Health Environment Assessment
PLAN4Health - Miami Valley Initiative
PLAN4Health - Miami Valley
A healthy community does not happen by accident. It requires a comprehensive approach covering all aspects of social, physical, and economic environments. Creating environments that promote healthy behaviors and improve health outcomes in our communities requires collaboration and partnerships between planning and health professionals.
MVRPC’s PLAN4Health – Miami Valley Initiative, launched in spring of 2021, explores how planning can impact health outcomes and seeks to achieve the goal of healthy people and communities in the Dayton Metro Region.
The PLAN4Health - Miami Valley Initiative is a multi-year effort with a focus on projects and programs intended to:
The PLAN4Health - Miami Valley Initiative does not seek to develop a regional health plan or duplicate activities undertaken by local public health departments. Rather, projects and programs are geared towards information sharing, capacity building, and generating collaborative solutions.
Click the button below to learn more about MVRPC's PLAN4Health - Miami Valley Initiative.
Keep scrolling to learn more about the Health Environment Assessment. The Health Environment Assessment is the first project from the PLAN4Health - Miami Valley Initiative.
Establishing a Baseline
County Health Rankings Model [1]
The County Health Rankings Model shows that clinical care only factors into 20% of overall health outcomes. The remaining 80% is attributed to social and economic factors, health behaviors, and the physical environment. [1] These are all elements that can be influenced through planning.
To improve health outcomes in the Region, we first need to understand where we are now, and what the trends have been on factors that are known to be key determinants of health.
The Health Environment Assessment, the first project of the PLAN4Health - Miami Valley Initiative, employs the Social Determinants of Health (SDOH) Model to establish a baseline and help guide future planning efforts. The baseline established from the Health Environment Assessment will be used to:
- Start a conversation between planners and public health professionals
- Provide insight to similar challenges faced by different communities in the Region
- Empower collaboration between organizations that focus on specific SDOH elements
Social Determinants of Health
There are many things that impact how well and how long we live. Beyond medical care, our health and well-being can be influenced by everything from education to the environments we find ourselves in. Collectively, these factors are called Social Determinants of Health (SDOH).
SDOH are defined as "conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks." [2]
SDOH can be grouped into five domains, as shown on the image.
Click the button below to explore additional resources related to SDOH.
In order to better understand conditions in the Region, it is helpful to see how the state ranks on factors associated with SDOH. According to the 2021 Health Value Dashboard, published by the Health Policy Institute of Ohio [3], Ohio ranks:
The Health Environment Assessment is a tool providing information to better understand local conditions and establish a baseline at the regional level.
Here are some important facts and features about the Health Environment Assessment:
- Covers the five (5) SDOH domains
- Analyzes and maps out twenty-three (23) indicators at the neighborhood level
- Examines current conditions and trends
- Provides interactive maps for each domain
- Shares highlights from the indicators
- Presents a composite map of all the domains as a SDOH index
- Shares findings from the assessment
Continue to the next section to see the conditions of each SDOH domain, starting with the Economic Stability Domain.
Economic Stability
The Economic Stability domain focuses on financial resources and factors. Five indicators are examined individually and together.
Click the button below to learn more about each indicator.
Map Legend
Across the Region, there is a dispersed pattern of areas that are less economically stable. Economic stability is found to be lower in older and established central cities and along major transportation corridors.
Click on the map to explore data for a given area.
The following information provides some of the highlights from the indicator analyses.
At the county level, the median income ranges from $51,542 to $77,668. At the neighborhood level, however, the gap between the area with the highest median income and lowest median income is extreme - over $192,000 difference between the highest and lowest income areas.
In the Region, nearly 1 in 7 people live in poverty, and many more struggle to afford things like healthy foods, health care, and quality housing.
There are pockets of poverty throughout the Region in both urban and rural communities alike.
When households pay more than 30% of their income on housing costs they are considered to live in "cost burden housing".
Region-wide, about 25% of households are considered to be cost burden when it comes to housing.
Living in cost burden housing is a distributed issue across the Region impacting households at all income levels. However, there are greater concentrations of cost burden in communities where incomes are low.
Education Access and Quality
The Education Access and Quality domain focuses on educational resources and factors. Four indicators are examined individually and together.
Click the button below to learn more about each indicator.
