COMMUNITY HEALTH ASSESSMENT FOR THE

BLOOMFIELD DEPARTMENT OF HEALTH AND HUMAN SERVICES

May 2013

Submitted to:

Bloomfield Department of Health and Human Services

Bloomfield, New Jersey

By:

Montclair State University

College of Education and Human Services

Center for Research and Evaluation on Education and Human Services (CREEHS)

Eden N. Kyse, Ph.D., Director, CREEHS

Rebecca Swann-Jackson M.Ed., Senior Research Associate, CREEHS

Dawn Diamond, MPH, Project Manager Stephanie Prall, Graduate Research Assistant, CREEHS With the financial support of: The Bloomfield Board of Health The Community Health Assessment is also funded in part by a grant from the Partners for Health Foundation,

which partners to strengthen health and wellness in the Montclair area.

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ACKNOWLEDGMENTS

The authors wish to acknowledge the following for their support on this report:

The Township of Bloomfield, Board of Health for the opportunity to better understand the emerging

health issues facing the residents we serve;

Karen Lore, Director of Health and Human Services; committee members Mike Fitzpatrick, Paula Peikes,

Donna Williams, Vincent Nicosia and Michael Hodges;

Particular thanks to Mike Fitzpatrick and Michael Hodges, for their participation, communication, and

assistance in recruiting focus group and key informant interview participants, and scheduling time and

space for focus group discussions and interviews, and for their collaboration and patience in answering

questions throughout the process;

The study participants, including community members and other key stakeholders, for their

participation, their interest in the study, and their thoughtful responses;

Partners for Health for their guidance and input, and the financial support of this project;

Montclair State University and CREEHS staff, including Dean Francine Peterman, Associate Dean Tamara

Lucas, Assistant Professor Lisa Lieberman, and Program Assistant Tina Seaboch for their contributions

and support.

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Community Health Assessment for the Bloomfield Health and Human Services Department

TABLE OF CONTENTS

EXECUTIVE SUMMARY…………………………………………………………………………………………………………. iii

BACKGROUND AND FRAMEWORK FOR THE COMMUNITY HEALTH ASSESSMENT (CHA) ........... 1

PURPOSE OF THE COMMUNITY HEALTH ASSESSMENT

DEMOGRAPHIC PROFILES OF TOWNSHIPS INCLUDED IN ASSESSMENT

METHODOLOGY OF THE COMMUNITY HEALTH ASSESSMENT……………………………..…………………9

RESULTS OF THE COMMUNITY HEALTH ASSESSMENT…………………………………………………………13

PERSONAL HEALTH/NUTRITION AND PHYSICAL ACTIVITY

COMMUNITY HEALTH/SIGNIFICANT HEALTH ISSUES AND BARRIERS

PUBLIC HEALTH ANNOUCEMENTS AND DISASTER PREPAREDNESS

QUALITY OF LIFE IN THE COMMUNITY

COLLABORATION AMONG COMMUNITY AGENCIES

SUMMARY AND NEXT STEPS………………………………………………………………………………………………..35

APPENDICES………………………………………………………………………………………………………………………...44

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EXECUTIVE SUMMARY Background

As part of their mission in the community, the Bloomfield Department of Health and

Human Services (BDHHS) aims to reduce or eliminate health threats through

medical, social, and environmental interventions, giving particular attention to

those members of the community who face barriers in obtaining health services.

BDHHS employees dedicate themselves to educating and protecting the community

by offering programs that promote environmental safety, healthy life choices, safer

food, disease control and more. A primary part of the department mission is to

to prevent disease and promote physical and mental well-being through policy

development, disease detection, prevention, education, and enforcement; in a

culturally competent manner that ensures the highest quality of life for the

population served. BDHHS divisions include Human Services (with its volunteer

arm, Neighbor to Neighbor Network), Public Health Nursing, Environmental Health,

and Health Education.

To encourage best practices and services, the national Public Health Accreditation

Board (PHAB) has created a framework for accreditation of state, county, tribal and

local community health departments. The overall goal is to advance the practice of

public health at the community level and throughout the nation while providing, at

all levels, an element of accountability of public health departments to the

populations they serve. In agreement with the principles of the PHAB, in the

interests of achieving accreditation, and with the goal of providing superior public

health services, the Township of Bloomfield, NJ Department of Health and Human

Services (BDHHS) received grant funding from Partners for Health (PFH), located in

Montclair, NJ, for the purpose of conducting a community health assessment.

With the backing of PFH, in November of 2012, BDHHS contracted with Montclair

State University’s Center for Research and Evaluation on Education and Human

Services (CREEHS) to collaborate in the development of data collection instruments

and to analyze and summarize collected data for a Comprehensive Community

Health Assessment that is suitable to meet the standards set by the PHAB.

The township of Bloomfield is currently under contract to supply public health

department services to the townships of Caldwell and Glen Ridge in New Jersey, in

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addition to serving the community of Bloomfield. Although public health services

are delivered to the three townships from under the same umbrella (BDHHS), the

three towns differ in meaningful ways, for instance population size, median age,

racial ethnic composition, and income and education levels.

Methods

For the Comprehensive Community Health Assessment, a mixed method of data

collection was used to enable analysis of both quantitative and qualitative data from

the three townships. The methods also allowed for gathering data from different

types of participants including random selection in the general public of adults over

18 years of age (N = 604) for participation in a telephone survey, three (3) specific

focus groups (faith-based, senior living, recreation department), and ten (10)

representatives from other Bloomfield agencies involved in the CHA process

through the key informant interviews.

Data collection instruments, prepared by CREEHS, with guidance and input from the

Bloomfield Department and Partners for Health, included a Community Health

Telephone Survey, a Community Focus Group Protocol, and a Key Informant

Interview Protocol. The Montclair State University Institutional Review Board (MSU

IRB) reviewed these instruments and protocols to ensure that all data collection was

performed in compliance with federal and state laws governing research that is

conducted with human participants. Data were collected by Braun Research

(telephone survey) and BDHHS (focus groups and key informant interviews) during

the months of March and April 2013.

This assessment, carried out with attention to generalizability to the township

populations, revealed valuable data that can be used to influence program planning.

However, as is often the case with the collection of data, limitations must be

considered in understanding and drawing conclusions and implications of the data

collected. First, the telephone survey sample included more female, more white,

and higher educated respondents than the general population of these towns.

Second, focus groups and key informant interviews are relevant for Bloomfield only,

and these, too, were limited in scope and number. Therefore, although the

assessment gathered data that previously were not accessible, conclusions must be

carefully considered, and likely reflect the responses of a healthier and more

connected population than actually exists in these three towns.

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Findings

ACCESS: To questions regarding access to general health services provided by

BDHHS, the response was between 94.5 - 99% access and, with specific regard to

childhood vaccinations, access was reported to be between 94 - 96.4%. These

numbers dropped for access to dental health services at 88.5 - 94% with 11.5% of

Bloomfield respondents reporting no access.

Answers regarding access to cancer prevention and treatment services in a range of

89 - 95.3% access and mental health care services in a range from 89.6 - 97.6%

access may have been slightly biased by the ability for respondents to claim, “don’t

need this service.” With regard to cancer services, respondents may not have

differentiated between “prevention” and “treatment” services. With regard to

mental health services, attitudes of privacy and embarrassment may impact

responses.

BARRIERS: For respondents stating no access to certain services, the two key

barriers were lack of money and lack of information on how to access the services.

The lack of money response may reflect lack of information about access to free

services and lack of knowledge about the potential for charity care available under

certain circumstances. In the focus groups, lack of knowledge regarding services

was discussed. Lack of awareness of services was a common theme in all three data

collection methods. Key informants also commented on the broader dilemma of the

uninsured and under insured and the correlation to use by these people of

emergency room services for general health care.

SELF-RATED HEALTH: For the state of New Jersey the percentage of respondents

who reported fair or poor health using the 2009 BRFSS question, “Would you say

that in general your health is excellent, very good, good, fair, or poor?”(6) ranged

from 13.5 – 15.2% for adults age 18 and over. For the similar question in the

BDHHS telephone survey, “How would you rate your personal health on a scale from

1 to 5, with 1 being very unhealthy and 5 being very healthy?”, the aggregate of data

from the three townships formed a range of 0.8 – 1.0% of adults age 18 and over

reporting unhealthy/very unhealthy. This may indicate an attitude of better self-

rated personal health in the BDHHS communities. There may be slight bias in the

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different wording of the question and in the likelihood that those who participated

in the surveys may have been healthier than the general population

SCREENINGS: Given the importance of screenings to disease prevention and

detection/early treatment, several of the numbers reported in the telephone survey

on use of health screenings appear low. This may be due in part to the question

limiting the response to screenings that occurred during the past year. If that time

frame was expanded to two or five years, as some of these tests are recommended,

the percentages would likely increase.

DIAGNOSIS OF CHRONIC DISEASE: Of the 604 respondents to the telephone survey,

there were 267 (44%) positive responses to having one or more chronic disease(s)

in the household. High blood pressure was the most reported diagnosis in all three

communities. Bloomfield reported the highest levels of diabetes, high blood

pressure, asthma, lung disease and mental health concerns. Consideration should

be given to the national data on health disparities that indicate higher levels of

diabetes in minority populations, recalling that Bloomfield’s Hispanic and African

American population accounts for 21.5% of those Bloomfield respondents surveyed,

while in Caldwell and Glen Ridge those minority numbers were, respectively, 5%

and 12.6% of the population. Overall there were 267 diagnoses of chronic diseases

in a survey of 604 households, suggesting that these communities, like much of the

US, must be increasingly focused on reducing chronic disease.

NUTRITION AND PHYSICAL ACTIVITY: The BDHHS health assessment sought data

on consumption of fruits and vegetables and extent of physical exercise by various

methods and specifically walking and/or biking. For consumption of fruits and

vegetables, the telephone survey data indicated that 83% of the respondents eat less

than 5 servings per day while the greater percentage of participants in the focus

groups and key informant interviews indicated awareness that 6 – 11 servings per

day would be optimum. This may indicate that there has been a small amount of

progress toward the population having an awareness of what they should be doing,

with less progress toward that awareness being a determinant of behavior change.

COMMUNITY HEALTH & QUALITY OF LIFE/SIGNIFICANT HEALTH ISSUES AND

BARRIERS: Diet and exercise and chronic disease are related in their direct impact

to the individual as well as to the community (as opposed to an issue of broader

community impact such as environmental concerns and social concerns). They are

also related in the fact that there is much developing scientific data that lack of

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healthy diet and exercise is one of the primary predictors of chronic disease. Nearly

half (47.8%) of telephone survey participants responded that diet/exercise/chronic

diseases are the community’s most pressing issues. This was also supported by

commentary in the Bloomfield Recreation Department focus group. From the other

two focus groups and in the key informant interviews, social concerns emerged as

the most significant health problems in the community. Despite the local data

indicating disturbing trends in household wellness (i.e. high rates of chronic

diseases), ratings from focus groups and interviews on quality of life in the

community were generally above average and focus groups indicated that BDHHS

had made an above average effort to inform the residents in times of disaster, for

instance, the recent Hurricane Sandy.

CONCLUSIONS: The demographic differences in the three townships that are

serviced by BDHHS will create challenges in program planning, for instance,

Bloomfield requires more attention to minority populations in order to reduce

nationally recognized health care disparities. Caldwell has a larger population

approaching middle-age. Glen Ridge has the highest percentage of population under

18 years of age making it an area for focus on youth-related health interventions, for

example, driving safety, sex, drug, and alcohol themes. BDHHS needs to move

forward with a constant eye towards these differences in the communities they

serve.

As the nation recognizes the impact of education on health and well-being, the

positive news is that all three communities appear to be above county, state, and

national education levels in percent of population that have received a high school

diploma and that have received bachelors’ degrees. These education levels may be

viewed as positive factor for the population’s comprehension of important

information about wellness and disease prevention.

Access to primary health care services was reported at 94% or better by telephone

survey respondents. While the question posed to BDHHS respondents differs from

data collection questions used by Healthy People 2020 (10), the data topic is similar.

Healthy People 2020 reported, in their baseline year of 2007, that 76.3 % of the U.S.

population had a usual primary care provider. The Healthy People 2020 target is

83.9%. At 94% access to primary healthcare services in the BDHHS communities, it

would appear that the population has greater access than the general U.S.

population. This should provide an opportunity for BDHHS from which to launch

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new programs through collaboration with local primary care physicians and

hospitals.

In a general analysis of most pressing health concerns and chronic disease

diagnoses, the data gathered appears to align with state and national concerns

regarding nutrition, exercise, and chronic disease. In the telephone survey there

were 267 reports of chronic disease diagnoses in 604 households. Nearly 50% of

the telephone survey respondents reported that they believe nutrition, exercise, and

chronic disease are the top health issues in the communities.

In contrast, self-rated health in the three communities appears to be better than

state of New Jersey data collected through the Behavioral Risk Factor Surveillance

System (6). For the state of New Jersey the percentage of respondents who reported

fair or poor health using the 2009 BRFSS question, “Would you say that in general

your health is excellent, very good, good, fair, or poor?” ranged from 13.5 – 15.2%

for adults age 18 and over. For the similar question in the BDHHS telephone survey,

“How would you rate your personal health on a scale from 1 to 5, with 1 being very

unhealthy and 5 being very healthy?”, the aggregate of data from the three

townships formed a range of 0.8 – 1.0% of adults age 18 and over reporting

unhealthy/very unhealthy.

In key respondent interviews (Bloomfield only), social concerns were reported as

the most significant health problems in the community. Responses reflect concern

by other community agency stakeholders regarding homelessness, discrimination,

alcohol and drug abuse and other social concerns. While these qualitative data may

reflect bias (i.e. the key respondents may have a greater awareness of the social

concerns because the agencies they represent are closer to the problem then the

random public), this portion of the data provides BDHHS with direction for

establishing the social concerns as targets for collaborative efforts by multiple

agencies.

Beyond accomplishing assessment goals for PHAB and BDHHS requirements, the

Partners for Health Foundation should also benefit from the data collection as the

PFH service footprint includes all three townships that were involved in the CHA.

Data gathered in response to questions on nutrition and physical activity should

allow the PFH organization to expand their data base on attitudes and behaviors

toward fruit and vegetable consumption, and walking and biking in the communities

surveyed by inclusion of the new data from Bloomfield, Caldwell, and Glen Ridge.

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In conclusion, supported by the quantitative and qualitative analysis of the mixed

method data collected in the Community Health Assessment, the BDHHS is in a good

position to pursue the PHAB accreditation. Empowered with the potential to

collaborate with other local agencies to achieve critical public health objectives, the

department will be able to bring a fresh approach to health education, health

interventions, and prevention strategies that will improve the health status of the

communities they serve.

