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Bradford Regional Medical Center

2015 Community Health Needs

Assessment

2015

2015 Bradford Regional Medical Center Community Health Needs Assessment Report

ACKNOWLEDGEMENTS

The Bradford Regional Medical Center (BRMC) Community Health Needs Assessment (CHNA) was developed with the support of Upper Allegheny Health System (UAHS) and Strategy Solutions, Inc. (SSI), the consulting group engaged by BRMC to assist with the assessment. Representatives from BRMC, UAHS and SSI worked collaboratively to guide and conduct the assessment. A steering committee made up of senior representatives of BRMC and UAHS, as well as representatives from local health departments, leading health and social service organizations and county government provided additional input. The combined expertise, input and knowledge of the members of the steering committee was vital to the project. This group deserves special recognition for their tireless oversight and support of the CHNA process. During this CHNA project, twenty-one individuals were interviewed by SSI including administrative and clinical staff from BRMC and UAHS, representatives from health and social service agencies, public health officers, physicians, clinicians, police officials, warden, school district personnel, manufacturing, and public and elected officials. SSI also conducted a community survey with 508 surveys completed. Finally, information was gathered by the project team through a series of focus groups. These information-gathering efforts allowed the project team and steering Committee to gain a better understanding of the health status, health care needs, service gaps and barriers to care of those living in the counties of McKean and Potter (PA) and southern Cattaraugus (NY), which represent the primary and secondary service area of Bradford Regional Medical Center. The administration of UAHS and BRMC would like to thank all of those who were involved in this project, particularly those who participated in interviews, survey efforts, focus groups and information gathering.


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PROJECT COORDINATION

Dennis McCarthy UAHS/BRMC Stacy Williams BRMC Cathy Rouff BRMC Debra Thompson Strategy Solutions, Inc. Jacqui Catrabone Strategy Solutions, Inc. Kathy Roach Strategy Solutions, Inc.

STEERING COMMITTEE MEMBERS

Francie Ambuske Bradford Hospital Foundation Sara Andrews Office of Economic and Community Development Gayle Bauer Bradford Township Richard Braun UAHS/BRMC Christy Clark UAHS/BRMC Tracy Colosimo The Pavilion at BRMC Mandi Davis United Way Robert Esch American Refining Group, Inc. Timothy Finan UAHS / BRMC Lisa Fiorentino, PhD Center for Rural Health / UPB Lori Freer Bradford Hospital Foundation Bruce Gallagher Zippo Manufacturing Company Sherri Geary McKean County Economic Development Joseph Goro, MD BRMC Steve Jackson YMCA Bill Leven Futures Rehabilitation Bruce Manning McKean County Emergency Management Tina Martin CARE for Children Dennis McCarthy UAHS / BRMC Sandra McKinley Bradford Hospital Foundation William Mills, MD UAHS / BRMC David Monroe BRMC Debbie Olson McKean County Department of Health James O'Mara Bradford Hospital Foundation Ron Orris Bradford Chamber of Commerce Bill Orzechowski McKean County Department of Aging Jill Owens, MD UAHS / BRMC William Pantuso Northwest Savings Bank


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Kathy Pascarella VNA of Northwest PA John Policastro Beacon Light Behavioral Health, Inc. Katy Pude Bradford Area School District Rhonda Race State Representative Martin Causer's Office Mary Reiley McCourt Label Cathy Rouff BRMC Marcie Schellhammer The Bradford Era Rick Seager Beacon Light Behavioral Health, Inc. Jackie Shine-Dixon BRMC Lee Sizemore McKean County Dept. Human Services Vickie Skvarka McKean County Department of Health Melissa Sullivan UAHS / BRMC Carol Vinca Zippo Stacy Williams BRMC Kimberly Young Psy.D. St. Bonaventure University Jeff Zewe UAHS / BRMC


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TABLE OF CONTENTS

Message to the Community ................................................................................. 1 Executive Summary .............................................................................................. 3 Methodology ........................................................................................................ 7 General Findings ................................................................................................ 17 Evaluation of the 2005 CHNA ............................................................................. 17 Demographics .................................................................................................... 19 Asset Inventory .................................................................................................. 21 Key Findings ....................................................................................................... 24 Other Secondary Data – Hospital Utilization Rates ........................................... 30 Primary Research Results ................................................................................... 32 Overall Community Health Status ...................................................................... 33 Initiatives Currently Underway .......................................................................... 36 Additional Suggestions ....................................................................................... 38 Topic Conclusions ............................................................................................... 41 Access to Quality Health Care .................................................................... 41 Chronic Disease .......................................................................................... 43 Healthy Environment .................................................................................. 45 Healthy Mothers, Babies and Children ....................................................... 46 Infectious Disease ....................................................................................... 47 Mental Health and Substance Abuse ......................................................... 48 Physical Activity and Nutrition ................................................................... 50 Tobacco Use ................................................................................................ 51 Unintentional and Intentional Injury .......................................................... 52 Top Priorities ...................................................................................................... 53 Prioritization and Significant Health Needs ....................................................... 57 Review and Approval ......................................................................................... 61


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TABLE OF TABLES

Table 1 ........ BRMC Stakeholder Interviews ...................................................... 11 Table 2 ........ BRMC Focus Groups Conducted .................................................. 13 Table 3 ........ BRMC Behavioral Risk Factor Comparative Table ........................ 26 Table 4 ........ BRMC Public Health Indicators .................................................... 27 Table 5 ........ BRMC County Health Rankings .................................................... 28 Table 6 ........ BRMC 2013 Pennsylvania Youth Survey ...................................... 29 Table 7 ........ Ambulatory Care Sensitive Conditions – ER Only ........................ 30 Table 8 ........ Mental Health ICD-9 Codes .......................................................... 31 Table 9 ........ Diagnosis Related Groups ............................................................ 32 Table 10 ...... Prioritization Criteria .................................................................... 57 Table 11 ...... BRMC CHNA Prioritization ........................................................... 58


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TABLE OF FIGURES

Figure 1 ....... BRMC Overall Service Area ............................................................ 8 Figure 2 ....... BRMC Asset Resources Map ........................................................ 23 Figure 3 ....... Community Survey – Community Health Status, N=508 ............. 33 Figure 4 ....... Focus Groups – Community Health Status .................................. 34 Figure 5 ....... Stakeholder Interviews – Environmental Factors Impacting Community Health ................................................................. 36 Figure 6 ....... Top Community Survey Health Problems .................................... 53 Figure 7 ....... BRMC Stakeholder Interviews Top Priorities ............................... 54 Figure 8 ....... BRMC Top 10 Focus Groups Priorities ......................................... 55


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Bradford Regional Medical Center (BRMC) is proud to present its 2015 Community Health Needs Assessment (CHNA) Report. BRMC is part of the Upper Alleghany Health System (UAHS) which includes BRMC and Olean General Hospital in Olean, NY. This report summarizes a comprehensive review and analysis of health status indicators, public health, socioeconomic, demographic and other qualitative and quantitative data from the primary service area of BRMC. This report also includes secondary and disease incidence and prevalence data from McKean and Potter Counties in Pennsylvania and Cattaraugus County in New York, as the BRMC service area includes portions of all of these counties. The data was reviewed and analyzed to determine the priority needs and issues facing the region. The primary purpose of this assessment was to identify the health needs and issues of the community defined as the primary service area of BRMC. In addition, the CHNA provides useful information for public health and health care providers, policy makers, social service agencies, community groups and organizations, religious institutions, businesses, and consumers who are interested in improving the health status of the community and region. The results enable the hospital, as well as other community providers, to more strategically identify community health priorities, develop interventions and commit resources to improve the health status of the region. The full report is also offered as a resource to individuals and groups interested in using the information to inform better health care and community agency decision making.

MESSAGE TO THE COMMUNITY


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Improving the health of the community and region is a top priority of BRMC. Beyond the education, patient care and program interventions provided by BRMC, we hope the information presented is not only a useful community resource, but also encourages additional activities and collaborative efforts that improve the health status of the community.


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The 2015 Bradford Regional Medical Center (BRMC) Community Health Needs Assessment (CHNA) was conducted to identify significant health issues and needs, as well as to provide critical information to BRMC and others in a position to make a positive impact on the health of the region’s residents. The results enable the hospital and other community partners to more strategically establish priorities, develop interventions and direct resources to improve the health of people living in the BRMC service area. To assist with the CHNA process, BRMC retained Strategy Solutions, Inc. (SSI), Erie, PA, a planning and research firm whose mission is to create healthy communities to conduct the collaborative study. The assessment followed best practices as outlined by the Association of Community Health Improvement. The assessment was also designed to ensure compliance with current Internal Revenue Service (IRS) guidelines for charitable 501(c)(3) tax-exempt hospitals that was published in December 2014. This CHNA and its supplemental resource data located in the appendices document include a detailed examination of the following areas:

Evaluation of the 2005 BRMC CHNA

Demographics & Socio-Economic Indicators

Access to Quality Health Care

Chronic Disease

Healthy Environment

Healthy Mothers, Babies and Children

Infectious Disease

Mental Health and Substance Abuse

Physical Activity and Nutrition

Tobacco Use

Injury

EXECUTIVE SUMMARY


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Secondary public health data on disease incidence and mortality, as well as behavioral risk factors, were gathered from numerous sources including the Pennsylvania Department of Health, New York Department of Health, the Centers for Disease Control, Healthy People 2020, and County Health Rankings, as well as a number of other reports and publications. Data were collected for BRMC, although some selected national data is included where local/regional data was not available. Demographic data were collected from the Nielsen/Claritas demographic database. Primary qualitative data collected specifically for this assessment included a total of 21 in-depth interviews with individuals from different consistencies and interest groups representing the needs of the BRMC service area. A BRMC community survey was conducted with 508 responses received from the region. In addition to gathering input from stakeholder interviews, input and guidance also came from BRMC and community representatives who served on the BRMC Steering Committee. After all primary (community survey, stakeholder interviews and focus groups) and secondary data were reviewed and analyzed by the Steering Committee, the data suggested a total of 44 distinct issues, needs and possible priority areas for potential intervention by BRMC. Members of the Upper Allegheny Health System Executive Team met on September 22, 2015 to review the final priorities (see Table 11 on page 54) selected by the BRMC Steering Committee. Using the methodology of looking at the four prioritization criteria of (i) accountable role of the hospital, (ii) magnitude of the problem, (iii) impact on other health outcomes and (iv) capacity (systems and resources) to implement evidence-based solutions, along with the rank order of the final priorities selected by the BRMC Steering Committee, the following top ten priorities are considered the most significant. Refer to Table 10 on page 54 for a more in-depth description of the four prioritization criteria.

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

2. Chronic Disease: Diabetes 3. Chronic Disease: Obesity 4. Chronic Disease: Breast Cancer 5. Access: Specialty Medical Care 6. Chronic Disease: Colorectal Cancer 7. Access: Access to Primary Care Services 8. Chronic Disease: COPD/Chronic Bronchitis


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9. Access: Customer Service in ER, Clinics, Physician's Offices 10. Chronic Disease: Lung Cancer

The implementation strategies selected by BRMC and its community partners will address the most significant needs through a variety of implementation strategies which will be published in a separate document.


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To guide this assessment, the hospital’s leadership team formed a Steering Committee that consisted of hospital and community leaders who represented the broad interests of the local region. These included representatives who understood the needs and issues related to various underrepresented groups including medically underserved populations, low-income persons, minority groups, and those with chronic disease needs, individuals with expertise in public health, and internal program managers. The BRMC Steering Committee met three times between June 2015 and October 2015 to provide guidance on the various components of the CHNA. Service Area Definition Consistent with IRS guidelines at the time of data collection, the project partners defined the community by geographic location based on the service area of BRMC. The geography of the BRMC region includes the counties of McKean and Potter in Pennsylvania, and Cattaraugus County in New York and is illustrated in Figure 1.

METHODOLOGY


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Figure 1: BRMC Overall Service Area

Asset Inventory

The hospital staff identified existing health care facilities and resources within their primary service area and the region overall available to respond to the significant health needs of the community. Resource directories currently utilized by the hospital’s case management and social service departments were compiled. The information included in the asset inventory and map includes a listing of community and hospital services: Community Resources: Abuse/Trauma Adoption Aid to Servicemen and Women After School and Summer Programs Alcohol and Drug Abuse Services

Animals-Law Enforcement, Shelter and Adoption Assisted Living Facilities Blind and Visual Services Blood Donation Breastfeeding Supports Business/Financial Development


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Camps Cancer Chamber of Commerce Child Care Child Guidance Child Health Child Protection and Placement Clothing Community Centers Consumer Protection Counseling or Therapy Credit Counseling and Protection Dental Care Disability Services Disaster Relief Domestic Violence Educational Support Emergency Numbers/Hotlines Employment and Vocational Counseling Financial Assistance Food and Nutritional Supports Grief Support HIV/AIDS Supports Health and Safety Supports Health Insurance Hearing Impaired Supports Home Health Care Homeless Assistance Hospitals

Housing and Utility Assistance Immunizations Legal Services Libraries McKean County Government Mental Health and Intellectual Disabilities Services Mentoring Missing Persons Nursing Homes Parenting Services and Supports Poison Prevention Pregnancy and Family Planning Probation and Parole Residential Care Schools Senior Centers Senior Citizen Supports Sexual Assault and Domestic Violence Smoking Cessation Speech, Physical and Occupational Therapy Suicide and Crisis Intervention Tourism Transportation Wellness/Fitness

Hospital Resources: Behavioral Health Services Cardiology Dental Services Family Medicine Foothills Medical Group Home Health and Hospice Long-Term Care Medical Supply Services

Nutritional Services Occupational Health Outpatient Services Rehabilitation Services Schools Sleep Disorders Speech Therapy Women’s Health


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Qualitative and Quantitative Data Collection In an effort to examine the health related needs of the residents of the county-wide service area and to meet current IRS guidelines and requirements, the methodology employed both qualitative and quantitative data collection and analysis methods. The staff, Steering Committee members and consulting team made significant efforts to ensure that the entire primary service territory, all socio-demographic groups and all potential needs, issues and underrepresented populations were considered in the assessment to the extent possible given the resource constraints of the project. This was accomplished by identifying focus groups and key stakeholders that represented various subgroups in the community. In addition, the process included public health participation and input, through extensive use of PA and NY Health Department and Centers for Disease Control data and public health department participation on the Steering Committee. The secondary quantitative data collection process included demographic and socio-economic data obtained from Nielsen/Claritas (www.claritas.com); disease incidence and prevalence data obtained from the Pennsylvania Departments of Health and Vital Statistics; New York Department of Health, Behavioral Risk Factor Surveillance Survey (BRFSS) data collected by the Centers for Disease Control and Prevention; American Community Survey and the Healthy People 2020 goals from HealthyPeople.gov. In addition, various health and health related data from the following sources were also utilized for the assessment: the US Department of Agriculture, the Pennsylvania Department of Education, and the County Health Rankings (www.countyhealthrankings.org). Selected data was also included from the McKean/Potter County 2013 PA Youth Survey and the National Survey Results on Drug Abuse – 1975-2013. Selected Emergency Department and inpatient utilization data from the hospital was also included. Economic data was obtained through the U.S. Census Bureau, Small Area Income and Poverty Estimates and the North Central PREP Partner’s 2014 Internal Assessment and Evaluation of Regional Economy Report. Data presented are the most recent published by the source at the time of the data collection. It is important to note that incidence rates and percentages tracked in Pennsylvania may not be tracked in New York, when reporting on Cattaraugus County, although every effort was made, including reaching out to the New York Department of Health, to obtain this data.

http://www.claritas.com/

http://www.countyhealthrankings.org/


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The primary data collection process also included conducting a community survey during July and August 2015, utilizing a mixed-methodology convenience sample, with data collection completed via paper and the Internet. Refer to Appendix E (pages 219-232) of the Supplemental Data Resource for a copy of the Community Survey. BRMC put a link to the survey on their website, ran ads in the Bradford Era, distributed the survey link via e-mail to local residents on their mailing lists and distributed paper surveys in selected locations in their facilities. A total of 508 surveys were completed by residents of the BRMC service area. The primary data collection process included qualitative data from 21 stakeholder interviews conducted during July and August 2015 by staff members of SSI. Refer to Appendix F (pages 233-236) of the Supplemental Data Resource for a copy of the interview guide. Stakeholders interviewed included individuals with expertise in the following disciplines and/or organizational affiliations:

YMCA/YWCA

Transportation

PA Department of Health

School District

Visiting Nurses Association

Hospital System

United Way

Homelessness/Low Income Community

Alcohol and Drug Abuse

Dental Services

Law Enforcement

Children and Youth

Aging Population

Manufacturing

Emergency Services

Financial Services Table 1. BRMC Stakeholder Interviews Date Conducted

Name Organization

Title

July 7, 2015 Steve Jackson YMCA Director


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Date Conducted Name

Organization

Title

July 7, 2015 Bill Keesler ATA Transportation Division Manager

July 8, 2015 Vickie Skvarka PA Department of Health

Community Health Nurse Supervisor

July 8, 2015 Katy Pude Bradford Area Schools Superintendent

July 9, 2015 Kathy Pascarella VNA Administrator

July 10, 2015 Dr. Jill Owens BRMC Family Medicine

July 10, 2015 Mandi Davis United Way Executive Director

July 13, 2015 Vanessa Castano YWCA Director

July 13, 2015 Barb Shufran Friendship Table Administrator

July 14, 2015 Heidi Stahlnecker Alcohol and Drug Abuse Services

Executive Director

July 14, 2015 Dr. Albert Sohnen Mt. Jewett Health Center - Dental Services

Dentist

July 20, 2015 Chief Chris Lucco Bradford Police Department

Chief of Police

July 21, 2015 Tina Martin Care for Children Executive Director

July 24, 2015 Bill Orzechowski McKean County Center on Aging

Executive Director

July 28, 2015 Jeanine Schoenecker

American Refining Group, Inc.

COO

August 3, 2015 Bruce Manning EMS Director

August 4, 2015 Becky Plummer Destinations-Bradford Executive Director

August 5, 2015 Jim Sharer McKean County Jail Warden

August 7, 2015 Julie Marasco Northwest Savings Bank

Regional President


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Date Conducted Name

Organization

Title

August 10, 2015 George Duke Zippo CEO

August 11, 2015 Eric Bridges North Central Planning and Development Commission

Executive Director

Focus groups were conducted with five different groups in June and July 2015 representing the following groups as seen in Table 2. Refer to Appendices G and H (pages 237-245) of the Supplemental Data Resource for copies of the focus group questions used.

Table 2. BRMC Focus Groups Conducted

Date Conducted Group Total # Participants

June 9, 2015 BRMC Medical Staff 24

July 1, 2015 McKean County Collaborative Board

28

July 1, 2015 University of Pitt-Bradford Students

9

July 2, 2015 Senior Center 28

July 2, 2015 Friendship Table 11

TOTAL PARTICIPANTS 100

Interviews and focus groups captured personal perspectives from community members, providers, and leaders with insight and expertise into the health of a specific population group or issue, a specific community or the county overall.


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Needs/Issues Prioritization Process On August 19, 2015, the BRMC Steering Committee met to review the primary and secondary data collected through the needs assessment process and discussed needs and issues present in both the region and their local service territory. The team from SSI, including Debra Thompson, President of Strategy Solutions, Inc., and Kathy Roach, Project Manager/Research Analyst, presented the data to the BRMC Steering Committee and discussed the needs of the local area, what the hospital and other providers are currently offering the community, and discussed other potential needs that were not reflected in the data collected. A total of 44 possible needs and issues were identified, based on disparities in the data (differences in sub-populations, comparison to state, national or Healthy People 2020 goals, negative trends, or growing incidence. Four criteria, including accountable role, magnitude of the problem, impact on other health outcomes, and capacity (systems and resources to implement evidence based solutions), were identified that the group would use to evaluate identified needs and issues. During the two weeks after the meeting, Steering Committee members from the hospital completed the prioritization exercise using the Survey Monkey Internet survey tool to rate each the needs and issues on a one to ten scale by each of the selected criteria. Thirty-two Steering Committee members participated in the prioritization exercise. The consulting team analyzed the data from the prioritization exercise and rank ordered the results by overall composite score (reflecting the scores of all criteria) for the BRMC region, as well as for the hospital’s Steering Committee. On October 5, 2015, BRMC’s Steering Committee met again to discuss the prioritization results and to review the CHNA report.


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Review and Approval The BRMC CHNA report was approved by the BRMC Board of Directors on October 28, 2015.


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Evaluation of the 2005 BRMC CHNA Implementation Strategies BRMC conducted an evaluation of the implementation strategies undertaken since the completion of the 2005 CHNA. Although the status for most county level indicators did not move substantially, it is clear that BRMC is working to improve the health of the community. In reviewing the status of each of the priority areas, BRMC reported that:

Educational materials and seminars were conducted both in the hospital and with community partners to address health as smoking, improper diet and lack of physical activity to address these problem areas.

Educational materials and seminars were conducted both in the hospital and community, with the hospital collaborating with the Center for Rural Health Practice, Pitt-Bradford and University of Pittsburgh, Main Campus to address unintentional injuries and suicide as often related to factors such as alcohol use, drug use and social isolation. BRMC has identified and partnered with lead organizations and groups to address specific health concerns. Those partners included local dentists, Department of Health, Family Planning, and Bradford Crisis Pregnancy Center. The result was the development of the Dental Centers in Bradford and Mount Jewett and a Women’s Health Services office in Bradford.

Additional resources are needed to address identified concerns of: cardiovascular disease, lung cancer, chronic lower respiratory disease, suicide, diabetes mellitus, asthma, child maltreatment, oral health and alcohol, tobacco and illicit drug use. The hospital’s Medical Office Building was constructed to provide one-stop shopping for area residents. Family Medicine, Oncology, Cardiology, Orthopedic

GENERAL FINDINGS


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Surgery, Urology, General Surgery, Pain Medicine, Sleep Disorders Center, Wound Care, Pediatrics, Dental Services, Hospice, Home Care, Skill Nursing Care, Rehabilitation Services and Family Practice are available to area residents at BRMC.

To address mental health BRMC’s Behavioral Health Services (BHS) provides comprehensive inpatient and outpatient psychiatric services to individuals with a wide range of mental health and addictions. BHS offers electro-convulsive therapy, tobacco cessation, alcohol detox and ER evaluations across for persons 18 years of age and older. BHS has the region’s only Dual Diagnosis Unit, caring for patients with both psychiatric disorders and substance abuse disorders. BRMC supports Emergency Room nurses in becoming certified SANE nurses (sexual assault nurse examiner) and the continued education required. BRMC works with Children & Youth and McKean County CASA (court appointed special advocate) for the safety of the children in our community. BRMC has a WIC program located with a prenatal program that provides medical care along with education for low-income or underinsured woman.


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For purposes of this assessment, the BRMC service area geography is defined as certain zip codes in McKean and Potter Counties in Pennsylvania and Cattaraugus County in New York. These zip codes include: Primary Service Area Secondary Service Area City/Town Zip Code City/Town Zip Code Bradford 16701 Kane 16735 Smethport 16749 Salamanca (NY) 14779 Eldred 16731 Coudersport 16915 Lewis Run 16738 Port Allegany 16743 Duke Center 16729 Shinglehouse 16748 Turtlepoint 16750 Genesee 16923 Gifford 16732 Limestone (NY) 14753 Rixford 16745 Roulette 16746 Cyclone 16726 Austin 16720 Crosby 16724 Harrison Valley 16927 Derrick City 16727 Mount Jewett 16740 Rew 16744 The above listed primary and secondary service area zip codes were used to pull Demographic data from Nielsen/Claritas and the U.S. Census Bureau – American Family Survey in order to report on the areas of: population, sex, race, age, marital status, educational status, household income, employment and poverty status, and travel time to work. Below are the Demographic conclusions from this data. For a more in-depth review of the Demographic data, please see pages 1-24 of BRMC’s CHNA Supplemental Data Resource, Appendix A.

DEMOGRAPHICS


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Demographic Conclusions

• Service area population has been steadily declining and projected to continue to decline from 64,307 in 2015 to 63,570 in 2020.

• Slightly more males (50.5%) than females (49.5%). • Over three-fourths of the residents are White (93.42%). • One third (36.4%) of the population is between the ages of 25 and 54. • Just under half (47.5%) of the population is married. • One in five (22.4%) have an Associate Degree or higher educational

attainment. A little under one in ten (8.3%) have not graduated high school.

• Just under one in five households (15.0%) have an annual income of $15,000 or less. Over half (58.6%) have annual incomes less than $50,000.

• Half of the population (50.3%) is employed. Very few (5.8%) residents are unemployed.

• The percentage of those living in poverty has been increasing for the counties of McKean, Potter and Cattaraugus since 2003 and all counties are above their corresponding states percentages.

• According to the North Central PREP Partner’s 2014 report, several individuals within the region, which includes McKean and Potter Counties, have exhausted the available unemployment compensation benefits which are available to them. The majority of these individuals represent Manufacturing; Trade, Transportation & Utilities; and Construction.

• Although the region saw an increase (13.2%) of online job postings for 2014, McKean County had the lowest increase in online job postings.

• Three-fourths of those employed (75.9%) travel less than 30 minutes to work.


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Asset Inventory A list of community assets and resources that are available in the community to support residents was compiled and is mapped in Figure 2 and listed in BRMC’s CHNA Supplemental Data Resource, Appendix B, pages 25-52. The assets identified are broken down into the following sections: Community Resources: Abuse/Trauma Adoption Aid to Servicemen and Women After School and Summer Programs Alcohol and Drug Abuse Services Animals-Law Enforcement, Shelter and Adoption Assisted Living Facilities Blind and Visual Services Blood Donation Breastfeeding Supports Business/Financial Development Camps Cancer Chamber of Commerce Child Care Child Guidance Child Health Child Protection and Placement Clothing Community Centers Consumer Protection Counseling or Therapy Credit Counseling and Protection Dental Care Disability Services Disaster Relief Domestic Violence Educational Support Emergency Numbers/Hotlines

Employment and Vocational Counseling Financial Assistance Food and Nutritional Supports Grief Support HIV/AIDS Supports Health and Safety Supports Health Insurance Hearing Impaired Supports Home Health Care Homeless Assistance Hospitals Housing and Utility Assistance Immunizations Legal Services Libraries McKean County Government Mental Health and Intellectual Disabilities Services Mentoring Missing Persons Nursing Homes Parenting Services and Supports Poison Prevention Pregnancy and Family Planning Probation and Parole Residential Care Schools Senior Centers Senior Citizen Supports Sexual Assault and Domestic Violence


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Smoking Cessation Speech, Physical and Occupational Therapy Suicide and Crisis Intervention

Tourism Transportation Wellness/Fitness

Hospital Resources: Behavioral Health Services Cardiology Dental Services Family Medicine Foothills Medical Group Home Health and Hospice Long-Term Care Medical Supply Services



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Figure 2: BRMC Asset Resources Map


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Key Findings –BRFSS & Public Health Data This assessment reviewed a number of indicators at the county level from the statewide Behavioral Risk Factor Survey (BRFSS), as well as disease incidence and mortality indicators. For this analysis, the service area data was compared to state and national data where possible. As outlined in the following tables, when looking at the BRFSS questions related to BRMC’s service area data, the regional rates that were worse than Pennsylvania include the percentage of people who are overweight, had a pneumonia vaccine, ever tested for HIV, reported never being a smoker, reported being a former smoker (Female), quit smoking at least 1 day in the past year and those reported being an everyday smoker. The public health data within BRMC’s service area has increasing rates of chronic diseases in several areas: bronchus and lung cancer incidence in McKean, Potter and Cattaraugus counties; bronchus and lung mortality in the counties of McKean and Cattaraugus; colorectal cancer incidence in McKean and Potter Counties; ovarian cancer incidence, ovarian cancer mortality and prostate cancer incidence in Cattaraugus County; heart disease mortality in McKean County; coronary heart disease mortality and cardiovascular mortality for the county of McKean; chronic lower respiratory disease (COPD) in Potter and Cattaraugus Counties; and cerebrovascular mortality and diabetes mortality in Cattaraugus County. For the Healthy Mothers, Babies and Children indicators, BRMC’s service area has increasing rates of prenatal care during the first trimester in McKean and Potter counties and breastfeeding in McKean and Potter counties. Decreasing trends for BRMC’s service area can be seen in non-smoking mothers during pregnancy and non-smoking mothers three months prior to pregnancy in McKean and Potter counties; teen pregnancy rates in McKean, Potter and Cattaraugus counties. Increasing trends can also be seen in mothers reporting WIC and Medicare assistance in McKean County; teen live birth outcomes in McKean and Potter counties; infant mortality in Cattaraugus County; and students in grades K-12 who are overweight in McKean, Potter and Cattaraugus counties. For the selected indicators within Infectious Disease, Mental Health and Substance Abuse, Tobacco Use and Injury, BRMC’s service has increasing rates of Chlamydia for both male and female in Cattaraugus County; Lyme


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disease in McKean and Potter counties; influenza and pneumonia mortality in McKean County; and suicide mortality in Cattaraugus County. Other indicators that show an increasing trend in the BRMC service area include unemployment, children living in poverty and children living in a single parent home in McKean County. There is also a decreasing trend in high school graduation rates for McKean County. The 2013 Pennsylvania Youth Survey for children in grades 6, 8, 10 and 12 for the BRMC service area shows that there are increasing rates in lifetime alcohol, marijuana and pain reliever use for all counties except Cattaraugus, as Cattaraugus County’s numbers cannot be reported as they do not have a like survey in New York; and percent of students who drove after drinking or using marijuana in the counties of McKean and Potter.


