Ochsner Medical Center ‐ Baton Rouge

Transcription

OchsnerMedical
Center‐BatonRouge
CommunityHealthNeedsAssessment
October 2015 Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Table of Contents  Introduction… Page: 1  Community Definition… Page: 2  Consultant Qualifications… Page: 3  Project Mission & Objectives … Page: 4  Methodology… Page: 5  Key Community Health Priorities… Page: 8  Community Health Needs Identification… Page: 24  Secondary Data… Page: 29  Key Stakeholder Interviews… Page: 59  Survey… Page: 68  Conclusions … Page: 75  Appendix A: Community Resource Inventory … Page: 77  Appendix B: Community Secondary Data Profile … Page: 93 Tripp Umbach Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Introduction Ochsner Medical Center – Baton Rouge, a 150‐bed acute care community hospital located in Baton Rouge, LA, in response to its community commitment, contracted with Tripp Umbach to facilitate a comprehensive Community Health Needs Assessment (CHNA). A CHNA was conducted between March 2015 and October 2015 that identifies the needs of the residents served by Ochsner Medical Center – Baton Rouge. As a partnering hospital of a regional collaborative effort to assess community health needs, Ochsner Medical Center – Baton Rouge collaborated with 15 hospitals and other community‐
based organizations in the region during the CHNA process. The following is a list of organizations that participated in the CHNA process in some way: 
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Louisiana Office of Public Health  The Metropolitan Hospital Council of New Orleans Humana Louisiana (MHCNO) Director – Medical Student Clerkship  Ochsner Medical Center Louisiana Public Health Institute  Ochsner Baptist Medical Center Acadian Ambulance  Ochsner Medical Center Northshore BREC  Ochsner St. Anne General Hospital  Ochsner Medical Center Westbank Baton Rouge Community College YMCA BR  St. Charles Parish Hospital BR Division of Human Development &  Children’s Hospital of New Orleans Services  Touro Infirmary LSU Health Science Center, Allied Health  University Medical Center Ochsner Health System Cancer Association of Greater New Orleans  East Jefferson General Hospital  West Jefferson Medical Center (CAGNO) Healthy Baton Rouge Initiative  Slidell Memorial Hospital EQ Health Solutions This report fulfills the requirements of the Internal Revenue Code 501(r)(3); a statute established within the Patient Protection and Affordable Care Act (ACA) requiring that non‐
profit hospitals conduct CHNAs every three years. The CHNA process undertaken by Ochsner Medical Center – Baton Rouge, with project management and consultation by Tripp Umbach, included extensive input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of public health issues, data related to vulnerable populations and representatives of vulnerable populations served by the hospital. Tripp Umbach worked closely with leadership from Ochsner Medical Center – Baton Rouge and a project oversight committee to accomplish the assessment. 1
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Community Definition While community can be defined in many ways, for the purposes of this report, the Ochsner Medical Center – Baton Rouge (OMC Baton Rouge) community is defined as 24 zip codes – including 5 parishes that hold a large majority (80%) of the inpatient discharges for the hospital (See Table 1 and Figure 1). Table 1. OMC Baton Rouge Study Area Definition – Zip Codes City Zip Code Parish Gonzales 70737 Ascension Parish Prairieville 70769 Ascension Parish Baker 70714 East Baton Rouge Parish Greenwell Springs 70739 East Baton Rouge Parish Zachary 70791 East Baton Rouge Parish Baton Rouge 70802 East Baton Rouge Parish Baton Rouge 70805 East Baton Rouge Parish Baton Rouge 70806 East Baton Rouge Parish Baton Rouge 70807 East Baton Rouge Parish Baton Rouge 70808 East Baton Rouge Parish Baton Rouge 70809 East Baton Rouge Parish City Baton Rouge Baton Rouge Baton Rouge Baton Rouge Baton Rouge Baton Rouge Plaquemine Denham Springs Denham Springs Livingston Walker Baton Rouge Port Allen 70810 East Baton Rouge Parish Zip Code 70814 70815 70816 70817 70818 70819 70764 70706 70726 70754 70785 Parish East Baton Rouge Parish East Baton Rouge Parish East Baton Rouge Parish East Baton Rouge Parish East Baton Rouge Parish East Baton Rouge Parish Iberville Parish Livingston Parish Livingston Parish Livingston Parish Livingston Parish 70767 West Baton Rouge Parish Figure 1. Map of Ochsner Medical Center – Baton Rouge Study Area 2
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Consultant Qualifications Ochsner Medical Center – Baton Rouge contracted with Tripp Umbach, a private healthcare consulting firm headquartered in Pittsburgh, Pennsylvania to complete the CHNA. Tripp Umbach is a recognized national leader in completing CHNAs, having conducted more than 300 CHNAs over the past 25 years; more than 75 of which were completed within the last three years. Today, more than one in five Americans lives in a community where Tripp Umbach has completed a CHNA. Paul Umbach, founder and president of Tripp Umbach, is among the most experienced community health planners in the United States, having directed projects in every state and internationally. Tripp Umbach has written two national guide books1 on the topic of community health and has presented at more than 50 state and national community health conferences. The additional Tripp Umbach CHNA team brought more than 30 years of combined experience to the project. 1
A Guide for Assessing and Improving Health Status Apple Book:
http://www.haponline.org/downloads/HAP_A_Guide_for_Assessing_and_Improving_Health_Status_Apple_Book_1
993.pdf and
A Guide for Implementing Community Health Improvement Programs:
http://www.haponline.org/downloads/HAP_A_Guide_for_Implementing_Community_Health_Improvement_Progra
ms_Apple_2_Book_1997.pdf
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Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Project Mission & Objectives The mission of the Ochsner Medical Center – Baton Rouge CHNA is to understand and plan for the current and future health needs of residents in its community. The goal of the process is to identify the health needs of the communities served by the hospital, while developing a deeper understanding of community needs and identifying community health priorities. Important to the success of the community needs assessment process is meaningful engagement and input from a broad cross‐section of community‐based organizations, who are partners in the CHNA. The objective of this assessment is to analyze traditional health‐related indicators, as well as social, demographic, economic, and environmental factors and measure these factors with previous needs assessments and state and national trends. Although the consulting team brings experience from similar communities, it is clearly understood that each community is unique. This project was developed and implemented to meet the individual project goals as defined by the project sponsors and included:  Ensuring that community members, including underrepresented residents and those with a broad‐based racial/ethnic/cultural and linguistic background are included in the needs assessment process. In addition, educators, health‐related professionals, media representatives, local government, human service organizations, institutes of higher learning, religious institutions, and the private sector will be engaged at some level in the process.  Obtaining information on the health status and socio‐economic/environmental factors related to the health of residents in the community.  Developing accurate comparisons to previous assessments and the state and national baseline of health measures utilizing most current validated data.  Utilizing data obtained from the assessment to address the identified health needs of the service area.  Providing recommendations for strategic decision‐making, both regionally and locally, to address the identified health needs within the region to use as a benchmark for future assessments.  Developing a CHNA document as required by the Patient Protection and Affordable Care Act (ACA). 4
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Methodology Tripp Umbach facilitated and managed a comprehensive CHNA on behalf of Ochsner Medical Center – Baton Rouge based on previous assessments completed by the hospital (2013) and the Mayors Healthy BR Initiative (2015). Building upon findings of both previous assessments, the assessment process included input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge and expertise of public health issues. The needs assessment data collection methodology was comprehensive and there were no gaps in the information collected. Key data sources in the CHNA included:  Community Health Assessment Planning: A series of meetings was facilitated by the consultants and the CHNA oversight committee consisting of leadership from Ochsner Medical Center – Baton Rouge and other participating hospitals and organizations. This process lasted from March 2015 until August 2015.  Secondary Data: Tripp Umbach completed comprehensive analysis of health status and socio‐economic environmental factors related to the health of residents of the Ochsner Medical Center – Baton Rouge community from existing data sources such as state and county public health agencies, Healthy BR 2014 CHNA, the Centers for Disease Control and Prevention, County Health Rankings, Truven Health Analytics, CNI, Healthy People 2020, and other additional data sources. This process lasted from March 2014 until August 2015.  Trending from 2013 CHNA: In 2013, Ochsner Medical Center – Baton Rouge contracted with Tripp Umbach to complete a CHNA. The data sources used for the current CHNA where the same data sources from the 2013 CHNA, which made it possible to review trends and changes across the hospital service area. There were several data sources with changes in the definition of specific indicators, which restricted the use of trending in several cases. The factors that could not be trended are clearly defined in the secondary data section of this report. Additionally, the findings from primary data (i.e., community leaders, stakeholders, and focus groups) are presented when relevant in the executive summary portion. The 2013 CHNA can be found online at: http://www.ochsner.org/giving/community‐
outreach/community‐health‐needs‐assessment/  Interviews with Key Community Stakeholders: Tripp Umbach worked closely with the CHNA oversight committee to identify leaders from organizations that included: 1) Public health expertise; 2) Professionals with access to community health related data; and 3) Representatives of underserved populations (i.e., seniors, low‐income 5
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach residents, youth, residents with a history of behavioral health and substance abuse, residents with disabilities, homeless, residents with a chronic illness/disease, and residents that are uninsured). Such persons were interviewed as part of the needs assessment planning process. A series of 11 interviews were completed with key stakeholders in the Ochsner Medical Center – Baton Rouge community. A complete list of organizations represented in the stakeholder interviews can be found in the Key Stakeholder Interviews section of this report. This process lasted from April 2015 until August 2015.  Survey of vulnerable populations: Tripp Umbach worked closely with the CHNA oversight committee to ensure that community members, including under‐
represented residents, were included in the needs assessment through a survey process. A total of 150 surveys were collected in the Ochsner Medical Center – Baton Rouge service area, which provides a +/‐ 7.32 confidence interval for a 95% confidence level. Tripp Umbach worked with the oversight committee to design a 32 question health status survey. The survey was offered in English, Spanish, and Vietnamese. The survey was administered by community‐based organizations providing services to vulnerable populations in the hospital service area. Community‐based organizations were trained to administer the survey using hand‐
distribution. Surveys were administered onsite and securely mailed to Tripp Umbach for tabulation and analysis. Surveys were analyzed using SPSS software. Geographic regions were developed by the CHNA oversight committee for analysis and comparison purposes:  Baton Rouge Region: Ascension, East Baton Rouge, Iberville and Livingston parishes.  Southeast Louisiana (SELA) Region: all parishes included in the study (Ascension, East Baton Rouge, Iberville, Jefferson, Lafourche, Livingston, Orleans, Plaquemines, St. Bernard, St. Charles, St. John the Baptist, St. Tammany, Terrebonne, and Washington parishes). Vulnerable populations were identified by the CHNA oversight committee and through stakeholder interviews. Vulnerable populations targeted by the surveys were residents that were: seniors, low‐income (including families), youth, residents with a history of behavioral health and substance abuse, residents with disabilities, homeless, residents with limited English speaking skills, diagnosed with a chronic illness/disease, and residents that are uninsured. This process lasted from May 2014 until July 2015. There are several inherent limitations to using a hand‐distribution methodology that targeted medically vulnerable and at‐risk populations. Often, the demographic characteristics of populations that are considered vulnerable populations are not the 6
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach same as the demographic characteristics of a general population. For example, vulnerable populations, by nature, may have significantly less income than a general population. For this reason the findings of this survey are not relevant to the general population of the hospital service area. Additionally, hand‐distribution is limited by the locations where surveys are administered. In this case Tripp Umbach asked CBOs to self‐select into the study and as a result there are several populations that have greater representation in raw data (i.e., low‐income, women, etc.). These limitations were unavoidable when surveying low‐income residents about health needs in their local communities.  Identification of top community health needs: Top community health needs were identified and prioritized by the Healthy Baton Rouge Initiative and validated by community leaders during a regional community health needs forum held on August 4, 2015. Consultants presented to community leaders the CHNA findings related to health needs identified in the Baton Rouge area found in secondary data, key stakeholder interviews, and surveys. Community leaders discussed the data presented, shared their visions and plans for community health improvement in their communities, and validated the top community health needs by providing potential solutions in the Ochsner Medical Center – Baton Rouge community.  Public comment regarding the 2013 CHNA and implementation plan: Ochsner Medical Center – Baton Rouge made the CHNA document publicly available on October 3, 2013. Since October 2013, Ochsner Medical Center – Baton Rouge has offered a link on their web page for questions and comments related to the CHNA document. While the main Ochsner Health System CHNA website has been viewed 6,326 times since October 2013, Ochsner Medical Center – Baton Rouge has not yet received any feedback related to the CHNA or 990 documents.  Final Community Health Needs Assessment Report: A final report was developed that summarizes key findings from the assessment process, including the priorities set by community leaders. 7
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Key Community Health Priorities Louisiana is a state that has not expanded Medicaid, a key component of health reform that extends Medicaid eligibility to a greater population of residents. Many health needs identified in this assessment relate to the lack of Medicaid expansion and the resulting restricted access to health services. The Top community health priorities is based on the CHNA completed by Healthy BR in 20142. In Baton Rouge, healthcare organizations, city and state agencies, for‐
profit businesses, educational institutions, faith‐based organizations, and nonprofit agencies have successfully joined forces to positively impact the health of our community through joint analysis, open discussion, and interactive action planning. Working together, participants are able to combine and analyze data, assess efforts currently in place, and identify gaps that need to be addressed. Ochsner Medical Center – Baton Rouge sought to build upon the 2014 Healthy BR CHNA. As a result, community leaders reviewed and discussed existing data, in‐depth interviews with community stakeholders representing a cross‐section of agencies, and survey findings presented by Tripp Umbach in a forum setting, which validated the four community health priorities in the Ochsner Medical Center – Baton Rouge community. Community leaders agreed with the following top community health needs that are supported by secondary and/or primary data: 1) HIV and other STDs; 2) Mental health and substance abuse; 3) Obesity; and 4) Overuse of emergency departments. Many of the same underlying factors were identified in the 2013 CHNA, with slightly different priorities. A summary of the top four needs in the Ochsner Medical Center – Baton Rouge community follows: HIV AND OTHER STDS Underlying factors identified by secondary data and primary input from community leaders, community stakeholders, and resident survey respondents: 1. Human Immunodeficiency Virus (HIV) and Sexually Transmitted Diseases (STDs) are associated with increased morbidity and mortality. Input from community leaders, stakeholders, and survey respondents align with the Healthy Baton Rouge Initiative 2015 CHNA in that addressing HIV and other STDs is a top health priority in the hospital service area. Primary data focused largely on the limited number of providers, the need for care coordination, and the fact that individuals with behavioral health and substance abuse needs often have poor health outcomes. Findings supported by study data: 2
More Information is available at: http://www.healthybr.com/community-health-needs-assessment.aspx
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Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach HIV and STDs are associated with increased morbidity and mortality. HIV transmission can be reduced or eliminated by addressing the primary methods of infection: safe sex practices, protection against transmission from an HIV‐positive mother to her baby during pregnancy or birth, preventive treatment and sterile supplies for injection drug users, widespread testing and medical care for those who test positive, and effective counseling and treatment programs. Louisiana ranks second in the nation in the number of newly diagnosed HIV cases. The Baton Rouge public health region accounted for 20% of the new HIV diagnoses, 25% of the new AIDS diagnoses, and 25% of citizens living with HIV. There is a higher rate of HIV diagnoses in the African American community, which accounted for 86% of the new HIV diagnoses.3 In 2013, Louisiana ranked highest among all states for gonorrhea (188.4 per 100,000 population) and congenital syphilis (51.3 per 100,000 live births), second for chlamydia case rates (521.6 per 100,000), and third for primary and secondary syphilis (9.2 per 100,000 population).4 During the CHNA conducted by Ochsner Medical Center – Baton Rouge in 2013, areas of specific focus identified included resident’s health and wellness specific to prevention and health education focused on prevention of chronic diseases – Especially prevention and health education focused on HIV/AIDS. Stakeholders perceived the health status of many residents as poor due to the limited education available and/or received on how to promote healthy living, specifically regarding HIV/AIDS in 2013. Baton Rouge and ranked second and third in rates of HIV infections at 43 per 100,000 people. The HIV/AIDS population in the region was increasing according to stakeholders in the 2013 CHNA. Baton Rouge was #1 in the nation for HIV/AIDS (e.g., Baton Rouge was, at that time, the highest in the nation per capita diagnosis of HIV). In the current study (2015), more than one‐third of stakeholders discussed HIV as a major health concern among residents. Stakeholders identified social and environmental determinants (e.g., limited prevention education, etc.), as well as personal choice and behaviors within the control of residents (e.g., treatment non‐compliance, risky behaviors, etc.) as driving the high rates of HIV. While residents are living longer with HIV, there can still be complications and management issues related to the diagnosis. Stakeholders felt that residents may not value themselves enough to avoid risky behaviors. While stakeholders understood the impact of social and environmental determinants like youth not learning the practices that reduce the spread of STIs like HIV in school settings, stakeholders also recognized that parents are choosing not to provide education to their children about preventing the spread of STDs and youth are making the decision to practice risky behaviors. 3 3
, Source: Healthy BR: 2015 Community Health Needs Assessment
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Community Health Needs Assessment Ochsner Medical Center – Baton Rouge 
Tripp Umbach From 2008 to 2010, many of the study area parishes experienced rises or slight declines then larger rises in the HIV/AIDS rates for their parish. Therefore, 2010 rates of HIV/AIDS in the Ochsner Medical Center – Baton Rouge study area are higher than 2008 rates. The Non‐Hispanic Black population continues to be the population that sees the highest rates of HIV/AIDS. East Baton Rouge Parish sees the highest rate of HIV/AIDS for the study area in the Non‐Hispanic Black population at 1,704.65 per 100,000 population. The next highest rate in the study area, also in the Non‐Hispanic Black population, is 1,288.68 per 100,000 population in Iberville Parish. Figure 2: Population with HIV/AIDS, Rate (Per 1,000 population) ‐
By Race/Ethnicity
2010
Ascension
2000
East Baton
Rouge
Iberville
1500
Livingston
1000
LOUISIANA
500
0
Non‐Hispanic White
Non‐Hispanic Black
Hispanic / Latino
USA
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East Baton Rouge Parish has reported the highest rate of chlamydia infection in the OMC Baton Rouge study area since 2009. The most current data, for 2011, shows the rate of chlamydia infection to be 743.9 per 100,000 population; considerably higher than the national chlamydia rate of 454.1 per 100,000 population.  Only Ascension Parish and Livingston Parish report lower chlamydia infection rates than the nation. Livingston Parish being the lowest in the study area at 263.3 per 100,000 population. Similar to chlamydia infection, East Baton Rouge Parish reports the highest rate of gonorrhea infection in the OMC Baton Rouge study area at 229.9 per 100,000 population; more than double the national rate of 103.1 per 100,000 population. East Baton Rouge Parish has consistently reported the highest rate of gonorrhea infection in the study area since 2003.  Also similar to chlamydia infection, only Ascension Parish and Livingston Parish report lower chlamydia infection rates than the nation. Livingston Parish being the lowest in the study area at 34.5 per 100,000 population. While the self‐reported HIV testing rates among survey respondents was much higher in the Baton Rouge region (80.3%) than the state (43.5%) and nation (35.2%), 40.6% of survey respondents indicated that HIV was one of their top 5 health concerns and 40.8% of survey respondents indicated that STDs was one of their top 5 health concerns. 10
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Table 2: Survey Responses‐ Ever Benn Tested For HIV HIV and other STDs has remained a top health priority and appears to be a theme in each data source included in this assessment. Primary data collected during this assessment from community leaders and residents offered several recommendations to address the need to address HIV and other STDs in the Ochsner Medical Center – Baton Rouge service area. Some of which included: 
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Increase the outreach and education for effective reduction of HIV and other STDs: Community leaders recommended that schools, community‐based programs, and health providers could all increase the information they offer youth and adults about effective methods for reducing the spread of HIV and other STDs. Increase screening rates for HIV and other STDs: Community leaders suggested that HIV testing can be easily offered in community settings where residents naturally congregate. There is a need to increase state funding for STDs screening and testing. MENTAL HEALTH AND SUBSTANCE ABUSE Underlying factors identified by secondary data and primary input from community leaders, community stakeholders, resident survey respondents, and the 2015 CHNA completed by Healthy BR: 1. There are not enough providers to meet the demand and the spectrum of services available in most areas is not comprehensive enough to treat individual needs. Input from community leaders, stakeholders, and survey respondents align with the Healthy Baton Rouge 2015 CHNA that addressing HIV and other STDs is a top health priority in the hospital service area. Primary data focused primarily on the limited number of providers, the need for care coordination, and the fact that individuals with behavioral health and substance abuse needs often have poor health outcomes. 11
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Findings supported by study data: Mental health refers to psychological, emotional, and social well‐being. Mental illnesses affects a person’s mood and how he or she feels, perceives, and behaves. Mood disorders are the most common of all mental disorders and include major depression. One in four Americans will be diagnosed with some form of mental illness in their lifetime and 17% of all Americans will suffer from depression at some point in their lives. In 2015, 16% of adults in Louisiana reported excessive drinking. Alcohol‐impaired driving deaths accounted for 33% of all driving deaths statewide. These trends are also reflected in (East Baton Rouge Parish), with 15% of adults reporting binge or heavy drinking. Alcohol was involved in 35% of motor vehicle crash deaths in EBR from 2007‐2012. The effects of substance abuse can result in separation from friends and family members, which may trigger depression. In 2014, 22% of EBR residents reported having inadequate social support. Locally, the number of mentally ill in parish prisons has doubled and the community is searching for solutions to decriminalize mental illness and provide residents with additional support.5 During the needs assessment conducted by Ochsner Medical Center – Baton Rouge in 2013, stakeholders were under the impression mental health services were limited at that time in the areas of capacity to meet the demand for services. They discussed negative effects of closures of mental health clinics and hospitals and the need for outpatient and inpatient psychiatric facilities (e.g., after Katrina, this service was never improved); mental health is a large issue (e.g., 3‐4 transports to North Louisiana each day for people to receive necessary mental health‐
related services).  Today, there is evidence of a shortage of mental health and substance abuse professionals in the hospital service area. Livingston, Iberville, and Ascension parishes all show a significantly larger population to provider ratio (4,189, 4,171, and 1,733 pop. for every 1 mental health provider respectively) than East Baton Rouge Parish and the state (155 and 859 pop. per provider respectively). However, there is no measure of the providers that are accepting under/uninsured and Medicaid eligible behavioral health patients. Both primary and secondary data suggests there is a need for additional behavioral health services in both geographical areas. Table 3: County Health Rankings –Mental Health Providers (Count/Ratio) by Parish Ascension East Baton Iberville Livingston LA Measure of Mental Health Providers* Parish Rouge Parish Parish Parish 691 8 32 Mental health providers (count) 5386 66 5
Source: Healthy BR: 2015 Community Health Needs Assessment 12
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Mental health providers (ratio 859:1
Population to provider) Tripp Umbach 1,733:1 155:1 4,171:1 4,189:1 *County Health Ranking 2015 The Healthy People 2020 goal is for mortality due to suicide to be less than or equal to 10.2 per 100,000 population; Ascension, East Baton Rouge, and Iberville parishes report rates lower than the HP2020 Goal. However, Livingston Parish reports the highest rate of age‐adjusted mortality due to suicide for the study area at 17.57 per 100,000 population; this rate has increase from the 2013 study (15.5) and is also higher than the national rate (11.82) and the highest rate found in an area served by Ochsner Health System. 17.57
Figure 3: Mortality ‐ Suicide‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2007‐2011
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10
9.54
9.65
14
10.16
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East Baton Rouge
11.82
18
11.94
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Ascension
Iberville
Livingston
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6
LOUISIANA
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2
USA
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*Source: Community Commons. 06/08/2015 
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Ascension Parish, Iberville Parish, and Livingston Parish all report higher rates of residents with depression than Louisiana (15.66%) and the country (15.45%). More than one in three survey respondents (37.9%) indicated they have ever received mental health treatment or counseling compared to 21.4% across the SELA Region. When asked to report health conditions that they had ever been diagnosed with by a health professional, survey respondents from the Baton Rouge area self‐reported higher diagnosis rates than the SELA Region, the state, and the nation for depressive disorder (32.3% vs. SELA – 21.5%, LA – 18.7%, and U.S. – 18.7%). More than one in four respondents (26%) indicated they have received counseling or therapy during the last 12 months and 15.8% of survey respondents indicated that they did not believe that mental health services were available to them. There is evidence in the secondary data of higher rates of substance abuse when compared to state and national norms. Livingston Parish is highest at 19.22%. The 13
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Tripp Umbach national rate of adults drinking excessively is 16.94%. Iberville Parish reports the highest rate, for the OMC Baton Rouge study area, of adults drinking excessively at 22.8%. Also, according to SAMSHA, the hospital service area reports a higher rate, as compared with Louisiana, of nonmedical use of pain relievers in the past year at 5.41% of the population aged 12+ years (increased since 2002‐2004 when it was 5.26%). The national rate of adults drinking excessively is 16.94%. Iberville Parish and Ascension Parish report higher rates of adults drinking excessively. Iberville Parish reports the highest rate, for the OMC Baton Rouge study area, of adults drinking excessively at 22.8%. 15.00%
15.90%
22.80%
10.00%
13.60%
20.00%
13.40%
25.00%
18.30%
Figure 4: Estimated Adults Drinking Excessively (A
Percentage),
2006‐2012
“Katrina has had a major 5.00%
impact on the mental health 0.00%
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of residents‐ the stress, and Residents in the study area are also concerned displacement of residents has with mental health and substance abuse with had an impact and the 58.9% of survey respondents indicating that response has not been mental health was one of their top five health adequate to meet the need.” ~ concerns and 47.8% indicated that drugs and alcohol was among the top five. First Responder A majority of stakeholders (90%) identified a health need related to mental health and/or substance abuse. Stakeholders discussed the lack of behavioral health and substance abuse resources in general and many noted that behavioral health and substance abuse needs are highest in communities with the highest rates of poverty. Stakeholders discussed how fragmented the behavioral health services are in the Capital Area with little care coordination. One stakeholder noted that it is not possible to make significant population health improvements without addressing behavioral health due to the impact of behavioral health on medical health, a sentiment that was echoed in the previous 2013 CHNA study. The education in schools was addressed as an issue related to the oversight of behavioral health. Stakeholders felt that youth are not always getting their behavioral health needs met in the school systems due to the lack of formal oversight for behavioral health in the school system. 14
Tripp Umbach Stakeholders felt that the culture and laws support substance abuse and identified tobacco, alcohol, marijuana, and prescription pain medications as the most common substances being abused. Stakeholders noted that behavioral health and substance abuse has an impact on the health status of residents in a variety of ways and often leads to poorer health outcomes. Several of the noted effects of behavioral health and substance abuse were:  Residents with a history of behavioral health and substance abuse do not always practice healthy behaviors and may be non‐compliant with necessary medical treatments (e.g., HIV treatments, etc.).  Babies born to mothers with behavioral health and/or substance abuse issues may not receive adequate prenatal care and/or consistent care Postpartum to facilitate healthy child development. Mothers that have a history of substance abuse may not inform their physician due to laws that may lead to the removal of other children in the home. Behavioral health has remained a top health priority and appears to be a theme in each data source included in this assessment. The underlying factors include: care coordination and workforce supply vs. resident demand. Primary data collected during this assessment from community leaders and residents offered several recommendations to address the need for behavioral health and substance abuse services. Some of which included: 
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Increase the use of evidence‐based practice in mental health settings: Community leaders recommended that health providers could support efforts to increase the use of evidence‐based practices (EBP) in mental health settings by implementing such practices on‐site and advocating the use of EBP in other settings. Increase the availability of behavioral health services and awareness: Community leaders recommended that behavioral health services begin to target residential communities where prevalence rates are highest (e.g., communities where poverty rates are highest) with education and outreach in order to normalize behavioral health services and reduce the stigma associated with seeking care. Integrate behavioral health, social services, and medical care: Community leaders suggested that health providers could increase the connection between medical, behavioral health, and social services offered in the community. Several leaders discussed the value of health information exchanges in connecting a community of providers. Leaders also discussed the value of co‐located services (e.g., behavioral health services that are offered in medical care settings and visa‐versa). OBESITY 15
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Underlying factors identified by secondary data and primary input from community leaders, community stakeholders, and resident survey respondents: 1. Limited access to healthy nutrition 2. Lack of safe exercise options 3. Limited access to prevention and education Community leaders identified access to healthy options as a community health priority. Community leaders and stakeholders understood that obesity in the hospital service area may be driven by both personal choices of residents and the amount of access individuals have to healthy options. Leaders focused discussions around the limited access residents have to healthy nutrition, safe exercise opportunities, and the need for education and outreach. There is agreement across data sources in support of decreasing the rate of obesity in the hospital service area. Findings supported by study data: One in two children in Louisiana is overweight or obese. Obesity related medical expenses cost Louisiana more than $3 billion annually. As cases of obesity rise in Louisiana and the U.S., the cases of related chronic diseases like diabetes increase. Obesity is defined as a body mass index (BMI) greater than 30. Obesity is a significant risk factor for diabetes, heart disease, and stroke. Lifestyle factors such as physical activity, healthy eating, and monitoring caloric intake can decrease the risk of obesity. The 12 stakeholders interviewed during the 2013 Ochsner Medical Center – Baton Rouge CHNA perceived the following problems and/or barriers for residents in the service area:  The health and wellness of residents, including high obesity rates that led to a myriad of health issues (i.e., increased blood pressure, cardiovascular disease, etc.);  Prevention and health education focused on prevention of chronic diseases – Especially diabetes and obesity;  Heart disease issues, which is also part of the existing obesity problem;  Growing number of children with a multitude of health needs that requires specialty services.  During the current study (2015), the rates of obesity in the OMC Baton Rouge study area and nationally have seen steady rises over the years. Ascension Parish is the lowest in the study area at 31.90% and closest to the U.S. rates (27.14%) for obesity and has seen, after peaking at 34.1% in 2010, a steady decline. 16
Tripp Umbach  Iberville Parish reports the highest rate of residents who are obese (39.4%), Livingston Parish is a close second with 35.60% of their population being obese; East Baton Rouge Parish ranks third highest at 32.20%. Iberville Parish reports the highest rate of residents who are overweight (37.16%); this rate is higher than the national rate of 35.78%.  The rest of the parishes in the OMC Baton Rouge study area fall below the national rate; Livingston Parish being the lowest at 31.41%. Figure 5: Percent Adults with BMI > 30.0 (Obese) ‐ Time
50.00%
45.00%
Ascension
East Baton Rouge
40.00%
Iberville
35.00%
Livingston
30.00%
25.00%
LOUISIANA
20.00%
USA
Survey respondents for the Baton Rouge region showed higher BMI averages than the SELA Region and national norms. Table 4: Survey Responses‐ Average BMI of Respondents Limited access to healthy nutrition:  In 2013, East Baton Rouge Parish reported the highest rate of fast food restaurants per population at 86.78 per 100,000 pop.; Ascension Parish follows at 74.62 per pop. These rates are higher than state (71.56) and national (72.74) norms. 17
Tripp Umbach In 2013, Livingston Parish reported the lowest rate of grocery stores per population at 12.5 per 100,000 pop.; Ascension Parish follows at 18.65 per 100,000 pop. Both are lower than state (21.88) and national (21.2) norms. Figure 5: Grocery Store Establishments, Rate per 100,000 population
45
40
Ascension
35
30
East Baton Rouge
25
20
Iberville
15
Livingston
10
5
LOUISIANA
0
USA

In 2013, Iberville Parish reported the lowest rate of recreation and fitness facilities per population at 3 per 100,000 pop.; Livingston Parish follows at 7.03 per 100,000 pop. Both are lower than state (9.6) and national (9.72) norms. Ascension Parish experiences the highest rate of population with low or no healthy food access and has a disparity index of 26.31 as compared to 19.31 in the State of Louisiana and a national rate of 16.59. Within the parish of Iberville, the Non‐Hispanic other population experiences the highest rate of low food access (72.7%) followed by the Non‐Hispanic Asian population (70.2%). These rates are the highest for the study area. East Baton Rouge Parish reports the next highest rates, for the study area, for Non‐
Hispanic Asian (64.9%) and Non‐Hispanic Black (64.2%) populations. Figure ##: Low Food Access ‐ Race, 2010
100.0%
80.0%
Non‐Hispanic Asian
60.0%
Non‐Hispanic American Indian
/ Alaska Native
Non‐Hispanic Other
40.0%
Multiple Race
20.0%
0.0%
Ascension East Baton Rouge Iberville
Livingston
LOUISIANA
USA
*Source: Community Commons. 06/08/2015 18
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach 
Over one‐half of stakeholders discussed the prevalence and cause of obesity among residents in Baton Rouge communities. Stakeholders indicated that obesity is an issue among adults, as well as a growing problem among youth. Stakeholders identified social and environmental determinants (e.g., culture, lack of awareness, limited access to healthy nutrition, etc.), as well as personal choice and behaviors within the control of residents (e.g., choices about nutrition, exercise, etc.) as driving the high rates of obesity. Food security was discussed by stakeholders related to the health of seniors and youth. Grocery stores are not often located in low‐income neighborhoods; creating what is being called a food desert. Youth and seniors residing in these food deserts may not have ready access to healthy nutrition due to the lack of transportation options.  Stakeholders felt that a lack of education coupled with low exposure to healthy resources causes residents in poverty to be unaware of healthy options. In situations where residents are aware of healthier choices, they may perceive these options to be out of their reach (e.g., healthy produce and nutrition may not be viewed as consistently attainable) due to a lack of grocery stores, limited transportation, and cost.  When asked if they felt a variety of services were available to them or their family, 12.8% of survey respondents indicated they did not feel healthy food was available to them in the Baton Rouge region. Lack of safe exercise options:  The Healthy People 2020 goal is for mortality due to homicide to be less than or equal to 5.5 per 100,000 population; only Ascension Parish reports a rate already lower than this HP2020 Goal. East Baton Rouge Parish reports the highest rate of age‐adjusted mortality due to homicide for the OMC Baton Rouge study area at 17.53 per 100,000 population; this rate is more than triple the national rate (5.63). 17.53
Figure 6: Mortality ‐ Homicide‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2007‐2011
10.03
5
Iberville
6.26
4.53
10
East Baton Rouge
5.63
15
Ascension
12.69
20
Livingston
LOUISIANA
USA
0
The education in schools was addressed as an issue related to the access youth have to physical exercise throughout the day. Additionally, stakeholders discussed the decline or absence of physical activity in the school system. Stakeholders felt that youth are 19
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach becoming obese for a variety of reasons, one of which is the limited exercise they may be participating in during school hours. 
Survey Respondents from the Baton Rouge Region report participating in physical activity much less than the U.S. rate. Table 5: Survey Responses‐ Percent of Respondents Participating in Regular Physical Activity Stakeholders discussed the implications of the limited access to healthy options that residents of the hospital service area have as some of the following:  Lifestyle diseases such as obesity, diabetes, cancer, hypertension, and cardiovascular disease. Several of these measures are high in the hospital service area;  Higher mortality rates related to lifestyle diseases. Primary data collected during this assessment from community leaders and residents offered recommendations to improve access to healthy options. Some of which included: 

Increase the awareness of obesity and preventive practices: Community leaders recommended that outreach education regarding the health impact of preventive practices (i.e., healthy food preparation, exercise, etc.) could be offered in a collaborative way by health service providers, city officials, and community‐based organizations. Increase the resources available to residents for healthy food and activity: Community leaders recommended that there is a need to offer healthy produce in several communities in the hospital service area. Also, leaders suggested the residents need convenient access to physical activity outlets and opportunities. OVERUSE OF EMERGENCY DEPARTMENTS Underlying factors identified by secondary data and primary input from community leaders, community stakeholders, and resident survey respondents: 1. Residents delay seeking health care 2. Higher hospitalization rates 20
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach An influx in emergency department volume throughout EBR has resulted in a collaborative approach to develop community‐wide initiatives to control excessive emergency room utilization. Using the Institute for Healthcare Improvement’s Triple Aim as a guide, hospital and public health officials have created plans that will improve the patient experience and the health of the population while reducing per capita costs of care. Findings supported by study data: Residents that are uninsured often seek health services when an issue becomes an emergency and requires more intense and costly care, which typically yields poorer outcomes than primary and preventive care practices. Stakeholders indicated that residents will, also, delay seeking healthcare until health issues become an emergency due to a lack of transportation. Stakeholders discussed the lack of care coordination provided for uninsured and underinsured residents, including seniors, who are seeking care in inappropriate settings like the emergency room. 
Across the country, 22.07% of residents report not having a regular doctor (77.93% have a regular doctor); in Louisiana the rate is 24.09%. Livingston Parish reports the highest rate of residents who do not have a regular doctor at 24.39%. 
Of the 14 PQI measures (chronic lung conditions, diabetes, heart conditions, and other conditions) there are three in the Ochsner Medical Center ‐ Baton Rouge study area that show higher rates than the state and/or the national rates. Table 6. Prevention Quality Indicators (PQI) Baton Rouge / LA / U.S.A. 2015
Prevention Quality Indicators (PQI) Baton Rouge Study Area 2015 PQI Diabetes Short‐Term Complications (PQI1) LA 2015 PQI Diabetes 79.02
98.10
Other Conditions 406.67 322.43
76.33
86.51
U.S.A.
2015 Baton Rouge – PQI LA Diff. 63.86
Baton Rouge – U.S.A. Diff. ‐ 19.08 + 15.16
Perforated Appendix (PQI2) 323.43
+ 84.24 + 83.24
Low Birth Weight (PQI9) 62.14
+ 10.18 + 14.19
 The most common forms of health insurance carried by survey respondents in the Baton Rouge Region were no insurance (37.8%) and Medicaid only (34.5%).  One‐third of survey respondents (32.9%) in the Baton Rouge Region could not see a doctor in the last 12 months because of cost; compared to the state (18.9%), and more than one in 10 reported seeking care in the emergency room. Additionally, one in four (25%) respondents reported not taking medications as prescribed in the last 12 months due to cost. 21
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Stakeholders noted that the need for accessible healthcare among medically vulnerable populations (e.g., uninsured, low‐income, Medicaid insured, etc.) has an impact on the health status of residents in a variety of ways and often leads to poorer health outcomes. Several of the noted effects were:  Higher cost of healthcare that results from hospital readmissions and increased usage of costly emergency medical care;  Residents delaying medical treatment and/or non‐compliant due to the lack of affordable options and limited awareness of what options do exist; and  Poor health outcomes in adult, maternal and pediatric care due to limited care coordination and lack of patient compliance. Primary data collected during this assessment from community leaders and residents offered recommendations to improve access to healthy options. Some of which included: 




