PALISADES MEDICAL CENTER
NORTH BERGEN, NJ
COMMUNITY HEALTH NEEDS ASSESSMENT
December 2012
TABLE OF CONTENTS
President’s Letter……………………………………………………………………
i
Executive Summary…………………………………………………………………
ii
Introduction…………………………………………………………………………...
1
Community Served………………………………………………………………
3
Existing Health Care Facilities and Resources…………………………….
6
Sources of Patient Service Revenue …………………………………………
7
Methods and Results……………………………………………………………….
8
How Data was Obtained………………………………………………………..
10
Limitations………………………………………………………………………...
11
Primary Data………………………………………………………………………
12
Secondary Data………………………………………………………………….
18
Health Needs of the Community………………………………………………
20
Primary and Chronic Disease Needs of the Community………………….
24
Prioritizing Issues and Addressing Community Health Needs……………..
25
Process for Prioritizing Needs…………………………………………………
25
Process for Consulting with Community…………………………………….
28
Collaborative Health Improvement Plan…………………………………………
29
Appendices……………………………………………………………………………
30
Appendices
Appendix A: Steering Committee and Community Partners…………………..
Appendix B: Palisades Medical Center Community Health Survey 2012
(English & Spanish)……………………………………………………
Appendix C: Community Health Needs Assessment – Community Health
Survey Final Report…………………………………………………..
Appendix D: Palisades Medical Center Focus Group Questions
(English & Spanish)……………………………………………………
Appendix E: Palisades Medical Center Focus Group Responses……………
30
61
65
Appendix F: County Health Profiles Comparison……………………………….
68
Appendix G: Palisades Medical Center Community Health Screening Data
72
Appendix H: County Health Rankings Comparison……………………………..
Appendix I: Palisades Medical Center Prioritizing Issues and Concerns
Worksheet………………………………………………………………
Appendix J: Action Plan Template……………………………………………….
73
31
40
76
77
From the President
At Palisades Medical Center, we are proud of our strong tradition of community service.
Our staff and volunteers work with our community partners to improve the lives of
thousands of local residents by continually offering free health screenings, educational
seminars, training and classes, facility tours and other activities. In fact, the New Jersey
Hospital Association recognized our efforts with its Community Outreach Award.
Palisades Medical Center’s strategic plan includes a key focus on identifying and
addressing the most pressing health needs in our communities. Our longstanding and
active partnerships with social and civic organizations, religious congregations, schools,
and local employers place us in a uniquely effective position to accomplish these
objectives. This 2012 Community Health Needs Assessment is the result of a
collaborative effort of our community partners that worked throughout the past year to
the most-pressing healthcare needs in our service area, including Cliffside Park,
Edgewater, Fairview, Guttenberg, North Bergen, Union City Weehawken, and West
New York.
This comprehensive report is the result of a thorough assessment of our area's
healthcare profile, including a review of public health data, summary patient information
from care providers, and new data obtained by means of focus groups, public forums
and a community needs assessment survey. This assessment also includes action
items and plans to address the prevailing healthcare concerns in our community.
We deeply appreciate the work of our Steering Committee and Community Partners that
are highlighted in this report. We also thank the hundreds of community residents that
provided valuable feedback in our surveys and forums.
For more information about the 2012 Community Health Needs Assessment, please
contact Annarelly “Annie” McNair, MPH, HO, Manager of the Community Needs
Assessment, at (201) 854-5201 or amcnair@palisadesmedical.org.
Bruce J. Markowitz
President and CEO
Palisades Medical Center
i
Executive Summary
The Palisades Medical Center Community Needs Assessment is a comprehensive
initiative to identify, analyze, and address the healthcare needs of eight municipalities in
northern Hudson and southern Bergen counties. These municipalities are Cliffside
Park, Edgewater, Fairview, Guttenberg, North Bergen, Union City, Weehawken, and
West New York. This initiative is also a partnership between the hospital, North Hudson
Community Action Corporation, Hudson Regional Health Commission, Union City Board
of Education and municipal health departments of North Bergen, West New York, Union
City, Guttenberg, Weehawken, and Cliffside Park.
The healthcare issues prevalent in the project’s service area are impacted by a number
of social and cultural factors. The area is urban, low-income, and largely Hispanic.
More than half the area’s population is foreign-born, and more than one in three
residents have limited English language proficiency.
The scope of this project included a thorough assessment of the area’s healthcare
profile, including a review of public health data, summary patient information from
hospital admissions and emergency room visits, and new data obtained by means of
focus groups and a community needs assessment survey. From this analysis, and with
additional input from a series of public forums, the project partners developed this
Community Needs Assessment to address the following five areas of concerns
identified in the assessment process; Access to Health Care, Alcohol Abuse,
Inadequate Social Support, Obesity, and Tobacco Use.
Action items for the five areas of concern will constitute specific plans to address the
prevailing healthcare issues in the community. They will effectively constitute sub-
ii
projects, each with their own deliverables, and will be promptly implemented by the
project partners.
After approximately six months of implementation, the project partners will undertake a
structured review of their progress on each of the action items. The partners will review
lessons learned, and will participate in a second series of public forums to obtain
community input. This process will conclude with revisions and improvements to the
action item plans, and the publication of a Collaborative Health Improvement Plan.
iii
Introduction
The March 2010 passage of the Patient Protection and Affordable Care Act introduced new
reporting requirements for private, not-for-profit hospitals to maintain 501(c)(3) tax-exempt
status. Effective for tax years beginning after March 2012, each non-profit hospital must
conduct a Community Health Needs Assessment (CHNA) at least once every three years on a
facility-by-facility basis, identify action plans to address unmet community health needs, and
report the results of each CHNA publicly.
The Palisades Medical Center (PMC) Community Needs Assessment project is a collaborative
initiative designed to deliver a Community Health Needs Assessment and a Collaborative
Health Improvement Plan that are responsive to the health disparities in the targeted
communities and will enhance coordination and collaboration among providers. The care
provider partnering with PMC in this initiative is the North Hudson Community Action
Corporation (NHCAC), the local Federally Qualified Health Center. Other partners that have
collaborated with us since the inception of the project have been the Union City Board of
Education and the public health partners include six health departments of the eight
municipalities within the service area, as well as Hudson Regional Health Commission. During
the data collection phase of the assessment, other community partners (Appendix A) were
invited to assist us in their expertise and with the implementation of the plans.
1
There was a significant body of existing work before this project began that shed light on the
needs of the service area. By way of example, the following three components were cited in
the Hudson County Community Health Improvement Plan (CHIP) prepared in 2007. These
examples are illustrative of the healthcare issues plaguing the service area:
•
Hudson County has the highest percentage of children living in poverty in NJ (22%)
•
Hudson County had the second highest rate in the state of hospital admissions for
“Ambulatory Care Sensitive” diagnoses (i.e. conditions treatable by a primary care
physician such as asthma, heart disease, diabetes, etc.) for populations under 65
years of age
•
Hudson County had the highest rate in NJ of hospital admissions for “Ambulatory
Care Sensitive” diagnoses for patients under 18 (double the statewide average)
All of this data again highlights the need for better access to primary care and improved
outreach, screening, and education in the service area. Identifying the social, economic, and
cultural barriers that have stymied past efforts in these areas are key components of the
planning process.
2
Community Served
This project will address the needs of eight municipalities in a contiguous area of northern
Hudson and southern Bergen counties. These municipalities are Cliffside Park, Edgewater,
Fairview, Guttenberg, North Bergen, Union City, Weehawken, and West New York. The area
may be generally described as urban, lower-income, and largely Hispanic. A significant
portion of the population has limited English language proficiency. The eight municipalities,
together with some key demographic data are set forth in the following table.
DEMOGRAPHIC DATA FOR THE SERVICE AREA, 2010 Census
Other
than
English
Spoken
at Home
English
Spoken
Less than
“Very Well"
Per Capita
Income
Below
Poverty
Level
Hispanic
Population
75.1%
87.2%
83.3%
72.3%
32.2%
46.5%
46.1%
34.0%
$25,674
$18,506
$24,419
$33,239
9.9%
20.0%
18.1%
16.0%
68.4%
84.7%
78.1%
64.8%
36.2%
----------53.0%
52.6%
-----------72.8%
20.1%
------------36.3%
$45,206
------------$24,633
12.9%
-----------15.8%
40.3%
------------74.2%
BERGEN COUNTY MUNICIPALITIES
47.8%
Edgewater
11,513
Fairview
13,835
53.3%
Cliffside Park
23,594
40.5%
------------- ----------Subtotal:
48,942
44.7%
46.5%
72.8%
59.2%
-----------55.3%
15.4%
32.2%
22.3%
------------21.7%
$58,220
$22,477
$36,157
------------$37,480
8.5%
15.0%
10.5%
-----------11.3%
11.1%
54.6%
28.4%
------------31.8%
249,608
51.4%
69.4%
33.4%
$27,152
14.9%
65.9%
634,266
905,116
8,791,894
40.6%
28.4%
20.3%
57.9%
36.7%
28.7%
25.3%
13.8%
12.1%
$31,024
$42,006
$34,858
15.1%
5.8%
9.1%
42.2%
16.1%
17.7%
Foreign
Location
Population
Born
HUDSON COUNTY MUNICIPALITIES
North Bergen
60,773
48.9%
Union City
66,455
57.0%
W. New York
49,708
60.7%
Guttenberg
11,176
52.1%
Weehawken
Subtotal:
TOTAL:
Hudson Cty.
Bergen Cty
New Jersey
12,554
------------200,666
Source: US Census Bureau: State & County Quick Facts. Data derived from Population Estimates, American
Community Survey, Census of Population & Housing, State & County Housing Unit Estimates, County Business
Patterns, Economic Census, Survey of Business Owners, Building Permits, Consolidated Federal Funds Report.
3
While the service area comprises less than 2.8% of New Jersey’s total population, it is home to
almost 11% of the state’s Hispanic population. More than half the area’s population is foreign
born and nearly 70% of the area’s residents do not speak English at home. More than one in
three report that they speak English less than very well-- a rate almost three times above the
statewide average.
As might be expected with these limited language skills, the earning power and economic well
being of the area’s residents is compromised. Per capita income is more than three quarters
of the average for New Jersey, while the poverty rate is nearly double the statewide average.
These social factors conspire to exacerbate the area’s healthcare challenges.
The service area’s five Hudson County communities constitute about 32% of the total Hudson
County population, while the Bergen County towns comprise only 5% of that county’s
population. In both cases, data for the service area was more challenging relative to the larger
county profiles. On average, residents of the Hudson County communities in the service area
earn 32% less than the typical Bergen County resident ($81,708 compared to $55,272
respectively), and are 46% more likely to have limited English-language proficiency.
Municipalities in the service area show about the same poverty rate and a higher percentage
of foreign born residents than Hudson County as a whole.
The three Bergen County municipalities in the service area show an even greater variance to
the overall Bergen County profile. The poverty rate in the Bergen County communities in the
service area is approximately double the overall rate for Bergen County, and the percentage of
residents with limited English-language proficiency is nearly double as well. It is arguable that
these three communities in fact have more in common with their Hudson County neighbors
than they do with their Bergen County peers.
Despite these variances, however, the overall health profiles of Hudson and Bergen Counties
are deemed to be generally reflective of the issues impacting the municipalities in the service
4
area. The social and economic profile of the service area suggests that its residents’ needs
may be needs different in degree, but not necessarily in kind.
Just over 80% of the service area’s population resides in Hudson County. As per Robert
Wood Johnson Foundation and University of Wisconsin County Health Rankings in 2012,
Hudson County ranks 16th among New Jersey’s 21 counties for Health Outcomes. It was
noted, however, that the County ranked 18th in the self-reporting of “poor or fair health” (24% of
respondents). Of greater concern, Hudson County ranked 19th for Health Factors, despite a
fairly respectable 12th place ranking for Health Behaviors. The rankings were brought down by
very low scores for Clinical Care measures, as 23% of the population lacks health insurance
coverage, care provider ratios were also low, and preventable hospital stays were high.
Adding to this problem are poor scores for both social and economic factors and for Hudson
County’s physical environment. Access to care and quality of care are obviously areas of
prime concern for the people of Hudson County.
By way of contrast, Bergen County ranks 4th among New Jersey counties in both Health
Outcomes and Health Factors. Bergen County finishes no lower than 4th place in any
subcategory except for a 5th place ranking for Morbidity.
The Hudson and Bergen County Community Health Improvement Plans (CHIP) constitute the
most significant current planning efforts to address the needs of this community. There is a
high level of congruence in the top five healthcare needs identified in both of the CHIPs.
