Health Priorities for Action

The Greater Brockton Community Health Network Area identifies health priorities for program and policy investments  by periodically assessing the demographics, assets, needs, indicators, and disparities in the communities of Abington, Avon, Bridgewater, Brockton, East Bridgewater, Easton, Holbrook, Stoughton, West Bridgewater, and Whitman.

In 2010, the Greater Brockton GBHA 22 engaged the Southeast Center for Healthy Communities to conduct a formal Community Health Assessment with the goal of identifying unmet community health needs, vulnerable populations, and gaps in existing community health services.

The Community Health Assessment used a five-pronged approach to address these areas: 1) conducting community impressions sessions mainly with Brockton residents to examine their perceptions of social determinants of health and health problems in the area, 2) analyzing existing data to determine how health outcomes in the city of Brockton and surrounding towns differ from the state’s overall numbers, 3) administering anonymous surveys for residents through boxes located in area towns, 4) reviewing existing programs and services in the area to determine gaps, and 5) conducting key informant interviews with people who work in GBHA 22 towns other than Brockton to discover how the needs of residents of area towns compare to the needs of residents inside the city.

The Greater Brockton GBHA 22 then decided upon the criteria it would use to select a short list of Health Priorities for Action from the many areas of need identified by the community health assessment. This process was facilitated by the Southeast Center for Healthy Communities and resulted in the following criteria for developing the list of Health Priorities for Action:

  • People in the Greater Brockton GBHA 22 see this as a problematic issue.
  • There is quantitative data for this issue that demonstrates that the issue is a serious problem within the Greater Brockton GBHA 22.
  • Addressing this issue will lead to an improvement in health outcomes with the potential to make a positive impact on the community.

The Greater Brockton GBHA 22 Steering Committee then applied these criteria to the findings from the Community Health Assessment to identify the following Health Priorities for Action: 1) asthma, (2) oral health, (3) nutrition/fitness and (4) substance abuse.

The Greater Brockton GBHA 22 will provide grant funding for initiatives that promote sustainable changes that will have a positive and enduring impact on these identified Health Priorities for Action.

The identified Health Priorities for Action are supported by these key findings from the Community Health Assessment:

Asthma

  • The city of Brockton had a higher prevalence of lifetime asthma among children in kindergarten through grade 8 (15%) than the state overall (11%) during the 2006-2007 school year.
  • Race/ethnicity disparities exist in GBHA 22 for emergency department visits for asthma.  Black non-Hispanic residents and Hispanic residents each had a higher rate of emergency department visits for asthma than non-Hispanic White residents. The pattern was the same for asthma-related emergency department visits for children age 0-9.
  • From 2006-2008, the city of Brockton had higher rates both of asthma hospitalizations and emergency department visits for asthma than the state overall.
  • Multiple participants in community impressions sessions identified asthma in both children and adults as a health issue of concern.
  • Many key informants outside of Brockton identified childhood asthma as a chronic health problem of concern, though they noted that asthma tends to be better controlled among the population of high school age.

Nutrition/Fitness

  • A lower percentage of GBHA residents age 18 and older (21%) reported consuming at least five fruits or vegetables per day than residents of the state overall in the same age group (27%).
  • Approximately 36% of tenth-graders in Brockton, 38% in West Bridgewater, and 41% in Stoughton were overweight or obese during the 2008-09 school year Approximately 31% of tenth-graders in the state overall were overweight or obese in the same time period.
  • Social determinants of health that emerged as themes from community impressions sessions included:
    • Eating unhealthy foods due to inability to afford healthy food or low-quality produce available in local supermarkets;
    • Barriers to physical activity such as the expense of after-school activities for children, parents not wanting to let children outside with needles and trash on the ground, “stranger danger,” and playgrounds in poor condition.
  • In discussions with key informants outside of Brockton, the following themes of concern emerged related to nutrition and fitness: obesity (both in children and adults); lack of exercise among both children and adults; parents have no time to be active or fix healthy meals due to being stressed, working, or otherwise busy; lack of sidewalks or sidewalks in poor condition; and children not engaging in unstructured play.

 

Oral Health

  • In years including 2004, 2006, and 2008, the GBHA had a greater percentage of people age 18 and older who reported five or more teeth missing due to decay or disease (19%) than the state overall (15%).
  • Themes of concern identified by key informants outside of Brockton included oral health problems and lack of dental insurance or dentists who accept MassHealth.
  • None of the communities in the GBHA have water fluoridation, which has important indications for oral health.

Substance Abuse

  • From 2005-2007, the opioid-related fatal overdose rate in the city of Brockton (15 per 100,000) was significantly higher than the state rate (9 per 100,000).
  • In 2007, the city of Brockton had higher rates of admission to BSAS facilities where alcohol, cocaine, crack, and heroin were the primary substances than the state overall. The city of Brockton also had a higher rate of admission to BSAS facilities where a needle had been used within a year of admission than the state overall.
  • For young adults age 20-24, Avon, Whitman, Holbrook, Stoughton, East Bridgewater, Brockton, and Abington had higher rates of admission to BSAS facilities for all substances than the state rate in 2007.
  • Both the city of Brockton and the GBHA towns other than Brockton had a higher rate of alcohol and other drug-related hospital discharges than the state overall from 2006-2008.
  • In discussions with key informants outside the city of Brockton, substance use both among adolescents and among people of all ages emerged as major themes of concern, along with alcohol use among adults.
  • During community impressions sessions, residents identified substance use, including injection drugs and alcohol, as major concerns. One major theme was that people were using substances to “escape” the stress of the economic downturn.

 

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