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CHNA Executive Summary

Parkland Health (Parkland) and the Dallas County Health and Human Services (DCHHS) undertook a joint Community Health Needs Assessment (CHNA) in adherence to the Patient Protection and Affordable Care Act (ACA) and as part of the accreditation process for public health departments.

In accordance with the ACA, the CHNA’s report was accepted by Parkland’s Board of Managers on September 18, 2019.

The overarching goal of this CHNA was to identify the geographic areas and populations that experience the most significant health disparities including, racial and ethnical minorities, low social economic populations, underserved population, those with chronic disease and those with infectious disease.

The methodology framework used for this CHNA includes: Public Health Practice, Community Based Participatory Research, Strategic Planning as well as qualitative and quantitative data analysis. The data used for this report was gathered from an array of data sources and from a series of focus groups conducted throughout Dallas County.

The following provides an overview of the key finding that emerged from this CHNA.

Findings

Access to Care

  • Health Insurance Coverage: There is high uninsured rate in Dallas County and high a high volume uninsured hospital discharges, particularly in Parkland. Of note, Dallas County has one of the highest uninsured rates among all urban counties in the nation—higher than both Harris County, Texas and Bexar County, Texas
  • Behavioral Health: Dallas County does not have enough behavioral health capacity to support the high demand for those services. Navigating the health system in Dallas County is difficult for those with behavioral health needs and there is a lack of integration between behavioral health and physical health. According to input provided by focus group participants, the demand for behavioral health services for school children, youth, and seniors is concerning.
  • Health Literacy: Provider and patient feedback from focus groups indicates there is a general lack of understanding of how to obtain/use health coverage, navigate the health system and adhere to treatment plans and provider instructions, which are often not culturally or linguistically accessible to the patient. There is an overall concern with the degree to which Dallas County residents, particularly racial and ethnic minorities and those living in southeast area of the County, have the capacity to obtain, communicate, process and understand information pertaining to health and health services.
  • Cultural Competency: The ever-increasing diversity of Dallas County requires greater resources devoted to cultural competency including the establishment of best practices.

Health Disparities

  • There are significant health disparities by race and ethnicity and by geographic location within the county. African American and people living in ZIP Codes located in Southeast Dallas continue to experience the highest burden of disease and mortality.

Special Populations

  • The demand for health services for homeless and elderly individuals continues to grow as these populations increase in numbers.

Chronic Conditions

  • Hypertension, cancer, diabetes, asthma, chronic kidney disease and chronic heart failure, which are related to tobacco use, poor nutrition and lack of physical activity are the leading causes of death and contributors of a high volume of inpatient hospitalizations.

Infectious Diseases

  • The increasing number of Sexually Transmitted Diseases, cases in Dallas County is a significant problem.