DEKALB MEDICAL HILLANDALE 2013 Community Health Assessment

Transcription

1 DEKALB MEDICAL HILLANDALE 2013 Community Health Assessment

2 Table of Contents Page METHODOLOGY 1 DEKALB MEDICAL AT HILLANDALE 6 Profile Population 8 Economics 9 Education 9 Housing 9 Households 10 Labor 10 Leading Causes Leading Causes of Hospitalization 12 Leading Causes of Mortality 12 Chronic Diseases Overview 16 Cancers 16 Cardiovascular Diseases 18 Diabetes 20 Asthma 21 Infectious Diseases Overview 23 Sexually Transmitted Diseases 23 HIV/AIDS 24 Respiratory Diseases 25 Injuries Overview 30 Leading Types of Injury 30 Deaths by Type of Injury 31 Maternal and Child Health Pregnancy 33 Low Birthweight 34 Infant Mortality 34 APPENDICES Differences in Health Status, Access to Healthcare, and Environment Acknowledgements Index of Tables and Figures Sources Resources and Services 44 * Indicates that this section includes a focus on related risk factors and behaviors. i

3 METHODOLOGY 1

4 Methodology Understanding a community s health needs helps health care organizations, like DeKalb Medical, develop programs and services to improve the health status of the populations they serve. The 2013 Community Health Assessment Report uses the latest demographic, health and risk behavior data to describe the health status of DeKalb County and Hillandale area (i.e., Lithonia and Redan) residents. DEMOGRAPHIC DATA SOURCES The county s population estimates were obtained from the U.S. Census Bureau s 2010 American Community Survey and The Georgia County Guide for 2010 through HEALTH DATA SOURCES DeKalb Community Service Board The DeKalb Community Service Board provided all of the data for the Behavioral Health in DeKalb County section. DeKalb County Board of Health The DeKalb County Board of Health s Division of Environmental Health provided data on West Nile virus for the Infectious Diseases in DeKalb County section. Georgia Department of Public Health Georgia Comprehensive Cancer Registry The Georgia Comprehensive Cancer Registry collects all cancer cases diagnosed among Georgia residents since January 1, The registry staff provided cancer data for the Chronic Diseases in DeKalb County section. HIV/AIDS Epidemiology Section The section staff provided HIV/AIDS data for the Infectious Diseases in DeKalb County section. Online Analytical Statistical Information System (OASIS) OASIS is a set of web-based tools for analyzing Georgia s public health data. Data from OASIS is used throughout the report. Refugee Program The program staff provided all of the data for the Refugee Health in DeKalb County section. State Electronic Notifiable Disease Surveillance System (SENDSS) SENDSS is a web-based reporting system that collects information pertaining to notifiable diseases in Georgia. State law requires that healthcare providers notify the state s public health system of diagnosed cases of over 50 diseases and conditions. 2

5 RISK BEHAVIOR DATA SOURCES The DeKalb County Board of Health conducts two surveys to assess residents health-related risk behaviors. One is the Behavioral Risk Factor Surveillance System survey of adults and the other is the Youth Risk Behavior Survey of high school students. Behavioral Risk Factor Surveillance System (BRFSS) Survey DeKalb County residents were interviewed by telephone. Telephone numbers were randomly dialed and respondents were randomly selected from the adult members of each household. Participation was voluntary and anonymous, and the sample did not include institutionalized individuals, households without telephones, and households that use only cellular telephones. Trained telephone interviewers administered the questionnaire. Data were weighted to represent the age, race/ethnicity and gender distributions of adults in DeKalb County. Logistic regression was used to compare age groups and trends over time. Youth Risk Behavior Survey (YRBS) A sample of students from all 20 traditional DeKalb County public high schools completed a written questionnaire. The number of participating classes varied depending on the population size of the school. Classes were randomly chosen from among all second period classes (excluding English as a Second Language and special education). All students within a selected class were eligible to participate. Passive consent forms were sent home for parents to sign if they did not want their child to participate. All students without a signed form were encouraged to participate. Participation was anonymous and voluntary and data are reported only in aggregate form. DCBOH employees administered the survey. Results were weighted, are representative of all students in DeKalb County public high schools, and are comparable to state and national YRBS data. Logistic regression analysis was used to analyze trends over time. STATISTICAL METHODS Percentages For the most part, disease and death-related data are analyzed using percentages instead of rates (e.g., number of cases per 100,000 population). Percentages are accessible to the general public and facilitate comparison between DeKalb County and the Hillandale area. Years of Potential Life Lost (YPLL) Years of potential life lost is used to compare causes of premature death. YPLL was calculated by subtracting the age of death from 75 years. The age of 75 years is used as the cut-off as it is close to life expectancy (78 years) in the United States. For example, a person who dies at age 27 has lost 75 minus 27, or 48 years, of potential life. A person who dies at age 72 has lost 75 minus 72, or 3 years, of potential life. Together, these two people contribute 48 plus 3, or 51 years, of potential life lost. The top ten leading causes of premature death are listed in the Leading Causes sections for DeKalb County and the Hillandale area. However, death data in other sections include people of all ages. 3

6 HILLANDALE AREA The Hillandale area was defined using the following census tracts from 2000: , , , , , 232.1, , , , , , 233.1, , , and LIMITATIONS Statistical limitation regarding some racial/ethnic groups Most of the report uses the racial categories of white, black, and other. Since the sizes of the Asian and Hispanic populations are too small for statistical purposes, these groups are included in the other category. Lack of some community-level prevalence data Much of the health data is defined using the International Classification of Diseases, Ninth Revision (ICD-9). The ICD-9 includes hospital data on individuals who went to an emergency room and/or were admitted. Since it does Created by: DeKalb County Board of Health (2012) Sources: DeKalb Medical and the Atlanta Regional Commission Hillandale Area Census Tracts Remaining DeKalb County Census Tracts Miles 4

