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Windham Hospital 2022 Community Health Improvement Plan to Address Inequity, Chronic Disease

January 18, 2022

Windham Hospital has released its 2022 Community Health Improvement Plan, identifying four areas of focus intended to address root causes of community health issues. The hospital’s community health department will work in conjunction with community partners to continue or implement programs that will be most effective in impacting change. “As community health leaders, this plan is essentially our call to action over the next three years to do our part to assure those we serve live long and healthy lives,” said Joseph Zuzel, director of Community Health for Hartford HealthCare’s East Region. “Community partnerships will be a key ingredient to achieving success. This plan aims to further develop and pursue active engagement with the community.” The 2021 Community Health Needs Assessment (CHNA) for Windham leveraged numerous sources of local, regional, state and national data along with input from community-based organizations and individuals. In addition to assessing traditional health status indicators, the 2021 CHNA took a close look at social determinants of health (SDH) such as poverty, housing, transportation, education, fresh food availability, and neighborhood safety and contains an Equity Profile. These two enhancements are in response to the lessons of COVID and in recognition of an emerging national priority to identify and address health disparities and inequities.  HHC and Windham are committed to addressing these disparities and inequities through its Community Health Improvement Plan (CHIP). “Health assessments help us examine changes to the health of our community, provide insights as to how residents can lead healthy and happy lives, and identify key health issues facing the community,” said Zuzel. “The definition of health now includes the quality of the community in which we live, work, and play – not just the lifestyle habits of individuals. A comprehensive assessment process must provide a framework that helps communities prioritize public health issues; identify resources for addressing them; and effectively develop and implement community health improvement plans.” The Windham Hospital region consists of Chaplin, Columbia, Coventry, Hampton, Lebanon, Mansfield, Scotland and Windham. The four areas of focus are:

  1. Promote Healthy Behaviors and Lifestyles.
  2. Reduce the Burden of Chronic Disease.
  3. Improve Health Equity, Social Determinants of Health, and Access to and Coordination of Care and Services.
  4. Enhance Community-Based Behavioral Health Services.

Community Assessment Results

The focus areas were identified based on results of surveys, interviews and analysis of data from other sources. Windham’s service area has subpar life expectancy, high levels of food insecurity and poverty, higher rates of diabetes, smoking and obesity, and higher rates of language isolation. The population has trouble accessing prenatal healthcare and a higher than average rate of teen births. Drug overdose deaths have skyrocketed, and depression and anxiety are reported more than the state average.
  • Self-rated health “Excellent” or “Very Good” is 46 percent in Windham compared to 60 percent in Connecticut (Data Haven).
  • Comparatively Short life expectancy (years) Windham 77.8 compared to 80.3 Connecticut (Data Haven).
  • Food Insecurity Windham 21% compared with 13 percent Connecticut (Data Haven).
  • Share of drug overdose deaths involving fentanyl, 2019-20 in Windham HSA 88% as compared to Share of drug overdose deaths involving fentanyl, 2015-16 in Windham HSA 36 percent.
  • Poverty Rate Windham HSA: Black 33 percent, Latino 30 percent, White 10 percent (Data Haven).
  • Poverty rate Windham 25 percent compared to 10 percent Connecticut (Data Haven).
  • Teen Births per 1,000 Population Windham 13.5 compared 10.9 Connecticut (SparkMap).
  • Late or No prenatal Care Windham 4.1 percent compared 3.4 percent Connecticut (SparkMap).

Programming

Zuzel’s team has developed programming and strategies to address the four focus areas.

Healthy Behaviors

RX for Health provides vouchers for fresh produce to individuals who are in need of nutritional support. Funded by Windham Hospital, vouchers are distributed in various settings such as pediatrician offices, soup kitchens, diabetes services, farmers markets, etc. Families exchange the vouchers at the Windham Farmers’ Market, Windham Hospital Farm stand and the Willimantic Food Coop. Healthy Choices is a program unique to the East Region -- a Windham Hospital-based registered dietician holds two information sessions at a local food pantry to teach first staff and then volunteers about food choices specific to several health conditions, including kidney disease, heart disease and diabetes. In this way, the pantry can provide disease specific food boxes.

Equity

Healthy Beginnings program serves new mothers and their babies who use the Windham Women’s Health Center for pre and post-natal care. Two home visits are offered, beginning around one week after delivery, to discuss programs that are available to both mom and baby and to discuss any concerns or challenges they may be facing in taking care of their new infant. Services offered may include information on Husky insurance, SNAP/EBT benefits, fuel assistance, Care4Kids, diaper bank locations, and how to apply for these programs. Information about the local lactation consultant and healthy growth and development for infants will also be provided. Additionally:
  • Create a community benefit infrastructure within Windham Hospital for greater knowledge of hospital-based community services.
  • Provide information and services that are linguistically responsive and culturally relevant in order to facilitate access to health related services.

Chronic Disease

Healthy Cooking initiative that will be implemented in Windham County. The Community Health Department in conjunction with Windham Hospital Food Services and Nutrition departments will offer cooking classes at no cost to individuals at a local teaching kitchen. Patients are invited to participate based on a Chronic disease diagnosis (Cardiac, diabetes, renal, need for nutritional support, etc.) A-OK with HHC is a program designed to meet the underserved members of our community where they are. A-OK consists of a blood pressure screening, along with an Hgb A1c test to screen for the possibility of diabetes. During testing, participants will be given culturally relevant education materials.

Behavioral Health

  • In hospital, identify at-risk patients, implement interventions, and establish triple aim goals for experience of care, cost, and population health.
  • Investigate and document the effectiveness of the Recovery Coach program.
  • Provide support groups at Windham hospital.