1

Schenectady CountyPrevention Agenda Prioritization Workgroup

2

Priority Area Prevent Chronic Diseases

Focus Area 1 Healthy Eating and Food Security

Focus Area 2 Physical Activity

Focus Area 3 Tobacco Prevention

Focus Area 4 Preventive Care and Management

Priority Area Promote a Healthy and Safe Environment

Focus Area 1 Injuries, Violence and Occupational Health

Focus Area 2 Outdoor Air Quality

Focus Area 3 Built and Indoor Environments

Focus Area 4 Water Quality

Focus Area 5 Food and Consumer Products

Priority Area Promote Healthy Women, Infants and Children

Focus Area 1 Maternal & Women’s Health

Focus Area 2 Perinatal & Infant Health

Focus Area 3 Child & Adolescent Health

Focus Area 4 Cross Cutting Healthy Women, Infants, & Children

Priority Area Promote Well-Being and Prevent Mental and Substance Use Disorders

Focus Area 1 Promote Well-Being

Focus Area 2 Prevent Mental and Substance Use Disorders

Priority Area Prevent Communicable Diseases

Focus Area 1 Vaccine-Preventable Diseases

Focus Area 2 Human Immunodeficiency Virus

Focus Area 3 Sexually Transmitted Infections

Focus Area 4 Hepatitis C Virus

Focus Area 5 Antibiotic Resistance and Healthcare-Associated Infections

NYS Prevention Agenda 2019-2024 Focus Areas

3

Prevent Chronic Diseases• Asthma (6)• Respiratory Diseases (17)• Diabetes (27)• Obesity (37)• Kidney Disease (45)• Cardiovascular Disease (52)

Promote Healthy Women, Infants and Children• Poor Birth Outcomes (78)• Prenatal Care (85)

Promote Mental Health and Substance Abuse• Mental Diseases and Suicide (90)• Substance Abuse (105)• Alcohol Use (114)

Prevent Infectious Disease• HIV/STDs (68)• Lyme Disease (75)

Selected Public Health Issues

4Ranking Categories

Indicator

DISPARITY

ABSOLUTE NUMBER

INDICATOR WEIGHTS

SIZE

SERIOUSNESS

TREND

5

Health Issue Score RankMental Health 3.20 1Kidney Disease 2.90 2Assault 2.70 3Stroke 2.50 4Lyme Disease 2.50 4Asthma 2.40 6Suicide 2.40 6Diabetes 2.17 8Drug Use 2.13 9Sexually Transmitted Disease 2.07 10Maternal and Infant 1.93 11Alcohol Use 1.80 12Prenatal Care 1.75 13Smoking 1.70 14Congestive Heart Failure 1.70 14Coronary Heart Disease 1.67 16COPD/CLRD 1.60 17Breast Cancer 1.38 18Unintended Pregnancy 1.38 19Obesity 1.34 20Childhood Lead Poisoning 1.31 21Newborn Drug 1.25 22HIV/AIDS 1.20 23Well Child Visits 0.67 24Food 0.33 25Housing 0.33 25Colorectal Cancer 0.28 27Falls -0.20 28Immunization -0.39 29Breastfeeding -0.67 30

Raw Results: Schenectady Public Health Issue Ranking

6

Asthma in Schenectady

7

The Effect of Asthma on the Population

Schenectady Capital Region

Current Number of Adults with Asthma (2016) 13,381 96,173

Number of ED Visits per year (2016) 876 3,973

Number of ED Visits (0-4 yrs.) per year (2016) 112 438

Number of Hospitalizations per year (2016) 76 451

Chronic Disease – Asthma

8

Asthma Indicators as Compared to the Capital Region and New York State (excl. NYC)

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Age-adjusted percentage of adults with current asthma (2016) 11.2% 3rd 12.9% 10.4%

Age-adjusted Asthma ED Visits/10,000 (2016) 56.7 4th 41.4 42.0

Asthma ED Visits ages 0-4/ 10,000 (2016) 122.6 4th 88.4 105.8

Age-adjusted Asthma Hospitalizations/10,000 (2016) 5.4 3rd 5.1 6.7

Chronic Disease – Asthma

9

Asthma ED Visit Rate per 10,000 Population, 2016

Prevention Agenda 2018 Objective: 75.1

Asthma ED Visit Rate per 10,000–Aged 0-4 Years, 2016

Prevention Agenda 2018 Objective: 196.5

Chronic Disease – Asthma

10

Age-adjusted Percent of Adults with Current Asthma for NYS (excl. NYC), Capital Region, and Schenectady County

2008-09 2013-14 2016

Schenectady 13.4 10.0 11.2

Capital Region NA 11.7 12.9

NYS excl. NYC 10.1 10.5 10.4

Chronic Disease – Asthma

11

2007 2008 2009 2010 2011 2012 2013 2014 2016Schenectady 11.6 12.9 12.3 10.4 10.5 8.9 7.5 7.8 5.4NYS, excl. NYC 11.4 12 13.4 11.5 11.5 11.1 10.1 10.3 6.7

0

2

4

6

8

10

12

14

16

Age-Adjusted Asthma Hospitalization Rate per 10,000 Population, NYS excl. NYC, Schenectady County, 2007-2014 and 2016

Chronic Disease – Asthma

12

2007 2008 2009 2010 2011 2012 2013 2014 2016Schenectady 67.1 73.3 79.9 72.9 81.5 80.4 74.8 74.5 56.7NYS, excl. NYC 52.4 53 57.4 52.4 53.6 52.6 51.1 49.1 42

0

10

20

30

40

50

60

70

80

90

Age-Adjusted Asthma ED Visit Rate per 10,000 Population, NYS excl. NYC, Schenectady County, 2007-2014 and 2016

Chronic Disease – Asthma

13

EQUITY

Adjusted Asthma Hospitalizations and ED Visits per 10,000 by Age, 2016Schenectady Capital Region NYS excl. NYC

Hospitalizations0-17 years 8.6 7.4 12.918-64 years 4.6 4.4 4.565+ years s 2.7 4.4ED Visits0-17 years 80.6 58.2 65.118-64 years 57.1 43.7 41.065+ years 23.4 13.2 16.1

