ohio valley hospital community health needs …...project. this group deserves special recognition...

Ohio Valley Hospital

Community Health Needs Assessment

2016 Full Report

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ACKNOWLEDGEMENTS

The Ohio Valley Hospital (OVH) Community Health Needs Assessment (CHNA) was developed with the support of Strategy Solutions, Inc. (SSI), the consulting group engaged by OVH to assist with the assessment. Representatives from OVH and SSI worked collaboratively to guide and conduct the assessment. A steering committee made up of senior representatives of OVH, as well as representatives from local health departments, leading health and social service organizations and county government provided additional input. The combined expertise, input and knowledge of the members of the steering committee was vital to the project. This group deserves special recognition for their tireless oversight and support of the CHNA process. During this CHNA project, ten individuals were interviewed by SSI including representatives from faith-based organizations, health and social service agencies, public health officers, media, community development, public safety, school district personnel, and public and elected officials. Finally, information was gathered by the project team through a series of focus groups. These information-gathering efforts allowed the project team and steering Committee to gain a better understanding of the health status, health care needs, service gaps and barriers to care of those living in Allegheny County, which represents the service area of OVH. The administration of OVH would like to thank all of those who were involved in this project, particularly those who participated in interviews, focus groups and information gathering.

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PROJECT COORDINATION

Megan (Eaton) Hinds Ohio Valley Hospital Debra Thompson Strategy Solutions, Inc. Kathy Roach Strategy Solutions, Inc. Jacqui Catrabone Strategy Solutions, Inc. Robin McAleer Strategy Solutions, Inc.

STEERING COMMITTEE MEMBERS

Joanne Marie Andiorio, Ph.D. Sto Rox Community Health Center – Retired David Bytnar Sto Rox Health Center Sr. Sarah Crotty Focus on Renewal Lisa Dalena Ohio Valley Hospital – Geropsych Unit Jim Lightner Ohio Valley Hospital – Emergency Services Angelo Lupariello, MD Advanced Kidney Care Sue Pfeifer Ohio Valley Hospital – Occupational Medicine Craig Rippole Trinity Commercial Development, LLC Peg Spisak Ohio Valley Hospital – Patient Safety Sarah Stewart Ohio Valley Hospital – Community Services/Seniors Susan Zikos Ohio Valley Hospital – Dietician/Diabetes Educator

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TABLE OF CONTENTS

EXECUTIVE SUMMARY ...................................................................................... 1

GENERAL FINDINGS ......................................................................................... 11

Evaluation of the 2013 OVH CHNA Implementation Strategies ............................. 13

Key Findings – BRFSS & Public Health Data ............................................................ 15

Overall Key Findings ............................................................................................... 17

Other Secondary Data: Hospital Utilization Rates ................................................. 22

Primary Research Results ....................................................................................... 33

Overall Community Health Status .......................................................................... 33

Initiatives Currently Underway ............................................................................... 35

Conclusions ............................................................................................................. 37

Prioritization and Significant Health Needs ............................................................ 48

Review and Approval .............................................................................................. 49

METHODOLOGY .............................................................................................. 51

Service Area Definition ........................................................................................... 56

Asset Inventory ....................................................................................................... 58

Qualitative and Quantitative Data Collection ........................................................ 59

Key Stakeholder Interviews .................................................................................... 59

Focus Groups Conducted........................................................................................ 61

Prioritization and Significant Health Needs ............................................................ 61

DEMOGRAPHICS ............................................................................................. 65

Service Area Demographics .................................................................................... 69

Community Assets .................................................................................................. 78

Demographic Conclusions ...................................................................................... 90

ACCESS TO QUALITY ........................................................................................ 91

HEALTH CARE .................................................................................................. 91

Access Issues........................................................................................................... 94

Access to Quality Health Care Conclusions .......................................................... 106

CHRONIC DISEASE ......................................................................................... 109

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Cancer ................................................................................................................... 112

Heart Disease ........................................................................................................ 120

Diabetes ................................................................................................................ 127

Chronic Disease Conclusions ................................................................................ 131

HEALTHY ENVIRONMENT .............................................................................. 133

Marcellus Shale Hydraulic Fracturing ................................................................... 137

High School Graduation Rates .............................................................................. 140

Unemployment ..................................................................................................... 141

Asthma .................................................................................................................. 142

Healthy Environment Conclusions ....................................................................... 145

HEALTHY MOTHERS, BABIES AND CHILDREN ............................................... 147

Pregnancy ............................................................................................................. 150

Assistance ............................................................................................................. 154

Breastfeeding ....................................................................................................... 156

Teen Pregnancy .................................................................................................... 157

Infant Mortality .................................................................................................... 159

Overweight and Obesity ....................................................................................... 161

Healthy Mothers, Babies and Children Conclusions............................................. 166

INFECTIOUS DISEASES ................................................................................... 169

Influenza and Pneumonia ..................................................................................... 172

Infectious Diseases ............................................................................................... 174

Infectious Disease Conclusions ............................................................................. 182

MENTAL HEALTH AND SUBSTANCE ABUSE ................................................... 183

Mental Health ....................................................................................................... 186

Substance Abuse .................................................................................................. 187

Mental Health and Substance Abuse Conclusions ............................................... 194

PHYSICAL ACTIVITY AND NUTRITION ............................................................ 195

Physical Activity and Nutrition Conclusions ......................................................... 205

TOBACCO USE ............................................................................................... 207

Tobacco Use Conclusions ..................................................................................... 215

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INTENTIONAL AND UNINTENTIONAL INJURY ............................................... 217

Unintentional and Intentional Injury Conclusions ................................................ 225

CONCLUSIONS ............................................................................................... 227

Demographic Conclusions .................................................................................... 229

Access to Quality Health Care Conclusions .......................................................... 230

Chronic Disease Conclusions ................................................................................ 231

Healthy Environment Conclusions ....................................................................... 233

Healthy Mothers, Babies and Children Conclusions............................................. 233

Infectious Disease Conclusions ............................................................................. 235

Mental Health and Substance Abuse Conclusions ............................................... 235

Physical Activity and Nutrition Conclusions ......................................................... 236

Tobacco Use Conclusions ..................................................................................... 237

Unintentional and Intentional Injury Conclusions ................................................ 238

PRIORITIZATION CRITERIA LISTING ............................................................... 239

Appendix A: Stakeholder Interview Guide .................................................... 249

Appendix B: Focus Group Interview Guide ................................................... 253

Appendix C: Focus Group Intercept Survey .................................................. 259

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TABLE OF TABLES

Table 1. OVH Behavioral Risk Factor Comparative Table ............................... 17

Table 2. OVH Public Health Indicators – Table 1 of 2 ..................................... 18

Table 3. OVH Public Health Indicators – Table 2 of 2 ..................................... 19

Table 4. OVH County Health Rankings ............................................................ 20

Table 5. OVH 2013 Pennsylvania Youth Survey .............................................. 21

Table 6. Ambulatory Care Sensitive Conditions-ER Only ................................ 22

Table 7. Hospital ER and Outpatient Discharges for Mental Health .............. 23

Table 8. Hospital DRG Conditions ................................................................... 24

Table 9. Service Line by DRG ........................................................................... 24

Table 10. DRG Breakdown by Oakdale Zip Code 15071 ................................. 26

Table 11. DRG Breakdown by Carnegie Zip Code 15106 ................................ 27

Table 12. DRG Breakdown by Coraopolis Zip Code 15108 ............................. 28

Table 13. DRG Breakdown by Imperial Zip Code 15126 ................................. 29

Table 14. DRG Breakdown by McKees Rocks Zip Code 15136 ....................... 30

Table 15. DRG Breakdown by Corliss Zip Code 15204 .................................... 31

Table 16. DRG Breakdown by Crafton Zip Code 15205 .................................. 32

Table 17. DRG Breakdown by Neville Island Zip Code 15225 ......................... 33

Table 18. OVH Steering Committee Membership .......................................... 55

Table 19. OVH Steering Committee Dates and Agenda Topics ...................... 55

Table 20. Service Area Zip Codes .................................................................... 56

Table 21. OVH Stakeholder Interviews ........................................................... 60

Table 22. OVH Focus Groups Conducted ........................................................ 61

Table 23. Prioritization Criteria ....................................................................... 62

Table 24. OVH CHNA Prioritization Survey Sorted by Total of Accountability, Magnitude, Impact and Capacity .................................................................... 63

Table 25. OVH Hospital Asset Resources Listing ............................................. 80

Table 26. OVH Community Asset Resources Listing ....................................... 86

Table 27. Prioritization Criteria ..................................................................... 241

Table 28. OVH CHNA Prioritization Survey - Sorted by Total ....................... 242

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Table 29. OVH CHNA Prioritization Survey Results - Sorted by Accountability (Hospital Role) ............................................................................................... 243

Table 30. OVH CHNA Prioritization Survey Results - Sorted by Magnitude + Impact + Capacity .......................................................................................... 245

Table 31. OVH CHNA Prioritization Survey Results – Top Ten Needs Comparison By Total Ranking, Magnitude/Impact/Capacity, and Accountability ............................................................................................... 247

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TABLE OF FIGURES

Figure 1. Focus Groups – Community Health Status ...................................... 34

Figure 2. Schematic of the Community Health Needs Assessment Process .. 54

Figure 3: OVH Overall Service Area ................................................................ 57

Neville Island 15225Figure 4. OVH Service Area ......................................... 68

Figure 5. OVH Service Area Population Trend ................................................ 69

Figure 6. OVH Service Area by Gender ........................................................... 70

Figure 7. OVH Service Area by Race ................................................................ 71

Figure 8. OVH Service Area by Age ................................................................. 72

Figure 9. OVH Service Area by Marital Status ................................................. 73

Figure 10. OVH Service Area by Education ..................................................... 74

Figure 11. OVH Service Area by Household Income ....................................... 75

Figure 12. OVH Service Area by Employment Status ...................................... 76

Figure 13. OVH Service Area by Travel Time to Work .................................... 77

Figure 14: OVH Asset Resources Map ............................................................ 79

Figure 15. Adults (Age 18-64) with No Health Insurance ............................... 94

Figure 16. Adults with No Personal Health Care Provider .............................. 95

Figure 17. Adults Who Reported Needing to See a Doctor But Could Not Due to Cost, Past Year ............................................................................................ 96

Figure 18. 2015 Focus Groups – Personal Health Status ................................ 97

Figure 19. PRC – Healthcare Insurance Coverage for Child ............................ 98

Figure 20. PRC – Lack Healthcare Insurance Coverage for Child .................... 99

Figure 21. PRC – Experienced Difficulties or Delays in Receiving Child’s Needed Healthcare in the Past Year ............................................................. 100

Figure 22. PRC – Child Visited a Physician for a Routine Checkup in the Past Year ............................................................................................................... 101

Figure 23. PRC – Child Visited a Dentist or Dental Clinic Within the Past Year....................................................................................................................... 102

Figure 24. PRC – Child Used an Urgent Care Center, QuickCare Clinic, or Other Walk-in Clinic in the Past Year ...................................................................... 103

Figure 25. 2015 Focus Groups – Access Problems, 1 of 3............................. 104

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Figure 28. Breast Cancer Incidence Rates ..................................................... 112

Figure 29. Breast Cancer Mortality Rates ..................................................... 113

Figure 30. Bronchus and Lung Cancer Incidence Rates ................................ 114

Figure 31. Lung Cancer Mortality Rates ........................................................ 115

Figure 32. Colorectal Cancer Incidence Rates .............................................. 116

Figure 33. Colorectal Cancer Mortality Rates ............................................... 117

Figure 34. Prostate Cancer Incidence Rates ................................................. 118

Figure 35. Prostate Cancer Mortality Rates .................................................. 119

Figure 36. Heart Disease Mortality Rates ..................................................... 120

Figure 37. Heart Attack Mortality Rates ....................................................... 121

Figure 38. Coronary Heart Disease Mortality Rates ..................................... 122

Figure 39. Cardiovascular Disease Mortality Rates ...................................... 123

Figure 40. Chronic Lower Respiratory Disease (COPD) Mortality Rates ....... 124

Figure 41. Cerebrovascular Disease Mortality Rates .................................... 125

Figure 42. Adults Ever Told They Had a Stroke (age 35 and older) .............. 126

Figure 43: Diabetes Mortality Rates ............................................................. 127

Figure 44. PRC – Child Has Diabetes ............................................................. 128

Figure 45. Mammogram Screenings ............................................................. 129

Figure 46. 2015 Focus Groups – Chronic Disease Problems ......................... 130

Figure 47. Asthma Hospitalizations 2009-2013 ............................................ 136

Figure 48. High School Graduation Rates ..................................................... 140

Figure 49. Unemployment ............................................................................ 141

Figure 50. Students with Asthma .................................................................. 142

Figure 51. PRC – Child Currently Has Asthma (US 2014) .............................. 143

Figure 52. PRC – Number of Asthma-Related ER/Urgent Care Visits in the Past Year (US 2014)............................................................................................... 144

Figure 53. Prenatal Care First Trimester ....................................................... 150

Figure 54. Non-Smoking Mother During Pregnancy ..................................... 151

Figure 55. Non-Smoking Mother Three Months Prior to Pregnancy ........... 152

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Figure 56. Low Birth Rate Babies Born ......................................................... 153

Figure 57. Mothers Reporting WIC Assistance ............................................. 154

Figure 58. Mothers Reporting Medicaid Assistance ..................................... 155

Figure 59. Mothers Reporting Breastfeeding ............................................... 156

Figure 60. Teen Pregnancy Rate, Ages 15-19 ............................................... 157

Figure 61. Teen Live Birth Outcomes, Ages 15-19 ........................................ 158

Figure 62. Infant Mortality ............................................................................ 159

Figure 63. Infant Mortality in Pennsylvania .................................................. 160

Figure 64. Overweight BMI, Grades K-6 ....................................................... 161

Figure 65. Overweight BMI, Grades 7-12 ..................................................... 162

Figure 66. Obese BMI, Grades 7-12 .............................................................. 163

Figure 67. PRC – Child Was Ever Fed Breast Milk ........................................ 164

Figure 68. PRC – Child Exclusively Breastfed for at Least Six Months .......... 165

Figure 69. Adults Who Had Pneumonia Vaccine, Age 65 and Older ............ 172

Figure 70. Influenza and Pneumonia Mortality ............................................ 173

Figure 71. Lyme Disease Incidence Rates ..................................................... 174

Figure 72. Ever Tested for HIV, Adults 18-64 ................................................ 175

Figure 73. Chlamydia Rate ............................................................................ 176

Figure 74. Chlamydia Rates, Female ............................................................. 177

Figure 75. Chlamydia Rates, Male ................................................................ 178

Figure 76. Gonorrhea Rates .......................................................................... 179

Figure 77. Gonorrhea Rates, Female ............................................................ 180

Figure 78. Gonorrhea Rates, Male ................................................................ 181

Figure 79. Mental and Behavioral Disorders Mortality Rate ........................ 186

Figure 80. Adults Who Reported Binge Drinking (Men=5 Drinks, Women=4 Drinks) ........................................................................................................... 187

Figure 81. Adults at Risk for Heavy Drinking (2 Drinks for Men/1 Drink for Women) ........................................................................................................ 188

Figure 82. Drug-Induced Mortality Rate ....................................................... 189

Figure 83. PAYS – Allegheny County Substance Use .................................... 190

Figure 84. PAYS – Allegheny County Pain Reliever Use ................................ 191

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Figure 85. PAYS – Allegheny County Risky Behaviors ................................... 192

Figure 86. 2015 Focus Groups – Mental Health and Substance Abuse Problems ....................................................................................................... 193

Figure 87. PRC – Number of Days in the Past Week on Which Children Were Physically Active for an Hour or Longer (US Children Age 2-17, 2014) ........ 198

Figure 88. Percentage of Children Physically Active for an Hour or Longer Every Day in Past Week (US Children Age 2-17) ........................................... 199

Figure 89. PRC – Hours of Children’s Screen Time (US Children Age 5-17, 2014) ............................................................................................................. 200

Figure 90. PRC – Children with Three or More Hours per School Day of Screen Time (TV, Computer, Video Games, Phone, Device, etc.) (US Children Age 5-17) ................................................................................................................. 201

Figure 91. PRC – Percentage of Children Having Five or More Servings of Fruits/Vegetables per Day ............................................................................ 202

Figure 92. PRC – Number of Fast Food Meals Children Consume (US Children Age 2-17, 2014) ............................................................................................. 203

Figure 93. 2015 Focus Groups - Physical Activity and Nutrition Problems .. 204

Figure 94. Male Adults Who Reported Being a Former Smoker .................. 210

Figure 95. Adults Who Reported Being a Current Smoker ........................... 211

Figure 96. Adults Who Quit Smoking at Least One Day in the Past Year ..... 212

Figure 97. Adults Reported Being an Everyday Smoker ............................... 213

Figure 98. 2015 Focus Groups – Tobacco Use Problems .............................. 214

Figure 99. Mortality Rate for Auto Accidents ............................................... 220

Figure 100. Suicide Mortality Rates ............................................................. 221

Figure 101. PRC – Children Injured Seriously Enough to Need Medical Treatment, Past Year .................................................................................... 222

Figure 102. Fall Mortality Rates ................................................................... 223

Figure 103. Firearm Mortality Rates ............................................................ 224

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EXECUTIVE SUMMARY

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Ohio Valley Hospital (OVH) is proud to present its 2016 Community Health Needs Assessment (CHNA) Report. This report summarizes a comprehensive review and analysis of health status indicators, public health, socioeconomic, demographic and other qualitative and quantitative data from the primary service area of OVH. This report also includes secondary and disease incidence and prevalence data from Allegheny County, as the OVH service area includes certain zip codes within this county (see Table 1 and Figure 1, page 8 for a listing of zip codes and the service area map). The data was reviewed and analyzed to determine the priority needs and issues facing the region. The primary purpose of this assessment was to identify the health needs and issues of the community defined as the primary service area of OVH. In addition, the CHNA provides useful information for public health and health care providers, policy makers, social service agencies, community groups and organizations, religious institutions, businesses, and consumers who are interested in improving the health status of the community and region. The results enable the hospital, as well as other community providers, to more strategically identify community health priorities, develop interventions and commit resources to improve the health status of the region. The full report is also offered as a resource to individuals and groups interested in using the information to inform better health care and community agency decision making.

