2016 - Heritage Valley Health System...Household Income – OVH Service Area Figure 8 illustrates...

Ohio Valley Hospital Community Health Needs Assessment

Secondary Data Resource

2016

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TABLE OF CONTENTS

Appendix A – Demographics .................................................................................. 1 Appendix B – Asset Resource Listing ................................................................. 15 Appendix C – Supplemental Data Resource by Topic Area ............................... 31 Access to Quality Health Care ...................................................... 33 Chronic Disease ........................................................................... 49 Healthy Environment ................................................................... 71 Healthy Mothers, Babies and Children ........................................ 83 Infectious Disease ...................................................................... 103 Mental Health and Substance Abuse ........................................ 115 Physical Activity and Nutrition .................................................. 125 Tobacco Use ............................................................................... 135 Unintentional and Intentional Injury ......................................... 143 Appendix D – Prioritization Criteria Listing ...................................................... 151 Appendix E – Stakeholder Interview Guide ..................................................... 161 Appendix F – Focus Group Interview Guide .................................................... 165 Appendix G – Focus Group Polling Guide ........................................................ 171

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TABLE OF TABLES

Table 1 ........ OVH Hospital Asset Resources Listing ........................................... 20 Table 2 ........ OVH Community Asset Resources Listing ..................................... 26 Table 3 ........ Prioritization Criteria .................................................................. 153 Table 4 ........ OVH CHNA Prioritization Survey Results – Sorted by Total ....... 153 Table 5 ........ OVH CHNA Prioritization Survey Results – Sorted by Accountability (Hospital Role) .................................................... 155 Table 6 ........ OVH CHNA Prioritization Survey Results – Sorted by Magnitude/Impact/Capacity ...................................................... 157 Table 7 ........ OVH CHNA Prioritization Survey Results – Top Ten Needs Comparison by Total Ranking, Magnitude/Impact/Capacity and Accountability ..................................................................... 159

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TABLE OF FIGURES

Figure 1 ....... OVH Service Area ........................................................................... 4 Figure 2 ....... OVH Service Area Population Trend ............................................... 5 Figure 3 ....... OVH Service Area by Gender .......................................................... 6 Figure 4 ....... OVH Service Area by Race ............................................................... 7 Figure 5 ....... OVH Service Area by Age ................................................................ 8 Figure 6 ....... OVH Service Area by Marital Status ................................................ 9 Figure 7 ....... OVH Service Area by Education .................................................... 10 Figure 8 ....... OVH Service Area by Household Income ...................................... 11 Figure 9 ....... OVH Service Area by Employment Status ..................................... 12 Figure 10 ..... OVH Service Area by Travel Time to Work ................................... 13 Figure 11 ..... OVH Asset Resources Map ............................................................ 19 Figure 12 ..... Adults (Age 18-64) with No Health Insurance .............................. 34 Figure 13 ..... Adults with No Personal Health Care Provider ............................. 35 Figure 14 ..... Adults Who Reported Needing to See a Doctor but Could Not Due to Cost, Past Year .................................................. 36 Figure 15 ..... 2015 Focus Groups – Personal Health Status ............................... 37 Figure 16 ..... PRC – Healthcare Insurance Coverage for Child ........................... 38 Figure 17 ..... PRC – Lack of Healthcare Insurance Coverage for Child ............... 39 Figure 18 ..... PRC – Experienced Difficulties or Delays in Receiving Child’s Needed Healthcare in the Past Year ............................................ 40 Figure 19 ..... PRC – Child Visited a Physician for a Routine Checkup in the71 Past Year ........................................................................................ 41 Figure 20 ..... PRC – Child Visited a Dentist or Dental Clinic Within the Past Year ................................................................................. 42 Figure 21 ..... PRC – Child Used an Urgent Care Center, QuickCare Clinic, or Other Walk-in Clinic in the Past Year ............................................ 43 Figure 22 ..... 2015 Focus Groups – Access Problems, 1 of 3 .............................. 44 Figure 23 ..... 2015 Focus Groups – Access Problems, 2 of 3 ............................. 45 Figure 24 ..... 2015 Focus Groups – Access Problems, 3 of 3 ............................. 45 Figure 25 ..... Breast Cancer Incidence Rates ...................................................... 50 Figure 26 ..... Breast Cancer Mortality Rates ...................................................... 51 Figure 27 ..... Lung Cancer Incidence Rates ........................................................ 52 Figure 28 ..... Lung Cancer Mortality Rates ......................................................... 53 Figure 29 ..... Colorectal Cancer Incidence Rates ................................................ 54 Figure 30 ..... Colorectal Cancer Mortality Rates ................................................ 55 Figure 31 ..... Prostate Cancer Incidence Rates .................................................. 56

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Figure 32 ..... Prostate Cancer Mortality Rates ................................................... 57 Figure 33 ..... Heart Disease Mortality Rates ...................................................... 58 Figure 34 ..... Heart Attack Mortality Rates ........................................................ 59 Figure 35 ..... Coronary Heart Disease Mortality Rates ..................................... 60 Figure 36 ..... Cardiovascular Disease Mortality Rates ........................................ 61 Figure 37 ..... Chronic Lower Respiratory Disease (COPD) Mortality Rates ........ 62 Figure 38 ..... Cerebrovascular Disease Mortality Rates ..................................... 63 Figure 39 ..... Adults Ever Told They Had a Stroke (age 35 and Older) .............. 64 Figure 40 ..... Diabetes Mortality Rates .............................................................. 65 Figure 41 ..... PRC – Child Has Diabetes ............................................................. 66 Figure 42 ..... Mammogram Screenings ............................................................. 67 Figure 43 ..... 2015 Focus Groups – Chronic Disease Needs ............................... 68 Figure 44 ..... Asthma Hospitalizations 2010 ...................................................... 72 Figure 45 ..... High School Graduation Rates ..................................................... 76 Figure 46 ..... Unemployment ............................................................................ 77 Figure 47 ..... Students with Asthma .................................................................. 78 Figure 48 ..... PRC – Child Currently Has Asthma (US 2014) ............................... 79 Figure 49 ..... PRC – Number of Asthma-Related ER/Urgent Care Visits in the Past Year (US 2014) ................................................................. 80 Figure 50 ..... Prenatal Care First Trimester ........................................................ 84 Figure 51 ..... Non-Smoking Mother During Pregnancy ...................................... 85 Figure 52 ..... Non-Smoking Mother Three Months Prior to Pregnancy ............. 86 Figure 53 ..... Low Birth Rate ............................................................................... 87 Figure 54 ..... Mothers Reporting WIC Assistance .............................................. 88 Figure 55 ..... Mothers Reporting Medicaid Assistance ...................................... 89 Figure 56 ..... Mothers Reporting Breastfeeding ................................................ 90 Figure 57 ..... Teen Pregnancy Rate, Ages 15 – 19 .............................................. 91 Figure 58 ..... Teen Live Birth Outcomes, Ages 15-19 ......................................... 92 Figure 59 ..... Infant Mortality ............................................................................. 93 Figure 60 ..... Infant Mortality in Pennsylvania ................................................... 94 Figure 61 ..... Overweight BMI, Grades K-6 ......................................................... 95 Figure 62 ..... Overweight BMI, Grades 7-12 ...................................................... 96 Figure 63 ..... Obese BMI, Grades 7-12 ............................................................... 97 Figure 64 ..... PRC – Child Was Ever Fed Breast Milk .......................................... 98 Figure 65 ..... PRC – Child Exclusively Breastfed for at Least Six Months ........... 99 Figure 66 ..... Adults Who Had Pneumonia Vaccine, Age 65 and Older ........... 104 Figure 67 ..... Influenza and Pneumonia Mortality ........................................... 105 Figure 68 ..... Lyme Disease Incidence Rates .................................................... 106

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Figure 69 ..... Ever Tested for HIV, Adults 18-64 ............................................... 107 Figure 70 ..... Chlamydia Rates ......................................................................... 108 Figure 71 ..... Chlamydia Rates, Female ............................................................ 109 Figure 72 ..... Chlamydia Rates, Male ................................................................ 110 Figure 73 ..... Gonorrhea Rates ......................................................................... 111 Figure 74 ..... Gonorrhea Rates, Female .......................................................... 112 Figure 75 ..... Gonorrhea Rates, Male .............................................................. 113 Figure 76 ..... Mental and Behavioral Disorders Mortality ............................... 116 Figure 77 ..... Adults Who Reported Binge Drinking (Men=5 Drinks, Women=4 Drinks) ....................................................................... 117 Figure 78 ..... Adults at Risk for Heavy Drinking (Men=2 Drinks, Women=1 Drink) ........................................................................ 118 Figure 79 ..... Drug-Induced Mortality Rates .................................................... 119 Figure 80 ..... PAYS – Allegheny County Substance Use .................................... 120 Figure 81 ..... PAYS – Allegheny County Pain Reliever Use ............................... 121 Figure 82 ..... PAYS – Allegheny County Risky Behaviors .................................. 122 Figure 83 ..... 2015 Focus Groups – Mental Health and Substance Abuse Problems ..................................................................................... 123 Figure 84 ..... PRC – Number of Days in the Past Week on Which Children Were Physically Active for an Hour or Longer (US Children Age 2-17, 2014) ........................................................................... 126 Figure 85 ..... PRC – Percentage of Children Physically Active for an Hour Or Longer Every Day in Past Week (US Children Age 2-17) ........ 127 Figure 86 ..... PRC – Hours of Children’s Screen Time (US Children, Age 5-17, 2014) ........................................................................... 128 Figure 87 ..... PRC – Children with Three or More Hours per School Day of Screen Time (TV, Computer, Video Games, Phone Device, etc.) ................................................................................. 129 Figure 88 ..... PRC – Percentage of Children Having Five or More Servings Of Fruits/Vegetables per Day ..................................................... 130 Figure 89 ..... PRC – Number of Fast Food Meals Children Consume (US Children Age 2-17, 2014) ............................................................. 131 Figure 90 ..... 2015 Focus Groups – Physical Activity and Nutrition Problems ..................................................................................... 132 Figure 91 ..... Male Adults Who Reported Being a Former Smoker ................. 136 Figure 92 ..... Adults Who Reported Being a Current Smoker .......................... 137 Figure 93 ..... Adults Who Quit Smoking at Least One Day in Past Year ........... 138 Figure 94 ..... Adults Reported Being an Everyday Smoker .............................. 139

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Figure 95 ..... 2015 Focus Groups – Tobacco Use Problems ............................. 140 Figure 96 ..... Mortality Rate for Auto Accidents .............................................. 144 Figure 97 ..... Suicide Mortality Rates ............................................................... 145 Figure 98 ..... PRC – Children Injured Seriously Enough to Need Medical Treatment, Past Year ................................................................... 146 Figure 99 ..... Fall Mortality Rate ...................................................................... 147 Figure 100 ... Firearm Mortality Rate ............................................................... 148

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Appendix A - Demographics

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Appendix A Demographics


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For purposes of this assessment, the OVH service area geography is defined as certain zip codes in Allegheny Countiy in Pennsylvania. These zip codes are listed below and mapped in Figure 1: Primary Service Area City/Town Zip Code Oakdale 15071 Carnegie 15106 Coraopolis 15108 Imperial 15126 McKees Rocks 15136 Corliss 15204 Crafton 15205 Neville Island 15225

DEMOGRAPHICS


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Figure 1. OVH Service Area

Population - OVH Service Area Figure 2 illustrates the OVH Service Area Population from the 2000 and 2010 Census, as well as the 2015 Estimate and 2020 Projection. From the 2000 to 2010 census, the OVH service area population has remained constant and is projected to increase from 131,102 in 2015 to 133,823 in 2020.


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Figure 2. OVH Service Area Population Trend

Source: www.nielsen/claritas.com


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Gender - OVH Service Area Figure 3 illustrates the OVH Service Area by Gender. A little over half (51.3%) of residents are Female, while 48.7% are Male. Figure 3. OVH Service Area by Gender



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Race – OVH Service Area Figure 4 illustrates the ethnicity breakdown of the service area of OVH. The predominant race for the primary service area is White Alone (84.9%). Only 9.4% of the service population is Black or African American Alone. Figure 4. OVH Service Area by Race



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Age – OVH Service Area Figure 5 illustrates the age breakdown for the service area of OVH. For 2015, over one-third (40.6%) of the population is within the age range of 25-54. The population of those in the age range of 55-84 years was just under one-third (28.9%). The lowest populations occur in the 15-24 year-old range (11.9%) and the 85 and older range (2.4%). Figure 5. OVH Service Area by Age



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Marital Status – OVH Service Area Figure 6 illustrates the service area by Marital Status for OVH. Almost half of the population (44.8%) is Married, Spouse Present, while approximately one-third (34.2%) of the population have Never Married. Persons Divorced, Widowed or Separated make up 20.9% of the primary service area population. Figure 6. OVH Service Area by Marital Status



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Education – OVH Service Area Figure 7 illustrates the level of education for the service area of OVH. A little over one-third of the population (33.4%) graduated from High School or obtained their GED. The percent of the population that either did not receive a High School Diploma or have Less than a 9th Grade education level is 6.5%. Conversely, 60.1% of the population have either Some College-No Degree, or obtained their Associate, Bachelor’s, Master’s, Professional School or Doctoral Degree, and one in four (42.2%) recevied an Associates Degree or higher. Figure 7. OVH Service Area by Education



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Household Income – OVH Service Area Figure 8 illustrates the Household Income for the service area of OVH. The income statistics indicates the OVH service area to be low to middle income; about one-tenth (11.4%) have an annual income of $15,000 or less. Almost half (46.1%) have annual incomes less than $50,000. Figure 8. OVH Service Area by Household Income



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Employment Status – OVH Service Area Figure 9 illustrates the Employment Status for the service area of OVH. Almost two-thirds of the population (62.3%) is presently in the workforce, while 32.1% of the population is not. The percent of those unemployed in the service area is 5.5%. Figure 9. OVH Service Area by Employment Status



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Travel Time to Work – OVH Service Area Figure 10 illustrates the estimated average Travel Time to Work for the service area of OVH. The commute time can be easily separated out into approximate thirds – travel time of less than 15 minutes (26.8%), travel time between 15-29 minutes (38.8%) and travel time of 30 minutes or more (34.5%). Almost three-fourths (65.6%) of residents in the primary service area travel less than 30 minutes to get to work. Figure 10. OVH Service Area by Travel Time to Work



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Demographic Conclusions

• The Ohio Valley Hospital service area population has been steadily increasing and is projected to continue to increase from 131,102 in 2015 to 133,823 in 2020.

