Community Health Needs Assessment Focusing on Evanston and the Rogers Park and West Ridge neighborhoods of Chicago
2013
Be in the know. This Community Health Needs Assessment is an overview of the health status of those who live in Evanston and the Rogers Park and West Ridge neighborhoods of Chicago. A collaborative team of community stakeholders—from social service agencies to business leaders—came together to gather and analyze health-related information, identify the most pressing needs and pinpoint ways to make improvements. Please turn to page 15 to learn more about this process. Based on the committee’s extensive research and review of available data, the following themes surfaced as the highest priority health needs for this community:
+ Access to Mental Health Care (including strategies to address substance abuse)
Our partners. ACCESS Community Health Network CJE Senior Life Consortium to Lower Obesity in Chicago Children (CLOCC) Cook County Commissioner Larry Suffredin’s Office Evanston Health Department Evanston/Skokie School District 65 Former Evanston Mayor Lorraine H. Morton
+ Adolescent Issues
Former Evanston Police Chief William Logan
+ Obesity and Chronic Diseases
Holmestead Communications
+ Safety and Violence
Howard Area Community Center McGaw YMCA
Economic Disparities & Language Barriers will be addressed throughout all priorities and strategies.
Oakton School PTA PEER Services, Inc. Presence Saint Francis Hospital
Get involved. Find out how to volunteer to help strengthen the community. + Call 877.737.INFO (877.737.4636) + Email community@presencehealth.org + Visit presencehealth.org/community
Rogers Park Business Alliance Saint Hilary Catholic Church Saint Nicholas Church Trilogy
Facts & Findings. Here is a snapshot of some of the key factors affecting the health and well-being of Evanston and the Rogers Park and West Ridge neighborhoods of Chicago—the Presence Saint Francis Hospital service area.
1 in 4
Almost half of ER outpatients are on Medicaid
Diabetes is the 3rd leading cause of death in our Chicago neighborhoods
1 in 4
are at risk for binge drinking
8%
in Evanston are uninsured— better than the national rate
Rogers Park residents are uninsured
West Ridge stands out for the diversity of languages spoken
17% suffer from obesity
Nearly 1 in 5 live in poverty
70%
of Rogers Park children are eligible for free or reduced lunch
3
Presence Saint Francis Hospital
Our Community. Overall, about half of residents are white.
U.S. 2010 Census, Rob Paral and Associates, 2011-2016 Evanston IPLAN
Race & ethnicity, 2010 100% 90% 80% 70% 60%
West Ridge has a substantial Asian population of 23%.
50% 40% 30% 20% 10%
Rogers Park White
Black
West Ridge Asian
2 or more races Hispanic/Latino
Evanston
Some areas measure race and ethnicity separately so that an individual could be counted more than once. Therefore, some totals are greater than 100%.
Spanish or Spanish Creole Chinese
Top languages spoken by those with limited English 2006-2010
Tagalog Russian
25%
Arabic 20%
Korean Serbo-Croatian American Community Survey
15%
10%
5%
Rogers Park
4
West Ridge
Evanston
Chicago
US
Other Indo-European languages African languages Hindi Gujarati Other
201,419 Total population in 2010
% living below poverty line, 2006-2010 23
Rogers Park
37 Households
15
West Ridge
27 11 10
Evanston
21
Chicago
Median household income 2006-2010
31 14
US
19
$70,000
20%
30%
40%
50%
US
Chicago
Evanston
West Ridge
Rogers Park
$10,000
All 3 communities have unemployment rates that are lower than Chicago overall. Population over 16 unemployed, 2010 12%
11.1%
10% 8% 6%
7.5%
7.9%
Rogers Park
West Ridge
7.9%
6.8%
4% 2%
Evanston
Chicago
American Community Survey, City of Chicago
$20,000
American Community Survey, Rob Paral and Associates
$46,877
$39,482
$40,000
$47,323
$50,000
$51,914
$68,107
10%
$60,000
$30,000
Children 0–11 American Community Survey, City of Chicago, Illinois Action for Children, 2011-2016 Evanston IPLAN
Rogers Park has the lowest household income, the highest poverty rate and the highest percentage of children living in poverty.
US
5
Access to care.
Chicago has a higher than ere d average number of uninsured oes y people our f at almost 20% am comparedilytogo15% ? nationwide. In the Presence Saint Francis Hospital service area, 11% are uninsured.
10.9% Uninsured
Where do members of your immediate family go when they have a medical health problem?
11% ER
inter
prete
rs req
ueste
d
where does yourCommunity family go?Clinic Private Doctor’s Office ER
Other
Urgent Care/Walk-in Center
kinof What kind d ohealth f insu rance insurance do you have? Private Insurance Medicare Uninsured Medicaid Other
About 1 in 10 people use the ER as their primary source of health care. The majority of survey respondents said that their immediate family goes to a doctor’s office for a medical health problem, but 11% said they go to the ER. Rogers Park had the highest percentage (24%) using the ER, while Evanston had the highest percentage (80%) who seek care at a doctor’s office.
Illinois Public Health Institute and Presence Health Community Survey
6
kind of insura
What’s preventing people from receiving care?
Where does the community come up short?
15% felt that cost prevented them from seeing a doctor. 8% said that there were no providers available based on their insurance or lack thereof.
Compared to Illinois, Evanston has a much lower than average Medicaid enrollment while Rogers Park and West Ridge have a higher rate. % of population enrolled in Medicaid, 2010 30%
29.1%
29.9%
25%
20%
15%
There are no primary care shortages in Evanston. However, Rogers Park has a shortage for all residents and West Ridge has a shortage for low-income residents.
Illinois Department of Healthcare & Family Services
20.7% 15.9%
10%
9.3% 5%
6.3%
60201
60202
60203
60626
60645
IL
West Ridge and Rogers Park lack mental health services for low-income residents.
7
Status of our health. Unlike the rest of the U.S., diabetes is the third leading cause of death in Rogers Park and West Ridge. Cancer and heart disease are the top two causes in the service area as well as in the rest of the country. Mortality rates were not officially available for Evanston, but the leading causes of death are identified as heart disease, cancer, chronic lower respiratory disease and influenza/pneumonia.
Causes of early death. Years of Potential Life Lost (YPLL) defines what is killing residents prematurely and can help determine prevention efforts. In all three communities, Rogers Park, West Ridge and Evanston, the leading cause is cancer. Of note, unintentional injury is the second leading cause in Rogers Park and the third in West Ridge. Years of potential life lost, top 5 causes, 2009*
Top 5 causes of death 2004-2008 (age-adjusted)
1180 226.7
West Ridge
36 32.7
166.2
74.7
64.3 39.6 35
Coronary heart disease
Diabetesrelated
8
179.8 173.6
49.5 38.9 37.0 50
Stroke
100
150
200
City of Chicago, CDC
US
916 406 1262 557
West Ridge
785 292 442
Lung cancer 197.8
70.3 52.1 46.4
332
Cancer (all sites)
150.2 156.7
162.7
Chicago
Rogers Park
250
Unintentional injury
City of Chicago
Rogers Park
1011
200
400
600
800
1000
1200
1400
Cancer (all sites)
Coronary heart disease
Unintentional injury
Breast cancer in females
Assault, homicide
Diabetes-related *Data not available for Evanston
Suicide rate
Rogers Park has the highest suicide rate in the area—more than Chicago, but less than U.S. average.
per 100,000 (age-adjusted)* 12
11.2
10
6 4
8.0 5.7
City of Chicago, CDC
8
6.5
2
Rogers Park West Ridge
Chicago
US
*Data not available for Evanston
The teen birth rate has gone down substantially in Rogers Park and risen slightly in West Ridge. Both communities are well below the Chicago rate. Teen birth rate per 1,000, age 15-19, 2000 and 2009 73.6
Rogers Park
40.8 2000
28.3
West Ridge
2009
29.9 80.5
Chicago
City of Chicago, CDC
57.0 47.7
US
34.3 10
20
30
40
50
60
70
80
The City of Evanston does not report teen birth rates. For 2006, the number of teen pregnancies in Evanston was 17.
Because Evanston and Chicago use different methods to collect and report health-related data, statistics for Evanston were not available for some categories or a direct comparison was not possible.
9
Status of our health.
Rogers Park has a very high rate of annual HIV infection, above both the city and U.S. rate.
(continued)
The annual rate indicates new cases per year and prevalence shows how many individuals are living with HIV. With newer treatments, people are living much longer, so a high prevalence rate may indicate a high risk for infection, but may also signify success, in that people are getting the treatment they need. Incidence rates are not available for Evanston. The cumulative number of HIV cases diagnosed in Evanston since 2005 is 42.
12.4% have been told they have asthma, similar to the national average. Asthma hospitalizations in Rogers Park were substantially higher than the national rate.
Average annual HIV infection rate per 100,000, 2010 60
60.0
40
40.5
30
Asthma hospitalizations, 2011
20
per 100,000, age 5-64 (age-adjusted)*
10
Rogers Park
151
60626
60645
17.4
13.2 West Ridge
Chicago
City of Chicago, CDC
50
US
HIV/AIDS prevalence rate
84
per 100,000, 2010
111
US
20
40
60
80
100 120 140
1200
1351.1
1000 800
756.5
600
160 400
469.4
321.1
200
*Data not available for Evanston
Rogers Park
10
West Ridge
Chicago
US
City of Chicago, CDC
City of Chicago, CDC
1400
Underweight/Normal (BMI 18.5–24.9) Overweight (BMI 25-29.9) Obese (BMI 30–39.9)
26% obese
28% obese
17% obese
Our community
Chicago
PSMEMC
Chicago
BRFSS 2009, Metropolitan Chicago Healthcare Council 2012
Fewer than 1 in 5 are obese, compared to more than 1 in 4 nationally.