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Overall Key Findings Table 3 below highlights the key findings of the Behavioral Risk Factor Survey for BRMC. Table 3. BRMC Behavioral Risk Factor Comparative Table

BRADFORD,

SULLIVAN, TIOGA,

LYCOMING, CLINTON,

POTTER

BRADFORD,

SULLIVAN, TIOGA,

LYCOMING, CLINTON,

POTTER

FOREST, ELK,

CAMERON,

CLEARFIELD,

JEFFERSON,

CLARION,

MCKEAN,

WARREN

FOREST, ELK,

CAMERON,

CLEARFIELD,

JEFFERSON,

CLARION,

MCKEAN,

WARREN PA PA CATTARAUGUS CATTARAUGUS NY NY US US HP 2020 Local PA NY US HP 2020

Behavior Risk 2008-10 2011-2013 2008-10 2011-2013 2008-10 2011-13 2008-2009 2013-2014 2008-20092013-2014 2010 2013 Goal Trend Comp Comp Comp Comp

ACCESS

Reported Health Poor or Fair 15.0% 17.0% 22.0% 20.0% 15.0% 17.0% 14.7% 16.7% +/- +/- +/-

Physical Health Not Good for 1+ Days in the Past Month 36.0% 35.0% 37.0% 39.0% 37.0% 38.0% +/- +/-

Poor Physical or Mental Health Preventing Usual Activities in the Past Month 19.0% 20.0% 22.0% 19.0% 21.0% 22.0% +/- =/-

No Health Insurance 20.0% 17.0% 16.0% 17.0% 13.0% 16.0% 15.7% 15.6% 17.8% 16.8% 0% +/- +/- +/- +

No Personal Health Care Provider 12.0% 15.0% 10.0% 12.0% 11.0% 13.0% 13.9% 17.0% 22.9% 16.1% + +/- - -

Routine Check-up Within the Past 2 Years 81.0% 81.0% 83.0% 84.0% 83.0% 83.0% 81.3% +/= +/- =/+

Needed to See a Doctor But Could Not Due to Cost, Past Year 12.0% 10.0% 12.0% 10.0% 11.0% 13.0% 12.7% 13.8% 15.3% 4.2% - - - +

CHRONIC DISEASE

Ever Told They Have Heart Disease- Age 35 and older 7.0% 6.0% 8.0% 8.0% 7.0% 7.0% 4.1% 4.1% -/= +/- +

Ever Told They Had a Heart Attack- Age 35 and Older 6.0% 6.0% 9.0% 7.0% 6.0% 6.0% 4.2% 4.3% =/- +/= +

Ever Told They Had a Stroke- Age 35 and older 3.0% 5.0% 4.0% 4.0% 12.0% 4.0% 2.8% +/= +/- =/+

Ever Told They Had a MI, Heart Disease, or Stroke- Age GE 35 12.0% 13.0% 13.0% 15.0% 12.0% 12.0% + +/-

Ever Told They Had Kidney Disease, Not Including Kidney Stones, Bladder Infection or Incontinence ND 2.0% ND 3.0% ND 2.0% 2.5% +/= +/= +/=

Overweight (BMI 25-30) 66.0% 66.0% 66.0% 67.0% 36.0% 36.0% 36.2% 35.4% +/= + + +

Obese (30-99.99) 30.0% 31.0% 32.0% 30.0% 28.0% 29.0% 28.3% 24.9% 27.5% 29.4% 30.5% +/- +/- +/- +/-

Adults Who Were Ever Told They Have Diabetes 9.0% 9.0% 11.0% 12.0% 9.0% 10.0% 9.7% +/= +/- +/-

HEALTHY ENVIRONMENT

Adults Who Have Ever Been Told They Have Asthma 12.0% 11.0% 11.0% 13.0% 14.0% 14.0% 13.8% 14.1% - - - -

Adults Who Currently Have Asthma 9.0% 8.0% 9.0% 9.0% 10.0% 10.0% 9.1% 9.0% -/= - -/=

INFECTIOUS DISEASE

Adults Who Had a Pneumonia Vaccine, Age 65 and older 65.0% 69.0% 63.0% 68.0% 70.0% 71.0% 68.8% 64.7% 68.8% 69.5% 90.0% + - - -

Ever Tested for HIV, Ages 18-64 29.0% 33.0% 24.0% 27.0% 34.0% 38.0% 35.2% 73.6% + - - -

MENTAL HEALTH AND SUBSTANCE ABUSE

Mental Health Not Good 1+ Days (PA)/14 Days (NY) in the Past Month 31.0% 33.0% 33.0% 32.0% 34.0% 36.0% 10.6% 11.7% 10.2% 11.2% +/- - +/-

Adults Who Reported Binge Drinking (5 drinks for men, 4 for women) 16.0% 17.0% 21.0% 17.0% 17.0% 18.0% 24.5% 11.9% 18.1% 17.8% 17.1% 16.8% 24.4% +/- +/- +/- +/- -

At Risk for Heavy Drinking (2 drinks for men, 1 for women daily) 7.0% 6.0% 7.0% 5.0% 5.0% 6.0% 17.8% 6.2% - +/- +/-

Reported Chronic Drinking (2 or more drinks daily for the past 30 days) 8.0% 6.0% 8.0% 6.0% 6.0% 6.0% 5.0% - +/- +

PHYSICAL ACTIVITY AND NUTRITION

No Leisure Time/Physical Activity in the Past Month 27.0% ND 29.0% ND 25.0% ND 23.9% 32.6%

No Leisure Time/Physical Activity in the Past Month: Education Level College 22.0% ND 15.0% ND 15.0% ND

TOBACCO USE

Adults Who Reported Never Being a Smoker 53.0% 52.0% 46.0% 52.0% 54.0% 53.0% 56.6% 55.0% +/- - -

Adults Who Reported Being a Former Smoker 25.0% 24.0% 25.0% 25.0% 26.0% 26.0% 25.1% 25.3% -/= - +/-

Adults Who Reported Being a Former Smoker (Female) 18.0% 21.0% 18.0% 22.0% 23.0% 22.0% + +/-

Adults Who Reported Being A Former Smoker (Male) 33.0% 28.0% 31.0% 30.0% 29.0% 29.0% - +/-

Currently using Chewing Tobacco, Snuff, or Snus, Somewhat or Everyday (Adults) ND 9.0% ND 12.0% ND 4.0% 4.2%

Currently using Chewing Tobacco, Snuff, or Snus, Somewhat or Everyday (Age 18-44) ND 13.0% ND 15.0% ND 6.0%

Currently using Chewing Tobacco, Snuff, or Snus, Somewhat or Everyday (Age 45-64) ND 8.0% ND 12.0% ND 3.0%

Currently using Chewing Tobacco, Snuff, or Snus, Somewhat or Everyday (Age 65+) ND 2.0% ND 7.0% ND 2.0%

Adults Who Have Quit Smoking at Least 1 Day in the Past Year (daily) 53.0% 45.0% 56.0% 50.0% 50.0% 54.0% 80.0% - +/- -

Adults Who Reported Being a Current Smoker 21.0% 23.0% 29.0% 23.0% 20.0% 22.0% 17.3% 18.8% 12.0% +/- +/- + +

Adults Who Reported Being An Everyday Smoker 17.0% 19.0% 24.0% 18.0% 15.0% 16.0% 12.4% 13.4% +/- + + Source: Pennsylvania Department of Health, New York Department of Health, Centers for Disease Control, www.healthypeople.gov

The color coding illustrates comparisons to the Healthy People 2020 goal or the national rate (if there is no HP 2020 goal). Red indicates that the regional data is worse than the comparison and green indicates better than the comparison. Yellow indicates that one county is higher and another is lower.


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Table 4 highlights various public health indicators included in the assessment for BRMC. Table 4. BRMC Public Health Indicators

Trend Trend Trend PA (2008)

PA (the last

year) NY (2008)

NY (the last

year) US (2010) US - 2012 HP 2020 PA NY US HP Goal

Public Health Data 2008 2009 2010 2011 2012 +/- 2008 2009 2010 2011 2012 +/- 2008 2009 2010 2011 2012 +/- Rate Rate Rate Rate Rate Rate Goal Comp Comp Comp Comp

CHRONIC DISEASE

Breast Cancer Rate per 100,000 70.7 47.2 50.5 70.2 40.5 +/- 95.9 ND 48.1 58.7 52.9 +/- 113.7 140.6 131.3 129.5 DNA +/- 71.2 69.4 137.1 135.8 121.9 122.0 41.0 +/- +/- +/- +

Breast Cancer Mortality Rate per 100,000 ND 25.4 ND ND ND ND ND ND ND ND 20.4 17.7 26.7 13.1 DNA +/- 13.9 12.5 21.8 21.3 22.2 21.5 20.7 +/- +/- +/-

Bronchus and Lung Cancer Rate per 100,000 74.4 61.4 70.9 68.2 77.1 +/- 52.6 78.7 59.6 102.9 73.4 +/- 87.7 75.3 76.0 92.8 DNA +/- 69.9 63.9 73.3 68.5 73.0 +/- + +/-

Bronchus and Lung Cancer Mortality Rate per 100,000 48.8 48.8 55.6 59.9 50.2 +/- 63.2 57.0 ND 61.7 51.3 +/- 48.5 54.8 53.5 51.5 DNA +/- 51.6 46.5 48.9 45.7 57.9 45.5 +/- + +/- +

Colorectal Cancer Rate per 100,000 44.2 56.4 52.0 32.7 49.2 +/- 43.2 ND 41.9 44.1 51.3 +/- 56.3 52.6 52.8 50.6 DNA - 49.5 42.5 47.0 41.5 46.1 38.6 +/- + +/- +/-

Colorectal Cancer Mortality Rate per 100,000 ND 19.9 18.7 19.0 ND ND ND ND ND ND 19.6 16.3 19.2 12.5 DNA +/- 18.1 15.8 15.5 13.9 16.9 18.1 14.5 +/- +/- +/-

Ovarian Cancer Rate per 100,000 ND ND ND ND ND ND ND ND ND ND 16.4 12.3 16.1 18.9 DNA +/- 13.5 11.9 13.9 13.0 11.3 +/- +

Ovarian Cancer Mortality Rate per 100,000 ND ND ND ND ND ND ND ND ND ND 5.6 7.4 19.5 6.3 DNA +/- 8.7 7.9 8.8 7.9 7.5 +/- +/-

Prostate Cancer Rate per 100,000 133.4 115.2 120.5 89.2 110.7 +/- 147.6 126.9 179.4 129.7 132.8 +/- 186.2 123.3 148.4 155.8 DNA +/- 148.7 101.7 172.5 152.4 128.3 +/- +/- +/-

Prostate Cancer Mortality Rate per 100,000 ND ND ND ND ND ND ND ND ND ND 38.7 12.6 18.0 16.9 DNA +/- 24.2 19.1 20.3 18.3 20.8 21.8 +/- +/- +/-

Heart Disease Mortality Rate per 100,000 222.5 212.7 242.4 258.8 302.1 + 181.6 152.7 157.6 143.2 121.6 - 286.4 259.4 313.2 293.6 258.9 +/- 207.3 175.2 207.0 181.7 176.8 +/- + +/-

Heart Attack Mortality Rate per 100,000 19.2 ND 20.8 ND ND ND ND ND ND ND 77.4 74.1 81.5 69.6 71.6 +/- 20.4 17.9 42.1 34.4 89.2 + -

Coronary Heart Disease Mortality Rate per 100,000 145.8 118.3 151.0 178.4 217.1 + 142.3 98.8 94.9 68.8 79.9 +/- 232.0 219.1 255.1 243.5 208.2 +/- 138.5 115.3 153.0 130.6 108.91 103.4 +/- + +/- +/-

Cardiovascular Mortality Rate per 100,000 291.0 276.5 284.9 307.8 349.0 + 252.9 194.3 230.4 201.3 183.4 +/- 323.1 316.4 372.7 351.7 314.6 +/- 264.5 225.5 255.7 227.0 233.73 +/- + +/-

Chronic Lower Respiratory Disease (COPD) Rate per 100,000 67.3 72.6 73.3 45.5 38.1 +/- 48.6 91.0 51.1 66.8 + 45.2 57.9 65.4 56.3 61.0 + 42.8 38.4 39.8 37.7 40.8 102.6 +/- + +/- -

Cerebrovascular Mortality Rate per 100,000 42.4 45.0 33.5 32.4 28.7 - 39.0 ND ND 46.1 ND 19.8 36.2 39.6 34.9 39.1 +/- 41.8 36.8 32.0 30.2 39.1 39.9 34.8 +/- +/- +/- +/-

Diabetes Mortality Rate per 100,000 26.7 23.7 ND 21.5 22.4 +/- ND ND ND ND ND 18.9 22.3 17.3 12.2 23.4 +/- 21.3 22.0 15.1 15.6 20.8 73.28 66.6 +/- +/- - -

Type I Diabetes, Students 0.45% 0.44% 0.44% 0.45% +/- 0.27% 0.20% 0.24% 0.25% +/- 19.6 0.32% +/-

Type II Diabetes, Students 0.10% 0.09% 0.12% 0.16% +/- 0.16% 0.20% 0.24% 0.04% +/- 0.30% 0.06% +

Alzheimer Mortality Rate per 100,000 25.4 19.4 ND ND ND ND ND ND ND ND 22.8 18.7 26.8

HEALTHY ENVIRONMENT

Student Health Asthma (% for PA; Rate for NY) 14.30% 14.97% 14.46% 14.49% +/- 10.51% 9.29% 8.60% 7.69% - 20.2 27.3 23.4 14.1 13.7 +/- 6.8% 12.05% 15.1 14.6 +/- +/-

HEALTHY MOTHERS, BABIES AND CHILDREN

Prenatal Care First Trimester 79.0% 79.3% 84.9% 81.3% 82.1% + 80.0% 84.5% 82.3% 86.9% 87.1% + 73.0% 76.3% 75.0% 71.6% 68.6% +/- 70.5% 72.4% 72.8% 75.4% 70.8% 77.9% + +/- +/- +/-

Non-Smoking Mother During Pregnancy 64.3% 66.6% 62.1% 68.2% 62.8% +/- 68.2% 67.0% 68.1% 69.9% 65.5% +/- 84.1% 85.2% 89.3% 98.6% - - -

Non-Smoking Mother 3 Months Prior to Pregnancy 58.7% 59.1% 54.5% 61.2% 54.7% +/- 63.5% 62.8% 62.2% 64.2% 61.8% +/- 77.6% 80.1% 76.8% - -

Low Birth-Weight Babies Born (% for PA; Rate for NY) 11.5% 9.7% 9.7% 5.6% 8.4% - 5.0% 8.7% 9.3% 6.5% ND +/- 1.2 1.7 1.4 1.5 2.6 +/- 8.3% 8.1% 1.4 1.4 8.0% 7.8% +/- +/- +/- +/-

Mothers Reporting WIC Assistance 56.7% 58.8% 59.0% 56.5% 57.2% +/- 58.5% 53.6% 56.5% 48.2% 50.6% - 39.0% 39.3% +

Mothers Reporting Medicaid Assistance 48.7% 54.2% 54.9% 45.7% 50.9% +/- 50.5% 47.4% 50.5% 47.7% 40.9% - 31.2% 33.6% +

Breastfeeding 48.1% 57.7% 55.8% 58.7% 61.3% + 68.0% 69.4% 75.4% 75.5% 79.3% + 66.3% 62.6% 65.0% 63.8% 65.4% +/- 66.5% 73.1% 72.3% 78.0% 77.0% 81.9% +/- - +/- -

Teen Pregnancy Rate per 100,000, Ages 15-19 43.1 45.3 39.9 34.3 27.5 +/- 41.1 40.1 34.2 51.3 37.6 +/- 12.1 13.3 9.7 10.6 8.6 +/- 44.3 33.7 7.0 5.8 34.2 30.0 36.2 +/- + +/- +/-

Teen Live Birth Outcomes, Ages 15-19 90.0% 95.9% 91.5% 97.9% 94.7% +/- 91.3% 95.5% 94.4% 92.6% 100.0% + 67.6% 69.5% 73.4% + +

Infant Mortality ND ND ND ND ND ND ND ND ND ND 7.0 6.1 2.0 11.0 7.7 +/- 7.3 7.0 5.8 5.4 6.2 6.1 6.0 +/- +/- +/-

Overweight BMI, Grades K-6 14.2% 17.0% + 13.1% 14.4% + 14.4% 18.4% + 15.9% 15.8% +/- +/-

Obese BMI, Grades K-6 21.0% 21.0% = 20.8% 19.2% - 14.8% 16.8% + 16.7% 17.2% 15.7% + - +

Overweight BMI, Grades 7-12 17.6% 17.6% = 17.5% 17.3% - 18.5% 16.8% - 16.4% 16.8% 30.3% + +/-

Obese BMI, Grades 7-12 22.1% 20.8% - 22.2% 22.8% + 21.8% 22.5% + 17.7% 18.2% 13.7% 16.1% + +

INFECTIOUS DISEASE

Lyme Disease Rate per 100,000 41.3 50.9 71.3 97.2 69.6 +/- ND ND ND 80.2 62.6 - 5.0 32.1 39.4 34.6 8.6 + +

Influenza and Pneumonia Mortality Rate per 100,000 17.0 25.4 ND 19.9 20.4 + 40.0 ND ND ND ND 16.7 13.3 16.2 15.1 + +

Chlamydia Rate per 100,000 (Female) 202.3 338.6 319.4 354.2 349.4 + ND 139.8 183.2 379.4 228.3 + 263.9 313.8 379.4 447.9 326.1 +/- 476.9 575.0 405.5 473.4 - -

Chlamydia Rate per 100,000 (Male) 85.3 108.0 90.3 113.4 150.4 +/- ND ND ND ND ND 63.9 66.3 88.1 111.6 99.3 +/- 193.7 279.1 165.8 202.4 - -

Gonorrhea Rate per 100,000 27.6 30.1 ND ND 25.5 +/- ND ND ND ND ND 21.3 10.0 5.0 3.8 18.9 +/- 88.9 120.6 59.6 70.2 106.7 - - -


Drug-Induced Mortality Rate per 100,000 ND ND ND ND ND ND ND ND ND ND 15.3 19.2 10.2 11.3

Mental & Behavioral Disorders Mortality Rate per 100,000 36.2 20.6 29.5 45.8 43.3 +/- 39.5 36.7 40.8 49.5 51.3 +/- 34.0 43.0 63.3 +/- -

INJURY

Auto Accident Mortality Rate per 100,000 28.0 ND ND ND ND ND ND ND ND ND 19.9 10.8 22.4 16.8 4.2 +/- 11.9 10.0 8.1 8.3 11.9 10.7 12.4 +/- +/- +/-

Suicide Mortality per 100,000 ND ND ND ND ND ND ND ND ND ND 8.1 15.6 7.1 14.5 13.7 +/- 11.9 12.1 8.1 9.7 12.1 4.5 10.2 +/- + +/-

Fall Mortality Rate per 100,000 ND ND ND ND ND ND ND ND ND ND 8.0 8.4 8.1 9.6 7.2

Firearm Mortality Rate (Accidental, Suicide, Homicide) ND ND ND ND ND ND ND ND ND ND 10.6 11.0 10.1 10.1 9.3

MCKEAN COUNTY POTTER COUNTY CATTARAUGUS COUNTY

Source: Pennsylvania Department of Health, New York Department of Health, Centers for Disease Control, www.healthypeople.gov



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Table 5 highlights various county health indicators included in the assessment for BRMC.

Table 5. BRMC County Health Rankings

Trend Trend PA - 2013

PA (the

last year) Trend NY - 2013

NY (the

last year US - 2010 HP 2020 PA NY US HP Goal

Other Indicators 2013 2014 2015 +/- 2013 2014 2015 +/- Rate Rate 2013 2014 2015 +/- +/- Rate Rate Goal Comp Comp Comp Comp

ACCESS

Mammogram Screenings 67.3% 64.9% 65.1% - 70.2% 65.8% 64.5% - 66.8% 63.4% 64.8% 60.0% 53.1% - 65.9% 63.1% 67.1% 81.1% +/- +/- +/- -

HEALTHY ENVIRONMENT

Unemployment Rates 8.5% 8.1% 7.8% - 9.1% 9.1% 9.4% + 7.9% 7.4% 8.7% 8.9% 8.1% +/- 8.2% 7.7% 8.9% +/- +/- +/-

High School Graduation Rates 93.0% 93.0% 90.0% - 90.0% 90.0% 88.0% =/- 83.0% 85.0% 78.0% 77.0% 80.0% +/- 77.0% 77.0% 82.4% + +/- +/-

Children Living in Poverty 24.0% 24.0% 28.0% =/+ 25.0% 24.0% 24.0% - 19.0% 19.0% 28.0% 29.0% 29.0% + 23.0% 23.0% + +/-

Children Living in Single Parent Homes 35.0% 37.0% 40.0% + 30.0% 29.0% 30.0% -/= 32.0% 33.0% 35.0% 33.0% 34.0% +/- 34.0% 35.0% +/- -/=


Limited Access to Healthy Foods 1.0% 1.0% 1.0% = 9.0% 9.0% 9.0% = 4.0% 4.0% 2.0% 2.0% 2.0% = 2.0% 2.0% +/- =

Food Insecurity 13.0% 14.0% + 13.0% 13.0% = 14.0% 11.0% 12.0% + 14.0% +/- -

Children Eligible for Free Lunch 36.0% 36.0% 35.0% =/+ 38.0% 38.0% 39.0% =/+ 33.0% 34.0% 33.0% 33.0% 33.0% = 41.0% 42.0% +/- -

TOBACCO USE

Adults who Smoke 33.0% 27.0% 27.0% - 22.0% 18.0% 18.0% - 21.0% 20.0% 21.0% 23.0% 23.0% + 18.0% 17.0% 20.0% 12.0% +/- + +/- +/-

MCKEAN COUNTY POTTER COUNTY CATTARAUGUS COUNTY

Source: County Health Rankings, Centers for Disease Control, www.healthypeople.gov



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Table 6 highlights various youth survey indicators included in the assessment for BRMC. Table 6. BRMC 2013 Pennsylvania Youth Survey MENTAL HEALTH AND SUBSTANCE ABUSE Trend Trend PA Trend NY US PA NY* US

2009 2011 2013 +/- 2009 2011 2013 +/- Rate 2009 2011 2013 +/- Rate Rate Comp Comp Comp

Alcohol Child/Adolescent Lifetime Use 2013 2013

Grade 6 ND 19.8% 19.5% - ND 16.8% 22.7% + 13.3% +/-

Grade 8 ND 37.2% 39.1% + ND 32.3% 43.9% + 35.1% 27.8% +/- +

Grade 10 ND 56.0% 66.4% + ND 51.6% 67.5% + 61.5% 52.1% +/- +

Grade 12 ND 68.0% 78.3% + ND ND 66.7% + 74.2% 68.2% +/- +/-

Overall ND 44.5% 50.9% + ND ND 50.6% + 56.9% +/-

Marijuana Child/Adolescent Lifetime Use

Grade 6 ND 1.5% 0.9% - ND 0.8% 2.8% + 0.8% +/=

Grade 8 ND 5.2% 4.1% - ND 5.5% 8.8% + 6.4% 16.5% +/- -

Grade 10 ND 25.4% 23.9% - ND 17.5% 25.6% + 25.8% 35.8% +/- -

Grade 12 ND 37.3% 39.2% + ND ND 21.1% + 40.3% 45.5% - -

Overall ND 16.7% 17.0% + ND ND 14.8% + 18.9% +

% of Children/Adolescents Who Drove After Drinking

Grade 6 ND 0.4% 0.4% = ND 0.0% 1.4% + 0.2% +/-

Grade 8 ND 1.8% 0.6% - ND 2.4% 2.7% + 0.4% +/-

Grade 10 ND 1.7% 3.6% + ND 1.5% 1.2% - 1.8% +/-

Grade 12 ND 11.3% 10.4% - ND ND 5.4% + 8.7% +/-

Overall ND 3.4% 3.9% + ND ND 2.7% + 2.9% +/-

% of Children/Adolescents Who Drove After Using Marijuana

Grade 6 ND 0.4% 0.4% = ND 0.0% 0.0% = 0.1% +/-

Grade 8 ND 0.4% 0.3% - ND 0.8% 1.3% + 0.4% +/-

Grade 10 ND 2.1% 3.1% + ND 0.7% 0.0% - 2.4% +/-

Grade 12 ND 10.3% 13.1% + ND ND 1.4% + 12.4% +/-

Overall ND 3.0% 4.4% + ND ND 0.7% + 4.1% +/-

Pain Reliever Child/Adolescent Lifetime Use

Grade 6 ND 1.9% 2.3% + ND 0.8% 1.3% + 2.1% +/-

Grade 8 ND 3.7% 3.5% - ND 5.5% 6.1% + 4.1% +/-

Grade 10 ND 5.3% 9.0% + ND 6.3% 9.6% + 8.3% +/-

Grade 12 ND 10.1% 14.0% + ND ND 3.8% + 12.1% +/-

Overall ND 5.0% 7.2% + ND ND 5.3% + 6.8% +/-

MCKEAN POTTER CATTARAUGUS*

*PAYS for Cattaraugus County was not available as there was no comparable youth survey in New York. ND = No Data as rates/percentages were too low to measure. Source: 2013 Pennsylvania Youth Survey, National Survey Results on Drug Abuse – 1975-2013



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Other Secondary Data: Hospital Utilization Rates As seen in Table 7, from 2012 through 2014, hospital inpatient discharges for ambulatory care sensitive conditions for BRMC increased for: vaccine preventable conditions, failure to thrive, gastroenteritis, cellulitis, hypertension, diabetes and COPD. For the same time period, hospital ER and inpatient discharges for mental health for BRMC, as seen in Table 8, increased for: bi-polar, personality disorders, alcohol related, depressions, stress related, Schizophrenia, other chronic organic psychosis, paranoia psychosis, conduct/social disturbances, dementia, transient organic psychotic, sexual deviations, emotional-youth and psychogenic disorders. Table 9 shows that from 2012 to 2014, hospital DRG conditions for BRMC increased for: alcohol/drug abuse, COPD, cancer, breast cancer, hypertension, and complications baby. Table 7. Ambulatory Care Sensitive Conditions – ER Only

Ambulatory Care Sensitive Conditions- ER Only

Preventable Conditions 2012 2013 2014

Dental Conditions 748 683 685

Vaccine Preventable Conditions 6 2 8

Iron Deficiency Anemias 14 10 7

Failure to Thrive 1 1 2

Congenital Syphilis 0 0 0

Hemophilus Meningitis ages 1-5 0 0 0

Nutritional Deficiencies 2 0 0

Acute Conditions 2012 2013 2014

Kidney/Urinary Infection 551 438 386

Severe ENT Infections 527 434 354

Gastroenteritis 270 231 300

Cellulitis 70 113 100

Convulsions 93 80 90

Hypoglycemia 45 45 43

Pelvic Inflammatory Dis 39 25 19

Cervical Cancer 0 1 0

Dehydration 1 0 0

Skin Grafts with Cellulitis 0 0 0


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Acute Conditions 2012 2013 2014

Bacterial Pneumonia 0 0 0

Chronic Conditions 2012 2013 2014

Asthma 100 70 96

Hypertension 58 62 62

Diabetes without other conditions 42 50 60

Grand Mal and other Epileptic 55 24 35

Angina 66 46 34

Diabetes with other conditions 17 21 30

COPD 14 19 22

CHF 35 24 19

Diabetes with ketoacidosis 8 12 14

Tuberculosis- Non Pulmonary 0 0 0

Pulmonary Tuberculosis 0 0 0

Table 8. Mental Health ICD-9 Codes

Mental Health ICD-9 File

Code 2012 ER 2012 IN 2013 ER 2013 IN 2014 ER 2014 IN

Drug Related 6455 873 5878 801 5454 834

Bi Polar 697 596 718 571 718 594

Personality Disorders 60 512 44 478 31 525

Alcohol Related 267 521 269 461 326 482

Anxiety 1229 497 903 559 966 476

Depressions 21 409 15 422 27 433

Stress Related 16 107 15 161 22 189

Schizophrenia 46 184 42 149 77 155

Other Chronic Organic Psych 83 174 119 162 151 141

Adjustment Related 190 142 193 116 162 118

Paranoia Psychosis 678 98 1059 92 1150 93

Mental Retardation 17 80 26 53 12 47

Conduct/Social Disturbances 32 14 24 17 25 25

Eating Disorders 0 19 2 17 0 17

Phobias 8 14 6 13 3 11

Dementia 3 4 1 4 0 7

Transient Organic Psychotic 1 1 0 14 1 5

Sexual Deviations 0 4 0 5 1 4

Sleep Disorders 11 6 17 1 10 3

Emotional- Youth 77 5 92 4 85 3


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Code 2012 ER 2012 IN 2013 ER 2013 IN 2014 ER 2014 IN

Psychogenic Disorders 9 0 6 1 10 2

Manic Disorder 0 1 0 0 0 0

Table 9. Diagnosis Related Groups

DRG File DRG File 2012 2013 2014

Alcohol/Drug Abuse 310 304 335

COPD 118 103 124

Pneumonia 150 147 120

Cancer 47 65 62

CHF 81 73 53

Bronchitis/Asthma >18 14 14 13

Breast Cancer 2 2 7

Bronchitis/Asthma < 18 9 8 7

Fracture 9 3 7

Hypertension 4 3 5

Complications Baby 16 12 5

Primary Research Results A total of 21 stakeholder interviews were conducted throughout the region. A BRMC community survey conducted through Internet and paper survey distribution received 508 completed surveys. Stakeholders were identified as experts in a particular field related to their background, experience or professional position and/or someone who understood the needs of a particular underrepresented group or constituency. A total of five focus groups were conducted in the overall region. While the interviews, focus groups and surveys were conducted across the region with various community constituencies, they were conducted using a convenience sample and thus are not necessarily representative of the entire population. The results reported herein are qualitative in nature and reflect the perceptions and experiences of interview and focus group participants.


