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SuffolkCountyCommunity Health Assessment2014-2017Steven BelloneSuffolk County ExecutiveJames L. Tomarken, MD, MPH, MBA, MSWCommissioner of HealthSuffolk County Department of Health Services3500 Sunrise Highway, Suite 124P.O. Box 9006Great River, NY 11739-9006Main (631) 854-0100scdhsweb@suffolkcountyny.gov
Suffolk County Department of Health Services (SCDHS)SUFFOLK COUNTYCOMMUNITY HEALTH ASSESSMENT 2014-2017Table of ContentsSECTION ONE – DESCRIPTION OF THE COMMUNITYA. Demographics, Morbidity & MortalityB. Health Status of the PopulationFAMILY HEALTHPrimary and Preventive Health CareFamily PlanningPrenatal Care and Infant MortalityChild HealthChildhood AsthmaLead PoisoningChildren with Special Healthcare NeedsDental HealthInjury PreventionMental HealthNutritionJail MedicineDISEASE CONTROLChronic DiseasesCardiovascular DiseaseHypertensionHigh ublic Health-Communicable DiseaseSexually Transmitted DiseasesHuman Immunodeficiency VirusTuberculosisVaccine Preventable DiseasesArthropod/Tick-Borne DiseaseFood / Water Borne DiseasesRabiesCommunity Health Assessment 42466363677274798389
Suffolk County Department of Health Services (SCDHS)ENVIRONMENT & HAZARD RESPONSEEnvironmental QualityNuisance ControlRadiation Protection & ControlEmergency Medical ServicesSECTION TWO-HEALTH CHALLENGESA. Behavioral Risk FactorsSmokingPhysical Activity and ObesityB. Environmental Risk FactorsC. Socioeconomic FactorsD. Policy EnvironmentE. Unique ON THREE-ASSETS & RESOURCESSuffolk County Department of Health Services Strategic PlanFAMILY HEALTHPrimary and Preventive Health CareTobacco CessationFamily PlanningPrenatal Care and Infant MortalityChild HealthLead PoisoningChildren with Special Healthcare NeedsDental HealthInjury PreventionMental HealthNutritionObesityJail MedicineDISEASE CONTROLChronic DiseasesCardiovascular DiseaseDiabetesCirrhosisArthritisAsthmaCommunity Health Assessment 4145145146147147147
Suffolk County Department of Health Services (SCDHS)CancerPublic Health-Communicable DiseasesSexually Transmitted Diseases/InfectionsHuman Immunodeficiency VirusTuberculosisVaccine Preventable DiseasesArthropod/Tick-Borne DiseaseFood / Water Borne DiseasesRabies ControlENVIRONMENT & HAZARD RESPONSEEnvironmental ProtectionNuisance ControlRadiation Protection & ControlEmergency Medical ServicesEmergency PreparednessSECTION FOUR-PROCESS & METHODSA. Process & MethodsB. BibliographyC. AcknowledgementsD. Data Sources By Health SectionCommunity Health Assessment 8180187191193
Suffolk County Department of Health Services (SCDHS)Community Health Assessment 2014-2017
Suffolk County Department of Health Services (SCDHS)SECTION ONE – Description of the CommunityA. DEMOGRAPHICS, MORBIDITY, AND MORTALITYAge and GenderRacial and Ethnic CompositionSuffolk County, occupying the easternend of Long Island, has a land area of 912.2square miles.Using 2012 PopulationEstimatesfrom2010U.S.CensusDemographic Profile data, the totalpopulation of Suffolk County is estimated tobe 1,499,273.The median age of thepopulation is 41.9 years, with 23.1% of thepopulation below the age of 18. Of the1,153,368 residents aged 18 and older,48.6% are male and 51.4% are female.Seniors aged 65 and older make up 14.5% ofthe population, with 42.8% males and 57.2%females. Children under the age of five makeup 5.6% of the population. Figure 1 displaysthe age distribution of Suffolk County.According to 2012 PopulationEstimatesfrom2010U.S.CensusDemographic Profile data, 87.2% of thepopulation is white, 9.1% is AfricanAmerican/black, 17.8% Hispanic/Latino,4.3% is Asian, and 1.1% is American Indianand Alaskan Native (note: these figures takecombinations of races into account). Figure 2depicts the change in the racial and ethnicmake-up of the population since 2007.Suffolk County is also home to two Indianreservations, the Shinnecock Reservation inSouthampton as well as the PoospatuckReservation, Unkechaug Nation in Shirley.Based on 5-year estimates from the2007-2011 American Community Survey .Age DistributionMaleFemale80 to 84 years70 to 74 years60 to 64 years50 to 54 years40 to 44 years30 to 34 years20 to 24 years10 to 14 yearsUnder 5 re 1. Age Distribution of Suffolk County by gender.Source: U.S. Census 2012 Population EstimatesCommunity Health Assessment 2014-20171