Chronic Disease – Asthma

14

Adjusted Asthma Hospitalizations and ED Visits per 10,000 by Gender, 2014-2016

Schenectady Capital Region

Hospitalizations

Male 19.8 19.4

Female 24.4 23.4

ED Visits

Male 61.0 43.9

Female 63.3 50.3

Chronic Disease – AsthmaEQUITY

15

Adjusted Asthma Hospitalizations and ED Visits per 10,000 by Race/Ethnicity, 2016

Schenectady Capital RegionHospitalizationsWhite non-Hispanic 20.7 19.7Black non-Hispanic 39.9 43.4Hispanic 17.0 18.1ED VisitsWhite non-Hispanic 47.3 31.6Black non-Hispanic 153.6 168.0Hispanic 92.9 70.9

Chronic Disease – AsthmaEQUITY

16

Neighborhood ED Visit Rate

Goose Hill/Union 111.9Hamilton Hill 229.3Mt. Pleasant 67.3Niskayuna 24.5Rotterdam 53.0Rural West 23.4

Scotia-Glenville 27.9Stockade 146.9

Upper State St 97.4Schenectady County 72.3

Chronic Disease – Asthma

17

Respiratory Disease in Schenectady

18Chronic Disease – Smoking & COPD/CLRD

The Effect of Respiratory Disease on the Population

Schenectady Capital Region

Number of Current Smokers (2016) 20,716 119,161

Number of COPD/CLRD Hospitalizations per year (2016) 427 2,633

Number of COPD/CLRD Deaths per year (2016) 84 534

Number of Lung Cancer cases per year (2011-15 avg.) 136 na

Number of Lung Cancer deaths per year (2011-15 avg.) 84 na

19

Respiratory Disease Indicators Compared to the Capital Region and New York State (excl. NYC)

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Adjusted % Cigarette Smoking among Adults (2016) 19.9 3rd 17.5 17.0 Adjusted Lung Cancer Incidence/100,000 (2011-2015) 69.4 -- na 67.2

Adjusted Lung Cancer Mortality/100,000 (2011-2015) 43.2 -- na 43.3

Adjusted COPD/CLRD Hospitalizations/10,000 (2014-2016) 24.4 3rd 27.6 23.7

Adjusted COPD/CLRD Mortality /100,000 (2013-2015) 39.7 -- 40.1 35.0

Chronic Disease – Smoking & COPD/CLRD

20

Percentage of Cigarette Smoking Among Adults, 2016

Prevention Agenda 2018 Objective: 12.3

Chronic Disease – Smoking & COPD/CLRD

21

Adjusted Percent of Adults Who are Current Smokers for NYS (excl. NYC), Capital Region, Schenectady County; 2003, 2008-09, 2013-14, 2016

2003 2008-09 2013-14 2016

Schenectady 22.8 17.0 17.7 19.9

Capital Region NA NA 19.7 17.5

NYS excl. NYC 22.1 18.9 18.0 17.0

Chronic Disease – Smoking & COPD/CLRD

22

2007-09 2008-10 2009-11 2010-12 2011-13 2012-14 2013-15Schenectady 50.5 54 54.7 50.9 45.4 44.5 44.1NYS, excl. NYC 47.1 45.6 44.4 43.9 43.1 40.2 39.5

0

10

20

30

40

50

60

Age-Adjusted Lung Cancer Mortality Rate per 100,000 Population, NYS excl. NYC, Schenectady County, 2007-2015

Chronic Disease – Smoking & COPD/CLRD

23

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 35.5 32.2 29.5 30.2 26.9 26.1 27.6 24.9 25.2 23.6NYS, excl. NYC 28.2 31.4 33.3 30.6 30.7 28.8 26.4 30.8 28.8 27.3

0

5

10

15

20

25

30

35

40

Age-Adjusted CLRD Hospitalization Rate per 10,000 Population, NYS excl. NYC, Schenectady County, 2007-2016

Chronic Disease – Smoking & COPD/CLRD

24

Adjusted Lung Cancer Incidence per 100,000 by Gender, 2011-2015Schenectady NYC excl. NYC

Male 78.1 74.5

Female 63.5 62.2

Adjusted COPD/CLRD Hospitalizations per 10,000 by Gender, 2014-16Schenectady NYC excl. NYC

Male 22.3 19.5

Female 26.4 24.6

Chronic Disease – Smoking & COPD/CLRDEQUITY

25

Adjusted COPD/CLRD Hospitalizations and Mortality by Race/Ethnicity, Age 18+

Schenectady Capital Region

Hospitalizations / 10,000 (2014-2016)

White non-Hispanic 22.8 20.2

Black non-Hispanic 36.5 44.5

Hispanic 15.1 17.3

Mortality / 100,000 (2013-2015)

White non-Hispanic 40.8 41.0

Black non-Hispanic 32.8 29.8

Hispanic 26.6 24.2

Chronic Disease – Smoking & COPD/CLRDEQUITY

26

NeighborhoodHospitalization

RateGoose Hill/Union 39.1

Hamilton Hill 60.4Mt. Pleasant 22.9Niskayuna 10.6Rotterdam 24.6Rural West 10.1

Scotia-Glenville 17.0Stockade 67.0

Upper State St 28.3Schenectady County 25.3

Chronic Disease – Smoking & COPD/CLRD

27

Diabetes in Schenectady

28

The Effect of Diabetes on the Population

Schenectady Capital Region

Current Number of Adults with Diabetes (2016) 12,026 64,920

Number of Diabetes Hospitalizations per year (primary dx) (2016) 228 1,323

Number of Diabetes Hospitalizations per year (any dx) (2016) 4,090 22,465

Number of Diabetes Short Term ComplicationHospitalizations per year – 18+ years (2016) 63 353

Number of Diabetes Deaths per year (2015) 37 190

Chronic Disease – Diabetes

29

Diabetes Indicators as Compared to the Capital Region and New York State (excl. NYC)

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Adjusted % of Adults with Diabetes (2014) 9.0 3rd 7.6 8.5

