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PLACE MATTERS TEAM ABC HEAT

PLACE MATTERS TEAM ABC HEAT. ALBUQUERQUE / BERNALILLO COUNTY HEALTH EQUITY ASSESSMENT TOOL TOM SCHARMEN MAY 2009. ALBUQUERQUE / BERNALILLO COUNTY HEALTH EQUITY ASSESSMENT TOOL. A Project of the Bernalillo County Place Matters Team

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PLACE MATTERS TEAM ABC HEAT

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  1. PLACE MATTERS TEAM ABC HEAT ALBUQUERQUE / BERNALILLO COUNTY HEALTH EQUITY ASSESSMENT TOOL TOM SCHARMEN MAY 2009

  2. ALBUQUERQUE / BERNALILLO COUNTY HEALTH EQUITY ASSESSMENT TOOL A Project of the Bernalillo County Place Matters Team ABC HEAT is a collaborative health equity initiative with the goal of providing communities and decision-makers in our city & county with evidence to build health into public and private policies and practices. We believe that decision-makers must have reliable data on health status, disparities, and the effects of social determinants of health. These data must be monitored at the local level in collaboration with the people and families who live there, and funding must be available to promote community participatory assessment to understand these health effects and to promote the application of findings to decision-makers. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  3. LONG TERM GOAL: • A CENTER FOR COMMUNITY HEALTH ASSESSMENT IN ALBUQUERQUE / BERNALILLO COUNTY • FUNCTIONS: • Comprehensive Profiles for County-wide efforts • Issue Specific Profiles • Support to Priority Setting, Grant Proposals, Program Evaluations • Health and Social Determinant Assessments • Environmental and Health Impact, Cumulative Impact, • Permitting Processes, Social Equity Impact • Rapid Response / Support for Planning and Development • Health Policy Research BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  4. Environmental Justice ForumsHealth Equity Assessment Strategy Meetings – ACQUISITION of Data and Selection of Indicators 8 FOCUS GROUPS with Diverse Participants INPUT & Discussion on Land Use and Health Policy ANALYSIS of Priority Indicators || || INTEGRATED PROCESSES || || MAPS & TABLES of Social Determinants and Health Outcomes ANALYSIS of Focus Group Conversations TOWN HALL Discussion of Results with Community and Policy Makers Preliminary HEALTH EQUITY TOOL in Accessible Formats REPORTS for Policy Makers and Community Advocates Formulation of POLICY Recommendations for Action COMMUNITY INPUT to the Health Equity Assessment Team Link DATA TO ACTION for the Environmental Justice Forums and other Social Determinants Efforts 1 2 3 4 5 6 7 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  5. PARTNERS ON THE ABC HEAT TEAM Bernalillo County Environmental Health Office NM Dept of Health, Local Region, Office of Community Assessment Will Athas, UNM HSC Bryan Patterson, UNM MPH Student UNM Bureau of Business and Economic Research UNM Institute for Public Health NM Dept of Health, Community Assessment Initiative NM Dept of Health, Bureau of Vital Records and Health Statistics South Valley Partners for Environmental Justice Bernalillo County Community Health Council BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  6. 2 - SELECTION OF INDICATORS THREE CLASSES OF INDICATORS Social Determinants Economic Security Livelihood Education Environmental Quality Health Care Access Housing Civic Involvement Community Safety Transportation Demographics Race/ Ethnicity Median Household Income Female-headed Households with Children Households w/ Children Educational Attainment Average Age Health Outcomes Age Adjusted Mortality Rates Morbidity (multiple causes) Maternal and Child Health (CADH – 2007) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  7. DETAIL OF ONE SOCIAL DETERMINANT Economic Security/Financial Resources Public Assistance Food stamps MEDICAID Enrollment TANF Local Programs – e.g., UNMCare Access to Capital Approval Rates- Home Purchase Mortgages # of Home Purchase Mortgages Foreclosures Delinquent Property Taxes Income& Poverty Median Household Income % Households Below Poverty % Individuals with Income <Poverty % Children <18 in Poverty Wealth/ Assets Media Value - Owner Occupied Homes Land/Building Assessed Value Sales Prices Average # of Vehicles ACQUIRED (or in process) = BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  8. 2 - SELECTION OF INDICATORS INDICATOR LINK: The Healthy Development Measurement Tool is a comprehensive evaluation metric to consider health needs in urban development plans and projects. The HDMT explicitly connects public health to urban development planning in efforts to achieve a higher quality social and physical environment that advances health. http://www.thehdmt.org/master_list.php (see handout or send an e-mail for a LARGE LIST of links)

