memorial hermann greater heights hospital...memorial hermann is a not-for-profit, community-owned,...
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2019 Community Health Needs Assessment
MEMORIAL HERMANN GREATER HEIGHTS HOSPITAL
HEALTHINSURANCE
Board Approved June 27, 2019
MemorialHermannGreaterHeightsHospitalCHNA20192
Table of Contents Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Introduction&Purpose...............................................................................................................................4SummaryofFindings...................................................................................................................................4PrioritizedAreas..........................................................................................................................................5
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 MemorialHermannGreaterHeightsHospital.............................................................................................6
Vision.......................................................................................................................................................6MissionStatement...................................................................................................................................6MemorialHermannHealthSystem.........................................................................................................6MemorialHermannGreaterHeightsHospitalServiceArea....................................................................7
Consultants..................................................................................................................................................8
Evaluation of Progress Since Prior CHNA .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 PriorityHealthNeedsandImpactfromPriorCHNA....................................................................................9
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Overview....................................................................................................................................................11SecondaryDataSources&Analysis...........................................................................................................11
SecondaryDataScoring.........................................................................................................................11DisparitiesAnalysis................................................................................................................................12
PrimaryDataMethods&Analysis.............................................................................................................12CommunitySurvey.................................................................................................................................12KeyInformantInterviews.......................................................................................................................14
DataConsiderations...................................................................................................................................16Race/EthnicGroupings..........................................................................................................................17ZipCodesandZipCodeTabulationAreas..............................................................................................17
Prioritization..............................................................................................................................................17PrioritizationProcess.............................................................................................................................17
Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Population..................................................................................................................................................20
Age.........................................................................................................................................................21Race/Ethnicity........................................................................................................................................22Language...............................................................................................................................................23
SocialandEconomicDeterminantsofHealth............................................................................................24Income...................................................................................................................................................24Poverty...................................................................................................................................................26FoodInsecurity......................................................................................................................................28Unemployment......................................................................................................................................29Education...............................................................................................................................................30Transportation.......................................................................................................................................32
SocioNeedsIndex®.....................................................................................................................................33
Data Synthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
MemorialHermannGreaterHeightsHospitalCHNA20193
Priorit ized Signif icant Health Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 PrioritizationResults..................................................................................................................................39AccesstoHealthcare..................................................................................................................................39EmotionalWell-Being................................................................................................................................43FoodasHealth...........................................................................................................................................46ExerciseIsMedicine...................................................................................................................................49
Non-Prioritized Significant Health Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 OlderAdultsandAging..............................................................................................................................51Cancers......................................................................................................................................................51Education...................................................................................................................................................52Transportation...........................................................................................................................................53Children’sHealth.......................................................................................................................................54Economy....................................................................................................................................................55
Other Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 BarrierstoCare..........................................................................................................................................56Disparities..................................................................................................................................................56
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 AppendixA:EvaluationSincePriorCHNA.................................................................................................60AppendixB.SecondaryDataMethodology...............................................................................................73AppendixC.PrimaryDataMethodology...................................................................................................93AppendixD.PrioritizationTool................................................................................................................108AppendixE.CommunityResources.........................................................................................................111
MemorialHermannGreaterHeightsHospitalCHNA20194
Executive Summary
Introduction & Purpose MemorialHermannGreaterHeightsHospital(MHGH)ispleasedtopresentits2019CommunityHealthNeedsAssessment(CHNA).ThisCHNAreportprovidesanoverviewoftheprocessandmethodsusedtoidentifyandprioritizesignificanthealthneedsacrossMemorialHermannHealthSystem’sregionalservicearea(includingMHGH),asfederallyrequiredbytheAffordableCareAct.MemorialHermannHealthSystempartneredwithConduentHealthyCommunitiesInstitute(HCI)toconducttheCHNAfor13facilities:
• MemorialHermannKatyHospital• MemorialHermannMemorialCityMedicalCenter• MemorialHermannGreaterHeightsHospital• MemorialHermannNortheastHospital• MemorialHermannSoutheastHospital• MemorialHermannSugarLandHospital• MemorialHermannSouthwestHospital• MemorialHermannTheWoodlandsMedicalCenter• MemorialHermannRehabilitationHospital–Katy• MemorialHermann–TexasMedicalCenter• TIRRMemorialHermann• MemorialHermannSurgicalHospitalKingwood• MemorialHermannSurgicalHospitalFirstColony
ThepurposeofthisCHNAistoofferacomprehensiveunderstandingofthehealthneedsinMHGH’sserviceareaandguidethehospital’splanningeffortstoaddressthoseneeds.Specialattentionhasbeengiventotheneedsofvulnerablepopulations,unmethealthneedsorgapsinservices,andinputfromthecommunity.TostandardizeeffortsacrosstheMemorialHermannHealthSystemandincreasethepotentialforimpactingtophealthneedsinthegreaterHoustonregion,communityhealthneedswereassessedandprioritizedataregional/systemlevel.Findingsfromthisreportwillbeusedtoidentifyanddevelopeffortstoimprovethehealthandqualityoflifeofresidentsinthecommunity.
Summary of Findings TheCHNAfindingsinthisreportresultfromtheanalysisofanextensivesetofsecondarydata(over100indicatorsfromnationalandstatedatasources)andprimarydatacollectedfromcommunityleaders,non-healthprofessionals,andorganizationsservingthecommunityatlarge,vulnerablepopulations,and/orpopulationswithunmethealthneeds.Throughanexaminationoftheprimaryandsecondarydata,thefollowingtophealthneedswereidentified:
MemorialHermannGreaterHeightsHospitalCHNA20195
Priorit ized Areas InMarch2019,stakeholdersfromthe13hospitalfacilitiesintheMemorialHermannHealthSystemcompletedasurveytoprioritizethesignificanthealthissues,basedoncriteriaincludinghealthimpactandriskaswellasconsiderationofMemorialHermann’sstrategicfocus.Thefollowingfourtopicswereidentifiedasprioritiestoaddress:
MHGHwilldevelopstrategiestoaddresstheseprioritiesinits2019ImplementationStrategy.
MemorialHermannHealthSystem’sSignificantHealthNeeds•AccesstoHealthServices•Cancers•Children’sHealth•Diabetes•Economy
•Education•FoodInsecurity•HeartDisease/Stroke•LackofHealthInsurance•Low-Income/Underserved
•MentalHealth•Obesity•OlderAdults/Aging•SubstanceAbuse•Transportation
MemorialHermannHealthSystem’sCHNAPriorities• AccesstoHealthcare• EmotionalWell-Being• FoodasHealth• ExerciseIsMedicine
MemorialHermannGreaterHeightsHospitalCHNA20196
Introduction
Memorial Hermann Greater Heights Hospital LocatedintheheartofHoustonadjacenttoTheHoustonHeights,MemorialHermannGreaterHeightsHospitalhasbeencaringforfamiliessince1966.A260-bedfacilitywithmorethan600affiliateddoctors,MHGreaterHeightsprovidesawiderangeofmedicalspecialties,includingheartandvascularcare,orthopedics,cancertreatment,sleeplabs,diagnosticimaging,rehabilitation,women’scare,andwoundcare.
Vision MemorialHermannwillbethepreeminenthealthsystemintheU.S.byadvancingthehealthofthoseweservethroughtrustedpartnershipswithphysicians,employeesandotherstodeliverthebestpossiblehealthsolutionswhilerelentlesslypursuingqualityandvalue.
Mission Statement MemorialHermannisanot-for-profit,community-owned,healthcaresystemwithspiritualvalues,dedicatedtoprovidinghighqualityhealthservicesinordertoimprovethehealthofthepeopleinSoutheastTexas.
Memorial Hermann Health System Oneofthelargestnot-for-profithealthsystemsinthenation,MemorialHermannHealthSystemisanintegratedsystemwithanexceptionalaffiliatedmedicalstaffandmorethan26,000employees.GovernedbyaBoardofcommunitymembers,theSystemservicesSoutheastTexasandtheGreaterHoustoncommunitywithmorethan300caredeliverysitesincluding19hospitals;thecountry’sbusiestLevel1traumacenter;anacademicmedicalcenteraffiliatedwithMcGovernMedicalSchoolatUTHealth;oneofthenation’stoprehabilitationandresearchhospitals;andnumerousspecialtyprogramsandservices.MemorialHermannhasbeenatrustedhealthcareresourceformorethan110yearsandasGreaterHouston’sonlyfull-service,clinicallyintegratedhealthsystem,wecontinuetoidentifyandmeetourregion’shealthcareneeds.AmongourdiverseportfolioisLifeFlight,thelargestandbusiestairambulanceserviceintheUnitedStates;theMemorialHermannPhysicianNetwork,MHMD,oneofthelargest,mostadvanced,andclinicallyintegratedphysicianorganizationsinthecountry;and,theMemorialHermannAccountableCareOrganization,operatingacaredeliverymodelthatgeneratesbetteroutcomesatlowercoststoconsumers,whileprovidingresidentsoftheGreaterHoustonareabroadaccesstohealthinsurancethroughtheMemorialHermannHealthInsuranceCompany.Specialtiesspanburntreatment,cancer,children’shealth,diabetesandendocrinology,digestivehealth,ear,noseandthroat,heartandvascular,lymphedema,neurosurgery,neurology,stroke,nutrition,ophthalmology,orthopedics,physicalandoccupationaltherapy,rehabilitation,roboticsurgery,sleepstudies,transplant,weightloss,women’shealth,maternityandwoundcare.SupportingtheSysteminitsimpactonoverallpopulationhealthistheCommunityBenefitCorporation.Atamarketshareof26.1%inthe‘expanded’greaterHoustonareaof12counties,ourvisionisthatMemorialHermannwillbeapreeminentintegratedhealthsystemintheU.S.byadvancingthehealthofthoseweserve.
MemorialHermannGreaterHeightsHospitalCHNA20197
Memorial Hermann Greater Heights Hospital Service Area TheserviceareaforMHGHiswithinHarrisCounty,Texas.ThegeographicboundariesoftheserviceareaareshowninFigure1.ThezipcodeswithinMHGH’sprimaryserviceareaarelistedinTable1andrepresentapproximately75%ofinpatientdischarges.
Figure1.MHGHServiceArea
Table1.ProportionofPatientPopulationServedbyZipCodeZIPCode PercentofPatient
Population77088 8.2%77022 7.7%77091 7.5%77092 6.2%77018 5.3%77009 5.1%77076 5.0%77093 4.7%77008 4.2%77026 3.5%77016 3.1%77040 2.6%77028 2.5%77037 1.7%77007 1.6%
MemorialHermannGreaterHeightsHospitalCHNA20198
ZIPCode PercentofPatientPopulation
77055 1.6%77060 1.5%77038 1.2%77078 1.2%77080 1.2%
Consultants MemorialHermannHealthSystemcommissionedConduentHealthyCommunitiesInstitute(HCI)toconductits2019CommunityHealthNeedsAssessment.HCIworkswithclientsacrossthenationtodrivecommunityhealthoutcomesbyassessingneeds,developingfocusedstrategies,identifyingappropriateinterventionprograms,establishingmonitoringsystems,andimplementingperformanceevaluationprocesses.TolearnmoreaboutConduentHealthyCommunitiesInstitute,pleasevisithttps://www.conduent.com/community-population-health.
MemorialHermannGreaterHeightsHospitalCHNA20199
Evaluation of Progress Since Prior CHNA TheCHNAprocessshouldbeviewedasathree-yearcycle.AnimportantpartofthatcycleisrevisitingtheprogressmadeonprioritytopicsfrompreviousCHNAs.Byreviewingtheactionstakentoaddresspriorityareasandevaluatingtheimpactoftheseactionsinthecommunity,anorganizationcanbetterfocusandtargetitseffortsduringthenextCHNAcycle.
Priority Health Needs and Impact from Prior CHNA MHGH’slastCHNAwasconductedin2016.ThepriorityareasinFY16-18were:
• HealthyLiving:Encourageandfosterhealthylifestylesthrougheducation,awarenessandearlydetectiontopreventillness.
• HealthcareAccess:Improvecommunityknowledgeabouthealthcareaccesspointsandreduceperceivedbarrierstocare.
• BehavioralHealth:Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.
EachoftheabovehealthtopicscorrelateswellwiththeprioritiesidentifiedforthecurrentCHNA(detailedbelow);thusMHGHwillbebuildinguponeffortsofpreviousyears.Adetailed
Figure2.CHNAProcess
AnalyzeData&
CommunityInput
PrioritizeHealthNeeds
CHNAReport&
ImplementationStrategy
Implement
EvaluateActionsTaken 3Year
Cycle
MemorialHermannGreaterHeightsHospitalCHNA201910
tabledescribingthestrategies/actionstepsandindicatorsofsuccessforeachoftheprecedingpriorityhealthtopicscanbefoundinAppendixA.MHGH’sprecedingCHNAwasmadeavailabletothepublicviathewebsiteandcommunityfeedbackdirectedtoMemorialHermann’sCommunityBenefitDepartment:http://www.memorialhermann.org/locations/heights/community-health-needs-assessment-greater-heights/.NocommentsorfeedbackwerereceivedontheprecedingCHNAatthetimethisreportwaswritten.
MemorialHermannGreaterHeightsHospitalCHNA201911
Methodology
Overview Twotypesofdatawereusedinthisassessment:primaryandsecondarydata.Primarydataaredatathathavebeencollectedforthepurposesofthiscommunityassessment.Primarydatawereobtainedthroughacommunitysurveyandkeyinformantinterviews.Secondarydataarehealthindicatordatathathavealreadybeencollectedbypublicsourcessuchasgovernmenthealthdepartments.Eachtypeofdatawasanalyzedusingauniquemethodology.FindingswereorganizedbyhealthtopicsandthensynthesizedforacomprehensiveoverviewofthehealthneedsinMHGH’sservicearea.
Secondary Data Sources & Analysis SecondarydatausedforthisassessmentwerecollectedandanalyzedfromHCI’scommunityindicatordatabase.Thisdatabase,maintainedbyresearchersandanalystsatHCI,includesover100communityindicatorsfromatleast15stateandnationaldatasources.HCIcarefullyevaluatessourcesbasedonthefollowingthreecriteria:thesourcehasavalidatedmethodologyfordatacollectionandanalysis;thesourcehasscheduled,regularpublicationoffindings;andthesourcehasdatavaluesforsmallgeographicareasorpopulations.
Secondary Data Scoring HCI’sDataScoringTool®wasusedtosystematicallysummarizemultiplecomparisonsinordertorankindicatorsbasedonhighestneed.Foreachindicator,thecommunityvaluewascomparedtoadistributionofTexasandUScounties,stateandnationalvalues,HealthyPeople2020,andsignificanttrendswerenoted.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariesbyindicatorandisdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.Thecomparisonscoresweresummarizedforeachindicator,andindicatorswerethengroupedintotopicareasforasystematicrankingofcommunityhealthneeds.PleaseseeAppendixBforfurtherdetailsonthequantitativedatascoringmethodologyaswellassecondarydatascoringresults.
Figure3.SummaryofTopicScoringAnalysis
MemorialHermannGreaterHeightsHospitalCHNA201912
Disparit ies Analysis Whenagivenindicatorhasdataavailableforsubgroupslikerace/ethnicity,ageorgender–andvaluesforthesesubgroupsincludeconfidenceintervals–significantdifferencesbetweenthesubgroups’valueandtheoverallvaluecanbedetermined.Asignificantdifferenceisdefinedastwovalueswithnon-overlappingconfidenceintervals.Onlysignificantdifferencesinwhichthevalueforasubgroupisworsethantheoverallvalueareidentified.Confidenceintervalsarenotavailableforallindicators.Inthesecases,therearenotenoughdatatodetermineiftwovaluesaresignificantlydifferentfromeachother.
Primary Data Methods & Analysis CommunityinputforMemorialHermannHealthSystemwascollectedtoexpandupontheinformationgatheredfromthesecondarydata.PrimarydatausedinthisassessmentconsistedofacommunitysurveyinEnglishandSpanishaswellaskeyinformantinterviews.SeeAppendixCforthesurveyandinterviewquestions.
Community Survey Inputfromcommunityresidentswascollectedthroughanonlinesurvey.Thissurveyconsistedof11questionsrelatedtotophealthneedsinthecommunity,individuals’perceptionoftheiroverallhealth,andweeklyexercisehabits.ThecommunitysurveywasdistributedonlinethroughSurveyMonkey®fromOctober23rdthroughNovember27thof2018.ThesurveywasmadeavailableinbothEnglishandSpanish.PapersurveyswerealsomadeavailableandanswerstothepapersurveywereenteredintotheSurveyMonkeytool.Atotalof285responseswerecollected.ResultsinthisreportarebasedontheserviceareaforMemorialHermannHealthSystem.Thiswasaconveniencesample,whichmeansresultsmaybevulnerabletoselectionbiasandmakethefindingslessgeneralizabletothepopulationasawhole.
Table2.CommunitySurveyOutreachCommunityEvent DescriptionStepHealthEvent–MoodyPark,77009
CommunityeventhostedbyMemorialHermannprovidingparkactivation,walkingtours,Zumbainstruction,and(throughapartnershipwithHoustonFoodBank)fooddistributiontolow-income,at-risk,andmostlyuninsuredresidents.
StepHealthEvent–CastilloPark,77009
CommunityeventhostedbyMemorialHermannprovidingparkactivation,walkingtours,Zumbainstruction,and(throughapartnershipwithHoustonFoodBank)fooddistributiontolow-income,at-risk,andmostlyuninsuredresidents.
MemorialHermannHealthCentersforSchools
10school-basedhealthclinicsin5schooldistricts(74schools)inHarrisandFortBendCounties,providingmedical,mentalhealth,anddentalcare,alongwithnutrition,navigation,andsummerbootcampprogramstouninsuredandunderinsuredchildrenthroughouttheGreaterHoustonarea.
WestOremYMCA,77085
Acommunity-centeredorganizationthatbringspeopletogethertobridgethegapsincommunityneeds(underservedresidents),nurturesresidents’potentialtolearn,grow,andthrive,andmobilizesthelocalcommunitytoeffectlasting,meaningfulchange.
SpringBranchCommunity
AFederallyQualifiedHealthCenter(FQHC)providingquality,affordablehealthcareservicestotheunderservedanduninsuredcommunitiesofSpring
MemorialHermannGreaterHeightsHospitalCHNA201913
Therace/ethnicitymake-upofsurveyrespondentsisshowninFigure4.ThelargestproportionofrespondentsidentifiedasHispanic/Latino(47.2%),22.4%asWhite,20.8%asBlack/AfricanAmerican,andtheremaining9.6%ofrespondentsasAsian/PacificIslander,OtherandNativeAmerican.
HealthCenter,77080
BranchandWestHouston.
WesleyCommunityCenter,77009
Amulti-purposesocialserviceagencyprovidingresidentsofHouston:short-termrent,utility,andfoodassistancetopreventhomelessnessandmaintainfamilyfinancialstability;acareerandpersonalfinancialservicecenter;andEarlyHeadStart,achilddevelopmentprogramservinginfantstotoddlerstopromoteschoolreadiness.
CompleteCommunities,Houston
PrograminitiatedbytheMayorofHoustoninfivecommunities-allhistoricallyunder-resourced,eachwithabaselevelofcommunityinvolvementandsupport,andwithdiversepopulations.Theprogramisdesignedtoenhanceaccesstoqualityaffordablehomes,jobs,well-maintainedparksandgreenspace,improvedstreetsandsidewalks,grocerystoresandotherretail,goodschoolsandtransitoptions.Communities:AcresHomes[77018,77088,77091],Gulfton[77056,77057,77081],NearNorthside[77009,77022,77026],SecondWard[77003,77011,77020],andThirdWard[77003,77004,77204].
HealthyLivingMatters
AHouston/HarrisCountyChildhoodObesityCollaborative-Acollaborativeofmulti-sectorleadersthatpromotepolicyaimedatsystem-levelandenvironmentalchangetoreducetheincidenceofchildhoodobesity.Prioritycommunitieswereselectedduetothelackofaccesstohealthyfoodoptionsandopportunitiestoengageinphysicalactivityaswellasfortheircommunityassetsandreadinessforchange.PriorityCommunities:CityofPasadena[77058,77059,77502,77503,77504,77505,77506,77507,77536,77571,77586],NearNorthside[77009,77022,77026],andFifthWard/KashmereGardens[77020,77026,and77028]
GreaterNorthsideHealthCollaborative
Non-profitcollaborativewhosegoalistoexpandactivelivingresourcesandincreaseaccesstoqualityhealthcareandhealthyfoodbypromotingresidentleadershipandcivicparticipation.
MemorialHermannGreaterHeightsHospitalCHNA201914
Figure4.SurveyRespondentsbyRace/Ethnicity
Surveyrespondentswereaskedtoselecttopissuesmostaffectingthecommunity’squalityoflife.AsshowninFigure5,themajorityofrespondentsidentifiedDiabetes,Obesity/Overweight,SubstanceAbuse,andMentalHealth&MentalDisordersastopissuesinthecommunity.
Figure5.TopIssuesAffectingQualityofLife(Survey)
Key Informant Interviews Communityinputwasalsocollectedthroughkeyinformantinterviews.
MemorialHermannHealthSystemjoinedwiththeEpiscopalHealthFoundation(EHF)intheirkeyinformantinterviewinitiativesupportingfourGreaterHoustonareahospitalsystemsinpreparingtheircommunityhealthneedsassessments.ThecollaboratinghospitalsofthisinitiativeincludeMemorialHermann,CHISt.Luke’sHealth,HoustonMethodist,andTexasChildren’s(Table3).Throughthispartnership,atotalof53interviewswereconductedwith
47.20%
22.40%
20.80%
4.80%3.60% 1.20%
Hispanic
White
AfricanAmerican
Asian/PacificIslander
Other
NativeAmerican
10%10%13%13%14%
17%23%26%26%
35%51%54%
64%69%
SexualHealthOralhealth
TeenagePregnancyReproductiveHealth
OtherRespiratory/LungDiseaseInjuries,Violence&Safety
ElderCareHeartDisease&Stroke
CancersMentalHealth&MentalDisorders
SubstanceAbuseObesity/Overweight
Diabetes
MemorialHermannGreaterHeightsHospitalCHNA201915
stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Communityleaderswithspecificexperienceworkingwithprioritypopulations,suchaswomen,children,peopleofcolor,thedisabled,andmore,werealsointerviewed.
Table3.MemorialHermannCollaborativePartners
Intotal,64keyinformantinterviewswereconductedbyphonefromAugustthroughNovember2018;53keyinformantinterviewswereconductedthroughthecollaborativeand11interviewswereconductedbyHCI.Intervieweeswhowereaskedtoparticipatewererecognizedashavingexpertiseinpublichealth,specialknowledgeofcommunityhealthneedsand/orrepresentedthebroadinterestofthecommunityservedbythehospital,and/orcouldspeaktotheneedsofmedicallyunderservedorvulnerablepopulations.Effortsweremadetoidentifyintervieweesworkinginand/orknowledgeableaboutthecountiesinMemorialHermannHealthSystem’sservicearea.AsseeninTable4,someintervieweeswereidentifiedwithknowledgeofmultiplecounties.
Table4.KeyInformantsbyCountyCounty KeyInformantsAustin IncludedinMultipleCountiesBrazoria 3Chambers 2
EpiscopalHealthFoundation’smissionistoadvancetheKingdomofGodwithspecificfocusonhumanhealthandwell-beingthroughgrants,research,andinitiativesinsupportoftheworkoftheDiocese,spanning57counties.Throughinformedaction,collaboration,empowerment,stewardship,transparency,andaccountabilitythefoundationstrivesforthetransformationofhumanlivesandorganizationswithcompassionforthepoorandpowerless.
CHISt.Luke’sHealth,apartofCatholicHealthInitiatives(CHI),oneofthenation’slargesthealthsystems,isdedicatedtoamissionofenhancingcommunityhealththroughhigh-quality,cost-effectivecare.Throughpartnershipswithphysiciansandcommunitypartners,CHISt.Luke’sHealthservesGreaterHoustonwithitscommitmenttoexcellenceandcompassionincaringforthewholepersonwhilecreatinghealthiercommunities.
HoustonMethodistisanonprofithealthcareorganizationservingGreaterHouston,dedicatedtoexcellenceinresearch,education,andpatientcare.HoustonMethodistbringscompassionandspiritualitytoallitsendeavorstohelpmeetthehealthneedsofthecommunitythroughthesystem’sICAREvalues:integrity,compassion,accountability,respect,andexcellence.
TexasChildren’sHospitalisanot-for-profitorganizationwhosemissionistocreateahealthierfutureforchildrenandwomenthroughoutGreaterHoustonandtheglobalcommunitybyleadinginpatientcare,education,andresearch.TexasChildren’siscommittedtocreatingahealthycommunityforchildrenbyprovidingthebestpediatriccarepossible,throughgroundbreakingresearchandemphasisoneducation,whilealsoofferingafullcontinuumoffamily-centeredcareforwomen,fromobstetricstowell-womancare.
