Community. Profile Lewis & Clark County. Public Health and Safety Division

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1 Community Helth Profile 2015 Lewis & Clrk County Public Helth nd Sfety Division

2 Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl Risk Fctors 14

3 Methods Methods for ll dt nlyses re in seprte document, Helth Profile Methodology. Demogrphic Informtion Lewis & Clrk County Montn Popultion, Census, April 1, , ,415 Popultion estimtes, July 1, ,856 1,023,579 Popultion, percent chnge April 1, 2010 July 1, % 3.5% Persons under 5 yers, July 1, % 6.0% Persons under 18 yers, July 1, % 22.1% Persons 65 yers nd over, July 1, % 16.2% Femle persons, July 1, % 49.8% White lone, July 1, % 89.5% Blck or Africn Americn lone, July 1, 2013 Americn Indin nd Alsk Ntive lone, July 1, % 0.6% 2.2% 6.5% Asin lone, July 1, % 0.8% Ntive Hwiin nd Other Pcific Islnder lone, July 1, % 0.1% Two or more rces, July 1, % 2.5% Hispnic or Ltino, July 1, % 3.3% White lone, not Hispnic or Ltino, July 1, % 87.0% Foreign born persons, % 2.0% Lnguge other thn English spoken t home, 3.6% 4.4% percent of persons ge 5 yers+, Z Vlue greter thn zero but less thn hlf unit of mesure shown. Dt from 1

4 Demogrphic Informtion High school grdute or higher, percent of persons ge 25 yers Bchelor s degree or higher, percent of persons ge 25 yers Lewis & Clrk County Montn 94.7% 92.1% 37.5% 28.7% Veterns, ,310 94,404 With disbility, under ge 65 yers, Men trvel time to work (minutes), workers ge 16 yers+, % 9.0% 17.6 minutes 18 minutes Medin gross rent, $737 $682 Owner-occupied housing units, % 68.3% Persons per household, Medin household income, $56,243 $46,230 Persons without helth insurnce, under ge 65 yers 15.1% 19.5% Persons in poverty 12.6% 16.5% Popultion per squre mile, Z Vlue greter thn zero but less thn hlf unit of mesure shown. Dt from 2

5 Communicble Disese Tble 1. Number nd rte of selected communicble diseses Montn, Lewis & Clrk County Lrge County Dt Montn Rte per Rte per Rte per 100,000 Number per 100, ,000 Helth Indictor Number (95% CI) County (95% CI) (95% CI) Chlmydi ,645 (222.3, 266.1) (340.4, 357.1) (359.5, 373.1) Heptitis C ,047 (82.4, 110.0) (102.9, 112.2) (119.1, 127.0) Pertussis (67.2, 92.2) (45.4, 51.6) (42.3, 47.0) Cmpylobcteriosis (20.8, 35.6) (19.0, 23.1) (20.6, 24.0) Deprtment of Corrections popultion included in county rte where pplicble. Dt provided by the Communicble Disese Epidemiology Section. Tble 2. Up-to-dte (UTD) on childhood vccintions for month old children s of Mrch 1st of the yer of ssessment bsed on immtrx dt reviewed during Vccines for Children Progrm Clinic Reviews conducted every other yer Montn, 2011 nd Helth Indictor Lewis & Clrk County Lrge County Dt Montn Number ssessed 2011 b 170 1,419 2,249 Number UTD ,305 Percent UTD 2011 c Number ssessed 2014 d - 1,573 4,042 Number UTD ,061 2,651 Percent UTD (95% CI) - (65.1, 69.8) (64.1, 67.1) UTD = 4 DTP, 3 Polio, 1 MMR, 3/4 HIB, 3 Hep B, 1 Vr, 4 PCV by 24 months. b In 2011, chrt reviews occurred. Clinics with fewer 50 chrt, the review included ll vilble chrts. Clinics with more thn 50 chrts, smple of chrts were reviewed nd vlidted. c Confidence intervl cnnot be clculted becuse the totl number of records reviewed is unknown. d In 2014, ll immuniztion records were reviewed electroniclly in the Montn Immuniztion Informtion System (immtrx). The precision of ech estimte ws quntified using 95% confidence intervls. Dt provided by the Immuniztion Section of the Communicble Disese Bureu. 3

