Maine Shared Community Health Needs Assessment 2018 Community

Maine Shared Community Health Needs Assessment 2018 Community Events Androscoggin County Community Engagement Forum Androscoggin Community Health Stakeholder Coalition and Maine Shared CHNA sponsors: 1

Thank you to the following sponsors of this forum! 2

Welcome and Introductions 3

Forum Agenda Time Spent Activity Speaker/Facilitator 5 minutes Welcome and Introductions Local Facilitator 10 -15 minutes Review of previously identified priorities and activities since last effort Local Facilitator 25 minutes Present key findings from Data Profile Q&A JSI 35 -45 minutes Facilitated discussion on data and identifying health priorities JSI & Local Facilitators 20 minutes Reconvene and full vote on health priorities JSI 10 minutes Wrap up and next steps Local Facilitator (or JSI if preferred) 4

Why are we here? 5

Guidance, Regulations & the Law Maine Shared Community Health Needs Assessment Images of PHAB and IRS from the internet 6

Steering Committee Program Manager Maine Shared CHNA Governance Metrics Committee Data Analysis Team Community Engagement Committee JSI Local Planning Teams 7

Health Improvement Process Community Health Needs Assessment (CHNA) Partners Evaluate Partners State Health Improvement Plan (SHIP) Partners Hospital Implementation Strategies (IS) Public Health District Health Improvement Plan (DPHIP) Partners 8

Local Activities and Accomplishments 9

Western District-Androscoggin County District/Hospital/Agency priority areas of work since the 2016 Shared CHNA Access to Care CMMC St. Mary’s DFD Russell Catholic Charities Community Concepts United Ambulance United Way Chronic Disease CMMC St. Mary’s Androscoggin Home Healthcare+Hospice (AHHH) Healthy Androscoggin United Ambulance Physical Activity/Obesity /Nutrition Western DCC Community Health Stakeholder Coalition CMMC St. Mary’s Bates College Healthy Androscoggin St. Mary’s Nutrition Center Environmental Health CMMC St. Mary’s Green and Healthy Homes Initiative (GHHI) Healthy Androscoggin Mental Health Western DCC Community Health Stakeholder Coalition CMMC St. Mary’s Tri-County Mental Health Services Lewiston Police Dept Substance and Alcohol Use Western DCC Community Health Stakeholder Coalition CMMC St. Mary’s Healthy Androscoggin Tri-County Mental Health Services Lewiston Police Dept Tobacco Use CMMC St. Mary’s Healthy Androscoggin 10

Accomplishments of Note Comm. U NITY R ecovery Forum 11

Partners 12

How to Read County Health Profile 13

How to Read County Health Profile 14

Key Findings 15

Demographics Androscoggin: Age Distribution Percent of Population Living in Rural Areas, 2012 -2016 16

Demographics Change in Percent of Population Age 25+ With Associates Degrees or Higher, 2000 -2016 17

Demographics Androscoggin: Gay, Lesbian, and Bisexual High School Students 14% 12% Maine 11% 7% 2011 2017 18

Health Equity Data Handouts include selected data for: • Sex • Race • Ethnicity • Sexual orientation • Education • Income • Rurality 19

Years of Potential Life Lost Androscoggin: Years of Potential Life Lost Per 100, 000 Population 10, 000 7, 070. 0 7, 253. 8 Maine 6529. 2 2010 -2012 YPLL measures premature death, or the years of potential life lost before the age of 75. 2014 -2016 20

Social Determinants of Health Unemployment Rate, 2012 -2016 Androscoggin: Individuals Living in Poverty 20% 16% 15% Maine 14% 2009 -2011 2012 -2016 21

Social Determinants of Health Androscoggin: Violent Crime Rate Per 100, 000 Population 500. 0 453. 0 421. 7 Maine 366. 7 2010 -2013 2014 -2016 22

Social Determinants of Health Percentage of Households that are Food Insecure, 2012 -2016 23

Health Behaviors - Obesity Androscoggin: Obesity (Adults) 35% Androscoggin: Obesity (High School) 35% 32% 28% Maine 30% 17% 14% 2011 2017 2011 Maine 15% 2017 24

Health Behaviors - Smoking Current Smoking (Adults), 2016 25

Health Behaviors - Smoking Androscoggin: Past-30 -Day Cigarette Smoking (High School) Androscoggin: Past-30 -Day E-Cigarette Use (High School) 25% 15 Maine 15% 11 9 8 13% 2011 2013 2015 2017 2015 14% 2017 26

Health Behaviors - Alcohol and Marijuana Androscoggin: Past 30 -day Alcohol and Marijuana Use (High School) Androscoggin: Binge Drinking (High School) 20% 35% 25 24 20 22 19 19 14% 20 20 Alcohol Maine 12% 9% Marijuana 2011 2013 2015 2017 2011 2015 27

Health Outcomes - Cancer All Cancer Deaths, 2016 28

Health Outcomes - Adult Chronic Disease Androscoggin: Diabetes Prevalence 15% Androscoggin: Asthma Prevalence 15% 12% 13% 11% Maine 12% Maine 10% 2011 -2013 2014 -2016 29

Health Outcomes - Adult Chronic Disease Androscoggin: High Cholesterol (Adults) Androscoggin: High Blood Pressure (Adults) 50% 41% Maine 40% 41% 36% 35% Maine 34% 2011 & 2013 & 2015 30

Health Outcomes - Mental Health Current Depression (Adults), 2014 -2016 Androscoggin: Sad/Hopeless 2+ Weeks in a Row (High School) 30% 27% Maine 27% 23% 2011 2017 31

Health Outcomes - Substance Use Overdose Deaths Per 100, 000 2012 -2016 32

Health Outcomes - Injury Androscoggin : Injury Deaths Per 100, 000 Population 80. 0 Androscoggin County: Fall-Related Deaths (Unintentional) 80. 0 66. 1 Maine 67. 9 53. 3 5. 3 2007 -2011 2012 -2016 2007 -2011 33 8. 3 Maine 9. 6 2012 -2016 33

Health Outcomes - Infectious Disease 500. 0 Androscoggin: New cases Per 100, 000 Population 495. 9 Lyme 330. 7 Hepatitis C (Chronic) Gonorrhea Maine 293. 4 Chlamydia Maine 92. 8 24. 5 46. 4 71. 5 2008 -2012 Maine 96. 5 67. 6 77. 8 98. 7 Maine 28. 9 2013 -2017 34

Health Access and Quality Unable to Obtain Care Due to Cost, 2014 -2016 35

Facilitated Discussion 36

Small Group Discussion Questions 1. Based on your own knowledge and experiences, are there any major health issues that are not represented in the data? (10 mins) 2. Based on the data, past priorities, and your observations, what do you see as the top needs of our community? (20 -25 mins) 3. What community resources are available to address these needs, and what more may be needed? (5 -10 mins) 37

Assets/Resources and Needs 38

Prioritization Exercise 39

Wrap Up and Next Steps 40

For more information: Western District Public Health Liaison Contact: Jamie Paul 207 -215 -6812 Jamie. L. Paul@maine. gov Androscoggin Community Health Stakeholder Coalition Contact: Elizabeth Keene 207 -777 -8806 ekeene@stmarysmaine. com or Erin Guay 207 -795 -5990 Guay. Er@cmhc. org 41