EPLAN 2011-2015
Evanston Project for the Local
Assessment of Needs
By: Evanston Health Department
Moving Forward
Background
• EPLAN – Evanston’s
version of the IPLAN
• IPLAN
– Conducted every 5
years by local health
departments
– Required for LHD
certification
– Based on Assessment
Protocol for
Excellence in Public
Health (APEX-PH)
Evanston Community Needs
Assessment Survey
• Conducted in December 2009
• Random sample of Evanston residents
• Investigated perceived public health
needs of those residents
Evanston Community Needs
Assessment Survey Results
1
Most Important
Factors for a
Healthy Community
Easy access to
affordable
health care
Low crime/safe
neighborhoods
2
Good jobs and
healthy economy
3
Most Important
Health Problems in
Our Community
Obesity
Substance abuse
Most Important
Risky Behaviors in
Our Community
Injury/violence
prevention
Being overweight
Drug abuse
Poor eating habits
Evanston Community Needs
Assessment Survey Results
Health Programs needed in Evanston in order of
importance:
1)
Nutrition services and promotion of physical activity
2)
Immunization services
3)
Mental health services
4)
Senior services
5)
Emergency preparedness
6)
Substance abuse prevention
7)
Family planning services
8)
Climate change initiatives
9)
Adolescent health promotion
10) Smoking cessation programs
EPLAN Survey
• Conducted during September to
December 2010
• Random sample of Evanston residents
• Survey questions adopted from the
BRFSS standardized surveys
• Investigated health behaviors and
beliefs of Evanston residents
EPLAN Survey Results
• Residents delayed seeking health care due to
cost issues
• High prevalence of hypertension
• Low rates of heart attack and stroke awareness
• High prevalence of smoking
• High prevalence of alcohol consumption and
binge-drinking patterns
• Residents identified multiple reasons for not
exercising regularly
• Poor nutritional habits
IL Department of Public
Health
Evanston
Outside City Limits
Diseases of the Heart
125
1
Malignant Neoplasms
111
4
Chronic Lower Respiratory Diseases
28
Cerebrovascular Diseases
24
Influenza and Pneumonia
22
Accidents
15
Diabetes Mellitus
12
Septicemia
11
Alzheimer’s Disease
10
Nephritis, Nephrotic Syndrome, and Nephrosis
7
Parkinson’s Disease
9
Intentional Self-harm (Suicide)
3
Essential Hypertension and Hypertensive
Renal Disease
1
1
EHAC Survey Administration
• Conducted in 2011 via
email
• For 21 council
members
• Investigated top three
health priorities for
Evanston
– Access to health care
– Chronic health
conditions
– Physical activity and
nutrition
Digging Deeper
• Access to Health Care
• Chronic Health Conditions
• Nutrition and Physical Activity
• Risk and Contributing Factors
• Community Health Plan Objectives and
Strategies
Access to Health Care
Risk and Contributing Factors
Lack of/Inadequate Health
Insurance
1)
Unemployment
–
–
2)
Lack of Health Care
Resources Tailored to the
Unique Needs of the
Community
1)
Job seekers lacking
necessary skill set
Non-availability of
jobs
–
Socioeconomic status
–
–
–
–
Lack of education
(e.g. high school
dropouts)
Racial disparities
Poverty
Language and
cultural barriers
Disparities in access to
health care
–
2)
Language and
cultural barriers (esp.
Hispanic
populations)
Knowledge barriers
among low-income
minority populations
Increasing rates of
teenage pregnancy
–
–
Lack of specialized
support groups and
community health
centers for teenagers
Lower high school
graduation rates
among minorities
Lack of Health Care
Providers/Facilities for
Underinsured and Uninsured
1)
Designated medically
underserved areas
–
2)
Closure of satellite
clinics by Cook
County
Fewer providers
accepting
Medicaid/Public Aid
–
–
Delayed
reimbursement
Low or no
reimbursement
Access to Health Care
Community Plan
Outcome
Objectives
By 2015, provide
access to
comprehensive
health care
services to lowincome families in
Evanston
US Census, 20052009 ACS Survey
• Percentage of
families below
poverty level: 4.8%
• Percentage of
individuals below
poverty level: 9.7%
Impact
Objectives
By 2013, establish
a Federally
Qualified Health
Center to provide
primary health
care and cater to
needs of 5,516
unduplicated
patients within 2
years of
establishment
Intervention
Strategies
• Opening a local
satellite clinic will
Improve access
• Provision of
umbrella services
will reduce
perceived barriers
• Home-grown
partnerships
promote
ownership of
programs by the
community
Resources
Available
• Evanston Health
Department
• Erie Family
Health Center
• NorthShore
University Health
System
• St. Francis
Hospital
• Local social
service agencies
Barriers and
Challenges
• Transportation
• Perceived
susceptibility
• Perceived threat
• Cues to action
Chronic Health Conditions
Risk and Contributing Factors
Tobacco Use
1)
Parent smoker
–
–
2)
1)
Access to tobacco
products
Addictive nature
–
Access to tobacco
products
Media
–
–
2)
–
–
Lack of anti-smoking
ordinances
Poor implementation
of existing
ordinances
Work place/public
smoking
–
3)
Perceived severity,
perceived threat
Perceived
susceptibility
Lack of free/mass
screening efforts in the
community
–
–
–
Excessive Alcohol Use
1)
Lack of/inadequate
health insurance
Transportation costs
Inherited costs (e.g.
