Collaborative Health Collaborative Health Planning to Address Urban Planning to Address Urban Community Health Needs Community Health Needs

in a Limited Resource in a Limited Resource Environment Environment

Camden City Healthy Camden City Healthy FuturesFutures

History of the PartnershipHistory of the Partnership

Last community assessment for the city was done in Last community assessment for the city was done in 1995 1995

Role of partnership as the health advisory Role of partnership as the health advisory committee to the Mayorcommittee to the Mayor

University leadership roleUniversity leadership role Limited success in obtaining grant support (Institute Limited success in obtaining grant support (Institute

for the Elimination of Health Disparities)for the Elimination of Health Disparities) In 2005 NJ counties were engaged in MAPP In 2005 NJ counties were engaged in MAPP

(Mobilizing Around Partnerships and Planning) and (Mobilizing Around Partnerships and Planning) and writing Community Health Improvement Plans writing Community Health Improvement Plans (CHIP). For Camden County this included: (CHIP). For Camden County this included: – Prioritization of health issues with special focus on the cityPrioritization of health issues with special focus on the city– BRFSS study with an oversample in the city of Camden BRFSS study with an oversample in the city of Camden

Partners in Camden Healthy Partners in Camden Healthy FuturesFutures

African-American Advisory Commission African-American Advisory Commission Association for Children of New Jersey Association for Children of New Jersey CamCare Health Corporation CamCare Health Corporation Camden Area Health Education Center Camden Area Health Education Center

(Camden AHEC) (Camden AHEC) Camden Community Camden Community

Recovery/Environmental Justice Coalition Recovery/Environmental Justice Coalition Camden County Department of Health & Camden County Department of Health &

Human Services Human Services Dr. Charles E. Brimm Medical Arts High Dr. Charles E. Brimm Medical Arts High

School School City of Camden City of Camden Community Planning and Advocacy Community Planning and Advocacy

Council Council Cooper Hospital University Medical Cooper Hospital University Medical

Center Center Healthy Mothers, Healthy Babies Healthy Mothers, Healthy Babies

Coalition of Camden City Coalition of Camden City Hispanic Family Center of Southern NJ, Hispanic Family Center of Southern NJ,

Inc. Inc. Lourdes Health System Lourdes Health System Medical Mission Sisters Medical Mission Sisters N.J. Dept. of Environmental Protection - N.J. Dept. of Environmental Protection -

Div. of Air Quality Evaluation Div. of Air Quality Evaluation

NJ Dept. of Health and Senior Services – NJ Dept. of Health and Senior Services – Asthma Awareness & Education Program Asthma Awareness & Education Program

Planned Parenthood of Southern New Jersey Planned Parenthood of Southern New Jersey Rowan University Urban & Public Policy Rowan University Urban & Public Policy

Institute Institute Rutgers University/Camden Rutgers University/Camden

– Department of Public Administration Department of Public Administration – Walter Rand Institute Walter Rand Institute – Cooperative ExtensionCooperative Extension

The South Jersey Environmental Justice The South Jersey Environmental Justice Alliance Alliance

University of Medicine and Dentistry of New University of Medicine and Dentistry of New Jersey:Jersey:

– Department of Government & Community Department of Government & Community AffairsAffairs

– Institute for the Elimination of Health Institute for the Elimination of Health DisparitiesDisparities

– New Jersey Dental SchoolNew Jersey Dental School– Robert Wood Johnson Medical SchoolRobert Wood Johnson Medical School– School of Health Related ProfessionsSchool of Health Related Professions– School of NursingSchool of Nursing– School of Osteopathic MedicineSchool of Osteopathic Medicine– School of Public Health School of Public Health

Union Organization for Social Service Union Organization for Social Service Virtua Health System Virtua Health System Weisman Children’s Rehabilitation HospitalWeisman Children’s Rehabilitation Hospital

University’s Role in Data University’s Role in Data CollectionCollection

Because of the university’s role—the partnership was able Because of the university’s role—the partnership was able to use graduate students to assist with data collection/ to use graduate students to assist with data collection/ analysis. analysis.