1

BACKGROUND AND FRAMEWORK FOR THE COMMUNITY HEALTH ASSESSMENT

(CHA)

As part of their mission in the community, the Bloomfield Department of Health and Human

Services (BDHHS) aims to reduce or eliminate health threats through medical, social, and

environmental interventions, giving particular attention to those members of the community who

face barriers in obtaining health services.

BDHHS employees dedicate themselves to educating and protecting the community by offering

programs that promote environmental safety, healthy life choices, safer food, disease control and

more. A primary part of the department mission is to prevent disease and promote physical and

mental well-being through policy development, disease detection, prevention, education, and

enforcement; in a culturally competent manner that ensures the highest quality of life for the

population served. The departments include Human Services (including its volunteer arm,

Neighbor to Neighbor Network), Public Health Nursing, and Environmental Health, and Health

Education.

Human Services is the township’s outpatient mental health and social services center, which aims

to foster a sense of well-being and wholeness. The Human Services Division is aided by a

contracted psychiatrist who prescribes medications and conducts consultations as needed. Public

health social workers provide counseling, crisis intervention, home visits and assessments as

required by state-mandated practice standards. At all times, special attention is given to the

community’s most vulnerable populations: people with special needs, and children.

The Neighbor to Neighbor Network is the volunteer arm of the Division of Human Services.

NTNN recruits and trains volunteers to support Bloomfield’s needy populations through

nontraditional programs, with an emphasis on seniors and low-income families.

In Public Health Nursing, the population is the patient. Focus is on achieving the greatest good

for every resident using nursing strategies that promote and protect the public’s health. The

BDHHS Public Health Nursing Staff identifies and reaches out to all who might benefit from

specific programs and services while collaborating with community stakeholders who are

invested in improving the health of individuals, families and the greater community.

Each year, Environmental Health conducts routine sanitary inspections of more than 500

business establishments and service providers within the community. Citizen requests generate

2

several hundred more inspections. Services include food service sanitation, food handler training

courses, public health investigations and complaints, childhood lead poisoning investigations, and

potable water sample testing.

“Many health department activities are devoted to solving a problem – but a health educator can

solve problems before they start” (Institute of Medicine). Health Education is an integral

component of the Health and Human Services Department. Programs such as alcohol abuse

control, drug abuse control, chronic disease prevention/management, nutrition and exercise

promotion, injury control, blood-borne pathogen safety, home safety, and HIV/AIDS are provided

directly by the health educator or coordinated with other community agencies. Health Education

also applies for and manages grants for the Department.

The national Public Health Accreditation Board (PHAB), based on extensive study, vetting and

testing, has created a framework for accreditation of state, county, tribal and local community

health departments. The overall goal of the PHAB is to advance the practice of public health at the

community level and throughout the nation while providing, at all levels, an element of

accountability of public health departments to the populations they serve. (1)

PHAB launched its initial accreditation program in September 2011. A common thread in PHAB

standards is collaboration in the local health environment to ensure that individual health

department goals and objectives are not created in isolation, but instead engage a representative

cross-section of appropriate community agencies. Standard 1.1 of the PHAB process requires that

the community, “Participate in or conduct a collaborative process resulting in a comprehensive

community health assessment.” While the PHAB does not require a specific format for the

community health assessment, the organization’s standards indicate that the CHA should include a

“measure”, a “purpose”, and information of “significance” to program development, funding

applications, coordination of community resources, and new ways to collaboratively use

community assets to improve the health status of the population.” Among several other criteria

for accreditation, a current Community Health Assessment is required in the PHAB application

documentation. The PHAB allows for the department applying for accreditation to structure the

format and decide the methodology of the Community Health Assessment. (1)(2)

In agreement with the principles of the PHAB, in the interests of achieving accreditation, and with

the goal of providing superior public health services, the Township of Bloomfield, NJ Department

of Health and Human Services (BDHHS) received grant funding from Partners for Health (PFH),

located in Montclair, NJ, for the purpose of conducting a community health assessment. PFH is a

local public charity whose mission is to administrate funding to strengthen general health and

wellness in the fifteen New Jersey communities that it serves. (3)

3

With the backing of PFH, in November of 2012, BDHHS contracted with Montclair State

University’s Center for Research and Evaluation on Education and Human Services (CREEHS) to

collaborate in the development of data collection instruments, and to analyze and summarize

collected data for a Comprehensive Community Health Assessment that is suitable to meet the

standards set by the PHAB.

DEMOGRAPHIC PROFILES OF TOWNSHIPS INCLUDED IN ASSESSMENT

The Township of Bloomfield is under contract to supply public health department services to the

townships of Caldwell and Glen Ridge in New Jersey, in addition to serving the community of

Bloomfield, a reflection of the growing need to coordinate public health services and health

education to meet the budgets and requirements of a variety of New Jersey communities. These

programs and services include:

environmental health services

food inspections

nuisance complaints

camp and community swimming pool inspections

nursing clinics for heart, stroke, diabetes

communicable disease surveillance and school audits

health education and promotion

In addition, the BDHHS Health Educator communicates general public health information and

disseminates media about BDHHS programs to the population of the three townships.

4

Figure 1 illustrates the location of the three towns in proximity to each other and to nearby

Newark, all within the borders of Essex County in New Jersey.

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Table 1 provides demographic data for the three townships involved in the Community Health

Assessment including, for comparison, reference data on Essex County, the state of New Jersey,

and the United States. Table 1 reference data is based on the 2010 Census. (4)

Table 1: General Population Characteristics Based on 2010 Census Townships of Bloomfield, Caldwell, Glen Ridge

plus County, State, National Data Data Segment Bloomfield Caldwell

Glen Ridge Essex

County New Jersey United States

Total Population 47312 45763*

7822 7854*

7618 7594*

783,969 787,744*

8,791,894 8,864,590*

308,745,538 313,914,040*

Median Age 37.7 40.4 40.3 36.4 39.0 39.3*

37.2 37.4*

% Female 52.7 53.2 51.1 52.0 51.9**

51.3 51.3**

50.8

% Male 47.3 46.8 48.9 48.0 48.1**

48.7 48.7**

49.2

% Adults 18 and older

78.8 81.5 67.9 75.1 76.5 76.0

% Children Under 18 years

21.2 18.0 32.0 24.9 24.6**

23.5 23.2**

24.0

% Ages 18 – 24 9.0 11.7 4.7 9.0 9.0 9.9

% Ages 25-44 31.0 27.8 22.4 29.0 27.0 27.0

% Ages 45-64 27.0 26.5 31.2 26.0 27.0 26.0

% Ages 65 + 12.0 16.0 9.5 11.0 11.7**

13.0 13.7**

13.0

Racial Ethnic not Hispanic/Latino

75.5 90.0 95.0 79.7 82.3 83.7

Hispanic/Latino 24.5 10.0 5.0 20.3 17.7 16.3

Asian 8.1 4.7 4.6 4.5 8.2 4.7

Hawaiian/ Pacific Islander

0.0

0.0

0.0

0.0

0.0

0.2

African American/ Black

17.1 3.0 5.4 39.3 12.8 12.2

White/Caucasian 47.1 80.6 82.4 33.2 59.3 63.7

Native American 0.2 0.1

0.0

0.2 0.1

0.7

Single Race, Other 0.9 0.1 0.4 0.8 0.3 0.2

Mixed Race 2.0 1.4 2.2 1.7 1.5 1.9

* 2012 estimates ** 2011 estimates

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Table 2 provides reference data for education levels, based on the 2007-2011 American

Community Survey - 5 Year Estimates. (5)

Table 2: Educational Levels Based on 2007-2011 America Community Survey for Townships of Bloomfield, Caldwell,

Glen Ridge plus County, State, National Data

Education Level Attained as % of Population 25 years and older

Bloomfield N= 33140

Caldwell N = 5499

Glen Ridge N = 4844

Essex County N = 512,885

New Jersey N = 5,926,262

United States N = 202,048,123

High School Diploma or higher

90.2 92.8 98.4 82.4 87.6 85.4

Bachelors’ Degree or higher

36.3 49.7 76.0 31.7 35.0 28.2

Although public health services are delivered to the three townships from under the same

umbrella (BDHHS), the three towns differ in meaningful ways, as shown in Tables 1 and 2. The

following sections highlight some of the unique aspects of each of the three communities:

Population size (Census 2010)

Bloomfield N = 47312

Caldwell N= 7822

Glen Ridge N=7618

Race/Ethnicity % other than white/Caucasian (Census 2010)

Bloomfield 52.9%

Caldwell 19.4%

Glen Ridge 17.6%

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Education: % Bachelors Degree or Higher

(population 25 years of age and older, American Community Survey 2007-2011)

Bloomfield 36.3%

Caldwell 54.1% (Data includes West Caldwell population.)

Glen Ridge 76.0%

Bloomfield _

Square miles: 5.328

Population Size: 47,312

Population Density: 8879.9 per square mile

Important to its history and demographic development is Bloomfield’s geographic location in

Essex County (Figure 1). While only a small segment of the township border is shared with the

city of Newark, the main local/commercial thoroughfare between Newark and the outlying

suburban communities, Bloomfield Avenue, runs directly out of Newark’s northwest corner

through Bloomfield, Glen Ridge and west through the township of Caldwell. The access for

automobile and bus traffic along this route is complemented with train service that, in several

areas, runs parallel to Bloomfield Avenue up through the township of Montclair.

In comparison with Caldwell and Glen Ridge, Bloomfield comes closest to paralleling the

demographic profile of Essex County, specifically with regard to median age (37.7 Bloomfield, 36.4

Essex County) and Hispanic/Latino population (24.5% Bloomfield, 20.3% Essex County). This

may be a result of the migration of populations between the city of Newark and the township of

Bloomfield. Bloomfield residents have the opportunity to maintain city-based employment in

Newark and Manhattan, by means of readily accessible transportation by automobile, bus, or train

to Newark and New York City, while living in a community with better housing, schooling, and

access to healthcare. Bloomfield also shares borders with East Orange, Glen Ridge, Montclair,

Clifton, Nutley, and Belleville increasing the potential for migration between these neighboring

townships.

8

Caldwell _____

Square miles: 1.16

Population Size: 7822

Population Density: 6710.3 per square mile

Caldwell lies slightly less than six miles west of Bloomfield, along the path of Bloomfield Avenue

with the townships of Glen Ridge, Montclair, and Verona lying in between. The agreement

between Caldwell and Bloomfield for BDHHS to supply public health services dates back

approximately 20 years.

The town is home to an 86% white/Caucasian population with a median age of 40.4 years. Of the

three townships, Caldwell has the oldest demographic of the three towns, with 42.5% of the

population at 45 years of age or older.

Glen Ridge

Square miles: 1.287

Population Size: 7618

Density: 5919.2 per square mile

Glen Ridge lies adjacent to Bloomfield along the Glen Ridge eastern border and was, in fact, part of

the township of Bloomfield prior to its incorporation in 1895. Prior to 2008, Bloomfield and Glen

Ridge had contracted for health services, with a several year interruption. The current Glen Ridge

contract with BDHHS began in January 2012.

The majority of the Glen Ridge population is white/Caucasian, at 82.4% of the total. Although

Bloomfield has the lowest median age of the three towns, Glen Ridge has the highest percentage,

among the three towns, of children under the age of 18.

All three townships, as shown in Table 2, are above county, state, and national levels in

attainment of high school diplomas and bachelors’ degrees. However, in comparing the three

townships, the spread between percentages of population achieving a bachelors’ degree or higher

is meaningful. There is a 17.8% spread between Bloomfield and Caldwell and a 39.7% spread

between Bloomfield and the adjacent town of Glen Ridge.

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Methodology of the Community Health Assessment

For the Community Health Assessment, a mixed method of data collection was used to enable

analysis of both quantitative and qualitative data from the three townships. The methods allowed

for gathering data from different types of participants, including random selection of adults over

18 years of age (N = 604) for participation in a telephone survey, three (3) specific focus groups

(faith-based, senior living, recreation department), and ten (10) key information interviews with

representatives from other Bloomfield agencies involved in the CHA process.

Data collection instruments, prepared by CREEHS, according to the agreement with the BDHHS,

included a Community Health Telephone Survey, a Community Focus Group Protocol, and a Key

Informant Interview Protocol. The Montclair State University Institutional Review Board (MSU

IRB) reviewed these instruments and protocols to ensure that all data collection was performed in

compliance with federal and state laws governing research that is conducted with human

participants.

The instruments and protocols were coordinated to build a strong assessment for presentation to

the PHAB and also to identify the needs of the BDHHS service area (e.g., behaviors, attitudes, and

barriers) relative to accessing available services, healthy eating and active living, and perceptions

of the most pressing public health issues in the community. Data were collected by Braun

Research Inc. (telephone survey) and BDHHS (focus groups and key informant) during the months

of March and April 2013.

The three methods are described in further detail below.

Community Health Telephone Survey

The Community Health Telephone Survey was designed and administered to gather quantitative

data about community members’ behaviors, attitudes, and awareness in the following areas:

access to local public health services, healthy eating and active living, and pressing public health

issues in the local communities. The survey, included in Appendix A, consists of locally developed

items, as well as items adapted from existing, validated survey instruments [e.g., the Center for

Disease Control’s National Behavioral Risk Factor Surveillance Systems (BRFSS, 6) and National

Health and Nutrition Examination Survey (NHANES, 7), and the U.S. Department of

Transportation’s National Survey of Bicyclists and Pedestrian Attitudes and Behavior (8)]. Survey

items were selected and adapted in collaboration with the Bloomfield Department of Health and

Human Services and with Partners for Health program staff.

10

The telephone survey was administered by Braun Research, Inc. of Princeton, to a random sample

of 604 households with a breakdown of 401 households in Bloomfield (zip code 07003), 100 in

Caldwell (zip code 07007) and 103 in Glen Ridge (zip code 07028). The survey was open for a

response by any adult (aged 18 or older) with confirmation that they lived in

Bloomfield/Caldwell/Glen Ridge. The confidence level of the telephone survey sample was +/-5%

for Bloomfield, and +/-9% for Glen Ridge and Caldwell.

In the interest of keeping the time for administration of the telephone survey to no more than 10

minutes, questions regarding public health announcements and disaster preparedness, impact of

local, state and national events on the community, and questions regarding collaboration with

other local agencies were not asked during the telephone survey. These topics were covered in

the focus groups and key informant interviews.

Before the start of each individual survey, participants were asked to consent to their willingness

to participate in this study and informed of their rights as a study participant. Each interview ran

for approximately 10 minutes.

Survey data were processed and analyzed using appropriate quantitative methods (e.g.,

frequencies, descriptive statistics). Summary data are reviewed in this report, with more detailed

survey responses presented in Appendix B.

Demographic information for the telephone survey sample is provided in Table 3. Demographics

for the telephone survey generally suggest that the respondent in the survey sample was more

likely to be female, more likely to be Caucasian, and had slightly higher educational level than the

general population demographic data for the three towns.

