified:
MemorialHermannNortheastHospitalCHNA20195
Priorit ized Areas InMarch2019,stakeholdersfromthe13hospitalfacilitiesintheMemorialHermannHealthSystemcompletedasurveytoprioritizethesignificanthealthissues,basedoncriteriaincludinghealthimpactandriskaswellasconsiderationofMemorialHermann’sstrategicfocus.Thefollowingfourtopicswereidentifiedasprioritiestoaddress:
MHNortheastwilldevelopstrategiestoaddresstheseprioritiesinits2019ImplementationStrategy.
MemorialHermannHealthSystem’sSignificantHealthNeeds•AccesstoHealthServices•Cancers•Children’sHealth•Diabetes•Economy
•Education•FoodInsecurity•HeartDisease/Stroke•LackofHealthInsurance•Low-Income/Underserved
•MentalHealth•Obesity•OlderAdults/Aging•SubstanceAbuse•Transportation
MemorialHermannHealthSystem’sCHNAPriorities• AccesstoHealthcare• EmotionalWell-Being• FoodasHealth• ExerciseIsMedicine
MemorialHermannNortheastHospitalCHNA20196
Introduction
Memorial Hermann Northeast Hospital A255-bedfacility,MemorialHermannNortheastHospitalhasbeencaringforfamiliesintheLakeHoustonandKingwoodareaformorethan30years,offeringworld-classcareclosetohome.Itsaffiliateddoctorsspanawidevarietyofservicesincludingcancercare,children’semergencyandNICUcare,heartandvascularcare,orthopedics,neurosciences,sleephealth,woundcare,andwomen’scare.ThehospitalistheanchorfortheinnovativeMemorialHermannConvenientCareCenterprovidingone-stop,highlycoordinatedaccesstoanextensivearrayofMemorialHermannservices.Additionally,MemorialHermannNortheastservesastheofficialhealthcareprovidertopassengerstravelingthroughHouston’sGeorgeBushInternationalAirport.
Vision MemorialHermannwillbethepreeminenthealthsystemintheU.S.byadvancingthehealthofthoseweservethroughtrustedpartnershipswithphysicians,employeesandotherstodeliverthebestpossiblehealthsolutionswhilerelentlesslypursuingqualityandvalue.
Mission Statement MemorialHermannisanot-for-profit,community-owned,healthcaresystemwithspiritualvalues,dedicatedtoprovidinghighqualityhealthservicesinordertoimprovethehealthofthepeopleinSoutheastTexas.
Memorial Hermann Health System Oneofthelargestnot-for-profithealthsystemsinthenation,MemorialHermannHealthSystemisanintegratedsystemwithanexceptionalaffiliatedmedicalstaffandmorethan26,000employees.GovernedbyaBoardofcommunitymembers,theSystemservicesSoutheastTexasandtheGreaterHoustoncommunitywithmorethan300caredeliverysitesincluding19hospitals;thecountry’sbusiestLevel1traumacenter;anacademicmedicalcenteraffiliatedwithMcGovernMedicalSchoolatUTHealth;oneofthenation’stoprehabilitationandresearchhospitals;andnumerousspecialtyprogramsandservices.MemorialHermannhasbeenatrustedhealthcareresourceformorethan110yearsandasGreaterHouston’sonlyfull-service,clinicallyintegratedhealthsystem,wecontinuetoidentifyandmeetourregion’shealthcareneeds.AmongourdiverseportfolioisLifeFlight,thelargestandbusiestairambulanceserviceintheUnitedStates;theMemorialHermannPhysicianNetwork,MHMD,oneofthelargest,mostadvanced,andclinicallyintegratedphysicianorganizationsinthecountry;and,theMemorialHermannAccountableCareOrganization,operatingacaredeliverymodelthatgeneratesbetteroutcomesatlowercoststoconsumers,whileprovidingresidentsoftheGreaterHoustonareabroadaccesstohealthinsurancethroughtheMemorialHermannHealthInsuranceCompany.Specialtiesspanburntreatment,cancer,children’shealth,diabetesandendocrinology,digestivehealth,ear,noseandthroat,heartandvascular,lymphedema,neurosurgery,neurology,stroke,nutrition,ophthalmology,orthopedics,physicalandoccupationaltherapy,rehabilitation,roboticsurgery,sleepstudies,transplant,weightloss,women’shealth,maternityandwoundcare.SupportingtheSysteminitsimpacton
MemorialHermannNortheastHospitalCHNA20197
overallpopulationhealthistheCommunityBenefitCorporation.Atamarketshareof26.1%inthe‘expanded’greaterHoustonareaof12counties,ourvisionisthatMemorialHermannwillbeapreeminentintegratedhealthsystemintheU.S.byadvancingthehealthofthoseweserve.
Memorial Hermann Northeast Hospital Service Area TheserviceareaforMHNortheastincludesHarris,LibertyandMontgomerycountiesinTexas.ThegeographicboundariesoftheserviceareaareshowninFigure1.ThezipcodeswithinMHNortheast’sprimaryserviceareaarelistedinTable1andrepresentapproximately75%ofinpatientdischarges(66.6%inHarrisCounty,1.5%inLibertyCounty,and8%inMontgomeryCounty).
Figure1.MHNortheastServiceArea
Table1.ProportionofPatientPopulationServedbyZipCodeZIPCode County PercentofPatient
Population77346 Harris 8.3%77338 Harris 8.2%77396 Harris 7.5%77016 Harris 6.6%77093 Harris 5.8%77039 Harris 5.6%77044 Harris 5.3%77339 Harris 4.2%77365 Montgomery 3.5%
MemorialHermannNortheastHospitalCHNA20198
ZIPCode County PercentofPatientPopulation
77357 Montgomery 3.1%77032 Harris 2.8%77336 Harris 2.6%77373 Harris 2.5%77078 Harris 2.2%77028 Harris 1.8%77345 Harris 1.6%77532 Harris 1.6%77327 Liberty 1.5%77372 Montgomery 1.4%
Consultants MemorialHermannHealthSystemcommissionedConduentHealthyCommunitiesInstitute(HCI)toconductits2019CommunityHealthNeedsAssessment.HCIworkswithclientsacrossthenationtodrivecommunityhealthoutcomesbyassessingneeds,developingfocusedstrategies,identifyingappropriateinterventionprograms,establishingmonitoringsystems,andimplementingperformanceevaluationprocesses.TolearnmoreaboutConduentHealthyCommunitiesInstitute,pleasevisithttps://www.conduent.com/community-population-health.
MemorialHermannNortheastHospitalCHNA20199
Evaluation of Progress Since Prior CHNA TheCHNAprocessshouldbeviewedasathree-yearcycle.AnimportantpartofthatcycleisrevisitingtheprogressmadeonprioritytopicsfrompreviousCHNAs.Byreviewingtheactionstakentoaddresspriorityareasandevaluatingtheimpactoftheseactionsinthecommunity,anorganizationcanbetterfocusandtargetitseffortsduringthenextCHNAcycle.
Priority Health Needs and Impact from Prior CHNA MHNortheast’slastCHNAwasconductedin2016.ThepriorityareasinFY16-18were:
• HealthyLiving:Encourageandfosterhealthylifestylesthrougheducation,awarenessandearlydetectiontopreventillness.
• HealthcareAccess:Improvecommunityknowledgeabouthealthcareaccesspointsandreduceperceivedbarrierstocare.
• BehavioralHealth:Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.
EachoftheabovehealthtopicscorrelateswellwiththeprioritiesidentifiedforthecurrentCHNA(detailedbelow);thusMHNortheastwillbebuildinguponeffortsofpreviousyears.A
Figure2.CHNAProcess
AnalyzeData&
CommunityInput
PrioritizeHealthNeeds
CHNAReport&
ImplementationStrategy
Implement
EvaluateActionsTaken 3Year
Cycle
MemorialHermannNortheastHospitalCHNA201910
detailedtabledescribingthestrategies/actionstepsandindicatorsofsuccessforeachoftheprecedingpriorityhealthtopicscanbefoundinAppendixA.MHNortheast’sprecedingCHNAwasmadeavailabletothepublicviathewebsiteandcommunityfeedbackdirectedtoMemorialHermann’sCommunityBenefitDepartment:http://www.memorialhermann.org/locations/northeast/community-health-needs-assessment-northeast/.NocommentsorfeedbackwerereceivedontheprecedingCHNAatthetimethisreportwaswritten.
MemorialHermannNortheastHospitalCHNA201911
Methodology
Overview Twotypesofdatawereusedinthisassessment:primaryandsecondarydata.Primarydataaredatathathavebeencollectedforthepurposesofthiscommunityassessment.Primarydatawereobtainedthroughacommunitysurveyandkeyinformantinterviews.Secondarydataarehealthindicatordatathathavealreadybeencollectedbypublicsourcessuchasgovernmenthealthdepartments.Eachtypeofdatawasanalyzedusingauniquemethodology.FindingswereorganizedbyhealthtopicsandthensynthesizedforacomprehensiveoverviewofthehealthneedsinMHNortheast’sservicearea.
Secondary Data Sources & Analysis SecondarydatausedforthisassessmentwerecollectedandanalyzedfromHCI’scommunityindicatordatabase.Thisdatabase,maintainedbyresearchersandanalystsatHCI,includesover100communityindicatorsfromatleast15stateandnationaldatasources.HCIcarefullyevaluatessourcesbasedonthefollowingthreecriteria:thesourcehasavalidatedmethodologyfordatacollectionandanalysis;thesourcehasscheduled,regularpublicationoffindings;andthesourcehasdatavaluesforsmallgeographicareasorpopulations.
Secondary Data Scoring HCI’sDataScoringTool®wasusedtosystematicallysummarizemultiplecomparisonsinordertorankindicatorsbasedonhighestneed.Foreachindicator,thecommunityvaluewascomparedtoadistributionofTexasandUScounties,stateandnationalvalues,HealthyPeople2020,andsignificanttrendswerenoted.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariesbyindicatorandisdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.Thecomparisonscoresweresummarizedforeachindicator,andindicatorswerethengroupedintotopicareasforasystematicrankingofcommunityhealthneeds.PleaseseeAppendixBforfurtherdetailsonthequantitativedatascoringmethodologyaswellassecondarydatascoringresults.
Figure3.SummaryofTopicScoringAnalysis
MemorialHermannNortheastHospitalCHNA201912
Disparit ies Analysis Whenagivenindicatorhasdataavailableforsubgroupslikerace/ethnicity,ageorgender–andvaluesforthesesubgroupsincludeconfidenceintervals–significantdifferencesbetweenthesubgroups’valueandtheoverallvaluecanbedetermined.Asignificantdifferenceisdefinedastwovalueswithnon-overlappingconfidenceintervals.Onlysignificantdifferencesinwhichthevalueforasubgroupisworsethantheoverallvalueareidentified.Confidenceintervalsarenotavailableforallindicators.Inthesecases,therearenotenoughdatatodetermineiftwovaluesaresignificantlydifferentfromeachother.
Primary Data Methods & Analysis CommunityinputforMemorialHermannHealthSystemwascollectedtoexpandupontheinformationgatheredfromthesecondarydata.PrimarydatausedinthisassessmentconsistedofacommunitysurveyinEnglishandSpanishaswellaskeyinformantinterviews.SeeAppendixCforthesurveyandinterviewquestions.
Community Survey Inputfromcommunityresidentswascollectedthroughanonlinesurvey.Thissurveyconsistedof11questionsrelatedtotophealthneedsinthecommunity,individuals’perceptionoftheiroverallhealth,andweeklyexercisehabits.ThecommunitysurveywasdistributedonlinethroughSurveyMonkey®fromOctober23rdthroughNovember27thof2018.ThesurveywasmadeavailableinbothEnglishandSpanish.PapersurveyswerealsomadeavailableandanswerstothepapersurveywereenteredintotheSurveyMonkeytool.Atotalof285responseswerecollected.ResultsinthisreportarebasedontheserviceareaforMemorialHermannHealthSystem.Thiswasaconveniencesample,whichmeansresultsmaybevulnerabletoselectionbiasandmakethefindingslessgeneralizabletothepopulationasawhole.
Table2.CommunitySurveyOutreachCommunityEvent DescriptionStepHealthEvent–MoodyPark,77009
CommunityeventhostedbyMemorialHermannprovidingparkactivation,walkingtours,Zumbainstruction,and(throughapartnershipwithHoustonFoodBank)fooddistributiontolow-income,at-risk,andmostlyuninsuredresidents.
StepHealthEvent–CastilloPark,77009
CommunityeventhostedbyMemorialHermannprovidingparkactivation,walkingtours,Zumbainstruction,and(throughapartnershipwithHoustonFoodBank)fooddistributiontolow-income,at-risk,andmostlyuninsuredresidents.
MemorialHermannHealthCentersforSchools
10school-basedhealthclinicsin5schooldistricts(74schools)inHarrisandFortBendCounties,providingmedical,mentalhealth,anddentalcare,alongwithnutrition,navigation,andsummerbootcampprogramstouninsuredandunderinsuredchildrenthroughouttheGreaterHoustonarea.
WestOremYMCA,77085
Acommunity-centeredorganizationthatbringspeopletogethertobridgethegapsincommunityneeds(underservedresidents),nurturesresidents’potentialtolearn,grow,andthrive,andmobilizesthelocalcommunitytoeffectlasting,meaningfulchange.
SpringBranchCommunity
AFederallyQualifiedHealthCenter(FQHC)providingquality,affordablehealthcareservicestotheunderservedanduninsuredcommunitiesofSpring
MemorialHermannNortheastHospitalCHNA201913
Therace/ethnicitymake-upofsurveyrespondentsisshowninFigure4.ThelargestproportionofrespondentsidentifiedasHispanic/Latino(47.2%),22.4%asWhite,20.8%asBlack/AfricanAmerican,andtheremaining9.6%ofrespondentsasAsian/PacificIslander,OtherandNativeAmerican.
HealthCenter,77080
BranchandWestHouston.
WesleyCommunityCenter,77009
Amulti-purposesocialserviceagencyprovidingresidentsofHouston:short-termrent,utility,andfoodassistancetopreventhomelessnessandmaintainfamilyfinancialstability;acareerandpersonalfinancialservicecenter;andEarlyHeadStart,achilddevelopmentprogramservinginfantstotoddlerstopromoteschoolreadiness.
CompleteCommunities,Houston
PrograminitiatedbytheMayorofHoustoninfivecommunities-allhistoricallyunder-resourced,eachwithabaselevelofcommunityinvolvementandsupport,andwithdiversepopulations.Theprogramisdesignedtoenhanceaccesstoqualityaffordablehomes,jobs,well-maintainedparksandgreenspace,improvedstreetsandsidewalks,grocerystoresandotherretail,goodschoolsandtransitoptions.Communities:AcresHomes[77018,77088,77091],Gulfton[77056,77057,77081],NearNorthside[77009,77022,77026],SecondWard[77003,77011,77020],andThirdWard[77003,77004,77204].
HealthyLivingMatters
AHouston/HarrisCountyChildhoodObesityCollaborative-Acollaborativeofmulti-sectorleadersthatpromotepolicyaimedatsystem-levelandenvironmentalchangetoreducetheincidenceofchildhoodobesity.Prioritycommunitieswereselectedduetothelackofaccesstohealthyfoodoptionsandopportunitiestoengageinphysicalactivityaswellasfortheircommunityassetsandreadinessforchange.PriorityCommunities:CityofPasadena[77058,77059,77502,77503,77504,77505,77506,77507,77536,77571,77586],NearNorthside[77009,77022,77026],andFifthWard/KashmereGardens[77020,77026,and77028]
GreaterNorthsideHealthCollaborative
Non-profitcollaborativewhosegoalistoexpandactivelivingresourcesandincreaseaccesstoqualityhealthcareandhealthyfoodbypromotingresidentleadershipandcivicparticipation.
MemorialHermannNortheastHospitalCHNA201914
Figure4.SurveyRespondentsbyRace/Ethnicity
Surveyrespondentswereaskedtoselecttopissuesmostaffectingthecommunity’squalityoflife.AsshowninFigure5,themajorityofrespondentsidentifiedDiabetes,Obesity/Overweight,SubstanceAbuse,andMentalHealth&MentalDisordersastopissuesinthecommunity.
Figure5.TopIssuesAffectingQualityofLife(Survey)
Key Informant Interviews Communityinputwasalsocollectedthroughkeyinformantinterviews.
MemorialHermannHealthSystemjoinedwiththeEpiscopalHealthFoundation(EHF)intheirkeyinformantinterviewinitiativesupportingfourGreaterHoustonareahospitalsystemsinpreparingtheircommunityhealthneedsassessments.ThecollaboratinghospitalsofthisinitiativeincludeMemorialHermann,CHISt.Luke’sHealth,HoustonMethodist,andTexasChildren’s(Table3).Throughthispartnership,atotalof53interviewswereconductedwith
47.20%
22.40%
20.80%
4.80%3.60% 1.20%
Hispanic
White
AfricanAmerican
Asian/PacificIslander
Other
NativeAmerican
10%10%13%13%14%
17%23%26%26%
35%51%54%
64%69%
SexualHealthOralhealth
TeenagePregnancyReproductiveHealth
OtherRespiratory/LungDiseaseInjuries,Violence&Safety
ElderCareHeartDisease&Stroke
CancersMentalHealth&MentalDisorders
SubstanceAbuseObesity/Overweight
Diabetes
MemorialHermannNortheastHospitalCHNA201915
stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Communityleaderswithspecificexperienceworkingwithprioritypopulations,suchaswomen,children,peopleofcolor,thedisabled,andmore,werealsointerviewed.
Table3.MemorialHermannCollaborativePartners
Intotal,64keyinformantinterviewswereconductedbyphonefromAugustthroughNovember2018;53keyinformantinterviewswereconductedthroughthecollaborativeand11interviewswereconductedbyHCI.Intervieweeswhowereaskedtoparticipatewererecognizedashavingexpertiseinpublichealth,specialknowledgeofcommunityhealthneedsand/orrepresentedthebroadinterestofthecommunityservedbythehospital,and/orcouldspeaktotheneedsofmedicallyunderservedorvulnerablepopulations.Effortsweremadetoidentifyintervieweesworkinginand/orknowledgeableaboutthecountiesinMemorialHermannHealthSystem’sservicearea.AsseeninTable4,someintervieweeswereidentifiedwithknowledgeofmultiplecounties.
Table4.KeyInformantsbyCountyCounty KeyInformantsAustin IncludedinMultipleCountiesBrazoria 3Chambers 2
EpiscopalHealthFoundation’smissionistoadvancetheKingdomofGodwithspecificfocusonhumanhealthandwell-beingthroughgrants,research,andinitiativesinsupportoftheworkoftheDiocese,spanning57counties.Throughinformedaction,collaboration,empowerment,stewardship,transparency,andaccountabilitythefoundationstrivesforthetransformationofhumanlivesandorganizationswithcompassionforthepoorandpowerless.
CHISt.Luke’sHealth,apartofCatholicHealthInitiatives(CHI),oneofthenation’slargesthealthsystems,isdedicatedtoamissionofenhancingcommunityhealththroughhigh-quality,cost-effectivecare.Throughpartnershipswithphysiciansandcommunitypartners,CHISt.Luke’sHealthservesGreaterHoustonwithitscommitmenttoexcellenceandcompassionincaringforthewholepersonwhilecreatinghealthiercommunities.
HoustonMethodistisanonprofithealthcareorganizationservingGreaterHouston,dedicatedtoexcellenceinresearch,education,andpatientcare.HoustonMethodistbringscompassionandspiritualitytoallitsendeavorstohelpmeetthehealthneedsofthecommunitythroughthesystem’sICAREvalues:integrity,compassion,accountability,respect,andexcellence.
TexasChildren’sHospitalisanot-for-profitorganizationwhosemissionistocreateahealthierfutureforchildrenandwomenthroughoutGreaterHoustonandtheglobalcommunitybyleadinginpatientcare,education,andresearch.TexasChildren’siscommittedtocreatingahealthycommunityforchildrenbyprovidingthebestpediatriccarepossible,throughgroundbreakingresearchandemphasisoneducation,whilealsoofferingafullcontinuumoffamily-centeredcareforwomen,fromobstetricstowell-womancare.
MemorialHermannNortheastHospitalCHNA201916
County KeyInformantsFortBend 10Galveston 7Harris 28Liberty 1Montgomery 4SanJacinto IncludedinMultipleCountiesWalker IncludedinMultipleCountiesWaller 2Wharton 2MultipleCounties* 5
Total
64
Interviewsweretranscribedandanalyzedusingthequalitativeanalytictool,Dedoose1.Interviewexcerptswerecodedbyrelevanttopicareasandkeyhealththemes.Threeapproacheswereusedtoassesstherelativeimportanceoftheneedsdiscussedintheseinterviews.Theseapproachesincluded:thefrequencybywhichahealthtopicwasdiscussedacrossallinterviews;thefrequencybywhichatopicwasdescribedbythekeyinformantasabarrier/challenge;andthefrequencybywhichatopicwasmentionedperinterviewee.
Data Considerations Severallimitationsofdatashouldbeconsideredwhenreviewingthefindingspresentedinthisreport.Althoughthetopicsbywhichdataareorganizedcoverawiderangeofhealthandhealth-relatedareas,dataavailabilityvariesbyhealthtopic.Sometopicscontainarobustsetofsecondarydataindicators,whileothersmayhavealimitednumberofindicatorsorlimitedsubpopulationscoveredbythosespecificindicators.Datascoresrepresenttherelativecommunityhealthneedaccordingtothesecondarydataforeachtopicandshouldnotbeconsideredtobeacomprehensiveresultontheirown.Inaddition,thesescoresreflectthesecondarydataresultsforthepopulationasawhole,anddonotrepresentthehealthorsocioeconomicneedthatismuchgreaterforsomesubpopulations.Moreover,manyofthesecondarydataindicatorsincludedinthefindingsarecollectedbysurvey,andthoughspecificmethodsareusedtobestrepresentthepopulationatlarge,thesemeasuresaresubjecttoinstability,especiallyforsmallerpopulations.TheIndexofDisparityisalsolimitedbydataavailability,whereindicatordatavariesbasedonthepopulationgroupsandserviceareasbeinganalyzed.
1DedooseVersion8.0.35,webapplicationformanaging,analyzing,andpresentingqualitativeandmixedmethodresearchdata(2018).LosAngeles,CA:SocioCulturalResearchConsultants,LLCwww.dedoose.com
*Five(5)oftheKeyInformantInterviewsrepresented2ormorecounties,including:Austin,Brazoria,Chambers,FortBend,Galveston,Harris,Liberty,Montgomery,SanJacinto,Walker,Waller,andWhartoncounties.
MemorialHermannNortheastHospitalCHNA201917
Race/Ethnic Groupings
Thesecondarydatapresentedinthisreportderivefrommultiplesources,whichmaypresentraceandethnicitydatausingdissimilarnomenclature.Forconsistencywithdatasourcesthroughoutthereport,subpopulationdatamayusedifferenttermstodescribethesameorsimilargroupsofcommunitymembers.
Zip Codes and Zip Code Tabulation Areas
ThisreportpresentsbothZIPCodeandZIPCodeTabulationArea(ZCTA)data.ZIPorZoneImprovementPlanCodeswerecreatedbytheU.S.PostalServicetoimprovemaildeliveryservice.Theyarebasedonpostalroutes,whichfactorindelivery-area,mailvolumeandgeographiclocation.Theyarenotdesignedtobeusedforstatisticalreportingandmaychangefrequently.SomeZIPCodesmayonlyincludeP.O.boxesorcoverlargeunpopulatedareas.ZCTAsorZIPCodeTabulationAreaswerecreatedbytheU.S.CensusBureauandaregeneralizedrepresentationsofZIPCodesthathavebeenassignedtocensusblocks.Therefore,ZCTAsarerepresentativeofgeographiclocationsofpopulatedareas.Inmostcases,theZCTAwillbethesameasitsZIPCode.ZCTAswillnotnecessarilyexistforZIPCodeareaswithonlybusinesses,singleormultipleaddresses,orforlargeunpopulatedareas.SinceZCTAsarebasedonthemostrecentCensusdata,theyaremorestablethanZIPCodesanddonotchangeasfrequently.DemographicsforthisreportaresourcedfromtheUnitedStatesCensusBureau,whichpresentsZCTAestimates.TablesandfiguresintheDemographicssectionofthisreportreferenceZIPCodesintitle(forpurposesoffamiliarity)butshowvaluesofZCTAs.DatafromothersourcesisrepresentativebyZIPCodesandarelabeledassuch.
Priorit ization Inordertofocuseffortsonasmallernumberofthemostsignificantcommunityissues,sixteenrepresentativesfromtheMemorialHermannHealthSystem(oneormorerepresentingeachfacility)participatedinanonlineprioritizationprocesstoprioritizethefifteensignificanthealthneedsidentifiedthroughthesecondaryandprimarydataanalyses.Theprioritizedhealthneedswillbeunderconsiderationforthedevelopmentofanimplementationplanthatwilladdresssomeofthecommunity’smostpressinghealthissues.
Priorit ization Process Toprioritizesignificanthealthneeds,MemorialHermannstakeholdersparticipatedinanonlinewebinaronMarch7,2019toreviewdatasynthesisresultsfollowedbycompletionofaprioritizationmatrixlistingsignificanthealthneedsandfourcriteriabywhichtorateeachneed.Participantsscoredeachneedforeachofthecriteriaonascalefrom1-5,with1meaningtherespondentstronglydisagreesto5meaningtherespondentstronglyagreesthatthehealthneedmeetsthecriterion.Respondentswerealsoabletoselect“Don’tKnow/Unsure”foreachhealthneed.Thecriteriaforprioritizationincludedtowhatextentanissue:
• Impactsmanypeopleinthecommunity• Significantlyimpactssubgroupsinthecommunity(gender,race/ethnicity,LGBTQ,etc.)
MemorialHermannNortheastHospitalCHNA201918
• Hasinadequateexistingresourcesinthecommunity• Hashighriskfordiseaseordeath
CompletionoftheprioritizationmatrixinAppendixDresultedinnumericalscoresforeachhealthneedthatcorrespondedtohowwelleachhealthneedmetthecriteriaforprioritization.Thescoreswererankedfromhighesttolowest(Table5).
Table5.ResultsfromMemorialHermannPrioritizationMatrixSignificantHealthNeed Impacton
CommunityImpactonSubgroups
InadequateResources
HighRisk AverageScore
Obesity(Exercise,NutritionandWeight)
4.69 4.00 3.19 4.50 4.09
MentalHealth 4.44 3.44 4.50 3.75 4.03Diabetes 4.50 4.00 3.25 4.19 3.98LackofHealthInsurance 4.31 4.19 3.38 4.00 3.97Low-Income/Underserved
4.19 4.19 3.44 4.00 3.95
HeartDisease/Stroke 4.44 3.82 2.81 4.44 3.88SubstanceAbuse 3.56 3.88 3.63 4.19 3.81AccesstoHealthServices
4.00 3.94 3.25 3.88 3.77
OlderAdultsandAging 4.38 3.81 3.13 3.75 3.76FoodInsecurity 3.88 4.00 3.44 3.50 3.70Cancers 4.19 3.19 3.00 4.31 3.67Education 3.88 3.81 3.00 3.13 3.45Transportation 4.00 3.88 2.81 3.00 3.42Children'sHealth 4.00 3.50 3.00 3.19 3.42Economy 3.31 3.31 2.69 2.88 3.05Inadditiontoratingeachneedinthematrix,prioritizationparticipantswereaskedtoratethelevelofimportanceofMemorialHermann’s4strategicpillars.
1. ImprovingAccesstoHealthcarethroughprogramming,education,andsocialservicesupport;
2. AddressingEmotionalWell-being(mentalandbehavioralhealth)throughinnovativeaccesspoints;
3. PromotingtheimportanceofahealthydietthroughscreeningandcreatingaccesstonutritiousFoodasHealth;and,
4. FosteringimprovedhealththroughExerciseIsMedicinewithculturallyappropriateactivities.
EachoftheseintersectingpillarsconnecttoeachotherthroughvariouspointsinMemorialHermannprogramsandinitiativesadvancingthehealthofourcommunities(Figure6).
MemorialHermannNortheastHospitalCHNA201919
Figure6.MemorialHermann’sFourPillarsforCommunityHealth
Over93%ofparticipantsrespondedthatthe4pillarswereimportantorveryimportant.TheMemorialHermannCommunityBenefitteamreviewedthesefindings,andtakingintoaccountthealignmentoftopneedswithMemorialHermann’sstrategicfocusareas,adecisionwasmadetointegrate:
• LackofHealthInsurance,Low-Income/Underserved,andAccesstoHealthServicesintoPillar1:AccesstoHealthcare
• MentalHealthandSubstanceAbuseintoPillar2:EmotionalWell-Being• Diabetes,FoodInsecurityandHeartDisease/StrokeintoPillar3:FoodasHealth• Obesity(Exercise,NutritionandWeight)intoPillar4:ExerciseIsMedicine
Throughthissystem-wideprioritizationprocess,thefollowingfourprioritiesforMemorialHermannHealthSystemare:
• AccesstoHealthcare(addressingAccesstoHealthServices,LackofHealthInsurance,andLow-Income/Underserved)
• EmotionalWellbeing(addressingMentalHealthandSubstanceAbuse)• FoodasHealth(addressingDiabetes,FoodInsecurity,andHeartDisease/Stroke)• ExerciseIsMedicine(addressingObesity)
ThesefourhealthtopicswillbeexploredfurtherinordertounderstandhowfindingsfromthesecondaryandprimarydataanalysesresultedineachissuebeingahighpriorityhealthneedforMemorialHermannHealthSystem.
MemorialHermannNortheastHospitalCHNA201920
Demographics ThefollowingsectionexploresthedemographicprofileofMHNortheast’sservicearea,includingHarris,Liberty,andMontgomerycounties.Thedemographicsofacommunitysignificantlyimpactitshealthprofile.Differentrace/ethnic,age,andsocioeconomicgroupshaveuniqueneedsandrequiredifferentapproachestohealthimprovementefforts.AlldemographicestimatesaresourcedfromtheU.S.CensusBureau’s2013-2017AmericanCommunitySurveyunlessotherwiseindicated.Furthermore,tablesinthissectionlistindicatorvaluesforthetop75%ofzipcodeswithinMHNortheast’sserviceareaindescendingorderofinpatientdischargesunlessotherwisenoted.
Population AccordingtotheU.S.CensusBureau’s2013-2017AmericanCommunitySurvey,the3countiesinMHNortheast’sserviceareahadpopulationsof4,652,980(HarrisCounty),83,658(LibertyCounty),and570,934(MontgomeryCounty).Figure7illustratesthepopulationsizebycountyandTable6byzipcode.ThemostpopulouszipcodesinMHNortheast’sserviceareaare77346,77373,and77396(allwithinHarrisCounty).
Figure7.PopulationbyCounty
MemorialHermannNortheastHospitalCHNA201921
Table6.PopulationbyZipCode
ZIPCode County TotalPopulationEstimate
77346 Harris 63,23377338 Harris 40,33577396 Harris 54,35277016 Harris 29,59777093 Harris 44,42877039 Harris 27,97277044 Harris 42,66577339 Harris 41,40377365 Montgomery 31,40677357 Montgomery 24,33477032 Harris 14,44377336 Harris 12,39777373 Harris 58,25577078 Harris 15,82077028 Harris 15,72577345 Harris 29,09077532 Harris 28,32077327 Liberty 22,43077372 Montgomery 12,351
AmericanCommunitySurvey,2013-2017
Age Figure8showsMHNortheast’sserviceareapopulationthatisunder18yearsold.26.9%ofHarrisCounty’spopulation,26.0%ofLibertyCounty’spopulation,and26.5%ofMontgomeryCounty’spopulationisunder18.HarrisandMontgomerycountieshavehigherproportionsofresidentsunder18comparedtothestateandnationalvalues(26%and22.6%,respectively).LibertyCounty’sproportionisequaltothestatevalue.
Figure8.PopulationUnder18
26.9%26.0%
26.5%26.0%
22.6%
20%
21%
22%
23%
24%
25%
26%
27%
28%
Harris Liberty Montgomery Texas U.S.
MemorialHermannNortheastHospitalCHNA201922
AsshowninFigure9,HarrisCountyhasasmallerproportionofolderadults(10.2%)comparedtoTexas(12.3%)andtheU.S.(15.6%).InLibertyCounty,12.8%ofthepopulationisover65yearsold.InMontgomeryCounty,12.9%ofresidentsareover65.
Figure9.PopulationOver65
Figure10showsthatHarrisCountyhasalargerproportionofresidentsunder5yearsold(7.7.%)comparedtobothTexas(7.2%)andtheU.S.(6.1%).Alittleover7%ofLibertyCounty’spopulationisunder5,whileMontgomeryCountyhas6.9%ofitspopulationunder5.
Figure10.PopulationUnder5
Race/Ethnicity Theraceandethnicitycompositionofapopulationisimportantinplanningforfuturecommunityneeds,particularlyforschools,businesses,communitycenters,healthcareandchildcare.Raceandethnicitydataarealsousefulforidentifyingandunderstandingdisparitiesinhousing,employment,income,andpoverty.AlargernumberofresidentsinLibertyandMontgomerycountiesidentifyasWhite,non-HispanicwhileHarrisCountyhasalargernumberofresidentswhoidentifyasHispanicorLatino.Figure11showstheracialcompositionofresidentsinHarrisCountywith42.2%of
10.2%
12.8% 12.9% 12.3%
15.6%
0%2%4%6%8%
10%12%14%16%18%
Harris Liberty Montgomery Texas U.S.
7.7%7.2% 6.9% 7.2%
6.1%
0%1%2%3%4%5%6%7%8%9%
Harris Liberty Montgomery Texas U.S.