Map Legend
The examination of four indicators for Education Access and Quality reveal that there is a dispersed pattern of areas that have lower educational outcomes. Education access and quality is identified to be lower in predominantly rural counties compared to other areas.
Click on the map to explore data for a given area.
The following information provides some of the highlights from the indicator analyses.
At the regional level, about 1 out of 11 people aged 25 or older do not have a high school diploma or equivalent. There is, however, a large gap within the Miami Valley when examined at the neighborhood level. Many areas have 100% attainment, while the lowest performing area only has about 51% attainment.
Regionally, about 47% of 3 and 4 year olds are enrolled in a preschool program. This is higher than Ohio's rate of 45% but lower than the national rate of 54%. Rural counties have the lower rates of enrollment.
In the Miami Valley, about 38% of the population aged 25 or older holds an associates degree or higher. This is an increase of 9% since 2000, but under the national rate of 41%.
Social and Community Context
The Social and Community Context domain focuses on community cohesion and social factors. Five indicators are examined individually and together.
Click the button below to learn more about each indicator.
Map Legend
Across the Region, there is a concentrated pattern of lower outcomes on the social and community context domain in Montgomery and Greene Counties. Better outcomes are observed in the Region's rural areas.
Click on the map to explore data for a given area.
The following information provides some of the highlights from the indicator analyses.
Regionally, about 1 in 14 households is a single-parent household. While this is lower than the national average, the number of single-parent households have been increasing. Since 2000, the number of single parent households in the Miami Valley has doubled.
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Civic participation allows people to develop and use knowledge, skills, and their voice to foster positive change. These actions can help improve conditions that influence health and well-being. For the Health Environment Assessment, civic participation was measured through voter turnout data.
Across the Region, nearly 3 out of 4 eligible voters participated in the 2020 election. The Miami Valley had a higher participation rate than both the state and nation.
Areas of concentrated poverty consist of places where the poverty rate is 40% or higher.
Across the Region, more than 48,000 people or 5% of the population live in areas of concentrated poverty. Since 2000, more places have been classified as areas of concentrated poverty and the number of people living in areas of concentrated poverty has increased by 15,670. Additionally, the income inequality gap has increased in every county in the Region since 2009.
Health Care Access and Quality
The Health Care Access and Quality domain focuses on access and understanding of health resources and factors. Four indicators are examined individually and together.
Click the button below to learn more about each indicator.
Map Legend
Our Region shows areas with poor health and health care outcomes are concentrated around central cities in each county. There are additional pockets of poor outcome areas, noticeably in western Miami County and eastern Darke County.
Click on the map to explore data for a given area.
The following information provides some of the highlights from the indicator analyses.
The Miami Valley has high prevalence of health insurance coverage - only about 6% of the population is uninsured. This is better than state and national rates. However, within the Region there are areas where up to 40% of the population lacks coverage.
Region-wide, 78% of adults reported having visited a doctor for a routine check up within the last year. Unlike other indicators, there is not a substantial difference between areas with the highest rates and lowest rates of routine check ups - 88% and 71% respectively.
In the Miami Valley, the average life expectancy from birth is 76 years and 5 months. Examining the data at the neighborhood level reveals that the difference by location is dramatic. There is a more than 25 year difference in the area with the highest life expectancy and the lowest life expectancy.
Neighborhood and Built Environment
The Neighborhood and Built Environment domain focuses on factors of places where people live, work, and play. Five indicators are examined individually and together.
Click the button below to learn more about each indicator.
Map Legend
There is a polarized pattern within the neighborhood and built environment domain with a concentration of poor outcomes centered around Dayton and first ring suburbs. By contrast, rural communities are showing better outcomes.
Click on the map to explore data for a given area.
The following information provides some of the highlights from the indicator analyses.
Low access to healthy foods measures proximity to the nearest supermarket, super center, or large grocery store. For urban areas the distance is one mile, and for rural areas the distance is ten miles.
According to these distance thresholds, about half of our Region's population is estimated to have poor access to healthy foods.
High vacancy rates are associated with decreased property values, higher crime rates, interruptions to social cohesion, and neighborhood stability. These conditions in the neighborhood contribute to and impact health and well-being of its residents directly and indirectly.
