bethesda health baptist health south florida · 2018-09-28 · bethesda health – baptist health...

Bethesda Health – Baptist Health South Florida

Community Health Needs Assessment

2018

Health Council of Southeast Florida 600 Sandtree Drive, Suite 101 Palm Beach Gardens, FL 33403 Phone: 561-844-4220

Table of Contents Acknowledgments .......................................................................................................................................................... 1

Executive Summary ........................................................................................................................................................ 2

Bethesda Health ............................................................................................................................................................. 8

Service Areas ............................................................................................................................................................. 9

Methodology ................................................................................................................................................................. 10

Demographic and Socioeconomic Profile ..................................................................................................................... 11

Demographic Characteristics ................................................................................................................................... 12

Population............................................................................................................................................................ 12

Population Growth ............................................................................................................................................... 22

Language ............................................................................................................................................................ 24

Socioeconomic Characteristics ................................................................................................................................ 26

Poverty ................................................................................................................................................................ 26

Income ................................................................................................................................................................ 32

Homelessness ..................................................................................................................................................... 38

Education ............................................................................................................................................................ 39

Business and Employment ................................................................................................................................... 43

Public Assistance Benefits ................................................................................................................................... 50

Housing and Environment .................................................................................................................................... 51

Transportation ..................................................................................................................................................... 53

Crime ................................................................................................................................................................... 54

Food Availability and Access................................................................................................................................ 55

Health Status Profile ..................................................................................................................................................... 56

Maternal and Child Health ........................................................................................................................................ 56

Prenatal Care Access ................................................................................................................................................. 56

Birth Counts and Rates ........................................................................................................................................ 64

Birth Weight ......................................................................................................................................................... 71

Fetal and Infant Mortality...................................................................................................................................... 76

Births to Overweight Mothers at Time Pregnancy Occurred .................................................................................. 82

Immunization ....................................................................................................................................................... 85

Oral Health ............................................................................................................................................................... 86

Behavioral Health ..................................................................................................................................................... 87

Domestic Violence ............................................................................................................................................... 87

Alcohol Consumption and Substance Use ............................................................................................................ 87

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Youth Bullying and Delinquent Behavior ............................................................................................................... 94

Suicides ............................................................................................................................................................... 96

Mental Health....................................................................................................................................................... 99

Morbidity and Mortality ........................................................................................................................................... 102

Morbidity ............................................................................................................................................................ 102

Mortality ............................................................................................................................................................. 143

Health Resources Availability and Access .............................................................................................................. 179

Licensed Facility Overview ................................................................................................................................. 179

Healthcare Provider Supply ............................................................................................................................... 182

Mental Health Provider Supply ........................................................................................................................... 184

Federal Health Professional Shortage Areas (HPSA) ......................................................................................... 186

Medically Underserved Areas (MUAs)/Populations (MUPs) ................................................................................ 188

Health Insurance ................................................................................................................................................ 189

Safety Net .......................................................................................................................................................... 198

Source: U.S. Department of Health & Human Services, 2018 ............................................................................. 199

Community Perspective .............................................................................................................................................. 200

Community Focus Groups ...................................................................................................................................... 200

Key Informant Interviews ........................................................................................................................................ 204

Identification of Priority Strategic Health Issues ........................................................................................................... 207

Methodology .......................................................................................................................................................... 207

Conclusion ................................................................................................................................................................. 207

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Table of Tables

Table 1: Total Population, Palm Beach County and Florida, 2016................................................................................ 12

Table 2: Total Population, Bethesda Health’s Service Areas ZIP Codes, 2016 ............................................................ 12

Table 3: Population by Gender, Palm Beach County and Florida, 2016 ....................................................................... 13

Table 4: Population by Age Group, Bethesda Health’s Primary Service Area ZIP Codes, 2016 .................................... 14

Table 5: Population by Age Group, Bethesda Health’s Secondary Service Area ZIP Codes, 2016 .............................. 15

Table 6: Population by Race and Ethnicity, Palm Beach County and Florida, 2016 ..................................................... 16

Table 7: Population by Race, Bethesda Health’s Primary Service Area ZIP Codes, 2016 ............................................ 17

Table 8: Population by Race, Bethesda Health’s Secondary Service Area ZIP Codes, 2016 ....................................... 18

Table 9: Population by Ethnicity, Bethesda Health’s Primary Service Area ZIP Codes, 2016 ....................................... 19

Table 10: Population by Ethnicity, Bethesda Health’s Secondary Service Area ZIP Codes, 2016 ................................ 20

Table 11: Population by Census County Division (CCD), Palm Beach County, 2016 ................................................... 21

Table 12: Population Change by Age, Palm Beach County, 2015-2016 ....................................................................... 22

Table 13: Foreign-Born Population, Palm Beach County and Florida, 2016 ................................................................. 23

Table 14: Languages Spoken at Home, Palm Beach County and Florida, 2016 .......................................................... 24

Table 15: Population 5 Years and Over Who Speak Another Language and Speak English Less Than "Very Well,"

Bethesda Health’s Service Area ZIP Codes, 2016 ....................................................................................................... 25

Table 16: Federal Poverty Guidelines, 2018 ................................................................................................................. 26

Table 17: Poverty Status in the Past 12 Months by Age, Gender, Race and Ethnicity, Palm Beach County and

Florida, 2016 ................................................................................................................................................................ 27

Table 18: Population Below 100% of the Federal Poverty Level, Bethesda Health’s Service Areas Compared to Palm

Beach County, Florida, and the U.S., 2012-2016 ......................................................................................................... 28

Table 19: Population Below 200% of the Federal Poverty Level, Bethesda Health’s Service Areas Compared to Palm


Table 20: Poverty Status in the Past 12 Months by Age Group, Bethesda Health’s Primary Service Area ZIP Codes,

2016 ............................................................................................................................................................................. 29

Table 21: Poverty Status in the Past 12 Months by Age Group, Bethesda Health’s Secondary Service Area ZIP

Codes, 2016 ................................................................................................................................................................. 30

Table 22: Poverty Status in the Past 12 Months, Families, Palm Beach County .......................................................... 30

Table 23: ALICE Population, Palm Beach County, 2015 .............................................................................................. 31

Table 24: Per Capita Income, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and the

U.S., 2012-2016 ........................................................................................................................................................... 32

Table 25: Household Income and Benefits, Palm Beach County and Florida, 2016 ..................................................... 33

Table 26: Family Income, Palm Beach County and Florida, 2016 ................................................................................ 34

Table 27: Families Earning Over $75,000, Bethesda Health’s Service Areas Compared to Palm Beach County,

Florida, and the U.S., 2012-2016 .................................................................................................................................. 35

Table 28: Percent of Families Earning Over $75,000, by Race, Bethesda Health’s Service Areas Compared to Palm


Table 29: Household, Family and Per Capita Income, Bethesda Health’s Primary Service Area ZIP Codes, 2016 ...... 36

Table 30: Household, Family and Per Capita Income, Bethesda Health’s Secondary Service Area ZIP Codes, 201637

Table 31: Homelessness Point-In-Time Summary, Palm Beach County, 2017-2018 ................................................... 38

Table 32: Educational Attainment, Palm Beach County and Florida, 2016 ................................................................... 39

Table 33: Educational Attainment by Race and Ethnicity, Palm Beach County and Florida, 2016 ............................... 40

Table 34: Percentage of High School Graduates, Palm Beach County and Florida, 2012-2017 ................................... 42

Table 35: High School Graduates, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and

the U.S., 2013-2014 ..................................................................................................................................................... 43

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Table 36: Employment Status, Palm Beach County and Florida, 2012-2016................................................................ 43

Table 37: Employment Status, Bethesda Health’s Primary Service Area ZIP Codes, 2012-2016 ................................. 44

Table 38: Employment Status, Bethesda Health’s Secondary Service Area ZIP Codes, 2012-2016 ............................ 45

Table 39: Employment by Industry, Palm Beach County and Florida, 2012-2016 ........................................................ 46

Table 40: Employment by Occupation, Palm Beach County and Florida, 2016 ............................................................ 47

Table 41: Occupation, Bethesda Health’s Primary Service Area ZIP Codes, 2012-2016 ............................................. 48

Table 42: Occupation, Bethesda Health’s Secondary Service Area ZIP Codes, 2012-2016 ........................................ 49

Table 43: Class of Worker, Palm Beach County and Florida, 2016 .............................................................................. 49

Table 44: Households with Public Assistance Income, Bethesda Health’s Service Areas Compared to Palm Beach

County, Florida, and the U.S., 2012-2016 .................................................................................................................... 50

Table 45: WIC Eligible Served, Palm Beach County and Florida, 2012-2017 .............................................................. 50

Table 46: Children Eligible for Free/Reduced Price Lunch, Bethesda Health’s Service Areas Compared to Palm

Beach County, Florida, and the U.S., 2014 .................................................................................................................. 51

Table 47: Population Receiving SNAP Benefits, Bethesda Health’s Service Areas Compared to Palm Beach County,


Table 48: Housing Cost Burden, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and the

U.S., 2012-2016 ........................................................................................................................................................... 52

Table 49: The Low-Income Housing Tax Credits (LIHTC) Properties and Units, Bethesda Health’s Service Areas

Compared to Palm Beach County, Florida, and the U.S., 2014 .................................................................................... 52

Table 50: Substandard Housing, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and

the U.S., 2012-2016 ..................................................................................................................................................... 52

Table 51: Availability of Recreation and Fitness Facilities, Bethesda Health’s Service Areas, Palm Beach County, and

Florida, 2015 ................................................................................................................................................................ 53

Table 52: Households with No Motor Vehicle, Bethesda Health’s Service Areas Compared to Palm Beach County,

Florida, and the U.S., 2012-2016 ................................................................................................................................. 53

Table 53: Index Crime Offenses, Palm Beach County, 2015-2016 ............................................................................... 54

Table 54: Violent Crime Offenses Reported, Bethesda Health’s Service Areas Compared to Palm Beach County,


Table 55: Food Insecurity Rate, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and the

U.S., 2014 .................................................................................................................................................................... 55

Table 56: Food Deserts by Census Tract, Bethesda Health’s Service Areas, Palm Beach County, Florida, and the

U.S., 2015 .................................................................................................................................................................... 55

Table 57: Fast-food Restaurant Density, Bethesda Health’s Service Areas, Palm Beach County, Florida, and the

U.S., 2015 .................................................................................................................................................................... 55

Table 58: Births with Adequate Prenatal Care (Kotelchuck Index), Palm Beach County and Florida, 2012-2016......... 57

Table 59: Births to Mothers with Less than Adequate Prenatal Care (Kotelchuck Index), Palm Beach County and

Florida, 2012-2016 ....................................................................................................................................................... 57

Table 60: Births to Mothers with Less than Adequate Prenatal Care (Kotelchuck Index), Bethesda Health’s Service

Area ZIP Codes, 2016 .................................................................................................................................................. 58

Table 61: Births to Mothers with Less than Adequate Prenatal Care (Kotelchuck Index) by Race, Palm Beach County

and Florida, 2016 ......................................................................................................................................................... 59

Table 62: Births to Mothers with Less than Adequate Prenatal Care (Kotelchuck Index) by Ethnicity, Palm Beach

County and Florida, 2016 ............................................................................................................................................. 59

Table 63: Percentage of Births to Mothers by Prenatal Care, Palm Beach County and Florida, 2014-2016 ................. 59

Table 64: Preterm Births (<37 weeks gestation), Palm Beach County and Florida, 2014-2016 ................................... 60

Table 65: Preterm Births (<37 weeks gestation), Bethesda Health’s Service Areas ZIP Codes, 2016 ......................... 63

Table 66: Total Resident Live Births, Palm Beach County and Florida, 2014-2016 ...................................................... 64


Table 67: Total Resident Live Births, Bethesda Health’s Service Areas ZIP Codes, 2016 ........................................... 64

Table 68: Births to Mothers Ages 15-17, Bethesda Health’s Service Areas ZIP Codes, 2016 ...................................... 65

Table 69: Births to Mothers Ages 18-19, Bethesda Health’s Service Areas ZIP Codes, 2016 ...................................... 66

Table 70: Repeat Births to Mothers Ages 15-19, Palm Beach County and Florida, 2012-2016 .................................... 68

Table 71: Repeat Births to Mothers Ages 18-19, Palm Beach County and Florida, 2016 ............................................. 71

Table 72: Live Births Under 2500 Grams (Low-Birth Weight), Palm Beach County and Florida, 2012-2016 ................ 71

Table 73: Live Births Under 1500 Grams (Very Low Birth Weight), Palm Beach County and Florida, 2012-2016 ........ 72

Table 74: Live Births with Low and Very Low Birth Weight, Bethesda Health’s Primary Service Area ZIP Codes, 2016

.....................................................................................................................................................................................73

Table 75: Live Births with Low and Very Low Birth Weight, Bethesda Health’s Secondary Service Area ZIP Codes, 2016

..................................................................................................................................................................................... 74

Table 76: Maternal Health Comparison Counts, Bethesda Health’s Service Areas, Palm Beach County and Florida,

2016 ............................................................................................................................................................................. 75

Table 77: Maternal Health Comparison Percentages, Bethesda Health’s Service Areas, Palm Beach County and

Florida, 2016 ................................................................................................................................................................ 75

Table 78: Fetal Deaths, Palm Beach County and Florida, 2014-2016 .......................................................................... 76

Table 79: Fetal Deaths by Race, Palm Beach County and Florida, 2014-2016........................................................... 76

Table 80: Fetal Deaths by Ethnicity, Palm Beach County and Florida, 2014-2016 ..................................................... 77

Table 81: Fetal Death Count, Bethesda Health’s Service Areas ZIP Codes, 2016 ....................................................... 78

Table 82: Infant Deaths, Palm Beach County and Florida, 2014-2016 ......................................................................... 78

Table 83: Infant Death Count, Bethesda Health’s Service Areas ZIP Codes, 2016 ...................................................... 81

Table 84: Percent of Two-Year-Old Children Fully Immunized, Palm Beach County and Florida, 2015-2017 .............. 85

Table 85: Immunization Levels in Kindergarten, Palm Beach County and Florida, 2015-2017 ..................................... 85

Table 86: Immunization Levels in 7th Grade, Palm Beach County and Florida, 2015-2017 ......................................... 85

Table 87: Selected Vaccine Preventable Disease Rate for All Ages, Palm Beach County and Florida, 2012-2016 ..... 86

Table 88: Preventable Hospitalizations Under 65 from Dental Conditions, Palm Beach County and Florida, 2014-2016

.....................................................................................................................................................................................86

Table 89: Domestic Violence by Offense Type to Victim's Relationship to Offender, Palm Beach County, 2016.......... 87

Table 90: Percent of Adults Who Engage in Heavy or Binge Drinking, Palm Beach County and Florida, 2007-2016 ..

88 Table 91: Percent of High School Students Reporting Binge Drinking, Palm Beach County and Florida, 2008-2016

. 88 Table 92: Percent of Middle School Students Reporting Binge Drinking, Palm Beach County and F..l.o..r.i.d..a..,..2..0..0..8..-

.2..0..1..6.....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................88

Table 93: Adults Who Are Current Smokers, Palm Beach County and Florida, 2007-2016 .......................................... 89

Table 94: Percent of High School Students Smoking Cigarettes in the Past 30 Days, Palm Beach County and Florida,

2008-2016 .................................................................................................................................................................... 89

Table 95: Percent of Middle School Students Smoking in the Past 30 Days, Palm Beach County and Florida, 2008-

2016 ............................................................................................................................................................................. 90

Table 96: Percent of Adults Who Are Current E-cigarette Users, Palm Beach County and Florida, 2016 .................... 90

Table 97: Percent of Adults Who Used Marijuana or Hashish During the Past 30 Days, Palm Beach County and Florida,

2016 ............................................................................................................................................................................. 90

Table 98: Percent of High School Students Using Marijuana/Hashish in the Past 30 Days, Palm Beach County and

Florida, 2008-2016 ....................................................................................................................................................... 91

Table 99: Percent of Middle School Students Using Marijuana/Hashish in the Past 30 Days, Palm Beach County and

Florida, 2008-2016 ....................................................................................................................................................... 91

Table 100: Opioid-Related Emergency Department Visits, Bethesda Health’s Service Areas, 2016 ............................ 92

Table 101: Opioid-Related Inpatient Discharges, Bethesda Health’s Service Areas, 2016 ........................................... 92


Table 102: Psychoactive Substance Use Related Emergency Department Visits, Bethesda Health’s Service Areas,

2016 ............................................................................................................................................................................. 93

Table 103: Psychoactive Substance Use Related Inpatient Discharges, Bethesda Health's Service Areas, 2016 ....... 94

Table 104: Percentage of Palm Beach and Florida Statewide Youth Who Reported Involvement in Bullying Behavior,

2016 ............................................................................................................................................................................. 95

Table 105: Percentage of Palm Beach and Florida Statewide Youth Who Reported Engaging in Delinquent Behavior

Within the Past 12 Months, 2016 ................................................................................................................................... 95

Table 106: Suicide Deaths, Palm Beach County and Florida, 2014-2016 .................................................................... 96

Table 107: Suicide Deaths by Gender, Palm Beach County and Florida, 2014-2016 ................................................. 99

Table 108: Percent of Adults with Good Mental Health, Palm Beach County and Florida, 2010-2016 ......................... 99

Table 109: Average Number of Unhealthy Mental Days in the Past 30 Days, Palm Beach County and Florida, 2010-

2016 ........................................................................................................................................................................... 100

Table 110: Adult Psychiatric Beds, Palm Beach County and Florida, 2012-2016 ....................................................... 100

Table 111: Child and Adolescent Psychiatric Beds, Palm Beach County and Florida, 2012-2016 .............................. 101

Table 112: Preventable Hospitalizations for Individuals Under the Age of 65 from All Conditions, Palm Beach County

and Florida, 2014-2016 .............................................................................................................................................. 102

Table 113: Senior Services Provided, Bethesda Health's Primary Service Area ZIP Codes, 2017 ............................. 103

Table 114: Senior Services Provided, Bethesda Health's Secondary Service Area ZIP Codes, 2017 ........................ 104

Table 115: Probable Alzheimer's Cases (65+), Palm Beach County and Florida, 2014-2016..................................... 105

Table 116: Hospitalizations from or with Diabetes, Palm Beach County and Florida, 2014-2016 ............................... 105

Table 117: Emergency Department Visits Due to Diabetes, Palm Beach County and Florida, 2013-2016 ................. 108

Table 118: Emergency Department Visits Due to Diabetes by Race, Palm Beach County and Florida, 2013-2016 108

Table 119: Emergency Room Visits due to Diabetes by Ethnicity, Palm Beach County and Florida, 2013-2016 ..... 109

Table 120: Percentage of Adults Who Are Overweight, Palm Beach County and Florida, 2010-2016 ........................ 109

Table 121: Percentage of Adults Who Are Obese, Palm Beach County and Florida, 2010-2016 ............................... 110

Table 122: Percentage of Adults Who Are Overweight or Obese, Palm Beach County and Florida, 2010-2016 ........ 110

Table 123: Hospitalizations from Congestive Heart Failure, Palm Beach County and Florida, 2014-2016 ................. 110

Table 124: Hospitalizations from Strokes, Palm Beach County and Florida, 2014-2016 ............................................ 113

Table 125: Hospitalizations from Coronary Heart Disease, Palm Beach County and Florida, 2014-2016 .................. 114

Table 126: Cancer Incidence, Palm Beach County and Florida, 2012-2014 ............................................................... 116

Table 127: Cancer Incidence by Race, Palm Beach County and Florida, 2012-2014 ............................................... 117

Table 128: Female Breast Cancer Incidence, Palm Beach County and Florida, 2012-2014 ....................................... 117

Table 129: Female Breast Cancer Cases at Advanced Stage When Diagnosed, Palm Beach County and Florida,

2012-2014 .................................................................................................................................................................. 120

Table 130: Cervical Cancer Incidence, Palm Beach County and Florida, 2012-2014 ................................................. 120

Table 131: Colorectal Cancer Incidence, Palm Beach County and Florida, 2012-2014 ............................................. 122

Table 132: Percentage of Adults Less than 65 Years of Age Who Have Ever Been Tested for HIV, Palm Beach

County and Florida, 2013 and 2016 ........................................................................................................................... 125

Table 133: Percentage of Adults Less than 65 Years of Age Who Had an HIV Test in the Past 12 Months, Palm

Beach County and Florida, 2013 and 2016 ................................................................................................................ 125

Table 134: HIV Cases, Palm Beach County and Florida, 2013-2016 ......................................................................... 125

Table 135: AIDS Cases, Palm Beach County and Florida, 2013-2016 ....................................................................... 127

Table 136: Total Gonorrhea, Chlamydia and Infectious Syphilis Cases, Palm Beach County and Florida, 2012- 2015130

Table 137: Hospitalizations from or with Asthma, Palm Beach County and Florida, 2014-2016 ................................. 130

Table 138: Preventable Hospitalizations Under 65 from Asthma, Palm Beach County and Florida, 2014-2016 ......... 133

Table 139: Emergency Room Visits Due to Asthma, Palm Beach County and Florida, 2013-2016 ............................ 133

Table 140: Emergency Room Visits Due to Asthma by Race, Palm Beach County and Florida, 2013-2016 ............ 134


Table 141: Emergency Room Visits Due to Asthma by Ethnicity, Palm Beach County and Florida, 2013-2016 ........ 134

Table 142: Preventable Hospitalizations Under 65 from Dehydration, Palm Beach County and Florida, 2014-2016 135

Table 143: Preventable Hospitalizations Under 65 from Gastroenteritis, Palm Beach County and Florida, 2014-2016

...................................................................................................................................................................................135

Table 144: Preventable Hospitalizations Under 65 from Kidney/Urinary Infections, Palm Beach County and Florida,

2014-2016 .................................................................................................................................................................. 136

Table 145: Preventable Hospitalizations Under 65 from Severe Ear, Nose and Throat Infections, Palm Beach County

and Florida, 2014-2016 .............................................................................................................................................. 136

Table 146: Non-Fatal Hospitalizations for Self-inflicted Injuries Ages 12-18, Palm Beach County and Florida, 2012-

2014 ........................................................................................................................................................................... 137

Table 147: Non-Fatal Hospitalizations for Self-inflicted Injuries Ages 19-21, Palm Beach County and Florida, 2012-

2014 ........................................................................................................................................................................... 137

Table 148: Hospitalizations for Non-Fatal Firearm Injuries, Palm Beach County and Florida, 2012-2014 .................. 138

Table 149: Non-Fatal Hospitalizations for Eating Disorders Ages 12-18, Palm Beach County and Florida, 2012-2014

...................................................................................................................................................................................140

Table 150: Hospitalizations for Non-Fatal Unintentional Falls, Palm Beach County and Florida, 2012-2014 .............. 140

Table 151: Leading Causes of Death, Palm Beach County, 2016 .............................................................................. 143

Table 152: Death Counts from All Causes, Bethesda Health’s Service Areas ZIP Codes, 2016 ................................ 144

Table 153: Alzheimer’s Disease Deaths, Palm Beach County and Florida, 2014-2016 .............................................. 144

Table 154: Death Counts from Alzheimer’s, Bethesda Health’s Service Areas ZIP codes, 2016 ............................... 145

Table 155: Death Counts from Respiratory Diseases, Bethesda Health’s Service Areas ZIP Codes, 2016 ............... 146

Table 156: Death Counts from Major Cardiovascular Diseases, Bethesda Health’s Service Areas ZIP Codes, 2016

...................................................................................................................................................................................147

Table 157: Congestive Heart Failure Deaths, Palm Beach County and Florida, 2014-2016 ....................................... 148

Table 158: Congestive Heart Failure Death Rates by Race, Palm Beach County and Florida, 2014-2016 .............. 148

Table 159: Congestive Heart Failure Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016 ......... 149

Table 160: Stroke Deaths, Palm Beach County and Florida, 2014-2016 .................................................................... 149

Table 161: Stroke Age-Adjusted Death Rates, by Race, Palm Beach County and Florida, 2014-2016 ...................... 150

Table 162: Stroke Age-Adjusted Death Rates, by Ethnicity, Palm Beach County and Florida, 2014-2016 ................. 150

Table 163: Female Breast Cancer Deaths, Palm Beach County and Florida, 2012-2016 ........................................... 151

Table 164: Death Counts from Breast Cancer, Bethesda Health Service Areas ZIP Codes, 2016 ............................. 152

Table 165: Cervical Cancer Deaths, Palm Beach County and Florida, 2012-2016 ..................................................... 155

Table 166: Death Counts from Cervical Cancer, Bethesda Health’s Service Areas ZIP Codes, 2016 ........................ 156

Table 167: Colorectal Cancer Deaths, Palm Beach County and Florida, 2012-2016 .................................................. 159

Table 168: Death Counts from Colorectal Cancer, Bethesda Health’s Service Areas ZIP Codes, 2016 ..................... 159

Table 169: Prostate Cancer Deaths, Palm Beach County and Florida, 2012-2016 .................................................... 162

Table 170: Death Counts from Prostate Cancer, Bethesda Service Areas ZIP Codes, 2016 ..................................... 163

Table 171: Death Counts from Pancreatic Cancer, Bethesda Health’s Service Areas ZIP Code, 2016 ...................... 166

Table 172: Diabetes Deaths, Palm Beach County and Florida, 2014-2016 ................................................................ 166

Table 173: Death Counts from Diabetes, Bethesda Health’s Service Areas ZIP Codes, 2016 ..................................... 169

Table 174: HIV/AIDS Deaths, Palm Beach County and Florida, 2014-2016 .............................................................. 169

Table 175: Death Counts from HIV/AIDS, Bethesda Health’s Service Areas ZIP Codes, 2016 ................................... 172

Table 176: Unintentional Injury Deaths, Palm Beach County and Florida, 2014-2016 ................................................ 172

Table 177: Unintentional Injury Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016 173

Table 178: Unintentional Injury Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016

...................................................................................................................................................................................173

Table 179: Deaths from Firearms Discharge, Palm Beach County and Florida, 2014-2016 ....................................... 174

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Table 180: Death Rates from Firearms Discharge, by Race, Palm Beach County and Florida, 2014-2016 ............... 174

Table 181: Homicide Deaths, Palm Beach County and Florida, 2014-2016 ............................................................... 175

Table 182: Homicide Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016 ................ 175

Table 183: Drug Poisoning Deaths, Palm Beach County and Florida, 2014-2016 ...................................................... 176

Table 184: Licensed Hospitals, Palm Beach County, as of April 2018. ..................................................................... 179

Table 185: Licensed Nursing Homes, Palm Beach County, as of April 2018 ............................................................ 180

Table 186: Total Licensed Florida Physicians, Palm Beach County and Florida, 2012-2017 ..................................... 182

Table 187: Licensed Registered Nurses, Bethesda Health’s Service Area, April 2018 ............................................... 183

Table 188: Total Licensed Florida Dentists, Palm Beach County and Florida, 2012-2017 .......................................... 184

Table 189: Licensed Clinical Social Workers, Palm Beach County and Florida, 2015-2017. ..................................... 184

Table 190: Licensed Mental Health Counselors, Palm Beach County and Florida, 2015-2018.................................. 184

Table 191: Licensed Psychologists, Palm Beach County and Florida, 2015-2017 ..................................................... 185

Table 192: Licensed Marriage and Family Therapists, Palm Beach County and Florida, 2015-2017 ......................... 185

Table 193: Primary Care Health Professional Shortage Areas (HPSAs), Palm Beach County, 2016 ......................... 186

Table 194: Dental Care Health Professional Shortage Areas (HPSAs), Palm Beach County, 2016 ........................... 187

Table 195: Mental Health Professional Shortage Areas (HPSAs), Palm Beach County, 2016 ..................................... 187

Table 196: Medically Underserved Populations and Areas, Palm Beach County, April 2018 ..................................... 188

Table 197: Uninsured Population, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and

the U.S., 2012-2016 ................................................................................................................................................... 189

Table 198: Uninsured Population by Age Group, Bethesda Health’s Service Areas Compared to Palm Beach County,

Florida, and the U.S., 2012-2016 ................................................................................................................................ 189

Table 199: Uninsured Adults, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and the

U.S., 2015 .................................................................................................................................................................. 190

Table 200: Uninsured Children, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and the

U.S., 2014 .................................................................................................................................................................. 190

Table 201: Uninsured Population by Race, Bethesda Health’s Service Areas Compared to Palm Beach County,


Table 202: Uninsured Population by Ethnicity, Bethesda Health’s Service Areas Compared to Palm Beach County,


Table 203: Estimated Number and Rate of Children (0-18) Uninsured, Bethesda Health’s Service Area ZIP Codes,

2012-2016 .................................................................................................................................................................. 192

Table 204: Median Monthly Medicaid Enrollment, Palm Beach County and Florida, 2015-2017 ................................ 193

Table 205: Population Receiving Medicaid, Bethesda Health’s Service Areas Compared to Palm Beach County,


Table 206: Title XXI Enrollment (CHIP and Full Pay), Palm Beach County, 2015-2018 ............................................. 194

Table 207: Title XXI (CHIP and Full Pay), Palm Beach County, April 2018 ................................................................ 195

Table 208: Children's Medical Services Enrollment, Palm Beach County, April 2018................................................. 195

Table 209: Medikids Enrollment by Plan, Palm Beach County, April 2018 ................................................................ 195

Table 210: Healthy Kids Enrollment by Plan, Palm Beach County, April 2018 .......................................................... 195

Table 211: Healthy Kids Enrollment by Medical Plan, Palm Beach County, April 2018 .............................................. 196

Table 212: Healthy Kids Enrollment by Dental Plan, Palm Beach County, April 2018 ................................................ 196

Table 213: Estimated Number and Rate of Children (0-18) Eligible for CHIP Coverage, Bethesda Health’s Service

Areas ZIP Codes, 2012-2016 ..................................................................................................................................... 197

Table 214: Title XIX (Medicaid) Enrollment, Palm Beach County, 2015-2018 ............................................................ 198

Table 215: Federally Qualified Health Centers (FQHCs) and Federally Qualified Health Center Look-Alikes, Palm

Beach County, Florida, as of April 2018 ..................................................................................................................... 199

Table 216: Site, Language, and Number of Participants in Focus Groups ................................................................. 200

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Table 217: Focus Group Target Population Matrix ...................................................................................................... 201

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Bethesda Health – Community Health Needs Assessment

Table of Figures

Figure 1: Bethesda Health’s Service Areas .................................................................................................................... 9

Figure 2: Population by Age, Palm Beach County and Florida, 2016 ........................................................................... 13

Figure 3: Educational Attainment, Bethesda Health’s Primary Service Area ZIP Codes, 2016 ...................................... 41

Figure 4: Educational Attainment, Bethesda Health’s Secondary Service Area ZIP Codes, 2016 ................................ 42

Figure 5: Percentage of Preterm Births (<37 weeks gestation) by Race, Palm Beach County and Florida, 2012-2016

.....................................................................................................................................................................................61

Figure 6: Percentage of Preterm Births (<37 weeks gestation) by Ethnicity, Palm Beach County and Florida, 2012-

2016 ............................................................................................................................................................................. 62

Figure 7: Birth Counts, by Mother's Age, Bethesda Health’s Primary Service Area, 2016 ............................................ 67

Figure 8: Birth Counts, by Mother's Age, Bethesda Health’s Secondary Service Area, 2016 ....................................... 68

Figure 9: Percentage of Repeat Births to Mothers Ages 15-19 by Race, Palm Beach County and Florida, 2012-2016

.....................................................................................................................................................................................69

Figure 10: Percentage of Repeat Births to Mothers Ages 15-19 by Ethnicity, Palm Beach County and Florida, 2012-

2016 ............................................................................................................................................................................. 70

Figure 11: Infant Death Rate Per 1,000 Live Births by Race, Palm Beach County and Florida, 2014-2016 ................ 79

Figure 12: Infant Death Rate Per 1,000 Live Births, by Ethnicity, Palm Beach County and Florida, 2014-2016 .......... 80

Figure 13: Percentage of Births to Mothers Overweight at Time Pregnancy Occurred, Palm Beach County and

Florida, 2012-2016 ....................................................................................................................................................... 82

Figure 14: Percentage of Births to Overweight Mothers at Time Pregnancy Occurred, by Race, Palm Beach County

and Florida, 2012-2016 ................................................................................................................................................ 83

Figure 15: Percentage of Births to Overweight Mothers at Time Pregnancy Occurred, by Ethnicity, Palm Beach

County and Florida, 2012-2016 .................................................................................................................................... 84

Figure 16: Suicide Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016 ...................... 97

Figure 17: Suicide Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016 ................. 98

Figure 18: Age-Adjusted Hospitalization Rates from or with Diabetes by Race, Palm Beach County and Florida,

2014-2016..................................................................................................................................................................106

Figure 19: Age-Adjusted Hospitalization Rates from or with Diabetes by Ethnicity, Palm Beach County and Florida,

2014-2016 .................................................................................................................................................................. 107

Figure 20: Age-Adjusted Hospitalization Rates from Congestive Heart Failure by Race, Palm Beach County and

Florida, 2014-2016 ..................................................................................................................................................... 111

Figure 21: Age-Adjusted Hospitalization Rates from Congestive Heart Failure by Ethnicity, Palm Beach County and

Florida, 2014-2016 ..................................................................................................................................................... 112

Figure 22: Age-Adjusted Hospitalization Rates from Stroke by Race, Palm Beach County and Florida, 2014-2016113

Figure 23: Age-Adjusted Hospitalization Rates from Stroke by Ethnicity, Palm Beach County and Florida, 2014-2016

...................................................................................................................................................................................114

Figure 24: Age-Adjusted Hospitalization Rates from Coronary Heart Disease by Race, Palm Beach County and

Florida, 2014-2016 ..................................................................................................................................................... 115

Figure 25: Age-Adjusted Hospitalization Rates from Coronary Heart Disease by Ethnicity, Palm Beach County and

Florida, 2014-2016 ..................................................................................................................................................... 116

Figure 26: Age-Adjusted Female Breast Cancer Incidence Rates by Race, Palm Beach County and Florida, 2012-

2014 ........................................................................................................................................................................... 118

Figure 27: Age-Adjusted Female Breast Cancer Incidence Rates by Ethnicity, Palm Beach County and Florida,

2012-2014..................................................................................................................................................................119

Figure 28: Age-Adjusted Cervical Cancer Incidence Rates by Race, Palm Beach County and Florida, 2012-2014 121

11 | P a g e

Bethesda Health – Community Health Needs Assessment

Figure 29: Age-Adjusted Cervical Cancer Incidence Rates by Ethnicity, Palm Beach County and Florida, 2012-2014

...................................................................................................................................................................................122

Figure 30: Age-Adjusted Colorectal Cancer Incidence Rates by Race, Palm Beach County and Florida, 2012-2014

...................................................................................................................................................................................123

Figure 31: Age-Adjusted Colorectal Cancer Incidence Rates by Ethnicity, Palm Beach County and Florida, 2012-

2014 ........................................................................................................................................................................... 124

Figure 32: Rate of HIV Cases by Race, Palm Beach County and Florida, 2014-2016 .............................................. 126

Figure 33: Rate of HIV Cases by Ethnicity, Palm Beach County and Florida, 2014-2016 ......................................... 127

Figure 34: Rate of AIDS Cases by Race, Palm Beach County and Florida, 2014-2016 ........................................... 128

Figure 35: Rate of AIDS Cases by Ethnicity, Palm Beach County and Florida, 2014-2016 ...................................... 129

Figure 36: Age-Adjusted Hospitalization Rates from or with Asthma by Race, Palm Beach County and Florida, 2014-

2016 ........................................................................................................................................................................... 131

Figure 37: Age-Adjusted Hospitalization Rates from or with Asthma by Ethnicity, Palm Beach County and Florida,

2014-2016 .................................................................................................................................................................. 132

Figure 38: Hospitalization Rates for Non-Fatal Firearm Injuries by Race, Palm Beach County and Florida, 2012-2014

...................................................................................................................................................................................138

Figure 39: Hospitalization Rates for Non-Fatal Firearm Injuries by Ethnicity, Palm Beach County and Florida, 2012-

2014 ........................................................................................................................................................................... 139

Figure 40: Hospitalization Rates for Non-Fatal Unintentional Falls by Race, Palm Beach County and Florida, 2012-

2014 ........................................................................................................................................................................... 141

Figure 41: Hospitalization Rates for Non-Fatal Unintentional Falls by Ethnicity, Palm Beach County and Florida,

2012-2014..................................................................................................................................................................142

Figure 42: Female Breast Cancer Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2012-2016

...................................................................................................................................................................................153

Figure 43: Female Breast Cancer Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2012-

2016. .......................................................................................................................................................................... 154

Figure 44: Cervical Cancer Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2012-2016 ....... 157

Figure 45: Cervical Cancer Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2012-2016 .

158 Figure 46: Colorectal Cancer Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2012-

2016 ... 160 Figure 47: Colorectal Cancer Age-Adjusted Death Rates by Ethnicity, Palm Beach County and

F..l.o..r.i.d..a..,..2..0..1..2..-.2..0..1..6..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................161

Figure 48: Prostate Cancer Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2012-2016 ...... 164

Figure 49: Prostate Cancer Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2012-2016.165

Figure 50: Diabetes Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016 .................. 167

Figure 51: Diabetes Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016 ............. 168

Figure 52: HIV/AIDS Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016 ................. 170

Figure 53: HIV/AIDS Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016 ............ 171

Figure 54: Drug Poisoning Death Rates by Race, Palm Beach County and Florida, 2014-2016 .............................. 177

Figure 55: Drug Poisoning Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016 ......................... 178


Acknowledgments

The 2018 Bethesda Health Community Health Needs Assessment is a result of the participation, contribution, and

dedication of a group of diverse community members and leaders.

Bethesda Health, along with the Health Council of Southeast Florida, would like to extend sincere appreciation and

gratitude to all who participated and contributed.

We would like to especially acknowledge the engagement and contribution of the following entities

that were represented on the Community Health Advisory Council:

211 Palm Beach/Treasure Coast

Aging & Disability Resource Center

Boynton Beach Fire Rescue

Boynton Beach Police Department

Children’s Services Council‒Palm Beach County

Coalition of Boynton West Residential Associations

Florida Department of Health‒Palm Beach County

Genesis Community Health Center

Gulfstream Goodwill Industries

Healthcare District of Palm Beach County

March of Dimes – Palm Beach Division

Palm Healthcare Foundation

The School District of Palm Beach County

Alpert Jewish Family & Children’s Services

Boynton Beach Mental Health Committee

Greater Boynton Beach Chamber of Commerce

Healthier Boynton Beach

Healthy Mothers, Healthy Babies

Hispanic Chamber of Commerce

National Alliance on Mental Illness (NAMI)‒Palm Beach

County

Palm Beach County Substance Awareness Coalition St.

John Missionary Baptist Church/Pathways to Prosperity,

Inc./Bridges

Additionally, we would like to acknowledge the following organizations that played a valuable role in the

gathering community insight and perspective that are vitally important for the community health needs

assessment:

St. John Missionary Baptist Church/Pathways to Prosperity Inc.

Healthy Mothers, Healthy Babies Coalition of Palm Beach County

The Lord’s Place

Coalition for Independent Living Options, Inc.

Bridges at Lake Worth


Executive Summary

In the spring of 2018, Bethesda Health, part of Baptist Heath South Florida, engaged the Health Council of

Southeast Florida (HCSEF) to facilitate its community health needs assessment (CHNA). The CHNA identifies

key health needs through systematic, comprehensive data collection and analysis and uses principles such as:1

A definition of community that encompasses both a significant enough area to allow for population-wide

interventions and measurable results, and includes a targeted focus to address disparities among

subpopulations

Proactive, broad, and diverse community engagement to improve results

Use of the highest-quality data pooled from, and shared among, diverse public and private sources

Maximum transparency to improve community engagement and accountability

Multisector collaborations that support shared ownership of all phases of community health improvement,

including assessment, planning, investment, implementation, and evaluation

The information gathered throughout the CHNA assists the hospital, as well as community partners, in identifying

needs and gaps in services and opportunities to enhance or improve elements of the current systems. Additionally,

through this process, disparities related to health access, health status, and health outcomes may also be identified.

The CHNA also functions as one of the requirements all not-for-profit (501(c)(3)) hospitals must complete for the

Internal Revenue Service (IRS) and the Patient Protection and Affordable Care Act to maintain their tax-exempt

status.

In March 2018, HCSEF organized an Advisory Council for the Bethesda Health’s 2018 CHNA. This group was

composed of a diverse group of stakeholders and community leaders representing various sectors. In April and

May, HCSEF convened the Advisory Council three times. At each of these meetings, HCSEF facilitated

discussions on various data points, answered questions regarding the data, and provided a structured approach to

gleaning insight and perspective from the Advisory Council members. Ultimately, HCSEF facilitated a multi-voting

exercise that resulted in the identification of the key priorities for residents and stakeholders alike in Bethesda

Health’s service areas. In summary, the CHNA provided the opportunity to:

Evaluate the health status of the population

Highlight unmet needs and opportunities for enhancement and improvement

Present the community’s perspective

Recommend potential priority areas

This CHNA report includes secondary data from appropriate national, state, and local databases, which includes

demographic, socioeconomic, health status, and health resources and availability profiles. Additionally, primary data

i.e., focus groups and key informant interviews conducted by the HCSEF, provides the

community’s perspective. The assessment is structured into four sections:

1. Demographic and Socioeconomic Profile

2. Health Status Profile

3. Health Resource Access and Availability Profile

4. Community Perspective

1 Community Health Assessments & Health Improvement Plans. (Nov 9, 2015). Retrieved June 5, 2018 from https://www.cdc.gov/stltpublichealth/cha/plan.html

http://www.cdc.gov/stltpublichealth/cha/plan.html


Demographic and Socioeconomic Profile

This section provides information on demographic and socioeconomic indicators. This data provides important

context as it delves into defining characteristics for those living in Bethesda’s service areas, and, when possible, as

compared to the county, the state, and, in some instances, the nation. Additionally, demographic and

socioeconomic factors are significant determinants of health. And finally, it is important to establish the base or the

denominators for disease incidence, prevalence, and mortality rates that are used in the assessment.

The total population in Palm Beach County is 1,398,757, with 64.6% (903,606) of the population living

in Bethesda’s service area.

Almost a quarter (24.2%) of residents in Bethesda’s service area are over the age of 65, which is a bit more

than Palm Beach County (22.7%) and significantly higher than Florida’s 19.1%.

In the Bethesda service area 77.8% of individuals identified as White, 14.6% identified as Black, 2.5%

identified as Asian and 2.6% identified as "some other race."

Additionally, 23.1% of those living in Bethesda’s service area identified as Hispanic or Latino, which is

higher than Palm Beach County (20.7%) and the United States (17.3%), but comparable to Florida (24.1%).

Over a quarter (26.1%) of residents living in the Bethesda service area reported being foreign-born which is

higher than Palm Beach County (23.8%), the state (19.9%), and the nation (13.3%).

Fourteen percent of residents in Bethesda’s service area have limited English proficiency, which is just a

bit higher than the county (12.8%).

Almost a fifth (13.9%) of Palm Beach County residents live below 100% of the federal poverty level (FPL)

and 33.6% have incomes at or below the 200% poverty level. There are comparable rates of poverty among

those living in Bethesda service area: 13.3% living below 100% FPL and 33.4% with incomes below 200%

FPL.

Health Status Profile

This section provides insight on the health status of the community, or the general health of the population. It is

important to understand what the illnesses, diseases, behaviors, risks, and outcomes to effectively identify health

priorities. When available, data was presented on those residing in Bethesda Health’s service area, and compared

to the county, state, or the nation.

Maternal Health

The resident live birth rate in Palm Beach County was 10.7 per 1,000 total population in Palm Beach County

in 2016.

In Palm Beach County, 26.8% of births were to mothers who had less than adequate prenatal care as

determined by the Kotelchuck index, and in the Bethesda service area the percentage was higher (31.8%).

Of the 1,370 preterm births (<37 weeks gestation) in Palm Beach County, 819 (59.7%) were born to

mothers living in Bethesda’s service area.

In 2016, most of the births to mothers living Bethesda’s service area were to mothers ages 30-34, followed

closely by age group 25-29.

Black (28.5%) and Hispanic (29.3%) women overweight at the time of pregnancy occurs at higher rates than

Whites (24.5%) and Non-Hispanics (24.4%).

Although the infant mortality rate has decreased significantly in Palm Beach County, there is still a

significant disparity between Black babies (6.7 per 1,000 births) and White babies (3.0 per 1,000 births).


Health Behaviors

The rate of adults who meet muscle-strengthening recommendations is lower in Palm Beach County

(34.6%) than Florida (38.2%). The rate of adults who are sedentary is higher in Palm Beach County (31.8%)

than in the state (29.8%). In Palm Beach County, more adults (58.5%) are inactive or insufficiently active

than Florida (56.7%).

Middle and high school students in Palm Beach County (22.1%) were less likely to be physically active for at

least 60 minutes per day on all seven of the past days when compared to the rate of Florida (22.9%).

16.3% of Palm Beach County’s residents currently smoke, which is a higher rate than Florida (15.5%).

E-cigarette use is significantly higher in Palm Beach County (6.4%) than Florida (4.7%). However, marijuana

and hashish use in the last 30 days is significantly lower in Palm Beach County (5.7%) compared to Florida

(7.4%).

