2016 South Lake Hospital Community Assessment Report

2016 Facility Report

2016 Community Health Needs Assessment

Table of Contents 3

Introduction 4
Executive Summary
South Lake Hospital Community Health Needs Assessment Process 7

Multi-county Assessment 7
County- and PSA-level Concerns 7
Hospital-specific Prioritization 7

Hospital Description 8
Hospital Service Area
9
ZIP Codes and Map
Community Description 9
Demographic Profile: Lake County 9
Population by Age 10
Population by Gender 10
Population by Race and Ethnicity 10
11
Multi-County Assessment Methodology
12
Secondary Data
Hot Spotting 12
Primary Data 12
Consumer Survey 13
Provider Survey 13
Stakeholder In-depth Interviews 13
Community Conversations 13
Retrospective Data Evaluation 15
Collaboration County-level Themes 15
15
Data Summary
16
Secondary Data
County Economic Demographics 16
Chronic Diseases 16
Health Disparities 17
Preventative Care 19
Maternal and Child Health 20
Quality of Life and Mental Health 21
Food Access 25
Healthcare Access and Utilization 27
Hot Spotting Maps (Inpatient) 29
Hot Spotting Maps (Outpatient) 31
Primary Data 35
Consumer Survey 39
Provider Survey Themes 39
Stakeholder Interviews 39
Community Conversations 40
Collaboration County-level Themes 40
41
Synthesized Themes
42
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Introduction

Introduction

Community engagement is the process of working collaboratively with and through groups of people
affiliated by geographic proximity, special interest or similar situations to address issues affecting
their well-being. It is a powerful vehicle for bringing about environmental, cultural, health and
behavioral changes that will improve the quality of life of the community. It oen involves
partnerships and coalitions that help mobilize resources and influence systems, change relationships
among partners, and serve as catalysts for changing policies, programs and practices.

Impact Partners, LLC conducts community engagement/assessment projects across the United States.
Since each community is unique, our approach to better understanding a community’s need is
aligned with the Social-Ecological Model. e Social-Ecological Model is a comprehensive approach
to health and urban planning that not only addresses a community’s or individual’s risk factors, but
also the norms, beliefs, and social and economic systems that create the conditions for poor
community health outcomes.

Impact Partners subscribes to the notion that social, natural and physical environments in which
people live, as well as their lifestyles and behaviors, can influence their quality of life and health
outcomes. Communities can achieve long-term quality of life improvements, prosperous economies,
and happy and healthy neighborhoods when ordinary citizens become involved and work together to
affect change and can influence the direction of a community, not just people who already have
power.

e new economy is simply this: when communities invest in quality of life assets and infrastructure,
their economies grow and people prosper. Period.

South Lake Hospital, in affiliation with Orlando Health, conducted its 2016 Community Health
Needs Assessment (CHNA) in two parts: a regional needs assessment for four counties in Central
Florida (Lake, Orange, Osceola and Seminole Counties) followed by assessments focused on South
Lake Hospital’s primary service area (PSA).

Impact Partners worked to build on top of South Lake Hospital’s first CHNA completed in 2013 and
integrated it with the work done by the Central Florida Community Benefit Collaboration in their
2013 CHNA to maintain the integrity of the original benchmark data, to evaluate the progress of the
previous priorities by comparing historical benchmark data and to measure long-term progress.

e content that follows includes data from a number of sources about Lake County and South Lake
Hospital’s PSA. is report does not include all of the indicators analyzed in the multi-county
CHNA; rather, it offers a condensed and consolidated picture of the concerns of South Lake
Hospital’s PSA. is data will be used by a group of South Lake Hospital administrators to determine
feasible and impactful priorities for the communities the hospital serves. A separate report reflecting
the work of the larger, multi-county CHNA will be disseminated to each of the Collaboration
partners, including Orlando Health, South Lake Hospital, in affiliation with Orlando Health, Florida
Hospital, Aspire Health Partners and multiple county health departments.

is document is specific to South Lake Hospital, in affiliation with Orlando Health.

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Executive Summary

Executive Summary

In Central Florida, there is a well-established tradition of healthcare organizations, providers,
community partners and individuals committed to meeting our local health needs. e region is
home to several respected hospitals that are ranked in the nation’s top 100, a Level One Trauma
Center, nine designated teaching hospitals and the University of Central Florida College of
Medicine. Even with the current economic challenges and healthcare’s changing landscape, these
organizations remain committed to serving Central Florida.

In spite of this dedication to meeting local health needs, there is still work to be done. In the center
of the Sunshine State, more than 2.3 million people live in Lake, Orange, Osceola and Seminole
Counties. Of these residents, approximately 6.2 percent are unemployed; poverty rates have
increased by 64 percent since 2000; childhood poverty is up 51 percent over the same period; the
cost of housing is a burden for many; emergency rooms (ERs) continue to be over-utilized; access to
healthy, nutritious food is not guaranteed; and homelessness persists.

ese societal challenges oen prevent Central Floridians from achieving the level of social, physical,
environmental and spiritual well-being that is necessary for maintaining health and quality of life.
CHNAs take into account these four areas of well-being, serve as a baseline of health status in a
given community, and are used to plan social and medical interventions relevant to the population.

Four not-for-profit hospitals — Orlando Health, South Lake Hospital, in affiliation with Orlando
Health, Florida Hospital and Aspire Health Partners — alongside the Florida Department of Health
in Lake, Orange, Osceola and Seminole Counties collaborated in 2015 and 2016 to create a CHNA
for Lake, Orange, Osceola and Seminole Counties. e CHNA describes the health of Central
Floridians for the purpose of planning interventions relevant to the community and to fulfill the IRS
Community Benefit requirements for all licensed not-for-profit hospitals. A CHNA — driven by
community input — is a systematic approach to collecting, analyzing, and using complex data and
information to identify priority areas for health improvement efforts.

Using national strategies including Healthy People 2020 (HP2020) and e Robert Wood Johnson
Foundation’s County Heath Rankings as a framework for the CHNA, data were compiled from the
most up-to-date, publicly available resources and primary research with community residents,
providers and stakeholders. A number of indicators about physical, behavioral and mental health;
built environment; as well as healthcare access, utilization and insurance coverage were evaluated
using both secondary and primary data as well as hospital claims data. Secondary data were gathered
on the county level from the U.S. Census Bureau, including the American Community Survey;
Florida Community Health Assessment Resource Tool Set (CHARTS); the Centers for Disease
Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) Data; County
Health Rankings; e Central Florida Cares Health System (CFCHS) 2015 Behavioral Health Needs
Assessment; and hospital utilization data. Primary data included surveys distributed to both
providers and consumers, in-depth interviews with community stakeholders, and community
conversations within Lake County and South Lake Hospital’s PSA. In order to provide more
geographically granular information, facility utilization data were used to generate hot spots in the
community. In combination with the other data sources, hot spotting allows the Collaboration to
prioritize community need in the provision of care (Cutts, Rafalski, Grant, & Marinescu, 2014).