• There are slightly more females (51.3%) than males (48.7%). • Over three-fourths of the residents in the service area are White

(84.9%). • Over one third (40.6%) of the population is between the ages of 25

and 54, while almost one-third of the population (28.9%) is between the ages of 55 and 84..

• Just under half (44.8%) of the population is married. • One in four (42.2%) have received an Associate Degree or higher

educational attainment. A little under one in ten (6.5%) residents have not graduated high school.

• Just over one in ten households (11.4%) have an annual income of $15,000 or less. Almost half (46.1%) have annual incomes less than $50,000.

• Over half of the population (62.3%) is currently employed. Very few (5.5%) residents are currently unemployed.

• Almost three-fourths of those employed (65.5%) travel less than 30 minutes to work.

Appendix B – Asset Resource Listing

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Appendix B Asset Resource Listing


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A list of community assets and resources that are available in the community to support residents was compiled and is mapped in Figure 11 and listed in Tables 1 and 2 of this report. The assets identified are broken down into the following sections: Hospital Resources: Acute Rehabilitation Unit Addiction Medicine Cardiology Cardiovascular Medicine Career Center Cataract & Eye Surgery Center Colon & Rectal Surgery Emergency Department Endocrinology Family Medicine Gastroenterology General & Vascular Surgery General Surgery Gynecology Infectious Disease Internal Medicine Laboratory Services Nephrology Neurology Nutrition Services Occupational Medicine Oncology Oncology & Hematology

Ophthalmology Oral & Maxillofacial Surgery Orthopedics Otolaryngology Pain Treatment Center Plastic & Reconstructive Surgery Podiatry Psychiatry Pulmonary Radiology & Medical Imaging Rehabilitation Services Respiratory Care Services Rheumatology Schools of Nursing Sleep Evaluation Center Thoracic & Cardiovascular Surgery Urology Wound Care Center

ASSET RESOURCES


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Community Resources: Assisted Living Clinic Dentist Diabetes Education Dialysis Drug Abuse & Alcohol Treatment Family Planning Food Bank

Nutritional Education Physicians-Surgeons Psychiatry and Mental Health Rehab & Physical Therapy Support Groups Women’s Health Vein Care


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Figure 11: OVH Asset Resources Map


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Table 1. OVH Hospital Asset Resources Listing

Hospital Department Address City State Zip Phone Number

Acute Rehabilitation Unit

Ohio Valley Hospital 25 Heckel Road McKees Rocks PA 15136 (412) 777-6770

Addiction Medicine

August Mantia, M.D. 603B McKnight Park Drive Pittsburgh PA 15237 (412) 366-8502

Cardiology

Ohio Valley Hospital Non-Invasive Diagnostic Procedures 25 Heckel Road McKees Rocks PA 15136 (412) 777-6136

Ohio Valley Hospital Minimally-Invasive Diagnostic Procedures 25 Heckel Road McKees Rocks PA 15136 (412) 777-6595

Ohio Valley Hospital Cardiac Rehabilitation 25 Heckel Road McKees Rocks PA 15136 (412) 777-6849

Jalit Tuchinda, M.D. 596 Pine Hollow Road McKees Rocks PA 15136 (412) 771-6003

Ladani Medical Associates 27 Heckel Road McKees Rocks PA 15136 (412) 777-4366

McGinnis Cardiovascular Institute at Ohio Valley Hospital

27 Heckel Road Suite 106 McKees Rocks PA 15136 (724) 260-7400

Rina K. Gandhi, M.D. 27 Heckel Road McKees Rocks PA 15136 (412) 777-4386

William E. Kunsman, M.D. 27 Heckel Road McKees Rocks PA 15136 (412) 777-4375

Cardiovascular Medicine

Ohio Valley Cardiovascular Medicine


Career Center


Ohio Valley Hospital Volunteer Opportunities 25 Heckel Road McKees Rocks PA 15136 (412) 777-6359

Cataract & Eye Surgery Center


Colon & Rectal Surgery

Colon and Rectal Wellness Center 27 Heckel Road McKees Rocks PA 15136 (412) 777-4352

Emergency Department


Endocrinology

Chemtech Building 1370 Washington Pike Bridgeville PA 15017 (412) 221-4740


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Sigrid Hagg, M.D. 201 Penn Center Boulevard Pittsburgh PA 15235 (412) 349-0283

Family Medicine

Drs. Sauer and Leibensperger Family Practice 27 Heckel Road McKees Rocks PA 15136 (412) 331-6503

Medical Group Robinson, LLC 5855 Steubenville Pike Suite 200 McKees Rocks PA 15136 (412) 490-2500

Montour Family Healthcare 1000 Cliff Minde Road Suite 110 Pittsburgh PA 15275 (412) 722-0102

Ohio Valley Primary Care 1308 5th Avenue Coraopolis PA 15108 (412) 262-4694

Robert F. Yellenik, M.D. 27 Heckel Road McKees Rocks PA 15136 (412) 777-4380

Sto-Rox Family Health Center 710 Thompson Avenue McKees Rocks PA 15136 (412) 771-6462

Gastroenterology

Center for Digestive Health & Nutrition 725 Cherrington Parkway Coraopolis PA 15108 (412) 262-1000

Roesch Taylor Medical Building 2100 Jane Street Pittsburgh PA 15203 (412) 488-7474

General & Vascular Surgery

Catalane & Willis Surgical Associates 27 Heckel Road McKees Rocks PA 15136 (412) 771-2266

General & Vascular Surgery Associates

1350 Locust Street Suite 205 Pittsburgh PA 15219 (412) 391-4360

Ohio Valley General & Vascular Surgery


General Surgery

Ohio Valley General & Vascular Surgery


Gynecology

Advanced Women’s Care of Pittsburgh


Womencare Associates 27 Heckel Road Suite 106 McKees Rocks PA 15136 (724) 775-0800

Infectious Disease

Ohio Valley Infectious Disease 27 Heckel Road Suite 206 McKees Rocks PA 15136 (412) 777-6882

Internal Medicine

Adrienne Young, M.D. 27 Heckel Road McKees Rocks PA 15136 (412) 771-0555


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Bhavank Doshi, M.D. LLC 27 Heckel Road Suite 106 McKees Rocks PA 15136 (412) 777-4353

Gateway Medical Group 27 Heckel Road Suite 207 McKees Rocks PA 15136 (412) 279-8940

Gerald D. Klug, M.D. 944 Beaver Grade Road Coraopolis PA 15108 (412) 269-0116

Greentree Medical Center 995 Greentree Road Pittsburgh PA 15220 (412) 920-1800

Internal Medicine of Robinson 6000 Steubenville Pike McKees Rocks PA 15136 (412) 490-7440

Ladani Medical Associates 27 Heckel Road McKees Rocks PA 15136 (412) 777-4366

Matthew Coppola, M.D. 601 Monroe Avenue Pittsburgh PA 15202 (412) 734-3030

Medical Group Robinson, LLC 5855 Steubenville Pike Suite 200 McKees Rocks PA 15136 (412) 490-2500

Neeta Raja, D.O. 27 Heckel Road McKees Rocks PA 15136 (412) 777-4366


Patel Medical Associates 27 Heckel Road Suite 101 McKees Rocks PA 15136 (412) 777-4366

Sto-Rox Family Health Center 710 Thompson Avenue McKees Rocks PA 15136 (412) 771-6462

West Hills Medical Providers, Inc. 27 Heckel Road McKees Rocks PA 15136 (412) 777-4319

West Penn Allegheny Oncology Network

133 Church Hill Road First Floor McKees Rocks PA 15136 (412) 722-1380

Laboratory Services

Ohio Valley Hospital Main Laboratory-Second Floor of Main Hospital 25 Heckel Road McKees Rocks PA 15136 (412) 777-6161

Ohio Valley Hospital Medical Office Building Phlebotomy Site/Registration 27 Heckel Road McKees Rocks PA 15136 (412) 777-6161

Nephrology

Advanced Kidney Care 27 Heckel Road McKees Rocks PA 15136 (412) 771-2970

Advanced Nephrology Associates 824 California Avenue Pittsburgh PA 15212 (412) 766-3232

Samuel Baroody, M.D. 824 California Avenue Pittsburgh PA 15212 (412) 766-3232

Three Rivers Nephrology & Hypertension Associates, LLC 1401 Forbes Avenue Pittsburgh PA 15219 (412) 232-8688

Neurology

Allegheny Neurological Associates

420 E North Avenue Suite 206 Pittsburgh PA 15212 (412) 359-8850


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Joseph Wapenski, M.D. 401 Smith Drive Cranberry PA 16066 (724) 772-7080

Nutrition Services


Occupational Medicine

Business Fit Ohio Valley Hospital Medical Office Building


Ohio Valley Primary Care


Oncology

UPMC/HVHS Cancer Center 1600 Coraopolis Heights Road Coraopolis PA 15108 (412) 604-2020

Oncology & Hematology

Venus A. Hadeed, M.D. 1600 Coraopolis Heights Road Coraopolis PA 15108 (412) 329-2500

West Penn Allegheny Oncology Network

133 Church Hill Road First Floor McKees Rocks PA 15136 (412) 722-1380

Ophthalmology

Associates in Ophthalmology 9970 Mountain View Drive 2nd Floor West Mifflin PA 15122 (412) 653-3080

Karlik Ophthalmology 1015 West View Park Drive Pittsburgh PA 15229 (412) 931-8101

Pittsburgh Oculoplastic Associates 3471 5th Avenue Pittsburgh PA 15213 (412) 681-4220

Sewickley Eye Center 27 Heckel Road McKees Rocks PA 15136 (412) 777-4300

Oral & Maxillofacial Surgery

Mark Grenadier, D.D.S. 4955 Steubenville Pike Suite 361 Pittsburgh PA 15205 (412) 788-9333

Orthopedics


Tri-State Orthopaedics & Sports Medicine, Inc.

4955 Steubenville Pike Suite 120 Pittsburgh PA 15205 (412) 787-7582

Otolaryngology

Bell, Froman, Orsini & Rago, ENT Associates 27 Heckel Road McKees Rocks PA 15136 (412) 771-0416

Kenneth Skolnick, M.D. 4955 Steubenville Pike Suite 200 Pittsburgh PA 15205 (412) 788-0444

Pain Treatment Center


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Ohio Valley Pain Treatment Center West Kenmawr Plaza 500 Pine Hollow Road McKees Rocks PA 15136 (412) 777-6400

Plastic & Reconstructive Surgery

Dinakar Golla, M.D. 107 Gamma Drive Suite 210 Pittsburgh PA 15238 (412) 963-6677

Lori Cherup, M.D. 27 Heckel Road Suite 106 McKees Rocks PA 15136 (412) 220-8181

Willis D. Shook, M.D. 1350 Locust Street Pittsburgh PA 15219 (412) 562-3320

Podiatry

Alan Catanzariti, DPM 4955 Steubenville Pike Pittsburgh PA 15205 (412) 787-7005

Beaver Valley Foot Clinic 2438 Brodhead Road West Aliquippa PA 15001 (724) 375-1577

Christopher J. Hajnosz, DPM 1074 Greentree Road Pittsburgh PA 15220 (412) 563-1440

Karl Saltrick, DPM 4955 Steubenville Pike Pittsburgh PA 15205 (412) 787-7005

Rodney M. Kosanovich, DPM 5676 Steubenville Pike McKees Rocks PA 15136 (412) 787-1276

Psychiatry

Ohio Valley Hospital Willow Brook Geropsychiatric Unit Third Floor 25 Heckel Road McKees Rocks PA 15136 (412) 777–6420

Ohio Valley Outpatient Psychiatry OVH Kennedy Township Outpatient Center 8 Hattman Drive Coraopolis PA 15108 (412)458-1331

Haranath Parepally, M.D. 8 Hattman Drive Coraopolis PA 15108 (412) 458-1331

Maher Ayyash, M.D. 25 Heckel Road McKees Rocks PA 15136 (412) 777-6420

Pulmonary

Ohio Valley Hospital Pulmonary Health Center 25 Heckel Road McKees Rocks PA 15136 (412) 777-6470

Pittsburgh Pulmonary Medicine, PC 601 Monroe Avenue Pittsburgh PA 15202 (412) 734-3050

South Hills Pulmonary Associates

1050 Bower Hill Road Suite 306 Pittsburgh PA 15243 (412) 572-6168

Radiology & Medical Imaging


Rehabilitation Services



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Debra J. Panucci, M.D., LLC 100 Medical Boulevard Canonsburg PA 15317 (724) 745-3908

Medical Rehabilitation, Inc. 1350 Locust Street Suite 409 Pittsburgh PA 15217 (412) 232-7608

Respiratory Care Services

Ohio Valley Hospital 25 Heckel Road McKees Rocks PA 15136 (412)777-6157

Rheumatology

Ohio Valley Rheumatology 27 Heckel Road Suite 207 McKees Rocks PA 15136 (724) 258-9680

Schools of Nursing

Ohio Valley Hospital School of Nursing 25 Heckel Road McKees Rocks PA 15136 (412) 777-6210

Ohio Valley Hospital School of Radiography 25 Heckel Road McKees Rocks PA 15136 (412) 777-6204

Sleep Evaluation Center


Surgical Services


Ohio Valley Hospital Outpatient Surgery 25 Heckel Road McKees Rocks PA 15136 (412) 777-6276

Thoracic & Cardiovascular Surgery

Gerald McGinnis Thoracic & Cardiovascular Institute

363 E. North Avenue 3rd Floor Pittsburgh PA 15232 (412) 359-6137

Urology

Triangle Urological Group 27 Heckel Road McKees Rocks PA 15136 (412) 777-4355

Valley Urological Associates 27 Heckel Road McKees Rocks PA 15136 (412) 771-3266

Wound Care Center

The Wound Care Center Kennedy Township Kenmawr Plaza 500 Pine Hollow Road McKees Rocks PA 15136 (412) 250-2600