Hudson and Bergen CHIPS: Top Five Health Issues (2007)
Hudson County
Bergen County
1) Access to Care
1) Access to Care
2) Substance Abuse
2) Mental Health
3) Heart Disease
3) Obesity
4) Diabetes
4) Alcohol, Tobacco, & Other Drugs
5) Lead Poisoning
5) Communication of Health Issues
5
Access to care is obviously the primary healthcare concern in both counties. The issue is only
exacerbated by low levels of insurance coverage, high poverty rates, and limited English
language proficiency prevalent in the service area.
Existing Health Care Facilities and Resources
Palisades Medical Center is the only hospital active within the service area. The non-profit
operates a 202-bed hospital providing a diverse range of inpatient and outpatient services,
including, among others, internal medicine, surgery, obstetrics, gynecology, cardiology,
pediatrics, emergency care, gastroenterology, diabetic care center, breast care center, wound
care center, palliative care program, pain relief center, rehabilitative medicine program, and
pediatric rehabilitation. The ancillary services of PMC include, among others, a
cardiopulmonary department, a laboratory, and radiology. As of December 31, 2011, medical
staff totaled 268 and approximately 89% are board-certified or board eligible. PMC also
credentials allied health professionals and licensed professionals, including advance practice
nurses and physician assistants.
Palisades is the largest employer in its service area with more than 1,300 employees and it
has an annual operating budget of approximately $150 million. The State of New Jersey’s
annual healthcare report card ranked Palisades as one of the top hospitals in the state and #1
in Hudson County. Palisades was also one of only two hospitals in New Jersey to receive a
perfect 100% score in treating heart attack patients. The State’s annual evaluation showed that
The Harborage at Palisades has “Zero Deficiencies” for the second consecutive year. The
New Jersey Hospital Association (NJHA) recognized Palisades Medical Center with its
Community Outreach Award for its positive impact in our local communities.
The closest alternative hospitals are Hackensack University Medical Center (approximately 9
miles north), Hoboken University Medical Center (about 4 - 5 miles south), and Christ Hospital
6
and the Jersey City Medical Center (each about 6 -7 miles to the south). North Hudson
Community Action Corporation, a federally qualified health center and Health Professional
Shortage Area (HPSA) designated facility operates three clinics in the service area. (A fourth
clinic in Garfield, NJ is the only FQHC serving southern Bergen County, and operates just
outside the service area). Each of the municipalities in the service area has its own health
department and the area is also served by two regional health departments; Hudson Regional
Health Commission and the Bergen County Department of Health Services.
Sources of Patient Service Revenue
The table below shows the historical trend in payer mix for Palisades Medical Center for the
years 2009-2011.
Payer
Medicare
Medicaid
NJ Blue Cross
HMO (1)
Commercial
Self-Pay and Other
Total
2009
51%
7%
3%
24%
1%
14%
100%
2010
50%
7%
4%
24%
1%
14%
100%
2011
49%
7%
4%
26%
1%
13%
100%
(1) Includes Medicare and Medicaid HMO programs
7
Methods and Results
PMC was awarded a grant from New Jersey Health Initiative, the statewide grantmaking
program of the Robert Wood Johnson Foundation to conduct the community needs
assessment and implement plans. A Steering Committee was formed to provide advice,
direction and information to develop and implement the assessment and action plan. The
Steering Committee includes members of Palisades Medical Centers, North Hudson
Community Action Corporation (the federally qualified health center in the service area),
Hudson Regional Health Commission (the county environmental health agency and Local
Information Network Communication Systems (LINCS) agency), Union City Board of Education
and Municipal Local Health Departments.
The first step was to review existing public health data. The area’s health care profile was
reviewed from multiple sources such as the Hudson County and the Bergen County
Community Health Improvement Plans (CHIP), the Robert Wood Johnson Foundation and
University of Wisconsin “County Health Rankings”, Health Research and Educational Trust
(HRET) of New Jersey “Building Healthier Communities: County Profiles of the Community’s
Health” for Hudson and Bergen counties, and United States Census Data for 2010.
For further comparison, 2010 hospital data was collected on Emergency Department Visits for
Primary Care Conditions and Hospital Admissions for Select Ambulatory Care Sensitive
Conditions. PMC’s rates were ranked and compared with those of Hudson County and New
Jersey for further analysis of the community’s healthcare profile.
Data gathered during Palisades Medical Center’s Community Health Screening in the spring of
2012 was also reviewed. These screenings are conducted by the hospital’s Community
Outreach Program at more than a dozen places of worship in the service area. Finally, recent
data was obtained by conducting four focus groups as well as distributing and collecting
community needs assessment surveys in the eight municipalities of the service area.
8
After the data was reviewed, the Steering Committee prioritized issues to select the top five
concerns the hospital will address in the Collaborative Health Improvement Plan. The partners
will work collaboratively to execute at least five action items from November 2012 to the
termination of the project. Individual plans will be developed for each of these initiatives, which
will include goals and measurable objectives. Relevant data will be collected as each action
item is executed. After approximately six months of operation, a “checkpoint” will be initiated
to determine progress and measure the effectiveness of each action item. The partners will
then undertake a comprehensive review of the action item executions. A participant’s
workshop will be held among the project partners to examine the results of their efforts and to
review lessons learned. This phase will also include public forums to provide community
members with an opportunity to provide their feedback and offer their suggestions for
improvement.
With the completion of the public forums, PMC and the project partners will refine the plans for
each action item and incorporate the changes in approach through the remainder of the project
term. The final results will be published in a report to be made available to the public at large.
9
How Data Was Obtained
This section describes the primary and secondary research that was conducted to gather
qualitative as well as quantitative data. Primary research was mainly conducted since the
service area encompasses eight municipalities in two different counties and furthermore, there
is only partial data available by zip codes. Therefore, to gather firsthand details on community
residents’ views and opinions of the service area, a survey tool was designed and focus
groups were conducted. To gather primary quantitative data, hospital data was collected.
Secondary research entailed reviewing existing data from other sources such as the Hudson
and Bergen counties Community Health Improvement Plans, County Health Rankings, and
other data available through multiple sites such as the New Jersey Department of Health,
Centers for Disease Control and Prevention (CDC) Healthy People 2020, CDC’s Behavioral
Risk Factor Surveillance System, and US Census. Overall, the project utilized a mixed
methods approach to provide the most informative, complete, balanced, and useful results.
10
Limitations
More than 80% of the population that Palisades Medical Center (PMC) serves resides in
Hudson County. Unfortunately, Hudson County does not have a county health department
and as a result, it is very challenging to obtain data at the county or local level. While Hudson
County has a Department of Health and Human Services it is not recognized by the New
Jersey Department of Health as a local health department. Another agency, Hudson Regional
Health Commission provides County Environmental Health Act (CEHA) and emergency
preparedness (LINCS) functions in support of the local health departments, but also does not
serve as a county health department. In Hudson County each municipality has its own
municipal health department or an inter-local agreement with another municipal health
department and they are all members of the Hudson Regional Health Commission, but no
formal method has been established for collecting non-emergency or environmental public
health data. In addition, as previously mentioned, the service area’s five Hudson County
communities constitute about 32% of the total Hudson County population, while the Bergen
County towns comprise only 5% of that county’s population. In both cases, data for the service
area was more challenging relative to the larger county profiles. Therefore, PMC decided that
it was best to collect primary data, or data obtained directly through surveys, interviews and
direct observation. Primary data is more costly to obtain than secondary data, which is
obtained through published sources, but it is also more current and more relevant to a
research project.
11
Primary Data
Community Health Survey
The hospital developed a survey tool similar to the one that was utilized for the Hudson County
Community Health Improvement Plan, which in turn, was gathered from one of the examples in
the National Association for County and City Health Officials website. The survey (Appendix
B), written in English and Spanish, was distributed in person at various gatherings such as
churches, libraries, community events and other settings from January 2012 through April
2012. For statistical significance, a survey sample size was calculated. Three hundred eighty
four surveys were needed for a 95% confidence level and a 5% confidence interval in a service
area of approximately 250,000 people. The anonymous survey consisted of 32 questions and
focused on demographics, community health and safety, personal health and community
health, and community life. A hospital representative would attend different events and
distribute the survey throughout the eight municipalities of the service area. A community
resident would complete the survey in person and return it to the hospital representative.
Survey completion time varied from 10-20 minutes and due to health literacy issues or lack of
reading skills, the bilingual hospital representative would assist a community resident if
necessary. Overall, four hundred forty six surveys were completed and response rate
accurately depicted each municipality based on the percentage of residents compared to the
whole service area. A consultant was hired to input the data and provide an overall summary
which is available in Appendix C.
12
The following are some questions and responses pertaining to community and personal health
from the survey:
Question 1: What do you think are the three most important factors that define a “Healthy
Community” (those factors that most affect the quality of life in a community). The top five
responses were Good Schools, Access to Health Care and Other Services, Low Crime/Safe
Neighborhoods, Good Jobs & Economy, and Clean and Healthy Environment.
Question 2: “What do you think are the three most important “health problems” in your
community” and the top six “health problems” selected were Lack of Access to Healthcare,
Chronic Diseases, Nutrition (Obesity), Substance Abuse, Teen Pregnancy, and Domestic
Violence.
Question 6: “What do you think are the three most serious safety problems for people in
your community?” The following were the top five responses: Alcohol & Drug Abuse, Unsafe
Driving, Smoking, Gang-related Activity, School Violence.
Question7: “Within the past year, were you able to get needed healthcare? 67% responded
“Yes”, 17% responded “No” and 15.2% responded “Not needed.”
Question 8: When asked:” How do you pay for your health care?” Health Insurance was the
top answer with 48% responses and Self Pay was the second most frequently identified
payment method, cited by 30% of the respondents. Other responses included Medicare,
Charity Care, NJ FamilyCare and Medicaid.
13
Focus Groups
Focus groups were conducted to help gain perspective as to the most significant health issues
and barriers to care impacting the service area. Four focus groups were conducted from
December 2011 through February 2012. Eleven questions were utilized from the University of
Medicine and Dentistry of New Jersey - School of Public Health, Health Systems and Policy
that had been successful in previous focus groups (Appendix D). Questions were mailed in
advance for all participants to review. During the focus group sessions, participants were first
asked to complete a consent form. Participants then sat in a circle seating arrangement so
that everyone could see each other and encourage discussion. The format consisted of a 45
minute discussion, 30 minute lunch break, and another 45 minute discussion.
The first focus group was completed with community leaders, the community partners and
members of the steering committee. The second one was done with hospital employees,
mostly nurses that also live in the service area. The third and fourth focus groups were
conducted with community residents as well as patients. Patients included those from
Palisades Medical Center as well as patients from the local Federally Qualified Health Center.
During the last two focus groups with community residents and patients, questions were
distributed in English and Spanish and all the discussions were translated into both languages.
Responses were compiled for all four focus groups and the following comments emphasize the
participants’ reactions (Appendix E):
When asked “What do you see as the most important health problems in the area surrounding
Palisades Medical Center?” The top three responses were:
•
Obesity and Diabetes
•
Cardiovascular Health and Hypertension
•
Mental Health: Stress, Depression, Alzheimer’s, Domestic Violence, ADHD, and
Autism
14
When asked “From your perspectives, what behaviors do residents engage in that place them
and perhaps others at greatest risk?” The top four responses were:
•
Substance Abuse: excessive alcohol, drugs, and smoking
•
Unhealthy Eating
•
Sedentary Lifestyle: lack of physical activity or exercise
•
Loneliness: lack of socialization, no family or friends, or support network
Hospital Data
In 2012, the Health Research and Educational Trust of New Jersey (HRET), an affiliate of the
New Jersey Hospital Association, published County Health Profiles for the twenty one counties
in New Jersey. HRET identified available data and statistical resources and then presented
them in an easy-to-use format via these profiles. Palisades Medical Center was specifically
interested in Emergency Department Visits for Primary Care Conditions and Hospital
Admissions for Select Ambulatory Care Sensitive (ACS) Conditions since access to primary
health care continues to be an important health issue. ACS conditions are unattended medical
conditions of individuals without proper access to primary and preventive healthcare that often
results in more severe episodes. This ultimately leads to the use of more expensive treatment
options, including hospital admissions for illnesses that could have been managed on an
outpatient basis.
Since more than 80% of the service area resides in Hudson County, it was decided that it was
best to compare New Jersey and Hudson County data for 2010 with Palisades Medical
Center’s admission and emergency department data (Appendix F). The New Jersey Hospital
Association suggested that for hospital data rates, calculations should be conducted based on
total population for each age category of the hospital admissions in 2010, while the county and
state rates be expressed in 1,000 per population.
15
When comparing the top 10 reasons for emergency department visits for primary care
conditions in children under 18 years of age, fever was ranked the highest at PMC while otitis
media and Eustachian tube disorders ranked first in both Hudson County and New Jersey.