Increase the cultural competence of health service providers: Community leaders recommended that the health service providers could increase the cultural sensitivity by offering multi‐lingual and multi‐cultural health services. This could be done by employing multi‐lingual and ethnically diverse healthcare professionals in medical and behavioral health settings. Leaders suggested that hospitals could recruit such professionals to the community. Provide health care to communities where barriers are the greatest: Community leaders recommended that health care be provided in communities where barriers are the greatest (e.g., rural areas, communities with high poverty rates and/or low rates of insured residents, etc.). Leaders suggested that this could be accomplished using a mobile medical unit staffed with health professionals. Leaders also suggested that medical providers could collaborate to offer transportation for health services to all communities. Increase awareness about the need for health services sought in appropriate settings: Community leaders recommended that health providers may need to educate residents about the necessity of primary care to maintain health status to avoid costly emergency care. Leaders suggested that education be provided about the appropriate settings to seek health services (e.g., primary care, emergency care, etc.). Increase awareness about health insurance options: Community leaders recommended that health providers could offer education and outreach related to the enrollment and eligibility criteria for Market Place, Medicaid, and other insurance products. Increase after‐hours access to health services: Community leaders recommended that the hours of operation for local Federally Qualified Health Centers (FQHCs) could be extended to offer after‐hours appointments for low‐income residents that are not able to take time off work. 22

Tripp Umbach Increase awareness about available health services: Community leaders recommended that health providers could provide education and outreach related to the variety of services that are available in the community. Additionally, leaders recommended that providers increase their own awareness about what services are available to patients in the communities where they practice. Develop shared ownership of the cost of overuse of the emergency departments: Community leaders recommended that health providers develop a shared risk and reward model related to the cost of all health services provided to residents in a geographical area. In this way each provider would receive the financial rewards for reducing the use of costly emergency room services. 23
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Community Health Needs Identification Forum The following qualitative data were gathered during a regional community planning forum held on August 4th in Baton Rouge, LA. The community planning forum was conducted with community leaders representing the primary service area for Ochsner Medical Center – Baton Rouge. Community leaders were identified by the CHNA oversight committee for Ochsner Medical Center – Baton Rouge. The community forum was conducted by Tripp Umbach consultants and lasted approximately three hours. Tripp Umbach presented the results from secondary data analysis, community leader interviews, and community surveys, and used these findings to engage community leaders in a group discussion. Top community health needs were identified and prioritized by the Healthy Baton Rouge Initiative and validated by community leaders during a regional community health needs forum held on August 4, 2015. Consultants presented to community leaders the CHNA findings related to health needs identified in the Baton Rouge area found in secondary data, key stakeholder interviews, and surveys. Community leaders discussed the data presented, shared their visions and plans for community health improvement in their communities, and validated the top community health needs by providing potential solutions in the Ochsner Medical Center – Baton Rouge community. GROUP RECOMMENDATIONS: The group provided many recommendations to address community health needs and concerns for residents in the Ochsner Medical Center – Baton Rouge service area. Below is a brief summary of the recommendations: Increase the awareness of obesity and preventive practices: Community leaders recommended that outreach education regarding the health impact of preventive practices (i.e., healthy food preparation, exercise, etc.) could be offered in a collaborative way by health service providers, city officials, and community‐based organizations. Increase the resources available to residents for healthy food and activity: Community leaders recommended that there is a need to offer healthy produce in several communities in the hospital service area. Also, leaders suggested the residents need convenient access to physical activity outlets and opportunities. Increase the outreach and education for effective reduction of HIV and other STDs: Community leaders recommended that schools, community‐based programs and health providers could all increase the information they offer youth and adults about effective methods for reducing the spread of HIV and other STDs. 24
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Increase screening rates for HIV and other STDs: Community leaders suggested that HIV testing can be easily offered in community settings where residents naturally congregate. There is a need to increase state funding for STIs screening and testing. Increase the use of evidence‐based practice in mental health settings: Community leaders recommended that health providers could support efforts to increase the use of evidence‐
based practices (EBP) in mental health settings by implementing such practices on‐site and advocating the use of EBP in other settings. Increase the availability of behavioral health services and awareness: Community leaders recommended that behavioral health services begin to target residential communities where prevalence rates are highest (e.g., communities where poverty rates are highest) with education and outreach in order to normalize behavioral health services and reduce the stigma associated with seeking care. Integrate behavioral health, social services, and medical care: Community leaders suggested that health providers could increase the connection between medical, behavioral health, and social services offered in the community. Several leaders discussed the value of health information exchanges in connecting a community of providers. Leaders also discussed the value of co‐located services (e.g., behavioral health services that are offered in medical care settings and visa‐versa). Increase the cultural competence of health service providers: Community leaders recommended that the health service providers could increase the cultural sensitivity by offering multi‐lingual and multi‐cultural health services. This could be done by employing multi‐lingual and ethnically diverse healthcare professionals in medical and behavioral health settings. Leaders suggested that hospitals could recruit such professionals to the community. Provide health care to communities where barriers are the greatest: Community leaders recommended that health care be provided in communities where barriers are the greatest (e.g., rural areas, communities with high poverty rates and/or low rates of insured residents, etc.). Leaders suggested that this could be accomplished using a mobile medical unit staffed with health professionals. Leaders also suggested that medical providers could collaborate to offer transportation for health services to all communities. Increase awareness about the need for health services sought in appropriate settings: Community leaders recommended that health providers may need to educate residents about the necessity of primary care to maintain health status to avoid costly emergency 25
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach care. Leaders suggested that education be provided about the appropriate settings to seek health services (e.g., primary care, emergency care, etc.). Increase awareness about health insurance options: Community leaders recommended that health providers could offer education and outreach related to the enrollment and eligibility criteria for Market Place, Medicaid, and other insurance products. Increase after‐hours access to health services: Community leaders recommended that the hours of operation for local FQHCs could be extended to offer after‐hours appointments for low‐income residents that are not able to take time off work. Increase awareness about available health services: Community leaders recommended that health providers could provide education and outreach related to the variety of services that are available in the community. Additionally, leaders recommended that providers increase their own awareness about what services are available to patients in the communities where they practice. Develop shared ownership of the cost of overuse of the emergency departments: Community leaders recommended that health providers develop a shared risk and reward model related to the cost of all health services provided to residents in a geographical area. In this way each provider would receive the financial rewards for reducing the use of costly emergency room services. PROBLEM IDENTIFICATION: The following is based on excerpts of the 2015 CHNA completed by the Healthy Baton Rouge Initiative. Needs were identified and prioritized using a community‐based approach. The top community health priorities identified by the Healthy Baton Rouge Initiative 2015 CHNA were: 6 1.
2.
3.
4.
HIV and Other STDs Mental Health & Substance Obesity Overuse of Emergency Departments The following summary represents the most important topic areas within the community, discussed at the planning retreat. Community leaders validated the following concerns are the most pressing problems and are identified as the most manageable to address. HIV AND OTHER STDS: 6 3
, Source: Healthy BR: 2015 Community Health Needs Assessment
26
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Human Immunodeficiency Virus (HIV) and Sexually Transmitted Diseases (STDs) are associated with increased morbidity and mortality. Contributing Factors: 


HIV transmission can be reduced or eliminated by addressing the primary methods of infection: safe sex practices, protection against transmission from an HIV‐positive mother to her baby during pregnancy or birth, preventive treatment and sterile supplies for injection drug users, widespread testing and medical care for those who test positive, and effective counseling and treatment programs. Louisiana ranks second in the nation in the number of newly diagnosed HIV cases. The Baton Rouge public health region accounted for 20% of the new HIV diagnoses, 25% of the new AIDS diagnoses and 25% of citizens living with HIV. There is a higher rate of HIV diagnoses in the African American community, which accounted for 86% of the new HIV diagnoses. MENTAL HEALTH & SUBSTANCE: Mental health refers to psychological, emotional, and social well‐being. A mental illness affects a person’s mood and how he or she feels, perceives, and behaves. Mood disorders are the most common of all mental disorders and include major depression. One in four Americans will be diagnosed with some form of mental illness in their lifetime and 17% of all Americans will suffer from depression at some point in their lives. Contributing Factors: 





There are not enough providers to meet the demand and the spectrum of services available in most areas is not comprehensive enough to treat individual needs. In 2015, 16% of adults in Louisiana reported excessive drinking. Alcohol‐impaired driving deaths accounted for 33% of all driving deaths statewide. These trends are also reflected in EBR, with 15% of adults reporting binge or heavy drinking. Alcohol was involved in 35% of motor vehicle crash deaths in EBR from 2007‐2012. The effects of substance abuse can result in separation from friends and family members, which may trigger depression. In 2014, 22% of EBR residents reported having inadequate social support. Locally, the number of mentally ill in parish prisons has doubled and the community is searching for solutions to decriminalize mental illness and provide residents with additional support. OBESITY: 27
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach One in two children in Louisiana is overweight or obese. Obesity related medical expenses cost Louisiana more than $3 billion annually. As cases of obesity rise in Louisiana and the U.S., the cases of related chronic diseases like diabetes increase. Obesity is defined as a body mass index (BMI) greater than 30. Obesity is a significant risk factor for diabetes, heart disease, and stroke. Lifestyle factors such as physical activity, healthy eating, and monitoring caloric intake can decrease the risk of obesity. Contributing Factors: 


A diet high in fresh vegetables and low in sodium and processed foods protects against and may also improve hypertension, cardiovascular disease, diabetes, obesity, and some forms of cancer. EBR rates 6.3 of a possible 10 on a Food Environment Index measuring distance to a grocery store for low‐income households. This is lower than the statewide score of 6.8 and the national score of 8.4. Physical activity can prevent and lower health risks from high blood pressure, heart disease diabetes, obesity, and some forms of cancer. While 93% of EBR residents report access to exercise opportunities, 25% are physically inactive. Interpersonal violence is responsible for negative physical and mental health outcomes. In 2014, the violent crime rate in EBR was 701 incidents/year per 100,000 population. This is higher than the overall Louisiana rate of 536 and much higher than the rate of 59 (90th percentile) for the U.S. OVERUSE OF EMERGENCY DEPARTMENTS: An influx in emergency department volume throughout EBR has resulted in a collaborative approach to develop community‐wide initiatives to control excessive emergency room utilization. Using the Institute for Healthcare Improvement’s Triple Aim as a guide, hospital and public health officials have created plans that will improve the patient experience and the health of the population while reducing per capita costs of care. 28
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Secondary Data Tripp Umbach worked collaboratively with the Ochsner Medical Center – Baton Rouge CHNA oversight committee to develop a secondary data process focused on three phases: collection, analysis, and evaluation. Tripp Umbach obtained information on the demographics, health status, and socio‐economic and environmental factors related to the health and needs of residents from the multi‐community service area of Ochsner Medical Center – Baton Rouge. The process developed accurate comparisons to the state baseline of health measures utilizing the most current validated data. In addition to demographic data, specific attention was focused on two key community health index factors: Community Need Index (CNI) and Prevention Quality Indicators Index (PQI). Tripp Umbach provided additional comparisons and trend analysis for CNI data from 2012 to present. Demographic Data Tripp Umbach gathered data from Truven Health Analytics, Inc. to assess the demographics of the Ochsner Medical Center ‐ Baton Rouge study area. Information pertaining to population change, gender, age, race, ethnicity, education level, housing, income, and poverty data are presented below. Information pertaining to population change, gender, age, race, ethnicity, education level, housing, income, and poverty data are presented below. Demographic Profile – Key Findings:  The Ochsner Medical Center – Baton Rouge study area encompasses more than 600,000 residents.  In 2015, the largest parish in the study area was East Baton Rouge Parish with 445,311 residents in 2015.  From 2015 to 2020, Ascension Parish is projected to experience the largest percentage change in population with a 7.4% increase (8,777 people).  East Baton Rouge Parish is projected to experience the largest rise in number of residents, going from 445,311 residents in 2015 to 455,297 residents in 2020 (an increase of 9,986 residents, 2.2%).  All four parishes in the study area are expected to increase in population between 2015 and 2020; adding an additional 22,742 people to the Ochsner Medical Center – Baton Rouge study area.
29
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach  The gender breakdown for the Ochsner Medical Center – Baton Rouge study area is generally consistent across the parishes and similar to state and national norms.  Iberville Parish reports the largest population of residents aged 65 and older (14.0%) followed by East Baton Rouge Parish (12.6%), and Livingston Parish (11.9%).  Livingston Parish reports the highest White, Non‐Hispanic population percentage at 88.1%, this is much higher than state (59.1%) and national norms (61.8%).  Iberville Parish reports the highest Black, Non‐Hispanic population across the study area counties at 47.1%; East Baton Rouge Parish reports the second highest percentage at 45.9%.  All of the study area parishes report lower rates of Hispanic residents as compared with the country (17.6%). Ascension Parish reports the highest Hispanic population rate at 5.2%. East Baton Rouge Parish reports the highest percentage of Asian or Pacific Islander residents (3.2%) as compared with the other parishes in the study area.  Iberville Parish reports the highest rate of residents with ‘Less than a high school’ degree (8.0%).  East Baton Rouge Parish reports the highest rate of residents with a Bachelor’s degree or higher with 34.4%; this is higher than state (21.7%) and national (28.9%) norms.  Iberville Parish reports the lowest average annual household income for the Ochsner Medical Center – Baton Rouge study area at $60,809.  Ascension Parish reports the highest average annual household income compared to the other parishes in the study area at $84,045; higher than state ($64,209) and national norms ($74,165). East Baton Rouge Parish is second highest at $71,173.  Iberville Parish and East Baton Rouge Parish report the highest rates of households that earn less than $15,000 per year (18.6% and 15.6% respectively). 30
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Community Needs Index (CNI) In 2005 Catholic Healthcare West, in partnership with Thomson Reuters, pioneered the nation’s first standardized Community Need Index (CNI).7 CNI was applied to quantify the severity of health disparity for every zip code in the study area based on specific barriers to health care access. Because the CNI considers multiple factors that are known to limit health care access, the tool may be more accurate and useful than other existing assessment methods in identifying and addressing the disproportionate unmet health‐related needs of neighborhoods or zip code areas. The CNI score is an average of five different barrier scores that measure various socio‐economic indicators of each community using the 2015 source data. The five barriers are listed below along with the individual 2015 statistics that are analyzed for each barrier. These barriers, and the statistics that comprise them, were carefully chosen and tested individually by both Dignity Health and Truven Health: 1. Income Barrier a. Percentage of households below poverty line, with head of household age 65 or more b. Percentage of families with children under 18 below poverty line c. Percentage of single female‐headed families with children under 18 below poverty line 2. Cultural Barrier a. Percentage of population that is minority (including Hispanic ethnicity) b. Percentage of population over age 5 that speaks English poorly or not at all 3. Education Barrier a. Percentage of population over 25 without a high school diploma 4. Insurance Barrier a. Percentage of population in the labor force, aged 16 or more, without employment b. Percentage of population without health insurance 5. Housing Barrier a. Percentage of households renting their home Every populated zip code in the United States is assigned a barrier score of 1,2,3,4, or 5 depending upon the zip code’s national rank (quintile). A score of 1 represents the lowest rank nationally for the statistics listed, while a score of 5 indicates the highest rank nationally. For example, zip codes that score a 1 for the Education Barrier contain highly educated populations; zip codes with a score of 5 have a very small percentage of high school graduates. 7
Truven Health Analytics, Inc. 2015 Community Need Index. 31
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach A total of 18 of the 24 zip code areas (75%) for the Ochsner Medical Center ‐ Baton Rouge study area fall above the median score for the scale (3.0), none fall at the median, and 6 fall below the median. Being above the median for the scale indicates that these zip code areas have more than average the number of barriers to health care accesss. Figure 6. Ochsner Medical Center – Baton Rouge Study Area 2015 CNI Map Table 7: Ochsner Medical Center – Baton Rouge ‐ 2015 CNI Detailed Data Zip City 70802 Baton Rouge 70805 Baton Rouge 70807 Baton Rouge 70806 Baton Rouge 70764 Plaquemine 70767 Port Allen 70814 Baton Rouge 70815 Baton Rouge 70816 Baton Rouge 70714 Baker 70726 Denham Springs 70737 Gonzales 2015 CNI Score Poverty 65+ Poverty Marrie
d w/ kids Poverty Single w/kids Limited English Minority No High School Diploma Un‐
employe
d Un‐
insured Renting 5.0 5.0 5.0 4.6 4.2 4.2 3.8 3.8 3.8 3.6 3.4 3.4 25.6% 26.6% 27.4% 15.2% 17.1% 14.5% 11.3% 9.2% 7.4% 10.2% 11.0% 12.7% 48.6% 45.3% 51.9% 29.0% 20.7% 21.2% 17.7% 20.8% 17.9% 17.4% 16.7% 17.1% 59.5% 53.1% 64.6% 49.9% 37.5% 51.6% 39.7% 41.9% 32.6% 32.0% 41.6% 43.1% 0.8% 0.9% 0.3% 2.0% 0.9% 0.8% 1.8% 3.9% 1.9% 0.3% 1.1% 2.2% 81.0% 96.0% 96.7% 56.7% 47.4% 46.5% 88.0% 65.4% 54.4% 72.6% 15.3% 35.1% 22.2% 25.9% 27.4% 16.5% 21.8% 17.2% 11.1% 11.7% 9.2% 14.2% 16.1% 11.9% 13.6% 13.7% 18.4% 13.1% 7.3% 8.5% 8.8% 8.9% 5.2% 7.7% 6.8% 6.8% 30.5% 25.8% 27.9% 20.4% 18.0% 11.9% 12.4% 13.9% 11.6% 13.3% 10.3% 10.7% 62.7% 55.2% 50.2% 56.6% 24.2% 29.0% 25.9% 33.9% 49.5% 24.6% 24.4% 23.6% 32
Zip Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Poverty 2015 Poverty Marrie
City CNI 65+ d w/ Score kids Tripp Umbach Poverty Single w/kids Limited English Minority No High School Diploma Un‐
employe
d Un‐
insured Renting 70754 Livingston 3.4 16.2% 18.1% 46.4% 0.1% 7.2% 21.6% 5.2% 14.6% 17.2% 70785 70808 70810 70819 70809 70791 70706 70818 70739 70769 70817 Walker Baton Rouge Baton Rouge Baton Rouge Baton Rouge Zachary Denham Springs Baton Rouge Greenwell Springs Prairieville Baton Rouge 3.4 3.4 3.4 3.4 3.2 2.8 2.4 2.4 2.2 2.2 2.2 7.3% 8.3% 7.8% 8.9% 4.5% 6.6% 7.3% 6.3% 8.5% 14.9% 4.5% 15.6%
13.4%
15.4%
15.6%
13.5%
13.0%
10.8%
11.3%
15.2%
7.8%
6.3%
38.3%
35.6%
40.8%
28.6%
28.2%
31.6%
39.4%
30.4%
37.6%
22.6%
15.5%
0.1%
0.6%
1.1%
4.2%
0.8%
0.1%
0.1%
0.3%
0.4%
0.8%
0.8%
9.0%
24.3%
43.5%
66.8%
28.9%
41.5%
8.1%
18.3%
13.9%
20.8%
25.7%
17.7% 3.5% 5.2% 13.2% 4.5% 9.7% 12.0% 7.4% 6.6% 7.2% 4.3% 7.5% 4.7% 5.6% 10.0%
4.4% 6.2% 6.1% 6.9% 6.2% 4.6% 5.9% 12.0%
16.2%
10.3%
11.5%
11.2%
9.8%
8.9%
9.6%
9.6%
6.9%
5.7%
20.0%
43.6%
31.4%
24.3%
45.6%
18.4%
12.1%
17.8%
15.3%
12.1%
23.0%
For the Ochsner Medical Center – Baton Rouge study area there are three zip code areas with CNI scores of 5.0, indicating significant barriers to health care access. These zip code areas are: 70802, 70805, and 70807 – Baton Rouge. These same three zip codes  70807 – Baton Rouge reports the highest rates in six of the nine areas represented in Table 4 (above): residents aged 65 and older living in poverty (27.4%); married parents living in poverty with children (51.9%); single parents living in poverty with children (64.6%); and, residents with no high school diploma (27.4%).  70807 – Baton Rouge also reports the highest rate of unemployed residents at 18.4%; more than double the state (6.6%) and more than triple the national (5.5%) rates.8  96.7% of the residents in zip code area 70807 (Baton Rouge) are minorities; the highest rate for the study area.  Zip code area 70802 in Baton Rouge reports the highest rates of uninsured residents (30.5%) and residents that rent (62.7%).  4.2% of residents living in zip code area 70819 experience limited English proficiency; the highest rate for the study area. On the other end of the spectrum, the lowest CNI score for the study area is 2.2 in 70739 – Greenwell Springs, 70769 – Prairieville, and 70817 – Baton Rouge.  Zip code area 70817 – Baton Rouge reports the lowest rates of residents aged 65 and older living in poverty (4.5%); married and single parents living in poverty with their children for the study area (6.3% and 15.5%, respectively). 70817 also reports the lowest rate of uninsured residents at 5.7%.  70769 – Prairieville and 70706 – Denham Springs show the lowest rate of renters at 12.1%. 8
March 2015 state and national statistics. U.S. Bureau of Labor Statistics. 33



Tripp Umbach Zip code area 70754 – Livingston reports the lowest minority rate for the study area at 7.2%. Baton Rouge zip code area 70808 reports the lowest rates of residents without a high school diploma at only 3.5%. Baton Rouge (70809) reports the lowest unemployment rate for the study area at only 4.4% and residents aged 65 and older living in poverty (4.5%). Four zip code areas (70706 – Denham Springs, 70791 – Zachary, 70785 – Walker, and 70754 – Livingston) report the lowest rate of residents with limited English proficiency at 0.1%. Chart 7. Overall CNI Values ‐ Ochsner Medical Center ‐ Baton Rouge & Parishes
5
4
3.7
3.5
4.0
3.0
2.8
3
2
1
0
OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
Iberville
Livingston
Figure 8. CNI Trending – Ochsner Medical Center – Baton Rouge Study Area 2011 ‐ 2015 CNI Difference Map 34
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Table 8. CNI Trending ‐ Ochsner Medical Center – Baton Rouge – 2011 to 2015 CNI Comparison 70802 Baton Rouge East Baton Rouge 5 5 5 5 5 2015 CNI Score 5.0 70805 Baton Rouge East Baton Rouge 5 5 5 5 5 5.0 5.0 0.0 70807 Baton Rouge East Baton Rouge 5 5 5 5 5 5.0 5.0 0.0 70806 Baton Rouge East Baton Rouge 4 5 4 5 5 4.6 4.6 0.0 70764 Plaquemine Iberville 3 5 5 5 3 4.2 n/a ‐‐‐ 70767 Port Allen West Baton Rouge 4 5 4 4 4 4.2 n/a ‐‐‐ 70814 Baton Rouge East Baton Rouge 3 5 3 4 4 3.8 2.8 + 1.0 70815 Baton Rouge East Baton Rouge 3 5 3 4 4 3.8 3.8 0.0 70816 Baton Rouge East Baton Rouge 3 5 2 4 5 3.8 3.0 + 0.8 70714 Baker East Baton Rouge 2 5 4 4 3 3.6 3.4 + 0.2 70726 Denham Springs Livingston 3 3 4 4 3 3.4 3.0 + 0.4 70737 Gonzales Ascension 3 4 3 4 3 3.4 3.2 + 0.2 70754 Livingston Livingston 4 2 5 4 2 3.4 2.6 + 0.8 70785 Walker Livingston 3 3 4 4 3 3.4 2.6 + 0.8 70808 Baton Rouge East Baton Rouge 3 4 1 4 5 3.4 3.0 + 0.4 70810 Baton Rouge East Baton Rouge 3 5 1 4 4 3.4 3.0 + 0.4 70819 Baton Rouge East Baton Rouge 2 5 3 4 3 3.4 3.0 + 0.4 70809 Baton Rouge East Baton Rouge 2 4 1 4 5 3.2 2.8 + 0.4 70791 Zachary East Baton Rouge 2 5 2 3 2 2.8 3.2 ‐ 0.4 70706 Denham Springs Livingston 3 2 3 3 1 2.4 1.8 + 0.6 70818 Baton Rouge East Baton Rouge 2 3 2 3 2 2.4 1.8 + 0.6 70739 Greenwell Springs East Baton Rouge 3 3 1 3 1 2.2 2.0 + 0.2 70769 Prairieville Ascension 2 4 2 2 1 2.2 1.6 + 0.6 70817 Baton Rouge East Baton Rouge 1 4 1 2 3 2.2 1.6 + 0.2 Zip Community Name County Income Rank Culture Education Rank Rank Insurance Rank Housing Rank 2011 CNI Score 5.0 Diff. 2011 – 2015 0.0 Across the 24 Ochsner Medical Center ‐ Baton Rouge study area zip codes: 



1 experienced a decline in their CNI score from 2011 to 2015, indicating a shift to fewer barriers to health care access (green, negative values) 5 remained the same from 2011 to 2015 16 experienced a rise in their CNI score from 2011 to 2015, indicating a shift to more barriers to health care access (red, positive values) 2 did not have comparable 2011 data (n/a values) Zip code area 70814 of Baton Rouge experienced the largest rise in CNI score, going from 2.8 in 2011 to 3.8 in 2015. 35
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Prevention Quality Indicators (PQI) and Pediatric Quality Indicators (PDI)9 The Prevention Quality Indicators index (PQI) was developed by the Agency for Healthcare Research and Quality (AHRQ). PQI is similarly referred to as Ambulatory Care Sensitive Hospitalizations. The quality indicator rates are derived from inpatient discharges by zip code using ICD diagnosis and procedure codes. There are 14 quality indicators. The PQI index identifies potentially avoidable hospitalizations for the benefit of targeting priorities and overall community health. The index measures number of residents living in the hospital service area, which are hospitalized for one of the following reasons (note: this does not indicate that the hospitalization took place at Ochsner Medical Center – Baton Rouge). Lower index scores represent fewer admissions for each of the PQIs. PQI Subgroups: 1. Chronic Lung Conditions 
PQI 5 Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults (40+) Admission Rate10  PQI 15 Asthma in Younger Adults Admission Rate11 2. Diabetes  PQI 1 Diabetes Short‐Term Complications Admission Rate  PQI 3 Diabetes Long‐Term Complications Admission Rate  PQI 14 Uncontrolled Diabetes Admission Rate  PQI 16 Lower Extremity Amputation Rate Among Diabetic Patients 3. Heart Conditions  PQI 7 Hypertension Admission Rate  PQI 8 Congestive Heart Failure Admission Rate  PQI 13 Angina Without Procedure Admission Rate 4. Other Conditions 
PQI 2 Perforated Appendix Admission Rate12 9
PQI and PDI values were calculated including all relevant zip‐code values from Louisiana; Mississippi data could not be obtained and was therefore not included. 10
PQI 5 for past study was COPD in 18+ population; PQI 5 for current study is now restricted to COPD and Asthma in 40+ population 11
PQI 15 for past study was Adult Asthma in 18+ population; PQI 15 for current study is now restricted to Asthma in 18‐39 population (“Younger”). 36



Tripp Umbach 13
PQI 9 Low Birth Weight Rate PQI 10 Dehydration Admission Rate PQI 11 Bacterial Pneumonia Admission Rate PQI 12 Urinary Tract Infection Admission Rate Table 9. Prevention Quality Indicators (PQI) Ochsner Medical Center ‐ Baton Rouge / LA / U.S.A. 2015 U.S.A. 2015 PQI OMC Baton Rouge Study Area – LA Diff. OMC Baton Rouge Study Area – U.S.A.
Diff. 531.03 495.71 ‐ 238.82 ‐ 203.50 34.27 42.83 46.02 ‐ 8.56 ‐ 11.75 Diabetes Short‐Term Complications (PQI1) 79.02 98.10 63.86 ‐ 19.08 + 15.16 Diabetes Long‐Term Complications (PQI3) 97.22 126.06 105.72 ‐ 28.84 ‐ 8.50 Uncontrolled Diabetes (PQI14) 6.32 15.57 15.72 ‐ 9.25 ‐ 9.40 9.12 12.74 16.50 ‐ 3.62 ‐ 7.38 Hypertension (PQI7) 29.34 46.06 54.27 ‐ 43.72 ‐ 24.93 Congestive Heart Failure (PQI8) 320.62 404.11 321.38 ‐ 83.49 ‐ 0.76 Angina Without Procedure (PQI13) Other Conditions 5.14 13.74 13.34 ‐ 8.60 ‐ 8.20 Perforated Appendix (PQI2) 406.67 322.43 323.43 + 84.24 + 83.24 Low Birth Weight (PQI9) 76.33 86.51 62.14 ‐ 10.18 + 14.19 Dehydration (PQI10) 71.95 124.53 135.70 ‐ 52.58 ‐ 63.75 Bacterial Pneumonia (PQI11) 180.50 305.80 248.19 ‐ 125.30 ‐ 67.69 Urinary Tract Infection (PQI12) 116.98 209.39 167.01 ‐ 92.41 ‐ 50.03 OMC Baton Rouge
Study Area 2015 PQI LA 2015 PQI COPD or Adult Asthma (PQI5) 292.21 Asthma in Younger Adults (PQI15) Diabetes Prevention Quality Indicators (PQI) Chronic Lung Conditions Lower Extremity Amputation Among Diabetics (PQI16) Heart Conditions Key Findings from 2015 PQI Data:  The only PQI measure in which the Ochsner Medical Center – Baton Rouge study area reports higher preventable admission rates than the State of Louisiana is for Perforated Appendix (406.67 preventable admissions per 1,000 admissions for any listed diagnosis of perforation or abscesses of the appendix for Ochsner Medical Center – Baton Rouge, 322.43 for LA). 12
PQI 2 changed from Perforated Appendix in Males 18+ for the past study to Perforated Appendix in Total 18+ population as a rate per 1,000 ICD‐9 code admissions for appendicitis. This shift has changed the values for this measure drastically and therefore, Tripp Umbach did not adjust.
13
Although not clearly explained by the AHRQ, it would seem that a definition of Newborn population has shifted
for PQI 9 because the values are drastically lower in 2014 than in previous years (2011). This has shifted PQI 9
values drastically. Tripp Umbach did not adjust.
37
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach  When comparing the Ochsner Medical Center – Baton Rouge PQI data to the national rates, the Ochsner Medical Center – Baton Rouge study area reports higher preventable hospital admissions for: o Diabetes, Short‐Term o Perforated Appendix Complications o Low Birth Weight  There are also a number of PQI measures in which the Ochsner Medical Center – Baton Rouge study area and many of the parishes in the study area report lower values than the nation (indicating areas in which there are fewer preventable hospital admissions than the national norm), these include: o COPD or Adult Asthma o Asthma in Younger Adults o Diabetes, Long‐Term Complications o Uncontrolled Diabetes o Lower Extremity Amputation among Diabetics o Hypertension (all of the areas are below the national rate) o Dehydration o Bacterial Pneumonia o Urinary Tract Infection
Pediatric Quality Indicators Overview The Pediatric Quality Indicators (PDIs) are a set of measures that can be used with hospital inpatient discharge data to provide a perspective on the quality of pediatric healthcare. Specifically, PDIs screen for problems that pediatric patients experience as a result of exposure to the healthcare system and that may be amenable to prevention by changes at the system or provider level. Development of quality indicators for the pediatric population involves many of the same challenges associated with the development of quality indicators for the adult population. These challenges include the need to carefully define indicators using administrative data, establish validity and reliability, detect bias and design appropriate risk adjustment, and overcome challenges of implementation and use. However, the special population of children invokes additional, special challenges. Four factors—differential epidemiology of child healthcare relative to adult healthcare, dependency, demographics, and development—can pervade all aspects of children’s healthcare; simply applying adult indicators to younger age ranges is insufficient. This PDIs focus on potentially preventable complications and iatrogenic events for pediatric patients treated in hospitals, and on preventable hospitalizations among pediatric patients. 38
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach The PDIs apply to the special characteristics of the pediatric population; screen for problems that pediatric patients experience as a result of exposure to the healthcare system and that may be amenable to prevention by changes at the provider level or area level; and, help to evaluate preventive care for children in an outpatient setting, and most children are rarely hospitalized. PDI Subgroups: 
PDI 14 Asthma Admission Rate (per 100,000 population ages 2 – 17) 
PDI 15 Diabetes, Short‐Term Complications Admission Rate (per 100,000 population ages 6 – 17) 
PDI 16 Gastroenteritis Admission Rate (per 100,000 population ages 3 months – 17 years) 
PDI 17 Perforated Appendix Admission Rate (per 1,000 admissions ages 1 – 17) 
PDI 18 Urinary Tract Infection Admission Rate (per 100,000 population ages 3 months – 17 years) Key Findings from PDI Data:  Iberville Parish reports the highest rate of preventable hospitalizations due to Asthma for children aged 2 to 17 at 131.79 per 100,000 population; higher than the national rate of 117.37  Ascension Parish reports the highest rates of diabetes, short‐term complications for those aged 6 to 17 years old for the Ochsner Medical Center – Baton Rouge study area (62.63); this rate is nearly triple the national rate of 23.89.  Iberville Parish and Livingston Parish report the highest rates of gastroenteritis for the Ochsner Medical Center – Baton Rouge study area at 45.47 and 42.76 per 100,000 population aged 3 months to 17 years, respectively; both fall below the national rate of 47.28.  Iberville Parish reports the highest rate of preventable hospitalizations due to perforated appendix for ages 1 to 17 years old with 666.67 per 100,000 admissions.  Livingston Parish reports the highest rate for preventable hospital admissions due to urinary tract infections for those aged 3 months to 17 years with 20.02 per 100,000 population being admitted while the national rate stands at 29.64. Community Commons Data Tripp Umbach gathered data from Community Commons related to social and economic factors, physical environment, clinical care, and health behaviors for the parishes of interest for 39
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach the Ochsner Medical Center – Baton Rouge (OMC Baton Rouge) CHNA.14 The data is presented in the aforementioned categories below. Food Insecure Population 

This indicator reports the estimated percentage of the population that experienced food insecurity at some point during the report year. Food insecurity is the household‐level economic and social condition of limited or uncertain access to adequate food. Iberville Parish reports the highest food insecurity rate with 17.37%; the only parish to exceed both the State of Louisiana rate and the national rate. While matching the state rate of 16.91%, East Baton Rouge Parish also reports higher than the nation. Households with No Motor Vehicle 
Iberville Parish reports the highest rate of households with no motor vehicle (9.94%). Medicaid 


Iberville Parish reports the highest rate of Insured Residents Receiving Medicaid at 27.05%; this rate is higher than state (25.70%) and national (20.21%) rates. The population under the age of 18 receives the highest rates of Medicaid assistance across all of the study area parishes. Iberville Parish reports the highest rate among the study area parishes of residents aged 65 and older receiving Medicaid (18.58%). Insurance 



14
Livingston Parish reports the highest rate of uninsured adults for the OMC Baton Rouge study area at 24.2%. Iberville Parish is a close second at 23.4%. These rates are higher than the nation (20.8%). All of the parishes in the study area report rates lower than the state (25.0%). Iberville Parish and Livingston Parish are the only parishes to see increases in rates of uninsured adults between 2011 and 2012. Iberville Parish shows the greatest increase going from 22.40% in 2011 to 23.40% in 2012. Similar to uninsured adults, Livingston Parish reports the highest rate of uninsured children across the study area parishes at 5.7%. Livingston Parish is the only parish in the study area to exceed the state rate of 5.6%. All of the parishes in the study area and Louisiana report lower rates of uninsured children as compared with the country (7.5%) Community Commons. http://www.communitycommons.org/ Accessed 06/08/2015. 40
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Uninsured Population 
In all of the parishes in the study area, men are more likely to be uninsured than women; consistent with state and national norms. 
Those aged 18 – 64 are more likely to be uninsured as compared with those under 18 or those 65 and older. Residents of Hispanic or Latino ethnicity are more likely to be uninsured than their counterparts. 96.3% of the Some Other Race population in Iberville Parish is uninsured. Residents reporting “Some Other Race”, for the entire study area, have the highest rates of being uninsured. More than 70% of the Asian population of Iberville Parish report being uninsured. 



Violent Crime 


Iberville Parish reports the highest violent crime rate across the OMC Baton Rouge study area counties at 1,163.01 per 100,000 population; almost triple the national rate of 395.5. East Baton Rouge Parish reports the second highest violent crime rate for the study area at 700.68 per 100,000 pop; almost double the national rate. Ascension Parish and Livingston Parish fall below the state and national rates at 269.53 and 318.1, respectively. Fast Food 
In 2013, East Baton Rouge Parish reported the highest rate of fast food restaurants per population at 86.78 per 100,000 pop.; Ascension Parish follows at 74.62 per pop.; these rates are higher than state (71.56) and national (72.74) norms. Grocery Stores  In 2013, Livingston Parish reported the lowest rate of grocery stores per population at 12.5 per 100,000 pop.; Ascension Parish follows at 18.65 per 100,000 pop.; both are lower than state (21.88) and national (21.2) norms. Recreation and Fitness Facilities 
In 2013, Iberville Parish reported the lowest rate of recreation and fitness facilities per population at 3 per 100,000 pop.; Livingston Parish follows at 7.03 per 100,000 pop.; both are lower than state (9.6) and national (9.72) norms. Low Food Access 41
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach 
The low‐income populations of Ascension Parish and East Baton Rouge Parish experience the highest rates of low food access (14.34% and 11.96% respectively). These rates are higher than the rates seen for the state (10.82%) and nation (6.27%). 
Ascension Parish experiences the highest rate of population with low or no healthy food access; this parish has a disparity index of 26.31 compared to 19.31 for the State of Louisiana and a national rate of 16.59. Within the parish of Iberville, the Non‐Hispanic other population experiences the highest rate of low food access (72.7%) followed by the Non‐Hispanic Asian population (70.2%). These rates are the highest for the study area. East Baton Rouge Parish reports the next highest rates, for the study area, for Non‐
Hispanic Asian (64.9%) and Non‐Hispanic Black (64.2%) populations. 

