Download Community Health Needs Assessment 2013

Community
Health Needs
Assessment
2013
Contents
Introduction ................................................................................................................................ 4
Background and Purpose.................................................................................................... 4
Service Area ....................................................................................................................... 5
Hospital Service Area Map .................................................................................................. 6
Consultants ......................................................................................................................... 6
Organizations and Partners ................................................................................................ 7
Methods ..................................................................................................................................... 7
Secondary Data Collection .................................................................................................. 7
Input from Persons who Represent the Community ............................................................ 8
Information Gaps ................................................................................................................ 8
Health Care Facilities and Community Resources .............................................................. 8
Identification and Prioritization of Health Needs ........................................................................10
Priority Health Needs .........................................................................................................10
Demographics ...........................................................................................................................12
Population ..........................................................................................................................12
Gender...............................................................................................................................13
Race/Ethnicity ....................................................................................................................13
Citizenship .........................................................................................................................14
Language ...........................................................................................................................14
Veterans ............................................................................................................................15
Social and Economic Factors ....................................................................................................16
Social and Economic Factors Ranking ...............................................................................16
Poverty ..............................................................................................................................16
Households ........................................................................................................................17
Free or Reduced Price Meals.............................................................................................18
Unemployment ...................................................................................................................19
Educational Attainment ......................................................................................................19
Homelessness ...................................................................................................................20
Crime and Violence ............................................................................................................21
Health Access ...........................................................................................................................22
Health Insurance Coverage ...............................................................................................22
Sources of Care .................................................................................................................23
1
Use of the Emergency Room .............................................................................................24
Access to Primary Care Community Clinics .......................................................................25
Underserved Areas ............................................................................................................26
Dental Care........................................................................................................................26
Birth Characteristics ..................................................................................................................27
Births .................................................................................................................................27
Teen Birth Rate ..................................................................................................................27
Prenatal Care.....................................................................................................................27
Low Birth Weight ................................................................................................................28
Infant Mortality ...................................................................................................................28
Breastfeeding.....................................................................................................................29
Mortality/Leading Causes of Death ...........................................................................................30
Mortality Rates ...................................................................................................................30
Leading Causes of Premature Death .................................................................................31
Chronic Disease........................................................................................................................32
Health Status .....................................................................................................................32
Diabetes ............................................................................................................................32
Heart Disease ....................................................................................................................33
High Blood Pressure ..........................................................................................................33
Cancer ...............................................................................................................................34
Asthma ..............................................................................................................................34
Disability ............................................................................................................................35
Health Behaviors.......................................................................................................................36
Health Behaviors Ranking ..................................................................................................36
Overweight and Obesity .....................................................................................................36
Fast Food...........................................................................................................................37
Soda Consumption ............................................................................................................38
Fresh Fruits and Vegetables ..............................................................................................38
Physical Activity .................................................................................................................38
Community Walkability .......................................................................................................40
HIV/AIDS ...........................................................................................................................40
Sexually Transmitted Diseases ..........................................................................................41
Teen Sexual History ...........................................................................................................41
2
Cigarette Smoking .............................................................................................................41
Alcohol and Drug Use ........................................................................................................41
Mental Health .....................................................................................................................42
Immunization of Children ...................................................................................................43
Flu and Pneumonia Vaccines.............................................................................................44
Mammograms and Pap Smears .........................................................................................44
Colorectal Cancer Screening .............................................................................................45
Community Input .......................................................................................................................46
Attachment 1. Benchmark Comparisons ...................................................................................63
Attachment 2: Community Stakeholders ..................................................................................64
3
Introduction
Background and Purpose
Henry Mayo Newhall Memorial Hospital (Henry Mayo) is a 238-bed nonprofit hospital
that serves the community of Santa Clarita, California. The mission of the hospital is to
improve the health of our community through compassion and excellence in health care
services. Founded in 1975, Henry Mayo is a fully-accredited, acute care hospital facility
and Level II trauma center that provides inpatient and outpatient services. Services
include a nationally recognized Advanced Primary Stroke Center, the Sheila R. Veloz
Breast Imaging Center, a behavioral health unit, outpatient wound care, maternity,
neonatal intensive care unit, cancer, comprehensive cardiovascular care, and infusion
center.
Henry Mayo has seen the Santa Clarita Valley experience tremendous growth and an
aging population. As a result, the need for expanded health care services has
dramatically increased. To grow with the community, the hospital has embarked on a
major long-term planning project which includes the construction of a new inpatient
hospital building that will add up to 120 new beds, new medical office buildings
designed to support hospital programs and services, a new central plant, new parking
structures and a life-saving helipad. Currently under construction is an education center
and medical office building. Recent improvements include a newly-renovated intensive
care unit (ICU), a new neonatal intensive care unit (NICU), a new operating room, new
infusion center, and expanded cardiovascular services. In the last five years, the
hospital also expanded and updated its entire emergency and imaging departments,
adding new and replacement technologies to improve the quality of care. Henry Mayo is
in the top 5% of the country with the latest advancement in electronic health records,
and is recognized as one of the “Most Wired” hospitals in the nation.
Henry Mayo has undertaken a Community Health Needs Assessment (CHNA) as
required by state and federal law. California Senate Bill 697 and the Patient Protection
and Affordable Care Act and IRS section 501(r)(3) direct tax exempt hospitals to
conduct a Community Health Needs Assessment and develop an Implementation
Strategy every three years. The Community Health Needs Assessment is a primary
tool used by the hospital to determine its community benefit plan, which outlines how it
will give back to the community in the form of health care and other community services
to address unmet community health needs. This assessment incorporates components
of primary data collection and secondary data analysis that focus on the health and
social needs of the service area.
4
Service Area
Henry Mayo Newhall Memorial Hospital is located at 23845 McBean Parkway, Valencia,
California. The hospital’s service area is Canyon Country, Castaic, Newhall, Santa
Clarita, Stevenson Ranch and Valencia.
FY12 hospital inpatient admissions data indicate that 78% of patients originate from the
following zip codes. This area is located in the Santa Clarita Valley, which is in north
Los Angeles County within Service Planning Area 2 (SPA 2).
Henry Mayo Newhall Memorial Hospital Service Area
City
Canyon Country
Castaic
Newhall
Santa Clarita
Stevenson Ranch
Valencia
Zip Code
91351, 91387
91384
91321
91350, 91390
91381
91354, 91355
5
Hospital Service Area Map
Source: HealthyCity.org
Consultants
The Community Health Needs Assessment has been conducted as a collaborative
effort between The Identity Group and Melissa Biel of Biel Consulting, Inc. The Identity
Group is a strategic health care consulting firm that was founded in 1989. The firm
specializes in working with community, non-profit hospitals, foundations and health
plans. Biel Consulting, Inc. is an independent consulting firm that works with hospitals,
clinics and community-based nonprofit organizations. Dr. Biel has over 10 years of
experience conducting hospital Community Health Needs Assessments and working
with hospitals on developing, implementing, and evaluating community benefit
programs.
6
Organizations and Partners
A number of organizations and agencies contributed time and resources to assist with
the conduct of this needs assessment. We acknowledge the following organizations
and agencies:
Action Family Counseling
Alzheimer’s Association
American Cancer Society, California Division
American Diabetes Association
Boys & Girls Club of Santa Clarita Valley
Child & Family Center
City of Santa Clarita, Newhall Community Center
College of the Canyons
Domestic Violence Center of Santa Clarita Valley
Help the Children
Henry Mayo Newhall Memorial Hospital Behavioral Health Unit
Los Angeles County, Department of Public Health
Los Angeles County Department of Mental Health - Santa Clarita Valley Mental
Health Center
Los Angeles Residential Community (LARC) LARC Ranch
Northeast Valley Health Corporation (NEVHC)
Northeast Valley Health Corporation – WIC Program
Samuel Dixon Family Health Centers, Inc.
Santa Clarita Adult Day Health Care
Santa Clarita Valley Central Office of Alcoholics Anonymous
Santa Clarita Valley Senior Center
Single Mothers Outreach
Methods
Secondary Data Collection
Secondary data were collected from a variety of local, county, and state sources to
present the hospital service area demographics, social and economic factors, health
access, birth characteristics, leading causes of death, chronic disease, and health
behaviors.
Analyses were conducted at the most local level possible for the Hospital service area,
given the availability of the data. For example, demographic data, birth and death data
are based on zip codes. Economic indicators are available by city. Other data are only
7
available at the county level. Sources of data include the U.S. Census American
Community Survey, California Department of Public Health, California Employment
Development Department, California Department of Education, California Department of
Justice, California Health Interview Survey, County Health Rankings, Los Angeles
Homeless Services Authority, Los Angeles County Public Health, Uniform Data Set, and
others. When pertinent, these data sets are presented in the context of the state.
The report includes benchmark comparison data that measures Henry Mayo Newhall
Memorial Hospital’s community data findings with Healthy People 2020 objectives
(Attachment 1). Healthy People 2020 objectives are a national initiative to improve the
public’s health by providing measurable objectives and goals that are applicable at
national, state, and local levels.
Input from Persons who represent the Community
Targeted interviews were used to gather information and opinions from persons who
represent the broad interests of the community served by the hospital. Twenty-four
interviews were completed during August, 2013. For the interviews, community
stakeholders identified by Henry Mayo were contacted and asked to participate in the
needs assessment. Interviewees included individuals who are leaders and
representatives of medically underserved, low-income, minority and chronic disease
populations, or regional, State or local health or other departments or agencies that
have “current data or other information relevant to the health needs of the community
served by the hospital facility.” A list of the stakeholder interview respondents, their
titles, organizations and leadership roles are in Attachment 2.
Information Gaps
Information gaps that impact the ability to assess health needs were identified. Most
notably, some data are only available at the county level, which make it difficult to
identify health needs at the local level. Also, data were not always collected on a yearly
basis, meaning that some data were several years old.
Health Care Facilities and Community Resources
Hospitals
Henry Mayo Newhall Memorial Hospital
Kaiser Foundation Hospital – Panorama City
Northridge Hospital Medical Center
Providence Holy Cross Medical Center
Valley Presbyterian Hospital
Clinics
Asian Pacific Health Care Venture
Comprehensive Community Health Center, Inc.
8
El Proyecto Del Barrio, Inc.
Mission City Community Network, Inc.
Northeast Valley Health Corporation
Samuel Dixon Family Health Centers, Inc.
Valley Community Clinic
Other Community Resources
A list of resources within the community that are available to meet identified community
health needs can be accessed at:
Los Angeles County Information and Referral Line www.211la.org
Los Angeles County Department of Mental Health
http://dmh.lacounty.gov/wps/portal/dmh/our_services
Healthy City www.healthycity.org/c/service
9
Identification and Prioritization of Health Needs
Based on the results of the primary and secondary data collection, health needs were
identified. Each health need was confirmed by more than one indicator or data source
(i.e., the health need was suggested by more than one source of secondary or primary
data). In addition, the health needs were based on the size of the problem (relative
portion of population afflicted by the problem); or the seriousness of the problem (impact
at individual, family, and community levels). To determine size or seriousness of a
problem, the health need indicators identified in the secondary data were measured
against benchmark data, specifically California state rates or Healthy People 2020
objectives. Indicators related to the health needs that performed poorly against these
benchmarks were considered to have met the size or seriousness criteria. Additionally,
primary data sources were asked to identify community and health issues based on the
perceived size or seriousness of a problem.
The identified health needs included:
Access to care
Alcohol and drugs
Asthma
Cardiovascular disease
Community safety and violence
Dental health
Diabetes
Homelessness
Mental health
Overweight and obesity
Smoking
Priority Health Needs
Priority setting is a required step in the community benefit planning process. The
Community Health Needs Assessment must provide a prioritized description of the
community health needs identified through the CHNA, and include a description of the
process and criteria used in prioritizing the health needs.
Henry Mayo engaged an internal leadership group that included the: CEO, CFO, COO,
CFO, CMO, Director Planning, Director Decision Support, Director Outpatient Services,
and the Managed Care Contract Specialist. This leadership team met in September,
2013 to review the identified community health needs. The group prioritized the health
needs ranking them based on criteria that included: the size of the issue, impact on
community health and quality of life, and availability of internal and external resources to
meet the need. For each of the health needs, the criteria were rated using a matrix to
10
assign points from 1-5, where a 1 rating was equivalent to a low criteria score and a 5
score was a high criteria score. The rating points were then tallied for a total score.
The health needs were ranked in the following priority order from highest to lowest
score.
Rank-Ordered Priority Health Needs
Access to Care
Diabetes
Asthma
Cardiovascular Disease
Obesity
Mental Health
Alcohol/Drugs
Homelessness
Dental Health
Violence
Smoking
11
Demographics
Population
According to the American Community Survey (averaged across five years, 2007 to
2011), the population for the Henry Mayo Newhall Memorial Hospital primary service
area was 266,980. Children and youth, ages 0-17 make up 26.8% of the population;
10.1% are 18-24 years of age; 29.0% are 25-44; 25.9% are 45-64; and 8.1% of the
population are seniors, 65 years of age and older. The area has higher percentages of
youth aged 5-17, and adults ages 45-64, and lower rates of children 0-4, young adults
aged 18-24, and seniors, than found in Los Angeles County and the state.