Table 3. Community Health Telephone Survey Sample Demographics

Bloomfield Caldwell

Glen Ridge

N= 401 N = 100 N= 103

Gender

(N=604)

Male 42.9% 46.0% 43.7%

Female 57.1% 54.0% 56.3%

Age

(N=604)

18-24 years 2.7% 4.0% 1.9%

25-44 years 24.9% 15.0% 24.3%

45-64 years 42.4% 39.0% 43.7%

65 or older 29.2% 39.0% 28.2%

Hispanic

(N=604) Yes, Hispanic 10.0% 4.0% 6.8%

Race

(N=604)

Asian (or Pacific Islander) 5.7% 3.0% 8.7%

Black (or African American) 11.5% 1.0% 5.8%

11

Mixed Race 3.7% 1.0% 0.0%

Native American (or American

Indian) 1.0% 2.0% 0.0%

White 72.6% 86.0% 79.6%

Other 2.2% 1.0% 1.0%

Education (Highest)

(N=604)

Less than high school diploma 2.2% 2.0% 1.0

High school graduate 22.9% 11.0% 16.5%

Associate degree 6.5% 9.0% 3.9%

Bachelor’s degree 31.4% 40.0% 35.9%

Graduate school & beyond 18.2% 26.0% 26.2%

Some college 17.5% 9.0% 13.6%

Annual Household Income

(N=604)

Less than $25,000 10.7% 4.0% 4.9%

$25,000 - $49,999 18.0% 12.0% 13.6%

$50,000 - $74,999 17.2% 19.0% 15.5%

$75,000 - $99,999 13.2% 12.0% 9.7%

$100,000 - $149,000 15.5% 12.0% 10.7%

$150,000 or more 11.0% 22.0% 24.3%

# Adults living in home

(N=604)

One 18.5% 21.0% 16.5%

Two 55.9% 55.0% 61.2%

Three or more 25.4% 22.0% 22.3%

# Children living in home

(N=604)

None 64.4% 63.8% 58.3%

One 14.2% 14.7% 16.5%

Two or more 20.7% 21.2% 24.3%

*percentages reported in the table are of all valid responses. Refusal on a particular item is not reflected here, however, the only

item with a large percentage of refusal was household income, where 14% of Bloomfield, 19% of Caldwell, and 21.4% of Glen Ridge

respondents did not answer this question.

Community Focus Groups

BDHHS assigned the Department’s Health Educator as the moderator for all focus group sessions,

which were conducted in Bloomfield only. An advertisement was placed on Bloomfield’s local

cable channel to promote participation in the focus groups. When that did not yield a satisfactory

number of participants, ideas on a variety of locations were brainstormed within the BDHHS and

this resulted in a decision on the following focus groups locations:

Kinder Towers Senior Living, 400 Hoover Road, Bloomfield, NJ 07003, April 10, 2013, N = 8

Bloomfield Recreation Department, 84 Broad Street, Bloomfield, NJ 07003, April 16, 2013, N = 7

New Light Baptist Church, 91 Dewey Street, Bloomfield, NJ 0700, April 28, 2013, N = 11

An MSU IRB-approved recruitment text was used for focus group participant recruitment

discussions. The recruitment text explained the purpose of the study and that BDHHS was

interested in gathering feedback to meet the standards of the national PHAB and to inform BDHHS

on better ways to serve the community.

12

Before the start of each focus group, participants were asked to review and complete consent

forms indicating their willingness to participate in this study and informing them of their rights as

a study participant. Focus groups ran between 25-55 minutes. With the permission of all

participants, focus groups were digitally recorded. Recordings and hand-written notes were then

content analyzed for common themes and summarized. A copy of the focus group protocol used is

included in Appendix A.

Questions regarding public health announcements and disaster preparedness were asked during

the focus groups, but not during the telephone survey and key informant interviews. Personal

health questions were not asked during the focus groups.

Community Focus Group data was analyzed by identifying typical themes, and triangulating focus

group data, where possible, with interviews, and telephone surveys.

Key Informant Interviews

For the third source of data and to address the PHAB’s strong suggestion for data that reflects

ongoing community collaboration, BDHHS conducted structured interviews with 10 key

informants and stakeholders from other agencies and organizations in the Bloomfield community.

Key informant interviews did not take place in Caldwell or Glen Ridge. The key informants were

representatives of the following organizations and services:

Bloomfield Volunteer Emergency Squad Bloomfield Government

A faith-based organization United Way - Bloomfield

A local business Bloomfield College

Clara Maass Medical Center Bloomfield High School

UMC Hackensack/Mountainside Hospital Bloomfield Recreation Department

BDHHS assigned the Department’s Health Educator and one Health Inspector as the interviewers

for all key informant interviews. An MSU IRB-approved recruitment text was used for interview

participant recruitment discussions. The recruitment text explained the purpose of the study and

that BDHHS was interested in gathering feedback to meet the standards of the national PHAB and

to inform BDHHS on better ways to serve the community. Potential participants were approached

in person and by telephone and email.

Questions regarding the impact of local, state and national events on the community, and

questions regarding collaboration with other local agencies, were asked during the key informant

interviews, but not during the telephone survey and focus groups. Personal health questions were

not asked during the key informant interviews.

13

Before the start of each interview, participants were asked to review and complete consent forms

indicating their willingness to participate in this study and informing them of their rights as a

study participant. Interviews ran from 25-55 minutes. With the permission of the participants,

interviews were digitally recorded. Recordings and hand-written notes were then content

analyzed for common themes and summarized. Common themes from the key informant

Interview data were identified and triangulated with focus group and telephone survey data,

wherever possible. A copy of the key informant interview protocol used is included in Appendix A.

RESULTS OF THE COMMUNITY HEALTH ASSESSMENT

The study was designed to provide an up-to-date Community Health Assessment for the

application requirements of the Public Health Accreditation Board, as well as to secure current

data to inform and improve public health services delivered by BDHHS. A mixed methods

approach, using three different types of data collection was implemented to gather information

about: residents’ current behaviors and attitudes in the areas of personal health, nutrition and

physical activity; community health including significant health issues and barriers; public health

announcements and disaster preparedness; quality of life in the community; and collaboration

among community agencies.

In most cases, the data are discussed by township since the demographics of the townships

involved in the CHA differ in important ways. Aggregate results of data are available in Appendix

B. Note that the telephone survey was conducted in all three townships, while focus groups and

interviews occurred only in Bloomfield.

14

PERSONAL HEALTH

Access to health care: Telephone survey participants were asked about personal and family

member access to five health services determined by the research team to be the key components

to preventative health care and maintenance of well-being. Table 4 provides full data on reported

access to services based on telephone survey question #2.

Note: Data is percent of respondents who indicated access or no access, eliminating those who respondents reporting “do not need this

service”.

Primary health care: Access to primary healthcare, as reported in the telephone survey, was

reportedly very high with Bloomfield at 94.5%, Caldwell at 99%, and Glen Ridge at 97.1%. It

should be noted that within these numbers there are respondents 65 or older who are eligible for

Medicare benefits. In Bloomfield, this population accounted for 29% of respondents, in Caldwell

39% and in Glen Ridge 28% eligible for Medicare benefits. The township of Bloomfield indicates

the highest rate of no access to primary health care at 5.5% of the participants surveyed.

Table 4.

Telephone Survey Personal and Family Access to Health Services

Bloomfield Caldwell Glen Ridge

a. Primary health care 94.5% 99.0% 97.1%

b. Childhood vaccinations 94.0% 96.4% 96.4%

c. Cancer prevention and

treatment 89.0% 95.3% 94.4%

d. Dental care 88.5% 94.0% 93.1%

e. Mental health care- including

depression, anxiety, drug and

alcohol treatment, or other

89.6% 97.6% 93.3%

15

Childhood vaccinations: This question is obviously only relevant to those with children, thus, a

high percentage of respondents in all three townships indicated that they do not require this

service (Bloomfield 40.9%, Caldwell 45%, Glen Ridge 46.6%). Of those that do require the service,

access to childhood vaccines was reported at 94% in Bloomfield, and 96.4% in both Caldwell and

Glen Ridge, similar to their responses for access to primary health care services.

Cancer prevention and treatment services: The overwhelming majority of respondents also

indicated that they had access to cancer prevention and treatment, at 89% in Bloomfield, 95.3% in

Caldwell, and 94.4% in Glen Ridge. Some respondents may have been confused by the inclusion of

both prevention and treatment, since 10-11% of all survey respondents claimed “don’t need this

service”, perhaps focusing more on treatment than prevention.

Dental care: Dental care access was also reportedly high, with 88.5% in Bloomfield, 94% in

Caldwell, and 93.1% in Glen Ridge. Notably, however, is that although primary care was reported

to be very high in all three communities, more than one in ten Bloomfield respondents reported

no access to dental care.

Mental health care: The question about mental health care access included further definition

regarding respondent’s access to treatment for depression, anxiety, drug and alcohol treatment, or

other. Reports of access to mental health care services, were similar or higher than dental care

access, at 89.6% in Bloomfield, 97.6% in Caldwell and 93.3% in Glen Ridge. Notably, however,

more than one in ten respondents indicated that they “don’t need this service” at 11.7% in

Bloomfield, 14% in Caldwell and 13.5% in Glen Ridge.

16

Table 5 supplies the complete data gathered on barriers and lack of access to services based on

Telephone Survey Question 2.

Table 5. Reasons why respondents could not access services? (Respondent was allowed to select

more than one.)

Bloomfield Caldwell Glen Ridge

N = 86 N = 11 N = 10

Lack of time 8.7% 0.0% 0.0%

Lack of motivation 4.3% 0.0% 0.0%

Lack of childcare 4.3% 0.0% 0.0%

Lack of money 40.6% 0.0% 66.7%

Lack of transportation 5.8% 16.7% 0.0%

Not physically capable 2.9% 0.0% 0.0%

Don’t know how to

access these services 30.4% 83.3% 33.3%

Barriers to accessing a variety of services was discussed in the survey, focus groups, and

interviews, but were asked reflective of different groups. That is, the phone survey asked people

to reflect on their own access to services, while the focus groups and interview participants were

asked about general access in the community.

Telephone survey respondents that answered “no” to any portion of the question regarding access

to the above services were further prompted for reasons as to why he/she/family members do not

have access to the services (Table 5). Bloomfield had the highest number of respondents

reporting no to any of the health care items (86), with 29 out of 86 (40.6%) reporting “lack of

money” as a barrier, and 21 out of 86 respondents (30.4%) reporting that they “don’t know how to

access these services.” Only 11 respondents in Caldwell and 10 respondents in Glen Ridge

answered no to any of the questions on access. Although the percentages for these two townships

are based on very small numbers, the barriers mentioned most often for Caldwell and Glen Ridge

were also “lack of money” and “don’t know how to access these services.”

17

Questions about barriers to access were also asked in the focus groups in Bloomfield, however,

responses reflected less on specific health services, and more about what was generally typical of

their community. The following themes were given when asked what barriers are keeping

community members from using “existing services”. Notably, many of the respondents focused on

barriers to personal health behaviors, rather than to services.

Insufficient number of days/week that transportation is available for food shopping

Disability inhibits walking/activity

Need general knowledge of what services are available

Red tape/bureaucracy

Need (more) health, nutrition, exercise classes, overcrowded exercise classes

Similarly, key informant respondents were asked about barriers to services in Bloomfield, and

offered the following general categories or themes:

Lack of awareness, lack of education

Lack of inpatient beds available for mental health patients. Many using ER

Uninsured/underinsured residents

Not enough (free) services, resulting in long waits, and making it harder for the working

poor

Older and student populations do not understand what is available for them

Fear factor for the undocumented population, homeless are ashamed

Lack of enthusiasm to become involved in improving personal health

Lack of time

Payment for health care: Respondents were asked how they currently pay for medical and

dental expenses and prompted to answer to “all that apply” from a list including private health

insurance, Veteran’s Administration, Medicare/Medicaid, NJ Family Care, cash, charity are, and

other. For medical expenses the most common method of payment is private health insurance

(e.g., Horizon, HMO, etc.) with percentages at approximately 79% for Bloomfield, 80% for

Caldwell, 85% for Glen Ridge. Medicare/Medicaid is used by approximately 36% of Bloomfield

respondents, 40% in Caldwell and 28% in Glen Ridge. These Medicare/Medicaid numbers are

directly correlated with the number of telephone survey respondents age 65 and older: 29%

Bloomfield, 39% Caldwell and 28% Glen Ridge.

18

For dental expenses, payment methods differ dramatically from other medical services, with use

of private dental insurance by approximately 62% of Bloomfield respondents, 60% Caldwell, 68%

Glen Ridge, to paying with cash (no insurance, or not covered) by approximately 31% in

Bloomfield, 35% in Caldwell, and 29% in Glen Ridge respondents.

With respondents allowed to state all forms of payment that apply, the number of overall

responses in both the medical (846) and dental (614) categories indicate that many residents are

using more than one form of payment for care. Many, for example, use Medicare plus a private

health insurance supplement, or private health insurance plus cash. In addition, AARP, employers,

military, friends and family that are doctors or dentists, were sources of payment (or free care)

mentioned.

Rating personal health on a 5 point scale: When respondents were asked to rate their personal

health on a five point scale with 1 being very unhealthy and 5 being very healthy, percentages of

respondents who self-rated their health at 5 or 4 were reported as:

Bloomfield: 79%

Caldwell : 82%

Glen Ridge: 90%

Self-ratings at the “1” level, very unhealthy, are limited, but may reflect a slight bias in terms of

who is available for telephone surveys:

Bloomfield 1.2%

Caldwell 1%

Glen Ridge 0%

Health screenings: Respondents to the telephone survey were asked to report which health

screenings she/he had completed during the past year and again were prompted to answer to “all

that apply” from a list including cholesterol, blood sugar for diabetes, blood pressure, dental,

prostate, mammogram, pap smear (the last three dependent on gender) (Table 6).

19

Table 6 supplies the complete data gathered on health screening performed in the past year

based on Telephone Survey Question 6.

Table 6. Health screenings performed in the past year? (Respondents were allowed to select all that

applied.)

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Cholesterol 76.1% 71.4% 72.8%

Blood sugar for diabetes 76.2% 76.0% 69.4%

Blood pressure 90.5% 92.0% 88.1%

Dental 75.1% 88.0% 75.2%

Prostate

(among men only) 46.2% 54.3% 33.3%

Mammogram

(among women only) 51.5% 61.1% 62.5%

Pap smear

(among women only) 56.2% 63.0% 64.3%

Other 24.5% 20.4% 20.0%

Respondents could also state “other” screenings, and this question yielded data on colonoscopy,

blood work, computed tomography (CAT scan), electrocardiogram (EKG), echocardiogram (ECO)

and magnetic resonance imaging (MRI), skin cancer, allergy, pregnancy, bone density, vision/eye,

sleep, stress, and “other” not defined.

