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CLINTON COUNTY HEALTH DEPARTMENT
Community Health Improvement Plan
January 2012
HealthierCommunity
Mobilizing for Action through
Planning & Partnership (MAPP)
Action for Health Subcommittee
Our mission is to improve and protect the health, well-being and environment of the people of Clinton County.
1
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Table of Contents
Executive Summary 2
History of MAPP 3
MAPP Health Priority Selection Process 4
Action for Health Chronic Disease Prevention Partnership 6
Spectrum of Prevention & Essential Public Health Services 6
Introduction 7
Summary of Accomplishments 8
Access to Mental Health Services 8
Chronic Disease (Tobacco Usage, Nutrition, Physical Activity) 9
Population Shift (Aging Population) 11
2010-2013 Focus Areas for Clinton County 13
Access to Quality Healthcare Data 14
Access to Quality Healthcare Improvement Strategies 15
Chronic Disease Data 16
Chronic Disease Objectives Improvement Strategies 18
Conclusion 21
Community Assets & Resources 22
Involved Organizations & Partnerships 23
Appendix 24
References 25
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C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Executive Summary
Access to Quality Healthcare Chronic Disease (Tobacco, Nutrition, Physical Activity)
The Clinton County Health Department has facilitated the Mobilizing for Action through Planning and Partnership (MAPP) in the community for the last nine years. The result was a comprehensive, widely distributed document that has been embraced by the members of the local public health system. The developed MAPP document also serves as the New York State Department of Health (NYSDOH) Community Health Assessment (CHA). The CHA includes the NYSDOH Prevention Agenda Objectives. Participants provided input into determining the priority areas to be worked on for the next four years. The Prevention Agenda areas selected mirror the selected MAPP priorities. The MAPP process provides the outline for broad, community-based efforts to improve health by engaging the many partners that are already doing the work. This has been accomplished by working with all members of the local public health system in schools, local businesses, health care providers and many others. A direct result of the MAPP process has been policy, system, and environment (built) change (PSE) throughout the community in a variety of sectors. The next step is to further build upon this effort by developing a Community Health Improvement Plan (CHIP) that will continue to serve as the “health roadmap” for future generations as a method to accomplish our mission. The CHIP will also serve as the guidance and working document for the local public health system to help outline planned objectives. The 2004 MAPP identified several community health priorities: access to mental health, chronic disease and the shifting population as the focus areas. In 2009, the MAPP priorities identified were: access to health care and chronic disease (tobacco, nutrition and physical activity). The following pages will outline the specifics of how the county will target resources to reduce and prevent the health impact in these selected areas. The Spectrum of Prevention tool will form the basis for the effort by providing a Best Practices comprehensive approach in the community that supports PSE change. The identification of the Ten Essential Services in the process will further support the national public health directions applied to a local effort. By focusing on the following identified priorities, the quality of life and level of personal health in our community will become stronger. The Clinton County CHIP and changes to community infrastructure will support PSE change in the following health areas:
These priorities will be the health initiatives for Clinton County to work on over the next four years.
3
What is MAPP?
Mobilizing for Action through Planning and
Partnerships (MAPP) is a community-wide strategic
planning tool for improving community health. MAPP
is an initiative led by the National Association of
County and City Health Officials, in collaboration with
the Centers for Disease Control and Prevention (CDC).
Facilitated by public health leadership, this tool helps
communities prioritize public health issues and
identify resources for addressing them.
MAPP is a process whereby programs, agencies,
organizations and institutions may engage in
partnerships for the good of the community. This
process first began in the tri-county (Clinton, Essex
and Franklin Counties) region in 2004-2005 during the
last Community Health Assessment (CHA) process.
Since then, Clinton County has worked towards
further identifying and focusing on priorities specific
to the region to improve health on a county-wide
level.
The Community Drives the Process
Community ownership is the fundamental
component of MAPP. Because the community's
strengths, needs, and desires drive the process, MAPP
provides the framework for creating a truly
community-driven initiative. Community participation
leads to collective thinking and, ultimately, results in
effective, sustainable solutions to complex problems.
Broad community participation is essential because a
wide range of organizations and individuals
contribute to the public's health. Public, private, and
voluntary organizations join community members
and informal associations in the provision of local
public health services.
The MAPP process brings these diverse interests
together to collaboratively determine the most
effective way to conduct public health activities.
To initiate the MAPP process, lead organizations in
the community begin by organizing themselves and
preparing to implement MAPP (Organize for Success/
Partnership Development). Community-wide
strategic planning requires a high level of
commitment from partners, stakeholders, and the
community residents who are recruited to
participate.
The second phase of the MAPP process is Visioning. A
shared vision and common values provide a
framework for pursuing long-range community goals.
During this phase, the community answers questions
such as "What would we like our community to look
like in 10 years?"
Next, the four MAPP Assessments are conducted
providing critical insights into challenges and
opportunities throughout the community:
The Community Themes and Strengths Assessment
provides a deep understanding of the issues residents
feel are important by answering the questions "What
is important to our community?" "How is quality of
life perceived in our community?" and "What assets
do we have that can be used to improve community
health?"
The Local Public Health System Assessment (LPHSA)
is a comprehensive assessment of all of the
organizations and entities that contribute to the
public's health. The LPHSA answers the questions
"What are the activities, competencies, and capacities
of our local public health system?" and "How are the
Essential Services being provided to our community?"