Adjusted Diabetes (primary dx) Hospitalizations/10,000 (2014-2016) 12.5 3rd 11.1 12.6

Adjusted Diabetes Mortality/100,000 (2013-2015) 18.3 -- 15.4 15.3

Hospitalizations for Short-Term Complications of Diabetes/10,000 – Ages 18+ years (2016) 5.2 3rd 4.6 4.1

Chronic Disease – Diabetes

30

Rate of hospitalization for short-term complications of diabetes per 10,000 –Aged 18+ years, 2016

Prevention Agenda 2018 Objective: 4.86

Chronic Disease – Diabetes

31

Adjusted Percent of Adults Ever Diagnosed with Diabetes NYS (excl. NYC), Capital Region, and Schenectady County

2003 2008-09 2013-14 2016

Schenectady 6.1 9.4 7.8 9.0

Capital Region NA NA 8.7 7.6

NYS excl. NYC 7.2 8.5 8.9 8.5

Chronic Disease – Diabetes

32

2007 2008 2009 2010 2011 2012 2013 2014 2015Schenectady 17.1 15.7 19.9 18.3 15.7 24.3 16.2 21.1 17.7NYS, excl. NYC 16.6 15.1 15.3 14.2 15.9 15.6 15.4 14.9 14.6

0

5

10

15

20

25

30

Age-Adjusted Diabetes Mortality Rate per 100,000 Population, NYS excl. NYC, Schenectady County, 2007-2015

Chronic Disease – Diabetes

33

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 5.1 6 5.7 6 7.6 7.9 11.4 6.7 6.5 5.2NYS, excl. NYC 4.5 4.7 4.8 5.1 5.4 5.7 6.1 6 5.5 4.1

0

2

4

6

8

10

12

Adjusted Diabetes Short-Term Complications Hospitalization Rate per 10,000 Aged 18+ Years, NYS excl. NYC, Schenectady County, 2007-2016

Chronic Disease – Diabetes

34

Age-Adjusted Diabetes Hospitalizations (primary dx) per 10,000 by Gender, 2014-2016Schenectady Capital Region

Male 16.5 13.2

Female 8.7 9.2

Age-Adjusted Diabetes Mortality per 10,000 by Gender, 2013-15Schenectady Capital Region

Male 26.9 21.3

Female 10.8 10.7

Chronic Disease – DiabetesEQUITY

35

Age - Adjusted Diabetes (primary dx) Hospitalizations per 10,000 by Race/Ethnicity, 2014-2016

Schenectady Capital Region

White non-Hispanic 10.1 9.4Black non-Hispanic 30.1 31.2Hispanic 10.0 10.1

Age-Adjusted Diabetes Mortality per 100,000 by Race/Ethnicity, 2013-2015Schenectady Capital Region

White non-Hispanic 15.5 14.4Black non-Hispanic 36.8 31.1Hispanic 31.8 21.3

Chronic Disease – DiabetesEQUITY

36

NeighborhoodHospitalization

RateGoose Hill/Union 8.6

Hamilton Hill 24.4Mt. Pleasant 9.7Niskayuna 2.7Rotterdam 7.7Rural West 2.5

Scotia-Glenville 4.3Stockade 19.9

Upper State St 6.8Schenectady County 7.5

Chronic Disease – Diabetes

37

Obesity in Schenectady

38

The Effect of Obesity on the Population, 2016

Schenectady Capital Region

Number of Obese Adults 30,744 191,462

Number of Obese Children and Adolescents 4,725 24,411

Number of Obese Children (2-4 years) in WIC 171 820

Number of Adults not engaged in Leisure Time Physical Activity in past 30 days 30,034 167,787

Chronic Disease – Obesity

39

Obesity Indicators as Compared to the Capital Region and New York State (excl. NYC)

Schenectady Capital Region

NYS excl.NYC

Value Quartile Value Value

Age-Adjusted percentage of adults who are obese (30+ BMI) (2016) 28.5 -- 27.1 27.5

% of Children and Adolescents who are Obese (2015-2016) 18.8 -- 16.7 17.3

% WIC Children (2-4 years) who are obese (2017) 15.6 3rd 15.2 11.9 (NYS)

Age-Adjusted percentage of adults not engaged in some type of leisure time physical activity in the last 30 days (2016)

24.1 -- 25.0 26.0

Chronic Disease – Obesity

40

Percentage of Adults Who Are Obese, 2016

Prevention Agenda 2018 Objective: 23.2

Chronic Disease – Obesity

41

Age-Adjusted Percent of Obese Adults for New York State (excl. NYC), Capital Region, Schenectady County; 2008-09, 2013-14, 2016

2003 2008-2009 2013-2014 2016

Schenectady County 22.9 31.4 32.8 28.5

Capital Region NA NA 27.8 27.1

NYS excl. NYC 20.8 24.2 27.0 27.5

Chronic Disease – Obesity

42

Percent of Children and Adolescents who are Obese for New York State (excl. NYC), Capital Region, Schenectady County; 2010-12, 2012-14, 2015-16

2010 – 2012 2012 – 2014 2014 – 2016

Schenectady County 19.5 18.8 18.8

Capital Region NA 17.2 16.7

NYS excl. NYC 17.6 17.3 17.3

Chronic Disease – Obesity

43

Age - Adjusted Percent of Adults engaged in some type of leisure time physical activity for New York State (excl. NYC), Capital Region, Schenectady; 2008-09,

2013-14, 20162003 2008-2009 2013-2014 2016

Schenectady County 80.1 79.5 77.7 75.9

Capital Region NA NA 76.6 75.0

NYS excl. NYC 77.6 78.9 73.8 74.0

Chronic Disease – Obesity

44

Percentage of Students Who Are Obese, By Capital Region School District and Quartile, 2014-2016

Chronic Disease – Obesity

45

Kidney Disease in Schenectady

46

The Effect of Kidney Disease on the PopulationSchenectady Capital Region

Number of Kidney Disease (any dx) Hospitalizations per year (2016) 3,414 20,033

Number of Kidney Disease ED Deaths per year (2016) 33 175

Kidney Disease Indicators Compared to the Capital Region and New York State (excl. NYC)

