Tài liệu ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT 2010 - 2013 doc

ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT
2010 – 2013





Edward A. Diana
County Executive

Jean M. Hudson, M.D., M.P.H.
Commissioner of Health

ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT
2010 - 2013

TABLE OF CONTENTS
Acknowledgements
Executive Summary and Key Findings
Exhibit Listing
Guide to Statistical Terms
Community Health Assessment (CHA) Index
Section 1 – Populations at Risk Page
A. Demographic and Health Status Information 1-23
1. The Population of Orange County 1-5
a. Population Growth Rates and Density
b. Population Demographics
c. Employment and Housing Characteristics
d. Projected Demographic Changes
e. Regional Perspective
2. Causes of Mortality in Orange County 5-7
a. Overall Mortality
b. Mortality Rates of Demographic Subpopulations
c. Leading Causes of Death
3. Health Status of County Residents 7-15
a. Family Health
 Child and Adolescent Health
 Maternal and Infant Health, Reproductive Health & Family Planning
 Intentional and Unintentional Injuries
b. Disease Control 15-23

 Sexually Transmitted Diseases
 HIV/AIDS
 Tuberculosis
 Other Communicable Diseases
 Vaccine Preventable Diseases
 Chronic Diseases
B. Access to Care 24-28
1. Availability and Utilization of Health Care Services 24-26
2. Barriers to Health Care Access 26-28
a. Financial
b. Structural
c. Personal
C. Behavioral Risk Factors
1. Core Behavioral Risk Factors 30-37
2. Optional Behavioral Risk Factors 37-39
3. Selected Youth Behavioral Risk Factors 39-40
D. The Local Health Care Environment
1. History 41
2. Physical and Social Factors 41-42
3. Economic Factors 43-44
E. Section One Exhibits 46-263

Section 2 – Local Health Unit Capacity Profile Page
A. Organizational Structure and Program Description 1-9
B. Current Trends and Workload 10-17
C. New Initiatives and Significant Accomplishments 18-20
D. Staff Qualifications and Skill Levels 21-22
E. Expertise and Technical Capacity for Community Health Assessments 23
Section 3 – Problems and Issues in the Community Page
A. Profile of Community Resources 1-31

B. Profile of Unmet Need for Health Services
1-3
Section 4 – Local Health Priorities Page
A. Priority Local Needs 1-16
 Priority Health Needs
 Accomplishments Related to Priority Areas
Section 5 – Opportunities for Action Page
A. Opportunities and Potential Action Steps 1-4
Section 6 – Community Report Card Page
 Introduction 1
 County Health Indicator Profiles 2-3
 Orange County Indicators for Tracking Public Health Priority Areas 4-7

Orange County Community Health Assessment 2010-2013

ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT
2010 - 2013

ACKNOWLEDGMENTS

Many thanks to all who worked to bring this document together:

Prevention Agenda Workgroup (see listing)

Orange County Department of Health Division Directors:
Chris Dunleavy, Deputy Commissioner of Health
Robert Deitrich, Director, Community Health Outreach
Marilyn Ejercito, R.N., M.S., Director, Public Health Nursing
Christopher Ericson, M.P.A., Director, Public Health Response
Matthias Schleifer, P.E., Assistant Commissioner, Environmental Health

Anne Vradenburgh, Director, Fiscal
Sheila Warren, R.N., M.Ed., Director, Intervention Services
Charles A. Catanese, M.D., Chief Medical Examiner

Robert Hastings, Health IT Consultant

Colleen Larsen, R.N., M.P.A., OCDOH Nurse Epidemiologist

Jacqueline Lawler, M.P.H., OCDOH Epidemiology Fellow

Chris Saccone, Executive Secretary/Administrative Assistant

Ed Waltz, Ph.D., Director, and Susan Wymer, B.S.N, R.N., Graduate Research
Assistant, Prevention Research Center, SUNY Albany School of Public Health

Mary Bevan, M.P.H., Project Director (Consultant)





Jean M. Hudson, M.D., M.P.H.
Commissioner of Health

Orange County Community Health Assessment 2010-2013

1

ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT
2010 - 2013

EXECUTIVE SUMMARY

The 2010-2013 Community Health Assessment (CHA) represents the ongoing efforts of representatives
from community-based health, social service, mental health, and education agencies, health care
providers, Advisory Board of Health and Health Department representatives to identify health needs and to
collectively determine strategies to improve the health of County residents. Submission of the CHA is a
requirement of the Municipal Public Health Services Plan. A complete assessment is conducted every four
years. New York State regulations designate the county health department as the lead agency in the
preparation and submission of the CHA.

As stated in the 2010-2013 NYSDOH CHA Guidance document, “Community health assessment is a core
function of public health agencies and a fundamental tool of public health practice. Its aim is to describe
the health of the community, by presenting information on health status, community health needs,
resources, and epidemiologic and other studies of current local health problems. It seeks to identify target
populations that may be at increased risk of poor health outcomes and to gain a better understanding of
their needs, as well as assess the larger community environment and how it relates to the health of
individuals. It also identifies those areas where better information is needed, especially information on
health disparities among different subpopulations, quality of health care, and the occurrence and severity
of disabilities in the population.” The CHA is the basis for all local public health planning, giving the local
health unit the opportunity to identify and interact with key community leaders, organizations and
interested residents about health priorities and concerns.

New York’s Prevention Agenda toward the Healthiest State initiative was launched in April 2008, to
promote collaborative community health planning focused in locally-selected health priority areas. The
Prevention Agenda designates local health departments and hospitals as the lead partners in this process.
Involving key community stakeholders, 2-3 priority areas are selected based on consideration of
demographic and health status data, health service delivery data, local and regional surveys and studies.
Opportunities for action are identified to focus improvement efforts and maximize outcomes through
coordination and collaboration. National and state benchmarks, such as Healthy People 2010 and

Prevention Agenda 2013 targets are used to monitor and evaluate progress.

Several strategies were used to encourage community input in establishing community health priorities.
The primary strategy is ongoing community collaboration. In addition, two versions of a local health
needs survey were developed to solicit input on local health needs from health providers, community
agencies, and residents. More than 160 provider/community agency and 760 resident surveys were
completed. Representatives from community agencies throughout the county also participated in “Health
Town Meetings” held in 4 distinct geographic areas of the county. These meetings were hosted by the
primary hospital/medical center in each region and the discussions were facilitated by representatives
from each Community Health Center serving county residents. The surveys and Health Town meetings
attempted to capture as broad participation as possible and reflect the priority health issues in the
communities in each area. Despite slight differences in geographic emphasis, the primary concerns raised
were highly consistent. This information, as well as analysis of the demographic, mortality, morbidity, and
behavioral risk indicators discussed in Section I – Populations at Risk informed the selection of local health
priorities aligned with the NYS Prevention Agenda.

