District 11 Health Profile

, FL, FL District 11 Health Profile 2013

Demographics 1 2013 Total Population 2,605,371 100.0% 73,927 100.0% 19,356,053 100.0% <5 156,182 6.0% 3,161 4.3% 1,112,910 5.7% 5-9 153,167 5.9% 3,092 4.2% 1,101,358 5.7% 10-14 154,199 5.9% 2,939 4.0% 1,130,674 5.8% 15-17 96,299 3.7% 1,920 2.6% 713,286 3.7% 18-20 106,404 4.1% 1,835 2.5% 773,073 4.0% 21-24 141,860 5.4% 3,048 4.1% 1,013,363 5.2% Age 25-34 354,184 13.6% 8,648 11.7% 2,351,889 12.2% 35-44 374,027 14.4% 9,403 12.7% 2,399,781 12.4% 45-54 387,921 14.9% 12,380 16.7% 2,733,594 14.1% 55-64 300,034 11.5% 13,796 18.7% 2,482,080 12.8% 65-74 204,404 7.8% 8,614 11.7% 1,939,068 10.0% 75-84 125,195 4.8% 3,764 5.1% 1,134,497 5.9% 85+ 51,495 2.0% 1,327 1.8% 470,480 2.4% Gender Male 1,261,941 48.4% 39,271 53.1% 9,460,272 48.9% Female 1,343,430 51.6% 34,656 46.9% 9,895,781 51.1% White 1,933,388 74.2% 65,876 89.1% 14,342,603 74.1% Race & Ethnicity Black/African American 482,323 18.5% 4,394 5.9% 3,156,564 16.3% Hispanic 1,744,123 66.9% 16,063 21.7% 4,661,896 24.1% Non-Hispanic 861,248 33.1% 57,864 78.3% 14,694,157 75.9% Page 1 District 11 Health Profile 2013

2. Economics 2013 Average Household Income 1 $58,947 $68,065 $59,964 Less than $15,000 183,965 20.3% 3,616 10.9% 1,187,427 15.6% $15,000 to $24,999 124,444 13.7% 4,035 12.2% 1,026,569 13.5% $25,000 to $34,999 109,839 12.1% 4,141 12.5% 978,050 12.8% $35,000 to $49,999 131,825 14.5% 5,784 17.4% 1,220,909 16.0% Household Income $50,000 to $74,999 144,850 16.0% 6,346 19.1% 1,345,889 17.6% $75,000 to $99,999 82,477 9.1% 3,840 11.6% 785,332 10.3% $100,000 to $124,999 49,495 5.5% 1,963 5.9% 437,693 5.7% $125,000 to $149,999 23,589 2.6% 932 2.8% 214,287 2.8% $150,000 to $199,999 27,518 3.0% 1,191 3.6% 231,349 3.0% $200,000 to $499,999 22,194 2.4% 1,053 3.2% 165,741 2.2% $500,000 or more 6,195 0.7% 260 0.8% 38,129 0.5% Median Household Income $38,977 $47,418 $42,662 Year/ Month Miami- Dade Percent of Businesses < 100 Employees 2 2011 98.3% 99.2% 98.1% Unemployment Rate (Annual Average) 3 Unemployment Rate (Not Seasonally Adjusted) 3 Percentage of PreK-12 Students Eligible for Free/Reduced Lunch 4 Percentage of High School Diplomas or Higher (Population 25 Years or Over) 1 2012 (Revise d August 2013 2012-2013 9.3% 5.0% 8.6% 8.4% 4.0% 7.1% 73.1% 44.1% 58.6% 2013 77.1% 89.9% 85.2% Percent with College Diplomas (Bachelor's Degree or Higher, Population 25 Years or 2013 25.6% 28.4% Over) 1 Percent of Persons Below 100% of the Federal Poverty Level (FPL) 5 Median Monthly Medicaid Enrollment (Rate per 100,000 Total Population) 6 25.7% 2012 20.8% 14.2% 17.1% 2011 23,110.8 9,759.7 16,524.1 Page 2 District 11 Health Profile 2013

3. Adult Behavioral Risk Factors 7 2010* Percentage of adults who are sedentary 24.5% 16.9% 24.0% Percentage of adults who are obese 28.1% 16.9% 27.2% Percentage of Adults who are overweight, not obese 38.3% 37.1% 37.8% Current Smokers 10.2% 21.4% 17.1% Heavy Drinkers (Men: > 2 drinks/day; Women: >1 drink/day); 1.9% 10.0% 5.2% Binge Drinkers (Men: 5+ drinks on a single occasion in the past month; Women: 4+) 11.6% 23.0% 13.7% Have ever been told by a doctor that they have diabetes 9.0% 7.3% 10.4% Have been told they currently have asthma 7.1% 5.8% 8.3% Adults aged 50+ who have ever had a sigmoidoscopy or colonoscopy Adults aged 50+ who have had a blood stool test within the past two years Women aged 40+ who have had a mammogram within the past two years Women aged 50+ who have had a mammogram within the past two years Women aged 18+ who have had a pap test within the past three years 71.4% 58.5% 68.2% 16.9% 15.7% 21.1% 78.9% 75.2% 77.1% 83.6% 76.8% 80.4% 74.5% 83.4% 80.4% *The results from the 2013 county level Behavioral Risk Factor Surveillance System Survey (BRFSS) will be available in May, 2014. Page 3 District 11 Health Profile 2013

4. Communicable Diseases 2012 Year Number Rate per 100,000 Number Rate per 100,000 Number Rate per 100,000 Reported New AIDS Cases 8 2012 620 24.5 22 30.4 2,775 14.6 Reported New HIV Cases 8 2012 1,262 49.8 27 37.4 5,388 28.3 Reported Tuberculosis Cases 9 2011 156 6.2 1 1.4 753 4.0 Gonorrhea Cases 10 2012 2,412 95.2 15 20.8 19,551 102.7 Chlamydia Cases 10 2012 9,650 380.7 129 178.5 77,851 408.8 Infectious Syphilis Cases 10 2012 348 13.1 4 5.5 1,375 7.2 Page 4 District 11 Health Profile 2013

Absence of Health Insurance Coverage 5 2012 Total 745,846 29.1% 19,021 25.9% 3,815,840 20.1% Under 6 years 12,679 7.0% 830 23.5% 103,028 8.0% 6 to 17 years 60,414 16.7% 1,525 20.0% 331,978 12.3% 18 to 24 years 105,910 42.1% 3,251 54.8% 602,903 34.1% 25 to 34 years 154,390 43.6% 3,633 48.6% 820,406 35.7% 35 to 44 years 150,661 40.8% 4,167 43.0% 705,930 29.9% 45 to 54 years 144,694 37.9% 2,901 23.7% 709,746 26.3% 55 to 64 years 101,435 34.7% 2,624 19.8% 492,243 20.1% 65 to 74 years 11,188 5.7% 62 0.7% 34,343 1.8% 75 years and over 4,475 2.6% 28 0.5% 15,263 1.0% Under 18 years 73,839 13.5% 2,355 21.1% 435,006 10.9% 18-64 656,344 39.8% 16,576 34.1% 3,331,228 28.8% 65 years or over 15,663 4.2% 90 0.7% 45,790 1.3% White 564,605 29.0% 16,008 24.3% 2,686,351 18.5% Black or African American 141,710 29.6% 2,544 47.5% 747,905 24.9% White, Not Hispanic 54,447 13.3% 11,327 22.0% 1,514,888 14.0% Hispanic 551,926 33.4% 5,048 32.3% 1,411,861 31.9% Not Hispanic 193,920 21.3% 13,973 24.1% 2,403,979 16.5% Non-Citizen 355,023 57.7% 4,171 58.7% 969,223 53.7% Page 5 District 11 Health Profile 2013

11, 12 6. Maternal and Infant Health Indicators 2012 Total Resident Live Births 30,479 709 212,954 Total Resident Live Birth Rate (per 1,000 Population) 12.0 9.8 11.2 Total Teen Births (Age 15-19) 1,685 37 15,950 Percent of Total Births 5.5% 5.2% 7.5% Rate per 1,000 Females Ages 15-19 21.0 25.3 27.2 Total Repeat Births to Teens Age 15-19 268 3 2,693 Percent of Teen Births 15.9% 8.1% 16.9% Low Birth Weight Infants (< 2500 Grams) 2,683 44 18,291 Low Birth Weight Rate 8.8% 6.2% 8.6% Percent of Births to Mothers with 1 st Trimester Prenatal Care 87.7% 83.5% 80.0% Percent Late or No Prenatal Care * 2.8% 3.5% 4.8% Infant Deaths 149 1 1,285 Infant Death Rate (per 1,000 Live Births) 4.9 1.4 6.0 Percent of Kindergarteners Immunized 91.5% 94.8% 92.1% *Late Prenatal Care refers to prenatal care commencing during the 3 rd Trimester Page 6 District 11 Health Profile 2013

13, 14, 15 7. Leading Causes of Death Monore 2012 Number Age Adjusted Death Rate Number Age Adjusted Death Rate Number Age Adjusted Death Rate Heart Diseases 4,857 161.6 135 137.2 41,643 155.3 Cancer 4,124 139.6 172 160.8 41,696 160.3 Stroke 856 28.5 16 19.0 8,372 31.2 Chronic Lower Respiratory Disease 852 28.4 28 27.8 10,525 39.1 Unintentional Injuries 632 23.0 44 53.4 8,561 39.7 All Causes, Total Deaths 18,580 628.9 662 642.8 175,849 680.7 5, 16, 17, 18 8. Hospital Utilization January 1, 2012 December 31, 2012 Total Resident Discharges 342,735 9,098 2,670,508 Rate per 100,000 Population 13,227.7 12,161.6 13,243.1 Total Licensed Beds (All Unit Types Excluding Skilled Nursing)* 9,155 202 60,590 Total Licensed Acute Care Beds (December 31, 2012) 7,419 157 50,258 Occupancy Rate (Acute Care Beds) 53.2% 35.7% 56.4% *There are 37 Skilled Nursing Beds in District 11 Page 7 District 11 Health Profile 2013

8. Hospital Utilization (Continued) 16 (2012) Number of Discharges Percent Total Resident Discharges 342,735 100.00% Hospitals 316,258 92.3% Resident Discharges by Hospital Jackson Memorial Hospital 35,950 10.5% Baptist Hospital Of Miami 35,526 10.4% Kendall Regional Medical Center 22,542 6.6% Palmetto General Hospital 22,230 6.5% Mount Sinai Medical Center 20,641 6.0% South Miami Hospital, Inc 17,460 5.1% Mercy Hospital 17,199 5.0% Aventura Hospital And Medical Center 17,175 5.0% University Of Miami Hospital 16,102 4.7% North Shore Medical Center 13,590 4.0% Hialeah Hospital 12,099 3.5% Homestead Hospital 10,510 3.1% Jackson North Medical Center 10,294 3.0% Jackson South Community Hospital 9,729 2.8% Miami Children's Hospital 9,258 2.7% All Remaining Hospitals 72,430 21.1% (2012) Total Resident Discharges (2012) Hospitals (2012) Hospitals (2012) Number of Discharges Percent 9,098 100.0% 5,389 59.2% 3,207 35.2% Resident Discharges by Hospital Lower Keys Medical Center 4,079 44.8% Baptist Hospital Of Miami 938 10.3% Mariners Hospital 487 5.4% Mount Sinai Medical Center 472 5.2% Fishermen's Hospital 455 5.0% Depoo Hospital 368 4.0% Homestead Hospital 339 3.7% South Miami Hospital, Inc 323 3.6% Jackson Memorial Hospital 292 3.2% University Of Miami Hospital 186 2.0% Miami Children's Hospital 181 2.0% All Remaining Hospitals 978 10.7% Page 8 District 11 Health Profile 2013