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
History of MAPP
4
The Community Health Status Assessment identifies
priority issues related to community health and
quality of life. Questions answered during the phase
include "How healthy are our residents?" and "What
does the health status of our community look like?"
The Forces of Change Assessment focuses on the
identification of forces such as legislation,
technology, and other issues that affect the context
in which the community and its public health system
operates. This section answers the questions "What
is occurring or might occur that affects the health of
our community or the local public health system?"
and "What specific threats or opportunities are
generated by these occurrences?"
Once a list of challenges and opportunities has been
generated from each of the four assessments, the
next step is to Identify Strategic Issues. During this
phase, participants identify linkages between the
MAPP assessments to determine the most critical
issues that must be addressed for the community to
achieve its vision. After issues have been identified,
participants Formulate Goals and Strategies for
addressing each issue. The final phase of MAPP is the
Action Cycle. During this phase, participants plan,
implement, and evaluate. These activities build upon
one another in a continuous, interactive manner to
ensure continued success.
In the following MAPP model, the "phases" of the
MAPP process are shown in the center of the model,
while the four MAPP Assessments - the key content
areas that drive the process - are shown in the four
outer arrows.
Choosing a Direction
Interactive group discussion around available data
framed by the MAPP Tool Chest for guidance, led to
the identification of sixteen strategic issues. The
sixteen strategic issues selected were based on the
four MAPP assessment areas. Each member of the
full MAPP committee was then provided with three
votes and could cast each of their votes in the area
they thought were priority issues in our community.
After the voting was complete, a final review and
discussion focused around the top three selected
strategic issues, formulating the issues into action
statements.
The action statements developed were:
1. How can the local public health system ensure
access to mental health services?
2. How can the local public health system effectively
address the current rates of chronic disease?
3. How will the local public health system handle the
expected population shift in the region?
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
2004 MAPP Priority Selection Process
5
In 2008, the New York State Department of Health and
the Hospital Association of New York State agreed to
merge the Community Health Assessment (CHA) and
the hospital required Community Service Plan (CSP).
The 2008-2009 MAPP/CHA/CSP process for priority selection included the following:
1. Data collection using the NYS Prevention Agenda
and other Community Health Assessment indicators by
the Data Collection & Needs Assessment Committees
(November 2008-June 2009)
2. Compilation and analysis of the Data by the Needs
Assessment and Data Collection Committees
(November 2008-June 2009)
3. Selection of first round of priorities using a
prioritization matrix and strategy by the Leadership
Committee and Hospital Partners (June 2009)
4. Selection of final priorities by sharing first round
priorities with the Full MAPP Committee for their input
in the form of focus groups. There were seven focus
groups with representatives from Clinton, Essex and
Franklin counties. Focus group information was
reported back to the Full MAPP Committee and then
compiled and reviewed again by the Leadership and
Needs Assessment Committees. These committees
weighed the data and focus group information in order
to come to group consensus and select final priorities
(August 2009).
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
2008-2009 MAPP Health Priority Selection Process
The 2010-2013 Tri-County (Clinton, Essex, Franklin) priorities were defined as:
1. Physical Activity/Nutrition/Tobacco (Chronic Disease)
2. Access to Quality Healthcare
Data Collection Data
Compilation
& Analysis
Selection of Final Priorities
Selection of 1st Round of
Priorities
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Action for Health Chronic Disease Partnership
The Clinton County Action for Health Partnership
was developed as a natural progression of the
MAPP process. It was recognized that a county
specific partnership was necessary to develop goals
and action plans to achieve results. Additionally,
timing allowed Clinton County to take advantage of
a grant funded initiative through NACCHO (National
Association of City and County Health Officials) to
be recognized as an ACHIEVE Community.
The Clinton County Health Department was a
successful ACHIEVE applicant in 2009 and was
selected to establish or enhance community based
partnerships to work on policy, system, and
environment (built) change (PSE). The funding
allowed a CHART (Community Health Action
Response Team) Team to be trained on PSE. The
CHART Team became an integral piece of the Action
for Health group by assisting and supporting
community based efforts. The CHART Team
developed a CAP (Community Action Plan). The CAP
was rolled into the Action for Health efforts therefore
reinforcing PSE change in the community. The
ACHIEVE activities were merged into the Action for
Health Partnerships from 2009-2011.
Goals and Objectives for 2004-2009
The Action for Health/ACHIEVE Initiative developed
objectives based on the earlier prioritization and
data from the MAPP process. Using the Spectrum of
Prevention to outline strategies, the group was able
to focus on some broad community initiatives.
Spectrum of Prevention is a framework that can be
used to address public health issues using seven
strategies. These strategies account for the
complexity of community health determinants and
may be used to develop comprehensive approaches
to address issues. While using these strategies is not a
new concept to health practitioners, it is using the
framework that reminds us of the many levels and
multitude of partners with whom we must conduct
our work in order to be effective in creating healthier
communities.
The Spectrum of Prevention was used as a guide to
develop the broad goals and objectives for each of
the three priorities. These strategies were defined by
each spectrum of prevention level. This ensured that
the specified goals and objectives supported the
health priorities Chronic Disease and Access to
Quality Healthcare with multifaceted prevention
initiatives.