Student projects included:Student projects included:1.1. City of Camden Focus Group Study with residents and City of Camden Focus Group Study with residents and

constituent groups (two separate student analyses constituent groups (two separate student analyses including in-depth analysis using Atlas.ti-2006) including in-depth analysis using Atlas.ti-2006)

2.2. BRFSS City/County Comparison StudyBRFSS City/County Comparison Study3.3. Healthy Camden City 2010-Update 2005 (comparison Healthy Camden City 2010-Update 2005 (comparison

with NJ Healthy People 2010 goals)with NJ Healthy People 2010 goals)4.4. Key Informant Stakeholder StudyKey Informant Stakeholder Study5.5. Provider SurveyProvider Survey

Use of Other Available Sources of Use of Other Available Sources of DataData

6.6. Camden Hospital and Emergency Room Health Data Camden Hospital and Emergency Room Health Data June 2006 (Camden Coalition of Healthcare Providers)June 2006 (Camden Coalition of Healthcare Providers)

7.7. Camden Kids Count 2004 Camden Kids Count 2004 8.8. Camden Waterfront South Air Toxics Pilot Project 2005 Camden Waterfront South Air Toxics Pilot Project 2005

(NJDEP)(NJDEP)9.9. From Data to Strategy: Information for Planning a From Data to Strategy: Information for Planning a

Smoking Cessation Program-2005 (Camden County Smoking Cessation Program-2005 (Camden County Cancer Coalition)Cancer Coalition)

10.10. Health Report Card Survey-2005 (Cooper University Health Report Card Survey-2005 (Cooper University Hospital Department of Family Medicine and Hospital Department of Family Medicine and CAMConnectCAMConnect

11.11. Camden City Health Profile (County Report for CHIP)Camden City Health Profile (County Report for CHIP)

Access to Health CareAccess to Health CarePercentage of Adults Who Report They Have a Source of Percentage of Adults Who Report They Have a Source of

Primary CarePrimary Care

Sources: NJDHSS, Center for Health Statistics, Behavioral Sources: NJDHSS, Center for Health Statistics, Behavioral Risk Factor Survey; Healthy New Jersey 2010: Update Risk Factor Survey; Healthy New Jersey 2010: Update 2005; Camden City/County Comparison Behavioral Risk 2005; Camden City/County Comparison Behavioral Risk Factor Survey; Healthy Camden City 2010: Update 2005Factor Survey; Healthy Camden City 2010: Update 2005

80

82

84

86

88

90

92

94

96

2001 2005 2001 Target

Camden City

CamdenCounty

New Jersey

NJ Target

PreferredEndpoint

Adolescent HealthAdolescent HealthTotal Number of Births per 1000 Females Aged 15 Through 17Total Number of Births per 1000 Females Aged 15 Through 17

0

10

20

30

40

50

60

70

80

90

2000 2001 2002 2003 Target

Camden CityTarget WhiteTarget BlackTarget HispanicNJ Target

Sources: NJDHSS, Center for Health Statistics; Healthy New Jersey Sources: NJDHSS, Center for Health Statistics; Healthy New Jersey 2010: 2010: Update 2005; National Center for Health Statistics and U.S. Update 2005; National Center for Health Statistics and U.S. Census Census Bureau; Healthy Camden City 2010: Update 2005.Bureau; Healthy Camden City 2010: Update 2005.

Adult HealthAdult HealthPercentage of Persons Aged 18+ Who Are Overweight But Not Percentage of Persons Aged 18+ Who Are Overweight But Not

ObeseObese..

