Community Health Assessment & Improvement Plan

The Columbia County Department of Health and its community partners have worked collaboratively to develop the Community 

Health Assessment (CHA) and Community Health Improvement Plan (CHIP) for 2014-2017.  This CHA/CHIP summarizes county 

demographic and health data from a variety of sources and presents a community plan for making measurable improvements in the 

following health priority areas: 
  • Chronic Disease Prevention,
  • Mental Health Promotion and Substance Abuse Prevention,
  • Arthropod-Borne Illness Prevention, and
  • Occupational Injury Prevention

We are very excited to share the information with you (attached below).  The plan will form the foundation of many community health


 improvement activities, which we hope will help the county to be a healthier, safer place to live, work, learn, and play.  As the county 


implements its Community Health Improvement Plan, New York State is also implementing its Health Improvement Plan (also known 


as the Prevention Agenda for 2013-2017).  We invite you to learn more about the state’s Prevention Agenda by visiting their website.



 

We encourage you to share the documents and information.  We welcome your questions, suggestions, and participation in the 


improvement process.  Please contact us at (518) 828-3358 or ccdoh@columbiacountyny.com.  Thank you!        



Executive Summary of the Community Health Assessment and Community Health Improvement Plan (2014-2017)

The Columbia County Department of Health (CCDOH) is deeply committed to the health, safety, and well-being of the community. CCDOH works collaboratively with community partners to monitor the health status of populations, identify health problems, and make vital community health improvements. To accomplish these activities, CCDOH regularly coordinates a Community Health Assessment (CHA), the results of which are used to develop a Community Health Improvement Plan (CHIP). This CHA/CHIP for 2014-2017 summarizes Columbia County demographic and health data from a variety of sources and presents a community plan for making measurable improvements in health priority areas: Chronic Disease Prevention, Mental Health Promotion and Substance Abuse Prevention, Arthropod-Borne Illness Prevention, and Occupational Injury Prevention.

Disease rates and indicators of poor health outcomes among Columbia County residents are worse than New York State’s rates in many areas. For example, the county’s emergency department visit rate is higher than the state’s, suggesting that many community residents do not have a regular source of health care. The age-adjusted total mortality rate for the county is higher than that for the state. Rates of preventive health screenings for some chronic disease are lower in Columbia County than those of the state.

Our CHIP prioritized the priority areas listed above because they were identified and highlighted as priority areas in the CHA. They are the areas in which the greatest health improvement impacts can be realized relative to the current health status of Columbia County residents.

In the area of chronic disease, several examples of poor health outcomes among community members follow. There are high rates of obesity (pediatric and adult). There are also high rates of heart disease, stroke, chronic lower respiratory disease/chronic obstructive pulmonary disease, and lung cancer. Many of these diseases can be prevented through health behaviors such as physical activity, eating a healthy diet, abstaining from tobacco use and substance abuse, and by early preventive screenings.

Within the Chronic Disease Prevention priority area of the CHIP, one focus is obesity prevention among children and adults. Obesity, considered a chronic disease, is a significant risk factor for other chronic diseases and conditions, including high blood pressure, type 2 diabetes, asthma, high cholesterol, stroke, heart disease, certain types of cancer, and osteoarthritis. Overweight and obesity may also contribute to psychological distress, depression, discrimination, and prejudice. A high percentage (57.5%) of adults in Columbia County are either overweight or obese (New York State: 60.6%), and 22.4% of adults in the county are obese (New York State: 24.3%). Of Columbia County public school district students, 37.1% are overweight or obese (New York State percentage: 33.7%), and 19.1% are obese (New York State: 17.6%). Among Columbia County children, overweight and obesity rates vary by public school district. Hudson City School district has the highest percentage of students who are either overweight or obese.

The CHIP activities for obesity prevention focus on physical activity and healthy eating habits because of the important role that these lifestyle factors have on preventing and managing chronic diseases. Also included are activities to promote breastfeeding, as research has correlated lower rates of obesity among mothers who breastfeed and children who were breastfed as infants. There will be two main components to the improvement activities for obesity prevention: a school-based component and community components.

The school-based component will entail working with schools to implement physical activity into the school day and helping schools to adopt policies which call for daily physical activity among all students. Actions to decrease the high obesity rates among children were included in the plan because instilling healthy habits in children is prevention at its best. Including children in efforts to increase physical activity will result in generating maximum impact on health status and can bring about positive health outcomes for generations.

The community-based components for obesity prevention will include: collaborating with employers to promote breastfeeding policies and accommodations; helping schools to implement joint use agreements to encourage and support physical activity among community members; promoting Eat Smart NY to encourage healthy eating behaviors; implementing the “Healthy Mondays” program; and working with Columbia Memorial Hospital to promote preventive health screenings among community members.