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Overall Community Health Status Community survey respondents (508) were asked to rate the health status of the community. A third of survey responses commented that their health status was “Fair” as seen in Figure 3 below. Figure 3. Community Survey – Community Health Status, N=508

Source: 2015 BRMC Community Survey, Strategy Solutions, Inc.

Other survey findings related to health status included:

Approximately five percent (4.2%) of the 2015 BRMC Community Survey respondents rated the health of their community as “Excellent” or “Very Good.”

Just over one-third (35.6%) of the BRMC Community Survey respondents rated the community health status as “Good.”

Over half (60.3%) of BRMC Community Survey respondents rated the health of their community as “Fair” or “Poor.”


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As seen in Figure 4, over half of focus group respondents (57.0%) rated the health status of the community as “Fair” or “Poor,” while just under half of the respondents (40.0%) rated the health status of the community as “Good.” Figure 4. Focus Groups – Community Health Status

Source: 2015 BRMC Focus Groups, Strategy Solutions, Inc.

When asked to comment on why they gave the rating they did, respondents cited the following community health issues:

Students have to go off campus for healthcare

Obesity is a problem

Drugs are a problem on campus

Poor community that spends money on fast food which leads to obesity

Lack of personal hygiene

Poor dental hygiene

Mental illness

Seeing an increase in behavioral health rates

Seems like a lot of people have cancer and diabetes

High incidence of alcohol, drugs, tobacco, prescription drug use

Lack of access to specialized services

Children come from broken families

People do not follow doctor’s orders

When asked to identify factors that impact the health of the community, focus group respondents indicated that a variety of things impact health including:


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No insurance

Lack of transportation

Large deductible that people can’t afford

Doctor is not very good

Insurance is expensive

Constant turnover of doctors

Cost of prescriptions

Lack of specialists in the area

No local VA hospital

Lack of health literacy Suggestions to improve community health by the focus group participants included:

Dermatologist

Allergist

On call orthopedics doctor

In home/community support (companionship and transportation)

Health literacy

More Section 8 housing

Affordable health care

Place for abused men

Taxi service

Expanded child care (after 5:00pm) Stakeholders were asked to identified the environmental factors that most contributed to the health of the community. Responses are listed in Figure 5.


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Figure 5. Stakeholder Interviews – Environmental Factors Impacting Community Health

Source: BRMC CHNA Stakeholder Interviews, 2015

Initiatives Currently Underway Stakeholders who were interviewed were asked to identify initiatives that are already underway that can address the health needs of the community. The initiatives included:

Friendship Table (4)

Food Pantry at Destinations (2)

YMCA (2)

United Way (2)

McKean County Collaborative Board (2)

Dental Clinic (2)

Walking Trail Association

Big Brothers and Big Sisters

4-H Clubs

CareerLink

Annual Kids Fest


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Hospital’s ER Urgi-Care

Access to Physicians

Well Respected Cardiologist

FCMC Social Work Services

Safe Baby program

Two certified car seat technicians at the hospital

Prescription referral program for the YMCA

CDC approved Diabetes prevention program

Youth Fit for Life Program and Enhanced Fitness at the YMCA

Gymnastics

McKean County Housing Stability Coalition

Free Summer Food Program for school-aged children

In-school Food Pantries

Pumping It Up on Parkway Field

Fuel up 60

Office on Aging

VNA

Community Nurses

Guardian Home and Community

McKean County Resource Directory

Prison Counselor to assist with detox

GED program for inmates

Walk Bradford

Farmer’s Market

Detox program at Maple Manor

Mental health agencies in the area

Fire departments certified in Quick Response Service

Prime Time Health

Bradford Senior Center

ATA

YWCA

Alcohol and Drug Abuse Services

Dickenson Mental Health


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Additional Suggestions Stakeholders also provided additional ideas and suggestions regarding how to improve the health of the community. Responses included:

More qualified physicians/surgeons/specialists (5)

More education regarding physical activity and nutrition (3)

Support economic improvement programs to combat poverty; end the cycle through education (3)

Advertise the walking trails more (2)

More partnerships with other agencies (2)

More transportation – funding and education (2)

A clinic in the community

Educate people on the need for a primary care physician, not the ER

Job readiness

Financial literacy education

Day care available for all shifts

More jobs in the area

Early learning programs

More accessibility to care

More foster parents so children can stay in the area for school and not jump from school district to school district

More education on the benefits of home health care

Lower the readmission rates for respiratory problems

Engage the Alliance more in initiatives for the community

Responsible family care for those incarcerated

Medical community working closer with the Drug and Alcohol Abuse Services and Mental Health to recognize frequent flyers

More evidence-based treatment strategies for substance abuse is needed

Access to primary/preventative care

Education regarding the importance of dental health

Mental health needs to be more thoroughly addressed in the community

More training for the police regarding handling mental health patients since they are the first responders

More volunteers for fire and EMS

911 dispatch should have a listing for all physicians/specialists in the area and the days in the office to inform public when they call


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Combine the mini health fairs into one large one

Educate the physicians regarding transportation hours/days as difficult to line everyone up for the services

More accessible case management

More funding for the homeless population

Educate the community on a wide variety of issues through town hall meetings where they visit, i.e., Friendship Table


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Access to Quality Health Care Access to comprehensive, quality health care is important for the achievement of health equity and for increasing the quality of life for everyone in the community. For a more in-depth review of the Access to Quality Health Care data, please see pages 55-80 of BRMC’s CHNA Supplemental Data Resource, Appendix C. Stakeholders identified the need for more transportation to out-of-town specialists as a community need. They also identified the need for the following: lack of follow up after hospital discharge, more education concerning dental care, a service to fill the gap between skilled home health care and custodial care, and better awareness of hospice and home health services in the community. It was suggested that many patients cannot afford health insurance due to a high deductible and copays. The Stakeholders also mentioned that access to care for specialists in area, reaching the underserved populations, high readmissions rates, lack of insurance to seek doctor on a regular basis, access to trauma center/place with higher medical skills/critical care and elderly assistance were other needs that they noted. Focus Group participants were asked to identify barriers to accessing health care. Responses included:

• No Insurance • Lack of Transportation • Large Deductible That I Can’t Afford • Doctor Is Not Very Good • Insurance is Expensive

TOPIC CONCLUSIONS


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• Constant Turnover of Doctors • Cost of Prescriptions • Lack Specialists in the Area • No Local VA Hospital • Lack of Health Literacy

Services needed but not available in the community included:

• Dermatologist • Allergist • On Call Ortho Doctor • In Home/Community Support (Companionship and Transportation) • Health Literacy • More Section 8 Housing • Affordable Health Care • Place for Abused Men • Taxi Service • Expanded Child Care (After 5pm)

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 in McKean County are more likely than average to rate their health status as fair or poor, compared to the state and the nation.

• The percentage of adults not seeing the doctor due to costs (10%) is higher than the HP goal of 4.2% but lower than the PA and US rates.

• Disability and difficulty characteristics for all three counties are trending upward, although all percentages are below their corresponding state. Cattaraugus County has a higher percentage for each of the characteristics than McKean and Potter Counties.

• 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%).


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• The Northeast U.S. 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%).

• Only 7.2% of community survey respondents rated their personal health as fair or poor, compared to 27% of the focus group respondents.

• The majority of survey (50.3%) and focus group (54%) respondents rated the health status of the community as fair or poor.

• Access to specialists, affordable health care and insurance were identified as access barriers by almost a fourth of community survey respondents.

• Focus group participants noted health care coverage, transportation and lack of specialists as access needs.

• Survey respondents noted that needed services include clinic/urgent care, dermatology, neurology, women’s health and mental health.

• Stakeholders identified transportation, lack of hospital follow up care/readmissions, dental care, lack of insurance and gaps in care delivery as access needs.

Chronic Disease Conditions that are long-lasting, relapse, remission and continued persistence are categorized as Chronic Disease. The issues of hypertension/high blood pressure, obesity/overweight, high cholesterol, Diabetes, and dental hygiene/dental problems were identified as major concerns in the community survey. For a more in-depth review of the Chronic Disease data, please see pages 81-114 of BRMC’s CHNA Supplemental Data Resource, Appendix C. Stakeholders identified obesity as a top community need. They also noted that obesity and diabetes prevention, chronic health issues, cancer, cardiovascular disease and childhood obesity were also needs of the community. Focus Group participants identified several chronic diseases as the biggest community needs, including obesity, Diabetes, high rate of cancer, hypertension, coronary heart disease and COPD. There are a number of observations and conclusions that can be derived from the data related to Chronic Disease. They include:


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• Breast cancer incidence is significantly lower in McKean County than it is in PA, however Potter and Cattaraugus County rates are higher.

• McKean County’s breast cancer mortality rate is significantly higher than PA in 2009.

• While the bronchus and lung cancer incidence rates in McKean and Potter Counties are comparable to the state, the Cattaraugus County rate is higher than the other counties; all are above the HP goal.

• The bronchus and lung cancer incidence rate is increasing in Potter County, although mortality in decreasing; mortality in McKean and Cattaraugus Counties is increasing.

• Colorectal cancer incidence rates are increasing in McKean and Potter Counties, while the rate in Cattaraugus County is decreasing, although all rates are above the HP goal.

• Almost 20% of the community respondents over age 55 have not had a colonoscopy.

• Prostate cancer rates are declining in all three counties. • In McKean County, heart disease incidence and mortality rates have

increased over the past few years and are significantly higher than the state rates, while the rates are decreasing in Potter and Cattaraugus Counties.

• Cerebrovascular mortality rates decreased in McKean County over the past few years, while they have increased in Potter and Cattaraugus Counties.

• Almost 8% of community survey respondents have been told that they have diabetes; the incidence of diabetes increases with age.

• Over half of the community survey respondents over age 65 have ever been told that they have high blood pressure; almost half indicated that they have high cholesterol or currently have hypertension/high blood pressure.

• 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 are slightly higher in McKean and Potter Counties than the PA rate, but lower than the US rate and HP goal.

• Focus group participants indicated that obesity, diabetes and cancer are significant community health needs.

• Stakeholders identified obesity, chronic diseases, cancer and cardiovascular diseases as community needs.


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Healthy Environment 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. Community survey respondents noted that allergies, lack of safe roads and sidewalks, employment opportunities/lack of jobs, poverty and affordable and available housing were all problems when looking at Healthy Environment. For a more in-depth review of the Healthy Environmental data, please see pages 115-128 of BRMC’s CHNA Supplemental Data Resource, Appendix A. Stakeholders identified the following needs regarding the health of their environment: homelessness, unemployment, high percentage of low income individuals, housing stability, and the perception that people do not want to work. Focus Group participants identified several environmental factors as contributing to community health needs. Poor socio-economic conditions were identified as one of the biggest community health needs. Education, welfare population, homelessness and aging population were identified as other health needs of the community. There are a number of observations and conclusions that can be derived from the data related to Healthy Environment. They include:

• High school graduation rates in McKean and Potter Counties are higher than Cattaraugus County, the state and nation as well as the HP goal.

• The percentage of children living in poverty and single parent households in McKean County increased from 2013 to 2015.

• Over a third of the survey respondents indicated that they are affected by lack of safe roads and sidewalks and almost all are affected by allergies.

• 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%).


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• 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.


• Focus group participants indicated that poor socio-economic conditions, education, and the welfare population are the most important environment-related needs.

• Stakeholders identified homelessness, unemployment and housing security as environment-related needs.

Healthy Mothers, Babies and Children 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. Community Survey respondents rated lack of early childhood development/child care, childhood obesity, child neglect, child emotional abuse and access to childhood immunizations as top community health needs. For a more in-depth review of the Healthy Mothers, Babies and Children data, please see pages 129-148 of BRMC’s CHNA Supplemental Data Resource, Appendix C. Stakeholders noted that there is a perception that lots of children are receiving free or reduced lunches, children lack vision insurance, there is a need to educate children on dental health, there is a need for women’s health services – similar to what Adagio used to provide in the community and that childhood obesity is a problem. Focus Group participants did not talk much about maternal child health issues, although lack of birth control and pregnant women taking drugs were noted as the biggest community health needs. There are a number of observations and conclusions that can be derived from the data related to Healthy Mothers, Babies and Children. They include:

• Prenatal care in the first trimester is increasing in McKean and Potter Counties and is significantly higher than the state rates; the rate is


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decreasing in Cattaraugus County and is lower than both other counties.

• Rates of non-smoking during pregnancy are significantly lower than the state rate in McKean and Potter Counties, are decreasing and are below the HP goal.

• The percentage of mothers reporting Medicaid assistance is increasing in McKean County and is significantly higher than PA. The rate is decreasing in Potter County.

• While increasing in McKean and Potter Counties, the breastfeeding rate McKean County is significantly lower than the state and below the HP goal.

• 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).


• The rates of children that are overweight and obese are increasing in all three counties.

• Focus group participants cited lack of birth control and drug use during pregnancy as important maternal/ child health needs.

• Stakeholders identified the percentage of children receiving free and reduce priced lunch, lack of vision insurance, lack of awareness of dental hygiene, women’s health and childhood obesity as the most important maternal/child health needs.

Infectious Disease 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). Community Survey respondents listed Influenza and Pneumonia, access to adult immunizations and sexual behaviors (unprotected, irresponsible and risky) as top community health needs. For a more in-depth review of the Infectious Disease data, please see pages 149-158 of BRMC’s CHNA Supplemental Data Resource, Appendix C.


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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 Focus Groups or Stakeholder Interviews. They include:

• Pneumonia vaccine rates for those over age 65 are increasing in McKean and Potter Counties but are below the HP goal.

• Influenza and pneumonia mortality is increasing in McKean County and is higher than the state rate, which has been decreasing.

• The percentage of adults age 18-64 ever tested for HIV is increasing in McKean and Potter Counties, although it is significantly lower than the state and is below the HP goal.

• Chlamydia rates are increasing in all three counties, although they are significantly lower than the state rate in McKean and Potter Counties. Male chlamydia rates are increasing.

• Lyme disease rates in McKean County are significantly higher than the state rates and are increasing.

• 17% of community survey respondents indicated that they are affected by influenza or pneumonia.

Mental Health and Substance Abuse 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


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heroin-related overdoses. Drug overdose deaths in Pennsylvania have now exceeded the number of deaths from automobile accidents. Community Survey respondents noted that chronic depression, driving under the influence of drugs or alcohol, illegal drug/prescription drug/alcohol abuse, and access to mental health services were top community health needs. For a more in-depth review of the Mental Health and Substance Abuse data, please see pages 159-174 of BRMC’s CHNA Supplemental Data Resource, Appendix C. Stakeholders identified mental health, substance abuse (drug and alcohol), need better collaboration between mental health/substance abuse and the medical community, prescription drug problem and the need for drug and alcohol rehabilitation as top community health needs. The most frequently mentioned top community health need mentioned by Focus Group participants was prescription drug abuse. Substance abuse, mental health and alcohol were also identified as problems in the community. 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 disorder mortality rates have been increasing in McKean and Potter Counties over the past five years.

• Over a quarter of the community survey respondents have been bothered by little interest or pleasure or have been depressed more than several days over the past two weeks or express that they are affected by chronic depression.

• Over half of the survey respondents had difficulty sleeping. • Youth alcohol and prescription narcotic drug use increases with age

throughout high school and has increased over the past four years in both McKean and Potter Counties.

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

• Youth driving after drinking has decreased slightly over the past few years while driving after marijuana has increased.

• Focus group participants identified prescription drug abuse, substance abuse mental health and alcohol abuse as serious problems in the community.


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• Stakeholders identified mental health, substance abuse, prescription drug use and the need for rehab and better care coordination as community needs.

Physical Activity and Nutrition 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. Community Survey respondents identified lack of exercise/physical activity, access to high quality/affordable foods and lack of recreational activities as the top community needs. For a more in-depth review of the Physical Activity and Nutrition data, please see pages 175-188 of BRMC’s CHNA Supplemental Data Resource, Appendix C. Stakeholders identified the following as top community health needs: nutrition, low access/need better access to healthy, fresh food, lack of nutrition education, inactivity, exercise, lifestyle choices, and costly to join a gym. Several Focus Group participants noted nutrition education/consequences of diet, lack of affordable exercise programs, lack of gyms in the area, poor nutrition and outdoor activity safety as the biggest community health needs. There are a number of observations and conclusions that can be derived from the data related to Physical Activity and Nutrition. These include:

• 15% of community survey respondents indicated that they have no physical activity.

• Less than a quarter of respondents eat the appropriate amounts of fruits and vegetables.

• Over a third of survey respondents indicated that they are affected by a lack of high quality affordable foods and over 40% are affected by lack of exercise/ physical activity.

• 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.


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• 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 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.

• Focus group participants indicated that nutrition education, lack of affordable exercise programs, lack of gyms and poor nutrition are serious problems in the community.

• Stakeholders indicated that nutrition and nutrition education, access to healthy food, inactivity and lack of exercise and the high cost of gym memberships are community needs.

Tobacco Use Tobacco Use is an important public health indicator as it relates to a number of chronic disease issues and conditions. Community Survey respondents stated that tobacco use and tobacco use during pregnancy were the two biggest community health needs issues. For a more in-depth review of the Tobacco Use data, please see pages 189-202 of BRMC’s CHNA Supplemental Data Resource, Appendix C. Both Stakeholders and Focus Group participants rated smoking as the biggest need regarding Tobacco Use. There are a number of observations and conclusions that can be derived from the data related to Tobacco Use. These include:


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• Smoking rates in the region are about double the HP goal (about 23%) although only 17% of the survey respondents indicated that they were affected by tobacco use.

• The percentage of people who have quit smoking for at least one day in the past year has decreased in the region and is much lower than the HP goal.

• The percentage of adults in McKean County using chewing tobacco is significantly higher than the state rate.

• Focus group participants indicated that tobacco use is a serious problem in the community.

Unintentional and Intentional Injury 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. Community Survey respondents that texting and driving, domestic abuse, violence, gun violence, motor vehicle crash deaths and sexual abuse were the top community health needs. For a more in-depth review of the Demographic data, please see pages 203-210 of BRMC’s CHNA Supplemental Data Resource, Appendix C. Focus Group participants noted that child abuse, sexual abuse and sexual violence were the top community health needs. There are a number of observations and conclusions that can be derived from the data related to Unintentional and Intentional Injury, although the topic was not discussed in stakeholder interviews. These include:

• About 17% of the survey respondents indicated that they were affected by texting and driving.

• 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%).

• Focus group respondents identified child abuse and sexual abuse as serious problems in the community.


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Top Priorities Figure 6 illustrates the top community health problems identified in the BRMC survey. Figure 6. Top BRMC Community Survey Problems

Source: BRMC CHNA Community Survey, 2015


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Figure 7 outlines the top priority community needs identified by the stakeholders who were interviewed. Figure 7. BRMC Stakeholder Interview Top Priorities



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Figure 8 outlines the top priority community health needs identified by Focus Group participants. Figure 8. BRMC Top 10 Focus Groups Top Priorities

Source: BRMC CHNA Focus Groups, 2015

The listing below illustrates the overall top priorities by topic area, based on input from the BRMC 2015 Community Survey, Stakeholder Interviews and Focus Groups. There were a total of 36 identified needs.


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Access: 1. Dental care access 2. Specialty care access 3. Urgent care access 4. Primary care access 5. Elder care 6. Transportation 7. Insurance Coverage 8. Health Literacy

Chronic Disease:

9. Obesity 10. Child Obesity 11. Breast Cancer 12. Lung Cancer 13. Colorectal Cancer 14. Prostate Cancer 15. Diabetes 16. Heart/CV Disease/

Cholesterol 17. COPD/Chronic Bronchitis

Healthy Environment:

18. Asthma

Healthy Mothers/Children: 19. Women’s health 20. Smoking during pregnancy 21. Breastfeeding 22. Drug abuse during

pregnancy

Infectious Diseases: 23. Chlamydia 24. Lyme Disease

Mental Health/Substance Abuse:

25. Depression 26. Prescription drug abuse

27. Drug abuse 28. Alcohol 29. Youth risk behaviors 30. Substance abuse rehab

Physical Activity and Nutrition:

31. Affordable fitness program 32. Nutrition education

Tobacco Use:

33. Smoking 34. Chewing Tobacco Use

Injury: 35. Sexual abuse 36. Child abuse


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Prioritization and Significant Health Needs As a result of the primary and secondary data analysis, the consulting team identified 44 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 August 19, 2015, the BRMC Steering Committee agreed with the list of potential needs, participated in prioritizing the needs based on the selected criteria and met again to discuss the prioritization results. Table 10 identified the selected criteria. Table 10. Prioritization Criteria

Table 11 illustrates the needs of the service area ranked by the steering committee. The top 10 needs that were identified include obesity, cardiovascular disease (heart disease, cholesterol, etc.), diabetes, prescription drug abuse, alcohol abuse, drug abuse/death, depression, breast cancer, substance abuse, and access to mental health services.


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Table 11. BRMC CHNA Prioritization Survey Sorted by Total of Accountability, Magnitude, Impact and Capacity Answer Options Accountable

Role Magnitude Impact Capacity Total Rank

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

9.03 7.77 9.10 7.31 33.21 1

Chronic Disease: Diabetes 8.80 7.46 9.03 7.21 32.50 2

Chronic Disease: Obesity 7.30 8.26 9.24 6.82 31.62 3

Chronic Disease: Breast Cancer 9.03 6.39 8.21 7.31 30.94 4

Access: Specialty Medical Care 9.17 7.32 8.14 6.14 30.77 5

Chronic Disease: Colorectal Cancer

9.03 5.97 8.00 7.17 30.17 6

Access: Access to Primary Care Services

8.60 5.96 8.03 7.55 30.14 7

Chronic Disease: COPD/Chronic Bronchitis

8.58 6.62 8.00 6.93 30.13 8

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

9.23 6.48 6.45 7.90 30.06 9

Chronic Disease: Lung Cancer 8.80 6.45 7.90 6.83 29.98 10

Access: Access to Mental Health Services

8.10 6.62 8.45 6.66 29.83 11

Access: Confidential Women's Health Services

8.19 7.08 7.10 7.21 29.58 12

Chronic Disease: Prostate Cancer 8.77 5.97 7.52 7.03 29.29 13

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

8.29 6.41 7.45 7.00 29.15 14

Access: Access to Urgent Care Services

8.65 5.92 6.86 7.21 28.64 15

Access: Affordability of Health Care/Insurance Costs/Copays

6.90 6.96 8.76 5.86 28.48 16

Access: Dental Hygiene/Dental Problems

7.19 6.71 7.07 7.07 28.04 17

Healthy Mothers, Babies & Children: Tobacco Use During Pregnancy

6.23 6.90 8.17 6.50 27.80 18

Healthy Mothers, Babies & Children: Drug Use During Pregnancy

5.83 6.86 8.50 6.28 27.47 19

Mental Health/Substance Abuse: Prescription Drug Misuse/Abuse

4.57 7.97 8.71 5.93 27.18 20


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Answer Options Accountable Role

Magnitude Impact Capacity Total Rank

Healthy Mothers, Babies & Children: Childhood Obesity

5.74 6.84 8.00 6.28 26.86 21

Access: Elder Care Services 6.06 5.69 7.93 6.90 26.58 22

Mental Health/Substance Abuse: Depression

4.26 7.50 8.14 6.38 26.28 23

Tobacco Use: Chewing Tobacco, Snuff, Snus

4.83 7.38 8.21 5.55 25.97 24

Mental Health/Substance Abuse: Drug Abuse/Mortality

3.80 7.59 8.62 5.96 25.97 25

Mental Health/Substance Abuse: Alcohol Abuse

3.35 8.03 8.48 6.07 25.93 26

Access: Community Awareness 6.32 6.11 6.31 7.17 25.91 27

Mental Health/Substance Abuse: Substance Abuse Rehabilitation

3.87 7.79 8.00 6.07 25.73 28

Healthy Mothers, Babies & Children: Breastfeeding

6.97 5.55 6.14 6.93 25.59 29

Tobacco Use: Smoking 4.71 6.79 8.34 5.62 25.46 30

Infectious Disease: Lyme Disease 6.77 5.32 6.55 6.45 25.09 31

Mental Health/Substance Abuse: Youth Risk Behaviors

3.07 7.31 8.04 6.34 24.76 32

Injury: Child Abuse 3.06 7.24 7.75 6.38 24.43 33

Physical Activity/Nutrition: Lack of Physical Activity/Recreation

3.03 6.59 8.14 6.41 24.17 34

Access: Health Literacy 5.03 5.34 6.90 6.86 24.13 35

Physical Activity/Nutrition: Nutrition Education

4.00 6.07 7.39 6.41 23.87 36

Injury: Sexual Abuse 2.84 6.40 7.62 6.34 23.20 37

Access: Emergency Transportation

4.43 5.24 6.90 6.59 23.16 38

Healthy Environment: Allergies 5.39 5.52 6.07 5.52 22.50 39

Infectious Disease: Chlamydia 6.29 4.17 5.45 6.17 22.08 40

Healthy Environment: Asthma 5.24 4.90 6.24 5.61 21.99 41

Access: Transportation To/From Medical Services

3.65 5.63 7.14 5.45 21.87 42

Social Environment: Poverty/Lack of Jobs/Unemployment

2.19 6.11 7.79 5.10 21.19 43

Healthy Environment: Homelessness/Affordable and Adequate Housing

2.35 5.00 7.14 4.72 19.21 44


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Members of the Upper Allegheny Health System Executive Team met on September 22, 2015 to review the final priorities selected by the BRMC Steering Committee. Using the methodology of looking at the four prioritization criteria of (i) accountable role of the hospital, (ii) magnitude of the problem, (iii) impact on other health outcomes and (iv) capacity (systems and resources) to implement evidence-based solutions, along with the rank order of the final priorities selected by the BRMC Steering Committee, the following top ten priorities are considered the most significant:

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

2. Chronic Disease: Diabetes 3. Chronic Disease: Obesity 4. Chronic Disease: Breast Cancer 5. Access: Specialty Medical Care 6. Chronic Disease: Colorectal Cancer 7. Access: Access to Primary Care Services 8. Chronic Disease: COPD/Chronic Bronchitis 9. Access: Customer Service in ER, Clinics, Physician's Offices 10. Chronic Disease: Lung Cancer

The above significant needs will be addressed in BRMC’s Implementation Strategy which will be published under separate cover and accessible to the public. Please refer to Appendix D – Prioritization Criteria Listings on pages 211-218 in the Supplemental Data Resource to see how the needs were prioritized by the different criteria of:

Accountability (hospital role)

Magnitude and Impact

Magnitude, Impact and Capacity

Top ten needs comparison by total ranking, accountability and magnitude and impact