Essential Public Health Services
The Essential Public Health Services provide a
framework for the responsibilities of all local public
health systems. As a nationally used tool, each of our
objectives fall into one of the ten services, thereby
aligning our goals with the national standards.
The 10 Essential Public Health Services, as defined by
the CDC National Public Health Performance
Standards Program, can be found in Appendix I. These
services will be referenced for each objective in the
priority improvement strategy charts.
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Spectrum of Prevention & Essential Public Health Services
7
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Influencing Policy & Legislation EPHS* #5
Changes in local, state & federal laws have the potential for achieving the broadest impact across a community. Effective formal & informal policies lead to widespread behavior change & ultimately change social norms.
Mobilizing Neighborhoods & Communities
EPHS #4
A relatively young concept, this includes meeting with communities to prioritize community concerns such as violence, unemployment and keeping families together, so that these needs may be addressed along with the health department goals.
Changing Organizational Practices
EPHS #6
Changes in internal regulations & norms, allows organizations to affect the health & safety of its members and the greater community.
Fostering Coalitions & Networks
EPHS #4
Coalitions & expanded partnerships are vital to public health movements and can be powerful advocates for legislative and organizational change. From grassroots partners to governmental coalitions, all have the potential to develop a comprehensive strategy for prevention.
Educating Providers EPHS #8
Providers have influence within their fields of expertise to transmit information, skills, and motivation to their colleagues, patients & clients. They can become front-line advocates for pubic health encouraging the adoption of healthy behaviors, screening for risks and advocating for policies and legislation.
Promoting Community Education
EPHS #3
Community education goals include reaching the greatest number of people possible with a message as well as mass media to shape the public's understanding of health issues.
Strengthening Individual Knowledge & Skills
EPHS #3
This is the classic public health approach and involves nurses, educators and trained community members working directly with clients in their homes, community settings or clinics in order to promote health.
Spectrum of Prevention
The following diagram offers a definition of the Spectrum of Prevention first developed by Larry Cohen,
then Director of the Prevention Program on Contra Costa County Health Services, a Public Health
Department in California, based on the work of Dr. Marshall Swift, and adapted for the use of this
document.
*Essential Public Health Services
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C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Summary of Accomplishments for Clinton County (2004-2009)
The following charts contain descriptions of the previous strides that have been made on these health
priorities. Each health priority is organized using the Spectrum of Prevention as a guide.
Access to Mental Health Services
Influencing Policy & Legislation
Supported Timothy’s Law in NYS.
Advocated for changes in health insurance coverage for mental health services & programs.
Mobilizing Neighborhoods & Communities
Developed a social marketing plan to increase awareness of issues surrounding suicide and available resources.
Participated in two regional conferences in Lake Placid that provided workshops on mental illness in our region.
Facilitated SPEAK training opportunities for members of the community, local educators, and providers. Changing
Organizational Practices
Implemented Columbia Teen Screen in local school districts.
Developed and distributed the tri-county Child and Adolescent Mental Health and Substance Abuse Services Resources Directory.
Fostering Coalitions & Networks
Joined several existing community based coalitions/partnerships in the tri-county region that address drug and substance abuse issues along with other mental health issues.
Submission of several regional/county grant applications to address access to care issues related to mental/emotional health.
Educating Providers Conducted a pilot program to determine if a standardized depression screening tool could be implemented in a pediatric office targeting children between the ages of 11-17.
Developed and conducted Gate Keeper suicide awareness training and education targeting providers, educators and members of the community on the available resources to effectively deal with issues related to suicide.
The North Country Healthy Heart Network (NCHHN) collaborated with providers to offer regular educational opportunities for providers in mental health settings.
Promoting Community Education
Participated in a comprehensive regional series of stories in the local Plattsburgh Press Republican on mental and emotional illness in the tri-county region and the available services.
Conducted several community presentations on tri-county mental/emotional health issues.
Strengthening Individual Knowledge & Skills
Conducted several professional presentations/trainings on the MAPP/CHA process to encourage collaboration.
Participated in several media outlet stories on MAPP/CHA to increase community membership understanding of this community collaboration.
Provided Community Resource Lists of providers to individual community members through worksite wellness initiatives of Adirondack Wellness Network.
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C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Summary of Accomplishments for Clinton County (2004-2009)
Chronic Disease (Tobacco Usage, Nutrition, Physical Activity)
Influencing Policy & Legislation
Implemented tobacco-free policies for hospitals and nursing homes. Facilitated the adoption of “No Tobacco Sponsorship” policies in numerous local municipalities .
Assisted several school districts as they developed and implemented their State Education required Nutrition and Physical Activity Policies. Reality Check programs worked to influence film and media outlets for tobacco marketing. Substance Abuse organizations tobacco-free grounds & treatment policies.
Mobilizing Neighborhoods & Communities
Provided mini-grant funding to local agencies/organizations to implement sustainable nutrition and physical activity opportunities. Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) training and Coordinated Approach to Child Health (CATCH) trainings. NAPSACC consultants assisted childcare providers in developing and implementing nutrition and physical activity policies. Participating on the City of Plattsburgh Saranac Trails Project to establish a multi-purpose trail through the City of Plattsburgh along the Saranac River. Applications have been written and submitted for Built Environment grants to coordinate built environment changes in several communities. Community Garden plans underway. Rural health network grant awarded to NCHHN focusing on environmental changes to support healthy living.
