Maine Shared Community Health Needs Assessment Androscoggin County Forum

Maine Shared Community Health Needs Assessment brings together various healthcare organizations to analyze health priorities in Androscoggin County. The forum includes presentations, discussions, and planning sessions to address key findings and identify health priorities.

• Community Health
• Maine
• Androscoggin County
• Health Assessment
• Healthcare Collaboration

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1. 2021 Maine Shared Community Health Needs Assessment Androscoggin County

2. The Maine Shared CHNA is a collaboration between the Maine Center for Disease Control and Prevention (Maine CDC), Central Maine Healthcare, Northern Light Health, MaineGeneral Health, and MaineHealth. 2

3. Thank you, forum supporters! Androscoggin Home Healthcare + Hospice Sandcastle Clinical & Education Services Central Maine Medical Center St. Mary s Regional Medical Center City of Auburn Public Health Sweetser Community Concepts Tri-County Mental Health Services Healthy Androscoggin Western Maine Community Action WIC (members of the Androscoggin Community Health Stakeholder Coalition) 3

4. Forum agenda Time Activity Speaker/Facilitator Holly Lasagna, Health Promotion Manager, Healthy Androscoggin, Central Maine Medical Center 5:00-5:05 pm Welcome and introductions Jo Morrissey, Program Manager, Maine Shared Community Health Needs Assessment Steve Jorgensen, President, St. Mary s Regional Medical Center Hugh Jones, Vice President of Service Line Strategy, Central Maine Healthcare Zoom environment and CHNA background 5:05-5:10 pm 5:10-5:15 pm Leadership remarks Elizabeth Keene, VP, Mission Integration, St. Mary s Regional Medical Center Review previous CHNA priorities and activities since last effort 5:15-5:25 pm Holly Lasagna, Health Promotion Manager, Healthy Androscoggin, Central Maine Medical Center Presentation of key findings from the data John Snow, Inc. 5:25-5:50 pm Break-out session facilitated discussion on data and health priority identification John Snow, Inc. & Local Facilitator(s) 5:50-6:50 pm Elizabeth Keene, VP, Mission Integration, St. Mary s Regional Medical Center 6:50-7:00 pm Wrap up and next steps 4

5. Share screen Join Audio, Mute On/Off Open/close participant list or chat Reactions Turn Video On/Off

6. Matching Interests Maine Shared Community Health Needs Assessment Images of PHAB and IRS from the internet 6

7. The Evolution of an Idea 2010 OneMaine 2015 SHNAPP 2018 2021 Maine Shared CHNA Maine Shared CHNA Forums 16 Forums 22 Mainstream Forums (live) 16+ Mainstream Forums (virtual) Surveys 1639 Surveys 2 Immigrant Forums 12+ Community Sponsored Events 45 Interviews 2000+ Oral Surveys 7

8. Inputs and Outcomes Ways to Provide Input Data Collected Outcomes District & County Reports DUE APRIL 2022 4 Health Priorities by county Related indicators Gaps/barriers and resources/assets Notable comparisons between attendee input and the data. Description of those who provided input Methodology Mainstream county forums Number of attendees Where attendees live (not CSE) List of data identified Forums and CSE only) Discussion notes (Forums and CSE only) Chat box comments (Forums and CSE only) Health Priorities Gaps and Resources Community sponsored events State Report DUE APRIL 2022 4 Health Priorities by Community Event and immigrant population. Related indicators Gaps/barriers and resources/assets, Notable comparisons to mainstream population. Description of those who provided input Methodology Oral Survey Forums, Events and Surveys conducted Fall 2021 8

9. Leadership remarks

10. Local Activities and Accomplishments 10

11. Western Maine District Androscoggin County Hospital and District priority areas of work since the 2019 Shared CHNA Social Determinants of Health Adverse Childhood Experiences (ACEs): Androscoggin Community Health Stakeholder Coalition Food Security: Androscoggin Home Healthcare + Hospice St. Mary s Regional Medical Center YMCA YWCA Housing: Androscoggin Home Healthcare + Hospice Recovery Connections Non-emergent Transportation: LAR Community Health Committee COVID-19 Testing & Vaccines Androscoggin Emergency Management Auburn Fire/Police Department Central Maine Medical Center City of Auburn Government City of Lewiston Government & Schools Community Clinical Services Healthy Androscoggin Lewiston Fire/Police Department St. Mary s Regional Medical Center YMCA Mental Health Substance Use Central Maine Medical Center Community Clinical Services Healthy Androscoggin Lewiston Police Department Recovery Connections St. Mary s Regional Medical Center Sweetser Tri-County Mental Health Services Central Maine Medical Center Community Clinical Services Healthy Androscoggin Lewiston Area Public Health Committee Lewiston Police Department Recovery Connections St. Mary s Regional Medical Center Sweetser Tri-County Mental Health Services Tobacco Use Access to Care Central Maine Medical Center Healthy Androscoggin St. Mary s Regional Medical Center Central Maine Medical Center Community Clinical Services Lewiston Police Department Recovery Connections St. Mary s Regional Medical Center Tri-County Mental Health Services YMCA YWCA 11

