THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM IN OUTAGAMIE COUNTY

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2 THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM IN OUTAGAMIE COUNTY Methodology: 2015 KEY FINDINGS SUMMARY The Behavioral Risk Facr Surveillance System Survey was conducted by the St. Norbert College Strategic Research Institute (SRI) gather information on the health practices and health related behavioral risks of residents of County outside the city of Applen, Wisconsin. A tal of 452 telephone interviews were completed between January 5, 2015 and January 30, Respondents were scientifically selected so that the survey would be representative of all of the county s adult population 18-years-old and older. The sample of random telephone numbers, obtained from Survey Sampling International (SSI), Sheln, Connecticut was selected from both listed and unlisted numbers. Respondents within each household were randomly selected using the Troldahl-Carter household selection technique. Up eight attempts were made contact a respondent at each household. The sample also included 25% cell only numbers which were also obtained by random sampling. With a sample size of 452 we can be 95 percent sure that the sample percentage reported will not vary by more than +/- 5 percent from what would have been obtained by interviewing all persons 18-years-old and older who live within County outside the city of Applen. The margin of error for smaller subgroups will be larger. The report contains percentages that are rounded up at the.5 level and down for levels below.5, thus leading some overall percentages not equaling 10. Decimal point reporting for percentages is not necessary because this level of precision does not significantly impact the percentage rates and can affect table and chart readability. Modifications of the draft questionnaire (based on the Center for Disease Control Risk Behavior Survey Instrument), including additional questions, were made by SRI in consultation with the Fox Valley Community Health Improvement Coalition. With the gaining popularity of cell phone only usage and identified lower representation of younger age cohorts, respondent data was weighted by age and gender realign the sample with the 2010 census age distribution. This process allows a better and more accurate comparison state and national results and will better represent people of all age and gender groups in County. The Behavioral Risk Facr Surveillance System Survey was a community collaborative effort paid for by Affinity Health System, ThedaCare and the County Public Health Division. 1

3 What do the percentages represent? Results of the Behavioral Risk Facr Surveillance System Survey of County can be generalized the overall adult population (persons 18-years-old or older) of County outside the city of Applen. In 2010, the U.S. Census Bureau recorded 86,942 adults age 18 or older in County minus Applen who were 18 or older in When using percentages from the County Behavioral Risk Facr Survey, it is important keep in mind what each percentage point actually represents in terms of the adult population in the area. One percentage point is approximately equal at least 869 individuals. For example, 49 percent of survey respondents said they always get the social and emotional support they need, therefore, 49 percent of the 2010 adult population represents 42,602 persons. The 2010 U.S. Census recorded 45,685 households in County minus the city of Applen. In some questions asked in the Behavior Risk Survey, respondents were asked report information about their household. Each percentage point for household-level data represents at least 457 households. Although all questions were analyzed by demographic variables only those shown be statistically significant have been included within this report. David G. Wegge, Executive Direcr Craig Stencel, Direcr of Operations Keri Pietsch, Research Assistant 100 Grant Street De Pere, WI

4 Summary Findings County Behavioral Risk Facr Surveillance System Survey 1. Overall Health Rating - Over half (54%) of the respondents from County felt their overall health was either very good or excellent. Sixty-five percent (65%) of respondents said that there was no time in the past 30 days that their physical health was not good and 64% indicated they had no days of poor mental health. Furthermore, 65% indicated they were not kept from usual activities by poor physical or mental health during the past 30 days. 2. Health Care Access - The majority of respondents have some type of health care coverage and more people are generally seeing docrs for annual physicals or checkups. However, up 5% of respondents indicated they themselves or someone in their household are not taking their medications due cost and 24% are still paying off medical bills over time. 3. Weight/Diet/Exercise - Respondent s BMI (body mass index) was calculated by using weight (rounding up for fractions) and height (in feet and inches) without shoes. According the CDC categories, 29% were neither overweight or obese, 3 were overweight, and 35% were obese. Additionally, the plurality of respondents said they eat one serving of vegetables per day and two servings of fruit per day. Seventy-four percent (74%) said they participated in physical activities or exercises during the past month; 84% reported they do moderate exercise in a typical week and 4 reported they do vigorous exercise in a typical week. 4. Inadequate Sleep - Thirty-nine percent (39%) of respondents reported sleeping 8 hours or more in a 24-hour period while reported sleeping 5 hours or less within a 24-hour period. 5. Asthma - Nineteen percent (19%) of all respondents said they had ever been ld they had asthma. Of those who ever had it, 69% said they still have it. There has also been a trending increase in asthma since Depressive Disorder - Twenty-three percent (23%) of respondents reported ever being ld they have a depressive disorder. 7. Diabetes - Ten percent (1) of respondents said a docr ld them they had diabetes, with another saying yes, but only during pregnancy. The vast majority, 8, said they had never been ld they had diabetes. 8. Oral Health - The majority (78%) of respondents had been a dentist within the past year. Additionally, said they had not visited a dentist in at least 5 years. 9. Tobacco Use - The majority of respondents (5) had not smoked at least 100 cigarettes in their lifetime. Of those who currently smoke some days or every day, 7 said they had tried quit for at least one day in the past year. Ninety- 3

