Sutter Medical Center Sacramento and Sutter Center for

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Sutter Medical Center Sacramento and Sutter Center for

Transcript Of Sutter Medical Center Sacramento and Sutter Center for

SUTTER MEDICAL CENTER SACRAMENTO AND SUTTER
CENTER FOR PSYCHIATRY
2019 Community Health Needs Assessment

Mission We enhance the well-being of people in the communities we serve through a not-for-proft commitment to compassion and excellence in healthcare services.
Vision Sutter Health leads the transformation of healthcare to achieve the highest levels of quality, access, and afordability.
Community Health Needs Assessment The following report contains Sutter Medical Center Sacramento and Sutter Center for Psychiatry’s 2019 Community Health Needs Assessment (CHNA), which is used to identify and prioritize the signifcant health needs of the communities we serve. CHNAs are conducted once every three years, in collaboration with other healthcare providers, public health departments and a variety of community organizations. This CHNA report guides our strategic investments in community health programs and partnerships that extend Sutter Health’s not-for-proft mission beyond the walls of our hospitals, improving health and quality of life in the areas we serve.

2019 Community Health Needs Assessment
Of
Sacramento County

Conducted on behalf of

Dignity Health Affiliates
Mercy Hospital of Folsom 1650 Creekside Dr. Folsom, CA 95630
Mercy San Juan Medical Center 6501 Coyle Ave.
Carmichael, CA 95608
Mercy General Hospital 4001 J St.
Sacramento, CA 95819
Methodist Hospital of Sacramento
7500 Hospital Dr. Sacramento, CA 95823

Sutter Health Affiliates
Sutter Medical Center Sacramento 2825 Capitol Ave.
Sacramento, CA 95816
Sutter Center for Psychiatry 7700 Folsom Blvd.
Sacramento, CA 95826