7 not capture individuals who did not access a hospital for care, it does not fully reflect the extent of some conditions and diseases in the community. For example, the prevalence of high blood pressure in DeKalb County and Hillandale is analyzed using the number of individuals who were discharged after a hospital stay for this condition. Since many individuals do not seek hospital care for high blood pressure, they are not captured. Lack of 2009 death data by cause of death The data on the county s 2009 deaths analyzed by cause of death are not available from OASIS. Lack of some data at the census tract level A number of census tract maps are included in the report to demonstrate the geographic distribution of health issues affecting DeKalb County residents. However, not all health data is available at the census tract level. 5

8 DEKALB MEDICAL AT HILLANDALE

9 PROFILE OF HILLANDALE 89

10 Profile of Hillandale This section provides an overview of the characteristics of residents of the Hillandale area (i.e., Lithonia and Redan), the service area for DeKalb Medical at Hillandale. The area is defined using a group of U.S. Census Bureau tracts. Some data reported for all of DeKalb County are not available at the census tract level. POPULATION Table 67: Population Profile of Hillandale, 2010 Total 2010 estimate 132,735 % Female 45.0 % Male 55.0 % Under 5 years of age 7.1 % 65 years of age and over 6.1 Median age (years) 32.0 % Born outside the United States 8.7 Source: U.S. Census Bureau, 2010 American Community Survey. Figure 23: Population Estimate (in percentages) by Race, Hillandale, Black/African American (non-hispanic) White (non-hispanic) Other 94.1 Source: U.S. Census Bureau, 2010 American Community Survey. Note: Percentages do not add to 100 due to rounding 8

11 ECONOMICS Table 68: Economic Profile of Hillandale, 2010 Median household income $50,439 Per capita income $21,814 Source: U.S. Census Bureau, 2010 American Community Survey. EDUCATION Among Hillandale residents, there were 30,845 students enrolled in K-12 in Figure 24: Educational Attainment (25 years of age and older), Hillandale, % 25% % % 10% 5% 0% Less than 9th grade 9th to 12th grade, no diploma High school diploma/ged Some college, no degree Associate s degree Bachelor s degree Graduate or professional degree Source: U.S. Census Bureau, 2010 American Community Survey. HOUSING Table 69: Housing Profile of Hillandale, 2010 Total housing units 55,142 % Occupied housing units 88.6 % Occupied housing units occupied by owner 56.5 Source: U.S. Census Bureau, 2010 American Community Survey. 9

12 HOUSEHOLDS Table 70: Household Profile of Hillandale, 2010 Total households 47,456 % Family households 67.1 % Family households with children under age % Husband-wife family households with children under age % Female householder, no husband present with children under age 18* 27.7 % Nonfamily household 32.9 % Householder living alone 28.8 Source: U.S. Census Bureau, 2010 American Community Survey. *A householder is the head of a household. LABOR Table 71: Labor Profile of Hillandale, 2010 Population 98,522 Civilian employed population 61,222 % Private wage and salary workers 76.1 % Government workers 19.5 % Self-employed in own not incorporated business workers 4.2 % Unpaid family workers 0.2 % Unemployed 10.9 Residents average one-way travel time to work in minutes 37.1 Source: U.S. Census Bureau, 2010 American Community Survey. Note: Profile is of residents 16 years of age and over. 10

13 LEADING CAUSES IN HILLANDALE 93

14 Leading Causes in Hillandale LEADING CAUSES OF HOSPITALIZATION There were a total of 76,073 hospitalizations in Hillandale between 2005 and The table below displays the top ten leading causes of these hospitalizations, which accounted for 17.9% of the hospitalizations in DeKalb County. Table 72: Top Ten Leading Causes of Hospitalization, Hillandale, Cause Number of Percentage* Hospitalizations 1. Pregnancy and childbirth complications 13, Cardiovascular diseases 9, Respiratory diseases 4, Digestive system diseases 4, Cancers 4, Mental and behavioral disorders 3, Endocrine, nutritional, and metabolic diseases 2, Genitourinary system diseases 2, Musculoskeletal system and connective tissue diseases 2, Injuries 2, Other causes 24, Total 76, Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. *Percentages are based on the total of all hospitalizations in Hillandale. In Hillandale from 2005 to 2010: The top four leading causes of hospitalization (i.e., pregnancy and childbirth complications, and cardiovascular, respiratory, and digestive system diseases) were the same as DeKalb County. The fifth through tenth leading causes of hospitalization were the same as DeKalb County but in a different order. For example, injuries were the seventh leading cause of hospitalization in DeKalb County but were the tenth leading cause of hospitalization in Hillandale. LEADING CAUSES OF MORTALITY Premature Death The total Years of Potential Life Lost (YPLL) due to premature death for Hillandale residents from 2005 to 2010 was 52,261.5 (excluding 2009). Table 73 displays the top ten leading causes of YPLL. Hillandale accounted for 21.3% of the YPLL resulting from premature death in DeKalb County between 2005 and 2010 (excluding 2009). 12

15 Table 73: Leading Causes of Premature Death, Hillandale, , 2010 Cause YPLL Percentage* 1. Injuries 11, Cancers 9, Cardiovascular diseases 9, Pregnancy and childbirth complications 4, Infectious and parasitic diseases 3, Respiratory system diseases 2, Digestive system diseases 1, Endocrine, nutritional and metabolic diseases 1, Congenital and chromosomal abnormalities 1, Nervous system diseases 1, Other causes 5, Total 52, Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. Note: 2009 data are not available. *Percentages are based on the total of all YPLLs for premature deaths. Death There were a total of 3,092 deaths in Hillandale between 2005 and 2010 (excluding 2009). The following table shows the top ten leading causes of death during these years. Hillandale accounted for 15.2% of the total deaths in DeKalb County during this period. Table 74: Leading Causes of Death, Hillandale, , 2010 Cause Number of Deaths Percentage 1. Cardiovascular diseases Cancers Injuries Respiratory system diseases Infectious and parasitic diseases Mental and behavioral disorders Genitourinary system diseases Endocrine, nutritional, and metabolic diseases Digestive system diseases Pregnancy and childbirth complications Other causes Total 3, Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. Note: 2009 data are not available. 13

16 In Hillandale from 2005 to 2008 and 2010: The top two leading causes of death were the same as DeKalb County (i.e., cardiovascular diseases and cancers) and were responsible for over half of all deaths. Injuries were the third leading cause of death, while respiratory diseases were the third leading cause of death in DeKalb County. Pregnancy and childbirth complications were the tenth leading cause of death, but they were not a leading cause of death in DeKalb County. 14

17 CHRONIC DISEASES IN HILLANDALE 97

18 Chronic Diseases in Hillandale OVERVIEW In Hillandale, chronic diseases were the leading causes of hospitalization and death in 2005 to This section reviews the following chronic diseases impacting Hillandale residents: cancers, cardiovascular diseases, diabetes, and asthma. CANCERS Cancer Hospital Discharges by Type, Race, and Sex There were 4,267 hospital discharges due to cancer in Hillandale in 2005 through The following figure and tables analyze cancer hospital discharges among Hillandale residents by type of cancer, race, and sex. Figure 25: Leading Types of Cancer Hospital Discharges as a Percentage of All Cancer Hospital Discharges, Hillandale, % 6% 4% 2% 0% Colon Lung Breast Prostate Ovary Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. 16

19 Table 75: Cancer Hospital Discharges among Blacks, Hillandale, Type of Cancer Percentage 1. Colon (incl. rectal) Breast Lung (incl. bronchial) Prostate Kidney 1.8 Other cancers 81.3 Total 100 Table 77: Cancer Hospital Discharges among Males, Hillandale, Type of Cancer Percentage 1. Lung (incl. bronchial) Prostate Colon (incl. rectal) Liver Esophagus 4.8 Other cancers 40.0 Total 100 Table 76: Cancer Hospital Discharges among Whites, Hillandale, Type of Cancer Percentage 1. Colon (incl. rectal) Lung (incl. bronchial) Ovary 5.8 4/5. Breast 4.6 4/5. Uterus 4.6 Other cancers 62.7 Total 100 Table 78: Cancer Hospital Discharges among Females, Hillandale, Type of Cancer Percentage 1. Breast Lung (incl. bronchial) Colon (incl. rectal) /5. Pancreas 6.4 4/5. Ovary 6.4 Other cancers 34.9 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. Deaths due to Cancer In Hillandale from 2005 to 2010, there were 735 deaths due to cancer. Figure 26: Leading Cancer Deaths by Type as a Percentage of All Cancer Deaths, Hillandale, , % % 15% 10% 5% 0% Lung Breast Colon Prostate Pancreas Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. Note: 2009 data are not available. 17

20 In Hillandale from 2005 to 2010: Over 22 percent of cancer deaths were due to lung cancer. Although pancreatic cancer was not a leading cause of hospitalization, it was fifth among the top five cancers causing death. CARDIOVASCULAR DISEASES Cardiovascular Disease Hospital Discharges by Type, Race, and Sex There were a total of 4,286 hospital discharges due to cardiovascular diseases in Hillandale between 2005 and Figure 27: Leading Types of Cardiovascular Disease Hospital Discharges as a Percentage of All Cardiovascular Disease Hospital Discharges, Hillandale, % % 9.0 0% Obstructive heart disease Stroke High blood pressure 1.4 Hypertensive heart disease Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. 18

21 Table 79: Cardiovascular Disease Hospital Discharges among Blacks, Hillandale, Type of Cardiovascular Disease Percentage 1. Obstructive heart disease Stroke High blood pressure Hypertensive heart disease Other cardiovascular diseases 55.6 Total 100 Table 81: Cardiovascular Disease Hospital Discharges among Males, Hillandale, Type of Cardiovascular Disease Percentage 1. Obstructive heart disease Stroke High blood pressure Hypertensive heart disease Other cardiovascular diseases 53.4 Total 100 Table 80: Cardiovascular Disease Hospital Discharges among Whites, Hillandale, Type of Cardiovascular Disease Percentage 1. Obstructive heart disease Stroke High blood pressure Hypertensive heart disease Other cardiovascular diseases 54.3 Total 100 Table 82: Cardiovascular Disease Hospital Discharge among Females, Hillandale, Type of Cardiovascular Disease Percentage 1. Obstructive heart disease Stroke High blood pressure Hypertensive heart disease Other cardiovascular diseases 56.7 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. Deaths due to Cardiovascular Disease There were 564 deaths from cardiovascular disease in Hillandale in 2005 to 2010, excluding Figure 28: Leading Cardiovascular Disease Deaths by Type as a Percentage of All Cardiovascular Disease Deaths, Hillandale, , % % % 5.4 0% Obstructive heart disease Stroke Hypertensive heart disease High blood pressure Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. Note: 2009 data are not available 19

22 DIABETES Diabetes Hospital Discharges by Race and Sex There were a total of 1,473 hospital discharges due to diabetes in Hillandale in 2005 to Deaths due to Diabetes Table 83: Diabetes Hospital Discharges by Race and Sex, Hillandale, Race Percentage Black 93.7 White 5.4 Other 0.9 Total 100 Sex Male 46.2 Female 53.8 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. There were 78 deaths due to diabetes in Hillandale in 2005 to 2010, excluding