The Wound Care Center North Hills Mt. Nebo Commons 107 Mt. Nebo Pointe Drive Pittsburgh PA 15237 (412) 847-7500


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Table 2. OVH Community Asset Resources Listing

Agency Address City State Zip Phone Number

Assisted Living

Chartiers Manor 814 Chartiers Avenue McKees Rocks PA 15136 (412) 331-8017

Leo Meyer Manor 1015 Church Avenue McKees Rocks PA 15136 (412) 331-8000

Ohio View Acres 250 Jefferson Drive McKees Rocks PA 15136 (412) 331-4633

Perry South Personal Care Home 1129 Tweed Street Pittsburgh PA 15204 (866) 477-3715

The Residence at Willow Lane 30 Heckel Road McKees Rocks PA 15136 (412) 331-6139

Clinic

Biez Clinic 960 Beaver Grade Road Coraopolis PA 15108 (412) 604-8941

MedExpress Urgent Care-Moon Township 8702 University Boulevard Moon PA 15108 (412) 299-3627

MedExpress Urgent Care-Robinson Township 5944 Steubenville Pike McKees Rocks PA 15136 (412) 787-3508

MinuteClinic-CVS 5703 Steubenville Pike McKees Rocks PA 15136 (866) 389-2727

Sto-Rox Neighborhood Family Health Center 710 Thompson Avenue McKees Rocks PA 15136 (412) 771-6460

Take Care Clinic-Walgreens 6906 University Boulevard Moon PA 15108 (412) 269-2501

Transitional Services Inc. 908 Dohrman Street #1 McKees Rocks PA 15136 (412) 771-3766

Dentist

Bradford E. Strobel, DMD 5949 Steubenville Pike McKees Rocks PA 15136 (412) 787-8280

Charles L. Barber, DMD 6114 Steubenville Pike McKees Rocks PA 15136 (412) 788-1911

Chestnut Hills Dental 6200 Steubenville Pike, Suite 102 McKees Rocks PA 15136 (412) 787-2027

Donald Dazen, DDS, DMD 710 Broadway Avenue McKees Rocks PA 15136 (412) 331-1115

Lora L. Medwid, DDS 1781 Pine Hollow Road McKees Rocks PA 15136 (412) 331-1417

McKees Rocks Dental 757 Chartiers Avenue McKees Rocks PA 15136 (412) 331-4629

Michael J. Hanna, DMD 1229 Silver Lane McKees Rocks PA 15136 (412) 859-3199

Michael A. Kail-Robinson Office 5458 Steubenville Pike McKees Rocks PA 15136 (412) 787-1442

Murphy's Family Dentistry 2601 Chartiers Avenue McKees Rocks PA 15204 (412) 331-6712

Pamela Brennan Clarke, DMD 27 Beaver Grade Road McKees Rocks PA 15136 (412) 788-6684

Robert M. Medwid Jr., DDS 705 Broadway Avenue McKees Rocks PA 15136 (412) 771-6556

South Hills Dental Arts-Ingram Crafton Office 2725 Center Street Pittsburgh PA 15205 (412) 922-9292


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The Silberg Center for Dental Science 6200 Steubenville Pike McKees Rocks PA 15136 (412) 787-8590

Diabetes Education

Diabetes Comprehensive Care Program Heritage Valley Health System

935 Thorn Run Road Suite 102 Coraopolis PA 15108 (412) 299-1686

Living Well with Diabetes Program Ohio Valley Hospital 25 Heckel Road McKees Rocks PA 15136 (412) 777-6205

Living Well with Diabetes Program Wound Care Center Ohio Valley Hospital


Dialysis

DaVita Thorn Run Dialysis 1136 Thorn Run Road Coraopolis PA 15108 (800) 424-6589

Fresenius Medical Care at Ohio Valley Hospital

3 Robinson Plaza Suite 110 Pittsburgh PA 15205 (412) 777-6161

Drug Abuse & Alcohol Treatment

Next Step Foundation 641 Broadway Avenue McKees Rocks PA 15136 (877) 508-2800

Clean & Sober Humans Association (CASH) A.D.A.'S House 825 Broadway Avenue McKees Rocks PA 15136 (412) 875-0020

Greenbriar Treatment Center-Robinson


Allegheny Christians Rehabilitation Detox Addiction Center 895 1st Street McKees Rocks PA 15136 (888) 929-4686

Christian Drug Detox and Rehab

5990 University Boulevard Suite 12-191 Coraopolis PA 15108 (412) 532-1785

Narcotics Anonymous Focus on Renewal Sto-Rox 701 Chartiers Avenue McKees Rocks PA 15136 (412) 331-1685

Family Planning

Planned Parenthood Moon Township Health Center

935 Beaver Grade Road Suite 12 Moon PA 15108 (412) 264-7205


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Food Bank

Inter-Church Food Bank 618 Russellwood Avenue McKees Rocks PA 15136 (412) 771-4088

Nutritional Education

Women Infants and Children (WIC) Program Sto-Rox Neighborhood Family Health Center 710 Thompson Avenue McKees Rocks PA 15136 (412) 331-5410

Physicians-Surgeons

Catalane & Willis Surgical Associates


Greater Pittsburgh Orthopaedic Associates Moon Office

725 Cherrington Parkway Suite 200 Coraopolis PA 15108 (412) 262-7800

Pediatrics South-Robinson 5676 Steubenville Pike Suite C&D McKees Rocks PA 15136 (412) 494-9588

Pine Hollow Medical Associates

133 Church Hill Road Suite 2A McKees Rocks PA 15136 (412) 722-1003

Psychiatry and Mental Health

Crossroads Counseling & Consulting Associates, PC Moon Township

1000 Commerce Drive Suite 1002 Coraopolis PA 15108 (412) 264-2155

Pathways 30 Heckel Road McKees Rocks PA 15136 (412) 771-2084

Peter C. Zubritzky, Ph.D. Licensed Psychologist 1767 Pine Hollow Road McKees Rocks PA 15136 (412) 331-6414

Pittsburgh Vet Center 2500 Baldwick Road Suite 15 Pittsburgh PA 15205 (412) 920-1765

Rehab and Physical Therapy

Hess Physical Therapy Crafton-Ingram Shopping Center 37 Foster Avenue Pittsburgh PA 15205 (412) 458-3445

Hess Physical Therapy Kenmawr Plaza 566 Pine Hollow Road McKees Rocks PA 15136 (412) 771-1055

Keystone Physical Therapy 725 Cherrington Parkway Moon PA 15108 (412) 741-1619

NovaCare Rehabilitation-Moon 1136 J. Thornrun Extension Coraopolis PA 15108 (412) 269-2275

Robinson Physical Therapy 5635 Steubenville Pike McKees Rocks PA 15136 ( 412) 787-8616


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THE pt GROUP 980 Beaver Grade Road Suite 204 Coraopolis PA 15108 (412) 262-3354

UPMC Centers for Rehab Services Robinson Township

5855 Steubenville Pike Suite 100 McKees Rocks PA 15136 (412) 788-4035

West Hills Health and Rehabilitation Center 951 Brodhead Road Coraopolis PA 15108 (412) 269-1101

Support Groups

Clean & Sober Humans Association (CASH) Club 825 Broadway Avenue McKees Rocks PA 15136 (412) 875-0020

Narcotics Anonymous Focus on Renewal Sto-Rox 701 Chartiers Avenue McKees Rocks PA 15136 (412) 331-1685

Vietnam Veterans Counseling Center HIV Support Group Pittsburgh Vet Center

2500 Baldwick Road Suite 15 Pittsburgh PA 15205 (412) 920-1765

Women's Health

Planned Parenthood Moon Township Health Center

935 Beaver Grade Road Suite 12 Moon PA 15108 (412) 264-7205


UPMC Womancare Associates Evan S. Shikora, D.O.

6200 Steubenville Pike Towerview First Floor McKees Rocks PA 15136 (412) 788-4963

Vein Care

Advanced Vein Center 937 Beaver Grade Road Coraopolis PA 15108 (724) 987-3220

Circulatory Centers-Moon Robinson

2 Robinson Plaza Suite 310 Pittsburgh PA 15205 (412) 329-1257

FeelNu Medi Spa and Wellness Center Medical Group Robinson

5855 Steubenville Pike Suite #200 Pittsburgh PA 15136 (412) 490-2500


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Appendix C – Supplemental Data Resource by Topic Area

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Appendix C

Supplemental Data Resource by Topic Area


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Access to comprehensive, quality healthcare is important for the achievement of health equity and for increasing the quality of life for everyone in the community. Issues related to a need for access to specialists in the area rather than travelling outside of the coverage area for care, an aging population, and a lack of psychiatric care in the area were identified in focus groups as factors impacting the health of the community.

ACCESS TO QUALITY HEALTH CARE


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No Health Insurance Figure 12 illustrates the percentage of adults ages 18-64 with no health insurance in the United States, Pennsylvania and throughout Allegheny County in for the years 2008-2014, where data is available. Adults ages 18-64 in Allegheny County had rates lower than the state and nation for all seven years. All clusters are above the Healthy People 2020 Goal (0%). Figure 12. Adults (Age 18-64) with No Health Insurance

Source: PA Department of Health, Centers for Disease Control, Healthy People 2020


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No Personal Health Care Provider Figure 13 illustrates the percentage of adults reporting that they have no personal health care provider in Pennsylvania and throughout Allegheny County for the cluster years 2008-2010, 2011-2013 and 2012-2014 where data is available. Allegheny County had a significantly higher rate of adults with no personal healthcare (17.0%) when compared to Pennsylvania (14.0%) for the cluster 2012-2014. Allegheny County and Pennsylvania percentages are below the US 2013 percentage of 22.9% for adults with no personal health care provider. Figure 13 Adults with No Personal Health Care Provider



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Doctor’s Visit Figure 14 shows adults who reported that they needed to see a doctor in the last year but could not due to cost in Pennsylvania and Allegheny County for the year clusters 2008-2010, 2011-2013 and 2012-2014, where data is available. Fewer adults in Allegheny County (11.0%) reported not being able to see a doctor due to cost when compared to the state for the year cluster 2012-2014. Both Pennsylvania and Allegheny County are below the USA percentage of 15.3% in 2013. Allegheny County and Pennsylvania percentages are above the Healthy People 2020 Goal of 4.2% for adults who needed to see a doctor in the past year but could not due to cost.

Figure 14. Adults Who Reported Needing to See a Doctor But Could Not Due to Cost, Past Year

Source: PA Department of Health, Centers for Disease Control,

Healthy People 2020


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Community Input Figure 15 illustrates the percentage of 2015 Focus Group participants who rated their personal health status. Almost one-third of the focus group respondents (27.9%) rated their personal health as fair or poor. Figure 15. 2015 Focus Groups – Personal Health Status

Source: OVH CHNA Focus Groups, 2015


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PRC National Child & Adolescent Health Survey, 2014 According to the PRC 2014 National Child & Adolescent Health Survey, more than half of the children in the United States are covered under Private 65.3% Insurance as seen in Figure 16. Figure 16. PRC – Healthcare Insurance Coverage for Child

Source: PRC National Child & Adolescent Health Survey, 2014


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According to the PRC 2014 National Child & Adolescent Health Survey, 6.6% of children in the Northeast Region are uninsured, which is comparable to the United States (6.5%) as seen in Figure 17. All regions and nation are above the Healthy People 2020 Goal of 100% insured. Figure 17. PRC – Lack Healthcare Insurance Coverage for Child

Source: PRC National Child & Adolescent Health Survey, 2014, U.S. Department of Health and Human

Services, Healthy People 2010


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Figure 18 shows that according to the PRC 2014 National Child & Adolescent Health Survey, one in four children (24.5%) in the Northeast Region experienced a barrier or delay in accessing the care they needed, which is lower than the United States (29.4%). Figure 18. PRC – Experienced Difficulties or Delays in Receiving Child’s Needed Healthcare in the Past Year



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Figure 19 shows that according to the PRC 2014 National Child & Adolescent Health Survey, the majority (91.7%) of children in the Northeast Region had a routine physician visit in the past year, which is higher when compared to the United States (85.3%). Figure 19. PRC – Child Visited a Physician for a Routine Checkup in the Past Year



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The PRC 2014 National Child & Adolescent Health Survey found that 83.6% of children in the Northeast region had an annual routine dental check-up, which is slightly lower than the United States (84.9%) as shown in Figure 20. The Northeast region is above the Healthy People 2020 Goal of 49.0%. Figure 20. PRC – Child Visited a Dentist or Dental Clinic Within the Past Year

Source: PRC National Child & Adolescent Health Survey, 2014, U.S. Department of Health and Human Services, Healthy People 2020


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Figure 21 shows the Northeast region (19.5%) had the lowest number of children accessing health care through an urgent care center when compared to the other regions and the United States (28.6%), according to the PRC 2014 National Child & Adolescent Health Survey. Figure 21. PRC – Child Used an Urgent Care Center, QuickCare Clinic, or Other Walk-in Clinic in the Past Year



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Figures 22-24 illustrate responses from the focus groups regarding the community issues related to access problems. Participants were asked to share their reasons for not having a health care provider, based on a 5-point scale where 5=Very Serious problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem and 1=Not a Problem. Overall, the top five access needs ranked by the Focus Group participants are cost of specialists (3.7), the need for specialists to communicate to each other (3.6), scheduling at doctor’s office (3.4), cost of co-pays (3.3), and information detail on what your health insurance covers (summary sheet) (3.3). Figure 22. 2015 Focus Groups – Access Problems, 1 of 3

Source: OVH Focus Groups, 2015


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Figure 23. 2015 Focus Groups – Access Problems, 2 of 3


Figure 24. 2015 Focus Groups – Access Problems, 3 of 3



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Access to Quality Health Care Conclusions There are a number of observations and conclusions that can be derived from the data related to Access to Quality Health Care. They include:

• Adults without health insurance in Allegheny County (12.0%) is lower than the PA and US rates but is higher than the HP goal of 0%.

• The percentage of adults with no personal health care provider in Allegheny County is significantly higher (17.0%) than the PA rate (14.0%) for the year cluster 2012-2014..

