university of utah health hospitals and clinics community
TRANSCRIPT
University of Utah Health Hospitals and Clinics
COMMUNITY HEALTH NEEDS ASSESSMENT
2
Table of Contents
1 EXECUTIVE NOTES Letter from CEO Gordon CrabtreeLife Expectancy at BirthPopulation Count and Race/Ethnicity Table by County, Utah and US
34 5 6
2 ABOUT UNIVERSITY OF UTAH HEALTH Mission, Vision, Values
78
3 COMMUNITY NEED AND COMMUNITY BENEFIT Multiple approaches to address health and wellbeing
910
4 202 1 CHNA ASSESSMENT BACKGROUNDProcess planning, governance and collaborationCommunity InputHealth IndicatorsPriority SelectionDefining Hospital Community
1112 13 14 15 16
5 IMPLEMENTATION GOALS Goal 1 Diabetes and ObesityGoal 2 Mental Health and SuicideGoal 3 Reducing Prescription Drug Misuse, Abuse, and OverdoseGoal 4 Racism and InequalityStatewide Reach
1718 23 26 29 34
6 SUMMARY Letter from RyLee Curtis and Steve Eliason
3536
EXECUTIVE NOTES
4
FROM THE CEO
What makes up a community?Is it the homes that make up neighborhoods, and the families that reside within them? Or the schools, non-profits, businesses, and places of worship that help build culture? Is it the diversity of the people?
I believe a community is made up of the bonds that tie all of these together. Never has it been more apparent what makes up a community than during the COVID-19 pandemic. We have seen communities come together not only to distribute masks to families in need, but to sew 5 million masks for their neighbors, and for health care workers. We’ve seen community leaders translate complicated health messages into several languages. Religious leaders encouraging their congregants to follow recommended health guidelines to keep their members safe.
As CEO of University of Utah Health Hospitals and Clinics, I am moved by the outpouring of our community’s gratitude for our frontline health care workers. At the end of the day, each and every one of our 12,000+ employees does what they do for the health and well-being of our community. They do this for you.
In the pages that follow, you will read about our strategies to address pressing community needs. Some strategies will improve internal processes to best serve community members who may become our patients. Others will highlight areas where we can work with community outside the hospital’s four walls and provide outreach, education, and the expertise of our care teams.
Thank you,
Gordon Crabtree, CPA, MBAChief Executive OfficerUniversity of Utah Health, Hospitals and Clinics
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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LIFE EXPECTANCY AT BIRTH BY LOCAL HEALTH DISTRICT, 2014-2018 AND U.S. 2017
Local Health District
Life Expectancy
at Birth (years)
Small Area Lowest Life Expectancy
Small Area Highest Life Expectancy
Difference Based on Zip Code
Davis County LHD
80.5 Clearfield/Hooper at 77
Kaysville/Fruit Heights & North Salt Lake at 82.3
5.3 years
Salt Lake County LHD
79.5 South Salt Lake at 73.7
Salt Lake City (Avenues) at 85.8
12.1 years
Tooele County LHD
78.2 Tooele Valley at 78.1
Tooele County (Other) at 78.8
0.7 years
Utah County LHD
80.4 Orem (North) at 77.1
Provo/BYU at 83.1
6 years
Weber-Morgan LHD
78.2 Ogden (Downtown) at 75
Weber County (East) at 81.6
6.6 years
UTAH 79.8Nation 78.6
THE DATA
Source: Public Health Indicator Based Information System (IBIS) Complete Health Indicator Report of Life Expectancy at Birth
Source: Public Health Indicator Based Information System (IBIS) Complete Health Indicator Report of Life Expectancy at Birth
Source: Public Health Indicator Based Information System (IBIS) Complete Health Indicator Report of Life Expectancy at Birth
78.280.5
78.2
79.5
80.4
DAVIS
SALTLAKE
UTAH
WEBER
MORGA
N
TOOELE
78.2
78.2
80.4
DAVIS
SALTLAKE
UTAH
WEBER
MORGA
N
TOOELE 79.5
80.5
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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Source: U.S. Census Bureau QuickFacts: 2019
AREA DEMOGRAPHICS
County Population Count
Davis County 355,481
Salt Lake County 1,160,437
Tooele County 72,259
Utah County 636,235
Weber County 260,213
UTAH 3,205,958Nation 328,239,523
THE DATA
RACE/ETHNICITY POPULATION AS PERCENT OF COUNTY
County White Alone
Black or African
American Alone
American Indian and
Alaska Native Alone
Asian Alone
Native Hawaiian
and Other Pacific
Islander Alone
Two or More
Races
Hispanic or Latino
White alone, not
Hispanic or Latino
Davis County
92% 1% 1% 2% 1% 3% 10% 83%
Salt Lake County
87% 2% 1% 5% 2% 3% 19% 70%
Tooele County
94% 1% 1% 1% 1% 2% 13% 83%
Utah County
93% 1% 1% 2% 1% 3% 12% 82%
Weber County
92% 2% 1% 2% 0% 3% 19% 76%
UTAH 91% 2% 2% 3% 1% 3% 14% 78%Nation 76% 13% 1% 6% 0% 3% 19% 60%
Source: U.S. Census Bureau QuickFacts: 2019
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
ABOUT UNIVERSITY OF UTAH HEALTH
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University of Utah Health, which includes Academics as well as Hospitals and Clinics, serves the people of Utah and beyond by continually improving individual and community health and quality of life. This is achieved through excellence in patient care, education, and research; each is vital to our mission and each makes the others stronger.• We provide compassionate care without compromise.• We educate scientists and health care professionals for the future.• We engage in research to advance knowledge and well-being.
CompassionCollaborationInnovation
ResponsibilityDiversityIntegrity
Quality Trust
A patient-focused Health Sciences Center distinguished by collaboration, excellence, leadership, and respect.
Our Mission
Our VisionOur Values
UNIVERSITY OF UTAH HEALTH
U of U Health is the Mountain West's only academic health care system, combining excellence in patient care, the latest in medical research, and teaching to provide leading-edge medicine in a caring and personal setting. The system provides care for Utahns and residents of five surrounding states in a referral area encompassing more than 10 percent of the continental United States.