23 ASTHMA Asthma Hospital Discharges by Race and Sex There were a total of 1,058 hospital discharges due to asthma in Hillandale in 2005 and Deaths due to Asthma Table 84: Asthma Hospital Discharges by Race and Sex, Hillandale, Race Percentage Black 93.4 White 5.4 Other 1.2 Total 100 Sex Male 61.2 Female 38.7 Total 99.9* Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. *Percentages do not add to 100 due to rounding. There were 12 deaths due to asthma in Hillandale in 2005 to 2010, excluding

24 104 INFECTIOUS DISEASES IN HILLANDALE

25 Infectious Diseases in Hillandale OVERVIEW This section provides data on the following infectious diseases impacting Hillandale residents: sexually transmitted diseases (STDs), Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), tuberculosis, influenza, and pneumonia. SEXUALLY TRANSMITTED DISEASES (STDs) This section includes the following diseases: Chancroid Chlamydia Gonorrhea Syphilis Lymphogranuloma venereum Please note that due to reporting practices: This section includes data on the three diseases covered in the Infectious Diseases in DeKalb County section plus two additional diseases. The data in this section cannot be broken down by specific diseases. Sexually Transmitted Disease Hospital Discharges by Race and Sex There were 18 hospital discharges related to sexually transmitted diseases in Hillandale between 2005 and Tables 85 and 86 analyze the hospital discharges for STD infections among Hillandale residents by race and sex. Table 85: STD Hospital Discharges by Race, Hillandale, Race Percentage Black White 0.0 Other 0.0 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale in 2005 to 2010: Only blacks had hospital discharges resulting from STDs. 23

26 Table 86: STD Hospital Discharges by Sex, Hillandale, Sex Percentage Male 55.6 Female 44.4 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale in 2005 to 2010: Males had a higher percentage of hospital discharges resulting from STDs than women. Deaths due to STDs There were no deaths due to STDs in Hillandale in 2005 to 2010, including HIV/AIDS HIV/AIDS Hospital Discharges by Race and Sex There were 558 hospital discharges for HIV/AIDS in Hillandale between 2005 and Tables 87 and 88 analyze HIV/AIDS hospital discharges among Hillandale residents by race and sex. Table 87: HIV/AIDS Hospital Discharges by Race, Hillandale, Race Percentage Black 96.4 White 1.8 Other 1.8 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale in 2005 to 2010: Blacks had the highest percentage of hospital discharges for HIV/AIDS compared to other races. 24

27 Table 88: HIV/AIDS Hospital Discharges by Sex, Hillandale, Sex Percentage Male 69.9 Female 30.1 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale in 2005 to 2010: Males had a higher percentage of hospital discharges for HIV/AIDS than females. Deaths due to AIDS There were 79 deaths due to AIDS in Hillandale in 2005 to 2010, excluding RESPIRATORY DISEASES Tuberculosis Tuberculosis Hospital Discharges by Race and Sex There were 19 hospital discharges resulting from tuberculosis among Hillandale residents in 2005 to Tables 89 and 90 analyze hospital discharges for tuberculosis among Hillandale residents by race and sex. Table 89: Tuberculosis Hospital Discharges by Race, Hillandale, Race Percentage Black 78.9 White 10.5 Other 10.6 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale in 2005 to 2010: Blacks had the highest percentage of tuberculosis hospital discharges compared to those of other races. 25

28 Table 90: Tuberculosis Hospital Discharges by Sex, Hillandale, Sex Percentage Male 57.9 Female 42.1 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale in 2005 to 2010: Males had a higher percentage of tuberculosis hospital discharges than females. Deaths due to Tuberculosis There was one death from tuberculosis in Hillandale in 2005 to 2010, excluding Influenza Influenza Hospital Discharges by Race and Sex There were 41 hospital discharges resulting from influenza among Hillandale residents in 2005 to Tables 91 and 92 analyze influenza hospital discharges among Hillandale residents by race and sex. Table 91: Influenza Hospital Discharges by Race, Hillandale, Race Percentage Black 92.7 White 4.9 Other 2.4 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale in 2005 to 2010: Blacks had a higher percentage of influenza hospital discharges than those of other races. 26

29 Table 92: Influenza Hospital Discharges by Sex, Hillandale, Sex Percentage Male 48.8 Female 51.2 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale in 2005 to 2010: Females had a slightly higher percentage of influenza hospital discharges than males. Deaths due to Influenza There were two deaths from influenza in Hillandale in 2005 to 2010, excluding Pneumonia Pneumonia Hospital Discharges by Race and Sex There were 1,454 hospital discharges related to pneumonia in Hillandale between 2005 and Tables 93 and 94 analyze pneumonia hospital discharges among Hillandale residents by race and sex. Table 93: Pneumonia Hospital Discharges by Race, Hillandale, Race Percentage Black 86.0 White 12.7 Other 1.2 Total 99.9* Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. *Percentages do not add to 100 due to rounding. In Hillandale in 2005 to 2010: Blacks had the highest percentage of pneumonia hospital discharges compared to other races. 27

30 Table 94: Pneumonia Hospital Discharges by Sex, Hillandale, Sex Percentage Male 42.0 Female 58.0 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale in 2005 to 2010: Females had a higher percentage of pneumonia hospital discharges than males. Deaths due to Pneumonia There were 33 deaths from pneumonia in Hillandale in 2005 to 2010, excluding

