1 metrowest massachusetts regional health dialogue massachusetts department of public health june...

1

Metrowest Massachusetts Regional Health Dialogue

Massachusetts Department of Public Health

June 21, 2007

2

Goals for holding regional dialogues

• Introduce new DPH leadership

• Present latest health data on your particular region

• Talk with residents and providers about data and identify areas of need

• Gather feedback to inform process of setting DPH priorities

3

Goals of New DPH leadership

• Use data and community input to set new priorities & reshape the Department

• Rely on science and evidence-based process to guide the work

• Strengthen ties with and support for local health and local agencies

• Increase resources to and visibility of public health in Massachusetts

4

Timetable

• Hold 8 regional dialogues with comprehensive data review and identification of key health concerns (by July)

• Identify short list of top priorities by end of August

• Hold second round of community dialogues to discuss action plans/results by end of calendar year

5

Socio-Demographics Indicators and Health Care

Access

6

WesternRegion Central

Region

SoutheastRegion

Metro WestRegion

NortheastRegion

BostonRegion

Executive Office of Healthand Human Services Regions

Western Region

Central Region

North East Region

Metro West Region

South East Region

Boston Region

7

A few comments about the limitations of this presentation

• A regional analysis has its drawbacks• Variability within a region – urban vs.

rural/suburban (i.e. Cambridge vs. the rest of the region)

• Variability by sub-population – race matters, poverty matters

• Our data don’t reflect all the important health indicators

8

STOW

DOVER

MILLIS

LINCOLN

LITTLETON CARLISLE

SHERBORN

PLAINVILLE

COHASSET

SOUTHBOROUGH

BOXBOROUGHACTON

SHARON

SUDBURY

CONCORD

HINGHAMHOPKINTON

CANTON

NATICK

WALPOLE

NORWELL

QUINCY

NEWTON

WESTON

FRAMINGHAM

WRENTHAM

MILTON

SCITUATEHOLLISTON

NORFOLK

MEDFIELD

LEXINGTON

FOXBOROUGH

BEDFORD

WALTHAM

MARLBOROUGH

HUDSON

ASHLAND

NEEDHAM

WAYLAND

WEYMOUTH

WOBURN

WESTBOROUGH

WILMINGTON

BRAINTREE

DEDHAM

NORTHBOROUGH

NORWOODRANDOLPH

WESTWOOD

BURLINGTON

WELLESLEY

CAMBRIDGE

MAYNARD

HULL

BELMONT

WINCHESTER

ARLINGTON

SOMERVILLE

WATERTOWN

BROOKLINE

Population in Communities Metrowest Region: 2005

Largest:Cambridge

101,529

Smallest:Sherborn

4,220

Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program

Population> 10,000

9

Race and Ethnic Breakdown of PopulationMetrowest Region and Massachusetts: 2005

Black* 6.0%

Hispanic 7.9%

White* 81.0%

Asian* 4.9%

Amer. Indian* 0.2%

Amer. Indian* 0.2%

Asian* 7.8%

White* 83.8%

Black* 4.3%

Hispanic 3.9%

Metrowest Massachusetts

* Non-Hispanics


Total Population: 1,488,582 Total Population: 6,349,097

10

Black* 14.9%

Hispanic 8.2%

Asian* 15.3%

Amer. Indian* 0.3%

White* 61.3%

Asian*20.8%

Hispanic2.7%

Black*3.2%

White*73.2%

Amer. Indian*0.2%

Race and Ethnic Breakdown of PopulationCambridge and Quincy : 2005

Cambridge

* Non-Hispanics

Quincy


Total Population: 101,529 Total Population: 90,458

11

White* 74.2%

Amer. Indian* 0.2%

Black* 5.8%

Hispanic 12.4%

Asian* 7.4%

Race and Ethnic Breakdown of PopulationSomerville and Framingham: 2005

Framingham

* Non-Hispanics


Total Population: 65,652

Asian*8.9%

Hispanic10.1%

Black*8.4% White*

72.4%

Amer. Indian*0.2%

Somerville

Total Population: 75,372

12

Population by Age Group Metrowest Region and Massachusetts: 2005

Ages Cambridge Quincy Somerville Framingham Metro west

Region

MA Total

0-19 years

19.1% 19.5% 18.4% 23.5% 24.4% 25.5%

20-24 years

15.4% 6.5% 12.7% 6.4% 5.9% 6.7%

25-44 years

36.0% 32.9% 39.3% 32.1% 29.5% 29.4%

45-64 years

20.2% 25.2% 19.0% 25.1% 26.6% 25.3%

65+ years

9.3% 15.9% 10.6% 12.9% 13.6% 13.3%

Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology Program

13Socio-Demographic IndicatorsMetrowest Region and Massachusetts:

