Coastal Health District Community Health Assessment 2010

Transcription

1 Coastal Health District Community Health Assessment 21 Bryan, Camden, Chatham, Effingham, Glynn, Liberty, Long, McIntosh Coastal Health District Department of Epidemiology; Page 1

2 Community Health Assessment 21 Produced by the Coastal Health District 9-1 Department of Epidemiology District Health Director: W. Douglas Skelton, MD District Program Manager: Saroyi Morris Assessment Developer: District Epidemiologist: Robert A. Thornton, B.S, MHSc Assessment Co-Developer: CDC Fellow: Rodriques A. Lambert, MPH, PhD(c) Coastal Health District Department of Epidemiology; Page 2

3 Table of contents Introduction....4 Objectives Health Assessment Demographics Maternal Health Chronic Disease Cancer BRFSS...28 Infectious Disease Injury and External Causes...45 Appendix Georgia Coastal Health District Bryan County Camden County Chatham County Effingham County Glynn County Liberty County Long County McIntosh County Coastal Health District Department of Epidemiology; Page 3

4 Introduction The Coastal Health District consists of Bryan, Camden, Chatham, Effingham, Glynn, Liberty, Long, and McIntosh counties. The mission of the Coastal Health District is to improve the health of those who live, work, and play in those counties by preventing illness and injury, promoting healthy behaviors and protecting from harm. Public health focuses on prevention and health promotion for the whole community rather than individuals. Public health plays a key role in protecting the environment and employing interventions aimed at improving human behavior, lifestyle and medical care. Public health is also responsive to threats that can affect the health of the defined population. The intent of this assessment is to provide our community leaders, decision-makers and the general public with helpful information about the health of our community. Many of the health indicators included within this assessment are based on conditions that can be found in the Healthy People 21 s 1-year national objectives for promoting health and preventing disease. In keeping with the 1 year target set by Healthy People 21, some graphs in this assessment will start with data from year 2 and will continue to the most recent data year available for each health indicator. The 21 Community Health Assessment has been created to provide an overall assessment of various health indicators for the Coastal Health District as a whole. Individual county data is available in the County Reference Sheets in the appendix at the end of the assessment. The assessment has been designed using the most recent data available. The data contained within the assessment was compiled primarily by utilizing state data resources: the State Electronic Notifiable Disease Surveillance System, the Online Analytical Statistical Information System, a compilation of health information from birth and death records as well as hospital discharge data, and the Georgia Behavioral Risk Factor Surveillance System. Coastal Health District Department of Epidemiology; Page 4

5 Introduction continued For more information about the services we provide, diseases we monitor, statistics or resources for health professionals, please visit one of the links below. Coastal Health District 9-1: ( Georgia Department Public Health: ( Coastal Health District Department of Epidemiology; Page 5

6 Assessment Objectives 1. To serve as a planning tool for community internal and external partners. 2. To provide key stakeholders with an indication of the status of health in their respective areas of interest. 3. To be utilized as a tool for measuring progress toward Healthy People 21 objectives. Healthy People 21 Indicators Population Demographics Maternal Health Chronic Disease Cancer Behavioral Health Infectious Disease Injury and Violence Environmental Health Access to Health Care The Leading Health Indicators have been used to measure the health of the nation over the last 1 years. Each of the 1 Leading Health Indicators has one or more objectives from Healthy People 21 associated with it. The charts and graphs within this assessment will be related to some of the objectives listed under these indicators. For detailed information relating to these indicators, please reference the link below. publications Coastal Health District Department of Epidemiology; Page 6

7 21 Health Assessment Demographics The population of the Coastal Health District was estimated in 29 at 553,987 residents and covers over 4,5 square miles of land. Racial and ethnic breakdown of the population reveals that 336,219 persons (6%) are of the white race; 175,231 (32%) persons are of the black race; 4% of the population is of Hispanic ethnicity; and 4% of persons are of other race/ethnicity. Of the 553,987 residents, 256,992 (46%) were residents of Chatham County making Chatham the most populated county in the Coastal Health District. The population of the Coastal Health District has grown by 66,994 residents (12%) since the year 2. Total Population population ,829, , year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 29 County Total Population 29 Total Popluation by Race (CHD) McIntosh Long 11,378 12,234 Liberty 62,186 Glynn Effingham Chatham Camden 76,82 53,541 48, , ,162 32% 21,715 4% 354,11 64% White Black Other Bryan 32,559 5, 1, 15, 2, 25, 3, population Coastal Health District Department of Epidemiology; Page 7

8 A G E A G E A G E Coastal Health District Department of Epidemiology; Page 8

9 Maternal Health The health of mothers, infants, and children is of critical importance, both as a reflection of the current health status of a large segment of the U.S. population and as a predictor of the health of the next generation. Infant mortality is an important measure of a nation s health and a worldwide indicator of health status and social well-being. As of 24, the U.S. infant mortality rates ranked 29 th among industrialized nations. In the past decade, critical measures of increased risk of infant death, such as new cases of low birth weight (LBW) and very low birth weight (VLBW), has actually increased in the United States. In addition, the disparity in infant mortality rates between whites and specific racial and ethnic groups (especially African Americans, American Indians, Native Hawaiians, and Puerto Ricans) persists. The infant mortality rate for African Americans is twice that of whites. Pregnancy Rate for Ages 1-55 rate per 1, females year Georgia Coastal Health District (Savannah) Linear (Coastal Health District (Savannah)) Linear (Georgia) 2-28 Pregnancy Rate Per 1, Females Aged 1-55 by Race (CHD) % % White Black Hispanic % Coastal Health District Department of Epidemiology; Page 9

10 Improper prenatal care, short intervals between pregnancies, socioeconomic stressors, poor health of mothers, and unavoidable genetic defects all contribute to poor pregnancy outcomes. These outcomes include low birth weight children (under 2.5 kilograms or 5.5 pounds), premature birth, infant death (less than a year of age), and maternal death. Timely prenatal care is one of the best ways to ensure the health of mothers and their infants. A medical visit prior to becoming pregnant is also crucial for women with chronic disorders such as diabetes and high blood pressure to assure a healthy pregnancy and outcome. 1 Percent Births With < 5 Prenatal Care Visits (PNCV) percent of birth year Georgia Coastal Health District Linear (Georgia) Linear (Coastal Health District) 2-27 Births with < 5 Prenatal Care Visits (PNCV) by Race (CHD) 449 1% 1,411 32% White Black Hispanic 2,568 58% Coastal Health District Department of Epidemiology; Page 1

11 54 Birth Rate Mothers Ages rate per 1, females year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Birth Rate by Race (CHD) 25 rate per 1, females year White Black Hispanic Coastal Health District Department of Epidemiology; Page 11

12 Percent Low Birthweight (LBW) Births (<25 grams) percent of births year Georgia Coastal Health District Linear (Georgia) Linear (Coastal Health District) 2-28 Low Birthweight (LBW) Births (<25 grams) by Race (CHD) 2-28 Very Low Birthweight (VLBW) Births (<15 grams) by Race (CHD) 326 5% 58 5% 3,588 56% 2,524 39% White Black Hispanic % % White Black Hispanic percent of births Percent Very Low Birthweight (VLBW) Births (<15 grams) year Geogia Coastal Health District Linear (Geogia) Linear (Coastal Health District) Coastal Health District Department of Epidemiology; Page 12

13 After birth, breastfeeding appears to be important in reducing infant mortality in the first year of life due to various infections, Sudden Infant Death Syndrome (SIDS), and other causes. Breastfeeding is not recommended for babies whose mothers have HIV infection. Positioning infants on their backs to sleep also is protective because it may reduce the risk of SIDS. The infant mortality rate from 2 to 27 in the Coastal Health District was 9.6 deaths per 1 live births compared to 8.4 for the state of Georgia. Data shows considerable racial disparities in infant mortality, a pattern also seen in many areas of the United States. African Americans have the highest rate of infant mortality among all races, with a rate of 14.9 deaths per 1 live births. The age of the mother is also important in the birth outcome. Premature birth, or birth before 37 weeks gestation, is a risk factor for infant death, and is more common among very young mothers and mothers over age 35. Smoking during pregnancy can have significant impacts on newborn children; a child of a mother who smokes during and immediately after pregnancy is times more likely to have a low birth weight and is 2.3 times more likely to die from SIDS. rate per 1, live births Infant Death Rate year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Rate per 1, live births Infant Death Rate By Race (CHD) Year White Black Linear (White) Linear (Black) Non-Hispanic Ethnicity Coastal Health District Department of Epidemiology; Page

14 Teen mothers are less likely to receive adequate prenatal care, are less likely to gain adequate weight during pregnancy, and are more likely to smoke than older mothers. Children born to teenage mothers are at greater risk of low birth weight, disability, and mortality during the first year of life. School is typically more difficult for children of young mothers. They are 5% more likely to repeat a grade, and in general, don t perform as well on standardized tests. Children of teen parents suffer higher rates of abuse and neglect than children of mothers who delay child bearing. From 2-29, nearly 15% of babies born to mothers ages in the Coastal Health District were premature, compared to 13.2% of the births to mothers ages rate per 1, females Teen Pregnancy Rate for Ages year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Birth Rate Ages rate per 1, females year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Coastal Health District Department of Epidemiology; Page 14

15 From 2-28, there were 75.1 pregnancies per 1, females ages for all races in the Coastal Health District compared to 71.3 for the state of Georgia. The pregnancy rate for white females ages was The pregnancy rate for black females ages was From 2-29, there were 11,6 births to mothers ages This represents 13.1% of all births in the Coastal Health District, compared to 12.1% for the state of Georgia. From 2-28, the Coastal Health District experienced a birth rate of 75.1 per 1, females ages compared to 71.3 for Georgia. From 2-29, 1% of all births were attributed to white mothers ages and 18.8% of all births were to African American mothers of the same age group. Teen Pregnancy Rate By Race Age (CHD) rate per 1, females age Year White Black Linear (White) Linear (Black) Non-Hispanic Ethnicity Coastal Health District Department of Epidemiology; Page 15

16 Chronic Disease The following table shows the leading causes of death due to chronic disease for the United States, the state of Georgia, and the Coastal Health District. The three leading causes of death in the United States are heart disease, cancer, and stroke. Chronic diseases are major causes of disability and significant contributors to increases in health care costs in the United States. The 1 leading causes of death (based on the International Classification of Diseases) United States 27 Georgia 27 Coastal Health District 27 1 Diseases of the heart (heart disease) Diseases of the heart (heart disease) Diseases of the heart (heart disease) 2 Malignant neoplasms (cancer) Malignant neoplasms (cancer) Malignant neoplasms (cancer) 3 Cerebrovascular disease (stroke) Accidents (unintentional injury) Accidents (unintentional injury) 4 Chronic lower respiratory diseases Cerebrovascular disease (stroke) Cerebrovascular disease (stroke) 5 Accidents (unintentional injury) Chronic lower respiratory diseases Chronic lower respiratory diseases 6 Alzheimer s disease Alzheimer s disease Alzheimer s disease 7 Diabetes mellitus (diabetes) Nephritis, nephrotic syndrome and nephrosis (kidney disease) Nephritis, nephrotic syndrome and nephrosis (kidney disease) 8 Influenza and pneumonia Diabetes mellitus (diabetes) Septicemia 9 Nephritis, nephrotic syndrome and nephrosis (kidney disease) Septicemia Influenza and pneumonia 1 Septicemia Influenza and pneumonia Diabetes mellitus (diabetes) Coastal Health District Department of Epidemiology; Page 16

17 Cardiovascular disease is the leading cause of death and a major cause of disability in the United States, Georgia, and the Coastal Health District. The aging population, obesity epidemic, underuse of prevention strategies, and suboptimal control of risk factors could actually increase the future cardiovascular disease burden. Major Cardiovascular Disease Death Rate rate per 1, population Healthy People 21 Target= Below 166 Deaths Per 1, Population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-27 Cardiovascular Disease Death Rate Per 1, Population by Race (CHD) 2-27 Cardiovascular Disease Death Rate Per 1, Population by Gender (CHD) % % White Black % % Male Female Coastal Health District Department of Epidemiology; Page 17

18 Heart disease is the leading cause of death for all people in the United States, Georgia, and the Coastal Health District. In the year 2, the death rate due to major cardiovascular disease in the Coastal Health District was 296.9/1,. In 27, the rate was 244.3/1, which shows some improvement. The Healthy People 21 target was to decrease the death rate due to heart disease to 166/1,. Obstructive Heart Disease (incl. heart attack) Death Rate rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Stroke Death Rate rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Coastal Health District Department of Epidemiology; Page 18

19 Nationally, the number of persons with diabetes has increased steadily over the past decade. It is estimated that a significant number of persons have the disease but are undiagnosed. The average number of deaths due to diabetes from 2 to 27 for the Coastal Health District is 15/1, compared to 18.1/1, for the state of Georgia. While the number of deaths due to diabetes seems to be low, the number of persons hospitalized with diabetes and complications due to diabetes has increased over the past several years. Diabetes is most common among older individuals. rate per 1, population Diabetes Hospital Discharge Rate year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-29 Diabetes Hospital Discharge Rate Per1, Population by Race (CHD) % White Black % Non-Hispanic Ethnicity 25 Diabetes Death Rate rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Coastal Health District Department of Epidemiology; Page 19

20 Asthma is a chronic (long-term) lung disease that affects both children and adults. The exact causes of asthma are unknown, but methods are available to treat and control the disease. The best ways to reduce the number of asthma attacks are to take medications as prescribed and avoid asthma triggers. The number of hospitalizations due to asthma is the greatest among children younger than 5 years of age. rate per 1, population Asthma Hospital Discharge Rate year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-29 Asthma Discharge Rate Per 1, Population by Race (CHD) % % White Black Non-Hispanic Ethnicity GA Department of Public Health; OASIS 12/ Asthma Hospital Discharge Rate by Age (CHD) rate per 1, population <Infancy Age 1-4 Age 5-12 Age Age 2-29 Age 3-44 Age Age 6-74 Age 75+ age group Coastal Health District Department of Epidemiology; Page 2

21 Chronic kidney disease can lead to chronic kidney failure. Chronic renal insufficiency is a type of renal disease that is usually asymptomatic. African Americans have the highest overall risk of chronic kidney disease. On average, African Americans develop end-stage renal failure at an earlier age than whites. Death Rate From Kidney Disease rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-27 Kidney Disease Death Rate Per 1, Population by Race (CHD) 2-27 Kidney Disease Death Rate Per 1, Per Population by Gender (CHD) % % Whites Blacks Non-Hispanic Ethnicity % % Male Fem ale GA Department of Public Health; OASIS 12/21 GA Department of Public Health; OASIS 12/21 Coastal Health District Department of Epidemiology; Page 21

22 Cancer Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the growth is not controlled, it can result in death. Cancer is caused by both internal and external factors. Many cancers can be prevented by lifestyle changes and many can be cured if detected and treated properly. Cancer is the second leading cause of death in the United States, Georgia, and the Coastal Health District. The average number of deaths due to cancer from 2-27 among Coastal Health District residents is 18/1, compared to 159/1, for the state of Georgia. Overall, deaths due to cancer are higher for whites compared to African Americans. rate per 1, population Total Cancer Death Rate year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Healthy People 21 Target= Below Deaths Per 1, Population 2-27 Cancer Death Rate Per 1, Population By Race (CHD) 2-27 Cancer Death Rate Per 1, Population by Gender (CHD) % % White Black Non-Hispanic % % Male Fem ale GA Department of Public Health; OASIS 12/21 GA Department of Public Health; OASIS 12/21 Coastal Health District Department of Epidemiology; Page 22

23 Lung cancer is the most common cause of cancer deaths among both males and females. Cigarette smoking is the most important risk factor for lung cancer. Other risk factors include occupational exposures and indoor and outdoor air pollution. The average number of deaths due to lung cancer among Coastal Health District residents from 2-27 is 53.4/1, which is slightly higher than the rate for the state of Georgia. The lung cancer death rate is somewhat higher for whites than African Americans in the Coastal Health District. rate per 1, population Total Lung Cancer Death Rate Healthy People 21 Target= Below 44.9 Deaths Per 1, Population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-27 Lung Cancer Death Rate by Race (CHD) 2-27 Lung Cancer Death Rate Per 1, Population by Gender (CHD) White % Black Non-Hispanic Eth % Male Fem ale % % GA Department of Public Health; OASIS 12/21 GA Department of Public Health; OASIS 12/21 Coastal Health District Department of Epidemiology; Page 23

