Working Together Towards A Healthier Westchester

Transcription

Working Together Towards a Healthier WestchesterWestchester CountyCommunity HealthAssessment &Improvement PlanWestchester CountyDepartment ofHealth2014-2017Robert P. Astorino, Westchester County ExecutiveCounty Board of LegislatorsSherlita Amler, MD, Commissioner of Health

Project Directors:Jiali Li, Ph.D., Director of Research and EvaluationRenee Recchia, MPH, Acting Deputy Commissioner of AdministrationProject Staff:Megan Cea, MPH, Assistant StatisticianStan Cho, MPH, Medical Data AnalystRosemary James, MPH , Medical Data AnalystJunaid Maqsood, Student Intern from New York Medical CollegeMilagros Venuti, MPA, Assistant StatisticianWith input from:Segun Okunoye, MPH, Management AnalystCamille C. Gonzalez, Jessica Huang, Qianyun Zhang, Student Interns fromColumbia University Mailman School Public HealthGraphic Design:Megan Cea, MPHContact:Jiali Li, Ph.D.Westchester County Department of Health, Planning and Evaluation10 County Center Road, White Plains, New York 10607914-995-7499

WESTCHESTER COUNTYDEPARTMENT OF HEALTHVisionWestchester County Department of Health is the valued leader, partner, andresource in preventing and responding to public health issues that affect the healthand well being of our community.MissionThe mission of the Westchester County Department of Health is to protect health,reduce environmental risks, prevent disease, and promote access to care and ahealthy lifestyle for people of all ages.

FOREWORDThe Westchester County Department of Health (WCDH) plays a leading role in promotinghealth, preventing disease, and prolonging meaningful life for Westchester County residents.WCDH monitors and controls the spread of communicable diseases, monitors and regulates airand water quality, enforces the state and local sanitary code, promotes local public healthactivities, and assures the availability of community health services.To comply with New York State Public Health Law, WCDH has collaborated with localhospitals and other community health partners to complete a Community Health Assessment(CHA), which describes the current health status of Westchester County residents, identifiesexisting gaps and health care barriers, assesses the availability and accessibility of health careservices, and specifies public health priorities in the County. In addition, a Community HealthImprovement Plan (CHIP) has been crafted to lay out the specific objectives, goals, and actionsof the Health Department to address the public health priorities identified in the CommunityHealth Assessment. Such efforts are documented in this volume: Westchester CountyCommunity Health Assessment (CHA) and Community Health Improvement Plan (CHIP),2014-2017.The first section of this document briefly describes the general demographic and socioeconomiccharacteristics of Westchester County population, followed by the assessment of current healthstatus and existing gaps as measured by the New York State Department of Health‟s PreventiveAgenda indicators. The collaborative process of identifying public health priorities andWCDH‟s improvement plan to address such priorities are included in the second section of thisdocument.The third section presents the regional profiles for each of the county‟s 25 towns. The profilespresent information on geographic locations, demographic and socioeconomic characteristics,open spaces and housing, vital statistics, emergency room visits, hospitalizations, chronicdiseases such as cancer, communicable diseases, public school student obesity status, and public

health relevant resources. A detailed map of sources is presented for each town. The lastsection of this document lists relevant resources and references.Supplementing the Westchester County Community Health Assessment (CHA) andCommunity Health Improvement Plan (CHIP), 2014-2017, six additional data reports arecompiled to provide detailed data addressing specific areas relevant to the County‟s publichealth. These reports are:Westchester County Community Health Assessment Supplemental Data Report 1.PopulationWestchester County Community Health Assessment Supplemental Data Report 2. VitalStatisticsWestchester County Community Health Assessment Supplemental Data Report 3.Communicable DiseasesWestchester County Community Health Assessment Supplemental Data Report 4.CancerWestchester County Community Health Assessment Supplemental Data Report 5.Emergency Room VisitsWestchester County Community Health Assessment Supplemental Data Report 6.HospitalizationsThe WCDH is thankful for the participation and support of local community partners fromacross multiple sectors in the process of identifying the public health priorities and developingWCDH‟s Community Health Improvement Plan. The plan is a living document to beimplemented, evaluated, and improved over the next four years. The WCDH is committed toworking with local community partners to address identified gaps, promote local public healthactivities, and further improve the community health of Westchester County.