Primary Care Physicians 



East Baton Rouge Parish reports the highest number of physicians across the study area parishes at 389. Iberville Parish reports the fewest physicians with only 11. East Baton Rouge Parish has the highest primary care physician (PCP) rate per 100,000 population at 102.58 in 2012. Livingston Parish reports the lowest rate of PCPs per 100,000 population at only 19.71 in 2012. Poor Health 

Similar to poor dental health, Livingston Parish reports the highest rates of poor general health (19.7%). East Baton Rouge Parish, at 15.5%, has the lowest rate in the OMC Baton Rouge study area and is the only parish to report a rate lower than the national rate of 15.74%. Dentists 




East Baton Rouge Parish reports the highest number of dentists across the study area parishes at 306. Iberville Parish reports the fewest dentists with only 12. East Baton Rouge Parish has the highest dentist rate per 100,000 population at 68.73 in 2013. Livingston Parish reports the lowest rate of dentists per 100,000 population for the OMC Baton Rouge study area at only 25.36 in 2013. Iberville Parish reports the highest rate of adults who have not had a dental exam for the OMC Baton Rouge study area (38.17%); the national rate is 30.15%. 42
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Dental Health 

Livingston Parish reports the highest rate of adults with poor dental health for the OMC Baton Rouge study area at 18.78%; this is higher than the national rate of 15.65%. Iberville Parish reports the next highest rate of adults with poor dental health at 17.57%. Federally Qualified Health Centers (FQHCs) 

Iberville Parish reports the highest rate of FQHCs per population at 5.99 per 100,000; more than five times the other parishes in the study area and triple the national rate of 1.92. Ascension Parish and East Baton Rouge Parish come in just under 1 FQHC per 100,000 population; Livingston Parish follows with 0.78 FQHCs per 100,000 population. Population Living in an HPSA (Health Professional Shortage Area) 
The parishes of East Baton Rouge, Iberville, and Livingston are all health care professional shortage areas (HPSA) designated parishes; therefore 100% of their populations live in an HPSA designated area. Regular Doctor 

Across the country, 22.07% of residents report not having a regular doctor (77.93% have a regular doctor); in Louisiana the rate is 24.09%. Livingston Parish reports the highest rate of residents who do not have a regular doctor at 24.39%. HIV/AIDS  The national rate of the population that has never been tested for HIV/AIDS is 62.79%; in Louisiana this rate is 56.23%.  Iberville Parish reports the highest rate of residents that have never been tested for HIV/AIDS across the OMC Baton Rouge study area at 63.05%.  The Non‐Hispanic Black population is the population that sees the highest rates of HIV/AIDS.  East Baton Rouge Parish sees the highest rate of HIV/AIDS for the study area in the Non‐
Hispanic Black population at 1,704.65 per 100,000 population. The next highest rate in the study area, also in the Non‐Hispanic Black population, is 1,288.68 per 100,000 population in Iberville Parish. 
From 2008 to 2010, many of the study area parishes experienced rises or slight declines then larger rises in the HIV/AIDS rates for their parish. Therefore 2010 rates of HIV/AIDS in the OMC Baton Rouge study area are higher than 2008 rates. 43
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Chlamydia Infection 

East Baton Rouge Parish has reported the highest rate of chlamydia infection in the OMC Baton Rouge study area since 2009. The most current data, for 2011, shows the rate of chlamydia infection to be 743.9 per 100,000 population; considerably higher than the national chlamydia rate of 454.1 per 100,000 population. Only Ascension Parish and Livingston Parish report lower chlamydia infection rates than the nation. Livingston Parish being the lowest in the study area at 263.3 per 100,000 population. Gonorrhea Infection 

Similar to chlamydia infection, East Baton Rouge Parish reports the highest rate of gonorrhea infection in the OMC Baton Rouge study area at 229.9 per 100,000 population; more than double the national rate of 103.1 per 100,000 population. East Baton Rouge Parish has consistently reported the highest rate of gonorrhea infection in the study area since 2003. Also similar to chlamydia infection, only Ascension Parish and Livingston Parish report lower chlamydia infection rates than the nation. Livingston Parish being the lowest in the study area at 34.5 per 100,000 population. Leisure Time Physical Activity 



Iberville Parish reports the highest rate of population with no leisure time activity (31.60%) for the OMC Baton Rouge study area; higher than state (29.8%) and national (22.64%) norms. All of the parishes of the OMC Baton Rouge study area report higher rates than the national norms for population who do not partake in leisure time physical activity. Men consistently report lower rates of not partaking in leisure time physical activity than women; this may be a reporting difference or that women do not actually partake in leisure time physical activity as men. Although Iberville Parish currently has the highest rate of population not partaking in leisure time physical activity in the study area at 31.60%, this rate has steadily declined since 2010 when the rate was 34.80%. Fruit/Vegetable Consumption 
Livingston Parish reports the highest rate of the parishes in the OMC Baton Rouge study area for adults not eating enough fruits and vegetables at 84.80%; higher than the national rate (75.6%). Ascension Parish, also higher than the national rate, follows closely at 84.4%. 44
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Excessive Drinking 

The national rate of adults drinking excessively is 16.94%; half of the parishes (Iberville Parish and Ascension Parish) in the OMC Baton Rouge study area report higher rates of adults drinking excessively. Iberville Parish reports the highest rate, for the OMC Baton Rouge study area, of adults drinking excessively at 22.8%. Smoking 

Livingston Parish reports the highest rate of adults smoking cigarettes across the OMC Baton Rouge study area with 24.1% of the population smoking; higher than Louisiana (21.9%) and the nation (18.08%). Ascension Parish reports the highest rate of adults trying to quit smoking in the past 12 months at 76.17%; this would be a prime population to target smoking cessation programs as they have already expressed interest in trying to stop smoking. Depression 

Ascension Parish, Iberville Parish, and Livingston Parish all report higher rates of residents with depression than Louisiana (15.66%) and the country (15.45%). Livingston Parish is highest at 19.22% East Baton Rouge Parish reports the lowest rate of residents with depression at 15.66%; matching the state rate and slightly above the national rate. Overweight and Obese 





Iberville Parish reports the highest rate of residents who are overweight (37.16%); this rate is higher than the national rate of 35.78%. The rest of the parishes in the OMC Baton Rouge study area fall below the national rate; Livingston Parish being the lowest at 31.41%. Iberville Parish reports the highest rate of residents who are obese (39.4%), Livingston Parish is a close second with 35.60% of their population being obese; East Baton Rouge Parish ranks third highest at 32.20%. Ascension Parish is fourth and lowest with 31.90% of the population being obese; the national rate is 27.14%. There are not significant differences in males and females in terms of obesity; for the study area, some parishes see women having higher rates of obesity, for other parishes, men are more likely to be obese. On a national level, men are more likely to be obese than women (27.7% vs. 26.59%). 45
Tripp Umbach The rates of obesity in the OMC Baton Rouge study area and nationally have seen steady rises over the years. Ascension Parish is the lowest in the study area at 31.90% and closest to the U.S. rates for obesity and has seen, after peaking at 34.1% in 2010, a steady decline. Mortality – Pedestrian Accident 

East Baton Rouge Parish reports the highest rate of age‐adjusted mortality due to pedestrian accident for the OMC Baton Rouge study area at 1.89 per 100,000 population. The Healthy People 2020 goal is for mortality due to pedestrian accident to be less than or equal to 1.3 per 100,000 population; Iberville and Livingston report rates already lower than this HP2020 Goal. Mortality – Homicide 


East Baton Rouge Parish reports the highest rate of age‐adjusted mortality due to homicide for the OMC Baton Rouge study area at 17.53 per 100,000 population; this rate is more than triple the national rate (5.63). The Healthy People 2020 goal is for mortality due to homicide to be less than or equal to 5.5 per 100,000 population; only Ascension Parish reports a rate already lower than this HP2020 Goal. The Non‐Hispanic Black population of East Baton Rouge Parish reports the highest rate of death as a result of homicide across the OMC Baton Rouge study area at 32.8 per 100,000 population. Mortality – Suicide 



Livingston Parish reports the highest rate of age‐adjusted mortality due to suicide for the OMC Baton Rouge study area at 17.57 per 100,000 population; this rate is higher than the national rate (11.82). The Healthy People 2020 goal is for mortality due to suicide to be less than or equal to 10.2 per 100,000 population; Ascension, East Baton Rouge, and Iberville parishes report rates already lower than this HP2020 Goal. The Hispanic/Latino population of the U.S. reports the highest rate of suicide at 32.88 per 100,000 population. For the OMC Baton Rouge study area, the Non‐Hispanic White population of Livingston Parish reports the highest rate of suicide at 18.6 per 100,000 population. 46
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach County Health Rankings The County Health Rankings were completed as collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.15 Each parish receives a summary rank for its health outcomes, health factors, and also for the four different types of health factors: health behaviors, clinical care, social and economic factors, and the physical environment. Analyses can also drill down to see specific parish‐level data (as well as state benchmarks) for the measures upon which the rankings are based. Parishes in each of the 50 states are ranked according to summaries of more than 30 health measures. Those having high ranks, e.g. 1 or 2, are considered to be the “healthiest.” Parishes are ranked relative to the health of other parishes in the same state on the following summary measures: 
Health Outcomes – Rankings are based on an equal weighting of one length of life (mortality) measure and four quality of life (morbidity) measures. 
Health Factors – Rankings are based on weighted scores of four types of factors:  Health behaviors •
65
60
55
50
45
40
35
30
25
20
15
10
5
0

Clinical care 
Social and economic 
Physical environment Louisiana has 64 parishes. A score of 1 indicates the “healthiest” parish for the state in a specific measure. A score of 64 for LA indicates the “unhealthiest” parish for the state in a specific measure. Ascension
45
East Baton Rouge
32
20
21
11
4
2
Iberville
3
Livingston
Health Outcomes
Health Factors
15
2015 County Health Rankings. Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute 47
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge 65
60
55
50
45
40
35
30
25
20
15
10
5
0
Tripp Umbach Ascension
37
32
23
East Baton Rouge
22
5
4
11
9
Iberville
Livingston
Mortality (Length of Life)
Morbidity (Quality of Life)
65
60
55
50
45
40
35
30
25
20
15
10
5
0
Ascension
East Baton Rouge
32
17
13
5
6
3
Health Behaviors
22
Iberville
1
Livingston
Clinical Care
65
60
55
50
45
40
35
30
25
20
15
10
5
0
56
Ascension
52
48
42
East Baton Rouge
27
17
Iberville
9
2
Social and Economic Factors
Physical Environment
Livingston
48
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Key Findings from County Health Rankings:  Iberville Parish reports the highest ranks (unhealthiest parish of the Ochsner Medical Center – Baton Rouge study area) for the majority of the County Health Rankings: o A rank of 32 out of the worst possible 64 (33rd “unhealthiest” parish in the state) for;  Health Outcomes  Mortality (Length of Life)  Health Behaviors o A rank of 45 (20th worst parish in the state) for health factors. o A rank of 37 (28th worst parish in the state) for morbidity (quality of life). o A rank of 56 (9th worst parish in the state) for social and economic factors.  Livingston Parish holds the highest rank for the study area for Clinical Care at 22 out of the worst possible of 64.  Ascension Parish reports the highest ranking (“unhealthiest”) for Physical Environment Factors across the Ochsner Medical Center – Baton Rouge study area at 52 (13th worst parish in the state). Livingston Parish follows close behind with a rank of 48 (17th worst parish in the state. Substance Abuse and Mental Health The Substance Abuse and Mental Health Services Administration (SAMHSA) gathers region specific data from the entire United States in relation to substance use (alcohol and illicit drugs) and mental health. Every state is parceled into regions defined by SAMHSA. The regions are defined in the ‘Substate Estimates from the 2010‐2012 National Surveys on Drug Use and Health’. Data is provided at the first defined region (i.e., those that are grouped). The Substate Regions for Louisiana are defined as such: •
•
Regions 1 and 10 (Data for Regions 1 and 10 provided separately for this grouping only) o Region 1 – Orleans, Plaquemines, St. Bernard o Region 10 – Jefferson Regions 2 and 9 o Region 2 – Ascension, East Baton Rouge, East Feliciana, Iberville, Pointe Coupee, West Baton Rouge, West Feliciana o Region 9 – Livingston, St. Helena, St. Tammany, Tangipahoa, Washington 49
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach •
Region 3 o Region 3 – Assumption, Lafourche, St. Charles, St. James, St. John the Baptist, St. Mary, Terrebonne • Regions 4, 5, and 6 o Region 4 – Acadia, Evangeline, Iberia, Lafayette, St. Landry, St. Martin, Vermilion o Region 5 – Allen, Beauregard, Calcasieu, Cameron, Jefferson Davis o Region 6 – Avoyelles, Catahoula, Concordia, Grant, La Salle, Rapides, Vernon, Winn • Regions 7 and 8 o Region 7 – Bienville, Bossier, Caddo, Claiborne, De Soto, Natchitoches, Red River, Sabine, Webster o Region 8 – Caldwell, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland, Tensas, Union, West Carroll Data concerning alcohol use, illicit drug use, and psychological distress for the various regions of the study area are shown here. Alcohol Use in the Past Month  For the Ochsner Medical Center – Baton Rouge study area (Regions 2 & 9) slightly more than half of the population aged 12 and older (50.99%) report alcohol use in the past month; decreasing from the 2002‐2004 rate by 0.08%. The State of Louisiana saw a slight rise; going from 47.01% in 2002‐2004 to 47.70% in 2010‐2012. Figure 13: Alcohol Use in the Past Month
60.00%
55.00%
50.00%
51.07%
50.99%
47.01%
47.70%
Regions 2 & 9
45.00%
40.00%
LA
35.00%
30.00%
2002‐2004
2010‐2012
Binge Alcohol Use in the Past Month 50
Tripp Umbach Regions 2 & 9, similar to Louisiana, show declining rates in the number of people that reported binge alcohol use in the past month. The most recent data shows 23.64% of the population in Regions 2 & 9 have engaged in binge alcohol use in the past month. Figure 14: Binge Alcohol Use in the Past Month
26.00%
25.73%
25.00%
24.00%
24.37%
23.77%
23.64%
23.00%
22.00%
Regions 2 & 9
21.00%
20.00%
LA
19.00%
18.00%
17.00%
16.00%
2002‐2004
2010‐2012
Perceptions of Great Rick of Having Five or More Alcoholic Drinks Once or Twice a Week  Regions 2 & 9 have shown a slight decline in the perceptions of risk of having five or more drinks once or twice a week from 42.21% (in 2002‐2004) to 41.49% (in 2010‐
2012).  The rates of perceptions of risk of having five or more drinks once or twice a week are on the rise and slightly better for Louisiana at 43.31%. 50.00%
Figure 15: Perceptions of Great Risk of Drinking Five or More Alcoholic Drinks
Regions 2 & 9
45.00%
42.35%
42.21%
43.31%
41.49%
40.00%
LA
35.00%
2002‐2004
2010‐2012
Needing but Not Receiving Treatment for Alcohol Use in the Past Year 51
Tripp Umbach Regions 2 & 9 and Louisiana have shown marked declines in the rates of residents needing but not receiving treatment for alcohol use from 2002‐2004 to 2010‐2012. The Ochsner Medical Center – Baton Rouge study area reports a lower rate (5.93%) than Louisiana (6.10%). 9.00%
8.50%
8.00%
Figure 16: Needing but Not Receiving Treatment for Alcohol Use in the Past Year
8.60%
Regions 2 & 9
7.66%
7.50%
7.00%
6.50%
6.10%
5.93%
6.00%
LA
5.50%
5.00%
2002‐2004
2010‐2012
Tobacco Use in the Past Month  30.30% of the population in the Ochsner Medical Center – Baton Rouge study area reports tobacco use in the past month; fairly consistent with the previous rate of 30.23% in 2002‐2004.  While still higher than Regions 2 & 9, the state rate saw a decline of 0.78%; standing at 31.98%. Figure 17: Tobacco Use in the Past Month
40.00%
Regions 2 & 9
35.00%
32.76%
31.98%
30.00%
30.23%
30.30%
LA
25.00%
2002‐2004
2010‐2012
Cigarette Use in the Past Month 52
Tripp Umbach Cigarette use in the past month is lower for Regions 2 & 9 in the 2010‐2012 analysis than the state; declining over the years from 26.44% to 24.92%. Figure 18: Cigarette Use in the Past Month
32.00%
30.00%
Regions 2 & 9
28.49%
28.00%
26.00%
26.44%
26.71%
LA
24.92%
24.00%
22.00%
2002‐2004
2010‐2012
Perceptions of Great Rick of Smoking One or More Packs of Cigarettes per Day  Both the Ochsner Medical Center – Baton Rouge study area and Louisiana report rises in the rate of perceptions of great risk of smoking one or more packs of cigarettes per day. Figure 19: Perceptions of Great Risk of Smoking One or More Packs of Cigarettes per Day
75.00%
73.59%
73.00%
Regions 2 & 9
71.55%
71.00%
69.08%
69.00%
69.01%
LA
67.00%
65.00%
2002‐2004
2010‐2012
Illicit Drug Use in the Past Month  Regions 2 & 9 show a nearly identical downward trend as compared to the State of Louisiana in rates of illicit drug use in the past month with both reporting slightly more 53
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach than 6.5% of their respective populations aged 12 and older participating in drug use for the most recent data (2010‐2012). Figure 20: Illicit Drug Use in the Past Month
10.00%
9.50%
9.00%
Regions 2 & 9
8.50%
8.00%
8.18%
7.98%
7.50%
LA
7.00%
6.85%
6.81%
6.50%
6.00%
2002‐2004
2010‐2012
Marijuana Use in the Past Month  Similar to illicit drug use, Regions 2 & 9 show a similar downward trend as compared to the State of Louisiana in rates of marijuana use in the past month with both reporting around 4.5% of their respective populations aged 12 and older participating in marijuana use for the most recent data (2010‐2012). Figure 21: Marijuana Use in the Past Month
8.00%
7.50%
7.00%
Regions 2 & 9
6.50%
6.00%
5.50%
5.92%
5.56%
5.00%
LA
4.60%
4.50%
4.50%
4.00%
2002‐2004
2010‐2012
Cocaine Use in the Past Year 54
Tripp Umbach Regions 2 & 9 continue to show a nearly identical downward trend as compared to the State of Louisiana in rates of cocaine use in the past year (1.36% and 1.5%, respectively); differing by only 0.14% for the most recent data (2010‐2012). Figure 22: Cocaine Use in the Past Year
4.00%
3.50%
Regions 2 & 9
3.00%
2.50%
2.64%
2.58%
LA
2.00%
1.50%
1.50%
1.00%
2002‐2004
1.36%
2010‐2012
Nonmedical Use of Pain Relievers in the Past Year  Regions 2 & 9 report a higher rate, as compared with Louisiana, of nonmedical use of pain relievers in the past year at 5.41% of the population aged 12 and over and have seen this rate rise since 2002‐2004 when it was 5.26%. Figure 23: Nonmedical Use of Pain Relievers in the Past Year
6.00%
5.50%
5.41%
Regions 2 & 9
5.26%
5.00%
5.06%
5.03%
LA
4.50%
4.00%
2002‐2004
2010‐2012
Needing but Not Receiving Treatment for Illicit Drug Use in the Past Year 55
Tripp Umbach Again, Regions 2 & 9 show a rate of residents reporting needing but not receiving treatment for illicit drug use in the past year, which is nearly identical to the overall state rate (2.32% and 2.36%, respectively). 4.00%
Figure 24: Needing but Not Receiving Treatment for Illicit Drug Use in the Past Year
3.50%
3.00%
Regions 2 & 9
3.15%
3.07%
LA
2.50%
2.36%
2.32%
2.00%
2002‐2004
2010‐2012
America’s Health Rankings America’s Health Rankings® is the longest‐running annual assessment of the nation’s health on a state‐by‐state basis. For the past 25 years, America’s Health Rankings® has provided a holistic view of the health of the nation. America’s Health Rankings® is the result of a partnership between United Health Foundation, American Public Health Association, and Partnership for Prevention™. For this study, the Louisiana State report was reviewed. The following were the key findings/rankings for Louisiana: -
-
Louisiana Ranks: o 48th overall in terms of health rankings o 44th for smoking o 45th for diabetes o 45th in obesity Louisiana Strengths: o Low incidence of pertussis o High immunization coverage among teens o Small disparity in health status by educational attainment 56
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge -
-
Tripp Umbach Louisiana Challenges: o High incidence of infectious disease o High prevalence of low birthweight o High rate of preventable hospitalizations Louisiana Highlights: o In the past year, children in poverty decreased by 15 percent from 31.0 percent to 26.5 percent of children. o In the past 2 years, physical inactivity decreased by 10 percent from 33.8 percent to 30.3 percent of adults. o In the past 20 years, low birthweight increased by 15 percent from 9.4 percent to 10.8 percent of births. Louisiana ranks 49th for low birthweight infants. o In the past 2 years, drug deaths decreased by 25 percent from 17.1 to 12.9 deaths per 100,000 population. o Since 1990, infant mortality decreased by 32 percent from 11.8 to 8.2 deaths per 1,000 live births. Louisiana now ranks 47th in infant mortality among states. 57
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Table 13. America’s Health Rankings ‐ Louisiana Measure Air Pollution All Determinants All Outcomes Binge Drinking Cancer Deaths Cardiovascular Deaths Children in Poverty Chlamydia Cholesterol Check Colorectal Cancer Screening Dental Visit, Annual Dentists Diabetes Disparity in Health Status Drug Deaths Excessive Drinking Fruits Heart Attack Heart Disease High Blood Pressure High Cholesterol High Health Status High School Graduation Immunization ‐ Adolescents Immunization – Children Immunization Dtap Immunization HPV female Immunization MCV4 Income Disparity Income Disparity Ratio Infant Mortality Rank Value Measure 26 48 44 21 47 46 44 47 26 39 48 39 45 16 27 22 44 41 40 47 41 47 46 11 31 16 12 9 48 1 47 9.2
‐0.53
‐0.273
16.3
217.4
307.5
26.5
597.9
76.2
61.5
56.1
49.6
11.6
26.5
12.9
17.7
1.18
5.3
5
39.8
40.7
44.4
72
72.6
69.1
87.9
42.1
87.7
0.491
5.68
8.2
Infectious Disease
Insufficient Sleep
Lack of Health Insurance
Low Birthweight
Median Household Income Obesity
Obesity – Youth
Occupational Fatalities
Overall
Personal Income, Per Capita Pertussis
Physical Activity
Physical Inactivity
Poor Mental Health Days
Poor Physical Health Days
Premature Death
Preterm Birth
Preventable Hospitalizations Primary Care Physicians
Public Health Funding
Salmonella
Smoking
Stroke
Suicide
Teen Birth Rate
Teeth Extractions
Underemployment Rate
Unemployment Rate, Annual Vegetables
Violent Crime
Youth Smoking
Rank Value 48
34
39
49
50
45
47
48
29
1
46
46
43
38
45
49
48
20
27
47
44
45
12
44
48
23
15
49
44
37
16.7
10.8
39,622
33.1
13.5
8.2
‐0.803
41,204
1.6
67.8
32.2
4.2
4.2
9625
15.3
80.3
123.7
69.01
33.7
23.5
4
12.5
43.1
9.6
12.7
6.2
1.64
496.9
12.1
58
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Key Stakeholder Interviews Tripp Umbach conducted interviews with community leaders on behalf of the Ochsner Medical Center Baton Rouge. Leaders who were targeted for interviews encompassed a wide variety of professional backgrounds including 1) Public health expertise; 2) Professionals with access to community health related data; and 3) Representatives of underserved populations. The interviews offered community leaders an opportunity to provide feedback on the needs of the community, secondary data resources, and other information relevant to the study. This report represents a section of the overall CHNA project completed by Tripp Umbach. DATA COLLECTION: The following qualitative data were gathered during individual interviews with 11 stakeholders in communities served by the Ochsner Medical Center Baton Rouge, a 150‐bed hospital located in Baton Rouge, LA. Each interview was conducted by a Tripp Umbach consultant and lasted approximately 60 minutes. All respondents were asked the same set of questions developed by Tripp Umbach and previously reviewed by an Ochsner Medical Center Baton Rouge CHNA oversight committee. The purpose of these interviews was for stakeholders to identify health issues and concerns affecting residents in the communities served by Ochsner Medical Center Baton Rouge, as well as ways to address those concerns. There was a diverse representation of community‐based organizations and agencies among the 11 stakeholders interviewed. Those organizations represented included:  Louisiana Office of Public Health  Baton Rouge Community College  Humana Louisiana  YMCA BR  Director ‐ Medical Student Clerkship  BR Division of Human Development & Services  Louisiana Public Health Institute  LSU Health Science Center, Allied Health  Acadian Ambulance  Ochsner Health System  BREC STAKEHOLDER RECOMMENDATIONS: The stakeholders provided many recommendations to address health issues and concerns for residents living in communities served by Ochsner Medical Center Baton Rouge. Below is a brief summary of the recommendations:  Incentivize healthy choices through employers and health insurance companies. Employers could offer monetary incentives and health insurance companies could offer discounted rates for practicing health behaviors. Entities responsible for the cost of unhealthy options show be held accountable (e.g., bars, fast food restaurants, residents making unhealthy choices) through a tax, similar to the tax placed on cigarettes. 59





Tripp Umbach Disseminate information on an ongoing basis regarding healthy options (e.g., Prenatal practices, healthy nutrition, food preparation, preventive practices, prevention of STIs, etc.) and health resources (e.g., location, eligibility, services, etc.). To do this hospitals could partner with local schools, community‐based organizations, etc. Increase collaboration between hospitals, FQHCs, and clinics: Stakeholders felt that hospital could be more connected with FQHCs and clinics in local communities through collaboration and referrals to reduce the use of emergency rooms and urgent care clinics. Stakeholders recommended that hospitals work with local FQHCs and clinics to provide access to specialty diagnostics and treatment for residents that are uninsured or Medicaid eligible. Additionally, stakeholders felt that increased collaboration could mean additional funding for healthcare providers throughout the community. Health and wellness groups could collaborate to provide food trucks with fresh produce and healthy foods at a fair price to neighborhoods that do not have grocery stores. These healthy food trucks could be available once or twice a week to increase access to healthy food. Healthcare providers could participate in a universal way in the exchange of health information in order to facilitate collaboration among all providers including FQHCs, Hospitals, and private practices. Integrate behavioral health services into primary care settings through co‐location of behavioral health providers to decrease stigma and increase treatment options for behavioral health. Additional integration could include psychiatric consultation on an as needed basis for primary care providers to treat behavioral health issues that are not severe or persistent. The state could develop a strategy to effectively address poverty throughout Louisiana. This strategy could include plans to increase access to health insurance by expanding Medicaid, as well as, increase the high‐quality early child education and care to disrupt the generational cycle of poverty. PROBLEM IDENTIFICATION: During the interview process, stakeholders discussed five overall health needs and concerns in their community. The top five health needs in order from most discussed to least discussed were: 1. Accessibility of health services 2. Common health concerns 3. Social and environmental determinants of health 4. Personal behaviors that impact health 5. Behavioral health, including substance abuse 60
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach ACCESSIBILITY OF HEALTH SERVICES: Every stakeholder articulated a need to improve the accessibility of health services (medical, dental, behavioral) in the Capital Area. Several acknowledged that there are health care resources in the Capital Area including multiple hospitals, clinics and urgent care practices. The discussion about accessibility of services was related most often to the cost of care, acceptance of insurance, awareness of services available, and the number and location of providers. Stakeholders discussed a shift in the way health services are provided from the charity care model where charity care was provided in a large charity hospital (Earl K. Long Medical Center) before 2013 when it closed to the more community‐based clinic model providing charity care to residents through a network of community‐based clinics and hospitals service Baton Rouge. Early this year (2015) Baton Rouge General Medical Center’s Mid‐city emergency room closed leaving some stakeholders unsure about the access residents will have to emergency care in northeast Baton Rouge. Most stakeholders felt that the community‐based clinic model may prove to be more efficient and accessible to residents in Capital Area communities. One of the most discussed about barriers to accessing health services in the Capital Area was the awareness of residents about what services are available and where they are located. One stakeholder addressed the expense related to disseminating information in a comprehensive ongoing way. Resources may not readily available to raise awareness about healthy practices and health services. Residents are not always securing health services in the proper locations because they are not aware of new clinics and services that may be available to them. The low reimbursement rates for health service providers like hospitals and community‐based clinics was often the topic of discussion with stakeholders. Stakeholders felt that hospitals are struggling to provide quality health services at the poor reimbursement rates paid by CMS. Low reimbursement rates were often cited as the reason hospitals are struggling to remain viable and continue to offer services to residents. This was particularly the case in areas with higher rates of poverty and rural areas. Stakeholders discussed the cost of health services in relationship to health insurance, uninsured care, and poor reimbursement rates of health service providers (medical, dental and behavioral). Many providers are not accepting patients with Medicaid insurance due to the low reimbursement rates. This does not include non‐profit hospitals. Stakeholders discussed the lack of Medicaid expansion placing a strain on health resources to meet the needs of uninsured and underinsured residents. Residents that are uninsured often seek health services when an issue becomes an emergency and requires more intense and costly care, which typically yields poorer outcomes than primary and preventive care practices. 61
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Stakeholders discussed the improvements in accessibility as well as the need to continue to increase access to health services in all regions. Many stakeholders discussed the fragmentation of health services and the gaps in services that are available. According to stakeholders there were several health services that are not readily available in their region, specifically: outpatient Medicaid providers (dental), uninsured prenatal care, inpatient behavioral health and substance abuse services, outpatient behavioral health and substance abuse services, care coordination, emergency medical care (northeast Baton Rouge) Primary care (rural areas). Stakeholders described disparate health resources with lower income neighborhoods containing the fewest resources. The Medicaid Waiver16 provides some access to care but does not cover prescription medications or specialty care. As a result, many community‐based clinics do not have access to specialty diagnostic services. Residents may have an undiagnosed illness that they cannot afford to treat due to the cost of medications. Stakeholders discussed the lack of care coordination provided for uninsured and underinsured residents, including seniors, who are seeking care in inappropriate settings like the emergency room. Stakeholders noted that the need for accessible healthcare among medically vulnerable populations (e.g., uninsured, low‐income, Medicaid insured, etc.) has an impact on the health status of residents in a variety of ways and often leads to poorer health outcomes. Several of the noted effects are:  Higher cost of healthcare that results from hospital readmissions and increased usage of costly emergency medical care.  Residents delaying medical treatment and/or non‐compliant due to the lack of affordable options and limited awareness of what options do exist.  Poor outcomes in adult, maternal and pediatric care due to limited care coordination and lack of patient compliance. COMMON HEALTH CONCERNS: Every stakeholder discussed specific health concerns of residents. The most common health concerns discussed by stakeholders were obesity, diabetes, heart disease, cancer, and HIV. 1. Diabetes – More than two‐thirds of stakeholders discussed the prevalence and cause of diabetes as a common health issue among residents. Stakeholders identified social and environmental determinants (e.g., lack of awareness, limited access to primary care, food deserts, etc.) as well as personal choice and behaviors within the control of residents (e.g., choices about nutrition, exercise, etc.) as driving the high rates of diabetes. 16
In 2015, there are multiple Medicaid Waivers operating in Louisiana. Residents are qualify for one of the Medicaid Waivers whereby receiving health services from health providers which accept the Medicaid Waiver, and are then eligible for Medicaid reimbursement. 62
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach 2. Heart disease – More than two‐thirds of stakeholders discussed heart disease and cardiovascular complications as a common health concern among residents. Stakeholders identified social and environmental determinants (e.g., lack of awareness, culture, etc.) as well as personal choice and behaviors within the control of residents (e.g., smoking, exercising, etc.) as driving the high rates of heart disease. 3. Obesity – Over one‐half of stakeholders discussed the prevalence and cause of obesity among residents in MHCNO communities. Stakeholders indicated that obesity is an issue among adults as well as a growing problem among youth. Stakeholders identified social and environmental determinants (e.g., culture, lack of awareness, limited access to healthy nutrition, etc.) as well as personal choice and behaviors within the control of residents (e.g., choices about nutrition, exercise, etc.) as driving the high rates of obesity. 4. HIV – More than one‐third of stakeholders discussed HIV as a major health concern among residents. Stakeholders identified social and environmental determinants (e.g., limited prevention education, etc.) as well as personal choice and behaviors within the control of residents (e.g., treatment non‐compliance, risky behaviors, etc.) as driving the high rates of HIV. While residents are living longer with HIV, there can still be complications and management issues related to the diagnosis. Stakeholders felt that residents may not value themselves enough to avoid risky behaviors. 5. Cancer – More than one‐third of stakeholders discussed cancer (i.e., breast cancer, pancreatic cancer, ling and skin cancer) as a common health concern among residents. Stakeholders identified social and environmental determinants (e.g., exposure to cancer causing agents in the environment, etc.) as well as personal choice and behaviors within the control of residents (e.g., smoking, excessive alcohol consumption, etc.) as driving the high rates of cancer. The impact of common health issues can be poor health outcomes of a population and greater consumption of health care resources. SOCIAL AND ENVIRONMENTAL DETERMINANTS OF HEALTH: Every stakeholder discussed the social and environmental determinants of health in Capital Area communities. The most common social and environmental factors discussed by stakeholders were the impact of culture, high rates of violence, lack of education, and poverty on the health of seniors, adults, and new born babies. Stakeholders discussed the impact that culture has on the practices, views and health of residents. Stakeholders noted that the culture of residents is close and supportive, but often centers around food and alcohol consumption. Traditional diets of residents are reflective of culture and historically are high in fried and fatty foods. Stakeholders noted that changing behavior can be difficult particularly when it is steeped in accepted cultural practices and supported by the economy of tourism. Excessive consumption of alcohol and fried foods can cause lifestyle diseases such as cardiovascular disease, obesity, diabetes and cancer. 63
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach The economy was discussed regarding the low‐income employment available and lack of opportunity many residents have. According to stakeholders, many residents live below the federal poverty line and there are few employment opportunities. Stakeholders addressed the high rates of poverty and the poor outcomes for residents in poverty. Discussions focused on poverty as an explanation for the high prevalence of substance abuse, low educational attainment, violence, poor health, limited access to health services, etc. Often stakeholders pointed out that the lack of opportunity, limited employment, and low educational attainment found in communities of poverty cause residents to have limited employment skills. Stakeholders felt that the lack of education coupled with low exposure to healthy resources causes residents in poverty to be unaware of healthy options. When residents are aware of healthier choices they may perceive these options to be out of their reach e.g., healthy produce and nutrition may not be viewed as consistently attainable due to a lack of grocery stores, limited transportation, and cost. Food security was discussed by stakeholders related to the health of seniors and youth. Grocery stores are not often located in low‐income neighborhoods creating what is being called a “food desert”. Youth and seniors residing in these food deserts may not have ready access to healthy nutrition due to the lack of transportation options. Transportation was addressed as a need in the Capital Area related to limited access to public transportation and the level of traffic congestion. The lack of adequate transportation impacts health in a variety of ways by increasing the response time for emergency medical transportation, limiting the access residents have to healthy options like medical providers and grocery stores with healthy produce. Residents are not able to attend appointment consistently due to a lack of dependable transportation. Often residents in rural areas are not able to get to and from the health services they need. For this reason, stakeholders indicated that rural residents often delay seeking health services until the issue becomes an emergency and potential outcomes are often poor. The topic of transportation was most often discussed in relationship to residents seeking health care and healthy nutrition in rural areas. Housing insecurity was discussed by stakeholders in relationship to the homeless population. Stakeholders indicated that residents may face one of three types of housing insecurities: 1) persistent relocation to be closer to resources (e.g., employment for parents, family/friends, etc.); 2) families that are homeless; and youth that are homeless by themselves (without adult accompaniment). Stakeholders felt that housing insecurity influences the ability for people to secure appropriate health services (e.g., medical, dental, behavioral health) consistently, proper 64
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach nutrition, etc. The health status of persons experiencing housing insecurity is often worse than those with stable living conditions. The education in schools was addressed as an issue related to the oversight of behavioral health, access youth have to physical exercise throughout the day, and education about reducing the spread of STIs and HIV. Stakeholders felt that youth are not always getting their behavioral health needs met in the school systems due to the lack of formal oversight for behavioral health in the school system. Additionally stakeholders discussed the decline or absence of physical activity in the school system. Stakeholders felt that youth are becoming obese for a variety of reasons, one of which is the limited exercise they may be participating in during school hours. Stakeholders discussed the level of health literacy among residents. Health literacy is influenced by literacy levels, and access to and understanding of technology (e.g., computers). Stakeholders noted that there is a high correlation between lower educational attainment and lower level of health literacy. Additionally, stakeholders felt that the movement toward electronic medical records, the use of online applications, and internet based systems may leave some residents that do not have access to computers and/or whom may be unfamiliar with computers without access to relevant health information. Stakeholders discussed the implications of social and environmental determinants of health as some of the following:  Lifestyle diseases such as obesity, diabetes, cancer, hypertension, and cardiovascular disease.  Higher rates of poor birth outcomes such as low birth weight.  Increased behavioral health symptoms of trauma e.g., risky behaviors, suicide, anxiety, depression, violence, apathy, etc.  Poor birth outcomes (e.g., low birth weight) and limited access to healthy options. PERSONAL BEHAVIORS THAT IMPACT HEALTH: More than eighty percent of the stakeholders interviewed discussed lifestyle choices that impact the health status and subsequent health outcomes for residents. Stakeholders noted that there are factors like smoking, lack of physical exercise, and risky behaviors that are related to the personal choices of residents and influence health outcomes. The topic of personal choice was most often discussed in relationship to obesity, the prevalence of STIs, and cancer and respiratory issues related to smoking and alcoholism. Note that these are also health concerns stakeholders felt were heavily influenced by social and environmental determinants of health. It is this coupling of social/environmental and personal choice determinants of health 65
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach that present the greatest challenge to improving lifestyle related diseases like diabetes, obesity, cancer, and STIs. Stakeholders recognized that there are social determinants that drive the rate of obesity such as food deserts, lack of awareness about healthy food preparation and the inability to exercise outdoors due to a lack of safety; however, stakeholders also recognized that residents often make personal choices based on preferences for unhealthy foods and limited motivation to exercise. At the same time that stakeholders recognized that there are social and environmental determinants of cancer and respiratory diseases like chemical run off from factories and pollution; they discussed the personal choice to continue smoking as an additional factor that facilitates low birth weight, the rates of cancer and COPD in communities where smoking rates are greatest. While stakeholders understood the impact of social and environmental determinants like youth not learning the practices that reduce the spread of STIs like HIV in school settings; stakeholders also recognized that parents are choosing not to provide education to their children about preventing the spread of STIs and youth are making the decision to practice risky behaviors. NEED FOR BEHAVIORAL HEALTH INCLUDING SUBSTANCE ABUSE SERVICES: Behavioral health services and issues were discussed separate from medical or dental health services, with approximately ninety percent of stakeholders identifying a health need related to behavioral health and/or substance abuse. Stakeholders discussed the lack of behavioral health and substance abuse resources in general and many noted that behavioral health and substance abuse needs are highest in communities with the highest rates of poverty. Stakeholders discussed how fragmented the behavioral health services are in the Capital Area with little care coordination. One stakeholder noted that it is not possible to make significant population health improvements without addressing behavioral health due to the impact of behavioral health on medical health. Stakeholders felt that the culture and laws support substance abuse and identified tobacco, alcohol and marijuana, and prescription pain medications as the most common substances being abused. Additionally, stakeholders believed youth are being exposed to substance abuse at a young age when parents abuse substances, which can lead to normalization of substance abuse issues and addiction. Stakeholders also felt that substance abuse is often a way for 66
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach residents to self‐medicate or cope with behavioral health issues including stress and serious mental illness (e.g., bipolar, schizophrenia, etc.). Often communities with higher rates of poverty are also the areas with limited resources available to treat diagnoses related to behavioral health and substance abuse. There is reportedly a resistance among behavioral health providers to accept Medicaid insurance and the cost of uninsured behavioral health services is unaffordable for residents who are Medicaid eligible. Stakeholders noted that there has been a decrease in funding for behavioral health and substance abuse services, which has led to limited resources. While there are inpatient beds and outpatient services available, stakeholders indicated that they are not adequate enough to meet the demand for behavioral health and substance abuse services in Capital Area communities. In recent years there has been a decrease in the number of inpatient beds and outpatient services often have lengthy waiting lists for diagnostic services as well as ongoing treatment. Stakeholders noted that behavioral health and substance abuse has an impact on the health status of residents in a variety of ways and often leads to poorer health outcomes. Several of the noted effects of behavioral health and substance abuse are:  Residents with a history of behavioral health and substance abuse do not always practice healthy behaviors and may be non‐compliant with necessary medical treatments (e.g., HIV treatments, etc.).  Babies born to mothers with behavioral health and/or substance abuse issues may not receive adequate prenatal care and/or consistent care Postpartum to facilitate healthy child development. Mothers that have a history of substance abuse may not inform their physician due to laws that may lead to the removal of other children in the home. 67
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Survey of Vulnerable Populations Tripp Umbach worked closely with the Community Health Needs Assessment (CHNA) oversight committee to ensure that community members, including under‐represented residents, were included in the needs assessment through a survey process. DATA COLLECTION: Vulnerable populations were identified by the CHNA oversight committee and through stakeholder interviews. Vulnerable populations targeted by the surveys were: seniors, low‐
income (including families), uninsured, Latino, chronically ill, had a mental health history, homeless, literacy challenged, limited English speaking, women of child bearing age, diabetic, and residents with special needs. A total of 150 surveys were collected in the Ochsner Medical Center – Baton Rouge service area, which provides a +/‐ 7.32 confidence interval for a 95% confidence level. Tripp Umbach worked with the oversight committee to design a 32 question health status survey. The survey was administered by community‐based organizations providing services to vulnerable populations in the hospital service area.  Community‐based organizations were trained to administer the survey using hand‐
distribution.  Surveys were administered onsite and securely mailed to Tripp Umbach for tabulation and analysis.  Surveys were analyzed using SPSS software. Limitations of Survey Collection: There are several inherent limitations to using a hand‐distribution methodology that targeted medically vulnerable and at‐risk populations I survey collection. Often, the demographic characteristics of populations that are considered vulnerable populations are not the same as the demographic characteristics of a general population. For example, vulnerable populations by nature may have significantly less income than a general population. For this reason the findings of this survey are not relevant to the general population of the hospital service area. Additionally, hand‐distribution is limited by the locations where surveys are administered. In this case Tripp Umbach asked CBOs to self‐select into the study and as a result there are several populations that have greater representation in raw data (i.e., low‐income, women, etc.). These limitations were unavoidable when surveying low‐income residents about health needs in their local communities. Demographics: Survey respondents were asked to provide basic anonymous demographic data. 68
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Table 14: Survey Responses – Self‐Reported Age of Respondent Age Respondents (%)
18‐24
25‐34
35‐44
45‐54
55‐64
65‐74
75‐84
85+
15.0%
27.2%
17.0%
20.4%
16.3%
2.0%
1.4%
.7%
 Of the surveys gathered: 67.9% were female, 32.1% were male  The majority of the survey respondents reported their race as Black or African American (63.2%), the next largest racial group was White or Caucasian (23.7%), and third largest Asian (5%). Table 15: Survey Responses – Self‐Reported Annual Income of Respondents Income Respondents (%)
< $10k
$10‐19,999
$20‐29,999
$30‐39,999
$40‐49,999
$50‐59,999
$60‐69,999
$70‐79,999
$80‐99,999
$100‐149,999
51.1%
13.5%
7.8%
2.8%
5.7%
‐‐
2.1%
1.4%
.7%
‐‐
 The household income level with the most responses was < $10,000 (27.6%) and $10,000 ‐ $19,999 (16.6%) o 57.4% of respondents reported less than $29,999 annual household income Healthcare:  The most popular place for residents to seek care is a doctor’s office (39.9%), with the free or reduced cost clinics being the second most popular (19.6%), urgent care clinics (11.5%) and ER (11.5%) third.  The most common forms of health insurance carried by respondents was no insurance (37.8%), Medicaid only (34.5%), and private or commercial only (16.9%).  The most common reason why individuals indicated that they do not have health insurance is because they can’t afford it (60%). 69