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Executive Summary

e findings from the Collaboration’s CHNA document identify the need for improvement in social
determinants of health, health status, access to care and built environment elements across the four
counties. e four-county area falls short of HP2020 goals in multiple areas, and is worse than state
statistics in many others. Disparities in access and preventative care as well as food access
demonstrate the need for concerted action in order to achieve health equity and overall health
improvement for the entire population. Health disparities are differences in health outcomes
between groups that reflect social inequalities. According to the CDC’s 2011 Health Disparities and
Inequalities Report, “Since the 1980s, our nation has made substantial progress in improving
residents’ health and reducing health disparities, but ongoing racial/ethnic, economic and other
social disparities in health are both unacceptable and correctable.” roughout this report, we will
highlight health disparities in the identified CHNA region.
ere are benefits to addressing the health of the community beyond simply having healthier
residents. According to e Robert Wood Johnson Foundation, improving the health of the
community benefits the bottom line of local businesses and the local economy. Healthier
communities help to cultivate a healthy, more productive workforce fueling future economic
growth. Healthy communities are also associated with higher rates of education, which benefits both
workers and employers. Finally, healthier communities attract more talented employees and a
healthier customer base that can strengthen their economies.
e issues brought to light in this report are the product of a social determinants approach to health;
that is, how the social conditions in which individuals live and work affect their physical health
(Lang, Lepage, Schieber, Lamy, & Kelly-Irving, 2012). us, rather than prioritizing physical
diagnoses that may need addressing, this report aims to guide efforts toward changing the aspects of
the environment that have causal links to those diagnoses.
County Health Rankings are published by the University of Wisconsin Population Health Institute
and e Robert Wood Johnson Foundation to help counties understand what influences how
healthy residents are now (Health Outcomes) and how healthy a county will be in the future (Health
Factors). Health Outcomes weigh Length of Life and Quality of Life equally and Health Factors are
comprised of Health Behaviors (weighted at 30 percent), Clinical Care (20 percent), Social and
Economic Factors (40 percent) and Physical Environment (10 percent). is results in a number of
rankings given to each county in a state. us, decision-makers in said counties can see how they
stack up relative to the other counties in their state on each of the aforementioned eight measures.
ey can also help these same decision-makers pinpoint areas of focus to improve the health and
well-being of the residents. All 67 counties in Florida receive rankings. Lake County’s health
rankings for 2015 are listed on the next page.

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Executive Summary

Lake County Health Rankings (2015)

HEALTH HEALTH LENGTH QUALITY HEALTH CLINICAL SOCIAL & PHYSICAL
OUTCOMES FACTORS OF LIFE OF LIFE BEHAVIOR
CARE ECONOMIC FACTORS ENVIRONMENT
19 16 21 15 11
19 17 31

Source: County Health Rankings and Roadmap - The Robert Wood Johnson Foundation Program

All of these data were used to identify the top health priorities in each county. Utilizing this larger
assessment data as a foundation, South Lake Hospital conducted individual assessments for this PSA.
e hospital worked in partnership with its affiliate, Orlando Health, to conduct the individual
assessments in a consistent manner to encourage collaboration across the healthcare system.

Individual assessments were conducted for the following Orlando Health and affiliate facilities:

• Arnold Palmer Medical Center
• Arnold Palmer Hospital for Children – Orange County
• Winnie Palmer Hospital for Women & Babies – Orange County

• Orlando Health Dr. P. Phillips Hospital – Orange County
• Orlando Health – Health Central Hospital – Orange County
• Orlando Health Orlando Regional Medical Center – Orange County

• UF Health Cancer Center – Orlando Health – Orange County
• Orlando Health South Seminole Hospital – Seminole County
• South Lake Hospital, in affiliation with Orlando Health – Lake County

is document is a campus-specific CHNA for South Lake Hospital, in affiliation with Orlando
Health, and the community it serves.

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Orlando Health CHNA Process

South Lake Hospital Community Health Needs Assessment Process

Multi-county Assessment
e multi-county assessment that covered Lake, Orange, Osceola and Seminole Counties, was
conducted by the Central Florida Community Benefit Collaboration. is Collaboration includes
Orlando Health, South Lake Hospital, in affiliation with Orlando Health, Florida Hospital, Aspire
Health Partners, and the Florida Department of Health in Lake, Orange, Osceola and Seminole
Counties.

County- and PSA-level Common Concerns
e multi-county assessment integrated a number of secondary and primary data sources to generate
lists of common concerns for the region as a whole, as well as for each county. County-level data were
then combined with demographic indicators for South Lake Hospital’s PSA and recommendations
were given to the South Lake Hospital’s Community Relations Department.

e South Lake Hospital Board of Directors approved the multi-county CHNA by the end of fiscal
year 2016 (September 30, 2016).

Hospital-specific Prioritization
An internal assessment team will be convened at South Lake Hospital and include case management,
nursing, medical staff, administration, finance, education, and other clinical and non-clinical strategy
individuals. e internal assessment team at each hospital will review the secondary and primary
data in the multi-county assessment. ey will also analyze hospital inpatient and emergency room
(ER) utilization data to determine the top reasons for inpatient admissions and ER use.

In order to determine hospital priorities, each internal assessment team will consider the intensity of
the need, hospital and community assets, ability to impact an issue, current community benefit
efforts and initiatives, existing relationships with community organizations and potential
opportunities for collaboration.

ese priorities, along with strategies to address needs, will be presented to the hospital president,
administration and leadership. Given the group’s support, they will then be submitted to the South
Lake Hospital Board of Directors for approval.

Provider & Collaboration Multi-county CHNA Process:
Consumer Surveys Themes From data collection to priorities

Stakeholder Community
Interviews Conversations

Primary Data Secondary Data

Hot Spotting

Priorities

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Hospital Description

Hospital Description

South Lake Hospital, in affiliation with Orlando Health, is a comprehensive community hospital
serving the residents of south Lake County. Our dedicated physicians, nurses, clinicians and support
team are committed to offering quality and compassionate care. We offer a wide scope of medical
care, including diagnostic imaging, orthopedics and rehabilitation, robotic surgery, women’s care and
cardiovascular services. With our advanced facilities, technology and expertise, we are able to
provide a full continuum of care to all residents of south Lake County.

As a 180-acre health, wellness and education campus, South Lake Hospital is home to the LiveWell
Fitness Center and National Training Center, that provides total body fitness, advanced rehabilitative
services and athletic training. We also serve as one of Orlando Health’s three Air Care Team
helicopter bases, allowing critical patients to be transported directly to Orlando Health Orlando
Regional Medical Center’s Level One Trauma Center, where they will receive the highest level of care
available.

South Lake Hospital’s advanced cardiovascular services can provide quick diagnosis and the most
effective treatment plans. South Lake Hospital has earned Chest Pain Center and Heart Failure
Accreditation from the Society of Cardiovascular Patient Care. Our comprehensive heart care
includes both inpatient and outpatient cardiology services and procedures, including cardiac
rehabilitation at the South Lake Heart & Vascular Institute.

Our experienced orthopedic team is dedicated to the complete diagnosis, treatment and prevention
of physical injuries, diseases and condition. From diagnosis to recovery, we offer the advanced
services throughout south Lake County. South Lake Hospital’s Clermont campus offers a high caliber
of rehabilitation services. e National Training Center is a leading outpatient facility for orthopedic
rehabilitation and sports medicine. Our physical therapists and health professionals take a
multidisciplinary approach to rehabilitation therapy that includes physical and occupational therapy.
We also offer specialized aquatic therapy at our Olympic-size pool. e center also offers intensive
post-rehab programs for sports performance, attracting both amateur and professional athletes for
recovery management and performance training.

Our Centre for Women’s Health is designed to meet the special needs of women throughout all
phases of life. e center combines innovative technologies with a comforting facility to foster
healthy living from maternity to maturity. Our experienced team has the specialty training to give
each patient, mother and child the attention they need.

Our comfortable obstetric unit has state-of-the-art technologies and amenities, and we offer a variety
of community classes covering childbirth, breastfeeding and newborn care to prepare families for
their new arrival. We’re pleased that our Obstetrics Department was recently honored by the
American College of Obstetricians and Gynecologists and the March of Dimes for reducing the
number of early elective inductions and cesarean deliveries. Our advanced diagnostic imaging
services offer shorter examination times with exceptional image quality to improve comfort and
expedite results. Services offered include 3D and digital mammography, 4D ultrasound, bone
densitometry and stereotactic breast biopsies.

South Lake Hospital combines acute hospital care and medical services with comprehensive wellness
programs, fitness training, and community health education classes and support groups to provide a
complete continuum of care to south Lake County communities.