A Prevention Agenda Workgroup was convened to finalize the determination of unmet health and service
needs, local health priorities, and opportunities for action. Workgroup representatives have extensive
experience in public health and health services delivery, including service to high risk populations
throughout the county. Working with a public health consultant, researchers from the SUNY Albany School
of Public Health, the OCDOH epidemiologist, and Division Directors formed our CHA development team.
The determination of local health priorities was guided by the 10 priority areas for public health action
specified in The Prevention Agenda for the Healthiest State.

Orange County Community Health Assessment 2010-2013

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The majority of residents in Orange County enjoy favorable health. Preliminary results from the most

recent NYSDOH Expanded Behavioral Risk Surveillance Survey found that 86% of Orange County adults
ages 18 and over surveyed reported their health status to be good to excellent. Access to quality primary
health care services is essential to maintain and improve health in the community. Access to primary care
promotes a consistent source of care to receive preventive health education and health screenings, early
detection and treatment of disease, and timely referrals for specialty care and other needed services.
Ongoing contact with a primary health care provider is essential to prevent complications and improve
health outcomes. Orange County is relatively well supplied with primary care providers, however all
residents do not have adequate access.

The leading health issues in Orange County, as in the state and the nation, result from a number of
factors, many of which can be controlled or modified. Harmful personal behaviors such as smoking,
overeating, poor nutrition, lack of physical activity, substance abuse, and unsafe sexual practices have
major impacts on individual health. Economic and language/cultural factors present barriers to access and
utilization of medical care and preventive health services. Income, unemployment, educational attainment,
inadequate housing, and lack of transportation are social factors which impact health or limit access to
care. Uncontrollable factors, including inherited health conditions or increased susceptibility to disease,
also significantly influence health.

In spite of the favorable health status enjoyed by most Orange County residents, health disparities persist
and are concentrated in the county’s uninsured and low income population groups. Lack of health
insurance and inadequate insurance coverage are increasing concerns in the current economic recession.
Even individuals and families with health insurance can find navigating the health care system difficult
especially when faced with personal or family illness. Persons who live in poverty or are uninsured are
more likely to have poor health status. Poverty underlies many of the social factors that contribute to poor
health. Differences for many health indicators are also apparent by gender, race/ethnicity, age, and
geographic area of residence. This information can be used to determine subgroups in the population in
need of further assessment, as well as to guide the development of programs and services to meet
identified health needs.

Recent trends in health indicators for County residents show improvement in overall mortality rates from

the leading causes of death – most notably heart disease and cancer. Key indicators of maternal and
infant health, such as births and pregnancies in teens, infant mortality and low birthweight births, have
also improved for county residents overall. There are indications of improvement in personal health habits
such as smoking rates and accessing screening services for early detection of certain diseases. However,
disparities in health care access and health status in high risk populations persist. The 2010-2013 CHA
also indicates areas in need of improvement in county residents such as unintentional injuries, ambulatory
care sensitive conditions, Prevention Quality Indicators for chronic diseases, receipt of early prenatal care,
prevalence of smoking and obesity, asthma-associated illness, cancer incidence, and disparities in
mortality from chronic diseases. Expanded joint planning and coordination of programs and services
among health care partners in the community focused in the health priority areas can reduce health
disparities and improve the health of all county residents.

The intent is for the Community Health Assessment to have significant value for the community, and to be
used to advance health-related service planning by a multitude of agencies. We welcome your comments
and reactions to this report, and invite you to participate in the assessment process going forward.


Jean M. Hudson, M.D., M.P.H.
Commissioner of Health
Orange County, New York
September 2009
Orange County Community Health Assessment 2010-2013
1

ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT
2010 - 2013

KEY FINDINGS

Demographic Trends

 According to the U.S. Census population estimates published by the New York State Data Center, Orange
County is the fastest-growing county in New York State; from April 1, 2000 to July 1, 2007, the county’s
population increased by an estimated 10.5%. Trends in population growth vary greatly by municipality -
communities with estimated population growth rates of twenty percent or more from 2000-2007 include
the towns of Minisink and Monroe, and the villages of Kiryas Joel, Maybrook, and Montgomery.

 Based on 2007 U.S. Census population estimates, the median age in the county has remained relatively
constant (34.6 years); the greatest number of residents fall in age range 25-54. The number of residents
ages 65-69 is forecasted to more than double from 2000-2020 primarily due to the entry of ‘baby
boomers’ into these age ranges.

 According to 2007 U.S. Census population estimates, the county’s single race composition is: 84.8%
White, 10.6% Black/African American, 2.4% Asian with the remaining 2.2% classified as other.
Hispanic/Latino, which is not a racial category, represents 15.9% of the county population. Since the
2000 Census, the greatest estimated rate of growth is in the Asian/Pacific Islander population which
increased by 75%. The second highest increase was in the Hispanic/Latino population, which grew by
50%. During this time, the Black/African American population is estimated to have increased by 44% and
the White population increased the least at 12%.

 According to the U.S. Census, over nine thousand (9,082) foreign born persons entered Orange County
from 1990-2000, up from 6,964 from 1980 to 1990. The majority (45.2%) were born in Latin America,
34.1% were born in Europe, and 16.4% were born in Asian countries. Kids’ Well-Being Clearinghouse data
report that the number of Orange County students K-12 with limited English proficiency increased by
35% from 2000 to 2007, from 9.3% to 12.6%.

 Recent educational attainment indicators for Orange County youth indicate improvement in educational
performance and in the intent to pursue higher education. The percent of high school graduates
receiving Regents Diplomas in Orange County’s Public Schools increased substantially from 1999-2000
to 2006-2007 (49.9% to 81.6%), in part due to the phase-in of Regent only diplomas statewide

.
The
number of high school graduates intending to enroll in college also increased during this same period,
from 81% to 83.7%.

 Poverty rates vary greatly throughout the county based on municipality. Poverty rates exceeding 25% for
families with related children under 18 are found in Orange County’s three cities (Middletown,
Newburgh, and Port Jervis), as well as in the town of Monroe, largely due to the impact of the village of
Kiryas Joel, where the poverty rate is more than 4 times the county average. Levels of poverty in the
county also vary depending on race, ethnicity and family composition. Married couple families have the
lowest overall poverty rates; the highest rates are seen in single mother families, and this rate exceeds
50% in single mother families with children under the age of five.

 Housing units within the county increased an estimated 9.2% from 2000 to 2007. The majority of
housing units in the county are owner occupied; however this also varies by municipality. Communities
with 50% or more of their housing units consisting of pre-1950 construction include Cornwall,
Highlands, and the county’s three cities of Middletown, Newburgh, and Port Jervis.