Whether it's for routine care or highly specialized treatment in orthopedics, stroke, ophthalmology, cancer, radiology, fertility, cardiology, genetic-related diseases, organ transplant, or more than 200 other medical specialties, U of U Health offers the latest technology and advancements, including some services available nowhere else in the region.
As part of that system, U of U Health Hospitals and Clinics is staffed by more than 5,000 practicing clinicians, including 1,700 physicians who support five hospitals:• University Hospital,• Huntsman Cancer Institute,• Neilsen Rehabilitation Hospital,• University Orthopaedic Center, and• Huntsman Mental Health Institute (HMHI) previously known as University
Neuropsychiatric Institute (UNI).
U of U Health Hospitals and Clinics also has 12 community clinics, nine urgent care locations, and several specialty centers, which include:• Cardiovascular Center,• Clinical Neurosciences Center,• John A. Moran Eye Center,• University Orthopaedic Center, and• Utah Diabetes Center.
U of U Health Hospitals and Clinics physicians also provide all the pediatric care at the Primary Children’s Hospital on campus, which is a joint venture with Intermountain Healthcare.
Consistently ranked #1 in quality in the nation among academic medical centers, our academic partners at University of Utah Health include the School of Medicine and Dentistry, and Colleges of Nursing, Pharmacy, and Health, which are internationally regarded research and teaching institutions.
Our health care system is integrated with University of Utah Health Plans which serves over 200,000 members through the administration of medical, mental health, and pharmacy benefits for self-funded employer groups as well as government programs including Medicare and Medicaid.
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
&COMMUNITY NEED& COMMUNITY BENEFIT
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment10
Approaches to identifying and addressing the health and wellbeing needs of our community
University of Utah Health uses multiple approaches to identify and address the health and wellbeing needs of our immediate and regional communities.
• U of U Health supports patients in need through thedirect provision of charity care and through debtwrite-offs for those unable to complete payment dueto hardship.
• In the 2019 fiscal year, U of U Health provided over$190.6 million in uncompensated care, which includeshospitals and clinics and the School of Medicine.
• U of U Health provides direct service to residents withspecial health needs and to those living in under-served communities through education efforts,telemedicine and outreach clinics, free screenings,and direct patient care through partnerships withmultiple community agencies.
The Patient Protection and Affordable Care Act (ACA), signed into law in March 2010, requires each nonprofit hospital to conduct a Community Health Needs Assessment (CHNA) every three years. After identifying and prioritizing unmet needs, each hospital is required to develop a three-year implementation strategy to address one or more identified community health needs. This report documents the process through which U of U Health conducted the CHNA, the key findings, the identified priorities, and the implementation strategies; this document will also be posted online, fulfilling the requirement to make the CHNA results available to the public.
THE COMMUNITY
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Process planning, governance and collaborationThe CHNA process was led by U of U Health Hospitals and Clinics leadership and staff, and was done in partnership with the Utah CHNA Collaboration. This collaboration has representatives from:
• Bear River Health Department
• Beaver Valley and Milford Hospitals
• Blue Mountain Hospital
• Central Utah Public Health Department
• Comagine Health
• Davis Behavioral Health
• Davis County Health Department
• Get Healthy Utah
• Intermountain Healthcare
• Kem C. Gardner Policy Institute
• MountainStar Healthcare
• Salt Lake County Health Department
• San Juan Health Department
• Shriner’s Hospital for Children
• Southeast Health Department
• Southwest Health Department
• Summit County Health Department
• Tooele County Health Department
• TriCounty Health Department
• Uintah Basin Healthcare
• University of Utah Health
• Utah County Health Department
• Utah Department of Health
• Utah Health Information Network
• Utah Hospital Association
• Wasatch County Health Department
• Weber Human Services
• Weber-Morgan Health Department
By partnering with the Utah CHNA Collaboration, we are better able to access community health data; reduce duplication of efforts; share expertise and resources in order to accomplish required tasks; and increase our ability to effect change by identifying areas of overlap and of opportunities to work together.
THE BACKGROUND
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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Community InputMEETINGSThe Utah CHNA Collaboration hosted 20 different community input meetings throughout 2018 and 2019, where attendees were invited to share their perspectives on the health needs of their community. Topics included chronic disease, air quality, mental health, and substance use.
Invitees included representatives from the following groups:
• Food pantries
• Groups representing underrepresentedpopulations
• Health advocacy organizations
• Health care providers
• Human service agencies
• Law enforcement
• Local businesses
• Local government
• Low-income, uninsured, and underservedpopulations
• Mental health service providers
• Safety net clinics
• School districts
• State and local health departments
ONLINE SURVEYAn online survey was sent to those who could not attend the community input meeting in person, which encouraged more representative feedback. Not all the people who received the invitation or follow-up survey responded to the request. Transcripts of each meeting and the survey results were reviewed to identify themes.
Overarching themes included:
• Chronic diseases associated with unhealthy weightand behaviors;
• Mental health and suicide;
• Air quality;
• Immunizations;
• Affordable housing;
• Substance use; and
• Social determinants of health and health equity.
THE BACKGROUND
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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Health IndicatorsFor our CHNA, we used the Utah CHNA Collaboration’s approved list of health indicators, which includes over 100 health indicators and accompanying data sets. After identifying common themes from all of the community input meetings, we narrowed down the health indicator list by identified themes to provide a profile for each of the five identified communities.
