Collaborative Health Planning to Address Urban Community Health Needs in a Limited Resource Environment Camden City Healthy Futures

History of the Partnership Last community assessment for the city was done in 1995 Last community assessment for the city was done in 1995 Role of partnership as the health advisory committee to the Mayor Role of partnership as the health advisory committee to the Mayor University leadership role University leadership role Limited success in obtaining grant support (Institute for the Elimination of Health Disparities) Limited success in obtaining grant support (Institute for the Elimination of Health Disparities) In 2005 NJ counties were engaged in MAPP (Mobilizing Around Partnerships and Planning) and writing Community Health Improvement Plans (CHIP). For Camden County this included: In 2005 NJ counties were engaged in MAPP (Mobilizing Around Partnerships and Planning) and writing Community Health Improvement Plans (CHIP). For Camden County this included: –Prioritization of health issues with special focus on the city –BRFSS study with an oversample in the city of Camden

Partners in Camden Healthy Futures African-American Advisory Commission African-American Advisory Commission Association for Children of New Jersey Association for Children of New Jersey CamCare Health Corporation CamCare Health Corporation Camden Area Health Education Center (Camden AHEC) Camden Area Health Education Center (Camden AHEC) Camden Community Recovery/Environmental Justice Coalition Camden Community Recovery/Environmental Justice Coalition Camden County Department of Health & Human Services Camden County Department of Health & Human Services Dr. Charles E. Brimm Medical Arts High School Dr. Charles E. Brimm Medical Arts High School City of Camden City of Camden Community Planning and Advocacy Council Community Planning and Advocacy Council Cooper Hospital University Medical Center Cooper Hospital University Medical Center Healthy Mothers, Healthy Babies Coalition of Camden City Healthy Mothers, Healthy Babies Coalition of Camden City Hispanic Family Center of Southern NJ, Inc. Hispanic Family Center of Southern NJ, Inc. Lourdes Health System Lourdes Health System Medical Mission Sisters Medical Mission Sisters N.J. Dept. of Environmental Protection - Div. of Air Quality Evaluation N.J. Dept. of Environmental Protection - Div. of Air Quality Evaluation NJ Dept. of Health and Senior Services – Asthma Awareness & Education Program NJ Dept. of Health and Senior Services – Asthma Awareness & Education Program Planned Parenthood of Southern New Jersey Planned Parenthood of Southern New Jersey Rowan University Urban & Public Policy Institute Rowan University Urban & Public Policy Institute Rutgers University/Camden Rutgers University/Camden –Department of Public Administration –Walter Rand Institute –Cooperative Extension The South Jersey Environmental Justice Alliance The South Jersey Environmental Justice Alliance University of Medicine and Dentistry of New Jersey: University of Medicine and Dentistry of New Jersey: –Department of Government & Community Affairs –Institute for the Elimination of Health Disparities –New Jersey Dental School –Robert Wood Johnson Medical School –School of Health Related Professions –School of Nursing –School of Osteopathic Medicine –School of Public Health Union Organization for Social Service Union Organization for Social Service Virtua Health System Virtua Health System Weisman Children’s Rehabilitation Hospital Weisman Children’s Rehabilitation Hospital

University’s Role in Data Collection Because of the university’s role—the partnership was able to use graduate students to assist with data collection/ analysis. Student projects included: 1.City of Camden Focus Group Study with residents and constituent groups (two separate student analyses including in- depth analysis using Atlas.ti-2006) 2.BRFSS City/County Comparison Study 3.Healthy Camden City 2010-Update 2005 (comparison with NJ Healthy People 2010 goals) 4.Key Informant Stakeholder Study 5.Provider Survey

Use of Other Available Sources of Data 6.Camden Hospital and Emergency Room Health Data June 2006 (Camden Coalition of Healthcare Providers) 7.Camden Kids Count Camden Waterfront South Air Toxics Pilot Project 2005 (NJDEP) 9.From Data to Strategy: Information for Planning a Smoking Cessation Program-2005 (Camden County Cancer Coalition) 10.Health Report Card Survey-2005 (Cooper University Hospital Department of Family Medicine and CAMConnect 11.Camden City Health Profile (County Report for CHIP)

Access to Health Care Percentage of Adults Who Report They Have a Source of Primary Care Sources: NJDHSS, Center for Health Statistics, Behavioral Risk Factor Survey; Healthy New Jersey 2010: Update 2005; Camden City/County Comparison Behavioral Risk Factor Survey; Healthy Camden City 2010: Update 2005

Adolescent Health Total Number of Births per 1000 Females Aged 15 Through 17 Sources: NJDHSS, Center for Health Statistics; Healthy New Jersey 2010: Update 2005; National Center for Health Statistics and U.S. Census Bureau; Healthy Camden City 2010: Update 2005.

Adult Health Percentage of Persons Aged 18+ Who Are Overweight But Not Obese. Sources: NJDHSS, Center for Health Statistics, Behavioral Risk Factor Surveillance System; Camden City/County Comparison/Behavioral Risk Factor Survey Breakdown; Healthy New Jersey 2010: Update 2005; Healthy Camden City 2010: Update 2005

Preventing and Reducing Major Diseases Cancer age-adjusted mortality rate from colorectal cancer per 100,000 standard population Sources: New Jersey Department of Health and Senior Services, Center for Health Statistics. Healthy New Jersey 2010: Update 2005 Healthy Camden City 2010: Update 2005

Mental Health Mortality Rate From Suicide per 100,000 Male Population Sources: NJDHSS, Center for Health Statistics; Healthy New Jersey 2010: Update 2005; Healthy Camden City 2010: Update 2005.