Suffolk County Department of Health Services (SCDHS)Population by Race/EthnicityAmerican IndianAsianHispanic or LatinoAfrican American/BlackWhite0102030405060708090100Percent of Total Population2007 Estimate2012 EstimateFigure 2. Racial and Ethnic composition of Suffolk County. Note that combinations of races are takeninto account.Source: ACS 2007 Estimates; U.S. Census 2012 Population Estimates(ACS) conducted by the U.S. Census Bureau,the median age for whites is 41.4 years. ForAfrican Americans/blacks it is 32.4, and forHispanics it is 29.1. The population under age5 makes up 5.3% of whites, 6.6% of AfricanAmericans/blacks, and 9.6% of Hispanics.The population aged 65 and older makes up4.8% of whites, 8.4% of AfricanAmericans/blacks and 4.6 % of Hispanics.Figure 3 details the stark differences in agecharacteristics by race.From the 2011 ACS, it is estimatedthat 14.2% of Suffolk’s population is foreignborn, with most hailing from Latin America(56.8%), Asia (20.1%), and Europe (19.7%)(Figure 4). Among the Asian immigrants,about two-thirds originate from either Chinaor India. Thirty-six percent of theAge DisparityUnder age 5Over age 65Median Age2045PERCENT3510305250MEDIAN AGE401520WhiteAfrican American/BlackHispanic or LatinoFigure 3. Age disparity by race/ethnicity in Suffolk County. Source: ACS 2011 5-year estimatesCommunity Health Assessment 2014-20172
Suffolk County Department of Health Services (SCDHS)World Region of Birth of Foreign-bornLatin AmericaAsiaEuropeAfricaNorthern AmericaOceania20.1%19.7%2.1%1.0%0.2%56.8%Figure 4. World Region of Birth of Foreign-born in Suffolk County.Source: ACS 2011 5-year estimatesHispanic/Latino population is foreign born,most commonly from El-Salvador, DominicanRepublic, and Ecuador. Twenty percent of theNative American/Alaska native population isforeign born, the majority of whomimmigrated from Latin America. Among blackimmigrants, most come from the Caribbean(specifically Haiti and Jamaica). About 9% ofthe white population of Suffolk is foreignborn, with most coming from Latin America(most notably El-Salvador and Colombia).About 7.3% of Suffolk Countyresidents are not U.S. citizens, and 6.9% arenaturalized. Among people at least five yearsold in Suffolk County, 21% spoke a languageother than English at home, where 60%spoke Spanish and 40% spoke some otherlanguage. Of those who spoke anotherlanguage than English at home, 43% reportedthat they did not speak English “very well.”Community Health Assessment 2014-2017HouseholdsFrom the 2011 ACS, the averagehousehold size was estimated at 2.93.Among whites it was 2.78, among AfricanAmericans/blacks it was 3.38, and amongHispanics/Latinos it was 4.35 (Figure 5). Forthe population aged fifteen and over, marriedbut not separated accounts for 55.9% of thepopulation— 55.8% amongst whites, 38.3%amongst African Americans/blacks and46.1% amongst Hispanics/Latinos. Femalehead of household with no husband presentand children under the age of 18 represents4.4% of whites, 16.8% of blacks, and 13.1%of Hispanics.Figure 5A displays the averagehousehold size by zip code in Suffolk County,where the darker colors indicate a higherestimated average household size. According3
