Bakersfield Memorial Hospital - Dignity Health
Bakersfield Memorial HospitalCommunity Health Needs Assessment2019
Table of ContentsExecutive Summary . 7Report Adoption, Availability and Comments. 10Assessment Purpose and Organizational Commitment . 11Community Definition . 12Community Need Index . 12Population . 14Race/Ethnicity . 16Language . 17Veterans . 19Citizenship . 19Assessment Process and Methods . 20Collaborative Process . 20Secondary Data Collection . 20Primary Data Collection . 20Public Comment . 22Project Oversight . 23Consultant . 23Social Determinants of Health . 24Social and Economic Factors Ranking . 24Poverty . 25Unemployment. 26Free and Reduced-Price Meals . 26Public Program Participation. 27Community Input – Economic Insecurity. 27Food Insecurity . 29Community Input – Food Insecurity . 30Households . 31Homelessness . 33Bakersfield Memorial Hospital2019 Community Health Needs Assessment2
Community Input – Housing and Homelessness . 33Educational Attainment . 35Preschool Enrollment. 36Reading to Children . 36Parks, Playgrounds and Open Spaces . 36Crime and Violence . 37Community Input – Violence and Community Safety . 38Air Quality . 40Community Input – Environmental Pollution . 40Health Care Access. 42Health Insurance Coverage . 42Sources of Care . 43Difficulty Accessing Care . 44Access to Primary Care Community Health Centers . 45Delayed or Forgone Care . 46Lack of Care Due to Cost, for Children . 46Community Input – Access to Health Care . 46Dental Care . 47Community Input – Dental Care. 48Birth Indicators . 50Births . 50Delivery Paid by Public Insurance or Self-Pay . 50Teen Birth Rate. 50Prenatal Care. 50Low Birth Weight. 51Premature Birth. 51Mothers Who Smoked Regularly During Pregnancy. 51Infant Mortality . 51Breastfeeding. 52Bakersfield Memorial Hospital2019 Community Health Needs Assessment3
Community Input – Birth Indicators . 52Leading Causes of Death . 54Life Expectancy at Birth . 54Leading Causes of Death . 54Heart Disease and Stroke . 55Cancer . 55Chronic Lower Respiratory Disease . 56Alzheimer’s Disease . 56Community Input – Alzheimer’s Disease . 57Unintentional Injury . 58Community Input – Unintentional Injury . 58Diabetes . 59Liver Disease . 59Kidney Disease . 59Pneumonia and Influenza . 59Drug Overdose . 60Homicide . 61Suicide . 61HIV. 61Acute and Chronic Disease . 62Hospitalization Rates by Diagnoses . 62Emergency Room Rates by Diagnoses . 62Diabetes . 62High Blood Pressure . 64Heart Disease . 65Asthma . 66Cancer . 67HIV. 68Coccidioidmycosis . 68Bakersfield Memorial Hospital2019 Community Health Needs Assessment4
Community Input – Chronic Diseases. 68Health Behaviors . 70Health Behaviors Ranking . 70Health Status . 70Disability . 70Sexually Transmitted Infections . 70Teen Sexual History . 71Community Input – Sexually Transmitted Infections . 71Overweight and Obesity . 72Fast Food . 74Soda/Sugar-Sweetened Beverage (SSB) Consumption . 74Adequate Fruit and Vegetable Consumption . 75Access to Fresh Produce . 75Physical Activity . 75Community Input – Overweight and Obesity . 77Mental Health . 79Satisfaction with Quality of Life . 79Mental Health. 79Mental Health Care Access . 79Community Input – Mental Health. 80Substance Use and Misuse. 82Cigarette Smoking . 82Alcohol . 82Marijuana Use, Youth . 83Opioid Use . 83Community Input – Substance Use and Misuse . 83Preventive Practices. 85Flu Vaccines . 85Immunization of Children . 85Bakersfield Memorial Hospital2019 Community Health Needs Assessment5
Mammograms . 85Pap Smears . 86Colorectal Cancer Screening . 86Community Input – Preventive Practices . 86Prioritized Description of Community Health Needs . 88Review of Primary and Secondary Data . 88Priority Health Needs . 88Resources to Address Community Health Needs . 91Impact of Actions Taken . 95Attachment 1. Benchmark Comparisons . 102Attachment 2. Community Stakeholder Interviewees . 103Attachment 3. Community Survey Report . 105Bakersfield Memorial Hospital2019 Community Health Needs Assessment6