Changing Organizational Practices
Collaboration with CVPH Medical Center, Clinton County Health Dept. and Joint Council for Economic Opportunity to establish a ADA Certified Diabetes Self-Management and Medical programs through the North Country Diabetes Project. Provided diabetes training in many local provider offices. NRT and materials provided to Substance Abuse organizations with training. North Country Heart Healthy Network (NCHHN) provided technical assistance & education to allow organizations to adopt evidence based tobacco dependence treatment office practices.
Fostering Coalitions & Networks
The ATFN tri-county partnership mobilized many members of the local public health system to address issues around second hand smoke and promotion of the NYSDOH Smokers Quit Line. Established the Eat Well, Play Hard Coalition to address physical activity and nutrition issues.
Established the Clinton County Action for Health Committee to address chronic disease (tobacco/nutrition/physical activity/built environment) issues.
Conducted several professional presentations/training on the MAPP/CHA process to encourage collaboration.
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C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Summary of Accomplishments for Clinton County (2004-2009)
Chronic Disease (Tobacco Usage, Nutrition, Physical Activity—continued)
Educating Providers Provided community agency training for staff participating in Kid Shape Program targeting families in the community dealing with childhood obesity. Provided training for school nurses and agencies, and pediatric provider offices on proper way to weigh and measure school age children using standardized methods and equipment. The North Country Healthy Heart Network collaborated with providers to offer regular educational opportunities for multi-level providers (MD, NP/PA, RN, LPN). Social Marketing Campaign-Don’t Be Silent About Smoking offered.
Promoting Community Education
Conducted a three part television series on diabetes. Established walking opportunities in the community and local school districts for student, staff and the general public. Social Marketing campaign for 1% or less milk with Stewarts & P.C.
Billboards about healthcare tobacco free grounds policy.
Strengthening Individual Knowledge & Skills
Participated in several media outlet stories on MAPP/CHA to increase community membership understanding of this community collaboration. Conducted community diabetes screening activities. Participated in county and other fair opportunities as outreach opportunities to interact with and educate community members. Worksite Wellness HRAs administered to hundreds through Adirondack Wellness Network. Provided Community Resource Lists of providers to individual community members through worksite wellness initiatives of Adirondack Wellness Network. Billboards about healthcare tobacco free grounds policy also promote 1 -866-NY QUITS info. Direct counseling offered by NCHHN.
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C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Summary of Accomplishments for Clinton County (2004-2009)
Population Shift (Aging Population)
Influencing Policy & Legislation
Supported state and national legislation providing resources to local communities to begin dealing with aging population issues.
Mobilizing Neighborhoods & Communities
Implemented a tri-county training program through the Eastern Adirondack Health Care Network for community members to become facilitators in Arthritis Self-Management classes. Facilitated
several media articles/stories related to aging issue.
Increased dementia screening opportunities through the Eastern Adirondack Health Care Network
Changing Organizational Practices
Point of Entry into services for the elderly was developed and implemented as part of a state wide effort through local Office for the Aging.
Participated in local health fair days/efforts to promote aging services and job opportunities.
Fostering Coalitions & Networks
Continued Continuity of Care collaboration addressing aging issues.
Educating Providers Conducted community education on issues related to the aging population targeting the workforce and area businesses.
Conducted a regional workshop related to aging issues to increase knowledge and understanding of the issues.
Promoting Community Education
Fairs and other community gathering opportunities were used to begin introducing the concept on single point of entry.
Fairs and community gatherings were used for educating community members as to the resources available to them or family members or friends as they age.
Strengthening Individual Knowledge & Skills
Distributed educational material on the negative health effects of exposure to second hand smoke. Conducted several professional presentations/training on the MAPP/CHA process to encourage collaboration.
Participated in several media outlet stories on MAPP/CHA to increase community membership understanding of this community collaboration.
13
Community Health Improvement Plan, January 2012
Access to Quality Healthcare
Chronic Disease
2010-2013 Focus Areas for Clinton
County
CLINTON COUNTY HEALTH DEPARTMENT
14
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Access to Quality Healthcare Data
Access to quality healthcare covers a range of issues, including adequate health insurance for all, physician
and other provider supply and distribution, and preventive, diagnostic and healthcare treatment.
There are many regional factors that impact access, such as rural geography, population density,
educational and employment opportunities, regional economics, transportation and more. All of these
factors interact and impact access to quality healthcare in Clinton County and the region.
Access to quality healthcare, in turn, determines health outcomes from preconception throughout life,
aging, and death. The targeted populations will be individuals who are less likely to have access to quality
healthcare, such as women, senior citizens, low-income residents, families with young children, less
educated residents, racial and ethnic minorities, and those without health insurance.
By selecting this as a priority, it provides the opportunity for hospitals, health departments and other
partners to further develop and coordinate efforts to positively impact the factors and issues that
comprise access to quality healthcare.
90.7 86.3 85.5
0
20
40
60
80
100
Clinton County (2008)
NYS (2008)
US (2006)
Figure 1a. Percent of Adults with Health Care Coverage
Per
cen
tage
(%
)
100% NYS Prevention
Agenda Objective
87.3 82.8 80.0
0
20
40
60
80
100
Clinton County (2008)
NYS (2008)
US (2006)
Per
cen
tage
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Figure 1b. Percent of Adults with Regular Health Care Provider 96%
NYS Prevention Agenda
Objective
The percent of adults with health care coverage in Clinton County (90.7%) is higher than the state (86.3%) and national (85.5%) percentages .