MemorialHermannNortheastHospitalCHNA201923
residentsidentifyingasHispanicorLatino(ofanyrace);30.6%asWhite;18.5%asBlackorAfricanAmerican;6.8%asAsian;and1.9%asAmericanIndianandAlaskaNative,NativeHawaiianandOtherPacificIslander,“Someotherrace”,and/or“Twoormoreraces”.
Figure11.Race/EthnicityinHarrisCounty
Figure12showstheracialcompositionofresidentsinLibertyCountywith65.8%ofresidentsidentifyingasWhite,non-Hispanic;21.9%asHispanicorLatino(ofanyrace);10.0%asBlackorAfricanAmerican;0.6%asAsian;and1.7%asAmericanIndianandAlaskaNative,NativeHawaiianandOtherPacificIslander,“Someotherrace”,and/or“Twoormoreraces”.
Figure12.Race/EthnicityinLibertyCounty
Figure13showstheracialcompositionofresidentsinMontgomeryCountywith67.9%ofresidentsidentifyingasWhite,non-Hispanic;23.0%asHispanicorLatino(ofanyrace);4.5%as
30.6%
18.5%
6.8%
42.2%
1.9%
White,non-Hispanic
BlackorAfricanAmerican
Asian
HispanicorLatino(ofanyrace)
Other
65.8%10.0%
0.6%
21.9%
1.7%
White,non-Hispanic
BlackorAfricanAmerican
Asian
HispanicorLatino(ofanyrace)
Other
MemorialHermannNortheastHospitalCHNA201924
BlackorAfricanAmerican;2.8%asAsian;and1.8%asAmericanIndianandAlaskaNative,NativeHawaiianandOtherPacificIslander,“Someotherrace”,and/or“Twoormoreraces”.
Figure13.Race/EthnicityinMontgomeryCounty
Language Languageisanimportantfactortoconsiderforoutreacheffortsinordertoensurethatcommunitymembersareawareofavailableprogramsandservices.
Figure14.LanguageOtherthanEnglishSpokenatHome
Figure14showstheproportionofresidentsinHarris,Liberty,andMontgomerycountieswhospeakalanguageotherthanEnglishathome.Asshown,alargerproportionofresidentsinHarrisCountyspeakalanguageotherthanEnglishathome(43.7%),incomparisontoLibertyandMontgomerycounties(18.9%and21%,respectively).HarrisCounty’sproportionishigherthanthestatevalue(35.3%)andmorethantwicethenationalvalue(21.3%).Thisisan
67.9%4.5%
2.8%
23.0%
1.8%
White,non-Hispanic
BlackorAfricanAmerican
Asian
HispanicorLatino(ofanyrace)
Other
43.7%
18.9% 21.0%
35.3%
21.3%
0%5%
10%15%20%25%30%35%40%45%50%
Harris Liberty Montgomery Texas U.S.
MemorialHermannNortheastHospitalCHNA201925
importantconsiderationfortheeffectivenessofservicesandoutreachefforts,whichmaybemoreeffectiveifconductedinlanguagesotherthanEnglishalone.
Table7.PopulationwithDifficultySpeakingEnglishbyZipCodeZIPCode County DifficultySpeaking
English77346 Harris 4.9%77338 Harris 10.9%77396 Harris 16.0%77016 Harris 14.7%77093 Harris 51.2%77039 Harris 61.0%77044 Harris 17.5%77339 Harris 5.2%77365 Montgomery 9.2%77357 Montgomery 15.2%77032 Harris 27.2%77336 Harris 2.7%77373 Harris 8.1%77078 Harris 16.9%77028 Harris 9.2%77345 Harris 2.2%77532 Harris 7.0%77327 Liberty 9.0%77372 Montgomery 7.6%Harris -- 20.4%Liberty -- 7.4%Montgomery -- 7.8%Texas -- 14.1%
AmericanCommunitySurvey,2013-2017
AsshowninTable7,HarrisCountyhasalargerproportionofresidentswithdifficultyspeakingEnglish(20.4%)comparedtoLibertyCounty(7.4%),MontgomeryCounty(7.8%),andthestateofTexas(14.1%).InHarrisCounty,themajorityofresidentsinzipcodes77093and77039havedifficultyspeakingEnglish(51.2%and61%,respectively).
Social and Economic Determinants of Health Thissectionexplorestheeconomic,environmental,andsocialdeterminantsofhealthinMHFacility’sservicearea.Socialdeterminantsaretheconditionsinwhichpeopleareborn,grow,work,live,andage,andthewidersetofforcesandsystemsshapingtheconditionsofdailylife.
Income Medianhouseholdincomereflectstherelativeaffluenceandprosperityofanarea.Areaswithhighermedianhouseholdincomesarelikelytohaveagreatershareofeducatedresidentsandlowerunemploymentrates.
MemorialHermannNortheastHospitalCHNA201926
Figure15comparesthemedianhouseholdincomevaluesforthe3countiesinMHNortheast’sserviceareatothemedianhouseholdincomevalueforTexasandtheUnitedStates.MontgomeryCounty’smedianhouseholdincomeof$74,323isgreaterthanthatofbothHarrisCounty($57,791)andLibertyCounty($48,344).HarrisCounty’smedianhouseholdincomeissimilartothestateandnationalvalues,whereasLibertyCounty’smedianhouseholdincomeislowerthanthestateandnationalvalues.
Figure15.MedianHouseholdIncome
AsshowninTable8,MHNortheast’stopzipcodesforinpatientdischargesrevealabroadrangeinmedianhouseholdincome.Zipcodes77338,77016,77093,and77039havemedianhouseholdincomeslowerthanthestateofTexas,whereaszipcode77346hasamedianhouseholdincomeof$98,840,whichisabout$40,000greaterthanthestatevalue.
$57,791
$48,344
$74,323
$57,051 $57,652
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
Harris Liberty Montgomery Texas U.S.
MemorialHermannNortheastHospitalCHNA201927
Table8.MedianHouseholdIncomebyZipCode
ZIPCode County MedianHouseholdIncome
77346 Harris $98,84077338 Harris $50,26377396 Harris $64,19577016 Harris $32,30277093 Harris $30,83777039 Harris $34,60877044 Harris $76,38777339 Harris $73,46677365 Montgomery $72,62377357 Montgomery $47,80577032 Harris $30,45177336 Harris $67,56377373 Harris $67,92477078 Harris $35,77077028 Harris $30,23377345 Harris $128,64677532 Harris $62,60677327 Liberty $40,63677372 Montgomery $51,818Harris -- $57,791Liberty -- $48,344Montgomery -- $74,323Texas -- $57,051
AmericanCommunitySurvey,2013-2017
Poverty FederalpovertythresholdsareseteveryyearbytheCensusBureauandvarybysizeoffamilyandagesoffamilymembers.Ahighpovertyrateisbothacauseandaconsequenceofpooreconomicconditions.Figure16showstheproportionofresidentslivingbelowthepovertylevelinHarris,Liberty,andMontgomerycountiescomparedtothestateofTexasandtheU.S.ThepercentagesofresidentslivingbelowthepovertylevelinbothHarrisCounty(16.8%)andLibertyCounty(16.2%)arehigherthanthenationalvalue(14.6%)andslightlyhigherthanthestatevalue(16.0%).AsmallerproportionofresidentsinMontgomeryCountylivebelowthepovertyvalue(10.3%),comparedtothestate(16%)andtheU.S.(14.6%)aswellasHarrisandLibertycounties.
MemorialHermannNortheastHospitalCHNA201928
Figure16.PeopleLivingBelowPovertyLevel
Figure17showstheproportionofresidentslivingbelowthepovertylevelbyrace/ethnicity.InHarrisCounty,22.6%ofHispanicorLatinoresidentsand21.8%ofBlackorAfricanAmericanresidentslivebelowthepovertylevel,comparedto7.0%Whiteand11.4%Asianresidents.ThepercentageofBlackandAsianresidentslivingbelowthepovertylevelinHarrisCountyishigherthanthestatevaluesforBlackandAsianresidents.Notably,theproportionofAsianresidentslivingbelowthepovertylevelinLibertyCounty(33.8%)isalmostthreetimesthestateandnationalvalues(10.6%and11.9%,respectively).Forallrace/ethnicitygroupsinMontgomeryCounty,thepercentageofresidentslivingbelowthepovertylevelislowerthanthevaluesforTexasandtheU.S.
16.8%16.2%
10.3%
16.0%
14.6%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
Harris Liberty Montgomery Texas U.S.
MemorialHermannNortheastHospitalCHNA201929
Figure17.PeopleLivingBelowPovertyLevelbyRace/Ethnicity
Figure18.PeopleLivingBelowPovertyLevelbyZipCode
7.0%
21.8%
11.4%
22.6%
12.4%15.5%
33.8%
27.2%
6.7%
13.1%
5.6%
21.5%
8.8%
21.4%
10.6%
23.0%
10.3%
25.2%
11.9%
22.2%
0%
5%
10%
15%
20%
25%
30%
35%
40%
White,non-Hispanic BlackorAfricanAmerican Asian HispanicorLatino
Harris Liberty Montgomery Texas U.S.
MemorialHermannNortheastHospitalCHNA201930
PovertyratesarehigherinHarrisCounty(16.8%)andLibertyCounty(16.2%)comparedtoMontgomeryCounty(10.3%).AsshowninFigure18andTable9,withinMHNortheast’sservicearea,6.6%ofresidentsinzipcode77346and14.7%ofresidentsinzipcode77338arelivingbelowthepovertylevel,comparedto16%inTexas.However,therearehigherproportionsofpeoplelivingbelowthepovertylevelinotherzipcodeswithMHNortheast’sservicearea,suchas77016,77093,77039,and77032(thelatterzipcodewithover40%ofpeoplelivingbelowthepovertylevel).
Table9.PeopleLivingBelowPovertyLevelbyZipCodeZIPCode County PeopleLivingBelow
PovertyLevel77346 Harris 6.6%77338 Harris 14.7%77396 Harris 12.7%77016 Harris 26.1%77093 Harris 36.6%77039 Harris 32.0%77044 Harris 11.9%77339 Harris 8.4%77365 Montgomery 12.1%77357 Montgomery 22.1%77032 Harris 40.1%77336 Harris 8.8%77373 Harris 12.2%77078 Harris 21.9%77028 Harris 28.0%77345 Harris 3.2%77532 Harris 14.2%77327 Liberty 21.9%77372 Montgomery 20.0%Harris -- 16.8%Liberty -- 16.2%Montgomery -- 10.3%Texas -- 16.0%
AmericanCommunitySurvey,2013-2017
Food Insecurity TheSupplementalNutritionAssistanceProgram(SNAP)isafederalassistanceprogramthatprovideslow-incomefamilieswithelectronicbenefittransfers(EBTs)thatcanbeusedtopurchasefood.Thegoaloftheprogramistoincreasefoodsecurityandreducehungerbyincreasingaccesstonutritiousfood.Table10showsthepercentofhouseholdswithchildrenthatparticipateinSNAPinthezipcodeswithinMHNortheast’sservicearea.HarrisCountyhasahigherproportionofhouseholdswithchildrenreceivingSNAP(67.7%)comparedtoTexas(64.3%);ontheotherhand,LibertyandMontgomerycountieshavelowerproportions(57.4%and61.7%,respectively)compared
MemorialHermannNortheastHospitalCHNA201931
tothestatevalue.Inparticular,zipcodes77346and77396inHarrisCountystandout,astheyareMHNortheast’stopzipcodesforinpatientdischargesandalsohavemorethan80%ofhouseholdswithchildrenreceivingSNAP.
Table10.HouseholdswithChildrenReceivingSNAPbyZipCode
ZIPCode County HouseholdswithChildrenReceivingSNAP
77346 Harris 84.4%77338 Harris 60.6%77396 Harris 83.2%77016 Harris 57.4%77093 Harris 71.6%77039 Harris 77.9%77044 Harris 76.9%77339 Harris 64.8%77365 Montgomery 51.1%77357 Montgomery 70.9%77032 Harris 68.0%77336 Harris 73.0%77373 Harris 75.3%77078 Harris 74.0%77028 Harris 41.6%77345 Harris 79.1%77532 Harris 65.7%77327 Liberty 60.4%77372 Montgomery 73.9%Harris -- 67.7%Liberty -- 57.4%Montgomery -- 61.7%Texas -- 64.3%
AmericanCommunitySurvey,2013-2017
Unemployment Theunemploymentrateisakeyindicatorofthelocaleconomy.Unemploymentoccurswhenlocalbusinessesarenotabletosupplyenoughappropriatejobsforlocalemployeesand/orwhenthelaborforceisnotabletosupplyappropriateskillstoemployers.Ahighrateofunemploymenthaspersonalandsocietaleffects.Duringperiodsofunemployment,individualsarelikelytofeelsevereeconomicstrainandmentalstress.Unemploymentisalsorelatedtoaccesstohealthcare,asmanyindividualsreceivehealthinsurancethroughtheiremployer.Ahighunemploymentrateplacesstrainonfinancialsupportsystems,asunemployedpersonsqualifyforunemploymentbenefitsandfoodstampprograms.Figure19displaystherateofunemploymentinHarris,Liberty,andMontgomerycountiesbetweenMay2017andNovember2018.Inallthreecounties,theunemploymentratehasexhibitedadecrease.Nevertheless,LibertyCounty’sunemploymentrateremainedhigherthan
MemorialHermannNortheastHospitalCHNA201932
theratesinHarrisandMontgomerycountiesaswellasTexasandtheU.SInNovember2018,theMontgomeryCountyrate(3.4%)wasalmostequivalenttothestateandnationalrates(3.5%).However,theunemploymentratesinHarrisCounty(3.8%)andLibertyCounty(5.0%)remainedhigherthanTexasandtheU.S.
Figure19.UnemploymentRateperCounty(U.S.BureauofLaborStatistics,2017-2018)
Education Graduatingfromhighschoolisanimportantpersonalachievementandisessentialforanindividual’ssocialandeconomicadvancement.Graduationratescanalsobeanimportantindicatoroftheperformanceofaneducationalsystem.Havingabachelor’sdegreeopensupcareeropportunitiesinavarietyoffieldsandisoftenaprerequisiteforhigher-payingjobs.Figure20displaystheproportionofresidentsinHarris,Liberty,andMontgomerycountieswhoare25yearsandolderwithatleastahighschooldegree.Nearly90%ofresidents25yearsandolderinMontgomeryCountyhaveatleastahighschooldegreecomparedto80.5%inHarrisCountyand77.1%inLibertyCounty.LibertyCounty’svalueislowerthantheU.S.(87.3%)andTexas(82.8%)whileMontgomeryCounty’svalueishigher.
5.1%
4.3% 4.3%3.8%
7.3%
6.0%5.7%
5.0%4.6%
3.7% 3.6%3.4%
4.4% 3.7% 3.7%3.5%
4.1% 3.9%3.6% 3.5%
0%
1%
2%
3%
4%
5%
6%
7%
8%
May2017 November2017 May2018 November2018
Harris Liberty Montgomery Texas UnitedStates
MemorialHermannNortheastHospitalCHNA201933
Figure20.People25+withaHighSchoolDegreeorHigher
Figure21showstheproportionofresidentsinHarris,Liberty,andMontgomerycountieswhoare25yearsandolderwithabachelor’sdegreeorhigher.Withover30%ofresidents25andolderhavingabachelor’sdegreeinHarrisandMontgomerycounties,thesecountieshaveaneconomicadvantagecomparedtoLibertyCounty(9.3%).Theproportionofresidents25andolderwithabachelor’sdegreeinMontgomeryCounty(33.7%)issomewhatbetterthanbothTexas(28.7%)andtheU.S.(30.9%).
Figure21.People25+withaBachelor'sDegreeorHigher
Table11displaystheeducationalattainmentindicatorsforresidents25yearsandolderbyzipcodeinMHNortheast’sservicearea.Forhighschooldegreeattainment,thezipcodewiththehighestrateis77345(97.4%)andthezipcodewiththelowestrateis77039(48.1%).Forattainmentofabachelor’sdegree,thezipcodewiththehighestrateis77345(62.9%)andthezipcodewiththelowestrateis77093(3.2%).ThezipcodeswithhighestproportionsofMHNortheast’sinpatientdischarges,zipcodes77346and77338,havemorethan85%ofpeople25yearsandolderwithahighschooldegree.Inzipcode77338,however,onlyapproximately17%ofresidents25yearsandolderhaveabachelor’sdegreeorhigher.
80.5%
77.1%
87.6%
82.8%
87.3%
70%72%74%76%78%80%82%84%86%88%90%
Harris Liberty Montgomery Texas U.S.
30.5%
9.3%
33.7%
28.7%30.9%
0%
5%
10%
15%
20%
25%
30%
35%
40%
Harris Liberty Montgomery Texas U.S.
MemorialHermannNortheastHospitalCHNA201934
Table11.People25+withaHighSchoolDegreeandPeople25+withaBachelor'sDegreebyZipCode
ZIPCode County HighSchoolDegreeorHigher
Bachelor’sDegreeorHigher
77346 Harris 93.6% 40.2%77338 Harris 85.7% 16.6%77396 Harris 83.5% 25.1%77016 Harris 71.9% 9.3%77093 Harris 48.7% 3.2%77039 Harris 48.1% 3.5%77044 Harris 83.6% 29.4%77339 Harris 95.7% 41.4%77365 Montgomery 81.1% 21.3%77357 Montgomery 72.0% 11.3%77032 Harris 62.2% 8.5%77336 Harris 87.1% 16.0%77373 Harris 91.6% 23.5%77078 Harris 69.6% 9.7%77028 Harris 74.5% 7.7%77345 Harris 97.4% 62.9%77532 Harris 85.0% 16.3%77327 Liberty 74.9% 9.7%77372 Montgomery 76.3% 6.3%Harris -- 80.5% 30.5%Liberty -- 77.1% 9.3%Montgomery -- 87.6% 33.7%Texas -- 82.8% 28.7%
AmericanCommunitySurvey,2013-2017
Transportation Therearenumerouswaysinwhichtransportationmayinfluencecommunityhealth.Publictransportationoffersmobility,particularlytopeoplewithoutcars.Transitcanhelpbridgethespatialdividebetweenpeopleandjobs,services,andtrainingopportunities.Publictransportationalsoreducesfuelconsumption,minimizesairpollution,andrelievestrafficcongestion.Walkingtoworkhelpsprotecttheenvironment,whilealsoprovidingthebenefitofdailyexercise.
MemorialHermannNortheastHospitalCHNA201935
Figure22.HouseholdsWithoutaVehiclebyZipCode
Figure22showsthepercentageofhouseholdswithoutavehicle.Asshown,zipcodes77078,77028,77032,and77016havethehighestpercentagesofhouseholdsthatdonothaveavehicle.
MemorialHermannNortheastHospitalCHNA201936
Table12.ModesofCommutingbyZipCode
ZIPCode County CommutebyWalking
CommuteByBiking
CommutebyDrivingAlone
CommutebyPublicTransportation
77346 Harris 0.4% 0.0% 86.7% 1.6%77338 Harris 2.4% 0.2% 80.9% 1.3%77396 Harris 0.9% 0.1% 81.6% 2.0%77016 Harris 1.4% 0.0% 80.1% 4.0%77093 Harris 0.9% 0.2% 76.5% 2.1%77039 Harris 1.2% 0.1% 79.5% 0.9%77044 Harris 0.4% 0.0% 85.8% 0.6%77339 Harris 0.8% 0.5% 83.2% 2.6%77365 Montgomery 1.6% 0.0% 84.0% 0.2%77357 Montgomery 1.1% 0.0% 83.9% 0.5%77032 Harris 0.6% 0.5% 76.6% 1.8%77336 Harris 4.2% 0.0% 81.2% 1.1%77373 Harris 1.0% 0.3% 80.7% 1.3%77078 Harris 0.2% 0.0% 78.4% 6.0%77028 Harris 0.9% 0.0% 78.3% 4.8%77345 Harris 0.9% 0.3% 81.6% 3.5%77532 Harris 1.4% 0.0% 85.0% 0.1%77327 Liberty 1.6% 0.3% 88.3% 0.3%77372 Montgomery 0.8% 1.0% 84.8% 1.2%Harris -- 1.5% 0.3% 79.3% 2.7%Liberty -- 1.0% 0.3% 88.9% 0.3%Montgomery -- 0.9% 0.2% 82.1% 1.2%Texas -- 1.6% 0.3% 80.5% 1.5%
AmericanCommunitySurvey,2013-2017
Table12displaysthedifferentmodesofcommutingusedbyresidentsofHarris,Liberty,andMontgomerycounties.InMontgomeryCounty,lessthan1%ofthepopulationcommutesbywalkingorbiking.InHarrisCounty,slightlymoreresidentscommutebywalking(1.5%)andbiking(0.3%).Inallthreecounties,themajorityofresidentscommutebydrivingalone;with79.3%inHarrisCounty,88.9%inLibertyCounty,and82.1%inMontgomeryCounty,comparedtothestatevalue(80.5%).PublictransportationisusedbyHarrisCountyresidents(2.7%),moresothanLibertyCountyresidents(1.6%)andMontgomeryCountyresidents(1.2%),perhapsindicativeofdifferencesinpublictransportationinfrastructure.InHarrisCounty,6.0%ofresidentslivinginzipcode77078commutebypublictransportation.ConsideringthetoptenzipcodesforinpatientdischargeswithinMHNortheast’sservicearea,zipcodes77396,77016,77093,and77339havethehighestproportionsofresidentscommutingbypublictransportation.
MemorialHermannNortheastHospitalCHNA201937
SocioNeeds Index® ConduentHealthyCommunitiesInstitutedevelopedtheSocioNeedsIndex®toeasilycomparemultiplesocioeconomicfactorsacrossgeographies.Thisindexincorporatesestimatesforsixdifferentsocialandeconomicdeterminantsofhealth–income,poverty,unemployment,occupation,educationalattainment,andlinguisticbarriers–thatareassociatedwithpoorhealthoutcomesincludingpreventablehospitalizationsandprematuredeath.Zipcodeswithineachcountyareassignedanindexvaluefrom0(lowneed)to100(highneed),basedonhowthosezipcodescomparetoothersintheU.S.Withineachcounty,thezipcodesarethenrankedfrom1(lowneed)to5(highneed)toidentifytherelativelevelofneed.Zipcodeswithpopulationsunder300personsareexcluded.
Figure23.SocioNeedsIndexbyZipCode
AsshowninFigure23andTable13,thetenzipcodeswithinMHNortheast’sserviceareathathavethehighestSocioNeedsIndexvaluesarewithinHarrisCounty;zipcodes77093,77039,77032,77028,77078,77016allhavevaluesgreaterthan95.ThezipcodeswithlargestproportionofinpatientdischargesatMHNortheast,zipcodes77346and77338,haveSocioNeedsIndexvaluesof11and71.9,respectively.
MemorialHermannNortheastHospitalCHNA201938
Table13.SocioNeedsIndexbyZipCode(InOrderofSocioNeedsIndexValue)
ZIPCode County SocioNeedsIndexValue
77093 Harris 99.377039 Harris 99.277032 Harris 98.877028 Harris 96.977078 Harris 96.677016 Harris 96.377357 Montgomery 8977327 Liberty 88.677372 Montgomery 83.277338 Harris 71.977365 Montgomery 56.377532 Harris 49.277396 Harris 47.677044 Harris 46.277373 Harris 4277336 Harris 2677339 Harris 23.977346 Harris 1177345 Harris 2.3
ConduentSocioNeedsIndex,2019
MemorialHermannNortheastHospitalCHNA201939
Data Synthesis Allformsofdatahavetheirownstrengthsandlimitations.TogainacomprehensiveunderstandingofthesignificanthealthneedsforMemorialHermannHealthSystem,thefindingsfromboththeprimarydataandthesecondarydatawerecomparedandstudiedtogether.Thesecondarydata,keyinformantinterviewsandcommunitysurveyweretreatedasthreeseparatesourcesofdata.Thesecondarydatawereanalyzedusingdatascoring,whichidentifiedhealthareasofneedbasedonthevaluesofindicatorsforeachtopicarea.(AppendixB).ThefollowingtablesdisplaythedatascoresforHealthandQualityofLifeTopicsforHarris,LibertyandMontgomerycounties.
Table14.HarrisCountyTopicScoresTopic ScoreTransportation 1.82Women'sHealth 1.81Immunizations&InfectiousDiseases 1.78OtherChronicDiseases 1.78PublicSafety 1.65Maternal,Fetal&InfantHealth 1.64Prevention&Safety 1.58SocialEnvironment 1.58Education 1.56Economy 1.55HeartDisease&Stroke 1.54Children'sHealth 1.52OlderAdults&Aging 1.50AccesstoHealthServices 1.48Exercise,Nutrition,&Weight 1.48Wellness&Lifestyle 1.42Men'sHealth 1.38Diabetes 1.34Environment 1.34SubstanceAbuse 1.33Cancer 1.31MortalityData 1.29MentalHealth&MentalDisorders 1.26RespiratoryDiseases 0.99
Table15.LibertyCountyTopicScores
Topic ScoreTransportation 2.28RespiratoryDiseases 2.25AccesstoHealthServices 2.08HeartDisease&Stroke 2.08
MemorialHermannNortheastHospitalCHNA201940
Topic ScoreMentalHealth&MentalDisorders 1.98OlderAdults&Aging 1.95Women'sHealth 1.89Education 1.88OtherChronicDiseases 1.85MortalityData 1.83Exercise,Nutrition,&Weight 1.81Prevention&Safety 1.76Wellness&Lifestyle 1.76Cancer 1.75Economy 1.75Maternal,Fetal&InfantHealth 1.71Children'sHealth 1.70SocialEnvironment 1.66Immunizations&InfectiousDiseases 1.56Environment 1.46PublicSafety 1.46Men'sHealth 1.32SubstanceAbuse 1.08
Table16.MontgomeryCountyTopicScores
Topic ScoreTransportation 1.93HeartDisease&Stroke 1.65AccesstoHealthServices 1.56OtherChronicDiseases 1.52Exercise,Nutrition,&Weight 1.50SubstanceAbuse 1.49Children'sHealth 1.37OlderAdults&Aging 1.36Women'sHealth 1.35PublicSafety 1.33Environment 1.32Immunizations&InfectiousDiseases 1.32MentalHealth&MentalDisorders 1.31Education 1.11SocialEnvironment 1.10RespiratoryDiseases 1.08Cancer 1.06Economy 1.04MortalityData 1.00Men'sHealth 0.95Wellness&Lifestyle 0.93Prevention&Safety 0.85
MemorialHermannNortheastHospitalCHNA201941
Topic ScoreMaternal,Fetal&InfantHealth 0.83
Thismethodologywasappliedtoeachofthe12countieswithinMemorialHermannHealthSystem’sprimaryserviceareaandthendatascorescalculatedfortheregioninordertodeterminesignificanthealthneedsacrossthesystem.Table17liststheresultingdatascoresforHealth&QualityofLifeTopicAreas.
Table17.MemorialHermannRegionTopicScoresTopic ScoreTransportation 1.84HeartDisease&Stroke 1.82AccesstoHealthServices 1.79OlderAdults&Aging 1.60Exercise,Nutrition,&Weight 1.56OtherChronicDiseases 1.52MentalHealth&MentalDisorders 1.50Children'sHealth 1.47Immunizations&InfectiousDiseases 1.43Education 1.43Women'sHealth 1.42SocialEnvironment 1.42Wellness&Lifestyle 1.41Maternal,Fetal&InfantHealth 1.41RespiratoryDiseases 1.41Economy 1.41Environment 1.40PublicSafety 1.36Cancer 1.31Prevention&Safety 1.26SubstanceAbuse 1.23Men'sHealth 1.21
Theanalysisofkeyinformantinterviewsoccurredusingthequalitativesoftware:Dedoose1.Forthecommunitysurvey,HCIperformedasimplereviewandanalysistoidentifytophealthneeds.Overall,eachmethodproducedindividualresultsthatrepresentthecommunityinputinthisreport.Thisconsolidatedinputleadstotheprioritizedheathneedsinthisreport.ThistriangulatedapproachisshowninFigure24.
MemorialHermannNortheastHospitalCHNA201942
Figure24.VisualofDataSynthesisApproach
TheteamusedthetriangulatedapproachtoidentifysignificanthealthneedsforMemorialHermannHealthSystem.Figure25displaystheresultsofthissynthesis.Formanyofthehealthtopicsevidenceofneedwaspresentacrossmultipledatasources,includingObesity,MentalHealth,AccesstoHealthServices,Transportation,andUninsured.Forotherhealthtopicstheevidencewaspresentinjustonesourceofdata,howeveritshouldbenotedthatthismaybereflectiveofthestrengthandlimitationsofeachtypeofdatathatwasconsideredinthisprocess.
SignificantHealthNeeds
HealthIndicatorData
(DataScoringAnalysis)
KeyInformantInterviews(Thematic
CodingAnalysis)CommunitySurvey
(ThematicAnalysis)
MemorialHermannNortheastHospitalCHNA201943
Figure25.DataSynthesisResults
MemorialHermannNortheastHospitalCHNA201944
Priorit ized Signif icant Health Needs
Priorit ization Results Uponcompletionoftheonlineprioritizationsurvey,fourhealthareaswereidentifiedforsubsequentimplementationplanningbyMemorialHermannHealthSystem.Thesefourhealthprioritiesare:AccesstoCare,EmotionalWell-Being,FoodasHealth,andExerciseIsMedicine.ThefollowingsectionwilldivedeeperintoeachofthesehealthtopicsinordertounderstandhowfindingsfromthesecondaryandprimarydataledtoeachhealthtopicbecomingapriorityhealthissueforMemorialHermannHealthSystem.Foreachprioritizedhealthneed,keyissuesaresummarized;secondarydatascoresarenotedforindicatorsofconcern;andcommunityinputisdescribed.
Access to Healthcare
Secondary Data AccesstoHealthServices,LackofInsuranceandLow-Income/UnderservedwereidentifiedassignificantneedsforMemorialHermannHealthSystem.AsshowninTable17,severalindicatorsreceivedscoresof1.75orabovethroughthesecondarydatascoringprocess:AdultsUnabletoSeeaDoctor(HarrisCounty);AdultswithHealthInsurance(HarrisandLibertycounties);ChildrenwithHealthInsurance(HarrisandLibertycounties);DentistRate(LibertyCounty);MentalHealthProviderRate(LibertyandMontgomerycounties);Non-PhysicianPrimaryCareProviderRate(LibertyCounty);PersonswithHealthInsurance(HarrisandLibertycounties);andPrimaryCareProviderRate(LibertyCounty).
Table18.SecondaryDataScoringResults:AccesstoHealthServices
County CountyValueComparedto:
Indicator Name Value DataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
AdultsUnableto Liberty --- --- --- --- --- ---
KeyIssues:• Rangeofbarriers,includingtransportation,accesstospecialtycare,lackofawareness,and
fearorstigma• Lackofhealthinsurance• Lowincomeandvulnerablegroups
SecondaryDataScoringMethodologyForeachindicator,eachcountyinMHNortheast’sserviceareawasassignedascorebasedonitscomparisontoothercommunities,whetherhealthtargetshavebeenmet,andthetrendoftheindicatorvalueovertime.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariedbyindicatorandwasdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.PleaseseeAppendixBforfurtherinformationonHCIDataScoringmethodology.
MemorialHermannNortheastHospitalCHNA201945
AffordtoSeeaDoctor[10](2015)
Montgomery
--- --- --- --- --- ---
Harris22.1
2 1.5 3 3 1.5 1.5percent
[10]TexasBehavioralRiskFactorSurveillanceSystem
AdultswithHealthInsurance:18-64[9]
(2016)
Liberty75.0
1.75 2 2 1.5 3 0percent
Montgomery79.7
1.47 0 1 1.5 3 1percent
Harris74.7
1.75 2 2 1.5 3 0percent
[9]SmallAreaHealthInsuranceEstimates
ChildrenwithHealthInsurance[9](2016)
Liberty88.7
1.81 1 2 1.5 3 1percent
Montgomery90.2
1.53 0 2 1.5 2 1percent
Harris89.4
1.81 1 2 1.5 3 1percent
[9]SmallAreaHealthInsuranceEstimates
DentistRate[4](2016)
Liberty26.9
1.83 2 3 3 1.5 0dentists/100,000population
Montgomery45.5
1.56 0 3 3 1.5 1dentists/100,000population
Harris66.3
0.5 0 0 2 1.5 0dentists/100,000population
[4]CountyHealthRankings
MentalHealthProviderRate[4]
(2017)
Liberty14.7
2.61 3 3 3 1.5 2providers/100,000population
Montgomery69.4
2 1 3 3 1.5 1.5providers/100,000population
Harris103.7
1.44 0 1 3 1.5 2providers/100,000population
[4]CountyHealthRankings
Non-Physician Liberty 39.2 2 2 3 3 1.5 0
MemorialHermannNortheastHospitalCHNA201946
PrimaryCareProviderRate[4]
(2017)
providers/100,000population
Montgomery55
1.67 1 3 3 1.5 0providers/100,000population
Harris72.2
1 0 1 3 1.5 0providers/100,000population
[4]CountyHealthRankings
PersonswithHealthInsurance[9](2016)
Liberty79.4
1.75 2 2 1.5 3 0percent
Montgomery83.1
1.47 0 1 1.5 3 1percent
Harris79.3
1.75 2 2 1.5 3 0percent
[9]SmallAreaHealthInsuranceEstimates
PrimaryCareProviderRate[4]
(2015)
Liberty23.9
2.83 3 3 3 1.5 3providers/100,000population
Montgomery61.8
1.22 0 1 3 1.5 1providers/100,000population
Harris57.2
1.61 0 2 3 1.5 2providers/100,000population
[4]CountyHealthRankings
WhenconsideringAccesstoHealthServices,itisimportanttotakeintoaccounttheeconomyandhowfinancialbarriersimpactcommunityresidents’abilitytoaccesscare.AsshowninTable19,allthreecountieshaveindicatorsofconcern,including:ChildFoodInsecurityRate(LibertyCounty);FamiliesLivingBelowPovertyLevel(HarrisandLibertycounties);FemalePopulation16+inCivilianLaborForce(LibertyandMontgomerycounties);FoodInsecurityRate(HarrisandLibertycounties);Homeownership(HarrisCounty);MedianHouseholdGrossRent(HarrisandMontgomerycounties);MedianHousingUnitValue(LibertyCounty);MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage(HarrisandMontgomerycounties);MortgagedOwnersMedianMonthlyHouseholdCosts(MontgomeryCounty);People65+LivingBelowPovertyLevel(HarrisandLibertycounties);PerCapitaIncome(LibertyCounty);PersonswithDisabilityLivinginPoverty(LibertyCounty);PersonswithDisabilityLivinginPoverty(5-year)(LibertyCounty);Population16+inCivilianLaborForce(LibertyCounty);SevereHousingProblems(HarrisandLibertycounties);SNAPCertifiedStores(Harris,LibertyandMontgomerycounties);StudentsEligiblefortheFreeLunchProgram(HarrisandLibertycounties);TotalEmploymentChange(LibertyCounty);andUnemployedWorkersinCivilianLaborForce(HarrisandLibertycounties).Outofthislist,HarrisandLibertycountieseachhaveeighteconomic
MemorialHermannNortheastHospitalCHNA201947
indicatorswithsecondarydatascoresabove2comparedtoMontgomeryCountywithfourindicatorsequaltoorabove2,indicatingpotentiallygreatereconomicneedinthosetwocounties.