Morbidity and Mortality

Although the hospitalization rates for many chronic diseases have decreased in recent years and the age-

adjusted rates for Palm Beach County are lower than Florida, there are sub-populations that have

considerably higher hospitalization rates for these diseases. In 2016:

o Blacks and Others were hospitalized twice as often as Whites for congestive heart failure (322.2

per 100,000 as compared to 126.2 per 100,000, respectively). The same disparity is observed in

hospitalizations for stroke (368.4 per 100,000 vs. 154.0 per 100,000) for Blacks and Others and

Whites, respectively.

o Whites (515.2 per 100,000) are hospitalized at nearly five times the rate of Blacks (107.2 per

100,000) for non-fatal unintentional falls. Non-Hispanics (496.4 per 100,000) are hospitalized at just

over three times the rate of Hispanics (154.4 per 100,000).

o Blacks and Others are hospitalized more than three times as often as Whites for diabetes (3,902.4

per 100,000 as compared to 1,450.4 per 100,000) and twice as often from or with Asthma (1,229.5

per 100,000 as compared to 568.6 per 100,000).

In 2016, the age-adjusted leading causes of death in Palm Beach County were cancer, heart disease,

unintentional injury, stroke, chronic lower respiratory disease, Alzheimer’s disease, suicide, and diabetes.

Between 2014 and 2016, death rates increased from drug poisoning, unintentional injuries, stroke, and

diabetes.

While there has been an increase in HIV cases, the death rate due to HIV/AIDS has declined.

Health Resources and Availability Profile

This section includes data on the various health resources and services available in this area.

In Palm Beach County during the 2016-2017 fiscal year, there were 5,341 licensed physicians and 1,131

licensed dentists, rates of 382.8 per 100,000 residents and 81.1 per 100,000 respectively both of which are

higher than the rates of Florida and have been so historically. Note: These rates are not reflective of

provider supply since numbers may include those who are not practicing or not practicing in this geographic

As of 2016, there are eight Medically Underserved Populations (MUPs) in Palm Beach County, six of them

are in Bethesda Hospital’s service area. There are 12 primary care HPSAs, nine of which are in

Bethesda’s service area. Palm Beach County has eight dental care and nine mental health HPSAs, with

five each in Bethesda’s service area.

The American Community Survey estimates that in 2012-2016, 16.5% of the population in Bethesda’s

service area were uninsured. Nearly a quarter of those between the ages of 18 and 64 are uninsured,

and 11.2% of those 18 and under are uninsured.


Community Perspective

The community’s perspective is a critical component of the Community Health Needs Assessment process. While

the secondary data provides a sound framework for understanding many of the needs, barriers, and challenges the

community has, it is the focus groups, key informant interviews, and community voices that provide additional and

necessary insight. This perspective may help validate certain data points or, in some cases, explain some of these

points. HCSEF gleaned the community’s perspective through strategic and methodical engagement of a diverse set

of stakeholders, either residing in Bethesda Health’s service area, providing services to those residing in the service

area, or with a vested interest in the service areas. HCSEF conducted five focus groups with residents or community

members and 12 key informant interviews with community stakeholders. Members of the Advisory Council also

contributed in this area. Listed below are the key health issues, barriers to care, opportunities to note, and

suggestions.

IMPORTANT NOTE: Except for a few specific instances, the information, i.e., issues, barriers, opportunities, and

suggestions, were NOT specific to Bethesda Health, but rather represented general sentiments pertaining to healthcare.

Key Health Issues Barriers to Care

Mental health

Substance abuse

Opioid epidemic

HIV/AIDS

Obesity (and its comorbidities)

Diabetes

Heart disease and hypertension

Cancer

Maternal morbidity

Dental/oral health

Increasing aging population

Accessibility to health care services, especially specialized care

High cost of healthcare and prescription medications

Lack of awareness of resources

Lack of knowledge, health education, and support e.g., support groups for various conditions

Effects of mental health conditions

Limited access to healthy, affordable food

Transportation

Language and communication barriers

Social isolation, especially among seniors

Fear, shame, stigma

Poverty

Opportunities Suggestions

Improve customer service from all levels

Cultural competency training and awareness can help in addressing the real or perceived disconnect between patients and providers

Community has an interest in more information and education

There is an interest in opportunities to relate to the provider community

There are opportunities to improve referral process to community services

Community partners are interested in formalizing relationships with the hospital

Enhance integration of mental and physical health

Improve communication between providers as well as with patients

Continue partnership with Health Advisory Council

Increase visibility in communities

Increase the use of Navigators to assist with eligibility, applications, and navigating the healthcare system


Priority Areas

At the last meeting of the Advisory Council, HCSEF facilitated a discussion wherein members shared issues, health

conditions, barriers, and challenges that had surfaced for them during the CHNA process. Individuals discussed

these items with their peers, then the group reviewed all suggestions and concluded with a multi-voting activity to

help determine priority areas. Over the next few years, Bethesda Health will commit resources, and partner with

community-based organizations to address the following priorities:

Increase Access to Mental Health Resources and Assistance

Increase Access to Health Services and Resources

Promote Healthy Lifestyles Through Emphasis on Prevention, Wellness, and Education

Improve Maternal and Child Health

Improve Access to Care and Resources for Seniors

Bethesda Health – Baptist Health South Florida will continue to build onto the Advisory Council’s recommendations

and fully develop their three-year Community Health Implementation Plan, with additional details on the

strategies and activities.


Bethesda Health 2015 CHNA Update

Upon conclusion of Bethesda Health’s 2015 Community Health Needs Assessment, the following priorities were

identified to focus efforts on over the next three years:

Increase Access to Primary Care Services

Increase Education on Prevention and Wellness

Reduce Prematurity in Palm Beach County

Since 2015, strides have been made towards addressing these priorities. In an effort to increase access to primary

care services, Bethesda has partnered with a local organization to have a Navigator stationed at Bethesda Hospital

East once a week to assist individuals who need insurance. In addition, Bethesda Health partnered with Genesis

Community Health, a federally qualified health clinic, to open a new clinic at Bethesda Hospital East. The clinic

provides primary care to children, adults, seniors, and expectant mothers.

With regard to increasing education for prevention and wellness, Bethesda’s Medical Residency program has

increased dramatically since 2015. Bethesda also held over 60 community physician lectures and provided more

than 25 screenings each year. Attending community events and enhancing partnerships with churches,

community centers, libraries and schools were other strategies Bethesda Health undertook to provide education

on prevention and wellness.

The organization also worked with the Boynton Beach Mental Health Committee to develop a mental health resource

brochure that was distributed across the county. Bethesda Health partnered with 211 to market community lectures

and support groups to residents. The final priority from the 2015 needs assessment was reducing prematurity. To

combat this issue, Bethesda Health developed an antepartum management program to educate patients about

preventing early delivery. The staff in the Obstetrics Emergency Department also began providing patients with

information on how to recognize and report the signs of pre-term labor. Lastly, Bethesda Health developed a policy

stipulating that all scheduled inductions and C-sections prior to 39 weeks gestation were to be documented for

medical necessity.

While Bethesda Health has successfully implemented strategies over the last three years to work towards addressing

these priorities, efforts must be ongoing to support lasting change. Additionally, the health needs of a community

often change and community health needs assessments need to be done continuously to ensure these needs are

identified and new strategies to address them are developed and implemented.


Bethesda Health

Bethesda Health has been dedicated to delivering nationally recognized quality and compassionate medical care

to the residents of Palm Beach County since 1959. In September 2017, Bethesda Health merged with Baptist

Health South Florida, the largest healthcare organization in the South Florida region. Bethesda joins eight

hospitals and more than 30 outpatient and urgent care facilities spanning three counties. Baptist Health has more

than 15,000 employees and 2,200 affiliated physicians and includes Baptist Medical Group, Baptist Outpatient

Services and internationally renowned centers of excellence. Both organizations share a vision for improving the

health of the community. The merger presented an opportunity for Bethesda Health to grow and expand services

for Palm Beach County residents.

Bethesda Health is comprised of two not-for-profit hospitals within the Baptist Health South Florida system.

Together Bethesda Hospital East and Bethesda Hospital West comprises of 675 physicians specializing in 40

areas; 2,579 employees; and 22 multispecialty physician practices. Additionally, they present a wide range of

specialties to the communities and patients they serve

Bethesda Hospital East opened its doors in 1959 with 70 beds, 32 physicians, and 65 employees. Maintaining the

mission “to provide quality health services in a caring manner,” it has since grown to a 401-bed facility with 670

physicians in more than 40 areas of specialty and a hospital staff of over 2,500.

Among the healthcare services provided by Bethesda Hospital East and its affiliates are:

Comprehensive cancer care

Comprehensive cardiovascular services

Orthopedics

Maternity services, including a Level III neonatal intensive care unit

Advanced Primary Stroke Center

Inpatient and outpatient rehabilitation

Wound care and hyperbaric medicine

Bethesda Hospital West opened its 80-bed facility in 2013 with the intention to serve the western communities of

southern Palm Beach County. Known as “The Jewel of the West,” Bethesda Hospital West includes all private

rooms, a state-of-the-art medical and surgical ICU, 24-hour Emergency Department, general medical department,

surgical and intensive care services, and diagnostic and rehabilitation. The special features of this facility include a

complete electronic medical records system and a unique surgical suite capable of diagnosis and minimally invasive

procedures for endovascular and cardiac care.

The services offered at Bethesda Hospital West include:

A 24-hour Emergency Department with 18 treatment rooms including a Pediatric Emergency Department.

Four full-service operating room suites for inpatient and outpatient surgery and two endoscopy suites.

General medical/telemetry and surgical services.

Full range of imaging services, including MRI, CT, general radiography, ultrasound, mammography and

cardiac stress testing.

Laboratory and inpatient pharmacy services.

Respiratory therapy.

Physical rehabilitation.


Service Area

Bethesda Health’s service area comprises of 31 ZIP codes and includes six

cities.

Figure 1: Bethesda Health’s Service Area

Primary Service Area ZIP Codes: 33414, 33426, 33435, 33436, 33437 33444, 33445, 33446, 33449, 33460 33461, 33462, 33463, 33467, 33472 33473, 33484

Secondary Service Area ZIP Codes: 33405, 33406, 33413, 33415, 33428 33431, 33432, 33433, 33434, 33483 33486, 33487, 33496,33498


Methodology

As part of The Internal Revenue Service (IRS) requires that a not-for-profit hospitals complete a Community Health

Needs Assessment (CHNA) every three years. Through this process, hospitals identify needs or gaps in the current

systems of care, as well as opportunities to improve the health status and health outcomes of the community.

Specific requirements for the assessment include: convening an advisory group of stakeholders, representing

various interests in the community; gathering primary and secondary data; and identifying priorities (and pertinent

goals) along with strategies and specific activities that will support progress towards the goals.

Bethesda Health contracted the Health Council of Southeast Florida (HCSEF) to facilitate the Community Health

Needs Assessment process. This assessment includes quantitative and qualitative data to highlight the needs of the

community. In this assessment, the qualitative data serves as the primary data and the quantitative data serves as

the secondary data. The Demographic and Socioeconomic Profile, Health Status Profile, and Health Resource

Availability and Access Profile contain secondary data while the Community Perspective section contains primary

data.

Secondary data sources utilized for this assessment include, but are not limited to: the U.S. Census Bureau, the

Florida Agency for Health Care Administration (AHCA), the Florida Department of Health (DOH), the Florida

Behavioral Risk Factor Surveillance System (BRFSS), the Youth Risk Behavioral Surveillance System (YRBSS),

Florida Department of Children and Families (DCF), and the University of Miami Cancer Data System. Primary data

for the community perspective was collected through qualitative methods, including focus groups and key informant

interviews.

Data for this assessment was collected, analyzed, and presented to community leaders to identify health indicators in

our community that are concerning, identify a need or gap, or present an opportunity for improvement. The

information provided in this assessment may be used to guide health planning activities to promote lasting health

improvements for our community.


Demographic and Socioeconomic Profile

Palm Beach County is located in southeast Florida and borders Martin County to the North, the Atlantic Ocean to

the East, Broward County to the South, and Hendry County to the West, and extends into Lake Okeechobee in the

Northwest. Palm Beach County was formed in 1909 and is now the third largest county in population in Florida. Not

including Lake Okeechobee, Palm Beach County is the second largest county in area in the state, covering 1,977

square miles. West Palm Beach is the largest city in area in the county, covering 52 square miles, and in population,

with about 108,161 residents.

Source: World Atlas Website – May 2018

This section highlights the demographic and socioeconomic characteristics of the residents of Palm Beach County

and, when available, specifically those of Bethesda Health’s service area. The demographic characteristics include

data that help describe the individuals who comprise this community population and provides important context and

background on this community. The socioeconomic characteristics provide insight into other factors that may affect

the health status of the community, such as poverty, income, homelessness, educational attainment, employment,

public assistance received by constituents, housing availability and costs, environment, transportation, crime, and

food availability and access.

Data in this CHNA is provided for Palm Beach County and, when available, specifically for Bethesda Health’s

service area. Data may also be provided for Florida and the United States for comparison purposes. Since Bethesda

Health’s service area makes up nearly 65 percent of the population of Palm Beach County, assumptions drawn from

the county-level data may be used in some cases to make inferences for Bethesda’s service area.


Demographic Characteristics

Population

Total Population

Table 1 presents the population of Palm Beach County and Florida for 2016. The population of the county

was 1,398,757, which comprised 7% of the state’s population of 19,934,451.

Table 1: Total Population, Palm Beach County and Florida, 2016

Palm Beach Florida

Count Percent Count Percent

Total Population 1,398,757 7.0% 19,934,451 (X)

Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016

Compiled by: Health Council of Southeast Florida, 2018

This table shows the population in Bethesda Health’s service area by ZIP code in 2016. The total population for the

primary service area was 559,232, which is 40% of Palm Beach County’s population. The secondary service area

had a total population of 344,374, or 24% of the county population. The primary and secondary service areas

combined represent the total service area, and had a population that makes up 64% of the county’s population.

Table 2: Total Population, Bethesda Health’s Service Area ZIP Codes, 2016

Primary Service Area Secondary Service Area

ZIP Code Total Population ZIP Code Total Population

33414 58,530 33405 20,972

33426 21,739 33406 25,709

33435 34,304 33413 15,865

33436 43,911 33415 49,938

33437 38,644 33428 39,853

33444 22,980 33431 18,535

33445 31,141 33432 20,284

33446 22,881 33433 42,445

33449 11,843 33434 20,438

33460 31,427 33483 11,566

33461 44,102 33486 24,118

33462 33,183 33487 18,336

33463 59,303 33496 22,210

33467 51,099 33498 14,105

33472 19,540

33473 9,954

33484 24,651

Total 559,232 Total 344,374




Population by Gender

The table below shows the population by gender in Palm Beach County and Florida in 2016. The population in the

county was 51.6% male and 48.4% male.

Table 3: Population by Gender, Palm Beach County and Florida, 2016

Palm Beach Florida


Male 676,486 48.4% 9,741,262 48.9%

Female 722,271 51.6% 10,193,189 51.1%



Population by Age

This table shows the population by age cohort in Palm Beach County and Florida for 2016. The largest cohorts are

45-54 years (13.7%), 35-44 years (11.7%), 25-34 years (11.6%), and 65-74 years (10.9%). Also, important to note is

that, relatively, Palm Beach County has a significantly older senior population, with 7.7% of the residents 75-84

years of age and 4.1% ages 85 and over.

Figure 2: Population by Age, Palm Beach County and Florida, 2016

85 years and over

75 to 84 years

65 to 74 years

60 to 64 years

55 to 59 years

45 to 54 years

35 to 44 years

25 to 34 years

20 to 24 years

15 to 19 years

10 to 14 years

5 to 9 years

Under 5 years

0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0%

Florida Palm Beach




The table below shows the population by age in Bethesda Health’s primary service area in 2016. Boynton

Beach/Canyon Springs, ZIP code 33473, had the highest percentage of individuals under 5 years of age (13.5%).

Adolescents ages 15-19 made up almost a tenth of the population in Wellington, ZIP code 33449. Young adults ages

25-34 made up 17.6% of the population in Lake Worth/Lantana, ZIP code 33460; 17.5% of the population in Delray

Beach, ZIP code 33444; 15.3% of the population in Lake Worth/Palm Springs, ZIP code 33461; and 15.2% of the

population in Boynton Beach, ZIP code 33426. Delray Beach, ZIP codes 33436 and 33484, had high percentages of

individuals ages 65 years and older. Individuals ages 65-74 and 75-84 each make up a fifth of the population in

Boynton Beach, ZIP code 33437. Aberdeen, ZIP code 33472, also had high percentages of individuals 65-74

(18.5%) and 75-84 (16.0%). In the primary service area, the highest populations were those individuals ages 45-54

(12.9%), followed by those 65-74 (12.0%), 35-44 (11.4%), and 25-34 (10.9%).

Table 4: Population by Age Group, Bethesda Health’s Primary Service Area ZIP Codes, 2016

ZIP

Code

Total

< 5

5-9

10-14

15-19

20-24

25-34

35-44

45-54

55-59

60-64

65-74

75-84

85+

33414 58,530 5.0% 7.3% 8.2% 8.3% 5.6% 9.1% 13.8% 17.0% 6.8% 4.5% 8.1% 4.7% 1.6%

33426 21,739 4.7% 3.9% 3.8% 4.3% 8.0% 15.2% 12.3% 12.8% 6.4% 6.4% 8.8% 7.4% 6.0%

33435 34,304 5.6% 6.0% 4.2% 5.6% 7.1% 11.5% 12.1% 14.0% 6.7% 5.6% 10.0% 8.4% 3.3%

33436 43,911 6.2% 4.7% 4.6% 3.4% 3.9% 11.5% 12.1% 12.6% 6.3% 7.2% 11.4% 9.9% 5.9%

33437 38,644 3.3% 3.5% 2.5% 1.9% 2.6% 7.5% 7.3% 6.8% 4.2% 6.0% 20.2% 23.3% 10.9%

33444 22,980 4.2% 5.2% 5.4% 6.0% 6.5% 17.5% 12.4% 15.7% 7.4% 5.6% 8.0% 4.1% 2.0%

33445 31,141 4.4% 3.5% 3.5% 5.0% 7.3% 11.7% 9.9% 12.0% 6.5% 7.0% 12.2% 9.2% 7.8%

33446 22,881 2.2% 2.0% 3.5% 1.9% 1.9% 3.5% 6.8% 7.4% 5.6% 7.1% 26.5% 20.6% 11.2%

33449 11,843 5.8% 5.4% 6.8% 9.1% 6.4% 8.1% 7.8% 18.9% 6.4% 3.8% 10.0% 8.2% 3.2%

33460 31,427 6.7% 7.5% 6.1% 5.1% 6.9% 17.6% 12.4% 15.5% 5.9% 4.5% 5.7% 4.0% 2.2%

33461 44,102 7.5% 8.2% 6.7% 5.6% 7.0% 15.3% 15.0% 13.0% 4.5% 4.0% 7.3% 4.1% 2.0%

33462 33,183 6.3% 5.0% 6.0% 5.1% 7.4% 12.7% 12.4% 14.9% 6.7% 5.4% 9.3% 5.5% 3.2%

33463 59,303 7.8% 7.4% 7.8% 8.2% 6.5% 14.6% 14.7% 12.8% 5.3% 4.5% 6.0% 3.3% 1.2%

33467 51,099 3.9% 4.3% 6.4% 6.6% 5.3% 5.9% 10.8% 15.7% 7.0% 5.8% 14.6% 9.1% 4.7%

33472 19,540 3.5% 4.5% 4.0% 6.1% 2.8% 6.9% 9.9% 13.0% 5.9% 5.2% 18.5% 16.0% 3.7%

33473 9,954 13.5% 11.0% 5.1% 3.9% 2.2% 11.7% 18.2% 10.7% 2.2% 7.4% 9.4% 4.6% 0.2%

33484 24,651 1.8% 1.6% 1.2% 1.9% 2.5% 4.6% 5.7% 7.1% 8.2% 8.3% 18.8% 21.8% 16.5%

Total 559,232 5.4% 5.4% 5.0% 5.2% 5.3% 10.9% 11.4% 12.9% 6.0% 5.8% 12.0% 9.7% 5.0%




This table shows the population by age in Bethesda Health’s secondary service area ZIP codes in 2016. The area of

Greenacres/Haverhill/West Palm Beach, ZIP code 33415, had the highest population of individuals under 5 years

(8.3%). Individuals ages 15-19 made up almost 17% of the population in Boca Raton, ZIP code 33431. Young

adults ages 25-34 made up a high percentage of the population in West Palm Beach, ZIP code 33405 (18.8%),

Greenacres/West Palm Beach (16.6%), and Cloud Lake/Glen Ridge/Lake Clarke Shores/Palm Springs, ZIP code

33406 (16.4%). Boca Raton, ZIP codes 33434 and 33496, had high populations of individuals ages 65-74 and

75-84. Individuals ages 65-75 made up almost a fifth of the population of Delray Beach/Gulf Stream, ZIP code 33483. Table 5: Population by Age Group, Bethesda Health’s Secondary Service Area ZIP Codes, 2016

ZIP

Code

Total

< 5

5-9

10-14

15-19

20-24

25-34

35-44

45-54

55-59

60-64

65-74

75-84

85+

33405 20,972 4.5% 7.0% 5.6% 6.2% 4.6% 18.8% 14.0% 14.7% 5.2% 3.6% 8.4% 4.3% 3.0%

33406 25,709 6.7% 6.8% 6.4% 5.8% 6.4% 16.4% 13.9% 14.4% 6.6% 4.6% 6.7% 3.7% 1.7%

33413 15,865 7.2% 6.4% 6.4% 7.8% 6.9% 16.6% 12.6% 12.9% 6.9% 3.9% 6.7% 3.9% 1.8%

33415 49,938 8.3% 6.8% 6.4% 6.8% 7.4% 13.4% 13.9% 12.5% 5.8% 4.9% 6.8% 4.9% 2.0%

33428 39,853 4.4% 6.5% 6.8% 8.4% 6.5% 11.3% 11.7% 16.2% 7.0% 6.1% 7.9% 4.4% 3.0%

33431 18,535 2.1% 3.5% 4.9% 16.8% 7.5% 9.9% 10.4% 12.8% 6.4% 5.6% 11.6% 5.3% 3.2%

33432 20,284 2.3% 2.3% 4.1% 5.1% 8.5% 9.6% 8.0% 14.2% 7.6% 8.1% 15.1% 10.3% 5.0%

33433 42,445 4.0% 4.6% 4.7% 5.5% 5.5% 10.2% 10.0% 13.4% 6.2% 5.8% 11.7% 9.5% 8.8%

33434 20,438 1.9% 3.1% 4.5% 4.4% 3.1% 7.0% 7.3% 11.2% 8.7% 6.6% 17.2% 15.7% 9.4%

33483 11,566 1.9% 3.2% 2.8% 1.8% 4.0% 11.1% 10.3% 13.3% 8.2% 9.2% 18.0% 10.8% 5.5%

33486 24,118 4.1% 6.0% 7.3% 5.5% 5.7% 12.6% 13.3% 15.5% 7.0% 6.3% 9.9% 4.4% 2.4%

33487 18,336 4.7% 4.3% 3.2% 3.9% 2.8% 8.7% 11.7% 11.7% 8.8% 8.6% 15.2% 12.1% 4.3%

33496 22,210 3.3% 4.5% 4.8% 4.8% 3.2% 6.9% 9.3% 11.4% 6.4% 7.1% 16.4% 15.6% 6.4%

33498 14,105 2.5% 6.3% 8.2% 7.1% 4.1% 7.0% 11.3% 15.0% 9.4% 8.7% 11.5% 5.5% 3.5%

Total 344,374 4.1% 5.1% 5.4% 6.4% 5.4% 11.4% 11.3% 13.5% 7.2% 6.4% 11.7% 7.9% 4.3%




Population by Race and Ethnicity

Table 6 contains the population in Palm Beach County and Florida by race and ethnicity for 2016. The population

identifying as Black or African American in the county (18.3%) was slightly higher than the population in the state

(16.1%). The population identifying as White was similar in both the county and state at roughly three-quarters of the

population. The Hispanic or Latino population in the county (20.7%) was lower than in the state (24.1%).

Table 6: Population by Race and Ethnicity, Palm Beach County and Florida, 2016

Palm Beach Florida


Total Population 1,398,757 7.0% 19,934,451 (X)

Race

One race 1,368,404 97.8% 19,439,083 97.5%

White 1,042,509 74.5% 15,130,748 75.9%

Black or African American 255,606 18.3% 3,216,994 16.1%

American Indian and Alaska Native 2,087 0.1% 52,904 0.3%

Asian 35,653 2.5% 521,272 2.6%

Native Hawaiian & Other Pacific Islander 539 0.0% 11,288 0.1%

Some other race 32,010 2.3% 505,877 2.5%

Two or more races 30,353 2.2% 495,368 2.5%

Ethnicity Hispanic or Latino (of any race) 289,651 20.7% 4,806,854 24.1%

Not Hispanic or Latino 1,109,106 79.3% 15,127,597 75.9%




ZIP Code Total White

Black or African

American

American

Indian and Asian

Alaska Native

33414 58,530 78.3% 14.2% 0.1% 2.9%

33426 21,739 75.9% 17.7% 0.2% 3.4%

33435 34,304 53.8% 40.2% 0.0% 1.3%

33436 43,911 74.3% 18.4% 0.2% 2.1%

33437 38,644 86.2% 10.5% 0.1% 1.5%

33444 22,980 44.5% 49.4% 0.1% 0.6%

33445 31,141 67.6% 23.7% 0.1% 3.8%

33446 22,881 91.5% 2.8% 0.0% 1.1%

33449 11,843 79.8% 12.5% 0.1% 5.6%

33460 31,427 69.1% 22.9% 0.8% 1.6%

33461 44,102 75.9% 16.3% 0.1% 0.9%

33462 33,183 72.1% 23.0% 0.0% 1.1%

33463 59,303 64.1% 26.8% 0.2% 3.6%

33467 51,099 85.1% 6.7% 0.1% 4.0%

33472 19,540 89.2% 6.2% 0.3% 2.3%

33473 9,954 79.6% 8.4% 0.0% 5.5%

33484 24,651 86.7% 7.8% 0.2% 2.1%

The table below shows the population in Bethesda Health’s primary service area ZIP codes by race in 2016. In the

primary service area, individuals identifying as Black or African American made up almost half of the population in

Delray Beach, ZIP code 33444, and over 40% of the population in Boynton Beach/Briny Breezes/Ocean Ridge, Zip

Code 33435. Additionally, more than a quarter of the population in Greenacres/Lake Worth, ZIP code 33463,

identified as Black or African American. White individuals comprise more than 85% of the population in five ZIP

codes in the primary service area (Delray Beach, ZIP code 33446; Aberdeen, ZIP code 33472; Delray Beach, ZIP

code 33484; Boynton Beach, ZIP code 33437; and Wellington/Greenacres/Lake Worth, ZIP code 33467. The largest

populations of individuals identifying as Asian were in Wellington, ZIP code 33449, (5.6%), and Boynton Beach/

Canyon Springs, ZIP code 33473 (5.5%).

Table 7: Population by Race, Bethesda Health’s Primary Service Area ZIP Codes, 2016

Native Hawaiian and Other

Pacific Islander

Some other race

Two or more races



0.0% 1.7% 2.8%

0.0% 1.0% 1.8%

0.0% 3.5% 1.1%

0.2% 2.7% 2.1%

0.0% 0.4% 1.4%

0.0% 4.4% 1.1%

0.1% 2.5% 2.1%

0.0% 2.6% 1.9%

0.0% 0.8% 1.2%

0.1% 3.3% 2.2%

0.1% 3.5% 3.2%

0.1% 0.8% 2.9%

0.0% 2.2% 3.2%

0.0% 2.1% 2.0%

0.0% 0.9% 1.2%

0.0% 4.4% 2.1%

0.1% 1.4% 1.6%


Zip Code Total White

Black or African

American

American

Indian and Asian

Alaska Native

33405 20,972 89.2% 4.8% 0.0% 1.7%

33406 25,709 83.2% 11.1% 0.1% 1.6%

33413 15,865 65.4% 23.9% 0.0% 3.3%

33415 49,938 73.6% 18.6% 0.1% 1.9%

33428 39,853 82.8% 7.4% 0.5% 3.0%

33431 18,535 86.3% 5.2% 0.0% 3.1%

33432 20,284 86.3% 7.6% 0.1% 1.2%

33433 42,445 85.8% 4.3% 0.4% 2.6%

33434 20,438 91.0% 2.7% 0.0% 2.1%

33483 11,566 90.9% 7.1% 0.1% 0.5%

33486 24,118 83.2% 4.2% 0.3% 3.9%

33487 18,336 89.0% 3.3% 0.0% 2.8%

33496 22,210 90.0% 1.2% 0.2% 3.5%

33498 14,105 82.8% 3.0% 0.2% 7.3%

This table shows the population in Bethesda Health’s secondary service area ZIP codes by race in 2016. Almost a

quarter of the population in Greenacres/West Palm Beach, ZIP code 33413, and nearly 19% of the population in

Greenacres/Haverhill/West Palm Beach, ZIP code 33415, identified as Black or African American (23.9% and

18.6%, respectively). In the secondary service area, all ZIP codes had a population of individuals identifying as

White greater than 65%, with some as high as 91% (Boca Raton, ZIP code 33434). The largest percentage of

individuals identifying as Asian in the secondary service area lived in Boca Raton, ZIP code 33498 (7.3%).

Table 8: Population by Race, Bethesda Health’s Secondary Service Area ZIP Codes, 2016

Native Hawaiian and Other

Pacific Islander

Some other race

Two or more races



0.0% 2.9% 1.4%

0.2% 1.1% 2.7%

0.1% 3.0% 4.3%

0.0% 2.3% 3.4%

0.0% 3.2% 3.1%

0.0% 2.0% 3.4%

0.0% 3.7% 1.2%

0.0% 4.1% 2.8%

0.0% 2.9% 1.2%

0.0% 0.7% 0.7%

0.0% 5.9% 2.6%

0.0% 3.1% 1.8%

0.0% 2.3% 2.9%

0.0% 5.7% 0.9%


Table 9 shows the population in Bethesda Health’s primary service area ZIP codes by ethnicity in 2016. More than

half of the population in Lake Worth/Palm Springs, ZIP code 33461, identified as Hispanic or Latino (53%).

Additionally, more than 35% of the population in Greenacres/Lake Worth, ZIP code 33463, and Lake Worth/

Lantana, ZIP code 33460, identified as Hispanic or Latino. Of the 17 ZIP codes in the primary service area, all but

three had more than 75% of individuals identify as not Hispanic or Latino.

Table 9: Population by Ethnicity, Bethesda Health’s Primary Service Area ZIP Codes, 2016

ZIP Code

Total population

Hispanic or Latino (of any race)

Not Hispanic or Latino

33461 44,102 53.0% 47.0%

33460 31,427 39.4% 60.6%

33463 59,303 35.5% 64.5%

33462 33,183 23.6% 76.4%

33414 58,530 22.8% 77.2%

33473 9,954 20.6% 79.4%

33449 11,843 19.0% 81.0%

33436 43,911 18.0% 82.0%

33467 51,099 16.1% 83.9%

33426 21,739 15.4% 84.6%

33435 34,304 12.6% 87.4%

33444 22,980 11.0% 89.0%

33445 31,141 10.1% 89.9%

33446 22,881 9.3% 90.7%

33437 38,644 8.9% 91.1%

33472 19,540 8.4% 91.6%

33484 24,651 7.0% 93.0%




The table below shows the population in Bethesda Health’s secondary service area ZIP codes by ethnicity in 2016.

At least half of the population in West Palm Beach, ZIP code 33405; Greenacres/Haverhill/West Palm Beach, ZIP

code 33415; and Cloud Lake/Glen Ridge/Lake Clarke Shores/Palm Springs, ZIP code 33406, identified as Hispanic

or Latino. Additionally, more than 30% of the population in Greenacres/West Palm Beach, ZIP code 33413, identified

as Hispanic or Latino. Ten ZIP codes had a population of which over 80% of individuals identified as not Hispanic or

Latino.

Table 10: Population by Ethnicity, Bethesda Health’s Secondary Service Area ZIP Codes, 2016

ZIP Code Total population Hispanic or Latino

(of any race) Not Hispanic or Latino

33405 20,972 55.10% 44.90%

33415 49,938 51.60% 48.40%

33406 25,709 50.00% 50.00%

33413 15,865 30.30% 69.70%

33428 39,853 19.70% 80.30%

33433 42,445 18.10% 81.90%

33486 24,118 16.10% 83.90%

33431 18,535 14.00% 86.00%

33498 14,105 12.90% 87.10%

33434 20,438 12.10% 87.90%

33487 18,336 11.80% 88.20%

33496 22,210 10.60% 89.40%

33432 20,284 10.20% 89.80%

33483 11,566 5.30% 94.70%




Population by Census County Division

Census county divisions (CCDs) are areas defined by the Census Bureau for statistical purposes and usually

coincide with the census tract boundaries.2 There are eleven CCDs in the county and six are in Bethesda Health’s

service area. These six are: Belle Glade-Pahokee, Boca Raton, Boynton Beach-Delray Beach, Lake Worth,

Sunshine Parkway, and West Palm Beach.

The table below shows the population in each CCD and the percent of the population they each have. The

population of Boynton Beach-Delray Beach CCD made up almost a quarter of the population of the county. Glades

CCD had the lowest population in the county.

Table 11: Population by Census County Division (CCD), Palm Beach County, 2016

Palm Beach Census County Division Population Percent

Total Population 1,398,757 100.0%

Belle Glade-Pahokee CCD 35,235 2.5%

Boca Raton CCD 133,999 9.6%

Boynton Beach-Delray Beach CCD 322,320 23.0%

Glades CCD 396 0.0%

Jupiter CCD 90,649 6.5%

Lake Worth CCD 220,420 15.8%

Riviera Beach CCD 106,287 7.6%

Royal Palm Beach-West Jupiter CCD 105,100 7.5%

Sunshine Parkway CCD 202,977 14.5%

Western Community CCD 28,185 2.0%

West Palm Beach CCD 153,189 11.0%



2 United States Census Bureau. (n.d.). Geographic terms and concepts – county subdivision. Retrieved from https://www.census.gov/geo/reference/gtc/gtc_cousub.html

http://www.census.gov/geo/reference/gtc/gtc_cousub.html


Population Growth

Table 12 shows the population change by age in Palm Beach County between 2015 and 2016. Overall, the county

had an increase of 1.4% in the population. The largest change was in the age group 65-74 years, which had a 4.1%

increase in the population, followed by those 25-34 years (2.6%), 55-59 years (2.2%), and 85 years and older

(2.1%).

Table 12: Population Change by Age, Palm Beach County, 2015-2016

Population Percent Change from 2015 to 2016 2015 2016

Total population 1,378,806 1,398,757 1.4%

Under 5 years 71,307 72,216 1.3%

5 to 9 years 75,651 75,696 0.1%

10 to 14 years 77,267 77,852 0.8%

15 to 19 years 79,329 79,641 0.4%

20 to 24 years 79,030 79,971 1.2%

25 to 34 years 158,559 162,811 2.6%

35 to 44 years 163,745 163,592 -0.1%

45 to 54 years 191,422 191,527 0.1%

55 to 59 years 90,945 93,008 2.2%

60 to 64 years 82,780 84,375 1.9%

65 to 74 years 146,931 153,160 4.1%

75 to 84 years 106,032 107,919 1.7%

85 years and over 55,808 56,989 2.1%

Median age (years) 44.1 44.3 0.5% Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016



This table shows the foreign-born population for Palm Beach County and Florida in 2016 by place of birth. The

county had a total of 354,765 individuals who were foreign-born, which is almost a quarter of the population; this is

higher than Florida (20.6%). Of those born in a foreign county, 73.1% were from Latin America.

Table 13: Foreign-Born Population, Palm Beach County and Florida, 2016

Palm Beach Florida


Total population 1,443,810 100.0% 20,612,439 100.0%

Total Foreign-Born Population 354,765 24.6% 4,236,511 20.6%

Total 333,024 100.0% 3,967,473 100.0%

Europe 39,362 11.8% 385,361 9.7%

Northern Europe 10,408 3.1% 99,259 2.5%

Western Europe 9,281 2.8% 89,817 2.3%

Southern Europe 6,444 1.9% 69,994 1.8%

Eastern Europe 13,056 3.9% 125,408 3.2%

Asia 32,442 9.7% 422,170 10.6%

Eastern Asia 6,411 1.9% 91,736 2.3%

South Central Asia 9,655 2.9% 116,832 2.9%

South Eastern Asia 9,990 3.0% 158,657 4.0%

Western Asia 6,085 1.8% 51,670 1.3%

Africa 5,868 1.8% 67,328 1.7%

Eastern Africa 953 0.3% 13,092 0.3%

Middle Africa 115 0.0% 1,737 0.0%

Northern Africa 1,890 0.6% 23,419 0.6%

Southern Africa 1,983 0.6% 10,632 0.3%

Western Africa 757 0.2% 15,105 0.4%

Oceania 618 0.2% 7,371 0.2%

Americas 254,734 76.5% 3,085,243 77.8%

Latin America 243,507 73.1% 2,973,577 74.9%

Caribbean 129,010 38.7% 1,644,876 41.5%

Central America 59,271 17.8% 624,207 15.7%

South America 55,226 16.6% 704,494 17.8%

Northern America 11,227 3.4% 111,666 2.8%




Language

Language is an important consideration since language barriers can significantly impact the delivery of safe

and effective healthcare, as well as people’s ability to access care or services.

Table 14 shows the population age 5 years and over who speak another language at home and those who speak

English less than “very well” in Palm Beach County and Florida in 2016. In the county, 30.2% of the population

speaks a language other than English. Of those, 42.3% speak English less than “very well.” Of the population who

speak a language other than English, 17.9% speak Spanish.

Table 14: Languages Spoken at Home, Palm Beach County and Florida, 2016

Palm Beach Florida

nguage other English

Speak a lan than E

guage other nglish

Speak a la than

Total Population Percent of

Speak English less

Total Population

Percent of

Speak English less

Population than "very well"

Population than "very well"

Population age 5 years and over 1,326,541 (X) 12.8% 18,840,238 (X) 11.7%

Speak a language other than English 400,304 30.2% 42.3% 5,327,751 28.3% 41.3%

Spanish 236,818 17.9% 44.7% 3,936,129 20.9% 43.1%

Other Indo-European languages 129,730 9.8% 39.0% 965,349 5.1% 35.0%

Asian and Pacific Island languages 20,514 1.5% 46.0% 297,950 1.6% 43.9%

Other languages 13,242 1.0% 24.9% 128,323 0.7% 26.7% Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016



The table below shows the population age 5 years and over who speak a language other than English and those who speak

English less than “very well” in the Bethesda Health’s service area ZIP codes in 2016. In the primary service area, over half

of the population in Lake Worth/Palm Springs, ZIP code 33461; Greenacres/Lake Worth, ZIP code 33463; and Lake Worth/

Lantana, ZIP code 33460, speak a language, other than English. In the secondary service area, about half of the

population in Greenacres/Haverhill/West Palm Beach, ZIP code 33415; West Palm Beach, ZIP code 33405; and

Cloud Lake/Glen Ridge/Lake Clarke Shores/Palm Springs, ZIP code 33406, speak a language other than

English.

Table 15: Population age 5 Years and Over that Speak Another Language and Speak English Less Than "Very Well," Bethesda Health’s Service Area ZIP Codes, 2016


ZIP Code

Total Population 5

years and

Speak a language other than English

Speak

English

ZIP Code

Total Population 5

years and

Speak a language other than English

Speak

over Percent of Population

less than "very well"

over Percent of Population

English less than

"very well"

33461 40,816 59.4% 53.8% 33415 45,777 58.3% 45.6%

33463 54,697 55.4% 43.0% 33405 20,030 56.7% 61.4%

33460 29,309 50.6% 56.4% 33406 23,983 49.1% 42.6%

33462 31,094 39.9% 45.4% 33413 14,720 42.3% 39.6%

33444 22,012 32.2% 45.8% 33428 38,106 38.2% 33.9%

33435 32,381 32.1% 56.6% 33433 40,741 27.5% 26.5%

33445 29,759 31.9% 38.9% 33498 13,748 26.6% 29.0%

33436 41,170 30.4% 50.5% 33431 18,142 25.7% 22.9%

33449 11,151 27.4% 17.4% 33486 23,127 25.7% 37.5%

33414 55,579 26.3% 27.1% 33496 21,483 24.5% 27.7%

33426 20,707 25.5% 47.0% 33432 19,824 24.4% 34.2%

33473 8,607 25.5% 23.7% 33434 20,049 23.9% 22.1%

33467 49,122 22.1% 33.8% 33487 17,466 23.3% 25.0%

33484 24,211 19.2% 49.4% 33483 11,343 14.1% 53.3%

33446 22,378 18.0% 29.1%

33437 37,380 16.4% 42.9%

33472 18,865 15.9% 32.4%




Socioeconomic Characteristics Social determinants of health are the conditions in the places where people are born, live, learn, work, play, worship,

and age that affect a range of health, functioning, and quality of life outcomes and risks.3 Healthy People 2020 has

identified the five key areas of social determinants of health as: economic stability, education, social and community

context, health and healthcare; and neighborhood and built environment. Social and economic characteristics lay the

foundation for the other determinants of health as they often determine where people live, their educational

attainment, their employment forecast, and services and resources to which they have access.

The characteristics detailed in this section include: poverty, income, homelessness, education, business and

employment, public assistance, housing, transportation, crime, and food insecurity.

Poverty

Poverty can negatively impact the health status of a population both directly and indirectly. An individual or family

living in poverty may not be able to afford some of the essentials that are foundational to health and well-being.

They may also be more likely to lack access to health insurance and have the resources to expend on healthcare

services, prevention, and other goods that support wellness, e.g., healthy foods. Persons living in poverty are also

more likely to live in housing with substandard conditions, in neighborhoods with certain environmental hazards, and

in communities that lack sufficient areas that provide safe places for exercise and recreation.

There are different terms to explain "poverty" depending on context. The U.S. Census Bureau uses "poverty

thresholds" which are used for calculating official poverty population statistics and are updated each year.4 The

Department of Health and Human Services (DHHS) uses the term "poverty guidelines" which are utilized when

determining financial eligibility for programs. These guidelines are often also referred to as the "federal poverty

levels" or FPL.

This table shows the U.S. Department of Health and Human Services 2018 poverty guidelines.

Table 16: Federal Poverty Guidelines, 2018

Persons in Family/Household Poverty Guideline

1 $12,140

2 $16,460

3 $20,780

4 $25,100

5 $29,420

6 $33,740

7 $38,060

8 $42,380

For families/households with more than 8 persons, add $4,320 for each additional person.

Source: U.S. Department of Health & Human Services, 2018


3 Office of Disease Prevention and Health Promotion. (n.d.). Social determinants of health. Retrieved from https://www.healthypeople.gov/2020/topics- objectives/topic/social-determinants-of-health 4 U.S. Department of Health and Human Services. (n.d.). Frequently asked questions related to the poverty guidelines and poverty. Retrieved from

https://aspe.hhs.gov/frequently-asked-questions-related-poverty-guidelines-and-poverty

http://www.healthypeople.gov/2020/topics-


years

over

over

Individuals in Poverty

Table 17 shows the 2016 data for individuals by age, gender, race, and ethnicity who have been below the poverty

level for the past 12 months in Palm Beach County and Florida. The data shown uses the federal poverty threshold

as determined by the U.S. Census Bureau. In Palm Beach County, 21.2% of the population under age 18 was

below the poverty level. Over a third of individuals who identified as "Native Hawaiian and Other Pacific"

Islander' (36.4%), almost a quarter of individuals who identified as "Black or African American" (24.7%), and a fifth

of individuals who identified as "Hispanic or Latino" (20.6%) were living below the federal poverty level.

Table 17: Poverty Status in the Past 12 Months by Age, Gender, Race and Ethnicity, Palm Beach County and Florida, 2016

Palm Beach Florida

Total

Below poverty

level

Percent below

poverty level

Total

Below poverty

level

Percent below

poverty level

Population for whom poverty status is determined

AGE

Under 18 years

Under 5 years

5 to 17 years

Related children of householder under 18

18 to 64

18 to 34 years

35 to 64 years

60 years and

65 years and

1,380,170 191,207 13.9% 19,514,334 3,139,258 16.1%

271,681

57,605

21.2%

4,000,918

933,624

23.3% 71,418 17,273 24.2% 1,076,977 280,374 26.0%

200,263 40,332 20.1% 2,923,941 653,250 22.3%

270,749 56,779 21.0% 3,983,326 917,148 23.0%

795,389 106,349 13.4% 11,783,535 1,818,564 15.4%

266,737 45,977 17.2% 4,118,883 796,849 19.3%

528,652 60,372 11.4% 7,664,652 1,021,715 13.3%

397,036 37,688 9.5% 4,962,541 546,691 11.0%

313,100 27,253 8.7% 3,729,881 387,070 10.4%

SEX

Male

665,394

84,888

12.8%

9,470,030

1,417,077

15.0% Female 714,776 106,319 14.9% 10,044,304 1,722,181 17.1%

RACE AND HISPANIC OR LATINO ORIGIN

White alone

1,030,261

113,157

11.0%

14,859,241

2,041,253

13.7%

Black or African American alone 250,286 61,836 24.7% 3,096,453 810,223 26.2%

American Indian and Alaska Native alone 2,087 291 13.9% 51,335 10,855 21.1%

Asian alone 35,435 4,091 11.5% 514,782 64,501 12.5%

Native Hawaiian and Other Pacific Islander alone

511 186 36.4% 10,978 2,442 22.2%

Some other race alone 31,612 6,139 19.4% 498,208 117,952 23.7%

Two or more races 29,978 5,507 18.4% 483,337 92,032 19.0%

ETHNICITY Hispanic or Latino origin (of any race) 286,041 58,847 20.6% 4,736,746 989,551 20.9%

White alone, not Hispanic or Latino 786,995 63,198 8.0% 10,864,934 1,228,963 11.3% Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016 Compiled by: Health Council of Southeast Florida, 2018


The table below shows the population below 100% of the federal poverty line in Bethesda Health’s service area,

Palm Beach County, Florida, and the United States for the years 2012-2016. In Bethesda’s service area, 13.3% of

the total population was living at 100% below the federal poverty level in the years provided; this percentage is

similar to that of the county.