HEALTH INDICATORS USED TO BUILD COMMUNITY HEALTH PROFILES INCLUDE:
Demographics:• Population Count by County• Race/Ethnicity Population as Percent of County
Reducing Obesity & Obesity-Related Chronic Conditions (Carryover from previous CHNA)• Percentage of Adolescents who were Obese by Local Health District; Grades 8, 10, 12 (2019)• Adult Obesity by Local Health District, Utah 2018• Fruit Consumed Two or More Times per Day by Local Health District 2017• Vegetables Consumed Three or More Times per Day by Local Health District 2015 and 2017• Food Insecurity, Limited Access to Healthy Food• SNAP Data by Local Health District• Senior Meals Data by County• Diabetes as an Underlying Cause of Death by Local Health District (2015-2018)• Coronary Heart Disease Deaths by Local Health District 2017-2018
Improving Mental Health and Reducing Suicide (Carryover from previous CHNA)• Suicide by Local Health District• SHARPS Self-Reported Suicide Indicators and Self Harm Data; Grades 6, 8, 10, 12 (2019)• SHARPS Self-Reported Depression Data; Grades 6, 8, 10, 12 (2019)• Estimated Utah Adults with Serious Mental Illness 2018• Seven or More Days of Poor Mental Health in the Past 30 Days 2018
Reducing Prescription Drug Misuse, Abuse and Overdose (Carryover from previous CHNA)• Naloxone Doses Distributed in Utah by Distribution Program 2016-2019• Opioid Deaths by Drug Category 2013-2018• Opioid-Related Emergency Department Visits per 10,000 Population 2016-2018• Opioid Prescriptions Dispensed per 1,000 Population 2014-2018• Drug Death By Local Health District 2016-2018• Drug Deaths by Local Health District Involving Opioids 2019
Reducing Inequities Caused by Social, Economic, and Structural Determinants of Health (NEW)• Poverty Rate by Race/Ethnicity by County, 5 Year Average 2013-2017• Education Attainment by County 2014-2018• Insurance, Median Household Income, and Poverty Percentage by Local Health District• Unemployment Rate by County in 2019• Number of Small Areas by Health Improvement Index Scores• Percent Racial/Ethnic Minorities in Small Areas with HII Score of “High” and “Very High”
THE BACKGROUND
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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Priority SelectionPriorities for U of U Health’s Hospitals and Clinics CHNA were determined after:• analyzing the aforementioned data;• reflecting on feedback from the Utah CHNA Collaboration;• reviewing qualitative themes from the community input meetings and surveys conducted in Salt Lake, Davis, Utah,
Tooele, and Weber counties;• reviewing the availability of known and effective interventions;• determining which areas were un-addressed or under-addressed;• and by considering which objectives synergized with other U of U Health initiatives including U of U Health’s
Strategy Refresh and U of U Health’s Value Roadmap.
Three-year plans have been outlined and implementation teams identified for each of the priorities which include:• Addressing diabetes, and reducing obesity and obesity-related chronic conditions;• Improving mental health and reducing suicide;• Reducing prescription drug misuse, abuse, and overdose; and• Addressing racism to reduce inequities caused by social, economic, and structural determinants of health.
Three of the four priorities are carried over from our previous CHNA.• These three issues (obesity and obesity-related chronic conditions, mental health and suicide, and prescription drug
misuse and abuse) were still top concerns for our community members.• You can find the impact assessment of U of U Health Hospital and Clinics' strategies to address these areas over the
last three years in the 2018-2020 Implementation Plan & Completion Report.• We will adjust our strategies based on the data in this report, and further deepen our work in these areas over the
next three years.
THE BACKGROUND
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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Defining the Hospital CommunityU of U Health Hospitals and Clinics provides care for Utahns and residents of five surrounding states in a referral area encompassing more than 10 percent of the continental United States. Due to our location in the heart of Salt Lake City, and after a review of the geographic origins of the hospital’s discharges in fiscal years 2017-2019, we have chosen to focus on five counties in Utah as our target communities for the Community Health Needs Assessment—Salt Lake, Davis, Utah, Tooele, and Weber—which make up 78% of Utah’s total population.
County U of U Health Population
Salt Lake County 63%
Davis County 10%
Utah County 6%
Tooele County 5%
Weber County 4%
THE BACKGROUND
CHNA TARGET COMMUNITIESSalt Lake County: With just over 1.1 million residents, Salt Lake County is Utah’s most populous and home to 36% of the state’s population. Its most populated cities are Salt Lake City and West Valley City with populations of 204,383 and 137,658, respectively. Salt Lake City has a 32% Ethnic/Racial minority population and West Valley City has a 51% Ethnic/Racial minority population. Salt Lake City is home to the University of Utah.
Utah County: Utah County’s population of 636,235 makes it Utah’s second most populated county, with 20% of the state’s residents. The most populated cities in Utah County are Provo and Orem, which are home to 123,027 and 98,040 residents, respectively. Provo has a 25.2% Ethnic/Racial minority population and Orem has a 23.1% Ethnic/Racial minority population. Provo is home to Brigham Young University.
Davis County: At 355,481, the population of Davis County makes up 11% of Utah’s population. Layton/South Weber and Clearfield Area/Hooper are the most populated cities in Davis County which are home to 83,944 and 72,508 residents, respectively. Layton/South Weber have a 20.1% Ethnic/Racial minority population and Clearfield Area/Hooper have a 22.0% Ethnic/Racial minority population.
Weber County: Weber County is home to 260,213 residents, making up 8% of the state’s population. Ogden and Ben Lomand are the most populated cities in Weber County which are home to 77,669 and 62,407 residents, respectively. Ogden has a 29.1% Ethnic/Racial minority population and Ben Lomand has a 28.9% Ethnic/Racial minority population. Weber County is home to Weber State University.
Tooele County: Tooele County’s population of 72,259 makes up 2% of Utah’s population. Tooele has a 17.4% Ethnic/Racial minority population.