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Review and Approval The 2015 Community Health Needs Assessment was presented and approved by the BRMC Board of Directors on October 28, 2015. The Bradford Regional Medical Center 2015 Community Health Needs Assessment is posted on the BRMC website (www.brmc.com). Printed copies are available by contacting: [email protected].

http://www.brmc.com/

mailto:[email protected]

This

Bradford Regional Medical Center 2015

Community Health Needs Assessment

2015 – Supplemental Data Resource

2015 Bradford Regional Medical Center Community Health Needs Assessment Report Supplemental Data Resource Appendix A - Demographics

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TABLE OF CONTENTS

Appendix A – Demographics .................................................................................. 1 Appendix B – Asset Resource Listing ................................................................. 25 Appendix C – Supplemental Data Resource by Topic Area ............................... 53 Access to Quality Health Care ...................................................... 55 Chronic Disease ........................................................................... 81 Healthy Environment ................................................................. 115 Healthy Mothers, Babies and Children ...................................... 129 Infectious Disease ...................................................................... 149 Mental Health and Substance Abuse ........................................ 159 Physical Activity and Nutrition .................................................. 175 Tobacco Use ............................................................................... 189 Unintentional and Intentional Injury ......................................... 203 Appendix D – Prioritization Criteria Listing ...................................................... 211 Appendix E – Community Survey Questions .................................................... 219 Appendix F – Stakeholder Interview Guide ..................................................... 233 Appendix G – Focus Group Interview Guide .................................................... 237 Appendix H – Focus Group Polling Guide ........................................................ 243


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TABLE OF TABLES

Table 1 ........ Unemployment Compensation by Age ........................................ 15 Table 2 ........ Unemployed Who Have Exhausted Their Unemployment Compensation Benefits ................................................................. 15 Table 3 ........ Top 10 Occupations with Online Ads ............................................ 16 Table 4 ........ Top 10 Skills in Online Ads ............................................................ 16 Table 5 ........ Compatibility of the Workforce .................................................... 17 Table 6 ........ BRMC Hospital Asset Resources Listing ........................................ 30 Table 7 ........ BRMC Community Asset Resources Listing ................................... 32 Table 8 ........ Disability/Difficulty Characteristics ............................................... 60 Table 9 ........ 2015 Community Survey – Never Had a Mammogram .............. 107 Table 10 ...... BRMC CHNA Prioritization Survey Results – Sorted by Total ..... 213 Table 11 ...... BRMC CHNA Prioritization Survey Results – Sorted by Accountability (Hospital Role) .................................................... 214 Table 12 ...... BRMC CHNA Prioritization Survey Results – Sorted by Magnitude/Impact/Capacity ...................................................... 216 Table 13 ...... BRMC CHNA Prioritization Survey Results – Top Ten Needs Comparison By Total Ranking, Magnitude/Impact/Capacity and Accountability ..................................................................... 218


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TABLE OF FIGURES

Figure 1 ....... BRMC Service Area ......................................................................... 4 Figure 2 ....... BRMC Service Area Population Trend ............................................. 5 Figure 3 ....... BRMC Service Area by Gender ........................................................ 6 Figure 4 ....... BRMC Service Area by Race ............................................................ 7 Figure 5 ....... BRMC Service Area by Age .............................................................. 8 Figure 6 ....... BRMC Service Area by Marital Status ............................................. 9 Figure 7 ....... BRMC Service Area by Education .................................................. 10 Figure 8 ....... BRMC Service Area by Household Income .................................... 11 Figure 9 ....... BRMC Service Area by Employment Status .................................. 12 Figure 10 ..... Poverty, All Ages (1997-2013) ....................................................... 13 Figure 11 ..... BRMC Service Area by Travel Time to Work ................................. 22 Figure 12 ..... BRMC Asset Resources Map ......................................................... 29 Figure 13 ..... Adults Who Reported Health as Fair or Poor ................................ 56 Figure 14 ..... Adults (Age 18-64) with No Health Insurance .............................. 57 Figure 15 ..... Adults with No Personal Health Care Provider ............................. 58 Figure 16 ..... Adults Who Reported Needing to See a Doctor but Could Not Due to Cost, Past Year .................................................. 59 Figure 17 ..... 2015 Community Survey – Personal Health Status ...................... 61 Figure 18 ..... 2015 Focus Groups – Personal Health Status ............................... 62 Figure 19 ..... 2015 Community Survey – Health Care Coverage, N=508 ........... 63 Figure 20 ..... PRC – Healthcare Insurance Coverage for Child ........................... 64 Figure 21 ..... PRC – Lack of Healthcare Insurance Coverage for Child ............... 65 Figure 22 ..... 2015 Community Survey – Could Not Fill Prescription Due to Cost, Past 12 Months, N=508 ............................................ 66 Figure 23 ..... 2015 Community Survey – Could Not See Medical Treatment Due to Cost, Past 12 Months, N=508 .......................... 67 Figure 24 ..... 2015 Community Survey – Could Not Get Healthcare Services Due to Lack of Transportation, Past 12 Months, N=508 ............................................................................................ 68 Figure 25 ..... PRC – Experienced Difficulties or Delays in Receiving Child’s Needed Healthcare in the Past Year ............................................ 69 Figure 26 ..... 2015 Community Survey – Regular Health Provider, N=508 ........ 70 Figure 27 ..... 2015 Community Survey – Routine Check Up, N=508 .................. 71 Figure 28 ..... PRC – Child Visited a Physician for a Routine Checkup in the71 Past Year ........................................................................................ 72 Figure 29 ..... 2015 Community Survey – Dental Check Up, N=508 .................... 73


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Figure 30 ..... PRC – Child Visited a Dentist or Dental Clinic Within the Past Year ................................................................................. 74 Figure 31 ..... PRC – Child Used an Urgent Care Center, QuickCare Clinic, or Other Walk-in Clinic in the Past Year ............................................ 75 Figure 32 ..... 2015 Community Survey – Affected by Access Problems, N=508 ............................................................................................ 76 Figure 33 ..... 2015 Focus Groups – Access Needs .............................................. 77 Figure 34 ..... Breast Cancer Incidence Rates ...................................................... 82 Figure 35 ..... Breast Cancer Mortality Rates ...................................................... 83 Figure 36 ..... Lung Cancer Incidence Rates ........................................................ 84 Figure 37 ..... Lung Cancer Mortality Rates ......................................................... 85 Figure 38 ..... Colorectal Cancer Incidence Rates ................................................ 86 Figure 39 ..... 2015 Community Survey – Colonoscopy, Age 55 and Over, N=508 ............................................................................................ 87 Figure 40 ..... Ovarian Cancer Incidence Rates ................................................... 88 Figure 41 ..... Ovarian Cancer Mortality Rates .................................................... 89 Figure 42 ..... Prostate Cancer Incidence Rates .................................................. 90 Figure 43 ..... 2015 Community Survey – Length of Time Since Last PSA Test ... 91 Figure 44 ..... Prostate Cancer Mortality Rates ................................................... 92 Figure 45 ..... Heart Disease Mortality Rates ...................................................... 93 Figure 46 ..... Coronary Heart Disease Mortality Rates ...................................... 94 Figure 47 ..... Cardiovascular Disease Mortality Rates ........................................ 95 Figure 48 ..... Chronic Lower Respiratory Disease (COPD) Mortality Rates ........ 96 Figure 49 ..... 2015 Community Survey – Told You Have High Blood Pressure, Age 65 and Older ........................................................... 97 Figure 50 ..... Cerebrovascular Disease Mortality Rates ..................................... 98 Figure 51 ..... Diabetes Mortality Rates .............................................................. 99 Figure 52 ..... 2015 Community Survey – Ever Told By a Doctor That They Have Diabetes ............................................................................. 100 Figure 53 ..... 2015 Community Survey – Ever Told By a Doctor That They Diabetes, By Age ......................................................................... 101 Figure 54 ..... PRC – Child Has Diabetes ............................................................ 102 Figure 55 ..... 2015 Community Survey – Overweight and Obese Adults ......... 103 Figure 56 ..... 2015 Community Survey – Overweight and Obese Adults, By Age .......................................................................................... 104 Figure 57 ..... Mammogram Screenings ............................................................ 105 Figure 58 ..... 2015 Community Survey – Mammogram ................................... 106 Figure 59 ..... 2015 Community Survey – Pap Test ........................................... 108


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Figure 60 ..... 2015 Community Survey – Affected By Chronic Disease Problems, 1 of 2, N=508 .............................................................. 109 Figure 61 ..... 2015 Community Survey – Affected by Chronic Disease Problems, 2 of 2, N=508 .............................................................. 110 Figure 62 ..... 2015 Focus Groups – Chronic Disease Needs ............................. 111 Figure 63 ..... Asthma Hospitalizations 2010 ..................................................... 116 Figure 64 ..... High School Graduation Rates .................................................... 120 Figure 65 ..... Children Living in Poverty ........................................................... 121 Figure 66 ..... Children Living in Single Parent Homes ...................................... 122 Figure 67 ..... PRC – Child Currently Has Asthma (US 2014) ............................. 123 Figure 68 ..... PRC – Number of Asthma-Related ER/Urgent Care Visits in the Past Year (US 2014) ............................................................... 124 Figure 69 ..... 2015 Community Survey – Affected by Social Environment Problems, 1 of 2 .......................................................................... 125 Figure 70 ..... 2015 Community Survey – Affected by Social Environment Problems, 2 of 2 .......................................................................... 126 Figure 71 ..... 2015 Focus Groups – Social Environment Problems .................. 127 Figure 72 ..... Prenatal Care First Trimester ...................................................... 130 Figure 73 ..... Non-Smoking Mother During Pregnancy .................................... 131 Figure 74 ..... Non-Smoking Mother Three Months Prior to Pregnancy ........... 132 Figure 75 ..... Low Birth Rate, Babies Born in PA .............................................. 133 Figure 76 ..... Low Birth Rate, Babies Born in NY .............................................. 134 Figure 77 ..... Mothers Reporting WIC Assistance ............................................ 135 Figure 78 ..... Mothers Reporting Medicaid Assistance .................................... 136 Figure 79 ..... Mothers Reporting Breastfeeding .............................................. 137 Figure 80 ..... Teen Live Birth Outcomes, Ages 15-19 ....................................... 138 Figure 81 ..... Infant Mortality ........................................................................... 139 Figure 82 ..... Overweight BMI, Grades K-6 ....................................................... 140 Figure 83 ..... Obese BMI, Grades K-6 ............................................................... 141 Figure 84 ..... PRC – Child Was Ever Fed Breast Milk ........................................ 142 Figure 85 ..... PRC – Child Exclusively Breastfed for at Least Six Months ......... 143 Figure 86 ..... 2015 Community Survey – Affected By Health Mothers, Babies, Children Programs, 1 of 2 ............................................... 144 Figure 87 ..... 2015 Community Survey – Affected By Health Mothers, Babies, Children Programs, 2 of 2 ............................................... 145 Figure 88 ..... 2015 Focus Groups – Healthy Mothers, Babies, Children Needs ........................................................................... 146 Figure 89 ..... Adults Who Had Pneumonia Vaccine, Age 65 and Older ........... 150 Figure 90 ..... Influenza and Pneumonia Mortality ........................................... 151


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Figure 91 ..... Ever Tested for HIV, Adults 18-64 ............................................... 152 Figure 92 ..... Chlamydia Rates, Female ............................................................ 153 Figure 93 ..... Chlamydia Rates, Male ................................................................ 154 Figure 94 ..... Gonorrhea Rates ......................................................................... 155 Figure 95 ..... Lyme Disease Incidence Rates .................................................... 156 Figure 96 ..... 2015 Community Survey – Affected By Infectious Disease ........ 157 Figure 97 ..... Mental and Behavioral Disorders Mortality ............................... 160 Figure 98 ..... Adults Who Reported Binge Drinking (Men=5 Drinks, Women=4 Drinks) ....................................................................... 161 Figure 99 ..... 2015 Community Survey – Binge Drinking .................................. 162 Figure 100 ... 2015 Community Survey – Little Interest or Pleasure in Doing Things, Past Two Weeks ................................................... 163 Figure 101 ... 2015 Community Survey – Feeling Down or Depressed, Past Two Weeks .................................................................................. 164 Figure 102 ... 2015 Community Survey – Affected by Mental Health or Substance Abuse Problems ......................................................... 165 Figure 103 ... PAYS – McKean County Substance Use ...................................... 166 Figure 104 ... PAYS – McKean County Pain Reliever Use .................................. 167 Figure 105 ... PAYS – McKean County Risky Behaviors ..................................... 168 Figure 106 ... PAYS – Potter County Substance Use ......................................... 169 Figure 107 ... PAYS – Potter County Pain Reliever Use ..................................... 170 Figure 108 ... PAYS – Potter County Risky Behaviors ........................................ 171 Figure 109 ... 2015 Focus Groups – Mental Health and Substance Abuse Problems ..................................................................................... 172 Figure 110 ... No Leisure Time/Physical Activity, Past Month .......................... 176 Figure 111 ... 2015 Community Survey – Physical Activity, Past 30 Days ......... 177 Figure 112 ... 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) ........................................................................... 178 Figure 113 ... PRC – Percentage of Children Physically Active for an Hour Or Longer Every Day in Past Week (US Children Age 2-17) ........ 179 Figure 114 ... PRC – Hours of Children’s Screen Time (US Children, Age 5-17, 2014) ........................................................................... 180 Figure 115 ... PRC – Children with Three or More Hours per School Day of Screen Time (TV, Computer, Video Games, Phone Device, etc.) ................................................................................. 181 Figure 116 ... PRC – Percentage of Children Having Five or More Servings Of Fruits/Vegetables per Day ..................................................... 182


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Figure 117 ... 2015 Community Survey – Five or More Servings Fruits and Vegetables per Day .............................................................. 183 Figure 118 ... PRC – Number of Fast Food Meals Children Consume (US Children Age 2-17, 2014) ............................................................. 184 Figure 119 ... 2015 Community Survey – Affected by Physical Activity and Nutrition Problems ............................................................... 185 Figure 120 ... 2015 Focus Groups – Physical Activity and Nutrition Problems ..................................................................................... 186 Figure 121 ... Adults Who Reported Being a Current Smoker .......................... 190 Figure 122 ... Adults Reported Never Being a Smoker ...................................... 191 Figure 123 ... 2015 Community Survey – Percent of Current Smokers ............ 192 Figure 124 ... 2015 Community Survey – Number of Cigarettes per Day ......... 193 Figure 125 ... Adults Reported Currently Using Chewing Tobacco, Snuff, Snus, Somewhat or Everyday ...................................................... 194 Figure 126 ... Adults Reported Currently Using Chewing Tobacco, Snuff, Snus, Somewhat or Everyday, Ages 18-44 .................................. 195 Figure 127 ... Adults Who Quit Smoking at Least One Day in Past Year ........... 196 Figure 128 ... Adults Reported Being an Everyday Smoker .............................. 197 Figure 129 ... 2015 Community Survey – Percent Use Chewing Tobacco, Snuff, or Snus .............................................................................. 198 Figure 130 ... 2015 Community Survey – Affected By Tobacco Use Problems ..................................................................................... 199 Figure 131 ... 2015 Focus Groups – Tobacco Use Problems ............................. 200 Figure 132 ... Mortality Rate for Auto Accidents .............................................. 204 Figure 133 ... Suicide Mortality Rates ............................................................... 205 Figure 134 ... PRC – Children Injured Seriously Enough to Need Medical Treatment, Past Year ................................................................... 206 Figure 135 ... 2015 Community Survey – Affected by Injury Problems ............ 207 Figure 136 ... 2015 Focus Groups – Injury Problems ........................................ 208


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Appendix A Demographics


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For purposes of this assessment, the BRMC service area geography is defined as certain zip codes in McKean and Potter Counties in Pennsylvania and Cattaraugus County in New York. These zip codes are listed below and mapped in Figure 1: Primary Service Area Secondary Service Area City/Town Zip Code City/Town Zip Code Bradford 16701 Kane 16735 Smethport 16749 Salamanca (NY) 14779 Eldred 16731 Coudersport 16915 Lewis Run 16738 Port Allegany 16743 Duke Center 16729 Shinglehouse 16748 Turtlepoint 16750 Genesee 16923 Gifford 16732 Limestone (NY) 14753 Rixford 16745 Roulette 16746 Cyclone 16726 Austin 16720 Crosby 16724 Harrison Valley 16927 Derrick City 16727 Mount Jewitt 16740 Rew 16744

DEMOGRAPHICS


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Figure 1. BRMC Service Area


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Population - BRMC Service Area Figure 2 illustrates the BRMC 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 BRMC service area population has been steadily declining and is projected to continue to decline from 64,307 in 2015 to 63,570 in 2020. Figure 2. BRMC Service Area Population Trend

Source: www.nielsen/claritas.com


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Gender - BRMC Service Area Figure 3 illustrates the BRMC Service Area by Gender. A little over half (50.5%) of residents are Male, while 49.5% are Female. Figure 3. BRMC Service Area by Gender



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Race – BRMC Service Area Figure 4 illustrates the ethnicity breakdown of the service area of BRMC. The predominant race for the primary service area is White Alone (93.4%). Only 1.8% of the service population is Black or African American Alone. Figure 4. BRMC Service Area by Race



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Age – BRMC Service Area Figure 5 illustrates the age breakdown for the service area of BRMC. For 2015, over one-third (36.4%) of the population is within the age range of 25-54, as well as the age range of 55-84 year-olds (30.7%). The lowest populations occur in the 15-24 year-old range (13.1%) and the 85 and older range (2.7%). Figure 5. BRMC Service Area by Age



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Marital Status – BRMC Service Area Figure 6 illustrates the service area by Marital Status for BRMC. Almost half of the population (47.5%) is Married, Spouse Present, while approximately one-third (28.0%) of the population have Never Married. Persons Divorced, Widowed or Separated make up 24.6% of the primary service area population. Figure 6. BRMC Service Area by Marital Status



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Education – BRMC Service Area Figure 7 illustrates the level of education for the service area of BRMC. A little under half of the population (49.1%) 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 11.1%. Conversely, 22.4% of the population have either Some College-No Degree, or obtained their Associate, Bachelor’s, Master’s, Professional School or Doctoral Degree. Figure 7. BRMC Service Area by Education



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Household Income – BRMC Service Area Figure 8 illustrates the Household Income for the service area of BRMC. The income statistics indicates the BRMC service area to be low to middle income; just under one in five households (15.0%) have an annual income of $15,000 or less. Over half (58.6%) have annual incomes less than $50,000. Figure 8. BRMC Service Area by Household Income



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Employment and Poverty Status – BRMC Service Area Figure 9 illustrates the Employment Status for the service area of BRMC. Over half of the population (51.7%) is presently in the workforce, while 43.1% of the population is not. The percent of those unemployed in the service area is 5.2%. Figure 9. BRMC Service Area by Employment Status



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The U.S. Census Bureau's Small Area Income and Poverty Estimates (SAIPE) program provides annual estimates of income and poverty statistics for all school districts, counties, and states. The main objective of this program is to provide estimates of income and poverty for the administration of federal programs and the allocation of federal funds to local jurisdictions. In addition to these federal programs, state and local programs use the income and poverty estimates for distributing funds and managing programs. Figure 10 represents the trends in poverty for McKean, Potter and Cattaraugus counties as compared to the nation, Pennsylvania and New York for the period 1997-2013. As seen in the graph below, the percentage of those living in poverty has been increasing for the counties of McKean, Potter and Cattaraugus since 2003 and all counties are above their corresponding states percentages. Figure 10. Poverty All Ages (1997-2013)

Source: U.S. Census Bureau, Small Area Income and Poverty Estimates


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The North Central PREP Partners conducted an internal assessment and evaluation of the regional economy in 2014. The regional economy is comprised of six counties: Cameron, Clearfield, Elk, Jefferson, McKean, and Potter. The assessment included evaluation of the regional economy, including a review of the currently available data from the Center for Workforce Information and Analysis. It also included labor market information; high demand occupations; recent, past and emerging trends; as well as projections of future expected regional employment needs. Part of the assessment included projections on unemployment and workforce noncompatibility in regards to available jobs. Following is excerpts from this report released on November 6, 2014. Health Care and Social Assistance companies represent the majority of the major employers in the region, although Manufacturing is the main employer in several of the counties. The region has an unemployment rate of 6% which is the 6th highest out of the 22 Workforce Investment Areas. Cameron County has the highest unemployment rate in the region (7.3%) while Elk County has the lowest (4.5%). Through May, 2015, McKean County has an unemployment rate of 6.2% while Potter County’s unemployment rate is 6.8%. Unemployment Facts The region had an unemployment of 6% and was ranked 6th highest among the 22 Workforce Investment Areas for unemployment rates. There is a greater percentage of males (56.3%) currently unemployed than females (43.7%). Individuals between the ages of 35 and 64 make up the majority of the regions unemployed population.

Several individuals within the region have exhausted the available unemployment compensation benefits which are available to them. The majority of these individuals represent Manufacturing; Trade, Transportation & Utilities; and Construction. Ages 45-54 have the highest percentage of unemployed individuals at 24.9%, which is comparable to the PA rate of 24.2%. Table 1 has the breakdown of those receiving unemployment compensation by age. Table 2 shows the percentage by Industry on those individuals who have exhausted their unemployment compensation benefits.


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Table 1. Unemployment Compensation by Age

Unemployment Compensation by Age

Workforce Investment Area

Pennsylvania

Ages 24 or Younger 7.0% 6.8%

Ages 25-34 16.9% 18.8%

Ages 35-44 20.6% 19.1%

Ages 45-54 24.9% 24.2%

Ages 55-64 21.2% 20.9%

Ages 65 and Older 9.4% 10.2% Source: Center for Workforce Information and Analysis, Fast Facts July 2014

Table 2. Unemployed Who Have Exhausted Their Unemployment Compensation Benefits

Pre – UC Industry

Workforce Investment Area

Pennsylvania

Exhaustees % of Total

Exhaustees % of Total

Manufacturing 560 17.2% 23,060 11.7%

Trade, Transportation & Utilities

540 16.6% 36,750 18.7%

Construction 530 16.3% 21,920 11.1%

Education & Health Services 470 14.4% 35.070 17.8%

Professional & Business Services

370 11.3% 35,370 18.0%

Natural Resource & Mining 270 8.3% 2,620 1.3%

Leisure & Hospitality 170 5.2% 15,920 8.1%

Other Services 110 3.4% 5,430 2.8%

Information 60 1.8% 3,320 1.7%

Financial Activities 60 1.8% 9,580 4.9%

Government 50 1.5% 2,520 1.3%

Unclassified Industry 70 1.5% 5,440 2.8%

Total 3,260 100% 197,000 100% Source: Center for Workforce Information and Analysis, Fast Facts July 2014

Tables 3 and 4 shows that there was an increase (13.2%) of online job postings in the region over the past year. McKean County had the lowest increase in online job postings. The industry clusters Government and Construction saw the greatest increase in online job postings, while Installation, Maintenance and Repair and Construction and Extraction occupations saw the greatest increase, all increasing by 50.0% or greater.


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Table 3. Top 10 Occupations with Online Ads

Top 10 Occupations with Online Ads June 2014

Heavy and Tractor-Trailer Truck Drivers 84

Retail Salesperson 62

Registered Nurses 60

Personal Care Aides 49

First-Line Supervisors of Retail Sales Workers 48

Maintenance and Repair Workers, General 45

Supervisors/Managers of Production and Operating Workers 37

Licensed Practical and Licensed Vocational Nurses 32

Helpers – Production Workers 32

Nursing Assistants 30

Table 4. Top 10 Skills in Online Ads

Top 10 Skills in Online Ads June 2014

Quality Assurance 38

Pediatrics 35

JavaScript 33

Behavioral Health 30

Flatbed Scanners 27

Preventative Maintenance Inspections 24

Forklifts 21

Preventative Maintenance 21

Quality Control 20

Bi-lingual 20

Industry Compatibility to Marcellus Shale As seen in Table 5, when looking at an industry growing in Pennsylvania, less than 25% of the region’s workforce is compatible with the skills necessary for employment in the industry.


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Table 5. Compatibility of the Workforce

NAICS Code NAICS Title

% Skilled Workforce in Industry

% of Region’s

Workforce Compatible

211111 Crude Petroleum and Natural Gas Extraction

23.9% 20.1%

211112 Natural Gas Liquid Extraction N/A N/A

213111 Drilling and Gas Wells 15.0% 19.1%

213112 Support Activities for Oil and Gas Operations

15.0% 19.1%

237120 Oil and Gas Pipeline and Related Structures Construction

47.0% 18.5%

486210 Pipeline Transportation of Natural Gas

36.6% 19.0%

221112 Fossil Fuel Electric Power Generation

48.8% 15.2%

221210 Natural Gas Distribution 37.8% 15.6%

221310 Water Supply and Irrigation Systems

65.7% 24.1%

221320 Sewage Treatment Facilities 65.7% 24.1%

237110 Water and Sewer Line and Related Structures Construction

47.0% 18.5%

237310 Highway, Street, and Bridge Construction

51.7% 17.5%

238912 Nonresidential Site Preparation Contractors

51.2% 17.5%

325110 Petrochemical Manufacturing N/A N/A

325120 Industrial Gas Manufacturing 29.2% 13.5%

331111 Iron and Steel Mills N/A N/A

331210 Iron and Steel Pipe and Tube Manufacturing from Purchased Steel

N/A N/A

333131 Mining Machinery and Equipment Manufacturing

24.6% 21.1%

333132 Oil and Gas Field Machinery and Equipment Manufacturing

24.6% 21.1%

423810 Construction and Mining (except 45.3% 20.5%


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NAICS Code NAICS Title

% Skilled Workforce in Industry

% of Region’s

Workforce Compatible

Oil Well) Machinery and Equipment Merchant Wholesalers

423830 Industrial Machinery and Equipment Merchant Wholesalers

45.3% 20.5%

423840 Industrial Supplies Merchant Wholesalers

45.3% 20.5%

484110 General Freight Trucking, Local 7.5% 24.0%

484220 Specialized Freight (except Used Goods) Trucking, Local

9.1% 24.9%

484230 Specialized Freight (except Used Goods) Trucking, Long-Distance

9.1% 24.9%

531190 Lessors of Other Real Estate Property

44.7% 22.9%

532412 Construction, Mining, and Forestry Machinery and Equipment Rental and Leasing

34.5% 19.8%

541330 Engineering Services 57.3% 3.9%

541360 Geophysical Surveying and Mapping Services

57.3% 3.9%

541380 Testing Laboratories 41.2% 7.5%

541620 Environmental Consulting Services 24.9% 23.2%

562910 Remediation Services 23.5% 18.3%

811310 Commercial and Industrial Machinery and Equipment (except Automotive and Electronic) Repair and Maintenance

48.0% 16.3%

924110 Admin. Of Air and Water Resources and Solid Waste Management Programs

N/A N/A

924120 Admin of Conservation Programs N/A N/A

926130 Regulation and Admin of Communications, Electric, Gas and Other Utilities

N/A N/A

Source: Economic Modeling Specialists, Inc.


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Workforce Growth The region saw a decline in employment as well as the number of companies in 2012. In the recent year, the industries showing an increase in employment by 50% of greater include: Government, Professional and Technical Services, and Agriculture, Forestry, Fishing and Hunting. Manufacturing companies reported the most consistent employment growth in the following areas:

Forging and Stamping

Basic Chemical Manufacturing

Other Wood Product Manufacturing

Unfortunately this industry also saw the greatest number of companies reduce their workforce in the following areas:

Agriculture, Construction and Mining Machinery Manufacturing

Machine Shops

Turned Product

Screw, Nut and Bolt Manufacturing

Other Electrical Equipment and Component Manufacturing

2014 High-Priority Occupations for North Central Workforce Investment Area (Those with 10 or more annual openings) Health Care Support and Health Care Professionals represent the occupations anticipating the highest number of annual openings, along with Transportation. There is a need for 50 or more:

Home Health Aides

Registered Nurses

Heavy & Tractor-Trailer Truck Drivers North Central WIA Industry and Occupation Employment 2010-2020 Long Term Projections The Health Care and Social Assistance industry is anticipating the greatest need for staff, although Arts, Entertainment and Recreation is expected to see the greatest percent of growth in the next 10 years.