MemorialHermannGreaterHeightsHospitalCHNA201916
County KeyInformantsFortBend 10Galveston 7Harris 28Liberty 1Montgomery 4SanJacinto IncludedinMultipleCountiesWalker IncludedinMultipleCountiesWaller 2Wharton 2MultipleCounties* 5
Total
64
Interviewsweretranscribedandanalyzedusingthequalitativeanalytictool,Dedoose1.Interviewexcerptswerecodedbyrelevanttopicareasandkeyhealththemes.Threeapproacheswereusedtoassesstherelativeimportanceoftheneedsdiscussedintheseinterviews.Theseapproachesincluded:thefrequencybywhichahealthtopicwasdiscussedacrossallinterviews;thefrequencybywhichatopicwasdescribedbythekeyinformantasabarrier/challenge;andthefrequencybywhichatopicwasmentionedperinterviewee.
Data Considerations Severallimitationsofdatashouldbeconsideredwhenreviewingthefindingspresentedinthisreport.Althoughthetopicsbywhichdataareorganizedcoverawiderangeofhealthandhealth-relatedareas,dataavailabilityvariesbyhealthtopic.Sometopicscontainarobustsetofsecondarydataindicators,whileothersmayhavealimitednumberofindicatorsorlimitedsubpopulationscoveredbythosespecificindicators.Datascoresrepresenttherelativecommunityhealthneedaccordingtothesecondarydataforeachtopicandshouldnotbeconsideredtobeacomprehensiveresultontheirown.Inaddition,thesescoresreflectthesecondarydataresultsforthepopulationasawhole,anddonotrepresentthehealthorsocioeconomicneedthatismuchgreaterforsomesubpopulations.Moreover,manyofthesecondarydataindicatorsincludedinthefindingsarecollectedbysurvey,andthoughspecificmethodsareusedtobestrepresentthepopulationatlarge,thesemeasuresaresubjecttoinstability,especiallyforsmallerpopulations.TheIndexofDisparityis
1DedooseVersion8.0.35,webapplicationformanaging,analyzing,andpresentingqualitativeandmixedmethodresearchdata(2018).LosAngeles,CA:SocioCulturalResearchConsultants,LLCwww.dedoose.com
*Five(5)oftheKeyInformantInterviewsrepresented2ormorecounties,including:Austin,Brazoria,Chambers,FortBend,Galveston,Harris,Liberty,Montgomery,SanJacinto,Walker,Waller,andWhartoncounties.
MemorialHermannGreaterHeightsHospitalCHNA201917
alsolimitedbydataavailability,whereindicatordatavariesbasedonthepopulationgroupsandserviceareasbeinganalyzed.
Race/Ethnic Groupings
Thesecondarydatapresentedinthisreportderivefrommultiplesources,whichmaypresentraceandethnicitydatausingdissimilarnomenclature.Forconsistencywithdatasourcesthroughoutthereport,subpopulationdatamayusedifferenttermstodescribethesameorsimilargroupsofcommunitymembers.
Zip Codes and Zip Code Tabulation Areas
ThisreportpresentsbothZIPCodeandZIPCodeTabulationArea(ZCTA)data.ZIPorZoneImprovementPlanCodeswerecreatedbytheU.S.PostalServicetoimprovemaildeliveryservice.Theyarebasedonpostalroutes,whichfactorindelivery-area,mailvolumeandgeographiclocation.Theyarenotdesignedtobeusedforstatisticalreportingandmaychangefrequently.SomeZIPCodesmayonlyincludeP.O.boxesorcoverlargeunpopulatedareas.ZCTAsorZIPCodeTabulationAreaswerecreatedbytheU.S.CensusBureauandaregeneralizedrepresentationsofZIPCodesthathavebeenassignedtocensusblocks.Therefore,ZCTAsarerepresentativeofgeographiclocationsofpopulatedareas.Inmostcases,theZCTAwillbethesameasitsZIPCode.ZCTAswillnotnecessarilyexistforZIPCodeareaswithonlybusinesses,singleormultipleaddresses,orforlargeunpopulatedareas.SinceZCTAsarebasedonthemostrecentCensusdata,theyaremorestablethanZIPCodesanddonotchangeasfrequently.DemographicsforthisreportaresourcedfromtheUnitedStatesCensusBureau,whichpresentsZCTAestimates.TablesandfiguresintheDemographicssectionofthisreportreferenceZIPCodesintitle(forpurposesoffamiliarity)butshowvaluesofZCTAs.DatafromothersourcesisrepresentativebyZIPCodesandarelabeledassuch.
Priorit ization Inordertofocuseffortsonasmallernumberofthemostsignificantcommunityissues,sixteenrepresentativesfromtheMemorialHermannHealthSystem(oneormorerepresentingeachfacility)participatedinanonlineprioritizationprocesstoprioritizethefifteensignificanthealthneedsidentifiedthroughthesecondaryandprimarydataanalyses.Theprioritizedhealthneedswillbeunderconsiderationforthedevelopmentofanimplementationplanthatwilladdresssomeofthecommunity’smostpressinghealthissues.
Priorit ization Process Toprioritizesignificanthealthneeds,MemorialHermannstakeholdersparticipatedinanonlinewebinaronMarch7,2019toreviewdatasynthesisresultsfollowedbycompletionofaprioritizationmatrixlistingsignificanthealthneedsandfourcriteriabywhichtorateeachneed.Participantsscoredeachneedforeachofthecriteriaonascalefrom1-5,with1meaningtherespondentstronglydisagreesto5meaningtherespondentstronglyagreesthatthehealthneedmeetsthecriterion.Respondentswerealsoabletoselect“Don’tKnow/Unsure”foreachhealthneed.
MemorialHermannGreaterHeightsHospitalCHNA201918
Thecriteriaforprioritizationincludedtowhatextentanissue:• Impactsmanypeopleinthecommunity• Significantlyimpactssubgroupsinthecommunity(gender,race/ethnicity,LGBTQ,etc.)• Hasinadequateexistingresourcesinthecommunity• Hashighriskfordiseaseordeath
CompletionoftheprioritizationmatrixinAppendixDresultedinnumericalscoresforeachhealthneedthatcorrespondedtohowwelleachhealthneedmetthecriteriaforprioritization.Thescoreswererankedfromhighesttolowest(Table5).
Table5.ResultsfromMemorialHermannPrioritizationMatrixSignificantHealthNeed Impacton
CommunityImpactonSubgroups
InadequateResources
HighRisk AverageScore
Obesity(Exercise,NutritionandWeight)
4.69 4.00 3.19 4.50 4.09
MentalHealth 4.44 3.44 4.50 3.75 4.03Diabetes 4.50 4.00 3.25 4.19 3.98LackofHealthInsurance 4.31 4.19 3.38 4.00 3.97Low-Income/Underserved
4.19 4.19 3.44 4.00 3.95
HeartDisease/Stroke 4.44 3.82 2.81 4.44 3.88SubstanceAbuse 3.56 3.88 3.63 4.19 3.81AccesstoHealthServices
4.00 3.94 3.25 3.88 3.77
OlderAdultsandAging 4.38 3.81 3.13 3.75 3.76FoodInsecurity 3.88 4.00 3.44 3.50 3.70Cancers 4.19 3.19 3.00 4.31 3.67Education 3.88 3.81 3.00 3.13 3.45Transportation 4.00 3.88 2.81 3.00 3.42Children'sHealth 4.00 3.50 3.00 3.19 3.42Economy 3.31 3.31 2.69 2.88 3.05Inadditiontoratingeachneedinthematrix,prioritizationparticipantswereaskedtoratethelevelofimportanceofMemorialHermann’s4strategicpillars.
1. ImprovingAccesstoHealthcarethroughprogramming,education,andsocialservicesupport;
2. AddressingEmotionalWell-being(mentalandbehavioralhealth)throughinnovativeaccesspoints;
3. PromotingtheimportanceofahealthydietthroughscreeningandcreatingaccesstonutritiousFoodasHealth;and,
4. FosteringimprovedhealththroughExerciseIsMedicinewithculturallyappropriateactivities.
MemorialHermannGreaterHeightsHospitalCHNA201919
EachoftheseintersectingpillarsconnecttoeachotherthroughvariouspointsinMemorialHermannprogramsandinitiativesadvancingthehealthofourcommunities(Figure6).
Figure6.MemorialHermann’sFourPillarsforCommunityHealth
Over93%ofparticipantsrespondedthatthe4pillarswereimportantorveryimportant.TheMemorialHermannCommunityBenefitteamreviewedthesefindings,andtakingintoaccountthealignmentoftopneedswithMemorialHermann’sstrategicfocusareas,adecisionwasmadetointegrate:
• LackofHealthInsurance,Low-Income/Underserved,andAccesstoHealthServicesintoPillar1:AccesstoHealthcare
• MentalHealthandSubstanceAbuseintoPillar2:EmotionalWell-Being• Diabetes,FoodInsecurityandHeartDisease/StrokeintoPillar3:FoodasHealth• Obesity(Exercise,NutritionandWeight)intoPillar4:ExerciseIsMedicine
Throughthissystem-wideprioritizationprocess,thefollowingfourprioritiesforMemorialHermannHealthSystemare:
• AccesstoHealthcare(addressingAccesstoHealthServices,LackofHealthInsurance,andLow-Income/Underserved)
• EmotionalWellbeing(addressingMentalHealthandSubstanceAbuse)• FoodasHealth(addressingDiabetes,FoodInsecurity,andHeartDisease/Stroke)• ExerciseIsMedicine(addressingObesity)
ThesefourhealthtopicswillbeexploredfurtherinordertounderstandhowfindingsfromthesecondaryandprimarydataanalysesresultedineachissuebeingahighpriorityhealthneedforMemorialHermannHealthSystem.
MemorialHermannGreaterHeightsHospitalCHNA201920
Demographics ThefollowingsectionexploresthedemographicprofileofMHGH’sservicearea,consistingofHarrisCounty.Thedemographicsofacommunitysignificantlyimpactitshealthprofile.Differentrace/ethnic,age,andsocioeconomicgroupshaveuniqueneedsandrequiredifferentapproachestohealthimprovementefforts.AlldemographicestimatesaresourcedfromtheU.S.CensusBureau’s2013-2017AmericanCommunitySurveyunlessotherwiseindicated.Furthermore,tablesinthissectionlistindicatorvaluesforthetop75%ofzipcodeswithinMHGH’sserviceareaindescendingorderofinpatientdischargesunlessotherwisenoted.
Population AccordingtotheU.S.CensusBureau’s2013-2017AmericanCommunitySurvey,HarrisCountyhadapopulationof4,652,980.Figure7illustratesthepopulationsizebycountyandTable6byzipcode.AsshowninTable6,themostpopulouszipcodesinMHGH’sserviceareaare77088and77040.
Figure7.HarrisCountyPopulation
Table6.PopulationbyZipCode
ZIPCode TotalPopulationEstimate77088 56,71677022 27,36477091 25,27777092 38,476
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ZIPCode TotalPopulationEstimate77018 28,07377009 37,75177076 35,14477093 44,42877008 34,49177026 22,79977016 29,59777040 48,27377028 15,72577037 20,03877007 35,82277055 45,00377060 44,54977038 30,65377078 15,82077080 45,665
AmericanCommunitySurvey,2013-2017
Age Figure8showsMHGH’sserviceareapopulationthatisunder18yearsold.Almost27%ofHarrisCounty’spopulationisunder18.HarrisCountyhasahigherproportionofresidentsunder18comparedtothestateandnationalvalues(26%and22.6%,respectively).
Figure8.PopulationUnder18
AsshowninFigure9,HarrisCountyhasasmallerproportionsofolderadultscomparedtoTexas(12.3%)andtheU.S.(15.6%).InHarrisCounty,10.2%ofresidentsareover65.
26.9%
26.0%
22.6%
20%
21%
22%
23%
24%
25%
26%
27%
28%
Harris Texas U.S.
MemorialHermannGreaterHeightsHospitalCHNA201922
Figure9.PopulationOver65
Figure10showsthatHarrisCountyhasalargerproportionofresidentsunder5yearsold(7.7%)comparedtobothTexas(7.2%)andtheU.S.(6.1%).
Figure10.PopulationUnder5
Race/Ethnicity Theraceandethnicitycompositionofapopulationisimportantinplanningforfuturecommunityneeds,particularlyforschools,businesses,communitycenters,healthcareandchildcare.Raceandethnicitydataarealsousefulforidentifyingandunderstandingdisparitiesinhousing,employment,income,andpoverty.Figure11showstheracialcompositionofresidentsinHarrisCountywith42.2%ofresidentsidentifyingasHispanicorLatino(ofanyrace);30.6%asWhite;18.5%asBlackorAfrican
10.2%
12.3%
15.6%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
Harris Texas U.S.
7.7%7.2%
6.1%
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
Harris Texas U.S.
MemorialHermannGreaterHeightsHospitalCHNA201923
American;6.8%asAsian;and1.9%asAmericanIndianandAlaskaNative,NativeHawaiianandOtherPacificIslander,“Someotherrace”,or“Twoormoreraces”.
Figure11.Race/EthnicityinHarrisCounty
Language Languageisanimportantfactortoconsiderforoutreacheffortsinordertoensurethatcommunitymembersareawareofavailableprogramsandservices.
Figure12.LanguageOtherthanEnglishSpokenatHome
Figure12showstheproportionofresidentsinHarrisCountywhospeakalanguageotherthanEnglishathome.Almost44%ofresidentsinHarrisCountyspeakalanguageotherthanEnglishascomparedto35.3%inTexasand21.3%intheU.S.Thisisanimportantconsiderationfortheeffectivenessofservicesandoutreachefforts,whichmaybemoreeffectiveifconductedinlanguagesotherthanEnglishalone.
30.6%
18.5%6.8%
42.2%
1.9%White,non-Hispanic
BlackorAfricanAmerican
Asian
HispanicorLatino(ofanyrace)
Other
43.7%
35.3%
21.3%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Harris Texas U.S.
MemorialHermannGreaterHeightsHospitalCHNA201924
Table7.PopulationwithDifficultySpeakingEnglishbyZipCode
ZIPCode
DifficultySpeakingEnglish
77088 27.3%77022 44.6%77091 22.7%77092 30.3%77018 13.1%77009 22.8%77076 63.9%77093 51.2%77008 5.9%77026 23.0%77016 14.7%77040 25.8%77028 9.2%77037 72.3%77007 4.7%77055 30.2%77060 55.4%77038 52.9%77078 16.9%77080 37.1%Harris 20.4%Texas 14.1%
AmericanCommunitySurvey,2013-2017
AsshowninTable7,HarrisCountyhasalargerproportionofresidentswithdifficultyspeakingEnglish(20.4%)comparedtothestateofTexas(14.1%).InHarrisCounty,overhalfofresidentsinzipcodes77076,77093,77037,77060,and77038havedifficultyspeakingEnglish.WithinMHGH’stopzipcodesforinpatientdischarges(77088and77022),overaquarterofcommunitymembershavedifficultyspeakingEnglish.
Social and Economic Determinants of Health Thissectionexplorestheeconomic,environmental,andsocialdeterminantsofhealthinMHGH’sservicearea.Socialdeterminantsaretheconditionsinwhichpeopleareborn,grow,work,live,andage,andthewidersetofforcesandsystemsshapingtheconditionsofdailylife.
Income Medianhouseholdincomereflectstherelativeaffluenceandprosperityofanarea.Areaswithhighermedianhouseholdincomesarelikelytohaveagreatershareofeducatedresidentsandlowerunemploymentrates.Figure13comparesthemedianhouseholdincomevaluesforHarrisCountytothemedianhouseholdincomevalueforTexasandtheU.S.Asshown,HarrisCounty’smedianhousehold
MemorialHermannGreaterHeightsHospitalCHNA201925
income($57,791)isslightlyhigherthanthestateandnationalvalues($57,051and$57,652,respectively).
Figure13.MedianHouseholdIncome
AsdisplayedinTable8,MHGH’stopzipcodesforinpatientdischargesrevealarelativelylowrangeinmedianhouseholdincome.Thetopfourzipcodesallhavemedianhouseholdincomeslowerthanthestatevalue($57,051),rangingbetween$30,164inzipcode77022and$44,472inzipcode77088.
Table8.MedianHouseholdIncomebyZipCodeZIPCode MedianHousehold
Income77088 $44,47277022 $30,16477091 $32,50077092 $39,92177018 $81,56577009 $49,38377076 $34,84277093 $30,83777008 $97,69077026 $26,64477016 $32,30277040 $55,43877028 $30,233
$57,791
$57,051
$57,652
$56,600
$56,800
$57,000
$57,200
$57,400
$57,600
$57,800
$58,000
Harris Texas U.S.
MemorialHermannGreaterHeightsHospitalCHNA201926
ZIPCode MedianHouseholdIncome
77037 $41,49177007 $121,45877055 $52,26977060 $28,94877038 $41,34777078 $35,77077080 $44,386Harris $57,791Texas $57,051
AmericanCommunitySurvey,2013-2017
Poverty FederalpovertythresholdsareseteveryyearbytheCensusBureauandvarybysizeoffamilyandagesoffamilymembers.Ahighpovertyrateisbothacauseandaconsequenceofpooreconomicconditions.Figure14showstheproportionofresidentslivingbelowthepovertylevelinHarrisCountycomparedtothestateandtheU.S.ThepercentageofresidentslivingbelowthepovertylevelinHarrisCountyis16.8%,whichishigherthanthenationalvalue(14.6%)andslightlyhigherthanthestatevalue(16.0%).
Figure14.PeopleLivingBelowPovertyLevel
Figure15showstheproportionofresidentslivingbelowthepovertylevelbyrace/ethnicity.InHarrisCounty,22.6%ofHispanicorLatinoresidentsand21.8%ofBlackorAfricanAmerican
16.8%
16.0%
14.6%
14%
14%
15%
15%
16%
16%
17%
17%
Harris Texas U.S.
MemorialHermannGreaterHeightsHospitalCHNA201927
residentslivebelowthepovertylevel,comparedto7%Whiteand11.4%Asianresidents.ThepercentageofBlackandAsianresidentslivingbelowthepovertylevelinHarrisCountyishigherthanthestatevaluesforBlackandAsianresidents.
Figure15.PeopleLivingBelowPovertyLevelbyRace/Ethnicity
Figure16.PeopleLivingBelowPovertyLevelbyZipCode
7.0%
21.8%
11.4%
22.6%
8.8%
21.4%
10.6%
23.0%
10.3%
25.2%
11.9%
22.2%
0%
5%
10%
15%
20%
25%
30%
White,non-Hispanic BlackorAfricanAmerican
Asian HispanicorLatino
Harris Texas U.S.
MemorialHermannGreaterHeightsHospitalCHNA201928
ThepovertyrateinHarrisCounty(16.8%)issimilartotheTexasvalue(16.0%)(Table9.)AsshowninFigure16andTable9,withinMHGH’sservicearea,over30%ofresidentsinzipcodes77076,77093,77026,and77060arelivingbelowthepovertylevel.MHGH’stopzipcodesforinpatientdischarges,77088and77022,haveover20%ofresidentslivingbelowthepovertylevel.
Table9.PeopleLivingBelowPovertyLevelbyZipCodeZIPCode PeopleLivingBelow
PovertyLevel
77088 21.0%77022 29.6%77091 28.5%77092 26.5%77018 17.5%77009 24.3%77076 33.7%77093 36.6%77008 6.0%77026 38.8%77016 26.1%77040 13.2%77028 28.0%77037 26.3%77007 6.0%77055 22.8%77060 37.1%77038 25.8%77078 21.9%77080 25.1%Harris 16.8%Texas 16.0%
AmericanCommunitySurvey,2013-2017
Food Insecurity TheSupplementalNutritionAssistanceProgram(SNAP)isafederalassistanceprogramthatprovideslow-incomefamilieswithelectronicbenefittransfers(EBTs)thatcanbeusedtopurchasefood.Thegoaloftheprogramistoincreasefoodsecurityandreducehungerbyincreasingaccesstonutritiousfood.Table10showsthepercentofhouseholdswithchildrenthatparticipateinSNAPinthezipcodeswithinMHGH’sservicearea.HarrisCountyhasaslightlyhigherproportionofhouseholdswithchildrenreceivingSNAP(67.7%)comparedtothestateofTexas(64.3%).WithinMHGH’stoptenzipcodesforinpatientdischarges,77092,77076,and77093allhaveproportionshigher
MemorialHermannGreaterHeightsHospitalCHNA201929
than70%.Furthermore,zipcodes77037,77038,and77080allhavemorethan80%ofhouseholdswithchildrenreceivingSNAP.
Table10.HouseholdswithChildrenReceivingSNAPbyZipCodeZIPCode HouseholdswithChildren
ReceivingSNAP77088 67.8%77022 52.7%77091 50.8%77092 71.4%77018 49.0%77009 58.7%77076 77.4%77093 71.6%77008 34.6%77026 49.2%77016 57.4%77040 65.6%77028 41.6%77037 81.7%77007 15.4%77055 72.4%77060 77.3%77038 81.1%77078 74.0%77080 81.3%Harris 67.7%Texas 64.3%
AmericanCommunitySurvey,2013-2017
Unemployment Theunemploymentrateisakeyindicatorofthelocaleconomy.Unemploymentoccurswhenlocalbusinessesarenotabletosupplyenoughappropriatejobsforlocalemployeesand/orwhenthelaborforceisnotabletosupplyappropriateskillstoemployers.Ahighrateofunemploymenthaspersonalandsocietaleffects.Duringperiodsofunemployment,individualsarelikelytofeelsevereeconomicstrainandmentalstress.Unemploymentisalsorelatedtoaccesstohealthcare,asmanyindividualsreceivehealthinsurancethroughtheiremployer.Ahighunemploymentrateplacesstrainonfinancialsupportsystems,asunemployedpersonsqualifyforunemploymentbenefitsandfoodstampprograms.Figure17displaystherateofunemploymentinHarrisCountybetweenMay2017andNovember2018.Althoughtheunemploymentratehasexhibitedadecrease,itremainshigher(3.8%)comparedtothestateandnationalrates(both3.5%)inNovember2018.
MemorialHermannGreaterHeightsHospitalCHNA201930
Figure17.UnemploymentRateperCounty(U.S.BureauofLaborStatistics,2017-2018)
Education Graduatingfromhighschoolisanimportantpersonalachievementandisessentialforanindividual’ssocialandeconomicadvancement.Graduationratescanalsobeanimportantindicatoroftheperformanceofaneducationalsystem.Havingabachelor’sdegreeopensupcareeropportunitiesinavarietyoffieldsandisoftenaprerequisiteforhigher-payingjobs.Figure18displaystheproportionofresidentsinHarrisCountywhoare25yearsandolderwithatleastahighschooldegree.Approximately80%ofresidents25yearsandolderinHarrisCountyhaveatleastahighschooldegree,whichislowerthantheU.S.(87.3%)andTexas(82.8%).
Figure18.People25+withaHighSchoolDegreeorHigher
5.1%
4.3% 4.3%3.8%
4.4%
3.7% 3.7% 3.5%
4.1% 3.9%3.6% 3.5%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
May2017 November2017 May2018 November2018
Harris Texas UnitedStates
80.5%
82.8%
87.3%
76%
78%
80%
82%
84%
86%
88%
Harris Texas U.S.
MemorialHermannGreaterHeightsHospitalCHNA201931
Figure19showstheproportionofresidentsinHarrisCountywhoare25yearsandolderwithabachelor’sdegreeorhigher.Theproportionofresidents25andolderwithabachelor’sdegreeinHarrisCounty(30.5%)ishigherthantherateinTexas(28.7%)andsimilartotheratefortheentireU.S.(30.9%).
Figure19.People25+withaBachelor'sDegreeorHigher
Table11displaystheeducationalattainmentindicatorsforresidents25yearsandolderbyzipcodeinMHGH’sservicearea.Forhighschooldegreeattainment,thezipcodewiththehighestrateis77007(95.5%)andthezipcodewiththelowestrateis77037(44.0%).Similarly,forattainmentofabachelor’sdegree,thezipcodewiththehighestrateis77007(74.8%)andthezipcodewiththelowestrateis77037(2.8%).ThezipcodeswithhighestproportionsofMHGHinpatientdischarges,zipcodes77088and77022,havemorethan55%ofpeople25yearsandolderwithahighschooldegree.However,lessthan14%ofresidents25yearsandolderhaveabachelor’sdegreeorhigherinthesetwozipcodes.