Suffolk County Department of Health Services (SCDHS)Average Household size54.35432.783.38210WhiteAfrican American/ BlackHispanic or LatinoFigure 5. Average household size by race/ethnicity in Suffolk County.Source: ACS 2011 5-year estimateFigure 5A. Average household size by zip code in Suffolk County.to 2011 ACS 5-year estimates, Brentwood(3.99), Wyandanch (3.78), and Central Islip(3.69) have the largest average householdsizes in Suffolk, while Moriches (2.00),Montauk (2.04), and Shelter Island (2.11)have the lowest average household sizeCommunity Health Assessment 2014-2017Educational AttainmentOf the population 25 years of age orolder, 90.0% have attained a high schooldiploma or higher. Those who have notgraduated from high school make up 10.0%of the total population. However, brokendown by race: of all white Suffolk residents,only 7.8% have not graduated from highschool, while 15.5% of African4
Suffolk County Department of Health Services (SCDHS)Educational AttainmentLess than high schoolHigh ic or LatinoAfrican 0%Figure 6. Educational attainment by race/ethnicity in Suffolk County.Source: ACS 2011 5-year estimatesAmerican/blacks have not graduated fromhigh school and 30.1% of Hispanics/Latinoshave not graduated from high school. Highschool graduates including equivalency,make up 30.4% of the Suffolk population—31.0% of the white population, 31.7% of theAfrican American/black population, and32.5% of the Hispanic/Latino population.Persons with a bachelor’s degree or highermake up an additional 32.9% of the Suffolkpopulation: 33.4% of whites, 22.4% ofAfrican Americans/blacks, and 15.1% ofHispanics/Latinos. All levels of educationalattainment are described in Figure 6.Figure 6A shows the proportion of SuffolkCounty adults who have graduated from highschool in each zip code, where theFigure 6A. Percentage of adults who have graduated from high school by zip code in Suffolk County.Community Health Assessment 2014-20175
Suffolk County Department of Health Services (SCDHS)darker regions indicate a higher percentage.The areas with the under 80% of high schoolgraduates include: Brentwood (68.7%),Central Islip (72.0%), Copiague (77.3%),Wyandanch (79.2%), and Riverhead (79.3%).Health InsuranceAmongtheciviliannoninstitutionalized population in SuffolkCounty, 89.7% have health insurancecoverage—91.8% of whites, 86.7% of s. For those under 18 yearsof age, 4.6% of the total population had nohealth insurance coverage (3.4% of whites,8.2% of African Americans/blacks, and 7.7%of Hispanics/Latinos). For those between 18and 64 years of age, 14.5% of the totalpopulation are uninsured. 11.8% of adultwhites, 17.2% of African Americans/blacks,and 36.1% of Hispanics/Latinos areuninsured (Figure 7). Of those who are undertwice the poverty threshold, a staggering44.5% are uninsured. Furthermore, of thosewho are uninsured, 40.9% are foreign-bornand 31.5% of uninsured are not U.S. citizensDisabilityData on disability from the AmericanCommunity Survey covered six disabilitytypes: (1) hearing difficulty (deaf or havingserious difficulty hearing); (2) visiondifficulty (blind or having serious difficultyseeing, even when wearing glasses); , concentrating, or makingdecisions due to a physical, mental, oremotionalproblem);(4)ambulatorydifficulty (having serious difficulty walking orclimbing stairs); (5) self-care difficulty(having difficulty bathing or dressing); and(6) independent living difficulty (havingdifficulty doing errands alone such as visitinga doctor’s office or shopping due to aphysical, mental, or emotional problem).Respondents who reported any of the sixdisability types are considered to have adisability.The disabled population represents6.8% of those between the ages of 18 and 64:6.6% of whites, 10.4% of . For children under 18 PERCENTAged 18-64 an American/BlackHispanic or LatinoFigure 7. Health insurance coverage status for those aged 18-64 by race/ethnicity in Suffolk County.Source: ACS 2011 3-year estimatesCommunity Health Assessment 2014-20176