5 seven percent (9) reported not using chewing bacco, snuff, or snus and 95% do not use electronic cigarettes. 10. Alcohol Consumption - Seventy-five percent (75%) of respondents reported drinking at least one drink of any alcoholic beverage one day in the past 30 days. Thirteen percent (13%) of respondents reported drinking at least one alcoholic beverage 15 or more days per month in the past 30 days. During the past 30 days when respondents drank, 2 reported having an average of one drink while 1 indicated 5 or more drinks. 11. Immunization - Only 4 of respondents reported having either the flu shot or flu vaccine sprayed in their nose within the past 12 months. 12. Falls - Seventy-three percent (73%) of respondents reported zero falls in the past 12 months while 14% reported one fall, 8% reported two falls, and 5% reported 3 or more falls. Of those who reported having fallen, 6 reported that their fall had not caused an injury. 13. Seatbelt Use - A large percentage (83%) of respondents reported always using their seatbelt while driving or riding in a car. 14. Drinking and Driving - The majority of respondents (95%) reported never driving while perhaps having o much drink while each reported driving one time or two times when they ve perhaps had o much drink. 15. Women s Health Issues - Ninety-three percent (93%) of women had a breast exam and 95% have had a Pap test. Additionally, 88% of women age 40 and over had a mammogram. 16. Colorectal Cancer Screening - Only 25% of respondents have used a blood sol home testing kit while more respondents (79%) have had a colonoscopy/sigmoidoscopy. 17. Alcohol Screening & Brief Intervention (ASBI) - A majority (7) of respondents reported that a health care provider did ask them how much they drink while only 4% reported being advised reduce or quit drinking at their last routine checkup. 18. Social Context - In the past 12 months, 14% of respondents were always or usually worried about having enough money pay their rent/mortgage while 1 reported being always or usually worried about having enough money buy nutritious meals. Over 6 were never worried about having enough money or rent/mortgage or for nutritious meals. 19. Hypertension and Cholesterol Awareness - Thirty-two percent (3) of respondents said they have high blood pressure, while 33% of those who had ever had their cholesterol checked said they had high cholesterol. 20. Emotional Support - Slightly under half of respondents (49%) feel they always receive the social and emotional support they need. 4

6 21. Screen Time - The majority of respondents (55%) spend 2-3 hours a day in front of an electronic screen at home or for leisure per day. 22. Sugar Drinks - The majority of respondents drank soda or pop with sugar over the past 30 days (55%), however, concerning sugared fruit drinks, tea, and energy drinks, the majority (6) never had any. 23. Family Dining - Thirty-one percent (3) of respondents reported eating a household meal gether more than 7 times in the past week while only 8% said they never ate a meal gether. 5

7 Demographics Eleven percent (1) of respondents were age 18-24, 1 were age 25-34, 19% were 35-44, 2 were age 45-54, 15% were age 55-64, and 1 were 65 years old and older. Ninety-seven percent (9) of respondents reported their ethnic heritage as white and reported American Indian, Alaska Native. No respondent reported their ethnic heritage as black or Asian, Pacific Islander. Two percent () of respondents in addition classifying their ethnic heritage also indicated being Hispanic/Latino. Fifty-six percent (5) of respondents reported being married, 1 divorced, 8% widowed, separated, 23% never been married, and identified as a member of an unmarried couple. No respondent reported their highest grade or year of education completed as never attended/kindergarten or grades 1-8. Three percent (3%) reported grades 9-11, 34% grade 12 or GED, 3 reported college 1-3 years, and 33% reported college 4 years or more. Education categories were then collapsed better assess statistically significant differences. Please see Figures 1 and 2 below. Figure 1 Education Categories Figure 2 Education Recoded Never Attended or Kindergarten, College 4 or more years, 33% Grades 9-11, 3% College 1-3 years, 3 Grades 1-8, Grade 12 or GED, 34% College degree 33% Some college or tech school 3 High school diploma or less 3 Sixty-two percent (6) of respondents reported being employed for wages, 19% reported retired, 5% each reported being self-employed or a homemaker, 3% each reported being unable work or being out of work for less than 1 year, reported being out of work for more than 1 year, and reported being a student. No respondent reported being a farmer. Employment categories were later collapsed better assess statistically significant differences. Please see Figures 3 and 4 below. 6