Table11.People25+withaHighSchoolDegreeandPeople25+withaBachelor'sDegreebyZipCodeZIPCode HighSchoolDegreeor
HigherBachelor’sDegreeorHigher
77088 70.9% 13.5%77022 55.7% 6.6%77091 74.2% 14.1%77092 73.4% 16.6%77018 85.0% 47.2%77009 70.2% 29.6%77076 52.1% 3.9%77093 48.7% 3.2%77008 93.0% 61.9%77026 62.5% 7.5%77016 71.9% 9.3%77040 78.6% 27.6%
30.5%
28.7%
30.9%
28%
28%
29%
29%
30%
30%
31%
31%
32%
Harris Texas U.S.
MemorialHermannGreaterHeightsHospitalCHNA201932
ZIPCode HighSchoolDegreeorHigher
Bachelor’sDegreeorHigher
77028 74.5% 7.7%77037 44.0% 2.8%77007 95.5% 74.8%77055 72.5% 33.9%77060 55.1% 6.1%77038 55.7% 8.1%77078 69.6% 9.7%77080 67.6% 17.3%Harris 80.5% 30.5%Texas 82.8% 28.7%
AmericanCommunitySurvey,2013-2017
Transportation Therearenumerouswaysinwhichtransportationmayinfluencecommunityhealth.Publictransportationoffersmobility,particularlytopeoplewithoutcars.Transitcanhelpbridgethespatialdividebetweenpeopleandjobs,services,andtrainingopportunities.Publictransportationalsoreducesfuelconsumption,minimizesairpollution,andrelievestrafficcongestion.Walkingtoworkhelpsprotecttheenvironment,whilealsoprovidingthebenefitofdailyexercise.
Figure20.HouseholdsWithoutaVehiclebyZipCode
MemorialHermannGreaterHeightsHospitalCHNA201933
Figure20showsthepercentageofhouseholdswithoutavehiclewithinMHGH'sservicearea.Asshown,morethan13%ofhouseholdsinzipcodes77022,77026and77091donothaveavehicle.
Table12.ModesofCommutingbyZipCode
ZIPCode CommutebyWalking
CommutebyBiking CommutebyDrivingAlone
CommutebyPublicTransportation
77088 0.5% 0.1% 79.1% 3.9%77022 2.0% 0.6% 78.2% 3.8%77091 0.9% 0.3% 79.8% 6.2%77092 1.7% 0.1% 76.5% 2.5%77018 0.5% 0.5% 82.6% 1.6%77009 3.7% 0.7% 72.9% 3.9%77076 1.3% 0.4% 77.0% 2.5%77093 0.9% 0.2% 76.5% 2.1%77008 1.5% 0.5% 81.8% 2.3%77026 1.9% 0.0% 70.6% 8.1%77016 1.4% 0.0% 80.1% 4.0%77040 1.4% 0.1% 81.8% 1.6%77028 0.9% 0.0% 78.3% 4.8%77037 2.1% 0.2% 80.9% 1.4%77007 0.9% 0.4% 83.9% 2.4%77055 2.9% 0.5% 70.4% 4.0%77060 2.3% 0.2% 71.7% 5.2%77038 0.8% 0.2% 82.6% 1.7%77078 0.2% 0.0% 78.4% 6.0%77080 3.1% 0.7% 71.5% 2.7%Harris 1.5% 0.3% 79.3% 2.7%Texas 1.6% 0.3% 80.5% 1.5%
AmericanCommunitySurvey,2013-2017
Table12displaysthedifferentmodesofcommutingusedbyresidentsofHarrisCounty.InHarrisCounty,1.5%ofresidentscommutebywalkingand0.3%commutebybiking.Themajorityofresidents(79.3%)commutebydrivingalone,whichissimilartothestatevalue(80.5%).PublictransportationisusedbyHarrisCountyresidents(2.7%)moresothanthestateofTexasasawhole(1.5%).ConsideringthetoptenzipcodesforinpatientdischargeswithinMHGH’sservicearea,zipcodes77091and77026havethehighestproportionsofresidentscommutingbypublictransportation(6.2%and8.1%,respectively).
SocioNeeds Index® ConduentHealthyCommunitiesInstitutedevelopedtheSocioNeedsIndex®toeasilycomparemultiplesocioeconomicfactorsacrossgeographies.Thisindexincorporatesestimatesforsixdifferentsocialandeconomicdeterminantsofhealth–income,poverty,unemployment,occupation,educationalattainment,andlinguisticbarriers–thatareassociatedwithpoorhealthoutcomesincludingpreventablehospitalizationsandprematuredeath.
MemorialHermannGreaterHeightsHospitalCHNA201934
Zipcodeswithineachcountyareassignedanindexvaluefrom0(lowneed)to100(highneed),basedonhowthosezipcodescomparetoothersintheU.S.Withineachcounty,thezipcodesarethenrankedfrom1(lowneed)to5(highneed)toidentifytherelativelevelofneed.Zipcodeswithpopulationsunder300personsareexcluded.
Figure21.SocioNeedsIndexbyZipCode
AsshowninFigure21andTable13,themajorityofzipcodes(13outof20)withinMHGH’sserviceareahaveSocioNeedsIndexvaluesgreaterthan95.ThezipcodeswiththelargestproportionofinpatientdischargesatMHGH,zipcodes77088and77022,haveSocioNeedsIndexvaluesof95.6and98.6,respectively.
Table13.SocioNeedsIndexbyZipCode(InOrderofSocioNeedsIndexValue)ZIPCode SocioNeedsIndexValue77060 99.577093 99.3
MemorialHermannGreaterHeightsHospitalCHNA201935
ZIPCode SocioNeedsIndexValue77076 99.177026 98.977037 98.977022 98.677038 97.677028 96.977078 96.677016 96.377080 95.677088 95.677091 95.577092 93.477009 90.277055 82.677040 71.877018 28.177008 7.877007 4.6
ConduentSocioNeedsIndex,2019
MemorialHermannGreaterHeightsHospitalCHNA201936
Data Synthesis Allformsofdatahavetheirownstrengthsandlimitations.TogainacomprehensiveunderstandingofthesignificanthealthneedsforMemorialHermannHealthSystem,thefindingsfromboththeprimarydataandthesecondarydatawerecomparedandstudiedtogether.Thesecondarydata,keyinformantinterviewsandcommunitysurveyweretreatedasthreeseparatesourcesofdata.Thesecondarydatawereanalyzedusingdatascoring,whichidentifiedhealthareasofneedbasedonthevaluesofindicatorsforeachtopicarea(AppendixB).Table14displaysthedatascoresforHealthandQualityofLifeTopicsforHarrisCounty.
Table14.HarrisCountyTopicScoresTopic ScoreTransportation 1.82Women'sHealth 1.81Immunizations&InfectiousDiseases 1.78OtherChronicDiseases 1.78PublicSafety 1.65Maternal,Fetal&InfantHealth 1.64Prevention&Safety 1.58SocialEnvironment 1.58Education 1.56Economy 1.55HeartDisease&Stroke 1.54Children'sHealth 1.52OlderAdults&Aging 1.50AccesstoHealthServices 1.48Exercise,Nutrition,&Weight 1.48Wellness&Lifestyle 1.42Men'sHealth 1.38Diabetes 1.34Environment 1.34SubstanceAbuse 1.33Cancer 1.31MortalityData 1.29MentalHealth&MentalDisorders 1.26RespiratoryDiseases 0.99
Thismethodologywasappliedtoeachofthe12countieswithinMemorialHermannHealthSystem’sprimaryserviceareaandthendatascorescalculatedfortheregioninordertodeterminesignificanthealthneedsacrossthesystem.Table15liststheresultingdatascoresforHealth&QualityofLifeTopics.
MemorialHermannGreaterHeightsHospitalCHNA201937
Table15.MemorialHermannRegionTopicScoresTopic ScoreTransportation 1.84HeartDisease&Stroke 1.82AccesstoHealthServices 1.79OlderAdults&Aging 1.60Exercise,Nutrition,&Weight 1.56OtherChronicDiseases 1.52MentalHealth&MentalDisorders 1.50Children'sHealth 1.47Immunizations&InfectiousDiseases 1.43Education 1.43Women'sHealth 1.42SocialEnvironment 1.42Wellness&Lifestyle 1.41Maternal,Fetal&InfantHealth 1.41RespiratoryDiseases 1.41Economy 1.41Environment 1.40PublicSafety 1.36Cancer 1.31Prevention&Safety 1.26SubstanceAbuse 1.23Men'sHealth 1.21
Theanalysisofkeyinformantinterviewsoccurredusingthequalitativesoftware:Dedoose1.Forthecommunitysurvey,HCIperformedasimplereviewandanalysistoidentifytophealthneeds.Overall,eachmethodproducedindividualresultsthatrepresentthecommunityinputinthisreport.Thisconsolidatedinputleadstotheprioritizedheathneedsinthisreport.ThistriangulatedapproachisshowninFigure22.
Figure22.VisualofDataSynthesisApproach
SignificantHealthNeeds
HealthIndicatorData
(DataScoringAnalysis)
KeyInformantInterviews(Thematic
CodingAnalysis)CommunitySurvey
(ThematicAnalysis)
MemorialHermannGreaterHeightsHospitalCHNA201938
TheteamusedthetriangulatedapproachtoidentifysignificanthealthneedsforMemorialHermannHealthSystem.Figure23displaystheresultsofthissynthesis.Formanyofthehealthtopicsevidenceofneedwaspresentacrossmultipledatasources,includingObesity,MentalHealth,AccesstoHealthServices,Transportation,andUninsured.Forotherhealthtopicstheevidencewaspresentinjustonesourceofdata,howeveritshouldbenotedthatthismaybereflectiveofthestrengthandlimitationsofeachtypeofdatathatwasconsideredinthisprocess.
Figure23.DataSynthesisResults
MemorialHermannGreaterHeightsHospitalCHNA201939
Priorit ized Signif icant Health Needs
Priorit ization Results Uponcompletionoftheonlineprioritizationsurvey,fourhealthareaswereidentifiedforsubsequentimplementationplanningbyMemorialHermannHealthSystem.Thesefourhealthprioritiesare:AccesstoCare,EmotionalWell-Being,FoodasHealth,andExerciseIsMedicine.ThefollowingsectionwilldivedeeperintoeachofthesehealthtopicsinordertounderstandhowfindingsfromthesecondaryandprimarydataledtoeachhealthtopicbecomingapriorityhealthissueforMemorialHermannHealthSystem.Foreachprioritizedhealthneed,keyissuesaresummarized;secondarydatascoresarenotedforindicatorsofconcern;andcommunityinputisdescribed.
Access to Healthcare
Secondary Data AccesstoHealthServices,LackofInsuranceandLow-Income/UnderservedwereidentifiedassignificantneedsforMemorialHermannHealthSystem.AsshowninTable16,thereareseveralindicatorsrelatedtoAccesstoHealthServiceswithdatascoresequaltoorgreaterthan1.75.InHarrisCounty,indicatorsofconcerninclude:AdultsUnabletoAffordtoSeeaDoctor,AdultswithHealthInsurance,ChildrenwithHealthInsurance,andPersonswithHealthInsurance.Over22%ofHarrisCountyadultsareunabletoaffordtoseeadoctor,whichishigherthantheproportioninTexas(18.3%)andtheU.S.(12.1%).Moreover,approximately20%ofresidentsinHarrisCountydonothavehealthinsurance.
KeyIssues:• Rangeofbarriers,includingtransportation,accesstospecialtycare,lackofawareness,and
fearorstigma• Lackofhealthinsurance• Lowincomeandvulnerablegroups
SecondaryDataScoringMethodologyForeachindicator,eachcountyinMHGH’sserviceareawasassignedascorebasedonitscomparisontoothercommunities,whetherhealthtargetshavebeenmet,andthetrendoftheindicatorvalueovertime.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariedbyindicatorandwasdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.PleaseseeAppendixBforfurtherinformationonHCIDataScoringmethodology.
MemorialHermannGreaterHeightsHospitalCHNA201940
Table16.SecondaryDataScoringResults:AccesstoHealthServices
County CountyValueComparedto:
Indicator Name Value DataScore
TXCounties
TXValue
USValue
HP2020Target
TrendOverTime
AdultsUnabletoAffordtoSeeaDoctor
[10](2015)Harris
22.12 1.5 3 3 1.5 1.5
percent
[10]TexasBehavioralRiskFactorSurveillanceSystem
AdultswithHealthInsurance:18-64[9]
(2016)Harris
74.71.75 2 2 1.5 3 0
percent
ChildrenwithHealthInsurance[9](2016) Harris
89.41.81 1 2 1.5 3 1
percent
PersonswithHealthInsurance[9](2016)
Harris79.3
1.75 2 2 1.5 3 0percent
[9]SmallAreaHealthInsuranceEstimates
PrimaryCareProviderRate[4](2015) Harris
57.21.61 0 2 3 1.5 2providers/100,000
population[4]CountyHealthRankings
WhenconsideringAccesstoHealthServices,itisimportanttotakeintoaccounttheeconomyandhowfinancialbarriersimpactcommunityresidents’abilitytoaccesscare.AsshowninTable17,thereareseveraleconomicindicatorswithdatascoresgreaterthan2inHarrisCounty.Economicindicatorsofconcern,including:Homeownership,SevereHousingProblems,StudentsEligiblefortheFreeLunchProgram,MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage,SNAPCertifiedStores,MedianHouseholdGrossRent,FamiliesLivingBelowPovertyLevel,andFoodInsecurityRate.Lessthan50%ofHarrisCountyresidentsownahome.Over20%ofresidentsinHarrisCountyhaveseverehousingproblems.Andmorethan58%ofstudentsareeligibleforthefreelunchprogramcomparedtothenationalvalueof42.6%.InHarrisCounty,thereareover14%offamilieslivingbelowthepovertylevelcomparedto13%inTexasand11%intheU.S.
Table17.SecondaryDataScoringResults:Economy
County CountyValueComparedto:
Indicator Name Value DataScore
TXCounties
TXValue
USValue
HP2020Target
TrendOverTime
ChildFoodInsecurityRate[5](2016) Harris 23.5
percent 1.67 1 2 3 1.5 0
[5]FeedingAmerica
MemorialHermannGreaterHeightsHospitalCHNA201941
ChildrenLivingBelowPovertyLevel[1](2012-2016)
Harris 26.0percent 1.67 2 2 3 1.5 0
[1]AmericanCommunitySurveyFamiliesLivingBelowPovertyLevel[1](2012-2016)
Harris 14.4percent
2.06 2 3 3 1.5 1
[1]AmericanCommunitySurvey
FoodInsecurityRate[5](2016) Harris
16.6percent 2.06 2 2 3 1.5 1
[5]FeedingAmerica
Homeownership[1](2012-2016)
Harris 49.6percent
2.44 3 2 3 1.5 2
[1]AmericanCommunitySurveyMedianHouseholdGrossRent[1](2012-
2016)Harris 937
dollars 2.08 3 2 1 1.5 3
[1]AmericanCommunitySurveyMedianMonthlyOwnerCostsfor
HouseholdswithoutaMortgage[1](2012-
2016)
Harris 534dollars
2.14 3 3 3 1.5 1
[1]AmericanCommunitySurveyMortgagedOwnersMedianMonthly
HouseholdCosts[1](2012-2016)
Harris1504dollars 1.81 3 2 2 1.5 1
[1]AmericanCommunitySurveyPeople65+Living
BelowPovertyLevel[1](2012-2016)
Harris 11.3percent
1.89 2 2 3 1.5 1
[1]AmericanCommunitySurveyPeopleLivingBelowPovertyLevel[1](2012-2016)
Harris17.4
percent 1.67 2 2 3 1.5 0
[1]AmericanCommunitySurveySevereHousing
Problems[4](2010-2014)
Harris20.9
percent 2.39 3 3 3 1.5 1
[4]CountyHealthRankings
SNAPCertifiedStores[17](2016)
Harris0.6
stores/1,000population
2.11 3 1.5 1.5 1.5 2
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlasStudentsEligiblefor
theFreeLunchProgram[8](2015-
Harris 58.2percent
2.22 2 3 3 1.5 1
MemorialHermannGreaterHeightsHospitalCHNA201942
Primary Data Duringthekeyinformantinterviewprocess,AccesstoHealthServiceswasdiscussedover160timesandwasraisedbyparticipantsalmost50timesinrelationtobarriersorchallengestoachievinghealthinthecommunity.Theprimarythemesrelatedtobarriersorchallengeswerelimitationstoprocuringspecialtycareservices,transportationtoservicesandhoursofoperation.Inadditiontotheprimarythemes,twoadditionalbarriersorchallengesstoodoutaskeyfactorsimpactingaccesstohealthcareservices,lackofknowledgeandstigmaorfearpreventingpeoplefromseekingcare.Theissuethatinterviewparticipantsweremostconcernedwithwaspatientsbeingabletoaccessfollowupcarewithspecialtycareproviders.Multipleparticipantsraisedconcernsthatevenifpatientsareabletoaccesspreventativeorprimarycareservices,theymaynotbeabletoaccesstheappropriatefollowupcarewithaspecialtycareprovider.Someparticipantsraisedthisconcernincontextofpatientsnotlivingnearaspecialistandothersraisedincontextofpatientsnotbeingabletoaffordthecostoffollowupcare.Aconcernbroughtupbyafewparticipants,thatforseriouschronicconditions,patientswouldultimatelyendupseekingcarefromemergencyservicesinstead.Anothercommonconcernraisedbyinterviewparticipantswastransportationtoservicesandhoursofoperationofserviceslimitingpatients’accesstocare.Participantsdescribedhowthesefactorsdeterminewhetherpatientsdecidetotakeofffromworkandseekservicesinthefirstplace.Afewparticipantsdescribedthemanyservicesandresourcesthatareavailabletothecommunitybutthatmanymaynotbeawarehowtheycanaccessorbenefitfromthem.Oneparticipantdescribedresourcesbeingconcentratedincertaingeographicareasandmoreremotelocationsnotbeingwellconnectedorknowledgeableabouthowtheymayalsobenefitfromtheseresources.Participantsdescribedthepotentialformorecollaborationandpartnershiptoconnectcommunitiestooneanother.Severalparticipantsdescribedadown-turninpeopleseekingpreventativecareserviceandhypothesizedthatoneofthefactorsmayberelatedtotheimmigrantcommunityintheregionexperiencingfearorstigmarelatedtohavingtoshowidentificationorproofofcitizenship.
2016)
[8]NationalCenterforEducationStatisticsTotalEmploymentChange[16](2014-
2015)Harris
2.4percent 1.67 1 3 2 1.5 1.5
[16]U.S.Census-CountyBusinessPatternsUnemployedWorkersinCivilianLaborForce
[15](July2018)Harris 4.4
percent 1.94 2 2 2 1.5 2
[15]U.S.BureauofLaborStatistics
MemorialHermannGreaterHeightsHospitalCHNA201943
“EventhoughweattheHealthDistrictdonotaskforproofofimmigrationstatus,peopledon'tunderstandthat,particularlysincewe'reagovernmentagency,andit'sbeenarealchallengetogetsomeofthesefolkstocomeinforservices.”Therewerealmost80referencestotheuninsuredpopulationinthekeyinformantinterviewsandlackofhealthinsurancewasraisedasabarrierorchallengetoachievinghealthinthecommunity19times.Lackofhealthinsurancewasmostoftenbroughtupincontextofpatientshavinglimitedfinancialresourcesandafactortonotaccessinghealthcareservices.Participantsdiscussedpatientsnothavingtheabilitytopayfeesformultipleappointmentco-paysornotseekingcareduetocompetingfinancialpriorities.Whilehealthcareservicesmaybeavailableinthecommunity,forthosewhoarelackinghealthinsurance,accessinghealthcareservicesisnotnecessarilyanoption.Lackofhealthinsurancecreatesaparticularchallengeforthosewhorequirespecialtycareservices.“Ithinkthosearethebiggesttwo—access,again,withthemajorityofouradultpopulationbeinguninsured,havingthemtrytofindaproviderthat,again,willtakeslidingfeescale,orreducedrates.Oncethey'reabletoaccessthoseservices,thenitbecomesamatterofpayingforthethingsthatareneeded.Thepatientcomesinandwediagnosethemwithdiabetes,thencomesthecostofmedications,andifthatpatientisneedingspecialtycareoutsideofthescopeofprimarycare,accesstospecialists.”Participantsbroughtupissuesrelatedtolowincomeorgroupswhomaybeunderservedinthecommunity115timesduringthekeyinformantinterviewprocess.Particulargroupsthatparticipantsfeltmayexperienceaddedchallengesaccessinghealthcareservicesincludedtheimmigrantpopulation,individualswithdisabilities,familieswithyoungchildren,andtheelderly.Severalparticipantsraisedfeesrelatedtoco-paysoroutofpocketexpensesasabarriertopatientsseekinginitialpreventativeservicesorongoingtreatmentforchronicconditions.Participantsidentifiedseveralgroupstheyfeltwereunderservedinthecommunity.Multipleparticipantsdiscussedtheuniqueandspecificchallengeswithprovidingculturallyappropriatecareforadiverseandrecentimmigrantpopulationinthecommunity.Participantsfeltthatfamilieswithyoungchildrenandtheelderlypopulationareparticularlyvulnerablegroupsinthecommunitythatexperiencebarriersandchallengesaccessinghealthcareservices.Specifically,participantsdiscussedthesegroupsexperiencinghighlevelsofpovertyplacingthemathigherriskforpoorhealthoutcomes.“Mostofthemareextremelylowincomeandtheyfallinthosecategorieswherewehaveasignificantnumberofelderlydisabled,singlemomsandtheirchildren,sovulnerablefolkshereinHouston.”
Emotional Well-Being
KeyIssues:• Mentalhealthaspartofoverallhealth• Needformorebehavioralhealthservicesandproviders• Alcoholandsubstanceabuse• Alzheimer’sanddementia
MemorialHermannGreaterHeightsHospitalCHNA201944
Secondary Data MentalHealthandSubstanceAbusewereidentifiedassignificantneedsforMemorialHermannHealthSystem.AsshowninTable18,thereareseveralindicatorsrelatedtoMentalHealth&MentalDisorderswithdatascoresgreaterthan1.5.InHarrisCounty,11.4%oftheMedicarePopulationhasAlzheimer’sDiseaseorDementia,whichishigherthantheU.S.value(9.9%).Moreover,80%ofresidentsinHarrisCountyreportedhaving5ormorepoormentalhealthdaysinthepastmonth.
Table18.SecondaryDataScoringResults:MentalHealth&MentalDisorders
County CountyValueComparedto:
Indicator Name ValueDataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
Alzheimer'sDiseaseorDementia:MedicarePopulation[3](2015)
Harris11.4
1.89 2 1 3 1.5 1percent
[3]CentersforMedicare&MedicaidServices
PoorMentalHealth:5+Days[4](2016)
Harris80.0
1.53 1.5 1 1.5 1.5 2percent
[4]CountyHealthRankings
SubstanceAbuseisanothertopicofconcerninHarrisCounty.Theproportionofalcohol-impaireddrivingdeathsishigherthanthestateandtheU.S.Therewere37.8%alcohol-impaireddrivingdeathsinHarrisCounty,comparedto28.3%and29.3%inTexasandtheU.S.,respectively(Table19).
Table19.SecondaryDataScoringResults:SubstanceAbuse
County CountyValueComparedto:
Indicator Name ValueDataScore
TXCounties
TX US HP2020Target
TrendOverTimeValue Value
Alcohol-ImpairedDrivingDeaths[4]
(2012-216)Harris
37.82.17 3 3 3 1.5 0
percent
[4]CountyHealthRankings
Primary Data Approximately50%ofcommunitysurveyrespondentscitedMentalHealthasoneofthetopissuesmostaffectingthequalityoflifeintheircommunityand52%ofrespondentsnotedSubstanceAbuse.Ininterviewswithkeyinformants,MentalHealthwasdiscussed113timesandwasraisedbyparticipants33timesasaneedsorconcernforthehealthofthecommunity.TheprimarythemesrelatedtoMentalHealthweretreatingmentalhealthaspartofoverallhealth,addressbehavioralhealthinschool,needforbehavioralhealthprovidersandservicesandolderadultswithAlzheimer’sanddementia.
