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Community Health Needs Assessment

The Community We Serve

Population & Demographics

MUSC has served the citizens of South Carolina since 1824. The total population of South Carolina is 4,625,364. The Charleston metropolitan area is comprised of Berkeley, Charleston, and Dorchester counties, with a total population of 664,607, or about 14% of all South Carolina residents. The largest South Carolina racial/ethic groups are White (68.4%) followed by Black (28.0%) and Hispanic (5.3%). 17.0% of South Carolina residents live below the federal poverty level. 14.7% of South Carolina residents are persons 65 years and over. Significant growth is anticipated in this community as the area continues to be recognized as an ideal location to live, work, and relax.

Community Health Behaviors

Engaging in healthy behaviors can reduce risk of morbidity and mortality from chronic and infectious diseases. However, engaging in unhealthy behaviors, such as smoking, obesity, excessive drinking, and physical inactivity can increase these risks. The Robert Woods Johnson Foundation (RWJF) created a “County Health Rankings & Road maps” feature that ranks counties on various community health access measures. Behavioral health factors were assessed for adult smoking, adult obesity, excessive drinking, and physical inactivity in Berkeley, Charleston, and Dorchester counties compared to the state of South Carolina and national benchmarks.

Table 1 illustrates the percentage of adults that reported being active smokers who have smoked 100 cigarettes or more. Table 2 illustrates the percentage of adults that reported a BMI of 30 or higher. Table 3 illustrates the percentage of the population that binge drinks or drinks heavily. Table 4 illustrates the percentage of adults reporting no leisure time physical activity. South Carolina is over the national benchmark thresholds in all health behavior categories.

Table 1.

Adult Smoking

1.

Berkeley County

23%

2.

Charleston County

18%

3.

Dorchester County

21%

4.

South Carolina

21%

5.

National Benchmark

13%

 

Table 3.

Excessive Drinking

1.

Berkeley County

16%

2.

Charleston County

22%

3.

Dorchester County

15%

4.

South Carolina

14%

5.

National Benchmark

7%

Table 2.

Adult Obesity

1.

Berkeley County

38%

2.

Charleston County

28%

3.

Dorchester County

30%

4.

South Carolina

31%

5.

National Benchmark

25%

 

Table 4.

Physical Inactivity

1.

Berkeley County

30%

2.

Charleston County

24%

3.

Dorchester County

26%

4.

South Carolina

28%

5.

National Benchmark

21%

 

Community Access to Primary Care

The future of U.S. healthcare will largely depend on the sustainability of accessible primary care. The Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) created a Geographic Health Professional Shortage Areas (HPSA) Analyzer to identify areas that have a shortage of primary medical care, dental, or mental health providers. Primary Care HPSAs are based on a population to physician ratio of 3,500:1. When there are 3,500 or more people per primary care physician, an area is eligible to be designated as a primary care HPSA. The following map illustrates primary medical shortages in the Charleston area, represented in green.

Health Professional Shortage Areas

Table 5 illustrates average ratio of population to primary care physician in Berkeley, Charleston, and Dorchester counties compared to the state of South Carolina and national benchmark. According to the RWJF, the level of access to primary care physicians in Berkeley, Charleston, and Dorchester counties is comparable to the state of South Carolina, and the national benchmark. As a whole, ratio averages are below the HPSA threshold of 3,500:1 for the following geographic regions.

Table 5.

Primary Care Physicians

1.

Berkeley County

3,438:1

2.

Charleston County

804:1

3.

Dorchester County

2,646:1

4.

South Carolina

1,545:1

5.

National Benchmark

1,067:1

 

Earlier this year, the South Carolina Department of Health and Human Services (SCDHHS) announced that MUSC Children’s Care Network was one of 16 primary care practices selected to receive a grant to participate in the Community Health Worker program (CHW), a component of the SCDHHS Health Access and the Right Time (HeART) initiative that uses trained and certified community residents to improve patient care and health outcomes in conjunction with the physicians’ medical home plan of care.

Community Access to Healthy Food

Food Access Research Atlas

Access to healthy food is critical for community health. Food deserts are defined as parts of the country vapid of fresh fruit, vegetables, and other healthy whole foods, usually found in impoverished areas. This is largely due to a lack of grocery stores, farmers’ markets, and healthy food providers, combined with transportation limitations. The US Department of Agriculture created a Food Access Research Atlas for mapping food deserts and exploring access to healthy and affordable foods nationwide. The following map illustrates the prevalence of food access within the tri-county area. The orange regions represent low-income census tracts where a significant number or share of residents is more than 0.5 miles from the nearest supermarket. The green regions represent low-income census tracts where a significant number or share of residents is more than one mile from the nearest supermarket.

The following tables illustrate the level of access to healthy foods and the presence of fast food restaurants in Berkeley, Charleston, and Dorchester counties, compared to the state of South Carolina, and national benchmarks, according to the RWJF. Table 6 illustrates the percentage of the population who are low-income and do not live close to a grocery store. Table 7 illustrates the percentage of all restaurants that are fast food establishments.

Table 6.

Access to Healthy Foods

1.

Berkeley County

7%

2.

Charleston County

6%

3.

Dorchester County

5%

4.

South Carolina

8%

5.

National Benchmark

1%

Table 7.

Fast Food Restaurants

1.

Berkeley County

58%

2.

Charleston County

44%

3.

Dorchester County

57%

4.

South Carolina

49%

5.

National Benchmark

27%

 

The above information suggests that our community’s physical environment does not sufficiently provide easy access to healthier foods. These environmental quality factors potentially influence other health concerns, such as poor nutrition and adult and childhood obesity.

MUSC Health Recognition

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