Population by Age
Henry Mayo Hospital
Service Area
Number
Percent
Age 0-4
Age 5-17
Age 18-24
Age 25-44
Age 45-64
Age 65+
Total
16,683
55,090
27,083
77,487
69,072
21,565
266,980
Los Angeles County
Number
6.2%
20.6%
10.1%
29.0%
25.9%
8.1%
100%
Percent
654,277
1,773,554
1,041,611
2,929,277
2,340,034
1,048,994
9,787,747
6.7%
18.1%
10.6%
29.9%
23.9%
10.7%
100%
California
Number
2,545,224
6,758,294
3,867,838
10,522,270
9,107,741
4,167,833
36,969,200
Percent
6.9%
18.3%
10.5%
28.5%
24.6%
11.3%
100.0%
Source: American Community Survey, 2007-2011
When the population is examined by place, Stevenson Ranch notably has the highest
concentration of children 0-17 (32.6%), and the lowest concentration of adults 18-64
(60.9%), in the hospital service area. The lowest concentration of children 0-17 (21.9%),
and the lowest concentration of seniors 65+ (4.1%) can be found in Castaic. The
highest concentration of seniors is found in Newhall (12.1%).
Population by Age and Zip Code
Geographic Area
Zip Code
Canyon Country
91351
Canyon Country
91387
Castaic
91384
Newhall
91321
Santa Clarita
91350
Santa Clarita
91390
Stevenson Ranch
91381
Valencia
91354
Valencia
91355
Henry Mayo Hospital Service Area
L.A. County
Ages 0-17
27.0%
28.3%
21.9%
25.5%
28.3%
27.8%
32.6%
29.7%
23.4%
26.9%
24.8%
Ages 18-64
65.3%
64.9%
74.1%
62.4%
63.3%
65.0%
60.9%
63.1%
65.5%
65.0%
64.5%
Ages 65+
Total Pop.
Median age
7.7%
6.9%
4.1%
12.1%
8.4%
7.2%
6.6%
7.2%
11.1%
8.1%
10.7%
31,596
39,991
29,617
34,948
32,449
19,348
18,597
28,330
32,104
266,980
9,787,747
35.2
33.0
31.9
33.7
35.1
40.2
37.2
37.0
36.8
35.2
34.6
Source: American Community Survey, 2007-2011
12
Gender
Of the area population, 51.6% are male and 48.4% are female, which is a higher ratio of
men to women than found in the county or the state.
Population by Gender
Gender
Male
Henry Mayo Hospital
Service Area
51.6%
Los Angeles
County
49.3%
48.4%
50.7%
Female
California
49.7%
50.3%
Source: American Community Survey, 2007-2011
Race/Ethnicity
The population of the service area consists primarily of White/Caucasians (52.5%) and
Latinos (28.8%). Asian/Pacific Islanders comprise 10.3% of the population, and African
Americans, Native Americans, those of mixed race, and all other races combined total
8.2% of the population. The area has a notably larger percentage of Whites, and a
smaller percentage of Latinos when compared to Los Angeles County or California.
Race/Ethnicity
Henry Mayo Hospital
Service Area
Number
Percent
White
Hispanic or Latino
Asian
Black or African American
American Indian/AK Native
Native HI / Pacific Islander
Other or Multiple
140,292
76,924
27,298
9,968
377
245
11,876
52.5%
28.8%
10.2%
3.7%
0.1%
0.1%
4.4%
Los Angeles
County
Number
Percent
2,749,159
4,644,328
1,331,809
816,625
17,324
23,979
204,523
28.1%
47.5%
13.6%
8.3%
0.2%
0.2%
2.1%
California
Number
15,028,200
13,752,743
4,760,615
2,159,863
151,324
132,395
984,060
Percent
40.7%
37.2%
12.9%
5.8%
0.4%
0.4%
2.7%
Source: American Community Survey, 2007-2011
When examined by place, Newhall was the highest concentration of Latinos (46.1%) in
the service area, Stevenson Ranch the highest concentration of Asians (23.7%), and
Castaic the highest concentration of African Americans (10.7%).
Population by Race and Ethnicity and Zip Code
Geographic Area
Zip Code
Canyon Country
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
91351
91387
91384
91321
91350
91390
91381
91354
91355
White
45.4%
45.7%
46.2%
42.5%
57.1%
69.5%
56.5%
55.0%
65.7%
Asian
7.0%
12.0%
4.6%
4.8%
9.9%
6.2%
23.7%
18.0%
10.4%
Hispanic/Latino
40.7%
31.5%
33.6%
46.1%
25.5%
18.4%
13.8%
17.7%
18.7%
Black
2.0%
5.0%
10.7%
3.0%
2.6%
2.0%
2.7%
3.9%
1.0%
13
Henry Mayo Hospital Service Area
Los Angeles County
52.5%
28.1%
10.2%
13.6%
28.8%
47.5%
3.7%
8.3%
Source: American Community Survey, 2007-2011
Citizenship
In the hospital service area, 20.7% of the overall population are foreign born and 9.5%
are not citizens. The highest concentration of foreign-born residents (29%) and the
highest concentration of non-citizens are found in Newhall.
Foreign Born Residents and Citizenship
Geographic Area
Canyon Country
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
Henry Mayo Hospital Service Area
Los Angeles County
Zip Code
91351
91387
91384
91321
91350
91390
91381
91354
91355
Foreign Born
25.4%
22.5%
16.0%
29.0%
16.6%
10.4%
23.1%
21.0%
17.5%
20.7%
35.6%
Not a U.S. Citizen
11.3%
10.7%
8.1%
20.7%
5.5%
2.2%
8.3%
7.0%
6.2%
9.5%
19.4%
Source: American Community Survey, 2007-2011
Language
In the hospital service area, 68.9% of residents speak only English in their homes.
Spanish is spoken in 19.4% of the homes; this is less than the number of Spanish
speaking households in the county (39.4%) and the state (28.6%). The service area
has noticeably fewer households that speak Asian/Pacific Island languages (6.9%) or
other Indo-European languages (3.7%) than speak Spanish or English.
Language Spoken at Home, Population 5 Years and Older
Henry Mayo Hospital
Service Area
Speaks Only English
Speaks Spanish
Speaks Asian/PI Language
Speak Indo-European Language
Speaks Other Language
68.9%
19.4%
6.9%
3.7%
1.1%
Los Angeles
County
43.4%
39.4%
10.8%
5.4%
1.0%
California
56.8%
28.6%
9.5%
4.3%
0.9%
Source: American Community Survey, 2007-2011
When communities are examined by language spoken in the home, Newhall has the
highest concentration of Spanish-speakers (35.9%). Stevenson Ranch has the highest
concentration of Asian/Pacific Islander languages (18.6%).
14
Language Spoken at Home
Geographic Area
Zip Code
Canyon Country
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
Henry Mayo Hospital Service Area
Los Angeles County
English
91351
91387
91384
91321
91350
91390
91381
91354
91355
59.5%
65.0%
68.8%
57.7%
75.7%
82.2%
67.4%
72.7%
77.6%
68.9%
43.4%
Spanish
30.7%
21.6%
24.9%
35.9%
13.4%
9.6%
7.9%
9.1%
9.9%
19.4%
39.4%
Asian/PI
4.6%
7.8%
3.5%
3.1%
6.5%
3.6%
18.6%
11.9%
6.9%
6.9%
10.8%
Indo
European
3.6%
3.7%
2.0%
2.8%
3.7%
3.6%
5.2%
5.2%
4.5%
3.7%
5.4%
Source: American Community Survey, 2007-2011
In the school districts in the service area 36.3% of students in the Newhall School
District are English learners, and 33.2% of Sulphur Springs Union District students are
English learners, compared with 19.2% of Saugus Union District students and 17.1% of
Castaic Union Elementary District students. The rates in all of the area's school districts
are lower than found among students in Los Angeles County as a whole.
English Learners and 'Fluent English Proficient' Students
School District
Acton-Agua Dulce Unified District
Castaic Union Elementary District
Newhall District
Saugus Union District
Sulphur Springs Union District
William S. Hart Union High District
Los Angeles County
Percent
21.8%
17.1%
36.3%
19.2%
33.2%
23.4%
52.5%
Source: California Department of Education DataQuest, 2012-2013
Veterans
In the Henry Mayo Hospital service area, 6.7% of the population 18 years and older are
veterans. This is slightly lower than the percentage of veterans found in California, but
higher than that of Los Angeles County.
Veterans
Veteran Status
Henry Mayo Hospital
Service Area
Los Angeles
County
California
6.7%
4.8%
7.3%
Source: American Community Survey, 2007-2011
15
Social and Economic Factors
Social and Economic Factors Ranking
The County Health Rankings ranks counties according to health factors data. Social and
economic indicators are examined as a contributor to the health of a county’s residents.
California’s 58 counties are ranked according to social and economic factors with 1
being the county with the best factors to 58 for that county with the poorest factors. This
ranking examines: high school graduation rates, unemployment, children in poverty,
social support, and others. Los Angeles County is ranked as a 41, in bottom of the third
quartile of all California counties according to social and economic factors.
Social and Economic Factors Ranking
County Ranking
(out of 58)
Los Angeles County
41
Source: County Health Rankings, 2013
Poverty
Poverty thresholds are used for calculating all official poverty population statistics. They
are updated each year by the Census Bureau. For 2011, the federal poverty level (FPL)
for one person was $10,890 and for a family of four $22,350.
Among the residents in the Henry Mayo service area, 7.3% are below 100% of the
federal poverty level (FPL) and 19.1% are below 200% of FPL. These rates of poverty
are not as high as those found in the county where 16.3% of residents are at poverty
level and 38.4% are below 200% of FPL. Newhall, however, has rates of poverty similar
to those found at the county level.
Ratio of Income to Poverty Level
Geographic Area
Zip Code
Canyon Country
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
Henry Mayo Hospital Service Area
Los Angeles County
California
91351
91387
91384
91321
91350
91390
91381
91354
91355
Below 100%
Poverty
6.7%
9.2%
6.7%
16.9%
3.9%
3.2%
5.2%
3.2%
6.0%
7.3%
16.3%
14.4%
Below 200%
Poverty
28.2%
20.6%
17.7%
38.7%
13.1%
9.3%
9.4%
10.0%
14.2%
19.1%
38.4%
33.9%
Source: American Community Survey, 2007-2011
16
Examining poverty levels by community and type of household paints an important
picture of the population within the hospital service area. Newhall has the highest levels
of poverty in the service area, across all household types. Overall children tend to
suffer at higher rates of poverty (9.1%) as compared to seniors (5.9%), and 22.1% of all
households with a female head-of-household and children, live in poverty.
Poverty Levels of Children, Seniors, and Female Head of Households with Children
Geographic Area
Zip Code
Canyon Country
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
Henry Mayo Hospital Service Area
Los Angeles County
California
91351
91387
91384
91321
91350
91390
91381
91354
91355
Children Under
18 Years Old
10.6%
12.5%
8.1%
23.7%
4.4%
3.2%
6.2%
3.0%
5.3%
9.1%
23.1%
19.9%
Seniors
5.4%
5.1%
2.2%
11.1%
4.6%
0.0%
5.4%
4.2%
6.7%
5.9%
11.7%
9.1%
Female HoH
with Children
21.5%
31.9%
7.7%
37.3%
12.8%
19.5%
30.5%
9.3%
13.2%
22.1%
35.8%
34.1%
Source: American Community Survey, 2007-2011
Households
The median household income in the area ranges from $58,130 in Newhall to $113,537
in Santa Clarita (91390). The communities in the service area, including Newhall, have
median household incomes that are higher than the county median household income.
Median Household Income
Geographic Area
Canyon Country
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
Henry Mayo Hospital Service Area
Los Angeles County
Zip Code
91351
91387
91384
91321
91350
91390
91381
91354
91355
Median Household Income
$74,649
$83,102
$98,330
$58,130
$99,876
$113,537
$112,399
$104,574
$86,721
$89,361
$56,266
Source: American Community Survey, 2007-2011
In the service area there are 85,135 households. The percentage of 3-person
households (18.6%), 4-person households (20.3%), and 5-person households (9.5%)
exceeds the county and state rates for these size households.
17
Household Size
Household Size
1 Person Households
2 Person Households
3 Person Households
4 Person Households
5 Person Households
6 Person Households
7+ Person Households
Henry Mayo Hospital
Service Area
17.7%
27.3%
18.6%
20.3%
9.5%
3.9%
2.6%
Los Angeles
County
24.2%
26.3%
16.3%
15.0%
8.7%
4.5%
5.0%
California
23.3%
29.1%
16.2%
15.0%
8.3%
4.0%
4.1%
Source: U.S. Census Bureau, 2010
In the hospital service area, residents have lower rates of supportive benefits than found
in the county: 2.7% of service area residents receive SSI benefits, 1.6% receive cash
public assistance income and, 2.4% of residents receive food stamp benefits. Despite
this, 30% of area households living in poverty report experiencing food insecurity, with
11.7% reporting food insecurity with hunger.
Household Supportive Benefits
Households
Supplemental Security Income (SSI)
Public Assistance
Food Stamps/SNAP
Henry Mayo Hospital
Service Area
85,135
2.7%
1.6%
2.4%
Los Angeles
County
3,218,518
5.8%
3.9%
6.2%
Source: American Community Survey, 2007-2011, by ZCTA
Food Insecurity
SPA 2
Households below 100% FPL Reporting Food Insecurity (based on a
series of 5 questions) without Hunger
Households below 100% FPL Reporting Food Insecurity with Hunger
18.3%
11.7%
Los Angeles
County
17.9%
12.8%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Free or Reduced Price Meals
The number of students eligible for the free and reduced price meal program is one
indicator of the socioeconomic status of a school district’s student population. In the
Sulphur Springs Union District, nearly half (45.5%) of the children are eligible for the
program. In Acton-Agua Dulce Unified, 37.2% of children meet program eligibility
requirements, while in Saugus Union District, the lowest concentration, only 18.2% of
the students are eligible. All of the area's districts have a smaller percentage of lowincome eligible students than the county or state. It is important to note that while
examining District totals provides an overview of the student population; this is an
average among all the schools. Within the District there are a number of schools with
18
higher and lower rates of eligible low-income children.