The other focus of the Chronic Disease Prevention priority area of the CHIP is preventing and decreasing tobacco use among community members. Cigarette smoking is directly linked to lung cancer, as well as to other respiratory diseases. A large percentage (23.1%) of Columbia County adults smokes cigarettes (New York State: 16.8%). In Columbia County, the lung cancer rate for males (102.9 per 100,000 persons) is much higher than the state’s rate for males (84.3 per 100,000). The county’s lung cancer rate for females (63.8 per 100,000) is also high (New York State: 64.5 per 100,000).



(Executive Summary, continued)

Mental health issues and substance abuse are prevalent in the county. Problem areas of note are prescription and other drug abuse, alcohol abuse, binge drinking, underage drinking, alcohol-related motor vehicle injuries and deaths, suicide, mental disorders such as depression and anxiety, co-occurring disorders, self-inflicted injury, stigma, difficulty accessing mental health services and substance abuse services, and scarcity of preventive services. 

Within the Mental Health Promotion and Substance Abuse Prevention priority area of the CHIP, the focus is prescription drug abuse prevention. It has been identified as a major problem in Columbia County and also a growing problem nationwide. In 2012, 14.8% of high school seniors nationwide reported using prescription drugs for nonmedical purposes. Prescription drugs are often easily accessible to adolescents, and abuse of those drugs can lead to severe health consequences and even death. The first focus area of the community health improvement efforts will be prescription drug abuse prevention among adolescents. This will entail utilizing health survey analyses to strategically implement improvement and prevention interventions in the Hudson City School District, as well as implementing preventive initiatives in other public school districts in the county. The efforts will also include community-wide media campaigns, education to medical providers, education to parents and community members, and information dissemination to health and human service organizations. The second focus area will be to continue the work of the Columbia-Greene Controlled Substance Task Force, which aims to decrease and prevent prescription drug abuse in the two counties through focusing on practice guidance for prescribers, community prevention, and linkages to treatment. 

Arthropod-Borne Illness Prevention is another community health priority. The county’s Lyme disease rate is much higher than that of most New York counties. Between 2008 and 2010, Columbia County had a Lyme disease rate of 824.8 per 100,000 persons, which was much higher than the New York State rate of 66.2 per 100,000. Related health concerns are the increasing cases of other arthropod-borne illnesses such as Ehrlichia, Babesia, and Anaplasma. Prevention methods employed for Lyme disease can also be utilized to prevent other arthropod-borne illnesses. Community health improvement strategies will focus on increasing community signage, conducting education and community outreach, and monitoring arthropod-borne illness rates. 

The county’s occupational injury rates are higher than those of the state. Workers age 16 and over in Columbia County have an occupational-related hospitalization rate of 37.7 per 10,000 persons (NYS: 19.7 per 10,000). Workers age 15 to 19 in the county have a rate of occupational injuries treated in the emergency department of 73.6 per 10,000 (NYS rate: 36.7 per 10,000). Community health improvement strategies to prevent occupational injuries will focus on working with employers to increase awareness of the high occupational injury rates and educate employers on proper employee training and safety methods. 

Aside from health issues in the priority areas, the county experiences other health concerns. There is a high infant mortality rate and a high percentage of pregnant women with late or no prenatal care. Other community issues include lead exposure, low immunization rates for some diseases, motor-vehicle related injuries, lack of a medical home for some individuals, unemployment, shortage of affordable housing, economic instability, and lack of widely-available public transportation. 

Although the county experiences these problem areas, there are areas in which the county is doing well. For example, there is a low violent crime index, and compared to the state, the county has a lower breast cancer mortality, lower diabetes hospitalization rate, lower diabetes mortality, lower teen pregnancy rate, and lower rates of many sexually transmitted diseases. 

Columbia Memorial Hospital has been an important partner as both of our agencies are working collaboratively to address the health needs of Columbia County residents in the hospital’s Community Services Plan and in CCDOH’s CHIP. Numerous other agencies and individuals have also contributed their expertise, time, and passion to this planning process, and they will continue to be invaluable partners in developing and implementing community health improvement activities, and in evaluating and measuring community health improvement outcomes. Various other community and regional agencies are also equipped and experienced to tackle Columbia County’s health issues. Agencies such as those in the local public health system and those listed in Attachment 2: 2013 Columbia-Greene Interagency Yellow Pages have been, and will continue to, strategically address community health concerns and work to prevent of disease. Collaboration and team work will be necessary in tackling health improvement activities. 

Thank you for taking the time to review this Community Health Assessment and Community Health Improvement Plan. This plan will form the foundation of many community health improvement activities, helping Columbia County to be a healthier, safer place to live, work, learn, and play. The Columbia County Department of Health and partners welcome your questions, suggestions, and participation in the improvement process; please contact us at (518) 828-3358 or ccdoh@columbiacountyny.com.