MemorialHermannGreaterHeightsHospitalCHNA201945
Someparticipantsdiscussedarecentshiftincaredeliveryandthecontinuedneedtoaddressmentalhealthaspartofaperson’stotalhealthsimilarlytohowchronicdiseaseismanaged.Oneparticularlyvulnerablepopulationthatwouldbenefitfromabroaderapproachtotreatment,inclusiveofmentalhealth,isthehomelesspopulation.Severalparticipantsbroughtupissuesregardinganeedformorebehavioralhealthprovidersandservicesinthecommunity.“(…)Ithinkthereneedstobemoreworkaroundfundingforbehavioralhealthbutalsofundingforrecruitingandtrainingtherapistsandbehavioralhealthspecialiststoaddresssubstanceabuse,anxiety,depressionandsuicidality.”Oneparticipantobservedrecentincreasesandchangeswithinthelocalpopulation.Fromtheparticipant’sperspective,thereshouldbemoreprogramsorservicestoaddressthegrowingneedforaddressingmentalhealthinthecommunity.Anotherparticipantsuggestedsolutionsforaddressingtheneedformorebehavioralhealthprovidersinthecommunitysuchasexpandingresidencyprogramsforpsychiatristsanddevelopingcomprehensivetelemedicineprogramstoprovideservicesmoreefficiently.Furthermore,participantsrecommendedaddressingbehavioralhealthwithyoungerpopulationsintheschools.Schoolsthatprovidebehavioralhealthservicesthroughtelemedicinehavebeenreceivedwellinthecommunityandtheperceptionisthattheyareeffective.Someparticipantsbelievethattheseprogramsshouldbeexpandedandavailableacrossthecommunity.“There[are]thementalhealthunitsthathavegoneoutintotheschools.They'renotschool-basedbutthat’sthevenuetheywilldrivetowiththeirmobileunits.Theyhaveabigimpact.They'reseeingthousandsofkids.They’vedonesometelemedicinewithmentalhealth,behavioralhealth,withsomeofthehighschools.FromwhatI’veheard,(…)it’sbeenprettyeffectiveandwellreceived.”AchallengethathealthcareprovidersidentifiedforthemedicalcommunityisadequatelyaddressingdementiaandAlzheimer’swithinthegeriatricpopulation.“Dementia’saterminalillness.(…)Muchmoreneedstobedonewithhealthcaresystemsaroundroutinescreeningandidentificationofitasanissue.(…)So,thatisthefirstthingthatneedstohappen.Thenthereneedstobeanunderstandingthattherearethings–therearemedicationsthatcanbehelpfultothesystemsofthedementia.(…)Butyoucanaffectitbyaddressingsomeofthesymptoms.”SubstanceAbusewasdiscussed55timesandwasraisedbyparticipants15timesasaneedorconcernforthehealthofthecommunity.MultipleuniquethemesemergedfromthekeyinformantinterviewsrelatedtoSubstanceAbuse:fundingfortreatmentprograms,invisibilityofalcoholism,overcomingstigmaofseekingtreatment,andemergingshiftsinoutreachmodels.Participantsidentifiedfundingforprogramsandavailabilityofservicesforthosewhomaynotbeabletoaffordtreatmentout-of-pocketasissuesthecommunityisfacingtoaddresssubstanceabuse.Oneparticipantraisedalcoholabusespecificallyasanissueinthecommunitythatdoesnotgettheamountofattentionofothersubstanceabusetopicsbutmayinfactbeimpactingalargerproportionofthepopulationandconnectedtomanyotherhealthissues.
MemorialHermannGreaterHeightsHospitalCHNA201946
Multipleparticipantsidentifiedculturalstigmaasabarrierforthosewhomaybenefitfromseekingtreatment.Stigmaorfearmaybeuniqueandvaryfrompopulationtopopulationinthecommunity.“Withsubstanceabuse,it’scultureandstigma.Nobodygoestosubstanceabusetreatmentontheirown.Theymaynotbeadjudicatedbutsomeoneisreally,reallypushingthem,familymember,boss.Noonegoestotreatmentifthey’renotunderduress.”Afewparticipantsdescribeduniqueapproachestooutreachandsubstanceabusetreatmentinthecommunitythatwouldsupportremovingbarriersforpeoplehavingtotakethefirststepontheirown.“Forinstance,it’sprettynew,butthere’saninitiativethat’scalledtheHeroesProjectthat’slookingatoverdoses,sowhenanoverdosehappens,they’resendingateamtotheER.So,it’sgotapeersupportspecialist,theEMPisinvolved–buttheyactuallygointotheERandtheydoaninterventiontheretotrytohelpwithlinkagetotreatmentsothatwecanassistthepatients.”
Food as Health
Secondary Data ThetopicsofDiabetesandHeartDisease&Strokeemergedassignificanthealthneeds.HeartDisease&StrokerosetothetopofthesecondarydatascoringresultsforMemorialHermannHealthSystem.AlthoughDiabeteswasnotinthetopresultsofthesecondarydatascoring,anindicatorofconcernforHarrisCountyistheproportionofdiabetesintheMedicarepopulation,which,at28.1%,ishigherthanthenationalvalue(26.5%)(Table20).
Table20.SecondaryDataScoringResults:Diabetes
County CountyValueComparedto:
Indicator Name ValueDataScore
TXCounties
TXValue
USValue
HP2020Target
TrendOverTime
Diabetes:MedicarePopulation[3](2015) Harris
28.11.67 2 1 2 1.5 1.5
percent
[3]CentersforMedicare&MedicaidServices
AsshowninTable21,anotherindicatorofconcernisStrokeintheMedicarePopulationwithaproportionof5.2%inHarrisCounty,comparedto4%intheU.S.
KeyIssues:• Foodinsecurityandlimitedaccesstohealthyfoods• Diabetesandheartdiseaselinkedtosocioeconomicfactors• Sedentarylifestyleanddrivingculture
MemorialHermannGreaterHeightsHospitalCHNA201947
Table21.SecondaryDataScoringResults:HeartDisease&Stroke
County CountyValueComparedto:
Indicator Name Value DataScore
TXCounties
TXValue
USValue
HP2020Target
TrendOverTime
HeartFailure:MedicarePopulation
[3](2015)Harris
16.0percent 1.89 1 2 3 1.5 1
Stroke:MedicarePopulation[3](2015)
Harris 5.2percent
2.61 3 3 3 1.5 2
[3]CentersforMedicare&MedicaidServices
Table22revealsfood-relatedindicatorsofconcern,includingSNAPCertifiedStoresaswellasFoodInsecurityRate.
Table22.SecondaryDataScoringResults:Nutrition
County CountyValueComparedto:
Indicator Name ValueDataScore
TXCounties
TXValue
USValue
HP2020Target
TrendOverTime
ChildFoodInsecurityRate[5](2016) Harris
23.51.67 1 2 3 1.5 0
percent
[5]FeedingAmerica
FastFoodRestaurantDensity[17](2014) Harris
0.71.67 2 1.5 1.5 1.5 1.5restaurants/1,000
population[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
FoodInsecurityRate[5](2016)
Harris16.6
2.06 2 2 3 1.5 1percent
[5]FeedingAmerica
SNAPCertifiedStores[17](2016) Harris
0.62.11 3 1.5 1.5 1.5 2stores/1,000
population[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
Primary Data Food-relatedtopicsemergedinthecommunityinputgatheredthroughthesurveyandkeyinformantinterviews.FoodInsecurity,FoodProgramsandFoodKnowledgeissueswerediscussedover170timesduringthekeyinformantinterviewsandwereraisedbyparticipants34timesinrelationtobarriersorchallengestoachievinghealthinthecommunity.Theprimarythemesrelatedtobarriersorchallengesthatemergedintheinterviewswereaccesstohealthyfoodsandaffordability,knowledgegapsandlimitedfoodfamiliarityandprogramlimitations.
MemorialHermannGreaterHeightsHospitalCHNA201948
Themostcommonissueraisedbykeyinformantparticipantsrelatedtofoodinsecuritywascommunitymembersnotbeingabletoaccesshealthyfoodsintheircommunity.Multipleparticipantsbelievedthatinmanycommunities,healthyfoodoptionswerenotavailabletopeoplewithinafive-mileradiusfromtheirhomeorwork.Participantsdescribed‘fooddeserts’asatopissueaffectinghealthinthecommunityandhowlimitedaccesstohealthyfoodsalsowascloselyassociatedwithpeoplealsobeingnotbeingabletoaffordhealthyfoods.Participantsalsodiscussedtheimbalanceofhealthyfoodoptionsforthosecommunitieswithlowerhousingpricesandingeneral,loweraverageincomes.Oneparticipantdescribedthelinkbetweenpeoplesecuringaffordablehousinginthecommunity,whichmaylimittheiroptionsforaccesstohealthyfoodchoices.
“Wehaveagrocerystoreoneverycornerbutnoteverycornerinthepoorneighborhoods.It’sbeenmypersonalexperiencethateatinghealthyisexpensive.Itcostsmoremoneytobuyhealthyfruitsandvegetablesandmorehealthyfood,ingeneralthanitdoestobuyfoodthat’snotsohealthy,that’shighfat,highcarb,highsugar….Itcostsmoremoney.Ittakeslongertoprepare.Whenyouhaveamomandadadoreitherandthey’retryingtohandletwojobs,ifnotthree.They’vegotkidsofvaryingages.Themechanicsofshoppingandpreparingmealsisprobablyanactivitythatgetsletgo.”
Someparticipantshaddirectexperiencewitheducatingthecommunityabouthealthyfoodsandeating.Theseparticipantssharedthatforsomecommunitymembers,theirknowledgeoffreshfruitsandvegetablesislimitedaswellasproperfoodstorageforfoodswithoutpreservatives.InMemorialHermann’scommunitysurvey,67%ofrespondentsselectedDiabetesasoneofthetopissuesmostaffectingthequalityoflifeintheircommunity.Duringkeyinformantinterviews,Diabeteswasdiscussed64timesandwasraisedbyparticipants32timesasahealthneedorconcerninthecommunity.ForthoseparticipantswhoraisedDiabetesasatophealthissueinthecommunity,uniquethemesemergedregardinghowdiabetesisimpactingspecificgroupsinthecommunityandthewayasedentarylifestyleimpactsdiabetes.MultipleparticipantsattributedthesurgeinobesityanddiabetesingeneralintheU.S.toashifttoamoresedentarylifestylewhileothersspecificallyidentifiedthelocalclimateanddrivingcultureaskeyfactorsleadingtoanincreaseinsedentarylifestylesimpactingtheregion.HeartDisease&Strokewasdiscussed34timesduringthekeyinformantinterviewsandwasraisedbyparticipants16timesasahealthneedorconcerninthecommunity.ForthoseparticipantswhoraisedHeartDisease&Strokeasatophealthissueinthecommunity,theuniquethemesthatemergedintheinterviewswerechronicdiseaseriskrelatedtosocioeconomicstatusandchallengeswithmanagingheart-relatedconditions.“Youhavesomanycommunitiesthatarefooddesertsso,ofcourse,Ithinkweareallatriskforthingslikediabetesandhypertension,obesity,stroke–but,Ithinkinadditiontothat,thosethataremostarealreadymarginalized.Peoplewhoarelowincome.Lowsocioeconomicstatus.So,education,andallofthoseindicatorsareprobablyevenmoreatriskforchronicdiseasesthansomeone,forexample,whohasaccesstocareandinsurance.So,theyprobablyaredoublyatrisk.”
MemorialHermannGreaterHeightsHospitalCHNA201949
Exercise Is Medicine
Secondary Data Exercise,Nutrition&Weightwasthefifthhighest-rankingtopicinthesecondarydatascoringresultsforMemorialHermannHealthSystem.AlthoughExercise,Nutrition&WeightdidnotrisetothetopofthesecondarydatascoringresultsforHarrisCounty,thereareindicatorsofconcern(Table23).Inparticular,anexercise-relatedindicatorwithscoreabove2is:WorkersWhoWalktoWork.
Table23.SecondaryDataScoringResults:Exercise,Nutrition&Weight
County CountyValueComparedto:
Indicator Name ValueDataScore
TXCounties
TXValue
USValue
HP2020Target
TrendOverTime
ChildFoodInsecurityRate[5](2016)
Harris23.5
1.67 1 2 3 1.5 0percent
[5]FeedingAmerica
Adults(18+Years)WhoAreObese[10](2016)
Harris32.0
1.67 1.5 1 2 2 2percent
[10]TexasBehavioralRiskFactorSurveillanceSystem
FastFoodRestaurantDensity[17](2014) Harris
0.71.67 2 1.5 1.5 1.5 1.5restaurants/1,000
population[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
FoodInsecurityRate[5](2016) Harris
16.62.06 2 2 3 1.5 1
percent
[5]FeedingAmerica
SNAPCertifiedStores[17](2016)
Harris0.6
2.11 3 1.5 1.5 1.5 2stores/1,000population
[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas
WorkerswhoWalktoWork[1](2012-2016) Harris
1.52.17 2 2 3 3 1.5
percent
[1]AmericanCommunitySurvey
KeyIssues:• Obesity• Walkabilityofcommunities• Safetyofoutdoorspacesandplacestoexercise
MemorialHermannGreaterHeightsHospitalCHNA201950
Primary Data Over60%ofMemorialHermann’scommunitysurveyrespondentsnotedObesityasatopissueaffectingthequalityoflifeintheircommunity.Inkeyinformantinterviews,Exercise,Nutrition&Weightwasdiscussedalmost170timesandwasraisedbyparticipants42timesasaneedorconcernforachievinghealthinthecommunity.TheprimarybarriersrelatedtoExercise,Nutrition&Weightidentifiedbyparticipantswerewalkability,accesstosafeoutdoorspacesandprogrammingthatmaynotmeettheneedsofcommunitiesfacingfinanciallimitations.Severalparticipantsdiscussedbarrierstohealthylifestylechangesanddescribedcommunitieswheresidewalksarelimitedorpedestrianpathwaysarenotavailable.Theabilityforcommunitymemberstomakesmallshiftsintheirdailylives,suchaswalkingregularly,maybemorefeasiblethanundertakinganexerciseregimen.Thelimitationsofpedestrianpathwaysandsaferwalkingspacespreventthoseinsomesectionsofthecommunityfrommakingtheseshifts.Forindividualswhomaynotbeabletoaffordgymmembershipsnorattendclassesduetoworkschedules,outdooractivitiesandfitnessareasofferafreealternative.Participantsfeltthatinmanyneighborhoods,theseoutdoorspacesarenotavailableduetodisrepairorunsafeenvironments.“Ithinkthebuiltenvironmentishuge,too.Ifyouliveoutinaplannedcommunity,theyusuallyhavewalkingtrails,ortheyhaveaprettyfountainareaforyoutowalkaroundit.Theyhavethoselittleexercisethingsthatyoustoponpartwayaroundthetrailandyoudoyourlittlepush-upsandyoursit-upsandyourpull-ups(…)Yougointothesepoorerareasandthere'snosidewalks.There'snolightsatnight.There'sapark—it'sallrustedequipment.”Participantsalsodescribedprogramsandfacilitiesthatareeitherlimitedorlacking.Theseprogramsincludedfreeexerciseprogramswithchildcareoptions,youthsportsleaguesandrecessintheschoolsandfreeorlow-costoptionsforair-conditionedfacilitiesduringtimesoftheyearwhentheweatherdoesnotpermitoutdooractivities.“InpoorareasofHouston,there’sjustnotalotofparks.There'snolittleleague,andthere'snosoccerleagues,andso,there'snotalotofrecessintheschools.There'sjustnot—thecultureamongthekidsisjustnotbeingcreatedaroundphysicalactivity.”
MemorialHermannGreaterHeightsHospitalCHNA201951
Non-Prioritized Significant Health Needs Thefollowingadditionalsignificanthealthneedsemergedfromareviewoftheprimaryandsecondarydata.Withtheneedtofocusontheprioritizedhealthneedsdescribedabove,thesetopicsarenotspecificallyprioritizedeffortsinthe2019-2022ImplementationStrategy.However,duetotheinterrelationshipsofsocialdeterminantneedsmanyoftheseareasfall,tangentially,withintheprioritizedhealthneedsandwillbeaddressedthroughtheupstreameffortsoftheprioritizedhealthneeds.Additionally,manyofthemareaddressedwithinongoingprogramsandservices.Examplesoftheseeffortsareprovidedbelowbytopicarea.
Older Adults and Aging
Secondary Data ThesecondarydatascoringresultsrevealedthetopicofOlderAdultsandAgingasasignificanthealthneedforHarrisCounty.OlderAdultsandAgingreceivedatopicscoreof1.5inthesecondarydataresultsforHarrisCounty.Indicatorsofnoteincluded:ChronicKidneyDiseaseandStrokeintheMedicarePopulationaswellasAge-AdjustedDeathRateduetoFalls.
Primary Data KeyinformantsandstakeholdersdiscussedOlderAdultsandAging.Over62%ofparticipantsinMemorialHermannHealthSystem’sprioritizationprocesscitedOlderAdultsasoneofthegroupsmostaffectedbypoorhealthoutcomes.Interviewswithkeyinformantsnotedthegrowingpopulationofolderadultsandneedsrelatedtospecializedcare,financialassistanceandoutreach.“…[W]earegoingtowatchtheliteraldoublingofthenumberofAmericansovertheageof65inthenext25years.Everyday,betweennowand2030,dayafterday,10,000Americanswillturn65,sowearewatchinganextraordinaryexpansionofchallengesofaging.(…)[M]oreandmoreAmericansaregoingtobegettingold,socaringforthismassiveincreaseintheagingpopulationisgoingtobeoneofthegreatchallengesIthink.”
Efforts MemorialHermannHealthSystemincludestwofreestandingRehabilitationHospitals(TIRRandKaty)aswellasaseniorlivingfacility(UniversityPlace),featuringindependentliving,personalassistanceservices,andaseparate,butattached,nursingcenter.Additionalcommunityoutreachincludeshealtheducationon:Alzheimer’sdisease,DiscountedDiabetesEducation,Education/outreachforSeniors,InjuryPrevention,FallPrevention,andsupportgroupsforvariouspopulations,including:Alzheimer’s,Amputees,Cardiacpatients,Chronicdisease,Diabetics,Grief,Parkinson’sdisease,Stroke,Survivorship,andmore.
Cancers
Secondary Data AlthoughCancerwasnotoneofthetoptentopicsinthesecondarydatascoringresultsforHarrisCounty,therearecertainindicatorstonote.Severalindicatorsareofconcernincluding:CervicalCancerIncidenceRateandAge-AdjustedDeathRateduetoBreastCancer(bothwith
MemorialHermannGreaterHeightsHospitalCHNA201952
indicatorscoresabove2),CancerintheMedicarePopulation,ColonCancerScreening,andAge-AdjustedDeathRateduetoProstateCancer.
Primary Data InMemorialHermann’scommunitysurvey,overonethirdofrespondentsnotedCancerasatopissueaffectingthequalityoflifeintheircommunity.Interviewswithkeyinformantsrevealedtheimportanceofmakingcancerscreeningservicesandspecialtycareavailableandaccessible(e.g.,telehealth,mobilemammography).
Efforts AsleadingprovidersofcancertreatmentinHouston,MemorialHermannCancerCentersarecommittedtocancertreatment,prevention,andresearch.Theirbroadgeographicalcoveragemakescancertreatmentextremelyaccessibleandconvenienttowherepatientsliveorwork.AlleightMemorialHermannCancerCentersareapprovedbytheAmericanCollegeofSurgeonsCommissiononCancer(ACoSCoC);only25percentofhospitalsacrossthecountryhavereceivedthisspecialrecognition.Withguaranteedaccesstocomprehensivecare,collaborativeteamapproachforcoordinatingthebestavailabletreatmentoptions,state-of-the-artequipmentandservices,educationandsupport,andlifelongpatientfollow-upthroughtheCancerRegistry,patientsareabletoaccessafullmenuoftherapiesandtreatmentoptions.Additionaloutreachincludeseducationandsupportgroupsforcancerpatients:Art,Self-guidedArtTherapy,Lymphedema,BrestCancer,OncologyNutritionTherapy,StressRelief,LookGoodFeelBetter,Yoga,Meditation,andHealthyEatingAdvices.
Education
Secondary Data Educationreceivedatopicscoreof1.56inthesecondarydataresultsforHarrisCounty.Thereareseveraleducation-relatedindicatorstoconsider:InfantsBorntoMotherswithLessThan12YearsofEducation(withavalueof27.5%inHarrisCounty,comparedto21.3%inTexasand15.9%intheU.S.),Student-to-TeacherRatio,HighSchoolDropOutRate,andPeople25+withaHighSchoolDegreeorHigher.
Primary Data Duringkeyinformantinterviews,thetopicofEducationcameupfrequentlyandinrelationtodifferentfocusareasandtargetaudiences,includingchildren,generalcommunitymembersaswellasproviders.Thelinkbetweenindividuals’levelofeducationandqualityoflifewasemphasized.Keyinformantsrecommendedfindingopportunitiestoexpandtheavailabilityofeducation(relatedtohealthandnon-healthtopics)aswellasintegratinghealtheducationintoexistingactivitiesinbothclinicalandnon-clinicalsettings,suchasschoolsandchurches.Opportunitieswerealsopointedouttoeducatehealthcareproviders(andprovidecontinuingeducation)onavailablecommunitylinkagesandresourcesandonhowtoinitiateconversationswithpatientsregardingdifferenthealthtopics.
MemorialHermannGreaterHeightsHospitalCHNA201953
“Wewanttogointodifferentgroupsandeducatethemonwhattheyshouldbedoingorshouldn’tbedoing.(…)Ithinkeducationisahugecomponentbutwe’vegottofigureouthowtointegratethat.Theeducation,withouttheintegrationintosomebody’slifestyle,doesn’tdothemanygood.”
Efforts MemorialHermannoperatestenHealthCentersforSchools,establishedin1996,offeringaccesstoprimarymedical,dentalandmentalhealthservicestounderservedchildrenat82schoolsintheGreaterHoustonArea.Researchshowsthatschool-basedhealthcentersincreaseeducationalsuccessbyprovidingmedicalandmentalhealthcarethatallowsstudentstostayinschoolandlearn.Theprimarygoaloftheprogramistokeepchildrenhealthyandfeelingwellsothattheystayinschoolandcanperformwellacademically,creatingafoundationforabrighterfuture.Byprovidingimprovedaccesstohealthcaretoat-riskchildrenacrosstheregion,MemorialHermannhasdemonstratedsuccessincreatinghealthieroutcomesforkids,includingimprovementsintheirphysicalhealth,theirmentalwellbeing,andeventheirattendancerateatschool.
Transportation
Secondary Data TransportationrosetothetopofthesecondarydatascoringresultsforHarrisCounty,withatopicscoreof1.82.Indicatorsofconcerninclude:SoloDriverswithaLongCommute,MeanTravelTimetoWork,andWorkerswhoWalktoWork.Furthermore,thereexisthighdisparitiesforafewoftheseindicators.
Primary Data ParticipantsraisedthetopicofTransportation59timesinrelationtobarriersorchallengestoachievinghealthinthecommunity–morethananyothertopic.KeyinformantsrepeatedlynotedthattheHoustonregionhassignificanttransportationissues(includingavailability,accessibility)thatimpactcommunitymembers’abilitytoaccesshealthprogramsandservices.Inadditiontolimitedoptionsforpublictransportation,travelcostandtimewerebroughtup.Moreover,forcertainpopulations,likeolderadultsorpeoplewithdisabilities,publictransportationisnotafeasibleoption.“Thisremarkablespread-outcity,thesizeofMassachusetts,istheGreaterHoustonMetropolitanArea.(…)Thisisnotacityandasuburbanymore,it’sametropolitanregionwitheighttotencentersofactivitythatarelargerthandowntownSanDiego,spreadoutoverthismassivearea,butgettingfromoneplacetoanotherisanincreasingchallenge.Povertyalsomeansinadequatetransportation,wehavenoreallygoodtransitsystembecauseit’salmostimpossibletodevelopagoodtransitsystemforacitysolackingindensityandsospreadoutasHoustonis.Wehaven’tsolvedthatproblem,andalotofthehealthcareissuescomebecausepeople[are]withoutacartryingtogettoahospital,ortohealthcare…”
Efforts MemorialHermannprovidesbusandtaxitokensasrequiredfordischargeandcontinuityofcareneeds.
MemorialHermannGreaterHeightsHospitalCHNA201954
OneMemorialHermannstrategicefforttonotonlyprovidetherightcareattherighttimeintherightplace,butalsoprovidetheopportunitytoaccesshelp/careviathetelephoneistheMemorialHermannNurseHealthLine.Establishedin2014,theNurseHealthLineisafreetelephoneserviceforGreaterHoustonresidentswhoareexperiencingahealthconcernandareunsureofwhattodoorwheretogo.Experienced,bilingualnursesusetheirtrainingandexpertisetoconductassessmentsbyphone,andareavailabletoanswercalls24hoursaday,sevendayaweekforanyresidentlivinginHarrisorsurroundingcounties.Theyhelpcallersdecidewhenandwheretogoformedicalcareandassistwithsocialservicereferralsandtransportationneeds.
Children’s Health
Secondary Data Children’sHealthreceivedatopicscoreof1.52inHarrisCounty.Particularindicatorstonoteinclude:ChildrenwithHealthInsurance,ChildFoodInsecurityRate,andChildrenwithLowAccesstoaGroceryStore.Closeto10%ofchildreninHarrisCountydonothavehealthinsurance.
