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Thomas N. Scharmen , MA, MPH, Epidemiologist

Progress Report of March 2010 Albuquerque - Bernalillo County Health Equity Assessment Tool ABC HEAT Bernalillo County Place Matters Team. Thomas N. Scharmen , MA, MPH, Epidemiologist Regions 1 & 3, Office of Community Assessment, Planning and Evaluation

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Thomas N. Scharmen , MA, MPH, Epidemiologist

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  1. Progress Report of March 2010Albuquerque - Bernalillo CountyHealth Equity Assessment ToolABC HEATBernalillo County Place Matters Team Thomas N. Scharmen, MA, MPH, 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

  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.

  3. AGENDA . . . THE HEALTH EQUITY ASSESSMENT TOOL NEEDS YOUR SUPPORT HOW CAN WE COLLABORATE? WHAT IS THE ROLE OF YOUR ORGANIZATION IN SUPPORT OF COMPREHENSIVE COMMUNITY ASSESSMENT IN BERNALILO COUNTY? WHAT IS THE ROLE OF COMPREHENSIVE COMMUNITY ASSESSMENT IN BERNALILO COUNTY IN SUPPORT OF YOUR ORGANIZATION ? BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  4. Place Matters Communities The Fair Health Movement BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  5. Definitions • Health Disparities: Statistical differences in disease, health outcomes or health access that occur among populations defined by specific characteristics • Health Inequity: Differences in health that are systematic and avoidable, unfair, or stemming from injustice • Research: Discovery, via scientific methods, of new knowledge (e.g., causation) that will have broad applications • Public Health Surveillance: Information for action and policy advocacy BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  6. Social Determinants of Health Land Use Planning Economic Development Housing Parks and Recreation Education Crime Racism/Discrimination Definitions BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  7. Source: World Health Organization, Report of the Commission on the Social Determinants of Health, 2008.  See also Robert Wood Johnson Foundation Report, Beyond Health Care:  New Directions to a Healthier America and CDC, Healthy People 2020. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  8. A MODEL AREA-BASED INDICATORS PROJECT The Healthy Development Measurement Tool is a comprehensive evaluation metric to consider health needs in urban San Francisco 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/

  9. http://www.thehdmt.org/

  10. SAN FRANCISCO, HDMT ALBUQUERQUE, HEAT http://www.thehdmt.org/master_list.php http://www.nmpha.org/Social_Determinants.html BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  11. NW To Santa Fe NE Rio Grande River Community Boundaries & Numbers Big “I” Downtown Albuquerque Interstate Highways Airport SE SW ALBUQUERQUE AND THE HEAT COMMUNITY BOUNDARIES HOW DO YOU DEFINE YOUR COMMUNITY? BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  12. 33 HEAT COMMUNITIES 141 Census Tracts were aggregated into 33 communities representing coherent neighborhoods in the city of Albuquerque and surrounding county. Each HEAT community contains roughly 3 to 6 whole census tracts. Social determinant and health outcome data are calculated for each of those 33 communities to produce data tables and maps for community decision makers. ABC HEAT will explore other definitions of communities, for example: coalitions of neighborhood associations, police beats, state representative districts, etc. The table at right gives the names and codes for each of the 33 communities. Each name corresponds to a major intersection within the community. The adjacent map points out familiar landmarks in Albuquerque. Red lines mark the HEAT Communities Input is appreciated regarding better ways to define the geography of your community. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  13. ABC HEAT WILL SOON BE ONLINE http://map4change.org/ BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  14. AGENDA . . . THE HEALTH EQUITY ASSESSMENT TOOL NEEDS YOUR SUPPORT HOW CAN WE COLLABORATE? WHAT IS THE ROLE OF YOUR ORGANIZATION IN SUPPORT OF COMPREHENSIVE COMMUNITY ASSESSMENT IN BERNALILO COUNTY? WHAT IS THE ROLE OF COMPREHENSIVE COMMUNITY ASSESSMENT IN BERNALILO COUNTY IN SUPPORT OF YOUR ORGANIZATION ? BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  15. Call us to set up a workshop for your project or group. Tom 897-5700 x126 George: 314-0326 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  16. << the SEERStat Tool • What is the Health Equity Assessment Tool? • A large inventory of datasets (> 90 indicators currently) • Information on the social and health conditions of local communities • Geo-coded birth & death files (16 yrs) • Organized by Bernalillo County Census Tracts (141), and by • Aggregations of tracts into meaningful community boundaries (33) • The indicators are being developed as multi-purpose, rapid responsetools, ready for • participatory research, • program planning, • priority setting and targeting, • grant proposals, • policy discussions, • environmental and health impact assessments, • . . .and multiple other forms of community decision-making. BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  17. CATEGORIES OF HEAT INDICATORS A. Health Outcomes Birth Death Morbidity BMI in Children B. Socio-economic Indicators Economic Security and Financial Resources School Readiness and Educational Attainment Adequate, Affordable and Safe Housing Law enforcement, incarceration C. Resources and Services Health Care Services Nutrition, Recreation, Schools Day Care, Food stores, Transportation D. Environment Stationary Sources of Pollution Air Quality Zoning, Permitting BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  18. <<Next in Line DETAIL OF ONE SOCIAL DETERMINANT Economic Security/Financial Resources Public Assistance Food Stamp enrollment 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 Median 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

