Transcript COMMUNITY HEALTH ASSESSMENT 2014 Marion County Public Health Department (MCPHD) COMMUNITY HEALTH ASSESSMENTFirst step in improving health status of Marion County residents Virginia A.

COMMUNITY HEALTH ASSESSMENT 2014
Marion County Public Health Department
(MCPHD)
COMMUNITY
HEALTH
ASSESSMENT
2014
First step in improving health
status of Marion County residents
Virginia A. Caine, MD
Director, MCPHD
COMMUNITY HEALTH ASSESSMENT 2014
What is a Community Health Assessment (CHA)?
Quantifies prevalent or impactful health issues
Detects health trends that merit attention
Identifies health inequities
Compares Marion County to peer cities and
the nation, to provide context
COMMUNITY HEALTH ASSESSMENT 2014
Why do a Community Health Assessment?
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Increases community awareness of health issues
Prioritizes community health needs
Identifies health disparities
Provides an evidence base for MCPHD’s
Community Health Improvement Plan (CHIP)
Improves the health status of our community
COMMUNITY HEALTH ASSESSMENT 2014
Top Priorities
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Unhealthy Weight
Poor Mental Health
Increasing Poverty Rates
Chronic Disease Prevention and Management
 Chief contributing factor: SMOKING
 Violence
COMMUNITY HEALTH ASSESSMENT 2014
Key Data Sources
National Sources
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2010 Census, American Community Survey
Bureau of Labor Statistics
County Health Rankings www.countyhealthrankings.org
Behavioral Risk Factor Surveillance System (BRFSS)
Local Sources
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Birth and Death Certificates
Hospital Discharges, ED visit data
CHA 2012 Telephone Survey
COMMUNITY HEALTH ASSESSMENT 2014
Community Health Assessment
2012 Telephone Survey
• 5013 total respondents
• 100 survey questions: health status, behavioral
risk factors, family, local resources
• Survey is a SAMPLE of whole-county population
(928,281), randomly selected to represent county
as a whole.
• Called cell phones as well as in-house phones to
reach a more diverse group
COMMUNITY HEALTH ASSESSMENT 2014
Survey Process
7 workgroups identified priority issues
– Workgroups: Ages 0-4, 5-11, 12-17, 18-34, 35-64, 65+,
& Environment
– Content experts, service providers, & community
members
– 3 to 5 meetings, reviewed data, discussed issues
Steering Committee selected overall priorities
– Reviewed workgroup’s output
– Synthesized that output into the overall priorities
COMMUNITY HEALTH ASSESSMENT 2014
Increasing Poverty Rate
COMMUNITY HEALTH ASSESSMENT 2014
County Poverty Rates DOUBLED
Between 2000 and 2012: Now 19%
100% Federal Poverty Level (FPL) Definition:
Family of 4 with annual household income less than
$23,496 (2012)
County residents meeting 100% FPL includes:
1 in 5 individuals
1 in 3 households with children
(up from 1 in 5, 2007)
COMMUNITY HEALTH ASSESSMENT 2014
High Poverty Concentration in 6
Central Marion County Zip Codes
 These zip codes have over
25% of their populations
living at or below 100%FPL
 They exceed County rates
of….
Poverty
7 times
Unemployment rate 3 times
Violent Crime rate 5 times
Zip Codes % FPL
46201
46204
46218
46225
46202
46208
COMMUNITY HEALTH ASSESSMENT 2014
36.9
33.6
33.4
32.5
29.8
28.8
COMMUNITY HEALTH ASSESSMENT 2014
COMMUNITY HEALTH ASSESSMENT 2014
More Than 1 in 4 Young Adults (18-34)
Met 100% Federal Poverty Guidelines
COMMUNITY HEALTH ASSESSMENT 2014
Chronic Disease
Prevention and Management
COMMUNITY HEALTH ASSESSMENT 2014
County Children:
High Prevalence of Chronic Disease
% Youth 5-17 ever diagnosed with….
Diabetes
2
High BP
2
Depression/Anxiety
9
ADHD
15
Asthma*
* Twice the national rate
20
0
5
10
15
COMMUNITY HEALTH ASSESSMENT 2014
20
25
County Adult Chronic Disease, 2012
(%) compared to U.S.
