Houston Hospitals, Institutes & Centers - MEMORIAL HERMANN THE WOODLANDS MEDICAL … · 2019. 6. 28. · affiliated with McGovern Medical School at UTHealth; one of the nation’s

2019 Community Health Needs Assessment

MEMORIAL HERMANN THE WOODLANDS MEDICAL CENTER

HEALTHINSURANCE

Board Approved June 27, 2019

MemorialHermannTheWoodlandsMedicalCenterCHNA20192

Table of Contents Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Introduction&Purpose...............................................................................................................................4SummaryofFindings...................................................................................................................................4PrioritizedAreas..........................................................................................................................................5

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 MemorialHermannTheWoodlandsMedicalCenter..................................................................................6

Vision.......................................................................................................................................................6MissionStatement...................................................................................................................................6MemorialHermannHealthSystem.........................................................................................................6MemorialHermannTheWoodlandsServiceArea...................................................................................7

Consultants..................................................................................................................................................8

Evaluation of Progress Since Prior CHNA .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 PriorityHealthNeedsandImpactfromPriorCHNA....................................................................................9

Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Overview....................................................................................................................................................11SecondaryDataSources&Analysis...........................................................................................................11

SecondaryDataScoring.........................................................................................................................11DisparitiesAnalysis................................................................................................................................12

PrimaryDataMethods&Analysis.............................................................................................................12CommunitySurvey.................................................................................................................................12KeyInformantInterviews.......................................................................................................................14

DataConsiderations...................................................................................................................................16Race/EthnicGroupings..........................................................................................................................17ZipCodesandZipCodeTabulationAreas..............................................................................................17

Prioritization..............................................................................................................................................17PrioritizationProcess.............................................................................................................................17

Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Population..................................................................................................................................................20

Age.........................................................................................................................................................21Race/Ethnicity........................................................................................................................................23Language...............................................................................................................................................24

SocialandEconomicDeterminantsofHealth............................................................................................25Income...................................................................................................................................................25Poverty...................................................................................................................................................27FoodInsecurity......................................................................................................................................29Unemployment......................................................................................................................................30Transportation.......................................................................................................................................33SocioNeedsIndex®.................................................................................................................................35

Data Synthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Priorit ized Signif icant Health Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 PrioritizationResults..................................................................................................................................42AccesstoHealthcare..................................................................................................................................42EmotionalWell-Being................................................................................................................................48


FoodasHealth...........................................................................................................................................52ExerciseIsMedicine...................................................................................................................................56

Non-Priorit ized Signif icant Health Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 OlderAdultsandAging..............................................................................................................................59Cancers......................................................................................................................................................60Education...................................................................................................................................................60Transportation...........................................................................................................................................61Children’sHealth.......................................................................................................................................62Economy....................................................................................................................................................63

Other Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 BarrierstoCare..........................................................................................................................................64Disparities..................................................................................................................................................64

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 AppendixA:EvaluationSincePriorCHNA.................................................................................................68AppendixB.SecondaryDataMethodology...............................................................................................96AppendixC.PrimaryDataMethodology.................................................................................................132AppendixD.PrioritizationTool................................................................................................................147AppendixE.CommunityResources.........................................................................................................150


Executive Summary

Introduction & Purpose MemorialHermannTheWoodlandsMedicalCenter(MHTheWoodlands)ispleasedtopresentits2019CommunityHealthNeedsAssessment(CHNA).ThisCHNAreportprovidesanoverviewoftheprocessandmethodsusedtoidentifyandprioritizesignificanthealthneedsacrossMemorialHermannHealthSystem’sregionalservicearea(includingMHTheWoodlands),asfederallyrequiredbytheAffordableCareAct.MemorialHermannHealthSystempartneredwithConduentHealthyCommunitiesInstitute(HCI)toconducttheCHNAfor13facilities:

• MemorialHermannKatyHospital• MemorialHermannMemorialCityMedicalCenter• MemorialHermannGreaterHeightsHospital• MemorialHermannNortheastHospital• MemorialHermannSoutheastHospital• MemorialHermannSugarLandHospital• MemorialHermannSouthwestHospital• MemorialHermannTheWoodlandsMedicalCenter• MemorialHermannRehabilitationHospital–Katy• MemorialHermann–TexasMedicalCenter• TIRRMemorialHermann• MemorialHermannSurgicalHospitalKingwood• MemorialHermannSurgicalHospitalFirstColony

ThepurposeofthisCHNAistoofferacomprehensiveunderstandingofthehealthneedsinMHTheWoodlands’serviceareaandguidethehospital’splanningeffortstoaddressthoseneeds.Specialattentionhasbeengiventotheneedsofvulnerablepopulations,unmethealthneedsorgapsinservices,andinputfromthecommunity.TostandardizeeffortsacrosstheMemorialHermannHealthSystemandincreasethepotentialforimpactingtophealthneedsinthegreaterHoustonregion,communityhealthneedswereassessedandprioritizedataregional/systemlevel.Findingsfromthisreportwillbeusedtoidentifyanddevelopeffortstoimprovethehealthandqualityoflifeofresidentsinthecommunity.

Summary of Findings TheCHNAfindingsinthisreportresultfromtheanalysisofanextensivesetofsecondarydata(over100indicatorsfromnationalandstatedatasources)andprimarydatacollectedfromcommunityleaders,non-healthprofessionals,andorganizationsservingthecommunityatlarge,vulnerablepopulations,and/orpopulationswithunmethealthneeds.Throughanexaminationoftheprimaryandsecondarydata,thefollowingtophealthneedswereidentified:


Priorit ized Areas InMarch2019,stakeholdersfromthe13hospitalfacilitiesintheMemorialHermannHealthSystemcompletedasurveytoprioritizethesignificanthealthissues,basedoncriteriaincludinghealthimpactandriskaswellasconsiderationofMemorialHermann’sstrategicfocus.Thefollowingfourtopicswereidentifiedasprioritiestoaddress:

MHTheWoodlandswilldevelopstrategiestoaddresstheseprioritiesinits2019ImplementationStrategy.

MemorialHermannHealthSystem’sSignificantHealthNeeds•AccesstoHealthServices•Cancers•Children’sHealth•Diabetes•Economy

•Education•FoodInsecurity•HeartDisease/Stroke•LackofHealthInsurance•Low-Income/Underserved

•MentalHealth•Obesity•OlderAdults/Aging•SubstanceAbuse•Transportation

MemorialHermannHealthSystem’sCHNAPriorities• AccesstoHealthcare• EmotionalWell-Being• FoodasHealth• ExerciseIsMedicine


Introduction

Memorial Hermann The Woodlands Medical Center Since1985,MemorialHermannTheWoodlandsMedicalCenterhasbeencontinuallyrecognizedfordeliveringahigherlevelofcare.ItisatraumacenterandisstillthefirstandonlyhospitalinMontgomeryCountytobegrantedMagnetstatusfornursingexcellencebytheAmericanNursesCredentialingCenter.MemorialHermannTheWoodlandsisa351-privatebed,full-service,comprehensive,acutecarefacilitythatbringstogethertheultimateinhealthcaretechnology,expertiseandhealingforfamiliesinsouthMontgomeryCounty,northHarrisCountyandsurroundingcommunities.

Vision MemorialHermannwillbethepreeminenthealthsystemintheU.S.byadvancingthehealthofthoseweservethroughtrustedpartnershipswithphysicians,employeesandotherstodeliverthebestpossiblehealthsolutionswhilerelentlesslypursuingqualityandvalue.

Mission Statement MemorialHermannisanot-for-profit,community-owned,healthcaresystemwithspiritualvalues,dedicatedtoprovidinghighqualityhealthservicesinordertoimprovethehealthofthepeopleinSoutheastTexas.

Memorial Hermann Health System Oneofthelargestnot-for-profithealthsystemsinthenation,MemorialHermannHealthSystemisanintegratedsystemwithanexceptionalaffiliatedmedicalstaffandmorethan26,000employees.GovernedbyaBoardofcommunitymembers,theSystemservicesSoutheastTexasandtheGreaterHoustoncommunitywithmorethan300caredeliverysitesincluding19hospitals;thecountry’sbusiestLevel1traumacenter;anacademicmedicalcenteraffiliatedwithMcGovernMedicalSchoolatUTHealth;oneofthenation’stoprehabilitationandresearchhospitals;andnumerousspecialtyprogramsandservices.MemorialHermannhasbeenatrustedhealthcareresourceformorethan110yearsandasGreaterHouston’sonlyfull-service,clinicallyintegratedhealthsystem,wecontinuetoidentifyandmeetourregion’shealthcareneeds.AmongourdiverseportfolioisLifeFlight,thelargestandbusiestairambulanceserviceintheUnitedStates;theMemorialHermannPhysicianNetwork,MHMD,oneofthelargest,mostadvanced,andclinicallyintegratedphysicianorganizationsinthecountry;and,theMemorialHermannAccountableCareOrganization,operatingacaredeliverymodelthatgeneratesbetteroutcomesatlowercoststoconsumers,whileprovidingresidentsoftheGreaterHoustonareabroadaccesstohealthinsurancethroughtheMemorialHermannHealthInsuranceCompany.Specialtiesspanburntreatment,cancer,children’shealth,diabetesandendocrinology,digestivehealth,ear,noseandthroat,heartandvascular,lymphedema,neurosurgery,neurology,stroke,nutrition,ophthalmology,orthopedics,physicalandoccupationaltherapy,rehabilitation,roboticsurgery,sleepstudies,transplant,weightloss,women’shealth,maternityandwoundcare.SupportingtheSysteminitsimpactonoverallpopulationhealthistheCommunityBenefitCorporation.Atamarketshareof26.1%inthe‘expanded’greaterHoustonareaof12counties,ourvisionisthatMemorialHermannwill


beapreeminentintegratedhealthsystemintheU.S.byadvancingthehealthofthoseweserve.

Memorial Hermann The Woodlands Service Area TheserviceareaforMHTheWoodlandsincludesHarrisandMontgomerycountiesinTexas.ThegeographicboundariesoftheserviceareaareshowninFigure1.ThezipcodeswithinMHTheWoodlands’primaryserviceareaarelistedinTable1andrepresentapproximately75%ofinpatientdischarges(21.7%inHarrisCountyand53.7%inMontgomeryCounty).

Figure1.MHTheWoodlandsServiceArea

Table1.ProportionofPatientPopulationServedbyZipCodeZIPCode County PercentofPatient

Population77386 Montgomery 7.4%77381 Montgomery 6.8%77373 Harris 5.5%77380 Montgomery 5.5%77388 Harris 5.0%77354 Montgomery 4.8%77389 Harris 3.9%77385 Montgomery 3.7%77382 Montgomery 3.6%77379 Harris 3.0%77301 Montgomery 2.9%


ZIPCode County PercentofPatientPopulation

77384 Montgomery 2.9%77375 Harris 2.8%77304 Montgomery 2.6%77356 Montgomery 2.6%77316 Montgomery 2.4%77302 Montgomery 2.3%77303 Montgomery 1.7%77378 Montgomery 1.7%77318 Montgomery 1.6%77073 Harris 1.5%77355 Montgomery 1.2%

Consultants MemorialHermannHealthSystemcommissionedConduentHealthyCommunitiesInstitute(HCI)toconductits2019CommunityHealthNeedsAssessment.HCIworkswithclientsacrossthenationtodrivecommunityhealthoutcomesbyassessingneeds,developingfocusedstrategies,identifyingappropriateinterventionprograms,establishingmonitoringsystems,andimplementingperformanceevaluationprocesses.TolearnmoreaboutConduentHealthyCommunitiesInstitute,pleasevisithttps://www.conduent.com/community-population-health.


Evaluation of Progress Since Prior CHNA TheCHNAprocessshouldbeviewedasathree-yearcycle.AnimportantpartofthatcycleisrevisitingtheprogressmadeonprioritytopicsfrompreviousCHNAs.Byreviewingtheactionstakentoaddresspriorityareasandevaluatingtheimpactoftheseactionsinthecommunity,anorganizationcanbetterfocusandtargetitseffortsduringthenextCHNAcycle.

Priority Health Needs and Impact from Prior CHNA MHTheWoodlands’lastCHNAwasconductedin2016.ThepriorityareasinFY16-18were:

• HealthyLiving:Encourageandfosterhealthylifestylesthrougheducation,awarenessandearlydetectiontopreventillness.

• HealthcareAccess:Improvecommunityknowledgeabouthealthcareaccesspointsandreduceperceivedbarrierstocare.

• BehavioralHealth:Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.

EachoftheabovehealthtopicscorrelateswellwiththeprioritiesidentifiedforthecurrentCHNA(detailedbelow);thusMHTheWoodlandswillbebuildinguponeffortsofpreviousyears.

Figure2.CHNAProcess

AnalyzeData&

CommunityInput

PrioritizeHealthNeeds

CHNAReport&

ImplementationStrategy

Implement

EvaluateActionsTaken 3Year

Cycle


Adetailedtabledescribingthestrategies/actionstepsandindicatorsofsuccessforeachoftheprecedingpriorityhealthtopicscanbefoundinAppendixA.MHTheWoodlands’precedingCHNAwasmadeavailabletothepublicviathewebsiteandcommunityfeedbackdirectedtoMemorialHermann’sCommunityBenefitDepartment:http://www.memorialhermann.org/locations/the-woodlands/community-health-needs-assessment-the-woodlands/.NocommentsorfeedbackwerereceivedontheprecedingCHNAatthetimethisreportwaswritten.


Methodology

Overview Twotypesofdatawereusedinthisassessment:primaryandsecondarydata.Primarydataaredatathathavebeencollectedforthepurposesofthiscommunityassessment.Primarydatawereobtainedthroughacommunitysurveyandkeyinformantinterviews.Secondarydataarehealthindicatordatathathavealreadybeencollectedbypublicsourcessuchasgovernmenthealthdepartments.Eachtypeofdatawasanalyzedusingauniquemethodology.FindingswereorganizedbyhealthtopicsandthensynthesizedforacomprehensiveoverviewofthehealthneedsinMHTheWoodlands’servicearea.

Secondary Data Sources & Analysis SecondarydatausedforthisassessmentwerecollectedandanalyzedfromHCI’scommunityindicatordatabase.Thisdatabase,maintainedbyresearchersandanalystsatHCI,includesover100communityindicatorsfromatleast15stateandnationaldatasources.HCIcarefullyevaluatessourcesbasedonthefollowingthreecriteria:thesourcehasavalidatedmethodologyfordatacollectionandanalysis;thesourcehasscheduled,regularpublicationoffindings;andthesourcehasdatavaluesforsmallgeographicareasorpopulations.

Secondary Data Scoring HCI’sDataScoringTool®wasusedtosystematicallysummarizemultiplecomparisonsinordertorankindicatorsbasedonhighestneed.Foreachindicator,thecommunityvaluewascomparedtoadistributionofTexasandUScounties,stateandnationalvalues,HealthyPeople2020,andsignificanttrendswerenoted.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariesbyindicatorandisdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.Thecomparisonscoresweresummarizedforeachindicator,andindicatorswerethengroupedintotopicareasforasystematicrankingofcommunityhealthneeds.PleaseseeAppendixBforfurtherdetailsonthequantitativedatascoringmethodologyaswellassecondarydatascoringresults.

Figure3.SummaryofTopicScoringAnalysis


Disparit ies Analysis Whenagivenindicatorhasdataavailableforsubgroupslikerace/ethnicity,ageorgender–andvaluesforthesesubgroupsincludeconfidenceintervals–significantdifferencesbetweenthesubgroups’valueandtheoverallvaluecanbedetermined.Asignificantdifferenceisdefinedastwovalueswithnon-overlappingconfidenceintervals.Onlysignificantdifferencesinwhichthevalueforasubgroupisworsethantheoverallvalueareidentified.Confidenceintervalsarenotavailableforallindicators.Inthesecases,therearenotenoughdatatodetermineiftwovaluesaresignificantlydifferentfromeachother.

Primary Data Methods & Analysis CommunityinputforMemorialHermannHealthSystemwascollectedtoexpandupontheinformationgatheredfromthesecondarydata.PrimarydatausedinthisassessmentconsistedofacommunitysurveyinEnglishandSpanishaswellaskeyinformantinterviews.SeeAppendixCforthesurveyandinterviewquestions.

Community Survey Inputfromcommunityresidentswascollectedthroughanonlinesurvey.Thissurveyconsistedof11questionsrelatedtotophealthneedsinthecommunity,individuals’perceptionoftheiroverallhealth,andweeklyexercisehabits.ThecommunitysurveywasdistributedonlinethroughSurveyMonkey®fromOctober23rdthroughNovember27thof2018.ThesurveywasmadeavailableinbothEnglishandSpanish.PapersurveyswerealsomadeavailableandanswerstothepapersurveywereenteredintotheSurveyMonkeytool.Atotalof285responseswerecollected.ResultsinthisreportarebasedontheserviceareaforMemorialHermannHealthSystem.Thiswasaconveniencesample,whichmeansresultsmaybevulnerabletoselectionbiasandmakethefindingslessgeneralizabletothepopulationasawhole.

Table2.CommunitySurveyOutreachCommunityEvent DescriptionStepHealthEvent–MoodyPark,77009

CommunityeventhostedbyMemorialHermannprovidingparkactivation,walkingtours,Zumbainstruction,and(throughapartnershipwithHoustonFoodBank)fooddistributiontolow-income,at-risk,andmostlyuninsuredresidents.

StepHealthEvent–CastilloPark,77009

CommunityeventhostedbyMemorialHermannprovidingparkactivation,walkingtours,Zumbainstruction,and(throughapartnershipwithHoustonFoodBank)fooddistributiontolow-income,at-risk,andmostlyuninsuredresidents.

MemorialHermannHealthCentersforSchools

10school-basedhealthclinicsin5schooldistricts(74schools)inHarrisandFortBendCounties,providingmedical,mentalhealth,anddentalcare,alongwithnutrition,navigation,andsummerbootcampprogramstouninsuredandunderinsuredchildrenthroughouttheGreaterHoustonarea.

WestOremYMCA,77085

Acommunity-centeredorganizationthatbringspeopletogethertobridgethegapsincommunityneeds(underservedresidents),nurturesresidents’potentialtolearn,grow,andthrive,andmobilizesthelocalcommunitytoeffectlasting,meaningfulchange.

SpringBranchCommunity

AFederallyQualifiedHealthCenter(FQHC)providingquality,affordablehealthcareservicestotheunderservedanduninsuredcommunitiesofSpring


Therace/ethnicitymake-upofsurveyrespondentsisshowninFigure4.ThelargestproportionofrespondentsidentifiedasHispanic/Latino(47.2%),22.4%asWhite,20.8%asBlack/AfricanAmerican,andtheremaining9.6%ofrespondentsasAsian/PacificIslander,OtherandNativeAmerican.

HealthCenter,77080

BranchandWestHouston.

WesleyCommunityCenter,77009

Amulti-purposesocialserviceagencyprovidingresidentsofHouston:short-termrent,utility,andfoodassistancetopreventhomelessnessandmaintainfamilyfinancialstability;acareerandpersonalfinancialservicecenter;andEarlyHeadStart,achilddevelopmentprogramservinginfantstotoddlerstopromoteschoolreadiness.

CompleteCommunities,Houston

PrograminitiatedbytheMayorofHoustoninfivecommunities-allhistoricallyunder-resourced,eachwithabaselevelofcommunityinvolvementandsupport,andwithdiversepopulations.Theprogramisdesignedtoenhanceaccesstoqualityaffordablehomes,jobs,well-maintainedparksandgreenspace,improvedstreetsandsidewalks,grocerystoresandotherretail,goodschoolsandtransitoptions.Communities:AcresHomes[77018,77088,77091],Gulfton[77056,77057,77081],NearNorthside[77009,77022,77026],SecondWard[77003,77011,77020],andThirdWard[77003,77004,77204].

HealthyLivingMatters

AHouston/HarrisCountyChildhoodObesityCollaborative-Acollaborativeofmulti-sectorleadersthatpromotepolicyaimedatsystem-levelandenvironmentalchangetoreducetheincidenceofchildhoodobesity.Prioritycommunitieswereselectedduetothelackofaccesstohealthyfoodoptionsandopportunitiestoengageinphysicalactivityaswellasfortheircommunityassetsandreadinessforchange.PriorityCommunities:CityofPasadena[77058,77059,77502,77503,77504,77505,77506,77507,77536,77571,77586],NearNorthside[77009,77022,77026],andFifthWard/KashmereGardens[77020,77026,and77028]

GreaterNorthsideHealthCollaborative

Non-profitcollaborativewhosegoalistoexpandactivelivingresourcesandincreaseaccesstoqualityhealthcareandhealthyfoodbypromotingresidentleadershipandcivicparticipation.


Figure4.SurveyRespondentsbyRace/Ethnicity

Surveyrespondentswereaskedtoselecttopissuesmostaffectingthecommunity’squalityoflife.AsshowninFigure5,themajorityofrespondentsidentifiedDiabetes,Obesity/Overweight,SubstanceAbuse,andMentalHealth&MentalDisordersastopissuesinthecommunity.

Figure5.TopIssuesAffectingQualityofLife(Survey)

Key Informant Interviews Communityinputwasalsocollectedthroughkeyinformantinterviews.

MemorialHermannHealthSystemjoinedwiththeEpiscopalHealthFoundation(EHF)intheirkeyinformantinterviewinitiativesupportingfourGreaterHoustonareahospitalsystemsinpreparingtheircommunityhealthneedsassessments.ThecollaboratinghospitalsofthisinitiativeincludeMemorialHermann,CHISt.Luke’sHealth,HoustonMethodist,andTexasChildren’s(Table3).Throughthispartnership,atotalof53interviewswereconductedwith

47.20%

22.40%

20.80%

4.80%3.60% 1.20%

Hispanic

White

AfricanAmerican

Asian/PacificIslander

Other

NativeAmerican

10%10%13%13%14%

17%23%26%26%

35%51%54%

64%69%

SexualHealthOralhealth

TeenagePregnancyReproductiveHealth

OtherRespiratory/LungDiseaseInjuries,Violence&Safety

ElderCareHeartDisease&Stroke

CancersMentalHealth&MentalDisorders

SubstanceAbuseObesity/Overweight

Diabetes


stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Communityleaderswithspecificexperienceworkingwithprioritypopulations,suchaswomen,children,peopleofcolor,thedisabled,andmore,werealsointerviewed.

Table3.MemorialHermannCollaborativePartners

Intotal,64keyinformantinterviewswereconductedbyphonefromAugustthroughNovember2018;53keyinformantinterviewswereconductedthroughthecollaborativeand11interviewswereconductedbyHCI.Intervieweeswhowereaskedtoparticipatewererecognizedashavingexpertiseinpublichealth,specialknowledgeofcommunityhealthneedsand/orrepresentedthebroadinterestofthecommunityservedbythehospital,and/orcouldspeaktotheneedsofmedicallyunderservedorvulnerablepopulations.Effortsweremadetoidentifyintervieweesworkinginand/orknowledgeableaboutthecountiesinMemorialHermannHealthSystem’sservicearea.AsseeninTable4,someintervieweeswereidentifiedwithknowledgeofmultiplecounties.

Table4.KeyInformantsbyCountyCounty KeyInformantsAustin IncludedinMultipleCountiesBrazoria 3Chambers 2

EpiscopalHealthFoundation’smissionistoadvancetheKingdomofGodwithspecificfocusonhumanhealthandwell-beingthroughgrants,research,andinitiativesinsupportoftheworkoftheDiocese,spanning57counties.Throughinformedaction,collaboration,empowerment,stewardship,transparency,andaccountabilitythefoundationstrivesforthetransformationofhumanlivesandorganizationswithcompassionforthepoorandpowerless.

CHISt.Luke’sHealth,apartofCatholicHealthInitiatives(CHI),oneofthenation’slargesthealthsystems,isdedicatedtoamissionofenhancingcommunityhealththroughhigh-quality,cost-effectivecare.Throughpartnershipswithphysiciansandcommunitypartners,CHISt.Luke’sHealthservesGreaterHoustonwithitscommitmenttoexcellenceandcompassionincaringforthewholepersonwhilecreatinghealthiercommunities.

HoustonMethodistisanonprofithealthcareorganizationservingGreaterHouston,dedicatedtoexcellenceinresearch,education,andpatientcare.HoustonMethodistbringscompassionandspiritualitytoallitsendeavorstohelpmeetthehealthneedsofthecommunitythroughthesystem’sICAREvalues:integrity,compassion,accountability,respect,andexcellence.

TexasChildren’sHospitalisanot-for-profitorganizationwhosemissionistocreateahealthierfutureforchildrenandwomenthroughoutGreaterHoustonandtheglobalcommunitybyleadinginpatientcare,education,andresearch.TexasChildren’siscommittedtocreatingahealthycommunityforchildrenbyprovidingthebestpediatriccarepossible,throughgroundbreakingresearchandemphasisoneducation,whilealsoofferingafullcontinuumoffamily-centeredcareforwomen,fromobstetricstowell-womancare.


County KeyInformantsFortBend 10Galveston 7Harris 28Liberty 1Montgomery 4SanJacinto IncludedinMultipleCountiesWalker IncludedinMultipleCountiesWaller 2Wharton 2MultipleCounties* 5Total 64

Interviewsweretranscribedandanalyzedusingthequalitativeanalytictool,Dedoose1.Interviewexcerptswerecodedbyrelevanttopicareasandkeyhealththemes.Threeapproacheswereusedtoassesstherelativeimportanceoftheneedsdiscussedintheseinterviews.Theseapproachesincluded:thefrequencybywhichahealthtopicwasdiscussedacrossallinterviews;thefrequencybywhichatopicwasdescribedbythekeyinformantasabarrier/challenge;andthefrequencybywhichatopicwasmentionedperinterviewee.

Data Considerations Severallimitationsofdatashouldbeconsideredwhenreviewingthefindingspresentedinthisreport.Althoughthetopicsbywhichdataareorganizedcoverawiderangeofhealthandhealth-relatedareas,dataavailabilityvariesbyhealthtopic.Sometopicscontainarobustsetofsecondarydataindicators,whileothersmayhavealimitednumberofindicatorsorlimitedsubpopulationscoveredbythosespecificindicators.Datascoresrepresenttherelativecommunityhealthneedaccordingtothesecondarydataforeachtopicandshouldnotbeconsideredtobeacomprehensiveresultontheirown.Inaddition,thesescoresreflectthesecondarydataresultsforthepopulationasawhole,anddonotrepresentthehealthorsocioeconomicneedthatismuchgreaterforsomesubpopulations.Moreover,manyofthesecondarydataindicatorsincludedinthefindingsarecollectedbysurvey,andthoughspecificmethodsareusedtobestrepresentthepopulationatlarge,thesemeasuresaresubjecttoinstability,especiallyforsmallerpopulations.TheIndexofDisparityisalsolimitedbydataavailability,whereindicatordatavariesbasedonthepopulationgroupsandserviceareasbeinganalyzed.

1DedooseVersion8.0.35,webapplicationformanaging,analyzing,andpresentingqualitativeandmixedmethodresearchdata(2018).LosAngeles,CA:SocioCulturalResearchConsultants,LLCwww.dedoose.com

*Five(5)oftheKeyInformantInterviewsrepresented2ormorecounties,including:Austin,Brazoria,Chambers,FortBend,Galveston,Harris,Liberty,Montgomery,SanJacinto,Walker,Waller,andWhartoncounties.


Race/Ethnic Groupings

Thesecondarydatapresentedinthisreportderivefrommultiplesources,whichmaypresentraceandethnicitydatausingdissimilarnomenclature.Forconsistencywithdatasourcesthroughoutthereport,subpopulationdatamayusedifferenttermstodescribethesameorsimilargroupsofcommunitymembers.

Zip Codes and Zip Code Tabulation Areas

ThisreportpresentsbothZIPCodeandZIPCodeTabulationArea(ZCTA)data.ZIPorZoneImprovementPlanCodeswerecreatedbytheU.S.PostalServicetoimprovemaildeliveryservice.Theyarebasedonpostalroutes,whichfactorindelivery-area,mailvolumeandgeographiclocation.Theyarenotdesignedtobeusedforstatisticalreportingandmaychangefrequently.SomeZIPCodesmayonlyincludeP.O.boxesorcoverlargeunpopulatedareas.ZCTAsorZIPCodeTabulationAreaswerecreatedbytheU.S.CensusBureauandaregeneralizedrepresentationsofZIPCodesthathavebeenassignedtocensusblocks.Therefore,ZCTAsarerepresentativeofgeographiclocationsofpopulatedareas.Inmostcases,theZCTAwillbethesameasitsZIPCode.ZCTAswillnotnecessarilyexistforZIPCodeareaswithonlybusinesses,singleormultipleaddresses,orforlargeunpopulatedareas.SinceZCTAsarebasedonthemostrecentCensusdata,theyaremorestablethanZIPCodesanddonotchangeasfrequently.DemographicsforthisreportaresourcedfromtheUnitedStatesCensusBureau,whichpresentsZCTAestimates.TablesandfiguresintheDemographicssectionofthisreportreferenceZIPCodesintitle(forpurposesoffamiliarity)butshowvaluesofZCTAs.DatafromothersourcesisrepresentativebyZIPCodesandarelabeledassuch.