Table 18: Population Below 100% of the Federal Poverty Level, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and the U.S., 2012-2016

Bethesda Health’s

Service Area

Palm Beach County, FL

Florida

United States

Total Population 894,671 1,380,170 19,514,334 310,629,645

Population with Income at or Below 100% FPL 119,304 191,207 3,139,258 46,932,225

Percent Population with Income at or Below 100% FPL 13.3% 13.9% 16.1% 15.1%



This table shows the population below 200% of the federal poverty line in Bethesda Health’s service area, Palm

Beach County, Florida, and the United States for the years 2012-2016. In Bethesda’s service area, a third of the

population was living at 200% below the federal poverty level in the years provided. This percentage is similar to that

of Palm Beach County.

Table 19: Population Below 200% of the Federal Poverty Level, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016

Bethesda Health’s

Service Area


Florida

United States


Population with Income at or Below 200% FPL 298,485 463,862 7,271,961 104,390,198

Percent Population with Income at or Below 200% FPL 33.4% 33.6% 37.3% 33.6%




The table below presents the data for individuals in Bethesda Health’s primary service area who have been below the

federal poverty level in the past 12 months by age in 2016. Lake Worth/Lantana, ZIP code 33460, had the highest

percentage of individuals in Bethesda Health’s primary service area living below the federal poverty level in 2016

(29.0%). This area also had the highest percentage of individuals under 18 years (43.1%) and 18-64 years (26.7%)

living below the federal poverty level. The city with the highest percentage of individuals 65 years and older living

below the federal poverty level in 2016 was Lake Worth/Palm Springs, ZIP code 33461.

Table 20: Poverty Status in the Past 12 Months by Age Group, Bethesda Health’s Primary Service Area ZIP Codes, 2016

ZIP Code

Population for whom poverty status is

determined

Under 18 years

18 to 64 years

65 years and

over

33460 29.0% 43.1% 26.7% 13.3%

33461 24.0% 36.5% 20.2% 17.1%

33444 23.7% 32.6% 22.7% 16.9%

33435 21.9% 33.0% 22.1% 11.3%

33463 17.5% 26.5% 14.5% 11.5%

33462 15.9% 21.9% 15.4% 10.8%

33445 13.8% 22.8% 14.3% 8.4%

33484 13.0% 13.5% 14.9% 11.7%

33436 10.6% 13.6% 10.4% 8.8%

33426 9.7% 4.7% 11.0% 9.4%

33446 8.2% 6.2% 11.3% 6.8%

33414 7.9% 12.0% 6.2% 7.2%

33437 7.8% 15.6% 9.9% 5.0%

33449 7.4% 11.2% 7.3% 3.5%

33467 6.2% 7.4% 6.3% 5.3%

33472 3.7% 1.9% 3.5% 4.7%

33473 1.2% 0.0% 1.7% 2.3%

Average 13.0% 17.8% 12.8% 9.1%




This table shows the individuals by age in Bethesda Health’s secondary service area who have been below the

federal poverty level in the past 12 months in 2016. West Palm Beach, ZIP code 33405, had the highest percentage

of individuals living in poverty in Bethesda's secondary service area (23.5%). This area also had the highest

percentage of individuals under 18 years (39.3%), between 18 and 64 years (19.7%), and 65 years and over (18.6%)

living below the federal poverty level.

Table 21: Poverty Status in the Past 12 Months by Age Group, Bethesda Health’s Secondary Service Area ZIP Codes, 2016

ZIP Code

Population for whom

poverty status is determined

Under 18 years

18 to 64 years

65 years and

over

33405 23.5% 39.3% 19.7% 18.6%

33415 23.3% 35.2% 19.6% 17.0%

33406 16.7% 26.8% 14.7% 7.4%

33432 13.5% 16.1% 17.2% 5.3%

33428 10.8% 17.2% 9.2% 8.1%

33413 10.7% 11.8% 11.0% 7.6%

33483 10.0% 18.0% 11.6% 5.3%

33431 9.6% 7.8% 11.1% 6.8%

33496 9.5% 12.6% 11.7% 5.6%

33433 8.8% 9.3% 9.8% 6.7%

33486 8.3% 5.9% 10.2% 3.8%

33434 8.0% 2.9% 8.6% 8.8%

33487 5.8% 7.1% 5.8% 5.4%

33498 3.7% 2.5% 3.2% 6.5%

Average 11.6% 15.2% 11.7% 8.1%



Families in Poverty

The table below shows families in poverty in Palm Beach and Florida in 2016.The percentage of families living below

the federal poverty level in 2016 in Palm Beach County (9.9%) is lower than the percentage in Florida (11.7%).

Table 22: Poverty Status in the Past 12 Months, Families, Palm Beach County

Palm Beach Florida

Count

Percent below poverty level

Count

Percent below poverty level

Families 336,708 9.9% 4,759,855 11.7%

With related children of householder under 18 years 139,882 16.9% 2,018,237 19.1%




ALICE Population

The ALICE (Asset Limited, Income Constrained, Employed) population is the segment of individuals who earn an

income higher than the federal poverty levels, but because of the cost of living for the area, find it difficult to afford

basic needs and sustenance.

Table 23 shows the total ALICE households in Palm Beach County and the percentage of ALICE population in

these areas in 2015. In the county, an average of 40% of households that are ALICE and 34 areas have a higher

percentage of ALICE population than the county's average. Notable for this assessment: 85% of Schall Circle

Census Designated Place (CDP) is ALICE; 76% of Westgate CDP is ALICE; and 74% of Mangonia Park is ALICE.

Table 23: ALICE Population, Palm Beach County, 2015

Town

Total HH

% ALICE & Poverty

Town

Total HH % ALICE

& Poverty

Palm Beach County 545,780 40% Loxahatchee Groves 1006 30%

Atlantis* 920 25% Mangonia Park 616 74% Belle Glade 5,715 72% North Palm Beach 6,092 35%

Belle Glade- Pahokee CCD 9,504 73% Ocean Ridge* 842 32%

Boca Raton 40,551 32% Pahokee* 1,822 71%

Boca Raton CCD* 58,068 33% Palm Beach* 4,738 21%

Boynton Beach 29,848 45% Palm Beach Gardens 22,945 31%

Boynton Beach - Delray Beach CCD* 136,295 43% Palm Beach Shores* 650 38%

Briny Breezes* 497 46% Palm Springs 7,684 68%

Cabana Colony CDP 849 42% Pine Air CDP 637 65%

Delray Beach 27,741 42% Plantation Mobile Home Park CDP* 291 70%

Greenacres 13,305 53% Riviera Beach 11,570 53%

Gulfstream* 310 18% Riviera Beach CCD* 42,352 44%

Gun Club Estates* 339 63% Royal Palm Beach 11,354 32%

Haverhill 630 46% Royal Palm - West Jupiter CCD* 37,692 31%

Highland Beach 2,026 24% Royal Palm Estates CDP 799 61%

Hypoluxo 1,330 30% San Castle CDP* 1,078 50%

Juno Beach* 1,982 33% Schall Circle CDP 388 85%

Juno Ridge CDP 318 70% Seminole Manor CDP 912 63%

Jupiter 24,356 32% South Bay 595 68%

Jupiter CCD* 36,810 32% South Palm Beach* 804 37%

Jupiter Farms CDP* 3,965 21% Sunshine Parkway CCD 71,218 30%

Kenwood Estates* 383 58% Tequesta* 2,534 41%

Lake Belvedere Estates CDP 936 28% The Acreage* 11,205 27%

Lake Clarke Shores 1,528 34% Watergate CDP 972 58%

Lake Park 2,942 55% Wellington 19,959 28%

Lake Worth 12,784 60% West Palm Beach* 41,168 48%

Lake Worth CCD* 74,418 57% West Palm Beach CCD 58,959 57%

Lantana 3884 52% Western Community CCD 9,072 24%

Limestone Creek CDP* 296 51% Westgate CDP 2,187 76% Source: United Way ALICE Report, 2017


Notes: Municipal-level data; municipal often relies on 3- and 5-year average, is not available for the smallest towns that don’t report income and may overlap

with Census Designated Places (CCD); items with an asterisk (*) were not included in the 2014 ALICE report


Income

In terms of the implications on health, healthcare, health status, and health outcomes, income is comparable to

poverty levels, as it provides a measure of the resources that individuals have for direct and indirect health-related

spending.

Per Capita Income

Per capita income is the mean income in a population determined by adding the incomes from a particular group and

dividing by the total population in that group. This table shows the per capita income for Bethesda Health’s service

area, Palm Beach County, Florida, and the United States for the years 2012-2016. The per capita income for

Bethesda’s service area was $33,880, which is lower than the county’s per capita income of $34,846.

Table 24: Per Capita Income, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and the U.S., 2012-2016

Bethesda Health’s

Service Area

Palm Beach County,

FL

Florida

United States


Total Income ($) $30,614,270,400 $48,741,560,000 $550,144,033,400 $9,502,305,741,900

Per Capita Income ($) $33,880 $34,846 $27,597 $29,829



Household Income

Household income refers to the income of the householder and all other people in the household age 15 and older,

regardless of whether they are related to the householder.5 Income for this measure includes earnings,

unemployment compensation, workers' compensation, Social Security, supplemental security income, public

assistance, veterans' payments, survivor benefits, pension or retirement income, interest, dividends, rents,

royalties, income from estates, trusts, educational assistance, alimony, child support, assistance from outside the

household, and other miscellaneous sources.

The median income is the point that divides the household income into halves, with one-half above the median and

the other half below.

5 United States Census Bureau. (September 2017). Household income: 2016: Retrieved from https://www.census.gov/programs-surveys/cps/technical- documentation/subject-definitions.html#family

http://www.census.gov/programs-surveys/cps/technical-


This table shows households by income bracket and household benefits received in Palm Beach County and Florida

in 2016. Over a fifth of households in Palm Beach County lived on less than $25,000 (21.7%) while over a quarter

lived on $100,000 or more (25.6%). Over 12% of households in Palm Beach County utilized cash public assistance

or food stamp benefits/SNAP.

Table 25: Household Income and Benefits, Palm Beach County and Florida, 2016

Palm Beach Florida


Total households 538,549 538,549 7,393,262 7,393,262

Less than $10,000 33,160 6.2% 556,637 7.5%

$10,000 to $14,999 24,834 4.6% 398,394 5.4%

$15,000 to $24,999 58,435 10.9% 869,520 11.8%

$25,000 to $34,999 55,660 10.3% 838,036 11.3%

$35,000 to $49,999 72,825 13.5% 1,102,789 14.9%

$50,000 to $74,999 94,198 17.5% 1,350,797 18.3%

$75,000 to $99,999 61,648 11.4% 832,126 11.3%

$100,000 to $149,999 69,797 13.0% 825,836 11.2%

$150,000 to $199,999 29,031 5.4% 297,029 4.0%

$200,000 or more 38,961 7.2% 322,098 4.4%

Median household income (dollars) 55,277 (X) 48,900 (X)

Mean household income (dollars) 85,839 (X) 69,936 (X)

With earnings 380,170 70.6% 5,333,921 72.1%

Mean earnings (dollars) 82,377 (X) 70,229 (X)

With Social Security 213,069 39.6% 2,701,549 36.5%

Mean Social Security income (dollars) 20,169 (X) 18,731 (X)

With retirement income 97,277 18.1% 1,453,372 19.7%

Mean retirement income (dollars) 29,948 (X) 26,105 (X)

With Supplemental Security Income 18,849 3.5% 372,667 5.00%

Mean Supplemental Security Income (dollars) 10,148 (X) 9,502 (X)

With cash public assistance income 10,914 2.0% 161,169 2.2%

Mean cash public assistance income (dollars) 2,696 (X) 2,836 (X)

With Food Stamp/SNAP benefits in the past 12 months 55,846 10.4% 1,092,862 14.8%




Family Income and Benefits

This table shows families by income bracket in Palm Beach County and in Florida from 2016. A "family" is defined by

the U.S. Census Bureau as any two or more people (not necessarily including a householder) residing together, and

related by birth, marriage, or adoption.6 In Palm Beach County, 14.3% of families had an income of less than

$25,000 while almost a third of families (32.6%) made over $100,000.

Table 26: Family Income, Palm Beach County and Florida, 2016

Palm Beach Florida


Families 336,708 336,708 4,759,855 4,759,855

Less than $10,000 13,257 3.90% 228,424 4.80%

$10,000 to $14,999 8,968 2.70% 158,068 3.30%

$15,000 to $24,999 26,086 7.70% 425,680 8.90%

$25,000 to $34,999 30,739 9.10% 485,458 10.20%

$35,000 to $49,999 43,775 13.00% 702,670 14.80%

$50,000 to $74,999 60,055 17.80% 937,785 19.70%

$75,000 to $99,999 44,145 13.10% 633,053 13.30%

$100,000 to $149,999 53,995 16.00% 667,040 14.00%

$150,000 to $199,999 23,436 7.00% 249,199 5.20%

$200,000 or more 32,252 9.60% 272,478 5.70%

Median family income (dollars) 68,427 (X) 59,139 (X)

Mean family income (dollars) 102,036 (X) 81,708 (X)



6 United States Census Bureau. (August 2015). Current population survey. Retrieved from https://www.census.gov/programs-surveys/cps/technical- documentation/subject-definitions.html#family

http://www.census.gov/programs-surveys/cps/technical-


The table below presents the counts and percentages of families in Bethesda Health’s service areas, Palm Beach

County, Florida, and the United States earning over $75,000 in 2012-2016. During this time, 44.9% of families in

Bethesda’s service area earned over $75,000; this is slightly lower than the county’s percentage of

45.7%.

Table 27: Families Earning Over $75,000, Bethesda Health’s Service Area Compared to Palm Beach County, Florida,

and the U.S., 2012-2016

Bethesda Health’s Service

Area


Florida

United States

Total Families 218,643 336,708 4,759,855 77,608,829

Families with Income Over $75,000 98,107 153,828 1,821,770 35,073,881

Percent Families with Income Over $75,000

44.9% 45.7% 38.3% 45.2%



Table 28 shows the counts and percentages of families in Bethesda Health’s service area, Palm Beach County,

Florida, and the United States earning over $75,000 by race in 2012-2016. There is a considerable disparity, with

less than a quarter of Black or African-American families in Bethesda’s service area having earned over $75,000

while 53.4% of Asian families and 48.3% of White families earned over $75,000 during the same period.

Table 28: Percent of Families Earning Over $75,000 by Race, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016

Bethesda Health’s Service Area


Florida United States

White 48.3% 50.5% 41.3% 48.5%

Black or African American 23.7% 23.4% 22.6% 27.9%

Native American / Alaska Native 42.9% 38.6% 31.7% 27.3%

Asian 53.4% 54.3% 48.2% 57.1%

Native Hawaiian / Pacific Islander 40.5% 35.6% 39.4% 38.1%

Some Other Race 34.3% 31.1% 23.1% 23.6%

Multiple Race 35.3% 33.7% 32.7% 39.3%




Income by Service Areas

The table below shows household, family, and per capita income in Bethesda Health’s primary service area ZIP

codes in 2016. In the primary service area, Lake Worth/Palm Springs, ZIP code 33461, had the lowest mean

household income ($45,273), mean family income ($50,692), and per capita income ($16,739). These values are

considerably lower than the county’s and state’s.

Table 29: Household, Family and Per Capita Income, Bethesda Health’s Primary Service Area ZIP Codes, 2016

Median household

income

Mean household

income

Median family income

Mean family income

Per capita income

Palm Beach County $55,277 $85,839 $68,427 $102,036 $34,846

Florida $48,900 $69,936 $59,139 $81,708 $27,598

33414 $78,726 $101,435 $86,506 $110,346 $34,801

33426 $52,530 $63,098 $60,913 $69,928 $28,808

33435 $41,204 $66,580 $44,135 $71,454 $28,061

33436 $52,374 $69,584 $65,645 $83,901 $30,405

33437 $59,193 $80,263 $73,367 $96,550 $40,353

33444 $50,696 $70,100 $51,581 $73,600 $27,313

33445 $50,597 $69,479 $60,870 $80,775 $31,673

33446 $52,193 $106,331 $82,500 $158,966 $57,064

33449 $106,369 $129,771 $117,794 $140,792 $45,051

33460 $36,170 $51,256 $39,783 $57,871 $19,867

33461 $34,758 $45,273 $39,407 $50,692 $16,739

33462 $48,489 $69,081 $52,020 $78,040 $26,942

33463 $50,048 $62,100 $53,255 $65,909 $19,859

33467 $66,028 $86,727 $80,608 $100,761 $35,210

33472 $67,680 $90,675 $78,221 $101,182 $38,296

33473 $136,362 $155,531 $136,362 $156,853 $48,125

33484 $36,712 $57,904 $56,194 $82,202 $33,799




This table shows household, family, and per capita income in Bethesda Health’s secondary service area ZIP codes

in 2016. The area of Greenacres/Haverhill/West Palm Beach, ZIP code 33415, had the lowest mean household

income ($46,999), mean family income ($49,422), and per capita income ($16,937). These values are considerably

lower than the county’s and state’s. Households in ZIP code 33498, had considerably and consistently higher values.

Table 30: Household, Family and Per Capita Income, Bethesda Health’s Secondary Service Area ZIP Codes, 2016

Median household

income

Mean household income

Median family income

Mean family income

Per capita income

Palm Beach County

$55,277 $85,839 $68,427 $102,036 $34,846

Florida $48,900 $69,936 $59,139 $81,708 $27,598

33405 $45,346 $77,249 $47,288 $90,867 $29,307

33406 $51,126 $68,294 $55,961 $72,066 $25,524

33413 $60,281 $68,643 $61,143 $71,040 $22,281

33415 $36,971 $46,999 $40,443 $49,422 $16,937

33428 $63,034 $81,789 $70,991 $91,257 $29,093

33431 $59,704 $106,880 $96,346 $142,301 $41,649

33432 $60,273 $131,608 $84,761 $176,447 $65,316

33433 $56,950 $82,654 $78,676 $106,443 $38,787

33434 $53,968 $103,233 $89,357 $138,713 $50,218

33483 $63,121 $125,302 $91,143 $170,411 $66,506

33486 $76,624 $106,109 $102,532 $128,836 $41,526

33487 $75,271 $119,645 $91,075 $143,266 $56,661

33496 $84,545 $144,996 $103,996 $181,734 $65,383

33498 $94,250 $132,729 $106,215 $148,512 $48,627




Homelessness

The table below shows homelessness at "a point in time" in 2017 and 2018. In 2018, there were a total of 6,282

homeless individuals in the county, which is a decrease from 2017. There were decreases in youth homelessness

(-32.5%) and chronic homelessness (-34.9%), but a significant increase among the veteran population (+100%) and

in families, both household (5.9%) and persons (5.5%).

Table 31: Homelessness Point-In-Time Summary, Palm Beach County, 2017-2018

Population Type 2017 2018 Percent Change

All Populations 1,607 1,308 -18.6%

Unsheltered 1,081 851 -21.3%

Sheltered 526 457 -13.1%

Veterans 65 130 100.0%

Unsheltered 26 83 219.2%

Sheltered 39 47 20.5%

Youth 117 79 -32.5%

Unsheltered 64 21 -67.2%


Chronic 252 164 -34.9%

Unsheltered 234 142 -39.3%


Families (Household) 101 107 5.9%


Sheltered 93 83 -10.8%

Families (Persons) 326 344 5.5%


Sheltered 300 261 -13.0%

Total 6,953 6,282 30.6%

Source: Palm Beach County Department of Community Services, 2018 Compiled by: Health Council of Southeast Florida, 2018


Education

Education may also play a key role in the health status of a population. The Centers for Disease Control and

Prevention (CDC) outlines the connection: more education can increase income, which can lead to better housing in

safer neighborhoods, access to healthier food, better medical care and health insurance, and (even) more

education.7

Educational Attainment

The table below shows the highest degree or level of education attained by the population 18-24 years and 25 years

and older in Palm Beach County and Florida in 2016. In the county, 87.9% of the population graduated high school or

higher, which is slightly higher than the state's percentage of 86.3%. More than a third of the population received a

bachelor's degree or higher (34.2%), which is also higher than the state’s percentage of 27.9%.

Table 32: Educational Attainment, Palm Beach County and Florida, 2016

Palm Beach Florida

Percent Total

Percent Males

Percent Females

Percent Total

Percent Males

Percent Females

Population 18 to 24 years

Less than high school graduate 16.8% 20.2% 13.2% 16.0% 18.6% 13.2%

High school graduate (includes equivalency)

29.2% 32.9% 25.4% 30.2% 33.4% 26.8%

Some college or associate's degree 44.8% 39.6% 50.2% 45.5% 41.5% 49.7%

Bachelor's degree or higher 9.2% 7.3% 11.2% 8.3% 6.5% 10.3%

Population 25 years and over

Less than 9th grade 5.9% 6.5% 5.3% 5.2% 5.4% 5.1%

9th to 12th grade, no diploma 6.2% 6.9% 5.5% 7.6% 8.3% 7.0%

High school graduate (includes equivalency)

25.1% 24.1% 26.0% 29.2% 29.2% 29.2%

Some college, no degree 19.8% 18.9% 20.7% 20.6% 20.2% 20.9%

Associate's degree 8.8% 7.5% 9.9% 9.6% 8.6% 10.5%

Bachelor's degree 21.5% 22.2% 20.8% 17.8% 17.9% 17.8%

Graduate or professional degree 12.7% 13.8% 11.8% 10.0% 10.5% 9.6%

Percent high school graduate or higher 87.9% 86.6% 89.2% 87.2% 86.3% 87.9%

Percent bachelor's degree or higher 34.2% 36.0% 32.6% 27.9% 28.4% 27.4%

Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016 Compiled by: Health Council of Southeast Florida, 2018

7 1. Freudenberg, N., & Ruglis, J. (2007). Reframing school dropout as a public health issue. Preventing Chronic Disease, 4(4). Retrieved from https://www.cdc.gov/pcd/issues/2007/oct/07_0063.htm.

http://www.cdc.gov/pcd/issues/2007/oct/07_0063.htm


Table 33 shows the highest degree or level of education attained by the population 18 years or over in Palm Beach

County and Florida in 2016 by race and ethnicity. Of individuals identifying as White, non-Hispanic in Palm Beach

County, nearly 95% graduated high school while only 72.4% of individuals identifying as Hispanic graduated.

Additionally, only three-quarters of individuals identifying as some other race and 78.0% of individuals identifying as

Black graduated high school. The percentage of individuals identifying as White, non-Hispanic and "some other

race" who graduated in the county are higher than the state's, but are lower than the state for individuals identifying

as Black or Hispanic. The percentage of those who obtained a bachelor's degree in Palm Beach County is higher

than Florida's across all races and ethnicities except Hispanic, which is the same for the county and state.

Table 33: Educational Attainment by Race and Ethnicity, Palm Beach County and Florida, 2016

Palm Beach Florida

Percent Total

Population

Percent Males

Percent Females

Percent Total

Population

Percent Males

Percent Females

White alone

High school graduate or higher 90.3% 89.0% 91.6% 88.7% 87.9% 89.4%


White alone, not Hispanic or Latino High school graduate or higher 94.6% 94.2% 95.1% 92.0% 91.3% 92.6%

Bachelor's degree or higher 40.6% 44.30 37.4% 31.3% 33.0% 29.6%

Black alone High school graduate or higher 78.00% 76.60% 79.20% 81.20% 79.60% 82.70%


American Indian or Alaska Native alone High school graduate or higher 71.00% 58.10% 84.70% 81.40% 78.00% 84.80%


Asian alone High school graduate or higher 88.30% 88.80% 87.90% 86.40% 88.60% 84.60%


Native Hawaiian and Other Pacific Islander alone High school graduate or higher 94.30% 97.10% 91.20% 87.80% 89.30% 86.60%


Some other race alone High school graduate or higher 75.30% 70.80% 79.70% 73.50% 71.70% 75.30%


Two or more races High school graduate or higher 82.50% 79.20% 85.70% 86.10% 84.80% 87.30%


Hispanic or Latino Origin High school graduate or higher 72.40% 68.20% 76.40% 77.60% 76.20% 78.90%

Bachelor's degree or higher 22.40% 21.30% 23.50% 22.40% 21.10% 23.60% Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016



This figure shows the highest degree or level of education attained by the population 25 years and older in Bethesda

Health’s primary service area in 2016. In Lake Worth/Lantana, ZIP code 33460, only 69.8% of the population

graduated high school. The area of Lake Worth/Palm Springs, ZIP code 33461, had the lowest percentage of

individuals with bachelor's degrees (15%).

Figure 3: Educational Attainment, Bethesda Health’s Primary Service Area ZIP Codes, 2016

100%

90%

80%

70%

60%

99% 97% 96% 95% 95%

62%

55%

94% 93% 92% 91% 90%

89%

82% 81%

79% 77%

71% 70%

50%

40%

30%

20%

41%

44%

41% 41%

34%

36%

34%

26%

35%

24% 24%

22%

25%

15%

19%

10%

0%

Percent High School Graduate or Higher Percent Bachelor's Degree



The figure below shows the highest degree or level of education attained by the population 25 years and older in

Bethesda Health’s secondary service area in 2016. In West Palm Beach, ZIP code 33405, only 71.7% of

individuals completed high school. The Greenacres/Haverhill/West Palm Beach area, ZIP code 33406, had the

lowest percentage of bachelor's degree recipients, with 14.6%.

Figure 4: Educational Attainment, Bethesda Health’s Secondary Service Area ZIP Codes, 2016

100%

90%

80%

70%

60%

50%

40%

30%

20%

97% 97% 96% 96% 96% 95% 95% 94%

52% 54% 55%

49% 50% 51% 47%

93% 92%

49% 48%

34%

87%

84%

26% 24%

77%

15%

72%

26%

10%

0%

Percent High School Graduate or Higher Percent Bachelor's Degree Graduate or Higher


High School Graduation

This table shows the percentage of individuals graduating high school in Palm Beach County and Florida for the

years 2012-2017. During this time, the percentage of high school graduates in Palm Beach County increased from

77.0% to 85.0%. The county's high school graduation rate has been consistently higher than the state’s.

Table 34: Percentage of High School Graduates, Palm Beach County and Florida, 2012-2017

Year Palm Beach Florida

2012 77.0% 74.5%

2013 76.3% 75.6%

2014 77.9% 76.1%

2015 79.4% 77.9%

2016 82.3% 80.7%

2017 85.0% 82.3%

Source: Florida Department of Education, Education Information, 2017 Compiled by: Health Council of Southeast Florida, 2018


The table below shows the numbers and percentages of individuals issued a high school diploma in Bethesda’s

service area, Palm Beach County, Florida, and the United States in the years 2013-2014. In Bethesda Health’s

service area, 79% of the student cohort was issued a diploma, which is the same percentage as the county. These

percentages are higher than the state’s percentage of 77.9%.

Table 35: High School Graduates, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2013-2014


Area


Florida

United States

Total Student Cohort 9,069 14,418 199,015 3,116,301

Estimated Number of Diplomas Issued

7,165 11,390 155,014 2,648,271

Percent Cohort Graduation 79.0% 79.0% 77.9% 85.0%

Source: US Department of Education, EDFacts. Accessed via DATA.GOV. Additional data analysis by CARES. 2014-15. Compiled by: Health Council of Southeast Florida, 2018

Business and Employment

Employment status is also a strongly correlated determinant of health status. In addition to the obvious and positive

connection between employment and income, jobs are also often the source of health insurance, as employee-

sponsored coverage is still the most prevalent means for obtaining insurance.

Unemployment

This table shows the employment status of the population 16 years and older in Palm Beach County and Florida for

2016. In Palm Beach County, 694,060 individuals were in the labor force, which is 60% of the county's population of

individuals 16 years and over. In 2016, the unemployment rate for Palm Beach County was 8.2%, which is slightly

lower than Florida’s rate of 8.4%.

Table 36: Employment Status, Palm Beach County and Florida, 2012-2016

Palm Beach Florida


Employment Status

Population 16 years and over 1,156,597 1,156,597 16,339,299 16,339,299

In labor force 694,060 60.0% 9,613,594 58.8%

Civilian labor force 693,752 60.0% 9,557,443 58.5%

Employed 636,646 55.0% 8,755,427 53.6%

Unemployed 57,106 4.9% 802,016 4.9%

Armed Forces 308 0.0% 56,151 0.3%

Not in labor force 462,537 40.0% 6,725,705 41.2%

Civilian labor force 693,752 693,752 9,557,443 9,557,443

Unemployment rate (X) 8.2% (X) 8.4%



The table below shows employment status of the population 16 years and over in Bethesda Health’s primary

service area by ZIP code from 2012-2016. Boynton Beach, ZIP code 33435, had the highest percentage of

unemployment in Bethesda’s primary service area (8.6%). On average, 5.1% of the population was unemployed.

Table 37: Employment Status, Bethesda Health’s Primary Service Area ZIP Codes, 2012-2016

ZIP Code


In labor force

Employed

Unemployed

33435 28,627 60.5% 51.9% 8.6%

33444 19,303 67.6% 59.5% 8.1%

33460 24,767 70.7% 63.0% 7.8%

33463 44,595 71.7% 63.9% 7.8%

33462 27,078 65.8% 58.4% 7.5%

33461 33,699 66.2% 59.9% 6.2%

33426 18,924 64.0% 58.2% 5.8%

33445 27,247 59.1% 53.8% 5.3%

33436 36,785 57.2% 52.6% 4.5%

33414 45,401 65.8% 61.7% 4.0%

33449 9,416 60.6% 56.6% 3.9%

33467 42,811 56.6% 53.0% 3.6%

33472 16,837 48.6% 45.4% 3.1%

33446 21,021 32.3% 29.3% 2.9%

33484 23,404 35.2% 32.2% 2.9%

33437 34,922 37.2% 34.4% 2.8%

33473 6,927 68.1% 66.1% 2.0%

Average 27,163 58.1% 52.9% 5.1%




This table shows employment status of the population 16 years and older in Bethesda Health’s secondary

service area by ZIP code from 2012-2016. Greenacres, ZIP code 33415, had the highest percentage of

unemployment in Bethesda’s secondary service area (7.5%). An average of 4.5% of individuals in the secondary

service area were unemployed during this time.

Table 38: Employment Status, Bethesda Health’s Secondary Service Area ZIP Codes, 2012-2016

ZIP Code


In labor force

Employed

Unemployed

33415 38,453 65.5% 58.0% 7.5%

33431 16,396 57.6% 50.5% 6.8%

33406 20,224 68.0% 61.4% 6.5%

33413 12,535 66.9% 61.4% 5.5%

33405 17,186 65.9% 60.8% 5.1%

33498 11,461 61.2% 56.5% 4.7%

33433 36,207 56.6% 52.2% 4.4%

33428 32,173 66.5% 62.6% 3.9%

33486 19,522 67.6% 63.5% 3.8%

33434 18,300 46.2% 42.6% 3.5%

33432 18,316 59.4% 55.8% 3.4%

33496 19,172 45.9% 42.6% 3.3%

33483 10,537 53.9% 51.1% 2.8%

33487 15,947 57.7% 55.7% 2.0%

Average 20,459 59.9% 55.3% 4.5%



Employment by Industry

Table 39 shows employment by industry in Palm Beach County and Florida. The greatest percentage of workers

in the county worked in educational services, healthcare and social assistance, accounting for over a fifth of

workers.

Table 39: Employment by Industry, Palm Beach County and Florida, 2012-2016

Palm Beach Florida


INDUSTRY

Civilian employed population 16 years and over 636,646 636,646 8,755,427 8,755,427

Agriculture, forestry, fishing and hunting, and mining 6,495 1.0% 93,226 1.1%

Construction 46,046 7.2% 598,521 6.8%

Manufacturing 28,006 4.4% 451,950 5.2%

Wholesale trade 16,508 2.6% 244,721 2.8%

Retail trade 83,460 13.1% 1,168,270 13.3%

Transportation and warehousing, and utilities 25,993 4.1% 447,070 5.1%

Information 12,607 2.0% 170,901 2.0%

Finance and insurance, and real estate and rental and leasing 51,546 8.1% 675,385 7.7%

Professional, scientific, management, and waste management services 96,415 15.1% 1,119,894 12.8%

Educational services, and healthcare and social assistance 131,586 20.7% 1,850,241 21.1%

Arts, entertainment, recreation, and accommodation, and food services 77,800 12.2% 1,075,694 12.3%

Other services, except public administration 37,732 5.9% 466,367 5.3%

Public administration 22,452 3.5% 393,187 4.5%



This table shows employment by occupation in Palm Beach County and Florida in 2016. Individuals in the

management, business, science, and arts occupations made up more than one-third of all occupations in the county.

Service occupations accounted for 20% of occupations in the county.

Table 40: Employment by Occupation, Palm Beach County and Florida, 2016

Palm Beach Florida


OCCUPATION

Civilian employed population 16 years and over 636,646 8,755,427

Management, business, science, and arts occupations 228,377 35.9% 3,002,055 34.3%

Service occupations 139,875 22.0% 1,787,073 20.4%

Sales and office occupations 165,164 25.9% 2,371,710 27.1%

Natural resources, construction, and maintenance occupations 57,450 9.0% 797,030 9.1%

Production, transportation, and material moving occupations 45,780 7.2% 797,559 9.1%



The table below shows the percentages of workers by occupation in Bethesda Health’s primary service area

ZIP codes from 2012-2016. Over a third of the workers in Lake Worth/Lantana, ZIP code 33460, worked in

service occupations.

Table 41: Occupation, Bethesda Health’s Primary Service Area ZIP Codes, 2012-2016

ZIP Code

Civilian

employed population 16

years and over

Management,

business, science, and

arts

Service occupations

Sales and

office occupations

Natural resources,

construction, and

maintenance

Production,

transportation, and material

moving

33414 28,023 44.6% 17.9% 27.1% 5.7% 4.6%

33426 11,005 32.8% 25.0% 29.1% 6.1% 7.1%

33435 14,845 30.6% 25.8% 25.4% 8.8% 9.3%

33436 19,337 35.5% 23.0% 29.7% 5.2% 6.6%

33437 12,014 40.6% 18.8% 30.2% 5.7% 4.8%

33444 11,486 30.4% 31.8% 22.4% 6.7% 8.5%

33445 14,669 36.7% 25.3% 25.4% 4.7% 7.8%

33446 6,168 50.5% 15.9% 28.0% 2.9% 2.7%

33449 5,334 49.0% 19.0% 25.0% 5.0% 2.0%

33460 15,601 21.2% 35.2% 18.8% 18.0% 6.7%

33461 20,193 17.5% 31.3% 22.7% 17.1% 11.4%

33462 15,808 24.9% 26.1% 26.0% 14.5% 8.4%

33463 28,495 26.3% 27.3% 24.1% 14.1% 8.3%

33467 22,700 41.3% 17.3% 27.3% 6.7% 7.4%

33472 7,652 43.9% 19.3% 27.1% 4.6% 5.2%

33473 4,577 52.3% 10.2% 33.2% 2.9% 1.3%

33484 7,544 40.0% 15.9% 30.1% 3.8% 10.1%



This table shows workers by occupation in Bethesda’s secondary service area ZIP codes from 2012-2016.

Nearly 30% of workers in Greenacres/Haverhill/West Palm Beach, ZIP code 33415, worked in service

occupations. Table 42: Occupation, Bethesda Health’s Secondary Service Area ZIP Codes, 2012-2016

ZIP Code

Civilian employed

population 16 years and

over

Management, business,

science, and arts

Service

occupations

Sales and

office occupations

Natural resources,

construction, and

maintenance

Production, transportation, and material

moving

33405 10,447 26.8% 27.5% 21.2% 16.5% 7.9%

33406 12,419 32.9% 24.4% 19.6% 15.2% 7.9%

33413 7,693 31.3% 19.7% 29.5% 10.9% 8.6%

33415 22,291 18.7% 29.9% 24.6% 16.4% 10.4%

33428 20,149 33.7% 19.9% 30.8% 9.2% 6.4%

33431 8,288 47.7% 17.5% 24.4% 5.7% 4.6%

33432 10,220 45.1% 19.3% 27.2% 4.1% 4.3%

33433 18,898 47.4% 15.9% 26.5% 5.1% 5.1%

33434 7,799 46.0% 16.1% 30.2% 4.3% 3.5%

33483 5,382 48.1% 15.5% 25.4% 6.1% 4.9%

33486 12,399 45.7% 15.9% 30.9% 5.0% 2.5%

33487 8,879 49.8% 12.9% 28.9% 3.9% 4.4%

33496 8,170 53.8% 10.5% 27.6% 3.7% 4.4%

33498 6,472 53.8% 11.3% 28.4% 3.3% 3.2%


The table below shows the 2016 data for the employed population in Palm Beach County and Florida by class of

worker. The majority of workers in Palm Beach County (81.7%) were private wage and salary workers. The

county had more government workers than the state but fewer self-employed workers.

Table 43: Class of Worker, Palm Beach County and Florida, 2016

Palm Beach Florida


Civilian employed population 16 years and over 636,646 636,646 8,755,427 8,755,427

Private wage and salary workers 527,083 82.8% 7,155,191 81.7%

Government workers 66,277 10.4% 1,067,720 12.2%

Self-employed in own (not incorporated) business 42,374 6.7% 518,771 5.9%

Unpaid family workers 912 0.1% 13,745 0.2%



Public Assistance Benefits

Households with Public Assistance Income

The table below shows households receiving public assistance income in Bethesda Health’s service area, Palm

Beach County, Florida, and the United States in 2012-2016. During this time, 6,360 households in Bethesda

Health’s service area received some type of public assistance income.

Table 44: Households with Public Assistance Income, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016




Total Households 348,993 538,549 7,393,262 117,716,237

Households with Public Assistance Income

6,360 10,914 161,169 3,147,577

Percent Households with Public Assistance Income

1.8% 2.0% 2.2% 2.7%



Women, Infants, and Children Program

WIC is a supplemental nutrition program that promotes optimum health for low-income pregnant, postpartum, and

breastfeeding women; infants; and children up to age 5. The program provides nutritious foods to supplement

diets, provides information on healthy eating, promotes and supports breastfeeding, and can make referrals to

other services in the area.

This table shows individuals eligible for WIC who were served in Palm Beach County and Florida from 2012-2017. In

2017, 72.4% of the eligible population was served in the county; this is higher than the state’s percentage of 69.3%.

Table 45: WIC Eligible Served, Palm Beach County and Florida, 2012-2017

Year

Palm Beach Florida


2012 29,484 88.9% 477,368 80.4%

2013 30,352 91.6% 488,961 83.8%

2014 31,076 92.2% 489,383 83.3%

2015 31,362 72.8% 492,039 74.7%

2016 31,394 73.8% 479,129 72.2%

2017 30,581 72.4% 462,116 69.3%

Source: Florida Department of Health, WIC & Nutrition Services, 2017 Compiled by: Health Council of Southeast Florida, 2018

School Lunch Program

A student may qualify for free or reduced-price based on the Federal Poverty Guidelines. Children with families who

have household incomes 130% of the federal poverty level may qualify for free lunch, and children with families

who have household incomes 185% of the federal poverty level may qualify for reduced-price lunch.


Table 46 shows children eligible for free or reduced-price in Bethesda Health’s service area, Palm Beach County,

Florida, and the United States in 2014. A total of 101,367 children in Bethesda’s service area were eligible for

free or reduced-lunch; this is 56.9% of the population. In the county, 58.9% of children were eligible for free or

reduced- lunch.

Table 46: Children Eligible for Free /Reduced-Price Lunch, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2014




Total Students 178,179 190,418 2,791,368 50,611,787

Number Free/Reduced-Price Lunch Eligible

101,367 112,163 1,642,740 25,893,504

Percent Free/Reduced-Price Lunch Eligible

56.9% 58.9% 58.9% 52.6%

Source: National Center for Education Statistics, NCES - Common Core of Data. 2015-16. Compiled by: Health Council of Southeast Florida, 2018

SNAP Benefits

This table shows households receiving Supplemental Nutrition Assistance Program (SNAP) benefits in Bethesda

Health’s service area, Palm Beach County, Florida, and the United States in 2012-2016. During this time, 35,010

households, or 10% of households in Bethesda’s service area, received SNAP benefits. This percentage is only

slightly lower than the county’s percentage of 10.4%.

Table 47: Population Receiving SNAP Benefits, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016



Florida

United States


Households Receiving SNAP Benefits

35,010 55,846 1,092,862 15,360,951

Percent of Households Receiving SNAP Benefits

10.0% 10.4% 14.8% 13.1%



Housing and Environment

Identifying households in which housing is a significant portion of living expenses or households that need assistance

paying for housing is important because it highlights cases in which families won’t be able to spend additional money on

health costs. Identifying the prevalence of the population who live in poor-quality housing is also critical when

examining health issues, because their housing may contain harmful environmental exposures, and,

because of the time spent in homes, these exposures are chronic.

Cost-burdened households are those in which the housing costs exceeds 30% of the income. The table below

provides the housing cost-burdened households in Bethesda Health’s service area, Palm Beach County,

Florida, and the United States during 2012-2016. In Bethesda’s service area, 39.6% of households were cost-

burdened, which is close to the county’s percentage of 39.9%.


Table 48: Housing Cost Burden, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016





Cost-Burdened Households 138,307 214,719 2,754,755 38,719,430

Percentage of Cost-Burdened Households 39.6% 39.9% 37.3% 32.9%



The Low-Income Housing Tax Credit (LIHTC) program provides tax credits for rental housing for lower income

households. This table shows the number of Low Income Housing Tax Credit LIHTC properties and units in

Bethesda Health’s service area, Palm Beach County, Florida, and the United States in 2014. There were 23 LIHTC

properties and 4,120 units in Bethesda’s service area in 2014.

Table 49: The Low-Income Housing Tax Credits (LIHTC) Properties and Units, Bethesda Health’s Service Areas Compared to Palm Beach County, Florida, and the U.S., 2014




LIHTC Properties 23 65 1,307 43,092

LIHTC Units 4,120 11,176 185,889 2,784,155

Source: US Department of Housing and Urban Development, 2014 Compiled by: Health Council of Southeast Florida, 2018

This table shows housing units with substandard conditions in Bethesda Health’s service area, Palm Beach

County, Florida, and the United States in 2012-2016. About 40% of the housing units in Bethesda’s service area

have one or more substandard conditions.

Table 50: Substandard Housing, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016


Area


Florida

United States

Total Occupied Housing Units 348,993 538,549 7,393,262 117,716,237

Occupied Housing Units with One or More Substandard Conditions

139,767 217,225 2,785,232 39,729,263

Percent Occupied Housing Units with One or More Substandard Conditions

40.1% 40.3% 37.7% 33.8%

Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016 Note: This indicator reports the number and percentage of owner- and renter-occupied housing units having at least one of the following conditions: 1) lacking complete plumbing facilities, 2) lacking complete kitchen facilities, 3) with 1.01 or more occupants per room, 4) selected monthly owner costs as a percentage of household income greater than 30%, and 5) gross rent as a percentage of household income greater than 30%. Compiled by: Health Council of Southeast Florida, 2018


The table below shows the availability of recreation and fitness facilities in Bethesda Health’s service area, Palm

Beach County, Florida, and the United States in 2015. In Bethesda’s service area, there were 123 recreation and

fitness facilities, which is a rate of 14.6 per 100,000 individuals.

Table 51: Availability of Recreation and Fitness Facilities, Bethesda Health’s Service Area, Palm Beach County, and Florida, 2015

Bethesda Health’s

Service Area


Florida

Total Population 848,303 1,320,134 18,801,310

Number of Establishments 124 193 1,962

Establishments, Rate per 100,000 Population

14.6 14.6 10.4

Source: US Census Bureau, County Business Patterns, 2015 Compiled by: Health Council of Southeast Florida, 2018

Transportation

Transportation impacts health, as a lack of transportation increases barriers to accessing healthy, quality foods;

going to medical or dental visits; or accessing resources.

Table 52 shows households with no motor vehicle in Bethesda Health’s service area, Palm Beach County,

Florida, and the United States in 2012-2016. The U.S. Census Bureau estimates there were a total of 21,895

households, or 6.3% of the households in Bethesda’s service area during this time, with no motor vehicle. This

percentage is only slightly lower than the county’s percentage of 6.6%.