The top six conditions (Fever, Abdominal Pain, Unspecified Viral Infection, Asthma, Otitis
Medical and Eustachian Tube Disorders, Anxiety Disorders including Post-traumatic stress
disorder (PTSD)) were comparable to Hudson County’s top seven conditions. In addition,
Hudson County rates were higher for these six conditions compared to New Jersey State.
When comparing the top 10 reasons for emergency visits for primary care conditions in adults
between the ages of 18-63, anxiety disorders including PTSD was ranked the highest at PMC
while alcohol dependence ranked first in both Hudson County and New Jersey. Alcohol
dependence rates in Hudson County more than doubled the state’s rates and it was ranked
third on the hospital’s list. The hospital’s top three conditions (Anxiety Disorders including
PTSD, Abdominal Pain and Alcohol Dependence) were comparable to Hudson County’s top
five conditions. In addition, Hudson County rates were higher for these three conditions
compared to the state.
When comparing hospital admissions for select ambulatory care sensitive (ACS) conditions in
children under 18 years of age, Asthma was ranked the highest at PMC and in New Jersey.
Asthma ranked second in Hudson County yet rates for the county were more than one and a
half percent higher than those for the state. The hospital’s top seven conditions for ACS in
children were comparable to the county’s top eight conditions. In addition, Hudson County
rates for the top seven county conditions were higher than the state’s rates.
When comparing hospital admissions for ACS conditions in adults between the ages of 18-63,
bacterial pneumonia was ranked the highest at PMC while asthma was ranked the highest in
Hudson County and dehydration volume depletion (secondary diagnosis) was ranked the
highest in New Jersey State. Diabetes admissions were second in the hospital’s rankings and
16
third for the county. Diabetes was ranked second in the state along with bacterial pneumonia,
both with a rate of 1.11 per 1,000 in the population. The hospital’s top eight conditions
(Bacterial pneumonia, diabetes, kidney/urinary infection, gastroenteritis, asthma, chronic
obstructive pulmonary disease (COPD), convulsions and congestive heart failure (CHF)) were
comparable to the county’s top nine conditions.
Community Health Screenings
Throughout the year, Palisades Medical Center’s staff takes an active role in the community by
partnering with multiple agencies to provide free health screenings and education programs in
multiple places of worship in the service area. The New Jersey Hospital Association
recognized Palisades Medical Center’s Community Outreach Program with its Community
Outreach Award for its unique and effective methods of reaching out to better serve the
healthcare needs of area residents. Body Mass Index (BMI) rates for adults participating in
these health screenings were collected. BMI is a simple index of weight-for-height that is
commonly used to classify overweight and obesity in adults. The World Health Organization
defines obesity as a BMI greater than or equal to 30. In the spring of 2012, between February
and April, PMC provided services in seven houses of worship and served 528 community
members (Appendix G). One-third or 33% of the participants were obese compared to the
County Health Rankings where in 2012, 24% of adults reported a BMI >/= 30 in Hudson
County. Usually higher rates were reflective of communities with lower socio economic status.
The Community Outreach Program will conduct additional screenings in the autumn of 2012
and continue to collect BMI data for future comparison.
17
Secondary Data
County Health Rankings
In 2010, the Robert Wood Johnson Foundation collaborated with the University of Wisconsin
Population Health Institute to create the County Health Rankings. The County Health
Rankings rank the health of nearly every county in the nation and show that much of what
affects health occurs outside of the doctor’s office. The County Health Rankings confirm the
critical role that factors such as education, jobs, income, and environment play in the health of
the community.
The Rankings were created to help counties understand what influences how healthy residents
are and how long they will live. They look at a variety of measures that affect health such as
the rate of people dying before age 75, high school graduation rates, access to healthier foods,
air pollution levels, income, and rates of smoking, obesity and teen births. The Rankings,
based on the latest data publicly available for each county, are unique in their ability to
measure the overall health of each county in all 50 states on the multiple factors that influence
health.
Since Palisades Medical Center serves five municipalities in Hudson County which constitute
about 32% of the total Hudson County Population and three municipalities in Bergen County
which constitute 5% of that county’s population, a chart was created to compare Hudson
County data with Bergen County data as well as New Jersey State data from 2010 to 2012
(Appendix H). The National Benchmark values were also added since they are the goals set
for all the counties in the nation.
In 2012, Hudson County ranked 16th among New Jersey’s 21 counties for Health Outcomes
and Bergen County ranked 4th. Health Outcomes are based on the equal weighting of
mortality (premature death) and morbidity measures. It is noted, however, that Hudson County
ranked 18th in morbidity measures due to the self-reporting of “poor or fair health” (24% of
18
respondents), “poor physical health days”, “poor mental health days” and results for “low birth
weight” (8.3%) while Bergen County ranked 5th with 12% of respondents self-reporting “poor or
fair health” and a “low birth weight” rate of 7.6%.
Of greater concern, Hudson County ranked 19th for Health Factors. Health Factors rankings
are based on weighted scores of four types of factors: behavioral, clinical, social and
economic, and environmental. Despite a fairly respectable 12th place ranking for Health
Behaviors (adult smoking, adult obesity, physical inactivity, excessive drinking, motor vehicle
crash death rate, sexually transmitted infections and teen birth rate), Bergen County ranked
4th. The rankings for Hudson County in the Health Factors category were brought down by
very low scores for Clinical Care measures (uninsured, primary care physicians, preventable
hospital stays, diabetic screening, mammography screening), as 23% of the population lacks
health insurance coverage, care provider ratios are low, and preventable hospital stays are
high compared to Bergen County where 13% are uninsured, care provider ratios are better
than the National Benchmark and preventable hospital stays were low compared to the state
average.
Despite the contrast in rates between Hudson and Bergen counties, it was previously
mentioned in the Community Served section that the three municipalities that Palisades
Medical Center serves in Bergen County have double the rate for poverty and nearly double
the rate for residents with limited English-language proficiency. Thus, it is fair to assess that
these municipalities have more in common with the Hudson County municipalities in the
service area than with the Bergen County as a whole.
19
Health Needs of the Community
With the completion of the information gathering stage, the steering committee and hospital
administrators identified the following nine topics as the areas of greatest need in the
community. This section reveals the nine topics in alphabetical order with supporting data that
was gathered in the Focus Groups (Appendix E), Community Surveys (Appendix C), County
Health Profiles (Appendix F), and County Health Rankings (Appendix H).
Access to Health Care
Focus Groups – Participants discussed that there was a great need for accessible care
outside the 9-5 hours, better patient-provider communication, and school-based health
Community Surveys – Access to Health Care was the most selected “top three” health
problem in the community (168 out of 455 responses)
County Health Profiles - Emergency Dept. visits by children (under 18 yrs old) in 2010
for Primary Care Conditions rate was 117.34 in county vs. 102.53 in NJ and for adults
(18-64 yrs old) rates were 166.44 in Hudson County vs. 136.92 in NJ (rates expressed
in 1,000 per population)
20
Alcohol and Drug Abuse
Focus Groups – Participants discussed that alcohol consumption and drug abuse were
two of the top three risky behaviors in the community
Community Surveys - The third most selected “health problem” (120 out of 455
responses) and alcohol and drug was the top safety problem (262 out of 455
responses)
County Health Profiles - Emergency Dept. visits by adults (18-64 yrs old) in 2010 for
Primary Care Condition: Alcohol dependence rate; 54.79 in Hudson County vs. 26.26 in
NJ & drug dependence rate (18-64 yrs old) 10.11 in Hudson County vs. 8.76 in NJ
(rates expressed in 1,000 per population)
Diabetes
Focus Groups – Participants discussed that diabetes was one of the top three most
important health problems
Community Surveys – Diabetes was the second top chronic illness that “they or family
member experience” (104 out of 455 responses)
County Health Profiles – Diabetes ranked 8th for Palisades Medical Center’s total
Ambulatory Care Sensitive (ACS) admissions for Children (under 18 yrs old) & ranked
2nd for total ACS admissions for Adults (18-64 yrs old)
Domestic Violence
Focus Groups – Participants discussed that domestic violence is one of the top
behaviors in the community that puts others at risk
Community Surveys – Domestic Violence ranked 5th as one of the”top three health
problems” that affects our community (87 out of 455 responses)
21
Hypertension / Cardiovascular Disease
Focus Groups – Participants discussed that hypertension and cardiovascular disease
were two of the top three most important health problems in our service area
Community Surveys – Hypertension and Cardiovascular Disease were selected as the
top three most important “health problems” in community and also selected as a top
chronic illness that they or family member experience (154 out of 455 responses)
County Health Profiles – Unspecified chest pain ranked 4th and Other chest pain ranked
5th for Palisades Medical Center’s total Ambulatory Care Sensitive (ACS) admissions for
Adults (18-64 yrs old) & Congestive Heart Failure ranked 8th and Angina ranked 10th
for total ACS admissions for Adults (18-64 yrs old)
Inadequate Social Support
Focus Groups – Participants discussed that Inadequate Social Support is a top behavior
that places person or others at risk due to loneliness, lack of socialization, and no family
or friends
Community Surveys - 59% of survey participants reported not participating in any
community activities
County Health Rankings - Percent of adults without social/emotional support 30% in
Hudson County vs. 21% in Bergen vs. 22% in NJ)
County Health Profiles - Depression and Other Mood Disorders ranked 6th in
Emergency Department visits for Adults (18 to 64 yrs old) in Individual Primary Care
Conditions, 2010
22
Obesity
Focus Groups – Participants discussed that obesity is one of the top three most
important health problems in our service area and also one of the top three behaviors
that residents engage that put them at risk
Community Surveys – Obesity was the second most selected “top three” health problem
in the community (152 out of 455 responses)
County Health Rankings - 28% adult physical inactivity in Hudson County vs. 24% In
Bergen vs. 25% in NJ
Teen Pregnancy
Focus Groups – Participants discussed that teen pregnancy was one of the top
five risky behaviors in our service area.
Community Survey – Teen Pregnancy was selected as a top three most important
“health problem” in community (99 out of 455 responses – ranked 4th)
County Health Rankings - Teen birth rate per 1,000 female population, ages 15-19; 39
in Hudson County vs. 8 in Bergen vs. 25 in NJ
Tobacco Use
Focus Groups – Participants discussed that tobacco use was one of the top three risky
behaviors affecting our community
Community Surveys – Tobacco use was the third most selected “health problem” in our
service area (120 out of 455 responses – ranked 3rd) & Smoking was ranked 3rd as a
safety problem 153 out of 455 responses)
County Health Rankings - Percent of adults that report smoking >/= 100 cigarettes; 19%
in Hudson County vs. 15% in Bergen vs. 17% in NJ
23
Primary and Chronic Disease Needs of the Community
To properly analyze primary and chronic disease needs for our service area, further analysis
occurred of the data collected on hospital admissions for ambulatory care sensitive conditions
for adults between the ages of 18-64, in 2010 (Appendix F). The data revealed that the
greatest admission was for bacterial pneumonia, an acute condition. Thus there needs to be a
greater emphasis by our primary care providers, federally qualified health centers, and the
public health community to promote pneumococcal vaccines.
Four out of the hospital’s top ten admissions were related to chronic diseases: diabetes,
asthma, chronic obstructive pulmonary disease, and congestive heart failure. Thus in
prioritizing issues and selecting concerns that Palisades Medical Center plans to address,
focus will have to occur on behaviors that affect these four conditions.
When reviewing hospital admissions rates for select ambulatory care sensitive conditions for
children under the age of 18, asthma was ranked the highest. Environmentally, there is a need
to implement policies for clean air as well as encourage smoking cessation to assist children in
their exposure to 2nd hand and 3rd hand smoke.
24
III. Prioritizing Issues and Addressing Community Health Needs
Process for Prioritizing Needs
After identifying the top issues assessed as needs in the hospital’s community, the steering
committee then met to prioritize the top five issues impacting the service area. A worksheet
was developed (Appendix I) utilizing the Healthy People 2020 MAP-IT framework as a guide.
Of greatest concern was which of the nine issues affected the majority in the community,
possible interventions in solving the problem, likelihood of success or impact, current
interventions that currently exist in the community and consequences if these issues are not
addressed. In August of 2012, the steering committee completed “prioritizing issues”
worksheets for each of the nine concerns and then after reviewing the information, target
issues were narrowed to the following five concerns: Access to Health Care, Alcohol Abuse,
Inadequate Social Support, Obesity, and Tobacco Use.
Access to Health Care was chosen as a top five issue due to the high rates of Emergency
Department visits in our hospital for Ambulatory Care Sensitive Conditions. Despite the
hospital’s great efforts to educate the community to utilize the Federally Qualified Health
Center as a primary clinic, Palisades Medical Center (PMC) continues to get increased
Emergency Department visits for those conditions. This is mainly due to the large number of
recent immigrants in our community as well as undocumented immigrants in our service area
that do not have health insurance and do not visit a Primary Care Physician on a regular basis.
