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IMPACT MONTEREY
COUNTYSecondary Data Report:
HEALTH
Ignacio A. Navarro Ph.D.Kim Judson Dr.PH.Institute for Community Collaborative StudiesCalifornia State University Monterey Bay
Introduction
Impact Monterey County
Community Stakeholders & Partners
Public
Health Community
Advocacy
Groups
CSUMB/ICCS
Researchers
Transportation
Faith
Community
Health &
Medical Groups
Social
Services
Media
Colleges &
Universities
City
Planners
Public
Safety
Parks &
Recreation
Elected Officials
Employers &
Business
LeadersEarly Care &
Education
Providers
K-12 Schools
Arts
Community
Behavioral
Health
Community
Health
Clinics
Hospitals
Tribal Leaders
Nonprofit
Organizations
Community
Leaders
2
Foundations
Collective Impact Relationships
3
Monterey County
Residents
Community Stakeholder
Groups
Impact MC Steering Committee
Data, Research & Analysis
Team
ICCS
Researchers
Data, Research & Analysis Team Organizations
4
• Cal State University Monterey Bay
• Community Foundation for Monterey County
• Community Volunteer
• CTB-McGraw Hill
• First 5 Monterey
• Grower-Shipper Association of Central CA
• Head Start Monterey County
• Monterey County Board of Supervisors’ representative
• Monterey County Department of Social Services
• Monterey County Health Department
• Middlebury Institute of International Studies at Monterey
• Naval Postgraduate School
• United Way of Monterey County
Data Analysis & Research Pre-Planning Phase
5
Oct2013-Jan2014
Collection & initial analysis of secondary data to identify themes for Aspirations Survey question development
Feb-June 2014
Selection of
indicators by
DataTeam for
analysis &
development of
Aspirations
Survey
questions
July-Dec 2014 Collection of Aspirations Survey data & analysis of selected indicators (available secondary data)
Jan-Apr 2015
Presentation of
secondary data
analysis &
Aspirations
Survey findings
Apr – May 2015 Final
report: “What are
residents’ aspirations
to improve life (for
education, health &
income) in Monterey
County?
Data Research & Analysis Team Oversight
Impact Monterey County Cycle
6
ICCS Final Report of Findings
Engage Community
around Findings
Community Goal Setting: Data
informs planning to develop Impact
Activities
Establish shared metrics (indicators,
measurement & approach)
Establish process to learn and
improve
Collect data, track results, evaluate
and report progress
Reflect and adapt and decide next
steps
Purpose of the Secondary Data Analysis
7
• What the secondary data analysis report does:
related to indicators selected by IMC Data
Research & Analysis Team
– Provides assessment of indicators as a
from population studies for analysis of primary
data (Aspirations Survey)
– Provides a from which IMC Stakeholders can
for each area of
interest – Education, Income, Health
Purpose of the Secondary Data Analysis
8
• What the secondary data analysis report do:
– Does not provide analysis of a of
indicators.
– Does not provide for all
indicators as this varies depending upon the availability of
data sets in Fall 2013 – Spring 2014.
– Does not that
delivers services related to Impact Monterey County’s areas
of interest (Education, Health or Income)
Secondary data presentation
HEALTH
9
• Third area of three – Education, Income, Health
• Review of HLTH indicators and what lies behind them, i.e., demographic dimensions*
• Analysis provides context for future discussions about which indicators to focus on for collective impact efforts
• * Health data sets did not include sub-county geographic distribution.
IMPACT MONTEREY COUNTYSecondary Data Report
Ignacio A. Navarro Ph.D.Kim Judson Dr.PH.Institute for Community Collaborative StudiesCalifornia State University Monterey Bay
Health
10
Background
11
Health Indicators selected based upon:
– Existing California Health Interview Survey (CHIS)* data and MCHD Community Health Assessment and other Monterey County reports
– Most significant differences compared with state and US data**
– Initial selections determined with IMC Data Committee (DC) for Aspirations Survey
– Final selections by DC with feedback from IMC Steering Committee (SC)
(Note: Health data was not available on a sub-county, i.e., district or zip code level for this report.)
*The California Health Interview Survey (CHIS) is the largest state health survey in the nation. Data for this study came from the 2011-12 CHIS survey of 512 adults (>18 years old) in Monterey County using a telephone survey employing a dual-frame random-digit-dial technique (both landline and cellular sampling frames). Note: Data is Pre-Affordable Care Act http://healthpolicy.ucla.edu/chis/Pages/default.aspx** For slides where data is available and applicable, boxes are included with comparison statistics for Monterey County (MC),California (CA), United States (US), Monterey County Health Department Community Health Improvement Plan (CHIP target), and U.S. Department of Health and Human Services Healthy People 2020 (2020 target).
BackgroundDemographic Variables: (Vary depending upon dataset)
• Ethnicity – CHIS & MCHD Dataset
• Latino
• White (non-Latino: NL)
• African American (NL)
• American -Indian/Alaska Native (NL)
• Asian (NL)
• Native Hawaiian/Pacific Islander (NL)
• Two or More Races (NL)
– MCHD via CHIS Dataset
• Latino
• White
• Other
• Gender – CHIS & MCHD datasets
• Male
• Female
• Income Levels*– CHIS Dataset
• 0-99% FPL*
• 100-199% FPL
• 200-299% FPL
• 300% FPL
– MCHD via CHIS Dataset
• INC <=138% FPL
• 138%<INC<=400% FPL
• INC>400% FPL
12*Federal Poverty Level (FPL) – A measure of income level issued annually by the Department of Health and Human Services and used to determine eligibility for certain programs and benefits. The Affordable Care Act has established three FPL thresholds used for calculating eligibility for Medicaid (MediCal) and other subsidized health insurance. Please see Appendix for FPL Income Guidelines. https://www.healthcare.gov/glossary/federal-poverty-level-FPL.