8 Figure 3 Employment Status Figure 4 Employment Recoded Unable work, 3% Student, Out of work <1yr, 3% Out of work >1yr, Farmer, Reitred, 19% Homemaker, 5% Self- Employed, 5% Employed for wages, 6 Student Retired 19% Not in the workforce 13% Self- Employed 5% Employed 6 Four percent (4%) of respondents reported an annual household income of less than $10,000, 5% reported $10,001 $15,000, reported $15,001 $20,000, 9% reported $20,001 $25,000, reported $25,001 $35,000, 1 reported $35,001 $50,000, 2 reported $50,001 $75,000, 28% reported $75,001 or more, and 9% reported don t know/not sure or refused state income. Please see Figure 5 below. Figure 5 Annual Household Income >$75,000 28% DK/RF 9% $50,001- $75,000 2 <$10,000 4% $20,000 $10,001- $15,000 5% $15,001- $20,001- $25,000 9% $25,001- $35,000 $35,001- $50,000 1 Fifty-nine percent (59%) of respondents reported not having any children under the age of 18 currently living in their household. Thirty-one percent 7

9 (3) reported 1-2 children, 1 reported 3-4 children, and reported 5 or more children less than 18 years of age currently living in their household. Fifteen percent (15%) of respondents were from Kaukauna (city), 1 Grand Chute, 9% Kimberly, 8% Little Chute, Greenville, and each for Freedom and Seymour (city). All other cities, villages, or wns garnered 5% or less each. Please see Table 1 below. Table 1 Demographic Location Bear Creek < Freedom Maple Creek < Black Creek (wn) Grand Chute 1 New London Black Creek (vil.) Greenville Nichols < Bovina < Hornia Oneida Buchanan 5% Hornville 5% Osborn Cicero 3% Kaukauna (city) 15% Seymour (city) Combined Locks 4% Kaukauna (wn) Seymour (wn) 3% Dale / Medina 4% Kimberly 9% Shiocn Deer Creek < Little Chute 8% Vandenbroek Ellingn / Stephensville Maine Half (5) of the respondent population was male and the other half (5) was female. Overall Health Rating Summary Finding #1 Over half (54%) of the respondents from County felt their overall health was either very good or excellent. Sixty-five percent (65%) of respondents said that there was no time in the past 30 days that their physical health was not good and 64% indicated they had no days of poor mental health. Furthermore, 65% indicated they were not kept from usual activities by poor physical or mental health during the past 30 days. Overall Ratings Over half (54%) of respondents felt their overall general health was either very good or excellent, this has remained fairly steady since Only responded that it was poor in Please see Figure 6 below. 8

10 8% 3% 9% 4% 3% 3% 4% 5% 15% % 19% 13% 39% 33% 3 43% 39% Figure 6 Would you say that in general your health is Excellent Very Good Good Fair Poor Tri- County Area Wisconsin Fifty-five percent (55%) of respondents age 18-24, 4 age 45-54, 43% age 25-34, and 33% age reported their general health as very good. Thirty-seven percent (3) of respondents age or 65 and over reported their general health as only good. In general, those who are younger ranked their general health as better than those who are older. Sixty percent (6) of respondents with a college degree reported their general health as excellent or very good. This was followed by respondents who have a high school diploma or less (5) and respondents with some college or tech school (5). Eighteen percent (18%) of respondents with some college or tech school reported their general health as only fair. No respondent with an annual household income of $15,000 or less reported their general health as excellent compared 24% who make $75,001 or more. Surprisingly, respondents making $20,000 or less had similar response rates (44% 55%) as those making $50,001 or more (44% 49%) in the very good category, with respondents making $10,001 $15,000 the highest at 55%. Please see Table 2 below. General Health Status Less than $10,000 Table 2 Income by General Health Status $10,001 $15,000 $15,001 $20,000 $20,001 $25,000 $25,001 $35,000 $35,001 $50,000 $50,001 $75,000 $75,001 or more Excellent 1 3% 4% 19% 15% 24% Very Good Good Fair Poor