Thus, by the time immigrants enter PMC’s Emergency Department, their condition has
worsened.
25
Alcohol Abuse was chosen as a top five issue since it is considered a serious health problem
as well as a safety problem in our community. Alcohol Abuse is also affecting children in this
community as younger adults report drinking alcohol on a regular basis. In a 2012 Student
Anonymous Survey of 9-12th graders in Union City 18.6% of 1,092 students reported “getting
drunk at least once in the past four weeks.” In 2011, it was 22.7% out of 1,162 students.
Inadequate Social Support was chosen as a top five issue because there seems to be a
disconnection between residents and services provided in the community. As previously
mentioned, with large numbers of recent immigrants in the community, many of them do not
know the health care system process and also do not have the family and community support
they were accustomed to in their homeland. Since health is also determined in part by access
to social and economic opportunities as well as the nature of social interactions and
relationships, the steering committee decided this would be an important issue in assisting the
community in resolving many of their health issues.
Obesity was chosen as a top five issue since it is a risk factor that contributed to some of the
top nine issues that were prioritized: Diabetes and Hypertension/Cardiovascular Disease.
Steering committee members decided that it would be important to target the behavior instead
of choosing multiple chronic diseases. Physical activity in the service area is limited due to the
community’s perception of unsafe streets. Nutrition and weight status are also of great
concern since many immigrants have limited health literacy skills and are not knowledgeable of
nutrition labels and may not have access to healthy foods.
26
Tobacco Use was also chosen as a top five issue since it is a behavior associated with asthma
and chronic obstructive pulmonary disease (COPD) which were top conditions in our County
Health Profiles (Appendix F). The steering committee also chose tobacco use as a top issue
since many smoking cessation programs have ceased in the community. In addition, there
has been an increase of children smoking regular cigarettes as well as marijuana. In a 2012
Student Anonymous Survey of 9-12th graders in Union City 14.9% of 1,092 students reported
“using marijuana at least once in the past four weeks.” In 2011, it was 13.8% out of 1,162
students.
27
Process for Consulting with Community
Throughout the entire needs assessment process, the hospital consulted with local health
officials, community residents, and community partners. Local health departments are
represented in our Steering Committee (Appendix A) which has been responsible in prioritizing
issues and reviewing all components of the projects on a quarterly basis as well as on a
needed basis. Community residents were able to voice their concerns during two focus group
sessions and also provide their views and opinions in their community health survey
responses. Residents were also invited to public forums for a complete overview of the
primary and secondary data that was collected as well as a discussion on the five needs that
were identified. Community residents will also be invited on an annual basis to future public
forums to discuss the impact of program implementation and evaluations of the Collaborative
Health Improvement Plan. PMC also consulted with community partners by inviting them to a
separate focus group. The same focus group questions were asked to the community partners
and their comments were valued based on their professional expertise and experience in
working with the community surrounding the hospital. Community partners will also be invited
to assist in the planning process of the Collaborative Health Improvement Plan by suggesting
potential projects that the hospital should implement as well as attending bi-annual meetings
on each of the five issues once the plans have been implemented and evaluated.
28
IV. Collaborative Health Improvement Plan
In the next step of the needs assessment, PMC will be utilizing the Healthy Wisconsin
Leadership Institute, Community Health Improvement Toolkit. Their template will be utilized to
develop goals and action plans for each of the five concerns (Appendix J). Community
partners, especially those with expertise in the selected top five issues, will be invited to attend
five working sessions. Each session will focus on one of the concerns. Once the community
partners suggest potential projects, the hospital will hold a public forum. At the public forum,
community residents will rank the suggested projects based on programs they would like to
see implemented in the community. The Steering Committee will then review all the projects
and select feasible plans. Actions plans will then be proposed to the Palisades Medical Center
Board of Governors for approval and implementation in the community. Once the projects are
implemented, they will be evaluated every six months through process and impact evaluation.
Public forums will be conducted on an annual basis with public health officials, community
residents, community partners and patients to discuss project implementation and evaluations
as well as to obtain feedback. The Steering Committee will meet on a quarterly basis to
monitor progress of the implemented plans and make any required changes based on
evaluations and community feedback. Community Partners will continue to meet on a biannual basis on each of the five areas of concerns to provide updates on standards of practice
and to monitor progress of the implemented plans as well.
29
Appendix A: Steering Committee and Community Partners
Steering Committee
•
•
•
•
•
•
•
•
•
•
Cliffside Park Health Department
Guttenberg Board of Health
Hudson Regional Health Commission
North Bergen Health Department
North Hudson Community Action Corporation
Palisades Medical Center
Union City Early Childhood Education Program
Union City Board of Health
Weehawken Board of Health
West New York Health Department
Community Partners
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
American Diabetes Association
Amerigroup
Bergen’s Promise
Bergen County Department of Health Services
Division of Child Protection and Permanency
Elite Healthcare Inc.
Healthfirst, NJ
Hoboken Family Planning
Horizon Health Center
Hudson Country Division of Planning
Hudson County Family Success Centers
Hudson Medical Assistance Customer Center
Hudson Partnership CMO
Partners in Prevention
Partnership for Maternal and Child Health of Northern, NJ
Puerto Rican Family Institute, Inc.
Save Latin America, Inc.
30
Appendix B: Palisades Medical Center Community Health Survey 2012 (English & Spanish)
Palisades Medical Center Community Health Survey 2012
Your opinion is important to us! Please take a moment to complete the survey below. The purpose of this survey
is to get your opinions about quality of life and health issues. Results of this survey will be available on the
Palisades Medical Center website (www.palisadesmedical.org). If you have previously completed this survey,
please do not fill out another. Thank you, and if you have any questions please contact us at
survey@palisadesmedical.org.
In this survey, “community” refers to the area where you live, shop and get services.
Please check one from the following list:
Cliffside Park
Edgewater
Fairview
Guttenberg
North Bergen
Union City
Weehawken
West New York
Please circle the number to the left of your answer.
1. In the following list, what do you think are the three most important factors that define a “Healthy Community”
(those factors that most affect the quality of life in a community).
Circle only three numbers:
1 Community Involvement
2 Low crime / safe neighborhoods
3 Good Schools
4 Access to health care & other services
5 Parks and recreation
6 Preventive health care education
7 Affordable housing
8 Tolerance for diversity
9
10
11
12
13
14
15
16
Good jobs and healthy economy
Strong family life
Healthy behaviors and lifestyles
Low death and disease rates
Religious or spiritual values
Arts and cultural events
Clean and Healthy Environment
Other___________________________
2. In the following list, what do you think are the three most important “health problems” in your
community? (Those problems that have the greatest impact on overall community health.)
Circle only three numbers:
1 Lack of Access to Healthcare (clinics in the
12 Infectious Diseases (TB, hepatitis, etc.)
evening hours, school-based care, etc.)
13 Food Borne Diseases
2 Mental health issues
14 Substance Abuse
3 Homicide
15 Sexual Assault/Rape
4 Child abuse / neglect
16 Chronic Diseases (cancer, heart, lungs, diabetes,
5 Suicide
high blood pressure)
6 Teenage pregnancy
17 Aging problems (arthritis, hearing/vision loss)
7 Domestic violence
18 Tobacco Use
8 Firearm-related injuries
19 Homelessness
9 Nutrition (obesity)
20 Undocumented Immigrant Population
10 Sexually Transmitted Disease (HIV, herpes,etc.)
21 Other_________________________
11 End of Life Care
3. How would you rate your community as a healthy community to live in? (Circle one)
1
Very Unhealthy
2
Unhealthy
3 Somewhat Healthy
4
Healthy
5
Very Healthy
4
Healthy
5
Very Healthy
4. How would you rate your own personal health? (Circle one)
1
Very Unhealthy
2
Unhealthy
3 Somewhat Healthy
5. How would you rate your community as a safe place to grow up or to raise children? (Circle one)
1
Very Unsafe
2
Unsafe
3 Somewhat Safe
4
Safe
5
Very Safe
31
6. In the following list, what do you think are the three most serious safety problems for people in your community?
Circle only three numbers:
Unsafe driving
Alcohol and drug abuse
Racism & intolerance
Not using seat belts and safety seats, helmets
Unsafe/unprotected sex
Unsafe roads/sidewalk conditions
Access to firearms by children
Smoking
1
2
3
4
5
6
7
8
7. Within the past year, were you able to get needed healthcare?
9
10
11
12
13
14
15
16
Yes
Manufacturing of methamphetamines
Growing Marijuana
School violence
Child abuse and neglect
Domestic violence
Gang-related activity
Senior abuse and neglect
Other____________________________
No
Not Needed
If no, please describe / explain: _____________________________________________________
8. How do you pay for your health care?
Circle all numbers that apply:
1
No insurance (pay cash)
2
Health Insurance (private insurance, Blue
Cross/Blue Shield, HMO)
Medicaid (public assistance)
Medicare
Medicare Supplemental Insurance
3
4
5
6
7
8
9
10
NJ FamilyCare
Veterans Administration
Indian Health Service
Charity Care
Other______________________________
9. Have you or anyone living in your home have any of the following chronic illnesses?
Circle all numbers that apply:
1
2
3
4
5
6
Diabetes
Cancer
Heart Disease
Lung Disease/Asthma
HIV/AIDS
Alcohol or drug dependency
7
8
9
10
11
High Blood Pressure
Hepatitis
Arthritis
Hearing/Vision Loss
Other ____________________
10. Within the past year, what type of health services did you or anyone living in your home receive outside your
community?
Circle all numbers that apply:
1
None
11
Immunizations
2
Lab work
12
General Practitioner care
3
General Surgery
13
Mental health services
4
Urology care
14
Eye Care
5
Ear, Nose, Throat Care
15
Orthopedic/Bone care
6
Podiatry Care
16
Cardiac/Heart Care
7
X-Ray/MRI
17
Dental Care
8
Hearing services
18
Orthodontia
9
Family Planning
19
Obstetrics/Gynecology
10 Emergency room service
20
Other____________________________
If you got health care outside your community, why? (Circle all numbers that apply)
1
2
3
My doctor is in another city.
No doctors or providers for services I need.
No doctors that speak my language.
4
5
6
insurance only covers doctors in another area.
No appropriate doctors accept Medicaid.
Could not find a good provider.
32
11. Within the past year, did you or anyone in your family require any type of mental health services?
No
If No, please go to question number 12.
Yes
If Yes, what type of service was utilized? (Circle all numbers that apply)
1
Crisis Care
3
Counseling/Therapy
2
Hospitalization
4
Drug & Alcohol
Where did you go for services? (Please explain/describe) _______________________________
12. Within the past year, what type of social service benefits did you or anyone in your family need?
Circle all numbers that apply:
1
None
6
Medicaid
2
Food Stamps
7
Respite Care
3
NJ FamilyCare
8
Subsidized Child Care
4
General Assistance
9
Charity Care
5
Housing Assistance
10
Other________________________
If you needed social benefits, were you able to get them in your community?
Yes
No
13. Within the past year, have any of your family/friends needed long-term care placement (nursing home,
rehab, etc.)?
Yes
No
If yes, was there any difficulty obtaining placement? Please describe / explain: ______________________________
14. Are you currently employed? (Circle one)
1
Not employed
3
Employed Part-time _____ (Hours per week)
2
Self-employed
4
Employed Full-time
If employed, who do you work for? _________________________________________________
and what type of work do you do? __________________________________________________
If not employed, what is the main reason you are not working? (Circle one)
1
Sick or disabled
3
Retired
5
Need training
2
Cannot find work
4
Taking care of family
6
Other____________________
5
6
Too much stress
Not Working
15. How much stress do you feel at your job on a regular basis? (Circle one)
1 None
2 A little stress
3
4
Some stress
A lot of stress
16. How many days in the past month were you not able to work or do your daily activities because
of illness? (Circle one)
1
None
2
One to several days
3
Most days
4
Every day
17. Do you think there are enough jobs in your community for youth?
Yes
No
for adults?
Yes
No
18. How much of your household income do you think goes into your rent or mortgage? (Circle one)
1
None
19. Do you 1 rent
2 One-third
2 own your home
3 One-half
3 live with others who rent/own
4 Three-fourths
4 other________? (Circle one)
33
20. Are you satisfied with your housing situation?
Yes
No
If no, why not? (Circle all numbers that apply)
1
too small /crowded
4
2
problems with other people
5
3
too run down / deteriorated
6
21. In my community, the places where I go for recreation most often are:
too expensive
too far from town/services
other _______________________
Circle only three numbers:
1
parks
8
health/fitness clubs
2
movie theaters
9
dance halls
3
live theater/dance performances/concerts
10
place for yoga, tai-chi, etc.
