Whitesburg ARH Hospital · community events. Whitesburg ARH is a smoke-free campus. “November’s...

240 Hospital Road | Whitesburg, KY 41858 | (606) 633-3500www.arh.org/whitesburg

2019 Community Health Needs Assessment

Whitesburg ARH Hospital

Appalachian Regional Healthcare | Whitesburg ARH Hospital CHNA 2019

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This Community Health Needs Assessment (CHNA) Implementation Strategy was

prepared for Appalachian Regional Healthcare by the Community and Economic

Development Initiative of Kentucky (CEDIK) at the University of Kentucky.

CEDIK works with stakeholders to build engaged communities and vibrant economies.

If you have questions about the assessment process, contact Melody Nall, CEDIK

Extension Specialist: [email protected] or (859) 218-5949.

cedik.ca.uky.edu


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Dear ARH Service Area Resident,

Sincerely,

Joseph L. Grossman

ARH President and Chief Executive Officer

Thank you for your interest in the 2018-2019 ARH Community Health Needs

Assessment (CHNA). The data reflected in this report was collected from surveys, focus

groups, and key informant interviews conducted in your local ARH community. These

results are being reported along with an update about how we utilized the results from

our previous needs assessment from three years ago. The unique design of this CHNA

permits an examination of the diverse aspects of each of our 12 ARH communities.

The assessment results from each ARH community demonstrate the desire for

individual and community health improvement. These results provide valuable

information that will be used by ARH for planning purposes, service improvements and

community outreach. Special thanks to the CHNA Community Steering Committees

in each of our 12 communities for giving of their valuable time and guiding this

community health needs assessment process.

ARH in partnership with our communities will use this assessment to identify respective

health concerns, measure the impact of current public health efforts and guide the

appropriate use of local resources. We also hope that together, we can improve the

health and well-being of the residents of Eastern Kentucky and Southern West Virginia.


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Appalachian Regional HealthcareAppalachian Regional Healthcare is a not-for-profit health system serving 350,000

residents across Eastern Kentucky and Southern West Virginia. Operating 12 hospitals,

multi-specialty physician practices, home health agencies, HomeCare Stores and

retail pharmacies, ARH is the largest provider of care and single largest employer in

southeastern Kentucky and the third largest private employer in southern West Virginia.

The ARH system employs more than 5,000 people and has a network of more than

600 active and courtesy medical staff members representing various specialties. ARH

is firmly committed to its mission of improving the health and promoting the well-

being of all people in Eastern Kentucky and Southern West Virginia.

Today we operate hospitals in Barbourville, Harlan, Hazard, Hyden, McDowell,

Martin, Middlesboro, Morgan County, South Williamson and Whitesburg, Kentucky,

and Beckley and Summers County, West Virginia. ARH has always responded to the

changing demands of rural healthcare. Over the years, we have built and acquired

new facilities as well as invested in new technology and medical capabilities.

MissionTo improve health and promote well-being of all the people in Central Appalachia

in partnership with our communities.

VisionTo provide unparalleled experience as the most trusted home for healthcare.

Value StatementPatient and family experience is our number one priority.


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Appalachian Regional Healthcare contracted with the Community and Economic

Development Initiative of Kentucky (CEDIK) in the fall of 2018 to conduct a Community

Health Needs Assessment (CHNA) in accordance with the Affordable Care Act (ACA).

The Affordable Care Act (ACA), enacted March 23, 2010, added new requirements that

hospital organizations must satisfy in order to be described in section 501(c)(3), as well

as new reporting and excise taxes.

The IRS requires hospital organizations to complete a CHNA and adopt an

implementation strategy at least once every three years. This CHNA was the third

prepared by CEDIK for this organization; prior reports were completed in 2013 and 2016.

Here is an overview of the CHNA process that CEDIK uses based on the IRS guidelines:

CHNA Background

Whitesburg ARH 2016 community health needs... addressed!

Goal: Decrease smoking in the community.Whitesburg ARH staff were trained in the Cooper Clayton method of smoking cessation,which is a service we offer to patients and staff alike and promote at health fairs and other

community events. Whitesburg ARH is a smoke-free campus.

