Welcome to the Pueblo City-County
Health Department
Thank you for being here today!
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Restrooms are located by the elevators
This is a tobacco-free campus. Thank you for not
using tobacco on Health Department grounds
We are a green building; green plastic bins in the
back of the room are available for recycling
In case of an emergency, please exit the building
using the stairs at the front or back of the building
Agenda
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Introduction/Purpose of Meeting (15 minutes)
Community Process to Determine Priorities
(15 minutes)
Overview of Public Health Priorities: statistics,
capacity, possible strategies (60 minutes)
Community Input (30 minutes)
Break (10 minutes)
Rank Public Health Priorities (30 minutes)
Next Steps (10 minutes)
Process to Narrow Down Priorities
PUEBLO COMMUNITY HEALTH
ASSESSMENT
Mission of Pueblo Community Health
Assessment
Pursuant to the Colorado Public Health Reauthorization Act
–Colorado counties are required to complete a
comprehensive community health assessment. To that end,
Pueblo City-County Health Department is tasked to
partner with various county-wide organizations and
individuals to complete a community health assessment.
The purpose of the assessment is to assist Pueblo in
deciding what its community health priorities are for the
next 5 years and what strategies will be used by various
public health organizations and partners to improve the
overall health of Pueblo residents.
* Based on geography of Pueblo County
Contributions to Health Assessment
Process
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PCCHD Community
Health Assessment
Team Internal (CHATI)
Members:
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Heather Maio
Chad Wolgram
Jenna Ward
Julie Kuhn
Lynn Procell
Kim Whittington
Sarah Joseph
Shylo Dennison
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Community Health Assessment
Steering Committee Members
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Donald Moore
Mary Gunn
Randy Evetts
Angela Jensen
Tony LaCombe
John LeFebre
Charlotte Yianokopolus-Veatch
Cindy Lau
Kirsten Taylor
Michelle DesLauriers
Barb Mettler
Steps of the Community Health
Assessment
1) Community Health Assessment &
Status Report (Data collection
based on health indicators;
strengths; & weaknesses)
2) Capacity Assessment & Report
(Who is doing what & how well?)
3) Prioritization process of public
health issues for community
4) Community Health Improvement
Plan (Priorities identified and
responsibilities assigned)
5) Strategic Plan for Pueblo CityCounty Health Department
Top 8 Priorities
*In alphabetical order
 Cardiovascular Disease
 Communicable/Infectious disease prevention
 Diabetes
 Lack of providers/Access to care
 Mental health
 Obesity (adult and childhood)
 Poverty
 Teen Pregnancy/Unintended pregnancy
Cardiovascular Disease

400
200
Pueblo
0
ke
ai
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ise
as
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ea
rt
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as
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l
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)h
He
ar
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se
as
es
ar
t
he
on
ar
y
(c
or
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se
as
es
o
ft
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se
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e
Colorado
Ce
re
br
Minority populations
have greater
disparities for CVD
600
Isc
he
m
ic