BackgroundDemographic Variables: (Vary depending upon dataset)
• Age (varies by indicator)– CHIS dataset
• Child (0-11)
• Adolescent (12-17)
• Adult (18-64)
• Senior (65+)
– MCHD via CHIS dataset
• 19-29 years
• 30-49 years
• 50-64 years
• 65+ years
• Immigration Status – MCHD/CHIS dataset
• U.S. Born citizen
• Naturalized citizen
• Non-citizen (LPR/VISA & Undocumented)
13
Communicable Diseases
Nutrition, Physical Activity, and Obesity
Behavioral Health
Overview of
Health
Indicators
Maternal, Infant, and Child Health
Injury and Violence
Chronic Diseases
Overweight/Obese adults and adolescents
Suicides ~ Drug-related deaths ~ Teens & adults
reporting binge drinking in past month
Blood Pressure ~ Heart Disease ~
Diabetes
Access to Health Services
Health Status
Usual source of care/MD Visits
Health Insurance ~Cost of care
Language Barriers
Online Health Information
Unintentional Injury Mortality rates ~
Homicides ~ Domestic Violence
Prenatal Care ~ Teen Pregnancy (Births)
Newly reported HIV/AIDS cases ~ Pertussis infection
rates
14
Access to Health Services• Indicators:
1. Health status
2. Usual source of care
3. Emergency Room visits
4. Doctor visits
5. Health insurance
6. Language Barriers
7. Online Health Information
• Data Sources:– California Health Interview Survey (CHIS), 2010-2012
– HealthyPeople.gov, 2014
– Monterey County Health Department Community Health Improvement Plan (CHIP), 2014
16
Access to Health Services
17
22.0%
28.0%
14.6%
43.1%
33.2%
30.3%
16.3%
12.7%
18.5%
34.9%
50.1%
32.1%
29.7%
24.7%
10.6%
35.9%
23.3%
12.4%
38.7%
10.7%
26.9%
32.6%
36.3%
18.1%
10.2%
22.9%
11.3%
10.4%
14.5%
32.8%
5.4%
3.6%
12.7%
2.8%
11.8%
7.6%
0% 50% 100%
Latino
White (non-latino)
African American (non-latino)
American-Indian/Alaska Native (non-latino)
Asian (non-latino)
U.S. Born
Naturalized
Non-citizen
RA
CE/
ETH
NIC
ITY
IMM
IGR
ATI
ON
Resident health status by Immigration status and Race/ethnicity, CHIS 2011-12
Excellent Very good Good Fair Poor
CA USMC 2020 TargetCHIP Target
Access to Health Services
27.618
14.3
^ Usual Source of Care - Is there a place that you usually go to when you are sick or need advice about your health?* LPR/VISA= Legal Permanent Residents/VISA recipient* *Undocumented Calculated by ICCS, not CHIS. Methodology in final report
27.6%22.4%19.7%31.6%
52.7% 48.8%23% 18.1%
11.3%
43.6%29.6%
14.0%
39.6%19.6%
20.7%
0%
50%
100%
Mo
nte
rey
Co
un
ty
US
Bo
rn
Nat
ura
lized
LPR
/VIS
A*
Un
do
cum
ente
d*
*
19
-29
yea
rs
30
-49
yea
rs
50
-64
yea
rs
65
+ y
ears
INC
<=
13
8%
FP
L
13
8%
<IN
C<
=40
0%
FP
L
INC
>40
0%
FP
L
Lati
no
Wh
ite
Oth
er
IMMIGRATION AGE POVERTY LEVEL RACE/ETHNICITY
No usual source of care^ by Immigration Status, Age, Race/Ethnicity and Poverty, CHIS 2011-12
13.6 55
Access to Health Services
19
(Note: Although there are no Kaiser facilities is MC, CHIS data is including Kaiser/HMO)Data less than 2% were not highlighted in graph.* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report*** Other= Some other place or Complementary and Alternative Medicine
59.3%73.9%
32.3%33.3%
47.3%46.6%
44.8%73.1%
78.3%38.3%
61.9%67.3%
35.7%74.2%
64.3%
38.4%23.4%
64.8%66.7%
52.1%52.8%
49.7%26.1%
20.9%56.2%
36.5%31.3%
63.7%20.8%
35.7%
2.9%2.1%
3.7%
3.8%
3%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
IC
ITY
MD Office/Kaiser/HMO Health Center/Gov't or Hosp Clinic ER Other***
For those with a usual source of care, kind of place by Immigration Status, Age, Race/Ethnicity and Poverty, CHIS 2011-12
Access to Health Services
20^ Usual Source of Care - Is there a place that you usually go to when you are sick or need advice about your health?(Note: Although there are no Kaiser facilities in MC, CHIS data includes Kaiser/HMO)
14.1%
19%
42.5%
7.6%
10.1%
20%
24.3%
11.5%
85.9%
81%
57.5%
92.4%
89.9%
80%
75.7%
88.5%
0% 50% 100%
MD Office/Kaiser/HMO
Health Center/Gov't or Hosp. Clinic
Some Other Place
No Usual Source of Care
Uninsured
Medicare & Others
Medicaid/Healthy Families
Private/Employment
USU
AL
SOU
RC
E O
FC
AR
EIN
SUR
AN
CE
TYP
E
Monterey County: Ever visited emergency room for own health in past 12 months, by Usual Source of Care^ and
Insurance Type, CHIS 2011-12
YES NO
Access to Health Services
21
Data (for 7-12 times) collected in CHIS, but no MC respondents in sample fell into these categories.Data less than 2% were not highlighted in graph.* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
87.7%86.1%
80.4%100%
95.4%100%
95.8%70.2%
84.2%96.2%
86.1%82.1%
99.0%76.6%
98.3%
10.6%
11.4%
19.6%
4.6%
4.2%
25.3%
13.6
3.8
13.9%
13.4%
20.1%
2.5%
4.6%2.2%
4.5%
3.4%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
Number of times visited ER in past year by Immigration, Age, Poverty Level, Race/ethnicity, CHIS 2011-12
0-2 times 3-6 times 13+ times
CA USMC 2020 TargetCHIP Target
55.3/32.3/4.522
Access to Health Services
Data (for 7-12 times) collected in CHIS, but no MC respondents in sample fell into these categories.Data less than 2% were not highlighted in graph.* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
57.6/30.2/4.2
55.3%49.8%51.5%
68.7%71.2%
77.7%61.2%
36.5%30%
66.4%50.7%51.4%
62.2%50.8%
50.9%
32.3%34%
39.5%25.1%
22.7%15%
32.2%39.7%
53.7%25.1%
36.7%33.5%
28.1%32.8%38.8%
4.5%5.7%4.3%3.5%1.2%2.6%2.3%
8.8%6%
5.2%5.9%3.6%
6.2%3.2%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
Number of doctor visits by, Immigration, Age, Poverty Level, Race/ethnicity, CHIS 2011-12 0-2 times 3-6 times 13+ times
NA NANA
CA USMC 2020 TargetCHIP Target
24.7 17.723
Access to Health Services
* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
NA
24.7%18.1%
10.5%
44.2%52.5%
35.7% 30.2%18.7%
2.7%
45%
23.6%10.8%
36.1%
19.4% 14.1%
0%
50%
100%
Mo
nte
rey
Co
un
ty
US
Bo
rn
Nat
ura
lized
LPR
/VIS
A*
Un
do
cum
ente
d**
19
-29
yea
rs
30
-49
yea
rs
50
-64
yea
rs
65
+ ye
ars
INC
<=
13
8%
FP
L
13
8%
<IN
C<=
40
0%
FP
L
INC
>40
0%
FP
L
Lati
no
Wh
ite
Oth
er
IMMIGRATION AGE POVERTY LEVEL RACE/ETHNICITY
Zero doctor visits in past year by Immigration, Age, Poverty Level, Race/ethnicity, CHIS 2011-12
NANA
.
