Kane County 2012-2016 Community HealtH improvement plan

years of service

EXECUTIVE SUMMARY

A Community Health Improvement Plan is a long-term, systematic effort to address health problems in a community based on results from a community health assessment. The plan recommends priorities for action and is used by health and other governmental, education, and social service agencies and organizations to implement policies and programs that promote health. The 2012-2016 Kane County Community Health Improvement Plan reflects the understanding that the quality of the communities where we live, work, and play is as important to achieving good health as going to the doctor for regular checkups, proper nutrition, and adequate physical activity. There are many factors, or determinants, that affect health and have a tremendous influence on health outcomes. The physical environment, social and economic factors, and clinical care all play a part in an individual’s health and are all incorporated into the plan.

Kane County is recognized nationally as leader in integrating health, land use and transportation planning. In 2010, acknowledging the importance of this integration, the Kane County Board became the first county in Illinois to formally provide policy direction to link health, land use, and transportation planning into a comprehensive master plan. As part of the formal integration and for the first time, there will be a stand-alone chapter on community health in the Kane County 2040 Plan. In 2011, we initiated a comprehensive community health assessment, aligning planning efforts with the five hospitals in Kane County, two United Way agencies, and the INC Board, who all provided direction and leadership to the process as well as resources and expertise.The Community Health Improvement Plan guides policy and program decisions that optimize health and well-being. Analysis of health, social and economic data as well as direct input from the community led to the identification of the top six threats to community health – obesity, chronic disease, infant mortality, childhood lead poisoning, communicable disease, and poor social & emotional wellness – and the selection of four priorities that will address these threats. The plan recommends 16 strategies to improve health and well-being across the lifespan for all Kane County residents. This is truly the community’s plan, designed to be implemented by community agencies, partners, and residents across the county. Working together we can ensure Healthy People, Healthy Living, Healthy Communities in Kane County and reach our vision of having the healthiest residents in Illinois.

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TABLE OF CONTENTS

Executive Summary ........................................................................................................................ i

Part 1 Introduction

Introduction .................................................................................................................................... 2

Community Health Improvement Plan Partnership ..................................................................... 10

Update on Past Priorities .............................................................................................................. 11

Part 2 Community Health Assessment

Methodology and Community Participation ................................................................................ 24

Assets ........................................................................................................................................... 28

Health Status of Kane County...................................................................................................... 31

Top Community Health Assessment Findings ............................................................................ 45

Part 3 Community Health Improvement Plan

Community Health Improvement Plan ........................................................................................ 62

Priorities and Strategies ............................................................................................................... 64

Strategy Selection ........................................................................................................................ 68

Implementation ............................................................................................................................ 90

Appendix A - Progress Report on Strategy Implementation 2007-2011 ........ See Comprehensive Version

Appendix B – Comprehensive Kane County Community Health Assessment Databook ........ See Comprehensive Version

Appendix C – Acknowledgements ............................................................................................. 92

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Introduction

Located 40 miles west of Chicago, Kane County is home to 515,269 people who reside in 30

municipalities. Kane is ranked as fifth largest by population of 102 Illinois counties and 51st

largest by area (522 sq miles). By 2040, the population is expected to reach 800,000 persons with

corresponding growth projected for households and jobs (53% and 64% respectively).1

2000 Census 2010 Census 2040 Estimate 404,119 515,269 (27.5% increase) 800,000 (55% increase)

The demographic profile has changed dramatically in the past two decades. The 2010 U.S.

Census reports the Hispanic population has tripled since 1990 and now stands at 158,390, or

31% of the total population, the highest proportion of Hispanic residents of all Illinois counties.

Kane County is notable for its age distribution. The median age in Kane is 35.4 years (national

median age of 36.7 years) and the fastest growing segment of the population is 55-69 year olds.

Children less than 18 years make up 34% (174,763) of the population. As it has throughout the

nation, the economic downturn is also affecting our residents in many ways that ultimately affect

our greatest resource: the health of our communities. Now, more than ever, we must address the

most pressing issues affecting our health to ensure that current and future Kane County residents

lead healthy, happy, and prosperous lives. Through periodic community health assessments, we

can examine these changes and focus our efforts based on the results.

Together, community health assessment and planning are important tools to use in determining

the overall health of a community and identifying the key health issues facing a community.

The quality of the community where we live, work, and play is as important to achieving good

health as going to the doctor for regular checkups, proper nutrition, and adequate physical

activity. There are many factors, or determinants, that affect health and have a tremendous

influence on health outcomes. The physical environment, social and economic factors, and

clinical care all play a part in an individual’s health. Instead of looking at health as purely the

absence of illness, the Kane County Health Department uses a different model where we see

                                                            1 “Population Forecast” Chicago Metropolitan Agency for Planning, http://www.cmap.illinois.gov/population-forecast  

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many factors relating to health: the economic & social opportunities and resources, living and

working conditions in homes and communities, medical care, and personal behavior. Figure 1

illustrates how these determinants work together to create a foundation of health and well-being.

These factors are not separate and can be influenced by each other. For example, personal

behaviors are shaped as much by social context as they are by individual risk factors.

Socioeconomic conditions, peer influences, marketing tactics, and policies and practices all

affect individual choices.

Figure 1: Influences on Health, Robert Wood Johnson Foundation

Another model the county is using to examine population health is the County Health Rankings.

In 2009, the Robert Wood Johnson Foundation collaborated with the University of Wisconsin

Population Health Institute to create health reports for all counties in all 50 states, called the

County Health Rankings. These reports allow counties to be compared, or ranked, relative to

other counties within each state. The University of Wisconsin Population Health Institute

developed a model for measuring health that includes several determinants of health including:

Physical Environment

Social and Economic Factors

Policies to promote healthier

homes, neighborhoods,

schools and workplaces

Policies to promote

economic development and reduce poverty 

Policies to promote child and youth

development and education, infancy

through college

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Clinical Care

Health Behaviors

Figure 2 shows how the various determinants of health, combined with programs and policies,

lead to certain health outcomes, measured by mortality (how long people live) and morbidity

(how healthy people feel while alive).

Figure 2 County Health Rankings Model

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With this model, a full 50% of health outcomes come from social and economic factors and the

physical environment, two areas that were not traditionally considered when assessing overall

health. Looking at Figure 2, health behaviors like tobacco use, alcohol consumption, and diet

and exercise can be directly related to the physical environment through the use of land use

policies and zoning. For example, if there is limited access to fresh produce in a neighborhood,

increasing the number of outlets that offer fresh fruits and vegetables makes the healthy choice

the easier choice. People living in food deserts cannot easily find healthy food options and often

choose the unhealthy, accessible fast food prevalent in their community. With tobacco and

alcohol use, the density of outlets that offer tobacco and alcohol can be limited, making it more

difficult to access these products which are known to have a detrimental effect on health.

Housing infrastructure plays a key role in the health of residents as well. Providing affordable

housing for all residents allows many people to live in healthier communities and lower their risk

for health problems caused by the environment. Residents who live in substandard housing have

an increased risk of being exposed to pollution, which can lead to health problems like asthma.

In addition, homes built before 1970 may have lead paint, exposing families to lead. Lead

exposure has negative impacts on the growth and development of young children and can be

prevented by a combined effort of the health department, medical community, parents, landlords,

contractors, and local decision makers.

Land use and transportation planners can plan walkable neighborhoods which provide residents

with the necessary amenities (sidewalks, access to trails, complete streets) to incorporate exercise

into a daily routine which leads to better health outcomes. Access to parks and recreational

facilities also makes physical activity more convenient. These factors are influenced by land use

and transportation planning policies and ordinances.

One key determinant that falls under both models is socioeconomic status. Low socioeconomic

status is associated with an increased risk for many diseases, including cardiovascular disease,

arthritis, diabetes, chronic respiratory diseases, and cervical cancer as well as frequent mental

distress.2 For example, in Kane County, the highest rates of adults who have been told by a

                                                            2 Brennan Ramirez LK, Baker EA, Metzler M. “Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health.” Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2008. http://www.cdc.gov/nccdphp/dach/chhep/pdf/SDOHworkbook.pdf  

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doctor that they have angina/coronary heart disease are those with the lowest income levels.

Figure 3 below demonstrates this difference:

Figure 3: Kane County Community Health Survey 2011

The department is able to analyze the information collected during a health assessment and

compare it by factors like age, income, race/ethnicity, and educational attainment. These factors

present other disparities in the community and allow the entire health system to focus on where

help is needed most.

In 2010, the Kane County Board became the only county government in Illinois to provide

policy direction to formally integrate health, land use, and transportation into a comprehensive

master plan. The Kane County 2040 Plan will have a stand-alone chapter dedicated to public

health entitled “Community Health” and includes an introductory chapter which describes how

health is the overarching theme for the plan. In 2011, this formal collaboration between the

planning disciplines was titled “Quality of Kane” to capture its mission to maintain and enhance

an exceptional Kane County with Healthy People, Healthy Living and Healthy Communities.

The three groups had previously worked together to create the Fit Kids 2020 Plan, but this is a

0.0%

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3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

Percent of Adult Population

Income

Percent of Kane County adults who report having been told they have angina or coronary heart 

disease & Income

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formal recognition of the collaboration. Figure 4 demonstrates how the three areas work

together to align planning efforts.

Figure 4: Quality of Kane Model

To kick off the campaign, the three departments held a series of public open houses in April and

May of 2011, inviting the community to learn about planning in Kane County and how the three

disciplines are working together on current and future plans. The six open houses were held

throughout the county in urban and rural areas. Attendees learned about the past, present, and

future of Kane County planning and were invited to discuss plans with staff members present at

the events. Approximately 150 attended the events over the six nights.

Soon after, work started on the individual chapters for the 2040 Plan which included land use,

transportation and health planning staff. The planners shared resources and worked together on

outlines for the chapters. In addition to the Community Health chapter, the 2040 Plan has a

chapter on Mobility and Connectivity which was written by the transportation planners. Staff

presented draft versions of the chapters to the Kane County Regional Planning Commission,

where they received feedback and guidance and continued editing them throughout the fall.

A second series of Public Open Houses took place in November, with two locations in urban

areas of the county. The public was invited to share their comments with the health, land use and

transportation planning staff present. Sixty people attended these sessions and gave the planners

constructive feedback on the plans presented. The health department received comments that

Community Health

Transportation Land Use 

2040 Transportation Plan

Bicycle Pedestrian Plan

Bus Rapid Transit Study

2012-2016 Community Health Improvement Plan

KCHD Strategic Plan

Fit Kids 2020 Plan

2040 Plan

2040 Energy Plan

Farmland Preservation

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were focused around services for senior citizens, including more affordable housing, more

healthy meal options, and better public transportation options.

The next step for the Quality of Kane campaign is the launch of the Kane County Planning

Cooperative. The main mission of the Cooperative will be to encourage education and

information sharing related to planning and to assist with local planning decisions. The

Cooperative will be staffed primarily with County planners from three departments –

Development and Community Services, Health and Division of Transportation (KDOT) – in

addition to support from the Chicago Metropolitan Agency for Planning (CMAP). The

Cooperative will fill the gap that currently exists due to the reduction or elimination of planning

staff among municipal and other partners and will be open to municipal staff, elected and

appointed officials, and other decision-makers. See Figure 5 for the Cooperative model.

Municipalities, park districts, school districts, hospitals and local taxing bodies with a critical

stake in local land use decisions may be understaffed but faced with a need to address new issues

Figure 5

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not previously seen at the magnitudes they are today. The

Kane County Planning Cooperative will establish a county-

wide partnership that provides direct technical assistance

and information for municipalities and local units of

government to make Kane County and its partners more

competitive for public and private grant funds. Participants

can benefit from a streamlined grant application preparation

process that meets current collaboration requirements from

funders and enhances opportunities for success.

A key objective for the health department is to integrate

Health Impact Assessment as part of projects, plans, and

policies at the county and municipal level. Health Impact

Assessment (HIA) helps policy makers analyze potential

health impacts by bringing together scientific data, health

expertise and public input to identify the potential—and

often overlooked—health effects of proposed new laws,

regulations, projects and programs. It offers practical

recommendations for ways to minimize risks and capitalize

on opportunities to improve health. HIA is a new tool that

is gaining favor with planning professionals nationwide

because it emphasizes the connection between the built

environment and health. Although the assessments are

focused on health, they can be most effective in the non-

health field: building a new transit system, developing an

agricultural plan, planning a city’s growth or deciding where

to locate a new school.

The 2011 Community Health Assessment plays an

important role in local health department voluntary

accreditation through the Public Health Accreditation Board

(PHAB). According to PHAB, “The goal of the national

Health Impact Assessment (HIA) Examples

The Kane County Health Department and Development and Community Services Department jointly applied for and were awarded a grant in 2011 to undergo training and conduct an HIA. The HIA team is examining an amendment to the county’s Farmland Protection Program. In 2012-2013, the Kane County Farmland Protection Commission and the Kane County Board will consider an amendment to Ordinance 01-67, the Farmland Protection Program. The proposed amendment, an implementation strategy of the master land use plan, will expand eligibility criteria to include small food producing farms, and ensure that acreage remains available for local food production. At present, 100% of participants in the farm protection program are conventional row crop and livestock producers situated in rural Kane. This policy balances investment in permanent farmland protection in all planning regions (food and farms, critical growth, and sustainable urban corridors) and encourages local food production for the benefit of population health.

Another example of an HIA is from Denver, Colorado where the master plan for a redevelopment project was considered. The South Lincoln Homes community is located in downtown Denver and is managed by the Denver Housing Authority. The HIA studied the potential health impacts of the redevelopment and included recommendations that were incorporated into the master plan. Through focus groups, interviews, food and walkability studies, and other data analysis, the HIA team encouraged that space for community gardens and a farmer’s market be included in the plan, as well as noise barriers, a stormwater management system, bike lanes, and pedestrian-friendly sidewalks.

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public health accreditation program is to promote and protect the health of the public by

advancing the quality and performance of all health departments in the United States through

national public health department accreditation.”3 This is the first time that public health

departments can demonstrate their performance against a set of national criteria. Accreditation

will benefit residents because it will ensure the health department is meeting these standards

which were created to protect and improve their health. Three main pre-requisites for

accreditation are a community health assessment, a community health improvement plan, and

department strategic plan, all of which are addressed in 2011-2012.