Heart Attack/CHD
7.7
Current Asthma
11
Diabetes
14
US 2010-12
Depression
21
High Cholesterol
MC 2012
24
High BP
31
0
10
20
30
COMMUNITY HEALTH ASSESSMENT 2014
40
Smoking
Marion County Adults – 2005 & 2012
35%
30%
27%
29%
25%
20%
15%
10%
5%
0%
2005
2012
95% CI: 2005 (24.4%-29.6%); 2012 (26.5% - 30.7%)
COMMUNITY HEALTH ASSESSMENT 2014
35%
Prevalence of Smoking by Race
Adults Over 18 Years Old
Marion County – 2005 & 2012
30%
25%
20%
2005
15%
2012
10%
5%
0%
White
Black
Latino
2005
25%
27%
18%
2012
30%
29%
16%
COMMUNITY HEALTH ASSESSMENT 2014
Unhealthy Weight
COMMUNITY HEALTH ASSESSMENT 2014
50% of County Youth 5-17 Were
Above Normal Weight
2005
22
2012
18
31
0%
19
20%
Obese
58
40%
Overweight
1
44
60%
Normal
COMMUNITY HEALTH ASSESSMENT 2014
6
80%
Underweight
100%
Overweight and Obesity Continue to
Increase in Marion County
• Obese Children
– 2005: 2 out of 10
– 2012: 3 out of 10
• Obese Adults
– 2005: 3 out of 12
– 2012: 4 out of 12
Adult Outcomes
Diabetes
CHD/Stroke
1 2012
CHA Telephone Survey
Marion County1
14.0%
7.7%
2
US2
9.5%
7.0%
2011 BRFSS
COMMUNITY HEALTH ASSESSMENT 2014
Obesity Related Health Outcomes
Adults
Marion County1
Diabetes
14.0%
CHD/Stroke
7.7%
1 2012
CHA Telephone Survey
2
2011 BRFSS
COMMUNITY HEALTH ASSESSMENT 2014
US2
9.5%
7.0%
Poor Mental Health
COMMUNITY HEALTH ASSESSMENT 2014
Major Depressive Disorder is the Leading
Cause of U.S. Disability, Ages 15-44
Depression is prevalent in all County age groups,
including:
1 in 5 (20%) Adults
1 in 10 (10%) Children (5-17)
U.S. 17.5% (2011)
U.S. 3.9% (2007)
COMMUNITY HEALTH ASSESSMENT 2014
Depression in Young Adults
Young Adults: A high prevalence of depression and poor
mental health days. High rates of abuse of prescription
painkillers.
47% of Marion County 18- to 25-year-olds reported having
14+ days in the past month of poor mental health – four
times the U.S. rate. (CDC 2011 BRFSS Survey)
COMMUNITY HEALTH ASSESSMENT 2014
Diagnosed Depression in
County Adolescents (12-17 years)
County adolescents are diagnosed with depression
(16%) and their suicide risk is high
• 12.8%
U.S. major
episode(2010-11)
2011
Indiana Teens:
Youthdepressive
Risk Behavior
Study4 2
• 29%
• 25%
• 18.9%
• 11%
had depressive symptoms that disturbed
normal activities
had been bullied at school
seriously considered suicide
had one or more attempts at suicide
COMMUNITY HEALTH ASSESSMENT 2014
Suicide: A Leading Cause of Deaths
• Among the 5 leading causes for ages 12-64
• (Nationally, the second leading cause for
ages 12-17)
• Third leading cause for ages 15-24 (30%
higher than U.S.)
• Fifth leading cause for ages 10-14
COMMUNITY HEALTH ASSESSMENT 2014
Increasing Dementia in Senior Adults
6-10% of persons over 65 develop dementia
• Alzheimer’s makes up 75% of dementia cases
• 8 in 10 dementia cases are never clinically
diagnosed
In past decade, Alzheimer’s Disease was the only
leading cause of death to increase among seniors (up
20%)
COMMUNITY HEALTH ASSESSMENT 2014
Violent Deaths and
Prevention
Homicide Deaths
Age
10-14
15-24
33-44
45-54
Rank*
3rd
1st
5th
9th
Deaths per 100,000
MC (2008-2010) US (2010)
2
0.9
31
10.9
16
6
13
4.4
* among all causes of death in Marion County
COMMUNITY HEALTH ASSESSMENT 2014
Inequities in Violent Death Rates
Among Race & Age (2008 - 2012)
15-24 black
15-24 white
25-34 white
25-34 black
171
84
44
19
15
Accidents
20
9
52
32
7
Intentional selfharm (suicide)
4
20
Assault (homicide)
COMMUNITY HEALTH ASSESSMENT 2014
Prison Admissions and Releases,
Marion County, 2012
Men
Women
Total
New
Admissions
2,902
488
3,390
Adult
Releases
3,811
537
4,348
COMMUNITY HEALTH ASSESSMENT 2014
Where Do We Go From Here?
COMMUNITY HEALTH ASSESSMENT 2014
Community Health Assessment &
Health Improvement Plan (2015)
• Identify short–term, evidence based intervention
strategies, and action steps
• Find committed partners to take substantial roles for
each issue
• Assure process and outcome monitoring occurs for
each specific action area to document change.
COMMUNITY HEALTH ASSESSMENT 2014
How Can You Help?
• Know and recognize key issues facing Marion
County
• Rank health issues as you see them affecting
your community
• Provide input in the development of the
Community Health Improvement Plan
• Visit http://health.mchd.com/ to learn more!
COMMUNITY HEALTH ASSESSMENT 2014
Questions? Contact Us
Marion County Public Health Department
Mary McKee – Director Public Health Practice
[email protected]
(317) 221-2080
Collette Duvalle– Public Health Communication
[email protected]
(317) 221-2463
Data questions: [email protected]
COMMUNITY HEALTH ASSESSMENT 2014
Thanks to everyone who helped make this
Community Health Assessment possible!
COMMUNITY HEALTH ASSESSMENT 2014