UC Davis Health
UC Davis Medical Center 2315 Stockton Blvd.
Sacramento, CA 95817

Conducted by

December 2018

Acknowledgements
We are deeply grateful to all those who contributed to this community health needs assessment. Many dedicated healthcare practitioners, community health experts, and members of social-service organizations working with the most vulnerable members of the Sacramento County community gave their expertise and insights to help guide and inform the findings of this assessment. Further, many community residents volunteered their time to provide valuable information as well. We also appreciate the collaborative spirit of the consultants at Harder+Company and their willingness to share the information they gathered while conducting a health assessment in the Sacramento area for Kaiser Permanente. Last, we especially acknowledge the sponsors of this assessment, Dignity Health, Sutter Health, and UC Davis Medical Center, who, using the results of these CHNAs, continuously work to improve the health of the communities they serve. To everyone who supported this important work, we extend our deepest, heartfelt gratitude.
Community Health Insights (www.communityhealthinsights.com) conducted the health assessment. Community Health Insights is a Sacramento-based research-oriented consulting firm dedicated to improving the health and well-being of communities across Northern California. This joint report was authored by:
 Dale Ainsworth, PhD, MSOD, Managing Partner of Community Health Insights and Assistant Professor of Health Science at California State University, Sacramento
 Heather Diaz, DrPH, MPH, Managing Partner of Community Health Insights and Professor of Health Science at California State University, Sacramento
 Mathew C. Schmidtlein, PhD, MS, Managing Partner of Community Health Insights and Associate Professor of Geography at California State University, Sacramento
 Traci Van, Senior Community Impact Specialist of Community Health Insights
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Table of Contents
Report Summary................................................................................................................................7 Introduction and Purpose...................................................................................................................9 Organization of this Report ................................................................................................................9 Method Overview............................................................................................................................10
Conceptual and Process Models ............................................................................................................ 10 Public Comments from Previously Conducted CHNAs ........................................................................... 10 Data Used in the CHNA........................................................................................................................... 10 Data Analysis .......................................................................................................................................... 11 Sacramento County – The Community Served...................................................................................11 Findings – Sacramento County..........................................................................................................12 Prioritized Significant Health Needs – Sacramento County ................................................................... 12 Populations Experiencing Health Disparities.......................................................................................... 16 Regions of Sacramento County.........................................................................................................17 Community Health Vulnerability Index .................................................................................................. 18 Communities of Concern........................................................................................................................ 19 Findings for Each Region ........................................................................................................................ 19
Prioritized Significant Health Needs by Region.................................................................................. 19 Northwest Region .............................................................................................................................. 21
Description of the Community Served........................................................................................... 21 Community Health Vulnerability Index.......................................................................................... 22 Communities of Concern ............................................................................................................... 22 Themes from Primary Data............................................................................................................ 23 Northeast Region ............................................................................................................................... 23 Description of the Community Served........................................................................................... 23 Community Health Vulnerability Index.......................................................................................... 25 Communities of Concern ............................................................................................................... 25 Themes from Primary Data............................................................................................................ 26 Central Region.................................................................................................................................... 27 Description of the Community Served........................................................................................... 27 Community Health Vulnerability Index.......................................................................................... 28 Communities of Concern ............................................................................................................... 28 Themes from Primary Data............................................................................................................ 29 South Region ...................................................................................................................................... 30 Description of the Community Served........................................................................................... 30 Community Health Vulnerability Index.......................................................................................... 31 Communities of Concern ............................................................................................................... 31 Themes from Primary Data............................................................................................................ 32 Resources Potentially Available to Meet the Significant Health Needs...............................................33 Impact/Evaluation of Actions Taken by Hospital ...............................................................................33 Conclusion .......................................................................................................................................34 Sacramento 2019 CHNA Technical Section ........................................................................................35 Results of Data Analysis.......................................................................................................................... 35 Secondary Data .................................................................................................................................. 35 Length of Life ................................................................................................................................. 35 Quality of Life................................................................................................................................. 37 Health Behaviors............................................................................................................................ 39