Students Eligible for Free or Reduced Price Meal Program
School District
Acton-Agua Dulce Unified District
Castaic Union Elementary District
Newhall District
Saugus Union District
Sulphur Springs Union District
William S. Hart Union High District
Los Angeles County
California
Students eligible for Free and
Reduced Price Meal Program
37.2%
24.3%
35.0%
18.2%
45.5%
20.5%
66.6%
57.5%
Source: California Department of Education DataQuest, 2011-2012
Unemployment
Santa Clarita has a relatively low unemployment rate of 6.7% when compared to the
county and the state.
Unemployment Rate, 2012 Average
Geographic Area
Unemployment Rate
Santa Clarita City
Los Angeles County
6.7%
11.0%
California
10.5%
Source: California Employment Development Department, Labor Market Information, 2012
Educational Attainment
In the 2011/12 school year, 93% of 12th graders graduated from William S. Hart Union
High District, and 80.8% from Acton-Agua Dulce Unified District, both were higher than
the Los Angeles County rate of 75% and the state rate of 78.7%.
School District
Acton-Agua Dulce Unified District
William S. Hart Union High District
Los Angeles County
California
Percent of 12th Grade
Students Graduating with
their Cohort
80.8%
93.0%
75.0%
78.7%
Source: California Department of Education DataQuest, 2011-2012
Of the population age 25 and over, 11.9% have less than a high school diploma, which
is better than county and state completion rates.
19
Population, 25 Years and Older, with No High School Diploma
Henry Mayo Hospital
Service Area
11.9%
Los Angeles
County
California
23.8%
18.9%
Source: American Community Survey, 2007-2011, by ZCTA
19.6% of service area adults are high school graduates and 33% are college graduates.
In Los Angeles County 20.8% of residents are high school graduates and 29.2% are
college graduates.
Educational Attainment of Adults, 25 Years and Older
Population 25 years and older
th
Less than 9 Grade
Some High School, No Diploma
High School Graduate
Some College, No Degree
Associate Degree
Bachelor Degree
Graduate or Professional Degree
Henry Mayo Hospital
Service Area
168,124
4.8%
7.1%
19.6%
26.1%
9.3%
22.6%
10.4%
Los Angeles
County
6,318,305
13.8%
10.1%
20.8%
19.2%
6.8%
19.1%
10.1%
California
23,797,884
10.4%
8.8%
21.1%
21.8%
7.7%
19.3%
11.0%
Source: American Community Survey, 2007-2011, by ZCTA
Homelessness
The Los Angeles Homeless Services Authority (LAHSA) conducts the biennial Greater
Los Angeles Homeless Count, for the Los Angeles Continuum of Care (LA CoC); it
includes all of LA County except for the cities of Glendale, Pasadena and Long Beach,
who conduct their own homeless counts. Comparing the homeless counts from 2009
and 2011, there was a significant increase in the number of homeless in SPA 2.
Homeless Census and Annual Estimate, 2009 and 2011
SPA 2
Los Angeles County
Total Homeless
2009
2011
3,753
4,727
53,046
51,340
Sheltered
Unsheltered
2011
2011
N/A
N/A
38%
62%
Source: Los Angeles Homeless Services Authority, 2009 and 2011 Los Angeles Homeless Count
Sheltered vs. Unsheltered for 2009 was not included as it covered different geographic areas than 2011.
The majority of homeless continue to be adult males. However, SPA 2 has a noticeably
higher percentage of homeless who are seniors, and lower percentages of other
measured subgroups, as compared to the county.
20
Homeless Population, by percentages
Geographic Area
Youth
18-24
1.9%
7.7%
Seniors
SPA 2
Los Angeles County
11.2%
7.2%
Children
under 18
Family
Members
11.7%
13.4%
Women
18%
20%
N/A
28%
Source: Los Angeles Homeless Services Authority, 2011 Los Angeles Homeless Count
Crime and Violence
Calls for domestic violence are categorized as with our without a weapon. In the city of
Santa Clarita there were 399 domestic violence calls in 2011. Only 20.8% of the calls
did not involve a weapon. Reports of domestic violence in Santa Clarita are 25% more
likely to involve a weapon than at the county level, and more than twice as likely as at
the state level.
Domestic Violence Calls, 2011
Geographic Area
Santa Clarita City
Los Angeles County
California
Total
399
39,817
158,547
Without
Weapon
20.8%
37.9%
60.9%
With
Weapon
79.2%
62.1%
39.1%
Source: California Department of Justice, Office of the Attorney General, 2011
15.6% of adults in SPA 2 indicated they had experienced physical or sexual violence by
an intimate partner since the age of 18, and 5.3% had been the victims of intimate
partner violence in the past year. These rates are higher than those found at both the
county and state levels.
Experienced Physical or Sexual Violence
SPA 2
By Intimate Partner Since Age 18
By Intimate Partner in Past Year
15.6%
5.3%
Los Angeles
County
12.7%
3.1%
California
14.8%
3.5%
Source: California Health Interview Survey, 2009
21
Health Access
Health Insurance Coverage
Health insurance coverage is considered a key component to accessing health care. In
SPA 2, adults ages 18-64 have the lowest rates of health insurance at 73%, children
have rates of 95.8%, and essentially zero seniors reported being without health
insurance. Rates of insurance coverage in the service area exceed county rates.
Compared to the county, more adults and children in SPA 2 were covered by private
insurance. Children were slightly more likely to be covered by Healthy Families than at
the county level, and children, adults, and seniors were all less likely to be covered by
Medi-Cal. As expected, a large proportion of seniors (92.6%) have Medicare coverage
in some form, which is higher than the 88.2% found among county seniors. Currently
insured children and adults were both less likely to have spent time uninsured within the
past year.
Insurance Coverage for Children, 0-17
SPA 2
Healthy Families
Medi-Cal
Healthy Kids
Private Insurance
No Insurance
Spent some time without
Insurance in the past year
Los Angeles County
13.9%
23.8%
2.3%
55.7%
4.2%
12.0%
34.4%
2.2%
46.4%
5.0%
5.4%
6.4%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Insurance Coverage for Adults, 18-64
SPA 2
Medi-Cal
Medicare
Private
No Insurance
Spent some time without
Insurance in the past year
Los Angeles County
14.4%
0.8%
57.9%
27.0%
17.3%
1.4%
52.9%
28.5%
8.4%
9.1%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
22
Insurance Coverage for Adults 65+
SPA 2
Medi-Medi
Medicare & Private
Medicare Only
Medi-Cal (w/o Medicare)
Private
No Insurance
Los Angeles County
24.2%
28.0%
40.4%
0.0%
5.9%
0.0%
25.9%
25.4%
36.9%
3.4%
6.4%
2.1%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Sources of Care
Residents who have a medical home and access to a primary care provider improve
continuity of care and decrease unnecessary ER visits. 96.2% of children in SPA 2
have a usual source of care, versus 95.2% for Los Angeles County. Among adults,
77.4% of adults in SPA 2 and 76.6% in L.A. County have a usual source of care.
No Usual Source of Care
SPA 2
Children with No Usual Source of Care
Adults with No Usual Source of Care
3.8%
22.6%
Los Angeles
County
4.8%
23.4%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
When looked at by race or ethnicity, African Americans, Latinos and Asians in SPA 2
are less likely to have a usual source of care than at the county or state level.
No Usual Source of Care by Race/Ethnicity
SPA 2
African American
Latino
Asian
White
Los Angeles County
13.3%
25.1%
22.5%
10.0%
10.1%
20.7%
19.3%
10.4%
California
11.0%
19.3%
14.4%
10.0%
Source: California Health Interview Survey, 2011-2012
The source of care for 56.6% of SPA 2 residents is a doctor’s office, HMO, or Kaiser.
Clinics and community hospitals are the source of care for 23.1%. The ER is a source
of care for a small percentage of area residents (0.9%). 18.5% of SPA 2 residents have
no source of care; this is higher than the state rate of 14.3%.
23
Sources of Care
56.6%
Los Angeles
County
56.7%
23.1%
24.6%
23.3%
0.9%
0.8%
18.5%
1.1%
0.9%
16.7%
1.1%
0.8%
14.3%
SPA 2
Dr. Office/HMO/Kaiser Permanente
Community clinic/Government clinic/
Community hospital
ER/Urgent Care
Other
No source of care
California
60.5%
Source: California Health Interview Survey, 2011-2012
Caregivers of children in SPA 2 reported that 9.6% of area children have difficulty
accessing medical care, 4.8% were unable to afford to see a doctor for a physical exam
or check-up in the past year, 3.5% were unable to afford to see a doctor when they had
an illness or health problem, and 4.1% were unable to afford needed prescription
medications. These percentages are all lower than those seen at the county level.
The numbers for adults were much higher, with 28.9% of adults in SPA 2 reporting that
obtaining needed medical care is either somewhat or very difficult, 16.8% could not
afford to see a doctor when they needed to in the past year, and 15.8% could not afford
needed prescription medications. The percentages who could not afford medical care or
prescriptions were, unexpectedly, slightly higher in SPA 2 than at the county level.
Health Care Barriers
9.6%
Los Angeles
County
12.3%
4.8%
6.4%
3.5%
6.1%
4.1%
5.7%
28.9%
31.7%
16.8%
16.0%
15.8%
15.4%
SPA 2
Children Who Have Difficulty Accessing Medical Care
Children Who Were Unable to Afford to See a Doctor for
a Physical Exam or Check-up in the Past Year
Children Who Were Unable to Afford to See a Doctor for
an Illness or Other Health Problem in the Past Year
Children Who Were Unable to Afford Prescription
Medicines in the Past Year
Adults Who Reported That Obtaining Needed Medical
Care When Needed is Somewhat or Very Difficult
Adults Who Did Not See a Doctor When Needed in the
Past Year Because They Could Not Afford It
Adults Who Reported They Could Not Afford Prescription
Medication When Needed, in the Past Year
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Use of the Emergency Room
An examination of ER use can lead to improvements in providing community-based
prevention and primary care. 19.5% of SPA 2 residents visited an ER over the period of
a year, which is slightly higher than at the county or state levels. Indeed, all sectors of
the population of SPA 2 utilize the ER at levels higher than the state, and most at levels
24
higher than the county. Seniors visit the ER at the highest rates of any age category at
the state and county level, but in SPA 2, children 0-17 are the highest utilizers.
Use of Emergency Room
SPA 2
Visited ER in last 12 months
19.5%
Los Angeles County
18.2%
California
17.9%
0-17 years old
18-64 years old
65 and older
23.9%
17.8%
20.0%
20.2%
16.9%
21.1%
19.1%
17.0%
19.7%
<100% of poverty level
<200% of poverty level
21.6%
20.4%
20.2%
21.1%
21.3%
19.1%
Source: California Health Interview Survey, 2011-2012
Access to Primary Care Community Clinics
Community clinics provide primary care (including medical, dental and mental health
services) for uninsured and medically underserved populations. Using ZCTA (ZIP Code
Tabulation Area) data for the Henry Mayo Newhall Memorial Hospital service area and
information from the Uniform Data System (UDS)1, 18.1% of the population in the
service area is categorized as low-income (200% of Federal Poverty Level) and 7.1% of
the population are living in poverty.
There are a number of Section 330 funded grantees (Federally Qualified Health Centers
– FQHCs and FQHC Look-Alikes) that serve the area, although the vast majority of
patients in all ZCTA's are served by Northeast Valley Health Corporation. Other clinics
include: Comprehensive Community Health Center, Inc., Valley Community Clinic, El
Proyecto Del Barrio, Inc., Asian Pacific Health Care Venture, and Mission City
Community Network, Inc. Even with Section 330 funded Community Health Centers
serving the area, there are a significant number of low-income residents who are not
served by one of these clinic providers. The FQHCs have a total of 11,821 patients in
the service area, which equates to 24.9% penetration among low-income patients and
4.3% penetration among the total population. From 2010-2011 the CHC providers
increased their number of patients for a 15.6% increase in patients served by
Community Health Centers in the service area. However, there remain 35,740 lowincome residents, approximately 75% of the population at or below 200% FPL that are
not served by a Section 330-funded grantee.
1
The UDS is an annual reporting requirement for grantees of HRSA primary care programs:
• Community Health Center, Section 330 (e)
• Migrant Health Center, Section 330 (g)
• Health Care for the Homeless, Section 330 (h)
• Public Housing Primary Care, Section 330 (i)
25
Low-Income Patients Served and Not Served by FQHCs
Geographic
Area
ZCTA
Canyon Country
91351
Canyon Country
91387
Castaic
91384
Newhall
91321
Santa Clarita
91350
Santa Clarita
91390
Stevenson Ranch 91381
Valencia
91354
Valencia
91355
Henry Mayo Service Area
LowIncome
Population
7,658
7,819
3,939
13,035
3,366
2,103
1,921
2,972
4,742
47,561
Patients
served by
Section 330
Grantees
In Service
Area
2,767
2,081
775
3,907
783
311
253
351
593
11,821
Penetration
among
Low-Income
Patients
Penetration
of Total
Population
36.1%
26.6%
19.7%
30.0%
23.3%
14.8%
13.2%
11.8%
12.5%
24.9%
8.9%
5.2%
2.6%
11.2%
2.3%
1.6%
1.3%
1.2%
1.8%
4.3%
Low-Income Not
Served
Number
Percent
4,891
5,738
3,164
9,128
2,583
1,792
1,668
2,621
4,149
35,740
63.9%
73.4%
80.3%
70.0%
76.7%
85.2%
86.8%
88.2%
87.5%
75.1%
Source: UDS Mapper, 2011
Underserved Areas
The northern part of the service area, including most of Castaic, part of Valencia
(sections of 91354 and 91355) and part of the 91390 area of Santa Clarita, is
designated as a Health Professionals Shortage Area (HPSA) based on geographic
area.
