1. 2015 Community Health Needs Assessment Summary Mt. Ascutney Hospital and Health Care, Valley Regional Hospital, New London Hospital, Dartmouth Hitchcock, Alice Peck Day Memorial Hospital, and Grace Cottage Hospital

2. Dartmouth- Hitchcock/APD Mt. AscutneyValley RegionalNew London Grace Cottage Mental HealthSubstance Use Mental Health Aging/Health Care for Seniors Substance UseMental Health Substance Use Chronic Diseases: Cancer, Diabetes, HTN Affordable health insurance; cost of Rx drugs Access to dental health care Affordable health insurance; cost of Rx drugs Mental Health/Mental Health Access Access to dental health care Affordable health insurance; cost of Rx drugs Physical Activity/Recreation Substance Use Physical Activity/Recreation Nutrition/Healthy Food Access to dental health care Nutrition/Healthy Food Cultural Competency Nutrition/Healthy Food Physical Activity/Recreation Nutrition/Healthy Food Health care for seniors Poverty/Income/Family Stress Income, poverty, employment; family stress Income, poverty and family stress Behavioral Health: Obesity, smoking etc Affordable Housing Access to Transportation Access to Primary Care Access to dental health care Chronic Pain Access to Primary Health Care Access to Primary Care Health care for seniors Access to Transportation Dental Health/Care Access/Affordability Health care for seniors Tobacco Use Access to Primary Health Care Transportation What Did Our Community Say? Most Critical Behavioral Health Needs

3. Substance Abuse Measures IHI 100 MHL menu Community Measures menu RWJ Foundation CoH measures IOM Core metricsManageable at Community Level Addiction Death ratesYesNoYes Alcohol Abuse-AdultsYesNo Yes Alcohol Abuse-YouthYesNo Yes Smoking-AdultsYesNo Yes Smoking-YouthNo (Yes) Alcohol dependence/misuse- Adults YesNoYes Adolescent binge drinking YesNo Yes Drug dependence/illicit use- Adults YesNoYes Behavioral Health Needs Substance Use

4. Mental Health Measures IHI 100 MHL Community Measures menu RWJ Foundation CoH measures IOM Core metricsManageable at Community Level Life satisfactionYesNo Yes DepressionYesNo Well-being ratingYes NoYes Self-rated mental health & mood YesNo Yes Drug dependence/illicit use- Adults YesNoYes Alcohol dependence/misuse YesNoYes Initiation & engagement for substance abuse treatment YesNo Yes Meaning & purposeYesNo Yes Mortality - suicideYesNo Yes Behavioral Health Needs Mental Health

5. Dartmouth- Hitchcock/APD Mt. AscutneyValley RegionalNew London Grace Cottage Mental HealthSubstance Use Mental Health Aging/Health Care for Seniors Substance UseMental Health Substance Use Chronic Diseases: Cancer, Diabetes, HTN Affordable health insurance; cost of Rx drugs Access to dental health care Affordable health insurance; cost of Rx drugs Mental Health/Mental Health Access Access to dental health care Affordable health insurance; cost of Rx drugs Physical Activity/Recreation Substance Use Physical Activity/Recreation Nutrition/Healthy Food Access to dental health care Nutrition/Healthy Food Cultural Competency Nutrition/Healthy Food Physical Activity/Recreation Nutrition/Healthy FoodHealth care for seniors Poverty/Income/Family Stress Income, poverty, employment; family stress Income, poverty and family stress Behavioral Health: Obesity, smoking etc Affordable Housing Access to Transportation Access to Primary Care Access to dental health care Chronic Pain Access to Primary Health Care Access to Primary CareHealth care for seniors Access to Transportation Dental Health/Care Access/Affordability Health care for seniors Tobacco Use Access to Primary Health Care Transportation What Did Our Community Say? Next Highest Priorities Affordability of Health Care, Oral Health Care, Prescriptions

6. Affordability of Care Health Care Health Care MeasuresIHI 100 MHL Community Measures menu RWJ Foundation CoH measures IOM Core metricsManageable at Community Level Access to primary careYesNo Yes Access to public healthYes NoYes Access to stable health insurance Yes NoYes Unmet/delay of care need YesNoYesNo Equitable: Stratification by race, gender YesNo Yes Family health care costYes No Per capita expenditure on health care YesNoYes Have a personal doctorYesNo Yes Health insurance coverage YesNo Yes Potentially preventable hospitalization rates Yes NoYes Insurance - uninsured population YesNo Yes Population living in a health professional shortage area YesNo Yes

