androscoggin county - maine.gov identified in this report are a synthesis of input provided at xx...

Androscoggin County Androscoggin County

Maine Shared Community Health Needs Assessment

<<Map of Maine, with Androscoggin County popped out>>

DRAFT

DRAFT – June 2017

Acknowledgements

The following report is funded through the generous support and contributions of the Maine

Shared Community Health Needs Assessment:

See www.maine.gov/SHNAPP/partners for a list of contributors and collaborating organizations.

Suggested citation: Central Maine Healthcare, Eastern Maine Healthcare Systems, Maine Center

for Disease Control and Prevention, an office of the Department of Health and Human Services,

MaineGeneral Medical Center, MaineHealth. (2019). Maine Shared Community Health Needs

Assessment. Portland, ME.

DRAFT – June 2017

For more detailed data go to: http://www.maine.gov/dhhs/mecdc/phdata/MaineCHNA page 3

Table of Contents

How to Use This Report ............................................................................................................... 3

Executive Summary ...................................................................................................................... 4

The Maine Shared CHNA Framework ....................................................................................... 5

Background and Methodology..................................................................................................... 5

Maine Shared CHNA Process ...................................................................................................... 6

County Demographics .................................................................................................................. 7

Key Health Indicators................................................................................................................... 8

Community Assets ...................................................................................................................... 10

Major Differences in Health ...................................................................................................... 11

Community Feedback ................................................................................................................. 12

Notes ............................................................................................................................................. 13

How to Use This Report

This report contains findings for Androscoggin County from the Maine Shared Community

Health Needs Assessment (Maine Shared CHNA) conducted in 2018-19. It provides high level

findings of the health needs and related community assets for the county. It is intended as a

starting point. In-depth data on health outcomes, health behaviors, health care access and

quality, and the social, community and physical environment can be found on the Maine Shared

CHNA website: http://www.maine.gov/dhhs/mecdc/phdata/MaineCHNA

The Maine Shared CHNA has several features that are important to keep in mind:

The Shared CHNA provides a reference for more than 180 indicators covering many

topics. It does not explore any individual topic in-depth. This report includes data on xx

indicators, but county and trend data are available for all on the Maine Shared CHNA

website.

The definitions and sources for each indicator discussed in the report are found on the

Maine Shared CHNA website.

Priorities identified in this report are a synthesis of input provided at xx community

forums conducted from September 2018 – March 2019.

http://www.maine.gov/dhhs/mecdc/phdata/MaineCHNA


DRAFT – June 2017


Executive Summary

Priorities identified via the community forums and a few supporting data points.

Nancy’s “vision” is that this can be pulled out as a “stand-alone” one pager.


DRAFT – June 2017


The Maine Shared CHNA Framework

Vision: Turn data into action.

Mission: To build a common understanding of Maine’s most pressing health needs.

There are a number of models for describing the health of a community. The Maine Shared

CHNA uses a hybrid of the County Health Ranking & Roadmaps, America’s Health Rankings,

the Maine Health Index, the Social Ecological Model and the Social Cognitive Theory

(Hyperlink to these).models:

Social, Community and Physical

Environment indicators include data

on where we work, live, learn and

play that affect our health, including

demographics and community assets.

Health Behavior indicators describe

health risk and protective factors in

which individuals engage.

Health Care Access and Quality

indicators describe how the health

care system assists us to become

healthier.

Health Outcome indicators describe

the health status of Mainers in terms of diseases we have, the severity of those disease as

indicated by diagnoses, emergency department use and hospitalizations, and deaths.

Background and Methodology

Public health and health care organizations share the goal of improving the lives of Maine

people. Health organizations, along with business, government, community organizations, faith

communities and individuals, have a responsibility to shape health improvement efforts based on

sound data, personal or professional experience and community need.

The Maine Shared CHNA Project is a collaborative effort among Maine’s four largest healthcare

systems – Central Maine HealthCare, Eastern Maine Healthcare Systems (EMHS),

MaineGeneral Health (MGH), MaineHealth – and the Maine Center for Disease Control and

Prevention (Maine CDC), an office of the Maine Department of Health and Human Services

Social, Community and Physical Environment

Health Behaviors

Health Care Access and

Quality

Health Outcomes


DRAFT – June 2017


(Maine DHHS). The current collaboration expands upon the OneMaine Health Collaborative

created in 2007 as a partnership among EMHS, MGH and MaineHealth. The Maine CDC and

other partners joined these entities to develop a public-private partnership in 2012. The four

hospital systems and the Maine CDC signed a memorandum of understanding in effect between

June 2014 and December 2019 committing resources to the Maine Shared CHNA.