 Among the seven counties in the Hudson Valley Region (HVR), Orange County is the second most
populated county, and ranks second in the rate of population growth from 1990-2000 and in the
number of Hispanic/Latino residents.


Orange County Community Health Assessment 2010-2013
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Health Status and Risk Indicators
 Overall Mortality and Leading Causes of Death: Since 1998 - 2000, there has been a steady decline in
the 3-year average age-sex adjusted mortality rate in the county. The 2004-2006 age-sex adjusted
mortality rate for county residents was below the Upstate rate. In 2004-2006, the mortality rate for

Black/African American residents in the county is highest, followed by that for White residents.
Hispanic/Latinos have the lowest overall mortality rate in the county, which may be due in part to
underreporting of ethnicity on death certificates. The leading causes of death in the county, as well as in
the state and nation, vary by age. In 2005-2007, heart disease and cancer together accounted for over
half (53%) of all county resident deaths, and are the leading causes of death in adults ages 45 and over.
The leading cause of death in children, adolescents, and young adults is accidents, in adults ages 25-44
the leading causes are cancer followed closely by accidents.

 Child Health: In general, the health of Orange County children is relatively good; however, there are
vulnerable groups within the population who lack consistent access to primary and preventive health
care such as children living in low income families without health care insurance. Analysis of the most
recent comparative data (2004-2006) shows improvement in hospitalization rates for children ages 0-4
for the following ambulatory care sensitive (ACS) conditions: asthma, pneumonia, and otitis media.
Improvements in hospitalization rates for otitis media are dramatic, and in 2004-2006 were below those
of the state, upstate, and HVR. Three-year hospitalization rates for Orange County infants and children
ages 0-4 remain consistently above those for the HVR for the other ACS conditions. The screening rate
for lead poisoning in children under 6 years of age remains
in
need of improvement. In addition,
findings of the 2003 NYSDOH Oral Health Survey were suggestive of a lack of access to or utilization of
preventive oral health services in third grade children.

 Adolescent Health: Adolescents in Orange County generally enjoy favorable health. Health risks in
teens most often include risky behaviors related to sexuality, alcohol, tobacco, and drugs, and accidents.
Pregnancy and birth rates in teens ages 15-19 have declined in Orange County from 1997-2006.
Nonetheless, in 2004-2006, pregnancy and birth rates were the second highest in the HVR; the highest
rates in the county are found in minority teens and in the county’s 3 cities. Indicators of youth risk
behaviors related to drug and alcohol use and for certain sexually-transmitted diseases indicate the need
for enhanced and affordable prevention, treatment and screening services for county youth.

 Maternal and Infant Health: The pregnancy rate for females ages 15-44 increased from 2004-2006;
Orange County’s rate remains above that for the HVR and Upstate. The percentage of women who are
receiving early prenatal care is well below HP2010 targets, and is lowest in teens, minority females, and
geographically, in the cities of Middletown and Newburgh. Birth rates were relatively constant from
2004-2006, and are, like pregnancy rates, higher than the average for the HVR and Upstate. Birth rates
are highest in Hispanic females. The city of Middletown has the highest birth rate in the county; the city
of Newburgh has the highest percentage of births to teens (ages 17 and under) and Medicaid/Self Pay
births. Infant mortality rates in the county have declined substantially since 2004, and the 2006 rate
met the HP 2010 target for the first time. Infant mortality (as a percentage of total births) is highest in
Black/African American infants, which is consistent with state and national findings. Orange County has
the second lowest rate of LBW in the HVR; within the county rates are highest in teens and in
Black/African Americans.

 Injuries: Overall mortality from unintentional injury or accidents in the County is higher than the HVR
and NYS. This is in part due to death rates from motor vehicle accidents (MVAs) which are higher than
the HVR, Upstate, and NYS. Rates of alcohol-related MVAs exceeded average rates for the region and for
NYS in 2004-2006.

 Disease Control: The number of cases of certain sexually transmitted diseases (STDs), in particular
Gonorrhea and Chlamydia has recently increased; a significant proportion of these cases are in
adolescents and demonstrate the need for enhanced prevention services, screening and treatment in
high risk groups. The case rate for HIV/AIDS is below that for Upstate and NYS. Advances in HIV
treatment have dramatically reduced AIDS mortality, and advances in testing, such as highly accurate
oral testing, will hopefully increase testing acceptance and frequency in high risk groups. Enhancements
to disease surveillance systems instituted by OCDOH permit closer monitoring for all reportable
communicable diseases, including TB and vaccine preventable diseases. The recent resurgence in
Pertussis cases in the county in children and adolescents is testimony of the need to achieve full
protection from vaccine preventable diseases through timely and complete immunization. Full protection
of county residents at highest risk from serious illness from influenza and pneumonia remains a priority;
efforts have been intensified with the arrival of pandemic H1N1 influenza. The rate of Lyme disease is

Orange County Community Health Assessment 2010-2013
3

high in the county as it is in several counties in the HVR, exceeds HP 2010 targets, and remains a
challenge. Rates for several enteric diseases, most notably Salmonellosis and Shigellosis, also require
close monitoring and follow-up in the communities where outbreaks occur. OCDOH continues to
enhance surveillance systems for the rapid notification of any unusual disease symptoms suggestive of
bioterrorism and for monitoring of influenza-like illness.

 Chronic Diseases: Although the mortality rates from cardiovascular diseases and cancer have declined
in recent years in county residents, categorically these diseases still account for the majority all adult
deaths in Orange County. Mortality rates from all causes and cardiovascular diseases are higher in
minorities than non-minorities in the county, and patterns suggest higher rates of mortality in
geographic areas with higher poverty levels and minority populations (the county’s cities). Analysis of
NYSDOH Prevention Quality Indicator health composites indicate excess hospital admission rates in the
county’s three cities related to certain chronic diseases. Comparative mortality rates from all
cardiovascular diseases in the county for 2004-2006 are below those for Upstate and NYS and slightly
above HVR rates.

Smoking is a major risk factor for cancer, cardiovascular diseases, and chronic respiratory conditions;
obesity is strongly linked with development of cardiovascular disease and breast cancer. Survey findings
from the 2003 NYSDOH Expanded Behavioral Risk Factor Surveillance System (EBRFSS) indicate rates of
smoking and obesity in county residents ages 18 and over far in excess of HP 2010 targets. Provisional
data from the 2008 EBRFSS suggest improvement in smoking rates by adults; however the prevalence of
overweight and obesity in adults have not shown improvement.