The five hospitals in Kane County are required to complete a health needs assessment as one

provision of the Patient Protection and Affordable Care Act of 2010 (ACA). It states that non-

profit hospitals will “conduct a community health needs assessment” and “adopt an

implementation strategy” once every three years. The ACA also specifies that hospital

assessments must “take into account input” from those who “represent the broad interests of the

community (including) those with special knowledge of or expertise in public health.”4 The

department worked with the hospitals to meet their requirement and demonstrate the importance

of conducting community health assessments every 3-5 years.

The focus on population-level health and the social determinants of health led the department to

approach the upcoming assessment with a different focus: looking to the community for

opportunities to collaborate with local organizations in conducting a robust community

assessment and create a true community plan that could be used throughout the county.

Community Health Improvement Plan Partnership

Community health assessment is an important tool in setting priorities, guiding health, land use

and transportation planning, program development, coordination of community resources, and

creation of new partnerships to improve the health of the population. The results are used to

define improvement areas and guide a community toward implementing and sustaining policy,

systems, and environmental conditions that improve community health. The results also assist

the community in prioritizing needs which lead to the appropriate allocation of available

                                                            3 “About PHAB”. Public Health Accreditation Board http://www.phaboard.org/about-phab/ 4 http://www.recovery.gov/About/Pages/The_Act.aspx  

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resources. The health assessment provides an evidence-

based core foundation for improving the health of a

community.

In 2011, the department conducted a community health

assessment in collaboration with several partners (see

Figure 6) to guide future health planning and meet the

state’s requirement for local health departments to update

their community health action plans every five years.

This assessment was used to update the 2006 Community

Health Action Plan and provided up to date data and

information that reflected the changes in social,

economic, and environmental factors over the past five

years.

Update on Past Priorities

To begin, we looked back at our priorities from the last health action plan and examined whether

health outcomes improved for the five priorities and what partnerships, policies, or system

changes were implemented. An evaluation of the past plan is an important step in the assessment

process because it helps us determine if what we did actually had a positive outcome and

people’s lives have improved. The five priorities were:

Improve access to health care for those without insurance

Eliminate the disparity in African American infant mortality

Reduce the level of chronic disease

Improve availability of community mental health services

Maintenance of core public health protection services

In addition, we measured progress on the priorities as part of the Progress Report on Strategy

Implementation 2007-2011 and presented the findings to various stakeholders. Below are

selected goals and measures for each priority. The full report is available in Appendix A of the

Comprehensive Version.

Community Health Assessment Partners

Delnor Hospital

Fox Valley United Way

INC Board

Provena Mercy Medical Center

Provena Saint Joseph Hospital

Rush-Copley Medical Center

Sherman Hospital

United Way of Elgin

Figure 6

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For Improve Access to Health Care, one goal was to have 98% of Kane County residents with

access to healthcare by 2030. This is important because a lack of health insurance may cause

people to skip routine, preventative care which can help people live longer, healthier lives. It

could also cause people to use hospital emergency departments for care which leads to higher

health care costs for all. Figure 7 shows that the percentage of residents in Kane County with

health insurance coverage has decreased to 89.1% in 2011.

For Eliminate the Disparity in African American Infant Mortality, two goals and measures show

progress:

Improve 1st trimester entry into prenatal care to 80% for African Americans by 2010

Zero disparity among racial groups in infant mortality by 2030

Figures 8 and 9 indicate that we have not reached our goals for either measure, but the disparity

is less, which demonstrates improvement.

75

80

85

90

95

100

1997 2002 2006 2008 2011

Percent of Adults

Kane County Health Insurance Coverage

Kane 

Collar

IL*

2030 Goal

*IL 2011 rate was actually for 2010

Figure 7

Behavioral Risk Factor Surveillance System Survey 

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0

10

20

30

40

50

60

70

80

90

2003 2004 2005 2006 2007 2008

Percent of Live Births

Kane County First Trimester Entry Into Prenatal Care 

All Kane County

All African American

2010 Goal

Source: Illinois Dept of Public Health

Figure 8

 

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14.0

16.0

18.0

20.0

99‐03

00 ‐04

01 ‐05

02 ‐06

03 ‐07

Rate per 1,000 Live Births

Infant Mortality Rates for Kane County By Race/Ethnicity, 5‐Year Averages, 1999 to 2007 

AFRICAN AMERICAN

WHITE     

HISPANIC    

KANE COUNTY

Source: IL Dept of Public Health

Figure 9

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As a result of the 2006 plan, two groups were formed to address infant mortality in the county,

the Elgin and Aurora Circles of Wise Women. Their mission is: Improve infant wellness and

survival through education and prevention by increasing health awareness within the African

American community; create a circle of change by promoting healthy behavior and increase the

circle of life by surrounding parents and infants with strong, loving community bonds. These

groups continue meeting monthly and support pregnant and new mothers by holding events,

participating in fairs, and providing information to a population that continues to see higher rates

of infant mortality than other racial/ethnic groups.

For Reduce the level of chronic disease, two following factors contributed to the level of chronic

disease found in the county. In Figure 10, the rate of adult smoking has decreased since 2006

and currently stands at 12% which is below the 2015 goal.

0 

5 

10

15

20

25

30

35

1997 2002 2006 2008 2011

Percent of Adult Population 

Adult Smoking, 1997 to 2011

Kane

IL 

US 

2015 Goal

*IL 2011 rate was actually for 

2010

Figure 10

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As seen in Figure 11, the adult overweight and obese population increased to 63.9% in 2011,

well above the 2015 goal of 50%, and higher than years past.

The next priority was Improve availability of community mental health services and was

measured by adults reporting feeling sad or depressed in the past 30 days and by high school

students reporting feeling sad or hopeless. Figure 12 shows the Kane County percentage

increased to 40.6 in 2008 from below 35 in 2006. Figure 13 indicates a slight increase for

Illinois and Chicago, but a decrease for the U.S.

Figure 11

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051015202530354045

1997 2002 2006 2008

Per

cen

t o

f A

du

lt P

op

ula

tio

n

Adults Reporting Feeling Sad or Depressed in Past 30 Days

1997 ‐ 2008

Kane

IL

2015 Goal

 

0

5

10

15

20

25

30

35

IL US Chicago

Per

cen

t o

f S

tud

ents

High School Students Who Reported Feeling Sad or Hopeless

2007

2009

2015 Goal

Source: Youth Risk Behavior Survey

Figure 12

Figure 13

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The Kane County Mental Health Council was formed as a result of the 2006 Community Health

Action Plan to address access to mental health services. Kane County has a wide array of private

and public mental health services but in many cases they are not well coordinated, unevenly

distributed, under-funded, and often not accessible to those without insurance. Awareness of

mental health needs and available resources is also relatively low. A Community Awareness

Committee meets monthly to develop awareness campaigns. It has established a Web site,

conducted news conferences, sponsored educational

programs for educators, developed presentation material

and is branching out into social media. The latest

program is the “We Support Mental Health” badge which

is an electronic campaign to raise awareness of mental

health needs in the community. Council members are

asked to display or embed a badge on their websites to show support for mental health. The next

step is to invite other community organizations to view their website, display the badge, and

learn more about mental health.

More information on the We Support Mental Health initiative can be found on the

following website: http://wesupportmentalhealth.org/

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The final priority from 2006 is Maintain core public health protection services. The measure in

Figure 14 demonstrates that Kane County is above the U.S. percentage for childhood

immunizations, but is below the goal of 90%. Figure 15 shows continued progress in lowering

the percentage of children with elevated blood lead levels, but we have not reached our goal of

0%.

60

65

70

75

80

85

90

2005 2006 2007 2008 2009

Percent  of Child

ren 

Goal/ MetaUSILKane

Childhood ImmunizationsPercent of Children age 19‐35 months

Source: IL Dept of Public Health

Figure 14

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Other partnerships, coalitions, and initiatives were created as a result of past community health

assessments and improvement plans. These were designed to address problems identified during

the planning process and continue their work today. The following graphic illustrates the path of

the last Community Health Assessment and the programs that came together as a result of it. A

few are described in more detail following Figure 16.

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

10.0%

'00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10

Percent of Child

ren

Percentage of Children with Elevated Blood Lead Level

Source: IL Dept of Public Health

Kane County Percentage of ChildrenGoal

Figure 15

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Coalition for Health and Wellness

The Kane County Coalition for Health and Wellness is a volunteer collaborative organization

focusing on improving the health of Kane County residents and providing the community with

health screening/referral services, assessments, educational outreach programs, and policy

advocacies. By bringing people together from across sectors, the coalition can better target the

health and wellness issues and concerns of county residents. The coalition was created as a

result of the last community health action plan. Some accomplishments include:

Created and maintains the Coalition Speakers Bureau Advocated for a Smoke-Free Illinois in the state legislature

g

Figure 16: 2006 Community Health Assessment

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Awarded a grant to enhance women’s health education Produced health messages for posting in PACE buses Enhanced awareness of physical education programs within Kane County schools Produced a Wellness Campaign Booklet (an action-based guide for groups, organizations

and companies) Offers a free Wellness Assessment tool for employees, along with free data compilation Creates and maintains the Stall Street Journal collection of flyers on timely public health

education topics Offers a free prop lending library for educational purposes

Fit Kids 2020 Plan

One of the most significant projects the health department coordinates is

the Fit Kids 2020 Plan. The purpose of the plan is to provide a strategic

framework that will guide the work of the community so that we will

reverse the toll of childhood obesity in our children by the year 2020.

The plan is a result of the county’s Making Kane County Fit for Kids

campaign, which was launched in 2008 with a Leadership Summit

attended by more than 100 executive leaders from Kane County

municipalities, school districts, park districts, businesses, the faith community, health care

providers, health and social service agencies, as well as local and state elected officials. Out of

this summit, the group created four strategic action principles that reach to the core of the obesity

problem in the county:

1. Providing parents and children with reliable, up-to-date information in multiple settings

regarding healthy physical activity and eating habits;

2. Supporting a culture of wellness and health promotion in our workplaces, schools, and

other institutions;

3. Develop land use, planning, and other public policies that foster and support physical

activity for all in our community;

4. Assure that fresh fruits and vegetables are affordable and accessible to all families in our

community.

In February 2010, the county held a Fit Kids 2020 Leadership Summit, where over 100 leaders

came together for a day and one-half and focused on what has led to the obesity problem, the

present state of the problem, and future actions that will reverse this trend. From this summit,

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work began on the Fit Kids 2020 Plan. Over 80 community

stakeholders worked together in sector-specific workgroups

(see Figure 17 for a listing) for more than six months to

create strategies and action steps for each sector. The plan

was adopted by the county board in April 2011.

There are some common themes that came out of the

workgroups and are reflected in the plan. They include:

Community Gardens

Healthy Food Policy

Walk to School Initiatives

Workplace Wellness

Land-Use Policy

Support of Breastfeeding

Transportation Policy

The action items identified by the groups have moved into the implementation stage, where

people are working together on ways to make them come to life. The Fit for Kids Funders’

Consortium, a public-private partnership of Kane agencies, was formed to coordinate and raise

funds to support the initiative’s work across sectors to reverse childhood obesity. Fit for Kids,

selected in 2009 as one of 50 Healthy Kids, Healthy Communities sites across the nation by the

Robert Wood Johnson Foundation, is now a highly visible, respected collaborative effort to

prevent childhood obesity in Kane County through the implementation of systems, policy and

environmental change. The Consortium offers a mini-grant program that is designed to give

organizations the funding necessary to carry out the work outlined in the plan. To date, more

than $330,000 has been awarded to the community to support the plan. Past grantee projects

include providing equipment necessary for several farmers’ markets to accept Link cards,

increasing access to fresh produce for lower-income residents; funding to a food bank

consortium to purchase refrigeration units, allowing them to offer fresh produce to clients; and

new playground equipment at a neighborhood’s soccer fields, providing a place for siblings to

play during the matches.

Sector Specific Workgroups

Built and Natural Environment

Economic Strength

Faith Community

Family, Culture, and Community

Food Policy

Healthcare and Medicine

Mobility

Recreation and Lifestyle

Schools and Education

Figure 17

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Part 2 Community Health Assessment

Figure 18 demonstrates how the 2011 Community Health Assessment data is used to update the

Community Health Improvement Plan and inform other county plans.

Figure 18

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Methodology and Community Participation

Kane County approached the 2011 Community Health Assessment differently than in years past.

In late 2010, we engaged the five hospitals in the county and the INC Board in a formal

Community Health Assessment Committee to fund and lead the assessment effort. In early 2011,

the Fox Valley United Way and the United Way of Elgin both formally agreed to fund and

support the assessment process as well. See Figure 6 for a listing of the partners. This

partnership allowed all agencies to meet their community assessment requirements and provided

an efficient use of assessment and planning resources from all involved agencies. The assessment

included the collection and analysis of the most up-to-date health, social, economic, housing and

other data as well as qualitative input directly from residents gathered through focus groups,

Community Cafés, Community Meetings and Quality of Kane Open Houses.

The assessment partnership funded a comprehensive

telephone survey of Kane County residents to collect

health status information for over 1,500 adults and the

caregivers of over 400 children. The survey questions

were created based on the Behavioral Risk Factor

Surveillance System survey, allowing the results to be

compared with state and national figures. Established

by the Centers for Disease Control and Prevention, the

BRFSS is the world’s largest, on-going telephone health

survey system, tracking health conditions and risk

behaviors in the United States yearly since 1984. This

is the first time amount of information is available about

the health of Kane County residents and the first time a

child survey was included. The Northern Illinois University Public Opinion Laboratory was

contracted to conduct the phone survey between March and July of 2011. Additional data was

collected from a number of sources to help us better understand the social and economic

environment in Kane County. See Figure 19 for a partial list of sources.

In addition to quantitative data, the department gathered qualitative information from residents

about the health of the community through the Quality of Kane Public Meetings, Focus Groups,

Secondary Data Sources

2010 U.S. Census

Centers for Disease Control and Prevention

Illinois Department of Public Health

Illinois Department of Employment Security

Kane County Health Department

Youth Risk Behavior Survey

Other Kane County Offices & Departments

Figure 19

  25 

Community Cafés and Community Meetings. These events provided an opportunity to hear

directly from residents about the factors most influencing health in their communities. This

information was used to help planners understand the health data collected. Over 200 residents

participated in at least one of these events.

The Quality of Kane Public Meetings were held in April, May, and November 2011. These

meetings provided community members an opportunity to hear about and provide their input on

planning initiatives in Kane County from three different planning disciplines: health, land use,

and transportation. These meetings were an opportunity to engage residents throughout Kane

County in the assessment process. There were six meetings total, two from each of the three

planning areas in the county. The planning areas are defined by the county and are used by all

departments. Figure 20 shows the boundaries for each area and a list of municipalities included

in each.