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Hospital Service Area

Hospital Service Area

ZIP Codes and Map
e PSA for South Lake
Hospital includes:

• Clermont (34711, 34712, 34713,

34714, 34715)

• Minneola (34715, 34755)
• Ferndale (34729)
• Groveland (34736, 34737)
• Mascotte (34753)
• Montverde (34756)

Community Description
Lake County is located north and west of Orange County. Tavares is the county seat and Clermont
is the largest city. e county has a population of just over 300,000 residents and is included in the
Orlando-Kissimmee-Sanford metropolitan statistical area. Lake County was established in 1887 from
portions of Sumter County to the west and Orange County to the east. e county has a total area of
1,157 square miles, 219 square miles (18.9 percent) of which is water.

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Hospital Service Area

Demographic Profile: Lake County

Population by Age (2010-2014)

NUMBER OF POPULATION BY AGE 85+
75-84
65-74 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 50,000 55,000
60-64
55-59
45-54
35-44
25-34
20-24
15-19
10-14
5-9
<5

0

Source: U.S. Census Bureau, 2010 -2014 American Community Survey 5-Year Estimates

Population by Gender (2010-2014)

48% 52%

FEMALE
MALE

Source: U.S. Census Bureau, 2010 -2014 American Community Survey 5-Year Estimates

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Hospital Service Area

Population by Race/Ethnicity (2010-2014)

WHITE 2% 2% HiISPANIC
BLACK 11% OR LATINO
ASIAN
AMERICAN INDIAN 13%
NATIVE HAWAIIAN
2+ RACES NON-HISPANIC
87%

85%

Source: U.S. Census Bureau, 2010-2014 American Community Survey 5-Year Estimates

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Multi-county Assessment Methodology

Multi-county Assessment Methodology

e multi-county assessment covering Lake, Orange, Osceola and Seminole Counties integrated
secondary and primary data to generate common themes and issues for the region as a whole and on
the county level. Secondary data about health indicators, healthcare utilization and insurance
coverage were gathered from sources including the U.S. Census, Florida CHARTS, BRFSS Data,
County Health Rankings and the American Community Survey. Primary data sources included a
consumer survey, a provider survey, in-depth interviews with community stakeholders and
community conversations.

Secondary Data
Existing data collected by other entities were utilized in the assessment. ese data sources included
the U.S. Census Bureau, including the American Community Survey; Florida Community Health
Assessment Resource Tool Set (CHARTS); the CDC’s BRFSS Data; County Health Rankings; and
hospital utilization data. ese resources provide data related to specific health indicators, built
environment, healthcare access and utilization, and health insurance coverage.

Hot Spotting
Patients who frequently over-utilize healthcare services typically suffer from multiple chronic
conditions, requiring frequent care provided by a number of different providers. Many also have
complicated social situations that directly impact their ability to get and stay well. Too oen, high-
utilizer patients experience inefficient, poorly coordinated care that results in multiple trips to ERs
and costly hospital admissions. Using open-source data and health insurance claims data from South
Lake Hospital standardized to the population across census tract, this method allows you to locate
“hot spots” for patients over-utilizing the healthcare system and map where they live — down to the
city block.
In addition to the standard health insurance claims data in most hot spotting projects, our hot
spotting includes economic variables and conditions, and the insertion of sophisticated geospatial
environmental data to analyze the correlation among healthcare utilization, health disparities,
mortality rates/life expectancy, socio-economics and the environmental conditions in which people
live. Such data includes, where available, data sets such as street grids, traffic signalization and counts,
location of bus stops, commuter rail stations, bike lanes and multi-use trails; land use and zoning;
parks/open space, schools, landfills, brownfields, etc.; parcel data to determine locations of fast food,
supermarkets, tobacco shops, liquor stores, convenience stores, etc.; crime and pedestrian crash data;
and water/sewer districts.

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Multi-county Assessment Methodology

Primary Data
Consumer Survey
e survey was distributed both in hard copy (1,407) and electronically via SurveyMonkey (291) with
a total of 1,698 responses. While most respondents completed the survey in English, 331 were
completed in Spanish, six in French and three in Creole. Data screening measures ensured that the
surveys analyzed were valid and provided useful data. First, survey responses were screened based on
answers to two conflicting items from the public safety subscale. Responses that had similar answers
to these two opposing questions were assumed to be invalid and dismissed. Second, rather than
discard an entire survey if it was incomplete, these cases were scanned for any subscales of the survey
that were complete. e responses to completed subscales were included in the analysis. Finally,
surveys with unidentified ZIP codes were not included in the final analysis. Aer data screening,
1,235 responses were analyzed.

Provider Survey
is survey, distributed electronically, included responses from 145 participants. e questions were
mostly open-ended and explored respondents’ views on the community’s deficits given a holistic
definition of a healthy community, issues related to healthcare services and forces of change in the
community.

Stakeholder In-depth Interviews
Interviews were conducted with 16 community stakeholders. Each interview lasted an average of 65
minutes. Aer each interview was fully transcribed, they were analyzed using qualitative analysis
principles from NVivo 11. First, a basic word frequency was run for each question and related set of
questions. en, this word frequency was expanded to include words similar to those with the highest
frequency. Finally, the context of the most frequently-used words and phrases were examined to
generate themes.
e structured interviews asked questions about the following topics:

• Community Health & Wellness Subscale:
• Physical
• Mental and Behavioral Health
• Environmental Health
• Social Health

• Risk Factors Subscale:
• Health-promoting Behaviors
• Sickness and Death Behaviors

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Multi-county Assessment Methodology

• Healthcare Access Subscale:
• Primary Healthcare
• Specialty Healthcare
• ER and Urgent Care
• Mental and Behavioral Healthcare
• Dental Care

• Forces of Change Subscale

Basic information for each stakeholder is outlined below:

Demographic Info for Stakeholder Participants from In-depth Interviews

SECTOR SELF ID RACE/ETHNICITY GENDER
ER PHYSICIAN/GOVERNMENT
FOOD SECURITY WHITE/LATINO M
HISPANIC HEALTH WHITE F
DEPARTMENT OF CHILDREN & FAMILIES LATINO F
H E A LT H C A R E WHITE M
LAW ENFORCEMENT M
FEDERALLY QUALIFIED HEALTH CENTER BLACK/AFRICAN AMERICAN M
HOMELESS COALITION BLACK/AFRICAN AMERICAN F
BEHAVIORAL HEALTH F
FAITH COMMUNITY/ BLACK HAITIAN M
INTERFAITH COMMUNITY WHITE M
URBAN LEAGUE WHITE M
SPECIALTY CARE WHITE F
EDUCATION BLACK F
COMMUNITY CONVENER WHITE F
AGING WHITE F
BUSINESS WHITE F
ER PHYSICIAN WHITE M

WHITE/LATINO
WHITE

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Multi-county Assessment Methodology

Community Conversations
Six community conversation sessions took place with a total of 102 participants. ese conversations
employed the World Café/Cross Pollination method. Each participant was seated at a table with other
participants. Each table engaged in conversation, writing down key thoughts and ideas on cards or
sketching them out on paper. Aer 20-30 minutes, participants were asked to change tables, carrying
thoughts from their previous table to their new group. roughout the process, a “table host” stayed
behind at each table to share the insights of their previous discussion with the new arrivals. Aer
these small-group rounds, all participants convened for a large-group conversation and collective
knowledge was harvested.
Retrospective Data Evaluation
e Collaboration conducted a retrospective data evaluation by looking backward and examining the
priorities selected during the first CHNA and evaluated their relevancy to date. e Collaboration also
reviewed and evaluated the progress of the Strategic Implementation Plans addressing these
previously agreed upon priority areas.
Collaboration County-level Themes
Members of the Collaboration developed a distilled list of county-level areas of concern based on the
knowledge that each of them brought to the group about the needs of the residents in each county.
Initially, any area of concern was heard and added to a list. en the group worked together in
multiple rounds of voting to drill down from dozens of topics to 15 areas of concern for Lake County.