  9. 1 - ACQUISITION OF DATA Cooperation of MANY agencies, each with its own set of barriers and concerns Sub-County Levels – Addresses or Census Tracts converted to Census Tract or Community Geographies – Different Agencies hold different pieces of same dataset, for example City and County. Protecting Confidentiality – Public Health Mandate and Authority INDICATORS COMPILED SO FAR A. Health Outcomes Birth Death B. Socio-economic Indicators 1. Economic Security and Financial Resources 2. School Readiness and Educational Attainment 3. Adequate, Affordable and Safe Housing 4. Criminal Activities C. Health Outcome Indicators 1. Availability and Utilization of Quality Health Care Services 2. Nutrition \ Life Style D. Other 1. Transportation 2. Community Agencies and Resources 3. Other BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  10. 1 - ACQUISITION OF DATA ‘NOT-SO-LOW’ HANGING FRUIT: Medicaid Enrollment Other Health Care Access or Insurance Indicators Food Stamp Enrollment Hospitalization and other Morbidity Asthma in the ER Environmental Indicators Permits to Pollute Sources Monitoring Levels Incarceration . . . And many more

  11. 3 - ANALYSIS OF PRIORITY INDICATORS THE HEAVY LIFTING Cleaning of datasets Geocoding of Addresses Creation of Census Tract and HEAT Community Level Measures Creation of Rapid Assessment Tools SEERStat – calculates birth rates and age-adjusted death rates at census tract or other levels for specific populations and causes BUILD DENOMINATORS! (WE’LL COME BACK TO SEERStat)