Source: Tableau
Source: Tableau
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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IMPLEMENTATION GOALS
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IMPLEMENTATION GOAL
STRATEGIES & INITIATIVES
Strengthen and support community-focused programs for addressing obesity & diabetes prevention• Increase the number of encounters between
community members and The Wellness Bus by 5%each year for the next 3 years
• Increase participation in both the Crush Diabetesand the Team Thrive childhood diabetes preventionprograms by 5% each year for the next 3 years
• Increase the reach of evidence-based programs forindividuals with obesity in underserved populations
• Create an obesity & diabetes prevention, education,and outreach taskforce to coordinate efforts to reachout to and learn from underrepresented populations
Improve access to healthy food• Research and create a food pharmacy that could be
piloted in a minimum of two U of U Health clinics• Increase participation in the Food Movement and You
program by 5% each year for the next 3 years
Increase screenings, referrals, and treatment for obesity and diabetes programs• Increase the number of patients that can access care
through Utah Diabetes and Endocrinology center• Increase the number of patients who participate in
the Intensive Diabetes Education And Support (IDEAS)program
• Increase the number of patients who participate in aComprehensive Weight Management Program
Encourage our 12,000+ Hospital & Clinic employees to participate in employee health and wellness programs• Implement a diabetes initiative to help our employees
and their families prevent and manage diabetes• Encourage participation in programs available to
employees
Addressing Diabetes and Reducing Obesity and Obesity-Related Chronic Conditions
Addressing obesity and diabetes were elements included in U of U Health’s Strategy Refresh. We have committed as a system to continue to advocate for clear, science-supported policy recommendations on public health needs related to obesity and diabetes. We will continue advancing work to successfully manage obesity-related chronic conditions in longitudinal, value-based payment care programs. Leveraging our integrated health system we will continue working alongside our partners and patients with chronic conditions to better coordinate their care and expand health coaching to more patients with chronic conditions.
Below are specific strategies and initiatives related to diabetes, obesity and obesity-related chronic conditions which University of Utah Hospitals and Clinics commits to as part of the Community Health Needs Assessment process and will work towards over the next three years.
University of Utah and University of Utah Health have come together as a community with renewed vision and the human talent needed for our institutions to navigate an increasingly complex and dynamic landscape. This process allowed our systems to refresh their strategies and address Utah’s growing and changing demographics, adapt to 21st-century workforce needs, enhance lifelong education opportunities, and find new ways to leverage unique strengths of University of Utah. The Strategy Refresh summarizes the great work ahead, starting now and continuing through 2025. The CHNA is a complimentary document and allows for alignment between community needs and Strategy Refresh Priorities.
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Community ProfileArea Diabetes, Obesity and Obesity-Related Chronic Conditions Information:
Source: Public Health Indicator Based Information System (IBIS)Complete Health Indicator Report of Daily Vegetable Consumption
VEGETABLES CONSUMED THREE OR MORE TIMES PER DAY BY LOCAL HEALTH DISTRICT, UTAH, 2018
Local Health District Age-Adjusted Percentage of
Adults 18+
Davis County LHD 14%
Salt Lake County LHD 15.30%
Tooele County LHD 11.80%
Utah County LHD 17.80%
Weber-Morgan LHD 15.50%
UTAH 15.30%Source: Public Health Indicator Based Information System (IBIS)
Complete Health Indicator Report of Daily Fruit Consumption
FRUIT CONSUMED TWO OR MORE TIMES PER DAY BY LOCAL HEALTH DISTRICT, UTAH, 2017
Local Health District Age-Adjusted Percentage of
Adults 18+
Davis County LHD 37.00%
Salt Lake County LHD 33.50%
Tooele County LHD 27.60%
Utah County LHD 39.40%
Weber-Morgan LHD 32.50%
UTAH 34.70%
Source: Public Health Indicator Based Information System (IBIS) Complete Health Indicator Report of Obesity Among
Children and Adolescents
OBESE ADOLESCENTS BY LOCAL HEALTH DISTRICT, GRADES 8, 10, AND 12, UTAH, 2019
Local Health District Percentage of Adolescents
Davis County LHD 8.50%
Salt Lake County LHD 11.10%
Tooele County LHD 12.20%
Utah County LHD 8.60%
Weber-Morgan LHD 12.10%
UTAH 9.80%Source: Public Health Indicator Based Information System (IBIS)
Complete Health Indicator Report of Obesity Among Adults
ADULT OBESITY BY LOCAL HEALTH DISTRICT, UTAH, 2018
Local Health District Percentage of Adolescents
Davis County LHD 26.30%
Salt Lake County LHD 28.40%
Tooele County LHD 43.00%
Utah County LHD 28.50%
Weber-Morgan LHD 30.30%
UTAH 28.40%
“So if you're a low income individual, you cannot afford to eat healthy. [You] just can't.
And [our] cooking skills, that is something that we have lost in this community. I mean
we can have great produce and great healthy items in the pantry, and nobody
knows what to do with it.”
– attendee at Ogden Community Input Meeting
THE DATA
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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County Percentage of Households
reporting “yes” to the statement:“The food that I
bought just didn't last, and I don't have money to
get more, often or sometimes”
Percentage of Households
reporting “yes” to the statement:
“I couldn't afford to eat balanced meals, often or sometimes”
Percentage of Individuals in
County with Limited Access
to Grocery Store (Low-income &
Low Access)
Number of Individuals in
County with Limited Access
to Grocery Store (Low-income &
Low Access)
Davis County 13% 18% 6% 18,820 Salt Lake County
13% 16% 3% 28,999
Tooele County 17% 19% 10% 5,774 Utah County 14% 16% 7% 35,678 Weber County 15% 17% 6% 14,371
UTAH - - - -
Community Profile