Primary Data WhendiscussingChildren’sHealth,keyinformantspointedoutspecificissuessuchaschildhoodobesity,accesstoservicesandbeinguninsured.Someparticipantsadvisedeffortstoengagechildren,familiesandcommunitiesmorecomprehensively.“Texasranksverylowindollarsspentonhealthforchildren.Weranklowinourranking,generally,inchildren’shealth.We’renotputtingenoughmoneyandresourcesintoit.Ithinkweneedtoshiftourattentionand(…)givemoreattentiontochildren’shealthandhowimportantitisforearlychildhooddevelopmentandforbraindevelopmentandongoinghealthintherestoftheirlives.Iwouldsayputthatasapriority.Putchildren’shealthasapriority.Notjustsayingtheearlyyears,notjustsayingzerotofivebutalsothroughoutearlyadolescence,pre-adolescence,earlyadolescenceandintotheteens.”
Efforts Children'sMemorialHermannHospital,licensedunderMemorialHermannTexasMedicalCenter,wasfoundedin1986andistheprimaryteachinghospitalforthepediatricandobstetrics/gynecologyprogramsatTheUniversityofTexasMedicalSchoolatHouston.Children'sMemorialHermannofferscareinmorethanthirtypediatricandwomen'srelatedspecialtiesincludingthelatestadvancesinmaternal-fetalmedicineandneonatalcriticalcareservices,andrenownedprogramsinpediatrictrauma,neurosciences,pulmonologyandcardiaccare.Morethan37,000childrencometoChildren'sMemorialHermannHospitaleachyear.InadditiontoMemorialHermann’sschool-basedhealtheffortsdescribedabove,MemorialHermannisanon-goingfinancialcollaboratorwithChildrenatRisk,a501non-profitorganizationthatdriveschangeforchildrenthroughresearch,education,andinfluencingpublicpolicy.
MemorialHermannGreaterHeightsHospitalCHNA201955
Economy
Secondary Data Withatopicscoreof1.55,EconomywasoneofthetoptentopicsinthesecondarydatascoringresultsforHarrisCounty.Inparticular,eighteconomicindicatorshadscoresabove2:Homeownership,SevereHousingProblems,StudentsEligiblefortheFreeLunchProgram,MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage,SNAPCertifiedStores,MedianHouseholdGrossRent,FamiliesLivingBelowPovertyLevel,andFoodInsecurityRate.Eightadditionalindicatorsreceivedscoresbetween1.5and2.
Primary Data Keyinformantsdiscussedfoodinsecurityandfooddesertsasfactorsrelatedtopoorhealthoutcomes.Theypointedoutthat,althoughindividualsmightunderstandthateatinghealthyfoodsisrecommended,theymaynothaveaccesstogrocerystoresorbeabletoaffordhealthierfoodoptions.Keyinformantsnotedtheimportanceofaddressingsocioeconomicbarrierstoimprovehealthandwellbeing.“(…)That’samatterofmoney.Youcaneducate[a]womanalldaylong,butifshe’sgotacoupleofkidstofeedandshecanfeedthemallforsevendollarsasopposedto25,she’sgoingtogotoMcDonald’s.”
Efforts It’sadauntingtaskinaregionlikeGreaterHouston,whichhasanestimated7millionpeopleandoneofthehighestratesofuninsuredandunderinsuredinthecountry.ButMemorialHermannbelievesthatwecanONLYimpactthehealthofourcommunity,andthehealthofindividuals,byfocusingonthemultipledeterminantsofhealththatplaythegreatestroleininfluencingaperson’soverallhealthandwellbeing.
MemorialHermannGreaterHeightsHospitalCHNA201956
Other Findings Criticalcomponentsinassessingtheneedsofacommunityareidentifyingbarriersanddisparitiesinhealthcare.Theidentificationofbarriersanddisparitieshelpsinformandfocusstrategiesforaddressingprioritizedhealthneeds.ThefollowingsectionoutlinesbarriersacrossMemorialHermannHealthSystemanddisparitiesastheypertaintoMHGH’sservicearea.
Barriers to Care Communityinputrevealedawiderangeofbarrierstocareandwellbeing.Asdiscussedintheprevioussection,transportationwasthemostfrequentlycitedbarrierinthecommunity,followedbyotherbarrierssuchasaccesstohealthservices,healthyfoodandexerciseoptions,lowincome,andfoodinsecurity.Overall,thesecondaryandprimarydataconfirmedthatsocioeconomicfactorsimpactcommunitymembers’abilitytoachievegoodhealth.“Manythingscomebacktopovertyandlackofdisposableincome.”Keyinformantsdescribedtheinfluenceofsocialdeterminantsofhealth(includingincome,poverty,language,education,employment)onhealthoutcomes.Participantsdiscussedtheimportanceofaddressingsocialandeconomicfactorstogetattherootcausesofpoorhealthandwellbeing.“Ithinkyouhavetounderstandthatalotoffolksworkfrompaychecktopaycheck,soiftheyactuallyendupatoneofthesemedicalcentersandtheyrequireathirtydollarcopayortendollarsorfifteendollars,thenthey’renotgoingtohaveit.So,they’regoingtowalkawayuntiltheydohavethatmoneyandthatcouldbemonthslater.So,iftheyaresick,they’rejustgoingtobecomesicker.So,that’soneofthebigbarriers.”
Disparit ies Significantcommunityhealthdisparitiesareassessedinboththeprimaryandsecondarydatacollectionprocesses.Table24identifiesthenumberofsecondarydatahealthindicatorswithahealthdisparityforMHGH’sservicearea.SeeAppendixBforthespecificindicatorswithsignificantdisparities.
Table24.NumberofHealthDisparitiesIdentifiedinSecondaryDataAnalysis
HarrisCountyBlackorAfricanAmerican(13)
White(8)HispanicorLatino(8)
OtherRace(7)AmericanIndianorAlaskaNative(6)
Male(10)Female(3)
<6yearsofage(2)25-44yearsofage(2)45-64yearsofage(2)65+yearsofage(2)
MemorialHermannGreaterHeightsHospitalCHNA201957
GeographicdisparitieswereidentifiedusingtheSocioNeedsIndex.AsshownearlierinTable13,themajorityofzipcodeswithinMHGH’sservicearea(includingthetopzipcodesforinpatientdischarges,zipcodes77088and77022)haveSocioNeedsIndexgreaterthan95,potentiallyindicatingpoorerhealthoutcomesforresidentsinthoseareas.
MemorialHermannGreaterHeightsHospitalCHNA201958
Conclusion TheCommunityHealthNeedsAssessmentforMHGHutilizedacomprehensivesetofsecondarydataindicatorstomeasurethehealthandqualityoflifeneedsforMHGH’sservicearea.Furthermore,thisassessmentwasinformedbyinputfromknowledgeableanddiverseindividualsrepresentingthebroadinterestsofthecommunity.MemorialHermann’ssystem-wideprioritizationprocessresultedinfourfocusareasorpillars:AccesstoHealthcare,EmotionalWell-Being,FoodasHealth,andExerciseIsMedicine.MHGHwillreviewtheseprioritiesmorecloselyduringtheImplementationStrategydevelopmentprocessanddesignaplanforaddressingthesepillarsmovingforward.Inaddition,MHGHinvitesyourfeedbackonthisCHNAreporttohelpinformthenextCommunityHealthNeedsAssessmentprocess.Ifyouhaveanyfeedbackorremarks,pleasesendthemto:[email protected].
MemorialHermannGreaterHeightsHospitalCHNA201959
Appendix
Appendix A: Evaluation Since Prior CHNA
Appendix B. Secondary Data Methodology
Secondary Data Sources
Secondary Data Scoring
Data Scoring Results
Appendix C. Primary Data Methodology
Community Input Participants
Key Informant Interview Questionnaire (Episcopal Health Foundation)
Key Informant Interview Questionnaire (Conduent Healthy Communities Institute)
Community Survey (English)
Community Survey (Spanish)
Appendix D. Priorit ization Tool
Priorit ization Survey
Appendix E. Community Resources
MemorialHermannGreaterHeightsHospitalCHNA201960
AppendixA.MHGreaterHeightsImpactReport
EvaluationSincePriorCHNA Priority1:HealthyLiving
Priority1: HealthyLiving
Goal1: Empowerindividualstomanagetheirhealthandbeproactiveintheircaretomaximizehealthylivingforfuturegenerations.
EarlyDetectionandScreeningObjective1.1: IncreaseawarenessandprovideearlydetectionscreeningsforourcommunityOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Numberofscreeningsprovided EstablishBaseline 600 700 5%>Baseline• Numberofeducation/supportgroupeventshostedorparticipatedin 61/year 40 35 75/year
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,31.1.1: Conductfreescreenings(cancer,HIV,HepatitisC,Vascular(screeningforblockedarteriesdiabetes,etc.) 1,2,31.1.2: Conductsupportgroupsondiabetes,cancer,woundcare,amputation,COPD,andstroke(See1.5.1) 1,2,31.1.3: ConductLunchandLearnsforemployers,organizationsandcommunitymembers(See1.3.5) 1,2,31.1.4: Provideinformationonservicesavailableandconducteducationsessionsathealthfairs(See1.2.3and
1.3.5) 1,2,3
Monitoring/EvaluationApproach:• Countsanddataassessedandenteredinadatabaseattheconclusionofeachevent• QuarterlyCommunityBenefitSteeringCommitteeReview
PotentialPartners:• Communityorganizationsthatworkwithat-riskpopulations–churches,countyclinics,safety-netresources• ChambersofCommerce,businessesandemployers
MemorialHermannGreaterHeightsHospitalCHNA201961
ObesityPreventionObjective1.2: EducatethecommunitytolivehealthierlifestylesthroughnutritionandexerciseOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Poundsofproducedistributedtocommunitypartnersviacommunitygarden EstablishBaselineYear1 500lbs 500 5%>Baseline• Numberoftimesco-opdistributesfoodatfacility EstablishBaselineYear1 12 12 Monthly• Numbereducationaleventsconnectedwithnutritionandexercise 5 5 8 10
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,31.2.1: Providefinancialsupportandcoordinatevolunteerstoestablishacommunitygardenwithalowerincome
neighborhood(See1.3.3) 1,2,3
1.2.2: Establishaco-opforfreshfruitsandvegetablesatthehospitalforstaffandcommunitymembers(See1.3.4)
1,2,3
1.2.3: Hosteducationalsessionsaboutnutritionandexercise(See1.1.4) 1,2,3 Monitoring/EvaluationApproach:
• Weighingpoundsoffooddonated/distributed• Amountoftimeco-oppick-upisavailableathospital• Countofeducationevents/participantsthathavenutritionfocusaggregatedandenteredinaftereachevent• QuarterlyreviewbyCommunityBenefitSteeringCommittee
PotentialPartners:• Diabetesorganizations• Localschools,churches,civicorganizations,HOAsandemployers• Localfarmer’smarket
MemorialHermannGreaterHeightsHospitalCHNA201962
AccesstoHealthyFoodObjective1.3: ProvideeducationonhealthyfoodoptionsandhealthierfoodatalowercostforourcommunitymembersOutcomeIndicators:
AnnualBaseline Year1 Year2 FY2020Target
• NumberofERpatientsscreenedforfoodinsecurityviatheMHERNavigationprogram 2,162 3581 3414 2,162
• NumberofCHWreferralstocommunityfoodpantriesviatheMHERNavigationprogram 709 1951 1827 709
• NumberofsupportedcommunityeventshostedbylocalpartnersviatheMHERNavigationprogram 0 1 12 2
• Establishmentofcommunitygarden NotImplemented Identified SupportingGarden Implemented• Poundsofproducedistributedtocommunitypartners EstablishBaselineYear1 500lbs 500lbs 5%>Baseline
Strategies: Year1Notes Year2Notes Timeline:Year1,2,3
1.3.1 ContinuetoparticipateintheMHERNavigationprograminwhichparticipantsarescreenedforfoodinsecurityandreferredtofoodpantriesifnecessary(See2.4.2)
1,2,3
1.3.2: Collectfoodtosupportfoodpantriesorspecialeventshostedbycommunitypartners 1,2,31.3.3: Providefinancialsupportandcoordinatevolunteerstoestablishacommunitygardenwithalowerincome
neighborhood(See1.2.1)
1,2,3
1.3.4: Establishaco-opforfreshfruitsandvegetablesatthehospitalforstaffandcommunitymembers(See1.2.2)
1,2,3
1.3.5: Provideeducationabouthealthyportionsandhealthyfoodchoicestoemployers,organizationsandcommunitymembersviahealthfairsandLunchandLearns(SeestrategiesunderObjective1.1)
1,2,3
Monitoring/EvaluationApproach:• CommunityGardenWorkplanMilestones• Co-opdistributionfrequencyandparticipants• Countofeducationalevents/participants• PatientactivitydocumentedandreportedwithintheMHERNavigationelectronicrecordsystem
PotentialPartners:• Localschools,churches,civicorganizations,HOAsandemployers• Localfarmer’smarket• MinistryAssistanceoftheNewNorthwestAlliance(MANNA)• WesleyCommunityCenter• LINC'sGreenspointPantry• ComunidaddeGracia• MHCommunityBenefitCorporation
MemorialHermannGreaterHeightsHospitalCHNA201963
Timefor/SafetyDuringPhysicalActivityObjective1.4: EncouragehealthylifestylesthroughsafeexercisepracticesOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Numberofstudentsreachedincoordinationwithfreephysicals 102/year 250 300 150• Partnerwithlocalorganizationstocreatesaferecreationalareas 0locations 2 0 3locations
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,31.4.1: ProvidefinancialsupporttolocalLittleLeaguetosupportspaceforfields. 1,2,31.4.2: Providefreephysicalexaminationsfortheareaschools(i.e.,Waltripandotherhighschools) 1,2,31.4.3: ProvidefinancialsupportfortherevitalizationofLittleThicketPark,WoodlawnPark,andShadyAcresPark Provided
FinancialsupportforB-CycleProgramatWoodlawn
Park
2
Monitoring/EvaluationApproach:• Rosterofstudentphysicalsprovided• Dollarsinvestedinrevitalizingparks
PotentialPartners:• Physicians• Localschools,organizationsandemployers• TIRZ5• Sportsassociations
MemorialHermannGreaterHeightsHospitalCHNA201964
ChronicDiseaseManagementObjective1.5: Providechronicdiseasemanagementservicestoincreaseoverallhealthandwell-beingofhigh-riskpopulationsOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Numberoftypesofchronicdiseasesupportgroups(Diabetes,COPD) 4 5 5 6• HIVScreeningsinER 561/year 901 1,135 600/year
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,31.5.1: Maintaincurrentsupportgroupsandestablishnewchronicdiseasesupportgroups(e.g.,diabetes,COPD,
CHF)(See1.1.2)Xreference
1.1.2Xreference
1.1.2 1,2,3
1.5.2: ConductHIVscreeningsintheERthroughtheCDCgrant 1,2,3 Monitoring/EvaluationApproach:
• Countofsupportgroup/participants• CountofHIVscreenings/%testedpositive
PotentialPartners:• Localschools• Churches• Civicorganizations• HOAs• Employers• Vendorswithchronicdiseaseeducationmaterial
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Priority2:AccesstoHealthCare
Priority2: HealthCareAccess
Goal2: Helpthepatientgettotherightlocation,attherightcost,attherighttime.
AvailabilityofPrimaryCareandSpecialtyProvidersObjective2.1: ProvidemultipleoptionsandavenuesforpatientstoaccessprimaryandspecialtyprovidersOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• NumberofvisitsatGreaterHeightsaffiliatedMH-UrgentCare 1,209(March–July) 5,883 10,869 9,000/year
• NumberofvisitsatNeighborhoodHealthCenterNorthwest 6,829 6629 6850 7,000• NumberofERreferralstotheNeighborhoodHealthCenter
Northwest 330 601 627 345
• NumberofMemorialHermannMedicalGroupPCPs&NPs 4 5 5 6• Numberoftelemedicineconsultations 187/year 216 149 187/year
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,32.1.1: RecruitPrimaryandSpecialtyCareProviderstomeetcommunityneed 1,2,32.1.2: EstablishasecondurgentcarecenterintheGreaterHeightscommunity 1,2,32.1.3: Provisionof24/7neurologicalconsultationstoGreaterHeightspatients,
throughtheuseoftelemedicinetechnologiessuchasdigitalimagingandreal-timevideoconferencingprovidingpatientswithcontinuityintreatment,afast-trackedprocess,andthemosteffectivedrugtherapies
1,2,3
Monitoring/EvaluationApproach:• CountofMHMGPCPsandNPs–SizeofPanels• Trackvolumesofunder/uninsuredtreatedatUrgentCare,NeighborhoodHealthCenterandCCC
PotentialPartners:• OtherMHHSentities• Localschools,churches,civicorganizations,HOAsandemployers
MemorialHermannGreaterHeightsHospitalCHNA201966
HealthInsuranceCoverageandCostsObjective2.2: Provideresourcestoincreaseawareness,education,andhealthinsurancecoverageandreducecostsforuninsuredandunderinsured
populationsOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• NumberofClassDPrescriptionstotheHoggSchool-BasedHealthCenterinsupportofprimarymedicalcareprovidedtouninsuredchildrenandteensatnocost
1,709 165 626 1,709
• NeighborhoodHealthCenterGHvouchersissued 330 666 1222 345
• NeighborhoodHealthCenterGHvouchersused 228 376
627seen
238notseen
(865total)
240
• %ofpatientsCardonisabletohelpassisttogetmedicalinsurancecoverage 21% 21.82% 21.35% 23%
Strategies: Year1Notes Year2Notes Timeline:Year1,2,3
2.2.1: ProvideClassDPrescriptionstotheHoggSchoolBasedHealthCenterinsupportofprimarymedicalcareprovidedtouninsuredchildrenandteensatnocost
1,2,3
2.2.2: SubsidizethecostforvouchersthatareprovidedforcommunitymemberstoobtainfreeandreducedcostcareattheNeighborhoodHealthCenterGHlocatednexttotheemergencyroom
1,2,3
2.2.3: ContractwithCardontoconsultonallpatientswhoareuninsuredorunderinsuredtoconnectthemwithavailablepayorresources
Cardonisathird-partyeligibilityvendor(paidbyMHSL)toassistpatientswiththe
applicationprocessforMedicaid,CountyIndigent,AffordableCareActInsuranceExchange,andotherthird-partypayors.
1,2,3
2.2.4Contractwithphysicianstoprovidecareforuninsuredpatients 1,2,3 Monitoring/EvaluationApproach:
• Countofvouchersissuedandusedonamonthlybasis• Countofpatientsconsulted/convertedbyCardononamonthlybasis
PotentialPartners:• NeighborhoodHealthCenterGreaterHeights• Localschools,churches,civicorganizations,HOAsandemployers• HarrisHealth(CommunitySafetyNet)• Cardon• MemorialHermannCommunityBenefitCorporation
MemorialHermannGreaterHeightsHospitalCHNA201967
TransportationObjective2.3: Providepatientsinneedwithjust-in-timetransportationresourcesOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• PatientTransportationFees $48,000/year $355,076 $297,797 $50,000yearStrategies: Year1Notes Year2Notes Timeline:
Year1,2,32.3.1: Providebuspasses,cabvouchers,andambulances,andwheelchairvansforfree
transportationtoandfromappointments
1,2,3
Monitoring/EvaluationApproach:• Numberofvouchersordollarscontributedtosubsidizedtransportationmonthly
PotentialPartners:• Metro,taxi,bussystem• Partnerorganizationswhoprovidefreeorreducedcostfortransportation
MemorialHermannGreaterHeightsHospitalCHNA201968
HealthCareNavigationObjective2.4: ConnectpatientstoresourcestohelpthemunderstandandnavigatetheirhealthcarejourneytoimprovepatientoutcomesOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• Numberofhospital'sassociatedcounties'callstoNurseHealthLine(Harris)
28,581 28624 29615 28,581
• NumberofpatientsenrolledintheERNavigationProgram 2,332 3387 3300 2,332• NumberofERNavigationpatientencounters 4,500 8498 9332 4,500• NumberofERNavigationreferralstocommunityresources 5,671 8810 7445 5,671• NumberofERNavigationscheduledappointments 302 470 332 302• Numberofdiseasespecificnursenavigatorsoncampus
(excludingER) 4 4 4 5
• Numberofeducation/supportgroupeventshostedorparticipatedin(Objective1.1) 61/year 6961 XRef.1.1 75/year
Strategies: Year1Notes Year2Notes Timeline:Year1,2,3
2.4.1: Providea24/7freeresourceviatheNurseHealthLinethatcommunitymembers(uninsuredandinsured)withintheMHHScommunitycancalltodiscusstheirhealthconcerns,receiverecommendationsontheappropriatesettingforcare,andgetconnectedtoappropriateresources
1,2,3
2.4.2 ContinuetoparticipateintheMHERNavigationprograminwhichpatientsarereferredtoamedicalhome(See1.3.1)
1,2,3
2.4.3: ProvideNurseNavigatorsfordiseasespecificcareincludingoncology,joint,bariatric,andamputationprevention
1,2,3
2.4.4Providehealthcarescreenings,educationalevents,healthfairs,physicalsandutilizetheappropriateresourcesateacheventtoconnectpatientswiththenecessarytoolstonavigatetheirhealthcarejourney(SeestrategiesunderObjective1.1)
1,2,3
Monitoring/EvaluationApproach:• PatientactivitydocumentedandreportedwithintheERNavigationelectronicrecordsystem• PatientcallsdocumentedwithintheNurseHealthLineelectronicrecordsystem
PotentialPartners:• IbnSinaFoundationClinic• SpringBranchCommunityHealthCenter• St.HopeCommunityHealthCenter• LegacyCommunityHealthCenter• HoustonAreaCommunityServices(HACS)• MemorialHermannCommunityBenefitCorporation
MemorialHermannGreaterHeightsHospitalCHNA201969
Priority3:BehavioralHealthThefollowingtablesprovidestrategiesandoutcomeindicatorsthatreflectanMHHSsystem-wideapproachtoBehavioralHealth.DataisnotspecifictoMHGreaterHeightsHospitalbuttothecommunityatlargewiththeexceptionofreductioninERencountersthatresultinapsychiatricinpatientstaythroughlinkageswithanetworkofbehavioralpartners.
Priority3: BehavioralHealth
Goal3: Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.
Objective3.1: Createnontraditionalaccesspointsaroundthecommunity(crisis/ambulatory,acutecare,andcommunity-basedchroniccaremanagement),andlinkthosewhoneedservicestopermanentprovidersandresourcesinthecommunity
OutcomeIndicators: AnnualBaseline
Year1 Year2 FY2020Target
• DecreaseinthenumberofERencountersthatresultinpsychiatricinpatientstay
1,146 1,213 1,135 1,0895%reductionofbaseline
• DecreaseinnumberofERencountersthatresultinpsychiatricinpatientstayatGreaterHeights 114
121 114108
• NumberofMemorialHermannCrisisClinictotalvisits 5,400 5,590 5,154 5%overbaseline• NumberofPsychiatricResponseCareManagementtotalvisits 1,200 1,103 1,259 5%overbaseline
Strategies:Year1Notes Year2Notes Timeline:
Year1,2,33.1.1: Providementalhealthassessment,care,andlinkagetoservicesinanacute
caresetting,24x7toservicesatGreaterHeightsAnuptickinacutecarevolumeoverthepastfiscalyearhascontributedtoahighernumberofpsychiatrictransfersoverall.
Anincreaseinacutecarevolumeandnumberofacutecaresitesoverthepastfiscalyearhavecontributedtoahighernumberofpsychiatrictransfersoverall.
1,2,3
MemorialHermannGreaterHeightsHospitalCHNA201970
Priority3: BehavioralHealth
Goal3: Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.
3.1.2: Createnontraditionalcommunityaccesstopsychiatricprovidersforindividualsexperiencingamentalhealthcrisis.ClinicalSocialWorkersconnectthetargetpopulationtoon-goingbehavioralhealthcare
Recruitingmentalhealthproviderswillingtocommittoanon-
traditionalscheduleremainsa
challenge.Continuingthisurgentcaremodeloftreatmentremainsapriority,duetolimitedmentalhealthtreatmentaccessinthecommunity
1,2,3
3.1.3: Engageindividualswithachronicmentalillnessandworktomaintainengagementwithtreatmentandstabilityinthecommunityviaenrollmentincommunity-basedmentalhealthcasemanagementprogram
Staffingissuesimpededyearonetarget.Identifyingappropriatelylicensedclinicianswillingtoconsideracareerthatiscommunitybasedwiththerequirementofmakinghomevisitsandworkingnon–traditionalhoursisanongoingchallenge.