On average 1 in 10 houses in the Region is vacant. Reviewing the historic trends reveals that housing vacancy has been increasing in the Region. Housing vacancy rates in the Region have increased by 3.2% since 2000.
Traffic can pose major health risks. Not only in terms of safety concerns from traffic incidents, but also noise pollution, emissions, congestion, and more. In the Miami Valley approximately 110,650 people or 12% of the population live in very close proximity to major roadways - like interstates - which increases exposure to these hazards.
Baseline: Pulling it All Together
Social Determinants of Health Index
The Health Environment Assessment developed a Social Determinants of Health (SDOH) Index for the purpose of establishing a comprehensive baseline of where the Region stands on key factors that are known to be indicators of health. The SDOH Index is a composite of all 23 indicators under the five domains. In addition, the conditions on the Social Determinants of Health were further examined at the domain and indicator levels to provide additional insights on the current status.
Map Legend
The map of the SDOH Index shown above reveals that our Region has varying degrees of health environment conditions. Generally our Region shows a polarizing pattern with urban and first tier suburban communities presenting weaker conditions in comparison to better conditions in the rural and outer ring suburbs.
Click on the map to explore data for a given area.
In the Miami Valley, the SDOH Index is fairly evenly distributed when applied to the general population. That is, about 28% of the Region’s residents live in areas with lower outcomes, 34% in areas with moderate outcomes, and 38% in areas with higher outcomes. However, some notable disparities are observed when examined amongst population of different characteristics.
For example, the Health Environment Assessment revealed that 64% of the urban population live in areas with low to very low SDOH outcomes compared to just 10% of the rural population.
Click below to explore the Health Environment Assessment Equity Analysis findings.
The next section summarizes the findings from the examinations on the Social Determinants of Health conditions, providing additional baselines at the regional and local levels.
Regional Baseline
At the domain level, the Health Care Access and Quality domain presented better outcomes, when compared to other domains.
Conversely, the Social and Community Context domain had lower outcomes. While there were no specific indicators that stood out with poor outcomes, collectively the indicators aligned to create less than desirable outcomes.
Click the button below to see how the Region performs on the twenty-three (23) indicators compared to the state and nation.
When examining individual indicators, the Region had several that outperformed state and national benchmarks.
Likewise, the Region had indicators that showed under-performance when compared to state and national data.
Local Baseline
The Health Environment Assessment revealed varying outcomes for communities across the Region.
The findings for each county at the domain and indicator levels are summarized below. They highlight the best and worst performing domain for each county in the Region. In addition, results from the indicator level examination are presented with highlights on indicators that are doing well and where improvements could be made to improve health outcomes. For this assessment, the twenty-three (23) indicators for each county were benchmarked to the regional baseline. The images below highlight each county's top three performing indicators and bottom three performing indicators.
Click on an image to enlarge the county level outcomes.
The Health Environment Assessment reveals that all areas - urban, suburban, and rural alike - have conditions that could be improved to bolster health and well-being for the Region's residents. Further, the assessment indicates that every community has an opportunity to address factors that contribute to poor health outcomes. The issues present, however, vary across the Region.
The baseline established from the Health Environment Assessment should serve as a foundation as our Region makes efforts to improve health outcomes in our communities. Innovative solutions through collaboration and partnership between planning and health professionals would be required to address our common issues at the regional level and unique challenges at the local level.
Keep Learning
Data and Maps for Domains and Indicators
About Us
Established in 1964, the Miami Valley Regional Planning Commission promotes collaboration among communities, stakeholders, and residents to advance regional priorities. MVRPC is a forum and resource where the Board of Directors identifies priorities and develops public policy and collaborative strategies to improve quality of life throughout the Miami Valley Region. MVRPC performs planning and research functions for our Region that ensure livable and equitable communities; clean air and water; robust roadway, transit, and active transportation options; and strategic community plans that chart the course for member communities and partners. As the designated Metropolitan Planning Organization (MPO), MVRPC is responsible for transportation planning in Greene, Miami and Montgomery Counties and parts of northern Warren County. MVRPC's areawide water quality planning designation encompasses five (5) counties: Darke, Preble plus the three MPO counties.
Contact Information
For more information, contact: Martin Kim, Director of Community and Regional Planning at mkim@mvrpc.org.