Table 52: Households with No Motor Vehicle, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016



Florida

United States

Total Occupied Households 348,993 538,549 7,393,262 117,716,237

Households with No Motor Vehicle

21,895 35,735 511,316 10,562,847

Percentage of Households with No Motor Vehicle

6.3% 6.6% 6.9% 9.0%




Crime

Crime affects health because it creates stress and anxiety and can have financial implications. In addition, the

presence of violent crimes in a community can have traumatic effects on the community.

The table below shows crime offenses in Palm Beach County in the years 2015-2016. A total of 48,613 crimes

were committed in 2016, with a majority being larceny (30,926) followed by burglary (7,770) and aggravated

assault (4,195). There was a 2.2% increase in crime offenses from 2015 to 2016. Table 53: Index Crime Offenses, Palm Beach County, 2015-2016

INDEX OFFENSES 2015 2016 Percent Change

Larceny 30,376 30,926 1.8

Burglary 7,646 7,770 1.6

Aggravated Assault 4,089 4,195 2.6

Motor Vehicle Theft 3,194 3,382 5.9

Robbery 1,650 1,753 6.2

Rape 520 511 -1.7

Murder 97 76 -21.6

Total Index Offenses 47,572 48,613 2.2

Source: Florida Department of Law Enforcement, 2015 Compiled by: Health Council of Southeast Florida, 2018

Table 54 shows the numbers and rates per 100,000 individuals of violent crime offenses reported in Bethesda

Health’s service area, Palm Beach County, Florida, and the United States in the years 2012-2014. There were 4,081

violent crime offenses reported in Bethesda’s service area and a rate of 462.93 per 100,000 individuals; this is very

similar to Palm Beach County’s rate of 462.90.

Table 54: Violent Crime Offenses Reported, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2014

Bethesda Health’s

Service Area Palm Beach County, FL

Florida

United States


Violent Crimes 4,081 6,351 92,236 1,181,036

Violent Crime Rate 462.93 462.90 472.10 379.70

Source: Federal Bureau of Investigation, FBI Uniform Crime Reports. Additional analysis by the National Archive of Criminal Justice Data. 2014 Compiled by: Health Council of Southeast Florida, 2018


Food Availability and Access

This table shows the population who were food-insecure in Bethesda Health’s service area, Palm Beach County,

Florida, and the United States in 2014. In Bethesda’s service area, there were 128,171 individuals who were food-

insecure, which is 14.7% of the population. This is the same percentage of food-insecure individuals in the county.

Table 55: Food Insecurity Rate, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2014


Area


Florida

United States


Food-Insecure Population, Total 128,171 199,460 3,227,600 47,448,890

Percent Food-Insecure 14.7% 14.7% 16.2% 14.9%

Source: Feeding America, 2014 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the prevalence of food deserts and food desert populations in Bethesda Health’s service

area, Palm Beach County, Florida, and the United States in 2015. In Bethesda’s service area, there were 60 food

desert census tracts and 277,104 individuals who were considered part of the food desert population.

Table 56: Food Deserts by Census Tract, Bethesda Health’s Services Area, Palm Beach County, Florida, and the U.S., 2015


Area


Florida

United States

Total Population (2010) 848,304 1,320,134 18,801,310 308,745,538

Food Desert Census Tracts 60 118 1,833 27,527

Other Census Tracts 151 219 2,381 45,337

Food Desert Population 277,104 517,586 9,211,621 129,885,212

Other Population 571,200 802,548 9,589,689 178,860,326

Source: US Department of Agriculture, Economic Research Service, USDA - Food Access Research Atlas, 2015 Compiled by: Health Council of Southeast Florida, 2018

This table shows the density of fast-food restaurants in Bethesda Health’s service area, Palm Beach County, Florida,

and the United States in 2015. In Bethesda’s service areas, there were 611 fast-food establishments; this is a rate of

72 per 100,000 individuals. This rate is similar to that of the county, but higher than the state’s.

Table 57: Fast-Food Restaurant Density, Bethesda Health’s Service Area, Palm Beach County, Florida, and the U.S., 2015


Area


Florida

United States


Number of Establishments 611 951 12,475 233,392

Establishments, Rate per 100,000 72.0 72.0 66.4 74.6

Source: US Census Bureau, County Business Patterns, 2015 Compiled by: Health Council of Southeast Florida, 2018


Health Status Profile This section provides data for Palm Beach County and Florida when available, and Bethesda Health’s service area

for the following categories: maternal and child health, oral health, behavioral health, and morbidity and mortality.

The data presented can be used to identify health priorities, inform policy development, to recognize gaps in

services or guide current services available.

Data in this section may be presented as counts, percentages, rates, or age-adjusted rates. Rates, or crude rates,

are the number of cases in a specific population divided by that population, multiplied by 100,000. Because almost

all diseases or health outcomes occur at different rates in different age groups, age-adjustment is a statistical way to

remove the confounder of age to allow for comparison between two different populations, resulting in age-adjusted

rates.8

Maternal and Child Health This section illustrates the following indicators: prenatal care access, birth counts and rates, birth weight, fetal and

infant mortality, births to overweight mothers, and immunization.

Some indicators are presented as data from the Kotelchuck Index, sometimes also referred to as the Adequacy of

Prenatal Care Utilization (APNCU) Index.9 This index determines the adequacy of prenatal care by comparing the

number of prenatal visits to the expected number of visits, determined by the American College of Obstetricians and

Gynecologists prenatal care standards for uncomplicated pregnancies. It does not measure the quality of prenatal

care and depends on the accuracy of the information the patient or provider gives. This is not an accurate measure

for high-risk pregnancies.

Prenatal Care Access

Adequate prenatal care is essential in ensuring the health of the mother and baby. The Office on Women's Health

states that babies of mothers who do not get prenatal care are three times more likely to have a low birth weight

and five times more likely to die than those born to mothers who do get care.10 Early and consistent prenatal care

allows for doctors to detect problems and treat them early.

8

New York State Department of Health. (n.d.). Age-adjusted rates – statistics teaching tools. Retrieved from

https://www.health.ny.gov/diseases/chronic/ageadj.htm 9

Utah Department of Health. (n.d.). The Kotelchuck Index. Retrieved from http://health.utah.gov/opha/IBIShelp/kotelchuck.html 10 Office on Women’s Health. (n.d.). Prenatal Care. Retrieved from https://www.womenshealth.gov/a-z-topics/prenatal-care

http://www.health.ny.gov/diseases/chronic/ageadj.htm

http://health.utah.gov/opha/IBIShelp/kotelchuck.html

http://www.womenshealth.gov/a-z-topics/prenatal-care


The table below presents births to mothers with adequate prenatal care using the Kotelchuck Index in Palm Beach

County and Florida from 2012 to 2016. The county's percent of births to mothers with adequate prenatal care has

fluctuated through this period of five years. Palm Beach County's percent for births to mothers with adequate prenatal

care has been consistently higher than Florida's. The most recent data shows that 64.8% of births in the county were

to mothers with adequate prenatal care.

Table 58: Births with Adequate Prenatal Care (Kotelchuck Index), Palm Beach County and Florida, 2012-2016

Year

Palm Beach Florida


2012 9,495 68.1% 140,627 66.0%

2013 9,538 67.2% 139,000 64.6%

2014 9,513 65.9% 139,307 63.3%

2015 10,061 67.6% 142,913 63.7%

2016 9,703 64.8% 139,433 62.0%

Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Compiled by: Health Council of Southeast Florida, 2018

Table 59 shows births to mothers with less than adequate prenatal care using the Kotelchuck Index in Palm Beach County and Florida for the years 2012-2016. Since 2012, Palm Beach County's percent of births to mothers with less than adequate prenatal care has fluctuated around a quarter of all births. The most recent data shows 26.8% of births in the county were to mothers with less than adequate prenatal care. The county’s percent of births to mothers with less than adequate prenatal care has remained below that of the state.

Table 59: Births to Mothers with Less than Adequate Prenatal Care (Kotelchuck Index), Palm Beach County and Florida, 2012-2016

Year

Palm Beach Florida


2012 3,374 26.2% 57,339 29%

2013 3,348 26.0% 59,837 30.1%

2014 3,602 27.5% 61,716 30.7%

2015 3,415 25.3% 59,841 29.5%

2016 3,552 26.8% 59,436 29.9%



This table shows births to mothers with less than adequate prenatal care using the Kotelchuck Index in Bethesda

Health’s primary and secondary service area ZIP codes in 2016. Almost half of the births in Lake Worth/Lantana,

ZIP code 33460 in Bethesda’s primary service area, were to mothers with less than adequate prenatal care. On

average, about a third of births in the primary service area received less than adequate prenatal care. Thirty-four

percent of births in Delray Beach/Gulf Stream, ZIP code 33483 in Bethesda’s secondary service area, were to

mothers with less than adequate prenatal care. In the secondary service area, an average of 30% of births were to

mothers with less than adequate prenatal care.

Table 60: Births to Mothers with Less than Adequate Prenatal Care (Kotelchuck Index), Bethesda Health’s Service Area ZIP Codes, 2016


ZIP Code

Total Births

Less than adequate prenatal care

ZIP Code

Total Births

Less than adequate prenatal care


33460 672 288 47.0% 33483 59 17 34.0%

33437 230 65 32.0% 33432 144 37 32.7%

33444 293 73 31.9% 33405 243 67 30.9%

33435 462 123 31.8% 33431 130 30 30.9%

33461 721 207 31.1% 33415 706 199 30.5%

33445 301 75 30.7% 33486 192 44 28.2%

33462 405 106 30.4% 33487 143 31 26.7%

33463 856 219 28.1% 33433 349 75 26.0%

33436 486 109 26.3% 33406 340 70 22.0%

33426 265 56 25.6% 33428 422 79 21.6%

33446 78 15 24.6% 33496 121 22 21.6%

33467 363 75 22.9% 33413 210 38 19.5%

33414 499 98 21.1% 33434 95 13 17.3%

33484 94 12 16.2% 33498 96 9 11.1%

Total 3,084 937 33.6% Total 1,966 500 30.0%

Source: Florida Department of Health, Bureau of Vital Statistics, 2016



Table 61 shows births to mothers with less than adequate prenatal care using the Kotelchuck Index by race in Palm

Beach County and Florida for 2016. In the county, women identifying as White had 834 more births with less than

adequate prenatal care than women identifying as Black & Other.

Table 61: Births to Mothers with Less than Adequate Prenatal Care (Kotelchuck Index) by Race, Palm Beach County and Florida, 2016

Palm Beach Florida

White Black & Other

Unknown Total White Black & Other

Unknown Total

2,180 1,346 26 3,552 39,372 19,708 356 59,436



This table shows the counts of births to mothers with less than adequate prenatal care using the Kotelchuck Index by

ethnicity in Palm Beach County and Florida in 2016. In the county, women identifying as Non-Hispanic or Haitian had

825 more births with less than adequate prenatal care than women identifying as Hispanic.

Table 62: Births to Mothers with Less than Adequate Prenatal Care (Kotelchuck Index) by Ethnicity, Palm Beach County and Florida, 2016

Palm Beach Florida

Hispanic

Non- Hispanic or

Haitian

Unknown

Total

Hispanic

Non- Hispanic or

Haitian

Unknown

Total

1,357 2,182 13 3,552 17,002 41,979 455 59,436


The table below shows the percent of births in Palm Beach County and Florida by the mothers’ prenatal care

status in 2014-2016 using the Kotelchuck Index. The percent of births to mothers with adequate prenatal care in

Palm Beach County decreased from 67.6% in 2015 to 64.8% in 2016. The percent of births to mothers with

adequate prenatal care in the county has been consistently higher in Palm Beach County.

Table 63: Percentage of Births to Mothers by Prenatal Care, Palm Beach County and Florida, 2014-2016

Palm Beach Florida

2014 2015 2016 2014 2015 2016

Births to Mothers With 1st Trimester Prenatal Care 75.7% 76.3% 75.8% 79.4% 79.3% 78.4%

Births to Mothers With 2nd Trimester Prenatal Care 16.5% 16.5% 16.8% 15.4% 15.3% 15.5%

Births to Mothers With 3rd Trimester Prenatal Care 6.5% 6.0% 6.1% 3.8% 3.9% 4.1%

Births with Adequate Prenatal Care (Kotelchuck index) 65.9% 67.6% 64.8% 63.3% 63.7% 62.0%



Preterm Births

Preterm births are defined as those births before 37 weeks gestation. Preterm births are a concern because they

can lead to health problems for the baby, such as trouble or delays in physical and cognitive development,

behavioral problems, neurological disorders, respiratory diseases, intestinal problems, infections, problems with

vision or hearing loss, and dental problems.11 Preterm birth may also cause babies to stay in the hospital longer,

incurring large costs and stress for the family.

This table shows the counts and rates of preterm births per 1,000 live births in Palm Beach County and Florida for

the years 2014-2016. In Palm Beach County, the preterm birth rate increased from 2014 to 2015, then decreased to

its lowest rate of 9.2 in the years provided in 2016. The county’s preterm birth rate was below the state’s rate in the

years shown below.

Table 64: Preterm Births (<37 weeks gestation), Palm Beach County and Florida, 2014-2016

Year

Count Rate per 1,000

2014 2015 2016 2014 2015 2016

Palm Beach 1,337 1,474 1,370 9.3 9.9 9.2

Florida 21,817 22,396 22,812 9.9 10 10.1


11 March of Dimes. (October 2013). Long-term health effects of premature birth. Retrieved from https://www.marchofdimes.org/complications/long-term-health- effects-of-premature-birth.aspx

http://www.marchofdimes.org/complications/long-term-health-


2012 2013 2014 2015 2016

Palm Beach White 9.1 8.5 8 8.7 8.3

Palm Beach Black & Other 12.6 10.7 11.5 12.4 10.7

Florida White 9.3 9 8.9 8.9 9.1

Florida Black & Other 12.6 12.5 12.4 12.7 12.7

The figure below shows the percentage of preterm births in Palm Beach County and Florida by race for the years

2012-2016. In the county, the percentage of preterm births for both the Black & Other population and White

population has fluctuated over the years shown. Women identifying as Black & Other in Palm Beach have had a

higher percentage of preterm births than women identifying as White. In 2016, 10.7% of births to women identifying

as Black & Other in the county were preterm and 8.3% of births to White women were preterm. The percentage of

preterm births for women identifying as Black & Other in the county has been lower than in the state; in 2016, these

percentages were 10.7 and 12.7, respectively. Those identifying as White in Palm Beach have also had lower

percentages of preterm births than those in Florida. In 2016, these percentages were 8.3 and 9.1, respectively.

Figure 5: Percentage of Preterm Births (<37 weeks gestation) by Race, Palm Beach County and Florida, 2012-2016

14

12

10

8

6



2012 2013 2014 2015 2016

Palm Beach Hispanic 9.4 8.5 8.4 9.2 8.9

Palm Beach Non-Hispanic 10.7 9.7 9.6 10.3 9.3

Florida Hispanic 9.2 8.9 9 9 9.1

Florida Non-Hispanic 10.6 10.4 10.3 10.4 10.5

This figure shows the percentage of preterm births in Palm Beach County and Florida by ethnicity for the years 2012-

2016. In the county, Hispanics and non-Hispanics have had a fluctuating percentage of preterm births over the years

shown. Non-Hispanics in the county have had a higher percentage of preterm births than Hispanics. The data from

2016 shows 9.3% of births to non-Hispanics in the county were preterm and 8.9% of births to Hispanics were

preterm. Hispanics in Palm Beach have typically had a lower percentage of preterm births than in Florida. In 2016,

9.1% of births to Hispanics in Florida were preterm. Non-Hispanics in the county have typically had a lower

percentage of preterm births than the state as well; in 2016, 10.5% of births to non-Hispanics in Florida were preterm.

Figure 6: Percentage of Preterm Births (<37 weeks gestation) by Ethnicity, Palm Beach County and Florida, 2012-2016

14

12

10

8

6



The table below shows preterm births for individuals living in Bethesda Health’s primary and secondary service

areas by ZIP code in 2016. Greenacres/Lake Worth, ZIP code 33463, had the highest number of preterm births in

Bethesda's primary service area (76). In the secondary service area, Greenacres/Haverhill/West Palm Beach, ZIP

code 33415, had the highest number of preterm births, with 63.

Table 65: Preterm Births (<37 weeks gestation), Bethesda Health’s Service Areas ZIP Codes, 2016


ZIP Code Births ZIP Code Births

33463 76 33415 63

33461 74 33428 36

33460 61 33405 26

33436 59 33413 26

33414 47 33406 20

33435 46 33433 15

33462 42 33496 13

33444 36 33487 12

33426 33 33432 10

33467 26 33486 9

33437 25 33431 8

33445 23 33434 8

33484 8 33498 8

33446 2 33483 7

Total 558 Total 261




Birth Counts and Rates

Total Births

The table below shows the counts and rate per 1,000 individuals of total resident live births in Palm Beach County

and Florida for the years 2014-2016. The birth rate for Palm Beach County fluctuated in the three-year period

shown but remained below Florida’s. The most recent data for the county show that there were a total of 14,963

births, which is 10.7 live births per 1,000.

Table 66: Total Resident Live Births, Palm Beach County and Florida, 2014-2016

Year


2014 2015 2016 2014 2015 2016

Palm Beach 14,433 14,873 14,963 10.6 10.8 10.7

Florida 219,905 224,273 225,018 11.2 11.3 11.1


Table 67 shows total resident live births for individuals living in Bethesda Health’s primary and secondary service

area by ZIP code in 2016. In the primary service area, Greenacres/Lake Worth, ZIP code 33463 had the highest

number of live births (856). There was a total of 5,725 live births in the primary service area. In the secondary service

area, Greenacres/Haverhill/West Palm Beach, ZIP code 33415 had the highest number of live births with 706. There

was a total of 3,250 live births in the secondary service area.

Table 67: Total Resident Live Births, Bethesda Health’s Service Areas ZIP Codes, 2016



33463 856 33415 706

33461 721 33428 422

33460 672 33433 349

33414 499 33406 340

33436 486 33405 243

33435 462 33413 210

33462 405 33486 192

33467 363 33432 144

33445 301 33487 143

33444 293 33431 130

33426 265 33496 121

33437 230 33498 96

33484 94 33434 95

33446 78 33483 59

Total 5,725 Total 3,250



Births by Age of Mother

The table below shows births to mothers ages 15-17 for individuals living in Bethesda Health’s service area by ZIP

code in 2016. In the primary service area, Lake Worth/Lantana, ZIP code 33460 had the highest number of births to

mothers ages 15-17, with 30 births. There was a total of 83 births to mothers ages 15-17 in the primary service

area. Greenacres/Haverhill/West Palm Beach, ZIP code 33415 had the highest number of births to mothers ages

15-17 in the secondary service area, with 10 births. In total, there were 18 births to mothers ages 15-17 in

Bethesda’s secondary service area.

Table 68: Births to Mothers Ages 15-17, Bethesda Health’s Service Areas ZIP Codes, 2016



33460 30 33415 10

33463 14 33406 3

33461 13 33405 2

33462 8 33428 1

33435 5 33431 1

33436 4 33433 1

33414 3

33437 2

33444 2

33445 1

33446 1

Total 83 Total 18




Table 69 shows births to mothers ages 18-19 for individuals living in Bethesda Health’s service area by ZIP code in

2016. Lake Worth/Palm Springs, ZIP code 33461, had 38 births to mothers ages 18-19. In the primary service area,

there were a total of 178 births to mothers ages 18-19. In the secondary service area, Greenacres/Haverhill/West

Palm Beach, ZIP code 33415 had 22 births to mothers ages 18-19. There were 61 births to mothers ages 18-19 in

the secondary service area.

Table 69: Births to Mothers Ages 18-19, Bethesda Health’s Service Areas ZIP Codes, 2016



33461 38 33415 22

33463 35 33406 11

33460 32 33413 7

33435 14 33428 6

33462 13 33405 5

33414 10 33431 3

33436 10 33432 3

33444 8 33433 2

33467 8 33483 1

33445 5 33486 1

33437 3

33426 1

33484 1

Total 178 Total 61




This table shows births by mother’s age for individuals living in Bethesda Health’s primary service area in 2016. The

age group 30-34 had the highest number of births, followed closely by the age group 25-29. There were two births to

mothers ages 0-14 and 80 births to mothers ages 15-17.

Figure 7: Birth Counts by Mother's Age, Bethesda Health’s Primary Service Area, 2016

1800

1600

1622 1648

1400

1200

1000

982

928

800

600

200

2 0

178

80

268

14

0-14 15-17 18-19 20-24 25-29 30-34 35-39 40-44 45+



The table below shows births by mother’s age for individuals living in Bethesda Health’s secondary service area in

2016. The largest number of births was to mothers ages 30-34. There were three births to mothers ages 0-14 and 18

to mothers ages 15-17.

Figure 8: Birth Counts by Mother's Age, Bethesda Health’s Secondary Service Area, 2016

1800

1600

1400

1073

1000

800

600

400

417

843

630

200

0

66

3 18

149

16

0-14 15-17 18-19 20-24 25-29 30-34 35-39 40-44 45 +


Repeat Births to Teenage Mothers

The table below shows repeat births to mothers ages 15-19 in Palm Beach County and Florida from 2012-2016. The

percentage of repeat births to mothers ages 15-19 in the county has been mostly decreasing since 2012. Palm

Beach County's percentage for repeat births to mothers ages 15-19 has been higher than Florida’s since 2012. The

most recent data shows the county’s percent of repeat births to mothers ages 15-19 was 16.1% while the state’s was

15.9%.

Table 70: Repeat Births to Mothers Ages 15-19, Palm Beach County and Florida, 2012-2016

Year

Palm Beach Florida


2012 157 18.7% 2,693 16.9%

2013 114 16.6% 2,283 16.4%

2014 118 17.9% 2,113 16.5%

2015 102 16.4% 1,889 15.8%

2016 100 16.1% 1,784 15.9%

Source: Florida Department of Health, Bureau of Vital Statistics Compiled by: Health Council of Southeast Florida, 2018


2012 2013 2014 2015 2016

Palm Beach 18 16.5 16.9 17.9 18.8

Palm Beach Black & Other 19.5 16.8 19 14.2 12.2

Florida White 15.5 14.7 15.8 15.3 15.5

Florida Black & Other 19.1 19 17.8 16.8 16.9

The graph below shows the percentage of repeat births to mothers ages 15-19 in Palm Beach County and Florida for

the years 2012-2016 by race. The percent of repeat births to mothers identifying as Black & Other in the county has

been decreasing since 2014 while it has been increasing for mothers identifying as White. The percent of mothers

identifying as Black & Other in the county who had repeat births was higher than that of mothers identifying as White

from 2012 to 2014; however, in 2015, the percentage of repeat births to mothers identifying as Black & Other fell

below that of mothers identifying as White. The 2016 data shows 18.8% of mothers identifying as White in the county

had repeat births while 12.2% of mothers identifying as Black & Other had repeat births. The percentage of repeat

births to mothers identifying as White in Palm Beach County has been consistently higher than the percent of repeat

births to White mothers in Florida, with the 2016 data for these being 18.8% and 15.5%, respectively. The percentage

of repeat births to mothers identifying as Black & Other in the county (12.2%) was lower than the state (16.9%) in

2016.

Figure 9: Percentage of Repeat Births to Mothers Ages 15-19 by Race, Palm Beach County and Florida, 2012-2016

25

20

15

10

5

0



2012 2013 2014 2015 2016

Palm Beach Hispanic 21.8 19.1 17.6 19.9 20.5

Palm Beach Non-Hispanic 16.9 14.6 17.9 13.5 11.7

Florida Hispanic 17.9 17.2 18 17.3 15.6

Florida Non-Hispanic 16.5 16.1 15.9 15.1 16.1

Figure 10 shows the percentage of repeat births to mothers ages 15-19 in Palm Beach County and Florida from

2012-2016 by ethnicity. The percentage of mothers identifying as Hispanic who had repeat births in the county

decreased from 2012-2014, but has been on the rise since. For mothers identifying as non-Hispanic, the percent of

repeat births has fluctuated in the years provided. The percent of mothers identifying as Hispanic in the county who

have had repeat births has almost always been higher than that of mothers identifying as non-Hispanic. The most

recent data shows a fifth of mothers identifying as Hispanic in the county had repeat births while 11.7% of mothers

identifying as non-Hispanic had repeat births. When comparing the county to the state, the percentage of mothers

identifying as Hispanic who have had repeat births in the county has almost always been higher than in the state.

The 2016 data shows a fifth of mothers identifying as Hispanic in Palm Beach County had repeat births while

15.6% of mothers identifying as Hispanic in Florida had repeat births. The most recent data also shows mothers

identifying as non-Hispanics in the county had a lower percentage of repeat births than in the state (11.7% and

16.1%, respectively).

Figure 10: Percentage of Repeat Births to Mothers Ages 15-19 by Ethnicity, Palm Beach County and Florida, 2012-2016

25

20

15

10

5

0



This table shows repeat births to mothers ages 18-19 in Palm Beach County and Florida from 2012-2016. The

percentage of repeat births to mothers ages 18-19 in the county has fluctuated over the time shown and slightly

increased from 2015-2016 from 19.2% to 20.6%. The county’s percentage of repeat births to mothers ages 18-19

has been higher than in Florida since 2012. The most recent data from 2016 shows Palm Beach County's

percent of repeat births to mothers ages 18-19 as 20.6% while Florida's was 19%.

Table 71: Repeat Births to Mothers Ages 18-19, Palm Beach County and Florida, 2016

Year

Palm Beach Florida


2012 130 20.9% 2,379 20.3%

2013 102 20.6% 2,009 19.6%

2014 106 21.0% 1,878 19.6%

2015 86 19.2% 1,641 18.5%

2016 89 20.6% 1,579 19.0%


Birthweight

Low-birthweight babies are more likely than babies of normal weight to have health problems. Risk factors for

having low-birthweight babies include smoking, drinking alcohol, or using drugs; exposure to air pollution or lead;

low socioeconomic status; domestic violence; age; and race.12 Because some of the risk factors can be prevented

or mitigated, low-birthweight babies are an important public health indicator. Furthermore, low-birthweight babies

indicate the importance of adequate prenatal care.

A low-birthweight baby is a baby who was born weighing less than 2500 grams, or 5 lbs., 4 oz., and a very low-

birthweight baby is a baby born weighing less than 1500 grams, or 3 lbs., 4 oz.

Low and Very Low-Birthweight

The table below shows babies born with a low-birthweight in Palm Beach County and Florida from 2012-2016.

Trends for the county show the percent of low-birthweight births has fluctuated around 8%, with the most recent data

for 2016 showing it at 8.3% of births. The percentage of low-birthweight babies in Palm Beach County has typically

been slightly lower than Florida's percentage.

Table 72: Live Births Under 2500 Grams (Low-Birthweight), Palm Beach County and Florida, 2012-2016

Year

Palm Beach Florida


2012 1,229 8.8% 18,291 8.6%

2013 1,162 8.2% 18,371 8.5%

2014 1,221 8.5% 19,104 8.7%

2015 1,259 8.5% 19,367 8.6%

2016 1,236 8.3% 19,661 8.7%


12 March of Dimes. (March 2018). Low birthweight. Retrieved from https://www.marchofdimes.org/complications/low-birthweight.aspx

http://www.marchofdimes.org/complications/low-birthweight.aspx


This table shows babies born very low birthweight in Palm Beach County and Florida in the years 2012-2016. The

percentage of very low-birthweight babies in the county has been decreasing since 2014. The percentage of very

low-birthweight babies in Palm Beach County has typically been lower than the state; the most recent data shows

1.3% of babies born in the county were very low-birthweight and 1.5% of babies born in the state were very low-

birthweight.

Table 73: Live Births Under 1500 Grams (Very Low-Birthweight), Palm Beach County and Florida, 2012-2016

Year

Palm Beach Florida


2012 207 1.5% 3,415 1.6%

2013 202 1.4% 3,311 1.5%

2014 232 1.6% 3,550 1.6%

2015 214 1.4% 3,497 1.6%

2016 199 1.3% 3,478 1.5%



The table below shows babies born with low and very low birthweight for individuals living in Bethesda Health’s

primary service area by ZIP code in 2016. Boynton Beach/Village of Golf, ZIP code 33436, had the highest percent

of low-birthweight babies in the primary service area with 13.2%. There was a total of 423 babies born with low-

birthweight in the primary service area. The highest percentage of very low-birthweight babies in Bethesda's primary

service area was in Boynton Beach/Briny Breezes/Ocean Ridge, ZIP code 33435. Seventy-three babies were born

with very low birthweight in Bethesda’s secondary service area.

Table 74: Live Births with Low and Very Low-Birthweight, Bethesda Health’s Primary Service Area ZIP Codes, 2016

Live Births Under 2500 Grams (Low-Birthweight)

Live Births Under 1500 Grams (Very Low-Birthweight)

ZIP Code Count Percent ZIP Code Count Percent

33436 56 13.2% 33435 12 16.4%

33461 55 13.0% 33461 11 15.1%

33435 53 12.5% 33444 9 12.3%

33444 50 11.8% 33436 8 11.0%

33460 41 9.7% 33460 8 11.0%

33462 36 8.5% 33426 6 8.2%

33414 31 7.3% 33462 5 6.8%

33426 31 7.3% 33467 5 6.8%

33437 22 5.2% 33437 4 5.5%

33467 21 5.0% 33445 4 5.5%

33445 18 4.3% 33414 1 1.4%

33484 6 1.4% 33446 0 0.0%

33446 3 0.7% 33484 0 0.0%

Total 423 Total 73 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Compiled by: Health Council of Southeast Florida, 2018


Table 75 shows babies born with low and very low-birthweight for individuals living in Bethesda Health’s secondary

service area by ZIP code in 2016. The area of Greenacres/Haverhill/West Palm Beach, ZIP code 33415,had the

highest percentage of babies born low-birthweight and very low-birthweight, 22.0% and 28%, respectively. There

were 223 babies born with low-birthweight and 32 born with very low-birthweight in the secondary service area.

Table 75: Live Births with Low and Very Low-Birthweight, Bethesda Health’s Secondary Service Area ZIP Codes, 2016

Live Births Under 2500 Grams (Low Birthweight)

Live Births Under 1500 Grams (Very Low-Birthweight)

ZIP Code Count Percent

ZIP Code Count Percent

33415 49 22.0% 33415 9 28%

33428 26 11.7% 33413 4 13%

33406 24 10.8% 33406 3 9%

33413 23 10.3% 33405 2 6%

33405 22 9.9% 33428 2 6%

33432 16 7.2% 33431 2 6%

33433 13 5.8% 33432 2 6%

33487 13 5.8% 33486 2 6%

33486 9 4.0% 33487 2 6%

33496 9 4.0% 33433 1 3%

33498 8 3.6% 33434 1 3%

33431 6 2.7% 33496 1 3%

33483 4 1.8% 33498 1 3%

33434 1 0.4% 33483 0 0%

Total 223 Total 32

Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Compiled by: Health Council of Southeast Florida


The table below shows the counts of live births, low and very low-birthweight babies born and mothers who received

less than adequate prenatal care using the Kotelchuck Index for individuals living in Bethesda Health’s primary and

secondary service areas, Palm Beach County, and Florida in 2016. In the primary service area, there were 5,725 live

births; 423 were low-birthweight and 73 were very low-birthweight. There were 1,521 births to mothers with less than

adequate prenatal care in the primary service area. There was a total of 3,250 live births in the secondary service

area; 223 were low birthweight and 32 were very low-birthweight. A total of 731 births were to mothers with less than

adequate prenatal care in Bethesda’s secondary service area.

Table 76: Maternal Health Comparison Counts, Bethesda Health’s Service Areas, Palm Beach County and Florida, 2016

Primary Service Area Secondary Service Area Palm Beach County Florida

Total Resident Live Births 5,725 3,250 14,963 225,018

Births <2500 grams 423 223 1,236 19,661

Births <1500 grams 73 32 199 3,478

Births to Less than Adequate Prenatal Care (Kotelchuck Index)

1,521 731 3,552 59,436


The table below shows the percentages of live births, low and very low-birthweight babies born and mothers who

received less than adequate prenatal care using the Kotelchuck Index for individuals living in Bethesda Health’s

primary and secondary service areas, Palm Beach County, and Florida in 2016. More than a third of babies born in

the county live in Bethesda’s primary service area. Additionally, more than a third of babies born low-birthweight or

very low birthweight live in the primary service area. Almost twenty-nine percent of births in the primary service area

and 25.2% of births in the secondary service area are to mothers who received less than adequate prenatal care.

The percentage of mothers who received less than adequate prenatal care in the primary service area was higher

than that of the county.

Table 77: Maternal Health Comparison Percentages, Bethesda Health’s Service Areas, Palm Beach County and Florida, 2016

Primary Service Area

Secondary Service Area

Palm Beach County

Florida

Total Resident Live Births 38% 22% 14,963 225,018

Births <2500 grams 34% 18% 6% 9%

Births <1500 grams 37% 16% 6% 2%

Births to Less than Adequate Prenatal Care (Kotelchuck Index)

28.6%

25.2%

26.8%

29.9%



Fetal and Infant Mortality

Fetal death is the spontaneous intrauterine death of a fetus at any time during pregnancy.13 Infant mortality is the

death of an infant before his or her first birthday. Infant mortality is considered an indicator of community health

status, poverty and socioeconomic status, and the availability and quality of health services.14

This table shows fetal deaths per 1,000 deliveries in Palm Beach County and Florida for the years 2014-2016. Since

2014, Palm Beach County's fetal death rate has fluctuated over the years provided. In this three-year span shown,

the county’s rate of fetal deaths has been higher than the state's. The most recent data shows Palm Beach

County's fetal death rate at 7.3 and Florida's at 6.8.

Table 78: Fetal Deaths, Palm Beach County and Florida, 2014-2016

Years

Palm Beach Florida


deliveries Count

Rate per 1,000 deliveries

2014 108 7.4 1,576 7.1

2015 104 6.9 1,541 6.8

2016 110 7.3 1,548 6.8


This table shows fetal deaths per 1,000 deliveries in Palm Beach County and Florida for the years 2014-2016 by

race. The fetal death rate among women identifying as White and Black & Other in the county have fluctuated in the

years shown. Women identifying as Black & Other in Palm Beach have a fetal death rate almost twice that of women

identifying as White. The fetal death rate for women identifying as White in Palm Beach was higher than in Florida in

2014 and 2016. Women identifying as Black in the county had a lower fetal death rate than in the state in 2014 and

2016.

Table 79: Fetal Deaths by Race, Palm Beach County and Florida, 2014-2016

Wh

ite

Palm Beach Black & Other

White

Florida

Black &

Other

Years

Count Rate per

1,000 deliveries

Count

Rate per 1,000

deliveries

Count

Rate per 1,000

deliveries

Count

Rate per 1,000

deliveries

2014 56 5.9 52 10.2 893 5.7 677 10.8

2015 48 4.8 56 11.2 831 5.1 703 11.2

2016 56 5.8 54 10.3 828 5.1 706 11


13 Centers for Disease Control and Prevention. (December 2016). Fetal deaths. Retrieved from https://www.cdc.gov/nchs/nvss/fetal_death.htm 14 Association of Maternal & Child Health Programs. (n.d.). Infant Mortality Toolkit. Retrieved from http://www.amchp.org/programsandtopics/data- assessment/InfantMortalityToolkit/Documents/Why%20Focus%20on%20IM.pdf

http://www.cdc.gov/nchs/nvss/fetal_death.htm

http://www.amchp.org/programsandtopics/data-


The table below shows fetal deaths per 1,000 deliveries in Palm Beach County and Florida for the years 2014-2016

by ethnicity. The fetal death rate has fluctuated for women identifying in both ethnic groups in the county for the years

provided. Women identifying as Non-Hispanic in Palm Beach have typically had higher fetal death rates than women

identifying as Hispanic. The fetal death rate for women identifying as non-Hispanic in Palm Beach was higher than

that of Florida in 2015 and 2016. Women identifying as Hispanic in the county had a higher fetal death rate than in

the state in 2014 and 2016.

Table 80: Fetal Deaths by Ethnicity, Palm Beach County and Florida, 2014-2016

Hisp

anic

Palm Beach Non-Hi

spanic

Hisp

anic

Florida

Non-Hi

spanic

Years

Count Rate per

1,000 deliveries

Count

Rate per 1,000

deliveries

Count

Rate per 1,000

deliveries

Count

Rate per 1,000

deliveries

2014 30 7.1 75 7.3 347 5.6 1,182 7.5

2015 19 4.1 79 7.6 338 5.3 1,158 7.2

2016 32 6.7 74 7.2 357 5.4 1,129 7.1




This table shows fetal deaths for individuals living in Bethesda Health’s primary and secondary service area by ZIP

code for 2016. There were six fetal deaths in Boynton Beach/Village Golf, ZIP code 33436, and a total of 23 fetal

deaths in the primary service area. In the secondary service area, Cloud Lake/Glen Ridge/Lake Clarke Shores/

Palm Springs had the highest number of fetal deaths (three) and there were a total of 11 fetal deaths for the area.

Table 81: Fetal Death Count, Bethesda Health’s Service Areas ZIP Codes, 2016


ZIP Code Count ZIP Code Count

33436 6 33406 3

33435 5 33405 2

33463 3 33415 2

33467 3 33428 1

33461 2 33432 1

33462 2 33433 1

33460 1 33486 1

33484 1 33413 0

33414 0 33431 0

33426 0 33434 0

33437 0 33483 0

33444 0 33487 0

33445 0 33496 0

33446 0 33498 0

Total 23 Total 11


The table below shows the count and infant death rate per 1,000 live births in Palm Beach County and Florida in

2014-2016. In the three-year span shown, Palm Beach County's infant death rate has fluctuated, but remained

below Florida's. The most recent data shows Florida's rate of infant deaths at 6.1 and Palm Beach County's at its

lowest in the years provided at 4.3.

Table 82: Infant Deaths, Palm Beach County and Florida, 2014-2016

Number of Total Live Births Number of Infant Deaths Rate per 1,000 Live Births

2014 2015 2016 2014 2015 2016 2014 2015 2016

Florida 219,905 224,273 225,018 1,327 1,400 1,380 6 6.2 6.1

Palm Beach

14,433

14,873

14,963

69

73

64

4.8

4.9

4.3



2014 2015 2016

Palm Beach White 3 3.2 3

Palm Beach Black & Other 8.1 8.3 6.7

Florida White 4.4 4.4 4.3

Florida Black & Other 10.2 11 10.7

Figure 11 shows the infant death rate per 1,000 live births in Palm Beach County and Florida for the years 2014-2016

by race. The infant mortality rate for babies identified as Black & Other in the county increased from 2014 to 2015

and then decreased considerably. The infant mortality rate for babies identified as White in the county has stayed

relatively the same. The death rate for babies identified as Black & Other in the county (6.7) was more than double

that of babies identified as White (3) in 2016. The infant mortality rate for babies identified as White (3) and Black &

Other (6.7) in Palm Beach County is lower than in Florida (4.3 and 10.7, respectively).

Figure 11: Infant Death Rate Per 1,000 Live Births by Race, Palm Beach County and Florida, 2014-2016

12

10

8

6

4

2

0



2014 2015 2016

Palm Beach Hispanic 4.3 4.2 4.7

Palm Beach Non-Hispanic 5 5 4

Florida Hispanic 4.9 4.8 5.4

Florida Non-Hispanic 4.9 4.8 5.4

This graph shows the infant death rate per 1,000 live births in Palm Beach County and Florida in the years 2014-

2016 by ethnicity. County trends show the rate of infant mortality has been fluctuating for babies identified as

Hispanic and decreasing for babies identified as non-Hispanic. In 2014 and 2015, babies identified as non-Hispanic

in Palm Beach County had a higher infant death rate than babies identified as Hispanic; however, in 2016, the infant

death rate for babies identified as non-Hispanic fell below that of the babies identified as Hispanic. Babies identified

as non-Hispanic in the county had a lower infant mortality rate (4) than babies identified as non-Hispanic in the state

(5.4) in 2016. Babies identified as Hispanic in Palm Beach also had a lower infant mortality rate (4.7) than their

counterparts in the state (5.4). In the years shown, the infant mortality rate for babies identified as Hispanics and non-

Hispanics in Florida was the same; therefore, the line for babies identified as Hispanics in Florida in babies Florida is

cannot be seen in the graph below.

Figure 12: Infant Death Rate Per 1,000 Live Births by Ethnicity, Palm Beach County and Florida, 2014-2016

10

8

6

4

2

0




Table 83 shows infant deaths for individuals living in Bethesda Health’s primary and secondary service area by ZIP

codes in 2016. In the primary service area, Boynton Beach/Village of Golf, ZIP code 33436, had the highest

number of infant deaths with 6. In total, there were 23 infant deaths in the area. In the secondary service area,

Cloud Lake/Glen Ridge/Lake Clarke Shores/Palm Springs, ZIP code 33406, had the highest number of infant

deaths (3). In the area, there was a total of 11 infant deaths.

Table 83: Infant Death Count, Bethesda Health’s Service Areas ZIP Codes, 2016



33436 6 33406 3

33435 5 33405 2

33463 3 33415 2

33467 3 33428 1

33461 2 33432 1

33462 2 33433 1

33460 1 33486 1

33484 1 33413 0

33414 0 33431 0

33426 0 33434 0

33437 0 33483 0

33444 0 33487 0

33445 0 33496 0

33446 0 33498 0

Total 23 Total 11




Births to Overweight Mothers at Time Pregnancy Occurred

Being overweight or obese during pregnancy can have harmful effects for women and their babies. For example,

it can increase the risk of complications during pregnancy, such as high blood pressure, preeclampsia, blood

clotting, gestational diabetes, Cesarean birth, or miscarriages or stillbirths. It may also cause problems for babies

such as premature birth, birth defects, diabetes, heart disease, or obesity later in life.15

This figure shows the percent of babies born to women who were overweight when they became pregnant. County

trends show the percentage of births have fluctuated in the years shown. The county’s percentage of births was

higher than the state of Florida’s from 2012-2015. The most recent data shows Palm Beach County had 25.9% of its

births to overweight mothers and Florida had 26.3%.

Figure 13: Percentage of Births to Mothers Overweight at Time Pregnancy Occurred, Palm Beach County and Florida, 2012-2016

32

30

28

26

24

22

20 2012 2013 2014 2015 2016

Palm Beach 25.4 26.7 27 27 25.9

Florida 25.2 25.7 25.7 26.1 26.3


15 March of Dimes. (August 2015). Being overweight during pregnancy. Retrieved from https://www.marchofdimes.org/pregnancy/being-overweight-during- pregnancy.aspx

http://www.marchofdimes.org/pregnancy/being-overweight-during-


2012 2013 2014 2015 2016

Palm Beach 24.1 25.2 25.4 26.3 24.5

Palm Beach 28 29.8 29.8 28.5 28.4

Florida 24.6 25.1 25 25.6 26

Florida 26.4 27.2 27.2 27.2 26.9

This table shows the percentage of babies born to women who were overweight when they became pregnant by race

from 2012-2016 in Palm Beach County and Florida. The percent of births to women identifying as Black & Other and

White who were overweight at the time pregnancy occurred in the county has fluctuated in the years provided. The

2016 data has these percentages at 28.4% and 24.5%, respectively. Given the most recent data available, the

percentage of births to overweight mothers identifying as White in Florida (26.0%) was higher than in Palm Beach

County(24.5%). The percentage of births to overweight mothers identifying as Black & Other in the county (28.4%)

was higher than in the state (26.9%) in 2016.

Figure 14: Percentage of Births to Overweight Mothers at Time Pregnancy Occurred by Race, Palm Beach County and Florida, 2012-2016

32

30

28

26

24

22

20



2012 2013 2014 2015 2016

Palm Beach 29 29.4 29.8 30.6 29.3

Palm Beach 23.9 25.6 25.8 25.4 24.4

Florida 28 28.6 28.1 28.9 28.9

Florida 24.1 24.6 24.7 24.9 25.2

Figure 15 shows the percentage of babies born to women who were overweight when they became pregnant by

ethnicity from 2012-2016 in Palm Beach County and Florida. Both ethnic populations in the county have seen

fluctuating percentages of births to overweight mothers in the years provided. The Hispanic population in the county

has had higher percentages of births than the non-Hispanic population. Hispanics in the county have had higher

percentages of births to overweight mothers than in the state; the most recent data has these percentages at 29.3%

and 28.9%, respectively. The 2016 data shows non-Hispanics in Florida had a higher percentage of births to

overweight mothers (25.2%) than non-Hispanics in Palm Beach County (24.4%).

Figure 15: Percentage of Births to Overweight Mothers at Time Pregnancy Occurred by Ethnicity, Palm Beach County and Florida, 2012-2016

32

30

28

26

24

22

20



Immunization

Immunizations are important to protect children from diseases and prevent the spread of disease. Immunizations also

prevent children from having to visit the doctor’s office, saving caregivers time and money.

Two-Year-Old Immunization

The table below shows the percent of two-year-old children in Palm Beach County and Florida who were fully

immunized in the years 2015-2017. The percentage of two-year olds immunized in the county has fluctuated over

the years provided. In 2017, 83.3% of two-year-olds in the county were fully immunized; this was lower than

Florida’s percent of 86.1.

Table 84: Percent of Two-Year-Old Children Fully Immunized, Palm Beach County and Florida, 2015-2017


2015 85.4% 85.5%

2016 90.5% 83.4%

2017 83.3% 86.1% Source: Florida Department of Health, Bureau of Immunization, 2017 Compiled by: Health Council of Southeast Florida, 2018

Kindergarten Immunization

Table 85 shows children in kindergarten fully immunized in Palm Beach County and Florida in the years 2015-2017.