4
social club/service club
11
church
5
rivers/lake/beaches/woods
12
senior center
6
sports fields
13
library
7
swimming pools
14
other____________________________
22. Approximately how many hours per month do you participate in community activities such as volunteering / suppor
groups / meetings / free trainings? (Circle one)
1 None
2 1-5 hours
3
6-10 hours
4 Over 10 hours
23. I would spend more time participating in community activities if (Circle one)
1
2
3
I had information about them
There were more activities available
Had time to do it
4
5
6
I had extra money
They were family-related activities
Other_____________________________
24. Would you like to obtain information on community events and activities?
Yes
No
If yes, how would you like to receive this information? (Circle all numbers that apply)
1 Television
4 Internet
2 Newspaper
5 Mail
3 Radio
6 Other_____________________________
Please answer the following questions about yourself so that we can see how different types of people feel about
these local health issues.
25. Zip code where you live:
26. Your Gender:
Male
29.
Female
27. Your age:
1 Under 18 years
2 18 - 25 years
3 26 - 39 years
4 40 - 54 years
5 55 - 64 years
6 65 - 80 years
7 Over 80 years
28. Group you most identify with:
1
2
3
4
5
6
African American / Black
Asian
Hispanic / Latino
Native American
White / Caucasian
Other__________________________
Annual Household Income:
Less than $20,000
$20,000 a $39,999
$40,000 a $74,999
Over $75,000
30. Number of people in your household: ____
1
2
3
4
31. Your highest education level:
Less than High School graduate
High School Diploma or GED
College degree or higher
Other_________________________
Where did you get this survey?
1
2
3
4
32.
1
2
3
4
5
6
7
Church
Community Meeting/Event
Grocery Store / Shopping Mall
Post Office
Electronic mail
Library
Other_______________________
34
Palisades Medical Center Encuesta de Salud Comunitaria 2012
¡Su opinión es importante para nosotros! Por favor tome uno momento para completar este cuestionario.
El propósito de esta encuesta es para obtener su opinión sobre asuntos de calidad de vida y de la salud.
Los resultados de este cuestionario estarán disponibles en la página Web de Palisades Medical Center
(www.palisadesmedical.org). Si usted ha llenado esta encuesta anteriormente, por favor no llene otra. Gracias, y si tienes
alguna pregunta, por favor comuníquese con nosotros vía survey@palisadesmedical.org.
En este cuestionario, la "comunidad" se refiere al área donde usted vive, hace compras y consigue servicios. Por favor de
la siguiente lista escoja una ciudad que consideras su comunidad:
Cliffside Park
Edgewater
Fairview
Guttenberg
North Bergen
Union City
Weehawken
West New York
Por favor circule el número a la izquierda de su respuesta.
1. En la lista siguiente, circule los tres factores más importantes que definen una "Comunidad Sana" (esos factores que
más afectan la calidad de vida en una comunidad).
Circule solamente tres números:
1 Participar o involucrarse en la comunidad
2 Crimen bajo / vecindades seguras
3 Buenas escuelas
4 Acceso al cuidado medico y otros servicios
5 Parques y recreaciones
6 Educación preventiva de cuidados médicos
7 Viviendas económicas
8 Tolerancia de diversidad, sin discriminación
9
10
11
12
13
14
15
16
Buenos trabajos y economía saludable
Fuerte apoyo familiar
Comportamiento y formas de vida sana
Baja proporciones de muerte y enfermedad
Religión y valores espirituales
Artes y acontecimientos culturales
Ambiente limpio y sano
Otro___________________________
2. ¿En la lista siguiente, cuales piensa usted son los tres "problemas de salud” que mas afectan la
comunidad? (Esos problemas que tienen mayor impacto en la salud de la comunidad.)
Circule solamente tres números:
1 Falta de acceso de cuidado médico (clínicas en
las tardes, cuidado vía escuelas, etc.)
2 Asuntos de salud mental
3 Homicidio
4 Abuso o negligencia de niños
5 Suicidio
6 Embarazo adolescente
7 Violencia domestica
8 Heridas relacionadas con armas de fuego
9 Nutrición (obesidad)
10 Enfermedades transmitida sexualmente (herpes)
11 Cuidado durante el final de vida
12
13
14
15
16
17
18
19
20
21
Enfermedades infecciosas (hepatitis, TB, etc.)
Enfermedades producidas por alimentos
Abuso de sustancias o drogas
Asalto o violaciones sexuales
Enfermedades crónicas (cáncer, corazón,
pulmones, diabetes, presión arterial)
Problemas de envejecimiento (artritis, perdida de
audición/oír o de la visión )
Uso de tabaco
Falta de vivienda o personas sin hogar
Población de inmigrantes indocumentados
Otro_________________________
3. ¿Cómo clasificaría su comunidad al respecto de una comunidad sana para vivir? (Circule uno)
1 Muy Mal
2 Poco Saludable
3 Algo Saludable
4 Saludable
5 Bien Saludable
4 Saludable
5 Bien Saludable
4. ¿Cómo usted clasificaría su propia salud personal? (Circule uno)
1 Muy Mal
2 Poco Saludable
3 Algo Saludable
5. ¿Cómo clasificaría su comunidad en aspecto de seguridad y desarrollo de niños? (Circule uno)
1 No Seguro
2 Poco Seguro
3 Algo Seguro
4 Seguro
5 Bien Seguro
35
6. ¿En la lista siguiente, cuales usted piensa que son los tres problemas más serios de seguridad
para personas en su comunidad?
Circule solamente tres números:
1
2
3
4
5
6
7
8
El conducir sin cuidado
Abuso de alcohol o drogas
Racismo e intolerancia
No usar cinturón, asientos de seguridad, cascos
Sexo sin protección
Caminos inseguros/condiciones de aceras
Acceso a armas de fuegos por niños
El fumar
7. ¿En el último año, pudo conseguir cuidado necesario de salud?
9
10
11
12
13
14
15
16
Fabricación de metanfetamina o meth
Sembrar marihuana
Violencia en las escuelas
Abuso y negligencia hacia los niños
Violencia domestica
Actividades de pandillas
Abandono y abuso de personas mayores
Otro_______________________________
Sí
No
No Fue Necesario
Si no, por favor describe o explique. _____________________________________________________
8. ¿Cómo usted paga por su atención medica?
Circule todo los números que apliquen:
1
2
Ningún seguro (pago en efectivo)
Seguro medico (seguro privado, HMO, seguro
del trabajo, Blue Cross/ Blue Shield)
Medicaid (ayuda publica)
Medicare (ayuda publica de personas mayores)
Seguro Suplementario de Medicare
3
4
5
6
7
8
9
10
NJ FamilyCare
Administración de Veteranos
Servicios de Salud para Americanos Nativos
Cuidado de Caridad (Charity Care)
Otro________________________________
9. ¿Usted o alguien que vive en su hogar tiene alguna de las siguientes enfermedades crónicas?
Circule todo los números que apliquen:
1
2
3
4
5
6
Diabetes
Cáncer
Enfermedad cardiaca o del corazón
Enfermedad de pulmones o Asma
VIH/SIDA
Dependencia de alcohol o drogas
7
8
9
10
11
Problemas de presión arterial
Hepatitis o inflamación del hígado
Artritis
Perdida de audición/oír o de la visión
Otro _________________________
10. ¿Dentro del último año, qué tipo de servicios médicos recibió usted u otra persona en su hogar
fuera de su comunidad?
Circule todo los números que apliquen:
1
2
3
4
5
6
7
8
9
10
Ninguno
Trabajo de laboratorio
Cirugía general
Cuidado de urología
Cuidado de oído, nariz, y garganta
Cuidado de podiatra
Placas o MRI
Servicios de oído o de la audiencia
Planificación familiar
Servicios de emergencias
11
12
13
14
15
16
17
18
19
20
Inmunizaciones
Cuidado general o internista
Servicios de salud mental
Cuidado de ojos o optometría
Cuidado ortopédicos o de hueso
Cuidado de cardiología o del corazón
Cuidado dental
Odontología
Obstetricia o ginecología
Otro____________________________
Si utilizó cuidado médico fuera de su comunidad, ¿porque? (Circule todos los que apliquen)
1 Mi medico esta en otra ciudad.
4 Mi seguro solamente cubre médicos en otras áreas.
2 No hay médicos o proveedores de servicios que necesito.
5 Ningún medico apropiado acepta Medicaid.
3 No hay médicos que hablen mi idioma.
6 No pude encontrar un proveedor bueno.
36
11. En este año, usted u otro miembro de su familia utilizó algún tipo de servicios de salud mental?
No
Sí
1
2
Si no, por favor siga la encuesta con la pregunta numero 12.
Si contesto sí, qué tipo de servicio utilizó? (Circule todo los números que apliquen)
Cuidado de Crisis (Crisis Care)
3
Consejero/Terapia
Hospitalización
4
Drogas y el Alcohol
¿Donde fue para los servicios? (Por favor explique/describe) ____________________________
12. ¿En el último año, qué tipo de servicios sociales necesitó usted u otro miembro de su familia?
Circule todo los números que apliquen:
11
12
13
14
15
Ninguno
Estampillas o cupones de alimentos
NJ Cuidado de Familia (NJ FamilyCare)
Asistencia general
Asistencia para la vivienda
16
17
18
19
20
Medicaid
Cuidado temporáneo o de plazo de familia
Descuento para cuidado de niño
Cuidado de Caridad (Charity Care)
Otra________________________
¿Si usted necesitó beneficios sociales, pudo conseguirlos en su comunidad?
Sí
No
13. ¿En el último año, algún miembro de su familia o alguna amistad suya ha necesitado colocación
de largo plazo de cuidado (facultad de enfermera, asilo de ancianos, etc.)? Sí
No
¿Si contesto que sí, tuvo dificultad en obtener colocación? Por favor explique o describe:
____________________________________________________________________________
14. ¿Estas actualmente empleado? (Circule uno)
1
Sin empleo
3
Tiempo Parcial (part-time) _____ Horas por semana
2
Independiente
4
Emplead
Si estas empleado, para quien trabaja usted: _________________________________________
Y que tipo de trabajo hace usted:___________________________________________________
Si no estas empleado, ¿cuál es la razón principal por la que no estás trabajando? (Circule uno)
1
2
Enfermo o lisiado
No consigo empleo
3
4
Retirado
Cuidando familia
15. ¿Cuánta tensión siente usted en su trabajo regularmente? (Circule uno)
1 Ninguna tensión
3 Alguna tensión
2 Un poco de tensión
4 Mucha tensión
5
6
Necesito entrenamiento
Otro______________
5
6
Demasiada tensión
No trabajo
16. ¿En el ultimo mes, cuántos días se paso usted sin trabajar o sin hacer sus actividades diarias
debido a alguna enfermedad? (Circule uno)
1 Ninguno
2 Uno a varios días
3 La mayoría de los días
4 Todo los días
17. ¿Crees que hay bastante trabajo en la comunidad para los jóvenes?
Sí
No
¿Para los adultos?
Sí
No
18. ¿Qué parte de su ingreso o salario va hacia su alquiler o hipoteca? (Circule uno)
1 Ninguno
2 Un tercio
3 Una mitad
4 Tres-cuartos
19. Usted 1 Alquila 2 Es dueño de su hogar 3 Vive con otros que alquilan o posean 4 Otro____?(Circule uno)
37
20. ¿Estás satisfecho con su situación de vivienda? Sí
No
¿Si no, porque? (Circule todo los números que apliquen)
1 Demasiado pequeño o apretado
2 Problemas con otras personas
3 Falta de mantenimiento / deteriorado
4
5
6
Muy caro
Muy lejos del pueblo o servicios
Otro_______________________
21. En mi comunidad, los lugares donde más frecuento para mi recreación son:
Circule solamente tres números:
1 parques
8 salones de ejercicio/salud
9 salones de bailes
2 teatros de películas
10 lugares de yoga, tai-chi, etc.
3 teatro en vivo/danzas/conciertos
4 club social/club de servicios
11 iglesias
12 centro de ansíanos
5 ríos/lagos/playas/bosques
6 campos de deportes
13 biblioteca
7 piscinas
14 otro_______________________________
22. ¿Aproximadamente cuantas horas al mes participas en actividades comunitarias, tales como
trabajo voluntario, grupos de apoyo, reuniones, entrenamientos gratis? (Circule uno)
1 ningunas
2 1-5 horas
3 6-10 horas
4 más de 10 horas
23. Me gustaría dedicarle más tiempo participando en actividades comunitarias si (Circule uno)
1 tuviera más información sobre ellas
2 hubieran más actividades disponibles
3 tuviera tiempo para hacerlas
4 tuviera más dinero
5 fueran actividades relacionadas con la familia
6 otro__________________________________
24. ¿Le gustaría obtener información sobre eventos y actividades comunitarias? Sí
No
Si deseas recibir información, señale de qué forma: (Circule todo los números que apliquen)
1 Televisión
2 Periódico
3 Radio
4 Internet
5 Correo
6 Otro_____________________________
Por favor conteste las siguientes preguntas sobre si mismo para poder ver cómo diversos grupos de personas se
sienten sobre los asuntos de la salud local.