Dental Care
22% of the children in SPA 2 do not have dental insurance, which is comparable to the
rate for L.A. County. 9.6% of SPA 2 children were unable to obtain dental care
(including checkups) in the past year, because they could not afford it, which is better
than the county's 12.6% rate.
29.8% of SPA 2's adults were unable to obtain dental care (including checkups) in the
past year because they could not afford it, which is similar to L.A. County.
Dental Care
Children Who Do Not Have Dental Insurance
Children Unable to Obtain Dental Care (including check-ups)
in the Past Year, Because They Could Not Afford It
Adults Unable to Obtain Dental Care (including check-ups) in
the Past Year, Because They Could Not Afford It
SPA 2
Los Angeles County
22.0%
21.8%
9.6%
12.6%
29.8%
30.3%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
26
Birth Characteristics
Births
In 2011, there were 2,986 births in the service area. The majority of the births were to
mothers who are White (36.8%) and Latino (34.3%). However, in Newhall 57.5% of
births were to Latina mothers and 20.5% were to White mothers. In Canyon Country,
43.3% of births were to Latinas and 29.8% of births were to White mothers.
Teen Birth Rate
In 2011, teen pregnancy rates occurred at a rate of 45.2 per 1,000 births (or 4.5% of
total births). This rate is considerably less than the teen pregnancy rate found in the
county and the state. The rates for Newhall, Castaic, and Canyon Country were higher
than for the other zip codes in the service area.
Births to Teenage Mothers (Under Age 20)
Geographic Area
Zip Code
Canyon Country
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
Henry Mayo Hospital Service Area
Los Angeles County
California
91351
91387
91384
91321
91350
91390
91381
91354
91355
Births to
Teen
Live Births
Mothers
30
422
30
575
14
226
33
435
4
366
6
157
4
178
6
315
8
312
135
2,986
10,480
130,312
38,834
503,856
Rate per
1,000 Live
Births
71.1
52.2
61.9
75.9
10.9
38.2
22.5
19.0
25.6
45.2
80.4
77.1
Source: California Department of Public Health, 2011
Prenatal Care
In 2011, pregnant women in the service area entered prenatal care late - after the first
trimester - at a rate of 110.5 per 1,000 live births. This rate of late entry into prenatal
care translates to 89% of women entering prenatal care within the first trimester. It is
lower in Newhall and Canyon Country, where 85% and 86.4% of women, respectively,
entered early into prenatal care. The area rate of early entry into prenatal care does
meet the Healthy People 2010 benchmark of 77.9% of women entering prenatal care in
the first trimester.
Late Entry Into Prenatal Care (After First Trimester)
Geographic Area
Canyon Country
Zip Code
91351
Late Prenatal
Care
60
Live
Births*
417
Rate
143.9
27
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
Henry Mayo Hospital Service Area
Los Angeles County
California
91387
91384
91321
91350
91390
91381
91354
91355
74
22
63
30
9
19
19
29
325
18,232
81,140
568
222
420
363
157
175
311
309
2,942
124,538
492,832
130.3
99.1
150.0
82.6
57.3
108.6
61.1
93.9
110.5
146.4
164.6
Source: California Department of Public Health, 2011
*Births in which the first month of prenatal care is unknown are not included in the tabulation.
Low Birth Weight
Low birth weight is a negative birth indicator. Babies born at a low birth weight are at
higher risk for disease, disability and possibly death. The Henry Mayo Newhall
Memorial Hospital service area has a lower rate of low birth weight babies (65.6 per
1,000 live births) when compared to the county (83.2 per 1,000 live births) and the state
(67.8 per 1,000 live births). The rate of low birth weight in the service area (6.6%) is
also lower than the Healthy People 2020 objective of 7.8% of births being low birth
weight. (When examining geographic areas with a small occurrence it is important to
use caution when drawing conclusions from data as small occurrences may result in
high rates.)
Low Birth Weight (Under 2,500 g)
Geographic Area
Canyon Country
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
Henry Mayo Hospital Service Area
Los Angeles County
California
Zip Code
91351
91387
91384
91321
91350
91390
91381
91354
91355
Low Birth
Rate per 1,000
Live Births
Weight
Live Births
28
422
66.4
35
575
60.9
14
226
62.0
18
435
41.4
34
366
92.9
9
157
57.3
14
178
78.7
19
315
60.3
25
312
80.1
196
2,986
65.6
10,844
130,312
83.2
34,159
503,856
67.8
Source: California Department of Public Health, 2011
Infant Mortality
Infant deaths are under one year of age. The infant death rate in the service area is 5.4
per 1,000 live births. In comparison, the infant death rate in the county is 4.8 and the
28
state is 4.7 deaths per 1,000 live births. The infant death rate in the service area is less
than the Healthy People 2020 objective of 6.0 deaths per 1,000 live births. (When
examining geographic areas with a small occurrence it is important to use caution when
drawing conclusions from data as small occurrences may result in high rates.)
Infant Mortality Rate, 2010
Geographic Area
Canyon Country
Canyon Country
Castaic
Newhall
Santa Clarita
Santa Clarita
Stevenson Ranch
Valencia
Valencia
Henry Mayo Hospital Service Area
Los Angeles County
California
Zip Code
91351
91387
91384
91321
91350
91390
91381
91354
91355
Infant Deaths Live Births
4
428
4
564
2
250
3
493
2
406
0
175
0
193
1
336
1
329
17
3,174
619
130,312
2,419
509,979
Death Rate
9.3
7.1
8.0
6.1
4.9
0.0
0.0
3.0
3.0
5.4
4.8
4.7
Source: California Department of Public Health, 2010
Breastfeeding
Breastfeeding has been proven to have considerable benefits to baby and mother. The
California Department of Public Health (CDPH) highly recommends babies be fed only
breast milk for the first six months of life. Data on breastfeeding are collected by
hospitals on the Newborn Screening Test Form. At Henry Mayo Newhall Memorial
Hospital 94.2% of women use some breastfeeding and 68% exclusively breastfeed their
infants, which is higher than rates for the county and the state.
In-Hospital Breastfeeding
Henry Mayo Hospital
Los Angeles County Hospitals
California
Any Breastfeeding
Number
Percent
1,065
94.2%
109,686
90.9%
481,183
91.7%
Exclusive Breastfeeding
Number
Percent
768
68.0%
56,478
46.8%
264,377
60.4%
Source: California Department of Public Health, Breastfeeding Hospital of Occurrence, 2011
29
Mortality/Leading Causes of Death
Mortality Rates
The three leading causes of death in the Hospital service area are heart disease,
cancer, and stroke. The crude death rate is a ratio of the number of deaths to the entire
population. The heart disease mortality rate in the service area is 110.9 per 100,000
persons, which is lower than the 160.7 seen at the county level, but still exceeds the
Healthy People 2020 objective of 100.8 deaths per 100,000 persons. The death rates
for the remaining top ten causes of death in the service area are lower than the rates for
the county, and also lower than the Healthy People 2020 objectives, where applicable.
Mortality Rates, per 100,000 Persons, 2010
Heart Disease
Cancer
Stroke
Alzheimer’s Disease
Chronic Lower Respiratory Disease
Unintentional Injuries
Influenza and Pneumonia
Diabetes
Liver Disease
Suicide
Henry Mayo Hospital
Service Area
Number
Rate
296
110.9
290
108.6
71
26.6
56
21.0
55
20.6
44
16.5
30
11.2
29
10.9
19
7.1
18
6.7
Los Angeles
County
Rate
160.7
141.2
33.4
22.8
28.1
19.5
20.0
19.3
11.9
8.1
HP 2020
Rate
100.8
160.6
33.8
No Objective
98.5
36.0
No Objective
65.8
No Objective
10.2
Source: California Department of Public Health, 2010
The five year average, age-adjusted cancer mortality rate for all cancer sites in Los
Angeles County was 158.6. Mortality from digestive system and respiratory system
cancers occurs at the highest rates.
Cancer Mortality Rates, per 100,000 Persons, Age-Adjusted, 2005-2009
Los Angeles County
Cancer, all sites
Digestive system
Respiratory system
Male genital
Female genital
Breast
Urinary system
Leukemia
Brain and Nervous system
Number
68,315
19,366
15,402
3,929
4,145
5,639
3,167
2,859
1,850
Rate
158.6
44.9
36.6
23.8
17.0
12.7
7.4
6.6
4.1
California
Rate
162.7
42.7
41.0
23.7
15.4
12.3
7.9
6.7
4.3
Source: California Cancer Registry (CCR), Cancer Surveillance Section, Cancer Surveillance and Research Branch,
California Department of Public Health, 2005-2009
30
Leading Causes of Premature Death
A premature death is one in which someone dies before age 75 (under age 1 is not
included). With 75 years set as a cut-off date, everyone who dies between the ages of
1-74 is considered to have died prematurely. Coronary heart, suicide and drug overdose
are the top three causes of premature death in SPA 2.
Leading Causes of Premature Death
SPA 2
Los Angeles County
#1 Cause
Coronary Heart
Disease
Coronary Heart
Disease
#2 Cause
Suicide
Homicide
#3 Cause
#4 Cause
Drug
Motor Vehicle
Overdose
Crash
Motor Vehicle
Liver Disease
Crash
#5 Cause
Liver
Disease
Suicide
Source: L.A. County Department of Public Health, Office of Health Assessment and Epidemiology. Mortality in Los Angeles County
2009: Leading Causes of death and premature death with trends for 2000-2009, October 2012.
Mortality rates are age-adjusted based on the 2000 Standard Population using the methods approved by the CDC.
31
Chronic Disease
Health Status
Among the residents in SPA 2, 4.7% of children were described by their caretakers as
being in fair or poor health, and 18.5% of SPA 2 adults described themselves in those
terms. These percentages are slightly lower than those found at the county level.
Adults in SPA 2 reported having 5.8 unhealthy days (either mental or physical) in the
past 30 days, and 2.5 days of the past 30 during which their activities were limited due
to poor physical and/or mental health. These are slightly higher rates than those seen at
the county level.
Health Status, Fair or Poor Health
SPA 2
Children with Fair or Poor Health
Adults with Fair or Poor Health
4.7%
18.5%
Los Angeles County
5.8%
20.7%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Unhealthy Days, Adults 18+
SPA 2
Average Number of Unhealthy Days (Mental and/or Physical)
in the past 30 days
Average Number of Days in the past 30 Days that Activities
Were Limited Due to Poor Physical and/or Mental Health.
Los Angeles County
5.8 days
5.4 days
2.5 days
2.1 days
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Diabetes
Diabetes is a growing concern in the community. In SPA 2 8.5% of the population has
been diagnosed as pre-diabetic, and 7.2% of adults have been diagnosed with
diabetes. For adults with diabetes, 50.5% were very confident they can control their
diabetes, which is lower than the levels found in the county and the state. 65.2% take
oral hypoglycemic mediations and 66.7% had a diabetes management care plan, both
of which are also lower than the levels found county and state-wide. 25.9% had never
had a foot exam, and 8.2% said that they had never had an HgA1c test.
32
Adult Diabetes
Diagnosed Pre/Borderline Diabetic
8.5%
Los Angeles
County
7.1%
Diagnosed with Diabetes
Very confident to Control Diabetes
Somewhat confident
Not confident
7.2%
50.5%
37.2%
12.3%
10.9%
60.9%
30.6%
8.5%
8.5%
58.6%
32.6%
8.8%
Takes oral hypoglycemic medications
Has a diabetic management care plan
Has never had a foot exam
65.2%
66.7%
25.9%
73.7%
77.8%
25.7%
72.0%
78.0%
27.8%
Never heard of the HgA1c test
Never had the HgA1c test
17.2%
8.2%
19.5%
9.3%
14.5%
10.6%
SPA 2
California
8.0%
Source: California Health Interview Survey, 2011-2012 (Lines 1-5) and 2009 (Lines 6-10)
When examined over time, it is clear that while the rate of diabetes in SPA 2 is lower
than that found in Los Angeles County as a whole, it is rising more than the county rate.
Adults Diagnosed with Diabetes, 2005-2011
Service Planning Area 2
Los Angeles County
2005
6.3%
8.6%
2007
7.0%
9.1%
2011
Change 2005-2011
9.6%
52.4%
9.9%
15.1%
Source: L.A. County Department of Public Health, 2012
Heart Disease
For adults in SPA 2, 5.3% have been diagnosed with heart disease. This is lower than
state and county rates. Among these adults, 56.5% are very confident they can
manage their condition, which is a higher level of confidence than that seen at the
county or state level. 77.0% of adults in SPA 2 have a management care plan
developed by a health care professional.
Adult Heart Disease
5.3%
Los Angeles
County
5.6%
Very Confident to Control Condition
Somewhat Confident to Control Condition
Not Confident to Control Condition
56.5%
36.6%
6.9%
49.5%
41.7%
8.8%
55.3%
35.3%
9.4%
Has a management care plan
77.0%
73.3%
74.1%
SPA 2
Diagnosed with heart disease
California
6.3%
Source: California Health Interview Survey, 2011-2012
High Blood Pressure
Hypertension (high blood pressure) and high cholesterol are co-morbidity factors for
diabetes and heart disease. In SPA 2, 23.9% of adults have been diagnosed with high
blood pressure, and 28.4% with high cholesterol. High cholesterol is found more often in
SPA 2 residents than in county residents as a whole.
33
High Blood Pressure
SPA 2
Ever Diagnosed with Hypertension
23.9%
Los Angeles County
24.0%
28.4%
Los Angeles County
25.6%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
High Cholesterol
SPA 2
Ever Diagnosed with High Cholesterol
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Cancer
In Los Angeles County, the age-adjusted cancer incidence rate is 451.9 per 100,000
persons. Digestive system cancers (92.5), female genital cancers (54.0) and leukemia
(12.1) occur at rates higher than the state rates for these types of cancer.