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Adjusted Kidney Disease (any dx) Hospitalizations / 10,000 (2014-2016) 167.3 4th 153.0 146.4

Adjusted Kidney Disease Mortality / 100,000 (2013-2015) 14.7 4th 12.6 11.3

Chronic Disease – Kidney Disease

47

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 117.3 129.1 154.3 143.2 161.7 153 161.2 158.3 168.5 175.3NYS, excl. NYC 108.1 119 127.5 132.5 141.2 136.8 136.5 137.1 145.4 156.6

0

20

40

60

80

100

120

140

160

180

200

Age-Adjusted Kidney Disease Hospitalization Rate (any diagnosis) per 10,000 Population, NYS excl. NYC, Schenectady County, 2007-2016

Chronic Disease – Kidney Disease

48

2007-09 2008-10 2009-11 2010-12 2011-13 2012-14 2013-15Schenectady 14.7 14.9 13.3 13.9 12.1 14.7 13.1NYS, excl. NYC 13.9 14 14 12.9 12.1 11.6 11.3

0

2

4

6

8

10

12

14

16

Age-Adjusted Kidney Disease Mortality Rate per 100,000 Population, NYS excl. NYC, Schenectady County, 2007-2015

Chronic Disease – Kidney Disease

49

Adjusted Kidney Disease Hospitalization Rate per 10,000 by Gender, 2014-2016

Schenectady Capital Region

Male 210.0 182.3

Female 127.6 130.7

Adjusted Kidney Disease Mortality Rate per 100,000 by Gender, 2013-2015Schenectady Capital Region

Male 17.0 17.0

Female 13.2 9.7

Chronic Disease – Kidney DiseaseEQUITY

50

Adjusted Kidney Disease Hospitalization Rate (any diagnosis) per 10,000 by Race/Ethnicity, 2014-2016

Schenectady Capital RegionWhite non-Hispanic 147.6 139.2Black non-Hispanic 317.3 343.7Hispanic 106.9 95.0

Adjusted Kidney Disease Mortality Rate per 100,000 by Race/Ethnicity, 2013-2015

Schenectady Capital RegionWhite non-Hispanic 13.6 11.7Black non-Hispanic 27.3 29.6Hispanic 0.0 6.9

Chronic Disease – Kidney DiseaseEQUITY

51

NeighborhoodHospitalization

RateGoose Hill/Union 211.0

Hamilton Hill 345.7Mt. Pleasant 163.8Niskayuna 107.5Rotterdam 156.6Rural West 113.2

Scotia-Glenville 113.3Stockade 296.1

Upper State St 191.2Schenectady County 163.3

Chronic Disease – Kidney Disease

52

Cardiovascular Disease in Schenectady

53

The Effect of Heart Disease on the PopulationSchenectady Capital Region

Number of Heart Attack Hospitalizations per year (2016) 350 1,773

Number of Heart attack Deaths per year (2015) 63 283

Number of CHD Hospitalizations per year (2016) 544 2,881

Number of CHD Deaths per year (2015) 273 1,447

Number of CHF Hospitalizations per year (2016) 440 2,257

Number of CHF Deaths per year (2015) 89 212

Number of Stroke Hospitalizations per year (2016) 495 3,017

Number of Stroke Deaths per year (2015) 54 361

Chronic Disease – Cardiovascular Disease

54

Heart Disease Indicators Compared to the Capital Region and New York State (excl. NYC)

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Adjusted Heart Attack Hospitalization/10,000 18.0 3rd 14.5 14.8Adjusted Heart Attack Mortality/100,000 (2013-15) 25.2 -- 23.2 32.3Adjusted Coronary Heart Disease Hospitalization/10,000 25.8 3rd 21.8 26.5Adjusted Coronary Heart Disease Mortality/100,000

(2013-15)123.

1 -- 112.7 124.3

Adjusted Congestive Heart Failure Hospitalization/10,000 21.6 3rd 18.8 21.4Adjusted Congestive Heart Failure Mortality/100,000

(2013-15) 19.9 4th 17.4 16.9

Adjusted Stroke Hospitalization/10,000 27.0 4th 21.3 23.1Adjusted Stroke Mortality/100,000 (2013-15) 31.2 3rd 27.6 28.6

Chronic Disease – Cardiovascular Disease

55

Age-Adjusted Heart Attack Hospitalization Rate per 10,000 Population, 2016

Prevention Agenda 2018 Objective: 14

Chronic Disease – Cardiovascular Disease

56

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 43.2 35.3 32.6 27.9 31.9 28.9 27.9 23.9 25.4 28.1NYS, excl. NYC 50.4 48 43.5 39.8 35.9 32.4 29.4 26.5 25.5 27.5

0

10

20

30

40

50

60

Age-Adjusted Coronary Heart Disease Hospitalization Rate per 10,000 Population, NYS excl. NYC, Schenectady, 2007-2016

Chronic Disease – Cardiovascular Disease

57

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 27.2 30.4 28.5 26.4 28.3 24.3 23.6 21.6 21.5 21.7NYS, excl. NYC 28.8 27.8 27.1 25.8 24.2 23 22.9 22 22.5 19.6

0

5

10

15

20

25

30

35

Age-Adjusted Congestive Heart Failure Hospitalization Rate per 10,000 Population, NYS excl. NYC, Schenectady County, 2007-2016

Chronic Disease – Cardiovascular Disease

58

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 33.6 27.8 23.1 24.3 25.7 24.3 22.3 23.3 26.09 31.6NYS, excl. NYC 26.4 25.5 25.5 25 24.5 23.7 22.6 22.1 22.4 24.7

0

5

10

15

20

25

30

35

40

Age-Adjusted Cerebrovascular Hospitalization Rate per 10,000 Population, NYS excl. NYC, Schenectady County, 2007-2016