Access to Health Services
24
About 1/3 of respondents sought an appointment with a doctor in 2-days in past year, except LPR/VISA @ 13.7%.* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
7.5%5.4%
12.1%20.6%
9.2%9%
5.7%8.9%
6.1%
13.7%
8.2%7.3%7.3%
15%13.2%
31%
7.9%14%21.7%
10.8%12.8%
28.3%14.5%
9.4%11%
13.3%21%
16.4%17.5%
9.5%
25.8%9.7%
12.7%16%
31.6%2.9%
15.9%22.8%
13.2%19.0%
15%
61.1%63.9%
47.5%79.4%
57.1%67.2%
59.9%64.2%
49.5%56.1%55.9%
66.6%67.6%
60.4%56.7%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
STA
TUS
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
How often respondent got an appointment in 2 days in past year by Immigration, Age, Poverty Level, Race/Ethnicity, CHIS 2011-12
Never Sometimes Usually Always
.
Access to Health Services
25
^ Usual Source of Care - Is there a place that you usually go to when you are sick or need advice about your health?(Note: Although there are no Kaiser facilities is MC, CHIS data is including Kaiser/HMO)
6.0%
4.1%
14.6%
42.7%
4.2%
13.4%
2.5%
7.3%
15.2%
17.6%
5.6%
4.9%
17%
12.9%
41.1%
9.5%
18.5%
8.2%
35.2%
6.2%
26.7%
16%
15.4%
60.3%
70.2%
79.8%
17.2%
72.6%
47%
40.4%
67.8%
MD Office/Kaiser/HMO
Health Center/Gov't or Hosp. Clinic
Some Other Place
No Usual Source of Care
Uninsured
Medicare & Others
Medicaid/Healthy Families
Private/Employment
USU
AL
SOU
RC
E O
FC
AR
EIN
SUR
AN
CE
How often respondent got an appointment in 2 days in past year by Usual Source of Care^ and Insurance Type, CHIS 2011-12
Never Sometimes Usually Always
CA USMC 2020 TargetCHIP Target
21.3 16.836.8
Over 65 not included due to MediCare coverageCounty, State, and US stats based on Uninsured All and part year & excludes 65+ years* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
26
Access to Health Services
23.5%15.6%
12.8%26.0%
54.8%27%
25.8%15.9%
38.8%26.3%
6.8%30.3%
13.1%24.5%
13.3%12%
11.2%23.3%
13.2%21.8%
10.6%6%
12.8%24.5%
15.5%12.9%
9.9%
63.2%72.4%76%
50.7%32.1%
51.2%63.7%
78.1%
48.3%49.2%
91.5%54.2%
73.9%65.6%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
IC
ITY
Insurance status in past 12 months by Immigration, Age, Poverty Level, Race/ethnicity, CHIS 2011-12
Uninsured All Year Uninsured Part Year Insured All Year
00
Access to Health Services
27
23.8%
3.2%
13.2%
1.7%
7.8%
45.1%
3.5%
1.7%
0% 50%
Uninsured
Medicare & Medicaid
Medicare & Others
Medicare Only
Medicaid
Employment Based
Privately Purchased
Healthy Families/Other Public
Monterey County: Type of current health insurance coverage (18+ years) CHIS 2011-12
Access to Health Services
28Data less than 2% were not highlighted in graph* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report.
23.8%15.1%
19.6%26.0%
58.0%34.0%31.2%
17.7%
41.0%29.8%
5.4%36.4%
10.7%23.9%
13.2%18.6%11.8%
3%
79.0%5.5
10.8%21.0%
25.5%10.7%
7.8%4.6%
6.6%34.3%
5.4%14.1%
10.7%
18.8%7.5%
13.9%
7.8%
45.1%49.7%
47.9%34.5%31.6%
45.1%51.3%
67.3%
24.3%43.1%
62.2%40.9%
48.0%47.3%
10.2%7%
13.3%12.0%14.1%
5.2%
6.7%6.8%
12.8%18.8%
10.4%8.7%
11.4%6%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
Uninsured Medicare & Others Medicaid Employment-Based Other
Top 4: Type of current health coverage (18-64 years), by Immigration, Age, Poverty Level, Race/ethnicity, CHIS 2011-12
Access to Health Services
29
0.2%
0.5%
0.6%
1.4%
2.0%
2.3%
2.4%
2.9%
3.0%
7.0%
14.8%
26.2%
36.6%
0% 50%
Thought was Insured
No Need- General
Other
Health Insurance Was Canceled/Was Dropped
Can Get Healthcare For Free/Pay For Own
Procrastination/Hans't Taken Steps To Get
Don't Know Where Or How to Get Insurance
Don't Believe in Insurance
Not Eligible Due To Health Or Other Problem
Can't Qualify For Public Program Coverage
Not Eligible Due To Citizenship/Immigration Status
Not Eligible Due To Working Status
Can't Afford/Too Expensive
Monterey County: Reason for being uninsured (all year/part year) in past 12 months, CHIS 2011-12
Data less than 4% were not highlighted in graph.Over 65 not included due to MediCare coverage* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
Access to Health Services
30
36.6%43%
55.3%31.7%
24.8%19.2%
48.8%59.4%
31.6%38.9%
48.3%24.0%
53.7%50.5%
26.2%32.9%
39.8%46.8%
4.7%30.8%
20.8%25.2%
14.1%36.6%
23.7%27%
33.9%16.4%
14.8%
43.6%
21.4%
11.3%
25.2%
8.5%
25.2%
7%
11.4%
4.2%
5.4%
11.8%
10.3%
10.2%
6.8
10.7%
6.7%
4.4%
12.4%
9.6%
4.9%
10.6%
19%
13.8%
12.6%
8.1%
15%
9.4%
17.7%
12.5%
6.1%
18.4%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
Can't Afford/Too Expensive Not Eligible Due To Working Status
Not Eligible Due To Citizenship/Immigration Status Can't Qualify For Public Program Coverage
Not Eligible Due To Health Or Other Problem Other
Top 5 reasons for uninsured (all & part year) in past 12 months, by Immigration, Age, Poverty Level, Race/ethnicity, CHIS 2011-12
Language Barriers in Monterey County
• 55.4% of Monterey County residents were identified to be
of Hispanic or Latino origin (US Census, 2010).