24 Prostate cancer is cancer of the glandular cells of the prostate gland. Prostate cancer usually occurs in older males. It is the leading cause of cancer among males in the U.S., across all races. It is also the second most common cause of death due to cancer in the U.S. among African American and white males. This is also true for Georgia. Death rates due to prostate cancer among Coastal Health District residents are almost twice as high for African American males compared to rates for white males. Prostate Cancer Death Rate rate per 1, population Healthy People 21 Target= Below 28.8 Deaths Per 1, Population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-27 Prostate Cancer Death Rate Per 1, Population by Race (CHD) % White Black Non-Hispanic Ethnicity % Coastal Health District Department of Epidemiology; Page 24

25 Breast cancer is a malignant tumor that starts in the cells of the breast. There are several types of breast cancer which may involve the lobules (the glands that produce milk), the ducts (which carry milk to the nipple), and/or fatty tissue, the lymph nodes, and blood vessels. Breast cancer is the most common cancer among women in the United States. While breast cancer is most commonly diagnosed in women, men can also get breast cancer. In Georgia, 99% of all diagnosed breast cancer cases were among women. The death rate from 2-27 due to breast cancer among Coastal Health District residents was slightly higher for white females. rate per 1, Total Breast Cancer Death Rate for Females Healthy People 21 Target= Below 22.3 Deaths Per 1, Population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-27 Breast Cancer Death Rate Per 1, Poulation by Race (CHD) % White Black Non-Hispanic Ethnicity % Coastal Health District Department of Epidemiology; Page 25

26 Colorectal cancer is a collective term for cancers of the colon and rectum. Since these cancers share many common features, they are often grouped together as colorectal cancer. Colorectal cancer affects both men and women and often occurs in people over 5 years of age. Males are more likely to be diagnosed with colorectal cancer than females. Males are also more likely to die from colorectal cancer than females. African Americans are more likely to be diagnosed with colorectal cancer than whites. African Americans are also more likely to die from colorectal cancer than whites. Colorectal Cancer Death Rate rate per 1, population Healthy People 21 Target= Below 13.9 Deaths Per 1, Population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-27 Colorectal Cancer Death Rate Per 1, Population by Race (CHD) 2-27 Colorectal Cancer Death Rate Per 1, Population by Gender (CHD) % % White Black Non-Hispanic Ethnicity % % Male Fem ale GA Department of Public Health; OASIS 12/21 GA Department of Public Health; OASIS 12/21 Coastal Health District Department of Epidemiology; Page 26

27 Overexposure to ultraviolet light may be a contributing risk factor to the development of skin cancer. While there are various types of skin cancers such as basal and squamous cell; melanoma is the deadliest of all skin cancers. White people have been associated more with death from melanoma of the skin than any other group. Accord to the 2-27 arrogate data related to deaths from melanoma, males are significantly more impacted by female within the Coastal Health District. rate per 1, population Skin Cancer Death Rate year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Healthy People 21 Target= Below 2.5 Deaths Per 1, Population 2-27 Skin Cancer Death Rate Per 1, Population by Gender (CHD) 1.5 3% Male Fem ale 3.5 7% Coastal Health District Department of Epidemiology; Page 27

28 Coastal Health District BRFSS The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based surveillance system, administered by the Georgia Department of Public Health, in conjunction with the Centers for Disease Control and Prevention. Georgia has been part of the BRFSS since 1984, gathering information about knowledge, attitudes, and health behaviors. Information collected from the Behavioral Risk Factor Surveys is used to: Track trends in behavioral change among the population Determine priority health issues and develop plans to address them Monitor the effectiveness of interventions Coastal Health District Department of Epidemiology; Page 28

29 Coastal Health District BRFSS Variable CHRONIC CONDITIONS Percent of Obese Adults Percent of Adults with Diabetes Percent of Adults with Asthma GA BRFSS 6/27/211 Percent of Adults who have been told that they have Coronary Heart Disease Percent Adults who have had a Heart Attack Percent of Adults who have had a Stroke Percent of Adults with a Disability Percent of Adults who have High Blood Pressure Percent of Adults who have High Blood Cholesterol, among those who have had their Cholesterol Level checked RISK BEHAVIORS Percent of Adults who Smoke Cigarettes Percent of Physically Inactive Adults Percent of Adults who Consume Less than 5 Fruits and Vegetables Serving Daily Percent of Adults who Binge Drink Percent of Adults with No Health Insurance PREVENTIVE PRACTICES Percent of Women, age 4+, with Mammography in the Last Two Years Percent of Women without Hysterectomy who Received a Pap Smear in the Last Three Years Percent of Adults, Ages 18-64, who Have Been Tested for HIV Percent of Adults, aged 65+ years, who have had an Influenza Vaccination within the last 12 months Percent of Adults, aged 65+ years, who have ever had a Pneumonia Vaccination Coastal Health District Department of Epidemiology; Page 29

30 Infectious Disease Under Georgia law certain diseases and conditions have been designated as notifiable. The purpose of notifiable disease surveillance is to indentify in a timely way any diseases or conditions that may require immediate public health intervention and follow-up; detect changing trends or patterns in disease occurrence; identify areas or communities that require special public health response as a result of changes in disease patterns; and assess and evaluate control prevention strategies. The following graphs detail the number of cases of each disease or condition reported from It should be noted that disease reporting is based on residence and not necessarily the location where the disease or condition was acquired. Reportable Disease Incidence, Annual Totals (CHD) Number of Cases Reported Ente ric Pathogens Hepatitis Invasive Pathogens Lead Blood Level Legionare's Disease Meningitis Vector Related GA Department of Public Health; SENDSS 6/28/11 Coastal Health District Department of Epidemiology; Page 3