Healthy People 2020 reported that 83.2% of persons had medical insurance in 2008, also aiming for a goal of 100% coverage.
Similarly, the percent of adults with a regular health care provider in Clinton County (87.3%) is higher than both the state (82.8%) and national (80.0%) percentages.
Healthy People 2020 reported that 76.3% of persons had a usual primary care provider in 2007, setting the goal for 83.9%.
Data taken from 2009 MAPP Document and Healthy People 2020.
15
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C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Chronic Disease
There are a wide variety of factors that contribute to the development of chronic diseases. Some of the
most prevalent causes that have been identified nationally, state-wide, and county-wide are tobacco
usage, inadequate nutrition, and lack of physical activity. By targeting these three areas, the high rates of
chronic disease and resulting health complications can be decreased.
Tobacco Usage
In 2008, the percent of adult smokers living in Clinton County was 19.8%, a rate that exceeds the New
York State Prevention Agenda Objective (NYS PAO) for 2013 and Health People 2020 Objectives. The high
age-adjusted incidence rates of these diseases in Clinton County indicate that smoking is indeed an area
of concern. Additionally, non-smokers in the presence of smoking individuals suffer from respiratory
diseases and other negative health effects. By decreasing smoking rates in adolescents, adults, and
prenatal women the prevalence of chronic disease can be prevented.
Nutrition & Physical Activity
The percentage of overweight and obese children and adults continues to increase in Clinton County,
mirroring both state and national trends. It is clear that residents are regularly eating and drinking
excessive calories while lacking adequate physical activity. In 2008, the percentage of obese (BMI>30)
adults in Clinton County was 32.6%, with only 24.9% of adults reporting that they consume five or more
fruits or vegetables per day. The Childhood Weight Collection Project conducted in 2006 reported that
43.4% of girls and 41.3% of boys (ages 2-19) were at-risk or overweight in Clinton County.
The percentages reported can only be improved by promoting overall lifestyle changes that support an
increase in physical activity and healthy eating habits. These changes will be enforced through community
partnerships, marketing campaigns, and local school involvement.
17
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Chronic Disease Data
N/A
74 77.483.2 77.3
N/A
0
20
40
60
80
100
Clinton
County
NYS US
2006
2008
Figure 2c. Percent of Adults Engaged in Some Type of Leisure Time Activity
Per
cen
tage
(%
)
80% NYS Prevention
Agenda
24.9 26.723.2
0
5
10
15
20
25
30
35
Clinton County
(2008)
NYS
(2008)
US
(2005)
Figure 2d. Percent of Adults Eating 5 or More Fruits or Vegetables Per Day
Per
cen
tage
(%
)
33% NYS Prevention
Agenda
Clinton County shows a higher rate of smoking
in adults (19.8%) than NYS (16.5%) but a lower
rate than the US percent (20.6%). Healthy
People 2020 is also aiming for 12% smoking
rate for adults.
In 2011, Clinton County data indicated that
51% of preschool, 61% of elementary school,
63% of middle school, and 51% of high school
children were in the elevated BMI percentile
( 85%). Additionally, pooled data for all ages
showed that 21% were 95th percentile.
The percent of adults who are obese is higher in Clinton
County (32.6%) than in NYS (23.6%) but not the US
(34.0%). Healthy People 2020 is aiming to decrease the
obesity rate to 30.6% for adults.
The percent of adults engaged in some type of leisure
time activity exceeds the NYS Prevention Agenda
Objective (80%).
The percent of adults eating five or more fruits or
vegetables per day in Clinton County (24.9%) is below
the NYS Prevention Agenda Objective of 33%.
N/A
22.9 25.1
32.6
23.6
34.0
0
10
20
30
40
Clinton County
NYS US
2006
2008
15% NYS Prevention
Agenda
Figure 2b. Percent of Adults Who Are Obese(BMI>30) for 2006 & 2008
Per
cen
tage
(%
)
16.1
18.220.119.8
16.5
20.6
0
5
10
15
20
25
Clinton County NYS US
2006
2008
Per
cen
tage
(%
)
Figure 2a. Percent Cigarette Smoking in Adults for 2006 & 2008
12%
NYS Prevention
Agenda
Data taken from 2009 MAPP Document and Healthy People 2020.