NORTH

Algonquin Barrington Hills Bartlett Burlington Carpentersville East Dundee Elgin Gilberts Hampshire Huntley Pingree Grove Sleepy Hollow South Elgin West Dundee

CENTRAL

Campton Hills Elburn Geneva La Fox Lily Lake Maple Park St. Charles Virgil Wayne

SOUTH

Aurora Batavia Big Rock Kaneville Montgomery North Aurora Sugar Grove

  26 

Finally, we conducted focus groups and Community Cafés with residents and Community

Meetings with stakeholders from various organizations throughout the county. Focus groups are

a key component in a community health assessment as they provide additional information in a

less structured setting. Instead of answering questions from a list of responses, participants are

asked open-ended questions that spark discussion among the group members. Holding multiple

sessions in different areas during different times ensured that enough information was gathered

to identify common themes in all the responses. Holding focus groups also helps the department

reach more people to inform them about the assessment and health improvement plan. Twelve

of the groups consisted of residents recruited by Northern Illinois University Public Opinion

Laboratory and were held in the three planning areas of the county with four meetings in each

area.

Figure 20: Kane County Planning Areas

  27 

Two Community Cafés were held in conjunction with the Strengthening Families organization

and used their “Parent Café” model. The model has specially trained parent coordinators who

host and facilitate the discussion. Three questions are presented at each session, one per table,

and participants move from one table to the next, building upon what was discussed by the prior

group. Responses are recorded by the table hosts on large pieces of paper and they are trained on

how to engage participants and keep the conversations flowing. Dinner and child care are

provided for attendees to encourage people to attend. The Strengthening Families Parent Cafés

are a valuable part of the community, bringing parents together to discuss topics that help keep

families strong and children safe by looking at the social-emotional side of health.

The Kane County Health Department used the trained parent hosts and facilitators to conduct the

Community Cafés but used questions relating to education, income/employment, and health

instead of the standard Parent Café questions. The questions were designed to generate a

discussion and allow participants to share personal stories and learn from each other. One

session was conducted in English and the other in Spanish.

For the Community Meetings, the department targeted existing groups to ask another series of

questions relating to health, education, and income/employment. This method was effective

because it did not require special recruitment of participants; meetings were held during existing

meeting times to increase participation. Table 1 summarizes the qualitative data collection

methods.

Type of Meeting Number of Meetings Number of Participants

Quality of Kane 8 210

Community Café 2 10 in Spanish-Speaking Session, 9 in English-Speaking Session

NIU Focus Groups 12 88

Community Meetings 6 52

369 Total Participants

Table 1: Methods of Qualitative Data Collection

  28 

The results of the survey, focus groups, Community Cafés, and Community Meetings were

analyzed along with the secondary data collected to identify potential threats to community

health. See Figure 19 for a partial list of sources used in the assessment.

For the first time, the results of the Kane County Community Health Assessment were made

available online in a webinar format in October and November 2011. The webinar provided

new, updated information on the overall health of our community, a progress report on our last

community health improvement plan and nine recommended key opportunities for community

health improvement over the next five years. Two versions were created, a 15 minute executive

summary and a 90 minute comprehensive review, both narrated by the Executive Director of the

Health Department. The webinars were available on-demand which allowed people to view them

at their own convenience and pace and permitted pausing/restarting at the click of a button. 169

individuals from many different agencies and communities viewed the webinar over a three

week period.

After viewing the webinar, an online survey asked residents, stakeholders, and other interested

parties to prioritize the nine recommended key opportunities for community health improvement,

provide input on who should be involved in addressing the issues, and comment on what

resources are currently available in the community. In addition, members of the Kane County

Board of Health and Health Advisory Committee participated in a retreat to review the data and

discuss the results.

Assets

As part of the assessment, the department examined the assets in the community: hospitals,

physicians, agencies, and partnerships which all help us achieve our vision of having the

healthiest residents in Illinois by 2030. There are five hospitals in Kane County, (two in Elgin,

one in Geneva, and two in Aurora) all of whom work closely with the department on the

assessment and many other projects including health access, wellness programs, and the Fit Kids

2020 Plan initiative. Five Federally Qualified Health Centers (FQHC) serve Kane County and

together they provided essential health services for 68,943 patients, dental services for 18,976

patients, and mental health services for 6,038 patients in 2010. These centers are crucial in

helping our vulnerable populations get access to the services they need.

  29 

Looking at physicians, there are 46.3 primary care physicians (including pediatricians) per

100,000 population, as compared to the national median of 54.6 per 100,000 population. Kane

has 9 pediatricians per 100,000 population as compared to the national median of 4 per 100,000.

This is beneficial to the county because of its large population of children under 18. The number

of specialists in the county is higher than the national median as well, with 85.8 per 100,000

compared to 31.7. Finally, the number of dentists in the county per 100,000 population is 53.7,

higher than the national median of 33. The county does not have a community mental health

center; however, there are 20 agencies coordinating the provision of services through the Kane

County Mental Health Council.5

There are currently numerous partnerships and coalitions active in the community which are

addressing community health issues. Kane County Health Department staff lead or participate in

many. These groups bring diverse perspectives and experiences to the table and because the

county is reaching out to as many leaders in the community as possible, it assures that all aspects

of community health and wellness are examined. With this important sharing of knowledge and

resources, the department’s reach is extended beyond the constraints of financial and human

capital. A partial listing of partnerships and coalitions excluding those already described, is

found below in Figure 21

                                                            5 “Area Resource File.” U.S. Department of Health and Human Services. Health Resources and Service Administration, 2008 

  30 

Activate Elgin An initiative to engage all sectors of the community to work in harmony providing all residents with opportunities to improve their health, well-being, and overall quality of life

Perinatal Committee Includes representatives from hospitals, community health centers, early intervention agencies, and home visitation programs focusing on collaboration and coordination about health messages, referral and linkage systems, and infant death review studies

Kane Community Health Access Integrated Network (KCHAIN)

The Network focuses on increasing access to specialty care for the uninsured and under-insured and decreasing inappropriate use of emergency departments by increasing coordination between providers and increasing community awareness

Kane County Continuum of Care The Continuum has brought together more than two dozen faith-based and community organizations that serve the homeless in Kane County, in order to assure coordination of services and exchange best practices

Kane County Breastfeeding Coalition Founded to promote the health benefits of breastfeeding

Compañeros en Salud Provides the Hispanic community and other diverse groups with the means to access resources and services for their health and well-being

All Our Kids Early Childhood Network (AOK) A coalition of 200 child service agencies that acts strategically to address gaps in child services

Kane County Healthy Places Coalition A new initiative led by KCHD will build capacity to address environmental issues in child-occupied settings and improve child health by establishing a child environmental health network to focus on three communities in the county with demographics that indicate that they bear a disproportionate environmental risk burden: Aurora in southern Kane, Elgin in northern Kane, and Carpentersville in the far northern region of Kane County.

Home Visitation Collaborative The Collaborative supports implementation of evidence-based home visitation programs serving low income families in Kane County

Figure 21 Community Partnerships and Coalitions

  31 

The Health Status of Kane County6

Demographic and Socio-Economic Characteristics

Kane County is the fifth largest county in Illinois, with a 2010 population of 515,269. It has

grown by about 30% since 2000 and by 60% since 1990. It is located 40 miles west of Chicago,

within the Chicago Metropolitan Area. Its land area is about 520 square miles, with a population

density of about 776.5 people per square mile. It has a small rural area (2.3% of total

population), mostly in the western half of the County. Most of its urban population is clustered

around the Fox River. The largest community in Kane County is Aurora on the southern end

with a population of 197,899. Aurora straddles four counties: DuPage, Kane, Kendall and Will.

Kane County is the 7th youngest county in Illinois, with a median age of 34.5 years. The largest

age group in Kane County is the 5 – 14 year olds, about 16% of the total population. This age

group has increased by about 25%, consistent with the County. However, the fastest growing

                                                            6 The complete 2011 Community Health Assessment Databook can be found in the Comprehensive Version available online www.kanehealth.com  

0

100,000

200,000

300,000

400,000

500,000

600,000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Count

Year

Kane County Population Trend

Source: US Census Bureau

Figure 22

  32 

age group in Kane is the age group 55 to 69 year which increased by more than 70%. In fact, the

60 to 64 year age group doubled in the last ten years.

The racial distribution has changed from 2000 to 2010. Non-Hispanic whites constitute 59% of

total population, a drop from 68% in 2000, while Hispanics now comprise 31% of the total

population, an increase from 24% in 2000. When compared to Illinois, the proportion of

Hispanics is double in Kane County and it has the largest proportion of Hispanics in the state.

Additionally, the Asian population at 17,505 has increased by 145% from its 2000 population.

39,870

84,605

67,909 68,90476,116 74,246

53,929

28,10821,582

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

Under 5 years

5 ‐ 14 15 ‐ 24 25 ‐ 34 35 ‐ 44 45 ‐ 54 55 ‐ 64 65 ‐ 74 75 +

Age Distribution of Kane County, 2010

Source: US Census Bureau

Figure 23

  33 

Demographics of Kane County Planning Areas7  

Northern Kane County Planning Area (NPA)

Northern Kane County (NPA) makes up about 37% of the total Kane County population, with a

2010 population of 189,284. It comprises 15 communities located in the northern third of Kane

County by land mass. The largest communities in NPA are Elgin, 44% of NPA population, and

Carpentersville, 20% of the population. These two communities are in the youngest 10% of

cities in Illinois respectively. NPA is quite diverse, with 55% white, 33% Hispanic, 6% Asian,

5% African American, as well as other races and combinations.

The age distribution shows that 30% of NPA population is aged less than 18 years, 9% under 5

years. However, 32% is aged 45 years and older. Although 14% of the population is 60 years or

older, this age group is the fastest growing age group in NPA as well as Kane County as a whole.

                                                            7 See Figure 20 for a list of municipalities in each Planning Area 

304,051

27,819591

17,505130 522 6,261

158,390

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

White*

Black or 

African

 American*

American 

Indian and 

Alaska Native*

Asian

*

Native 

Haw

aiian/O

the

r Pacific Isl.*

Some other 

race*

Two or more 

races*

Hispan

ic any 

Race

Po

pu

lati

on

Co

un

tRacial and Ethnic Distribution in Kane County

2000

2010

* Not of Hispanic orgin

Source: US Census Bureau

Figure 24

  34 

Southern Kane Planning Area (SPA)

Southern Kane makes up about 37 % of the Kane County population, with a 2010 population of

192,259. It comprises seven communities located in the southern third of Kane County by land

mass. The largest communities in SPA are Aurora, comprising 68% of SPA as a whole, and

Batavia, 14% of SPA. Aurora is home to the largest Hispanic community in Illinois outside

Chicago. It is quite racial/ethnically diverse, with 46% of the population white, 42% Hispanic,

9% African American and 2% Asian.

The age distribution showed that SPA is also a younger community, with a third of the

population aged less than 18 years and 9% under 5 years old. On the other hand, 31% is aged 45

and older, while 13% of the population is aged 60 years and older. Although the latter is a

smaller proportion than the population of children in SPA, this is by far the fastest growing age

group in the planning area.

Central Kane Planning Area (CPA)

The Central Kane Planning Area is located midpoint between the North and South of the County.

Its population of 73,514 is about 14% of Kane County’s 2010 population. It comprises eight

communities. The largest community in the CPA is St Charles, with a 2010 population estimate

of about 32,000. The demographics of CPA, according to the 2010 U.S. Census, showed a

homogenous community in terms of race and ethnicity. White non-Hispanics made up 88% of

the population. Although the population grew, the proportion of the races did not change

appreciably from 2000 to 2010. African Americans and Asian races contributed 1% and 3%

respectively. Hispanics made up about 7% of the 2010 population.

The CPA is a relatively older community than the other planning areas. The age distribution

showed 27% of the population less than 18 years old, with only 5% under age 5, while about

17% of the population was aged 60 and older. About 42% of its population is aged 45 and older,

compared to NPA and SPA at 32% and 31% respectively.

Socio-Economic Characteristics

The unemployment rate, at 10.3% in 2010, has increased significantly in the past few years,

doubling from 1990 to 2010. This rate was similar to the overall Illinois rate but higher than the

  35 

U.S. rate of 9.6%. Most municipalities in the county also experienced increased unemployment

rates. The Kane County parts of Aurora and Elgin, as well as Carpentersville, had higher

unemployment rates than Kane County overall.

Similarly, poverty rates have increased by two thirds to 11.1% in Kane County. When viewed

by race/ethnicity, one third of African Americans living in Kane County are below the poverty

level compared to one in five Hispanics and one in twenty whites. Seventeen percent of children

less than 18 years old lived below the poverty level, while 24% of female-headed households

were below the poverty level.

There were 10,194 cases of violent crime reported in Kane County in 2009. At a crime index rate

of 2,008.4 per 100,000, it was lower than Illinois rate of 3,298.8 per 100,000 but slightly higher

than the collar county average of 1,998.2 per 100,000. The Kane 2010 rate was a reduction of

40% from 2000. The top three crimes were burglary (328.8), aggravated assault/battery (164.7)

and theft (1,346.6).

General Health and Access to Care Kane County residents are living longer, like many other counties around the U.S. The life

expectancy for Kane County in 2007 was 81 years for women and 77.4 for men, having

increased from 79.7 for women and 75.3 for men in 2000. Similarly, life expectancy for Illinois

and the U.S. increased as well. Life expectancy was lower for African Americans (75.4 for

females and 70.1 for males) than whites (79.9 for females and 75.5 for males).

The age adjusted mortality rate for Kane County decreased by 16% from 2000 to 2007. Similar

declines were evident in all races and ethnicities. In 2007, the African American age adjusted

death rate was 1,019.8 per 100,000, more than double those of Asian or Pacific Islanders and

Hispanics, as well as 40% higher than the rate for whites. Years of Potential Life Lost (YPLL) at

age 75 for Kane County in 2007 was 482,355 person years or 4,800.4 per 100,000.

In the 2011 Community Health Assessment (CHA) phone survey of Kane County adult residents

conducted by the Health Department in partnership with area hospitals, the INC Board and the

major United Ways in the county, 89% of Kane adult residents reported that they had health

insurance coverage compared to 87.8% in 2002. In Illinois, 87% of adults reported having health

  36 

care coverage, compared to 85% in the U.S. Additionally, 67% had a routine health check up

within the past year compared to 73.5% in 2002. The U.S. 2010 Census reported that 86.8% of

the total population had health insurance, compared to 86.2% for Illinois, and lower than the

Healthy People 2020 goal of 100%. There is a disparity in health insurance coverage for

residents in the county: 73% of Hispanics had health insurance and 83% of African Americans,

compared to 94% for non-Hispanic whites.