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Data Summary

Data Summary

Secondary Data
Because data on the indicators examined for this assessment are measured on the county level, the
data that follow reflect statistics and figures for Lake County, Florida.
County Economic Demographics
Since 2000, Lake County has had a median household income that is below that of the state of
Florida. e county has seen a 51 percent increase in the poverty level between 2000-2014. A similar
increase in children living below the poverty level has taken place — a 31 percent increase between
2000-2013. In 2014, 46 percent of Lake County residents spent 35 percent or more of their income on
rent and 35 percent reported being cost burdened or severely cost burdened by the cost of their
housing. e number of homeless individuals in Lake County has fluctuated significantly since 2008
(see next page). Further, seven percent of Lake County’s student population is homeless.

Severely Cost Burdened by Census Tract ACS (2009-2013) - Lake County

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Data Summary

Lake County Homeless Count

2008 2009 2010 2011 2012 2013 2014 2015

518 491 796 1,008 1,019 282 187 265

Source: 2015 Point-in-Time County, Homeless Services Network of Central Florida

Adults Who Are Obese (2002-2013)

Chronic Diseases 35% HP2020
Overall, the most recent data on chronic % GOAL
diseases for Lake County reflect data that are (30.5a%)
less than positive than the state-wide level.
ere is room to improve on many indicators PERCENT OF ADULTS 25%
relative to the HP2020 goals.
While the percent of obese adults in Lake 20%
County has increased from 20.8 percent in
2002 to 27.5 percent in 2013, the county is 15%
still below the HP2020 goal of 30.5 percent
and marginally above the state-level figure. 10%

High Blood Pressure Prevalence - Adults (2002-2013) 5%

0% LAKE FLORIDA

2002 20.8% 20.4%
2007 25.8% 24.1%
2010 29.8% 27.2%
2013 27.5% 26.4%

Source: Florida Charts, 2016: Florida Behavioral Risk Factor Surveillance System
This chart reflects the most current open-sourced data available at the time the report was printed.

Adults Who Have Ever Been Told They Had a Stroke
(2007-2013)

PERCENT OF ADULTS 45% HP2020 PERCENT OF ADULTS 5.0%
40% GOAL
LAKE (26.9a%) 4.0% LAKE FLORIDA
35%
28% FLORIDA 3.0% 3.8% 3.1%
30% 36% 28% 3.4% 3.5%
44% 28% 2.0% 4.5% 3.7%
25% 39% 34%
35% 1.0%
20%
0.0%
15% 2007
2010
10% 2013
5%
0%

2002
2007
2010
2013

Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most
current open-sourced data available at the time the report was printed. current open-sourced data available at the time the report was printed.

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Data Summary

In 2013, the percent of people in Lake County with high blood pressure, stroke, high cholesterol and
diabetes is above the state average. HIgh blood pressure rates increased steadily from 2002-2010, then
dropped slightly in 2013. High cholesterol levels have fluctuated slightly but have maintained levels at
least three times as high as the HP2020 goal.

e percent of adults with diagnosed diabetes has increased by 60 percent since 2002.

Finally, it is important to note that there is very little data for chronic diseases by race/ethnicity for

Lake County. Adults With Diagnosed Diabetes (2002-2013)

Adults Who Have Even Been Told They Had
High Cholesterol (2002-2013)

16%

45%PERCENT OF ADULTS 14%
40% PERCENT OF ADULTS 12%
35% 10%
30% 8%
25%

20% LAKE HP2020 6% LAKE FLORIDA
GOAL
15% 39.6% (13.5a%) 4% 9.5% 8.2%
39.7% 12.9% 8.7%
10% 42.5% FLORIDA 2% 13.4% 10.4%
41.8% 35.2% 15.2% 11.2%
5% 37.1% 0%
0% 38.6% 2002
33.4% 2007
2002 2010
2007 2013
2010
2013

Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most
current open-sourced data available at the time the report was printed. current open-sourced data available at the time the report was printed.

Top Causes of Death - Lake County (Rate per 100,000) (2008-2014)

CAUSE OF DEATH 2008 2010 2012 2014 HP2020
GOALS

CANCER 161.4 172.9 159.9 157.8 161.4
145.4 158.3 139.0 160.5 103.4
HEART DISEASE 53.2 55.4 52.0 64.2 36.4

UNINTENTIONAL 38.0 36.7 37.9 39.5 N/A
INJURY

CHRONIC LOWER
RESPIRATORY
DISEASE

CEREBROVASCULAR 30.8 34.0 28.7 33.4 34.8
DISEASE 26.3 30.8 18.5 22.3 N/A

ALZHEIMER’S
DISEASE

DIABETES 22.8 23.8 21.4 21.7 65.8

Source: Florida Charts, 2015: Florida BRFSS. N/A = no data reported in source. Causes of death are sorted from highest to lowest for each county based on the
average age-adjusted death rate over the four years measured. This table reflects the most current open-sourced data available at the time the report was printed.

2016 CHNA: South Lake Hospital Facility Report
– 18 –

Data Summary

Health Disparities Adults Currently With Asthma by Race/
Ethnicity (2002-2013)
Data on the racial disparities in the percent of
adults currently with asthma is inconsistent 12%
and sometimes nonexistent. Compared to
2002, Non-Hispanic White adults saw an PERCENT OF ADULTS 10%
increase from 2002-2013. Hispanic adults saw 8%
a similar increase. 6%

While the age-adjusted death rate for cancer 4%
in Lake County dropped slightly for White 2%
adults, they still had the highest rates across
racial/ethnic groups. Black and Hispanic 0% 2007 2010 2013
adults saw jumps in the death rate from 2012-
2014. 2002 9.4%
N/A
e death rate for cerebrovascular disease has LAKE 9.7%
decreased for Black and Hispanic adults;
White adults experienced an increase from NON-HISP. WHITE 5.7% 5.5% 5.4%
2012-2014. NON-HISP. BLACK N/A
HISPANIC 5.1%
N/A N/A
2.7% N/A

Age-Adjusted Death Rate for Cancer by Race/ Source: Florida Charts, 2015: BRFSS. N/A = No data reported by the source.
Ethnicity (per 100,000) (2012-2014) This chart reflects the most current open-sourced data available at the time the
report was printed.

180 HP2020 Age-Adjusted Death Rate for Cerebrovascular
160 GOAL Disease (per 100,000) (2012-2014)
(161.4)

AGE-ADJUSTED RATE PER 100,000 140

120 60

100 AGE-ADJUSTED RATE PER 100,000 50

80 40

60 HP2020
GOAL

30 (34.8)

40 20

20 10

0 0
2012 2014 2012 2014 2012 2014 2012 2014 2012 2014 2012 2014

WHITE BLACK HISPANIC WHITE BLACK HISPANIC

162.3 158.1 123.6 149.6 93.0 121.0 27.4 32.4 54.1 41.3 38.7 35.1

Source: Florida Charts, 2015: Death Query. This chart reflects the most current Source: Florida Charts, 2015: Death Query. This chart reflects the most current
open-sourced data available at the time the report was printed. open-sourced data available at the time the report was printed.

2016 CHNA: South Lake Hospital Facility Report
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Data Summary

e death rate for coronary heart disease has Age-Adjusted Death Rate for Coronary Heart
only slightly increased for White adults and Disease by Race/Ethnicity (2012-2014)
remained relatively unchanged for Black
adults; however, Hispanic adults have seen a AGE-ADJUSTED RATE PER 100,000 120 HP2020
significant increase from 2012-2014. 100 GOAL
(103.4)
Preventative Care
80
State-level, preventative care percentages have
dropped. However, indicators are mixed in 60
Lake County. Between 2002-2010, the number
of Lake County women aged 40 and older 40
who had received mammograms in the past
year experienced an increase. e percentages 20
for Lake County and the state of Florida for
mammograms are well below the HP2020 0
goal of 81.1 percent. 2012 2014 2012 2014 2012 2014

Lake County is far from the HP2020 goal for WHITE BLACK HISPANIC
adult women receiving pap tests and was
below the state percent in 2013. 99.0 112.4 110.6 112.2 72.1 95.3

Source: Florida Charts, 2015: Death Query. This chart reflects the most current
open-sourced data available at the time the report was printed.