CaseManagerspartnerwiththeirclientsto
identifyspecificrecoverygoalsandutilizeevidence-
basedpracticestofacilitateclient
achievement.Wecontinuetopartnerwithcommunityproviderstoaddressthementalhealth
needsoftheGreaterHoustonCommunity.
1,2,3
Monitoring/EvaluationApproach:• EMR/registrationsystem(trackandtrenddaily,weekly,monthly)
PotentialPartners:• Systemacutecarecampuses• MemorialHermannMedicalGroup• Networkofpublicandprivateproviders
MemorialHermannGreaterHeightsHospitalCHNA201971
Objective3.2: Reducestigmainordertopromotementalwellnessandimprovecommunityawarenessthatmentalhealthispartofphysicalhealthandoverallwell-being
OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target• Numberofpresentations/educationalsessionsforhealthcare
professionalswithinMHHS50sessionsperyear 63 71 5%increaseover
baseline• Numberofpresentations/educationalsessionsforcorporations 5 7 8 5%overbaseline• NumberoftrainingsatGHERNursingTrainings(timeincludes
trainingmaterialdevelopmentandimplementation)5trainings(8hours) 0 0 5trainings(8
hours)
• GHMedFloorNursingdebriefing 1training(3hours) 0 0 1training(3hours)
• GHManagementandcommunicationwithdisruptivepatients(timeincludestrainingmaterialdevelopmentandimplementation)
1training(4hours) 0 0 1training(4hours)
• TrainingonAcuteCareConcepts-systemnurseresidentprogram 15trainings(45hourstotal/3hours
each)*18 9
15trainings(45hourstotal/3hourseach)*
• TrainingonCMORoundtable-system-wide 1training(2hours)* 0 4 1training(2hours)*
*Totaltimeincludestrainingmaterialdevelopmentandimplementation
531.6
Strategies: Year1Notes Year2Notes Timeline:Year1,2,3
3.2.1: ProvidementalhealtheducationsessionswithintheMHhealthsystemfornursesandphysicians
1,2,3
3.2.2: WorkwithemployersolutionsgrouptoprovideeducationandtrainingwithcorporationsonMHtopics(stress,PTSD)
1,2,3
Monitoring/EvaluationApproach:• Requestsforpresentationsandsessionstrackedviacalendar/excel
PotentialPartners:• Systemacutecarecampuses• SystemMarketingandCommunications• Employersolutionsgroup
MemorialHermannGreaterHeightsHospitalCHNA201972
Objective3.3: Qualityofmentalhealthandsubstanceabuseservices:access,link,andpracticeutilizingevidence-basedpracticetopromoteoverallwellness
OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target
• NumberofMemorialHermannCrisisClinicfollow-upspostdischargewithclinicpatients
7,716 6,431 5,154 5%overbaseline
• PsychiatricResponseCaseManagementreductioninsystemERutilization
54.4% 53.0% 50% 5%increaseoverbaseline
Strategies: Year1Notes Year2Notes Timeline:Year1,2,3
3.3.1: MHCCfollow-upwithdischargedpatientsandtheirfamiliestoassesswell-beingandconnectthemtocommunityresources
1,2,3
3.3.2: PsychiatricResponseCaseManagementProgramutilizesevidence-basedpracticeinterventions(motivationalinterviewing,MHFirstAid,CAMS,etc.)toreduceERutilizationforprogramenrollees
1,2,3
Monitoring/EvaluationApproach:• Socialworklogs(Excelspreadsheet)
PotentialPartners:• Systemacutecarecampuses• Community-basedclinicalproviders• Networkofpublicandprivateproviders
MemorialHermannGreaterHeightsHospitalCHNA2019 73
AppendixB.SecondaryDataMethodology
SecondaryDataSourcesThemainsourceforthesecondarydata,ordatathathavebeenpreviouslycollected,isthecommunityindicatordatabasemaintainedbyConduentHealthyCommunitiesInstitute.ThefollowingisalistofbothlocalandnationalsourcesusedinMemorialHermannGreaterHeights’CommunityHealthNeedsAssessment.
HarrisCounty1. AmericanCommunitySurvey2. AmericanLungAssociation3. CentersforMedicare&MedicaidServices4. CountyHealthRankings5. FeedingAmerica6. InstituteforHealthMetricsandEvaluation7. NationalCancerInstitute8. NationalCenterforEducationStatistics9. SmallAreaHealthInsuranceEstimates10. TexasBehavioralRiskFactorSurveillanceSystem11. TexasDepartmentofFamilyandProtectiveServices12. TexasDepartmentofStateHealthServices13. TexasEducationAgency14. TexasSecretaryofState15. U.S.BureauofLaborStatistics16. U.S.Census-CountyBusinessPatterns17. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas18. U.S.EnvironmentalProtectionAgency
MemorialHermannGreaterHeightsHospitalCHNA2019 74
SecondaryDataScoring
Datascoringisdoneinthreestages:
Foreachindicator,eachcountyinMemorialHermannGreaterHeights’serviceareaisassignedascorebasedonitscomparisontoothercommunities,whetherhealthtargetshavebeenmet,andthetrendoftheindicatorvalueovertime.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariesbyindicatorandisdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.
Indicatorsarecategorizedintotopicareasandeachtopicareareceivesascore.Indicatorsmaybecategorizedinmorethanonetopicarea.Topicscoresaredeterminedbythecomparisonsofallindicatorswithinthetopic.
ComparisontoaDistributionofCountyValues:WithinStateandNation
Foreaseofinterpretationandanalysis,indicatordataontheCommunityDashboardisvisuallyrepresentedasagreen-yellow-redgaugeshowinghowthecommunityisfaringagainstadistributionofcountiesinthestateortheUnitedStates.Adistributioniscreatedbytakingallcountyvalueswithinthestateornation,orderingthemfromlowtohigh,anddividingthemintothreegroups(green,yellow,red)basedontheirorder.Indicatorswiththepoorestcomparisons(“inthered”)scoredhigh,whereasindicatorswithgoodcomparisons(“inthegreen”)scoredlow.
Comparisons • Quantitatively
score all possible comparisons
Indicators • Summarize
comparison scores for each indicator
Topics • Summarize
indicator scores by topic area
MemorialHermannGreaterHeightsHospitalCHNA2019 75
ComparisontoValues:State,National,andTargets
Eachcountyiscomparedtothestatevalue,thenationalvalue,andtargetvalues.Targetvaluesincludethenation-wideHealthyPeople2020(HP2020)goals.HealthyPeople2020goalsarenationalobjectivesforimprovingthehealthofthenationsetbytheDepartmentofHealthandHumanServices’(DHHS)HealthyPeopleInitiative.Forallvaluecomparisons,thescoringdependsonwhetherthecountyvalueisbetterorworsethanthecomparisonvalue,aswellashowclosethecountyvalueistothetargetvalue.
TrendOverTime
TheMann-Kendallstatisticaltestfortrendwasusedtoassesswhetherthecountyvalueisincreasingovertimeordecreasingovertime,andwhetherthetrendisstatisticallysignificant.Thetrendcomparisonusesthefourmostrecentcomparablevaluesforthecounty,andstatisticalsignificanceisdeterminedatthe90%confidencelevel.Foreachindicatorwithvaluesavailableforfourtimeperiods,scoringwasdeterminedbydirectionofthetrendandstatisticalsignificance.
MissingValues
Indicatorscoresarecalculatedusingthecomparisonscores,availabilityofwhichdependsonthedatasource.Ifthecomparisontypeispossibleforanadequateproportionofindicatorsonthecommunitydashboard,itwillbeincludedintheindicatorscore.Afterexclusionofcomparisontypeswithinadequateavailability,allmissingcomparisonsaresubstitutedwithaneutralscoreforthepurposesofcalculatingtheindicator’sweightedaverage.Wheninformationisunknownduetolackofcomparabledata,theneutralvalueassumesthatthemissingcomparisonscoreisneithergoodnorbad.
IndicatorScoring
Indicatorscoresarecalculatedasaweightedaverageofallincludedcomparisonscores.Ifnoneoftheincludedcomparisontypesarepossibleforanindicator,noscoreiscalculatedandtheindicatorisexcludedfromthedatascoringresults.
TopicScoring
Indicatorscoresareaveragedbytopicareatocalculatetopicscores.Eachindicatormaybeincludedinuptothreetopicareasifappropriate.Resultingscoresrangefrom0-3,whereahigherscoreindicatesagreaterlevelofneedasevidencedbythedata.Atopicscoreisonlycalculatedifitincludesatleastthreeindicators.
MemorialHermannGreaterHeightsHospitalCHNA2019 76
DataScoringResults Thefollowing tableslisteachindicatorbytopicareaforMemorialHermannGreaterHeights’servicearea(HarrisCounty).SecondarydataforthisreportareuptodateasofNovember2,2018.
MemorialHermannGreaterHeightsHospitalCHNA2019 77
HarrisCounty
SCORE ACCESSTOHEALTHSERVICES UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.00AdultsUnabletoAffordtoSeeaDoctor percent 22.1 18.3 12.1 2015 10
1.81 ChildrenwithHealthInsurance percent 89.4 100 90.3 2016 9
1.75AdultswithHealthInsurance:18-64 percent 74.7 100 77.4 2016 9
1.75 PersonswithHealthInsurance percent 79.3 100 81.4 2016 9
1.61 PrimaryCareProviderRateproviders/100,000
population 57.2 59.9 75.5 2015 4
1.44 MentalHealthProviderRateproviders/100,000
population 103.7 98.8 214.3 2017 4
1.00Non-PhysicianPrimaryCareProviderRate
providers/100,000population 72.2 66.8 81.2 2017 4
0.50 DentistRatedentists/100,000
population 66.3 55.9 67.4 2016 4
SCORE CANCER UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.53 CervicalCancerIncidenceRatecases/100,000
females 11 7.3 9.2 7.5 2011-2015
7
2.25Age-AdjustedDeathRateduetoBreastCancer
deaths/100,000females 23.2 20.7 20.2 20.9 2011-2015 Black 7
1.94 Cancer:MedicarePopulation percent 7.6 7.1 7.8 2015 3
1.58ColonCancerScreening:SigmoidoscopyorColonoscopy percent 57.6 62.3 2016 10
1.53Age-AdjustedDeathRateduetoProstateCancer
deaths/100,000males 19.8 21.8 18.1 19.5 2011-2015 7
1.39 BreastCancerIncidenceRatecases/100,000
females 113.2 111.7 124.7 2011-2015 7
MemorialHermannGreaterHeightsHospitalCHNA2019 78
1.33 ProstateCancerIncidenceRatecases/100,000
males 102.5 95.4 109 2011-2015 7
1.22Age-AdjustedDeathRateduetoColorectalCancer
deaths/100,000population 14.6 14.5 14.4 14.5 2011-2015 7
1.00 AllCancerIncidenceRatecases/100,000population 402.6 401.3 441.2 2011-2015 7
0.94Age-AdjustedDeathRateduetoCancer
deaths/100,000population 157.8 161.4 156.4 163.5 2011-2015 Black,Male 7
0.94 ColorectalCancerIncidenceRatecases/100,000population 38.8 39.9 38.1 39.2 2011-2015 7
0.89OralCavityandPharynxCancerIncidenceRate
cases/100,000population 10.9 10.9 11.6 2011-2015 7
0.50LungandBronchusCancerIncidenceRate
cases/100,000population 50.9 53.1 60.2 2011-2015 7
0.33Age-AdjustedDeathRateduetoLungCancer
deaths/100,000population 37.5 45.5 39 43.4 2011-2015 7
SCORE CHILDREN'SHEALTH UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.81 ChildrenwithHealthInsurance percent 89.4 100 90.3 2016 9
1.67 ChildFoodInsecurityRate percent 23.5 23 17.9 2016 5
1.50ChildrenwithLowAccesstoaGroceryStore percent 5.4 2015 17
1.11 SubstantiatedChildAbuseRatecases/1,000children 5.4 8.5 2017 11
SCORE DIABETES UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.67 Diabetes:MedicarePopulation percent 28.1 28.2 26.5 2015
3
1.44 AdultswithDiabetes percent 10.2 11.2 10.5 2016
10
0.92Age-AdjustedDeathRateduetoDiabetes
deaths/100,000population 20.2 21.7 21.2 2010-2014
Black,Hispanic,Male 12
MemorialHermannGreaterHeightsHospitalCHNA2019 79
SCORE ECONOMY UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.44 Homeownership percent 49.6 55 55.9 2012-2016 1
2.39 SevereHousingProblems percent 20.9 18.3 18.8 2010-2014 4
2.22StudentsEligiblefortheFreeLunchProgram percent 58.2 52.9 42.6 2015-2016 8
2.14MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage dollars 534 467 462 2012-2016 1
2.11 SNAPCertifiedStoresstores/1,000population 0.6 2016
17
2.08 MedianHouseholdGrossRent dollars 937 911 949 2012-2016
1
2.06FamiliesLivingBelowPovertyLevel percent 14.4 13 11 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other 1
2.06 FoodInsecurityRate percent 16.6 15.4 12.9 2016 5
1.94UnemployedWorkersinCivilianLaborForce percent 4.4 4 4.1 July2018 15
1.89People65+LivingBelowPovertyLevel percent 11.3 10.8 9.3 2012-2016
Asian,BlackorAfricanAmerican,HispanicorLatino,Other,Female,75+ 1
1.81MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1504 1444 1491 2012-2016
1
1.67 ChildFoodInsecurityRate percent 23.5 23 17.9 2016
5
1.67ChildrenLivingBelowPovertyLevel percent 26 23.9 21.2 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other,<6 1
1.67 PeopleLivingBelowPovertyLevel percent 17.4 16.7 15.1 2012-2016AmericanIndianorAlaskaNative,Black 1
MemorialHermannGreaterHeightsHospitalCHNA2019 80
orAfricanAmerican,HispanicorLatino,Other,Female,<6,6-11,12-17,18-24
1.67 TotalEmploymentChange percent 2.4 3.2 2.5 2014-2015 16
1.50RentersSpending30%orMoreofHouseholdIncomeonRent percent 46.8 48 47.3 2012-2016 1
1.42PersonswithDisabilityLivinginPoverty(5-year) percent 25.4 25.1 27.6 2012-2016 1
1.33Low-IncomeandLowAccesstoaGroceryStore percent 6.3 2015 17
1.33PeopleLiving200%AbovePovertyLevel percent 61.6 62.8 66.4 2012-2016 1
1.08 MedianHousingUnitValue dollars 145600 142700 184700 2012-2016 1
0.97PersonswithDisabilityLivinginPoverty percent 22.9 24.2 26.6 2016 1
0.94FemalePopulation16+inCivilianLaborForce percent 59.8 57.7 58.3 2012-2016 1
0.94Population16+inCivilianLaborForce percent 68.3 64.2 63.1 2012-2016 1
0.89HouseholdswithCashPublicAssistanceIncome percent 1.5 1.6 2.7 2012-2016 1
0.67 HomeownerVacancyRate percent 1.5 1.6 1.8 2012-2016 1
0.50 MedianHouseholdIncome dollars 55584 54727 55322 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other 1
0.50 PerCapitaIncome dollars 29850 27828 29829 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,NativeHawaiianor
OtherPacific 1
MemorialHermannGreaterHeightsHospitalCHNA2019 81
Islander,Other,TwoorMoreRaces
SCORE EDUCATION UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.92InfantsBorntoMotherswith<12YearsEducation percent 27.5 21.6 15.9 2013
12
1.89 Student-to-TeacherRatio students/teacher 16.4 15.4 17.7 2015-2016
8
1.67 HighSchoolDropOutRate percent 2.6 2 2016
13
1.67People25+withaHighSchoolDegreeorHigher percent 80.2 82.3 87 2012-2016
Male,35-44,45-64,65+ 1
0.67People25+withaBachelor'sDegreeorHigher percent 30.1 28.1 30.3 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,NativeHawaiianor
OtherPacificIslander,Other,45-
64,65+ 1
SCORE ENVIRONMENT UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.39 SevereHousingProblems percent 20.9 18.3 18.8 2010-2014 4
2.11 SNAPCertifiedStoresstores/1,000population 0.6 2016 17
1.75 AnnualOzoneAirQuality grade F 2014-2016 2
1.69 AnnualParticlePollution grade C 2014-2016 2
1.67 FastFoodRestaurantDensityrestaurants/1,000
population 0.7 2014 17
1.61RecognizedCarcinogensReleasedintoAir pounds 1962916 2017 18
1.50ChildrenwithLowAccesstoaGroceryStore percent 5.4 2015 17
MemorialHermannGreaterHeightsHospitalCHNA2019 82
1.50 FarmersMarketDensitymarkets/1,000population 0 2016 17
1.50 GroceryStoreDensitystores/1,000population 0.2 2014 17
1.33Low-IncomeandLowAccesstoaGroceryStore percent 6.3 2015 17
1.33 RecreationandFitnessFacilitiesfacilities/1,000population 0.1 2014 17
1.25 DrinkingWaterViolations percent 1.7 6.6 FY2013-14 4
1.17 PBTReleased pounds 210516 2017 18
1.00 FoodEnvironmentIndex 7.2 6 7.7 2018 4
1.00HouseholdswithNoCarandLowAccesstoaGroceryStore percent 0.9 2015 17
1.00People65+withLowAccesstoaGroceryStore percent 1.4 2015 17
0.89 LiquorStoreDensitystores/100,000population 6.3 6.8 10.5 2015 16
0.67 AccesstoExerciseOpportunities percent 90.4 80.6 83.1 2018 4
0.17 HousesBuiltPriorto1950 percent 6.2 7.4 18.2 2012-2016 1
SCORE EXERCISE,NUTRITION,&WEIGHT UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.17 WorkerswhoWalktoWork percent 1.5 3.1 1.6 2.8 2012-2016 White,non-Hispanic 1
2.11 SNAPCertifiedStoresstores/1,000population 0.6 2016 17
2.06 FoodInsecurityRate percent 16.6 15.4 12.9 2016 5
1.67 Adults(18+Years)WhoAreObese percent 32 30.5 33.6 29.9 2016 10
1.67 ChildFoodInsecurityRate percent 23.5 23 17.9 2016 5
1.67 FastFoodRestaurantDensityrestaurants/1,000
population 0.7 2014 17
1.50 AdultswhoareOverweightor percent 66.7 68.4 65.2 2016 10
MemorialHermannGreaterHeightsHospitalCHNA2019 83
Obese
1.50ChildrenwithLowAccesstoaGroceryStore percent 5.4 2015 17
1.50 FarmersMarketDensitymarkets/1,000population 0 2016 17
1.50 GroceryStoreDensitystores/1,000population 0.2 2014 17
1.42AdultFruitandVegetableConsumption percent 18.7 17.2 2015 10
1.33Low-IncomeandLowAccesstoaGroceryStore percent 6.3 2015 17
1.33 RecreationandFitnessFacilitiesfacilities/1,000population 0.1 2014 17
1.00 FoodEnvironmentIndex 7.2 6 7.7 2018 4
1.00HouseholdswithNoCarandLowAccesstoaGroceryStore percent 0.9 2015 17
1.00People65+withLowAccesstoaGroceryStore percent 1.4 2015 17
0.67 AccesstoExerciseOpportunities percent 90.4 80.6 83.1 2018 4
SCORE HEARTDISEASE&STROKE UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.61 Stroke:MedicarePopulation percent 5.2 4.5 4 2015 3
1.89HeartFailure:MedicarePopulation percent 16 15.5 13.5 2015 3
1.50AtrialFibrillation:MedicarePopulation percent 7.3 7.4 8.1 2015 3
1.44Hyperlipidemia:MedicarePopulation percent 43.2 46.1 44.6 2015 3
1.42Age-AdjustedDeathRateduetoCerebrovascularDisease(Stroke)
deaths/100,000population 41.5 34.8 42 37.3 2010-2014 Black 12
1.33 IschemicHeartDisease:Medicare percent 28.8 28.8 26.5 2015
3
MemorialHermannGreaterHeightsHospitalCHNA2019 84
Population
1.22Hypertension:MedicarePopulation percent 55.5 57.5 55 2015
3
0.92Age-AdjustedDeathRateduetoHeartDisease
deaths/100,000population 167.6 173 171.9 2010-2014 Black,White,Male 12
SCOREIMMUNIZATIONS&INFECTIOUSDISEASES UNITS
HARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.33 GonorrheaIncidenceRatecases/100,000population 182.1 160.2 2017 12
2.33 SyphilisIncidenceRatecases/100,000population 59.3 40.6 2017 12
2.11 ChlamydiaIncidenceRatecases/100,000population 571.4 511.6 2017 12
1.83 TuberculosisIncidenceRatecases/100,000population 6.6 1 4.5 2013-2017 12
1.78Adults65+withInfluenzaVaccination percent 57.2 57.3 58.6 2016 10
1.67 HIVDiagnosisRatecases/100,000population 26.3 16.1 2016
12
1.17Adults65+withPneumoniaVaccination percent 73.5 90 71.3 73.4 2016
10
1.00Age-AdjustedDeathRateduetoInfluenzaandPneumonia
deaths/100,000population 14 14.2 15.2 2010-2014 Black,Male 12
SCOREMATERNAL,FETAL&INFANTHEALTH UNITS
HARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.36 InfantMortalityRatedeaths/1,000live
births 6.8 6 5.8 6 2013 12
1.97MotherswhoReceivedEarlyPrenatalCare percent 56.1 77.9 59.2 74.2 2013 12
1.92InfantsBorntoMotherswith<12YearsEducation percent 27.5 21.6 15.9 2013 12
MemorialHermannGreaterHeightsHospitalCHNA2019 85
1.81 BabieswithLowBirthWeight percent 8.6 7.8 8.3 8 2013 12
1.61 BabieswithVeryLowBirthWeight percent 1.5 1.4 1.4 1.4 2013 12
1.25 PretermBirths percent 11.8 9.4 12 11.4 2013 12
0.58 TeenBirths percent 2.5 2.8 4.3 2014 12
SCORE MEN'SHEALTH UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.53Age-AdjustedDeathRateduetoProstateCancer
deaths/100,000males 19.8 21.8 18.1 19.5 2011-2015 7
1.33 ProstateCancerIncidenceRatecases/100,000
males 102.5 95.4 109 2011-2015 7
1.28 LifeExpectancyforMales years 76.4 76.2 76.7 2014 6
SCOREMENTALHEALTH&MENTALDISORDERS UNITS
HARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.89Alzheimer'sDiseaseorDementia:MedicarePopulation percent 11.4 11.7 9.9 2015
3
1.53 PoorMentalHealth:5+Days percent 80 81.5 2016
10
1.50PoorMentalHealth:AverageNumberofDays days 3.7 3.4 3.8 2016 4
1.44 MentalHealthProviderRateproviders/100,000
population 103.7 98.8 214.3 2017 4
1.17 FrequentMentalDistress percent 11.2 10.6 15 2016 4
0.94Age-AdjustedDeathRateduetoSuicide
deaths/100,000population 10.3 10.2 11.7 12.5 2010-2014 White,Male 12
0.94 Depression:MedicarePopulation percent 14.8 17 16.7 2015
3
0.64Age-AdjustedDeathRateduetoAlzheimer'sDisease
deaths/100,000population 17.9 26.6 24.5 2010-2014 White,Female 12
MemorialHermannGreaterHeightsHospitalCHNA2019 86
SCORE OLDERADULTS&AGING UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.67ChronicKidneyDisease:MedicarePopulation percent 20.9 19.9 18.1 2015
3
2.61 Stroke:MedicarePopulation percent 5.2 4.5 4 2015
3
2.06Age-AdjustedDeathRateduetoFalls
deaths/100,000population 10.4 7.2 7.4 8.3 2010-2014 White,Male 12
1.94 Cancer:MedicarePopulation percent 7.6 7.1 7.8 2015 3
1.89Alzheimer'sDiseaseorDementia:MedicarePopulation percent 11.4 11.7 9.9 2015 3
1.89HeartFailure:MedicarePopulation percent 16 15.5 13.5 2015 3
1.89People65+LivingBelowPovertyLevel percent 11.3 10.8 9.3 2012-2016
Asian,BlackorAfricanAmerican,HispanicorLatino,Other,Female,75+ 1
