Community Health Assessment Tompkins County, NY 2005–2010

Purpose  Describes the health of the community  Basis for strategic planning  Determine health priorities  Data and technical assistance for researchers, community  NYSDOH categorical grants  Fulfills NYSDOH mandate

CHA Structure

Structure Demographics Health Care environment CHA Core Indicators –Data Analysis –Resources –Opportunities for Action –Figures, Tables, Maps

CHA Core Indicators Designated by NYSDOH Healthy People 2010: 15 categories Article 6 references

CHA Core Indicators (NYSDOH)

Data Sources Community Health Assessment (CHA) Clearinghouse, NYSDOH –NY Community Health Data Set –County Health Indicator profiles CHA Indicators (CHAIs), NYSDOH –13 health topic areas U.S. Census Bureau

Data Sources: Local TC Health Department TC Planning Department TC Youth Services Health Planning Council County Office for the Aging Cayuga Medical Center COMPASS II

Working with the data ~Working with small pops. ~ Using 3-year averages

Sampling Error CHA p. 121 (Expanded BRFSS, NYSDOH) SMALL POPULATIONS

Distorted Rates Maternal Mortality: Rate /100,000 live births CHA p. 148 (NYS Vital Stats) Total maternal deaths Upstate, …20 Total maternal deaths Tompkins, …1 SMALL POPULATIONS

Working with the data ~Working with small populations ~ Using 3-year averages

Evens out ups & downs CHA p. 128 (TCHD Annual Report, ) 3-YR AVERAGE

1 spike lasts 3 years CHA p. 135 (NYS SPARCS data as of Aug. 2004) 3-YR AVERAGE Deaths in only 2 of 7 yrs Yet, rate >0 in 5 of 7 yrs

Numbers of Note Demographics

Special Tab #137 (U.S. Census 2000) Tompkins County Planning Department College students + non-college students –Long form question 8a: “at any time since February 1, 2000, has this person attended regular school or college?” –“Yes” for ages 17+ years = college student Demographics

Population Transience Over half of Tompkins’ 2000 pop. had lived in a different county 5 years earlier. –One-fifth in a different state CHA pp. 20, 31 (U.S. Census 2000: Residence in 1995 for the pop. 5 years and over.) Demographics

Poverty (Individuals) Tompkins’ individual poverty rate is the highest in the area. –Excl. students, it’s close to the lowest. CHA p. 34 (TC Planning Dept, Spec. Tab 137) Demographics

Median Income Tompkins’ median household income is below that of NYS; –Tompkins’ median family income > NYS CHA p. 33 (TC Planning Dept, Spec. Tab 137); 2000 Census SF-3 [P77] Demographics

Numbers of Note Health Indicators

Breast cancer incidence CHA p. 68 (NYS Cancer Registry data as of Aug. 2004) Age adj. Rate /100,000 female residents,

Breast cancer mortality CHA p. 67 (NYS Vital Statistics data as of Aug. 2004) Crude Rate /100,000 female residents

Colorectal cancer mortality CHA p. 71 (NYS Vital Statistics data as of Aug. 2004) Age adj. Rate /100,000 residents,

Prostate Cancer Tompkins’ incidence rate is significantly higher than both NYS and Upstate (age-adj.) –Mortality rates: the only significant difference is for Tioga County (see chart, next slide) CHA p. 74 (NYS Cancer Registry)

Incidence rate CHA p. 74 (NYS Cancer Registry) Prostate cancer

Incidence by ZIP CHA p. 74 (NYS Cancer Registry) Prostate cancer: expected

Expected by ZIP New York State Department of Health, New York State Cancer Registry Prostate Cancer Incidence by ZIP Code, New York State, Tompkins County Zip CodePost Office # of Cancers Observ'd# of Cancers Expected Pct Differ from Expected 14882Lansing* to 100% above expected 13053Dryden* to 50% below expected 13068Freeville to 50% below expected 13073Groton within 15% of expected 13736Berkshire* 6 5.4within 15% of expected 13864Willseyville* 1 3.0more than 50% below expected 14817Brooktondale* 7 6.8within 15% of expected 14850Ithaca to 49% above expected 14867Newfield within 15% of expected 14883Spencer* to 49% above expected 14886Trumansburg* within 15% of expected * This ZIP Code crosses county boundaries. The values provided are for the entire ZIP Code, not just the portion in this county Revised:September 2001Accessed: 11/30/2004 Prostate cancer

Late stage incidence CHA p. 75 (NYS Cancer Registry) Prostate Cancer: Expected incidence

Diabetes incidence CHA p. 81 (NYSDOH Expanded BRFSS, 2003) Expanded BRFSS, 2003

Diabetes related hospitalizations CHA p. 82 (SPARCS data as of Sep. 2004) Rate /10,000 residents,

Adult Diabetes in NYS CHA p. 80 (NYS BRFSS as of Dec. 2004) BRFSS: Percent residents age 18+

Cardiovascular disease mortality CHA p. 101 (NYS Vital Statistics data as of Aug. 2004) Average Age adj. Rate /100,000 residents,

Diseases of the heart: Mortality CHA p. 102 (NYS Vital Statistics) Crude Rate /100,000 residents

Birth Rate: /1,000 females age CHA p. 88 (NYS Vital Stats ) Family Planning

Teens age Tompkins has the lowest teenage birth rates in the area. CHA p. 88 (NYS Vital Stats ) Births per 1,000 female residents

Births to mothers age years Almost half of Tompkins’ births are to mothers age 30–44. CHA p. 92 (NYS Vital Stats ) Percent of live births

Postneonatal Mortality (28 days–1 yr.) CHA p. 153 (NYS Vital Stats, ) Average Rate per 1,000 Live Births

3-year average CHA p. 155 (NYS Vital Stats as of Aug 2004) (Age 28 days–1 yr) Postneonatal Mortality (28 days–1 year) 2,525 births

Infant Mortality (up to age 1 yr.) CHA p. 154 (NYS Vital Stats, ) Neonatal + Postneonatal = Infant

Child Immunization CHA p. 123 (TCHD Annual Reports) Percent

Oral Health CHA p. 173 Percent Tompkins County 3rd graders Caries Untreated caries Sealants Dental visit Insurance Flouride supp

Suicides CHA p. 133 (NYS Vital Stats ) Age. adj. Rate /100,000 residents

Teen suicides CHA p. 134 (NYS SPARCS data as of Aug. 2004) Age. adj. Rate /100,000 residents

Priorities

Compass II  Lack of specialty care  Lack of affordable primary care  Lack of money to pay for Rx and doctor visits  Cost of health care premiums  Poverty a critical problem

TCHD  Aging population and need for related services  Emergency preparedness and response  Emerging infectious disease Reduction in State financial support

Commission for a Healthy CNY  Access to dental care  Obesity  Access to mental health care  Stroke medical management

Online access /wellness/cha05/ Theresa Lyczko: Ted Schiele: