WINTHROP-UNIVERSITY HOSPITAL

COMMUNITY NEEDS ASSESSMENT

2013

Winthrop-University Hospital
259 First Street
Mineola, NY 11501
www.winthrop.org
1-866-WINTHROP

TABLE OF CONTENTS
I.

Introduction1

II.

Community Served..2

III.

CHNA Process, Methodology and Findings..4

IV.

Identified Needs.13

V.

Prioritization of Needs...15

VI.

Community Assets Identified.19

VII.

Conclusion..19

Appendix
1.

Preliminary Community Health Assessment Data

2.

Community Based Organization Interview Findings

3.

Community Surveys & Certificate of Translation

4.

Community Health Assessment Survey Results

5.

Community Resources

I. Introduction
A provision of the Affordable Care Act requires that not-for-profit hospitals conduct and publish a
Community Health Needs Assessment (CHNA) once every three years, and annually report to the IRS the
steps it is taking to address the needs it has identified. To complete this requirement and produce the
most effective assessment possible, Winthrop-University Hospital collaborated with the Nassau County
Department of Health, four other Nassau County Hospitals and academic partners to conduct the
assessment. The following report outlines the assessment process, the findings and a prioritization of
significant health needs.

ABOUT WINTHROP-UNIVERSITY HOSPITAL

Winthrop-University Hospital is a 591-bed, not-for-profit regional healthcare resource located
in the Incorporated Village of Mineola in Nassau County, a suburban community that borders
New York City and Suffolk County. Founded in 1896, Winthrop owns the distinction of being
Long Islands first voluntary hospital. We offer an extensive range of preventive, diagnostic and
clinical medical services through a broad range of primary care and specialized inpatient and
outpatient programs. Winthrop delivers the highest level of care to newborns, children and
adults as evidenced by our respective designations as a NYS Regional Trauma Center, NYS
Department of Health Stroke Center, NYS Regional Perinatal Center and NACHRI Designated
Childrens Hospital (National Association of Childrens Hospitals and Related Institutions).
Winthrop is also the first nationally accredited Breast Health Center in Nassau County, a Breast
Imaging Center of Excellence, an accredited Bariatric Surgery Center of Excellence, a
Hypertrophic Cardiomyopathy Center of Excellence, and a Level-4 Epilepsy Center.
We are also currently building The Research and Academic Center, a 95,000 square-foot, fivestory facility that will house laboratories, academic lecture halls and clinics which will facilitate
bench-to-bedside research, cross-fertilization of ideas and access to the most current
information available.
Winthrop currently spends $5.8 million on unsubsidized research; our 2014 budgeted
unsubsidized expense has been increased to $6.5 million. We have chosen to focus many of our
research programs on health issues directly affecting the communities we serve. Diabetes,
therefore, is a primary focus, both in the adult and pediatric population.
Our work in diabetes has been recognized nationally. Winthrops Diabetes Education Center
was the first in New York State to be recognized by the American Diabetes Association in
accordance with National Standards for Diabetes Self Management Education and Support. We
are also the first New York State Major Teaching Hospital to be awarded a Gold Seal of
Approval for Inpatient Diabetes Care by the Joint Commission.
The Hospital employs over 6,900 dedicated individuals, including nearly 1,500 nurses; our
medical staff includes more than 1,800 full-time and voluntary attending physicians.
1

During 2012, Winthrop logged over 70,000 Emergency Department visits, discharged 31,724
inpatients and delivered 4,360 newborns. This included 8,629 inpatient surgical discharges, 590
of which were open-heart operations; an additional 20,428 ambulatory surgical cases were also
performed. There were over 79,000 visits to community residents by the Hospitals certified
Home Health Agency and more than 42,000 visits through its Long Term Homecare Program.

MISSION STATEMENT
It is the mission of Winthrop-University Hospital to provide high-quality, safe, culturally
competent, and comprehensive healthcare services in a teaching and research environment,
which improve the health and well-being of the residents of Nassau County and contiguous
county areasbased on a profound commitment to an enduring guiding principle Your
Health Means Everything.

ACADEMIC AND CLINICAL AFFILIATIONS

Winthrop is the Clinical Campus of the Stony Brook University School of Medicine and an
affiliated member of the New York-Presbyterian Healthcare System.

II. Community Served

Winthrops primary core service area is Nassau County. According to 2012 Population estimates
from the U.S. Census Bureau, Nassau County has an estimated population of 1,349,233. The
median age of residents is 41.1; 89.9% are high school graduates or have achieved higher
education, and a median household income is $95,832 with an estimated 5.2% of individuals
below poverty level. 1 Race is reported as: 64.1% white alone, not Hispanic or Latino; 15.3%
Hispanic or Latino; 12.2% Black or African American and 8.4% Asian.2
Estimated data from County Health Ranking and Roadmaps from the University of Wisconsin
Population Health Institute indicates that although Nassau County is ranked as number 1 in
New York State for Health Factors, it is number 8 in Health Outcomes; Health Behaviors are
ranked at 3. The unemployment rate is 6.7%, compared with the national benchmark of 5.0%.
Approximately 12% of the population is uninsured; the national benchmark is 11%. Primary
care physician rates are solid about 675 patients to one doctor, compared to 1,067 patients to
one doctor nationally. An estimated 9% of children live in poverty, compared to 14% nationally.
Although adult obesity is estimated at 21% in Nassau compared to 25% nationally, physical
inactivity affects 23% of our population compared to 21% nationally. Excessive drinking rates
are high: 16% compared to national estimates of 7%. Teen birth rate is at 12% compared to
21% nationally.3
1

http://factfinder2.census.gov/faces/nav/jsf/pages/community_facts.xhtml
http://quickfacts.census.gov/qfd/states/36/36059.html
3
http://www.countyhealthrankings.org/app/new-york/2013/county/snapshorts/059
2

There are 12 hospitals within Nassau County and approximately 40 urgent care centers.4 There
is no tracking system in New York State to indicate the precise number of healthcare
professionals currently practicing. However, in 2013 the New York State Education Department
reported the following licensing statistics: 10,067 registered licensed physicians and 1,490
physicians assistants5, 1,562 nurse practitioners6; and 2,153 licensed dentists in Nassau.7
Nassau County represents a dichotomy, as health disparities exist within and between
townships of varying socioeconomic composition. There are also differences in health status
based on race and ethnicity. For example, infant mortality is much higher among African
Americans than Caucasians. Latinos have higher rates of teen pregnancies, tuberculosis and
deaths from injuries. The causes of these disparities are numerous and complex, and include
differences in income, education, housing, and access to healthcare. Identifying and addressing
disparities was one of the collaborative teams public health goals.
Winthrops comprehensive approach to healthcare delivery includes the provision of both
primary and specialty services to our service area. The Hospitals primary/core service area has
historically been Nassau County, in Core Areas A, B, and C (See map below); based on an
analysis of 2012 discharge data (Table 1), 80.6% of Winthrops discharges are from this area.
Therefore, this was the focus of our assessment.

Blue: Core A; Green: Core B; Pink: Core C; Purple: Core D; Yellow: Core E

http://www.itriage.com
http://www.op.nysed.gov/prof/med/medcounts.htm
6
http://www.op.nysed.gov/prof/nurse/nursecounts.htm
7
http://www.op.nysed.gov/prof/dent/dentcounts.htm
5

Table 1

Discharge Data 2012

(excluding normal newborns)
Core Areas
A
B
C
Nassau Total

Total
17,472
6,953
1,149
25,574

% of Total
55.1%
21.9%
3.6%
80.6%

D
E
Other
TOTAL

1,560
506
4,084
31,724

4.9%
1.6%
12.9%
100%

Within Core Areas A, B and C, 30% of Winthrops discharges are from select communities (Table
2,) i.e., those that are designated by the NCDOH as experiencing health disparities. Although
they include Elmont (11003), Inwood (11096), Freeport (11520), Glen Cove (11542), Uniondale
(11553), Long Beach (11561), and Roosevelt (11575) Hempstead (11550) and Westbury
(11590) in Core Area A are geographically closest to the hospital and provide 24% of our patient
population. Significant attention was paid to these areas.
Table 2