• The percentage of adults not seeing the doctor due to costs (11.0%) is higher than the HP goal of 4.2% but lower than the PA and US rates.

• According to the PRC National Child & Adolescent Health Survey, one in four children (24.5%) in the Northeast Region experienced a barrier or delay in accessing the care they needed, which is lower than the United States (29.4%).

• According to the PRC National Child & Adolescent Health Survey, the majority (91.7%) of children in the Northeast Region had a routine physician visit in the past year, which is higher when compared to the United States (85.3%).

• The study also found that 83.6% of children in the Northeast region had an annual routine dental check-up, which is slightly lower than the United States (84.9%).

• The Northeast region (19.5%) had the lowest number of children accessing health care through an urgent care center when compared to the other regions and the United States (28.6%).

• Almost one-third of the focus group respondents (27.9%) rated their personal health as fair or poor.

• The majority of focus group (57.5%) respondents rated the health status of the community as good.

• Focus group participants noted cost of specialists, the need for specialists to communicate with each other, appointment scheduling, cost of copays, not knowing what is covered under insurance plan, and larger print on medicine bottles as access problems.

• Focus group participants noted that needed services include transportation, free dental clinic, need for resource guide in doctors’ offices, services for seniors (senior center, meals on wheels), podiatrist, health insurance, welfare coverage, non-repetition of tests, and more affordable health services as access needs.


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• Stakeholders identified better medication management, affordable health care/medication/ insurance, transportation, more offerings for people with physical disabilities, access to health institutes,, the need for the health clinic to be free (no copays), emergency services, physician shortage, lack of preventative care for children and adults and large deductibles as access needs.


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Conditions that are long-lasting, relapse, have remission and continued persistence are categorized as chronic diseases. The issues of obesity, hypertension/high blood pressure, high cholesterol and a high cancer rate were identified as major concerns in the focus groups and participants commented that it is the root of many other health problems.

CHRONIC DISEASE


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Cancer Figure 25 illustrates the breast cancer incidence rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County is significantly higher for all of the years except 2011 when compared to the Pennsylvania rate and is also higher than the Healthy People goal (41.0). It is lower than the United States rates. Figure 25. Breast Cancer Incidence Rates



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Figure 26 illustrates the breast cancer mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County has been decreasing for the years 2009 (16.1) through 2012 (12.2) and is lower than the Pennsylvania rates, United States rates and Healthy People goals (20.6). Figure 26. Breast Cancer Mortality Rates



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Figure 27 illustrates the bronchus and lung cancer incidence rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County was significantly higher than Pennsylvania for the years 2008 through 2011, and higher than Pennsylvania (63.9) for 2012. Figure 27. Bronchus and Lung Cancer Incidence Rates

Source: PA Department of Health, Centers for Disease Control


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Figure 28 illustrates the lung cancer mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The lung cancer incidence rate in Allegheny County has been decreasing from 2008 (54.5) through 2012 (52.3). The lung cancer mortality rate is still significantly higher than Pennsylvania for the years 2010 (52.2), 2011 (52.4) and 2012 (52.3), but is lower than the 2012 US rate (57.9). The nation, state and county are all above the Healthy People goal (45.5). Figure 28. Lung Cancer Mortality Rates



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Figure 29 illustrates the colorectal cancer incidence rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County for 2012 (40.0) is lower than Pennsylvania (42.5) and the United States (46.1) for the same year. The nation, state and county are all higher than the Healthy People 2020 Goal of 38.6. Figure 29. Colorectal Cancer Incidence Rates



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Figure 30 illustrates the colorectal cancer mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County for 2012 (14.9) is lower than the Pennsylvania (15.8) and United States (18.1) rates for the same year. The rate is only slightly higher than the Healthy People 2020 goal of 14.5. Figure 30. Colorectal Cancer Mortality Rates



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Figure 31 illustrates the prostate cancer incidence rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. In 2012, the rate in Allegheny County (112.1) was significantly higher than the Pennsylvania rate (101.7), but was well below the rate for the United States (128.3). Figure 31. Prostate Cancer Incidence Rates



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Figure 32 illustrates the prostate cancer mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. In the most recent year data is available, the nation (20.8) and Pennsylvania (19.1) met the Healthy People 2020 Goal of 21.2, but Allegheny County fell short at 22.1. Figure 32. Prostate Cancer Mortality Rates



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Heart Disease Figure 33 illustrates the heart disease mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The heart disease rate in Allegheny County has been decreasing over the past five years, but the 2012 rate (180.1) is higher than Pennsylvania (175.2) and the United States (176.8). Figure 33. Heart Disease Mortality Rates



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Heart Attack Figure 34 illustrates the heart attack mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County for 2008 (18.3) was significantly lower than the Pennsylvania rate (20.4) and is slightly lower (17.7) than the 2012 Pennsylvania rate (17.9). Allegheny County and the state all fall well below the rate of the nation (89.2). Figure 34. Heart Attack Mortality Rates



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Figure 35 illustrates the coronary heart disease mortality rate for the United States, and Allegheny County for the years 2008 through 2012, where data is available. For all five years ending in 2012, the coronary heart disease mortality rate in Allegheny County has been significantly higher than the Pennsylvania rate, as well as being higher than the nation and HP goal. Figure 35. Coronary Heart Disease Mortality Rates



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Figure 36 illustrates the cardiovascular disease mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County for 2011 (246.2) was significantly higher than the Pennsylvania rates. Figure 37. Cardiovascular Disease Mortality Rates



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Figure 37 illustrates the COPD mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. In 2012, the COPD mortality rate in Allegheny County (36.2) was lower than both the state (38.4) and Healthy People 2020 goal (102.6). Figure 37. Chronic Lower Respiratory Disease (COPD) Mortality Rates



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Figure 38 illustrates the cerebrovascular disease mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The cerebrovascular disease mortality rate in Allegheny County has been decreasing over the past five years. In 2012 the rate in Allegheny County (34.3) was lower than the state (36.8), the nation (39.9) and Healthy People 2020 goal (34.8). Figure 38. Cerebrovascular Disease Mortality Rates



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Figure 39 illustrates the percentage of adults ever told they had a stroke (ages 35 and older) for the United States, Pennsylvania, and Allegheny County for the year clusters 2008-2010, 2011-2013 and 2012-2014, where data is available. The percentage of adults ever told they had a stroke for the period of 2011-2013 for Allegheny County (4.0%) is higher than the nation (2.8%) but is equal to the state (4.0%). Allegheny County is slightly higher (5.0%) than the state (4.0%) for the year cluster 2012-2014. Figure 39. Adults Ever Told They Had a Stroke (age 35 and older)



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Diabetes Figure 40 illustrates the diabetes mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. For the years 2009-2011, the diabetes mortality rates in Allegheny County were significantly lower than the state. In 2012, the rate in Allegheny County (20.6) was lower than the state (22.0), the nation (73.3) and the Healthy People 2020 goal (66.6). Figure 40: Diabetes Mortality Rates



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Figure 41 illustrates that according to the PRC National Child & Adolescent Health Survey, twice as many children in the Northeast region (1.4%) have diabetes compared to the United States (0.7%). Figure 41. PRC – Child Has Diabetes



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Figure 42 illustrates the percentage of women who received a mammogram in the United States, Pennsylvania and Allegheny County for the years 2010 and 2013-2015, where data is available. The percentage of women receiving a mammogram has been decreasing over the past three years (58.0%, 49.4% and 50.9%) and are lower than the state (63.4%), nation (67.1%) and the Healthy People 2020 goal (81.1%). Figure 42. Mammogram Screenings



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Figure 43 illustrates the average scores for chronic disease related problems identified during the OVH 2015 Focus Groups. Participants were asked to rate the extent each community health issue was a problem in the local community on a 5 point scale, where 5=Very Serious Problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem, and 1=Not at all a Problem. Arthritis (4.0) and Joint issues (3.8) were identified as a serious problems, followed by diabetes (3.4), heart problems (3.2) and obesity (3.2). Figure 43. 2015 Focus Groups – Chronic Disease Problems



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Chronic Disease Conclusions There are a number of observations and conclusions that can be derived from the data related to Chronic Disease. They include:

• Breast cancer incidence rates are significantly higher for all years but 2011 when compared to the PA rate and lower than the US rate.

• The Allegheny County trend for breast cancer deaths has been decreasing for the years 2009-2012 and is lower than the PA and US rates and HP goal.

• Bronchus and lung cancer rates were significantly higher than PA for the years 2008-2011 and higher than PA for 2012.

• Bronchus and lung cancer mortality rates were significantly higher for the years 2010-2012 than PA and higher than the HP goal, but lower than the 2012 US rate.

• Colorectal cancer incidence rate for 2012 (40.0) is lower than the PA rate (42.5) and the US rate (46.1) but higher than the HP goal (38.6).

• Colorectal cancer mortality rate for 2012 (14.9) is lower than the PA rate (15.8) and US rate (18.1) and slightly higher than the HP goal (14.5).

• Prostate cancer incidence rate for 2012 (112.1) is significantly higher than the PA rate (101.7) but lower than the US rate (128.3).

• Prostate cancer mortality rate for 2012 (22.1) is slightly higher than the PA rate (19.1), US rate (20.8) and HP goal (21.2).

• The trend for heart disease mortality rate is showing a decline over the five-year period, but the 2012 rate (180.1) is still higher than the PA rate (175.2) and US rate (176.8).

• Heart attack mortality rate for 2008 (18.3) was significantly lower than the PA rate (20.4) and is slightly lower (17.7) than the 2012 PA rate (17.9).

• For all five years ending 2012, the coronary heart disease mortality rate has been significantly higher than the PA rate, as well as being higher than the US rate and HP goal.

• The cardiovascular mortality rate for 2011 (246.2) was significantly higher than the PA rate.

• The 2012 chronic lower respiratory disease (COPD) rate (36.2) is lower than the PA rate (38.4) and HP goal (102.6).

• The trend for the cerebrovascular mortality rate has been decreasing over the last five years and for 2012 (34.3) is lower than the PA rate (36.8), the US rate (39.9) and HP goal (34.8).


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• The percentage of adults age 35 and older who were ever told they had a stroke (4.0%) for the period 2011-2013 is higher than the US (2.8%) and equal to PA.

• Diabetes mortality rates for the years 2009-2011 were significantly lower than the PA rates. For 2012, the rate is lower (20.6) than the PA rate (22.0), the US rate (73.3) and the HP goal (66.6).

• According to the PRC National Child & Adolescent Health Survey, twice as many children in the Northeast region (1.4%) have diabetes compared to the United States (0.7%).

• Mammogram screening rates have been decreasing over the past three years (58.0%, 49.4% and 50.9%) and are lower that the PA rate (63.4%), the US rate (67.1%) and the HP goal (81.1%).

• Stakeholders interviewed listed diabetes, obesity, heart disease, hypertension, aging population, cancer and emphysema as chronic disease needs of the community.

• Focus group participants identified the following as chronic disease needs: diabetes, high blood pressure, heart problems, COPD, obesity, cancer, arthritis, kidney problems and sleep apnea.

• The top ten chronic disease problems that the focus group participants listed were:

• Arthritis • Joint issues • Diabetes • Heart problems • Obesity • Breast cancer • COPD • Congestive heart failure • Colon cancer • Melanoma/skin cancer


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Environmental quality is a general term which refers to varied characteristics that relate to the natural environment such as air and water quality, pollution and noise, weather as well as the potential effects such characteristics have on physical and mental health. In addition, environmental quality also refers to the socio-economic characteristics of a given community or area, including economic status, education, crime and geographic information. In 1980, the CDC established the National Center for Environmental Health. In 2006, the Pennsylvania Department of Health began collection of environmental data associated with health. This is a fairly new process with limited national and state data available. The goal is to include the following:

Ambient Air Quality Measures (Ozone, PM 2.5)

Contaminants in Drinking Water (arsenic, nitrates, disinfectant-by-products, lead)

Hospitalization for Asthma and Myocardial Infarction

Birth Defects and related Premature Births

Childhood Blood Lead

Vital Statistics and Birth Outcomes

Cancer

HEALTHY ENVIRONMENT


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Asthma and Other Respiratory Diseases Figure 44 shows the rate of asthma hospitalizations for the counties in Pennsylvania for the years 2009-2013. Figure 44. Asthma Hospitalizations 2009-2013

Source: Pennsylvania Health Care Cost Containment Council (PHC4)


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Marcellus Shale Hydraulic Fracturing Marcellus Shale hydraulic fracturing and drilling is active in counties (McKean, Potter and Cattaraugus) of OVH’s primary service area, making the potential environmental and health issues important to study and consider. Fracking,” or hydraulic fracturing, is a widely used oil and gas drilling technique. Fracking involves injecting water mixed with sand and chemicals deep underground to fracture rock formations and release trapped gas. There are few comprehensive studies that outline the net effects of these processes on the community or the environment. As a result, there are several psycho-social issues associated with Marcellus Shale and “fracking” that have been documented, including the stress associated with health concerns and community disruptions associated with the drilling processes themselves. The information included in this study provides relevant excerpts from the few comprehensive studies that have been published to date. Although “real time” air quality data is available in selected areas, the compiled data is several years old (2007). Additionally, water quality data is only collected in municipalities that have public water systems and is not centrally reported, making accessing it a challenge. Outside of urban areas, water quality data is sporadic and dependent on individual owner testing; current testing standards do not include some of the substances of concern related to fracking. One study, “Drilling down on fracking concerns: The potential and peril of hydraulic fracturing to drill for natural gas” noted, “In 2008 and 2009, total dissolved solids (TDS) levels exceeded drinking standards in the Monongahela River, the source of drinking water for some residents of Pittsburgh. Pittsburgh’s water treatment plants are not equipped to remove them from the water supplied to residents.” The study also notes “….statistical analyses of post-drilling versus pre-drilling water chemistry did not suggest major influences from gas well drilling or hydro fracturing (fracking) on nearby water wells, when considering changes in potential pollutants that are most prominent in drilling waste fluids.”1

1 Kenworth, Tom, Weiss, Daniel J., Lisbeth, Kaufman and Christina C. DiPasquale (21 March

2011). Drilling down on fracking concerns: The potential and peril of hydraulic fracturing to