Source: Utahns Fight Against Hunger County Food Access Profiles
THE DATA
FOOD INSECURITY, LIMITED ACCESS TO HEALTHY FOOD BY COUNTY, 2017
County Percentage of Individuals Food
Insecure
Number of Individuals Food
Insecure
Percentage of Children Food
Insecure
Number of Children Food
Insecure
Davis County 11% 36,310 14% 15,140 Salt Lake County
12% 130,130 15% 45,360
Tooele County 11% 6,880 14% 3,040 Utah County 13% 73,640 14% 28,620 Weber County 12% 29,680 16% 11,260
UTAH 11% - - -
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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Source: Utahns Fight Against HungerCounty Food Access Profiles
SNAP UTILIZATION BY COUNTY
County Number of SNAP
Households
Number of SNAP
Individuals, April 2019
Percent of County
Population Participating
in SNAP, April 2019
Number of Average Monthly
SNAP Households,
SFY, 2018
Number of Low-income
Individuals Enrolled in SNAP, 2017
Estimated Number of
Low-income Individuals
NOT Enrolled in SNAP, 2017
Davis County
5,699 14,107 4.12% 6,289 16,595 7,961
Salt Lake County
31,090 68,556 6.11% 34,014 80,924 65,414
Tooele County
1,824 4,384 6.76% 1,949 5,618 882
Utah County
8,905 24,407 4.12% 9,780 29,317 53,272
Weber County
8,972 19,163 7.74% 9,679 21,949 17,022
Community Profile
THE DATA
Source: Utahns Fight Against HungerCounty Food Access Profiles
SENIOR MEALS BY COUNTY, 2018
County Number of Congregate
Meal Sites
Congregate Meals
| People Served
Congregate Meals
| Meals Served
Meals on Wheels
| People Served
Meals on Wheels | Meals Served
Senior Food Boxes
| Number of Participants
Senior Food Boxes
| Number of Pickup
Sites
Davis County
3 1,256 28,243 684 83,406 55 3
Salt Lake County
19 8,514 198,345 2,334 334,538 1,989 56
Tooele County
4 813 16,546 230 26,203 64 1
Utah County
15 12 2,899 1,218 122,294 132 6
Weber County
13 12 2,316 951 138,984 476 9
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DIABETES AS AN UNDERLYING CAUSE OF DEATH BY LOCAL HEALTH DISTRICT, 2015-2018
Local Health District Age-Adjusted Rate per 100k
Population
Davis County LHD 23%
Salt Lake County LHD 26%
Tooele County LHD 30%
Utah County LHD 22%
Weber-Morgan LHD 26%
UTAH 24%Source: Public Health Indicator Based Information System (IBIS)
Health Indicator Report of Deaths due to Diabetes as Underlying Cause
CORONARY HEART DISEASE DEATHS BY LOCAL HEALTH DISTRICT, 2017-2018
Local Health District Age-Adjusted Rate per 100k
Population
Davis County LHD 67.1%
Salt Lake County LHD 62.5%
Tooele County LHD 66.6%
Utah County LHD 63.5%
Weber-Morgan LHD 74.1%
UTAH 64.8%
Source: Public Health Indicator Based Information System (IBIS)Health Indicator Report of Coronary Heart Disease (CHD) Deaths
THE DATA
Community Profile
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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STRATEGIES & INITIATIVES
Increase screenings, referrals, and treatment coordination between mental health and primary care providers: • Implement Collaborative Care for patients with major
depressive disorders in order to improve healthoutcomes, with a goal to see a 50% improvement inPHQ-9/PROMIS depression scores
• Improve screenings for suicide risk and increaseaccess to effective behavioral health treatment byimplementing the Zero Suicide programming of theColumbia Suicide Severity Screening (C-SSRS) inprimary care settings
• Integrate substance abuse screening, briefintervention, and referral and treatment (SBIRT)practices into primary care settings
• Increasing access to and use of the SafeUT app and ofschool-based mental health (with referral supports)
• Improve transitions of care from inpatient Psychiatry toPrimary Care and from Community Crisis Encountersto Primary Care
• Expand Call-Up, the Psychiatrist Consultation Programthat provides primary care providers with access totelehealth psychiatric consultations (peer-to-peerconsulting)
Improve access to mental health services: • Extend 24/7 mobile crisis outreach teams (MCOT)
across the entire state – UNI provides dispatchservices to all MCOT teams
• Enhance the statewide crisis call center to serve asthe centralized hub for coordinating behavioral healthand crisis support services
• Create the Salt Lake County community-basedbehavioral health receiving center
Improving Mental Health and Reducing Suicide
Improving mental health and reducing suicide were elements included in U of U Health’s Strategy Refresh. Our vision is that access to and the quality of mental health services in Utah are materially improved statewide, and the mental health of Utah’s population is better than it is today. Over the next few years we will be launching initiatives for the Huntsman Mental Health Institute and we will continue to expand the reach of mental health services through programs like SafeUT, statewide crisis call center, and Call-Up.
In 2019, the Huntsman family announced a historic gift of $150 million to establish the Huntsman Mental Health Institute with an initial focus on advancing knowledge and relieving suffering through research-informed treatment of mental illness with a strong focus on improving mental health services for college-age adults, increasing access to mental health services in rural communities across Utah, and identifying the genetic underpinnings of mental illness.
Below are specific strategies and initiatives related to improving mental health and reducing suicide which University of Utah Hospitals and Clinics commits to as part of the Community Health Needs Assessment process and will work towards over the next three years.
IMPLEMENTATION GOAL
University of Utah and University of Utah Health have come together as a community with renewed vision and the human talent needed for our institutions to navigate an increasingly complex and dynamic landscape. This process allowed our systems to refresh their strategies and address Utah’s growing and changing demographics, adapt to 21st-century workforce needs, enhance lifelong education opportunities, and find new ways to leverage unique strengths of University of Utah. The Strategy Refresh summarizes the great work ahead, starting now and continuing through 2025. The CHNA is a complimentary document and allows for alignment between community needs and Strategy Refresh Priorities.