In terms of other chronic diseases, in 2004-2006 the diabetes mortality rate was above HVR, Upstate,
and NYS rates. Comparatively higher mortality rates from cirrhosis in males and alcohol-related motor
vehicle accidents in the county indicate the need for prevention and treatment programs and services
related to alcohol abuse. Rates of hospitalization for asthma in children as well as in adolescents and

adults exceed HP2010 targets for all ages except 15-24, and the average rate (all ages) was above that
for NYS, the second highest in the HVR, and below that for NYS. Asthma mortality rates in county
residents from 2004-2006 were the highest in the HVR, and well above those for Upstate and NYS.

Incidence rates for cancer by site in county males and females were higher than those for the HVR and
NYS for lung and bronchus, thyroid, and colorectal cancer; for females incidence rates were comparable
to the HVR for breast cancer and higher than the HVR for cervical cancer. The incidence rate for prostate
cancer was slightly higher than that the HVR and NYS rates. Overall cancer mortality rates in county
residents have shown improvement from 2004-2006. Gender disparities in disease incidence and
mortality are apparent for certain types of cancer and cardiovascular diseases - males are
disproportionately affected by heart disease, cerebrovascular disease (stroke), and cancer of the lung
and bronchus and colon; females are disproportionately affected by breast cancer.

To reduce chronic disease incidence, prevalence, and mortality, access to preventive education, primary
care, and early screening and detection services in the county should be expanded, especially for those
at highest risk for health disparities - the uninsured, recent immigrants, minorities, and low income
groups.


Refer to Sections IV and V - Local Health Priorities and Opportunities for Action for a detailed
summary of recommendations based on assessment findings.

Orange County Community Health Assessment 2010-2013

1

ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT

2010 - 2013

EXHIBIT LISTING
SECTION ONE: POPULATIONS AT RISK
A1. Demographic Information
Exhibit 1A.1 Trends in Orange County Municipal Population, 1970 -2000
(1970-2000 Census Comparisons, counts and percentage change)
Exhibit 1A.2a A Slice of Orange – Census 2000 Profile
1A.2b Annual Estimates of the Population for Minor Civil Divisions in New York, Listed
Alphabetically Within County: April 1, 2000 - July 1, 2007
Exhibit 1A.3 Orange County Population Density Map, 2000
Exhibit 1A.4 Orange County Population Growth Map, 1990-2000
Exhibit 1A.5a-c Age Distribution by Municipality: Orange County, 1990-2000
(1990-2000 Census Comparisons, counts and percentage change)
Exhibit 1A.6 Orange County Population by Gender and Age, 2000
(2000 Census counts and percentages)
Exhibit 1A.7a Orange County Population Map by Municipality, Age, Race, and Ethnicity, 1990
and 2000
1A.7b Annual County Resident Population Estimates by Age, Race, and Hispanic Origin,
July 2000 to July 2007
Exhibit 1A.8 Orange County Population by Single Race and Year, 1990-2000
(1990/2000 Census Comparisons, counts and percentage change)
Exhibit 1A.9a-c Orange County Population by Municipality and Hispanic Origin, 1990-2000
(1990/2000 Census Comparisons, counts and percentage change)
Exhibit 1A.10a-c White Population of Orange County by Age and Municipality, 1990-2000
(1990/2000 Census comparisons, counts and % change)
Exhibit 1A.11a-c Hispanic/Latino Population of Orange County by Age and Municipality, 1990-2000
(1990/2000 Census comparisons, counts and % change)
Exhibit 1A.12a-c Asian Population of Orange County by Age and Municipality, 1990-2000
(1990/2000 Census comparisons, counts and % change)

Exhibit 1A.13a-c Black or African American Population of Orange County by Age and Municipality,
1990-2000 (1990/2000 Census comparisons, counts and % change)
Exhibit 1A.14a Nativity and Region of Birth, Orange County Population, 1990-2000
1A.14b Foreign-Born Population by Zip Code, Orange County and Hudson Valley Region,
1990-2000
Exhibit 1A.15 Language Spoken at Home by Municipality: Orange County 2000
Exhibit 1A.16a-c Limited English Proficiency and Eligibility for Free or Reduced School Lunch by
School District, 2007-2008
Exhibit 1A.17 Educational Attainment Persons 25 and Over by Municipality, 2000
Exhibit 1A.18 Orange County Families by Municipality and Income, 2000
Exhibit 1A.19 Orange County High School Graduates Receiving NYS Regents Diplomas by School
District, 2006-2007
Exhibit 1A.20 Persons Below Poverty Level: Orange County, 2000
Exhibit 1A.21a-b Orange County Recipients of Financial and Medical Assistance by Type and
Municipality, December 2008.
Exhibit 1A.22 Orange County Department of Social Services Population Served, 2005-2008

Orange County Community Health Assessment 2010-2013

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Exhibit 1A.23 Demographic Profile of Public School Districts in Orange County, 2007-2008
(Racial/Ethnic Composition, Attendance, Suspension, and Drop-Out Rates, Socioeconomic
Indicators)
Exhibit 1A.24a-b Poverty Status by Age, Race, Ethnicity and Household Type in Orange County,
2000
Exhibit 1A.25 Employed Persons 16 and Over by Municipality and Occupation: Orange County,
2000
Exhibit 1A.26a-d Selected Housing Characteristics in Orange County by Municipality, 2000
(Count and percentages of: owner occupied units, renter-occupied units, pre-1950 housing

units, over 1 occupant per room, owner/renter costs of 30% + household income)
Exhibit 1A.27 Projected Population of Orange County 2005-2025
Exhibit 1A.28 Orange County Preliminary Population Projections by Age and Gender, 2005-2035
Exhibit 1A.29 Orange County Regional Comparisons, 2000
(Population by Age and Race/Employment & Poverty)
Exhibit 1A.30 Orange County Regional Comparisons, 2000
(Income & Educational Attainment/Median Family Income/Percent Aged 25+ with a College
or Graduate Degree)
Exhibit 1A.31 Orange County Municipalities by Zone, 2009

Exhibit 1A.32 Orange County Municipalities by Zip Code, 2009

A2. Health Status Information
Leading Causes of Death and Mortality Rates

Exhibit 1A.33a-c Mortality from All Causes by Gender, Ethnicity, Race, Age, and Zone, Orange
County and Upstate NY, 1998-2006
Exhibit 1A.34 Top 10 Causes of Death, Orange County, Upstate NY, and NYS, 2005-2007
Exhibit 1A.35 Number of Deaths from Leading Causes, Ranked within Age Groups, by Gender,
Orange County, 2004-2006

Family Health
Exhibit 1A.36a-e Hospital Discharge Rates for Ambulatory Care Sensitive (ACS) Conditions (Ages 0-
4, 5-14), Orange County, Hudson Valley Region, and NYS, 2004-2006
(Includes Asthma, Gastroenteritis, Otitis Media, and Pneumonia)
ACS Conditions Ages 0-4 and Asthma Ages 5-14, Ten Year Time Trends, Orange
County and Upstate NY, 1997-2006
Exhibit 1A.37 Percentage of Children Screened At or Around Age Two Years by County: 2002
Birth Cohort (2003-2005 Blood Lead Test Data), New York State Excluding New
York City (Map)