11 1 13% 19% 15% 24% % 28% 25% 25% 65% % 65% The majority or plurality of respondents who are self-employed (5), a student (5), employed (4), or not in the workforce (4) reported their general health as very good. The plurality of respondents who are retired (3) reported their general health as only good. Those who are self-employed had the highest percentage who reported their general health as poor (9%). More females (2) than males (9%) reported their general health as excellent but more males (43%) than females (35%) reported their general health as very good. Slightly more females (14%) reported their general health as fair or poor than males (1). Having children less than 18 years old currently living in the household of the respondent had a statistically significant impact on their overall general health. Most respondents with children (4) or without children (38%) reported their general health as very good. A larger percentage of respondents without kids reported their general health as fair (13%) or poor (3%) compared with respondents who do have children under 18 years old living in their household (9% fair; poor). Physically Unhealthy Days Sixty-five percent (65%) of respondents said that there was no time in the past 30 days that their physical health (including physical illness and injury) was not good, which is similar 2011 (6). Twelve percent (1) reported their physical health as not good 1-2 days during the past 30 days and 23% reported 3 days or more. Please see Figure 7 below. Figure 7 Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good? days 1-2 days 3 or more days Tri- County Area Wisconsin 10

12 There is a general decrease in the number of respondents reporting no physically unhealthy days in the past 30 days as age increases from Seventy-two percent (7) of respondents age reported zero days compared 58% of respondents age Respondents age fell slightly off this pattern with 59% reporting zero days, 13% less than those age Respondents age 65 and over also fell slightly off this pattern with 7 reporting zero days, 1 more than respondents age Respondents age had the greatest percentage of having 3 or more physically unhealthy days within the past 30 days (3). Please see Table 3 below. Table 3 Age by Number of Physically Unhealthy Days Number of 65 and Days over 0 days 59% % days or more days Even though tal household income is statistically significant, no general pattern emerged. Respondents with an annual income of $75,001 or more or $20,001 $25,000 had the highest percentage in terms of not having any physically unhealthy days, while respondents with an annual income of $35,001 $50,000 had the highest percentage of respondents who reported having 3 or more physically unhealthy days in the past 30 days (44%). Only 3 of respondents who make $10,001 $15,000 reported not having any physically unhealthy days in the past 30 days, which is much lower than respondents who make less than $10,000 (59%) or $15,001 $20,000 (7). Please see Table 4 below. Number of Days Table 4 Income by Number of Physically Unhealthy Days Less than $10,000 $10,001 $15,000 $15,001 $20,000 $20,001 $25,000 $25,001 $35,000 $35,001 $50,000 $50,001 $75,000 $75,001 or more 0 days 59% % 69% 75% 1-2 days or more days As education increased, the percentage of respondents reporting physically unhealthy days decreased. Seventy percent (7) of respondents with a college degree reported no physically unhealthy days compared 6 with a high school diploma or less. Also, only 1 of respondents with a college degree reported 3 or more physically unhealthy days in the past 30 days compared 28% with some college or tech school and 24% with a high school diploma or less. Mentally Unhealthy Days When asked how many days respondents felt stress, depression, or problems with emotions, 64% of respondents said they did NOT suffer from this during the last 30 days, which is up 3% from 2011 (6). Fourteen percent (14%) said they 11

13 14% % % 9% 24% 2 25% 25% 64% % 6 did have 1 or 2 mentally unhealthy days and 2 said they had 3 or more mentally unhealthy days in the past 30 days. Please see Figure 8 below. Figure 8 Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good? days 1-2 days 3 or more days Tri- County Area Wisconsin The majority of respondents age (5), (6), (64%), (75%), or 65 and over (8) reported not having any mentally unhealthy days within the past 30 days. Only 4 of respondents age reported no mentally unhealthy days in the past 30 says while 53% reported 3 or more. Interestingly, there is a general decrease in respondents reporting no mentally unhealthy days in the past 30 days as education increases. Sixty-nine percent (69%) of respondents with a high school diploma or less, 63% with some college or tech school, and 6 with a college degree reported not having any mentally unhealthy day in the past 30 days. Respondents with some college or tech school had the highest number of respondents who reported having 3 or more mentally unhealthy days in the past 30 days at 2. Even though annual household income was statistically significant, no general pattern emerged. Seventy-eight percent (78%) of respondents with an annual income of $75,001 or more reported no mentally unhealthy days within the past 30 days compared only 3 who earn $10,001 $15,000 annually. Fifty percent (5) of those making $10,001 $15,000 and 44% who make $20,001 $25,000 reported having 3 or more mentally unhealthy day in the past 30 days. All other income categories garnered 3 or less in terms of having 3 or more mentally unhealthy days. Please see Table 5 below. 12