MESSAGE TO THE COMMUNITY

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

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The 2016 Ohio Valley Hospital (OVH) Community Health Needs Assessment (CHNA) was conducted to identify significant health issues and needs, as well as to provide critical information to OVH and others in a position to make a positive impact on the health of the region’s residents. The results enable the hospital and other community partners to more strategically establish priorities, develop interventions and direct resources to improve the health of people living in the OVH service area. To assist with the CHNA process, OVH retained Strategy Solutions, Inc. (SSI), Erie, PA, a planning and research firm whose mission is to create healthy communities to conduct the collaborative study. The assessment followed best practices as outlined by the Association of Community Health Improvement. The assessment was also designed to ensure compliance with current Internal Revenue Service (IRS) guidelines for charitable 501(c)(3) tax-exempt hospitals that was published in December 2014. This CHNA and its supplemental resource data located in the appendices document include a detailed examination of the following areas:

Evaluation of the 2013 OVH CHNA

Demographics & Socio-Economic Indicators

Access to Quality Health Care

Chronic Disease

Healthy Environment

Healthy Mothers, Babies and Children

Infectious Disease

Mental Health and Substance Abuse

Physical Activity and Nutrition

Tobacco Use

Injury Secondary public health data on disease incidence and mortality, as well as behavioral risk factors, were gathered from numerous sources including the

EXECUTIVE SUMMARY

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Pennsylvania Department of Health, Healthy Communities Institute, the Centers for Disease Control, Healthy People 2020, and County Health Rankings, as well as a number of other reports and publications. Data were collected for OVH, although some selected national data is included where local/regional data was not available. Demographic data were collected from the Nielsen/Claritas demographic database. Primary qualitative data collected specifically for this assessment included a total of ten in-depth interviews with individuals from different consistencies and interest groups representing the needs of the OVH service area, along with seven focus groups reaching a total of 80 participants. In addition to gathering input from stakeholder interviews, input and guidance also came from OVH and community representatives who served on the OVH Steering Committee. After all primary (stakeholder interviews and focus groups) and secondary data were reviewed and analyzed by the Steering Committee during a meeting on March 9, 2016, the data suggested a total of 46 distinct issues, needs and possible priority areas for potential intervention by OVH. Members of the OVH Steering Committee met on April 11, 2016 to review the final priorities (see Table 24 on page 63). Using the methodology of looking at the four prioritization criteria of (i) accountable role of the hospital, (ii) magnitude of the problem, (iii) impact on other health outcomes and (iv) capacity (systems and resources) to implement evidence-based solutions, along with the rank order of the final priorities selected by the OVH Steering Committee, the following nine priorities are considered the most significant. Refer to Table 23 on page 62 for a more in-depth description of the four prioritization criteria.

1. Chronic Disease: Diabetes 2. Chronic Disease: Cardiovascular Disease (Heart Disease, Cholesterol,

etc.) 3. Chronic Disease: Overweight/Obesity 4. Access to Quality Health Services: Knowledge of all Services in the

Area 5. Access to Quality Health Services: Primary Care Services 6. Access to Quality Health Services: Transportation for Self/

Healthcare Workers 7. Mental Health/Substance Abuse: Mental Health 8. Physical Activity/Nutrition: Eating Habits/Access to Healthy Foods 9. Tobacco Use: Smoking

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Methodology To guide this assessment, the hospital’s leadership team formed a Steering Committee that consisted of hospital and community agencies who represented the broad interests of the local region. These included representatives who understood the needs and issues related to various underrepresented groups including medically underserved populations, low-income persons, minority groups, and those with chronic disease and mental health needs, individuals with expertise in public health, and internal program managers. The OVH Steering Committee met three times between November 2015 and April 2016 to provide guidance on the various components of the CHNA. Service Area Definition Consistent with IRS guidelines at the time of publication, OVH defined their community by geographic location. More specifically, the geographic location of the primary service area encompasses portions of Allegheny County and includes Oakdale, Carnegie, Coraopolis, Imperial, McKees Rocks, Corliss, Crafton, and Neville Island. This assessment collected disease incidence and prevalence data and included primary data collection efforts in the form of stakeholder interviews and focus groups. Demographics For purposes of this assessment, the community is defined as OVH’s primary service area including Allegheny County in Pennsylvania. The total population in the OVH service area as of the 2010 Census is approximately 128,000 people. Overall, the service region’s population is expected to increase slightly over the next several years. The service area has slightly more females than males, and a sizable portion of the service area (almost half) is between the ages of 25 and 54. The service area is primarily low to middle income; about one-third of the population has incomes less than $35,000. While the majority of the service area population is white, non-Hispanic (84.9%), the area is more ethnically diverse than many parts of Allegheny County. About 7.0% of the regional population has not completed high school, while about a third (33.4%) has a high school diploma or GED, and another quarter (27.7%) has completed some college or obtained an associate degree.

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Asset Inventory Consistent with IRS requirements at the time of publication, OVH identified existing health care facilities and resources within the hospital and community available to respond to the health needs of the community. The information included in the asset inventory and map is a subset of the information maintained and utilized by internal staff when making referrals to community resources. Evaluation of 2013 OVH CHNA Implementation Strategies OVH conducted an evaluation of the implementation strategies undertaken since the completion of the 2013 CHNA. Although the status for most county level indicators did not move substantially, it is clear that OVH is working to improve the health of the community. Please refer to page XX of this report for a more in-depth evaluation of OVH’s 2013 CHNA implementation strategies. Qualitative and Quantitative Data Collection In an effort to examine the health related needs of the residents of the service area and to meet current IRS guidelines and requirements, the methodology employed both qualitative and quantitative data collection and analysis methods. The staff, Steering Committee members and consulting team made significant efforts to ensure that the entire primary service territory, all socio-demographic groups and all potential needs, issues and underrepresented populations were considered in the assessment to the extent possible given the resource constraints of the project. This was accomplished by identifying focus groups and key stakeholders that represented various subgroups in the community. In addition, the process included public health participation and input, through extensive use of the PA Health Department and Centers for Disease Control data and public health department participation on the Steering Committee. Needs/Issues Prioritization Process On November 9, 2015, the OVH Steering Committee met to review the secondary data collected through the needs assessment process. On March 9, 2016, the OVH Steering Committee met to discuss needs and issues present in their local service territory. The team from SSI, including Debra Thompson, President of Strategy Solutions, Inc., and Kathy Roach, Project

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Manager/Research Analyst, presented the data to the OVH Steering Committee and discussed the needs of the local area, what the hospital and other providers are currently offering the community, and discussed other potential needs that were not reflected in the data collected. A total of 46 possible needs and issues were identified, based on disparities in the data (differences in sub-populations, comparison to state, national or Healthy People 2020 goals, negative trends, or growing incidence). Four criteria, including accountable role, magnitude of the problem, impact on other health outcomes, and capacity (systems and resources to implement evidence based solutions), were identified that the group would use to evaluate identified needs and issues. Implementation Strategy Development Process Consistent with IRS requirements, OVH will be completing their implementation strategy process and obtaining Board of Directors approval by November 15, 2016. The implementation strategies selected by OVH and its community partners will address the most significant needs through a variety of implementation strategies which will be published in a separate document. Review and Approval The OVH CHNA report was approved by the OVH Board of Directors on May 31, 2016.

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GENERAL FINDINGS

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Evaluation of the 2013 OVH CHNA Implementation Strategies OVH conducted an evaluation of the implementation strategies undertaken since the completion of the 2013 CHNA. Although the status for most county level indicators did not move substantially, it is clear that OVH is working to improve the health of the community. In reviewing the status of the priority area, OVH reported the following: Priority Area: Chronic Disease, Senior Population Goal: Address diabetes, obesity and other chronic diseases prevalent in the community, by implementing prevention and diabetes management strategies within the senior population. In evaluating this priority area, OVH reported that the following objectives of this priority area had been met: Host Annual Diabetes Day: OVH hosted its annual Diabetes Day each March (2013, 2014 and 2015), with each year seeing an increase in the attendance for this event. In 2014, the hospital instituted an outreach program to target those participants who attended the event the previous year. OVH also started a survey in 2014 to track who attends the event on a yearly basis. The hospital continued to offer free health screenings during the event, including bone density scans, foot screenings, blood glucose, blood pressure, height, weight, BMI, body fat analysis, visual acuity, and Glaucoma screenings. OVH also offered A1C testing with the results of this test sent to either the person’s primary care physician (PCP) or, if no PCP, a recommendation on a PCP to see for their A1C results.

GENERAL FINDINGS

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OVH’s Seniority members were encouraged to attend Diabetes Day by making it their monthly meeting, especially since most of the vendors present for this event were geared to the senior population. Increase the awareness regarding the importance of Diabetes education and screening in the community: OVH marketed their Annual Diabetes Day through the hospital’s website, flyers posted around the OVH and handed out around the community, including at Focus on Renewal and local churches, and through the monthly Seniority newsletter. The hospital also marketed the event through social media, including Facebook and Diabetes Day blog. OVH also reached out to 500 people via email and mail informing them of Diabetes Day, Living Well with Diabetes classes and free support groups. OVH also has hospital employees and OVH nursing students attend community health fairs to administer flu shots, bone density testing and other screenings, as well as offering information regarding Diabetes. The hospital’s senior living center also hosts a series of lectures with OVH physicians in order to educate the community on a wide range of health issues. For the hospital’s annual 5K run, Diabetes and nutrition educational brochures where inserted into each runner’s packets. OVH partnered with the Western Area YMCA’s after school program/health initiative through the funding of their healthy snack, as well as offering discussion on healthy habits and healthy life choices. Facilitate Seniority meetings that include screenings, testing and education: Each month, OVH sponsors a lecture series for Seniority members on a variety of topics including, Diabetes, health and nutrition and chronic disease management. The hospital has also instituted healthy food demonstrations at these meetings to promote healthy snacking and eating. OVH’s Rehab Services Department also attended various monthly meetings to showcase exercises that can be done in a chair or very easily for seniors with limited mobility. At certain times of the during the Seniority monthly meetings, free glucose testing and body fat analysis was also provided to the members. Conduct Living Well with Diabetes classes: OVH has created a physician referral program called Living Well with Diabetes. This is a ten-hour program which consists of an individual, private consultation, followed by eight, one-hour group class time, designed to provide information and skills to assist

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with the management of their Diabetes. Topics discussed during this program include: nutrition, exercise, stress, medication, blood glucose monitoring, prevention/detection/and treatment of high and low blood sugar, and long-term complications of high/low blood sugar. The hospital has reported that there are 12-50 people who attend the Diabetes Support Group at any one time, with two people attending the monthly Diabetes classes. OVH is currently working with the YMCA to be the host site for a pre-Diabetes class that will be held in the fall of 2015 and continue as a pilot for one year. Free Diabetes Support Group meetings: As stated above, OVH offers a Diabetes Support Group that is attended by anywhere from 12 to 50 people at any one time, offering education, problem solving and full support on living with Diabetes.

Key Findings – BRFSS & Public Health Data This assessment reviewed a number of indicators at the county level from the statewide Behavioral Risk Factor Survey (BRFSS), as well as disease incidence and mortality indicators. For this analysis, the service area data was compared to state and national data where possible. As outlined in the following tables, when looking at the BRFSS questions related to OVH’s primary service area data, the regional rates that were worse than Pennsylvania include the percentage of people with no personal health care provider and adults who reported binge drinking (5 drinks for men; 4 for women). The Chronic Disease public health data within OVH’s primary service area that have regional rates worse than Pennsylvania include: breast cancer incidences, bronchus and lung cancer incidences, bronchus and lung cancer mortality, prostate cancer incidences, prostate cancer mortality, heart disease mortality, coronary heart disease mortality, cardiovascular mortality, and cerebrovascular (stroke) mortality. Mammogram screenings is lower than the state. Regarding Healthy Environment, OVH’s primary service area has increasing rates of students with asthma. For the Healthy Mothers, Babies and Children indicators, OVH’s primary service area has increasing rates of teen live birth outcomes and students in

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grades K-6 who are overweight. The service area also saw a decrease in rates for breastfeeding. For the selected indicators within Infectious Disease, and Mental Health and Substance Abuse, OVH’s primary service area has increasing rates of influenza and pneumonia mortality, chlamydia, females with chlamydia, males with chlamydia, gonorrhea, females with gonorrhea, males with gonorrhea, drug-induced mortality, mental and behavioral disorders mortality. The 2013 Pennsylvania Youth Survey for children in grades 8, 10 and 12 for the OVH primary service area shows that there are increasing rates in lifetime alcohol, marijuana and pain reliever use; and percent of students who drove after using marijuana in grades 10 and 12 is also increasing.

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Overall Key Findings Table 1 below highlights the key findings of the Behavioral Risk Factor Survey for OVH. Table 1. OVH Behavioral Risk Factor Comparative Table

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

ALLEGHENY ALLEGHENY ALLEGHENY Trend PA PA PA US US HP 2020 PA US HP 2020

Behavior Risk 2008-2010 2011-2013 2012-2014 +/- 2008-10 2011-13 2012-14 2010 2013 Goal Comp Comp Comp

ACCESS

Reported Health Poor or Fair 14.0% 15.0% 15.0% + 15.0% 17.0% 17.0% 14.7% 16.7% - -

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

Poor Physical or Mental Health Preventing Usual Activities in the Past Month 21.0% 23.0% 22.0% + 21.0% 22.0% 22.0% -/+

No Health Insurance 12.0% 12.0% 12.0% = 13.0% 16.0% 15.0% 17.8% 16.8% 0% - - +

No Personal Health Care Provider 13.0% 16.0% 17.0% + 11.0% 13.0% 14.0% 22.9% 16.1% -/+ - +/-

Routine Check-up Within the Past 2 Years 83.0% 84.0% 85.0% + 83.0% 83.0% 83.0% 81.3% +/= +

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

CHRONIC DISEASE

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

Ever Told They Had a Heart Attack- Age 35 and Older 6.0% 5.0% 6.0% -/= 6.0% 6.0% 7.0% 4.2% 4.3% - +

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

Ever Told They Had a MI, Heart Disease, or Stroke- Age GE 35 11.0% 12.0% 13.0% + 12.0% 12.0% 13.0% -/=

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

Overweight (BMI 25-30) 63.0% 62.0% 63.0% -/= 64.0% 65.0% 65.0% 68.8% 69.0% - -

Obese (30-99.99) 28.0% 26.0% 26.0% - 28.0% 29.0% 30.0% 27.5% 29.4% 30.5% - - -

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

HEALTHY ENVIRONMENT

Adults Who Have Ever Been Told They Have Asthma 15.0% 13.0% 13.0% - 14.0% 14.0% 14.0% 13.8% 14.1% +/- +/-

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

INFECTIOUS DISEASE

Adults Who Had a Pneumonia Vaccine, Age 65 and older 77.0% 79.0% 78.0% + 70.0% 71.0% 70.0% 68.8% 69.5% 90.0% + + -

Ever Tested for HIV, Ages 18-64 32.0% 37.0% 38.0% + 34.0% 38.0% 38.0% 35.2% 73.6% -/= +/- -

MENTAL HEALTH AND SUBSTANCE ABUSE

Mental Health Not Good 1+ Days 34.0% 36.0% 36.0% + 34.0% 36.0% 36.0% -/=

Adults Who Reported Binge Drinking (5 drinks for men, 4 for women) 19.0% 20.0% 20.0% + 17.0% 18.0% 17.0% 17.1% 16.8% 24.4% + + -

At Risk for Heavy Drinking (2 drinks for men, 1 for women daily) 6.0% 8.0% 7.0% + 5.0% 6.0% 6.0% 6.2% +/= +/-

Reported Chronic Drinking (2 or more drinks daily for the past 30 days) 6.0% 7.0% 6.0% +/= 6.0% 6.0% 6.0% 5.0% +/-

PHYSICAL ACTIVITY AND NUTRITION

No Leisure Time/Physical Activity in the Past Month 19.0% 21.0% 20.0% + 25.0% 21.0% 21.0% 23.9% 32.6% -/= -

No Leisure Time/Physical Activity in the Past Month: Education Level College 14.0% 14.0% 13.0% =/- 15.0% 14.0% 13.0% +/=

TOBACCO USE

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

Adults Who Reported Being a Former Smoker 28.0% 25.0% 26.0% - 26.0% 26.0% 25.0% 25.1% 25.3% +/= +/-

Adults Who Reported Being a Former Smoker (Female) 24.0% 23.0% 23.0% - 23.0% 22.0% 22.0% +

Adults Who Reported Being A Former Smoker (Male) 32.0% 28.0% 28.0% - 29.0% 29.0% 29.0% +/-

Currently using Chewing Tobacco, Snuff, or Snus, Somewhat or Everyday (Adults) ND 3.0% 3.0% = ND 4.0% 4.0% 4.2% - -

Adults Who Have Quit Smoking at Least 1 Day in the Past Year (daily) 48.0% 53.0% 56.0% + 50.0% 54.0% 54.0% 80.0% +/- -

Adults Who Reported Being a Current Smoker 18.0% 22.0% 21.0% + 20.0% 22.0% 21.0% 17.3% 18.8% 12.0% +/-/= +/- +

Adults Who Reported Being An Everyday Smoker 13.0% 17.0% 16.0% + 15.0% 16.0% 15.0% 12.4% 13.4% +/- +/-

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

P a g e | 18

Table 2 highlights various public health indicators included in the assessment for OVH. Table 2. OVH Public Health Indicators – Table 1 of 2


Trend PA (2008)

PA (the last

year) US (2010) US (2012) HP 2020 PA US

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

CHRONIC DISEASE

Breast Cancer Rate per 100,000 79.0 76.1 73.2 73.3 78.1 +/- 71.2 69.4 121.9 122.0 41.0 + -

Breast Cancer Mortality Rate per 100,000 14.4 16.1 12.0 13.8 12.2 +/- 13.9 12.5 22.2 21.5 20.7 - -

Bronchus and Lung Cancer Rate per 100,000 79.7 76.8 73.6 75.5 67.6 - 69.9 63.9 73.0 + +/-

Bronchus and Lung Cancer Mortality Rate per 100,000 54.5 53.4 52.2 52.4 52.3 - 51.6 46.5 57.9 45.5 + -

Colorectal Cancer Rate per 100,000 47.2 49.5 41.3 42.6 40.0 +/- 49.5 42.5 46.1 38.6 +/- +/-

Colorectal Cancer Mortality Rate per 100,000 19.1 17.0 15.9 15.8 14.9 - 18.1 15.8 16.9 18.1 14.5 +/- +/-