Priorit ization Inordertofocuseffortsonasmallernumberofthemostsignificantcommunityissues,sixteenrepresentativesfromtheMemorialHermannHealthSystem(oneormorerepresentingeachfacility)participatedinanonlineprioritizationprocesstoprioritizethefifteensignificanthealthneedsidentifiedthroughthesecondaryandprimarydataanalyses.Theprioritizedhealthneedswillbeunderconsiderationforthedevelopmentofanimplementationplanthatwilladdresssomeofthecommunity’smostpressinghealthissues.

Priorit ization Process Toprioritizesignificanthealthneeds,MemorialHermannstakeholdersparticipatedinanonlinewebinaronMarch7,2019toreviewdatasynthesisresultsfollowedbycompletionofaprioritizationmatrixlistingsignificanthealthneedsandfourcriteriabywhichtorateeachneed.Participantsscoredeachneedforeachofthecriteriaonascalefrom1-5,with1meaningtherespondentstronglydisagreesto5meaningtherespondentstronglyagreesthatthehealthneedmeetsthecriterion.Respondentswerealsoabletoselect“Don’tKnow/Unsure”foreachhealthneed.Thecriteriaforprioritizationincludedtowhatextentanissue:

• Impactsmanypeopleinthecommunity• Significantlyimpactssubgroupsinthecommunity(gender,race/ethnicity,LGBTQ,etc.)


• Hasinadequateexistingresourcesinthecommunity• Hashighriskfordiseaseordeath

CompletionoftheprioritizationmatrixinAppendixDresultedinnumericalscoresforeachhealthneedthatcorrespondedtohowwelleachhealthneedmetthecriteriaforprioritization.Thescoreswererankedfromhighesttolowest(Table5).

Table5.ResultsfromMemorialHermannPrioritizationMatrixSignificantHealthNeed Impacton

CommunityImpactonSubgroups

InadequateResources

HighRisk AverageScore

Obesity(Exercise,NutritionandWeight)

4.69 4.00 3.19 4.50 4.09

MentalHealth 4.44 3.44 4.50 3.75 4.03Diabetes 4.50 4.00 3.25 4.19 3.98LackofHealthInsurance 4.31 4.19 3.38 4.00 3.97Low-Income/Underserved

4.19 4.19 3.44 4.00 3.95

HeartDisease/Stroke 4.44 3.82 2.81 4.44 3.88SubstanceAbuse 3.56 3.88 3.63 4.19 3.81AccesstoHealthServices

4.00 3.94 3.25 3.88 3.77

OlderAdultsandAging 4.38 3.81 3.13 3.75 3.76FoodInsecurity 3.88 4.00 3.44 3.50 3.70Cancers 4.19 3.19 3.00 4.31 3.67Education 3.88 3.81 3.00 3.13 3.45Transportation 4.00 3.88 2.81 3.00 3.42Children'sHealth 4.00 3.50 3.00 3.19 3.42Economy 3.31 3.31 2.69 2.88 3.05Inadditiontoratingeachneedinthematrix,prioritizationparticipantswereaskedtoratethelevelofimportanceofMemorialHermann’s4strategicpillars.

1. ImprovingAccesstoHealthcarethroughprogramming,education,andsocialservicesupport;

2. AddressingEmotionalWell-being(mentalandbehavioralhealth)throughinnovativeaccesspoints;

3. PromotingtheimportanceofahealthydietthroughscreeningandcreatingaccesstonutritiousFoodasHealth;and,

4. FosteringimprovedhealththroughExerciseIsMedicinewithculturallyappropriateactivities.

EachoftheseintersectingpillarsconnecttoeachotherthroughvariouspointsinMemorialHermannprogramsandinitiativesadvancingthehealthofourcommunities(Figure6).


Figure6.MemorialHermann’sFourPillarsforCommunityHealth

Over93%ofparticipantsrespondedthatthe4pillarswereimportantorveryimportant.TheMemorialHermannCommunityBenefitteamreviewedthesefindings,andtakingintoaccountthealignmentoftopneedswithMemorialHermann’sstrategicfocusareas,adecisionwasmadetointegrate:

• LackofHealthInsurance,Low-Income/Underserved,andAccesstoHealthServicesintoPillar1:AccesstoHealthcare

• MentalHealthandSubstanceAbuseintoPillar2:EmotionalWell-Being• Diabetes,FoodInsecurityandHeartDisease/StrokeintoPillar3:FoodasHealth• Obesity(Exercise,NutritionandWeight)intoPillar4:ExerciseIsMedicine

Throughthissystem-wideprioritizationprocess,thefollowingfourprioritiesforMemorialHermannHealthSystemare:

• AccesstoHealthcare(addressingAccesstoHealthServices,LackofHealthInsurance,andLow-Income/Underserved)

• EmotionalWellbeing(addressingMentalHealthandSubstanceAbuse)• FoodasHealth(addressingDiabetes,FoodInsecurity,andHeartDisease/Stroke)• ExerciseIsMedicine(addressingObesity)

ThesefourhealthtopicswillbeexploredfurtherinordertounderstandhowfindingsfromthesecondaryandprimarydataanalysesresultedineachissuebeingahighpriorityhealthneedforMemorialHermannHealthSystem.


DemographicsThefollowingsectionexploresthedemographicprofileofMHTheWoodlands’servicearea,includingHarrisandMontgomerycounties.Thedemographicsofacommunitysignificantlyimpactitshealthprofile.Differentrace/ethnic,age,andsocioeconomicgroupshaveuniqueneedsandrequiredifferentapproachestohealthimprovementefforts.AlldemographicestimatesaresourcedfromtheU.S.CensusBureau’s2013-2017AmericanCommunitySurveyunlessotherwiseindicated.Furthermore,tablesinthissectionlistindicatorvaluesforthetop75%ofzipcodeswithinMHTheWoodlands’serviceareaindescendingorderofinpatientdischargesunlessotherwisenoted.

Population AccordingtotheU.S.CensusBureau’s2013-2017AmericanCommunitySurvey,thetwocountiesinMHTheWoodlands’serviceareahadpopulationsof4,652,980(HarrisCounty)and570,934(MontgomeryCounty).Figure7illustratesthepopulationsizebycountyandTable6byzipcode.ThemostpopulouszipcodesinMHTheWoodlands’serviceareaare77379(HarrisCounty),77373(HarrisCounty),and77386(MontgomeryCounty).

Figure7.PopulationbyCounty


Table6.PopulationbyZipCode

ZIPCode County TotalPopulationEstimate

77386 Montgomery 53,04277381 Montgomery 36,91977373 Harris 58,25577380 Montgomery 26,69177388 Harris 45,84177354 Montgomery 35,90477389 Harris 31,88377385 Montgomery 23,57877382 Montgomery 40,54677379 Harris 78,22677301 Montgomery 31,80177384 Montgomery 16,47277375 Harris 50,52577304 Montgomery 28,69277356 Montgomery 25,88877316 Montgomery 21,27277302 Montgomery 19,31177303 Montgomery 19,69577378 Montgomery 16,15077318 Montgomery 15,43777073 Harris 42,78077355 Montgomery 27,271

AmericanCommunitySurvey,2013-2017

Age Figure8showsMHTheWoodlands’serviceareapopulationthatisunder18yearsold.26.9%ofHarrisCounty’spopulationand26.5%ofMontgomeryCounty’spopulationisunder18.BothHarrisandMontgomerycountieshavehigherproportionsofresidentsunder18comparedtothestateandnationalvalues.


Figure8.PopulationUnder18

AsshowninFigure9,HarrisCountyhasasmallerproportionofolderadults(10.2%)comparedtoTexasandtheU.S.(12.3%and15.6%,respectively).InMontgomeryCounty,12.9%ofresidentsareover65.

Figure9.PopulationOver65

Figure10showsthatHarrisCountyhasalargerproportionofresidentsunder5yearsold(7.7%)comparedtobothTexasandtheU.S.(7.2%and6.1%,respectively).Approximately7%ofMontgomeryCounty’spopulationisunder5.

26.9% 26.5%26.0%

22.6%

20%21%22%23%24%25%26%27%28%

Harris Montgomery Texas U.S.

10.2%

12.9% 12.3%

15.6%

0%2%4%6%8%

10%12%14%16%18%



Figure10.PopulationUnder5

Race/Ethnicity Theraceandethnicitycompositionofapopulationisimportantinplanningforfuturecommunityneeds,particularlyforschools,businesses,communitycenters,healthcareandchildcare.Raceandethnicitydataarealsousefulforidentifyingandunderstandingdisparitiesinhousing,employment,income,andpoverty.AlargernumberofresidentsinMontgomeryCountyidentifyasWhite,non-HispanicwhileinHarrisCountytherearealargernumberofresidentswhoidentifyasHispanicorLatino.Figure11showstheracialcompositionofresidentsinHarrisCountywith42.2%ofresidentsidentifyingasHispanicorLatino(ofanyrace);30.6%asWhite;18.5%asBlackorAfricanAmerican;6.8%asAsian;and1.9%asAmericanIndianandAlaskaNative,NativeHawaiianandOtherPacificIslander,“Someotherrace”,and/or“Twoormoreraces”.

Figure11.Race/EthnicityinHarrisCounty

Figure12showstheracialcompositionofresidentsinMontgomeryCountywith67.9%ofresidentsidentifyingasWhite,non-Hispanic;23.0%asHispanicorLatino(ofanyrace);4.5%asBlackorAfricanAmerican;2.8%asAsian;and1.8%asAmericanIndianandAlaskaNative,NativeHawaiianandOtherPacificIslander,“Someotherrace”,and/or“Twoormoreraces”.

7.7%6.9% 7.2%

6.1%

0%1%2%3%4%5%6%7%8%9%


30.6%

18.5%

6.8%

42.2%

1.9% White,non-Hispanic

BlackorAfricanAmerican

Asian

HispanicorLatino(ofanyrace)

Other


Figure12.Race/EthnicityinMontgomeryCounty

Language Languageisanimportantfactortoconsiderforoutreacheffortsinordertoensurethatcommunitymembersareawareofavailableprogramsandservices.

Figure13.LanguageOtherthanEnglishSpokenatHome

Figure13showstheproportionofresidentsinHarrisandMontgomerycountieswhospeakalanguageotherthanEnglishathome.MontgomeryCountyhas21%ofresidentswhospeakalanguageotherthanEnglishathome(similartothestatevalue).HarrisCounty’sproportionismorethantwiceMontgomeryCounty’svalue,with44%ofresidentsspeakingalanguageotherthanEnglishathome.Thisisanimportantconsiderationfortheeffectivenessofservicesandoutreachefforts,whichmaybemoreeffectiveifconductedinlanguagesotherthanEnglishalone.

67.9%4.5%

2.8%

23.0%

1.8%White,non-Hispanic

BlackorAfricanAmerican

Asian

HispanicorLatino(ofanyrace)

Other

43.7%

21.0%

35.3%

21.3%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%



Table7.PopulationwithDifficultySpeakingEnglishbyZipCode

ZIPCode County DifficultySpeakingEnglish

77386 Montgomery 4.7%77381 Montgomery 3.3%77373 Harris 8.1%77380 Montgomery 7.4%77388 Harris 9.0%77354 Montgomery 7.1%77389 Harris 9.0%77385 Montgomery 9.4%77382 Montgomery 6.2%77379 Harris 8.8%77301 Montgomery 25.6%77384 Montgomery 3.1%77375 Harris 12.5%77304 Montgomery 5.1%77356 Montgomery 1.1%77316 Montgomery 4.4%77302 Montgomery 8.5%77303 Montgomery 9.8%77378 Montgomery 15.2%77318 Montgomery 5.1%77073 Harris 20.8%77355 Montgomery 5.1%Harris -- 20.4%Montgomery -- 7.8%Texas -- 14.1%


AsshowninTable7,HarrisCountyhasalargerproportionofresidentswithdifficultyspeakingEnglish(20.4%)comparedtoMontgomeryCounty(7.8%)andthestateofTexas(14.1%).AlthoughMontgomeryCountyhasarelativelylowervalueoverall,over25%ofresidentsinzipcode77301havedifficultyspeakingEnglish.

Social and Economic Determinants of Health Thissectionexplorestheeconomic,environmental,andsocialdeterminantsofhealthinMHTheWoodland’servicearea.Socialdeterminantsaretheconditionsinwhichpeopleareborn,grow,work,live,andage,andthewidersetofforcesandsystemsshapingtheconditionsofdailylife.

Income Medianhouseholdincomereflectstherelativeaffluenceandprosperityofanarea.Areaswithhighermedianhouseholdincomesarelikelytohaveagreatershareofeducatedresidentsandlowerunemploymentrates.


Figure14comparesthemedianhouseholdincomevaluesforthetwocountiesinMHTheWoodlands’serviceareatothemedianhouseholdincomevalueforTexasandtheU.S.Montgomery’smedianhouseholdincomeof$74,323isgreaterthanthatofHarrisCounty($57,791).HarrisCounty’smedianhouseholdincomeissimilartothestateandnationalvalues.

Figure14.MedianHouseholdIncome

AsshowninTable8,MHTheWoodlands’topzipcodesforinpatientdischargesrevealarelativelyhighrangeinmedianhouseholdincome.At$99,076and$103,439respectively,zipcodes77386and77381havemedianhouseholdincomesnoticeablyhigherthanthestateofTexas($57,051).

Table8.MedianHouseholdIncomebyZipCode

ZIPCode County MedianHouseholdIncome77386 Montgomery $99,07677381 Montgomery $103,43977373 Harris $67,92477380 Montgomery $68,83977388 Harris $87,57477354 Montgomery $79,44077389 Harris $115,72577385 Montgomery $88,22077382 Montgomery $139,90277379 Harris $99,69377301 Montgomery $40,79577384 Montgomery $85,37177375 Harris $69,44677304 Montgomery $60,56877356 Montgomery $77,44477316 Montgomery $86,71977302 Montgomery $63,32877303 Montgomery $52,283

$57,791

$74,323

$57,051 $57,652

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000



ZIPCode County MedianHouseholdIncome77378 Montgomery $55,11477318 Montgomery $61,72277073 Harris $54,07977355 Montgomery $83,713Harris -- $57,791Montgomery -- $74,323Texas -- $57,051


Poverty FederalpovertythresholdsareseteveryyearbytheCensusBureauandvarybysizeoffamilyandagesoffamilymembers.Ahighpovertyrateisbothacauseandaconsequenceofpooreconomicconditions.Figure15showstheproportionofresidentslivingbelowthepovertylevelinHarrisandMontgomerycountiescomparedtoTexasandtheU.S.ThepercentageofresidentslivingbelowthepovertylevelinHarrisCounty(16.8%)ishigherthanthenationalvalue(14.6%)andslightlyhigherthanthestatevalue(16.0%).Approximately10%ofresidentsinMontgomeryCountylivebelowthepovertyvalue,whichislowerthanboththestateandnationalvalues.

Figure15.PeopleLivingBelowPovertyLevel

Figure16showstheproportionofresidentslivingbelowthepovertylevelbyrace/ethnicity.InHarrisCounty,22.6%ofHispanicorLatinoresidentsand21.8%ofBlackorAfricanAmericanresidentslivebelowthepovertylevel,comparedto7.0%Whiteand11.4%Asianresidents.ThepercentageofBlackandAsianresidentslivingbelowthepovertylevelinHarrisCounty(21.8%and11.4%,respectively)ishigherthanthestatevaluesforBlackandAsianresidents.Forallrace/ethnicitygroupsinMontgomeryCounty,thepercentageofresidentslivingbelowthepovertylevelislowerthanthevaluesforTexasandtheU.S.

16.8%

10.3%

16.0%14.6%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%



Figure16.PeopleLivingBelowPovertyLevelbyRace/Ethnicity

Figure17.PeopleLivingBelowPovertyLevelbyZipCode

PovertyratesarehigherinHarrisCounty(16.8%)comparedtoMontgomeryCounty(10.3%).AsshowninFigure17Error!Referencesourcenotfound.andTable9,withinMHTheWoodlands’

7.0%

21.8%

11.4%

22.6%

6.7%

13.1%

5.6%

21.5%

8.8%

21.4%

10.6%

23.0%

10.3%

25.2%

11.9%

22.2%

0%

5%

10%

15%

20%

25%

30%

White,non-Hispanic BlackorAfricanAmerican Asian HispanicorLatino



servicearea,18.8%ofresidentsinzipcode77301and20.1%ofresidentsinzipcode77378arelivingbelowthepovertylevel,bothhigherthanthevalueforTexas(16%).

Table9.PeopleLivingBelowPovertyLevelbyZipCode

ZIPCode County PeopleLivingBelowPovertyLevel

77386 Montgomery 3.6%77381 Montgomery 4.1%77373 Harris 12.2%77380 Montgomery 11.4%77388 Harris 5.3%77354 Montgomery 12.7%77389 Harris 4.9%77385 Montgomery 8.0%77382 Montgomery 2.4%77379 Harris 4.0%77301 Montgomery 18.8%77384 Montgomery 4.2%77375 Harris 10.1%77304 Montgomery 10.5%77356 Montgomery 7.3%77316 Montgomery 7.8%77302 Montgomery 14.7%77303 Montgomery 12.0%77378 Montgomery 20.1%77318 Montgomery 6.9%77073 Harris 14.9%77355 Montgomery 7.6%Harris -- 16.8%Montgomery -- 10.3%Texas -- 16.0%


Food Insecurity TheSupplementalNutritionAssistanceProgram(SNAP)isafederalassistanceprogramthatprovideslow-incomefamilieswithelectronicbenefittransfers(EBTs)thatcanbeusedtopurchasefood.Thegoaloftheprogramistoincreasefoodsecurityandreducehungerbyincreasingaccesstonutritiousfood.Table10showsthepercentofhouseholdswithchildrenthatparticipateinSNAPinthezipcodeswithinMHTheWoodlands’servicearea.HarrisCountyhasahigherproportionofhouseholdswithchildrenreceivingSNAPcomparedtoTexas,whileMontgomeryCountyhasalowerproportioncomparedtothestatevalue.Inparticular,zipcodes77386and77373standout,astheyrepresentMHTheWoodlands’topzipcodesforinpatientdischargesandalsohavemorethan75%ofhouseholdswithchildrenreceivingSNAP.MHTheWoodlands’topzipcodes


forinpatientdischargesrevealabroadrangeofeconomiccircumstancesintheservicearea.Zipcode77381has20.5%ofhouseholdswithchildrenreceivingSNAP,whereastheproportioninzipcode77386isfourtimeshigher(81.8%).

Table10.HouseholdswithChildrenReceivingSNAPbyZipCode

ZIPCode County HouseholdswithChildrenReceivingSNAP

77386 Montgomery 81.8%77381 Montgomery 20.5%77373 Harris 75.3%77380 Montgomery 60.0%77388 Harris 68.3%77354 Montgomery 67.8%77389 Harris 77.6%77385 Montgomery 52.8%77382 Montgomery 0.0%77379 Harris 68.2%77301 Montgomery 55.7%77384 Montgomery --77375 Harris 67.4%77304 Montgomery 39.6%77356 Montgomery 30.2%77316 Montgomery 69.8%77302 Montgomery 89.4%77303 Montgomery 58.9%77378 Montgomery 65.8%77318 Montgomery 60.5%77073 Harris 86.0%77355 Montgomery 86.1%Harris -- 67.7%Montgomery -- 61.7%Texas -- 64.3%


Unemployment Theunemploymentrateisakeyindicatorofthelocaleconomy.Unemploymentoccurswhenlocalbusinessesarenotabletosupplyenoughappropriatejobsforlocalemployeesand/orwhenthelaborforceisnotabletosupplyappropriateskillstoemployers.Ahighrateofunemploymenthaspersonalandsocietaleffects.Duringperiodsofunemployment,individualsarelikelytofeelsevereeconomicstrainandmentalstress.Unemploymentisalsorelatedtoaccesstohealthcare,asmanyindividualsreceivehealthinsurancethroughtheiremployer.Ahighunemploymentrateplacesstrainonfinancialsupportsystems,asunemployedpersonsqualifyforunemploymentbenefitsandfoodstampprograms.


Figure18displaystherateofunemploymentinHarrisandMontgomerycountiesbetweenMay2017andNovember2018.Inbothcounties,theunemploymentratehasexhibitedadecrease.InNovember2018,theMontgomeryCountyrate(3.4%)wasalmostequivalenttothestateandnationalrate.However,theunemploymentrateinHarrisCounty(3.8%)remainshigherthanTexasandtheU.S.

Figure18.UnemploymentRateperCounty(U.S.BureauofLaborStatistics,2017-2018)

EducationGraduatingfromhighschoolisanimportantpersonalachievementandisessentialforanindividual’ssocialandeconomicadvancement.Graduationratescanalsobeanimportantindicatoroftheperformanceofaneducationalsystem.Havingabachelor’sdegreeopensupcareeropportunitiesinavarietyoffieldsandisoftenaprerequisiteforhigher-payingjobs.Figure19displaystheproportionofresidentsinHarrisandMontgomerycountieswhoare25yearsandolderwithatleastahighschooldegree.Nearly90%ofresidents25yearsandolderinMontgomeryCountyhaveatleastahighschooldegreecomparedto80.5%inHarrisCounty.MontgomeryCounty’svalueishigherthantheU.S.(87.3%)andTexas(82.8%)whileHarrisCounty’svalue(80.5%)islower.

5.1%

4.3% 4.3%3.8%

4.6%

3.7% 3.6% 3.4%

4.4%

3.7% 3.7%3.5%

4.1% 3.9%3.6% 3.5%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

May2017 November2017 May2018 November2018

Harris Montgomery Texas UnitedStates


Figure19.People25+withaHighSchoolDegreeorHigher

Figure20showstheproportionofresidentsinHarrisandMontgomerycountieswhoare25yearsandolderwithabachelor’sdegreeorhigher.Withover30%ofresidents25andolderhavingabachelor’sdegreeinHarrisandMontgomerycounties,bothhaveaneconomicadvantagecomparedtosomeothercountiesinthestate.Theproportionofresidents25andolderwithabachelor’sdegreeinMontgomeryCounty(33.7%)ishigherthanthestatevalue(28.7%)andtheU.S.(30.9%).

Figure20.People25+withaBachelor'sDegreeorHigher

Table10displaystheeducationalattainmentindicatorsforresidents25yearsandolderbyzipcodeinMHTheWoodlands’servicearea.Forhighschooldegreeattainment,thezipcodewiththehighestrateis77381(98%)andthezipcodewiththelowestrateis77301(63.2%).Forattainmentofabachelor’sdegree,thezipcodewiththehighestrateis77382(64.9%)andthezipcodewiththelowestrateis77303(12.3%).ThezipcodeswithhighestproportionsofMHTheWoodlands’inpatientdischarges,zipcodes77386and77381,havemorethan90%ofpeople25yearsandolderwithahighschooldegree.Furthermore,inbothzipcodes,over40%residents25yearsandolderhaveabachelor’sdegreeorhigher,comparedtothestatevalueof28.7%.

80.5%

87.6%

82.8%

87.3%

76%

78%

80%

82%

84%

86%

88%

90%


30.5%

33.7%

28.7%

30.9%

26%

27%

28%

29%

30%

31%

32%

33%

34%

35%



Table11.People25+withaHighSchoolDegreeandPeople25+withaBachelor'sDegreebyZipCode

ZIPCode County HighSchoolDegreeorHigher

Bachelor’sDegreeorHigher

77386 Montgomery 94.8% 42.3%77381 Montgomery 98.0% 61.9%77373 Harris 91.6% 23.5%77380 Montgomery 93.6% 47.9%77388 Harris 91.2% 35.7%77354 Montgomery 89.1% 31.2%77389 Harris 95.1% 54.2%77385 Montgomery 89.7% 33.9%77382 Montgomery 97.1% 64.9%77379 Harris 94.7% 47.8%77301 Montgomery 63.2% 12.7%77384 Montgomery 94.6% 47.1%77375 Harris 89.7% 30.8%77304 Montgomery 90.2% 35.0%77356 Montgomery 96.6% 39.2%77316 Montgomery 90.4% 31.7%77302 Montgomery 84.1% 19.2%77303 Montgomery 76.0% 12.3%77378 Montgomery 78.1% 14.2%77318 Montgomery 92.3% 26.1%77073 Harris 82.7% 16.4%77355 Montgomery 88.4% 28.5%Harris -- 80.5% 30.5%Montgomery -- 87.6% 33.7%Texas -- 82.8% 28.7%


Transportation Therearenumerouswaysinwhichtransportationmayinfluencecommunityhealth.Publictransportationoffersmobility,particularlytopeoplewithoutcars.Transitcanhelpbridgethespatialdividebetweenpeopleandjobs,services,andtrainingopportunities.Publictransportationalsoreducesfuelconsumption,minimizesairpollution,andrelievestrafficcongestion.Walkingtoworkhelpsprotecttheenvironment,whilealsoprovidingthebenefitofdailyexercise.


Figure21.HouseholdsWithoutaVehiclebyZipCode

Figure21showsthepercentageofhouseholdswithoutavehicle.Asshown,zipcodes77301and77302havethehighestpercentagesofhouseholdsthatdonothaveavehicle.

Table12.ModesofCommutingbyZipCode

ZIPCode County CommutebyWalking

CommutebyBiking

CommutebyDrivingAlone

CommutebyPublicTransportation

77386 Montgomery 1.2% 0.0% 82.0% 1.3%77381 Montgomery 1.5% 0.2% 81.1% 2.7%77373 Harris 1.0% 0.3% 80.7% 1.3%77380 Montgomery 1.6% 0.9% 81.3% 2.0%77388 Harris 0.9% 0.1% 83.8% 1.6%77354 Montgomery 1.2% 0.0% 80.2% 0.3%77389 Harris 0.9% 0.0% 85.4% 0.9%77385 Montgomery 0.2% 0.1% 79.2% 1.2%77382 Montgomery 1.3% 0.0% 81.6% 3.7%77379 Harris 0.6% 0.1% 84.3% 1.8%77301 Montgomery 0.5% 1.2% 75.0% 0.6%77384 Montgomery 0.0% 0.0% 81.6% 1.1%77375 Harris 1.2% 0.3% 79.0% 0.7%


ZIPCode County CommutebyWalking

CommutebyBiking

CommutebyDrivingAlone

CommutebyPublicTransportation

77304 Montgomery 1.7% 0.6% 83.5% 1.0%77356 Montgomery 1.1% 0.0% 79.3% 0.7%77316 Montgomery 0.4% 0.0% 83.6% 0.9%77302 Montgomery 0.6% 0.0% 84.9% 1.5%77303 Montgomery 0.6% 0.0% 84.6% 0.4%77378 Montgomery 0.0% 0.0% 88.3% 0.1%77318 Montgomery 1.1% 0.0% 79.7% 1.0%77073 Harris 0.5% 0.0% 80.8% 2.3%77355 Montgomery 0.5% 0.0% 86.9% 0.7%Harris -- 1.5% 0.3% 79.3% 2.7%Montgomery -- 0.9% 0.2% 82.1% 1.2%Texas -- 1.6% 0.3% 80.5% 1.5%


Table12displaysthedifferentmodesofcommutingusedbyresidentsofHarrisandMontgomerycounties.InMontgomeryCounty,lessthan1%ofthepopulationcommutesbywalking.InHarrisCounty,slightlymoreresidentscommutebywalking(1.5%).Inbothcounties,themajorityofresidentscommutebydrivingalone(79.3%inHarrisCountyand82.1%inMontgomeryCounty),whichissimilartothestatevalue(80.5%).PublictransportationisusedbyHarrisCountyresidents(2.7%)moresothanMontgomeryresidents(1.2%),perhapsindicativeofdifferencesinpublictransportationinfrastructure.AlthoughpublictransportationisnotascommoninMontgomeryCountycomparedtoHarrisCounty,3.7%ofresidentslivinginzipcode77382commutebypublictransportation.ConsideringthetoptenzipcodesforinpatientdischargeswithinMHTheWoodlands'servicearea,zipcodes77380,77381,and77382havethehighestproportionsofresidentscommutingbypublictransportation.

SocioNeeds Index® ConduentHealthyCommunitiesInstitutedevelopedtheSocioNeedsIndex®toeasilycomparemultiplesocioeconomicfactorsacrossgeographies.Thisindexincorporatesestimatesforsixdifferentsocialandeconomicdeterminantsofhealth–income,poverty,unemployment,occupation,educationalattainment,andlinguisticbarriers–thatareassociatedwithpoorhealthoutcomesincludingpreventablehospitalizationsandprematuredeath.Zipcodeswithineachcountyareassignedanindexvaluefrom0(lowneed)to100(highneed),basedonhowthosezipcodescomparetoothersintheU.S.Withineachcounty,thezipcodesarethenrankedfrom1(lowneed)to5(highneed)toidentifytherelativelevelofneed.Zipcodeswithpopulationsunder300personsareexcluded.


Figure22.SocioNeedsIndexbyZipCode

AsshowninFigure22andTable13,mostofthezipcodeswithinMHTheWoodlands’serviceareawiththehighestSocioNeedsIndexvaluesarewithinMontgomeryCounty;zipcodes77301and77303bothhavevaluesgreaterthan80.ThezipcodeswithlargestproportionofinpatientdischargesatMHTheWoodlands,zipcodes77386and77381,havelowSocioNeedsIndexvalues(6.2and2.4,respectively).