Blood pressure screenings were the most reported, ranging from 88.1 to 92% of respondents

reporting a blood pressure screening. The ranges for other common screenings were between

71.4 to 76.1% for cholesterol, and 69.4 to 76.2% for blood sugar screenings. Dental screenings

ranged from 75.1 - 88%.

Notably, screenings that were specific to gender (prostate, mammogram, and pap smears) were

the least likely to have been received, with only 56.2 to 64.3% of women in all three towns

receiving pap tests, 51.5 to 62.5% receiving mammograms, and of men in all three towns receiving

prostate exams, 33.3 to 54.3%.

20

Disease Diagnosis: Of the total telephone survey respondents, 267

claimed “yes” to more than one disease diagnosis in the household.

Table 7 supplies the complete data gathered on number of disease

diagnoses in surveyed households based on Telephone Survey

Question 7.

Table 7.

Disease Diagnoses in Surveyed Households

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Cancer 16.1% 21.0% 13.7%

Diabetes 24.8% 18.0% 14.9%

High blood pressure 51.0% 38.0% 40.6%

Asthma 24.1% 16.0% 22.8%

Heart Disease 16.8% 20.0% 10.9%

Lung Disease 7.3% 5.0% 2.0%

Mental Health Concerns 10.0% 6.1% 5.9%

Other 7.6% 4.0% 3.0%

Respondents to the telephone survey were asked if she/he or anyone in the household had ever

been diagnosed with cancer, diabetes, high blood pressure, asthma, heart disease, lung disease,

and mental health concerns. Respondents had the ability to state “yes” to more than one disease

and could also state “other” diagnoses which yielded responses including arthritis, osteoporosis,

urinary tract disorders, celiac disease, Crohn’s disease, multiple sclerosis, stroke, thyroid disease,

and “other” not defined.

High blood pressure was the most reported diagnosis in all three communities. Bloomfield

reported the highest level of high blood pressure diagnoses at 51.0% and also the highest level of

diabetes diagnoses at 24.8%, asthma diagnoses at 24.1%, lung disease diagnoses at 7.3% and

mental health diagnoses at 10%. Caldwell reported the highest level of cancer diagnoses at 21.0%

and heart disease diagnoses at 20.0%. Glen Ridge respondents reported the lowest level of all

diagnoses with the exception of high blood pressure at 40.6% and asthma at 22.8%. Caldwell

“High blood pressure was

the most reported diagnosis

in all three communities.”

21

reported the lowest numbers in high blood pressure diagnoses at 38.0% and asthma diagnoses at

16.0%.

Nutrition: All three methods of the Community Health Assessment included questions regarding

consumption of fruits and vegetables. Telephone survey respondents were also asked about

consumption of sugar sweetened beverages. The structure of the questions regarding fruit and

vegetable consumption differed between methods, however, the data can be reviewed together to

provide depth to the picture of attitudes and behaviors in the community.

Participants in the telephone survey were asked how many servings of fruits and/or vegetables

they had eaten on the previous day. Figure 2 displays responses from each township sample.

Figure 2. How many servings of fruits and/or vegetables did you eat yesterday? A serving

equals one medium apple, a handful of broccoli, or a cup of greens.

The average number of fruit/vegetable servings per day was 2.8 servings, slightly higher in

Caldwell and Glen Ridge and slightly lower in Bloomfield. The majority, 83% of respondents

surveyed, stated they ate less than 5 servings per day.

Notably, in two of the three focus groups and six of the ten interviews, participants indicated that

they believe people in the community do not eat enough fruits and vegetables. Following the

question of nutrition behavior, respondents in the focus groups and key information interviews

were asked, “How many servings of fruits and vegetables (per day) do you believe are enough?” A

22

total of 36 people were asked this question, across the two data methods with the following

results:

6-11 servings per day 18 respondents, 50%

1-5 servings per day 4 respondents, 11%

Respondents in the focus groups and interviews were also prompted to discuss what would make

it easier for community members to eat more fruits and vegetables. The following themes were

reported as ideas for how to enable community members to eat more fruits and vegetables:

Fruits and vegetables need to be cheaper

It is cheaper to eat “fast” foods

Increase farmers’ markets in number, size, variety of produce, access (now only one

small farmers’ market); Have one on both ends of town, not only in center; Have it for

more than the summer season

Make township bus available for food shopping more than current schedule of 2 times

per week

More conveniently located store that sells fruits and vegetables

Delivery of fruits and vegetables to certain locations (such as Kinder Towers lobby)

Better teaching in the schools about healthy eating

Awareness campaigns (about healthy eating)

United Way and other non-profits can help on an educational level

Partner with a chef; Provide education on how to prepare fruits and vegetables so that

they last for the entire week

Engage a nutritionist and the school newspaper

Specifically, interview respondents noted the following barriers to eating fruits and vegetables in

their communities:

Parents do not have enough time.

Our culture is not active.

Children do not want to exert themselves.

Healthy eating is not made attractive.

More access to green markets, community markets, victory gardens.

There are cultural beliefs about eating certain foods.

23

With regard to healthy eating, the telephone survey respondents were also asked, on average, how

many sugar sweetened sodas or other sweetened drinks do you drink per day? It was further

defined that: One serving equals one 12 ounce can, bottle, or glass. Include sweetened iced tea,

sports drinks, fruit punch or other fruit-flavored drinks. Do NOT include diet soda, seltzer, sugar free

drinks, or 100% juice.

The mean number of servings per day reported for the entire respondent group was .46, or less

than one half serving per day, however 70% or more respondents said that they do not drink any

servings. Thus, among only those who drink sugar sweetened beverages, 16% in Bloomfield,

22.7% in Caldwell, and 1% in Glen Ridge report drinking three or more sugar sweetened

beverages a day.

Physical activity: Respondents to all three data collection methods (telephone survey, focus

groups, key informant interviews) in the Community Health Assessment were asked questions

regarding physical activity. The structure of the questions regarding physical activity differed

slightly between methods, however, the data can be reviewed together to provide more depth to

the picture of physical activity in the community.

Participants in the telephone survey were asked how frequently they participated in physical

activity during the past month. Figure 3 displays responses from each township sample.

24

Figure 3. During the past month, other than your regular job, how often did you participate

in any physical activities or exercises such as walking, dancing, soccer, gardening, or

running for exercise?

The majority of telephone survey respondents reported exercising fewer than four times per week

(67.7%). Greater than half of the respondents (52.3%) reported exercising fewer than three times

per week. The Caldwell sample indicated the highest level of exercising at 54% of respondents

reporting that they exercise three or more times per week.

Asked their reasons for not exercising, telephone survey respondents mentioned laziness,

boredom, age, taking a few days off to rest the body, the internet, and pain, as reasons for not

exercising at all or for not exercising more than they do now.

Figures 4 and 5 provide the overall telephone survey data for reasons why respondents do not

walk or bike.

0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

Never About once or twice a week

About 3 times a week

More than 3 times a week

Pa

rtic

ipa

nt

Re

spo

nse

Physical Activity

Figure 3.

Bloomfield

Caldwell

Glen Ridge

25

Figure 4. What are the top reasons that respondents did not walk more frequently?

Figure 5. What are the top 2 reasons that you do not ride a bicycle more frequently?

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

100%

Bad weather/wrong

season

Too busy/no opportunity

Disability/other

health impairment

Pa

rtic

ipa

nt

Re

spo

nse

Reasons for Not Walking

Figure 4.

Bloomfield

Caldwell

Glen Ridge

0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

Bad weather / Wrong season

Don't have access to a bike

Disability_other health

impairment

Pa

rtic

ipa

nt

Re

spo

nse

Reasons for Not Biking

Figure 5.

Bloomfield

Caldwell

Glen Ridge

26

When the question regarding physical exercise was posed to the focus groups held in Bloomfield,

the moderator prompted further discussion regarding which type of (physical) activities were

being performed, for how long, and how often. Individual respondents reported participation in

walking, yoga, swimming, biking, golfing, weight training, and gym memberships.

Respondents in the focus groups were also prompted to discuss what keeps her/him from

participating in physical activity or exercise and what would make it easier to exercise more. The

following reasons (keeps respondent from participating) were reported:

dangerous to walk because of cars

goose droppings

arthritis

Comments on what would make it easier to exercise more included:

“walk” signs

bike paths

less goose droppings

advertisement in Bloomfield paper, in “The Buzz”, internet

more classes

community center with exercise classes

In the ten Key Informant interviews with people who are involved in the variety of community

agencies in the Bloomfield area, time was mentioned by 50% of the participants, and money and

lack of energy were listed in four out of ten (40%) interviews as the reasons community members

do not exercise more often.

Specific responses within these categories are identified below:

TIME - too busy, lack of time, many people have two or more jobs, no prioritization,

days are already scheduled from 4:30 AM to 10:00 PM, not wanting to cut short time

with family

MONEY - cannot afford gym membership/lack of an affordable (exercise) facility, taxes

too high

ENERGY – not enough sleep, laziness, no energy, stress, parents are overworked and

want to come to watch TV

KNOWLEDGE – people do not understand long-term health benefits, lack of knowledge

of the benefits of exercise for chronic disease prevention

27

Other reasons that were mentioned by the interviewees included boredom (while doing a physical

activity) and not having a partner to walk with.

Suggestions by the key informants for making it easier for community members to exercise more:

create a walking club

use of school gym(s) in winter for walking/exercise

more promotion about the importance of a healthy lifestyle/exercise

put the exercise stations back in the park

promote (physical activity) through media, church leaders, politicians

utilize Brookside Park and have fundraisers

Mentioned by six out of the ten (60%) key informants was the need for additional education and

promotion regarding the fact that physical activity is a critical part of a healthy lifestyle and

disease prevention. Taken together as answers to the question on reasons for “lack of” exercise

and “suggestions for” a higher level of exercise in the general community, health

education/promotion was mentioned the greatest number of times by the Key Informants.

The focus groups were also asked if they ever walked or used a bike to do shopping or errands.

The responses suggested that physical activity such as walking or biking was rare in the context of

day to day errands. At Kinder Towers Senior Living all respondents reported “no” to riding a bike.

Two reported that that they walk to the CVS/Quick Chek weekly. There was one report at the New

Light Baptist Church of occasionally riding a bike to the dry cleaners, and one report at the

Bloomfield Recreation Department of walking to the post office.

Compiling responses from the three focus groups to the question why they do not bike or walk to

do your shopping or errands, included:

distance

no food stores in the (Bloomfield) downtown area

time

physical challenges

weather

danger

Other comments on biking included lack of enjoyment, fear of falling, boredom, laziness, age, and

use of other types of equipment at the gym.

28

Related to these reasons for not walking during day to day activities or errands, Bloomfield focus

group and interview participants varied on whether Bloomfield was suitable for walking, with the

following specific responses:

Not suitable for biking – need a bike lane on the main routes.

Not as a whole; but residential areas are suitable.

(Bloomfield is) a great walking community.

(For walking), Parks are good.

Not safe for children walking when school lets out.

Bloomfield is not suitable for biking or walking.

Uneven sidewalks.

No. Too much traffic.

Summarizing responses from the focus groups and the interviews together, with regard to the

question about what improvements could be made, in order to increase the Bloomfield’s

suitability for walking/biking, the important theme of safety was notable. Following are specific

quotes that reflect this theme:

It would be helpful if there were ‘walk’ signs . It would also be helpful if there were bike paths.

Nicer sidewalks.” And, “Keep sidewalks in better repair.

(Eliminate) fear in society about allowing children to be out of sight (so that the outdoor

activity doesn’t have to be organized activity and/or confined to the (residential) backyard.

Bike lanes.

(Promote) biking in places where there is less traffic.

Promote biking – Tour of Bloomfield day for bicyclists.

Promote use of track at Foley Field.

Bike lanes. We already have ‘Complete Streets’ program

Driver education definitely necessary.

Create and promote bicycle lanes, routes, mile markers. (Install) bike racks.

Make recycled bikes available. Provide helmets.

Clara Maass has walking programs and they are hoping to get the community involved.

More cross walks. Closing of some streets at times.

29

In an overall summary regarding physical exercise, only 3.9% of the

respondents of the total telephone survey sample stated that they

had no safe place to ride a bike. Bloomfield was at 3.7%. The main

reasons for not walking more often were bad weather (34.1%

aggregate) and being too busy (26.6% aggregate). 89.2%

(aggregate) of telephone respondents had not ridden a bicycle in

the past 30 days, possibly a higher percentage due to the survey being administered during the

month of March. For telephone survey respondents, the main reason for not riding a bike was the

weather at 25.3% aggregate (24.6% in Bloomfield). Bloomfield is generally rated as suitable for

walking, far less suitable for riding a bike. Telephone survey respondents were less likely to list

safety concerns, than those in the interviews and focus groups, however, it is likely that this

reflects the nature of the question wording in each of the methods. Notably, in eight out of ten key

respondent interviews and two out of three focus groups, the need for bike lanes was pronounced.

“Notably, in eight out of ten

key informant interviews and

two out of three focus

groups, the need for bike

lanes was pronounced.”

30

RESULTS ON COMMUNITY HEALTH/SIGNIFICANT HEALTH ISSUES AND BARRIERS

All three data collection methods were used to gather data on attitudes about the community’s

health needs and the most pressing health issues facing the

community. The question was similarly phrased in the telephone

questionnaire, focus group and key informant interview protocols.

Table 8 supplies the complete data gathered on the most pressing

public health issues in the surveyed community, based on

Telephone Survey Question 15.

“Nearly 50% of the

telephone survey

respondents reported that

they believe nutrition,

exercise, and chronic

disease are the top health

issues in the community.”

Table 8.

Most pressing public health issue in the respondents’ community? (Respondents were allowed to select one.)

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Total N

Responding %

Total N

Responding %

Total N

Responding %

Infectious diseases

(STD’s, HIV/AIDS) 36 10.9% 11 11.0% 6 5.8%

Chronic diseases

(for example, heart disease, cancer,

diabetes, and asthma)

91 27.7% 27 27.0% 24 23.3%

Environmental Living

Conditions (for example, air and

water quality, mold, lead)

34

10.3% 4 4.0% 6 5.8%

Mental Health Concerns (for

example, anxiety, depression) 12 3.6% 2 2.0% 3 2.9%

Social Concerns

(for example, homelessness,

discrimination, alcohol and drug

abuse)

22 6.7% 3 3.0% 7 6.8%

Diet and Exercise

(for example, lack of physical

activity, poor nutrition, obesity)

94 28.6% 19 19.0% 34 33.0%

Community Safety

(for example, violent crime and

motor vehicle accidents)

35 10.6% 3 3.0% 8 7.8%

Health Care System/Health

Insurance

(for example, Obama Care, lack of

insurance, payments and costs)

2 0.6% 1 1.4% 0 0.0%

Other 3 0.9% 0 0.0% 1 1.1%

31

The aggregate of telephone survey data indicates that the two most pressing public health issues,

from the perspective of respondents, are diet/exercise and chronic disease. Responses from the

focus group held at the Bloomfield Recreation Department directly paralleled the telephone

survey naming diet, exercise, obesity in the population, heart disease, and diabetes as the most

significant health problems in the community. The other two focus groups, however, discussed

broader environmental and social issues, with comments such as:

Cancer rate for last 10 years, specifically Hobson Street radius, exceeds what is normal

Serious rat problem near Home Depot

Homeless situation by CVS

Water quality

Community Safety. Watsessing Park near East Orange, gun shots.)