Exhibit 1A.38 Incidence Rate of Blood Lead Levels >
10 mcg/dL Among Children Under Six Years
by County: Three Year Average Rates, 2003-2005, New York State Excluding New
York City (Map)
Exhibit 1A.39 Selected Kids’ Well-Being Indicators, Orange County and Rest of State, 2003-2007
Exhibit 1A.40 Death Rates in Children and Adolescents, Orange County, Hudson Valley Region,
and NYS, 2004-2006
Exhibit 1A.41 Suicide and Self-Inflicted Injury Mortality and Hospital Discharge Rates (All Ages,
Ages 15-19), Orange County, Hudson Valley Region, and NYS, 2004-2006
Exhibit 1A.42a-c Teenage Pregnancy Rates by Age Group (10-14), (15-17), (15-19), Orange County
and Upstate NY, Ten Year Time Trends, 1997-2006
Exhibit 1A.43 Teenage Pregnancy Rate by Age Group (Ages 10-14, 15-17, 18-19), and Induced
Termination of Pregnancy (ITOPS) to Pregnancy Ratio (All Ages) Orange County,
Hudson Valley Region, and NYS, 2004-2006
Exhibit 1A.44a-c Teenage Birth Rates by Age Group (10-14), (15-17) (15-19), Orange County and
Upstate NY, Ten Year Time Trends, 1997-2006
Exhibit 1A.45 Teenage Births (Age 15-17) - Percentage per 100 Live Births, Orange County and
Upstate NY, Ten Year Time Trends 1997-2006

Orange County Community Health Assessment 2010-2013

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Exhibit 1A.46a-d Births to Teen Mothers (17 years of age and younger) per 100 Live Births by Race,
Ethnicity, Age and Zone, Orange County, 1998-2006
Exhibit 1A.47a-d Medicaid/Self-Pay Births Percentage per 100 Live Births, by Race, Ethnicity, Age
and Zone, Orange County, 1998-2006
1A.47e Medicaid/Self Pay Births Percentage per 100 Live Births, 1998-2006
Exhibit 1A.48a-d Births with Early (First Trimester) Prenatal Care by Race, Ethnicity, Age and Zone,
Orange County, 1998-2006

1A.48e Births with Early (First Trimester) Prenatal Care Percentage per 100 Live Births,
Orange County and Upstate NY, Ten Year Time Trends, 1997-2006
Exhibit 1A.49a-d Births with Late (Last Trimester, No Care) Prenatal Care by Race, Ethnicity, Age and
Zone, Orange County, 1998-2006
1A.49e Births with Late (Last Trimester, No Care) Prenatal Care Percentage per 100 Live
Births, Orange County and Upstate NY, Ten Year Time Trends, 1997-2006
Exhibit 1A.50a-d Early Gestational Age Births (< 37 weeks gestation) by Race, Ethnicity, Age and
Zone, Orange County, 1998-2006
1A.50e Short Gestation Births (< 37 weeks gestation) per 100 Live Births, Orange County
and Upstate NY, Ten Year Time Trends, 1997-2006
Exhibit 1A.51a-d Low Birthweight Births (<2500 grams), by Race, Ethnicity, Age and Zone, Orange
County, 1998-2006
1A.51e Low Birthweight Births (<2500 grams) Percentage Births per 100 Live Births,
Orange County and Upstate NY, Ten Year Time Trends 1997-2006
Exhibit 1A.52 Pregnancy Rates, Females Age 15-44, Orange County and Upstate, Ten Year Time
Trends, 1997-2006
Exhibit 1A.53a Birth Rates by Maternal Race, Ethnicity, Age and Zone, Orange County, 1998-2006
1A.53b Birth Rate (Ages 15-44), Orange County and Upstate NY, Ten Year Time Trends
1997-2006
Exhibit 1A.54 Maternal Mortality Rates, Orange County, Hudson Valley Region, and NYS, 2004-
2006
Exhibit 1A.55 Infant Mortality Rates by Race, Ethnicity, and Zone, Orange County 1998-2006
Exhibit 1A.56 Neonatal Mortality Rates by Race and Ethnicity, Orange County, 1998-2006
Exhibit 1A.57 Post Neonatal Mortality Rates, Orange County, 1998-2006
Exhibit 1A.58 Infant Mortality Rates, Orange County and Upstate NY, Ten Year Time Trends,
1997-2006
Exhibit 1A.59 Neonatal Mortality Rates, Orange County and Upstate NY, Ten Year Time Trends,
1997-2006
Exhibit 1A.60 Post-Neonatal Mortality Rates, Orange County and Upstate NY, Ten Year Time
Trends, 1997-2006

Exhibit 1A.61 Very Low Birthweight (<1,500 grams) Births, Orange County, Hudson Valley
Region, Number and Percentage per 100 Live Births, 2004-2006
Exhibit 1A.62 Newborn Drug-Related Discharges, Orange County, Hudson Valley Region, and
NYS, 2004-2006
Exhibit 1A.63 Comparison of Domestic Violence Reporting and Arrest Rates in New York State,
Analysis of the 1997 and 2000 Domestic Incident Statistical Databases – Domestic
Violence Reporting Practices by County
Exhibit 1A.64 Homicide Mortality, Orange County, Hudson Valley Region, and NYS, 2004-2006
Exhibit 1A.65a-b Mortality from Total Accidents by Gender, Ethnicity, Race, Age, and Zone, Orange
County and Upstate NY, 1998-2006
Exhibit 1A.66 Discharge Rates from Unintentional Injury by Age, Orange County, Hudson Valley
Region, and New York State, 2004-2006
Exhibit 1A.67 Mortality Rates from Unintentional Injury by Age, Orange County, Hudson Valley
Region, and New York State, 2004-2006
Exhibit 1A.68 Mortality from Motor Vehicle Accidents, Total and Alcohol-Related, Orange County,
Hudson Valley Region, and New York State, 2004-2006

Orange County Community Health Assessment 2010-2013

4

Exhibit 1A.69 Mortality from Motor Vehicle Accidents, Orange County and Upstate New York,
Ten Year Time Trends, 1997-2006
Exhibit 1A.70 Discharge Rates for Traumatic Brain Injury, Orange County, Hudson Valley Region,
and Upstate, 2004-2006
Disease Control – Communicable Disease
Exhibit 1A.71 Cases and Rates of Early Syphilis, (All Ages, Ages 15-19), and Congenital Syphilis,
Orange County, Hudson Valley Region, and NYS, 2004-2006
Exhibit 1A.72 Cases and Rates of Gonorrhea, (All Ages, Ages 15-19), Orange County, Hudson
Valley Region and NYS, 2004-2006

