Erie County Health Assessment
Healthy People 2010
The Community Health Assessment for Erie County New York is a tool to assess and analyze the community's health status, identify needs, and available services. This information is helpful for identifying trends, planning, developing new programs, and making sound decisions regarding the resources that are available in public health to improve the health of the people of Erie County.
General Population Description
Erie County is located in Western New York and has a population of nearly one million people. The county seat is located in Buffalo, New York, the largest city in the region and the second largest city in the state. Erie County and Buffalo have had significant financial difficulties over the past five years, which is partly due to a shrinking tax base. Nearly 83% of the population has a high school diploma or equivalent and nearly a quarter has a Bachelor's degree or higher. Most of the population obtains health insurance through their employer or Medicaid and state sponsored programs such as Child Health Plus and Family Health Plus help to fill some of the health insurance gaps.
Population at Risk / Health Status
The community health assessment examines eighteen areas of the health in Erie County. Each area offers statistics and data, problem identification, available resources, and needed resources to address that specific issue, As with Healthy People 2010, it is noted that health disparities are a significant problem in Erie County. Minorities bear a larger portion of the disease burden. This Community Health Assessment focuses on the following areas addressing the assessment, analysis, and interventions for each health area.
Access to Care
Erie County has a significant number of hospitals, community based clinics and community based organizations to assist citizens of Erie County in their health and social needs. There are twelve hospitals in Erie County with 3126 beds. Erie County is also fortune to have a National Cancer Institute designated comprehensive cancer center at the Roswell Park Cancer Institute, a level three trauma center at the Erie County Medical Center Corporation, and a pediatric hospital and trauma center at Women's and Children's Hospital.
Erie County Health Department Capacity Profile
The mission of the Erie County Department of Health is to protect the public's health, to prevent disease and premature death through the promotion of healthy living and wellness, and to provide a safety net of services for those with limited access to healthcare. The Department is organized into five divisions and two administrative support units. The divisions are; Public Health, Safety and Wellness; Public Health Laboratory & Environmental Services; Emergency Medical Services and Office of Public Health Emergency Preparedness/ Response; Medical Examiner; and Division of Special Needs.
Erie County Health Priorities
The priorities of the Erie County Health Department include meeting the requirements of local, State, and federal mandates as well as addressing essential public health services. As a significant potion of the Erie County Department of Health's budget was cut in the 2005 budget process, the need to identify and secure funding from outside sources has become even more important to maintaining services and filling the identified gaps.
Plan for Action
To address the needs and priorities that have been identified in the Community Health Assessment, the Erie County Department of Health will strive to reduce health disparities by conducting more outreach activities in minority communities, integrate health promotion messages into more public health programs, increase efficiency and continue to support collaboration in the community, and continue to seek funding and resources from outside sources to support needed programs and services. Through these efforts, the Erie County Department of Health hopes to prevent disease and injury and improve the health status of Erie County residents.
1. Chronic Disease-Cancer
Erie County consistently has elevated rates of cancer when compared with other comparison regions. Strides have been made though, notably, prostate cancer rates in Erie County are now below the Healthy People 2010 goal. Erie County is also ahead of other areas in early diagnosis of many different types of cancer.
2. Chronic Disease - Diabetes
Erie County has lower age-adjusted death rates due to diabetes than the nation. Despite the fact that the number of people with diabetes has increased, the age adjusted death rate has remained relatively stable. The obesity crisis has had a tremendous impact on the population including huge increases in Type 2 diabetes in children. One of the major needs is more focused funding and dedicated staff to implement CDC proven programs focusing on nutrition and physical activity.
3. Environmental Health - Lead Poisoning Prevention Program
Erie County has a very high number of children with elevated lead levels. One of the major problems is that children with elevated lead levels often have no symptoms, so testing of children, especially those who live in older homes, is extremely important. In Erie County, 64% of all housing was built prior to 1960. In some zip codes within the City of Buffalo, the percentage of housing that was built prior to 1960 exceeds 90%. One of the items that could help decrease the number of children exposed to lead would be increased funding for lead abatement and if possible replacement of old housing stock in the city of Buffalo.
4. Family Planning
The rate of teen pregnancy has noted a significant decrease in Erie County since the spike in rates in 2000. The abortion rate in Erie County is still significantly higher than other municipalities, and the birth percentage for females age 10-17 remains high. The Erie County Health Department operates the Teen Wellness program as well as multiple family planning clinic facilities. Increased access to family planning services, focusing on the young adult population (age 20-29) and additional funding for marketing these programs could help further decrease the rate of unintended pregnancies.
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5. Food Safety
The safety of the food we eat is a principal concern of the Environmental Health division of the Erie County Health Department. The focus on restaurant inspections and prevention activities has resulted in improvement in many areas, but they have not yet reached the Healthy People 2010 goal for rates of Escherichia Coli 0157:H7 rates. The expanded use of electronic technologies for restaurant inspections, permit applications, online training for restaurant owners as well as the online availability of rules and regulations could further assist in the reduction of food borne illness.
6. Chronic Disease - Heart Disease and Stroke
Cardiovascular Disease is the leading cause of death in Erie County. Erie County has shown significant strides in age adjusted death rates for CVD but still has rates higher than the U.S. and New York State. African American males have the highest rate of deaths from CVD. There are a number of programs in Erie County working to address this issue. There is a need for increased intervention to the African American community as well as general public education about positive heart health behaviors such as regular exercise and smart nutritional choices.