Ovarian Cancer Rate per 100,000 13.7 12.2 13.9 10.6 11.8 +/- 13.5 11.9 11.3 +/- +/-

Ovarian Cancer Mortality Rate per 100,000 8.5 8.3 9.2 7.7 8.9 +/- 8.7 7.9 7.5 +/- +/-

Prostate Cancer Rate per 100,000 145.0 134.7 124.9 119.9 112.1 - 148.7 101.7 128.3 + +/-

Prostate Cancer Mortality Rate per 100,000 22.2 20.3 19.9 18.6 22.1 - 24.2 19.1 20.8 21.8 +/- +/-

Heart Disease Mortality Rate per 100,000 210.7 191.5 185.4 193.5 180.1 - 207.3 175.2 176.8 + +

Heart Attack Mortality Rate per 100,000 18.3 17.3 16.5 17.7 17.7 - 20.4 17.9 89.2 +/- -

Coronary Heart Disease Mortality Rate per 100,000 156.4 140.4 135.4 139.2 129.3 - 138.5 115.3 108.91 103.4 + +

Cardiovascular Mortality Rate per 100,000 268.2 243.1 236.4 246.2 225.6 - 264.5 225.5 233.73 + +/-

Chronic Lower Respiratory Disease (COPD) Rate per 100,000 43.1 39.2 37.0 41.5 36.2 - 42.8 38.4 40.8 102.6 +/-

Cerebrovascular Mortality Rate per 100,000 43.4 38.6 39.2 38.2 34.3 - 41.8 36.8 39.1 39.9 34.8 +/- +/-

Diabetes Mortality Rate per 100,000 19.9 16.2 17.4 16.8 20.6 +/- 21.3 22.0 20.8 73.28 66.6 +/- -

Type I Diabetes, Students 0.32% 0.32% 0.34% 0.36% +/= 19.6 0.32% +/=

Type II Diabetes, Students 0.08% 0.08% 0.08% 0.07% -/= 0.30% 0.06% +

Alzheimer Mortality Rate per 100,000 20.7 17.9 18.3 20.0 18.5 - 22.8 18.7 26.8 +/- -

HEALTHY ENVIRONMENT

Student Health Asthma 4.3% 11.4% 11.8% 12.4% + 6.8% 12.05% +/-

HEALTHY MOTHERS, BABIES AND CHILDREN

Prenatal Care First Trimester 85.6% 87.1% 88.8% 89.2% 89.1% + 70.5% 72.4% 70.8% 77.9% + +

Non-Smoking Mother During Pregnancy 83.0% 83.8% 84.8% 85.1% 86.8% + 84.1% 85.2% 89.3% 98.6% +/- -

Non-Smoking Mother 3 Months Prior to Pregnancy 80.1% 80.9% 81.9% 82.5% 84.5% + 77.6% 80.1% 76.8% +/= +

Low Birth-Weight Babies Born 8.9% 8.1% 8.0% 7.7% 7.6% - 8.3% 8.1% 8.0% 7.8% +/- +/-

Mothers Reporting WIC Assistance 31.3% 32.1% 31.5% 30.8% 28.4% +/- 39.0% 39.3% -

Mothers Reporting Medicaid Assistance 33.6% 32.0% 22.9% 25.8% 30.0% - 31.2% 33.6% +/=

Breastfeeding 64.0% 68.5% 68.4% 70.1% 72.0% + 66.5% 73.1% 77.0% 81.9% - -

Teen Pregnancy Rate per 100,000, Ages 15-19 41.7 38.0 38.2 33.4 30.6 - 44.3 33.7 34.2 30.0 36.2 +/- +

Teen Live Birth Outcomes, Ages 15-19 57.1% 59.1% 58.1% 57.8% 59.7% + 67.6% 69.5% 73.4% - -

Infant Mortality 8.3% 7.4% 7.6% 6.1% 5.9% - 7.3% 7.0% 6.2% 6.1% 6.0% +/- +/-

Overweight BMI, Grades K-6 15.6% 17.4% 17.3% + 15.9% +/-

Obese BMI, Grades K-6 15.2% 15.9% 15.3% + 16.7% 15.7% -

Overweight BMI, Grades 7-12 17.1% 17.5% 17.1% +/= 16.4% 30.3% + -

Obese BMI, Grades 7-12 15.3% 15.0% 15.9% +/- 17.7% 13.7% 16.1% - +

ALLEGHENY COUNTY


http://www.healthypeople.gov/

P a g e | 19

Table 3 highlights various public health indicators included in the assessment for OVH. Table 3. OVH Public Health Indicators – Table 2 of 2


Trend PA (2008)

PA (the last

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

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

INFECTIOUS DISEASE

Lyme Disease Rate per 100,000 1.3 2.4 1.5 0.8 +/- 32.1 39.4 8.6 - -

Influenza and Pneumonia Mortality Rate per 100,000 17.8 16.9 17.3 19.6 15.1 +/- 16.7 13.3 16.2 15.1 + +/=

Chlamydia Rate per 100,000 428.2 403.4 412.1 489.0 524.2 +/- 339.3 430.9 +

Chlamydia Rate per 100,000 (Female) 593.7 557.9 556.4 647.8 693.9 +/- 476.9 575.0 +/-

Chlamydia Rate per 100,000 (Male) 246.0 232.1 254.6 316.4 340.6 +/- 193.7 279.1 +/-

Gonorrhea Rate per 100,000 177.6 126.0 134.7 157.4 194.6 +/- 88.9 120.6 106.7 + +

Gonorrhea Rate per 100,000 (Female) 199.3 149.4 154.9 179.0 219.5 +/- 97.1 128.0 +

Gonorrhea Rate per 100,000 (Male) 153.7 99.9 112.7 133.7 167.7 +/- 80.3 112.8 +/-


Drug-Induced Mortality Rate per 100,000 18.6 17.8 18.6 20.5 22.7 +/- 15.3 19.2 10.2 11.3 +/- + +

Mental & Behavioral Disorders Mortality Rate per 100,000 36.3 35.4 41.5 42.0 46.5 +/- 34.0 43.0 63.3 +/- -

INJURY

Auto Accident Mortality Rate per 100,000 6.5 6.2 6.7 5.5 5.7 +/- 11.9 10.0 11.9 10.7 12.4 - - -

Suicide Mortality per 100,000 10.1 10.6 9.8 10.8 11.7 +/- 11.9 12.1 12.1 4.5 10.2 - + +/-

Fall Mortality Rate per 100,000 10.0 8.5 12.2 11.8 11.5 +/- 8.0 8.4 8.1 9.6 7.2 + +/- +

Firearm Mortality Rate (Accidental, Suicide, Homicide) 13.1 12.2 11.2 11.7 12.6 - 10.6 11.0 10.1 10.1 9.3 + + +

ALLEGHENY COUNTY


P a g e | 20

Table 4 highlights various county health indicators included in the assessment for OVH. Table 4. OVH County Health Rankings

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

Trend PA - 2013

PA (the

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

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

ACCESS

Mammogram Screenings 58.0% 49.4% 50.9% - 66.8% 63.4% 67.1% 81.1% - - -

HEALTHY ENVIRONMENT

Unemployment Rates 7.0% 6.9% 6.5% - 7.9% 7.4% 8.9% - -

High School Graduation Rates 86.0% 86.0% 89.0% + 83.0% 85.0% 82.4% + +

Children Living in Poverty 19.0% 19.0% 19.0% = 19.0% 19.0% =

Children Living in Single Parent Homes 34.0% 33.0% 33.0% - 32.0% 33.0% +/=


Limited Access to Healthy Foods 6.0% 6.0% 6.0% = 4.0% 4.0% +

Food Insecurity 14.0% 14.0% = 14.0% =

Children Eligible for Free Lunch 32.0% 32.0% 33.0% + 33.0% 34.0% -

TOBACCO USE

Adults who Smoke 19.0% 19.0% = 21.0% 20.0% 20.0% 12.0% - - +

ALLEGHENY COUNTY


P a g e | 21

Table 5 highlights various youth survey indicators included in the assessment for OVH. Table 5. OVH 2013 Pennsylvania Youth Survey

Source: 2013 Pennsylvania Youth Survey, National Survey Results on Drug Abuse – 1975-2013

MENTAL HEALTH AND SUBSTANCE ABUSE Trend PA US PA US

2009 2011 2013 +/- Rate Rate Comp Comp

Alcohol Child/Adolescent Lifetime Use 2013 2013

Grade 6 17.2% 14.1% - 13.3% +/-

Grade 8 33.1% 35.8% + 35.1% 27.8% +/- +

Grade 10 48.3% 65.3% + 61.5% 52.1% +/- +/-

Grade 12 58.0% 79.3% + 74.2% 68.2% +/- +/-

Overall 36.8% 48.2% + 56.9% -

Marijuana Child/Adolescent Lifetime Use

Grade 6 1.1% 1.9% + 0.8% +

Grade 8 8.0% 10.5% + 6.4% 16.5% + -

Grade 10 13.4% 31.7% + 25.8% 35.8% +\- -

Grade 12 33.3% 50.3% + 40.3% 45.5% +/- +/-

Overall 11.4% 22.8% + 18.9% +/-

% of Children/Adolescents Who Drove After Drinking

Grade 6 0.4% 0.5% + 0.2% +

Grade 8 0.4% 1.1% + 0.4% +/=

Grade 10 0.8% 2.0% + 1.8% +/-

Grade 12 9.7% 10.7% + 8.7% +

Overall 1.9% 3.3% + 2.9% +/-

% of Children/Adolescents Who Drove After Using Marijuana

Grade 6 0.4% 0.2% - 0.1% +

Grade 8 0.6% 0.8% + 0.4% +

Grade 10 1.2% 3.1% + 2.4% +/-

Grade 12 9.8% 13.5% + 12.4% +/-

Overall 2.1% 4.1% + 4.1% -/=

% Pain Reliever Child/Adolescent Lifetime Use

Grade 6 1.9% 2.6% + 2.1% +/-

Grade 8 2.5% 4.6% + 4.1% +/-

Grade 10 4.7% 10.4% + 8.3% +/-

Grade 12 8.0% 16.5% + 12.1% +/-

Overall 3.6% 8.3% + 6.8% +/-

ALLEGHENY COUNTY


Page | 22

Other Secondary Data: Hospital Utilization Rates As seen in Table 6, from 2013 through 2015, hospital inpatient discharges for ambulatory care sensitive conditions for Ohio Valley Hospital (OVH) increased for: bacterial pneumonia, severe ENT infections, angina, and COPD. For the same time period, hospital ER and inpatient discharges for mental health for OVH, as seen in Table 7, increased for: Dementia, alcohol-related incidences, drug-related incidences, other chronic organic psychotic, Schizophrenia, manic disorder, depression, bi-polar, paranoia psychosis, anxiety, and conduct/social disturbances. Table 8 shows that from 2013 to 2015, hospital DRG conditions for OVH increased for: hypertension, breast cancer, cancer, alcohol/drug abuse and COPD. In reviewing the data for OVH regarding the hospital’s service lines by DRG conditions, Table 9 shows increases in Cardiology, General/Colon/Rectal Surgery, Endocrinology, GI, General Medicine, Hematology/Oncology, Nephrology, Neurology, Oral Surgery, Orthopedic Surgery, Otolaryngology, Psychiatry, Pulmonary, and Spine Surgery for the period 2013 to 2015. Table 6. Ambulatory Care Sensitive Conditions-ER Only Ambulatory Care Sensitive Conditions - ER Only

Preventable Conditions 2013 2014 2015

Congenital Syphilis 0 0 0

Failure to Thrive 0 0 0

Dental Conditions 0 0 0

Vaccine Preventable Cond 11 11 3

Hemophilus Meningitis ages 1-5 0 0 1

Iron Deficinecy Anemias 0 0 0

Nutritional Deficiencies 0 0 0

Acute Conditions

Bacterial Pneumonia 105 80 106

Cervical Cancer 0 0 0

Cellulitis 0 0 0

Convulsions 0 0 0

Dehydration 1 0 0

Gastroenteritis 240 224 186

Hypoglycemia 4 1 4

Page | 23

Ambulatory Care Sensitive Conditions - ER Only

Kidney/Urinary Infection 274 303 264

Pelvic Inflammatory Dis 0 0 0

Severe ENT Infections 207 237 247

Skin Grafts with Cellulitis 0 0 0

Chronic Conditions

Angina 2 11 5

Asthma 0 0 0

COPD 426 333 429

CHF 0 1 0

Diabetes with ketoacidosis 0 0 0

Diabetes with other conditions 0 0 0

Diabetes without other conditions 0 0 0

Chronic Conditions

Grand Mal and other Epileptic 0 0 0

Hypertension 104 88 75

Tuberculosis- Non Pulmonary 0 0 0

Pulmonary Tuberculosis 0 0 0

Table 7. Hospital ER and Outpatient Discharges for Mental Health

Mental Health ICD-9 File

Code 2013 ER

2013 OUT-OPT

2014 ER

2014 OUT-OPT

2015 ER

2015 OUT-OPT

Drug Related 83 62 91 113 130 75

Anxiety 96 88 95 94 109 58

Alcohol Related 51 4 63 8 58 7

Depressions 20 67 13 50 29 42

Other Chronic Organic Psychotic 11 19 13 29 12 19

Manic Disorder 6 57 5 60 11 57

Bi Polar 7 68 5 69 11 70

Paranoia Psychosis 4 15 7 19 11 15

Schizophrenia 2 19 2 19 7 71

Conduct/Social Disturbances 0 0 2 1 3 4

Transient Organic Psychotic 3 3 3 0 2 3

Dementia 0 4 0 6 1 5

Psychogenic Disorders 1 1 1 0 1 1

Stress Related 4 11 10 3 1 6

Adjustment Related 1 2 3 0 1 2

Page | 24

Mental Health ICD-9 File

Code 2013 ER

2013 OUT-OPT

2014 ER

2014 OUT-OPT

2015 ER

2015 OUT-OPT

Phobias 0 0 0 0 0 0

Personality Disorders 0 1 0 0 0 0

Sexual Deviations 0 3 0 2 0 3

Sleep Disorders 0 4 0 10 0 6

Eating Disorders 0 0 0 0 0 0

Emotional- Youth 0 2 0 0 0 0

Mental Retardation 0 4 0 8 0 2

Table 8. Hospital DRG Conditions

DRG File

DRG File 2013 2014 2015

Hypertension 3 15 12

CHF 112 130 93

Breast Cancer 1 1 2

Cancer 3 3 7

Pneumonia 149 134 145

Complications Baby 0 0 0

Bronchitis/Asthma 27 29 26

Alcohol/Drug Abuse 13 19 22

COPD 127 136 139

Fracture 15 18 5

Table 9. Service Line by DRG Service Line by DRG

2013 2014 2015

Cardio-Thoracic Surgery 34 20 25

Cardiology 422 530 533

General/Colon/Rectal Surgery 261 215 274

Dermatology 126 95 117

Endocrinology 107 100 118

GI 332 372 344

General Medicine 45 59 85

Hematology/Oncology 114 116 118

Infectious disease 49 28 36

Normal Newborn and Neonates 0 0 0

Nephrology 114 124 122

Page | 25

Service Line by DRG

2013 2014 2015

Neurology 98 120 132

Neurosurgery 33 19 30

OB/GYN 25 20 9

Ophthalmology 6 10 3

Oral Surgery 1 2 2

Orthopedic Surgery 276 301 321

Otolaryngology 25 34 33

Plastic Surgery 27 29 15

Psychiatry 241 287 356

Pulmonary 495 489 497

Musculoskeletal 22 19 20

Spine Surgery 8 7 10

Urology 69 69 60

Vascular Surgery 135 120 115

The following tables (Tables 10-17) depict conditions by zip code for the years 2012-2015 based on ICD-9 outpatient hospital utilization data. The top three conditions that residents from the service area zip codes were seen include:

• Diabetes • Heart Related Condition(s) • Bronchitis

Overall, the number of residents being seen in the hospital for each condition appears to be declining, although some zip codes have seen fluctuation in these numbers over the years. When looking at Oakdale, zip code 15071, the following observations can be made:

• The number of residents seen in the hospital due to diabetes has fluctuated over the four years, but when comparing 2012 to 2015, the number has decreased in half.

• Heart related conditions increased in 2013, but have been decreasing ever since.

• Residents being seen for bronchitis had been steadily increasing since 2012, but in the most recent year reduced my more than half.

Page | 26

• The mental health related numbers have fluctuated over the years but decreased in the recent year as well as when compared to 2012.

• Drug related visits had been increasing, although in the most recent year no visits were reported.

• Hypertension numbers have remained fairly consistent. Table 10. DRG Breakdown by Oakdale Zip Code 15071

Oakdale Zip Code: 15071

Year

2012 2013 2014 2015 Total

Diabetes 191 100 130 86 277

Heart Related 28 37 29 14 108

Bronchitis 11 12 20 8 51

Pneumonia 12 10 12 9 43

Mental Health Related 7 5 7 2 21

Drug Related 1 3 4 0 8

Hypertension 1 1 1 0 3

Total 251 168 203 119 511

When looking at Carnegie, zip code 15106, the following observations can be made:

• The number of residents seen for diabetes has fluctuated over the past few years, but has been increasing since 2014 and when compared to 2012 has almost doubled.

• Heart related conditions have been steadily decreasing over the past four years and have reduced by half when comparing 2012 to 2015.

• Residents being seen for bronchitis decreased between 2012 and 2013, but has been increasing ever since; although is still lower when compared to 2015.

• The mental health related numbers have been increasing since 2012; although has been steady over the past two years.

• Drug related visits have remained fairly consistent over the last four years.

• Hypertension numbers have remained fairly consistent over the last four years.

Page | 27

Table 11. DRG Breakdown by Carnegie Zip Code 15106

Carnegie Zip Code: 15106

Year

2012 2013 2014 2015 Total

Diabetes 94 201 98 163 229



Pneumonia 15 7 9 3 34




Total 173 253 146 203 448

When looking at Coraopolis, zip code 15108, the following observations can be made:

• The number of residents seen for diabetes has fluctuated over the past few years, but has been increasing since 2014.

• Heart related conditions have fluctuated over the past four years, but decreased between 2014 and 2015 and is lower when comparing 2012 to 2015.

• Residents being seen for bronchitis decreased between 2012 and 2013, but has been increasing ever since.