Suffolk County Department of Health Services (SCDHS)Figure 8A. Percent unemployed by zip code in Suffolk County.years of age, 3.4% are disabled: 2.5% ofwhites, 4.3% of African Americans/blacks,and 2.5% of Hispanics/Latinos. Among thosewho are older than 64, a larger portion of29.5% are disabled (29.3% of whites, 34.4%of African Americans/blacks, and 27.7% ofHispanics/Latinos).Employment, Income and PovertyAccording to the 2011 ACS, theunemployment rate in Suffolk for those aged16 and older was 6.4% countywide: 6.1% forwhites, 9.8% for African Americans, and 8.1%for Hispanics.Figure8Adescribestheunemployment rate for each zip code area inSuffolk County, where the darker areasindicate a higher proportion of unemployedadults. The three areas with above 10%Community Health Assessment 2014-2017unemployment are Stony Brook (zip code11794, 13.6%), Center Moriches (13.5%),and Central Islip (11.1%).Median household income in 2011was 87,187 ( 812, margin of error). Byrace, the median household incomes were 89,877 ( 752) for whites, 70,024 forAfrican Americans/blacks ( 3,538), 70,342 ( 1,950) for Hispanics/Latinos, 92,893 ( 5,077) for Asians, 56,875 ( 15,898) for American Indians/AlaskanNatives, and 62,143 ( 3,734) for thoselisted as other (Figure 8).Figure 8B depicts median householdincome by zip code area in Suffolk County,where the darker colors indicate areas with ahigher median household income. Theregions with the lowest median householdincomes are Greenport ( 51,305), Ridge7
Suffolk County Department of Health Services (SCDHS)( 53,092), and Riverhead ( 53,438).Median Household Income by Race 120,000.00 100,000.00 92,893 87,187 80,000.00 70,024 70,342 56,875 60,000.00 62,143 40,000.00 20,000.00 WhiteAfricanHispanic or LatinoAmerican/BlackAsianAmerican Indianor Alaskan NativeOtherFigure 8. Median household income by race/ethnicity in Suffolk County. The error bars represent the margin of error.Source: ACS 2011 3-year estimatesFigure 8B. Median household income by zip code in Suffolk County.ThepercentofhouseholdswithSupplemental Security Income was 2.7% forSuffolk in its entirety: 2.5% for whites, 5.7%Community Health Assessment 2014-2017for African Americans/blacks, and 4.3% forHispanics/Latinos. Public assistance incomewithin the population was: 1.1% for8
Suffolk County Department of Health Services (SCDHS)Below Poverty LevelUnder 18Aged 18-64Over 652015PERCENTSuffolk: 0.8% for whites, 4.2% for s. Social Security income isdistributed to 30.4% of the total population:31.8% of whites, 25.7% of s.About 5.7% of Suffolk Countyresidents are below the poverty level .5%ofHispanics/Latinos). Poverty percentagesamong residents between the ages of 18 and64 were 5.4%: for whites it was 4.5%, forAfrican Americans/blacks it was 9.9%, andfor Hispanics/Latinos it was 9.5%. For thoseunder age 18, the Suffolk poverty rate was6.7% (4.9% of whites, 15.7% of s).1050WhiteAfricanAmerican/BlackHispanic orLatinoFigure 9. Below poverty level by age group and byrace/ethnicity in Suffolk County.Source: ACS 2011 5-year estimatesFor those 65 and older, the Suffolk povertyrate was 5.5% (5.1% of whites, 8.3% ofAfrican Americans/blacks, and 10.6% ofHispanics/Latinos).Figure 9A. Below poverty level by zip code in Suffolk CountyCommunity Health Assessment 2014-20179
Suffolk County Department of Health Services (SCDHS)African American/black and 26.1% areHispanic/Latino.Figure 9A displays the percent belowthe poverty level by zip code, with the darkerregions indicating a higher rate of poverty.The areas with the highest rates of povertyare Greenport (16.3%), Patchogue (15.4%),and Mastic Beach (13.6%).HousingOwn ackHispanic orLatinoFigure 10. Housing tenure by race/ethnicity in SuffolkCounty.Source: ACS 2011 5-year estimatesFigure 9 displays the percent of thepopulation below the poverty level by agegroup.Female-headedhouseholdswithchildren under the age of 18 had a povertyrate of 17.6% (8.8% of