  12. 3 - ANALYSIS OF PRIORITY INDICATORS BUILD DENOMINATORS POPULATION COUNTS FOR EACH . . . GENDER (2) ETHNICITY (2) RACE (5) 5-YEAR AGE GROUP + INFANTS (18) CENSUS TRACT (141) YEAR, 1990-2005 (16) = 812,160 DENOMINATORS (Bernalillo County only!) 1990 thru 2000 – Extrapolated from Census 2001 thru 2005 – Purchased from Geolytics Need to repeat for Census Block Groups and for entire state. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  13. 4 - MAPS & TABLES OF SOCIAL DETERMINANTS AND HEALTH OUTCOMES Indicators at CENSUS TRACT LEVELS for uniformity and analysis Indicators at HEAT COMMUNITY LEVELS for participatory assessment presentations Indicators at OTHER LEVELS School Boundaries, Zip Codes, State Representative Districts, Police Beats Indicators of SOCIAL and DEMOGRAPHIC STATUS Indicators of HEALTH STATUS BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  14. Low Birth Weight Births Albuquerque Census Tracts, 2001 - 2005 Percent low birth weight births equals the number of births of infants weighing less than 2500 grams (5.5 lbs) divided by the total number of births among the same population. Low Birth Weight Births, 2003 U.S.A. 7.8% N.M. 8.1% Bernalillo County 8.4% Source: NMDOH, BVRHS Source: NMDOH, BVRHS; Analysis: T Scharmen, NMDOH, Region 3, Office of Community Assessment CENSUS TRACTS (141) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  15. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Age-Adjusted Death Rates, Persons aged 5 to 64, Years 1990 through 2005, n = 3413 HEAT COMMUNITY BOUNDARIES (33) Premature Death from Chronic Disease Whites 1990 - 2005 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  16. HEAT COMMUNITY BOUNDARIES (33) Premature Death from Chronic Disease Hispanics 1990-2005 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  17. Place Matters – Albuquerque / Bernalillo County Health Equity Assessment Tool ALBUQUERQUE AND THE HEAT COMMUNITY BOUNDARIES BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  18. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Age-Adjusted Death Rates, All ages, Years 1990 through 2005, N = 62,902 ALL CAUSES OF DEATH ALL RACES HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  19. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Age-Adjusted Death Rates, All ages, Years 1990 through 2005, N = 40,603 ALL CAUSES OF DEATH WHITES HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  20. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Age-Adjusted Death Rates, All ages, Years 1990 through 2005, N = 19,238 ALL CAUSES OF DEATH HISPANICS HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  21. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Age-Adjusted Death Rates, All ages, Years 1990 through 2005, N = 1322 ALL CAUSES OF DEATH NATIVE AMERICANS HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  22. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Age-Adjusted Death Rates, All ages, Years 1990 through 2005, N = 1454 ALL CAUSES OF DEATH AFRICAN AMERICANS HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  23. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Age-Adjusted Death Rates, All ages, Years 1990 through 2005, N = 371 ALL CAUSES OF DEATH ASIANS HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  24. WHY DOES PLACE MATTER? WHY DOES RACE MATTER? BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  25. FORECLOSURES CENSUS TRACTS (141) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  26. APS 4TH GRADE READING SCORES ELEMENTARY SCHOOL BOUNDARIES (87) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  27. APS FREE OR REDUCED PRICE LUNCH ELEMENTARY SCHOOL BOUNDARIES (87) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  28. DAY CARE CAPACITY HEAT COMMUNITY BOUNDARIES (33) PLACE MATTERS – ABC HEAT Source: NM Children, Youth and Families Dept., 2007 Capacity = Available Day Care slots per 100 resident children under 10 yrs. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  29. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Age-Adjusted Death Rates, All ages, Years 1990 through 2005, N = 166 ASTHMA MORTALITY 1990-2005 HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  30. PLACE MATTERS – ABC HEAT Source: Farm to Table, 2007 Food Stores includes supermarkets, specialty grocery stores, small markets, health food stores, fresh produce stores, supercenters, and big box stores. Convenience stores are not included. FOOD MARKETS HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  31. Source: NM YRRS 2005; Analysis: T Scharmen HIGH SCHOOL BOUNDARIES (11) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  32. PRISON ADMISSION: ADULTS & YOUTH (Adults only) • FACTS ABOUT YOUTH ADMITTED TO JUVENILE JUSTCE CUSTODY • In Martinez Town / Barelas (87102) and West Mesa (87121), youth are placed in detention at nearly 10 times the rate of youth in the West Side (87120) and Paradise Hill (87114) neighborhoods. • The South Valley (87105), SE Heights (87108) , West Mesa (87121), Martinez Town / Barelas (87102) neighborhood areas account for 50% of all juveniles admitted to custody from Albuquerque’s 16 neighborhood areas. • FACTS ABOUT ADULT PRISON ADMISSIONS • Residents from neighborhoods that have the most people going to prison (incarcerated) are imprisoned up to 30 times more often than the lowest. • Two of Albuquerque’s 16 neighborhood areas (87102 and 87105) account for 35% of all prison admissions from the city. • 24% of all prison admissions from Albuquerque were admitted on the basis of violations of parole. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL Source: The After Prison Initiative, Open Society Institute, 2003