Table19.SecondaryDataScoringResults:Economy
County CountyValueComparedto:
Indicator Name ValueDataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
ChildFoodInsecurityRate[5](2016)
Liberty26.0
2.17 3 3 3 1.5 0percent
Montgomery21.2
1.17 0 1 3 1.5 0percent
Harris23.5
1.67 1 2 3 1.5 0percent
[5]FeedingAmerica
ChildrenLivingBelowPovertyLevel[1](2012-2016)
Liberty23.3
1.39 1 1 2 1.5 1percent
Montgomery14.8
0.17 0 0 0 1.5 0percent
Harris26.0
1.67 2 2 3 1.5 0percent
[1]AmericanCommunitySurvey
FamiliesLivingBelowPovertyLevel[1](2012-2016)
Liberty12.4
1.72 2 1 3 1.5 1percent
Montgomery8.3
0.56 0 0 0 1.5 1percent
Harris14.4
2.06 2 3 3 1.5 1percent
[1]AmericanCommunitySurvey
FemalePopulation16+inCivilianLaborForce[1](2012-2016)
Liberty39.5
2.83 3 3 3 1.5 3percent
Montgomery53.6
2 1 2 2 1.5 3percent
Harris59.8
0.94 0 1 1 1.5 2percent
[1]AmericanCommunitySurvey
FoodInsecurityRate[5](2016)
Liberty18.7
2.39 3 3 3 1.5 1percent
Montgomery 14.6 1.33 1 1 3 1.5 0
MemorialHermannNortheastHospitalCHNA201948
percent
Harris16.6
2.06 2 2 3 1.5 1percent
[5]FeedingAmerica
Homeownership[1](2012-2016)
Liberty64.8
0.83 0 0 0 1.5 3percent
Montgomery65.6
0.61 0 0 0 1.5 2percent
Harris49.6
2.44 3 2 3 1.5 2percent
[1]AmericanCommunitySurvey
HouseholdswithCashPublic
AssistanceIncome[1](2012-2016)
Liberty1.9
1.61 2 3 0 1.5 2percent
Montgomery1.1
0.56 1 0 0 1.5 1percent
Harris1.5
0.89 2 1 0 1.5 1percent
[1]AmericanCommunitySurvey
MedianHouseholdGrossRent[1](2012-
2016)
Liberty801
1.42 2 0 0 1.5 3dollars
Montgomery1077
2.58 3 3 3 1.5 3dollars
Harris937
2.08 3 2 1 1.5 3dollars
[1]AmericanCommunitySurvey
MedianHousingUnitValue[1](2012-2016)
Liberty89100
1.75 2 3 3 1.5 0dollars
Montgomery190000
0.58 0 0 1 1.5 0dollars
Harris145600
1.08 0 1 3 1.5 0dollars
[1]AmericanCommunitySurvey
MedianMonthlyOwnerCostsfor
HouseholdswithoutaMortgage[1](2012-
2016)
Liberty414
1.08 2 0 0 1.5 1.5dollars
Montgomery531
2.58 3 3 3 1.5 3dollars
Harris534
2.14 3 3 3 1.5 1dollars
[1]AmericanCommunitySurvey
MemorialHermannNortheastHospitalCHNA201949
MortgagedOwnersMedianMonthly
HouseholdCosts[1](2012-2016)
Liberty1160
0.97 2 0 0 1.5 1dollars
Montgomery1635
2.19 3 3 2 1.5 2dollars
Harris1504
1.81 3 2 2 1.5 1dollars
[1]AmericanCommunitySurvey
People65+LivingBelowPovertyLevel
[1](2012-2016)
Liberty10.6
1.94 2 1 3 1.5 2percent
Montgomery7.7
0.78 0 0 0 1.5 2percent
Harris11.3
1.89 2 2 3 1.5 1percent
[1]AmericanCommunitySurvey
PeopleLiving200%AbovePovertyLevel
[1](2012-2016)
Liberty60.5
1.72 2 2 2 1.5 1percent
Montgomery73.0
0.56 0 0 1 1.5 1percent
Harris61.6
1.33 1 2 2 1.5 0percent
[1]AmericanCommunitySurvey
PeopleLivingBelowPovertyLevel[1](2012-2016)
Liberty17.3
1.67 2 2 3 1.5 0percent
Montgomery11.0
0.17 0 0 0 1.5 0percent
Harris17.4
1.67 2 2 3 1.5 0percent
[1]AmericanCommunitySurvey
PerCapitaIncome[1](2012-2016)
Liberty22065
1.83 2 3 3 1.5 0dollars
Montgomery35912
0.17 0 0 0 1.5 0dollars
Harris29850
0.5 0 1 1 1.5 0dollars
[1]AmericanCommunitySurvey
PersonswithDisabilityLivinginPoverty[1](2016)
Liberty28.0
1.81 1.5 3 2 1.5 1percent
Montgomery17.9
0.86 1.5 0 0 1.5 2percent
MemorialHermannNortheastHospitalCHNA201950
Harris22.9
0.97 1.5 1 0 1.5 1percent
[1]AmericanCommunitySurvey
PersonswithDisabilityLivinginPoverty(5-year)[1]
(2012-2016)
Liberty28.4
1.92 2 3 2 1.5 1.5percent
Montgomery19.1
0.75 0 0 0 1.5 1.5percent
Harris25.4
1.42 1 2 1 1.5 1.5percent
[1]AmericanCommunitySurvey
Population16+inCivilianLaborForce[1](2012-2016)
Liberty51.3
2.83 3 3 3 1.5 3percent
Montgomery63.7
1.5 0 2 1 1.5 3percent
Harris68.3
0.94 0 1 1 1.5 2percent
[1]AmericanCommunitySurvey
SevereHousingProblems[4](2010-
2014)
Liberty18.5
2.11 3 2 1 1.5 2percent
Montgomery16.0
1.28 2 0 0 1.5 2percent
Harris20.9
2.39 3 3 3 1.5 1percent
[4]CountyHealthRankings
SNAPCertifiedStores[17](2016)
Liberty0.8
1.78 2 1.5 1.5 1.5 2stores/1,000population
Montgomery0.5
1.89 3 1.5 1.5 1.5 1stores/1,000population
Harris0.6
2.11 3 1.5 1.5 1.5 2stores/1,000population
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
StudentsEligiblefortheFreeLunch
Program[8](2015-2016)
Liberty55.5
2.11 2 2 3 1.5 2percent
Montgomery35.1
0.56 0 0 0 1.5 1percent
Harris58.2
2.22 2 3 3 1.5 1percent
MemorialHermannNortheastHospitalCHNA201951
[8]NationalCenterforEducationStatistics
TotalEmploymentChange[16](2014-
2015)
Liberty-3.7
2.5 3 3 3 1.5 1.5percent
Montgomery3.5
1 1 1 0 1.5 1.5percent
Harris2.4
1.67 1 3 2 1.5 1.5percent
[16]U.S.Census-CountyBusinessPatterns
UnemployedWorkersinCivilianLaborForce[15](July
2018)
Liberty6.1
2.61 3 3 3 1.5 2percent
Montgomery3.8
1.28 1 1 1 1.5 2percent
Harris4.4
1.94 2 2 2 1.5 2percent
[15]U.S.BureauofLaborStatistics
Primary Data Duringthekeyinformantinterviewprocess,AccesstoHealthServiceswasdiscussedover160timesandwasraisedbyparticipantsalmost50timesinrelationtobarriersorchallengestoachievinghealthinthecommunity.Theprimarythemesrelatedtobarriersorchallengeswerelimitationstoprocuringspecialtycareservices,transportationtoservicesandhoursofoperation.Inadditiontotheprimarythemes,twoadditionalbarriersorchallengesstoodoutaskeyfactorsimpactingaccesstohealthcareservices,lackofknowledgeandstigmaorfearpreventingpeoplefromseekingcare.Theissuethatinterviewparticipantsweremostconcernedwithwaspatientsbeingabletoaccessfollowupcarewithspecialtycareproviders.Multipleparticipantsraisedconcernsthatevenifpatientsareabletoaccesspreventativeorprimarycareservices,theymaynotbeabletoaccesstheappropriatefollowupcarewithaspecialtycareprovider.Someparticipantsraisedthisconcernincontextofpatientsnotlivingnearaspecialistandothersraisedincontextofpatientsnotbeingabletoaffordthecostoffollowupcare.“Wecantakecareofhelpingthemcontroltheirdiabetes,andkeeptheirbloodpressureincheck,andwecantreatthemforthatcommoncold,wecanprovidethatannualpapsmearforthewomanandprovidethatmammogram,butit'swhenthepersonexperiencessomethingofamoresignificantissue—saytheyhaveagallbladderattack,ortheyhaveahernia—thatisjustaresourcethatwesimplydon'thave.Orsomeoneneedstoseeanorthopedicsurgeon.Wetrytotakecareofthemthebestthatwecaninthesettingthatwehave,butthatisahugebarrierthatwefacewithourpatients,orthatourpatientsface.So,whathappensisitbecomesanurgentsituation,andtheyendupintheemergencyroom,andthey'regivensurgeryonanemergencybasis.”Anothercommonconcernraisedbyinterviewparticipants,wastransportationtoservicesandhoursofoperationofserviceslimitingpatients’accesstocare.Participantsdescribedhow
MemorialHermannNortheastHospitalCHNA201952
thesefactorsdeterminewhetherpatientsdecidetotakeofffromworkandseekservicesinthefirstplace.Afewparticipantsdescribedthemanyservicesandresourcesthatareavailabletothecommunitybutthatmanymaynotbeawarehowtheycanaccessorbenefitfromthem.Oneparticipantdescribedresourcesbeingconcentratedincertaingeographicareasandmoreremotelocationsnotbeingwellconnectedorknowledgeableabouthowtheymayalsobenefitfromtheseresources.Participantsdescribedthepotentialformorecollaborationandpartnershiptoconnectcommunitiestooneanother.“Iwouldlovetoseesomebodyfromthepublicassistance,andI’lljustcallitMedicaid,orthepublicbenefits,maybehaveanofficeinsidethehospital.Thatwouldbephenomenal.I’veworkedinadifferentstateasahospitalsocialworkerpreviously,andtherewassomeonefromapublicassistance,fromtheDepartmentofHumanHealthandWelfareServicesinthehospital,andthatpersonwasabletoconnectthepeopletherewithemergencyMedicaid,withMedicaid,whichalsohelpsthehospital.Havetheirbillspaidandwhatnot,andmaybeitwouldcutdownonoutsourcingandsomeofthecollectionsandwhatnot.Ithinkthatthatwouldbewonderful,wouldbetohavesomeonefromthestatepublicbenefitsprogramhousedinsidethehospital.”Severalparticipantsdescribedadown-turninpeopleseekingpreventativecareserviceandhypothesizedthatoneofthefactorsmayberelatedtotheimmigrantcommunityintheregionexperiencingfearorstigmarelatedtohavingtoshowidentificationorproofofcitizenship.“EventhoughweattheHealthDistrictdonotaskforproofofimmigrationstatus,peopledon'tunderstandthat,particularlysincewe'reagovernmentagency,andit'sbeenarealchallengetogetsomeofthesefolkstocomeinforservices.”Therewerealmost80referencestotheuninsuredpopulationinthekeyinformantinterviewsandlackofhealthinsurancewasraisedasabarrierorchallengetoachievinghealthinthecommunity19times.Lackofhealthinsurancewasmostoftenbroughtupincontextofpatientshavinglimitedfinancialresourcesandafactortonotaccessinghealthcareservices.Participantsdiscussedpatientsnothavingtheabilitytopayfeesformultipleappointmentco-paysornotseekingcareduetocompetingfinancialpriorities.Whilehealthcareservicesmaybeavailableinthecommunity,forthosewhoarelackinghealthinsurance,accessinghealthcareservicesisnotnecessarilyanoption.Lackofhealthinsurancecreatesaparticularchallengeforthosewhorequirespecialtycareservices.“Ithinkthosearethebiggesttwo—access,again,withthemajorityofouradultpopulationbeinguninsured,havingthemtrytofindaproviderthat,again,willtakeslidingfeescale,orreducedrates.Oncethey'reabletoaccessthoseservices,thenitbecomesamatterofpayingforthethingsthatareneeded.Thepatientcomesinandwediagnosethemwithdiabetes,thencomesthecostofmedications,andifthatpatientisneedingspecialtycareoutsideofthescopeofprimarycare,accesstospecialists.”Participantsbroughtupissuesrelatedtolowincomeorgroupswhomaybeunderservedinthecommunity115timesduringthekeyinformantinterviewprocess.Particulargroupsthatparticipantsfeltmayexperienceaddedchallengesaccessinghealthcareservicesincludedtheimmigrantpopulation,individualswithdisabilities,familieswithyoungchildren,andtheelderly.Severalparticipantsnotedfeesrelatedtoco-paysoroutofpocketexpensesasabarrier
MemorialHermannNortheastHospitalCHNA201953
topatientsseekinginitialpreventativeservicesorongoingtreatmentforchronicconditions.Participantsidentifiedseveralgroupstheyfeltwereunderservedinthecommunity.Multipleparticipantsdiscussedtheuniqueandspecificchallengeswithprovidingculturallyappropriatecareforadiverseandrecentimmigrantpopulationinthecommunity.Participantsfeltthatfamilieswithyoungchildrenandtheelderlypopulationareparticularlyvulnerablegroupsinthecommunitythatexperiencebarriersandchallengesaccessinghealthcareservices.Specifically,participantsdiscussedthesegroupsexperiencinghighlevelsofpovertyplacingthemathigherriskforpoorhealthoutcomes.“Mostofthemareextremelylowincomeandtheyfallinthosecategorieswherewehaveasignificantnumberofelderlydisabled,singlemomsandtheirchildren,sovulnerablefolkshereinHouston.”
Emotional Well-Being
Secondary Data MentalHealthandSubstanceAbusewereidentifiedassignificantneedsforMemorialHermannHealthSystem.MentalHealth&MentalDisordersrankedfifthforLibertyCounty’ssecondarydataresults,whileSubstanceAbuserankedsixthinthetoptopicsforMontgomeryCounty.AsshowninTable20,LibertyCountyhasseveralmentalhealthindicatorsofconcern:MentalHealthProviderRate,Age-AdjustedDeathRateduetoAlzheimer'sDisease,Age-AdjustedDeathRateduetoSuicide,andDepressionintheMedicarePopulation.InMontgomeryCounty,mentalhealthindicatorsofnoteinclude:MentalHealthProviderRateandAge-AdjustedDeathRateduetoSuicide.WhileMentalHealth&MentalDisordersdidnotrankashighforHarrisCounty,anindicatortonoteisAlzheimer'sDiseaseorDementiaintheMedicarePopulation.
Table20.SecondaryDataScoringResults:MentalHealth&MentalDisorders
County CountyValueComparedto:
Indicator Name Value DataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
MentalHealthProviderRate[4]
(2017)
Liberty14.7
2.61 3 3 3 1.5 2providers/100,000population
Montgomery69.4
2 1 3 3 1.5 1.5providers/100,000population
Harris 103.7 1.44 0 1 3 1.5 2
KeyIssues:• Mentalhealthaspartofoverallhealth• Needformorebehavioralhealthservicesandproviders• Alcoholandsubstanceabuse• Alzheimer’sanddementia
MemorialHermannNortheastHospitalCHNA201954
providers/100,000population
[4]CountyHealthRankings
Age-AdjustedDeathRatedueto
Alzheimer'sDisease[12](2010-2014)
Liberty38.5
2.36 3 3 3 1.5 2deaths/100,000population
Montgomery18.8
0.64 0 0 0 1.5 1deaths/100,000population
Harris17.9
0.64 0 0 0 1.5 1deaths/100,000population
[12]TexasDepartmentofStateHealthServices
Age-AdjustedDeathRateduetoSuicide[12](2010-2014)
Liberty14
2.28 1.5 3 3 3 2deaths/100,000population
Montgomery14.6
2.28 1.5 3 3 3 2deaths/100,000population
Harris10.3
0.94 1.5 0 0 2 1deaths/100,000population
[12]TexasDepartmentofStateHealthServices
Depression:MedicarePopulation
[3](2015)
Liberty17.5
1.94 2 2 2 1.5 2percent
Montgomery15.9
1.28 1 1 1 1.5 2percent
Harris14.8
0.94 1 0 0 1.5 2percent
[3]CentersforMedicare&MedicaidServices
Alzheimer'sDiseaseorDementia:
MedicarePopulation[3](2015)
Liberty10.9
1.67 1 1 2 1.5 1.5percent
Montgomery10.7
1.67 1 1 2 1.5 1.5percent
Harris11.4
1.89 2 1 3 1.5 1percent
[3]CentersforMedicare&MedicaidServices
PoorMentalHealth:5+Days[10](2016)
Liberty
--- --- --- --- --- ---
Montgomery
--- --- --- --- --- ---
Harris 80 1.53 1.5 1 1.5 1.5 2
MemorialHermannNortheastHospitalCHNA201955
percent
[10]TexasBehavioralRiskFactorSurveillanceSystem
SubstanceAbuseisanothertopicofconcernforMemorialHealthSystem.BothHarrisandMontgomerycountieshaveindicatorswithscoresabove2.Therewereover37%alcohol-impaireddrivingdeathsinHarrisCountyandalmost33%inMontgomeryCounty,comparedto21.8%inLibertyCounty.Moreover,21%ofadultsdrinkexcessivelyinMontgomeryCountyascomparedtothenationalvalueof18%.
Table21.SecondaryDataScoringResults:SubstanceAbuse
County CountyValueComparedto:
Indicator Name ValueDataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
AdultswhoDrinkExcessively[4](2016)
Liberty19.4
1.67 3 1 2 0 1.5percent
Montgomery21.0
2.17 3 2 3 0 1.5percent
Harris18.1
1.5 2 1 2 0 1.5percent
[4]CountyHealthRankings
Alcohol-ImpairedDrivingDeaths[4]
(2012-2016)
Liberty21.8
0.72 1 0 0 1.5 1percent
Montgomery32.9
2.06 2 3 3 1.5 1percent
Harris37.8
2.17 3 3 3 1.5 0percent
[4]CountyHealthRankings
Primary Data Approximately50%ofcommunitysurveyrespondentscitedMentalHealthasoneofthetopissuesmostaffectingthequalityoflifeintheircommunityand52%ofrespondentsnotedSubstanceAbuse.Ininterviewswithkeyinformants,MentalHealthwasdiscussed113timesandwasraisedbyparticipants33timesasaneedsorconcernforthehealthofthecommunity.TheprimarythemesrelatedtoMentalHealthweretreatingmentalhealthaspartofoverallhealth,addressbehavioralhealthinschool,needforbehavioralhealthprovidersandservices,andolderadultswithAlzheimer’sanddementia.Someparticipantsdiscussedarecentshiftincaredeliveryandthecontinuedneedtoaddressmentalhealthaspartofaperson’stotalhealthsimilarlytohowchronicdiseaseismanaged.Oneparticularlyvulnerablepopulationthatwouldbenefitfromabroaderapproachto
MemorialHermannNortheastHospitalCHNA201956
treatment,inclusiveofmentalhealth,isthehomelesspopulation.Severalparticipantsbroughtupissuesregardinganeedformorebehavioralhealthprovidersandservicesinthecommunity.“Wehereseeahugegapinmentalhealth,there’sjustnotalotofsupportiveservicesformentalhealth,andwe’reseeingthattoreallyhitouryoungadults,ouradultswhoareintheir20s.WeseealotofpeoplehavingalotofPTSDorevenhavingapsychoticbreak,andweonlyhaveoneagencythatwouldsupportsomebodymaybewithoutinsurancethat’shavingmentalhealthissues,whichiscausingsomuchtraumaforthemfromthatpointforward.Iwouldsayoneofthehugeindicatorsforuswouldbementalhealth,it’shugeforus.”Oneparticipantobservedrecentincreasesandchangeswithinthelocalpopulation.Fromtheparticipant’sperspective,thereshouldbemoreprogramsorservicestoaddressthegrowingneedforaddressingmentalhealthinthecommunity.Anotherparticipantsuggestedsolutionsforaddressingtheneedformorebehavioralhealthprovidersinthecommunitysuchasexpandingresidencyprogramsforpsychiatristsanddevelopingcomprehensivetelemedicineprogramstoprovideservicesmoreefficiently.Furthermore,participantsrecommendedaddressingbehavioralhealthwithyoungerpopulationsintheschools.Schoolsthatprovidebehavioralhealthservicesthroughtelemedicinehavebeenreceivedwellinthecommunityandtheperceptionisthattheyareeffective.Someparticipantsbelievethattheseprogramsshouldbeexpandedandavailableacrossthecommunity.“There[are]thementalhealthunitsthathavegoneoutintotheschools.They'renotschool-basedbutthat’sthevenuetheywilldrivetowiththeirmobileunits.Theyhaveabigimpact.They'reseeingthousandsofkids.They’vedonesometelemedicinewithmentalhealth,behavioralhealth,withsomeofthehighschools.FromwhatI’veheard,(…)it’sbeenprettyeffectiveandwellreceived.”AchallengethathealthcareprovidersidentifiedforthemedicalcommunityisadequatelyaddressingdementiaandAlzheimer’swithinthegeriatricpopulation.“Dementia’saterminalillness.(…)Muchmoreneedstobedonewithhealthcaresystemsaroundroutinescreeningandidentificationofitasanissue.(…)So,thatisthefirstthingthatneedstohappen.Thenthereneedstobeanunderstandingthattherearethings–therearemedicationsthatcanbehelpfultothesystemsofthedementia.(…)Butyoucanaffectitbyaddressingsomeofthesymptoms.”SubstanceAbusewasdiscussed55timesandwasraisedbyparticipants15timesasaneedorconcernforthehealthofthecommunity.MultipleuniquethemesemergedfromtheinterviewsrelatedtoSubstanceAbuse:fundingfortreatmentprograms,invisibilityofalcoholism,overcomingstigmaofseekingtreatment,andemergingshiftsinoutreachmodels.Participantsidentifiedfundingforprogramsandavailabilityofservicesforthosewhomaynotbeabletoaffordtreatmentout-of-pocketasissuesthecommunityisfacingtoaddresssubstanceabuse.Oneparticipantraisedalcoholabusespecificallyasanissueinthecommunitythatdoesnotgettheamountofattentionofothersubstanceabusetopicsbutmayinfactbeimpactingalargerproportionofthepopulationandconnectedtomanyotherhealthissues.Multipleparticipants
MemorialHermannNortheastHospitalCHNA201957
identifiedculturalstigmaasabarrierforthosewhomaybenefitfromseekingtreatment.Stigmaorfearmaybeuniqueandvaryfrompopulationtopopulationinthecommunity.“Withsubstanceabuse,it’scultureandstigma.Nobodygoestosubstanceabusetreatmentontheirown.Theymaynotbeadjudicatedbutsomeoneisreally,reallypushingthem,familymember,boss.Noonegoestotreatmentifthey’renotunderduress.”Afewparticipantsdescribeduniqueapproachestooutreachandsubstanceabusetreatmentinthecommunitythatwouldsupportremovingbarriersforpeoplehavingtotakethefirststepontheirown.“Forinstance,it’sprettynew,butthere’saninitiativethat’scalledtheHeroesProjectthat’slookingatoverdoses,sowhenanoverdosehappens,they’resendingateamtotheER.So,it’sgotapeersupportspecialist,theEMPisinvolved–buttheyactuallygointotheERandtheydoaninterventiontheretotrytohelpwithlinkagetotreatmentsothatwecanassistthepatients.”
Food as Health
Secondary Data ThetopicsofDiabetesandHeartDisease&StrokeemergedassignificanthealthneedsforMemorialHermannHealthSystem.HeartDisease&StrokerankedasthesecondmostimportanttopicforMontgomeryCountyandwasthefourthhighest-rankingtopicforLibertyCounty.AlthoughthetopicofDiabetesdidnotreceiveahighsecondarydatascoreoverall,DiabetesintheMedicarePopulationisofconcerninLibertyCounty,withavalueof31.4%comparedtotheU.S.valueof26.5%inadditiontoexhibitinganegativetrend(Table22).
Table22.SecondaryDataScoringResults:Diabetes
County CountyValueComparedto:
Indicator Name Value DataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
Diabetes:MedicarePopulation[3](2015)
Liberty31.4
2.83 3 3 3 1.5 3percent
Montgomery24.8
0.94 0 0 1 1.5 2percent
Harris28.1
1.67 2 1 2 1.5 1.5percent
[3]CentersforMedicare&MedicaidServices
KeyIssues:• Foodinsecurityandlimitedaccesstohealthyfoods• Diabetesandheartdiseaselinkedtosocioeconomicfactors• Fooddeserts
MemorialHermannNortheastHospitalCHNA201958
AsshowninTable23HeartDisease&StrokeisalsoaconcerningtopicinLibertyCounty.Sixindicatorshavescoresequaltoorabove2,includingAge-AdjustedDeathRateduetoHeartDiseaseaswellasthefollowingindicatorsintheMedicarePopulation:AtrialFibrillation,HeartFailure,Hyperlipidemia,IschemicHeartDisease,andStroke.IndicatorsofconcerninMontgomeryCountyincludeAtrialFibrillation,HyperlipidemiaandStroke(allintheMedicarePopulation).InHarrisCounty,indicatorstoobserveareHeartFailureandStroke(bothintheMedicarePopulation).
Table23.SecondaryDataScoringResults:HeartDisease&Stroke
County CountyValueComparedto:
Indicator Name ValueDataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
Age-AdjustedDeathRatedueto
CerebrovascularDisease(Stroke)[12]
(2010-2014)
Liberty41.1
1.75 1 1 3 3 1.5deaths/100,000population
Montgomery38.5
1.25 1 1 2 3 0deaths/100,000population
Harris41.5
1.42 1 1 3 3 0deaths/100,000population
Age-AdjustedDeathRateduetoHeartDisease[12](2010-
2014)
Liberty257.6
2.14 3 3 3 1.5 1deaths/100,000population
Montgomery173.2
1.25 1 2 2 1.5 0deaths/100,000population
Harris167.6
0.92 1 1 1 1.5 0deaths/100,000population
[12]TexasDepartmentofStateHealthServices
AtrialFibrillation:MedicarePopulation
[3](2015)
Liberty8.2
2 2 3 2 1.5 1.5percent
Montgomery8.8
2.44 3 3 2 1.5 2percent
Harris7.3
1.5 1 1 1 1.5 3percent
HeartFailure:MedicarePopulation
[3](2015)
Liberty20.4
2.39 3 3 3 1.5 1percent
Montgomery14.6
1.22 0 1 2 1.5 1percent
Harris 16.0 1.89 1 2 3 1.5 1
MemorialHermannNortheastHospitalCHNA201959
percent
[3]CentersforMedicare&MedicaidServices
Hyperlipidemia:MedicarePopulation
[3](2015)
Liberty46.0
2 2 1 2 1.5 3percent
Montgomery46.3
1.94 2 2 2 1.5 2percent
Harris43.2
1.44 1 1 1 1.5 2percent
Hypertension:MedicarePopulation
[3](2015)
Liberty60.4
1.83 2 2 2 1.5 1.5percent
Montgomery56.0
1.61 1 1 2 1.5 2percent
Harris55.5
1.22 1 1 2 1.5 1percent
[3]CentersforMedicare&MedicaidServices
IschemicHeartDisease:Medicare
Population[3](2015)
Liberty33.2
2 2 3 3 1.5 0percent
Montgomery28.6
1.17 1 1 2 1.5 0percent
Harris28.8
1.33 1 2 2 1.5 0percent
[3]CentersforMedicare&MedicaidServices
Stroke:MedicarePopulation[3](2015)
Liberty5.8
2.5 3 3 3 1.5 1.5percent
Montgomery4.6
2.28 2 2 3 1.5 2percent
Harris5.2
2.61 3 3 3 1.5 2percent
[3]CentersforMedicare&MedicaidServices
Table24revealsthatLibertyCountyhasseveralnutrition-relatedindicatorsofconcern:FoodInsecurityRate,ChildFoodInsecurityRate,GroceryStoreDensity,andHouseholdswithNoCarandLowAccesstoaGroceryStore.InbothHarrisandMontgomerycounties,SNAPCertifiedStoresareofconcern;additionalindicatorsofnoteincludeFoodInsecurityRateinHarrisCountyandGroceryStoreDensityinMontgomeryCounty.
Table24.SecondaryDataScoringResults:Nutrition
County CountyValueComparedto:
Indicator Name Value DataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
MemorialHermannNortheastHospitalCHNA201960
FoodInsecurityRate[5](2016)
Liberty18.7
2.39 3 3 3 1.5 1percent
Montgomery14.6
1.33 1 1 3 1.5 0percent
Harris16.6
2.06 2 2 3 1.5 1percent
[5]FeedingAmerica
ChildFoodInsecurityRate[5](2016)
Liberty26.0
2.17 3 3 3 1.5 0percent
Montgomery21.2
1.17 0 1 3 1.5 0percent
Harris23.5
1.67 1 2 3 1.5 0percent
[5]FeedingAmerica
GroceryStoreDensity[17](2014)
Liberty0.1
1.94 2 1.5 1.5 1.5 2stores/1,000population
Montgomery0.1
1.83 2 1.5 1.5 1.5 1.5stores/1,000population
Harris0.2
1.5 1 1.5 1.5 1.5 1.5stores/1,000population
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
HouseholdswithNoCarandLowAccesstoaGroceryStore[17]
(2015)
Liberty3.4
1.83 3 1.5 1.5 1.5 1.5percent
Montgomery1.5
1.17 1 1.5 1.5 1.5 1.5percent
Harris0.9
1 0 1.5 1.5 1.5 1.5percent
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
SNAPCertifiedStores[17](2016)
Liberty0.8
1.78 2 1.5 1.5 1.5 2stores/1,000population
Montgomery0.5
1.89 3 1.5 1.5 1.5 1stores/1,000population
Harris0.6
2.11 3 1.5 1.5 1.5 2stores/1,000population
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
FoodEnvironment Liberty 6.6 1.72 2 0 3 1.5 1
MemorialHermannNortheastHospitalCHNA201961
Index[4](2018)
Montgomery7.5
1.22 1 0 2 1.5 1
Harris7.2
1 1 0 2 1.5 0
[4]CountyHealthRankings
ChildrenwithLowAccesstoaGroceryStore[17](2015)
Liberty4.3
1.33 1 1.5 1.5 1.5 1.5percent
Montgomery5.6
1.67 2 1.5 1.5 1.5 1.5percent
Harris5.4
1.5 1 1.5 1.5 1.5 1.5percent
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
FastFoodRestaurantDensity[17](2014)
Liberty0.5
1.33 1 1.5 1.5 1.5 1.5restaurants/1,000population
Montgomery0.6
1.5 1 1.5 1.5 1.5 1.5restaurants/1,000population
Harris0.7
1.67 2 1.5 1.5 1.5 1.5restaurants/1,000population
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
Primary Data Food-relatedtopicsemergedinthecommunityinputgatheredthroughthesurveyandkeyinformantinterviews.FoodInsecurity,FoodProgramsandFoodKnowledgeissueswerediscussedover170timesduringthekeyinformantinterviewsandwereraisedbyparticipants34timesinrelationtobarriersorchallengestoachievinghealthinthecommunity.Theprimarythemesrelatedtobarriersorchallengesthatemergedintheinterviewswereaccesstohealthyfoodsandaffordability,knowledgegapsandlimitedfoodfamiliarityandprogramlimitations.Themostcommonissueraisedbykeyinformantparticipantsrelatedtofoodinsecuritywascommunitymembersnotbeingabletoaccesshealthyfoodsintheircommunity.Multipleparticipantsbelievedthatinmanycommunities,healthyfoodoptionswerenotavailabletopeoplewithinafive-mileradiusfromtheirhomeorwork.Participantsdescribed‘fooddeserts’asatopissueaffectinghealthinthecommunityandhowlimitedaccesstohealthyfoodsalsowascloselyassociatedwithpeoplealsobeingnotbeingabletoaffordhealthyfoods.
“Wehaveareallylargecounty.(…)Thewestdoesn’tcatertotheeastveryeasilyandviceversa.(…)Onceyougetoffofthatinterstate,youstartgettingintotheeastcountyandwestcountyyou’llgomilesandmilesandmileswithoutgrocerystores,sotherearefooddesertsinourcommunity.”