TABLE OF CONTENTSVision and Mission of Westchester County Department of HealthForewordTable of ContentsSection One1I Who We Are: Demographic and Socioeconomic CharacteristicsII How We Are Doing: New York State Prevention Agenda29A. Improve Health Status and Reduce Health Disparities12B. Prevent Chronic Disease14C. Prevent HIV, STDs, and Vaccine-Preventable Diseases and Health CareAssociated Infections18D. Promote Healthy Women, Infants, and Children22E. Promote Mental Health and Prevent Substance Abuse28F. Promote a Healthy and Safe Environment31Section Two37III Identifying Public Health Priorities and Actions Needed381. Westchester County Health Planning Team: January-October 2013392. WC Health Planning Team Members413. WC Health Planning Team Monthly Meetings444. Priority Areas:47i. Prevent Chronic Disease: Reduce Racial Disparities by Decreasing thePercentage of Blacks and Hispanics Dying Prematurely from HeartRelated Diseases48ii. Promote Healthy Women, Infants and Children: Increase the Proportionof Infants that are Breastfed5. Health Planning Summit: Working Together Towards a Healthier Westchester5156i. Health Planning Summit Invitation and Agenda57ii. Health Summit Attending Community Partners59

iii Health Summit Attending WCDH Staff63iv. Facilitated Breakout Sessions: Identifying Barriers, Actions Needed andBest Practices64A. Prevent Chronic Disease: Reduce Racial Disparities by Decreasingthe Percentage of Blacks and Hispanics Dying Prematurely fromHeart Related Diseases64B. Promote Healthy Women, Infants and Children: Increase theProportion of Infants that are Breastfed68IV WCDH Community Health Improvement Plan (CHIP) - Working Together Towards aHealthier Westchester 2014-2017741. Prevent Chronic Disease: Reduce Racial Disparities by Decreasing thePercentage of Blacks and Hispanics Dying Prematurely from Heart RelatedDiseases762. Promote Healthy Women, Infants and Children: Increase the Proportion ofInfants that are BreastfedSection ThreeV Community Health Regional ProfilesWestchester County82909198Bedford Town104Cortlandt Town110Eastchester Town116Greenburgh Town122Harrison Town/Village128Lewisboro Town134Mamaroneck Town140Mount Kisco Town/Village146Mount Pleasant Town152Mount Vernon158New Castle Town164New Rochelle170North Castle Town176

North Salem Town182Ossining Town188Peekskill194Pelham Town200Pound Ridge Town206Rye City212Rye Town218Scarsdale Town/Village224Somers Town230White Plains236Yonkers242Yorktown Town248Section Four254VI Appendices2551. Hospitals2562. Residential Care: Nursing Homes, Adult Care Facilities, Hospice2573. Visiting Home Health Care Service2594. Federally Qualified Neighborhood Health Centers2615. Mental Health Programs2626. Breastfeeding Support Agencies and Consultants2707. Public Schools2718. Private Schools2779. Colleges and Universities28010. Advantage After-School Programs28111. Public Libraries282

SECTION ONE1

WHO WE ARE:DEMOGRAPHIC ANDSOCIOECONOMIC CHARACTERISTICS2

WESTCHESTER COUNTY“Westchester has it all”. Indeed, with an area of about 450 square miles, Westchester County isone of the most beautiful places in the country, home to nearly one million people according tothe 2010 Census. The County is just north of New York. It is bordered on the west by theHudson River, on the north by Putnam County, and on the east by the Long Island Sound andConnecticut‟s Fairfield County. Within its border, there are breathtaking rolling hills, parks,farmland, lakes, reservoirs, running rivers, as well as modern cities and advanced roads.In addition to its gorgeous natural scenery, Westchester County is rich in its historical andcultural heritage. It has been home and still home to many famous figures in the country. Manysignificant historical sites and estates are within walking distance. Twelve collages have theirmain campuses and headquarters in the County. The very first and only government-plannedamusement park in the country, Playland, still has its pre-1930 roller coaster, the DragonCoaster, rolling and rolling.Currently, the County contains six cities and 19 towns (many include incorporated villageswithin the town borders). Like its kaleidoscopic geographic and natural features, the County‟spopulation is also diversified and ever-changing, with an increasing number of various minoritygroups and foreign-born population, further enriching the County‟s history and culture.Data presented in this section are from the 2010 U.S. Census, the 2007-2011 Annual AmericanCommunity Surveys conducted by the U.S. Census Bureau, and vital records from New YorkState Department of Health.3

