The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.

1. Presentation by Erin Lenhardt, Daniel Lynn,
Veronica Locke, Jessica Jacobs, and Karen Jose

2. “Good health is the bedrock
on which social progress is
built. A nation of healthy
people can do those things
that make life worth-while,
and as the level of health
increases so does the
potential for happiness.”
- Lalonde Report, 1974

3.  Quantitative measures that are pieces of
health care puzzle that answers:
◦ How healthy is the community?
◦ Is the community in balance?
◦ What factors affect health in the community?
◦ Are the programs, services, and policies effective?
◦ If not, which areas are in need of improvement?
◦ Is the community proceeding towards or away from
its ideal of health?

4.  Stable population, rising slightly

7.  Six health-related indicators:
1. Obesity & Unhealthy Eating Habits
2. Tobacco Usage
3. Substance Abuse
4. Mental Health
5. Injury/Unintentional Accidents
6. Health Care Access

8.  Excessive body fat, high BMI
◦ Diabetes, heart disease, cerebrovascular disease (stroke)
◦ 44% of total mortality

9.  Several tobacco-related diseases
◦ Chronic lower respiratory disease, malignant
neoplasms (cancer), cerebrovascular disease (stroke)
◦ 33% of total mortality in county

10.  Excessive tobacco, alcohol, & drug usage
 2% of total deaths in county

11.  All accidents, including those attributed to substance abuse
 Accidents account for 6% of mortality in county
◦ Predominately affects 15-24 age group: 26%

12.  15-44 age group: 46% of suicides
 Affects +75 population: 95%

13.  Lower rates of infant, neonatal deaths
 Better access to maternal care in Hillsboro County

14.  Health insurance
 Health care resource allocation
 Positive signs
 Key Middleboro characteristics:
◦ Economically stagnant
◦ High unemployment
◦ Rising health care costs
◦ All contributing to escalating uninsured

15.  Rising levels of uninsured
 Decreased employer-based insurance – increasing commercial
 Implications: less necessary care provided, or none provided at all

16.  Shifting trends – declining hospital inpatient care utilization
◦ Implications:
 Suggests some health care costs too high - no insurance or underinsured
 Suggests medically underserved population - foregoing necessary treatment?
 Less spent on health care – various economic consequences

17.  Recent legislation: cannot exclude due to pre-
existing medical conditions
◦ Will expand access to insurance coverage
 Bill under consideration: small business reform
and health insurance purchasing pools
◦ More affordable health insurance
 Managed care penetration
◦ Fee-for-service decreasing
 Prescription drug coverage expanding
◦ More comprehensive, affordable care

20.  Accurate framing of
community’s issues
 Provides sound
solutions
 Window to
Middleboro’s values
and vision

21.  Any Questions?