EPLAN 2011-2015

Evanston Project for the Local Assessment of Needs

By: Evanston Health Department

Moving Forward

Background

• EPLAN – Evanston’s version of the IPLAN

• IPLAN– Conducted every 5

years by local health departments

– Required for LHD certification

– Based on Assessment Protocol for Excellence in Public Health (APEX-PH)

Evanston Community Needs Assessment

Survey• Conducted in December 2009• Random sample of Evanston

residents• Investigated perceived public health

needs of those residents

Evanston Community Needs Assessment

Survey Results

Most Important Health Problems in

Our Community

Obesity Substance abuseInjury/violence

prevention

Most Important Risky Behaviors in

Our Community

Being overweight Drug abuse Poor eating habits

Most Important Factors for a

Healthy Community

Easy access toaffordablehealth care

Low crime/safeneighborhoods

Good jobs andhealthy economy

1

2 3

Evanston Community Needs Assessment

Survey ResultsHealth Programs needed in Evanston in order of importance:

1) Nutrition services and promotion of physical activity

2) Immunization services3) Mental health services4) Senior services 5) Emergency preparedness 6) Substance abuse prevention7) Family planning services8) Climate change initiatives9) Adolescent health promotion10) Smoking cessation programs

EPLAN Survey

• Conducted during September to December 2010

• Random sample of Evanston residents

• Survey questions adopted from the BRFSS standardized surveys

• Investigated health behaviors and beliefs of Evanston residents

• Residents delayed seeking health care due to cost issues

• High prevalence of hypertension• Low rates of heart attack and stroke

awareness• High prevalence of smoking• High prevalence of alcohol consumption and

binge-drinking patterns• Residents identified multiple reasons for not

exercising regularly• Poor nutritional habits

EPLAN Survey Results

IL Department of Public Health

Evanston

Outside City Limits

Diseases of the Heart 125 1

Malignant Neoplasms 111 4

Chronic Lower Respiratory Diseases 28

Cerebrovascular Diseases 24

Influenza and Pneumonia 22 1

Accidents 15

Diabetes Mellitus 12

Septicemia 11

Alzheimer’s Disease 10

Nephritis, Nephrotic Syndrome, and Nephrosis

7

Parkinson’s Disease 9

Intentional Self-harm (Suicide) 3

Essential Hypertension and Hypertensive Renal Disease

1

EHAC Survey Administration

• Conducted in 2011 via email

• For 21 council members

• Investigated top three health priorities for Evanston– Access to health care– Chronic health

conditions– Physical activity and

nutrition

• Access to Health Care• Chronic Health Conditions• Nutrition and Physical Activity

• Risk and Contributing Factors• Community Health Plan Objectives

and Strategies

Digging Deeper

Access to Health CareRisk and Contributing Factors

Lack of/Inadequate Health Insurance

Lack of Health Care Resources Tailored to

the Unique Needs of the Community

Lack of Health Care Providers/Facilities for

Underinsured and Uninsured

1) Unemployment– Job seekers lacking

necessary skill set– Non-availability of

jobs

2) Socioeconomic status– Lack of education

(e.g. high school dropouts)

– Racial disparities– Poverty– Language and

cultural barriers

1) Disparities in access to health care

– Language and cultural barriers (esp. Hispanic populations)

– Knowledge barriers among low-income minority populations

2) Increasing rates of teenage pregnancy

– Lack of specialized support groups and community health centers for teenagers

– Lower high school graduation rates among minorities

1) Designated medically underserved areas

– Closure of satellite clinics by Cook County

2) Fewer providers accepting Medicaid/Public Aid

– Delayed reimbursement

– Low or no reimbursement

Access to Health Care Community Plan

Outcome Objectives

Impact Objectives

Intervention Strategies

Resources Available

Barriers and Challenges

By 2015, provideaccess tocomprehensive health care services to low-income families

in Evanston

US Census, 2005-2009 ACS Survey• Percentage of families below poverty level:

4.8%

• Percentage ofindividuals belowpoverty level:

9.7%

By 2013, establish

a FederallyQualified HealthCenter to provideprimary healthcare and cater toneeds of 5,516unduplicatedpatients within 2years ofestablishment

• Opening a localsatellite clinic willImprove access• Provision ofumbrella serviceswill reduceperceived

barriers• Home-grownpartnershipspromoteownership ofprograms by thecommunity

• Evanston Health

Department• Erie Family Health Center• NorthShore University Health System• St. Francis Hospital• Local social service agencies

• Transportation• Perceived susceptibility• Perceived

threat• Cues to action

Chronic Health Conditions

Risk and Contributing FactorsTobacco Use Lack of Primary

Prevention EffortsExcessive Alcohol Use

1) Parent smoker– Access to tobacco

products– Addictive nature

2) Peer pressure– Access to tobacco

products– Media

3) Secondhand smoking– Lack of anti-

smoking ordinances

– Poor implementation of existing ordinances

– Work place/public smoking

1) Cost of screening– Lack of/inadequate

health insurance– Transportation

costs– Inherited costs (e.g.