6 Chronic Disese Tble 3. Inptient dmissions for selected chronic conditions Montn, Lewis & Clrk County Lrge County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) Asthm (55.3, 80.6) (43.2, 49.6) 47.7 (45.2, 50.3) Chronic Obstructive Pulmonry Disese (COPD) b 1, (821.2, 900.6) 2, (696.6, 719.4) (708.1, 725.6) Crdiovsculr Disese 1, (707.9, 781.6) 2, (735.8, 759.3) (737.7, 755.8) Dibetes (types 1 nd 2) 1, (631.2, 702.2) 2, (769.0, 793.5) (812.8, 832.3) Rtes re ge stndrdized to the 2000 Projected US Popultion using Distribution #1 s described in Klein nd Schoenborn 2001 nd given per 100,000 person yers. b Chronic obstructive pulmonry disese (COPD), includes chronic bronchitis, emphysem, bronchiectsis, nd chronic irwy obstruction. Does not meet stndrds of relibility or precision. Inptient dmission nd ED visit dt provided courtesy of prticipting MHA members, collected through the Montn Hospitl Dischrge Dt System (MHDDS). 4

7 Tble 4. Inptient dmissions for injury by type nd mechnism of injury Montn, Lewis & Clrk County Lrge County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) All Unintentionl Injury (382.8, 439.7) 1, (490.6, 510.4) (530.6, 546.8) Flls (175.6, 213.6) (256.5, 270.5) (263.2, 274.3) Struck by/ginst (13.8, 17.5) 18.0 (16.5, 19.6) Motor Vehicle (18.5, 33.4) (43.7, 50.0) 60.6 (57.8, 63.6) Poisoning (38.9, 59.5) (35.0, 40.6) 36.3 (34.2, 38.5) Intentionl Self-Hrm (101.2, 134.6) (109.9, 120.0) (102.6, 110.5) Trumtic Brin Injury (45.3, 66.9) Rtes re ge stndrdized to the 2000 Projected US Popultion using Distribution #1 s described in Klein nd Schoenborn 2001 nd given per 100,000 person yers. Does not meet stndrds of relibility or precision. Inptient dmission nd ED visit dt provided courtesy of prticipting MHA members, collected through the Montn Hospitl Dischrge Dt System (MHDDS) (77.4, 85.5) 91.3 (87.9, 94.8) 5

8 Tble 5. Emergency Deprtment visits for selected chronic conditions Montn, Lewis & Clrk County Lrge County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) Asthm (270.6, 323.0) (247.0, 262.1) (254.0, 266.2) Chronic Obstructive Pulmonry Disese (COPD) b 1, (863.2, 946.8) 2, (662.4, 685.3) (795.2, 814.8) Crdiovsculr Disese (307.6, 357.5) (277.7, 292.4) (366.2, 379.3) Dibetes (types 1 nd 2) 2,450 1,142.1 (1095.4, ) 3, ,152.0 (1136.9, ) 1,235.6 (1223.3, ) Rtes re ge stndrdized to the 2000 Projected US Popultion using Distribution #1 s described in Klein nd Schoenborn 2001 nd given per 100,000 person yers. b Chronic obstructive pulmonry disese (COPD), includes chronic bronchitis, emphysem, bronchiectsis, nd chronic irwy obstruction. Does not meet stndrds of relibility or precision. Inptient dmission nd ED visit dt provided courtesy of prticipting MHA members, collected through the Montn Hospitl Dischrge Dt System (MHDDS). 6

9 Tble 6. Emergency deprtment visits for injury by type nd mechnism of injury Montn, Lewis & Clrk County Lrge County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) All Unintentionl Injury 10,038 5,432.3 (5324.0, ) 14, ,520.6 (5486.1, ) 5,901.8 (5873.1, ) Flls 3,964 2,057.8 (1992.4, ) 5, ,926.7 (1906.6, ) 2,020.0 (2003.7, ) Struck by/ginst 1, (706.4, 789.3) 1, (740.0, 765.9) (809.4, 831.1) Motor Vehicle (415.4, 478.7) 1, (510.2, 531.3) (511.5, 528.6) Poisoning (88.2, 119.1) (88.8, 97.9) 95.4 (91.8, 99.1) Intentionl Self-Hrm (137.6, 175.9) (90.1, 99.3) (100.6, 108.4) Trumtic Brin Injury (494.5, 563.1) 1, (658.0, 682.1) (640.5, 659.5) Rtes re ge stndrdized to the 2000 Projected US Popultion using Distribution #1 s described in Klein nd Schoenborn 2001 nd given per 100,000 person yers. Does not meet stndrds of relibility or precision. Inptient dmission nd ED visit dt provided courtesy of prticipting MHA members, collected through the Montn Hospitl Dischrge Dt System (MHDDS). 7