Source: US Census Bureau

Additionally, 27% of residents who were at 200% of the federal poverty level or lower were

uninsured compared to 7% for those above 200% of the federal poverty level.

0%5%10%15%20%25%30%

All Races White Black or African American

Asian White not Hispanic

Hispanic of any race

Percent of Population

Population With No Health Insurance By Race/Ethnicity

Kane

Illinois

0%

5%

10%

15%

20%

25%

Total: < 18 yrs: 18 ‐ 64 yrs: >=65 yrsPercent of Population

Population With No Health Insurance By Age

Kane

Illinois

Figure 25

  37 

Maternal and Child Health Indicators

The total births in Kane County decreased by 5% from 2000 to 2008, similar to Illinois’ 4.5%

decrease. The largest proportion of births was among Hispanics (45%) and white non-Hispanics

(44%). African American and Asian births were 6.5% and 4.4% respectively. The teen birth

rate for Kane County in 2008 was 42.4 per 1,000 females aged 15 to 19. This was a 22%

decrease from the teen birth rate in 2000. The Kane teen birth rate was higher than Illinois (38.1)

and the U.S. (41.5) for the same year.

Adequacy of prenatal care has been shown to improve birth outcomes. In Kane County, only

72% of mothers received adequate prenatal care as measured by Kessner Index, compared to the

Illinois average of 73% and HP 2020 goal of 77.6%. African Americans and Hispanics had the

lowest rate at 55% and 63% respectively. Asians and non-Hispanic whites had rates higher than

Illinois at 83% and 76% respectively. Adequate prenatal care rate for whites met the HP 2020

objective.

In 2008, 568 or about 6% of Kane County babies were born with a birthweight below 2,500

grams (5.5 lbs). Of these, 101 had a birthweight less than 1,500 grams (3.3 lbs). Kane County

has consistently met the HP 2020 objective of below 7.8%. Similarly, about 10% of Kane

County babies were born before 37 weeks of pregnancy. This rate was same as Illinois, lower

than the U.S. rate, and met the HP 2020 objective of 11.4% or below.

4.4%6.5%

44.0%

0.1%0.0%

0.0%

45.0%

Kane County  Births By Race/Ethnicity, 2008

Asian not Hispanic

Black not Hispanic

White not Hispanic

American Indian & Alaska Native not HispanicNative Hawaiian other Pacific Islander not HispanicSome Other Race/Unknown

Hispanic of any Race

Source: IL Dept of Public Health

Figure 26

  38 

Infant mortality rates for all races/ethnicities in Kane County are declining. The decline is

greatest among African American infants, yet, twice as many African American babies died

before their first birthday compared to all other races/ethnicities in Kane County. The Kane

County infant mortality rate for 2008 was 6.6 per 1,000 live births, lower than the Illinois rate of

7.2. The 5-year Kane infant mortality rate average for 2004 to 2008 was 5.6. Comparing infant

mortality for the different races and ethnicities, the white infant mortality at 4.9 was lower than

the HP 2020 objective of 6.0. The African American rate at 10.8 was more than double the

white rate. The Hispanic infant mortality rate was 5.9 per 1,000, also lower than the HP 2020

objective.

Indicated child abuse/neglect increased by about 12% from 2000 (9.1 per 1,000 children) to 2010

(8.0 per 1,000 children). This was about the same as the Illinois rate.

Chronic Disease Indicators

Chronic diseases are among the most common, costly, and preventable of all health problems in

the U.S. In 2007, a total of 2,687 residents died in Kane County. With an age adjusted rate of

714.5 per 100,000, the death rate was lower than Illinois and U.S., both at 760 per 100,000.

Non‐Communicable 

Diseases(Chronic Diseases)

81%

Accidents      6%

Influenza and Pneumonia  

4%

Kidney Disease      4%

Alzheimer's Disease3%

Septicemia2%

Mortality Distribution, Kane County 2007

Figure 27

  39 

This was a 16% reduction from the 2000 rate of 847.9. The three leading causes of death in

Kane County were: cancer, heart disease and stroke, all of which are chronic diseases.

Non-communicable diseases (NCDs) accounted for 81% of all deaths in Kane County in 2007.

These non-communicable diseases include: cancer, heart disease, stroke, chronic lower

respiratory disease (CLRD) and diabetes mellitus. Several behavioral risk factors are responsible

for many of these NCDs. The 2011 Community Health Assessment survey in Kane County

revealed that only 54% of adults meet recommended levels of physical activity, 14% eat

recommended five servings of fruits and vegetables, and 39% of adults were told they had high

cholesterol. Although the overall Kane County smoking rates decreased to 12%, meeting the HP

2020 objective for the first time this year, there is economic disparity in smoking rates in Kane

County as seen in the graph below:

Heart disease is the leading cause of death in Kane County, with an age adjusted rate of 171.8

per 100,000. Although it has declined 15% the last five years and is lower than the Illinois and

U.S. rates of approximately 190, it singly accounts for 23% of total deaths. Coronary heart

disease is the major sub-type of heart disease, causing 411 deaths, an age adjusted rate of 116.3

per 100,000. Kane County has yet to achieve the HP 2020 goal of 100.8 per 100,000.

Figure 28

  40 

Cancer was the major cause of death in 24% of deaths in Kane County in 2007, an age adjusted

rate of 164.5 per 100,000. Although the Kane rate was lower than Illinois and U.S. rates, it is

still higher than the HP 2020 goal of reducing it to 160.6 per 100,000. The most common cancer

was bronchus and lung cancer, with a total of 174 deaths or 27% of all cancer deaths, and an age

adjusted rate of 44.9 per 100,000. There is racial/ethnic disparity in cancer mortality. African

American age adjusted cancer death rate was 200.4, compared with Hispanic death rate of 90.2

and white rate of 173.2 per 100,000.

Cerebrovascular disease or stroke mortality rate was 41.9 per 100,000 in 2007. This rate has

decreased 19% in the last five years but has still not reduced the HP 2020 objective of 33.8.

Diabetes mellitus is the 5th leading cause of death in Kane County, with an age adjusted death

rate of 24.9 per 100,000. The Kane rate was slightly higher than Illinois and U.S. rates. Unlike

other causes of death mentioned so far, diabetes deaths increased 20% from 2003 to 2006. It is

highest among Hispanics.

There were 9,340 new cases of cancer for 2003 to 2007 combined. This translates to about 1,868

cases per year. The most common cancers in Kane County were lung/bronchus, breast, prostate

and colorectal cancers. There is great gender and racial disparities in many of the cancers. The

age adjusted cancer incidence rates for African American males were at least twice higher in

stomach, kidney, multiple myeloma, bronchus and lung compared to white males. African

American prostate cancer rate was almost twice that of whites as well. African American female

incidence rate for multiple myeloma was more than five times the white female rate. Although

Kane rates were similar to Illinois rates for all races, Kane County was higher than Illinois

among African Americans for lung/bronchus, multiple myeloma, kidney among males, and

leukemia among females. For whites, Kane County rates were slightly higher for invasive breast

cancer.

  41 

Source: IL Dept of Public Health 2007

Hospitalizations are often used as a surrogate for prevalence of diseases. There were a total of

39,506 hospitalizations for Kane County residents (excluding hospitalizations for newborn and

delivery) in 2009, a rate of 77.4 per 1,000 residents. The top five causes of hospitalization were

heart disease, mental disorders, pneumonia, injury and cancer.

The 2011 Community Health Assessment survey showed that 63.9% of Kane adults were obese

or overweight. Obesity is a key risk factor for chronic diseases and it increased by 9% from 2002

to 2011. Among children in Kane County, 36% were obese or overweight. Similarly, 18.2% of

adults reported binge drinking, increasing 4.6% from 2002. Diabetes prevalence among adults

increased 135% from 3.7% in 2002 to 8.7% in 2011. The map below shows diabetes

hospitalizations of Kane County residents in 2010.

4,053, 23%

3,760, 21%

1,723, 10%

1,679, 10%

1,670, 10%

1,170, 7%

974, 6%

920, 5%

793, 4%711, 4%

Leading Causes of Hospitalization

Heart Disease

Mental Disorders

Pneumonia/Influenza

Injury

Cancer

Stroke

Urinary Dis. ‐ Other

Dorsopathies

Rehabilitation

Infection ‐ Septicemia

Figure 29

  42 

Figure 30

  43 

About 9% of Kane County adults reported that their mental health was not good 14 or more days

in the past 30 days, compared to 9.7% and 10.6% for Illinois and U.S., respectively.

Additionally, 13% have diagnosed depressive disorder.

Infectious Disease Indicators There were 537 cases of reportable infectious diseases in Kane County in 2011. The leading

reportable diseases were Hepatitis C virus infection (chronic or resolved), salmonellosis,

pertussis, varicella (Chicken Pox), and Hepatitis B (chronic). Among vaccine preventable

diseases, there were 51 cases of pertussis, two cases of mumps, and 40 cases of chickenpox. The

2010 immunization rate for Kane County among children 19 to 35 months was 72.8%. The

Illinois rate is the same as the Kane rate and the U.S. rate was 69.9%. The HP 2020 objective is

to increase the immunization rate for children 19 to 35 months to 80%.

Tuberculosis cases in Kane County increased 22% from 4.9 per 100,000 in 2000 to 6 per

100,000 in 2010. The Kane County rate was double the Illinois rate and was the highest rate of

tuberculosis in Illinois. The Illinois rate for 2010 was 2.9 per 100,000. The HP 2020 objective is

1.0 per 100,000.

In 2010, reportable sexually transmitted diseases have decreased over the last five years.

Chlamydia decreased by 19% to 214.5 per 100,000, while gonorrhea decreased by 57% to 31.6

per 100,000. Both rates are lower than Illinois rates for both categories. As of December 2010,

a total of 104 HIV cases had been diagnosed since 2005, at a rate of 3.4 per 100,000. This rate is

lower than that of Illinois but higher than the collar counties. Similarly, 137 cumulative cases of

AIDS (a rate of 4.5 per 100,000) have been diagnosed in Kane County since 2005. The rate of

4.5 per 100,000 was lower than Illinois but higher than the collar counties.

Environmental/Occupational/Injury Control Indicators There was insufficient data on environmental indicators. The chemical scorecard, a website

maintained by Environmental Defense Fund, showed that Kane County ranked at the top 20% of

all counties in the U.S. for non-cancer hazards, air releases of suspected cardiovascular or blood

toxicants, air releases of suspected kidney toxicants, total production-related waste and total off-

site transfers.

  44 

Accidents are the 6th leading cause of death in Kane County. In 2007, the age adjusted rate for

Kane County was 24.6 per 100,000. This rate is much lower than the Illinois and the U.S. rates

of 33.4 and 40 per 100,000 respectively. Kane County has met the HP 2020 goal of reducing

accidents to no more than 53.3 per 100,000. Homicide is no longer a leading cause of death in

Kane County. There were 17 deaths due to homicide in 2007, a rate of 3.4 per 100,000. The

suicide death rate in 2007 was 8.4 per 100,000, about the same as the rate five years ago. Kane

County has met HP 2020 objective of less than 10.2 per 100,000 for suicide.

The 2011 Community Health Assessment survey revealed that 2.5% of Kane County adults have

driven drunk at least once in the past 30 days.

Blood lead levels in children decreased 33% from 2007 to 2009. Kane County’s lead poisoning

rate was higher than Illinois and the U.S.

The criminal sexual assault rate for Kane County in 2009 was 39.2 per 100,000. This rate was

61% higher than the average for collar counties. Aggravated assault at a rate of 164.7 per

100,000 was 53% higher than the collar counties average. Kane County crime rates were higher

than collar county average rates in all categories except theft and murder.

Sentinel Events

In looking at specific indicators that serve as sentinel events for lack of access to care,

uncontrolled hypertension, which is usually among the adult population, decreased about 16%

from 2005 to 44.1 per 100,000 in 2009. Tuberculosis in Kane County increased to 6.0 per

100,000 in 2010, double the Illinois rate for the same year. Uncontrolled hypertension and

tuberculosis are indicators for inadequate access to care for adults.

Hospitalizations for dehydration, rheumatic fever and asthma are sentinel indicators for children.

Asthma hospitalization in 2008 showed that Kane County rates for the age groups 5 to 9 years

and 10 to 14 years were significantly higher than Illinois when Cook County was excluded from

Illinois. In the age group 10 to 14 years, Kane County was almost 10 times higher than Illinois

excluding Cook County. The rate for the 5 to 9 age group was 1.5 times Illinois excluding Cook

County.

  45 

In looking at in-situ breast cancer, a sentinel event for lack of access to primary care for cancer,

the incidence rate was 30.4 per 100,000. There was no racial disparity as the white and African

American rates were 30.3 and 30.1 respectively.

Top Community Health Assessment Findings

Analysis of the 2011 Community Health Survey data, secondary data, online survey results, and

qualitative data, the Kane County Health Assessment results point to six major threats to

community health and well-being:

Obesity

Chronic Disease

Infant Mortality

Childhood Lead Poisoning

Communicable Disease

Poor Social and Emotional Wellness

These issues contribute to a lower quality of life for many Kane County residents, as well as

increased spending on health care costs. To improve the overall quality of life in Kane County,

the Community Health Improvement Plan recommends four cross-cutting priorities to address

these threats. Each priority can be addressed through implementation of one or more evidence-

based strategies that are described in the next section.

Six Top Threats to Community Health in Kane County

OBESITY

For adults, obesity is defined as having a Body Mass Index (BMI) equal to or greater than 30.

The calculation for BMI uses a person’s height and weight. For children and teens, the

calculation is more precise, using height, weight, age, and gender.

  46 

37% 33% 33% 35% 35% 36%

28%

18%

37% 29% 29% 28%

0%

10%

20%

30%

40%

50%

60%

70%

80%

North Central South Kane Illinois US

Adult Overweight/Obesity 2011 

Kane County Community Health Survey 2011

Why is it important for us to focus on obesity? The problem of obesity in the United States

has reached epidemic levels and Kane County is experiencing equally high rates for adults and

children.