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Another study The Impact of Marcellus Gas Drilling on Rural Drinking Water Supplies, noted “when comparing dissolved methane concentrations in the 48 wells that were sampled both before and after drilling, the research found no statistically significant increases in methane levels after drilling and no significant correlation to distance from drilling. However, the researchers suggest that more intensive research on the occurrence and sources of methane in water wells is needed.”2 According to the Pediatric Environmental Health Unit of the American Academy of Pediatrics, a study conducted in New York and Pennsylvania found that methane contamination of private drinking water wells was associated with proximity to active natural gas drilling.” (Osborne SG, et al., 2011). “While many of the chemicals used in the drilling and fracking process are proprietary, the list includes benzene, toluene, ethyl benzene, xylene, ethylene glycol, glutaraldehyde and other substances with a broad range of potential toxic effects on humans ranging from cancer to adverse effects on the reproductive, neurological, and endocrine systems.” (ATSDR, Colborn T., et al., U.S. EPA 2009). “Sources of air pollution around a drilling facility include diesel exhaust from the use of machinery and heavy trucks, and fugitive emissions from the drilling and NGE/HF practices….volatile organic compounds can escape capture from the wells and combine with nitrogen oxides to produce ground level ozone.” (CDPHE 2008, 2010)3 Recent research conducted by the RAND Corporation analyzed water quality, air quality and road damage. The RAND results of the water quality and road damage are not yet published. An article titled “Estimation of regional air-quality damages from Marcellus Shale natural gas extraction in Pennsylvania.”4

drill for natural gas. Center for American Progress. Retrieved from http://www.americanprogress.org/wp-content/uploads/issues/2011/03/pdf/fracking.pdf. 2 Boyer, Elizabeth W., Ph.D., Swistck, Bryan R., M.S., Clark, James, M.A.; Madden, Mark, B.S.

and Rizzo, Dana E., M.S. (March 2012). The impact of Marcellus gas drilling on rural drinking water supplies. Pennsylvania State University for the Center for Rural Pennsylvania. Retrieved from http://www.rural.palegislature.us/documents/reports/Marcellus_and_drinking_water_2012.pdf. 3 n.a. (August 2011). PEHSU information on natural gas extraction and hydraulic fracturing

for health Professionals. American Academy of Pediatrics. Retrieved from http://aoec.org/pehsu/documents/hydraulic_fracturing_and_children_2011_health_prof.pdf. 4 Litovitz, A., Curtright, A., Abramzon, S., Burger, N. and Samaras, C. (31 January 2013).

Estimation of regional air-quality damages from Marcellus Shale natural gas extraction in


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This paper provides an estimate of the conventional air pollutant emissions associated with the extraction of unconventional shale gas in Pennsylvania, as well as the monetary value of the associated regional environmental and health damages. The conclusions include:

In 2011, the total monetary damages from conventional air pollution emissions from Pennsylvania-based shale gas extraction activities is estimated to have ranged from $7.2 to $32 million dollars. For comparison, the single largest coal-fired power plant alone produced $75 million in annual damages in 2008.

This emissions burden is not evenly spread, and there are some important implications of when and where the emissions damages occur. In counties where extraction activity is concentrated, air pollution is equivalent to adding a major source of [nitrogen oxides oxide] NOx emissions, even though individual facilities are generally regulated separately as minor sources. The majority of emissions are related to the ongoing activities which will persist for many years into the future; compressor stations alone represent 60 to 75 percent of all damages.

Further study of the magnitude of emissions, including primary data collection, and development of appropriate regulations for emissions will both be important. This is because extraction-related emissions, under current industry practices, are virtually guaranteed and will be part of the cost of doing business.

Pennsylvania. Rand Corporation, 8(1). Retrieved from http://iopscience.iop.org/1748-9326/8/1/014017/pdf/1748-9326_8_1_014017.pdf.


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High School Graduation Rates Figure 45 displays high school graduation rates for Pennsylvania and Allegheny County for the years 2013 through 2015, where data is available. The high school graduation rates in Allegheny County are higher than the state, as well as falling above the Healthy People 2020 goal. Figure 45. High School Graduation Rates

Source: www.countyhealthrankings.org, Healthy People 2020


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Unemployment Figure 46 illustrates the unemployment rates in Pennsylvania and Allegheny County for the years 2013-1015, where data is available. The unemployment rates in Allegheny County are lower than the state, and are showing a decreasing trend overall for the three years ending 2015. Figure 46. Unemployment

Source: www.countyhealthrankings.org


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Asthma Figure 47 illustrates the percentage of students with asthma in Pennsylvania and Allegheny County for the years 2008 through 2012, where data is available. In Allegheny County, the number of students with asthma has been trending upward since 2009, and in 2012 Allegheny County had a higher percentage (12.4%) than the state (12.1%). Figure 47. Students with Asthma

Source: PA Department of Health


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Figure 48 shows that according to the PRC National Child & Adolescent Health Survey, one in ten children (10.6%) in the Northeast Region have Asthma, which is slightly lower when compared to the United States (11.6%). Figure 48. PRC – Child Currently Has Asthma (US 2014)

Source: PRC National Child and Adolescent Health Surveys, 2014


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Figure 49 illustrates that slightly more than one in four (27.0%) children in the United States had an Asthma-related visit to the Emergency Room or Urgent Care Facility in 2014. According to the survey, the trend for children having an Asthma-related visit to the Emergency Room or Urgent Care is on the decline between the years 2012 and 2014. Figure 49. PRC – Number of Asthma-Related ER/Urgent Care Visits in the Past Year (US 2014)

Source: PRC National Child and Adolescent Health Surveys, 2014


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Healthy Environment Conclusions There are a number of observations and conclusions that can be derived from the data related to Health Environment. They include:

• High school graduation rates in Allegheny County are higher than the

state as well as the HP goal. • The unemployment rates in Allegheny County are lower than PA and

are showing a decreasing trend. • The percentage of students with asthma is trending upward for the

years 2009-2012. • According to the PRC National Child & Adolescent Health Survey, one

in ten children (10.6%) in the Northeast Region have Asthma, which is slightly lower when compared to the United States (11.6%).

• Slightly more than one in four (27.0%) children in the United States had an Asthma related visit to the Emergency Room or Urgent Care Facility.

• Stakeholders identified air quality, generational poverty, low socioeconomic environment, Section 8 and public housing, and losing welfare benefits if hired as environment-related needs

• Focus group participants indicated that high unemployment, homelessness, burglaries, need for shelters, unsafe playgrounds, safety issues/violence, poverty, and crime are the most important environment-related needs.


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Improving the well-being of mothers, babies and children is a critical and necessary component of community health. The well-being of children determines the health of the next generation and can help predict future public health challenges for families, communities and the health care system. The healthy mothers, babies and children topic area addresses a wide range of conditions, health behaviors and health systems indicators that affect the health, wellness and quality of life for the entire community including: prenatal care, smoking during pregnancy, low-birth weight babies, infant mortality, social service assistance, breastfeeding and teen pregnancy. When available for a given health indicator, Healthy People 2020 (HP 2020) goals and state and national rates were included.

HEALTHY MOTHERS, BABIES AND CHILDREN


Page | 84

Figure 50 illustrates the percentage of mothers receiving prenatal care during their first trimester in the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. Allegheny County had significantly more mothers accessing prenatal care during the first trimester compared to the state for the years 2008 through 2012. The percentage of mothers receiving prenatal care during their first trimester in Allegheny County for 2012 (89.1%) was also higher than the nation (70.8%) and the Healthy People 2020 goal of 77.9%. Figure 50. Prenatal Care First Trimester



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Figure 51 illustrates the percentage of nonsmoking mothers during pregnancy in the United States, Pennsylvania, New York, and the service area counties in 2008 through 2012, where data is available. Allegheny County had significantly higher non-smoking mothers during pregnancy in 2012 (86.8%) when compared to the state (85.2%). Allegheny County had a lower percentage in 2012 (86.8%) than the nation (89.3%) and the Healthy People 2020 goal (98.6%). Figure 51. Non-Smoking Mother During Pregnancy



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Figure 52 illustrates the percentage of nonsmoking mothers three months prior to pregnancy in the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. Allegheny County had significantly higher percentages for mothers not smoking three months prior to pregnancy when compared to the state for all five years, and is also higher than the nation. Figure 52. Non-Smoking Mother Three Months Prior to Pregnancy



Page | 87

Figure 53 illustrates the percentage of low birth rate babies born in the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. Allegheny County (7.6%) had significantly fewer low birth rate babies born compared to the state (8.1%) in 2012, and was slightly lower than the nation (8.0%) and Healthy People 2020 Goal (7.8%). Figure 53. Low Birth Rate Babies Born



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Figure 54 illustrates percentage of mothers reporting WIC Assistance in Pennsylvania and Allegheny County in 2008 through 2012, where data is available. Allegheny County had a significantly lower percentage of mothers reporting WIC Assistance compared to the state for all five years. Figure 54. Mothers Reporting WIC Assistance



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Figure 55 illustrates percentage of mothers reporting Medicaid Assistance in Pennsylvania and Allegheny County in 2008 through 2012, where data is available. Allegheny County had significantly fewer mothers reporting Medicaid Assistance compared to the state in 2009-2012, but it is trending upward for the years 2011 (25.8%) and 2012 (30.0%). Figure 55. Mothers Reporting Medicaid Assistance



Page | 90

Figure 56 illustrates percentage of mothers who report breastfeeding in the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. Compared to Pennsylvania, Allegheny County had a significantly lower percentage of mothers reporting breastfeeding for all five years. Allegheny County fell short when compared to the nation (77.0%) and the Healthy People 2020 goal of 81.9% in 2012. Figure 56. Mothers Reporting Breastfeeding



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Figure 57 illustrates the percentage of teen pregnancies for teenagers ages 15-19 in the United States, Pennsylvania, and Allegheny Counties from 2008 through 2012, where data is available. When compared to Pennsylvania, Allegheny County had a significantly lower percentage of teen pregnancies for teenagers ages 15-19 for the years 2008-2009 and 2011-1012. Allegheny County was below the Healthy People Goal of 36.2% in 2012 (30.6%). Figure 57. Teen Pregnancy Rate, Ages 15-19



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Figure 58 illustrates the percentage of teen live births in the United States, Pennsylvania, and Allegheny County from 2008 through 2012, where data is available. When Compared to Pennsylvania, Allegheny County had a significantly lower percentage of live teen birth outcomes for all five years. In 2012, Allegheny County (59.7%) had a much lower percentage of teen live birth outcomes compared to the nation (73.4%) and the state (69.5%). Figure 58. Teen Live Birth Outcomes, Ages 15-19



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Infant Mortality Figure 59 illustrates infant mortality rate in the United States, Pennsylvania, and Allegheny County from 2008 through 2012, where data is available. The rate in Allegheny County has been trending downward for the last five years, and was lower in 2012 (5.9%) than the state (7.0%) and nation (6.1%). Figure 59. Infant Mortality



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Figure 60 illustrates infant mortality rates for the counties in Pennsylvania between 2006 and 2010. The infant mortality rate in Allegheny County was 6.2-8.1. Figure 60. Infant Mortality in Pennsylvania

Source: PA Department of Health-Pennsylvania Vital Statistics 2010


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Figure 61 illustrates the percentage of students in Kindergarten through 6th grade who are considered Overweight in Pennsylvania and Allegheny County for 2008 through 2012, where data is available. The percentage of student in Kindergarten through 6th grade who are considered Overweight in Allegheny County in 2011 (17.3%) is higher than the state (15.9%). Figure 61. Overweight BMI, Grades K-6

Source: PA Department of Health


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Figure 62 illustrates the percentage of students in 7th through 12th grade who are considered Overweight in the United States, Pennsylvania, and Allegheny County for 2008 through 2012, where data is available. Compared to Pennsylvania (16.4%) in 2011, Allegheny County (17.1%) had a higher percentage of students considered overweight in grades 7-12. Figure 62. Overweight BMI, Grades 7-12



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Figure 63 illustrates the percentage of students in 7th through 12th grade who are considered Obese in the United States, Pennsylvania, and Allegheny County for 2008 through 2012, where data is available. The percentage of students in grades 7-12 that were obese in 2011 (15.9%) is lower than PA (17.7%) and the HP goal (16.1%) but higher than the US (13.7%). Figure 63. Obese BMI, Grades 7-12



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Figure 64 illustrates the percentage of children in the United States in 2014 that had ever been fed breast milk. Over half (69.4%) of the children in the United States had been fed breast milk, which falls below the Healthy People 2020 Goal of 81.9%. Figure 64. PRC – Child Was Ever Fed Breast Milk

Source: PRC National Child and Adolescent Health Survey, 2014, U.S. Department of Health and Human



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Figure 65 illustrates the percentage of children in the United States in 2014 that were exclusively breastfed for at least 6 months. Approximately one in four (26.8%) children in the Northeast region was exclusively breastfed for at least 6 months, which is slightly lower than the nation (27.2%). Figure 65. PRC – Child Exclusively Breastfed for at Least Six Months

Source: PRC National Child and Adolescent Health Survey, 2014, U.S. Department of Health and Human



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Healthy Mothers, Babies and Children Conclusions There are a number of observations and conclusions that can be derived from the data related to Healthy Mothers, Babies and Children. They include:

• The percentage of mothers accessing prenatal care during the first trimester is significantly higher than PA for the five years 2008-2012 and for 2012 is above the US and HP goal.

• The percentage of non-smoking mothers during pregnancy is significantly higher than PA for years 2010 and 2012 but is lower than the US and HP goal for 2012.

• The percentage of non-smoking mothers three months prior to pregnancy is significantly higher than PA for the five years 2008-2012.

• Babies born with a low birth rate percentage for 2012 (7.6%) is significantly lower than PA (8.1%) and is slightly lower than the US (8.0%) and HP goal (7.8%).

• The percentage of mothers reporting WIC assistance is significantly lower than PA for the five years 2008-2012.

• The percentage of mothers reporting Medicaid assistance is significantly lower than PA for the four years 2009-2012 and is trending upward for the years 2011 and 2012.

• The percentage of mothers who breastfeed is significantly lower than PA for the five years 2008-2012 but for 2012 (72.0%) is lower than the US (77.0%) and HP goal (81.9%).

