Writing and Organizing the CHA Document

1
Writing and Organizing the CHA Document

• Shirin Scotten, MPH
• Davie County Health Department
• Healthy Carolinians of Davie County

2
The Beginnings

• Cover
• Acknowledgements
• Table of Contents
• Executive Summary
• Definitions and Abbreviations
• Space-saving tip Combine with references

3
Executive Summary In Depth

• Explain CHA process who, when, why, how
• Tell where secondary data came from
• County Health Data Book, LINC NC and US Census
  data consistent
• Explain survey process, how you analyzed data and
  how representative it appears
• Explain review process for ALL data
• Explain how issues were prioritized
• Tell what you are going to do about them

4
Describe Population

• Total Population
• By age
• By gender
• By race
• By ethnicity
• Net migration
• People per square mile
• Urban vs. rural percentages

5
Describe Community Status

• Primary and Secondary Education
• children and change over time
• drop-out rate
• Per pupil expenditure
• Post-Secondary Education
• Educational attainment of residents
• Available education (ex. colleges)
• adults and effect of influx/ exodus

6
Describe Community Status

• Job Market
• Largest employers (or type employers)
• Unemployment rate
• with disability status
• Retired
• Commuting into/ out of county for work
• Significant changes

7
Describe Community Status

• Income
• Per capita
• Median household income
• Change over time
• Poverty
• Differences by geography, gender, race, etc.
• Change over time

8
Just the Facts

• What is killing us?
• Causes of death
• Life expectancy at birth and age 65
• Years of potential life lost (YPLL)
• What is killing our children?
• Are our children born healthy?
• Does our community support being healthy?

9
What is killing us?

• List all from CHDB and compare
• NC vs. county data
• By gender within county
• By race within county
• Review top 3 in county
• Compare to NC, as whole, by race, and gender
• Compare deaths 64 and younger to 65
• http//www.schs.state.nc.us/SCHS/data/lcd/lcd.cfm

10
What is killing us?

• Discuss the following and explore if different
  from state totals, by gender, by race
• Heart Disease
• Stroke (as a cardiovascular disease)
• Cancer
• Break down into lung, colon, breast, prostate
• Incidence
• Incidence vs. Mortality
• Mortality
• By age categories

11
What is killing us?

• Explore if different from state totals, by
  gender, or by race
• Injuries
• Unintentional motor vehicle injuries
• All other unintentional motor vehicle injuries
• Suicide
• Homicide
• Infectious Diseases
• Septicemia
• Pneumonia Influenza
• AIDS/ HIV

12
What is killing us?

• Explore if different from state totals, by
  gender, or by race
• Metabolic Disease Deaths
• Diabetes
• Nephritis, Nephrotic Syndrome and Nephrosis
• Alzheimers Disease
• Chronic Lower Respiratory Disease

13
What is killing our children?

• Infant death rate
• Causes of child deaths

14
Are our children born healthy?

• Pregnancy
• Rate over years
• How it compares to the state
• Pregnancy outcomes
• Live births
• Abortions
• Fetal deaths
• Discuss in further detail if differences found by
  age, race/ ethnicity or if a prioritized area

15
Are our children born healthy?

• Teen pregnancies
• Differences by race, ethnicity, age, etc.
• Adequate prenatal care
• Smoking
• Cesarean births
• Low birth weight
• Birth spacing
• High parity

16
Does our community support being healthy?

• Providers per person
• Dentists per person
• Hospital use rate
• Insurance coverage
• Medicaid coverage
• Health Choice/ Health Check Enrollment
• Food stamps
• Low-income home energy assistance block grant

17
Does our community support being healthy?

• Child Care
• children in child care
• subsidized
• Child Abuse
• School Violence
• Domestic Violence
• Restraining orders issued
• Arrests

18
Does our community support being healthy?

• Community Violence
• Juvenile justice participants
• Violent crime
• Property crime
• Mental health
• Drug abuse treatment stays
• population treated for MH/DD/SA

19
Does our community support being healthy?

• Childhood lead
• Infectious diseases vector-borne, food and
  water-borne, TB
• Air quality
• (if no monitoring) asthma hospitalizations,
  smoke-free businesses
• EPA maps by county
• Water availability/ sources/ public supply per
  day
• Superfund sites

20
Survey Summary

• Key points/ greatest concerns/ surprising
  findings
• Compare survey vs. county demographics
• City/ town dwellers
• Rural vs. urban
• Gender
• Race/ ethnicity
• Age

• Education
• Marital status
• Household size
• Household income
• Employment status

21
Report Survey Responses

• Follow order of survey
• Be specific and clear on results
• Provide greater detail if
• stats showed a county sub-population disparity
• there is a county-level disparity or initiative
• there is a regional-level disparity or initiative
• responses vary significantly by demographics
• Compare results with other data sources
• BRFSS for your region
• Pull in related health data

22
Finding Out About Youth

• Option 1 Ask care-givers about the health and
  behaviors of children living in their homes.
  Compare with
• CHAMP (state level)
• NC-NPASS (limited population)
• Option 2 Ask children/ adolescents themselves
• YRBS (state level typically)
• NC Youth Tobacco Survey (regional level)

23
To Wrap Up

• Focus Groups/ Stakeholder Interviews
• Mention results grouped by the issue
• References
• To verify findings or find further information
• Community Resources
• Nice to include
• Example Survey