“November’s Lung Cancer Lunch and

Learn was a culminating event to display

Whitesburg ARH’s focus on community

health. This event, which was well

attended by community members as well

as our community partners, combined

smoking cessation efforts, patient

testimonials, and highlighted services

offered throughout the ARH system.”

A word from our CEO...

Goal: Provide community programs, special events, and health fairs.Whitesburg ARH Hospital has sponsored and participated in many community events, including

school health fairs, opioid summits, and luncheons (examples: heart health, lung cancer, breast

cancer programs).

WARH is also very involved in schools, conducting an annual back to school bash, teacher

breakfasts, as well as sponsoring teams and sporting events. Whitesburg ARH also hosts a

scrubs camp each year for students wanting to learn about healthcare professions.

Whitesburg ARH also has representation on many community committees/groups, including

Rotary Club, Lions Club, Planning Commission, Chamber of Commerce, and others.

240 Hospital Road, Whitesburg, KY 41858 www.arh.org/whitesburg

Goal: Expand social media as a part of ourmarketing and public relations plan.

The Whitesburg ARH Hospital Facebook

page has been used to promote services,

events, physicians, etc. We have worked to

increase response rate and have added

additional users as page administrators to

ensure timeliness of replies and for

monitoring of the page for comments, etc.

We have recently promoted events on the

page and have conducted a

giveaway for an iPad.

Whitesburg ARH employees table at the John B. Brown Bowl.

Whitesburg ARH conducts a Community Health Needs Assessment every three years.We are excited to share our progress from the last assessment, as we prioritize our next goals

based on recent community input.

Thank you for your continued support of Whitesburg ARH.

Dena C. Sparkman

Community CEO, Whitesburg ARH


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1. Introduction 9

2. The Assessment Process 11

3. Secondary Data Exploration: 11

Community, Economic, and Health Profiles

4. Hospital Utilization Data 14

5. The Community Steering Committee 17

6. Community Feedback 18

7. Survey Results 21

8. Prioritization of Identified Health Needs 23

9. Implementation Strategy 24

10. Next Steps 26

11. Appendix 27

Secondary Data Sources

Survey

12. Approval 34

Table of Contents


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Introduction

Whitesburg ARH Hospital Whitesburg ARH Hospital has been a member of the community since 1956. The

hospital enjoys the reputation of achieving excellence as a patient oriented and

community centered hospital that is accredited by DNV GL-Healthcare.

Services

• Clinics

• Aquatic Therapy

• Cancer Care

• Dialysis

• Ear, Nose and Throat

• Emergency

• Heart Care

• Home Health

• HomeCare Stores

• Imaging

• MRI

• Nuclear Medicine

• Obstetrics and Gynecology

• Occupational Therapy

• Orthopedics

• PET Scan

• Pharmacy

• Physical Therapy

• Rehabilitation Therapy

• Sleep Lab

• Speech Language - Pathology

• Surgery

• Swing Beds

• Urology


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A Portrait of the Community Served by Whitesburg ARH Hospital

• Whitesburg is the county seat of Letcher County, Kentucky, United States.

• Whitesburg is home to Appalshop, a multi-disciplinary arts and education center

founded in 1969 which produces original films, video, theater, music and spoken-

word recordings, radio, photography, multimedia, and books.

• The public radio station licensed for Whitesburg is WMMT.

• Whitesburg’s major newspaper is The Mountain Eagle.

• Whitesburg is known for its ubiquitous cut stone. The city was home to a

community of Italian stonemasons who moved there with the coming of the

Louisville and Nashville Railroad in 1911-1912.

Map created with Google Maps, 2019


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Assessment ProcessThe assessment process included collecting secondary data related to the health

of the community. Social and economic data as well as health outcomes and

providers data were collected from secondary sources to help provide context for the

community (see below). In addition, CEDIK compiled hospital utilization data to better

understand who was using the facility and for what services (next section). Finally,

with the assistance of the Community Steering Committee, input from the community

was collected through focus group discussions and surveys.

First we present the demographic, social, economic and health outcomes data that

were compiled through secondary sources. These data that follow were retrieved from

County Health Rankings February 2019. For data sources see appendix.

Demographics

Indicator (2017)LetcherCounty Kentucky

National Level

2017 Population Estimate 22,339 4,454,189 323,127,513

Percent Population Change, 2010-2017 -8.9% 2.6% 5.3%

Percent of Population under 18 years 21.6% 22.7% 22.80%

Percent of Population 65 year and older 18.9% 16.0% 15.20%

Percent of Population Non-Hispanic White 97.5% 84.6% 61.3%

Percent of Population African American 0.6% 8.1% 12.4%

Percent of Population Hispanic 0.8% 3.7% 17.8%

Percent of Population other Race 1.9% 7.2% 8.5%

Percent of the Population not Proficient in English 0.1% 1.0% 4%


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Social and Economic Factors

IndicatorLetcherCounty Kentucky

National Benchmark*

Median HH Income, Not Hispanic/Latino $30,598 $48,744 n/a

Graduation Rate of 9th Grade Cohort in 4 Years 92.0% 89.2% 83.0%Percentages of Ages 25-44 with Some Post-Secondary

College 51.0% 60.3% 65.0%Percent of Unemployed Job-Seeking Population 16

Years and Older 11.9% 5.0% 4.9%

Percent of Children in Poverty 45.0% 24.4% 20.0%Percent of Children Qualifying for Free or Reduced

Lunches 74.0% 59.4% 52.0%

Percent of Single-Parent Households 43.0% 34.6% 34.0%

Violent Crime Rate per 100,000 population 34 215 380

Injury Death Rate per 100,000 population 115 88 65

Firearm Fatalities Rate per 100,000 population 20 15 11

Health Behaviors


National Benchmark*

Percent Adult Smokers 24.0% 24.5% 17.0%

Percent Obese Adults with BMI >= 30 39.0% 33.7% 28.0%

Percent Physically Inactive Adults 35.0% 28.1% 23.0%

Percent of Adult Excessive Drinking 12.0% 15.8% 18.0%

Motor Vehicle Mortality Rate 25 17 11Chlamydia Rate Newly Diagnosed per 100,000

Population 102.7 395 478.8

Teen Birth Rate Ages 15-19 per 1,000 Population 59 38 27

*National Benchmarks indicate the 90th percentile at the national level “n/a” denotes where national benchmarks where not made available by County Health Rankings.


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Health Outcomes


National Benchmark*

Years of Potential Life Lost Rate 12,100 9,047 6,700

Percent of Population in Fair/Poor Health 26.0% 21.3% 16.0%

Physically Unhealthy Days 5.4 4.8 3.7

Mentally Unhealthy Days 4.8 4.8 3.8

Percent of Live Births with Low Birth Weight 11.0% 8.9% 8.0%

Percent of Population who are Diabetic 18.0% 12.8% 10.0%

HIV Prevalence Rate 87 180 362

Child Mortality Rate N/A 58.5 50

Physical Environment

IndicatorLetcher County Kentucky

National Benchmark*

Average Daily Density of Air Pollution - PM 2.5 9.2 10.3 8.7

Presence of Drinking Water Violations Yes Yes YesPercentage of Severe Housing Problems with at least

one of the following: Overcrowding, High Housing Cost, or Lack of Kitchen or Plumbing Facilities 13.0% 14.4% 19.0%

Percentage of Workforce Driving Alone to Work 85.0% 82.2% 76.0%Percentage of Workforce Commuting Alone for More

than 30 Minutes 31.0% 29.0% 35.0%


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Table: Hospital Inpatient Discharges, 1/1/17 - 12/31/17

County of Origin DischargesTotal

ChargesAverage Charges

Letcher - KY 2,347 $56,760,095 $24,184

Perry - KY 458 $8,416,554 $18,377

Harlan - KY 302 $6,325,336 $20,945

Knott - KY 299 $5,609,116 $18,760

Pike - KY 118 $3,095,886 $26,236

Leslie - KY 25 $335,971 $13,439

Floyd - KY 18 $251,216 $13,956

Breathitt - KY 15 $114,270 $7,618

Dickenson - VA 14 $220,239 $15,731

Wise - VA 11 $221,063 $20,097

The Tables below provide an overview of Whitesburg ARH Hospital’s patients and in

particular where they come from, how they pay, and why they visited.

Hospital Utilization Data


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Table: Hospital Inpatient Payer Mix, 1/1/17 - 12/31/17

Payer DischargesTotal


Medicare (Excluding Medicare Managed Care) 1,402 $39,591,925 $28,240

WellCare of Kentucky Medicaid Managed Care 853 $13,436,904 $15,753

Medicare Managed Care 302 $8,975,608 $29,721

Blue Cross Blue Shield 270 $4,893,215 $18,123

Passport Medicaid Managed Care 126 $2,060,048 $16,350

Commercial - HMO 104 $1,233,221 $11,858

Black Lung 102 $3,801,030 $37,265

Table: Hospital Outpatient Visits, 1/1/17 - 12/31/17

County of Origin VisitsTotal


Letcher - KY 40,474 79,222,869 1,957

Knott - KY 4,485 8,402,016 1,873

Perry - KY 2,885 7,701,091 2,669

Harlan - KY 2,534 6,763,845 2,669

Pike - KY 1,779 3,698,462 2,079

Floyd - KY 479 714,900 1,492

Wise - VA 279 556,741 1,995

Leslie - KY 164 628,152 3,830


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Table: Hospital Inpatient Diagnosis Related Group, 1/1/17 - 12/31/17

DRG Description DischargesTotal


Newborn care 303 $979,876 $3,234

Pulmonary disease w mcc 276 $8,571,443 $31,056

Normal delivery 261 $2,411,124 $9,238

Heart failure 188 $5,992,155 $31,873

Septicemia w mcc 138 $6,176,458 $44,757

Pulmonary disease w cc 118 $2,708,836 $22,956

Digestive disorders w/o mcc 118 $2,002,991 $16,975

C-section w/o cc/mcc 113 $1,904,354 $16,853

Table: Hospital Outpatient Payer Mix, 1/1/17 - 12/31/17

Payer VisitsTotal


Medicare (Excluding Medicare Managed Care) 17,616 $32,797,964 $1,862

WellCare of Kentucky Medicaid Managed Care 14,744 $30,399,512 $2,062

Medicare Managed Care 5,153 $9,306,651 $1,806

Blue Cross Blue Shield 4,744 $11,454,478 $2,415

Commercial - HMO 3,415 $6,401,593 $1,875

Passport Medicaid Managed Care 1,273 $2,679,548 $2,105

Anthem Medicaid Managed Care 1,219 $2,803,767 $2,300

Humana Medicaid Managed Care 1,133 $2,524,399 $2,228

Commercial - Other 1,015 $2,562,555 $2,525


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The Community Steering CommitteeThe Community Steering Committee is a vital part to the CHNA process. These individuals represent organizations and agencies from the service area and in particular, the individuals who were willing to volunteer enabled the hospital to get input from populations that were often not engaged in conversations about their health needs. CEDIK provided a list of potential agencies and organizations that would facilitate broad input.

The Community Steering Committee met twice as a group. At the first meeting, hospital representatives welcomed and expressed appreciation to committee members for assisting with the CHNA process. In order to allow open discussion, hospital representatives then excused themselves to allow the focus group to be conducted. At the second and final committee meeting, hospital representatives joined the conversation to hear the data results.

Whitesburg ARH HospitalCommunity Steering Committee

Name Organization

Scottie Billiter Letcher County Central High School

Bill Frazier Shriners

Betty Frazier Shriners

Roy Crawford Retired Engineer

Scotty Caudill Letcher Manor

Beth Halcomb Social Services - DCBS

Debbie Baker Letcher County Senior Citizens


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Community FeedbackIn order to collect primary data from community residents, focus groups were

conducted in Letcher County and in the area that Whitesburg ARH patients reside.