14 9% 13% 18% 25% 1 13% % 25% 3 29% % 63% 58% % Number of Days Table 5 Income by Number of Mentally Unhealthy Days Less than $10,000 $10,001 $15,000 $15,001 $20,000 $20,001 $25,000 $25,001 $35,000 $35,001 $50,000 $50,001 $75,000 $75,001 or more 0 days 53% % 64% % 1-2 days or more days When analyzing employment and number of mentally unhealthy days, it was found that respondents who are retired had the highest percentage of respondents reporting zero mentally unhealthy days within the past 30 days (8), followed by those who are self-employed (73%), those who are employed (6), and those who are not in the workforce (5). No student reported not having any mentally unhealthy days within the past 30 days; half reported 1-2 days and the other half reported 3 or more days. Number of Days Poor Physical or Mental Health Kept You From Normal Activities Sixty-five percent (65%) of respondents indicated they had NO physical or emotional health problems during the last 30 days which kept them from their normal activities, which is up 8% from 2011 (5). Nine percent (9%) of respondents reported 1-2 days in which their physical or mental health problems kept them from doing their normal activities and 2 reported 3 or more days. Please see Figure 9 below. Figure 9 During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation? days 1-2 days 3 or more days Tri- County Area Wisconsin 13

15 As age increased, the number of respondents who reported not having any days in which their poor physical or mental health kept them from doing their usual activities also decreased from 75% age % age There is a slight increase from age (49%) respondents age 65 and over (55%) in terms of having zero days in which their poor physical or mental health kept them from doing their usual activities in the past 30 days. Respondents age had the highest percentage who reported 3 or more days (4). Seventy-four percent (74%) of respondents with a college degree, 6 with a high school diploma or less, and 5 with some college or tech school reported not having any days in the past 30 days in which their poor physical or mental health kept them from doing their usual activities. Thirty-eight percent (38%) of respondents with some college or tech school reported 3 or more days. The majority of respondents with an annual household income of $15,001 or greater (5 8) reported not having any days in the past 30 days in which their poor physical or mental health kept them from doing their usual activities. However, 7 of respondents making less than $10,000 reported 3 or more days. There was a plurality split for respondents who make $10,001 $15,000 at 38% for zero days and 3 or more days. Overall, the majority of respondents who are a student (10), employed (73%), self-employed (58%), or retired (54%), reported not having any days in which poor physical or mental health kept them from doing their usual activities. Over half of respondents not in the workforce reported 3 or more days in the past 30 days (55%). Health Care Access Summary Finding #2 The majority of respondents have some type of health care coverage and more people are generally seeing docrs for annual physicals or checkups. However, up 5% of respondents indicated they themselves or someone in their household are not taking their medications due cost and 24% are still paying off medical bills over time. Primary Source of Health Care Coverage Sixty-two percent (6) of respondents in 2015 reported their primary source of health care coverage as a plan purchased through an employer or union while another 15% reported Medicare as their primary source of health care coverage. Twelve percent (1) reported a plan that they or another family member buys on their own, 5% reported TRICARE, VA, or Military, and 4% reported Medicaid or some other state program. Additionally, of respondents reported not having any type health care coverage. Please see Figure 10 below. 14

16 4% 5% 4% 3% 1 15% 13% % 4% 3% 3% 1 2 9% 55% 5 54% 6 Figure 10 What is the primary source of your health care coverage? Is it A plan purchased through an employer or union Medicare TRICARE, VA, or Military Some other source A plan that you or another family members buys on your own Medicaid or other state program Alaska Native, Indian Health Service, Tribal Health Services None Tri-County Area Wisconsin The majority of respondents age (53% 83%) reported their primary source of health care coverage be a plan purchased through an employer or union. The majority of respondents age 65 and over (84%) reported Medicare as their primary source of health care coverage. The majority of respondents with a high school diploma or less (54%), some college or tech school (59%), or a college degree (73%) reported their primary source of health care coverage as a plan purchased through an employer or union. Between 5 and 9 of respondents with an annual household income of $25,001 or more reported their primary source of health care coverage as a plan purchased through an employer or union. Forty-four percent (44%) of respondents who make less than $10,000 annually, 29% who make $10,001 $15,000, and 28% who make $20,001 $25,000 reported having a plan that they or another family member buys on their own. Fifty percent (5) of respondents who make $15,001 $20,000 annually reported their primary source of health care coverage as Medicare. All respondents who are students, 8 who are employed, 59% who are selfemployed, and 38% who are not in the workforce reported their primary source of health care coverage as a plan purchased through an employer or union. Sixtysix percent (6) of respondents who are retired reported Medicare as their primary source of health care coverage. Please see Table 6 below. 15

