1 TRENDS in The Human Condition on Cape Cod (2005–to-2007) Presented By: Warren Smith, Data Analyst Steve Brown, Community Coordinator Barnstable County Dept. of Human Services June 26, 2008

2 Outline 1. Research Questions (a review) 2. Top Household Problems/Challenges (a review) 3. Top Barriers to Service Access (a review) 4. The “Most Needy” Defined (a review) –Most Needy’s Top Household Problems & Service Barriers (a review) 5. Trends Among Most Needy Households: (new!) –Changes in Reports of Problems & Barriers (prevalence) Positive Changes Negative Changes –Changes in Seriousness of Problems & Barriers Positive Changes Negative Changes

3 Research Questions 1.What Are The Human Needs? 2.How Serious Are The Human Needs? 3.Who Are The Needy?

4 Survey History (a review) 1995: Original The Human Condition 2001: The Human Condition – 2001 Cape Cod Community Survey: (4-Years) –2004: Monitoring The Human Condition –2005: Monitoring The Human Condition –2006: Monitoring The Human Condition –2007: Monitoring The Human Condition

5 Household Problems: Overall

6 Service Barriers: Overall

7 Cape Cod’s “Most Needy” Includes: 19% of Households 26% of Adults (18+) 30% of Young People (0-17)

8 Who Are “Most Needy” Compared to Overall Cape Cod Sample: –Problems and Service Barriers: 2.5x to 3x Times More Households Report Problems/Barriers also, 2.5x to 3x Times More Seriousness Reported Thumbnail Sketch: –Very low income, mostly “working poor,” young families, renters, single parents, minorities, in poorer health, receive financial assistance, live in Hyannis, Yarmouth, Harwich, or Falmouth.

9 Household Problems of The “Most Needy” (a review)

10 Service Barriers of The “Most Needy” (a review)

11 TRENDS (New!) Over Period 2005-to-2007 (Latest 3 Years of MTHC Surveys) What’s Changed? What’s Changing?

12 “Statistically Significant” Changes What Does This Mean? Statistically Significance (p-value) “One could say that the statistical significance of a result tells us something about the degree to which the result is “true” … For example. A p-value of indicates that there is a 5% probability that [a trend] ….. is a “fluke.” StatSoft. Inc , Elementary Concepts in Statistics, There are no absolutes in statistics! (Warren Smith) We contract significance testing out to an expert; Dr. Sonia Sheffield, Ph.D. Professional, with over 20 years of public and private sector experience in statistical analysis. Worked with us since 1994.

13 Household Problem Trends

14 Service Barrier Trends

15 Among The Most Needy Prevalence (i.e., Changes in Proportion of Households Reporting Problem or Barrier to Service) How Widespread is the Problem or Barrier?

16 Significant Prevalence Changes “Not Enough Money to Pay For Housing”. +45% since 2005 “Not Always Having Enough Money for Food”. +40% since 2005 “Not Being Able to Afford Recreational Activities”. +12% since 2005

17 Significant Prevalence Changes “A Lot of Anxiety or Stress in Household”. +3% since % since 2006 (↑↑) - recently

18 Significant Prevalence Changes “Not Able to Afford Nutritious Food”. +46% since 2005 “Inadequate Opportunities to Learn New Skills or For Work Advancement”. +28% since 2005

19 Significant Prevalence Changes “Not Able to Find or Afford After-School Child Care”. +85% since 2005 “Not Able to Find or Afford Child Day Care”. +67% since 2005 “Immigration Status or Visa Dispute”. +54% since % since 2006 (↓↓) - recently

20 Significant Prevalence Changes “Not Able to Find Appropriate Senior (65+) Housing”. +33% since % since 2006 (↓↓) - recently “Seriously Overweight Person(s) in Household”. +7% UP slightly since – 30% DOWN since 2006 (↓↓) - recently

21 Significant Prevalence Changes “Could Not Afford Fees or Costs for Service” (as Service Barrier). +23% since 2005

22 GOOD NEWS!!! Prevalence Decreased “Insurance Not Accepted for Services” (as Service Barrier). - 18% since % since 2006 (↓↓) - recently

23 Among The Most Needy Seriousness (i.e., Changes in Seriousness Reported) How Serious is the Problem or Barrier?

24 Significant Seriousness Changes “Not Always Having Enough Money for Food”. +50% since 2005 “Not Enough Money To Pay For Housing”. +47% since 2005 “Not Able to Afford Legal Help”. +39% since 2005

25 Significant Seriousness Changes “Not Being Able to Afford Recreational Activities”. +37% since 2005 “A Lot of Anxiety or Stress in Household”. +2% since % since 2006 (↑↑) - recently

26 Significant Seriousness Changes “Not Able to Afford Nutritious Food”. +62% since 2005 “Inadequate Opportunities to Learn New Skills or For Work Advancement”. +45% since 2005 “Paying For a Mental Health Counselor”. +30% since 2005

27 Significant Seriousness Changes “Not Able to Find or Afford After-School Child Care”. +86% since 2005 “Immigration Status or Visa Issues”. +81% since % since 2006 (↓↓) - recently “Not Able to Find or Afford Child Day Care”. +80% since 2005