The region is projected, over the next 10 years, to need 200 or more individuals in the following occupations:


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Office & Administrative Support Occupations

Sales & Related Occupations

Production Occupations

Transportation & Material Moving Occupations

Food Preparation & Serving Related Occupations

Construction & Extraction Occupations

Retail Sales Workers Job Skills Needed

When looking at 650 occupations, over half of them require knowledge in the following areas:

English Language

Customer and Personal Service

Mathematics

Administration and Management

When looking at 651 occupations, over half of them require general work activity that includes:

Getting Information

Identifying Objects, Actions, and Events

Monitor Processes, Materials, or Surroundings

Communicating with Supervisors, Peers, or Subordinates

Making Decisions and Problem Solving

Establishing and Maintaining Interpersonal Relationships

Updating and Using Relevant Knowledge

Evaluating Information to Determine Compliance with Standards

Documenting/Recording Information

Processing Information

Organizing, Planning and Prioritizing Work

Judging the Qualities of Things, Services or People

Communicating with Persons Outside Organization

Handling and Moving Objects

Inspecting Equipment, Structures, or Material

When looking at 221 occupations, over half of them require knowledge of the following tools and technology:

Personal computers


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Database user interface and query software

Desktop/notebook computers

Spreadsheet software

Word processing software


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Travel Time to Work – BRMC Service Area Figure 11 illustrates the estimated average Travel Time to Work for the service area of BRMC. The commute time can be easily separated out into approximate thirds – travel time of less than 15 minutes (44.3%), travel time between 15-29 minutes (31.6%) and travel time of 30 minutes or more (24.2%). The majority (75.9%) of residents in the primary service area travel less than 30 minutes to get to work. Figure 11. BRMC Service Area by Travel Time to Work



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Demographic Conclusions

• Service area population has been steadily declining and projected to continue to decline from 64,307 in 2015 to 63,570 in 2020.

• Slightly more males (50.5%) than females (49.5%). • Over three-fourths of the residents are White (93.42%). • One third (36.4%) of the population is between the ages of 25 and 54. • Just under half (47.5%) of the population is married. • One in five (22.4%) have an Associate Degree or higher educational

attainment. A little under one in ten (8.3%) have not graduated high school.

• Just under one in five households (15.0%) have an annual income of $15,000 or less. Over half (58.6%) have annual incomes less than $50,000.

• Half of the population (50.3%) is employed. Very few (5.8%) residents are unemployed.

• The percentage of those living in poverty has been increasing for the counties of McKean, Potter and Cattaraugus since 2003 and all counties are above their corresponding states percentages.

• According to the North Central PREP Partner’s 2014 report, several individuals within the region, which includes McKean and Potter Counties, have exhausted the available unemployment compensation benefits which are available to them. The majority of these individuals represent Manufacturing; Trade, Transportation & Utilities; and Construction.

• Although the region saw an increase (13.2%) of online job postings for 2014, McKean County had the lowest increase in online job postings.

• Three-fourths of those employed (75.9%) travel less than 30 minutes to work.

2015 Bradford Regional Medical Center Community Health Needs Assessment Report Supplemental Data Resource 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 12 and listed in Tables 6 and 7 of this report. The assets identified are broken down into the following sections: Community Resources: Abuse/Trauma Adoption Aid to Servicemen and Women After School and Summer programs Alcohol and Drug Abuse Services Animals-Law Enforcement, Shelter and Adoption Assisted Living Facilities Blind and Visual Services Blood Donation Breastfeeding Supports Business/Financial Development Camps Cancer Chamber of Commerce Child Care Child Guidance Child Health Child Protection and Placement Clothing

Community Centers Consumer Protection Counseling or Therapy Credit Counseling and Protection Dental Care Disability Services Disaster Relief Domestic Violence Educational Support Emergency Numbers/Hotlines Employment and Vocational Counseling Financial Assistance Food and Nutritional Supports Grief Support HIV/AIDS Supports Health and Safety Supports Health Insurance Hearing Impaired Supports Home Health Care Homeless Assistance

ASSET RESOURCES


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Hospitals Housing and Utility Assistance Immunizations Legal Services Libraries McKean County Government Mental Health and Intellectual Disabilities Services Mentoring Missing Persons Nursing Homes Parenting Services and Supports Poison Prevention Pregnancy and Family Planning

Probation and Parole Residential Care Schools Senior Centers Senior Citizen Supports Sexual Assault and Domestic Violence Smoking Cessation Speech, Physical and Occupational Therapy Suicide and Crisis Intervention Tourism Transportation Wellness/Fitness

Hospital Resources: Cardiology Dental Services Mental Health Services Family Medicine Foothills Medical Group Home Health and Hospice Long-Term Care Medical Supply Services



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Figure 12: BRMC Asset Resources Map


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Table 6. BRMC Hospital Asset Resources Listing

BRADFORD REGIONAL MEDICAL CENTER

Address City State Zip Phone

Ambulatory Care 116 Interstate Parkway Bradford PA 16701 814-362-8325

Auxiliary 116 Interstate Parkway Bradford PA 16701 814-362-8432

Cardiology Address City State Zip Phone

Upbeat - Cardiac Rehab 116 Interstate Parkway Bradford PA 16701 814-362-8426

Cardiology Services (T & Th) 116 Interstate Parkway Bradford PA 16701 814-362-8720

Dental Services Address City State Zip Phone

Bradford Dental Center 600 Chestnut Street Bradford PA 16701 814-362-8478

Mt. Jewett Health Center 406 Franklin Street Smethport PA 16749 814-975-1195

Mental Health Services Address City State Zip Phone

Behavioral Health Services 116 Interstate Parkway Bradford PA 16701

- Inpatient Services 814-362-8319

- Outpatient Services

814-362-8220

Family Medicine Address City State Zip Phone

Bradford Family Practice 116 Interstate Parkway Bradford PA 16701 814-363-9484

Mt. Jewett Health Center 122 West Main Street Mt. Jewett PA 16740 814-975-1188

Smethport Health Center 406 Franklin Street Bradford PA 16701 814-887-5655

Foothills Medical Group Address City State Zip Phone

Cancer Care 116 Interstate Parkway Bradford PA 16701 814-362-8425

Hematology 116 Interstate Parkway Bradford PA 16701 814-362-8425

General Surgery 116 Interstate Parkway Bradford PA 16701 814-362-4222

Orthopedic Surgery & Sports Medicine 116 Interstate Parkway Bradford PA 16701 814-363-8308

Otolaryngology 116 Interstate Parkway Bradford PA 16701 814-362-5503

Pain Medicine 116 Interstate Parkway Bradford PA 16701 814-362-8674

Pediatrics 116 Interstate Parkway Bradford PA 16701 814-362-8390

Urology 116 Interstate Parkway Bradford PA 16701 814-362-8729

Home Health & Hospice Address City State Zip Phone

VNA of Northwest PA* 1223 East Main Street Bradford PA 16701 814-362-7466

*A partnership of Kaleida Health and BRMC

Long-Term Care Address City State Zip Phone

the Pavilion at BRMC 200 Pleasant Street Bradford PA 16701 814-362-8293

Medical Supply Services Address City State Zip Phone

Bradford Regional Medical Services 116 Interstate Parkway Bradford PA 16701 814-368-4143


Page | 31

Nutritional Services Address City State Zip Phone

Center for Diabetes & Nutrition Education 116 Interstate Parkway Bradford PA 16701 814-362-8717

WIC Program 222 West Washington Street Bradford PA 16701 814-362-4346

Occupational Health Address City State Zip Phone

Occupational Health Systems 116 Interstate Parkway Bradford PA 16701 814-362-3200

Outpatient Services Address City State Zip Phone

Imaging Services 116 Interstate Parkway Bradford PA 16701 814-362-8200

Immediate Treatment Center 116 Interstate Parkway Bradford PA 16701 814-362-8275

Laboratory Services 116 Interstate Parkway Bradford PA 16701 814-362-8247

Respiratory Services 116 Interstate Parkway Bradford PA 16701 814-362-8296

Wound Clinic 116 Interstate Parkway Bradford PA 16701 814-362-8245

Rehabilitation Services Address City State Zip Phone

In-patient Services 116 Interstate Parkway Bradford PA 16701 814-362-8264

SMART 116 Interstate Parkway Bradford PA 16701 814-362-4222

Schools Address City State Zip Phone

School of Radiography 116 Interstate Parkway Bradford PA 16701 814-362-8292

Sleep Disorders Address City State Zip Phone

Sleep Disorder Center 116 Interstate Parkway Bradford PA 16701 814-362-8732

Speech Therapy Address City State Zip Phone

SMART 116 Interstate Parkway Bradford PA 16701 814-362-4222

Women's Health Address City State Zip Phone

Healthy Beginnings Plus 222 West Washington Street Bradford PA 16701 814-362-4722

Women's Health Services 159 Interstate Parkway Bradford PA 16701 814-362-8480

Obstetrics & Gynecology 116 Interstate Parkway Bradford PA 16701 814-362-8240


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Table 7. BRMC Community Asset Resources Listing Name Address City State Zip Phone

Abuse/Trauma

ChildLine (Child Abuse Hotline) 800-932-0313

Office of Human Service, Elder Abuse Hotline

800-672-7145

Sexual Assault/Domestic Violence Hotline

888-822-6325

YWCA Victims’ Resource Center 24 West Corydon Street

Bradford PA 16701 814-368-4235

Adoption

Adagio Health 70-1/2 Mechanic Street

Bradford PA 16701 814-368-6129

Adelphoi Village 119 Village Way Latrobe PA 15650 724-804-7000

Adoptions From the Heart 1225 South Main Street #207

Greensburg PA 15601 800-355-5500 724-853-6533

Catholic Charities Counseling and Adoptions Services

125 Main Street, Suite 601

Bradford PA 16701 814-368-8644

Children’s Aid Society 1008 S 2nd Street Clearfield PA 16830 814-765-2686

Family Services of Northwestern PA 5100 Peach Street Erie PA 16509 800-634-2560 814-866-4500

Kids Peace 4184 Seneca Street West Seneca NY 14224 800-257-3223 716-675-7065

McKean County Children and Youth Services

17155 US-6 Smethport PA 16749 814-887-3350

Three Rivers Adoption Council 307 4th Avenue, #310

Pittsburgh PA 15222 412-471-8722

Twin Tiers Pregnancy Care Center 84-90 Boylston Street, Suite 201

Bradford PA 16701 814-368-3388 800-395-HELP

Aid to Servicemen and Women

American Red Cross 302 Congress Street Bradford PA 16701 814-368-6197

McKean County Veterans' Services 500 West Main Street, Courthouse

Smethport PA 16749 814-887-3241

After School and Summer Programs

See Schools

Bradford Learning Center 90 Jackson Avenue Bradford PA 16701 814-368-6622

Child Care Information Services P.O. Box 389 139 W. Fourth Street

Emporium PA 15834 800-638-4670 814-486-1974

KIDS in Kane Child Care Center 101 High Point Drive Kane PA 16735 814-837-6795

Kane Area Community Center 46 Fraley Street Kane PA 16735 814-837-9472

McKean County Family Centers 1 Mechanic Street Bradford PA 16701 814-362-1834

Penn State Cooperative Extension 17129 Route 6 Smethport PA 16749 814-887-5613


Page | 33

Name Address City State Zip Phone

Rainbow Corner Preschool 20 Russell Boulevard

Bradford PA 16701 814-362-4621

St. Bernard’s Elementary School 450 West Washington Street

Bradford PA 16701 814-368-5302

YMCA of Bradford 59 Boylston Street Bradford PA 16701 814-368-6101

Alcohol and Drug Abuse Services

Alcohol and Drug Abuse Services, Inc. 120 Chestnut Street Port Allegany PA 16743 814-642-9541

Maple Manor 118 Chestnut Street Port Allegany PA 16743 814-642-9522

Outpatient Treatment and Prevention, Bradford Office

2 Main Street, Seneca Building, 6th Floor

Bradford PA 16701 814-362-6517

Port Allegany Office 120 Chestnut Street Port Allegany PA 16743 814-642-9541

Alcoholics Anonymous (AA), NA and Al-Anon

79 Mechanic Street Bradford PA 16701 800-494-3414 800-356-9996

American Liver Foundation Landmarks Building, Suite 215 100 West Station Square Drive

Pittsburgh PA 15219 866-434-7044

BRMC’s Bradford Recovery Systems 116 Interstate Parkway

Bradford PA 16701 814-362-8422

Family Advocacy for Addiction Treatment

900 S. Arlington Avenue, Suite 127

Harrisburg PA 17109 866-709-0590

Animals—Law Enforcement, Shelter and Adoption

Bureau of Dog Law Enforcement 13410 Dunham Road

Meadville PA 16335 814-332-6890

McKean County SPCA 80 Glenwood Avenue

Bradford PA 16701 814-362-8850

Assisted Living Facilities

Chapel Ridge 200 St. Francis Drive Bradford PA 16701 814-368-8499

Lakeview Senior Care and Living Center

15 W. Willow Street Smethport PA 16749 814-887-5716

Lutheran Home at Kane 100 High Point Drive Kane PA 16735 814-837-6706

Pine Oak Personal Care Home 50 Congress Street Bradford PA 16701 814-362-6455

Blind and Visual Services

Bradford Area Public Library 67 West Washington Street

Bradford PA 16701 814-362-6527

Charles Cole Memorial Hospital 1001 E. Second Street, U.S. Route 6

Coudersport PA 16915 814-274-9300

McKean County Assistance Office 68 Chestnut Street, Suite B

Bradford PA 16701 814-362-4671 800-822-1108

Pennsylvania Association of the Blind 90 East Shady Lane Enola PA 17025 717-234-3261

Vision and Blindness Resources - Erie Center

2402 Cherry Street Erie PA 16502 800-881-9205 814-455-0995


Page | 34


Blood Donation

American Red Cross 4961 Pittsburgh Ave Erie PA 16509 814-833-0942

Community Blood Bank 2646 Peach Street Erie PA 16508 814-456-4206

Breastfeeding Support

Bradford Regional Medical Center, Healthy Beginnings Plus (Maternity Unit)

199 Pleasant Street Bradford PA 16701 814-368-4711

La Leche League International 957 N. Plum Grove Road

Schaumburg IL 60173 800-LA-LECHE 877-452-5324

Project RAPPORT 110 Campus Drive Bradford PA 16701 814-362-6535

WIC, Bradford Hooker-Fulton Building 3rd Floor

Bradford PA 16701 814-362-4346

WIC, Kane 112 Greeves Street Kane PA 16735 814-837-8038

WIC, Port Allegany 53 Church Street Port Allegany PA 16743 814-642-7476

Business/Financial Development

Bradford’s Office of Economic and Community Development

20 Russell Boulevard

Bradford PA 16701 814-368-7170

McKean County Economic Development Office

17137 Route 6 Smethport PA 16749 814-887-3256


Pennsylvania CareerLink—McKean County

40 Davis Street Bradford PA 16701 814-363-9100

University of Pittsburgh at Bradford’s Business Resource Center

Seneca Building, 2 Main Street

Bradford PA 16701 814-362-5078

Camps

Allegheny National Forest Visitors Bureau

80 E. Corydon Street P.O. Box 371

Bradford PA 16701 800-473-9370

American Respiratory Alliance of Western PA, Camp Huff-N-Puff

Cranberry Professional Park 201 Smith Drive, Suite E

Cranberry Township

PA 16066 800-220-1990

Boy Scouts of America 814-368-6471

Camp JJ P.O. Box 446 Bradford PA 16701 814-362-9755

Camp Penuel P.O. Box 510 Eldred PA 16731 814-225-3222

Girl Scouts, Keystone Tall Tree Council

RD 7, Box 362 Kittanning PA 16201 724-543-2681

Highmark Caring Place Bayview Office Park, Building 2 510 Cranberry Street

Erie PA 16507 866-212-4673

National Kidney Foundation of Western PA, Camp Time Out

188 Macartney Lane Ligonier PA 15658 412-823-6041


Page | 35


Penn State Cooperative Extension 4-H Camps


Penn-York Camp & Retreat Center 266 Northern Potter Road

Ulysses PA 16948 814-848-9811

Pennsylvania State Police Troop “C”-Camp Cadet

485 North Findley Street

Punxsutawney PA 15767 814-938-0512

Resting Waters Girl Scouts Camp 2566 Campbelltown Road

Kane PA 16735 814-778-5424

University of Pittsburgh at Bradford 300 Campus Drive Bradford PA 16701 814-362-7500

Cancer


Bradford PA 16701 814-368-6129

American Cancer Society 56 Thompson Avenue P.O. Box 67

Bradford PA 16701 814-368-3646


Coudersport PA 16915 814-274-9300

McKean County Visiting Nurses Association and Hospice

20 School Street P.O. Box 465

Bradford PA 16701 814-362-7466 800-342-5862

Chamber of Commerce

Bradford Area Chamber of Commerce

121 Main Street Bradford PA 16701 814-368-7115

Kane Area Chamber of Commerce 54 Fraley Street Kane PA 16735 814-837-6565

Port Allegany Chamber of Commerce 42 N. Main Street Port Allegany PA 16743 814-642-2526

Smethport Area Chamber of Commerce

502 W. King Street Smethport PA 16749 814-887-6020

Child Care

Apple of My Eye Daycare 138 Bayard Street Kane PA 16735 814-837-1044

Arnot Child Care 19 Oak Street Port Allegany PA 16734 814-642-9669

Bradford Learning Center 90 Jackson Avenue Bradford PA 16701 814-368-6622

Child Care Information Services 135 W. Fourth Street P.O. Box 389

Emporium PA 15834 800-638-4670 814-486-1974

KIDS in Kane Child Care Center 101 High Point Drive Kane PA 16735 814-837-6795

NTCAC Head Start Program Hooker-Fulton Building, 5th Floor 125 Main Street

Bradford PA 16701 800-638-4670 814-486-1161

Rainbow Corner Preschool 20 Russell Boulevard P.O. Box 616

Bradford PA 16701 814-362-4621


Bradford PA 16701 814-368-5302

YMCA Childcare Program 79 Mechanic Street Bradford PA 16701 814-368-1610

Child Guidance


Page | 36


Beacon Light Behavioral Health Systems

Bradford 800 East Main Street

Bradford PA 16701 814-362-5250

Custer City 945 South Avenue Custer City PA 16725 814-362-5250

Dickinson Mental Health Center, Partial Hospitalization Program

15-17 Kennedy Street

Bradford PA 16701 814-362-7464

The Guidance Center 110 Campus Drive Bradford PA 16701 814-362-6535



McKean County Family Centers

Bradford 1 Mechanic Street Bradford PA 16701 814-362-1834

Kane 2 Greeves Street Kane PA 16735 814-837-5148

Otto-Eldred 160 Main Street Eldred PA 16731 814-225-2513

Port Allegany 63 Main Street Port Allegany PA 16743 814-642-9281

Smethport 83 S. Marvin Street P.O. Box 411

Smethport PA 16749 814-887-9344

McKean County Juvenile Probation 500 W. Main Street Smethport PA 16749 814-887-3365

Northern Tier Community Action Corporation, Head Start

Hooker-Fulton Building, 5th Floor 125 Main Street

Bradford PA 16701 800-638-4670 814-486-1161


Seneca Highlands Intermediate Unit 9

119 Mechanic Street

Smethport PA 16749 814-887-5512

YWCA 24 West Corydon Street

Bradford PA 16701 814-368-4235

Child Health

CARE for Children 20 Russell Boulevard

Bradford PA 16701 814-362-4621


Coudersport PA 16915 814-274-9300

BRMC's Healthy Beginnings Plus 199 Pleasant Street Bradford PA 16701 814-368-4722

Highmark CHIP Program 717 State Street Erie PA 16501 814-871-6858


Bradford PA 16701 800-822-1108 814-362-4671

McKean County Visiting Nurses Association


Smethport PA 16749 814-887-3241

Pennsylvania Department of Health 84-90 Boylston Street, Gleason Building

Bradford PA 16701 814-368-0426

Highmark Caring Place Bayview Office Park, Building 2 510 Cranberry

Erie PA 16507 866-212-4673


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Street


Bradford PA 16701 814-362-4346




Child Protection and Placement

ChildLine 800-932-0313



Clothing

Catholic Charities Counseling and Adoption Services


Bradford PA 16701 814-368-8644

Goodwill, Bradford 75 Forman Street Bradford PA 16701 814-363-9106

Goodwill, Kane 86 Fraley Street Kane PA 16735 814-837-8620

Goodwill, Northern Central PA 163 Preston Way Falls Creek PA 15840 814-371-2821

Northern Tier Thrift Store 18 N. Main Street Port Allegany PA 16743 814-642-5010

Pink Elephant Resale Shop 420 W. Main Street Smethport PA 16749 814-887-2279

SACKS Resale Shop 24 Pine Street Bradford PA 16701 814-368-6186

Salvation Army-Kane 28 Fraley Street Kane PA 16735 814-837-1235


Bradford PA 16701 814-368-3388

Community Centers

Kane Area Community Center 46 Fraley Street Kane PA 16735 814-837-6565



Consumer Protection

Office of Attorney General, Bureau of Consumer Protection

101 State Street, Suite 1009

Erie PA 16501 800-441-2555

Counseling or Therapy

Addis and Associates 23 Kennedy Street, Suite 202

Bradford PA 16701 814-362-2136


800 East Main Street

Bradford PA 16701 814-362-5250

Bradford Regional Medical Center 116 Interstate Parkway

Bradford PA 16701 814-368-4143



Bradford PA 16701 814-368-8644


Sagewood, Inc. 734 East Main Street

Bradford PA 16701 814-362-5579


Page | 38



Bradford PA 16701 814-368-3388 800-395-HELP

Credit Counseling and Protection

Consumer Credit Counseling Service 800-762-2271


Dental Care

McKean County Dental Center 600 Chestnut Street Extension

Bradford PA 16701 814-362-8478

Disability Services

ABOARD 35 Wilson Street, Suite 100

Pittsburgh PA 15223 800-827-9385 412-781-4116


Bradford PA 16701 814-368-3646

American Heart Association 823 Filmore Avenue Erie PA 16505 814-368-7650

American Respiratory Alliance of Western PA

201 Smith Drive, Suite F Cranberry Professional Park

Cranberry Township

PA 16066 800-220-1990

Arthritis Foundation 100 West Station Square, Suite 1950

Pittsburgh PA 15219 800-776-0746 412-566-1645

BRMC’s SMART Rehab Services Interstate Parkway Bradford PA 16701 814-362-4222



Bradford PA 16701 814-362-5250

Bureau of Blindness and Visual Services

4200 Lovell Place Erie PA 16503 814-871-4401 Voice

866-521-5073 Voice*

814-871-4599 TTY

888-884-5513 TTY*

CARE for Children 20 Russell Boulevard P.O. Box 616

Bradford PA 16701 814-362-4621

Community Resources for Independence

360 High Street Bradford PA 16701 866-313-1060 814-362-9170

Dickinson Center Psychiatric Rehabilitation Program


Bradford PA 16701 814-362-7464

Disability Rights Network 1315 Walnut Street, Suite 400

Philadelphia PA 19107 800-692-7443

Disabled American Veterans 1000 Liberty Avenue, Room 1606

Pittsburgh PA 15222 412-395-6241

Epilepsy Foundation 800-361-5885


Page | 39


Futures Rehabilitation Center 1 Futures Way Bradford PA 16701 814-368-4101

The Guidance Center, Case Management

110 Campus Drive Bradford PA 16701 814-362-6535

The Guidance Center, SCAN/PEP Early Intervention Program

83 S. Marvin Street P.O. Box 411

Smethport PA 16749 814-887-5591

Helpmates Home Health Care, Inc. 437 W. Main Street Smethport PA 16749 814-887-2881

LINK to Aging and Disability Resources

800-753-8827

Life and Independence For Today (LIFT)

503 East Arch Street St. Mary's PA 15857 800-341-LIFT

Make a Wish Foundation 312 West Mahoning Street

Punxsutawney PA 15767 814-938-8888

The Main Place, MR Activity Center 9 Main Street Bradford PA 16701 814-362-5960

March of Dimes Birth Defects Foundation

1407 Peninsula Drive

Erie PA 16505 800-433-5210

McKean County Assistance Office, Disabled Advocacy Program

68 Chestnut Street, Suite B

Bradford PA 16701 814-362-4671 800-822-1108

McKean County Visiting Nurses Association


Bradford PA 16701 814-362-7466 800-342-5862

National Kidney Foundation of Western PA

3109 Forbes Avenue Suite 101

Pittsburgh PA 15213 412-261-4115

Office of Human Services Area Agency on Aging

17155 Route 6 P.O. Box 394

Smethport PA 16749 800-282-1688 814-887-5672

Office of Vocational Rehabilitation 199 Beaver Drive DuBois PA 15801 800-922-4017 814-371-7340

Parent Education and Advocacy Leadership Center

1119 Penn Avenue, Suite 400

Pittsburgh PA 15222 412-281-4404


Pennsylvania Families Incorporated 800-947-4941

Pennsylvania Tourette Syndrome Association

132 W. Middle Street

Gettysburg PA 17331 800-990-3300

Prader-Willi Syndrome Association 800-926-4797

Seneca Highlands Intermediate Unit 9 Early Intervention Services

65 East Valley Road Smethport PA 16749 814-887-9287

Seneca Highlands Intermediate Unit 9

119 Mechanic Street

814-887-5512

Shriners Hospital 1645 West 8th Street

Erie PA 16505 814-875-8700

Social Security Administration 175 N. Union Street Olean NY 14760 800-772-1213 716-372-1021

Special Kids Network 800-986-4550

Disaster Relief

American Red Cross – Emergency 302 Congress Street Bradford PA 16701 814-368-6197


Page | 40


Services

Christian Community Services - Food Pantry

Main and Fulton Streets

Smethport PA 16749 814-887-8233

Salvation Army Emergency Lodging and Food Pantry

111 Jackson Avenue Bradford PA 16701 814-368-7012

Domestic Violence


888-822-6325

YWCA Victims’ Resource Center 814-368-4235

Educational Support

See Schools

Beacon Light Alternative Education Support


Bradford PA 16701 814-362-6568 814-642-2902


Bradford PA 16701 814-362-4671 800-822-1108


Northern Tier Community Action Corporation Head Start

125 Main Street Hooker-Fulton Building, 5th Floor

Bradford PA 16701 800-638-4670 814-486-1161

Northwest PA Area Health Education Center (AHEC)

8425 Peach Street Erie PA 16509 814-217-6084




Seneca Highlands Intermediate Unit 9 Family Literacy Program

119 Mechanic Street

Smethport PA 16749 814-887-5512

University of Pittsburgh at Bradford 300 Campus Drive Bradford PA 16701 814-362-7500

University of Pittsburgh at Bradford Continuing Education and Regional Development

2 Main Street, Seneca Building, Suite 115

Bradford PA 16701 814-362-5115

Emergency Numbers and Hotlines

Ambulance, Fire, Emergency 911

ChildLine (Child Abuse Hotline) 800-932-0313


888-822-6325

Office of Human Services, Elderly Abuse/ Neglect

814-772-2273

Mental Health Crisis Hotline 800-459-6568

McKean County Crime Stoppers 800-PA-TIPS

McKean County Juvenile Probation 814-887-4911

Poison Control Center Hotline 800-222-1222

STD/HIV Hotline 800-222-8922


Page | 41


Twin Tiers Pregnancy Care Center 814--368-3388

Employment and Vocational Counseling

Futures Rehabilitation Center 1 Futures Way Bradford PA 16701 814-368-4101


Bradford PA 16701 814-362-4671 800-822-1108

New Choices Career Development Program


Bradford PA 16701 814-362-6188

Office of Vocational Rehabilitation 199 Beaver Drive DuBois PA 15801 800-922-4017 814-371-7340



Seneca Highlands Intermediate Unit 9 Family Literacy Program

119 Mechanic Street

Smethport PA 16749 814-887-5512

Financial Assistance

Highmark Blue Cross Blue Shield 717 State Street Erie PA 16501 814-871-6858


Bradford PA 16701 800-822-1108

McKean County Domestic Relations Office

500 West Main Street, Courthouse

Smethport PA 16749 814-887-3366



Food and Nutrition Supports

Angel Food Ministries - Bradford 55 N. Bennett Street Bradford PA 16701 814-368-8129

Angel Food Ministries - Kane 200 Dawson Street Kane PA 16735 814-837-6920

Angel Food Ministries - Eldred 1300 Prentisvale Road

Eldred PA 16731 814-966-3998

Angel Food Ministries - Port Allegany 205 Arnold Avenue Port Allegany PA 16743 814-642-9261