Executive SummaryThe purpose of this Community Health Needs Assessment (CHNA) is to identify andprioritize health needs of the community served by Dignity Health – BakersfieldMemorial Hospital. The priorities identified in this report help to guide the hospital’scommunity health improvement programs and community benefit activities, as well asits collaborative efforts with other organizations that share a mission to improve health.This CHNA report meets requirements of the Patient Protection and Affordable Care Actand California Senate Bill 697 that not-for-profit hospitals conduct a Community HealthNeeds Assessment at least once every three years.The Community Health Needs Assessment process was overseen by the Kern CountyCommunity Benefit Collaborative. The Collaborative is comprised of Delano RegionalMedical Center, Dignity Health (Mercy and Memorial Hospitals), Kern Medical, AdventistHealth (Bakersfield and Tehachapi Valley), Valley Children’s Healthcare and KaiserPermanente.Community DefinitionBakersfield Memorial Hospital is located at 420 34th Street, Bakersfield, California,93301.The service area for the hospital includes four communities consisting of 13 ZIPCodes in Kern County. Memorial determines the community for the purposes of thisCHNA by assigning ZIP Codes based on patient discharges. Over 70% of inpatientdischarges constitute the Primary Service Area.One tool used to assess health need is the Community Need Index (CNI) created andmade publicly available by Dignity Health and Truven Health Analytics. The CNIanalyzes data, at the ZIP Code level, on five factors known to contribute or be barriersto health care access: income, culture/language, education, housing status, andinsurance coverage. CNI scores range from 1.0 (lowest barriers) to 5.0 (highestbarriers) for each ZIP Code in the hospital service area. The average CNI score by ZIPCode was 4.1, indicating a High Need service area.Assessment Process and MethodsSecondary and primary data were collected to complete the CHNA. Secondary datawere collected from a variety of local, county and state sources to present ademographic profile, social determinants of health, health care access, birth indicators,leading causes of death, acute and chronic disease, health behaviors, mental health,substance use and misuse, and preventive practices. The analysis of secondary datayielded a preliminary list of community health needs, which then informed primary dataBakersfield Memorial Hospital2019 Community Health Needs Assessment7
collection. The following criteria were used to identify community health needs:1. The size of the problem (relative portion of population afflicted by the problem)2. The seriousness of the problem (impact at individual, family, and communitylevels)The following community health needs were determined: Access to health care Alzheimer’s disease Birth indicators Chronic diseases (asthma, cancer, diabetes, heart disease, kidney disease,liver disease, lung disease, stroke, Valley Fever) Dental care/oral health Economic insecurity Environmental pollution Food insecurity Housing and homelessness Mental health Overweight and obesity Preventive practices Sexually transmitted infections Substance use and misuse Unintentional injuries Violence and injuryPrimary data were obtained through community surveys and interviews with 41 keycommunity stakeholders, public health, and service providers, members of medicallyunderserved, low-income, and minority populations in the community, and individuals ororganizations serving or representing the interests of such populations. The primarydata collection process was designed to validate secondary data findings, identifyadditional community issues, solicit information on disparities among subpopulations,ascertain community assets potentially available to address needs and discover gaps inresources.Priority Significant NeedsCalculations from community stakeholders prioritized the community health needs. Abrief description of the top six priority needs follows: Housing and homelessness – 40.9% of service area families spend 30% or moreof their income on housing. Despite a downward trend in homelessness in recentBakersfield Memorial Hospital2019 Community Health Needs Assessment8