1.78Adults65+withInfluenzaVaccination percent 57.2 57.3 58.6 2016 10
1.72Osteoporosis:MedicarePopulation percent 6.3 6.5 6 2015 3
1.67 Diabetes:MedicarePopulation percent 28.1 28.2 26.5 2015 3
1.50AtrialFibrillation:MedicarePopulation percent 7.3 7.4 8.1 2015 3
1.44Hyperlipidemia:MedicarePopulation percent 43.2 46.1 44.6 2015 3
1.44 People65+LivingAlone percent 24.4 23.9 26.4 2012-2016 1
1.33IschemicHeartDisease:MedicarePopulation percent 28.8 28.8 26.5 2015 3
1.22Hypertension:MedicarePopulation percent 55.5 57.5 55 2015 3
1.17Adults65+withPneumoniaVaccination percent 73.5 90 71.3 73.4 2016 10
1.00People65+withLowAccesstoaGroceryStore percent 1.4 2015 17
MemorialHermannGreaterHeightsHospitalCHNA2019 87
0.94 Asthma:MedicarePopulation percent 7.3 8.2 8.2 2015 3
0.94 Depression:MedicarePopulation percent 14.8 17 16.7 2015 3
0.94
RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 27.8 31.6 30 2015 3
0.64Age-AdjustedDeathRateduetoAlzheimer'sDisease
deaths/100,000population 17.9 26.6 24.5 2010-2014 White,Female 12
0.39 COPD:MedicarePopulation percent 9.6 11.1 11.2 2015
3
SCORE OTHERCHRONICDISEASES UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.67ChronicKidneyDisease:MedicarePopulation percent 20.9 19.9 18.1 2015 3
1.72Osteoporosis:MedicarePopulation percent 6.3 6.5 6 2015 3
0.94
RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 27.8 31.6 30 2015 3
SCORE PREVENTION&SAFETY UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.39 SevereHousingProblems percent 20.9 18.3 18.8 2010-2014
4
2.06Age-AdjustedDeathRateduetoFalls
deaths/100,000population 10.4 7.2 7.4 8.3 2010-2014 White,Male 12
1.19 DeathRateduetoDrugPoisoningdeaths/100,000
population 10.2 9.8 16.9 2014-2016
4
0.69Age-AdjustedDeathRateduetoUnintentionalInjuries
deaths/100,000population 36.1 36.4 37.6 39.2 2010-2014 White,Male 12
SCORE PUBLICSAFETY UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
MemorialHermannGreaterHeightsHospitalCHNA2019 88
2.17 Alcohol-ImpairedDrivingDeaths percent 37.8 28.3 29.3 2012-2016 4
1.67 ViolentCrimeRatecrimes/100,000
population 713.7 407.6 2012-2014 4
1.11 SubstantiatedChildAbuseRatecases/1,000children 5.4 8.5 2017 11
SCORE RESPIRATORYDISEASES UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.83 TuberculosisIncidenceRatecases/100,000population 6.6 1 4.5 2013-2017 12
1.78Adults65+withInfluenzaVaccination percent 57.2 57.3 58.6 2016 10
1.17Adults65+withPneumoniaVaccination percent 73.5 90 71.3 73.4 2016 10
1.00Age-AdjustedDeathRateduetoInfluenzaandPneumonia
deaths/100,000population 14 14.2 15.2 2010-2014 Black,Male 12
0.94 Asthma:MedicarePopulation percent 7.3 8.2 8.2 2015 3
0.50LungandBronchusCancerIncidenceRate
cases/100,000population 50.9 53.1 60.2 2011-2015 7
0.39 COPD:MedicarePopulation percent 9.6 11.1 11.2 2015 3
0.33Age-AdjustedDeathRateduetoLungCancer
deaths/100,000population 37.5 45.5 39 43.4 2011-2015 7
SCORE SOCIALENVIRONMENT UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.67 MeanTravelTimetoWork minutes 28.6 25.9 26.1 2012-2016 Male 1
2.50 LinguisticIsolation percent 11.8 7.9 4.5 2012-2016 1
2.44 Homeownership percent 49.6 55 55.9 2012-2016 1
2.17 Single-ParentHouseholds percent 36.2 33.3 33.6 2012-2016 1
2.14MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage dollars 534 467 462 2012-2016 1
MemorialHermannGreaterHeightsHospitalCHNA2019 89
2.08 MedianHouseholdGrossRent dollars 937 911 949 2012-2016 1
1.81MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1504 1444 1491 2012-2016
1
1.75 PersonswithHealthInsurance percent 79.3 100 81.4 2016
9
1.67ChildrenLivingBelowPovertyLevel percent 26 23.9 21.2 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other,<6 1
1.67People25+withaHighSchoolDegreeorHigher percent 80.2 82.3 87 2012-2016
Male,35-44,45-64,65+ 1
1.67 PeopleLivingBelowPovertyLevel percent 17.4 16.7 15.1 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,Other,Female,<6,6-11,12-17,18-24 1
1.67 TotalEmploymentChange percent 2.4 3.2 2.5 2014-2015 16
1.67VoterTurnout:PresidentialElection percent 58.4 58.8 2016 14
1.44 People65+LivingAlone percent 24.4 23.9 26.4 2012-2016 1
1.11 SubstantiatedChildAbuseRatecases/1,000children 5.4 8.5 2017 11
1.08 MedianHousingUnitValue dollars 145600 142700 184700 2012-2016 1
0.94FemalePopulation16+inCivilianLaborForce percent 59.8 57.7 58.3 2012-2016 1
0.94Population16+inCivilianLaborForce percent 68.3 64.2 63.1 2012-2016 1
0.67People25+withaBachelor'sDegreeorHigher percent 30.1 28.1 30.3 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,NativeHawaiianor
OtherPacificIslander,Other,45-
64,65+ 1
MemorialHermannGreaterHeightsHospitalCHNA2019 90
0.50 MedianHouseholdIncome dollars 55584 54727 55322 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,
Other 1
0.50 PerCapitaIncome dollars 29850 27828 29829 2012-2016
AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,NativeHawaiianor
OtherPacificIslander,Other,Two
orMoreRaces 1
SCORE SUBSTANCEABUSE UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.17 Alcohol-ImpairedDrivingDeaths percent 37.8 28.3 29.3 2012-2016 4
1.50 AdultswhoDrinkExcessively percent 18.1 25.4 19.4 18 2016 4
1.28
Adults(18+Years)ReportingBingeDrinkingWithintheLast12months percent 16.6 24.2 17.9 16.9 2016 10
1.19 DeathRateduetoDrugPoisoningdeaths/100,000
population 10.2 9.8 16.9 2014-2016 4
0.94 AdultswhoSmoke percent 12.1 12 14.3 17.1 2016 10
0.89 LiquorStoreDensitystores/100,000population 6.3 6.8 10.5 2015
16
SCORE TRANSPORTATION UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.83 SoloDriverswithaLongCommute percent 45.8 36.9 34.7 2012-2016
4
2.67 MeanTravelTimetoWork minutes 28.6 25.9 26.1 2012-2016 Male 1
2.17 WorkerswhoWalktoWork percent 1.5 3.1 1.6 2.8 2012-2016 White,non-Hispanic 1
1.44 WorkerswhoDriveAlonetoWork percent 79.1 80.3 76.4 2012-2016White,non-
Hispanic,25-44,55- 1
MemorialHermannGreaterHeightsHospitalCHNA2019 91
59
1.33 HouseholdswithoutaVehicle percent 6.4 5.6 9 2012-2016
1
1.28WorkersCommutingbyPublicTransportation percent 2.8 5.5 1.5 5.1 2012-2016
HispanicorLatino,NativeHawaiianor
OtherPacificIslander,Twoor
MoreRaces,White,non-Hispanic,Male,
25-44 1
1.00HouseholdswithNoCarandLowAccesstoaGroceryStore percent 0.9 2015
17
SCORE WELLNESS&LIFESTYLE UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
1.83Self-ReportedGeneralHealthAssessment:PoororFair percent 18.2 18.2 16 2016 4
1.75 PoorPhysicalHealth:5+Days percent 80.6 81.5 2016 10
1.67 InsufficientSleep percent 33.9 32.7 38 2016 4
1.28 LifeExpectancyforMales years 76.4 76.2 76.7 2014 6
1.17 FrequentPhysicalDistress percent 11.5 10.8 15 2016
4
1.17PoorPhysicalHealth:AverageNumberofDays days 3.6 3.5 3.7 2016
4
1.06 LifeExpectancyforFemales years 81 80.8 81.5 2014
6
SCORE WOMEN'SHEALTH UNITSHARRISCOUNTY HP2020 TEXAS U.S.
MEASUREMENTPERIOD HIGHDISPARITY* Source
2.53 CervicalCancerIncidenceRatecases/100,000
females 11 7.3 9.2 7.5 2011-2015 7
2.25Age-AdjustedDeathRateduetoBreastCancer
deaths/100,000females 23.2 20.7 20.2 20.9 2011-2015 Black 7
MemorialHermannGreaterHeightsHospitalCHNA2019 92
1.39 BreastCancerIncidenceRatecases/100,000
females 113.2 111.7 124.7 2011-2015 7
1.06 LifeExpectancyforFemales years 81 80.8 81.5 2014 6
MemorialHermannGreaterHeightsHospitalCHNA201993
AppendixC.PrimaryDataMethodology
CommunityInputParticipantsAccessHealth(FQHC)(FortBendFamilyHealthCenter)AIDSFoundationofHoustonAssociationfortheAdvancementofMexicanAmericansAvenueCDCCatholicCharities-ArchdioceseofGalvestonCatholicCharities-FortBendChildAdvocatesofFortBendChildrenatRiskChristClinicCityofHouston,DepartmentofParksandRecreationCoastalAreaHealthEducationCenters(AHEC)CommunityHealthChoiceElCentrodeCorazonEpiscopalHealthFoundationFortBendCountyHealthandHumanServicesFortBendCountySheriff'sOfficeFortBendRegionalCouncilOnSubstanceAbuseFortBendSeniorsMealsonWheelsFortBendWomen'sCenterGalvestonCountyHealthDistrictGalvestonCountyMentalHealthDeputiesGreaterHoustonPartnershipGreaterHoustonWomen'sChamberofCommerce
GulfCoastMedicalFoundationHarrisCountyPublicHealthHealthcarefortheHomeless-HoustonHOPEClinic(FQHC)HoustonFoodBankHoustonHealthDepartmentHoustonHousingAuthorityHoustonIndependentSchoolDistrictInterfaithCommunityClinicKinderInstituteLegacyCommunityHealthLibertyCountySheriff'sOfficeLoneStarFamilyHealthCenterMidtownArtsandTheaterCenterHoustonMontgomeryCountyWomen'sCenterBaker-RipleyEarlyHeadStartPatientCareInterventionCenter(PCIC)PrairieViewA&MUniversitySantaMariaHostel,Inc.TheArcofFortBendCountyTheHarrisCenterforMentalHealthandIDD(formerlyMHMRA)TheRoseTheWomen'sHomeTri-CountyServicesBehavioralHealthcareUnitedWayofBrazoriaCountyUnitedWayofGreaterHoustonUnitedWayofHarrisandMontgomeryCountyWestChambersMedicalCenter(FQHC)YMCAofGreaterHouston
MemorialHermannGreaterHeightsHospitalCHNA201994
KeyInformantInterviewQuestionnaire(EpiscopalHealthFoundation)• Goodmorning/afternoon[NAMEOFINFORMANT].Mynameis[NAMEOFINTERVIEWER],
andIamwithHealthResourcesinAction,anon-profitpublichealthorganizationbasedinBoston.Thankyouforspeakingwithmetoday.
• Aswementionedinourinterviewinvitation,theEpiscopalHealthFoundationis
coordinatinganinterviewinitiativetosupportfourGreaterHoustonareahospitalsystemsinpreparingtheircommunityhealthneedsassessments.ThecollaboratinghospitalsincludeCHISt.Luke’s,HoustonMethodistHospital,MemorialHermannHealthSystem,andTexasChildren’sHospital.
• Thepurposeofthisinterviewistogainagreaterunderstandingofthehealthstatusand
wellbeingofresidentsintheGreaterHoustonareaanddeterminehowthesehealthneedsarecurrentlybeingaddressed.Interviewslikethisonearebeingconductedwithabout70stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Wearealsointerviewingcommunityleaderswithspecificexperienceworkingwithprioritypopulationssuchaswomen,children,peopleofcolor,andthedisabledtonameafew.
• Weareinterestedinhearingpeople’sfeedbackontheneedsofthebroaderGreater
Houstoncommunityandthepopulationsyouworkwithasaleaderinyourcommunity.TheFoundationandthefourhospitalswelcomeyourcriticalfeedbackandsuggestionsforhealthimprovementactivitiesinthefuture.Yourhonestyduringtoday’sinterviewisencouragedandappreciated.
• Aswementionedinourinterviewinvitation,theinterviewwilllastbetween45minutesto
anhouranditwillberecorded.Afteralltheinterviewsarecompleted,HealthResourcesinActionwillprovideatranscriptofyourinterviewtothefourhospitalsforuseinpreparingtheircommunityhealthneedsassessmentreports.Eachhospitalwillkeepyourinterviewtranscriptconfidentialandaccessibleonlytotheteamthatispreparingthecommunityhealthneedsassessmentreport.HealthResourcesinActionwillalsobepreparingareportofthegeneralthemesthatemergeacrossalltheinterviewstohelpthehospitalspreparetheirreports.
• TheFoundationhasaskedHealthResourcesinActiontoaskallintervieweeshowtheywish
anyquotesfromtoday’sinterviewtobepresentedinreports.Therearethreeoptions.Quotesmaybepresentedanonymouslywithoutyournameororganization,presentedwithyournameandorganization,orpresentedwithonlythesectoryourepresent.Whichoptionwouldyouliketochoose?
• RECORDRESPONSEFROMINTERVIEWEE:rAnonymousrNameandorganizationrSector
• Thankyou.Wewillnoteyourchoiceinthetranscriptthatweprovidetothehospitals.
MemorialHermannGreaterHeightsHospitalCHNA201995
• IFTHERESPONDENTISUNSUREATTHETIMEOFTHEINTERVIEW:Ok,pleasefeelfreetothinkitoverandwewillfollowupwithyouforyourdecisionbeforewesendthetranscripttothehospitals.
• Doyouhaveanyquestionsbeforewebegin?BEGINRECORDINGTHEINTERVIEW
INTERVIEWQUESTIONNAIRE(55MINUTES)
NOTESTOINTERVIEWER:• INTERVIEWQUESTIONSMAYBEADDEDORTAILOREDTOMEETTHESPECIFIC
POSITION/ROLEOFTHEINTERVIEWEE• THEQUESTIONSINTHEINTERVIEWQUESTIONNAIREAREINTENDEDTOSERVEASAGUIDE,
NOTASCRIPTBACKGROUND(5MINUTES)• Canyoutellmealittlebitaboutyourroleatyourorganization/agency?
o Hasyourorganization/agencyeverpartneredwithanyofthefourhospitalsinvolvedinthissharedcommunityhealthneedsassessmentbefore?IFSO,PROBEINWHATCAPACITY/PROGRAM
• Howwouldyoudescribethecommunityyourepresent/thecommunityyourorganizationserves/theGreaterHoustonpopulationatlarge?Whataresomeofitsdefiningcharacteristicsintermsofdemographics?INTERVIEWER:ESTABLISHWHATTHEINFORMANTCONSIDERSTHECOMMUNITYTOBEFROMTHEIRPERSPECTIVE
COMMUNITYISSUES(20minutes)INTERVIEWER:VARYTHELABELOF‘COMMUNITY’BASEDONTHEINFORMANT’SBACKGROUNDANDHOWHEORSHEDESCRIBESTHECOMMUNITY;BESURETOPROBEONWOMEN’SANDCHILDREN’SISSUESTOENSUREWEADDRESSTHENEEDSOFTHECHILDREN’SHOSPITALSINALLQUESTIONSASRELEVANT• Thinkingaboutthestatusofthecommunitytoday,howwouldyouratetheoverallhealth
statusofresidentsonascaleof1to5with1beingpoorand5beingveryhealthy?
• Ifyouhadtopickyourtop3healthconcernsinthecommunity,whatwouldtheybe?PROBEIN-DEPTHBASEDONINFORMANTAREAOFEXPERTISE
o Whodoyouconsidertobethepopulationsinthecommunitymostvulnerableorat
riskfortheseconditions/issues?§ IFNOTYETMENTIONED,PROBESPECIFICALLYONPRIORITYPOPULATION
RELEVANTTOTHEINFORMANT’SEXPERTISE:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityfor[PRIORITYPOPULATION]?
MemorialHermannGreaterHeightsHospitalCHNA201996
§ FORINFORMANTSEXPERTISEWITHWOMENANDCHILDREN:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityforchildrenandtheirfamilies?Howaboutforwomen?
§ IFNOTYETDISCUSSED:Ofthetopthreeissuesyoumentioned,whichwould
yourankasyourtopissue?Howdoyouseethisissueaffectingcommunitymembers’dailylivesandtheirhealth?PROBEIN-DEPTHINSPECIFICFOCUSAREAS;MAYASKABOUTONEISSUEATTIMEANDFOCUSONPERSON’SAREAOFEXPERTISE.
• Fromyourexperience,whatareresidents’biggestbarrierstoaddressingthetop3health
issuesyouidentified?o PROBE:Socialdeterminantsofhealth?o PROBE:Barrierstoaccessingmedicalcare?o PROBE:Barrierstoaccessingpreventiveservicesorprograms?
FOCUSAREA:HEALTHYLIVING(5MINUTES)• I’dliketoaskyouaboutbarriersaffectinghealthylivingandthepreventionofobesity.
o Whataresomeofthebarrierstohealthyeatingandphysicalactivityamongthecommunitiesyouserve?
§ Whatpopulationsaremostaffectedbybarrierstohealthylivingandphysicalactivity?PROBEABOUTFOODINSECURITYANDACCESSTOSAFESPACESFORPHYSICALACTIVITY
o Whateffortsorprogramsareyouawareofthatpromotehealthyliving?PROBEABOUTHEALTHYLIVINGMATTERSCOLLABORATIVE
ACCESSTOHEALTHCAREANDPUBLICHEALTH/PREVENTIONSERVICES(15MINUTES)
• I’dliketoaskyouaboutaccesstohealthcareandsocialservicesinyourcommunity.
o Whatdoyouseeasthestrengthsofthehealthcareandsocialservicesinyourcommunity?
o Whatdoyouseeasitslimitations?• Whatchallenges/barriersdoresidentsinyourcommunityfaceinaccessinghealthcareand
socialservices?[PROBEINDEPTHFORBARRIERSTOCARE:INSURANCEISSUES,LANGUAGEBARRIERS,ACCESSTOHEALTHINFORMATION/HEALTHLITERACY,LACKOFTRANSPORTION,CHILDCARE,ETC.]
o Whatdoyouthinkneedstohappeninthecommunityyouservetohelpresidentsovercomeoraddressthesechallenges?
• Whatprograms,services,orpoliciesareyouawareofinthecommunitythataddressaccess
tohealthcareandsocialservices?
o Inyouropinion,howeffectivehavetheseprograms,services,orpoliciesbeenataddressingthehealthneedsofresidents?
MemorialHermannGreaterHeightsHospitalCHNA201997
o Whatprogram,services,orpoliciesarecurrentlynotavailablethatyouthinkshould
be?
IMPROVINGTHEHEALTHOFTHECOMMUNITY/RESIDENTS(10MINUTES)• Whatdoyouthinkneedstohappeninthecommunityyouservetohelpresidentsovercome
oraddressthechallengestheyfaceinbeingabletobehealthy?
• Earlierinthisinterview,youmentioned[TOPISSUE]asbeingyourtophealthpriorityforarearesidents.Whatdoyouthinkneedstobedonetoaddress[TOPISSUEHERE]?
o Whatdoyouthinkhospitalscandotoaddressthisissuethattheyaren’tdoingrightnow?Doyouhaveanysuggestionsabouthowhospitalscanbecreativeorworkoutsidetheirtraditionalroletoaddressthisissueandimprovecommunityhealth?
o Whatkindsofopportunitiesarecurrentlyouttherethatcanbeseizedupontoaddresstheseissues?Forexample,aretheresome“lowhangingfruit”–currentcollaborationsorinitiativesthatcanbestrengthenedorexpanded?
VISIONFORTHECOMMUNITY(5MINUTES)
• Thehospitalsinvolvedinthisinitiativewillbeplanningtheirstrategytoimprovethehealth
ofthecommunitiestheyserve.Whatadvicedoyouhaveforthegroupdevelopingtheplantoaddressthetophealthneedsyou’vementioned?
CLOSING(5MINUTES)
Thankyousomuchforyourtime.That’sitformyquestions.Isthereanythingelsethatyouwouldliketomentionthatwedidn’tdiscusstoday?AsImentioned,afteralloftheinterviewsarecompleted,wewillbesendingyourinterviewtranscriptstothefourhospitals.Eachhospitalwillmaketheircommunityhealthneedsassessmentreportspubliclyavailablewhentheyarecomplete.Ifyouhaveanyquestions,pleasefeelfreetoreachouttoJenniferMineoattheEpiscopalHealthFoundationwhoiscoordinatingthiseffortonbehalfofthefourhospitals.Thankyouagain.Haveagoodmorning/afternoon.
MemorialHermannGreaterHeightsHospitalCHNA201998
KeyInformantInterviewQuestionnaire(ConduentHealthyCommunitiesInstitute)Goodmorning/afternoon[NAMEOFINFORMANT].Mynameis[NAMEOFINTERVIEWER],andIamwithConduentHealthyCommunitiesInstitute.Mycolleague[name]isalsoontheline.WeareworkingwithMemorialHermannHealthSystemtoconductaCommunityHealthNeedsAssessment.• Thepurposeofthisinterviewistogainagreaterunderstandingofthehealthstatusand
wellbeingofresidentsintheGreaterHoustonareaanddeterminehowthesehealthneedsarecurrentlybeingaddressed.Interviewslikethisonearebeingconductedwithabout12stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Wearealsointerviewingcommunityleaderswithspecificexperienceworkingwithprioritypopulationssuchaswomen,children,peopleofcolor,andthedisabledtonameafew.
• Weareinterestedinhearingpeople’sfeedbackontheneedsofthecommunityandthe
populationsyouworkwithasaleaderinyourcommunity.MemorialHermannwelcomeyourcriticalfeedbackandsuggestionsforhealthimprovementactivitiesinthefuture.Yourhonestyduringtoday’sinterviewisencouragedandappreciated.
• Aswementionedinourinterviewinvitation,theinterviewwilllastbetween45minutesto
anhouranditwillberecorded.Afteralltheinterviewsarecompleted,wewillanalyzeandsummarizealltheinterviewstoincorporateintothecommunityhealthneedsassessmentreports.EachMHhospitalwillkeepyourinterviewtranscriptconfidentialandaccessibleonlytotheteamthatispreparingthecommunityhealthneedsassessmentreport.
• MemorialHermannhasaskedHCItoaskallintervieweeshowtheywishanyquotesfromtoday’sinterviewtobepresentedinreports.Therearethreeoptions.Quotesmaybepresentedanonymouslywithoutyournameororganization,presentedwithyournameandorganization,orpresentedwithonlythesectoryourepresent.
• Whichoptionwouldyouliketochoose?
• RECORDRESPONSEFROMINTERVIEWEE:rAnonymousrNameandorganizationrSector
• Thankyou.Wewillnoteyourchoiceinthetranscriptthatweprovidetothehospitals.
• IFTHERESPONDENTISUNSUREATTHETIMEOFTHEINTERVIEW:Ok,pleasefeelfreetothinkitoverandwewillfollowupwithyouforyourdecisionbeforewesendthetranscripttothehospitals.
• Doyouhaveanyquestionsbeforewebegin?BEGINRECORDINGTHEINTERVIEW
MemorialHermannGreaterHeightsHospitalCHNA201999
INTERVIEWQUESTIONNAIRE(55MINUTES)
NOTESTOINTERVIEWER:• INTERVIEWQUESTIONSMAYBEADDEDORTAILOREDTOMEETTHESPECIFIC
POSITION/ROLEOFTHEINTERVIEWEE• THEQUESTIONSINTHEINTERVIEWQUESTIONNAIREAREINTENDEDTOSERVEASAGUIDE,
NOTASCRIPTBACKGROUND(5MINUTES)• Canyoutellmealittlebitaboutyourroleatyourorganization?
o Hasyourorganization/agencyeverpartneredwithMH’scommunityhealthneedsassessmentbefore?IFSO,PROBEINWHATCAPACITY/PROGRAM
• Howwouldyoudescribethecommunityyourepresent/thecommunityyourorganizationserves?Whataresomeofitsdefiningcharacteristicsintermsofdemographics?INTERVIEWER:ESTABLISHWHATTHEINFORMANTCONSIDERSTHECOMMUNITYTOBEFROMTHEIRPERSPECTIVE
COMMUNITYISSUES(20minutes)INTERVIEWER:VARYTHELABELOF‘COMMUNITY’BASEDONTHEINFORMANT’SBACKGROUNDANDHOWHEORSHEDESCRIBESTHECOMMUNITY;BESURETOPROBEONWOMEN’SANDCHILDREN’SISSUESTOENSUREWEADDRESSTHENEEDSOFTHECHILDREN’SHOSPITALSINALLQUESTIONSASRELEVANT• Thinkingaboutthestatusofthecommunitytoday,howwouldyouratetheoverallhealth
statusofresidentsonascaleof1to5with1beingpoorand5beingveryhealthy?