13.5%

14.0%

14.5%

15.0%

15.5%

16.0%

16.5%

17.0%

Overweight Obese

Percent of WIC Population

Overweight/Obesity for WIC Children 2 to 5 Years Old

Kane

IL

US

Source:  CDC Pediatric Nutrition Surveillance

The current percentage of adults in Kane County who are overweight (BMI between 25 and

29.9) is 34.5%. Those who are obese make up 29.4% which means, together, 63.9% of Kane

County adults are considered overweight and obese. According to the Centers for Disease

Figure 31

Overweight      Obese 

Figure 32

  47 

Control and Prevention, being overweight or obese can increase the risk for health problems

including heart disease, type 2 diabetes, high blood pressure, cancer, stroke, and osteoarthritis.

With a large young population, it is critical that this issue be addressed now to prevent future

health problems which affect residents’ quality of life and worker productivity. The following

root cause analysis worksheet provides details on contributing factors to obesity.

  48 

Health Problem Root Cause Analysis Indirect Contributing FactorDirect Contributing Factor

Indirect Contributing Factor

Risk Factor Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing Factor

Health Problem

Indirect Contributing Factor

Direct Contributing Factor

Indirect Contributing Factor

Risk Factor Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing FactorSocial norms and cultural values Overw eight & obestiy view ed positively

Perceived lack of time

Dominance of motorized transport

Walkability of community & environment

Limited or no healthy options available

Limited restaurant nutritional information

Not breastfeeding

Healthy options cost more

Overweight & Obesity

Limited active transport

Limited acces to fresh fruits & vegetables

Poor food literacy

Sedentary lifestyle

Low levels of physical activityPhysical Inactivity

Unhealthy Diet

Learned patterns of unhealthy behaviors from family and/or friends

Abundance of unhealthy options (i.e. fast food)

Advertising

Nutrition education is low priority

Perceived dangers and safety concerns

Decrease in physical activity

Limited or no PA at w ork

Lack of know ledge or education about importance of PA

Increase in screen time

Parental modeling

Health Problem

A situation or condition of people which is considered undesirable, is likely to exist

in the future, and is measured as death, disease

or disability

Risk Factor

Scientifically established factors that are related directly to the level of a

health problem.

Direct Contributing Factor

Scientifically established factors that directly affect the

risk factor

 

Indirect Contributing Factor

Community specific factors that directly affect the direct

contributing factor

 

  49 

CHRONIC DISEASE

Chronic disease refers to those illnesses that are not spread from person to person and instead are

caused by a person’s behavior or genetics. Examples of chronic diseases include stroke, heart

disease, cancer, diabetes, and arthritis. The Centers for Disease Control and Prevention identifies

four modifiable risk behaviors -- lack of physical activity, poor nutrition, tobacco use, and

excessive alcohol consumption—which are responsible for much of the illness, suffering, and

early death related to chronic diseases.8

020406080

100120140160180200

2002 2003 2004 2005 2006 2007 2008 2009

Rat

e p

er 1

00,

000

Po

pu

lati

on

Trends in Diabetes Hospitalization, 2002 to 2009

Kane

IL

Why is it important for us to focus on chronic disease? Chronic diseases – such as heart

disease, stroke, cancer, diabetes, and arthritis – are among the most common, costly, and

preventable of all health problems in the U.S. These diseases also cause major limitations in

daily living for many residents.9 Chronic disease is costly to health care providers and insurance

companies and puts an undue strain on the entire health system. The cost of heart disease and

stroke in the United States is estimated to be $444 billion for 2010. As seen in Figure 34, these

diseases account for 80% of all deaths in Kane County. With the rapidly growing older

population in the county, these diseases will become more prevalent unless preventative action                                                             8 “Chronic Diseases and Health Promotion.” Centers for Disease Control and Prevention. http://www.cdc.gov/chronicdisease/overview/index.htm  9 “Chronic Diseases and Health Promotion” Centers for Disease Control and Prevention http://www.cdc.gov/chronicdisease/overview/index.htm  

Figure 33

  50 

is taken. Without proper insurance, people are unable to keep their conditions under control and

will end up in hospital emergency rooms for issues that could be more effectively managed by

regular visits to a physician.

Non 

Communicable (Chronic) Diseases81%

Accidents       6%

Influenza and Pneumonia  

4%

Nephritis, etc.          4%

Alzheimer's Disease3%

Septicemia2%

Mortality Distribution, Kane County 2007

Source: Illinois Dept. of Public Health

Figure 34

  51 

Health Problem Root Cause Analysis Indirect Contributing FactorDirect Contributing Factor

Indirect Contributing Factor

Risk Factor Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing Factor

Indirect Contributing Factor

Risk Factor Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing Factor

Indirect Contributing Factor

Risk Factor Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing Factor

Risk Factor

Indirect Contributing Factor

Direct Contributing Factor

No health insurance

Lack of access to quality preventive care services

Education

Lack of medical home

Unemployment

No health insurance

Low SES

Uncontrolled Hypertension

No regular ongoing source of care Lack of medical home

Unemployment

EducationLow SES

Healthy options cost more

Decrease in physical activity

Sedentary lifestyle Limited or no physical activity at w ork

Lack of know ledge or education about importance of physical activity

Increase in screen time

Limited restaurant nutritional information

Not breastfeeding

Social norms and cultural values Overw eight & obestiy view ed positively

Learned patterns of unhealthy behaviors from family and/or friends

Social and cultural factors Easy access to alcohol

Chronic Disease

Perceived lack of time

Dominance of motorized transport

Limited active transport Walkability of community & environment

Perceived dangers and safety concerns

Limited access to fruits and vegetables Limited or no healthy options available

Abundance of unhealthy options (i.e. fast food)

Advertising

Unhealthy Diet Poor food literacy Nutrition education is low priority

Health Problem

Environment that encourages excessive drinking

Alcohol Consumption Easy access to alcohol

Physical Inactivity Low levels of physical activity Parental modeling

Beginning drinking at an early age

Family history

Parents w ho are alcoholic

No alcohol restriction in the family for under-aged family members

Peer pressure

Steady drinking over time

Environment that encourages excessive drinking

  52 

INFANT MORTALITY

Infant mortality has long been known to be the best single measure of the health of a population,

group or community. This is measured as the rate of babies who die before their first birthday

per 1,000 births. Women who have access to and begin prenatal care in their first trimester of

pregnancy can improve their chances for having a healthy baby. With prenatal care, potential

pregnancy and delivery problems are found early and treated as soon as possible.

0

5

10

15

20

25

1997

-20

01

1998

-20

02

1999

-20

03

2000

-20

04

2001

-20

05

2002

-20

06

2003

-20

07

Rat

e pe

r 1,

000

Live

Bir

ths

5‐Year Infant Mortality Rates for Kane County By Race/Ethnicity 

KANE COUNTY

WHITE

AFRICAN AMERICAN

HISPANIC

Infant mortality rates for all races/ethnicities in Kane County are declining. The decline is greatest among African American infants, yet, twice as many African American babies died 

before their first birthday compared to all other races/ethnicities in Kane County

Source: IL Dept of Public Health

Why is it important for us to focus on infant mortality? In Kane County, there is a disparity

in the infant mortality rate when compared by race/ethnicity; the rate is two times higher for

African-Americans than for Hispanic and white residents. Looking at the current trend, which is

improving, it will still take another two generations to close the gap in rates. However, by

implementing various strategies, like increasing the number of African-American women who

enter prenatal care in the first trimester, that gap can be closed by 2030.

Figure 35

  53 

Health Problem Analysis Worksheet Indirect Contributing FactorDirect Contributing Factor

Indirect Contributing Factor

Risk Factor Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing Factor

Health Problem

Indirect Contributing Factor

Direct Contributing Factor

Indirect Contributing Factor

Risk Factor Direct Contributing Factor

Indirect Contributing Factor

Direct Contributing FactorTeen pregnancy Low perceived risk of drug or alcohol use

Lack of commitment to school

Tobacco use Mental health status

Access to tobacco products

No daycare

Limited education about importance

Poor health status

Low Birth Weight Lack of prenatal care Lack of transportation

Low self esteem

Truancy

Teen pregnancy Inadequate after school programs

Sexual promiscuity

Infant Mortality

Low SES

Lack of family support

Stress Poverty

Stress

Prematurity Smoking Easy access to cigarettes

  54 

CHILDHOOD LEAD

Lead is highly toxic, especially to young children. Lead exposure can result in lasting

impairment of a child’s development and behavior such as decreased IQ and attention span and

increased risk for delinquent behavior.

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

2004 2005 2006 2007 2008 2009

Percent of Children tested

Elevated Blood Lead Levels in Children

Kane

Illinois

US

Why is it important for us to focus on childhood lead exposure? Lead poisoning is entirely

preventable. The key is stopping children from coming into contact with lead and treating

children who have been poisoned by lead. Unfortunately, Illinois leads the nation in the

percentage of lead poisoned children. Outside of Cook County, Kane County has the highest

rate of childhood lead poisoning in the state. Nearly 1,500 children in Kane are documented to

have elevated blood lead levels and need to have their homes evaluated for lead hazards and

have the lead hazards reduced or eliminated.

Figure 36

  55 

Health Problem Root Cause Analysis Indirect Contributing FactorDirect Contributing Factor

Risk Factor

Indirect Contributing Factor

Direct Contributing Factor

Health Problem

Indirect Contributing Factor

Direct Contributing Factor

Risk Factor

Indirect Contributing Factor

Direct Contributing Factor

Low SES

Lead Poisoning

Lack of culturally appropriate messaging

Exposure to lead-based paint

Lack of access to electronic messaging

EducationPoverty

Language barriers

Use of lead cooking pots

Lack of culturally appropriate messaging

Cultural factors

Lack of access to abatement resourcesHouses built prior to 1978

Cultural practice Lack of access to electronic media

Language access

Communication Lack of access to electronic media

Language access

  56 

COMMUNICABLE DISEASE

A communicable disease such as a cold is a disease that spreads from person-to-person.

Communicable diseases are diseases that you can “catch” from someone or something else.

Why is it important for us to focus on communicable diseases? People in the United States

continue to get diseases that are vaccine preventable. Viral hepatitis, influenza, and tuberculosis

(TB) remain among the leading causes of illness and death in the United States and account for

substantial spending on the related consequences of infection. Because the U.S. health care

system focuses on treatment of illnesses, rather than health promotion, patients do not always

receive adequate information about prevention and healthy lifestyles.

0

1

2

3

4

5

6

7

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

Rate per 100,000

Tuberculosis Trends, 2000 to 2010

Kane Illinois IL Excl ChicagoSource: IL Dept of Public Health

Vaccines are among the most cost-effective clinical preventive services and are a core

component of any preventive services package. Childhood immunization programs provide a

very high return on investment. For example, for each birth cohort vaccinated with the routine

immunization schedule society:

Figure 37

  57 

✿ Saves 33,000 lives ✿ Prevents 14 million cases of disease ✿ Reduces direct health care costs by $9.9 billion ✿ Saves $33.4 billion in indirect costs10

Unfortunately, only 56% of 2 year olds in Kane County received the recommended vaccinations

in 2010. Outbreaks of communicable disease lead to increased absenteeism in workplaces and

schools and increased healthcare costs. A robust healthcare system in Kane County working to

prevent, identify early, and treat communicable diseases is critical to reducing the burden of

communicable disease.

0%

10%

20%

30%

40%

50%

60%

70%

80%

2005 2006 2007 2008 2010

Percent of Records Assessed

Adequate Immunization for 24 ‐ 35 Month Olds (4:3:3:1:3)

Kane

Illinois

DTP/DTap 4, POLIO 3+, MMR 1, Hib 3+, & Hep B 3

Source: Illinois Dept of Public Health

                                                            10 “Immunization and Infectious Diseases” HealthyPeople2020.gov http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=23  

Figure 38

  58 

Health Problem Root Cause Analysis Indirect Contributing FactorDirect Contributing Factor

Risk FactorDirect Contributing Factor

Direct Contributing Factor

Health Problem

Direct Contributing Factor

Risk Factor

Direct Contributing Factor

Communicable Disease

Restaurant staff not trained on proper food handling

Perception of vaccine safety

Lack of know ledge of available immunization resources

Media coverage on linking autism to vaccination

Multiple sexual partners

Immunization coverage

Injection drug use

Low socio-economic status

Unsasfe food handling at restaurants Lack of funding resources to remedy food violations

Sale of homemade foods at restaurants

Unemployment

Access to healthcare High health insurance deductible

Low socio-economic status

Foodborne contamination

Increased incidence of vaccine-preventable diseases

High risk behavior

Lack of know ledge of proper foodhandling

Unsafe food handling at home Cultural norms

  59 

POOR SOCIAL AND EMOTIONAL WELLNESS

Mental health is a state of successful performance of mental function, resulting in productive

activities, fulfilling relationships with other people, and the ability to adapt to change and to

cope with challenges. Mental health is essential to personal well-being, family and interpersonal

relationships, and the ability to contribute to community or society.

Why is it important for us to focus on poor social and emotional wellness? Mental disorders

are among the most common causes of disability. The resulting disease burden of mental illness

is among the highest of all diseases.

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

North Central South Kane

Percent of Adult Population

Kane Adults Reporting Their Mental Health Was Not Good 14 or More Days in Last 30 Days

Kane County Community Health Survey 2011

Mental health and physical health are closely connected. Mental health plays a major role in

people’s ability to maintain good physical health. Mental illnesses, such as depression and

anxiety, affect people’s ability to participate in health-promoting behaviors. In turn, problems

with physical health, such as chronic diseases, can have a serious impact on mental health and

decrease a person’s ability to participate in treatment and recovery.

Figure 39

  60 

81%

82%

82%

83%

83%

84%

84%

85%

85%

86%

North Central South Kane

Percent of Adult Population

Kane Adults Reporting Usually/Always Getting Social/Emotional Support

Kane County Community Health Survey 2011

Figure 40

  61 

Health Problem Root Cause Analysis Indirect Contributing FactorDirect Contributing Factor

Risk Factor

Health Problem

Direct Contributing Factor

Risk Factor

Low education

Low SES Unemployment

Under-employment

Lack of access to quality early developmental resources

Lack of culturally appropriate messaging

Communication Lack of access to electronic media

Language access

Financial constraints of agencies

Capacity of early childhood programs Language access

Shortage of qualif ied staff

Social and Emotional Wellness

Low education

Stress

Stress Unemployment

Under-employment

Depression

Sudden change in SES due to layoffs

Alcohol Family history

Lack of physical activity

Self Image Poor nutrition

Lack of tailored relevant health messaging

  62 

Part 3 Community Health Improvement Plan

Community Health Improvement Plan

The collaborative effort on the 2011 Community Health Assessment continues with the update to

the Community Health Improvement Plan. The Kane County Community Health Improvement

Plan (CHIP) is a comprehensive set of policy and program recommendations for our community

based on the most up-to-date information. It identifies areas where we can have the largest

impact on improving the quality of life for all Kane residents – particularly the most vulnerable

residents of our community – by reducing preventable sickness and death. Each priority area is

equally important in improving our health and well-being. All priorities have goals and measures

for improvement over the next five years. These will be tracked and reported each year.