Chronic Disease – Cardiovascular Disease

59

Adjusted CHD Hospitalization Rate per 10,000 by Gender, 2014-2016

Schenectady Capital Region

Male 34.6 36.6

Female 18.2 17.7

Adjusted CHD Mortality Rate per 100,000 by Gender, 2013-2015

Schenectady Capital Region

Male 160.4 154.3

Female 90.8 93.3

Chronic Disease – Cardiovascular DiseaseEQUITY

60

Adjusted CHF Hospitalization Rate per 10,000 by Gender, 2014-2016

Schenectady Capital Region

Male 25.2 25.8

Female 18.6 17.8

Adjusted CHF Mortality Rate per 100,000 by Gender, 2013-2015

Schenectady Capital Region

Male 22.6 20.0

Female 17.3 14.5

Chronic Disease – Cardiovascular DiseaseEQUITY

61

Adjusted Stroke Hospitalization Rate per 10,000 by Gender, 2014-2016

Schenectady Capital Region

Male 29.5 23.8

Female 25.2 19.3

Adjusted Stroke Mortality Rate per 100,000 by Gender, 2013-2015

Schenectady Capital Region

Male 31.9 27.5

Female 30.6 27.0

Chronic Disease – Cardiovascular DiseaseEQUITY

62

Adjusted Coronary Heart Disease Hospitalizations per 10,000 by Race / Ethnicity, 2014-2016

Schenectady Capital RegionWhite non-Hispanic 24.0 24.6Black non-Hispanic 30.5 28.8Hispanic 15.0 23.4

Adjusted Coronary Heart Disease Mortality per 100,000 by Race/Ethnicity, 2013-2015

Schenectady Capital RegionWhite non-Hispanic 118.3 120.6Black non-Hispanic 149.9 140.9Hispanic 105.0 81.8

Chronic Disease – Cardiovascular DiseaseEQUITY

63

Adjusted Congestive Heart Failure Hospitalizations per 10,000 by Race/Ethnicity, 2014-2016

Schenectady Capital RegionWhite non-Hispanic 19.4 21.0Black non-Hispanic 40.8 40.7Hispanic 24.0 34.5

Adjusted Congestive Heart Failure Mortality per 100,000 by Race/Ethnicity, 2013-2015

Schenectady Capital RegionWhite non-Hispanic 19.7 17.1Black non-Hispanic 13.1* 15.2Hispanic 17.2* 9.0*Fewer than 10 events in numerator; rate is unstable

Chronic Disease – Cardiovascular DiseaseEQUITY

64

Adjusted Stroke Hospitalizations per 10,000 by Race/Ethnicity, 2014-2016Schenectady Capital Region

White non-Hispanic 25.4 20.0

Black non-Hispanic 38.4 33.1

Hispanic 16.6 12.1

Adjusted Stroke Mortality per 100,000 by Race/Ethnicity, 2013-2015Schenectady Capital Region

White non-Hispanic 31.3 27.3

Black non-Hispanic 21.2 26.2

Hispanic 18.0* 22.9*Fewer than 10 events in numerator; rate is unstable

Chronic Disease – Cardiovascular DiseaseEQUITY

65

NeighborhoodHospitalization

RateGoose Hill/Union 21.5

Hamilton Hill 24.1Mt. Pleasant 16.8Niskayuna 11.9Rotterdam 14.5Rural West 14.9

Scotia-Glenville 14.0Stockade 26.6

Upper State St 19.0Schenectady County 17.5

Chronic Disease – Cardiovascular Disease

66

NeighborhoodHospitalization

RateGoose Hill/Union 31.5

Hamilton Hill 38.9Mt. Pleasant 22.2Niskayuna 12.6Rotterdam 24.0Rural West 16.0

Scotia-Glenville 16.4Stockade 29.4

Upper State St 25.8Schenectady County 22.5

Chronic Disease – Cardiovascular Disease

67

NeighborhoodHospitalization

RateGoose Hill/Union 28.1

Hamilton Hill 36.7Mt. Pleasant 24.3Niskayuna 19.3Rotterdam 21.8Rural West 20.2

Scotia-Glenville 21.2Stockade 37.1

Upper State St 26.4Schenectady County 25.5

Chronic Disease – Cardiovascular Disease

68

Sexually Transmitted Diseases in Schenectady

69

The Effect of STDs on the Population, 2016

Schenectady Capital Region

Number of Gonorrhea cases per year Females 15-44 Years 123 412

Number of Gonorrhea cases per Males 15-44 Years 95 368

Number of Chlamydia cases per year, ages 15-44 (female) 1,943 2,699

Primary and Secondary Syphilis in Males 5 68

Number of HIV cases per year 11 59

Number of AIDS deaths per year (2015) 1 12

Infectious Disease – STDs

70

STD Indicators per 100,000,and Risk Quartile Compared to Capital Region and NYS excl. NYC., 2016

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Gonorrhea cases rate Female 15-44 years 418.5 4th 223.8 197.1

Gonorrhea cases rate Male 15-44 years 321.0 4th 236.5 230.0Chlamydia cases rate Female 15-44 years 1,943.0 4th 1,466.1 1,351.6

Primary and Secondary Syphilis in Males 6.6 3rd 14.4 9.1

HIV Cases Rate 6.9 3rd 6.1 6.9

Age-adjusted AIDS Mortality (2013-15) 0.7 3rd 1.1 1.0

Infectious Disease – STDs

71

Gonorrhea Case Rate per 100,000 Women – Aged 15-44 Years, 2016

Prevention Agenda 2018 Objective: 183.4

Gonorrhea Case Rate per 100,000 Men– Aged 15-44 Years, 2016

Prevention Agenda 2018 Objective: 199.5

Infectious Disease – STDs

72

Newly Diagnosed HIV Case Rate per 100,000 Population, 2014-2016

Prevention Agenda 2018 Objective: 16.1

Infectious Disease – STDs

73

2013 2014 2015 2016 2017Schenectady 90.9 83.0 107.2 157.8 207.7NYS excl. NYC 57.5 58.8 77.5 89.1 94.8

0

50

100

150

200

250

Gonorrhea Case Rate per 100,000 Population, Schenectady and NYS, excl. NYC, 2013-2017

Infectious Disease – STDs

74

2013 2014 2015 2016 2017Schenectady 454.5 500.9 506.6 537.5 566.1NYS excl. NYC 337.6 354.4 363 380.6 408.9

0

100

200

300

400

500

600

Chlamydia Case Rate per 100,000 Population, Schenectady and NYS, excl. NYC, 2013-2017

Infectious Disease – STDs

75

Lyme Disease in Schenectady

76

Lyme Disease Indicators as Compared to the Capital Region and New York State (excl. NYC), 2017

Schenectady Capital Region NYS excl.NYC

Number Rate Quartile Number Rate Rate

Lyme Disease Case Rate per 100,000 115 74.4 3rd 27.1 241.0 77.8

Infectious Disease – Lyme Disease

77

2013 2014 2015 2016 2017Schenectady 36.7 33.5 75.8 75.7 74.4NYS excl. NYC 60.9 51.9 65.1 58.7 77.8

0

10

20

30

40

50

60

70

80

90

Lyme Disease Case Rate per 100,000 Population, Schenectady and NYS, excl. NYC, 2013-2017

Infectious Disease – Lyme Disease

78

Poor Birth Outcomes in Schenectady

79

The Effect of Poor Birth Outcomes on the Population, 2016Schenectady Capital Region

Number of Premature Births 156 879Number of Low Birthweight Births 159 750Number of Infant Deaths per 1,000 Live Births 12 50

Poor Birth Outcomes Compared to the Capital Region and New York State (excl. NYC), 2016

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Percent of Premature Births 9.6 - 9.9 10.5Percent of Low Birthweight Births 9.4 4th 7.8 7.7Infant Mortality Rate per 1,000 Live Births 7.1 4th 5.2 5.1

Women, Infants & Children–Poor Birth Outcome

80

Percentage of Preterm Birth, 2016

Prevention Agenda 2018 Objective: 10.2

Women, Infants & Children–Poor Birth Outcome

81

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 13 9.9 10.6 12 11.6 11.5 10.4 10.4 11.5 9.6NYS excl. NYC 11.9 11.5 11.5 11.1 11 10.9 10.9 10.8 10.6 10.5

0

2

4

6

8

10

12

14

Percent of Premature Births (<37 weeks gestation), NYS excl. NYC, Schenectady County, 2007-2016

Women, Infants & Children–Poor Birth Outcome

82

Percent of Premature Births by Race/Ethnicity, 2014-2016Schenectady Capital Region

White non-Hispanic 9.5 9.5

Black non-Hispanic 14.9 14.9

Hispanic 11.3 11.7

Percent of Premature Births by Medicaid Status, 2014-2016Schenectady Capital Region

Percent of Mothers with Medicaid 11.4 10.7

Percent of Mothers without Medicaid 10.1 10.0

Women, Infants & Children–Poor Birth OutcomeEQUITY

83

Percent of Low Birthweight Births by Race/Ethnicity, 2012-2014

Schenectady Capital Region

White non-Hispanic 7.3 6.8

Black non-Hispanic 10.8 12.8

Hispanic 7.1 7.3

Women, Infants & Children–Poor Birth OutcomeEQUITY

84

NeighborhoodPercent of Total

Births

Goose Hill/Union 14.6

Hamilton Hill 11.1

Mt. Pleasant 11.9

Niskayuna 9.8

Rotterdam 7.9

Rural West 9.8

Scotia-Glenville 6.9

Stockade 9.1

Upper State St 11.6

Schenectady County 10.3

Women, Infants & Children–Poor Birth Outcome

85

Prenatal Care in Schenectady

86

The Effect of Prenatal Care on the Population, 2016Schenectady Capital Region

Number of births without early (1st trimester) prenatal care (PNC) per year 393 2,200

Number of births with late or no (3rd trimester) PNC per year 97 445

Number of births without adequate PNC (Kotelchuck) per year (2013-15 avg.) 394 2,514

Women, Infants & Children – Prenatal Care

87

Prenatal Care Compared to the Capital Region and New York State (excl. NYC), 2016

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Number of births without early PNC per year 76.8 -- 77.0 76.9Number of births with late or no PNC per year 5.7 3rd 4.7 4.3

Number of births without adequate PNC per year (2013-15 avg.) 76.2 -- 72.7 70.2

Women, Infants & Children – Prenatal Care

88

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 5.4 5.6 5.3 3.6 4.3 3.9 4 3.5 4.7 5.7NYS excl. NYC 4.3 4.4 4.3 4.3 4.1 4.1 4.2 4.1 4 4.3

0

1

2

3

4

5

6

Percent of Births with Late (3rd Trimester) or No Prenatal Care, NYS excl. NYC, Schenectady County, 2007-2016

Women, Infants & Children – Prenatal Care

89

Percent of Early Prenatal Care by Race/Ethnicity, 2016Schenectady Capital Region

White non-Hispanic 80.0 82.3

Black non-Hispanic 73.8 69.6

Hispanic 77.3 72.9

Percent of Late or No Prenatal Care by Race/Ethnicity, 2016Schenectady Capital Region

White non-Hispanic 4.6 3.2Black non-Hispanic 8.6 8.1Hispanic 6.1 5.7

Women, Infants & Children – Prenatal CareEQUITY

90

Mental Diseases and Suicide in Schenectady

91

Effect of Mental Health Diseases and Disorders on the Population

Schenectady Capital Region

Number of Adults with Poor Mental Health for 14+ days in Last Month (2016) 17,375 84,522

Number of Mental Disease and Disorder ED Visits per Year (2016) 3.739 17,045

Number of Mental Disease and Disorder Hospitalizations per year (2016) 1,926 8,829

Number of Self-inflicted Injury Hospitalizations per Year (2016) 20 164

Number of Suicide Deaths per year (2014-16 avg.) 19 129

Mental Health– Mental Diseases and Suicide

92

Mental Disease and Disorders Indicators Compared to the Capital Region and New York State (excl. NYC)

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Percent of Adults with Poor Mental Health Days for 14 or More Days in the Last Month (2016)

14.9 4th 11.5 11.2

Age-Adjusted Mental Disease and Disorders ED Visit Rate / 10,000 (2014-2016) 235.8 4th 162.0 147.8

Age-Adjusted Mental Disease and Disorders Hospitalization Rate / 10,000 (2014-2016) 97.0 4th 67.9 64.1