31 INJURIES IN HILLANDALE 111

32 Injuries in Hillandale OVERVIEW Injuries are a leading cause of emergency room visits, hospitalizations, and deaths in Hillandale. Between 2005 and 2010, injuries were responsible for 52,066 emergency room (ER) visits, 2,341 hospitalizations, and at least 311 deaths in the area. These represent 18.2 percent of all ER visits, 3.1 percent of all hospitalizations, and at least 10.1 percent of all deaths in Hillandale. LEADING TYPES OF INJURY Figure 29: Leading Injuries by Type as a Percentage of All Injury-Related Emergency Room Visits, Hillandale, % 20% % 5.8 0% Falls Motor vehicle crashes Assaults Accidental poisonings Intentional self-harm Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. Tables 95 and 98 analyze injuries among Hillandale residents by race and sex. Table 95: Injuries among Blacks, Hillandale, Type of Injury Percentage 1. Falls Motor vehicle crashes Assaults Accidental poisonings Intentional self-harm 0.6 Other injuries 50.8 Total 100 Table 96: Injuries among Whites, Hillandale, Type of Injury Percentage 1. Falls Motor vehicle crashes Assaults Accidental poisonings Intentional self-harm 0.9 Other injuries 45.6 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. 30

33 In Hillandale from 2005 to 2010: Whites experienced a higher percentage of falls than blacks. Blacks experienced a higher percentage of motor vehicle crashes and assaults than whites. Table 97: Injuries among Males, Hillandale, Type of Injury Percentage 1. Falls Motor vehicle crashes Assaults Accidental poisonings Intentional self-harm 0.5 Other injuries 55.6 Total 100 Table 98: Injuries among Females, Hillandale, Type of Injury Percentage 1. Falls Motor vehicle crashes Assaults Accidental poisonings Intentional self-harm 0.8 Other injuries 45.0 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. In Hillandale from 2005 to 2010: Females experienced higher percentages of falls and motor vehicle crashes than men. DEATHS BY TYPE OF INJURY Figure 30: Injury Deaths by Type as a Percentage of All Injury-Related Deaths, Hillandale, , % % % 10% % Assaults Motor vehicle crashes Intentional self-harm Accidental poisonings Falls Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. Note: 2009 data are not available. In Hillandale, between 2005 and 2010, excluding 2009: Almost two-thirds (64 percent) of injury-related deaths in Hillandale were due to assaults and motor vehicle crashes. More than one in ten injury-related deaths (11.6 percent) in Hillandale were due to intentional self-harm (suicide). 31

34 114 MATERNAL AND CHILD HEALTH IN HILLANDALE

35 Maternal and Child Health in Hillandale PREGNANCY There were 12,223 pregnancies in Hillandale between 2005 and Hillandale pregnancies accounted for 12.6 percent of the total pregnancies in DeKalb County during this period. Table 99 analyzes all pregnancies among Hillandale residents by race and separates out pregnancies to females under age 20. Table 99: Pregnancies by Race, Hillandale, Race Percentage All Ages Black 89.2 White 2.6 Other 8.1 Total 99.9* Years of Age Black 89.8 White 1.6 Other 8.6 Total Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. *Percentages do not add to 100 due to rounding. In Hillandale from 2005 to 2010: The percentages of pregnancies for blacks and whites were similar for females of all ages and for females under age

36 LOW BIRTHWEIGHT There were 1,501 low birthweight babies born in Hillandale between 2005 and 2010, which accounted for 2.6% of the low birthweight babies born in DeKalb County during this period. Table 100 analyzes low birthweight babies among Hillandale residents by race. INFANT MORTALITY Table 100: Low Birthweight Babies by Race, Hillandale, Race Percentage* Black 90.3 White 1.9 Other 7.9 Total Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. *Percentages do not add to 100 due to rounding. Between 2005 and 2010 (excluding 2009), there were 110 deaths of Hillandale infants, which accounted for 24.8 percent of the total infant deaths in DeKalb County during this period. Table 101 analyzes Hillandale s infant deaths by race. Table 101: Infant Deaths by Race, Hillandale, , 2010 Race Percentage Black 91.8 White 6.4 Other 1.8 Total 100 Source: Online Analytical Statistical Information System (OASIS), Georgia Department of Public Health. Note: 2009 data are not available. In Hillandale from 2005 to 2010, excluding 2009: The percentage of black infant deaths was more than 14 times that of white infant deaths. 34

37 APPENDICES 117

38 DIFFERENCES IN HEALTH STATUS, ACCESS TO HEALTHCARE, AND ENVIRONMENT There are a number of factors that contribute to a person s state of health. DeKalb County residents health varies by race and income. The factors contributing to these differences may be biological, socioeconomic, psychosocial, behavioral, or social in nature. The tables below reflect differences in health status, access to healthcare, and environment by race and income. Figure 31: Differences in Health Status, Access to Healthcare, and Environment by Race, DeKalb County, 2011 Black White Other Races Health Status % Diagnosed with diabetes % Overweight % Obese % Are a current smoker % Heart attack % Stroke Access to Healthcare % No health insurance % No doctor s visit Environment % Perceive their neighborhood to be slightly safe or not at all safe Source: 2011 Behavioral Risk Factor Surveillance System. Note: Overweight and obesity ranges are determined by using weight and height to calculate a number called the body mass index (BMI). BMI is used because, for most people, it correlates with their amount of body fat. An adult who has a BMI between 25 and 29.9 is considered overweight. An adult who has a BMI of 30 or higher is considered obese. 36