In the county, the percentage of children who were fully immunized has steadily increased. In 2017, 14,000

kindergarten children were fully immunized, which is 93.6%. Ninety-four percent of Florida’s kindergarten children

were fully immunized in 2017.

Table 85: Immunization Levels in Kindergarten, Palm Beach County and Florida, 2015-2017



2015 13,431 89.4% 213,552 93.3%

2016 13,521 90.7% 210,376 93.7%

2017 14,000 93.6% 211,311 94.1% Source: Florida Department of Health, Bureau of Immunization, 2017 Compiled by: Health Council of Southeast Florida, 2018

Seventh Grade Immunization

This table shows children in seventh grade fully immunized in Palm Beach County and Florida in the years 2015-

2017. The percentage of seventh graders in the county who were immunized has fluctuated over the years shown

below. A total of 15,204 children in seventh grade were fully immunized in 2017, which is 95.9% of seventh graders

in the county; this is the same percentage as Florida.

Table 86: Immunization Levels in 7th Grade, Palm Beach County and Florida, 2015-2017



2015 14,405 93.5% 213,852 95.7%

2016 14,586 93.1% 217,350 96.3%

2017 15,204 95.9% 219,402 95.9% Source: Florida Department of Health, Bureau of Immunization, 2017 Compiled by: Health Council of Southeast Florida, 2018


Vaccine-Preventable Diseases

The table below shows the count and rate per 100,000 individuals of vaccine-preventable diseases in Palm Beach

County and Florida for the years 2012-2016. The rate of cases fluctuated in the county over the years shown, but

remained below that of the state. In 2016, there were 59 cases of vaccine-preventable diseases and a rate of 4.2 per

100,000 individuals.

Table 87: Selected Vaccine-Preventable Disease Rate for All Ages, Palm Beach County and Florida, 2012-2016


Count Rate Count Rate

2012 53 4 876 4.6

2013 57 4.2 1,120 5.8

2014 39 2.9 1,130 5.8

2016 59 4.2 1,070 5.3 Source: Florida Department of Health, Bureau of Epidemiology, 2016

Note: Includes: Diphtheria, Acute Hepatitis B, Measles, Mumps, Pertussis, Rubella, Tetanus, and Polio


Oral Health According to the Centers for Disease Control and Prevention, oral health impacts our quality of life because it affects

our ability to speak, smile, eat, and show emotions. 16 Oral health may also affect our self-esteem, school

performance, and attendance at work or school. Access to oral care is critical to health because oral diseases have

been linked to other chronic diseases such as diabetes and heart disease. In children, untreated cavities may cause

pain and infections that can lead to problems with eating, speaking, playing, and learning.17 Oral health is also

important during pregnancy, as some studies have found a link between gum disease and premature birth and low

birthweight.18 For every adult 19 years of age or older without medical insurance, there are three who are without

dental insurance. 19 There are also disparities in oral health; for example, non-Hispanic blacks, Hispanics, and

American Indians and Alaska Natives have the poorest oral health of all racial and ethnic groups in the country.20

Table 88 shows the counts and rates per 100,000 individuals of preventable hospitalizations for individuals under the

age of 65 for dental conditions in Palm Beach County and Florida in the years 2014-2016. In 2016, there were 165

preventable hospitalizations for individuals under the age of 65 from dental conditions, which is a rate of 15.4 per

100,000. The county’s 2016 rate (15.4) was higher than the state’s rate (13.7).

Table 88: Preventable Hospitalizations Under 65 from Dental Conditions, Palm Beach County and Florida, 2014-2016


Count Rate per 100,000 Count Rate per 100,000

2014 129 12.2 1,841 11.6

2015 140 13.1 1,835 11.4

2016 165 15.4 2,239 13.7 Source: Florida Agency for Health Care Administration (AHCA), 2016 ICD9-CM code(s): 521-523,525,528, ICD10-CM Code(s): K02, K03, K04, K05, K060, K061, K062, K08, K12, K13, M276, A690, K098


16 Centers for Disease Control and Prevention. (October 2015). Oral health basics. 17 Centers for Disease Control and Prevention. (January 2018). Children’s oral health. 18 March of Dimes. (January 2013). Dental health during pregnancy. 19 Centers for Disease Control and Prevention. (July 2016). Adult oral health. 20 Centers for Disease Control and Prevention. (May 2016). Disparities in oral health.


Behavioral Health This section provides data for the following indicators: domestic violence, alcohol consumption and substance use,

and suicides.

Domestic Violence

Victims of domestic violence may suffer direct injuries or indirect consequences such as stress. These injuries can

affect the cardiovascular, gastrointestinal, endocrine and immune systems.21 Victims may also suffer from

psychological effects from the violence.

The table below shows the number of reported domestic violence cases by offense type and victim’s relationship

to offender in Palm Beach County in 2016. There was a total of 4,291 reported domestic violence cases in 2016,

with 3,690 being simple assault and 1,014 being aggravated assault.

Table 89: Domestic Violence by Offense Type to Victim's Relationship to Offender, Palm Beach County, 2016

Offense Total Spouse Parent Child Sibling Other Family

Cohabitant Other Arrests

Simple Assault 3,690 892 541 259 358 283 964 393 2,817

Aggravated Assault 1,014 202 115 95 101 90 260 151 813

Rape 64 8 9 22 9 9 4 3 15

Threat/Intimidation 64 14 5 7 7 8 13 10 36

Simple Stalking 43 22 1 0 1 2 7 10 30

Fondling 31 0 6 16 7 2 0 0 2

Aggravated Stalking 8 5 0 0 0 2 0 1 7

Murder 6 5 0 1 0 0 0 0 5

Manslaughter 1 0 0 0 0 1 0 0 2

Total Offenses 4,921 1,148 677 400 483 397 1,248 568 3,727

Source: Florida Department of Law Enforcement, 2016 Compiled by: Health Council of Southeast Florida, 2018

Alcohol Consumption and Substance Use

Substance use can have serious health effects. Excessive alcohol use can increase the risk of developing health

problems such as brain and liver damage, heart disease, and hypertension.22 Tobacco use and smoking damage

almost every organ in the body and often lead to lung cancer, respiratory disorders, heart disease, and stroke.23

While the long-term effects of e-cigarettes are still unknown, it is evident most e-cigarettes contain nicotine, which is

toxic to developing fetuses and can harm brain development.24 Additionally, aerosols used in e-cigarettes may

contain cancer-causing chemicals. Marijuana use can cause problems with memory and learning, distorted

perception, loss of coordination, and difficulty in thinking and problem-solving.25 Given the national concern over the

opioid epidemic, information on opioid use is also presented in this section. The National Institute on Drug Abuse

highlights the highly addictive nature of opioids.26 Given that heroin is cheaper and easier to get than prescription

opioids in some places, nearly 80 percent of Americans using heroin reported prior misuse of prescription opioids.

21 Centers for Disease Control and Prevention. (August 2017). Intimate partner violence: Consequences. 22 Substance Abuse and Mental Health Services Administration. (October 2015). Alcohol. 23 Substance Abuse and Mental Health Services Administration. (October 2015). Substance use disorders. 24 Centers for Disease Control and Prevention. (April 2018). Electronic cigarettes. 25 Substance Abuse and Mental Health Services Administration. (November 2016). Marijuana (Cannabis). 26 National Institute on Drug Abuse. (2018). Prescription opioids.


This table shows the percent of adults who engaged in heavy or binge drinking in Palm Beach County and Florida for

the years 2007-2016. In the county, this percentage has continuously increased since 2007. The percentage of

adults who engaged in this behavior was the highest it has been in the years shown in 2016, with 17.8% of adults

engaging in this behavior. This percentage is similar to the 17.5% of adults who reported engaging in heavy or binge

drinking in the state.

Table 90: Percent of Adults Who Engage in Heavy or Binge Drinking, Palm Beach County and Florida, 2007-2016


2007 14.6% 16.2%

2010 14.8% 15.0%

2013 17.0% 17.6%

2016 17.8% 17.5% Source: Florida Behavioral Risk Factor Surveillance System, 2016 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the percent of high school students who reported binge drinking in Palm Beach County and

Florida for the years 2008-2016. The county’s percentage of adolescents engaging in this behavior has been

decreasing since 2008. This percentage reached the lowest it has been in the years shown in 2016 (9.8%). The

county’s percentage of high school students engaging in this behavior was higher than the state’s percentage in

every year except 2016; in this year, the percentage of high school students reporting binge drinking in Florida was

10.9%.

Table 91: Percent of High School Students Reporting Binge Drinking, Palm Beach County and Florida, 2008-2016


2008 21.8% 21.5%

2010 21.0% 19.6%

2012 18.1% 16.4%

2014 15.9% 13.7%

2016 9.8% 10.9% Source: Florida Department of Children and Families, Florida Youth Substance Abuse Survey (FYSAS), 2016 Compiled by: Health Council of Southeast Florida, 2018

This table shows the percent of middle school students who reported binge drinking in Palm Beach County and

Florida in the years 2008-2016. Trends in Palm Beach County show the percent of middle school students reporting

this behavior has continued to decrease since 2010. The percentage of middle school students who engaged in this

behavior fell to its lowest percentage in 2016 (3.3%). The percentages in the county and state have been similar for

the years shown.

Table 92: Percent of Middle School Students Reporting Binge Drinking, Palm Beach County and Florida, 2008-2016


2008 5.9% 6.2%

2010 6.6% 6.9%

2012 4.2% 4.7%

2014 4.2% 3.9%



Table 93 shows the percent of adults who were current smokers in Palm Beach County and Florida for the years

2007-2016. The percentage of adults who were current smokers in the county decreased by almost half from 2007 to

2010, but has been increasing since then. The percentage of adult smokers in the county was lower than the

percentage of adult smokers in the state between 2007 and 2013 but was slightly higher in 2016. The most recent

data shows the percent of adults who were current smokers in the county was 16.3% and 15.5% in the state.

Table 93: Adults Who Are Current Smokers, Palm Beach County and Florida, 2007-2016


2007 17.5% 19.3%

2010 9.0% 17.1%

2013 9.5% 16.8%

2016 16.3% 15.5% Source: Florida Behavioral Risk Factor Surveillance System, 2016 Compiled by: Health Council of Southeast Florida, 2018

This table shows the percent of high school students who smoked cigarettes in the past 30 days in Palm Beach

County and Florida in the years 2008-2016. In the county, the percentage of high school students who reported

smoking cigarettes in the past 30 days has been declining since 2010. The percentage of high school students who

engaged in this behavior was the lowest it has been in the five years shown in 2016 (2.7%). The percent of high

school students in Palm Beach County engaging in this behavior has been lower than in the state; the 2016 data

shows these numbers as 2.7% and 5.2%, respectively.

Table 94: Percent of High School Students Smoking Cigarettes in the Past 30 Days, Palm Beach County and Florida, 2008-2016


2008 11.4% 14.5%

2010 13.0% 13.1%

2012 9.3% 10.1%

2014 7.2% 7.5%



The table below shows the percent of middle school students who reported smoking cigarettes in the past 30 days in

Palm Beach County and Florida in the years 2008-2016. Trends for Palm Beach County show the percent of middle

schoolers engaging in this behavior has continued to decrease since 2008. The percentage of middle school

students who engaged in this behavior was the lowest it has been in the five years shown in 2016 (1.3%). The

percentage of middle school students in the county who reported smoking was consistently lower than in the state. In

2016, 1.3% of middle school students in the county reported smoking while 1.7% of students in the state reported

smoking.

Table 95: Percent of Middle School Students Smoking in the Past 30 days, Palm Beach County and Florida, 2008-2016


2008 4.2% 5.0%

2010 4.2% 4.9%

2012 2.6% 3.3%

2014 2.5% 2.3%


This table shows the percent of adults who are current e-cigarette users in Palm Beach County and Florida in 2016.

In the county, 6.4% of adults were e-cigarette smokers; this is higher than the state’s percent of 4.7%.

Table 96: Percent of Adults Who Are Current E-cigarette Users, Palm Beach County and Florida, 2016


2016 6.4% 4.7% Data Source: Florida Behavioral Risk Factor Surveillance System, 2016


Table 97 shows the percent of adults who used marijuana or hashish during the past 30 days in Palm Beach County

and Florida in 2016. In Palm Beach County, 5.7% of adults reported using marijuana or hashish during the past 30

days; in the state, 7.4% of the adult population reported marijuana or hashish use.

Table 97: Percent of Adults Who Used Marijuana or Hashish During the Past 30 Days, Palm Beach County and Florida, 2016


2016 5.7% 7.4% Data Source: Florida Behavioral Risk Factor Surveillance System, 2016



This table shows the percent of high school students who reported using marijuana/hashish in the past 30 days in

Palm Beach County and Florida for the years 2008-2016. In the county, the percentage of high school students

who reported using marijuana/hashish has fluctuated and in 2016 was the lowest it had been in the years

presented, at 15.4%. The county’s percentage of high schoolers who engaged in this behavior was higher than the

state’s for all years shown except 2016. In this year, the county’s percentage was 15.4% and the state’s was

17.0%. Table 98: Percent of High School Students Using Marijuana/Hashish in the Past 30 Days, Palm Beach County and Florida, 2008-2016


2008 17.4% 16.2%

2010 22.7% 18.6%

2012 20.6% 18.5%

2014 22.6% 18.6%


The table below shows the percent of middle school students who reported using marijuana/hashish in the past 30

days in Palm Beach County and Florida in the years 2008-2016. In the county, the percentage of middle schoolers

engaging in this behavior has consistently decreased since 2010. The percentage of middle school students who

engaged in this behavior was the lowest it has been in the five years shown in 2016, at 2.4%. For the years

provided, the county’s percentage of middle schoolers who reported using marijuana/hashish in the past 30 days

was typically lower than that of the state.

Table 99: Percent of Middle School Students Using Marijuana/Hashish in the Past 30 Days, Palm Beach County and Florida, 2008-2016


2008 3.8% 4.4%

2010 6.0% 5.7%

2012 2.7% 4.2%

2014 4.1% 4.2%



This table shows opioid-related emergency department visits from those living in Bethesda Health’s service area in

2016. Included are visits with opioids coded as the principal diagnosis as well as other diagnoses (1-9). There

were 594 emergency department visits in which opioids were related to the primary diagnosis and 1,586

emergency department visits in which opioids were related to either the principal or other diagnosis.

Table 100: Opioid-Related Emergency Department Visits, Bethesda Health’s Service Area, 2016

Diagnosis Code Count

Principal Diagnosis 594

Other Diagnosis 1 513









Total 1,586

Source: Agency for Health Care Administration (AHCA), Emergency Department Visits, 2016 Data Note(s): Includes F11-F11.99 CPT Codes Compiled by: Health Council of Southeast Florida, 2018

Table 101 shows opioid-related inpatient discharges for those living in Bethesda Health’s service areas in 2016.

This data includes inpatient discharges in which opioids were related to the principal diagnoses as well as other

diagnoses (1-30). There were 315 inpatient discharges in which opioids were related to the principal diagnoses and

2,048 inpatient discharges in which opioids were related to either the principal or other diagnosis.

Table 101: Opioid-Related Inpatient Discharges, Bethesda Health’s Service Area, 2016


Principal Diagnosis 315











All Other (11-30) 137

Total 2,048

Source: American Health Care Administration (AHCA), 2016 Data Note(s): Includes F11-F11.99 CPT Codes Compiled by: Health Council of Southeast Florida, 2018


Below are the number of psychoactive substance use-related emergency department visits for those living in

Bethesda Health’s service area in 2016. This data includes emergency department visits in which psychoactive

substances were related to the principal diagnosis as well as other diagnoses (1-9). Bethesda’s service area

residents had 4,508 emergency department visits in which psychoactive substance use was related to the

principal diagnosis and 32,250 emergency department visits in which a diagnosis was related to psychoactive

substance use either as the principal or other diagnosis.

Table 102: Psychoactive Substance Use-Related Emergency Department Visits, Bethesda Health’s Service Area, 2016


Principal Diagnosis 4,508

Other Diagnosis 1 12,799









Total 35,250

Source: American Health Care Administration (AHCA), 2016 Data Note(s): Includes F10.0-F19.99 CPT Codes Compiled by: Health Council of Southeast Florida, 2018


The table below has the psychoactive substance use-related inpatient discharges for residents of Bethesda Health’s

service areas in 2016. This data contains inpatient discharges in which psychoactive substances were related to the

principal diagnosis as well as other diagnoses (1-30). Bethesda’s service area residents had 1,496 inpatient

discharges in which psychoactive substance use was related to the principal diagnosis and 16,266 inpatient

discharges in which a diagnosis was related to psychoactive substance use either as the principal diagnosis or other diagnosis. Table 103: Psychoactive Substance Use-Related Inpatient Discharges, Bethesda Health's Service Areas, 2016


Principal Diagnosis 1,496











All Other (11-30) 2,668

Total 16,266

Source: American Health Care Administration (AHCA), 2016 Data Note(s): Includes F10-F19 CPT Codes Compiled by: Health Council of Southeast Florida, 2018

Youth Bullying and Delinquent Behavior

Bullying can have adverse effects on the health of those who bully others and those who are bullied, which may

persist into adult life. Children who bully others are more likely to abuse alcohol and other drugs later in life; get into

fights, vandalize property, and drop out of school; engage in early sexual activity; have criminal convictions as

adults; and be abusive towards their partners or children as adults.27 Children who are bullied may experience

physical, school, and mental health issues. These children are more likely to have depression and anxiety, feelings

of sadness and loneliness; changes in sleep and eating patterns; health complaints; and decreased academic

achievement. The StopBullying.gov website notes that of the 15 school shootings in the 1990s, 12 of the shooters

had a history of being bullied. Delinquent behavior can also negatively affect, health as research has found this

behavior is significantly associated with smoking, alcohol consumption, and drug use.28

27 StopBullying.gov. (2017). Effects of bullying. Retrieved from https://www.stopbullying.gov/at-risk/effects/index.html 28 Junger, M., Stroebe, W., Van der Laan, A.M. (2010). Delinquency, health behavior and health. British Journal of Health Psychology, 6(2), 103-120.

http://www.stopbullying.gov/at-risk/effects/index.html


This table shows the percent of youth in Palm Beach County and Florida who reported involvement in bullying

behavior in 2016. The county’s percentages were higher than the state's for the following measures: the percent of

middle schoolers who were victims of cyberbullying in the past 30 days (8.3%), the percent of middle schoolers who

verbally bullied others in the past 30 days (14.7%), the percent of middle schoolers who cyberbullied others in the

past 30 days (4.2%), the percent of high schoolers who were kicked or shoved in the past 30 days (8.3%), and the

percent of high schoolers who physically bullied others in the past 30 days (5.4%).

Table 104: Percentage of Palm Beach and Florida Statewide Youth Who Reported Involvement in Bullying Behavior, 2016

Palm Beach Florida

Middle School High School Middle School High School

Skipped school because of bullying 5.1% 7.9% 7.6% 8.2%

Was kicked or shoved in past 30 days 18.3% 8.3% 19.6% 8.1%

Was taunted or teased in past 30 days 32.1% 20.8% 35.3% 22.5%

Was victim of cyberbullying in past 30 days

8.3% 6.6% 7.8% 7.6%

Physically bullied others in past 30 days 7.5% 5.4% 7.6% 4.9%

Verbally bullied others in past 30 days 14.7% 10.3% 14.3% 10.4%

Cyberbullied others in past 30 days 4.2% 4.0% 3.6% 4.1%

Source: Florida Department of Children and Families, Florida Youth Substance Abuse Survey (FYSAS), 2016 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the percentage of youth in Palm Beach County and Florida who reported engaging in

delinquent behavior in the past 12 months for the year 2016. The percentages in the county are lower than in the

state for all behaviors except the percent of middle schoolers who reported taking a handgun to school (0.6% in the

county and 0.4% in the state) and the percent of middle schoolers who reported attacking someone with intent to

harm (6.2% in the county and the state).

Table 105: Percentage of Palm Beach and Florida Statewide Youth Who Reported Engaging in Delinquent Behavior Within the Past 12 Months, 2016

Palm Beach Florida

Middle School High School Middle School High School

Carrying a handgun 2.7% 4.7% 5.0% 5.8%

Selling drugs 1.3% 4.9% 1.6% 6.0%

Attempting to steal a vehicle 0.8% 0.9% 1.0% 1.5%

Being arrested 1.7% 2.4% 1.9% 2.8%

Taking a handgun to school 0.6% 0.4% 0.4% 0.7%

Getting suspended 10.5% 7.5% 10.6% 9.1%

Attacking someone with intent to harm 6.2% 4.9% 6.2% 6.1%

Source: Florida Department of Children and Families, Florida Youth Substance Abuse Survey (FYSAS), 2016 Compiled by: Health Council of Southeast Florida, 2018


Suicides

The prevalence of suicide is important in the context of community health planning since it may identify gaps in

services, challenges in accessing care, the need for additional prevention efforts, and opportunities to improve the

mental health system of care.

The table below shows the number of suicides and the age-adjusted suicide death rate per 100,000 individuals in

Palm Beach County and Florida in the years 2014-2016. There were 230 suicides in the county in 2016 and a rate of

15.2 per 100,000. The suicide rates for the county have been higher than the state’s in the three years shown; in

2016, the state had a rate of 14.1 suicides per 100,000.

Table 106: Suicide Deaths, Palm Beach County and Florida, 2014-2016

Years

Palm Beach Florida


2014 236 15 2,961 13.8

2015 229 15.5 3,152 14.5

2016 230 15.2 3,122 14.1

Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): X60-X84, Y87.0 Compiled by: Health Council of Southeast Florida, 2018


The figure below shows the age-adjusted suicide death rate per 100,000 individuals by race in Palm Beach County

and Florida for the years 2014-2016. Trends in the county show a fluctuation throughout the across races. Individuals

identifying as White in Palm Beach County had higher suicide rates than individuals identifying as Black & Other in

the three years shown; in 2016, individuals identifying as White had a suicide rate 2.5 times higher than individuals

identifying as Black & Other (17.5 and 6.6, respectively). When comparing county and state, individuals identifying

as White in Palm Beach had a higher suicide death rate than in the state in all three years; in 2016 these rates were

17.5 and 16.0, respectively). Individuals identifying as Black & Other in the county had consistently higher death

rates in the county.

Figure 16: Suicide Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016

18 16.8

15.7

18.3

16.7

17.5

16

14

12

10

8 7.2 6.5 6.6

5.8 5.3 6.1

4

2

0

2014 2015 2016

Palm Beach White Palm Beach Black & Other Florida White Florida Black & Other



Figure 17 shows the suicide death rate per 100,000 individuals by ethnicity in Palm Beach County and Florida for the

years 2014-2016. Trends in the county show a fluctuating suicide death rate for individuals identifying as Hispanic

and a fairly constant suicide death rate for individuals identifying as non-Hispanic. Individuals identifying as non-

Hispanic in the county have had consistently higher suicide death rates than individuals identifying as Hispanic; in

2016, individuals identifying as non-Hispanic had a suicide death rate more than double that of individuals identifying

as Hispanic (17.1 and 7.5, respectively). The suicide death rate for the non-Hispanic population in Palm Beach

County (17.1) has been higher than the state’s rate (16.1). Individuals identifying as Hispanic in the county had a

higher suicide death rate than in the state in 2015 and 2016; in 2016 these rates were 7.5 and 7.3, respectively.

Figure 17: Suicide Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016

20

18 17.2 17

15.5

16.4

17.1

16.1

14

12

8 6.5

6

9.9

7.9 8.1

7.5

7.3

4

2

0

2014 2015 2016

Palm Beach Hispanic Palm Beach Non-Hispanic Florida Hispanic Florida Non-Hispanic


Data note(s): ICD-10 Code(s): X60-X84, Y87.0 Compiled by: Health Council of Southeast Florida, 2018


The table below shows the number of suicides and suicide death rate per 100,000 individuals in Palm Beach County

and Florida by gender in the years 2014-2016. In Palm Beach County, there were 156 male suicide deaths and a rate

of 21.6 per 100,000 and 74 female suicide deaths and a rate of 9.2 per 100,000 in 2016. Males in the county have a

suicide rate 2.3 times higher than females. The suicide death rate decreased from 2014 to 2015 for males in the

county and has remained constant. For females in the county, the suicide death rate has fluctuated over the three

years shown. When comparing the county to the state, females in Palm Beach County have had a higher suicide

death rate than females in the state over the three years shown; in 2016, these rates were 9.2 and 7.0, respectively.

Males in the county had a lower death rate than males in the state in 2015 and 2016; in the most recent data

available, these rates were 21.6 and 21.7, respectively.

Table 107: Suicide Deaths by Gender, Palm Beach County and Florida, 2014-2016

Male

Palm Beach Female

Male

State

Female

Years

Count Rate per

100,000

Count

Rate per

100,000

Count

Rate per

100,000

Count

Rate per

100,000

2014 177 23.5 59 7 2,277 21.9 684 6.3

2015 156 21.6 73 10 2,412 22.8 740 6.8

2016 156 21.6 74 9.2 2,345 21.7 777 7.0


Mental Health

Mental health is a serious health issue as it can affect quality of life and put individuals at risk of developing unhealthy

or unsafe behaviors such as alcohol or drug abuse, violence or self-destructive behavior, and suicide.29 Mental health

disorders can affect physical health as well as they have been associated with chronic diseases such as diabetes,

heart disease, and cancer.

Mental Health

Table 108 below shows the percent of adults who indicated they had good mental health in Palm Beach County

and Florida for the years 2010, 2013, and 2016. This percentage has steadily decreased in the county over the

years shown. The percentage in the county was higher than in the state in 2010 and 2013 but fell below in 2016.

This data indicates that 11.7% of adults in the county reported having less than "good" mental health in 2016.

Table 108: Percent of Adults with Good Mental Health, Palm Beach County and Florida, 2010-2016


2010 90.6% 88.2%

2013 90.4% 87.3%

2016 88.3% 88.6%

Source: Florida Behavioral Risk Factor Surveillance System, 2016 Notes: Caution should be taken when comparing 2013 data with previous years due to changes in survey methodology. Compiled by: Health Council of Southeast Florida, 2018

29 Healthy People 2020. (n.d.). Mental health. Retrieved from https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Mental-Health

http://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Mental-Health


This table shows the average number of poor mental health days reported in the past 30 days in Palm Beach County and

Florida for the years 2010, 2013, and 2016. The average number of poor mental health days in the county has fluctuated

over the years shown and increased to 3.6 in 2016; this was the same as the state. The data for the

2013 and 2016 shows the county’s average number of poor mental health days was below that of the state.

Table 109: Average Number of Poor Mental Health Days in the Past 30 Days, Palm Beach County and Florida, 2010-2016


2010 3.2 3.8

2013 3.1 4.1

2016 3.6 3.6

Source: Florida Behavioral Risk Factor Surveillance System, 2016 Notes: Caution should be taken when comparing 2013 data with previous years due to changes in survey methodology. Compiled by: Health Council of Southeast Florida, 2018

Number of Psychiatric Beds

The table below shows the counts and rates per 100,000 individuals of adult psychiatric beds in Palm Beach County

and Florida for the years 2012-2016. The count of adult psychiatric beds in the county has not changed in the five

years provided. The county’s number of beds has been consistently lower than the state's. The most recent data

shows in the county there were 224 beds and a rate of 16.1 per 100,000 individuals. Florida had a rate of 20.8 beds

per 100,000 in 2016.

Table 110: Adult Psychiatric Beds, Palm Beach County and Florida, 2012-2016

Year

Palm Beach Florida


2012 224 16.7 3,736 19.5

2013 224 16.6 3,862 20

2014 224 16.4 3,968 20.3

2015 224 16.2 4,182 21

2016 224 16.1 4,208 20.8

Source: Florida Agency for Health Care Administration (AHCA), 2016 Compiled by: Health Council of Southeast Florida, 2018


This table below has counts and rates per 100,000 individuals of child and adolescent psychiatric beds in Palm

Beach County and Florida for the years 2012-2016. The number of child and adolescent beds has not

changed during this number. The rate of beds in the county has been consistently lower than in the state.

Table 111: Child and Adolescent Psychiatric Beds, Palm Beach County and Florida, 2012-2016

Year

Palm Beach Florida


2012 27 2 522 2.7

2013 27 2 520 2.7

2014 27 2 538 2.7

2015 27 2 513 2.6

2016 27 1.9 545 2.7



Morbidity and Mortality Morbidity is another term for illness. The tables and figures in the section below present the counts and rates for the

following diseases: Alzheimer’s; diabetes; congestive heart failure; stroke; cancer; HIV; AIDS; sexually transmitted

diseases; asthma; gastroenteritis; kidney/urinary infections; ear, nose, and throat infections; self-inflicted injuries,

firearm injuries, eating disorders, and falls.

Mortality is another term for death. The tables and figures in the section below present the counts and rates for the

following diseases: Alzheimer’s, respiratory diseases, major cardiovascular diseases, congestive heart failure, stroke,

cancer, diabetes, HIV/AIDS, unintentional injuries, firearm discharge, homicide, and drug poisoning.

Morbidity

This table shows the counts and rates per 100,000 individuals of preventable hospitalizations for those

individuals under the age of 65 for all conditions in Palm Beach County and Florida for the years 2014-2016. The

preventable hospitalization rate for the county has fluctuated in the years provided. In 2016, there were 12,245

preventable hospitalizations for all conditions and a rate of 1,139.70; this was higher than the state’s rate of

1,130.3. Table 112: Preventable Hospitalizations for Individuals Under the Age of 65 from All Conditions, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 11,945 1,128.60 188,273 1,181.9

2015 11,965 1,120.60 186,540 1,158.4

2016 12,245 1,139.70 184,205 1,130.3



Table 113 shows the population utilizing Your Aging & Disability Resource Center (ADRC) services and the number

of individuals with various disabilities living in each of Bethesda Health's primary service area ZIP codes as of April

2017. There was a total population of 167,957 individuals aged 60 and over in Bethesda’s primary service area. Of

these, 10,064 received SNAP benefits; 1,183 were clients of ADRC; and 1,623 individuals were on the waitlist. In

addition, there were 706 meal sites, 252 clients who received delivered meals, and 478 who were on the list for meal

delivery. A total of 8,624 individuals 65 years and over had difficulty with self-care or activities of daily living (ADL);

15,578 had difficulty with instrumental activities of daily living (IADL) or independent living; and 8,959 had cognitive

difficulties.

Table 113: Senior Services Provided, Bethesda Health's Primary Service Area ZIP Codes, 2017

ZIP Code

Total Population

60+

SNAP Participation

Active Clients

(All Services)

Waitlist Clients

(All Services)

Active Clients (Meal Sites)

Active Clients

(Delivered Meals)

Waitlist Clients

(Delivered Meals)

Total with Self-

care/ADL Difficulty

65+

Total with

Independent Living/IADL

Difficulty 65+

Total with

Cognitive Difficulty

65+

33414 9,924 407 36 67 17 11 18 428 737 432

33426 5,890 303 56 53 40 7 15 644 886 512

33435 8,891 916 189 122 144 28 41 367 789 577

33436 14,926 577 90 121 63 16 40 570 1,429 718

33437 23,212 276 60 120 26 16 34 1,033 1,853 906

33444 4,590 839 82 83 46 22 29 283 514 274

33445 11,181 537 45 91 27 10 22 869 1,333 700

33446 14,927 475 90 128 53 17 36 896 1,375 716

33449 2,660 43 4 10 2 1 5 100 205 164

33460 4,998 895 44 61 17 15 19 177 323 387

33461 7,305 1,412 117 128 86 21 37 391 463 396

33462 7,607 680 52 101 19 15 28 396 854 557

33463 8,303 1,314 95 124 56 22 41 347 821 548

33467 17,349 645 87 145 47 17 42 795 1,508 854

33472 8,603 119 16 45 7 3 10 243 500 126

33473 1,728 25 6 2 5 1 0 18 67 34

33484 15,863 601 114 222 51 30 61 1,067 1,921 1,058

Total 167,957 10,064 1,183 1,623 706 252 478 8,624 15,578 8,959

Source: Your Aging & Disability Resource Center, Palm Beach County, 2017 Notes: ADL refers to activities of daily living; IADL refers to instrumental activities of daily living Compiled by: Health Council of Southeast Florida, 2018


This table shows the population utilizing services and the number of individuals with specific disabilities in

Bethesda's secondary service area as of April 2017. There was a total population of 96,601 individuals 60 years

and over in Bethesda's secondary service area. In total, 5,441 individuals over 60 years utilized SNAP benefits;

625 used ARDC services; and 868 individuals were on the waitlist for services. Additionally, there were 312 meal sites, 153 individuals who were delivered meals, and 255 who were on the waitlist for meals. A total of 6,239 individuals had difficulty with self-care and activities of daily living (ADL); 9,942 had difficulty with instrumental

activities of daily living (IADL) or living independently; and 5,037 had cognitive difficulties. Table 114: Senior Services Provided, Bethesda Health's Secondary Service Area ZIP Codes, 2017

ZIP Total

SNAP

Code Population

Participation 60+

Active Clients

All Services

Waitlist Clients

All Services

Active Clients (Meal Sites)

Active Clients

(Delivered Meals)

Waitlist Clients

(Delivered Meals)

Total

with Self- care/ADL Difficulty

65+

Total with

Independent Living/IADL

Difficulty 65+

Total with Cognitive Difficulty

65+

33405 4,127 681 50 94 11 23 32 551 626 480

33406 3,878 604 31 62 18 6 20 117 250 243

33413 2,516 249 21 22 11 3 10 428 227 53

33415 9,089 1,678 161 183 93 40 54 667 1,233 604

33428 8,636 579 66 95 26 20 26 519 1,023 486

33431 4,681 134 32 30 14 8 5 216 503 167

33432 7,222 186 20 24 10 2 9 387 653 292

33433 15,533 303 45 76 19 12 8 1,019 1,745 911

33434 10,182 449 103 152 51 23 54 654 1,127 501

33483 5,027 101 12 16 8 1 6 248 459 288

33486 5,225 119 23 15 17 2 5 339 437 232

33487 6,766 112 15 29 9 2 6 232 349 176

33496 9,831 153 33 46 19 7 13 663 994 412

33498 3,888 93 13 24 6 4 7 199 316 192

Total 96,601 5,441 625 868 312 153 255 6,239 9,942 5,037 Source: Your Aging & Disability Resource Center, Palm Beach County, 2017 Notes: ADL- Activities of Daily Living; IADL - Instrumental Activities of Daily Living Compiled by: Health Council of Southeast Florida, 2018


Alzheimer’s

The table below shows probable Alzheimer’s cases for those aged 65 years and older in Palm Beach County and

Florida in 2014-2017. The percentage of probable cases in the county has fluctuated in the years shown. In 2017,

there were 50,925 probable cases of Alzheimer’s in Palm Beach County, which is an increase from

2016.

Table 115: Probable Alzheimer's Cases (65+), Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 47,227 15.4% 485,000 13.3%

2015 47,106 15.0% 489,003 12.9%

2016 47,890 14.9% 507,862 12.9%

2017 50,925 15.5% 541,446 13.3%

Source: Department of Elder Affairs, 2017 Compiled by: Health Council of Southeast Florida, 2018

Diabetes

This table shows the counts and age-adjusted rate of hospitalizations from or with diabetes per 100,000 individuals in

Palm Beach County and Florida for the years 2014-2016. The hospitalization rate has continuously increased for the

county in the three years provided. There were 38,330 hospitalizations from or with diabetes in the county in 2016,

which was a rate of 1,847.30 per 100,000 individuals. The county’s rate for this indicator has been consistently lower

than the state's.

Table 116: Hospitalizations from or with Diabetes, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 36,212 1,797.9 594,637 2,321.2

2015 37,574 1,835.0 617,606 2,350.4

2016 38,330 1,847.3 632,161 2,344.5

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 250.00-250.93 and ICD-10-CM Code(s): E10, E11, E13. Includes both primary and contributing diagnoses. Compiled by: Health Council of Southeast Florida, 2018


Figure 18 shows the age-adjusted rate of hospitalizations from or with diabetes per 100,000 individuals by race in

Palm Beach County and Florida for the years 2014-2016. For both racial groups in the county, the hospitalization rate

has fluctuated in the time period shown. Individuals identifying as Black & Other has had consistently higher rates of

hospitalizations than individuals identifying as White; in 2016, individuals identifying as Black & Other had a

hospitalization rate 2.5 times that of individuals identifying as White (3,902.4 and 1,450.4, respectively). Individuals

identifying as White in the county had consistently lower hospitalization rates than those in the state; in 2016 these

rates were 1,450.4 and 1,974.8, respectively. Similarly, individuals identifying as Black & Other in the county had

consistently lower death rates than in the state. In 2016, identifying as Black & Other in the county had a

hospitalization rate of 3,902.4 and those in the state had a hospitalization rate of 4,221.1.

Figure 18: Age-Adjusted Hospitalization Rates from or with Diabetes, by Race, Palm Beach County and Florida, 2014- 2016

4500

4000

4121.6

4410.8 4284.3 4221.1

3869.3 3902.4

3500

3000

2500

1500

1934.1 1969.4 1974.8

1387.8 1453.1 1450.4

1000

500

0

2014 2015 2016

Palm Beach Palm Beach Florida Florida

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 250.00-250.93 and ICD-10-CM Code(s): E10, E11, E13. Includes both primary and contributing diagnoses. Compiled by: Health Council of Southeast Florida, 2018


2,341.5 2,339.6

This figure shows the age-adjusted rate of hospitalizations from or with diabetes per 100,000 individuals by ethnicity

in Palm Beach County and Florida for the years 2014-2016. Individuals identifying as Hispanic in the county have

had a fluctuating hospitalization rate over the years shown while individuals identifying as non-Hispanic have had a

steady increase in hospitalizations from 2014-2016. In the county, individuals identifying as Hispanic have had

higher hospitalization rates than individuals identifying as non-Hispanic; in 2016 these rates were 2,071.7 and

1,813.7, respectively. Individuals identifying as Hispanic in the county have had consistently lower hospitalization

rates than individuals identifying as Hispanic in the state. The 2016 data shows individuals identifying as Hispanic in

the county had a hospitalization rate of 2,071.0 while those in the state had a hospitalization rate of 2,365.2.

Individuals identified as non-Hispanic in the county also had lower hospitalization rates than individuals identifying

as non- Hispanic in the state over the years provided; in 2016, these rates were 1,813.7 and 2,339.6, respectively.

Figure 19: Age-Adjusted Hospitalization Rates from or with Diabetes by Ethnicity, Palm Beach County and Florida, 2014-2016

4500

4000

3500

3000

2500

2000

2,410.1 2,412.6 2,365.2

2,285.8 2,000.3 1,992.4 2,071.7

1,737.9 1,805.0 1,813.7

1500

1000

500

0

2014 2015 2016


Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 250.00-250.93. Includes both primary and contributing diagnoses ICD-10-CM Code(s): E10, E11, E13. Includes both primary and contributing diagnoses. Compiled by: Health Council of Southeast Florida, 2018


The table below shows the count and rate of emergency department visits due to diabetes per 100,000 individuals in

Palm Beach County and Florida for the years 2013-2016. The rate of emergency department visits due to diabetes

has increased in the county since 2013. The county’s rate for emergency department visits due to diabetes has been

consistently lower than the state’s during this time.

Table 117: Emergency Department Visits Due to Diabetes, Palm Beach County and Florida, 2013-2016

Year

Palm Beach Florida


2013 1,986 147.2 36,313 188

2014 2,022 148.2 38,483 196.5

2015 2,172 157.1 41,061 206.4

2016 2,319 166.2 46,417 229.4

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 250.00-250.93. Includes both primary and contributing diagnoses ICD-10-CM Code(s):E10, E11, E13. Includes both primary and contributing diagnoses. Compiled by: Health Council of Southeast Florida, 2018

Table 118 shows the count and rate of emergency department visits due to diabetes per 100,000 individuals by race

in Palm Beach County and Florida for the years 2013-2016. The rate of emergency room visits due to diabetes has

consistently increased for individuals identifying as White in the county in the years shown and fluctuated for

individuals identifying as Black & Other. Individuals identifying as Black & Other in the county have had consistently

higher rates of emergency room visits than individuals identifying as White. During the years included, this disparity

has been more than threefold. Emergency department visits in the county rates across all races have been

consistently lower than the state.

Table 118: Emergency Department Visits Due to Diabetes by Race, Palm Beach County and Florida, 2013-2016

Wh

ite

Palm Beach Black

& Other

White

Florida

Black & Other Year





2013 865 83.7 1,111 352.9 19,831 131.3 16,266 386.6

2014 891 85.6 1,122 346.5 21,763 142.4 16,483 383.2

2015 1,089 103.7 1,073 322.7 23,652 152.7 17,168 389.8

2016 1,130 107.0 1,176 346.4 26,716 169.9 19,498 432.5

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 250.00 - 250.93 and ICD-10-CM Code(s): E10, E11, E13.10, and E13.65. Includes primary and contributing diagnoses. Compiled by: Health Council of Southeast Florida, 2018


2010-2016

This table shows the count and rate of emergency department visits due to diabetes per 100,000 individuals by

ethnicity in Palm Beach County and Florida for the years 2013-2016. There has been an increase in the rate of

emergency room visits due to diabetes in the county for the years shown. In Palm Beach County, individuals

identifying as non-Hispanic have had a higher rate of emergency room visits than individuals identifying as Hispanic.

Table 119: Emergency Room Visits Due to Diabetes by Ethnicity, Palm Beach County and Florida, 2013-2016

Hisp

anic

Palm Beach Non-Hi

spanic

Hisp

anic

Florida

Non-Hi

spanic

Year Count

Rate per 100,000




2013 321 118.8 1,640 152.1 6,813 151.7 29,067 196.1

2014 343 124 1,646 151.2 7,228 156.1 30,635 204.9

2015 375 131.4 1,754 159.9 7,863 164.1 32,584 215.7

2016 409 139.2 1,887 171.4 8,976 180.9 36,810 241.1

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 250.00 - 250.93. Includes primary and contributing diagnoses. ICD-10-CM Code(s): E10, E11, E13.10, and E13.65. Includes primary and contributing diagnoses. Compiled by: Health Council of Southeast Florida, 2018

Overweight and Obesity

The table below shows the percentage of adults who reported being overweight in Palm Beach County and Florida

for the years 2010, 2013, and 2016. The percentage of adults who reported being were overweight in the county has

continuously decreased over the years shown. In 2016, almost a third of adults in the county reported being

overweight. The county’s percentage of adults who reported being overweight was higher than the state in 2010 and

2013.

Table 120: Percentage of Adults Who Are Overweight, Palm Beach County and Florida,


2010 41.8% 37.8%

2013 40.2% 36.4%

2016 32.1% 35.8%

Source: Behavioral Risk Factor Surveillance System (BRFSS), 2016 Compiled by: Health Council of Southeast Florida, 2018


This table shows the percentage of adults who reported being obese in Palm Beach County and Florida for the years

2010, 2013, and 2016. In the county, the percentage of adults who reported being obese increased over the years

shown, but remained below the state. In 2016, over a fifth of adults in the county reported being obese.

Table 121: Percentage of Adults who are Obese, Palm Beach County and Florida, 2010-2016


2010 19.4% 27.2%

2013 19.9% 26.4%

2016 20.8% 27.4%


Table 122 shows the percentage of adults in Palm Beach County and Florida who reported being overweight or

obese in 2010, 2013, and 2016. In the county, the percentage of adults who reported being overweight or obese has

declined over the years shown. And, the county’s percentage has remained below that of the state in the years

provided. In 2016, over half of the population in the county reported being overweight or obese.

Table 122: Percentage of Adults Who Are Overweight or Obese, Palm Beach County and Florida, 2010-2016


2010 61.3% 65.0%

2013 60.1% 62.8%

2016 52.9% 63.2%


Congestive Heart Failure

The table below shows the counts and age-adjusted rates of hospitalizations from congestive heart failure per

100,000 individuals in Palm Beach County and Florida for the years 2014-2016. The hospitalization rate from

congestive heart failure in the county decreased considerably from 2015 to 2016. There were 3,972

hospitalizations from congestive heart failure in the county in 2016, which is a rate of 158.7 hospitalizations per

100,000 individuals. Table 123: Hospitalizations from Congestive Heart Failure, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 4,595 188.6 65,666 240.8

2015 4,655 188.6 68,444 244.2

2016 3,972 158.7 57,727 200.7

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 428.0, 428.2, 428.3, 428.4, 428.9 and ICD-10-CM Code(s): I50.2, I50.3, I50.4, I50.9. Includes primary diagnosis only. Compiled by: Health Council of Southeast Florida, 2018


The figure below shows the age-adjusted rate of hospitalizations from congestive heart failure per 100,000

individuals in Palm Beach County and Florida by race for the years 2014-2016. While there has been a downward

trend in the hospitalization rates across all races in the county, individuals identifying as Black & Other have higher

hospitalization rates. In 2016 the hospitalization rates for those identifying as Black & Other was more than double

those identifying as White (322.2 and 126.2, respectively). The hospitalization rates for both racial groups in Palm

Beach County have been lower than the hospitalizations rates in Florida

Figure 20: Age-Adjusted Hospitalization Rates from Congestive Heart Failure by Race, Palm Beach County and Florida, 2014-2016

500

450

400

350

386.4

457.8 450.5

356.3

322.2

365.9

300

250

200

150

198.9 202.3

153.6 153.2

126.2

167.1

100

50

0

2014 2015 2016




The figure below shows the age-adjusted rate of hospitalizations from congestive heart failure per 100,000 individuals

in Palm Beach County and Florida by ethnicity for the years 2014-2016. In the county, the hospitalization rate for

individuals identifying as Hispanic has fluctuated over the years shown but has decreased for individuals

identifying as non-Hispanic. The hospitalization rate for individuals identifying as non-Hispanic was higher than for

Hispanics in 2014 and 2015; however, in 2016 the hospitalization rate for individuals identifying as non-Hispanic

(158.6) fell below that of individuals identifying as Hispanic (159.6). The hospitalization rates for both Hispanic and non-

Hispanics in Palm Beach County have been lower than the hospitalizations rates for Florida.