Cancer Incidence, per 100,000 Persons, Age Adjusted, 2005-2009
All sites
Male genital
Breast
Digestive system
Female genital
Respiratory system
Urinary system
Leukemia
Brain and nervous system
Los Angeles County
451.9
146.0
78.0
92.5
54.0
49.4
31.7
12.1
5.6
California
474.7
150.1
81.5
87.9
51.6
56.2
34.0
11.9
6.2
Source: California Cancer Registry (CCR), Cancer Surveillance Section, Cancer Surveillance and Research Branch,
California Department of Public Health
Asthma
The population diagnosed with asthma in SPA 2 is 13.5%. 47.9% of asthmatics take
medication to control their symptoms, which is a higher rate than for state or county
residents. Among youth, 18.8% have been diagnosed with asthma, and 24.8% of them
visited the ER during the past year due to asthma, which are both higher percentages
than those seen at the county or state level. 71% of asthmatics are very confident that
they can control and manage their asthma, which is less confidence than expressed at
the county and state levels.
34
Asthma
13.5%
18.8%
Los Angeles
County
12.7%
14.5%
14.4%
14.4%
13.7%
24.8%
22.8%
21.2%
47.9%
46.7%
44.1%
42.6%
46.6%
39.6%
71.0%
26.2%
2.8%
73.4%
22.9%
3.7%
76.9%
19.8%
3.3%
SPA 2
Diagnosed with Asthma, Total Population
Diagnosed with Asthma, 0-17 Years Old
ER Visit in Past Year Due to Asthma,
Total Population
ER Visit in Past Year Due to Asthma,
0-17 Years Old
Takes Daily Medication to Control Asthma,
Total Population
Takes Daily Medication to Control Asthma,
0-17 Years Old
Very Confident to Control and Manage Asthma
Confident to Control and Manage Asthma
Not Confident to Control and Manage Asthma
California
14.1%
15.4%
Source: California Health Interview Survey, 2011-2012, except for confidence levels, which are 2009
Disability
In SPA 2, 28.1% of adults had a physical, mental or emotional disability. The rate of
disability in the state was 29.9%. The percent of adults who couldn't work for at least
one year due to their disability (3.6%) was also lower than the state or county rates.
Population with a Disability
SPA 2
Adults with a disability
Couldn’t work for at least one
year, due to impairment
Los Angeles County
California
28.1%
29.8%
29.9%
3.6%
6.0%
5.8%
Source: California Health Interview Survey, 2011-2012
35
Health Behaviors
Health Behaviors Ranking
County Health Rankings examines healthy behaviors and ranks counties according to
health behavior data. California’s 58 counties are ranked from 1 (healthiest) to 58 (least
healthy) based on a number of indicators that include: adult smoking, obesity, physical
inactivity, excessive drinking, sexually transmitted infections, and others. A ranking of
18 puts Los Angeles County in the top third of California counties for health behaviors.
Health Behaviors Ranking
Los Angeles County
County Ranking
(out of 58)
18
Source: County Health Rankings, 2013
Overweight and Obesity
Over half (55.6%) of adults are overweight or obese in SPA 2, a rate lower than that
seen on the county or state level. Children, too, tend to be less overweight and obese in
SPA 2 than in the larger populations. When looked at over time, however, obesity
among adults is rising in SPA 2 at a faster rate than in the county.
Overweight or Obese
SPA 2
Adult
Teen
Child
55.6%
16.6%
9.6%
Los Angeles County
58.9%
17.1%
13.3%
California
59.8%
15.8%
12.6%
Source: California Health Interview Survey, 2011-2012
Adult Obesity
2005
Service Planning Area 2
Los Angeles County
17.0%
20.9%
2007
17.1%
22.2%
2011
21.1%
23.6%
Change
2005-2011
24.1%
12.9%
Source: L.A. County Department of Public Health, 2012
Rates of obesity among African Americans and Latinos in SPA 2 are lower than rates
seen at the county and state levels, but remain higher than those seen among Whites
and Asians. Asians and Whites in SPA 2 show slightly higher rates of obesity than seen
at the county level, but lower than state levels. Asians are far less likely to be obese
when compared to other races.
36
Adult Overweight and Obesity by Race/Ethnicity
SPA 2
African American
Asian
Latino
White
65.9%
35.3%
62.3%
55.5%
Los Angeles
County
71.6%
34.9%
68.9%
52.7%
California
72.4%
37.1%
70.7%
57.2%
Source: California Health Interview Survey, 2011-2012
The physical fitness test (PFT) for students in California schools is the FitnessGram®.
One of the components of the PFT is measurement of body composition (measured by
skinfold measurement, BMI, or bioelectric impedance). Children who do not meet the
“Healthy Fitness Zone” criteria for body composition are categorized as needing
improvement or at high risk (overweight/obese). Among 5th graders, between 24.5%
(in the Saugus Union District) and 34.1% (in the Sulphur Springs Union District) of the
service area's 5th graders need improvement or are at high risk. This compares
favorably with the 51.4% seen at the county levels. Ninth graders also compare well,
with 21% of Acton-Agua Dulce and 19.7% of William S. Hart District's students needing
improvement or being at high risk, compared to the county's 44.1%.
5th and 9th Graders, Body Composition, Needs Improvement + High Risk
School District
Acton-Agua Dulce Unified District
Castaic Union Elementary District
Newhall District
Saugus Union District
Sulphur Springs Union District
William S. Hart Union High District
Los Angeles County
Fifth Grade
33.0%
28.6%
26.1%
24.5%
34.1%
N/A
51.4%
Ninth Grade
21.0%
N/A
N/A
N/A
N/A
19.7%
44.1%
Source: California Department of Education, Fitnessgram Physical Fitness Testing Results, 2011-2012
Fast Food
44.4% of children and 37.9% of adults in SPA 2 eat fast food at least once per week.
These rates are lower than those seen in L.A. County.
Fast Food Consumption
SPA 2
Children Who Were Reported to Eat Fast Food at Least Once a
Week
Adults Who Reported Eating Fast Food at Least Once a Week
Los Angeles
County
44.4%
50.5%
37.9%
40.0%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
37
Soda Consumption
33.5% of children and 31.6% of adults in SPA 2 drink at least one soda or sweetened
drink per day, which are lower rates than seen at the county level.
Soda or Sweetened Drink Consumption
Los Angeles
County
SPA 2
Children Reported to Drink At Least One Soda or Sweetened
Drink a Day
Adults Who Reported Drinking At Least One Soda or Sweetened
Drink a Day
33.5%
38.3%
31.6%
35.5%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Fresh Fruits and Vegetables
90% of SPA 2 adults find accessing fresh produce (fruits and vegetable) to be
somewhat or very easy. That number is slightly lower for those adults who are
caretakers of children 0-17 (88.1% said access was somewhat or very easy). Despite
the ease of access, only 17.1% of SPA 2 adults reported eating the recommended 5 or
more servings of fruit and vegetables in the previous day.
Access to and Consumption of Fresh Fruits and Vegetables, Adults
Los Angeles
County
SPA 2
Adults Who Reported That Accessing Fresh Produce (Fruits and
Vegetables) was Very or Somewhat Easy
Caretakers of Children, 0-17, That Reported Community Access
to Fresh Produce (Fruits and Vegetables) was Good or Excellent
Adults Who Reported Eating 5 or More Servings of
Fruit/Vegetables in the Past Day
90.0%
89.7%
88.1%
81.9%
17.1%
16.2%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Physical Activity
For school-aged children in SPA 2, 29.6% engage in physical activity for at least one
hour a day, 7 days a week. An additional 59.4% participate in physical activities
regularly, and 11% do not participate in any physical activity. Physical activities include
walking, biking, or skateboarding to/from school; participating in team sports; bicycling,
rollerblading, or skateboarding for fun; physically interactive games such as DDR / Wii
Sports / Wii Fit; and/or Gymnastic, Dance or Karate Classes.
Physical Activity, Children 6-17
SPA 2
One hour or more per day, 7 days per week
Participates
Does not Participate
29.6%
59.4%
11.0%
Los Angeles County
28.7%
60.3%
10.9%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
38
61.3% of SPA 2 adults meet aerobic activity guidelines (vigorous activity for 75 minutes
a week or moderate activity for 150 minutes a week) and 36.3% meet muscle
strengthening guidelines (at least two days per week of muscle strengthening); only
28.4% meet both guidelines; 12.8% of SPA 2 adults engage in no aerobic activity
weekly, and 11.2% engage in neither aerobic nor strengthening activities. 48.9% of
SPA 2's adults utilize neighborhood walking paths, parks, playgrounds or sports fields.
35.2% do not, and an additional 16% report that their neighborhood does not have any
of the above, which is higher than the 14.2% for Los Angeles County.
Physical Activity, Adults
SPA 2
Meet Aerobic Activity Guidelines (Vigorous activity for 75 minutes
a week or Moderate activity for 150 minutes a week)
Meet Muscle Strengthening Guidelines (at least 2 days/week of
muscle strengthening).
Meet Both Aerobic and Strengthening Guidelines
Engage in No Aerobic Activity Weekly
Engage in No Aerobic or Strengthening Activities
Use Walking Paths, Parks, Playgrounds or Sports Fields in Their
Neighborhood
Do Not Use Neighborhood Paths, Parks, Playgrounds or Fields
Report Their Neighborhood Does Not Have Any of the Above
Los Angeles
County
61.3%
61.8%
36.3%
37.1%
28.4%
12.8%
11.2%
29.7%
12.0%
10.2%
48.9%
51.5%
35.2%
16.0%
34.3%
14.2%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
One of the components of the physical fitness test (PFT) for students in schools is
measurement of aerobic capacity through run and walk tests. Children who meet the
established standards for aerobic capacity are categorized in the Healthy Fitness Zone.
Between 59.8% (Acton-Agua Dulce Unified) and 79.7% (Saugus Union) of area fifth
graders meet the Healthy Fitness Zone standards for aerobic capacity. Among ninth
graders, 72.4% of Acton-Agua Dulce Unified, and 75.4% of William S. Hart Union
District's ninth graders meet the standards. All of the above rates compare favorably
with rates seen at the county level.
5th and 9th Grade Students, Aerobic Capacity, Healthy Fitness Zone
School District
Acton-Agua Dulce Unified District
Castaic Union Elementary District
Newhall District
Saugus Union District
Sulphur Springs Union District
William S. Hart Union High District
Los Angeles County
Fifth Grade
59.8%
75.2%
78.9%
79.7%
66.6%
N/A
58.8%
Ninth Grade
72.4%
N/A
N/A
N/A
N/A
75.4%
57.6%
Source: California Department of Education, Fitnessgram Physical Fitness Testing Results, 2011-2012
39
Community Walkability
WalkScore.com ranks over 2,500 cities with a walk score. The walk score for a location
is determined by its access to amenities. Many locations are sampled within each city
and an overall score is issued for the walkability of that city. A higher score indicates an
area is more accessible to walking while a lower score indicates a more vehicle
dependent location.
WalkScore.com has established the range of scores as follows:
0-24: Car Dependent (Almost all errands require a car)
25-49: Car Dependent (A few amenities within walking distance)
50-69: Somewhat Walkable (Some amenities within walking distance)
70-89: Very Walkable (Most errands can be accomplished on foot)
90-100: Walker's Paradise (Daily errands do not require a car)
Based on this scoring method, all of the zip codes in the service area were rated "Car
Dependent".
Walkability
Geographic Area
Walk Score
91355 - Valencia
91350 - Santa Clarita
91354 - Valencia
91387 - Canyon Country
91351 - Canyon Country
91321 - Newhall
91381 - Stevenson Ranch
91384 - Castaic
91390 - Santa Clarita
43
40
29
20
15
11
8
0
0
Source: WalkScore.com, 2012
HIV/AIDS
The number of cases of HIV/AIDS diagnosed in SPA 2 and L.A. County dropped from
2010 to 2011. SPA 2 shows a lower rate of infection than does Los Angeles County.
HIV/AIDS Diagnoses, 2010 - 2011
2010
SPA 2
Los Angeles County
Number
240
2,065
2011
Rate
11
20
Number
250
1,880
Rate
11
18
Source: County of Los Angeles, Public Health, 2011 Annual HIV Surveillance Report
40
Sexually Transmitted Diseases
Rates of Chlamydia, gonorrhea and syphilis (both primary/secondary and early latent)
are all lower for SPA 2 than for Los Angeles County.
STD Cases, Rate per 100,000 Persons, 2010
SPA 2
Chlamydia
Gonorrhea
Primary & Secondary Syphilis
Early Latent Syphilis
295.0
52.1
4.8
5.2
Los Angeles County
455.1
96.8
6.5
9.2
Source: County of Los Angeles, Public Health, Sexually Transmitted Disease Morbidity Report, 2010
Teen Sexual History
85.6% of SPA 2 teens indicated they have never had sex, 11.4% that they had their first
sexual encounter after the age of 15, and 3% that they had had a sexual encounter
when they were younger than 15. Of those youth who had sex, 65.7% had been tested
for an STD within the previous year.
Teen Sexual History
Never Had Sex
First Encounter Under 15 Years Old
First Encounter Over 15 Years Old
85.6%
3.0%
11.4%
Los Angeles
County
79.7%
11.1%
9.2%
If Had Sex, Tested for STD in Past Year
65.7%
46.6%
SPA 2
California
81.7%
7.6%
10.7%
32.2%
Source: California Health Interview Survey, 2011-2012
Cigarette Smoking
In SPA 2, 13.8% of adults are current smokers, with an additional 1% who smoke, but
'not regularly'; 20.6% of residents are former smokers, and 64.6% identify as nonsmokers.