  19. ~900,000 Denominators for Bernalillo County • The HEAT - SEERStat Tool • Age-Adjusted Mortality Rates by PLACE • For Any - • Cause of Death • By Any - • Age Group • Sex • Race/Ethnicity • Year (1990 to 2005) • Census Tract (or combination of) http://seer.cancer.gov/resources BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  20. SEERStat Tool 1. Choose the Cause of Death BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  21. SEERStat Tool 2. Set the Table Layout - DIABETES, by RACE and HEAT COMMUNITY BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  22. SEERStat Tool 3. Run the Rates WHITE HISPANIC BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  23. SEERStat Tool 4-a. Create the Maps – HEAT Community Rates - DIABETES BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  24. POVERTY SEERStat Tool 4-b. Correlate Place / Poverty with Race and Sex DIABETES MORTALITY – UNDER 65 YEARS Age-Adjusted Death Rates, Bernalillo County, 2001-2005 W. ATHAS, PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  25. SAMPLE APPLICATIONS TEEN BIRTHS and POVERTY INJURY PREVENTION and POVERTY ACADEMIC ACHIEVEMENT, DROPOUTS and YOUTH IN PRISON ALCOHOL LICENSING HEALTHY WEIGHT and FOOD STORES ASTHMA and STATIONARY SOURCES OF POLLUTION DAY CARE CAPACITY and CHILD POPULATIONS FOREIGN BORN, LANGUAGE LEVEL and ‘UNAUTHORIZED’ RESIDENTS BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  26. SAMPLE APPLICATION TEEN BIRTH AND POVERTY BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

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

  28. Source: NMDOH, BVRHS; Analysis: T Scharmen, NMDOH, Region 3, Office of Community Assessment BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  29. POVERTY Source: NMDOH, BVRHS; Analysis: T Scharmen, NMDOH, Region 3, Office of Community Assessment TEEN BIRTH RATES INCREASE BASED ON POVERTY AND PLACE BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  30. POVERTY TEEN BIRTH RATES INCREASE BASED ON POVERTY AND PLACE AND RACE W. ATHAS, PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  31. HISPANIC TEEN BIRTH RATES, DOÑA ANA COUNTY, 1990 - 2005 Las Cruces Las Cruces 16-yr Cumulative Rates, Census Tracts Data Source: NMDOH, BVRHS Analysis: T Scharmen, NMDOH