Discharge Data 2012 Select Communities

(excluding normal newborns)
Core Areas
A
B
C
TOTAL

Total Select
Communities
6,217
1,307
143

% of Total

WUH Total

81%
17%
2%

17,472
6,953
1,149

% of WUH
Total
24%
5%
.6 %

7,667

100%

25,574

30%

III. CHNA Process, Methodology and Findings

Winthrop conducted the CHNA in collaboration with Catholic Health Services, Long Beach Memorial
Hospital, North Shore LIJ Health System, and South Nassau Communities Hospital. Our academic
partners included Adelphi University, Hofstra University and Stony Brook University. Our public health
expert was Tavora Buchman, PhD, Director, Division of Quality Improvement, Epidemiology and
Research from the Nassau County Department of Health, whose expertise was instrumental in our
collaborative process. Dr. Buchman presented preliminary statistical data that identified the most

significant health needs within Nassau County, including health disparities in select

communities. She also organized workgroup meetings, invited academic experts to help
develop assessment tools (surveys and key-informant interviews), compiled data, and
presented the results to the collaborative group and community partners.
Preliminary community health assessment data presented by the Nassau County Department of
Health to the collaborative workgroup on January 15, 2013, compared Nassau County, NYS and
select communities within Nassau County to identify population health problems and health
disparities. This comparison included rates of age/ethnicity/race distribution, diseases of the
cardiovascular system (including stroke), diseases of the respiratory system, diabetes and liver
disease, injuries (intentional and unintentional), cancer, communicable diseases, mortality, and
pregnancy/perinatal outcomes. Sources of information included SPARCS data (2008-2010),
NYSDOH Vital Statistics, NYS Cancer Registry and the NYSDOH Surveillance System. Data were
age-adjusted (direct standardization of rates) based on 2000 U.S. standard population (See
Attachment 1).
The collaborative workgroup determined that in addition to census, hospitalization and vital
statistics data, the assessment should include the voice of the community (i.e., the
communitys perception of need). The workgroup agreed that in order to be effective, both
qualitative and quantitative data should be collected from community organizations and the
population-at-large. Two subcommittees Community-Based Organizations (CBOs) and
Community-Wide Survey were formed with representation from the five not-for-profit
hospitals, academic partners and the Nassau County Department of Health; each subcommittee
was charged with developing and implementing the procedures to collect the information. The
following explains and summarizes the results of both processes.
Community-Based Organizations Key Interview Process

The Community-Based Organizations (CBO) subcommittee was charged with conducting key
informant interviews with Nassau Countys health and human services providers. The
subcommittee met on January 25, 2013, to develop a list of key community organizations and a
CBO interview guide. Emphasis was placed on groups that addressed one or more of the
following populations: minorities/medically underserved, seniors, womens/childrens services,
special populations and individuals with disease-specific conditions. The subcommittee
included:

Adelphi University
Hofstra University

1. Professor of Public Health

Director of the MPH Program
1.Associate Professor
Graduate Director, Master of Public Health & Master of
Science in Community, Health Programs