These groups were conducted as separate meetings or in conjunction with other

regularly scheduled meetings in the county. Thirty-four individuals participated in three

focus groups. Representation from the Letcher County Schools, Letcher County Senior

Center, Letcher Manor and other underserved populations in the service area were

invited to share their thoughts, opinions and health care needs. Below is an aggregated

list of ideas generated from all focus groups.

Resident’s vision for a healthy community

• Health Education

• Healthcare – Hospital, good doctors

• Culture – arts and things to do

• Drug Free Community

• Economic Opportunity

• Transportation –specifically publictransportation

• Parent Involvement/caringenvironment for children

• Recreation centers in otherareas of the county

• Clean community, no litter

• Farmers market

• Healthy restaurants

• Parks

• Clean water


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What are the most significant health needs in Letcher County?

• Lack of transportation

• Drugs and substance use

• Lack of healthy lifestyles – tobacco, unhealthy eating habits, vaping

• Obesity

• Diabetes

• Heart disease

• Cancer

• Mental health

• Hep C and HIV rates increasing

• Adverse childhood experiences

• Poverty

• Grandparents and family members raising grandchildren

• COPD

• Lack of exercise

• Dementia

• Drugs

• Arthritis

• Services for seniors that are homebound

• Good foot doctor – podiatrist

• Diabetic doctor

• Diseases from the coal mines – COPD, black lung

• Healthy foods are too expensive

What is your perception of the current health care system including hospital, health department, clinics, physicians, EMS & other essential services* in Letcher County?

(*Essential services include public utilities, access to healthy food, access to housing, etc.)

Responses sorted into strengths and opportunities for improvement in the health care system.


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Strengths of the health care system in Letcher County

• Good nurses, good aides, good staff

• The workout center is great – “it’s what keeps us healthy”

• “I love what they do for me”

• ARH brings in some specialists, one day a week

• “This is a very good place here,” I have been treated well

Opportunities for improving the health care system in Letcher County

• Opportunities for improving the health care system in Letcher County

• Doctors need to spend more time with their patients

• Need more specialists – dermatologist, urologist, rheumatologist, thyroidspecialists, pediatricians, neurologist, eye specialist

• Lower prices on medicines

• Fresh foods are expensive

• Need diagnostics to be available here instead of having to travel

What can be done to better meet health needs of residents in Letcher County?

• Lower drug costs

• Senior exercise program

• Places you can get cheaper glasses

• Drug treatment center – not effective

• Surgery available here instead of going away

• Reduce need to travel for care – expanding services

• Additional specialists

• Overcrowded facilities, long wait times

• Medical literacy – having someone to help explain what is going on health-wise –caregiver

• Transportation


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271 Surveys*

Households are satisfied with their ability to access

health care services in their county.

*Can’t afford it (30%), can’t take off from work (21%), nospecialist in my community (10%), no appointment available

(4%), no transportation (3%).**Other responses included: clinic, MCHC (Mountain

Comprehensive Health Care).

Top three health challenges households face:

* Not all survey respondents answered every question.Respondents = total number of responses for each question; Households = questions where respondents were asked if “anyone in their household” were impacted.

Winter 2018 Survey Results

Whitesburg ARH

Respondents have a family doctor.

75% visit their family doctor regularly.

Where respondents who do not have a family doctor go most often for healthcare:

Households are currently without health insurance.

Routine physical 168

Mammogram 101

Pap smear 89

Prostate-Specific Antigen (PSA) test 21

Colonoscopy 33

Routine health care accessed by respondents:

Respondent’s rating of their personal health (red bar) and the overall health of the people in this county (gray bar).


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Households who have used specialty services at an ARH hospital or at another hospital in the past 24 months:

Hospitals* visited in the last 24 months by households:

Top three most important factors for a healthy community:

Households that have used a

hospital in the past 24 months.

How far respondents have to travel to see a specialist. 51% would be willing to use telehealth services for specialty care.

Residents that think the county

meets these factors.