Tripp Umbach One‐third of respondents (32.9%) could not see a doctor in the last 12 months because of cost; compared to the state (18.9%). Most respondents had been examined by a physician within the last 12 months at least once (65.8%). One in four (25%) respondents reported not taking medications as prescribed in the last 12 months due to cost. Figure 25: Survey ‐ Methods of Regular Transportation
Percent of Responses
35
Family/Friend car
30
25
Public
Transportation
20
15
Taxi/Cab
10
5
Walk
0
Baton Rouge Region
 Many respondents indicated that their primary form of transportation is some method other than their own car. Table 16: Survey Responses Related to HIV/AIDS Testing Baton LA
U.S.
Ever Been Rouge Tested for HIV Region
Yes
80.3% 43.5% 35.2%
No
19.7% 56.5% 64.8%

The Baton Rouge region reports a higher rate of HIV testing (80.3%) than the state (43.5%) or the U.S. (35.2%). Health Services: 70
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Table 17: Survey Responses – Health Services Received During the Previous 12 Month Period Test Received
14 Parish SELA Region
Baton Rouge
Check up 45.8%
50.7%
Blood test 52.3%
49.3%
Urinalysis
23%
32.7%
Counseling or therapy
31.5%
26.0%
Flu shot
31.1%
26.0%
 Respondents from the Baton Rouge region report higher testing rates than those across the SELA Region for check ups and urinalysis, but lower rates for blood tests, counseling and flu shots.  Most respondents did not prefer to receive health services in a language other than English. Table 18: Survey Responses – Perceptions about Health Service Availability Available to Baton Rouge
Available to me
others
Not available
Dental services
65.9%
15.6%
11.1%
Vision services
65.9%
13.3%
10.4%
Medical specialist
53.7%
11.8%
5.9%
Mental health services
50.4%
9.8%
6.0%
Safe places to walk and play
75.9%
6.0%
10.5%
Affordable, safe, and healthy housing
63.4%
14.9%
9.0%

When asked if the following was available to them or their family at least one in 10 respondents indicated they did not have access to: services for 60+ (14.7%), healthy foods (12.8%), employment assistance (13.4%), cancer treatment (11.8%), women’s health (10.3%), pediatric and adolescent health (11.9%), accessible transportation (11.5%), and primary care doctors (11.4%). 71
NA
7.4%
10.4%
28.7%
33.8%
7.5%
12.7%
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Table 19: Survey Responses – Preferences for Receiving Information about Healthcare Preferred Method Respondents (%)
Newspaper
38.7%
TV
46.7%
Internet
36.7%
Word of Mouth
65.3%
Radio
18.7%
Library
11.3% Clinics
19.3%
Faith/Religious Organizations
14.7%
Call 2‐1‐1
2.7%
Other
9.3%
 Respondents reported preferring to receive information by word of mouth most often. Common Health Issues: Table 20: Survey Responses – Health Issues Respondents Reported Ever Diagnosed with Ever Diagnosed with SELA Region Baton Rouge LA* U.S.* High blood pressure
High blood cholesterol
Heart attack
Asthma
Still have asthma
COPD, emphysema or chronic bronchitis
Arthritis/rheumatoid, gout, lupus, or fibromyalgia
Depressive disorder
Pre‐diabetes or borderline diabetes
Diabetes
Skin cancer
Other types of cancer (Breast‐20.5%)
Receiving mental health treatment/medication
44.8% 30% 6.2% 13.2% 8.8% 4.2% 36.1%
23.8%
6.8%
17.9%
14.0%
3.4%
39.9%
‐‐ 5.3% 5.3% ‐‐ 7.5% 31.4% ‐‐ 4.3% 4.3% ‐‐ 6.5% 27.8% 21.9%
26.4%
25.3% 21.5% 18.6% 16% 2.8% 4.4% 21.4% 32.6%
11.5%
13.8%
0%
3.5%
37.9%
18.7%
11.6%
10.3%
5% 6.6% ‐‐ 18.7% 9.7% 9.7% 6% 6.7% ‐‐ * Source: CDC 
Survey respondents from the Baton Rouge Region self‐reported lower diagnosis rates for many of the measures than the SELA region, the state and the nation with few exceptions (i.e., asthma, mental health, and cancer). When asked to report health conditions that they had ever been diagnosed with by a health professional, survey respondent from the Baton Rouge Region reported: 72

Tripp Umbach Higher diagnosis rates than the SELA Region, the state and the nation for asthma (17.9% vs. SELA‐ 13.2%, LA‐ 5.3%, and U.S.‐ 4.3%); and depressive disorder (32.6% vs. SELA‐ 21.5%, LA‐ 18.7%, and U.S.‐ 18.7%). More than one‐third (37.9%) survey respondents indicated they have received mental health treatment or medication at some point in their lives. Table 21: Survey Responses – Top Health Concerns Reported Health Concern Baton Rouge
SELA Region
Diabetes
High Blood Pressure
Drugs and Alcohol
Cancer
Heart disease
50.8%
49.9%
47.7%
42.1%
38.5%
58.9%
57.9%
47.8%
40.8%
40.6%
 When asked to identify five of the top health concerns in their communities; there was a great deal of agreement between the two regions. Several of the additional choices that were not as popular were: adolescent health, asthma, family planning / birth control, flood related health concerns (like mold), hepatitis infections, HIV, maternal and child health, pollution (e.g., air quality, garbage), sexually transmitted diseases, stroke, teen pregnancy, tobacco use, violence or injury, other, and don’t know. Lifestyle: Table 22: Survey Responses – Average Body Mass Index of Survey Respondents Weight & BMI
SELA Region Baton Rouge Region Avg. Female (5’4”)* Avg. Male (5’9”)*
BMI**
29.3
29.21
26.5
26.6
* Source: CDC ** Survey Respondents were asked to report their weight and height, from which the BMI calculation was possible.  Respondents in both regions show higher weight and BMI than national and state averages regardless of gender.  Most respondents reported having access to fresh fruits and vegetables (86.5%). Table 23: Survey Responses – Self‐Reported Smoking Rates Smoking SELA Region
Baton Rouge
LA* U.S.* Everyday 15.5%
34.0%
19.3%
15.4%
Some days 8.1%
8.8%
6.4%
5.7%
Not at all 74.7%
55.8%
‐‐
‐‐
*Behavioral Risk Factor Surveillance System 73
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Table 24: Survey Responses – Self‐Reported Physical Activity Rates Physical Activities SELA Region
Baton Rouge
U.S.* Yes 74.7%
57.3%
55.6%
No 25.3%
42.7%
44.4%
*Behavioral Risk Factor Surveillance System Respondents in both the SELA and Baton Rouge regions report lower rates of physical activity than those reported for the nation. 74
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Conclusions and Recommended Next Steps The community needs identified through the Ochsner Medical Center – Baton Rouge CHNA process are not all related to the provision of traditional medical services provided by medical centers. However, the top needs identified in this assessment do “translate” into a wide variety of health‐related issues that may ultimately require hospital services. Each health need identified has an impact on population health outcomes and ultimately the cost of healthcare in the region. For example: unmet behavioral health and substance abuse needs lead to increased use of emergency health services, increased death rates due to suicide, and higher consumption of other human service resources (e.g., the penal system). Ochsner Medical Center – Baton Rouge working closely with community partners, understands that the CHNA document is only a first step in an ongoing process. It is vital that ongoing communication and a strategic process follow the assessment – with a clear focus on addressing health priorities for the most vulnerable residents in the hospital service area. The hospital service area contains affluent populations and populations with higher socio‐
economic needs (e.g., low‐income, residents with a behavioral health history, unemployed, uninsured, homeless, seniors, etc.); which presents a unique challenge for hospital leadership when planning to meet the needs of all residents. There are pockets of vulnerable populations in the hospital service area, which include Baton Rouge (70802, 70805, 70807, and 70806); Plaquemine (70764), and Port Allen (70767). With the highest suicide rate in the Ochsner Health system foot‐print it will be important to consider the impact of behavioral health on health outcomes in these areas. Ensuring access to health services by increasing care coordination across the service area to the most vulnerable populations in areas of concentrated poverty will have the greatest impact on outcomes. Hospital leadership will need to consider the health disparities that exist among Native American residents in Plaquemines Parish; Asian residents in St. Charles Parish; and African American populations throughout the service area. It is important to expand existing partnerships and build additional partnerships with multiple community organizations when developing strategies to address the top identified needs. Implementation strategies will need to consider the higher need areas in the study area and address the multiple barriers to healthcare. It will be necessary to review evidence‐based practices prior to planning to address any of the needs identified in this assessment due to the complex interaction of the underlying factors at work driving the need in local communities. Tripp Umbach recommends the following actions be taken by the hospital sponsors in close partnership with community organizations over the next five months. Recommended Action Steps: 75
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach  Widely communicate the results of the CHNA document to Ochsner Medical Center‐ Baton Rouge staff, providers, leadership and boards.  Review the CHNA findings with a decision making body (e.g., a Board of Directors) for approval.  Make the CHNA widely available to community residents, as well as through multiple outlets such as: the hospital website and stakeholder organizations.  Review relevant evidence‐based practices that the community has the capacity to implement.  Develop “Working Groups” to focus on specific strategies to address the top needs identified in the CHNA. The working groups should meet for a period of four to six weeks to review evidence‐based practices and develop action plans for each health priority, which should include the following: 