9. Preventable Hospitalizations 19 2012 PQI 1 Diabetes Short-term Complications Admission Rate per 100,000 population 18 years and older AHRQ Prevention Quality Indicators (PQI) Residents Residents Residents Admissions Rate Admissions Rate Admissions Rate 1,089 56.1 33 54.1 10,173 68.1 2 Perforated Appendix Admission Rate (% all discharges age 18 years and older with diagnosis code for appendicitis) 426 20.4% 23 25.6% 3,713 26.0% 3 Diabetes Long-term Complications Admission Rate per 100,000 population 18 years and older 2,949 151.9 51 83.6 20,473 137.1 5 Chronic Obstructive Pulmonary Disease (COPD) Admission Rate per 100,000 population 18 years and older 4,346 223.9 129 211.5 40,223 269.4 7 Hypertension Admission Rate per 100,000 population 18 years and older 2,353 121.2 29 47.5 14,594 97.8 8 Congestive Heart Failure (CHF) Admission Rate per 100,000 population 18 years and older 8,204 422.7 155 254.1 56,254 376.8 9 Low Birth Weight Rate (% all live born births) 1,995 6.7% 24 3.5% 13,243 6.4% 10 Dehydration Admission Rate per 100,000 population 18 years and older 973 50.1 38 62.3 8,267 55.4 11 Bacterial Pneumonia Admission Rate per 100,000 population 18 years and older 6,096 314.1 185 303.3 48,592 325.5 12 Urinary Tract Infection Admission Rate per 100,000 population 18 years and older 6,214 320.1 134 219.7 37,994 254.5 13 Angina w/o Procedure Admission Rate per 100,000 population 18 years and older 258 13.3 20 32.8 2,443 16.4 14 Uncontrolled Diabetes Admission Rate per 100,000 population 18 years and older 902 46.5 15 24.6 4,635 31.0 15 Adult Asthma Admission Rate per 100,000 3,183 164.0 59 96.7 20,929 140.2 16 Rate of Lower-extremity Amputation among Patients with Diabetes per 100,000 population 18 years and older 869 44.8 14 23.0 5,803 38.9 Page 9 District 11 Health Profile 2013

9. Preventable Hospitalizations (Continued) 19 2012 PQI AHRQ Pediatric Quality Indicators (PDI) Residents Residents Residents Admissions Rate Admissions Rate Admissions Rate 14 Asthma Admission Rate per 100,000 population ages 2 to 17 years 748 149.7 10 100.1 5,404 141.4 15 Diabetes Short-term Complications Admission Rate per 100,000 population ages 6 to 17 years 102 27.4 1 13.2 756 26.6 16 Gastroenteritis Admission Rate per 100,000 population ages 29 days to 17 years (Please refer to the note below) 678 121.1 19 170.9 3,235 75.6 17 Perforated Appendix Admission Rate (% all discharges ages 1 to 17 years with diagnosis code for appendicitis) 194 45.6% 3 25.0% 997 31.9% 18 Urinary Tract Infection Admission Rate per 100,000 ages 29 days to 17 years Please refer to the note below) 487 87.0 15 135.0 2,501 58.5 Note: For PDI-16 and PDI-18 (Gastroenteritis and Urinary Tract Infection, respectively) there is an issue with the Agency for Health Research and Quality (AHRQ) requirements and the Agency for Health Care Administration (AHCA) inpatient discharge data. The AHRQ analysis requirements, for PDI-16 and PDI-18, state "All non-maternal discharges ages 3 months to 17 years" need to be excluded (i.e. 0-89 days) The AHCA hospital discharge data does not have data for the "Age in Days" for records indicating an Age of Zero (0). Therefore, it is not possible to exclude records of children with age 29-89 days (0-28 days are excluded via neonate exlusion). Page 10 District 11 Health Profile 2013