25. Código postal donde vives: ______
26. Su género:
Masculino
Femenino
27. Su edad:
1 Menos de 18 años
2 18 - 25 años
3 26 - 39 años
4 40 - 54 años
5 55 - 64 años
6 65 - 80 años
7 Mas de 80 años
28. Grupo con quien más tu te identificas:
1
2
3
4
5
6
Americano Africano / Negro
Asiático
Hispano / Latino
Americano Nativo
Blanco / Caucásico
Otro___________________________
29. Ingreso Anual del Hogar:
1
2
3
4
Menos de $20,000
$20,000 a $39,999
$40,000 a $74,999
Mas de $75,000
30. Numero de personas en su hogar:____
31. Nivel más alto de su educación:
1 Menos de secundaria
2 Secundaria o Equivalente
3 Graduado universitario o nivel mas alto
Otro________________________
32. ¿Donde recibió este cuestionario?
1 Iglesia
2 Reunión o Evento de la Comunidad
3 Supermercado o Áreas de Compras
4 Correo
5 Correo Electrónico
6 Biblioteca
7 Otro________________________
38
Community Health
Needs Assessment
Consumer Survey
May 2012
40
TABLE OF CONTENTS
Page
INTRODUCTION .....................................................................................................
42
RESPONDENT PROFILE .......................................................................................
43
COMMUNITY HEALTH AND SAFETY....................................................................
43
PERSONAL HEALTH AND COMMUNITY HEALTH ASSETS/ISSUES ..................
48
COMMUNITY LIFE—EMPLOYMENT, HOUSING, COMMUNITY INVOLVEMENT
55
41
Introduction
In order to obtain community residents’ opinions for the Community Health Needs
Assessment, a detailed consumer survey was conducted. The pen and paper survey
was distributed at community gatherings during March and April 2012, resulting in 446
completed surveys. Specific venues for survey completion included:
• Churches—42% of respondents.
• Community meetings or events—36% of respondents.
• Libraries—11% of respondents.
• Other—10% of respondents.
The sample was drawn from eight Hudson County towns.
• The most frequently sampled towns were North Bergen and Union City, each
comprising 24% of the survey sample.
• West New York residents were 20% of the sample.
• Residents of Cliffside Park, Edgewater, Fairview, Guttenberg and Weehawken
each comprised less than 10% of the survey sample.
42
Respondent Profile
Individuals completing the survey were:
• Two thirds women.
• Predominant Hispanic (64%). Over a quarter (27%) were Caucasian, 3% were
Asian and 2% were African-American.
• Respondent age was evenly distributed:
34% were between the ages of 40 and 54 years.
31% were under 40 years of age.
35% were over 55 years of age.
• Two-thirds of respondents reported median household incomes under $30,000.
This includes35% with incomes under $20,000.
West New York and Union City residents have the lowest incomes with
55% and 49% reporting incomes under $20,000, respectively.
Weehawken resident had significantly higher incomes than other
participants, with 61% reporting incomes of $75,000.
Edgewater residents also had incomes above those of respondents from
other towns (41% over $75,000 and 35% earning between $40,000 and
$74,999).
• Nearly 40% of respondents are unemployed. Of these, 31% are retired and 24%
cannot find work.
• Nine percent of respondents had not completed high school, 46% were high
school graduates and 41% had a college degree or higher.
Community Health and Safety
Participants were given a list of attributes and asked to identify the three most important
factors that define a healthy community.
• Good schools was the most frequent answer, provided by 46% of
respondents.1
• This was followed by access to health care and other services (39%) and low
crime/safe neighborhood (37%).
• Responses did not vary significantly by town of residence. (Refer to Tables 2
and 2A)
The most important health problems in participants’ communities included:
1. Lack of Access to Healthcare
2. Chronic Diseases and Nutrition/Obesity
3. Substance Abuse
4. Teen Pregnancy
5. Domestic Violence
Detail is provided in Tables 3 and 3A below.
1
Throughout this analysis, if questions allowed multiple answers, percentages are based on the total
number of respondents (n=446).
43
When asked to rate their communities as a healthy community to live in with 1 being
“very unhealthy” and 5 being “very healthy,” the average rating was 3.20.
• Ratings ranged from 2.95 in Guttenberg to 3.53 in Weehawken. (Refer to Tables
4 and 4A)
• Participants were asked to rate their communities’ as safe places to grow up or
raise children. On a scale with one being “very unsafe” and 5 being “very safe,”
the overall rating was 3.30.
• Responses ranged from 3.04 for Fairview residents to 3.79 for Weehawken
residents.
•
The top community safety issues included: alcohol and drug abuse, unsafe driving, smoking,
gang-related activity and school violence. (Refer to Tables 5, 5A, 6 and 6A)
44
45
46
47
Personal Health and Community Health Assets/Issues
When asked to rate their own health with one being very unhealthy and five being very
healthy, respondents’ overall rating was 3.55.
• Responses ranged from 3.93 for Cliffside Park residents to 3.10 for Guttenberg
residents. (Refer to Tables 7 and 7A)
48
Respondents were asked if they were able to get needed health care in the past year.
• Two thirds (67%) responded positively and 16% reported not needing health
care.
• Seventeen percent were not able to get needed health care. (Refer to Table 8)
The largest percentages who were unable to access needed healthcare
were Edgewater (27%) and West New York (28%) residents.
Participants were asked how they pay for health care. Multiple responses were
allowed.
• Health insurance was the most frequent response, with 204 (48%) reporting this.
• Self pay was the second most frequently identified payment method, cited by 133
(30%) respondents.
It should be noted, self pay and charity care are often considered together
since it is often very difficult for individuals to pay for expensive health
care treatment without insurance. In this case, however, some of the
respondents may have provided both answers.
• Although 50 respondents reported using Medicare for payment, 68 were over 65
years of age and would be eligible for this payment method.
• New Jersey FamilyCare and Medicaid were the payment method for 37 and 33
respondents, respectively. (Refer to Table 9)
When asked about chronic illnesses that they or their family members experience,
nearly a third of respondents reported high blood pressure. This was followed by:
• Over 100 (22%) with diabetes, arthritis (21%), vision/hearing loss (15%), and
lung disease/asthma (14%). (Refer to Table 10)
When asked about health care services received outside the community, 165 (37%) do
not receive any services outside the community. Services received outside the
community included:
• Lab work (30%),
• Dental care (27%),
• Eye care (23%),
• Emergency treatment (19%),
• Ob/Gyn (14%),
• General practice (13%),
• Immunology (12%)
• Cardiology (10%). (Refer to Table 11)
The most frequent reason for receiving health care outside the community was doctor
location (77%), and having to use doctors required by insurance (18%).
• Additional reasons and towns of residence are presented in Tables 12 and 12A.
Ten percent of respondents report they or someone in their family required mental
health services in the past year.
49
•
•
•
The most frequent service used was counseling, with over two thirds of those
using mental health services accessing this.
Thirteen respondents (30%) reported inpatient hospitalization for a mental
disorder.
Two respondents reported crisis care, and two personally or had family members
who accessed substance abuse treatment. (Refer to Tables 13 and 13A)
In the last year, social service benefits were needed by 38% of respondents or their
families. Those that needed benefits most frequently accessed:
• New Jersey FamilyCare (15%)
• Medicaid (14%)
• Food Stamps (13%)
• Charity Care (12%)
• Housing Assistance (5%)
Two-thirds of respondents report being able to access needed social services in their
local communities. (Refer to Table 14)
• 45% of North Bergen residents were not able to access social services in their
local community compared to 24% of Union City residents.
• All Weehawken residents needing social services were able to access them in
their local community.
Seven percent of respondents report a family member or friend needed long term care
placement in the past year.
50
51
52
53
54
Community Life—Employment, Housing, Community Involvement
Forty percent of respondents are employed full-time, and 39% are unemployed. The
remaining 22% are either self-employed or employed part time.
• Among those who are not working, 31% report it is because they are retired, and
24% report it is because they cannot find work.
• 22% cannot work because they are taking care of family, and 7% are sick or
disabled.
• Among those unemployed, Weehawken has the lowest level with 16%, and
Union City the highest at 45%. (Refer to Tables 15 and 15A)
• Seventeen percent of respondents feel there are not jobs available in the
community for adults, and 26% feel there are not enough jobs available for youth.
While 15% do not spend any of their income on housing, the remaining 85% are evenly
divided between those that spend one third (28%), one half (30%) and three-quarters
(27%) of their incomes on housing.
• Twenty-eight percent own their own homes, while 59% rent their home/apartment
and 12% live with others.
Participants living in Edgewater (46%), Guttenberg (43%) and
Weehawken (37%) are most likely to own their homes.
Participants living in West New York (72%) and Union City (68%) are most
likely to rent.
• While 65% are satisfied with their current housing, 35% are not.
• For those who are not satisfied, the most frequent reasons are the
accommodations are too expensive and they are too small/too crowded. (Refer
to Tables 16, 16A, 17 and 17A).
Places respondents use for recreation include:
• Parks was the most frequent response with early 70% citing it. Parks use is
similar by all participants regardless of town of residence.
• Churches provide recreation for 49% of respondents. North Bergen residents
reported recreation through churches to a greater extent than residents of other
towns.
• Movie theaters and libraries were cited equally, each by a quarter of participants.
• Swimming Pools are used by 17% of respondents. (Refer to Tables 18 and 18A)
When asked how many hours per month they participate in community activities, 59% of
survey participants stated that they do not spend time with these activities.
• Twenty seven percent spend between one and five hours per month, including
43% of Guttenberg residents who provided this response.
• Nine percent report spending over ten hours per month in community activities
with the highest level of participation from Weehawken (28%) and Edgewater
(23%) residents.
• Needing information about these events and not having enough free time were
the two most frequently cited barriers to participation in community activities.
• Eighty six percent would like to receive information about community activities.
55
The best ways to communicate these activities include: mail (45%),
internet (31%), newspaper (30%), television (28%), and radio (15%).
(Refer to Tables 19, 19A and 20)
56
57
58
59
60
Appendix D: Palisades Medical Center Focus Group Questions
(English & Spanish)
Palisades Medical Center (PMC)
Focus Group Questions
The purpose of this focus group is to get your opinions about key community health
issues surrounding the neighborhoods in the Palisades Medical Center serving area
that includes Cliffside Park, Edgewater, Fairview, Guttenberg, North Bergen, Union City,
Weehawken, and West New York. The PMC Community Health Needs Assessment
Steering Committee will use the results from this and other similar focus groups that we
will be conducting with other groups to identify the most pressing problems that can be
addressed through community action. Your opinions are very important.
1. What are some of the things you see as being strengths; positive aspects (assets) in
the community surrounding Palisades Medical Center?
Do all community members have access to these? If not, which community
members and groups are less likely to have access to them?
What factors do you think are the most important for the health and well-being of the
community surrounding Palisades Medical Center?
How about for raising children in terms of schools, day care, after school
programs, etc.?
How about in terms of job opportunity, career growth, higher education, and
affordable housing?
How about for seniors in terms of housing, networking, transportation, etc.?
How about safety in terms of the home, the work place, schools, playgrounds,
parks, malls, etc?
What about networks of support during times of stress and need (family, faithbased, agencies, etc?
What do you see as the most important health problems in the area surrounding
Palisades Medical Center?
2. More specifically, in terms of the health care system in the community surrounding
PMC, what key elements do you think should be considered (should be included)?
Consider such things as availability, accessibility, affordability, acceptability, and
appropriateness.
61
Availability: do services exist in the community surrounding PMC; are they
around?
Accessibility: if the services are there, are the hours and locations convenient so
that you and/or others that you know are able to get to them?
Affordability: do you and/or others know that you know who need the services
have the resources (i.e., the money and/or health insurance) to pay (cover the
cost) for the services?
Acceptability: are you and/or others pleased with the services and the way they
have been delivered to you and/or to others in the community surrounding PMC?
Appropriateness: do the services that you and others have received in the
community surrounding PMC seem to be the right ones?
3. From your perspectives, what behaviors do residents engage in that place them and
perhaps others at greatest risk?
4. Relative to these factors that you have just mentioned, how would you rate the
overall quality of life in the community surrounding PMC?
If the community were going to tackle some of these issues, in what rank order
would you place tackling the top three to five of them?
From your perspective, how can the residents in the community surrounding PMC
make a difference in the quality of life in their community?