• More than 50% of households in Monterey County are
reported to speak a language other than English at home,
compared with 43% for California (US Census, 2010).
• Close to half of Monterey County residents speak English
‘not very well’ or ‘not at all’ (44.1%) compared with 35.2%
for California (CHIS, 2012)
3131
Access to Health Services
Access to Health Services
32
^ For those who visited a doctor in past 12-months* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
3.7%
2.1%
4.1%
3.2%
10.9%
0.6%
8.4%
2.5%
1.9%
4.1%
6.1%
1.2%
3.9%
2.8%
4.8%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
Reported hard time understanding doctor during last visit, by Immigration, Age, Poverty Level,
Race/ethnicity, CHIS 2011-12^
80.9%61.3%100%100%83.6%
100%37.1%60.4%77.3%87.0%59.4%74.2%69.8%100%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
IC
ITY
Of those reporting hard time understanding doctor during last visit (n=9,042): Hard Time Understanding Doctor Because of Language Spoken, by Immigration,
Age, Poverty Level, Race/ethnicity, CHIS 2011-12^
0%
Access to Health Services
33
13.3%3.5%
12.8%39.5%
56%
24.3%17.5%
21.5%13.3%
25.2%0.8%
13.8%2.3%
18.5%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
STA
TUS
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
Reported needing someone else to help understand doctor, by Immigration, Age, Poverty Level,
Race/ethnicity, CHIS 2011-12
* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
0%
Access to Health Services
34
13.7%
11.4%
15.3%
11.6%
27.5%
6.9%
12.3%
0% 50%
MD Office/Kaiser/HMO
Health Center/Gov't or Hosp. Clinic
Some Other Place
No Usual Source of Care
Uninsured
Medicare & Others
Medicaid/Healthy Families
Private/Employment
USU
AL
SOU
RC
E O
FC
AR
EIN
SUR
AN
CE
Reported needing someone else to help understand doctor, by Usual Source of Care and Insurance Type, CHIS 2011-12
0%
Access to Health Services
35
No data available for age 19-29 years.Data less than 3% were not highlighted in graph.* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
3.3%
9.8%
16.2%
4.4%
8.2%
41.2%100%
46.8%19.0%
26.8%
38.2%19.9%
76.1%19.7%
49.1%
57.9%100%
13.8%
46.9%
36.2%81%
52.6%
51.8%63.9%
10.5%53.1%
46.5%
31.2%
72.1%
6.2%
20.6%
10%
27.2%
10.9%
7.2%
13.5%
100%
6%
Monterey CountyUS Born
NaturalizedLPR/VISA*
Undocumented**19-29 years30-49 years50-64 years
65+ yearsINC <=138% FPL
138%<INC<=400% FPLINC>400% FPL
LatinoWhiteOther
IMM
IGR
ATI
ON
STA
TUS
AG
EP
OV
ERT
Y LE
VEL
RA
CE/
ETH
NIC
ITY
Who helped you understand doctor during last visit, by Immigration, Age, Poverty Level, Race/ethnicity, CHIS 2011-12
Minor Child (Under age 18) Adult Family Member or Frield of MineMedical Staff Including Nurses / Docs Prof. Interpreter (Person/Phone)Other (Patients, Someone Else)
Access to Health Services
36
* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
75.9%87.5%
68%63.2%
51.2%88.9%
79.3%69.2%
55%62%
71.4%90.4%
70%84.6%
71.9%
24.1%12.5%
32%36.8%
48.8%11.1%
20.7%30.8%
45%38%
28.6%9.6%
30%15.4%
28.1%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
STA
TUS
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
Ever used the internet, by Immigration, Age, Poverty Level, Race/ethnicity, CHIS 2011-12
Yes No
Access to Health Services
37
62.2%71.3%
54.2%63.3%
18.1%54.4%
65.7%76.0%
50.8%51.1%
59.7%69.5%
42.3%73.2%73.6%
37.8%28.7%
45.8%36.7%
81.9%45.6%
34.3%24%
49.2%48.9%
40.3%30.5%
57.7%26.8%26.4%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
STA
TUS
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
Used internet to find medical information in past 12 months, by Immigration, Age, Poverty Level,
Race/ethnicity, CHIS 2011-12 Yes No
* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
Access to Health Services
38
Data less than 3% not highlighted in graph* LPR/VISA= Legal Permanent Residents/VISA recipient**Undocumented Calculated by ICCS, not CHIS. Methodology in final report
67.6%75.9%
70.2%55.6%
22.2%60.1%
71.1%78.1%
61.3%42.6%
61.2%84.9%
48.4%80.6%
74.1%
18.7%15.4%
18.9%27.3%
32.2%20.9%
21.3%12%
17.3%23.1%
26.9%10.3%
26.0%12.6%
18.3%
11.9%7%
6.8%17.1%
45.5%19.1%
7.6%5.3%
14.6%34.%1
8%3.8%
24.7%3.9%6.5%
4%
4.66.8%
4%
0% 50% 100%
Monterey County
US Born
Naturalized
LPR/VISA*
Undocumented**
19-29 years
30-49 years
50-64 years
65+ years
INC <=138% FPL
138%<INC<=400% FPL
INC>400% FPL
Latino
White
Other
IMM
IGR
ATI
ON
STA
TUS
AG
EP
OV
ERTY
LEV
ELR
AC
E/ET
HN
ICIT
Y
Very Confident Somewhat Confident Not Too Confident Not At All Confident
Confidence completing an application online, by Immigration, Age, Poverty Level, Race/ethnicity, CHIS 2011-12
Access to Health Services ~ Moving Forward
39
• Establish a systematic approach to data collection, analysis and
reporting.
• Select (and prioritize) important variables that contribute to
improved health outcomes to study on a periodic basis.
• Partner with Central Coast Alliance for Health to collaborate
on (MediCal) provider and patient data analysis directed at
improving the system’s ability to address selected population
health issues.
• Conduct periodic data collection of all health care service
providers throughout the County and explore contributions to
improvements in health status.