  32. SAMPLE APPLICATION INJURY PREVENTION AND POVERTY BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  33. WHERE DO PEOPLE IN EXTREME POVERTY LIVE? PERCENT OF PERSONS IN EXTREME POVERTY 2000 (less than 100% of the Federal Poverty Level) BERNALILLO COUNTY CENSUS TRACTS US CENSUS 2000 PLACE MATTERS – ABC HEAT Source: U.S. Census BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  34. Unintentional Injury Deaths, 2000 U.S.A. 34.8 N.M. 53.6 Bernalillo County 46.4 Source: NCHS NVSR; NMDOH IBIS UNINTENTIONAL INJURY DEATH RATES, ALL AGES, RACES AND ETHNICITIES PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  35. POVERTY UNINTENTIONAL INJURY MORTALITY Average Annual Age-Adjusted Death Rates in Persons < 75 Years By Race/Ethnicity and Poverty Level, Bernalillo County, 1996-2005 W. ATHAS, PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  36. KEY INDICATOR: The percent of people in poverty has been shown to be a representative and understandable proxy measure of socioeconomic position at the census tract level. (Kreiger, et al, 2003) Non-Fatal Intentional Weapons Related Injury, Massachusetts, 1995-97 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  37. YOUTH HOMICIDE RATES, ALBUQUERQUE, 1990-2005 WHITE HISPANIC AFRICAN AMERICAN NATIVE AMERICAN

  38. DRUG INDUCED DEATHS, BERNALILLO COUNTY, 1990 - 2005 Includes accidental deaths, intentional deaths (suicide, homicide), and deaths with undetermined intention from poisoning or exposure to illicit or legal drugs (prescription or over-the-counter). Rates are age-adjusted and calculated for all ages, sexes and racial / ethnic groups over the 16-year period of 1990-2005. N=986 deaths. T. Scharmen, PLACE MATTERS – ABC HEAT Source: NMDOH, BVRHS BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  39. SAMPLE APPLICATION ACADEMIC ACHIEVEMENT, DROPOUTS AND YOUTH IN PRISON BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  40. FREE OR REDUCED-PRICE LUNCH BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  41. FOURTH GRADE READING SCORES (% PROFICIENT) BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  42. Source: APS-SIS, January 2009 ; Map: NMDOH, OCAPE BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  43. 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. Source: NM Dept of Corrections, NM CYFD; Analysis: The After Prison Initiative, Open Society Institute, 2003 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  44. SAMPLE APPLICATION ALCOHOL LICENSING BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  45. ALCOHOL AVAILABILITY, 2008 BERNALILLO COUNTY CENSUS TRACTS PLACE MATTERS – ABC HEAT Source: NMRLD, Alcohol and Gaming Division, 2008 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  46. New CVS Liquor License ALCOHOL AVAILABILITY 2008 South East Heights Albuquerque Liquor License for On/Off Premises PLACE MATTERS – ABC HEAT Source: NMRLD, Alcohol and Gaming Division, 2008 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  47. Proposed CVS Liquor License DWI Resource Center: http://www.dwiresourcecenter.org/downloads/naap/ABQ_Map11.gif

  48. Neighborhood wins liquor license fight At Wednesday night's City Council meeting, councilors approved an appeal by the La Mesa Community Improvement Association to reject any approval for a liquor license at the new CVS Pharmacy near Central and Louisiana. Neighbors who had joined the fight against the pharmacy getting a liquor license rejoiced following the decision, including Nancy Bearse, President of the neighborhood association. "I'm just so happy, I feel like crying," said Bearse. "Yes, this is a long struggle, this is why we do community grassroots efforts, this is what it's all about." KOB, Eyewitness News 401/20/2010

  49. SAMPLE APPLICATION HEALTHY WEIGHT AND FOOD STORES BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

  50. Diabetes Deaths, 2000 U.S.A. 24.6 N.M. 29.8 Bernalillo County 23.5 Source: NCHS NVSR; NMDOH IBIS DIABETES DEATH RATES, ALL RACES AND ETHNICITIES TOTAL DEATHS = 1882 BERNALILLO COUNTY PLACE MATTERS TEAM - - - - - HEALTH EQUITY ASSESSMENT TOOL

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