Challenges …. In 2003 almost all residents can identify a primary health care provider and 93% of residents report having health insurance. So….why are so many residents still utilizing the Emergency Departments every year? One out of two residents use the ED for care. In 2003 almost all residents can identify a primary health care provider and 93% of residents report having health insurance. So….why are so many residents still utilizing the Emergency Departments every year? One out of two residents use the ED for care. Source: Camden Hospital and Emergency Room Health Data June 2006 Camden Coalition of Healthcare Providers and CAMConnect Camden Coalition of Healthcare Providers and CAMConnect

Setting Health Goals Created spreadsheet with data from the 11 studies Created spreadsheet with data from the 11 studies Partners worked through all of the data (where there were overlaps and what were priorities) and identified Five General Categories: Partners worked through all of the data (where there were overlaps and what were priorities) and identified Five General Categories: 1.Community Health/Healthy Lifestyles 2.Family Health and Parenting Concerns 3.Safety and Violence Prevention 4.Mental Health 5.Environmental Health Concerns

Creating Action Plans Action planning grids were developed based on MAPP design. Action planning grids were developed based on MAPP design. Teams then identified “actionable” items that aligned with partner agencies’ agendas Teams then identified “actionable” items that aligned with partner agencies’ agendas All data/reports were put on CD as well as posted online at All data/reports were put on CD as well as posted online at Executive Summary was developed for the community Executive Summary was developed for the community

SUBCOMMITTEE-Camden City Camden City Community Health Task Force Topic/Issue-High mortality rate for cancer in the City 11/15/07 Specific Aim or Purpose: Decrease mortality rates for cancer in the City through earlier detection and treatment Desired Outcome or Improvement Target: Plan to Achieve Target-Action Steps: What will be done (brief description) Who will do it?By when? Evaluation Lung cancer-2002 Camden City 53/100,000 NJ 50/100,000 Breast Cancer mortality rate is increasing in Camden City rather than decreasing 17.02/100, /100,000 in 2003 Colo-Rectal Cancer mortality rate is increasing in Camden City rather than decreasing 15.2/100, /100,000 in 2003 Invasive Cervical Cancer 5 year average Camden City 23.5/100,000 Camden County 9.7/100,000 Men’s Health > 39 years old PSA within the last year? Camden City 52.5% Camden County 68.1% Ever had a DRE? Camden City 49.3% Camden county 73.9%

Year One Camden City Health Priorities Community Health  Diabetes (Obesity, Physical Activity, Nutrition) and Cancer Community Health  Diabetes (Obesity, Physical Activity, Nutrition) and Cancer Environmental Health  Lead Poisoning and Asthma Environmental Health  Lead Poisoning and Asthma Safety & Violence Prevention  Street Violence Safety & Violence Prevention  Street Violence Mental Health  Depression Mental Health  Depression Family Health  Adolescent Pregnancy Family Health  Adolescent Pregnancy

Efforts to Address Camden City Health Priorities All five priorities  All five priorities  –Creation of Camden High School Public Health Club which focuses on our priorities –Cable TV public health series on how to access resources Diabetes/Obesity and Nutrition  Diabetes/Obesity and Nutrition  –Farmer’s Markets –Coalition of HealthCare Providers -Merck Grant formed Diabetes Collaborative –Health Information Exchange Coordination of Treatment –Partnership grant applications for Community Putting Prevention to Work Mental Health  Open Community Forums on Dual Diagnosis (Mental Health and Substance Abuse) and Integration of Care. Mental Health  Open Community Forums on Dual Diagnosis (Mental Health and Substance Abuse) and Integration of Care. Environment  Camden City designated as NJ Model Lead-Safe City Environment  Camden City designated as NJ Model Lead-Safe City Safety and Violence Prevention  Mayor’s Prevention of Youth Violence Program-Campaign Against Youth Violence as a Public Health Problem Safety and Violence Prevention  Mayor’s Prevention of Youth Violence Program-Campaign Against Youth Violence as a Public Health Problem

2009 Public Health Cable TV Series Dateline: Education Moderated by Bart Leff Dateline: Education Moderated by Bart Leff Cable Channel 19 Cable Channel 19 –Adolescent Pregnancy –Diabetes--Nutrition/Physical exercise/Obesity –Public Safety and Street Violence –Lead Prevention –Mental Health-Depression DVDs in clinics & physician waiting rooms DVDs in clinics & physician waiting rooms Follow-up booklets on each topic distributed throughout the city & posted online at Follow-up booklets on each topic distributed throughout the city & posted online at

Lessons Learned Targeted efforts must not only inform the community about the issue but also how to access available resources Targeted efforts must not only inform the community about the issue but also how to access available resources Because not all priorities can be accomplished in Year One…set goals for Year Two Because not all priorities can be accomplished in Year One…set goals for Year Two Start where resources are available and build. This includes staff resources and money Start where resources are available and build. This includes staff resources and money Use the community health needs assessment priorities for seeking grant funding Use the community health needs assessment priorities for seeking grant funding There is essential support in partnering with academic health centers (school of public health) There is essential support in partnering with academic health centers (school of public health) Educate the community to use available benchmarks whenever possible Educate the community to use available benchmarks whenever possible There is strength in the value of the partnership There is strength in the value of the partnership Push forward despite limitations  progress will begin to take shape Push forward despite limitations  progress will begin to take shape