Age-Adjusted Suicide Mortality Rate per 100,000 (2014-2016) 11.7 3rd 11.1 9.6

Age-Adjusted Self-inflicted Injury Hospitalizations per 10,000 (2014-2016) 8.0 4th 5.3 4.4

Mental Health– Mental Diseases and Suicide

93

Age-Adjusted Percentage of Adults with Poor Mental Health for 14 or More Days in the Last Month, 2016

Prevention Agenda 2018 Objective: 10.1

Mental Health– Mental Diseases and Suicide

94

Age- Adjusted Suicide Death Rate per 100,000 Population, 2014-2016

Prevention Agenda 2018 Objective: 5.9

Mental Health– Mental Diseases and Suicide

95

Adjusted Percentage of Adults with 14+ Poor Mental Health Days in Past Month, New York State (excl. NYC), Schenectady County and Capital Region;

2003, 2008-09, 2013-14, 20162003 2008-2009 2013-2014 2016

Schenectady County N/A 9.6 11.2 14.9

Capital Region N/A N/A 13.5 11.5

NYS (excl. NYC) 9.4 10.9 11.8 11.2

Mental Health– Mental Diseases and Suicide

96

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 171.5 181.7 193.4 208.2 234.5 216.8 205.3 224.2 236.7 247.1NYS excl. NYC 103.1 108.7 112.5 119.6 123.9 130.4 128.7 132.1 148.7 162.6

0

50

100

150

200

250

300

Age-Adjusted Mental Disease and Disorder ED Visits per 10,000 Population, NYS excl. NYC, Schenectady County, 2007-2016

Mental Health– Mental Diseases and Suicide

97

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Schenectady 99.7 100.8 118.6 118.6 114 100.8 99.7 78.4 86.6 126.2NYS excl. NYC 54.5 55.7 56 56.6 58.2 56.4 53.1 51.4 57.8 82.2

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20

40

60

80

100

120

140

Age-Adjusted Mental Disease and Hospitalization Rate per 10,000 Population, NYS excl. NYC, Schenectady County, 2007-2016

Mental Health– Mental Diseases and Suicide

98

2007-2009 2008-2010 2009-2011 2010-2012 2011-2013 2012-2014 2013-2015 2014-2016Schenectady 8.5 7.4 11.3 11.6 12.6 11.5 10.6 11.7NYS excl. NYC 7.7 8.1 8.7 9.5 9.7 9.2 9.1 9.6

0

2

4

6

8

10

12

14

Age-Adjusted Suicide Mortality per 100,000 Population, NYS excl. NYC, Schenectady County, 2007-2016

Mental Health– Mental Diseases and Suicide

99

Age-Adjusted Mental Disease and Disorder (primary dx) Hospitalizations per 10,000 by Gender, 2014-2016

Schenectady Capital RegionMale 103.6 55.8Female 90.7 53.9

Age-Adjusted Mental Disease and Disorder (primary dx) ED Visits per 10,000 by Gender, 2014-2016

Schenectady Capital RegionMale 258.3 150.6Female 214.6 129.4

Mental Health– Mental Diseases and SuicideEQUITY

100

Age-Adjusted Suicide Mortality per 100,000 by Gender, 2013-2015

Schenectady Capital Region

Male 16.5 16.9

Female 5.2 4.8

Self- Inflicted Injury Hospitalizations per 10,000 by Gender, 2014-2016

Male 6.1 5.8

Female 9.8 9.1

Mental Health– Mental Diseases and SuicideEQUITY

101

Age - Adjusted Mental Disease and Disorder (primary dx) ED Visits per 10,000 by Race/Ethnicity, 2014-2016

Schenectady Capital Region

White non-Hispanic 217.1 129.4Black non-Hispanic 355.1 245.6Hispanic 185.8 116.2

Age - Adjusted Mental Disease and Disorder (primary dx) Hospitalizations per 10,000 by Race/Ethnicity, 2014-2016

Schenectady Capital Region

White non-Hispanic 89.0 52.1Black non-Hispanic 152.0 87.3Hispanic 83.9 42.3

Mental Health– Mental Diseases and SuicideEQUITY

102

Age-Adjusted Self-Inflicted Injury Hospitalizations per 10,000 by Race/Ethnicity, 2014-2016

Schenectady Capital RegionWhite non-Hispanic 7.3 7.4Black non-Hispanic 12.1 8.3Hispanic 6.7 4.5

Age-Adjusted Suicide Mortality per 100,000 by Race/Ethnicity, 2013-2015

Schenectady Capital Region

White non-Hispanic 11.8 11.6

Black non-Hispanic 6.4 6.6

Hispanic 2.7 3.6

Mental Health– Mental Diseases and SuicideEQUITY

103

NeighborhoodHospitalization

RateGoose Hill/Union 146.0

Hamilton Hill 248.6Mt. Pleasant 72.2Niskayuna 51.6Rotterdam 80.7Rural West 45.5

Scotia-Glenville 59.9Stockade 313.8

Upper State St 110.8Schenectady County 98.4

Mental Health– Mental Diseases and Suicide

104

Neighborhood Mortality Rate

Goose Hill/Union 21.2Hamilton Hill 13.0Mt. Pleasant 11.7Niskayuna 6.5Rotterdam 17.3Rural West 17.4

Scotia-Glenville 9.2Stockade 11.5

Upper State St 9.7Schenectady County 11.6

Mental Health– Mental Diseases and Suicide

105

Substance Abuse in Schenectady

106

The Effect of Substance Abuse on the Population

Schenectady Capital Region

Number of Drug Abuse ED Visits (2016) 1,641 8,873

Number of Drug Abuse Hospitalizations (2016) 736 3,889

Number of Opioid Overdose ED visits (2015 - 2017) 108 446

Number of Opioid Overdose Hospitalizations (2015 -2017) 27 102

Number of Opioid Overdose Deaths (2015 - 2017) 21 91

Mental Health– Substance Abuse

107

Substance Abuse Indicators Compared to the Capital Region and New York State (excl. NYC)