  33. Source: APS-SIS, January 2009 ; Map: NMDOH, OCAPE HIGH SCHOOL BOUNDARIES (11) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  34. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Years 1990 through 2005, N = 934 INFANT MORTALITY ALL RACES HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  35. PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS Years 1990 through 2005, N = 70 INFANT MORTALITY AFRICAN AMERICANS HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  36. D R A F T LIFE EXPECTANCY AT BIRTH Bernalillo County HEAT Communities Both Sexes, 2001-2005 Life Expectancy Comparisons USA (2003)* 77.4 years NM (2001-03)* 77.3 years Bernalillo County (2001-05) 80.3 years*Source: NCHS Life expectancy is a key measure of the health status of a population. It is defined as the average number of years a baby born in a particular area or population can be expected to live if it experiences the current age-specific mortality rates of that particular area or population throughout its life. These estimates use the methods described by Chiang, 1968 (see references). PLACE MATTERS – ABC HEAT Source: Deaths - NMDOH-BVRHS; Population - Geolytics, Inc. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  37. 5 - PRELIMINARY HEALTH EQUITY INDEX Correlation of Social Indicators with Health Outcome Indicators Factor Analysis and Regression Analysis of Groups of Indicators Creation of a single, combined score for each community EXAMPLE – POVERTY AND BIRTH OUTCOMES BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  38. PLACE MATTERS – ABC HEAT Source: U.S. Census POVERTY HEAT COMMUNITY BOUNDARIES (33) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  39. PLACE MATTERS – ABC HEAT Source: US Census 2000 Source: NMDOH, BVRHS; Analysis: T Scharmen, NMDOH, Region 3, Office of Community Assessment CENSUS BLOCK GROUPS (~450) POVERTY AND HEALTH OUTCOMES Poverty is presented on this map in five categories, using a small geography (census block groups). Imagine if these categories of non-adjacent block groups were each a ‘community’ and we calculated the same health indicator for each one. The bar graph on the right represents the teen birth rate of each of those ‘communities’. It shows a strong relationship with poverty: Wherever there is a higher percent of the population living in poverty, there is a higher teen birth rate. We call this a social determinant of health. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  40. Teen Birth Rates, Albuquerque Census Tracts, 2001 - 2005 Teen Birth Rates, 2003 U.S.A. 41.6 N.M. 62.6 Bernalillo County 59.8 Source: NMDOH, BVRHS Source: NMDOH, BVRHS; Analysis: T Scharmen, NMDOH, Region 3, Office of Community Assessment CENSUS TRACTS (141) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  41. Low Birth Weight Births Albuquerque Census Tracts, 2001 - 2005 Percent low birth weight births equals the number of births of infants weighing less than 2500 grams (5.5 lbs) divided by the total number of births among the same population. Low Birth Weight Births, 2003 U.S.A. 7.8% N.M. 8.1% Bernalillo County 8.4% Source: NMDOH, BVRHS Source: NMDOH, BVRHS; Analysis: T Scharmen, NMDOH, Region 3, Office of Community Assessment CENSUS TRACTS (141) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  42. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  43. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  44. 6 - REPORTS FOR POLICY MAKERS AND COMMUNITY ADVOCATES Policy Makers – Not Yet Community Advocates – Bernalillo County Health Council Pathways Project Local Neighborhood Collaboratives Health Equity Working Group Local Issue Specific Programs Local Grant Efforts APS School Health Advisory Council Local Non-Profits 7 - LINK DATA TO ACTION for the Environmental Justice Forums and other Social Determinants Efforts Comprehensive Community Assessment Tools contribute to planning, priority setting, targeting and program evaluation. Check out the new Bernalillo County Community Health Profile, due out in mid May, 2009. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  45. THANKS TO THE NUMBERS CRUNCHERS: WILL ATHAS BRYAN PATTERSON DAREN RUIZ DOLESWAR BHANDARI DAVID BROUDY ERIN PHIPPS LEORA JAEGER ALBUQUERQUE / BERNALILLO COUNTY HEALTH EQUITY ASSESSMENT TOOL BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  46. THANK YOU ALBUQUERQUE / BERNALILLO COUNTY HEALTH EQUITY ASSESSMENT TOOL Thomas N. Scharmen, M.A., M.P.H., Epidemiologist Regions 1 & 3, Office of Community Assessment, Planning and Evaluation Public Health Division, New Mexico Department of Health North Valley Public Health Office 7704-A 2nd St, NW Albuquerque, NM 87107 Telephone: 897-5700 ext 126; Fax: 897-1010 E-mail: thomas.scharmen@state.nm.us BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  47. BERNALILLO COUNTY COMMUNITY HEALTH COUNCIL • COUNTY PROFILE PRIORITY SETTING – OPEN HOUSES: • April 21st, 3:00-7:00– (Northeast Quadrant)Location TBD • April 23rd, 3:00-7:00– (Southeast Quadrant)Location TBD • April 27th, 3:00-7:00– (Northwest Quadrant) Los Griegos Community Center, 12th and Candelaria • April 29th, 3:00-7:00– (Southwest Quadrant) South Valley Health Commons, 2001 Centro Familiar, SW • May 4th, 3:00-7:00– (East Mountains) Los Vecinos Community Center,478 1/2 Old Hwy. 66, Tijeras 87059 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

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