Exhibit 1A.73 Cases and Rates of Chlamydia by Gender, Race, Ethnicity, and Age, Orange
County, Hudson Valley Region, and NYS, 2004-2006
Exhibit 1A.74 Discharge Rates for Pelvic Inflammatory Disease, Orange County, Hudson Valley
Region, and NYS, 2004-2006
Exhibit 1A.75a Cases and Rates of AIDS, Orange County, Hudson Valley Region and NYS, 2004-
2006
1A.75b Cases and Rates of HIV Infection, Orange County, Hudson Valley Region, and
Upstate NY, 2000-2006
1A.75c Persons Living with AIDS and HIV Infection by Gender, Ethnicity, Race, and Age,
and Mode of Transmission/Risk Category, Orange County, Ryan White Mid-
Hudson Region, and Upstate NY, Cumulative to 2006.
Exhibit 1A.76a Trends in AIDS Mortality, Orange County and Upstate NY, Ten Year Time Trend,
1997-2006
1A.76b Trends in AIDS Mortality Orange County, Hudson Valley Region, and NYS, 1997-
2006
Exhibit 1A.77 HIV Positive Newborns, Orange County, Hudson Valley Region, and NYS, 2001-
2003
Exhibit 1A.78a Cases and Rates of Tuberculosis in Orange County, Hudson Valley Region, and
Rest of NYS, 2004-2006
1A.78b Cases and Rates of Tuberculosis by Gender, Ethnicity and Race, Orange County,
Hudson Valley Region, and Upstate NY, 1998-2006
Exhibit 1A.79 Total Cases and Rates of Selected Reportable Communicable Diseases, Orange
County, Hudson Valley Region, and Rest of NYS, 2004-2006

Disease Control – Chronic Disease

Exhibit 1A.80
Mortality from Pneumonia by Gender, Ethnicity, Race, Age, and Zone, Orange
County and Upstate NY, 1998-2006
Exhibit 1A.81 Mortality from Cardiovascular Disease by Gender, Ethnicity, Race, Age, and Zone,

Orange County and Upstate NY, 1998-2006

Exhibit 1A.82a-c Trends in Cardiovascular, Cerebrovascular, and Diseases of the Heart Mortality,
Orange County, 1997-2006
Exhibit 1A.83a
Admission Rates for Prevention Quality Indicators for Orange County Adult
Population, 2005-2006
1A.83b Discharge Rates for Diseases of the Heart, Cardiovascular Disease, and
Cerebrovascular Disease by Gender, Orange County, Hudson Valley Region and
Upstate NY, 2004-2006
Exhibit 1A.84a-b Mortality from Diseases of the Heart by Gender, Ethnicity, Race, Age, and Zone,
Orange County and Upstate NY, 1998-2006
Exhibit 1A.85a-b Mortality from Cerebrovascular Disease by Gender, Ethnicity, Race, Age, and Zone,
Orange County and Upstate NY, 1998-2006
Exhibit 1A.86 Cancer Incidence and Mortality Rates from all Causes by Gender, Orange County,
2001-2005
Exhibit 1A.87 Trends in Cancer Incidence and Mortality Rates by Gender, Orange County and
NYS, 1976-2005

Orange County Community Health Assessment 2010-2013

5

Exhibit 1A.88a Age-Adjusted Cancer Incidence Rates by Site and Gender, Orange County, 2001-
2005
1A.88b Discharge Rates for Neoplasms by Gender, Orange County, Hudson Valley Region,
and Upstate NY, 2004-2006
Exhibit 1A.89a-c Mortality from Malignant Neoplasms by Gender, Ethnicity, Race, Age, and Zone,
Orange County and Upstate NY, 1997-2005

Exhibit 1A.90 Lung and Bronchus Cancer, Incidence and Mortality Rates by Gender, Orange
County, Hudson Valley Region, and NYS, 2001-2005
Breast Cancer, Incidence and Mortality Rates, Orange County, Hudson Valley
Region, and NYS, 2001-2005
Cervical Cancer, Incidence and Mortality Rates, Orange County, Hudson Valley
Region, and NYS, 2001-2005
Exhibit 1A.91a-e Trends in Mortality Rates from Cancer: Lung and Bronchus, Breast, Cervical,
Colorectal, and Oral, Orange County and Upstate NY, 1997-2006
Exhibit 1A.92 Colorectal Cancer, Incidence and Mortality Rates by Gender, Orange County,
Hudson Valley Region, and NYS, 2001-2005
Prostate Cancer, Annual Incidence and Mortality Rates, Orange County, Hudson
Valley Region, and NYS, 2001-2005
Oral Cavity and Pharyngeal Cancer, Incidence and Mortality Rates by Gender,
Orange County, Hudson Valley Region, and NYS, 2001-2005
Exhibit 1A.93a-b Mortality from Diabetes by Gender, Ethnicity, Race, Age, and Zone, Orange County
and Upstate NY, 1998-2006
Exhibit 1A.94* Discharge Rates for Diabetes by Gender, Orange County and Upstate NY, 2004-
2006
Exhibit 1A.95a-b
Mortality from COPD/CLRD by Gender, Ethnicity, Race, Age, and Zone, Orange
County and Upstate NY, 1998-2006
Exhibit 1A.96
Discharge Rates for COPD/CLRD by Gender, Orange County and Upstate NY, 2004-
2006
Exhibit 1A.97 Trends in Asthma Mortality, Orange County and Upstate NY, 1997-2006
Exhibit 1A.98a-b Mortality from Cirrhosis of the Liver by Gender, Ethnicity, Race, Age, and Zone,
Orange County and Upstate NY, 1998-2006
Exhibit 1A.99 Discharge Rates for Cirrhosis of the Liver by Gender, Orange County and Upstate
NY, 2004-2006
B. Access to Care

Exhibit 1B.1 Hospital/Medical Center Services in Orange County New York, 2009
Exhibit 1B.2 Hospital/Medical Center Service Statistics: Orange County New York, 2008
Exhibit 1B.3 Community Health Center Services in Orange County New York, 2009
Exhibit 1B.4 Hospital/Medical Center and Community Health Center Locations in Orange
County New York, 2009
Exhibit 1B.5 Certified Home Health Agencies and Long Term Home Health Care Programs in
Orange County New York, 2009
Exhibit 1B.6 Nursing Facilities in Orange County New York, 2009
Exhibit 1B.7 Managed Care Plans in Orange County New York, 2009
Exhibit 1B.8 Expanded BRFSS Access to Care Results, Orange County, Hudson Valley
Region, and NYS, 2003