26% of all deaths
caused by Heart
Disease in Pueblo
Disparities
800
di

1000
as
cu
la
r

1074.2 per 100,000Pueblo County
961.8 per 100,000Colorado
1200
ov

Hospital Discharge for CVD, 2009
Age-Adjusted Rate (per 100,000)
Rate of Cardiovascular
Disease
M
aj
or
ca
rd
i
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Cardiovascular Disease
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Evidence based strategies
 Comprehensive
strategies to reduce blood pressure
(http://www.bmj.com/content/326/7404/1419.short)
 Ensure screenings for high risk individuals
(http://www.bmj.com/content/326/7404/1419.short)
Communicable/Infectious Disease
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Influenza (flu)
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Pueblo County: 33 influenza-associated hospitalizations 2010-2011
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Disparities
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Colorado average: 20.9
Elderly
Infants
Immune-compromised individuals
Tuberculosis
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Pueblo County: 1.9 cases per 100,000
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Colorado: 2.3 cases per 100,000
Disparities
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Prison and homeless populations
Communicable/Infectious Disease
The Rate of Positive Chlamydia Cases Reported in 1524 Year-Olds per 100,000
Rate per 100,000 people
4000
3500
3000
2500
Pueblo
2000
Colorado
1500
1000
500
0
Females
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Males
Disparities
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18-24 year olds
Minority females
Those with multiple
partners
Drug users
Communicable/Infectious Disease
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Evidence based strategies (www.cdc.gov)
 Increase
vaccines with chart reminders, electronic health
records, mailed/telephoned reminders
 Comprehensive education on preventing transmission
 Increase and encourage testing
Diabetes
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5% of all deaths in Pueblo
are caused by Diabetes
Mellitus, Type II
Evidence based strategies
(www.thecommunityguide.org)
 Case
management
interventions to improve
glycemic control
 Self-management
education in communitygathering places for adults
with type 2 diabetes
Lack of Providers/Access to Care
% enrolled in Medicare and
dual eligible in 2008-2009
12.40%
18.80%
Pueblo
Weld
Mesa
Colorado
17.10%
10.90%
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Disparities
 Low
socioeconomic individuals
 Ethnic and minority populations
Lack of Providers/Access to Care
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Evidence based
strategies
Ensuring eligible
individuals are
enrolled in available
insurance programs
(i.e. CHP+, Medicaid,
etc.)
 Increase the number
of physician assistants
and nurse practitioners
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Safety Net Provider Locations in Pueblo County, 2007
Type
# of Clinics
Rural Health Clinics
0
and Emergency Departments
2
Safety Net Dental Clinics
1
Safety Net Mental Health Clinics
3
School Based Health Centers
5
Clinic Delivery Sites
5
Other Primary Care Clinics
0
ClinicNet Clinics
1
Public Health Departments and Nursing Services that
Provide Primary Care Services
1
Mental Health
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Poor mental health days
was highest at 31% for
ages 18-24 in Pueblo
County
Disparities
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Greatest percentage of
suicides occurred among
non-Hispanic whites
Highest race/ethnicity
and age-specific rates
were among American
Indian/Alaska Native
adolescents and young
adults.
Parents who reported behavioral or mental health
problems in children ages 1-14
27
26.5
26
Percentage
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25.5
25
24.5
24
Pueblo
Colorado
Mental Health
Evidence based strategies
 Collaborative
care for managing depressive disorders
 Home and clinic-based depression care management
Poor Mental Health Days, 2009
4
Average Number of Unhealthy Days
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3.5
3
2.5
2
1.5
1
0.5
0
Pueblo
Colorado
National Benchmark
Obesity
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Children Eating Fruits and Vegetables
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Pueblo County: 5.8% consumed five or more fruits and
vegetables per day Colorado: 9.6%
Percent of Overweight and Obese Adults, 20072009
35
70
30
60
25
50
20
Obese
Overweight/Obese
15
10
Percent of Adults
Percent of Youth
Percent of Youth
(ages 2-14)
Overweight and Obese, 2007-2009
40
Obese
Overweight/Obese
30
20
5
10
0
Pueblo
Colorado
HP 2020
objective
0
Pueblo
Colorado
HP 2020
Objective
Obesity
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Disparities
 Lower
socioeconomic status and middle income (living in
suburban areas without connectivity)
 Minority populations
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Evidence based strategies (www.thecommunityguide.org)
 Behavioral
interventions to reduce screen time
 Multi-component coaching or counseling interventions to
reduce weight and maintain weight loss
 Worksite wellness programs (trainings, policy/system
changes)
Poverty
Percent of Pueblo County Population in Poverty, 2009
% of total population
30
25
20
Pueblo
15
Colorado
10
5
0
adult poverty
Median Household Income, 2009
$60,000
Dollars in Thousands
$50,000
$40,000
$30,000
$20,000
$10,000
$0
Pueblo
Colorado
child poverty
Poverty
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Disparities
 Ethnic
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and Minority Populations
Evidence based strategies
 Increase
financial literacy
(http://www.practicalmoneyskills.com/foreducators/stat
e_standards/process.php)
 Improve graduation rates
(http://www.cdc.gov/PCD/issues/2007/oct/pdf/07_0
063.pdf)
Teen/Unintended Pregnancy
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Pueblo County: 55.6% unintended and 44.4% intended
Pueblo County Hispanic population: 49.7% of pregnancies
considered intended
In 2009, 17% of all births in Pueblo County were to teens
Teen/Unintended Pregnancy
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Disparities
 Lower
socio-economic women
 Young women whose mothers were teen moms
 Hispanic teens
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Evidence based strategies (www.thecommunityguide.org)
 Youth
development, behavioral interventions:
interventions coordinated with community service to
reduce sexual risk behaviors in adolescents
 Comprehensive risk reduction intervention for adolescents
(abstinence as well as other scientifically proven
prevention methods)
Questions?
For Further Questions
Call Shylo Dennison, Public Health Planner
719-583-4353
dennison@co.pueblo.co.us