• The teen pregnancy rate for Allegheny County was significantly lower than PA for the years 2008-2009 and 2011-2012, and for 2012 (30.6) is below the HP goal (36.2).

• Teen live birth outcomes percentages for the five years 2008-2012 are significantly lower than PA.

• Infant mortality percentages for Allegheny County are trending downward for the last five years.

• The percentage of students in grades K-6 that were overweight in 2011 (17.3%) is higher than PA (15.9%).

• The percentage of students in grades 7-12 that were overweight in 2011 (17.1%) is higher than the 2012 PA percentage (16.4%) but lower than the US (30.3%).

• The percentage of students in grades 7-12 that were obese in 2011 (15.9%) is lower than PA (17.7%) and the HP goal (16.1%) but higher than the US (13.7%).


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• According to the PRC National Child & Adolescent Health Survey, over half (69.4%) of children in the United States were fed breast milk.

• One in four (26.8%) children in the Northeast Region were exclusively breastfed for the first six months, which is slightly less when compared to the United States (27.2).

• Stakeholders interviewed identified lack of parenting skills, OVH no longer offering a maternity ward, and pediatrics and family care as needs in the community.

• Focus group participants identified lack of parenting skills, number of single parents, and the lack of women’s health as needs in the community.


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Pathogenic microorganisms, such as bacteria, viruses, parasites or fungi, cause infectious diseases; these diseases can be spread, directly or indirectly, from one person to another. These diseases can be grouped in three categories: diseases which cause high levels of mortality; diseases which place on populations heavy burdens of disability; and diseases which owing to the rapid and unexpected nature of their spread can have serious global repercussions (World Health Organization).

INFECTIOUS DISEASE


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Figure 66 illustrates percentage of adults age 65 and older who have had a pneumonia vaccine in the United States, Pennsylvania, and Allegheny County for the cluster years 2008-2010, 2011-2013, and 2012-2014 where data is available. In Allegheny County, the percentage of adults over the age of 65 receiving a pneumonia vaccine was significantly higher for all years than the state and nation, but was lower than the Healthy People 2020 goal of 90.0%. Figure 66. Adults Who Had Pneumonia Vaccine, Age 65 and Older



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Figure 67 illustrates influenza and pneumonia mortality rate for the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. The influenza and pneumonia mortality rate in Allegheny County was significantly higher than the state rate for the years 2009 through 2012. Figure 67. Influenza and Pneumonia Mortality



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Figure 68 illustrates Lyme disease incidence rates in the United States in 2012, as well as Pennsylvania and Allegheny County in 2008 through 2012, where data is available. The rates in Allegheny County are significantly lower than the state rates for the years of 2008-2010 and 2012. Figure 68. Lyme Disease Incidence Rates



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Figure 69 illustrates the percentage of adults age 18 to 64 who have ever been tested for HIV in the United States in 2013 as well as Pennsylvania and Allegheny County for the cluster years 2008-2010, 2011-2013 and 2012-2014. When compared to the state, the percentage of adults age 18-64 that had been tested for HIV in Allegheny County was roughly the same, but both state and county are well below the Healthy People goal of 73.6%.

Figure 69. Ever Tested for HIV, Adults 18-64



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Figure 70 illustrates chlamydia rates in Pennsylvania and Allegheny County for 2008 through 2012. For all five reporting years, Allegheny County’s chlamydia rates are significantly higher than the state rate and the trend for the county has been increasing over the last three years. Figure 70. Chlamydia Rate



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Figure 71 illustrates chlamydia rates in females in Pennsylvania and Allegheny County for 2008 through 2012, where data is available. For the years 2008 through 2012, the rate of chlamydia in females in Allegheny County is significantly higher than the state rates, with an increasing trend during the last three years. Figure 71. Chlamydia Rates, Female



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Figure 72 illustrates chlamydia rate in males in Pennsylvania and Allegheny County in 2008 through 2012, where data is available. For the years 2008 through 2012, the rate of chlamydia in males in Allegheny County is significantly higher than the state rates, with an increasing trend over the last three years. Figure 72. Chlamydia Rates, Male



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Figure 73 illustrates the gonorrhea rate in the United States in 2012 as well as Pennsylvania and Allegheny County in 2008 through 2012, where data is available. For the years 2008-2012, Allegheny County’s gonorrhea rates have been significantly higher than the state rates, with an increasing trend over the last four years. Figure 73. Gonorrhea Rates



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Figure 74 illustrates gonorrhea rates in females in Pennsylvania and Allegheny County for 2008 through 2012, where data is available. For the years 2008-2012, the rate of females with gonorrhea in Allegheny County has been significantly higher than the state rate, with an increasing trend over the least four years. Figure 74. Gonorrhea Rates, Female



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Figure 75 illustrates gonorrhea rates in males in Pennsylvania and Allegheny County for 2008 through 2012, where data is available. For the years 2008-2012, the rate of males with gonorrhea in Allegheny County has been significantly higher than the state rate, with an increasing trend over the least four years. Figure 75. Gonorrhea Rates, Male



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Infectious Disease Conclusions There are a number of observations and conclusions that can be derived from the data related to Infectious Disease, although the topic was not discussed in the Stakeholder Interviews. They include:

• The percentage of adults age 65 and older who had a pneumonia vaccine was significantly higher than PA for the years 2008-2010, 2011-2013 and 2012-2014 but was lower than the HP goal.

• The influenza and pneumonia mortality rate was significantly higher than the PA rate for the years 2009-2012.

• Lyme disease incidence rates are significantly lower than the PA rates for the recording years of 2008-2010 and 2012.

• The percentage of adults age 18-64 who have ever been tested for HIV for 2012-2014 (38.0%) is equal to the PA percentage but lower than the HP goal (73.6%).

• The chlamydia rates for all adults, females and males for the past five years (2008-2012) have been significantly higher than the PA rate.

• The gonorrhea rates for all adults, females and males for the past five years (2008-2012) have been significantly higher than the PA rate.

• Stakeholder interviews did not identify any infectious disease needs. • Focus group participants mentioned that pneumonia was a small

problem.


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Mental Health refers to a broad array of activities directly or indirectly related to the mental well-being component included in the World Health Organization’s definition of health: “A state of complete physical, mental and social well-being, and not merely the absence of disease.” Mental health is related to the promotion of well-being, the prevention of mental disorders, and the treatment and rehabilitation of people affected by mental disorders. According to the World Health Organization, substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. Psychoactive substance use can lead to dependence syndrome – a cluster of behavioral, cognitive and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state. Western Pennsylvania has experienced an epidemic of heroin and opiate abuse in the past 8-10 years. Pennsylvania now has the 7th highest drug overdose mortality rate in the United States, with over 3,000 deaths being heroin-related overdoses. Drug overdose deaths in Pennsylvania have now exceeded the number of deaths from automobile accidents.

MENTAL HEALTH AND SUBSTANCE ABUSE


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Figure 76 illustrates the mental and behavioral health disorders mortality rate for the United States in 2012, as well as Pennsylvania and Allegheny County in 2008 through 2012. The rate in 2012 in Allegheny County (46.5) is significantly higher than the state (43.0) but is lower than the nation (63.3). For the years 2009 and 2010, the county rate is also significantly higher than the state rate. Figure 76. Mental and Behavioral Disorders Mortality Rate



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Figure 77 illustrates the percentage of adults who report binge drinking in the United States, Pennsylvania and Allegheny County for the cluster years 2008-2010, 2011-2013 and 2012-2014. Binge drinking is defined as five or more drinks in one sitting for males and four or more drinks in one sitting for females. Allegheny County had a significantly higher percentage of adults who reported binge drinking for the years 2011-2013 and 2012-2014 when compared to the state, but is still below the Healthy People 2020 Goal of 24.4%. Figure 77. Adults Who Reported Binge Drinking (Men=5 Drinks, Women=4 Drinks)



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Figure 78 illustrates the percentage of adults who are at risk for heavy drinking in the United States, Pennsylvania and Allegheny County for the cluster years 2008-2010, 2011-2013 and 2012-2014. Heavy drinking is defined as two drinks in one day for males and one drink a day for females. Allegheny County (8.0%) had a significantly higher percentage of adults who were at risk for heavy drinking than the state (6.0%) for the years 2011-2013. Figure 78. Adults at Risk for Heavy Drinking (2 Drinks for Men/1 Drink for Women)



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Figure 79 illustrates the drug-induced mortality rate in the United States in 2012, as well as Pennsylvania for 2008 and 2012, and Allegheny County for 2008 through 2014. In 2012, the drug-induced mortality rate in Allegheny County (22.7) was significantly higher when compared to the state, the nation, and the Healthy People 2020 Goal (11.3). Figure 79. Drug-Induced Mortality Rate



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Figure 80 illustrates the percentage of youth in grades 6th through 12th in Allegheny County who report using alcohol or marijuana in 2009, 2011, and 2013, as well as in Pennsylvania and nation in 2013, where data is available. The percentage of students who report using alcohol in all grades has increased between 2009 and 2013, as has the percentage of students reported using marijuana. Both groups are also higher than the state percentage for 2013. Figure 80. PAYS – Allegheny County Substance Use

Source: PA Youth Survey, 2009-2013


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Figure 81 illustrates the percentage of youth in grades 6th through 12th in Allegheny County who report using prescription pain relievers in 2009, 2011, and 2013, as well as in Pennsylvania and nation in 2013, where data is available. Students in grades 6 (2.6), 8 (4.6), 10 (10.4) and 12 (16.5) have a higher percentage of students using pain relievers when compared to the state for the year 2013. The percentage is also increasing for students in 10th and 12th grades, as well as overall. Figure 81. PAYS – Allegheny County Pain Reliever Use



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Figure 82 illustrates the percentage of youth in grades 6th through 12th in Allegheny County who report driving after using alcohol or marijuana in 2009, 2011, and 2013, as well as in Pennsylvania and nation in 2013, where data is available. A higher percentage of youth in all grades report driving after alcohol when compared to the state, as well as driving after marijuana use. Figure 82. PAYS – Allegheny County Risky Behaviors



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Figure 83 illustrates the average scores for mental health and substance use problems identified during the OVH 2015 Focus Groups. Participants were asked to rate the extent each community health issue was a problem in the local community on a 5 point scale, where 5=Very Serious Problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem, and 1=Not at all a Problem. The participants ranked prescription drug abuse (4.2) and substance abuse (4.2) is serious problems in their area. Figure 83. 2015 Focus Groups – Mental Health and Substance Abuse Problems

Source: 2015 OVH Focus Groups


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Health and Substance Abuse Conclusions

There are a number of observations and conclusions that can be derived from the data related to Mental Health and Substance Abuse. They include:

• Mental and behavioral disorders mortality rate for 2012 (46.5) is significantly higher than the PA (43.0) but lower than the US rate (63.3).

• The percentage of adults who reported binge drinking (5 drinks for men; 4 for women) was significantly higher for the years 2011-2013 and 2012-2014 than the state, but is below the HP goal of 24.4%.

• The percentage of adults who were at risk for heavy drinking (2 drinks for men; 1 for women daily) was significantly higher (8.0%) than PA (6.0%) for 2011-2013.

• The 2012 drug-induced mortality rate (22.7) was significantly higher than the PA rate (19.2), and higher than the US (10.2) and HP goal (11.3).

• Youth alcohol and prescription narcotic drug use increases with age throughout high school and has increased over the past four years in Allegheny County.

• Marijuana use has increased over the past four years in Allegheny County.

• Youth driving after drinking or using marijuana has increased slightly over the past few years.

• Stakeholders interviewed identified mental health, high school students using drugs, drug and alcohol addiction, prescription drug abuse, crime and violence as it revolves around drug activity, Health Center no longer offering counseling services and Focus on Renewal not having any crisis funds to help as mental health and substance abuse needs.

• Focus group participants identified drugs and alcohol, depression, mental health medication and mental stress as mental health and substance abuse needs.

• Focus group participants mentioned that Alzheimer disease was somewhat of a problem in the area.


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Regular physical activity reduces the risk for many diseases, helps control weight, and strengthens muscles, bones and joints. Proper nutrition and maintaining a healthy weight are critical to good health. Physical activity and nutrition topics explored include: levels of physical activity, availability of fast or fresh food, and utilization of free and reduced-price lunches for school aged children.

PHYSICAL ACTIVITY AND NUTRITION


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Figure 84 illustrates the number of days in the past week children in the United States were physically active for one hour or longer in 2014. Slightly less than half (43.2%) of children age two through seventeen were physically active for one hour or longer seven days out of the week. A very small percentage (2.6%) report not being physically active for one hour or longer during a week. Figure 84. PRC – Number of Days in the Past Week on Which Children Were Physically Active for an Hour or Longer (US Children Age 2-17, 2014)



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Figure 85 illustrates the percentage of children that were physically active for one hour or longer every day in the past week in 2014. Children in the Northeast region were slightly less active (41.0%) when compared to the nation (43.2%), West (47.0%) and South (43.3%). The national trend is decreasing, with over half of children (57.3%) being physically active every day during the past week in 2012. Figure 85. Percentage of Children Physically Active for an Hour or Longer Every Day in Past Week (US Children Age 2-17)



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Figure 86 illustrates the hours children ages five through seventeen spend per day on TV/videos/video games or on a computer/cell phone/handheld device in the United States. One in three children (30.1%) spend three or more hours per day on TV/videos or video games. Approximately one in four (27.4%) spend three more hours per day on a computer, cell phone, or handheld device. For this graph, respondents with children who are not in school were asked about “weekdays,” while parents of children in school were asked about typical “school days” when responding this survey question. Figure 86. PRC – Hours of Children’s Screen Time (US Children Age 5-17, 2014)



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Figure 87 illustrates the percentage of children who spend three or more hours per school day on a computer, device, watching TV, etc. in the United States. Over half (63.8%) in the United States have three or more hours of screen time on a school day. Children in the Northeast Region (65.2%) were slightly higher when compared to the nation (63.8%), West (59.9%) and Midwest (58.1%). For this graph, respondents with children who are not in school were asked about “weekdays,” while parents of children in school were asked about typical “school days” when responding this survey question. Figure 87. PRC – Children with Three or More Hours per School Day of Screen Time (TV, Computer, Video Games, Phone, Device, etc.) (US Children Age 5-17)



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Figure 88 illustrates the percentage of children in the United States in 2014 receiving five or more servings per day of fruits and/or vegetables. Less than half (41.8%) of children are receiving five or more servings of fruits and/or vegetables daily, which is declining compared to 2012 (46.4%). Approximately one third (33.9%) of children in the Northeast Region are receiving five or more servings, which is lower than all other regions. Figure 88. PRC – Percentage of Children Having Five or More Servings of Fruits/Vegetables per Day



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Figure 89 illustrates the number of fast food meals children age two through seventeen consume in the past week. Slightly less than one in three children (30.1%) did not consume any fast food meals within the past week. Just over one in five children (22%) consumed four or more fast food meals in the past week. Figure 89. PRC – Number of Fast Food Meals Children Consume (US Children Age 2-17, 2014)



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Figure 90 illustrates the average scores for the physical activity and nutrition related health problems identified during the OVH 2015 Focus Groups. Respondents were asked to rate the extent each community health issue was a problem in the local community on a 5 point scale, where 5=Very Serious Problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem, and 1=Not at all a Problem. Senior nutrition is poor (3.0) and lack of diet and nutrition information (3.0) were identified as Serious Problems. Figure 90. 2015 Focus Groups - Physical Activity and Nutrition Problems

Source: OVH CHNA Community Survey, 2015


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Physical Activity and Nutrition Conclusions There are a number of observations and conclusions that can be derived from the data related to Physical Activity and Nutrition. These include:

• According to the PRC National Child & Adolescent Health Survey, just under half (43.2%) of children in the United States are physically active seven days a week. The majority (97.4%) are active at least one day per week.