Table13.SocioNeedsIndexbyZipCode(InOrderofSocioNeedsIndexValue)

ZIPCode County SocioNeedsIndexValue77301 Montgomery 91.677303 Montgomery 81.377073 Harris 77.177378 Montgomery 69.977302 Montgomery 67.077373 Harris 42.077355 Montgomery 34.077318 Montgomery 32.377304 Montgomery 30.477375 Harris 24.677385 Montgomery 17.3


ZIPCode County SocioNeedsIndexValue77354 Montgomery 14.177356 Montgomery 13.277388 Harris 13.177380 Montgomery 11.577316 Montgomery 11.477379 Harris 8.177389 Harris 7.277386 Montgomery 6.277384 Montgomery 5.877381 Montgomery 2.477382 Montgomery 2.2

ConduentSocioNeedsIndex,2019


Data Synthesis Allformsofdatahavetheirownstrengthsandlimitations.TogainacomprehensiveunderstandingofthesignificanthealthneedsforMemorialHermannHealthSystem,thefindingsfromboththeprimarydataandthesecondarydatawerecomparedandstudiedtogether.Thesecondarydata,keyinformantinterviewsandcommunitysurveyweretreatedasthreeseparatesourcesofdata.Thesecondarydatawereanalyzedusingdatascoring,whichidentifiedhealthareasofneedbasedonthevaluesofindicatorsforeachtopicarea(AppendixB).Table14andTable15displaythedatascoresforHealthandQualityofLifeTopicsforHarrisandMontgomerycounties.

Table14.HarrisCountyTopicScoresTopic ScoreTransportation 1.82Women'sHealth 1.81Immunizations&InfectiousDiseases 1.78OtherChronicDiseases 1.78PublicSafety 1.65Maternal,Fetal&InfantHealth 1.64Prevention&Safety 1.58SocialEnvironment 1.58Education 1.56Economy 1.55HeartDisease&Stroke 1.54Children'sHealth 1.52OlderAdults&Aging 1.50AccesstoHealthServices 1.48Exercise,Nutrition,&Weight 1.48Wellness&Lifestyle 1.42Men'sHealth 1.38Diabetes 1.34Environment 1.34SubstanceAbuse 1.33Cancer 1.31MortalityData 1.29MentalHealth&MentalDisorders 1.26RespiratoryDiseases 0.99

Table15.MontgomeryCountyTopicScores

Topic ScoreTransportation 1.93HeartDisease&Stroke 1.65AccesstoHealthServices 1.56OtherChronicDiseases 1.52


Topic ScoreExercise,Nutrition,&Weight 1.50SubstanceAbuse 1.49Children'sHealth 1.37OlderAdults&Aging 1.36Women'sHealth 1.35PublicSafety 1.33Environment 1.32Immunizations&InfectiousDiseases 1.32MentalHealth&MentalDisorders 1.31Education 1.11SocialEnvironment 1.10RespiratoryDiseases 1.08Cancer 1.06Economy 1.04MortalityData 1.00Men'sHealth 0.95Wellness&Lifestyle 0.93Prevention&Safety 0.85Maternal,Fetal&InfantHealth 0.83

Thismethodologywasappliedtoeachofthe12countieswithinMemorialHermannHealthSystem’sprimaryserviceareaandthendatascorescalculatedfortheregioninordertodeterminesignificanthealthneedsacrossthesystem.Table16liststheresultingdatascoresforHealth&QualityofLifeTopicAreas.

Table16.MemorialHermannRegionTopicScoresTopic ScoreTransportation 1.84HeartDisease&Stroke 1.82AccesstoHealthServices 1.79OlderAdults&Aging 1.60Exercise,Nutrition,&Weight 1.56OtherChronicDiseases 1.52MentalHealth&MentalDisorders 1.50Children'sHealth 1.47Immunizations&InfectiousDiseases 1.43Education 1.43Women'sHealth 1.42SocialEnvironment 1.42Wellness&Lifestyle 1.41Maternal,Fetal&InfantHealth 1.41RespiratoryDiseases 1.41Economy 1.41Environment 1.40


Topic ScorePublicSafety 1.36Cancer 1.31Prevention&Safety 1.26SubstanceAbuse 1.23Men'sHealth 1.21

Theanalysisofkeyinformantinterviewsoccurredusingthequalitativesoftware:Dedoose1.Forthecommunitysurvey,HCIperformedasimplereviewandanalysistoidentifytophealthneeds.Overall,eachmethodproducedindividualresultsthatrepresentthecommunityinputinthisreport.Thisconsolidatedinputleadstotheprioritizedheathneedsinthisreport.ThistriangulatedapproachisshowninFigure23.

Figure23.VisualofDataSynthesisApproach

TheteamusedthetriangulatedapproachtoidentifysignificanthealthneedsforMemorialHermannHealthSystem.Figure24displaystheresultsofthissynthesis.Formanyofthehealthtopicsevidenceofneedwaspresentacrossmultipledatasources,includingObesity,MentalHealth,AccesstoHealthServices,Transportation,andUninsured.Forotherhealthtopicstheevidencewaspresentinjustonesourceofdata,howeveritshouldbenotedthatthismaybereflectiveofthestrengthandlimitationsofeachtypeofdatathatwasconsideredinthisprocess.

SignificantHealthNeeds

HealthIndicatorData

(DataScoringAnalysis)

KeyInformantInterviews(Thematic

CodingAnalysis)CommunitySurvey

(ThematicAnalysis)


Figure24.DataSynthesisResults


Prioritized Significant Health Needs

Priorit ization Results Uponcompletionoftheonlineprioritizationsurvey,fourhealthareaswereidentifiedforsubsequentimplementationplanningbyMemorialHermannHealthSystem.Thesefourhealthprioritiesare:AccesstoCare,EmotionalWell-Being,FoodasHealth,andExerciseIsMedicine.ThefollowingsectionwilldivedeeperintoeachofthesehealthtopicsinordertounderstandhowfindingsfromthesecondaryandprimarydataledtoeachhealthtopicbecomingapriorityhealthissueforMemorialHermannHealthSystem.Foreachprioritizedhealthneed,keyissuesaresummarized;secondarydatascoresarenotedforindicatorsofconcern;andcommunityinputisdescribed.

Access to Healthcare

Secondary Data AccesstoHealthServices,LackofInsuranceandLow-Income/UnderservedwereidentifiedassignificantneedsforMemorialHermannHealthSystem.AsshowninTable17,severalindicatorsreceivedscoresof1.75orabovethroughthesecondarydatascoringprocess:AdultsUnabletoSeeaDoctor(HarrisCounty);AdultswithHealthInsurance(HarrisCounty);ChildrenwithHealthInsurance(HarrisCounty);MentalHealthProviderRate(MontgomeryCounty);andPersonswithHealthInsurance(HarrisCounty).

Table17.SecondaryDataScoringResults:AccesstoHealthServices

County CountyValueComparedto:

Indicator Name ValueDataScore

TXCounties

TX US HP2020Target

TrendOverTimeValue Value

AdultsUnabletoAffordtoSeea

Doctor[10](2015)Montgomery

--- --- --- --- --- ---

KeyIssues:• Rangeofbarriers,includingtransportation,accesstospecialtycare,lackofawareness,and

fearorstigma• Lackofhealthinsurance• Lowincomeandvulnerablegroups

SecondaryDataScoringMethodologyForeachindicator,eachcountyinMHTheWoodlands’serviceareawasassignedascorebasedonitscomparisontoothercommunities,whetherhealthtargetshavebeenmet,andthetrendoftheindicatorvalueovertime.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariedbyindicatorandwasdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.PleaseseeAppendixBforfurtherinformationonHCIDataScoringmethodology.


Harris22.1

2 1.5 3 3 1.5 1.5percent

[10]TexasBehavioralRiskFactorSurveillanceSystem

AdultswithHealthInsurance:18-64[9]

(2016)

Montgomery79.7

1.47 0 1 1.5 3 1percent

Harris74.7

1.75 2 2 1.5 3 0percent

[9]SmallAreaHealthInsuranceEstimates

ChildrenwithHealthInsurance[9](2016)

Montgomery90.2

1.53 0 2 1.5 2 1percent

Harris89.4

1.81 1 2 1.5 3 1percent


DentistRate[4](2016)

Montgomery45.5

1.56 0 3 3 1.5 1dentists/100,000population

Harris66.3

0.5 0 0 2 1.5 0dentists/100,000population

[4]CountyHealthRankings

MentalHealthProviderRate[4]

(2017)

Montgomery69.4

2 1 3 3 1.5 1.5providers/100,000population

Harris103.7

1.44 0 1 3 1.5 2providers/100,000population


Non-PhysicianPrimaryCare

ProviderRate[4](2017)

Montgomery55


Harris72.2

1 0 1 3 1.5 0providers/100,000population


PersonswithHealthInsurance[9](2016)

Montgomery83.1

1.47 0 1 1.5 3 1percent

Harris79.3

1.75 2 2 1.5 3 0percent


PrimaryCare Montgomery 61.8 1.22 0 1 3 1.5 1


ProviderRate[4](2015)

providers/100,000population

Harris57.2



WhenconsideringAccesstoHealthServices,itisimportanttotakeintoaccounttheeconomyandhowfinancialbarriersimpactcommunityresidents’abilitytoaccesscare.AsshowninTable18,bothcountieshaveindicatorsofconcern,including:FamiliesLivingBelowPovertyLevel(HarrisCounty);FemalePopulation16+inCivilianLaborForce(MontgomeryCounty);FoodInsecurityRate(HarrisCounty);Homeownership(HarrisCounty);MedianHouseholdGrossRent(HarrisandMontgomerycounties);MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage(HarrisandMontgomerycounties);MortgagedOwnersMedianMonthlyHouseholdCosts(MontgomeryCounty);People65+LivingBelowPovertyLevel(HarrisCounty);SevereHousingProblems(HarrisCounty);SNAPCertifiedStores(HarrisandMontgomerycounties);StudentsEligiblefortheFreeLunchProgram(HarrisCounty);andUnemployedWorkersinCivilianLaborForce(HarrisCounty).Outofthislist,HarrisCountyhadeighteconomicindicatorswithsecondarydatascoresabove2comparedtoMontgomeryCountywithfourindicatorsequaltoorabove2,indicatingpotentiallygreatereconomicneedinHarrisCounty.

Table18.SecondaryDataScoringResults:Economy



TXCounties

TX US HP2020Target


ChildFoodInsecurityRate[5](2016)

Montgomery21.2

1.17 0 1 3 1.5 0percent

Harris23.5

1.67 1 2 3 1.5 0percent

[5]FeedingAmerica

ChildrenLivingBelowPovertyLevel[1](2012-2016)

Montgomery14.8

0.17 0 0 0 1.5 0percent

Harris26.0

1.67 2 2 3 1.5 0percent

[1]AmericanCommunitySurvey

FamiliesLivingBelowPovertyLevel[1](2012-2016)

Montgomery8.3

0.56 0 0 0 1.5 1percent

Harris14.4

2.06 2 3 3 1.5 1percent



FemalePopulation16+inCivilianLaborForce[1](2012-2016)

Montgomery53.6

2 1 2 2 1.5 3percent

Harris59.8

0.94 0 1 1 1.5 2percent


FoodInsecurityRate[5](2016)

Montgomery14.6

1.33 1 1 3 1.5 0percent

Harris16.6

2.06 2 2 3 1.5 1percent

[5]FeedingAmerica

Homeownership[1](2012-2016)

Montgomery65.6

0.61 0 0 0 1.5 2percent

Harris49.6

2.44 3 2 3 1.5 2percent


MedianHouseholdGrossRent[1](2012-

2016)

Montgomery1077

2.58 3 3 3 1.5 3dollars

Harris937

2.08 3 2 1 1.5 3dollars


MedianMonthlyOwnerCostsfor

HouseholdswithoutaMortgage[1](2012-

2016)

Montgomery531

2.58 3 3 3 1.5 3dollars

Harris534

2.14 3 3 3 1.5 1dollars


MortgagedOwnersMedianMonthly

HouseholdCosts[1](2012-2016)

Montgomery1635

2.19 3 3 2 1.5 2dollars

Harris1504

1.81 3 2 2 1.5 1dollars


People65+LivingBelowPovertyLevel

[1](2012-2016)

Montgomery7.7

0.78 0 0 0 1.5 2percent

Harris11.3

1.89 2 2 3 1.5 1percent


PeopleLivingBelowPovertyLevel[1](2012-2016)

Montgomery11.0

0.17 0 0 0 1.5 0percent

Harris 17.4 1.67 2 2 3 1.5 0


percent


SevereHousingProblems[4](2010-

2014)

Montgomery16.0

1.28 2 0 0 1.5 2percent

Harris20.9

2.39 3 3 3 1.5 1percent


SNAPCertifiedStores[17](2016)

Montgomery0.5

1.89 3 1.5 1.5 1.5 1stores/1,000population

Harris0.6


[17]U.S.DepartmentofAgriculture-FoodEnvironmentAtlas

StudentsEligiblefortheFreeLunch

Program[8](2015-2016)

Montgomery35.1

0.56 0 0 0 1.5 1percent

Harris58.2

2.22 2 3 3 1.5 1percent

[8]NationalCenterforEducationStatistics

TotalEmploymentChange[16](2014-

2015)

Montgomery3.5

1 1 1 0 1.5 1.5percent

Harris2.4

1.67 1 3 2 1.5 1.5percent

[16]U.S.Census-CountyBusinessPatterns

UnemployedWorkersinCivilianLaborForce[15](July

2018)

Montgomery3.8

1.28 1 1 1 1.5 2percent

Harris4.4

1.94 2 2 2 1.5 2percent

[15]U.S.BureauofLaborStatistics

Primary Data Duringthekeyinformantinterviewprocess,AccesstoHealthServiceswasdiscussedover160timesandwasraisedbyparticipantsalmost50timesinrelationtobarriersorchallengestoachievinghealthinthecommunity.Theprimarythemesrelatedtobarriersorchallengeswerelimitationstoprocuringspecialtycareservices,transportationtoservicesandhoursofoperation.Inadditiontotheprimarythemes,twoadditionalbarriersorchallengesstoodoutaskeyfactorsimpactingaccesstohealthcareservices,lackofknowledgeandstigmaorfearpreventingpeoplefromseekingcare.Theissuethatinterviewparticipantsweremostconcernedwithwaspatientsbeingabletoaccessfollowupcarewithspecialtycareproviders.


“Wehaveayear-longwaitinglistforourdentalservices(…)havingmoreclinicsorplacesforpatientstogoisahugeneed.”Multipleparticipantsraisedconcernsthatevenifpatientsareabletoaccesspreventativeorprimarycareservices,theymaynotbeabletoaccesstheappropriatefollowupcarewithaspecialtycareprovider.Someparticipantsraisedthisconcernincontextofpatientsnotlivingnearaspecialistandothersraisedincontextofpatientsnotbeingabletoaffordthecostoffollowupcare.“Wecantakecareofhelpingthemcontroltheirdiabetes,andkeeptheirbloodpressureincheck,andwecantreatthemforthatcommoncold,wecanprovidethatannualpapsmearforthewomanandprovidethatmammogram,butit'swhenthepersonexperiencessomethingofamoresignificantissue—saytheyhaveagallbladderattack,ortheyhaveahernia—thatisjustaresourcethatwesimplydon'thave.Orsomeoneneedstoseeanorthopedicsurgeon.Wetrytotakecareofthemthebestthatwecaninthesettingthatwehave,butthatisahugebarrierthatwefacewithourpatients,orthatourpatientsface.So,whathappensisitbecomesanurgentsituation,andtheyendupintheemergencyroom,andthey'regivensurgeryonanemergencybasis.”Anothercommonconcernraisedbyinterviewparticipants,wastransportationtoservicesandhoursofoperationofserviceslimitingpatients’accesstocare.Participantsdescribedhowthesefactorsdeterminewhetherpatientsdecidetotakeofffromworkandseekservicesinthefirstplace.Afewparticipantsdescribedthemanyservicesandresourcesthatareavailabletothecommunitybutthatmanymaynotbeawarehowtheycanaccessorbenefitfromthem.Oneparticipantdescribedresourcesbeingconcentratedincertaingeographicareasandmoreremotelocationsnotbeingwellconnectedorknowledgeableabouthowtheymayalsobenefitfromtheseresources.Participantsdescribedthepotentialformorecollaborationandpartnershiptoconnectcommunitiestooneanother.“Iwouldlovetoseesomebodyfromthepublicassistance,andI’lljustcallitMedicaid,orthepublicbenefits,maybehaveanofficeinsidethehospital.Thatwouldbephenomenal.I’veworkedinadifferentstateasahospitalsocialworkerpreviously,andtherewassomeonefromapublicassistance,fromtheDepartmentofHumanHealthandWelfareServicesinthehospital,andthatpersonwasabletoconnectthepeopletherewithemergencyMedicaid,withMedicaid,whichalsohelpsthehospital.Havetheirbillspaidandwhatnot,andmaybeitwouldcutdownonoutsourcingandsomeofthecollectionsandwhatnot.Ithinkthatthatwouldbewonderful,wouldbetohavesomeonefromthestatepublicbenefitsprogramhousedinsidethehospital.”Severalparticipantsdescribedadown-turninpeopleseekingpreventativecareserviceandhypothesizedthatoneofthefactorsmayberelatedtotheimmigrantcommunityintheregionexperiencingfearorstigmarelatedtohavingtoshowidentificationorproofofcitizenship.Therewerealmost80referencestotheuninsuredpopulationinthekeyinformantinterviewsandlackofhealthinsurancewasraisedasabarrierorchallengetoachievinghealthinthecommunity19times.Lackofhealthinsurancewasmostoftenbroughtupincontextofpatients


havinglimitedfinancialresourcesandafactortonotaccessinghealthcareservices.Participantsdiscussedpatientsnothavingtheabilitytopayfeesformultipleappointmentco-paysornotseekingcareduetocompetingfinancialpriorities.Whilehealthcareservicesmaybeavailableinthecommunity,forthosewhoarelackinghealthinsurance,accessinghealthcareservicesisnotnecessarilyanoption.Lackofhealthinsurancecreatesaparticularchallengeforthosewhorequirespecialtycareservices.“Ithinkthosearethebiggesttwo—access,again,withthemajorityofouradultpopulationbeinguninsured,havingthemtrytofindaproviderthat,again,willtakeslidingfeescale,orreducedrates.Oncethey'reabletoaccessthoseservices,thenitbecomesamatterofpayingforthethingsthatareneeded.Thepatientcomesinandwediagnosethemwithdiabetes,thencomesthecostofmedications,andifthatpatientisneedingspecialtycareoutsideofthescopeofprimarycare,accesstospecialists.”Participantsbroughtupissuesrelatedtolowincomeorgroupswhomaybeunderservedinthecommunity115timesduringthekeyinformantinterviewprocess.Particulargroupsthatparticipantsfeltmayexperienceaddedchallengesaccessinghealthcareservicesincludedtheimmigrantpopulation,individualswithdisabilities,familieswithyoungchildren,andtheelderly.Severalparticipantsraisedfeesrelatedtoco-paysoroutofpocketexpensesasabarriertopatientsseekinginitialpreventativeservicesorongoingtreatmentforchronicconditions.Participantsidentifiedseveralgroupstheyfeltwereunderservedinthecommunity.Multipleparticipantsdiscussedtheuniqueandspecificchallengeswithprovidingculturallyappropriatecareforadiverseandrecentimmigrantpopulationinthecommunity.Participantsfeltthatfamilieswithyoungchildrenandtheelderlypopulationareparticularlyvulnerablegroupsinthecommunitythatexperiencebarriersandchallengesaccessinghealthcareservices.Specifically,participantsdiscussedthesegroupsexperiencinghighlevelsofpovertyplacingthemathigherriskforpoorhealthoutcomes.

Emotional Well-Being

Secondary Data MentalHealthandSubstanceAbusewereidentifiedassignificantneedsforMemorialHermannHealthSystem.SubstanceAbuserankedsixthinthetoptopicsforMontgomeryCounty’ssecondarydataresults.AsshowninTable19,inMontgomeryCounty,mentalhealthindicatorsofnoteinclude:MentalHealthProviderRateandAge-AdjustedDeathRateduetoSuicide.WhileMentalHealth&MentalDisordersdidnotrankashighforHarrisCounty,anindicatortonoteisAlzheimer'sDiseaseorDementiaintheMedicarePopulation.

KeyIssues:• Mentalhealthaspartofoverallhealth• Needformorebehavioralhealthservicesandproviders• Alcoholandsubstanceabuse• Alzheimer’sanddementia


Table19.SecondaryDataScoringResults:MentalHealth&MentalDisorders



TXCounties

TX US HP2020Target


Age-AdjustedDeathRateduetoSuicide[12](2010-2014)

Montgomery14.6

2.28 1.5 3 3 3 2deaths/100,000

population

Harris10.3

0.94 1.5 0 0 2 1deaths/100,000population

[12]TexasDepartmentofStateHealthServices

Alzheimer'sDiseaseorDementia:

MedicarePopulation[3](2015)

Montgomery10.7

1.67 1 1 2 1.5 1.5percent

Harris11.4

1.89 2 1 3 1.5 1percent

[3]CentersforMedicare&MedicaidServices

MentalHealthProviderRate[4]

(2017)

Montgomery69.4

2 1 3 3 1.5 1.5providers/100,000population

Harris103.7



PoorMentalHealth:5+Days[10](2016)

Montgomery

--- --- --- --- --- ---

Harris80.0

1.53 1.5 1 1.5 1.5 2percent


SubstanceAbuseisanothertopicofconcernforMemorialHermannHealthSystem.BothHarrisandMontgomerycountieshaveindicatorswithscoresabove2.Therewereover37%alcohol-impaireddrivingdeathsinHarrisCountyandalmost33%inMontgomeryCounty,comparedto29.3%intheU.S.Moreover,21%ofadultsdrinkexcessivelyinMontgomeryCountyascomparedtothenationalvalueof18%.

Table20.SecondaryDataScoringResults:SubstanceAbuse


Indicator Name Value DataScore

TXCounties

TX US HP2020Target


AdultswhoDrink Montgomery 21.0 2.17 3 2 3 0 1.5


Excessively[4](2016) percent

Harris18.1

1.5 2 1 2 0 1.5percent


Alcohol-ImpairedDrivingDeaths[4]

(2012-2016)

Montgomery32.9

2.06 2 3 3 1.5 1percent

Harris37.8

2.17 3 3 3 1.5 0percent


Primary Data Approximately50%ofcommunitysurveyrespondentscitedMentalHealthasoneofthetopissuesmostaffectingthequalityoflifeintheircommunityand52%ofrespondentsnotedSubstanceAbuse.Ininterviewswithkeyinformants,MentalHealthwasdiscussed113timesandwasraisedbyparticipants33timesasaneedsorconcernforthehealthofthecommunity.TheprimarythemesrelatedtoMentalHealthweretreatingmentalhealthaspartofoverallhealth,addressbehavioralhealthinschool,needforbehavioralhealthprovidersandservices,andolderadultswithAlzheimer’sanddementia.Someparticipantsdiscussedarecentshiftincaredeliveryandthecontinuedneedtoaddressmentalhealthaspartofaperson’stotalhealthsimilarlytohowchronicdiseaseismanaged.Oneparticularlyvulnerablepopulationthatwouldbenefitfromabroaderapproachtotreatment,inclusiveofmentalhealth,isthehomelesspopulation.Severalparticipantsbroughtupissuesregardinganeedformorebehavioralhealthprovidersandservicesinthecommunity.“Wehereseeahugegapinmentalhealth,there’sjustnotalotofsupportiveservicesformentalhealth,andwe’reseeingthattoreallyhitouryoungadults,ouradultswhoareintheir20s.WeseealotofpeoplehavingalotofPTSDorevenhavingapsychoticbreak,andweonlyhaveoneagencythatwouldsupportsomebodymaybewithoutinsurancethat’shavingmentalhealthissues,whichiscausingsomuchtraumaforthemfromthatpointforward.Iwouldsayoneofthehugeindicatorsforuswouldbementalhealth,it’shugeforus.”Oneparticipantobservedrecentincreasesandchangeswithinthelocalpopulation.Fromtheparticipant’sperspective,thereshouldbemoreprogramsorservicestoaddressthegrowingneedforaddressingmentalhealthinthecommunity.Anotherparticipantsuggestedsolutionsforaddressingtheneedformorebehavioralhealthprovidersinthecommunitysuchasexpandingresidencyprogramsforpsychiatristsanddevelopingcomprehensivetelemedicineprogramstoprovideservicesmoreefficiently.Furthermore,participantsrecommendedaddressingbehavioralhealthwithyoungerpopulationsintheschools.Schoolsthatprovidebehavioralhealthservicesthroughtelemedicinehavebeenreceivedwellinthecommunityandtheperceptionisthattheyare


effective.Someparticipantsbelievethattheseprogramsshouldbeexpandedandavailableacrossthecommunity.“There[are]thementalhealthunitsthathavegoneoutintotheschools.They'renotschool-basedbutthat’sthevenuetheywilldrivetowiththeirmobileunits.Theyhaveabigimpact.They'reseeingthousandsofkids.They’vedonesometelemedicinewithmentalhealth,behavioralhealth,withsomeofthehighschools.FromwhatI’veheard,(…)it’sbeenprettyeffectiveandwellreceived.”AchallengethathealthcareprovidersidentifiedforthemedicalcommunityisadequatelyaddressingdementiaandAlzheimer’swithinthegeriatricpopulation.“Dementia’saterminalillness.(…)Muchmoreneedstobedonewithhealthcaresystemsaroundroutinescreeningandidentificationofitasanissue.(…)So,thatisthefirstthingthatneedstohappen.Thenthereneedstobeanunderstandingthattherearethings–therearemedicationsthatcanbehelpfultothesystemsofthedementia.(…)Butyoucanaffectitbyaddressingsomeofthesymptoms.”SubstanceAbusewasdiscussed55timesandwasraisedbyparticipants15timesasaneedorconcernforthehealthofthecommunity.MultipleuniquethemesemergedfromtheinterviewsrelatedtoSubstanceAbuse:fundingfortreatmentprograms,invisibilityofalcoholism,overcomingstigmaofseekingtreatment,andemergingshiftsinoutreachmodels.Participantsidentifiedfundingforprogramsandavailabilityofservicesforthosewhomaynotbeabletoaffordtreatmentout-of-pocketasissuesthecommunityisfacingtoaddresssubstanceabuse.“(…)we’reseeingalotofaddictionand(…)ifyoudon’thavethefundstogointoatreatmentprogram,youroptionsarelimitedandthere’sawaittime.”Oneparticipantraisedalcoholabusespecificallyasanissueinthecommunitythatdoesnotgettheamountofattentionofothersubstanceabusetopicsbutmayinfactbeimpactingalargerproportionofthepopulationandconnectedtomanyotherhealthissues.Multipleparticipantsidentifiedculturalstigmaasabarrierforthosewhomaybenefitfromseekingtreatment.Stigmaorfearmaybeuniqueandvaryfrompopulationtopopulationinthecommunity.“Withsubstanceabuse,it’scultureandstigma.Nobodygoestosubstanceabusetreatmentontheirown.Theymaynotbeadjudicatedbutsomeoneisreally,reallypushingthem,familymember,boss.Noonegoestotreatmentifthey’renotunderduress.”Afewparticipantsdescribeduniqueapproachestooutreachandsubstanceabusetreatmentinthecommunitythatwouldsupportremovingbarriersforpeoplehavingtotakethefirststepontheirown.“Forinstance,it’sprettynew,butthere’saninitiativethat’scalledtheHeroesProjectthat’slookingatoverdoses,sowhenanoverdosehappens,they’resendingateamtotheER.So,it’sgotapeersupportspecialist,theEMPisinvolved–buttheyactuallygointotheERandtheydoaninterventiontheretotrytohelpwithlinkagetotreatmentsothatwecanassistthepatients.”


Food as Health

Secondary Data ThetopicsofDiabetesandHeartDisease&StrokeemergedassignificanthealthneedsforMemorialHermannHealthSystem.HeartDisease&StrokerankedasthesecondmostimportanttopicforMontgomeryCounty.AlthoughthetopicofDiabetesdidnotreceiveahighsecondarydatascoreoverall,28.1%oftheMedicarePopulationhasdiabetesinHarrisCounty,comparedtotheU.S.valueof26.5%.(Table21)

Table21.SecondaryDataScoringResults:Diabetes



TXCounties

TX US HP2020Target


Diabetes:MedicarePopulation[3](2015)

Montgomery24.8

0.94 0 0 1 1.5 2percent

Harris28.1

1.67 2 1 2 1.5 1.5percent


AsshowninTable22HeartDisease&StrokeisalsoaconcerningtopicinMontgomeryandHarriscounties.IndicatorstonoteincludeAtrialFibrillation,HyperlipidemiaandStroke(allintheMedicarePopulation).InHarrisCounty,indicatorstoobserveareHeartFailureandStroke(bothintheMedicarePopulation).