Orange County Community Health Assessment 2010-2013

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C. Behavioral Risk Factors
Exhibit 1C.1 Expanded BRFSS Results for Core Modules, Orange County, Hudson Valley Region
and Rest of NYS, 2003, with HP 2010 comparisons
(Includes: Health Status/Healthy Days, Health Care Access, Exercise, Diabetes, Asthma,
Arthritis, Tobacco Use, Tobacco ETS, Alcohol Consumption, Mammography, Sexual
Behavior, Family Planning, Cardiovascular Disease, Prostrate Cancer Screening, Colorectal
Screening)
Exhibit 1C.2 Expanded BRFSS Results for Optional Modules, Orange County, Hudson Valley
Region and Rest of NYS, 2003, with HP 2010 comparisons
(Includes: Cholesterol Awareness, Disability, Nutrition, Hypertension Awareness, Injury
Control (Falls), Immunization, Oral Health, Weight Control, and Women’s Health)
Exhibit 1C.3 Adolescent/Young Adult Suicide (Age 15-19) Annual Death Rate Per 100,000
Residents Ages 15-19, 2004-2006
Exhibit 1C.4a-b Youth Risk Indicator Rates, 2002

D. The Local Health Care Environment
Exhibit 1D.1 Regional Perspective Map


SECTION TWO: LOCAL HEALTH UNIT CAPACITY PROFILE

Exhibit 2.1a-h Orange County Department of Health Organization Charts, 2009
Exhibit 2.2 Orange County Departmental Program Listing and Contact Numbers, 2009
Exhibit 2.3 Orange County Department of Health Intervention Services Schedule, 2009
Exhibit 2.4 Orange County Department of Health Clinic Services Schedule, 2008-2009
Exhibit 2.5 Orange County Department of Health FTEs by Division, 2009

SECTION THREE: PROBLEMS AND ISSUES IN THE COMMUNITY

Exhibit 3.1 Resource Guide for Health and Related Services, Orange County, 2009
Exhibit 3.2 Listing of OCDOH Staff Community Affiliations, 2009

SECTION FOUR: LOCAL HEALTH PRIORITIES

Exhibit 4.1a-b Orange County Department of Health Community Agency/Provider and
Resident/Health Consumer Local Health Needs Survey Forms, 2009
Exhibit 4.2a-e CHA Community Health Town Meeting Regions
Exhibit 4.3 CHA Prevention Agenda Workgroup Roster

Orange County Community Health Assessment 2010-2013

7

LIST OF FIGURES
SECTION ONE: POPULATIONS AT RISK
Figure 1 Top 10 Leading Causes of Death in Orange County, New York, 2005-2007
Figure 2 Children Age 19-35 Months That Are Fully Immunized (4:3:1:3:3), New York State,
2000-2006
Figure 3 Orange County Infant Mortality Rate per 1,000 Live Births, 1997-2006
Figure 4 Orange County Cardiovascular Disease Death Rate per 100,000 Population, 1997-
2006
Figure 5 Orange County Diseases of the Heart Death Rate per 100,000 Population, 1997-
2006
Figure 6 Orange County Cerebrovascular Disease (Stroke) Death Rate per 100,000

Population, 1997-2006
Figure 7 Orange County Female Breast Cancer Death Rate per 100,000 Female Population,
1997-2006
Figure 8 Orange County Diabetes Death Rate per 100,000 Population, 1997-2006
Figure 9 Core Behavioral Risk Factors Overview
Figure 10 Current Use of Cigarettes Among Middle and High School Students by Region, New
York State, 2000-2006
Figure 11 Percent of Women Who Smoked During the Last 3 Months of Pregnancy, New York
State (Excluding New York City), 1995-2003
Figure 12 Binge Drinking Among Adults Aged 18 Years or Older, New York State, 1995-2003
Figure 13 High School Students Reporting Binge Drinking During the Past Month, New York
State, 1997-2003
Figure 14 Adults (aged 18 years and older) Who Have Been Told They Have High Blood
Cholesterol: New York BRFSS, 1991-2001
Figure 15 Adults (aged 18 years and older) Who Have Been Told They Have High Blood
Pressure: New York BRFSS, 1991-2001
Figure 16 NYSDOH Oral Health Survey of Third Grade Children Summary Results For Orange
County, 2003

SECTION TWO: LOCAL HEALTH UNIT CAPACITY PROFILE

Figure 1 CHAA/LTHHCP Major Diagnostic Categories by Year, 2007-2008
Figure 2 CHAA/LTHHCP Visits by Year by Discipline, 2004-2007
Figure 3 Tuberculosis Control Program Tests and Cases, 2004-2008
Figure 4 Total Annual Visits, OCDOH STD Clinics, 2004-2008
Figure 5 Sexually Transmitted Disease Cases by Year, 2004-2008
Figure 6 HIV Case Interviews and Partners Identified for Notification, 2004-2008
Figure 7 HIV Clinic Visits by Year, 2004-2008
Figure 8 Immunization Program Vaccinations, 2004-2008
Figure 9 Early Intervention Clients and Costs, 2003-2008

Figure 10 Preschool Special Education Clients and Costs, 1994-2004
Figure 11 Early Intervention and ICHAP Referrals and Active Cases, 2003-2008
Figure 12 ATUPA 5 Year Comparison, 2003-2008
























Orange County Community Health Assessment 2010-2013 Guide to Statistical Terms 1

GUIDE TO STATISTICAL TERMS

Weight Statistics

• Underweight is defined as less than 5th percentile based on the 2000 CDC growth chart
percentiles for weight-for length for children under 2 years and a body mass index (BMI)-for-age
for children 2 years and older.
• Overweight is defined as less than or equal to the 95th percentile based on the 2000 CDC growth
chart percentiles for BMI-for-age.

Pregnancies

• Pregnancies are the sum of the number of live births, induced terminations of pregnancies, and
fetal deaths (20+ weeks gestation).
• Pregnancy rates are the number of pregnancies in a particular age group per 1,000 females in
that same age group.

Birth Rates

• Birth rates are the annual number of live births to women in a particular age group per females in
that same age group.

Induced Abortion to Birth Ratio

• This is computed by dividing the number of induced terminations of pregnancy by the number of
live births and then multiplying by 100.

Mortality Rates

• The mortality rates are rates per 100,000 population with the exception of work related
mortality.
• Work related mortality is per 100,000 employed (Number employed provided by the NYS
Department of Labor).
• Both crude and age adjusted rates are presented.

Hospitalization Rates

• The rates presented are per 100,000 persons in a specific age group or the total population.