Objectives Anticipated impact Target population Planned action steps Planned resource commitment Collaborating organizations Evaluation methods and metrics Annual progress 76
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach APPENDIX A Community
Resource Inventory OCHSNER MEDICAL CENTER
– BATON ROUGE
September, 2015 77
Tripp Umbach completed an inventory of community resources available in the Ochsner Medical Center Kenner (OMC Kenner) service area using resources identified by the hospital leadership, internet research and United Way’s 211 First Call for Help community resource database. Using the zip codes which define the OMC Kenner community (70065, 70068, 70062, 70003, 70047, 70084, 70087, 70001, 70119, 70070,
70123, 70006, 70005, 70002, 70057, 70079, 70049, 70043, 70094, 70126, 70117, 70053, 70122, 70129, 70071,70039, 70052, 70051, 70056, and 70118) more than 191 community resources were identified with the capacity to meet the three community health needs identified in the OMC Kenner CHNA. (Please refer to the Community Health Needs Assessment Report to review the detailed community needs.)
No restrictions
Provides home care services, companionship
care, fellowship care, and adult day care.
*
70068
St. John the
Baptist
More Information
No restrictions
Provides home care services, companionship
care, fellowship care, and adult day care.
70053
Jefferson
More Information
No restrictions
Provides home healthcare. South Central
Application Center for Medicaid.
70087
St. Charles
http://www.accesshealthla.org/
St. Rose Elementary and
Albert Cammon Middle
School
Federally qualified health center providing access
to WIC, primary, preventive, pediatric,
behavioral, dental, substance abuse, and some
specialty care regardless of ability to pay.
*
X
X
X
X
X
X
*
X
X
Students
*
X
X
X
X
X
X
*
X
St. Charles
No restrictions
*
X
X
X
X
X
X
*
70072
Jefferson
Students
*
X
X
X
X
X
X
Joshua Butler Elementary School
300 Fourth Street
Westwego, LA 70094
70094
Jefferson
Students
*
X
X
X
X
X
Paradis Wellness Center
434 South Street
Paradis, LA 70080
70080
R.J. Vial Elementary School
and J.B. Martin Middle
School
*
X
X
X
X
Riverdale High School
240 Riverdale Drive
Jefferson, LA 70121
70121
Students
*
X
X
X
ACCESS HEALTH LOUISIANA
No restrictions
Bonnabel High School
2801 Bruin Drive
Kenner, LA 70065
70065
Jefferson
No restrictions
70070
No restrictions
Internists - Cardiology and Nephrology
Drive Raj and Drive Jay
1057 Paul Maillard Rd, Suite 240
Luling, LA 70070
(985) 785-2045
John Ehret High School
4300 Patriot Street
Marrero, LA 70072
No restrictions
No restrictions
No restrictions
St. Charles
Jefferson
BEHAVIORS THAT IMPACT HEALTH
More Information
Supervision of young people
Jefferson
Public transportation availability
70053
Recreational activities availability
X
70053
Healthy nutrition
*
St. Charles
ACCESS TO HEALTHY OPTIONS
70070
*
Limited outreach service provision
No restrictions
More Information
Collaboration of business, hospitals and communities
More Information
Jefferson
X
Services for Latino/Vietnamese residents (including
translation services)
*
Jefferson
70072
X
Limited information dissemination
Adults involved with the
court system
RESOURCE AWARENESS AND HEALTH LITERACY
No restrictions
More Information
Pediatric Behavioral health (psychiatry, counseling,
etc.)
More Information
St. John the
Baptist
Substance abuse
*
70068
Services Provided
Mental health
Provides home healthcare and assistance with
independent living.
No restrictions
BEHAVIORAL HEALTH AND SUBSTANCE ABUSE
No restrictions
More Information
Pediatric Health Care
X
Population Served
Jefferson
Coordination of healthcare
X
Internet Information
70062
Transportation availability
*
Zip Code Column1
2200 Veterans Blvd., Suite 115
Kenner, LA 70062
Phone: (504) 466-1550 1 (888) 988-8088
40TH JUDICIAL DISTRICT ADULT St. John the Baptist 104 Ormond Blvd, Suite B
COURT OUTPATIENT
La Place, LA 70068
COUNSELING
Phone: (985)359-3315
A BEAM OF LIGHT
No restrictions
5201 WestBank Expressway
Marrero, LA 70072
Phone: (504) 328-1627 (866) 328-1627
A PIECE OF MIND CARE
No restrictions
116 Oak Lane Suite B
PROVIDER, INC
Luling, LA 70070
Phone: (985) 785-4451 (888) 900-4451
A+ PEOPLE SERVICES
No restrictions
12 A Westbank EXpressway Suite 204
Gretna, LA 70053
Phone: (504) 362-4866 (866) 294-5672
A-1 ABSOLUTE BEST CARE
No restrictions
401 Whitney Avenue, Suite 401
Gretna LA 70056
Phone Number: 504 368-0206
A-1 ABSOLUTE BEST CARE
No restrictions
534 East Airline Highway
La Place LA 70068
Phone Number: 985 651-6003
A-1 CUSTOMIZED COMPANION No restrictions
2100 Belle Chase Highway Suite C
CARE
Gretna, LA 70053
Phone: (504) 259-4628 (888) 321-2375
No restrictions
Albert Cammon Wellness Center
232 Pirate Drive
St Rose, LA 70087
(985) 308-6101
Cost of health insurance
Limited availability of medical professionals
Provides home healthcare. Children's Choice
Waiver. Greater New Orleans Area Application
Center for Medicaid.
Provides substance abuse services.
Counties Served Contact Information
No restrictions
Costly fees that may be unaffordable for some
residents
Limited availability of affordable preventive care
Organization/Provider
1ST CLASS CARE, EVERY TIME
ACCESS TO HEALTHCARE AND MEDICAL SERVICES
INVENTORY OF COMMUNITY RESOURCES AVAILABLE TO ADDRESS COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MHCNO CHNA
*
X
X
*
X
*
X
*
X
X
*
X
*
X
*
X
X
*
X
*
X
X
*
X
X
X
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X
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X
X
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X
X
X
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X
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*
X
X
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X
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X
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X
X
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X
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X
*
X
X
X
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X
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X
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X
X
X
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X
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X
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X
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X
X
X
*
X
*
X
*
X
X
*
X
X
X
*
X
*
X
*
X
X
X
*
X
X
X
*
X
*
X
*
X
X
X
X
X
No restrictions
St. Charles Community Health Center
16004 River Road
Norco, LA 70079
(985) 725-9330
70079
St. Charles
http://www.stcchc.org/
No restrictions
*
X
X
X
X
X
X
*
X
X
X
*
X
*
X
*
No restrictions
70065
Jefferson
No restrictions
*
X
X
X
X
X
X
*
X
X
X
*
X
*
X
*
No restrictions
200 W. Esplanade Avenue
Suites 305, 310, 413
Kenner, LA 70065
(504) 712-7800
843 Milling Avenue
Luling, LA 70070
(985) 785-5800
70070
St. Charles
No restrictions
*
X
X
X
X
X
X
*
X
X
X
*
X
*
X
*
No restrictions
853 Milling Avenue
Luling, LA 70070
(985) 785-5800
70070
St. Charles
No restrictions
*
X
X
X
X
X
X
*
X
X
X
*
X
*
X
*
ACCESS PREGNANCY AND
REFERRAL CENTERS
No restrictions
921 Aris Avenue, Ste. B
Metairie, LA 70005
(504) 832-1503
70065
Jefferson
http://accesspregnancy.com/access- Women
pregnancy-counseling-new-orleansmetairie/
*
X
X
X
X
*
X
*
X
*
X
*
Provides individualized support and referrals for
pregnancy-related concerns and application for
Medicaid. Professional counseling services are
available by referral.
X
X
X
78
No restrictions
Jefferson
More Information
No restrictions
2145 Rev. Richard Wilson Drive
Kenner, LA 70062
Phone: (504) 472-0068
1799 Stumpf Blvd., Bldg. 7, Suite 1
Gretna, LA 70056
Phone: (504) 368-4535
3200 Ridgelake Drive, Suite 100
Metairie, LA 70002
Phone: 504.581.4333
1141 Whitney Avenue Building 4
Gretna, LA 70056
P: 504-347-1120
925 Behrman Highway, Suite 14
Gretna, LA 70056
Phone: 504-433-8668
4200 S. I-10 Service Rd. West, Metairie, LA
504-889-0388
70062
Authentic Community Living,
Inc.
70056
Jefferson
http://dhh.louisiana.gov/index.cfm/ No restrictions
directory/detail/5375
Provides support services to individuals with
developmental disabilities.
*
70002
Jefferson
http://beaconbh.com.kntrl2.com/ab No restrictions
out-us
Provides behavioral and mental health care.
*
70056
Jefferson
https://new-orleanswestbank.bhgrecovery.com/
No restrictions
70056
Jefferson
Targets Vietnamese
population
70001
Jefferson
Provides access to services for Vietnamese
population. South Central Application Center for
Medicaid.
The BSA provides a program for young people
that builds character, trains them in the
responsibilities of participating citizenship, and
develops personal fitness.
BOAT PEOPLE SOS
No restrictions
BOY SCOUTS OF AMERICA
SOUTHEAST LOUISIANA
COUNCIL
Jefferson, Orleans,
Plaquemine, St.
John the Baptist, St.
Bernard, St.
Charles, St.
Tammany
BOYS & GIRLS CLUB OF
SOUTHEAST LOUISIANA
No restrictions
CANCER ASSOCIATION OF
GREATER NEW ORLEANS
No restrictions
CANON HOSPICE
No restrictions
CARE, INC
No restrictions
CELEBRATION HOPE CENTER
No restrictions
*
70003
Jefferson
http://alphacaresupport.com/5339. Individuals with
developmental disabilities
html
*
70121
Jefferson
www.cancer.org
Cancer patients and their
families
Provides community support services for
individuals with developmental delays/disabilities
and/or HIV.
Provides access to information and services for
cancer patients and their families.
70005
Jefferson
www.heart.org
No restrictions
Provides information and support relating to
diseases of the heart.
70068
St. John the
Baptist
http://www.angelcarela.com/Person No restrictions
al-Care-Services.html
*
X
X
X
70003
Jefferson
http://www.angelcarela.com/Person No restrictions
al-Care-Services.html
*
X
X
X
70001
Jefferson
www.arcgno.org/
X
X
Jefferson
Jefferson
www.arcgno.org/
www.arcgno.org/
www.bsa-selacouncil.org
Individuals with intellectual Arc provides various services throughout the
disabilities and their
entire community including Family Services
families.
Coordination, Respite, Personal Care,
Employment/Habitation and Supported Living
Assistance.
Adults with intellectual
Provides support for individuals to take part in
disabilities
volunteer projects and work at other non-profit
agencies and/or provides support and supervision
in various community and health and fitness
activities relevant to each individual’s interest.
Adults with intellectual
disabilities
No restrictions
Youth
Youth
Provides support for individuals to take part in
volunteer projects and work at other non-profit
agencies and/or provides support and supervision
in various community and health and fitness
activities relevant to each individual’s interest.
70053
Jefferson
More Information
70123
Jefferson
http://www.cagno.org/wp/services- Targets cancer patients and Patient services program can help cover the costs
their families
offered/
of prescription pain and treatment medications,
colostomy bags and comfort items (bedpads, etc.)
for cancer patients who cannot afford them.
Also, provides health education.
1221 S. Clearview Parkway, 4th Floor
Jefferson, LA 70121
(504)818-2723
3013 Highway 51, Suite A , La Place, LA 70068
Phone: (985) 653-7575 (800) 630-9883
FaX: (985) 653-4996
Email: Tsalinas@careinc.com
70121
Jefferson
http://www.canonhospice.com/
70068
St. John the
Baptist
http://www.careinc.com/Services/ta No restrictions
bid/56/Default.aspX
1901-B Airline Drive
Metairie, LA 70001
Phone: (504) 833-4673
70001
Jefferson
http://www.healingheartsnola.org/c No restrictions
hc/?page_id=19
*
X
*
X
*
X
X
X
X
*
X
*
X
X
X
X
X
X
X
X
*
X
X
X
*
X
X
Assisting individuals with daily living skills,
transportation, companionship, meal
preparation, personal hygiene, medication
reminders, social activities and light
housekeeping.
*
*
X
*
X
*
X
*
X
*
X
*
X
X
X
X
X
X
X
X
*
X
X
X
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X
X
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X
X
X
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X
X
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X
X
X
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X
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X
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X
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X
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X
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X
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X
X
X
X
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X
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*
X
X
X
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*
X
X
X
X
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X
X
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X
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X
X
X
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X
X
X
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X
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X
X
X
X
X
X
X
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X
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X
X
X
X
X
X
X
X
*
X
X
X
*
*
X
Club programs work to achieve three priority
outcomes: academic success, good character and
citizenship and healthy lifestyles.
Provides end of life care. South Central
*
X
Westbank Boys & Girls Club
900 Tenth Street
Gretna, LA 70053
504-368-3434
824 Elmwood Park Blvd., Suite 154
New Orleans, LA 70123
Phone: (504) 733.5539
No restrictions
*
*
X
Assurance Care Provider, LLC
Provides home healthcare.
X
X
70002
http://www.dhh.state.la.us/index.cf No restrictions
m/directory/detail/3139
*
X
Individual Options
3406 Hessmer Avenue
Metairie, LA 70002
504-267-7741
Jefferson
Provides alcohol and substance abuse treatment.
X
ARC OF GREATER NEW ORLEANS Jefferson, Orleans,
St. Bernard,
Plaquemines and St.
Tammany
70056
No restrictions
X
*
Healthy nutrition
70094
http://www.arrno.com/
X
Individual Options
333 Sala Avenue
Westwego, LA 70094
504-341-4414
Jefferson
*
ARC OF GREATER NEW ORLEANS Jefferson, Orleans,
St. Bernard,
Plaquemines and St.
Tammany
70001
X
Provides treatment of addictive disorders.
No restrictions
http://acercanhelp.com/services-2/
Jefferson
etc.)
70001
Substance abuse
Provides services and access to resources for
people with disabilities.
Mental health
Population Served
X
X
residents
X
Jefferson
X
70056
BHG NEW ORLEANS WESTBANK No restrictions
TREATMENT CENTER
Services Provided
*
1799 Stumpf Blvd., Bldg. 3 Suite 1 ,
Gretna, LA 70056
Phone: (504) 361-8807 (866) 363-8807
ADDICTION COUNSELING &
No restrictions
2321 North Hullen Street
EDUCATIONAL RESOURCES
Suite B
(ACER)
Metairie, LA 70001
504-941-7580
ADDICTION RECOVERY
No restrictions
4933 Wabash Street
RESOURCES
Metairie, LA 70001
1.866.399.HOPE (4673)
All America Personal Care, Inc. No restrictions
4232 Williams Blvd. Suite 109
Kenner, LA 70065
Phone: (504) 214-3940 (866) 364-1822
ALPHACARE SUPPORT
No restrictions
7809 Airline Drive Suite 210
COORDINATION, LLC
Metairie, LA 70003
Phone: 504-731-3100
AMERICAN CANCER SOCIETY
No restrictions
2605 River Road
NEW ORLEANS OFFICE
New Orleans, LA
504-469-0021
AMERICAN HEART ASSOCIATION No restrictions
110 Veterans Blvd., Suite 160
Metairie, LA
504-830-2300
ANGEL'S CARE, LLC
No restrictions
1317 Airline Hwy STE C
La Place, LA 70068
985-359-2162
ANGEL'S CARE, LLC
No restrictions
7809 Airline Drive, Suite 208 B
Metairie, LA 70003
Phone: (504) 739-1592 (866) 739-1592
ARC OF GREATER NEW ORLEANS Jefferson, Orleans, 925 S. Labarre Road
St. Bernard,
Metairie, LA 70001
Plaquemines and St. Phone: 504-837-5140
Tammany
BEACON BEHAVIORAL HOSPITAL No restrictions
Zip Code Column1
Accessibility Community Living, No restrictions
Inc.
X
*
X
X
X
*
*
X
X
X
*
*
*
X
X
*
*
X
X
*
X
79
CHILDREN'S HOSPITAL MEDICAL No restrictions
PRACTICE CORPORATION
(CHMPC)
(CHMPC)
(CHMPC)
Children
Provides pediatric health care and treatment of
minor illnesses and injuries after regular business
hours.
70072
Jefferson
More Information
Children
Provides primary and preventive pediatric health
care.
70001
Jefferson
More Information
Children
care.
70002
Jefferson
More Information
Children
care.
70001
Jefferson
More Information
Children
care.
70047
St. Charles
More Information
Children
care.
70006
Jefferson
More Information
Children
care.
70068
St. John the
Baptist
More Information
Children
care.
70123
Jefferson
More Information
70068
St. John the
Baptist
http://www.choicesla.com/services/ Adults
70094
Jefferson
More Information
Residents of Westwego
Multi-use playground facilities with organized
sports programs for youth. Contact our Park
Director, Brian Plaisance at 340-4440
Children
care.
Choices of Louisiana, Inc.
No restrictions
CITY OF WESTWEGO
Jefferson
DAUGHTERS OF CHARITY
HEALTH CENTER
No restrictions
111 N Causeway Blvd
Metairie, LA 70001
(504) 482-0084
70001
Jefferson
More Information
No restrictions
A federally qualified health center providing
primary, preventive, behavioral, pediatric and
dental health care. Greater New Orleans Area
DuraCARE Counseling &
Consulting Services, LLC
No restrictions
70002
Jefferson
http://duracarecounseling.com/servi No restrictions
ces/
Provides behavioral health, mental health, and
substance abuse services.
EAST JEFFERSON GENERAL
HOSPITAL
No restrictions
4323 Division Street, Suite 102
METAIRIE, LA 70002
Phone: (504) 327-5753
4200 Houma Blvd
Metairie, LA 70006-2996
(504) 454-4000
70006
Jefferson
http://www.ejgh.org/
No restrictions
Provides primary, preventive, emergency, mental
health and specialty care. Greater New Orleans
Area Application Center for Medicaid.
ERNEST J. TASSIN SENIOR
CITIZEN CENTER
Jefferson
701 Fourth Street
Westwego, LA 70094
(504) 309-6230
201 Evans Road
Building 1, Suite 100
Harahan, LA 70123
504-888-9111
70094
Jefferson
More Information
Senior residents of
Westwego
Provides recreation, nutrition, and transportation
to doctor appointments
70123
Jefferson
www.fhfjefferson.org
Residents of Jefferson Parish Provides individualized services, information,
that are disabled and their resources and support to positively enhance the
families.
independence, productivity and inclusion of
individuals with disabilities.
3525 N. Causeway #700 , Metairie, LA 70002
Phone: (504) 828-6070 (800) 770-0143
Email: familyhelpers@fhogno.com
1799 Stumpf Blvd, Building 5, Suite 3B
Gretna, LA 70056
Phone: 504.733-4031
201 Evans Road,Building 3, Suite 311
Harahan, LA 70123
Phone: 504.733.4031
4103 LAC Couture Drive
Harvey, LA 70058
Phone: (504) 368-9935
401 Whitney Avenue Suite 104 , Gretna, LA 70056
504-361-9950
info@gctfs.org
70002
Jefferson
Provides home healthcare. Medicaid application
site.
70056
Jefferson
More Information
No restrictions
70123
Jefferson
More Information
No restrictions
70058
Jefferson
http://www.gatewayrecovery.com/
Adult males
Provides behavioral health, mental health,
substance abuse, and counseling services for all
ages.
Provides behavioral health, mental health,
substance abuse, and counseling services for all
ages.
70056
Jefferson
http://www.gctfs.org/about_us.php Persons with disabilites
Provides services and access to resources for
people with disabilities.
2100 Belle Chasse Highway
Gretna, LA 70053
Phone: (504) 367-6630
70053
Jefferson
More Information
FAMILIES HELPING FAMILIES OF Jefferson
JEFFERSON INC.
FAMILY HELPERS OF GREATER
NEW ORLEANS
No restrictions
FAMILY SERVICE OF GREATER
NEW ORLEANS
No restrictions
FAMILY SERVICE OF GREATER
NEW ORLEANS
No restrictions
Gateway Recovery Systems
No restrictions
GULF COAST SOCIAL SERVICES
Orleans,
Plaquemines, St.
Bernard, Jefferson
Holistic Educational
Rehabilitation Center
No restrictions
No restrictions
X
*
X
*
*
X
X
*
X
*
X
*
X
X
*
X
*
X
X
*
X
X
*
X
*
X
X
X
*
X
X
*
X
*
X
X
X
X
*
X
X
*
X
*
X
X
X
X
X
*
X
X
*
X
*
X
X
X
X
X
*
X
X
*
X
*
X
X
X
X
X
*
*
X
X
X
X
X
X
*
X
X
X
X
X
*
X
X
X
X
*
X
X
X
*
X
X
*
X
*
X
X
etc.)
*
Substance abuse
X
Mental health
X
*
X
X
*
X
*
*
*
X
X
X
X
X
X
X
X
X
*
X
X
X
*
X
*
X
*
X
X
X
*
X
*
X
*
*
X
X
X
X
X
X
X
X
X
*
X
*
X
*
*
X
X
*
X
X
X
*
X
Healthy nutrition
X
X
*
X
*
More Information
residents
Jefferson
70001
Services Provided
Provides non-emergency medical transportation.
(CHMPC)
Children’s Hospital After Hours
3040 33rd Street (Located at I-10 and Causeway, next
to the Galleria)
Metairie, LA 70001
Phone (504) 837-7760
Kids First Westbank
829 Barataria Blvd.
Marrero, LA 70072
(504) 368-7337
Lakeside Pediatrics
4740 S I-10 Service Road
Metairie, LA 70001
(504) 883-3703
Metairie Pediatrics
2201 Veteran's Blvd., Suite 300
Metairie, LA 70002
Phone: (504) 833-7374
Napoleon Pediatrics - Metairie
3040 33rd Street
Metairie, LA 70001
(504) 219-0880
Ormond Pediatrics
141 Ormond Center Court
Destrehan, LA 70047
(985) 764-7337
Pelican Pediatric Physicians
3100 Kingman Street, Suite 110
Metairie, LA 70006
(504) 887-6355
Pelican Pediatric Physicians
501 Rue de Sante
Suite 13
La Place, LA 70068
(985) 652-6359
Physicians of River Ridge
9605 Jefferson Highway, Suite E
River Ridge, LA 70123
(504) 738-1604
128 Woodland Drive
La Place, LA 70068
Phone: (985) 651-3777
419 Avenue A ,
Westwego, LA
504-341-3424
Population Served
No restrictions
(CHMPC)
(CHMPC)
Jefferson
(CHMPC)
Zip Code Column1
(CHMPC)
70058
(CHMPC)
2112 Saulet Place
Harvey, LA 70058
(504) 415-7948
Jefferson, Orleans,
Plaquemines, St.
Bernard
CHEATAM MEDICAL TRANSIT
X
X
X
X
*
X
*
X
*
X
X
X
X
*
X
X
X
*
X
X
*
*
X
X
X
*
X
X
*
*
X
X
X
X
X
*
X
*
X
*
X
X
80
X
*
JEFFERSON COMMUNITY
ACTION PROGRAMS (JEFFCAP)
JEFFERSON COMMUNITY
JEFFERSON COMMUNITY
JEFFERSON COMMUNITY
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
70094
Jefferson
http://www.jeffparish.net/index.asp Residents of Jefferson Parish Centers provide emergency assistance for rent,
x?page=416
utilities and medical services. Centers distribute
commodities provided by USDA, FEMA and the
Food Box. Citizens can rent the facilities for
nominal fees. They also host Recreational, Senior,
Youth Development and Civic Association
meetings; income tax assistance and cultural
activities are also offered. South Central
70003
Gretna Community Center
1700 Monroe Street
Gretna, LA 70056
Telephone: (504) 376-2130
70056
Harvey Community Center
1501 Estalote Street
Harvey, LA 70058
Telephone: (504) 227-1221
70058
Hazel Rhea Hurst Community Center
1121 S. Causeway Blvd.
Jefferson, LA 70121
Telephone: (504) 838-4277
70121
J C Simmons Community Center
4008 U.S. Highway 90
Avondale, LA 70094
Telephone: (504) 349-5414
70094
Marrero Community & Senior Center
1861 Ames Blvd.
Marrero, LA 70072
Telephone: (504) 349-5950
70072
Barataria/Lafitte Head Start
Sharlene Adams, Center Supervisor
4977 City Park Road
Lafitte, LA 70067
Telephone: (504)689-3384
70067
Beechgrove Head Start
(Vacant), Center Supervisor
721 Tricia Court
Westwego, LA 70094
Telephone: (504)437-4852
70094
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
x?page=416
activities are also offered. Greater New Orleans
x?page=416
activities are also offered.
x?page=416
x?page=416
activities are also offered. Greater New Orleans
x?page=416
activities are also offered.
x?page=416
http://www.jeffparish.net/index.asp Residents of Jefferson Parish The program establishes a supportive learning
x?page=417
environment for children, parents, and staff;
giving them enhanced awareness, refined skills,
and increased understanding of values. Head
Start embraces a comprehensive vision of
healthcare for children and families.
x?page=417
X
*
X
X
*
*
X
X
X
X
*
X
X
*
*
X
X
X
X
*
X
X
*
*
X
X
X
X
*
X
X
*
*
X
X
X
X
*
X
X
*
*
X
X
X
X
*
X
X
*
*
X
X
X
X
*
X
X
*
X
X
X
*
etc.)
Substance abuse
Mental health
residents
*
JEFFERSON COMMUNITY
Jefferson
Services Provided
Healthy nutrition
JEFFERSON COMMUNITY
Jefferson
Dorothy B. Watson Community Center
1300 S. Myrtle Street
Metairie, LA 70003
Telephone: (504) 736-6480
No restrictions
JEFFERSON COMMUNITY
Jefferson
Population Served
More Information
JEFFERSON COMMUNITY
Jefferson
Jefferson
Zip Code Column1
70001
JEFFERSON COMMUNITY
3616 I-10 Service Road South
Metairie, LA 70001
Phone: (504) 838-5257
Bridge City Community Center
301 Third Emanuel Street
Bridge City, LA 70094
Telephone: (504) 349-5464
Jefferson
Jefferson Addictive Disorders
Clinic
X
*
X
X
X
X
X
X
*
X
X
X
X
*
X
X
X
*
*
X
X
X
X
X
X
*
X
X
X
X
*
X
X
X
*
81
70072
Terrytown-Gretna Head Start
Gloria McKenzie, Center Supervisor
2315 Park Place
Gretna, LA 70056
Telephone: (504)392-9890
70056
Jefferson
Jefferson
x?page=417
x?page=417
x?page=417
JEFFERSON COMMUNITY
HEALTH CARE CENTERS
No restrictions
11312 Jefferson Highway
River Ridge, LA 70123
(504) 463-3002
70123
Jefferson
More Information
No restrictions
JEFFERSON COMMUNITY
HEALTH CARE CENTERS
No restrictions
70072
Jefferson
More Information
No restrictions
JEFFERSON COMMUNITY
HEALTH CARE CENTERS
No restrictions
1855 Ames Boulevard
Marrero, LA 70072
(504) 371-8958
3932 U.S. Highway 90
Avondale, LA 70094
504.436.2223
70094
Jefferson
More Information
JEFFERSON COMMUNITY
HEALTH CARE CENTERS
No restrictions
5140 Church Street
Lafitte, LA 70067
504.349.6525
6620 Riverside Dr. Ste 107
Metairie LA 70003
Phone: (504) 888-5880
70067
Jefferson
More Information
70003
Jefferson
http://www.jcoa.net/about
3616 S. I-10 Service Road
Metairie, LA 70001
504-838-5257 Adults
504-838-5002 Child/Adolescents
70001
Jefferson
More Information
5001 West Bank Expway, Marrero, LA 70072
504-349-8708 Adults
504-349-8755 Child/Adolescents
1000 West Esplanade Ave.
Metairie, LA 70005
(504) 838-4375
102 Willow Dr.
Gretna, LA 70053
(504) 364-2716
125 Acadia Dr.
Waggaman, LA 70094
(504) 736-8475
143 Ludwig Lane
Grand Isle, LA 70358
(985) 787-3450
70072
Jefferson
More Information
70005
Jefferson
http://www.jplibrary.net/
70053
Jefferson
70094
Jefferson
70358
Jefferson
JEFFERSON COUNCIL ON AGING, Jefferson
INC.
JEFFERSON PARISH HUMAN
SERVICES AUTHORITY
Jefferson
JEFFERSON PARISH HUMAN
SERVICES AUTHORITY
Jefferson
JEFFERSON PARISH LIBRARY
Jefferson
Jefferson
Jefferson
Jefferson
Federally qualified health center providing
primary, preventive, behavioral and dental health
care for adults and children. Greater New
Orleans Area Application Center for Medicaid.
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etc.)
X
Substance abuse
X
Mental health
X
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Lapalco Head Start
Antoinette Davis, Center Supervisor
2001 Lincolnshire Drive
Marrero, LA 70072
Telephone: (504)349-5185
Jefferson
Healthy nutrition
70062
x?page=417
Kenner Head Start
Linda Morris, Center Supervisor
200 Decatur Street
Kenner, LA 70062
Telephone: (504)736-8770
Jefferson
70058
x?page=417
Jutland Head Start
Chanel Davis, Center Supervisor
1821 Jutland Drive
Harvey, LA 70058
Telephone: (504)349-5500
Jefferson
x?page=417
Jefferson
70358
Services Provided
JEFFERSON COMMUNITY
Jefferson
Grand Isle Head Start
(Grand Isle Public School)
Sharlene Adams, Center Supervisor
149 Ludwig Lane
Grand Isle, LA 70358
Telephone: (504)689-3384
Jefferson
Population Served
JEFFERSON COMMUNITY
Jefferson
70062
x?page=417
JEFFERSON COMMUNITY
Jefferson
Clay Street Head Start
(Washington Elementary School)
Linda Morris, Center Supervisor
606 Clay Street
Kenner, LA 70062
Telephone: (504)736-8770
Jefferson
residents
JEFFERSON COMMUNITY
Jefferson
70002
JEFFERSON COMMUNITY
Jefferson
Zip Code Column1
Causeway Head Start
Lisa Mitchell, Center Supervisor
3420 N. Causeway Blvd.
Suite B
Metairie, LA 70002
Telephone: (504)838-1000
JEFFERSON COMMUNITY
Jefferson
JEFFERSON COMMUNITY
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care for adults and children.
No restrictions
care for adults and children. South Central
No restrictions
care for adults and children.
Seniors of Jefferson Parish Provides programs for seniors including access to
social services, wellness, transportation,
nutrition, recreation, physical activity and social
opportunities.
Residents of Jefferson Parish Jefferson Parish Human Services Authority
(JPHSA) is the public service provider for mental
health, addictive disorders, and developmental
disabilities services in Jefferson parish.
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Residents of Jefferson Parish A federally qualified health center providing
mental health and substance abuse services for
adults and children.
Residents of Jefferson Parish Provides educational programing for all ages,
community activities, meeting rooms, internet
access, and health awareness.
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82
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
JEFFERSON PARISH PUBLIC
SCHOOL SYSTEM
Jefferson
JEFFERSON TRANSIT
Jefferson
MAGNOLIA COMMUNITY
SERVICES
No restrictions
MARCH OF DIMES - METRO
NEW ORLEANS DIVISION
No restrictions
MERCY FAMILY CENTER
No restrictions
MMO BEHAVIORAL HEALTH
SYSTEM
No restrictions
NEW ORLEANS CHILDRENS
HEALTH PROJECT
Orleans
OCHSNER HEALTH SYSTEM
No restrictions
No restrictions
No restrictions
No restrictions
No restrictions
No restrictions
70001
Jefferson
70058
Jefferson
70121
Jefferson
70001
Jefferson
70067
Jefferson
70072
Jefferson
70065
Jefferson
70094
Jefferson
70003
Jefferson
70056
Jefferson
70123
Jefferson
70058
Jefferson
21 Westbank Exp
Gretna LA 70053
Phone: (504) 364-3450
100 Central Avenue
Jefferson, LA 70121
Phone: (504) 731-1371 (866) 266-1612
70053
Jefferson
70121
Jefferson
3000 26th Street, Suite 100,
Metairie, LA
(504) 836-2087
110 Veterans Memorial Blvd., Suite 425
Metairie, LA 70005
(504) 838-8283
70002
Jefferson
70005
Jefferson
More Information
No restrictions
4429 Shores Drive
Metairie, LA 70006
Ph: 504.267.6028
Hispanic Resource Center
4312 Florida Ave.
Kenner, LA 70065
70006
Jefferson
http://www.mmoinc.com/services
Adults
70065
Jefferson
http://www.nochp.org/services/heal Children
th-services
Provides primary, preventive, and mental health
care, asthma & allergy services, weight
management & education, and health education.
Lieselotte Tansey Breast Center at Ochsner
Phone: 504-842-6406
Ochsner Center for Primary Care and Wellness
Phone: 504-842-4747
Ochsner Health Center - Destrehan Family Health
159 Longview Drive
Destrehan, LA 70047
Phone: 985-764-7669
70121
Jefferson
More Information
No restrictions
Provides health care services for detection and
treatment of breast disease.
70121
Jefferson
More Information
No restrictions
Provides primary, preventive and specialty health
care.
70047
St. Charles
More Information
No restrictions
Provides primary and preventive health care.
Ochsner Health Center - Driftwood
2120 Driftwood Blvd.
Kenner, LA 70065
Phone: 504-443-9500
Ochsner Health Center - Elmwood
1221 S. Clearview Pkwy.
Harahan, LA 70121
Ochsner Health Center - Gretna
441 Wall Blvd.
Gretna, LA 70056
Phone: 504-371-6550
70065
Jefferson
More Information
No restrictions
Provides primary, preventive, and specialty care.
Also, provides nutrition education and
information.
70121
Jefferson
More Information
No restrictions
care.
70056
Jefferson
More Information
No restrictions
Adults with intellectual and We offer supports and services in nineteen group
other developmental
homes, supported community living, a
disabilities.
vocational/day habilitation program, and
supported employment.
http://www.marchofdimes.com/loui Pregnant women and
Provide support to pregnant women to ensure
newborns
siana/
best outcome for both mother and baby.
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Healthy nutrition
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etc.)
Substance abuse
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X
http://www.mcsnola.org/programs/
Provides outpatient counseling, psychiatry,
educational services and school based mental
health services to children, youth, and adults.
Greater New Orleans Area Application Center for
Medicaid.
Provides behavioral and mental health care.
residents
X
Jefferson
Services Provided
Residents of Jefferson Parish Provides virtual access to information, health
research, online news and events, and free
internet access.
http://jpschools.org/departments/ Residents of Jefferson Parish Provides youth education, nutrition, opportunities
for physical activity, health education, health
assessments, health screenings, and English as a
second language program and translation
services.
http://www.jeffersontransit.org/def Jefferson Parish
Provides public transportation and special
ault.php
paratransit services.
Population Served
Jefferson
Jefferson
70123
Zip Code Column1
219 Soniat Ave.
Harahan, LA 70123
(504) 736-8745
2350 Metairie Rd.
Metairie, LA 70001
(504) 838-4353
2751 Manhattan Blvd.
Harvey, LA 70058
(504) 364-2660
4036 Jefferson Hwy.
Jefferson, LA 70121
(504) 838-4350
4747 West Napoleon Ave.
Metairie, LA 70001
(504) 838-1190
4917 City Park Drive
Lafitte, LA 70067
(504) 689-5097
5550 Belle Terre Rd.
Marrero, LA 70072
(504) 349-5910
630 West Esplanade Ave.
Kenner, LA 70065
(504) 736-8730
635 Fourth St.
Westwego, LA 70094
(504) 349-5912
6646 Riverside Drive
Metairie, LA 70003
(504) 838-1193
680 Heritage Ave.
Terrytown, LA 70056
(504) 364-2717
E-branch
128 Sauve Road, River Ridge, LA 70123
736-6455
501 Manhattan Blvd
Harvey, LA 70058
Phone: 504-349-7600
Jefferson
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83
No restrictions
No restrictions
No restrictions
No restrictions
No restrictions
No restrictions
No restrictions
No restrictions
No restrictions
RELIABLE COMMUNITY
ALTERNATIVES, INC.
No restrictions
RELIABLE COMMUNITY
ALTERNATIVES, INC.
No restrictions
St. Charles
More Information
No restrictions
Provides primary, preventive, and specialty care.
70002
Jefferson
More Information
No restrictions
Provides primary, preventive, specialty and
urgent health care. Also, provides nutrition
education and information.
70068
St. John the
Baptist
More Information
No restrictions
Provides primary, preventive, specialty,
emergency health care.
70056
Jefferson
More Information
No restrictions
psychiatric and mental health care.
70047
St. Charles
More Information
Children
Provides pediatric health care.
70006
Jefferson
More Information
Children
Provides pediatric health care.
70121
Jefferson
More Information
Children
Provides specialty pediatric care.
Ochsner Hospital For Children
Phone: 1-866-OCHSNER
Ochsner Kenner Medical Office Building - Ochsner
Health Clinics
200 West Esplanade Avenue
Kenner, LA 70065
Phone: 504-443-9500
Ochsner Medical Center - Kenner
Kenner, LA 70065
Phone: 504-443-9500
Ochsner Medical Center - West Bank Campus
2500 Belle Chasse Highway
Gretna, LA 70056
Phone: 504-392-3131
Ochsner Medical Center
Ochsner Medical Complex – River Parishes
500 Rue de Santé
La Place, LA 70068
Phone: 985-652-7000
St. Charles Parish Hospital
1057 Paul Maillard Rd.
Luling, LA 70070
Phone: 985-785-6242
The Gayle and Tom Benson Cancer Center
151 Almedia Rd, Suite 6
St. Rose, LA 70087
Office (985) 465-5322
5416 Veterans Memorial Boulevard
Suite 315
Metairie, LA 70003
Office (504) 779-4740
70121
Jefferson
More Information
Children
Provides primary, preventive, specialty and
emergency health care for children.
70065
Jefferson
More Information
No restrictions
Provides preventive and specialty health care.
70065
Jefferson
More Information
No restrictions
Provides primary, preventive, specialty, and
70056
Jefferson
More Information
No restrictions
Provides primary, preventive, behavioral, mental,
specialty, and emergency health care.
70121
Jefferson
More Information
No restrictions
emergency health care. Greater New Orleans
70068
St. John the
Baptist
More Information
No restrictions
70070
St. Charles
More Information
No restrictions
70121
Jefferson
More Information
No restrictions
psychiatric and mental, and emergency health
care. Also provides nutrition education and
information.
Provides health care services for detection and
treatment of cancer.
70087
St. Charles
http://rcainc.net/services.htm
No restrictions
Provides personal care. Application Center for
Medicaid.
70003
Jefferson
http://rcainc.net/services.htm
No restrictions
Provides personal care. Application Center for
Medicaid.
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70070
No restrictions
Provides primary, preventive, specialty, pediatric,
pediatric specialty and urgent health care.
No restrictions
Healthy nutrition
No restrictions
More Information
Jefferson
No restrictions
70072
No restrictions
No restrictions
etc.)
More Information
Substance abuse
No restrictions
St. John the
Baptist
Mental health
70068
No restrictions
care.
No restrictions
No restrictions
Services Provided
More Information
Population Served
Jefferson
residents
No restrictions
70065
Zip Code Column1
Ochsner Health Center - Kenner
Kenner, LA 70065
Phone: 504-464-8506
Ochsner Health Center - La Place Medical
735 W. 5th Street
La Place, LA 70068
Phone: 985-652-9504
Ochsner Health Center - Lapalco
4225 Lapalco Blvd.
Marrero, LA 70072
Phone: 504-371-9355
Ochsner Health Center - Luling
1057 Paul Maillard Rd.
Luling, LA 70070
Phone: 985-785-3740
Ochsner Health Center - Metairie
2005 Veterans Memorial Blvd.
Metairie, LA 70002
Phone: (504) 836-9820
Ochsner Health Center – River Parishes
502 Rue de Santé
La Place, LA 70068
Phone: 985-652-3500
Ochsner Health Center - West Bank
120 Meadowcrest Street
Gretna, LA 70056
Phone: 504-371-9355
Ochsner Health Center For Children - Destrehan
1970 Ormond Blvd.
Destrehan, LA 70047
Phone: 985-764-6036
Ochsner Health Center For Children - Metairie
4901 Veterans Memorial Blvd.
Metairie, LA 70006
Phone: 504-887-1133
Ochsner Health Center For Children - New Orleans
Phone: 504-842-3900
No restrictions
RESOURCES FOR HUMAN
DEVELOPMENT
RESOURCES FOR HUMAN
DEVELOPMENT
RESOURCES FOR HUMAN
DEVELOPMENT
Jefferson
No restrictions
Jefferson, Orleans
RESOURCES FOR HUMAN
DEVELOPMENT
Jefferson, Orleans
RESOURCES FOR HUMAN
DEVELOPMENT
Jefferson, Orleans
RESOURCES FOR HUMAN
DEVELOPMENT
No restrictions
RESPONSIABILTIY HOUSE
No restrictions
70058
JPHSA Pathways Phase I
1901 West Bank Expressway
Suite 550
Harvey, LA 70058
Phone: 504-376-2524
70058
Family House Louisiana
112 Holmes Blvd., Bldg. B, Apt. 1
Terrytown, LA 70056
Phone: (504) 367-7600
70056
Assertive Community Treatment Team 2
Suite 550
Harvey, LA 70058
Phone: 504-247-9120
70058
Suite 550
Harvey, LA 70058
Phone: 504-247-9120
Assertive Community Treatment Team 1
Suite 550
Harvey, LA 70058
Phone: 504-247-9120
151 Meadowcrest Street, Suite C
Gretna , LA 70056
Phone: (504) 361-9573
1799 Stumpf Blvd., Bldg. 7, Ste. 4
Terrytown, LA 70056
Phone: (504) 367-4426
Jefferson
Jefferson
Jefferson
Jefferson
Jefferson
http://www.rhd.org/Program.aspx? Pregnant women and
women with children
pid=48
Phase I provides permanent supportive housing
for homeless, mentally ill and/or chemically
dependent individuals. The program's capacity is
16 (unaccompanied men and women) for
Jefferson Parish residents. RHD administers
Pathways on behalf of the Jefferson Parish
Human Services Authority.
Family House is a residential substance abuse
treatment program for pregnant women and
women with children. While at Family House,
women receive individual therapy, individual
parenting, and groups that include: substance
abuse education, parenting education, trauma,
feelings process, life skills and much more.
http://www.rhd.org/Program.aspx? Consumers in Jefferson
The ACT Program provides community based
Parish and the Greater New services to individuals with severe and persistent
pid=7
Orleans area
mental illness. Their mental illness may also be
accompanied by a substance abuse disorder
and/or a developmental disability. ACT is an
evidenced based, recovery oriented service
delivery model that provides a holistic,
multidisciplinary approach of consumer care. ACT
support services are not time bound. The primary
goals of the program are to lessen or eliminate
the debilitating symptoms of mental illness each
consumer experiences, minimize or prevent
recurrent acute episodes of the illness and to
enhance quality of life and functioning.
70058
Jefferson
http://www.rhd.org/Program.aspx? Adult residents of Jefferson Provides community based services to individuals
Parish and Greater New
pid=8
with severe and persistent mental illness.
Orleans
70058
Jefferson
http://www.rhd.org/Program.aspx? Consumers in Jefferson
The ACT Program provides community based
Parish and the Greater New services to individuals with severe and persistent
pid=8
Orleans area
mental illness. Their mental illness may also be
accompanied by a substance abuse disorder
and/or a developmental disability. ACT is an
evidenced based, recovery oriented service
delivery model that provides a holistic,
multidisciplinary approach of consumer care. ACT
support services are not time bound. The primary
goals of the program are to lessen or eliminate
the debilitating symptoms of mental illness each
consumer experiences, minimize or prevent
recurrent acute episodes of the illness and to
enhance quality of life and functioning.
70056
Jefferson
More Information
70056
Jefferson
http://www.responsibilityhouse.org/ No restrictions
contact_us0.aspx
Adults in the Greater New
Orleans area
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X
X
*
X
X
X
X
*
X
X
*
X
X
X
X
*
X
X
*
X
X
X
X
*
X
*
X
*
X
X
85
X
X
X
X
Healthy nutrition
*
X
X
etc.)
Substance abuse
*
Mental health
Pathways-Phase II is a supervised independent
living program for adults with a severe and
persistent mental illness or a co-occurring
disorder with mental illness as primary. The
program provides 10 beds (men and women) for
Jefferson Parish residents. RHD administers
Pathways on behalf of the Jefferson Parish
Human Services Authority.
http://www.rhd.org/Program.aspx? Homless of Jefferson Parish Provides support case management, van
pid=126
transportation, bus tokens, community education
and awareness, clothing, water, snacks, and
blankets and housing referrals to homeless
individuals in Jefferson Parish.
http://www.rhd.org/Program.aspx? Women
RHD's Focused Outreach Case Management
pid=2253
Program empowers and supports women who
are involved with the criminal justice system and
Department of Children and Family Services as a
result of their struggles with substance abuse.
The overall aim of services is to promote and
support individual recovery utilizing a
comprehensive, empowerment, and strengthsbased approach. The program supports
treatment rather than incarceration and keeping
families together and children out of state
custody. The Focused Outreach Case
Management Program includes LA-SAFE and
Reach-In CARE services.
http://www.rhd.org/Program.aspx? Jefferson Parish
pid=4
residents
Services Provided
Population Served
No restrictions
70001
http://www.rhd.org/Program.aspx? Jefferson Parish
pid=111
RESOURCES FOR HUMAN
DEVELOPMENT
Project Reach
2121 Ridgelake Avenue
Suite 206B
Metairie, LA 70001
Phone: 504-832-5123
RIC/LA-SAFE Focused Outreach Case Management
Program
Suite 550
Harvey, LA 70058
Phone: 504-376-2524
Jefferson
Jefferson
70058
RESOURCES FOR HUMAN
DEVELOPMENT
Zip Code Column1
JPHSA Pathways Phase II
Suite 550
Harvey, LA 70058