Bradford PA 16701 814-368-8644

Christian Community Services Main and Fulton Streets

Smethport PA 16749 814-887-8233

Destinations Bradford 1 Main Street Bradford PA 16701 814-331-4551

Free and Reduced Lunch Program See school listings

Friendship Table 21 E. Corydon Street Bradford PA 16701 814-362-6658

La Leche League 957 N. Plum Grove Road

Schaumburg IL 60173 800-LA-LECHE 877-452-5324


Bradford PA 16701 814-362-4671 800-822-1108



Page | 42



17155 Route 6 P.O. Box 394

Smethport PA 16749 800-282-1688 814-887-5672

Salvation Army Food Pantry 111 Jackson Avenue Bradford PA 16701 814-362-5579

WIC - Bradford Hooker-Fulton Building, 3rd Floor

Bradford PA 16701 814-362-4346

WIC - Kane 112 Greeves Street Kane PA 16735 814-837-8038

WIC - Port Allegany 53 Church Street Port Allegany PA 16743 814-642-7476

Grief Support

Community Nurses, Inc.-Bradford 15 Main Street Bradford PA 16701 814-363-9870

Community Nurses, Inc.-Kane 628A North Fraley Street

Kane PA 16735 814-837-8285

Highmark Caring Place 510 Cranberry Street Bayview Office Park, Building 2

Erie PA 16507 866-212-4673

McKean County VNA and Hospice 20 School Street P.O. Box 465

Bradford PA 16701 814-362-7466 866-342-5862

HIV/AIDS Supports

AIDS Factline 800-662-6080


HIV Counseling and Testing 84-90 Boylston Street

Bradford PA 16701 814-368-0426

Northwest PA Rural AIDS Alliance 800-359-2437


Bradford PA 16701 814-368-0426

STD/HIV Hotline 800-227-8922

Health and Safety Supports


Bradford PA 16701 814-368-6129


Bradford PA 16701 814-368-3646

American Heart Association 823 Filmore Avenue Erie PA 16505 814-368-7650

American Liver Foundation 100 West Station Square, Suite 215

Pittsburgh PA 15219 866-434-7044


American Respiratory Alliance 201 Smith Drive, Suite F Cranberry Professional Park

Cranberry Township

PA 16066 800-220-1990

Arthritis Foundation 100 West Station Square, Suite 1950

Pittsburgh PA 15219 800-776-0746 412-566-1645


Page | 43



Bradford PA 16701 814-368-4143


Bradford PA 16701 814-362-4621

Charles Cole Hospital 1001 E. Second Street, U.S. Route 6

Coudersport PA 16915 814-274-9300

Epilepsy Foundation 800-361-5885

Hemophilia Center of Western PA 3636 Boulevard of the Allies

Pittsburgh PA 15213 412-209-7280



Bradford PA 16701 800-342-5862

National Kidney Foundation of Western PA

412-261-4115




Bradford PA 16701 814-368-0426

Project RAPPORT 9 Main Street Bradford PA 16701 814-362-5960


Bradford PA 16701 814-362-4346



YMCA 59 Boylston Street Bradford PA 16701 814-368-6101

Health Insurance

Healthy Baby Helpline 1011 Mumma Road, Suite 100

Wormleysburgh PA 17043 800-986-2229

Healthy Kids Helpline 1011 Mumma Road, Suite 100

Wormleysburgh PA 17043 800-986-5437

Highmark CHIP and Adult Basic Programs

717 State Street Erie PA 16501 814-871-6858


Bradford PA 16701 814-362-4671 800-822-1108


Hearing Impaired Supports

See Schools

Seneca Highlands Intermediate Unit #9 Early Intervention Program


Seneca Highlands Intermediate Unit #9

119 Mechanic Street

Smethport PA 16749 814-887-5512

Home Health Care

Charles Cole Memorial Hospital 1001 E. Second Coudersport PA 16915 814-274-9300


Page | 44


Street, U.S. Route 6

Community Nurses, Inc.-Bradford 15 Main Street Bradford PA 16701 814-363-9870

Community Nurses, Inc.-Kane 628A North Fraley Street

Kane PA 16735 814-837-8285

Helpmates Home Health Care, Inc. 437 W. Main Street Smethport PA 16749 814-887-2881

Kane Community Hospital Home Health

4372 Route 6 Kane PA 16736 814-837-8585



Bradford PA 16701 814-362-7466 800-342-5862

Pediatric Services of America 63 Main Street Port Allegany PA 16743 814-642-9500 800-882-3519

Homeless Assistance

Bradford Housing Authority 2 Bushnell Street Bradford PA 16701 814-362-3535

Bradford Housing Authority-Section 8 Housing

2 Bushnell Street Bradford PA 16701 814-368-7205

Genesis House 107 South Barry Street

Olean NY 14760 716-373-3354


Bradford PA 16701 814-362-4671 800-822-1108

PATH Projects for Assistance in Transition from Homelessness

802 Hooker Fulton Building

Bradford PA 16701 814-362-4601

Salvation Army 111 Jackson Avenue Bradford PA 16701 814-368-7012


Bradford PA 16701 814-368-4235

Hospitals


Bradford PA 16701 814-368-4143


Coudersport PA 16915 814-274-9300

DuBois Regional Medical Center 100 Hospital Avenue DuBois PA 15801 814-371-2200

Penn Highlands Elk 763 Johnsonburg Road

St. Mary's PA 15857 814-788-8000

Kane Community Hospital 4372 Route 6 Kane PA 16735 814-837-8585

Olean General Hospital (Upper Allegheny Health System)

515 Main Street Olean NY 14700 716-373-2600

Shriner’s Hospital (Erie) 1645 West 8th Street

Erie PA 16505 814-875-8700

Housing and Utility Assistance

Bradford Housing Authority 2 Bushnell Street Bradford PA 16701 814-362-3535

Bradford Housing Authority-Section 8 Housing

2 Bushnell Street Bradford PA 16701 814-368-7205


Page | 45


Bradford’s Office of Economic and Community Development

20 Russell Boulevard

Bradford PA 16701 814-368-7170

Catholic Charities Counseling and Adoption Services.


Bradford PA 16701 814-368-8644


Bradford PA 16701 814-362-4671 800-822-1108

McKean County Redevelopment and Housing Authority

410 East Water Street

Smethport PA 16749 814-887-5563

Northern Tier Community Action Corporation

125 Main Street Hooker-Fulton Building, 5th Floor

Bradford PA 16701 800-638-4670 814-486-1161

PATH Projects for Assistance in Transition from Homelessness

802 Hooker Fulton Building

Bradford PA 16701 814-362-4601

Salvation Army 111 Jackson Avenue Bradford PA 16701 814-368-7012

USDA, Rural Development 216 Spring Run Road, Room 103

Mill Hill PA 17751 570-726-3196 x4


Bradford PA 16701 814-368-4235

Immunizations

American Liver Foundation 100 West Station Square Drive Landmarks Building, Suite 215

Pittsburgh PA 15219 866-434-7044


Bradford PA 16701 814-368-4143


Coudersport PA 16915 814-274-9300

Pennsylvania Department of Health 84-90 Boylston Street Gleason Building

Bradford PA 16701 814-368-0426

Legal Services

Northwestern Legal Services 100 Main Street Bradford PA 16701 800-665-6957 814-362-6596

Libraries

Bradford Area Public Library 67 West Washington Street

Bradford PA 16701 814-362-6527

Friends Memorial Library (Kane) 230 Chase Street Kane PA 16735 814-837-7010

Hamlin Memorial Library (Smethport)

123 S. Mechanic Street

Smethport PA 16749 814-887-9262

Mount Jewett Memorial Public Library

7 East Main Street Mount Jewitt PA 16740 814-778-5588

SW Smith Memorial Public Library (Port Allegany)

22 Church Street Port Allegany PA 16743 814-642-9210


Page | 46


University of Pittsburgh at Bradford, Hanley Library


McKean County Government

See McKean County Offices—Direct Line listing

814-887-3200

Mental Health and Intellectual Disabilities Services

Addis and Associates 23 Kennedy Street, Suite 202

Bradford PA 16701 814-362-2136



Bradford PA 16701 814-362-5250

BRMC’s Bradford Recovery Systems 116 Interstate Parkway

Bradford PA 16701 814-362-8422 800-446-2583


Coudersport PA 16915 814-274-9300

Dickinson Center Psychiatric Rehabilitation Program


Bradford PA 16701 814-362-7464

Evergreen Elm 71 Main Street, Suite 303

Bradford PA 16701 814-362-6853

Futures Rehabilitation Center, Inc. 1 Futures Way Bradford PA 16701 814-368-4101


McKean County Department of Human Services


The Main Place, MR Activity Center 9 Main Street Bradford PA 16701 814-362-5960

Mental Health Crisis Hotline 814-362-4623 800-459-6568

STEPS Drop-In Center 62 Main Street Bradford PA 16701 814-362-6260

Mentoring

Big Brothers Big Sisters of McKean County

602 West DuBois Avenue, Unit 1

DuBois PA 15801 814-887-5591

Mentor Parent Program P.O. Box 47 Pittsfield PA 16340 888-447-1431 814-563-3470

Parent to Parent of PA 3814 Asbury Road Erie PA 16506 888-727-2706

Missing Persons

Local Police 911

Pennsylvania State Police Missing Persons

3178 Route 219 Kane PA 16735 814-778-5555

Nursing Homes

Bradford Ecumenical Home 100 St. Francis Drive Bradford PA 16701 814-368-5648

Bradford Manor Nursing Home 50 Langmaid Lane Bradford PA 16701 814-362-6090

Lakeview Senior Care and Living Center

15 W. Willow Street Smethport PA 16749 814-887-5716

Lutheran Home at Kane 100 High Point Drive Kane PA 16735 814-837-6706


Page | 47


The Pavilion at BRMC 200 Pleasant Street Bradford PA 16701 814-362-4533

Sena-Kean Manor 17083 Route 6 Smethport PA 16749 814-887-5601

Parenting Services and Supports


Bradford PA 16701 814-362-4621





Mentor Parent Program P.O. Box 47 Pittsfield PA 16340 888-447-1431 814-563-3470

Parent to Parent of PA 3814 Asbury Road Erie PA 16506 888-727-2706


Seneca Highlands Family Literacy Program

119 Mechanic Street

Smethport PA 16749 814-887-5512


Poison Prevention

Poison Control Hotline 800-222-1222

Pregnancy and Family Planning


Bradford PA 16701 814-368-6129

BRMC Healthy Beginnings Plus 199 Pleasant Street Bradford PA 16701 814-368-4722



Bradford PA 16701 814-368-8644


Coudersport PA 16915 814-274-9300

La Leche League International 800-LA-LECHE 877-452-5324

Project RAPPORT of The Guidance Center

9 Main Street Bradford PA 16701 814-362-5960


Bradford PA 16701 800-395-HELP 814-368-3388

Probation and Parole

McKean County Adult Probation Department

500 W. Main Street Smethport PA 16749 814-887-3305

McKean County Juvenile Probation Department

500 W. Main Street Smethport PA 16749 814-887-3365

Residential Care



Bradford PA 16701 814-362-5250

Ramsbottom Center, Inc. 800 East Main Street

Bradford PA 16701 814-362-5250 814-362-7405


Page | 48


Evergreen Elm 71 Main Street, Suite 303

Bradford PA 16701 814-362-6853

YWCA 59 Boylston Street Bradford PA 16701 814-368-6101

Schools

Private



Bradford PA 16701 814-362-6568 814-642-2902

Bradford Area Christian Academy 23 Chambers Street Bradford PA 16701 814-368-6800

The Bradford Learning Center 90 Jackson Avenue Bradford PA 16701 814-368-6622

Milton Hershey School P.O. Box 830 Hershey PA 17033 888-647-5439 717-520-2000


Bradford PA 16701 814-368-5302

Bradford School District 150 Lorana Avenue Bradford PA 16701 814-362-3841

G. G. Blaisdell Elementary School 265 Constitution Avenue

Bradford PA 16701 814-362-6834

School Street Elementary School 76 School Street Bradford PA 16701 814-368-3183

Floyd C. Fretz Junior High School 140 Lorana Avenue Bradford PA 16701 814-362-3508

Bradford Area Senior High School 81 Interstate Parkway

Bradford PA 16701 814-362-3845

Kane School District 400 W. Hemlock Avenue

Kane PA 16735 814-837-9570

Chestnut Street Elementary School

226 Chestnut Street Kane PA 16735 814-837-7555

Kane Area Middle School 400 Hemlock Avenue

Kane PA 16735 814-837-6030

Kane Area High School 6965 Route 321 Kane PA 16735 814-837-6821

Otto-Eldred School District 143 Sweitzer Drive Duke Center PA 16729 814-966-3214

Otto-Eldred Elementary School 5 Bennett Street Eldred PA 16731 814-225-4779

Otto-Eldred High School 143 Sweitzer Drive Duke Center PA 16729 814-966-3212

Port Allegany School District 20 Oak Street Port Allegany PA 16743 814-642-2596

Port Allegany Elementary School 85 Clyde Lynch Drive

Port Allegany PA 16743 814-642-9557

Port Allegany Junior/Senior High School

200 Oak Street Port Allegany PA 16743 814-642-2544

Seneca Highlands Area Vo-Tech School

219 Edison Bates Drive

Port Allegany PA 16743 814-642-2573

Smethport School District 414 S. Mechanic Street

Smethport PA 16749 814-887-5543

Smethport Elementary School 414 S. Mechanic Street

Smethport PA 16749 814-887-5013

Smethport Junior/Senior High School

412 S. Mechanic Street

Smethport PA 16749 814-887-5545


Page | 49


Senior Centers

Bradford Senior Activity Center, Inc. 60 Campus Drive Bradford PA 16701 814-368-4412

Eldred Senior Center 169 Main Street Eldred PA 16731 814-225-4752

Kane Area Senior Center 100 Fraley Street Kane PA 16735 814-837-6981

Mount Jewett Senior Center 8 Main Street Mt. Jewett PA 16740 814-778-5547

Port Allegany Senior Center 216 N. Main Street Port Allegany PA 16743 814-642-2101

Smethport Senior Center 119 Main Street Smethport PA 16749 814-887-5630

Senior Citizen Supports

American Red Cross, Meals on Wheels

302 Congress Street Bradford PA 16701 814-368-6197

Bradford Ecumenical Home, Inc 100 St. Francis Drive Bradford PA 16701 814-368-5648

Bradford Senior Activity Center, Inc. 60 Campus Drive Bradford PA 16701 814-368-4412

Chapel Ridge 200 St. Francis Drive Bradford PA 16701 814-368-8499

Elder Abuse/Neglect Hotline 800-672-7145

Helpmates Home Health Care, Inc. 437 N. Main Street Smethport PA 16749 814-887-2881

Kane Senior Center 100 Fraley Street Kane PA 16735 814-837-6981


Bradford PA 16701 814-362-4671 800-822-1108

McKean County VNA Project CARE 20 School Street P.O. Box 465

Bradford PA 16701 814-362-7466 800-342-5862

McKean County Veterans’ Affairs 500 West Main Street, Courthouse

Smethport PA 16749 814-887-3241


17155 Route 6 P.O. Box 394

Smethport PA 16749 800-282-1688 814-887-5672

Social Security Administration 175 Union Street Olean NY 14760 800-772-1213 716-372-1021

Vision and Blindness Resources - Erie Center

2402 Cherry Street Erie PA 16502 800-881-9205 814-455-0995

Sexual Assault and Domestic Violence


888-822-6325


Bradford PA 16701 814-368-4235

Smoking Cessation

Alcohol and Drug Abuse Services, Tobacco Coalition (Bradford)

2 Main Street Seneca Building, 6th Floor

Bradford PA 16701 814-362-6517

Alcohol and Drug Abuse Services, Tobacco Coalition (Kane)

814-837-7691

Alcohol and Drug Abuse Services, Tobacco Coalition (Port Allegany)

120 Chestnut Street Port Allegany PA 16743 814-642-9541


Page | 50


Bradford Recovery Systems 116 Interstate Parkway

Bradford PA 16701 814-362-8422 800-446-2583 800-446-2583

Pennsylvania Quit Line 800-784-8669

Speech, Physical and Occupational Therapy

BRMC’s SMART Rehab Services 2 North Center Street

Bradford PA 16701 814-362-4222


Bradford PA 16701 814-362-4621


Coudersport PA 16915 814-274-9300

The Guidance Center, SCAN/PEP Program

83 S. Marvin Street P.O. Box 411

Smethport PA 16749 814-887-5591



Bradford PA 16701 814-362-7466 800-342-5862

Rehabilitation Today 660 East Main Street

Bradford PA 16701 814-368-3300

Seneca Highlands Early Intervention Program


Seneca Highlands Special Education Services

119 Mechanic Street

Smethport PA 16749 814-887-5512

Suicide and Crisis Intervention

The Guidance Center, MH Crisis Intervention


Mental Health Crisis Hotline 814-362-4623 800-459-6568

YWCA Homeless Shelter 24 West Corydon Street

Bradford PA 16701 814-368-4235


Bradford PA 16701 814-368-4235

Tourism

Allegany National Forest Visitors Bureau

80 E. Corydon Street P.O. Box 371

Bradford PA 16701 800-473-9370

Transportation


Bradford PA 16701 814-368-3646


Area Transportation Authority (ATA) 44 Transportation Center

Johnsonburg PA 15845 814-965-2111


Bradford PA 16701 814-362-4671 800-822-1108

National Kidney Foundation of 412-261-4115


Page | 51


Western PA

Wellness/Fitness

Bradford Regional Medical Center, Upbeat Program

116 Interstate Parkway

Bradford PA 16701 814-362-8426

Eldred Borough Volunteer Fire Department Fitness Center

5 Platt Street Eldred PA 16731 814-225-4667

Kane Community Center/Fitness Center

46 Fraley Street Kane PA 16735 814-837-9472

Port Allegany Health Center 45 N. Pine Street Port Allegany PA 16743 814-462-7205

Smethport Wellness Center 83 Marvin Street Smethport PA 16749 814-887-5213

YMCA 59 Boylston Street Bradford PA 16701 814-368-6101


Page | 52


2015 Bradford Regional Medical Center Community Health Needs Assessment Report Supplemental Data Resource Appendix C – Supplemental Data Resource by Topic Area

Page | 53

Appendix C

Supplemental Data Resource By Topic Area


Page | 54



Page | 55

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


Page | 56

General Health Status Figure 13 displays the percentage of adults who reported their health as “fair” or “poor” in the United States, Pennsylvania, and the counties of the service area for 2008-2010 and 2011-2013. Adults in the McKean County cluster who reported their health as “fair” or “poor” was significantly higher in 2008-2010 (22.0%) and higher than the state and nation for 2011-2013 (20.0%). Adults in the Potter County cluster are showing an increasing trend of those adults who reported their health as Fair or Poor. Figure 13. Adults Who Reported Health as Fair or Poor

Source: PA Department of Health, NY Department of Health, Center for Disease Control


Page | 57

No Health Insurance Figure 14 illustrates the percentage of adults ages 18-64 with no health insurance in the United States, Pennsylvania and throughout the counties of the service area in 2008-2010 and 2011-2013. Adults ages 18-64 in the service area counties had rates comparable to the state and nation. All clusters are above the Healthy People 2020 Goal (0%). Figure 14. Adults (Age 18-64) with No Health Insurance

Source: PA Department of Health, NY Department of Health, Center for Disease Control,

Healthy People 2020


Page | 58

No Personal Health Care Provider Figure 15 illustrates the percentage of adults reporting that they have no personal health care provider in Pennsylvania and throughout the service area counties. The service area counties in the McKean Cluster and Cattaraugus had lower rates of adults with no personal care provider compared to the state, with adults in the Potter County cluster having the highest rate (15.0%). All service area counties and Pennsylvania percentages are below the Healthy People 2020 Goal of 16.1% for adults with no personal health care provider. Only the state of New York had a higher rate than the Healthy People 2020 Goal. Figure 15 Adults with No Personal Health Care Provider

Source: PA Department of Health, NY State Department of Health Center for Disease Control,

Healthy People 2020


Page | 59

Doctor’s Visit Figure 16 shows adults who reported that they needed to see a doctor in the last year but could not due to cost in Pennsylvania and the service area counties in 2008-2010 and 2011-2013. All clusters were comparable to the Pennsylvania state rate (13%) and New York state rate (13.8%), with decreasing trends in all clusters but Cattaraugus. All service area counties and state 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 16. Adults Who Reported Needing to See a Doctor But Could Not Due to Cost, Past Year


Healthy People 2020


Page | 60

Table 8 shows estimated data on behalf of the American Community Survey and U.S. Census Bureau regarding disabilities/difficulties in the counties of McKean, Potter and Cattaraugus, along with the states and nation. Each of the three counties is trending upward for the years 2012 and 2013, but all are lower than their corresponding state percentage. Cattaraugus County shows a higher percentage for each of the difficulties listed than McKean or Potter Counties. Table 8. Disability/Difficulty Characteristics

McKean County

McKean County Trend Potter

CountyPotter County Trend Cattaraugus

CountyCattaraugus

County Trend PA Trend NY Trend USA Trend

2012 2013 +/- 2012 2013 +/- 2012 2013 +/- 2013 +/- 2013 +/- 2013 +/-Disability status 3.40% 3.80% + 3.60% 4.10% + 5.40% 5.70% + 5.70% - 6.20% - 5.20% +/-Hearing difficulty 1.80% 1.90% + 2.40% 2.50% + 3.80% 3.90% + 3.80% - 4.40% - 3.60% +/-Vision difficulty 1.90% 2.10% + 2.60% 2.90% + 4.10% 4.20% + 4.20% - 4.70% - 3.90% +/-Cognitive difficulty 2.30% 2.50% + 2.70% 3.00% + 4.00% 4.30% + 4.30% - 4.90% - 4.00% +/-

Ambulatory difficulty 2.30% 2.40% + 2.80% 3.00% + 4.20% 4.30% + 4.30% - 4.90% - 4.10% +/-

Self-care difficulty 2.30% 2.40% + 2.80% 3.00% + 4.10% 4.30% + 4.30% - 4.90% - 4.10% +/-Independent living difficulty 2.50% 2.70% + 2.90% 3.00% + 3.90% 4.00% + 4.30% - 4.90% - 4.00% =/-

Source: U.S. Census Bureau, 2009-2013 5-Year American Community Survey


Page | 61

Community Input Figure 17 illustrates the percentage of 2015 Community Survey respondents who rated their personal health status. Over three-fourths of the respondents (92.9%) rated their personal health as “Good,” “Very Good,” or “Excellent.” Figure 17. 2015 Community Survey – Personal Health Status, N=508



Page | 62

Figure 18 illustrates the percentage of 2015 Focus Group participants who rated their personal health status. Almost three-fourths of the participants (74.0%) rated their personal health as “Good,” “Very Good,” or “Excellent.” One fourth of the participants (27.0%) rated their personal health as “Fair” or “Poor.” Figure 18. 2015 Focus Groups – Personal Health Status



Page | 63

Figure 19 illustrates the percentage of 2015 Community Survey respondents with health insurance throughout the counties of the service area. 9 out of 10 survey respondents indicated that they have some type of health care coverage. Figure 19. 2015 Community Survey – Health Care Coverage, N=508



Page | 64

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 20. Figure 20. PRC – Healthcare Insurance Coverage for Child

Source: PRC National Child & Adolescent Health Survey, 2014


Page | 65

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 21. All regions and nation are above the Healthy People 2020 Goal of 100% insured. Figure 21. 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


Page | 66

Figure 22 illustrates the percentage of 2015 Community Survey respondents who were unable to fill a prescription due the cost. Over three-fourths of the respondents (86.1%) were able to fill a prescription, while 12.5% of the respondents could not due to cost. Figure 22. 2015 Community Survey – Could Not Fill Prescription Due to Cost, Past 12 Months, N=508



Page | 67

Figure 23 illustrates the percentage of 2015 Community Survey respondents who were unable to seek medical treatment due to cost over the past 12 months. Over three-fourths of the respondents (84.6%) were able to seek medical treatment while 14.0% of the respondents could not seek medical treatment due to cost. Figure 23. 2015 Community Survey – Could Not Seek Medical Treatment Due to Cost, Past 12 Months, N=508



Page | 68

Figure 24 illustrates the percentage of 2015 Community Survey respondents who were unable to obtain health care services due to a lack of transportation over the past year. 9 out of 10 survey respondents indicated that transportation wasn’t a barrier to obtaining health care. Figure 24. 2015 Community Survey – Could Not Get Healthcare Services Due to Lack of Transportation, Past 12 Months, N=508



Page | 69

Figure 25 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 25. PRC – Experienced Difficulties or Delays in Receiving Child’s Needed Healthcare in the Past Year



Page | 70

Figure 26 illustrates the percentage of 2015 Community Survey respondents who have a regular health provider. 9 out of 10 survey respondents indicated that they have some type of health care provider. Figure 26. 2015 Community Survey – Regular Health Provider, N=508



Page | 71

Figure 27 illustrates the percentage of 2015 Community Survey respondents who receive a regular check-up. Over three-fourths of the respondents (82.6%) have received a checkup within the last year, while 8.2% of respondents haven’t had a checkup in the past two or more years. Figure 27. 2015 Community Survey – Routine Check Up, N=508



Page | 72

Figure 28 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 28. PRC – Child Visited a Physician for a Routine Checkup in the Past Year



Page | 73

Figure 29 illustrates the percentage of 2015 Community Survey respondents who have received a dental checkup. Almost three-fourths of respondents (71.5%) have received a dental checkup with the past year while 17.0% haven’t visited a dentist for a routine checkup in the last two or more years. Figure 29. 2015 Community Survey – Dental Check Up, N=508



Page | 74

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 30. The Northeast region is above the Healthy People 2020 Goal of 49.0%. Figure 30. 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


Page | 75

Figure 31 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 31. PRC – Child Used an Urgent Care Center, QuickCare Clinic, or Other Walk-in Clinic in the Past Year



Page | 76

Figure 32 illustrates responses from the 2015 Community Survey regarding the community issues related to being affected by access problems. Respondents were asked to share their reasons for experiencing access problems. Overall, almost a quarter of the respondents answered that availability of specialists/specialty medical care as the main reason for experiencing access problems, followed by access to affordable health care as it relates to co-pays and deductibles) (23.8%) and access to insurance coverage (23.5%). Figure 32. 2015 Community Survey – Affected By Access Problems, N=508



Page | 77

Figure 33 illustrates responses from the focus groups regarding the community issues related to access needs. 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 lack of healthcare coverage in the workplace (4.2), lack of transportation (3.7), access to medical care (3.7), decrease access to specialty care (3.6), and poor dental care (3.5) Figure 33. 2015 Focus Groups – Access Needs

Source: BRMC Focus Groups, 2015


Page | 78

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

• Adults in McKean County are more likely than average to rate their health status as fair or poor, compared to the state and the nation.

• The percentage of adults not seeing the doctor due to costs (10%) is higher than the HP goal of 4.2% but lower than the PA and US rates.

• Disability and difficulty characteristics for all three counties are trending upward, although all percentages are below their corresponding state. Cattaraugus County has a higher percentage for each of the characteristics than McKean and Potter Counties.

• 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%).

• Only 7.2% of community survey respondents rated their personal health as fair or poor, compared to 27% of the focus group respondents.

• The majority of survey (50.3%) and focus group (54%) respondents rated the health status of the community as fair or poor.

• Access to specialists, affordable health care and insurance were identified as access barriers by almost a fourth of community survey respondents.

• Focus group participants noted health care coverage, transportation and lack of specialists as access needs.

• Survey respondents noted that needed services include clinic/urgent care, dermatology, neurology, women’s health and mental health.


Page | 79

• Stakeholders identified transportation, lack of hospital follow up care/readmissions, dental care, lack of insurance and gaps in care delivery as access needs.