31 Hepatitis means inflammation of the liver and can be caused by drugs, toxic substances, and several infectious agents including viruses. Hepatitis B and C are transmitted by blood and/or body fluids while Hepatitis A is transmitted through the fecal-oral route. All of the hepatitis viruses can cause fatigue, vomiting, diarrhea, abdominal pain, jaundice, dark urine and pale stools. Hepatitis B and C may lead to liver cancer, cirrhosis, and possibly death. Hepatitis B and C were more commonly reported in the Coastal Health District over the past several years than Hepatitis A. Hepatitis B can be a serious infection, but in many cases, the immune system can fight the infection adequately. Hepatitis B can be passed from an infected mother to her baby at birth. Hepatitis B can survive outside the body for at least 7 days. Some persons with Hepatitis B may become chronic carriers of the virus, and continue to be infectious all their lives. Most people who become infected with Hepatitis C do not clear the infection, and therefore become chronic carriers. Those persons who inject street drugs with shared needles or are otherwise exposed to blood from infected persons are at increased risk of getting infected with Hepatitis C. Hepatitis C can also be passed from mother to child during birth. Hepatitis C is usually mild in the early stages of infection. It is often not recognized until the infection reaches the chronic stage when liver damage has occurred. Within the state of GA Hepatitis infections are categorized as acute, chronic or infected. The infected category represents known infections that do not have enough data to determine rather they are acute or chronic. Hepatitis Incidence (Coastal Health District) Number of Cases Reported A (Acute) B (Acute) B (Chronic) B (Infected) C (Chronic) C (Infected) GA Department of Public Health; SENDSS 6/28/11 Vector-Borne Disease Incidence (Coastal Health District) Number of Cases Reported Ehrlichia Chaffeensis Lyme Disease Malaria Q Fever Rocky Mountain Spotted Fever GA Department of Public Health; SENDSS 6/28/11 Coastal Health District Department of Epidemiology; Page 31

32 Invasive Pathogens Incidence (Coastal Health District) Number of Cases Reported Haemophilus Influenzae (Invasive) 2 MRSA (Community Assoc.) Streptocococal Disease, Group A Streptococal Disease, Group B Streptococcus Pheumoniae GA Department of Public Health; SENDSS 6/28/11 Enteric diseases, such as salmonellosis and shigellosis, affect the gastrointestinal system and are usually associated with contaminated food or poor hygiene. Common symptoms of enteric disease include nausea, vomiting and diarrhea. In some cases, more serious illness or even death may occur. According to the CDC, an estimated 76 million cases of foodborne illness and 5, associated deaths occur in the United States each year. Most cases of enteric disease are mild and go unreported while others can cause significant health problems. Enteric Pathogens Incidence (Coastal Health District) Campylobacteriosis Cryptosporidiosis Giardiasis Hemolytic Uremic Syndrome Salmonellosis Shiga Toxin Producing E. Coli (Stec) Shigellosis Vibriosis-Other Yersina Number of Cases Reported GA Department of Public Health; SENDSS 6/28/11 Coastal Health District Department of Epidemiology; Page 32

33 Meningitis Incidence (Coastal Health District) Number of Reported Cases Crytococcus Specify Agent Staph Areus Unknown Neisseria GA Department of Public Health; SENDSS 6/28/ Legionnellosis Incidence (Coastal Health District) Number of Cases Reported GA Department of Public Health; SENDSS 6/28/11 Coastal Health District Department of Epidemiology; Page 33

34 The occurrence of sexually transmitted diseases (STDs) such as chlamydia, gonorrhea and syphilis is an indicator of unprotected sexual contact, a primary risk factor for HIV infection. STDs can cause infertility, negative pregnancy outcomes, pelvic inflammatory disease, and cancer. Unfortunately, many cases of notifiable STDs are undiagnosed. Any sexually active individual can be infected with gonorrhea, chlamydia and/or syphilis. These diseases are spread through vaginal, anal, or oral sex. Some STDs can be passed from mother to child during pregnancy or birth. Total Reported Sexually Transmitted Disease Rate rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-29 STD Rate by Type rate per 1, population Chlamydia Gonorrhea Syphilis Georgia Coastal Health District Coastal Health District Department of Epidemiology; Page 34

35 Chlamydia is the most commonly reported infectious disease in the United States and gonorrhea is the second most common. The highest reported rates of infection in the Coastal Health District are among sexually active teenagers and young adults. Gonorrhea and chlamydia rates for African Americans are much higher than for whites. Chlamydia is detected more often in women than in men, while gonorrhea rates are similar between the two sexes. 6 Total Chlamydia Rate rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-29 Chlamydia Rate Per 1, Population by Race (CHD) 2-29 Chlamydia Rate Per 1, Population by Gender (CHD) % 5.6 7% % White Black Hispanic Male Fem ale % % Coastal Health District Department of Epidemiology; Page 35

36 3 Total Gonorrhea Rate rate per1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-29 Gonorrhea Rate Per 1, Population by Race (CHD) 2-29 Gonorrhea Rate Per 1, Population by Gender (CHD) % % White Black Hispanic % % Male Fem ale % Coastal Health District Department of Epidemiology; Page 36

37 Syphilis is caused by the bacteria, Treponema palidum, that moves throughout the body and reproduces once a day. Once diagnosed, it can easily be treated with penicillin or other antibiotics. Syphilis has been known to facilitate the transmission of HIV and to increase the likelihood of poor pregnancy outcomes (i.e., fetal death, infants born with physical and mental developmental disabilities). The national rate of syphilis infections decreased during the 199s; however, according to the CDC it has increased in recent years. The Coastal Health District follows this national trend. The rate of primary and secondary syphilis is higher among males than females. African Americans, by far, have more diagnosed cases of syphilis than whites. Total Syphilis Rate for All Stages rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-29 Syphilis Rate Per 1, Population by Race (CHD) 2-29 Syphilis Rate Per 1, Population by Gender (CHD) % 9.1 4% % White Black % Male Fem ale Coastal Health District Department of Epidemiology; Page 37