Sources: Sources:

NJDHSS, Center for Health Statistics, Behavioral Risk Factor Surveillance System; Camden NJDHSS, Center for Health Statistics, Behavioral Risk Factor Surveillance System; Camden City/County Comparison/Behavioral Risk Factor Survey Breakdown; Healthy New Jersey 2010: City/County Comparison/Behavioral Risk Factor Survey Breakdown; Healthy New Jersey 2010: Update 2005; Healthy Camden City 2010: Update 2005Update 2005; Healthy Camden City 2010: Update 2005

0

10

20

30

40

50

60

70

80

neither overweight obese

Camden City

Camden County

Target neither

NJ Target-overweight

Preventing and Reducing Major Diseases Preventing and Reducing Major Diseases CancerCancer

age-adjusted mortality rate from colorectal cancer age-adjusted mortality rate from colorectal cancer per 100,000 standard populationper 100,000 standard population

0

5

10

15

20

25

30

2003 2002 Target

Camden CityNJNJ Target

Sources: New Jersey Department of Health and Senior Services, Center for Health Statistics.Healthy New Jersey 2010: Update 2005Healthy Camden City 2010: Update 2005

Mental HealthMental HealthMortality Rate From Suicide per 100,000 Male PopulationMortality Rate From Suicide per 100,000 Male Population

Sources: NJDHSS, Center for Health Statistics; Healthy New Sources: NJDHSS, Center for Health Statistics; Healthy New Jersey 2010: Update 2005; Healthy Camden City 2010: Jersey 2010: Update 2005; Healthy Camden City 2010: Update 2005.Update 2005.

05

101520253035404550

1999-2001

2000-2002

2003-2005

NJTarget15-19

Camden City males 25-34 rate/100,000NJ males 25-34rate/100,000NJ Target 15-19

Challenges ….Challenges ….

In 2003 almost all residents can identify a In 2003 almost all residents can identify a primary health care provider and 93% of primary health care provider and 93% of residents report having health insurance. residents report having health insurance. So….why are so many residents still So….why are so many residents still utilizing the Emergency Departments utilizing the Emergency Departments every year? One out of two residents use every year? One out of two residents use the ED for care. the ED for care.

Source: Camden Hospital and Emergency Room Health Data June Source: Camden Hospital and Emergency Room Health Data June 20062006

Camden Coalition of Healthcare Providers and CAMConnectCamden Coalition of Healthcare Providers and CAMConnect

Setting Health Goals Setting Health Goals

Created spreadsheet with data from the 11 Created spreadsheet with data from the 11 studiesstudies

Partners worked through all of the data Partners worked through all of the data (where there were overlaps and what were (where there were overlaps and what were priorities) and identified priorities) and identified Five General Five General CategoriesCategories::1.1. Community Health/Healthy LifestylesCommunity Health/Healthy Lifestyles

2.2. Family Health and Parenting ConcernsFamily Health and Parenting Concerns

3.3. Safety and Violence PreventionSafety and Violence Prevention

4.4. Mental HealthMental Health

5.5. Environmental Health Concerns Environmental Health Concerns

Creating Action Plans Creating Action Plans Action planning grids were developed Action planning grids were developed

based on MAPP design. based on MAPP design. Teams then identified “actionable” Teams then identified “actionable”

items that aligned with partner items that aligned with partner agencies’ agendasagencies’ agendas

All data/reports were put on CD as well All data/reports were put on CD as well as posted online at as posted online at www.camconnect.orgwww.camconnect.org

Executive Summary was developed for Executive Summary was developed for the communitythe community

SUBCOMMITTEE-Camden CitySUBCOMMITTEE-Camden CityCamden City Community Health Task ForceCamden City Community Health Task ForceTopic/Issue-High mortality rate for cancer in the City Topic/Issue-High mortality rate for cancer in the City

11/15/0711/15/07 Specific Aim or Purpose: Decrease mortality rates for cancer in the City through earlier detection and treatment

Desired Outcome or Improvement Target:

Plan to Achieve Target-Action Steps:

What will be done (brief description)

Who will do it? By when?