39 Figure 32: Differences in Health Status, Access to Healthcare, and Environment by Income, DeKalb County, 2011 Less than $15,000 $15,000-24,999 $25,000-34,999 $35,000-49,999 $50,000 and up Health Status % Diagnosed with diabetes % Overweight % Obese % Are a current smoker % Heart attack % Stroke Access to Healthcare % No health insurance % No doctor s visit Environment % Perceive their neighborhood to be slightly safe or not at all safe Source: 2011 Behavioral Risk Factor Surveillance System. Note: Overweight and obesity ranges are determined by using weight and height to calculate a number called the body mass index (BMI). BMI is used because, for most people, it correlates with their amount of body fat. An adult who has a BMI between 25 and 29.9 is considered overweight. An adult who has a BMI of 30 or higher is considered obese. 37

40 ACKNOWLEDGEMENTS DeKalb Medical, Inc., and the DeKalb County Board of Health thank the following individuals for their time and expertise in creating this report. DeKalb Community Service Board Maxime Bouadoumou Burton May, M.A., M.S.W., L.C.S.W. Gary Richey, C.P.A. DeKalb County Board of Health Vickie Elisa, B.A. S. Elizabeth Ford, M.D., M.B.A. Jessica Grippo, M.P.H. Elizabeth Hedgepeth, M.P.H., C.P.H. Michelle Leon, B.S. Jewell Martin, M.H.S.A., B.S.N., R.N. Nia Mitchell, M.P.H., C.P.H. Leslie Richmond, M.D., M.B.A. Beth Ruddiman, Ph.D. Keir Sims, B.A. Juanette Willis DeKalb Medical, Inc. Don Fears, M.A. Sarah Kalaf, R.N., B.S.N., C.P.H.Q. Jacquelyn Paynter, R.N., M.P.H., C.C.M. Georgia Department of Public Health Kenya Baqi Richard Dunville, M.P.H. Ladonna Jones, M.P.H. Chrissy McNamara, M.S.P.H. Monica L. Vargas, M.S.P.H., M.B.A. 38

41 INDEX OF TABLES AND FIGURES Methodology Figure 1: Hillandale Area Census Tracts Demographic Profile of DeKalb County Table 1: Population Profile of DeKalb County, 2010 Figure 2: Population Estimate (in percentages) by Race/Ethnicity, DeKalb County, 2010 Table 2: Healthcare Profile of DeKalb County Figure 3: Health Insurance Coverage, DeKalb County, 2010 Table 3: Economic Profile of DeKalb County, 2010 Table 4: Educational Profile of DeKalb County, School Year Figure 4: Educational Attainment (25 years of age and older), DeKalb County, 2010 Table 5: Housing Profile of DeKalb County, 2010 Table 6: Household Profile of DeKalb County, 2010 Table 7: Labor Profile of DeKalb County, 2010 Table 8: Crime Profile of DeKalb County, 2010 Table 9: Disability Profile of DeKalb County, 2010 Leading Causes in DeKalb County Table 10: Top Ten Leading Causes of Hospitalization, DeKalb County, Table 11: Leading Causes of Premature Death, DeKalb County, , 2010 Table 12: Leading Causes of Death, DeKalb County, , 2010 Chronic Diseases in DeKalb County Table 13: Chronic Disease Risk Factors, DeKalb County, 2010 and 2011 Figure 5: Leading Types of Cancer Diagnosed as a Percentage of All Cancer Cases, DeKalb County, Table 14: Cancers among Blacks, DeKalb County, Table 15: Cancers among Whites, DeKalb County, Table 16: Cancers among Males, DeKalb County, Table 17: Cancers among Females, DeKalb County, Figure 6: Cancer Deaths by Type as a Percentage of All Cancer Deaths, DeKalb County, , 2010 Figure 7: Cancer Hospital Discharges, DeKalb County, Table 18: Tobacco Use among High School Students, DeKalb County, Figure 8: Leading Types of Cardiovascular Disease Hospital Discharges as a Percentage of All Cardiovascular Disease Hospital Discharges, DeKalb County, Table 19: Cardiovascular Diseases among Blacks, DeKalb County, Table 20: Cardiovascular Diseases among Whites, DeKalb County, Table 21: Cardiovascular Diseases among Males, DeKalb County, Table 22: Cardiovascular Diseases among Females, DeKalb County, Figure 9: Cardiovascular Disease Deaths by Type as a Percentage of all Cardiovascular Disease Deaths, DeKalb County, , 2010 Figure 10: Cardiovascular Disease Hospital Discharges, DeKalb County, Table 23: Physical Activity among High School Students, DeKalb County, Table 24: Stroke Performance Measures, DeKalb Medical at North Decatur, Table 25: Diabetes by Race, DeKalb County, Table 26: Diabetes by Sex, DeKalb County,