To what extent do you believe that there is an active sense of responsibility and
engagement, and of civic pride in shared accomplishments?
5. What other things, if any, do you think are pressing and should be considered as we
gather information that will be used to support initiatives to make a difference in the
community surrounding Palisades Medical Center?
Courtesy of the University of Medicine and Dentistry of New Jersey - School of Public Health, Health Systems and Policy
62
Palisades Medical Center (PMC)
Preguntas Para el Grupo de Enfoque
El propósito de este programa de enfoque es de obtener tus opiniones sobre las
soluciones de los problemas de la salud en la comunidad alrededor de Palisades
Medical Center que incluye Cliffside Park, Edgewater, Fairview, Guttenberg, North
Bergen, Union City, Weehawken, and West New York. Los resultados de este enfoque
con los resultados de otros grupos de enfoque serán utilizados para identificar los más
urgentes problemas que pueden ser dirigidos a través de acción en la comunidad. Tus
opiniones son muy importantes.
1. ¿Cuales son algunas cosas que tú ves como puntos fuertes, como
aspectos positivos en la comunidad que rodea Palisades Medical
Center?
¿Tienen todos los miembros acceso a esto? ¿Si no, cuales miembros
de la comunidad y grupos son los menos que tienen acceso a ellos?
¿Que factores usted piensa que son los más importantes para la salud y
el bienestar de la comunidad que rodea Palisades Medical Center?
¿Como en criar niños en aspectos escolares, cuidado diurno escolar,
programas después de la escuela etc.?
¿Como, en aspectos de oportunidades de trabajo, expansión de
carreras, educación superior y recursos de vivienda?
¿Como, para ancianos en aspecto de vivienda, transportación,
sistemas de información etc.?
¿Como, en seguridad en aspecto del hogar del sitio de trabajo,
escuelas, patios de recreo, parques, centros comerciales?
¿Como, en cadenas de apoyo, durante tiempos malos y necesidad
de (familia, confianza, agencias, etc.)?
¿Cuál cree usted que son los problemas más importantes del área
alrededor de Palisades Medical Center?
63
2. Más específicamente, en aspectos de sistemas de cuidado de salud en
la comunidad que rodea Palisades Medical Center, que elementos de
solución tú piensas que pueden ser considerados como disponibilidad,
accesibilidad, recursos, aceptación y propiedad.
3. ¿De su perspectivas, que conducta toman los residentes que los ponen
a ellos o quizás a otros en el más riesgo?
4. ¿Relativo a estos factores que usted ha mencionado, como cualificaría
la calidad de vida que hay en el área que rodea Palisades Medical
Center?
¿Si la comunidad va a enfrentar algunos de estos casos, cuáles tres tú
quisieras enfrentar?
¿Del punto de tú perspectiva, como pueden los residentes del área que
rodea PMC hacer una diferencia en la calidad de vida de la comunidad?
¿Hasta que magnitud tú crees que hay un sentido activo de
responsabilidad y compromiso, y de orgullo cívico en compartir logros
en esta área?
5. Que otras cosas, si hay alguna, tú crees que son urgentes y deben ser
consideradas, en lo que reunimos información que será usada para
apoyar iniciativas para hacer una diferencia en la comunidad que rodea
Palisades Medical Center.
Courtesy of the University of Medicine and Dentistry of New Jersey - School of Public Health, Health Systems and Policy
64
Appendix E: Palisades Medical Center Focus Group Responses
Palisades Medical Center (PMC)
Focus Group Questions and Overall Responses
The purpose of this focus group is to get your opinions about key community health
issues surrounding the neighborhoods in the Palisades Medical Center serving area
that includes Cliffside Park, Edgewater, Fairview, Guttenberg, North Bergen, Union City,
Weehawken, and West New York. The PMC Community Health Needs Assessment
Steering Committee will use the results from this and other similar focus groups that we
will be conducting with other groups to identify the most pressing problems that can be
addressed through community action. Your opinions are very important.
1. What are some of the things you see as being strengths; positive aspects (assets) in
the community surrounding Palisades Medical Center?
• Cultural diversity
• Large Spanish-speaking population able to assist each other
• Multiple and diverse houses of worship
• Many restaurants with varying prices
• Proximity of services (supermarkets, parks, laundry mats, recreation,
libraries)
• Transportation and proximity to Manhattan
Do all community members have access to these? If not, which community
members and groups are less likely to have access to them?
Elderly and Disabled
What factors do you think are the most important for the health and well-being of the
community surrounding Palisades Medical Center?
How about for raising children in terms of schools, day care, after school
programs, etc.?
How about in terms of job opportunity, career growth, higher education, and
affordable housing?
How about for seniors in terms of housing, networking, transportation, etc.?
How about safety in terms of the home, the work place, schools, playgrounds,
parks, malls, etc?
What about networks of support during times of stress and need (family, faithbased, agencies, etc)?
•
•
•
Senior Housing and Senior Daycare centers and activities
Better elementary and high school education to prepare for college
Better safety and security (visible patrol officers in community, parks,
etc.)
65
What do you see as the most important health problems in the area surrounding
Palisades Medical Center?
•
•
•
•
•
•
•
•
•
•
Obesity and Diabetes
Cardiovascular Health and Hypertension
Mental Health – Stress, Depression, Alzheimer’s, Domestic Violence,
ADHD, Autism
Sexually Transmitted Infections - HIV
Substance Abuse – alcohol, drugs, smoking
Contamination, Air Pollution
Cancer
Asthma and COPD (Chronic Obstructive Pulmonary Disease)
Thyroid
Pain Management, Arthritis, Back Pain
2. More specifically, in terms of the health care system in the community surrounding
PMC, what key elements do you think should be considered (should be included)?
Consider such things as availability, accessibility, affordability, acceptability, and
appropriateness.
Availability: do services exist in the community surrounding PMC; are they
around?
Accessibility: if the services are there, are the hours and locations convenient so
that you and/or others that you know are able to get to them?
Affordability: do you and/or others know that you know who need the services
have the resources (i.e., the money and/or health insurance) to pay (cover the
cost) for the services?
Acceptability: are you and/or others pleased with the services and the way they
have been delivered to you and/or to others in the community surrounding PMC?
Appropriateness: do the services that you and others have received in the
community surrounding PMC seem to be the right ones?
•
•
•
•
•
Accessible healthcare outside of the 9-5 hours
Emergency care on evenings and weekends that accepts all insurance
and/or no insurance, not just the Emergency Room at a hospital, especially
for single adult, and/or non-documented, and/or homeless.
Reasonable waiting-time at physician’s offices – over crowdedness
Patient – provider communication: patient is not receiving all the necessary
information from their MD and/or Pharmacist, Patients need to have a
prepared set of questions
School-based health for children and more physical activity programs
after–school.
66
3. From your perspectives, what behaviors do residents engage in that place them and
perhaps others at greatest risk?
• Substance Abuse – excessive alcohol – drugs – smoking
• Unhealthy eating
• Sedentary Lifestyle – lack of physical activity/exercise
• Loneliness – lack of socialization, no family or friends, no support network
• Unprotected sex
• Domestic Violence
• Non-compliance with medication or scheduled prescriptions
4. Relative to these factors that you have just mentioned, how would you rate the
overall quality of life in the community surrounding PMC? Fair to Good – unfair
question due to a divided community of different socioeconomic status – it all
depends on family income level.
If the community were going to tackle some of these issues, in what rank order
would you place tackling the top three to five of them? (In bold lettering on
question 3)
From your perspective, how can the residents in the community surrounding PMC
make a difference in the quality of life in their community?
• Become a better citizen (i.e. know your neighbor, volunteer, have a better
attitude)
• Empower yourself (voice your opinion, learn about resources in the
community and demand more services from your local government and
agencies)
• Attend community and faith-based events, lectures, meetings, activities
that are created for ALL ages.
To what extent do you believe that there is an active sense of responsibility and
engagement, and of civic pride in shared accomplishments?
• Minimal / poor
5. What other things, if any, do you think are pressing and should be considered as
we gather information that will be used to support initiatives to make a difference
in the community surrounding Palisades Medical Center?
• Develop more support groups in multiple areas pertaining to social,
physical and mental health.
• Develop an affordable satellite clinic available to all residents
• Develop more community hours /volunteer work for students and elders –
potentially pairing up of the two.
• Develop more adult athletic leagues
Courtesy of the University of Medicine and Dentistry of New Jersey - School of Public Health, Health Systems and Policy
67
Appendix F: County Health Profiles Comparison
2010: Top 10 emergency department visits for primary care conditions
Children - under 18 years (Rates are in parenthesis)
1
2
Palisades Medical Center
Fever (35.73)
3
Abdominal pain, unspecified site
(27.23)
Unspecified viral infection, in
conditions classified elsewhere and
of unspecified site (22.98)
4
Asthma (20.62)
5
Otitis media and Eustachian tube
disorders (17.00)
Anxiety disorders including PTSD
(11.80)
6
7
Head injury, unspecified (6.14)
8
Attention deficit and disruptive
behavior disorders (2.83)
9
Other mental disorders, excluding
drug or alcohol dependence
(includes mental retardation) (0.94)
Unspecified site of ankle sprain and
strain (0.00)
10
Hudson County
Otitis media and
Eustachian tube
disorders (20.40)
Fever (17.74)
New Jersey State
Otitis media and
Eustachian tube disorders
(18.21)
Fever (12.27)
Unspecified viral
infection, in
conditions classified
elsewhere and of
unspecified site
(11.95)
Asthma (9.78)
Asthma (9.56)
Head injury,
unspecified (7.73)
Anxiety disorders
including PTSD
(6.83)
Abdominal pain,
unspecified site
(6.54)
Other mental
disorders, excluding
drug or alcohol
dependence
(includes mental
retardation) (5.66)
Attention deficit and
disruptive behavior
disorders (5.31)
Unspecified site of
ankle sprain and
strain (5.30)
Unspecified viral infection,
in conditions classified
elsewhere and of
unspecified site (9.14)
Head injury, unspecified
(8.58)
Anxiety disorders
including PTSD (5.76)
Unspecified site of ankle
sprain and strain (5.73)
Attention deficit and
disruptive behavior
disorders (4.40)
Abdominal pain,
unspecified site (4.35)
Other mental disorders,
excluding drug or alcohol
dependence (includes
mental retardation) (4.29)
Notes:
PTSD – Post-traumatic stress disorder
Unadjusted crude rates represent hospital emergency department treat-and-release visits by each age category
for select primary care conditions as primary diagnoses in 2010, calculated based on total population for each
age category of the hospital admissions in 2010, the county and state are expressed per 1,000 population. The
aggregated rates reflect all primary care conditions combined.
ED Visits for Individual Primary Care Conditions are rank ordered from high to low for 2010 hospital rates. The
top 10 conditions for each age group are shown for comparison to Hudson County.
Source: Palisades Medical Center data from 2010; County Health Profiles 2012 – Hudson County HRET.
68
2010: Top 10 emergency department visits for primary care conditions
Adults - between 18-64 years (Rates are in parenthesis)
1
2
Palisades Medical Center
Anxiety disorders including PTSD
(99.22)
Abdominal pain, unspecified site
(42.70)
3
Alcohol dependence (41.57)
4
Unspecified chest pain (20.39)
5
Other chest pain (20.39)
6
Asthma (16.27)
7
Depression and other mood
disorders (8.92)
Diabetes mellitus (8.58)
8
9
10
Other mental disorders, excluding
drug or alcohol dependence
(includes mental retardation) (3.38)
Drug dependence (1.81)
Hudson County
Alcohol dependence
(54.79)
Anxiety disorders
including PTSD
(26.30)
Other mental
disorders, excluding
drug or alcohol
dependence
(includes mental
retardation) (14.88)
Drug dependence
(10.11)
Abdominal pain,
unspecified site
(9.28)
Depression and
other mood
disorders (7.07)
Unspecified chest
pain (6.78)
Asthma (5.99)
Diabetes mellitus
(5.70)
Other chest pain
(5.59)
New Jersey State
Alcohol dependence
(26.26)
Anxiety disorders
including PTSD
(23.86)
Other mental
disorders, excluding
drug or alcohol
dependence
(includes mental
retardation) (13.83)
Depression and
other mood
disorders (9.36)
Drug dependence
(8.76)
Abdominal pain,
unspecified site
(7.46)
Diabetes mellitus
(6.23)
Unspecified chest
pain (6.04)
Asthma (5.62)
Other chest pain
(5.48)
Notes:
PTSD – Post-traumatic stress disorder
Unadjusted crude rates represent hospital emergency department treat-and-release visits by each age category
for select primary care conditions as primary diagnoses in 2010, calculated based on total population for each
age category of the hospital admissions in 2010, the county and state are expressed per 1,000 population. The
aggregated rates reflect all primary care conditions combined.