loss of pay)
Personal choice
–
Secondhand smoking
–
Cost of screening
–
Peer pressure
–
3)
Lack of Primary Prevention
Efforts
Organizational costs
Transportation costs
Poor advertisement
Access to alcohol
–
–
2)
Parental tolerance
Access to alcohol at
home Poor
implementation of
law at points of sale
Peer pressure
–
–
–
Adult role models
who drink
Glamorization by
media
Social acceptance
Chronic Health Conditions
Community Plan
Outcome
Objectives
Impact
Objectives
By 2015, reduce
the number of
deaths caused by
cardiovascular
disease by 10%
By March 2012,
increase
participation rate
in Kick Butts Day
by 10%
2006 IPLAN data
for Evanston
• Coronary heart
disease mortality
rates: Crude
number – 92;
Premature (<65) –
17
By March 2013,
increase the
number of
residents who quit
smoking by at
least 10%
Intervention
Strategies
• Reducing client
out-of-pocket
costs for smoking
cessation
therapies
• Mass media
campaigns when
used with other
interventions
Resources
Available
• Evanston Health
Department
• NorthShore
University Health
System
• St. Francis
Hospital
• YMCA
• PEER Services
• Northwestern
University
Barriers and
Challenges
• Addictive nature
• Secondhand
smoke exposure
• Access to
products
Physical Activity and
Nutrition
Risk and Contributing Factors
Physical Inactivity
1)
Access to facilities
–
–
–
–
–
2)
Cost of working out
Transportation
Poor time management
Bad weather conditions
Availability of parks, walking paths, and
bike routes
Poor Nutrition
1)
–
–
–
–
2)
–
Lack of awareness
Low perceived risk
Television viewing, video gaming, and
computers
Inconsistent efforts
3)
Media
Ease of access
Distorted portion control
Lifestyle/convenience
Addictive nature of junk food
–
–
–
Behavioral choices
–
–
–
Abundance of fast food and junk food
High fat content
Food additives
Perceptions regarding comfort food
Availability of nutritious food
–
–
–
Cost of fruits and vegetables
Distribution of supermarkets
Seasonal availability
Physical Activity and
Nutrition Community Plan
Outcome
Objectives
By 2015, reduce
the number of
adults who do not
get any exercise
by 10%
BRFSS 2009
Suburban Cook
County
Percentage of
residents who
currently do not
get any exercise:
24%
Impact
Objectives
By 2012, increase
the number of
participants in
Women Out
Walking program
by 10%
Intervention
Strategies
• Community-wide
campaigns
• Social support
interventions to
community
settings
Resources
Available
• Evanston Health
Department
• City of Evanston
• Northwestern
University
• Evanston
Chamber of
Commerce
• Evanston 150
• Rotary
International
• Evanston Public
Library
Barriers and
Challenges
• Bad weather
• Poor time
management
• Cost of gym
memberships
Acknowledgements
•
Evanston Health Department Staff
–
•
Evanston Health Advisory Council
–
•
–
–
–
–
John Alexander, MD, Acting Executive Director and Medical Director of Northwestern University Health
Services Evanston Campus
Dr. Kalyan Nadiminti, St. Francis Hospital
Dianne Rucinski, Ph.D, Health Evaluation Collaborative & Institute for Health Research and Policy
Rebecca Wurtz, MD, MPH, Director of the MPH Program at Northwestern University
Felicia Morgan, Salvation Army Social Services
Northwestern University Volunteers
–
•
George S. Rudis, MA, CPHA
Community Members
–
•
Karen Chavers; Mary Daley; Natasha Deutsch; Kim Fisher; Avery Hart, MD; Delores Holmes; Dr. Edward
Hughes; Mary Larson, CSN; Louis Rowitz, PhD; Bonnie Lockhart, RN; Angelique Richard, PhD, RN; Paul
Luning, MD, MPH; Woody McCally; Julianne Russell; Mark Schroeder; Marybeth Schroeder; C. Louise
Brown; Donald W. Zeiglar, PhD; Judith Simon; Tanille Baaske Smith; Jennifer Vyenielo
IL Department of Public Health
–
•
Bruce Doblin, MD; Carl Caneva; Jonathan Webb; Sree Pilla; Dr. Avinash Pasam; Diane Keenan; Sandra
Waggoner; Robyn Nisi
Lauren Slubowski; Sana Ali; Sarah Basore; Sophia Blachman-Biatch; Laura Booth; Chelsea Cooper;
Lauren Dawson; Blake Erickson; Allison Finn; Jennifer Hemesath; Jenna Kastan; Ummul-Kiram
Kathawalla; Lindsey Kreutzer; Allison Lazarus; Joanne Maliekel; Anna Messier; Marielle Meurice;
Kathryn Nathanson; Christopher Oh; Sojung Park; Lakshmi Ramachandran; Alexandra Rivkin; Emily
Roskey; Jay Shiao; Ritika Singh; Meera Sriram; Matthew Stephens; Leah Thomas; Sandeep Tummala;
Katherine Wang; Alexandra Wong; Teisha Lightbourne; Jessice Gottesman; Katie Raynolds; Swen
Hendrickson; Ben Diapola
Kellie Perkins, Health Director Intern
–
–
(757) 329-4005
[email protected]
Thank You
Are there any questions?
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EPLAN Survey - City of Evanston