38 AIDS (Acquired Immunodeficiency Syndrome) was first reported in the United States in 1981 and has since become a major worldwide epidemic. AIDS is caused by HIV (Human Immunodeficiency Virus), which attacks cells of the immune system and destroys the body s ability to fight off infections. In the beginning of the epidemic, people died within about 1 years after becoming infected with HIV. In 1996, the introduction of HAART (highly active antiretroviral therapy), commonly known as triple cocktail, has significantly slowed the progression of HIV to AIDS and from AIDS to death. HIV infection is most commonly spread by direct contact with blood, semen or vaginal fluid during unprotected sex with an infected partner. It is also spread among injection drug users by sharing needles contaminated with HIV. In addition, an infected mother can pass HIV to her baby during pregnancy or delivery, as well as through breastfeeding. Persons Living with HIV (not AIDS) & AIDS by Gender, (CHD) Number of Cases HIV(Not AIDS) AIDS Fem ale Male Persons Living with HIV (Not AIDS) & AIDS by Race, (CHD) 28 HIV (Not AIDS) AIDS 3% 1% 24% White 4% 25% White Black Black 72% Hispanic/Latino, All Races Other[1] 71% Hispanic/Latino, All Races Coastal Health District Department of Epidemiology; Page 38

39 Persons Living with HIV (Not AIDS) & AIDS by Age, (CHD) 28 Age in years HIV (Not AIDS) AIDS >= Total Persons Living with HIV (Not AIDS) & AIDS by transmission category, (CHD) 28 HIV (Not AIDS) AIDS 25% MSM IDU 31% 31% MSM IDU MSM/IDU MSM/IDU 55% 6% 3% 11% High risk heterosexual NIR/NRR 1% 21% 3% 13% High risk heterosexual Other NIR/NRR Coastal Health District Department of Epidemiology; Page 39

40 Newly Diagnosed HIV (Not AIDS) Cases by Gender and Race in Coastal Health District (9-1), Georgia: 27, 28, and 29 Newly Diagnosed HIV (Not AIDS) Case by Gender Number of Cases Year Fem ale Male Total Newly Diagnosed HIV (Not AIDS) Cases by Race Race White Black Hispanic/Latino All Races Asian/Hawaiian/Pacific Islander 1 Other 1 2 Total Coastal Health District Department of Epidemiology; Page 4

41 Newly Diagnosed AIDS Cases by gender, race, age and transmission category in the Coastal Health District (9-1), Georgia: 27, 28, and Newly Diagnosed AIDS Cases by Gender Number of Cases Year Fem ale Male Total Newly Diagnosed AIDS Cases by Race Race White Black Hispanic/Latin, All Races Other 1 Total Coastal Health District Department of Epidemiology; Page 41

42 Newly Diagnosed AIDS Cases by Age Age in years >= Total Newly Diagnosed AIDS Cases by transmission category Transmission Category MSM (men who have sex with men) IDU (Injection drug use) MSM and IDU 1 2 High Risk Heterosexual NIR/NRR (No Identified Risk / No Reported Risk) Total Coastal Health District Department of Epidemiology; Page 42

43 Tuberculosis (TB) is a bacterial infection, primarily affecting the lungs. TB can take one of two forms: an active version (TB disease) or one that lays dormant with the body (latent-tb infection or LTBI). Only patients with active TB can spread TB to others. Transmission occurs through the air when an infected individual with TB coughs, sneezes, laughs or sings. Transmission usually takes place only after prolonged exposure with someone who has the disease. Patients require treatment with multiple drugs for six months or longer to cure, preferably by directly observed therapy (DOT). Those with LTBI can develop active disease later in life. Individuals at higher risk for this include young children, patients with HIV, diabetics, cancer patients, and those recently infected with TB. Progression of the disease can usually be prevented by taking a single drug for 4-9 months. TB was once the leading cause of death in the United States, but use of antibiotics greatly reduced the rates of infection and death. There has been an increase, however, in strains of TB resistant to multiple forms of antibiotics, both in the U.S. and in other parts of the world. This results from the misuse of drugs, either in appropriately prescribed medication or patient failure to complete the treatment course. TB Case Numbers and Rates District 9-1 (Coastal), Year Rates are per 1, population Source: GA TB surveillance database Number Rate Coastal Health District Department of Epidemiology; Page 43

44 21 TB Case Count for Coastal Health District (CHD) 9-1 CHD Long Liberty Bryan Effingham Chatham: McIntosh Glynn Camden GA Department of Public Health; SENDSS 6/28/11 A high level of lead in the bloodstream can lead to learning disabilities, behavioral problems, seizures, and even death. The primary source of lead poisoning in children is lead associated with aging paint. Although lead-based paint has been banned for years, it can still be found in some older homes. Children under age six, particularly those living in older housing, are at the highest risk for lead poisoning. Other common sources of lead poisoning in children are: lead glazed pottery (jars and tiles), certain vinyl products (blinds), imported toys and jewelry, contaminated soil, and automobile parts such as batteries and radiators. 3 Elevated Blood Lead Levels Incidence (CHD) Number of Cases Reported Lead Blood Level GA Department of Public Health; SENDSS 6/28/11 Coastal Health District Department of Epidemiology; Page 44

45 Injury & External Causes Injuries are among the leading causes of death among persons of all ages. Injuries such as motor vehicle crashes, drownings, poisonings, animal bites, homicide, and suicide are preventable. There are numerous factors that affect injury risk, such as non-use of safety belts, driving under the influence, and domestic violence. rate per 1, population Death Rate Due To External Causes year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 27 Deaths Due to External Causes (CHD) Legal Intervention Hom icide 59 Suicide Poisoning Fire and Smoke Exposure 13 Drow ing 6 Accidental Shooting 1 Falls 29 Motor Vehicle Crashes number of deaths Coastal Health District Department of Epidemiology; Page 45