18
C
lin
to
n
Co
un
ty
H
ea
lt
h
De
pa
rt
me
nt
Chro
nic
Dis
ease
Im
pro
vem
ent
Str
ateg
ies
Co
mm
un
ity
Hea
lth
Imp
rove
men
t P
lan
, Ja
nu
ary
201
2
ATF
N: A
dir
on
dac
k To
bac
co F
ree
Net
wo
rk
S
RT:
Sar
anac
Riv
er T
rail
T
DC
: Th
e D
eve
lop
men
t C
orp
ora
tio
n
Ob
ject
ive
Esti
mat
ed
Dat
e
of
Co
mp
leti
on
O
utc
om
e P
artn
ers
M
eth
od
Es
sen
tial
Se
rvic
e
Co
nti
nu
e w
ork
to
est
ablis
h a
N
o T
ob
acco
po
licy
on
all
Clin
ton
Co
un
ty p
rop
erty
Dec
emb
er 2
011
A
def
ined
po
licy
will
be
in
pla
ce f
or
Clin
ton
Co
un
ty
pro
per
ties
Co
un
ty L
egis
latu
re
ATF
N
CC
HD
1
Infl
uen
cin
g P
olic
y &
Le
gisl
atio
n—
P
olic
y 5
Esta
blis
h 2
ad
dit
ion
al
com
mu
nit
y ga
rden
s in
C
linto
n C
ou
nty
Sep
tem
ber
201
2
Two
loca
tio
ns
will
be
iden
tifi
ed a
nd
op
erat
ion
al
CC
HD
O
neW
ork
Sou
rce
To
wn
of
Pla
ttsb
urg
h
2
Mo
bili
zin
g N
eigh
bo
rho
od
s &
C
om
mu
nit
ies—
Envi
ron
men
t
5
Esta
blis
h a
tas
k fo
rce
to
dev
elo
p a
to
ol f
or
asse
ssin
g/in
ven
tory
ing
avai
lab
le
ph
ysic
al a
ctiv
ity
op
po
rtu
nit
ies
thro
ugh
ou
t C
linto
n C
ou
nty
fo
r al
l age
s
Dec
emb
er 2
012
A
sses
smen
t to
ol d
evel
op
ed
for
futu
re u
se in
det
erm
inin
g in
ven
tory
of
cou
nty
bas
ed
ph
ysic
al a
ctiv
ity
pro
gram
s,
acti
viti
es, a
nd
eve
nts
CC
HD
SU
NY
Pla
ttsb
urg
h s
tud
ent
inte
rns
Tow
n o
f P
latt
sbu
rgh
C
om
mu
nit
y Yo
uth
C
om
mis
sio
ns
3
Mo
bili
zin
g N
eigh
bo
rho
od
s &
C
om
mu
nit
ies—
Syst
ems
5
Cre
ate
a p
relim
inar
y d
esig
n
for
trai
l an
d b
ike
con
nec
tivi
ty in
Clin
ton
C
ou
nty
May
20
13
Co
mp
lete
d d
esig
n p
lan
fo
r tr
ail a
nd
bik
e co
nn
ecti
vity
To
wn
of
Pla
ttsb
urg
h
Cit
y o
f P
latt
sbu
rgh
SR
T C
om
mit
tee
TD
C
Pla
nn
ing
Off
ice
of
Clin
ton
C
ou
nty
To
wn
of
Sara
nac
4
Mo
bili
zin
g N
eigh
bo
rho
od
s &
C
om
mu
nit
ies—
Envi
ron
men
t
4
Imp
lem
ent
chan
ges
in o
ne
area
res
tau
ran
t to
off
er
hea
lth
ier
op
tio
ns
wh
en
din
ing
ou
t
Oct
ob
er 2
012
C
han
ges
will
be
inco
rpo
rate
d
into
fac
ility
men
u in
on
e lo
cal
eate
ry
CC
HD
Lo
cal r
est
aura
nt
SUN
Y N
utr
itio
n D
ept.
Lo
cal m
edia
A
me
riC
orp
s fo
r th
e A
dir
on
dac
ks
5
Ch
angi
ng
Org
aniz
atio
nal
P
ract
ices
—
Syst
ems
3
19
C
lin
to
n
Co
un
ty
H
ea
lt
h
De
pa
rt
me
nt
Chro
nic
Dis
ease
Im
pro
vem
ent
Str
ateg
ies
Co
mm
un
ity
Hea
lth
Imp
rove
men
t P
lan
, Ja
nu
ary
201
2
Ob
ject
ive
Esti
mat
ed
Dat
e
of
Co
mp
leti
on
O
utc
om
e P
artn
ers
M
eth
od
Es
sen
tial
Se
rvic
e
Esta
blis
h p
olic
ies
in a
min
imu
m o
f th
ree
wo
rksi
tes
for
suga
r-sw
eet
en
ed
bev
erag
e an
d/o
r sn
ack
ven
din
g o
pti
on
s fo
r th
eir
emp
loye
es
Mar
ch 2
01
2
Po
licie
s at
3 lo
cati
on
s w
ill b
e d
evel
op
ed, s
ign
ed a
nd
im
ple
men
ted
Loca
l Bu
sin
ess
CC
HD
C
VP
H
SUN
Y P
latt
sbu
rgh
M
un
icip
alit
ies
6
Ch
angi
ng
Org
aniz
atio
nal
P
ract
ices
—
Po
licy
5
Init
iate
ch
ange
s in
op
tio
ns
at a
m
inim
um
of
on
e w
ork
site
wit
h
cafe
teri
a-ty
pe
ven
din
g fo
r h
ealt
hie
r fo
od
ch
oic
es f
or
thei
r em
plo
yee
s
Sep
tem
ber
20
12
O
ne
wo
rksi
te w
ill h
ave
pre
an
d p
ost
imp
lem
ente
d
chan
ges
in o
pti
on
s fo
r fo
od
Loca
l bu
sin
ess
CC
HD
A
me
riC
orp
s fo
r th
e A
dir
on
dac
ks
7
Ch
angi
ng
Org
aniz
atio
nal
P
ract
ices
—
Syst
ems
3
Esta
blis
h a
sn
ack
ven
din
g m
ach
ine
po
licy
at C
VP
H f
or
the
en
tire
fac
ility
D
ecem
ber
20
12
P
olic
y w
ill b
e co
mp
lete
d a
nd
fu
lly im
ple
men
ted
C
VP
H F
ou
nd
atio
n
CC
HD
V
end
ing
com
pan
y
8
Ch
angi
ng
Org
aniz
atio
nal
P
ract
ices
—
Po
licy
5
Intr
od
uce
at
leas
t 3
-5 w
ork