MemorialHermannNortheastHospitalCHNA201962
Participantsalsodiscussedtheimbalanceofhealthyfoodoptionsforthosecommunitieswithlowerhousingpricesandingeneral,loweraverageincomes.Oneparticipantdescribedthelinkbetweenpeoplehavingtoworkmultiplejobsandhavingtimetoshopforandpreparehealthyfoods.
“Wehaveagrocerystoreoneverycornerbutnoteverycornerinthepoorneighborhoods.It’sbeenmypersonalexperiencethateatinghealthyisexpensive.Itcostsmoremoneytobuyhealthyfruitsandvegetablesandmorehealthyfood,ingeneralthanitdoestobuyfoodthat’snotsohealthy,that’shighfat,highcarb,highsugar….Itcostsmoremoney.Ittakeslongertoprepare.Whenyouhaveamomandadadoreitherandthey’retryingtohandletwojobs,ifnotthree.They’vegotkidsofvaryingages.Themechanicsofshoppingandpreparingmealsisprobablyanactivitythatgetsletgo.”
Someparticipantshaddirectexperiencewitheducatingthecommunityabouthealthyfoodsandeating.Theseparticipantssharedthatsomecommunitymembershavelimitedknowledgeoffreshfruitsandvegetablesandwouldbenefitfromearlyeducationforparentsandchildreninschools..
“Andthereareplaceswhichwearereallyconcernedabout,whichiseastofI45wherethere’sthisfoodinsecurity,fooddesert,andallotherproblemsthatarehappening,andwe’reseeingincreasingincidenceofchildobesityinthoseareas,andthosezipcodes.Sodefinitelyeducationisthekey.Itstartsfromprobablyprenatalcareofmom,anditgoesontoschool.”
InMemorialHermann’scommunitysurvey,67%ofrespondentsselectedDiabetesasoneofthetopissuesmostaffectingthequalityoflifeintheircommunity.Duringkeyinformantinterviews,Diabeteswasdiscussed64timesandwasraisedbyparticipants32timesasahealthneedorconcerninthecommunity.ForthoseparticipantswhoraisedDiabetesasatophealthissueinthecommunity,emergedregardinghowdiabetesisimpactingspecificgroupsinthecommunityandthewayasedentarylifestyleimpactsdiabetes.MultipleparticipantsattributedthesurgeinobesityanddiabetesingeneralintheU.S.toashifttoamoresedentarylifestylewhileothersspecificallyidentifiedthelocalclimateanddrivingcultureaskeyfactorsleadingtoanincreaseinsedentarylifestylesimpactingtheregion.HeartDisease&Strokewasdiscussed34timesduringthekeyinformantinterviewsandwasraisedbyparticipants16timesasahealthneedorconcerninthecommunity.ForthoseparticipantswhoraisedHeartDisease&Strokeasatophealthissueinthecommunity,theuniquethemesthatemergedintheinterviewswerechronicdiseaseriskrelatedtosocioeconomicstatusandchallengeswithmanagingheart-relatedconditions.“Youhavesomanycommunitiesthatarefooddesertsso,ofcourse,Ithinkweareallatriskforthingslikediabetesandhypertension,obesity,stroke–but,Ithinkinadditiontothat,thosethataremostarealreadymarginalized.Peoplewhoarelowincome.Lowsocioeconomicstatus.So,education,andallofthoseindicatorsareprobablyevenmoreatriskforchronicdiseasesthansomeone,forexample,whohasaccesstocareandinsurance.So,theyprobablyaredoublyatrisk.”
MemorialHermannNortheastHospitalCHNA201963
Exercise Is Medicine
Secondary Data Exercise,Nutrition&Weightwasthefifthhighest-rankingtopicinthesecondarydatascoringresultsforMemorialHermannHealthSystem.ItreceivedthesametopicrankinginMontgomeryCountyand,althoughitdidnotrankashighinthesecondarydatascoringresultsforLibertyCounty,itreceivedatopicscoreover1.8.Table25displaysindicatorsofconcern,withseveralscoresequaltoorabove2.InMontgomeryCounty,anindicatorspecifictoexerciseisWorkersWhoWalktoWork(withascoreof2.78),whileinLibertyCountythesameindicatoralongwithAccesstoExerciseOpportunitiesscoredabove2.HarrisCountyalsohasoneexercise-relatedindicatorofconcern:WorkersWhoWalktoWork.
Table25.SecondaryDataScoringResults:Exercise,Nutrition&Weight
County CountyValueComparedto:
Indicator Name Value DataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
WorkerswhoWalktoWork[1](2012-2016)
Liberty1.0
2.67 3 3 3 3 1.5percent
Montgomery1.0
2.78 3 3 3 3 2percent
Harris1.5
2.17 2 2 3 3 1.5percent
[1]AmericanCommunitySurvey
FoodInsecurityRate[5](2016)
Liberty18.7
2.39 3 3 3 1.5 1percent
Montgomery14.6
1.33 1 1 3 1.5 0percent
Harris16.6
2.06 2 2 3 1.5 1percent
[5]FeedingAmerica
AccesstoExerciseOpportunities[4]
(2018)
Liberty59.5
2.17 2 3 3 1.5 1.5percent
Montgomery82.7
1 0 1 2 1.5 1.5percent
KeyIssues:• Obesityandconvenienceoffastfood• Walkabilityofcommunities• Safetyofoutdoorspacesandplacestoexercise
MemorialHermannNortheastHospitalCHNA201964
Harris90.4
0.67 0 0 1 1.5 1.5percent
[4]CountyHealthRankings
ChildFoodInsecurityRate[5](2016)
Liberty26.0
2.17 3 3 3 1.5 0percent
Montgomery21.2
1.17 0 1 3 1.5 0percent
Harris23.5
1.67 1 2 3 1.5 0percent
[5]FeedingAmerica
GroceryStoreDensity[17](2014)
Liberty0.1
1.94 2 1.5 1.5 1.5 2stores/1,000population
Montgomery0.1
1.83 2 1.5 1.5 1.5 1.5stores/1,000population
Harris0.2
1.5 1 1.5 1.5 1.5 1.5stores/1,000population
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
HouseholdswithNoCarandLowAccesstoaGroceryStore[17]
(2015)
Liberty3.4
1.83 3 1.5 1.5 1.5 1.5percent
Montgomery1.5
1.17 1 1.5 1.5 1.5 1.5percent
Harris0.9
1 0 1.5 1.5 1.5 1.5percent
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
SNAPCertifiedStores[17](2016)
Liberty0.8
1.78 2 1.5 1.5 1.5 2stores/1,000population
Montgomery0.5
1.89 3 1.5 1.5 1.5 1stores/1,000population
Harris0.6
2.11 3 1.5 1.5 1.5 2stores/1,000population
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
FoodEnvironmentIndex[4](2018)
Liberty6.6
1.72 2 0 3 1.5 1
Montgomery7.5
1.22 1 0 2 1.5 1
Harris 7.2 1 1 0 2 1.5 0
MemorialHermannNortheastHospitalCHNA201965
[4]CountyHealthRankings
RecreationandFitnessFacilities[17]
(2014)
Liberty0
1.67 2 1.5 1.5 1.5 1.5facilities/1,000population
Montgomery0.1
1.33 1 1.5 1.5 1.5 1.5facilities/1,000population
Harris0.1
1.33 1 1.5 1.5 1.5 1.5facilities/1,000population
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
ChildrenwithLowAccesstoaGroceryStore[17](2015)
Liberty4.3
1.33 1 1.5 1.5 1.5 1.5percent
Montgomery5.6
1.67 2 1.5 1.5 1.5 1.5percent
Harris5.4
1.5 1 1.5 1.5 1.5 1.5percent
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
Adults(18+Years)WhoAreObese[10]
(2016)
Liberty
--- --- --- --- --- ---
Montgomery
--- --- --- --- --- ---
Harris32.0
1.67 1.5 1 2 2 2percent
[10]TexasBehavioralRiskFactorSurveillanceSystem
FastFoodRestaurantDensity[17](2014)
Liberty0.5
1.33 1 1.5 1.5 1.5 1.5restaurants/1,000population
Montgomery0.6
1.5 1 1.5 1.5 1.5 1.5restaurants/1,000population
Harris0.7
1.67 2 1.5 1.5 1.5 1.5restaurants/1,000population
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
Primary Data Over60%ofMemorialHermann’scommunitysurveyrespondentsnotedObesityasatopissueaffectingthequalityoflifeintheircommunity.Inkeyinformantinterviews,Exercise,Nutrition&Weightwasdiscussedalmost170timesandwasraisedbyparticipants42timesasaneedorconcernforachievinghealthinthecommunity.TheprimarybarriersrelatedtoExercise,Nutrition&Weightidentifiedbyparticipantswerewalkability,accesstosafeoutdoorspaces,
MemorialHermannNortheastHospitalCHNA201966
programmingthatmaynotmeettheneedsofcommunitiesfacingfinanciallimitations,andtheconvenienceofunhealthyfoods.Severalparticipantsdiscussedbarrierstohealthylifestylechangesanddescribedcommunitieswheresidewalksarelimitedorpedestrianpathwaysarenotavailable.Theabilityforcommunitymemberstomakesmallshiftsintheirdailylives,suchaswalkingregularly,maybemorefeasiblethanundertakinganexerciseregimen.Thelimitationsofpedestrianpathwaysandsaferwalkingspacespreventthoseinsomesectionsofthecommunityfrommakingtheseshifts.Forindividualswhomaynotbeabletoaffordgymmembershipsnorattendclassesduetoworkschedules,outdooractivitiesandfitnessareasofferafreealternative.Participantsfeltthatinmanyneighborhoods,theseoutdoorspacesarenotavailableduetodisrepairorunsafeenvironments.“Ithinkthebuiltenvironmentishuge,too.Ifyouliveoutinaplannedcommunity,theyusuallyhavewalkingtrails,ortheyhaveaprettyfountainareaforyoutowalkaroundit.Theyhavethoselittleexercisethingsthatyoustoponpartwayaroundthetrailandyoudoyourlittlepush-upsandyoursit-upsandyourpull-ups(…)Yougointothesepoorerareasandthere'snosidewalks.There'snolightsatnight.There'sapark—it'sallrustedequipment.”Participantsalsodescribedprogramsandfacilitiesthatareeitherlimitedorlacking.Theseprogramsincludedfreeexerciseprogramswithchildcareoptions,youthsportsleaguesandrecessintheschoolsandfreeorlow-costoptionsforair-conditionedfacilitiesduringtimesoftheyearwhentheweatherdoesnotpermitoutdooractivities.“InpoorareasofHouston,there’sjustnotalotofparks.There'snolittleleague,andthere'snosoccerleagues,andso,there'snotalotofrecessintheschools.There'sjustnot—thecultureamongthekidsisjustnotbeingcreatedaroundphysicalactivity.”Achallengethatseveralparticipantsraisedistheconvenienceandlowcostofunhealthyfoods.Forfamiliesthatmayhavefinancialortimelimitations,theconvenienceofinexpensive,lesshealthyfoodsisdifficulttocontendagainst.“Wehavethebigchaingrocerystoreshereinthecommunity,butalotoftimes,becauseourpopulationislimitedwithfunds,thebadfoodsaretheonesthatarethecheapestandmostaccessible,sotheygoinandbuythecheapest/fastestthingtheycanget.”
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Non-Prioritized Significant Health Needs Thefollowingadditionalsignificanthealthneedsemergedfromareviewoftheprimaryandsecondarydata.Withtheneedtofocusontheprioritizedhealthneedsdescribedabove,thesetopicsarenotspecificallyprioritizedeffortsinthe2019-2022ImplementationStrategy.However,duetotheinterrelationshipsofsocialdeterminantneedsmanyoftheseareasfall,tangentially,withintheprioritizedhealthneedsandwillbeaddressedthroughtheupstreameffortsoftheprioritizedhealthneeds.Additionally,manyofthemareaddressedwithinongoingprogramsandservices.Examplesoftheseeffortsareprovidedbelowbytopicarea.
Older Adults and Aging
Secondary Data OlderAdultsandAgingwasatopicofconcernforHarris,LibertyandMontgomerycounties,withatopicscoreof1.5forHarrisCounty’ssecondarydataresults,atopicscorecloseto2forLibertyCounty,andastheeighthhighest-rankingtopicforMontgomeryCounty.Acrossallthreecounties,StrokeintheMedicarePopulationisanindicatortobeawareof.InHarrisCounty,additionalindicatorsscoringabove2includeChronicKidneyDiseaseintheMedicarePopulationaswelltheAge-AdjustedDeathRateduetoFalls.InLibertyCounty,severalindicatorsareconcerningintheMedicarePopulation(Diabetes,ChronicKidneyDisease,Asthma,COPD,andHeartFailure);anotherindicatorscoringabove2inLibertyCountyistheAge-AdjustedDeathRateduetoAlzheimer’sDisease.InMontgomeryCounty,AtrialFibrillationintheMedicarePopulationisanindicatorwithscoreabove2.
Primary Data KeyinformantsandstakeholdersdiscussedOlderAdultsandAging.Over62%ofparticipantsinMemorialHermannHealthSystem’sprioritizationprocesscitedOlderAdultsasoneofthegroupsmostaffectedbypoorhealthoutcomes.Interviewswithkeyinformantsnotedthegrowingpopulationofolderadultsandneedsrelatedtospecializedcare,financialassistanceandoutreach.“…[W]earegoingtowatchtheliteraldoublingofthenumberofAmericansovertheageof65inthenext25years.Everyday,betweennowand2030,dayafterday,10,000Americanswillturn65,sowearewatchinganextraordinaryexpansionofchallengesofaging.(…)[M]oreandmoreAmericansaregoingtobegettingold,socaringforthismassiveincreaseintheagingpopulationisgoingtobeoneofthegreatchallengesIthink.”
Efforts MemorialHermannHealthSystemincludestwofreestandingRehabilitationHospitals(TIRRandKaty)aswellasaseniorlivingfacility(UniversityPlace),featuringindependentliving,personalassistanceservices,andaseparate,butattached,nursingcenter.Additionalcommunityoutreachincludeshealtheducationon:Alzheimer’sdisease,DiscountedDiabetesEducation,Education/outreachforSeniors,InjuryPrevention,FallPrevention,andsupportgroupsforvariouspopulations,including:Alzheimer’s,Amputees,Cardiacpatients,Chronicdisease,Diabetics,Grief,Parkinson’sdisease,Stroke,Survivorship,andmore.
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Cancers
Secondary Data Cancerisatopicthatreceivedasecondarydatascoreof1.75forLibertyCountywithseveralconcerningindicators:Age-AdjustedDeathRateduetoLungCancer,OralCavityandPharynxCancerIncidenceRate,CervicalCancerIncidenceRate,Age-AdjustedDeathRateduetoCancer,LungandBronchusCancerIncidenceRate,andAge-AdjustedDeathRateduetoColorectalCancer.CancerwasnotatoptopicforHarrisandMontgomerycounties’secondarydataresults.However,thereareacoupleofindicatorstonoteinHarrisCounty(withscoresabove2):CervicalCancerIncidenceRateandAge-AdjustedDeathRateduetoBreastCancer.
Primary Data InMemorialHermann’scommunitysurvey,overonethirdofrespondentsnotedCancerasatopissueaffectingthequalityoflifeintheircommunity.Interviewswithkeyinformantsrevealedtheimportanceofmakingcancerscreeningservicesandspecialtycareavailableandaccessible(e.g.,telehealth,mobilemammography).
Efforts AsleadingprovidersofcancertreatmentinHouston,MemorialHermannCancerCentersarecommittedtocancertreatment,prevention,andresearch.Theirbroadgeographicalcoveragemakescancertreatmentextremelyaccessibleandconvenienttowherepatientsliveorwork.AlleightMemorialHermannCancerCentersareapprovedbytheAmericanCollegeofSurgeonsCommissiononCancer(ACoSCoC);only25percentofhospitalsacrossthecountryhavereceivedthisspecialrecognition.Withguaranteedaccesstocomprehensivecare,collaborativeteamapproachforcoordinatingthebestavailabletreatmentoptions,state-of-the-artequipmentandservices,educationandsupport,andlifelongpatientfollow-upthroughtheCancerRegistry,patientsareabletoaccessafullmenuoftherapiesandtreatmentoptions.Additionaloutreachincludeseducationandsupportgroupsforcancerpatients:Art,Self-guidedArtTherapy,Lymphedema,BrestCancer,OncologyNutritionTherapy,StressRelief,LookGoodFeelBetter,Yoga,Meditation,andHealthyEatingAdvices.
Education
Secondary Data Educationreceivedatopicscoreof1.56inthesecondarydatascoringforHarrisCountyand1.88forLibertyCounty.InLibertyCounty,indicatorsofconcerninclude:People25+withaBachelor’sDegreeorHigher,People25+withaHighSchoolDegreeorHigherandInfantsBorntoMotherswithLessthan12YearsEducation.Thereareseveraleducation-relatedindicatorstoconsiderinHarrisCounty:InfantsBorntoMotherswithLessThan12YearsofEducation(withavalueof27.5%inHarrisCounty,comparedto21.3%inTexasand15.9%intheU.S.),Student-to-TeacherRatio,HighSchoolDropOutRate,andPeople25+withaHighSchoolDegreeorHigher.
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Primary Data Duringkeyinformantinterviews,thetopicofEducationcameupfrequentlyandinrelationtodifferentfocusareasandtargetaudiences,includingchildren,generalcommunitymembersaswellasproviders.Thelinkbetweenindividuals’levelofeducationandqualityoflifewasemphasized.Keyinformantsrecommendedfindingopportunitiestoexpandtheavailabilityofeducation(relatedtohealthandnon-healthtopics)aswellasintegratinghealtheducationintoexistingactivitiesinbothclinicalandnon-clinicalsettings,suchasschoolsandchurches.Opportunitieswerealsopointedouttoeducatehealthcareproviders(andprovidecontinuingeducation)onavailablecommunitylinkagesandresourcesandonhowtoinitiateconversationswithpatientsregardingdifferenthealthtopics.“Ithinkitcomesdowntoeducationbecauseprobably75%ofourdiagnoseddiabetesaretype2diabetes,andthatissomethingthatwithproperdiet,properexercise,andeducationthatmanypatientscanovercome,andsowehaveworked,andwecontinuetoprovide(…)thepropereducation.”“Wewanttogointodifferentgroupsandeducatethemonwhattheyshouldbedoingorshouldn’tbedoing.(…)Ithinkeducationisahugecomponentbutwe’vegottofigureouthowtointegratethat.Theeducation,withouttheintegrationintosomebody’slifestyle,doesn’tdothemanygood.”
Efforts MemorialHermannoperatestenHealthCentersforSchools,establishedin1996,offeringaccesstoprimarymedical,dentalandmentalhealthservicestounderservedchildrenat82schoolsintheGreaterHoustonArea.Researchshowsthatschool-basedhealthcentersincreaseeducationalsuccessbyprovidingmedicalandmentalhealthcarethatallowsstudentstostayinschoolandlearn.Theprimarygoaloftheprogramistokeepchildrenhealthyandfeelingwellsothattheystayinschoolandcanperformwellacademically,creatingafoundationforabrighterfuture.Byprovidingimprovedaccesstohealthcaretoat-riskchildrenacrosstheregion,MemorialHermannhasdemonstratedsuccessincreatinghealthieroutcomesforkids,includingimprovementsintheirphysicalhealth,theirmentalwellbeing,andeventheirattendancerateatschool.
Transportation
Secondary Data ForHarris,LibertyandMontgomerycounties,Transportationrosetothetopofthesecondarydatascoringresults,withatopicscoreof1.82inHarrisCounty,2.28inLibertyCountyand1.93inMontgomeryCounty.Inallthreecounties,indicatorsofconcerninclude:SoloDriverswithaLongCommute,MeanTravelTimetoWork,andWorkerswhoWalktoWork.Inadditiontothese,anotherindicatortonoteforLibertyandMontgomerycountiesisWorkerswhoDriveAlonetoWork.Furthermore,thereexisthighdisparitiesforafewoftheseindicators.
Primary Data ParticipantsraisedthetopicofTransportation59timesinrelationtobarriersorchallengestoachievinghealthinthecommunity–morethananyothertopic.KeyinformantsrepeatedlynotedthattheHoustonregionhassignificanttransportationissues(includingavailability,
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accessibility)thatimpactcommunitymembers’abilitytoaccesshealthprogramsandservices.Inadditiontolimitedoptionsforpublictransportation,travelcostandtimewerebroughtup.Moreover,forcertainpopulations,likeolderadultsorpeoplewithdisabilities,publictransportationisnotafeasibleoption.“Thisremarkablespread-outcity,thesizeofMassachusetts,istheGreaterHoustonMetropolitanArea.(…)Thisisnotacityandasuburbanymore,it’sametropolitanregionwitheighttotencentersofactivitythatarelargerthandowntownSanDiego,spreadoutoverthismassivearea,butgettingfromoneplacetoanotherisanincreasingchallenge.Povertyalsomeansinadequatetransportation,wehavenoreallygoodtransitsystembecauseit’salmostimpossibletodevelopagoodtransitsystemforacitysolackingindensityandsospreadoutasHoustonis.Wehaven’tsolvedthatproblem,andalotofthehealthcareissuescomebecausepeople[are]withoutacartryingtogettoahospital,ortohealthcare…”“Houstonisreallyspreadout(…)anditcangofromcitytoruralveryquickly.Thefamiliesintheruralcommunitiesthatreallyarewithina20-mileradiusofthecity,soreallystillwithintheHoustonaddress,Ithinkthattransportationforthemisahugebarrier.That’satoughone,becauseHoustonissobig,anditcangoquicklytorural,veryquickly,andyourzipcodeisstillreflectingHouston.”
Efforts MemorialHermannprovidesbusandtaxitokensasrequiredfordischargeandcontinuityofcareneeds.OneMemorialHermannstrategicefforttonotonlyprovidetherightcareattherighttimeintherightplace,butalsoprovidetheopportunitytoaccesshelp/careviathetelephoneistheMemorialHermannNurseHealthLine.Establishedin2014,theNurseHealthLineisafreetelephoneserviceforGreaterHoustonresidentswhoareexperiencingahealthconcernandareunsureofwhattodoorwheretogo.Experienced,bilingualnursesusetheirtrainingandexpertisetoconductassessmentsbyphone,andareavailabletoanswercalls24hoursaday,sevendayaweekforanyresidentlivinginHarrisorsurroundingcounties.Theyhelpcallersdecidewhenandwheretogoformedicalcareandassistwithsocialservicereferralsandtransportationneeds.
Children’s Health
Secondary Data
Inthesecondarydataresults,Children’sHealthreceivedatopicscoreof1.52inHarrisCountyand1.70inLibertyCounty.Inbothcounties,theChildFoodInsecurityRateisanindicatorofconcern.HarrisCountyhasotherindicatorstonoteincluding:ChildrenwithHealthInsuranceandChildrenwithLowAccesstoaGroceryStore.Closeto10%ofchildreninHarrisCountydonothavehealthinsurance.
Primary Data WhendiscussingChildren’sHealth,keyinformantspointedoutspecificissuessuchaschildhoodobesity,immunization,accesstoservicesandbeinguninsured.Someparticipantsadvisedeffortstoengagechildren,familiesandcommunitiesmorecomprehensively.
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“AlotofpeoplewontgotoaFQHCtogettheirkidimmunizedbecauseit’sahugedoctorvisitthatrequiresalotofpaperworkandtime/effort.”“Texasranksverylowindollarsspentonhealthforchildren.Weranklowinourranking,generally,inchildren’shealth.We’renotputtingenoughmoneyandresourcesintoit.Ithinkweneedtoshiftourattentionand(…)givemoreattentiontochildren’shealthandhowimportantitisforearlychildhooddevelopmentandforbraindevelopmentandongoinghealthintherestoftheirlives.Iwouldsayputthatasapriority.Putchildren’shealthasapriority.Notjustsayingtheearlyyears,notjustsayingzerotofivebutalsothroughoutearlyadolescence,pre-adolescence,earlyadolescenceandintotheteens.”
Efforts Children'sMemorialHermannHospital,licensedunderMemorialHermannTexasMedicalCenter,wasfoundedin1986andistheprimaryteachinghospitalforthepediatricandobstetrics/gynecologyprogramsatTheUniversityofTexasMedicalSchoolatHouston.Children'sMemorialHermannofferscareinmorethanthirtypediatricandwomen'srelatedspecialtiesincludingthelatestadvancesinmaternal-fetalmedicineandneonatalcriticalcareservices,andrenownedprogramsinpediatrictrauma,neurosciences,pulmonologyandcardiaccare.Morethan37,000childrencometoChildren'sMemorialHermannHospitaleachyear.InadditiontoMemorialHermann’sschool-basedhealtheffortsdescribedabove,MemorialHermannisanon-goingfinancialcollaboratorwithChildrenatRisk,a501non-profitorganizationthatdriveschangeforchildrenthroughresearch,education,andinfluencingpublicpolicy.
Economy
Secondary Data
Inthesecondarydatascoringresults,Economyreceivedatopicscoreof1.55inHarrisCountyand1.75inLibertyCounty.HarrisandLibertycountieseachhaveeighteconomicindicatorswithscoresabove2.InHarrisCounty,indicatorsofconcerninclude:Homeownership,SevereHousingProblems,StudentsEligiblefortheFreeLunchProgram,MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage,SNAPCertifiedStores,MedianHouseholdGrossRent,FamiliesLivingPovertyLevel,andFoodInsecurityRate.InLibertyCounty,concerningindicatorsare:FemalePopulation16+inCivilianLaborForce,Population16+inCivilianLaborForce,UnemployedWorkersinCivilianLaborForce,TotalEmploymentChange,FoodInsecurityRate,ChildFoodInsecurityRate,SevereHousingProblems,andStudentsEligiblefortheFreeLunchProgram.
Primary Data Keyinformantsdiscussedfoodinsecurityandfooddesertsasfactorsrelatedtopoorhealthoutcomes.Theypointedoutthat,althoughindividualsmightunderstandthateatinghealthyfoodsisrecommended,theymaynothaveaccesstogrocerystoresorbeabletoaffordhealthierfoodoptions.Keyinformantsnotedtheimportanceofaddressingsocioeconomicbarrierstoimprovehealthandwellbeing.
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“Ithinkinsomeofthelowerincomeneighborhoods,theoptionsforbuyingfoodarelimitedanddonotofferalotofhealthychoices,andthatalotoftimehealthierfoodcostsmore.Andsotheabilitytoeasilygetandaffordhealthyfood,whetheryou’reeatingathomeoreatingout,arejustmorelimitedforsomepeopleandinsomeneighborhoods…”
Efforts It’sadauntingtaskinaregionlikeGreaterHouston,whichhasanestimated7millionpeopleandoneofthehighestratesofuninsuredandunderinsuredinthecountry.ButMemorialHermannbelievesthatwecanONLYimpactthehealthofourcommunity,andthehealthofindividuals,byfocusingonthemultipledeterminantsofhealththatplaythegreatestroleininfluencingaperson’soverallhealthandwellbeing.
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Other Findings Criticalcomponentsinassessingtheneedsofacommunityareidentifyingbarriersanddisparitiesinhealthcare.Theidentificationofbarriersanddisparitieshelpsinformandfocusstrategiesforaddressingprioritizedhealthneeds.ThefollowingsectionoutlinesbarriersacrossMemorialHermannHealthSystemanddisparitiesastheypertaintoMHNortheast’sservicearea.
Barriers to Care Communityinputrevealedawiderangeofbarrierstocareandwellbeing.Asdiscussedintheprevioussection,transportationwasthemostfrequentlycitedbarrierinthecommunity,followedbyotherbarrierssuchasaccesstohealthservices,healthyfoodandexerciseoptions,lowincome,andfoodinsecurity.Overall,thesecondaryandprimarydataconfirmedthatsocioeconomicfactorsimpactcommunitymembers’abilitytoachievegoodhealth.“Manythingscomebacktopovertyandlackofdisposableincome.”Keyinformantsdescribedtheinfluenceofsocialdeterminantsofhealth(includingincome,poverty,language,education,employment)onhealthoutcomes.Participantsdiscussedtheimportanceofaddressingsocialandeconomicfactorstogetattherootcausesofpoorhealthandwellbeing.“Ithinkyouhavetounderstandthatalotoffolksworkfrompaychecktopaycheck,soiftheyactuallyendupatoneofthesemedicalcentersandtheyrequireathirtydollarcopayortendollarsorfifteendollars,thenthey’renotgoingtohaveit.So,they’regoingtowalkawayuntiltheydohavethatmoneyandthatcouldbemonthslater.So,iftheyaresick,they’rejustgoingtobecomesicker.So,that’soneofthebigbarriers.”
Disparit ies Significantcommunityhealthdisparitiesareassessedinboththeprimaryandsecondarydatacollectionprocesses.Table26identifiesthenumberofsecondarydatahealthindicatorswithahealthdisparityforMHNortheast’sservicearea.SeeAppendixBforthespecificindicatorswithsignificantdisparities.
Table26.NumberofHealthDisparitiesIdentifiedinSecondaryDataAnalysis
HarrisCounty LibertyCounty MontgomeryCountyBlackorAfricanAmerican(13)White(8)HispanicorLatino(8)OtherRace(7)AmericanIndianorAlaskaNative(6)
HispanicorLatino(5) OtherRace(8)BlackorAfricanAmerican(6)HispanicorLatino(6)AmericanIndianorAlaskaNative(3)TwoorMoreRaces(3)
Male(10)Female(3)
Male(4) Male(5)
<6yearsofage(2) 45-54yearsofage(1) <6yearsofage(1)
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GeographicdisparitieswereidentifiedusingtheSocioNeedsIndex.Zipcodes77093,77039,77032,77028,77078,77016(withvaluesgreaterthan95)inHarrisCountywereidentifiedashavingthehighestsocioeconomicneed,potentiallyindicatingpoorerhealthoutcomesforresidentsinthoseareas.ThezipcodeswithlargestproportionofinpatientdischargesatMHNortheast,zipcodes77346and77338,haveSocioNeedsIndexvaluesof11and71.9,respectively.
25-44yearsofage(2)45-64yearsofage(2)65+yearsofage(2)
65+yearsofage(1)
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Conclusion TheCommunityHealthNeedsAssessmentforMHNortheastutilizedacomprehensivesetofsecondarydataindicatorstomeasurethehealthandqualityoflifeneedsforMHNortheast’sservicearea.Furthermore,thisassessmentwasinformedbyinputfromknowledgeableanddiverseindividualsrepresentingthebroadinterestsofthecommunity.MemorialHermann’ssystem-wideprioritizationprocessresultedinfourfocusareasorpillars:AccesstoHealthcare,EmotionalWell-Being,FoodasHealth,andExerciseIsMedicine.MHNortheastwillreviewtheseprioritiesmorecloselyduringtheImplementationStrategydevelopmentprocessanddesignaplanforaddressingthesepillarsmovingforward.Inaddition,MHNortheastinvitesyourfeedbackonthisCHNAreporttohelpinformthenextCommunityHealthNeedsAssessmentprocess.Ifyouhaveanyfeedbackorremarks,pleasesendthemto:Deborah.Ganelin@memorialhermann.org.
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Appendix
Appendix A: Evaluation Since Prior CHNA
Appendix B. Secondary Data Methodology
Secondary Data Sources
Secondary Data Scoring
Data Scoring Results
Appendix C. Primary Data Methodology
Community Input Participants
Key Informant Interview Questionnaire (Episcopal Health Foundation)
Key Informant Interview Questionnaire (Conduent Healthy Communities Institute)
Community Survey (English)
Community Survey (Spanish)
Appendix D. Priorit ization Tool
Priorit ization Survey
Appendix E. Community Resources
MemorialHermannNortheastHospitalCHNA2019 77
AppendixA.MHNortheastImpactReport
EvaluationSincePriorCHNAPriority1:HealthyLiving
Priority1: HealthyLiving
Goal1: Preventavoidableinjuryandpreventand/ormanagechronicdiseasestoensureoptimalhealthandsafetyforcommunityresidents.
EarlyDetectionandScreeningObjective1.1:Facilitateearlyidentificationof,andinterventionfor,keyhealthconditionstodecreasemortalityfromtheseconditionsOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Numberofcontactsforscreeningshealthfairs 9,77525contacts
11,650attendees10,765
10,200
• Numberofcancerscreeningevents 2 3 3 3• Numberofschoolsaspartners 15 22 22 15• Numberofstudentsperyearexamined 4,500 6080 11,331 4,725
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,31.1.1: ConductathleticphysicalsinpublicschoolsinMSandHS(fullphysicalsandEKG);partner
withschoolstoprovideaconcussiontrainedPCPorEDphysicianonsiteatHSgames(See1.4.1)
1,2,3
1.1.2: Hostfreehealthscreenings(1screening/quarterforcommunity)tocover:prostate/skincancer,cholesterol,BP,bloodglucose(See1.2.2)
1,2,3
1.1.3: Facilitateemployerhealthfairs(31/year):provideresourcesforancillaryservicesandprevention,directaccesstoscheduleappointmentsforabnormalscreenings(See1.2.4,strategiesofObjective1.5)
1,2,3
1.1.4: Conducteducationandoutreach“LunchandLearns”byproviderstoseniorgroup,employers,andcommunityontopicsre:nutrition/weightmanagement,strokesupport,cancersupport,etc.(2/mon,24peryear)
1,2,3
1.1.5: ConductBMIscreeningandbodyfatpercentage.(see1.1.3) 1,2,3
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Priority1: HealthyLiving
Goal1: Preventavoidableinjuryandpreventand/ormanagechronicdiseasestoensureoptimalhealthandsafetyforcommunityresidents.