Figure 21: Age-Adjusted Hospitalization Rates from Congestive Heart Failure by Ethnicity, Palm Beach County and Florida, 2014-2016

500

450

400

350

300

250

200

150

242.6 249.1

224.8 224.1 190 189.7

163 171.2 159.6

158.6

184.2

204.4

100

50

0

2014 2015 2016




Stroke

This table shows the counts and age-adjusted rate of hospitalizations from strokes per 100,000 individuals in Palm

Beach County and Florida for the years 2014-2016. In the county, the rate of hospitalizations due to strokes has

steadily decreased since 2014. In 2016, there were 4,347 hospitalizations from strokes in the county and a rate of

190.7; this rate is lower than the state’s rate (228.8).

Table 124: Hospitalizations from Strokes, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 4,530 204.8 66,968 250.8

2015 4,396 195.4 67,046 244

2016 4,347 190.7 64,740 228.8

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 430-438. Includes primary diagnosis only. ICD-10-CM Code(s):I60-I63, I65-I67, I69, G45.4. Includes primary diagnosis only. Compiled by: Health Council of Southeast Florida, 2018

The figure below shows the rate of age-adjusted hospitalizations from strokes per 100,000 individuals by race in

Palm Beach County and Florida for the years 2014-2016. Since 2014, the rates in the county for hospitalizations for

both individuals identifying as White and Black & Other have steadily decreased. Still though, there is a disparity

between Whites and Blacks & Others. In 2016, the rate for those identifying as Black & Other in the county (368.4

per 100,000) was more than double that of Whites (154.0 per 100,000). This disparity also exists at the state level.

Figure 22: Age-Adjusted Hospitalization Rates from Stroke by Race, Palm Beach County and Florida, 2014-2016

450

400

350

417.6

405.4

395.9

384.5

368.4

367.4

300

250

150

220.7 214.3

169.1 160 154

199.9

100

50

0

2014 2015 2016


Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 430-438 and ICD-10-CM Code(s):I60-I63, I65-I67, I69, G45.4. Includes primary diagnosis only. Compiled by: Health Council of Southeast Florida, 2018


This figure shows the rate of age-adjusted hospitalization rates from strokes per 100,000 individuals by ethnicity in

Palm Beach County and Florida for 2014-2016. The rate for individuals identifying as Hispanic in the county has

fluctuated during this time, but steadily decreased for the non-Hispanic population. In the county, individuals

identifying as non-Hispanic have had a higher rate of hospitalizations than individuals identifying as Hispanic in the

period shown. In 2016, these rates were 188.7 and 181.3, respectively. The hospitalization rates from stroke for both

ethnic groups in the county have been lower than the state.

Figure 23: Age-Adjusted Hospitalization Rates from Stroke by Ethnicity, Palm Beach County and Florida, 2014-2016

450

400

350

300

250

203.2

253 247.9

213.2 210.2

232.2

200 186.6 190.3 192 181.3 188.7 190.1

150

100

50

0

2014 2015 2016


Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 430-438 and ICD-10-CM Code(s):I60-I63, I65-I67, I69, G45.4. Includes primary diagnosis only. Compiled by: Health Council of Southeast Florida, 2018

Coronary Heart Disease

Table 125 shows the count and age-adjusted rate of hospitalizations from coronary heart disease per 100,000

individuals in Palm Beach County and Florida for the years 2014-2016. In the county, the rate has fluctuated over the

three years shown but remained consistently below the state. In 2016, there were 5,013 hospitalizations from

coronary heart disease and a rate of 229.0 per 100,000 individuals.

Table 125: Hospitalizations from Coronary Heart Disease, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 4,987 234.9 78,494 297.3

2015 5,109 237.9 80,637 297.7

2016 5,013 229.0 82,727 297.0

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): Includes primary diagnosis only. ICD-9-CM Code(s): 410, 411, 412, 413, 414, 429.2 and ICD-10-CM Code(s): I20, I21, I22, I23, I24, I25 Compiled by: Health Council of Southeast Florida, 2018


This figure shows the age-adjusted rate of hospitalizations from coronary heart disease per 100,000 individuals by

race in Palm Beach County and Florida for the years 2014-2016. Data show hospitalization rates have fluctuated for

both racial groups in the county. In the county, individuals identifying as Black & Other considerably higher

hospitalization rates from coronary heart disease than individuals identifying as White; in 2016, these rates were

307.6 and 209.9, respectively. Hospitalization rates for individuals identifying as Black & Other and

White in Palm Beach have been consistently lower than in the state. In 2016, individuals identifying as Black &

Other in Florida had a hospitalization rate of 354.3 and individuals identifying as White had a hospitalization rate of

282.7. Figure 24: Age-Adjusted Hospitalization Rates from Coronary Heart Disease by Race, Palm Beach County and Florida, 2014-2016

350

300

366.8 354.1 354.3

309.7 310.7 307.6

281.4 283.2 282.7

200

216.8 221.1 209.9

150

100

50

0

2014 2015 2016


Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 410, 411, 412, 413, 414, 429.2. Includes primary diagnosis only ICD-10-CM Code(s): I20, I21, I22, I23, I24, I25 Includes primary diagnosis only. Compiled by: Health Council of Southeast Florida, 2018


The figure below shows the age-adjusted rate of hospitalizations from coronary heart disease per 100,000 individuals

by ethnicity in Palm Beach County and Florida for the years 2014-2016. The non-Hispanic population in the county

has had higher hospitalization rates than the Hispanic population in the years provided. In 2016, non-Hispanics in the

county had a hospitalization rate of 228.4, and individuals identifying as Hispanic had a hospitalization rate of 203.6.

Hospitalization rates have fluctuated during the years across the population. Moreover, Palm Beach County has had

lower hospitalization rates than in the state.

Figure 25: Age-Adjusted Hospitalization Rates from Coronary Heart Disease by Ethnicity, Palm Beach County and Florida, 2014-2016

400

350

300

250

200

199.9

295.9 301 299.6

269.2 259.5 260.2

227.6 234.2 228.4 216

203.6

150

100

50

0

2014 2015 2016


Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): Includes primary diagnosis only. ICD-9-CM Code(s): 410, 411, 412, 413, 414, 429.2 and ICD-10-CM Code(s): I20, I21, I22, I23, I24, I25 Compiled by: Health Council of Southeast Florida, 2018

Cancer

This table shows the number of new cancer cases and the age-adjusted cancer incidence rate per 100,000

individuals in Palm Beach County and Florida in 2012 and 2014. Palm Beach County saw an increase in new

cancer cases in the years shown and a fluctuation in the incidence rate. This data shows Palm Beach County's

cancer incidence rate has been consistently lower than Florida's. In 2016, there were 8,727 new cases of cancer in

the county and a rate of 426.1 per 100,000.

Table 126: Cancer Incidence, Palm Beach County and Florida, 2012-2014

Year

Palm Beach Florida


2012 8,356 417.6 106,166 426.2

2013 8,429 414.5 108,829 427.2

2014 8,727 426.1 110,602 427.2

Source: University of Miami (FL) Medical School, Florida Cancer Data System, 2014 Compiled by: Health Council of Southeast Florida, 2018


This table shows the number of new cancer cases and the age-adjusted cancer incidence rate per 100,000

individuals in Palm Beach County and Florida between 2012 and 2014 by race. The cancer incidence rate in the

county has fluctuated over the years shown; however, individuals identifying as White have had a higher ra te o f

cancer than individuals identifying as Black & Other. In 2014, these incidence rates were 429.8 and 368.8,

respectively. When comparing the county to the state, individuals identifying as White in Palm Beach had a lower

incidence rate than the state in 2012 and 2013 and individuals identifying as Black & Other had a lower incidence

rate than the state in all three years shown.

Table 127: Cancer Incidence by Race, Palm Beach County and Florida, 2012-2014

Wh

ite

Palm Beach Black & Other

White

Florida

Black & Other Year





2012 7,422 424.4 878 371.1 92,331 431.1 13,110 385.7

2013 7,451 423.6 929 364.7 94,162 430.6 13,595 382.7

2014 7,642 429.8 993 368.8 94,971 425.5 14,133 379.3


The table below shows the number of new breast cancer cases and the age-adjusted breast cancer incidence rate

per 100,000 females in Palm Beach County and Florida between 2012 and 2014. The incidence rate has fluctuated

in the county over the three years presented. The incidence rate of breast cancer has been consistently higher in

Palm Beach County than in Florida. The most recent data from 2014 shows Palm Beach had an incidence rate of

126.8 and Florida had an incidence rate of 118.0. There were 1,271 new cases of breast cancer among females in

the county in 2014.

Table 128: Female Breast Cancer Incidence, Palm Beach County and Florida, 2012-2014

Year

Palm Beach Florida


2012 1,210 122.2 14,903 116.6

2013 1,208 120.6 15,268 117.5

2014 1,271 126.8 15,570 118



2012 2013 2014

Palm Beach White 125.9 125.1 130.4

Palm Beach Black & Other 101.9 91.2 109.9

Florida White 117.4 117.7 118.3

Florida Black & Other 105.5 104.9 106.4

This figure shows the age-adjusted breast cancer incidence rate per 100,000 females by race in Palm Beach County

and Florida between 2012 and 2014. The breast cancer incidence rate for women identifying as White and Black &

Other in the county has fluctuated over the years provided. In Palm Beach, women identifying as White experienced

a higher incidence rate of breast cancer than women identifying as Black & Other. In 2016, these rates were 130.4

and 109.9. The incidence rate among women identifying as White in Palm Beach County has been consistently

higher than that in Florida; in 2014, these rates were 130.4 and 106.4. The incidence rate for women identifying as

Black & Other in the county was lower than in Florida in 2012 and 2013, but was higher in 2014 (109.9 and 106.4,

respectively).

Figure 26: Age-Adjusted Female Breast Cancer Incidence Rates by Race, Palm Beach County and Florida, 2012-2014

140

120

100

80

60

40

20

0



2012 2013 2014


Palm Beach Non-Hispanic 129.1 130.3 135.7

Florida Hispanic 88.2 87 89.1

Florida Non-Hispanic 123.3 125 125.2

Figure 27 shows the age-adjusted breast cancer incidence rate per 100,000 females in Palm Beach County and

Florida from 2012-2014 by ethnicity. In the county, both Hispanic and non-Hispanic women have had fluctuating

incidence rates in the years provided. Women identifying as non-Hispanic in the county have consistently higher

incidence rates than women identifying as Hispanic. In 2014, these rates were 135.7 and 78.5, respectively. The

breast cancer incidence rate for Palm Beach was higher than in Florida for all three years provided; in 2014, non-

Hispanic women in the state had an incidence rate of 125.2. Women identifying as Hispanic in the county have had

consistently lower incidence rates than those in the state. In 2014, women identifying as Hispanic in Florida had an

incidence rate of 89.1.

Figure 27: Age-Adjusted Female Breast Cancer Incidence Rates by Ethnicity, Palm Beach County and Florida, 2012- 2014

140

120

100

80

60

40

20

0



This table shows breast cancer cases among females that were at an advanced stage when diagnosed in Palm

Beach County and Florida in 2012-2014. In the county, the percent of females learning they had breast cancer at an

advanced stage fluctuated during the time provided. The percentages in the county have been consistently lower

than the state’s; in 2014, these percentages were 28.4 and 33.4. In 2014, there were 361 cases of breast cancer

among females that were at an advanced stage when diagnosed in the county.

Table 129: Female Breast Cancer Cases at Advanced Stage when Diagnosed, Palm Beach County and Florida, 2012- 2014

Year

Palm Beach Florida


2012 389 32.1 5,053 33.9

2013 316 26.2 5,071 33.2

2014 361 28.4 5,202 33.4


The table below shows the number of new cases of cervical cancer and the age-adjusted incidence rate of

cervical cancer per 100,000 females in Palm Beach County and Florida between 2012 and 2014. The incidence

rate in the county has fluctuated over the time shown, but has remained below Florida’s rate. The 2014 data shows

Palm Beach County had an incidence rate of 7.5 and Florida had a rate of 8.5. There were 61 cases of cervical

cancer in the county in 2014.

Table 130: Cervical Cancer Incidence, Palm Beach County and Florida, 2012-2014

Palm Beach Florida


2012 62 7.9 888 8.4

2013 54 6.8 914 8.6

2014 61 7.5 918 8.5



16

14

12

10

8

6

4

2

0

This figure shows the age-adjusted cervical cancer incidence rate per 100,000 females in Palm Beach County and

Florida by race from 2012 to 2014. In Palm Beach County, the incidence rate for White women increased from 2012

to 2013, and stayed about the same in 2014. The cervical cancer incidence rate fluctuated among women identifying

as Black & Other in the county in the years shown. Women identifying as Black & Other in the county had a higher

incidence rate of cervical cancer. In 2014, these rates were 10.4 and 7.0, respectively. The incidence rate for women

identifying as White in the county has been consistently lower than the state’s, which was 8.5 in 2014. The incidence

rate for women identifying as Black & Other in the county was higher than the state in 2012 and 2014.

Figure 28: Age-Adjusted Cervical Cancer Incidence Rates by Race, Palm Beach County and Florida, 2012-2014

2012 2013 2014

Palm Beach White 5.7 7 7

Palm Beach Black & Other 15.1 10 10.4

Florida White 8.2 8.2 8.5

Florida Black & Other 10.1 10.3 8.4



2012 2013 2014


Palm Beach Non-Hispanic 8 6.9 7.8

Florida Hispanic 8 8.7 7.6

Florida Non-Hispanic 8.5 8.6 8.8

This figure shows the age-adjusted cervical cancer incidence rate per 100,000 females in Palm Beach County

and Florida by ethnicity in 2012-2014. The incidence rate for both women identifying as Hispanic and non-

Hispanic in Palm Beach County increased from 2013-2014. The incidence rate of cervical cancer for women

identifying as non-Hispanic in the county has been higher than for women identifying as Hispanic. In 2014, these

rates were 7.8 and 6.2, respectively. The incidence rate across all ethnicities in Palm Beach County has been

consistently lower than the state.

Figure 29: Age-Adjusted Cervical Cancer Incidence Rates by Ethnicity, Palm Beach County and Florida, 2012-2014

16

14

12

10

8

6

4

2

0


The table below shows the number of new cases of colorectal cancer and the age-adjusted rate of new cases per

100,000 individuals in Palm Beach County and Florida between 2012 and 2014. The incidence rate for colorectal

cancer in the county stayed relatively the same over the three years shown. In 2014, there 650 new cases of

colorectal cancer in the county, which is a rate of 31.7 per 100,000. The incidence rate for colorectal cancer in Palm

Beach County has been consistently lower than in Florida.

Table 131: Colorectal Cancer Incidence, Palm Beach County and Florida, 2012-2014

Year

Palm Beach Florida


2012 655 31.8 9,245 36.7

2013 687 32.1 9,545 37

2014 650 31.7 9,638 36.9



Figure 30 shows the age-adjusted colorectal cancer incidence rate per 100,000 individuals by race in Palm Beach

County and Florida in 2012-2014. Both individuals identifying as Black & Other and White in the county have had

fluctuating incidence rates of colorectal cancer over the years provided. In the county, individuals identifying as Black

& Other have had a consistently higher rate of developing colorectal cancer than those identifying as White. In 2014,

these rates were 32.5 and 30.9, respectively. The incidence rates for both groups are lower than the state’s.

Individuals identifying as Black & Other in the state had a colorectal cancer incidence rate of 39.7 and those

identifying as White had an incidence rate of 35.5.

Figure 30: Age-Adjusted Colorectal Cancer Incidence Rates by Race, Palm Beach County and Florida, 2012-2014

50

45

40 35.4

38.5 40.1 39.7

36.1 36.2 35.5

35 31.6 32.4

30

32.3 30.9

32.5

25

20

15

10

5

0

2012 2013 2014




The figure below shows the age-adjusted incidence rate of colorectal cancer per 100,000 individuals by ethnicity in

Palm Beach County and Florida for the years 2012-2014. Individuals identifying as Hispanic in Palm Beach County

have had a consistently lower incidence rate of colorectal cancer than individuals identifying as non-Hispanic. In

2014, individuals identifying as Hispanic in the county had a colorectal cancer incidence rate of 25.5 and individuals

identifying as non-Hispanic had an incidence rate of 32.9. The county’s incidence rates across all ethnic groups are

lower than the state’s. In 2014, individuals identifying as Hispanic in the state had a colorectal cancer incidence rate

of 34 and individuals identifying as non-Hispanic had an incidence rate of 37.5.

Figure 31: Age-Adjusted Colorectal Cancer Incidence Rates by Ethnicity, Palm Beach County and Florida, 2012-2014

50

45

40 37.7 37.7 37.5 35.1

35 30.2

30

25

32.3 33.9 33.1 32.9 34

24.7 25.5

20

15

10

5

0

2012 2013 2014



125 | P a g e Bethesda Health – Community Health Assessment

HIV

This table shows adults less than 65 years of age who have ever been tested for HIV in Palm Beach County and

Florida in 2013 and 2016. In 2016, 54.1% of the population in Palm Beach County less than 65 years of age were

tested for HIV; this is slightly less than the state’s percentage of 55.3%.

Table 132: Percentage of Adults Less than 65 Years of Age Who Have Ever Been Tested for HIV, Palm Beach County and Florida, 2013 and 2016


2013 42.8% 50.6%

2016 54.1% 55.3%

Source: Florida Behavioral Risk Factor Surveillance System, 2016 Compiled by: Health Council of Southeast Florida, 2018

The table below shows adults less than 65 years of age who had an HIV test in the past 12 months in Palm Beach

County and Florida in 2013 and 2016. In 2016, 21% of the population in Palm Beach County less than 65 years

of age had an HIV test in the past 12 months; this percentage is higher than Florida’s rate of 19.7%.

Table 133: Percentage of Adults Less than 65 Years of Age Who Had an HIV Test in the Past 12 Months, Palm Beach County and Florida, 2013 and 2016


2013 13.1% 15.6%

2016 21.0% 19.7%

Source: Florida Behavioral Risk Factor Surveillance System, 2016 Compiled by: Health Council of Southeast Florida, 2018

Table 135 shows the number and rate of HIV cases per 100,000 individuals in Palm Beach County and Florida in the

years 2013-2016. In 2016, there were 306 cases of HIV in Palm Beach County, which is a rate of 21.9 per 100,000

individuals; this is lower than Florida’s rate of 24.6.

Table 134: HIV Cases, Palm Beach County and Florida, 2013-2016

Year

Palm Beach Florida


2013 324 24 4,370 22.6

2014 318 23.3 4,599 23.5

2015 283 20.5 4,708 23.7

2016 306 21.9 4,972 24.6

Source: Florida Department of Health, HIV/AIDS Section, 2016 Compiled by: Health Council of Southeast Florida, 2018


The figure below shows the rate of HIV cases per 100,000 individuals by race in Palm Beach County and Florida in

2014-2016. The rates of HIV cases in the county have been decreasing among individuals identifying as White and

fluctuating among individuals identifying as Black. Individuals identifying as Black in Palm Beach County have had

a higher burden of HIV cases than individuals identifying as White. In 2016, the rate of HIV cases per 100,000for

individuals identifying as Black was more than seven times greater than the rate of HIV cases among individuals

identifying as White (68.3 and 8.7, respectively). The rate of HIV cases for individuals identifying as Black in Palm

Beach County was higher than in Florida in 2014 and 2016. In 2016, the rate of HIV cases for individuals

identifying as Black in the state was 66.2.

Figure 32: Rate of HIV Cases by Race, Palm Beach County and Florida, 2014-2016

70 68.6

60

68.3

66.1 64.9 66.2

60.6

50

40

30

20

10.1

10.8

8.8

10.2

8.7

10.6

0

2014 2015 2016

Palm Beach White Palm Beach Black Florida White Florida Black



This figure shows the rate of HIV cases per 100,000 individuals by ethnicity in Palm Beach County and Florida in

2014-2016. In Palm Beach County, the rate of HIV cases among individuals identifying as Hispanic and non-

Hispanic has fluctuated over the years shown. Individuals identifying as non-Hispanic in the county have had higher

rates of HIV cases than individuals identifying as Hispanic since 2014. In 2016, these rates were 22.5 and 19.7,

respectively. Individuals identifying as Hispanic in the county have had lower rates of HIV cases than those in the

state. In 2016, there was a rate of 31.9 HIV cases among individuals identifying as Hispanic in the state. Individuals

identifying as non-Hispanic in the county had higher rates of HIV cases than those in the state in 2014 and 2016.

Individuals identifying as non-Hispanic in the state had a rate of 22.2 HIV cases in 2014.

Figure 33: Rate of HIV Cases by Ethnicity, Palm Beach County and Florida, 2014-2016

70

60

50

40

30 27.8

30.4 31.9

23.1 23.3 22.2 21 21.5 22.5 22.2

18.6 19.7

10

0

2014 2015 2016



AIDS

The table below shows the number and rate of AIDS cases per 100,000 individuals in Palm Beach County and

Florida for the years 2013-2016. The rate of AIDS cases in the county has consistently decreased over the years

shown. The rate of AIDS cases in Palm Beach County was higher than the rate of AIDS cases in Florida for the years

2013-2015. In 2016, there were 143 AIDS cases in the county, which is a rate of 10.3 per 100,000.

Table 135: AIDS Cases, Palm Beach County and Florida, 2013-2016

Year

Palm Beach Florida


2013 213 15.8 2,876 14.9

2014 163 11.9 2,166 11.1

2015 159 11.5 2,129 10.7

2016 143 10.3 2,119 10.5


42.3

4

37.6 37.3 36 35.1

4.6

3.9

4.5

4.2

4.3

The figure below shows the rate of AIDS cases per 100,000 individuals in Palm Beach County and Florida by race for

the years 2014-2016. In the county, individuals identifying as White have had a fluctuating rate of AIDS cases while

individuals identifying as Black have seen a decrease in the rate of AIDS cases over the years provided. There is a

disparity in the county of the rate of AIDS cases among individuals identifying as Black and individuals identifying as

White. In 2016, this disparity was more than eight-fold (35.1 and 4.2, respectively). The rate of AIDS cases among

individuals identifying as Black in the county has been higher than the state since 2014. In 2016, individuals

identifying as Black in the state had a rate of 33.6 AIDS cases. Individuals identifying as White in the county have

had lower rates of AIDS cases than those in the state. In 2016, the rate of AIDS cases for individuals identifying as

White in Florida was 4.3.

Figure 34: Rate of AIDS Cases by Race, Palm Beach County and Florida, 2014-2016

70

60

50

40 33.6

30

20

10

0

2014 2015 2016




This figure shows the rate of AIDS cases per 100,000 by ethnicity in Palm Beach County and Florida in 2012-2016.

Individuals identifying as non-Hispanic in the county have had a decreasing rate of AIDS cases and individuals

identifying as Hispanic have had a fluctuating rate of AIDS cases in the years provided. In Palm Beach County,

individuals identifying as Hispanic have had a lower rate of AIDS cases than individuals identifying as non-Hispanic.

In 2016, these rates were 6.1 and 11.4, respectively. When comparing the county to the state, individuals identifying

as Hispanic in Palm Beach have had lower rates of AIDS cases than Florida. In 2016, the rate of AIDS cases for

individuals identifying as Hispanic in the state was 10.3. Individuals identifying as non-Hispanic in the county have

had higher rates of AIDS cases than in the state. The rate of AIDS cases for individuals identifying as non-Hispanic

in the state was 10.5 in 2016.

Figure 35: Rate of AIDS Cases by Ethnicity, Palm Beach County and Florida, 2014-2016

70

60

50

40

30

20

12.7

11.5

12 11

11.4

10.5

9 9.7 10

9.5 9.6 10.3 6.1

0

2014 2015 2016




Sexually Transmitted Diseases

The table below shows the counts and rates of gonorrhea, chlamydia, and infectious syphilis cases per 100,000

individuals in Palm Beach County and Florida in the years 2012-2015. The rate of these sexually transmitted

diseases has consistently increased in the county in the years provided, but has remained below the state. In 2015,

there were 6,755 cases of gonorrhea, chlamydia, and infectious syphilis, which is a rate of 488.7 per 100,000

individuals.

Table 136: Total Gonorrhea, Chlamydia & Infectious Syphilis Cases, Palm Beach County and Florida, 2012- 2015

Year

Palm Beach Florida


2012 4,752 355.2 98,777 516.6

2013 5,676 420.8 103,566 536.2

2014 5,955 436.3 105,461 538.6

2015 6,755 488.7 116,929 587.6 Data Source: Florida Department of Health, Bureau of Communicable Diseases, 2015 Compiled by: Health Council of Southeast Florida, 2018

Asthma

Table 137 shows the number of hospitalizations and age-adjusted rates of hospitalizations from or with asthma

per 100,000 individuals in Palm Beach County and Florida in the years 2014-2016. The county’s rate has

continuously increased over the years provided but remained below the state. In 2016, there were 12,005

hospitalizations and a rate of 743 per 100,000 individuals.

Table 137: Hospitalizations from or with Asthma, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 10,879 690.9 176,487 820.2

2015 11,865 737.3 187,857 851.8

2016 12,005 743 187,985 835.1

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 493. Includes both primary and contributing diagnoses. ICD-10-CM Code(s): J45 Includes both primary and contributing diagnoses. Compiled by: Health Council of Southeast Florida, 2018


This figure shows the age-adjusted hospitalization rates from or with asthma per 100,000 individuals by race in Palm

Beach County and Florida for 2014-2016. The hospitalization rate has fluctuated for those identifying as White in the

county but has consistently increased for those identifying as Black & Other in the years provided. In the county,

there is a disparity of hospitalizations between those identifying as Black & Other and those identifying as White. In

2016, these rates were 1,229.5 and 568.6, respectively. The hospitalization rate for individuals identifying as White in

Palm Beach has been consistently lower than in the state; in 2016, these rates were 568.6 and 690.4. Individuals

identifying as Black in the county have also had lower hospitalization rates than in the state (1229.5 and 1344.3,

respectively).

Figure 36: Age-Adjusted Hospitalization Rates from or with Asthma by Race, Palm Beach County and Florida, 2014- 2016

1400 1351.4 1372.6 1344.3

1229.5

1200 1154.4 1170.3

1000

800

600

538.7

674.5 704.2 690.4

590.5 568.6

400

200

0

2014 2015 2016


Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 493. Includes both primary and contributing diagnoses. ICD-10-CM Code(s): J45 Includes both primary and contributing diagnoses. Compiled by: Health Council of Southeast Florida, 2018


The figure below shows the age-adjusted hospitalization rates from or with asthma per 100,000 individuals by

ethnicity in Palm Beach County and Florida for 2014-2016. Individuals identifying as Hispanic and non-Hispanic in

the county have seen an increasing trend of hospitalization rates from or with asthma. In Palm Beach, individuals

identifying as non-Hispanic have had higher hospitalization rates than individuals identifying as Hispanics in the years

provided; in 2016, these rates were 764.3 and 680.4. Individuals identifying as Hispanics in the county have had

lower hospitalization rates than in the state. In 2016, individuals identifying as Hispanic in the state had a

hospitalization rate of 736.5. Individuals identifying as non-Hispanic in Palm Beach have also had lower

hospitalization rates than in the state. The 2016 data shows individuals identifying as non-Hispanic in Florida had a

hospitalization rate of 865.7.

Figure 37: Age-Adjusted Hospitalization Rates from or with Asthma by Ethnicity, Palm Beach County and Florida, 2014- 2016

1400

1200

837 878 865.7

800 745.7 759.7 765.9 764.3 736.5

600

601.6

710.8 663.3 680.4

400

200

0

2014 2015 2016


Source: Florida Agency for Health Care Administration (AHCA), 2016 ICD-9-CM Code(s): 493. Includes both primary and contributing diagnoses. ICD-10-CM Code(s): J45 Includes both primary and contributing diagnoses. Compiled by: Health Council of Southeast Florida, 2018


This table shows the number and rate per 100,000 individuals of preventable hospitalizations for individuals under

age 65 from asthma in Palm Beach County and Florida in 2014-2016. The rate of preventable hospitalizations from

asthma has been consistently declining in the county in the years provided. In 2016, there were 1,292 preventable

hospitalizations in the county due to asthma; this is a rate of 120.3. The county’s rate for preventable

hospitalizations from asthma in 2016 was higher than that of the state, which was 80.1.

Table 138: Preventable Hospitalizations Under 65 from Asthma, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 1,492 141 20,296 127.4

2015 1,332 124.7 17,389 108

2016 1,292 120.3 13,048 80.1

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD9-CM code(s): 493 , ICD10-CM Code(s): J45 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the number and rate of emergency room visits due to asthma per 100,000 individuals in Palm

Beach County and Florida from the years 2013-2016. In 2016, there were 6,254 emergency room visits due to

asthma in Palm Beach County. The rate of emergency room visits due to asthma has fluctuated in the county in the

years shown below. The rate of emergency room visits due to asthma in the county decreased from 473.6 in 2015 to

448.3 in 2016; this rate was lower than the state’s rate of 498.6.

Table 139: Emergency Room Visits Due to Asthma, Palm Beach County and Florida, 2013-2016

Year

Palm Beach Florida


2013 6,226 461.6 100,010 517.8

2014 6,456 473 105,417 538.4

2015 6,546 473.6 100,480 505

2016 6,254 448.3 100,878 498.6

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 493. Includes primary diagnosis only. ICD-10-CM Code(s): J45. Includes primary diagnosis only. Compiled by: Health Council of Southeast Florida, 2018


Table 140 shows the number and rate of emergency room visits due to asthma per 100,000 individuals by race in

Palm Beach County and Florida from the years 2013-2016. The rate for individuals identifying as White in the county

has fluctuated in the four years shown, while it has continuously decreased for individuals identifying as Black &

Other. In the county, individuals identifying as Black & Other had more than 4.5 times the rate of emergency room

visits due to asthma as individuals identifying as White in 2016 (1,101.70 and 235.8, respectively). The rate for both

groups in the county has been mostly lower than the rates for the state.

Table 140: Emergency Room Visits Due to Asthma by Race, Palm Beach County and Florida, 2013-2016

Wh

ite

Palm Beach Black

& Other

White

Florida

Black & Other Year





2013 2,202 213 4,002 1,271.10 47,222 312.6 52,122 1238.7

2014 2,377 228.3 4,033 1,245.60 52,257 342 52,367 1217.6

2015 2,634 250.9 3,877 1,166.10 50,494 325.9 49,396 1121.4

2016 2,489 235.8 3,740 1,101.70 49,572 315.3 50,837 1127.5


The table below shows the number and rate of emergency room visits due to asthma per 100,000 individuals by

ethnicity in Palm Beach County and Florida from the years 2013-2016. In the county, individuals identifying as

Hispanic and non-Hispanic had fluctuating emergency room visit rates due to asthma over the years provided.

Individuals identifying as non-Hispanic had higher rates than individuals identifying as non-Hispanic in the county for

the years 2013-2015; in 2016, the rate of emergency room visits for individuals identifying as non-Hispanic fell below

that of individuals identifying as Hispanic. In this year, individuals identifying as Hispanic in the county had an

emergency room visit rate of 456.6 and individuals identifying as non-Hispanic had a rate of 440.2. The rates for both

Hispanics and non-Hispanics in Palm Beach County have been lower than in Florida.

Table 141: Emergency Room Visits Due to Asthma by Ethnicity, Palm Beach County and Florida, 2013-2016

Hisp

anic

Palm Beach Non-Hi

spanic

Hisp

anic

Florida

Non-Hi

spanic

Year Count

Rate per 100,000




2013 1,191 440.8 4,966 460.4 24,681 549.5 74,098 499.9

2014 1,279 462.5 5,066 465.5 26,748 577.5 76,719 513.2

2015 1,276 447 5,199 474.1 26,060 543.9 72,961 483

2016 1,342 456.6 4,848 440.2 27,460 553.3 71,800 470.3



Dehydration

The table below shows the number and rate of preventable hospitalizations per 100,000 individuals for individuals

under age 65 from dehydration in Palm Beach County and Florida for the years 2014-2016. The rate of preventable

hospitalizations from dehydration in the county has fluctuated over the years provided. In 2016, there were 897

preventable hospitalizations due to dehydration in the county and a rate of 83.5. The county’s rate of

hospitalizations was higher than the state's during this time.

Table 142: Preventable Hospitalizations Under 65 from Dehydration, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 919 86.8 12,583 79

2015 964 90.3 12,152 75.5

2016 897 83.5 11,105 68.1

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD9-CM Code(s): 276.5, ICD10-CM Code(s): E86 Compiled by: Health Council of Southeast Florida, 2018

Gastroenteritis

The table below shows the number and rate of preventable hospitalizations from gastroenteritis per 100,000 for

individuals under age 65 in Palm Beach County and Florida in the years 2014-2016. In the county, the rate of

preventable hospitalizations from gastroenteritis steadily increased in the years provided. There were 744

preventable hospitalizations for gastroenteritis in 2016 in Palm Beach County, which is a rate of 69.2. When

comparing the county to the state, the county had a higher hospitalization rate in 2015 and 2016.

Table 143: Preventable Hospitalizations Under 65 from Gastroenteritis, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 574 54.2 8,781 55.1

2015 607 56.8 9,068 56.3

2016 744 69.2 9,250 56.8

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD9-CM code(s): 558.9, ICD10-CM Code(s): K529, K5289 Compiled by: Health Council of Southeast Florida, 2018


Kidney/Urinary Infections

The table below shows the number and rate of preventable hospitalizations from kidney/urinary infections per

100,000 for individuals under age 65 in Palm Beach County and Florida for the years 2014-2016. The preventable

hospitalization rate in the county has fluctuated over the years shown. There were 416 preventable hospitalizations

due to kidney/urinary infections in Palm Beach County in 2016. The county’s rate of preventable hospitalizations for

kidney/urinary infections in 2016 was 38.7. The hospitalization rate for the county was higher than the state in 2015

and 2016.

Table 144: Preventable Hospitalizations Under 65 from Kidney/Urinary Infections, Palm Beach County and Florida, 2014- 2016

Year

Palm Beach Florida


2014 594 56.1 9,071 56.9

2015 625 58.5 8,170 50.7

2016 416 38.7 5,528 33.9

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD9-CM code(s): 590.0,599.0,599.9, ICD10-CM Code(s): N10, N11, N12 Compiled by: Health Council of Southeast Florida, 2018

Ear, Nose, and Throat Infections

This table shows the number and rate of preventable hospitalizations from severe ear, nose, and throat infections

per 100,000 for individuals under age 65 in Palm Beach County and Florida for the years 2014-2016. The rate of

preventable hospitalizations in the county has steadily increased over the years shown. In 2016, there were 375

preventable hospitalizations due to severe ear, nose, and throat infections in the county, which is a rate of 34.9. The

county’s rate of preventable hospitalizations was higher than the state's in all three years shown below.

Table 145: Preventable Hospitalizations Under 65 from Severe Ear, Nose, & Throat Infections, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 204 19.3 3,014 18.9

2015 276 25.8 3,243 20.1

2016 375 34.9 3,661 22.5

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM codes: 382,462,463,465,472.1, ICD10-CM Code(s): H66, J02, J03, J06, J312 Compiled by: Health Council of Southeast Florida, 2018


Self-inflicted Injuries

Table 146 shows the number and rate of hospitalizations for non-fatal self-inflicted injuries per 100,000 individuals for

those ages 12-18 in Palm Beach County and Florida for the years 2012-2014. In the county, the hospitalization rate

has steadily increased in the years provided, more than doubling between 2012 and 2013. In 2014, there were 172

hospitalizations for non-fatal self-inflicted injuries in Palm Beach County and a rate of 156.1. The county’s rate was

higher than the state's in 2013 and 2014.

Table 146: Non-Fatal Hospitalizations for Self-inflicted Injuries Ages 12-18, Palm Beach County and Florida, 2012-2014

Year

Palm Beach Florida


2012 77 69.5 1,169 71.3

2013 168 152.6 1,547 95.5

2014 172 156.1 1,829 112.9

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): E950-E95 Compiled by: Health Council of Southeast Florida, 2018

This table shows the number and rate of hospitalizations for non-fatal self-inflicted injuries per 100,000 individuals for

those ages 19-21 in Palm Beach County and Florida for the years 2012-2014. The county’s hospitalization rate has

steadily decreased over the years provided and has remained below the state's. In 2014, there were 24

hospitalizations for self-inflicted injuries in the county and a rate of 51.3 per 100,000 individuals.

Table 147: Non-Fatal Hospitalizations for Self-inflicted Injuries Ages 19-21, Palm Beach County and Florida, 2012-2014

Year

Palm Beach Florida


2012 34 74.3 654 86.9

2013 30 64.5 561 74.1

2014 24 51.3 576 75.8

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): E950-E95 Compiled by: Health Council of Southeast Florida, 2018


Firearm Injuries

This table shows the number and rate of hospitalizations for non-fatal firearm injuries per 100,000 individuals in Palm

Beach County and Florida for the years 2012-2014. The rate of hospitalizations has increased over the years

provided. In 2014, there were 163 hospitalizations for non-fatal firearm injuries in Palm Beach County. The county’s

rate for these years has been consistently higher than the state's.

Table 148: Hospitalizations for Non-Fatal Firearm Injuries, Palm Beach County and Florida, 2012-2014

Year

Palm Beach Florida


2012 134 10 1,719 9

2013 136 10.1 1,604 8.3

2014 163 11.9 1,656 8.5


This figure shows the rate of hospitalizations for non-fatal firearm injuries per 100,000 individuals in Palm Beach

County and Florida by race for the years 2012-2014. The hospitalization rates for non-fatal firearm injuries has

increased for both groups in the time shown. In the county, there was a disparity in hospitalizations for non-fatal

firearm injuries by race over the three years shown. Individuals identifying as Black were hospitalized at a rate 12

times higher than individuals identifying as White in 2014 (44.1 and 3.7, respectively). Since 2012, the hospitalization

rate for individuals identifying as Black in Palm Beach County has been higher than in Florida. In 2014, individuals

identifying as Black in the state had a hospitalization rate of 30.5. Individuals identifying as White in the state had a

higher hospitalization rate than those in the county in 2012 and 2013, but fell below in 2014. In this year,

individuals identified as White in the state had a hospitalization rate of 3.5.

Figure 38: Hospitalization Rates for Non-Fatal Firearm Injuries by Race, Palm Beach County and Florida, 2012-2014

45

40 38.8 39.3

44.1

35

30.5 30

28.3

30.5

25

20

15

10

5 2.7

4.2

2.7

3.6

3.7

3.5

0

2012 2013 2014



The figure below shows the rate of hospitalizations for non-fatal firearm injuries per 100,000 individuals in Palm

Beach County and Florida by ethnicity for the years 2012-2014. The hospitalization rates due to non-fatal firearm

injuries have fluctuated in the three-year span shown for both ethnic groups in the county. Individuals identifying as

non-Hispanic in the county had higher hospitalization rates than individuals identifying as Hispanic for the years

provided. In 2014, individuals identifying as non-Hispanic in the county had more than two times the rate of

hospitalizations as individuals identifying as Hispanic (13.3 and 5.4, respectively). Individuals identifying as non-

Hispanic in the county had consistently higher rates of hospitalization than those in the state. In 2014, individuals

identifying as non-Hispanic in the state had a hospitalization rate of 9.4. Individuals identifying as Hispanic in the

county had a higher hospitalization rate in 2013 and 2014. In 2014, individuals identifying as Hispanic in Florida had

a hospitalization rate of 4.0.

Figure 39: Hospitalization Rates for Non-Fatal Firearm Injuries by Ethnicity, Palm Beach County and Florida, 2012-2014

45

40

35

30

25

20

15

11.4

10

9.6

10.8

7

13.3

8.9 9.4

5 3.1

5.7 5.3 5.4 4

0

2012 2013 2014




Eating Disorders

The table below shows the number and rate of hospitalizations for non-fatal eating disorders per 100,000 individuals

for those ages 12-18 in Palm Beach County and Florida for the years 2012-2014. The hospitalization rate has

steadily increased in the county; from 2013 to 2014 it nearly doubled. In 2014, there were 45 hospitalizations for non-

fatal eating disorders in the county. The rate for the county was lower than the state in 2012 and 2013, but in 2014 it

was higher (40.8 and 33.4, respectively).

Table 149: Non-Fatal Hospitalizations for Eating Disorders Ages 12-18, Palm Beach County and Florida, 2012-2014

Year

Palm Beach Florida


2012 20 18.1 359 21.9

2013 22 20 514 31.7

2014 45 40.8 541 33.4

Source: Florida Agency for Health Care Administration (AHCA), 2016 Data note(s): ICD-9-CM Code(s): 307.50-307.5 Compiled by: Health Council of Southeast Florida, 2018

Unintentional Falls

This table shows the number and rate of hospitalizations for non-fatal unintentional falls per 100,000 individuals in

Palm Beach County and Florida in 2012-2014. The hospitalization rate for the county decreased from 2012 to

2013, then had a large increase between 2013 and 2014. The rate for the county was higher than the state for all

three years shown. In 2014, there were 5,951 hospitalizations for non-fatal unintentional falls in Palm Beach

County. The county’s rate for 2014 was 436.0.

Table 150: Hospitalizations for Non-Fatal Unintentional Falls, Palm Beach County and Florida, 2012-2014

Year

Palm Beach Florida


2012 5,196 388.4 62,535 327.1

2013 5,139 381.0 63,173 327.1

2014 5,951 436.0 67,840 346.5



515.2

453.5 442.8

394.1

364.1

363.1

107.2

116.1

99.4

116.1

101

111.7

Figure 40 shows the rate per 100,000 individuals of hospitalizations for non-fatal unintentional falls in Palm Beach

County and Florida by race in the years 2012-2014. In Palm Beach County, individuals identifying as Black have

seen a steady increase in the hospitalization rate for non-fatal unintentional falls. Individuals identifying as White in

the county have had a fluctuating hospitalization rate. In the county, there is a disparity between the races for

hospitalization rates for non-fatal unintentional falls. Individuals identifying as White in the county had a

hospitalization rate 4.6 times that of individuals identifying as Black (515.2 and 107.2, respectively). The

hospitalization rate for individuals identifying as White in the county has been consistently higher than in the state. In

2014, the hospitalization rate for individuals identifying as White in the state was 394.1. The hospitalization rate for

individuals identifying as Black in the county has been consistently lower than in the state. Individuals identifying as

Black in the state had a hospitalization rate of 116.1 in 2014.

Figure 40: Hospitalization Rates for Non-Fatal Unintentional Falls by Race, Palm Beach County and Florida, 2012-2014

600

500

400

300

200

100

0

2012 2013 2014




496.4

444.2 438.1

383.1

132.5

362.9

359.9

194.8

184.2

134

196.4

154.4

The figure below shows the rate per 100,000 individuals of hospitalizations for non-fatal unintentional falls in Palm

Beach County by ethnicity in the years 2012-2014. The hospitalization rate for both ethnicities in the county has

fluctuated over the years shown. Individuals identifying as non-Hispanic in the county have had much higher

hospitalization rates than those individuals identifying as Hispanic. In 2014, individuals identifying as non-Hispanic in

Palm Beach had a hospitalization rate of 496.4 and those identifying as Hispanic had a rate of 154.4. The rate of

hospitalizations for individuals identifying as non-Hispanic in the county has been consistently higher than in the

state. In 2014, individuals identifying as non-Hispanic in Florida had a hospitalization rate of 383.1. The

hospitalization rate for individuals identifying as Hispanic in Palm Beach was consistently lower than those in the

state. Individuals identifying as Hispanic in Florida had a hospitalization rate of 194.8 in 2014.

Figure 41: Hospitalization Rates for Non-Fatal Unintentional Falls by Ethnicity, Palm Beach County and Florida, 2012- 2014

600

500

400

300

200

100

0

2012 2013 2014




Mortality

Leading Causes of Death

The table below shows the leading causes of death in Palm Beach County by number of deaths, percent of total

deaths, crude death rate, age-adjusted death rate per 100,000 individuals, and years of potential life lost for

2016.There was a total of 14,646 deaths in the county in 2016 and 7,765.6 years per life lost. Heart disease was

the leading cause of death, accounting for more than a quarter of all deaths (25.4%). Cancer had the largest age-

adjusted death rate, with 140.0. Unintentional injuries accounted for the largest years of potential life lost, at

2,224.5.