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Adjusted Drug Abuse ED Visits (2014-2016) 99.5 4th 76.8 68.5Adjusted Drug Abuse Hospitalizations (2014-2016) 36.2 4th 29.5 28.7Adjusted Opioid Overdose ED Visit rate/100,000 (2015 - 2017) 69.7 4th 46.4 54.0

Adjusted Opioid Overdose Hospitalization rate/100,000 (2015 - 2017) 17.4 4th 10.6 16.7

Adjusted Opioid Overdose Mortality Rate/ 100,000 (2015 - 2017) 13.6 3rd 9.5 13.8

Mental Health– Substance Abuse

108

2010 11 2012 2013 2014 2015 2016 2017Schenectady 18.1 15.5 15.5 24.5 36 54.3 77.6 78.3NYS, excl. NYC 13.2 15.8 18 25 30.2 41 59.4 62.7

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40

50

60

70

80

90

Age-Adjusted Opioid Overdose ED Visits per 100,000 Population, NYS excl. NYC, Schenectady County, 2010-2017

Mental Health– Substance Abuse

109

2010 2011 2012 2013 2014 2015 2016 2017Schenectady 9.7 11.6 10.3 17.4 10.9 18.8 16.2 16.8NYS, excl. NYC 14.3 16.1 16.2 16.9 17.3 16.7 16.8 17.1

0

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14

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18

20

Age-Adjusted Opioid Overdose Hospitalizations per 100,000 Population, NYS excl. NYC, Schenectady County, 2010-2017

Mental Health– Substance Abuse

110

2010 2011 2012 2013 2014 2015 2016 2017Schenectady 1.3 3.2 3.2 7.1 3.2 7.8 18.8 20.1NYS, excl. NYC 5.2 7.4 7.6 9.8 10.2 13.5 17.7 17.8

0

5

10

15

20

25

Age-Adjusted Opioid Overdose Mortality Rate per 100,000 Population, NYS excl. NYC, Schenectady County, 2010-2017

Mental Health– Substance Abuse

111

Age Adjusted Opioid Overdose ED Visits and Hospitalizations by Gender per 100,000Schenectady Capital Region

ED Visits, 2014-2016

Male 71.7 46.8

Female 33.5 25.1

Hospitalizations, 2014-2016

Male 13.0 10.5

Female 11.1 7.8

Mental Health– Substance AbuseEQUITY

112

Age Adjusted Opioid Overdose ED Visits, Hospitalizations by Race/Ethnicity per 100,000, 2014-2016

Schenectady Capital Region

ED Visits

White non-Hispanic 59.1 31.7Black non-Hispanic 50.4 26.0Hispanic 42.5 20.4

Hospitalizations

White non-Hispanic 13.7 9.8Black non-Hispanic 9.1 6.5Hispanic 10.0 8.1

Mental Health– Substance AbuseEQUITY

113

Neighborhood ED Visit Rate

Goose Hill/Union 52.9Hamilton Hill 91.3Mt. Pleasant 24.5Niskayuna 30.3Rotterdam 40.0Rural West 42.8

Scotia-Glenville 36.2Stockade 50.3

Upper State St 42.0Schenectady County 39.8

Mental Health– Substance Abuse

114

Alcohol Use in Schenectady

115

The Effect of Alcohol Abuse on the Population, 2016

Schenectady Capital Region

Number of Adults Who Binge Drank During the Past Month 19,021 122,086

Number of Alcohol Related Motor Vehicle Injuries and Deaths per Year 45 428

Number of Cirrhosis Hospitalizations per Year 139 821Number of Cirrhosis Deaths per Year 19 99

Mental Health– Alcohol Use

116

Alcohol Abuse Indicators Compared to the Capital Region and New York State (excl. NYC), 2016

Schenectady Capital Region

NYS excl. NYC

Value Quartile Value Value

Age-adjusted percentage of adult binge drinking during the past month (2016) 18.3 -- 18.1 19.1

Alcohol related motor vehicle injuries and deaths/100,000 (2013-15) 32.0 -- 43.8 39.9

Adjusted cirrhosis hospitalization rate/10,000 (2014-16) 1.3 -- 1.3 1.7

Adjusted cirrhosis mortality rate/100,000 (2013-15) 8.6 3rd 9.1 7.2

Mental Health– Alcohol Use

117

Age-Adjusted Percentage of Adults Binge Drinking During the Past Month, 2016

Prevention Agenda 2018 Objective: 18.4

Mental Health– Alcohol Use

118

Adjusted Percentage of Adults who were Binge Drinkers for New York State (excl. NYC), Schenectady and Capital Region; 2003, 2008-09, 2013-14, 2016

2003 2008-2009 2013-2014 2016

Schenectady County 12.3 19.8 16.1 18.3

Capital Region N/A N/A 18.3 18.1

NYS excl. NYC 15.2 19.8 17.4 19.1

Mental Health– Alcohol Use

119

2007 2008 2009 2010 2011 2012 2013 2014 2015Schenectady 49.7 52.2 63.7 42 38.7 38.7 35.4 31.5 29.1NYS excl. NYC 54.7 52 51.7 46.2 45.3 45.6 41.9 39.7 38

0

10

20

30

40

50

60

70

Alcohol-Related Motor Vehicle Injury and Death Rate per 10,000 Population, NYS excl. NYC and Schenectady County, 2007-2015

Mental Health– Alcohol Use

120

2007-2009 2008-2010 2009-2011 2010-2012 2011-2013 2012-2014 2013-2015Schenectady 10.1 7.9 7.8 8.3 7.8 8.1 8.6NYS excl. NYC 6.5 6.6 6.8 7.1 7.2 7.2 7.1

0

2

4

6

8

10

12

Age-Adjusted Cirrhosis Mortality Rate per 100,000 Population, NYS excl. NYC and Schenectady County, 2007-2015

Mental Health– Alcohol Use

121

Neighborhood Mortality Rate

Goose Hill/Union 16.2Hamilton Hill 11.2Mt. Pleasant 6.4Niskayuna 3.1Rotterdam 11.1Rural West 9.6

Scotia-Glenville 5.5Stockade 24.5

Upper State St 6.9Schenectady County 8.2

Mental Health– Alcohol Use

6