Goose droppings

Car vandalism

For the interview respondents, the most pressing health problems in the community were ranked

in the following order, the first being the problem mentioned most often:

Social Concerns (homelessness, discrimination, alcohol and drug abuse) mentioned in 7

of 10 interviews

Mental Health Concerns (anxiety, depression) mentioned in 6 of 10 interviews

Diet and Exercise (lack of physical activity, poor nutrition, obesity) mentioned in 5 of 10

interviews

Chronic Diseases (heart disease, cancer, diabetes, asthma) mentioned in 4 of 10

interviews

Infectious Diseases (STD’s, HIV/AIDS) mentioned in 2 of 10 interviews

Community Safety (violent crime, motor vehicle accidents) mentioned in 1 of 10

interviews

Health Care System/Health Insurance (Obamacare, lack of insurance, payments and

costs) mentioned in 1 of 10 interviews

As shown, there was only one individual who discussed environmental living conditions or the

health care system/health insurance as barriers to use of services, in both interviews or focus

groups.

32

Public Health Announcements: Only the Focus Groups were asked questions regarding public

health announcements and disaster preparedness, this information being particularly of interest

to BDHHS following Hurricane Sandy. While acknowledging to the participants that multiple

sources were available from which to receive important health department notifications, the

groups were asked what sources they used. The predominant response was “Reverse 9-1-1”. The

second most common response was television and specifically the NJ News Channel.

Assessments of the town’s ability to get information to the residents differed dramatically across

the three focus groups. The New Light Baptist Church group responded that efforts are below

average, not so good, and that more notice is needed on road closures. Respondents at the

Bloomfield Recreation Department said that “The Buzz” and television stations are a good source

of township information. Kinder Towers respondents agreed unanimously that Bloomfield does a

very good/excellent job in getting information out to the residents. Participants were also asked if

their experience before, during, or after Hurricane Sandy had impacted their decision in any way.

Responses ranged from “not really” to a belief that Bloomfield did a good job assisting during the

storm.

These differences likely reflect meaningful differences in the living conditions and life experiences

of participants of each of the focus groups. They speak to the importance of gathering information

from across disparate groups, in order to assess the strengths and needs of the community.

Quality of Life in the Community: The Focus Group Protocol and Key Informant Interview

Protocol asked participants to reflect on the overall quality of life in their community. The

questions encourage participants to consider community needs in areas that would not typically

be the responsibility of the public health department. These included, for example, work of the

police or fire department or the department of transportation, that might impact on health. Asked

to rate the township, on a 10 point scale (with 10 being the highest rating) as a healthy and safe

community in which to live, the following responses were received:

Focus Groups

Bloomfield Recreation Department (N= 7): answers ranged from 4 – 9 with the most frequent

response at 8/9.

Kinder Towers (N=8): a unanimous rating of 10.

New Light Baptist Church (N= 11): answers ranged from 3 – 9.

Key Informant Interviews (N=10)

Responses ranged from 5 – 9 with the median ranking at 7

33

Across all three focus groups and interviews, Bloomfield was considered in a range of medium to

high as a healthy and safe community.

Asked for factors that could improve overall quality of life in the community, one focus group did

not supply an answer. The two other focus groups suggested:

better traffic control

better maintenance of roads

environmental cleanup

increased police presence

increased exercise class offerings

In the key informant interviews, asked for the “top three” factors that would improve quality of

life in the town, there was great variability, from safety issues, to employment, to environmental

concerns. “Access to services” and “health education” were each mentioned by 4 of the 10 (40%)

of the respondents, and “cultural activities” by 30%. Below are the additional responses,

mentioned by individual key informants

Population needs to feel embraced and cared for by the community they live in

Community education and understanding of the importance of wellness and

preventative care

Access to healthcare, specifically preventative care.

Safe sidewalks and streets

Improved rates of employment

More parking spaces

Leaf collection done more often

More (public) recreation (programs) for children

Greater police presence

More visible Fire Department

Awareness of the Neighbor-to-Neighbor Program (a local 501c3 organization) and

residents should watch out for each other

More carnivals, festivals, sports events to be held in Bloomfield. Bloomfield needs a

greater sense of community; More cultural activities

34

Continuation of the re-development

Continuation of open government aspect

Homelessness should be reduced; Also renters and owners have different outlook on

upkeep of homes

Impact of Local, State and National Events on the Community: Questions about local, state,

and national events were asked of the key informants, only. Respondents were asked what they

think will have the greatest impact on the local health department, and were given examples

including the Patient Protection and Affordable Care Act (Obamacare), new gun laws, climate

change, etc. In response to mention by the interviewer of the Patient Protection and Affordable

Care Act (Obamacare), comments by interviewees were recorded in seven out of ten interviews.

Responses were mostly positive with respect to the law, as might be anticipated, given the nature

of the key informants (that is, people who were connected to government, social services, and

non-profit organizations ).

“It is vital to the health system. It is creating more visibility and openness because the

general public will seek the local health department more and the local health department

will feel more comfortable dialoging with hospitals. It will also provide more services

traditionally NOT available so the local health department will probably provide more

referrals for those services.”

“Obamacare will cause the local health department to be more pro-active in providing

wellness (services) and education, currently underutilized.”

“Obamacare is a huge plus; (there are) too many people without health insurance. It will

greatly impact the health department.”

Specifically with regard to the Social Security Bill and Medicare/Medicaid: “Seniors barely

have enough and now they will have less. The health department can educate people on

NOT using the ER for primary care and answer questions about Obamacare.”

During the telephone survey administration asking respondents what they thought was the most

pressing public health issue, two respondents provided the following comments which were

calculated in the “Other” category. These are more typical of general public commentary on the

new healthcare law:

“Obamacare is going to kill us all. The Independent Payment Advisory Board set up by the

new senator in Massachusetts will kill all the elderly.”

35

“The healthcare system as a whole is out of whack. If someone gets or has those mentioned

things <the health issues mentioned by interviewer>, they cannot get the care they need

because they can’t afford it.”

The other “event” mentioned was with regard to gun laws. Two Key Informants responded by

simply stating gun laws will have an impact on the community. One informant made the following

comment:

“Gun laws don’t necessarily address the problem of safety (which) goes back to education

and provision of services.”

Collaboration Among Community Agencies: Because of their associations with various

community agencies, key informants were asked, “To what extent do you or your agency

collaborate with other agencies and organizations in Bloomfield, in an effort toward improving

community health outcomes?” Interviewees were asked specifically about the following types of

organizations/agencies (schools, hospitals, local government, etc.) The responses are summarized

below:

Schools: Contact with the Board of Education was reported. Involvement in the “Young

Consumers Program” was mentioned, as well as participation in obesity programs, exercise

programs, gardening programs. Moderate collaboration was mentioned by one respondent.

Three out of ten respondents made no mention of collaboration with schools.

Hospitals/Other Health Agencies: Collaboration between the Volunteer Emergency Squad and

home health care agencies/social workers was mentioned. The need for more interaction

between hospitals and the community was voiced by one informant. The New Light Baptist

Church, Bloomfield High School and Bloomfield College were reported to have collaborations with

Mountainside and Clara Maass Hospitals.

Local Government: Six out of ten respondents mentioned collaboration with local government

agencies including the health department, police department, and one group related to or

perceived to be part of government, the Chamber of Commerce.

Law Enforcement: Seven out of ten respondents, including representatives from the hospitals

and schools and United Way, reported collaboration with law enforcement agencies

Faith-based Organizations: Six out of ten respondents discussed collaboration with faith-based

organizations. Two respondents stated, “Not so much.” One of those two specifically stated that

this organization would be open to future collaboration.

36

Social Service Agencies: Six out of ten respondents reported collaboration with a variety of local

social service agencies.

Local Businesses: Two respondents stated active and current collaboration with local businesses.

Other respondents stated that they had collaborated in the past but not currently, claimed

occasional collaboration, responded that collaboration had recently started, and claimed

membership in the Chamber of Commerce.

37

SUMMARY AND NEXT STEPS

Purpose

The BDHHS decision to apply for accreditation by the national Public Health Accreditation Board

places them in a small, but growing, group of local health departments around the country. A

current Community Health Assessment is required in the PHAB application process, but the CHA is

also a critical baseline step in determining areas where BDHHS can steer the focus of the

department in the coming months and years. Completion of the CHA fulfills one of the

requirements of the PHAB application for accreditation, and can provide important information to

the township on the attitudes and behaviors of the BDHHS audience relative to current health

education and services in the community.

Methods

The mixed method of data collection used for the CHA enabled BDHHS to pull information from

diverse respondents. The Community Health Telephone Survey drew data from a random sample

of 604 residents living in Bloomfield, Caldwell, and Glen Ridge, the three towns being served by

BDHHS at the time of data collection. The Community Focus Groups were performed at three sites

in Bloomfield including a senior living environment, a faith-based organization, and the

Bloomfield Recreation Department. These site choices allowed for input from a group that was >

55 years of age, a multi-aged, faith-based group, and a group of participants already using

township services at the recreation department. The Key Informant Interviews were performed

with Bloomfield community stakeholders from a diverse selection of agencies and organizations in

the township. This agency-specific data collection approach provided an additional perspective on

the potential for collaboration among local agencies for the improvement of health outcomes.

Overall, use of this mixed method of data collection also allowed for triangulation analysis of both

quantitative and qualitative data in order to identify common themes and consistent remarks

across the three methods.

Summary of Findings

ACCESS: To questions regarding access to general health services provided by BDHHS, the

response was between 94.5 - 99% access and, with specific regard to childhood vaccinations,

access was reported to be between 94 - 96.4%. These numbers dropped for access to dental

health services at 88.5 - 94% with 11.5% of Bloomfield respondents reporting no access.

38

Answers regarding access to cancer prevention and treatment services in a range of 89 - 95.3%

access and mental health care services in a range from 89.6 - 97.6% access may have been slightly

biased by the ability for respondents to claim, “don’t need this service.” With regard to cancer

services, respondents may not have differentiated between “prevention” and “treatment” services.

With regard to mental health services, attitudes of privacy and embarrassment may impact

responses.

BARRIERS: For respondents stating no access to certain services, the two key barriers were lack

of money and lack of information on how to access the services. The lack of money response may

reflect lack of information about access to free services and lack of knowledge about the potential

for charity care available under certain circumstances. In the focus groups, lack of knowledge

regarding services was discussed. Lack of awareness of services was a common theme in all three

data collection methods. Key informants also commented on the broader dilemma of the

uninsured and under insured and the correlation to use by these people of emergency room

services for general health care.

SELF-RATED HEALTH: For the state of New Jersey the percentage of respondents who reported

fair or poor health using the 2009 BRFSS question, “Would you say that in general your health

is excellent, very good, good, fair, or poor?”(6) ranged from 13.5 – 15.2% for adults age 18 and

over. For the similar question in the BDHHS telephone survey, “How would you rate your

personal health on a scale from 1 to 5, with 1 being very unhealthy and 5 being very healthy?”, the

aggregate of data from the three townships formed a range of 0.8 – 1.0% of adults age 18 and over

reporting unhealthy/very unhealthy. This may indicate an attitude of better self-rated personal

health in the BDHHS communities. There may be slight bias in the different wording of the

question and in the likelihood that those who participated in the surveys may have been healthier

than the general population

SCREENINGS: Given the importance of screenings to disease prevention and detection/early

treatment, several of the numbers reported in the telephone survey on use of health screenings

appear low. This may be due in part to the question limiting the response to screenings that

occurred during the past year. If that time frame was expanded to two or five years, as some of

these tests are recommended, the percentages would likely increase. For example, in the state of

New Jersey, cholesterol screenings done within the last five years (9) indicate > 80% of

respondents having had a screening while the BDHHS telephone survey response was between

71.4 – 76.1%. At the national level, 76% of respondents indicated that cholesterol screenings had

been done within the last five years. The Healthy People 2020 (10) target for cholesterol

screenings is > 82% population compliance.

39

DIAGNOSIS OF CHRONIC DISEASE: Of the 604 respondents to the telephone survey, there were

267 (44%) positive responses to having one or more chronic disease(s) in the household. High

blood pressure was the most reported diagnosis in all three communities.

Bloomfield reported the highest levels of diabetes, high blood pressure, asthma, lung disease and

mental health concerns. Consideration should be given to the national data on health disparities

that indicate higher levels of diabetes in minority populations, recalling that Bloomfield’s Hispanic

and African American population accounts for 21.5% of those Bloomfield respondents surveyed,

while in Caldwell and Glen Ridge those minority numbers were, respectively, 5% and 12.6% of the

population.

Overall there were 267 diagnoses of chronic diseases in a survey of 604 households, suggesting

that these communities, like much of the US, must be increasingly focused on reducing chronic

disease.

NUTRITION AND PHYSICAL ACTIVITY: The BDHHS health assessment sought data on

consumption of fruits and vegetables and extent of physical exercise by various methods and

specifically walking and/or biking.

For consumption of fruits and vegetables, the telephone survey data indicated that 83% of the

respondents eat less than 5 servings per day while the greater

percentage of participants in the focus groups and key informant

interviews indicated awareness that 6 – 11 servings per day would

be optimum. This may indicate that there has been a small amount

of progress toward the population having an awareness of what

they should be doing, with less progress toward that awareness

being a determinant of behavior change.

COMMUNITY HEALTH & QUALITY OF LIFE/SIGNIFICANT HEALTH ISSUES AND BARRIERS: Diet

and exercise and chronic disease are related in their direct impact to the individual as well as to

the community (as opposed to an issue of broader community impact such as environmental

concerns and social concerns). They are also related in the fact that there is much developing

scientific data that lack of healthy diet and exercise is one of the primary predictors of chronic

disease. Nearly half (47.8%) of telephone survey participants responded that

diet/exercise/chronic diseases are the community’s most pressing issues. This was also

supported by commentary in the Bloomfield Recreation Department focus group.

From the other two focus groups and in the key informant interviews, social concerns emerged as

the most significant health problems in the community. There may be bias in this data due to the

“83% of respondents

surveyed stated that they

ate less than 5 servings

(fruits/vegetables) per day.”