Chronic Disease
• Indicator:– Blood Pressure
– Heart Disease
– Diabetes
Data Source:
– California Health Interview Survey (CHIS), 2010-2012
– HealthyPeople.gov, 2014
– Monterey County Health Department Community Health Improvement Plan (CHIP), 2014
41
CA USMC 2020 TargetCHIP Target
Chronic Disease: High Blood Pressure
27.2 29
30.4% 25.9%
0%
50%
100%
Male Female
Blood pressure: Ever diagnosed with high blood pressure by
Gender, CHIS 2011-12
24.1%32.9%
21.2%*
64.9%*
34.3%*
-
19.6%*
0.0%
50.0%
100.0%
Blood pressure: Ever diagnosed with high blood pressure by Race/ethnicity, CHIS 2011-12
- (hyphen) Estimate is less than 500 people* Statistically unstable, interpret with caution
4228.1 NANA
CA USMC 2020 TargetCHIP Target
Chronic Disease: High Blood Pressure
-11.7%
38.0%
58.7%66.9%*
0%
50%
100%
Adult 18-24 years
Adult 25-39 years
Adult 40-64 years
Senior 65-79 years
Senior 80+years
Blood pressure: Ever diagnosed with high blood pressure by ‘adult’ age, CHIS 2011-12
4327.228.1
- (hyphen) Estimate is less than 500 people* Statistically unstable, interpret with caution
NA29NA
CA USMC 2020 TargetCHIP Target
Chronic Disease: Heart Disease
5.0%*11.6%
- -3.8%* - -
0%
50%
Heart disease: Ever diagnosed with heart disease by
Race/ethnicity, CHIS 2011-12
3.0%*8.2%
15.7%
35.5%
0%
50%
Adult 18-24
Adult 25-39
Adult 40-64
Senior 65-79
Heart disease: Ever diagnosed with heart
disease by Age , CHIS 2011-12
6.344
7.5
- (hyphen) Estimate is less than 500 people* Statistically unstable, interpret with caution
NA
7.1%
12.5%
4.6%
0%
50%
U.S. Borncitizen
Naturalizedcitizen
Non-citizen
Heart disease: Ever diagnosed with heart
disease by Immigration Status, CHIS 2011-12
NAImprove baseline
CA USMC 2020 TargetCHIP Target
Chronic Disease: Diabetes
9.8% 8.7%- -
19.0%*
- -0.0%
50.0%
100.0%
Diabetes: Ever diagnosed with diabetes by Race/ethnicity, CHIS 2011-12
8.4
- (hyphen) = Estimate is less than 500 people* Statistically unstable, interpret with caution
459.7 NA
6.5%
18.0%*11.1%*
0%
50%
100%
U.S. Borncitizen
Naturalizedcitizen
Non-citizen
Diabetes: Ever diagnosed with diabetesby Immigration Status, CHIS 2011-12
NA7.2/1,000
CA USMC 2020 TargetCHIP Target
Chronic Disease: Diabetes
8.4
- - 7.3%* 14.7%0%
50%
100%
Child (0-11) Adolescent (12-17) Adult (18-64) Senior (65+)
Diabetes: Ever diagnosed with diabetes by Age, CHIS 2011-12
Type I diabetes
11%Type II
diabetes89%
Type of diabetes: Type I or Type I, CHIS 2011-12
- (hyphen) = Estimate is less than 500 people* Statistically unstable, interpret with caution
469.7 NA NA7.2/1,000
Injury and Violence
• Indicators:
– Unintentional Injury Mortality rates*
– Homicides
• Data Source:
– California Health Interview Survey (CHIS), 2009-2012
– HealthyPeople.gov, 2014
– Monterey County Health Department:
• Community Health Assessment, 2013
• Community Health Improvement Plan (CHIP), 2014
48
* Deaths caused by injuries where there is no evidence of predetermined intent, e.g., car accidents , suffocation, poisoning., and falls.
CA USMC 2020 TargetCHIP Target
Injury and Violence
30.5
29.4
0
5
10
15
20
25
30
35
40
45
50
Rat
e p
er
10
0,0
00
Age-adjusted Unintentional Mortality rate per 100,000 by Race/ethnicity, MCHD 1999-2010
Asian/Pacific Islander (nH) Black (nH)
Hispanic/Latino, any race Multiple/Other races (nH)
White (nH) Monterey County
10
15
20
25
30
35
40
45
50
Age-adjusted unintentional mortality rates per 100,00 by gender, MCHD 2013
Male Female
26.9 40.4
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.
4929.4 36.4Improve baseline
CA USMC 2020 TargetCHIP Target
Injury and Violence
Graph Source: Monterey County Health Department 2013 Community Assessment* Statistically unstable, some data years suppressed to preserve confidentiality, e.g. 99-01, 00-02, 02-03, 06-10.** Statistically unstable, interpret with caution
26.950
29.4
30.529.4
0
10
20
30
40
50
60
70
80
90
100
rate
pe
r 1
00
,00
0
Unintentional mortality rate per 100,000 by Age, MCHD 1999-2010
<1 year *
1 to 14 years**
15 to 24 years
25 to 44 years
45 to 64 years
65+ years
Monterey County
40.4 36.4Improve baseline
CA USMC 2020 TargetCHIP Target
Injury and Violence
10.2 6.1
Graph Source: Monterey County Health Department 2013 Community AssessmentData for 1to 14 years is suppressed to preserve confidentiality* Statistically unstable, interpret with caution
515.3
5.110.2
0
25
50
2005-07 2006-08 2007-09 2008-10R
ate
pe
r 1
00
,00
0
Age-adjusted homicide rate per 100,000 by Race/ethnicity, MCHD
2005-2010
Asian/Pacific Islander (nH) * Black (nH)*
Hispanic/Latino, any race* Multiple/Other races (nH)*
White (nH) * Monterey County
5.110.2
0
25
50
2005-07 2006-08 2007-09 2008-10
Rat
e p
er
10
0,0
00
Homicide rates per 100,000 by Age, MCHD 2005-2010
1 to 14 years* 15 to 24 years*
25 to 44 years 45 to 64 years
Monterey County
5.55.5
CA USMC 2020 TargetMC Target
Injury and Violence
52
Domestic Violence (CHIS, 2009)
9.0%
18.4%
0%
50%
Male Female
Ever experienced physical or sexual violence by an intimate partner since age 18 by gender,
CHIS 2009
14.4% 15.5%
- -8.1%
- -0%
50%
Ever experienced physical or sexual violence by an intimate partner since age 18 by Race/ethnicity, CHIS 2009
- (hyphen) = Estimate is less than 500 people* Statistically unstable, interpret with caution
15.6%
7.8%
13.9%
0%
50%
U.S. Borncitizen
Naturalizedcitizen
Non-citizen
Ever experienced physical or sexual violence by an intimate partner
since age 18 by Immigration Status, CHIS 2009
1.9 NA3.5 NANA
Maternal, Infant and Children
54
• Indicator:
– Prenatal Care
– Teen Pregnancy (Births)
• Data Source:
– HealthyPeople.gov, 2014
– Monterey County Health Department:
• Community Health Assessment, 2013
• Community Health Improvement Plan (CHIP), 2014
CA USMC 2020 TargetCHIP Target
Maternal, Infant and Children
78.4
74.6
50
60
70
80
90
100
2005-07 2006-08 2007-09 2008-10
Rat
e p
er
10
0
Entry into prenatal care in first trimester per 100 population by mother’s age, MCHD 2005-2010
17 years and less 18 to 24 years
25 to 34 years 35+ years
Monterey County
78.4
74.6
50
60
70
80
90
100
2005-07 2006-08 2007-09 2008-10R
ate
pe
r 1
00
Entry into prenatal care in first trimester per 100 population by mother’s race/ethnicity, MCHD 2005-2010
Asian/Pacific Islander (nH) Black (nH)
Hispanic/Latino, any race Multiple/Other races (nH)
White (nH) Monterey County
83.5 per 100 70.8%
Source: California Department of Public Health, Health Information and Research Section, Birth Statistical Master File 1999-2010; statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.