WESTCHESTER COUNTYPopulation Density by Municipality, 2010MANTUPYTNUOCAge Distribution, 201065-747.2%NORTH SALEM75 TICUCrotononHudsonTBEDFORDPOUND RIDGE45-6427.8%MOUNTKISCOTNEW liffManorNNORTH CASTLEPleasantvilleNOSex Distribution, 2010CTotal Population: 949,113MOUNT PLEASANTSleepyHollowE RR I VWestchester CountyPopulation Density:2,107 per square bbs leEASTCHE STERSCARSDALETuckahoeRYENEWROCHELLECITYPelham ManorORKLarchmontNGISLANDSOUND2,000-4,999 per square milePopulation Distribution by Age and Sex, 201048.7% 27,8800-40-451.0%5-95-949.0% 30,94910-1410-1448.9% 32,11133,569 51.1%Other Race8.7%Asian5.5%Black14.6%White68.1%Female29,319 51.3%32,263Two or MoreRaces, 3.2%5,000-9,999 per square mile10,000 per square mileMaleRace & Ethnicity, 2010 1,000 per square mile1,000-1,999 per square mileLYOMamaroneckPELHAMWPopulation per Square MileMAMARORYENECKMOUNT PelhamVERNONNEMale48.1%RyeBrookWHITE PLAINSYONKERSFemale51.9%15-17 48.0% 20,13521,774 52.0% 510 37.1%65-7465-7475 75 123,47852.3%138,07655.7% 38,29562.3% 43,8464NonHispanic78.2%Hispanic21.8%

WhiteBlackWhiteAsianBlackTwo or TwoOtherAsianorMore Races MoreAge Distribution, Blacks, 201065-746.7%Percent Change in Population by Race & Ethnicity,2000 to %-4.8%0.0-10.025-4426.5%Age Distribution, Hispanics, 201065-743.2%Total Number of Births & Deaths, 2003-201175 2.0%15,0000-48.8%45-6419.0%5-98.2%13,000Number of BirthsNumber of anic HispanicNonNonHispanic HipanicRaces75 0-44.9% 3%658,8580-45.4%75 9.3%Change in Population by Race & Ethnicity, 2000-201028,161Age Distribution, Whites, 2010200920102011

Population Distribution by Place of Birth, 2010Foreign Born24.6%Percent Change in Family Structure,2000 to 201030.025.020.015.010.05.00.0-5.0-10.0US Born75.4%26.5%8.7%4.9%3.0%-1.0%-3.8%Population Distribution by Language Spoken atHome, 2010Spanish,57.3%English,68.4%Family Structure Distribution By Race& Ethnicity, Island, 9.6%90%Other, 4.1%80%4.0%8.7%27.0%70%Family Structure among Households with OwnChildren Under 18 years of Age, 20108.0%12.6%49.7%60%50%40%Single-FatherFamily, ple FamilySingle-Mother FamilySingle-Father Family6Hispanic

Educational Attainment among AdultsAged 25 Years and Older, 2007-2011Rate of Educational Attainment amongAdults Aged 25 Years and Older by Sex,2007-2011Rates are per 1,000 persons.134.6High e118.6219.8Less than HighSchool12.7%Master'sDegree orHigher22.0%225.8MaleBachelor'sDegree22.5%Some Collegeor Associate'sDegree20.3%Less than High School/High SchoolGEDRate of Educational Attainment amongAdults Aged 25 Years and Older by Race& Ethnicity, 2007-2011Master'sDegree orHigher 90,000 80,725Hispanic 80,000494.4BlackBachelor'sDegreeMedian Household Income, WestchesterCounty, New York State, & the United States,2007-2011Rates are per 1,000 persons.WhiteSomeCollege/Associate'sDegree 70,000 56,951 60,000249.3 40,000180.0196.2288.2189.1281.1270.0210.7 50,000 30,000 20,00090.3163.7318.6 52,762 10,000Less thanHighSomeBachelor'sHigh School School/ GED College/ Degree orAssociate's HigherDegree WestchesterCounty7New York StateUnited States

Median Household Income by Race &Ethnicity, 2007-2011Percent of Population Living Below thePoverty Level by Sex, 2007-2011 117,9269.8%8.9% 100,2217.9% 92,729 50,719 panicWhitePercent of Population Unemployed by Race& Ethnicity, 2007-2011Percent of Population Living Below thePoverty Level by Race & 5%5.8%

HOW WE ARE DOING:NEW YORK STATEPREVENTION AGENDA9

Prevention Agenda Priority Areas and Health IndicatorsIn the effort to make New York the healthiest state, New York State Department of Healthadopted the Prevention Agenda 2013-2017, a four-year plan, to identify New York‟s mosturgent health concerns. Developed in collaboration with multiple organizations, the planidentified five public health priorities: Prevent Chronic Diseases Prevent HIV, STDs, and Vaccine Preventable Diseases, and Healthcare AssociatedInfections Promote Healthy Women, Infants and Children Promote Mental Health and Prevent Substance Abuse Promote a Healthy and Safe EnvironmentThe Prevention Agenda calls for improving health status in all five priority areas and reducinghealth disparities for racial, ethnic, disability, socioeconomic and other groups who experiencethem. For each priority, the Prevention Agenda established specific goals and presentedevidence based and best practice interventions for action that can be implemented by varioussectors within the public health system to meet such goals. In addition, the Prevention Agendaprovided measurable objectives that can be used to assess current status and monitor progressesin the future.As part of the Community Health Assessment, WCDH Planning & Evaluation (WCDH P&E)conducted an extensive review and analysis of all the health indicators contained in the NYSPrevention Agenda and compared Westchester County indicators with the NYS 2017objectives.For each indicator presented in the NYS prevention Agenda, WCDH P&E reviewed whetherthe County is below, in range, or exceeding the state objective, the estimated number of peopleimpacted when not meeting the goal, the County‟s overall ranking for the indicator comparedto other New York counties, and the performance range of all the counties within the state.10