Long Beach Medical Center

1. Special Projects Representative

Nassau County Department of Health

1. Director, Division of Quality Improvement, Epidemiology

& Research
2. Epidemiologist
3. Intern

North Shore LIJ Medical Center

St. Francis Hospital
Winthrop-University Hospital

1. Director , Public Health Initiatives

1. Director, Rehabilitation & Community Services
1. Assistant Director, Community Relations

A qualitative CBO interview guide was developed and included questions with added prompts regarding
New York States Five Prevention Agenda Priorities (Prevent Chronic Diseases; Promote a Healthy and
Safe Environment; Promote Healthy Women, Infants and Children; Promote Mental Health and Prevent
Substance Abuses; Prevent HIV, STDs, Vaccine-Preventable Diseases), significant health problems in the
CBOs communities, barriers to care, quality of care, current health services, and recommendations for
improving services.
The interviewers included representatives from the hospitals, the academic partners and the county
health department. All interviewers were required to participate in a training session to ensure
consistency across the interviewing process. This training was provided on February 6, 2013, by an
Assistant Professor of Preventive Medicine in the Divisions of Evaluative Services and Community Health
at Stony Brook University. As a result of the training, modifications were made to the interview guide. A
copy of the final CBO interview guide is included as Attachment 2.
The group agreed that all interviews should be audio-recorded and transcribed.
were shared among the hospitals and the Department of Health.

Transcription duties

COMMUNITY-BASED ORGANIZATION KEY INFORMANT INTERVIEW DATA

Interviews with community-based organizations were conducted between March and April of 2013.
Representation included:
American Cancer Society
Syosset, NY
American Diabetes Association
Melville, NY
American Heart Association
Plainview, NY
Catholic Charities
Hicksville, NY
Circulo de la Hispanidad
Long Beach, NY
FEGS Health & Human Services (Federation of
Employment & Guidance Service System)
Hempstead, NY

1. Director of Patient and Family Services

1. Director, Long Island Operations
1. Regional Vice President Field Operations
1. Director of Development and
Communications
2. Developer, Information and Referral
1. Executive Director
2. Chief Director of Services and Operations
1. Senior Director
2. Director of HIV Services
3. Vice President, Long Island Operations

Health and Welfare Council of Long Island

Hempstead, NY
Island Harvest
Mineola, NY
Jewish Association Serving the Aging (JASA)
Long Beach, NY
LI GLBT (Gay, Lesbian, Bisexual, Transgender)
Garden City, NY
Long Island Council of Churches
Hempstead, NY
Mental Health Association
Of Nassau County
Glen Cove, NY
Perinatal Services Network
Uniondale, NY
Planned Parenthood
Hempstead, NY
Massapequa, NY
Glen Cove, NY
Project Independence
Roslyn Heights, NY
Sustainable Long Island
Farmingdale, NY
United Way
Deer Park, NY

1. President and CEO

1. SNAP Outreach Coordinator
1. Director, Long Beach Services
1. Chief Operating Officer and Director of
Development for Long Island
1. Director
2. Nassau County Coordinator
1. Director of Special Projects
1. Coordinator
1. Senior Vice President for Health Services,
Planned Parenthood of Nassau County

1. Deputy Commissioner
2. Senior Citizen program Development
Specialist
1. Executive Director
1. Senior Vice President

The collaborative workgroup hired a consultant to analyze results. Staff from the Nassau County
Department of Health interviewed three potential consultants to conduct the qualitative
analysis of the key informant interviews. With input from an academic partner, a doctoral
candidate in Public Health at CUNY Graduate Center was selected Jessica B. Steier, MPH, DPH
Candidate. The hospitals contracted with and paid for the consultant. The consultant coded the
key informant transcripts using Atlas TI software. Coding reliability was tested and an analysis
was conducted to identify emergent themes. The findings were presented to the committee
and CBOs on May 15, 2013 and are included as Attachment 3.
Participants overwhelmingly reported chronic disease as one of the most pressing
health problems; 76.4% of organizations feel it is a priority; 50% feel it is the number
one health priority.
The most commonly mentioned chronic diseases were diabetes, heart disease and
cancer.
Obesity was seen as the most important risk factor for chronic conditions; preventing
obesity among youth, especially among minority populations, represented a strong
theme.
7