2000Cambridge Quincy Somerville Framingham Metro

west Region

MA

Per Capita Income

$31,156 $26,001 $23,628 $27,758 $34,341 $25,952

Those living below 100% poverty

12.9% 7.3% 12.5% 8.1% 5.3% 9.3%

Less than a High School Educ.

10.5% 14.8% 19.4% 12.9% 9.0% 15.2%

Speak language other than English at home

31.2% 23.8% 35.6% 29.2% 21.9% 18.7%

Foreign born 25.9% 20.0% 29.3% 21.2% 12.1% 12.2%

Unemployed 3.6% 5.2% 4.0% 4.1% 4.2% 5.1%


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Birth Indicators

15

Infant Mortality Rates by EOHHS Region Massachusetts: 2003-2005

4.8 4.9

4.0**4.7

5.6 5.45.7

0

1

2

3

4

5

6

7

8

9

10

Western Central Northeast Metrowest Southeast Boston MA

Infa

nt

De

ath

s

pe

r 1

,00

0 L

ive

Bir

ths


Infant Mortality Rate: deaths of infants less than one year of age per 1000 live births

Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better

16

4.2

7.3

4.1

1.7

4.04.13.0

4.9

7.0

11.2

0

2

4

6

8

10

12

White non-Hispanic

Black non-Hispanic

Hispanic Asian Overall

Infa

nt

dea

ths

per

1,0

00 l

ive

bir

ths Metrowest

Massachusetts

Infant Mortality Rates by Race/Ethnicity Metrowest Region and Massachusetts: 2003-2005

NA= Calculations based on less than 5 events are excluded


* Statistically Significantly different from state (p ≤.05)

17

21.7

35.1

13.0**

8.3**

0

5

10

15

20

25

30

35

40

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Bir

ths

pe

r 1

,00

0

wo

me

n a

ge

s 1

5-1

9

Teen Birth RateMetrowest Region and Massachusetts: 1990-2005

Massachusetts

Metrowest Region


Teen birth rates are number of births to women ages 15-19 per 1000 females ages 15-19.

Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state

18

Public Source of Prenatal Care Payment byMetrowest Cities and Massachusetts: 2003-2005

32.6

17.2

33.0

36.6

17.0

40.7

0

15

30

45

Cambridge Quincy Framingham Somerville Metrowest MA

Pe

rce

nt

of

Pu

bli

c P

ay

me

nt

Bir

ths

(%

)


Statistically different from state (p ≤.05)– Red (*) Statistically higher than state- Green (**) statistically lower than state

**

*

*

Public: Government programs including Commonhealth, Healthy Start, Medicaid/MassHealth, and free care

**

19

Leading Causes of Death

20Leading Causes of Death

Metrowest Region and Massachusetts:2005


MassachusettsN=53,776

Heart Disease

13,248 24.6%

Cancer

13,159 24.5%

Stroke 2,979 5.5%

Chronic Lower Respiratory Disease (formerly COPD)

2,643 4.9%

Influenza and pneumonia 1,932 3.6%

Unintentional Injuries 1,883 3.5%

Alzheimer's 1,635 3.0%

Nephritis 1,403 2.6%

Diabetes 1,271 2.4%

Septicemia

982 1.8%

Metrowest RegionN=11,437

Cancer

2,881 25.2%

Heart Disease

2,771 24.2%

Stroke

656 5.7%

Chronic Lower Respiratory Disease (formerly COPD)

541 4.7%

Influenza and pneumonia

423 3.7%

Unintentional Injuries

344 3.0%

Alzheimer's

341 3.0%

Nephritis

302 2.6%

Diabetes

265 2.3%

Septicemia

221 1.9%

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Chronic Disease Outcomes and Overweight/Obesity

22Adults who are Overweight1 by EOHHS Region, Massachusetts:

1995 & 2005

57.8

49.5 45.7

43.5 44.6

50.2

35.7

45.1

52.057.5

60.8

55.952.6

56.1

0

10

20

30

40

50

60

70

Western Central Northeast MetroWest

Southeast Boston MA

Per

cen

t

1995 2005

Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), Health Survey Program

1 Obesity: BMI greater than or equal to 25


23

Hospital Discharge Rates for Hypertension by Metrowest Cities and Massachusetts: 2003-2005

38.731.0

73.6

32.4

60.4

40.9

65.3

0

25

50

75

100

Cambridge Quincy Norwood Sharon Randolph Metrowest MA

Dis

char

ges

p

er 1

00,0

00


**

*

**

Age-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database

24Hospital Discharge Rate for Hypertension

by Race/EthnicityMetrowest Region Massachusetts: 2003-2005

26 28

176

143

66

89

3322

0

20

40

60

80

100

120

140

160

180

200

Metrowest Region Massachusetts

Dis

ch

arg

es

pe

r 1

00

,00

0

White non-Hispanic Black non-Hispanic

Hispanic Asian non-Hispanic



**

25

Heart Disease Mortality Rateby Metrowest Cities and Massachusetts: 2003-2005

185.7 182.5

231.2

161.6 159.8

0

50

100

150

200

250

Cambridge Quincy Randolph Metrowest Massachusetts

Dea

ths

per

100

,000



**

*

**

Age-adjusted to the 2000 US standard population

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Prevalence of Diabetes Massachusetts: 1994-2005

3.8

5.6

6.46.25.8

5.6

5.8

4.9

4.3

4.7

3.8

0

1

2

3

4

5

6

7

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Per

cen

t

Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), Health Survey Program

27

Diabetes Hospital Discharges by Metrowest Cities and Massachusetts: 2003-2005

133

178

136

169178

186

111

0

25

50

75

100

125

150

175

200

Cambridge Quincy Weymouth Randolph Norwood Metrowest MA

Dis

ch

arg

es

pe

r 1

00

,00

0


* *


*

**

*

28Diabetes Hospital Discharge Rate by Race/Ethnicity

Metrowest Region Massachusetts: 2003-2005

368

114105

301

151

242

4530

0

50

100

150

200

250

300

350

400


Dis

char

ges

p

er 1

00,0

00

White non-Hispanic Black non-Hispanic

Hispanic Asian non-Hispanic


**


**

**

**

29

Cancer

30

139.8 138.9135.3127.8

146.7134.9139.6

0

50

100

150

200


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

op

ula

tio

n

Age-adjusted to the 2000 US standard population. Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Cancer Registry

***


Incidence Rates for Invasive Female Breast Cancer by EOHHS Region,

Massachusetts: 1999-2003

31Women Ages 40+ who have had a mammography in Past 2 Years by EOHHS Region

Massachusetts: 2005

82.0 84.187.183.486.9 83.0 80.1

0

20

40

60

80

100


Southeast Boston MA

Per

cen

t

Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Health Survey Program


32Incidence Rates for Invasive Lung Cancer by EOHHS Region, Massachusetts: 1999-2003

72.076.7

67.2 69.965.1

77.777.5

0

25

50

75

100


Southeast Boston MA

Cas

es p

er 1

00,0

00 p

op

ula

tio

n

Age-adjusted to the 2000 US standard population. Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Cancer Registry

*


*** *

**

33

Adults who Currently Smoke by EOHHS Region, Massachusetts: 2005

20.418.1

12.4

18.318.821.2

19.5

0

5

10

15

20

25

30


Southeast Boston MA

Per

cen

t

Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Health Survey Program

**


34

Substance Abuse

35Substance Abuse Admissions-

Alcohol Primary Substance by Metrowest Cities, Massachusetts: 2005

661

404

925

710785

306

820

0

100

200

300

400

500

600

700

800

900

1000

Cambridge Quincy Dedham Westborough Framingham Metrowest MA

Cru

de

rate

per

100

,000

Source: Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2005.

*

**


*

*

**

36Substance Abuse Admissions-

Cocaine Primary Substance by Metrowest Cities, Massachusetts: 2005

62

85

173

2334

0

25

50

75

100

125

150

175

200

Cambridge Quincy Dedham Metrowest MA

Cru

de

rate

per

100

,000

Source: Massachusetts Department of Public Health. BSAS Substance Abuse Treatment Programs 2005.

*

**

*


**

37

Opioid-Related Emergency Department Visit Ratesby Metrowest Cities and Massachusetts: 2005

188

134

298

240

189

277

0

100

200

300

400

Cambridge Quincy Somerville Weymouth Metrowest MA

Vis

its

per

100

,000


**

Age-adjusted to the 2000 US standard population

*

*


*

38

Injury/Violence

39Emergency Department Visit Rates for Motor Vehicle-related Injuries by

Metrowest Cities and Massachusetts: 2003-2005

1465

956

2363

1204

1498

724

1660

0

500

1000

1500

2000

2500

Cambridge Quincy Framingham Norwood Randolph Metrowest MA

Vis

its

per

100

,000


**

*

Age-adjusted to the 2000 US standard population.Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Emergency Visits

*

**

**

40Hospitalization Rates for Fall-Related Injuries Persons Ages 65+ by EOHHS Region

Massachusetts: 2003-2005

2,024

2,333 2,254 2,311 2,2752146**

2443*

0

500

1000

1500

2000

2500

3000

Western Central Northeast Metro West Southeast Boston MassachusettsTotal

Ho

spit

al D

isch

arg

es p

er 1

00,0

00



41

Infectious Diseases

42

Persons Living with HIV by Metrowest Cities and Massachusetts : 2005

133.2

386.1

203.4

352.6

247.1

0

50

100

150

200

250

300

350

400

450

Quincy Cambridge Somerville Metrowest MA

Per

son

s p

er 1

00,0

00

**

*


Source: MDPH, BCDC HIV/AIDS Files as of 09/01/06

*

**

Crude rates

43

138

1136

781

85

1028

370

0

200

400

600

800

1000

1200


Per

son

s p

er 1

00,0

00

White non-Hispanic Black non-HispanicHispanic


Persons Living with HIV by Race/Ethnicity Metrowest Region and Massachusetts : 2005

**

Source: MDPH, BCDC HIV/AIDS Files as of 09/01/06Crude rates

**

44

Asthma

45Pediatric Asthma Prevalence Among School Children, Grades K-8

by EOHHS Region Massachusetts: 2005-2006

10.5 10.69.4

10.1

12.7

9.8

13.0

0

5

10

15

20


Southeast Boston MA

Pe

rce

nt

Source: MDPH, Center for Environmental Health, Pediatric Asthma Surveillance (2005-2006)

**

** ****


46LAWRENCE1494.5

FRAMINGHAM1639.3

NORWOOD1823.2

Pediatric Asthma Emergency Visit Rates by TownsAmong Children Ages <5

Metrowest Region - Massachusetts 2004-2005

Emergency Visit Rates by Townsper 100,000

Significantly higher than state rate

Not different from state rate

Significantly lower than state rateTowns with less than 5 cases in the period were excluded.

Massachusetts State Total Rate: 1,136.2

Source: Division of Health Care Finance and Policy. Calendar Year 2005. Emergency Visits

47

Summary• The Metrowest region is a healthy place to live

• Residents of certain communities are affected disproportionately by health issues, including the following:Framingham: Access to private sources for prenatal care,

admissions for substance abuse, emergency visits by children ages <5 with asthma

Randolph: Hospitalizations for hypertension and diabetes, deaths to heart disease, emergency visits for motor vehicle injuries

Norwood: Hospitalizations for hypertension and diabetes, emergency visits for motor vehicle injuries and by children ages <5 with asthma

Quincy: Hospitalizations for diabetes, admissions for cocaine, emergency visits for opioid-related injuries

Somerville: Access to private sources for prenatal care, opioid-related emergency visits, persons living with HIV

Weymouth: Hospitalizations for diabetes, emergency visits for opioid-related injuries

Sharon: Hospitalizations for hypertensionCambridge: Persons living with HIV

48

The following groups of the Metrowest region, when compared with those at the state level, have higher rates of:Blacks & Latinos: emergency visits for

opioid-related injuries

Whites: incidence for female breast cancer; hospitalizations for persons ages 65+ due to fall injuries

Refugees: high TB rates; increased lead poisoning among children

Health Disparities

49

How Can You Access these Data?

• Hard Copies: (617) 624-5674

• TDD/TTY: (617) 624-6001

• DPH Website:

mass.gov/dph/bhsre/resep/resep.htm

• For other questions or suggestions:

[email protected], 617-624-6021

• For more detailed community data:

http://masschip.state.ma.us/

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