Phone: 504-376-2524
Jefferson
RESOURCES FOR HUMAN
DEVELOPMENT
70123
ST. CHARLES COUNCIL ON
AGING, INC
St. Charles
ST. CHARLES PARISH
St. Charles
ST. CHARLES PARISH LIBRARY
St. Charles
RIVER PARISHES TRANSIT
AUTHORITY
RIVER PARISHES TRANSIT
AUTHORITY
SEASIDE HEALTH CARE
SEASIDE HEALTH CARE
SOUTH CENTRAL LOUISIANNA
HUMAN SERVICES AUTHORITY
ST ROSE COMMUNITY CENTER
ST. JOHN ARC
Jefferson
70068
http://www.riveroakshospital.com/
No restrictions
http://rptarolls.org/
Residents of St. Charles and Provides public transportation services.
St. John the Baptist Parishes
*
X
No restrictions
*
X
www.rptarolls.org
70056
Jefferson
http://www.seasidehc.com/seaside- Adults
behavioral-center-locations/
Partial hospitalization and intensive outpatient
programs for patients 18 and older.
70006
Jefferson
http://www.seasidehc.com/seaside- Adults
behavioral-center-locations/
Inpatient program offering adult psychiatric
services for patients 30 and older.
70068
St. John the
Baptist
http://www.sclhsa.org/
Residents of Lafourche, St.
Charles, St. John, and
Terrebonne Parishes
Provides primary health care, addictive disorder,
developmental disability and mental health
services for adults and children.
*
X
X
X
X
70068
St. John the
Baptist
Terrebonne Parishes
*
X
X
X
70068
St. John the
Baptist
Terrebonne Parishes
*
X
X
X
70087
St. Charles
http://www.stcharlesparishla.gov/departments/communityservices/st-rose-community-center
Residents of St. Charles
Parish
Drop-in center for at-risk youth.
626 Pine St., Suite A
Hahnville LA 70057
Phone: (985) 783-6683
70057
St. Charles
http://www.stcharlescoa.com/home Seniors
.html
Department of Community Services
14564 River Road
New Sarpy, LA 70078
Phone: 9857647944
70078
St. Charles
http://www.stcharlesparishla.gov/departments/communityservices/programs-and-services
105 Lakewood Drive
P.O. Box 949
Luling, LA 70070
Phone: (985) 785-8471
St. Charles
14996 River Road, Suite A
P.O. Box 444
Hahnville, LA 70057
Phone: (985) 783-2341
St. Charles
160 West Campus Drive
P.O. Box 759
Destrehan, LA 70047
Phone (Circulation): (985) 764-2366
St. Charles
197 Good Hope Street
Norco, LA 70079
Phone: (985) 764-6581
St. Charles
307 Audubon Street
Paradis, LA 70080
Phone: (985) 758-1868
St. Charles
90 East Club Drive
St. Rose, LA 70087
Phone: (504) 465-0646
St. John the Baptist 101 Bamboo Rd
La Place, LA 70068
Phone: (985) 652-8003
70070
St. Charles
http://www.myscpl.org/branches.ht Residents of St. Charles
Parish
ml
Provides educational programing for all ages,
70057
St. Charles
Parish
ml
70047
St. Charles
Parish
ml
70079
St. Charles
Parish
ml
70080
St. Charles
http://www.myscpl.org/branches.ht
ml
70087
St. Charles
http://www.myscpl.org/branches.ht
ml
70068
St. John the
Baptist
http://www.thearc.org/page.aspx?pi
d=2191&reid=sG7tmOpNm%2fw%3
d&bbsys=0&bbrt=0
ST. JOHN PARISH LIBRARY
Parish
Parish
entire community including transportation,
families.
Family Services Coordination, Respite, Personal
Care, Employment/Habitation and Supported
Living Assistance.
St. John the Baptist 111 Historic Front Street
Garyville, LA 70051
Phone Number: 985-535-6868
St. John the Baptist 170 West 10th Street
Reserve, LA 70084
St. John the Baptist 2920 Highway 51
LaPlace, LA 70068
St. John the Baptist 2979 Highway 18
Edgard, LA 70049
ST. JOHN THE BAPTIST COUNCIL St. John the Baptist 214 Regala Park Rd.
ON AGING
Reserve, LA 70084
985-479-0272
70051
St. John the
Baptist
http://stjohn.lib.la.us/
Residents of St. John the
Baptist Parish
70084
St. John the
Baptist
Baptist Parish
70068
St. John the
Baptist
Baptist Parish
70049
St. John the
Baptist
Baptist Parish
70084
St. John the
Baptist
http://www.sjbparish.com/services_ Seniors
general.php?id=76
TECHE ACTION CLINIC
70049
St. John the
Baptist
http://www.tabhealth.org/services
No restrictions
159 East Third Street
Edgard, LA 70049
Ph: (985) 497-8726
No restrictions
Provides programs for seniors including access to
opportunities.
Provides primary, preventive, behavioral, and
women's health care, health education, nutrition
education, and access to WIC and Medicaid.
*
X
X
X
*
*
X
X
X
X
X
X
Healthy nutrition
X
X
*
X
*
X
X
*
X
X
X
*
X
X
X
*
X
X
X
*
X
X
*
X
X
*
X
X
X
*
X
X
X
*
X
X
*
X
X
*
X
X
X
*
X
X
X
*
X
X
*
*
X
X
X
*
X
X
X
*
*
X
X
X
X
*
X
X
X
*
*
X
X
X
X
*
X
X
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
*
X
X
X
X
*
X
*
X
X
X
X
*
X
*
X
X
X
X
X
etc.)
Substance abuse
Mental health
X
*
St. John the
Baptist
Provides programs for seniors including access to
opportunities.
Access point for community services. Provides
emergency financial assistance, food pantry,
information on services, and referrals. South
Central Application Center for Medicaid.
*
X
70069
Parish
Public transportation and paratransit services
*
Services Provided
Provides mental healthcare.
Population Served
residents
Zip Code Column1
1525 River Oaks Rd W
New Orleans, LA 70123-2199
(504) 734-1740
St. Charles, St. John 149 Woodland Dr.
the Baptist
LaPlace, LA 70068
Phone: (504) 304-2000
St. Charles
P.O. Box 2444
La Place, LA
877-651-1171
No restrictions
229 Bellemeade Blvd.
Gretna, LA 70056
(504) 391-2440
No restrictions
4200 Houma Blvd, 4th floor
Metairie, LA 70006
(504) 503-4900
Lafourche, St.
River Parishes Assessment Center
Charles, St. John,
421 Airline Highway Suite L
and Terrebonne
La Place, LA 70068
Phone: 985.651.7064
Lafourche, St.
River Parishes Behavioral Health Center
Charles, St. John,
1809 W. Airline Highway
and Terrebonne
La Place, LA 70068
Phone: 985.652.8444
Lafourche, St.
River Parishes Children and Adolescent Center
Charles, St. John,
421 Airline Highway, Suite L
and Terrebonne
La Place, LA 70068
Phone: 985.651.7064
St. Charles
608 Mockingbird Lane
St. Rose, LA 70087
Phone: (504) 305-5138
No restrictions
River Oaks Hospital
X
*
X
X
X
X
X
X
*
X
X
X
X
X
X
X
X
*
X
*
X
*
X
X
X
X
X
X
X
X
*
*
86
http://www.arcofstcharles.com/
entire community including transportation,
families.
Family Services Coordination, Respite, Personal
Care, Employment/Habitation and Supported
Living Assistance.
3616 S I-10 Service Road W.
Metairie, LA 70001
Phone: 504.349.8748
JPHSA Clinic
5001 Westbank Expressway
Marrero, LA 70072
Phone: 504.349.8748
P. O. Box 200 170 Ludwig Lane
Grand Isle LA 70358
Phone: (985) 787-3196
Behavioral Health Clinic – Metairie
4641 Fairfield St., Suite F
Metairie, LA 70006
(504) 988-7250
Tulane Center for Women's Health
4720 South I-10 Service Road, Suite 300
Metairie, LA 70001
504-988-8070
Tulane-Lakeside Hospital
4700 South I-10 Service Road West
Metairie, LA 70001
504-780-8282
1111 Medical Center Blvd.
Suite S-850
Marrero, LA 70072
Phone: 504.347.5511
Grand Isle Multiplex
3101 Louisiana Highway 1
Grand Isle, LA, 70358
Lapalco Clinic
3909 Lapalco Blvd.
Suite 100
Harvey, LA 70058
504.349.6900
Manhattan Clinic
2845 Manhattan Blvd.
Harvey, LA 70058
504.349.6930
Oakwood Clinic
175 Hector Avenue
Gretna, LA 70056
504.349.6925
701 4th Street
Westwego LA 70094
Phone: 504-328-3664
6691 Riverside Drive
Metairie, LA
504-888-9622
150 Cleveland Avenue
Slidell, LA 70438
Client Services: 985-643-5746
314 & 316 Austin Street
Bogalusa, LA 70427
Client Services: 985-735-1687
911 Washington Street
Franklinton, LA 70438
Office: 985-839-4090
70001
Jefferson
http://www.temsela.org/contact_us. No restrictions
html
Provides access to community, social, and
assistance services to disadvantaged individuals.
70072
Jefferson
http://www.temsela.org/contact_us. No restrictions
html
Provides access to community, social, and
assistance services to disadvantaged individuals.
70358
Jefferson
http://www.townofgrandisle.com/co Elderly,disabled,needy
mmunity/
70006
Jefferson
http://tulane.edu/som/departments Adults
/psychiatry/patientCare/behavioralhealth-clinic.cfm
Provides transportation, information on
community services, and recreation and social
opportunities.
Provides adult mental health psychotherapy and
medication management.
70001
Jefferson
http://tulane.edu/som/patients/inde Women
x.cfm
Provides women's health care.
70001
Jefferson
http://tulane.edu/som/patients/inde No restrictions
x.cfm
Provides specialty health care. Greater New
Orleans Area Application Center for Medicaid.
70072
Jefferson
More Information
No restrictions
Provides adult and pediatric primary and
preventive care. South Central Application Center
for Medicaid.
70358
Jefferson
More Information
No restrictions
preventive care.
70058
Jefferson
More Information
No restrictions
preventive care.
THE EXTRA MILE, SOUTHEAST
LOUISIANA, INC
No restrictions
THE EXTRA MILE, SOUTHEAST
LOUISIANA, INC
No restrictions
TOWN OF GRAND ISLE
Jefferson,
Lafourche,
Terrebonne
TULANE UNIVERSITY SCHOOL OF No restrictions
MEDICINE
MEDICINE
MEDICINE
WEST JEFFERSON MEDICAL
CENTER
No restrictions
CENTER
No restrictions
CENTER
No restrictions
CENTER
No restrictions
CENTER
No restrictions
Westwego Ernest J. Tassin
Senior Center
Jefferson
YMCA
No restrictions
YOUTH SERVICE BUREAU
No restrictions
No restrictions
No restrictions
70058
Jefferson
More Information
No restrictions
preventive care.
70056
Jefferson
More Information
No restrictions
preventive care.
70094
Jefferson
http://www.cityofwestwego.com/co Seniors and disabled
Provides non-emergency medical transportation.
residents of Westwego area
ntent/senior-center
70003
Jefferson
More Information
Youth
X
*
X
X
X
X
*
X
*
X
X
X
X
X
X
X
*
X
X
*
X
X
X
X
*
X
*
X
X
X
X
*
X
X
X
X
*
*
X
*
X
*
X
X
X
X
X
*
X
X
Healthy nutrition
X
X
X
etc.)
X
Substance abuse
X
Mental health
*
St. Charles
70039
13771 Highway 631 (Old Spanish Trail)
Boutte, LA 70039
Telephone:
(985) 785-0971
St. Charles
The Arc of St. Charles (CRP)
Provides primary, preventive, behavioral, and
women's health care, health education, nutrition
education, and access to WIC and Medicaid.
No restrictions
Services Provided
http://www.tabhealth.org/services
Population Served
St. John the
Baptist
residents
70084
Zip Code Column1
471 Central Avenue
Reserve, LA 70084
Ph: (985) 479-1315
No restrictions
TECHE ACTION CLINIC
*
X
X
X
*
X
*
X
X
X
X
X
*
X
X
X
X
*
X
*
*
X
X
X
X
X
*
X
X
X
X
*
X
*
*
X
X
X
X
X
X
*
X
X
X
*
X
*
*
X
X
X
X
X
X
*
X
X
X
*
X
*
*
X
X
X
X
X
X
*
X
X
X
*
X
*
*
X
X
X
X
X
X
*
X
X
X
*
X
*
*
X
X
X
X
X
X
*
X
X
X
*
X
*
X
X
X
*
X
X
*
X
X
X
*
X
X
*
X
The YMCA provides programs for all ages to
promote wellness and physical fitness.
70438
http://www.ysbworks.com/contact. Youth
php
*
X
X
X
70427
php
*
X
X
X
70438
php
*
X
X
X
X
*
87
*
X
X
*
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach APPENDIX B Secondary
Data Profile OCHSNER MEDICAL CENTER – BATON ROUGE
August, 2015 88
Table of Contents Ochsner Medical Center Baton Rouge Study Area Definition Demographic Data Community Needs Index (CNI) Prevention Quality Indicators (PQI) and Pediatric Quality Indicators (PDI) Prevention Quality Indicators (PQI) Pediatric Quality Indicators Overview Community Commons Data Social and Economic Factors Physical Environment Clinical Care Health Behaviors Health Outcomes County Health Rankings Substance Abuse and Mental Health America’s Health Rankings 89
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Ochsner Medical Center Baton Rouge Study Area Definition While community can be defined in many ways, for the purposes of this report, the Ochsner Medical Center Baton Rouge (OMC Baton Rouge) community is defined as 24 zip codes – including 5 parishes that hold a large majority (80%) of the inpatient discharges for the hospital (See Table 1 and Figure 1). Table 1. OMC Baton Rouge Study Area Definition – Zip Codes City Zip Code Parish City Zip Code Parish Gonzales
70737
Ascension Parish
Baton Rouge
70814
East Baton Rouge Parish
Prairieville
70769
Ascension Parish
Baton Rouge
70815
Baker
70714
Baton Rouge
70816
Greenwell
Springs
70739
Baton Rouge
70817
Zachary
70791
Baton Rouge
70818
Baton Rouge
70802
Baton Rouge
70819
Baton Rouge
70805
Plaquemine
70764
Iberville Parish
Baton Rouge
70806
Denham Springs
70706
Livingston Parish
Baton Rouge
70807
Denham Springs
70726
Livingston Parish
Baton Rouge
70808
Livingston
70754
Livingston Parish
Baton Rouge
70809
Walker
70785
Livingston Parish
Baton Rouge
70810
Port Allen
70767
West Baton Rouge Parish
Figure 1. Map of Ochsner Medical Center Baton Rouge Study Area 90
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Demographic Data Tripp Umbach gathered data from Truven Health Analytics, Inc. to assess the demographics of the Ochsner Medical Center Baton Rouge study area. Information pertaining to population change, gender, age, race, ethnicity, education level, housing, income, and poverty data are presented below. Population Change The OMC Baton Rouge study area encompasses more than 600,000 residents. In 2015, the largest parish in the study area is East Baton Rouge Parish with 445,311 residents in 2015. From 2015 to 2020, Ascension Parish is projected to experience the largest percentage change in population with a 7.4% increase (8,777 people). East Baton Rouge Parish is projected to experience the largest rise in number of residents, going from 445,311 residents in 2015 to 455,297 residents in 2020 (an increase of 9,986 residents, 2.2%). All four parishes in the study area are expected to increase in population between 2015 and 2020; adding an additional 22,742 people to the OMC Baton Rouge study area. Table 2. Population Size and Change Projections 2015, 2020 OMC Baton Rouge Study Area 2015 Total Population Ascension East Baton Iberville Livingston Parish Rouge Parish Parish Parish Louisiana USA 618,807 118,325 445,311 34,539 132,798 4,662,874 319,459,991 2020 Projected 641,549 Population 127,102 455,297 34,936 140,699 4,800,027 330,689,265 # Change 22,742 8,777 9,986 397 7,901 137,153 11,229,374 % Change 3.7% 7.4% 2.2% 1.1% 5.9% 2.9% 3.5% 91
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Chart 1. Population Change 2015 ‐ 2020
20.0%
15.0%
7.4%
2.2%
1.1%
2.9%
3.5%
USA
5.9%
3.7%
5.0%
Louisiana
10.0%
0.0%
Livingston
Iberville
East Baton Rouge
‐10.0%
Ascension
OMC Baton Rouge
Study Area
‐5.0%
Gender The gender breakdown for the OMC Baton Rouge study area is generally consistent across the parishes/counties and similar to state and national norms. Chart 2. Gender (2015)
100%
51.0%
50.5%
49.0%
51.9%
70%
50.7%
80%
51.5%
90%
60%
49.5%
49.0%
20%
51.0%
30%
48.1%
Male
49.3%
Fema
40%
48.5%
50%
OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
Iberville
Livingston
LA
10%
0%
Age 92
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville Parish reports the largest population of residents aged 65 and older (14.0%) followed by East Baton Rouge Parish (12.6%), and Livingston Parish (11.9%). Chart 3. Age (2015)
100%
12.5%
10.6%
12.6%
14.0%
12.0%
11.4%
11.9%
12.9%
25.6%
28.5%
23.7%
40%
14.7%
12.9%
15.4%
30%
10.7%
13.4%
20%
4.1%
9.2%
4.6%
4.1%
9.4%
4.0%
10%
20.4%
22.8%
19.0%
OMC Baton
Rouge Study
Ascension
East Baton
Rouge
90%
80%
11.9%
13.9%
14.7%
12.6%
12.7%
27.5%
25.3%
26.3%
13.6%
14.1%
13.3%
9.1%
4.4%
10.0%
4.1%
9.9%
4.0%
18.0%
21.9%
20.1%
19.1%
Iberville
Livingston
LOUISIANA
USA
11.6%
70%
60%
27.2%
50%
14.5%
0%
Race Livingston Parish reports the highest White, Non‐Hispanic population percentage at 88.1%, this is much higher than state (59.1%) and national norms (61.8%). Iberville Parish reports the highest Black, Non‐Hispanic population across the study area counties at 47.1%; East Baton Rouge Parish reports the second highest percentage at 45.9%. All of the study area parishes report lower rates of Hispanic residents as compared with the country (17.6%). Ascension Parish reports the highest Hispanic population rate at 5.2%. East Baton Rouge Parish reports the highest percentage of Asian or Pacific Islander residents (3.2%) as compared with the other parishes in the study area. 93
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Chart 4. Race (2015)
1.6%
100%
90%
4.2% 2.4%
4.1%
3.2%
1.0%
2.8% 0.5%
2.3%
1.5%
3.5% 0.6%
6.3%
4.9%
3.1%
1.8%
5.3%
17.6%
22.7%
80%
70%
1.7%
1.5%
5.2% 1.3%
34.4%
45.9%
Asian & Pacific
Hispanic
32.0%
47.1%
Hispanic
12.3%
60%
Black Non‐His
50%
White Non‐His
88.1%
40%
30%
All Others
69.3%
57.4%
20%
45.1%
48.6%
East Baton
Rouge
Iberville
59.1%
61.8%
LOUISIANA
USA
10%
0%
OMC Baton
Rouge Study
Area
Ascension
Livingston
Education Level Iberville Parish reports the highest rate of residents with ‘Less than a high school’ degree (8.0%). East Baton Rouge Parish reports the highest rate of residents with a Bachelor’s degree or higher with 34.4%; this is higher than state (21.7%) and national (28.9%) norms. 94
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Chart 5. Education Level (2015)
100%
90%
29.3%
12.3%
22.4%
24.1%
70%
27.3%
Some College/Assoc. D
29.1%
27.6%
Less than High School
41.6%
31.1%
37.1%
34.3%
28.1%
26.5%
15.5%
8.9%
3.5%
8.8%
2.7%
8.3%
3.1%
OMC Baton
Rouge Study
Area
Ascension
East Baton
Rouge
High School Degree
Some High School
40.1%
20%
0%
24.0%
26.7%
40%
10%
28.9%
Bachelor's Degree or G
29.0%
50%
30%
21.7%
34.4%
80%
60%
17.4%
11.9%
11.1%
8.0%
5.2%
6.1%
8.0%
5.9%
Iberville
Livingston
LOUISIANA
USA
Income Iberville Parish reports the lowest average annual household income for the OMC Baton Rouge study area at $60,809. Ascension Parish reports the highest average annual household income compared to the other parishes in the study area at $84,045; higher than state ($64,209) and national norms ($74,165). East Baton Rouge Parish is second highest at $71,173. Iberville Parish and East Baton Rouge Parish report the highest rates of households that earn less than $15,000 per year (18.6% and 15.6% respectively). 95
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach OMC Baton
Rouge Study
Area
Ascension
East Baton
Rouge
Iberville
$74,165 $64,209 $68,773 $60,809 $71,173 $73,875 $90,000
$80,000
$70,000
$60,000
$50,000
$40,000
$30,000
$20,000
$10,000
$‐
$84,045 Chart 6. Average Annual Household Income (2015)
Livingston
LOUISIANA
USA
Chart 7. Annual Household Income Detail (2015)
100%
90%
23.3%
80%
70%
60%
50%
40%
30%
20%
10%
31.1%
21.1%
11.4%
12.8%
14.9%
17.2%
17.0%
16.3%
24.3%
23.3%
19.3%
10.1%
10.6%
8.2%
16.6%
11.3%
18.6%
11.1%
15.3%
17.7%
16.3%
17.0%
23.1%
12.7%
10.3%
15.6%
OMC Baton
Rouge Study
Area
Ascension
East Baton
Rouge
Iberville
Over $100K
$75‐100K
12.0%
$50‐75K
17.8%
$25‐50K
$15‐25K
23.9%
12.6%
9.8%
13.2%
22.8%
24.5%
23.0%
18.6%
0%
22.6%
<$15K
10.8%
12.3%
16.9%
12.7%
Livingston
LOUISIANA
USA
Community Needs Index (CNI) In 2005 Catholic Healthcare West, in partnership with Thomson Reuters, pioneered the nation’s first standardized Community Need Index (CNI).17 CNI was applied to quantify the severity of health disparity for every zip code in the study area based on specific barriers to health care access. Because the CNI considers multiple factors that are known to limit health care access, the tool may be more accurate and useful than other existing assessment methods in 17
Truven Health Analytics, Inc. 2015 Community Need Index. 96
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach identifying and addressing the disproportionate unmet health‐related needs of neighborhoods or zip code areas. The CNI score is an average of five different barrier scores that measure various socio‐economic indicators of each community using the 2015 source data. The five barriers are listed below along with the individual 2015 statistics that are analyzed for each barrier. These barriers, and the statistics that comprise them, were carefully chosen and tested individually by both Dignity Health and Truven Health: Income Barrier Percentage of households below poverty line, with head of household age 65 or more Percentage of families with children under 18 below poverty line Percentage of single female‐headed families with children under 18 below poverty line Cultural Barrier Percentage of population that is minority (including Hispanic ethnicity) Percentage of population over age 5 that speaks English poorly or not at all Education Barrier Percentage of population over 25 without a high school diploma Insurance Barrier Percentage of population in the labor force, aged 16 or more, without employment Percentage of population without health insurance Housing Barrier Percentage of households renting their home Every populated zip code in the United States is assigned a barrier score of 1,2,3,4, or 5 depending upon the zip code’s national rank (quintile). A score of 1 represents the lowest rank nationally for the statistics listed, while a score of 5 indicates the highest rank nationally. For example, zip codes that score a 1 for the Education Barrier contain highly educated populations; zip codes with a score of 5 have a very small percentage of high school graduates. Table 3. Complete Zip Code CNI List – 2011 to 2015 Comparison Parish Income Rank Culture Education Insurance Rank Rank Rank Baton Rouge East Baton Rouge 5
5
5
70805 Baton Rouge East Baton Rouge 5
5
70806 Baton Rouge East Baton Rouge 70764 Plaquemine 70767 Port Allen Zip Community Name 70802 5
Housing 2015 CNI Rank Score 5 5.0
2011 CNI Score 5.0
Diff. 2011 – 2015 0.0
5
5
5 5.0
5.0
0.0
5
5
5
5 5.0
5.0
0.0
4
5
4
5
5 4.6
4.6
0.0
Iberville 3
5
5
5
3 4.2
n/a
‐‐‐
West Baton Rouge 4
5
4
4
4 4.2
n/a
‐‐‐
97
70814 Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Baton Rouge East Baton Rouge 3
5
3
4
4 Tripp Umbach 3.8
2.8
+ 1.0
5
3
4
4 3.8
3.8
0.0
5
2
4
5 3.8
3.0
+ 0.8
70714 Baker East Baton Rouge 2
5
4
4
3 3.6
3.4
+ 0.2
70726 Denham Springs Livingston 3
3
4
4
3 3.4
3.0
+ 0.4
70737 Gonzales Ascension 3
4
3
4
3 3.4
3.2
+ 0.2
70754 Livingston Livingston 4
2
5
4
2 3.4
2.6
+ 0.8
70785 Walker Livingston 3
3
4
4
3 3.4
2.6
+ 0.8
4
1
4
5 3.4
3.0
+ 0.4
5
1
4
4 3.4
3.0
+ 0.4
5
3
4
3 3.4
3.0
+ 0.4
4
1
4
5 3.2
2.8
+ 0.4
70791 Zachary East Baton Rouge 2
5
2
3
2 2.8
3.2
‐ 0.4
70706 Denham Springs Livingston 3
2
3
3
1 2.4
1.8
+ 0.6
3
2
3
2 2.4
1.8
+ 0.6
70739 Greenwell Springs East Baton Rouge 3
3
1
3
1 2.2
2.0
+ 0.2
70769 Prairieville Ascension 2
4
2
2
1 2.2
1.6
+ 0.6
4
1
2
3 2.2
1.6
+ 0.2
A total of 18 of the 24 zip code areas (75%) for the OMC Baton Rouge study area fall above the median score for the scale (3.0), none fall at the median, and 6 fall below the median. Being above the median for the scale indicates that these zip code areas have more than average the number of barriers to health care access. 98
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Figure 2. OMC Baton Rouge Study Area 2015 CNI Map Across the 24 OMC Baton Rouge study area zip codes: 1 experienced a decline in their CNI score from 2011 to 2015, indicating a shift to fewer barriers to health care access (green, negative values) 5 remained the same from 2011 to 2015 16 experienced a rise in their CNI score from 2011 to 2015, indicating a shift to more barriers to health care access (red, positive values) 2 did not have comparable 2011 data (n/a values) Zip code area 70814 of Baton Rouge experienced the largest rise in CNI score, going from 2.8 in 2011 to 3.8 in 2015. 99
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Figure 3. OMC Baton Rouge Study Area 2011 ‐ 2015 CNI Difference Map The available data behind the rankings illustrates the supporting data for each CNI ranking. Table 4. OMC Baton Rouge ‐ 2015 CNI Detailed Data City 2015 CNI Score Poverty 65+ Poverty Poverty Married Single w/ kids w/kids Limited English 70802 Baton Rouge 5.0 25.6% 48.6%
59.5%
0.8%
70805 Baton Rouge 5.0 26.6% 45.3%
53.1%
0.9%
Zip No High School Diploma Un‐
Un‐
employed insured Renting 81.0%
22.2% 13.6% 30.5%
62.7%
96.0%
25.9% 13.7% 25.8%
55.2%
Minority 100
70807 Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Baton Rouge 5.0 27.4% 51.9%
64.6%
0.3%
96.7%
27.4% Tripp Umbach 18.4% 27.9%
50.2%
70806 Baton Rouge 4.6 15.2% 29.0%
49.9%
2.0%
56.7%
16.5% 13.1% 20.4%
56.6%
70764 Plaquemine 4.2 17.1% 20.7%
37.5%
0.9%
47.4%
21.8% 7.3% 18.0%
24.2%
70767 Port Allen 4.2 14.5% 21.2%
51.6%
0.8%
46.5%
17.2% 8.5% 11.9%
29.0%
70814 Baton Rouge 3.8 11.3% 17.7%
39.7%
1.8%
88.0%
11.1% 8.8% 12.4%
25.9%
70815 Baton Rouge 3.8 9.2% 20.8%
41.9%
3.9%
65.4%
11.7% 8.9% 13.9%
33.9%
70816 Baton Rouge 3.8 7.4% 17.9%
32.6%
1.9%
54.4%
9.2% 5.2% 11.6%
49.5%
70714 Baker 3.6 10.2% 17.4%
32.0%
0.3%
72.6%
14.2% 7.7% 13.3%
24.6%
70726 Denham Springs 3.4 11.0% 16.7%
41.6%
1.1%
15.3%
16.1% 6.8% 10.3%
24.4%
70737 Gonzales 3.4 12.7% 17.1%
43.1%
2.2%
35.1%
11.9% 6.8% 10.7%
23.6%
70754 Livingston 3.4 16.2% 18.1%
46.4%
0.1%
7.2%
21.6% 5.2% 14.6%
17.2%
70785 Walker 3.4 7.3% 15.6%
38.3%
0.1%
9.0%
17.7% 7.5% 12.0%
20.0%
70808 Baton Rouge 3.4 8.3% 13.4%
35.6%
0.6%
24.3%
3.5% 4.7% 16.2%
43.6%
70810 Baton Rouge 3.4 7.8% 15.4%
40.8%
1.1%
43.5%
5.2% 5.6% 10.3%
31.4%
70819 Baton Rouge 3.4 8.9% 15.6%
28.6%
4.2%
66.8%
13.2% 10.0% 11.5%
24.3%
70809 Baton Rouge 3.2 4.5% 13.5%
28.2%
0.8%
28.9%
4.5% 4.4% 11.2%
45.6%
70791 Zachary 2.8 6.6% 13.0%
31.6%
0.1%
41.5%
9.7% 6.2% 9.8%
18.4%
70706 Denham Springs 2.4 7.3% 10.8%
39.4%
0.1%
8.1%
12.0% 6.1% 8.9%
12.1%
70818 Baton Rouge 2.4 6.3% 11.3%
30.4%
0.3%
18.3%
7.4% 6.9% 9.6%
17.8%
70739 Greenwell Springs 2.2 8.5% 15.2%
37.6%
0.4%
13.9%
6.6% 6.2% 9.6%
15.3%
70769 Prairieville 2.2 14.9% 7.8%
22.6%
0.8%
20.8%
7.2% 4.6% 6.9%
12.1%
70817 Baton Rouge 2.2 4.5% 6.3%
15.5%
0.8%
25.7%
4.3% 5.9% 5.7%
23.0%
For the OMC Baton Rouge study area there are three zip code areas with CNI scores of 5.0, indicating significant barriers to health care access. These zip code areas are: 70802, 70805, and 70807 – Baton Rouge. These same three zip codes 70807 – Baton Rouge reports the highest rates in six of the nine areas represented in Table 4 (above): residents aged 65 and older living in poverty (27.4%); married parents 101
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach living in poverty with children (51.9%); single parents living in poverty with children (64.6%); and, residents with no high school diploma (27.4%). 70807 – Baton Rouge also reports the highest rate of unemployed residents at 18.4%; more than double the state (6.6%) and more than triple the national (5.5%) rates.18 96.7% of the residents in zip code area 70807 (Baton Rouge) are minorities; the highest rate for the study area. Zip code area 70802 in Baton Rouge reports the highest rates of uninsured residents (30.5%) and residents that rent (62.7%). 4.2% of residents living in zip code area 70819 experience limited English proficiency; the highest rate for the study area. On the other end of the spectrum, the lowest CNI score for the study area is 2.2 in 70739 – Greenwell Springs, 70769 – Prairieville, and 70817 – Baton Rouge. Zip code area 70817 – Baton Rouge reports the lowest rates of residents aged 65 and older living in poverty (4.5%); married and single parents living in poverty with their children for the study area (6.3% and 15.5%, respectively). 70817 also reports the lowest rate of uninsured residents at 5.7%. 70769 – Prairieville and 70706 – Denham Springs show the lowest rate of renters at 12.1%. Zip code area 70754 – Livingston reports the lowest minority rate for the study area at 7.2%. Baton Rouge zip code area 70808 reports the lowest rates of residents without a high school diploma at only 3.5%. Baton Rouge (70809) reports the lowest unemployment rate for the study area at only 4.4% and residents aged 65 and older living in poverty (4.5%). Four zip code areas (70706 – Denham Springs, 70791 – Zachary, 70785 – Walker, and 70754 – Livingston) report the lowest rate of residents with limited English proficiency at 0.1%. 18
March 2015 state and national statistics. U.S. Bureau of Labor Statistics. 102
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Chart 8. Overall CNI Values ‐ OMC Baton Rouge & Parishes
5
4
3.7
3.5
4.0
3.0
2.8
3
2
1
0
OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
Iberville
Livingston
103
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Prevention Quality Indicators (PQI) and Pediatric Quality Indicators (PDI)19 Prevention Quality Indicators (PQI) The Prevention Quality Indicators index (PQI) was developed by the Agency for Healthcare Research and Quality (AHRQ). PQI is similarly referred to as Ambulatory Care Sensitive Hospitalizations. The quality indicator rates are derived from inpatient discharges by zip code using ICD diagnosis and procedure codes. There are 14 quality indicators. The PQI index identifies potentially avoidable hospitalizations for the benefit of targeting priorities and overall community health. Lower index scores represent fewer admissions for each of the PQIs. PQI Subgroups: Chronic Lung Conditions PQI 5 Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults (40+) Admission Rate20 PQI 15 Asthma in Younger Adults Admission Rate21 Diabetes PQI 1 Diabetes Short‐Term Complications Admission Rate PQI 3 Diabetes Long‐Term Complications Admission Rate PQI 14 Uncontrolled Diabetes Admission Rate PQI 16 Lower Extremity Amputation Rate Among Diabetic Patients Heart Conditions PQI 7 Hypertension Admission Rate PQI 8 Congestive Heart Failure Admission Rate 19
PQI and PDI values were calculated including all relevant zip‐code values from Louisiana; Mississippi data could not be obtained and was therefore not included. 20
PQI 5 for past study was COPD in 18+ population; PQI 5 for current study is now restricted to COPD and Asthma in 40+ population 21
PQI 15 for past study was Adult Asthma in 18+ population; PQI 15 for current study is now restricted to Asthma in 18‐39 population (“Younger”). 104
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach PQI 13 Angina Without Procedure Admission Rate Other Conditions PQI 2 Perforated Appendix Admission Rate22 PQI 9 Low Birth Weight Rate23 PQI 10 Dehydration Admission Rate PQI 11 Bacterial Pneumonia Admission Rate PQI 12 Urinary Tract Infection Admission Rate Table 5. Prevention Quality Indicators (PQI) OMC Baton Rouge / LA / U.S.A. 2015 Prevention Quality Indicators (PQI) OMC Baton Rouge Study Area 2015 PQI LA 2015 PQI U.S.A. 2015 PQI OMC Baton Rouge Study Area – LA Diff. OMC Baton Rouge Study Area – U.S.A.
Diff. Chronic Lung Conditions COPD or Adult Asthma (PQI5) 292.21
531.03
495.71
‐ 238.82 ‐ 203.50
Asthma in Younger Adults (PQI15) 34.27
42.83
46.02
‐ 8.56 ‐ 11.75
Diabetes Short‐Term Complications (PQI1) 79.02
98.10
63.86
‐ 19.08 + 15.16
Diabetes Long‐Term Complications (PQI3) 97.22
126.06
105.72
‐ 28.84 ‐ 8.50
Uncontrolled Diabetes (PQI14) 6.32
15.57
15.72
‐ 9.25 ‐ 9.40
Lower Extremity Amputation Among Diabetics (PQI16) 9.12
12.74
16.50
‐ 3.62 ‐ 7.38
Diabetes Heart Conditions 22
PQI 2 changed from Perforated Appendix in Males 18+ for the past study to Perforated Appendix in Total 18+ population as a rate per 1,000 ICD‐9 code admissions for appendicitis. This shift has changed the values for this measure drastically and therefore, Tripp Umbach did not adjust.
23
Although not clearly explained by the AHRQ, it would seem that a definition of Newborn population has shifted
for PQI 9 because the values are drastically lower in 2014 than in previous years (2011). This has shifted PQI 9
values drastically. Tripp Umbach did not adjust.
105
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Hypertension (PQI7) 29.34
46.06
54.27
Tripp Umbach ‐ 43.72 ‐ 24.93
Congestive Heart Failure (PQI8) 320.62
404.11
321.38
‐ 83.49 ‐ 0.76
Angina Without Procedure (PQI13) 5.14
13.74
13.34
‐ 8.60 ‐ 8.20
Perforated Appendix (PQI2) 406.67
322.43
323.43
+ 84.24 + 83.24
Low Birth Weight (PQI9) 76.33
86.51
62.14
‐ 10.18 + 14.19
Dehydration (PQI10) 71.95
124.53
135.70
‐ 52.58 ‐ 63.75
Bacterial Pneumonia (PQI11) 180.50
305.80
248.19
‐ 125.30 ‐ 67.69
Urinary Tract Infection (PQI12) 116.98
209.39
167.01
‐ 92.41 ‐ 50.03
Other Conditions Key Findings from 2015 PQI Data: The only PQI measure in which the OMC Baton Rouge study area reports higher preventable admission rates than the State of Louisiana is for Perforated Appendix (406.67 preventable admissions per 1,000 admissions for any listed diagnosis of perforation or abscesses of the appendix for OMC Baton Rouge, 322.43 for LA). When comparing the OMC Baton Rouge PQI data to the national rates, the OMC Baton Rouge study area reports higher preventable hospital admissions for: Diabetes, Short‐Term Complications Low Birth Weight Perforated Appendix There are also a number of PQI measures in which the OMC Baton Rouge study area and many of the parishes in the study area report lower values than the nation (indicating areas in which there are fewer preventable hospital admissions than the national norm), these include: COPD or Adult Asthma Hypertension (all of the areas are Asthma in Younger Adults below the national rate) Diabetes, Long‐Term Complications Dehydration Uncontrolled Diabetes Bacterial Pneumonia Urinary Tract Infection Lower Extremity Amputation among Diabetics 106
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach 495.71
600.00
531.03
548.24
Chronic Lung Conditions: Iberville
149.31
300.00
200.00
Ascension
East Baton Rouge
255.20
284.59
400.00
292.21
500.00
OMC Baton Rouge
Study Area
Livingston
LOUISIANA
100.00
U.S.A.
0.00
COPD or Adult Asthma (PQI 5)
31.68
33.42
40.00
34.27
46.02
50.00
42.83
43.84
60.00
55.36
OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
30.00
Iberville
20.00
Livingston
10.00
LOUISIANA
U.S.A.
0.00
Asthma in Younger Adults (PQI 15)
Diabetes: 107
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach OMC Baton Rouge
Study Area
98.10
100.18
92.51
Ascension
63.86
66.44
80.00
62.81
100.00
79.02
120.00
East Baton Rouge
60.00
Iberville
40.00
Livingston
20.00
LOUISIANA
U.S.A.
0.00
Diabetes, Short‐Term Complications (PQI 1)
105.72
126.06
102.21
97.76
100.00
88.40
120.00
97.22
140.00
129.87
OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
80.00
Iberville
60.00
Livingston
40.00
LOUISIANA
20.00
U.S.A.
0.00
Diabetes, Long‐Term Complications (PQI 3)
18.00
16.00
15.72
15.57
OMC Baton Rouge
Study Area
Ascension
14.00
East Baton Rouge
12.00
4.00
2.86
5.03
6.00
Iberville
4.57
6.32
8.00
7.18
10.00
Livingston
LOUISIANA
2.00
U.S.A.
0.00
Uncontrolled Diabetes (PQI 14)
108
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge 8.00
OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
8.53
7.40
10.00
9.12
12.00
10.58
14.00
12.74
16.00
Tripp Umbach 15.50
16.05
18.00
Iberville
Livingston
6.00
4.00
LOUISIANA
2.00
U.S.A.
0.00
Lower Extremity Amputation Among Diabetics (PQI 16)
46.06
60.00
East Baton Rouge
Iberville
15.12
30.00
20.00
OMC Baton Rouge
Study Area
Ascension
27.60
29.68
29.34
40.00
30.93
50.00
54.27
Heart Conditions: Livingston
LOUISIANA
10.00
U.S.A.
0.00
Hypertension (PQI 7)
300.00
250.00
OMC Baton Rouge
Study Area
321.38
404.11
226.74
350.00
320.62
400.00
326.84
450.00
314.56
500.00
438.68
Ascension
East Baton Rouge
Iberville
200.00
Livingston
150.00
100.00
LOUISIANA
50.00
U.S.A.
0.00
Congestive Heart Failure (PQI 8)
109
Tripp Umbach 13.34
13.74
16.00
OMC Baton Rouge
Study Area
Ascension
12.00
East Baton Rouge
7.15
10.00
Iberville
3.50
4.00
3.49
6.00
5.14
8.00
LOUISIANA
0.00
2.00
Livingston
U.S.A.
0.00
Angina Without Procedure (PQI 13)
OMC Baton Rouge
Study Area
323.43
400.00
322.43
Ascension
352.94
427.08
428.57
500.00
406.67
600.00
500.00
Other Conditions: East Baton Rouge
300.00
Iberville
200.00
Livingston
100.00
LOUISIANA
U.S.A.
0.00
Perforated Appendix (PQI 2)
86.51
62.14
70.00
OMC Baton Rouge
Study Area
Ascension
60.69
80.00
61.19
90.00
76.33
100.00
78.76
85.20
East Baton Rouge
60.00
Iberville
50.00
40.00
Livingston
30.00
20.00
LOUISIANA
10.00
U.S.A.
0.00
Low Birth Weight (PQI 9)
110
140.00
Tripp Umbach 135.70
160.00
OMC Baton Rouge
Study Area
Ascension
67.97
78.65
East Baton Rouge
64.93
80.00
63.10
100.00
71.95
120.00
Iberville
60.00
Livingston
40.00
LOUISIANA
20.00
U.S.A.
0.00
Dehydration (PQI 10)
OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
167.43
171.19
200.00
159.55
250.00
180.50
300.00
248.19
250.91
350.00
305.80
Iberville
150.00
Livingston
100.00
LOUISIANA
50.00
U.S.A.
0.00
Bacterial Pneumonia (PQI 11)
125.11
74.32
100.00
116.98
150.00
124.49
200.00
153.61
250.00
50.00
OMC Baton Rouge
Study Area
167.01
209.39
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
U.S.A.
0.00
Urinary Tract Infection (PQI 12)
111
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Pediatric Quality Indicators Overview The Pediatric Quality Indicators (PDIs) are a set of measures that can be used with hospital inpatient discharge data to provide a perspective on the quality of pediatric healthcare. Specifically, PDIs screen for problems that pediatric patients experience as a result of exposure to the healthcare system and that may be amenable to prevention by changes at the system or provider level. Development of quality indicators for the pediatric population involves many of the same challenges associated with the development of quality indicators for the adult population. These challenges include the need to carefully define indicators using administrative data, establish validity and reliability, detect bias and design appropriate risk adjustment, and overcome challenges of implementation and use. However, the special population of children invokes additional, special challenges. Four factors—differential epidemiology of child healthcare relative to adult healthcare, dependency, demographics, and development—can pervade all aspects of children’s healthcare; simply applying adult indicators to younger age ranges is insufficient. This PDIs focus on potentially preventable complications and iatrogenic events for pediatric patients treated in hospitals, and on preventable hospitalizations among pediatric patients. The PDIs apply to the special characteristics of the pediatric population; screen for problems that pediatric patients experience as a result of exposure to the healthcare system and that may be amenable to prevention by changes at the provider level or area level; and, help to evaluate preventive care for children in an outpatient setting, and most children are rarely hospitalized. PDI Subgroups: PDI 14 Asthma Admission Rate (per 100,000 population ages 2 – 17) PDI 15 Diabetes, Short‐Term Complications Admission Rate (per 100,000 population ages 6 – 17) PDI 16 Gastroenteritis Admission Rate (per 100,000 population ages 3 months – 17 years) PDI 17 Perforated Appendix Admission Rate (per 1,000 admissions ages 1 – 17) PDI 18 Urinary Tract Infection Admission Rate (per 100,000 population ages 3 years) months – 17 112
117.52
54.34
80.00
Tripp Umbach OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
64.92
100.00
86.95
120.00
131.79
105.22
140.00
60.00
Iberville
Livingston
40.00
LOUISIANA
20.00
U.S.A.
0.00
Asthma ‐ Ages 2 ‐ 17 years (PDI 14)
62.63
70.00
OMC Baton Rouge
Study Area
60.00
East Baton Rouge
23.89
36.00
35.81
40.00
38.15
37.95
42.86
50.00
Ascension
30.00
Iberville
Livingston
20.00
LOUISIANA
10.00
U.S.A.
0.00
Diabetes, Short‐Term Complications ‐ Ages 6 ‐ 17 years (PDI 15)
35.00
47.28
42.76
32.48
40.00
34.85
45.00
36.97
50.00
45.47
OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
30.00
Iberville
20.00
15.00
14.22
25.00
10.00
Livingston
LOUISIANA
5.00
U.S.A.
0.00
Gastroenteritis ‐ Ages 3 months ‐ 17 years (PDI 16)
113
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach OMC Baton Rouge
Study Area
344.22
322.09
Ascension
360.00
400.00
666.67
444.44
500.00
403.51
600.00
461.54
700.00
East Baton Rouge
Iberville
300.00
Livingston
200.00
LOUISIANA
100.00
U.S.A.
0.00
Perforated Appendix ‐ Ages 1 ‐ 17 years (PDI 17)
20.02
30.00
25.00
6.18
10.00
11.20
15.00
12.67
20.00
23.89
35.00
29.64
OMC Baton Rouge
Study Area
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
5.00
U.S.A.
0.00
Urinary Tract Infection ‐ Ages 3 months ‐ 17 years (PDI 18)
Key Findings from PDI Data: Iberville Parish reports the highest rate of preventable hospitalizations due to Asthma for children aged 2 to 17 at 131.79 per 100,000 population; higher than the national rate of 117.37 Ascension Parish reports the highest rates of diabetes, short‐term complications for those aged 6 to 17 years old for the OMC Baton Rouge study area (62.63); this rate is nearly triple the national rate of 23.89. Iberville Parish and Livingston Parish report the highest rates of gastroenteritis for the OMC Baton Rouge study area at 45.47 and 42.76 per 100,000 population aged 3 months to 17 years, respectively; both fall below the national rate of 47.28. Iberville Parish reports the highest rate of preventable hospitalizations due to perforated appendix for ages 1 to 17 years old with 666.67 per 100,000 admissions. 114
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Livingston Parish reports the highest rate for preventable hospital admissions due to urinary tract infections for those aged 3 months to 17 years with 20.02 per 100,000 population being admitted while the national rate stands at 29.64. Community Commons Data Tripp Umbach gathered data from Community Commons related to social and economic factors, physical environment, clinical care, and health behaviors for the parishes of interest for the Ochsner Medical Center Baton Rouge CHNA.24 The data is presented in the aforementioned categories below. Social and Economic Factors Free/Reduced Price Lunch Eligible Iberville Parish reports the highest rate of public school students who are eligible for free or reduced lunch eligible and has seen a rise in this rate (83.41%). 24
Community Commons. http://www.communitycommons.org/ Accessed 06/08/2015. 115
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Percent Population Free/Reduced Price Lunch Eligible, 2012‐2013 100.00%
90.00%
80.00%
70.00%
Ascension
East Baton Rouge
Iberville
60.00%
Livingston
LOUISIANA
USA
50.00%
40.00%
2009‐10
2010‐11
2011‐12
2012‐13
Ascension
44.67%
48.26%
49.19%
49.07%
East Baton Rouge
72.96%
73.51%
74.88%
73.86%
Iberville
85.78%
83.75%
80.98%
83.41%
Livingston
46.46%
47.20%
50.20%
50.82%
LOUISIANA
65.78%
66.20%
67.12%
66.23%
USA
47.76%
49.24%
48.29%
51.77%
Food Insecure Population This indicator reports the estimated percentage of the population that experienced food insecurity at some point during the report year. Food insecurity is the household‐level economic and social condition of limited or uncertain access to adequate food. Iberville Parish reports the highest food insecurity rate with 17.37%; the only parish to exceed both the State of Louisiana rate and the national rate. While matching the state rate of 16.91%, East Baton Rouge Parish also reports higher than the nation. 116
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Ascension
15.94%
18.00%
16.91%
20.00%
17.37%
16.91%
Food Insecure Population, Percent, 2012
East Baton Rouge
10.45%
14.00%
12.00%
10.00%
9.86%
16.00%
Iberville
Livingston
8.00%
6.00%
LOUISIANA
4.00%
2.00%
USA
0.00%
