1. Community Health Assessment Tompkins County, NY 2005–2010

2. 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

3. CHA Structure

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

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

6. CHA Core Indicators (NYSDOH)

7. 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

8. 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

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

10. Sampling Error CHA p. 121 (Expanded BRFSS, 2003 - NYSDOH) SMALL POPULATIONS

11. Distorted Rates Maternal Mortality: Rate /100,000 live births CHA p. 148 (NYS Vital Stats) Total maternal deaths Upstate, 2000-2002…20 Total maternal deaths Tompkins, 2000-02…1 SMALL POPULATIONS

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

13. Evens out ups & downs CHA p. 128 (TCHD Annual Report, 2001-2003) 3-YR AVERAGE

14. 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

15. Numbers of Note Demographics

16. 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

17. 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

18. 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

19. 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

20. Numbers of Note Health Indicators

21. Breast cancer incidence CHA p. 68 (NYS Cancer Registry data as of Aug. 2004) Age adj. Rate /100,000 female residents, 1997-2001

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

23. Colorectal cancer mortality CHA p. 71 (NYS Vital Statistics data as of Aug. 2004) Age adj. Rate /100,000 residents, 1998-2002

24. 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)

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

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

27. Expected by ZIP New York State Department of Health, New York State Cancer Registry Prostate Cancer Incidence by ZIP Code, New York State, 1994-1998 Tompkins County Zip CodePost Office # of Cancers Observ'd# of Cancers Expected Pct Differ from Expected 14882Lansing* 14 9.3 50 to 100% above expected 13053Dryden* 9 11.015 to 50% below expected 13068Freeville 6 10.715 to 50% below expected 13073Groton 15 17.1within 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 173 116.315 to 49% above expected 14867Newfield 15 13.7within 15% of expected 14883Spencer* 14 10.815 to 49% above expected 14886Trumansburg* 17 19.8within 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

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

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

30. Diabetes related hospitalizations CHA p. 82 (SPARCS data as of Sep. 2004) Rate /10,000 residents, 1998-2003

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

32. Cardiovascular disease mortality CHA p. 101 (NYS Vital Statistics data as of Aug. 2004) Average Age adj. Rate /100,000 residents, 2000-2002

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

34. Birth Rate: /1,000 females age 15-44 CHA p. 88 (NYS Vital Stats 2000-2002) Family Planning

35. Teens age 15-19 Tompkins has the lowest teenage birth rates in the area. CHA p. 88 (NYS Vital Stats 2000-2002) Births per 1,000 female residents

36. Births to mothers age 30-44 years Almost half of Tompkins’ births are to mothers age 30–44. CHA p. 92 (NYS Vital Stats 2000-2002) Percent of live births

37. Postneonatal Mortality (28 days–1 yr.) CHA p. 153 (NYS Vital Stats, 2000-2002) Average Rate per 1,000 Live Births

38. 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

39. Infant Mortality (up to age 1 yr.) CHA p. 154 (NYS Vital Stats, 2000-2002) Neonatal + Postneonatal = Infant

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

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

42. Suicides CHA p. 133 (NYS Vital Stats 2000-2002) Age. adj. Rate /100,000 residents

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

44. Priorities

45. 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

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

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

48. Online access www.tompkins-co.org /wellness/cha05/ Theresa Lyczko: tlyczko@tompkins-co.org Ted Schiele: tschiele@tompkins-co.org