whites, 17.7% ofAfrican Americans/blacks, and 20.6% amongHispanics/Latinos). About 4.1% of allhouseholds in Suffolk County receive foodstamps/SNAP, where 46.8% of thosereceiving assistance are white, 22.4% areHousingOwner-occupied housing makes up80.8% of the housing stock in Suffolk, andrenters represent 19.2%. For whites, ownersrepresent 84.8%, renters represent 15.2% ofthe total. Among African Americans/blacks,owners make up 65.4%, renters represent34.6%. Hispanic/Latino owners make up64.4% and renters make up 35.6% (Figure10).Figure 10A. Median Gross Rent by Zip Code in Suffolk County.Source: ACS 2011 5-year estimatesCommunity Health Assessment 2014-201710
Suffolk County Department of Health Services (SCDHS)Average household size for owners is3.03 and 2.51 for renters. Among whites it is2.90 for owners, 2.27 for renters. For AfricanAmericans/blacks it is 3.64 for owners and2.97 for renters, and for Hispanics/Latinos,owner household size is 4.62 and renter sizeis 3.93.Figure 10A depicts the median grossrent across Suffolk County. The cost ofrenting in Suffolk is quite high, as the averagemedian monthly rent is about 1531.Health IndicatorsHealth-specific mortality, morbidityand natality are discussed elsewhere in thisdocument. However, some overall trends arenoted here.NatalityOverall infant mortality declined from85 to 72 deaths between 2007 and 2009 froma rate of 4.6 to 4.3 per 1,000 live births, a6.5% drop. Neonatal deaths (infants 28days old) increased marginally from 59 to 61,though the rate increased from 3.2 to 3.6 per1,000 live births, or 12.5%. For postneonatal deaths (infants 1 month to 1 year),the decline was from 26 to 11, or from a rateof 1.4 to 0.7, a precipitous 50.0% drop.Spontaneous fetal deaths ( 20 weeksgestation), however, increased from 60 to 71,from a rate of 3.2 to 4.2, a 31.3% increase.MortalityFrom the most recently available data,there were 11,336 deaths in Suffolk Countyin 2011. The leading causes of death wereheart disease (3,248 deaths; age-adjustedCommunity Health Assessment 2014-2017rate of 187 per 100,000), cancer (2,776deaths; age-adjusted rate of 162 per100,000), unintentional injuries (642 deaths,age-adjusted rate of 41 per 100,000), chroniclower respiratory diseases (585 deaths; ageadjusted rate of 35 per 100,000), and stroke(435 deaths, age-adjusted rate of 25 per100,000).The age-adjusted total mortality ratefor Suffolk County fell between 2007-2010—from 724.8 to 671.9 per 100,000, which is a7.3% decline.MorbidityPreventing misuse of prescriptionopioid drugs—namely the use of prescriptionopioids in manners other than prescribedand the use of these medications withoutprescriptions—is a major public healthconcern for Suffolk County. A summarydocumentofdataresourcesandrecommended guidelines was distributed toall prescribers in 2012. In Suffolk County,deaths involving opiates have risen by 30%in the period between 2007-2011. Theincidence of one opiate in particular,oxycodone (which appears in 33% of opioidrelated deaths), nearly doubled between2007 and 2011.Based on data from 2008-2010, it isestimated that 16.5% of all students(elementary, middle, and high school) areobese, where another 15.2% are overweight(but not obese). 29.1% of all elementaryschool students are either overweight orobese (15.2% are obese), while 35.5% ofmiddle and high school students are eitheroverweight or obese (18.4% are obese). Datafrom the New York State Expanded11
Suffolk County Department of Health Services (SCDHS)Behavioral Risk Factor Surveillance Systemfrom 2008-2009 indicate that about 59.6% ofSuffolk County adults are either overweightor obese, where 20.9% of adults a
Suffolk County Executive James L. Tomarken, MD, MPH, MBA, MSW Commissioner of Health Suffolk County Suffolk County Department of Health Services 3500 Sunrise Highway, Suite 124 P.O. Box 9006 Great River, NY 11