• The number of visits for pneumonia has been decreasing over the past four years.

• The mental health related numbers increased between 2012 and 2013, but then decreased and has remained consistent.

• Alcohol related visits drastically increased between 2012 and 2013, and have been decreasing ever since.

• Drug related visits have fluctuated over the past four years, but has been increasing the past two years.

• Hypertension numbers have been decreasing over the past several years and has been steady the last two.

Page | 28

Table 12. DRG Breakdown by Coraopolis Zip Code 15108

Coraopolis Zip Code: 15108

Year

2012 2013 2014 2015 Total

Diabetes 753 519 497 556 1197

Heart Related 118 106 115 79 418

Bronchitis 32 44 38 33 147

Pneumonia 46 35 34 25 140


Alcohol Related 2 15 2 1 20



Total 985 756 712 721 2046

When looking at Imperial, zip code 15126, the following observations can be made:

• The number of residents seen for diabetes has fluctuated over the past few years.

• Heart related conditions have also fluctuated over the past four years, but have decreased in the most recent year.

• Residents being seen for bronchitis has been steadily decreasing over the past four years.

• The number of pneumonia related visits has fluctuated over the four years, but has deceased in the most recent year and when compared to 2012.

• The mental health related numbers increased between 2012 and 2013, but then decreased and has remained consistent.

• Drug related visits have fluctuated over the past four years, but has decreased in the most recent year.

Page | 29

Table 13. DRG Breakdown by Imperial Zip Code 15126

Imperial Zip Code: 15126

Year

2012 2013 2014 2015 Total

Diabetes 142 119 135 104 249



Pneumonia 8 3 5 2 18



Total 187 160 176 133 405

When looking at McKees Rocks, zip code 15136, the following observations can be made:

• The number of residents seen for diabetes had been decreasing over the initial three years, but increased in the most recent year.

• Heart related conditions have steadily been decreasing over the last four years.

• Residents being seen for bronchitis increased between 2012 and 2013, but has been decreasing ever since.

• The number of visits for pneumonia has fluctuated over the last four years, with a decrease in the most recent year.

• The mental health related numbers increased between 2012 and 2013, where they remained steady before decreasing in the most recent year.

• Alcohol related visits decreased between 2012 and 2013 and then have been increasing ever since.

• Drug related visits decreased between 2012 and 2013 and then have been increasing ever since.

• Hypertension numbers decreased between the first two years but have been increasing since.

• Visits related to dental conditions have been consistent.

Page | 30

Table 14. DRG Breakdown by McKees Rocks Zip Code 15136

McKees Rocks Zip Code: 15136

Year

2012 2013 2014 2015 Total

Diabetes 1212 1091 1024 1058 3000

Heart Related 311 301 259 167 1038

Bronchitis 186 198 172 140 696

Pneumonia 78 66 77 71 292





Dental 0 0 0 1 1

Total 1904 1756 1665 1549 5489

When looking at Corliss, zip code 15024, the following observations can be made:

• The number of residents seen for diabetes decreased between the first two years and then has been increasing.

• Residents being seen for bronchitis has fluctuated over the last four years but has decreased in the most recent year.

• Heart related conditions have also fluctuated over the last few years, with an increase in the most recent.

• The number of visits for pneumonia has fluctuated over the last four years, with a alight decease in the most recent year.

• The mental health related numbers increased between 2012 and 2013, but have been decreasing the last two.

• Drug related visits have fluctuated over the last few years, with a decrease in the most recent.

• Alcohol related visits decreased between the first two years and have remained consistent.

• Hypertension related visits decreased between the first two years and have remained consistent.

Page | 31

Table 15. DRG Breakdown by Corliss Zip Code 15204

Corliss Zip Code: 15204

Year

2012 2013 2014 2015 Total

Diabetes 254 219 228 237 688

Bronchitis 50 40 48 43 181


Pneumonia 26 13 17 16 72





Total 378 333 336 341 1138

When looking at Crafton, zip code 15205, the following observations can be made:

• The number of residents seen for diabetes has fluctuated over the last four years with an increase in the most recent year.

• Heart related conditions have fluctuated over the last four years with a decrease in the most recent year.

• Residents being seen for bronchitis has steadily been decreasing. • The number of visits for pneumonia has fluctuated over the last four

years, with an increase in the most recent year. • The mental health related numbers increased between 2012 and

2013 but have been decreasing since. • Drug related visits decreased between 2012 and 2013 and then have

been increasing ever since. • Alcohol related visits decreased between 2012 and 2013 and then

increased to remain consistent the last two years. • Hypertension numbers have been fairly steady.

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Table 16. DRG Breakdown by Crafton Zip Code 15205

Crafton Zip Code: 15205

Year

2012 2013 2014 2015 Total

Diabetes 346 356 337 352 959


Bronchitis 69 49 42 32 192

Pneumonia 38 34 23 31 126





Total 559 525 522 500 1674

When looking at Neville Island, zip code 15225, the following observations can be made:

• The number of residents seen for diabetes has fluctuated over the last four years with a decrease in the most recent year.

• Heart related conditions have fluctuated over the last four years with a decrease in the most recent year.

• Residents being seen for bronchitis has steadily been decreasing. • Drug related visits have fluctuated with a slight increase in the recent

year. • The mental health related numbers have fluctuated; although there

was an increase in the most recent year. • The number of visits for pneumonia increased in 2013 to decrease the

following year.

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Table 17. DRG Breakdown by Neville Island Zip Code 15225

Neville Island Zip Code: 15225

Year

2012 2013 2014 2015 Total

Diabetes 16 25 21 17 52





Pneumonia 0 3 0 0 3

Total 28 33 29 27 90

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

Overall Community Health Status As seen in Figure 1, just under a quarter (23.3%) of the participants rated the health of the community as “Fair” or “Poor”, while over half (57.5%) rated the health of the community as “Good.”

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Figure 1. Focus Groups – Community Health Status

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

Suggestions to improve community health by stakeholders interviewed included:

• More activities geared to younger people and families • Programs for younger people on healthy living • Need to bring local and county governments together to address

these needs • Have a community pool that is accessible, but there is no longer a

lifeguard (Boys Club needs resource to staff the position) • Better infrastructure to connect kids to health professionals (costly

for parents to get them there) • More activities geared to younger people and families • Programs for younger people on healthy living • Need to bring local and county governments together to address

these needs • Have a community pool that is accessible, but there is no longer a

lifeguard (Boys Club needs resource to staff the position) • Better infrastructure to connect kids to health professionals (costly

for parents to get them there) • More activities geared to younger people and families • Programs for younger people on healthy living

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• Need to bring local and county governments together to address these needs

• Have a community pool that is accessible, but there is no longer a lifeguard (Boys Club needs resource to staff the position)

• Better infrastructure to connect kids to health professionals (costly for parents to get them there)

Initiatives Currently Underway

• UPMC sponsors races • Highmark sponsors things in the community • Family Practice has dieticians available • Educational program for seniors (over age 55) • Health Fairs • Diabetes Programs • Live Well Allegheny • Yoga classes in the park (will be offered next year) • Focus on economic empowerment and bringing in companies that

provide career sustaining employment • Working with Penn State Extension to offer cooking classes in the

community (this fall) • Working with Focus on Renewal to develop commercial kitchen • Pastor Hogan is in the community speaking with people and has been

successful in getting some heroin users off the street and connected to church

• Focus on Renewal does intake and makes referrals for substance abuse

• There are a few halfway houses in the community • Working with County and Friends of River – to connect trail to

Allegheny Passage • Health Center is partnering with four mental health providers to

address mental health problem • OVH should join the neighborhood partnership • Schools have Healthy Family Night where they talk about nutrition

and food choices (and are fed healthy food) • Sto Rox Health Center offers a clinic (primary care, women’s health,

podiatrist, OB/GYN, optometrist) with connections to OVH • Community Development Corporation is working on community

development improvements • CSX is renovating train area to make it intermodal transition between

trucks and trains

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• Focus on Renewal has food bank, computer classes, etc… • OVH added transportation services • Community Development Corporation has fresh foods on Friday

afternoon • Focus on Renewal is trying to put together programs for wellness for

girls and healthy eating • Focus on Renewal offers positive parenting program which is now at

the Art Center so children can play and do activities • OVH Gero-Psych program • OVH publishes health information, conducts initiatives in the area –

very visible in the community • YMCA offers after school program, health and wellness programs • OVH has a top notch nursing program (which offers scholarships to

those that qualify) • OVH does screening seminars and healthy information • OVH has Seniority group with lectures • OVH offers bio screenings for $30 • Mobile health to provide screenings • Hospital writes off a lot of those that are uninsured • Sto Rox clinic does a great job and offers a lot of services

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Conclusions Access to Quality Health Care Access to comprehensive, quality health care is important for the achievement of health equity and for increasing the quality of life for everyone in the community. Cost of medication and health insurance, increasing costs of health care, lack of primary care due to physician shortage all impact an individual’s ability to access health care and were concerns addressed by the stakeholders interviewed. Focus group participants noted transportation, dental care, lack of services for seniors, need for a podiatrist, and cost of health insurance and health care as access needs. There are a number of observations and conclusions that can be derived from the data related to Access to Quality Health Care. They include:

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

• The percentage of adults with no personal health care provider is significantly higher (17.0%) than the PA rate (14.0%).

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

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

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

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

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

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

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

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

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

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

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

Chronic Disease Conditions that are long-lasting, relapse, remission and continued persistence are categorized as Chronic Disease. The issues of diabetes, obesity, heart disease, hypertension, aging population, cancer and emphysema were noted by stakeholders as health problems in the community. Focus Group participants identified arthritis as a top community need. They also noted that joint issues, diabetes, heart problems, obesity, and breast cancer were also needs of the community. There are a number of observations and conclusions that can be derived from the data related to Chronic Disease. They include:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• Diabetes mortality rates for the years 2009-2011 were significantly lower than the PA rates. For 2012, the rate is lower (20.6) than the PA rate (22.0), the US rate (73.28) and the HP goal (66.6).

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

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

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

• 2016 Focus Group participants report the following to be serious problems (where 5=Very Serious Problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem, and 1=Not a Problem):

• Arthritis (4.0) Healthy Environment Environmental quality is a general term which refers to varied characteristics that relate to the natural environment such as air and water quality, pollution and noise, weather as well as the potential effects such characteristics have on physical and mental health. In addition, environmental quality also refers to the socio-economic characteristics of a given community or area, including economic status, education, crime and geographic information. Community survey respondents noted that allergies, lack of safe roads and sidewalks, employment opportunities/lack of jobs, poverty and affordable and available housing were all problems when looking at Healthy Environment. The issues of air quality, generational poverty, the service area is a low socioeconomic environment, poverty, and finding a job means losing benefits were noted by stakeholders as health problems in the community. Focus Group participants identified several environmental problems as contributing to community health needs. High unemployment (which causes low self-esteem), a lot of homeless people, high number of burglaries in the area, the need shelters, playgrounds are not safe, lot of safety issues/violence in the area, poverty and crime were identified as health problems of the community. There are a number of observations and conclusions that can be derived from the data related to Healthy Environment. They include:

• High school graduation rates in Allegheny County are higher than the state and nation as well as the HP goal.

• The unemployment rates in Allegheny County are lower than PA and are showing a decreasing trend.

• The percentage of students with asthma is trending upward for the years 2009-2012.

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• According to the PRC National Child & Adolescent Health Survey, one in ten children (10.6%) in the Northeast Region have Asthma, which is slightly lower when compared to the United States (11.6%).

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

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

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

Healthy Mothers, Babies and Children The well-being of children determines the health of the next generation and can help predict future public health challenges for families, communities, and the health care system. The healthy mothers, babies and children topic area addresses a wide range of conditions, health behaviors, and health systems indicators that affect the health, wellness, and quality of life for the entire community. Stakeholders interviewed identified lack of parenting (either not being present or do not have the skills), OVH no longer has a maternity ward, and the need for pediatrics and family care – there are a lot of young families in the community. Focus Group participants identified lack of parenting skills, high number of single parents, the need for women’s health, and child abuse as the top Healthy Mothers, Babies and Children problems facing the community. There are a number of observations and conclusions that can be derived from the data related to Healthy Mothers, Babies and Children. They include:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Infectious Disease Pathogenic microorganisms, such as bacteria, viruses, parasites or fungi, cause infectious diseases; these diseases can be spread, directly or indirectly, from one person to another. These diseases can be grouped in three categories: diseases which cause high levels of mortality; diseases which place on populations heavy burdens of disability; and diseases which owing to the rapid and unexpected nature of their spread can have serious global repercussions (World Health Organization). Focus group participants mentioned that pneumonia was a small problem in the community. There are a number of observations and conclusions that can be derived from the data related to Infectious Disease, although the topic was not discussed in Stakeholder Interviews. They include:

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

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

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

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

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

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

• Stakeholder interviews did not comment on infectious diseases. • Focus group participants mentioned that pneumonia was a small

problem. Mental Health and Substance Abuse Mental Health refers to a broad array of activities directly or indirectly related to the mental well-being component included in the World Health Organization’s definition of health: “A state of complete physical, mental and social well-being, and not merely the absence of disease.” Mental health is

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related to the promotion of well-being, the prevention of mental disorders, and the treatment and rehabilitation of people affected by mental disorders. According to the World Health Organization, substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. Psychoactive substance use can lead to dependence syndrome – a cluster of behavioral, cognitive and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state. Western and Central Pennsylvania has experienced an epidemic of heroin and opiate abuse in the past 8-10 years. Pennsylvania now has the 7th highest drug overdose mortality rate in the United States, with over 3,000 deaths being heroin-related overdoses. Drug overdose deaths in Pennsylvania have now exceeded the number of deaths from automobile accidents. The most frequently mentioned top community health need mentioned by Focus Group participants was Alzheimer Disease. Drugs and alcohol, people living alone who are depressed (and are unaware they are), mental health issues and people not taking their medication, and mental stress were also identified as problems in the community. Stakeholders interviewed mentioned the following mental health and substance abuse needs: mental health is a huge problem, high school students using drugs, drug and alcohol addiction, prescription drug abuse, crime and violence revolves around drug activity, the Health Center no longer has anyone offer counseling services, and Focus on Renewal does not have any crisis funds to help There are a number of observations and conclusions that can be derived from the data related to Mental Health and Substance Abuse. They include:

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

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

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

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

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

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

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

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

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

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

Physical Activity and Nutrition Regular physical activity reduces the risk for many diseases, helps control weight, and strengthens muscles, bones and joints. Proper nutrition and maintaining a healthy weight are critical to good health. Physical activity and nutrition topics explored include: levels of physical activity, availability of fast or fresh food, and utilization of free and reduced-price lunches for school aged children. Stakeholders interviewed identified the following physical activity and nutrition needs in the community: lifestyle – poor diet and inactivity, nutrition education, recreation/opportunities for physical education, nutrition is a major issue – try to encourage people to visit farm truck foods that come weekly, awareness of available community recreation (3rd street

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park has reopened and has outdoor fitness equipment), students are not all receiving good nutrition, more fresh produce, education – not sure clients realize a bottle of water is healthier than a bottle of soda, people struggle to find time to exercise and prepare a healthy meal (quicker to get fast food), and nutrition coaching. Focus Group participants mentioned the following as top community health needs regarding physical activity and nutrition: hospital offer diet and nutrition classes, people do not watch what they eat or exercise, people live sedentary lifestyles, and people are too busy to cook – poor diet. There are a number of observations and conclusions that can be derived from the data related to Infectious Disease. They include:

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

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


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

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

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

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

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

• Stakeholders interviewed identified poor diet and inactivity, bad nutrition, nutrition education, recreation/opportunities for physical

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education, available community recreation, school nutrition, food bank nutrition, time to exercise and prepare a healthy meal and nutrition coaching as physical activity and nutrition needs.

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

Tobacco Use Tobacco Use is an important public health indicator as it relates to a number of chronic disease issues and conditions. The issues of emphysema due to tobacco use, smoking being a big problem, second hand smoke, seeing health care professionals smoking, and people needing to want to stop smoking were noted by stakeholders as health problems in the community. Focus Group participants rated smoking as somewhat of a problem and commented that a lot of people smoke and smoking causes health problems. There are a number of observations and conclusions that can be derived from the data related to Tobacco Use. These include:

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

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

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

• The percentage of adults who reported being an everyday smoker is trending upward from 2008-2014 and the 2012-2014 percentage (16.0%) is higher than the US percentage of 13.4%).

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

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

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

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Unintentional and Intentional Injury The topic of injury relates to any intentional or unintentional injuries that can be suffered by individuals. Injury topics explored include: auto accident mortality, suicide, fall mortality, firearm mortality, burns, head injuries and domestic violence. Stakeholders interviewed commented that domestic abuse might be a problem. Focus Group participants noted that gun violence was an identified community health needs. There are a number of observations and conclusions that can be derived from the data related to Unintentional and Intentional Injury, although the topic was not discussed in stakeholder interviews. These include:

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

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

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

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

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

• Stakeholders interviewed mentioned domestic abuse as a possible need.

• Focus group participants indicated gun violence as a need.

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

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prioritization criteria used included: (i) accountable role; (ii) magnitude of the problem; (iii) impact on other health outcomes; and (iv) capacity (systems and resources) to implement evidence based solutions. Members of the OVH CHNA Steering Committee met on April 11, 2016 to review the final priorities selected by the prioritization process. Using the methodology of looking at the four prioritization criteria outlined above, along with the rank order of the final priorities selected by the OVH Steering Committee, the following priorities are considered the most significant to OVH:

• Chronic Disease: Diabetes • Chronic Disease: Cardiovascular Disease (Heart Disease, Cholesterol,

etc.) • Access to Quality Health Services: Transportation for Self/Healthcare

Workers • Access to Quality Health Services: Knowledge of Services in the Area • Mental Health/Substance Abuse: Mental Health • Tobacco Use: Smoking • Physical Activity/Nutrition: Eating Habits/Access to Healthy Foods

The above significant needs will be addressed in OVH’s Implementation Strategy which will be published under separate cover and accessible to the public. Review and Approval The 2016 Community Health Needs Assessment was presented and approved by the OVH Board of Directors on May 31, 2016. The Ohio Valley Hospital 2016 Community Health Needs Assessment is posted on the OVH website (ohiovalleyhospital.org). Printed copies are available by contacting: [email protected].

http://www.fcmcpa.org/

mailto:[email protected]

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METHODOLOGY

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The process of completing the 2016 OVH CHNA began in June 2015. The purpose of this study is to complete a comprehensive assessment of the health status and healthcare access needs of residents living in the OVH primary service area. The CHNA and planning process is a significant step toward meeting the goal and mission of OVH to improve the health of the community. This initiative brought the hospital, public health, and other community leaders together in a collaborative approach to:

Identify the current health status of community residents to include baseline data for benchmarking and assessment purposes

Identify the availability of treatment services, strengths, service gaps, and opportunities

Determine unmet community health needs and target priorities

Develop a plan to direct community benefit and allocation of resources to meet targeted needs

Enhance strategic planning for future services As illustrated in Figure 2, the CHNA process develops a system that is better able to meet the needs of our communities will avoiding duplicative efforts and achieving economies of scale. This process supports the commitment of a cross section of community agencies and organizations working together to achieve healthier communities. The CHNA process facilitated by Strategy Solutions, Inc. in 2015-2016, follows best practices as outlined by the Association of Community Health Improvement, a division of the American Hospital Association in their CHNA Toolkit and follows the final regulations of IRS 990 guidelines.