Patient education should emphasize prevention versus treatment, with a focus on

healthy lifestyles (eating healthy and exercising)
There should be increased communication across organizations to ensure visibility of
available programs and resources
A taskforce with members from various organizations would be helpful to brainstorm
additional ideas and solutions
Increased patient navigation and case management services would break down
barriers to care
Barriers to care:
Inadequate public transportation in the county
Language barriers for non-English speaking persons seeking quality health services
Lack of awareness of available health resources (e.g. need to update 211 information
banks that provide confidential information and referral for help with food, housing,
employment, healthcare, etc.)
Undocumented immigrant populations not accessing healthcare services due to fear of
being reported and LGBT (lesbian, gay, bisexual and transgender) populations not
accessing care due to fear of being treated differently
Other themes included: the need for more in-home health and mental health services
for homebound seniors; heavy reliance on emergency rooms for primary care; and the
need for women to play a larger role in helping men access needed health services

INDIVIDUAL SURVEYS
The Individual Survey Subcommittee agreed that the use of a uniform survey distributed widely
throughout communities in Nassau County would help ascertain the health perceptions and key
concerns of residents, as well as identify service needs and barriers to care. The subcommittee included:
Adelphi University
Hofstra University

1. Professor of Public Health, Director of the MPH Program

1. Associate Professor, Graduate Director, Master of Public
Health and Master of Science in Community, Health Programs

Long Beach Medical Center

1. Special Projects Representative

Nassau County Department of Health

1. Director, Division of Quality Improvement, Epidemiology &

Research
2. Epidemiologist
3. Intern

North Shore LIJ Medical Center

1. Director, Public Health Initiatives

2. Health Educator
3. Director, Community Benefit

St. Francis Hospital

South Nassau Communities Hospital
Winthrop-University Hospital

1. Community Health, Promotion Programs, Marketing &

Conference Management
1. Director of Community Education
1. Assistant Director, Community Relations

Surveys were translated into a certified copy of Spanish and widely distributed throughout the
county (Attachments 4 & 5). Each Nassau County Hospital and NCDOH distributed the survey to
community members at events targeting various age groups, diverse populations and
communities with health disparities. The survey was distributed between February and April
2013. It reached a broad spectrum of community residents from many different zip codes.
According to 2010 US Census estimates, 19% of Nassau Countys population reside in select
communities. Out of 1070 surveys returned, 25.8% were from select communities, indicating
that there was proportionate representation from populations with health disparities.
OUTCOME OF SURVEY
The survey results were analyzed by the NCDOH and shared with the CHA/CHIP committee
and community partners on May 15, 2013. Responses were analyzed according to two
separate populations: Nassau County in its entirety and select communities (communities with
health disparities). Complete survey results are included as Attachment 6.

The top health concerns for all the respondents and the select communities were the
following chronic diseases: cancer, obesity, diabetes and heart disease.
All respondents indicated that health screenings/educational programs on chronic
disease especially diabetes and blood pressure were needed, highlighting the
importance of routine well care, nutrition and physical activity.
Womens and childrens health were also cited as a priority; it should be noted that 72%
of respondents were women
Select communities identified substance abuse as an additional high priority health
concern.
Both the total respondents and the select communities identified healthy food choices,
recreational facilities, weight loss programs, clean air and water and job opportunities
as items needed to improve the health of the community.
All the respondents receive the majority of their health information from health
professionals, the internet, television and family/friends.
Over 50% of the total respondents and 70% of the select community respondents had a
smart phone.

Barriers to Care
The top concerns for barriers to medical treatment included:
No insurance
Lack of ability to pay deductibles and co-pays
Fear of discussing health issues
9

Lack of knowledge about the importance of routine medical care

As noted above, the results of both the Key-Informant Interviews and the Individual Surveys
were shared with the CHA/CHIP committee and community partners on May 15, 2013.
Attendees included:
Adelphi University

1. Professor Public Heath, Director of the MPH

Program

Catholic Health Services

FEGS Health & Human Services (Federation of
Employment and Guidance Services)
Hofstra University

1. CHS Vice President Public and External Affairs

1. Project Director
2. Care Coordinator
1. Associate Professor, Graduate Director,
Master of Public Health and Master of Science
in Community Health Programs
1. Director, Senior Services

Jewish Association Service the Aging (JASA)

Long Beach Services
Long Beach Medical Center
Mental Health Association of Nassau County
Mercy Hospital