5574.6 per 100 77.9%NA
CA USMC 2020 TargetCHIP Target
Maternal, Infant and Children
29.4 40.256
Graph Source: Monterey County Health Department 2013 Community Assessment
52.5
11.2 12 9.3 9
29.8 32.2 35.6 39.2
79.775.4
71.566.2
22.2 22 20.2 21.316.3 17.4 17.5 18.2
57.2 56.1 54.852.5
0
50
100
2005-07 2006-08 2007-09 2008-10
2005-10 Birth rates to teen mothers (age 15 to 19) per 1,000 population by mother’s race/ethnicity, MCHD 2005-2010
Asian/Pacific Islander (nH) Black (nH) Hispanic/Latino, any race
Multiple/Other races (nH) White (nH) Monterey County
36.2Improve baseline
CA USMC 2020 TargetCHIP Target57
Maternal, Infant and Children
29.4 40.2
Graph Source: Monterey County Health Department 2013 Community Assessment
52.5
13 13.5 13.1 12.5
129.7
127.2120.7 111.6129.5
130.3 129.3125.6
24.6 24.4 24.6 24.7
0
50
100
150
2005-07 2006-08 2007-09 2008-10
2005-10 Birth rates per 1,000 population by mother’s age, MCHD 2005-2010
17 years and less 18 to 24 years 25 to 34 years 35+ years
36.2Improve baseline
Behavioral Health
59
• Indicators:– Drug-related Deaths
– Suicides
– Teens who reported binge* drinking in past month
– Adults who reported binge* drinking in past month
– Data Sources:
– California Health Interview Survey (CHIS), 2009-2012
– HealthyPeople.gov, 2014
– Monterey County Health Department:• Community Health Assessment, 2013
• Community Health Improvement Plan (CHIP), 2014
• Binge drinking can be defined as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or above.
CA USMC 2020 TargetCHIP Target
Behavioral Health
9.6
0
5
10
15
20
25
rate
pe
r 1
00
,00
0
Asian/Pacific Islander (nH) Black (nH)
Hispanic/Latino, any race Multiple/Other races (nH)
White (nH)* Monterey County
Age-adjusted accidental poisoning/ unintentional drug-related mortality rates per
100,000 by race/ethnicity, MCHD 2008-10
9.6
0
5
10
15
20
25
rate
pe
r 1
00
,00
0
Male Female Monterey County
Age-adjusted accidental poisoning/unintentional drug-related mortality rates per 100,000 by gender, MCHD
2008-10
8.7 13.2
Drug-related Deaths (Overdose)
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.* Data statistically unstable for this category
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.
609.6 Baseline
(13.2)NA
CA USMC 2020 TargetCHIP Target
Behavioral HealthSuicides
10.1
0
5
10
15
20
25
rate
pe
r 1
00
,00
0
Suicide rates per 100,000 by age, MCHD 1999-2010
15 to 24 years* 25 to 44 years 45 to 64 years 65+ years* Monterey County
14.0 11.3
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.* Statistically unstable, interpret with caution
6110.1 10.2NA
CA USMC 2020 TargetCHIP Target
Behavioral HealthSuicides
14.0 11.3
7.110.1
0
5
10
15
20
25
rate
pe
r 1
00
,00
0
Age-adjusted suicide rates per 100,000 by race/ethnicity, MCHD 1999-2010
Asian/Pacific Islander (nH) * Black (nH)*
Hispanic/Latino, any race* Multiple/Other races (nH)*
White (nH)* Monterey County
7.1 10.1
0
5
10
15
20
25
rate
pe
r 1
00
,00
0
Age-adjusted suicide rates per 100,000 by gender, MCHD 1999-2010
Male Female Monterey County
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.* Statistically unstable, interpret with caution
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.
6210.1 10.2NA
CA USMC 2020 TargetCHIP Target
Teens who reported binge drinking in past month
3.6 9.5
Substance Abuse
YES4.4%NO
95.6%
Monterey County: Teens reported to binge drink in past month, CHIS
2011-12
-
10.0%
0%
25%
50%
Male Female
Axi
s Ti
tle
Teens reporting binge drinking in past month by Immigration Status, CHIS 2011-
12
634.4
- (hyphen) = Estimate is less than 500 people* Statistically unstable, interpret with caution
4.90%* - -
0%
25%
50%
Teens reporting binge drinking in past month by Immigration Status, CHIS 2011-
12
8.6NA
CA USMC 2020 TargetCHIP Target
Adults who reported binge drinking in past month
31.1 27.1
Substance Abuse
NO 65.9%
YES34.1%
Monterey County: Adults who binge drink in past year,
CHIS 2011-12
37.9% 35.2%
18.5%*
- 4.3%* -
50.8%*
0%
50%
100%
Adult binge drinking in past year by Race/ethnicity, CHIS 2011-12
- (hyphen) = Estimate is less than 500 people* Statistically unstable, interpret with caution
6434.1 24.424.4
CA USMC 2020 TargetCHIP Target
Adults who reported binge drinking in past month
Substance Abuse
NO 65.9%
YES34.1%
Monterey County: Adults who binge drink in past year,
CHIS 2011-12
- (hyphen) = Estimate is less than 500 people* Statistically unstable, interpret with caution
46.5% 46.2%
18.5%*
15.6%
4.3%*
0%
50%
100%
Adult binge drinking in past year by age group, CHIS 2011-12
6531.1 27.134.1 24.424.4
Nutrition, Physical Activity,
and Obesity
67
• Indicators:
– Overweight/Obese adults and adolescents
– Data Sources:
– California Health Interview Survey (CHIS), 2011-12
– Healthypeople.org, 2014
– Monterey County Health Department Community
Health Improvement Plan (CHIP), 2014
CA USMC 2020 TargetCHIP Target
6. Nutrition, Physical Activity, and Obesity
12.6 10.4 (ages 2-5)
6811.1
* Data not available due to estimate less than 500 people
88.9%88.9%
83.4%95.7%
85.6%98.2%
100.0%100.0%70.4%
100.0%86.1%86.5%
76.6%100.0%
11.1%11.1%
16.6%4.3%
14.4%
13.9%13.5%
23.4%
0% 50% 100%
Monterey County
U.S. Born citizen
Naturalized citizen*
Non-citizen*
Male
Female
Latino
White (non-latino)
African American (non-latino)
American-Indian/Alaska Native (non-latino)
Asian (non-latino)
Native Hawaiian/Pacific Islander (non-latino)*
Two or More Races (non-latino)
0-99% FPL
100-199% FPL
200-299% FPL
300% FPL and above
IMM
IGR
ATI
ON
GEN
DER
RA
CE/
ETH
NIC
ITY
PO
VER
TYLE
VEL
Obesity: Children (0-12years) Overweight/Not Overweight for age (not factoring height), by Immigration, Gender, Race/ethnicity, and Poverty Level, CHIS 2011-12
Not overweight for age Overweight for age
9.4 (ages 2-5) NA
CA USMC 2020 TargetCHIP Target
6. Nutrition, Physical Activity, and Obesity
69
Data less than 2% not highlighted in graph* Statistically unstable, interpret with caution**At-Risk - greater probability of becoming overweight.*** Data not available due to estimate being less than 500 people
11.94.8 17.9 16.89.7 (at-risk & Ob.)