METHODOLOGY

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Figure 2. Schematic of the Community Health Needs Assessment Process

Association for Community Health Improvement CHNA Toolkit

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To guide this assessment, the hospital’s leadership team formed a Steering Committee that consisted of hospital and community agencies who represented the broad interests of the local region. These included representatives who understood the needs and issues related to various underrepresented groups including medically underserved populations, low-income persons, minority groups, and those with chronic disease and mental health needs, individuals with expertise in public health, and internal program managers. Please Table 18 for the complete listing of Steering Committee members. Table 18. OVH Steering Committee Membership

Names Representing

Joanne Marie Andiorio, Ph.D. Sto Rox Community Health Center – Retired

David Bytnar Sto Rox Health Center

Sr. Sarah Crotty Focus on Renewal

Lisa Dalena OVH – Geropsych Unit

Megan (Eaton) Hinds OVH

Jim Lightner OVH – Emergency Services

Angelo Lupariello, MD Advanced Kidney Care

Sue Pfeifer OVH – Occupational Medicine

Craig Rippole Trinity Commercial Development, LLC

Peg Spisak OVH – Patient Safety

Sarah Stewart OVH – Community Services/Seniors

Susan Zikos OVH – Dietitian/Diabetes Educator

The OVH Steering Committee met three times between November 2015 and April 2016 to provide guidance on the various components of the CHNA. Table 19 outlines the Steering Committee meeting dates and agenda items. Table 19. OVH Steering Committee Dates and Agenda Topics

Date Meeting Location Topic

November 9, 2015 OVH Project overview and review of primary and secondary data

March 9, 2016 OVH Discuss needs and issues present in local territory by zip code

April 11, 2016 OVH Review and discuss prioritization results and implementation strategies

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Service Area Definition Consistent with IRS guidelines at the time of data collection, the project partners defined the community by geographic location based on the service area of OVH. Table 20 outlines the zip codes and municipalities that are included in the OVH primary service area. The geography of the OVH region is illustrated in Figure 3. Zip Code 15275 is in the middle of the service area, but has no population and, therefore, is not included in the demographic analysis of the OVH region. The hospital does, however, target this business district with awareness materials. Table 20. Service Area Zip Codes

Zip Code City

15071 Oakdale

15106 Carnegie

15108 Coraopolis

15126 Imperial

15136 McKees Rocks

15204 Corliss

15205 Crafton

15225 Neville Island

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Figure 3: OVH Overall Service Area

Strategy Solutions, Inc., a planning and research firm with the mission to create healthy communities, was retained by OVH to facilitate the process. The Strategy Solutions, Inc. consulting team that was involved in the project included: Debra Thompson, BS, MBA, President, served as the Project Director, completed stakeholder interviews and the final report Kathy Roach, BS, Project Manager, facilitated community focus groups, completed stakeholder interviews, completed the demographic and secondary data charting required for the project, and drafted the final report Jacqui Catrabone, BA, MS, Director of Nonprofit and Community Services, conducted stakeholder interviews and provided data analysis support Robin McAleer, BA, Project Coordinator, assisted with interview scheduling and logistics, conducted stakeholder interviews and provided report editing

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Asset Inventory

The hospital staff identified existing health care facilities and resources within their primary service area and the region overall available to respond to the significant health needs of the community. Resource directories currently utilized by the hospital’s case management and social service departments were compiled. The information included in the asset inventory and map includes a listing of community and hospital services: Community Resources: Assisted Living Clinic Dentist Diabetes Education Dialysis Drug Abuse & Alcohol Treatment Family Planning Food Bank

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

Hospital Resources: Acute Rehabilitation Unit Addiction Medicine Cardiology Cardiovascular Medicine Career Center Cataract & Eye Surgery Center Colon & Rectal Surgery Emergency Department Endocrinology Family Medicine Gastroenterology General & Vascular Surgery General Surgery Gynecology Infectious Disease Internal Medicine Laboratory Services Nephrology Neurology Nutrition Services Occupational Medicine

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

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Qualitative and Quantitative Data Collection In an effort to examine the health related needs of the residents of the service area and to meet current IRS guidelines and requirements, the methodology employed both qualitative and quantitative data collection and analysis methods. The staff, Steering Committee members and consulting team made significant efforts to ensure that the entire primary service territory, all socio-demographic groups and all potential needs, issues and underrepresented populations were considered in the assessment to the extent possible given the resource constraints of the project. This was accomplished by identifying focus groups and key stakeholders that represented various subgroups in the community. In addition, the process included public health participation and input, through extensive use of the PA Health Department and Centers for Disease Control data and public health department participation on the Steering Committee. The secondary quantitative data collection process included demographic and socio-economic data obtained from Nielsen/Claritas (www.claritas.com); disease incidence and prevalence data obtained from the Pennsylvania Departments of Health and Vital Statistics; Behavioral Risk Factor Surveillance Survey (BRFSS) data collected by the Centers for Disease Control and Prevention; American Community Survey and the Healthy People 2020 goals from HealthyPeople.gov. In addition, various health and health related data from the following sources were also utilized for the assessment: the US Department of Agriculture, the Pennsylvania Department of Education, and the County Health Rankings (www.countyhealthrankings.org). Selected data was also included from the Allegheny County 2013 PA Youth Survey and the National Survey Results on Drug Abuse – 1975-2013. Selected Emergency Department and inpatient utilization data from the hospital was also included. Economic data was obtained through the U.S. Census Bureau, Small Area Income and Poverty Estimates and the North Central PREP Partner’s 2014 Internal Assessment and Evaluation of Regional Economy Report. Data presented are the most recent published by the source at the time of the data collection.

Key Stakeholder Interviews The primary data collection process included qualitative data from ten stakeholder interviews conducted during October and November 2015 by staff members of SSI (see Table 21). Refer to Appendix A for a copy of the interview guide. Stakeholders interviewed included individuals with expertise in the following disciplines and/or organizational affiliations:

http://www.claritas.com/

http://www.countyhealthrankings.org/

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Faith-Based Organization

Police Department

Health Center

Media

Physician

School District

Community Development

Government Officials Table 21. OVH Stakeholder Interviews

Date Conducted Name Organization Title

10/20/15 Chris Crytzer Focus on Renewal Associate Director of External Relations

10/20/15 Chief Anthony Bruni Kennedy Township Police Department

Chief of Police

10/22/15 Fr. Regis Ryan Sto Rox Neighborhood Family Health Center

Executive Director

10/26/15 Doug Hughey Allegheny West Magazine

Publisher/Editor

10/28/15 Dr. Gary Sauer Doctors Sauer and Liebensperger Family Practice

10/28/15 Terry DeCarbo Sto Rox Schools Superintendent

10/28/15 Taris Vrcek McKees Rocks CDC Executive Director

10/28/15 Anita Kulik Kennedy Township Commissioner

11/5/15 Dr. Gene Battistella West Hills Medical Providers

11/6/15 Rep. Nick Kotik 45th Legislative District State Representative

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Focus Groups Conducted Focus groups were conducted with seven different groups in October 2015 representing the following groups as seen in Table 22. Refer to Appendices B and C for copies of the focus group questions used.

Table 22. OVH Focus Groups Conducted

Date Conducted Group Total # Participants

10/14/15 YMCA 9

10/14/15 Food Bank 14

10/21/15 Diabetic Support Group 6

10/21/15 Food Bank 6

10/23/15 Flu Clinic 9

10/28/15 Seniority 28

10/28/15 Willows 8

TOTAL PARTICIPANTS 80

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

Prioritization and Significant Health Needs As a result of the primary and secondary data analysis, the consulting team identified 46 distinct community needs and issues that demonstrated disparity, negative trend or gap between the local/ regional data and the state, national or healthy people goal and/or that qualitative information

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suggested that it was a growing need in the community. At their meeting on March 9, 2016, the OVH Steering Committee agreed with the list of potential needs, participated in prioritizing the needs based on the selected criteria and met again on April 11, 2016 to discuss the prioritization results. Table 23 identified the selected criteria. Table 23. Prioritization Criteria

Table 24 illustrates the needs of the service area ranked by the steering committee. The top 15 needs that were identified by the OVH CHNA Steering Committee include diabetes, cardiovascular disease (heart disease, cholesterol, etc.), COPD/chronic bronchitis, cerebrovascular disease (stroke), overweight/obesity, lung cancer, knowledge of all services in the area, primary care services, access to patient advocate, transportation for self/ healthcare workers, Alzheimer disease, prescription drug misuse/abuse, mental health, alcohol abuse, drug abuse/mortality, arthritis, pneumonia, medication management, asthma, and health care safety training regarding medication management.

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Table 24. OVH CHNA Prioritization Survey Sorted by Total of Accountability, Magnitude, Impact and Capacity

Members of the OVH CHNA Steering Committee met on April 11, 2016 to review the final priorities selected by the prioritization process. Using the methodology of looking at the four prioritization criteria of (i) accountable role of the hospital, (ii) magnitude of the problem, (iii) impact on other health outcomes and (iv) capacity (systems and resources) to implement evidence-based solutions, along with the rank order of the final priorities selected by the OVH Steering Committee, the following priorities are considered the most significant to OVH:

Hospital 8.0 or above

Accountability Magnitude Impact Capacity Total Rank

Chronic Disease: Diabetes 9.71 8.63 9.38 9.00 36.72 1

Chronic Disease: Cardiovascular Disease (Heart Disease,

Cholesterol, etc.) 9.38 7.63 8.38 8.50 33.89 2

Chronic Disease: COPD/Chronic Bronchitis 8.63 7.50 8.86 8.75 33.74 3

Chronic Disease: Cerebrovascular Disease (Stroke) 8.75 6.75 9.13 8.50 33.13 4

Chronic Disease: Overweight/Obesity 9.13 7.13 7.88 7.00 31.14 5

Chronic Disease: Lung Cancer 8.50 7.13 8.00 7.38 31.01 6

Access to Quality Health Services: Knowledge of all Services

in the Area 8.00 7.25 7.63 7.88 30.76 7

Access to Quality Health Services: Primary Care Services 8.38 6.13 8.13 6.88 29.52 8

Access to Quality Health Services: Access to Patient Advocate 8.88 5.50 7.38 7.38 29.14 9

Access to Quality Health Services: Transportation for

Self/Healthcare Workers 6.25 7.88 7.88 7.00 29.01 10

Chronic Disease: Alzheimer Disease 8.25 6.13 8.00 6.63 29.01 11

Mental Health/Substance Abuse: Prescription Drug

Misuse/Abuse 6.00 7.88 8.50 6.50 28.88 12

Mental Health/Substance Abuse: Mental Health 5.63 7.25 8.38 7.25 28.51 13

Mental Health/Substance Abuse: Alcohol Abuse 6.25 7.25 8.75 6.13 28.38 14

Mental Health/Substance Abuse: Drug Abuse/Mortality 5.88 7.75 8.50 5.75 27.88 15

Chronic Disease: Arthritis 8.50 5.50 6.75 6.63 27.38 16

Infectious Disease: Pneumonia 7.75 6.00 6.86 6.50 27.11 17

Access to Quality Health Services: Medication Management 5.57 7.38 7.38 5.88 26.21 18

Healthy Environment: Asthma 6.13 6.50 7.75 5.75 26.13 19

Access to Quality Health Services: Health Care Safety Training

Regarding Medication Management 5.25 7.25 6.88 6.63 26.01 20

Chronic Disease: Colorectal Cancer 7.25 5.50 6.38 6.63 25.76 21

Physical Activity/Nutrition: Eating Habits/Access to Healthy

Foods 5.13 6.38 7.75 5.63 24.89 22

Chronic Disease: Prostate Cancer 7.00 5.38 5.75 6.63 24.76 23

Access to Quality Health Services: Access to Short-Term

Home Health Assistance 5.71 6.38 7.00 5.50 24.59 24

Access to Quality Health Services: Affordability of Health

Care/Insurance Costs/Co-Pays/Deductibles 5.63 6.75 8.25 3.88 24.51 25

Access to Quality Health Services: Communication Between

Doctors/Specialists/Insurance Companies 6.75 6.50 6.50 4.63 24.38 26

Access to Quality Health Services: Health/Insurance Literacy 5.00 6.75 6.25 6.25 24.25 27

Tobacco Use: Smoking 3.25 7.38 7.25 5.38 23.26 28

Access to Quality Health Services: Elder Care Nutrition

Services 5.88 5.13 5.63 6.13 22.77 29

Chronic Disease: Melanoma/Skin Cancer 6.75 4.88 5.75 5.00 22.38 30

Access to Quality Health Services: Access to At-Home Risk

Assessment 6.00 5.00 6.00 5.25 22.25 31

Injury: Falls 3.88 6.50 6.00 5.13 21.51 32

Injury: Suicide 3.25 6.00 6.50 5.75 21.50 33

Access to Quality Health Services: Health Insurance 4.38 7.25 7.38 2.38 21.39 34

Infectious Disease: HIV Testing 4.63 5.00 7.00 4.75 21.38 35

Access to Quality Health Services: Shorter Pre-Approval Wait

Time 4.50 4.63 5.25 5.00 19.38 36

Access to Quality Health Services: Better Scheduling at

Doctor's Offices 5.63 4.25 5.13 4.00 19.01 37

Access to Quality Health Services: Communication Between

Home Health Workers/Patient/Family 3.75 5.38 5.75 4.13 19.01 38

Healthy Mothers, Babies & Children: Childhood Obesity 2.63 5.88 6.88 3.25 18.64 39

Social Environment: Poverty/Lack of Jobs/Unemployment 2.00 6.38 7.50 2.75 18.63 40

Healthy Mothers, Babies & Children: Tobacco Use During

Pregnancy 2.00 5.29 6.25 3.13 16.67 41

Healthy Mothers, Babies & Children: Teen Pregnancy 2.00 5.13 6.63 2.88 16.64 42

Healthy Mothers, Babies & Children: Teen Live Birth Outcomes 2.13 4.63 6.00 3.25 16.01 43

Healthy Mothers, Babies & Children: Breastfeeding 2.00 4.63 4.75 3.13 14.51 44

Injury: Auto Accidents 2.75 4.38 4.88 2.25 14.26 45

Injury: Firearm 2.13 4.75 5.00 2.00 13.88 46

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• Chronic Disease: Diabetes • Chronic Disease: Cardiovascular Disease (Heart Disease, Cholesterol,

etc.) • Access to Quality Health Services: Transportation for Self/Healthcare

Workers • Access to Quality Health Services: Knowledge of Services in the Area • Mental Health/Substance Abuse: Mental Health • Tobacco Use: Smoking • Physical Activity/Nutrition: Eating Habits/Access to Healthy Foods

The above significant needs will be addressed in OVH’s Implementation Strategy which will be published under separate cover and accessible to the public.

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DEMOGRAPHICS

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

DEMOGRAPHICS

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Figure 4. OVH Service Area

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Service Area Demographics Population - OVH Service Area Figure 5 illustrates the OVH Service Area Population from the 2000 and 2010 Census, as well as the 2015 Estimate and 2020 Projection. From the 2000 to 2010 census, the OVH service area population has remained constant and is projected to increase from 131,102 in 2015 to 133,823 in 2020. Figure 5. OVH Service Area Population Trend

Source: www.nielsen/claritas.com

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Gender - OVH Service Area Figure 6 illustrates the OVH Service Area by Gender. A little over half (51.3%) of residents are Female, while 48.7% are Male. Figure 6. OVH Service Area by Gender


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Race – OVH Service Area Figure 7 illustrates the ethnicity breakdown of the service area of OVH. The predominant race for the primary service area is White Alone (84.9%). Only 9.4% of the service population is Black or African American Alone. Figure 7. OVH Service Area by Race


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Age – OVH Service Area Figure 8 illustrates the age breakdown for the service area of OVH. For 2015, over one-third (40.6%) of the population is within the age range of 25-54. The population of those in the age range of 55-84 years was just under one-third (28.9%). The lowest populations occur in the 15-24 year-old range (11.9%) and the 85 and older range (2.4%). Figure 8. OVH Service Area by Age


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Marital Status – OVH Service Area Figure 9 illustrates the service area by Marital Status for OVH. Almost half of the population (44.8%) is Married, Spouse Present, while approximately one-third (34.2%) of the population have Never Married. Persons Divorced, Widowed or Separated make up 20.9% of the primary service area population. Figure 9. OVH Service Area by Marital Status


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Education – OVH Service Area Figure 10 illustrates the level of education for the service area of OVH. A little over one-third of the population (33.4%) graduated from High School or obtained their GED. The percent of the population that either did not receive a High School Diploma or have Less than a 9th Grade education level is 6.5%. Conversely, 60.1% of the population have either Some College-No Degree, or obtained their Associate, Bachelor’s, Master’s, Professional School or Doctoral Degree, and one in four (42.2%) recevied an Associates Degree or higher. Figure 10. OVH Service Area by Education


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Household Income – OVH Service Area Figure 11 illustrates the Household Income for the service area of OVH. The income statistics indicates the OVH service area to be low to middle income; about one-tenth (11.4%) have an annual income of $15,000 or less. Almost half (46.1%) have annual incomes less than $50,000. Figure 11. OVH Service Area by Household Income


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Employment Status – OVH Service Area Figure 12 illustrates the Employment Status for the service area of OVH. Almost two-thirds of the population (62.3%) is presently in the workforce, while 32.1% of the population is not. The percent of those unemployed in the service area is 5.5%. Figure 12. OVH Service Area by Employment Status


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Travel Time to Work – OVH Service Area Figure 13 illustrates the estimated average Travel Time to Work for the service area of OVH. The commute time can be easily separated out into approximate thirds – travel time of less than 15 minutes (26.8%), travel time between 15-29 minutes (38.8%) and travel time of 30 minutes or more (34.5%). Almost three-fourths (65.6%) of residents in the primary service area travel less than 30 minutes to get to work. Figure 13. OVH Service Area by Travel Time to Work


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Community Assets The map below in Figure 14 identifies an inventory of hospital and community assets and resources for OVH service area that the CHNA Steering Committee identified as important to the health of the community. The hospital assets are categorized into several areas, including: acute rehabilitation, addiction medicine, cardiology, career center, cataract and eye surgery, colon and rectal surgery, emergency department, endocrinology, family medicine, gastroenterology, general and vascular surgery, general surgery, gynecology, infectious disease, internal medicine, laboratory services, nephrology, neurology, nutrition, occupational medicine, primary care, oncology and hematology, ophthalmology, oral and maxillofacial surgery, orthopedics, otolaryngology, paint treatment, plastic and reconstructive surgery, podiatry, psychiatry, pulmonary, radilogy and medical imaging, rehabilitation, respiratory care, rheumatology, school of nursing, sleep evaluation, surgical services, thoracic and cardiovascular surgery, urology and wound care center. The community assets and resources are categorized into several areas, including: assisted living, clinics, dentists, diabetes education, dialysis, drug abuse and alcohol treatment, family planning, food bank, nutritional education, physicians-surgeons, psychiatry and mental health, rehab and physical therapy, support groups, women’s health and vein care. The full listing of hospital assets and resources are listed in Table 25. The full listing of community assets and resources are listed in Table 26.