40

fact that the agencies represented in the interviews may have a greater awareness of local social

concerns. Several of the agencies involved are dedicated to addressing social issues such as

education, poverty, drug and alcohol abuse, teen pregnancy, and community safety.

Despite the local data indicating disturbing trends in household wellness (i.e. high rates of chronic

diseases), ratings from focus groups and interviews on quality of life in the community were

generally above average and focus groups indicated that BDHHS had made an above average effort

to inform the residents in times of disaster, for instance, the recent Hurricane Sandy.

LIMITATIONS: As is often the case with the collection of data, limitations must be considered in

understanding and drawing conclusions based on the data collected. First, the telephone survey

sample included more female, more white, and higher educated respondents than the general

population of these towns. Second, focus groups and key informant interviews are relevant for

Bloomfield only, and these, too, were limited in scope and number. Therefore, although the

assessment gathered data that previously were not accessible, conclusions must be considered

carefully, and likely reflect the responses of a healthier and more connected population than

actually exists. Nevertheless, the assessment was carried out in a statistically significant manner

and revealed valuable data that can be used to influence program planning. The confidence level

of the telephone survey sample number is generally regarded as adequate for generalization to the

larger population.

CONCLUSIONS: The demographic differences in the three townships that are serviced by BDHHS

will create challenges in program planning, for instance, Bloomfield requires more attention to

minority populations in order to reduce nationally recognized health care disparities. Caldwell

has a larger population approaching middle-age. Glen Ridge has the highest percentage of

population under 18 years of age making it an area for focus on youth-related health

interventions, for example, driving safety, sex, drug, and alcohol themes. BDHHS needs to move

forward with a constant eye towards these differences in the communities they serve.

As the nation recognizes the impact of education on health and well being, the positive news is

that all three communities appear to be above county, state, and national education levels in

percent of population that have received a high school diploma and that have received bachelors

degrees. These education levels may be viewed as positive factor for the population’s

comprehension of important information about wellness and disease prevention.

Access to primary health care services was reported at 94% or better by telephone survey

respondents. While the question posed to BDHHS respondents differs from data collection

questions used by Healthy People 2020 (10), the data topic is similar. Healthy People 2020

41

reported, in their baseline year of 2007, that 76.3 % of the U.S. population had a usual primary

care provider. The Healthy People 2020 target is 83.9%. At 94% access to primary healthcare

services in the BDHHS communities, it would appear that the population has greater access than

the general U.S. population. This should provide an opportunity for BDHHS from which to launch

new programs through collaboration with local primary care physicians and hospitals.

In a general analysis of most pressing health concerns and chronic disease diagnoses, the data

gathered appears to align with state and national concerns regarding nutrition, exercise, and

chronic disease. In the telephone survey there were 267 reports of chronic disease diagnoses in

604 households. Nearly 50% of the telephone survey respondents reported that they believe

nutrition, exercise, and chronic disease are the top health issues in the communities.

In contrast, self-rated health in the three communities appears to be better than state of New

Jersey data collected through the Behavioral Risk Factor Surveillance System (6). For the state of

New Jersey the percentage of respondents who reported fair or poor health using the 2009 BRFSS

question, “Would you say that in general your health is excellent, very good, good, fair, or poor?”

ranged from 13.5 – 15.2% for adults age 18 and over. For the similar question in the BDHHS

telephone survey, “How would you rate your personal health on a scale from 1 to 5, with 1 being

very unhealthy and 5 being very healthy?”, the aggregate of data from the three townships formed

a range of 0.8 – 1.0% of adults age 18 and over reporting unhealthy/very unhealthy. This may

indicate an attitude of better self-rated personal health in the BDHHS communities and also may

be reflective of the telephone survey sample.

In key respondent interviews (Bloomfield only), social concerns

were reported as the most significant health problems in the

community. Responses reflect concern by other community agency

stakeholders regarding homelessness, discrimination, alcohol and

drug abuse and other social concerns. While these qualitative data

may reflect bias (i.e. the key respondents may have a greater

awareness of the social concerns because the agencies they

represent are closer to the problem then the random public), this portion of the data provides

BDHHS with direction for establishing the social concerns as targets for collaborative efforts by

multiple agencies.

Beyond accomplishing assessment goals for PHAB and BDHHS requirements, the Partners for

Health Foundation should also benefit from the data collection as the PFH service footprint

includes all three townships that were involved in the CHA. Data gathered in response to

questions on nutrition and physical activity should allow the PFH organization to expand their

“In key informant interviews,

social concerns were

reported as the most

significant health problems

in the community.”

42

data base on attitudes and behaviors toward fruit and vegetable consumption, and walking and

biking in the communities surveyed by inclusion of the new data from Bloomfield, Caldwell, and

Glen Ridge .

In conclusion, supported by the quantitative and qualitative analysis of the mixed method data

collected in the Community Health Assessment, the BDHHS is in a good position to pursue the

PHAB accreditation. Empowered with the potential to collaborate with other local agencies to

achieve critical public health objectives, the department will be able to bring a fresh approach to

health education, health interventions, and prevention strategies that will improve the health

status of the communities they serve.

Recommendations for Next Steps

CAMPAIGNS PROMOTING ACCESS: All future campaigns promoting access to BDHHS services

should highlight the importance of including dental health and mental health for overall well being

and longevity. The other key word to be used in all service promotions should be “prevention”.

HEALTH SCREENINGS: Increase health education and promotion regarding all types of health

screenings with targeted information about when and where the screenings are available for free

in or near the community. Collaborate with local agencies and organizations that specialize in

information on targeted screenings. In the program planning and evaluation process, schedule an

online survey for the year 2014 to collect data on health screenings done within the last 2 and 5

years. Compare data to the CDC and Healthy People 2020 targets. Adapt health education and

screening promotions as necessary.

NUTRITION AND PHYSICAL ACTIVITY: Nutrition and physical activity are the national disease

prevention priority to address issues of epidemic proportions. BDHHS should continue and

reinforce health education promotions that encourage higher levels of fruit and vegetable

consumption and higher levels of walking and biking. Investigate with Partners for Health the

potential to bring their “Eat, Play, Live… Better” program to Bloomfield. Collaborate with all

possible local agencies and organizations to push a consistent message based on data and

collateral available from the USDA, the Center for Disease Prevention and Control, and Healthy

People 2020. Focus on school-based programs starting in the pre-school environment.

Consider that BDHHS should become the steering agency to ensure that all other local agencies are

engaged in the same intervention message with regard to nutrition and physical activity. Take a

careful look at all the data (thoughts/suggestions/barriers) discussed in Section III, A. Items 11

and 12 and bring that information into any meetings and collaborations on nutrition and physical

43

exercise. Consider active BDHHS involvement in providing information on the current national

legislation that impacts our food systems.

SOCIAL CONCERNS: BDHHS might give consideration to scheduling/facilitating (at first) monthly

then quarterly meetings with local agency representatives to brainstorm/develop/create

interventions in agreement on the top two most pressing community social concerns.

STAFFING: Prepare targeted job descriptions for full- or part-time staff positions that will support

the health program planning and evaluation in areas mentioned above. Investigate creative ways

of using students, interns, and other low-cost staffing options.

PHAB ACCREDITATION: With the completion of the Comprehensive Community Health

Assessment, the BDHHS is well-positioned to complete other requirements of the PHAB

accreditation process and submit the application for accreditation.

44

APPENDIX A – DATA COLLECTION INSTRUMENTS

Community Health Telephone Survey

Community Focus Group Protocol

Key Informant Interview Protocol

45

A. Instruments

1. Community Health Assessment - Telephone Survey

Township of Bloomfield

Community Health Assessment – Telephone Survey

Hello. My name is _______ and I am calling on behalf of the Township of Bloomfield Department of Health and Human

Services. We’re conducting an important survey to inform and improve public health services in your community. I am not

selling anything, and I will not ask for any contributions or donations.

Your household has been randomly chosen from all households in Bloomfield (or Glen Ridge, Caldwell) to participate in this

survey. All answers you give will be confidential. Your contact information (such as your phone number) will not be shared

with anyone. You can stop the interview at any time or decide not to answer any question. The interview should take about 8-

10 minutes. If you have any questions that I can’t answer, I will give you a telephone number for more information.

Do you agree to participate?

May I please speak to the youngest male aged 18 or older who is now at home?

IF NO MALE AVAILABLE: May I please speak to the youngest female aged 18 or older who is now at home?

S1. To start, let me confirm that you currently live in Bloomfield (Glen Ridge, Caldwell)?

DISASTER PREPAREDNESS

In light of the recent impact of Hurricane Sandy on our community, please tell us your thoughts about emergency

preparedness for such disasters by responding to the following questions.

1. During NON-emergency situations, which source do you primarily rely on for information/notifications?

Television

Radio

Internet

Police loud

speakers

Family/Friend

Local Cable

Channel

Township

Website

Code Red

Other

(specify)____

2. During emergency situations, which source do you primarily rely on for information/notifications?

Television

Radio

Internet

Police loud

speakers

Family/Friend

Local Cable

Channel

Township

Website

Code Red

Other

(specify)____

3. Do you currently have an emergency plan, which includes an emergency supply kit and family communication

plan?

Yes, I have a plan and kit.

I have a plan but no kit. I have a kit but no plan. I have neither.

46

4. Would you like to receive recommendations from the Health Department on how to improve your emergency

plan?

Yes

No

COMMUNITY HEALTH

5. Please select which of the following you think are the most pressing public health issues in your community?

Select up to 3. a. Infectious diseases (for example, flu, sexually transmitted diseases (STD’s), HIV/AIDS

b. Chronic diseases (for example, heart disease, cancer, diabetes, and asthma)

c. Environmental Living Conditions (for example, air and water quality, mold, lead)

d. Social Concerns (for example, homelessness, discrimination, alcohol and drug abuse)

e. Diet and Exercise (for example, lack of physical activity, poor nutrition, obesity)

f. Community Safety (for example, violent crime and motor vehicle accidents

g. Other (specify: ____________)

PERSONAL HEALTH

6. Are you and your family able to access the following services if needed?

a. Primary health care

Yes

No

I don’t use

this service

I don’t know if the

service is available

b. Childhood vaccinations

Yes

No

I don’t use

this service

I don’t know if the

service is available

c. Cancer prevention and treatment services

Yes

No

I don’t need

this service

I don’t know if the

service is available

d. Dental care

Yes

No

I don’t use

this service

I don’t know if the

service is available

e. Mental health care - including for depression, anxiety, drug and alcohol treatment, or other

Yes

No

I don’t use

this service

I don’t know if the

service is available

7. If you or your family are not able to access these services, please check all the reasons why you are not able to do

so.

Lack of time

Lack of energy

Lack of childcare

Lack of money

Lack of transportation

Not physically capable

8. How do you currently pay for your medical care? (select all that apply)

Private Health Insurance (e.g.,

Horizon BCBS, HMO, etc.)

Veteran’s Administration

Medicare/Medicaid

NJ FamilyCare

Pay cash (no insurance)

Charity care

Other (specify:______________)

9. How do you pay for your dental care? (select all that apply)

Private Dental Insurance (e.g.,

Delta Dental, etc.)

Veteran’s Administration

NJ FamilyCare

Pay cash (no insurance)

Charity care

Other (specify:______________)

10. Which screenings have you had in the past year? (select all that apply)

cholesterol

blood sugar for diabetes

blood pressure

dental

prostate or mammogram

pap smear

Other (specify:___________________________)

11. Have you or anyone in your household ever been diagnosed with one of the following illnesses?

Cancer

Diabetes

High blood pressure

Asthma

Heart Disease

Lung Disease

Other (Specify:___)

12. How would you rate your personal health?

Very Healthy Healthy

Somewhat

healthy

Unhealthy Very

unhealthy

Don’t know

13. Thinking about the past 30 days, about how many of those days did you walk?

By “walk”, we mean any outdoor walking, jogging, or running that lasts at least 10 minutes.

________ (Please enter a number between 0 and 30.)

14. What are the top 3 reasons that you do not walk more frequently?

Bad weather/wrong season

Too busy/no opportunity

No safe place to walk

Disability/other health impairment

Other transportation is faster

Other (specify: ______________________)

15. Thinking about the past 30 days, about how many of those days did you ride a bicycle? ________ (Please enter a

number between 0 and 30.)

16. What are the top 3 reasons that you do not ride a bicycle more frequently

Bad weather/wrong season

Too busy/no opportunity

No safe place to ride

No safe place to leave my bike

Disability/other health impairment

Don’t have access to a bike

Other transportation is faster

Other (specify: ____________________)

17. During the past month, other than your regular job, how often did you participate in any physical activities or

exercises? Such as walking, dancing, soccer, gardening, or running for exercise? Would you say…

Never About once or twice

a week

About 3 times

a week

More than 3 times

a week

18. How many servings of fruit and/or vegetables did you eat yesterday?

A serving equals one medium apple, a handful of broccoli, or a cup of greens.

______ servings yesterday

19. On average, how many sugar sweetened sodas or other sweetened drinks do you drink per day?

One serving equals one 12 ounce can, bottle, or glass. Include sweetened iced tea, sports drinks, fruit punch or other

fruit-flavored drinks. Do NOT include diet soda, seltzer, sugar free drinks, or 100% juice.

______ servings per day

DEMOGRAPHICS

Finally, please tell us a little bit about yourself. Remember, your responses are confidential.

This information is being requested so that we can know more about who is responding to this survey so that we can help

the Township of Bloomfield Department of Health and Human Services best direct the services they offer to your

community.

20. How many adults (age 18 or older) currently live in your home (at least most of the time)?

____ Adults (18 years or older)

21. How many how many children (under 18) currently live in your home (at least most of the time)?

____ Children (under 18 years old)

22. What do you consider to be your gender?

23. Into which of the following ranges does your age fall?

18-24

25-44

45-64

65 or older

24. What is your marital status?

Single

Married

Widowed

Separated/Divorced

Domestic Partnership

25. Which of the following is(are) the racial/ethnic group(s) you most identify with:

Hispanic/Latino

White/Caucasian

Black or African American

Asian

Native Hawaiian or Other Pacific Islander

Native American/Alaskan Native

Other (specify: ________________)

Male Female

26. What is your highest level of school completed?

Less than high school diploma

High school graduate(high school

diploma or equivalent – including

GED)

Associate degree or Trade School (for example, AA, AS, Trade

School )

Bachelor’s degree(for example: BA, AB, BS)

Graduate school & beyond (for example: MA, MD, JD, PhD)

27. What is your current employment status?

Employed Full-time

Employed Part-time

Unemployed and currently seeking a job

Unemployed and not currently seeking a job

Retired

28. Which of the following ranges would you say best reflects your total annual household income?

Less than $25,000

$25,000 to less than $50,000

$50,000 to less than $75,000

$75,000 to less than $100,000

$100,000 to less than $150,000

$150,000 or more

29. With regard to the Community Health Survey, do you have any general concerns or questions that you wish

to make known to us?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

30. In the future, would you be willing to participate in this survey via Internet?

Thank you for participating in this survey! Your feedback is greatly appreciated.