Women 18+ Who Received a Pap Test in
the Past Year (2002-2013)

Women 40+ Who Received a Mammogram 100%
in the Past Year (2002-2010) 90%
80%
PERCENT OF WOMEN 40+ 90% HP2020 PERCENT OF WOMEN 40+ HP2020
80% GOAL 70% GOAL
70% LAKE (81.1a%) 60% LAKE (93.0a%)
60% 50%
50% 61.0% FLORIDA 40% 64.8% FLORIDA
40% 67.1% 65.3% 30% 65.7% 70.7%
30% 66.5% 64.9% 20% 58.1% 64.8%
20% 61.9% 10% 44.3% 67.1%
10% 51.4%
0%
0%
2002
2002 2007
2007 2010
2010 2013

Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most
current open-sourced data available at the time the report was printed. current open-sourced data available at the time the report was printed.

2016 CHNA: South Lake Hospital Facility Report
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Data Summary

Both Florida and Lake County are below the Adults 50+ Who Received a Sigmoidoscopy or
HP2020 goal for adults aged 50 and older Colonoscopy in the Past 5 Years (2002-2013)
who received a sigmoidoscopy or
colonoscopy in the past five years. PERCENT OF ADULTS 50+ 80% HP2020
GOAL
Maternal and Child Health 70% LAKE (70.5%)

Lake County mothers are more likely to have 60% 44.2% FLORIDA
first trimester prenatal care than the average 57.8% 70.7%
Floridian woman. However, Hispanic 50% 58.1% 64.8%
mothers have the lowest numbers for 61.4% 67.1%
prenatal care. 40% 51.4%

Infant mortality in the state has hovered 30%
around the HP2020 goal of 6.0, while Lake
County’s infant mortality rate has steadily 20%
increased since 2012 to 8.8. e mortality 10%
rate among the Black population in the
county remains significantly high 0%
at 11.8.
2002
2007
2010
2013

Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most
current open-sourced data available at the time the report was printed.

Births to Mothers With 1st Trimester Prenatal Care by Infant Mortality by Race/Ethnicity (per 1,000 Live
Race/Ethnicity (2014) Births) (2014)

PERCENT oOF BIRTHS 100% PER 1,000 LIVE BIRTHS 12 HP2020
90% 11 GOAL
80% 10 (6.0)
70% 9
60% WHITE BLACK HISPANIC NON-HISPAN. 8
50% 85.9% 80.1% 78.0% 86.9% 7
40% 81.5% 72.6% 80.1% 79.1% 6
30% 5
20% 4
10% 3
0% 2

LAKE 1
FLORIDA 0 WHITE

Source: Florida Charts, 2015: Florida DOH, Bureau of Vital Stats. This chart reflects 7.8
the most current open-sourced data available at the time the report was printed.

BLACK HISPANIC
11.8 6.5

Source: Florida Charts, 2015: Florida DOH, Bureau of Vital Stats. This chart reflects
the most current open-sourced data available at the time the report was printed.

2016 CHNA: South Lake Hospital Facility Report
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Data Summary

In Lake County, the percent of children born Births to Mothers With Less Than a High School Education
to mothers with less than a high school by Race/Ethnicity (2014)
education has consistently been higher than
the state average. Within the county, 25%
Hispanic mothers with less than a high
school education are more likely than other 20%
racial/ethnic groups to have a child.
PERCENT OF BIRTHS 15%
e preterm birth rate in 2014 for Lake
County (14.4) was higher than the state of 10%
Florida (13.4). e Black population has the
highest rate for preterm birth than any other 5%
racial/ethnic group in the county and the
state. 0% WHITE BLACK HISPANIC NON-HISPAN.
13.3% 14.0% 19.2% 11.7%
e rate of children being born with low LAKE 12.6% 16.1% 19.8% 10.7%
birth weight is higher in Lake County than in FLORIDA
the state overall. Black residents are more
likely to give birth to a baby weighing less Source: Florida Charts, 2015: Florida DOH, Bureau of Vital Stats. This chart reflects
than 2,550 grams in both Lake County and the most current open-sourced data available at the time the report was printed.
the state of Florida.

Preterm Birth Rate (<37 Weeks) by Race/Ethnicity Low Birth Weight (<2,550 grams) by Race/Ethnicity
(2014) (2014)

NUMBER OF BIRTHS (PER 1,000) 22 NUMBER OF BIRTHS (PER 1,000) 20
20 18
18 WHITE BLACK HISPANIC NON-HISPAN. 16 WHITE BLACK HISPANIC NON-HISPAN.
16 13.1 21.6 12.4 15.0 14 7.6 17.1 8.6 9.1
14 12.2 17.7 13.7 13.3 12 7.3 13.3 7.4 9.2
12 10
10 8

8 6
6 4
4 2
2 0
0
LAKE
LAKE FLORIDA
FLORIDA

Source: Florida Charts, 2015: Florida DOH, Bureau of Vital Stats. This chart reflects Source: Florida Charts, 2015: Florida DOH, Bureau of Vital Stats. This chart reflects
the most current open-sourced data available at the time the report was printed. the most current open-sourced data available at the time the report was printed.

2016 CHNA: South Lake Hospital Facility Report
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Data Summary

Childhood obesity is a topic of interest in the Middle School Students Reporting BMI at or Above 95th
state and part of our national public health Percentile (2002-2013)
conversation. In 2002 and 2007, Lake County
had a percent of middle school students with a 20%
BMI at or above the 95th percentile comparable
to the state. In 2010 and 2013, the percent was PERCENT aoOF MIDDLE SCHOOL STUDENTS 16%
higher than the state level. e percent of high
school students in Lake County with a BMI at 12%
or above the 95th percentile also jumped above
the state level for 2010 and 2013. 8%

Level of childhood physical activity, a related 4%
indicator, may provide some insight into the
issue of childhood obesity. While Lake 0% 2002 2007 2010 2013
County’s children appear to get about the same 10.0% 11.0% 14.0% 14.0%
among of vigorous physical activity as the LAKE 11.0% 11.0% 12.0% 11.0%
average Floridian child, more than a third of FLORIDA
middle and high school students reported not
getting enough of this kind of activity in 2013.

Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most current
open-sourced data available at the time the report was printed.

High School Students Reporting BMI at or Above 95th Middle School Students Without Sufficient Vigorous
Percentile (2002-2013) Physical Activity (2002-2013)

20% 35%

PERCENT aoOF HIGH SCHOOL STUDENTS PERCENT aoOF MIDDLE SCHOOL STUDENTS 30%

16%

25%

12% 20%

8% 15%

4% 10%
5%

0% 2002 2007 2010 2013 0% 2002 2007 2010 2013
14.0% 11.0% 14.0% 15.0% 31.0% 31.3% 29.4% 34.7%
LAKE 11.0% 11.0% 12.0% 11.0% LAKE 30.9% 31.6% 30.7% 29.9%
FLORIDA FLORIDA

Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most current Source: Florida Charts, 2015: Florida DOH, Bureau of Epidemiology. This chart reflects
open-sourced data available at the time the report was printed. the most current open-sourced data available at the time the report was printed.

2016 CHNA: South Lake Hospital Facility Report
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Data Summary

e percent of middle and high school High School Students Without Sufficient Vigorous
students who report binge drinking is at or Physical Activity (2002-2013)
lower than the state level but still of concern.
In 2014, four percent of middle school 50%
students and 12 percent of high school
students self-reported binge drinking. PERCENT aoOF HIGH SCHOOL STUDENTS 40%

30%

20%
10%

0% 2002 2007 2010 2013
40.9% 42.5% 39.8% 35.4%
LAKE 40.7% 40.6% 39.1% 37.3%
FLORIDA

Source: Florida Charts, 2015: Florida DOH, Bureau of Epidemiology. This chart reflects
the most current open-sourced data available at the time the report was printed.