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Figure 14: OVH Asset Resources Map

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Table 25. OVH Hospital Asset Resources Listing

Hospital Department Address City State Zip Phone Number

Acute Rehabilitation Unit

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

Addiction Medicine

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

Cardiology

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

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

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

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

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

McGinnis Cardiovascular Institute at Ohio Valley Hospital

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

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

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

Cardiovascular Medicine

Ohio Valley Cardiovascular Medicine


Career Center


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

Cataract & Eye Surgery Center


Colon & Rectal Surgery

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

Emergency Department


Endocrinology

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

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

Family Medicine

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

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

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

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

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

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

Gastroenterology

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

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

General & Vascular Surgery

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

General & Vascular Surgery Associates

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

Ohio Valley General & Vascular Surgery


General Surgery

Ohio Valley General & Vascular Surgery


Gynecology

Advanced Women’s Care of Pittsburgh


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

Infectious Disease

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

Internal Medicine

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

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

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

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

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

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

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

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

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

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


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

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

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

West Penn Allegheny Oncology Network

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

Laboratory Services

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

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

Nephrology

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

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

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

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

Neurology

Allegheny Neurological Associates

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

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

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Nutrition Services


Occupational Medicine

Business Fit Ohio Valley Hospital Medical Office Building


Ohio Valley Primary Care


Oncology

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

Oncology & Hematology

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

West Penn Allegheny Oncology Network

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

Ophthalmology

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

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

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

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

Oral & Maxillofacial Surgery

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

Orthopedics


Tri-State Orthopaedics & Sports Medicine, Inc.

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

Otolaryngology

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

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

Pain Treatment Center

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

Plastic & Reconstructive Surgery

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

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

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

Podiatry

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

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

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

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

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

Psychiatry

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

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

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

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

Pulmonary

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

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

South Hills Pulmonary Associates

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

Radiology & Medical Imaging


Rehabilitation Services


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

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

Respiratory Care Services

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

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Rheumatology

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

Schools of Nursing

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

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

Sleep Evaluation Center


Surgical Services


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

Thoracic & Cardiovascular Surgery

Gerald McGinnis Thoracic & Cardiovascular Institute

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

Urology

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

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

Wound Care Center

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

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

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Table 26. OVH Community Asset Resources Listing

Agency Address City State Zip Phone Number

Assisted Living

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

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

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

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

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

Clinic

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

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

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

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

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

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

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

Dentist

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

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

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

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

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

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

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

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

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

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

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

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


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

Diabetes Education

Diabetes Comprehensive Care Program Heritage Valley Health System

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

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

Living Well with Diabetes Program Wound Care Center Ohio Valley Hospital


Dialysis

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

Fresenius Medical Care at Ohio Valley Hospital

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

Drug Abuse & Alcohol Treatment

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

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

Greenbriar Treatment Center-Robinson


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

Christian Drug Detox and Rehab

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

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

Family Planning

Planned Parenthood Moon Township Health Center

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

Food Bank

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

Nutritional Education

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

Physicians-Surgeons

Catalane & Willis Surgical Associates


Greater Pittsburgh Orthopaedic Associates Moon Office

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

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

Pine Hollow Medical Associates

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

Psychiatry and Mental Health

Crossroads Counseling & Consulting Associates, PC Moon Township

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

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

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

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

Rehab and Physical Therapy

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

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

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

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

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

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

UPMC Centers for Rehab Services Robinson Township

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

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

Support Groups

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

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

Vietnam Veterans Counseling Center HIV Support Group Pittsburgh Vet Center

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

Women's Health

Planned Parenthood Moon Township Health Center

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


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

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

Vein Care

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

Circulatory Centers-Moon Robinson

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

FeelNu Medi Spa and Wellness Center Medical Group Robinson

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

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Demographic Conclusions For purposes of this assessment, the community is defined as OVH’s primary service area including Allegheny County in Pennsylvania. The total population in the OVH service area as of the 2010 Census is approximately 128,000 people. Overall, the service region’s population is expected to increase slightly over the next several years. The service area has slightly more females than males, and a sizable portion of the service area (almost half) is between the ages of 25 and 54. The service area is primarily low to middle income; about one-third of the population has incomes less than $35,000. While the majority of the service area population is white, non-Hispanic (84.9%), the area is more ethnically diverse than many parts of Allegheny County. About 7.0% of the regional population has not completed high school, while about a third (33.4%) has a high school diploma or GED, and another quarter (27.7%) has completed some college or obtained an associate degree. There are a number of observations and conclusions that can be derived from the data related to Demographics. They include:

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

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

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

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

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

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

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

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

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

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ACCESS TO QUALITY HEALTH CARE

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

ACCESS TO QUALITY HEALTH CARE

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Access Issues No Health Insurance Figure 15 illustrates the percentage of adults ages 18-64 with no health insurance in the United States, Pennsylvania and throughout Allegheny County in for the years 2008-2014, where data is available. Adults ages 18-64 in Allegheny County had rates lower than the state and nation for all seven years. All clusters are above the Healthy People 2020 Goal (0%). Figure 15. Adults (Age 18-64) with No Health Insurance

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

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No Personal Health Care Provider Figure 16 illustrates the percentage of adults reporting that they have no personal health care provider in Pennsylvania and throughout Allegheny County for the cluster years 2008-2010, 2011-2013 and 2012-2014 where data is available. Allegheny County had a significantly higher rate of adults with no personal healthcare (17.0%) when compared to Pennsylvania (14.0%) for the cluster 2012-2014. Allegheny County and Pennsylvania percentages are below the US 2013 percentage of 22.9% for adults with no personal health care provider. Figure 16. Adults with No Personal Health Care Provider


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Doctor’s Visit Figure 17 shows adults who reported that they needed to see a doctor in the last year but could not due to cost in Pennsylvania and Allegheny County for the year clusters 2008-2010, 2011-2013 and 2012-2014, where data is available. Fewer adults in Allegheny County (11.0%) reported not being able to see a doctor due to cost when compared to the state for the year cluster 2012-2014. Both Pennsylvania and Allegheny County are below the USA percentage of 15.3% in 2013. Allegheny County and Pennsylvania percentages are above the Healthy People 2020 Goal of 4.2% for adults who needed to see a doctor in the past year but could not due to cost.

Figure 17. Adults Who Reported Needing to See a Doctor But Could Not Due to Cost, Past Year

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

Healthy People 2020

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Community Input Figure 18 illustrates the percentage of 2015 Focus Group participants who rated their personal health status. Almost one-third of the focus group respondents (27.9%) rated their personal health as fair or poor. Figure 18. 2015 Focus Groups – Personal Health Status

Source: OVH CHNA Focus Groups, 2015

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PRC National Child & Adolescent Health Survey, 2014 According to the PRC 2014 National Child & Adolescent Health Survey, more than half of the children in the United States are covered under Private 65.3% Insurance as seen in Figure 19. Figure 19. PRC – Healthcare Insurance Coverage for Child

Source: PRC National Child & Adolescent Health Survey, 2014

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According to the PRC 2014 National Child & Adolescent Health Survey, 6.6% of children in the Northeast Region are uninsured, which is comparable to the United States (6.5%) as seen in Figure 20. All regions and nation are above the Healthy People 2020 Goal of 100% insured. Figure 20. PRC – Lack Healthcare Insurance Coverage for Child

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

Services, Healthy People 2010

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Figure 21 shows that according to the PRC 2014 National Child & Adolescent Health Survey, one in four children (24.5%) in the Northeast Region experienced a barrier or delay in accessing the care they needed, which is lower than the United States (29.4%). Figure 21. PRC – Experienced Difficulties or Delays in Receiving Child’s Needed Healthcare in the Past Year


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Figure 22 shows that according to the PRC 2014 National Child & Adolescent Health Survey, the majority (91.7%) of children in the Northeast Region had a routine physician visit in the past year, which is higher when compared to the United States (85.3%). Figure 22. PRC – Child Visited a Physician for a Routine Checkup in the Past Year


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The PRC 2014 National Child & Adolescent Health Survey found that 83.6% of children in the Northeast region had an annual routine dental check-up, which is slightly lower than the United States (84.9%) as shown in Figure 23. The Northeast region is above the Healthy People 2020 Goal of 49.0%. Figure 23. PRC – Child Visited a Dentist or Dental Clinic Within the Past Year

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

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Figure 24 shows the Northeast region (19.5%) had the lowest number of children accessing health care through an urgent care center when compared to the other regions and the United States (28.6%), according to the PRC 2014 National Child & Adolescent Health Survey. Figure 24. PRC – Child Used an Urgent Care Center, QuickCare Clinic, or Other Walk-in Clinic in the Past Year


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Figures 25-27 illustrate responses from the focus groups regarding the community issues related to access problems. Participants were asked to share their reasons for not having a health care provider, based on a 5-point scale where 5=Very Serious problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem and 1=Not a Problem. Overall, the top five access needs ranked by the Focus Group participants are cost of specialists (3.7), the need for specialists to communicate to each other (3.6), scheduling at doctor’s office (3.4), cost of co-pays (3.3), and information detail on what your health insurance covers (summary sheet) (3.3). Figure 25. 2015 Focus Groups – Access Problems, 1 of 3

Source: OVH Focus Groups, 2015

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Figure 26. 2015 Focus Groups – Access Problems, 2 of 3


Figure 27. 2015 Focus Groups – Access Problems, 3 of 3


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

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

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








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


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CHRONIC DISEASE

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

CHRONIC DISEASE

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Cancer Figure 28 illustrates the breast cancer incidence rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County is significantly higher for all of the years except 2011 when compared to the Pennsylvania rate and is also higher than the Healthy People goal (41.0). It is lower than the United States rates. Figure 28. Breast Cancer Incidence Rates


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Figure 29 illustrates the breast cancer mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County has been decreasing for the years 2009 (16.1) through 2012 (12.2) and is lower than the Pennsylvania rates, United States rates and Healthy People goals (20.6). Figure 29. Breast Cancer Mortality Rates


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Figure 30 illustrates the bronchus and lung cancer incidence rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County was significantly higher than Pennsylvania for the years 2008 through 2011, and higher than Pennsylvania (63.9) for 2012. Figure 30. Bronchus and Lung Cancer Incidence Rates

Source: PA Department of Health, Centers for Disease Control

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Figure 31 illustrates the lung cancer mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The lung cancer incidence rate in Allegheny County has been decreasing from 2008 (54.5) through 2012 (52.3). The lung cancer mortality rate is still significantly higher than Pennsylvania for the years 2010 (52.2), 2011 (52.4) and 2012 (52.3), but is lower than the 2012 US rate (57.9). The nation, state and county are all above the Healthy People goal (45.5). Figure 31. Lung Cancer Mortality Rates


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Figure 32 illustrates the colorectal cancer incidence rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County for 2012 (40.0) is lower than Pennsylvania (42.5) and the United States (46.1) for the same year. The nation, state and county are all higher than the Healthy People 2020 Goal of 38.6. Figure 32. Colorectal Cancer Incidence Rates


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Figure 33 illustrates the colorectal cancer mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County for 2012 (14.9) is lower than the Pennsylvania (15.8) and United States (18.1) rates for the same year. The rate is only slightly higher than the Healthy People 2020 goal of 14.5. Figure 33. Colorectal Cancer Mortality Rates


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Figure 34 illustrates the prostate cancer incidence rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. In 2012, the rate in Allegheny County (112.1) was significantly higher than the Pennsylvania rate (101.7), but was well below the rate for the United States (128.3). Figure 34. Prostate Cancer Incidence Rates


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Figure 35 illustrates the prostate cancer mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. In the most recent year data is available, the nation (20.8) and Pennsylvania (19.1) met the Healthy People 2020 Goal of 21.2, but Allegheny County fell short at 22.1. Figure 35. Prostate Cancer Mortality Rates


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Heart Disease Figure 36 illustrates the heart disease mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The heart disease rate in Allegheny County has been decreasing over the past five years, but the 2012 rate (180.1) is higher than Pennsylvania (175.2) and the United States (176.8). Figure 36. Heart Disease Mortality Rates


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Heart Attack Figure 37 illustrates the heart attack mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County for 2008 (18.3) was significantly lower than the Pennsylvania rate (20.4) and is slightly lower (17.7) than the 2012 Pennsylvania rate (17.9). Allegheny County and the state all fall well below the rate of the nation (89.2). Figure 37. Heart Attack Mortality Rates


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Figure 38 illustrates the coronary heart disease mortality rate for the United States, and Allegheny County for the years 2008 through 2012, where data is available. For all five years ending in 2012, the coronary heart disease mortality rate in Allegheny County has been significantly higher than the Pennsylvania rate, as well as being higher than the nation and HP goal. Figure 38. Coronary Heart Disease Mortality Rates


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Figure 39 illustrates the cardiovascular disease mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The rate in Allegheny County for 2011 (246.2) was significantly higher than the Pennsylvania rates. Figure 39. Cardiovascular Disease Mortality Rates


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Figure 40 illustrates the COPD mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. In 2012, the COPD mortality rate in Allegheny County (36.2) was lower than both the state (38.4) and Healthy People 2020 goal (102.6). Figure 40. Chronic Lower Respiratory Disease (COPD) Mortality Rates


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Figure 41 illustrates the cerebrovascular disease mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. The cerebrovascular disease mortality rate in Allegheny County has been decreasing over the past five years. In 2012 the rate in Allegheny County (34.3) was lower than the state (36.8), the nation (39.9) and Healthy People 2020 goal (34.8). Figure 41. Cerebrovascular Disease Mortality Rates


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Figure 42 illustrates the percentage of adults ever told they had a stroke (ages 35 and older) for the United States, Pennsylvania, and Allegheny County for the year clusters 2008-2010, 2011-2013 and 2012-2014, where data is available. The percentage of adults ever told they had a stroke for the period of 2011-2013 for Allegheny County (4.0%) is higher than the nation (2.8%) but is equal to the state (4.0%). Allegheny County is slightly higher (5.0%) than the state (4.0%) for the year cluster 2012-2014. Figure 42. Adults Ever Told They Had a Stroke (age 35 and older)


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Diabetes Figure 43 illustrates the diabetes mortality rate for the United States, Pennsylvania, and Allegheny County for the years 2008 through 2012, where data is available. For the years 2009-2011, the diabetes mortality rates in Allegheny County were significantly lower than the state. In 2012, the rate in Allegheny County (20.6) was lower than the state (22.0), the nation (73.3) and the Healthy People 2020 goal (66.6). Figure 43: Diabetes Mortality Rates


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Figure 44 illustrates that according to the PRC National Child & Adolescent Health Survey, twice as many children in the Northeast region (1.4%) have diabetes compared to the United States (0.7%). Figure 44. PRC – Child Has Diabetes


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Figure 45 illustrates the percentage of women who received a mammogram in the United States, Pennsylvania and Allegheny County for the years 2010 and 2013-2015, where data is available. The percentage of women receiving a mammogram has been decreasing over the past three years (58.0%, 49.4% and 50.9%) and are lower than the state (63.4%), nation (67.1%) and the Healthy People 2020 goal (81.1%). Figure 45. Mammogram Screenings


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Figure 46 illustrates the average scores for chronic disease related problems identified during the OVH 2015 Focus Groups. Participants were asked to rate the extent each community health issue was a problem in the local community on a 5 point scale, where 5=Very Serious Problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem, and 1=Not at all a Problem. Arthritis (4.0) and Joint issues (3.8) were identified as a serious problems, followed by diabetes (3.4), heart problems (3.2) and obesity (3.2). Figure 46. 2015 Focus Groups – Chronic Disease Problems


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

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



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











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

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

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HEALTHY ENVIRONMENT

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

Ambient Air Quality Measures (Ozone, PM 2.5)

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

Hospitalization for Asthma and Myocardial Infarction

Birth Defects and related Premature Births

Childhood Blood Lead

Vital Statistics and Birth Outcomes

Cancer

HEALTHY ENVIRONMENT

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Asthma and Other Respiratory Diseases Figure 47 shows the rate of asthma hospitalizations for the counties in Pennsylvania for the years 2009-2013. Figure 47. Asthma Hospitalizations 2009-2013

Source: Pennsylvania Health Care Cost Containment Council (PHC4)

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

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

2011). Drilling down on fracking concerns: The potential and peril of hydraulic fracturing to drill for natural gas. Center for American Progress. Retrieved from http://www.americanprogress.org/wp-content/uploads/issues/2011/03/pdf/fracking.pdf.