Yes No Don’t know

2

2. Community Health Assessment – Community Focus Group Protocol

Township of Bloomfield

Community Focus Group Protocol

Thank you all for taking the time to speak with us today.

My name is ____________________________ and this is __________________________. We are from the Bloomfield Health and Human

Services Department working in conjunction with the Center for Research and Evaluation on Education and Human

Services at Montclair State University. We are conducting a Community Health Assessment as one of the requirements to

receive national accreditation for our local health department. As one of the components of the overall health

assessment, we’re talking to groups of community members, such as yourselves, to gather information about how the

local health department might better serve the community.

This focus group should take less than an hour. If it’s OK with all of you, we would like to audio record the session because

we don’t want to miss any of your comments. Although we may take some notes during this session, we can’t possibly

write fast enough to get it all down. All responses will be kept confidential. We will make sure that any information we

include in our report(s) does not identify any of you individually as the respondent. We will use the recording to

summarize the common themes that come across from all focus groups and other data sources. The recording will not be

shared with anyone outside of the MSU and Bloomfield Health and Human Services Department research team.

Remember that you are a volunteer. We hope you will choose to participate in the focus group because your responses

may help the Bloomfield Health and Human Services Department to improve their programs and better serve you and

your community. But it’s OK if you want to stop at any time and not be in the focus group. You do not have to answer any

questions that you don’t want to answer.

Are there any questions about what I have just explained?

Are you willing to participate in this focus group? (If so, please sign consent form.)

A. Significant Health Issues and Barriers

First, let’s talk about health problems in our community.

1) Which category (or categories) do you think is the most significant health problem in our community and why?

2) Based on the identified health problems that we just discussed, what barriers do you feel are limiting these needed

services to residents? In other words, what keeps community members from using existing services that were

designed to address these health issues?

Now, let’s talk about Bloomfield as a healthy and safe community.

3) On a scale of 1-10, with 10 being the optimal healthy and safe community, how would you rate Bloomfield as a

healthy and safe community to live in? Please share your rating and explain why you gave that rating.

B. Nutrition and Physical Activity

Next, let’s talk about healthy eating and active living.

4) Do you think people in your community eat enough fruits and vegetables? How many fruits and vegetables do you

believe is enough?

a. What would make it easier for them (or you) to eat more fruits and vegetables?

5) Have you participated in any physical activity or exercise in the past month – such as walking, biking, dancing,

soccer, or running?

a. If so, tell me about it. Which activities? How often? For how long did you usually keep at it each time?

b. If not, why not? What keeps you from participating in physical activity or exercise? What would make it

easier to exercise more?

6) Do you ever walk or bike to do your shopping or errands?

a. If so, how often? Where?

b. If not, why not?

c. Do you find Bloomfield suitable for biking/walking? What improvements could be made to make

biking/walking in Bloomfield better?

C. Public Health Announcements and Disaster Preparedness

Now let’s talk about public health announcements and disaster preparedness.

7) During emergency and non-emergency situations, there are multiple sources from which you can receive

important health department notifications. What are your sources?

8) In your opinion, how well does the Township get information to its residents?

a. Has your experience before, during, or after Hurricane Sandy impacted your opinion in any way?

D. Quality of Life in the Community

Finally…

9) What do you believe are the top three factors in improving the overall quality of life in our community?

Community Health Issues

In a recent telephone survey, we asked respondents about a more specific list of possible community health problems.

These health problems fall into the more general categories of public health issues listed below:

Infectious Diseases – such as flu, sexually transmitted diseases (STD’s), HIV/AIDS

Chronic Diseases – such as heart disease, cancer, diabetes, and asthma

Environmental Living Conditions – such as air and water quality, mold, lead

Social Concerns – such as homelessness, discrimination, alcohol and drug abuse

Diet and Exercise – such as lack of physical activity, poor nutrition, obesity

Community Safety – such as violent crime and motor vehicle accidents

For the purpose of this Focus Group, and in the interest of adhering to our time frame, we will discuss these

categories (rather than the expanded list).

3. Community Health Assessment – Key Informant Interview Protocol

Township of Bloomfield

Key Informant Interview Protocol

Thank you for taking the time to speak with me today.

My name is ____________________________ and I am from the Bloomfield Health and Human Services Department. I am

working in conjunction with the Center for Research and Evaluation on Education and Human Services at Montclair State

University. We are conducting a Community Health Assessment as one of the requirements to receive national

accreditation for our local health department. As one of the components of the overall health assessment, we’re talking

to representatives from the various community service agencies, such as yourself, to gather information about how the

local health department might better serve the community.

This interview should take less than an hour. If it’s OK with you, I would like to audio record the session because I don’t

want to miss any of your comments. Although I may take some notes during this session, I can’t possibly write fast

enough to get it all down. All responses will be kept confidential. I will make sure that any information I include in my

report does not identify you individually as the respondent. I will use the recording to summarize the common themes

that come across from all interviews and other data sources. The recording will not be shared with anyone outside of the

MSU and Bloomfield Health and Human Services Department research team.

Remember that you are a volunteer. I hope you will choose to participate in the interview because your responses may

help the Bloomfield Health and Human Services Department to improve their programs and better serve you and your

community. But it’s OK if you want to stop at any time and not go further with the interview. You do not have to answer

any questions that you don’t want to answer.

Are there any questions about what I have just explained?

Are you willing to participate in this interview? (If so, please sign consent form.)

A. Significant Health Issues and Barriers

First, let’s talk about health problems in our community.

Hand out the attached printed list of general community health issues.

1) Which category (or categories) do you think is the most significant health problem in our community and

why?

2) Based on the identified health problems that we just discussed, what barriers do you feel are limiting these

needed services to residents? In other words, what keeps community members from using existing services

that were designed to address these health issues?

Now, let’s talk about Bloomfield as a healthy and safe community.

3) On a scale of 1-10, with 10 being the optimal healthy and safe community, how would you rate Bloomfield as

a healthy and safe community to live in? Please share your rating and explain why you gave that rating.

B. Nutrition and Physical Activity

Next, let’s talk about healthy eating and active living.

4) Do you think people in our community eat enough fruits and vegetables? How many fruits and vegetables do

you believe is enough?

a. In your opinion, what would make it easier for residents of our community to eat more fruits and vegetables?

5) What keeps community members from engaging in more physical activity or exercise? What would make it

easier to exercise more?

a. Do you find Bloomfield suitable for biking/walking?

b. What improvements could be made to make biking/walking in Bloomfield better?

C. Public Health Announcements and Disaster Preparedness

Now let’s talk about public health announcements and disaster preparedness.

6) During emergency and non-emergency situations, there are multiple sources from which you can receive

important health department notifications. What are your sources?

Television

Radio

Internet Police loud

speakers Family/Friend

Local Cable

Channel Township

Website Code Red Other

(specify)____

a. In your opinion, how well does the Township get information to its residents?

b. Has your experience before, during, or after Hurricane Sandy impacted your opinion in any way?

D. Quality of Life in the Community

Next, let’s talk about quality of life in the community.

7) What do you believe are the top three factors in improving overall quality of life in our community?

Be open to the informant’s answer. If “none”, then note “no initial comment” followed by a probe, for example;

improvements to the business district, free health screenings, a greater police presence in the township parks,

increased security in the school system, etc.

8) Are you aware of any current local, state, or national events that you believe will impact the health and safety

of our community, for example; The Patient Protection and Affordable Care Act (Obamacare), new gun laws,

climate change? What events do you believe will have the greatest impact on our local health department?

E. Collaboration Among Community Agencies

9) To what extent do you collaborate with other agencies and organizations in Bloomfield in an effort toward

improving community health outcomes? For example,

Schools?

Hospitals and other health agencies?

Local Government?

Law Enforcement?

Faith-based organizations?

Social Service Agencies?

Local Businesses?

Thank you for your participation!

Community Health Issues

In a recent telephone survey, we asked respondents about a more specific list of possible community

health problems.

These health problems fall into the more general categories of public health issues listed below:

Infectious Diseases – such as flu, sexually transmitted diseases (STD’s), HIV/AIDS

Chronic Diseases – such as heart disease and diabetes

Environmental Living Conditions – such as air and water quality, mold, lead

Social Concerns – such as homelessness, discrimination, alcohol and drug abuse

Diet and Exercise – such as lack of physical activity, poor nutrition, obesity

Community Safety – such as violent crime and motor vehicle accidents

For the purpose of this interview, and in the interest of adhering to our time frame, we will discuss

these categories (rather than the expanded list). However, please provide us with any topic that we

may have missed that you believe should be on the list.

Thank you for your participation!

APPENDIX B – DATA TABLES Community Health Telephone Survey Data Tables

S1. To start, let me confirm that you currently live in Bloomfield (Glen Ridge, Caldwell)?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Yes N=401

(100.0%)

N=100

(100.0%)

N=103

(100.0%)

PERSONAL HEALTH

1. Are you and your family able to access the following services?

a. Primary health care

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Yes N=377

(94.0%)

N=98

(98.0%)

N=99

(96.1%)

No N=22

(5.5%)

N=1

(1.0%)

N=3

(2.9%)

Don’t need this service N=0

(0.0%)

N=1

(1.0%)

N=1

(1.0%)

Don’t know_Refused N=2

(0.5%)

N=0

(0.0%)

N=0

(0.0%)

b. Childhood vaccinations

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Yes N=220

(54.9%)

N=53

(53.0%)

N=53

(51.5%)

No N=14

(3.5%)

N=2

(2.0%)

N=2

(1.9%)

Don’t need this service N=164

(40.9%)

N=45

(45.0%)

N=48

(46.6%)

Don’t know_Refused N=3

(0.7%)

N=0

(0.0%)

N=0

(0.0%)

c. Cancer prevention and treatment services

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Yes N=300

(74.8%)

N=82

(82.0%)

N=84

(81.6%)

No N=37

(9.2%)

N=4

(4.0%)

N=5

(4.9%)

Don’t need this service N=40

(10.0%)

N=11

(11.0%)

N=11

(10.7%)

Don’t know_Refused N=24

(6.0%)

N=3

(3.0%)

N=3

(2.9%)

d. Dental care

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Yes N=348

(86.8%)

N=94

(94.0%)

N=95

(92.2%)

No N=45

(11.2%)

N=6

(6.0%)

N=7

(6.8%)

Don’t need this service N=7

(1.7%)

N=0

(0.0%)

N=1

(1.0%)

Don’t know_Refused N=1

(0.2%)

N=0

(0.0%)

N=0

(0.0%)

e. Mental health care – including for depression, anxiety, drug and alcohol treatment, or other

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Yes N=301

(75.1%)

N=80

(80.0%)

N=83

(80.6%)

No N=35

(8.7%)

N=2

(2.0%)

N=6

(5.8%)

Don’t need this service N=47

(11.7%)

N=14

(14.0%)

N=14

(13.6%)

Don’t know_Refused N=18

(4.5%)

N=4

(4.0%)

N=0

(0.0%)

2. Which of the following are reasons why you cannot access any of these services?

Bloomfield

N=86

Caldwell

N=11

Glen Ridge

N=10

Lack of time N=6

(7.0%)

N=0

(0.0%)

N=0

(0.0%)

Lack of motivation N=3

(3.5%)

N=0

(0.0%)

N=0

(0.0%)

Lack of childcare N=3

(3.5%)

N=0

(0.0%)

N=0

(0.0%)

Lack of money N=29

(33.7%)

N=0

(0.0%)

N=6

(60.0%)

Lack of transportation N=4

(4.7%)

N=1

(9.1%)

N=0

(0.0%)

Not physically capable N=3

(3.5%)

N=0

(0.0%)

N=0

(0.0%)

Don’t know how to

access these services

N=21

(24.4%)

N=5

(45.5%)

N=3

(30.0%)

None of these N=15

(17.4%)

N=5

(45.5%)

N=1

(10.0%)

Don’t know_Refused N=2

(2.3%)

N=0

(0.0%)

N=0

(0.0%)

3. How do you currently pay for your medical care? (select all that apply)

Bloomfield

N=570

Caldwell

N=138

Glen Ridge

N=138

Private Health Insurance (for

example, Horizon, HMO, etc.)

N=316

(78.8%)

N=80

(80.0%)

N=88

(85.4%)

Veteran’s Administration N=22

(5.5%)

N=7

(7.0%)

N=2

(1.9%)

Medicare/Medicaid N=146

(36.4%)

N=40

(40.0%)

N=29

(28.2%)

NJ FamilyCare N=21

(5.2%)

N=1

(1.0%)

N=5

(4.9%)

Pay cash (no insurance) N=42

(10.5%)

N=9

(9.0%)

N=10

(9.7%)

Charity care N=13

(3.2%)

N=0

(0.0%)

N=3

(2.9%)

Employer pays N=4

(0.7%)

N=0

(0.0%)

N=0

(0.0%)

Other N=6

(1.1%)

N=1

(1.0%)

N=1

(1.0%)

Don’t know_Refused N=0

(0.0%)

N=0

(0.0%)

N=0

(0.0%)

4. How do you currently pay for your dental care? (select all that apply)

Bloomfield

N=405

Caldwell

N=104

Glen Ridge

N=105

Private Dental Insurance (for

example, Delta Dental)

N=248

(61.8%)

N=60

(60.0%)

N=70

(68.0%)

Veteran’s Administration N=9

(2.2%)

N=5

(5.0%)

N=0

(0.0%)

NJ FamilyCare N=8

(2.0%)

N=1

(1.0%)

N=4

(3.9%)

Pay cash (no insurance) N=125

(31.2%)

N=35

(35.0%)

N=30

(29.1%)

Charity care N=6

(1.5%)

N=1

(1.0%)

N=0

(0.0%)

Employer Pays N=4

(1.0%)

N=0

(0.0%)

N=0

(0.0%)

Other N=9

(2.2%)

N=2

(2.0%)

N=1

(1.0%)

Don’t know_Refused N=0

(0.0%)

N=0

(0.0%)

N=0

(0.0%)

5. How would you rate your personal health on a scale from 1 to 5, with 1 being very unhealthy and

5 being very healthy?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Mean personal health 4.11 4.26 2.17

5 (very healthy) N=150

(37.4%)

N=46

(46.0%)

N=41

(39.8%)

4 N=166

(41.4%)

N=36

(36.0%)

N=52

(50.5%)

3 N=62

(15.5%)

N=15

(15.0%)

N=8

(7.8%)

2 N=15

(3.5%)

N=1

(1.0%)

N=2

(1.9%)

1 (very unhealthy) N=5

(1.2%)

N=1

(1.0%)

N=0

(0.0%)

Missing N=4

(1.0%)

N=1

(1.0%)

N=0

(0.0%)

6. Which health screenings have you had in the past year? (select all that apply)

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Cholesterol N=302

(76.1%)

N=70

(71.4%)

N=75

(72.8%)

Blood sugar for diabetes N=301

(76.2%)

N=76

(76.0%)

N=68

(69.4%)

Blood pressure N=361

(90.5%)

N=92

(92.0%)

N=89

(88.1%)

Dental N=299

(75.1%)

N=88

(88.0%)

N=76

(75.2%)

Prostate N=78

(46.2%)

N=25

(54.3%)

N=15

(33.3%)

Mammogram N=117

(51.5%)

N=33

(61.1%)

N=35

(62.5%)

Pap smear N=127

(56.2%)

N=34

(63.0%)

N=36

(64.3%)

Other N=96

(24.5%)

N=20

(20.4%)

N=20

(20.0%)

7. Have you or anyone in your household ever been diagnosed with one of the following?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Cancer N=64

(16.1%)

N=21

(21.0%)

N=14

(13.7%)

Diabetes N=99

(24.8%)

N=18

(18.0%)

N=15

(14.9%)

High blood pressure N=203

(51.0%)

N=38

(38.0%)

N=41

(40.6%)

Asthma N=96

(24.1%)

N=16

(16.0%)

N=23

(22.8%)

Heart Disease N=67

(16.8%)

N=20

(20.0%)

N=11

(10.9%)

Lung Disease N=29

(7.3%)

N=5

(5.0%)

N=2

(2.0%)

Mental Health Concerns N=40

(10.0%)

N=6

(6.1%)

N=6

(5.9%)

Other N=25

(7.6%)

N=4

(4.0%)

N=3

(3.0%)

8. Thinking about the past 30 days, about how many of those days did you walk? By “walk”, we

mean any outdoor walking, jogging, or running that lasts at least 10 minutes.