10 Tble 7. Cncer incidence Montn, Lewis & Clrk County Lrge County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) All Cncer 1, (434.5, 492.3) (435.6, 453.7) (432.9, 446.8) Prostte (mles) (87.7, 128.3) (111.9, 125.0) (108.1, 117.8) Brest (femle) (79.3, 116.8) (112.4, 125.7) (110.8, 120.9) Lung nd Bronchus (53.4, 75.1) (52.4, 58.8) 56.4 (54.0, 58.9) Colon nd Rectum (31.2, 48.6) (32.2, 37.3) 36.9 (35.0, 39.0) Corpus Uteri (femle) (16.3, 36.1) (21.2, 27.0) 25.4 (23.2, 27.9) Melnom (19.9, 34.2) 82.3 Does not meet stndrds of relibility or precision. Cncer incidence dt re from the Montn Centrl Tumor Registry (24.4, 29.0) 24.9 (23.2, 26.7) 8

11 Figure 1: Age-djusted cncer incidence rtes by cncer site Montn, Age-Adjusted Cncer Incidence Rte by Cncer Site, Montn, Rte per 100,000 people Lewis & Clrk Lrge Counties All Montn 0 Prostte (mle) Brest (femle) Lung & Bronchus Colon & Rectum Corpus Uteri (femle) Melnom Tble 8. Tobcco retilers by county, Montn Helth Indictor Lewis & Clrk County Retiler Number 52 Retilers per 1,000 popultion 0.79 Dt from: 9

12 Mternl nd Child Helth Tble 9. Totl births occurring in Lewis & Clrk County, Helth Indictor Lewis & Clrk County Montn Number of births 2,214 35,881 Dt bout births were tbulted from birth certifictes of infnts to Montn-resident mothers who delivered in Montn, , covering more thn 95% of ll births. Tble 10. Teen birth rte per 1,000 femles ge yers, ,b Helth Indictor Lewis & Clrk County Montn Teen birth rte per 1, Due to the smll number of events in some counties, five yer rtes hve been used to include more counties with t lest 20 events over the five yers. Not ll counties hd enough events to be included. b Full report cn be found t: nd%20pregnncy%20report%20finl.pdf Denomintor less thn 20; rtes bsed on fewer thn 20 events re not sttisticlly relible. Tble 11. WIC dt by county Montn, Lewis & Clrk Lrge County County Dt Montn Helth Indictor Percent Percent Percent Children (2 5 yers of ge) overweight or obese Initite brestfeeding Denomintor less thn 20; rtes bsed on fewer thn 20 events re not sttisticlly relible. Dt provided by the WIC Progrm in the Fmily nd Community Helth Bureu. 10

13 Tble 12. Births to Montn resident mothers occurring in Lewis & Clrk County, Lewis & Clrk County Lrge County Dt Montn Percent Percent Percent Helth Indictor Number (95% CI) Number (95% CI) Number (95% CI) Born less thn 37 weeks (8.8, 11.3) 2, (8.4, 9.2) 3, (8.8, 9.4) Born weighing less thn 2,500 grms (7.0, 9.3) 1, (6.8, 7.4) 2, (7.0, 7.6) Women entering prentl cre fter first trimester (17.6, 20.9) 5, (22.9, 24.0) 9, (26.2, 27.2) Women whose Kotelchuk Index is 80% b 1, (79.8, 83.1) 18, (79.4, 80.4) 26, (74.6, 75.5) Smoking during pregnncy (15.8, 18.9) 3, (13.6, 14.5) 5, (15.9, 16.7) Eduction less thn high school grdute (8.8, 11.4) 2, (8.9, 9.6) 4, (11.6, 12.3) Any insurnce 2, (94.4, 96.2) 21, (92.2, 92.8) 33, (92.0, 92.6) Receiving WIC (33.0, 37.0) 7, (30.7, 31.9) 12, (34.1, 35.1) Brestfeeding t dischrge 2, (92.4, 94.5) 21,281 Dt bout births were tbulted from birth certifictes of infnts to Montn-resident mothers who delivered in Montn, , covering more thn 95% of ll births. Demogrphic informtion on the birth certifictes is self-reported by prents; medicl informtion is bstrcted from medicl records. b Kotelchuk Index: computed index of dequcy of prentl cre, function of erly initition nd enough visits, 80% or greter is defined s dequte. Too few events to report or complimentry suppression of corresponding cell. Does not meet stndrds of relibility or precision (91.6, 92.3) 31, (88.6, 89.2) 11