*Why another hospital?Service I needed was not available (41%), physician referred me (37%), I prefer larger hospitals (5%), insurance requires me to go elsewhere (2%).


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Prioritization of Identified Health NeedsTo facilitate prioritization of identified health needs, a ranking process was used.

Health needs were ranked based on five factors:

1) The ability of Appalachian Regional Healthcare to evaluate and measure

outcomes.

2) The number of people affected by the issue or size of the issue.

3) The consequences of not addressing this problem.

4) Prevalence of common themes.

5) The existence of hospital programs which respond to the identified need.

Health needs were then prioritized taking into account their overall ranking, the degree

to which Appalachian Regional Healthcare can influence long-term change, and the

impact of the identified health needs on overall health.

Appalachian Regional Healthcare convened as a system and within each individual

facility to develop the implementation strategy after priorities were discussed.

Appalachian Regional Healthcare will continue to work with the community to execute

the implementation plan and realize the goals that have been positioned to build a

healthier community – a healthier Kentucky and West Virginia.


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Implementation Strategy

Availability of Specialists

Goal: Increase awareness of current available specialists, and work to improve

availability of specialists through a regional, collaborative approach in recruitment.

• Inventory all available specialists both in the community and within a 45 minute

driving distance.

• Analyze data on population and demographics compared to recommended

availability.

• Add a “Specialist Table” to all health fairs and community events.

• Promote specialties via social media platforms to increase awareness.

• Add as an agenda item for discussion at medical staff and community meetings.

Community Partners: MCHC, Chamber of Commerce, Letcher County Health

Department.

Food Insecurity

Goal: Make efforts to address the problem of food insecurity in Letcher County.

• School and community gardens, with sensitivity to prior efforts in the community.

• Budget education for individuals and families with fixed incomes to improve their

ability to feed their families with consistency.

• Check on laws to protect restaurants if willing to donate leftover foods.

• Create a hunger volunteer board.

• Improve coordination between relevant agencies at the state and local levels.

Community Partners: MCHC, Letcher County Food Pantry, School Systems, CANE

Kitchen, Letcher County Conservation District, local restaurants, LKLP, Chamber of

Commerce, UK Extension Office, Letcher County Health Department.


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Implementation Strategy, continued

Health/Medical Literacy and Advocacy

Goal: Improve the community navigation of the health care system to facilitate better

outcomes through utilization of known resources.

• Capitalize on educational opportunities at community events, such as health

fairs.

• Revise patient education materials to improve understanding by all patients.

• Provide education to individuals and caregivers regarding the importance of

medication compliance.

• Educate and connect individuals to resources available to assist with purchase of

medications.

Community Partners: School systems, Letcher County Senior Citizens, MCHC, UK

Extension Office, Letcher County Health Department, Letcher County Autism Support

Group.


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Next StepsThis Implementation Strategy will be rolled out over the next three years, from Fiscal

Year 2020 through the end of Fiscal Year 2022.

Appalachian Regional Healthcare will kick off the implementation strategy by initiating

collaborative efforts with community leaders to address each health priority identified

through the assessment process.

Periodic evaluation of goals/objectives for each identified priority will be conducted to

assure that we are on track to complete our plan as described.

At the end of Fiscal Year 2022, Appalachian Regional Healthcare will review the

implementation strategy and report on the success experienced through the

collaborative efforts of improving the health of the community.


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Appendix

Demographics

Social and Economic Factors

Sources for all secondary data used in this report:

Indicator (2017) Original Source Year

Total Population Census Population Estimates 2017

Percent Population Changes, 2010-2017 Census Population Estimates 2017

Percent of Population under 18 years Census Population Estimates 2017

Percent of Population 65 year and older Census Population Estimates 2017

Percent of Population Non-Hispanic White Census Population Estimates 2017

Percent of Population African American Census Population Estimates 2017

Percent of Population Hispanic Census Population Estimates 2017

Percent of Population other Race Census Population Estimates 2017

Percent of Population Not Proficient in EnglishAmerican Community Survey

5-year Estimates2013-2017

All "National Level" Demographics U.S. Census QuickFacts 2017

Indicator Original Source Year

Median Household Income, Non Hispanic/LatinoSmall Area Income and

Poverty Estimates 2013

Graduation Rate of 9th Grade Cohort in 4 YearsState sources and the National Center for Education Statistics Varies