Monitoring/EvaluationApproach:• AthleticPhysicals–Keepalogofnumbersforeachschoolevent• HealthScreenings–Tracknumberofparticipantsregistered• HealthFairs–Documentnumberofgiveawaysgiventoparticipants• LunchandLearns–Keepalogofnumberofparticipantsateachevent
PotentialPartners:• Schooldistricts• Employers• PhysiciansandMid-levelproviders• Staff• FreeStandingEDsandUrgentCares• LakeHoustonArea,KingwoodandEastMontgomeryCountyChambersofCommerce• Media
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ObesityPreventionObjective1.2:Decreaseobesityforallagesasmeasuredbybodyfatpercentageand/orBMIOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Numberofattendeesatlunchandlearn 40 1,235 Xreferenceto1.1.4 45• Numberoflunchandlearnsessions 2 3 Xreferemcetp1.1.4 3• Participationnumberinwellnesscenter 440 762 186 475• Numberofcontactsforscreeningshealthfairs 4,750 11,650 10,765 4,980
Strategies:Year1Notes
Year2Notes Timeline:
Year1,2,31.2.1: Facilitatelunchandlearnsessionswithendocrinologistsforemployersandseniorson
nutritionandweightmanagement(see1.1.4) 1,2,3
1.2.2: Hosthealthscreenings(1screening/quarterforcommunity)tocover:prostate/skincancer,cholesterol,BP,bloodglucose(see1.1.2)
1,2,3
1.2.3: Providesubsidizedhealthandwellnessservicestocommunityaton-siteWellnessCenter(SeniorBalance,yoga,Zumba,etc.)
1,2,3
1.2.4: Hostemployerhealthfairsandprovidescreeningsforbodyfatpercentageand/orBMI 1,2,3 Monitoring/EvaluationApproach:
• LunchandLearns–Keeplogofnumberofattendeesateachfunction• HealthScreenings–Tracknumberofparticipantsregistered• HealthFairs–Documentnumberofgiveawaysgiventoparticipants
PotentialPartners:• Schooldistricts• Employers• PhysiciansandMid-levelproviders• Staff• FreeStandingEDsandUrgentCares• ChamberofCommerce• Media
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AccesstoHealthyFoodObjective1.3:Supportaccesstohealthyfood,especiallyforthosemostinneedOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• NumberofERpatientsscreenedforfoodinsecurityviatheERNavigationprogram
1,786 2208 2528 1,786
• NumberofCHWreferralstocommunityfoodpantriesviatheERNavigationprogram
283 368 715 283
• NumberofERNavigationsupportedcommunityeventshostedbylocalpartners 2
28 4
• Numberofpoundsoffoodraisedinfooddrive 18,000lbs. 7400 20,873 19,000
• Numberoffamiliesinneedimpacted 725HAAMdispersesthe
foodHAAMdispersesthe
food 760
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,31.3.1: ContinuetoparticipateintheMHERNavigationprograminwhichparticipantsare
screenedforfoodinsecurityandreferredtofoodpantriesifnecessary.(See2.4.2) 1,2,3
1.3.2: Collectfoodtosupportfoodpantriesorspecialeventshostedbycommunitypartners(Conductbiannualfooddrivewithsisteragency–HAAMdispersesthroughFoodBank)
1,2,3
Monitoring/EvaluationApproach:• FoodDrives–Keeplogofpoundsweighed• PatientactivitydocumentedandreportedwithintheERNavigationelectronicrecordsystem
PotentialPartners:• HAAM• Media• Schooldistricts• Staff• FamilyTime• MemorialHermannCommunityBenefitCorporation
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Timefor/SafetyDuringPhysicalActivityObjective1.4: IncreasethenumberofcommunitymembersinformedaboutstrategiesformakingtimeforandensuringsafetyduringphysicalactivityOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Numberofpresentations 3 19 2 4• Numberofattendeesatpresentations 120 2000 1200 126• Numberofhealthfairs(propermechanicsandexercise
demonstrations)4 1 5 5
• Numberofattendeesathealthfairs 2,500 800 3,250 2,625
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,31.4.1: ProvideliaisontoworkwithAthleticTrainersateachschoolandprovidehotlinebackto
ourphysiciantoaddressissuesofhydration,stretching,etc.Provideathleticphysicalsfortheseschools.(see1.1.1)
1,2,3
1.4.2: AddressissuesofhydrationandbodymechanicsviaEmployerFairs(see1.1.3) 1,2,31.4.3: Conductseniorfairsaddressingseasonally-relevanttopicssuchassunburn,mosquito
bites 1,2,3
1.4.4: DiscusswaystoincludeworkoutactivitiesthroughouttheworkdayatphysicianfacilitatedEmployerLunchandLearns(see1.1.4)
1,2,3
Monitoring/EvaluationApproach:• HealthFairs–Documentnumberofgiveawaysgiventoparticipants• LunchandLearns–Keeplogofnumberofattendeesateachfunction
PotentialPartners:• UniversityofHoustonSchoolofPharmacy• MHHSathletictrainerteam• ChambersofCommerce• Media• PhysiciansandMid-levelProviders• Staff• Employers• CommunitySeniors
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ChronicDiseaseManagementObjective1.5:Increasethenumberofpatientswhoaremaintainingtheircurrenthealthstatusthroughcompliancewithrecommendedand/or
prescribedregimensforchronicdiseasemanagementOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Numberofhealth/employerfairs 18 25 20 19• Numberofattendeesathealth/employerfairs 9,775 11,650 Xrefto1.1.3 10,200• Numberofpresentations 9 8 1 10• Numberofattendeesatpresentations 610 36 35 640• Numberofstrokesupportmeetings 5 6 4 6• Numberofattendeesatstrokesupportmeetings 62 36 15 65• Numberofbreastcancersupportmeetings 5 12 11 6• Numberofattendeesatbreastcancersupportmeetings 52 147 139 55
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,31.5.1: Providenutritionistsanddieticiansathealthfairsandemployerfairstodiscussspecific
plansforthosewithdiabetesandprovideinformationonchronicpainmanagement(see1.1.3)
1,2,3
1.5.2: Providecarotidarteryscreening(preventionandmanagement)(see1.1.3) 1,2,31.5.3: Conductbonedensityscreening(see1.1.3) 1,2,31.5.4: ConductBMIscreeningandbodyfatpercentage(see1.1.3) 1,2,31.5.5: ConductABIscreeningsforarterydisease(see1.1.3 1,2,31.5.6: Conductpresentationsforsleepdisorders,diabetes,heartconditions(see1.1.4) 1,2,31.5.7: ConductaStrokeSupportGroup 1,2,31.5.8: ConductEKGscreeningsatcommunityandemployerhealthfairs(see1.1.3) 1,2,31.5.9: ConductaBreastCancerSupportGroup. 1,2,3
Monitoring/EvaluationApproach:• HealthFairs–Documentnumberofgiveawaysgiventoparticipants• Presentations–Keeplogofnumberofattendeesateachfunction• Screenings–Keeplogofnumberofattendeesateachfunction• SupportGroups–Loginsheets
MemorialHermannNortheastHospitalCHNA2019 83
Priority1: HealthyLiving
Goal1: Preventavoidableinjuryandpreventand/ormanagechronicdiseasestoensureoptimalhealthandsafetyforcommunityresidents.
PotentialPartners:• Physicianpractices• Staff• Employers• Media• Communitymembers• ChambersofCommerce
MemorialHermannNortheastHospitalCHNA2019 84
Priority2:AccesstoHealthCare
Priority2: HealthCareAccess
Goal2: Ensureallpatientshaveaccesstoappropriatecareatthetimeandplacetheyneedit,regardlessofabilitytopay.
AvailabilityofPrimaryCareandSpecialtyProvidersObjective2.1: Connectpatientstoappropriatemedicalhomes,careandbenefits,andreduceinappropriateERuse
OutcomeIndicators:AnnualBaseline Year1 Year2 FY2020
Target• NumberofpatientsenrolledintheERNavigationProgram 1,930 2162 2,479 1,930• NumberofERNavigationpatientencounters 4,532 5712 6,936 4,532• NumberofERNavigationreferralstocommunityresources 4,864 4890 5,481 4,864• NumberofERNavigationscheduledappointments 204 259 246 204• Numberofappointmentsattempted 511 488 242 511• Numberofphysiciansrecruitedannually 9 5 7 10
• Numberofreferralsandcompletedappointmentsmadebyhealthfairs(quarterly)
47
488referralsbasedonnumber
attempted/completedappointmentswere
nottracked
49 50
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,32.1.1: ContinuetoparticipateintheMHERNavigationprograminwhichpatientsarereferredtoamedical
home(See2.4.2)ERnavigatorworkswithERunfundedpatients,facilitatesaccesstocountyclinics,assistswithgoldcard,etc.
1,2,3
2.1.2: RecruitspecialiststhruUT,existingcommunitypractices,MHMedicalGroup,andMNA(MischerNeuroscienceAssociates)toensureadequateemergencycare,acutecareandqualitypostacutecare.
1,2,3
2.1.3: ProvideaPCPCoordinatortoidentifypatientswhodonothaveaPCP,regardlessofabilitytopay;providefactsheets;makefollowupappointmentsforthemwhilestillinpatient;alsorefertoneighborhoodhealthcenterifappropriate.
1,2,3
Monitoring/EvaluationApproach:• DatafromMemorialHermannMedicalGrouponHealthFairs• PatientactivitydocumentedandreportedwithintheERNavigationelectronicrecordsystem
MemorialHermannNortheastHospitalCHNA2019 85
Priority2: HealthCareAccess
Goal2: Ensureallpatientshaveaccesstoappropriatecareatthetimeandplacetheyneedit,regardlessofabilitytopay.
PotentialPartners:• UniversityofTexas(UT)Physicians• MemorialHermannMedicalGroup• MischerNeurosciencesAssociates• AlignedMHMDPhysicianPractices• MHHS• NeighborhoodHealthCenterNortheast• MemorialHermannCommunityBenefitCorporation
MemorialHermannNortheastHospitalCHNA2019 86
HealthInsuranceCoverageandCostsObjective2.2: HelppatientsapplyforandsecurecoveragetoaccessappropriatecareOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• NumberofClassDPrescriptionsprovidedtotheNimitzandBurbankSchoolBasedHealthCenters
235 252 628 235
• %ofpatientsscreened,%patientswhocompliedwithapplicationprocess,%patientswhoqualifiedforassistance
92%ofuninsuredscreened84%compliedwithapplication
process84%qualifiedforassistance
PatientsscreenedIP–99%Ou-95%
85%patientscompliedwith
applicationprocess93%patientswho
qualifiedforassistance
Patientsscreened99%IP97%OU
75%compliedwithapplicationprocess,80%qualifiedforassistance
95%ofuninsuredscreened
84%compliedwithapplication
process84%qualifiedfor
assistance
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,32.2.1: ProvideClassDPrescriptionstotheNimitzandBurbankSchoolBasedHealthCentersinsupport
ofprimarymedicalcareprovidedtouninsuredchildrenandteensatnocost
1,2,3
2.2.2: Continuetoscreenpatientsandadviseongovernmentalprogramsforcoverage;stateemployeesreceivebenefitsonsite
1,2,3
2.2.3: ContinuecooperativeagreementwithNortheastHospitalFoundationtoenabletheuninsuredtoaccessscreeningmammographiesandtreatmentasappropriate
1,2,3
Monitoring/EvaluationApproach:• Track%ofpatientsscreenedthroughreportingtool
PotentialPartners:• Third-Partyeligibilityvendors• NortheastHospitalFoundation• MemorialHermannCommunityBenefitCorporation
MemorialHermannNortheastHospitalCHNA2019 87
TransportationObjective2.3: FacilitatetransportationhomeupondischargeforpatientsinneedOutcomeIndicators:
AnnualBaseline Year1 Year2 FY2020Target
• Numberoftaxivouchers 238 282 238 238
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,32.3.1: Providecabvouchersfortransportbackhomeafterdischarge 1,2,3
Monitoring/EvaluationApproach:• Trackinlogbook
PotentialPartners:• Cabcompanies
MemorialHermannNortheastHospitalCHNA2019 88
HealthCareNavigationObjective2.4: Assistpatientswitheffectiveutilizationof,andself-directionon,resourcestomeettheirhealthcareneedsOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Numberofhospital'sassociatedcounties'callstoNurseHealthLine(Harris,Liberty,andMontgomeryCounties)
30,323 30,226 31,459 30,323
• NumberoftouchesinER(navigation) 4,532 2162 2479 4,532• Numberoftouches(oncology) 600 500 1111 630• NumberofpatientsassistedinaccessingPatientPortal 1,192 2860 2447 1,192• NumberofPCPreferrals 511 2162 2479 511• Numberofreferralstocommunityresources 4,864 4890 5,481 4,864
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,32.4.1: Providea24/7freeresourceviatheNurseHealthLinethatcommunitymembers(uninsuredand
insured)withintheMHHScommunitycancalltodiscusstheirhealthconcerns,receiverecommendationsontheappropriatesettingforcare,andgetconnectedtoappropriateresources
1,2,3
2.4.2: ContinuetoparticipateintheMHERNavigationprograminwhichpatientsarereferredtoamedicalhome(See1.3.1)
1,2,3
2.4.3: Providenursenavigatorforoncologypatients 1,2,32.4.4: Providemedicalsocialworkerforallpatientstohelpthemconnectwithappropriatecare
settingspostdischarge 1,2,3
2.4.7: Providelocalstafftohelppatientslinktothepatientportalandlearnhowtoaccess/useitontheirsmartdevicessotheycanconnectupondischarge
1,2,3
Monitoring/EvaluationApproach:• TrackpatientsvisitedbyPCPCoordinator• PatientactivitydocumentedandreportedwithintheERNavigationelectronicrecordsystem
PotentialPartners:• NeighborhoodHealthCenterNortheast• MemorialHermannCommunityBenefitCorporation
MemorialHermannNortheastHospitalCHNA2019 89
Priority3:BehavioralHealthThefollowingtablesprovidestrategiesandoutcomeindicatorsthatreflectanMHHSsystem-wideapproachtoBehavioralHealth.DataisnotspecifictoMHNortheastHospitalbuttothecommunityatlargewiththeexceptionofreductioninERencountersthatresultinapsychiatricinpatientstaythroughlinkageswithanetworkofbehavioralpartners.
Priority3: BehavioralHealth
Goal3: Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.
Objective3.1: Createnontraditionalaccesspointsaroundthecommunity(crisis/ambulatory,acutecare,andcommunity-basedchroniccaremanagement),andlinkthosewhoneedservicestopermanentprovidersandresourcesinthecommunity
OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target• DecreaseinnumberofERencountersthatresultinpsychiatricinpatient
stay1,146 1,213 1,135 1,089
5%reductionofbaseline
• DecreaseinnumberofERencountersthatresultinpsychiatricinpatientstay–Northeast
108 134 131 103
• NumberofMemorialHermannCrisisClinictotalvisits 5,400 5,590 5,154 5%overbaseline
• NumberofPsychiatricResponseCareManagementtotalvisits 1,200 1,103 1,259 5%overbaseline
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,33.1.1: Providementalhealthassessment,care,andlinkagetoservicesinanacutecaresetting,24x7
atNortheast.Anuptickinacutecarevolumeoverthepastfiscalyearhascontributedtoahighernumberofpsychiatrictransfersoverall.
Anincreaseinacutecarevolumeandnumberofacutecaresitesoverthepastfiscalyearhavecontributedtoahighernumberof
psychiatrictransfersoverall.
1,2,3
MemorialHermannNortheastHospitalCHNA2019 90
Priority3: BehavioralHealth
Goal3: Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.
3.1.2: Createnontraditionalcommunityaccesstopsychiatricprovidersforindividualsexperiencingamentalhealthcrisis.ClinicalSocialWorkersconnectthetargetpopulationtoon-goingbehavioralhealthcare
Recruitingmentalhealthproviders
willingtocommittoanon-traditionalscheduleremainsachallenge.Continuingthisurgentcaremodeloftreatmentremainsapriority,duetolimitedmentalhealth
treatmentaccessinthecommunity.
1,2,3
3.1.3: Engageindividualswithachronicmentalillnessandworktomaintainengagementwithtreatmentandstabilityinthecommunityviaenrollmentincommunity-basedmentalhealthcasemanagementprogram
Staffingissuesimpededyearonetarget.Identifyingappropriatelylicensedclinicianswillingtoconsideracareerthatiscommunity-basedwiththerequirementofmakinghomevisitsandworkingnon–traditionalhoursisanongoingchallenge.
CaseManagerspartnerwiththeirclientstoidentifyspecificrecoverygoalsandutilizeevidence-basedpracticesto
facilitateclientachievement.Wecontinuetopartnerwithcommunity
providerstoaddressthementalhealth
needsoftheGreaterHoustonCommunity.
1,2,3
Monitoring/EvaluationApproach:• EMR/registrationsystem(trackandtrenddaily,weekly,monthly)
MemorialHermannNortheastHospitalCHNA2019 91
Priority3: BehavioralHealth
Goal3: Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.
PotentialPartners:• Systemacutecarecampuses• MHMG• Networkofpublicandprivateproviders
MemorialHermannNortheastHospitalCHNA2019 92
Objective3.2: Reducestigmainordertopromotementalwellnessandimprovecommunityawarenessthatmentalhealthispartofphysicalhealthandoverallwell-being
OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target• Numberofpresentations/educationalsessionsforhealthcareprofessionals
withinMHHS50sessionsperyear 63 71 5%increase
overbaseline• Numberofpresentations/educationalsessionsforcorporations 5 7 8 5%over
baseline• NEManagementandcommunicationwithdisruptivepatients 1training(4hours)
offeredtwotimesperyear
0 0
1training(4hours)offeredtwotimesper
year• TrainingonAcuteCareConcepts-systemnurseresidentprogram
15trainings(45hourstotal/3hourseach)*
18 9
15trainings(45hours
total/3hourseach)*
• TrainingonCMORoundtable-system-wide 1training(2hours)* 0 4 1training(2hours)*
*Totaltimeincludestrainingmaterialdevelopmentandimplementation 531.6
Strategies: Year1Notes Year2Notes Timeline:Year1,2,3
3.2.1: ProvidementalhealtheducationsessionswithintheMHhealthsystemfornursesandphysicians
1,2,3
3.2.2: WorkwithemployersolutionsgrouptoprovideeducationandtrainingwithcorporationsonMHtopics(stress,PTSD)
1,2,3
Monitoring/EvaluationApproach:Requestsforpresentationsandsessionstrackedviacalendar/excel
PotentialPartners:• Systemacutecarecampuses• SystemMarketingandCommunications• Employersolutionsgroup
MemorialHermannNortheastHospitalCHNA2019 93
Objective3.3: Qualityofmentalhealthandsubstanceabuseservices:access,link,andpracticeutilizingevidence-basedpracticetopromoteoverallwellness
OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target• NumberofMemorialHermannCrisisClinicfollow-upspostdischargewith
clinicpatients7,716 6,431 5,154 5%overbaseline
• PsychiatricResponseCaseManagementreductioninsystemERutilization 54.4% 53.0% 50% 5%increaseoverbaseline
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,33.3.1: Socialworkersfollow-upwithdischargedpatientsandtheirfamiliestoassesswell-being
andconnectthemtocommunityresourcesThegoalistocontinuetoeducatethecommunity,includingotherhealthsystems,aboutthecrisiscliniclevelofcaresothatwhensomeoneisexperiencingamentalhealthcrisisorneedsimmediateaccesstoabehavioralhealthprovider,theclinicwillbetheidentifiedreferralsource.
TheSystemhasseenanoverallincreaseinpatientacuitywithcomplexphysicalandbehavioralhealthneedsrequiringhigherlevelsofcare.TheCrisisClinicandPsychResponseCaseManagementProgramscontinuetomeettheneedsofpatientswithbehavioralhealthconditionsbyprovidingimmediateaccesstoamentalhealthprovider.
1,2,3
MemorialHermannNortheastHospitalCHNA2019 94
Priority3: BehavioralHealth
Goal3: Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.
3.3.2: PsychiatricResponseCaseManagementProgramutilizesevidence-basedpracticeinterventions(motivationalinterviewing,MHFirstAid,CAMS,etc.)toreduceERutilizationforprogramenrollees
CaseManagerscontinuetopartnerwithcommunity
agenciesinanefforttoconnectprogram
enrolleestoresourcesfor
ongoingwellness.Programclinicianscontinuetouseevidence-based
practiceinterventionsto
reduceERutilizationandimprovequality
oflife.
1,2,3
Monitoring/EvaluationApproach:• Socialworklogs(Excelspreadsheet)
PotentialPartners:• Systemacutecarecampuses• Community-basedclinicalproviders• Networkofpublicandprivateproviders
MemorialHermannNortheastHospitalCHNA2019 95
AppendixB.SecondaryDataMethodology
SecondaryDataSourcesThemainsourceforthesecondarydata,ordatathathavebeenpreviouslycollected,isthecommunityindicatordatabasemaintainedbyConduentHealthyCommunitiesInstitute.ThefollowingisalistofbothlocalandnationalsourcesusedinMemorialHermannNortheast’sCommunityHealthNeedsAssessment.
HarrisCounty1. AmericanCommunitySurvey2. AmericanLungAssociation3. CentersforMedicare&MedicaidServices4. CountyHealthRankings5. FeedingAmerica6. InstituteforHealthMetricsandEvaluation7. NationalCancerInstitute8. NationalCenterforEducationStatistics9. SmallAreaHealthInsuranceEstimates10. TexasBehavioralRiskFactorSurveillanceSystem11. TexasDepartmentofFamilyandProtectiveServices12. TexasDepartmentofStateHealthServices13. TexasEducationAgency14. TexasSecretaryofState15. U.S.BureauofLaborStatistics16. U.S.Census-CountyBusinessPatterns17. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas18. U.S.EnvironmentalProtectionAgency
LibertyCounty1. AmericanCommunitySurvey2. CentersforMedicare&MedicaidServices3. CountyHealthRankings4. FeedingAmerica5. InstituteforHealthMetricsandEvaluation6. NationalCancerInstitute7. NationalCenterforEducationStatistics8. SmallAreaHealthInsuranceEstimates9. TexasDepartmentofFamilyandProtectiveServices10. TexasDepartmentofStateHealthServices11. TexasEducationAgency12. TexasSecretaryofState13. U.S.BureauofLaborStatistics14. U.S.Census-CountyBusinessPatterns
MemorialHermannNortheastHospitalCHNA2019 96
15. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas16. U.S.EnvironmentalProtectionAgency
MontgomeryCounty1. AmericanCommunitySurvey2. AmericanLungAssociation3. CentersforMedicare&MedicaidServices4. CountyHealthRankings5. FeedingAmerica6. InstituteforHealthMetricsandEvaluation7. NationalCancerInstitute8. NationalCenterforEducationStatistics9. SmallAreaHealthInsuranceEstimates10. TexasDepartmentofFamilyandProtectiveServices11. TexasDepartmentofStateHealthServices12. TexasEducationAgency13. TexasSecretaryofState14. U.S.BureauofLaborStatistics15. U.S.Census-CountyBusinessPatterns16. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas17. U.S.EnvironmentalProtectionAgency
MemorialHermannNortheastHospitalCHNA2019 97
SecondaryDataScoring
Datascoringisdoneinthreestages:
Foreachindicator,eachcountyinMemorialHermannNortheast’sserviceareaisassignedascorebasedonitscomparisontoothercommunities,whetherhealthtargetshavebeenmet,andthetrendoftheindicatorvalueovertime.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariesbyindicatorandisdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.
Indicatorsarecategorizedintotopicareasandeachtopicareareceivesascore.Indicatorsmaybecategorizedinmorethanonetopicarea.Topicscoresaredeterminedbythecomparisonsofallindicatorswithinthetopic.
ComparisontoaDistributionofCountyValues:WithinStateandNation
Foreaseofinterpretationandanalysis,indicatordataontheCommunityDashboardisvisuallyrepresentedasagreen-yellow-redgaugeshowinghowthecommunityisfaringagainstadistributionofcountiesinthestateortheUnitedStates.Adistributioniscreatedbytakingallcountyvalueswithinthestateornation,orderingthemfromlowtohigh,anddividingthemintothreegroups(green,yellow,red)basedontheirorder.Indicatorswiththepoorestcomparisons(“inthered”)scoredhigh,whereasindicatorswithgoodcomparisons(“inthegreen”)scoredlow.
Comparisons • Quantitatively
score all possible comparisons
Indicators • Summarize
comparison scores for each indicator
Topics • Summarize
indicator scores by topic area
MemorialHermannNortheastHospitalCHNA2019 98
ComparisontoValues:State,National,andTargets
Eachcountyiscomparedtothestatevalue,thenationalvalue,andtargetvalues.Targetvaluesincludethenation-wideHealthyPeople2020(HP2020)goals.HealthyPeople2020goalsarenationalobjectivesforimprovingthehealthofthenationsetbytheDepartmentofHealthandHumanServices’(DHHS)HealthyPeopleInitiative.Forallvaluecomparisons,thescoringdependsonwhetherthecountyvalueisbetterorworsethanthecomparisonvalue,aswellashowclosethecountyvalueistothetargetvalue.
TrendOverTime
TheMann-Kendallstatisticaltestfortrendwasusedtoassesswhetherthecountyvalueisincreasingovertimeordecreasingovertime,andwhetherthetrendisstatisticallysignificant.Thetrendcomparisonusesthefourmostrecentcomparablevaluesforthecounty,andstatisticalsignificanceisdeterminedatthe90%confidencelevel.Foreachindicatorwithvaluesavailableforfourtimeperiods,scoringwasdeterminedbydirectionofthetrendandstatisticalsignificance.
MissingValues
Indicatorscoresarecalculatedusingthecomparisonscores,availabilityofwhichdependsonthedatasource.Ifthecomparisontypeispossibleforanadequateproportionofindicatorsonthecommunitydashboard,itwillbeincludedintheindicatorscore.Afterexclusionofcomparisontypeswithinadequateavailability,allmissingcomparisonsaresubstitutedwithaneutralscoreforthepurposesofcalculatingtheindicator’sweightedaverage.Wheninformationisunknownduetolackofcomparabledata,theneutralvalueassumesthatthemissingcomparisonscoreisneithergoodnorbad.
IndicatorScoring
Indicatorscoresarecalculatedasaweightedaverageofallincludedcomparisonscores.Ifnoneoftheincludedcomparisontypesarepossibleforanindicator,noscoreiscalculatedandtheindicatorisexcludedfromthedatascoringresults.
TopicScoring
Indicatorscoresareaveragedbytopicareatocalculatetopicscores.Eachindicatormaybeincludedinuptothreetopicareasifappropriate.Resultingscoresrangefrom0-3,whereahigherscoreindicatesagreaterlevelofneedasevidencedbythedata.Atopicscoreisonlycalculatedifitincludesatleastthreeindicators.
MemorialHermannNortheastHospitalCHNA2019 99
DataScoringResults Thefollowing tableslisteachindicatorbytopicareaforeachofthecountiesinMemorialHermannNortheast’sservicearea.SecondarydataforthisreportareuptodateasofNovember2,2018.