10. Emergency Department (ED) Utilization 20 2012 Number 864,674 30,405 7,053,265 Total Resident ED Visits Percent 100.0% 100.0% 100.0% Usually, the presenting problem(s) are self-lmited or minor. CPT Code 99281 Number 142,036 4,959 511,841 Percent 16.4% 16.3% 7.3% Usually, the presenting problem(s) are of low to moderate severity. CPT Code: 99282 Number 167,416 3,703 908,717 Percent 19.4% 12.2% 12.9% Usually, the presenting problem(s) are of moderate serverity. CPT Code: 99283 Number 314,164 10,643 2,817,584 Percent 36.3% 35.0% 39.9% Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function CPT Code: 99284 Number 188,461 8,168 2,131,949 Percent 21.8% 26.9% 30.2% Usually, the presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function CPT Code: 99285 Number 52,597 2,932 683,174 Percent 6.1% 9.6% 9.7% Note: The above analysis contains records for all emergency department visits for which the severity of the visit did not result in an inpatient admission. All records that do not have one of the 5 above mentioned CPT codes (in the CPT code fields) are discarded. The data file contains 10 CPT code fields: Principal CPT Code field (PRINCPT) and 9 other secondary CPT (OTHCPT 1-9) code fields. From these 10 CPT code fields, the CPT code found with the most severe acuity is used to categorize each patient record. Page 11 District 11 Health Profile 2013

1, 18, 21, 22 11. Hospital Unit Type Inventory and Utilization Hospital Unit Type Licensed Hospitals 33 4 292 Licensed Hospitals 25 4 218 Licensed Beds 7,412 207 50,373 Licensed Beds per Acute Care 2.9 2.9 2.6 1,000 Population Occupancy Rate 53.2% 35.7% 56.9% Average Length of Stay (2012) 5.0 days 3.7 days Not Available Licensed Hospitals 3 0 24 Long Term Care Licensed Beds 129 0 1,398 Occupancy Rate 89.9% 66.2% Average Length of Stay (2012) 26.9 days Not Available Licensed Hospitals 9 0 51 Comprehensive Medical Rehabilitation Licensed Beds 358 0 2,404 Occupancy Rate 64.9% 62.6% Average Length of Stay (2012) 13.2 days Not Available Licensed Hospitals 13 1 81 Psychiatric Adult Licensed Beds 752 25 3,736 Occupancy Rate 59.7% 14.3% 66.3% Average Length of Stay 6.1 days 3.3 days Not Available Licensed Hospitals 3 0 36 Psychiatric Child/Adolescent Licensed Beds 82 0 730 Occupancy Rate 52.8% 55.1% Average Length of Stay (2012) 5.0 days Not Available Licensed Hospitals 3 1 22 Substance Abuse Adult Licensed Beds 73 20 369 Occupancy Rate 19.0% 8.4% 52.2% Average Length of Stay (2012) 5.2 days 2.7 days Not Available Note: Licensed Hospitals and Licensed Hospital Beds are as of July 19, 2013 Occupancy Rate is for July 2012- June 2013 Page 12 District 11 Health Profile 2013

1, 18, 21, 22 12. Nursing Home Inventory and Utilization Licensed Community Nursing Homes (September 1, 2013) 54 2 656 Licensed Beds (July 1, 2013) 8,456 240 80,042 Licensed /Active Beds per 1,000 Population 3.2 3.2 4.1 Patient Days (July 1, 2012- June 30, 2013) 2,680,479 43,866 25,457,012 Occupancy Rate 88.1% 50.1% 87.3% Note to the Reader: Please note that this Health Profile reflects aggregate or county-wide numbers. Specific geographic areas within the and/or population segments may have higher or lower rates Page 13 District 11 Health Profile 2013