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Mean days 14.51 15.83 17.74

< 10 Days N=162

(40.4%)

N=37

(37.0%)

N=31

(30.1%)

10 days or more N=235

(58.6%)

N=62

(62.0%)

N=67

(65.0%)

Missing N=4

(1.0%)

N=1

(1.0%)

N=5

(4.9%)

9. What are the top 2 reasons that you do not walk more frequently?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Bad weather/wrong season N=185

(30.6%)

N=44

(11.0%)

N=41

(41.0%)

Too busy/no opportunity N=143

(23.7%)

N=32

(8.0%)

N=36

(36.0%)

No safe place to walk N=13

(2.6%)

N=1

(0.2%)

N=3

(3.0%)

Disability/other health impairment N=71

(11.8%)

N=15

(3.7%)

N=11

(11.0%)

Other transportation is faster N=32

(5.3%)

N=3

(0.7%)

N=11

(11.0%)

Already walk/run or go to the

gym/Other exercise

N=14

(2.3%)

N=4

(1.0%)

N=3

(3.0%)

Don’t feel like it/ Lazy N=10

(1.7%)

N=5

(1.2%)

N=3

(3.0%)

Other N=14

(2.3%)

N=2

(0.5%)

N=3

(3.0%)

None of these N=45

(7.5%)

N=21

(5.2%)

N=22

(22.0%)

Don’t Know Refused N=3

(0.5%)

N=0

(0.0%)

N=1

(1.0%)

10. Thinking about the past 30 days, about how many of those days did you ride a bicycle?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Mean days .98 1.45 .60

0 Days (none) N=359

(89.5%)

N=87

(87.0%)

N=93

(90.3%)

1 or more days N=42

(10.5%)

N=13

(13.0%)

N=10

(9.7%)

Missing N=0

(0.0%)

N=0

(0.0%)

N=0

(0.0%)

11. What are the top 2 reasons that you do not ride a bicycle more frequently?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Bad weather/wrong season N=132

(32.9%)

N=29

(29.0%)

N=40

(38.8%)

Too busy/no opportunity N=60

(15.0%)

N=6

(6.0%)

N=15

(14.6%)

No safe place to ride N=20

(5.0%)

N=10

(10.0%)

N=1

(1.0%)

No safe place to leave my

bike

N=11

(2.7%)

N=0

(0.0%)

N=3

(2.9%)

Disability/other health

impairment

N=74

(18.5%)

N=13

(13.0%)

N=12

(11.7%)

Don’t have access to a bike N=154

(38.4%)

N=41

(41.0%)

N=36

(35.0%)

Other transportation is

faster

N=27

(6.7%)

N=2

(2.0%)

N=6

(5.8%)

Other/None of these N=47

(11.7%)

N=24

(24.0%)

N=16

(15.3%)

Don’t know_Refused N=2

(0.5%)

N=1

(1.0%)

N=1

(1.0%)

12. During the past month, other than your regular job, how often did you participate in any

physical activities or exercise (such as walking, dancing, soccer, gardening, or running for

exercise)? Would you say…

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Never N=94

(23.4%)

N=20

(20.0%)

N=19

(18.4%)

About once or twice a week N=123

(30.7%)

N=25

(25.0%)

N=35

(34.0%)

About 3 times a week N=57

(14.2%)

N=18

(18.0%)

N=18

(17.5%)

More than 3 times a week N=124

(30.9%)

N=37

(37.0%)

N=31

(30.1%)

Don’t know_Refused N=3

(0.7%)

N=0

(0.0%)

N=0

(0.0%)

13. How many servings of fruit and/or vegetables did you eat yesterday? A serving equals one

medium apple, a handful of broccoli, or a cup of greens.

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Mean number of servings 2.70 3.01 3.02

Less than 5 (including 0) N=343

(85.5%)

N=79

(79.0%)

N=80

(77.7%)

5 or more N=49

(12.2%)

N=19

(19.0%)

N=20

(19.4%)

Missing N=9

(2.2%)

N=2

(2.0%)

N=3

(2.9%)

14. On average, how many sugar sweetened sodas or other sweetened drinks do you drink per day?

One serving equals one 12 once can, bottle, or glass. Include sweetened iced tea, sports drinks, fruit

punch or other fruit-flavored drinks. Do NOT include diet soda, seltzer, sugar free drinks, or 100%

juice.

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Mean number of servings .48 .54 .31

None N=280

(69.8%)

N=73

(73.0%)

N=80

(77.7%)

One or two N=82

(20.4%)

N=17

(17.0%)

N=15

(14.6%)

3 or more N=16

(4.0%)

N=5

(5.0%)

N=1

(1.0%)

Missing N=23

(5.7%)

N=5

(5.0%)

N=7

(6.8%)

COMMUNITY HEALTH

15. Please select which of the following you think is the most pressing public health issue in your

community? Select 1.

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Infectious diseases

(STD’s, HIV/AIDS)

N=36

(9.0%)

N=11

(11.0%)

N=6

(5.8%)

Chronic diseases

(for example, heart disease, cancer, diabetes, and

asthma)

N=91

(22.7%)

N=27

(27.0%)

N=24

(23.3%)

Environmental Living Conditions (for example,

air and water quality, mold, lead)

N=34

(8.5%)

N=4

(4.0%)

N=6

(5.8%)

Mental Health Concerns (for example, anxiety,

depression)

N=12

(3.0%)

N=2

(2.0%)

N=3

(2.9%)

Social Concerns

(for example, homelessness, discrimination, alcohol

and drug abuse)

N=22

(5.5%)

N=3

(3.0%)

N=7

(6.8%)

Diet and Exercise

(for example, lack of physical activity, poor

nutrition, obesity)

N=94

(23.4%)

N=19

(19.0%)

N=34

(33.0%)

Community Safety

(for example, violent crime and motor vehicle

accidents)

N=35

(8.7%)

N=3

(3.0%)

N=8

(7.8%)

Health Care System/Health Insurance

(for example, Obama Care, lack of insurance,

payments and costs)

N=3

(0.7%)

N=1

(1.0%)

N=0

(0.0%)

Other N=1

(0.2%)

N=1

(1.0%)

N=1

(1.0%)

None of these N=24

(6.0%)

N=11

(11.0%)

N=7

(6.8%)

Don’t know_Refused N=48

(12.0%)

N=19

(19.0%)

N=7

(6.8%)

DEMOGRAPHICS

16. How many adults age 18 or older currently live in your home (at least most of the time)?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Mean number of adults 2.21 2.14 2.11

One N=74

(18.5%)

N=21

(21.0%)

N=17

(16.5%)

Two N=224

(55.9%)

N=55

(55.0%)

N=63

(61.2%)

3 or more N=102

(25.4%)

N=22

(22.0%)

N=23

(22.3%)

Missing N=1

(0.2%)

N=2

(2.0%)

N=0

(0.0%)

17. How many children under 18 currently live in your home (at least most of the time)?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Mean number of children under 18 0.65 0.42 0.76

None N=256

(63.8%)

N=73

(73.0%)

N=60

(58.3%)

One N=59

(14.7%)

N=10

(10.0%)

N=17

(16.5%)

Two or more N=85

(21.2%)

N=15

(15.0%)

N=25

(24.3%)

Missing N=1

(0.2%)

N=2

(2.0%)

N=1

(1.0%)

18. What do you consider to be your gender?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Male N=172

(42.9%)

N=46

(46.0%)

N=45

(43.7%)

Female N=229

(57.1%)

N=54

(54.0%)

N=58

(56.3%)

Missing N=0

(0.0%)

N=0

(0.0%)

N=0

(0.0%)

19. Into which of the following ranges does your age fall?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

18-24 N=11

(2.7%)

N=4

(4.0%)

N=2

(1.9%)

25-44 N=100

(24.9%)

N=15

(15.0%)

N=25

(24.3%)

45-64 N=170

(42.4%)

N=39

(39.0%)

N=45

(43.7%)

65 or older N=117

(29.2%)

N=39

(39.0%)

N=29

(28.2%)

Missing/Don’t know_Refused N=3

(0.7%)

N=3

(3.0%)

N=2

(1.9%)

20. Are you, yourself, of Hispanic or Latino origin, such as Mexican, Puerto Rican, Cuban, or some

other Spanish background?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Yes N=40

(10.0%)

N=4

(4.0%)

N=7

(6.8%)

No N=360

(89.8%)

N=92

(92.0%)

N=95

(92.0%)

Don’t Know N=0

(0.0%)

N=0

(0.0%)

N=0

(0.0%)

Refused N=1

(0.2%)

N=4

(4.0%)

N=1

(1.0%)

Missing N=0

(0.0%)

N=0

(0.0%)

N=0

(0.0%)

21. Which of the following racial/ethnic group(s) do you most identify with?

Bloomfield

N=402

Caldwell

N=100

Glen Ridge

N=103

Asian (or Pacific Islander) N=23

(5.7%)

N=3

(3.0%)

N=9

(8.7%)

Black (or African American) N=46

(11.5%)

N=1

(1.0%)

N=6

(5.8%)

Mixed Race N=15

(3.7%)

N=1

(1.0%)

N=0

(0.0%)

Native American (or American Indian) N=4

(1.0%)

N=2

(2.0%)

N=0

(0.0%)

White N=291

(72.6%)

N=86

(86.0%)

N=82

(79.6%)

Other N=9

(2.2%)

N=1

(1.0%)

N=1

(1.0%)

Don’t know N=3

(0.7%)

N=1

(1.0%)

N=2

(1.9%)

Refused N=10

(2.5%)

N=5

(5.0%)

N=3

(2.9%)

Missing N=0

(0.0%)

N=0

(0.0%)

N=0

(0.0%)

22. What is your highest level of school completed?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Less than high school diploma N=9

(2.2%)

N=2

(2.0%)

N=1

(1.0%)

High school graduate

(or equivalent -including GED)

N=92

(22.9%)

N=11

(11.0%)

N=17

(16.5%)

Associate degree or Trade School N=26

(6.5%)

N=9

(9.0%)

N=4

(3.9%)

Bachelor’s degree N=126

(31.4%)

N=40

(40.0%)

N=37

(35.9%)

Graduate school & beyond N=73

(18.2%)

N=26

(26.0%)

N=27

(26.2%)

Some college N=70

(17.5%)

N=9

(9.0%)

N=14

(13.6%)

Missing/ Don’t know_Refused N=5

(1.2%)

N=3

(3.0%)

N=3

(2.9%)

23. Which of the following ranges would you say best reflects your total annual household income?

Bloomfield

N=401

Caldwell

N=100

Glen Ridge

N=103

Less than $25,000 N=43

(10.7%)

N=4

(4.0%)

N=5

(4.9%)

$25,000 - $50,000 N=72

(18.0%)

N=12

(12.0%)

N=14

(13.6%)

$50,000 - $75,000 N=69

(17.2%)

N=19

(19.0%)

N=16

(15.5%)

$75,000 - $100,000 N=53

(13.2%)

N=12

(12.0%)

N=10

(9.7%)

$100,000 - $150,000 N=62

(15.5%)

N=12

(12.0%)

N=11

(10.7%)

$150,000 or more N=44

(11.0%)

N=22

(22.0%)

N=25

(24.3%)

Missing/Don’t know_Refused N=58

(14.5%)

N=19

(19.0%)

N=22

(21.4%)

References for BDHHS Community Health Assessment

(1) Public Health Accreditation Board website

http://www.phaboard.org/about-phab/public-health-accreditation-background/

Accessed January 15, 2013

(2) Public Health Accreditation Board

Telephone calls and emails for confirmation.

April 8, 2013

(3) Partners for Health Foundation website

http://www.partnersfdn.org/faq_about.html

Accessed January 15, 2013

(4) Census 2010

http://www.zip-codes.com/zip-code/

Accessed April 1, 2013 http://98.130.138.182/ZipCode/07003.php

Accessed June 24, 2013

(5) American Community Survey 2007-2011

http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_11_5YR_D

P02

Bloomfield, Caldwell, Glen Ridge, Essex County, New Jersey, U.S. Education Levels Data

Accessed April 1, 2013

(6) Center for Disease Control’s National Behavioral Risk Factor Surveillance Systems (BRFSS) 2009

www.cdc.gov/brfss/

Accessed May 15, 2013

(7) National Health and Nutrition Examination Survey (NHANES)

http://www.cdc.gov/nchs/nhanes.htm

(8) U.S. Department of Transportation’s National Survey of Bicyclists and Pedestrian Attitudes and

Behavior

http://www.nhtsa.gov/Driving+Safety/Research+&+Evaluation/National+Survey+of+Bicyclist+and+

Pedestrian+Attitudes+and+Behavior

(9) Morbidity and Mortality Weekly Report

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6135a2.htm

Accessed April 15, 2013

(10) Healthy People 2020. Proportion of persons with a usual primary care provider

http://www.healthypeople.gov/2020/topicsobjectives2020/nationaldata.aspx?topicId=1

Accessed May 25, 2013

(11) Harvard School of Public Health, Fruits and Vegetable Servings Per Day

http://www.hsph.harvard.edu/nutritionsource/vegetables-full-story/#bottom_line

Accessed May 25, 2013