site
s to
fo
od
, bev
erag
e, a
nd
ven
din
g ch
ange
s th
at c
an b
e im
ple
men
ted
to
im
pac
t em
plo
yee
hea
lth
Feb
ruar
y 2
01
2
Dat
es a
nd
att
end
ance
at
dev
elo
ped
bu
sin
ess
wo
rksh
op
w
ill b
e d
ocu
men
ted
Dev
elo
pm
ent
Co
rpo
rati
on
C
CH
D
CV
PH
Lo
cal B
usi
nes
ses
Am
eri
Co
rps
for
the
Ad
iro
nd
acks
M
un
icip
alit
ies
9
Ch
angi
ng
Org
aniz
atio
nal
P
ract
ices
—
Po
licy
Ass
ist
thre
e sc
ho
ol d
istr
icts
in
esta
blis
hin
g an
d s
ub
mit
tin
g p
lan
s fo
r p
hys
ical
ed
uca
tio
n t
o s
tate
ed
uca
tio
n d
epar
tmen
t fo
r ap
pro
val
Jun
e 2
01
2
Thre
e id
enti
fied
sch
oo
l d
istr
icts
will
su
bm
it p
lan
s to
th
e N
Y St
ate
Ed
uca
tio
n
Dep
artm
ent
CC
HD
—H
ealt
hy
Sch
oo
ls N
Y Sc
ho
ol d
istr
icts
N
Y St
ate
Edu
cati
on
Dep
t.
10
Ch
angi
ng
Org
aniz
atio
nal
P
ract
ices
—
Po
licy
5
20
C
lin
to
n
Co
un
ty
H
ea
lt
h
De
pa
rt
me
nt
Chro
nic
Dis
ease
Im
pro
vem
ent
Str
ateg
ies
Co
mm
un
ity
Hea
lth
Imp
rove
men
t P
lan
, Ja
nu
ary
201
2
HP
P: H
ealt
h, P
lan
nin
g &
Pro
mo
tio
n
O
bje
ctiv
e Es
tim
ate
d D
ate
o
f C
om
ple
tio
n
Ou
tco
me
Par
tner
s M
eth
od
Es
sen
tial
Se
rvic
e
11
Invo
lve
fou
r d
iffe
ren
t ag
enci
es/
ind
ivid
ual
s/o
rgan
izat
ion
s th
rou
gh a
var
iety
of
ven
ues
to
co
mm
un
icat
e a
bo
ut
the
sust
ain
abili
ty o
f to
bac
co p
olic
ies
targ
etin
g yo
uth
Dec
emb
er 2
01
2
Soci
al m
arke
tin
g ca
mp
aign
will
b
e co
nd
uct
ed a
nd
su
stai
nab
le
tob
acco
po
licie
s w
ill b
e p
lan
ned
ATF
N
Fost
eri
ng
Co
alit
ion
s &
Net
wo
rks—
P
olic
y 3
12
Op
en t
he
Sara
nac
Riv
er T
rail
to t
he
pu
blic
th
rou
gh a
n
edu
cati
on
al “
lau
nch
” ev
ent
Jun
e 2
01
2
SRT
will
be
op
en a
nd
id
enti
fied
to
co
mm
un
ity
mem
ber
s
SRT
Co
mm
itte
e
Cit
y o
f P
latt
sbu
rgh
P
rom
oti
ng
Co
mm
un
ity
Edu
cati
on
—En
viro
nm
ent
5
13
Dev
elo
p a
tem
pla
te a
nd
pla
n
for
sust
ain
able
gro
cery
sto
re
tou
rs in
corp
ora
tin
g W
IC f
oo
d
item
s an
d h
ealt
hie
r sh
op
pin
g fo
r C
linto
n C
ou
nty
larg
er
mar
kets
Jan
uar
y 2
013
C
urr
icu
lum
an
d b
usi
nes
s p
lan
fo
r su
stai
nab
le t
ou
rs
will
be
com
ple
ted
CC
HD
—W
IC
CC
HD
—H
PP
G
roce
ry s
tore
s C
om
mu
nit
y p
arti
cip
ants
A
me
riC
orp
s fo
r th
e A
dir
on
dac
ks
Stre
ngt
hen
ing
Ind
ivid
ual
K
no
wle
dge
&
Skill
s—
Syst
ems
5
21
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Conclusion
The local public health system in Clinton County has embraced the concepts and methods needed to effectively address the identified major health issues impacting our residents. It has become focused on the development and implementation of plans based on best practice models that have proven successful in other parts of New York State and the country. While we anticipate that benefits will not be demonstrated immediately, the established partnerships and collaborations have assured that favorable health change indicators ultimately will be seen. Keeping these efforts dynamic within the community will be a challenge for everyone. The direction that has been paved by various groups has been institutionalized within their agencies’ strategic plans and some within their annual budgets. Ownership of the objectives identified and implemented is shared, along with the credit for the success. The CHIP (Community Health Improvement Plan) will help to provide an additional bond of cooperation throughout the community, formulate a strategic and coordinated community plan for change, and serve as the future infrastructure for the local public health system to fulfill the mission.