MemorialHermannNortheastHospitalCHNA2019 100
HarrisCounty
SCORE ACCESSTOHEALTHSERVICES UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.00AdultsUnabletoAffordtoSeeaDoctor percent 22.1 18.3 12.1 2015 10
1.81 ChildrenwithHealthInsurance percent 89.4 100 90.3 2016 9
1.75AdultswithHealthInsurance:18-64 percent 74.7 100 77.4 2016 9
1.75 PersonswithHealthInsurance percent 79.3 100 81.4 2016 9
1.61 PrimaryCareProviderRateproviders/100,000
population 57.2 59.9 75.5 2015 4
1.44 MentalHealthProviderRateproviders/100,000
population 103.7 98.8 214.3 2017 4
1.00Non-PhysicianPrimaryCareProviderRate
providers/100,000population 72.2 66.8 81.2 2017 4
0.50 DentistRatedentists/100,000
population 66.3 55.9 67.4 2016 4
SCORE CANCER UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.53 CervicalCancerIncidenceRatecases/100,000
females 11 7.3 9.2 7.5 2011-2015
7
2.25Age-AdjustedDeathRateduetoBreastCancer
deaths/100,000females 23.2 20.7 20.2 20.9 2011-2015 Black 7
1.94 Cancer:MedicarePopulation percent 7.6 7.1 7.8 2015 3
1.58ColonCancerScreening:SigmoidoscopyorColonoscopy percent 57.6 62.3 2016 10
1.53Age-AdjustedDeathRateduetoProstateCancer
deaths/100,000males 19.8 21.8 18.1 19.5 2011-2015 7
1.39 BreastCancerIncidenceRatecases/100,000
females 113.2 111.7 124.7 2011-2015 7
MemorialHermannNortheastHospitalCHNA2019 101
1.33 ProstateCancerIncidenceRatecases/100,000
males 102.5 95.4 109 2011-2015 7
1.22Age-AdjustedDeathRateduetoColorectalCancer
deaths/100,000population 14.6 14.5 14.4 14.5 2011-2015 7
1.00 AllCancerIncidenceRatecases/100,000population 402.6 401.3 441.2 2011-2015 7
0.94Age-AdjustedDeathRateduetoCancer
deaths/100,000population 157.8 161.4 156.4 163.5 2011-2015 Black,Male 7
0.94 ColorectalCancerIncidenceRatecases/100,000population 38.8 39.9 38.1 39.2 2011-2015 7
0.89OralCavityandPharynxCancerIncidenceRate
cases/100,000population 10.9 10.9 11.6 2011-2015 7
0.50LungandBronchusCancerIncidenceRate
cases/100,000population 50.9 53.1 60.2 2011-2015 7
0.33Age-AdjustedDeathRateduetoLungCancer
deaths/100,000population 37.5 45.5 39 43.4 2011-2015 7
SCORE CHILDREN'SHEALTH UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.81 ChildrenwithHealthInsurance percent 89.4 100 90.3 2016 9
1.67 ChildFoodInsecurityRate percent 23.5 23 17.9 2016 5
1.50ChildrenwithLowAccesstoaGroceryStore percent 5.4 2015 17
1.11 SubstantiatedChildAbuseRatecases/1,000children 5.4 8.5 2017 11
SCORE DIABETES UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.67 Diabetes:MedicarePopulation percent 28.1 28.2 26.5 2015
3
1.44 AdultswithDiabetes percent 10.2 11.2 10.5 2016
10
0.92Age-AdjustedDeathRateduetoDiabetes
deaths/100,000population 20.2 21.7 21.2 2010-2014
Black,Hispanic,Male 12
MemorialHermannNortheastHospitalCHNA2019 102
SCORE ECONOMY UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.44 Homeownership percent 49.6 55 55.9 2012-2016 1
2.39 SevereHousingProblems percent 20.9 18.3 18.8 2010-2014 4
2.22StudentsEligiblefortheFreeLunchProgram percent 58.2 52.9 42.6 2015-2016 8
2.14MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage dollars 534 467 462 2012-2016 1
2.11 SNAPCertifiedStoresstores/1,000population 0.6 2016
17
2.08 MedianHouseholdGrossRent dollars 937 911 949 2012-2016
1
2.06FamiliesLivingBelowPovertyLevel percent 14.4 13 11 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other 1
2.06 FoodInsecurityRate percent 16.6 15.4 12.9 2016 5
1.94UnemployedWorkersinCivilianLaborForce percent 4.4 4 4.1 July2018 15
1.89People65+LivingBelowPovertyLevel percent 11.3 10.8 9.3 2012-2016
Asian,BlackorAfricanAmerican,HispanicorLatino,Other,Female,75+ 1
1.81MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1504 1444 1491 2012-2016
1
1.67 ChildFoodInsecurityRate percent 23.5 23 17.9 2016
5
1.67ChildrenLivingBelowPovertyLevel percent 26 23.9 21.2 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other,<6 1
MemorialHermannNortheastHospitalCHNA2019 103
1.67 PeopleLivingBelowPovertyLevel percent 17.4 16.7 15.1 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,Other,Female,<6,6-11,12-17,18-24 1
1.67 TotalEmploymentChange percent 2.4 3.2 2.5 2014-2015 16
1.50RentersSpending30%orMoreofHouseholdIncomeonRent percent 46.8 48 47.3 2012-2016 1
1.42PersonswithDisabilityLivinginPoverty(5-year) percent 25.4 25.1 27.6 2012-2016 1
1.33Low-IncomeandLowAccesstoaGroceryStore percent 6.3 2015 17
1.33PeopleLiving200%AbovePovertyLevel percent 61.6 62.8 66.4 2012-2016 1
1.08 MedianHousingUnitValue dollars 145600 142700 184700 2012-2016 1
0.97PersonswithDisabilityLivinginPoverty percent 22.9 24.2 26.6 2016 1
0.94FemalePopulation16+inCivilianLaborForce percent 59.8 57.7 58.3 2012-2016 1
0.94Population16+inCivilianLaborForce percent 68.3 64.2 63.1 2012-2016 1
0.89HouseholdswithCashPublicAssistanceIncome percent 1.5 1.6 2.7 2012-2016 1
0.67 HomeownerVacancyRate percent 1.5 1.6 1.8 2012-2016 1
0.50 MedianHouseholdIncome dollars 55584 54727 55322 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other 1
0.50 PerCapitaIncome dollars 29850 27828 29829 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican, 1
MemorialHermannNortheastHospitalCHNA2019 104
HispanicorLatino,NativeHawaiianor
OtherPacificIslander,Other,Two
orMoreRaces
SCORE EDUCATION UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.92InfantsBorntoMotherswith<12YearsEducation percent 27.5 21.6 15.9 2013
12
1.89 Student-to-TeacherRatio students/teacher 16.4 15.4 17.7 2015-2016
8
1.67 HighSchoolDropOutRate percent 2.6 2 2016
13
1.67People25+withaHighSchoolDegreeorHigher percent 80.2 82.3 87 2012-2016
Male,35-44,45-64,65+ 1
0.67People25+withaBachelor'sDegreeorHigher percent 30.1 28.1 30.3 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,NativeHawaiianor
OtherPacificIslander,Other,45-
64,65+ 1
SCORE ENVIRONMENT UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.39 SevereHousingProblems percent 20.9 18.3 18.8 2010-2014 4
2.11 SNAPCertifiedStoresstores/1,000population 0.6 2016 17
1.75 AnnualOzoneAirQuality grade F 2014-2016 2
1.69 AnnualParticlePollution grade C 2014-2016 2
1.67 FastFoodRestaurantDensityrestaurants/1,000
population 0.7 2014 17
MemorialHermannNortheastHospitalCHNA2019 105
1.61RecognizedCarcinogensReleasedintoAir pounds 1962916 2017 18
1.50ChildrenwithLowAccesstoaGroceryStore percent 5.4 2015 17
1.50 FarmersMarketDensitymarkets/1,000population 0 2016 17
1.50 GroceryStoreDensitystores/1,000population 0.2 2014 17
1.33Low-IncomeandLowAccesstoaGroceryStore percent 6.3 2015 17
1.33 RecreationandFitnessFacilitiesfacilities/1,000population 0.1 2014 17
1.25 DrinkingWaterViolations percent 1.7 6.6 FY2013-14 4
1.17 PBTReleased pounds 210516 2017 18
1.00 FoodEnvironmentIndex 7.2 6 7.7 2018 4
1.00HouseholdswithNoCarandLowAccesstoaGroceryStore percent 0.9 2015 17
1.00People65+withLowAccesstoaGroceryStore percent 1.4 2015 17
0.89 LiquorStoreDensitystores/100,000population 6.3 6.8 10.5 2015 16
0.67 AccesstoExerciseOpportunities percent 90.4 80.6 83.1 2018 4
0.17 HousesBuiltPriorto1950 percent 6.2 7.4 18.2 2012-2016 1
SCORE EXERCISE,NUTRITION,&WEIGHT UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.17 WorkerswhoWalktoWork percent 1.5 3.1 1.6 2.8 2012-2016 White,non-Hispanic 1
2.11 SNAPCertifiedStoresstores/1,000population 0.6 2016 17
2.06 FoodInsecurityRate percent 16.6 15.4 12.9 2016 5
1.67 Adults(18+Years)WhoAreObese percent 32 30.5 33.6 29.9 2016 10
MemorialHermannNortheastHospitalCHNA2019 106
1.67 ChildFoodInsecurityRate percent 23.5 23 17.9 2016 5
1.67 FastFoodRestaurantDensityrestaurants/1,000
population 0.7 2014 17
1.50AdultswhoareOverweightorObese percent 66.7 68.4 65.2 2016 10
1.50ChildrenwithLowAccesstoaGroceryStore percent 5.4 2015 17
1.50 FarmersMarketDensitymarkets/1,000population 0 2016 17
1.50 GroceryStoreDensitystores/1,000population 0.2 2014 17
1.42AdultFruitandVegetableConsumption percent 18.7 17.2 2015 10
1.33Low-IncomeandLowAccesstoaGroceryStore percent 6.3 2015 17
1.33 RecreationandFitnessFacilitiesfacilities/1,000population 0.1 2014 17
1.00 FoodEnvironmentIndex 7.2 6 7.7 2018 4
1.00HouseholdswithNoCarandLowAccesstoaGroceryStore percent 0.9 2015 17
1.00People65+withLowAccesstoaGroceryStore percent 1.4 2015 17
0.67 AccesstoExerciseOpportunities percent 90.4 80.6 83.1 2018 4
SCORE HEARTDISEASE&STROKE UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.61 Stroke:MedicarePopulation percent 5.2 4.5 4 2015 3
1.89HeartFailure:MedicarePopulation percent 16 15.5 13.5 2015 3
1.50AtrialFibrillation:MedicarePopulation percent 7.3 7.4 8.1 2015 3
1.44 Hyperlipidemia:Medicare percent 43.2 46.1 44.6 2015 3
MemorialHermannNortheastHospitalCHNA2019 107
Population
1.42Age-AdjustedDeathRateduetoCerebrovascularDisease(Stroke)
deaths/100,000population 41.5 34.8 42 37.3 2010-2014 Black 12
1.33IschemicHeartDisease:MedicarePopulation percent 28.8 28.8 26.5 2015
3
1.22Hypertension:MedicarePopulation percent 55.5 57.5 55 2015
3
0.92Age-AdjustedDeathRateduetoHeartDisease
deaths/100,000population 167.6 173 171.9 2010-2014 Black,White,Male 12
SCOREIMMUNIZATIONS&INFECTIOUSDISEASES UNITS
HARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.33 GonorrheaIncidenceRatecases/100,000population 182.1 160.2 2017 12
2.33 SyphilisIncidenceRatecases/100,000population 59.3 40.6 2017 12
2.11 ChlamydiaIncidenceRatecases/100,000population 571.4 511.6 2017 12
1.83 TuberculosisIncidenceRatecases/100,000population 6.6 1 4.5 2013-2017 12
1.78Adults65+withInfluenzaVaccination percent 57.2 57.3 58.6 2016 10
1.67 HIVDiagnosisRatecases/100,000population 26.3 16.1 2016
12
1.17Adults65+withPneumoniaVaccination percent 73.5 90 71.3 73.4 2016
10
1.00Age-AdjustedDeathRateduetoInfluenzaandPneumonia
deaths/100,000population 14 14.2 15.2 2010-2014 Black,Male 12
SCOREMATERNAL,FETAL&INFANTHEALTH UNITS
HARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.36 InfantMortalityRate deaths/1,000live 6.8 6 5.8 6 2013 12
MemorialHermannNortheastHospitalCHNA2019 108
births
1.97MotherswhoReceivedEarlyPrenatalCare percent 56.1 77.9 59.2 74.2 2013 12
1.92InfantsBorntoMotherswith<12YearsEducation percent 27.5 21.6 15.9 2013 12
1.81 BabieswithLowBirthWeight percent 8.6 7.8 8.3 8 2013 12
1.61 BabieswithVeryLowBirthWeight percent 1.5 1.4 1.4 1.4 2013 12
1.25 PretermBirths percent 11.8 9.4 12 11.4 2013 12
0.58 TeenBirths percent 2.5 2.8 4.3 2014 12
SCORE MEN'SHEALTH UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.53Age-AdjustedDeathRateduetoProstateCancer
deaths/100,000males 19.8 21.8 18.1 19.5 2011-2015 7
1.33 ProstateCancerIncidenceRatecases/100,000
males 102.5 95.4 109 2011-2015 7
1.28 LifeExpectancyforMales years 76.4 76.2 76.7 2014 6
SCOREMENTALHEALTH&MENTALDISORDERS UNITS
HARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.89Alzheimer'sDiseaseorDementia:MedicarePopulation percent 11.4 11.7 9.9 2015
3
1.53 PoorMentalHealth:5+Days percent 80 81.5 2016
10
1.50PoorMentalHealth:AverageNumberofDays days 3.7 3.4 3.8 2016 4
1.44 MentalHealthProviderRateproviders/100,000
population 103.7 98.8 214.3 2017 4
1.17 FrequentMentalDistress percent 11.2 10.6 15 2016 4
0.94Age-AdjustedDeathRateduetoSuicide
deaths/100,000population 10.3 10.2 11.7 12.5 2010-2014 White,Male 12
MemorialHermannNortheastHospitalCHNA2019 109
0.94 Depression:MedicarePopulation percent 14.8 17 16.7 2015
3
0.64Age-AdjustedDeathRateduetoAlzheimer'sDisease
deaths/100,000population 17.9 26.6 24.5 2010-2014 White,Female 12
SCORE OLDERADULTS&AGING UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.67ChronicKidneyDisease:MedicarePopulation percent 20.9 19.9 18.1 2015
3
2.61 Stroke:MedicarePopulation percent 5.2 4.5 4 2015
3
2.06Age-AdjustedDeathRateduetoFalls
deaths/100,000population 10.4 7.2 7.4 8.3 2010-2014 White,Male 12
1.94 Cancer:MedicarePopulation percent 7.6 7.1 7.8 2015 3
1.89Alzheimer'sDiseaseorDementia:MedicarePopulation percent 11.4 11.7 9.9 2015 3
1.89HeartFailure:MedicarePopulation percent 16 15.5 13.5 2015 3
1.89People65+LivingBelowPovertyLevel percent 11.3 10.8 9.3 2012-2016
Asian,BlackorAfricanAmerican,HispanicorLatino,Other,Female,75+ 1
1.78Adults65+withInfluenzaVaccination percent 57.2 57.3 58.6 2016 10
1.72Osteoporosis:MedicarePopulation percent 6.3 6.5 6 2015 3
1.67 Diabetes:MedicarePopulation percent 28.1 28.2 26.5 2015 3
1.50AtrialFibrillation:MedicarePopulation percent 7.3 7.4 8.1 2015 3
1.44Hyperlipidemia:MedicarePopulation percent 43.2 46.1 44.6 2015 3
1.44 People65+LivingAlone percent 24.4 23.9 26.4 2012-2016 1
1.33IschemicHeartDisease:MedicarePopulation percent 28.8 28.8 26.5 2015 3
MemorialHermannNortheastHospitalCHNA2019 110
1.22Hypertension:MedicarePopulation percent 55.5 57.5 55 2015 3
1.17Adults65+withPneumoniaVaccination percent 73.5 90 71.3 73.4 2016 10
1.00People65+withLowAccesstoaGroceryStore percent 1.4 2015 17
0.94 Asthma:MedicarePopulation percent 7.3 8.2 8.2 2015 3
0.94 Depression:MedicarePopulation percent 14.8 17 16.7 2015 3
0.94
RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 27.8 31.6 30 2015 3
0.64Age-AdjustedDeathRateduetoAlzheimer'sDisease
deaths/100,000population 17.9 26.6 24.5 2010-2014 White,Female 12
0.39 COPD:MedicarePopulation percent 9.6 11.1 11.2 2015
3
SCORE OTHERCHRONICDISEASES UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.67ChronicKidneyDisease:MedicarePopulation percent 20.9 19.9 18.1 2015 3
1.72Osteoporosis:MedicarePopulation percent 6.3 6.5 6 2015 3
0.94
RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 27.8 31.6 30 2015 3
SCORE PREVENTION&SAFETY UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.39 SevereHousingProblems percent 20.9 18.3 18.8 2010-2014
4
2.06Age-AdjustedDeathRateduetoFalls
deaths/100,000population 10.4 7.2 7.4 8.3 2010-2014 White,Male 12
1.19 DeathRateduetoDrugPoisoningdeaths/100,000
population 10.2 9.8 16.9 2014-2016
4
MemorialHermannNortheastHospitalCHNA2019 111
0.69Age-AdjustedDeathRateduetoUnintentionalInjuries
deaths/100,000population 36.1 36.4 37.6 39.2 2010-2014 White,Male 12
SCORE PUBLICSAFETY UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.17 Alcohol-ImpairedDrivingDeaths percent 37.8 28.3 29.3 2012-2016 4
1.67 ViolentCrimeRatecrimes/100,000
population 713.7 407.6 2012-2014 4
1.11 SubstantiatedChildAbuseRatecases/1,000children 5.4 8.5 2017 11
SCORE RESPIRATORYDISEASES UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.83 TuberculosisIncidenceRatecases/100,000population 6.6 1 4.5 2013-2017 12
1.78Adults65+withInfluenzaVaccination percent 57.2 57.3 58.6 2016 10
1.17Adults65+withPneumoniaVaccination percent 73.5 90 71.3 73.4 2016 10
1.00Age-AdjustedDeathRateduetoInfluenzaandPneumonia
deaths/100,000population 14 14.2 15.2 2010-2014 Black,Male 12
0.94 Asthma:MedicarePopulation percent 7.3 8.2 8.2 2015 3
0.50LungandBronchusCancerIncidenceRate
cases/100,000population 50.9 53.1 60.2 2011-2015 7
0.39 COPD:MedicarePopulation percent 9.6 11.1 11.2 2015 3
0.33Age-AdjustedDeathRateduetoLungCancer
deaths/100,000population 37.5 45.5 39 43.4 2011-2015 7
SCORE SOCIALENVIRONMENT UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.67 MeanTravelTimetoWork minutes 28.6 25.9 26.1 2012-2016 Male 1
MemorialHermannNortheastHospitalCHNA2019 112
2.50 LinguisticIsolation percent 11.8 7.9 4.5 2012-2016 1
2.44 Homeownership percent 49.6 55 55.9 2012-2016 1
2.17 Single-ParentHouseholds percent 36.2 33.3 33.6 2012-2016 1
2.14MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage dollars 534 467 462 2012-2016 1
2.08 MedianHouseholdGrossRent dollars 937 911 949 2012-2016 1
1.81MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1504 1444 1491 2012-2016
1
1.75 PersonswithHealthInsurance percent 79.3 100 81.4 2016
9
1.67ChildrenLivingBelowPovertyLevel percent 26 23.9 21.2 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other,<6 1
1.67People25+withaHighSchoolDegreeorHigher percent 80.2 82.3 87 2012-2016
Male,35-44,45-64,65+ 1
1.67 PeopleLivingBelowPovertyLevel percent 17.4 16.7 15.1 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,Other,Female,<6,6-11,12-17,18-24 1
1.67 TotalEmploymentChange percent 2.4 3.2 2.5 2014-2015 16
1.67VoterTurnout:PresidentialElection percent 58.4 58.8 2016 14
1.44 People65+LivingAlone percent 24.4 23.9 26.4 2012-2016 1
1.11 SubstantiatedChildAbuseRatecases/1,000children 5.4 8.5 2017 11
1.08 MedianHousingUnitValue dollars 145600 142700 184700 2012-2016 1
0.94FemalePopulation16+inCivilianLaborForce percent 59.8 57.7 58.3 2012-2016 1
0.94 Population16+inCivilianLabor percent 68.3 64.2 63.1 2012-2016 1
MemorialHermannNortheastHospitalCHNA2019 113
Force
0.67People25+withaBachelor'sDegreeorHigher percent 30.1 28.1 30.3 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,NativeHawaiianor
OtherPacificIslander,Other,45-
64,65+ 1
0.50 MedianHouseholdIncome dollars 55584 54727 55322 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other 1
0.50 PerCapitaIncome dollars 29850 27828 29829 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,NativeHawaiianor
OtherPacificIslander,Other,Two
orMoreRaces 1
SCORE SUBSTANCEABUSE UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.17 Alcohol-ImpairedDrivingDeaths percent 37.8 28.3 29.3 2012-2016 4
1.50 AdultswhoDrinkExcessively percent 18.1 25.4 19.4 18 2016 4
1.28
Adults(18+Years)ReportingBingeDrinkingWithintheLast12months percent 16.6 24.2 17.9 16.9 2016 10
1.19 DeathRateduetoDrugPoisoningdeaths/100,000
population 10.2 9.8 16.9 2014-2016 4
0.94 AdultswhoSmoke percent 12.1 12 14.3 17.1 2016 10
0.89 LiquorStoreDensitystores/100,000population 6.3 6.8 10.5 2015
16
MemorialHermannNortheastHospitalCHNA2019 114
SCORE TRANSPORTATION UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.83 SoloDriverswithaLongCommute percent 45.8 36.9 34.7 2012-2016
4
2.67 MeanTravelTimetoWork minutes 28.6 25.9 26.1 2012-2016 Male 1
2.17 WorkerswhoWalktoWork percent 1.5 3.1 1.6 2.8 2012-2016 White,non-Hispanic 1
1.44 WorkerswhoDriveAlonetoWork percent 79.1 80.3 76.4 2012-2016
White,non-Hispanic,25-44,55-
59 1
1.33 HouseholdswithoutaVehicle percent 6.4 5.6 9 2012-2016
1
1.28WorkersCommutingbyPublicTransportation percent 2.8 5.5 1.5 5.1 2012-2016
HispanicorLatino,NativeHawaiianor
OtherPacificIslander,Twoor
MoreRaces,White,non-Hispanic,Male,
25-44 1
1.00HouseholdswithNoCarandLowAccesstoaGroceryStore percent 0.9 2015
17
SCORE WELLNESS&LIFESTYLE UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.83Self-ReportedGeneralHealthAssessment:PoororFair percent 18.2 18.2 16 2016 4
1.75 PoorPhysicalHealth:5+Days percent 80.6 81.5 2016 10
1.67 InsufficientSleep percent 33.9 32.7 38 2016 4
1.28 LifeExpectancyforMales years 76.4 76.2 76.7 2014 6
1.17 FrequentPhysicalDistress percent 11.5 10.8 15 2016
4
1.17PoorPhysicalHealth:AverageNumberofDays days 3.6 3.5 3.7 2016
4
MemorialHermannNortheastHospitalCHNA2019 115
1.06 LifeExpectancyforFemales years 81 80.8 81.5 2014
6
SCORE WOMEN'SHEALTH UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.53 CervicalCancerIncidenceRatecases/100,000
females 11 7.3 9.2 7.5 2011-2015 7
2.25Age-AdjustedDeathRateduetoBreastCancer
deaths/100,000females 23.2 20.7 20.2 20.9 2011-2015 Black 7
1.39 BreastCancerIncidenceRatecases/100,000
females 113.2 111.7 124.7 2011-2015 7
1.06 LifeExpectancyforFemales years 81 80.8 81.5 2014 6
MemorialHermannNortheastHospitalCHNA2019 116
LibertyCounty
SCORE ACCESSTOHEALTHSERVICES UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.83 PrimaryCareProviderRateproviders/100,000
population 24 60 76 2015 3
2.61 MentalHealthProviderRateproviders/100,000
population 15 99 214 2017 3
2.00Non-PhysicianPrimaryCareProviderRate
providers/100,000population 39 67 81 2017 3
1.83 DentistRatedentists/100,000
population 27 56 67 2016 3
1.81 ChildrenwithHealthInsurance percent 88.7 100.0 90.3 2016 8
1.75AdultswithHealthInsurance:18-64 percent 75.0 100.0 77.4 2016 8
1.75 PersonswithHealthInsurance percent 79.4 100.0 81.4 2016 8
SCORE CANCER UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.56Age-AdjustedDeathRateduetoLungCancer
deaths/100,000population 63.8 45.5 39.0 43.4 2011-2015 6
2.44OralCavityandPharynxCancerIncidenceRate
cases/100,000population 14.3 10.9 11.6 2011-2015 6
2.42 CervicalCancerIncidenceRatecases/100,000
females 10.7 7.3 9.2 7.5 2011-2015 6
2.33Age-AdjustedDeathRateduetoCancer
deaths/100,000population 196.1 161.4 156.4 163.5 2011-2015 Male 6
2.22LungandBronchusCancerIncidenceRate
cases/100,000population 78.4 53.1 60.2 2011-2015 6
2.17Age-AdjustedDeathRateduetoColorectalCancer
deaths/100,000population 16.0 14.5 14.4 14.5 2011-2015 6
MemorialHermannNortheastHospitalCHNA2019 117
1.86Age-AdjustedDeathRateduetoBreastCancer
deaths/100,000females 22.4 20.7 20.2 20.9 2011-2015 6
1.83 ColorectalCancerIncidenceRatecases/100,000population 41.5 39.9 38.1 39.2 2011-2015 6
1.53Age-AdjustedDeathRateduetoProstateCancer
deaths/100,000males 21.1 21.8 18.1 19.5 2011-2015 6
1.17 AllCancerIncidenceRatecases/100,000population 401.0 401.3 441.2 2011-2015 6
1.06 Cancer:MedicarePopulation percent 6.8 7.1 7.8 2015 2
1.00 BreastCancerIncidenceRatecases/100,000
females 98.4 111.7 124.7 2011-2015 6
0.17 ProstateCancerIncidenceRatecases/100,000
males 75.0 95.4 109.0 2011-2015 6
SCORE CHILDREN'SHEALTH UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.17 ChildFoodInsecurityRate percent 26.0 23.0 17.9 2016 4
1.81 ChildrenwithHealthInsurance percent 88.7 100.0 90.3 2016 8
1.50 SubstantiatedChildAbuseRatecases/1,000children 13.3 8.5 2017 9
1.33ChildrenwithLowAccesstoaGroceryStore percent 4.3 2015 15
SCORE ECONOMY UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.83FemalePopulation16+inCivilianLaborForce percent 39.5 57.7 58.3 2012-2016 1
2.83Population16+inCivilianLaborForce percent 51.3 64.2 63.1 2012-2016 1
MemorialHermannNortheastHospitalCHNA2019 118
2.61UnemployedWorkersinCivilianLaborForce percent 6.1 4.0 4.1 July2018 13
2.50 TotalEmploymentChange percent -3.7 3.2 2.5 2014-2015 14
2.39 FoodInsecurityRate percent 18.7 15.4 12.9 2016 4
2.17 ChildFoodInsecurityRate percent 26.0 23.0 17.9 2016 4
2.11 SevereHousingProblems percent 18.5 18.3 18.8 2010-2014 3
2.11StudentsEligiblefortheFreeLunchProgram percent 55.5 52.9 42.6 2015-2016 7
1.94People65+LivingBelowPovertyLevel percent 10.6 10.8 9.3 2012-2016 TwoorMoreRaces 1
1.92PersonswithDisabilityLivinginPoverty(5-year) percent 28.4 25.1 27.6 2012-2016 1
1.83 PerCapitaIncome dollars 22065 27828 29829 2012-2016
BlackorAfricanAmerican,HispanicorLatino,Other 1
1.81PersonswithDisabilityLivinginPoverty percent 28.0 24.2 26.6 2016 1
1.78 SNAPCertifiedStoresstores/1,000population 0.8 2016 15
1.75 MedianHousingUnitValue dollars 89100 142700 184700 2012-2016 1
1.72FamiliesLivingBelowPovertyLevel percent 12.4 13.0 11.0 2012-2016 HispanicorLatino 1
1.72PeopleLiving200%AbovePovertyLevel percent 60.5 62.8 66.4 2012-2016 1
1.67 PeopleLivingBelowPovertyLevel percent 17.3 16.7 15.1 2012-2016
HispanicorLatino,NativeHawaiianor
OtherPacificIslander 1
1.61HouseholdswithCashPublicAssistanceIncome percent 1.9 1.6 2.7 2012-2016 1
MemorialHermannNortheastHospitalCHNA2019 119
1.50Low-IncomeandLowAccesstoaGroceryStore percent 7.7 2015 15
1.42 MedianHouseholdGrossRent dollars 801 911 949 2012-2016 1
1.39ChildrenLivingBelowPovertyLevel percent 23.3 23.9 21.2 2012-2016 HispanicorLatino 1
1.33 MedianHouseholdIncome dollars 49655 54727 55322 2012-2016
BlackorAfricanAmerican,Hispanic
orLatino 1
1.08MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage dollars 414 467 462 2012-2016 1
0.97MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1160 1444 1491 2012-2016 1
0.83 Homeownership percent 64.8 55.0 55.9 2012-2016 1
0.72RentersSpending30%orMoreofHouseholdIncomeonRent percent 35.1 48.0 47.3 2012-2016 1
0.61 HomeownerVacancyRate percent 1.2 1.6 1.8 2012-2016 1
SCORE EDUCATION UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.39People25+withaBachelor'sDegreeorHigher percent 10.0 28.1 30.3 2012-2016 1
2.06People25+withaHighSchoolDegreeorHigher percent 76.2 82.3 87.0 2012-2016 Other 1
1.97InfantsBorntoMotherswith<12YearsEducation percent 24.2 21.6 15.9 2013 10
1.78 Student-to-TeacherRatio students/teacher 15.4 15.4 17.7 2015-2016 7
MemorialHermannNortheastHospitalCHNA2019 120
1.22 HighSchoolDropOutRate percent 1.7 2.0 2016 11
SCORE ENVIRONMENT UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.17 AccesstoExerciseOpportunities percent 59.5 80.6 83.1 2018 3
2.11 SevereHousingProblems percent 18.5 18.3 18.8 2010-2014 3
1.94 GroceryStoreDensitystores/1,000population 0.1 2014 15
1.83HouseholdswithNoCarandLowAccesstoaGroceryStore percent 3.4 2015 15
1.78 SNAPCertifiedStoresstores/1,000population 0.8 2016 15
1.72 FoodEnvironmentIndex 6.6 6.0 7.7 2018 3
1.67 RecreationandFitnessFacilitiesfacilities/1,000population 0.0 2014 15
1.61RecognizedCarcinogensReleasedintoAir pounds 947 2017 16
1.50 FarmersMarketDensitymarkets/1,000population 0.0 2016 15
1.50Low-IncomeandLowAccesstoaGroceryStore percent 7.7 2015 15
1.39 PBTReleased pounds 0 2017 16
1.33ChildrenwithLowAccesstoaGroceryStore percent 4.3 2015 15
1.33 FastFoodRestaurantDensityrestaurants/1,000
population 0.5 2014 15
1.33People65+withLowAccesstoaGroceryStore percent 2.2 2015 15
0.75 DrinkingWaterViolations percent 0.0 6.6 FY2013-14 3
MemorialHermannNortheastHospitalCHNA2019 121
0.61 LiquorStoreDensitystores/100,000population 3.8 6.8 10.5 2015 14
0.17 HousesBuiltPriorto1950 percent 4.8 7.4 18.2 2012-2016 1
SCOREEXERCISE,NUTRITION,&WEIGHT UNITS
LIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.67 WorkerswhoWalktoWork percent 1.0 3.1 1.6 2.8 2012-2016 1
2.39 FoodInsecurityRate percent 18.7 15.4 12.9 2016 4
2.17 AccesstoExerciseOpportunities percent 59.5 80.6 83.1 2018 3
2.17 ChildFoodInsecurityRate percent 26.0 23.0 17.9 2016 4
1.94 GroceryStoreDensitystores/1,000population 0.1 2014 15
1.83HouseholdswithNoCarandLowAccesstoaGroceryStore percent 3.4 2015 15
1.78 SNAPCertifiedStoresstores/1,000population 0.8 2016 15
1.72 FoodEnvironmentIndex 6.6 6.0 7.7 2018 3
1.67 RecreationandFitnessFacilitiesfacilities/1,000population 0.0 2014 15
1.50 FarmersMarketDensitymarkets/1,000population 0.0 2016 15
1.50Low-IncomeandLowAccesstoaGroceryStore percent 7.7 2015 15
1.33ChildrenwithLowAccesstoaGroceryStore percent 4.3 2015 15
1.33 FastFoodRestaurantDensityrestaurants/1,000
population 0.5 2014 15
1.33People65+withLowAccesstoaGroceryStore percent 2.2 2015 15
MemorialHermannNortheastHospitalCHNA2019 122
SCORE HEARTDISEASE&STROKE UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.50 Stroke:MedicarePopulation percent 5.8 4.5 4.0 2015 2
2.39HeartFailure:MedicarePopulation percent 20.4 15.5 13.5 2015 2
2.14Age-AdjustedDeathRateduetoHeartDisease
deaths/100,000population 257.6 173.0 171.9 2010-2014 Male 10
2.00AtrialFibrillation:MedicarePopulation percent 8.2 7.4 8.1 2015 2
2.00Hyperlipidemia:MedicarePopulation percent 46.0 46.1 44.6 2015 2
2.00IschemicHeartDisease:MedicarePopulation percent 33.2 28.8 26.5 2015 2
1.83Hypertension:MedicarePopulation percent 60.4 57.5 55.0 2015 2
1.75Age-AdjustedDeathRateduetoCerebrovascularDisease(Stroke)
deaths/100,000population 41.1 34.8 42.0 37.3 2010-2014 10
SCOREIMMUNIZATIONS&INFECTIOUSDISEASES UNITS
LIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.33Age-AdjustedDeathRateduetoInfluenzaandPneumonia
deaths/100,000population 20.6 14.2 15.2 2010-2014 10
1.67 SyphilisIncidenceRatecases/100,000population 20.3 40.6 2017 10
1.44 ChlamydiaIncidenceRatecases/100,000population 369.4 511.6 2017 10
1.44 GonorrheaIncidenceRatecases/100,000population 87.3 160.2 2017 10
MemorialHermannNortheastHospitalCHNA2019 123
1.39 TuberculosisIncidenceRatecases/100,000population 2.0 1.0 4.5 2013-2017 10
1.06 HIVDiagnosisRatecases/100,000population 3.7 16.1 2016 10
SCOREMATERNAL,FETAL&INFANTHEALTH UNITS
LIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.36 PretermBirths percent 13.5 9.4 12.0 11.4 2013 10
2.08MotherswhoReceivedEarlyPrenatalCare percent 52.3 77.9 59.2 74.2 2013 10
1.97InfantsBorntoMotherswith<12YearsEducation percent 24.2 21.6 15.9 2013 10
1.75 BabieswithLowBirthWeight percent 8.2 7.8 8.3 8.0 2013 10
1.72BabieswithVeryLowBirthWeight percent 1.5 1.4 1.4 1.4 2013 10
1.31 InfantMortalityRatedeaths/1,000live
births 5.6 6.0 5.8 6.0 2013 10
0.75 TeenBirths percent 2.8 2.8 4.3 2014 10
SCORE MEN'SHEALTH UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.28 LifeExpectancyforMales years 71.6 76.2 76.7 2014 5
1.53Age-AdjustedDeathRateduetoProstateCancer
deaths/100,000males 21.1 21.8 18.1 19.5 2011-2015 6
0.17 ProstateCancerIncidenceRatecases/100,000
males 75.0 95.4 109.0 2011-2015 6
MemorialHermannNortheastHospitalCHNA2019 124
SCOREMENTALHEALTH&MENTALDISORDERS UNITS
LIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.61 MentalHealthProviderRateproviders/100,000
population 15 99 214 2017 3
2.36Age-AdjustedDeathRateduetoAlzheimer'sDisease
deaths/100,000population 38.5 26.6 24.5 2010-2014 10
2.28Age-AdjustedDeathRateduetoSuicide
deaths/100,000population 14.0 10.2 11.7 12.5 2010-2014 10
1.94 Depression:MedicarePopulation percent 17.5 17.0 16.7 2015 2
1.67Alzheimer'sDiseaseorDementia:MedicarePopulation percent 10.9 11.7 9.9 2015 2
1.50 FrequentMentalDistress percent 11.8 10.6 15.0 2016 3
1.50PoorMentalHealth:AverageNumberofDays days 3.8 3.4 3.8 2016 3
SCORE OLDERADULTS&AGING UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.83 Diabetes:MedicarePopulation percent 31.4 28.2 26.5 2015 2