Graduation Rate This indicator is relevant because research suggests education is one the strongest predictors of health (Freudenberg & Ruglis, 2007). Iberville Parish reports the lowest overall graduation rate as well as the lowest on‐time graduation rate throughout the study area parishes (59.1% overall graduation, 45.6% on‐time graduation). The Healthy People 2020 Target for on‐time graduation is 82.4% – all of the study area parishes and the states fall below this goal. However, some of the study area parishes report equivalent or very close to on‐time graduation rates than the national average (Ascension Parish and East Baton Rouge Parish). 117
75.5%
45.6%
60.0%
67.3%
74.5%
75.5%
82.2%
73.4%
Tripp Umbach 63.4%
70.0%
76.0%
80.0%
59.1%
90.0%
68.6%
100.0%
87.0%
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge 50.0%
Ascension
East Baton Rouge
Iberville
40.0%
Livingston
30.0%
20.0%
LOUISIANA
10.0%
0.0%
USA
Cohort Graduation Rate
(2001‐2012)
On‐Time Graduation Rate
(2008‐2009)
Households with No Motor Vehicle Iberville Parish reports the highest rate of households with no motor vehicle (9.94%). Percentage of Households with No Motor Vehicle, 2009‐2013
9.94%
8.48%
East Baton Rouge
7.26%
10.00%
4.00%
2.00%
Iberville
Livingston
3.62%
6.00%
4.38%
8.00%
9.07%
12.00%
Ascension
LOUISIANA
USA
0.00%
118
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Cost Burdened Households This indicator reports the percentage of the households where housing costs exceed 30% of total household income. This indicator provides information on the cost of monthly housing expenses for owners and renters. The information offers a measure of housing affordability and excessive shelter costs. The data also serve to aid in the development of housing programs to meet the needs of people at different economic levels. East Baton Rouge Parish reports a higher percentage of cost‐burdened households as compared with other parishes in the study area at 33.17%. All of the parishes in the OMC Baton Rouge study area report lower rates of cost‐burdened households than the national average (35.47%). Percentage of Cost Burdened Households (Over 30% of Income), 2009‐2013
21.80%
30.00%
25.00%
35.47%
29.02%
35.00%
23.25%
40.00%
22.38%
33.17%
Ascension
East Baton Rouge
Iberville
Livingston
20.00%
15.00%
LOUISIANA
10.00%
USA
5.00%
0.00%
Public Assistance This indicator reports the percentage households receiving public assistance income. Public assistance income includes general assistance and Temporary Assistance to Needy Families (TANF). Separate payments received for hospital or other medical care (vendor payments) are excluded. This does not include Supplemental Security Income (SSI) or noncash benefits such as Food Stamps. All of the study area parishes report lower rates of households receiving public assistance income than the rates seen for the country. Iberville Parish reports the highest rate of households receiving public assistance at 1.95%. Ascension Parish reports the lowest rate of households receiving public assistance at only 1.03%. 119
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach 2.82%
Percent Households with Public Assistance Income, 2009‐2013
3.00%
Ascension
East Baton Rouge
1.95%
2.50%
1.47%
Iberville
1.17%
1.21%
1.50%
1.03%
2.00%
Livingston
1.00%
LOUISIANA
0.50%
USA
0.00%
Iberville Parish reports the highest average amount of public assistance received by households at $3,990. Average Public Assistance Received (in USD), 2009‐2013
$4,500
$3,807 $3,990 Ascension
$2,500
$2,000
$1,500
$3,055 $1,867 $3,000
$2,790 $3,500
$2,547 $4,000
East Baton Rouge
Iberville
Livingston
LOUISIANA
$1,000
$500
USA
$0
120
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach SNAP Benefits 24.55%
Percent Households Receiving SNAP Benefits, 2009‐2013
10.00%
16.63%
Iberville
12.40%
15.00%
15.40%
20.00%
12.22%
25.00%
East Baton Rouge
14.98%
30.00%
Ascension
Livingston
LOUISIANA
5.00%
0.00%
USA
Iberville Parish reports the highest rate of households receiving SNAP benefits across the OMC Baton Rouge study area at 24.55%. The American Indian/Alaska Native population of Ascension Parish reports a high rate of receiving SNAP benefits at 66.39%. The Black population of Iberville Parish also reports one of the highest rates of receiving SNAP benefits across the study area at 43.99%. The American Indian/Alaska Native, African‐American/Black, and Multiple Race populations of the OMC Baton Rouge study area see some of the highest rates of receiving SNAP benefits. The Non‐Hispanic White, Asian, and Hispanic/Latino populations report some of the lowest rates of receiving SNAP benefits for the OMC Baton Rouge study area. 121
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Percent Households Receiving SNAP Benefits, by Race, 2009‐2013
Ascension
70.00%
60.00%
East Baton Rouge
50.00%
Iberville
40.00%
30.00%
Livingston
20.00%
10.00%
LOUISIANA
0.00%
Non‐Hispanic
White
Black
Asian
American
Other Race Multiple Race Hispanic /
Indian /
Latino
Alaska Native
USA
Households Receiving SNAP Benefits, Disparity Index The Index of Disparity (ID) measures the magnitude of variation in indicator percentages across population groups. Specifically, the index of disparity is defined as "the average of the absolute differences between rates for specific groups within a population and the overall population rate, divided by the rate for the overall population and expressed as a percentage". All of the parishes in the study area report “High Disparity” when it comes to SNAP benefits. Ascension Parish reports the highest SNAP Benefits Disparity Index score for the study area at 72.63; East Baton Rouge Parish is next highest at 58.83. 122
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Households Receiving SNAP Benefits,
Disparity Index Score
2009‐2013
62.62
52.67
50.00
40.00
East Baton Rouge
Iberville
37.12
42.22
60.00
58.83
70.00
72.63
80.00
Ascension
Livingston
30.00
20.00
LOUISIANA
10.00
0.00
Households Receiving SNAP Benefits, Disparity Index Score
(0 = No Disparity; 1 ‐ 40 = Some Disparity; Over 40 = High Disparity)
USA
123
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Medicaid Iberville Parish reports the highest rate of Insured Residents Receiving Medicaid at 27.05%; this rate is higher than state (25.70%) and national (20.21%) rates. 20.00%
25.70%
Ascension
East Baton Rouge
20.21%
21.13%
17.19%
25.00%
21.74%
30.00%
27.05%
Percent of Insured Population Receiving Medicaid, 2009‐2013
15.00%
Iberville
Livingston
10.00%
LOUISIANA
5.00%
USA
0.00%
The population under the age of 18 receives the highest rates of Medicaid assistance across all of the study area parishes. Iberville Parish reports the highest rate among the study area parishes of residents aged 65 and older receiving Medicaid (18.58%). Percent of Insured Population Receiving Medicaid, by Age Group,
2009‐2013
60.00%
Ascension
East Baton Rouge
50.00%
Iberville
40.00%
30.00%
Livingston
20.00%
LOUISIANA
10.00%
0.00%
Under Age 18
Age 18 ‐ 64
Age 65 and Older
USA
124
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Insurance Livingston Parish reports the highest rate of uninsured adults for the OMC Baton Rouge study area at 24.2%. Iberville Parish is a close second at 23.4%. These rates are higher than the nation (20.8%). All of the parishes in the study area report rates lower than the state (25.0%). Percent Population Without Medical Insurance (Uninsured Adults) ‐ 2012
Percent Population With Medical Insurance (Uninsured Adults) ‐ 2012
100%
90%
19.6%
21.8%
23.4%
24.2%
25.0%
20.8%
80.4%
78.2%
76.6%
75.8%
75.0%
79.2%
Ascension
East Baton
Rouge
Iberville
Livingston
LOUISIANA
USA
80%
70%
60%
50%
40%
30%
20%
10%
0%
Iberville Parish and Livingston Parish are the only parishes to see increases in rates of uninsured adults between 2011 and 2012. Iberville Parish shows the greatest increase going from 22.40% in 2011 to 23.40% in 2012. Percent Population without Medical Insurance (Uninsured Adults)
Ascension
28.00%
26.00%
East Baton Rouge
24.00%
22.00%
Iberville
20.00%
18.00%
Livingston
16.00%
14.00%
LOUISIANA
12.00%
10.00%
USA
2008
2009
2010
2011
2012
125
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Similar to uninsured adults, Livingston Parish reports the highest rate of uninsured children across the study area parishes at 5.7%. Livingston Parish is the only parish in the study area to exceed the state rate of 5.6%. All of the parishes in the study area and Louisiana report lower rates of uninsured children as compared with the country (7.5%) Percent Population Without Medical Insurance (Uninsured Children) ‐ 2012
Percent Population With Medical Insurance (Uninsured Children) ‐ 2012
100%
5.2%
5.0%
4.9%
5.7%
5.6%
7.5%
94.8%
95.0%
95.1%
94.3%
94.4%
92.5%
Ascension
East Baton
Rouge
Iberville
Livingston
LOUISIANA
USA
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
From 2011 to 2012, half of the parishes in the study area (Ascension Parish and East Baton Rouge Parish) reported slight declines in the rates of uninsured children. The rate of uninsured children in Iberville Parish saw the greatest rise going from 22.40% in 2011 to 23.40% in 2012. Livingston Parish only saw 0.2% increase. Percent Population without Medical Insurance (Uninsured Children), 2012
10.00%
Ascension
East Baton Rouge
9.00%
8.00%
Iberville
7.00%
6.00%
5.00%
Livingston
4.00%
3.00%
LOUISIANA
2.00%
1.00%
0.00%
2008
2009
2010
2011
2012
USA
126
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Uninsured Population In all of the parishes in the study area, men are more likely to be uninsured than women; consistent with state and national norms. Uninsured ‐ Gender, 2009‐2013
20.00%
18.02%
18.00%
16.78%
16.51%
15.20%
16.00%
13.50%
12.85%
14.00%
12.86%
16.38%
16.25%
14.54%
13.04%
Male
13.43%
Female
12.00%
10.00%
8.00%
6.00%
4.00%
2.00%
0.00%
Ascension
East Baton
Rouge
Iberville
Livingston
LOUISIANA
USA
Those aged 18 – 64 are more likely to be uninsured as compared with those under 18 or those 65 and older. 20.00%
20.59%
21.20%
18.40%
20.02%
25.00%
23.93%
30.00%
24.87%
Uninsured ‐ Age, 2009‐2013
Under Age 18
Age 18 ‐ 64
Age 65
0.74%
Livingston
LOUISIANA
0.97%
7.61%
0.47%
5.81%
6.03%
0.35%
2.63%
1.02%
3.20%
5.00%
0.62%
10.00%
5.83%
15.00%
0.00%
Ascension
East Baton Rouge
Iberville
USA
127
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Residents of Hispanic or Latino ethnicity are more likely to be uninsured than their counterparts. Uninsured ‐ Ethnicity, 2009‐2013
45.00%
40.79%
40.34%
40.00%
36.66%
35.44%
35.00%
Hispanic/Latino
32.06%
29.62%
30.00%
Not Hispanic or
Latino
25.00%
20.00%
16.21%
15.87%
15.00%
13.15%
11.80%
13.35%
11.92%
10.00%
5.00%
0.00%
Ascension
East Baton
Rouge
Iberville
Livingston
LOUISIANA
USA
96.3% of the Some Other Race population in Iberville Parish is uninsured. Residents reporting “Some Other Race”, for the entire study area, have the highest rates of being uninsured. More than 70% of the Asian population of Iberville Parish report being uninsured. Uninsured ‐ Race, 2009‐2013
100.00%
90.00%
80.00%
Black or African American
Native American / Alaska Native
70.00%
Asian
60.00%
Native Hawaiian / Pacific Islander
50.00%
Some Other Race
40.00%
Multiple Race
30.00%
20.00%
10.00%
0.00%
Ascension
East Baton
Rouge
Iberville
Livingston
LOUISIANA
USA
128
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Social Support Ascension Parish exhibits the highest rate of residents with a lack of social or emotional support at 21.5% of the population; this is slightly lower than the state (21.7%) but, higher than the national (20.68%) rate. 22.00%
21.00%
20.40%
20.50%
21.50%
20.50%
18.90%
20.00%
19.50%
19.00%
Ascension
East Baton Rouge
20.68%
21.50%
21.70%
Lack of Social or Emotional Support (Age‐Adjusted Percentage), 2006‐2012
Iberville
Livingston
LOUISIANA
18.50%
18.00%
USA
17.50%
Poverty East Baton Rouge Parish and Iberville Parish show the highest rates of population that is living below the federal poverty level (100% FPL) at 19.18% and 19.16%, respectively. Both parishes are higher than state (19.08%) and national (15.37%) norms. Ascension Parish and Livingston Parish both report rates below both the state and national rates (12.29% and 13.32%, respectively). 15.00%
19.08%
Ascension
East Baton Rouge
15.37%
12.29%
20.00%
13.32%
19.18%
25.00%
19.16%
Percent Population in Poverty (Below 100% FPL), 2009‐2013
Iberville
Livingston
10.00%
LOUISIANA
5.00%
0.00%
USA
129
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Across all of the study area regions, women are more likely than men to be living in poverty. 20.99% of female residents of East Baton Rouge Parish are living in poverty (the highest rate across the study area). Poverty ‐ Gender, 2009‐2013
25.00%
20.99%
20.00%
17.22%
21.35%
19.88%
18.41%
15.23%
14.94%
16.65%
Male
16.57%
Female
14.11%
15.00%
11.36%
10.00%
9.55%
5.00%
0.00%
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
USA
In general, the Hispanic/Latino population of the study area is living in poverty at higher rates than their counterparts. In Iberville Parish, 26.35% of the Hispanic/Latino population is living below the federal poverty level (the highest for the study area). East Baton Rouge Parish is next highest at 24.65%. Poverty ‐ Ethnicity, 2009‐2013
30.00%
26.35%
25.00%
24.66%
24.65%
22.86%
18.97%
20.00%
21.35%
18.97%
18.99%
15.63%
13.25%
15.00%
11.75%
Hispanic / Latino
Not Hispanic / Latino
13.50%
10.00%
5.00%
0.00%
Ascension
East Baton
Rouge
Iberville
Livingston
LOUISIANA
USA
130
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach The Asian and Multiple Race populations of Ascension Parish experience some of the highest rates of living in poverty as compared with the other study area parishes (39.09% and 32.04% respectively). Poverty ‐ Race, 2009‐2013
45.00%
White
40.00%
35.00%
Asian
30.00%
25.00%
Some Other Race
Multiple Race
20.00%
15.00%
10.00%
5.00%
0.00%
Ascension
East Baton
Rouge
Iberville
Livingston
LOUISIANA
USA
For populations living below 100% of the federal poverty level, East Baton Rouge Parish and Iberville Parish reported the highest rates (seen above). The same is true for populations living below 200% of the federal poverty level; Iberville Parish reports the highest rate at 43.27% with East Baton Rouge Parish following at 37.41%. 131
Ascension
East Baton Rouge
34.23%
35.00%
25.64%
40.00%
39.56%
45.00%
30.44%
37.41%
50.00%
43.27%
Percent Population with Income at or Below 200% FPL,
2009‐2013
Iberville
25.00%
Livingston
20.00%
15.00%
LOUISIANA
10.00%
5.00%
USA
0.00%
Children in Poverty More than 27% of the children and adolescents (under 18) in East Baton Rouge Parish are living in poverty (below 100% FPL). 15.00%
21.58%
16.36%
16.80%
25.00%
20.00%
Ascension
27%
30.00%
26.55%
27.30%
Children in Poverty ‐ Below 100% FPL, 2009‐2013
East Baton Rouge
Iberville
Livingston
10.00%
LOUISIANA
5.00%
USA
0.00%
The OMC Baton Rouge study area is mixed when comparing male and female children living in poverty. Male children are more likely to live in poverty in Ascension Parish and East Baton Rouge Parish. Female children are more likely to live in poverty in Iberville Parish and Livingston Parish. Iberville Parish reports the highest rate for children living in poverty with 29.65% of male children living in poverty. 132
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Children in Poverty ‐ Gender, 2009‐2013
35.00%
28.38%
26.25%
30.00%
27.43%
26.59%
23.19%
25.00%
20.00%
29.65%
18.75%
Male
Female
21.72%
21.45%
17.78%
14.91%
14.99%
15.00%
10.00%
5.00%
0.00%
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
USA
Similar to gender, the ethnicity of a child varies in whether or not it is related to living in poverty or not. For adults, the Hispanic/Latino population is more likely to live in poverty than their counterparts. The same is true for children in all but one of the study area parishes. Livingston Parish reports 15.36% of Hispanic/Latino children versus 16.40% of Non‐Hispanic/Latino children live in poverty. Iberville Parish reports the highest, by far, rate of Hispanic/Latino children living in poverty at 54.73%. Children in Poverty ‐ Ethnicity, 2009‐2013
60.00%
54.73%
Hispanic / Latino
50.00%
Not Hispanic or Latino
40.00%
30.81%
30.00%
20.00%
32.88%
27.05%
32.39%
27.06%
25.89%
25.96%
18.27%
16.40%
15.36%
15.90%
10.00%
0.00%
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
USA
79.27% of the Native American/Alaska Native population in Ascension Parish lives in poverty. This is more than double the state rate (36.27%) for the same population. Across the OMC Baton Rouge study area, the African‐American/Black population sees some of the highest rates of poverty across the OMC Baton Rouge study area. 133
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Almost 50% of the African‐American/Black population of Louisiana is living in poverty. Children in Poverty ‐ Race, 2009‐2013
100.00%
90.00%
80.00%
70.00%
Asian
60.00%
50.00%
Some Other Race
40.00%
Multiple Race
30.00%
20.00%
10.00%
0.00%
Ascension
East Baton
Rouge
Iberville
Livingston
LOUISIANA
USA
Similar to children living in poverty below the 100% FPL, Iberville Parish and East Baton Rouge Parish report the highest rates of children living below 200% of the federal poverty level as well (55.12% and 48.82%, respectively). 32.98%
40.00%
30.00%
43.81%
49.29%
50.00%
35.63%
48.82%
60.00%
55.12%
Children in Poverty ‐ Below 200% FPL, 2009‐2013
Ascension
East Baton Rouge
Iberville
Livingston
20.00%
LOUISIANA
10.00%
USA
0.00%
Teen Birth Rate In general, the OMC Baton Rouge study area parishes have seen steady declines in the rates of births to teen mothers (aged 15‐19). 134
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville Parish reported a slight rise in the teen birth rates from the 2005‐2011 5‐year estimate census to the 2006‐2012 5‐year estimate census. Teen Birth Rate (Age 15‐19, per 1,000 population)
Ascension
70
65
East Baton Rouge
60
55
Iberville
50
45
Livingston
40
35
LOUISIANA
30
USA
Ascension Parish reports the highest teen birth rate in the study area (66.6 per 1,000 pop.) for the Hispanic/Latino population. Across the study area, the Non‐Hispanic Black and Hispanic/Latino populations experience the highest teen birth rates. Teen Birth Rate (Age 15‐19, per 1,000 population) ‐ By Race/Ethnicity,
2006‐2012
80
Ascension
East Baton Rouge
70
60
Iberville
50
40
Livingston
30
20
LOUISIANA
10
0
Hispanic or Latino
USA
Unemployment Rate In 2013; Iberville Parish reported the highest unemployment rates at 8.4% (LA = 6.7%, USA = 7.4%). 135
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Unemployment Rate by Year
12.0%
11.0%
East Baton Rouge
10.0%
9.0%
Iberville
8.0%
7.0%
6.0%
Livingston
5.0%
4.0%
LOUISIANA
3.0%
2.0%
USA
For the most current reported data, the same parish (Iberville Parish) reports the highest unemployment rate at 7.5%. (LA = 6.4%, USA = 5.6%). Unemployment Rate by Month
Ascension
10.0%
9.0%
East Baton Rouge
8.0%
Iberville
7.0%
6.0%
Livingston
5.0%
4.0%
LOUISIANA
3.0%
USA
Violent Crime Iberville Parish reports the highest violent crime rate across the OMC Baton Rouge study area counties at 1,163.01 per 100,000 population; almost triple the national rate of 395.5. East Baton Rouge Parish reports the second highest violent crime rate for the study area at 700.68 per 100,000 pop; almost double the national rate. 136
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Ascension Parish and Livingston Parish fall below the state and national rates at 269.53 and 318.1, respectively. 1,163.01
Violent Crime Rate (Per 100,000 Pop.), 2010‐2012
1200
700.68
1000
East Baton Rouge
269.53
400
532.9
600
318.1
800
Iberville
395.5
1400
Ascension
Livingston
LOUISIANA
200
USA
0
Physical Environment Fast Food In 2013, East Baton Rouge Parish reported the highest rate of fast food restaurants per population at 86.78 per 100,000 pop.; Ascension Parish follows at 74.62 per pop.; these rates are higher than state (71.56) and national (72.74) norms. Fast Food Establishments, Rate per 100,000 population
100
90
80
70
60
50
40
30
20
10
0
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
USA
Grocery Stores In 2013, Livingston Parish reported the lowest rate of grocery stores per population at 12.5 per 100,000 pop.; Ascension Parish follows at 18.65 per 100,000 pop.; both are lower than state (21.88) and national (21.2) norms. 137
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Grocery Store Establishments, Rate per 100,000 population
45
40
East Baton Rouge
35
30
Iberville
25
20
Livingston
15
10
LOUISIANA
5
0
USA
Recreation and Fitness Facilities In 2013, Iberville Parish reported the lowest rate of recreation and fitness facilities per population at 3 per 100,000 pop.; Livingston Parish follows at 7.03 per 100,000 pop.; both are lower than state (9.6) and national (9.72) norms. Recreation and Fitness Facility Access, Establishment Rate per 100,000 population
Ascension
18
16
East Baton Rouge
14
12
Iberville
10
8
Livingston
6
4
LOUISIANA
2
0
USA
Housing All of the OMC Baton Rouge study area parishes have far lower rates of HUD‐Assisted housing units per 10,000 units than the state and nation. East Baton Rouge Parish reports the highest rate for the study area at 416.81 per 10,000 units. Livingston Parish reports the lowest rate of HUD‐Assisted housing units at 60.99 per 10,000 units. 138
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach HUD‐Assisted Units, Rate per 10,000 Housing Units, 2013
1,959.58
2500
East Baton Rouge
1,468.19
2000
1500
Ascension
Iberville
Livingston
LOUISIANA
60.99
258.91
500
416.81
129.71
1000
USA
0
Housing Unit Age (below) ‐ This indicator reports, for a given geographic area, the median year in which all housing units (vacant and occupied) were first constructed. Iberville Parish has the highest median housing age at 38 years old; East Baton Rouge Parish is a close second reporting its median housing age at 37. Housing Unit Age ‐ Years Old, 2013
Ascension
45
40
37
38
38
39
East Baton Rouge
35
30
25
20
Iberville
21
23
Livingston
15
10
LOUISIANA
5
USA
0
Iberville Parish reports the highest rate of overcrowded housing at 6.02%; this is higher than state (3.96%) and national (4.21%) norms. 139
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Percentage of Housing Units Overcrowded, 2008‐2012
Ascension
6.02%
7.00%
6.00%
4.21%
3.96%
3.24%
4.00%
3.69%
5.00%
4.17%
East Baton Rouge
Iberville
Livingston
3.00%
2.00%
LOUISIANA
1.00%
USA
0.00%
30.00%
25.00%
20.00%
36.11%
30.09%
22.99%
35.00%
25.84%
40.00%
24.66%
33.36%
East Baton Rouge Parish reports the highest rate, for the OMC Baton Rouge study area, of housing units with substandard conditions (33.56%). The state rate is 30.09% and the national rate is 36.11%. Percent Occupied Housing Units with One or More Substandard Conditions
Ascension
2009‐2013
East Baton Rouge
Iberville
Livingston
15.00%
10.00%
5.00%
LOUISIANA
USA
0.00%
Livingston Parish reports the highest rate of housing units lacking complete plumbing facilities at 1.28% (LA = 0.54%, USA = 0.49%). Iberville Parish reports the highest rate of housing units lacking complete kitchen facilities at 4.91% (LA = 4.66%, USA = 3%). Iberville Parish also reports the highest rate of housing units lacking telephone facilities at 3.43% (LA = 2.91%, USA = 2.44%). 140
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach 2009‐2013
2.44%
2.91%
2.90%
3.43%
3.02%
2.20%
3%
East Baton Rouge
Iberville
0.49%
Livingston
0.54%
0.71%
1.00%
0.48%
0.47%
2.00%
1.28%
3.00%
4.66%
4.91%
2.91%
4.00%
3.20%
5.00%
4.22%
Ascension
6.00%
LOUISIANA
0.00%
Housing Units Lacking
Complete Plumbing Facilities
Housing Units Lacking
Complete Kitchen Facilities
Total Housing Units Lacking
Telephone Service
USA
Iberville Parish reports the highest rate of vacant housing for the OMC Baton Rouge study area at 12.11%; East Baton Rouge Parish at 11.12%; these are lower than state (13.5%) and national (12.45%) norms. 7.99%
12.00%
10.00%
8.00%
9.46%
11.12%
14.00%
12.11%
16.00%
12.45%
13.50%
Vacant Housing Units, Percent, 2009‐2013
Ascension
East Baton Rouge
Iberville
Livingston
6.00%
LOUISIANA
4.00%
2.00%
USA
0.00%
Low Food Access The low‐income populations of Ascension Parish and East Baton Rouge Parish experience the highest rates of low food access (14.34% and 11.96% respectively). These rates are higher than the rates seen for the state (10.82%) and nation (6.27%). 141
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville
10.00%
6.27%
8.25%
12.00%
Ascension
East Baton Rouge
10.82%
14.00%
11.96%
16.00%
14.34%
Percent Low Income Population with Low Food Access, 2010
8.00%
Livingston
2.06%
6.00%
4.00%
LOUISIANA
2.00%
USA
0.00%
Ascension Parish experiences the highest rate of population with low or no healthy food access; this parish has a disparity index of 26.31 compared to 19.31 for the State of Louisiana and a national rate of 16.59. 16.59
22.06
Ascension
East Baton Rouge
19.31
20
23.99
25
20.22
30
26.31
Population with Low or No Healthy Food Access,
Racial Disparity Index, 2010
Iberville
15
Livingston
10
5
LOUISIANA
0
Population with Low or No Healthy Food Access, Racial Disparity Index
(0 = No Disparity; 1 ‐ 15 = Some Disparity; Over 15 = High Disparity)
USA
Within the parish of Iberville, the Non‐Hispanic other population experiences the highest rate of low food access (72.7%) followed by the Non‐Hispanic Asian population (70.2%). These rates are the highest for the study area. East Baton Rouge Parish reports the next highest rates, for the study area, for Non‐
Hispanic Asian (64.9%) and Non‐Hispanic Black (64.2%) populations. 142
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Low Food Access ‐ Race, 2010
100.0%
90.0%
80.0%
Non‐Hispanic Asian
70.0%
60.0%
Non‐Hispanic American
Indian / Alaska Native
50.0%
Non‐Hispanic Other
40.0%
Multiple Race
30.0%
Hispanic or Latino
20.0%
10.0%
0.0%
Ascension
East Baton
Rouge
Iberville
Livingston
LOUISIANA
USA
Iberville Parish has the highest rate of SNAP‐Authorized retailers for the OMC Baton Rouge study area at 119.81 per 100,000 population. Ascension Parish reports the fewest SNAP‐Authorized retailers for the study area at only 83.94 per 100,000 population. 80
Ascension
104.62
East Baton Rouge
78.44
100
83.94
120
96.07
105.19
140
119.81
SNAP‐Authorized Retailers, Rate per 100,000 population, 2014
Iberville
Livingston
60
40
LOUISIANA
20
0
USA
East Baton Rouge Parish has the highest rate of WIC‐Authorized retailers for the OMC Baton Rouge study area at 16.99 per 100,000 population. Livingston Parish reports the fewest WIC‐Authorized retailers for the study area with 10.75 per 100,000 population. The State of Louisiana has an overall rate of WIC‐
143
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Authorized retailers of 15.7 per 100,000 population; the national rate being 15.6 per 100,000 pop. 10.75
14
15.6
15.7
16
15.05
14.55
18
16.99
WIC‐Authorized Food Store Rate (Per 100,000 Population), 2011
12
Ascension
East Baton Rouge
Iberville
10
Livingston
8
6
LOUISIANA
4
2
USA
0
East Baton Rouge Parish reports the highest rate of residents using public transportation to commute to work (1.75%); higher than state (1.30%) and but much lower than national (5.01%) rates. Percent Population Using Public Transit for Commute to Work, 2009‐2013
5.01%
6.00%
Ascension
East Baton Rouge
5.00%
Iberville
4.00%
Livingston
0.00%
LOUISIANA
0.27%
1.00%
0.31%
0.11%
2.00%
1.30%
1.75%
3.00%
USA
Clinical Care Primary Care Physicians East Baton Rouge Parish reports the highest number of physicians across the study area parishes at 389. 144
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville Parish reports the fewest physicians with only 11. Primary Care Physicians, 2012
Ascension
2,960
3500
3000
East Baton Rouge
2500
2000
Iberville
1500
Livingston
25
50
500
11
389
1000
LOUISIANA
0
East Baton Rouge Parish has the highest primary care physician (PCP) rate per 100,000 population at 102.58 in 2012. Livingston Parish reports the lowest rate of PCPs per 100,000 population at only 19.71 in 2012. Primary Care Physicians, Rate per 100,000 population
Ascension
120
East Baton Rouge
100
80
Iberville
60
Livingston
40
20
LOUISIANA
0
USA
Dentists East Baton Rouge Parish reports the highest number of dentists across the study area parishes at 306. 145
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville Parish reports the fewest dentists with only 12. 2,341
Dentists, 2013
2500
Ascension
East Baton Rouge
2000
1500
Iberville
1000
306
Livingston
LOUISIANA
34
12
32
500
0
East Baton Rouge Parish has the highest dentist rate per 100,000 population at 68.73 in 2013. Livingston Parish reports the lowest rate of dentists per 100,000 population for the OMC Baton Rouge study area at only 25.36 in 2013. 80
50.61
70
63.18
68.73
Dentists, Rate per 100,000 population, 2013
30
25.36
40
27.97
50
35.96
60
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
20
10
USA
0
Mammogram – Medicare Enrollees Ascension Parish, Iberville Parish, and Livingston Parish all reported a decline in the rates of women with Medicare receiving a mammogram. 146
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach East Baton Rouge Parish was the only parish to see an increase in the rate of women with Medicare receiving a mammogram in the past two years; going from 64.58% in 2011 to 65.42% in 2012. Female Medicare Enrollees with Mammogram in Past 2 years
Ascension
70.00%
East Baton Rouge
65.00%
60.00%
Iberville
55.00%
50.00%
Livingston
45.00%
40.00%
LOUISIANA
35.00%
USA
Cancer Screening – Pap Test Louisiana reports 78.1% of their populations as having received a Pap Test; this rate is slightly lower than the national rate of 78.48%. Livingston Parish reports the lowest rate of female residents aged 18 and older receiving a Pap Test at 78.30%. 78.48%
78.10%
80%
78.30%
80.00%
80.90%
85.00%
81.80%
Cancer Screening ‐ Pap Test (Age‐Adjusted Percentage), 2006‐2012
Ascension
East Baton Rouge
75.00%
70.00%
Iberville
65.00%
60.00%
Livingston
55.00%
50.00%
LOUISIANA
45.00%
40.00%
USA
35.00%
Cancer Screening – Sigmoidoscopy or Colonoscopy 147
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach 61.34% of the national age‐appropriate population (aged 50 and older) receives a sigmoidoscopy or colonoscopy; across the State of Louisiana only 54.5% receive this screening. Iberville Parish reports the lowest rate of residents receiving a sigmoidoscopy or colonoscopy at only 36.20%. 60.00%
61.34%
54.50%
56.70%
65.00%
59.60%
62.10%
Cancer Screening ‐ Sigmoidoscopy or Colonoscopy (Age‐Adjusted Percentage)
2006‐2012
55.00%
Ascension
East Baton Rouge
Iberville
50.00%
Livingston
45.00%
36.20%
LOUISIANA
40.00%
USA
35.00%
HIV/AIDS The national rate of the population that has never been tested for HIV/AIDS is 62.79%; in Louisiana this rate is 56.23%. Iberville Parish reports the highest rate of residents that have never been tested for HIV/AIDS across the OMC Baton Rouge study area at 63.05%. 55.00%
50.00%
45.00%
49.52%
62.79%
56.23%
60.00%
53.51%
65.00%
61.16%
63.05%
Percent Adults Never Screened for HIV/AIDS, 2011‐2012
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
40.00%
USA
35.00%
Pneumonia Vaccine 148
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach The majority of the OMC Baton Rouge study area, three of the four parishes, report higher rates than the national rate (67.51%) for residents receiving the pneumonia vaccination. Ascension Parish reports the lowest rate of residents receiving the pneumonia vaccination at 61%. 65.00%
67.51%
68.50%
70.00%
61.00%
75.00%
77.70%
70.00%
80.00%
74.60%
Pneumonia Vaccination (Age‐Adjusted Percentage), 2006‐2012
60.00%
Ascension
East Baton Rouge
Iberville
Livingston
55.00%
50.00%
LOUISIANA
45.00%
40.00%
USA
35.00%
Diabetes Screening The national rate of diabetes screening in 2012 was 84.57% of the diabetic Medicare population. Livingston Parish, at 85.07%, reports higher than the national rate; the other three parishes report lower rates, with the lowest being 79.65% for Ascension Parish. Diabetes Management ‐ Hemoglobin A1c Test, Percent Medicare Enrollees with Diabetes with Annual Exam
90.00%
88.00%
Ascension
East Baton Rouge
86.00%
84.00%
Iberville
82.00%
80.00%
78.00%
Livingston
76.00%
74.00%
72.00%
LOUISIANA
70.00%
USA
High Blood Pressure 149
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach All of the parishes in the OMC Baton Rouge study area report lower rates of adult residents with high blood pressure who are not taking their medication than the national average; the national rate being 21.74%. East Baton Rouge Parish reports the highest rate of adult residents with high blood pressure not taking their medication for the study area at 17.81%. 21.74%
High Blood Pressure, Percent Adults Not Taking Medication, 2006‐2010
15.00%
16.29%
14.17%
15.14%
20.00%
17.81%
25.00%
Ascension
East Baton Rouge
Iberville
Livingston
10.00%
LOUISIANA
5.00%
USA
0.00%
Dental Exam Iberville Parish reports the highest rate of adults who have not had a dental exam for the OMC Baton Rouge study area (38.17%); the national rate is 30.15%. 30.00%
25.00%
20.00%
30.15%
24.58%
35.00%
28.93%
40.00%
34.28%
45.00%
32.79%
38.17%
Percent Adults with No Dental Exam, 2006‐2010
Ascension
East Baton Rouge
Iberville
Livingston
15.00%
10.00%
LOUISIANA
5.00%
USA
0.00%
Federally Qualified Health Centers (FQHCs) 150
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville Parish reports the highest rate of FQHCs per population at 5.99 per 100,000; more than five times the other parishes in the study area and triple the national rate of 1.92. Ascension Parish and East Baton Rouge Parish come in just under 1 FQHC per 100,000 population; Livingston Parish follows with 0.78 FQHCs per 100,000 population. Rate of Federally Qualified Health Centers per 100,000 population,
2014
5.99
7
Ascension
East Baton Rouge
6
Iberville
5
4
2.1
LOUISIANA
0.78
1
0.91
0.93
2
1.92
Livingston
3
USA
0
Regular Doctor Across the country, 22.07% of residents report not having a regular doctor (77.93% have a regular doctor); in Louisiana the rate is 24.09%. Livingston Parish reports the highest rate of residents who do not have a regular doctor at 24.39%. 22.07%
24.39%
17.56%
20.00%
17.02%
25.00%
21.86%
30.00%
24.09%
Percent Adults Without Any Regular Doctor, 2011‐2012
15.00%
Ascension
East Baton Rouge
Iberville
Livingston
10.00%
LOUISIANA
5.00%
USA
0.00%
Population Living in an HPSA (Health Professional Shortage Area) 151
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach The parishes of East Baton Rouge, Iberville, and Livingston are all health care professional shortage areas (HPSA) designated parishes; therefore 100% of their populations live in an HPSA designated area. 100%
100%
100%
Percentage of Population Living in a HPSA, March 2015
East Baton Rouge
74.13%
100.00%
90.00%
80.00%
Ascension
Iberville
70.00%
34.07%
60.00%
50.00%
30.00%
20.00%
10.19%
40.00%
Livingston
LOUISIANA
10.00%
USA
0.00%
Health Behaviors Leisure Time Physical Activity Iberville Parish reports the highest rate of population with no leisure time activity (31.60%) for the OMC Baton Rouge study area; higher than state (29.8%) and national (22.64%) norms. All of the parishes of the OMC Baton Rouge study area report higher rates than the national norms for population who do not partake in leisure time physical activity. 29.80%
31.60%
Ascension
East Baton Rouge
22.64%
25.00%
29%
30.00%
25.40%
35.00%
27.60%
Percent Population with No Leisure Time Physical Activity, 2012
Iberville
20.00%
Livingston
15.00%
10.00%
LOUISIANA
5.00%
USA
0.00%
Men consistently report lower rates of not partaking in leisure time physical activity than women; this may be a reporting difference or that women do not actually partake in leisure time physical activity as men. 152
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Percent Population with No Leisure Time Physical Activity ‐ Gender, 2012
40.00%
34.80%
35.00%
30.30%
30.00%
25.00%
31.60%
29.10%
24.60%
28.40%
26.20%
32.87%
Males
26.45%
21.20%
23.94%
21.20%
Females
20.00%
15.00%
10.00%
5.00%
0.00%
Although Iberville Parish currently has the highest rate of population not partaking in leisure time physical activity in the study area at 31.60%, this rate has steadily declined since 2010 when the rate was 34.80%. Percent Population with No Leisure Time Physical Activity ‐ Time
Ascension
40.00%
38.00%
36.00%
East Baton Rouge
34.00%
32.00%
Iberville
30.00%
28.00%
Livingston
26.00%
24.00%
22.00%
LOUISIANA
20.00%
USA
Fruit/Vegetable Consumption 153
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Livingston Parish reports the highest rate of the parishes in the OMC Baton Rouge study area for adults not eating enough fruits and vegetables at 84.80%; higher than the national rate (75.6%). Ascension Parish, also higher than the national rate, follows closely at 84.4%. 80.00%
75.67%
81.10%
84.80%
90.00%
79.70%
84.40%
Percent Adults with Inadequate Fruit/Vegetable Consumption, 2005‐2009
70.00%
Ascension
East Baton Rouge
Iberville
60.00%
50.00%
Livingston
40.00%
30.00%
LOUISIANA
20.00%
10.00%
USA
0.00%
Excessive Drinking The national rate of adults drinking excessively is 16.94%; half of the parishes (Iberville Parish and Ascension Parish) in the OMC Baton Rouge study area report higher rates of adults drinking excessively. Iberville Parish reports the highest rate, for the OMC Baton Rouge study area, of adults drinking excessively at 22.8%. 22.80%
Estimated Adults Drinking Excessively (Age‐Adjusted Percentage),
2006‐2012
16.94%
15.90%
East Baton Rouge
13.60%
15.00%
13.40%
20.00%
18.30%
25.00%
Ascension
Iberville
Livingston
10.00%
LOUISIANA
5.00%
USA
0.00%
Smoking 154
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Livingston Parish reports the highest rate of adults smoking cigarettes across the OMC Baton Rouge study area with 24.1% of the population smoking; higher than Louisiana (21.9%) and the nation (18.08%). 15.00%
Ascension
East Baton Rouge
18.08%
14.50%
20.00%
16.80%
19.10%
25.00%
24.10%
30.00%
21.90%
Percent Population Smoking Cigarettes (Age‐Adjusted), 2006‐2012
Iberville
Livingston
10.00%
LOUISIANA
5.00%
USA
0.00%
Ascension Parish reports the highest rate of adults trying to quit smoking in the past 12 months at 76.17%; this would be a prime population to target smoking cessation programs as they have already expressed interest in trying to stop smoking. 60.00%
60.02%
60.22%
65.81%
58.99%
70.00%
63.39%
80.00%
76.17%
Percent Smokers with Quit Attempts in Past 12 Months, 2011‐2012
Ascension
East Baton Rouge
Iberville
50.00%
40.00%
Livingston
30.00%
20.00%
LOUISIANA
10.00%
USA
0.00%
Health Outcomes Depression 155
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Ascension Parish, Iberville Parish, and Livingston Parish all report higher rates of residents with depression than Louisiana (15.66%) and the country (15.45%). Livingston Parish is highest at 19.22% East Baton Rouge Parish reports the lowest rate of residents with depression at 15.66%; matching the state rate and slightly above the national rate. 15.45%
15.66%
16.50%
15.66%
18.34%
20.00%
19.22%
Percent Population with Depression, 2012
25.00%
Ascension
East Baton Rouge
Iberville
15.00%
Livingston
10.00%
LOUISIANA
5.00%
USA
0.00%
Diagnosed Diabetes Iberville Parish reports the highest rate of residents with diagnosed diabetes (12.2%). All of the study area parishes as well as the overall state rate for Louisiana are higher than national rates for population being diagnosed with diabetes. 8.00%
12%
12.20%
Ascension
East Baton Rouge
9.11%
10.00%
11.53%
12.00%
11.50%
14.00%
11.20%
Population with Diagnosed Diabetes, Age‐Adjusted Rate, 2012
Iberville
Livingston
6.00%
4.00%
LOUISIANA
2.00%
USA
0.00%
Men have higher rates of being diagnosed with diabetes than women for the OMC Baton Rouge study area. 13.2% of the Iberville Parish male population reports being diagnosed with diabetes; the highest rate in the study area. 156
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Population with Diagnosed Diabetes, Age‐Adjusted Rate ‐ Gender, 2012
14.00%
12.00%
10.00%
13.20%
11.20%
10.10%
12.30%
11.40%
11.90%
12.09%
11.30%
10.60%
9.40%
Males
9.62%
8.28%
Females
8.00%
6.00%
4.00%
2.00%
0.00%
The rate of diagnosed diabetes cases has seen steady and marked rises from 2004 to 2011 for the OMC Baton Rouge study area parishes. Population with Diagnosed Diabetes, Age‐Adjusted Rate ‐ Time
Ascension
16.00%
14.00%
12.00%
10.00%
East Baton Rouge
Iberville
Livingston
8.00%
LOUISIANA
6.00%
USA
Looking specifically at the Medicare population, Iberville Parish reports the highest rate of diagnosed diabetes at 33.15%; the national rate being 27.03%. Ascension Parish follows closely at 30.22%. 157
29.05%
27.76%
30.00%
33.15%
35.00%
27.72%
30.22%
Percent Adults with Diabetes (Medicare Population), 2012
25.00%
Ascension
East Baton Rouge
Iberville
20.00%
Livingston
15.00%
10.00%
LOUISIANA
5.00%
USA
0.00%
High Cholesterol Half of the parishes (Iberville and Livingston) report higher rates of residents with high cholesterol than the national average of 38.52%. Iberville Parish is highest at 46.50% Ascension Parish and East Baton Rouge Parish are below state and national rates at 34.95% and 34.70%, respectively. 35.00%
38.52%
38.68%
40.00%
34.70%
45.00%
34.95%
50.00%
42.34%
46.50%
Percent Adults with High Cholesterol, 2011‐2012
Ascension
East Baton Rouge
Iberville
30.00%
25.00%
Livingston
20.00%
15.00%
LOUISIANA
10.00%
5.00%
USA
0.00%
158
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Looking specifically at the Medicare population, Ascension Parish reports the highest rate of residents with high cholesterol at 45.16% (differing from Iberville Parish for the total population); the national rate being 44.75%. Livingston Parish is a close second at 44.36%. 44.00%
44.75%
45.00%
43.77%
46.00%
44.36%
45.16%
Percent Adults with High Cholesterol (Medicare Pop.), 2012
Ascension
East Baton Rouge
41.48%
42.00%
41.04%
Iberville
43.00%
Livingston
41.00%
LOUISIANA
40.00%
39.00%
USA
38.00%
Heart Disease East Baton Rouge Parish reports the highest rate of residents who have heart disease (4.07%); lower than both state (4.91%) and national rates (4.40%). 3.00%
4.91%
3.54%
4.00%
2.96%
5.00%
3.35%
4.07%
6.00%
4.40%
Percent Adults with Heart Disease, 2011‐2012
Ascension
East Baton Rouge
Iberville
Livingston
2.00%
LOUISIANA
1.00%
0.00%
USA
159
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Looking specifically at the Medicare population, Iberville Parish reports the highest rate of residents with heart disease at 29.97% (differing from East Baton Rouge Parish for the total population); the national rate being 28.55%. 28.55%
32.24%
29.97%
28.93%
30.00%
26.06%
35.00%
27.47%
Percent Adults with Heart Disease (Medicare Pop.), 2012
Ascension
East Baton Rouge
Iberville
25.00%
20.00%
Livingston
15.00%
LOUISIANA
10.00%
5.00%
USA
0.00%
High Blood Pressure Iberville Parish the highest rate of residents who have high blood pressure (34.4%); this rate is higher than the national rate of 28.16%. 25.00%
20.00%
34.10%
32.50%
28.16%
30.00%
30.40%
35.00%
28.20%
40.00%
34.40%
Percent Adults with High Blood Pressure, 2006‐2012
Ascension
East Baton Rouge
Iberville
Livingston