42 Figure 11: Diabetes Hospital Discharges, DeKalb County, Table 27: 40 Self-Perception of Weight and Weight Loss Behaviors among High School Students, DeKalb County, Table 28: Asthma by Race, DeKalb County, Table 29: Asthma by Sex, DeKalb County, Figure 12: Asthma Hospital Discharges, DeKalb County, Table 30: Asthma Among High School Students, DeKalb County, Infectious Diseases in DeKalb County Table 31: Vaccine-Preventable Diseases, DeKalb County, Figure 13: Chlamydia, Gonorrhea, and Syphilis Cases as a Percentage of All STD Cases, DeKalb County, Table 32: Chlamydia, Gonorrhea, and Syphilis Cases by Race, DeKalb County, Table 33: Chlamydia, Gonorrhea, and Syphilis Cases by Sex, DeKalb County, Table 34: Sexual Risk Behaviors among High School Students, DeKalb County, 2010 Table 35: STD Diagnoses among High School Students, DeKalb County, 2010 Figure 14: Persons Newly Diagnosed with HIV by Method of Transmission as a Percentage of All Persons Newly Diagnosed with HIV, DeKalb County, Table 36: Method of HIV Transmission by Race, DeKalb County, Table 37: Method of HIV Transmission Sex, DeKalb County, Table 38: Injection Drug Use among High School Students, DeKalb County, 2010 Table 39: HIV/AIDS Education among High School Students, DeKalb County, 2010 Figure 15: Hepatitis A, B, and C Cases by Type as a Percentage of All Hepatitis A, B and C Cases, DeKalb County, Table 40: Hepatitis by Type and Race, DeKalb County, Table 41: Hepatitis by Type and Sex, DeKalb County, Figure 16: Cases of Six Foodborne, Waterborne, and Environmental Disease Cases by Type as a Percentage of All Cases of the Six Diseases, DeKalb County, Table 42: Foodborne, Waterborne, and Environmental Diseases by Race, DeKalb County, Table 43: Foodborne, Waterborne, and Environmental Diseases by Sex, DeKalb County, Figure 17: Cases of Six Invasive Bacterial Diseases Cases as a Percentage of All Cases of the Six Diseases, DeKalb County, Table 44: Invasive Bacterial Diseases by Race, DeKalb County, Table 45: Invasive Bacterial Diseases by Sex, DeKalb County, Table 46: Tuberculosis Hospital Discharges by Race and Sex, DeKalb County, Table 47: Influenza Hospital Discharges by Race and Sex, DeKalb County, Table 48: Pneumococcal Immunizations of Pneumonia Patients, DeKalb Medical at North Decatur and Hillandale, Table 49: Influenza Immunizations of Pneumonia Patients, DeKalb Medical at North Decatur and Hillandale, Table 50: West Nile Virus Cases by Race and Sex, DeKalb County, Injuries in DeKalb County Figure 18: Leading Injuries by Type as a Percentage of All Injury-Related Emergency Room Visits, DeKalb County, Table 51: Injuries among Blacks, DeKalb County, Table 52: Injuries among Whites, DeKalb County, Table 53: Injuries among Males, DeKalb County, Table 54: Injuries among Females, DeKalb County,

43 Figure 19: Injury Deaths by Type as a Percentage of All Injury-Related Deaths, DeKalb County, , 2010 Figure 20: Emergency Room Visits for Injury, DeKalb County, Table 55: Injury Risk Behavior among High School Students, DeKalb County, Behavioral Health in DeKalb County Figure 21: Number of Clients Served by Outpatient Services, DeKalb County, Table 56: Mental Health Disorder Category for New Clients as a Percentage of All New Clients, DeKalb Community Service Board, Table 57: Developmental Disability Cases by Severity as a Percentage of All Developmental Disability Cases, DeKalb Community Service Board, Table 58: Suicidal Thoughts and Behaviors among High School Students, DeKalb County, Maternal and Child Health in DeKalb County Table 59: Pregnancies by Race, DeKalb County, Table 60: Low Birthweight Babies by Race, DeKalb County, Table 61: Infant Deaths by Race, DeKalb County, , 2010 Table 62: Sudden Infant Death Syndrome (SIDS) Deaths by Race, DeKalb County, , 2010 Table 63: Sexual Behaviors among High School Students, DeKalb County, Refugee Health in DeKalb County Table 64: Refugee Arrivals by Country of Origin as a Percentage of All Refugee Arrivals, DeKalb County, Figure 22: Leading Causes of Abnormal Screening Results as a Percentage of All Refugees Screened, DeKalb County, Table 65: Leading Causes of Abnormal Screening Results among All Male Refugees Screened, DeKalb County, Table 66: Leading Causes of Abnormal Screening Results among All Female Refugees Screened, DeKalb County, Hillandale Demographic Profile Table 67: Population Profile of Hillandale, 2010 Figure 23: Population Estimate (in percentages) by Race, Hillandale, 2010 Table 68: Economic Profile of Hillandale, 2010 Figure 24: Educational Attainment (25 years of age and older), Hillandale, 2010 Table 69: Housing Profile of Hillandale, 2010 Table 70: Household Profile of Hillandale, 2010 Table 71: Labor Profile of Hillandale, 2010 Leading Causes in Hillandale Table 72: Leading Causes of Hospitalization, Hillandale, Table 73: Leading Causes of Premature Death, Hillandale, , 2010 Table 74: Leading Causes of Death, Hillandale, , 2010 Chronic Diseases in Hillandale Figure 25: Leading Types of Cancer Hospital Discharges as a Percentage of All Cancer Hospital Discharges, Hillandale, Table 75: Cancer Hospital Discharges among Blacks, Hillandale, Table 76: Cancer Hospital Discharges among Whites, Hillandale,

