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Inefficient uses of the health care system remain despite improvements

• One in four emergency calls for medical services were for nonurgent needs.
• Emergency departments continue to be used for preventable issues, such as asthma and dental care.

Residents encounter challenges in navigating health and human services

• There is a lack of health insurance for some groups, including noncitizen immigrants, and there is insufficient funding to support the needs of these groups.
• Residents are often unaware of available services and resources or might not know how to access or navigate known services and resources.
• Shortages of primary care providers, behavioral health providers, and dentists affect access, as does the cultural competency of providers.

Spending on health and human services is low

• Estimated county spending on health and human services departments is $39 per person, about one-third to one-seventh the per-person spending of surrounding Maryland counties.

Systemic inequities in drivers of health place some communities farther behind in building healthy futures

• Districts are differentially affected by drivers of health and thus encounter different health challenges.
• District 2 has high rates of uninsurance and is predominantly Hispanic, a population with a teen birth rate more than double the county rate.
• District 3 has the highest poverty rate and numerous community "hot spots" of low-income individuals with poor access to healthy food.
• District 7 is predominantly black and has low health literacy and the highest emergency department visit rates for adults and children in the county.

With evolving demographics and a changing health system landscape, the Prince George's County Council, acting as the County Board of Health, is considering its future policy approaches and resource allocations related to health and well-being.

To inform this path forward, the authors of this report used primary and secondary data to describe both the health needs of county residents and drivers of health within the county, inclusive of the social, economic, built, natural, and health service environments. This report integrates these findings, an analysis of budget documents, and a review of promising practices from other communities to situate recommendations in a Health in All Policies framework to foster aligned and integrated planning and budgeting across the county to promote health and well-being.

Findings from the assessment indicate a shared interest among leaders and residents to embrace a holistic strategy for health and well-being in the county. Inefficient uses of the health care system are identified, highlighting a need to rebalance investments in health care use and drivers of health. Additionally, challenges in navigating health and human services and inequities in drivers of health across communities are noted, signaling broader concerns related to residents' access to health and human services that influence health and well-being outcomes.

Recommendations are provided for several paths forward for the county to pursue a more integrated policy approach to influence health and well-being outcomes.

• Chapter One:

  Introduction

• Chapter Two:

  Demographic Profile

• Chapter Three:

  Health and Well-Being

• Chapter Four:

  Drivers of Health: Health Care Service Environment

• Chapter Five:

  Drivers of Health: Social and Economic Environment

• Chapter Six:

  Drivers of Health: Built and Natural Environments

• Chapter Seven:

  Connecting Drivers of Health with Health Outcomes: Examples for Children and Noncitizen Immigrants

• Chapter Eight:

  Exploring Prince George's County Budget for Health

• Chapter Nine:

  Conclusions and Recommendations

• Appendix A:

  Overview of Focus Groups and Key Informant Interviews

• Appendix B:

  Data Sources

• Appendix C:

  Maps Illustrating Variation in ED Visits and Inpatient Hospitalizations Among Prince George's County Residents, 2017

• Appendix D:

  Sample Integrated Health in All Policies Budget Planning Template

• Appendix E:

  Guidance for Implementing Health in All Policies in Prince George's County