5.4%
8.6%
4.8%
82.4%84.1%
65.8%88.1%
75.5%78.5%
86.5%
100.0%100.0%
87.9%62.7%
75.5%92.4%
10.3%8.0%
34.2%3.1%
19.1%14.3%
12.1%12.2%
24.5%
4.80%5.30%
8.80%
5.60%
19.70%
0% 50% 100%
Monterey County
U.S. Born citizen*
Naturalized citizen***
Non-citizen*
Male*
Female*
Latino
White (non-latino)*
African American (non-latino)***
American-Indian/Alaska Native (non-latino)***
Asian (non-latino)
Native Hawaiian/Pacific Islander (non-latino)
Two or More Races (non-latino)***
0-99% FPL*
100-199% FPL*
200-299% FPL*
300% FPL and above*
IMM
IGR
AT
ION
GEN
DE
RR
AC
E/ E
THN
ICIT
YP
OV
ERTY
Obesity: Teens (12-17 years) body mass index (4 levels), by Immigration, Gender, Race/ethnicity, and Poverty Level, CHIS 2011-12
Underweight (within lowest 5th percentile) Normal weight (5th up to 85th percentile)
At risk of overweight** (85th up to 95th percentile) Overweight/obese (highest 5th percentile)
CA USMC 2020 TargetCHIP Target
6. Nutrition, Physical Activity, and Obesity
33.9/ 22.6 NA / 33.9 70
37.2/25.1
Data less than 3% not highlighted in graph.* Data not available due to Estimate being less than 500 people
NA / 30.5 Improve baseline
3.2%
36.0%36.9%
31.6%37.0%
29.5%42.4%
29.8%41.4%
61.4%
40.2%
49.2%37.4%
23.7%30.9%
43.7%
37.2%37.7%
32.5%39.6%
45.9%28.6%
41.4%33.4%
11.2%
46.5%
26.0%48.6%32.7%
37.6%
25.1%23.8%
34.0%21.8%23.6%
26.6%26.7%24.3%21.4%
13.4%
50.8%34.3%
27.1%33.3%
17.3%
0% 50% 100%
Monterey County
U.S. Born citizen
Naturalized citizen
Non-citizen
Male
Female
Latino
White (non-latino)
African American (non-latino)
American-Indian/Alaska Native (non-latino)*
Asian (non-latino)
Native Hawaiian/Pacific Islander (non-latino)*
Two or More Races (non-latino)
0-99% FPL
100-199% FPL
200-299% FPL
300% FPL and above
IMM
IGR
ATI
ON
GEN
DER
RA
CE/
ETH
NIC
ITY
PO
VER
TYLE
VEL
Obesity: Adult body mass index (4 levels), by Immigration, Gender, Race/ethnicity, and Poverty Level, CHIS 2011-12
Underweight( 0 - 18.49) Normal (18.5 - 24.99 ) Overweight (25.0 - 29.99) Obese (30.0 or higher)
Communicable Diseases• Indicators:
– Newly reported HIV/AIDS cases
– Pertussis
• Data Source:
– Monterey County Health Department:
• Community Health Assessment, 2013
• Community Health Improvement Plan (CHIP), 2014
72
CA USMC 2020 TargetCHIP Target
Newly reported HIV/AIDS cases
Communicable Diseases
8.7 4.3 (HIV)
8.70
25
50
75
2005-07 2006-08 2007-09 2008-10 2009-11
Newly reported HIV/AIDS cases per 100,000 by age group, MCHD
2005-11
0 to 14 years* 15 to 24 years* 25 to 44 years
45 to 64 years 65+ years* Monterey County
8.70
25
50
75
2005-07 2006-08 2007-09 2008-10 2009-11
Newly reported HIV/AIDS cases per 100,000 by Race/ethnicity, MCHD
2005-11
Asian/Pacific Islander (nH)* Black (nH)*
Hispanic/Latino, any race Multiple/Other races (nH)*
White (nH) Monterey County
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.* Statistically unstable, interpret with caution
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.* Statistically unstable, interpret with caution
73 4.6 per 100 (HIV)/ 13.8 per 100,000 (AIDS)
3.5 per100 (HIV)/ 12.4 per 100,000 (AIDS) NA
CA USMC 2020 TargetCHIP Target
Pertussis infection rates
Communicable Disease
748.02
14.6
0
5
10
15
20
25
2005-07 2006-08 2007-09 2008-10 2009-11
0 to 14 years*
15 to 24 years*
25 to 44 years*
45 to 64 years*
65+ years*
Monterey County
Pertussis infection rates per 100,000 by age group, MCHD 2005-11
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.* Statistically unstable, interpret with caution
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.* Statistically unstable, interpret with caution
0
5
10
15
20
25
2005-07 2006-08 2007-09 2008-10 2009-11
Male* Female Monterey County
Pertussis infection rates per 100,000 by Gender, MCHD 2005-11
14.6 8.97 NANA
CA USMC 2020 TargetCHIP Target
Pertussis infection rates
Communicable Disease
758.2
Source: California Department of Public Health, statistical analyses performed by Monterey County Health Department, Surveillance and Epidemiology Unit.* Statistically unstable, interpret with caution
14.6
0
5
10
15
20
25
2005-07 2006-08 2007-09 2008-10 2009-11
Asian/Pacific Islander (nH)* Black (nH)* Hispanic/Latino, any race*
Multi-Race/Other (nH)* White (nH)* Monterey County
Pertussis infection rates per 100,000 by Race/ethnicity, MCHD 2005-11
14.6 8.97 NANA
General: Moving Forward
76
• Wide variation in health conditions across demographic groups.