US
US
Rogers Park has the highest rate of mental health admission—almost double that of Chicago.
per 100,000, 2007 (age-adjusted)* 2000
2059.7 1500
1000
1111.6 730.5
500
Rogers Park
West Ridge
City of Chicago Community Area Health Inventory
Mental health admission rate for reasons other than substance abuse
Chicago
*Data not available for Evanston
11
Health & behavior. 17.4% of people smoke, more than the Chicago and national average. Current smokers 20% 15%
17.4%
16.9%
17.1%
IL
US
14.2% 10%
5 servings of fruits and vegetables are recommended daily, yet only 35% said they ate more than 1 a day. Illinois Public Health Institute and Presence Health Community Survey
12
5%
Community
Chicago
BRFSS 2009, Metropolitan Chicago Healthcare Council 2012
About 25% get no exercise in a normal week and fewer than 1 in 10 get the recommended 30 minutes per day.
23% are considered at risk for binge drinking.
30%
22.8%
20%
19.5%
18.3%
10%
Community
Chicago
IL
15.1%
BRFSS 2009, Metropolitan Chicago Healthcare Council 2012
Alcohol consumption—at risk for binge drinking
US
Rogers Park has the highest rate of admission for substance abuse and drugs in the area, but still lower than the Chicago average. Substance abuse and drugs, admission rate per 100,000, 2007 (age-adjusted)*
Rogers Park
City of Chicago Community Area Health Inventory
West Ridge
514.5
138.8
640.3
Chicago
200
400
600
800
*Data not available for Evanston
13
Almost 1 in 5 Rogers Park residents suffer from food insecurity—a rate higher than the U.S. overall.
Barriers to health.
This means that thousands either do not have enough to eat or don’t know where their next meal is coming from.
Rogers Park reported more homicides, drug crimes and violent crimes when compared to West Ridge and Evanston. Evanston reported more weapons violations. Crime data, 2011 per 100,000 residents
4 16
Our community 385
Drug crimes
1355 304
Violent crimes
1074
(against persons)
Violent crimes
2422
(against community/ property)
Weapons Violations
Chicago
6965 68 4713 1,000
2,000
3,000
4,000
5,000
6,000
7,000
Homelessness is a major challenge. Although exact numbers are difficult to confirm, the Chicago Coalition for the Homeless estimates over 100,000 Chicagoans were homeless during the 2011-12 school year. The City of Evanston documented 550 homeless people in 2011. 14
City of Chicago Data Portal, Evanston Police Department
Homicides
Greater Chicago Food Depository, USDA
% of population experiencing food insecurity, 2009 20%
15%
18.5%
10%
13.8%
13.3%
West Ridge
Evanston
14.7%
5%
Rogers Park
US
Nearly 50% of all residents in the Chicago neighborhoods are cost burdened by housing. Renters are much more likely to be cost burdened in Evanston.
Measuring our health. This Community Health Needs Assessment is the result of a partnership between Presence Health, the Illinois Public Health Institute and a diverse group of community organizations and local leaders. In July 2012, a Steering Committee was created to address the overall goal of improving the health and well-being of the community with a special focus on the needs of the most vulnerable. The Committee examined a wide range of factors that impact health, from the causes of disease and death to income and unemployment rates. Statistics came from sources like the U.S. Census and the City of Chicago. Direct input from residents was also obtained through a community survey that explored perceptions about quality of life and barriers to health. Gaps in services were identified and prioritized needs were determined (see page 2).
Residents who pay more than 30% of their income on housing are considered cost burdened.
% of residents cost burdened by home type, 2009
Taking action.
20%
Renters
Evanston
Chicago
West Ridge
Rogers Park
10%
Owners
Chicago Rehab Network
53%
55% 48%
35%
30%
50% 47%
40%
43%
50%
53%
60%
Based on these priorities, Action Teams were formed to develop goals and objectives that build from existing efforts in the community. The result is targeted action plans that help place resources where they are most needed and can be the most effective. The Steering Committee will continue to provide support and oversight of these plans as part of a long term, comprehensive effort for improvement.
Read more. Visit presencehealth.org/community to get the whole story of the Community Health Needs Assessment and view the full Community Health Profile and Community Input Reports. 15
Get involved. Find out how to volunteer to help strengthen the community. + Call 877. 737.INFO + Email community@presencehealth.org + Visit presencehealth.org/community
355 Ridge Avenue Evanston, Illinois 60202