12. Accomplishments of Note Social Determinants of Health: Adverse Childhood Experiences (ACEs) -Created resource list -Trained health care and school employees Food Security -Added one new community garden & one school garden -Established Local Foods, Local Places council and work plan -Engaged community members as Community Food Champions -Developing Community Food Center as part of Choice grant Supportive Housing -Emergency Wellness Shelter coordinated by Community Concepts Mental Health: -14 members of the Lewiston Youth Advisory Council participated in a Photo Voice project for mental health support coordinated by Healthy Androscoggin -St. Mary s opened a new child/adolescent psychiatric unit and will open a new adult psychiatric unit this fall -Tri-County Mental Health Services and Lewiston Police Department expanded the program for mental health support professionals to ride along with Lewiston police officers Lewiston Youth Advisory Council Photo Voice Project 12

13. Accomplishments of Note Substance Use: -Tri-County CommUNITY Recovery Grant -Over 250 people attended Rally for Recovery in Kennedy Park Update on selected priorities and activities since the 2019 Shared CHNA Tobacco Use: -Youth Vaping Initiative -T21 -Quit & Win Program Access to Care: -Auburn Mall high-volume vaccine clinic totals through 10/5/21 13

14. How to Read the County Health Profiles and Health Equity Data Sheets 14

15. How to Read County Health Profile CHANGE shows statistically significant changes in the indicator over time, based on 95% confidence interval (see description on page 3). means the health issue or problem is getting better over time. ! means the health issue or problem is getting worse over time. means the change was not statistically significant. EXAMPLE N/A means there is not enough data to make a comparison. BENCHMARK compares [COUNTY] data to state and national data, based on 95% confidence interval (see description on page 3). means [COUNTY] is doing significantly better than the state or national average. ! means [COUNTY is doing significantly worse than the state or national average. means there is no statistically significant difference between the data points. N/A means there is not enough data to make a comparison. ADDITIONAL SYMBOLS means results may be statistically unreliable due to small numbers, use caution when interpreting. * means data is unavailable because of lack of data or suppressed data due to a small number of respondents. 15

16. EXAMPLE How to Read County Health Profile AROOSTOOK COUNTY BENCHMARKS INDICATOR POINT 1 POINT 2 MAINE +/- U.S. +/- CHANGE 2015-2019 11.8% ! 2009-2011 15.6% 2015-2019 16.1% 2019 Individuals living in poverty N/A 12.3% Individuals living in poverty 16.1% 15.6% 12.3% 11.8% 2009-2011 Aroostook County 2015-2019 Aroostook County 2015-2019 Maine 2019 U.S. 16

17. For More Data www.mainechna.org 17

18. Key Findings 18

19. Demographics Life Expectancy 2017-2019 National Center for Health Statistics, CDC RANK MAINE ANDROSCOGGIN COUNTY 1 Cancer Heart Disease 2 Heart Disease Cancer 3 Unintentional Injury Chronic Lower Respiratory Disease Chronic Lower Respiratory Disease 4 Unintentional Injury 5 Stroke Alzheimer's Disease

20. Demographics Age distribution for Androscoggin County AGE ANDROSCOGGIN COUNTY POPULATION 107,602 Under 5 5-9 10-14 15-19 20-24 STATE OF MAINE POPULATION 1,362,359 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ 0 2,000 4,000 6,000 8,000 10,000 10,000 8,000 6,000 4,000 2,000 0 Population in 2019 Population in 2010

21. Demographics Percentage of people living in rural areas 2019 New England Round Table for Rural Health

22. Demographics Percent of population over age 25 with an associate s degree or higher Change in percent of population over age 25 with an associate s degree or higher 2010 to 2015-2019 2010 American Community Survey 2015-2019 American Community Survey

23. Demographics Change in percent of population in poverty 2010 to 2015-2019 Percent of population in poverty 2010 American Community Survey 2015-2019 American Community Survey

24. Demographics

25. Demographics

26. Health Indicators Fair or poor health (self-rated) 20.0% 17.3% 16.8% 16.2% 2011-2013 2015-2017 2015-2017 Maine 2018 U.S. Androscoggin County Androscoggin County 26

27. Health Indicators Overall death rate per 100,000 population 858.5 784.8 764.9 715.2 2007-2011 2015-2019 2015-2019 Maine 2019 U.S. Androscoggin County Androscoggin County 27