Percent of Population with Some College EducationAmerican Community Survey

5-year Estimates 2013-2017Percent of Unemployed Job-Seeking Population 16

Years and Older Bureau of Labor Statistics 2017

Percent of Children in PovertySmall Area Income and

Poverty Estimates 2017


28

Health Behaviors

Social and Economic Factors, continuedIndicator Original Source Year

Percent of Children Eligible for Free or Reduced Lunch

National Center for Education Statistics 2012

Percent of Single Parent Households American Community

Survey 5-yr est.2009- 2013

Violent Crime Rate (per 100,000 population)Uniform Crime Reporting,

Federal Bureau of Investigation2005- 2010

Injury Death Rate (per 100,000 population) CDC WONDER mortality data2013-2017

Firearm Fatalities Rate (per 100,000 population) CDC WONDER mortality data2013-2017


Percent of Adults who Smoke RegularlyBehavioral Risk Factor Surveillance System 2016

Percent of Adults who are Obese (BMI>30) CDC Diabetes Interactive Atlas 2015

Percent of Adults who are Physically Inactive During Leisure Time CDC Diabetes Interactive Atlas 2015

Percent of Adults who Drink Excessively (Heavy or Binge)

Behavioral Risk Factor Surveillance System 2016

Motor Vehicle Crash Deaths (per 100,000 population) CDC WONDER mortality data

2011-2017

STDs: Chlamydia Rate (per 100,000 population)National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 2016

Teen Birth Rate (per 1,000 females ages 15-19)National Center for Health Statistics –

Natality files2011-2017


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Health Outcomes


Premature Death (Years of Potential Life Lost Before Age 75 per 100,000 population)

National Center for Health Statistics

2015-2017

Percent of Adults Reporting Poor or Fair Health Behavioral Risk Factor Surveillance System 2016

Average Poor Physical Health Days in Past 30 Days Behavioral Risk Factor Surveillance System 2016

Average Poor Mental Health Days in Past 30 Days Behavioral Risk Factor Surveillance System 2016

Percent of Babies Born with Low Birthweight (<2500 grams)

National Center for Health Statistics

2011-2017

Percent of Adults with DiabetesNational Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation 2015

HIV Prevalence Rate (per 100,000 population)

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 2015

Child Mortality (per 100,000 population) CDC WONDER mortality data2014-2017


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Physical Environment


Average Daily Density of Air Pollution - PM 2.5 State-specific sources & EDFacts 2014

Presence of Drinking Water Violations Safe Drinking Water Information System 2017Percentage of Severe Housing Problems with at

least one of the following: Overcrowding, High Housing Cost, or Lack of Kitchen or Plumbing

FacilitiesComprehensive Housing Affordability

Strategy (CHAS) data2011-2015

Percentage of Workforce Driving Alone to Work American Community Survey2013-2017

Percentage of Workforce Commuting Alone for More than 30 Minutes American Community Survey

2013-2017


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9Pharmacies

70+

Clinics12Hospitals

11Home Care Stores

11Home Health Agencies

Appalachian Regional Healthcare

VIRGINIA

TENNESSEE

OHIO

KENTUCKY

WEST VIRGINIA

MORGAN COUNTY

TUG VALLEY

MCDOWELL

WHITESBURG

HAZARD

HARLAN

MIDDLESBORO

BECKLEY

SUMMERS COUNTY

Lexington

Huntington

Charleston

MARY BRECKINRIDGE

BARBOURVILLE

OUR LADY OF THE WAY

Find us on Facebook: www.facebook.com/appalachianRegionalHealthcare

www.arh.org

LArgeSt HeALtHCAre SyStem in eAStern KentuCKy

Largest employer in southeastern kentucky and the thirdlargest private employer in southern West Virginia!

5000+

employees

600+

Providers

theFamiLy caReof

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