The overall goal of the Maine Shared CHNA is to “turn data into action” by conducting a shared

community health improvement planning process for stakeholders across the state. The

collaborative assessment and planning effort will ultimately lead to the implementation of

comprehensive strategies for community health improvement. As part of the larger project, the

Maine Shared CHNA has pooled its resources to inform the community benefits reporting needs

of hospitals, support state and local public health accreditation efforts and provide valuable

population health assessment data for use in prioritizing and planning for community health

improvement.

Quantitative data are important and a solid starting point, but the numbers represent people who

live in Maine. The overall goal of the Maine Shared CHNA is to “turn data into action.”

Community engagement is therefore a critical next step, assuring shared ownership and

commitment to collective action. The perspectives of those who live in our communities bring

these numbers to life. xx community forums were held from September 2018 – March 2019,

where the data was discussed and some initial priorities were identified. We invite all readers to

use the information in this report and at http://www.maine.gov/dhhs/mecdc/phdata/MaineCHNA as

part of the solution to develop healthier communities in Maine.

Maine Shared CHNA Process

Maine Shared CHNA Activities:

Post- Maine Shared CHNA Planning:

Data summaries published

Community forums held to

discuss data and identify priorities

Shared Community Health Needs Assessments

published

Hospitals develop Implementation

strategies for their community benefit

programs

District Coordinating Councils for Public Health

develop District Public Health Improvement

Plans

Maine CDC and the State Coordination Council for

Public Health develop the State Health

Improvement Plan



DRAFT – June 2017


County Demographics

Androscoggin County has a total population of

107,604, with a population that is slightly younger

compared to the state. The county also has the

largest Black or African American population in

Maine. The socioeconomic characteristics of

Androscoggin County are below state average on

many measures including income, poverty rates,

education, and general health status.

Figure 1. Androscoggin County Population

Population TRENDS and PROJECTIONS

Figure 2. Population by Race/Ethnicity (U.S. Census

2013)

0.7%

1.1%

1.4%

1.4%

95.2%

0.4%

0.7%

3.8%

1.7%

93.0%

American Indian andAlaska Native

Asian

Black or AfricanAmerican

Hispanic

White

Androscoggin County Maine

Androscoggin County, in the midst of the southwestern section of Maine, is the second-smallest county in the state by total area. It hosts two of Maine’s largest cities, Lewiston and Auburn and is home to several hospitals including Central Maine Medical Center and Saint Mary's Regional Medical Center in Lewiston.

Key Demographics

Population Androscoggin

County Maine

Overall Population 107,604 1.33 mil Population density (per sq. mile)

230.2 43.1

Percentage living in rural areas

30.4% 66.4%

Single parent families 41.5% 29.1% 65+ living alone 42.2% 40.1% Population living with a disability

15.8% 16.3%

Economic Status

Median household income

$44,921 $46,974

Unemployment rate 5.5% 5.7%

Adults living in poverty 15.6% 13.6%

Children living in poverty

23.8% 18.5%

Education

HS graduation rate 80.6% 86.5%

Health Status

Adults rating health as fair/poor

17.5% 14.9%

Adults with 3+ chronic conditions

34.6% 27.9%

Adults with primary care provider

87.6% 87.4%

121,164 Population (2014)

X Adults age 65+

$46,808 Median Household Income

17.7% Children live in poverty

5.4% Unemployment Rate (2014)

14% Rate their health as fair/poor

28.3%

Androscoggin County


DRAFT – June 2017


Key Health Indicators

The above heading is used by Healthy People 2020 where there are 28 indicators identified as

“leading.” This would be our table of the top 20.

Possible format: add county data, and a column for a trend “sparkline” Could switch to

landscape format OR spread across two pages.

