While the vast majority of children across the Chicago region had health insurance coverage, fewer than 40% of kids in certain neighborhoods received a flu vaccine and more than half were obese.
That's just one of the health disparities highlighted as part of the recently released neighborhood-level survey of children’s health in the western and southern parts of Chicago. Conducted by the Sinai Urban Health Institute (SUHI)—the community research arm of the Sinai Health System—the Sinai Community Health Survey 2.0 is the largest community-driven, face-to-face survey ever conducted in Chicago, with answers given by primary caregivers. Overall, about 400 caregivers completed the survey.
It offers an intimate look across nine Chicago neighborhoods in an effort to focus on community partnerships to tackle social determinants of health, including healthy behaviors, healthcare access, obesity and nutrition, and food insecurity.
It's especially valuable because community health assessments often lack a focus on children, Pamela Roesch, SUHI’s director of health equity and assessment research, told FierceHealthcare. Children in these communities are going to become adults in these communities, she said. And researchers are already seeing signs of cardiovascular disease and diabetes in these younger populations.
“It’s an important group of people and it’s harder to get data on them, so we need to think about other ways of looking at it, like with this latest release of information on a neighborhood level,” Roesch said.
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Insights from the data include:
- Many children in these communities fall short of the recommended guidelines for physical activity, sleep and screen time; less than one-third of children met recommendations for screen time limits.
- Less than half of the children in these three communities had received a flu vaccine in the past year.
- While obesity varied greatly across communities, more than half of children ages 2 and 3 were obese.
- Child food insecurity affected children in all communities. Almost one-third of non-Hispanic black and Hispanic/Latino households with young children suffered food insecurity.
The report also looked at adults in an effort to discover unmet needs. Roesch said that anywhere between 11% and 34% of adults in these communities were uninsured.
“These numbers highlight to our healthcare system that even with the ACA [Affordable Care Act], barriers need to break down in order for people to get the needed care,” Roesch said.
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For example, Roesch points to the fact that the neighborhood of West Englewood had the lowest level of uninsured adults, 11%, but had the highest percentage of unmet prescription needs. Similarly, while most children were insured and attended well-child visits, many did not receive a flu vaccine and as many as two in five had visited an emergency department in the past year.
One unique aspect modeled in this survey was how it was administered. SUHI works with a community advisory board for collecting and disseminating all information. Partners on the local level, already embedded in the community, were the ones to go into the homes and ask the respondents questions.
How health systems can replicate the study
SUHI will be publishing a paper that highlights how other health systems can collect more meaningful data.
Among the lessons: while there are always barriers to collecting data on this type of scale, Roesch recommends to other health systems to engage with community residents throughout the process. In this study, community reps helped to pick and specifically word questions and then oversaw the administration of the survey.
“In order to overcome some of the barriers, we foresaw the need to have residents and stakeholders in the room—as partners—to make sure information was addressing their priorities too,” Roesch said.
Roesch warned that the study was expensive. However, she notes that a large-scale survey does not need to be done in order to continually build a meaningful relationship. On a smaller scale, systems can host focus groups or attend town hall meetings in order to better understand at a neighborhood level.
“People are living these issues in their daily lives so we need to address them as soon as possible,” she said.