HCHIP Primary Care













Primary Care, Wellness and Preventative Care
Cardiovascular disease, diabetes, asthma and sexually transmitted infections

High rates of obesity, diabetes, cardiovascular disease, asthma, and associated morbidity continue to affect Hampden County residents. An estimated 30% of adults in the population are obese, with high rates also observed among children. Heart disease is the leading cause of death in Hampden County. One third of Hampden County adults have hypertension, a risk factor for cardiovascular disease, with rates increasing in older adults to an estimated 55%. Approximately 20% of the population has pre-diabetes or diabetes, and 12% of adults and 19% of school children have asthma. Asthma morbidity rates were particularly high among Latinos. High rates of sexually transmitted infections (STIs) and teen pregnancy continue to occur, and unsafe sexual behavior contributes to these statistics.

Some conditions, such as asthma and diabetes can be managed with medication and preventative care. ER visits and hospitalizations often occur as a result of extreme circumstances, which may be due to a lack of either medicine or preventative care.  Many visits to the ER are also considered “non-emergent” or avoidable, and may be due to long wait times at urgent care clinics or a shortage of primary care providers.  In Hampden County 54% of residents live in a health care professional shortage area (vs 14.6% in MA); this particularly affects those living in Springfield, Holyoke, West Springfield, Westfield, Chester and Blandford.  The shortage of medical professionals itself can lead to long wait times for appointments and needed care.

In the development of the Hampden CHIP, hospital focus groups identified several barriers to preventative and on-going wellness care. These include the need for increased health literacy among patients, increased provider sensitivity towards different cultures, and health information available in a wider range of languages.

Strategy Implementation
The Primary Care, Wellness and Preventative Care Domain Team chose the following strategies to implement in 2019-2020:







Meeting Agendas and Notes


  •  # of non-emergent ER visits – by race, age, zip code, immigration status
  • # of CHWs in Hampden County
  • # of graduates from CHW training programs
  • # of evidence-based sex ed programs in schools
  • Rates of STIs in residents aged 15-24 – by zip code, race, age
  • Teen pregnancy rates