15.00%
10.00%
LOUISIANA
5.00%
0.00%
USA
160
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Looking specifically at the Medicare population, Iberville Parish continues to report the highest rate of residents with high blood pressure at 60.81%; the national rate being 55.49%. 59.00%
Ascension
East Baton Rouge
58.50%
60.00%
59.03%
61.00%
59.24%
62.00%
60.81%
63.00%
61.83%
Percent Adults with High Blood Pressure (Medicare Pop.), 2012
Iberville
55.49%
58.00%
57.00%
56.00%
Livingston
LOUISIANA
55.00%
54.00%
53.00%
USA
52.00%
Overweight and Obese Iberville Parish reports the highest rate of residents who are overweight (37.16%); this rate is higher than the national rate of 35.78%. The rest of the parishes in the OMC Baton Rouge study area fall below the national rate; Livingston Parish being the lowest at 31.41%. 34.00%
33.00%
32.00%
31.00%
34.48%
35.00%
31.41%
36.00%
32.75%
37.00%
34.78%
38.00%
35.78%
37.16%
Percent Adults Overweight, 2011‐2012
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
30.00%
29.00%
USA
28.00%
161
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville Parish reports the highest rate of residents who are obese (39.4%), Livingston Parish is a close second with 35.60% of their population being obese; East Baton Rouge Parish ranks third highest at 32.20%. Ascension Parish is fourth and lowest with 31.90% of the population being obese; the national rate is 27.14%. 30.00%
Ascension
East Baton Rouge
27.14%
34.14%
35.00%
35.60%
40.00%
32.20%
31.90%
45.00%
39.40%
Percent Adults with BMI > 30.0 (Obese), 2012
Iberville
25.00%
Livingston
20.00%
15.00%
LOUISIANA
10.00%
5.00%
USA
0.00%
There are not significant differences in males and females in terms of obesity; for the study area, some parishes see women having higher rates of obesity, for other parishes, men are more likely to be obese. On a national level, men are more likely to be obese than women (27.7% vs. 26.59%). Percent Adults with BMI > 30.0 (Obese) ‐ Gender, 2012
45.00%
40.40%
38.30%
40.00%
35.00%
30.00%
25.00%
32.50%
32.40%
31.50% 31.70%
37.40%
33.90%
34.17%
34.08%
Males
27.70%
26.59%
Females
20.00%
15.00%
10.00%
5.00%
0.00%
162
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach The rates of obesity in the OMC Baton Rouge study area and nationally have seen steady rises over the years. Ascension Parish is the lowest in the study area at 31.90% and closest to the U.S. rates for obesity and has seen, after peaking at 34.1% in 2010, a steady decline. Percent Adults with BMI > 30.0 (Obese) ‐ Time
Ascension
50.00%
45.00%
East Baton Rouge
40.00%
Iberville
35.00%
Livingston
30.00%
25.00%
LOUISIANA
20.00%
USA
Asthma Livingston Parish reports the highest rate of adults with asthma for the OMC Baton Rouge study area at 12.91%; this is lower than the national rate of 13.36%. 10.00%
8.00%
13.36%
12.91%
Ascension
East Baton Rouge
Iberville
7.83%
12.00%
10.61%
14.00%
12.60%
16.00%
11.65%
Percent Adults with Asthma, 2011‐2012
Livingston
6.00%
4.00%
LOUISIANA
2.00%
USA
0.00%
163
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Dental Health Livingston Parish reports the highest rate of adults with poor dental health for the OMC Baton Rouge study area at 18.78%; this is higher than the national rate of 15.65%. Iberville Parish reports the next highest rate of adults with poor dental health at 17.57%. 16.00%
14.00%
18.70%
15.65%
18.00%
13.36%
14.28%
20.00%
18.78%
17.57%
Percentage Adults with Poor Dental Health, 2006‐2010
Ascension
East Baton Rouge
Iberville
12.00%
10.00%
Livingston
8.00%
6.00%
LOUISIANA
4.00%
2.00%
USA
0.00%
Poor Health Similar to poor dental health, Livingston Parish reports the highest rates of poor general health (19.7%). East Baton Rouge Parish, at 15.5%, has the lowest rate in the OMC Baton Rouge study area and is the only parish to report a rate lower than the national rate of 15.74%. Ascension
East Baton Rouge
15.74%
19.60%
19.70%
15.50%
20.00%
17.80%
25.00%
18.90%
Poor General Health, Age‐Adjusted Percentage, 2006‐2012
Iberville
15.00%
Livingston
10.00%
LOUISIANA
5.00%
0.00%
USA
Chlamydia Infection 164
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach East Baton Rouge Parish has reported the highest rate of chlamydia infection in the OMC Baton Rouge study area since 2009. The most current data, for 2011, shows the rate of chlamydia infection to be 743.9 per 100,000 population; considerably higher than the national chlamydia rate of 454.1 per 100,000 population. Only Ascension Parish and Livingston Parish report lower chlamydia infection rates than the nation. Livingston Parish being the lowest in the study area at 263.3 per 100,000 population. Chlamydia Infection Rate (Per 100,000 Pop.)
800.0
700.0
Ascension
East Baton Rouge
600.0
500.0
Iberville
400.0
300.0
Livingston
200.0
LOUISIANA
100.0
0.0
USA
Gonorrhea Infection Similar to chlamydia infection, East Baton Rouge Parish reports the highest rate of gonorrhea infection in the OMC Baton Rouge study area at 229.9 per 100,000 population; more than double the national rate of 103.1 per 100,000 population. East Baton Rouge Parish has consistently reported the highest rate of gonorrhea infection in the study area since 2003. Also similar to chlamydia infection, only Ascension Parish and Livingston Parish report lower chlamydia infection rates than the nation. Livingston Parish being the lowest in the study area at 34.5 per 100,000 population. Gonorrhea Infection Rate (Per 100,000 Pop.)
400.0
350.0
Ascension
East Baton Rouge
300.0
250.0
Iberville
200.0
150.0
Livingston
100.0
50.0
LOUISIANA
0.0
USA
165
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach HIV/AIDS The Non‐Hispanic Black population is the population that sees the highest rates of HIV/AIDS. East Baton Rouge Parish sees the highest rate of HIV/AIDS for the study area in the Non‐
Hispanic Black population at 1,704.65 per 100,000 population. The next highest rate in the study area, also in the Non‐Hispanic Black population, is 1,288.68 per 100,000 population in Iberville Parish. Population with HIV/AIDS, Rate (Per 1,000 population) ‐ By Race/Ethnicity
2010
Ascension
East Baton Rouge
1800
1600
1400
1200
1000
800
600
400
200
0
Iberville
Livingston
LOUISIANA
Hispanic / Latino
USA
From 2008 to 2010, many of the study area parishes experienced rises or slight declines then larger rises in the HIV/AIDS rates for their parish. Therefore 2010 rates of HIV/AIDS in the OMC Baton Rouge study area are higher than 2008 rates. Population with HIV/AIDS, Rate (Per 100,000 Pop.)
900
Ascension
800
700
East Baton Rouge
600
500
Iberville
400
300
Livingston
200
100
LOUISIANA
0
USA
Breast Cancer 166
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville Parish reports the highest incidence rate of breast cancer for the OMC Baton Rouge study area at 137.1 per 100,000 population; this is higher than the national rate of 122.7 per 100,000 pop. The Healthy People 2020 goal is for breast cancer incidence to be less than or equal to 40.9 per 100,000 population; all of the study area parishes and state report rates more than double this goal. 120
122.7
121.3
107.5
109.7
140
137.1
160
127.8
Breast Cancer ‐ Annual Incidence Rate (Per 100,000 Pop.),
2007‐2011
Ascension
East Baton Rouge
Iberville
100
80
Livingston
60
LOUISIANA
40
20
USA
0
The White population of Iberville Parish reports the highest rate of breast cancer incidence when looking at incidence by race/ethnicity (146.5 per 100,000 pop.). Breast Cancer ‐ Annual Incidence Rate (Per 100,000 pop.) ‐
By Race/Ethnicity, 2007‐2011
160
Ascension
East Baton Rouge
140
120
Iberville
100
80
Livingston
60
40
LOUISIANA
20
0
White
Black
Asian / Pacific
Islander
American Indian / Hispanic or Latino
Alaskan Native
USA
Cervical Cancer 167
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Ascension Parish reports the highest incidence rate of cervical cancer for the OMC Baton Rouge study area at 9.5 per 100,000 population; this is higher than the national rate of 7.8 per 100,000 pop. The Healthy People 2020 goal is for cervical cancer incidence to be less than or equal to 7.1 per 100,000 population; all of the study area parishes and state report rates higher than this goal. 8
9.4
Ascension
East Baton Rouge
7.8
9
8.7
8.1
10
9.5
Cervical Cancer ‐ Annual Incidence Rate (Per 100,000 Pop.)
2007‐2011
Iberville
7
6
5
Livingston
4
3
LOUISIANA
2
1
USA
0
Colon and Rectum Cancer Iberville Parish reports the highest incidence rate of colon and rectum cancer for the OMC Baton Rouge study area at 64.2 per 100,000 population; this is higher than the national rate of 43.3 per 100,000 pop. The Healthy People 2020 goal is for colon and rectum cancer incidence to be less than or equal to 38.7 per 100,000 population; all of the study area parishes and state report rates higher than this goal. 168
Colon and Rectum Cancer ‐ Annual Incidence Rate (Per 100,000 Pop.)
2007‐2011
51
43.3
50
East Baton Rouge
53.4
47.5
60
49.2
70
Ascension
Iberville
40
Livingston
30
20
LOUISIANA
10
USA
0
The African‐American/Black population reports higher rates of colon and rectum cancer incidence as compared with other racial groups for the OMC Baton Rouge study area, the state, and nationally. Colon and Rectum Cancer ‐ Annual Incidence Rate (Per 100,000 pop.) ‐
80
Ascension
East Baton Rouge
70
60
Iberville
50
40
Livingston
30
20
LOUISIANA
10
0
White
Black
Asian / Pacific
Islander
Alaskan Native
USA
Lung Cancer Livingston Parish reports the highest incidence rate of lung cancer for the OMC Baton Rouge study area at 80.4 per 100,000 population followed closely by Ascension Parish with 79.5 per 100,000 population and Iberville Parish with 77.7 per 100,000 population; these values are higher than the national rate of 64.9 per 100,000 population as well as the state rate of 74.2 per 100,000 population. 169
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Only East Baton Rouge Parish, at 60.7 per 100,000 population, reports a rate below state and national norms. 70
Ascension
East Baton Rouge
64.9
60.7
80
74.2
77.7
79.5
90
80.4
Lung Cancer ‐ Annual Incidence Rate (Per 100,000 Pop.),
2007‐2011
Iberville
60
50
Livingston
40
30
LOUISIANA
20
10
USA
0
The White population in Livingston Parish reports the highest rate of lung cancer incidence when looking at incidence by race/ethnicity (81 per 100,000 pop.). Lung Cancer ‐ Annual Incidence Rate (Per 100,000 pop.) ‐
90
Ascension
East Baton Rouge
80
70
Iberville
60
50
40
Livingston
30
20
LOUISIANA
10
0
White
Black
Asian / Pacific
Islander
Alaskan Native
USA
Prostate Cancer Iberville Parish reports the highest incidence rate of prostate cancer for the OMC Baton Rouge study area at 231.5 per 100,000 population followed closely by East Baton Rouge Parish at 221.5; these values are higher than the national rate of 142.3 per 100,000 pop. 170
142.3
150
Ascension
East Baton Rouge
159.8
200
231.5
194.9
250
221.5
Prostate Cancer ‐ Annual Incidence Rate (Per 100,000 Pop.)
2007‐2011
Iberville
Livingston
100
LOUISIANA
50
USA
0
The African‐American/Black population reports higher rates of prostate cancer incidence as compared with other racial groups for the OMC Baton Rouge study area, the states, and nationally. Prostate Cancer ‐ Annual Incidence Rate (Per 100,000 pop.) ‐
300
Ascension
East Baton Rouge
250
Iberville
200
150
Livingston
100
50
LOUISIANA
0
White
Black
Asian / Pacific
Islander
Alaskan Native
USA
Low Birth Weight East Baton Rouge Parish Orleans Parish reports the highest rate of low‐weight births for the OMC Baton Rouge study area at 12% followed closely by Iberville Parish at 11.9 %. All of the study area parishes report higher rates of low‐weight births than the national rate of 8.2%. 171
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach The Healthy People 2020 goal is for low –weight births to be less than or equal to 7.8%; all of the study area parishes and state report rates higher than this goal. 10.90%
8.30%
10.00%
8.70%
12.00%
Ascension
East Baton Rouge
8.20%
12%
14.00%
11.90%
Low Birth Weight, Percent of Total, 2006‐2012
Iberville
8.00%
Livingston
6.00%
4.00%
LOUISIANA
2.00%
USA
0.00%
The Non‐Hispanic African‐American/Black population sees higher rates of low‐weight births as compared with other racial groups for the OMC Baton Rouge study area, the states, and nationally. Low Birth Weight, Percent of Total ‐ By Race/Ethnicity, 2006‐2012
Ascension
18.00%
16.00%
East Baton Rouge
14.00%
12.00%
Iberville
10.00%
8.00%
Livingston
6.00%
4.00%
LOUISIANA
2.00%
0.00%
Non‐Hispanic Black Non‐Hispanic Asian or
Pacific Islander
Hispanic or Latino
USA
East Baton Rouge Parish reports the highest rate of low‐weight births in 2006‐2012 (12%), this rate has remained fairly consistent since 2002‐2008. None of the parishes in the study area report a rate lower than the national rate of 8.2%. Although, Livingston Parish comes the closest at 8.3% and is the lowest of the study area. 172
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Low Birth Weight, Percent of Total ‐ By Year
Ascension
15.00%
14.00%
East Baton Rouge
13.00%
12.00%
11.00%
Iberville
10.00%
9.00%
8.00%
Livingston
7.00%
6.00%
LOUISIANA
5.00%
USA
Mortality ‐ Cancer Iberville Parish reports the highest rate of age‐adjusted mortality due to cancer for the OMC Baton Rouge study area at 218.85 per 100,000 population. All of the study area parishes report higher rates of mortality due to cancer than the national rate of 174.08 per 100,000 population. The Healthy People 2020 goal is for mortality due to cancer to be less than or equal to 160.6 per 100,000 population; all of the study area parishes and state report rates higher than this goal. 150
Ascension
East Baton Rouge
174.08
198.92
218.85
187.77
200
185.17
250
187.76
Mortality ‐ Cancer ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.),
2007‐2011
Iberville
Livingston
100
LOUISIANA
50
0
USA
Across the OMC Baton Rouge study area, state, and nationally; men have higher mortality rates due to cancer than women. 173
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Mortality ‐ Cancer ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Gender, 2007‐2011
300
250
240.02
261.36
232.43
238.6
250.54
Male
211.52
Female
186.07
200
154.05
151.02
149.17
162.56
150
147.92
100
50
0
The Non‐Hispanic Black population of Livingston Parish reports the highest rate of mortality due to cancer for the OMC Baton Rouge study area with 249.04 per 100,000 population. The Non‐Hispanic Black population sees higher rates of mortality due to cancer as compared with other racial groups for the OMC Baton Rouge study area. Mortality ‐ Cancer ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐
300
Ascension
East Baton Rouge
250
200
Iberville
150
Livingston
100
50
LOUISIANA
0
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
Non‐Hispanic Hispanic or Latino
American Indian /
Alaskan Native
USA
Mortality – Heart Disease Livingston Parish reports the highest rate of age‐adjusted mortality due to heart disease for the OMC Baton Rouge study area at 225.43 per 100,000 population. 174
Ascension
East Baton Rouge
184.55
148.15
200
225.43
250
193.99
208.48
Mortality ‐ Heart Disease ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.)
2007‐2011
Iberville
150
Livingston
100
LOUISIANA
50
USA
0
On a national level and for all of the study area parishes, men are more likely to die as a result of heart disease than women. Mortality ‐ Heart Disease ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐
By Gender, 2007‐2011
300
277.58
255.02
250
200
246.58
175.24
156.33
150
283.02
230.61
171.9
182
Male
Female
186.54
148.54
125.83
100
50
0
The Non‐Hispanic Black population of Ascension Parish reports the highest rate of death due to heart disease in the OMC Baton Rouge study area at 258.65 per 100,000 pop. 175
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Mortality ‐ Heart Disease ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐
300
Ascension
East Baton Rouge
250
200
Iberville
150
Livingston
100
50
LOUISIANA
0
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
Non‐Hispanic
Hispanic / Latino
American Indian /
Alaskan Native
USA
Mortality – Ischemic Heart Disease Livingston Parish reports the highest rate of age‐adjusted mortality due to ischemic heart disease for the OMC Baton Rouge study area at 137.34 per 100,000 population. The Healthy People 2020 goal is for mortality due to ischemic heart disease to be less than or equal to 103.4 per 100,000 population; Iberville Parish reports a rate already lower than this HP2020 Goal. 100
80
70.46
120
118.96
109.11
140
116.65
160
125.58
137.34
Mortality ‐ Ischemic Heart Disease ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2007‐2011
Ascension
East Baton Rouge
Iberville
Livingston
60
40
LOUISIANA
20
0
USA
On a national level and for all of the study area parishes, men are more likely to die as a result of ischemic heart disease than women. 176
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Mortality ‐ Ischemic Heart Disease ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Gender, 2007‐2011
200
184.17
180
160
167.23
148.16
151.1
157.16
Male
Female
140
120
100
93.46
91.72
98.24
93.6
78.36
80
89.72
51.51
60
40
20
0
Non‐Hispanic Black residents of Livingston Parish report the highest rate of death due to ischemic heart disease for the OMC Baton Rouge study area at 156.9 per 100,000 population. Mortality ‐ Ischemic Heart Disease ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Race/Ethnicity, 2007‐2011
Ascension
180
East Baton Rouge
160
140
120
Iberville
100
80
Livingston
60
40
20
LOUISIANA
0
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
American Indian /
Alaskan Native
USA
Mortality – Lung Disease 177
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville Parish reports the highest rate of mortality due to lung disease for the OMC Baton Rouge study area at 95.19 per 100,000 population; this is more than double the national rate of 42.67. Iberville has the highest rate, by far; the next highest rate being 52.14 for Livingston Parish. Mortality ‐ Lung Disease ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2007‐2011
95.19
Ascension
100
East Baton Rouge
90
80
40
42.67
42.36
50
32.92
47.71
60
52.14
Iberville
70
Livingston
LOUISIANA
30
20
10
USA
0
On a national level and for all of the OMC Baton Rouge study area parishes, men are more likely to die as a result of lung disease than women. Mortality ‐ Lung Disease ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Gender, 2007‐2011
140
125.96
120
Male
Female
100
80
60
40
70.46
47.3747.32
39.27
29.33
64.68
43.32
50.64
37.14
49.57
38.24
20
0
178
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach The Non‐Hispanic Black population of Iberville Parish reports the highest rate of death as a result of lung disease for the OMC Baton Rouge study area at 119.81 per 100,000 population. Mortality ‐ Lung Disease ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Race/Ethnicity, 2007‐2011
Ascension
140
East Baton Rouge
120
100
Iberville
80
60
Livingston
40
20
LOUISIANA
0
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
Non‐Hispanic
Hispanic / Latino
American Indian /
Alaskan Native
USA
Mortality – Stroke East Baton Rouge Parish reports the highest rate of age‐adjusted mortality due to stroke for the OMC Baton Rouge study area at 54.75 per 100,000 population. The Healthy People 2020 goal is for mortality due to stroke to be less than or equal to 33.8 per 100,000 population; all of the OMC Baton Rouge study area parishes report rates higher than this goal. Ascension
East Baton Rouge
40.39
47.53
44.84
45.38
50
54.75
60
47.24
Mortality ‐ Stroke ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2007‐2011
Iberville
40
30
20
Livingston
LOUISIANA
10
0
USA
179
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach On a national level, men are more likely to die as a result of stroke than women (40.51 per 100,000 pop. vs. 39.62); this is fairly consistent across the OMC Baton Rouge study area; the exception being East Baton Rouge Parish. Mortality ‐ Stroke ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Gender, 2007‐2011
60
50
49.23
45.86
53.33
54.2
48.32
42.35
45.79
48.36
44.26
45.97
Male
40.51
Female
39.62
40
30
20
10
0
The Non‐Hispanic Black population of East Baton Rouge Parish reports the highest rate of death as a result of stroke for the OMC Baton Rouge study area at 77.06 per 100,000 population. This population sees some of the highest rates across the study area parishes. Mortality ‐ Stroke ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Race/Ethnicity, 2007‐2011
90
80
70
60
50
40
30
20
10
0
Ascension
East Baton Rouge
Iberville
Livingston
LOUISIANA
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
American Indian /
Alaskan Native
USA
Mortality – Unintentional Injury 180
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Livingston Parish reports the highest rate of age‐adjusted mortality due to unintentional injury for the OMC Baton Rouge study area at 71.88 per 100,000 population. The Healthy People 2020 goal is for mortality due to unintentional injury to be less than or equal to 36.0 per 100,000 population; all of the OMC Baton Rouge study area parishes report rates higher than this goal. East Baton Rouge Parish comes closest to the HP2020 goal with 37.22 per 100,000 population 71.88
Mortality ‐ Unintentional Injury ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2007‐2011
80
Ascension
East Baton Rouge
40
Iberville
38.85
50
44.38
37.22
51
60
49.92
70
Livingston
30
LOUISIANA
20
10
USA
0
On a national level and across all of the OMC Baton Rouge study area parishes, men are more likely to die as a result of unintentional injury than women. Mortality ‐ Unintentional Injury ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Gender, 2007‐2011
120
104.21
100
Male
Female
80
72.05
70.41
52.42
60
54.9
53.19
43.11
40
33.1
31.27
23.64
30.81
25.67
20
0
181
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach The Non‐Hispanic White population of Livingston Parish reports the highest rate of mortality due to unintentional injury for the OMC Baton Rouge study area at 74 per 100,000 population. The Non‐Hispanic White population of Iberville Parish reports the next highest rate at 67.04 per 100,000 population. Mortality ‐ Unintentional Injury ‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Race/Ethnicity, 2007‐2011
Ascension
80
East Baton Rouge
70
60
Iberville
50
40
Livingston
30
20
10
LOUISIANA
0
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
Non‐Hispanic
Hispanic / Latino
American Indian /
Alaskan Native
USA
Mortality – Motor Vehicle Accident Iberville Parish reports the highest rate of deaths due to motor vehicle accidents for the OMC Baton Rouge study area at 12.38 per 100,000 population; this is higher than the national rate of 7.55 per 100,000 population. This rate is also much higher than the other study area parishes which are closer to the national rate of 7.5. 12.38
Mortality ‐ Motor Vehicle Accident‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2007‐2011
14
Ascension
East Baton Rouge
12
4
Livingston
4.58
6
7.55
7.73
8
7.74
Iberville
8.53
10
LOUISIANA
2
0
USA
Men are more likely to die as a result of a motor vehicle accident than women. 182
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Mortality ‐ Motor Vehicle Accident‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Gender, 2007‐2011
18
15.73
16
14
Male
12.84
11.36
12
11.98
Female
11.3
10
8
6
6.8
4.89
4.82
4.02
3.72
4
2.63
2
0
0
The Non‐Hispanic White population of the Iberville Parish reports the highest rate of death due to motor vehicle accident at 18.15 per 100,000 population. Mortality ‐ Motor Vehicle Accident‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Race/Ethnicity
Ascension
20
East Baton Rouge
18
16
14
Iberville
12
10
8
Livingston
6
4
LOUISIANA
2
0
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
American Indian /
Alaskan Native
USA
Mortality – Pedestrian Accident 183
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach East Baton Rouge Parish reports the highest rate of age‐adjusted mortality due to pedestrian accident for the OMC Baton Rouge study area at 1.89 per 100,000 population. The Healthy People 2020 goal is for mortality due to pedestrian accident to be less than or equal to 1.3 per 100,000 population; Iberville and Livingston report rates already lower than this HP2020 Goal. Mortality ‐ Pedestrian Accident‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2008‐2010
East Baton Rouge
2.1
1.38
1.89
2
1.87
2.5
1
Iberville
Livingston
0.78
1
1.5
Ascension
LOUISIANA
0.5
USA
0
Mortality – Homicide East Baton Rouge Parish reports the highest rate of age‐adjusted mortality due to homicide for the OMC Baton Rouge study area at 17.53 per 100,000 population; this rate is more than triple the national rate (5.63). The Healthy People 2020 goal is for mortality due to homicide to be less than or equal to 5.5 per 100,000 population; only Ascension Parish reports a rate already lower than this HP2020 Goal. 17.53
Mortality ‐ Homicide‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2007‐2011
18
East Baton Rouge
12.69
20
16
10.03
14
12
5.63
6.26
4.53
6
Iberville
Livingston
10
8
Ascension
LOUISIANA
4
2
USA
0
Men are more likely to die as a result of homicide than women. 184
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Mortality ‐ Homicide‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Gender, 2007‐2011
35
30.76
30
Male
Female
25
20.92
20
14.64
15
10
8.49
8.87
7.97
5.27
5.14
5
4.62
2.36
0
0
0
The Non‐Hispanic Black population of East Baton Rouge Parish reports the highest rate of death as a result of homicide across the OMC Baton Rouge study area at 32.8 per 100,000 population. Mortality ‐ Homicide‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Race/Ethnicity, 2007‐2011
Ascension
35
East Baton Rouge
30
25
Iberville
20
15
Livingston
10
5
LOUISIANA
0
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
American Indian /
Alaskan Native
USA
Mortality – Suicide 185
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Livingston Parish reports the highest rate of age‐adjusted mortality due to suicide for the OMC Baton Rouge study area at 17.57 per 100,000 population; this rate is higher than the national rate (11.82). The Healthy People 2020 goal is for mortality due to suicide to be less than or equal to 10.2 per 100,000 population; Ascension, East Baton Rouge, and Iberville parishes report rates already lower than this HP2020 Goal. Mortality ‐ Suicide‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.), 2007‐2011
17.57
Ascension
18
10
10.16
12
9.54
9.65
14
11.94
16
East Baton Rouge
11.82
20
Iberville
Livingston
8
6
LOUISIANA
4
2
USA
0
Men are more likely than women to die as a result of a suicide. Mortality ‐ Suicide‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Gender, 2007‐2011
35
30.06
30
Male
Female
25
20
20.19
18.73
16.92
19.35
16.41
15
10
6.68
4.43
3.18
5
0
4.89
0
0
The Hispanic/Latino population of the U.S. reports the highest rate of suicide at 32.88 per 100,000 population. 186
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach For the OMC Baton Rouge study area, the Non‐Hispanic White population of Livingston Parish reports the highest rate of suicide at 18.6 per 100,000 population. Mortality ‐ Suicide‐ Age‐Adjusted Death Rate, (Per 100,000 Pop.) ‐ By Race/Ethnicity, 2007‐2011
Ascension
35
East Baton Rouge
30
25
Iberville
20
15
Livingston
10
5
LOUISIANA
0
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
American Indian /
Alaskan Native
USA
Infant Mortality Rate 10.9
East Baton Rouge Parish reports the highest rate of infant mortality due for the OMC Baton Rouge study area at 10.9 per 1,000 births; this rate is higher than the national rate of 6.52 per 1,000 births. The Healthy People 2020 goal is for infant mortality to be less than or equal to 6.0 per 1,000 births; only Livingston Parish reports a rate already lower than this HP2020 Goal. 12
Infant Mortality Rate, (Per 1,000 Births), 2006‐2010
Ascension
8.9
8.5
8.5
East Baton Rouge
10
5.2
6
6.52
8
Iberville
Livingston
4
LOUISIANA
2
0
USA
The Non‐Hispanic Black population of East Baton Rouge reports the highest rate of infant mortality for the OMC Baton Rouge study area parishes at 15.4 per 1,000 births. 187
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Infant Mortality Rate, (Per 1,000 Pop.) ‐ By Race/Ethnicity, 2006‐2010
18
East Baton Rouge
16
14
12
Iberville
10
8
Livingston
6
4
2
LOUISIANA
0
Non‐Hispanic
White
Non‐Hispanic
Black
Non‐Hispanic
Asian
American Indian /
Alaskan Native
USA
188
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach County Health Rankings The County Health Rankings were completed as a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.25 Each parish/county receives a summary rank for its health outcomes, health factors, and also for the four different types of health factors: health behaviors, clinical care, social and economic factors, and the physical environment. Analyses can also drill down to see specific parish/county‐level data (as well as state benchmarks) for the measures upon which the rankings are based. Parishes/Counties in each of the 50 states are ranked according to summaries of more than 30 health measures. Those having high ranks, e.g. 1 or 2, are considered to be the “healthiest.” Parishes/Counties are ranked relative to the health of other parishes/counties in the same state on the following summary measures: Health Outcomes – Rankings are based on an equal weighting of one length of life (mortality) measure and four quality of life (morbidity) measures. Health Factors – Rankings are based on weighted scores of four types of factors: Health behaviors Clinical care Social and economic Physical environment Louisiana has 64 parishes. A score of 1 indicates the “healthiest” parish for the state in a specific measure. A score of 64 for LA indicates the “unhealthiest” parish for the state in a specific measure. 65
60 55
50
45
40
35
30
25
20
15
10
5
0
Ascension
45
East Baton Rouge
32
20
21
Iberville
11
4
2
3
Livingston
Health Outcomes
Health Factors
25
2015 County Health Rankings. Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute 189
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge 65
60
55
50
45
40
35
30
25
20
15
10
5
0
37
East Baton Rouge
32
23
22
5
4
11
9
Iberville
Livingston
Mortality (Length of Life)
Morbidity (Quality of Life)
65
60
55
50
45
40
35
30
25
20
15
10
5
0
Ascension
East Baton Rouge
32
22
17
13
5
Iberville
6
3
1
Livingston
Health Behaviors
Clinical Care
65
60
55
50
45
40
35
30
25
20
15
10
5
0
56
Ascension
52
48
42
East Baton Rouge
27
17
Iberville
9
2
Livingston
Social and Economic Factors
Physical Environment
Key Findings from County Health Rankings: 190
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Iberville Parish reports the highest ranks (unhealthiest parish of the OMC Baton Rouge study area) for the majority of the County Health Rankings: A rank of 32 out of the worst possible 64 (33rd “unhealthiest” parish in the state) for; Health Outcomes Mortality (Length of Life) Health Behaviors A rank of 45 (20th worst parish in the state) for health factors. A rank of 37 (28th worst parish in the state) for morbidity (quality of life). A rank of 56 (9th worst parish in the state) for social and economic factors. Livingston Parish holds the highest rank for the study area for Clinical Care at 22 out of the worst possible of 64. Ascension Parish reports the highest ranking (“unhealthiest”) for Physical Environment Factors across the OMC Baton Rouge study area at 52 (13th worst parish in the state). Livingston Parish follows close behind with a rank of 48 (17th worst parish in the state. 191
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Substance Abuse and Mental Health The Substance Abuse and Mental Health Services Administration (SAMHSA) gathers region specific data from the entire United States in relation to substance use (alcohol and illicit drugs) and mental health. Every state is parceled into regions defined by SAMHSA. The regions are defined in the ‘Substate Estimates from the 2010‐2012 National Surveys on Drug Use and Health’. Data is provided at the first defined region (i.e., those that are grouped). The Substate Regions for Louisiana are defined as such: Regions 1 and 10 (Data for Regions 1 and 10 provided separately for this grouping only) Region 1 – Orleans, Plaquemines, St. Bernard Region 10 – Jefferson Regions 2 and 9 Region 2 – Ascension, East Baton Rouge, East Feliciana, Iberville, Pointe Coupee, West Baton Rouge, West Feliciana Region 9 – Livingston, St. Helena, St. Tammany, Tangipahoa, Washington Region 3 Region 3 – Assumption, Lafourche, St. Charles, St. James, St. John the Baptist, St. Mary, Terrebonne Regions 4, 5, and 6 Region 4 – Acadia, Evangeline, Iberia, Lafayette, St. Landry, St. Martin, Vermilion Region 5 – Allen, Beauregard, Calcasieu, Cameron, Jefferson Davis Region 6 – Avoyelles, Catahoula, Concordia, Grant, La Salle, Rapides, Vernon, Winn Regions 7 and 8 Region 7 – Bienville, Bossier, Caddo, Claiborne, De Soto, Natchitoches, Red River, Sabine, Webster Region 8 – Caldwell, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland, Tensas, Union, West Carroll Data concerning alcohol use, illicit drug use, and psychological distress for the various regions of the study area are shown here. 192
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Alcohol Use in the Past Month For the OMC Baton Rouge study area (Regions 2 & 9) slightly more than half of the population aged 12 and older (50.99%) report alcohol use in the past month; decreasing from the 2002‐
2004 rate by 0.08%. The State of Louisiana saw a slight rise; going from 47.01% in 2002‐2004 to 47.70% in 2010‐2012. Alcohol Use in the Past Month
60.00%
55.00%
50.00%
51.07%
50.99%
47.01%
47.70%
Regions 2 & 9
45.00%
40.00%
LA
35.00%
30.00%
2002‐2004
2010‐2012
Binge Alcohol Use in the Past Month Regions 2 & 9, similar to Louisiana, show declining rates in the number of people that reported binge alcohol use in the past month. The most recent data shows 23.64% of the population in Regions 2 & 9 have engaged in binge alcohol use in the past month. 193
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Binge Alcohol Use in the Past Month
26.00%
25.73%
25.00%
24.00%
24.37%
23.77%
23.64%
23.00%
22.00%
Regions 2 & 9
21.00%
20.00%
LA
19.00%
18.00%
17.00%
16.00%
2002‐2004
2010‐2012
Perceptions of Great Rick of Having Five or More Alcoholic Drinks Once or Twice a Week Regions 2 & 9 have shown a slight decline in the perceptions of risk of having five or more drinks once or twice a week from 42.21% (in 2002‐2004) to 41.49% (in 2010‐2012). The rates of perceptions of risk of having five or more drinks once or twice a week are on the rise and slightly better for Louisiana at 43.31%. Perceptions of Great Risk of Drinking Five or More Alcoholic Drinks
50.00%
Regions 2 & 9
45.00%
42.35%
42.21%
43.31%
41.49%
40.00%
LA
35.00%
2002‐2004
2010‐2012
Needing but Not Receiving Treatment for Alcohol Use in the Past Year 194
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Regions 2 & 9 and Louisiana have shown marked declines in the rates of residents needing but not receiving treatment for alcohol use from 2002‐2004 to 2010‐2012. The OMC Baton Rouge study area reports a lower rate (5.93%) than Louisiana (6.10%). Needing but Not Receiving Treatment for Alcohol Use in the Past Year
9.00%
8.50%
8.00%
8.60%
Regions 2 & 9
7.66%
7.50%
7.00%
6.50%
6.10%
5.93%
6.00%
LA
5.50%
5.00%
2002‐2004
2010‐2012
Tobacco Use in the Past Month 30.30% of the population in the OMC Baton Rouge study area reports tobacco use in the past month; fairly consistent with the previous rate of 30.23% in 2002‐2004. While still higher than Regions 2 & 9, the state rate saw a decline of 0.78%; standing at 31.98%. Tobacco Use in the Past Month
40.00%
Regions 2 & 9
35.00%
32.76%
31.98%
30.00%
30.23%
30.30%
LA
25.00%
2002‐2004
2010‐2012
Cigarette Use in the Past Month 195
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Cigarette use in the past month is lower for Regions 2 & 9 in the 2010‐2012 analysis than the state; declining over the years from 26.44% to 24.92%. Cigarette Use in the Past Month
32.00%
30.00%
Regions 2 & 9
28.49%
28.00%
26.00%
26.44%
26.71%
LA
24.92%
24.00%
22.00%
2002‐2004
2010‐2012
Perceptions of Great Rick of Smoking One or More Packs of Cigarettes per Day Both the OMC Baton Rouge study area and Louisiana report rises in the rate of perceptions of great risk of smoking one or more packs of cigarettes per day. Perceptions of Great Risk of Smoking One or More Packs of Cigarettes per Day
75.00%
73.59%
73.00%
Regions 2 & 9
71.55%
71.00%
69.08%
69.00%
69.01%
LA
67.00%
65.00%
2002‐2004
2010‐2012
Illicit Drug Use in the Past Month 196
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Regions 2 & 9 show a nearly identical downward trend as compared to the State of Louisiana in rates of illicit drug use in the past month with both reporting slightly more than 6.5% of their respective populations aged 12 and older participating in drug use for the most recent data (2010‐2012). Illicit Drug Use in the Past Month
10.00%
9.50%
9.00%
Regions 2 & 9
8.50%
8.00%
8.18%
7.98%
7.50%
LA
7.00%
6.85%
6.81%
6.50%
6.00%
2002‐2004
2010‐2012
Marijuana Use in the Past Month Similar to illicit drug use, Regions 2 & 9 show a similar downward trend as compared to the State of Louisiana in rates of marijuana use in the past month with both reporting around 4.5% of their respective populations aged 12 and older participating in marijuana use for the most recent data (2010‐2012). Marijuana Use in the Past Month
8.00%
7.50%
7.00%
Regions 2 & 9
6.50%
6.00%
5.50%
5.92%
5.56%
5.00%
LA
4.60%
4.50%
4.50%
4.00%
2002‐2004
2010‐2012
197
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Cocaine Use in the Past Year Regions 2 & 9 continue to show a nearly identical downward trend as compared to the State of Louisiana in rates of cocaine use in the past year (1.36% and 1.5%, respectively); differing by only 0.14% for the most recent data (2010‐2012). Cocaine Use in the Past Year
4.00%
3.50%
Regions 2 & 9
3.00%
2.50%
2.64%
2.58%
LA
2.00%
1.50%
1.50%
1.00%
1.36%
2010‐2012
2002‐2004
Nonmedical Use of Pain Relievers in the Past Year Regions 2 & 9 report a higher rate, as compared with Louisiana, of nonmedical use of pain relievers in the past year at 5.41% of the population aged 12 and over and have seen this rate rise since 2002‐2004 when it was 5.26%. 198
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Nonmedical Use of Pain Relievers in the Past Year
6.00%
5.50%
5.41%
Regions 2 & 9
5.26%
5.00%
5.06%
5.03%
LA
4.50%
4.00%
2002‐2004
2010‐2012
Needing but Not Receiving Treatment for Illicit Drug Use in the Past Year Again, Regions 2 & 9 show a rate of residents reporting needing but not receiving treatment for illicit drug use in the past year which is nearly identical to the overall state rate (2.32% and 2.36%, respectively). Needing but Not Receiving Treatment for Illicit Drug Use in the Past Year
4.00%
3.50%
3.00%
Regions 2 & 9
3.15%
3.07%
LA
2.50%
2.36%
2.32%
2.00%
2002‐2004
2010‐2012
199
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach America’s Health Rankings America’s Health Rankings® is the longest‐running annual assessment of the nation’s health on a state‐
by‐state basis. For the past 25 years, America’s Health Rankings® has provided a holistic view of the health of the nation. America’s Health Rankings® is the result of a partnership between United Health Foundation, American Public Health Association, and Partnership for Prevention™. For this study, the Louisiana State report was reviewed. The following were the key findings/rankings for Louisiana: Louisiana Ranks: 48th overall in terms of health rankings 44th for smoking 45th for diabetes 45th in obesity Louisiana Strengths: Low incidence of pertussis High immunization coverage among teens Small disparity in health status by educational attainment Louisiana Challenges: High incidence of infectious disease High prevalence of low birthweight High rate of preventable hospitalizations Louisiana Highlights: In the past year, children in poverty decreased by 15 percent from 31.0 percent to 26.5 percent of children. In the past 2 years, physical inactivity decreased by 10 percent from 33.8 percent to 30.3 percent of adults. In the past 20 years, low birthweight increased by 15 percent from 9.4 percent to 10.8 percent of births. Louisiana ranks 49th for low birthweight infants. In the past 2 years, drug deaths decreased by 25 percent from 17.1 to 12.9 deaths per 100,000 population. Since 1990, infant mortality decreased by 32 percent from 11.8 to 8.2 deaths per 1,000 live births. Louisiana now ranks 47th in infant mortality among states. 200
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Table 6. America’s Health Rankings ‐ Louisiana Measure Rank Value
Measure
Rank Value
Air Pollution 26 9.2
Infectious Disease
48 All Determinants 48 ‐0.53
Insufficient Sleep
34 37
All Outcomes 44 ‐0.273
Lack of Health Insurance
39 16.7
Binge Drinking 21 16.3
Low Birthweight
49 10.8
Cancer Deaths 47 217.4
Median Household Income 50 39,622
Cardiovascular Deaths 46 307.5
Obesity
45 33.1
Children in Poverty 44 26.5
Obesity – Youth
13.5
Chlamydia 47 597.9
Occupational Fatalities
47 8.2
Cholesterol Check 26 76.2
Overall
48 ‐0.803
Colorectal Cancer Screening 39 61.5
Personal Income, Per Capita 29 41,204
Dental Visit, Annual 48 56.1
Pertussis
1 1.6
Dentists 39 49.6
Physical Activity
46 67.8
Diabetes 45 11.6
Physical Inactivity
46 32.2
Disparity in Health Status 16 26.5
Poor Mental Health Days
43 4.2
Drug Deaths 27 12.9
Poor Physical Health Days
38 4.2
Excessive Drinking 22 17.7
Premature Death
45 9625
Fruits 44 1.18
Preterm Birth
49 15.3
Heart Attack 41 5.3
Preventable Hospitalizations 48 80.3
Heart Disease 40 5
Primary Care Physicians
20 123.7
High Blood Pressure 47 39.8
Public Health Funding
27 69.01
High Cholesterol 41 40.7
Salmonella
47 33.7
High Health Status 47 44.4
Smoking
44 23.5
201
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach High School Graduation 46 72
Stroke
45 4
Immunization ‐ Adolescents 11 72.6
Suicide
12 12.5
Immunization – Children 31 69.1
Teen Birth Rate
44 43.1
Immunization Dtap 16 87.9
Teeth Extractions
48 9.6
Immunization HPV female 12 42.1
Underemployment Rate
23 12.7
Immunization MCV4 9 87.7
Unemployment Rate, Annual 15 6.2
Income Disparity 48 0.491
Vegetables
49 1.64
Income Disparity Ratio 1 5.68
Violent Crime
44 496.9
Infant Mortality 47 8.2
Youth Smoking
12.1
202
Community Health Needs Assessment Ochsner Medical Center – Baton Rouge Tripp Umbach Figure 4. Louisiana Health Rankings Bubble Chart 203

Ochsner Medical Center ‐ Baton Rouge

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