The plan can be used by health, government, education, community, social service, faith-based

and other agencies to identify where resources are best directed to improve the quality of life in

Kane County. Individuals and agencies are encouraged to identify the areas they are best

positioned to support and use the recommended strategies to help make their community

healthier.

The plan includes four overarching priorities which address each of the six top health threats and

complement the goals of the Kane County 2040 Plan. The priorities were developed by

considering the root causes contributing to the health issues we face. In order to successfully

address the health threats, we must focus our efforts not only on better access to medical care or

personal behaviors but also on assuring that our social, economic and built environments

contribute to good health. The priorities recognize the interconnectedness of our personal

behaviors with the systems and environments we live in. To be successful in improving

population health, we believe we have to address issues in each of these areas. Each priority is

color-coded and the strategies, measures, and goals are easily tied back to the priorities.

Priority 1: Support Health Behaviors that Promote Well-Being and Prevent Disease

Priority 2: Increase Access to High Quality, Holistic Preventive and Treatment Services Across the Health Care System

Priority 3: Support and Create Health Promoting Neighborhoods, Towns and Cities

Priority 4: Promote Social, Economic, and Educational Environments that Optimize Health

  63 

The four priorities align with the State Health Improvement Plan (SHIP) for Illinois. In 2010,

the state identified five “Public Health System Priorities” which came out of their review of

existing state and local plans and other data.11

Improve Access to Health Services

Enhance Data and Health Information Technology

Address Social Determinants of Health and Health Disparities

Measure, Manage, Improve and Sustain the Public Health System

Assure a Sufficient Workforce and Human Resources

Aligning our efforts with those of the state helps reinforce the importance of working together to

make the most out of limited resources. If local health departments are all working toward

similar goals, there is a greater chance for positive change at the local level and statewide.

The priorities were also created to

coordinate with the National

Prevention Strategy, which is a

federal-level public health plan to

move the nation’s focus away from

sickness and disease to prevention

and wellness.12 The Strategy

identifies four Strategic Directions

and includes seven priorities with

evidence-based recommendations

for action utilizing federal resources

as well as state and local level

partnerships with public health

professionals and public and private

organizations (see Figure 41)

                                                            11 Illinois Department of Public Health. Illinois State Health Improvement Plan 2010. http://www.idph.state.il.us/ship/09-10_Plan/SHIP_Final_2010.pdf  12 National Prevention Council, National Prevention Strategy, Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General, 2011 http://www.healthcare.gov/prevention/nphpphc/strategy/report.pdf 

Figure 41

  64 

The four Strategic Directions are:

Healthy and Safe Community Environments

Clinical and Community Preventive Services

Empowered People

Elimination of Health Disparities

Like the SHIP, the National Prevention Strategy is based on the idea that all sectors must work

together to address the most pressing health issues in the United States.

Priorities and Strategies

Within each priority, several strategies are identified to address major contributing factors to

premature illness and death. The recommended strategies are supported by evidence of success

or “evidence-based practice.” The “Community Guide”13 published by the Centers for Disease

Control and Prevention, includes more information about each of these strategies and the careful

study and research that supports these strategies as being effective. Each strategy includes a

measure as well as baseline data and the goal for the next five years. These measures and goals

were determined and reviewed by stakeholders including the Community Assessment Partners,

Kane County Health Advisory Committee, Kane County Board of Health, and Kane County staff

members. Each measure will be tracked and reported on each year to provide an update on the

progress made towards the 2016 goals. The detailed description of the strategies along with

specific measures and explanations of each are found at the end of this section. The following is

a listing of the strategies, how they align with the top six threats to community health, and a

summary of each one with evidence supporting the selection of each.

                                                            13 “The Community Guide” Community Preventive Services Taskforce http://www.thecommunityguide.org/index.html  

 

65 

Community Health Improvement Plan Priorities and Strategies

Priority 1 – Support Health Behaviors that Promote Well-Being and Prevent DiseaseReduce tobacco use and exposure to environmental tobacco smoke.

Increase access to, and consumption, of fresh fruits and

vegetables.

Coordinate the effective communication of tailored,

accurate and actionable health information to Kane County residents across the lifespan.

Create environments that prevent excessive consumption of

alcohol.

Priority 2 – Increase Access to High Quality, Holistic Preventive and Treatment Services Across the Health Care System

Increase the proportion of residents of all ages that have regular, ongoing sources of medical and

dental care.

Increase the proportion of residents of all ages who

receive appropriate, evidence-based clinical

preventive services.

Focus culturally appropriate outreach and

engagement efforts to eliminate racial disparities

in health outcomes, especially in infant

mortality.

Enhance systems to support the prevention, early identification and

treatment of communicable diseases in

the community.

Enhance systems to support the prevention, early identification and

evidence-based treatment of mental health

conditions.

Priority 3 –Support & Create Health Promoting Neighborhoods, Towns & Cities

Increase the availability and variety of high quality, safe and affordable housing and compact,

mixed use developments.

Institute “complete streets” types of policies to ensure that

roadways are designed and operated with all users in mind -

including bicyclists, public transportation vehicles and riders,

and pedestrians of all ages and abilities.

Assure access to safe playgrounds, parks, trails and

open space.

Assure access to safe food and clean and safe water and air.

Priority 4 – Promote Social, Economic and Educational Environments that Optimize Health Increase the proportion of children who have

high-quality early developmental support, especially in child care and education.

Increase the proportion of Kane County young people that complete high school education.

Increase the job skills and readiness of Kane County residents that are unemployed.

 

66 

Priorities and Strategies Aligned with 6 Top Threats to Community Health

Priority 1 – Support Health Behaviors that Promote

Well-Being and Prevent Disease

Priority 2 – Increase Access to High Quality, Holistic Preventive and Treatment Services Across the Health

Care System

Reduce tobacco use

and exposure to

environmental tobacco smoke.

Increase access to, and consumption, of fresh fruits

and vegetables.

Coordinate the effective

communication of tailored,

accurate and actionable

health information to Kane County

residents across the lifespan.

Create environments that prevent

excessive consumption

of alcohol.

Increase the

proportion of

residents of all ages that have regular, ongoing

sources of medical

and dental care.

Increase the proportion of residents of all ages

who receive appropriate,

evidence-based

clinical preventive services.

Focus culturally

appropriate outreach and engagement

efforts to eliminate

racial disparities in

health outcomes,

especially in infant

mortality.

Enhance systems to support the prevention,

early identification and treatment

of communicable diseases in the

community.

Enhance systems to support the prevention,

early identificatio

n and evidence-

based treatment of mental

health conditions.

Obesity

X X X X X X

Chronic Disease

X X X X X X X X

Infant Mortality

X X X X X X X X

Childhood Lead

Poisoning X X X X

Communicable

Disease X X X X X X

Poor Social &

Emotional Wellness

X X X X X X

 

67 

Priority 3 – Support & Create Health Promoting Neighborhoods, Towns & Cities

Priority 4 – Promote Social, Economic and Educational Environments that

Optimize Health

Increase the availability and variety of high quality, safe

and affordable housing and

compact, mixed use

developments.

Institute “complete

streets” types of policies to ensure that

roadways are designed and operated with

all users in mind -

including bicyclists,

public transportation vehicles and riders, and

pedestrians of all ages and

abilities.

Assure access to safe

playgrounds, parks, trails and open

space.

Assure access to safe

food and clean

and safe water

and air.

Increase the proportion of children who

have high-quality early

developmental support,

especially in child care and

education.

Increase the

proportion of Kane County young

people that complete

high school

education.

Increase the job skills and readiness of Kane County residents that

are unemployed.

Obesity X X X X X X

Chronic Disease X X X X X X

Infant Mortality X X X X

Childhood Lead Poisoning X X X X

Communicable Disease X X X

Poor Social & Emotional Wellness

X X X X X X

  68 

Strategy Selection

SUPPORT HEALTH BEHAVIORS THAT PROMOTE WELL-BEING

AND PREVENT DISEASE

1. Reduce tobacco use and exposure to environmental tobacco smoke.

3. Coordinate the effective communication of tailored, accurate and actionable health information to Kane County residents across their lifespan.

2. Increase access to and consumption of, fresh fruits and vegetables.

4. Create environments that prevent excessive consumption of alcohol.

The County Health Rankings model (see Figure 2 ) indicates that health behaviors account for

30% of health outcomes and the National Prevention Strategy recommends empowering people

to make healthy choices as a method of improving community health.14 The information

gathered as part of the assessment, along with the evidence from the two models, emphasizes

that personal health choices and behaviors are an important component in overall health and

should be a key priority for the Community Health Improvement Plan.

The first strategy of reducing use of tobacco and exposure to environmental tobacco smoke has a

direct affect on chronic disease. According to the CDC, smoking causes certain types of cancer,

bronchitis, emphysema, heart disease, and stroke, all chronic diseases.15 Many people who do

not use tobacco products are exposed to hazardous environmental tobacco smoke and therefore

need to be protected through policies that prohibit smoking in public and private places.

                                                            14 National Prevention Council, National Prevention Strategy, Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General, 2011 http://www.healthcare.gov/prevention/nphpphc/strategy/report.pdf  15 Centers for Disease Control and Prevention. “Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004,” Morbidity and Mortality Weekly Report 2008;57(45):1226–8. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5745a3.htm  

PRIORITY 1

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The next strategy calls for an increase in access to and consumption of fresh fruits and

vegetables. This strategy will help reduce obesity rates by providing residents with healthy

options, particularly those residents in lower-income areas who do not have healthy options

available in their neighborhoods. There is evidence that shows that access to supermarkets in

underserved areas leads to an increased consumption of fruits and vegetables by adults.16

The third strategy focuses on the coordination of effective communication, which has an impact

on all six top threats to community health. Health care and public health professionals are

turning to the Internet and other technology-dependent methods of sharing information to reach

as many people as possible. However, not everyone has access to or is comfortable with these

types of communications. We must take into account all residents across the lifespan and ensure

we are not leaving out any groups. Research has shown that those who do not receive messages

are more prone to lower usage rates of preventive services, less knowledge of chronic disease

management, higher rates of hospitalization, and poorer reported health status.17

The final strategy for Priority 1 addresses excessive consumption of alcohol.18 By creating

environments that prevent the excessive consumption of alcohol, we can influence rates of

obesity, chronic disease, infant mortality, and communicable disease for the better and have a

positive effect on social and emotional wellness. According to the County Health Rankings,

there is a strong correlation between excessive drinking and motor vehicle crashes due to

alcohol-impaired driving. In addition, excessive drinking puts residents at a higher risk for

alcohol poisoning, hypertension, fetal alcohol syndrome, sudden infant death syndrome, sexually

transmitted infections, and suicide.19 Preventing consumption of alcohol is a proactive method

for helping residents live healthier lives.

                                                            16 Centers for Disease Control and Prevention. “Recommended Community Strategies and Measurements to Prevent Obesity in the United States,” Morbidity and Mortality Weekly Report. 2009;58(7): 8. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5807a1.htm  17 “Health Communication and Health Information Technology” U.S. Department of Health and Human Services. Healthy People.gov. http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=18 18 Excessive consumption refers to consuming 4 drinks in a session for women, 5 drinks in a session for men 19 Naimi TS, Brewer RD, Molded A, Denny C, Ferula MK, Marks JS. “Binge drinking among US adults,” Journal of the American Medical Association 2003;289:70—5 http://jama.ama-assn.org/content/289/1/70.full

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Bright Spot: Elgin Community Garden Network

You could say the Elgin Community Garden Network is a “growing” affair. A passionate group of volunteers committed to teaching sustainable gardening skills and helping to feed the hungry in the Elgin area, the ECGN has worked with the Elgin Firefighters to raise money to support their efforts. The Fire Fighters also contributed time and labor to help build and install the gardens. The ECGN has created a partnership with the City of Elgin to raise funds and to use city land for gardens. In addition, the Network has received two $10,000 Fit Kids grants from the Making Kane County Fit for Kids Funders Consortium for its programs. The EGCN has participated with the City adding gardening to summer pre-school and youth programs. School District U-46 is also an active participant.

The gardening effort in Elgin has continued to expand and “grow,” supporting health behaviors that promote well-being and prevent disease. The gardens increase access to and consumption of fresh fruits and vegetables as a way to help battle chronic disease. A focus of the gardening effort is children. The children participate in “planting days,” and plenty of fun and educational opportunities are scheduled for them. Here, they get a hands-on education. The original goal was to provide 200 pounds of produce to local soup kitchens and food pantries. This past season they donated almost 700 pounds of fresh produce. And, their reach extends beyond growing and giving produce away. In addition to planting giving gardens, the ECGN team has located gardens at low income housing complexes and local schools. In the past year, more gardens have been added and include schools, The Centre, East Side Recreation Center and low income communities. There are now 17 garden sites and plans are already underway for the 2012 season. The ECGN has continued to add partnerships to work together to expand the reach of the gardens. For a complete list of all the gardening events and opportunities, check out the Elgin Community Garden Network, Facebook page at http://www.facebook.com/ElginCommunityGardens.   

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INCREASE ACCESS TO HIGH QUALITY, HOLISTIC PREVENTIVE

AND TREATMENT SERVICES ACROSS THE HEALTH CARE

SYSTEM

Increase the proportion of residents of all ages that have regular, ongoing sources of medical and dental care.

Enhance systems to support the prevention, early identification and treatment of communicable diseases in the community.

Increase the proportion of residents of all ages who receive appropriate, evidence-based clinical preventive services.

Enhance systems to support the prevention, early identification and evidence-based treatment of mental health conditions.

Focus culturally appropriate outreach and engagement efforts to eliminate racial disparities in health outcomes, especially in infant mortality.