7. Affordability of Care Oral Care Health Care MeasuresIHI 100 MHL Community Measures menu RWJ Foundation CoH measures IOM Core metricsManageable at Community Level Access to dentistsYesNo Yes Access to stable health insurance Yes NoYes Delay of needed careYesNoYesNo Dental visit in last year Yes NoYes Dental care utilizationYesNo Yes

8. Dartmouth- Hitchcock/APD Mt. AscutneyValley RegionalNew London Grace Cottage Mental HealthSubstance Use Mental Health Aging/Health Care for Seniors Substance UseMental Health Substance Use Chronic Diseases: Cancer, Diabetes, HTN Affordable health insurance; cost of Rx drugs Access to dental health care Affordable health insurance; cost of Rx drugs Mental Health/Mental Health Access Access to dental health care Affordable health insurance; cost of Rx drugs Physical Activity/Recreation Substance Use Physical Activity/Recreation Nutrition/Healthy Food Access to dental health care Nutrition/Healthy Food Cultural Competency Nutrition/Healthy Food Physical Activity/Recreation Nutrition/Healthy Food Health care for seniors Poverty/Income/Family Stress Income, poverty, employment; family stress Income, poverty and family stress Behavioral Health: Obesity, smoking etc Affordable Housing Access to Transportation Access to Primary Care Access to dental health care Chronic Pain Access to Primary Health Care Access to Primary CareHealth care for seniors Access to Transportation Dental Health/Care Access/Affordability Health care for seniors Tobacco Use Access to Primary Health Care Transportation What Did Our Community Say? Next Highest Priorities Active Living and Healthy Food Needs

9. Health Care MeasuresIHI 100 MHL Community Measures menu RWJ Foundation CoH measures IOM Core metricsManageable at Community Level Access to dentistsYesNo Yes Access to stable health insurance Yes NoYes Delay of needed careYesNoYesNo Dental visit in last year Yes NoYes Dental care utilizationYesNo Yes Behavioral Health Active Living and Healthy Food Needs

10. Dartmouth- Hitchcock/APD Mt. AscutneyValley RegionalNew London Grace Cottage Mental HealthSubstance Use Mental Health Aging/Health Care for Seniors Substance UseMental Health Substance Use Chronic Diseases: Cancer, Diabetes, HTN Affordable health insurance; cost of Rx drugs Access to dental health care Affordable health insurance; cost of Rx drugs Mental Health/Mental Health Access Access to dental health care Affordable health insurance; cost of Rx drugs Physical Activity/Recreation Substance Use Physical Activity/Recreation Nutrition/Healthy Food Access to dental health care Nutrition/Healthy Food Cultural Competency Nutrition/Healthy Food Physical Activity/Recreation Nutrition/Healthy Food Health care for seniors Poverty/Income/Family Stress Income, poverty, employment; family stress Income, poverty and family stress Behavioral Health: Obesity, smoking etc Affordable Housing Access to Transportation Access to Primary Care Access to dental health care Chronic Pain Access to Primary Health Care Access to Primary CareHealth care for seniors Access to Transportation Dental Health/Care Access/Affordability Health care for seniors Tobacco Use Access to Primary Health Care Transportation What Did Our Community Say? Next Highest Priorities Social Determinants of Health

11. Dartmouth- Hitchcock/APD Mt. AscutneyValley RegionalNew London Grace Cottage Mental HealthSubstance Use Mental Health Aging/Health Care for Seniors Substance UseMental Health Substance Use Chronic Diseases: Cancer, Diabetes, HTN Affordable health insurance; cost of Rx drugs Access to dental health care Affordable health insurance; cost of Rx drugs Mental Health/Mental Health Access Access to dental health care Affordable health insurance; cost of Rx drugs Physical Activity/Recreation Substance Use Physical Activity/Recreation Nutrition/Healthy Food Access to dental health care Nutrition/Healthy Food Cultural Competency Nutrition/Healthy Food Physical Activity/Recreation Nutrition/Healthy FoodHealth care for seniors Poverty/Income/Family Stress Income, poverty, employment; family stress Income, poverty and family stress Behavioral Health: Obesity, smoking etc Affordable Housing Access to Transportation Access to Primary Care Access to dental health care Chronic Pain Access to Primary Health Care Access to Primary CareHealth care for seniors Access to Transportation Dental Health/Care Access/Affordability Health care for seniors Tobacco Use Access to Primary Health Care Transportation What Did Our Community Say? Next Highest Priorities Access to Care (type, quality, transportation, community and home-based)