years, there was a spike of 9% in homelessness from 2017 to 2018, and a 46%increase in the number of unsheltered homeless. Many stakeholders commentedthere are not enough homeless housing resources in Kern County.Mental health – Among adults in Kern County, 12% had experienced seriouspsychological distress in the past year. Serious psychological distress wasexperienced by 4% of area teens. Stakeholders commented on the lack of countyresources available to address mental health issues. As well, there continues to be astigma associated with mental illness.Access to health care – Health insurance coverage is a key component toaccessing health care. The Healthy People 2020 objective is for 100% insurancecoverage for all population groups. In the hospital service area, 86.5% of residentshave insurance coverage. Health care coverage was higher among children, ages 0to 17. 94.4% of children and 80.6% of adults have health insurance. 5.7% of KernCounty adults had difficulty finding a primary-care doctor and 11.3% had difficultyobtaining specialty care.Economic insecurity – Among residents in the service area, 23.7% are at or below100% of the federal poverty level (FPL) and 47.8% are low-income (200% of FPL orbelow). These rates are higher than county and state rates of poverty. 32.1% ofservice area children live in poverty and 12.6% of area seniors live in poverty.Substance use and misuse – In Kern County, 14.6% of adults smoke cigarettes.This is higher than the state rate (12.1%) and the Healthy People 2020 objective(12%). Among Kern County adults, 32.6% had engaged in binge drinking in the pastyear, and 12.5% of Kern County teens binge drank in the past month. Opioidoverdose visits (excluding heroin) to the ER in Kern County were 18.9 visits per100,000 persons, a higher rate than found in the state (10.3 per 100,000 persons).Community members noted increases in meth and opioid use and the increase invaping among the youth.Chronic diseases – Heart disease, cancer and lung disease are the top threecauses of death in the service area. Among Kern County adults, 15.6% have beendiagnosed as pre-diabetic, and 11.1% reported they have been diagnosed withdiabetes. 7.8% of adults have been diagnosed with heart disease and 34% havebeen diagnosed with high blood pressure. In Kern County, 23.7% of children, underage 18, have been diagnosed with asthma.Resources Potentially AvailableThe resources potentially available to address the community health needs aredocumented in this report. Resources are also available at Healthy Kern Countywww.healthykern.org and 211 Kern County at http://www.capk.org/211Kern/.Bakersfield Memorial Hospital2019 Community Health Needs Assessment9
Report Adoption, Availability and CommentsThis CHNA report was adopted by the Memorial Community Board on May 22, 2019.This report is widely available to the public on the hospital’s website and a paper copy isavailable for inspection, upon request, at Memorial Hospital’s Administration Office.Written comments on this report can be submitted to Memorial Hospital’s AdministrationOffice at 420 34th Street, Bakersfield, California, 93301 or by email through the websiteat it-report-health-needs-assessment.Bakersfield Memorial Hospital2019 Community Health Needs Assessment10