Nassau County Department of Health

Nassau County Lions Club Foundation

Nassau County Perinatal Services Network
Nassau-Suffolk Hospital Council
Nu Health Family Health Centers
Planned Parenthood of Nassau County
South Nassau Communities Hospital
St. Francis Hospital

St. Joseph
Sustainable Long Island

The Long Island GLBT Services Network (Gay,

Lesbian, Bisexual, Transgender
Town of North Hempstead Project
Independence

1. Special Projects Representative

1. Director, Project Hope
1. Director of Planning and Community Health
2. Public Relations, Marketing and Events
Coordinator
1. Director, Division of Quality Improvement,
Epidemiology & Research
2. Epidemiologist
3. Intern
1. Secretary
1. Director
1. Director of Communications
1. Quality Assurance Coordinator
1. Representative
1. Community Educator
1. Manager, Community Health Promotion
Programs; Emergency Cardiac Care Programs,
Marketing & Conference Management
1. Project Manager/Supply Chain Liaison
1. Executive Director
2. Community Planner/
Educational Program Coordinator
1. Chief Operating Officer
2. Director of Programs
1. Deputy Commissioner Department of Services
for the Aging

10

United Way of Long Island

Winthrop-University Hospital

1. Senior Vice President, HIV/AIDS

Grant Management
2. Contract Administrator/Quality Manager
1. Assistant Director, Community Relations &
Special Projects

At this collaborative meeting with our community partners, the following data was shared and
presented by the Department of Health:

Rates of disease burden and vital statistics data, including health disparities by
age, sex and community:
o Chronic disease, Injury, Perinatal Outcomes, Communicable Disease
Community-wide survey results:
o Normally distributed, represented demographics in the county
o Obesity, Chronic Disease (Cardiovascular Disease, Diabetes, Cancer) and
Mental Heath emerged as priorities
Key Informant Interview process:
o Chronic disease overwhelming report
o Obesity ranked as most important risk factor
o Mental Heath also emerged; reported as important
The following preliminary priorities emerged as a result of this collaborative effort:
Prevent Chronic Disease
1. Reduce Obesity in Children and Adults
2. Increase Access to High Quality Chronic Disease Preventive Care and Management in
both Clinical and Community Settings

In addition, the collaborative group decided to touch on and promote mental health as
well address substance abuse.

WINTHROPS CULTURAL COMPETENCY COMMITTEE

In addition to the collaborative process, Winthrop engaged local community partners in a
discussion on May 21, 2013 to clarify the needs of their communities, validate the findings and
discuss solutions. Representation included:

Hempstead Hispanic Civic Association

Hempstead, NY

1. Executive Director
11

BQLI-AHEC
(Brooklyn-Queens Long Island Area
Health Education Center)

1. LI Program Coordinator
2. Area Health Education Center

Nassau County Department of Health

Uniondale, NY
Perinatal Service Network, DOH
Uniondale, NY
Hispanic Counseling Center
Hempstead, NY
Noticia (Hispanic Newspaper)

1. Commissioner, Nassau County Dept. of Health

St. Brigids Church

Westbury, NY
Winthrop Pediatrics (Hempstead
Outpatient Clinic)
Hempstead, NY
Winthrop Womens Wellness
(Hempstead Outpatient Clinic)
Hempstead, NY

Winthrop-University Hospital
Mineola, NY

1. Director
1. Program Coordinator
1. Sales Director
2. Executive Assistant
1. Director
1. Practice Manager
2. Certified Child Life Specialist
1. Social Worker
2. Ancillary Practice Manager
3. Nurse Manager
4. Summer Intern
1. Chief Executive Officer
2. Vice President, Womens & Childrens Services
3. Director of Development
4. Manager, Community Training
5. Community Outreach Educator
6. Community Outreach Educator
7. Manager, Community Outreach
8. Director of Pastoral Care
9. Assistant Director, Community Relations
10. Administrative Director, OB/GYN

These concerns were clarified by Winthrops community partners:

It was determined that obesity and diabetes, along with other chronic diseases such as
cancer and heart disease, are the most important conditions to be addressed.
Concerns were also raised about mental health issues, drug and alcohol abuse, asthma,
illegal alien status, domestic violence, and womens ignorance about contraception,
The high cost of food, cultural food issues that undermine health (such as traditional,
high fat high carbohydrate diets) and lack of access to affordable, appropriate food
were also discussed.
12

The consensus of opinion is that the hospital needs to go into the community, during
weekends or another appropriate times when the underserved are available. CBOs are
looking for health screenings and follow-up. Participating agencies offered to act as
liaisons by letting their respective populations know that the Hospital will be coming to
them.
Barriers to Care were similar.
Mistrust on the part of the community (e.g. fear of the undocumented)
Lack of insurance for the working poor
Lack of access to care on weekends
Language barriers
Lack of knowledge about managing conditions
Transportation difficulties (e.g. a single mother taking children on two buses to the
Hempstead clinic).

IV. Identified Needs

In addition to the survey, key-informant interview process and discussions with our partners,
Winthrop also researched the top causes of death in Nassau County during 2011 (see below).
They were: heart disease, cancer, CLRD (Chronic Lower Respiratory Disease, i.e., asthma,
COPD), stroke and unintentional injury. 8

500

Top Causes of Death, Nassau

County
2011
Average Rate per
100,000
Population

http://www.health.ny.gov/statistics/leadingcauses_death/deaths_by_county.htm
13

The Leading Causes of

Premature Death in
Nassau County (before
age 75) were slightly
different cancer was
number one and heart
disease two,
unintentional injury
came in third, followed
by CRLD and stroke.

Leading Causes of Premature Death

Nassau County (Before Age 75)
250
200
150
100
50

Average Rate per

100,00 Population

The above information is in alignment with our assessment; the health conditions cited as the
leading causes of death were recognized as the top concerns by the community we serve. In
addition, according to the Center for Disease Control, chronic diseases are the nations leading
causes of death and disability. Heart disease, stroke, cancer, and diabetes are among the most
prevalent, costly, and preventable of all health problems. 9 Leading a healthy lifestyle (e.g.,
avoiding tobacco use, being physically active, and eating well) greatly reduces a persons risk for
developing chronic disease. Access to high quality care and affordable prevention measures
(including screening and appropriate follow-up) are essential steps in saving lives, reducing
disability and lowering costs for medical care.
Therefore, the assessment identified public health priorities that are aligned with national,
state and community health concerns. The most significant needs identified are as follows:
Reduce Obesity in Children and Adults
The prevention and management of chronic disease:
o diabetes
o heart disease
o cancer
o lung conditions
o stroke
Mental health and substance abuse
Women and Childrens Health
Unintentional Injuries (Falls)
Dental Services

http://www.cdc.gov/chronicdisease/overview/index.htm

14

V. Prioritization of Needs
The process included a discussion with our community partners, an examination of resources
and the feasibility of the success of possible interventions. The following criteria were utilized
in determining the prioritization of needs:
SPARCS data (2008-2010), NYSDOH Vital Statistics, NYS Cancer Registry and the
NYSDOH Surveillance System
Winthrops Admissions Data
The severity of the public health need
Results from Community Survey and Key Informant Interviews from CBOs
Resources both hospital and community-based
Health disparities within our core market area
New York State Prevention Agenda Priorities
Priorities of Healthy People 2020
Feedback from Winthrops leadership team, many of whom sit on the boards of local
organizations
Informal discussions with Winthrops healthcare providers

RANKING
Winthrop ranked priorities based on the burden, scope and urgency of the health need, health
disparities in select communities and the importance the community placed on addressing the
needs. Priorities are as follows:
1. Reduce obesity in children and Adults The evidence supporting significant health risks
associated with obesity is compelling: obesity and overweight are the second leading cause of
preventable death in the United States and may soon overtake tobacco as the leading cause of
death. By the year 2050, obesity is predicted to shorten life expectancy in the US by two to five
years.
Obesity-related condition include heart disease, stroke, type 2 diabetes and certain types of
cancer all identified by our assessment as public health priorities. Therefore, it was
determined that Winthrop may make the most significant impact on public health by
addressing obesity.
2. Diabetes There are significant disparities with select communities that were identified in
our report from the NCDOH (see chart).