14 Mortlity Tble 13. Medin ge t deth in yers by rce nd sex Montn, Lewis & Clrk County Lrge County Dt Montn Helth Indictor Mle Femle Mle Femle Mle Femle White Americn Indin Too few events to report or complimentry suppression of corresponding cell. Tble 14. Frequency nd ge-djusted rtes of selected cuses of deth by county ll cuse Montn residents, Lewis & Clrk County Lrge County Dt Montn Age-djusted Age-djusted Age-djusted Rte per 100,000 Rte per 100,000 Rte per 100,000 Helth Indictor Number (95% CI) Number (95% CI) Number (95% CI) All Cuses 1, (659.2, 729.9) 15, (702.3, 725.1) 27, (735.8, 753.9) Homicide Suicide (19.1, 23.4) (20.6, 24.1) All injuries (42.2, 48.3) 1, (50.7, 56.0) Motor vehicle Accidents (12.5, 16.0) (18.2, 21.5) Confidence Intervls (95%) For The Age Adjusted Rte Are Computed Using the Fy-Feuer (1997) Method Ntionl Center for Helth Sttistics. Vintge 2013 postcensl estimtes of the resident popultion of the United Sttes (April 1, 2010, July 1, 2010 July 1, 2013), by yer, County, single-yer of ge (0, 1, 2,.., 85 yers nd over), bridged rce, Hispnic origin, nd sex. Prepred under collbortive rrngement with the U.S. Census Bureu. Avilble from: s of June 26, 2014, following relese by the U.S. Census Bureu of the unbridged Vintge 2013 postcensl estimtes by 5-yer ge group on June 26, Too few events to report or complimentry suppression of corresponding cell. Does not meet stndrds of relibility or precision. Dt provided by the Office of Epidemiology nd Scientific Support. 12

15 Tble 15. Frequency nd ge-djusted rtes of selected cuses of deth by county ll cuse Montn residents, Lewis & Clrk County Lrge County Dt Montn Age-djusted Rte per 100,000 Age-djusted Rte per 100,000 Age-djusted Rte per 100,000 Helth Indictor Number (95% CI) Number (95% CI) Number (95% CI) Deths Attributed to Drugs (2.2, 3.4) All Cncer (132.2, 165.0) 3, (149.6, 160.2) 5, (152.1, 160.3) Cerebrovsculr (33.2, 38.3) 1, (33.9, 37.9) Hert Disese (120.7, 151.9) 3, (135.2, 145.2) 5, (148.5, 156.5) All Liver (14.9, 17.8) Alcohol-Relted Liver Disese (7.6, 9.7) Dibetes (14.0, 17.5) (18.4, 21.4) Pneumoni nd Influenz (11.3, 14.4) (12.6, 15.1) Chronic Lower Respirtory Disese nd Asthm 146 1, (47.8, 54.0) 1, (48.3, 53.0) Confidence Intervls (95%) For The Age Adjusted Rte Are Computed Using the Fy-Feuer (1997) Method Ntionl Center for Helth Sttistics. Vintge 2013 postcensl estimtes of the resident popultion of the United Sttes (April 1, 2010, July 1, 2010 July 1, 2013), by yer, County, single-yer of ge (0, 1, 2,.., 85 yers nd over), bridged rce, Hispnic origin, nd sex. Prepred under collbortive rrngement with the U.S. Census Bureu. Avilble from: s of June 26, 2014, following relese by the U.S. Census Bureu of the unbridged Vintge 2013 postcensl estimtes by 5-yer ge group on June 26, Too few events to report or complimentry suppression of corresponding cell. Does not meet stndrds of relibility or precision. Dt provided by the Office of Epidemiology nd Scientific Support. 13

16 Behviorl Risk Fctors Becuse of the smll numbers in Montn, behviorl risk fctor helth indictors re reported by Montn s Helth Plnning Regions s demonstrted below. Here is the link to the 2013 nnul report, regionl comprisons of 2013 helth indictors strt on pge 32: Annul/2013MTBRFSSAnnulReport.pdf 14

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