Middle and High School Students Reporting Binge Drinking
(2012-2014)

20%

16%

PERCENT aoOF STUDENTS 12%

8%

4%

0% 2012 2014 2012 2014

LAKE MIDDLE SCHOOL HIGH SCHOOL
FLORIDA
4.0% 4.0% 17.0% 12.0%
5.0% 4.0% 16.0% 14.0%

Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most current
open-sourced data available at the time the report was printed.

2016 CHNA: South Lake Hospital Facility Report
– 24 –

Data Summary

Quality of Life and Mental Health
e most opportunities for recreation and fitness facilities exist in the ZIP codes in the southern
portion of Lake County. ese opportunities become more sparse or are not measured the farther
north one goes. It should be noted, however, how much of the state is colored in blue (see map below),
indicating quite a number of residents with access to recreation and fitness facilities.

Recreation and Fitness Facilities in Lake County (Rate per 100,000) (2016)

Population Within One-Half Mile of a Park in Lake County (2016)

2016 CHNA: South Lake Hospital Facility Report
– 25 –

Data Summary

In the northern portion of Lake County, there HIV Cases (Rate per 100,000) (2010 -2014)
are a number of people within one-half mile of
a park (see map on previous page). is is RATE PER 100,000 45
likely due to Ocala National Forest covering 40
much of this portion of the county. e 35 2010 2012 2014
southern portion of the county provides lower 30 12.1 10.9 19.3
access to parks. 25 26.0 23.7 31.4
e HIV rate in Lake County has increased 20
since 2010, but has consistently remained 15
lower than the state-level rate. 10
Lake County has a slightly higher percent of
adults with a depressive disorder than the 5
state. e percent of adults with a depressive 0
disorder decreases significantly as income
increases, and as residents get older. LAKE
A similar trend is true for adults who report FLORIDA
having poor mental health on 14 or more of
the past 30 days. Higher income consistently Source: Florida Charts, 2015: Florida DOH, Bureau of HIV/AIDS. This chart reflects
the most current open-sourced data available at the time the report was printed.
Adults With a Depressive Disorder by Income (2014)
Adults Who Had Poor Mental Health on 14 or
35% More of the Past 30 Days by Income (2007-2013)

30% 25%

25% 20%

20% 15%
PERCENT OF ADULTS
PERCENT OF ADULTS
15% 10%

5%
10%

5% 0% 2007 2010 2013

0% <$25K $25K-$49,999 $50K+ <$25K 6.7% LAKE 14.8%
31.1% 15.5% $25K - $49,999 13.6% 10.5%
LAKE 23.8% 16.5% 13.3% $50K+ 6.6% 16.4% 5.6%
FLORIDA 11.3% 10.8%
3.6%

Source: Florida Charts, 2015: BRFSS. This chart reflects the most current
open-sourced data available at the time the report was printed.

Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most
current open-sourced data available at the time the report was printed.

2016 CHNA: South Lake Hospital Facility Report
– 26 –

Data Summary

appears associated with having fewer poor Adults Who Always/Usually Receive Social and
mental health days. Education appears to be Emotional Support They Need by Income (2007-2010)
related to mental health in a similar fashion.
ere is not enough race/ethnicity-level data 100%
to draw any conclusions about differences
across this category. 80%

Social and emotional support appears to follow PERCENT OF ADULTS 60%
the same trend along income lines over time.
Additionally, across the income spectrum, 40%
more Lake County residents believed they
received the support they needed in 2010 than 20%
in 2007.
0% 2007 LAKE 2010
Food Access
<$25K 68.1% 74.0%
Food access appears to be an issue for Lake $25K - $49,999 79.2% 72.7%
County census tracts. A large portion of the $50K+ 86.8% 93.2%
county has a modified retail food
environmental score below 15 (low access, Source: Florida Charts, 2015: BRFSS. This chart reflects the most current
poor access or no access to healthy retail food open-sourced data available at the time the report was printed.
outlets). High access is defined as a score of
over 30 and nowhere in the county does a
score of 30 or higher exist.

Modified Retail Food Environmental Index Score by Census Tract -
Lake County (2016)

2016 CHNA: South Lake Hospital Facility Report
– 27 –

Data Summary

A number of residents in the northern Family Households Receiving SNAP - Lake County (2016)
and southern portions of the county
receive Supplemental Nutrition
Assistance Program (SNAP) benefits
and nearly all of the food deserts are
located in census tracts with high
percentages of SNAP recipients.

Food Deserts by Census Tract - Lake County (2016)

2016 CHNA: South Lake Hospital Facility Report
– 28 –

Data Summary

Healthcare Access and Utilization Insurance Coverage by Income (2010 -2013)PERCENT OF ADULTS
100%
Both the state and Lake County have seen a 80%
small decrease in health insurance coverage 60%
since 2002. Residents ages 18-44 continue to
be the lowest covered age group. Since 2010- 40%
2013, those ages 45-64 saw the smallest
decrease in coverage. Similar to data for the 20%
state, higher income in Lake County is
associated with nearly full insurance coverage. 0% 2010 LAKE 2013

Health insurance coverage across racial and <$25K 76.0% 60.0%
ethnic groups is not well measured in Lake $25K - $49,999 92.0% 87.0%
County. $50K+ 97.0% 96.0%

Additionally, an increasing number of Lake
County residents, and Floridians on the whole,
have skipped a trip to the doctor due to cost.

Source: Florida Charts, 2015: BRFSS. This chart reflects the most current
open-sourced data available at the time the report was printed.

Insurance Coverage by Race/Ethnicity (2010 -2013) Adults Who Could Not See a Doctor at Least
100% Once in the Past Year Due to Cost (2007-2013)
80%
60% 25%

20%

PERCENT OF ADULTS 40% PERCENT OF ADULTS 15%
10%
20%
5%

0% 2010 LAKE 2013 0%

NON-HISP. WHITE 89.8% 84.3% LAKE 2007 2010 2013
NON-HISP. BLACK N/A N/A FLORIDA 13.6% 13.1% 19.1%
HISPANIC N/A 15.1% 17.3% 20.8%
51.7%

Source: Florida Charts, 2015: BRFSS. N/A = No data in source. This chart reflects Source: Florida Charts, 2015: Florida BRFSS. This chart reflects the most current
the most current open-sourced data available at the time the report was printed. open-sourced data available at the time the report was printed.

2016 CHNA: South Lake Hospital Facility Report
– 29 –

Data Summary

Top 10 Diagnoses for ER Visits at South Lake Hospital (2015)

ToOP 10 DIAGNOSES FOR ER VISITS (2015)

#1 HYPERTENSION #6 SCREEN MAMMOGRAM

#2 LONG-TERM USE MEDS #7 HEADACHE

#3 TYPE II DIABETES #8 ACCIDENT IN HOME

#4 EXTERNAL CAUSE STATUS, OTHER SPECIFIED #9 URINARY TRACT INFECTION

#5 HYPERLIPIDEMIA #10 ABNORMAL ELECTROCARDIOGRAM

Top 10 Diagnoses for Inpatient Admissions at South Lake Hospital (2015)

ToOP 10 DIAGNOSES FOR INPATIENT ADMISSIONS (2015)

#1 HYPERTENSION #6 ATRIAL FIBRILLATION

#2 HYPERLIPIDEMIA #7 ESOPHAGEAL REFLUX

#3 LONG-TERM USE MEDS #8 HYPOTHYROIDISM

#4 TYPE II DIABETES #9 ACUTE KIDNEY FAILURE

#5 CORONARY ATHEROSCLEROSIS #10 TOBACCO USE DISORDER

2016 CHNA: South Lake Hospital Facility Report
– 30 –

Data Summary

Hot Spot Map (Inpatient)
South Lake Hospital, in affiliation with Orlando Health: Uninsured Inpatient Hot Spot