Table22.SecondaryDataScoringResults:HeartDisease&Stroke



TXCounties

TX US HP2020Target


AtrialFibrillation:MedicarePopulation

[3](2015)

Montgomery8.8

2.44 3 3 2 1.5 2percent

Harris7.3

1.5 1 1 1 1.5 3percent

HeartFailure:MedicarePopulation

[3](2015)Montgomery

14.61.22 0 1 2 1.5 1

percent

KeyIssues:• Foodinsecurityandlimitedaccesstohealthyfoods• Diabetesandheartdiseaselinkedtosocioeconomicfactors• Fooddeserts


Harris16.0

1.89 1 2 3 1.5 1percent

Hyperlipidemia:MedicarePopulation

[3](2015)

Montgomery46.3

1.94 2 2 2 1.5 2percent

Harris43.2

1.44 1 1 1 1.5 2percent

Hypertension:MedicarePopulation

[3](2015)

Montgomery56.0

1.61 1 1 2 1.5 2percent

Harris55.5

1.22 1 1 2 1.5 1percent

Stroke:MedicarePopulation[3](2015)

Montgomery4.6

2.28 2 2 3 1.5 2percent

Harris5.2

2.61 3 3 3 1.5 2percent


Table23displaysnutrition-relatedindicators.InbothHarrisandMontgomerycounties,SNAPCertifiedStoresareofconcern;additionalindicatorsofnoteincludeFoodInsecurityRateinHarrisCountyandGroceryStoreDensityinMontgomeryCounty.

Table23.SecondaryDataScoringResults:Nutrition



TXCounties

TX US HP2020Target



Montgomery21.2

1.17 0 1 3 1.5 0percent

Harris23.5

1.67 1 2 3 1.5 0percent

[5]FeedingAmerica

ChildrenwithLowAccesstoaGroceryStore[17](2015)

Montgomery5.6

1.67 2 1.5 1.5 1.5 1.5percent

Harris5.4

1.5 1 1.5 1.5 1.5 1.5percent


FastFoodRestaurantDensity[17](2014)

Montgomery0.6

1.5 1 1.5 1.5 1.5 1.5restaurants/1,000population

Harris0.7





Montgomery14.6

1.33 1 1 3 1.5 0percent

Harris16.6

2.06 2 2 3 1.5 1percent

[5]FeedingAmerica

GroceryStoreDensity[17](2014)

Montgomery0.1

1.83 2 1.5 1.5 1.5 1.5stores/1,000population

Harris0.2




Montgomery0.5


Harris0.6



Primary Data Food-relatedtopicsemergedinthecommunityinputgatheredthroughthesurveyandkeyinformantinterviews.FoodInsecurity,FoodProgramsandFoodKnowledgeissueswerediscussedover170timesduringthekeyinformantinterviewsandwereraisedbyparticipants34timesinrelationtobarriersorchallengestoachievinghealthinthecommunity.Theprimarythemesrelatedtobarriersorchallengesthatemergedintheinterviewswereaccesstohealthyfoodsandaffordability,knowledgegapsandlimitedfoodfamiliarityandprogramlimitations.Themostcommonissueraisedbykeyinformantparticipantsrelatedtofoodinsecuritywascommunitymembersnotbeingabletoaccesshealthyfoodsintheircommunity.Multipleparticipantsbelievedthatinmanycommunities,healthyfoodoptionswerenotavailabletopeoplewithinafive-mileradiusfromtheirhomeorwork.Participantsdescribed‘fooddeserts’asatopissueaffectinghealthinthecommunityandhowlimitedaccesstohealthyfoodsalsowascloselyassociatedwithpeoplealsobeingnotbeingabletoaffordhealthyfoods.

“Wehaveareallylargecounty.(…)Thewestdoesn’tcatertotheeastveryeasilyandviceversa.(…)Onceyougetoffofthatinterstate,youstartgettingintotheeastcountyandwestcountyyou’llgomilesandmilesandmileswithoutgrocerystores,sotherearefooddesertsinourcommunity.”

Participantsalsodiscussedtheimbalanceofhealthyfoodoptionsforthosecommunitieswithlowerhousingpricesandingeneral,loweraverageincomes.Oneparticipantdescribedthelink


betweenpeoplehavingtoworkmultiplejobsandhavingtimetoshopforandpreparehealthyfoods.

“Wehaveagrocerystoreoneverycornerbutnoteverycornerinthepoorneighborhoods.It’sbeenmypersonalexperiencethateatinghealthyisexpensive.Itcostsmoremoneytobuyhealthyfruitsandvegetablesandmorehealthyfood,ingeneralthanitdoestobuyfoodthat’snotsohealthy,that’shighfat,highcarb,highsugar….Itcostsmoremoney.Ittakeslongertoprepare.Whenyouhaveamomandadadoreitherandthey’retryingtohandletwojobs,ifnotthree.They’vegotkidsofvaryingages.Themechanicsofshoppingandpreparingmealsisprobablyanactivitythatgetsletgo.”

Someparticipantshaddirectexperiencewitheducatingthecommunityabouthealthyfoodsandeating.Theseparticipantssharedthatsomecommunitymembershavelimitedknowledgeoffreshfruitsandvegetablesandwouldbenefitfromearlyeducationforparentsandchildreninschools.

“Andthereareplaceswhichwearereallyconcernedabout,(…)eastofI45wherethere’sthisfoodinsecurity,fooddesert,andallotherproblemsthatarehappening,andwe’reseeingincreasingincidenceofchildobesityinthoseareas,andthosezipcodes.Sodefinitelyeducationisthekey.Itstartsfromprobablyprenatalcareofmom,anditgoesontoschool.”

InMemorialHermann’scommunitysurvey,67%ofrespondentsselectedDiabetesasoneofthetopissuesmostaffectingthequalityoflifeintheircommunity.Duringkeyinformantinterviews,Diabeteswasdiscussed64timesandwasraisedbyparticipants32timesasahealthneedorconcerninthecommunity.ForthoseparticipantswhoraisedDiabetesasatophealthissueinthecommunity,uniquethemesemergedregardinghowdiabetesisimpactingspecificgroupsinthecommunityandthewayasedentarylifestyleimpactsdiabetes.MultipleparticipantsattributedthesurgeinobesityanddiabetesingeneralintheU.S.toashifttoamoresedentarylifestylewhileothersspecificallyidentifiedthelocalclimateanddrivingcultureaskeyfactorsleadingtoanincreaseinsedentarylifestylesimpactingtheregion.HeartDisease&Strokewasdiscussed34timesduringthekeyinformantinterviewsandwasraisedbyparticipants16timesasahealthneedorconcerninthecommunity.ForthoseparticipantswhoraisedHeartDisease&Strokeasatophealthissueinthecommunity,theuniquethemesthatemergedintheinterviewswerechronicdiseaseriskrelatedtosocioeconomicstatusandchallengeswithmanagingheart-relatedconditions.“Youhavesomanycommunitiesthatarefooddesertsso,ofcourse,Ithinkweareallatriskforthingslikediabetesandhypertension,obesity,stroke–but,Ithinkinadditiontothat,thosethataremostarealreadymarginalized.Peoplewhoarelowincome.Lowsocioeconomicstatus.So,education,andallofthoseindicatorsareprobablyevenmoreatriskforchronicdiseasesthansomeone,forexample,whohasaccesstocareandinsurance.So,theyprobablyaredoublyatrisk.”


Exercise Is Medicine

Secondary Data Exercise,Nutrition&Weightwasthefifthhighest-rankingtopicinthesecondarydatascoringresultsforMemorialHermannHealthSystem.ItreceivedthesametopicrankinginMontgomeryCountyand,althoughitdidnotrankashighinthesecondarydatascoringresultsforHarrisCounty,thereareindicatorstonote.Table24displaysindicatorsofconcern,withseveralscoresequaltoorabove1.75.Anexercise-relatedindicatorofconcernis:WorkersWhoWalktoWork(withanindicatorscoreof2.78inMontgomeryCountyand2.17inHarrisCounty).

Table24.SecondaryDataScoringResults:Exercise,Nutrition&Weight



TXCounties

TX US HP2020Target


Adults(18+Years)WhoAreObese[10]

(2016)

Montgomery

--- --- --- --- --- ---

Harris32.0

1.67 1.5 1 2 2 2percent



Montgomery21.2

1.17 0 1 3 1.5 0percent

Harris23.5

1.67 1 2 3 1.5 0percent

[5]FeedingAmerica

ChildrenwithLowAccesstoaGroceryStore[17](2015)

Montgomery5.6

1.67 2 1.5 1.5 1.5 1.5percent

Harris5.4

1.5 1 1.5 1.5 1.5 1.5percent


FastFoodRestaurantDensity[17](2014)

Montgomery0.6


Harris0.7


KeyIssues:• Obesityandconvenienceoffastfood• Walkabilityofcommunities• Safetyofoutdoorspacesandplacestoexercise




Montgomery14.6

1.33 1 1 3 1.5 0percent

Harris16.6

2.06 2 2 3 1.5 1percent

[5]FeedingAmerica

GroceryStoreDensity[17](2014)

Montgomery0.1


Harris0.2




Montgomery0.5


Harris0.6



WorkerswhoWalktoWork[1](2012-

2016)

Montgomery1.0

2.78 3 3 3 3 2percent

Harris1.5

2.17 2 2 3 3 1.5percent


Primary Data Over60%ofMemorialHermann’scommunitysurveyrespondentsnotedObesityasatopissueaffectingthequalityoflifeintheircommunity.Inkeyinformantinterviews,Exercise,Nutrition&Weightwasdiscussedalmost170timesandwasraisedbyparticipants42timesasaneedorconcernforachievinghealthinthecommunity.TheprimarybarriersrelatedtoExercise,Nutrition&Weightidentifiedbyparticipantswerewalkability,accesstosafeoutdoorspaces,programmingthatmaynotmeettheneedsofcommunitiesfacingfinanciallimitations,andtheconvenienceofunhealthyfoods.Severalparticipantsdiscussedbarrierstohealthylifestylechangesanddescribedcommunitieswheresidewalksarelimitedorpedestrianpathwaysarenotavailable.Theabilityforcommunitymemberstomakesmallshiftsintheirdailylives,suchaswalkingregularly,maybemorefeasiblethanundertakinganexerciseregimen.Thelimitationsofpedestrianpathwaysandsaferwalkingspacespreventthoseinsomesectionsofthecommunityfrommakingtheseshifts.


Forindividualswhomaynotbeabletoaffordgymmembershipsnorattendclassesduetoworkschedules,outdooractivitiesandfitnessareasofferafreealternative.Participantsfeltthatinmanyneighborhoods,theseoutdoorspacesarenotavailableduetodisrepairorunsafeenvironments.“Ithinkthebuiltenvironmentishuge,too.Ifyouliveoutinaplannedcommunity,theyusuallyhavewalkingtrails,ortheyhaveaprettyfountainareaforyoutowalkaroundit.Theyhavethoselittleexercisethingsthatyoustoponpartwayaroundthetrailandyoudoyourlittlepush-upsandyoursit-upsandyourpull-ups(…)Yougointothesepoorerareasandthere'snosidewalks.There'snolightsatnight.There'sapark—it'sallrustedequipment.”Participantsalsodescribedprogramsandfacilitiesthatareeitherlimitedorlacking.Theseprogramsincludedfreeexerciseprogramswithchildcareoptions,youthsportsleaguesandrecessintheschoolsandfreeorlow-costoptionsforair-conditionedfacilitiesduringtimesoftheyearwhentheweatherdoesnotpermitoutdooractivities.Anotherchallengethatseveralparticipantsraisedistheconvenienceandlowcostofunhealthyfoods.Forfamiliesthatmayhavefinancialortimelimitations,theconvenienceofinexpensive,lesshealthyfoodsisdifficulttocontendagainst.“Wehavethebigchaingrocerystoreshereinthecommunity,butalotoftimes,becauseourpopulationislimitedwithfunds,thebadfoodsaretheonesthatarethecheapestandmostaccessible,sotheygoinandbuythecheapest/fastestthingtheycanget.”


Non-Priorit ized Signif icant Health Needs Thefollowingadditionalsignificanthealthneedsemergedfromareviewoftheprimaryandsecondarydata.Withtheneedtofocusontheprioritizedhealthneedsdescribedabove,thesetopicsarenotspecificallyprioritizedeffortsinthe2019-2022ImplementationStrategy.However,duetotheinterrelationshipsofsocialdeterminantneedsmanyoftheseareasfall,tangentially,withintheprioritizedhealthneedsandwillbeaddressedthroughtheupstreameffortsoftheprioritizedhealthneeds.Additionally,manyofthemareaddressedwithinongoingprogramsandservices.Examplesoftheseeffortsareprovidedbelowbytopicarea.

Older Adults and Aging

Secondary Data OlderAdultsandAgingwasatopicofconcernforHarrisandMontgomerycounties,withatopicscoreof1.5forHarrisCounty’ssecondarydataresultsandastheeighthhighest-rankingtopicinMontgomeryCounty.Inbothcounties,StrokeintheMedicarePopulationisanindicatortobeawareof.InHarrisCounty,additionalindicatorsscoringabove2includeChronicKidneyDiseaseintheMedicarePopulationaswelltheAge-AdjustedDeathRateduetoFalls.InMontgomeryCounty,AtrialFibrillationintheMedicarePopulationisanindicatorwithscoreabove2.

Primary Data KeyinformantsandstakeholdersdiscussedOlderAdultsandAging.Over62%ofparticipantsinMemorialHermannHealthSystem’sprioritizationprocesscitedOlderAdultsasoneofthegroupsmostaffectedbypoorhealthoutcomes.Interviewswithkeyinformantsnotedthegrowingpopulationofolderadultsandneedsrelatedtospecializedcare,financialassistanceandoutreach.“…[W]earegoingtowatchtheliteraldoublingofthenumberofAmericansovertheageof65inthenext25years.Everyday,betweennowand2030,dayafterday,10,000Americanswillturn65,sowearewatchinganextraordinaryexpansionofchallengesofaging.(…)[M]oreandmoreAmericansaregoingtobegettingold,socaringforthismassiveincreaseintheagingpopulationisgoingtobeoneofthegreatchallengesIthink.”

Efforts MemorialHermannHealthSystemincludestwofreestandingRehabilitationHospitals(TIRRandKaty)aswellasaseniorlivingfacility(UniversityPlace),featuringindependentliving,personalassistanceservices,andaseparate,butattached,nursingcenter.Additionalcommunityoutreachincludeshealtheducationon:Alzheimer’sdisease,DiscountedDiabetesEducation,Education/outreachforSeniors,InjuryPrevention,FallPrevention,andsupportgroupsforvariouspopulations,including:Alzheimer’s,Amputees,Cardiacpatients,Chronicdisease,Diabetics,Grief,Parkinson’sdisease,Stroke,Survivorship,andmore.


Cancers

Secondary Data CancerwasnotatoptopicforHarrisandMontgomerycounties’secondarydataresults.However,thereareacoupleofindicatorstonoteinHarrisCounty(withscoresabove2):CervicalCancerIncidenceRateandAge-AdjustedDeathRateduetoBreastCancer.

Primary Data InMemorialHermann’scommunitysurvey,overonethirdofrespondentsnotedCancerasatopissueaffectingthequalityoflifeintheircommunity.Interviewswithkeyinformantsrevealedtheimportanceofmakingcancerscreeningservicesandspecialtycareavailableandaccessible(e.g.,telehealth,mobilemammography).

Efforts AsleadingprovidersofcancertreatmentinHouston,MemorialHermannCancerCentersarecommittedtocancertreatment,prevention,andresearch.Theirbroadgeographicalcoveragemakescancertreatmentextremelyaccessibleandconvenienttowherepatientsliveorwork.AlleightMemorialHermannCancerCentersareapprovedbytheAmericanCollegeofSurgeonsCommissiononCancer(ACoSCoC);only25percentofhospitalsacrossthecountryhavereceivedthisspecialrecognition.Withguaranteedaccesstocomprehensivecare,collaborativeteamapproachforcoordinatingthebestavailabletreatmentoptions,state-of-the-artequipmentandservices,educationandsupport,andlifelongpatientfollow-upthroughtheCancerRegistry,patientsareabletoaccessafullmenuoftherapiesandtreatmentoptions.Additionaloutreachincludeseducationandsupportgroupsforcancerpatients:Art,Self-guidedArtTherapy,Lymphedema,BrestCancer,OncologyNutritionTherapy,StressRelief,LookGoodFeelBetter,Yoga,Meditation,andHealthyEatingAdvices.

Education

Secondary Data Educationreceivedatopicscoreof1.56inthesecondarydatascoringforHarrisCounty.Thereareseveraleducation-relatedindicatorstoconsiderinHarrisCounty:InfantsBorntoMotherswithLessThan12YearsofEducation(withavalueof27.5%inHarrisCounty,comparedto21.3%inTexasand15.9%intheU.S.),Student-to-TeacherRatio,HighSchoolDropOutRate,andPeople25+withaHighSchoolDegreeorHigher.

Primary Data Duringkeyinformantinterviews,thetopicofEducationcameupfrequentlyandinrelationtodifferentfocusareasandtargetaudiences,includingchildren,generalcommunitymembersaswellasproviders.Thelinkbetweenindividuals’levelofeducationandqualityoflifewasemphasized.Keyinformantsrecommendedfindingopportunitiestoexpandtheavailabilityofeducation(relatedtohealthandnon-healthtopics)aswellasintegratinghealtheducationintoexistingactivitiesinbothclinicalandnon-clinicalsettings,suchasschoolsandchurches.Opportunitieswerealsopointedouttoeducatehealthcareproviders(andprovidecontinuing


education)onavailablecommunitylinkagesandresourcesandonhowtoinitiateconversationswithpatientsregardingdifferenthealthtopics.“Ithinkitcomesdowntoeducationbecauseprobably75%ofourdiagnoseddiabetesaretype2diabetes,andthatissomethingthatwithproperdiet,properexercise,andeducationthatmanypatientscanovercome,andsowehaveworked,andwecontinuetoprovide(…)thepropereducation.”“Wewanttogointodifferentgroupsandeducatethemonwhattheyshouldbedoingorshouldn’tbedoing.(…)Ithinkeducationisahugecomponentbutwe’vegottofigureouthowtointegratethat.Theeducation,withouttheintegrationintosomebody’slifestyle,doesn’tdothemanygood.”

Efforts MemorialHermannoperatestenHealthCentersforSchools,establishedin1996,offeringaccesstoprimarymedical,dentalandmentalhealthservicestounderservedchildrenat82schoolsintheGreaterHoustonArea.Researchshowsthatschool-basedhealthcentersincreaseeducationalsuccessbyprovidingmedicalandmentalhealthcarethatallowsstudentstostayinschoolandlearn.Theprimarygoaloftheprogramistokeepchildrenhealthyandfeelingwellsothattheystayinschoolandcanperformwellacademically,creatingafoundationforabrighterfuture.Byprovidingimprovedaccesstohealthcaretoat-riskchildrenacrosstheregion,MemorialHermannhasdemonstratedsuccessincreatinghealthieroutcomesforkids,includingimprovementsintheirphysicalhealth,theirmentalwellbeing,andeventheirattendancerateatschool.

Transportation

Secondary Data ForHarrisandMontgomerycounties,Transportationrosetothetopofthesecondarydatascoringresults,withatopicscoreof1.82inHarrisCountyand1.93inMontgomeryCounty.Inbothcounties,indicatorsofconcerninclude:SoloDriverswithaLongCommute,MeanTravelTimetoWork,andWorkerswhoWalktoWork.Inadditiontothese,anotherindicatortonoteforMontgomeryCountyisWorkerswhoDriveAlonetoWork.Furthermore,thereexisthighdisparitiesforafewoftheseindicators.

Primary Data ParticipantsraisedthetopicofTransportation59timesinrelationtobarriersorchallengestoachievinghealthinthecommunity–morethananyothertopic.KeyinformantsrepeatedlynotedthattheHoustonregionhassignificanttransportationissues(includingavailability,accessibility)thatimpactcommunitymembers’abilitytoaccesshealthprogramsandservices.Inadditiontolimitedoptionsforpublictransportation,travelcostandtimewerebroughtup.Moreover,forcertainpopulations,likeolderadultsorpeoplewithdisabilities,publictransportationisnotafeasibleoption.“Thisremarkablespread-outcity,thesizeofMassachusetts,istheGreaterHoustonMetropolitanArea.(…)Thisisnotacityandasuburbanymore,it’sametropolitanregionwitheighttotencentersofactivitythatarelargerthandowntownSanDiego,spreadoutoverthismassivearea,butgettingfromoneplacetoanotherisanincreasingchallenge.Povertyalsomeansinadequatetransportation,wehavenoreally


goodtransitsystembecauseit’salmostimpossibletodevelopagoodtransitsystemforacitysolackingindensityandsospreadoutasHoustonis.Wehaven’tsolvedthatproblem,andalotofthehealthcareissuescomebecausepeople[are]withoutacartryingtogettoahospital,ortohealthcare…”“Houstonisreallyspreadout(…)anditcangofromcitytoruralveryquickly.Thefamiliesintheruralcommunitiesthatreallyarewithina20-mileradiusofthecity,soreallystillwithintheHoustonaddress,Ithinkthattransportationforthemisahugebarrier.That’satoughone,becauseHoustonissobig,anditcangoquicklytorural,veryquickly,andyourzipcodeisstillreflectingHouston.”

Efforts MemorialHermannprovidesbusandtaxitokensasrequiredfordischargeandcontinuityofcareneeds.OneMemorialHermannstrategicefforttonotonlyprovidetherightcareattherighttimeintherightplace,butalsoprovidetheopportunitytoaccesshelp/careviathetelephoneistheMemorialHermannNurseHealthLine.Establishedin2014,theNurseHealthLineisafreetelephoneserviceforGreaterHoustonresidentswhoareexperiencingahealthconcernandareunsureofwhattodoorwheretogo.Experienced,bilingualnursesusetheirtrainingandexpertisetoconductassessmentsbyphone,andareavailabletoanswercalls24hoursaday,sevendayaweekforanyresidentlivinginHarrisorsurroundingcounties.Theyhelpcallersdecidewhenandwheretogoformedicalcareandassistwithsocialservicereferralsandtransportationneeds.

Children’s Health

Secondary Data

Inthesecondarydataresults,Children’sHealthreceivedatopicscoreof1.52inHarrisCounty.HarrisCountyhasseveralindicatorstonoteincluding:ChildFoodInsecurityRate,ChildrenwithHealthInsuranceandChildrenwithLowAccesstoaGroceryStore.Closeto10%ofchildreninHarrisCountydonothavehealthinsurance.

Primary Data WhendiscussingChildren’sHealth,keyinformantspointedoutspecificissuessuchaschildhoodobesity,immunization,accesstoservicesandbeinguninsured.Someparticipantsadvisedeffortstoengagechildren,familiesandcommunitiesmorecomprehensively.“AlotofpeoplewontgotoaFQHCtogettheirkidimmunizedbecauseit’sahugedoctorvisitthatrequiresalotofpaperworkandtime/effort.”“Texasranksverylowindollarsspentonhealthforchildren.Weranklowinourranking,generally,inchildren’shealth.We’renotputtingenoughmoneyandresourcesintoit.Ithinkweneedtoshiftourattentionand(…)givemoreattentiontochildren’shealthandhowimportantitisforearlychildhooddevelopmentandforbraindevelopmentandongoinghealthintherestoftheirlives.Iwouldsayputthatasapriority.Putchildren’shealthasapriority.Notjustsayingtheearlyyears,notjustsayingzerotofivebutalsothroughoutearlyadolescence,pre-adolescence,earlyadolescenceandintotheteens.”


Efforts Children'sMemorialHermannHospital,licensedunderMemorialHermannTexasMedicalCenter,wasfoundedin1986andistheprimaryteachinghospitalforthepediatricandobstetrics/gynecologyprogramsatTheUniversityofTexasMedicalSchoolatHouston.Children'sMemorialHermannofferscareinmorethanthirtypediatricandwomen'srelatedspecialtiesincludingthelatestadvancesinmaternal-fetalmedicineandneonatalcriticalcareservices,andrenownedprogramsinpediatrictrauma,neurosciences,pulmonologyandcardiaccare.Morethan37,000childrencometoChildren'sMemorialHermannHospitaleachyear.InadditiontoMemorialHermann’sschool-basedhealtheffortsdescribedabove,MemorialHermannisanon-goingfinancialcollaboratorwithChildrenatRisk,a501non-profitorganizationthatdriveschangeforchildrenthroughresearch,education,andinfluencingpublicpolicy.

Economy

Secondary Data

Inthesecondarydatascoringresults,Economyreceivedatopicscoreof1.55inHarrisCounty.HarrisCountyhaseighteconomicindicatorswithscoresabove2:Homeownership,SevereHousingProblems,StudentsEligiblefortheFreeLunchProgram,MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage,SNAPCertifiedStores,MedianHouseholdGrossRent,FamiliesLivingBelowPovertyLevel,andFoodInsecurityRate.

Primary Data Keyinformantsdiscussedfoodinsecurityandfooddesertsasfactorsrelatedtopoorhealthoutcomes.Theypointedoutthat,althoughindividualsmightunderstandthateatinghealthyfoodsisrecommended,theymaynothaveaccesstogrocerystoresorbeabletoaffordhealthierfoodoptions.Keyinformantsnotedtheimportanceofaddressingsocioeconomicbarrierstoimprovehealthandwellbeing.“Ithinkinsomeofthelowerincomeneighborhoods,theoptionsforbuyingfoodarelimitedanddonotofferalotofhealthychoices,andthatalotoftimehealthierfoodcostsmore.Andsotheabilitytoeasilygetandaffordhealthyfood,whetheryou’reeatingathomeoreatingout,arejustmorelimitedforsomepeopleandinsomeneighborhoods…”

Efforts It’sadauntingtaskinaregionlikeGreaterHouston,whichhasanestimated7millionpeopleandoneofthehighestratesofuninsuredandunderinsuredinthecountry.ButMemorialHermannbelievesthatwecanONLYimpactthehealthofourcommunity,andthehealthofindividuals,byfocusingonthemultipledeterminantsofhealththatplaythegreatestroleininfluencingaperson’soverallhealthandwellbeing.


Other Findings Criticalcomponentsinassessingtheneedsofacommunityareidentifyingbarriersanddisparitiesinhealthcare.Theidentificationofbarriersanddisparitieshelpsinformandfocusstrategiesforaddressingprioritizedhealthneeds.ThefollowingsectionoutlinesbarriersacrossMemorialHermannHealthSystemanddisparitiesastheypertaintoMHTheWoodlands’servicearea.

Barriers to Care Communityinputrevealedawiderangeofbarrierstocareandwellbeing.Asdiscussedintheprevioussection,transportationwasthemostfrequentlycitedbarrierinthecommunity,followedbyotherbarrierssuchasaccesstohealthservices,healthyfoodandexerciseoptions,lowincome,andfoodinsecurity.Overall,thesecondaryandprimarydataconfirmedthatsocioeconomicfactorsimpactcommunitymembers’abilitytoachievegoodhealth.“Manythingscomebacktopovertyandlackofdisposableincome.”Keyinformantsdescribedtheinfluenceofsocialdeterminantsofhealth(includingincome,poverty,language,education,employment)onhealthoutcomes.Participantsdiscussedtheimportanceofaddressingsocialandeconomicfactorstogetattherootcausesofpoorhealthandwellbeing.“Ithinkyouhavetounderstandthatalotoffolksworkfrompaychecktopaycheck,soiftheyactuallyendupatoneofthesemedicalcentersandtheyrequireathirtydollarcopayortendollarsorfifteendollars,thenthey’renotgoingtohaveit.So,they’regoingtowalkawayuntiltheydohavethatmoneyandthatcouldbemonthslater.So,iftheyaresick,they’rejustgoingtobecomesicker.So,that’soneofthebigbarriers.”

Disparit ies Significantcommunityhealthdisparitiesareassessedinboththeprimaryandsecondarydatacollectionprocesses.Table25identifiesthenumberofsecondarydatahealthindicatorswithahealthdisparityforMHTheWoodlands’servicearea.SeeAppendixBforthespecificindicatorswithsignificantdisparities.

Table25.NumberofHealthDisparitiesIdentifiedinSecondaryDataAnalysis

HarrisCounty MontgomeryCountyBlackorAfricanAmerican(13)White(8)HispanicorLatino(8)OtherRace(7)AmericanIndianorAlaskaNative(6)

OtherRace(8)BlackorAfricanAmerican(6)HispanicorLatino(6)AmericanIndianorAlaskaNative(3)TwoorMoreRaces(3)

Male(10)Female(3)

Male(5)

65+yearsofage(2) <6yearsofage(1)65+yearsofage(1)


GeographicdisparitieswereidentifiedusingtheSocioNeedsIndex.AsshownpreviouslyinTable13,mostofthezipcodeswithinMHTheWoodlands’serviceareawiththehighestSocioNeedsIndexvaluesarewithinMontgomeryCounty;zipcodes77301and77303bothhavevaluesgreaterthan80.


Conclusion TheCommunityHealthNeedsAssessmentforMHTheWoodlandsutilizedacomprehensivesetofsecondarydataindicatorstomeasurethehealthandqualityoflifeneedsforMHTheWoodlands’servicearea.Furthermore,thisassessmentwasinformedbyinputfromknowledgeableanddiverseindividualsrepresentingthebroadinterestsofthecommunity.MemorialHermann’ssystem-wideprioritizationprocessresultedinfourfocusareasorpillars:AccesstoHealthcare,EmotionalWell-Being,FoodasHealth,andExerciseIsMedicine.MHTheWoodlandswillreviewtheseprioritiesmorecloselyduringtheImplementationStrategydevelopmentprocessanddesignaplanforaddressingthesepillarsmovingforward.Inaddition,MHTheWoodlandsinvitesyourfeedbackonthisCHNAreporttohelpinformthenextCommunityHealthNeedsAssessmentprocess.Ifyouhaveanyfeedbackorremarks,pleasesendthemto:[email protected].