7. HIV/AIDS
HIV in Erie County is increasingly becoming a problem for racial and ethnic minorities. Age adjusted death rates have decreased significantly due to the introduction of HAART. It is estimated that 75% of HIV infected persons are not receiving services. Currently the ECDOH provides HIV prevention through Peer Navigators and in the Teen Wellness program. HIV training is offered to health and human service providers throughout the region. Syringe exchange is provided by Project Reach and the implementation of the SEAD project has helped get used syringes off the street. Future funding should focus on extensive outreach and case management to zip codes with known high rates of HIV infection, as well as efforts to reach the many individuals who are infected but are not in treatment.
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8. Immunizations and Infectious Diseases
Erie County has made significant strides in the rates of those who have received immunizations for vaccine preventable diseases. Work still needs to be done on conditions like Pertussis and Haemophilus influenza Type b (Hib). TB has also been showing a general decrease but recently had an increase in cases noted in foreign born individuals. There is a continued concern about multi drug resistant TB (MDR Tb) as well. The ECDOH has the Immunization Action Plan which looks to increase immunization rates. The Tuberculosis Control program provides evaluation and treatment of TB as well as community outreach. A statewide registry for vaccines as well as restoration of funding for increased directly observed therapy with TB could assist in meeting the goals of these two public health concerns.
9. Injury Prevention and Control
Motor vehicle deaths in Erie County have decreased and are now lower than Upstate New York and New York State rates. The homicide rates show that Erie County is equal or higher than New York State and national rates. The NY State Police and the Buffalo Police both have initiatives to combat violence in the area. Erie County has a regional renowned Trauma Center at the Erie County Medical Center that makes the tertiary prevention of injuries among the best in the nation. Funding for programs to decrease violence as well as promote safety for children would further improve outcomes in this area.
10. Maternal and Child Health
This area of the assessment again demonstrates significant racial disparities. In the U.S. African American women are nearly four times as likely to die from complications of pregnancy. Erie County has had elevated rates but recently has shown a significant decrease and is approaching the HP 2010 goal. Infant Mortality Rates are nearly three times higher for African Americans than for Caucasians.
Erie County has a much larger percentage of women who had no prenatal care or began it in the last trimester of pregnancy. Programs to address the significant disparities in this area need to be expanded and reach communities of highest risk.
11. Oral Health
Erie County operates a dental health program to reach school age children and provide them with education about the importance of dental hygiene. There is also a dental clinic located at the Jesse Nash Health Center. Although strides have been made, Erie County has not yet reached any of the HP 2010 goals in relation to oral health. Tailoring programs for high risk children may assist in reaching these goals.
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12. Nutrition, Overweight, Physical Activity and Fitness
Poor diet and physical inactivity is quickly approaching being the leading preventable cause of death in America. Erie County is no different than the U.S. in this area. Black women are disproportionately affected in this area of health. The county, state, and country have multiple proven programs to address these issues, but more dedicated staff and funding is needed to stop the negative trends in this area.
13. Chronic Disease - Respiratory Disease
Asthma is the leading chronic illness in children today. Erie County has made improvements in many indicators in this health area, but deaths from COPD continue to rise in the county. Asthma is often influenced by environmental factors.
The Western New York Asthma Coalition is extensively involved in prevention and education efforts. More intensive case management could assist in addressing the problems in this area.
14. Communicable Disease - Sexually Transmitted Diseases
Erie County consistently has some of the highest rates in the state and country for Gonorrhea and Chlamydia. Untreated STDs can cause serious health consequences including infertility. The ECDOH operates a specialized STD clinic and offers STD testing in the family planning and OB clinics. Addressing high risk populations through outreach and education may assist in lowering the rates of STDs.
15. Substance Abuse
Substance Abuse continues to be a problem in society today. The use of alcohol, drugs and other substances can lead to more destructive behaviors. There are multiple treatment programs as well as harm reduction programs such as the syringe exchange to try to address these issues. There is still an extensive need for additional resources such as on demand drug treatment and an increase in community centered programming.
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16. Tobacco Use
Smoking is the single most avoidable cause of death in the U.S. Adult smoking has shown little change in the last ten years. Progress has been made with teenagers but further work is needed to address this population. More community based, culturally sensitive, risk group focused activities need to be implemented.
The Erie-Niagara Tobacco-Free Coalition is a collaboration of many agencies that can assist individuals and develop programs to stop smoking.
17. Vision and Hearing
To maintain sensory health vision screening for persons with diabetes proper and timely medical management of otitis media is necessary. New York State has implemented newborn hearing screening and Erie County has favorable rates around otitis media and vision screening for people with diabetes. Further prevention education and promotion of the newborn hearing screening program could further improve the rates in this area.
18. Emerging Health Issues
Issues that are currently in the eye of the public as well as Public Health professionals include Avian Flu, CA-MRSA, SARS and bioterrorism. This is not an exhaustive list but the continued vigilance of those who work in public health is needed to assure these issues do not begin to be a more significant cause of death and disability. With all the areas that a health department has to deal with on a daily basis it is important to remember the importance of having staff readily available to address a variety of emerging health issues.