Preventive care is a key method of maintaining proper health and goes beyond trips to the

doctor’s office. The entire community plays a role in preventive care, from policies and

programs that encourage people to get the care they need to sharing information with other

agencies to identify potential outbreaks of diseases and communicating services available to

residents. The quality of services and access to treatment is also an important component of

health. Quality care is tailored to the patient, timely, and appropriate for the problem. Treatment

for mental health conditions will help people achieve psychological, social, and emotional well-

being which can lead to better overall health.20 This priority was chosen because it is a proactive

way of improving health, rather than a reactive view of addressing the symptom instead of the

root cause.

The first strategy in this priority is to increase the proportion of residents that have regular,

ongoing sources of medical and dental care. Having a primary care provider increases patient

trust in the provider, helps maintain provider-patient communication, and leads to a greater                                                             20 “Mental Health Basics” Centers for Disease Control and Prevention. http://www.cdc.gov/mentalhealth/basics.htm

PRIORITY 2

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likelihood that patients will receive the care they need.21 Studies have shown that having a usual

and ongoing source of care will lead to better health outcomes and fewer disparities, which in

turn will reduce rates of obesity, chronic disease, and other threats to community health

identified in the health assessment.22

The next strategy will increase the proportion of residents who receive appropriate, evidence-

based clinical preventive services. This strategy affects all of the top threats because of the

evidence that early intervention leads to better health outcomes by detecting early warning signs

or symptoms (proactive) or by early detection of a problem allowing for early treatment.23 In

addition, clinical preventive services include childhood immunizations which prevent disease,

which is measured as part of this strategy.

The third strategy is to focus culturally appropriate outreach and engagement efforts to eliminate

racial disparities in health outcomes, especially in infant mortality. According to the Robert

Wood Johnson report, “Overcoming Obstacles to Health”, there is a disparity in health by

race/ethnicity at every income level, with African-Americans and Hispanics reporting poor/fair

health.24 In Kane County, there is a great disparity in infant mortality, with African-American

babies having a higher rate than Hispanics and whites. Infant mortality is recognized as the best

single measure of the health of a population, group, or community and ties in with the six top

threats to community health.25

Strategy Four is focused on enhancing systems to support the prevention, early identification and

treatment of communicable diseases in the community. This strategy is relevant to the top threat

of communicable disease, as the county is responding to a large outbreak of tuberculosis in a

community. The surveillance of communicable diseases leads to early intervention and is an

                                                            21 “Access to Health Services” U.S. Department of Health and Human Services. Healthy People.gov http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=1 22 http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=1 23 http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=1 24 Braverman, Paula and Egeter, Susan. Report from the Robert Wood Johnson Foundation to the Commission to Build a Healthier America: Overcoming Obstacles to Health. Princeton, NJ: Robert Wood Johnson Foundation, 2008. http://www.rwjf.org/files/research/obstaclestohealth.pdf 25 Reidpath DD, Allotey P. Infant mortality rate as an indicator of population health. Journal of Epidemiology& Community Health.2003;57:344–6  

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important tool for public health professionals, reducing illness, hospitalization, and death from

vaccine-preventable diseases and other infectious diseases.26

The final strategy for Priority 2 is enhancing systems to support the prevention, early

identification and evidence-based treatment of mental health conditions. Mental health is closely

related to physical health, affecting people’s ability to maintain good physical health and

participate in health promoting behaviors.27 The CDC’s “Healthy Days” questions allow us to

track mental health status using an internationally recognized standard for measuring population

health.28

                                                            26 “Immunization and Infectious Diseases” U.S. Department of Health and Human Services. Healthy People.gov. http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=23 27 “Mental Health and Mental Disorders” U.S. Department of Health and Human Services, Healthy People.gov http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=28 28 “Surveillance Overview” Centers for Disease Control and Prevention. http://www.cdc.gov/hrqol/overview.htm  

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SUPPORT & CREATE HEALTH-PROMOTING NEIGHBORHOODS, TOWNS, & CITIES

Increase the availability and variety of high quality, safe and affordable housing and compact, mixed-use development.

Assure access to safe playgrounds, parks, trails and open space.

Institute “complete streets” types of policies to ensure that roadways are designed and operated with all users in mind – including bicyclists, public transportation vehicles and riders, and pedestrians of all ages and abilities.

Assure access to safe food and clean and safe water and air.

The environment, both the built where we live, learn, work, and play and the natural, plays a

critical role in our health and well-being. Living in safe housing gives us a chance to be

physically active and protects us from environmental hazards like lead and allergens.29 Increased

use of public transportation decreases air pollution, leading to better health outcomes for

residents. This priority focuses on the environmental factors that affect our health and what can

be done to improve community health.

The first strategy is to increase the availability and variety of high quality, safe and affordable

housing and compact, mixed use developments. This strategy will have an effect on obesity,

chronic disease, childhood lead poisoning, and social/emotional wellness. The percent of

children in Kane County with elevated blood lead levels is higher than Illinois overall. Children

with high levels of lead in their blood are at risk for damage to the brain and nervous system,

                                                            29 National Prevention Council, National Prevention Strategy, Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General, 2011 http://www.healthcare.gov/prevention/nphpphc/strategy/report.pdf  

PRIORITY 3

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behavior and learning problems, slowed growth, and hearing problems, making this one of the

top threats to community health in Kane County.30

The next strategy is to institute “complete streets” types of policies to ensure that roadways are

designed and operated with all users in mind - including bicyclists, public transportation vehicles

and riders, and pedestrians of all ages and abilities. These policies increase opportunities for

residents to incorporate physical activity into their daily routine, leading to lower rates of obesity

and chronic disease, as well as improving social and emotional wellness. Residents will have

greater success in losing weight and maintaining a healthy weight if they are engaged in regular

physical activity.31

The next strategy is to assure access to safe playgrounds, parks, trails and open space. Looking

at children in particular, they need a safe environment where they are able to utilize parks, trails,

and open spaces to get the physical activity they need to be healthy. The problem of childhood

obesity in Kane County is alarming, with 14.7% of children considered overweight and another

21.8% of children considered obese.32 As with the prior strategy, maintaining a healthy weight is

easier when people are engaged in regular physical activity.

The final strategy for this priority is to assure access to safe food and clean and safe water and air

which contribute to the top threats of chronic disease and communicable disease. The measure

for this strategy focuses on foodborne outbreaks in Kane County. The CDC estimates that each

year roughly 48 million people get sick, 128,000 are hospitalized, and 3,000 die of foodborne

diseases in the U.S.33 By keeping the food system safe for all residents through preventive

methods like food safety, education, surveillance and restaurant inspections, we can help control

and prevent foodborne outbreaks.

                                                            30 “Lead in Paint, Dust, and Soil”, U.S. Environmental Protection Agency http://www.epa.gov/lead/pubs/leadinfo.htm#health 31 “Physical Activity for a Healthy Weight”, Centers for Disease Control and Prevention http://www.cdc.gov/healthyweight/physical_activity/index.html 32 Kane County Community Health Survey, 2011 33 “2011 Estimates of Foodborne Illness” Centers for Disease Control and Prevention http://www.cdc.gov/foodborneburden/2011-foodborne-estimates.html  

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Bright Spots: Aurora Township

As we battle the epidemic of childhood obesity, we see the importance of physical activity as a way to help combat the chronic diseases that are so often associated with it. We know that physical activity is an important part of regular family life, and children are more likely to remain active throughout their lives if they learn those lifestyle behaviors at an early age.

In urban areas, one of the biggest barriers for children increasing physical activity is providing access to safe playgrounds, parks, trails and open space. That’s where Aurora Township comes in. With the help of business donations, local volunteers and Fit Kids grants from the Making Kane County Fit for Kids Funders Consortium, new playground equipment was installed Nov. 11th and 12th , 2011.

At the site of a previous eyesore, the new playground is at the corner of Jackson Street and Montgomery Road. Up until about 10 years ago, the property was a virtual dump. Only after a significant clean-up nine years ago was the property turned into a soccer field, and then an additional field was added. Now, the equipment has been added. The equipment was installed to give siblings a place to be physically active while they watch soccer. Prior to this, parents bribed the younger kids into behaving with food. Now they can be physically active.

The equipment was chosen with the help of children and is geared toward ages 3 to 12. As many as 52 kids can be active at the same time and swings will be added in the near future. Community donations of cement were given by Ace Hardware and Farm and Fleet. Muscle was provided by local Labor Union 149 who helped install the playground as volunteers on Veterans Day. Also, 15 soccer parents lent their muscles, and one entire family, including a 4-year-old, helped. This was truly a community project.

 

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PROMOTE SOCIAL, ECONOMIC AND EDUCATIONAL

ENVIRONMENTS THAT OPTIMIZE HEALTH

Increase the proportion of children who have high-quality early developmental support, especially in child care and education.

Increase the job skills and readiness of Kane County residents that are unemployed.

Increase the proportion of Kane County young people that complete high school education

The fourth priority focuses on education and employment, recognizing the important link

between these factors and health. People with higher educational attainment are better equipped

to make decisions about their health behaviors and those of their family. Those who are

employed have access to employer-sponsored health insurance, including employee wellness

programs, and the income provides enough money to afford to live in a safe neighborhood, with

quality schools and access to healthy food.

The first strategy is to increase the proportion of children who have high-quality early

developmental support, especially in child care and education. Children’s health is shaped by

community influences such as safety, school quality, presence of favorable role models and

availability of healthful foods and recreational opportunities.34 Helping children get the early

childhood support they need, through school or family-based programs will help them live

healthier lives.

The next strategy is increase the proportion of Kane young people that complete high school

education. The relationship between higher education and improved health outcomes is well

known, with higher education leading to increased job opportunities which generally provide

                                                            34 Egerter, S., Braveman, P., Pamuk, E., Cubbin, C., Dekker, M., Pedregon, V., Sadegh-Nobari, T. Robert Wood Johnson Foundation Commission to Build a Healthier America, America’s Health Starts with Healthy Children: How do States Compare? http://www.commissiononhealth.org/Documents/ChildrensHealth_Chartbook.pdf

PRIORITY 4

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access to health care.35 Not only does one’s education level affect his or her health; education

can have multigenerational implications that make it an important measure for the health of

future generations. The following graphic illustrates how a parent’s educational attainment is

important in a child’s environment and the effect on health.36

                                                            35 Cutler D, Lleras-Muney A. Education and Health: Evaluating Theories and Evidence. Cambridge, MA: National Bureau of Economic Research;2006. Working Paper Series, no. 12352 http://www.nber.org/papers/w12352.pdf 36 Egerter, S., Braveman, P., Pamuk, E., Cubbin, C., Dekker, M., Pedregon, V., Sadegh-Nobari, T. Robert Wood Johnson Foundation Commission to Build a Healthier America, America’s Health Starts with Healthy Children: How do States Compare? 2008. http://www.commissiononhealth.org/Documents/ChildrensHealth_Chartbook.pdf  

Higher levels of parents' education

Better jobs and increased family 

income

Affordability of good housing, a 

safe neighborhood with access to recreational 

opportunities and nutritious diet

Higher levels of parents' education

Healthier behaviors by 

parents

Good role models for children and lower exposure to 

unhealthy conditions such as secondhand 

smoke

Increased family income

Resources to cope with 

stressors (e.g., child care, 

transportation, health 

insurance)

Decreased levels of 

chronic  stress experienced by children

Positive effects on neuroendocrine systems that can lead to lesser 

risks for developing 

chronic diseases such as heart disease and diabetes

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The final strategy in Priority 4 is to increase the job skills and readiness of Kane County

residents that are unemployed. There is a strong correlation between employment and health,

particularly in access to care and mental health. Unemployment in particular has been shown to

lead to an increase in unhealthy behaviors related to alcohol and tobacco consumption, diet,

exercise, and other health-related behaviors, which in turn can lead to increased risk for disease

or mortality.37 Studies have also shown that people who lose a job through no fault of their own

were twice as likely to develop a new health problem, such as high blood pressure, diabetes, or

heart disease over the next year and a half compared with those who were continuously

employed.38 Through coordinating job training programs and increasing job skills, we can

address all of the six top threats to community health in Kane County.

                                                            37 “Employment” County Health Rankings http://www.countyhealthrankings.org/health-factors/employment 38 Strully, Kate W., “Job Loss and Health in the U.S. Labor Market” Demography 46 no. 2, (2009): 221-246. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831278/   

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Detailed Priorities and Strategies Strategy Measure Data Source Evidence

Priority 1 –

Support Health

Behaviors that Promote Well-Being and Prevent

Disease

Reduce tobacco use and exposure to environmental tobacco smoke.

Measure: Percentage of Kane County adults (over age 18) who report being current smokers. Current smoking was defined as having smoked at least 100 cigarettes in a lifetime and still smoking some days or every day. 2011 Baseline: 12% of Kane County adults report smoking cigarettes currently 2016 Goal: Decrease percent of adults who currently smoke to 9%

Kane County Community Health Survey (CHS).

The percentage of the adult population who are current smokers represents the extent of health risk in a community related to tobacco use. Measuring the prevalence of tobacco use in the population can alert communities to potential adverse health outcomes in the future and can be valuable for assessing the need for cessation programs or the effectiveness of existing programs. http://www.countyhealthrankings.org/health-factors/tobacco-use

Increase access to, and consumption, of fresh fruits and vegetables.

Measure: Percentage of Kane County adults who report eating at least five servings of fruits and vegetables per day. 2011 Baseline: 14.4% of adults 25.5% of children 2016 Goal:

17.3% for adults 30.6% for children

Kane County Community Health Survey or Illinois BRFSS

Access to and availability of healthier foods can help people follow healthful diets. For example, better access to retail venues that sell healthier options may have a positive impact on a person’s diet; these venues may be less available in low-income or rural neighborhoods. HP2020: http://www.healthypeople.go

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v/2020/topicsobjectives2020/overview.aspx?topicId=29#nine

Coordinate the effective communication of tailored, accurate and actionable health information to Kane County residents across the lifespan.

Measure: The percent of the adult population that is satisfied with health communication from the KCHD. 2011 Baseline: 89% satisfied (2009 H1N1 campaign) 2016 Goal:

60% very satisfied 30% satisfied

Kane County H1N1 Communications Survey

Effective use of communication and technology by health care and public health professionals can bring about an age of patient- and public-centered health information and services. By strategically combining health IT tools and effective health communication processes, there is the potential to:

Improve health care quality and safety.

Increase the efficiency of health care and public health service delivery.

Improve the public health information infrastructure.

Support care in the community and at home.

Facilitate clinical and consumer decision-making.

Build health skills and knowledge.

HP2020:

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http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=18

Create environments that prevent excessive consumption of alcohol.