Appendix

Appendix A: Evaluation Since Prior CHNA

Appendix B. Secondary Data Methodology

Secondary Data Sources

Secondary Data Scoring

Data Scoring Results

Appendix C. Primary Data Methodology

Community Input Participants

Key Informant Interview Questionnaire (Episcopal Health Foundation)

Key Informant Interview Questionnaire (Conduent Healthy Communities Institute)

Community Survey (English)

Community Survey (Spanish)

Appendix D. Priorit ization Tool

Priorit ization Survey

Appendix E. Community Resources

MemorialHermannTheWoodlandsMedicalCenterCHNA2019 68

AppendixA.MHTheWoodlandsImpactReport

EvaluationSincePriorCHNAPriority1:HealthyLiving

Priority1: HEALTHYLIVING

Goal1:Promotehealthylivingandprovideresourcestoencouragethecommunitytobeproactiveintheiroverallhealth.

EarlyDetectionandScreeningObjective1.1:IncreasescreeningtopromoteearlydetectionandreduceadvancedstagesofdiseasesOutcomeIndicators: Annual

BaselineYear1 Year2

FY2020Target

• Numberofparticipantsinscreenings(e.g.skincancerandmammograms.)

Skin40Mammogram

300

SkinCancer53Mammograms314

SkinCancer25Mammograms

311

Skin45Mammogram315

• NumberoflowdoseCTscansatareducedcosttocatchlungcancerearlier

0(newprogram)Establishbaselinein

Y1

63LungCTScans 84LungCT

Scans LowDoseLungCTs70

• Numberofeducationaltalks/events,suchashealthfairs(handoutswithpreventativeinformation);numberofattendees(Seealso1.2,1.3,1.4)

Events:40annually

Attendees:500

Events:29Attendees:1,635

Events:25(6healthfairs,

19talks)Attendees:

3,339

Events:40(annually)Attendees:580(5%annually)

• NumberofSupportGroups,numberofattendees(Seealso1.2,1.3,1.4)

14Groups220

Attendees

Events:16Attendees:3,920

Groups:26Attendees:

2,785

14Groups254Attendees(5%annually)

Strategies:Year1Notes Year2Notes Timeline:

Year1,2,31.1.1: Provideeducation/awarenesshealthtalks

atareaschoolsand/orlocalbusinesses(See1.2.3,1.3.5,1.4.5,1.5.1)

1,2,3




1.1.2: ProvidefreescreeningmammogramsandbreastultrasoundsasneededforInterfaithCommunityClinicpatientsandunder/uninsuredpatientsofprivatephysicians

47breastultrasoundsperformedforunderservedwomen

67breastultrasoundsperformedforunderserved

women

1,2,3

1.1.3: Providefreeannualscreeningsforskincancerduringanannualevent

53screenedforskincancer;26referredforabiopsyand12BasalCellCarinomasand3

Melanomasdiagnosed

25screenedforskincancer;6

referredforabiopsyand1Squamous

CellCarinomadiagnosed.

1,2,3

1.1.4: ConductlowdoseCTscansforolderadultstodiagnoselungcanceratearlierstagestopreventStage3&4canceratareducedcost(communicatetoPCPsviatheirsupportpaperworkforthesepatientstomakethemawareofthisservice)

63screened;65%hadanothersignificantfindingleadingtofollow-upwithspecialist(e.g.

emphasema)

84peoplescreened

1,2,3

Monitoring/EvaluationApproach:• Patient/participantexperiencesurveys• EventslogmaintainedbyMarketingManager,OncologyNurseNavigator,andImagingDirectors.• MammogramscreeningstrackedbyOutpatientImaging

PotentialPartners:• Communitycompanies/employers(healthfairs,talks,screenings)• Areaschools(healthfairs,talks,screenings)• Communityorganizationsthatworkwithlowincomepatients(e.g.TheRose,InterfaithCommunityClinic)• Areaphysicians(togivetalks,beathealthfairs,and/orpromotefreeorlowcostprograms,likeInthePinkandLungCancerCTscanstotheirpatients)


ObesityPreventionObjective1.2IncreaseeducationalofferingsthatpromotehealthyeatingandexerciseOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target


Events:40annually

Attendees:500

28annually

Attendees4,000

Events:25(6healthfairs,

19talks)

Attendees:3,339

Events:32(annually)

Attendees:4,200(5%annually)

• NumberofSupportGroups,numberofattendees(See1.1)

See1.14groups

Attendees:700

3groups

Attendees:740

5groups

Attendees:800

• Numberofexerciseclasses,fooddemonstrationsandhealthyfoodeducationforcancersurvivorsandfamily

EstablishbaselineinY1

8Events

Attendees:1,000

10events

Attendees:1,389

10Events

Attendees:1,200


Year1,2,31.2.1: Conductnocostsupportgroupsforweight

lossandforconditionswhereobesityplaysarole-diabetes,heartdisease,andstroke

4groups 3groups

1,2,3

1.2.2: Providefacilitieson-campusforCanopyprogramtoconductexerciseclassestocancersurvivorsandtheircaregivers(e.g.,yoga,ballroomdancing,linedancing,guidedmeditation,taichi)(See1.4.2)andfreefooddemonstrationsandeducationabouthealthyfoodoptionsforcancersurvivorsandfamiliesvianutritionistsanddietarystaff(See1.3.1)

Demokitchen,flexiblespaceforfitnessactivitiesorevents

Demokitchen,flexiblespaceforfitnessactivitiesorevents;haveexpandedthesetoinclude

childrenofacancer

survivortoo.

1,2,3




1.2.3: Provideeducation/awarenesshealthtalksatareaschoolsand/orlocalbusinesses

Healthfairscreenings:BMI,nutritionist,diabetesinfo,heartinfo,bloodpressureand/or

strokeriskassessments

Healthfairscreenings:

BMI,nutritionist,diabetesinfo,heartinfo,blood

pressureand/orstroke

riskassessments–traumaisalsoeducatingthepublicon

balanceandstrength.

1,2,3

Monitoring/EvaluationApproach:• Patient/participantexperiencesurveys• EventslogmaintainedbyMarketingManager&OccupationalMedicineLiaison• CanopyprogramsmaintainedbyCanopyCoordinator

PotentialPartners:• Communitycompanies/employers(healthfairs,talks,screenings)• Areaschools(healthfairs,talks,screenings)• Communityorganizationsthatworkwithlowincomepatients(e.g.InterfaithCommunityClinic)• Areaphysicians(togivetalks,beathealthfairs,and/orpromotefreeorlowcostprogramstotheirpatients)


AccesstoHealthyFoodObjective1.3:IncreaseeducationabouthealthyfoodstoimproveaccessandawarenessOutcomeIndicators: Annual

BaselineYear1 Year2 FY2020Target

• Poundsoffooddonatedtolocalfoodpantries

14,000lbs. Donated2,471lbsand$4,531incashdonated;thistranslatesto25,126lbsoffood

MemorialHermannfood

drivediscontinued

16,300lbs.total(5%annually)

• NumberofFarmer’sMarketsheld(numberofparticipanttransactions)

5sessions$1,750insalesonavg

/session

5events,$1,750avg/session–8/16$1,400insales;9/16$2,100;10/16$1,700;3/17$1,900;and4/17$1,800

5sessionsMay31,April5,Nov.17,Oct.26,Sept.27

Sessions:3totalSalesof$2,000/session

• Numberoffooddemonstrationsandhealthyfoodeducationforcancersurvivorsandfamily

8evemtsAttendees:

637

8events,637attendees–cookingdemos70attendess;Oncologynutrition117,Cookingtogether(kids)60;Special

Functionswithhealthyfoods(endofyearsurvivorevents120,BreastFriendsChristmasparty130,Valentine’sTea42,Cinco

deMayoFiesta98

41totalevents489attendees• EatingWell

ThruCancer

• CookingDemos

• OncologyNutrition

• CookingTogether• ValTea• Cincode

MayoChristmas

10eventsAttendees800


Events:40annually

Attendees:500

Xreferenceto1.2.1.

Events:40(annually)Attendees:580(5%annually)

• NumberofSupportGroups,numberofattendees(See1.1)

See1.1 Xreferenceto1.1.1

See1.1

• Numberofattendeesatweeklybreastfeedingsupportgroup

26weekly 34 26weekly





Year1,2,31.3.1: Nutritionistsand

dietarystaffprovidefreefooddemonstrationsandeducationabouthealthyfoodoptionsforcancersurvivorsandfamiliesviatheprogramatCanopy(Seestrategy1.2.2)

Canopycancersurvivorshipcenterhasademokitchen,flexiblespaceforfitnessactivitiesorevents.

AtCanopy,suppliesandfoodarepaidforusingFoundationmonies;thisiswhytherearenochargesinthoseareas

Canopycancersurvivorshipcenterhasademokitchen,flexiblespaceforfitnessactivitiesor

events.

AtCanopy,suppliesandfoodarepaidforusingFoundationmonies;thisiswhythereareno

chargesinthoseareas1,2,3

1.3.2: CollectfoodtosupportfoodpantriesorspecialeventshostedbycommunitypartnerssuchastheMontgomeryCountyFoodBankand/orInterfaithFoodPantry

DonatedtotheInterfaithFoodBank–webrokea6-yrrecordinFY17! NofooddriveinFY18.

1,2,3

1.3.3: OfferFarmer’sMarketson-campusforstaff,patients,patientfamilies,andcommunitymembers

HeldintheHealingGardenattheCampusandonceintheCafeteriaduetorain.

HeldintheHealingGardenattheCampusandonceintheCafeteriaduetorain.Therewasanattempttoextendthefarmer’smarketinpartbysettingupproducebinsintheCafeteria.Thiswasnotoverlysuccessful,andalsoourcafeteriaisverysmallandcrowdedandlinescanbelong.

NofinancialsalesdatareceivedforFY18bydeadline

2,3




1.3.4 Provideeducation/awarenesshealthtalksatareaschoolsand/orlocalbusinesses(Seestrategy1.1.1)

TOTALSFY17:943peopleserved/15events

TOTALS:604attendees/13events-HalliburtonSeries:NavigatingNutritionLabels(9/1/16,46,2shr)

-HuntsmanCorp.Talks(2-3locationsrotating):DiabetesPreventions(PlantSite,7/26,32,2vhr,1shr);DiabetesPrevention(9/2,81,2vhr,1shr);StressMgt.(PlantSite,11/1,29,2shr);StressMgt.(2/24/17,84,2shr);Diabetes(3/15,45,2vhr,1shr);CholesterolMgt(PlantSite,3/28,38,2v

hr,1shr);ColorectalCancer(6/14,35,2vhr,1shr).

-StrikeCorp.Talks:Diabetes(8/2/16,37,2vhr,1shr);Men’sHealth(9/6,48,6vhr,2shr);Women’sHealth(10/4,35,6vhr,2shr);HeartHealth&CholesterolBabyFair:200attendees(freeeventandincludedinPriority1);MHTWhas9lactationconsultantsandoneispresentforsupportgroups

DonationtoMealsonWheels,plusstaffworkingondistributionandsharingintoonpreventingslips,tripsandfalls(majorcauseoftrauma).

(11/1,54,2vhr,1shr);NutritionTrends&Fads(12/6,40,3shr)

MealsonWheels:BronzeSponsorofMilesforMeals$1,000contributionHelpsfeed139seniorsameal.

10thAnnualBabyFairforExpectant,New&ExperiencedParents(8/6/16,200)breastfeedingpromotion,WIC,LaLecheLeague,Mother'sMilkBankof

Austin

TOTFY18:961ppl/8events

• HuntsmanTalks

• SeniorWoodlandsTownshipTalks

• LoneStarCollegeAdultLifelongLearning:DocTalks

• CanopyDocTalks

• PelvicFloorCommunityTalk

• HeartHealthyTalk

• TraumaSymposium

NationalNightOutatAuburnLakes(firstaidandhealthinfogivenout

1,2,3




1.3.5 Provideeducation/awarenessonbreastfeedingbenefitsformotherandbaby(nutrition,bonding,lowcostalternativetoformula,immunityboosting,etc.)viaBabyFairandbreastfeedingsupportgroup

Supportgroupsmeetinperinatalclassroombehindlactationcenterandsupportgroupsarefacilitatedbyalactationconsultantnurse

Supportgroupsmeetinperinatalclassroombehindlactationcenterandsupportgroupsare

facilitatedbyalactationconsultantnurse

NoBabyFairinFY18.

1,2,3

31weeklyattendeesAllAboutMomsSupportGroup:15

momsweeklyonavg.

AdventuresinBreastfeedingSupportGroup:16

momsweeklyonavg.

Monitoring/EvaluationApproach:• Patient/participantexperiencesurveys(PatientSatisfactionsurveyonhospitalfood)• EventslogmaintainedbyMarketingManager,OccupationMedicineLiaison,andOncologyNurseNavigator• FoodBankreport




PotentialPartners:• InterfaithFoodPantry;MontgomeryCountyFoodBank• Communitycompanies/employers(healthfairs,talks)• Areaschools(healthfairs,talks)• Communityorganizationsthatworkwithlowincomepatients(e.g.InterfaithCommunityClinic)• Areaphysicians(togivetalks,beathealthfairs,and/orpromotefreeorlowcostprogramstotheirpatients)• Localgrowersoffreshproduce/farmers


Timefor/SafetyDuringPhysicalActivityObjective1.4:Increasetheavenuesforthecommunitytoparticipateinactivitiesthatpromotesafephysicalactivity

OutcomeIndicators: AnnualBaseline

Year1 Year2 FY2020Target

• Numberofeventswhereweprovidemedicalsupport/athletictrainers

350Events FY17:414events395athleticeventsatschoolswhereMHTWprovided

AthleticTrainercoverage;19communityeventswhereATs,firstaidandaphysicianwereprovidedformedical

coverage

52freeinjuryscreeningsatISMIforschoolageathletes

3,900studentphysicalswhereanominalfeewaschargedandallfundsweredonatedbacktotheschoolsintheformofadonationfromMHTW…inFY17thistotaled$82,365

350Events

• Numberofeducationaltalks/eventslikehealthfairs(handoutswithpreventativeinformation);numberofattendees(Seealso1.2,1.3,1.4)

Events:40annually

Attendees:500

Events:40

(annually)Attendees:580(5%

annually)• Numberofexerciseclassestocancersurvivorsandtheircaregivers

Events:8Attendees1,000

12events,1,665attendees

CookingandNutritionrelatedofferingsatCanopyinFY17:cookingdemos70attendees,oncologynutrition117;

CookingTogether(kids)60;specialfunctionswithhealthyfoods(endofyrsurvivorevent120,BreastFriends

Christmasparty130,Valentine’sTea42,CincodeMayoFiesta98)

FitnessrelatedclassesatCanopyCancerSurvivorshipCenterinFY17:dancing35attendees,Pilates40,Yoga754,

TaiChi199

10events

Attendees:1,389• Yoga• TaiChi• Pilates

• GuidedMeditation• EatingWellThruCancer

• CookingDemos• OncologyNutrition• CookingTogether• ActiveAfterCancer• CancerRehab

Events:10

Attendees:1,200




• Financialsupportofwalk/runs

4Events FY17:15eventsAmericanHeartAssoc.HeartWalk:Nov.2016,$5,000contribution,ourMHTWstaffteamsraisedanother

$21,000!

ConroeISDKidsRunningforKids:$500contribution

Leukemia&LymphomaSociety’sLighttheNight:Oct.2016,$5,000contribution

MultipleSclerosisSociety’sWalkMS:Oct.2016,$1,000contribution

WoodlandsUnitedMethodistSchool’sWalk/Run:$500contribution

ResolveWalkofHope(Infertility):$500contribution

MarchofDimes’MarchforBabies:$3,500contribution,plusourMHTWstaffteamraisedanother$8,700

YMCA’sDragonBoatRaces:FirstAidcoveragefor4daysandtwoteamscametoa$4,800contribution(fundsraised

benefitYMCAmembershipsforlowincomefamilies)

YMCARunThruTheWoods:$6,500contributionandincludedFirstAidcoverageatThanksgivingmorning5K(fundsraisedalsobenefitYMCAmembershipsforlow

incomefamilies)

CB&ITri:$9,168contribution

10forTexas:Oct.2016,$9,166contribution

MuddyTrails:$9,166contribution

AmericanCancerSociety’sRelayforLife:$1,000contribution

WoodforestCharityRun:$750contribution

BirdiesforParkinsonsGolfTournament:$2,000contribution

15EventsFY18EventsandContributions:

• AHAHeartWalk$5K• CISDKidsRunningforKids$500

• L&LSLighttheNight$5K• WalkMS$1K

• WUMWalkRun$500• WalkofHope$500

• MoDMarchforBabies$3.5K• YMCADragonBoatRaces$4.8K

• YMCARunThruTheWoods$9,166• CB&ITri$9,166

• MuddyTrails$9,166• 10forTexas$9,166• RelayforLife$1K

• WoodforestCharityRun$750BirdiesforParkinson’s$2K

Total:$61,214.00

4Events





Year1,2,3

1.4.1: Providefinancialsupporttofour(4)runs;10forTexas,CBITri,MuddyTrailsandRunThruTheWoodsinthecommunity

ThesefourarepartofTheWoodlandsTownshipsponsoredruns,butwecontributeand/orparticipateinfarmore

(listedabove).

ThesefourarepartofTheWoodlandsTownshipsponsoredruns,butwecontributeand/orparticipateinfarmore(listedabove).

1,2,3

1.4.2: Providefacilitieson-campusforCanopyprogramtoconductexerciseclassestocancersurvivorsandtheircaregivers(e.g.,yoga,ballroomdancing,linedancing,guidedmeditation,taichi)(See1.2.2)

InFY17,alsoperformed52freeinjuryscreeningsforstudentathletesinourISMIClinic.

10events

Attendees:1,3891,2,3

1.4.3:Providemedicalsupport/trainerpresenceandfirstaidsuppliesatcommunitysportingeventsandotherannualevents(runs,walks,andclubs)

Weperformed3,900studentphysicalsatanominalfee,whichweinturndonatedBACKtotheschools.Areaschoolsreceivedatotalof$82,365fromMemorial

Hermannfromthesephysicals.

Weperformedcardiacscreeningsforstudentsingrades7-12atanominalcost.63studentstookadvantageatTheWoodlandsHighSchooland2ofthosewerereferredto

affiliatedpedicardiologistFaustinoRamos,MD

Wedidcontinuetoperformschoolphysicalsforanominalfeeanddonatedbacktoindividual

schools.

Wealsocontinuedtoperformcardiacheartscreeningsforstudentsatanominalcharge.

1,2,3




1.4.4: Conducteducation/awarenesshealthtalksatareaschoolsand/orlocalbusinesses(Seestrategy1.1.1)

TOTFY18:961ppl/8events

• HuntsmanTalks

• SeniorWoodlandsTownshipTalks

• LoneStarCollegeAdultLifelongLearning:DocTalks

• CanopyDocTalks

• PelvicFloorCommunityTalk

• HeartHealthyTalk

• TraumaSymposium

NationalNightOutatAuburnLakes(firstaidandhealthinfogivenout)

1,2,3

Monitoring/EvaluationApproach:• Participantexperiencesurveys• EventslogmaintainedbyMarketingManager,OccupationalMedicineLiaisonandOncologyNurseNavigator

PotentialPartners:• Communitycompanies/employers(healthfairs,talks)• Areaschools(healthfairs,talks)• Areaphysicians(togivetalks,beathealthfairs,and/orpromotefreeorlowcostprogramstotheirpatients)


ChronicDiseaseManagement:Objective1.5: Providesupporttothoseimpactedwithachronicdiseasetohelpthemeffectivelycontrolandmonitortheirprogress.OutcomeIndicators: Annual

BaselineYear1 Year2 FY2020Target

• Numberofeducationaltalks/events,suchashealthfairs(handoutswithpreventative

information);numberofattendees(Seealso1.2,1.3,1.4)

Events:6annually

Attendees:300

FY17:309attendees/6events-WoodlandsTownshipSeniorCommunityTalks:

Arthritis(9/30,79,2vhr,1shr)-HuntsmanCorp.Talks(2-3locationsrotating):DiabetesPrevention(PlantSite,7/26,32,2vhr,1shr);DiabetesPrevention(9/2,81,2vhr,1shr);Diabetes(3/15/17,45,2vhr,1shr);andColorectalCancer(6/14,35,2vhr,1shr).

-StrikeCorp.Talks:Diabetes(8/2/16,37,2vhr,1shr)

Events:8Attendees:350




• NumberofSupportGroups,numberofattendees.(See1.1)

8groupsAttendees:

1000

FY17:12groups/2,310attendees-MendedHearts:9/15/1641attendees;11/740;1/19/1718;3/1618;and5/1818(10shrtotal);

$1,080catering-DiabetesSupportGroup:7/138;8/1810;9/1413;10/208;11/917;12/1512;1/11/1716;2/8

9;4/2022;5/311;6/147(22staffhrs)-WeightLossSupportGroup:Meets2xmo,

about18-20attendees/session456attendees(12vhr)

-Parkinson’sSupportGroup:Meetsmo,7-15attendees/session…144attendees(14shr)

-MultipleSclerosis(MS)SupportGroup:Meetsmo,10-15attendees/session…144attendees

(14shr)-DysautonomiaSupportGroup:Meetsmo,2-4attendees/session…36attendees(14shr)

-CancerEducation&-CancerWidowsSupportGroup:42attendeesforFY17(14shr)

-LookGood,FeelBetter(Cancer):57attendeesforFY17(14shr)

-ArtTherapySupportGroup(Cancer):644attendeesforFY17(14shr,18vhr)SupportGroup:222attendeesforFY17(14shr)

-CancerCoffee&Chatting:252attendeesforFY17(14shr)

-TealTalesOvarianCancerSupportGroup:45attendeesforFY17(14shr)

10groupsAttendees:1,250

• Numberofpatientsreceivingfreeprosthetics,wigsandscarves

126 FY17:88items64wigs,24breastprosthesis,and22scarves

providedfreeofcharge

FY18:92items

Wigsandprosthesis,plus26scarves

168(10%annually)





Year1,2,31.5.1: Conducteducation/awarenesshealthtalks

atareaschoolsand/orlocalbusinesses(Seestrategy1.1.1)

1,2,3

1.5.2: Conductnocostsupportgroupsforweightlossandforconditionswhereobesityplaysarole-diabetes,heartdisease,andstroke(Seestrategy1.2.1)

1,2,3

1.5.3 ProvideNurseOncologyNavigatorsupportand/orCanopycoordinatorsupporttofitpatientswithfreeprosthesis,wigsandscarvesprovidedbyCanopy

Canopycancersurvivorshipcenterhasasalonlikeroomforshavingparties,wigfittings,

scarvesandprosthesisfittings

Canopycancer

survivorshipcenterhasasalonlikeroomforshaving

parties,wigfittings,

scarvesandprosthesisfittings

1,2,3

Monitoring/EvaluationApproach:• Patient/participantexperiencesurveys• EventslogmaintainedbyMarketingManager&OccupationalMedicineLiaison• OncologyNurseNavigatortomaintainlogofprosthetics,wigsandscarves

PotentialPartners:• Communitycompanies/employers(healthfairs,talks)• Areaschools(healthfairs,talks)• Areaphysicians(togivetalks,beathealthfairs,and/orpromotefreeorlowcostprogramstotheirpatients)


Priority2:AccesstoHealthCare

Priority2: HEALTHCAREACCESS

Goal2: Improveaccesspointstoprimarycareandspecialtyprovidersbyreducingbarriers.

AvailabilityofPrimaryCareandSpecialtyProvidersObjective2.1: IncreasethenumberofprimarycareandspecialtycareprovidersinlocalsettingsOutcomeIndicators: AnnualBaseline Year1 Year2 FY

2020Target

• Numberofhospital'sassociatedcounties'callstoNurseHealthLine(Montgomery,WalkerandHarris)(See2.4.1)

30,089 30,130Top3adultconcerns:abdominalpain,vaginalsymptomsandchestpain.

Top3pediatricconcerns:fever,vomitingandcoughing.

31,407 30,089

• PeopleservedthroughInterfaithCommunityClinic 2,107patients8,681visits

$682,275incharitycare2,190patients

NumberofVisits:9,686

$685,059.25incharitycare

2,184patientsNumberofVisits:

9,846

2,212patients

9,115visits

• Numberoftelemedicineconsultations 275/year(in2015) FY17Total:324Stroke:284

PediatricSurgery:40

FY18Total:282Stroke:266

PediatricSurgery:16

275/year

Strategies:

Year1Notes Year2Notes Timeline:Year1,2,3




2.1.1:Providea24/7freeresourceviatheNurseHealthLinethatcommunitymembers(uninsuredandinsured)withintheMHHScommunitycancalltodiscusstheirhealthconcerns,receiverecommendationsontheappropriatesettingforcare,andgetconnectedtoappropriateresources.(see2.4.1)

Morethan46%ofallpatientsseenintheEmergencyRoomarethereforPrimaryCare

relatedconditions.

Open24/7,365daysayearwithEnglishandSpanish-

speakingRNs

AccordingtotheNurseHealthLine,78%whowouldhave

gonetotheERforcare…wereredirectedtoprimarycare

AlsoaccordingtotheNurseHealthLine,ofthosethatwere

triagedbytheRNonthephone,49%weredirectedtoPCP,33%totheER,and18%to

self-careathome

1,2,3

2.1.2:ProvidefundingsupportfortheInterfaithCommunityClinicwhichprovidesfreecaretounderservedpopulations.

TheClinicislocatedacrossI45fromMHTW.

TheClinicislocatedacrossI45from

MHTW.1,2,3




2.1.3:Providetelemedicineconsultsfreeofchargeforstrokeandpediatricsurgerypatients,todetermineifadditionaltransferandassociatedexpenseisnecessaryorcouldbeavoided(See2.3.2)PeditelemedicineconsultsintheERandintheNICU;ofthe

40,only9hadtobetransferredtoCMHHintheTMC;21wereadmittedor

stayedadmittedatMHTW;and10weretreatedandd/cto

home

StrokeConsultsintheERwiththeTMC;ofthoseconsults,27weregiventPAand13were

transferredtotheTMC

1,2,3

Monitoring/EvaluationApproach:• Patient/participantexperiencesurveys• InterfaithCommunityClinicfeedback• ERvisitsandInterfaithCommunityClinicfundingtrackedthroughfinance• TelemedicineconsultsmaintainedintheER• NurseHealthLinecalls

PotentialPartners:• Governmentrelationsoffice• Areaphysicians(togivetalks,beathealthfairs,and/orpromotefreeorlowcostprogramstotheirpatients)• MemorialHermannCommunityBenefitCorporation


HealthInsuranceCoverageandCostsObjective2.2IncreasehealthinsurancecoverageforuninsuredandunderinsuredpopulationsOutcomeIndicators: AnnualBaseline Year1 Year2 FY

2020Target

NumberofpeoplesuccessfullyinsuredthroughRCA

1,400patientsscreened

1,842patientsscreened.Atotalof678ofthese

patientswereabletobeplacedintoaprogramtoassistthemwithmedical

costs.

1,230patientsscreened.Atotalof584ofthesepatientswere

abletobeplacedintoaprogramtoassistthemwith

medicalcosts

1,621

(5%annually)

Strategies: Year1Notes Year2Notes Timeline:Year1,2,3

2.2.1: ContractwithResourceCorporationofAmerica(RCA)toprovideservicestoincreaseinsurancecoverageforcommunity

RCAisathird-partyeligibilityvendor(paidbyMHTW)toassistpatientswiththe

applicationprocessforMedicaid,CountyIndigent,AffordableCareActInsuranceExchange,andotherthird-partypayors.

Ofthosescreened:55placedintoMedicaidforAged&Disabled;240intoCountyprograms;273intotraditionalMedicaid;96

intoSocialSecDisability;14intoVVC(CrimeVictims’

Assistance)

Placedamong:MedicaidforAged&Disabled;County

programs;traditionalMedicaid;SocialSecDisability;VVC(Crime

Victims’Assistance

1,2,3

Monitoring/EvaluationApproach:• LogofinsuredthroughRCA

PotentialPartners:• CaseWorkers


TransportationObjective2.3:ReducethebarrieroftransportationtomoreefficientlyaccesshealthcareservicesOutcomeIndicators:

AnnualBaseline Year1 Year2 FY2020Target

• Numberofpatientswhodidnotneedtobetransferredduetotelemedicineconsults

Stroke200Pediatric–Establish

baselineinY140

PeditelemedicineconsultsintheERandintheNICU;ofthe40,only9hadtobe

transferredtoCMHHintheTMC;21wereadmittedorstayedadmittedatMHTW;and10weretreatedand

d/ctohome

284StrokeConsultsintheERwiththeTMC;ofthoseconsults,27weregiventPAand13weretransferredto

theTMC

Stroke231(5%annually)Pediatric(once

baselineestablishe

d)50

• Numberofvouchersused 182 211 240 211(5%annually)

Strategies: Year1Notes Year2Notes Timeline:Year1,2,3

2.3.1:Providetransportationvouchersforpatientstoreturnhomefollowingcare Averageof18taxivoucherspermonthperOARichard

Smedley,RN

Averageof20taxivoucherspermonthperOARichardSmedley,RN

1,2,3

2.3.2:Providetelemedicineconsultsfreeofchargeforstrokeandpediatricsurgerypatients,todetermineifadditionaltransferandassociatedexpenseisnecessaryorcouldbeavoided(See2.1.3)

231 2621,2,3

Monitoring/EvaluationApproach:• Patientexperiencesurveys• TelemedicineconsultsmaintainedintheER• Vouchercountmaintainedbycasemanagement

PotentialPartners:• Areaphysicians(topromotefreeorlowcostprogramstotheirpatients)• Communityorganizationsthatworkwithlowincomepatients(e.g.TheRose,InterfaithCommunityClinic)


HealthCareNavigationObjective2.4: ConnectpatientstoresourcestohelpthembetternavigatethehealthcaresystemOutcomeIndicators: AnnualBaseline Year1 Year2 FY2020

Target

• Numberofhospital'sassociatedcounties'callstoNurseHealthLine(Montgomery,Walker,andHarris)(See2.1.1)

30,089 30,130Top3adultconcerns:abdominalpain,vaginalsymptomsandchestpain.Top3pediatricconcerns:

fever,vomitingandcoughing.