References 1. Nielsen Claritas. The Nielsen Company 2. 2011 Business Patterns (NAICS), CenStats Databases, U.S. Census Bureau; http://censtats.census.gov/cbpnaic/cbpnaic.shtml 3. State of Labor Force Summary (Annual Average), State of Department of Economic Opportunity, Released September 20, 2013; http://www.floridajobs.org/labor-marketinformation/data-center/statistical-programs/local-area-unemployment-statistics 4. Free/Reduced-Price Lunch Eligibility, Data Report, Education Information & Accountability Services, Department of Education, Series 2013-22D, May 2013; http://www.fldoe.org/eias/eiaspubs/word/frplunch1213.doc 5. 2012 American Community Survey 1-Year Estimates; http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml 6. Agency for Health Care Administration, Department of Health, Division of Public Health Statistics & Performance Management, CHARTS.com, October 9, 2013; http://www.floridacharts.com/ 7. Behavioral Risk Factor Surveillance System, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2011; http://www.cdc.gov/brfss/ 8. Department of Health, Bureau of HIV/AIDS, CHARTS.com, Department of Health, Division of Public Health Statistics & Performance Management, October 10, 2013; http://www.floridacharts.com/ 9. Department of Health, Bureau of TB & Refugee Health, CHARTS.com, Department of Health, Division of Public Health Statistics & Performance Management, October 11, 2013; http://www.floridacharts.com/ 10. Department of Health, Bureau of STD Prevention & Control, CHARTS.com, Department of Health, Division of Public Health Statistics & Performance Management, October 11, 2013; http://www.floridacharts.com/ 11. Department of Health, Bureau of Vital Statistics, CHARTS.com, Department of Health, Division of Public Health Statistics & Performance Management, December 8, 2013; http://www.floridacharts.com/charts/dataviewer/birthviewer/birthviewer.aspx?cid=0025 12. Department of Health, Bureau of Immunization, CHARTS.com, Department of Health, Division of Public Health Statistics & Performance, December 8, 2013; http://www.floridacharts.com/charts/otherindicators/nonvitalindnogrpdataviewer.aspx?cid=00 75 13. Department of Health, Office of Health Statistics and Assessment; CHARTS.com, Department of Health, Division of Public Health Statistics and Performance Management, December 9, 2013; http://www.floridacharts.com/charts/displayhtml.aspx?reporttype=7226&=13&year=2 012&tn=33 14. Department of Health, Office of Health Statistics and Assessment; CHARTS.com, Department of Health, Division of Public Health Statistics and Performance Management, December 9, 2013; http://www.floridacharts.com/charts/displayhtml.aspx?reporttype=7226&=44&year=2 012&tn=33 15. Department of Health, Office of Health Statistics and Assessment; CHARTS.com, Department of Health, Division of Public Health Statistics and Performance Management, December 9, 2013; http://www.floridacharts.com/charts/displayhtml.aspx?reporttype=7226&=69&year=2 012&tn=33 16. Hospital Inpatient Data File, Calendar Year 2012, Agency for Health Care Administration; Medi Dat Online Healthcare Business Intelligence for Executives, HealthScope, Inc.; https://www.healthscopereports.com/index.asp Page 14 District 11 Health Profile 2013

17. United States Department of Commerce, United States Census Bureau, American Fact Finder; http://factfinder2.census.gov/faces/nav/jsf/pages/community_facts.xhtml 18. Hospital Bed Need Projections & Service Utilization by District, July 2013 Batching Cycle, Certificate of Need Program Office, Agency for Health Care Administration, December 10, 2013; http://ahca.myflorida.com/mchq/con_fa/publications/docs/flhospbedneed/jul2013_hospit albedneedprojections.pdf 19. Hospital Inpatient & Emergency Department Analytical System, Calendar Year 2012; ( Agency for Health Care Administration Hospital Inpatient Data File, Nielsen Claritas Inc., population data and Agency for Healthcare Research and Quality Prevention and Pediatric Quality Indicators Technical Specifications), Broward Regional Health Planning Council, Inc.; http://healthdata.brhpc.org/start.aspx 20. Hospital Inpatient & Emergency Department Analytical System, Calendar Year 2012; ( Agency for Health Care Administration Emergency Department Patient Data File), Broward Regional Health Planning Council, Inc.; http://healthdata.brhpc.org/index.aspx 21. Hospital Beds and Services List, July 19, 2013, Certificate of Need Office, agency for Health Care Administration; http://ahca.myflorida.com/mchq/con_fa/publications/docs/hospbedsrvlist/jul2013_hospital BedsandServicesList.pdf 22. District 11 Hospital Utilization Report, Calendar Year 2012, Health Council of South 23. Nursing Home Utilization by District and Subdistrict, July 2012- June 2013, Certificate of Need, Agency for Health Care Administration, September 27, 2013; http://ahca.myflorida.com/mchq/con_fa/publications/docs/flnursingutilization/nh_uti lizationbydistrict_subdistrict-jul2012-jun2013.pdf Page 15 District 11 Health Profile 2013