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Clinical Care.................................................................................................................................... 41 Social and Economic or Demographic Factors............................................................................... 43 Physical Environment..................................................................................................................... 45 CHNA Methods and Processes ............................................................................................................... 46 Conceptual Model .............................................................................................................................. 46 Process Model .................................................................................................................................... 47 Primary Data Collection and Processing................................................................................................. 49 Primary Data Collection...................................................................................................................... 49 Key Informant Results.................................................................................................................... 49 Focus Group Results....................................................................................................................... 51 Primary Data Processing .................................................................................................................... 53 Secondary Data Collection and Processing ............................................................................................ 53 CDPH Health-Outcome Data .............................................................................................................. 53 ZIP Code Definitions ........................................................................................................................... 54 Rate Smoothing.................................................................................................................................. 55 Community Health Vulnerability Index (CHVI)................................................................................... 56 Significant Health Need Identification Dataset.................................................................................. 57 County Health Rankings Data............................................................................................................. 59 CDPH Data .......................................................................................................................................... 61 HRSA Data .......................................................................................................................................... 61 California Cancer Registry Data.......................................................................................................... 62 Census Data........................................................................................................................................ 62 CalEnviroScreen Data ......................................................................................................................... 63 Google Transit Feed Specification (GTFS) Data.................................................................................. 63 Descriptive Socioeconomic and Demographic Data .......................................................................... 64 Detailed Analytical Methodology ........................................................................................................... 65 Community of Concern Identification................................................................................................ 65 2016 Community of Concern ......................................................................................................... 66 Community Health Vulnerability Index (CHVI) .............................................................................. 66 Mortality ........................................................................................................................................ 66 Integration of Secondary Criteria .................................................................................................. 66 Preliminary Primary Communities of Concern .............................................................................. 66 Integration of Preliminary Primary and Secondary Communities of Concern .............................. 66 Significant Health Need Identification ............................................................................................... 66 Health Need Prioritization.................................................................................................................. 73 Detailed List of Resources to Address Health Needs for Sacramento County ....................................... 75 Limits and Information Gaps ............................................................................................................94 Appendix A: Impact of Actions Taken Since Previously Conducted CHNA (2016) ................................95
List of Tables
Table 1: Community Health Vulnerability Index Indicators........................................................................ 19 Table 2: Prioritized Significant Health Needs by Region............................................................................. 20 Table 3: Population Characteristics for the Northwest Region ZIP Codes.................................................. 21 Table 4: Identified Communities of Concern for the Northwest Region .................................................... 23 Table 5: Themes from Primary Data Collection, Northwest Region........................................................... 23 Table 6: Population Characteristics for the Northeast Region ZIP Codes................................................... 24
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Table 7: Identified Communities of Concern for the Northeast Region ..................................................... 26 Table 8: Themes from Primary Data, Northeast Region............................................................................. 26 Table 9: Population Characteristics for Central Region ZIP Codes.............................................................. 27 Table 10: Identified Communities of Concern for the Central Region ....................................................... 29 Table 11: Themes from Primary Data, Central Region ............................................................................... 29 Table 12: Population Characteristics for South Region ZIP Codes.............................................................. 30 Table 13: Identified Communities of Concern for the South Region.......................................................... 32 Table 14: Themes from Primary Data, South Region.................................................................................. 32 Table 15: Resources Potentially Available to Meet Significant Health Needs in Priority Order for Sacramento County..................................................................................................................................... 33 Table 16: Length of life indicators compared to state benchmarks ........................................................... 35 Table 17: Quality of life Indicators compared to state benchmarks .......................................................... 37 Table 18: Health behaviors indicators compared to state benchmarks..................................................... 39 Table 19: Clinical care indicators compared to state benchmarks ............................................................. 41 Table 20: Social and economic or demographic factor Indicators compared to state benchmarks .......... 43 Table 21: Physical environment indicators compared to state benchmarks.............................................. 45 Table 22: Key informant sample for Sacramento County........................................................................... 49 Table 23: Focus Group Interview list for Sacramento County .................................................................... 52 Table 24: Mortality and birth-related indicators used in the CHNA/CHA .................................................. 53 Table 25: Indicators used to create the Community Health Vulnerability Index ....................................... 56 Table 26: Health-factor and health-outcome data used in CHNA, including data source and time period in which the data were collected.................................................................................................................... 57 Table 27: County Health Rankings dataset, including Indicators, the time period the data were collected, and the original source of the data............................................................................................................. 60 Table 28: Detailed description of data used to calculate percentage of population with disabilities, households without a vehicle, and the mRFEI............................................................................................ 62 Table 29: Transportation agencies used to compile the proximity to public transportation Indicator ..... 64 Table 30: Descriptive socioeconomic and demographic data descriptions................................................ 64 Table 31: Potential health needs ................................................................................................................ 67 Table 32: Primary theme and secondary indicators used to identify significant health needs.................. 68 Table 33: Benchmark comparisons to show indicator performance CHNA indicators .............................. 71 Table 34: Resources Available to Potentially Meet Significant Health Needs............................................ 75