31326

30,089

• Numberofpatientnavigators 1 1 2 1-2Strategies: Year1Notes Year2Notes Timeline:

Year1,2,32.4.1: Providea24/7freeresourceviatheNurseHealthLinethatcommunitymembers

(uninsuredandinsured)withintheMHHScommunitycancalltodiscusstheirhealthconcerns,receiverecommendationsontheappropriatesettingforcare,andgetconnectedtoappropriateresources(See2.1.1)

1,2,3

2.4.2: Increasenumberofpatientnavigatorstoprovideservicestoourcancerpatients Stilljusttheone–CarolynAllsen,RNwhoisnow

officedinCanopy(CancerSurvivorshipCenter)

1,2,3

Monitoring/EvaluationApproach:• Patient/participantexperiencesurveys• NurseHealthLinecalllog

PotentialPartners:• Areaphysicians(togivetalks,beathealthfairs,and/orpromotefreeorlowcostprogramstotheirpatients)• MemorialHermannCommunityBenefitCorporation


Priority3:BehavioralHealthThefollowingtablesprovidestrategiesandoutcomeindicatorsthatreflectanMHHSsystem-wideapproachtoBehavioralHealth.DataisnotspecifictoMHTheWoodlandsbuttothecommunityatlargewiththeexceptionofreductioninERencountersthatresultinapsychiatricinpatientstaythroughlinkageswithanetworkofbehavioralpartners.

Priority3: BehavioralHealth

Goal3: Ensurethatallcommunitymemberswhoareexperiencingamentalhealthcrisishaveaccesstoappropriatepsychiatricspecialistsatthetimeoftheircrisis,areredirectedawayfromtheER,arelinkedtoapermanent,communitybasedmentalhealthprovider,andhavethenecessaryknowledgetonavigatethesystem,regardlessoftheirabilitytopay.

Objective3.1: Createnontraditionalaccesspointsaroundthecommunity(crisis/ambulatory,acutecare,andcommunity-basedchroniccaremanagement),andlinkthosewhoneedservicestopermanentprovidersandresourcesinthecommunity

OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target• DecreaseinnumberofERencountersthatresultinpsychiatricinpatientstay

1,146 1,213 1,135 1,0895%reductionof

baseline• DecreaseinnumberofERencountersthatresultinpsychiatricinpatientstay–TheWoodlands

157 166 179 149

• NumberofMemorialHermannCrisisClinictotalvisits 5,400 5,590 5,590 5%overbaseline

• NumberofPsychiatricResponseCareManagementtotalvisits 1,200 1,103 1,259 5%overbaseline


Year1,2,33.1.1: Providementalhealthassessment,care,andlinkagetoservicesinanacutecaresetting,24x7

atTheWoodlandsAnuptickinacutecarevolumeoverthepastfiscalyearhascontributedtoahighernumberofpsychiatrictransfersoverall.

Anincreaseinacutecarevolumeandnumberofacutecaresitesoverthepastfiscalyearhavecontributedtoahighernumberof

psychiatrictransfersoverall.

1,2,3




3.1.2: Createnontraditionalcommunityaccesstopsychiatricprovidersforindividualsexperiencingamentalhealthcrisis.ClinicalSocialWorkersconnectthetargetpopulationtoon-goingbehavioralhealthcare

Recruitingmentalhealthproviders

willingtocommittoanon-traditionalscheduleremainsachallenge.Continuingthisurgentcaremodeloftreatmentremainsapriority,duetolimitedmentalhealth

treatmentaccessinthecommunity.

1,2,3

3.1.3: Engageindividualswithachronicmentalillnessandworktomaintainengagementwithtreatmentandstabilityinthecommunityviaenrollmentincommunity-basedmentalhealthcasemanagementprogram

Staffingissuesimpededyearonetarget.Identifyingappropriatelylicensedclinicianswillingtoconsideracareerthatiscommunitybasedwiththerequirementofmakinghomevisitsandworkingnon–traditionalhoursisanongoingchallenge.

CaseManagerspartnerwiththeirclientstoidentifyspecificrecoverygoalsandutilizeevidence-basedpracticesto

facilitateclientachievement.Wecontinuetopartnerwithcommunity

providerstoaddressthementalhealth

needsoftheGreaterHoustonCommunity.

1,2,3

Monitoring/EvaluationApproach:• EMR/registrationsystem(trackandtrenddaily,weekly,monthly)




PotentialPartners:• Systemacutecarecampuses• MemorialHermannMedicalGroup• Networkofpublicandprivateproviders


Objective3.2: Reducestigmainordertopromotementalwellnessandimprovecommunityawarenessthatmentalhealthispartofphysicalhealthandoverallwell-being

OutcomeIndicators:AnnualBaseline Year1 Year2 FY2020

Target• Numberofpresentations/educationalsessionsforhealthcareprofessionalswithinMHHS 50sessionsperyear 63 71

5%increaseoverbaseline

• Numberofpresentations/educationalsessionsforcorporations5 7 8

5%overbaseline

• TWStressmanagement(totaltimeincludestrainingmaterialdevelopmentandimplementation)

1training(6.5hours)*

0

1 1training(6.5hours)*

• TrainingonAcuteCareConcepts-systemnurseresidentprogram 15trainings(45hourstotal/3hourseach)*

18 9

15trainings(45hours

total/3hourseach)*

• TrainingonCMORoundtable-system-wide1training(2hours)* 0 4

1training(2hours)*

*Totaltimeincludestrainingmaterialdevelopmentandimplementation 531.6 Strategies: Year1

NotesYear2Notes

Timeline:Year1,2,3

3.2.1: ProvidementalhealtheducationsessionswithintheMHhealthsystemfornursesandphysicians

1,2,3

3.2.2: WorkwithemployersolutionsgrouptoprovideeducationandtrainingwithcorporationsonMHtopics(stress,PTSD)

1,2,3

Monitoring/EvaluationApproach:• Requestsforpresentationsandsessionstrackedviacalendar/excel

PotentialPartners:• Systemacutecarecampuses• SystemMarketingandCommunications• Employersolutionsgroup


Objective3.3: Qualityofmentalhealthandsubstanceabuseservices:access,link,andpracticeutilizingevidence-basedpracticetopromoteoverallwellness

OutcomeIndicators: AnnualBaseline Year1 Year2 FY2020Target• NumberofMemorialHermannCrisisClinicfollow-upspostdischargewithclinicpatients

7,716 6,431 5,154 5%overbaseline

• PsychiatricResponseCaseManagementreductioninsystemERutilization 54.4% 53.0% 50% 5%increaseoverbaseline


Year1,2,33.3.1: Socialworkersfollow-upwithdischargedpatientsandtheirfamiliestoassesswell-being

andconnectthemtocommunityresourcesThegoalistocontinuetoeducatethecommunity,includingotherhealthsystems,aboutthecrisiscliniclevelofcaresothatwhensomeoneisexperiencingamentalhealthcrisisorneedsimmediateaccesstoabehavioralhealthprovider,theclinicwillbetheidentifiedreferralsource.

TheSystemhasseenanoverallincreaseinpatientacuitywithcomplexphysicalandbehavioralhealthneedsrequiringhigherlevelsofcare.TheCrisisClinicandPsychResponseCaseManagementProgramscontinuetomeettheneedsofpatientswithbehavioralhealthconditionsbyprovidingimmediateaccesstoamentalhealthprovider.

1,2,3




3.3.2: PsychiatricResponseCaseManagementProgramutilizesevidence-basedpracticeinterventions(motivationalinterviewing,MHFirstAid,CAMS,etc.)toreduceERutilizationforprogramenrollees

CaseManagerscontinuetopartnerwithcommunity

agenciesinanefforttoconnectprogram

enrolleestoresourcesfor

ongoingwellness.Programclinicianscontinuetouseevidence-based

practiceinterventionsto

reduceERutilizationandimprovequality

oflife.

1,2,3

Monitoring/EvaluationApproach:• Socialworklogs(Excelspreadsheet)

PotentialPartners:• Systemacutecarecampuses• Community-basedclinicalproviders• Networkofpublicandprivateproviders


AppendixB.SecondaryDataMethodology

SecondaryDataSourcesThemainsourceforthesecondarydata,ordatathathavebeenpreviouslycollected,isthecommunityindicatordatabasemaintainedbyConduentHealthyCommunitiesInstitute.ThefollowingisalistofbothlocalandnationalsourcesusedinMemorialHermannTheWoodlands’CommunityHealthNeedsAssessment.

HarrisCounty1. AmericanCommunitySurvey2. AmericanLungAssociation3. CentersforMedicare&MedicaidServices4. CountyHealthRankings5. FeedingAmerica6. InstituteforHealthMetricsandEvaluation7. NationalCancerInstitute8. NationalCenterforEducationStatistics9. SmallAreaHealthInsuranceEstimates10. TexasBehavioralRiskFactorSurveillanceSystem11. TexasDepartmentofFamilyandProtectiveServices12. TexasDepartmentofStateHealthServices13. TexasEducationAgency14. TexasSecretaryofState15. U.S.BureauofLaborStatistics16. U.S.Census-CountyBusinessPatterns17. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas18. U.S.EnvironmentalProtectionAgency

MontgomeryCounty1. AmericanCommunitySurvey2. AmericanLungAssociation3. CentersforMedicare&MedicaidServices4. CountyHealthRankings5. FeedingAmerica6. InstituteforHealthMetricsandEvaluation7. NationalCancerInstitute8. NationalCenterforEducationStatistics9. SmallAreaHealthInsuranceEstimates10. TexasDepartmentofFamilyandProtectiveServices11. TexasDepartmentofStateHealthServices12. TexasEducationAgency13. TexasSecretaryofState14. U.S.BureauofLaborStatistics


15. U.S.Census-CountyBusinessPatterns16. U.S.DepartmentofAgriculture-FoodEnvironmentAtlas17. U.S.EnvironmentalProtectionAgency


SecondaryDataScoring

Datascoringisdoneinthreestages:

Foreachindicator,eachcountyinMemorialHermannTheWoodlands’serviceareaisassignedascorebasedonitscomparisontoothercommunities,whetherhealthtargetshavebeenmet,andthetrendoftheindicatorvalueovertime.Thesecomparisonscoresrangefrom0-3,where0indicatesthebestoutcomeand3theworst.Availabilityofeachtypeofcomparisonvariesbyindicatorandisdependentuponthedatasource,comparabilitywithdatacollectedforothercommunities,andchangesinmethodologyovertime.

Indicatorsarecategorizedintotopicareasandeachtopicareareceivesascore.Indicatorsmaybecategorizedinmorethanonetopicarea.Topicscoresaredeterminedbythecomparisonsofallindicatorswithinthetopic.

ComparisontoaDistributionofCountyValues:WithinStateandNation

Foreaseofinterpretationandanalysis,indicatordataontheCommunityDashboardisvisuallyrepresentedasagreen-yellow-redgaugeshowinghowthecommunityisfaringagainstadistributionofcountiesinthestateortheUnitedStates.Adistributioniscreatedbytakingallcountyvalueswithinthestateornation,orderingthemfromlowtohigh,anddividingthemintothreegroups(green,yellow,red)basedontheirorder.Indicatorswiththepoorestcomparisons(“inthered”)scoredhigh,whereasindicatorswithgoodcomparisons(“inthegreen”)scoredlow.

Comparisons • Quantitatively

score all possible comparisons

Indicators • Summarize

comparison scores for each indicator

Topics • Summarize

indicator scores by topic area


ComparisontoValues:State,National,andTargets

Eachcountyiscomparedtothestatevalue,thenationalvalue,andtargetvalues.Targetvaluesincludethenation-wideHealthyPeople2020(HP2020)goals.HealthyPeople2020goalsarenationalobjectivesforimprovingthehealthofthenationsetbytheDepartmentofHealthandHumanServices’(DHHS)HealthyPeopleInitiative.Forallvaluecomparisons,thescoringdependsonwhetherthecountyvalueisbetterorworsethanthecomparisonvalue,aswellashowclosethecountyvalueistothetargetvalue.

TrendOverTime

TheMann-Kendallstatisticaltestfortrendwasusedtoassesswhetherthecountyvalueisincreasingovertimeordecreasingovertime,andwhetherthetrendisstatisticallysignificant.Thetrendcomparisonusesthefourmostrecentcomparablevaluesforthecounty,andstatisticalsignificanceisdeterminedatthe90%confidencelevel.Foreachindicatorwithvaluesavailableforfourtimeperiods,scoringwasdeterminedbydirectionofthetrendandstatisticalsignificance.

MissingValues

Indicatorscoresarecalculatedusingthecomparisonscores,availabilityofwhichdependsonthedatasource.Ifthecomparisontypeispossibleforanadequateproportionofindicatorsonthecommunitydashboard,itwillbeincludedintheindicatorscore.Afterexclusionofcomparisontypeswithinadequateavailability,allmissingcomparisonsaresubstitutedwithaneutralscoreforthepurposesofcalculatingtheindicator’sweightedaverage.Wheninformationisunknownduetolackofcomparabledata,theneutralvalueassumesthatthemissingcomparisonscoreisneithergoodnorbad.

IndicatorScoring

Indicatorscoresarecalculatedasaweightedaverageofallincludedcomparisonscores.Ifnoneoftheincludedcomparisontypesarepossibleforanindicator,noscoreiscalculatedandtheindicatorisexcludedfromthedatascoringresults.

TopicScoring

Indicatorscoresareaveragedbytopicareatocalculatetopicscores.Eachindicatormaybeincludedinuptothreetopicareasifappropriate.Resultingscoresrangefrom0-3,whereahigherscoreindicatesagreaterlevelofneedasevidencedbythedata.Atopicscoreisonlycalculatedifitincludesatleastthreeindicators.


DataScoringResults Thefollowing tableslisteachindicatorbytopicareaforeachofthecountiesinMemorialHermannTheWoodlands’servicearea.SecondarydataforthisreportareuptodateasofNovember2,2018.


HarrisCounty

SCORE ACCESSTOHEALTHSERVICES UNITSHARRISCOUNTY HP2020 TEXAS U.S.

MEASUREMENTPERIOD HIGHDISPARITY* Source

2.00AdultsUnabletoAffordtoSeeaDoctor percent 22.1 18.3 12.1 2015 10

1.81 ChildrenwithHealthInsurance percent 89.4 100 90.3 2016 9

1.75AdultswithHealthInsurance:18-64 percent 74.7 100 77.4 2016 9

1.75 PersonswithHealthInsurance percent 79.3 100 81.4 2016 9

1.61 PrimaryCareProviderRateproviders/100,000

population 57.2 59.9 75.5 2015 4

1.44 MentalHealthProviderRateproviders/100,000

population 103.7 98.8 214.3 2017 4

1.00Non-PhysicianPrimaryCareProviderRate

providers/100,000population 72.2 66.8 81.2 2017 4

0.50 DentistRatedentists/100,000

population 66.3 55.9 67.4 2016 4

SCORE CANCER UNITSHARRISCOUNTY HP2020 TEXAS U.S.


2.53 CervicalCancerIncidenceRatecases/100,000

females 11 7.3 9.2 7.5 2011-2015

7

2.25Age-AdjustedDeathRateduetoBreastCancer

deaths/100,000females 23.2 20.7 20.2 20.9 2011-2015 Black 7

1.94 Cancer:MedicarePopulation percent 7.6 7.1 7.8 2015 3

1.58ColonCancerScreening:SigmoidoscopyorColonoscopy percent 57.6 62.3 2016 10

1.53Age-AdjustedDeathRateduetoProstateCancer

deaths/100,000males 19.8 21.8 18.1 19.5 2011-2015 7

1.39 BreastCancerIncidenceRatecases/100,000

females 113.2 111.7 124.7 2011-2015 7


1.33 ProstateCancerIncidenceRatecases/100,000

males 102.5 95.4 109 2011-2015 7

1.22Age-AdjustedDeathRateduetoColorectalCancer

deaths/100,000population 14.6 14.5 14.4 14.5 2011-2015 7

1.00 AllCancerIncidenceRatecases/100,000population 402.6 401.3 441.2 2011-2015 7

0.94Age-AdjustedDeathRateduetoCancer

deaths/100,000population 157.8 161.4 156.4 163.5 2011-2015 Black,Male 7

0.94 ColorectalCancerIncidenceRatecases/100,000population 38.8 39.9 38.1 39.2 2011-2015 7

0.89OralCavityandPharynxCancerIncidenceRate

cases/100,000population 10.9 10.9 11.6 2011-2015 7

0.50LungandBronchusCancerIncidenceRate


0.33Age-AdjustedDeathRateduetoLungCancer

deaths/100,000population 37.5 45.5 39 43.4 2011-2015 7

SCORE CHILDREN'SHEALTH UNITSHARRISCOUNTY HP2020 TEXAS U.S.


1.81 ChildrenwithHealthInsurance percent 89.4 100 90.3 2016 9

1.67 ChildFoodInsecurityRate percent 23.5 23 17.9 2016 5

1.50ChildrenwithLowAccesstoaGroceryStore percent 5.4 2015 17

1.11 SubstantiatedChildAbuseRatecases/1,000children 5.4 8.5 2017 11

SCORE DIABETES UNITSHARRISCOUNTY HP2020 TEXAS U.S.


1.67 Diabetes:MedicarePopulation percent 28.1 28.2 26.5 2015

3

1.44 AdultswithDiabetes percent 10.2 11.2 10.5 2016

10

0.92Age-AdjustedDeathRateduetoDiabetes

deaths/100,000population 20.2 21.7 21.2 2010-2014

Black,Hispanic,Male 12


SCORE ECONOMY UNITSHARRISCOUNTY HP2020 TEXAS U.S.


2.44 Homeownership percent 49.6 55 55.9 2012-2016 1

2.39 SevereHousingProblems percent 20.9 18.3 18.8 2010-2014 4

2.22StudentsEligiblefortheFreeLunchProgram percent 58.2 52.9 42.6 2015-2016 8

2.14MedianMonthlyOwnerCostsforHouseholdswithoutaMortgage dollars 534 467 462 2012-2016 1

2.11 SNAPCertifiedStoresstores/1,000population 0.6 2016

17

2.08 MedianHouseholdGrossRent dollars 937 911 949 2012-2016

1

2.06FamiliesLivingBelowPovertyLevel percent 14.4 13 11 2012-2016

AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,

Other 1

2.06 FoodInsecurityRate percent 16.6 15.4 12.9 2016 5

1.94UnemployedWorkersinCivilianLaborForce percent 4.4 4 4.1 July2018 15

1.89People65+LivingBelowPovertyLevel percent 11.3 10.8 9.3 2012-2016

Asian,BlackorAfricanAmerican,HispanicorLatino,Other,Female,75+ 1

1.81MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1504 1444 1491 2012-2016

1

1.67 ChildFoodInsecurityRate percent 23.5 23 17.9 2016

5

1.67ChildrenLivingBelowPovertyLevel percent 26 23.9 21.2 2012-2016


Other,<6 1

1.67 PeopleLivingBelowPovertyLevel percent 17.4 16.7 15.1 2012-2016AmericanIndianorAlaskaNative,Black 1


orAfricanAmerican,HispanicorLatino,Other,Female,<6,6-11,12-17,18-24

1.67 TotalEmploymentChange percent 2.4 3.2 2.5 2014-2015 16

1.50RentersSpending30%orMoreofHouseholdIncomeonRent percent 46.8 48 47.3 2012-2016 1

1.42PersonswithDisabilityLivinginPoverty(5-year) percent 25.4 25.1 27.6 2012-2016 1

1.33Low-IncomeandLowAccesstoaGroceryStore percent 6.3 2015 17

1.33PeopleLiving200%AbovePovertyLevel percent 61.6 62.8 66.4 2012-2016 1

1.08 MedianHousingUnitValue dollars 145600 142700 184700 2012-2016 1

0.97PersonswithDisabilityLivinginPoverty percent 22.9 24.2 26.6 2016 1

0.94FemalePopulation16+inCivilianLaborForce percent 59.8 57.7 58.3 2012-2016 1

0.94Population16+inCivilianLaborForce percent 68.3 64.2 63.1 2012-2016 1

0.89HouseholdswithCashPublicAssistanceIncome percent 1.5 1.6 2.7 2012-2016 1

0.67 HomeownerVacancyRate percent 1.5 1.6 1.8 2012-2016 1

0.50 MedianHouseholdIncome dollars 55584 54727 55322 2012-2016


Other 1

0.50 PerCapitaIncome dollars 29850 27828 29829 2012-2016

AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,NativeHawaiianor

OtherPacific 1


Islander,Other,TwoorMoreRaces

SCORE EDUCATION UNITSHARRISCOUNTY HP2020 TEXAS U.S.


1.92InfantsBorntoMotherswith<12YearsEducation percent 27.5 21.6 15.9 2013

12

1.89 Student-to-TeacherRatio students/teacher 16.4 15.4 17.7 2015-2016

8

1.67 HighSchoolDropOutRate percent 2.6 2 2016

13

1.67People25+withaHighSchoolDegreeorHigher percent 80.2 82.3 87 2012-2016

Male,35-44,45-64,65+ 1

0.67People25+withaBachelor'sDegreeorHigher percent 30.1 28.1 30.3 2012-2016

AmericanIndianorAlaskaNative,BlackorAfricanAmerican,NativeHawaiianor

OtherPacificIslander,Other,45-

64,65+ 1

SCORE ENVIRONMENT UNITSHARRISCOUNTY HP2020 TEXAS U.S.



2.11 SNAPCertifiedStoresstores/1,000population 0.6 2016 17

1.75 AnnualOzoneAirQuality grade F 2014-2016 2

1.69 AnnualParticlePollution grade C 2014-2016 2

1.67 FastFoodRestaurantDensityrestaurants/1,000

population 0.7 2014 17

1.61RecognizedCarcinogensReleasedintoAir pounds 1962916 2017 18



1.50 FarmersMarketDensitymarkets/1,000population 0 2016 17

1.50 GroceryStoreDensitystores/1,000population 0.2 2014 17


1.33 RecreationandFitnessFacilitiesfacilities/1,000population 0.1 2014 17

1.25 DrinkingWaterViolations percent 1.7 6.6 FY2013-14 4

1.17 PBTReleased pounds 210516 2017 18

1.00 FoodEnvironmentIndex 7.2 6 7.7 2018 4

1.00HouseholdswithNoCarandLowAccesstoaGroceryStore percent 0.9 2015 17

1.00People65+withLowAccesstoaGroceryStore percent 1.4 2015 17

0.89 LiquorStoreDensitystores/100,000population 6.3 6.8 10.5 2015 16

0.67 AccesstoExerciseOpportunities percent 90.4 80.6 83.1 2018 4

0.17 HousesBuiltPriorto1950 percent 6.2 7.4 18.2 2012-2016 1

SCORE EXERCISE,NUTRITION,&WEIGHT UNITSHARRISCOUNTY HP2020 TEXAS U.S.


2.17 WorkerswhoWalktoWork percent 1.5 3.1 1.6 2.8 2012-2016 White,non-Hispanic 1



1.67 Adults(18+Years)WhoAreObese percent 32 30.5 33.6 29.9 2016 10

1.67 ChildFoodInsecurityRate percent 23.5 23 17.9 2016 5



1.50 AdultswhoareOverweightor percent 66.7 68.4 65.2 2016 10


Obese


1.50 FarmersMarketDensitymarkets/1,000population 0 2016 17


1.42AdultFruitandVegetableConsumption percent 18.7 17.2 2015 10



1.00 FoodEnvironmentIndex 7.2 6 7.7 2018 4




SCORE HEARTDISEASE&STROKE UNITSHARRISCOUNTY HP2020 TEXAS U.S.


2.61 Stroke:MedicarePopulation percent 5.2 4.5 4 2015 3

1.89HeartFailure:MedicarePopulation percent 16 15.5 13.5 2015 3

1.50AtrialFibrillation:MedicarePopulation percent 7.3 7.4 8.1 2015 3

1.44Hyperlipidemia:MedicarePopulation percent 43.2 46.1 44.6 2015 3

1.42Age-AdjustedDeathRateduetoCerebrovascularDisease(Stroke)

deaths/100,000population 41.5 34.8 42 37.3 2010-2014 Black 12

1.33 IschemicHeartDisease:Medicare percent 28.8 28.8 26.5 2015

3


Population

1.22Hypertension:MedicarePopulation percent 55.5 57.5 55 2015

3

0.92Age-AdjustedDeathRateduetoHeartDisease

deaths/100,000population 167.6 173 171.9 2010-2014 Black,White,Male 12

SCOREIMMUNIZATIONS&INFECTIOUSDISEASES UNITS

HARRISCOUNTY HP2020 TEXAS U.S.


2.33 GonorrheaIncidenceRatecases/100,000population 182.1 160.2 2017 12

2.33 SyphilisIncidenceRatecases/100,000population 59.3 40.6 2017 12

2.11 ChlamydiaIncidenceRatecases/100,000population 571.4 511.6 2017 12

1.83 TuberculosisIncidenceRatecases/100,000population 6.6 1 4.5 2013-2017 12

1.78Adults65+withInfluenzaVaccination percent 57.2 57.3 58.6 2016 10

1.67 HIVDiagnosisRatecases/100,000population 26.3 16.1 2016

12

1.17Adults65+withPneumoniaVaccination percent 73.5 90 71.3 73.4 2016

10

1.00Age-AdjustedDeathRateduetoInfluenzaandPneumonia

deaths/100,000population 14 14.2 15.2 2010-2014 Black,Male 12

SCOREMATERNAL,FETAL&INFANTHEALTH UNITS



2.36 InfantMortalityRatedeaths/1,000live

births 6.8 6 5.8 6 2013 12

1.97MotherswhoReceivedEarlyPrenatalCare percent 56.1 77.9 59.2 74.2 2013 12

1.92InfantsBorntoMotherswith<12YearsEducation percent 27.5 21.6 15.9 2013 12


1.81 BabieswithLowBirthWeight percent 8.6 7.8 8.3 8 2013 12

1.61 BabieswithVeryLowBirthWeight percent 1.5 1.4 1.4 1.4 2013 12

1.25 PretermBirths percent 11.8 9.4 12 11.4 2013 12

0.58 TeenBirths percent 2.5 2.8 4.3 2014 12

SCORE MEN'SHEALTH UNITSHARRISCOUNTY HP2020 TEXAS U.S.



deaths/100,000males 19.8 21.8 18.1 19.5 2011-2015 7


males 102.5 95.4 109 2011-2015 7

1.28 LifeExpectancyforMales years 76.4 76.2 76.7 2014 6

SCOREMENTALHEALTH&MENTALDISORDERS UNITS



1.89Alzheimer'sDiseaseorDementia:MedicarePopulation percent 11.4 11.7 9.9 2015

3

1.53 PoorMentalHealth:5+Days percent 80 81.5 2016

10

1.50PoorMentalHealth:AverageNumberofDays days 3.7 3.4 3.8 2016 4


population 103.7 98.8 214.3 2017 4

1.17 FrequentMentalDistress percent 11.2 10.6 15 2016 4

0.94Age-AdjustedDeathRateduetoSuicide

deaths/100,000population 10.3 10.2 11.7 12.5 2010-2014 White,Male 12

0.94 Depression:MedicarePopulation percent 14.8 17 16.7 2015

3

0.64Age-AdjustedDeathRateduetoAlzheimer'sDisease

deaths/100,000population 17.9 26.6 24.5 2010-2014 White,Female 12


SCORE OLDERADULTS&AGING UNITSHARRISCOUNTY HP2020 TEXAS U.S.