Evaluation

•Lung cancer-2002 Camden City 53/100,000NJ 50/100,000•Breast Cancer mortality rate is increasing in Camden City rather than decreasing17.02/100,00026.75/100,000 in 2003•Colo-Rectal Cancer mortality rate is increasing in Camden City rather than decreasing15.2/100,00029.1/100,000 in 2003

•Invasive Cervical Cancer 5 year average 1998-2002Camden City 23.5/100,000Camden County 9.7/100,000•Men’s Health > 39 years oldPSA within the last year?Camden City 52.5%Camden County 68.1%Ever had a DRE?Camden City 49.3%Camden county 73.9%

Year One Year One Camden City Health Priorities Camden City Health Priorities

Community HealthCommunity Health Diabetes (Obesity, Diabetes (Obesity, Physical Activity, Nutrition) and CancerPhysical Activity, Nutrition) and Cancer

Environmental HealthEnvironmental Health Lead Poisoning and Lead Poisoning and AsthmaAsthma

Safety & Violence PreventionSafety & Violence Prevention Street Street ViolenceViolence

Mental HealthMental Health DepressionDepression Family HealthFamily Health Adolescent PregnancyAdolescent Pregnancy

Efforts to Address Efforts to Address Camden City Health PrioritiesCamden City Health Priorities

All five prioritiesAll five priorities – Creation of Camden High School Public Health Club which focuses on Creation of Camden High School Public Health Club which focuses on

our prioritiesour priorities– Cable TV public health series on how to access resourcesCable TV public health series on how to access resources

Diabetes/Obesity and NutritionDiabetes/Obesity and Nutrition – Farmer’s MarketsFarmer’s Markets– Coalition of HealthCare Providers -Merck Grant formed Diabetes Coalition of HealthCare Providers -Merck Grant formed Diabetes

Collaborative Collaborative – Health Information Exchange Coordination of Treatment Health Information Exchange Coordination of Treatment – Partnership grant applications for Community Putting Prevention to Partnership grant applications for Community Putting Prevention to

WorkWork Mental HealthMental Health Open Community Forums on Dual Diagnosis Open Community Forums on Dual Diagnosis

(Mental Health and Substance Abuse) and Integration of Care.(Mental Health and Substance Abuse) and Integration of Care. EnvironmentEnvironment Camden City designated as NJ Model Lead-Safe Camden City designated as NJ Model Lead-Safe

CityCity Safety and Violence PreventionSafety and Violence Prevention Mayor’s Prevention of Youth Mayor’s Prevention of Youth

Violence Program-Campaign Against Youth Violence as a Public Violence Program-Campaign Against Youth Violence as a Public Health ProblemHealth Problem

2009 Public Health 2009 Public Health Cable TV SeriesCable TV Series

Dateline: EducationDateline: Education Moderated by Bart Leff Moderated by Bart Leff Cable Channel 19Cable Channel 19

– Adolescent PregnancyAdolescent Pregnancy– Diabetes--Nutrition/Physical exercise/ObesityDiabetes--Nutrition/Physical exercise/Obesity– Public Safety and Street ViolencePublic Safety and Street Violence– Lead PreventionLead Prevention– Mental Health-DepressionMental Health-Depression

DVDs in clinics & physician waiting roomsDVDs in clinics & physician waiting rooms Follow-up booklets on each topic Follow-up booklets on each topic

distributed throughout the city & posted distributed throughout the city & posted online at online at www.camconnect.orgwww.camconnect.org

Lessons LearnedLessons Learned

Targeted efforts must not only inform the community about Targeted efforts must not only inform the community about the issue but also how to access available resources the issue but also how to access available resources

Because not all priorities can be accomplished in Year One…Because not all priorities can be accomplished in Year One…set goals for Year Two set goals for Year Two

Start where resources are available and build. This includes Start where resources are available and build. This includes staff resources and moneystaff resources and money

Use the community health needs assessment priorities for Use the community health needs assessment priorities for seeking grant fundingseeking grant funding

There is essential support in partnering with academic health There is essential support in partnering with academic health centers (school of public health)centers (school of public health)

Educate the community to use available benchmarks Educate the community to use available benchmarks whenever possible whenever possible

There is strength in the value of the partnership There is strength in the value of the partnership Push forward despite limitationsPush forward despite limitations progress will begin to take progress will begin to take

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