46 27 Deaths Due to External Causes Among Whites (CHD) Legal Intervention Homicide 4 13 Suicide Poisoning Fire and Smoke Exposure Drow ing Accidental Shooting 1 2 Falls Motor Vehicle Crashes number of deaths Incidence Count Incidence Rate 27 Deaths Due to External Causes Among Blacks (CHD) Legal Intervention Hom icide Suicide Poisoning Fire and Smoke Exposure Drow ing Accidental Shooting 2 Falls Motor Vehicle Crashes number of deaths Incidence Count Incidence Rate Coastal Health District Department of Epidemiology; Page 46

47 25 Motor Vehicle Related Death Rate rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) GA Department of Public Health; OASIS 2-27 Homicide Rate Per 1, by Gender (CHD) 2-27 Motor Vehicle Related Death Rate Per 1, by Gender (CHD) 5 25% Male Fem ale % Male Fem ale % % Homicide Rate rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Coastal Health District Department of Epidemiology; Page 47

48 Suicide Rates* by County Coastal Public Health District Chatham: 1 Effingham: 14 District =11 (State = 11) Bryan: 11 Long: 12 Liberty: 1 McIntosh: 8 Glynn: 12 Camden: 11 * per 1, persons per year Source: Georgia Division of Public Health, Vital Records Death Data, Total Suicide Death Rate rate per 1, population year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) Coastal Health District Department of Epidemiology; Page 48

49 Alcoholism is a diagnosable disease characterized by a strong craving for alcohol, continued use despite harm or physical injury, the inability to limit drinking, physical illness when drinking stops, and the need to increase the amount consumed in order to feel the effects. Heavy drinking generally refers to more than an average of two drinks a day for men and one drink for women. According to the National Institute on Alcohol Abuse and Alcoholism, one of every 13 adults is an alcoholic or abuses alcohol, and an even greater number engage in such activities such as binge drinking and regular heavy drinking. The CDC reports that excessive alcohol use is the third leading lifestyle-related cause of death for people in the U.S. each year, accounting for 75, deaths annually. Linked with cirrhosis of the liver, motor vehicle crashes, injuries, cancer, and drowning, alcohol is involved in nearly 4% of traffic deaths. rate per 1, population Alcoholic Liver Disease Hospital Discharge Rate year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-28 Alcoholic Liver Disease Rate Per 1, by Race (CHD) 2-28 Alcoholic Liver Disease Rate Per 1, by Gender (CHD) % White Black % % Male Fem ale % Coastal Health District Department of Epidemiology; Page 49

50 rate per 1, population Hospital Discharges Related To Drug Overdose Rate year Georgia Coastal Health District (Savannah) Linear (Georgia) Linear (Coastal Health District (Savannah)) 2-28 Hospital Discharges Related to Drug Overdose Rate Per 1, by Race (CHD) 2-28 Hospital Discharges Related to Drug Overdose Rate Per 1, Population by Gender (CHD) 21 32% White Black % Male Fem ale % % rate per 1, population Drug Overdose Hospital Discharge Rate Per 1, Population by Age (CHD) Age Age 2-29 Age 3-44 Age Age 6-74 Age 75+ age Coastal Health District Department of Epidemiology; Page 5

51 Appendix I County Profiles Georgia Coastal Health District Bryan County Camden County Chatham County Effingham County Glynn County Liberty County Long County McIntosh County Coastal Health District Department of Epidemiology; Page 51

52 Georgia 29 Population Totals 1 Total Population: 9,829,211 Black Population: 2,926,844 White Population: 5,648,743 Hispanic Population: 819,887 All Other Population: 433,737 Maternal/ Infant Care 28 1 Annual Births 28: 146,464 Black 44,947 White 58,72 Hispanic 2,357 Teen Births Ages : 17,477 Black 7,617 White 5,59 Hispanic 2,536 Low Birth Weight Births (<25 grams) 28: 14,14 Black 6,272 White 4,38 Hispanic 1,363 Population Age Groups 29 1 Age Categories: <1 156, , ,153, , ,411, ,111, ,948, ,5, ,188 Infant Mortalities 27: 1,198 Black 63 White 47 Hispanic 75 Education Total Enrollment 1,69,681 Total Graduate 83,517 High School Dropout 18,96 Economic / Employment 2 Average Annual Unemployment Rate, Median Household Income 28 Model-Estimate $5,834 Per Capita Income 27 $33,499 Families Living Below Poverty Level % in Education (Age 25 Older) 2 2 % Bachelor Degree 16. % Dropout 21.4 % High School Diploma 28.7 Medical Care Community 2 Total Practicing Physicians 26 18,422 General Hospitals General Nursing Homes Persons Per Physician Ratio References 1. GA OASIS 2. UGA County Statistics Coastal Health District Department of Epidemiology; Page 52

53 Coastal Health District 29 Population Totals 1 Total Population: 553,987 Black Population: 175,231 White Population: 336,219 Hispanic Population: 22,267 All Other Population: 2,27 Maternal/ Infant Care 1 Annual Births 28: 8,888 Black 2,868 White 3,5 Hispanic 649 Teen Births Ages : 1,114 Black 557 White 311 Hispanic 79 Low Birth Weight Births 28: 859 Black 391 White 254 Hispanic 4 Population Age Groups 29 1 Age Categories: <1 9, , , , , , , , ,837 Infant Mortalities 27: 79 Black 45 White 3 Hispanic 3 Economic / Employment ( All Values are County Averages) Annual Unemployment Rate, Median Household Income 28 Model-Estimate $47,993.5 Per Capita Income 27 $29, Families Living Below Poverty Level % in Education (All Values arecounty Average) Total Enrollment 1, Total Graduate High School Dropout 173 Education (Age 25 Older) (All Values are County Average) % Bachelor Degree 1.5 % Dropout 2.51 % High School Diploma Medical Care Community (All Values are County Average) Total Practicing Physicians General Hospitals General Nursing Homes Persons Per Physician Ratio 26 1,148.9 References 1. GA OASIS 2. UGA County Statistics Coastal Health District Department of Epidemiology; Page 53