• The study found that less than half (41.0%) of children in the Northeast Region were physically active for an hour or longer in the past week, which is slightly lower than the United States (43.2%).

• According to the PRC National Child & Adolescent Health Survey, over half (59.9%) of children in the United States are spending more than an hour per day playing video games or watching TV.

• Slightly fewer (49.3%) are spending over an hour on a computer, cell phone or other hand held device.

• Over half (65.2%) of the children in the Northeast Region are spending over three hours in on “screen time”, which is higher than the United States (63.8%).

• According to the PRC National Child & Adolescent Health Survey, one in three (33.9%) children is receiving five or more servings of fruits and vegetables per day, which is lower compared to the United States (41.8%).

• Over half (69.9%) of children in the United States are eating fast food at least one time per week.

• Stakeholders interviewed identified poor diet and inactivity, bad nutrition, nutrition education, recreation/opportunities for physical education, available community recreation, school nutrition, food bank nutrition, time to exercise and prepare a healthy meal and nutrition coaching as physical activity and nutrition needs.

• Focus group participants identified diet and nutrition classes, awareness of nutrition/exercise, sedentary lifestyle and too busy to cook as physical activity and nutrition needs.


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Page | 135

Tobacco Use is an important public health indicator as it relates to a number of chronic disease issues and conditions.

TOBACCO USE


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Figure 91 illustrates the percentage of male adults who report being a former smoker in Pennsylvania and Allegheny County during 2008 through 2014. The percentage of male adults who report being a former smoker in Allegheny County is decreasing for the cluster years 2008 through 2014. Figure 91. Male Adults Who Reported Being a Former Smoker



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Figure 92 illustrates the percentage of adults who report being a current smoker in the United States in 2008-2010 and 2011-2013, as well as Pennsylvania and Allegheny County during the cluster years of 2008-2010, 2011-2013 and 2012-2014. In 2012-2014, the percentage of adults who reported being a current smoker in Allegheny County (21.0%) is equal to Pennsylvania (21.0%), but higher than the Healthy People 2020 Goal of 12.0%. Figure 92. Adults Who Reported Being a Current Smoker



Page | 138

Figure 93 illustrates the percentage of adults who quit smoking at least one day in the past year for the cluster years 2008-2010, 2011-2013 and 2012-2014 for Pennsylvania and Allegheny County, where data is available. The percentage of adults who quit smoking at least one day in the past year in Allegheny County during 2012-2014 (56.0%) is higher than the state (54.0%) but lower than the Healthy People 2020 Goal (80.0%). Figure 93. Adults Who Quit Smoking at Least One Day in the Past Year



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Figure 94 illustrates the percentage of adults who report being an everyday smoker cluster years 2008-2010, 2011-2013 and 2012-2014 for Pennsylvania and Allegheny County, where data is available. The percentage of adults who reported being an everyday smoker is trending upward from 2008-2014 in Allegheny County. The 2012-2014 percentage for Allegheny County (16.0%) is slightly higher than the state (15.0%). Figure 94. Adults Reported Being an Everyday Smoker



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Figure 95 illustrates the average scores for tobacco use problems identified during the OVH 2015 Focus Groups. Participants were asked to rate the extent each community health issue was a problem in the local community on a 5 point scale, where 5=Very Serious Problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem, and 1=Not at all a Problem. Smoking (3.4) was identified as a Serious Problem. Figure 95. 2015 Focus Groups – Tobacco Use Problems



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Tobacco Use Conclusions There are a number of observations and conclusions that can be derived from the data related to Tobacco Use. These include:

• The percentage of male adults who reported being a former smoker is showing a downward trend from 2008-2014.

• The percentage of adults who reported being a current smoker for 2012-2014 (21.0%) is equal to the PA percentage but higher than the US (18.8%) and HP goal (12.0%).

• The 2012-2014 percentage of adults who quit smoking at least one day in the past year (56.0%) is lower than the HP goal (80.0%).

• The percentage of adults who reported being an everyday smoker is trending upward from 2008-2014 and the 2012-2014 percentage (16.0%) is slightly higher than the state (15.0%).

• Stakeholders interviewed identified emphysema, smoking, second hand smoke, the need for people to want to stop smoking and seeing health care professionals smoking as tobacco use needs.

• Focus group participants identified the large number of smokers and smoking causes health problems as tobacco use needs.

• Focus group participants mentioned that smoking was somewhat of a problem in the area.


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The topic of injury relates to any intentional or unintentional injuries that can be suffered by individuals. Injury topics explored include: auto accident mortality, suicide, fall mortality, firearm mortality, burns, head injuries and domestic violence.

INTENTIONAL AND UNINTENTIONAL INJURY


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Figure 96 illustrates auto accident mortality rates in the United States in 2010 and 2012, as well as Pennsylvania and Allegheny County from 2008 through 2012, where data is available. The auto accident mortality rate in Allegheny County for the five years reported was significantly lower than the state rates, and lower than the nation and Healthy People 2020 Goal of 12.4. Figure 96. Mortality Rate for Auto Accidents



Page | 145

Figure 97 illustrates suicide mortality rates in the United States in 2010 and 2012, as well as Pennsylvania and Allegheny County from 2008 through 2012, where data is available. In 2012, the suicide mortality rate in Allegheny County (11.7) had increased from previous years, but was lower than the state (12.1). Allegheny County’s 2012 suicide rate was above the Healthy People 2020 Goal of 10.2. Figure 97. Suicide Mortality Rates



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Figure 98 illustrates the percentage of children in 2014 in the United States injured seriously enough to require medical treatment during the past year. One in ten (10.6%) children in the United States was injured seriously enough to need medical attention during 2014. The national trend decreased from 2012 (11.3%). Children in the Northeast region had a lower percentage (7.1%) when compared to the nation, as well as the other regions. Figure 98. PRC – Children Injured Seriously Enough to Need Medical Treatment, Past Year



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Figure 99 illustrates fall mortality rates in the United States in 2010 and 2012, as well as Pennsylvania and Allegheny County from 2008 through 2012, where data is available. In Allegheny County the fall mortality rate is significantly higher than the PA rate for the years 2008 and 2010-2012 and above the healthy people 2020 goal of 7.2. Figure 99. Fall Mortality Rates



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Figure 100 illustrates firearm mortality rates (accidental, suicide, homicide) in the United States in 2010 and 2012, as well as Pennsylvania and Allegheny County from 2008 through 2012, where data is available. In 2012, the firearm mortality rate in Allegheny County (12.6) was higher when compared to the state (11.0), the nation (10.1) and the Healthy People 2020 Goal (9.3). Figure 100. Firearm Mortality Rates



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Unintentional and Intentional Injury Conclusions There are a number of observations and conclusions that can be derived from the data related to Unintentional and Intentional Injury. These include:

• The auto accident mortality rate for the five years 2008-2012 was significantly lower than the PA rate and lower than the US rate and HP goal.

• The suicide mortality rate for 2012 (11.7) is slightly lower than the PA rate (12.1) and slightly higher than the HP goal (10.2).

• According to the PRC National Child & Adolescent Health Survey, 7.1% of children in the Northeast region had an injury serious enough to require medical attention in the past year, which is lower when compared to the United State (10.6%).

• The fall mortality rate is significantly higher than the PA rate for the years 2008 and 2010-2012 and above the HP goal of 7.2.

• The firearm mortality rate for 2012 (12.6) is higher than the PA rate (11.0), the US rate (10.1) and the HP goal (9.3).

• Stakeholders interviewed mentioned domestic abuse as a possible need.

• Focus group participants indicated gun violence as a need.


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Appendix D – Prioritization Criteria Listings

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Appendix D

Prioritization Criteria Listings


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As a result of the primary and secondary data analysis, the consulting team identified 46 distinct community needs and issues that demonstrated disparity, negative trend or gap between the local/ regional data and the state, national or healthy people goal and/or that qualitative information suggested that it was a growing need in the community. At their meeting on March 9, 2016, the OVH Steering Committee agreed with the list of potential needs, participated in prioritizing the needs based on the selected criteria and met again on April 11, 2016 to discuss the prioritization results. Table 3 identified the selected criteria. Table 3. Prioritization Criteria

Table 4. OVH CHNA Prioritization Survey - Sorted by Total

Answer Options Accountable

Role Magnitude Impact Capacity Total

Access: Customer Service in ER, Clinics, Physician's Offices

9.23 6.48 6.45 7.90 30.06

Access: Specialty Medical Care 9.17 7.32 8.14 6.14 30.77

Chronic Disease: Cardiovascular Disease (Heart Disease, Cholesterol, etc.)

9.03 7.77 9.10 7.31 33.21

Chronic Disease: Breast Cancer 9.03 6.39 8.21 7.31 30.94

Chronic Disease: Colorectal Cancer 9.03 5.97 8.00 7.17 30.17

Chronic Disease: Diabetes 8.80 7.46 9.03 7.21 32.50


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Chronic Disease: Lung Cancer 8.80 6.45 7.90 6.83 29.98

Chronic Disease: Prostate Cancer 8.77 5.97 7.52 7.03 29.29

Access: Access to Urgent Care Services 8.65 5.92 6.86 7.21 28.64

Access: Access to Primary Care Services 8.60 5.96 8.03 7.55 30.14

Chronic Disease: COPD/Chronic Bronchitis 8.58 6.62 8.00 6.93 30.13

Healthy Mothers, Babies & Children: Need to Expand Women's Health Services/Prenatal Care

8.29 6.41 7.45 7.00 29.15

Access: Confidential Women's Health Services 8.19 7.08 7.10 7.21 29.58

Access: Access to Mental Health Services 8.10 6.62 8.45 6.66 29.83

Chronic Disease: Obesity 7.30 8.26 9.24 6.82 31.62

Access: Dental Hygiene/Dental Problems 7.19 6.71 7.07 7.07 28.04

Healthy Mothers, Babies & Children: Breastfeeding 6.97 5.55 6.14 6.93 25.59

Access: Affordability of Health Care/Insurance Costs/Copays

6.90 6.96 8.76 5.86 28.48

Infectious Disease: Lyme Disease 6.77 5.32 6.55 6.45 25.09

Access: Community Awareness 6.32 6.11 6.31 7.17 25.91

Infectious Disease: Chlamydia 6.29 4.17 5.45 6.17 22.08

Healthy Mothers, Babies & Children: Tobacco Use During Pregnancy

6.23 6.90 8.17 6.50 27.80

Access: Elder Care Services 6.06 5.69 7.93 6.90 26.58

Healthy Mothers, Babies & Children: Drug Use During Pregnancy

5.83 6.86 8.50 6.28 27.47

Healthy Mothers, Babies & Children: Childhood Obesity

5.74 6.84 8.00 6.28 26.86

Healthy Environment: Allergies 5.39 5.52 6.07 5.52 22.50

Healthy Environment: Asthma 5.24 4.90 6.24 5.61 21.99

Access: Health Literacy 5.03 5.34 6.90 6.86 24.13

Tobacco Use: Chewing Tobacco, Snuff, Snus 4.83 7.38 8.21 5.55 25.97

Tobacco Use: Smoking 4.71 6.79 8.34 5.62 25.46

Mental Health/Substance Abuse: Prescription Drug Misuse/Abuse

4.57 7.97 8.71 5.93 27.18

Access: Emergency Transportation 4.43 5.24 6.90 6.59 23.16

Mental Health/Substance Abuse: Depression 4.26 7.50 8.14 6.38 26.28

Physical Activity/Nutrition: Nutrition Education 4.00 6.07 7.39 6.41 23.87

Mental Health/Substance Abuse: Substance Abuse Rehabilitation

3.87 7.79 8.00 6.07 25.73

Mental Health/Substance Abuse: Drug Abuse/Mortality

3.80 7.59 8.62 5.96 25.97

Access: Transportation To/From Medical Services 3.65 5.63 7.14 5.45 21.87

Mental Health/Substance Abuse: Alcohol Abuse 3.35 8.03 8.48 6.07 25.93

Mental Health/Substance Abuse: Youth Risk Behaviors

3.07 7.31 8.04 6.34 24.76


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Injury: Child Abuse 3.06 7.24 7.75 6.38 24.43

Physical Activity/Nutrition: Lack of Physical Activity/Recreation

3.03 6.59 8.14 6.41 24.17

Injury: Sexual Abuse 2.84 6.40 7.62 6.34 23.20

Healthy Environment: Homelessness/Affordable and Adequate Housing

2.35 5.00 7.14 4.72 19.21

Social Environment: Poverty/Lack of Jobs/Unemployment

2.19 6.11 7.79 5.10 21.19

Table 5. OVH CHNA Prioritization Survey Results - Sorted by Accountability (Hospital Role)