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

2 Boyer, Elizabeth W., Ph.D., Swistck, Bryan R., M.S., Clark, James, M.A.; Madden, Mark, B.S.

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

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

Estimation of regional air-quality damages from Marcellus Shale natural gas extraction in Pennsylvania. Rand Corporation, 8(1). Retrieved from http://iopscience.iop.org/1748-9326/8/1/014017/pdf/1748-9326_8_1_014017.pdf.

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

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

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

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

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High School Graduation Rates Figure 48 displays high school graduation rates for Pennsylvania and Allegheny County for the years 2013 through 2015, where data is available. The high school graduation rates in Allegheny County are higher than the state, as well as falling above the Healthy People 2020 goal. Figure 48. High School Graduation Rates

Source: www.countyhealthrankings.org, Healthy People 2020

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Unemployment Figure 49 illustrates the unemployment rates in Pennsylvania and Allegheny County for the years 2013-1015, where data is available. The unemployment rates in Allegheny County are lower than the state, and are showing a decreasing trend overall for the three years ending 2015. Figure 49. Unemployment

Source: www.countyhealthrankings.org

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Asthma Figure 50 illustrates the percentage of students with asthma in Pennsylvania and Allegheny County for the years 2008 through 2012, where data is available. In Allegheny County, the number of students with asthma has been trending upward since 2009, and in 2012 Allegheny County had a higher percentage (12.4%) than the state (12.1%). Figure 50. Students with Asthma

Source: PA Department of Health

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Figure 51 shows that according to the PRC National Child & Adolescent Health Survey, one in ten children (10.6%) in the Northeast Region have Asthma, which is slightly lower when compared to the United States (11.6%). Figure 51. PRC – Child Currently Has Asthma (US 2014)

Source: PRC National Child and Adolescent Health Surveys, 2014

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Figure 52 illustrates that slightly more than one in four (27.0%) children in the United States had an Asthma-related visit to the Emergency Room or Urgent Care Facility in 2014. According to the survey, the trend for children having an Asthma-related visit to the Emergency Room or Urgent Care is on the decline between the years 2012 and 2014. Figure 52. PRC – Number of Asthma-Related ER/Urgent Care Visits in the Past Year (US 2014)

Source: PRC National Child and Adolescent Health Surveys, 2014

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

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

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

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

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

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




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


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Pregnancy Figure 53 illustrates the percentage of mothers receiving prenatal care during their first trimester in the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. Allegheny County had significantly more mothers accessing prenatal care during the first trimester compared to the state for the years 2008 through 2012. The percentage of mothers receiving prenatal care during their first trimester in Allegheny County for 2012 (89.1%) was also higher than the nation (70.8%) and the Healthy People 2020 goal of 77.9%. Figure 53. Prenatal Care First Trimester


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Figure 54 illustrates the percentage of nonsmoking mothers during pregnancy in the United States, Pennsylvania, New York, and the service area counties in 2008 through 2012, where data is available. Allegheny County had significantly higher non-smoking mothers during pregnancy in 2012 (86.8%) when compared to the state (85.2%). Allegheny County had a lower percentage in 2012 (86.8%) than the nation (89.3%) and the Healthy People 2020 goal (98.6%). Figure 54. Non-Smoking Mother During Pregnancy


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Figure 55 illustrates the percentage of nonsmoking mothers three months prior to pregnancy in the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. Allegheny County had significantly higher percentages for mothers not smoking three months prior to pregnancy when compared to the state for all five years, and is also higher than the nation. Figure 55. Non-Smoking Mother Three Months Prior to Pregnancy


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Figure 56 illustrates the percentage of low birth rate babies born in the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. Allegheny County (7.6%) had significantly fewer low birth rate babies born compared to the state (8.1%) in 2012, and was slightly lower than the nation (8.0%) and Healthy People 2020 Goal (7.8%). Figure 56. Low Birth Rate Babies Born


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Assistance Figure 57 illustrates percentage of mothers reporting WIC Assistance in Pennsylvania and Allegheny County in 2008 through 2012, where data is available. Allegheny County had a significantly lower percentage of mothers reporting WIC Assistance compared to the state for all five years. Figure 57. Mothers Reporting WIC Assistance


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Figure 58 illustrates percentage of mothers reporting Medicaid Assistance in Pennsylvania and Allegheny County in 2008 through 2012, where data is available. Allegheny County had significantly fewer mothers reporting Medicaid Assistance compared to the state in 2009-2012, but it is trending upward for the years 2011 (25.8%) and 2012 (30.0%). Figure 58. Mothers Reporting Medicaid Assistance


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Breastfeeding Figure 59 illustrates percentage of mothers who report breastfeeding in the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. Compared to Pennsylvania, Allegheny County had a significantly lower percentage of mothers reporting breastfeeding for all five years. Allegheny County fell short when compared to the nation (77.0%) and the Healthy People 2020 goal of 81.9% in 2012. Figure 59. Mothers Reporting Breastfeeding


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Teen Pregnancy Figure 60 illustrates the percentage of teen pregnancies for teenagers ages 15-19 in the United States, Pennsylvania, and Allegheny Counties from 2008 through 2012, where data is available. When compared to Pennsylvania, Allegheny County had a significantly lower percentage of teen pregnancies for teenagers ages 15-19 for the years 2008-2009 and 2011-1012. Allegheny County was below the Healthy People Goal of 36.2% in 2012 (30.6%). Figure 60. Teen Pregnancy Rate, Ages 15-19


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Figure 61 illustrates the percentage of teen live births in the United States, Pennsylvania, and Allegheny County from 2008 through 2012, where data is available. When Compared to Pennsylvania, Allegheny County had a significantly lower percentage of live teen birth outcomes for all five years. In 2012, Allegheny County (59.7%) had a much lower percentage of teen live birth outcomes compared to the nation (73.4%) and the state (69.5%). Figure 61. Teen Live Birth Outcomes, Ages 15-19


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Infant Mortality Figure 62 illustrates infant mortality rate in the United States, Pennsylvania, and Allegheny County from 2008 through 2012, where data is available. The rate in Allegheny County has been trending downward for the last five years, and was lower in 2012 (5.9%) than the state (7.0%) and nation (6.1%). Figure 62. Infant Mortality


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Figure 63 illustrates infant mortality rates for the counties in Pennsylvania between 2006 and 2010. The infant mortality rate in Allegheny County was 6.2-8.1. Figure 63. Infant Mortality in Pennsylvania

Source: PA Department of Health-Pennsylvania Vital Statistics 2010

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Overweight and Obesity Figure 64 illustrates the percentage of students in Kindergarten through 6th grade who are considered Overweight in Pennsylvania and Allegheny County for 2008 through 2012, where data is available. The percentage of student in Kindergarten through 6th grade who are considered Overweight in Allegheny County in 2011 (17.3%) is higher than the state (15.9%). Figure 64. Overweight BMI, Grades K-6

Source: PA Department of Health

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Figure 65 illustrates the percentage of students in 7th through 12th grade who are considered Overweight in the United States, Pennsylvania, and Allegheny County for 2008 through 2012, where data is available. Compared to Pennsylvania (16.4%) in 2011, Allegheny County (17.1%) had a higher percentage of students considered overweight in grades 7-12. Figure 65. Overweight BMI, Grades 7-12


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Figure 66 illustrates the percentage of students in 7th through 12th grade who are considered Obese in the United States, Pennsylvania, and Allegheny County for 2008 through 2012, where data is available. The percentage of students in grades 7-12 that were obese in 2011 (15.9%) is lower than PA (17.7%) and the HP goal (16.1%) but higher than the US (13.7%). Figure 66. Obese BMI, Grades 7-12


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Figure 67 illustrates the percentage of children in the United States in 2014 that had ever been fed breast milk. Over half (69.4%) of the children in the United States had been fed breast milk, which falls below the Healthy People 2020 Goal of 81.9%. Figure 67. PRC – Child Was Ever Fed Breast Milk

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


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Figure 68 illustrates the percentage of children in the United States in 2014 that were exclusively breastfed for at least 6 months. Approximately one in four (26.8%) children in the Northeast region was exclusively breastfed for at least 6 months, which is slightly lower than the nation (27.2%). Figure 68. PRC – Child Exclusively Breastfed for at Least Six Months

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


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














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

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



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INFECTIOUS DISEASES

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

INFECTIOUS DISEASE

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Influenza and Pneumonia Figure 69 illustrates percentage of adults age 65 and older who have had a pneumonia vaccine in the United States, Pennsylvania, and Allegheny County for the cluster years 2008-2010, 2011-2013, and 2012-2014 where data is available. In Allegheny County, the percentage of adults over the age of 65 receiving a pneumonia vaccine was significantly higher for all years than the state and nation, but was lower than the Healthy People 2020 goal of 90.0%. Figure 69. Adults Who Had Pneumonia Vaccine, Age 65 and Older


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Figure 70 illustrates influenza and pneumonia mortality rate for the United States, Pennsylvania, and Allegheny County in 2008 through 2012, where data is available. The influenza and pneumonia mortality rate in Allegheny County was significantly higher than the state rate for the years 2009 through 2012. Figure 70. Influenza and Pneumonia Mortality


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Infectious Diseases Figure 71 illustrates Lyme disease incidence rates in the United States in 2012, as well as Pennsylvania and Allegheny County in 2008 through 2012, where data is available. The rates in Allegheny County are significantly lower than the state rates for the years of 2008-2010 and 2012. Figure 71. Lyme Disease Incidence Rates


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Figure 72 illustrates the percentage of adults age 18 to 64 who have ever been tested for HIV in the United States in 2013 as well as Pennsylvania and Allegheny County for the cluster years 2008-2010, 2011-2013 and 2012-2014. When compared to the state, the percentage of adults age 18-64 that had been tested for HIV in Allegheny County was roughly the same, but both state and county are well below the Healthy People goal of 73.6%. Figure 72. Ever Tested for HIV, Adults 18-64


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Figure 73 illustrates chlamydia rates in Pennsylvania and Allegheny County for 2008 through 2012. For all five reporting years, Allegheny County’s chlamydia rates are significantly higher than the state rate and the trend for the county has been increasing over the last three years. Figure 73. Chlamydia Rate


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Figure 74 illustrates chlamydia rates in females in Pennsylvania and Allegheny County for 2008 through 2012, where data is available. For the years 2008 through 2012, the rate of chlamydia in females in Allegheny County is significantly higher than the state rates, with an increasing trend during the last three years. Figure 74. Chlamydia Rates, Female


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Figure 75 illustrates chlamydia rate in males in Pennsylvania and Allegheny County in 2008 through 2012, where data is available. For the years 2008 through 2012, the rate of chlamydia in males in Allegheny County is significantly higher than the state rates, with an increasing trend over the last three years. Figure 75. Chlamydia Rates, Male


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Figure 76 illustrates the gonorrhea rate in the United States in 2012 as well as Pennsylvania and Allegheny County in 2008 through 2012, where data is available. For the years 2008-2012, Allegheny County’s gonorrhea rates have been significantly higher than the state rates, with an increasing trend over the last four years. Figure 76. Gonorrhea Rates


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Figure 77 illustrates gonorrhea rates in females in Pennsylvania and Allegheny County for 2008 through 2012, where data is available. For the years 2008-2012, the rate of females with gonorrhea in Allegheny County has been significantly higher than the state rate, with an increasing trend over the least four years. Figure 77. Gonorrhea Rates, Female


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Figure 78 illustrates gonorrhea rates in males in Pennsylvania and Allegheny County for 2008 through 2012, where data is available. For the years 2008-2012, the rate of males with gonorrhea in Allegheny County has been significantly higher than the state rate, with an increasing trend over the least four years. Figure 78. Gonorrhea Rates, Male


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







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

problem.

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


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Mental Health Figure 79 illustrates the mental and behavioral health disorders mortality rate for the United States in 2012, as well as Pennsylvania and Allegheny County in 2008 through 2012. The rate in 2012 in Allegheny County (46.5) is significantly higher than the state (43.0) but is lower than the nation (63.3). For the years 2009 and 2010, the county rate is also significantly higher than the state rate. Figure 79. Mental and Behavioral Disorders Mortality Rate


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Substance Abuse Figure 80 illustrates the percentage of adults who report binge drinking in the United States, Pennsylvania and Allegheny County for the cluster years 2008-2010, 2011-2013 and 2012-2014. Binge drinking is defined as five or more drinks in one sitting for males and four or more drinks in one sitting for females. Allegheny County had a significantly higher percentage of adults who reported binge drinking for the years 2011-2013 and 2012-2014 when compared to the state, but is still below the Healthy People 2020 Goal of 24.4%. Figure 80. Adults Who Reported Binge Drinking (Men=5 Drinks, Women=4 Drinks)


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Figure 81 illustrates the percentage of adults who are at risk for heavy drinking in the United States, Pennsylvania and Allegheny County for the cluster years 2008-2010, 2011-2013 and 2012-2014. Heavy drinking is defined as two drinks in one day for males and one drink a day for females. Allegheny County (8.0%) had a significantly higher percentage of adults who were at risk for heavy drinking than the state (6.0%) for the years 2011-2013. Figure 81. Adults at Risk for Heavy Drinking (2 Drinks for Men/1 Drink for Women)


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Figure 82 illustrates the drug-induced mortality rate in the United States in 2012, as well as Pennsylvania for 2008 and 2012, and Allegheny County for 2008 through 2014. In 2012, the drug-induced mortality rate in Allegheny County (22.7) was significantly higher when compared to the state, the nation, and the Healthy People 2020 Goal (11.3). Figure 82. Drug-Induced Mortality Rate


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Figure 83 illustrates the percentage of youth in grades 6th through 12th in Allegheny County who report using alcohol or marijuana in 2009, 2011, and 2013, as well as in Pennsylvania and nation in 2013, where data is available. The percentage of students who report using alcohol in all grades has increased between 2009 and 2013, as has the percentage of students reported using marijuana. Both groups are also higher than the state percentage for 2013. Figure 83. PAYS – Allegheny County Substance Use

Source: PA Youth Survey, 2009-2013

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Figure 84 illustrates the percentage of youth in grades 6th through 12th in Allegheny County who report using prescription pain relievers in 2009, 2011, and 2013, as well as in Pennsylvania and nation in 2013, where data is available. Students in grades 6 (2.6), 8 (4.6), 10 (10.4) and 12 (16.5) have a higher percentage of students using pain relievers when compared to the state for the year 2013. The percentage is also increasing for students in 10th and 12th grades, as well as overall. Figure 84. PAYS – Allegheny County Pain Reliever Use


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Figure 85 illustrates the percentage of youth in grades 6th through 12th in Allegheny County who report driving after using alcohol or marijuana in 2009, 2011, and 2013, as well as in Pennsylvania and nation in 2013, where data is available. A higher percentage of youth in all grades report driving after alcohol when compared to the state, as well as driving after marijuana use. Figure 85. PAYS – Allegheny County Risky Behaviors


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Figure 86 illustrates the average scores for mental health and substance use problems identified during the OVH 2015 Focus Groups. Participants were asked to rate the extent each community health issue was a problem in the local community on a 5 point scale, where 5=Very Serious Problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem, and 1=Not at all a Problem. The participants ranked prescription drug abuse (4.2) and substance abuse (4.2) is serious problems in their area. Figure 86. 2015 Focus Groups – Mental Health and Substance Abuse Problems

Source: 2015 OVH Focus Groups

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Mental Health and Substance Abuse Conclusions

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











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


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Figure 87 illustrates the number of days in the past week children in the United States were physically active for one hour or longer in 2014. Slightly less than half (43.2%) of children age two through seventeen were physically active for one hour or longer seven days out of the week. A very small percentage (2.6%) report not being physically active for one hour or longer during a week. Figure 87. PRC – Number of Days in the Past Week on Which Children Were Physically Active for an Hour or Longer (US Children Age 2-17, 2014)


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Figure 88 illustrates the percentage of children that were physically active for one hour or longer every day in the past week in 2014. Children in the Northeast region were slightly less active (41.0%) when compared to the nation (43.2%), West (47.0%) and South (43.3%). The national trend is decreasing, with over half of children (57.3%) being physically active every day during the past week in 2012. Figure 88. Percentage of Children Physically Active for an Hour or Longer Every Day in Past Week (US Children Age 2-17)


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Figure 89 illustrates the hours children ages five through seventeen spend per day on TV/videos/video games or on a computer/cell phone/handheld device in the United States. One in three children (30.1%) spend three or more hours per day on TV/videos or video games. Approximately one in four (27.4%) spend three more hours per day on a computer, cell phone, or handheld device. For this graph, respondents with children who are not in school were asked about “weekdays,” while parents of children in school were asked about typical “school days” when responding this survey question. Figure 89. PRC – Hours of Children’s Screen Time (US Children Age 5-17, 2014)


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Figure 90 illustrates the percentage of children who spend three or more hours per school day on a computer, device, watching TV, etc. in the United States. Over half (63.8%) in the United States have three or more hours of screen time on a school day. Children in the Northeast Region (65.2%) were slightly higher when compared to the nation (63.8%), West (59.9%) and Midwest (58.1%). For this graph, respondents with children who are not in school were asked about “weekdays,” while parents of children in school were asked about typical “school days” when responding this survey question. Figure 90. PRC – Children with Three or More Hours per School Day of Screen Time (TV, Computer, Video Games, Phone, Device, etc.) (US Children Age 5-17)


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Figure 91 illustrates the percentage of children in the United States in 2014 receiving five or more servings per day of fruits and/or vegetables. Less than half (41.8%) of children are receiving five or more servings of fruits and/or vegetables daily, which is declining compared to 2012 (46.4%). Approximately one third (33.9%) of children in the Northeast Region are receiving five or more servings, which is lower than all other regions. Figure 91. PRC – Percentage of Children Having Five or More Servings of Fruits/Vegetables per Day


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Figure 92 illustrates the number of fast food meals children age two through seventeen consume in the past week. Slightly less than one in three children (30.1%) did not consume any fast food meals within the past week. Just over one in five children (22%) consumed four or more fast food meals in the past week. Figure 92. PRC – Number of Fast Food Meals Children Consume (US Children Age 2-17, 2014)


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Figure 93 illustrates the average scores for the physical activity and nutrition related health problems identified during the OVH 2015 Focus Groups. Respondents were asked to rate the extent each community health issue was a problem in the local community on a 5 point scale, where 5=Very Serious Problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem, and 1=Not at all a Problem. Senior nutrition is poor (3.0) and lack of diet and nutrition information (3.0) were identified as Serious Problems. Figure 93. 2015 Focus Groups - Physical Activity and Nutrition Problems

