June 11, 2015
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Access to care, increasing obesity rates and social capital among key topics from the region's largest health survey

PHILADELPHIA— The impact of the Affordable Care Act, obesity rates and social capital in Southeastern Pennsylvania are some of the key topics released today from the 2015 Southeastern Pennsylvania Household Health Survey (HHS), a biennial survey conducted by Public Health Management Corporation's (PHMC) Community Health Data Base. HHS is the most comprehensive health survey in the region and the largest in the country, covering 10,000 randomly selected households in Bucks, Chester, Delaware, Montgomery and Philadelphia counties. The 2015 data release marks the fourteenth survey since the launch in 1983.

"The Household Health Survey is a unique, one-of-a-kind local snapshot based on its sophisticated analysis of data at the regional, county and even smaller geographical levels," said Francine Axler, Executive Director of PHMC's Community Health Data Base. "The biennial survey changes frequently to stay on trend with the evolving health care and community landscape, and can measure health, social status and access to care over time. The 2015 data features 14 new topic areas, including information on the Affordable Care Act, HIV testing, and use of e-cigarettes and vaporizers."

Despite the drop in individuals without health insurance – 12.4 percent in 2012 to 8.5 percent in 2015 – cost is a huge barrier to entry for many across the region. Of the more than 520,000 adults under the age of 65 who looked into buying insurance on, 67.4 percent found it difficult to find a plan with monthly premiums they could afford. Finding a plan with reasonable co-pays and deductibles was difficult for 68.7 percent of the respondents who looked into health insurance on Among adults without insurance, the number one reason cited was cost (44.7 percent), followed by lost job or changed employers (11.1 percent), employer does not offer coverage/or not eligible (7.4 percent), difficulties associated with the website (3.6 percent), and objections to the Affordable Care Act (2.1 percent).

With or without insurance, more than 323,000 (10.2 percent) adults in Southeastern PA were sick at some point this year, but did not seek care due to the cost. More than one in seven adults did not fill a prescription due to cost.

Other key findings include:
• 36.9 percent of those who looked into buying insurance through, or more than 190,000 adults in Southeastern PA, enrolled in a plan.
• The number of uninsured children in SEPA slightly decreased from 3.3 percent in 2012 to 2.3 percent in 2015; this percentage represents 21,313 children with no private or public health insurance.
• In Philadelphia, the rates of uninsured adults decreased even more dramatically, from 18.5 percent in 2012 to 12.3 percent in 2015 and 3.9 percent, or 13,122, children in Philadelphia are uninsured, down from 4.6 percent in 2012.
• Younger adults aged 18-34 are twice as likely to lack health insurance as their older counterparts aged 35-64. Males are more likely than females to be uninsured.
• Latino adults are more likely to be uninsured than any other race or ethnicity.

Nearly 30 percent of adults (age 20+) in the region are obese, an increase from 27.7 percent in 2012 and 21 percent in 2000. Among children aged 6-17, 21.4 percent are considered obese in 2015 vs. 18.5 percent in 2012.

On a county level, Philadelphia has the highest rate of childhood obesity at 32 percent and the largest increase in obesity rates since 2012 (+7.5 percent). Philadelphia is followed by Montgomery County (18.8 percent), Delaware (17.8 percent) Bucks County (14.2 percent) and Chester County (10.3 percent). Chester County reported the lowest levels of childhood obesity in the region and is the only county in Southeastern PA that saw a decrease in obesity levels since 2012 (-3 percent).

Included in this year's survey was a series of questions designed to assess social capital, or the expected collective or economic benefits derived from cooperation between individuals and groups. Topics such as how much trust you have in your neighbors, would you help/have you helped your neighbors, number of organizations you are involved in, access to safe outdoor space and more were included to measure social capital rankings for the region. Social capital results are based on a 10-point score derived from five questions.

In Southeastern PA, Chester County reported the highest levels of social capital at 20.8 percent, followed by Montgomery County (16.1 percent), Bucks County (15.7 percent), Delaware County (12.9 percent) and Philadelphia County (8.6 percent).

In Philadelphia, Center City reported the highest levels of social capital at 16.1 percent, followed by South Philadelphia (11.5 percent), Upper North Philadelphia (9.5 percent), Southwest Philadelphia (8.3 percent) West Philadelphia (7.6 percent) and Lower North Philadelphia (6.3 percent).

Social capital questions can provide useful insights into the health of a community, especially when measured against other indicators such as obesity. For example, among adults who have access to a nearby park or outdoor space they are comfortable visiting, slightly more than one-quarter, or 28.3 percent, are obese compared to more than three in ten, or 35.5 percent, of those who do not have access to parks or outdoor space.

Other key social capital findings in Southeastern Pennsylvania include:
• 54.2 percent said most people would always/often be willing to help their neighbors.
• 85.5 percent agree or strongly agree that they feel they belong in their neighborhood.
• 78.2 percent have a park or outdoor space they are comfortable visiting, vs. 21.8 percent who do not.
• 48.5 percent of people in Southeastern PA participate in one or more community organization and 25.2 percent participate in two or more.

"Leading health care organizations, policy makers and non-profits trust CHDB and the HHS to help identify the unmet needs of our community, and assist in organizational planning, program implementation and service prioritization," added Axler.

The 2015 HHS survey is the largest and most in-depth local survey in the country, conducted by telephone and covering areas such as mental health, barriers to care, sources of care, health behaviors, health status, screenings, disease prevention and more.

About Public Health Management Corporation's Community Health Data Base
Public Health Management Corporation (PHMC) is a nonprofit public health institute that creates and sustains healthier communities. The Community Health Data Base (CHDB) includes the Household Health Survey, the largest regional health surveys in the country. The Pew Charitable Trusts, United Way of Southeastern Pennsylvania, United Way of North Penn, Green Tree Community Health Foundation, North Penn Community Health Foundation, Thomas Scattergood Foundation, Pottstown Area Health and Wellness Foundation, and more than 350 local agencies from the health, government, nonprofit and academic sectors help to support the CHDB and the survey. For more information, visit