Table 151: Leading Causes of Death, Palm Beach County, 2016

Causes of Death Death

Counts

Percent of

Total Deaths

Crude Rate Per 100,000

Age- Adjusted

Death Rate Per 100,000

2016 YPLL < 75 Per

100,000 Under 75

All Causes 14,646 100.0 1,049.8 597.9 7,765.6

Heart Disease 3,715 25.4 266.3 131.0 878.3

Cancer 3,368 23.0 241.4 140.0 1,546.9

Stroke 1,045 7.1 74.9 36.1 199.2

Unintentional Injury 998 6.8 71.5 68.1 2,224.5

Chronic Lower Respiratory Disease 719 4.9 51.5 26.4 147.7

Alzheimer's Disease 550 3.8 39.4 17.0 18.5

Diabetes 306 2.1 21.9 12.9 150.0

Nephritis, Nephrotic Syndrome & Nephrosis 241 1.6 17.3 9.4 91.4

Suicide 230 1.6 16.5 15.2 469.8

Chronic Liver Disease and Cirrhosis 195 1.3 14.0 10.4 217.2

Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data Note(s): Age-adjusted death rates are computed using the year 2000 standard population. YPLL = Years of Potential Life Lost Compiled by: Health Council of Southeast Florida, 2018


Deaths from All Causes

The table below shows the death count by ZIP code in Bethesda Health’s service area in 2016. In the primary

service area, Boynton Beach, ZIP code 33437, had the largest number of deaths (759). There were a total of 5,933

deaths in the primary service area. Boca Raton, ZIP code 33433, had the largest number of deaths in the secondary

service area, with 657; in this area, there were a total of 3,449 deaths.

Table 152: Death Counts from All Causes, Bethesda Health’s Service Areas ZIP Codes, 2016



33437 759 33433 657

33484 600 33415 394

33467 598 33434 362

33436 517 33428 288

33446 513 33496 269

33445 415 33487 195

33435 388 33432 193

33462 372 33406 183

33463 368 33486 181

33461 313 33405 179

33414 306 33431 160

33426 287 33483 156

33460 279 33498 127

33444 218 33413 105

Total 5,933 Total 3,449


Alzheimer’s Deaths

This table shows the numbers and age-adjusted rates per 100,000 individuals of Alzheimer’s deaths in Palm Beach

County and Florida in 2014-2016. The death rate due to Alzheimer’s in the county decreased in the three years

shown. The death rates in the county were lower than in the state in 2015 and 2016. There were 550 deaths from

Alzheimer’s in 2016, which is a rate of 17 per 100,000.

Table 153: Alzheimer’s Disease Deaths, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 642 20.5 5,814 19.2

2015 624 19.3 7,021 22.4

2016 550 17 7,152 22.2

Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data Note(s): ICD-10 Code(s): G30 Compiled by: Health Council of Southeast Florida, 2018


The table below shows the death counts for Alzheimer’s in Bethesda’s primary and secondary service area by

ZIP code in 2016. There were a total of 204 deaths due to Alzheimer’s in the primary service area and 125 in the

secondary service area. In the primary service area, there were 27 deaths due to Alzheimer’s in

Wellington/Greenacres/Lake Worth, ZIP code 33467, in 2016. Boca Raton, ZIP code 33433, had the highest

death count due to Alzheimer’s in the secondary service area in 2016, with 30.

Table 154: Death Counts from Alzheimer’s, Bethesda Health’s Service Area ZIP codes, 2016



33467 27 33433 30

33437 23 33434 17

33484 23 33487 11

33435 18 33496 11

33436 18 33405 9

33426 17 33431 9

33414 16 33486 9

33445 15 33415 8

33446 12 33406 4

33462 10 33428 4

33463 10 33432 4

33461 9 33498 4

33460 4 33483 3

33444 2 33413 2

Total 204 Total 125 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data Note(s): ICD-10 Code(s): G30 Compiled by: Health Council of Southeast Florida, 2018


Respiratory Diseases Deaths

This table shows the death counts due to respiratory diseases in Bethesda’s primary and secondary service area ZIP

codes in 2016. There were 482 deaths due to respiratory diseases in Bethesda’s primary service area in 2016 and

270 in the secondary service area. In the primary service area, Boynton Beach, ZIP code 33437, had the highest

number of deaths from respiratory diseases (63). In the secondary service area, the area of Greenacres/Haverhill/

West Palm Beach had 50 deaths due to respiratory diseases.

Table 155: Death Counts from Respiratory Diseases, Bethesda Health’s Service Area ZIP Codes, 2016



33437 63 33415 50

33484 62 33433 47

33436 49 33434 27

33446 46 33428 21

33467 46 33406 19

33462 41 33496 19

33463 34 33432 15

33435 29 33486 15

33461 23 33487 14

33414 22 33405 11

33445 22 33431 11

33426 18 33483 10

33460 15 33413 7

33444 12 33498 4

Total 482 Total 270 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data Note(s): ICD-10 Code(s): J00-J99 Compiled by: Health Council of Southeast Florida, 2018


Major Cardiovascular Diseases Deaths

The table below shows the number of deaths due to cardiovascular diseases in Bethesda’s service areas by ZIP

code in 2016. There were a total of 2,068 deaths due to cardiovascular diseases in the primary service area and

1,228 in the secondary service area in 2016. In the primary service area, Boynton Beach, ZIP code 33437, had the

highest number of deaths due to major cardiovascular diseases (267). Boca Raton, ZIP code 33433, had the

highest number of deaths due to major cardiovascular diseases in the secondary service area (285).

Table 156: Death Counts from Major Cardiovascular Diseases, Bethesda Health’s Service Areas ZIP Codes, 2016



33437 267 33433 285

33484 235 33434 140

33467 225 33415 139

33446 192 33428 86

33436 170 33496 84

33445 158 33487 69

33435 133 33405 68

33462 129 33432 63

33463 112 33486 60

33426 104 33406 55

33414 97 33483 52

33461 96 33431 45

33460 83 33498 44

33444 67 33413 38

Total 2,068 Total 1,228 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data Note(s): ICD-10 Code(s): I00-I78 Compiled by: Health Council of Southeast Florida, 2018


Congestive Heart Failure Deaths

This table shows the counts of deaths and death rates per 100,000 individuals from congestive heart failure in

Palm Beach County and Florida in the years 2014-2016. In 2016, there were 260 deaths in Palm Beach County due

to congestive heart failure and a death rate of 8.4. The county’s death rate for congestive heart failure has

fluctuated in the three-year span shown. The county’s death rates due to congestive heart failure have been lower

than the state’s rate since 2014.

Table 157: Congestive Heart Failure Deaths, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 276 8.7 3,366 11.3

2015 267 8.3 3,663 11.9

2016 260 8.4 3,917 12.4 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): I50.0 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the death rates per 100,000 from congestive heart failure by race in Palm Beach County

and Florida in the years 2014-2016. Individuals identifying as White in the county has seen a decrease in the

death rate since 2014; however, the Black & Other population has seen a steady increase. Individuals identifying

as Black & Other have had higher death rates than individuals identifying as White in the county. The rates for the

county have been consistently lower than those in the state.

Table 158: Congestive Heart Failure Death Rates by Race, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida

White Black & Other White Black & Other

2014 8.9 5 11.3 10

2015 8.3 8 11.7 12.2

2016 8.3 8.9 12.2 12.6 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): I50.0 Compiled by: Health Council of Southeast Florida, 2018


This table shows the death rates per 100,000 individuals from congestive heart failure by ethnicity in Palm Beach

County and Florida in the years 2014-2016. The death rate for individuals identifying as Hispanic in the county has

fluctuated since 2014, while it has continued to decrease for individuals identifying as non-Hispanic. In the county,

individuals identifying as Hispanic had a higher death rate due to congestive heart failure than non-Hispanics in 2015

and 2016. The death rates for individuals identifying as Hispanic in the county were lower than that of the state in

2014 and 2016. The death rates for individuals identifying as non-Hispanic in the county were consistently lower than

in the state.

Table 159: Congestive Heart Failure Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida

Hispanic Non-Hispanic Hispanic Non-Hispanic

2014 6 8.1 9.2 10.6

2015 9.4 7.3 8.6 10.9

2016 8.6 5.2 10.2 10.4 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): I50.0 Compiled by: Health Council of Southeast Florida, 2018

Stroke Deaths

The table below shows the counts of deaths and age-adjusted death rates due to strokes per 100,000 individuals in

Palm Beach County and Florida in 2014-2016. The death rate for strokes has been increasing in the county since

2014. In 2016, there were 1,045 deaths due to stroke in Palm Beach County and a rate of 36.1 per 100,000. The

death rate for Palm Beach County has been consistently lower than the death rate for Florida.

Table 160: Stroke Deaths, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 789 29.3 9,605 33.4

2015 945 33.1 11,410 38.1

2016 1,045 36.1 11,843 38.5 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): I60-I69 Compiled by: Health Council of Southeast Florida, 2018


This table shows the age-adjusted death rates due to strokes per 100,000 individuals by race in Palm Beach County

and Florida for the years 2014-2016. Data trends show death rates for individuals identifying as Black have been

fluctuating, while steadily increasing for individuals identifying as White in the county. In Palm Beach County,

individuals identifying as Black have had a higher death rate due to strokes than individuals identifying as White

since 2014. The death rate for individuals identifying as Black in the county was higher than the death rate in the

state in 2014 and 2015, but fell below in 2016. The death rate for individuals identifying as White in the county were

consistently lower than in the state.

Table 161: Stroke Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida

White Black White Black

2014 26.4 49.3 31.3 46.6

2015 30.5 56.7 35.8 52.1

2016 34.5 43 36.5 50.9 Source: Florida Department of Health, Bureau of Vital Statistics Data note(s): ICD-10 Code(s): I60-I69 Compiled by: Health Council of Southeast Florida, 2018

Table 162 shows the age-adjusted death rates due to strokes per 100,000 individuals by ethnicity in Palm Beach

County and Florida for the years 2014-2016. Death rates for both groups in the county have been steadily increasing

in the time period presented. Individuals identifying as Hispanic in Palm Beach County had a consistently higher

death rate than individuals identifying as non-Hispanic. Death rates for individuals identifying as Hispanic and non-

Hispanic in the county were consistently lower than in the state.

Table 162: Stroke Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 29.7 29.5 31.1 33.9

2015 37.1 32.6 37.9 38.2

2016 38.2 36.1 38 38.7 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): I60-I69 Compiled by: Health Council of Southeast Florida, 2018


Cancer Deaths

The table below shows the number and rate of deaths per 100,000 females due to breast cancer in Palm Beach

County and Florida in 2012-2016. The death rate for the county has fluctuated over the years shown. The death

rate in Palm Beach County has typically been lower than the state’s rate. In 2016, there were 230 deaths due to

breast cancer, at a rate of 19 per 100,000 females.

Table 163: Female Breast Cancer Deaths, Palm Beach County and Florida, 2012-2016



2012 217 20 2,818 20.7

2013 201 17.5 2,749 19.8

2014 227 20.2 2,862 19.9

2015 215 18.8 2,847 19.5

2016 230 19 2,904 19.3 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Compiled by: Health Council of Southeast Florida, 2018


This table shows the number of deaths due to breast cancer in Bethesda Health’s service areas by ZIP code in

2016. There were a total of 85 deaths in the primary service area and 52 deaths in the secondary service area.

Boynton Beach, ZIP code 33437, had the largest number of deaths due to breast cancer in the primary service area

(11). In the secondary service area, Boca Raton, ZIP code 33433, and Boca Raton/Highland Beach, ZIP code

33487, each had seven deaths due to breast cancer.

Table 164: Death Counts from Breast Cancer, Bethesda Health Service Areas ZIP Codes, 2016



33437 11 33433 7

33463 10 33487 7

33446 9 33415 6

33467 8 33496 6

33414 7 33434 5

33445 7 33431 4

33462 6 33405 3

33426 5 33413 3

33435 5 33428 3

33436 5 33483 3

33460 4 33486 3

33461 3 33432 1

33484 3 33498 1

33444 2 33406 0



2012 2013 2014 2015 2016

Palm Beach 19.8 16.5 18.7 17.2 18

Palm Beach 20.9 21.9 23.3 24.1 23.5

Florida 20.1 19 19.1 18.7 18.4

Florida 23 22.6 23 22.9 22.9

This figure shows the age-adjusted death rate for breast cancer per 100,000 females by race in Palm Beach County

and Florida from 2012 to 2016. The death rate for women identifying with both racial groups in the county has

fluctuated over the years shown. In Palm Beach County, females identifying as Black & Other have had a higher

death rate than those identifying as White, although women identifying as White have a higher incidence rate of the

disease. In 2016, these rates were 23.5 and 18.0, respectively. The death rate for women identifying as White in the

county is lower than the state’s death rate for women identifying as White. Women identifying as White in the state

had a death rate of 18.4 in 2016. Women identifying as Black & Other in Palm Beach County had a higher death rate

than women identifying as Black & Other in Florida in the years 2014-2016. In 2016, women identifying as Black &

Other in the state had a death rate of 22.9.

Figure 42: Female Breast Cancer Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2012-2016

25

20

15

10

5

0



This figure shows the age-adjusted death rate for breast cancer per 100,000 females by ethnicity in Palm Beach

County and Florida for the years 2012-2016. In Palm Beach County, women identifying as non-Hispanic face a

higher death rate due to breast cancer than women identifying as Hispanic. In 2016 these rates were 20.2 and 13.6,

respectively. The death rates for both ethnicities in Palm Beach County are lower than the state’s death rates for the

two groups. Women identifying as non-Hispanic in the state had a death rate of 20.4 in 2016 and women identifying

as Hispanic had a death rate of 14.8.

Figure 43: Female Breast Cancer Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2012-2016.

25

20

15

10

5

0 2012 2013 2014 2015 2016

Palm Beach 13 9.8 18.8 12.7 13.6

Palm Beach 20.4 19.1 20.4 19.6 20.2

Florida 17.1 14.5 17.1 15.5 14.8

Florida 21.5 20.9 20.6 20.6 20.4



The table below shows the age-adjusted count and rate of deaths due to cervical cancer per 100,000 females in

Palm Beach County and Florida in 2012-2016. The death rate from cervical cancer in the county has fluctuated over

the years shown. In 2016, there were 26 deaths due to cervical cancer in the county, an age-adjusted rate of 2.6 per

100,000. The county’s death rate has been mostly lower than the state, except in 2016, when the death rate was the

same.

Table 165: Cervical Cancer Deaths, Palm Beach County and Florida, 2012-2016

Palm Beach Florida


2012 15 1.7 337 2.9

2013 23 2.8 349 2.9

2014 18 2.2 331 2.8

2015 20 2.1 288 2.3

2016 26 2.6 330 2.6 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Compiled by: Health Council of Southeast Florida, 2018


The table below shows the number of deaths due to cervical cancer in Bethesda Health’s service areas by ZIP code

in 2016. There were four deaths due to cervical cancer in the primary service area and nine in the secondary service

area. In the primary service area, Royal Palm Beach/Wellington/West Palm Beach, ZIP code 33414; Boynton

Beach, ZIP code 33426; Delray Beach, ZIP code 33445; and Wellington/Greenacres/Lake Worth, ZIP code 33467,

each had one death due to cervical cancer. The area of Greenacres/Haverhill/West Palm Beach, ZIP code 33415,

and Boca Raton, ZIP code 33486, in the secondary service area each had two deaths due to cervical cancer.

Table 166: Death Counts from Cervical Cancer, Bethesda Health’s Service Areas ZIP Codes, 2016



33414 1 33415 2

33426 1 33486 2

33445 1 33413 1

33467 1 33428 1

33435 0 33432 1

33436 0 33434 1

33437 0 33483 1

33444 0 33405 0

33446 0 33406 0

33460 0 33431 0

33461 0 33487 0

33462 0 33433 0

33463 0 33496 N/A

33484 0 33498 N/A



This figure shows the age-adjusted cervical cancer death rates per 100,000 females in Palm Beach County and

Florida in 2012-2016 by race. In Palm Beach County, the death rates for women identifying as White and Black &

Other have fluctuated. Women identifying as Black & Other in the county had higher death rates from cervical

cancer than women identifying as White in 2012-2015; in 2016 these rates were 1.1 and 3.0, respectively. The

cervical cancer death rate for White women in the county was higher than in the state in 2015 and 2016. In 2016, the

death rate for women identifying as White in the state was 2.6. The death rate from cervical cancer for women

identifying as Black & Other in the county was lower than in the state in every year except 2013. Women identifying

as Black & Other in the state had a death rate of 2.9 in 2016.

Figure 44: Cervical Cancer Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2012-2016

6

5

4

3

2

1

0

2012 2013 2014 2015 2016

Palm Beach 1.7 2.1 1.8 2.5 3

Palm Beach 1.9 5.3 3 0.6 1.1

Florida 2.6 2.7 2.6 2.3 2.6

Florida 4.5 4.2 3.7 2.4 2.9



The figure below shows the age-adjusted cervical cancer death rate per 100,000 females for women in Palm Beach

County and Florida in 2012-2016 by ethnicity. In the county in the years 2013, 2014, and 2016, women identifying as

non-Hispanic had a higher death rate than women identifying as Hispanic; in 2016, these rates were 2.7 and 1.3,

respectively. In 2014, there were no deaths due to cervical cancer in the Hispanic population. When comparing the

county and state, women identifying as non-Hispanic in Palm Beach County had a lower death rate than the state in

2012-2015; in 2016, both the state and the county had the same death rate for women identifying as non-Hispanic

(2.7). In 2012, 2013, and 2015, women identifying as Hispanic in Palm Beach County had a higher death rate than

women identifying as Hispanic in Florida. In 2016, women identifying as Hispanic in the state had a death rate of 2.3.

Figure 45: Cervical Cancer Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2012-2016

6

5

4

3

2

1

0 2012 2013 2014 2015 2016

Palm Beach 2.8 2.5 0 2.3 1.3

Palm Beach 1.6 3 2.6 2.2 2.7

Florida 2.7 2.3 2.4 1.8 2.3

Florida 3 3.1 2.9 2.4 2.7



This table shows the age-adjusted count and rate of deaths due to colorectal cancer per 100,000 individuals in

Palm Beach County and Florida in 2012-2016. The death rate in the county has fluctuated over the years shown,

but remained below that of the state. In 2016, there were 308 deaths due to colorectal cancer and a rate of 13.5 per

100,000.

Table 167: Colorectal Cancer Deaths, Palm Beach County and Florida, 2012-2016

Year

Palm Beach Florida


2012 267 12.1 3,637 14.1

2013 265 11.8 3,706 13.9

2014 264 11.9 3,682 13.5

2015 290 12.8 3,765 13.4

2016 308 13.5 3,953 13.7 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Compiled by: Health Council of Southeast Florida, 2018

The table below shows deaths due to colorectal cancer in Bethesda Health’s service area by ZIP code in 2016.

There were 115 deaths in the primary service area and 76 in the secondary service area. Boynton Beach/Village

of Golf, ZIP code 33436, had the largest number of deaths in the primary service area (15) and Boca Raton, ZIP

code 33433, had the largest number of deaths in the secondary service area (16).

Table 168: Death Counts from Colorectal Cancer, Bethesda Health’s Service Area ZIP Codes, 2016



33436 15 33433 16

33446 12 33415 10

33467 11 33406 7

33484 11 33428 6

33437 10 33434 6

33462 10 33487 6

33445 9 33486 5

33461 9 33432 4

33435 8 33496 4

33426 5 33498 4

33414 4 33413 3

33460 4 33405 2

33463 4 33483 2

33444 3 33431 1



The figure below shows the age-adjusted colorectal cancer death rate per 100,000 individuals by race in Palm Beach

County and Florida in the years 2012-2016. In the county, the death rate from colorectal cancer for individuals

identifying as White and Black & Other has increased over the last three years. Individuals identifying as Black &

Other in the county have had a higher death rate than those identifying as White. In 2016, individuals identifying as

Black & Other in the county had a death rate of 17.9 while individuals identifying as White had a rate of 12.5. The

death rate for individuals identifying as White in Palm Beach County has been lower than Florida’s since 2012 while

the death rates for individuals identifying as Black & Other in the county have been higher than in the state since

2014. In the state, individuals identifying as White had a death rate of 13.2 and individuals identifying as Black &

Other had a death rate of 16.1 in 2016.

Figure 46: Colorectal Cancer Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2012-2016

20

18

16

14

12

10

8

6

4

2

0 2012 2013 2014 2015 2016

Palm Beach 11.6 11.1 11.1 12.1 12.5

Palm Beach 15 14.4 16.6 17.9 17.9

Florida 13.6 13.6 13.2 13 13.2

Florida 16.8 15.7 14.7 15.6 16.1



Figure 47 shows the age-adjusted colorectal cancer death rate per 100,000 individuals by ethnicity in Palm Beach

County and Florida in 2012-2016. The death rate for individuals identifying as non-Hispanic and Hispanic in the

county has been rising since 2014. Individuals identifying as Hispanic in Palm Beach County have typically had

lower death rates than individuals identifying as non-Hispanic. In 2016, these rates were 11.8 and 14.3,

respectively. Individuals identifying as Hispanic in the county have had lower death rates than those in the state. In

2016, individuals identifying as Hispanic in Florida had a death rate of 12.7. The death rate for individuals identifying

as non-Hispanic in the county has been lower in the state for every year shown except 2016. In this year, individuals

identifying as non-Hispanic in the state had a death rate of 14.0.

Figure 47: Colorectal Cancer Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2012-2016

20

18

16

14

12

10

8

6

4

2

0 2012 2013 2014 2015 2016

Palm Beach 12.6 9.7 9.6 8.5 11.8

Palm Beach 12.3 12.2 12.3 13.4 14.3

Florida 13.2 13.5 12.7 12 12.7

Florida 14.3 14.1 13.7 13.8 14



The table below shows the age-adjusted count and rate of deaths due to prostate cancer per 100,000 individuals

in Palm Beach County and Florida in 2012-2016. The death rate in the county has increased since 2014. The

death rate for Palm Beach County has been lower than the state of Florida’s since 2012. The data from 2016

shows there were 188 deaths due to prostate cancer, which was a rate of 15.7 per 100,000.

Table 169: Prostate Cancer Deaths, Palm Beach County and Florida, 2012-2016

Palm Beach Florida


2012 167 15.6 2,031 17.7

2013 180 16.5 2,125 17.8

2014 140 12.1 2,112 17.1

2015 154 13.0 2,187 16.9

2016 188 15.7 2,220 16.7 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Compiled by: Health Council of Southeast Florida, 2018


This table shows deaths due to prostate cancer in Bethesda Health’s service areas by ZIP code in 2016.There were

74 deaths due to prostate cancer in the primary service area and 43 in the secondary service area. In the primary

service area, Boynton Beach, ZIP code 33437, had the largest number of prostate cancer deaths (14). Boca Raton,

ZIP code 33433, had the largest number of deaths due to prostate cancer in the hospital’s secondary service area

with seven.

Table 170: Death Counts from Prostate Cancer, Bethesda Service Area ZIP Codes, 2016



33437 14 33433 7

33446 10 33431 5

33436 6 33498 5

33463 6 33413 4

33414 5 33434 4

33426 5 33486 3

33445 5 33487 3

33461 5 33406 2

33467 5 33415 2

33484 5 33432 2

33435 3 33483 2

33462 3 33496 2

33460 2 33405 1

33444 0 33428 1



This figure shows the age-adjusted death rate due to prostate cancer per 100,000 individuals by race in Palm Beach

County and Florida in 2012-2016. In the county, the death rate from prostate cancer has increased from 2014-2016

for individuals identifying as White and fluctuated for individuals identifying as Black & Other. County trends show

individuals identifying as Black & Other have had a death rate more than double those identifying as White; in 2016,

these rates were 31.4 and 14.4, respectively. The death rate due to prostate cancer for individuals identifying as

Black & Other in the county was higher than in the state in 2012, 2013, and 2016. In 2016, individuals identifying as

Black & Other in the state was 28.0. The death rates for individuals identifying as White in the county have been

consistently lower than in the state. Individuals identifying as White in the state had a death rate of 15.4 in

2016.

Figure 48: Prostate Cancer Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2012-2016

40

35

30

25

20

15

10

5

0 2012 2013 2014 2015 2016

Palm Beach 14.1 14.7 11 11.5 14.4

Palm Beach 35.8 36.9 29.1 27.6 31.4

Florida 15.9 16.2 15.5 15.3 15.4

Florida 35.6 33.1 31.8 31.3 28



This figure shows the age-adjusted death rate for prostate cancer per 100,000 individuals in Palm Beach County

and Florida by ethnicity in 2012-2016. In Palm Beach County, the death rate for prostate cancer for individuals

identifying as Hispanic and non-Hispanic has steadily increased in the last three years. Individuals identifying as

Hispanic in the county had higher death rates than those identifying as non-Hispanic in 2015 and 2016; in 2016,

these rates were18.5 and 15.3, respectively. When comparing the county and state, individuals identifying as

Hispanic in Palm Beach County had a lower death rate in 2014 and 2015, but a higher death rate in 2016. In 2016,

individuals identifying as Hispanic in the state had a death rate of 17.4. Individuals identifying as non-Hispanic in the

county had lower death rates than the state in all five years shown. Individuals identifying as non-Hispanic in the

state had a death rate of 16.5 in 2016.

Figure 49: Prostate Cancer Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2012-2016

40

35

30

25

20

15

10

5

0 2012 2013 2014 2015 2016

Palm Beach 13.1 18.5 11.7 13.9 18.5

Palm Beach 15.9 16.5 12.2 12.8 15.3

Florida 19.1 18.1 17.1 17.8 17.4

Florida 17.5 17.7 17 16.8 16.5



The table below shows deaths due to pancreatic cancer in Bethesda Health’s service areas by ZIP code in

2016. There were 104 deaths in the primary service area and 82 in the secondary service area. The primary

service area Boynton Beach, ZIP code 33437, had 14 deaths due to pancreatic cancer. Boca Raton, ZIP code

33433, had the highest number of deaths (17) in the secondary service area.

Table 171: Death Counts from Pancreatic Cancer, Bethesda Health’s Service Area ZIP Code, 2016



33437 14 33433 17

33436 11 33496 8

33446 11 33406 7

33445 8 33415 7

33461 8 33483 7

33484 8 33428 6

33462 7 33432 6

33414 6 33434 6

33426 6 33431 4

33463 6 33486 4

33467 6 33498 4

33435 5 33487 3

33444 5 33413 2

33460 3 33405 1


Diabetes Deaths

This table shows the counts of deaths and age-adjusted death rates for diabetes per 100,000 individuals in Palm

Beach County and Florida in 2014-2016. In the county, the death rate due to diabetes has fluctuated in the three

years shown. The 2016 data for the county shows there were 306 diabetes deaths and a death rate of 12.9. Death

rates for Palm Beach County have been consistently lower than Florida’s death rates in the time period presented.

Table 172: Diabetes Deaths, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 279 12.5 5,324 19.6

2015 274 12 5,394 19.1

2016 306 12.9 5,780 20.1 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): E10-E14 Compiled by: Health Council of Southeast Florida, 2018


The figure below shows the age-adjusted death rates for diabetes per 100,000 individuals by race in Palm Beach

County and Florida in 2014-2016. The diabetes death rate for individuals identifying as White in the county has

increased over the years shown and decreased for those individuals identifying as Black. Individuals identifying as

Black in Palm Beach County had a death rate more than double that of individuals identifying as White; in 2016,

these rates were 24.9 and 11.2, respectively. When comparing the county to the state, the county’s death

rates from diabetes are lower than the state's for both groups. In 2016, individuals identifying as Black in the county

had a death rate of 33.7, and individuals identifying as White had a death rate of 17.9.

Figure 50: Diabetes Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016

40

35

29.5 30

25

20

35.1

34.1 33.7

26.5

24.9

17.4 16.9 17.9

15

10.2 10.1 11.2

10

5

0

2014 2015 2016


Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): E10-E14 Compiled by: Health Council of Southeast Florida, 2018


This figure shows the age-adjusted death rates for diabetes per 100,000 individuals by ethnicity in Palm Beach

County and Florida in 2014-2016. Those identifying as Hispanic and non-Hispanic in Palm Beach County had

similar death rates from diabetes in the years shown. In 2016, individuals identifying as Hispanic in the county had

a death rate of 13.2 and those identifying as non-Hispanic had a death rate of 13.1. The death rates

from diabetes in the county for both ethnic groups have been lower than in the state. In 2016, individuals identifying

as Hispanic in the state had a death rate of 18.6, and those identifying as non-Hispanic had a death rate of

20.5. Figure 51: Diabetes Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016

40

35

30

25

20

15 12.5

12.5

17.7

20.2

11.9

12.2

19.2

19.2

13.2

13.1

18.6

20.5

10

5

0

2014 2015 2016


Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): E10-E14 Compiled by: Health Council of Southeast Florida, 2018


This table shows the death count from diabetes in Bethesda’s service area by ZIP code in 2016. There were a total

of 129 deaths from diabetes in the primary service area and 60 in the secondary service area in 2016. Delray

Beach, ZIP code 33484, had the highest number of deaths (17) from diabetes in the primary service area (17) and

the area of Greenacres/Haverhill/West Palm Beach, ZIP code 33415, had the highest number of deaths (17) from

diabetes in the secondary service area (12).

Table 173: Death Counts from Diabetes, Bethesda Health’s Service Area ZIP Codes, 2016



33484 17 33415 12

33435 14 33433 7

33436 14 33434 7

33467 14 33483 6

33437 12 33428 4

33463 10 33496 4

33461 9 33405 3

33462 9 33406 3

33426 7 33413 3

33414 5 33432 3

33444 5 33487 3

33460 5 33431 2

33445 4 33486 2

33446 4 33498 1

Total 129 Total 60 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): E10-E14 Compiled by: Health Council of Southeast Florida, 2018

HIV/AIDS Deaths The table below shows the number of deaths and age-adjusted death rate from HIV/AIDS per 100,000 in Palm

Beach County and Florida in 2014-2016. The death rate in the county has fluctuated over the years shown. The

county’s death rate from HIV/AIDS was higher than the state’s in 2014 and 2015. In 2016, there were 54 deaths from

HIV/AIDS in Palm Beach County for a rate of 3.6 deaths per 100,000 individuals.

Table 174: HIV/AIDS Deaths, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 64 4.4 878 4.2

2015 66 4.7 873 4

2016 54 3.6 864 3.9 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): B20-B24 Compiled by: Health Council of Southeast Florida, 2018


Figure 52 shows the age-adjusted death rate from HIV/AIDS per 100,000 by race in Palm Beach County and Florida

in 2014-2016. The death rate for HIV/AIDS for individuals identifying as Black in the county has steadily decreased

over the years shown but fluctuated for those individuals identifying as White. There is a disparity in the death rate

from HIV/AIDS between the races. In 2016, individuals identifying as Black had a death rate 7.6 times that of

those individuals identifying as White in the county (13 and 1.7, respectively). When comparing county to state,

individuals identifying as Black in Palm Beach had a higher death rate than those in the state in 2014 and 2015. In

2016, individuals identifying as Black in Florida had a death rate of 15.0. Individuals identifying as White in the

county had a lower death rate than in the state in 2014 and 2016. In 2016, individuals identifying as White in the

death rate state had 1.9.

Figure 52: HIV/AIDS Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016

25

20.4

20

15

16.5

16.5

14.9 15

13

10

5

1.2 2

2.1

2.1

1.7

1.9

0

2014 2015 2016


Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): B20-B24 Compiled by: Health Council of Southeast Florida, 2018


The figure below shows the age-adjusted death rate per 100,000 from HIV/AIDS by ethnicity in Palm Beach County

and Florida in 2014-2016. Trends show the death rate from HIV/AIDS for individuals identifying as Hispanic and

non-Hispanic decreased from 2015 to 2016. Individuals identifying as non-Hispanic in the county have a higher

death rate than individuals identifying as Hispanics; this disparity was almost double in 2016 (4.1 and

2.1, respectively). The death rate for individuals identifying as non-Hispanic in the county was were higher than in

the state in 2014 and 2015. In 2016, individuals identifying as non-Hispanic in the state had a death rate of 4.4. The

death rate for individuals identifying as Hispanic in the county was lower than in the state in 2015 and 2016.

Individuals identifying as Hispanic in the state had a death rate of 2.2 in 2016.

Figure 53: HIV/AIDS Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016

25

20

15

10

5 4.7

5 5.1

4.4 4.1 4.4

2.8 2.3 2.4 2.6 2.1 2.2

0

2014 2015 2016


Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): B20-B24 Compiled by: Health Council of Southeast Florida, 2018


This table shows deaths due to HIV/AIDS in Bethesda’s primary and secondary service area by ZIP code in 2016.

In the primary service area, there were a total of 22 deaths due to HIV/AIDS, and in the secondary service area

there were five. Delray Beach, ZIP code 33444, had the highest number of deaths due to HIV/AIDS in Bethesda’s

primary service area in 2016 (7). In the secondary service area, West Palm Beach, ZIP code 33405;

Greenacres/Haverhill/West Palm Beach, ZIP code 33415; Boca Raton, ZIP code 33428; Boca Raton, ZIP code

33431; and Boca Raton/Highland Beach, ZIP code 33487, each had one death due to HIV/AIDS.

Table 175: Death Counts from HIV/AIDS, Bethesda Health’s Service Area ZIP Codes, 2016



33444 7 33405 1

33460 3 33415 1

33426 2 33428 1

33461 2 33431 1

33463 2 33487 1

33414 1 33406 0

33435 1 33413 0

33437 1 33433 0

33445 1 33434 0

33462 1 33483 0

33467 1 33486 0

33436 0 33432 N/A

33484 0 33496 N/A

33446 N/A 33498 N/A

Total 22 Total 5 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): B20-B24 Compiled by: Health Council of Southeast Florida, 2018

Unintentional Injury Deaths

This table shows the numbers and rates of deaths from unintentional injuries per 100,000 individuals in Palm

Beach County and Florida in 2014-2016. The death rate from unintentional injuries in the county has increased

from 38.8 in 2014 to 68.1 in 2016. In 2016, there were a total of 998 deaths from unintentional injuries in

the county, which is a rate of 68.1. Palm Beach County’s rates in 2015 and 2016 were higher than Florida’s.

Table 176: Unintentional Injury Deaths, Palm Beach County and Florida, 2014-2016


Count Rate per 100,000 Count Rate per 100,000 2014 622 38.8 9,128 40.7 2015 802 50.9 10,346 45.9 2016 998 68.1 12,522 55.7

Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): V01-X59, Y85-Y86 Compiled by: Health Council of Southeast Florida, 2018


Table 177 shows the death rates from unintentional injuries per 100,000 individuals by race in Palm Beach County

and Florida in 2014-2016. The death rates for both racial groups in the county fluctuated in the three-year span

shown. In Palm Beach County, individuals identifying as Black & Other had almost double the death rate due to

unintentional injuries as individuals identifying as White in the years shown; in 2016, these rates were 10.3 and 5.8,

respectively. The death rate for individuals identifying as Black & Other in the county has been consistently lower or

equal to that of the state. In the county, individuals identifying as White had a higher death rate than in the state in

2014 and 2016.

Table 177: Unintentional Injury Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 5.9 10.2 5.7 10.8

2015 4.8 11.2 5.1 11.2

2016 5.8 10.3 5.1 11 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): V01-X59, Y85-Y86 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the death rate from unintentional injuries per 100,000 individuals by ethnicity in Palm Beach

County and Florida in 2014-2016. Both groups in the county have seen the death rates fluctuate in the time period

shown. In the county, individuals identifying as non-Hispanic had higher death rates than those identifying as

Hispanic. In 2016, these rates were 7.2 and 6.7, respectively. Individuals identifying as non-Hispanic in the county

had higher death rates than in the state in 2015 and 2016. Individuals identifying as Hispanic in the county had higher

death rates than in the state in 2014 and 2016.

Table 178: Unintentional Injury Age-Adjusted Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 7.1 7.3 5.6 7.5

2015 4.1 7.6 5.3 7.2

2016 6.7 7.2 5.4 7.1 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): V01-X59, Y85-Y86 Compiled by: Health Council of Southeast Florida, 2018


Firearm Discharge Deaths

This table shows the counts of deaths and death rates per 100,000 individuals from firearms discharge in Palm

Beach County and Florida in 2014-2016. The county’s death rate has decreased in the three years presented and

has remained equal to or higher than the state's. In 2016, there were 177 deaths from firearms discharge and

a rate of 12.8; this rate is equal to that of the state.

Table 179: Deaths from Firearms Discharge, Palm Beach County and Florida, 2014-2016


Count Rate per 100,000 Count Rate per 100,000 2014 187 13.4 2,375 11.6 2015 167 12.9 2,553 12.3 2016 177 12.8 2,696 12.8

Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): W32-W34, X93-X95, X72-X74, Y22-Y24, Y35.0 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the death rates per 100,000 individuals from firearms discharge by race in Palm Beach

County and Florida in 2012-2016. In these three years, the rate has fluctuated. Individuals

identifyed as Black & Other had nearly double the death rate due to firearms discharge than that of individuals

identifying as White in Palm Beach County in the years provided; in 2016 these rates were 19.5 and 10.1,

respectively. The death rate for individuals identifying as Black & Other in the county has been consistently

higher than the state.

Table 180: Death Rates from Firearms Discharge by Race, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 9.9 19.8 10.8 15.2

2015 9.4 21.5 11 17.4

2016 10.1 19.5 10.1 14.7 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): W32-W34, X93-X95, X72-X74, Y22-Y24, Y35.0 Compiled by: Health Council of Southeast Florida, 2018


Homicide Deaths

This table shows the number of deaths and age-adjusted homicide death rates per 100,000 individuals in Palm

Beach County and Florida in 2014-2016. The county’s death rate for homicides in Palm Beach County has

decreased over the three years shown, but remains higher than Florida’s death rate. There were 89 homicide

deaths in 2016 in Palm Beach County and a rate of 7.3; this rate is higher than the state’s death rate of 6.9.

Table 181: Homicide Deaths, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 97 8.2 1,139 6.2

2015 99 8 1,185 6.3

2016 89 7.3 1,292 6.9 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): X85-Y09, Y87.1 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the age-adjusted homicide death rate per 100,000 individuals by race in Palm Beach County

and Florida in 2014-2016. In the county, the death rate for individuals identifying as Black & Other has fluctuated

over the three years presented and decreased for individuals identifying as White. There is a disparity of homicide

death rates by race; individuals identifying as Black & Other in Palm Beach County had a death rate more than five

times higher than that of individuals identifying as Whites in 2016 (16.9 and 3.2, respectively). The death rate for

individuals identifying as White in the county was higher than the state’s rate in 2014 and 2015 but fell in 2016. In

2016, individuals identifying as White in the state had a death rate of 4.1. The death rate for individuals identifying

as Black & Other in Palm Beach County has been consistently higher than the death rate for those in the state.

Individuals identifying as Black & Other in the state had a death rate of 14.8 in 2016.

Table 182: Homicide Age-Adjusted Death Rates by Race, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 3.9 18.2 3.6 13.5

2015 3.9 19 3.4 14.8

2016 3.2 16.9 4.1 14.8 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): X85-Y09, Y87.1 Compiled by: Health Council of Southeast Florida, 2018


Drug Poisoning Deaths

The table below shows the number of deaths and death rates from drug poisoning per 100,000 individuals in Palm

Beach County and Florida in 2014-2016. The death rate has been increasing in the county since 2014 and has

been higher than the state’s death rates for the three years presented; in 2016, it was almost double. In the county,

there were 583 deaths from drug poisoning and a rate of 46.4 deaths per 100,000 in 2016.

Table 183: Drug Poisoning Deaths, Palm Beach County and Florida, 2014-2016

Year

Palm Beach Florida


2014 229 17.4 2,487 12.6

2015 318 24.9 3,028 15.5

2016 583 46.4 4,692 23.9 Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): X40-X44, X60-X64, X85, Y10-Y14 Compiled by: Health Council of Southeast Florida, 2018


This figure shows the death rate per 100,000 individuals from drug poisoning in Palm Beach County and Florida by

race in 2014-2016. For both groups in the county, the death rates have continuously increased over the years

shown. In Palm Beach County, individuals identifying as White had a death rate more than four times that of

individuals identifying as Black & Other; in 2016, these rates were 60.2 and 11.3, respectively. The death rates for

both individuals identifying as White and Black & Other in the county have been higher than the state in the years

provided. In 2016, individuals identifying as White in the state had a death rate of 28.5 and those identifying as Black

h a d a d e a t h r a t e o f 9 . 5 .

Figure 54: Drug Poisoning Death Rates by Race, Palm Beach County and Florida, 2014-2016

70

60.2 60

50

40

30

22

20

10 4.8

14.9

4.6

32

18.5

6

5.3

11.3

28.5

9.5

0

2014 2015 2016


Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): X40-X44, X60-X64, X85, Y10-Y14 Compiled by: Health Council of Southeast Florida, 2018


6.5

Figure 55 shows the death rates per 100,000 individuals from drug poisoning in Palm Beach County and Florida

by ethnicity in 2014-2016. Individuals identifying as non-Hispanic in the county had much higher death rates than

those identifying as Hispanic. In 2016, these rates were 53.9 and 22.4, respectively. When comparing county to

state, both ethnic groups in the county had higher death rates than in the state. In 2016, the death rate for

individuals identifying as non-Hispanic in the state was 28.0 and those identifying as Hispanic was 11.1.

Figure 55: Drug Poisoning Death Rates by Ethnicity, Palm Beach County and Florida, 2014-2016

70

60

53.9

50

40

30

20.6 20 15

30.3

18.6

22.4

28

11.1 8.6

10 4.7 6.1

0

2014 2015 2016


Source: Florida Department of Health, Bureau of Vital Statistics, 2016 Data note(s): ICD-10 Code(s): X40-X44, X60-X64, X85, Y10-Y14 Compiled by: Health Council of Southeast Florida, 2018


Health Resources Availability and Access

Licensed Facility Overview

Hospitals

The table below lists the licensed hospitals in Palm Beach County, their location, the number of licensed beds and

profit status as of April 2018. There are 17 hospitals with 4,223 licensed beds. Six of the hospitals are not-for-profit

and 11 are for-profit.

Table 184: Licensed Hospitals, Palm Beach County, as of April 2018

Name Street City Licensed Beds Profit Status

Bethesda Hospital East Boynton Beach 401 Not-For-Profit

Bethesda Hospital West Boynton Beach 80 Not-For-Profit

Boca Raton Regional Hospital Boca Raton 400 Not-For-Profit

Delray Medical Center Delray Beach 536 For-Profit

Good Samaritan Medical Center West Palm Beach 333 For-Profit

JFK Medical Center Atlantis 486 For-Profit

JFK Medical Center North Campus West Palm Beach 245 For-Profit

Jupiter Medical Center Jupiter 207 Not-For-Profit

Kindred Hospital - The Palm Beaches Riviera Beach 70 For-Profit

Lakeside Medical Center Belle Glade 70 Not-For-Profit

Palm Beach Gardens Medical Center Palm Beach Gardens 199 For-Profit

Palms West Hospital Loxahatchee 204 For-Profit

Select Specialty Hospital – Palm Beach Lake Worth 60 For-Profit

St. Mary's Medical Center West Palm Beach 460 For-Profit

The Jerome Golden Center For Behavioral Health West Palm Beach 44 Not-For-Profit

Wellington Regional Medical Center Wellington 233 For-Profit

West Boca Medical Center Boca Raton 195 For-Profit Source: Agency for Health Care Administration (AHCA), 2017 Compiled by: Health Council of Southeast Florida, 2018


Nursing Homes The table below lists the licensed nursing homes in Palm Beach County, their location, number of licensed beds and

profit status as of April 2018. There are 55 nursing homes with a total of 6,349 beds; 16 of the nursing homes are

not-for-profit and 39 are for-profit.