Cigarette Smoking, Adults
SPA 2
Current smoker
Non-Regular Smoker
Former Smoker
Non-Smoker
Los Angeles County
13.8%
1.0%
20.6%
64.6%
13.1%
1.5%
19.5%
66.0%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Alcohol and Drug Use
54.7% of adults in SPA 2 reported drinking in the past month. Heavy drinking is defined
as more than 30 drinks for women and more than 60 drinks for men. 3.8% of adults in
SPA 2 reported heavy drinking in the past month. Binge drinking is defined as
consuming a certain amount of alcohol within a set period of time. For males this is five
41
or more drinks per occasion and for females it is four or more drinks per occasion.
Among adults, 14.9% in SPA 2 had engaged in binge drinking in the past year.
Alcohol Consumption and Binge Drinking, Adult
SPA 2
Reported Drinking Alcohol in the Past Month.
Reported Heavy Drinking in the Past Month
Reported Binge Drinking in the Past Month
54.7%
3.8%
14.9%
Los Angeles
County
51.9%
3.5%
15.4%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
3.4% of SPA 2 adults reported having used methamphetamines, cocaine or Ecstasy in
the past year, which is higher than the 2.3% reported in L.A. County. Only 4.4%
reported misusing prescription drugs within the past year, compared to 5.2% of L.A.
County residents. Drug overdose was listed as the third leading cause of premature
death in SPA 2 for 2009, the last year for which data was made available.
Adult Illegal Drug Use
SPA 2
Reported Using Methamphetamines, Cocaine or
Ecstasy in the Past Year.
Reported Misusing Any Form of Prescription Drugs
in the Past Year.
Los Angeles
County
3.4%
2.3%
4.4%
5.2%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Among teens in SPA 2, 9.2% have tried drugs and 5% have used marijuana in the past
year. These rates are lower than found in the county.
Teen Illegal Drug Use
SPA 2
Ever tried marijuana, cocaine, sniffing glue, other
drugs
Marijuana use in past year
9.2%
5.0%
Los Angeles
County
14.6%
10.2%
Source: California Interview Health Survey, 2011-2012
Mental Health
63.5% of SPA 2 adults reported receiving sufficient social and emotional support. 8.8%
of SPA 2 residents tried to access mental health care in the prior 12 months, and 7.2%
of area residents stated that they were unable to receive mental health care or
counseling when they needed it during the prior year because they could not afford it.
12.5% of SPA 2 residents have been diagnosed with anxiety, and 7.2% of residents are
either currently being treated or are having symptoms of anxiety. 13.9% had been
diagnosed with depression, and 8.9% of SPA 2 residents were either being currently
42
treated or experiencing symptoms of depression. 12% were considered to be at risk for
major depression, and 8.5% were both at risk for major depression and were primary
caregivers for a child 0-17.
Mental Health Indicators, Adults
SPA 2
Reported Receiving Sufficient (Always/Usually) Social and Emotional
Support.
Los Angeles
County
63.5%
64.0%
8.8%
7.5%
7.2%
6.1%
Ever Diagnosed with Anxiety
Ever Diagnosed with Anxiety and Either Currently Being Treated For
Anxiety or Currently Having Symptoms of Anxiety.
12.5%
11.3%
7.2%
6.4%
Ever Diagnosed with Depression
Ever Diagnosed with Depression and Either Currently Being Treated For
Anxiety or Currently Having Symptoms of Depression.
At Risk for Major Depression
At Risk for Major Depression AND Primary Caretaker of a Child 0-17
13.9%
12.2%
8.9%
8.3%
12.0%
8.5%
10.4%
9.2%
Reported They Tried to Access Mental Health Care in the Past 12
Months.
Unable to Receive Mental Health Care or Counseling When Needed (in
the past year) Because They Could Not Afford It.
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
7.7% of respondents in SPA 2 reported that they had tried to access mental health care
for a child/children between the ages of 3 and 17 within the past year. 3% of children in
SPA 2 were reported to have been unable to afford mental health care or counseling
within the prior year, just slightly higher than the 2.6% seen county-wide.
Mental Health Access, Children 3-17
SPA 2
Respondents Who Reported They Tried to Access Mental Health Care
for Children in the Past Year
Children Reported as Unable to Afford Mental Health Care or Counseling
in the Past Year
Los Angeles
County
7.7%
7.8%
3.0%
2.6%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Immunization of Children
Rates of compliance with childhood immunizations upon entry into kindergarten vary
among area school districts. The overall rate of immunization for the Henry Mayo
Newhall Memorial Hospital service area is 86.5%, which is lower than the rate for Los
Angeles County, and lower than the state rate. William S. Hart Union High District has a
rate of 60%, but this represents only one school: Santa Clarita Valley International
School. Immunization rates in other area districts range between 73% (Acton-Agua
Dulce Unified) and 93.8% (Castaic Union Elementary District), with only Castaic and
Newhall Districts having rates higher than the Los Angeles County rate.
43
Up-to-Date Immunization Rates of Children Entering Kindergarten, 2011-2012
School District
Acton-Agua Dulce Unified District
Castaic Union Elementary District
Newhall District
Saugus Union District
Sulphur Springs Union District
William S. Hart Union High District
(Santa Clarita Valley International School)
Henry Mayo Service Area
Los Angeles County
California
Immunization Rate
73.0%
93.8%
90.9%
86.6%
80.7%
60.0%
86.5%
89.2%
91.0%
Source: California Department of Public Health, Immunization Branch, 2011-2012
Flu and Pneumonia Vaccines
36.4% of SPA 2 adults and 47.5% of children received a flu shot in the prior 12 months.
Among seniors, 65.4% of SPA 2 residents received the flu shot, and 64.3% reported
ever having received a pneumonia vaccination. All three rates are slightly higher than
county rates.
Flu Vaccine, Past 12 months
SPA 2
Received Flu Vaccine, 65+ Years Old
Received Flu Vaccine, 18+
65.4%
36.4%
Los Angeles County
64.2%
33.7%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Flu Vaccine, Past 12 months, Children 0-17
SPA 2
Received Flu Vaccine
47.5%
Los Angeles County
45.4%
Source: California Health Interview Survey, 2009
Pneumonia Vaccine, 65+
SPA 2
Adults 65+ Who Reported Ever Having a
Pneumonia Vaccination.
64.3%
Los Angeles County
61.3%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Mammograms and Pap Smears
The Healthy People 2020 objective for mammograms is 81% of women 40+ years have
a mammogram in the past two years. In SPA 2, women have met that objective with
82.8% of women 50-74 obtaining mammograms. The Healthy People 2020 objective for
Pap smears in the past three years is 93%. In SPA 2, 84% of women had a Pap smear
in the past three years. Both rates are higher than county rates.
44
Women Mammograms and Pap Smears
SPA 2
Women 50-74 Who Reported Having a
Mammogram in the Past 2 Years.
Women 18-65 Who Reported Having a Pap Smear
within the Past 3 Years.
Los Angeles County
82.8%
79.8%
84.0%
82.8%
Source: L.A. County Department of Public Health, 2011 LA County Health Survey
Colorectal Cancer Screening
In SPA 2, 75.8% of adults over 50 received colorectal cancer screenings. Of those
adults advised to obtain screening, 67% were compliant at the time of the
recommendation.
Colorectal Cancer Screening, Adults 50+
SPA 2
Screening Sigmoidoscopy, Colonoscopy or Fecal
Occult Blood Test
Compliant with Screening at Time of
Recommendation
Los Angeles County
75.8%
75.7%
67.0%
66.5%
Source: California Health Interview Survey, 2009
45
Community Input
Introduction
Twenty-four telephone interviews were conducted for the Henry Mayo Newhall
Memorial Hospital (Henry Mayo) Community Health Needs Assessment in August 2013.
Interview participants included mental health and substance abuse agencies;
community clinics/health centers; public health and WIC; City of Santa Clarita
community services; a community advocate representing senior citizen issues; and a
number of agencies focused on specific issues and/or vulnerable populations, including
Alzheimer’s disease, cancer, children, single mothers, the developmentally disabled,
and services for seniors. The interviewees spoke to issues and needs in the area
surrounding the hospital. Attachment 2 lists the interview participants and their
organizational affiliations.
Interview Topics
Interview participants were asked to share their perspectives on a number of topics,
including:
Biggest issues or concerns facing the community
Existing and needed actions/activities to address community issues
Health problems impacting people in the community
Challenges faced in obtaining primary care and specialty care, mental/behavioral
health services and social services, and suggested strategies to facilitate access
Barriers to obtaining prevention and treatment services for chronic diseases and
resources used for education and for chronic disease self-management
Reasons for emergency room use for non-emergency care and
recommendations to address this
Recommended roles for hospitals and healthcare providers in addressing
community health needs
Other notes and comments
Biggest Issues or Concerns in the Community
A number of interview participants reflected that the Santa Clarita Valley is viewed by
many of its residents as an affluent area, and that the existence and needs of lowerincome, uninsured, and homeless individuals and families who live in the “pockets of
poverty” are often overlooked or ignored. One participant noted that, “there is so much
need in the San Fernando Valley that the Santa Clarita Valley gets forgotten.”
The biggest issues and concerns in the community were identified to include:
The economy, jobs, and financial struggles among many families who are having
difficulty making ends meet. Many people have lost jobs, are running out of
unemployment, are underemployed, or can only find low-wage jobs.
46
Difficulty in accessing health care (including medications) due to lack of
coverage and/or cost and shortage of Medi-Cal providers in the area for both
primary care and specialty care services.
Substance abuse overall, but particularly drug use among youth, high-school age
through mid-20s, including heroin use (mentioned numerous times),
methamphetamines, marijuana and prescription drugs. There have been a
number of heroin-related deaths within this age group in the past several years.
Lack of housing and other social services to meet the needs of the homeless,
especially when the winter shelter is closed.
Shortage of mental health services and long waits for services coupled with
mental health needs among area residents, including the homeless mentally ill
and those suffering from depression, anxiety and despair due to difficult or
changing life circumstances.
Domestic violence.
Lack of services for seniors and their caregivers, including affordable or
subsidized respite care, access to a quality skilled nursing facility in the Santa
Clarita Valley, adult day services, services for monolingual seniors speaking
Spanish, Tagalog and other Asian languages, and outreach to isolated,
homebound seniors.
Lack of access to affordable dental care.
Lack of coordination among health care and mental health providers, often due to
HIPAA restrictions, that negatively impacts both medical and mental health
outcomes for patients.
Lack of public health services in the area since the Los Angeles County Valencia
Health Center closed down and area residents are required to go to Pacoima for
public health services such as immunizations, TB, flu shots, etc.
Lack of local Los Angeles County Department of Health Services (DHS) in the
area, with the closest DHS services located in the Antelope Valley.
Other concerns also identified:
Questions and concerns regarding the Affordable Care Act (ACA), including:
o Whether it will be effective in increasing coverage and access to care;
o What will occur with the residually uninsured after the ACA is in effect
(including the undocumented and those who chose to pay the penalty
rather than get coverage); and
o How the ACA will affect access to mental health services for families in the
Santa Clarita Valley.
Transportation.
Affordable housing.
47
Homelessness and mental health concerns among the community college
student population.
Lack of support groups and transportation to medical services for cancer
patients, especially problematic for those needing to travel great distances for
daily radiation treatments.
Lack of a pediatric endocrinologist at Mayo or elsewhere in the Santa Clarita
Valley.
Physician and hospital staff training relative to patients with dementia and
development disabilities, and how to work with these patients in outpatient and
inpatient settings.
Food security/hunger.
Causes for these issues were thought to include:
Stress and lack of resources (e.g., income, insurance) among many victims of
domestic violence.
Lack of support experienced by single mothers.
Lack of knowledge of the affordable services and resources that are available.
Risk factors for drug and alcohol use among youth, including latch-key kids who
are not participating in after-school activities, easy accessibility, curiosity,
boredom, first time users getting hooked, lack of parental supervision or
engagement, the perception that marijuana is “okay,” and alcoholism in the
family.
Concern that the ACA will be too expensive, and people will choose the penalty
over purchasing coverage.
Lack of new funding for affordable housing.
Difficulty in accessing and using transportation for seniors.
Lack of preparation within the area for the population boom among the ethnic
communities who are monolingual.
Lack of support groups for cancer patients (other than breast cancer groups) and
lack of reliable transportation options for patients needing daily radiation
treatment.
HIPAA can inhibit communication across medical providers and systems.
Disabled population is living longer due to medical advancements, but now
experiencing more issues of aging.
Education and language barriers can be challenges to accessing health care and
other services.
Lack of funding to meet the mental health service needs of the indigent,
undocumented and others with limited means.
48
Lack of integration among the hospital and other service agencies to most fully
address the needs of patients – noted as an issue for those with dementia,
developmentally disabled, mentally ill, and among mothers/families with young
children where there may be post-partum depression.
Existing and Needed Actions/Activities to Address Community Issues
The interview participants identified a number of local strategies that are working to
address community issues and concerns, including some programs that the interview
participants are involved in. Several of the efforts around drug and alcohol prevention
were identified to include:
Annual Heroin Kills symposium, led by the Mayor’s Blue Ribbon Task Force/City
of Santa Clarita, to educate the community about local drug use and provide
information on local initiatives to address the problem as well as on available
resources. Local nonprofits such as the Boys & Girls Club, and others, promote
attendance at the event, and the City’s cable television station tapes and
broadcasts it a number of times to promote exposure to the content.
The Mayor’s Blue Ribbon Task Force meets monthly to develop prevention
strategies. It includes the city, school district, police department and other
providers.
The school district takes education for students around the dangers of drunk
driving seriously, including innovative programs such as reminding students
every 15 minutes one day of the year that teens are killed by drunk drivers every
15 minutes and bringing cars that have been in alcohol-related accidents onto
the school site for viewing.
Parent education provided by the Boys & Girls Club and other agencies related
to the importance of parenting teens, including issues such as text messaging
and bullying.