loss of pay)

2) Personal choice– Perceived severity,

perceived threat– Perceived

susceptibility

3) Lack of free/mass screening efforts in the community

– Organizational costs

– Transportation costs

– Poor advertisement

1) Access to alcohol– Parental tolerance– Access to alcohol at

home Poor implementation of law at points of sale

2) Peer pressure– Adult role models

who drink– Glamorization by

media– Social acceptance

Chronic Health Conditions Community

PlanOutcome Objectives

Impact Objectives

Intervention Strategies

Resources Available

Barriers and Challenges

By 2015, reducethe number ofdeaths caused bycardiovasculardisease by 10%

2006 IPLAN data for Evanston• Coronary heartdisease mortalityrates: Crudenumber – 92;Premature (<65)

– 17

By March 2012, increaseparticipation ratein Kick Butts Day by 10%

By March 2013,increase thenumber ofresidents who

quitsmoking by atleast 10%

• Reducing clientout-of-pocketcosts for smokingcessation therapies• Mass mediacampaigns whenused with otherinterventions

• Evanston Health

Department• NorthShore University Health System• St. Francis Hospital• YMCA• PEER Services• NorthwesternUniversity

• Addictive nature

• Secondhandsmoke exposure• Access toproducts

Physical Activity and Nutrition

Risk and Contributing FactorsPhysical Inactivity Poor Nutrition

1) Access to facilities– Cost of working out– Transportation– Poor time management– Bad weather conditions– Availability of parks, walking paths,

and bike routes

2) Behavioral choices– Lack of awareness– Low perceived risk– Television viewing, video gaming,

and computers– Inconsistent efforts

1) Abundance of fast food and junk food– Media– Ease of access– Distorted portion control– Lifestyle/convenience

2) Addictive nature of junk food– High fat content– Food additives– Perceptions regarding comfort food

3) Availability of nutritious food– Cost of fruits and vegetables– Distribution of supermarkets– Seasonal availability

Physical Activity and Nutrition Community

PlanOutcome Objectives

Impact Objectives

Intervention Strategies

Resources Available

Barriers and Challenges

By 2015, reducethe number ofadults who do

notget any exerciseby 10%

BRFSS 2009Suburban CookCountyPercentage of residents whocurrently do not get any exercise:24%

By 2012, increase

the number ofparticipants inWomen OutWalking programby 10%

• Community-wide

campaigns• Social supportinterventions tocommunitysettings

• Evanston Health

Department• City of

Evanston• NorthwesternUniversity• EvanstonChamber ofCommerce• Evanston 150• RotaryInternational• Evanston PublicLibrary

• Bad weather• Poor timemanagement• Cost of gymmemberships

• Evanston Health Department Staff– Bruce Doblin, MD; Carl Caneva; Jonathan Webb; Sree Pilla; Dr. Avinash Pasam; Diane Keenan;

Sandra Waggoner; Robyn Nisi• Evanston Health Advisory Council

– Karen Chavers; Mary Daley; Natasha Deutsch; Kim Fisher; Avery Hart, MD; Delores Holmes; Dr. Edward Hughes; Mary Larson, CSN; Louis Rowitz, PhD; Bonnie Lockhart, RN; Angelique Richard, PhD, RN; Paul Luning, MD, MPH; Woody McCally; Julianne Russell; Mark Schroeder; Marybeth Schroeder; C. Louise Brown; Donald W. Zeiglar, PhD; Judith Simon; Tanille Baaske Smith; Jennifer Vyenielo

• IL Department of Public Health– George S. Rudis, MA, CPHA

• Community Members– John Alexander, MD, Acting Executive Director and Medical Director of Northwestern University

Health Services Evanston Campus– Dr. Kalyan Nadiminti, St. Francis Hospital– Dianne Rucinski, Ph.D, Health Evaluation Collaborative & Institute for Health Research and

Policy– Rebecca Wurtz, MD, MPH, Director of the MPH Program at Northwestern University– Felicia Morgan, Salvation Army Social Services

• Northwestern University Volunteers– Lauren Slubowski; Sana Ali; Sarah Basore; Sophia Blachman-Biatch; Laura Booth; Chelsea

Cooper; Lauren Dawson; Blake Erickson; Allison Finn; Jennifer Hemesath; Jenna Kastan; Ummul-Kiram Kathawalla; Lindsey Kreutzer; Allison Lazarus; Joanne Maliekel; Anna Messier; Marielle Meurice; Kathryn Nathanson; Christopher Oh; Sojung Park; Lakshmi Ramachandran; Alexandra Rivkin; Emily Roskey; Jay Shiao; Ritika Singh; Meera Sriram; Matthew Stephens; Leah Thomas; Sandeep Tummala; Katherine Wang; Alexandra Wong; Teisha Lightbourne; Jessice Gottesman; Katie Raynolds; Swen Hendrickson; Ben Diapola

• Kellie Perkins, Health Director Intern– (757) 329-4005– kdperkins89@yahoo.com

Acknowledgements

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