22
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Community Assets & Resources
The following organizations and groups have been used in the MAPP process and will be contacted for further assistance in the community health
improvement plan process and implementation:
Local & State Government Town Offices in Clinton County: Altona Dannemora Ausable Ellenburg Beekmantown Mooers Black Brook Peru Chazy Saranac Champlain Schuyler Falls Clinton Plattsburgh City of Plattsburgh City of Plattsburgh Recreation Dept. Clinton County Mental Health Dept. Clinton County Nursing Home Clinton County Office for the Aging Clinton County Department of Social Services Clinton County Legislature Clinton County Board of Health Village of Champlain Village of Keeseville Village of Rouses Point Youth Bureau of Clinton County Hospital CVPH Medical Center CVPH Board of Directors Foundation of CVPH Medical Center Health Care Providers North Country Home Services Planned Parenthood of the North Country NY
Libraries Clinton County Library System Schools CV Tech of Clinton County Technical Assistance Center of SUNY Plattsburgh Local Public School Districts in Clinton County Ausable Valley North Eastern Beekmantown Peru Chazy Plattsburgh Northern Adirondack Saranac SUNY Plattsburgh Fienberg Library SUNY Plattsburgh Presidents Office Clinton Community College Community Based Organizations American Red Cross
Advocacy and Resources Center
Behavior Health Services North, Inc.
Champlain Valley Family Center
City of Plattsburgh Recreation Department
Child Care Coordinating Center
Cornell Cooperative Extension
Eastern Adirondack Health Care Network
Joint Council for Economic Opportunity
Local Chambers of Commerce & Reps National Alliance on Mental Illness of Champlain Valley
RSVP of Clinton County
Senior Citizens Council of Clinton County
23
Leadership Committee Paula Calkins Lacombe, Director Clinton County Health Department Laurie Williams Clinton County Health Department Jerie Reid Clinton County Health Department Hospital Partners: Michael Hildebran CVPH Medical Center Data Collection Consultant Committee SUNY Plattsburgh Technical Assistance Center Theresa Bennett Victoria Zinser Duley SUNY Plattsburgh Nursing Program Anne Bongiorno, Instructor An Du , SUNY Student Theresa Oszust , SUNY Student Joanna Meyer , SUNY Student Chris Mikkelson, SUNY Student Eastern Adirondack Health Care Network Lythia “Lee” Vera Clinton County Health Department Laurie Williams SUNY Albany School of Public Health Jennifer Sadd
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
MAPP 2004-2009 Clinton County Public Health Members
The following organizations and individuals participated in the assessment and
prioritization of community health needs:
Action for Health Members
American Cancer Association American Heart Association Behavioral Health Services North Child Care Coordinating Council City of Plattsburgh Recreation Department Clinton Community College Clinton County Health Department Administration Clinton County Health Department Home Care Services Clinton County Health Department Nutrition Services Clinton County Healthy Schools NY Clinton County Office for the Aging Clinton County Planning & Transportation Clinton County Youth Bureau Cornell Cooperative Extension & 4H Club CVPH Medical Center CVPH Medical Library Development Corporation Eastern Adirondack Health Care Network Family Connections of Clinton County Foundation of CVPH Medical Center Northeastern Clinton Central School Nurse PARC Wellness Center SUNY Plattsburgh Sports & Wellness Program SUNY Plattsburgh Nursing Department Town of Plattsburgh Town of Plattsburgh Planning Department Town of Plattsburgh Recreation Department United Way of Clinton and Franklin Counties
24
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
Appendix I. 10 Essential Public Health Services
1. Monitor health status to identify and solve community health
problems.
2. Diagnose and investigate health problems and health hazards
in the community.
3. Inform, educate, and empower people about health issues.
4. Mobilize community partnerships and action to identify and
solve health problems.
5. Develop policies and plans that support individual and
community health efforts.
6. Enforce laws and regulations that protect health and ensure
safety.
7. Link people to needed personal health services and assure the
provision of health care when otherwise unavailable.
8. Assure competent public and personal health care workforce.
9. Evaluate effectiveness, accessibility, and quality of personal
and population-based health services.
10. Research for new insights and innovative solutions to health
problems
25
C l i n t o n C o u n t y H e a l t h D e p a r t m e n t
Community Health Improvement Plan, January 2012
References
MAPPing Our Way to a Healthier Community in Clinton, Essex & Franklin Counties, NY: 2010-2013
Community Health Assessment, Priorities and Strategies, 2009.
Available on the web at:
Local Public Health Sites: www.clintonhealth.org www.co.essex.ny.us/PublicHealth
www.franklincony.org
Hospital Partner Sites: www.amccares.org www.alicehyde.com
www.cvph.org www.ech.org
www.interlakeshealth.com
U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion.
Healthy People2020. Washington, DC. Available at www.healthypeople.gov/2020.
Centers for Disease Control and Prevention. National Public Health Performance Standards Program
(NPHPSP). 10 Essential Public Health Services. Atlanta, GA. Available at www.cdc.gov/nphpsp/
essentialservices.html.
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