2.67ChronicKidneyDisease:MedicarePopulation percent 20.1 19.9 18.1 2015 2
2.61 Asthma:MedicarePopulation percent 12.2 8.2 8.2 2015 2
2.50 Stroke:MedicarePopulation percent 5.8 4.5 4.0 2015 2
2.39 COPD:MedicarePopulation percent 19.4 11.1 11.2 2015 2
2.39HeartFailure:MedicarePopulation percent 20.4 15.5 13.5 2015 2
2.36Age-AdjustedDeathRateduetoAlzheimer'sDisease
deaths/100,000population 38.5 26.6 24.5 2010-2014 10
MemorialHermannNortheastHospitalCHNA2019 125
2.00AtrialFibrillation:MedicarePopulation percent 8.2 7.4 8.1 2015 2
2.00Hyperlipidemia:MedicarePopulation percent 46.0 46.1 44.6 2015 2
2.00IschemicHeartDisease:MedicarePopulation percent 33.2 28.8 26.5 2015 2
1.94 Depression:MedicarePopulation percent 17.5 17.0 16.7 2015 2
1.94People65+LivingBelowPovertyLevel percent 10.6 10.8 9.3 2012-2016 TwoorMoreRaces 1
1.83Hypertension:MedicarePopulation percent 60.4 57.5 55.0 2015 2
1.67Alzheimer'sDiseaseorDementia:MedicarePopulation percent 10.9 11.7 9.9 2015 2
1.56Age-AdjustedDeathRateduetoFalls
deaths/100,000population 8.0 7.2 7.4 8.3 2010-2014 10
1.44Osteoporosis:MedicarePopulation percent 5.8 6.5 6.0 2015 2
1.44
RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 30.1 31.6 30.0 2015 2
1.33People65+withLowAccesstoaGroceryStore percent 2.2 2015 15
1.06 Cancer:MedicarePopulation percent 6.8 7.1 7.8 2015 2
0.94 People65+LivingAlone percent 23.4 23.9 26.4 2012-2016 1
SCORE OTHERCHRONICDISEASES UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.67ChronicKidneyDisease:MedicarePopulation percent 20.1 19.9 18.1 2015 2
1.44Osteoporosis:MedicarePopulation percent 5.8 6.5 6.0 2015 2
MemorialHermannNortheastHospitalCHNA2019 126
1.44
RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 30.1 31.6 30.0 2015 2
SCORE PREVENTION&SAFETY UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.11 SevereHousingProblems percent 18.5 18.3 18.8 2010-2014 3
2.08Age-AdjustedDeathRateduetoUnintentionalInjuries
deaths/100,000population 63.5 36.4 37.6 39.2 2010-2014 Male 10
1.56Age-AdjustedDeathRateduetoFalls
deaths/100,000population 8.0 7.2 7.4 8.3 2010-2014 10
1.31 DeathRateduetoDrugPoisoningdeaths/100,000
population 12.9 9.8 16.9 2014-2016 3
SCORE PUBLICSAFETY UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.17 ViolentCrimeRatecrimes/100,000
population 433.2 407.6 2012-2014 3
1.50 SubstantiatedChildAbuseRatecases/1,000children 13.3 8.5 2017 9
0.72 Alcohol-ImpairedDrivingDeaths percent 21.8 28.3 29.3 2012-2016 3
SCORE RESPIRATORYDISEASES UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.61 Asthma:MedicarePopulation percent 12.2 8.2 8.2 2015 2
2.56Age-AdjustedDeathRateduetoLungCancer
deaths/100,000population 63.8 45.5 39.0 43.4 2011-2015 6
2.39 COPD:MedicarePopulation percent 19.4 11.1 11.2 2015 2
MemorialHermannNortheastHospitalCHNA2019 127
2.33Age-AdjustedDeathRateduetoInfluenzaandPneumonia
deaths/100,000population 20.6 14.2 15.2 2010-2014 10
2.22LungandBronchusCancerIncidenceRate
cases/100,000population 78.4 53.1 60.2 2011-2015 6
1.39 TuberculosisIncidenceRatecases/100,000population 2.0 1.0 4.5 2013-2017 10
SCORE SOCIALENVIRONMENT UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.83FemalePopulation16+inCivilianLaborForce percent 39.5 57.7 58.3 2012-2016 1
2.83Population16+inCivilianLaborForce percent 51.3 64.2 63.1 2012-2016 1
2.61 MeanTravelTimetoWork minutes 35.6 25.9 26.1 2012-2016 Male 1
2.50 TotalEmploymentChange percent -3.7 3.2 2.5 2014-2015 14
2.39People25+withaBachelor'sDegreeorHigher percent 10.0 28.1 30.3 2012-2016 1
2.06People25+withaHighSchoolDegreeorHigher percent 76.2 82.3 87.0 2012-2016 Other 1
1.83 PerCapitaIncome dollars 22065 27828 29829 2012-2016
BlackorAfricanAmerican,HispanicorLatino,Other 1
1.75 MedianHousingUnitValue dollars 89100 142700 184700 2012-2016 1
1.75 PersonswithHealthInsurance percent 79.4 100.0 81.4 2016 8
1.67 PeopleLivingBelowPovertyLevel percent 17.3 16.7 15.1 2012-2016
HispanicorLatino,NativeHawaiianor
OtherPacificIslander 1
1.50 SubstantiatedChildAbuseRate cases/1,000 13.3 8.5 2017 9
MemorialHermannNortheastHospitalCHNA2019 128
children
1.42 MedianHouseholdGrossRent dollars 801 911 949 2012-2016 1
1.39ChildrenLivingBelowPovertyLevel percent 23.3 23.9 21.2 2012-2016 HispanicorLatino 1
1.33 MedianHouseholdIncome dollars 49655 54727 55322 2012-2016
BlackorAfricanAmerican,Hispanic
orLatino 1
1.33VoterTurnout:PresidentialElection percent 55.3 58.8 2016 12
1.28 LinguisticIsolation percent 3.3 7.9 4.5 2012-2016 1
1.08MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage dollars 414 467 462 2012-2016 1
0.97MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1160 1444 1491 2012-2016 1
0.94 People65+LivingAlone percent 23.4 23.9 26.4 2012-2016 1
0.83 Homeownership percent 64.8 55.0 55.9 2012-2016 1
0.56 Single-ParentHouseholds percent 26.4 33.3 33.6 2012-2016 1
SCORE SUBSTANCEABUSE UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.67 AdultswhoDrinkExcessively percent 19.4 25.4 19.4 18.0 2016 3
1.31 DeathRateduetoDrugPoisoningdeaths/100,000
population 12.9 9.8 16.9 2014-2016 3
0.72 Alcohol-ImpairedDrivingDeaths percent 21.8 28.3 29.3 2012-2016 3
0.61 LiquorStoreDensitystores/100,000population 3.8 6.8 10.5 2015 14
MemorialHermannNortheastHospitalCHNA2019 129
SCORE TRANSPORTATION UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.67WorkerswhoDriveAlonetoWork percent 87.8 80.3 76.4 2012-2016
45-54AmericanIndianorAlaskaNative,Asian 1
2.67 WorkerswhoWalktoWork percent 1.0 3.1 1.6 2.8 2012-2016 1
2.61 MeanTravelTimetoWork minutes 35.6 25.9 26.1 2012-2016 Male 1
2.61SoloDriverswithaLongCommute percent 58.7 36.9 34.7 2012-2016 3
2.06WorkersCommutingbyPublicTransportation percent 0.2 5.5 1.5 5.1 2012-2016 1
1.83HouseholdswithNoCarandLowAccesstoaGroceryStore percent 3.4 2015 15
1.50 HouseholdswithoutaVehicle percent 5.5 5.6 9.0 2012-2016 1
SCORE WELLNESS&LIFESTYLE UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.28 LifeExpectancyforFemales years 76.8 80.8 81.5 2014 5
2.28 LifeExpectancyforMales years 71.6 76.2 76.7 2014 5
1.83Self-ReportedGeneralHealthAssessment:PoororFair percent 18.2 18.2 16.0 2016 3
1.50 FrequentPhysicalDistress percent 11.8 10.8 15.0 2016 3
1.50PoorPhysicalHealth:AverageNumberofDays days 3.8 3.5 3.7 2016 3
1.17 InsufficientSleep percent 32.7 32.7 38.0 2016 3
MemorialHermannNortheastHospitalCHNA2019 130
SCORE WOMEN'SHEALTH UNITSLIBERTYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.42 CervicalCancerIncidenceRatecases/100,000
females 10.7 7.3 9.2 7.5 2011-2015 6
2.28 LifeExpectancyforFemales years 76.8 80.8 81.5 2014 5
1.86Age-AdjustedDeathRateduetoBreastCancer
deaths/100,000females 22.4 20.7 20.2 20.9 2011-2015 6
1.00 BreastCancerIncidenceRatecases/100,000
females 98.4 111.7 124.7 2011-2015 6
MontgomeryCounty
SCORE ACCESSTOHEALTHSERVICES UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.00 MentalHealthProviderRateproviders/100,000
population 69 99 214 2017 4
1.67Non-PhysicianPrimaryCareProviderRate
providers/100,000population 55 67 81 2017 4
1.56 DentistRatedentists/100,000
population 46 56 67 2016 4
1.53 ChildrenwithHealthInsurance percent 90.2 100.0 90.3 2016 9
1.47AdultswithHealthInsurance:18-64 percent 79.7 100.0 77.4 2016 9
1.47 PersonswithHealthInsurance percent 83.1 100.0 81.4 2016 9
1.22 PrimaryCareProviderRateproviders/100,000
population 62 60 76 2015 4
SCORE CANCER UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.72 Cancer:MedicarePopulation percent 7.8 7.1 7.8 2015 3
MemorialHermannNortheastHospitalCHNA2019 131
1.58 CervicalCancerIncidenceRatecases/100,000
females 8.0 7.3 9.2 7.5 2011-2015 7
1.56OralCavityandPharynxCancerIncidenceRate
cases/100,000population 12.2 10.9 11.6 2011-2015 7
1.33 BreastCancerIncidenceRatecases/100,000
females 117.6 111.7 124.7 2011-2015 7
1.19Age-AdjustedDeathRateduetoProstateCancer
deaths/100,000males 17.8 21.8 18.1 19.5 2011-2015 7
1.08Age-AdjustedDeathRateduetoBreastCancer
deaths/100,000females 19.6 20.7 20.2 20.9 2011-2015 7
0.94Age-AdjustedDeathRateduetoLungCancer
deaths/100,000population 42.4 45.5 39.0 43.4 2011-2015 7
0.83 AllCancerIncidenceRatecases/100,000population 398.9 401.3 441.2 2011-2015 7
0.83LungandBronchusCancerIncidenceRate
cases/100,000population 56.4 53.1 60.2 2011-2015 7
0.78Age-AdjustedDeathRateduetoColorectalCancer
deaths/100,000population 14.4 14.5 14.4 14.5 2011-2015 7
0.67 ColorectalCancerIncidenceRatecases/100,000population 36.6 39.9 38.1 39.2 2011-2015 7
0.67 ProstateCancerIncidenceRatecases/100,000
males 88.7 95.4 109.0 2011-2015 7
0.61Age-AdjustedDeathRateduetoCancer
deaths/100,000population 156.0 161.4 156.4 163.5 2011-2015 Male 7
SCORE CHILDREN'SHEALTH UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.67ChildrenwithLowAccesstoaGroceryStore percent 5.6 2015 16
1.53 ChildrenwithHealthInsurance percent 90.2 100.0 90.3 2016 9
MemorialHermannNortheastHospitalCHNA2019 132
1.17 ChildFoodInsecurityRate percent 21.2 23.0 17.9 2016 5
1.11 SubstantiatedChildAbuseRatecases/1,000children 5.5 8.5 2017 10
SCORE ECONOMY UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.58 MedianHouseholdGrossRent dollars 1077 911 949 2012-2016 1
2.58MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage dollars 531 467 462 2012-2016 1
2.19MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1635 1444 1491 2012-2016 1
2.00FemalePopulation16+inCivilianLaborForce percent 53.6 57.7 58.3 2012-2016 1
1.89 SNAPCertifiedStoresstores/1,000population 0.5 2016 16
1.50Population16+inCivilianLaborForce percent 63.7 64.2 63.1 2012-2016 1
1.33 FoodInsecurityRate percent 14.6 15.4 12.9 2016 5
1.33Low-IncomeandLowAccesstoaGroceryStore percent 5.9 2015 16
1.28 SevereHousingProblems percent 16.0 18.3 18.8 2010-2014 4
1.28UnemployedWorkersinCivilianLaborForce percent 3.8 4.0 4.1 July2018 14
1.17 ChildFoodInsecurityRate percent 21.2 23.0 17.9 2016 5
1.06RentersSpending30%orMoreofHouseholdIncomeonRent percent 39.4 48.0 47.3 2012-2016 1
1.00 TotalEmploymentChange percent 3.5 3.2 2.5 2014-2015 15
MemorialHermannNortheastHospitalCHNA2019 133
0.86PersonswithDisabilityLivinginPoverty percent 17.9 24.2 26.6 2016 1
0.78People65+LivingBelowPovertyLevel percent 7.7 10.8 9.3 2012-2016
BlackorAfricanAmerican,HispanicorLatino,Other 1
0.75PersonswithDisabilityLivinginPoverty(5-year) percent 19.1 25.1 27.6 2012-2016 1
0.61 Homeownership percent 65.6 55.0 55.9 2012-2016 1
0.58 MedianHousingUnitValue dollars 190000 142700 184700 2012-2016 1
0.56FamiliesLivingBelowPovertyLevel percent 8.3 13.0 11.0 2012-2016
BlackorAfricanAmerican,HispanicorLatino,Other 1
0.56HouseholdswithCashPublicAssistanceIncome percent 1.1 1.6 2.7 2012-2016 1
0.56PeopleLiving200%AbovePovertyLevel percent 73.0 62.8 66.4 2012-2016 1
0.56StudentsEligiblefortheFreeLunchProgram percent 35.1 52.9 42.6 2015-2016 8
0.39 MedianHouseholdIncome dollars 70805 54727 55322 2012-2016
BlackorAfricanAmerican,HispanicorLatino,Other,
TwoorMoreRaces 1
0.17ChildrenLivingBelowPovertyLevel percent 14.8 23.9 21.2 2012-2016
HispanicorLatino,Other 1
0.17 HomeownerVacancyRate percent 1.2 1.6 1.8 2012-2016 1
0.17 PeopleLivingBelowPovertyLevel percent 11.0 16.7 15.1 2012-2016
12-17,18-24,6-11,<6BlackorAfricanAmerican,HispanicorLatino,Other 1
0.17 PerCapitaIncome dollars 35912 27828 29829 2012-2016
AmericanIndianorAlaskaNative,Black
orAfricanAmerican,Hispanic 1
MemorialHermannNortheastHospitalCHNA2019 134
orLatino,Other,TwoorMoreRaces
SCORE EDUCATION UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.89 Student-to-TeacherRatio students/teacher 16.2 15.4 17.7 2015-2016 8
1.22People25+withaHighSchoolDegreeorHigher percent 86.8 82.3 87.0 2012-2016
AmericanIndianorAlaskaNative 1
1.08InfantsBorntoMotherswith<12YearsEducation percent 17.6 21.6 15.9 2013 11
1.00 HighSchoolDropOutRate percent 0.9 2.0 2016 12
0.33People25+withaBachelor'sDegreeorHigher percent 33.0 28.1 30.3 2012-2016
25-34,65+AmericanIndianor
AlaskaNative,Other,TwoorMore
Races 1
SCORE ENVIRONMENT UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.89 SNAPCertifiedStoresstores/1,000population 0.5 2016 16
1.83 GroceryStoreDensitystores/1,000population 0.1 2014 16
1.75 AnnualOzoneAirQuality grade F 2014-2016 2
1.67ChildrenwithLowAccesstoaGroceryStore percent 5.6 2015 16
1.50 FarmersMarketDensitymarkets/1,000population 0.0 2016 16
1.50 FastFoodRestaurantDensityrestaurants/1,000
population 0.6 2014 16
MemorialHermannNortheastHospitalCHNA2019 135
1.39RecognizedCarcinogensReleasedintoAir pounds 16762 2017 17
1.33Low-IncomeandLowAccesstoaGroceryStore percent 5.9 2015 16
1.33People65+withLowAccesstoaGroceryStore percent 2.5 2015 16
1.33 RecreationandFitnessFacilitiesfacilities/1,000population 0.1 2014 16
1.28 SevereHousingProblems percent 16.0 18.3 18.8 2010-2014 4
1.25 DrinkingWaterViolations percent 1.7 6.6 FY2013-14 4
1.22 FoodEnvironmentIndex 7.5 6.0 7.7 2018 4
1.17HouseholdswithNoCarandLowAccesstoaGroceryStore percent 1.5 2015 16
1.00 AccesstoExerciseOpportunities percent 82.7 80.6 83.1 2018 4
0.67 LiquorStoreDensitystores/100,000population 6.3 6.8 10.5 2015 15
0.39 HousesBuiltPriorto1950 percent 1.2 7.4 18.2 2012-2016 1
SCOREEXERCISE,NUTRITION,&WEIGHT UNITS
MONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.78 WorkerswhoWalktoWork percent 1.0 3.1 1.6 2.8 2012-2016 1
1.89 SNAPCertifiedStoresstores/1,000population 0.5 2016 16
1.83 GroceryStoreDensitystores/1,000population 0.1 2014 16
1.67ChildrenwithLowAccesstoaGroceryStore percent 5.6 2015 16
1.50 FarmersMarketDensitymarkets/1,000population 0.0 2016 16
MemorialHermannNortheastHospitalCHNA2019 136
1.50 FastFoodRestaurantDensityrestaurants/1,000
population 0.6 2014 16
1.33 FoodInsecurityRate percent 14.6 15.4 12.9 2016 5
1.33Low-IncomeandLowAccesstoaGroceryStore percent 5.9 2015 16
1.33People65+withLowAccesstoaGroceryStore percent 2.5 2015 16
1.33 RecreationandFitnessFacilitiesfacilities/1,000population 0.1 2014 16
1.22 FoodEnvironmentIndex 7.5 6.0 7.7 2018 4
1.17 ChildFoodInsecurityRate percent 21.2 23.0 17.9 2016 5
1.17HouseholdswithNoCarandLowAccesstoaGroceryStore percent 1.5 2015 16
1.00 AccesstoExerciseOpportunities percent 82.7 80.6 83.1 2018 4
SCORE HEARTDISEASE&STROKE UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.44AtrialFibrillation:MedicarePopulation percent 8.8 7.4 8.1 2015 3
2.28 Stroke:MedicarePopulation percent 4.6 4.5 4.0 2015 3
1.94Hyperlipidemia:MedicarePopulation percent 46.3 46.1 44.6 2015 3
1.61Hypertension:MedicarePopulation percent 56.0 57.5 55.0 2015 3
1.25Age-AdjustedDeathRateduetoCerebrovascularDisease(Stroke)
deaths/100,000population 38.5 34.8 42.0 37.3 2010-2014 11
MemorialHermannNortheastHospitalCHNA2019 137
1.25Age-AdjustedDeathRateduetoHeartDisease
deaths/100,000population 173.2 173.0 171.9 2010-2014 MaleBlack 11
1.22HeartFailure:MedicarePopulation percent 14.6 15.5 13.5 2015 3
1.17IschemicHeartDisease:MedicarePopulation percent 28.6 28.8 26.5 2015 3
SCOREIMMUNIZATIONS&INFECTIOUSDISEASES UNITS
MONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.67 SyphilisIncidenceRatecases/100,000population 13.1 40.6 2017 11
1.50 ChlamydiaIncidenceRatecases/100,000population 265.4 511.6 2017 11
1.44 HIVDiagnosisRatecases/100,000population 7.7 16.1 2016 11
1.39 TuberculosisIncidenceRatecases/100,000population 1.8 1.0 4.5 2013-2017 11
1.28 GonorrheaIncidenceRatecases/100,000population 52.4 160.2 2017 11
0.67Age-AdjustedDeathRateduetoInfluenzaandPneumonia
deaths/100,000population 10.8 14.2 15.2 2010-2014 11
SCOREMATERNAL,FETAL&INFANTHEALTH UNITS
MONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.75MotherswhoReceivedEarlyPrenatalCare percent 60.7 77.9 59.2 74.2 2013 11
1.08InfantsBorntoMotherswith<12YearsEducation percent 17.6 21.6 15.9 2013 11
0.83BabieswithVeryLowBirthWeight percent 1.1 1.4 1.4 1.4 2013 11
MemorialHermannNortheastHospitalCHNA2019 138
0.75 PretermBirths percent 10.4 9.4 12.0 11.4 2013 11
0.47 BabieswithLowBirthWeight percent 6.6 7.8 8.3 8.0 2013 11
0.47 InfantMortalityRatedeaths/1,000live
births 4.5 6.0 5.8 6.0 2013 11
0.42 TeenBirths percent 2.0 2.8 4.3 2014 11
SCORE MEN'SHEALTH UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.19Age-AdjustedDeathRateduetoProstateCancer
deaths/100,000males 17.8 21.8 18.1 19.5 2011-2015 7
1.00 LifeExpectancyforMales years 76.7 76.2 76.7 2014 6
0.67 ProstateCancerIncidenceRatecases/100,000
males 88.7 95.4 109.0 2011-2015 7
SCOREMENTALHEALTH&MENTALDISORDERS UNITS
MONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.28Age-AdjustedDeathRateduetoSuicide
deaths/100,000population 14.6 10.2 11.7 12.5 2010-2014 Male 11
2.00 MentalHealthProviderRateproviders/100,000
population 69 99 214 2017 4
1.67Alzheimer'sDiseaseorDementia:MedicarePopulation percent 10.7 11.7 9.9 2015 3
1.28 Depression:MedicarePopulation percent 15.9 17.0 16.7 2015 3
0.67 FrequentMentalDistress percent 10.2 10.6 15.0 2016 4
0.67PoorMentalHealth:AverageNumberofDays days 3.3 3.4 3.8 2016 4
MemorialHermannNortheastHospitalCHNA2019 139
0.64Age-AdjustedDeathRateduetoAlzheimer'sDisease
deaths/100,000population 18.8 26.6 24.5 2010-2014 11
SCORE OLDERADULTS&AGING UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.44AtrialFibrillation:MedicarePopulation percent 8.8 7.4 8.1 2015 3
2.28 Stroke:MedicarePopulation percent 4.6 4.5 4.0 2015 3
2.00ChronicKidneyDisease:MedicarePopulation percent 18.3 19.9 18.1 2015 3
1.94Hyperlipidemia:MedicarePopulation percent 46.3 46.1 44.6 2015 3
1.72 Cancer:MedicarePopulation percent 7.8 7.1 7.8 2015 3
1.67Alzheimer'sDiseaseorDementia:MedicarePopulation percent 10.7 11.7 9.9 2015 3
1.61Hypertension:MedicarePopulation percent 56.0 57.5 55.0 2015 3
1.39 COPD:MedicarePopulation percent 11.7 11.1 11.2 2015 3
1.33People65+withLowAccesstoaGroceryStore percent 2.5 2015 16
1.33
RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 28.5 31.6 30.0 2015 3
1.28 Asthma:MedicarePopulation percent 7.7 8.2 8.2 2015 3
1.28 Depression:MedicarePopulation percent 15.9 17.0 16.7 2015 3
1.22HeartFailure:MedicarePopulation percent 14.6 15.5 13.5 2015 3
1.22Osteoporosis:MedicarePopulation percent 5.8 6.5 6.0 2015 3
MemorialHermannNortheastHospitalCHNA2019 140
1.17IschemicHeartDisease:MedicarePopulation percent 28.6 28.8 26.5 2015 3
0.94 Diabetes:MedicarePopulation percent 24.8 28.2 26.5 2015 3
0.78People65+LivingBelowPovertyLevel percent 7.7 10.8 9.3 2012-2016
BlackorAfricanAmerican,HispanicorLatino,Other 1
0.64Age-AdjustedDeathRateduetoAlzheimer'sDisease
deaths/100,000population 18.8 26.6 24.5 2010-2014 11
0.50Age-AdjustedDeathRateduetoFalls
deaths/100,000population 5.1 7.2 7.4 8.3 2010-2014 11
0.50 People65+LivingAlone percent 21.5 23.9 26.4 2012-2016 1
SCORE OTHERCHRONICDISEASES UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.00ChronicKidneyDisease:MedicarePopulation percent 18.3 19.9 18.1 2015 3
1.33
RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 28.5 31.6 30.0 2015 3
1.22Osteoporosis:MedicarePopulation percent 5.8 6.5 6.0 2015 3
SCORE PREVENTION&SAFETY UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.28 SevereHousingProblems percent 16.0 18.3 18.8 2010-2014 4
1.08 DeathRateduetoDrugPoisoningdeaths/100,000
population 10.6 9.8 16.9 2014-2016 4
0.53Age-AdjustedDeathRateduetoUnintentionalInjuries
deaths/100,000population 34.1 36.4 37.6 39.2 2010-2014 Male 11
MemorialHermannNortheastHospitalCHNA2019 141
0.50Age-AdjustedDeathRateduetoFalls
deaths/100,000population 5.1 7.2 7.4 8.3 2010-2014 11
SCORE PUBLICSAFETY UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.06 Alcohol-ImpairedDrivingDeaths percent 32.9 28.3 29.3 2012-2016 4
1.11 SubstantiatedChildAbuseRatecases/1,000children 5.5 8.5 2017 10
0.83 ViolentCrimeRatecrimes/100,000
population 171.2 407.6 2012-2014 4
SCORE RESPIRATORYDISEASES UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.39 COPD:MedicarePopulation percent 11.7 11.1 11.2 2015 3
1.39 TuberculosisIncidenceRatecases/100,000population 1.8 1.0 4.5 2013-2017 11
1.28 Asthma:MedicarePopulation percent 7.7 8.2 8.2 2015 3
0.94Age-AdjustedDeathRateduetoLungCancer
deaths/100,000population 42.4 45.5 39.0 43.4 2011-2015 7
0.83LungandBronchusCancerIncidenceRate
cases/100,000population 56.4 53.1 60.2 2011-2015 7
0.67Age-AdjustedDeathRateduetoInfluenzaandPneumonia
deaths/100,000population 10.8 14.2 15.2 2010-2014 11
SCORE SOCIALENVIRONMENT UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.61 MeanTravelTimetoWork minutes 32.5 25.9 26.1 2012-2016 Male 1
2.58 MedianHouseholdGrossRent dollars 1077 911 949 2012-2016 1
MemorialHermannNortheastHospitalCHNA2019 142
2.58MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage dollars 531 467 462 2012-2016 1
2.19MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1635 1444 1491 2012-2016 1
2.00FemalePopulation16+inCivilianLaborForce percent 53.6 57.7 58.3 2012-2016 1
1.50Population16+inCivilianLaborForce percent 63.7 64.2 63.1 2012-2016 1
1.47 PersonswithHealthInsurance percent 83.1 100.0 81.4 2016 9
1.22People25+withaHighSchoolDegreeorHigher percent 86.8 82.3 87.0 2012-2016
AmericanIndianorAlaskaNative 1
1.11 SubstantiatedChildAbuseRatecases/1,000children 5.5 8.5 2017 10
1.00 TotalEmploymentChange percent 3.5 3.2 2.5 2014-2015 15
0.83 LinguisticIsolation percent 3.7 7.9 4.5 2012-2016 1
0.67VoterTurnout:PresidentialElection percent 65.5 58.8 2016 13
0.61 Homeownership percent 65.6 55.0 55.9 2012-2016 1
0.58 MedianHousingUnitValue dollars 190000 142700 184700 2012-2016 1
0.50 People65+LivingAlone percent 21.5 23.9 26.4 2012-2016 1
0.39 MedianHouseholdIncome dollars 70805 54727 55322 2012-2016
BlackorAfricanAmerican,HispanicorLatino,Other,
TwoorMoreRaces 1
0.39 Single-ParentHouseholds percent 23.8 33.3 33.6 2012-2016 1
0.33People25+withaBachelor'sDegreeorHigher percent 33.0 28.1 30.3 2012-2016
25-34,65+AmericanIndianor
AlaskaNative,Other,TwoorMore 1
MemorialHermannNortheastHospitalCHNA2019 143
Races
0.17ChildrenLivingBelowPovertyLevel percent 14.8 23.9 21.2 2012-2016
HispanicorLatino,Other 1
0.17 PeopleLivingBelowPovertyLevel percent 11.0 16.7 15.1 2012-2016
12-17,18-24,6-11,<6BlackorAfricanAmerican,HispanicorLatino,Other 1
0.17 PerCapitaIncome dollars 35912 27828 29829 2012-2016
AmericanIndianorAlaskaNative,Black
orAfricanAmerican,HispanicorLatino,Other,
TwoorMoreRaces 1
SCORE SUBSTANCEABUSE UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.17 AdultswhoDrinkExcessively percent 21.0 25.4 19.4 18.0 2016 4
2.06 Alcohol-ImpairedDrivingDeaths percent 32.9 28.3 29.3 2012-2016 4
1.08 DeathRateduetoDrugPoisoningdeaths/100,000
population 10.6 9.8 16.9 2014-2016 4
0.67 LiquorStoreDensitystores/100,000population 6.3 6.8 10.5 2015 15
SCORE TRANSPORTATION UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.78 WorkerswhoWalktoWork percent 1.0 3.1 1.6 2.8 2012-2016 1
2.61 MeanTravelTimetoWork minutes 32.5 25.9 26.1 2012-2016 Male 1
2.61SoloDriverswithaLongCommute percent 49.9 36.9 34.7 2012-2016 4
MemorialHermannNortheastHospitalCHNA2019 144
2.17WorkerswhoDriveAlonetoWork percent 81.5 80.3 76.4 2012-2016 1
1.67WorkersCommutingbyPublicTransportation percent 1.3 5.5 1.5 5.1 2012-2016 16-19,20-24Other 1
1.17HouseholdswithNoCarandLowAccesstoaGroceryStore percent 1.5 2015 16
0.50 HouseholdswithoutaVehicle percent 3.6 5.6 9.0 2012-2016 1
SCORE WELLNESS&LIFESTYLE UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.39 LifeExpectancyforFemales years 80.7 80.8 81.5 2014 6
1.17 InsufficientSleep percent 31.8 32.7 38.0 2016 4
1.00 LifeExpectancyforMales years 76.7 76.2 76.7 2014 6
0.67 FrequentPhysicalDistress percent 9.9 10.8 15.0 2016 4
0.67PoorPhysicalHealth:AverageNumberofDays days 3.3 3.5 3.7 2016 4
0.67Self-ReportedGeneralHealthAssessment:PoororFair percent 14.1 18.2 16.0 2016 4
SCORE WOMEN'SHEALTH UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.58 CervicalCancerIncidenceRatecases/100,000
females 8.0 7.3 9.2 7.5 2011-2015 7
1.39 LifeExpectancyforFemales years 80.7 80.8 81.5 2014 6
1.33 BreastCancerIncidenceRatecases/100,000
females 117.6 111.7 124.7 2011-2015 7
MemorialHermannNortheastHospitalCHNA2019 145
1.08Age-AdjustedDeathRateduetoBreastCancer
deaths/100,000females 19.6 20.7 20.2 20.9 2011-2015 7
MemorialHermannNortheastHospitalCHNA2019146
AppendixC.PrimaryDataMethodology
CommunityInputParticipantsAccessHealth(FQHC)(FortBendFamilyHealthCenter)AIDSFoundationofHoustonAssociationfortheAdvancementofMexicanAmericansAvenueCDCCatholicCharities-ArchdioceseofGalvestonCatholicCharities-FortBendChildAdvocatesofFortBendChildrenatRiskChristClinicCityofHouston,DepartmentofParksandRecreationCoastalAreaHealthEducationCenters(AHEC)CommunityHealthChoiceElCentrodeCorazonEpiscopalHealthFoundationFortBendCountyHealthandHumanServicesFortBendCountySheriff'sOfficeFortBendRegionalCouncilOnSubstanceAbuseFortBendSeniorsMealsonWheelsFortBendWomen'sCenterGalvestonCountyHealthDistrictGalvestonCountyMentalHealthDeputiesGreaterHoustonPartnershipGreaterHoustonWomen'sChamberofCommerce
GulfCoastMedicalFoundationHarrisCountyPublicHealthHealthcarefortheHomeless-HoustonHOPEClinic(FQHC)HoustonFoodBankHoustonHealthDepartmentHoustonHousingAuthorityHoustonIndependentSchoolDistrictInterfaithCommunityClinicKinderInstituteLegacyCommunityHealthLibertyCountySheriff'sOfficeLoneStarFamilyHealthCenterMidtownArtsandTheaterCenterHoustonMontgomeryCountyWomen'sCenterBaker-RipleyEarlyHeadStartPatientCareInterventionCenter(PCIC)PrairieViewA&MUniversitySantaMariaHostel,Inc.TheArcofFortBendCountyTheHarrisCenterforMentalHealthandIDD(formerlyMHMRA)TheRoseTheWomen'sHomeTri-CountyServicesBehavioralHealthcareUnitedWayofBrazoriaCountyUnitedWayofGreaterHoustonUnitedWayofHarrisandMontgomeryCountyWestChambersMedicalCenter(FQHC)YMCAofGreaterHouston
MemorialHermannNortheastHospitalCHNA2019147
KeyInformantInterviewQuestionnaire(EpiscopalHealthFoundation)• Goodmorning/afternoon[NAMEOFINFORMANT].Mynameis[NAMEOFINTERVIEWER],
andIamwithHealthResourcesinAction,anon-profitpublichealthorganizationbasedinBoston.Thankyouforspeakingwithmetoday.
• Aswementionedinourinterviewinvitation,theEpiscopalHealthFoundationis
coordinatinganinterviewinitiativetosupportfourGreaterHoustonareahospitalsystemsinpreparingtheircommunityhealthneedsassessments.ThecollaboratinghospitalsincludeCHISt.Luke’s,HoustonMethodistHospital,MemorialHermannHealthSystem,andTexasChildren’sHospital.
• Thepurposeofthisinterviewistogainagreaterunderstandingofthehealthstatusand
wellbeingofresidentsintheGreaterHoustonareaanddeterminehowthesehealthneedsarecurrentlybeingaddressed.Interviewslikethisonearebeingconductedwithabout70stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Wearealsointerviewingcommunityleaderswithspecificexperienceworkingwithprioritypopulationssuchaswomen,children,peopleofcolor,andthedisabledtonameafew.
• Weareinterestedinhearingpeople’sfeedbackontheneedsofthebroaderGreater
Houstoncommunityandthepopulationsyouworkwithasaleaderinyourcommunity.TheFoundationandthefourhospitalswelcomeyourcriticalfeedbackandsuggestionsforhealthimprovementactivitiesinthefuture.Yourhonestyduringtoday’sinterviewisencouragedandappreciated.
• Aswementionedinourinterviewinvitation,theinterviewwilllastbetween45minutesto
anhouranditwillberecorded.Afteralltheinterviewsarecompleted,HealthResourcesinActionwillprovideatranscriptofyourinterviewtothefourhospitalsforuseinpreparingtheircommunityhealthneedsassessmentreports.Eachhospitalwillkeepyourinterviewtranscriptconfidentialandaccessibleonlytotheteamthatispreparingthecommunityhealthneedsassessmentreport.HealthResourcesinActionwillalsobepreparingareportofthegeneralthemesthatemergeacrossalltheinterviewstohelpthehospitalspreparetheirreports.
• TheFoundationhasaskedHealthResourcesinActiontoaskallintervieweeshowtheywish
anyquotesfromtoday’sinterviewtobepresentedinreports.Therearethreeoptions.Quotesmaybepresentedanonymouslywithoutyournameororganization,presentedwithyournameandorganization,orpresentedwithonlythesectoryourepresent.Whichoptionwouldyouliketochoose?
• RECORDRESPONSEFROMINTERVIEWEE:rAnonymousrNameandorganizationrSector
• Thankyou.Wewillnoteyourchoiceinthetranscriptthatweprovidetothehospitals.
MemorialHermannNortheastHospitalCHNA2019148
• IFTHERESPONDENTISUNSUREATTHETIMEOFTHEINTERVIEW:Ok,pleasefeelfreetothinkitoverandwewillfollowupwithyouforyourdecisionbeforewesendthetranscripttothehospitals.
• Doyouhaveanyquestionsbeforewebegin?BEGINRECORDINGTHEINTERVIEW
INTERVIEWQUESTIONNAIRE(55MINUTES)
NOTESTOINTERVIEWER:• INTERVIEWQUESTIONSMAYBEADDEDORTAILOREDTOMEETTHESPECIFIC
POSITION/ROLEOFTHEINTERVIEWEE• THEQUESTIONSINTHEINTERVIEWQUESTIONNAIREAREINTENDEDTOSERVEASAGUIDE,
NOTASCRIPTBACKGROUND(5MINUTES)• Canyoutellmealittlebitaboutyourroleatyourorganization/agency?
o Hasyourorganization/agencyeverpartneredwithanyofthefourhospitalsinvolvedinthissharedcommunityhealthneedsassessmentbefore?IFSO,PROBEINWHATCAPACITY/PROGRAM
• Howwouldyoudescribethecommunityyourepresent/thecommunityyourorganizationserves/theGreaterHoustonpopulationatlarge?Whataresomeofitsdefiningcharacteristicsintermsofdemographics?INTERVIEWER:ESTABLISHWHATTHEINFORMANTCONSIDERSTHECOMMUNITYTOBEFROMTHEIRPERSPECTIVE
COMMUNITYISSUES(20minutes)INTERVIEWER:VARYTHELABELOF‘COMMUNITY’BASEDONTHEINFORMANT’SBACKGROUNDANDHOWHEORSHEDESCRIBESTHECOMMUNITY;BESURETOPROBEONWOMEN’SANDCHILDREN’SISSUESTOENSUREWEADDRESSTHENEEDSOFTHECHILDREN’SHOSPITALSINALLQUESTIONSASRELEVANT• Thinkingaboutthestatusofthecommunitytoday,howwouldyouratetheoverallhealth
statusofresidentsonascaleof1to5with1beingpoorand5beingveryhealthy?