The number of indicators that Westchester County has achieved the goals and the number ofindicators the County needs improvement are summarized for each priority area.The analysis results are presented for each priority area with the following format:Priority AreaWestchester County Status Compared toNew York State 2017 ObjectivesNumber of IndicatorsAchievedNeeds ImprovementXYZHealth Indicators and Westchester County‟s Current StatusIndicator1 ABCD2 EFGNYS 2017ObjectiveWestchesterCounty(WC)OBJ1WC1OBJ2WC2WC Statuscompared toNYSObjective &Rank amongNYSCountiesn1/N1n2/N2Range in NYSMinimumMaximumMIN1MAX1MIN2MAX2The symbol presented in the column “WC Status compared to NYS Objective & Rank amongNYS Counties” indicates Westchester County‟s current status compared to the New York State2017 objective. The blue triangle indicates a status better than the 2017 objective; the red,inverted triangle indicates a status worse than the New York State 2017 objective. The firstnumber inside the symbol is Westchester County‟s ranking among all New York State countiesfor which data are available, the second number inside the symbol is the number of countieswith available data. For example, 13/45 means that Westchester County ranked 13th out of the45 New York State counties with data.11

A. Improve Health Status and Reduce Health DisparitiesWestchester County Status Compared toNew York State 2017 ObjectivesNumber of IndicatorsAchievedNeeds Improvement835Health Indicators and Westchester County‟s Current StatusIndicatorPercentage of premature1 death (before age 65years)(2008-2010)NYS 2017ObjectiveWestchesterCounty(WC)21.820.02Ratio of Black nonHispanics to Whitenon-Hispanics1.872.483Ratio of Hispanics toWhite non-Hispanics1.863.16133.3123.75Ratio of Black nonHispanics to Whitenon-Hispanics1.852.286Ratio of Hispanics tonon-Hispanics1.381.3010084.0CI: (83.184.9)Age-adjusted preventablehospitalizations rate per410,000 (ages 18 years)(2008-2010)Percentage of adults with7 health insurance (ages18-64)(2010)12WC Statuscompared toNYSObjective &Rank 2Range in 0.324.010.002.6074.7(73.9-75.5)88.9(87.989.9)

Health Indicators and Westchester County‟s Current StatusIndicatorAge-adjusted percentageof adults who have a8 regular health careprovider (ages18 years)(2008-2009)NYS 2017Objective90.8WestchesterCounty(WC)85.3CI: (80.989.7)13WC Statuscompared toNYSObjective &Rank amongNYSCounties*31/62Range in NYSMinimumMaximum78.9(71.9-86.0)95.2(92.997.4)

B. Prevent Chronic DiseasesIObesity Create community environments that support healthy choices and physical activity. Promote good nutrition and physical activity in early child care and school settings. Expand the role of health care providers and insurers in obesity prevention. Expand the role of public and private employers in obesity prevention.Westchester County Status Compared toNew York State 2017 ObjectivesNumber of IndicatorsAchievedNeeds Improvement220Health Indicators and Westchester County‟s Current StatusNYS 2017ObjectiveWestchesterCounty(WC)Age-adjustedI.1 percentage of adultswho are obese(2008-2009)23.019.9CI: (14.924.8)Percentage of childrenI.2 and adolescents whoare obese(2010-2012)16.714.0IndicatorWC Statuscompared toNYSObjective &Rank amongNYSCountiesRange in 24.4I Obesity14In Range3/623/62

B. Prevent Chronic DiseasesII Tobacco Use and Secondhand Smoke Exposure Prevent tobacco use by youth. Promote smoking cessation. Eliminate exposure to secondhand smoke.Westchester County Status Compared toNew York State 2017 ObjectivesNumber of IndicatorsAchievedNeeds Improvement110Health Indicators and Westchester County‟s Current StatusIndicatorNYS 2017ObjectiveWestchesterCounty(WC)WC Statuscompare

amusement park in the country, Playland, still has its pre-1930 roller coaster, the Dragon Coaster, rolling and rolling. Currently, the County contains six cities and 19 towns (many include incorporated villages within the town borders). Like its ka