Measure: The percent of the adult population that reports consuming more than 4 (women) or 5 (men) alcoholic beverages on a single occasion in the past 30 days. 2011 Baseline: 27.6% of adults 2016 Goal: 22% of adults

Kane County CHS or Illinois BRFSS

Excessive drinking is a risk factor for a number of adverse health outcomes such as alcohol poisoning, hypertension, acute myocardial infarction, sexually transmitted infections, unintended pregnancy, fetal alcohol syndrome, sudden infant death syndrome, suicide, interpersonal violence, and motor vehicle crashes. County Health Rankings: http://www.countyhealthrankings.org/health-factors/alcohol-use

Priority 2 – Increase Access to

High Quality, Holistic

Preventive and

Treatment Services

Across the Health

Increase the proportion of residents of all ages that have regular, ongoing sources of medical and dental care.

Measure: The percent of adult population that reports having a personal doctor or health care provider. 2011 Baseline: 83.6% of adults 2016 Goal: 88% of adults

Kane County CHS or Illinois BRFSS

Improving health care services depends in part on ensuring that people have a usual and ongoing source of care. People with a usual source of care have better health outcomes and fewer disparities and costs. HP2020: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=1

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Care System

Increase the proportion of residents of all ages who receive appropriate, evidence-based clinical preventive services.

Measures: Hospitalization rate for diabetes

per 100,000 residents The percent of two-year olds

who receive age-appropriate immunizations.

2011 Baseline:

138 hospitalizations for diabetes per 100,000 residents (2009)

56% of two-year olds received age-appropriate immunizations (2010).

2016 Goal:

100 hospitalizations for diabetes per 100,000 residents

75% of two-year olds receive age-appropriate immunizations

Illinois Department of Public Health

Hospitalization for diagnoses amenable to outpatient services suggests that the quality of care provided in the outpatient setting was less than ideal. The measure may also represent the population’s tendency to overuse the hospital as a main source of care. CHR: http://www.countyhealthrankings.org/illinois/kane/5 Vaccines are among the most cost-effective clinical preventive services and are a core component of any preventive services package. Childhood immunization programs provide a very high return on investment. For example, for each birth cohort vaccinated with the routine immunization schedule (this includes DTap, Td, Hib, Polio, MMR, Hep B, and varicella vaccines), society:

Saves 33,000 lives. Prevents 14 million

cases of disease. Reduces direct health

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care costs by $9.9 billion.

Saves $33.4 billion in indirect costs.

HP2020: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=23

Focus culturally appropriate outreach and engagement efforts to eliminate racial disparities in health outcomes, especially in infant mortality.

Measure: African American infant mortality rate per 1,000 live births (5-year average) 2011 Baseline: 12.2 deaths per 1,000 live births (2003-2007) 2016 Goal: 9.8 deaths per 1,000 live births

Illinois Department of Public Health

Infant mortality rates are an important indicator of the health of a nation because they are associated with maternal health, quality of and access to medical care, socioeconomic conditions, and public health practices. CDC: http://www.cdc.gov/mmwr/preview/mmwrhtml/su6001a9.htm

Enhance systems to support the prevention, early identification and treatment of communicable diseases in the community.

Measure: The number of new cases (Incidence) of Tuberculosis in Kane County per 100,000 residents. 2011 Baseline: 6 confirmed cases per 100,000 residents 2016 Goal: 2 confirmed cases per 100,000 residents

Kane County Health Department, Disease Prevention Division

The infectious disease public health infrastructure, which carries out disease surveillance at the federal, state, and local levels, is an essential tool in the fight against newly emerging and re-emerging infectious diseases. HP2020:

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http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=23

Enhance systems to support the prevention, early identification and evidence-based treatment of mental health conditions.

Measure: Percentage of Adults Reporting Poor Mental Health. Data represent adults who reported their mental health was not good on 14 or more days during the past 30 days. 2011 Baseline: 9% of adults 2016 Goal: 7% of adults

Kane County Community Health Survey or Illinois BRFSS

The CDC Healthy Days measures are an acknowledged standard for population health surveillance by national and international groups. The four core Healthy Days questions have been asked of all participants in the Behavioral Risk Factor Surveillance System (BRFSS) from 1993 through 2009 (except in 2002 when only 20 states asked these questions). Since 2000, the Healthy Days measures have also been administered to respondents aged 12 years or older in the National Health and Nutrition Examination Survey (NHANES). These measures are now accepted as standards in the United States and have been used in other countries including Canada, Sweden, and Italy. http://www.cdc.gov/hrqol/overview.htm

Priority 3 – Support & Create

Increase the availability and variety of high quality, safe and

Measure: Percent of children under six years old with elevated blood lead levels

Kane County Health Department, Disease Prevention

Lead exposure can result in lasting impairment of a child’s development and

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Health Promoting Neighborhoods, Towns & Cities

affordable housing and compact, mixed use developments.

2011 Baseline: 1.0% of children less than 6 years old tested have elevated lead levels in their blood. 2016 Goal: 0.65% of children less than 6 years old tested will have elevated lead levels in their blood.

Division behavior such as decreased IQ and attention span and increased risk for delinquent behavior (Centers for Disease Control and Prevention 2005d).

Institute “complete streets” types of policies to ensure that roadways are designed and operated with all users in mind - including bicyclists, public transportation vehicles and riders, and pedestrians of all ages and abilities.

Measure: The percent of Kane County adults who meet the recommended level of physical activity. The percent of Kane County adults who are considered obese as measured by their Body Mass Index (BMI). 2011 Baseline:

53.5% of adults meet physical activity recommendations.

29.4% of adults are considered obese.

2016 Goal:

64% of adults meet physical activity recommendations

26% of adults are considered obese

Kane County CHS Most weight loss occurs because of decreased caloric intake. However, evidence shows the only way to maintain weight loss is to be engaged in regular physical activity. Most importantly physical activity reduces risks of cardiovascular disease and diabetes beyond that produced by weight reduction alone. CDC: http://www.cdc.gov/healthyweight/physical_activity/index.html

Assure access to safe playgrounds, parks, trails and open space.

Measure: The percentage of Kane County children who are considered obese as measured by their BMI. 2011 Baseline: 21.8% of children under 18 are considered obese

Kane County CHS Physical activity is an important part of regular family life. Studies have shown that lifestyles learned as children are much more likely to stay with a person into adulthood. If

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2016 Goal: 18.5% of children under 18 are considered obese

sports and physical activities are a family priority, they will provide children and parents with a strong foundation for a lifetime of health. American Academy of Pediatrics: http://www.aap.org/healthtopics/physact.cfm

Assure access to safe food and clean and safe water and air.

Measure: The number of foodborne outbreaks identified in Kane County. 2011 Baseline: 3 confirmed foodborne outbreaks in 2011 2016 Goal: 0 confirmed foodborne outbreaks

Kane County Health Department

Foodborne diseases affect tens of millions of people and kill thousands in the United States each year. They also cause billions of dollars in healthcare-related and industry costs annually. CDC: http://www.cdc.gov/WinnableBattles/FoodSafety/index.html

Priority 4 – Promoting Social, Economic and Educational environments that optimize

Increase the proportion of children who have high-quality early developmental support, especially in child care and education.

Measure: This measure is not finalized and is under development. The intended measure will be based on the kindergarten readiness assessment currently being developed in Illinois. The Illinois State Board of Education is establishing a Kindergarten Individual Development Survey (KIDS) Advisory Committee comprised of early childhood experts who will guide the state department of education as it

TBD Evidence shows that experiences in the 1st years of life are extremely important for a child’s healthy development and lifelong learning. How a child develops during this time affects future cognitive, social, emotional, and physical development, which influences school readiness

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health moves forward with recommendations for developing a comprehensive kindergarten readiness assessment process. It is expected that the readiness assessment will be piloted this fall during the 2012-2013 school year. More information is available from the Illinois State Board of Education39

and later success in life. Research on a number of adult health and medical conditions points to predisease pathways that have their beginnings in early and middle childhood. (HP2020)

Increase the proportion of Kane County young people that complete high school education.

Measure: High school graduation rate, reported as the percent of the county’s ninth-grade cohort in public schools that graduates from high school in four years. 2011 Baseline: 87.1% (2011) Range: 68.7%-96% 2016 Goal: 90%

Illinois State Board of Education

The relationship between more education and improved health outcomes is well known, with years of formal education correlating strongly with improved work and economic opportunities, reduced psychosocial stress, and healthier lifestyles. CHR: http://www.countyhealthrankings.org/illinois/kane/21

Increase the job skills and readiness of Kane County residents that are unemployed.

Measure: The percent of the civilian labor force, age 16 and older, in Kane County that is unemployed but seeking work. Data is the most recent calendar-year annual estimate for unemployment. 2011 Baseline: 10.3% (2010 annual estimate) 2016 Goal: 5.4%

U.S. Bureau of Labor Statistics (BLS), Local Area Unemployment Statistics (LAUS). The most recent calendar-year annual estimate for unemployment.

While employment has been associated with health improvements, unemployment has been linked with declines in health status. Unemployment may lead to physical health responses ranging from self-reported physical illness to mortality, especially suicide.

                                                            39 Kindergarten Readiness Stakeholder Committee Report to the Illinois Board of Education. “A New Beginning: The Illinois Kindergarten Individual Development Survey” April 2011. http://www.isbe.net/assessment/pdfs/agendas/KIDS/KIDS_report.pdf) 

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(National benchmark set at 90th percentile for all counties: 2012 County Health Rankings. Other important measures of success for this strategy include the percentage of workers who completed job skills enhancement programs who subsequently entered employment and retained employment three quarters after program completion.

Kane County Department of Employment & Education

It has also been shown to lead to an increase in unhealthy behaviors related to alcohol and tobacco consumption, diet, exercise, and other health-related behaviors, which in turn can lead to increased risk for disease or mortality. CHR: http://www.countyhealthrankings.org/health-factors/employment

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Implementation

The Kane County Community Health Improvement Plan (CHIP) is designed to be implemented

by organizations and groups throughout the community. Through the Community Health

Assessment process, we identified six top threats to the health of our communities. We know that

these six threats: Obesity, Communicable Disease, Chronic Disease, Infant Mortality, Childhood

Lead Poisoning, and Poor Social & Emotional Wellness are responsible for much of the

premature illness and death in Kane County. These threats affect our quality of life every day.

The CHIP identifies four high priority areas for work over the next four years in order to address

the six top health threats. The priority areas consider that where we live, learn, work and play can

have a greater impact on how long and well we live than medical care alone. And, a person’s

health and chances of becoming sick and dying early are greatly influenced by powerful social

factors such as education, income, housing and neighborhoods. Fortunately, as individuals and as

a community, there are many actions we can take to make our communities healthier.

The CHIP recommends proven, evidence-based strategies for each of the four priority areas.

There are sixteen recommended strategies to address the top health threats. The strategies were

selected because there is existing evidence that shows these strategies can positively impact the

top health threats identified through the community health assessment. In an era of declining

resources for all agencies, it is more important than ever to focus our efforts and limited

resources on strategies that have been proven to work.

Clearly, not every organization can address all 16 strategies. Some strategies focus on changing

individual behavior and creating environments that make the healthy choice the easy choice.

Others focus on enhancing connections across the healthcare system, while others focus on

changing our neighborhoods to be more health promoting. The final set of strategies recognizes

the critical importance of education to a person’s health. The CHIP provides a framework of

recommended policies and programs to be implemented. Organizations throughout the county

can identify the strategies on which they can focus their efforts and resources and have the most

impact.

Hospitals may choose to focus their Community Benefit Plans on strategies to increase access to

high-quality, holistic preventive and treatment services. School districts might focus on

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increasing students’ access to fresh fruits and vegetables through enhancements to their school

lunch programs. Faith communities might choose to promote walking to services as an

opportunity to increase physical activity. Municipalities can institute “complete streets” policies

to ensure that roadways are designed with all users in mind – including bicyclists, public

transportation vehicles and riders, and pedestrians of all ages and abilities. Community colleges

might enhance programs to train job seekers on the skills they need to qualify for new jobs. Over

the next six months, community leaders will be identified for each strategy and action plans will

be developed.

The CHIP is also part of a larger Kane County plan to shape our environments in ways that

promote and optimize health for all. For the first time, the Kane County 2040 Plan integrates

planning for community health with land use and transportation issues. The overarching theme

for the 2040 Plan is Healthy People, Healthy Living, Healthy Communities. This theme

recognizes and emphasizes the connection between the most important resource in Kane County

– its people – with the opportunities and barriers for healthy living created by the built and

natural environment, and how together they shape the overall health of communities.

Ultimately, the health of Kane County depends on the health of all residents. The Community

Health Improvement Plan calls on individuals, organizations, employers and communities to take

action using the recommended strategies to improve the health of Kane County residents. How

will you take action?

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APPENDIX C

ACKNOWLEDGEMENTS

The Kane County Health Department would like to thank our partners for their dedication of time and resources in completing the 2011 Kane County Community Health Assessment and 2012-2016 Community Health Improvement Plan. Without their expertise, input, and financial support, this plan would not have been possible.

Lynne Bosley, President, United Way of Elgin Edward Hunter, Vice President, Mission Services, Provena Mercy Medical Center and

Provena Saint Joseph Hospital Tina Link, Director, Community Outreach, Sherman Hospital Michael Meyer, President, Fox Valley United Way Jerry Murphy, Executive Director, INC Board Karin Podolski, Director, Community Health and Outreach, Cadence Health Terese Raabe, Director, Planning and Business Development, Rush-Copley Medical

Center The department would also like to thank the members of the Kane County Health Advisory Committee for their input and support throughout the assessment and planning process.

Lourdes Blacksmith, Director of Federal and Cultural Relations, Waubonsee Community College

Richard Chroust, DDS Diane Homan, MD, Vice President, Quality Patient Safety Officer, Rush-Copley Medical

Center Jeanette Mihalec, Chairman, Kane County Public Health Committee Carmella Moran, PhD, RN, Director and Associate Professor, Aurora University School

of Nursing Karin Podolski, RN, MPH, Director, Community Health and Outreach, Cadence Health David Stone, PhD, Director, Office of Sponsored Projects, Northern Illinois University Robert Tanner, LCSW, ACSW, President, CEO Greater Elgin Family Care Center

Linnea Windel, RN, MSN, President, CEO VNA Health Care

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Community Health Improvement Plan Record of Change

Date of Change Changes Made Person Responsible

August 13, 2012 Corrected typographical errors

Jackie Forbes

Release Date: April 9th, 2012