Assessment Purpose and Organizational CommitmentThe purpose of this Community Health Needs Assessment (CHNA) is to identify andprioritize health needs of the community served by Dignity Health – BakersfieldMemorial Hospital. The priorities identified in this report help to guide the hospital’scommunity health improvement programs and community benefit activities, as well asits collaborative efforts with other organizations that share a mission to improve health.This CHNA report meets requirements of the Patient Protection and Affordable Care Actand in California Senate Bill 697 that not-for-profit hospitals conduct a CommunityHealth Needs Assessment at least once every three years. The Community HealthNeeds Assessment process was overseen by the Kern County Community BenefitCollaborative. The Collaborative is comprised of Delano Regional Medical Center,Dignity Health (Mercy and Memorial Hospitals), Kern Medical, Adventist Health(Bakersfield and Tehachapi Valley), Valley Children’s Healthcare and KaiserPermanente.Dignity Health Mission StatementWe are committed to furthering the healing ministry of Jesus. We dedicate ourresources to: Delivering compassionate, high-quality, affordable health services; Serving and advocating for our sisters and brothers who are poor anddisenfranchised; and Partnering with others in the community to improve the quality of life.Bakersfield Memorial Hospital2019 Community Health Needs Assessment11
Community DefinitionBakersfield Memorial Hospital is located at 420 34th Street, Bakersfield, California93301.The service area for the hospital includes four communities consisting of 13 ZIPCodes in Kern County. Memorial determines the community for the purposes of thisCHNA by assigning ZIP Codes based on patient discharges. Over 70% of inpatientdischarges constitute the Primary Service Area.Memorial Hospital Service AreaPlace*LamontZIP Code93301, 93304, 93305, 93306, 93307, 93308,93309, 93311, 93312, 9331393241Shafter93263Bakersfield93268Taft*When place names are used within the report, they primarily refer to the geographic area covered by aZIP Code, rather than the incorporated city that bears that name.Community Need IndexOne tool used to assess health need is the Community Need Index (CNI) created andmade publicly available by Dignity Health and Truven Health Analytics. The CNIanalyzes data, at the ZIP Code level, on five factors known to contribute or be barriersto health care access: income, culture/language, education, housing status, andinsurance coverage. Scores from 1.0 (lowest barriers) to 5.0 (highest barriers) for eachfactor are averaged to calculate a CNI score for each ZIP Code in the community.Research has shown that communities with the highest CNI scores experience twicethe rate of hospital admissions for ambulatory care sensitive conditions as those withthe lowest scores.Among Memorial Hospital service area ZIP Codes, all but four scored higher than 4.0,making them High Need communities. The following map depicts the Community NeedIndex for the hospital’s geographic service area based on national need.Bakersfield Memorial Hospital2019 Community Health Needs Assessment12
Bakersfield Memorial Hospital2019 Community Health Needs Assessment13
PopulationThe population in the Memorial Hospital (Memorial) service area is 578,397. Thepopulation largely lives in a densely populated area, with 582.85 persons per squaremile, as compared to 107.15 persons per square mile for Kern County.Population578,397871,337Total Land Area(Square Miles)992.368,131.93Population Density(Per Square Mile)582.85107.1538,654,206155,792.65248.11Total PopulationMemorial Service AreaKern CountyCaliforniaSource: U.S. Census Bureau, American Community Survey, 2012-2016, DP05. http://factfinder.census.gov.Source geography: Tract. Accessed from CARES Engagement Network. http://www.engagementnetwork.org/assessmentFrom 2011 to 2016, the population of the service area increased by 5.9%, which ishigher than the 4.8% increase in population countywide.Total Population and Change in Population, 2011-2016Total populationChange in population, 2011-2016Memorial Service Area578,3975.9%Kern County871,3374.8%Source: U.S. Census Bureau, American Community Survey, 2007-2011 & 2012-2016, DP05. http://factfinder.census.govIn the service area, 49.7% of the population is male and 50.3% is female.Population by GenderMaleFemaleMemorial ServiceArea49.7%50.3%Kern CountyCalifornia51.3%48.7%49.7%50.3%Source: U.S. Census Bureau, American Community Survey, 2012-2016, DP05. http://factfinder.census.govChildren and youth, ages 0-17, make up 30.8% of the population. 60.0% are adults,ages 18-64, and 9.2% of the population is seniors, 65 and over. The service area has ahigher percentage of youth, ages 0-17, and a lower percentage of adults, ages 35-84,than the county.Population by Age0–45–910 – 14Memorial ServiceArea8.8%8.8%8.3%Bakersfield Memorial Hospital2019 Community Health Needs AssessmentKern CountyCalifornia8.3%8.4%8.0%6.5%6.6%6.6%14