The Drug Free Youth In Town (DEFY IT) program is a collaboration of the city,
school district and county to establish voluntary clubs at schools to develop drugfree messaging and programming, including providing education at 6 th grade
assemblies.
Efforts focused on community outreach and services were identified to include:
City of Santa Clarita Human Services Department provides families with
information on city programs and services, and also has an Outreach
Neighborhood Services (ONS) program targeted to hard-to-reach families to
provide information, materials and resources.
Help the Children accepts donations (e.g., food, clothing) and then redirects the
donations to other human service agencies that provide the direct services.
49
Several churches have programs to help meet the needs of the area’s lowincome and homeless, including Real Life Church, which helped to establish a
community outreach/resource center in Newhall called Savia, and Church of
Hope, which provides assistance to homeless living in the wash.
Henry Mayo conducts health fairs in Valencia, Canyon Country and Newhall,
which are helpful and important.
The Santa Clarita Valley Senior Center provides a meal program and a food
pantry to provide food resources.
Efforts focused on improving access to and/or coordination of care and services were
identified to include:
A Mental Health Consortium has been established that includes a number of
mental health organizations, domestic violence services and a few health
providers (including Mayo’s Behavioral Health Unit) to identify, discuss and
address gaps in services. The Consortium has written a grant to support their
collaborative process.
Henry Mayo provides charity care to help uninsured and under-insured people.
The ACA will increase the number of people eligible for Medi-Cal and make
health insurance premiums more affordable for many others.
The ACA has also prompted Los Angeles County to move in the direction of
Patient-Centered Medical Homes, which will facilitate more communication
between providers to address a patient’s full spectrum of needs.
The Santa Clarita Valley Mental Health Center works to get releases from
patients to allow providers to talk with each other across systems.
Additional activities occurring to help address identified needs include:
Breast cancer support group has been in place for many years as a partnership
between the American Cancer Society (ACS) and Henry Mayo Hospital.
ACS tried to fill the need for additional support groups by providing online support
groups and also offers minimal transportation assistance with volunteer drivers.
WeSPARK offers additional services in the San Fernando Valley, which some
patients are willing to drive to for access.
Dial-A-Ride provides transportation to seniors to hospital/medical appointments.
Both the Alzheimer’s Association and LARC Ranch offer training for hospital staff
on addressing the needs of their respective patient populations (i.e., patients with
dementia and developmentally disabled people). LARC Ranch has trained staff
at Henry Mayo.
The City of Santa Clarita is working on developing a healthy built environment to
increase access to physical activity.
Several area nonprofit organizations provide substance abuse and mental health
services, including Action, the Henry Mayo BHU, Child & Family Center, and the
50
Santa Clarita Valley Mental Health Center, which is a Los Angeles County
Department of Mental Health facility. There are also a number of 12-step
programs in the area, including Alcoholics Anonymous (AA), Overeaters
Anonymous (OA), ALAnon, TeenGroup and Narcotics Anonymous (NA).
In response to the question of what else needs to be done, or what some possible
solutions to the issues/concerns facing the community might be, interviewees
suggested the following:
More coordination needed among nonprofits to facilitate networking and problem
solving and to reduce competition for dollars.
The Mental Health Consortium needs funding to collaborate more effectively to
address gaps.
More organization needed to facilitate communication and relationship building
between mental health and medical providers so that partnerships will be in place
when the ACA takes effect and these relationships are mandated.
A pediatric endocrinologist is needed to serve the Santa Clarita Valley.
Reduce the stigma associated with domestic violence and sexual assault.
Educate teens about healthy relationships and with anti-bullying programs.
Support groups are needed for single mothers to help reduce their isolation and
stress.
Translations and services are needed for the many monolingual populations in
the area, including Spanish-speaking, Koreans and a growing Middle Eastern
population.
Constant acknowledgement and messaging will be needed to reduce the drug
problem among youth. Give parents a chance to meet and form supportive
networks with other parents via churches, nonprofits, schools, etc.
Affordable or subsidized respite care for caregivers for the elderly and the
chronically ill.
Ongoing training for staff at Henry Mayo to work with special need populations,
such as the developmentally disabled and people with dementia.
Promote access to specialty care and to medications.
Address the housing situation for homeless and also create sober living housing
– both of which will have to combat neighborhood opposition.
Create centralized place for information on local services/resources.
Health Problems Impacting People in the Community
Several health problems that are impacting the community were identified. Most of
these have been persistent over time, while others are showing an increase. The health
problems identified most frequently included:
51
Drug use among youth, especially heroin, but also methamphetamines,
marijuana and prescription painkillers.
Mental health problems, particularly depression and anxiety.
Health problems associated with aging, most notably Alzheimer’s disease and
other forms of dementia. It was noted that as the baby boomers age, the
incidence of dementias are increasing. Vascular dementia, which leads to ministrokes and other symptoms similar to dementia, was identified as the second
leading type of dementia.
Other health issues associated with aging, including:
o Chronic diseases (e.g., diabetes, hypertension, COPD, Congestive Heart
Failure)
o Mobility problems (e.g., knees, hips, balance/falls, difficult time walking)
Co-morbidities; i.e., people with Alzheimer’s disease, developmental disabilities
or mental health problems also dealing with chronic disease or other medical
problems. Treatment for the medical problems is complicated by the presence of
the other issue.
Overweight and obesity among children and adults, and related complications
(e.g., hypertension and a high prevalence of Type 1 Diabetes among children).
Reasons posited for the obesity epidemic included:
Lack of access to fruits and vegetables.
Carbohydrates are less expensive and easy to access.
Interrelated with poor self-esteem; people self-medicate with food.
Cultural issues and family-wide obesity.
Kids given unhealthy snacks for school and after-school activities.
Other health problems also identified included:
Among the college-age population - Women’s health issues, sexually transmitted
infections, acne, chronic urinary tract infections, mental health problems and
dental health problems.
Alcoholism.
Lack of Medi-Cal physicians in the Santa Clarita Valley, necessitating that people
drive to the San Fernando Valley for services, which presents transportation
challenges.
Autism.
Challenges Faced in Obtaining Primary Care, Specialty Care, Mental/Behavioral
Health Services and Social Services, and Suggested Strategies to Facilitate
Access
52
Interview respondents were asked about the problems and challenges children and
families face in obtaining several different types of services, and what might make it
easier for them to access these services.
Primary Care and Specialty Care Services
The most frequently identified challenges in obtaining primary care were lack of
insurance and cost. Additional challenges included:
Difficulties experienced by people with jobs who do not qualify for Medi-Cal but
cannot afford insurance, including affording care and taking time off work for
medical appointments.
Lack of services for the uninsured. The local community health centers have
reached capacity for seeing new uninsured patients and there are no Los
Angeles County Public Health or Department of Health Services (DHS) clinics in
the area. Northeast Valley Health Corporation noted that they only opened their
Santa Clarita Valley clinic three years ago, but they have already exceeded
capacity and do not have enough resources (i.e., funding, exam rooms, doctors)
to see new uninsured adults.
Student Health Center at College of the Canyons cannot manage students with
chronic diseases and so has to refer out to other clinics. However, the other
clinics may not be accepting new patients.
Transportation, especially for the elderly, disabled and lower-income families.
This is particularly a problem when the only available appointments are in the
San Fernando Valley.
As noted above, transportation is also a hardship for cancer patients traveling to
the Santa Clarita Valley for daily radiation treatments over 6-8 weeks from areas
including Bakersfield and the Antelope Valley.
Language barriers to informational materials and to communication with health
care professionals. There is a shortage of providers who speak Spanish and the
other languages spoken in the area.
Shortage of physicians who accept Medi-Cal and of Primary Care Physicians
(PCPs) overall, as many graduating physicians opt to specialize rather than
provide primary care.
Difficulty recruiting doctors to the Santa Clarita Valley, as the commute to the
area is seen as too long.
Documentation status.
Lack of understanding of local resources and how to access them.
Lack of coordination of medical services for the homeless.
Cost of medications and diabetic testing strips, resulting in people not complying
with medication recommendations or testing for diabetes as often as they should.
53
Lack of training/awareness among primary care providers about treating people
with mental illness, Alzheimer’s disease, or developmental disabilities.
Not many specialists in private practice have an interest in providing low-cost
services.
Suggestions for what would make it easier to obtain primary care and specialty care
included:
More resources for primary care and specialty care for the uninsured. More
people will qualify for Medi-Cal under the ACA, but increased capacity for seeing
these patients will be needed via existing or new clinics (i.e., exam rooms,
physicians).
Increased presence of Los Angeles County Public Health and DHS services.
Increased language capacity.
Transportation assistance/alternatives.
Partnerships between primary care providers, hospitals and relevant agencies for
serving patients with special needs (e.g., mentally ill, developmentally disabled,
patients with dementia). Los Angeles County Department of Mental Health,
Alzheimer’s Association and LARC Ranch all expressed interest in participating
in these partnerships.
Hopes for the potential of the ACA to provide affordable coverage for more
individuals and families, but also concerns whether it will really make a difference
– and who will get left behind.
Mental Health and Behavioral Health Services
The problems and challenges in obtaining mental health services included:
Shortage of mental health providers and long waits for services, especially for
those who are un/under-insured. Services are insufficient for both chronically
mentally ill and for those suffering from anxiety or depression.
Limited funding/resources at local agencies such as the Child & Family Center
and the Santa Clarita Valley Mental Health Center (a Los Angeles County
Department of Mental Health clinic) means that these agencies have to triage
patients and only serve those with the most severe and acute needs, leaving
many people unserved and without service options. Santa Clarita Valley Mental
Health Center clinic only serves adults at this point.
People with mental health problems often present in the emergency room, likely
indicating lack of access to other resources.
Transitional care is no longer available in our community.
Skilled nursing resources are inadequate for the growing need.
Growing need for local services for veterans returning from recent wars with a
variety of problems (e.g., PTSD, traumatic brain injury, family problems). Due to
54
insufficient resources in the Santa Clarita Valley and specialized insurance
coverage that many local agencies cannot accept, veterans often have to travel
to the San Fernando Valley Veteran’s Administration for services.
Lack of a comprehensive adult day care center that includes counseling and
psychiatric services.
Need for dementia care services. Families cannot afford the needed home care.
Lack of knowledge among families about mental health resources or where to get
this information, as many families are not linked to the community centers that
can provide referrals and do not have internet access.
Some sub-populations that face greater risk for depression and anxiety include
caregivers of people with Alzheimer’s disease, domestic violence victims and
single mothers. In addition, Samuel Dixon Health Center estimates that one-third
of their patients have a mental health diagnosis in addition to their medical
condition. While medication can be provided, counseling to help address
underlying stressors is hard to access.
Suggestions for improving access to mental health services included:
Increase the availability/capacity of low-cost/free services for people who need
counseling for anxiety and depression at local mental health providers such as
Child & Family Center and the Santa Clarita Valley Mental Health Center.
Expand services at the Mental Health Center to also include children. Expand
services in different languages as needed.
Outreach to neighborhoods regarding available services, including door-to-door
outreach and flyers. Provide outreach and materials in the appropriate
languages.
Implement the Mental Health Consortium’s collaboration grant. Several service
providers expressed interest in knowing more about what is happening at other
agencies to facilitate better patient referrals for needed services.
Create a larger network of local nonprofits that includes health care providers,
mental health providers, city services and other social/human service
organizations.
Recruit psychiatrists and geropsychiatrists to the Santa Clarita Valley.
Social Services
Problems and challenges to obtaining social services were identified as:
Lack of knowledge about available services or where to get this information.
Community Centers, Single Mothers Outreach, the WIC program and Alcoholics
Anonymous are good sources of referrals for the people they serve, but this is
still a limited population.
55
Transportation was identified numerous times relative to the size of the Santa
Clarita Valley, the distance to Los Angeles or the San Fernando Valley, and the
inadequacy of the local bus system.
Needs of the homeless were also mentioned several times. The homeless
population is growing but is mostly ignored. The only resource is the Winter
Shelter, which only serves men and only for a limited time during the year.
Needs of the college-age student population were identified to include
homelessness, victimization of domestic violence and sexual assault, and need
for access to food and clothing.
Lack of affordable or subsidized respite services for caregivers.
Several respondents noted that Henry Mayo does a good job of linking patients
to services; however, when the closest services are in the San Fernando Valley,
there are often transportation barriers.
Suggestions for making it easier to obtain social services included:
A nonprofit health organization, called Health Leads, is working to improve
access to services through volunteer patient advocates who link clients with
services.
A community resource guide is needed. Not everyone has access to the
Internet. We need to communicate better about the existing services available.
Outreach to neighborhoods regarding available services, including door-to-door
outreach and flyers. Provide outreach and materials in the appropriate
languages.
Boys & Girls Club offers affordable recreational activities.
College of the Canyons is starting a food pantry and community garden to help
address the food need among students. They are also starting a program to give
out clothes from their Lost and Found.
Educate people on how to use the Internet and create better access to the
Internet.
Provide information on community resources at primary care sites.
Create and share a resource guide with local service providers.
Expand basic need services (e.g., housing, food, clothing) from Los Angeles into
the Santa Clarita Valley to better meet the local need.
More outreach to increase awareness of local 12-step programs and more
awareness overall between local providers of available services.
Barriers to Obtaining Prevention and Treatment Services for Chronic Diseases
and Resources used for Education and for Chronic Disease Self-Management
Many of the barriers to obtaining prevention and treatment services for chronic diseases
are those mentioned previously; i.e., lack of insurance, cost, language barriers,
56
documentation status, and transportation barriers to obtaining services not available in
the Santa Clarita Valley, especially for the elderly and lower-income families.
Other barriers noted by the respondents included:
Lack of a diabetes clinic or Congestive Heart Failure clinic in the area to help
provide ongoing monitoring for disease management and to prevent unneeded
emergency room visits.