Indicator Unit Maine U.S. Comparison Year Trend

Rate per 1,000 live

births 6.5 5.9

2015

95% CI 5.2 - 8.0 5.8 - 6.0

Rate per 100,000† 73.1 63.9

2015 95% CI

68.5 - 77.7

63.6 - 64.1

95% CI 13.3 - 15.3

Percent 14.1 13.9

2015 95% CI

13.3 - 15.0

12.5 - 15.5

Percent 30.0 29.8

2015 95% CI

28.6 - 31.4

NA

Percent 34.1 30.9

2015 95% CI

32.8 - 35.5

NA

Percent 9.9 9.9

2015 95% CI 9.0 - 10.7 NA

Percent 11.2 9.2

2015 95% CI

10.3 - 12.2

NA

Rate per 10,000

† 65.1

NA 2012

95% CI 63.7 - 66.6

ME doing better than the U.S.

ME similar to the U.S.

ME doing worse than the U.S.

Comparison data not available.

NA: Data are not available.

95% CI: 95% Confidence Interval of the rate or percent.

Years shown are the most recent years where data for both Maine and the U.S. are available.


DRAFT – June 2017


Leading health indicators continued

Should we focus only on outcomes?

Order: By “topic” or divided by the four “classes” of indicators?


DRAFT – June 2017


Community Assets

Similar to the leader health indicators, pick 4-8 assets that map well, possibly with layers:

o Health Professional shortage areas, layered with hospital s and FQHCs1-2 pages of data on

community assets with maps

o Walking trails, farmers markets,…

o Schools, etc.

Tied these titles to the four classes of indicators?


DRAFT – June 2017


Major Differences in Health

Could add 4-6 pages of maps/graphs (2-4 per page) with county comparisons of data or other disparity

data. Include descriptive visual titles “York County has the highest rates of Lyme disease diagnoses in the

state” and possibly SHORT analyses (1-3 sentences)

Some choices for data could be based on the specific demographics of the county (even though the data

will be “state-level”


DRAFT – June 2017


Community Feedback

Forums were held in xx communities throughout xx County as follows:

[List of forums with dates/locations/number of people]

Themes from the discussions at the forums included:

[Summary of concerns, etc.]

Priorities identified by forum participants included:

[Top 3-5 priorities identified]


DRAFT – June 2017


Notes

The Maine Shared CHNA has several reports and datasets for public use: (This might be useful to include somewhere?)

County-Level Maine Shared Community Health Needs Assessment Reports summarize

the data and provide insights into regional findings. These reports explore the priorities,

challenges and resources for each county and contain detailed and summary tables.

State-Level Maine Shared Community Health Needs Assessment Report includes

information on each health issue, including analysis of sub-populations. The report

includes state summaries and detailed tables.

Summary tables for each public health district, each county, and the cities of Portland and

Bangor and the combined cities of Lewiston/Auburn.

Detailed Tables with each indicator – by subpopulation, county, urban area, public health

district and year – are available on the Maine CDC website and may be downloaded at


Health Indicator Data Sources

This section lists the data source, year and additional notes for each indicator. In addition to the

stakeholder survey conducted as a primary data source for this project, the secondary data

sources used in this assessment include:

Child Maltreatment Report, Administration

on Children Youth and Families

Maine Cancer Registry (MCR)

MaineCare

Maine Behavioral Risk Factor Surveillance

System (BRFSS)

Maine CDC Drinking Water Program

Maine CDC HIV Program

Maine CDC Lead Program

Maine CDC National Electronic Disease

Surveillance System (NEDSS)

Maine CDC Public Health Emergency

Preparedness (PHEP)

Maine CDC STD Program

Maine CDC Vital Records

Maine Department of Education

Maine Department of Public Safety

Maine Department of Labor

Maine Health Data Organization (MHDO)

Maine Integrated Youth Health Survey

(MIYHS)

Maine Office of Data Research and Vital

Records

National Immunization Survey (NIS)

National Survey of Children w// Special

Health Care Needs

National Center for Health Statistics

U.S. Bureau of Labor Statistics

U.S. CDC WONDER & WISQARS

U.S. Census



DRAFT – June 2017

For more detailed data go to: www.maine.gov/SHNAPP/

Back page stuff – non-discrimination notice, etc. logos again, etc. (put acknowledgements here?)

http://www.maine.gov/SHNAPP/

androscoggin county - maine.gov identified in this report are a synthesis of input provided at xx...

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