44 Table 77: Cancer Hospital Discharges among Males, Hillandale, Table 78: Cancer Hospital Discharges among Females, Hillandale, Figure 26: Leading Cancer Deaths by Type as a Percentage of All Cancer Deaths, Hillandale, , 2010 Figure 27: Leading Types of Cardiovascular Disease Hospital Discharges as a Percentage of All Cardiovascular Disease Hospital Discharges, Hillandale, Table 79: Cardiovascular Disease Hospital Discharges among Blacks, Hillandale, Table 80: Cardiovascular Disease Hospital Discharges among Whites, Hillandale, Table 81: Cardiovascular Disease Hospital Discharges among Males, Hillandale, Table 82: Cardiovascular Disease among Females, Hillandale, Figure 28: Leading Cardiovascular Disease Deaths by Type as a Percentage of all Cardiovascular Disease Deaths, Hillandale, , 2010 Table 83: Diabetes Hospital Discharges by Race and Sex, Hillandale, Table 84: Asthma Hospital Discharges by Race and Sex, Hillandale, Infectious Diseases in Hillandale Table 85: STD Hospital Discharges by Race, Hillandale, Table 86: STD Hospital Discharges by Sex, Hillandale, Table 87: HIV/AIDS Hospital Discharges by Race, Hillandale, Table 88: HIV/AIDS Hospital Discharges by Sex, Hillandale, Table 89: Tuberculosis Hospital Discharges by Race, Hillandale, Table 90: Tuberculosis Hospital Discharges by Sex, Hillandale, Table 91: Influenza Hospital Discharges by Race, Hillandale, Table 92: Influenza Hospital Discharges by Sex, Hillandale, Table 93: Pneumonia Hospital Discharges by Race, Hillandale, Table 94: Pneumonia Hospital Discharges by Sex, Hillandale, Injuries in Hillandale Figure 29: Leading Injuries by Type as a Percentage of All Injury-Related Emergency Room Visits, Hillandale, Table 95: Injuries among Blacks, Hillandale, Table 96: Injuries among Whites, Hillandale, Table 97: Injuries among Males, Hillandale, Table 98: Injuries among Females, Hillandale, Figure 30: Injury Deaths by Type as a Percentage of All Injury-related Deaths, Hillandale, , 2010 Maternal and Child Health in Hillandale Table 99: Pregnancies by Race, Hillandale, Table 100: Low Birthweight Babies by Race, Hillandale, Table 101: Infant Deaths by Race, Hillandale, , 2010 Appendices Figure 31: Figure 32: Differences in Health Status, Access to Healthcare, and Environment by Race, DeKalb County, 2011 Differences in Health Status, Access to Healthcare, and Environment by Income, DeKalb County,

45 SOURCES The 2010 Georgia County Guide, The University of Georgia The 2011 Georgia County Guide, The University of Georgia The 2012 Georgia County Guide, The University of Georgia DeKalb Community Service Board DeKalb County Board of Health 2010 DeKalb Youth Risk Behavior Survey (YRBS) Report 2011 DeKalb County Communities Putting Prevention to Work (CPPW) Behavioral Risk Factor Surveillance System (BRFSS) Report Diagnostic and Statistical Manual for Mental Disorders, Fourth edition (DSM-IV-TR) Georgia Department of Public Health Georgia Comprehensive Cancer Registry HIV/AIDS Epidemiology Section Office of Refugee Health Online Analytical Statistical Information System (OASIS) State Electronic Notifiable Disease Surveillance System (SENDSS) International Classification of Diseases, Ninth Revision, Clinical Modification, Sixth edition, 2009 (ICD-9) U.S. Census Bureau, 2010 American Community Survey 43

46 RESOURCES AND SERVICES DeKalb County Board of Health ( Clifton Springs (South DeKalb) Health Center 3110 Clifton Springs Road Decatur, GA Phone: Services: STD/HIV Testing, TB, Dental, Hearing and Vision Screening, WIC, Family Planning, Women s Health, Children s Health, Immunizations, Adolescent Health and Youth Development, BreastTest and More East DeKalb Health Center 2277 S. Stone Mountain-Lithonia Road Lithonia, GA Phone: Services: Hearing and Vision Screening, WIC, Women s Health, Children s Health, Immunizations, Adolescent Health and Youth Development Eleanor L. Richardson Health Center 445 Winn Way Decatur, GA Phone: Services: STD/HIV Testing, HIV Treatment, Health Assessment and Promotion, Environmental Health, Refugee Health, Vital Records Kirkwood Health Center 30 Warren Street Atlanta, GA Phone: Services: Dental, WIC, Adolescent Health and Youth Development North DeKalb Health Center 3807 Clairmont Road Chamblee, GA Phone: Services: STD/HIV Testing, TB, Dental, Hearing and Vision Screening, WIC, Women s Health, Children s Health, Immunizations, Travel Medicine T. O. Vinson (Central) Health Center 440 Winn Way Decatur, GA Phone: Services: STD/HIV Testing, TB, Dental, Hearing and Vision Screening, WIC, Women s Health, Children s Health, Immunizations, Travel Medicine 44

47 DeKalb Medical ( DeKalb Medical at Downtown Decatur 450 N. Candler Street Decatur, GA Phone: Services: Long Term Acute Care (additional recovery time for serious illnesses, rehabilitation, etc.), Rehabilitation Services, Intensive Nursing and Respiratory Care with Therapeutic Services, Wound Care DeKalb Medical at Hillandale 2801 DeKalb Medical Parkway Lithonia, GA Phone: Services: Inpatient Medical Care, Inpatient and Outpatient Surgery, Intensive Care Unit, Emergency Department, Diagnostic Imaging Technology DeKalb Medical at North Decatur 2701 N. Decatur Road Decatur, GA Phone: Services: 24-hour Emergency Services, Commission on Cancer-accredited Cancer Center, Health Promotion Programs and Wellness Center, Maternity Center, Surgical Weight Loss Center, Joint Solutions Center, Surgical Services, Inpatient and Outpatient Rehabilitation Services, Sleep Disorder Center, Cardiovascular Services, Comprehensive Wound Care Center DeKalb Community Service Board ( CHOICE Program 2277 S. Stone Mountain-Lithonia Road Lithonia, GA Services: Community-based day habilitation program for individuals with developmental disabilities Clifton Springs Center 3110 Clifton Springs Road, Suite B Decatur, GA Services: Community support; Adult, adolescent and child outpatient mental health services Criminal Justice Services Court Services 455 Winn Way Decatur, GA Services: Clinical evaluations; outpatient substance abuse treatment program; mental health screening; state-certified domestic violence program; risk reduction/dui school Crossroads Program 23 Warren Street, SE Atlanta, GA