28 Significant Seriousness Changes “Not Able to Find Appropriate Senior (65+) Housing”. +44% since % since 2006 (↓↓) - recently

29 Significant Seriousness Changes “Lack of Transportation” (as Service Barrier). +56% since 2005 “Services Not in Appropriate Place or Part of Town” (as Service Barrier). +34% since 2005 “Could Not Afford Fees or Costs for Service” (as Service Barrier). +25% since 2005

30 Significant Seriousness Changes “Lack of Information on Where to Go For Services” (as Service Barrier). +24% since 2005 “Cost of Taking Time Away From Work”. +19% since 2005 (as Service Barrier) “Services Not Accepting New Patients/Clients” (as Service Barrier). +17% since 2005

31 Good News! Seriousness Decreased “Seriously Overweight Person(s) in Household”. - 30% DOWN since 2006 (↓↓) - recently “Hours of Services Are Not Convenient”. - 17% since 2006 (as Service Barrier) (↓↓) recently

32 SUMMARY Increased: Since 2005 Prevalence Seriousness “Not Being Able to Find or Afford After-School Child Care” + 85% +86% “Immigration Status or Visa Dispute” +54% +81% “Not Being Able to Find or Afford Child Day Care” + 67% +80% “Not Able To Afford Nutritious Food” + 46% +62%

33 SUMMARY Increased: Since 2005 Prevalence Seriousness “Lack of Transportation” (Service Barrier) % “Not Always Having Enough Money for Food” + 40% +50% “Not Having Enough Money to Pay for Housing” + 45% +47%

34 SUMMARY Increased: Since 2005 Prevalence Seriousness “Inadequate Opportunities to Learn New Skills or for Advancement at Work” + 28% + 45% “Not Able to Find Appropriate Senior (65+) Housing” +33% +44% “Not Being Able to Afford Legal Help” % “Paying For a Mental Health Counselor” %

35 SUMMARY Increased: Since 2005 Prevalence Seriousness “Not Able to Afford Recreational Activities” + 12% + 37% “Seriously Overweight Person(s) in Household” + 7% - “Having a Lot of Anxiety or Stress in Household” + 3% + 2%

36 SUMMARY Increased in BOTH Years: Since 2005 and Since 2006 Prevalence Seriousness “Having a Lot of Anxiety or Stress in the Household” + 3% + 2% (since 2005) +31% +33% (since 2006)

37 SUMMARY Decreased: Prevalence Seriousness “Not Able to Find Appropriate Senior (65+) Housing“ - 47% - 55% (since 2006) “Immigration Status or Visa Dispute” - 53% - 50% (since 2006) “Seriously Overweight Person(s) the Household” - 30% -30% (since 2006) “Insurance Not Accepted For Services” - 25% - (since 2006) - 18% - (since 2005) “Hours of Service Were Not Convenient” % (since 2006)

38 Q & A What Surprised You? What Themes Do You See? What Patterns Emerge?

39 Problems & Service Barriers That Have NOT Changed Significantly in PREVALENCE Over The Past 3 Years ( )

40 Among The Most Needy Prevalence (i.e., Changes in Proportion of Households Reporting Problem or Barrier to Service) How Widespread is the Problem or Barrier?

41 NOT Significant Prevalence Changes “Discrimination (due to HIV, AIDS, TB, etc.)” “Lack of Handicap Access” (as Service Barrier) “Discrimination (due to Race, Age, Sexual Identity/Orientation etc.)” “Discrimination Toward Mentally Ill Persons” “Feelings of Discrimination” (as Service Barrier)

42 NOT Significant Prevalence Changes “Lack of Transportation” (as Service Barrier) “Lack of Information on Where to Go For Services” (as Service Barrier) “Household Overcrowding” “Hours of Services Are Not Convenient:” (as Service Barrier) “Household Overcrowding”

43 NOT Significant Prevalence Changes “Hours of Services Are Not Convenient” (as Service Barrier) “Paying For a Mental Health Counselor” “Cost of Taking Time Away From Work” (as Service Barrier) “Inadequate Money to Pay Doctor/Dentist, or to Buy Prescriptions”

44 Problems & Service Barriers That Have NOT Changed Significantly in SERIOUSNESS Over The Past 3 Years ( )

45 Among The Most Needy Seriousness (i.e., Changes in Seriousness Reported) How Serious is the Problem or Barrier?

46 NOT Significant Seriousness Changes “Discrimination (due to HIV, AIDS, TB, etc.)” “Discrimination (due to Race, Age, Language, Sexual Orientation/Identity, etc)” “Lack of Handicap Access” (as Service Barrier) “Experiencing Physical Conflict in Household” “Feelings of Discrimination” (as Service Barrier) “Household Overcrowding”

47 NOT Significant Seriousness Changes “Paying Insurance Deductibles/Co-Payment” (as Service Barrier) “Inadequate Money to Pay Doctor, Dentist, or to Buy Prescription Med’s”