Birth and Death Related Indicators

• Information is extracted from birth, death and fetal death certificates.
• Race is categorized as White, Black and Other. Total includes race not stated.
• Hispanic is a separate count equal to Hispanic White, Hispanic Blacks, Hispanic Others and
Hispanic Not Stated. When percentages are calculated records with missing information for the
indicator of interest are excluded from the calculation.

The following are definitions of these indicators:

• Infant Mortality: number of deaths less than 1 year of age per 1,000 live births.
• Neonatal Mortality: number of deaths less than 28 days old per 1,000 live births.
• Postneonatal Mortality: number of deaths between 28+ days old and under 1 year of age per
1,000 live births.

Orange County Community Health Assessment 2010-2013 Guide to Statistical Terms 2

• Spontaneous Fetal Deaths (20+ weeks gestation) - Spontaneous fetal death rate is the number of
spontaneous fetal deaths (gestation 20 weeks or more) per 1,000 spontaneous fetal deaths
(gestation 20 weeks or more) plus live births.

• Low Birthweight Births - Low birthweight births are the number of infants born weighing less than
2500 grams.
• Very Low Birthweight Births - Very low birthweight births are the number of infants born weighing
less than 1500 grams.
• Prematurity Rate - Prematurity rate is the percent of infants born before 37 weeks gestation.
• Maternal Mortality Rate - Maternal mortality rate is the number of deaths due to complications of
pregnancy, childbirth and puerperium (ICD-9 codes 630-676 before 1999 or ICD-10 codes O00-
O99 in 1999 or later) per 100,000 live births.
• Early Prenatal Care - Early prenatal care is the number of births to women who began prenatal
care within the first three months of pregnancy (first trimester).
• Late or No Prenatal Care - Late or no prenatal care is the number of births to women who began
prenatal care within the last 3 months of pregnancy (3rd trimester) or not at all.

AIDS Case Rate

• AIDS case rates are presented as rates per 100,000 population.

Newborn HIV Seropositive Rate

• The seropositive rate is the percent of positive results. The presence of HIV antibodies in
newborns indicates infection of the mother and not necessarily infection of the infant.

Syphilis and Gonorrhea

• Early Syphilis includes any of the first three stages of syphilis (primary, secondary or latent of less
than 1 year duration).
• Congenital syphilis is passed from mother to infant during pregnancy. Rates for syphilis and
gonorrhea are rates per 100,000 population.
• Congenital syphilis rates are per 10,000 births.

2010-13 Community Health Assessment
1

COVER PAGE

County: Orange


Local Health Department Address: 124 Main Street, Goshen, New York 10924


Telephone: 845-291-2332 Fax: 845-291-2341

Submitted by: Jean M. Hudson, M.D., M.P.H.
E-MAIL:

Prepared by: CHA Development Team



GENERAL COUNTY INFORMATION

Health Department Type (please check one
):

⌧ Full Service Less than Full Service


Organization Type (please check one):

⌧ Single Agency Multiple Agency,
(Health Only) please list: __________________________

__________________________


2010-13 Community Health Assessment
2

CHA – Prevention Agenda Description and Priority Areas

This form provides a summary of the Prevention Agenda activities and priorities, which are
described in more detail within the CHA document.
1. With whom did you partner to establish the 2-3 Prevention Agenda priority areas?
Please check all that apply and where lines are provided, list partners:

X
Hospitals: Bon Secours Charity Health System (3 sites)
Orange Regional Medical Center (2 sites)

St. Luke’s/Cornwall Hospital (2 sites)

X
CBOs: Occupations; Maternal-Infant Services Network; Independent Living;
Mobile Life; Volunteer EMS Services; Home Care, Adult Day Care, and
Assisted Living Agencies; Safe Homes; Safe Harbors; and Breast Cancer
Options.

X

Other local government agencies: Office for the Aging, Department of Social Services,
Department of Mental Health, Youth Bureau, Child Protective Services, Municipal EMS
Services, and Municipal Department of Human Services and Senior Services.

X
Not for Profits: Greater Hudson Valley Family Health Care, Hudson River Health
Care,Middletown Community Health Centers, YMCA, YWCA, Head Start ,and TASA.


X
Other LHDs, please list: All Hudson Valley Region LHDs (Collaborative Regional
Health Survey of Local Health Needs): Dutchess, Putnam, Rockland, Sullivan,

Ulster, and Westchester.

X Primary/medical care providers X Schools

X Faith organizations __ HMOs

X Businesses X Rural Health Networks (MISN)

X Others: County Legislators, Town Supervisors, Board of Health Members, Local
Police Departments.



2. What are the 2-3 priority areas your collaborative has selected, please check:

X
Access to Quality Health Care

___Tobacco Use
X Health Mothers/Babies/Children
___Physical Activity/Nutrition
___Unintentional Injury
___Healthy Environment
X
Chronic Disease
___Infectious Disease
___Community Preparedness
___Mental Health/Substance Abuse

2010-13 COMMUNITY HEALTH ASSESSMENT

County: Orange


3
3. Did your collaborative use the services of a contractor to assist you in the process you used to
arrive at your priority areas? Y/N
Please provide their contact information: Mary L. Bevan, M.P.H, Public Health Consultant



4. What was your collaborative process? Check all that apply:
X
In-person meetings
X Phone calls
X Conference calls
X Other – Regional Health Town Meetings
Please briefly describe your process:

Several integrated strategies were used to facilitate and invite agency, health care provider, and
community input in establishing local health priorities. The first strategy was ongoing
communication with and consultation from the community collaborators listed in Section III,
Exhibits 3.1 and 3.2. OCDOH representatives meet with these groups regularly to discuss
community-based health initiatives and emerging health and service delivery needs. In addition, two
versions of a regional survey of local health needs were developed collaboratively with
representatives from all HVR counties with assistance from health researchers at New York Medical
College School of Public Health. The surveys were administered in the community and online via
the County’s website to solicit input on local health needs from a diversity of community-based
health providers, community agencies, and residents. As part of the local health priority
identification process, OCDOH and local hospital leads co-convened Health Town Meetings in each
of the county’s 4 health planning regions, to gain further input and insight of health needs at the
community level. These meetings were hosted by the hospital or medical center based each region.
Town meetings included an overview of the CHA/CSP process, Prevention Agenda Priorities, and
discussion of leading health indicators in each priority area.
5. Please indicate the individuals from your agency who were involved in the process. Check all
that apply.
X
Local Public Health Director/Commissioner
X Nurses
X Supervising
X Line/program
X Sanitarians/environmental engineers
X Physicians/PAs
X Community Planners
X Health Educators
X Others, please provide title: Nurse Epidemiologist & SUNY Albany SPH Epidemiology Fellow

6. Were any of the following individuals involved in the process?

Board of Health member(s) X Y ___N
Member(s) of the county legislature X Y ___N
County Executive/Administrator X Y ___N