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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Source: Public Health Indicator Based Information System (IBIS)Complete Health Indicator Report of Suicide
SUICIDE RATES BY LOCAL HEALTH DISTRICT
Local Health District Age-Adjusted Rate Per 100k
Population UT 2016-2018
U.S. 2015-2017
Davis County LHD 19.9Salt Lake County LHD 22.1Tooele County LHD 23.6Utah County LHD 16.6Weber-Morgan LHD 28.9
UTAH 22.2Nation 13.6
Source: FY 2018 Mental Health Scorecard for Audits. (2018, November)Department of Substance Abuse and Mental Health
ESTIMATED UTAH ADULTS WITH SERIOUS MENTAL ILLNESS, 2018
Local Health District Percent of Population
with SMI
Number with SMI
Davis County LHD 4.6% 10,238
Salt Lake County LHD
4.8% 38,364
Tooele County LHD 5.2% 2,164
Utah County LHD 5.6% 21,221
Weber-Morgan LHD
4.8% 8,698
THE DATA
Community Profile
Source: Public Health Indicator Based Information System (IBIS)Health Indicator Report of Health Status: Mental Health Past 30 Days
ESTIMATED UTAH ADULTS WITH SEVEN OR MORE DAYS OF POOR MENTAL HEALTH IN THE PAST 30 DAYS, 2018
Local Health District Age-Adjusted Percentage of
Adults
Davis County LHD 17%Salt Lake County LHD 19%Tooele County LHD 21%Utah County LHD 18%Weber-Morgan LHD 20%
UTAH 18%Nation 19%
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Source: Utah Dept. of Human Services, SHARP Survey2019 SHARP Survey Reports
SELF REPORTED DEPRESSION DATA, GRADES 6, 8, 10, 12; 2019
County High Depressive Symptoms
Moderate Depressive Symptoms
No Depressive Symptoms
Felt Sad or Hopeless for Two Weeks or More in a Row
During the Past Year
Davis County 9% 58% 33% 26%Salt Lake County 16% 13% 8% 17%Tooele County 11% 61% 28% 29%Utah County 8% 63% 29% 26%Weber County 9% 62% 29% 30%
UTAH 9% 62% 29% 28%
THE DATA
Community ProfileSELF REPORTED SUICIDE INDICATORS AND SELF HARM DATA; GRADES 6, 8, 10, 12; 2019
County During the Past 12 Months,
Did You Ever Seriously Consider Attempting Suicide
(Answered 'Yes')
During the Past 12 Months, Did You
Make a Plan About How You Would
Attempt Suicide?(Answered 'Yes')
During the Past 12 Months, How
Many Times Did You Actually
Attempt Suicide?(Answered 1 or
More Times)
Purposeful Self Harm (Without Suicidal
Intention, e.g. Cutting or Burning)
(Answered 1 or More Times During the Past 12 Months)
Davis County 16% 11% 6% 15%Salt Lake County
18% 13% 8% 17%
Tooele County
19% 16% 9% 19%
Utah County 15% 11% 5% 14%Weber County
17% 13% 8% 16%
UTAH 16% 12% 7% 15%
Source: Utah Dept. of Human Services, SHARP Survey2019 SHARP Survey Reports
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STRATEGIES & INITIATIVES
Increase prevention efforts through education and community outreach: • Improve and increase patient education about proper
drug disposal• Increase community outreach and access to pain
management education materials• Increase community education regarding substance
use awareness
Measure prescribing practices within U of U Health to identify and create best practices: • Measure the current patterns of controlled substance
prescribing for patients with acute versus chronicdisease and develop best practices in a patient-centered manner
• Measure Buprenorphine-specific prescribing rates• Measure how U of U Health Hospitals and Clinics
clinicians co-prescribe controlled substancesalongside opioids
Expand access to treatment through trainings and standardization of processes: • Expand Naloxone trainings throughout the community
and within the U of U Health system• Expand Buprenorphine waiver trainings throughout
the community and within the U of U Health system• Leverage our electronic medical record platform, EPIC,
to encourage best prescribing practices through theuse of care coordination and standardization
Reducing Prescription Drug Misuse, Abuse, and Overdose
Reducing prescription drug misuse, abuse, and overdose were elements included in U of U Health’s Strategy Refresh. We have committed as a system to continue to advocate for clear, science-supported policy recommendations on public health needs related to opioids. And we will work with patients with chronic conditions to learn how to better coordinate care for them, and expand health coaching to more patients with chronic conditions.
Below are specific strategies and initiatives related to reducing prescription drug misuse, abuse, and overdose which University of Utah Hospitals and Clinics commits to as part of the Community Health Needs Assessment process and will work towards over the next three years.
IMPLEMENTATION GOAL
University of Utah and University of Utah Health have come together as a community with renewed vision and the human talent needed for our institutions to navigate an increasingly complex and dynamic landscape. This process allowed our systems to refresh their strategies and address Utah’s growing and changing demographics, adapt to 21st-century workforce needs, enhance lifelong education opportunities, and find new ways to leverage unique strengths of University of Utah. The Strategy Refresh summarizes the great work ahead, starting now and continuing through 2025. The CHNA is a complimentary document and allows for alignment between community needs and Strategy Refresh Priorities.
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OPIOID DEATHS BY DRUG CATEGORY
THE DATA
“…what I'm seeing a lot of is the socioeconomic disadvantages these families have, are
creating all types of mental health issues from food insecurities, improper early childhood
intervention, and it just moves up…socioeconomic status is part of it can be part of the loneliness,
part of the drug abuse, part of those things. I have families who are struggling because of the
socioeconomic disadvantages due to someone who has an addiction in their family. Or the food
insecurities because of an addiction in their family. So I just think it all ties so closely.”
– attendee at Ogden Community Input Meeting
Community Profile
NEWBORNS WITH NAS
Source: Utah Department of HealthOpioid Data Dashboard
Source: Utah Department of HealthOpioid Data Dashboard
NALOXONE DOSES DISTRIBUTED IN UTAH BY DISTRIBUTION PROGRAM
Source: Utah Department of HealthOpioid Data Dashboard
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OPIOID PRESCRIPTIONS DISPENSED PER 1,000 POPULATION
DRUG OVERDOSE DEATHS INVOLVING OPIOIDS BY LOCAL HEALTH DISTRICT, 2019
Local Health District Age-Adjusted Rate Per 100k
Population
Davis County LHD 9.9
Salt Lake County LHD 20.3
Tooele County LHD 17.4
Utah County LHD 13.3
Weber-Morgan LHD 19.7
UTAH 16.7
Source: Utah Department of HealthOpioid Data Dashboard
DRUG DEATHS BY LOCAL HEALTH DISTRICT, 2016-2018*
Local Health District Age-Adjusted Rate Per 100k
Population
Davis County LHD 17
Salt Lake County LHD 23.3
Tooele County LHD 21.4
Utah County LHD 20.2
Weber-Morgan LHD 25.4
UTAH 21.9*The Consensus Recommendations for National and State Poisoning Surveillancedefinition of a drug is as follows: A drug is any chemical compound that is chieflyused by or administered to humans or animals as an aid in the diagnosis, treatment, or prevention of disease or injury, for the relief of pain or suffering, to control orimprove any physiologic or pathologic condition, or for the feeling it causes.