List of Figures
Figure 1: Populations experiencing disparities across all regions............................................................... 17 Figure 2: Sacramento County map with designated regions...................................................................... 18 Figure 3: Northwest Region map ................................................................................................................ 21 Figure 4: Community Health Vulnerability Index for the Northwest Region.............................................. 22 Figure 5: Communities of Concern for the Northwest Region ................................................................... 22 Figure 6: Northeast Region map ................................................................................................................. 24 Figure 7: Community Health Vulnerability Index for the Northeast Region............................................... 25 Figure 8: Communities of Concern for the Northeast Region .................................................................... 25 Figure 9: Map of the Central Region........................................................................................................... 27 Figure 10: Community Health Vulnerability Index for the Central Region ................................................. 28 Figure 11: Communities of Concern for the Central Region....................................................................... 28 Figure 12: Map of the South Region ........................................................................................................... 30
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Figure 13: Community Health Vulnerability Index for the South Region ................................................... 31 Figure 14: Communities of Concern for the South Region ......................................................................... 31 Figure 15: Length of life indicators ............................................................................................................. 36 Figure 16: Quality of life indicators............................................................................................................. 38 Figure 17: Health behavior indicators......................................................................................................... 40 Figure 18: Clinical care indicators ............................................................................................................... 42 Figure 19: Social and economic factors ...................................................................................................... 44 Figure 20: Physical environment................................................................................................................. 45 Figure 21: Community Health Assessment Conceptual Model as modified from the County Health Rankings Model, Robert Wood Johnson Foundation, and University of Wisconsin, 2015 ........................ 47 Figure 22: CHNA/CHA process model ......................................................................................................... 48 Figure 23: Process followed to identify Communities of Concern ............................................................. 65 Figure 24: Process followed to identify Significant Health Needs .............................................................. 67
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Report Summary
Purpose
The purpose of this community health needs assessment (CHNA) was to identify and prioritize significant health needs of the greater Sacramento area community. The priorities identified in this report help guide nonprofit hospitals’ community health improvement programs and community benefit activities as well as their collaborative efforts with other organizations that share a mission to improve health. This CHNA report meets requirements of the Patient Protection and Affordable Care Act (and in California, Senate Bill 697) that nonprofit hospitals conduct a community health needs assessment at least once every three years. The CHNA was conducted by Community Health Insights (www.communityhealthinsights.com) and was a collaboration between Dignity Health, Sutter Health, and UC Davis Health System. Multiple other community partners collaborated to conduct the CHNA.
Community Definition
The definition of the community served included most portions of Sacramento County, and a small portion of western El Dorado County, California. Regarded as a highly diverse community, Sacramento County covers 994 square miles and is home to approximately 1.5 million residents. The CHNA uses this definition of the community served, as this is the primary geographic area served by the seven nonprofit hospitals that collaborated on this CHNA.
Assessment Process and Methods
The data used to conduct the CHNA were identified and organized using the widely recognized Robert Wood Johnson Foundation’s County Health Rankings model.1 This model of population health includes many factors that impact and account for individual health and well-being. Further, to guide the overall process of conducting the assessment, a defined set of data-collection and analytic stages were developed. These included the collection and analysis of both primary (qualitative) and secondary (quantitative) data. Qualitative data included interviews with 121 community health experts, socialservice providers, and medical personnel in one-on-one and group interviews as well as one town hall meeting. Further, 154 community residents participated in 15 focus groups across the county.
Focusing on social determinants of health to identify and organize secondary data, datasets included measures to describe mortality and morbidity and social and economic factors such as income, educational attainment, and employment. Measures also included indicators to describe health behaviors, clinical care (both quality and access), and the physical environment.
Process and Criteria to Identify and Prioritize Significant Health Needs
Primary and secondary data were analyzed to identify and prioritize significant health needs. This began by identifying 10 potential health needs (PHNs). These PHNs were those identified in previously conducted CHNAs. Data were analyzed to discover which, if any, of the PHNs were present in the area. After these were identified, PHNs were prioritized based on rankings provided by primary data sources. Data were also analyzed to detect emerging health needs beyond those 10 PHNs identified in previous CHNAs.
1 See: http://www.countyhealthrankings.org/
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List of Prioritized Significant Health Needs
The following significant health needs were identified and are listed below in prioritized order. Two of the health needs, numbers four and nine, are health needs that have not been previously identified in earlier CHNAs. 1. Access to quality primary healthcare services 2. Access to mental/behavioral/substance-abuse services 3. Access to basic needs such as housing, jobs, and food 4. System navigation 5. Injury and disease prevention and management 6. Safe and violence-free environment 7. Access to active living and healthy eating 8. Access to meeting functional needs (transportation and physical mobility) 9. Cultural competency 10. Access to specialty and extended care
Resources Potentially Available to Meet the Significant Health Needs
In all, 665 resources were identified in the Sacramento County area that were potentially available to meet the identified significant health needs. The identification method included starting with the list of resources from the 2016 CHNAs, verifying that each resource still existed, and then adding newly identified resources into the 2019 CHNA report.
Conclusion
This CHNA report details the health needs of the Sacramento County community as a part of a collaborative partnership between Dignity Health, Sutter Health, and the UC Davis Health System. It provides an overall health and social examination of Sacramento County and the needs of community members living in parts of the area experiencing health disparities. The CHNA provides a comprehensive profile to guide decision-making for the implementation of community health improvement efforts. This report also serves as an example of a successful collaboration between local healthcare systems to provide meaningful insights to support improved health in the community they serve.
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HealthDataCommunitiesCommunityAssessment