Total M + I


9.23 6.48 6.45 7.90 30.06 12.93

Access: Specialty Medical Care 9.17 7.32 8.14 6.14 30.77 15.46


9.03 7.77 9.10 7.31 33.21 16.87

Chronic Disease: Breast Cancer 9.03 6.39 8.21 7.31 30.94 14.60

Chronic Disease: Colorectal Cancer 9.03 5.97 8.00 7.17 30.17 13.97

Chronic Disease: Diabetes 8.80 7.46 9.03 7.21 32.50 16.49

Chronic Disease: Lung Cancer 8.80 6.45 7.90 6.83 29.98 14.35

Chronic Disease: Prostate Cancer 8.77 5.97 7.52 7.03 29.29 13.49

Access: Access to Urgent Care Services 8.65 5.92 6.86 7.21 28.64 12.78

Access: Access to Primary Care Services 8.60 5.96 8.03 7.55 30.14 13.99

Chronic Disease: COPD/Chronic Bronchitis 8.58 6.62 8.00 6.93 30.13 14.62


8.29 6.41 7.45 7.00 29.15 13.86

Access: Confidential Women's Health Services 8.19 7.08 7.10 7.21 29.58 14.18

Access: Access to Mental Health Services 8.10 6.62 8.45 6.66 29.83 15.07

Chronic Disease: Obesity 7.30 8.26 9.24 6.82 31.62 17.50

Access: Dental Hygiene/Dental Problems 7.19 6.71 7.07 7.07 28.04 13.78

Healthy Mothers, Babies & Children: Breastfeeding 6.97 5.55 6.14 6.93 25.59 11.69


6.90 6.96 8.76 5.86 28.48 15.72

Infectious Disease: Lyme Disease 6.77 5.32 6.55 6.45 25.09 11.87

M+I of 14.0 or greater


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Total M + I

Access: Community Awareness 6.32 6.11 6.31 7.17 25.91 12.42

Infectious Disease: Chlamydia 6.29 4.17 5.45 6.17 22.08 9.62


6.23 6.90 8.17 6.50 27.80 15.07

Access: Elder Care Services 6.06 5.69 7.93 6.90 26.58 13.62


5.83 6.86 8.50 6.28 27.47 15.36


5.74 6.84 8.00 6.28 26.86 14.84

Healthy Environment: Allergies 5.39 5.52 6.07 5.52 22.50 11.59

Healthy Environment: Asthma 5.24 4.90 6.24 5.61 21.99 11.14

Access: Health Literacy 5.03 5.34 6.90 6.86 24.13 12.24

Tobacco Use: Chewing Tobacco, Snuff, Snus 4.83 7.38 8.21 5.55 25.97 15.59

Tobacco Use: Smoking 4.71 6.79 8.34 5.62 25.46 15.13


4.57 7.97 8.71 5.93 27.18 16.68

Access: Emergency Transportation 4.43 5.24 6.90 6.59 23.16 12.14

Mental Health/Substance Abuse: Depression 4.26 7.50 8.14 6.38 26.28 15.64

Physical Activity/Nutrition: Nutrition Education 4.00 6.07 7.39 6.41 23.87 13.46


3.87 7.79 8.00 6.07 25.73 15.79


3.80 7.59 8.62 5.96 25.97 16.21

Access: Transportation To/From Medical Services 3.65 5.63 7.14 5.45 21.87 12.77

Mental Health/Substance Abuse: Alcohol Abuse 3.35 8.03 8.48 6.07 25.93 16.51

Mental Health/Substance Abuse: Youth Risk Behaviors 3.07 7.31 8.04 6.34 24.76 15.35

Injury: Child Abuse 3.06 7.24 7.75 6.38 24.43 14.99


3.03 6.59 8.14 6.41 24.17 14.73

Injury: Sexual Abuse 2.84 6.40 7.62 6.34 23.20 14.02


2.35 5.00 7.14 4.72 19.21 12.14


2.19 6.11 7.79 5.10 21.19 13.90


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Table 6. OVH CHNA Prioritization Survey Results - Sorted by Magnitude + Impact + Capacity

hospital role rating 8.0 or higher


Role Magnitude Impact Capacity Total Total M, I, C

Chronic Disease: Obesity 7.30 8.26 9.24 6.82 31.62 24.32


9.03 7.77 9.10 7.31 33.21 24.18

Chronic Disease: Diabetes 8.80 7.46 9.03 7.21 32.50 23.70


4.57 7.97 8.71 5.93 27.18 22.61

Mental Health/Substance Abuse: Alcohol Abuse 3.35 8.03 8.48 6.07 25.93 22.58


3.80 7.59 8.62 5.96 25.97 22.17

Mental Health/Substance Abuse: Depression 4.26 7.50 8.14 6.38 26.28 22.02

Chronic Disease: Breast Cancer 9.03 6.39 8.21 7.31 30.94 21.91


3.87 7.79 8.00 6.07 25.73 21.86

Access: Access to Mental Health Services 8.10 6.62 8.45 6.66 29.83 21.73

Mental Health/Substance Abuse: Youth Risk Behaviors

3.07 7.31 8.04 6.34 24.76 21.69


5.83 6.86 8.50 6.28 27.47 21.64

Access: Specialty Medical Care 9.17 7.32 8.14 6.14 30.77 21.60


6.90 6.96 8.76 5.86 28.48 21.58


6.23 6.90 8.17 6.50 27.80 21.57

Chronic Disease: COPD/Chronic Bronchitis 8.58 6.62 8.00 6.93 30.13 21.55

Access: Access to Primary Care Services 8.60 5.96 8.03 7.55 30.14 21.54

Access: Confidential Women's Health Services 8.19 7.08 7.10 7.21 29.58 21.39

Injury: Child Abuse 3.06 7.24 7.75 6.38 24.43 21.37

Chronic Disease: Lung Cancer 8.80 6.45 7.90 6.83 29.98 21.18

Chronic Disease: Colorectal Cancer 9.03 5.97 8.00 7.17 30.17 21.14


3.03 6.59 8.14 6.41 24.17 21.14

Tobacco Use: Chewing Tobacco, Snuff, Snus 4.83 7.38 8.21 5.55 25.97 21.14


5.74 6.84 8.00 6.28 26.86 21.12


8.29 6.41 7.45 7.00 29.15 20.86

Access: Dental Hygiene/Dental Problems 7.19 6.71 7.07 7.07 28.04 20.85


9.23 6.48 6.45 7.90 30.06 20.83


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Role Magnitude Impact Capacity Total Total M, I, C

Tobacco Use: Smoking 4.71 6.79 8.34 5.62 25.46 20.75

Access: Elder Care Services 6.06 5.69 7.93 6.90 26.58 20.52

Chronic Disease: Prostate Cancer 8.77 5.97 7.52 7.03 29.29 20.52

Injury: Sexual Abuse 2.84 6.40 7.62 6.34 23.20 20.36

Access: Access to Urgent Care Services 8.65 5.92 6.86 7.21 28.64 19.99

Physical Activity/Nutrition: Nutrition Education 4.00 6.07 7.39 6.41 23.87 19.87

Access: Community Awareness 6.32 6.11 6.31 7.17 25.91 19.59

Access: Health Literacy 5.03 5.34 6.90 6.86 24.13 19.10


2.19 6.11 7.79 5.10 21.19 19.00

Access: Emergency Transportation 4.43 5.24 6.90 6.59 23.16 18.73

Healthy Mothers, Babies & Children: Breastfeeding 6.97 5.55 6.14 6.93 25.59 18.62

Infectious Disease: Lyme Disease 6.77 5.32 6.55 6.45 25.09 18.32

Access: Transportation To/From Medical Services 3.65 5.63 7.14 5.45 21.87 18.22

Healthy Environment: Allergies 5.39 5.52 6.07 5.52 22.50 17.11


2.35 5.00 7.14 4.72 19.21 16.86

Healthy Environment: Asthma 5.24 4.90 6.24 5.61 21.99 16.75

Infectious Disease: Chlamydia 6.29 4.17 5.45 6.17 22.08 15.79


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Table 7. OVH CHNA Prioritization Survey Results – Top Ten Needs Comparison By Total Ranking, Magnitude/Impact/Capacity, and Accountability

Answer Option Total Ranking

M+I+C Ranking

Hospital Ranking

Chronic Disease: Cardiovascular Disease (Heart Disease, Cholesterol, etc.) 1 1 2

Chronic Disease: Diabetes 2 2 5

Chronic Disease: Obesity 3

Chronic Disease: Breast Cancer 4 3 3

Access: Specialty Medical Care 5 5 1

Chronic Disease: Colorectal Cancer 6 10 4

Access: Access to Primary Care Services 7 7 8

Chronic Disease: COPD/Chronic Bronchitis 8 6 9

Access: Customer Service in ER, Clinics, Physician's Offices 9

Chronic Disease: Lung Cancer 10 9 6

Access: Access to Mental Services 11 4

Access: Confidential Women's Health Services 12 8

Access: Affordability of Health Care/Insurance Costs/Copays 16 ---

Chronic Disease: Prostate Cancer 13 13 7

Healthy Mothers, Babies & Children: Need to Expand Women's Health Services/Prenatal Care 14 11 10

Please note that there is no ranking in the M+I+C column regarding Access: Affordability of Health Care/Insurance Costs/Copays as the hospital accountability score was below 8.00.

* Using Hospital Accounta- bility at 8.00 or higher

* Using M+I at 14.00 or higher


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Appendix E – Stakeholder Interview Guide

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Appendix E

Stakeholder Interview Guide


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Thank you for taking the time to talk with us to support the Ohio Valley Hospital Community Health Needs Assessment Process. 1. First of all, could you tell me a little bit about yourself and your background/ experience with community health related issues.

2. What, in your opinion, are the top 3 community health needs for Allegheny County?

3. What, in your opinion are the issues and the environmental factors that are driving these community health needs?

1.

2.

3.

Others mentioned:

4. Check to see if the area they were selected to represent is one of the top priorities identified above. If not mentioned, say…. Our records indicate that you were selected to participate in these individual interviews because you have specific background/experience/ knowledge regarding __________________. What do you feel are the key issues related to this topic area?


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What, in your opinion are the issues and the environmental factors that are driving the needs in this topic area?

5. What activities/initiatives are currently underway in the community to address the needs within this topic area?

6. What more, in your opinion, still needs to be done in order to address this community health topic area.

7. What advice do you have for the project steering committee who

is implementing this community health assessment process?

Appendix F – Focus Group Topic Guide

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Appendix F

Focus Group Interview Guide


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Community Health Assessment

Focus Group Topic Guide Draft

[Insert Date]


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I. Introduction

Hello, my name is _____________________ and we’re going to be talking about community health. We are attempting to conduct a community health assessment by asking diverse members of the community to come together and talk to us about community health problems, services that are available in the community, barriers to people using those services, and what kinds of things that could or should be done to improve the health of the community. Does anyone have any initial questions? Let’s get started with the discussion. As I stated earlier, we will be discussing different aspects of community health. First, I have a couple of requests. One is that you speak up and only one person speaks at a time. The other thing is, please say exactly what you think. There are no right or wrong answers in this. We’re just as interested in your concerns as well as your support for any of the ideas that are brought up, so feel free to express your true opinions, even if you disagree with an idea that is being discussed. I would also ask that you do some self-monitoring. If you have a tendency to be quiet, force yourself to speak and participate. If you like to talk, please offer everyone a chance to participate. Also, please don’t be offended if I think you are going on too long about a topic and ask to keep the discussion moving. At the end, we will vote on each of the topic areas brought up and rank them according to how important they are to the health status of the community. Also, we have an outline of the topics that we would like to discuss before the end of our meeting. If someone brings up an idea or topic that is part of our later questions, I may ask you to “hold that thought” until we get to that part of our discussion. Now, to get started, perhaps it would be best to introduce ourselves. Let’s go around the table one at a time and I’ll start. Please tell your name, a current community initiative or project that you are currently


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involved in (or a community health issue that is important to you) and your favorite flavor of ice cream.

II. Overall Community Health Status

A. Overall, how would you rate the health status of your community? Would you say, in general, that your community’s health status is Excellent, Very Good, Good, Fair or Poor. OPTIONFINDER NOTE: If someone asks how we define community, ask, “How would you define it?”

B. Why do you say that?

C. Overall, how would you rate your personal health status? Would you say, in general, that your community’s health status is Excellent, Very Good, Good, Fair or Poor. OPTIONFINDER

D. What are the things that you think are impacting the health of the community?

E. Why do you say that?

F. How do you think a person’s individual health affects the health of the community? Do you think there’s a link between individual health and the health of the community?

G. Why do you say that?

III. Community Health Needs A. Based on your experience in your neighborhood and community,

what do you think the single biggest community health need is? (BUILD LIST INTO OPTIONFINDER).

B. Why do you say that?


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C. What are some of the other problems that are impacting the health of the community? (BUILD LIST INTO OPTIONFINDER).

D. How much of a problem do you think each is in this community?

OPTIONFINDER

Access to Services A. What solutions to these problems are currently available in the

community? What are you aware of? Are you aware of community agencies and organizations who are working on these?

B. To what extent do people use these services/solutions? Why?

C. What are the things/barriers that prevent people from using these services?

D. Why do you say that?

IV. Potential Solutions

A. What should the community be doing to improve community health? BUILD INTO OPTIONFINDER

B. How important is each of these to focus on over the next 3 years? OPTIONFINDER

C. Who do you think should take the lead on each?

OPTIONFINDER D. What advice would you give those of us who are working on

this community assessment?

Appendix G – Focus Group Intercept Survey

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Appendix G

Focus Group Intercept Survey


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1. How would you rate your personal health? Would you say

it is Excellent, Very Good, Good, Fair or Poor? a. Why do you say that?

2. What health related problems or concerns are you/your family experiencing/dealing with?

3. Are you able to get the health care you/your family need? (try to determine barriers such as transportation, lack of insurance, cost, etc.)

4. What other problems or concerns are you/your family experiencing/dealing with? (i.e. lack of jobs, cost of food, drugs, etc…)

5. What, if any, services do you/your family need that are not available in your community?

6. What, if any, services do you/your family currently use?

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