Table 185: Licensed Nursing Homes, Palm Beach County, as of April 2018

Name Street City Licensed

Beds Profit Status

Abbey Delray Delray Beach 100 Not-For-Profit

Abbey Delray South Delray Beach 90 Not-For-Profit

Avante at Boca Raton, Inc. Boca Raton 144 For-Profit

Avante at Lake Worth, Inc. Lake Worth 138 For-Profit

Barrington Terrace of Boynton Beach Boynton Beach 29 For-Profit

Boca Raton Rehabilitation Center Boca Raton 120 Not-For-Profit

Boulevard Rehabilitation Center Boynton Beach 167 For-Profit

Boynton Beach Rehabilitation Center Boynton Beach 168 For-Profit

Boynton Health Care Center Boynton Beach 99 For-Profit

Chatsworth at PGA National Palm Beach Gardens 76 For-Profit

Consulate Health Care of West Palm Beach West Palm Bch 120 For-Profit

Coral Bay Healthcare and Rehabilitation West Palm Bch 120 For-Profit

The Crossings Lake Worth 60 For-Profit

Darcy Hall of Life Care West Palm Beach 220 For-Profit

Edward J. Healey Rehabilitation and Nursing Center Riviera Beach 120 Not-For-Profit

Encore at Boca Raton Rehabilitation and Nursing Center Boca Raton 154 For-Profit

Finnish-American Village Lake Worth 45 Not-For-Profit

Gardens Court Palm Beach Gardens 120 For-Profit

Glades Health Care Center Pahokee 120 Not-For-Profit

Hamlin Place of Boynton Beach Lantana 120 Not-For-Profit

Harbour's Edge Delray Beach 54 Not-For-Profit

Health Center at Sinai Residences Boca Raton 60 Not-For-Profit

Heartland Health Care and Rehabilitation Center of Boca Raton Boca Raton 120 For-Profit

Heartland Health Care Center - Boynton Beach Boynton Beach 120 For-Profit

Heartland Health Care Center - Prosperity Oaks Palm Beach Gardens 120 For-Profit

Joseph L. Morse Health Centerm Inc. West Palm Beach 310 Not-For-Profit

Jupiter Medical Center Pavilion, Inc. Jupiter 120 Not-For-Profit

Lake View Care Center at Delray Delray Beach 120 For-Profit

Lakeside Health Center West Palm Beach 107 For-Profit

Lourdes-Noreen Mckeen Residence for Geriatric Care Inc. West Palm Beach 132 Not-For-Profit

Manorcare Health Services Delray Beach 120 For-Profit

Manorcare Health Services Boca Raton 180 For-Profit

Manorcare Health Services - Boynton Beach Boynton Beach 180 For-Profit

Manorcare Health Services West Palm Beach West Palm Beach 120 For-Profit


Medicana Nursing and Rehab Center Lake Worth 117 For-Profit

Menorah House Boca Raton 120 For-Profit

North Lake Care Center Lake Park 85 For-Profit

Nursing Center at La Posada Palm Beach Gardens 40 For-Profit

Nuvista Living at Wellington Green Wellington 120 For-Profit

Oasis Health and Rehabilitation Center Lake Worth 120 For-Profit

Palm Garden of West Palm Beach West Palm Beach 176 For-Profit

Regents Park Nursing & Rehabilitation Center Boca Raton 180 For-Profit

Rehabilitation Center at Jupiter Gardens LLC Jupiter 120 For-Profit

Rehabilitation Center of The Palm Beaches West Palm Beach 99 Not-For-Profit

Renaissance Health and Rehabilitation West Palm Beach 120 For-Profit

Royal Palm Beach Health and Rehabilitation Center Royal Palm Beach 120 For-Profit

Savannah Cove of The Palm Beaches West Palm Beach 30 For-Profit

Signature Healthcare of Palm Beach Lake Worth 120 For-Profit

Stratford Court of Boca Raton Boca Raton 60 For-Profit

Terraces of Lake Worth Care Center Lake Worth 99 For-Profit

Vi at Lakeside Village Lantana 60 For-Profit

The Waterford Juno Beach 60 Not-For-Profit

Willowbrooke Court at St. Andrews Estates Boca Raton 89 Not-For-Profit

Willowbrooke Court Skilled Care Center– Edgewater at Boca Pointe

Boca Raton 101 Not-For-Profit

Wood Lake Health and Rehabilitation Center Greenacres 120 For-Profit Source: Agency for Health Care Administration (AHCA), 2018 Compiled by: Health Council of Southeast Florida, 2018


Healthcare Provider Supply

Physicians

This table shows the number and rate per 100,000 individuals of physicians in Palm Beach County and Florida in

2012-2017. Since fiscal year 2012-2013, Palm Beach County has added 1,064 physicians. Fiscal year 2016-

2017 shows Palm Beach County had a higher rate of physicians per 100,000 individuals (382.8) than

Florida (315.5). This data does not specify whether the physician is actively practicing in the county and is not an

accurate representation of supply nor can it be used as a proxy measure for access to care.

Table 186: Total Licensed Florida Physicians, Palm Beach County and Florida, 2012-2017

Year

Palm Beach Florida


FY 12-13 4,277 319.7 50,586 264.6

FY 13-14 4,369 323.9 53,259 275.7

FY 14-15 4,246 311.1 50,679 258.8

FY 15-16 4,195 303.5 49,456 248.6

FY 16-17 5,341 382.8 63,825 315.5

Source: Florida Department of Health, Division of Medical Quality Assurance, 2017 Compiled by: Health Council of Southeast Florida


Nurses

This table shows the number of licensed Registered Nurses in Bethesda’s service area in April 2018. According to

the Florida Department of Health license verification database, there were 14,097 licensed Registered Nurses with

an "address of record" in Palm Beach County. This data does not specify whether the nurse is actively practicing

in the county and is not an accurate representation of supply nor can it be used as a proxy measure for access to

care.

Table 187: Licensed Registered Nurses, Bethesda Health’s Service Area, April 2018

City Count

ATLANTIS 563

BOCA RATON 2,841

BOYNTON BEACH 2,013

BRINY BREEZES 2

DELRAY 19

DELRAY BEACH 1,392

GLEN RIDGE 1

GREENACRES 269

GULF STREAM 1

HAVERHILL 9

HIGHLAND BEACH 12

HYPOLUXO 21

LAKE CLARKE SHORES 5

LAKE WORTH 1,361

LANTANA 143

MANALAPAN 7

OCEAN RIDGE 12

PALM BEACH 1

PALM SPRINGS 164

ROYAL PALM BEACH 562

VILLAGE OF GOLF 3

WELLINGTON 922

WEST PALM BEACH 3,774

Total 14,097 Source: Florida Department of Health, Division of Medical Quality Assurance, 2018 FL Department of Health, License Verifications


Dentists

This table shows the number and rate per 100,000 individuals of licensed dentists in Palm Beach County and

Florida in 2012-2017. In fiscal year 2016-2017, there were 1,131 licensed dentists in Palm Beach County with a rate

of 81.1 per 100,000 individuals; this is higher than the state's rate of 57.5. Since fiscal year 2012-2013, Palm Beach

County has added 81 licensed dentists. This data does not specify whether the dentist is actively practicing in the

county and is not an accurate representation of supply nor can it be used as a proxy measure for access to care.

Table 188: Total Licensed Florida Dentists, Palm Beach County and Florida, 2012-2017


Count Rate Count Rate FY 12-13 1,050 78.5 10,443 54.6 FY 13-14 975 72.3 10,396 53.8 FY 14-15 1,151 84.3 11,635 59.4 FY 15-16 1,080 78.1 10,986 55.2 FY 16-17 1,131 81.1 11,641 57.5 Source: Florida Department of Health, Division of Medical Quality Assurance, 2017 Compiled by: Health Council of Southeast Florida

Mental Health Provider Supply

Licensed Clinical Social Workers

This table shows the number of licensed clinical social workers in Palm Beach County and Florida in 2015-2017.

Since fiscal year 2015, Palm Beach County has added four licensed clinical social workers. This data does not

specify whether the licensed clinical social workers are actively practicing in the county and is not an accurate

representation of supply or nor may it be used as a proxy measure for access to care.

Table 189: Licensed Clinical Social Workers, Palm Beach County and Florida, 2015-2017


FY 15-16 974 8,581

FY 16-17 978 8,897 Source: Florida Department of Health, Division of Medical Quality Assurance, 2017 Compiled by: Health Council of Southeast Florida, 2018

Licensed Mental Health Counselors

The table below shows the number of licensed mental health counselors in Palm Beach County and Florida in

2015-2017. Palm Beach County has seen an increase in 54 licensed mental health counselors since fiscal year

2015. This data does not specify whether the licensed mental health counselors are actively practicing in the county

and is not an accurate representation of supply nor can it be used as a proxy measure for access to care.

Table 190: Licensed Mental Health Counselors, Palm Beach County and Florida, 2015-2018


FY 15-16 825 9,689 FY 16-17 879 10,135

Source: Florida Department of Health, Division of Medical Quality Assurance, 2017 Compiled by: Health Council of Southeast Florida, 2018


Licensed Psychologists

The table below shows the number of licensed psychologists in Palm Beach County and Florida between fiscal years

2015-2017. Palm Beach County has added 23 licensed psychologists since fiscal year 2015. This data does not

specify whether the licensed psychologists are actively practicing in the county and is not an accurate representation

of supply nor can it be used as a proxy measure for access to care.

Table 191: Licensed Psychologists, Palm Beach County and Florida, 2015-2017


FY 15-16 482 4,422


Licensed Marriage and Family Therapists

The table below shows the number of licensed marriage and family therapists in Palm Beach County and Florida

in 2015-2017. Palm Beach County has added six licensed marriage and family therapists since fiscal year 2015.

This data does not specify whether the licensed marriage and family therapists are actively practicing in the

county and is not an accurate representation of supply nor can it be used as a proxy measure for access to care.

Table 192: Licensed Marriage and Family Therapists, Palm Beach County and Florida, 2015-2017


FY 15-16 195 1,766



Federal Health Professional Shortage Area (HPSAs)

Health Professional Shortage Areas (HPSAs) are designated by the Health Resources and Services Administration

(HRSA) as having shortages of primary care, dental care or mental health providers and can be geographic (a

county or service area), population (e.g., low income or Medicaid eligible) or facilities (e.g., federally qualified health

centers, or state or federal prisons).30 Scoring criteria among all disciplines of HPSA includes population-to-provider

ratio, percentage of population below 100 percent of the Federal Poverty Level (FPL), and travel time to the nearest

source of care (NSC) outside the HPSA designation.31 Each discipline has additional scoring criteria as well. Scores

range from zero to 25 for primary care and mental health and zero to 26 for dental. The higher the HPSA score, the

greater the priority for the area.

Primary Care – Palm Beach County

This table shows the primary care health professional shortage areas in Palm Beach County in 2016. There are four

components used for scoring primary care HPSAs: population-to-provider ratio, percent of population below 100

percent FPL, infant health index (based on infant mortality rate or low-birth rate), and travel time to NSC.12 Primary

care HPSAs can receive scores from zero to 25 a score between 0-25. There are 12 primary care HPSAs in the

county.

Table 193: Primary Care Health Professional Shortage Area (HPSAs), Palm Beach County, 2016

HPSA Name ID Type Score

Low Income/Migrant Farmworker - Belle Glade/Pahokee/Palm Beach

1125137609 Low Income Migrant Farmworker

Population HPSA 19

Genesis Community Health 11299912AX Comprehensive Health Center 18

Low Income - Boynton Beach 1128675661 Low Income Population HPSA 18

Health Care District of Palm Beach County 1129991217 Comprehensive Health Center 17

Low Income - Boca Raton 1128914050 Low Income Population HPSA 17

Low Income - Greenacres 1121591415 Low Income Population HPSA 17

Foundcare Health Center 11299912AD Comprehensive Health Center 16

Florida Community Health Centers, Inc. 112999124W Comprehensive Health Center 15

Low Income - West Palm Beach 1126672852 Low Income Population HPSA 13

Low Income - Lantana/Lake Worth 1123910811 Low Income Population HPSA 13

Low Income - Delray Beach 1123152425 Low Income Population HPSA 13

South Bay Correctional Facility 11299912AE Correctional Facility 9

Source: U.S. Department of Health & Human Services, 2016 Compiled by: Health Council of Southeast Florida

30 Health Resources & Services Administration. (October 2016). Health Professional Shortage Areas (HPSAs). Retrieved from https://bhw.hrsa.gov/shortage-

designation/hpsas 31

Health Resources & Services Administration. (October 2016). Health Professional Shortage Areas (HPSAs) application and scoring process. Retrieved

from https://bhw.hrsa.gov/shortage-designation/hpsa-process


Dental Care – Palm Beach County

This table shows the dental care health professional shortage areas in Palm Beach County in 2016. There are four

components used for scoring dental HPSAs: population-to-provider ratio, percent of population below 100 percent

FPL, water fluoridation status, and travel time to NSC.12 Dental health HPSAs can receive scores from zero to 26.

There are eight dental care HPSAs in the county.

Table 194: Dental Care Health Professional Shortage Area (HPSAs), Palm Beach County, 2016


Foundcare Health Center 61299912OX Comprehensive Health Center 23

Low Income - Belle Glade 6128922241 Low Income Population HPSA 21

Health Care District of Palm Beach County 612999120I Comprehensive Health Center 20

Genesis Community Health 61299912PH Comprehensive Health Center 19

Low Income - Boynton Beach 6121313361 Low Income Population HPSA 17

Low Income - West Palm Beach 6129074108 Low Income Population HPSA 16

Florida Community Health Centers, Inc. 612999123C Comprehensive Health Center 13

South Bay Correctional Facility 61299912P2 Correctional Facility 6

Source: U.S. Department of Health & Human Services, 2016 Compiled by: Health Council of Southeast Florida

Mental Health Care – Palm Beach County

This table shows the mental health professional shortage areas in Palm Beach County in 2016. There are seven

components used for scoring the mental health HPSA: population-to-provider ratio, percent of population below

100 percent FPL, elderly ratio, youth ratio, alcohol abuse prevalence, substance abuse prevalence, and travel

time to NSC.12 Mental health HPSA can receive a scores from zero to 25. There are nine HPSAs in the county.

Table 195: Mental Health Professional Shortage Area (HPSAs), Palm Beach County, 2016


Foundcare Health Center 712999129A Comprehensive Health Center 21

Genesis Community Health 71299912A0 Comprehensive Health Center 19

Belle Glade/Pahokee 7123755864 HPSA Geographic High Needs 19

Health Care District of Palm Beach County 7129991205 Comprehensive Health Center 17

Florida Community Health Centers, Inc. 7129991295 Comprehensive Health Center 14

Belle Glade – Pahokee CCD N/A Minor Civil Division N/A

Lake Worth CCD N/A Minor Civil Division N/A

Riviera Beach CCD N/A Minor Civil Division N/A

West Palm Beach CCD N/A Minor Civil Division N/A Source: U.S. Department of Health & Human Services, 2016 Compiled by: Health Council of Southeast Florida


Medically Underserved Areas (MUAs)/Populations (MUPs)

Medically Underserved Areas (MUAs)/Populations (MUPs) are designated by the Health Resources Service

Administration (HRSA) as having too few primary care providers, high infant mortality, high poverty or high elderly

populations.32 MUAs may include a whole county; a group of neighboring counties; a group of urban census tracts;

or a group of civil divisions. MUPs are specific sub-groups of people living in a defined geographic area that may

face economic, cultural or linguistic barriers to healthcare. MUPs may include the homeless; low-income; Medicaid-

eligible; Native American; or migrant farmworkers. MUA/P designations are based on the Index of Medical

Underservice (IMU).33 IMU is calculated based on four criteria: population-to-provider ratio, percent of population

below the FPL, percent of the population over age 65, and the infant mortality rate. IMU can range from zero to 100,

where zero represents the completely underserved. Areas or populations with IMUs of 62.0 or less qualify for

designation as an MUA/P.

This table shows the MUPs and MUAs in Palm Beach County in April 2018; there are a total of eight.

Table 196: Medically Underserved Populations and Area, Palm Beach County, April 2018

Name

ID

Type

Designation Date

Update Date

IMU Score

Low Income - Jupiter 7817 MUP 04/15/2011 04/15/2011 61.2

Low Income/ M F W - Belle Glade/ Pahokee 7531 MUP 05/11/1994 03/23/2006 53.6

Low Income - Lantana/ Lake Worth 7280 MUP 08/28/2002 08/28/2002 58.9

Low Income - Delray Beach 7279 MUP 08/28/2002 08/28/2002 46.7

Low Income - Boca Raton 7246 MUP 07/26/2002 05/29/2007 57.8

Low Income - Greenacres 7245 MUP 07/25/2002 10/05/2007 47.5

Low Income - West Palm Beach 7064 MUP 06/22/2001 06/22/2001 59.9

Low Income - Boynton Beach 570 MUP 09/04/2002 05/22/2007 56.2 Source: U.S. Department of Health & Human Services, 2016 Compiled by: Health Council of Southeast Florida

32 Health Resources & Services Administration. (October 2016). Medically Underserved Areas and Populations (MUA/Ps). Retrieved from https://bhw.hrsa.gov/shortage-designation/muap 33 Health Resources & Services Administration. (October 2016). Medically Underserved Area/Population (MUA/P) application process. Retrieved from https://bhw.hrsa.gov/shortage-designation/muap-process



Area

Palm Beach County

Florida

United States

Total Population (For Whom Insurance Status is Determined)

898,656

1,386,355

19,621,207

313,576,137

Total Uninsured Population 148,481 221,310 3,211,340 36,700,246

Percent Uninsured Population 16.5% 16.0% 16.4% 11.7%

Health Insurance

Uninsured

The table below shows the population that was uninsured in Bethesda’s service area, Palm Beach County, Florida,

and the United States in 2012-2016. Over 16 percent of the population in Bethesda’s service area was uninsured

compared to 16percent in Palm Beach County, 16.4 percent in Florida, and 11.7 percent in the United States.

Table 197: Uninsured Population, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016



This table shows the population that was uninsured by age group in Bethesda Health’s service area, Palm Beach

County, Florida, and the United States in 2012-2016. Almost a quarter of the age group 18-64 in Bethesda’s

service area was uninsured. Eleven percent of the population aged 18-64 and 1.5 percent of the population aged

65 were also uninsured. These percentages are higher than the county, state and country.

Table 198: Uninsured Population by Age Group, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016


Area

Palm Beach County

Florida

United States

Under Age 18 11.2% 10.4% 9.0% 5.9%

Age 18 - 64 24.8% 23.6% 23.6% 16.4%

Age 65 1.5% 1.4% 1.4% 0.9% Source: U.S. Census Bureau, 2012-2016, American Community Survey 5-Year Estimates,

2016 Compiled by: Health Council of Southeast Florida, 2018


Table 199 shows uninsured adults ages 18-64 in Bethesda’s service area, Palm Beach County, Florida, and the United States in 2015. Over one-fifth of the adult population in Bethesda’s service areas were without medical insurance in 2015, as compared to 20.2 percent in the county, 19.5 percent in the state, and 13.2 percent in the country. Table 199: Uninsured Adults, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2015


Area

Palm Beach County

Florida

United States

Total Population Age 18 - 64 505,516 806,664 11,930,518 194,584,952

Population With Medical Insurance 403,266 643,502 9,606,466 168,884,012

Percent Population With Medical Insurance 79.8% 79.8% 80.5% 86.8%

Population Without Medical Insurance 102,249 163,162 2,324,052 25,700,940

Percent Population Without Medical Insurance 20.2% 20.2% 19.5% 13.2%

Source: US Census Bureau, Small Area Health Insurance Estimates, 2015 Compiled by: Health Council of Southeast Florida, 2018

The table below shows uninsured children under 19 years of age in Bethesda’s service area, Palm Beach County,

Florida, and the United States in 2014. A total of 8.8 percent of the population under 19 years of age in Bethesda’s

services area were without medical insurance, compared to 8.8 percent in Palm Beach County, 7.3 percent in

Florida, and 5.1 percent in the United States.

Table 200: Uninsured Children, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2014


Area

Palm Beach County

Florida

United States

Total Population Under Age 19 180,349 287,131 4,250,715 76,217,025

Population With Medical Insurance 164,438 261,799 3,938,645 72,369,595

Percent Population With Medical Insurance 91.2% 91.2% 92.7% 95.0%

Population Without Medical Insurance 15,911 25,332 312,070 3,847,430

Percent Population Without Medical Insurance 8.8% 8.8% 7.3% 5.1%

Source: US Census Bureau, Small Area Health Insurance Estimates, 2015 Compiled by: Health Council of Southeast Florida, 2018


The table below shows the uninsured population by race in Bethesda Health’s service area, Palm Beach County,

Florida, and the United States in 2012-2016. The group with the highest percentage of uninsured individuals in

Bethesda’s service area was Native American/Alaska Native, with 45.7 percent. This group was followed by "some

other race" with 29.4 percent, Black or African American with 25.6 percent, Native Hawaiian/Pacific Islander with

23.7 percent, "multiple race" with 21 percent, Asian with 14.8 percent, and on-Hispanic White with 8.8 percent. The

percentages of uninsured in Bethesda’s service area for Native American/Alaska Native, Black or African

American, and "multiple race" populations were higher than the percentages in the county.

Table 201: Uninsured Population by Race, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016


Area

Palm Beach County

Florida

United States

Native American/Alaska Native 45.7% 41.3% 24.6% 23.3%

Some Other Race 29.4% 32.2% 30.6% 26.0%

Black or African American 25.6% 22.5% 19.6% 13.7%

Native Hawaiian/Pacific Islander 23.7% 41.3% 21.4% 13.6%

Multiple Race 21.0% 19.1% 15.4% 10.5%

Asian 14.8% 15.4% 16.9% 10.8%

Non-Hispanic White 8.8% 8.9% 11.6% 8.1% Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016


The table below shows the uninsured population by ethnicity in Bethesda Health’s service area, Palm Beach

County, Florida, and the United States in 2012-2016. Thirty percent of the Hispanic/Latino population in

Bethesda’s service area were uninsured. This is higher than the county, state and the U.S.

Table 202: Uninsured Population by Ethnicity, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016


Area

Palm Beach County

Florida

United States

Total Hispanic/Latino 63,356 84,953 1,205,591 12,756,229

Total Not Hispanic/Latino 85,125 136,357 2,005,749 23,944,017

Percent Hispanic/Latino 30.4% 29.5% 25.3% 23.4%

Percent Not Hispanic or Latino 12.3% 12.4% 13.5% 9.2% Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016



The table shows the numbers and rates of uninsured children ages 0-18 per 100,000 in Bethesda Health's primary

and secondary service area from 2012-2016 by ZIP code. Lake Worth/Lantana, ZIP code 33460 had the highest

rate of uninsured children in the primary service area, 16.6. In the primary service area, there is an average of 10

children uninsured per 100,000. In the secondary service area, Greenacres/Haverhill/West Palm Beach, ZIP code

33415 had the highest rate of uninsured children, 17.9. There is an average of 9.5 children uninsured per 100,000

in the secondary service area.

Table 203: Estimate Number and Rate of Children (0-18) Uninsured, Bethesda Health’s Service Area ZIP Codes, 2012- 2016


ZIP Code Total Uninsured Uninsured Rate ZIP Code Total Uninsured Uninsured Rate

33460 1,216 16.6 33415 2,293 17.9

33461 1,849 16.3 33406 980 16.4

33463 2,669 16.1 33432 373 15.6

33445 642 14.4 33413 431 11.1

33462 971 14.2 33428 1,011 11.0

33435 805 12.3 33405 469 10.9

33426 400 12.0 33483 119 10.8

33436 926 11.9 33433 717 10.1

33449 332 11.3 33498 314 10.0

33484 164 10.9 33487 149 5.6

33414 1,094 7.1 33431 150 5.6

33444 297 6.9 33486 193 3.8

33437 269 6.6 33496 99 2.7

33472 194 6.2 33434 44 1.8

33467 582 6.1

33446 117 5.8

33473 - -

Total 12,527 10.3 Total 7,342 9.5 Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates


Medicaid

Medicaid is a program funded jointly by states and the federal government to provide health coverage to eligible

individuals.34

This table shows the median monthly Medicaid enrollment in Palm Beach County and Florida between 2015 and

2017. The most recent data from 2017 shows the median monthly enrollment in Medicaid was 235,972, which was

a rate of 16,723, 10 per 100,000. In Palm Beach County, the median monthly enrollment in Medicaid has steadily

increased since 2015. It is important to note the median monthly Medicaid enrollment includes those enrolled in the

Medically Needy program. This program is for individuals who have income or assets that exceed the limits for

34 Centers for Medicare & Medicaid Services. (n.d.). Medicaid. Retrieved from https://www.medicaid.gov/medicaid/index.html

http://www.medicaid.gov/medicaid/index.html


regular Medicaid.35 In this program, an individual must have a certain amount of medical bills each month before

Medicaid can be approved for the remainder of the month.

Table 204: Median Monthly Medicaid Enrollment, Palm Beach County and Florida, 2015-2017

Year

Palm Beach Florida


2015 225,275 16,299.10 3,959,891 19901.2

2016 227,748 16,324.70 3,979,899 19672.2

2017 235,972 16,723.10 4,030,447 19607.4

Source: Agency for Health Care Administration (AHCA), 2017 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the population receiving Medicaid in Bethesda’s service area, Palm Beach County, Florida,

and the United States in 2012-2016. In Bethesda’s service area, 17.4 percent of the insured population was

receiving Medicaid.

Table 205: Population Receiving Medicaid, Bethesda Health’s Service Area Compared to Palm Beach County, Florida, and the U.S., 2012-2016


Area

Palm Beach County

Florida

United States

Total Population (For Whom Insurance Status Is Determined)

898,656 1,386,355 19,621,207 313,576,137

Population With Any Health Insurance 750,175 1,165,045 16,409,867 276,875,891

Population Receiving Medicaid 130,175 206,666 3,543,041 59,874,221

Percent of Insured Population Receiving Medicaid

17.4% 17.7% 21.6% 21.6%



35 Florida Department of Children & Families. (n.d.). What is the Medically Needy program? Retrieved from http://www.myflfamilies.com/faq/what-medically- needy-program

http://www.myflfamilies.com/faq/what-medically-


Florida KidCare – CHIP and Medicaid for Children

Florida KidCare is the state's health insurance program for uninsured children who meet income and eligibility

requirements.36 Florida KidCare provides health insurance to children in families with incomes up to 200 percent of

the federal poverty level (FPL). There are two programs under Florida KidCare: Medicaid for Children

(Title XIX funds), which is for children whose families make up to 133 percent of the FPL, and the Children's Health

Insurance Program (CHIP) (Title XXI funds), which is for children whose families make between 133.01-200.01

percent of the FPL. Under CHIP, there are two programs: Medikids, for children ages one through four, and Healthy

Kids, for children five through 18. Children's Medical Services (CMS) is an additional plan run by CHIP for children

with special needs who require extensive preventive and ongoing care, but does not have the same income

requirements as MediKids and Healthy Kids. Families who make between 133.01-200 percent of the FPL may

qualify for a subsidized plan where they may have to pay $15-20 per family. Families who make 200.01 percent of

the FPL or more may qualify for full-pay plans where they are required to pay the entire premium per child. There

are no premium payments for Medicaid for Children or CMS.

CHIP

The table below shows the number of children enrolled in CHIP in Palm Beach County between 2015 and 2018 by

month.

Table 206: Title XXI Enrollment (CHIP and Full Pay), Palm Beach County, 2015-2018

Month 2015 2016 2017 2018

January 16,819 13,709 14,635 15,837

February 16,486 13,688 14,837 16,265

March 16,736 14,037 14,985 16,452

April 16,757 14,314 15,182 16,875

May 16,970 14,413 15,267

June 16,953 14,548 15,502

July 16,780 14,747 15,516

August 16,287 14,746 15,659

September 15,871 14,919 15,799

October 14,483 14,887 16,086

November 14,104 14,806 16,136

December 13,973 14,695 15,984

Source: Florida Covering Kids and Families, 2018 Compiled by: Health Council of Southeast Florida, 2018

36 Agency for Health Care Administration. (n.d.) Florida KidCare.


This table shows the number of children in Palm Beach County enrolled in each of the CHIP programs as of April

2018. There was an increase in enrollment of 2.55 percent between March and April. There was a total of 16,875

children enrolled in Title XXI.

Table 207: Title XXI (CHIP and Full Pay), Palm Beach County, April 2018

MediKids Total

(1-4)

Healthy Kids Total (5-18)

Children's Medical Services

(1-18)

Month Total

Prior Month

Total

Percent Change

Palm Beach 2,639 13,461 775 16,875 16,456 2.55% Source: Florida Health Kids, as of April 2018 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the number of children enrolled in Palm Beach County in the Children’s Medical Services

program of CHIP as of April 2018. There was a total of 775 children enrolled.

Table 208: Children's Medical Services Enrollment, Palm Beach County, April 2018

Children's Medical Services (1-18)

Palm Beach 775 Source: Florida Health Kids, as of April 2018 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the number of children enrolled in Palm Beach County in the subsidy and full-pay plans

of MediKids as of April 2018. There was a total of 2,639 children enrolled.

Table 209: MediKids Enrollment by Plan, Palm Beach County, April 2018

MediKids Subsidy (1-4)

MediKids Full Pay (1-4)

MediKids Total (1-4)

Palm Beach 2,007 632 2,639 Source: Florida Health Kids, as of April 2018 Compiled by: Health Council of Southeast Florida, 2018

The table below shows the number of children enrolled in Palm Beach County in the subsidy and full-pay plans

of Healthy Kids as of April 2018. There was a total of 13,461 children enrolled.

Table 210: Healthy Kids Enrollment by Plan, Palm Beach County, April 2018

Healthy Kids Subsidy (5-18)

Healthy Kids Full Pay (5-18)

Healthy Kids Total (5-18)

Palm Beach 12,229 1,232 13,461 Source: Florida Health Kids, as of April 2018 Compiled by: Health Council of Southeast Florida, 2018


This table shows the number of children in Palm Beach County enrolled in each of the Healthy Kids medical plans in

April 2018.

Table 211: Healthy Kids Enrollment by Medical Plan, Palm Beach County, April 2018

Medical

Aetna Staywell Sunshine Amerigroup United

Palm Beach 5,010 7,219 1,232 -- -- Source: Florida Health Kids, as of April 2018 Compiled by: Health Council of Southeast Florida, 2018

This table shows the number of children in Palm Beach County enrolled in each of the Healthy Kids dental plans in

April 2018.

Table 212: Healthy Kids Enrollment by Dental Plan, Palm Beach County, April 2018

Dental

Argus DentaQuest MCNA

Palm Beach 2,454 5,997 4,796 Source: Florida Health Kids, as of April 2018 Compiled by: Health Council of Southeast Florida, 2018


The table below shows the number of uninsured children, the number of children eligible for CHIP, and the

percentage of children eligible for CHIP in Bethesda Health's primary and secondary service areas by ZIP code

between 2012 and 2016. In Boynton Beach/Village of Golf, ZIP code 33436 in Bethesda's primary service area, 40.3

percent of children were eligible for CHIP. The area in Bethesda's secondary service area with the highest

percentage of CHIP-eligible children was Greenacres/West Palm Beach, ZIP code 33413 (48.3 percent).

Table 213: Estimate Number and Rate of Children (0-18) Eligible for CHIP Coverage, Bethesda Health’s Service Area ZIP Codes, 2012-2016


ZIP Code

Total Uninsured

Total CHIP Eligible

Percent CHIP

Eligible

ZIP Code

Total Uninsured

Total CHIP Eligible

Percent CHIP

Eligible

33436 926 373 40.3% 33413 431 208 48.3%

33467 582 216 37.1% 33433 717 177 24.7%

33463 2,669 766 28.7% 33483 119 27 22.7%

33461 1,849 500 27.0% 33428 1,011 228 22.6%

33444 297 80 26.9% 33486 193 43 22.3%

33462 971 203 20.9% 33406 980 205 20.9%

33435 805 147 18.3% 33415 2,293 427 18.6%

33445 642 112 17.4% 33434 44 7 15.9%

33446 117 16 13.7% 33487 149 17 11.4%

33414 1,094 145 13.3% 33432 373 15 4.0%

33460 1,216 161 13.2% 33405 469 - 0.0%

33449 332 21 6.3% 33431 150 - 0.0%

33484 164 8 4.9% 33496 99 - 0.0%

33426 400 13 3.3% 33498 314 - 0.0%

33437 269 - 0.0%

33472 194 - 0.0%

33473 - - -

Total 12,527 2,761 17.0% Total 7,342 1,354 15.1% Source: U.S. Census Bureau, 2012-2016 American Community Survey 5-Year Estimates, 2016



Medicaid for Children

The table below shows the number of children enrolled in Medicaid for Children in Palm Beach County between 2015

and 2018. The most recent data shows a total of 138,881 children were enrolled in Medicaid in February 2018.

Table 214: Title XIX (Medicaid) Enrollment, Palm Beach County, 2015-2018

Month 2015 2016 2017 2018

January 126,495 138,351 143,822 138,283

February 127,682 138,797 144,321 138,881

March 129,481 138,771 144,684

April 130,450 139,060 144,551

May 131,580 139,270 144,551

June 132,602 139,613 144,882

July 133,908 140,617 145,266

August 135,038 141,437 143,194

September 135,757 141,356 143,202

October 136,735 142,122 143,232

November 136,984 142,547 141,519

December 137,399 143,194 142,056

Source: Florida Covering Kids and Families, 2018 Compiled by: Health Council of Southeast Florida, 2018

Safety Net

The Institute of Medicine defines safety net providers as “providers that organize and deliver a significant level of

both health and other health-related services to the uninsured, Medicaid and other vulnerable populations.”37

Additionally, safety providers are those who “by mandate or mission offer access to care regardless of a patient’s

ability to pay.” Core safety net providers include public hospitals, community health centers and local health

departments. The populations typically served by the safety net include poor people who are uninsured, those of

minority and immigrant status, those living in geographically or economically disadvantaged communities, or

those who have a broad range of social, demographic and poverty-related health problems.

Federally Qualified Health Centers, Federally Qualified Health Center Look-Alikes

Federally Qualified Health Centers (FQHCs) are community-based healthcare providers that receive funds from the

HRSA Health Center Program to provide primary care services in underserved areas.38 Centers must meet a

stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating

under a governing board that includes patients.

Federally Qualified Health Center Look-Alikes are community-based healthcare providers that meet the

requirements of the HRSA Health Center Program, but do not receive Health Center Program funding.39 These

centers provide primary care services in underserved areas, provide care on a sliding fee scale based on ability to

pay and operate under a governing board that includes patients.

37 Insititute of Medicine. (2000). America’s health care safety net: Intact but endangered. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK224521/ 38 Health Resources & Services Administration. (May 2018). Federally Qualified Health Centers. Retrieved from https://www.hrsa.gov/opa/eligibility-and- registration/health-centers/fqhc/index.html 39 Health Resources & Services Administration. (May 2018). Federally Qualified Health Center Look-Alike. Retrieved from https://www.hrsa.gov/opa/eligibility- and-registration/health-centers/fqhc-look-alikes/index.html

http://www.ncbi.nlm.nih.gov/books/NBK224521/

http://www.hrsa.gov/opa/eligibility-and-

http://www.hrsa.gov/opa/eligibility-


The table below shows the Federally Qualified Health Centers (FQHC) and Federally Qualified Health Center Look-

Alikes in Palm Beach County as of April 2018. There were a total of 22 FQHC and look-alikes as of April 2018.

Table 215: Federally Qualified Health Centers (FQHCs) and Federally Qualified Health Center Look-Alikes, Palm Beach County as of April 2018

Site Address Site City Site Postal Code Location Type

2815 S Seacrest Blvd Ste W-Er Boynton Beach 33435-7969 Permanent

2623 S Seacrest Blvd Ste 65 Boynton Beach 33435-7541 Permanent

7408 Lake Worth Rd Lake Worth 33467-2502 Permanent

2330 S Congress Ave West Palm Beach 33406-7608 Permanent

1901 S Congress Ave Ste 100 Boynton Beach 33426-6556 Permanent

1250 Southwinds Dr Lantana 33462-1459 Permanent

1515 N Flagler Dr West Palm Beach 33401 Permanent

23123 State Road 7 Ste 108 Boca Raton 33428-5489 Permanent

38754 State Road 80 Belle Glade 33430-5615 Permanent

1500 NW Avenue L Belle Glade 33430-1729 Permanent

170 S Barfield Hwy Ste 103 Pahokee 33476-1868 Permanent

941 SE 1st St Belle Glade 33430-4353 Permanent

1041 45th St Mangonia Park 33407-2402 Permanent

1000 45th St West Palm Beach 33407-2416 Permanent

181 Crawford Blvd Boca Raton 33432 Permanent

411 W Indiantown Rd Jupiter 33458-3538 Permanent

30 SE 6th St Boca Raton 33432-6016 Permanent

2623 S Seacrest Blvd Ste 112 Boynton Beach 33435-7531 Permanent

225 S Congress Ave Delray Beach 33445-4616 Permanent

1150 45th St West Palm Beach 33407-2361 Permanent

5827 Corporate Way West Palm Beach 33407-2000 Permanent

840 US Highway 1 Ste 120 North Palm Beach 33408-3858 Permanent

Source: U.S. Department of Health & Human Services, 2018 Compiled by: Health Council of Southeast Florida, 2018


Community Perspective

To gain insight into the thoughts, opinions and concerns of the community and community leaders, the Health

Council of Southeast Florida conducted community focus groups and key informant interviews. Five focus groups

and 12 key informant interviews were conducted using qualitative methods to gather in-depth information. The

tools utilized aimed to garner discussion around key health issues, barriers to health, and gaps or areas for

improvement specific to the community. The methods and results of the focus groups and key informant interviews

are detailed below.

Community Focus Groups

Methodology

The Health Council developed a tool for the focus groups which contained eight questions. Questions included what

the participants envision a healthy community looks like, key health issues they see in the community, barriers to

health, unmet needs in the community, gaps in services, thoughts on the opiate crisis in Palm Beach County, and

ideas for improving the health of the community. A script was also developed for the facilitator and read at the

beginning of each focus group session. The script contained information on the purpose of the focus group, what is

expected of participants and reassurance they would remain anonymous. The facilitator also had a set of probes for

each question to guide discussions.

The Health Council specifically targeted the following populations: young adults, the homeless, those with disabilities,

those from lower income households, the senior population, parents, uninsured/underinsured population, males,

racial and ethnic minorities, those with limited English proficiency, and those living in Bethesda Health’s service

areas.

Prior to the focus group, participants were provided with a demographic questionnaire. Participants were incentivized

for participation with $20 gift cards to Walmart. Each session lasted approximately 60-90 minutes. Sessions were

audio recorded and notes were taken throughout to ensure all the information was captured. Recordings were later

transcribed and analyzed to pull out common themes, which are detailed in the results section. A total of five focus

groups were conducted, with between 5-16 participants. Two sessions were conducted in Spanish and three in

English.

The table below provides information from the focus groups.

Table 216: Site, Language and Number of Participants in Focus Groups

Site Language

The Lords Place - Men's Campus English

Pathway 2 Prosperity English

CILO English/ASL

Bridges of Lake Worth - West Spanish

Healthy Mothers, Healthy Babies Spanish


Table 217: Focus Group Target Population Matrix

The Lord's

BRIDGES of

Healthy

Coalition for

Population Place- Men's Campus

Lake Worth – West

Mothers, Healthy Babies

Independent Living Options

Pathways to Prosperity, Inc.

Young Adults X X

Those Who Are Homeless X

Those With Disabilities

Lower Income Households* X X X X X

Seniors/Elderly Population X X

Parents X X X

Uninsured/ Underinsured

Populations X X X X

Males X X

Racial & Ethnic Minorities X X X X

Those With Limited English Proficiency (LEP)

X X

East Service Area X X X

West Service Area X X X

*Not targeted

Results

Listed below are themes that emerged during analyzing focus group recordings. Information shared was not

specific to Bethesda Health’s hospitals but generalized to the community, health and social services, and the

healthcare system.

Key Health Issues

Mental health

Substance abuse

HIV/AIDS

Obesity

Diabetes

High blood pressure

Cancer

Dental/Oral health

Causes of Health Issues


Lack of knowledge and health education

Poor quality care, customer service and communication

Limited access to resources to maintain healthy lifestyle, specifically:


Healthy foods

Physicians/Dentists

Safe places to exercise

Complex healthcare coverage system, which leads to difficulties in navigating the system

Populations With Unmet Needs

Seniors/elderly population

Youth and young adults

Those who are homeless

Barriers and Challenges to Care

Affordable health coverage

Access to affordable prescription coverage


Lack of knowledge and health education

Physical and mental comorbidities; Each of these affects one another but are not seen as equal in priority

when being treated

Limited access to healthy food that is affordable

Outreach and education, e.g., health fairs and community events

Transportation

Language barriers and communication challenges

Challenges in Maintaining Health

There is not enough emphasis on health, the emphasis is on healthcare

There are not enough support groups

Diabetes management

Mental health

Substance abuse

Healthy foods are expensive and not accessible

Prescriptions are very expensive

Managing multiple conditions is difficult

The Opioid Epidemic

People have been over-prescribed certain medications, so the doctors need more education to avoid this

They need to regulate the sober houses a lot more

A lot of people are coming from "out of town" seeking help

Law enforcement has handled this epidemic well

People who legitimately need opiates are having difficulty getting them


To really address this epidemic, we are going to have to get at the root causes, i.e. people are filling a void,

many have undiagnosed or untreated mental illnesses

Suggestions

Mental health should be integrated with physical health, i.e., the two areas cannot be separated

Customer Service

Perception that this may be related to socio-economic status, health insurance and health coverage

Improve communication with patients

Provide referrals for services in the community

Communicate with other providers, so that care is coordinated and diagnostics are not duplicated

Consider having more navigators or resources that assist with eligibility and navigating the healthcare

system

Lower costs of healthcare services

Increase the number of staff to alleviate wait-times


Key Informant Interviews

Methodology

HCSEF developed a tool that was similar to the one developed for the focus groups. For the key informant

interviews, HCSEF targeted individuals representing multiple sectors and diverse interests. Participants were

instructed to share insights in the context of the role they had in the community.

Interviews were conducted via telephone and lasted approximately 30 - 45 minutes. Using a script to ensure

consistency, the interviewer began with an overview of the community health needs assessment process, the

purpose of the assessment, and how the information would be used. Participants were reassured that their

responses and ensuing conversations were confidential and would not be attributed to them or their agencies or

organizations.

Results

A total of 12 key informant interviews were conducted. The interviewer took notes which were then coded and

analyzed for themes and threads. Listed below are those recurring themes.

Key Health Issues

Mental health/Behavioral health

Not just deep-end, e.g., stress, anxiety disorders

Diabetes

Substance use

Opioid epidemic

Obesity & associated comorbidities

Chronic diseases, especially those with multiple diagnoses

Hypertension & heart disease

Cancer

Maternal morbidity

Dental/oral health


Accessibility to healthcare services

Those With Significant Unmet Needs

Elderly

Caregivers/Seniors

Those with mental illness

Those who are homeless

African Americans

Haitians

Hispanic/Latino population

Older teens and young adults


Those with disabilities

Low-income

Significant aging Jewish population

Barriers and Challenges to Care

Significant social isolation, especially among the seniors

Need for “cultural competency” among the providers, i.e., there is a disconnect

Lack of knowledge and awareness of services and resources

Lack of coordination and collaboration among service providers, i.e., fragmentation in system

Transportation

Fear, shame, stigma

Access to specialized care

Food access, especially healthy options


Poverty

Accessibility to healthcare services

Challenges in Maintaining Health

Lack of education

Lack of knowledge and awareness about resources and services, e.g., health literacy

Access to care: transportation

Access to care: general

Untreated mental illness, impact of Adverse Childhood Experiences (ACEs)

Poor choices (that individuals make)

Lack of a focus or emphasis on prevention

Limited access to resources to maintain healthy lifestyle

Healthy foods that are not cost-prohibitive

Safe places to exercise

Stigma, fear, shame

Poverty

The Opioid Epidemic

Acknowledgement that the problem affects ALL populations

Responsibility for the problem should be shared

Acknowledgment that many affected are not "residents" of Palm Beach County

The stigma of addiction must be addressed

There is a need for education among the providers

Must acknowledge that many are dual-diagnosed with mental health and substance abuse issues

There is a need for more cost-effective resources


Opportunities to Build Upon

Several interviewees mentioned that Bethesda’s management team is open and receptive

Many noted that they have enjoyed a long-standing relationship with Bethesda

Several interviewees mentioned that while they do not have a formal relationship with the hospital, they

would be interested in conversations about the potential of forging one for the good of the community

During hurricane, Bethesda and Palm Beach Sheriff's Office forged partnership others might consider replicating

Officer stationed/out-posted at hospital during the storm

Suggestions

Enhance awareness of resources in the community

o Suggestion: Key social workers/discharge planners could tour certain facilities

o Suggestion: Provide resource guide to ER staff

Engage (and partner) more with community-based organizations

o Examples: Care coordination and discharge planning

Rely on the expertise of community-based organizations

Consider co-training

Increase visibility in communities

o Examples: Attend and sponsor health fairs and community events

Engage with civic organizations

Establish an Advisory Committee to glean community and resident perspective

Training:

o Integrate trauma-informed care training for providers

o Integrate "cultural competency" training for providers and staff

o Promote understanding of ACEs among staff

Hospital could serve as hub for critical conversations around population health management, e.g., an

anchor institution

Provide education to community, as the hospital is viewed as a credible source


Identification of Priority Strategic Health Issues

On May 14, 2018, HCSF presented the quantitative and qualitative data to the Advisory Council. This

presentation was to serve as the basis for which to begin prioritizing needs that would feed into the development

of Bethesda Health’s strategic plan for the next three to five years.

Methodology

On May 14, 2018, the Health Council facilitated an interactive session with the Advisory Council at Bethesda

Hospital East. Following a presentation of highlighted indicators from the quantitative and qualitative, HCSEF

initiated the discussion around the needs, issues and priorities that resonated with the Advisory Council. After all

ideas were captured, participants engaged in additional discussion and vetting. Listed below are the health issues

the Advisory Council members identified during this part of the exercise:

Opioid crisis/epidemic

Meal shortage/access

Aging population/senior issues

Mental health

Chronic disease management

Diabetes/weight management

Obesity

Race/ethnic disparities

Health Education

Partnerships

Access to medical and mental health services

Infant mortality

Support for caregivers of the senior population

Access to information

Community awareness/outreach

Disease prevention

Then, using a multi-voting process, members were asked to narrow the list. Listed below are the top priority areas

as identified by the Advisory Council.

Maternal and Child Health

Expanding Access to Care & Services

Mental Health/Behavioral Health

Promoting Health and Wellness

Health Education

Increasing Community Awareness/Outreach

Conclusion

Community Health Needs Assessments are an important tool that engages key stakeholders in the community to

identify health needs, gaps in services and areas for improvement to guide strategies to improve the well-being of

the community. After the assessment, it is important to sustain the momentum by developing a solid

implementation plan. To this end, Bethesda Health is continuing to work with other providers and community-based

resources to develop specific strategies that support the priority areas and outline their plan for the next few years.

This information will be included in Bethesda Health’s community health implementation plan and be used to

largely guide the hospital's community health efforts.