15 – 1718 – 2021 – 2425 – 3435 – 4445 – 5455 – 6465 – 7475 – 8485 Memorial 1.1%Kern 1.8%Source: U.S. Census Bureau, American Community Survey, 2012-2016, DP05. http://factfinder.census.govBakersfield 93305, 93307, Lamont and Shafter ZIP Codes have the largest percentagesof youth, ages 0-17, in the service area. Bakersfield ZIP Codes 93301 and 93309 havethe highest percentage of seniors in the service area. The weighted average of themedian age in the service area is 30.2 years, which is younger than the median countyage of 31.2 and the median state age of 36.0.Population by Youth, Ages 0-17, and Seniors, Ages 65 ZIP eldBakersfieldLamontShafterTaftMemorial Service AreaKern uthAges 0 – 7%35.6%35.4%30.5%30.8%29.5%23.7%SeniorsAges 65 3%8.6%9.2%9.9%12.9%Median 728.430.2*31.236.0Source: U.S. Census Bureau, American Community Survey, 2012-2016, DP05. http://factfinder.census.gov *Weighted averageSeniors living alone may be isolated and lack adequate support systems. In the servicearea, rates of seniors living alone range from 13.1% in Bakersfield 93313 to 31.7% inBakersfield 93301.Bakersfield Memorial Hospital2019 Community Health Needs Assessment15
Seniors Living AloneZIP 9.7%Taft9326825.1%Kern County22.9%California
The Collaborative is comprised of Delano Regional Medical Center, Dignity Health (Mercy and Memorial Hospitals), Kern Medical, Adventist Health (Bakersfield and Tehachapi Valley), Valley Children’s Healthcare and Kaiser Permanente. Community Definition . Bakersfield Memorial Hospital is located at 420 34th Street, Bakersfield, California,
15-A1 Bakersfield Superior Court 1315 Truxtun Ave, 1661 L Street Bakersfield 93301 Kern SRO 15-A2 Bakersfield Superior Court Modular 1415 Truxtun Avenue Bakersfield 93301 Kern SRO 15-C1 Bakersfield Juvenile Center 2100 College Ave. Bakersfield 93305 Kern SRO 15-D1 Delano/North Kern Court 1122 Jefferson St. Delano 93215 Kern SRO
Marian Regional Medical Center, and Mercy Southwest Hospital operates under a consolidated license issued to Mercy Hospital (in Bakersfield). 5 The four facilities are Bakersfield Memorial Hospital, Community Hospital of San Bernardino, Saint Francis Memorial Hospital, and Sierra
Aug 01, 2017 · Bakersfield Memorial Hospital – Dial 77, Dial 70 for Security Kern Medical Center – Dial 5# Mercy Hospital & Mercy Southwest Hospital – Dial 7777 San Joaquin Hospital – Dial 700 Delano Regional Medical Center – Dial 0 Bakersfield Heart Hospital
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accomplish this goal, the Article explores the concept of human dignity, a fundamental right yet to be invoked in the context of substantive criminal law. The U.S. Supreme Court's jurisprudence invokes conflicting accounts of human dignity: liberty as dignity, on the one hand, and communitarian virtue as dignity, on the other.
Marian Regional Medical Center—Santa Maria Other Coastal Surgical Institute—Pismo Beach Plaza Surgery Center—Santa Maria Templeton Surgery Center—Templeton . Millennium Surgery Center Inc.—Bakersfield Mercy Hospice—Bakersfield Mercy Memorial Home Health—Bakersfield
Bakersfield Homeless Center) Awarded contract in 2020. -Establish direct partnerships with Bakersfield-Kern-Regional Homeless Collaborative and Bakersfield Homeless Center. -Staff HMIS training via Kern Behavioral Health and Recovery Services. -directly connect patients who are homeless with supportive services and housing. Source of Data:
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