Onondaga County Community Health Assessment and ...

1 Onondaga County Community Health Assessment and Improvement Plan2019-2021 Onondaga Countyongovhealth Department J. Ryan McMahon, IICounty ExecutiveIndu Gupta, MD, MPHC ommissioner of Health This page intentionally left blank Onondaga County Community Health Assessment and Improvement Plan | 2019-2021 i Authors Bridget K. Volz, MPH, CAS, CPHE pidemiologistOnondaga County Health DepartmentRebecca Shultz, MPHD irector of Community Health Onondaga County Health DepartmentIsabella BagliettoResearch Technician IOnondaga County Health DepartmentIndu Gupta, MD, MPH, MA, FACP CommissionerOnondaga County Health DepartmentSteering CommitteeOnondaga County Health DepartmentIndu Gupta, MD, MPH, MA, FACPR ebecca Shultz, MPHB ridget K.

2 Volz, MPH, CAS, CPHI sabella BagliettoCrouse HealthBob AllenKris WaelderHealtheConnectionsRachel Kramer, ScD, MHSSt. Joseph s HealthDeborah WelchMichelle A. Brown, MPAB randiss Pearson, MS, FNP-CUpstate University HospitalShawna Craigmile-Sciacca, LCSWC indy Jaconski, MPHS tacey Keefe, MPAA cknowledgements The Steering Committee wishes to thank all agencies and individuals who supported the development of the 2019 2021 Onondaga County Community Health Assessment and Improvement Plan. Onondaga County Community Health Assessment and Improvement Plan | 2019-2021 ii Participating Health Department and Hospitals Onondaga County Health Department John H. Mulroy Civic Center 421 Montgomery Street Syracuse, NY 13202 Crouse Health 736 Irving Avenue Syracuse, NY 13210 St.

3 Joseph s Health 301 Prospect Avenue Syracuse, NY 13203 Upstate University Hospital 750 E. Adams Street Syracuse, NY 13210 Onondaga County Community Health Assessment and Improvement Plan | 2019-2021 iii Table of Contents 1. Message from the Commissioner of Health .. x2. Executive Summary .. xi3. Introduction .. 14. Community Health Assessment .. 2 What Creates Health and Well-Being a Public Health 3 Key Concepts in Emerging Public Health Practice .. 4 Public Health .. 4 Health 4 Health Across the 6 Health Across All 6 Geographic Profile .. 7 Community 8 Determinants of Determinants.

4 15 Environmental Determinants ..23 Policy Determinants ..33 Behavioral Determinants ..36 Access to Health Status: Distribution of Disease and Illness ..39 Improve Health Status and Reduce Health Disparities ..39 Prevent Chronic Diseases ..44 Promote Well-Being and Prevent Mental and Substance Use Disorders ..56 Promote a Healthy and Safe Environment ..63 Promote Healthy Women, Infants, and Communicable Diseases ..776. Community Assets and Resources ..867. Community Community Health Improvement Area 1: Prevent Chronic 101 Priority Area 2: Promote Well-Being and Prevent Mental and Substance Use 1139. 119 Onondaga County Community Health Assessment and Improvement Plan | 2019-2021 iv Appendices 1.

5 Community Health Assessment and Improvement Plan Methodology 2. Community Engagement Summary 3. Community Engagement Survey Health System Feedback 4. County Health Rankings Model 5. Onondaga County Community Health Improvement Plan Tracking and Revision Process 6. Onondaga County Health Equity Coalition Member Agencies 7. Onondaga County Drug Task Force Member Agencies 8. Data Tables 9. Data Technical Notes 10. Map: People Living Below Poverty Level in the City of Syracuse, 2013 -2017 11. United Way ALICE Report: Asset Limited Income Constrained Employed, Onondaga County 12. Map: Elevated Blood Lead Levels among Tested Children, by Census Tract, Syracuse, 2018 Onondaga County Community Health Assessment and Improvement Plan | 2019-2021 v List of Figures Figure 1: Map of Onondaga County .

6 7 Figure 2: Population distribution by age group, Onondaga County and Syracuse, 2013 2017 .. 8 Figure 3: Projected population, under 5 years and 65 years or older, Onondaga County , 2020 - 9 Figure 4: Population by race, Onondaga County and Syracuse ..10 Figure 5: Place of birth for Onondaga County s foreign-born populations ..11 Figure 6: Determinants of Health ..14 Figure 7: Adults aged 25 years and older, with high school education or higher, by race, Onondaga County and Syracuse ..16 Figure 8: Adults aged 25 years and older, with Bachelor s degree or higher, by race, Onondaga County and Syracuse ..17 Figure 9: Median income by race and ethnicity, Onondaga County .

7 18 Figure 10: Unemployment rate, by race, Onondaga County and Syracuse ..20 Figure 11: Means of transportation to work, Onondaga County and Syracuse ..24 Figure 12: Percentage of students eligible for free or reduced lunch, by school district, Onondaga County , 2017-2018 ..26 Figure 13: Food deserts by census tract, Syracuse, 2015 ..27 Figure 14: Violent crimes and firearm related violent crimes per 100,000 population, Onondaga County and NYS excluding NYC, 2018 ..28 Figure 15: Age-adjusted homicide mortality rate per 100,000 population, Onondaga County and NYS excluding NYC, 2007-2016 ..29 Figure 16: Assault-related hospitalization rate, by race, ethnicity, and income, Onondaga County , 2016.

8 29 Figure 17: Impact of Climate Change on Health , Centers for Disease Control and Prevention ..30 Figure 18: Average summer temperatures, New York State, 1981-2016 .. 31 Figure 19: Heat Vulnerability Index, Onondaga County ..32 Figure 20: Percent of population without Health insurance, by race, Onondaga County and Syracuse ..38 Figure 21: Percentage of premature death (before 65 years), by municipality, Onondaga County , 2013 -2016 ..40 Onondaga County Community Health Assessment and Improvement Plan | 2019-2021 vi Figure 22: Life expectancy in Syracuse census tracts, 2015 ..41 Figure 23: Preventative hospitalizations per 10,000 adults aged 18 years and older, by race and ethnicity, Onondaga County , 2016.

9 42 Figure 24: Percentage of adults reporting poor physical Health 14 days in the last month, by census tract, Syracuse, 2016 ..42 Figure 25: Percentage of adults reporting poor mental Health 14 days in the last month, by census tract, Syracuse, 2016 ..43 Figure 26: Physical activity and nutrition behaviors, Onondaga County , 2016 ..44 Figure 27: Overweight and obesity rates among public school students, by grade level, Onondaga County , 2016-2018 ..45 Figure 28: Overweight and obesity rates among public school students, Onondaga County , 2010-2018 ..45 Figure 29: Percentage of children and adolescents who are overweight or obese, by school district, Onondaga County , 2016-2018.

10 46 Figure 30: Disparities in adult obesity, Onondaga County , 2016 ..47 Figure 31: Percentage of adults with obesity by census tract, Syracuse, 2016 ..47 Figure 32: Emergency department visit rate for hypertension, per 10,000 population, by race and ethnicity, Onondaga County , 2014-2016 ..48 Figure 33: Age-adjusted mortality rate for diseases of the heart, per 100,000 population, by race and ethnicity, Onondaga County , 2012-2016 ..49 Figure 34: Age-adjusted mortality rate due to stroke, per 100,000 population, by race and ethnicity, Onondaga County , Central NY, and NYS, 2014-2016 ..50 Figure 35: Age-adjusted emergency department visit and hospitalization rates due to diabetes, per 10,000 aged 18+ years, by race and ethnicity, Onondaga County 2014-2016.