2016 CHNA: South Lake Hospital Facility Report
– 31 –

Data Summary

South Lake Hospital: Uninsured Inpatient Hot Spot, cont’d.
In this inpatient specific hot spot analysis for South Lake Hospital, in affiliation with Orlando Health,
there is an unemployment rate of 10 percent with 16 percent of the population living in poverty. e
average annual median household income is just over $50,000. e 213 uninsured visits cost more
than $6.3 million and accounted for 12 percent of all uninsured inpatient visits between 2012-2015.
e majority of visits from the hot spot were associated with White patients, followed by Other at 24
percent. Ages 40-59 accounted for approximately 45 percent of visits. Single live births was the most
frequent primary diagnosis code in inpatient visits within this hot spot. Approximately 23 percent of
visits were diagnosed with tobacco use disorder outside the primary diagnoses. Visits with a primary
diagnosis of acute pancreatitis resulted in the highest costs to the hospital at nearly $400,000 and
accounted for six percent of the visits between 2012-2015. To protect privacy, any analysis less than
two percent has been removed.

Comparison: Hot Spot Visits to All Visits

CRITERIA HOT SPOT
TOTAL UNINSURED VISITS 213
TOTAL UNINSURED COST
PERCENT TO ALL INPATIENT UNINSURED VISITS $6,390,903
PERCENT TO ALL INPATIENT UNINSURED COST 12%
HOMELESS-SHELTER VISITS (%)* 10%
HOMELESS-SHELTER VISITS COST* 0%
—

*Includes those listed as homeless, unknown or address of homeless shelter/service facility

Top 5 Primary Diagnoses and Costs**

DIAGNOSIS TOTAL COST % OF ALL VISITS AVG. COST PER VISIT
$62,239 IN HOT SPOT $2,829
V30.00 - SINGLE LIVEBORN, BORN IN HOSPITAL, 10% $29,860
DELIVERED W/O CESAREAN SECTION $388,178 $33,741
577 - ACUTE PANCREATITIS $202,443 6% $25,717
38.9 - SEPTICEMIA NOS $154,304 3% $55,825
427.31 - ATRIAL FIBRILLATION $279,125 3% $5,244
574 - CHOLELITH WITH AC CHOLECYST $26,218 2% $32,085
V30.01 - SINGLE LIFE NEWBORN, BORN IN $160,426 2%
HOSPITAL, DELIVERED W/O CESAREAN SECTION 2%
786.5 - CHEST PAIN

**In some instances, multiple diagnoses had the same percent of hot spot visits that fell into the top five; in these instances, all diagnoses were included in the Top 5 table.

2016 CHNA: South Lake Hospital Facility Report
– 32 –

Data Summary

South Lake Hospital: Uninsured Inpatient Hot Spot, cont’d.

Top 5 Secondary Diagnoses and Costs

DIAGNOSIS TOTAL COST % OF ALL VISITS AVG. COST PER VISIT
$1,884,493 IN HOT SPOT $38,459
305.1 - TOBACCO USE DISORDER $1,815,324 23% $38,624
401.9 - ESSENTIAL (PRIMARY) HYPERTENSION $1,041,887 22% $35,927
V58.69 - LONG-TERM USE MEDS NEC $1,039,627 $37,130
272.4 - HYPERLIPIDEMIA NEC/NOS $952,987 14% $45,380
250 - DMII W/O CMP NT ST UNCNTR
13%

10%

Top 5 Highest Cost Primary Diagnoses TOTAL COST % OF ALL VISITS AVG. COST PER VISIT
IN HOT SPOT $28,860
DIAGNOSIS $388,178 6% $55,825
$279,125 $33,741
577 - ACUTE PANCREATITIS $202,443 2% N/A
574 - CHOLELITH W AC CHOLECYST $185,617 N/A
38.9 - SEPTICEMIA NOS $181,358 3%
410.71 - SUBENDOCARDIAL INFARCTION,
INITIAL EPISODE OF CARE N/A
592.1 - CALCULUS OF URETER
N/A

Hospital Visitors by Race/Ethnicity Hospital Visitors by Age

RACE/ETHNICITY PERCENT AGE PERCENT
WHITE 52% 0-18 14%
OTHER 24% 19-29 16%
BLACK/AFRICAN AMERICAN 15% 30-39 14%
EAST INDIAN 7% 40-49 23%
ASIAN 1% 50-59 22%
60-69 9%
70-79 0%
80+ 1%

2016 CHNA: South Lake Hospital Facility Report
– 33 –

Data Summary

South Lake Hospital: Uninsured Inpatient Hot Spot, cont’d.

Census Tract Summaries

CENSUS TRACT % UNEMPLOYED MED. HH INCOME % BELOW POVERTY
8.9% $41,450 21.4%
12-069-031305 9.2% $59,190 10.2%
12-069-031307 9.6% $50,320 15.8%
AVERAGE

2016 CHNA: South Lake Hospital Facility Report
– 34 –

Data Summary

Hot Spot Map (Outpatient)
South Lake Hospital, in affiliation with Orlando Health: Uninsured ER/Outpatient Hot Spot

2016 CHNA: South Lake Hospital Facility Report
– 35 –

Data Summary

South Lake Hospital: Uninsured ER/Outpatient Hot Spot, cont’d.

In this outpatient specific hot spot analysis for South Lake Hospital, in affiliation with Orlando
Health, nearly 14 percent of the population lives in poverty despite an average annual median
household income of more than $50,000. e unemployment rate for the area is approximately eight
percent. e 1,544 uninsured visits cost more than $3.1 million and accounted for five percent of all
uninsured outpatient visits between 2012-2015. Most visits from the hot spot were associated with
White patients at 44 percent, followed by Other at 28 percent. Ages 19-29 accounted for
approximately 31 percent of visits. Acute upper respiratory infection was the most frequent primary
diagnosis code in outpatient visits within this hot spot. Approximately seven percent of visits were
diagnosed with hypertension outside the primary diagnoses. Visits with a primary diagnosis of
headache resulted in highest costs to the hospital at nearly $150,000 and accounted for three percent
of the visits between 2012-2015. To protect privacy, any analysis less than two percent has been
removed.

Comparison: Hot Spot Visits to All Visits

CRITERIA HOT SPOT
TOTAL UNINSURED VISITS å1,544
TOTAL UNINSURED COST
PERCENT TO ALL ER OUTPATIENT UNINSURED VISITS $3,112,961
PERCENT TO ALL ER OUTPATIENT UNINSURED COST 5%
HOMELESS SHELTER VISITS (%)* 4%
HOMELESS SHELTER VISITS COST* 0%
—

*Includes those listed as homeless, unknown or address of homeless shelter/service facility

Top 5 Primary Diagnoses and Costs

DIAGNOSIS TOTAL COST % OF ALL VISITS AVG. COST PER VISIT
$41,908 IN HOT SPOT $873
465.9 - aACUTE UPPER RESPIRATORY INFECTIONS $146,833 3% $3,263
OF UNSPECIFIED SITE $71,097 $1,734
784 - HEADACHE $19,293 3% $482
729.5 - PAIN IN LIMB $23,898 $664
525.9 - DENTAL DISORDER NOS 3%
462 - ACUTE PHARYNGITIS
3%

2%

2016 CHNA: South Lake Hospital Facility Report
– 36 –

Data Summary

South Lake Hospital: Uninsured ER/Outpatient Hot Spot, cont’d.