• Monterey County Health Department systematically collects,
analyzes and makes available to the public, data on population
health issues across demographic groups (and where possible)
geographic regions and responds (with available funding)
• Central Coast Alliance for Health systematically collects and
analyzes medical provider data and works with providers to improve
the medical system’s capacity to address health problems.
• Health Information Systems (and use of Electronic Health Records
Systems) are beginning to allow more system-wide data sharing to
improve monitoring and tracking of selected health conditions by
demographic groups.
General Health: Moving Forward
77
• Determine which variables to explore on a sub-county level across demographic groups to determine which individual and community level health concerns are appropriate for this project.
• Continue to explore connections between income, education and health to better understand distribution of individual and community health problems across demographic groups.
• Engage medical, public health and social service providers in efforts to address health equity issues through cross-sector collaboration.
IMPACT MONTEREY COUNTYSecondary Data Report
Ignacio A. Navarro Ph.D.Kim Judson Dr.PH.Institute for Community Collaborative StudiesCalifornia State University Monterey Bay
Thank You
78
80
Person in family/household Poverty guideline
For families/households with more than 8 persons, add $4,160 for each additional person.
1 $11,770
2 15,930
3 20,090
4 24,250
5 28,410
6 32,570
7 36,730
8 40,890
2015 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF
COLUMBIA
Source: U.S. Department of Health & Human Services (2015). http://aspe.hhs.gov/poverty/15poverty.cfm
References
• California Department of Health Care Services. (October 2012). Finding California’s Medi-Cal population:
Challenges and methods in calculating Medi-Cal enrollment numbers. Sacramento, CA: Research and Analytic
Studies Branch.
• California Department of Education. (2013). Report to the governor and the legislation: 2011-12 California physical
fitness test report. Sacramento, CA.Assessment Development and Administration Division District,
School, and Innovation Branch.
• California Department of Public Health. (2015). STD: Sexually transmitted diseases in California 2013. Center for
Infectious Diseases, Division of Communicable Disease Control.
• California Department of Public Health. (2014). Unintentional Injury Death Data Trends for Years 2000-2010.
Office of Health Information and Research. Retrieved from
http://www.cdph.ca.gov/programs/ohir/Pages/UnInjury2010Total.aspx
• California Department of Public Health. (2013a). Chronic Hepatitis B and Hepatitis C Infections in California. Center
for Infectious Diseases.
• California Department of Public Health. (2013b). California addresses the national HIV/AIDS strategy goals and
objectives. Office of AIDS.
• California Department of Public Health. (2013c). Pertussis Report. Sacramento, CA. Immunizations Branch.
• California Department of Public Health. (2010a). Healthy California: Food safety. Sacramento, CA.
• California Department of Public Health. (2010b). Healthy California 2010: Focus Area 16-Maternal, Infant, and
Child Health. Sacramento, CA.
81
References cont.
• California Department of Public Health. (2009a). General fertility rates, total fertility rates, and birth rates by age and
race/ethnicity group of mother. Sacramento, CA. Department of Finance, Race and Ethnic Populations
with Age and Sex Detail.
• California Department of Public Health. (2009b). Leading causes of death, death rates, age-adjusted death rates, and
percentage change by sex. Sacramento, CA. Department of Finance, Race and Ethnic Populations with Age
and Sex Detail.
• Centers for Disease Control & Prevention. (2012). Health,United States, 2012: With special feature on emergency care.
Sacramento, CA. U.S Department of Health and Human Services.
• Centers for Disease Control Prevention. (July 2010). Unintentional drug poisoning in the United States. Atlanta, GA.
National Viral Statistics System.
• Centers for Disease Control & Prevention. (2013). High blood pressure facts. Retrieved from
http://www.cdc.gov/bloodpressure/facts.htm
• City of Salinas. (2010). Salinas comprehensive strategy for community-wide violence reduction 2010-2012. Salinas; CA.
• Hamilton, B. E., Martin, J.A., Osterman, M.J., & Curtin, S. C. (May 2014). Births: Preliminary data for 2013.
National Vital Statistics Reports, 63(2), 2
• Hernandez, L.B. (2011). Monterey County birth outcomes. Monterey County Health Department. Salinas; CA
• Humphrey, A.,Lee, L., Green R. (2011). Aspirations for later life (Research report No 737). National Centre for Social
Research. Department for Work and Pensions.
• Health Indicators Warehouse. (2014). Health Indicators Warehouse: Indicator List. Retrieved from
http://healthindicators.gov/App_Resources/Documents/HIW_Indicator_List.pdf
82
References cont.
• Institute for Community Collaborative Studies. (June 2012). Phase I report: Preliminary profile of health care needs & safety net providers that serve residents of Monterey County. Seaside, CA, Judson, K. & Navarro, I.
• Kidsdata.org. (2013a). Kindergarteners with all required immunizations. Retrieved from http://www.kidsdata.org/topic/292/immunizations-kindergarteners/
• Kidsdata.org. (2013b). Reports of gang membership, by grade level. Retrieved from http://www.kidsdata.org/topic/668/gang-grade/table#fmt=950&loc=2,32 0&tf=65&ch=613,614,69,305,306,431&sortColumnId=0&sortType=asc
• Monterey County Health Department. (2014). 2014-2018 Community health improvement plan for Monterey County, California. Salinas, CA.
• Monterey County Health Department. (2011). Health Brief: Overweight and obesity in Monterey County. Salinas; CA
• Monterey County Health Department. (2011). Strategic plan 2011-2015. Salinas: CA.
• Monterey County Health Department. (2013). Monterey County 2013 Community health assessment. Salinas: CA.
• National Household Education Surveys Program. (2005). Before- and After-School Programs and Activities. Retrieved from: http://nces.ed.gov/nhes/pdf/aspa/2005_aspa.pdf
• University of California Los Angeles Center for Health Policy Research (2013). California Health Interview Survey: 2011-2012 Questionnaire. Regents of the University of California.
http://healthpolicy.ucla.edu/chis/Pages/default.aspx
• U.S. Department of Health and Human Services. (2013). Healthy People 2020. Retrieved from http://www.healthypeople.gov/
• National Center for HIV/AIDS, Virus Hepatitis, STD & TB Prevention. (2009). Viral Hepatitis Surveillance: United States. Atlanta, GA. Center for Disease Control.
• Sirna, M. (2012) Sonoma County Human Services Department Upstream Investments: Indicators of success 2012 update. Santa Rosa, CA. Sonoma County Human Services Department
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