THE DATA
OPIOID-RELATED EMERGENCY DEPARTMENT VISITS PER 10,000 POPULATION
Community Profile
Source: Utah Department of HealthOpioid Data Dashboard
Source: Public Health Indicator Based Information System (IBIS)Complete Health Indicator Report of Drug Overdose
and Poisoning Incidents
Source: Utah Department of HealthOpioid Data Dashboard
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Addressing Racism to Reduce Inequities
We recognize racism as a public health crisis and believe anti-Black racism is one major cause of health disparities that we observe in our society. Addressing racism to reduce inequities caused by social, economic, and structural determinants of health were elements included in U of U Health’s Strategy Refresh. Our vision is to actively value equity, diversity, and inclusion and see the reflection and impact of these values at all levels of the organization—by recruiting and retaining diverse faculty, trainees, students, and employees. We will ensure Utahns who seek care from U of U Health have easy and direct access to our services. And we will finalize an integrated, comprehensive care plan for patients with elevated socioeconomic and clinical risks.
IMPLEMENTATION GOALBelow are specific strategies and initiatives related to reducing inequities caused by social, economic, and structural determinants of health which University of Utah Hospitals and Clinics commits to as part of the Community Health Needs Assessment process and will work towards over the next three years.
STRATEGIES & INITIATIVES Implement impact hiring programs: • Develop and implement U of U Health diversity and
inclusion strategies, including recruitment, performancemanagement, staff development, engagement, andretention
• Create and fill the position of Senior Director of HR forEquity, Diversity, and Inclusion
Implement a system-based approach to understanding our patients’ social determinants of health (SDOH): • Convene a U of U Health workgroup to develop system-
based approaches to screening and referrals for SDOH• Actively participate in ongoing community-led
meetings about community and statewide initiatives toaddress SDOH
• Increase the capture rate of sexual orientation, genderidentity, pronouns, and chosen name fields
Encourage enrollment in health insurance programs: • Create community-based partnerships to assist
uninsured individuals with the health insuranceapplication process
• Create outreach and education materials to encourageuninsured individuals to enroll in health care coverageand to seek primary and preventive care services
Help clinicians and staff provide culturally responsive care: • Improve access to foundational health resources in
languages other than English• Create learning modules available to all staff
highlighting best practices in caring for LGBTQIA+patients
• Improve access to the Intensive Outpatient Clinic forqualifying patients
University of Utah and University of Utah Health have come together as a community with renewed vision and the human talent needed for our institutions to navigate an increasingly complex and dynamic landscape. This process allowed our systems to refresh their strategies and address Utah’s growing and changing demographics, adapt to 21st-century workforce needs, enhance lifelong education opportunities, and find new ways to leverage unique strengths of University of Utah. The Strategy Refresh summarizes the great work ahead, starting now and continuing through 2025. The CHNA is a complimentary document and allows for alignment between community needs and Strategy Refresh Priorities.
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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THE DATA
Source: U.S. Census BureauQuickFacts: 2019
EDUCATION ATTAINMENT BY COUNTY (PERCENT OF PERSONS AGE 25 YEARS+)
County High School Graduate
Bachelor's Degree
Davis County 96% 38%
Salt Lake County 90% 35%
Tooele County 91% 23%
Utah County 94% 40%
Weber County 90% 24%
UTAH 92% 33%Nation 88% 32%
Community ProfileArea Inequities Caused by Social, Economic, and Structural Determinants of Health
Source: Utahns Fight Against HungerCounty Food Access Profiles
POVERTY RATE BY RACE/ETHNICITY BY COUNTY, 5 YEAR AVERAGE 2013-2017
County White Alone
Black or African
American Alone
American Indian
and Alaska Native alone
Asian alone
Native Hawaiian
and Other Pacific
Islander alone
Some other race
alone
Two or more races
Hispanic or Latino
Origin (of any
race)
White alone,
not Hispanic or Latino
Davis County
5.5% 23% n/a n/a n/a 12% 9% 17% 5%
Salt Lake County
8% 29% 25% 14% 14% 23% 13% 20% 7%
Tooele County
10% 27% 30% 15% 15% 23% 14% 20% 9%
Utah County
11% 24% 19% 23% 13% 26% 15% 19% 10%
Weber County
11% 15.5% 22% n/a n/a 22% 22% 23% 9%
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THE DATA
Community ProfileArea Inequities Caused by Social, Economic, and Structural Determinants of Health
KEY SOCIOECONOMIC FACTORS BY LOCAL HEALTH DISTRICT
Local Health District
Persons without health
insurance, under age 65
Median household income in
2018 dollars
Persons in poverty, percent
Davis County LHD
7% 79,690 6%
Salt Lake County LHD
12% 71,230 9%
Tooele County LHD
10% 71,020 7%
Utah County LHD
9% 70,408 9%
Weber-Morgan LHD
10% 64,636 9%
UTAH 11% 68,374 9%Nation 10% 60,293 11%
Source: Public Health Indicator Based Information System (IBIS)IBIS-PH Indicator Reports Introduction
Source: Utahns Against HungerCounty Food Access Profiles
UNEMPLOYMENT RATE BY COUNTY, 2019
County Unemployment Rate
Davis County 2.60%
Salt Lake County
2.73%
Tooele County 3.05%
Utah County 2.55%
Weber County 3.22%
UTAH 2.90%
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THE DATA
The ten indicators included in the HII describe important determinants of health information:
1. Population aged ≥25 yearswith <9 years of education, %
2. Population aged ≥25 yearswith at least a high schooldiploma, %
3. Median family income, $
4. Income disparity
5. Owner-occupied housingunits, % (home ownership rate
6. Civilian labor force populationaged ≥16 years unemployed,% (unemployment rate)
7. Families below poverty level, %
8. Population below 150% of thepoverty threshold, %
9. Single-parent households withchildren aged <18 years, %
10. The HII ranges from 71.89 to160.87.
The higher the HII score, the more improvement the area needs.
Within our five identified communities, there are 12 small areas that have an HII score of “High” and 11 that have an HII score of “Very High.” The areas with “High” and “Very High” HII scores tend to have a higher percentage of racial/ethnic minorities.