• Ifyouhadtopickyourtop3healthconcernsinthecommunity,whatwouldtheybe?PROBEIN-DEPTHBASEDONINFORMANTAREAOFEXPERTISE
o Whodoyouconsidertobethepopulationsinthecommunitymostvulnerableorat
riskfortheseconditions/issues?§ IFNOTYETMENTIONED,PROBESPECIFICALLYONPRIORITYPOPULATION
RELEVANTTOTHEINFORMANT’SEXPERTISE:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityfor[PRIORITYPOPULATION]?
§ FORINFORMANTSEXPERTISEWITHWOMENANDCHILDREN:Whatdoyou
thinkarethemostpressinghealthconcernsinthecommunityforchildrenandtheirfamilies?Howaboutforwomen?
§ IFNOTYETDISCUSSED:Ofthetopthreeissuesyoumentioned,which
wouldyourankasyourtopissue?Howdoyouseethisissueaffecting
MemorialHermannGreaterHeightsHospitalCHNA2019100
communitymembers’dailylivesandtheirhealth?PROBEIN-DEPTHINSPECIFICFOCUSAREAS;MAYASKABOUTONEISSUEATTIMEANDFOCUSONPERSON’SAREAOFEXPERTISE.
• Fromyourexperience,whatareresidents’biggestbarrierstoaddressingthetop3health
issuesyouidentified?o PROBE:Socialdeterminantsofhealth?o PROBE:Barrierstoaccessingmedicalcare?o PROBE:Barrierstoaccessingpreventiveservicesorprograms?
FOCUSAREA:HEALTHYLIVING(5MINUTES)• I’dliketoaskyouaboutbarriersaffectinghealthylivingandthepreventionofobesity.
o Whataresomeofthebarrierstohealthyeatingandphysicalactivityamongthecommunitiesyouserve?
§ Whatpopulationsaremostaffectedbythesebarrierstohealthylivingandphysicalactivity?PROBEABOUTFOODINSECURITYANDACCESSTOSAFESPACESFORPHYSICALACTIVITY
o Whateffortsorprogramsareyouawareofthatpromotehealthyliving?PROBEABOUTHEALTHYLIVINGMATTERSCOLLABORATIVE
ACCESSTOHEALTHCAREANDPUBLICHEALTH/PREVENTIONSERVICES(15MINUTES)
• I’dliketoaskyouaboutaccesstohealthcareandsocialservicesinyourcommunity.
o WhatAREthestrengthsofthehealthcareandsocialservicesinyourcommunity?
o Whataresomeoftheirlimitations?• Whatchallenges/barriersdoresidentsinyourcommunityfacewhenaccessinghealthcare
andsocialservices?[PROBEINDEPTHFORBARRIERSTOCARE:INSURANCEISSUES,LANGUAGEBARRIERS,ACCESSTOHEALTHINFORMATION/HEALTHLITERACY,LACKOFTRANSPORTION,CHILDCARE,ETC.]
o Whatdoyouthinkneedstohappeninthecommunitytohelpresidentsovercomeoraddressthesechallenges?
• Whatprograms,services,orpoliciesareyouawareofthataddressaccesstohealthcare
andsocialservices?
o Inyouropinion,howeffectivehavetheseprograms,services,orpoliciesbeenataddressingthehealthneedsofresidents?
o Whatprogram,services,orpoliciesnotavailablethatyouthinkshouldbe?
IMPROVINGTHEHEALTHOFTHECOMMUNITY/RESIDENTS(10MINUTES)
MemorialHermannGreaterHeightsHospitalCHNA2019101
• Whatdoyouthinkneedstohappeninthecommunitytohelpresidentsovercomeoraddressthechallengestheyfaceinbeingabletobehealthy?
• Earlierinthisinterview,youmentioned[TOPISSUE]asbeingyourtophealthpriorityforarearesidents.Whatdoyouthinkneedstobedonetoaddress[TOPISSUEHERE]?
o Whatdoyouthinkhospitalscandotoaddressthisissuethattheyarenotdoingrightnow?
o Doyouhaveanysuggestionsabouthowhospitalscanbecreativeorworkoutsidetheirtraditionalroletoaddressthisissueandimprovecommunityhealth?
o Whatkindsofopportunitiesarecurrentlyouttherethatcanbeseizedupontoaddresstheseissues?Forexample,aretheresome“lowhangingfruit”–currentcollaborationsorinitiativesthatcanbestrengthenedorexpanded?
VISIONFORTHECOMMUNITY(5MINUTES)
• Thehospitalsinvolvedinthisinitiativewillbeplanningtheirstrategytoimprovethehealth
ofthecommunitiestheyserve.Whatadvicedoyouhaveforthegroupdevelopingtheplantoaddressthetophealthneedsyou’vementioned?
CLOSING(5MINUTES)
Thankyousomuchforyourtime.That’sitformyquestions.Isthereanythingelsethatyouwouldliketomentionthatwedidn’tdiscusstoday?AsImentioned,afteralloftheinterviewsarecompleted,wewillbesendingyourinterviewtranscriptstoMemorialHermann.Thecommunityhealthneedsassessmentreportswillbepubliclyavailablewhentheyarecomplete.Ifyouhaveanyquestions,pleasefeelfreetoreachouttoDeborahGanelinatMemorialHermannwhoiscoordinatingthiseffort.Thankyouagain.Haveagoodmorning/afternoon.
MemorialHermannGreaterHeightsHospitalCHNA2019102
CommunitySurvey(English)MemorialHermannHealthSystemisconductingaCommunityHealthNeedsAssessmentfortheGreaterHoustonarea.ThisassessmentallowsMemorialHermanntobetterunderstandthehealthstatusandneedsofthecommunityandusetheknowledgegainedtoimplementprogramsthatwillbenefitthecommunity.Wecanbetterunderstandcommunityneedsbygatheringvoicesfromthecommunity.Thissurveyallowscommunitymemberslikeyoutotellusaboutwhatyoufeelareimportantissuesforyourcommunity.Weestimatethatitwilltakeabout5minutestocompletethissurvey.Thankyouverymuchforyourinputandyourtime!1. Pleaselookatthislistofcommunityissues.Inyouropinion,whatarethetop5issuesmost
affectingthequalityoflifeinyourcommunity?o Diabeteso Obesity/Overweighto Respiratory/LungDisease(asthma,COPD,etc.)o Cancerso MentalHealthandMentalDisorderso Injuries,ViolenceandSafetyo SubstanceAbuse(alcohol,tobacco,drugs,etc.)o OralHealtho HeartDiseaseandStrokeo SexualHealth(HIV/AIDS,STDs,etc.)o TeenagePregnancyo ElderCareo ReproductiveHealth(familyplanning)o Other(pleasespecify):______________________________
2. Howwouldyourateyourownpersonalhealth?
o Veryhealthyo Somewhathealthyo Unhealthyo Veryunhealthy
3. Abouthowmanytimesaweekdoyouexerciseorperformaphysicalactivitylikewalking,
running,bicycling,etc.?o Lessthan1timeaweeko 2-3timesaweeko 5ormoretimesaweeko Nevero Other(pleasespecify):______________________________
MemorialHermannGreaterHeightsHospitalCHNA2019103
4. Whataresomeofthebarriersorchallengestoexercisingonaregularbasisforyou?o Noplacestoexerciseo Notimetoexerciseo Idon’tlikeexercisingo Feelunsafeexercisinginthecommunityo Noneofmyfriendsorfamilyexerciseo Nochildcareo Lackoffundstopayforgymorclasseso Notransportationo Other(pleasespecify):______________________________
5. Howmuchdoyouagreeordisagreewitheachofthestatementsbelow. Agree
stronglyAgree Disagree Disagree
stronglyTherearegoodparksforchildren,adultsandpeopleofallabilitiestoenjoyinmycommunity
Inthepast12months,IhadaproblemgettingthehealthcareIneededformeorafamilymemberfromanytypeofhealthcareprovider,dentist,pharmacy,orotherfacility
Idon’tknowwheretogetservicesformyselfwhenIamsad,depressedorneedsomeonetotalkto
IamconfidentIcangetanappointmentwhenIneedtoseemydoctorfairlyquickly
Ihaveaplacetoreceivemedicalcareotherthantheemergencyroom
Withinthepast12months,IworriedwhethermyfoodwouldrunoutbeforeIgotmoneytobuymore
Withinthepast12months,thefoodIboughtjustdidn’tlastandIdidn’thavemoneytogetmore
Therearemanyoptionsforhealthyandaffordablefoodinmycommunity
6. Hasyourdoctorevertoldyouthatyouhaveanyofthefollowing?(Markallthatapply)
o Highbloodpressureo Highcholesterolo Cancero Diabeteso Obesityo Asthmao Heartdiseaseo Other(pleasespecify):______________________________
Now,afewquestionssothatwecanseehowdifferenttypesofpeoplefeelaboutthequestionsasked.7. Zipcodewhereyoulive:______________________________8. Whatisyourage?______________________________
MemorialHermannGreaterHeightsHospitalCHNA2019104
9. Whatisyourrace/ethnicity?o Whiteo Black/AfricanAmericano Hispanic/Latinoo Asian/PacificIslandero NativeAmericano Other(pleasespecify):______________________________
10. Whataretheagesofchildrenlivinginyourhousehold?
o 11andyoungero 12-18yearsoldo 18andoldero None
11. Whatkindofmedicalinsuranceorcoveragedoyouhave?
o Privateo Employer-sponsoredo Medicaido Medicareo Noneo Other(pleasespecify):______________________________
Thankyouforcompletingthissurvey!
MemorialHermannGreaterHeightsHospitalCHNA2019105
CommunitySurvey(Spanish)MemorialHermannHealthSystemestárealizandounaEvaluacióndelasNecesidadesdeSaluddelaComunidadeneláreametropolitanadeHouston.EstaevaluaciónpermiteaMemorialHermann
comprendermejorelestadodesaludylasnecesidadesdelacomunidad,asícomousarlainformaciónobtenidaparaponerenprácticaprogramasquebeneficienalacomunidad.
1.Lealalistadeproblemasdelacomunidad.Ensuopinión¿cuálessonlos5problemasquemásafectanlacalidaddevidaensucomunidad?□ Diabetes□ Obesidad/sobrepeso□ Enfermedadesrespiratorias/pulmonares(asma,enfermedadpulmonarobstructivacrónica[EPOC],etc.)
□ Cáncer□ Saludmentalytrastornosmentales□ Lesiones,violenciayseguridad□ Drogodependencia(alcohol,tabaco,drogas,etc.)
□ Saludbucal□ Enfermedadescardíacasyaccidentescerebrovasculares
□ Saludsexual(VIH/sida,enfermedadesdetransmisiónsexual[ETS],etc.)
□ Embarazosdeadolescentes□ Cuidadodeancianos□ Saludreproductiva(planificaciónfamiliar)
□ Otros,(especifique):_________________________________________________________
2.¿Cómocalificaríasupropiasaludpersonal?□ Muybuena□ Bastantebuena
□ Mala□ Muymala
3.¿Aproximadamente,cuántasvecesporsemanahaceejerciciooalgunaactividadfísica,comocaminar,correr,andarenbicicleta,etc.?□ Menosde1vezporsemana□ De2a3vecesporsemana
□ 5omásvecesporsemana□ Nunca
□ Otros,(especifique):_________________________________________________________
4.¿Cuálessonalgunasdelasbarrerasodificultadesqueleimpidenhacerejercicioregularmente?□ Notengounlugardondehacerejercicio.□ Notengotiempoparahacerejercicio.□ Nomegustahacerejercicio.□ Nomesientoseguro/ahaciendoejercicioenmicomunidad.
□ Ningunodemisamigosofamiliareshacenejercicio.
□ Notengoconquiéndejaramishijosmientrashagoejercicio.
□ Notengodineroparapagarungimnasiooclases.
□ Notengoaccesoatransporte.
□ Otros,(especifique):_________________________________________________________
Calculamosqueletomaráunos5minutoscompletarestaencuesta.
MemorialHermannGreaterHeightsHospitalCHNA2019106
5.¿Lehadichosumédicoalgunadelassiguientesafecciones?(Marquetodaslasopcionesquecorrespondan).□ Presiónarterialalta□ Colesterolalto□ Cáncer□ Diabetes
□ Obesidad□ Asma□ Enfermedadcardíaca
□ Otros,(especifique):_________________________________________________________
6.¿Enquémedidaestádeacuerdooendesacuerdoconcadaunadelassiguientesafirmaciones? Muyde
acuerdoDe
acuerdoEn
desacuerdoMuyen
desacuerdoEnmicomunidad,haybuenosparquesparaniños,adultosypersonascontodotipodecapacidadesparanuestrodisfrute.
Enlosúltimos12meses,tuveunproblemaparaobtenerelcuidadomédicoquenecesitabaparamíoparaunfamiliarporpartedecualquiertipodeproveedordecuidadodelasalud,dentista,farmaciauotrocentrosanitario.
Nosédóndeobtenerserviciosparamícuandoestoytriste,deprimido/a,onecesitohablarconalguien.
Séconseguridadquepuedoobtenerunacitaconmimédicoconciertarapidez.
Tengoamidisposiciónunlugarpararecibircuidadosmédicosquenoseaunasaladeemergencias.
Enlosúltimos12meses,mepreocupédesilacomidaseagotaríaantesdeobtenerdineroparacomprarmásalimentos.
Enlosúltimos12meses,losalimentosquecomprésimplementenoduraronlosuficienteynotuvedineroparacomprarmás.
Enmicomunidadhaymuchasopcionesparacompraralimentossaludablesyasequibles.
7.Códigopostaldesucasa:_________________________8.¿Cuántosañostiene?_________________9.¿Cuálessuraza/origenétnico?□ Blanco/a□ Negro/aoafroamericano/a□ Hispano/aolatino/a
□ Asiático/aoisleño/adelPacífico□ Indígenaamericano/a□ Otro/a,(especifique):______________
10.¿Cuántosañostienenlosniños/asquevivenensucasa?□ 11ymenos□ Entre12y18años
□ Másde18años□ Ninguno
Ahoraleharemosalgunaspreguntasparapodervercómosesientenlosdistintosgruposdepersonasacercadelaspreguntasquelehemoshecho.
MemorialHermannGreaterHeightsHospitalCHNA2019107
11.¿Quétipodeseguromédicoocoberturatiene?□ Privado□ Patrocinadoporunempleador□ Medicaid
□ Medicare□ Ninguno□ Otro,(especifique):________
MemorialHermannGreaterHeightsHospitalCHNA2019108
AppendixD.PrioritizationTool
PrioritizationSurveyThankyouforyourparticipationinthisprioritizationprocess.TheCommunityHealthNeedsAssessment(CHNA)processhasmultiplesteps.Afterthoroughresearchhasbeencompletedtoidentifythesignificanthealthneedsinthecommunity,thesesignificanthealthneedsmustbeprioritizedforfurtherstrategicplanningandimplementation.Prioritizationistheprocessofdeterminingthemostimportantorurgenthealthneedstoaddressincommunities.BelowisadiagramthatshowsthemethodsthatwereusedtoidentifykeyissuesacrossMemorialHermann’sserviceareas.Thesethreemethodsincluded:asecondarydatareview,acommunitysurveyandkeyinformantinterviews.Asyousee,someissuesrevealedthemselvesacrossmultiplemethods.Reviewingthisdiagrammayhelpyoucompletethissurvey.
1. Thefollowinghealthneedsarenotlistedbyorderofimportance.Foreachhealthneed,click
onthearrowonthedropdownboxandselectyouragreementwitheachstatement.Ifyouareonatabletorphone,pleasescrollallthewaytotherightforeachrow.
Theissueimpactsmanypeopleinmycommunity
Thisissuesignificantlyimpactssubgroups
Therearenotenoughexistingandadequateresourcesto
Thisissuehashighriskfordiseaseordeath
MemorialHermannGreaterHeightsHospitalCHNA2019109
(subgroupsbyage,gender,race/ethnicity,LGBTQ,etc.)
addressthisissueinmycommunity
AccesstoHealthServices
HeartDiseaseandStroke
OlderAdultsandAging
Obesity(Exercise,NutritionandWeight)
Transportation MentalHealth Diabetes SubstanceAbuse Cancers LackofHealthInsurance
Education FoodInsecurity Low-Income/Underserved
Children’sHealth Economy 2. IndicatethelevelofimportancethatshouldbegiventowardseachofMemorialHermann’s
4Pillars.Keydefinitionsarelistedbelow.
NotImportant
SomewhatImportant
Important VeryImportant
NotSure
Accesstocare(includinghealthcareaccess,healthcareresourceawareness,healthcarenavigation/literacy)
Foodashealth(includingfoodinsecurity,foodprograms,foodknowledge)
Exerciseasmedicine(includingobesity,accesstoparks,safeplacestoexercise)
Emotionalwell-being(includingemotionalhealth,mentalhealth,substanceabuse)
Keydefinitions:Healthcarenavigation/literacy:needforeducationinnavigatinghealthsystemsFoodinsecurity:lackingreliableaccesstohealthyfoodoptions
MemorialHermannGreaterHeightsHospitalCHNA2019110
Foodprograms:programs,effortsorservicesdesignedtoaddressfoodissuesFoodknowledge:one’sunderstandingofhealthyfoods3. Whoinyourcommunityismostaffectedbypoorhealthoutcomes?(Selectupto5)
o Lesbian,Gay,Bisexual,Transgender,QueerorQuestioning(LGBTQ)o OlderAdultso PersonswithDisabilities(cognitive,sensoryorphysicaldisability)o Racial/EthnicMinorityPopulationso Veteranso Immigrantsorotherundocumentedpersonso Personsexperiencinghomelessnessorprecariouslyhousedo OtherPopulations(pleasespecify):____________________________
4. Pleaseprovideyourname:__________________________________________
5. Pleaseprovideyouremailaddress:__________________________________________
6. Pleaseselectthename(s)ofthehealthcarefacilityorfacilitiesyourepresent.Youmay
choosemorethanone.o MemorialHermannKatyo MemorialHermannMemorialCityo MemorialHermannGreaterHeightso MemorialHermannNortheasto MemorialHermannSoutheasto MemorialHermannSugarLando MemorialHermannSouthwesto MemorialHermannTheWoodlandso KatyRehabo TexasMedicalCentero TIRRMemorialHermanno MemorialHermannSurgicalHospitalKingwoodo MemorialHermannSurgicalHospitalFirstColonyo MemorialHermannFirstColonyHospital(ER)o MemorialHermannTomballHospital(ER)o Other(pleasespecify):_____________________________
ThankyouforyourinputandparticipationintheCommunityHealthNeedsAssessmentprocess.
MemorialHermannGreaterHeightsHospitalCHNA2019111
AppendixE.CommunityResourcesThefollowingisalistofcommunityresourcesmentionedbycommunityinputparticipants.2-1-1TexasA.C.TaylorHealthCenterAccessHealthAcresHomeHealthCenterAIDSFoundationHoustonAldineHealthCenterAmericanHeartAssociationAmericanRedCrossAmistadCommunityHealthCenterAreaAgencyonAgingAssociationfortheAdvancementofMexicanAmericansAvenue360Health&WellnessAvenueCDCBaker-RipleyBastropCommunityHealthCenterBaylorTeenHealthClinicBaysideClinicBaytownHealthCenterBeeBusyWellnessCenterBoatPeopleSOSBo'sPlaceBrighterBitesBrownsvilleCommunityHealthCenterBuffaloBayouPartnershipBurlesonFamilyMedicalCenterBVCAA-HealthPointCanDoHoustonCasadeAmigosHealthCenterCasaElBuenSamaritanoCatholicCharitiesoftheArchdioceseofGalveston-Houston-FortBendCentralCareCommunityHealthChambersCommunityHealthCenterCHISt.Luke'sHealthChildAdvocatesofFortBendChildrenatRiskChristClinicChristianCommunityServicesCenter(CCSC)CHRISTUSHealthSystemCitiesChangingDiabetesCityofHoustonCityofHouston,DepartmentofParksandRecreation
CityofPasadenaCoastalAreaHealthEducationCenters(AHEC)CommunityHealthChoiceCountyIndigentHealthCareProgramCovenantwithChristCommunityServiceCenterCypressHealthCenterDannyJacksonHealthCenterDentalHygieneClinicE.A."Squatty"LyonsHealthCenterElCentroDeCorazonElFrancoLeeHealthCenterEpiscopalHealthFoundationFamilyServices(GalvestonCounty)FortBendConnectFortBendCountyCollaborativeInformationSystemFortBendCountyHealthandHumanServicesFortBendCountySheriff'sOfficeFortBendRegionalCouncilOnSubstanceAbuseFortBendSeniorsMealsonWheelsFortBendWomen'sCenterGalvestonCountyHealthDistrictGalvestonCountyMentalHealthDeputiesGoHealthyHoustonTaskForceGoodRxGreaterHoustonPartnershipGreaterHoustonWomen'sChamberofCommerceGulfCoastCommunityServicesAssociationGulfCoastMedicalFoundationGulfgateHealthCenterHarmonyHouseRespiteCenterHarrisCenterCrisisLineHarrisCountyPublicHealthandEnvironmentalServices(HCPHES)HarrisCountyRidesHarrisCountySocialServicesHarrisHealthSystemHarvestGreen(Development)HEALInitiative
MemorialHermannGreaterHeightsHospitalCHNA2019112
HealthCenterofSoutheastTexasHealthcarefortheHomeless-HoustonHealthyLivingMatters(HarrisCounty)HelpingHandsFoodPantryHOPEClinic(FQHC)HoustonFoodBankHoustonHealthDepartmentHoustonHousingAuthorityHoustonIndependentSchoolDistrictHoustonRyanWhitePlanningCouncilHoustonShifaSynottClinicHuntsvilleMemorialHospitalClinicIbnSinaFoundationIndiaHouseCharityClinicInterfaithCommunityClinicInterfaithMinistriesMealsonWheelsInterfaithofTheWoodlandsKinderInstituteLaNuevaCasaHealthCenterLegacyHealth(FQHC)LeonCountyCommunityHealthCenterLibertyCountySheriff'sOfficeLoneStarFamilyHeathCenter(FQHC)LongBranchHealthCenterLongTermRecoveryGroupLosBarriosUnidosCommunityClinicMagnoliaHealthCenterMamieGeorgeCommunityCenterMartinLutherKingJr.HealthCenterMedicalPlusSuppliesMEHOP-MatagordaEpiscopalHealthOutreachProgramMETHeadStartMethodistHospitalMetroliftMidtownArtsandTheaterCenterHoustonMontgomeryCountyFoodBankMontgomeryCountyWomen’sCenterNeighborhoodHealthCenterNorthwestAssistanceMinistry'sChildren'sClinicNorthwestHealthCenterNuestraClinicadelVallePatMcWatersHealthClinic-SecondMileMissionPatientCareInterventionCenter(PCIC)PearlandCommunityHealthCenterPediatric&AdolescentHealthCenter
PhysiciansatSugarCreekPlannedParenthoodPrairieViewA&MUniversityQuentinMeaseHospitalRegionalAssociationofGrantMakersRegionalMedicalCenterRobertCarrascoHealthClinicRSVPMedSpaSanJoseClinicSantaMariaHostel,Inc.SettegastHealthCenterSevaClinicCharityMedicalFacilityShelteringArmSeniorServicesDivisionofBakerRipleyShifaClinicSmithClinicSocialSecurityAdministrationSpringBranchCommunityHealthCenterSt.HopeFoundationSt.Vincent'sHouseStephenF.AustinCommunityHealthNetworkStrawberryHealthCenterTexanaBehavioralHealthTexasA&MAgriLifeExtensionServiceTexasChildren’sHospitalTexasMedicaidandCHIPMedicalTransportationProgramTheArcofFortBendCountyTheBeaconTheHarrisCenterforMentalHealthandIDD(formerlyMHMRA)TheRoseTheWomen'sHomeThomasStreetHealthCenterTOMAGWAClinicTri-CountyServicesBehavioralHealthcareUberHealthUnitedWayofBrazoriaCountyUnitedWayofGreaterHoustonUnitedWayProjectBlueprintUniversityofHouston-CollegeofOptometryUniversityofTexasHealth-DentalUniversityofTexasHealthServicesUniversityofTexasPhysiciansUrbanHarvestUTMB
MemorialHermannGreaterHeightsHospitalCHNA2019113
ValbonaHealthCenterVCareClinicVecinoHealthCenterWestChambersMedicalCenter(FQHC)WestHoustonAssistanceMinistries(WHAM)WholeLifeServiceCenterWomen'sCareCenterWorkforceSolutionsYMCAofGreaterHouston