28. Health Indicators Cost barriers to health care 14.2% 12.0% 10.9% 10.6% 2011-2013 2015-2017 2015-2017 Maine 2016 U.S. Androscoggin County Androscoggin County 28

29. Health Indicators Lung cancer deaths per 100,000 population 60.3 54.4 45.5 33.4 2007-2011 2015-2019 2015-2019 Maine 2019 U.S. Androscoggin County Androscoggin County 29

30. Health Indicators Cardiovascular disease deaths per 100,000 population 221.2 216.8 213.4 193.9 2007-2011 2015-2019 2015-2019 Maine 2019 U.S. Androscoggin County Androscoggin County 30

31. Health Indicators Stroke deaths per 100,000 population 40.3 37 35.9 33.9 2007-2011 2015-2019 2015-2019 Maine 2019 U.S. Androscoggin County Androscoggin County 31

32. Health Indicators Diabetes hospitalizations (principal diagnosis) per 10,000 population 16.9 12.7 2016-2018 2016-2018 Maine Androscoggin County 32

33. Health Indicators Diabetes emergency department rate (principal diagnosis) per 10,000 population 45.8 31.2 2016-2018 2016-2018 Maine Androscoggin County 33

34. Health Indicators Injury deaths per 100,000 population 83.9 82.8 71.2 53.3 2007-2011 2015-2019 2015-2019 Maine 2019 U.S. Androscoggin County Androscoggin County 34

35. Health Indicators Fall-related deaths (unintentional) per 100,000 population 15.9 14.4 10.2 5.3 2007-2011 2015-2019 2015-2019 Maine 2019 U.S. Androscoggin County Androscoggin County 35

36. Health Indicators Fall-related injury (unintentional) emergency department rate per 10,000 population 371 307.4 2016-2018 2016-2018 Maine Androscoggin County 36

37. Health Indicators Poisoning deaths (unintentional and undetermined intent) per 100,000 population 28 26.1 21.4 11.8 2007-2011 2015-2019 2015-2019 Maine 2019 U.S. Androscoggin County Androscoggin County 37

38. Health Indicators Violent crime rate per 100,000 population Violent crime rate per 100,000 population 366.7 174.6 158.4 149.2 143.4 137.8 114.9 2019 Maine 2019 U.S. 2015 2016 2017 2018 2019 38

39. Health Indicators Mental health emergency department rate per 10,000 population 278.8 181.5 2016-2018 2016-2018 Maine Androscoggin County 39

40. Health Indicators Anxiety, lifetime 26.3% 22.0% 21.4% 2012-2014 2015-2017 2015-2017 Maine Androscoggin County Androscoggin County 40

41. Health Indicators Sad/hopeless for two weeks in a row (high school students) 34.1% 32.1% 26.7% 2017 2019 2019 Maine Androscoggin County Androscoggin County 41

42. Health Indicators Drug-induced deaths per 100,000 population 29.5 28.4 22.8 12.7 2007-2011 2015-2019 2015-2019 Maine 2019 U.S. Androscoggin County Androscoggin County 42

43. Health Indicators Alcohol-induced deaths per 100,000 population 14.9 11.6 10.4 8.8 2007-2011 2015-2019 2015-2019 Maine 2019 U.S. Androscoggin County Androscoggin County 43

44. Health Indicators Drug-affected infant reports per 1,000 births Drug-affected infant reports per 1,000 births 160 140 113.5 120 107.8 101.1 100 96.9 95.1 83.7 73.7 80 73.9 60.4 60 41 40 20 0 2018-2019 2018-2019 Maine Androscoggin County 2010 2011 2012 2013 2014 2015 2016 2017 44

45. Health Indicators Binge drinking (adults) 17.9% 17.4% 17.2% 16.4% 2012-2014 2015-2017 2015-2017 Maine 2017 U.S. Androscoggin County Androscoggin County 45

46. Health Indicators Binge drinking (high school students) 9.1% 8.2% 6.2% 2015 2019 2109 Maine Androscoggin County Androscoggin County 46

47. Health Indicators Past 30-day misuse of prescription drugs (high school students) Past 30-day misuse of prescription drugs (high school students) 7.5% 7.2% 5.5% 5.1% 5.0% 4.7% 2011 2013 2015 2017 2019 Maine (2019) 47

48. Health Indicators Overdose emergency medical service responses per 10,000 population 108.1 96.2 76.7 2019 2020 2020 Maine Androscoggin County Androscoggin County 48

49. Health Indicators Past-30-day e-cigarette use (high school students) 28.7% 28.3% 14.1% 2017 2019 2019 Maine Androscoggin County Androscoggin County 49

50. Breakout Discussions 50

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