ED Visits for Individual Primary Care Conditions are rank ordered from high to low for 2010 hospital rates. The
top 10 conditions for each age group are shown for comparison to Hudson County.
Source: Palisades Medical Center data from 2010; County Health Profiles 2012 – Hudson County HRET.
69
2010: Hospital admissions for select ambulatory care sensitive conditions
Children - under 18 years (Rates are in parenthesis)
1
Palisades Medical Center
Asthma (17.07)
2
Gastroenteritis (15.50)
3
Bacterial pneumonia (10.94)
4
Dehydration volume depletion
(primary diagnosis) (9.86)
5
Kidney/Urinary infection (9.12)
6
Convulsions (4.97)
7
Severe ENT infections (3.07)
8
Diabetes (1.08)
9
Pelvic inflammatory disease (0.00)
10
Chronic obstructive pulmonary
disease (0.00)
11
Hudson County
Bacterial
pneumonia (2.70)
Asthma (2.55)
Dehydration volume
depletion
(secondary
diagnosis) (1.86)
Dehydration volume
depletion (primary
diagnosis) (1.75)
Gastroenteritis
(0.92)
Kidney/Urinary
infection (0.87)
Convulsions (0.77)
Severe ENT
infections (0.42)
Diabetes (0.19)
Pelvic inflammatory
disease (0.01)
Chronic obstructive
pulmonary disease
(0.00)
New Jersey State
Asthma (1.62)
Bacterial
pneumonia (1.33)
Dehydration volume
depletion
(secondary
diagnosis) (1.07)
Kidney/Urinary
infection (0.50)
Dehydration volume
depletion (primary
diagnosis) (0.48)
Convulsions (0.37)
Gastroenteritis
(0.30)
Diabetes (0.27)
Severe ENT
infections (0.23)
Pelvic inflammatory
disease (0.01)
Chronic obstructive
pulmonary disease
(0.00)
Notes:
PTSD – Post-traumatic stress disorder
Unadjusted crude rates represent hospital emergency department treat-and-release visits by each age category
for select primary care conditions as primary diagnoses in 2010, calculated based on total population for each
age category of the hospital admissions in 2010, the county and state are expressed per 1,000 population. The
aggregated rates reflect all primary care conditions combined.
ED Visits for Individual Primary Care Conditions are rank ordered from high to low for 2010 hospital rates. The
top 10 conditions for each age group are shown for comparison to Hudson County.
Source: Palisades Medical Center data from 2010; County Health Profiles 2012 – Hudson County HRET.
70
2010: Hospital admissions for select ambulatory care sensitive conditions
Adults - between 18-64 years (Rates are in parenthesis)
1
Palisades Medical Center
Bacterial pneumonia (14.10)
Hudson County
Asthma (1.58)
2
Diabetes (13.77)
3
Kidney/Urinary infection (11.50)
Dehydration volume
depletion
(secondary
diagnosis) (1.44)
Diabetes (1.21)
4
Gastroenteritis (9.19)
5
Asthma (8.56)
6
7
Chronic obstructive pulmonary
disease (4.42)
Convulsions (4.07)
8
Congestive Heart Failure (2.06)
9
10
Dehydration volume depletion
(primary diagnosis) (1.61)
Angina (0.98)
11
Pelvic inflammatory disease (0.72)
12
Severe ENT infections (0.26)
Bacterial
pneumonia (1.05)
Chronic obstructive
pulmonary disease
(0.84)
Kidney/Urinary
infection (0.74)
Gastroenteritis
(0.62)
Congestive Heart
Failure (0.48)
Convulsions (0.19)
Angina (0.18)
Dehydration volume
depletion (primary
diagnosis) (0.15)
Severe ENT
infections (0.10)
Pelvic inflammatory
disease (0.07)
New Jersey State
Dehydration volume
depletion
(secondary
diagnosis) (1.55)
Diabetes (1.11)
Bacterial
pneumonia (1.11)
Asthma (1.10)
Chronic obstructive
pulmonary disease
(0.74)
Kidney/Urinary
infection (0.74)
Congestive Heart
Failure (0.60)
Gastroenteritis
(0.46)
Convulsions (0.23)
Dehydration volume
depletion (primary
diagnosis) (0.18)
Angina (0.18)
Severe ENT
infections (0.08)
Pelvic inflammatory
disease (0.08)
Notes:
PTSD – Post-traumatic stress disorder
Unadjusted crude rates represent hospital emergency department treat-and-release visits by each age category
for select primary care conditions as primary diagnoses in 2010, calculated based on total population for each
age category of the hospital admissions in 2010, the county and state are expressed per 1,000 population. The
aggregated rates reflect all primary care conditions combined.
ED Visits for Individual Primary Care Conditions are rank ordered from high to low for 2010 hospital rates. The
top 10 conditions for each age group are shown for comparison to Hudson County.
Source: Palisades Medical Center data from 2010; County Health Profiles 2012 – Hudson County HRET.
71
Appendix G: Palisades Medical Center Community Health Screening Data
Body Mass Index (BMI) scores over 30 from community health screenings organized by
Palisades Medical Center (January - May 2012)
Month
February
February
March
March
April
April
April
Place
Temple Beth El
N. Bergen
St. Joseph Church
W. New York
St. Augustine Church
Union City
Our Lady of Fatima Church
N. Bergen
Immaculate
Heart of Mary Chapel
N. Bergen
First United Methodist Church
Union City
Grove Reformed Church
N. Bergen
Total # of
people seen
at screening
Total # of
people with a
BMI > 30
%
31
10
33%
119
42
36%
103
45
43%
89
27
30%
83
26
31%
51
12
23%
52
11
21%
72
Appendix H: County Health Rankings Comparison
Hudson County
2010
2011
2012
Bergen County
2010 2011 2012
New Jersey State
2010 2011 2012
National Benchmark
2010
2011
2012
6,615
6,503
6,224
4,314
4,215
4,183
6,294
6,170
5,987
4,295
5,564
5,466
24%
25%
24%
12%
12%
12%
16%
15%
15%
10%
10%
10%
4.1
4.3
4.3
2.8
2.8
2.8
3.3
3.4
3.4
2.7
2.6
2.6
Health Outcomes
Mortality
Premature death - years of potential life lost
before age 75 per 100,000 population (ageadjusted)
Morbidity
Poor or fair health - Percent of adults reporting
fair or poor health (age-adjusted)
Poor physical health days - Average number
of physically unhealthy days reported in past 30
days (age-adjusted)
Poor mental health days - Average number of
mentally unhealhty days reported in past 30
days (age-adjusted)
3.5
3.5
3.4
2.8
2.8
2.9
3.3
3.3
3.3
2.8
2.3
2.3
Low birthweight - Percent of live births with
low birthweight (<2500 grams)
8.2%
8.2%
8.3%
7.3%
7.4%
7.6%
8.1%
8.2%
8.3%
6.50%
6%
6%
Health Factors
Health Behaviors
Adult smoking - Percent of adults that report
smoking >/= 100 cigarettes and that they
currently smoke
20%
20%
19%
15%
15%
15%
18%
17%
17%
14%
15%
14%
23%
24%
24%
20%
21%
22%
24%
24%
25%
20%
25%
25%
Adult obesity - Percent of adults that report a
BMI >/= 30
Physical inactivity - Percent of adults aged 20
and over reporting no leisure time physical
activity
Binge drinking - Percent of adults that report
binge drinking in the past 30 days
Excessive drinking - Binge plus heavy drinking
Motor vehicle crash death rate - Motor vehicle
crash deaths per 100,000 population
28%
15%
6
24%
13%
16%
16%
6
6
6
25%
14%
16%
16%
6
6
9
21%
12%
16%
16%
9
9
6
8%
8%
12
12
73
Hudson County
2011
2012
2010
Chlamydia rate (Sexually transmitted
infections) - Chlamydia rate per 100,000
population
Teen birth rate - Teen birth rate per 1,000
female population, ages 15-19
Clinical Care
Uninsured adults - Percent of population under
age 65 without health insurance
Primary care provider rate - Primary care
provider rate per 100,000 population
Primary care physicians - Ratio of population
to primary care phsicians
Preventable hospital stays - Hospitalization
rate for ambulatory-care sensitive conditions per
1,000 Medicare enrollees
Diabetic screening - Percent of diabetic
Medicare enrollees that receive HbA1c
screening
Mammography screening - Percent of female
Medicare enrollees that receive mammography
screening
Hospice use - Percent of chronically ill
Medicare enrollees in hospice care in last 6
months of life
Social & Economic Factors
High school graduation - Percent of ninth
grade cohort that graduates in 4 years
College degrees - Percent of population age
25+ with 4 year college degree or higher
Some college - Percent of adults aged 25-44
years with some post-secondary education
Unemployment - Percent of population age
16+ unemployed but seeking work
Bergen County
2010 2011 2012
New Jersey State
2010 2011 2012
National Benchmark
2010
2011
2012
316
323
342
107
106
121
247
258
276
91
83
84
40
39
39
9
8
8
27
26
25
9
22
22
26%
27%
23%
18%
18%
13%
17%
19%
14%
13%
13%
11%
631-1
631-1
92
170
124
583-1
5831
170
8081
8081
1,170:1
1,170:1
108
106
93
70
67
63
81
78
72
70
52
49
69%
72%
76%
77%
79%
82%
76%
78%
80%
81%
89%
89%
53%
55%
59%
62%
58%
62%
74%
74%
20%
53%
80%
80%
79%
58%
94%
95%
97%
44%
32%
6.0%
26%
65%
65%
10.7%
10.8%
5.0%
27%
59%
85%
84%
32%
89%
34%
75%
75%
.7.9%
8.1%
6.0%
98%
92%
47%
64%
64%
9.2%
9.5%
4%
68%
68%
5.30%
5.40%
74
Hudson County
2011
2012
2010
Children in poverty - Percent of children under
age 18 in poverty
Income inequality - Gini coefficient of income
inequality based on household income
Inadequate social support - Percent of adults
without social/emotional support
Single-parent households - Percent of all
households that are single-parent households
Children in single-parent households Percent of children that live in household
headed by single parent
Violent crime rate - Violent crime rate per
100,000 population
Physical Environment
Air pollution-particulate matter days - Annual
number of unhealthy air quality days due to fine
particulate matter
Air pollution-ozone days - Annual number of
unhealthy air quality days due to ozone
Access to healthy foods - Healthy food outlets
include grocery stores and produce
stands/farmers' markets
21%
24%
48
6%
6%
8%
New Jersey State
2010 2011 2012
11%
47
31%
30%
12%
44%
30%
12%
14%
46
22%
22%
6%
18%
44%
21%
National Benchmark
2010
2011
2012
4%
11%
13%
17%
14%
14%
6%
20%
40
23%
23%
9%
28%
18%
22%
28%
20%
683
640
571
110
107
107
345
336
322
85
100
73
11
9
9
8
6
6
4
5
5
1
0
0
12
10
10
17
9
9
14
11
11
6
0
0
63%
100%
77%
85%
57%
84%
69%
92%
Limited access to healthy foods - Percent of
population who are low-income and do not live
close to a grocery store
Fast food restaurants - Percent of all
resturauants that are fast food establishments
Liquor store density - Number of liquor stores
per 10,000 population
Access to recreational facilities - Rate of
recreational facilities per 100,000 population
24%
Bergen County
2010 2011 2012
0%
1%
4%
0%
56%
49%
50%
25%
2.8
1.9
9
10
2.0
21
20
15
15
17
16
Note: Blank values reflect unreliable or missing data. National Benchmark = 90th percentile (i.e. only 10% are better)
Source URL: http://www.countyhealthrankings.org/node/1917/archived-data/2010
75
Appendix I: Palisades Medical Center Prioritizing Issues and Concerns Worksheet
COMMUNITY HEALTH NEEDS ASSESSMENT
PRIORITIZING ISSUES / CONCERNS
Issue/Concern: ________________________________________________________________
Primary data for selecting this issue: ________________________________________________
_____________________________________________________________________________
Population(s) affected: ___________________________________________________________
Seriousness/urgency: ___________________________________________________________
Available data sources: __________________________________________________________
Possible interventions (behavioral, environmental, legislative, etc.) effective in solving problem:
_____________________________________________________________________________
_____________________________________________________________________________
Likelihood of success/impact (taking into account available resources): ____________________
_____________________________________________________________________________
Current interventions addressing issue in community that we may expand: __________________
_____________________________________________________________________________
Consequences if not addressed (personal, societal, economic): __________________________
_____________________________________________________________________________
76
APPENDIX J: Action Plan Template
PALISADES MEDICAL CENTER
ACTION PLAN TEMPLATE
Goal:
Objective:
Activity
Timeframe
(Due Date)
Resources Required
Lead
Anticipated
Products or Results
Date
Completed
77