Personal barriers and resistance to engaging in prevention activities.
Stigma and potential loss of treatment/care opportunities when physicians do not
take symptoms of dementia seriously and do not offer access to available
resources.
There is no pediatric endocrinologist in the Santa Clarita Valley, necessitating
families to travel outside the area for this service.
Patients with mental health problems require additional coaching and support to
foster compliance with medications or other chronic disease management
recommendations.
It was noted that many people do not learn about or manage their chronic diseases due
to cost, competing priorities in their lives, and/or lack of capability to do so. The health
care services, education programs and materials people use to learn more about their
chronic diseases and to care for themselves were identified to include:
Henry Mayo Hospital offers a number of opportunities, including:
o Health fairs, including health screenings (e.g., Body Composition
Index, cholesterol, blood pressure), at community centers in
neighborhoods with large low-income, Latino populations.
o New, interventional cardiovascular services previously not available in
the area, such as stents, balloons and surgeries.
o Hospital-sponsored education programs in the community, often at no
charge (e.g., spine education, CPR training, tobacco cessation).
Information provided by community health centers (i.e., Northeast Valley Health
Corporation and Samuel Dixon) either directly or through other nonprofits (e.g.,
Newhall Community Center). The community health centers also offer patient
education provided by nurse practitioners, medical assistants, and dieticians.
Santa Clarita Valley Senior Center provides weekly blood pressure readings and
a dietician on a monthly basis who provides blood sugar readings. They also
provide many exercise classes and health education classes.
College of the Canyons Student Health Center offers two wellness events per
year focused on high-risk behaviors such as alcohol use, drug use and stress
management. They indicated a need for assistance to offer more prevention
resources to students.
57
Internet research for those who have access to the Internet and ability to use it.
Many older adults have never learned to use the internet.
Alzheimer’s Association provides educational materials, but is limited by funding
on the extent of education provided.
American Diabetes Association (ADA) and American Cancer Society also
provide information on their websites and offer printed materials to the extent that
they can. The ADA also offers assistance to families through their Safe at
School initiative to provide the school guidance, based on physician
recommendations, on how to manage a child’s diabetes during the school day.
Several recommendations were made to facilitate access to information about chronic
disease management, including:
Media outreach and use of social media are important strategies for reaching
younger audiences.
Visual information (i.e., videos) is more helpful than written materials.
A walk-in clinic for chronic disease management would be helpful.
Reasons for Emergency Room Use for Non-Emergency Care and
Recommendations to Address This
The majority of the interview participants said they are aware of people using the
emergency room for non-emergency purposes. The primary reasons identified for this
included lack of insurance and a regular source of care. Additional reasons included:
Knowing they will be treated regardless of insurance status or ability to pay.
Cost of services prohibitive at urgent care or a physician’s office, and payment
not required up front in the emergency room. Some people never expect to pay
the bill and are not concerned about the impact on their credit.
Convenient hours and accessibility; no appointment is needed and services are
available in the evenings and on weekends when most other clinics or provider
offices are closed.
Lack of awareness of low-cost options, such as community clinics.
Lack of capacity at local community health centers/clinics to provide medical
homes for new, uninsured patients due to lack of exam rooms and funding.
Emergency room seen as a safe place for the undocumented.
Use by Medi-Cal Managed Care patients who do not have access to covered
services in the Santa Clarita Valley, and so use the emergency room rather than
travel to the San Fernando Valley.
Attempts to access pain medications.
People with mental illness and have chaotic lives often do not engage in
preventive behaviors or manage their chronic diseases, and so end up with
conditions requiring emergency care.
58
Recommendations for how to address the use of the emergency room for nonemergency care included:
Utilize mobile health clinics to serve the homeless and provide prevention and
primary care services.
Case management and assistance to foster education and jobs.
Health care coverage, as may be more available through the ACA.
More low-cost health care clinics and affordable urgent care, open during hours
that are convenient for people on various work schedules.
Educate students and community members about the ACA and also about
appropriate emergency room use.
Develop a diversion program with the local community health centers to help
prevent inappropriate emergency room use. Co-locate community health center
services on the Hospital campus and/or assist in funding more exam rooms.
Hospital may wish to consider accepting Medi-Cal to better serve these patients
who live in the area.
Provide wellness coaches or educators to patients at discharge to help prevent
readmission. These coaches/educators need to speak the languages of the
population and have cultural sensitivity.
Address alcoholism and substance abuse issues to foster healthier people who
can access jobs and hopefully insurance.
Recommended Roles for Hospitals and Health Care Providers in Addressing
Community Health Needs
Although this question was not framed relative to Henry Mayo, many of the respondents
reflected on how the hospital supports the community now and how it could further
address community needs.
Some of the current activities that Henry Mayo and other local agencies participate in
that address health needs were identified to include:
Health fairs sponsored by Henry Mayo at the Newhall Community Center.
Santa Clarita Valley Senior Center offers weekly blood pressure screenings and
monthly opportunities for blood sugar screenings and to meet with a dietician.
Henry Mayo provides agencies with flu vaccines for seniors.
Suggestions for how Henry Mayo Hospital and other health care providers can help to
more effectively address community health needs included:
A number of interviewees noted the need for more collaboration among local
health, mental health, substance abuse and social service providers. An agency
needs to take the lead to convene this type of collaborative group on a quarterly
basis to share information, network, reduce competition for dollars, and identify
59
opportunities for coordinated strategies to address gaps in services. It was noted
that this leadership would create more visibility for Henry Mayo in the community
and also create deeper relationships between the Hospital and community
agencies, as the Hospital is seen somewhat as operating by itself rather than as
integrated within the community.
Several interviewees also noted the value of building partnerships with large
institutions that serve many people (i.e., schools, City Parks & Recreation
programs, colleges, faith organizations) and then leveraging those partnerships
to conduct outreach and education related to prevention, screenings and access
to affordable primary care services. It was noted that people need continuous
reminders of the low-cost health care options.
Foster integration between health care and mental health services to achieve
better health outcomes.
The needs of Spanish-speaking people need to be better addressed via
information, signage, and services available by Spanish-speaking providers. This
is also true for other major languages spoken in the community, such as Korean.
Hospital and urgent care services that can accept Medi-Cal for payment.
Expand health fairs to other community sites to reach additional people.
Conduct outreach to homeless people in the wash and in other places they live.
Go to them versus expecting them to come to community agencies. The staff of
the Santa Clarita Valley Mental Health Center knows where the homeless are
located and can help develop effective outreach strategies.
Utilize media channels such as the AARP newsletter to conduct outreach and
education.
Reminders for patients about needed screenings are helpful.
More direct chronic disease management is needed to better control chronic
diseases and prevent unneeded emergency room visits and hospitalizations. A
follow-up phone call program was suggested.
Outreach is needed for isolated, home-bound elderly people to identify their
needs, assure they are taking their medications and have sufficient food, etc.
Affordable or subsidized respite care is needed for caregivers of the elderly and
of people with chronic diseases.
A larger staff of geriatric physicians is needed to better serve the health needs of
older adults in the area, including a neurologic clinic to help diagnose and treat
dementia and Alzheimer’s disease.
Evaluate the need for a pediatric endocrinologist to serve the needs of children
with diabetes.
A nonprofit skilled nursing facility, possibly run in partnership with the hospital.
Simple education about the ACA is needed to review employer responsibilities,
coverage options and eligibility, including Medi-Cal and Medicare.
60
Any service for which people have to travel to the San Fernando Valley is a
need.
An expansion of non-pharmaceutical, holistic alternatives to drug therapy is
needed.
Comments/Other
At the close of the interview, participants were given an opportunity to share any final
thoughts or comments. Several participants expressed their support for the Hospital’s
participation in the needs assessment process and their hopes that it will improve the
health of the community. Other comments included:
Appreciation about the Hospital, including that it:
o Is a “good presence” and “good community partner.”
o Has a senior management team that is progressive and trying to build a
community hospital that meets the needs of the community. It was noted
that the Hospital is constantly upgrading its facilities (including the parking
lot), is increasing its bed-count capacity, and is building a new facility for
training and continuing education.
o Has a volunteer Auxiliary that conducts food drives and fundraisers.
o Recently opened a NICU, meeting an important community need.
Interest in learning more about the needs assessment, getting involved and
working with the Hospital.
Interest in working the Hospital more closely on the issue of drug use in the
community; i.e., to develop parent education strategies and have more
discussion of the issue.
The Hospital could be more proactive in addressing the needs of special needs
patients, such as those who are hearing impaired.
There are opportunities for the Hospital to work more closely with a number of
community agencies as well as the public health department. There is interest
among many community agencies in partnering more closely with the Hospital to
better serve the populations they specialize in, including the lowincome/uninsured, developmentally disabled, college students, mentally ill
patients, substance abuse population, patients with Alzheimer’s disease and
other cognitive impairments, homeless, WIC patients and others.
There is an opportunity for the Hospital to improve its cultural competency, and
better serve Spanish-speaking and lower-income populations, bring Spanishspeaking staff into the Hospital, and to offer many more services in Spanish.
Northeast Valley Community Health Center would like to work together with
Henry Mayo to develop contracts that would allow Medi-Cal deliveries to occur at
the Hospital, in the community where the women live.
61
62
Attachment 1. Benchmark Comparisons
Where data were available, health and social indicators in the Henry Mayo Newhall
Memorial Hospital service area were compared to Healthy People 2020 objectives. The
bolded items are indicators that do not meet established objectives; non-bolded items
meet or exceed benchmarks.
Service Area Data
High school graduation rate
88.1%
Child health insurance rate
95.8%
Adult health insurance rate
73.0%
Heart disease deaths
110.9 per 100,000
Cancer deaths
108.6 per 100,000
Stroke deaths
26.6 per 100,000
Suicides
6.7 per 100,000
Diabetes deaths
10.9 per 100,000
Unintentional injury deaths
16.5 per 100,000
Breast cancer incidence
78.0 per 100,000
Early prenatal care
89% of women
Low birth weight infants
6.6% of live births
Infant death rate
5.4 per 1,000 live births
Breastfeeding (any)
94.2%
Adults with an ongoing source of care
77.4%
Adult obese
21.1%
Diabetic annual foot exam
74.1%
Adults engaging in binge drinking
14.9%
Cigarette smoking by adults
13.8%
Senior flu vaccine
65.4%
Childhood flu vaccine
47.5%
Adults 50+ colorectal cancer screening
75.8%
Adult women who have had a Pap smear
84.0%
Women over 50 who have had a mammogram
82.8%
Healthy People 2020 Objectives
High school graduation rate
84%
Child health insurance rate
100%
Adult health insurance rate
100%
Heart disease deaths
100.8 per 100,000
Cancer deaths
160.6 per 100,000
Stroke deaths
33.8 per 100,000
Suicides
10.2 per 100,000
Diabetes deaths
65.8 per 100,000
Unintentional injury deaths
36.0 per 100,000
Breast cancer incidence
20.6 per 100,000
Early prenatal care
77.9% of women
Low birth weight infants
7.8% of live births
Infant death rate
6.0 per 1,000 live births
Breastfeeding (any)
81.9%
Adults with an ongoing source of care
89.4%
Adult obese
30.6%
Diabetic annual foot exam
74.8%
Adults engaging in binge drinking
24.4%
Cigarette smoking by adults
12%
Senior flu vaccine
90%
Childhood flu vaccine
80%
Adults 50+ colorectal cancer screening
70.5%
Adult women who have had a Pap smear
93%
Women who have had a mammogram
81.1%
63
Attachment 2: Community Stakeholders
Name
Title
1
Nancy Agosto
Director
2
Frank Alvarez, MD,
MPH
3
Amy Anneberg
4
Lori Blumenthal
Area Health Officer, SPA 1
and SPA 2
Director of Healthcare
Corporate Initiatives
Manager, Step Out Walk
5
Julie Calderon
Human Services Supervisor
6
Elizabeth Cravitz
Director, Case Management &
Social Services
7
Linda Davies
Executive Director
8
Christine Goulet
9
Robert Hill
10
Cathy Ladd
WIC Area Manager
Community Member,
Representing Seniors
Vice President of Programs
11
Cheryl Laymon
Chief Operating Officer
12
Michelle Majors
Mental Health Clinical
Program Head
13
Myles McNamara
Past President
14
Joanne Melton
Manager, Central Office
Suzann Nelsen &
Linda Lieblang
Teresa (Missy)
Nitescu
Director of Support Services
Associate Executive Director
17
Jeanine Prado
Human Services Administrator
18
19
20
Cary Quashen
Colleen Reeves, NP
Michael Santomauro
21
Larry Schallert
22
DaAnne Smith
Kathleen Sturkey &
Chris Bratzel
Founder
Director, Student Health Ctr.
Director
Director of Program
Development
Executive Director
Executive Director &
Executive Officer
Jim Ventress
Executive Director
15
16
23
24
Chief Operating Officer
Organization
Santa Clarita
Adult Day Health Care
Los Angeles County
Department of Public Health
American Cancer Society,
California Division
American Diabetes Association
City of Santa Clarita,
Newhall Community Center
Henry Mayo Hospital
Domestic Violence Center of
Santa Clarita Valley
NEVHC – WIC Program
N/A
Alzheimer’s Association
Samuel Dixon Family Health
Centers, Inc.
Los Angeles County Department
of Mental Health - Santa Clarita
Valley Mental Health Center
SCV Senior Center Foundation
Santa Clarita Valley Central
Office of Alcoholics Anonymous
Santa Clarita Valley Senior
Center
Northeast Valley Health
Corporation (NEVHC)
Newhall Community Center
City of Santa Clarita
Action Family Counseling
College of the Canyons
Help the Children
Child & Family Center
Single Mothers Outreach
Los Angeles Residential
Community (LARC) LARC Ranch
Boys & Girls Club of
Santa Clarita Valley
64