• Ifyouhadtopickyourtop3healthconcernsinthecommunity,whatwouldtheybe?PROBEIN-DEPTHBASEDONINFORMANTAREAOFEXPERTISE
o Whodoyouconsidertobethepopulationsinthecommunitymostvulnerableorat
riskfortheseconditions/issues?§ IFNOTYETMENTIONED,PROBESPECIFICALLYONPRIORITYPOPULATION
RELEVANTTOTHEINFORMANT’SEXPERTISE:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityfor[PRIORITYPOPULATION]?
MemorialHermannNortheastHospitalCHNA2019149
§ FORINFORMANTSEXPERTISEWITHWOMENANDCHILDREN:Whatdoyou
thinkarethemostpressinghealthconcernsinthecommunityforchildrenandtheirfamilies?Howaboutforwomen?
§ IFNOTYETDISCUSSED:Ofthetopthreeissuesyoumentioned,whichwould
yourankasyourtopissue?Howdoyouseethisissueaffectingcommunitymembers’dailylivesandtheirhealth?PROBEIN-DEPTHINSPECIFICFOCUSAREAS;MAYASKABOUTONEISSUEATTIMEANDFOCUSONPERSON’SAREAOFEXPERTISE.
• Fromyourexperience,whatareresidents’biggestbarrierstoaddressingthetop3health
issuesyouidentified?o PROBE:Socialdeterminantsofhealth?o PROBE:Barrierstoaccessingmedicalcare?o PROBE:Barrierstoaccessingpreventiveservicesorprograms?
FOCUSAREA:HEALTHYLIVING(5MINUTES)• I’dliketoaskyouaboutbarriersaffectinghealthylivingandthepreventionofobesity.
o Whataresomeofthebarrierstohealthyeatingandphysicalactivityamongthecommunitiesyouserve?
§ Whatpopulationsaremostaffectedbybarrierstohealthylivingandphysicalactivity?PROBEABOUTFOODINSECURITYANDACCESSTOSAFESPACESFORPHYSICALACTIVITY
o Whateffortsorprogramsareyouawareofthatpromotehealthyliving?PROBEABOUTHEALTHYLIVINGMATTERSCOLLABORATIVE
ACCESSTOHEALTHCAREANDPUBLICHEALTH/PREVENTIONSERVICES(15MINUTES)
• I’dliketoaskyouaboutaccesstohealthcareandsocialservicesinyourcommunity.
o Whatdoyouseeasthestrengthsofthehealthcareandsocialservicesinyourcommunity?
o Whatdoyouseeasitslimitations?• Whatchallenges/barriersdoresidentsinyourcommunityfaceinaccessinghealthcareand
socialservices?[PROBEINDEPTHFORBARRIERSTOCARE:INSURANCEISSUES,LANGUAGEBARRIERS,ACCESSTOHEALTHINFORMATION/HEALTHLITERACY,LACKOFTRANSPORTION,CHILDCARE,ETC.]
o Whatdoyouthinkneedstohappeninthecommunityyouservetohelpresidentsovercomeoraddressthesechallenges?
• Whatprograms,services,orpoliciesareyouawareofinthecommunitythataddressaccess
tohealthcareandsocialservices?
MemorialHermannNortheastHospitalCHNA2019150
o Inyouropinion,howeffectivehavetheseprograms,services,orpoliciesbeenat
addressingthehealthneedsofresidents?
o Whatprogram,services,orpoliciesarecurrentlynotavailablethatyouthinkshouldbe?
IMPROVINGTHEHEALTHOFTHECOMMUNITY/RESIDENTS(10MINUTES)• Whatdoyouthinkneedstohappeninthecommunityyouservetohelpresidentsovercome
oraddressthechallengestheyfaceinbeingabletobehealthy?
• Earlierinthisinterview,youmentioned[TOPISSUE]asbeingyourtophealthpriorityforarearesidents.Whatdoyouthinkneedstobedonetoaddress[TOPISSUEHERE]?
o Whatdoyouthinkhospitalscandotoaddressthisissuethattheyaren’tdoingrightnow?Doyouhaveanysuggestionsabouthowhospitalscanbecreativeorworkoutsidetheirtraditionalroletoaddressthisissueandimprovecommunityhealth?
o Whatkindsofopportunitiesarecurrentlyouttherethatcanbeseizedupontoaddresstheseissues?Forexample,aretheresome“lowhangingfruit”–currentcollaborationsorinitiativesthatcanbestrengthenedorexpanded?
VISIONFORTHECOMMUNITY(5MINUTES)
• Thehospitalsinvolvedinthisinitiativewillbeplanningtheirstrategytoimprovethehealth
ofthecommunitiestheyserve.Whatadvicedoyouhaveforthegroupdevelopingtheplantoaddressthetophealthneedsyou’vementioned?
CLOSING(5MINUTES)
Thankyousomuchforyourtime.That’sitformyquestions.Isthereanythingelsethatyouwouldliketomentionthatwedidn’tdiscusstoday?AsImentioned,afteralloftheinterviewsarecompleted,wewillbesendingyourinterviewtranscriptstothefourhospitals.Eachhospitalwillmaketheircommunityhealthneedsassessmentreportspubliclyavailablewhentheyarecomplete.Ifyouhaveanyquestions,pleasefeelfreetoreachouttoJenniferMineoattheEpiscopalHealthFoundationwhoiscoordinatingthiseffortonbehalfofthefourhospitals.Thankyouagain.Haveagoodmorning/afternoon.
MemorialHermannNortheastHospitalCHNA2019151
KeyInformantInterviewQuestionnaire(ConduentHealthyCommunitiesInstitute)Goodmorning/afternoon[NAMEOFINFORMANT].Mynameis[NAMEOFINTERVIEWER],andIamwithConduentHealthyCommunitiesInstitute.Mycolleague[name]isalsoontheline.WeareworkingwithMemorialHermannHealthSystemtoconductaCommunityHealthNeedsAssessment.• Thepurposeofthisinterviewistogainagreaterunderstandingofthehealthstatusand
wellbeingofresidentsintheGreaterHoustonareaanddeterminehowthesehealthneedsarecurrentlybeingaddressed.Interviewslikethisonearebeingconductedwithabout12stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Wearealsointerviewingcommunityleaderswithspecificexperienceworkingwithprioritypopulationssuchaswomen,children,peopleofcolor,andthedisabledtonameafew.
• Weareinterestedinhearingpeople’sfeedbackontheneedsofthecommunityandthe
populationsyouworkwithasaleaderinyourcommunity.MemorialHermannwelcomeyourcriticalfeedbackandsuggestionsforhealthimprovementactivitiesinthefuture.Yourhonestyduringtoday’sinterviewisencouragedandappreciated.
• Aswementionedinourinterviewinvitation,theinterviewwilllastbetween45minutesto
anhouranditwillberecorded.Afteralltheinterviewsarecompleted,wewillanalyzeandsummarizealltheinterviewstoincorporateintothecommunityhealthneedsassessmentreports.EachMHhospitalwillkeepyourinterviewtranscriptconfidentialandaccessibleonlytotheteamthatispreparingthecommunityhealthneedsassessmentreport.
• MemorialHermannhasaskedHCItoaskallintervieweeshowtheywishanyquotesfromtoday’sinterviewtobepresentedinreports.Therearethreeoptions.Quotesmaybepresentedanonymouslywithoutyournameororganization,presentedwithyournameandorganization,orpresentedwithonlythesectoryourepresent.
• Whichoptionwouldyouliketochoose?
• RECORDRESPONSEFROMINTERVIEWEE:rAnonymousrNameandorganizationrSector
• Thankyou.Wewillnoteyourchoiceinthetranscriptthatweprovidetothehospitals.
• IFTHERESPONDENTISUNSUREATTHETIMEOFTHEINTERVIEW:Ok,pleasefeelfreetothinkitoverandwewillfollowupwithyouforyourdecisionbeforewesendthetranscripttothehospitals.
• Doyouhaveanyquestionsbeforewebegin?BEGINRECORDINGTHEINTERVIEW
MemorialHermannNortheastHospitalCHNA2019152
INTERVIEWQUESTIONNAIRE(55MINUTES)
NOTESTOINTERVIEWER:• INTERVIEWQUESTIONSMAYBEADDEDORTAILOREDTOMEETTHESPECIFIC
POSITION/ROLEOFTHEINTERVIEWEE• THEQUESTIONSINTHEINTERVIEWQUESTIONNAIREAREINTENDEDTOSERVEASAGUIDE,
NOTASCRIPTBACKGROUND(5MINUTES)• Canyoutellmealittlebitaboutyourroleatyourorganization?
o Hasyourorganization/agencyeverpartneredwithMH’scommunityhealthneedsassessmentbefore?IFSO,PROBEINWHATCAPACITY/PROGRAM
• Howwouldyoudescribethecommunityyourepresent/thecommunityyourorganizationserves?Whataresomeofitsdefiningcharacteristicsintermsofdemographics?INTERVIEWER:ESTABLISHWHATTHEINFORMANTCONSIDERSTHECOMMUNITYTOBEFROMTHEIRPERSPECTIVE
COMMUNITYISSUES(20minutes)INTERVIEWER:VARYTHELABELOF‘COMMUNITY’BASEDONTHEINFORMANT’SBACKGROUNDANDHOWHEORSHEDESCRIBESTHECOMMUNITY;BESURETOPROBEONWOMEN’SANDCHILDREN’SISSUESTOENSUREWEADDRESSTHENEEDSOFTHECHILDREN’SHOSPITALSINALLQUESTIONSASRELEVANT• Thinkingaboutthestatusofthecommunitytoday,howwouldyouratetheoverallhealth
statusofresidentsonascaleof1to5with1beingpoorand5beingveryhealthy?
• Ifyouhadtopickyourtop3healthconcernsinthecommunity,whatwouldtheybe?PROBEIN-DEPTHBASEDONINFORMANTAREAOFEXPERTISE
o Whodoyouconsidertobethepopulationsinthecommunitymostvulnerableorat
riskfortheseconditions/issues?§ IFNOTYETMENTIONED,PROBESPECIFICALLYONPRIORITYPOPULATION
RELEVANTTOTHEINFORMANT’SEXPERTISE:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityfor[PRIORITYPOPULATION]?
§ FORINFORMANTSEXPERTISEWITHWOMENANDCHILDREN:Whatdoyou
thinkarethemostpressinghealthconcernsinthecommunityforchildrenandtheirfamilies?Howaboutforwomen?
MemorialHermannNortheastHospitalCHNA2019153
§ IFNOTYETDISCUSSED:Ofthetopthreeissuesyoumentioned,whichwouldyourankasyourtopissue?Howdoyouseethisissueaffectingcommunitymembers’dailylivesandtheirhealth?PROBEIN-DEPTHINSPECIFICFOCUSAREAS;MAYASKABOUTONEISSUEATTIMEANDFOCUSONPERSON’SAREAOFEXPERTISE.
• Fromyourexperience,whatareresidents’biggestbarrierstoaddressingthetop3health
issuesyouidentified?o PROBE:Socialdeterminantsofhealth?o PROBE:Barrierstoaccessingmedicalcare?o PROBE:Barrierstoaccessingpreventiveservicesorprograms?
FOCUSAREA:HEALTHYLIVING(5MINUTES)• I’dliketoaskyouaboutbarriersaffectinghealthylivingandthepreventionofobesity.
o Whataresomeofthebarrierstohealthyeatingandphysicalactivityamongthecommunitiesyouserve?
§ Whatpopulationsaremostaffectedbythesebarrierstohealthylivingandphysicalactivity?PROBEABOUTFOODINSECURITYANDACCESSTOSAFESPACESFORPHYSICALACTIVITY
o Whateffortsorprogramsareyouawareofthatpromotehealthyliving?PROBEABOUTHEALTHYLIVINGMATTERSCOLLABORATIVE
ACCESSTOHEALTHCAREANDPUBLICHEALTH/PREVENTIONSERVICES(15MINUTES)
• I’dliketoaskyouaboutaccesstohealthcareandsocialservicesinyourcommunity.
o WhatAREthestrengthsofthehealthcareandsocialservicesinyourcommunity?
o Whataresomeoftheirlimitations?• Whatchallenges/barriersdoresidentsinyourcommunityfacewhenaccessinghealthcare
andsocialservices?[PROBEINDEPTHFORBARRIERSTOCARE:INSURANCEISSUES,LANGUAGEBARRIERS,ACCESSTOHEALTHINFORMATION/HEALTHLITERACY,LACKOFTRANSPORTION,CHILDCARE,ETC.]
o Whatdoyouthinkneedstohappeninthecommunitytohelpresidentsovercomeoraddressthesechallenges?
• Whatprograms,services,orpoliciesareyouawareofthataddressaccesstohealthcare
andsocialservices?
o Inyouropinion,howeffectivehavetheseprograms,services,orpoliciesbeenataddressingthehealthneedsofresidents?
o Whatprogram,services,orpoliciesnotavailablethatyouthinkshouldbe?
MemorialHermannNortheastHospitalCHNA2019154
IMPROVINGTHEHEALTHOFTHECOMMUNITY/RESIDENTS(10MINUTES)• Whatdoyouthinkneedstohappeninthecommunitytohelpresidentsovercomeor
addressthechallengestheyfaceinbeingabletobehealthy?
• Earlierinthisinterview,youmentioned[TOPISSUE]asbeingyourtophealthpriorityforarearesidents.Whatdoyouthinkneedstobedonetoaddress[TOPISSUEHERE]?
o Whatdoyouthinkhospitalscandotoaddressthisissuethattheyarenotdoingrightnow?
o Doyouhaveanysuggestionsabouthowhospitalscanbecreativeorworkoutsidetheirtraditionalroletoaddressthisissueandimprovecommunityhealth?
o Whatkindsofopportunitiesarecurrentlyouttherethatcanbeseizedupontoaddresstheseissues?Forexample,aretheresome“lowhangingfruit”–currentcollaborationsorinitiativesthatcanbestrengthenedorexpanded?
VISIONFORTHECOMMUNITY(5MINUTES)
• Thehospitalsinvolvedinthisinitiativewillbeplanningtheirstrategytoimprovethehealth
ofthecommunitiestheyserve.Whatadvicedoyouhaveforthegroupdevelopingtheplantoaddressthetophealthneedsyou’vementioned?
CLOSING(5MINUTES)
Thankyousomuchforyourtime.That’sitformyquestions.Isthereanythingelsethatyouwouldliketomentionthatwedidn’tdiscusstoday?AsImentioned,afteralloftheinterviewsarecompleted,wewillbesendingyourinterviewtranscriptstoMemorialHermann.Thecommunityhealthneedsassessmentreportswillbepubliclyavailablewhentheyarecomplete.Ifyouhaveanyquestions,pleasefeelfreetoreachouttoDeborahGanelinatMemorialHermannwhoiscoordinatingthiseffort.Thankyouagain.Haveagoodmorning/afternoon.
MemorialHermannNortheastHospitalCHNA2019155
CommunitySurvey(English)MemorialHermannHealthSystemisconductingaCommunityHealthNeedsAssessmentfortheGreaterHoustonarea.ThisassessmentallowsMemorialHermanntobetterunderstandthehealthstatusandneedsofthecommunityandusetheknowledgegainedtoimplementprogramsthatwillbenefitthecommunity.Wecanbetterunderstandcommunityneedsbygatheringvoicesfromthecommunity.Thissurveyallowscommunitymemberslikeyoutotellusaboutwhatyoufeelareimportantissuesforyourcommunity.Weestimatethatitwilltakeabout5minutestocompletethissurvey.Thankyouverymuchforyourinputandyourtime!1. Pleaselookatthislistofcommunityissues.Inyouropinion,whatarethetop5issuesmost
affectingthequalityoflifeinyourcommunity?o Diabeteso Obesity/Overweighto Respiratory/LungDisease(asthma,COPD,etc.)o Cancerso MentalHealthandMentalDisorderso Injuries,ViolenceandSafetyo SubstanceAbuse(alcohol,tobacco,drugs,etc.)o OralHealtho HeartDiseaseandStrokeo SexualHealth(HIV/AIDS,STDs,etc.)o TeenagePregnancyo ElderCareo ReproductiveHealth(familyplanning)o Other(pleasespecify):______________________________
2. Howwouldyourateyourownpersonalhealth?
o Veryhealthyo Somewhathealthyo Unhealthyo Veryunhealthy
3. Abouthowmanytimesaweekdoyouexerciseorperformaphysicalactivitylikewalking,
running,bicycling,etc.?o Lessthan1timeaweeko 2-3timesaweeko 5ormoretimesaweeko Nevero Other(pleasespecify):______________________________
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4. Whataresomeofthebarriersorchallengestoexercisingonaregularbasisforyou?
o Noplacestoexerciseo Notimetoexerciseo Idon’tlikeexercisingo Feelunsafeexercisinginthecommunityo Noneofmyfriendsorfamilyexerciseo Nochildcareo Lackoffundstopayforgymorclasseso Notransportationo Other(pleasespecify):______________________________
5. Howmuchdoyouagreeordisagreewitheachofthestatementsbelow. Agree
stronglyAgree Disagree Disagree
stronglyTherearegoodparksforchildren,adultsandpeopleofallabilitiestoenjoyinmycommunity
Inthepast12months,IhadaproblemgettingthehealthcareIneededformeorafamilymemberfromanytypeofhealthcareprovider,dentist,pharmacy,orotherfacility
Idon’tknowwheretogetservicesformyselfwhenIamsad,depressedorneedsomeonetotalkto
IamconfidentIcangetanappointmentwhenIneedtoseemydoctorfairlyquickly
Ihaveaplacetoreceivemedicalcareotherthantheemergencyroom
Withinthepast12months,IworriedwhethermyfoodwouldrunoutbeforeIgotmoneytobuymore
Withinthepast12months,thefoodIboughtjustdidn’tlastandIdidn’thavemoneytogetmore
Therearemanyoptionsforhealthyandaffordablefoodinmycommunity
6. Hasyourdoctorevertoldyouthatyouhaveanyofthefollowing?(Markallthatapply)
o Highbloodpressureo Highcholesterolo Cancero Diabeteso Obesityo Asthmao Heartdiseaseo Other(pleasespecify):______________________________
Now,afewquestionssothatwecanseehowdifferenttypesofpeoplefeelaboutthequestionsasked.
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7. Zipcodewhereyoulive:______________________________8. Whatisyourage?______________________________9. Whatisyourrace/ethnicity?
o Whiteo Black/AfricanAmericano Hispanic/Latinoo Asian/PacificIslandero NativeAmericano Other(pleasespecify):______________________________
10. Whataretheagesofchildrenlivinginyourhousehold?
o 11andyoungero 12-18yearsoldo 18andoldero None
11. Whatkindofmedicalinsuranceorcoveragedoyouhave?
o Privateo Employer-sponsoredo Medicaido Medicareo Noneo Other(pleasespecify):______________________________
Thankyouforcompletingthissurvey!
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CommunitySurvey(Spanish)MemorialHermannHealthSystemestárealizandounaEvaluacióndelasNecesidadesdeSaluddelaComunidadeneláreametropolitanadeHouston.EstaevaluaciónpermiteaMemorialHermann
comprendermejorelestadodesaludylasnecesidadesdelacomunidad,asícomousarlainformaciónobtenidaparaponerenprácticaprogramasquebeneficienalacomunidad.
1.Lealalistadeproblemasdelacomunidad.Ensuopinión¿cuálessonlos5problemasquemásafectanlacalidaddevidaensucomunidad?□ Diabetes□ Obesidad/sobrepeso□ Enfermedadesrespiratorias/pulmonares(asma,enfermedadpulmonarobstructivacrónica[EPOC],etc.)
□ Cáncer□ Saludmentalytrastornosmentales□ Lesiones,violenciayseguridad□ Drogodependencia(alcohol,tabaco,drogas,etc.)
□ Saludbucal□ Enfermedadescardíacasyaccidentescerebrovasculares
□ Saludsexual(VIH/sida,enfermedadesdetransmisiónsexual[ETS],etc.)
□ Embarazosdeadolescentes□ Cuidadodeancianos□ Saludreproductiva(planificaciónfamiliar)
□ Otros,(especifique):_________________________________________________________
2.¿Cómocalificaríasupropiasaludpersonal?□ Muybuena□ Bastantebuena
□ Mala□ Muymala
3.¿Aproximadamente,cuántasvecesporsemanahaceejerciciooalgunaactividadfísica,comocaminar,correr,andarenbicicleta,etc.?□ Menosde1vezporsemana□ De2a3vecesporsemana
□ 5omásvecesporsemana□ Nunca
□ Otros,(especifique):_________________________________________________________
4.¿Cuálessonalgunasdelasbarrerasodificultadesqueleimpidenhacerejercicioregularmente?□ Notengounlugardondehacerejercicio.□ Notengotiempoparahacerejercicio.□ Nomegustahacerejercicio.□ Nomesientoseguro/ahaciendoejercicioenmicomunidad.
□ Ningunodemisamigosofamiliareshacenejercicio.
□ Notengoconquiéndejaramishijosmientrashagoejercicio.
□ Notengodineroparapagarungimnasiooclases.
□ Notengoaccesoatransporte.
□ Otros,(especifique):_________________________________________________________
Calculamosqueletomaráunos5minutoscompletarestaencuesta.
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5.¿Lehadichosumédicoalgunadelassiguientesafecciones?(Marquetodaslasopcionesquecorrespondan).□ Presiónarterialalta□ Colesterolalto□ Cáncer□ Diabetes
□ Obesidad□ Asma□ Enfermedadcardíaca
□ Otros,(especifique):_________________________________________________________
6.¿Enquémedidaestádeacuerdooendesacuerdoconcadaunadelassiguientesafirmaciones? Muyde
acuerdoDe
acuerdoEn
desacuerdoMuyen
desacuerdoEnmicomunidad,haybuenosparquesparaniños,adultosypersonascontodotipodecapacidadesparanuestrodisfrute.
Enlosúltimos12meses,tuveunproblemaparaobtenerelcuidadomédicoquenecesitabaparamíoparaunfamiliarporpartedecualquiertipodeproveedordecuidadodelasalud,dentista,farmaciauotrocentrosanitario.
Nosédóndeobtenerserviciosparamícuandoestoytriste,deprimido/a,onecesitohablarconalguien.
Séconseguridadquepuedoobtenerunacitaconmimédicoconciertarapidez.
Tengoamidisposiciónunlugarpararecibircuidadosmédicosquenoseaunasaladeemergencias.
Enlosúltimos12meses,mepreocupédesilacomidaseagotaríaantesdeobtenerdineroparacomprarmásalimentos.
Enlosúltimos12meses,losalimentosquecomprésimplementenoduraronlosuficienteynotuvedineroparacomprarmás.
Enmicomunidadhaymuchasopcionesparacompraralimentossaludablesyasequibles.
7.Códigopostaldesucasa:_________________________8.¿Cuántosañostiene?_________________9.¿Cuálessuraza/origenétnico?□ Blanco/a□ Negro/aoafroamericano/a□ Hispano/aolatino/a
□ Asiático/aoisleño/adelPacífico□ Indígenaamericano/a□ Otro/a,(especifique):______________
10.¿Cuántosañostienenlosniños/asquevivenensucasa?
Ahoraleharemosalgunaspreguntasparapodervercómosesientenlosdistintosgruposdepersonasacercadelaspreguntasquelehemoshecho.
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□ 11ymenos□ Entre12y18años
□ Másde18años□ Ninguno
11.¿Quétipodeseguromédicoocoberturatiene?□ Privado□ Patrocinadoporunempleador□ Medicaid
□ Medicare□ Ninguno□ Otro,(especifique):________
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AppendixD.PrioritizationTool
PrioritizationSurveyThankyouforyourparticipationinthisprioritizationprocess.TheCommunityHealthNeedsAssessment(CHNA)processhasmultiplesteps.Afterthoroughresearchhasbeencompletedtoidentifythesignificanthealthneedsinthecommunity,thesesignificanthealthneedsmustbeprioritizedforfurtherstrategicplanningandimplementation.Prioritizationistheprocessofdeterminingthemostimportantorurgenthealthneedstoaddressincommunities.BelowisadiagramthatshowsthemethodsthatwereusedtoidentifykeyissuesacrossMemorialHermann’sserviceareas.Thesethreemethodsincluded:asecondarydatareview,acommunitysurveyandkeyinformantinterviews.Asyousee,someissuesrevealedthemselvesacrossmultiplemethods.Reviewingthisdiagrammayhelpyoucompletethissurvey.
1. Thefollowinghealthneedsarenotlistedbyorderofimportance.Foreachhealthneed,click
onthearrowonthedropdownboxandselectyouragreementwitheachstatement.Ifyouareonatabletorphone,pleasescrollallthewaytotherightforeachrow.
Theissueimpactsmanypeopleinmycommunity
Thisissuesignificantlyimpacts
Therearenotenoughexistingandadequate
Thisissuehashighriskfordiseaseordeath
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subgroups(subgroupsbyage,gender,race/ethnicity,LGBTQ,etc.)
resourcestoaddressthisissueinmycommunity
AccesstoHealthServices
HeartDiseaseandStroke
OlderAdultsandAging
Obesity(Exercise,NutritionandWeight)
Transportation MentalHealth Diabetes SubstanceAbuse Cancers LackofHealthInsurance
Education FoodInsecurity Low-Income/Underserved
Children’sHealth Economy 2. IndicatethelevelofimportancethatshouldbegiventowardseachofMemorialHermann’s
4Pillars.Keydefinitionsarelistedbelow.
NotImportant
SomewhatImportant
Important VeryImportant
NotSure
Accesstocare(includinghealthcareaccess,healthcareresourceawareness,healthcarenavigation/literacy)
Foodashealth(includingfoodinsecurity,foodprograms,foodknowledge)
Exerciseasmedicine(includingobesity,accesstoparks,safeplacestoexercise)
Emotionalwell-being(includingemotionalhealth,mentalhealth,substanceabuse)
Keydefinitions:
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Healthcarenavigation/literacy:needforeducationinnavigatinghealthsystemsFoodinsecurity:lackingreliableaccesstohealthyfoodoptionsFoodprograms:programs,effortsorservicesdesignedtoaddressfoodissuesFoodknowledge:one’sunderstandingofhealthyfoods3. Whoinyourcommunityismostaffectedbypoorhealthoutcomes?(Selectupto5)
o Lesbian,Gay,Bisexual,Transgender,QueerorQuestioning(LGBTQ)o OlderAdultso PersonswithDisabilities(cognitive,sensoryorphysicaldisability)o Racial/EthnicMinorityPopulationso Veteranso Immigrantsorotherundocumentedpersonso Personsexperiencinghomelessnessorprecariouslyhousedo OtherPopulations(pleasespecify):____________________________
4. Pleaseprovideyourname:__________________________________________
5. Pleaseprovideyouremailaddress:__________________________________________
6. Pleaseselectthename(s)ofthehealthcarefacilityorfacilitiesyourepresent.Youmay
choosemorethanone.o MemorialHermannKatyo MemorialHermannMemorialCityo MemorialHermannGreaterHeightso MemorialHermannNortheasto MemorialHermannSoutheasto MemorialHermannSugarLando MemorialHermannSouthwesto MemorialHermannTheWoodlandso KatyRehabo TexasMedicalCentero TIRRMemorialHermanno MemorialHermannSurgicalHospitalKingwoodo MemorialHermannSurgicalHospitalFirstColonyo MemorialHermannFirstColonyHospital(ER)o MemorialHermannTomballHospital(ER)o Other(pleasespecify):_____________________________
ThankyouforyourinputandparticipationintheCommunityHealthNeedsAssessmentprocess.
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AppendixE.CommunityResourcesThefollowingisalistofcommunityresourcesmentionedbycommunityinputparticipants.2-1-1TexasA.C.TaylorHealthCenterAccessHealthAcresHomeHealthCenterAIDSFoundationHoustonAldineHealthCenterAmericanHeartAssociationAmericanRedCrossAmistadCommunityHealthCenterAreaAgencyonAgingAssociationfortheAdvancementofMexicanAmericansAvenue360Health&WellnessAvenueCDCBaker-RipleyBastropCommunityHealthCenterBaylorTeenHealthClinicBaysideClinicBaytownHealthCenterBeeBusyWellnessCenterBoatPeopleSOSBo'sPlaceBrighterBitesBrownsvilleCommunityHealthCenterBuffaloBayouPartnershipBurlesonFamilyMedicalCenterBVCAA-HealthPointCanDoHoustonCasadeAmigosHealthCenterCasaElBuenSamaritanoCatholicCharitiesoftheArchdioceseofGalveston-Houston-FortBendCentralCareCommunityHealthChambersCommunityHealthCenterCHISt.Luke'sHealthChildAdvocatesofFortBendChildrenatRiskChristClinicChristianCommunityServicesCenter(CCSC)CHRISTUSHealthSystemCitiesChangingDiabetesCityofHouston
CityofHouston,DepartmentofParksandRecreationCityofPasadenaCoastalAreaHealthEducationCenters(AHEC)CommunityHealthChoiceCountyIndigentHealthCareProgramCovenantwithChristCommunityServiceCenterCypressHealthCenterDannyJacksonHealthCenterDentalHygieneClinicE.A."Squatty"LyonsHealthCenterElCentroDeCorazonElFrancoLeeHealthCenterEpiscopalHealthFoundationFamilyServices(GalvestonCounty)FortBendConnectFortBendCountyCollaborativeInformationSystemFortBendCountyHealthandHumanServicesFortBendCountySheriff'sOfficeFortBendRegionalCouncilOnSubstanceAbuseFortBendSeniorsMealsonWheelsFortBendWomen'sCenterGalvestonCountyHealthDistrictGalvestonCountyMentalHealthDeputiesGoHealthyHoustonTaskForceGoodRxGreaterHoustonPartnershipGreaterHoustonWomen'sChamberofCommerceGulfCoastCommunityServicesAssociationGulfCoastMedicalFoundationGulfgateHealthCenterHarmonyHouseRespiteCenterHarrisCenterCrisisLineHarrisCountyPublicHealthandEnvironmentalServices(HCPHES)HarrisCountyRidesHarrisCountySocialServices
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HarrisHealthSystemHarvestGreen(Development)HEALInitiativeHealthCenterofSoutheastTexasHealthcarefortheHomeless-HoustonHealthyLivingMatters(HarrisCounty)HelpingHandsFoodPantryHOPEClinic(FQHC)HoustonFoodBankHoustonHealthDepartmentHoustonHousingAuthorityHoustonIndependentSchoolDistrictHoustonRyanWhitePlanningCouncilHoustonShifaSynottClinicHuntsvilleMemorialHospitalClinicIbnSinaFoundationIndiaHouseCharityClinicInterfaithCommunityClinicInterfaithMinistriesMealsonWheelsInterfaithofTheWoodlandsKinderInstituteLaNuevaCasaHealthCenterLegacyHealth(FQHC)LeonCountyCommunityHealthCenterLibertyCountySheriff'sOfficeLoneStarFamilyHeathCenter(FQHC)LongBranchHealthCenterLongTermRecoveryGroupLosBarriosUnidosCommunityClinicMagnoliaHealthCenterMamieGeorgeCommunityCenterMartinLutherKingJr.HealthCenterMedicalPlusSuppliesMEHOP-MatagordaEpiscopalHealthOutreachProgramMETHeadStartMethodistHospitalMetroliftMidtownArtsandTheaterCenterHoustonMontgomeryCountyFoodBankMontgomeryCountyWomen’sCenterNeighborhoodHealthCenterNorthwestAssistanceMinistry'sChildren'sClinicNorthwestHealthCenterNuestraClinicadelValle
PatMcWatersHealthClinic-SecondMileMissionPatientCareInterventionCenter(PCIC)PearlandCommunityHealthCenterPediatric&AdolescentHealthCenterPhysiciansatSugarCreekPlannedParenthoodPrairieViewA&MUniversityQuentinMeaseHospitalRegionalAssociationofGrantMakersRegionalMedicalCenterRobertCarrascoHealthClinicRSVPMedSpaSanJoseClinicSantaMariaHostel,Inc.SettegastHealthCenterSevaClinicCharityMedicalFacilityShelteringArmSeniorServicesDivisionofBakerRipleyShifaClinicSmithClinicSocialSecurityAdministrationSpringBranchCommunityHealthCenterSt.HopeFoundationSt.Vincent'sHouseStephenF.AustinCommunityHealthNetworkStrawberryHealthCenterTexanaBehavioralHealthTexasA&MAgriLifeExtensionServiceTexasChildren’sHospitalTexasMedicaidandCHIPMedicalTransportationProgramTheArcofFortBendCountyTheBeaconTheHarrisCenterforMentalHealthandIDD(formerlyMHMRA)TheRoseTheWomen'sHomeThomasStreetHealthCenterTOMAGWAClinicTri-CountyServicesBehavioralHealthcareUberHealthUnitedWayofBrazoriaCountyUnitedWayofGreaterHoustonUnitedWayProjectBlueprint
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UniversityofHouston-CollegeofOptometryUniversityofTexasHealth-DentalUniversityofTexasHealthServicesUniversityofTexasPhysiciansUrbanHarvestUTMBValbonaHealthCenterVCareClinicVecinoHealthCenterWestChambersMedicalCenter(FQHC)WestHoustonAssistanceMinistries(WHAM)WholeLifeServiceCenterWomen'sCareCenterWorkforceSolutionsYMCAofGreaterHouston