54 Bryan County 29 Population Totals 1 Total Population: 32,559 Black Population: 4,978 White Population: 25,245 Hispanic Population: 1,17 All Other Population: 1,166 Maternal/ Infant Care 1 Annual Births 28: 466 Black 65 White 23 Hispanic 23 Teen Births Ages : 46 Black 12 White 23 Hispanic 3 Low Birth Weight Births 28: 33 Black 5 White 21 Hispanic Population Age Groups 29 1 Age Categories: < , , , , , , , ,48 Infant Mortalities 27: 3 Black 1 White 2 Hispanic Education Total Enrollment 6,491 Total Graduate 363 High School Dropout 68 Economic / Employment 2 Average Annual Unemployment Rate, Median Household Income 28 Model-Estimate $62,38 Per Capita Income 27 $33,882 Families Living Below Poverty Level % in Education (Age 25 Older) 2 2 % Bachelor Degree 13.2 % Dropout 21. % High School Diploma 32.8 Medical Care Community 2 Total Practicing Physicians General Hospitals 27 General Nursing Homes 28 1 Persons Per Physician Ratio 26 1,739.2 References 1. GA OASIS 2. UGA County Statistics Coastal Health District Department of Epidemiology; Page 54

55 Snapshot 21: Bryan Population Estimate, 29: 32,559 Bryan Rank Georgia County (of 157) Health Outcomes 29 Mortality 3 Premature death Years of potential life lost before age 75 per 1, population (age-adjusted) 8,242 8,269 Morbidity Poor or fair health Percent of adults reporting fair or poor health (age-adjusted) 11% 17% 4 Poor physical health days Average number of physically unhealthy days reported in past 3 days (age-adjusted) Poor mental health days Average number of mentally unhealthy days reported in past 3 days (age-adjusted) Low birth weight Percent of live births with low birth weight (< 25 grams) 7.8% 9.1% Health Factors 19 Health Behaviors 72 Adult smoking Percent of adults that report smoking at least 1 cigarettes and that they currently smoke 26% 21% Adult obesity Percent of adults that report a BMI >= 3 28% 29% Binge drinking Percent of adults that report binge drinking in the past 3 days 16% 13% Motor vehicle crash death rate Motor vehicle crash deaths per 1, population Chlamydia rate Chlamydia rate per 1, population Teen birth rate Teen birth rate per 1, female population, ages Coastal Health District Department of Epidemiology; Page 55

56 Snapshot 21: Bryan Clinical Care County Georgia 15 Uninsured adults Percent of population under age 65 without health insurance 17% 19% Primary care provider rate Primary care provider rate per 1, population 91 1 Preventable hospital stays Hospitalization rate for ambulatory-care sensitive conditions per 1, Medicare enrollees 81 8 Diabetic screening Percent of diabetic Medicare enrollees that receive HbA1c screening 76% 79% Hospice use Percent of chronically ill Medicare enrollees in hospice care in last 6 months of life 55% 37% Social & Economic Factors 11 High school graduation Percent of ninth grade cohort that graduates in 4 years 75% 62% College degrees Percent of population age 25+ with 4 year college degree or higher 27% 27% Unemployment Percent of population age 16+ unemployed but seeking work 5% 6% Children in poverty Percent of children under age 18 in poverty 13% 2% Income inequality Gini coefficient of income inequality based on household income 4 46 Inadequate social support Percent of adults without social/ emotional support 21% Single-parent households Percent of all households that are singleparent households 13% 11% Homicide rate Deaths due to homicide per 1, population (age-adjusted) 8 Physical Environment 112 Air pollution-particulate matter days Annual number of unhealthy air quality days due to fine particulate matter 18 9 Air pollution-ozone days Annual number of unhealthy air quality days due to ozone 2 Access to healthy foods Healthy food outlets include grocery stores and produce stands/farmers' markets 67% 41% Liquor store density Number of liquor stores per 1, population.7.9 * 9th percentile, i.e., only 1% are better Note: Blank values reflect unreliable or missing data Source URL: Coastal Health District Department of Epidemiology; Page 56

57 Camden County 29 Population Totals 1 Total Population: 48,277 Black Population: 9,343 White Population: 35,77 Hispanic Population: 1,276 All Other Population: 1,888 Maternal/ Infant Care 1 Annual Births 28: 919 Black 139 White 518 Hispanic 42 Teen Births Ages : 123 Black 33 White 64 Hispanic 6 Low Birth Weight Births 28: 53 Black 11 White 24 Hispanic 3 Population Age Groups 29 1 Age Categories: < , , , , , , , ,638 Infant Mortalities 27: 6 Black 1 White 4 Hispanic 1 Education Total Enrollment 9,477 Total Graduate 548 High School Dropout 131 Economic / Employment 2 Average Annual Unemployment Rate, Median Household Income 28 Model-Estimate $51,985 Per Capita Income 27 $28,288 Families Living Below Poverty Level % in Education (Age 25 Older) 2 2 % Bachelor Degree 1.3 % Dropout 16.7 % High School Diploma 33.2 Medical Care Community 2 Total Practicing Physicians General Hospitals 27 1 General Nursing Homes 28 1 Persons Per Physician Ratio References 1. GA OASIS 2. UGA County Statistics Coastal Health District Department of Epidemiology; Page 57