15

Hospitalization from Type 2

Diabetes occurs more than
twice as often in the select
communities than it does in
the rest of Nassau County.
Given the significant health
disparity
in
select
communities, the potential
complications that lead to
heart disease, stroke, eye
problems, amputations and
more,
the emphasis the
public placed on diabetes in our assessment and Winthrops expertise in the area of diabetes
management, the Hospital has chosen to prioritize and address diabetes case findings, prevention and
management.

3. Asthma Asthma
poses a health disparity
in Nassau County, as
illustrated
by
the
accompanying
chart.
Interventions that focus
on proper management
can impact healthcare
costs and the long-term
effects on our countys
fourth leading cause of
death.

4. Cardiovascular Disease, Including Stroke The number one killer of adults both nationally
and within Nassau County. Interventions such as cholesterol screenings, public education, and
the benefits of a healthy lifestyle will be addressed by the Hospital.

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5. Women and Childrens Health Perinatal outcomes in select communities are poor (See
charts). Winthrop has a Womens Wellness Clinic in Hempstead to address access and barriers
to care and will make this a priority.

6. Cancer Identified as a priority by our community, Prostate, Lung, Breast and Colon Cancer
have the highest incidence of occurrence in Nassau County. Winthrop currently has a broad
spectrum of cancer services that include diagnosis, treatment and support. We will work with
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community partners on public education efforts that will emphasize the importance of reducing
risk factors and seeking appropriate screenings.
7. Mental Health & Substance Abuse Identified as a significant health problem by our
community, we have limited resources in this field. However, we have a referral system in
place and will address the issue through public education efforts.
8. Unintentional Injuries (Falls)
Falls in the elderly are a
significant risk factor for
hospitalization, loss of quality of
life and death.
We will
continue to address this issue
through public education that
addresses risks and balance
exercises.

9. Dental Care In conducting the assessment, Winthrop noted the link between the lack of
routine dental care and complications with diabetes, and other systemic diseases10. For
example, oral health is considered to be a public health opportunity by the New York State
Department of Health11, due to its link with diabetes. The action notes: Because chronic
periodontal inflammation has been identified as a potential risk factor for poor glycemic
control, routine dental care may help prevent complications from diabetes. This will be
addressed through education and free screenings.

10

http://www.webmd.com/oral-health/features/oral-health-the-mouth-body-connection?page=2
http://www.health.ny.gov/statistics/prevention/injury_prevention/information_for_action/docs/20118_ifa_report.pdf
11

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VI. Community Assets Identified

The collaborative effort identified a number of strong community assets (Attachment 9),
including the other four hospitals and their community programs, an adequate number of
primary care physicians, health
clinics, and community-based
organizations.

VII. CONCLUSION
Our assessment revealed that
Nassau County has the resources necessary to support health, yet there are communities
experiencing significant health disparities. It is also notable that an estimated 46 percent of
deaths in New York State are attributable to modifiable risk factors. Tobacco use, poor diet,
lack of physical activity, and alcohol consumption are the most common behaviors linked to
preventable deaths. Because of this, Winthrop will work with community partners to improve
outcomes by stressing the importance of a healthy lifestyle, seeking appropriate clinical
services and treatment, and improving access to care.
In addition, our county-wide assessment led to an initiative called the Long Island Collaborative,
a coalition of Nassau and Suffolk County Hospitals, community-based organizations and
businesses that will focus on improving the health of residents, primarily by focusing on
reducing obesity and managing and preventing chronic conditions. The collaborative effort will
also address mental health. This initiative is moving forward with a three-pronged approach
that will encompasses programming, policy, and public outreach. It is hoped that this
collaborative effort will make a positive impact on population health.

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