SMALL AREAS BY HEALTH IMPROVEMENT INDEX SCORES
Local Health District
Very Low
Low Average High Very High
Davis County LHD
4 4 1 - -
Salt Lake County LHD
9 7 5 5 7
Tooele County LHD
- - 1 1 -
Utah County LHD
5 5 1 4 3
Weber-Morgan LHD
2 1 1 2 1
TOTAL 20 17 9 12 11Source: Utah Department of Health
The Utah Health Improvement Index
Community ProfileThe Utah Department of Health recently created a composite measure of social determinants of health by geographic area called the Health Improvement Index (HII).
*Davis County is not included in this chart because they don't have any small health areas that are “high” or “very high”
Source: Utah Department of HealthThe Utah Health Improvement Index
HII SCORE OF “HIGH” AND “VERY HIGH”
Local Health District*
Average Percent Racial/Ethnic
Minority
Salt Lake County LHD
41.5%
Tooele County LHD
18.70%
Utah County LHD
22.3%
Weber-Morgan LHD
29.0%
AVERAGE 26.2%
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THE DATA
The HII report allows us to quickly identify areas where addressing social determinants of health through a health equity lens can move the needle on health disparities and ultimately adverse health outcomes. The HII report underscores the need to implement interventions with a focus on health equity, as this will be more effective because the areas with “High” and “Very High” HII scores tend to have a higher percentage of racial/ethnic minorities.
Source: Utah Department of HealthThe Utah Health Improvement Index
Community Profile
How to use this classification:Very High HII >120; geographically, this is a very high health disparities area; SUBSTANTIAL IMPROVEMENTS are needed to advance health equity and reduce health disparities in the area.
High HII >105 and <=120; geographically, this is a health disparities area; IMPROVEMENTS are needed to advance health equity in the area and reduce health disparities.
Average HII >94 and <=105; geographically, this is NOT a health disparities area; adverse health outcomes CANNOT be considered health disparities.
Low HII >80 and <94; geographically, this is NOT a health disparities area. In terms of health equity, this area is doing BETTER than average; adverse health outcomes in this area cannot be considered health disparities.
Very Low HII <80; geographically, this is NOT a health disparities area. In terms of health equity, this area is doing MUCH BETTER than average; adverse health outcomes in this area cannot be considered health disparities.
More than 1/3 of the Areas are Considered High or Very High
■ Very Low■ Low■ Average■ High■ Very High
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
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Since University of Utah Hospital opened its doors in Salt Lake City, Utah, in 1965, U of U Health has grown from a single county hospital to an exemplary regional health care system that includes five hospitals, 12 community health centers, several specialty centers, and an extensive network of affiliate partners throughout the Mountain West region. Additionally, 81 telehealth sites offer on-demand access for both referring providers and patients.
A number of the strategies and tactics U of U Health Hospitals and Clinics will take to address our four main Community Health Needs Assessment goals will not only benefit our five target communities, but could also have a statewide and even regional impact.
STRATEGYCLINICAL REACH
Source: FY19 System Summary
CLINICAL REACH
● Affiliate Partners ◆ Outreach Clinics ● Telehealth Sites
Statewide Reach
IMPLEMENTATION GOAL: ADDRESSING DIABETES AND REDUCING OBESITY AND OBESITY-RELATED CHRONIC CONDITIONSStrengthen and support community-focused programs for addressing obesity & diabetes prevention• Increase participation in both the Crush Diabetes
and the Team Thrive childhood diabetes preventionprograms by 5% each year for the next 3 years.
• Increase the reach of evidence-based programs forindividuals with obesity in underserved populations.
• Create an obesity & diabetes prevention, education,and outreach taskforce to coordinate efforts to reachout to, and learn from, underrepresented populations.
IMPLEMENTATION GOAL: IMPROVING MENTAL HEALTH AND REDUCING SUICIDEIncrease screenings, referrals, and treatment coordination between mental health and primary care providers: • Increasing access to and use of the SafeUT app and of
school-based mental health (with referral supports).• Expand Call-Up, the Psychiatrist Consultation Program
that provides primary care providers with access totelehealth psychiatric consultations (peer-to-peerconsulting).
Improve access to mental health services: • Extend 24/7 mobile crisis outreach teams (MCOT)
across the entire state – UNI provides dispatchservices to all MCOT teams.
• Enhance the statewide crisis call center to serve asthe centralized hub for coordinating behavioral healthand crisis support services.
IMPLEMENTATION GOAL: REDUCING PRESCRIPTION DRUG MISUSE, ABUSE, AND OVERDOSEIncrease prevention efforts through education and community outreach:• Increase community outreach and access to pain
management education materials.• Increase community education regarding substance
use awareness.
Expand access to treatment through trainings and standardization of processes:• Expand naloxone trainings throughout the community
and within the U of U Health system.• Expand Buprenorphine waiver trainings throughout
the community and within the U of U Health system.
IMPLEMENTATION GOAL: ADDRESSING RACISM TO REDUCE INEQUITIES Implement a system-based approach to understanding our patients’ social determinants of health (SDOH):• Actively participate in ongoing community-led
meetings about community and statewide initiatives toaddress SDOH.
Encourage enrollment in health insurance programs:• Create community-based partnerships to assist
uninsured individuals with the health insuranceapplication process.
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
SUMMARY
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Community matters. University of Utah Health is a proud member of our community. We strive to be an equal partner, both offering our expertise, and listening to the experiences of the individuals who make up our community. It is our commitment to collaborate with the intent to better understand community needs, and work to address those needs both through internal process improvement and by offering support outside our hospital’s four walls.
The COVID-19 pandemic has shown just how interconnected we all really are. It has opened our eyes to health inequities that have existed long before COVID-19, and the importance of addressing them going forward. It’s underscored the significance of addressing chronic conditions earlier, to avoid co-morbidities and help individuals live longer. We’ve forged new partnerships, and strengthened old ones. As a community that is bonded together after going through a pandemic—we will survive, and we will thrive.
We would love to hear from you about how we can work together to make our community healthier and stronger. Let’s connect.
RyLee CurtisDirector, Community [email protected]
Steve EliasonSr. Director, Finance and Strategic Project [email protected]
SUMMARY
2021-2023 University of Utah Health Hospitals and Clinics Community Health Needs Assessment
50 N. Medical DriveSalt Lake City, UT 84132
801-581-2121