2.67ChronicKidneyDisease:MedicarePopulation percent 20.9 19.9 18.1 2015

3

2.61 Stroke:MedicarePopulation percent 5.2 4.5 4 2015

3

2.06Age-AdjustedDeathRateduetoFalls



1.89Alzheimer'sDiseaseorDementia:MedicarePopulation percent 11.4 11.7 9.9 2015 3

1.89HeartFailure:MedicarePopulation percent 16 15.5 13.5 2015 3


Asian,BlackorAfricanAmerican,HispanicorLatino,Other,Female,75+ 1


1.72Osteoporosis:MedicarePopulation percent 6.3 6.5 6 2015 3

1.67 Diabetes:MedicarePopulation percent 28.1 28.2 26.5 2015 3



1.44 People65+LivingAlone percent 24.4 23.9 26.4 2012-2016 1

1.33IschemicHeartDisease:MedicarePopulation percent 28.8 28.8 26.5 2015 3

1.22Hypertension:MedicarePopulation percent 55.5 57.5 55 2015 3

1.17Adults65+withPneumoniaVaccination percent 73.5 90 71.3 73.4 2016 10



0.94 Asthma:MedicarePopulation percent 7.3 8.2 8.2 2015 3

0.94 Depression:MedicarePopulation percent 14.8 17 16.7 2015 3

0.94

RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 27.8 31.6 30 2015 3


deaths/100,000population 17.9 26.6 24.5 2010-2014 White,Female 12

0.39 COPD:MedicarePopulation percent 9.6 11.1 11.2 2015

3

SCORE OTHERCHRONICDISEASES UNITSHARRISCOUNTY HP2020 TEXAS U.S.


2.67ChronicKidneyDisease:MedicarePopulation percent 20.9 19.9 18.1 2015 3

1.72Osteoporosis:MedicarePopulation percent 6.3 6.5 6 2015 3

0.94

RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 27.8 31.6 30 2015 3

SCORE PREVENTION&SAFETY UNITSHARRISCOUNTY HP2020 TEXAS U.S.


2.39 SevereHousingProblems percent 20.9 18.3 18.8 2010-2014

4



1.19 DeathRateduetoDrugPoisoningdeaths/100,000

population 10.2 9.8 16.9 2014-2016

4

0.69Age-AdjustedDeathRateduetoUnintentionalInjuries


SCORE PUBLICSAFETY UNITSHARRISCOUNTY HP2020 TEXAS U.S.



2.17 Alcohol-ImpairedDrivingDeaths percent 37.8 28.3 29.3 2012-2016 4

1.67 ViolentCrimeRatecrimes/100,000

population 713.7 407.6 2012-2014 4


SCORE RESPIRATORYDISEASES UNITSHARRISCOUNTY HP2020 TEXAS U.S.


1.83 TuberculosisIncidenceRatecases/100,000population 6.6 1 4.5 2013-2017 12


1.17Adults65+withPneumoniaVaccination percent 73.5 90 71.3 73.4 2016 10


deaths/100,000population 14 14.2 15.2 2010-2014 Black,Male 12




0.39 COPD:MedicarePopulation percent 9.6 11.1 11.2 2015 3


deaths/100,000population 37.5 45.5 39 43.4 2011-2015 7

SCORE SOCIALENVIRONMENT UNITSHARRISCOUNTY HP2020 TEXAS U.S.


2.67 MeanTravelTimetoWork minutes 28.6 25.9 26.1 2012-2016 Male 1

2.50 LinguisticIsolation percent 11.8 7.9 4.5 2012-2016 1

2.44 Homeownership percent 49.6 55 55.9 2012-2016 1

2.17 Single-ParentHouseholds percent 36.2 33.3 33.6 2012-2016 1



2.08 MedianHouseholdGrossRent dollars 937 911 949 2012-2016 1

1.81MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1504 1444 1491 2012-2016

1

1.75 PersonswithHealthInsurance percent 79.3 100 81.4 2016

9

1.67ChildrenLivingBelowPovertyLevel percent 26 23.9 21.2 2012-2016


Other,<6 1

1.67People25+withaHighSchoolDegreeorHigher percent 80.2 82.3 87 2012-2016

Male,35-44,45-64,65+ 1

1.67 PeopleLivingBelowPovertyLevel percent 17.4 16.7 15.1 2012-2016

AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,Other,Female,<6,6-11,12-17,18-24 1


1.67VoterTurnout:PresidentialElection percent 58.4 58.8 2016 14







AmericanIndianorAlaskaNative,BlackorAfricanAmerican,NativeHawaiianor

OtherPacificIslander,Other,45-

64,65+ 1




Other 1


AmericanIndianorAlaskaNative,BlackorAfricanAmerican,HispanicorLatino,NativeHawaiianor

OtherPacificIslander,Other,Two

orMoreRaces 1

SCORE SUBSTANCEABUSE UNITSHARRISCOUNTY HP2020 TEXAS U.S.



1.50 AdultswhoDrinkExcessively percent 18.1 25.4 19.4 18 2016 4

1.28

Adults(18+Years)ReportingBingeDrinkingWithintheLast12months percent 16.6 24.2 17.9 16.9 2016 10


population 10.2 9.8 16.9 2014-2016 4

0.94 AdultswhoSmoke percent 12.1 12 14.3 17.1 2016 10

0.89 LiquorStoreDensitystores/100,000population 6.3 6.8 10.5 2015

16

SCORE TRANSPORTATION UNITSHARRISCOUNTY HP2020 TEXAS U.S.


2.83 SoloDriverswithaLongCommute percent 45.8 36.9 34.7 2012-2016

4


2.17 WorkerswhoWalktoWork percent 1.5 3.1 1.6 2.8 2012-2016 White,non-Hispanic 1

1.44 WorkerswhoDriveAlonetoWork percent 79.1 80.3 76.4 2012-2016White,non-

Hispanic,25-44,55- 1


59

1.33 HouseholdswithoutaVehicle percent 6.4 5.6 9 2012-2016

1

1.28WorkersCommutingbyPublicTransportation percent 2.8 5.5 1.5 5.1 2012-2016

HispanicorLatino,NativeHawaiianor

OtherPacificIslander,Twoor

MoreRaces,White,non-Hispanic,Male,

25-44 1

1.00HouseholdswithNoCarandLowAccesstoaGroceryStore percent 0.9 2015

17

SCORE WELLNESS&LIFESTYLE UNITSHARRISCOUNTY HP2020 TEXAS U.S.


1.83Self-ReportedGeneralHealthAssessment:PoororFair percent 18.2 18.2 16 2016 4

1.75 PoorPhysicalHealth:5+Days percent 80.6 81.5 2016 10

1.67 InsufficientSleep percent 33.9 32.7 38 2016 4


1.17 FrequentPhysicalDistress percent 11.5 10.8 15 2016

4

1.17PoorPhysicalHealth:AverageNumberofDays days 3.6 3.5 3.7 2016

4

1.06 LifeExpectancyforFemales years 81 80.8 81.5 2014

6

SCORE WOMEN'SHEALTH UNITSHARRISCOUNTY HP2020 TEXAS U.S.



females 11 7.3 9.2 7.5 2011-2015 7


deaths/100,000females 23.2 20.7 20.2 20.9 2011-2015 Black 7



females 113.2 111.7 124.7 2011-2015 7

1.06 LifeExpectancyforFemales years 81 80.8 81.5 2014 6


MontgomeryCounty

SCORE ACCESSTOHEALTHSERVICES UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.



population 69 99 214 2017 4

1.67Non-PhysicianPrimaryCareProviderRate

providers/100,000population 55 67 81 2017 4

1.56 DentistRatedentists/100,000

population 46 56 67 2016 4

1.53 ChildrenwithHealthInsurance percent 90.2 100.0 90.3 2016 9

1.47AdultswithHealthInsurance:18-64 percent 79.7 100.0 77.4 2016 9

1.47 PersonswithHealthInsurance percent 83.1 100.0 81.4 2016 9

1.22 PrimaryCareProviderRateproviders/100,000

population 62 60 76 2015 4

SCORE CANCER UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.




females 8.0 7.3 9.2 7.5 2011-2015 7

1.56OralCavityandPharynxCancerIncidenceRate



females 117.6 111.7 124.7 2011-2015 7


deaths/100,000males 17.8 21.8 18.1 19.5 2011-2015 7


deaths/100,000females 19.6 20.7 20.2 20.9 2011-2015 7

0.94 Age-AdjustedDeathRatedueto deaths/100,000 42.4 45.5 39.0 43.4 2011-2015 7


LungCancer population

0.83 AllCancerIncidenceRatecases/100,000population 398.9 401.3 441.2 2011-2015 7



0.78Age-AdjustedDeathRateduetoColorectalCancer


0.67 ColorectalCancerIncidenceRatecases/100,000population 36.6 39.9 38.1 39.2 2011-2015 7


males 88.7 95.4 109.0 2011-2015 7

0.61Age-AdjustedDeathRateduetoCancer

deaths/100,000population 156.0 161.4 156.4 163.5 2011-2015 Male 7

SCORE CHILDREN'SHEALTH UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.



1.53 ChildrenwithHealthInsurance percent 90.2 100.0 90.3 2016 9

1.17 ChildFoodInsecurityRate percent 21.2 23.0 17.9 2016 5


SCORE ECONOMY UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.





2.19MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1635 1444 1491 2012-2016 1







1.28UnemployedWorkersinCivilianLaborForce percent 3.8 4.0 4.1 July2018 14


1.06RentersSpending30%orMoreofHouseholdIncomeonRent percent 39.4 48.0 47.3 2012-2016 1


0.86PersonswithDisabilityLivinginPoverty percent 17.9 24.2 26.6 2016 1


BlackorAfricanAmerican,HispanicorLatino,Other 1

0.75PersonswithDisabilityLivinginPoverty(5-year) percent 19.1 25.1 27.6 2012-2016 1

0.61 Homeownership percent 65.6 55.0 55.9 2012-2016 1


0.56FamiliesLivingBelowPovertyLevel percent 8.3 13.0 11.0 2012-2016

BlackorAfricanAmerican,Hispanic 1


orLatino,Other

0.56HouseholdswithCashPublicAssistanceIncome percent 1.1 1.6 2.7 2012-2016 1

0.56PeopleLiving200%AbovePovertyLevel percent 73.0 62.8 66.4 2012-2016 1

0.56StudentsEligiblefortheFreeLunchProgram percent 35.1 52.9 42.6 2015-2016 8


BlackorAfricanAmerican,HispanicorLatino,Other,

TwoorMoreRaces 1

0.17ChildrenLivingBelowPovertyLevel percent 14.8 23.9 21.2 2012-2016

HispanicorLatino,Other 1

0.17 HomeownerVacancyRate percent 1.2 1.6 1.8 2012-2016 1


12-17,18-24,6-11,<6BlackorAfricanAmerican,HispanicorLatino,Other 1


AmericanIndianorAlaskaNative,Black

orAfricanAmerican,HispanicorLatino,Other,

TwoorMoreRaces 1

SCORE EDUCATION UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.


1.89 Student-to-TeacherRatio students/teacher 16.2 15.4 17.7 2015-2016 8

1.22People25+withaHighSchoolDegreeorHigher percent 86.8 82.3 87.0 2012-2016

AmericanIndianorAlaskaNative 1



1.00 HighSchoolDropOutRate percent 0.9 2.0 2016 12


25-34,65+AmericanIndianor

AlaskaNative,Other,TwoorMore

Races 1

SCORE ENVIRONMENT UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.




1.75 AnnualOzoneAirQuality grade F 2014-2016 2


1.50 FarmersMarketDensitymarkets/1,000population 0.0 2016 16



1.39RecognizedCarcinogensReleasedintoAir pounds 16762 2017 17





1.25 DrinkingWaterViolations percent 1.7 6.6 FY2013-14 4

1.22 FoodEnvironmentIndex 7.5 6.0 7.7 2018 4




0.67 LiquorStoreDensitystores/100,000population 6.3 6.8 10.5 2015 15

0.39 HousesBuiltPriorto1950 percent 1.2 7.4 18.2 2012-2016 1

SCOREEXERCISE,NUTRITION,&WEIGHT UNITS

MONTGOMERYCOUNTY HP2020 Texas U.S.


2.78 WorkerswhoWalktoWork percent 1.0 3.1 1.6 2.8 2012-2016 1




1.50 FarmersMarketDensitymarkets/1,000population 0.0 2016 16







1.22 FoodEnvironmentIndex 7.5 6.0 7.7 2018 4





SCORE HEARTDISEASE&STROKE UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.



2.28 Stroke:MedicarePopulation percent 4.6 4.5 4.0 2015 3


1.61Hypertension:MedicarePopulation percent 56.0 57.5 55.0 2015 3

1.25Age-AdjustedDeathRateduetoCerebrovascularDisease(Stroke)


1.25Age-AdjustedDeathRateduetoHeartDisease

deaths/100,000population 173.2 173.0 171.9 2010-2014 MaleBlack 11

1.22HeartFailure:MedicarePopulation percent 14.6 15.5 13.5 2015 3


SCOREIMMUNIZATIONS&INFECTIOUSDISEASES UNITS



1.67 SyphilisIncidenceRatecases/100,000population 13.1 40.6 2017 11

1.50 ChlamydiaIncidenceRatecases/100,000population 265.4 511.6 2017 11

1.44 HIVDiagnosisRate cases/100,000 7.7 16.1 2016 11


population

1.39 TuberculosisIncidenceRatecases/100,000population 1.8 1.0 4.5 2013-2017 11

1.28 GonorrheaIncidenceRatecases/100,000population 52.4 160.2 2017 11


deaths/100,000population 10.8 14.2 15.2 2010-2014 11

SCOREMATERNAL,FETAL&INFANTHEALTH UNITS



1.75MotherswhoReceivedEarlyPrenatalCare percent 60.7 77.9 59.2 74.2 2013 11


0.83BabieswithVeryLowBirthWeight percent 1.1 1.4 1.4 1.4 2013 11

0.75 PretermBirths percent 10.4 9.4 12.0 11.4 2013 11

0.47 BabieswithLowBirthWeight percent 6.6 7.8 8.3 8.0 2013 11

0.47 InfantMortalityRatedeaths/1,000live

births 4.5 6.0 5.8 6.0 2013 11

0.42 TeenBirths percent 2.0 2.8 4.3 2014 11

SCORE MEN'SHEALTH UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.



deaths/100,000males 17.8 21.8 18.1 19.5 2011-2015 7



males 88.7 95.4 109.0 2011-2015 7


SCOREMENTALHEALTH&MENTALDISORDERS UNITS



2.28Age-AdjustedDeathRateduetoSuicide



population 69 99 214 2017 4


1.28 Depression:MedicarePopulation percent 15.9 17.0 16.7 2015 3

0.67 FrequentMentalDistress percent 10.2 10.6 15.0 2016 4

0.67PoorMentalHealth:AverageNumberofDays days 3.3 3.4 3.8 2016 4



SCORE OLDERADULTS&AGING UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.



2.28 Stroke:MedicarePopulation percent 4.6 4.5 4.0 2015 3






1.61Hypertension:MedicarePopulation percent 56.0 57.5 55.0 2015 3



1.33

RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 28.5 31.6 30.0 2015 3


1.28 Depression:MedicarePopulation percent 15.9 17.0 16.7 2015 3

1.22HeartFailure:MedicarePopulation percent 14.6 15.5 13.5 2015 3

1.22Osteoporosis:MedicarePopulation percent 5.8 6.5 6.0 2015 3


0.94 Diabetes:MedicarePopulation percent 24.8 28.2 26.5 2015 3


BlackorAfricanAmerican,HispanicorLatino,Other 1






SCORE OTHERCHRONICDISEASES UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.




1.33

RheumatoidArthritisorOsteoarthritis:MedicarePopulation percent 28.5 31.6 30.0 2015 3

1.22Osteoporosis:MedicarePopulation percent 5.8 6.5 6.0 2015 3

SCORE PREVENTION&SAFETY UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.




population 10.6 9.8 16.9 2014-2016 4

0.53Age-AdjustedDeathRateduetoUnintentionalInjuries




SCORE PUBLICSAFETY UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.




0.83 ViolentCrimeRatecrimes/100,000

population 171.2 407.6 2012-2014 4

SCORE RESPIRATORYDISEASES UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.



1.39 TuberculosisIncidenceRatecases/100,000population 1.8 1.0 4.5 2013-2017 11









SCORE SOCIALENVIRONMENT UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.





2.19MortgagedOwnersMedianMonthlyHouseholdCosts dollars 1635 1444 1491 2012-2016 1



1.47 PersonswithHealthInsurance percent 83.1 100.0 81.4 2016 9

1.22People25+withaHighSchoolDegreeorHigher percent 86.8 82.3 87.0 2012-2016

AmericanIndianorAlaskaNative 1



0.83 LinguisticIsolation percent 3.7 7.9 4.5 2012-2016 1

0.67VoterTurnout:PresidentialElection percent 65.5 58.8 2016 13


0.61 Homeownership percent 65.6 55.0 55.9 2012-2016 1




BlackorAfricanAmerican,HispanicorLatino,Other,

TwoorMoreRaces 1

0.39 Single-ParentHouseholds percent 23.8 33.3 33.6 2012-2016 1


25-34,65+AmericanIndianor

AlaskaNative,Other,TwoorMore

Races 1

0.17ChildrenLivingBelowPovertyLevel percent 14.8 23.9 21.2 2012-2016

HispanicorLatino,Other 1


12-17,18-24,6-11,<6BlackorAfricanAmerican,HispanicorLatino,Other 1


AmericanIndianorAlaskaNative,Black

orAfricanAmerican,HispanicorLatino,Other,

TwoorMoreRaces 1

SCORE SUBSTANCEABUSE UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.


2.17 AdultswhoDrinkExcessively percent 21.0 25.4 19.4 18.0 2016 4



population 10.6 9.8 16.9 2014-2016 4

0.67 LiquorStoreDensity stores/100,000 6.3 6.8 10.5 2015 15


population

SCORE TRANSPORTATION UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.


2.78 WorkerswhoWalktoWork percent 1.0 3.1 1.6 2.8 2012-2016 1


2.61SoloDriverswithaLongCommute percent 49.9 36.9 34.7 2012-2016 4

2.17WorkerswhoDriveAlonetoWork percent 81.5 80.3 76.4 2012-2016 1

1.67WorkersCommutingbyPublicTransportation percent 1.3 5.5 1.5 5.1 2012-2016 16-19,20-24Other 1


0.50 HouseholdswithoutaVehicle percent 3.6 5.6 9.0 2012-2016 1

SCORE WELLNESS&LIFESTYLE UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.


1.39 LifeExpectancyforFemales years 80.7 80.8 81.5 2014 6

1.17 InsufficientSleep percent 31.8 32.7 38.0 2016 4


0.67 FrequentPhysicalDistress percent 9.9 10.8 15.0 2016 4

0.67PoorPhysicalHealth:AverageNumberofDays days 3.3 3.5 3.7 2016 4

0.67Self-ReportedGeneralHealthAssessment:PoororFair percent 14.1 18.2 16.0 2016 4


SCORE WOMEN'SHEALTH UNITSMONTGOMERYCOUNTY HP2020 Texas U.S.



females 8.0 7.3 9.2 7.5 2011-2015 7

1.39 LifeExpectancyforFemales years 80.7 80.8 81.5 2014 6


females 117.6 111.7 124.7 2011-2015 7


deaths/100,000females 19.6 20.7 20.2 20.9 2011-2015 7


AppendixC.PrimaryDataMethodology

CommunityInputParticipantsAccessHealth(FQHC)(FortBendFamilyHealthCenter)AIDSFoundationofHoustonAssociationfortheAdvancementofMexicanAmericansAvenueCDCCatholicCharities-ArchdioceseofGalvestonCatholicCharities-FortBendChildAdvocatesofFortBendChildrenatRiskChristClinicCityofHouston,DepartmentofParksandRecreationCoastalAreaHealthEducationCenters(AHEC)CommunityHealthChoiceElCentrodeCorazonEpiscopalHealthFoundationFortBendCountyHealthandHumanServicesFortBendCountySheriff'sOfficeFortBendRegionalCouncilOnSubstanceAbuseFortBendSeniorsMealsonWheelsFortBendWomen'sCenterGalvestonCountyHealthDistrictGalvestonCountyMentalHealthDeputiesGreaterHoustonPartnershipGreaterHoustonWomen'sChamberofCommerce

GulfCoastMedicalFoundationHarrisCountyPublicHealthHealthcarefortheHomeless-HoustonHOPEClinic(FQHC)HoustonFoodBankHoustonHealthDepartmentHoustonHousingAuthorityHoustonIndependentSchoolDistrictInterfaithCommunityClinicKinderInstituteLegacyCommunityHealthLibertyCountySheriff'sOfficeLoneStarFamilyHealthCenterMidtownArtsandTheaterCenterHoustonMontgomeryCountyWomen'sCenterBaker-RipleyEarlyHeadStartPatientCareInterventionCenter(PCIC)PrairieViewA&MUniversitySantaMariaHostel,Inc.TheArcofFortBendCountyTheHarrisCenterforMentalHealthandIDD(formerlyMHMRA)TheRoseTheWomen'sHomeTri-CountyServicesBehavioralHealthcareUnitedWayofBrazoriaCountyUnitedWayofGreaterHoustonUnitedWayofHarrisandMontgomeryCountyWestChambersMedicalCenter(FQHC)YMCAofGreaterHouston


KeyInformantInterviewQuestionnaire(EpiscopalHealthFoundation)• Goodmorning/afternoon[NAMEOFINFORMANT].Mynameis[NAMEOFINTERVIEWER],

andIamwithHealthResourcesinAction,anon-profitpublichealthorganizationbasedinBoston.Thankyouforspeakingwithmetoday.

• Aswementionedinourinterviewinvitation,theEpiscopalHealthFoundationis

coordinatinganinterviewinitiativetosupportfourGreaterHoustonareahospitalsystemsinpreparingtheircommunityhealthneedsassessments.ThecollaboratinghospitalsincludeCHISt.Luke’s,HoustonMethodistHospital,MemorialHermannHealthSystem,andTexasChildren’sHospital.

• Thepurposeofthisinterviewistogainagreaterunderstandingofthehealthstatusand

wellbeingofresidentsintheGreaterHoustonareaanddeterminehowthesehealthneedsarecurrentlybeingaddressed.Interviewslikethisonearebeingconductedwithabout70stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Wearealsointerviewingcommunityleaderswithspecificexperienceworkingwithprioritypopulationssuchaswomen,children,peopleofcolor,andthedisabledtonameafew.

• Weareinterestedinhearingpeople’sfeedbackontheneedsofthebroaderGreater

Houstoncommunityandthepopulationsyouworkwithasaleaderinyourcommunity.TheFoundationandthefourhospitalswelcomeyourcriticalfeedbackandsuggestionsforhealthimprovementactivitiesinthefuture.Yourhonestyduringtoday’sinterviewisencouragedandappreciated.

• Aswementionedinourinterviewinvitation,theinterviewwilllastbetween45minutesto

anhouranditwillberecorded.Afteralltheinterviewsarecompleted,HealthResourcesinActionwillprovideatranscriptofyourinterviewtothefourhospitalsforuseinpreparingtheircommunityhealthneedsassessmentreports.Eachhospitalwillkeepyourinterviewtranscriptconfidentialandaccessibleonlytotheteamthatispreparingthecommunityhealthneedsassessmentreport.HealthResourcesinActionwillalsobepreparingareportofthegeneralthemesthatemergeacrossalltheinterviewstohelpthehospitalspreparetheirreports.

• TheFoundationhasaskedHealthResourcesinActiontoaskallintervieweeshowtheywish

anyquotesfromtoday’sinterviewtobepresentedinreports.Therearethreeoptions.Quotesmaybepresentedanonymouslywithoutyournameororganization,presentedwithyournameandorganization,orpresentedwithonlythesectoryourepresent.Whichoptionwouldyouliketochoose?

• RECORDRESPONSEFROMINTERVIEWEE:rAnonymousrNameandorganizationrSector

• Thankyou.Wewillnoteyourchoiceinthetranscriptthatweprovidetothehospitals.


• IFTHERESPONDENTISUNSUREATTHETIMEOFTHEINTERVIEW:Ok,pleasefeelfreetothinkitoverandwewillfollowupwithyouforyourdecisionbeforewesendthetranscripttothehospitals.

• Doyouhaveanyquestionsbeforewebegin?BEGINRECORDINGTHEINTERVIEW

INTERVIEWQUESTIONNAIRE(55MINUTES)

NOTESTOINTERVIEWER:• INTERVIEWQUESTIONSMAYBEADDEDORTAILOREDTOMEETTHESPECIFIC

POSITION/ROLEOFTHEINTERVIEWEE• THEQUESTIONSINTHEINTERVIEWQUESTIONNAIREAREINTENDEDTOSERVEASAGUIDE,

NOTASCRIPTBACKGROUND(5MINUTES)• Canyoutellmealittlebitaboutyourroleatyourorganization/agency?

o Hasyourorganization/agencyeverpartneredwithanyofthefourhospitalsinvolvedinthissharedcommunityhealthneedsassessmentbefore?IFSO,PROBEINWHATCAPACITY/PROGRAM

• Howwouldyoudescribethecommunityyourepresent/thecommunityyourorganizationserves/theGreaterHoustonpopulationatlarge?Whataresomeofitsdefiningcharacteristicsintermsofdemographics?INTERVIEWER:ESTABLISHWHATTHEINFORMANTCONSIDERSTHECOMMUNITYTOBEFROMTHEIRPERSPECTIVE

COMMUNITYISSUES(20minutes)INTERVIEWER:VARYTHELABELOF‘COMMUNITY’BASEDONTHEINFORMANT’SBACKGROUNDANDHOWHEORSHEDESCRIBESTHECOMMUNITY;BESURETOPROBEONWOMEN’SANDCHILDREN’SISSUESTOENSUREWEADDRESSTHENEEDSOFTHECHILDREN’SHOSPITALSINALLQUESTIONSASRELEVANT• Thinkingaboutthestatusofthecommunitytoday,howwouldyouratetheoverallhealth

statusofresidentsonascaleof1to5with1beingpoorand5beingveryhealthy?

• Ifyouhadtopickyourtop3healthconcernsinthecommunity,whatwouldtheybe?PROBEIN-DEPTHBASEDONINFORMANTAREAOFEXPERTISE

o Whodoyouconsidertobethepopulationsinthecommunitymostvulnerableorat

riskfortheseconditions/issues?§ IFNOTYETMENTIONED,PROBESPECIFICALLYONPRIORITYPOPULATION

RELEVANTTOTHEINFORMANT’SEXPERTISE:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityfor[PRIORITYPOPULATION]?


§ FORINFORMANTSEXPERTISEWITHWOMENANDCHILDREN:Whatdoyou

thinkarethemostpressinghealthconcernsinthecommunityforchildrenandtheirfamilies?Howaboutforwomen?

§ IFNOTYETDISCUSSED:Ofthetopthreeissuesyoumentioned,whichwould

yourankasyourtopissue?Howdoyouseethisissueaffectingcommunitymembers’dailylivesandtheirhealth?PROBEIN-DEPTHINSPECIFICFOCUSAREAS;MAYASKABOUTONEISSUEATTIMEANDFOCUSONPERSON’SAREAOFEXPERTISE.

• Fromyourexperience,whatareresidents’biggestbarrierstoaddressingthetop3health

issuesyouidentified?o PROBE:Socialdeterminantsofhealth?o PROBE:Barrierstoaccessingmedicalcare?o PROBE:Barrierstoaccessingpreventiveservicesorprograms?

FOCUSAREA:HEALTHYLIVING(5MINUTES)• I’dliketoaskyouaboutbarriersaffectinghealthylivingandthepreventionofobesity.

o Whataresomeofthebarrierstohealthyeatingandphysicalactivityamongthecommunitiesyouserve?

§ Whatpopulationsaremostaffectedbybarrierstohealthylivingandphysicalactivity?PROBEABOUTFOODINSECURITYANDACCESSTOSAFESPACESFORPHYSICALACTIVITY

o Whateffortsorprogramsareyouawareofthatpromotehealthyliving?PROBEABOUTHEALTHYLIVINGMATTERSCOLLABORATIVE

ACCESSTOHEALTHCAREANDPUBLICHEALTH/PREVENTIONSERVICES(15MINUTES)

• I’dliketoaskyouaboutaccesstohealthcareandsocialservicesinyourcommunity.

o Whatdoyouseeasthestrengthsofthehealthcareandsocialservicesinyourcommunity?

o Whatdoyouseeasitslimitations?• Whatchallenges/barriersdoresidentsinyourcommunityfaceinaccessinghealthcareand

socialservices?[PROBEINDEPTHFORBARRIERSTOCARE:INSURANCEISSUES,LANGUAGEBARRIERS,ACCESSTOHEALTHINFORMATION/HEALTHLITERACY,LACKOFTRANSPORTION,CHILDCARE,ETC.]

o Whatdoyouthinkneedstohappeninthecommunityyouservetohelpresidentsovercomeoraddressthesechallenges?

• Whatprograms,services,orpoliciesareyouawareofinthecommunitythataddressaccess

tohealthcareandsocialservices?


o Inyouropinion,howeffectivehavetheseprograms,services,orpoliciesbeenat

addressingthehealthneedsofresidents?

o Whatprogram,services,orpoliciesarecurrentlynotavailablethatyouthinkshouldbe?

IMPROVINGTHEHEALTHOFTHECOMMUNITY/RESIDENTS(10MINUTES)• Whatdoyouthinkneedstohappeninthecommunityyouservetohelpresidentsovercome

oraddressthechallengestheyfaceinbeingabletobehealthy?

• Earlierinthisinterview,youmentioned[TOPISSUE]asbeingyourtophealthpriorityforarearesidents.Whatdoyouthinkneedstobedonetoaddress[TOPISSUEHERE]?

o Whatdoyouthinkhospitalscandotoaddressthisissuethattheyaren’tdoingrightnow?Doyouhaveanysuggestionsabouthowhospitalscanbecreativeorworkoutsidetheirtraditionalroletoaddressthisissueandimprovecommunityhealth?

o Whatkindsofopportunitiesarecurrentlyouttherethatcanbeseizedupontoaddresstheseissues?Forexample,aretheresome“lowhangingfruit”–currentcollaborationsorinitiativesthatcanbestrengthenedorexpanded?

