You are on page 1of 53

EVERYTHING’S

BIGGER IN TEXAS
Including Health Disparities…
Dallas County, Texas
Dallas County Community
Needs Index
Community Need Index Dallas County
Zip codes – 75019 & 75217

North Dallas

2.4

5.0
South Dallas

Source: http://cni.chw-interactive.org
The Big Picture

Category NW North Dallas SE South Dallas

Population 41,069 84,371

Per capita income $30-47,000 $13-17,000

Premature Deaths (per 100K) 3,744 8,000

Families in Poverty by % 7-10% 20-30%

CNI 2.4 5

% w/o Health Insurance 12% 25%

% Single Parent Household 0.10-19.9% 34.5-75%

Food Desert No Yes

PCP per 100,000 ~ 90 ~ 75

Data from DallasCounty.org
Dallas Households
Family Structure Comparison
The Racial Makeup of 75019
(North Dallas )

Source: U.S. Census Bureau
The Racial Makeup of 75019
(North Dallas)

Source: U.S. Census Bureau
The Racial Makeup of 75019
(North Dallas )

Source: U.S. Census Bureau
The Racial Makeup of 75217
(South Dallas)

Source: U.S. Census Bureau
The Racial Makeup of 75217
(South Dallas)

Source: U.S. Census Bureau
The Racial Makeup of 75217
(South Dallas)

Source: U.S. Census Bureau
Racial Comparisons

US Census Data
Healthcare Access -
Insurance
Healthcare Access :
Insurance
Healthcare Access: Insurance
Healthcare Access: Insurance
Healthcare Access :
Insurance
North Dallas (75019) - Hospitals

Source: Google Maps
South Dallas (75217) - Hospitals

Source: Google Maps
Community Assets
North Dallas South Dallas (75217)
(75019)
FREE- •Elite Care None
STANDING Emergency Center
EMERGENCY • Legacy ER
DEPARTMENT
S
Women’s Clinics •Southeast Dallas Women's
Health Center
Pediatric Clinics •Children’s Medical Center
Pleasant Grove -Pediatric Group
•DISD Parkland Balch Springs
Youth & Family Health Center
•DISD Parkland Youth & Family –
Balch Springs
•Pediamed

PCP per 100,000 ~90 ~75
(as of 2014)

Source: http://www.dallascounty.org/
North Dallas (75019) - Schools

Source: Google Maps
South Dallas (75217) - Schools

Source: Google Maps
North Dallas (75019) - Grocery Stores

Source: Google Maps
South Dallas (75217) Grocery Stores

Source: Google Maps
South Dallas (75217) - Hispanic Grocery
Stores

Source: Google Maps
North Dallas (75019) - Fast Food Restaurants

Source: Google Maps
South Dallas (75217) - Fast Food Restaurants

Source: Google Maps
Where is the Food Desert?
North Dallas (75019) - Parks

Source: Google Maps
South Dallas (75217) - Parks

Source: Google Maps
North Dallas (75019) - Liquor Stores

Source: Google Maps
South Dallas (75217) - Liquor Stores

Source: Google Maps
North Dallas (75019) - Cash Check
Establishments

Source: Google Maps
South Dallas (75217) - Cash Check
Establishments

Source: Google Maps
North Dallas (75019) – Recreation
Centers

Source: Google Maps
North Dallas (75217) – Recreation Centers

Source: Google Maps
What does all of
this mean?
Health Outcomes

. Better Intermediate Worse

Premature death & alcohol Adult obesity STIs
impaired driving deaths

Access to exercise Physical inactivity Teen births
opportunities

Diabetes monitoring Mammography screening Children in poverty

Preventable hospital days Inadequate social support
Preventable Hospital Stays

Source: CountyHealthData.org
Sexual Health Outcomes
Length of Life
1.Premature death
a. Rate - (YPLL-75) (Years of lost potential life)
b. Before 75 per 100,000 people,
c. Measures risk of dying prior to age 75
d. Important
i. Allows communities target resources to high risk areas
e. Weakness
i. Difficult to interpret
ii. Deaths after 75 not counted
iii. Chronic disease not captured
Premature Deaths
Poor or fair health
4. Now - combination
1. Percentage (vs rate as BRFSS(Behavioral Risk Factor
Surveillance System) and
per above) multilevel modeling approach
using
2. Measures percentage of a. Age
self interpretation of b. Sex
poor or fair health c. race/ethnicity
3. Prior to 2016 - results
5. Drawbacks - eliminates
over 7 years via people health promotions and/or
with landline phones population uniqueness

6. Best to use Local data AND
County Health Rankings
Clinical Care

1.Uninsured = 25% (2014) VS State uninsured 21%
2.Percentage of those less that 65
3.Impact on hospital stays
a. Uninsurance decreases length of stay (DRG’s)
(diagnosis related groups)
i. Uninsured (2.77 days)
ii. Private insurance (2.89 days)
iii. MAID (3.19 days)
b. Mortality - not significantly different
Clinical Care cont.
1.Uninsured = 25% (2014) VS State uninsured 21%
2.Percentage of those less that 65
3.Impact on hospital stays
a. Uninsurance decreases length of stay (DRG’s) (diagnosis related
groups)
i. Uninsured (2.77 days)
ii. Private insurance (2.89 days)
iii. MAID (3.19 days)
b. Mortality - not significantly different
Premature Deaths
Social and Economic Factors

1. Children in Poverty
a. Percentage study - children <18 in poverty (As per
American Community Survey, 5 year estimate 2001-1015)
i. Blacks - 34%
ii. Hispanic - 35%
iii. White - 12%
b. Social Programs policies increasing
i. Child care - financing for working parent, and parents
attending school
ii. May need more - mental health support ie., mindfullness
model to increase
1. Self worth - feeling good about self
2. Comfort with others
3. Self respect
4. Decision making that will shape own environment
Limitations

■ Community Need Index – data is not comprehensive, we
found many gaps. Our team compensated for this by utilizing
map data from GoogleMaps.
■ Survey Data is often incongruent in frequency and
measurements. Ex: ACS 5 year estimates in 1 year
increments vs. Census data by decades
■ Data is often recorded using county as the measure, making
zip code level data inaccessible. Our team examined data
provided by cities/municipalities as opposed to federal level
data.
Policy Recommendations

■ Incentivize full service grocery stores in South Dallas
■ Build out more schools in South Dallas to alleviate
crowding/low quality
■ Wraparound Healthcare access to care (uninsured)
■ Sexual Health Education and Preventative Services and
Treatment
Policy Recommendations
(cont.)
■ Increase community support services to alleviate childhood
poverty including job training, English language classes for
adults,
■ Insure ALL children via CHIP programs (expansion)
■ More coordination of non-profit + community services (1/2 of
all NPO[100K] in TX are in Dallas & Houston)
Policy Recommendations
(dallascounty.org)

■ Structural changes in workplaces and orgs to address
disease, skill building and educate providers
■ Culturally Competent strategies of delivery (ease of
accessibility regardless of status)
■ On site care (school nurses, grocery store, co-location,
workplace care)