Source: OVH CHNA Community Survey, 2015

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








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


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TOBACCO USE

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

TOBACCO USE

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Figure 94 illustrates the percentage of male adults who report being a former smoker in Pennsylvania and Allegheny County during 2008 through 2014. The percentage of male adults who report being a former smoker in Allegheny County is decreasing for the cluster years 2008 through 2014. Figure 94. Male Adults Who Reported Being a Former Smoker


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Figure 95 illustrates the percentage of adults who report being a current smoker in the United States in 2008-2010 and 2011-2013, as well as Pennsylvania and Allegheny County during the cluster years of 2008-2010, 2011-2013 and 2012-2014. In 2012-2014, the percentage of adults who reported being a current smoker in Allegheny County (21.0%) is equal to Pennsylvania (21.0%), but higher than the Healthy People 2020 Goal of 12.0%. Figure 95. Adults Who Reported Being a Current Smoker


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Figure 96 illustrates the percentage of adults who quit smoking at least one day in the past year for the cluster years 2008-2010, 2011-2013 and 2012-2014 for Pennsylvania and Allegheny County, where data is available. The percentage of adults who quit smoking at least one day in the past year in Allegheny County during 2012-2014 (56.0%) is higher than the state (54.0%) but lower than the Healthy People 2020 Goal (80.0%). Figure 96. Adults Who Quit Smoking at Least One Day in the Past Year


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Figure 97 illustrates the percentage of adults who report being an everyday smoker cluster years 2008-2010, 2011-2013 and 2012-2014 for Pennsylvania and Allegheny County, where data is available. The percentage of adults who reported being an everyday smoker is trending upward from 2008-2014 in Allegheny County. The 2012-2014 percentage for Allegheny County (16.0%) is slightly higher than the state (15.0%). Figure 97. Adults Reported Being an Everyday Smoker


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Figure 98 illustrates the average scores for tobacco use problems identified during the OVH 2015 Focus Groups. Participants were asked to rate the extent each community health issue was a problem in the local community on a 5 point scale, where 5=Very Serious Problem, 4=Serious Problem, 3=Somewhat of a Problem, 2=Small Problem, and 1=Not at all a Problem. Smoking (3.4) was identified as a Serious Problem. Figure 98. 2015 Focus Groups – Tobacco Use Problems


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




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


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


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INTENTIONAL AND UNINTENTIONAL INJURY

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

INTENTIONAL AND UNINTENTIONAL INJURY

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Figure 99 illustrates auto accident mortality rates in the United States in 2010 and 2012, as well as Pennsylvania and Allegheny County from 2008 through 2012, where data is available. The auto accident mortality rate in Allegheny County for the five years reported was significantly lower than the state rates, and lower than the nation and Healthy People 2020 Goal of 12.4. Figure 99. Mortality Rate for Auto Accidents


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Figure 100 illustrates suicide mortality rates in the United States in 2010 and 2012, as well as Pennsylvania and Allegheny County from 2008 through 2012, where data is available. In 2012, the suicide mortality rate in Allegheny County (11.7) had increased from previous years, but was lower than the state (12.1). Allegheny County’s 2012 suicide rate was above the Healthy People 2020 Goal of 10.2. Figure 100. Suicide Mortality Rates


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Figure 101 illustrates the percentage of children in 2014 in the United States injured seriously enough to require medical treatment during the past year. One in ten (10.6%) children in the United States was injured seriously enough to need medical attention during 2014. The national trend decreased from 2012 (11.3%). Children in the Northeast region had a lower percentage (7.1%) when compared to the nation, as well as the other regions. Figure 101. PRC – Children Injured Seriously Enough to Need Medical Treatment, Past Year


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Figure 102 illustrates fall mortality rates in the United States in 2010 and 2012, as well as Pennsylvania and Allegheny County from 2008 through 2012, where data is available. In Allegheny County the fall mortality rate is significantly higher than the PA rate for the years 2008 and 2010-2012 and above the healthy people 2020 goal of 7.2. Figure 102. Fall Mortality Rates


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Figure 103 illustrates firearm mortality rates (accidental, suicide, homicide) in the United States in 2010 and 2012, as well as Pennsylvania and Allegheny County from 2008 through 2012, where data is available. In 2012, the firearm mortality rate in Allegheny County (12.6) was higher when compared to the state (11.0), the nation (10.1) and the Healthy People 2020 Goal (9.3). Figure 103. Firearm Mortality Rates


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








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CONCLUSIONS

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Demographic Conclusions For purposes of this assessment, the community is defined as OVH’s primary service area including Allegheny County in Pennsylvania. The total population in the OVH service area as of the 2010 Census is approximately 128,000 people. Overall, the service region’s population is expected to increase slightly over the next several years. The service area has slightly more females than males, and a sizable portion of the service area (almost half) is between the ages of 25 and 54. The service area is primarily low to middle income; about one-third of the population has incomes less than $35,000. While the majority of the service area population is white, non-Hispanic (84.9%), the area is more ethnically diverse than many parts of Allegheny County. About 7.0% of the regional population has not completed high school, while about a third (33.4%) has a high school diploma or GED, and another quarter (27.7%) has completed some college or obtained an associate degree. There are a number of observations and conclusions that can be derived from the data related to Demographics. They include:

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

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

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

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

• Just under half (44.8%) of the population is married.

CONCLUSIONS

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• One in four (42.2%) have received an Associate Degree or higher educational attainment. A little under one in ten (6.5%) residents have not graduated high school.

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

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

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

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

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








• Focus group participants noted cost of specialists, the need for specialists to communicate with each other, appointment scheduling,

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cost of copays, not knowing what is covered under insurance plan, and larger print on medicine bottles as access problems.



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

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



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





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

• Arthritis • Joint issues • Diabetes • Heart problems • Obesity • Breast cancer

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• COPD • Congestive heart failure • Colon cancer • Melanoma/skin cancer

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

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

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

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

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

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




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


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

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



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







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

problem.

Mental Health and Substance Abuse Conclusions

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




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





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


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




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


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


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








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PRIORITIZATION CRITERIA LISTING

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Prioritization Criteria Listings

As a result of the primary and secondary data analysis, the consulting team identified 46 distinct community needs and issues that demonstrated disparity, negative trend or gap between the local/ regional data and the state, national or healthy people goal and/or that qualitative information suggested that it was a growing need in the community. At their meeting on March 9, 2016, the OVH Steering Committee agreed with the list of potential needs, participated in prioritizing the needs based on the selected criteria and met again on April 11, 2016 to discuss the prioritization results. Table 27 identified the selected criteria. Table 27. Prioritization Criteria

Tables 28-30 below show the prioritization breakdown sorted by total, accountability (hospital role), and magnitude, impact, and capacity.

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Table 28. OVH CHNA Prioritization Survey - Sorted by Total Answer Options

Accountable Role

Magnitude Impact Capacity Total

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

9.23 6.48 6.45 7.90 30.06

Access: Specialty Medical Care 9.17 7.32 8.14 6.14 30.77

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

9.03 7.77 9.10 7.31 33.21

Chronic Disease: Breast Cancer 9.03 6.39 8.21 7.31 30.94

Chronic Disease: Colorectal Cancer 9.03 5.97 8.00 7.17 30.17

Chronic Disease: Diabetes 8.80 7.46 9.03 7.21 32.50

Chronic Disease: Lung Cancer 8.80 6.45 7.90 6.83 29.98

Chronic Disease: Prostate Cancer 8.77 5.97 7.52 7.03 29.29

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

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

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

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

8.29 6.41 7.45 7.00 29.15

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

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

Chronic Disease: Obesity 7.30 8.26 9.24 6.82 31.62

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

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

Access: Affordability of Health Care/Insurance Costs/Copays

6.90 6.96 8.76 5.86 28.48

Infectious Disease: Lyme Disease 6.77 5.32 6.55 6.45 25.09

Access: Community Awareness 6.32 6.11 6.31 7.17 25.91

Infectious Disease: Chlamydia 6.29 4.17 5.45 6.17 22.08

Healthy Mothers, Babies & Children: Tobacco Use During Pregnancy

6.23 6.90 8.17 6.50 27.80

Access: Elder Care Services 6.06 5.69 7.93 6.90 26.58

Healthy Mothers, Babies & Children: Drug Use During Pregnancy

5.83 6.86 8.50 6.28 27.47

Healthy Mothers, Babies & Children: Childhood Obesity

5.74 6.84 8.00 6.28 26.86

Healthy Environment: Allergies 5.39 5.52 6.07 5.52 22.50

Healthy Environment: Asthma 5.24 4.90 6.24 5.61 21.99

Access: Health Literacy 5.03 5.34 6.90 6.86 24.13

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

Tobacco Use: Smoking 4.71 6.79 8.34 5.62 25.46

Mental Health/Substance Abuse: Prescription Drug Misuse/Abuse

4.57 7.97 8.71 5.93 27.18

Access: Emergency Transportation 4.43 5.24 6.90 6.59 23.16

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

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

Mental Health/Substance Abuse: Substance Abuse Rehabilitation

3.87 7.79 8.00 6.07 25.73

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Answer Options Accountable

Role Magnitude Impact Capacity Total

Mental Health/Substance Abuse: Drug Abuse/Mortality

3.80 7.59 8.62 5.96 25.97

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

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

Mental Health/Substance Abuse: Youth Risk Behaviors

3.07 7.31 8.04 6.34 24.76

Injury: Child Abuse 3.06 7.24 7.75 6.38 24.43

Physical Activity/Nutrition: Lack of Physical Activity/Recreation

3.03 6.59 8.14 6.41 24.17

Injury: Sexual Abuse 2.84 6.40 7.62 6.34 23.20

Healthy Environment: Homelessness/Affordable and Adequate Housing

2.35 5.00 7.14 4.72 19.21

Social Environment: Poverty/Lack of Jobs/Unemployment

2.19 6.11 7.79 5.10 21.19

Table 29. OVH CHNA Prioritization Survey Results - Sorted by Accountability (Hospital Role)



Total M + I


9.23 6.48 6.45 7.90 30.06 12.93

Access: Specialty Medical Care 9.17 7.32 8.14 6.14 30.77 15.46


9.03 7.77 9.10 7.31 33.21 16.87

Chronic Disease: Breast Cancer 9.03 6.39 8.21 7.31 30.94 14.60

Chronic Disease: Colorectal Cancer 9.03 5.97 8.00 7.17 30.17 13.97

Chronic Disease: Diabetes 8.80 7.46 9.03 7.21 32.50 16.49

Chronic Disease: Lung Cancer 8.80 6.45 7.90 6.83 29.98 14.35

Chronic Disease: Prostate Cancer 8.77 5.97 7.52 7.03 29.29 13.49

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

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

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


8.29 6.41 7.45 7.00 29.15 13.86

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

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

Chronic Disease: Obesity 7.30 8.26 9.24 6.82 31.62 17.50

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

M+I of 14.0 or greater

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Total M + I

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


6.90 6.96 8.76 5.86 28.48 15.72

Infectious Disease: Lyme Disease 6.77 5.32 6.55 6.45 25.09 11.87

Access: Community Awareness 6.32 6.11 6.31 7.17 25.91 12.42

Infectious Disease: Chlamydia 6.29 4.17 5.45 6.17 22.08 9.62


6.23 6.90 8.17 6.50 27.80 15.07

Access: Elder Care Services 6.06 5.69 7.93 6.90 26.58 13.62


5.83 6.86 8.50 6.28 27.47 15.36


5.74 6.84 8.00 6.28 26.86 14.84

Healthy Environment: Allergies 5.39 5.52 6.07 5.52 22.50 11.59

Healthy Environment: Asthma 5.24 4.90 6.24 5.61 21.99 11.14

Access: Health Literacy 5.03 5.34 6.90 6.86 24.13 12.24

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

Tobacco Use: Smoking 4.71 6.79 8.34 5.62 25.46 15.13


4.57 7.97 8.71 5.93 27.18 16.68

Access: Emergency Transportation 4.43 5.24 6.90 6.59 23.16 12.14

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

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


3.87 7.79 8.00 6.07 25.73 15.79


3.80 7.59 8.62 5.96 25.97 16.21

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

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

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

Injury: Child Abuse 3.06 7.24 7.75 6.38 24.43 14.99


3.03 6.59 8.14 6.41 24.17 14.73

Injury: Sexual Abuse 2.84 6.40 7.62 6.34 23.20 14.02


2.35 5.00 7.14 4.72 19.21 12.14


2.19 6.11 7.79 5.10 21.19 13.90

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Table 30. OVH CHNA Prioritization Survey Results - Sorted by Magnitude + Impact + Capacity

hospital role rating 8.0 or higher


Role Magnitude Impact Capacity Total Total M, I, C

Chronic Disease: Obesity 7.30 8.26 9.24 6.82 31.62 24.32


9.03 7.77 9.10 7.31 33.21 24.18

Chronic Disease: Diabetes 8.80 7.46 9.03 7.21 32.50 23.70


4.57 7.97 8.71 5.93 27.18 22.61

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


3.80 7.59 8.62 5.96 25.97 22.17

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

Chronic Disease: Breast Cancer 9.03 6.39 8.21 7.31 30.94 21.91


3.87 7.79 8.00 6.07 25.73 21.86

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

Mental Health/Substance Abuse: Youth Risk Behaviors

3.07 7.31 8.04 6.34 24.76 21.69


5.83 6.86 8.50 6.28 27.47 21.64

Access: Specialty Medical Care 9.17 7.32 8.14 6.14 30.77 21.60


6.90 6.96 8.76 5.86 28.48 21.58


6.23 6.90 8.17 6.50 27.80 21.57

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

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

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

Injury: Child Abuse 3.06 7.24 7.75 6.38 24.43 21.37

Chronic Disease: Lung Cancer 8.80 6.45 7.90 6.83 29.98 21.18

Chronic Disease: Colorectal Cancer 9.03 5.97 8.00 7.17 30.17 21.14


3.03 6.59 8.14 6.41 24.17 21.14

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


5.74 6.84 8.00 6.28 26.86 21.12


8.29 6.41 7.45 7.00 29.15 20.86

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


9.23 6.48 6.45 7.90 30.06 20.83

Tobacco Use: Smoking 4.71 6.79 8.34 5.62 25.46 20.75

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Role Magnitude Impact Capacity Total Total M, I, C

Access: Elder Care Services 6.06 5.69 7.93 6.90 26.58 20.52

Chronic Disease: Prostate Cancer 8.77 5.97 7.52 7.03 29.29 20.52

Injury: Sexual Abuse 2.84 6.40 7.62 6.34 23.20 20.36

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

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

Access: Community Awareness 6.32 6.11 6.31 7.17 25.91 19.59

Access: Health Literacy 5.03 5.34 6.90 6.86 24.13 19.10


2.19 6.11 7.79 5.10 21.19 19.00

Access: Emergency Transportation 4.43 5.24 6.90 6.59 23.16 18.73

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

Infectious Disease: Lyme Disease 6.77 5.32 6.55 6.45 25.09 18.32

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

Healthy Environment: Allergies 5.39 5.52 6.07 5.52 22.50 17.11


2.35 5.00 7.14 4.72 19.21 16.86

Healthy Environment: Asthma 5.24 4.90 6.24 5.61 21.99 16.75

Infectious Disease: Chlamydia 6.29 4.17 5.45 6.17 22.08 15.79

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Table 31 shows top ten needs comparison by total ranking, magnitude/impact/capacity ranking and by accountability (hospital role) ranking. Table 31. OVH CHNA Prioritization Survey Results – Top Ten Needs Comparison By Total Ranking, Magnitude/Impact/Capacity, and Accountability

Answer Option Total Ranking

M+I+C Ranking

Hospital Ranking

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

Chronic Disease: Diabetes 2 2 5

Chronic Disease: Obesity 3

Chronic Disease: Breast Cancer 4 3 3

Access: Specialty Medical Care 5 5 1

Chronic Disease: Colorectal Cancer 6 10 4

Access: Access to Primary Care Services 7 7 8

Chronic Disease: COPD/Chronic Bronchitis 8 6 9

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

Chronic Disease: Lung Cancer 10 9 6

Access: Access to Mental Services 11 4

Access: Confidential Women's Health Services 12 8

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

Chronic Disease: Prostate Cancer 13 13 7

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

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

* Using Hospital Accounta- bility at 8.00 or higher

* Using M+I at 14.00 or higher

Members of the OVH Steering Committee met on April 11, 2016 to review the final priorities. Using the methodology of looking at the four prioritization criteria of (i) accountable role of the hospital, (ii) magnitude of the problem, (iii) impact on other health outcomes and (iv) capacity (systems and resources) to implement evidence-based solutions, along with the rank order of the final priorities selected by the OVH Steering Committee, the following nine priorities are considered the most significant. Refer to Table

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27 on page 241 for a more in-depth description of the four prioritization criteria.

1. Chronic Disease: Diabetes 2. Chronic Disease: Cardiovascular Disease (Heart Disease, Cholesterol,

etc.) 3. Chronic Disease: Overweight/Obesity 4. Access to Quality Health Services: Knowledge of all Services in the

Area 5. Access to Quality Health Services: Primary Care Services 6. Access to Quality Health Services: Transportation for Self/

Healthcare Workers 7. Mental Health/Substance Abuse: Mental Health 8. Physical Activity/Nutrition: Eating Habits/Access to Healthy Foods 9. Tobacco Use: Smoking

The above significant needs will be addressed in OVH’s Implementation Strategy which will be published under separate cover and accessible to the public after November 15, 2016.

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Appendix A

Stakeholder Interview Guide

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

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

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

1.

2.

3.

Others mentioned:

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

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

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

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

is implementing this community health assessment process?

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Appendix B

Focus Group Interview Guide

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Community Health Assessment

Focus Group Topic Guide Draft

[Insert Date]

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I. Introduction

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

II. Overall Community Health Status

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

B. Why do you say that?

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

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

E. Why do you say that?

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

G. Why do you say that?

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

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

B. Why do you say that?

C. What are some of the other problems that are impacting the health

of the community? (BUILD LIST INTO OPTIONFINDER).

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

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

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

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

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

D. Why do you say that?

IV. Potential Solutions

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

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

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

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

this community assessment?

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Appendix C

Focus Group Intercept Survey

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1. How would you rate your personal health? Would you say it is Excellent, Very Good, Good, Fair or Poor?

a. Why do you say that?

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

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

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

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

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

ohio valley hospital community health needs …...project. this group deserves special recognition...

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