VISIONFORTHECOMMUNITY(5MINUTES)

• Thehospitalsinvolvedinthisinitiativewillbeplanningtheirstrategytoimprovethehealth

ofthecommunitiestheyserve.Whatadvicedoyouhaveforthegroupdevelopingtheplantoaddressthetophealthneedsyou’vementioned?

CLOSING(5MINUTES)

Thankyousomuchforyourtime.That’sitformyquestions.Isthereanythingelsethatyouwouldliketomentionthatwedidn’tdiscusstoday?AsImentioned,afteralloftheinterviewsarecompleted,wewillbesendingyourinterviewtranscriptstothefourhospitals.Eachhospitalwillmaketheircommunityhealthneedsassessmentreportspubliclyavailablewhentheyarecomplete.Ifyouhaveanyquestions,pleasefeelfreetoreachouttoJenniferMineoattheEpiscopalHealthFoundationwhoiscoordinatingthiseffortonbehalfofthefourhospitals.Thankyouagain.Haveagoodmorning/afternoon.


KeyInformantInterviewQuestionnaire(ConduentHealthyCommunitiesInstitute)Goodmorning/afternoon[NAMEOFINFORMANT].Mynameis[NAMEOFINTERVIEWER],andIamwithConduentHealthyCommunitiesInstitute.Mycolleague[name]isalsoontheline.WeareworkingwithMemorialHermannHealthSystemtoconductaCommunityHealthNeedsAssessment.• Thepurposeofthisinterviewistogainagreaterunderstandingofthehealthstatusand

wellbeingofresidentsintheGreaterHoustonareaanddeterminehowthesehealthneedsarecurrentlybeingaddressed.Interviewslikethisonearebeingconductedwithabout12stakeholdersfromarangeofsectorssuchasgovernment,healthcare,business,andcommunityserviceorganizations.Wearealsointerviewingcommunityleaderswithspecificexperienceworkingwithprioritypopulationssuchaswomen,children,peopleofcolor,andthedisabledtonameafew.

• Weareinterestedinhearingpeople’sfeedbackontheneedsofthecommunityandthe

populationsyouworkwithasaleaderinyourcommunity.MemorialHermannwelcomeyourcriticalfeedbackandsuggestionsforhealthimprovementactivitiesinthefuture.Yourhonestyduringtoday’sinterviewisencouragedandappreciated.

• Aswementionedinourinterviewinvitation,theinterviewwilllastbetween45minutesto

anhouranditwillberecorded.Afteralltheinterviewsarecompleted,wewillanalyzeandsummarizealltheinterviewstoincorporateintothecommunityhealthneedsassessmentreports.EachMHhospitalwillkeepyourinterviewtranscriptconfidentialandaccessibleonlytotheteamthatispreparingthecommunityhealthneedsassessmentreport.

• MemorialHermannhasaskedHCItoaskallintervieweeshowtheywishanyquotesfromtoday’sinterviewtobepresentedinreports.Therearethreeoptions.Quotesmaybepresentedanonymouslywithoutyournameororganization,presentedwithyournameandorganization,orpresentedwithonlythesectoryourepresent.

• Whichoptionwouldyouliketochoose?

• RECORDRESPONSEFROMINTERVIEWEE:rAnonymousrNameandorganizationrSector

• Thankyou.Wewillnoteyourchoiceinthetranscriptthatweprovidetothehospitals.

• IFTHERESPONDENTISUNSUREATTHETIMEOFTHEINTERVIEW:Ok,pleasefeelfreetothinkitoverandwewillfollowupwithyouforyourdecisionbeforewesendthetranscripttothehospitals.

• Doyouhaveanyquestionsbeforewebegin?BEGINRECORDINGTHEINTERVIEW


INTERVIEWQUESTIONNAIRE(55MINUTES)

NOTESTOINTERVIEWER:• INTERVIEWQUESTIONSMAYBEADDEDORTAILOREDTOMEETTHESPECIFIC

POSITION/ROLEOFTHEINTERVIEWEE• THEQUESTIONSINTHEINTERVIEWQUESTIONNAIREAREINTENDEDTOSERVEASAGUIDE,

NOTASCRIPTBACKGROUND(5MINUTES)• Canyoutellmealittlebitaboutyourroleatyourorganization?

o Hasyourorganization/agencyeverpartneredwithMH’scommunityhealthneedsassessmentbefore?IFSO,PROBEINWHATCAPACITY/PROGRAM

• Howwouldyoudescribethecommunityyourepresent/thecommunityyourorganizationserves?Whataresomeofitsdefiningcharacteristicsintermsofdemographics?INTERVIEWER:ESTABLISHWHATTHEINFORMANTCONSIDERSTHECOMMUNITYTOBEFROMTHEIRPERSPECTIVE

COMMUNITYISSUES(20minutes)INTERVIEWER:VARYTHELABELOF‘COMMUNITY’BASEDONTHEINFORMANT’SBACKGROUNDANDHOWHEORSHEDESCRIBESTHECOMMUNITY;BESURETOPROBEONWOMEN’SANDCHILDREN’SISSUESTOENSUREWEADDRESSTHENEEDSOFTHECHILDREN’SHOSPITALSINALLQUESTIONSASRELEVANT• Thinkingaboutthestatusofthecommunitytoday,howwouldyouratetheoverallhealth

statusofresidentsonascaleof1to5with1beingpoorand5beingveryhealthy?

• Ifyouhadtopickyourtop3healthconcernsinthecommunity,whatwouldtheybe?PROBEIN-DEPTHBASEDONINFORMANTAREAOFEXPERTISE

o Whodoyouconsidertobethepopulationsinthecommunitymostvulnerableorat

riskfortheseconditions/issues?§ IFNOTYETMENTIONED,PROBESPECIFICALLYONPRIORITYPOPULATION

RELEVANTTOTHEINFORMANT’SEXPERTISE:Whatdoyouthinkarethemostpressinghealthconcernsinthecommunityfor[PRIORITYPOPULATION]?

§ FORINFORMANTSEXPERTISEWITHWOMENANDCHILDREN:Whatdoyou

thinkarethemostpressinghealthconcernsinthecommunityforchildrenandtheirfamilies?Howaboutforwomen?


§ IFNOTYETDISCUSSED:Ofthetopthreeissuesyoumentioned,whichwouldyourankasyourtopissue?Howdoyouseethisissueaffectingcommunitymembers’dailylivesandtheirhealth?PROBEIN-DEPTHINSPECIFICFOCUSAREAS;MAYASKABOUTONEISSUEATTIMEANDFOCUSONPERSON’SAREAOFEXPERTISE.

• Fromyourexperience,whatareresidents’biggestbarrierstoaddressingthetop3health

issuesyouidentified?o PROBE:Socialdeterminantsofhealth?o PROBE:Barrierstoaccessingmedicalcare?o PROBE:Barrierstoaccessingpreventiveservicesorprograms?

FOCUSAREA:HEALTHYLIVING(5MINUTES)• I’dliketoaskyouaboutbarriersaffectinghealthylivingandthepreventionofobesity.

o Whataresomeofthebarrierstohealthyeatingandphysicalactivityamongthecommunitiesyouserve?

§ Whatpopulationsaremostaffectedbythesebarrierstohealthylivingandphysicalactivity?PROBEABOUTFOODINSECURITYANDACCESSTOSAFESPACESFORPHYSICALACTIVITY

o Whateffortsorprogramsareyouawareofthatpromotehealthyliving?PROBEABOUTHEALTHYLIVINGMATTERSCOLLABORATIVE

ACCESSTOHEALTHCAREANDPUBLICHEALTH/PREVENTIONSERVICES(15MINUTES)

• I’dliketoaskyouaboutaccesstohealthcareandsocialservicesinyourcommunity.

o WhatAREthestrengthsofthehealthcareandsocialservicesinyourcommunity?

o Whataresomeoftheirlimitations?• Whatchallenges/barriersdoresidentsinyourcommunityfacewhenaccessinghealthcare

andsocialservices?[PROBEINDEPTHFORBARRIERSTOCARE:INSURANCEISSUES,LANGUAGEBARRIERS,ACCESSTOHEALTHINFORMATION/HEALTHLITERACY,LACKOFTRANSPORTION,CHILDCARE,ETC.]

o Whatdoyouthinkneedstohappeninthecommunitytohelpresidentsovercomeoraddressthesechallenges?

• Whatprograms,services,orpoliciesareyouawareofthataddressaccesstohealthcare

andsocialservices?

o Inyouropinion,howeffectivehavetheseprograms,services,orpoliciesbeenataddressingthehealthneedsofresidents?

o Whatprogram,services,orpoliciesnotavailablethatyouthinkshouldbe?


IMPROVINGTHEHEALTHOFTHECOMMUNITY/RESIDENTS(10MINUTES)• Whatdoyouthinkneedstohappeninthecommunitytohelpresidentsovercomeor

addressthechallengestheyfaceinbeingabletobehealthy?

• Earlierinthisinterview,youmentioned[TOPISSUE]asbeingyourtophealthpriorityforarearesidents.Whatdoyouthinkneedstobedonetoaddress[TOPISSUEHERE]?

o Whatdoyouthinkhospitalscandotoaddressthisissuethattheyarenotdoingrightnow?

o Doyouhaveanysuggestionsabouthowhospitalscanbecreativeorworkoutsidetheirtraditionalroletoaddressthisissueandimprovecommunityhealth?

o Whatkindsofopportunitiesarecurrentlyouttherethatcanbeseizedupontoaddresstheseissues?Forexample,aretheresome“lowhangingfruit”–currentcollaborationsorinitiativesthatcanbestrengthenedorexpanded?

VISIONFORTHECOMMUNITY(5MINUTES)

• Thehospitalsinvolvedinthisinitiativewillbeplanningtheirstrategytoimprovethehealth

ofthecommunitiestheyserve.Whatadvicedoyouhaveforthegroupdevelopingtheplantoaddressthetophealthneedsyou’vementioned?

CLOSING(5MINUTES)

Thankyousomuchforyourtime.That’sitformyquestions.Isthereanythingelsethatyouwouldliketomentionthatwedidn’tdiscusstoday?AsImentioned,afteralloftheinterviewsarecompleted,wewillbesendingyourinterviewtranscriptstoMemorialHermann.Thecommunityhealthneedsassessmentreportswillbepubliclyavailablewhentheyarecomplete.Ifyouhaveanyquestions,pleasefeelfreetoreachouttoDeborahGanelinatMemorialHermannwhoiscoordinatingthiseffort.Thankyouagain.Haveagoodmorning/afternoon.


CommunitySurvey(English)MemorialHermannHealthSystemisconductingaCommunityHealthNeedsAssessmentfortheGreaterHoustonarea.ThisassessmentallowsMemorialHermanntobetterunderstandthehealthstatusandneedsofthecommunityandusetheknowledgegainedtoimplementprogramsthatwillbenefitthecommunity.Wecanbetterunderstandcommunityneedsbygatheringvoicesfromthecommunity.Thissurveyallowscommunitymemberslikeyoutotellusaboutwhatyoufeelareimportantissuesforyourcommunity.Weestimatethatitwilltakeabout5minutestocompletethissurvey.Thankyouverymuchforyourinputandyourtime!1. Pleaselookatthislistofcommunityissues.Inyouropinion,whatarethetop5issuesmost

affectingthequalityoflifeinyourcommunity?o Diabeteso Obesity/Overweighto Respiratory/LungDisease(asthma,COPD,etc.)o Cancerso MentalHealthandMentalDisorderso Injuries,ViolenceandSafetyo SubstanceAbuse(alcohol,tobacco,drugs,etc.)o OralHealtho HeartDiseaseandStrokeo SexualHealth(HIV/AIDS,STDs,etc.)o TeenagePregnancyo ElderCareo ReproductiveHealth(familyplanning)o Other(pleasespecify):______________________________

2. Howwouldyourateyourownpersonalhealth?

o Veryhealthyo Somewhathealthyo Unhealthyo Veryunhealthy

3. Abouthowmanytimesaweekdoyouexerciseorperformaphysicalactivitylikewalking,

running,bicycling,etc.?o Lessthan1timeaweeko 2-3timesaweeko 5ormoretimesaweeko Nevero Other(pleasespecify):______________________________


4. Whataresomeofthebarriersorchallengestoexercisingonaregularbasisforyou?

o Noplacestoexerciseo Notimetoexerciseo Idon’tlikeexercisingo Feelunsafeexercisinginthecommunityo Noneofmyfriendsorfamilyexerciseo Nochildcareo Lackoffundstopayforgymorclasseso Notransportationo Other(pleasespecify):______________________________

5. Howmuchdoyouagreeordisagreewitheachofthestatementsbelow. Agree

stronglyAgree Disagree Disagree

stronglyTherearegoodparksforchildren,adultsandpeopleofallabilitiestoenjoyinmycommunity

Inthepast12months,IhadaproblemgettingthehealthcareIneededformeorafamilymemberfromanytypeofhealthcareprovider,dentist,pharmacy,orotherfacility

Idon’tknowwheretogetservicesformyselfwhenIamsad,depressedorneedsomeonetotalkto

IamconfidentIcangetanappointmentwhenIneedtoseemydoctorfairlyquickly

Ihaveaplacetoreceivemedicalcareotherthantheemergencyroom

Withinthepast12months,IworriedwhethermyfoodwouldrunoutbeforeIgotmoneytobuymore

Withinthepast12months,thefoodIboughtjustdidn’tlastandIdidn’thavemoneytogetmore

Therearemanyoptionsforhealthyandaffordablefoodinmycommunity

6. Hasyourdoctorevertoldyouthatyouhaveanyofthefollowing?(Markallthatapply)

o Highbloodpressureo Highcholesterolo Cancero Diabeteso Obesityo Asthmao Heartdiseaseo Other(pleasespecify):______________________________

Now,afewquestionssothatwecanseehowdifferenttypesofpeoplefeelaboutthequestionsasked.


7. Zipcodewhereyoulive:______________________________8. Whatisyourage?______________________________9. Whatisyourrace/ethnicity?

o Whiteo Black/AfricanAmericano Hispanic/Latinoo Asian/PacificIslandero NativeAmericano Other(pleasespecify):______________________________

10. Whataretheagesofchildrenlivinginyourhousehold?

o 11andyoungero 12-18yearsoldo 18andoldero None

11. Whatkindofmedicalinsuranceorcoveragedoyouhave?

o Privateo Employer-sponsoredo Medicaido Medicareo Noneo Other(pleasespecify):______________________________

Thankyouforcompletingthissurvey!


CommunitySurvey(Spanish)MemorialHermannHealthSystemestárealizandounaEvaluacióndelasNecesidadesdeSaluddelaComunidadeneláreametropolitanadeHouston.EstaevaluaciónpermiteaMemorialHermann

comprendermejorelestadodesaludylasnecesidadesdelacomunidad,asícomousarlainformaciónobtenidaparaponerenprácticaprogramasquebeneficienalacomunidad.

1.Lealalistadeproblemasdelacomunidad.Ensuopinión¿cuálessonlos5problemasquemásafectanlacalidaddevidaensucomunidad?□ Diabetes□ Obesidad/sobrepeso□ Enfermedadesrespiratorias/pulmonares(asma,enfermedadpulmonarobstructivacrónica[EPOC],etc.)

□ Cáncer□ Saludmentalytrastornosmentales□ Lesiones,violenciayseguridad□ Drogodependencia(alcohol,tabaco,drogas,etc.)

□ Saludbucal□ Enfermedadescardíacasyaccidentescerebrovasculares

□ Saludsexual(VIH/sida,enfermedadesdetransmisiónsexual[ETS],etc.)

□ Embarazosdeadolescentes□ Cuidadodeancianos□ Saludreproductiva(planificaciónfamiliar)

□ Otros,(especifique):_________________________________________________________

2.¿Cómocalificaríasupropiasaludpersonal?□ Muybuena□ Bastantebuena

□ Mala□ Muymala

3.¿Aproximadamente,cuántasvecesporsemanahaceejerciciooalgunaactividadfísica,comocaminar,correr,andarenbicicleta,etc.?□ Menosde1vezporsemana□ De2a3vecesporsemana

□ 5omásvecesporsemana□ Nunca


4.¿Cuálessonalgunasdelasbarrerasodificultadesqueleimpidenhacerejercicioregularmente?□ Notengounlugardondehacerejercicio.□ Notengotiempoparahacerejercicio.□ Nomegustahacerejercicio.□ Nomesientoseguro/ahaciendoejercicioenmicomunidad.

□ Ningunodemisamigosofamiliareshacenejercicio.

□ Notengoconquiéndejaramishijosmientrashagoejercicio.

□ Notengodineroparapagarungimnasiooclases.

□ Notengoaccesoatransporte.


Calculamosqueletomaráunos5minutoscompletarestaencuesta.


5.¿Lehadichosumédicoalgunadelassiguientesafecciones?(Marquetodaslasopcionesquecorrespondan).□ Presiónarterialalta□ Colesterolalto□ Cáncer□ Diabetes

□ Obesidad□ Asma□ Enfermedadcardíaca


6.¿Enquémedidaestádeacuerdooendesacuerdoconcadaunadelassiguientesafirmaciones? Muyde

acuerdoDe

acuerdoEn

desacuerdoMuyen

desacuerdoEnmicomunidad,haybuenosparquesparaniños,adultosypersonascontodotipodecapacidadesparanuestrodisfrute.

Enlosúltimos12meses,tuveunproblemaparaobtenerelcuidadomédicoquenecesitabaparamíoparaunfamiliarporpartedecualquiertipodeproveedordecuidadodelasalud,dentista,farmaciauotrocentrosanitario.

Nosédóndeobtenerserviciosparamícuandoestoytriste,deprimido/a,onecesitohablarconalguien.

Séconseguridadquepuedoobtenerunacitaconmimédicoconciertarapidez.

Tengoamidisposiciónunlugarpararecibircuidadosmédicosquenoseaunasaladeemergencias.

Enlosúltimos12meses,mepreocupédesilacomidaseagotaríaantesdeobtenerdineroparacomprarmásalimentos.

Enlosúltimos12meses,losalimentosquecomprésimplementenoduraronlosuficienteynotuvedineroparacomprarmás.

Enmicomunidadhaymuchasopcionesparacompraralimentossaludablesyasequibles.

7.Códigopostaldesucasa:_________________________8.¿Cuántosañostiene?_________________9.¿Cuálessuraza/origenétnico?□ Blanco/a□ Negro/aoafroamericano/a□ Hispano/aolatino/a

□ Asiático/aoisleño/adelPacífico□ Indígenaamericano/a□ Otro/a,(especifique):______________

10.¿Cuántosañostienenlosniños/asquevivenensucasa?

Ahoraleharemosalgunaspreguntasparapodervercómosesientenlosdistintosgruposdepersonasacercadelaspreguntasquelehemoshecho.


□ 11ymenos□ Entre12y18años

□ Másde18años□ Ninguno

11.¿Quétipodeseguromédicoocoberturatiene?□ Privado□ Patrocinadoporunempleador□ Medicaid

□ Medicare□ Ninguno□ Otro,(especifique):________


AppendixD.PrioritizationTool

PrioritizationSurveyThankyouforyourparticipationinthisprioritizationprocess.TheCommunityHealthNeedsAssessment(CHNA)processhasmultiplesteps.Afterthoroughresearchhasbeencompletedtoidentifythesignificanthealthneedsinthecommunity,thesesignificanthealthneedsmustbeprioritizedforfurtherstrategicplanningandimplementation.Prioritizationistheprocessofdeterminingthemostimportantorurgenthealthneedstoaddressincommunities.BelowisadiagramthatshowsthemethodsthatwereusedtoidentifykeyissuesacrossMemorialHermann’sserviceareas.Thesethreemethodsincluded:asecondarydatareview,acommunitysurveyandkeyinformantinterviews.Asyousee,someissuesrevealedthemselvesacrossmultiplemethods.Reviewingthisdiagrammayhelpyoucompletethissurvey.

1. Thefollowinghealthneedsarenotlistedbyorderofimportance.Foreachhealthneed,click

onthearrowonthedropdownboxandselectyouragreementwitheachstatement.Ifyouareonatabletorphone,pleasescrollallthewaytotherightforeachrow.

Theissueimpactsmanypeopleinmycommunity

Thisissuesignificantlyimpacts

Therearenotenoughexistingandadequate

Thisissuehashighriskfordiseaseordeath


subgroups(subgroupsbyage,gender,race/ethnicity,LGBTQ,etc.)

resourcestoaddressthisissueinmycommunity

AccesstoHealthServices

HeartDiseaseandStroke

OlderAdultsandAging

Obesity(Exercise,NutritionandWeight)

Transportation MentalHealth Diabetes SubstanceAbuse Cancers LackofHealthInsurance

Education FoodInsecurity Low-Income/Underserved

Children’sHealth Economy 2. IndicatethelevelofimportancethatshouldbegiventowardseachofMemorialHermann’s

4Pillars.Keydefinitionsarelistedbelow.

NotImportant

SomewhatImportant

Important VeryImportant

NotSure

Accesstocare(includinghealthcareaccess,healthcareresourceawareness,healthcarenavigation/literacy)

Foodashealth(includingfoodinsecurity,foodprograms,foodknowledge)

Exerciseasmedicine(includingobesity,accesstoparks,safeplacestoexercise)

Emotionalwell-being(includingemotionalhealth,mentalhealth,substanceabuse)

Keydefinitions:


Healthcarenavigation/literacy:needforeducationinnavigatinghealthsystemsFoodinsecurity:lackingreliableaccesstohealthyfoodoptionsFoodprograms:programs,effortsorservicesdesignedtoaddressfoodissuesFoodknowledge:one’sunderstandingofhealthyfoods3. Whoinyourcommunityismostaffectedbypoorhealthoutcomes?(Selectupto5)

o Lesbian,Gay,Bisexual,Transgender,QueerorQuestioning(LGBTQ)o OlderAdultso PersonswithDisabilities(cognitive,sensoryorphysicaldisability)o Racial/EthnicMinorityPopulationso Veteranso Immigrantsorotherundocumentedpersonso Personsexperiencinghomelessnessorprecariouslyhousedo OtherPopulations(pleasespecify):____________________________

4. Pleaseprovideyourname:__________________________________________

5. Pleaseprovideyouremailaddress:__________________________________________

6. Pleaseselectthename(s)ofthehealthcarefacilityorfacilitiesyourepresent.Youmay

choosemorethanone.o MemorialHermannKatyo MemorialHermannMemorialCityo MemorialHermannGreaterHeightso MemorialHermannNortheasto MemorialHermannSoutheasto MemorialHermannSugarLando MemorialHermannSouthwesto MemorialHermannTheWoodlandso KatyRehabo TexasMedicalCentero TIRRMemorialHermanno MemorialHermannSurgicalHospitalKingwoodo MemorialHermannSurgicalHospitalFirstColonyo MemorialHermannFirstColonyHospital(ER)o MemorialHermannTomballHospital(ER)o Other(pleasespecify):_____________________________

ThankyouforyourinputandparticipationintheCommunityHealthNeedsAssessmentprocess.


AppendixE.CommunityResourcesThefollowingisalistofcommunityresourcesmentionedbycommunityinputparticipants.2-1-1TexasA.C.TaylorHealthCenterAccessHealthAcresHomeHealthCenterAIDSFoundationHoustonAldineHealthCenterAmericanHeartAssociationAmericanRedCrossAmistadCommunityHealthCenterAreaAgencyonAgingAssociationfortheAdvancementofMexicanAmericansAvenue360Health&WellnessAvenueCDCBaker-RipleyBastropCommunityHealthCenterBaylorTeenHealthClinicBaysideClinicBaytownHealthCenterBeeBusyWellnessCenterBoatPeopleSOSBo'sPlaceBrighterBitesBrownsvilleCommunityHealthCenterBuffaloBayouPartnershipBurlesonFamilyMedicalCenterBVCAA-HealthPointCanDoHoustonCasadeAmigosHealthCenterCasaElBuenSamaritanoCatholicCharitiesoftheArchdioceseofGalveston-Houston-FortBendCentralCareCommunityHealthChambersCommunityHealthCenterCHISt.Luke'sHealthChildAdvocatesofFortBendChildrenatRiskChristClinicChristianCommunityServicesCenter(CCSC)CHRISTUSHealthSystemCitiesChangingDiabetesCityofHouston

CityofHouston,DepartmentofParksandRecreationCityofPasadenaCoastalAreaHealthEducationCenters(AHEC)CommunityHealthChoiceCountyIndigentHealthCareProgramCovenantwithChristCommunityServiceCenterCypressHealthCenterDannyJacksonHealthCenterDentalHygieneClinicE.A."Squatty"LyonsHealthCenterElCentroDeCorazonElFrancoLeeHealthCenterEpiscopalHealthFoundationFamilyServices(GalvestonCounty)FortBendConnectFortBendCountyCollaborativeInformationSystemFortBendCountyHealthandHumanServicesFortBendCountySheriff'sOfficeFortBendRegionalCouncilOnSubstanceAbuseFortBendSeniorsMealsonWheelsFortBendWomen'sCenterGalvestonCountyHealthDistrictGalvestonCountyMentalHealthDeputiesGoHealthyHoustonTaskForceGoodRxGreaterHoustonPartnershipGreaterHoustonWomen'sChamberofCommerceGulfCoastCommunityServicesAssociationGulfCoastMedicalFoundationGulfgateHealthCenterHarmonyHouseRespiteCenterHarrisCenterCrisisLineHarrisCountyPublicHealthandEnvironmentalServices(HCPHES)HarrisCountyRidesHarrisCountySocialServices


HarrisHealthSystemHarvestGreen(Development)HEALInitiativeHealthCenterofSoutheastTexasHealthcarefortheHomeless-HoustonHealthyLivingMatters(HarrisCounty)HelpingHandsFoodPantryHOPEClinic(FQHC)HoustonFoodBankHoustonHealthDepartmentHoustonHousingAuthorityHoustonIndependentSchoolDistrictHoustonRyanWhitePlanningCouncilHoustonShifaSynottClinicHuntsvilleMemorialHospitalClinicIbnSinaFoundationIndiaHouseCharityClinicInterfaithCommunityClinicInterfaithMinistriesMealsonWheelsInterfaithofTheWoodlandsKinderInstituteLaNuevaCasaHealthCenterLegacyHealth(FQHC)LeonCountyCommunityHealthCenterLibertyCountySheriff'sOfficeLoneStarFamilyHeathCenter(FQHC)LongBranchHealthCenterLongTermRecoveryGroupLosBarriosUnidosCommunityClinicMagnoliaHealthCenterMamieGeorgeCommunityCenterMartinLutherKingJr.HealthCenterMedicalPlusSuppliesMEHOP-MatagordaEpiscopalHealthOutreachProgramMETHeadStartMethodistHospitalMetroliftMidtownArtsandTheaterCenterHoustonMontgomeryCountyFoodBankMontgomeryCountyWomen’sCenterNeighborhoodHealthCenterNorthwestAssistanceMinistry'sChildren'sClinicNorthwestHealthCenterNuestraClinicadelValle

PatMcWatersHealthClinic-SecondMileMissionPatientCareInterventionCenter(PCIC)PearlandCommunityHealthCenterPediatric&AdolescentHealthCenterPhysiciansatSugarCreekPlannedParenthoodPrairieViewA&MUniversityQuentinMeaseHospitalRegionalAssociationofGrantMakersRegionalMedicalCenterRobertCarrascoHealthClinicRSVPMedSpaSanJoseClinicSantaMariaHostel,Inc.SettegastHealthCenterSevaClinicCharityMedicalFacilityShelteringArmSeniorServicesDivisionofBakerRipleyShifaClinicSmithClinicSocialSecurityAdministrationSpringBranchCommunityHealthCenterSt.HopeFoundationSt.Vincent'sHouseStephenF.AustinCommunityHealthNetworkStrawberryHealthCenterTexanaBehavioralHealthTexasA&MAgriLifeExtensionServiceTexasChildren’sHospitalTexasMedicaidandCHIPMedicalTransportationProgramTheArcofFortBendCountyTheBeaconTheHarrisCenterforMentalHealthandIDD(formerlyMHMRA)TheRoseTheWomen'sHomeThomasStreetHealthCenterTOMAGWAClinicTri-CountyServicesBehavioralHealthcareUberHealthUnitedWayofBrazoriaCountyUnitedWayofGreaterHoustonUnitedWayProjectBlueprint


UniversityofHouston-CollegeofOptometryUniversityofTexasHealth-DentalUniversityofTexasHealthServicesUniversityofTexasPhysiciansUrbanHarvestUTMBValbonaHealthCenterVCareClinicVecinoHealthCenterWestChambersMedicalCenter(FQHC)WestHoustonAssistanceMinistries(WHAM)WholeLifeServiceCenterWomen'sCareCenterWorkforceSolutionsYMCAofGreaterHouston

Documents

Houston Hospitals, Institutes & Centers - MEMORIAL HERMANN THE WOODLANDS MEDICAL … · 2019. 6. 28. · affiliated with McGovern Medical School at UTHealth; one of the nation’s