Page | 80



Page | 81

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


Page | 82

Cancer Figure 34 illustrates the breast cancer incidence rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The rate in McKean County has fluctuated over the past five years and in 2009 (47.2) and 2012 (40.5) was significantly lower than Pennsylvania (69.4 in 2012). The rate in Potter County has also fluctuated and in 2012 (52.9) was lower than Pennsylvania and the nation (122.0). The breast cancer incidence rate in Cattaraugus County has been decreasing over the last three years and in 2011 (129.5) was below New York (135.8). In the most recent year data is available, McKean County (40.5) met the Healthy People 2020 Goal of 41.0, while the nation, states, and other service area counties did not. Figure 34. Breast Cancer Incidence Rates


Healthy People 2020


Page | 83

Figure 35 illustrates the breast cancer mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. Data is not available in Potter County. The rate in McKean County in 2011 (25.4) was significantly higher compared to Pennsylvania. The rate in Cattaraugus County decreased between 2010 and 2011 and in 2011 (13.1) was lower than New York (21.3). For the last year data is available, Pennsylvania (12.5) and Cattaraugus County (13.1) exceeded the Healthy People 2020 Goal on 20.6. Figure 35. Breast Cancer Mortality Rates


Healthy People 2020


Page | 84

Figure 36 illustrates the lung cancer incidence rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The rate in McKean County increased between 2011 and 2012 and in 2012 (77.1) was above the nation (73.0) and Pennsylvania (63.9). The rate in Potter County decreased between 2011 and 2012, but remained just above the nation and state in 2012 (73.4). The rate in Cattaraugus County has increased the past three years data is available and in 2011 (92.8) was above New York (68.5). The lung cancer incidence rate in the United States, Pennsylvania, New York, and the service area counties fall well above the Healthy People 2020 Goal of 20.6. Figure 36. Lung Cancer Incidence Rates


Healthy People 2020


Page | 85

Figure 37 illustrates the lung cancer mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The rate in both McKean and Potter counties decreased between 2011 and 2012, although the 2012 rate (50.2, 51.3) remained higher compared to Pennsylvania (46.5). The lung cancer incidence rate in Cattaraugus County has been decreasing over the past three years, but in 2011 (51.5) remained above New York (45.7). Compared to the Healthy People 2020 Goal of 45.5, the nation, states and service area counties fall just short of meeting the goal. Figure 37. Lung Cancer Mortality Rates


Healthy People 2020


Page | 86

Figure 38 illustrates the colorectal cancer incidence rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The rate in Potter County has been increasing over the past three years, as has the rate in McKean County between 2011 and 2012. For 2012, McKean (49.2) and Potter (51.3) counties had a higher colorectal cancer incidence rate when compared to the nation (46.1) and Pennsylvania (42.5). The rate in Cattaraugus County decreased between 2010 and 2011, but in 2011 (50.6) remained higher than New York (41.5). With the exception of McKean County in 2011, the nation, states, and service area counties fall above the Healthy People 2020 Goal of 38.6. Figure 38. Colorectal Cancer Incidence Rates


Healthy People 2020


Page | 87

Figure 39 shows that for adult respondents age 55 and older on the 2015 BRMC Community Survey, the majority (80.9%) have had a colonoscopy. Figure 39. 2015 Community Survey – Colonoscopy, Age 55 and Over, N=508



Page | 88

Figure 40 illustrates the ovarian cancer incidence rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. Data is not available for McKean and Potter counties. The ovarian cancer incidence rate has been increasing over the past four years in Cattaraugus County and has remained above the rate for New York. For all years data is available, the nation, states and county fell above the Healthy People 2020 Goal of 7.10. Figure 40. Ovarian Cancer Incidence Rates


Healthy People 2020


Page | 89

Figure 41 illustrates the ovarian cancer mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. Data is not available for McKean and Potter counties. The rate in Cattaraugus County decreased drastically from 2010 to 2011, and in 2011 (6.3) was lower than New York (7.9). For all years data is available, the nation, states, and county fall above the Healthy People 2020 Goal of 2.2. Figure 41. Ovarian Cancer Mortality Rates


Healthy People 2020


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Figure 42 illustrates the prostate cancer incidence rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The rate in McKean County was significantly lower compared to Pennsylvania in 2011, although the rate (110.7) increased the following year and was above Pennsylvania (101.7). The rate in Potter County has remained consistent the past two years and was above the state in 2012. The prostate cancer rate in Cattaraugus County has been increasing over the past three years and has remained slightly higher than New York. Figure 42. Prostate Cancer Incidence Rates



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Figure 43 shows that over a half of males (70.0%) age 65+ who responded to the 2015 BRMC Community Survey have had a prostate-specific antigen (PSA) test with the last year. All of the male respondents over the age of 65 have had a PSA test within the past five years. Figure 43. 2015 Community Survey – Length of Time Since Last PSA Test



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Figure 44 illustrates the prostate cancer mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. Data was not available for McKean or Potter Counties. The rate in Cattaraugus County has fluctuated over the past four years, and in 2011 (16.9) was lower compared to the state (18.3). In the most recent year data is available the nation, states and county all met the Healthy People 2020 Goal of 21.2. Figure 44. Prostate Cancer Mortality Rates


Healthy People 2020


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Heart Disease Figure 45 illustrates the heart disease mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The rate in McKean County has been increasing over the past four years and was significantly higher when compared to Pennsylvania in 2010 through 2012. The rate has also been above that of the nation and Pennsylvania. The rate in Potter County has been decreasing over the past three years and was significantly lower (121.6) compared to Pennsylvania (175.2) in 2012. The rate has consistently been lower compared to the nation and state. The heart disease rate in Cattaraugus County has been decreasing over the past three years, but continues to remain above the rate of the nation and New York. Figure 45. Heart Disease Mortality Rates



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Figure 46 illustrates the coronary heart disease mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The rate in McKean County has been increasing over the past four years and in 2011 and 2012 had a coronary heart disease mortality rate significantly higher when compared to Pennsylvania. The rate in Potter County had been decreasing from 2008 through 2011 and was significantly lower compared to Pennsylvania in 2011, although the rate increased in 2012. The coronary heart disease mortality rate in Cattaraugus County has been decreasing over the past three years, although the rate remains above the nation and New York. Potter County has met and exceeded the Healthy People 2020 goal of 103.4 for four of the five years, while the other counties, state and nation fall above the goal. Figure 46. Coronary Heart Disease Mortality Rates


Healthy People 2020


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Figure 47 illustrates the cardiovascular disease mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The rate in McKean County has been increasing over the past four years and was significantly higher compared to the state in 2010 through 2012. The rate in Potter County has been decreasing over the past three years and has remained below the Pennsylvania and national rate. The rate in Cattaraugus County has been decreasing over the past three years, but has remained above the nation and New York. Figure 47. Cardiovascular Disease Mortality Rates



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Figure 48 illustrates the COPD mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The COPD mortality rate in McKean County was significantly higher when compared to the state in 2008 through 2010, and has steadily been decreasing since then. The rate in Potter County has fluctuated and was significantly higher compared to the state in 2009 and 2011. The COPD mortality rate in Cattaraugus County has fluctuated over the years but has remained higher compared to New York. The nation, states, and service area counties all meet and in some cases exceeded the Healthy People 2020 Goal of 102.6. Figure 48. Chronic Lower Respiratory Disease (COPD) Mortality Rates


Healthy People 2020


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Figure 49 illustrates that just over half (52.4%) of Community Survey respondents age 65 and older have been told that they have high blood pressure, while 3.2% have been told they are borderline or pre-hypertensive. Figure 49. 2015 Community Survey – Told You Have High Blood Pressure, Age 65 and Older



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Figure 50 illustrates the cerebrovascular disease mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. The cerebrovascular disease mortality rate in McKean County has been decreasing over the past four years, while the rate in Cattaraugus County increased between 2011 and 2012. In 2012, the rate in McKean County (28.7) was less than the nation (39.9) and Pennsylvania (36.8). The rate in Cattaraugus County (39.1) was lower than the nation (39.9), but higher compared to New York (30.2). In 2012, New York and McKean County met the Healthy People 2020 Goal of 34.8. Figure 50. Cerebrovascular Disease Mortality Rates


Healthy People 2020


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Diabetes Figure 51 illustrates the diabetes mortality rate for the United States, Pennsylvania, New York, and the service are counties for years 2008 through 2012, where data is available. Data was not available for Potter County. The diabetes mortality rate in McKean County has been decreasing over the past five years, and in 2012 (22.4) was comparable to Pennsylvania (22.0). The diabetes mortality rate in Cattaraugus County nearly double between 2011 (12.2) and 2012 (23.4) and was above the New York rate in both years data was available. In 2012, the states and service area counties were much lower when compared to the nation (73.3). Pennsylvania, New York, and the service area counties all met and exceeded the Healthy People 2020 Goal of 66.6. Figure 51: Diabetes Mortality Rates


Healthy People 2020


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Figure 52 shows that a very small percentage of 2015 BRMC Community Survey respondents have ever been told they have diabetes (8.5%). The majority of respondents have not been told they have diabetes (88.0%). Figure 52. 2015 Community Survey – Ever Told By a Doctor That They Have Diabetes



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Figure 53 illustrates the percentage of 2015 BRMC Community Survey respondents who have ever been told they have diabetes, by age. One in four (27.9%) of respondents age 75 and older have been told they have diabetes, as well as one in five (20.3%) of those age 65 to 74. Figure 53. 2015 Community Survey – Ever Told By a Doctor That They Have Diabetes, By Age



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Figure 54 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 54. PRC – Child Has Diabetes



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Figure 55 illustrates that overall, 70.5% of the BRMC Community Survey respondents are considered overweight or obese. Figure 55. 2015 Community Survey – Overweight and Obese Adults



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Figure 56 shows that half of respondents in each age group on the BRMC Community Survey are considered overweight or obese. The highest percentage (78.3%) is between the ages of 18 to 24 and 65 to 74. Figure 56. 2015 Community Survey – Overweight and Obese Adults, By Age



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Figure 57 illustrates the percentage of adults who received a mammogram screening for the years 2010-2015. All three counties of McKean, Potter and Cattaraugus are showing a downward trend with regards to receiving an annual mammogram. While McKean and Potter counties are in line with the Pennsylvania percentage for 2015, Cattaraugus County (53.1%) is below the New York state percentage of 63.1%. All state and county percentages are below the Healthy People 2020 Goal of 81.1% Figure 57. Mammogram Screenings


Healthy People 2020


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Figure 58 shows that over half (53.7%) of the female BRMC Community Survey respondents had a mammogram within the past year. In contrast, 21.2% of respondents have never had a mammogram. Figure 58. 2015 Community Survey – Mammogram



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Table 9 shows that the majority of female survey respondents age 18 to 24 (89.5%) and 25 to 34 (85.9%) have never had a mammogram. Table 9. 2015 Community Survey – Never Had a Mammogram



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Figure 59 shows that slightly less than half (42.0%) of female BRMC Community Survey respondents had a pap test within the past year. A very small percentage (1.8%) reported never having had a pap test. Figure 59. 2015 Community Survey – Pap Test



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Figure 60 illustrates the percentage of respondents affected by chronic disease related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. Slightly less than half (42.3%) of the respondents are affected by high cholesterol. One in four respondents is affected by dental hygiene/dental problems (28.2%), asthma/COPD related issues (27.3%) or heart disease (25.1%). Figure 60. 2015 Community Survey – Affected By Chronic Disease Problems, 1 of 2, N=508



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Figure 61 illustrates the percentage of respondents affected by chronic disease related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. Just under half of the respondents report being affected by hypertension/high blood pressure (45.5%) or obesity and overweight (44.8%). One in three (30.7%) respondents are affected by diabetes and one in four (27.7%) are affected by cancer. Figure 61. 2015 Community Survey – Affected By Chronic Disease Problems, 2 of 2, N=508



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Figure 62 illustrates the average scores for chronic disease related problems identified during the BRMC 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. Obesity (4.0) was identified as a serious problem, while diabetes (3.4) and high rates of caner (3.3) were identified as somewhat of a problem. Figure 62. 2015 Focus Groups – Chronic Disease Needs



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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 is significantly lower in McKean County than it is in PA, however Potter and Cattaraugus County rates are higher

• McKean County’s breast cancer mortality rate is significantly higher than PA in 2009

• While the bronchus and lung cancer incidence rates in McKean and Potter Counties are comparable to the state, the Cattaraugus County rate is higher than the other counties; all are above the HP goal

• The bronchus and lung cancer incidence rate is increasing in Potter County, although mortality in decreasing; mortality in McKean and Cattaraugus Counties is increasing

• Colorectal cancer incidence rates are increasing in McKean and Potter Counties, while the rate in Cattaraugus County is decreasing, although all rates are above the HP goal

• Almost 20% of the community respondents over age 55 have not had a colonoscopy

• Prostate cancer rates are declining in all three counties • In McKean County, heart disease incidence and mortality rates have

increased over the past few years and are significantly higher than the state rates, while the rates are decreasing in Potter and Cattaraugus Counties

• Cerebrovascular mortality rates decreased in McKean County over the past few years, while they have increased in Potter and Cattaraugus Counties

• Almost 8% of community survey respondents have been told that they have diabetes; the incidence of diabetes increases with age

• Over half of the community survey respondents over age 65 have ever been told that they have high blood pressure; almost half indicated that they have high cholesterol or currently have hypertension/high blood pressure

• 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 are slightly higher in McKean and Potter Counties than the PA rate, but lower than the US rate and HP goal.


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• Focus group participants indicated that obesity, diabetes and cancer are significant community health needs.

• Stakeholders identified obesity, chronic diseases, cancer and cardiovascular diseases as community needs.


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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 63 shows the rate of asthma hospitalizations for the counties in Pennsylvania in 2010. The rate in McKean County (13.4) is slightly higher than that of Potter County (7.8). Figure 63. Asthma Hospitalizations 2010

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 BRMC’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 64 displays high school graduation rates for Pennsylvania, New York and the service area counties for 2013-2015. The high school graduation rates in both McKean and Potter Counties decreased between 2014 and 2015, while the rate in Pennsylvania and Cattaraugus County increased. When looking at the most recent year, 2015, McKean (90.0%) and Potter (88.0%) counties had a higher high school graduation rate than Pennsylvania (85.0%). During 2015, Cattaraugus County (80.0%) had a higher graduation rate compared to New York (77.0%). McKean and Potter counties have consistently met and exceeded the Healthy People 2020 goal of 82.4%, while Cattaraugus County falls just short. Figure 64. High School Graduation Rates

Source: www.countyhealthrankings.org, Healthy People 2020


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Figure 65 illustrates the percentage of children living in poverty for the Pennsylvania, New York the BRMC service area for the years 2013-2015. McKean and Potter Counties have a smaller percentage of children living in poverty when compared to the Pennsylvania, while Cattaraugus County has a higher percentage of children living in poverty compared to New York. Figure 65. Children Living in Poverty

Source: www.countyhealthrankings.org


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Figure 66 illustrates the percentage of children living in single parent homes for Pennsylvania, New York and the BRMC service area for the years 2013-2015, where data is available. The percentage of children living in single parent homes has been increasing in McKean County over the past three years, with percentages higher compared to the state and other service area counties. The percentage of children in Potter County living in single parent homes has remained consistent over the past three years and has been lower when compared to the state. The percentage of children living in single parents homes in Cattaraugus County has remained fairly consistent and has been comparable to New York. Figure 66. Children Living in Single Parent Homes

Source: www.countyhealthrankings.org


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Figure 67 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 67. PRC – Child Currently Has Asthma (US 2014)

Source: PRC National Child and Adolescent Health Surveys, 2014


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Figure 68 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 68. 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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Figure 69 illustrates the percentage of respondents affected by social or healthy environment related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. One in three (34.7%) respondents is affected by lack of safe roads and sidewalks. Figure 69. 2015 Community Survey – Affected By Social Environment Problems, 1 of 2



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Figure 70 illustrates the percentage of respondents affected by social or healthy environment related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. Just under half (43.7%) of the respondents report being affected by allergies, while one in five (19.8%) are affected by employment opportunities/lack of jobs. Figure 70. 2015 Community Survey – Affected By Social Environment Problems, 2 of 2



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Figure 71 illustrates the average scores for healthy and social environment problems identified during the BRMC 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. Poor socioeconomic conditions were identified by participants as a serious problem (4.1). Figure 71. 2015 Focus Group – Social Environment Problems



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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 McKean and Potter Counties are

higher than Cattaraugus County, the state and nation as well as the HP goal.

• The percentage of children living in poverty and single parent households in McKean County increased from 2013 to 2015.

• Over a third of the survey respondents indicated that they are affected by lack of safe roads and sidewalks and almost all are affected by allergies.


• 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.


• Focus group participants indicated that poor socio-economic conditions, education, and the welfare population are the most important environment-related needs.

• Stakeholders identified homelessness, unemployment and housing security as 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


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Figure 72 illustrates the percentage of mothers receiving prenatal care during their first trimester in the United States, Pennsylvania, New York, and the service area counties in 2008 through 2012, where data is available. McKean and Potter County had a higher percentage of mothers receiving prenatal care during their first trimester compared to Pennsylvania for all five years, which is also higher compared to the nation. The percentage of mothers in Cattaraugus County receiving prenatal care in their first trimester has been decreasing over the past four years and has been lower when compared to New York and the nation. McKean and Potter counties continue to meet and exceed the Healthy People 2020 Goal of 77.9% of mothers receiving prenatal care in the first trimester, while the nation, states and Cattaraugus County fall just short. Figure 72. Prenatal Care First Trimester

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

People 2020


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Figure 73 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. Data is not available for New York or Cattaraugus County. McKean and Potter counties had significantly fewer nonsmoking mothers during pregnancy compared to the state for all five years, which is also lower compared to the nation. The nation, state and service area counties fall short of meeting the Healthy People 2020 Goal of 98.6% of mothers not smoking during pregnancy. Figure 73. Non-Smoking Mother During Pregnancy


People 2020


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Figure 74 illustrates the percentage of nonsmoking mothers three months prior to pregnancy in the United States, Pennsylvania, New York, and the service area counties in 2008 through 2012, where data is available. Data is not available for New York or Cattaraugus County. McKean and Potter counties had significantly fewer nonsmoking mothers three months prior to pregnancy compared to the state for all five years, which is also lower compared to the nation. Figure 74. Non-Smoking Mother Three Months Prior to Pregnancy

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


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Figure 75 illustrates the percentage of low birth rate babies born in Pennsylvania for 2008 through 2012, where data is available. In 2008, McKean County (11.5%) had a significantly higher percentage of low birth rate babies born compared to Pennsylvania (8.3%), although the rate has been decreasing and was significantly lower compared to the state in 2011 (5.6%). In most years, the nation, state and service area counties fall just short of meeting the Healthy People 2020 Goal of 7.8%. Figure 75. Low Birth Rate, Babies Born in PA

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


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Figure 76 illustrates the percentage of low birth rate babies born in New York for 2008 through 2012, where data is available. Cattaraugus County has a similar percentage of low birth rate babies compared to the state. Figure 76. Low Birth Rate, Babies Born in NY

Source: NY Department of Health, Center for Disease Control


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Figure 77 illustrates percentage of mothers reporting WIC Assistance in Pennsylvania, New York, and the service area counties in 2008 through 2012, where data is available. Data was not available for New York or Cattaraugus County. McKean County had a significantly higher percentage of mothers reporting WIC Assistance for all five years when compared to Pennsylvania, as did Potter County with the exception of 2011. Figure 77. Mothers Reporting WIC Assistance



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Figure 78 illustrates percentage of mothers reporting Medicaid Assistance in Pennsylvania, New York, and the service area counties in 2008 through 2012, where data is available. Data was not available for New York or Cattaraugus County. McKean County had a significantly higher percentage of mothers reporting Medicaid Assistance for all five years when compared to Pennsylvania. Potter County had significantly more mothers reporting Medicaid Assistance compared to Pennsylvania for 2008 through 2011, with a decrease in the percentage in 2012. Figure 78. Mothers Reporting Medicaid Assistance



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Figure 79 illustrates percentage of mothers who report breastfeeding in the United States, Pennsylvania, New York, and the service area counties in 2008 through 2012, where data is available. Compared to Pennsylvania, McKean County had a significantly lower percentage of mothers reporting breastfeeding for all five years, although the percentage has been increasing. McKean County has fewer mothers breastfeeding when compared to the nation, Pennsylvania, New York and the other service area counties. For the most recent year, 2012, Pennsylvania, McKean and Cattaraugus Counties had a lower percentage of mothers breastfeeding compared to the nation. The counties, states and nation fall short of meeting the Healthy People 2020 Goal of 81.9% of mothers breastfeeding. Figure 79. Mothers Reporting Breastfeeding

Source: PA Department of Health, NY Department of Health, Center for Disease Control, Healthy

People 2020


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Figure 80 illustrates the percentage of teen live births in the United States, Pennsylvania, New York, and the service area counties from 2008 through 2012, where data is available. Data was not available for New York or Cattaraugus County. When compared to Pennsylvania, McKean County had a significantly higher percentage of teen live birth outcomes in 2008 through 2011, with the percentage decreasing in 2012. Both McKean and Potter Counties have higher teen live birth outcomes compared to both the United States and Pennsylvania. Figure 80. Teen Live Birth Outcomes, Ages 15-19



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Figure 81 illustrates infant mortality rates for the counties in Pennsylvania between 2006 and 2010. The infant mortality rate in McKean County was 6.2-8.1, while the rate in Potter County was not available due to the low number of births during those years. Figure 81. Infant Mortality

Source: Pennsylvania Department of Health -- Pennsylvania Vital Statistics 2010


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Figure 82 illustrates the percentage of students in Kindergarten through 6th grade who are considered Overweight in Pennsylvania, New York, and the service are counties for 2008 through 2012, where data is available. Compared to Pennsylvania (15.9%) in 2011, McKean County (17.0%) had a higher percentage of students considered overweight, compared to Potter County (14.4%) which was lower than the state. When looking at New York (18.4%) for 2012, Cattaraugus County (18.4%) had a higher percentage of overweight students. Figure 82. Overweight BMI, Grades K-6



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Figure 83 illustrates the percentage of students in Kindergarten through 6th grade who are considered Obese in Pennsylvania, New York, and the service are counties for 2008 through 2012, where data is available. Compared to Pennsylvania (16.7%) in 2011, McKean County (21.0%) and Potter County (19.2%) had a higher percentage of students considered obese. When looking at New York (17.2%) for 2012, Cattaraugus County (16.8%) had a slightly lower percentage of obese students. Figure 83. Obese BMI, Grades K-6



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Figure 84 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 84. 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 85 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 85. 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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Figure 86 illustrates the percentage of respondents affected by infectious disease related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. Community survey respondents were not all that affected by these problems, with the highest percentage (6.9%) being affected by lack of early childhood development/child care. Figure 86. 2015 Community Survey – Affected By Healthy Mothers, Babies, Children Problems, 1 of 2



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Figure 87 illustrates the percentage of respondents affected by healthy mothers, babies, and children related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. The items on this chart affected less than 5% of the community survey respondents. Figure 87. 2015 Community Survey – Affected By Healthy Mothers, Babies, Children Problems, 2 of 2



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Figure 88 illustrates the average scores for healthy mothers, babies and children problems identified during the BRMC 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. Participants identified lack of birth control (3.2) as somewhat of a problem. Figure 88. 2015 Focus Groups, Healthy Mothers, Babies, and Children Needs



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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:

• Prenatal care in the first trimester is increasing in McKean and Potter Counties and is significantly higher than the state rates; the rate is decreasing in Cattaraugus County and is lower than both other counties.

• Rates of non-smoking during pregnancy are significantly lower than the state rate in McKean and Potter Counties, are decreasing and are below the HP goal.

• The percentage of mothers reporting Medicaid assistance is increasing in McKean County and is significantly higher than PA. The rate is decreasing in Potter County.

• While increasing in McKean and Potter Counties, the breastfeeding rate McKean County is significantly lower than the state and below the HP goal.


• 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).


• The rates of children that are overweight and obese are increasing in all three counties.

• Focus group participants cited lack of birth control and drug use during pregnancy as important maternal/ child health needs.

• Stakeholder identified the percentage of children receiving free and reduce priced lunch, lack of vision insurance, lack of awareness of dental hygiene, women’s health and childhood obesity as the most important maternal/child health needs.


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Page | 149

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


Page | 150

Figure 89 illustrates percentage of adults age 65 and older who have had a pneumonia vaccine in the United States, Pennsylvania, New York and the service area county clusters in 2008-2010 and 2011-2013, where data is available. The Pennsylvania county clusters have a slightly lower percentage of adults receiving the pneumonia vaccine compared to the state, while Cattaraugus County has a higher percentage when compared to New York. The states and service area county clusters all fall below the Healthy People 2020 Goal of 90.0%. Figure 89. Adults Who Had Pneumonia Vaccine, Age 65 and Older


People 2020


Page | 151

Figure 90 illustrates influenza and pneumonia mortality rate for the United States, Pennsylvania, New York, and the service area county clusters in 2008 through 2012, where data is available. Data was not available for New York or Cattaraugus County. The influenza and pneumonia mortality rate in 2008 for Potter County (40.0) was significantly higher when compared to Pennsylvania (16.7). The rate was also higher than the United States (15.1) and McKean County (20.4). Figure 90. Influenza and Pneumonia Mortality



Page | 152

Figure 91 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, New York and the service area counties in 2008-2010 and 2011-2013, where data is available. Data was not available for New York or Cattaraugus County. During 2011-2013 the Potter County cluster (33.0%) had a significantly lower percentage of adults ever tested for HIV when compared to Pennsylvania (38.0%). The McKean County cluster had significantly fewer adults ever tested for HIV compared to Pennsylvania in 2008-2010 and 2011-2013. The nation, Pennsylvania and service area county clusters are well below the Healthy People 2020 Goal of 73.6%. Figure 91. Ever Tested for HIV, Adults 18-64



Page | 153

Figure 92 illustrates chlamydia rates in females in Pennsylvania, New York and the service area counties for 2008 through 2012. For all available years, the rates in McKean and Potter Counties were significantly lower when compared to Pennsylvania. In 2012, the service area counties all had a rate lower than Pennsylvania and New York. Figure 92. Chlamydia Rates, Female



Page | 154

Figure 93 illustrates chlamydia rate in males in Pennsylvania, New York, and the service area counties in 2008 through 2012, where data is available. Data was not available for Potter County. McKean County had a significantly lower chlamydia rate for males all five years when compared to the state, although the rate has been increasing over the past two years. In 2012, McKean (150.4) and Cattaraugus (99.3) Counties had rates lower then Pennsylvania (279.1) and New York (202.4). Figure 93. Chlamydia Rates, Male



Page | 155

Figure 94 illustrates the gonorrhea rate in the United States in 2012 as well as Pennsylvania, New York, and the service area counties in 2008 through 2012, where data is available. Data was not available for Potter County. The rate in McKean County was significantly lower when compared to the state in 2008, 2009, and 2012. The service area counties have a lower rate in 2012 compared to the nation, Pennsylvania and New York. Figure 94. Gonorrhea Rates



Page | 156

Figure 95 illustrates Lyme disease incidence rates in the United States in 2012, as well as Pennsylvania, New York and the service area counties in 2008 through 2012, where data is available. McKean County had a significantly higher rate of Lyme disease in 2010, 2011, and 2012 when compared to the state for the respective year. In 2012, McKean County (69.6) had a higher Lyme disease incidence rate than the nation (8.6), Pennsylvania (39.4), New York (34.6) and Cattaraugus County (5.0). Figure 95. Lyme Disease Incidence Rates



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Figure 96 illustrates the percentage of respondents affected by infectious disease related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. Slightly less than one in five (17.2%) of respondents report being affected by influenza and pneumonia. Figure 96. 2015 Community Survey – Affected By Infectious Disease



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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 Focus Groups or Stakeholder Interviews. They include:

• Pneumonia vaccine rates for those over age 65 are increasing in McKean and Potter Counties but are below the HP goal.

• Influenza and pneumonia mortality is increasing in McKean County and is higher than the state rate, which has been decreasing.

• The percentage of adults age 18-64 ever tested for HIV is increasing in McKean and Potter Counties, although it is significantly lower than the state and is below the HP goal.

• Chlamydia rates are increasing in all three counties, although they are significantly lower than the state rate in McKean and Potter Counties. Male chlamydia rates are increasing.

• Lyme Disease rates in McKean County are significantly higher than the state rates and are increasing.

• 17% of community survey respondents indicated that they are affected by influenza or pneumonia.


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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.