Top 5 Secondary Diagnoses and Costs

DIAGNOSIS TOTAL COST % OF ALL VISITS AVG. COST PER VISIT
$241,627 IN HOT SPOT
401.9 - UNSPECIFIED ESSENTIAL HYPERTENSION $145,233 7% $2,369
305.1 - TOBACCO USE DISORDER $160,750 $2,269
250 - DIABETES MELLITUS $192,095 4% $3,152
787.02 - NAUSEA ALONE $76,376 $4,269
786.2 - COUGH 3% $1,776

3%
3%

Top 5 Highest Cost Primary Diagnoses TOTAL COST % OF ALL VISITS AVG. COST PER VISIT
$146,833 IN HOT SPOT $3,263
DIAGNOSIS $115,232 3% $4,268
$96,156 $3,846
784 - HEADACHE $91,056 2% $3,140
786.5 - CHEST PAIN $86,621 $2,887
789.09 - ABDOMINAL PAIN, OTHER 2%
SPECIFIED SITE
789 - ABDOMINAL PAIN, UNSPECIFIED SITE 2%
599 - URINARY TRACT INFECTION, SITE NOT
SPECIFIED 2%

Hospital Visitors by Race/Ethnicity Hospital Visitors by Age

RACE/ETHNICITY PERCENT AGE PERCENT
WHITE 44% 0-18 12%
OTHER 28% 19-29 31%
BLACK/AFRICAN AMERICAN 25% 30-39 24%
EAST INDIAN 2% 40-49 16%
HISPANIC 1% 50-59 13%
ASIAN 0% 60-69 4%
NATIVE HAWAIIAN/PACIFIC 0% 70-79 0%
80+ 0%

2016 CHNA: South Lake Hospital Facility Report
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Data Summary

South Lake Hospital: Uninsured ER/Outpatient Hot Spot, cont’d.

Census Tract Summaries

CENSUS TRACT % UNEMPLOYED MED. HH INCOME % BELOW POVERTY
9.9% $41,450 21.4%
12-069-031305 9.2% $59,190 10.2%
12-069-031307 6.0% $52,180 8.9%
12-069-031309 8.4% $50,940 13.5%
AVERAGE

2016 CHNA: South Lake Hospital Facility Report
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Data Summary

Primary Data
Consumer Survey
Consumer survey data was scanned for themes based only on the responses of those from the ZIP
codes included in South Lake Hospital’s PSA (see page 9). emes from the 65 PSA respondents
included:

• Nearly 90 percent were satisfied with their life as a whole.
• Moderate satisfaction with their neighborhood and neighborhood connectivity.
• Only 30 percent say they can easily walk to stores, leaving the majority who cannot. Fewer than 40

percent of respondents say there are many places within walking distance. is issue may have to do
with a lack of sidewalks, drivers exceeding the speed limit and limited crosswalks.

• ere may be an issue accessing public transit, as more than 90 percent say it is not easy to walk to a

transit stop from their home.

• Decent biking infrastructure; 55 percent note easy access to trails, 30 percent believe it is unsafe to

ride a bike in their neighborhood and 40 percent note lack of facilities for biking.

• High perceived sense of safety/low crime.
• Physical and emotional problems each kept about 20 percent of respondents from fully engaging in

their regular activities.

Provider Survey Themes
Providers in Lake County noted the following as important issues:

• Poverty
• Homelessness
• Access to quality and nutritious foods
• Affordability of healthcare
• Wages
• Behavioral health services
• Need for cultural competency and equity

e most prominent Forces of Change noted by providers in Lake County included:

• Fast population growth
• Vaping/e-cigarettes
• Political divisiveness
• Medicaid expansion

2016 CHNA: South Lake Hospital Facility Report
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Data Summary

Stakeholder Interviews

Region-wide themes for stakeholder interviews are reported below since respondents oen served
more than one county. Common concerns included:

• Diabetes/obesity

• Poor nutrition

• Depression/anxiety/bipolar

• Substance abuse

• Vaping/e-cigarettes

• Inappropriate use of ERs

• Inappropriate use of ERs and jails for mental health services

• No Medicaid expansion

• Need more funding and support from the state for mental health services

• Influence of factors that aren’t traditionally thought of as health issues (beginning to think of these

things as laying the foundation for better physical health and overall wellness)

}• Employment/wages Viewed as major contributing
factors to level of homelessness
• Lack of affordable housing
• Food insecurity

• ere is a noticeable disparity between the strengths and assets/individual priorities of privileged

communities and impoverished ones

• Emphasis on the importance of education and prevention

Community Conversations

• Poverty
• Unaffordable health insurance
• Strong health education programs
• Stress
• Poor nutrition/food access
• Family dysfunction
• Poor access to pharmacies
• Substance/alcohol abuse
• Inappropriate use of ERs for primary care and mental health
• Prominent trails and parks
• Low affordable housing
• Poor water supply and quality

2016 CHNA: South Lake Hospital Facility Report
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Data Summary

Collaboration County-level Themes
While the Collaboration identified dozens of areas of concern for Lake County, they worked together
to select the 15 most pressing and feasible issues to tackle. ey are as follows:

• Mental illness/depression
• Diabetes
• Heart disease
• Poor access to food/nutrition
• Obesity
• Substance abuse
• Poor birth outcomes
• Inappropriate ER visits
• Poverty
• Asthma
• Falls
• Cancer
• HIV/AIDS
• Drowning
• Dental Care

2016 CHNA: South Lake Hospital Facility Report
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Synthesized Themes

Synthesized Themes

e following table provides a synthesis of the areas of concern across all of the data sources. Each data
collection method was scanned for themes and significant disparities across various demographic
items (race, education, income, etc.). e most common themes and indicators with the starkest
disparities were marked as areas of concern for each data collection method. ose areas are then
marked below to give the reader a visual representation of how oen each theme appeared across data
collection methods. e areas of concern are organized from most frequently discussed to least
frequently discussed.
It is important to note during prioritization that some themes may be noted as important by decision-
makers, but not viewed as priorities by the residents and vice-versa. Across the board, access and
affordability of services, both physical and mental health, continue to be the biggest obstacle to overall
health and well-being.

2016 CHNA: South Lake Hospital Facility Report
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Synthesized Themes

Synthesized Themes

SECONDARY DATA PRIMARY DATA

COLLABORATION CONSUMER PROVIDER STAKEHOLDER COMMUNITY

2016 DATA THEMES SURVEYS SURVEYS INTERVIEWS CONVERSATIONS

NEED FOR/ACCESS TO X X XX X X
MENTAL HEALTH SERVICES

ACCESS TO QUALITY/ X X XX X
NUTRITIOUS FOODS

AFFORDABILITY OF X XX
HEALTHCARE

DIABETES XX X

OBESITY X X

POVERTY XX X

SUBSTANCE ABUSE X XX

HEART DISEASE X X
X
INAPPROPRIATE USE X X
OF ER XX

VAPING/E CIGARETTES

MEDICAID EXPANSION X X XX
X
MATERNAL & CHILD X
HEALTH

AFFORDABLE HOUSING

LOW WAGES XX

FOOD INSECURITY X XX
X X
BIKE /PEDESTRIAN
FRIENDLY INFRASTRUCTURE

CANCER

TRANSPORTATION X

CANCER SCREENINGS X

STRESS X

2016 CHNA: South Lake Hospital Facility Report
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Synthesized Themes

Synthesized Themes, cont’d.

SECONDARY DATA PRIMARY DATA

COLLABORATION CONSUMER PROVIDER STAKEHOLDER CCOOMMMMUUNNIITTYY

22001166 DDAATTAA THEMES SURVEYS SURVEYS INTERVIEWS CCOONNVVEERRSSAATTIIOONNSS

FAMILY DYSFUNCTION X

POOR ACCESS TO X
PHARMACIES

WATER SUPPLY/QUALITY X

ASTHMA X

FALLS X

DROWNING X

HOMELESSNESS X

STI/HIV X

DENTAL CARE X

INACTIVITY X
X
NEED FOR CULTURAL X
COMPETENCE/EQUITY

POPULATION GROWTH

POLITICAL DIVISIVENESS X

2016 CHNA: South Lake Hospital Facility Report
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