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Figure 97 illustrates the mental and behavioral health disorders mortality rate for the United States in 2012, as well as Pennsylvania, McKean and Potter Counties in 2008 through 2012. The state and service area counties have a lower mental and behavioral disorders mortality rate when compared to the state in 2012. The rate in 2012 in Potter County (51.3) is slightly higher compared to McKean County (43.3) and the state (43.0). The rate in Pennsylvania and Potter County have been increasing over the past five years. Figure 97. Mental and Behavioral Disorders Mortality

Source: PA Department of Health, Centers for Disease Control


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Figure 98 illustrates the percentage of adults who report binge drinking in the United States in 2013, Pennsylvania from 2011-2013 and New York and the service area county clusters from 2008-2010 and 2011-2013. Binge drinking is defined as five or more drinks in one sitting for males and four or more drinks in one sitting for females. With the exception of Cattaraugus County, Pennsylvania, New York and the other service area county clusters have a higher percentage of adults who report binge drinking during 2011-2013. During 2011-2013, the nation, Pennsylvania, New York and the service area county clusters exceeded the Healthy People 2020 Goal of 24.4%. Figure 98. Adults Who Reported Binge Drinking (Men=5 Drinks, Women=4 Drinks)


People 2020


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Figure 99 illustrates the percentage of community survey respondents who report binge drinking in the past 30 days. Binge drinking was defined as five or more drinks on the same occasion for males and four or more drinks on the same occasion for females. A slightly higher percentage of females (35.5%) reported binge drinking in the past month than males (34.9%). Figure 99. 2015 Community Survey – Binge Drinking

Source: 2015 BRMC Community Survey


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Figure 100 illustrates the percentage of community survey respondents who report having little interest or pleasure in doing things during the past two weeks. One in five (22.3%) report having little interest of pleasure in doing things several days during the past two weeks, while the majority did not experience this at all. Figure 100. 2015 Community Survey – Little Interest or Pleasure in Doing Things, Past Two Weeks



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Figure 101 illustrates the percentage of community survey respondents who report feeling down or depressed during the past two weeks. One in five (21.2%) of respondents report feeling depressed for several days during the past two weeks, while the majority (73.9%) did not. Figure 101. 2015 Community Survey – Feeling Down or Depressed, Past Two Weeks



Page | 165

Figure 102 illustrates the percentage of respondents affected by mental health and substance use related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. One in four (25.6%) respondents report being affected by Chronic Depression, while 14.5% report being affected by Alcohol Abuse. Figure 102. 2015 Community Survey – Affected By Mental Health or Substance Abuse Problems



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Figure 103 illustrates the percentage of youth in grades 6th through 12th in McKean 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 grades 10 and 12 has increased between 2011 and 2013. A higher percentage of youth in all grades report using alcohol when compared to the state, while a lower percentage report using marijuana when compared to the state. Figure 103. PAYS – McKean County Substance Use

Source: PA Youth Survey, 2009-2013


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Figure 104 illustrates the percentage of youth in grades 6th through 12th in McKean 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 (2.3), 10 (9.0) and 12 (14.0) have a higher percentage of students using pain relievers when compared to the state. The percentage is also increasing for students in 10th and 12th grades, as well as overall. Figure 104. PAYS – McKean County Pain Reliever Use



Page | 168

Figure 105 illustrates the percentage of youth in grades 6th through 12th in McKean 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 with the exception of students in 8th grade with a slightly smaller percentage. Figure 105. PAYS – McKean County Risky Behaviors



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Figure 106 illustrates the percentage of youth in grades 6th through 12th in Potter 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. A higher percentage of youth in grades 6 (22.7), 8 (35.1) and 10 (67.5) report using alcohol in 2013 in Potter County than the state and nation. Youth in grades 6 (2.8) and 8 (8.8) also report a higher percentage of marijuana youth than the state. Figure 106. PAYS – Potter County Substance Use



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Figure 107 illustrates the percentage of youth in grades 6th through 12th in Potter 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 (6.1) and 10 (9.6) had higher rates of students using pain relievers when compared to the state (4.1, 8.3). Figure 107. PAYS - Potter County Pain Reliever Use



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Figure 108 illustrates the percentage of youth in grades 6th through 12th in Potter County who report driving after alcohol or marijuana use in 2009, 2011, and 2013, as well as in Pennsylvania and nation in 2013, where data is available. Potter County had a higher percentage of students overall who report driving after alcohol or marijuana use when compared to the state. Youth in grades 6 (1.4) and 8 (2.7) were more likely to have driven after alcohol use when compared to the state (0.2, 0.4), while those in 8th grade (1.3) were also more likely to have driven after marijuana use when compared to the state (0.4) Figure 108. PAYS - McKean County Risky Behavior



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Figure 109 illustrates the average scores for mental health and substance use problems identified during the BRMC 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. Prescription Drug Abuse (4.2) and Substance Abuse (4.2) were identified as Serious Problems. Figure 109. 2015 Focus Groups – Mental Health and Substance Abuse Problems

Source: 2015 BRMC 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 disorder mortality rates have been increasing in McKean and Potter Counties over the past 5 years.

• Over a quarter of the community survey respondents have been bothered by little interest or pleasure or have been depressed more than several days over the past two weeks or express that they are affected by chronic depression.

• Over half of the survey respondents had difficulty sleeping. • Youth alcohol and prescription narcotic drug use increases with age

throughout high school and has increased over the past four years in both McKean and Potter Counties.

• Marijuana use has increased over the past four years in Potter County. • Youth driving after drinking has decreased slightly over the past few

years while driving after marijuana has increased. • Focus group participants identified prescription drug abuse, substance

abuse mental health and alcohol abuse as serious problems in the community.

• Stakeholders identified mental health, substance abuse, prescription drug use and the need for rehab and better care coordination as community needs.


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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.



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Figure 110 illustrates the percentage of individuals in the United States in 2013, as well as Pennsylvania and the BRMC service region counties in 2008-2010, where data is available. There is no data available for New York or Cattaraugus County. The service area county clusters (27.0% and 29.0%) have higher rates when compared to the nation (23.9%) and Pennsylvania (25.0%). The service area counties, nation, and Pennsylvania all exceeded the Healthy People 2020 goal of 32.6%. Figure 110. No Leisure Time/Physical Activity, Past Month


People 2020


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Figure 111 illustrates the percentage of BRMC 2015 Community Survey respondents who reported being physically active during the past 30 days. The majority (84.4%) of respondents report being physical active during the past 30 days. Figure 111. 2015 Community Survey – Physical Activity, Past 30 Days



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Figure 112 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 112. 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 113 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 113. 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 114 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 114. PRC – Hours of Children’s Screen Time (US Children Age 5-17, 2014)



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Figure 115 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 115. 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 116 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 116. PRC – Percentage of Children Having Five or More Servings of Fruits/Vegetables per Day



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Table 117 illustrates the percentage of respondents on the 2015 BRMC Community Survey who report daily receiving five or more servings of fruits and vegetables. One in five (21.1%) of the respondents report consuming five or more servings of fruit per day, while less than one in ten (9.1%) report consuming five or more servings of vegetables per day. Table 117. 2015 Community Survey – Five or More Servings Fruits and Vegetables Per Day



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Figure 118 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 118. PRC – Number of Fast Food Meals Children Consume (US Children Age 2-17, 2014)



Page | 185

Figure 119 illustrates the percentage of respondents affected by physical activity and nutrition related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. One in four (27.7%) of the respondents is affected by lack of recreation opportunities. A third of the respondents (34.5%) are affected by access to high quality affordable foods. Slightly less than half (40.2%) are affected by lack of exercise/physical activity. Figure 119. 2015 Community Survey – Affected By Physical Activity and Nutrition Problems



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Figure 120 illustrates the average scores for the physical activity and nutrition related health problems identified during the BRMC 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. Nutrition Education and Consequences of Chosen Diet (4.1) and Lack of Affordable Exercise Programs (4.0) were identified as Serious Problems. Figure 120. 2015 Focus Groups - Physical Activity and Nutrition Problems



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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:

• 15% of community survey respondents indicated that they have no physical activity.

• Less than a quarter of respondents eat the appropriate amounts of fruits and vegetables.

• Over a third of survey respondents indicated that they are affected by a lack of high quality affordable foods and over 40% are affected by lack of exercise/ physical activity.

• 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 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.

• Focus group participants indicated that nutrition education, lack of affordable exercise programs, lack of gyms and poor nutrition are serious problems in the community.

• Stakeholders indicated that nutrition and nutrition education, access to healthy food, inactivity and lack of exercise and the high cost of gym memberships are community needs.


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Page | 189

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 121 illustrates the percentage of adults who report being a current smoker in the United States in 2013, as well as Pennsylvania and the service area counties during 2008-2010 and 2011-2013. Data was not available for New York and Cattaraugus County. During 2008-2010, the county cluster which includes McKean County (29.0%) had a significantly higher percentage of adults who report being a current smoker when compared to Pennsylvania (20.0%), although the rate did decrease between 2008-2010 and 2011-2013. The United States, Pennsylvania, and service area counties all exceed the Healthy People 2020 Goal of 12% of the population reporting being a current smoker. Figure 121. Adults Who Reported Being a Current Smoker


People 2020


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Figure 122 illustrates the percentage of adults who report never being a smoker in the United States in 2013, as well as Pennsylvania and the service area counties during 2008-2010 and 2011-2013. Data is not available for New York and Cattaraugus County. During 2011 through 2013, the service area counties (52.0%) have slightly fewer adults who report never being a smoker when compared to the nation (55.0%) and Pennsylvania (53.0%). The percentage of adults who report never being a smoker in the county cluster which includes McKean County increased between 2008-2010 and 2011-2013. Figure 122. Adults Reported Never Being a Smoker


People 2020


Page | 192

Figure 123 illustrates the percentage of smokers in the community on the BRMC 2015 Community Survey. An overwhelmingly majority of the respondents (85.5%) do not smoke. Figure 123. 2015 Community Survey – Percent of Current Smokers



Page | 193

Figure 124 illustrates the number of cigarettes per day by smokers on the BRMC 2015 Community Survey. Respondents were asked to share how many cigarettes per day they smoke. Almost half (42.9) of respondents reported that they smoke between 6 and 10 cigarettes per day, with an additional 33.8% smoking more than 10 cigarettes per day. Figure 124. 2015 Community Survey – Number of Cigarettes per Day



Page | 194

Figure 125 illustrates the percentage of adults ages during 2011-2013 in Pennsylvania and the service area counties who report currently using chewing tobacco, snuff or snus somewhat or every day. No data was available for New York or Cattaraugus County. The service area clusters which include Potter (9.0%) and McKean (12.0%) counties have a significantly higher percentage of adults who report using smokeless tobacco when compared to Pennsylvania (4.0%). The counties also have double the percentage of adults using smokeless tobacco when compared to the nation (4.2%). Figure 125. Adults Reported Currently Using Chewing Tobacco, Snuff, Snus, Somewhat or Everyday



Page | 195

Figure 126 illustrates the percentage of adults ages 18 through 44 during 2011-2013 in Pennsylvania and the service area counties who report currently using chewing tobacco, snuff or snus somewhat or every day. No data was available for New York or Cattaraugus County. The service area clusters which include Potter (13.0%) and McKean (15.0%) counties have a significantly higher percentage of adults ages 18 to 44 who report using smokeless tobacco when compared to Pennsylvania (6.0%). Figure 126. Adults Reported Currently Using Chewing Tobacco, Snuff, Snus, Somewhat or Everyday, Ages 18-44



Page | 196

Figure 127 illustrates the percentage of adults who quit smoking at least one day in the past year in 2008-2010 and 2011-2013 for Pennsylvania and the service area counties. Data was not available for New York and Cattaraugus County. The service area counties show a decrease in the percentage of adults who have quit smoking in the past year between 2008-2010 and 2011-2013. During 2011-2013, the service area counties had fewer adults that quit smoking when compared to Pennsylvania, which is also showing an increase in the percentage of adults who quit smoking. Pennsylvania and the service around counties are well below meeting the Healthy People 2020 Goal of 80.0% of adults quitting smoking at least one day in the past year. Figure 127. Adults Who Quit Smoking at Least One Day in the Past Year


People 2020


Page | 197

Figure 128 illustrates the percentage of adults who report being an everyday smoker in the United States in 2013, as well as Pennsylvania and the BRMC service area counties in 2008-2010 and 2011-2013. No data was available for New York. In 2008-2010, the county cluster which includes McKean County (24.0%) had significantly more adults report being an every day smoker when compared to Pennsylvania (15.0%). The percentage was also higher when compared to the other counties, although it did decrease in the following years. During 2011-2013, the service area counties (19.0% and 18.0%) had higher rates of adults reporting being an everyday smoker when compared to the nation (13.4%) and Pennsylvania (16.0%). Figure 128. Adults Reported Being an Everyday Smoker



Page | 198

Figure 129 illustrates the percentage of respondents who use chewing tobacco, snuff, or snus in the community on the BRMC 2015 Community Survey. An overwhelmingly majority of the respondents (94.1%) do not use any form of smokeless tobacco. Figure 129. 2015 Community Survey – Percent Use Chewing Tobacco, Snuff, or Snus



Page | 199

Figure 130 illustrates the percentage of respondents affected by tobacco use related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue affected them or a family member. Slightly less than one in five (17.9%) of the respondents report being affected by Tobacco Use. Figure 130. 2015 Community Survey – Affected By Tobacco Use Problems



Page | 200

Figure 131 illustrates the average scores for tobacco use problems identified during the BRMC 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 (4.1) was identified as a Serious Problem. Figure 131. 2015 Focus Groups – Tobacco Use Problems



Page | 201

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

• Smoking rates in the region are about double the HP goal (about 23%) although only 17% of the survey respondents indicated that they were affected by tobacco use.

• The percentage of people who have quit smoking for at least one day in the past year has decreased in the region and is much lower than the HP goal.

• The percentage of adults in McKean County using chewing tobacco is significantly higher than the state rate.

• Focus group participants indicated that tobacco use is a serious problem in the community.


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Page | 203

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 132 illustrates auto accident mortality rates in the United States in 2010 and 2012, as well as Pennsylvania, New York, and the BRMC hospital service area counties from 2008 through 2012, where data is available. The rate in McKean County in 2008 (28.0) was significantly higher when compared to Pennsylvania (11.9), and was higher when compared to the other service area counties. The rate in Cattaraugus County has steadily been decreasing since 2010, with rates in 2012 lower than the state, Pennsylvania and New York. In the most recent year, the nation, both states, and Cattaraugus County exceeded the Healthy People 2020 Goal of 12.4. Figure 132. Mortality Rate for Auto Accidents


People 2020


Page | 205

Figure 133 illustrates suicide mortality rates in the United States in 2010 and 2012, as well as Pennsylvania, New York and the BRMC hospital service area counties from 2008 through 2012, where data is available. In the most recent year, Pennsylvania (12.1), New York (9.7), and Cattaraugus County (13.7) all had higher suicide mortality rates when compared to the United States (4.5). When compared to the Healthy People 2020 Goal of 10.2, in 2012 both the nation and New York exceeded the Health People 2020 Goal. Figure 133. Suicide Mortality Rates


People 2020


Page | 206

Figure 134 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 134. PRC – Children Injured Seriously Enough to Need Medical Treatment, Past Year



Page | 207

Figure 135 illustrates the percentage of respondents who indicated being affected in some way by the injury related health problems on the BRMC 2015 Community Survey. Respondents were asked to rate the extent each community health issue has affected them or a family member. Slightly less than one in five (16.3%) of the respondents have been affected by Texting and Driving. Figure 135. 2015 Community Survey – Affected By Injury Problems



Page | 208

Figure 136 illustrates the average scores for the injury related health problems identified during the BRMC 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. Child Abuse (3.4) and Sexual Abuse (3.1) were identified as Somewhat of a Problem. Figure 136. 2015 Focus Groups – Injury Problems



Page | 209

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, although the topic was not discussed in stakeholder interviews. These include:

• About 17% of the survey respondents indicated that they were affected by texting and driving.

• 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%).

• Focus group respondents identified child abuse and sexual abuse as serious problems in the community.


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2015 Bradford Regional Medical Center Community Health Needs Assessment Report Supplemental Data Resource Appendix D – Prioritization Criteria Listings

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Appendix D

Prioritization Criteria Listings


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Table 10. BRMC CHNA Prioritization Survey - Sorted by Total Answer Options

Accountable Role

Magnitude Impact Capacity Total


9.23 6.48 6.45 7.90 30.06

Access: Specialty Medical Care 9.17 7.32 8.14 6.14 30.77


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

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


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


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


6.23 6.90 8.17 6.50 27.80

Access: Elder Care Services 6.06 5.69 7.93 6.90 26.58


5.83 6.86 8.50 6.28 27.47


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


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


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Answer Options Accountable

Role Magnitude Impact Capacity Total

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


3.87 7.79 8.00 6.07 25.73


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


3.07 7.31 8.04 6.34 24.76

Injury: Child Abuse 3.06 7.24 7.75 6.38 24.43


3.03 6.59 8.14 6.41 24.17

Injury: Sexual Abuse 2.84 6.40 7.62 6.34 23.20


2.35 5.00 7.14 4.72 19.21


2.19 6.11 7.79 5.10 21.19

Table 11. BRMC 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

M+I of 14.0 or greater


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Total M + I

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

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


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Total M + I


2.35 5.00 7.14 4.72 19.21 12.14


2.19 6.11 7.79 5.10 21.19 13.90

Table 12. BRMC 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


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


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Role Magnitude Impact Capacity Total Total M, I, C


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

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 13. BRMC 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

2015 Bradford Regional Medical Center Community Health Needs Assessment Report Supplemental Data Resource Appendix E – Stakeholder Interview Guide

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Appendix E

Community Survey Questions


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Bradford Regional Medical Center is interested in learning about the health of the residents in McKean and Potter Counties. Your input in this process is very important. We are asking that you complete this survey that will help us to identify the needs of our community so that we can work together to address those needs. The survey should take approximately 5-10 minutes to complete, and we ask that you please complete by August 10, 2015. Your responses are important and will provide us with information that will allow us to identify the most pressing needs of our community so that we might all work together to address those needs. Please note that your responses are completely anonymous. If you have questions regarding the survey, or need assistance completing this survey please contact Jacqui or Kathy at 1-866-480-8003. Thank you for your participation! 1. How would you rate your (personal) overall health? Excellent Very Good Good Fair Poor 2. Overall, how would you rate the health status of your community? Excellent Very Good Good Fair Poor 3. What is your gender? Male Female 4. During the past month, other than your regular job, did you participate

in any physical activities or exercises such as running, aerobics, golf, gardening, or walking for exercise?

Yes No Don't Know 5. Do you have a regular health care provider? Yes (Skip to question 7) No Don't Know (Skip to question 7)


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6. If you do not have or use a regular health care provider, please tell us why:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7. Do you have any kind of medical insurance coverage, including health

insurance, prepaid plans such as HMO’s or government plans such as Medicare?

Yes No Don't Know 8. Sigmoidoscopy and colonoscopy are exams in which a tube is

inserted in the rectum to view the colon for signs of cancer or other health problems. Have you ever had either of these exams?

Yes No Don't Know 9. Do you currently use chewing tobacco, snuff, or snus every day, some

days, or not at all? (Note: snus [Swedish for snuff] is a moist smokeless tobacco, usually sold in small pouches that are placed under the lip against the gum)

Every day Some days Not at all 10. Do you currently smoke? Yes No (Skip to question 12) 11. Please enter the number of cigarettes smoked per day: ___________ 12. Have you ever been told by a doctor, nurse, or other health care

professional that you have high blood pressure? Yes Yes, but only during pregnancy No Told borderline or pre-hypersensitive Don't Know 13. Have you ever been told by a doctor that you have diabetes?


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Yes Yes, but only during pregnancy No No, pre-diabetes or borderline diabetes Don't Know 14. About how long has it been since you last had your blood pressure

checked by a doctor, nurse, or other health care provider? Less than 6 months 6 months to less than 12 months 12 months to less than 2 years 2 years to less than 5 years 5 years or more Never 15. About how long has it been since you last visited a doctor for a routine

checkup? A routine checkup is a physical exam, not an exam for a specific injury, illness, or condition.

Less than 6 months 6 months to less than 12 months 12 months to less than 2 years 2 years to less than 5 years 5 years or more Never 16. About how long has it been since you last visited a dentist or dental

clinic for any reason? (Include visits to specialists, such as orthodontists)

Less than 6 months 6 months to less than 12 months 12 months to less than 2 years 2 years to less than 5 years 5 years or more Never 17. About how long has it been since you last had your cholesterol checked? Less than 6 months 6 months to less than 12 months 12 months to less than 2 years 2 years to less than 5 years 5 years or more Never 18. FEMALES ONLY: How long has it been since your last Pap test? Less than 6 months


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6 to less than 12 months 12 months to less than 2 years 2 years to less than 5 years 5 years or more Never had one 19. FEMALES ONLY: How long has it been since your last mammogram? Less than 6 months 6 to less than 12 months 12 months to less than 2 years 2 years to less than 5 years 5 years or more Never had one 20. MALES ONLY: A prostate-specific Antigen test, also called a PSA

test, is a blood test used to check men for prostate cancer. How long has it been since your last PSA test?

Less than 6 months 6 to less than 12 months 12 months to less than 2 years 2 years to less than 5 years 5 years or more Never had one 21. During the past month, not counting juice, how many times per day,

week, or month did you eat fruit? (Count fresh, frozen or canned fruit) Day _____ Week _____ Month _____ 22. During the past month, how many times per day, week, or month did

you eat dark green vegetables for example broccoli or leafy greens including romaine, chard, collard greens, or spinach?

Day _____ Week _____ Month _____ 23. FEMALES ONLY: Considering all types of alcoholic beverages, how

many times in the last 30 days have you had 4 or more drinks on the same occasion (at the same time or within a couple of hours of each other)? ________

24. MALES ONLY: Considering all types of alcoholic beverages, how

many times in the last 30 days have you had 5 or more on the same


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occasion (at the same time or within a couple of hours of each other)? ________

25. In the last 30 days, what is the largest number of drinks that you have

had on any one occasion? ________ 26. Over the past two weeks, how often have you been bothered by little

interest or pleasure in doing things? Not at all Several days More than half the days Nearly every day 27. Over the past two weeks, how often have you been bothered by

feeling down, depressed, or hopeless? Not at all Several days More than half the days Nearly every day 28. Over the past two weeks, how often have you had trouble falling

asleep or staying asleep or sleeping too much? Not at all Several days More than half the days Nearly every day 29. About how much do you weigh without shoes? _____________ 30. About how tall are you without shoes? Feet ___________________ Inches ___________________


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Social and Environmental Issues 31. Have the following directly affected you or your family in the last 24 months? Very

Serious Affect

Serious Affect

Somewhat of an Affect

Small Affect

No Affect

Affordable and Adequate Housing

□ □ □ □ □

Homelessness □ □ □ □ □ Employment Opportunities/ Lack of Jobs

□ □ □ □ □

Poverty □ □ □ □ □ Lack of Recreational Opportunities

□ □ □ □ □

Lack of Safe Roads and Sidewalks

□ □ □ □ □

Lack of Early Childhood Development/Child Care

□ □ □ □ □

Access to High Quality Affordable Healthy Foods

□ □ □ □ □

Behaviors 32. Have the following directly affected you or your family in the last 24 months? Very

Serious Affect

Serious Affect


Small Affect

No Affect

Alcohol Abuse □ □ □ □ □ Prescription Drug Abuse □ □ □ □ □ Illegal Drug Use □ □ □ □ □ Crime □ □ □ □ □ Delinquency/Youth Crime □ □ □ □ □ Domestic Violence □ □ □ □ □ Sexual Abuse □ □ □ □ □ Child Physical Abuse □ □ □ □ □ Child Sexual Abuse □ □ □ □ □ Child Emotional Abuse □ □ □ □ □ Child Neglect □ □ □ □ □ Violence □ □ □ □ □ Gun Violence □ □ □ □ □ Lack of Exercise/Physical Activity

□ □ □ □ □


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Very Serious Affect

Serious Affect


Small Affect

No Affect

Sexual Behaviors (unprotected, irresponsible/risky)

□ □ □ □ □

Teenage Pregnancy □ □ □ □ □ Tobacco Use □ □ □ □ □ Tobacco Use in Pregnancy □ □ □ □ □ Driving Under the Influence of Drugs or Alcohol

□ □ □ □ □

Texting and Driving □ □ □ □ □ Motor Vehicle Crash Deaths □ □ □ □ □ Gambling □ □ □ □ □ Access 33. Have the following directly affected you or your family in the last 24

months? (Consider things like coverage under your health benefit plan, cost of service, location, transportation, knowledge of providers, etc...)

Very

Serious Affect

Serious Affect


Small Affect

No Affect

Access to Insurance Coverage

□ □ □ □ □

Access to Adult Immunizations

□ □ □ □ □

Access to Childhood Immunizations

□ □ □ □ □

Access to General Health Screenings (including blood pressure, cholesterol, colorectal cancer and diabetes)

□ □ □ □ □

Access to Mental Health Care Services

□ □ □ □ □

Access to Prenatal Care □ □ □ □ □ Access to Transportation to Medical Care Providers and Services

□ □ □ □ □

Access to Women's Health Services

□ □ □ □ □

Access to Primary Medical Care Providers

□ □ □ □ □

Availability of □ □ □ □ □


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Very Serious Affect

Serious Affect


Small Affect

No Affect

Specialists/Specialty Medical Care Access to Affordable Health Care (related to copays and deductibles)

□ □ □ □ □

Access to Dementia Care Services

□ □ □ □ □

Access to Dental Care □ □ □ □ □ Access to Men’s Shelter in the Area

□ □ □ □ □

34. Was there a time in the past 12 months when you experienced any of the following: Yes No Don't Know Could not fill a prescription due to cost Could not seek medical treatment because of cost Could not get health care services because of lack

of transportation 35. What other things kept you from receiving the health care you needed in the past 12 months?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Health Problems 36. Have the following directly affected you or your family in the last 24 months? Very

Serious Affect

Serious Affect


Small Affect

No Affect

Asthma/COPD related issues □ □ □ □ □ Cancer □ □ □ □ □ Diabetes □ □ □ □ □ Influenza and Pneumonia □ □ □ □ □ Heart Disease □ □ □ □ □


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Very Serious Affect

Serious Affect


Small Affect

No Affect

Obesity and Overweight □ □ □ □ □ Childhood Obesity □ □ □ □ □ Cardiovascular Disease and Stroke

□ □ □ □ □

High Cholesterol □ □ □ □ □ Hypertension/High Blood Pressure

□ □ □ □ □

Dental Hygiene/Dental Problems

□ □ □ □ □

Allergies □ □ □ □ □ Chronic Depression □ □ □ □ □ 37. What do you feel are the top three health problems in the county you

live in? (For Example: Cancer, Diabetes, Obesity, Etc...) Your response does not need to be limited to the topics previously listed.

Problem 1

__________________________________________________________________________________________________________________________

Problem 2 __________________________________________________________________________________________________________________________

Problem 3 _________________________________________________________________________________________________________________________ 38. What do you feel are the top three social or environmental problems

in the county you live in? (For Example: High Rates of Drug Use, Poor Weather Conditions, Lack of Jobs, Etc...) Your response does not need to be limited to the topics previously listed.

Problem 1

__________________________________________________________________________________________________________________________


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Problem 2 __________________________________________________________________________________________________________________________ Problem 3 __________________________________________________________________________________________________________________________ 39. What additional health care services would you like in the area?

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The following are for statistical purposes only: 40. What is the zip code where you currently live?

14753, Limestone, NY 16740, Mount Jewett, PA 14779, Salamanca, NY 16743, Port Allegany, PA 16701, Bradford, PA 16744, Rew, PA 16720, Austin, PA 16745, Rixford, PA 16724, Crosby, PA 16746, Roulette, PA 16726, Cyclone, PA 16748, Shinglehouse, PA 16727, Derrick City, PA 16749, Smethport, PA 16729, Duke Center, PA 16750, Turtlepoint, PA 16731, Eldred, PA 16915, Coudersport, PA 16732, Gifford, PA 16923, Genesee, PA 16735, Kane, PA 16927, Harrison Valley, PA 16738, Lewis Run, PA Other, Please Specify ___________________________

41. What county do you currently live in? McKean Potter Other, Please Specify_________________________________________ 42. How many children under the age of 18 live in your household? ________


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43. Which one or more of the following would you say is your race? CHECK ALL THAT APPLY Caucasian/White Black or African American Asian Native Hawaiian or other Pacific Islander Native American

Alaska Native Other Don't Know 44. Are you Hispanic or Latino? Yes No Don't Know 45. What is the highest grade or year of school you completed? Less than 9th Grade Some High School, No Diploma High School Graduate (or GED) Some College, No Degree Associate Degree Bachelor's Degree Master's Degree Professional School Degree Doctorate Degree 46. What is your annual household income? Less than $15,000 $15,000 to less than $25,000 $25,000 to less than $50,000 $50,000 to less than $75,000 $75,000 or more 47. What is your marital status? Single, Never Married Married Divorced Widowed Separated Member of an unmarried couple


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48. What is your employment status? Currently employed for wages Self-employed Out of work for less than one year Out of work for more than one year Homemaker Student Retired Unable to work Other, Please Specify _____________________________ 49. If you are currently employed how many minutes do you travel for work one way? Less than 15 minutes 15 to 29 minutes 30 to 44 minutes 45 to 59 minutes 1 to 2 hours 2 hours or more 50. What is your age? 18-24 25-34 35-44 45-54 55-64 65-74 75 and older

Thank you very much for your time and input!

2015 Bradford Regional Medical Center Community Health Needs Assessment Report Supplemental Data Resource Appendix F – Focus Group Topic Guide

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Appendix F

Stakeholder Interview Guide


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Thank you for taking the time to talk with us to support the Bradford Regional Medical Center 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 McKean 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 is your opinion concerning an Urgent Care in the area?

8. What is your opinion regarding an assisted living facility in the community?

9. What is your opinion regarding community paramedicine being offered in the region?

10. What advice do you have for the project steering committee who is implementing this community health assessment process?

2015 Bradford Regional Medical Center Community Health Needs Assessment Report Supplemental Data Resource Appendix H – Focus Group Polling Guide

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Appendix G

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


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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?

C. What are some of the other problems that are impacting the health

of the community? (BUILD LIST INTO OPTIONFINDER).


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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?


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Appendix H

Focus Group Polling Guide


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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?

bradford regional medical center 2015 community health ... chna 2015 web.pdf · primary qualitative...

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