17 Table 6 Employment Status by Primary Source of Health Care Coverage Insurance Type Employed Selfemployed Not in the workforce Student Retired A plan purchased through an employer or union 8 59% 38% 10 15% A plan that you or a family member buys on your own Medicare Medicaid or other state program like Badgercare Tricare, VA, or military Alaska Native, Indian Health Service, Tribal Health Services Some other source None, we don t have coverage The majority of both males (58%) and females (65%) reported their primary source of health care coverage be a plan purchased through an employer or union. When comparing having children in the household under 18 years old and the respondent s primary source of health care coverage, it was found that most respondents with children (83%) or without children (48%) had a plan purchased through an employer or union. The next highest category for respondents without children living with them was Medicare (23%) or a plan that they or a family member buys on their own (19%). Docr s Cost Interestingly, even with a high percentage of coverage, in 2015, 9% of respondents said there was at least one time in the past 12 months when they did not go the docr when needed because they could not afford the cost. Please see Figure 11 below. 16

18 9% 5% 9% 1 14% % 95% 9 89% 8 Figure 11 Was there a time in the past 12 months when you needed see a docr but could not because of cost? Yes No Tri- County Area Wisconsin The majority of respondents from all age categories (7 99%) reported no, there was not a time in the past 12 months when they needed see a docr but couldn t because of the cost. The highest percentage reporting yes was for those age at 24%. When analyzing tal household income with this question, those making $10,001 $15,000 had the highest percentage who reported yes there was a time in the past 12 months when they needed see a docr but couldn t because of the cost at 2. The next highest was those with an annual household income of $25,001 $35,000 at 2 followed by those making less than $10,000 at 18%. All other income categories garnered 14% or less in terms of not seeing a docr in the past 12 months because of cost. When analyzing a respondent s primary source of health care coverage by whether or not the respondent had gone a docr in the past 12 months when needed because of cost, a significant difference was found. Ninety percent (9) of respondents who don t have health care coverage reported not seeing a docr when needed in the past 12 months because of cost. The same was true for 13% who have a plan that they or a family member buys on their own, 13% who have Medicaid or some other state program like Badgercare, 8% who have a plan purchased through an employer or union, 5% who have Tricare, VA, or military, and only 3% who have Medicare. 17

19 9% 13% 9% 5% 5% 4% 9% 1 1 4% 14% 8% 13% 8% 19% % 7 7 Last Routine Checkup As seen in Figure 12 below, a larger number of respondents (78%) have seen the docr within the past year for a routine physical or checkup in 2015 than in 2011 (7). Nine percent (9%) have had a checkup within the past 2 years, reported within the past 5 years, and reported 5 or more years ago. Additionally, 2015 was the first year in which all respondents reported having a routine physical or checkup. Please see Figure 12 below. Figure 12 About how long has it been since you last visited a docr for a routine checkup? Within past year (1-12 months ago) Within past 5 years (2-5 years ago) Never Within past 2 years (1-2 years ago) 5 or more years ago 2015 Tri- County Area Wisconsin The majority of respondents from all age categories reported having their last routine checkup within the past year; 7 age 25-34, 7 age 45-54, 73% age 35-44, 8 age 18-24, 8 age 55-64, and 94% age 65 and over. Ten percent (1) of respondents age reported their last routine checkup as being 5 or more years ago, followed closely by 9% who are age All income categories, besides those making $25,001 $35,000, are between 7 and 94% in terms of having their last routine checkup within the past year. Besides respondents with an annual household income of $25,001 $35,000 (63%), respondents making $15,001 $20,000 had the lowest percentage in terms of having their last routine checkup with in the past year at 7 and those making less than $10,000 had the highest percentage at 94%. Fifteen percent (15%) of respondents who make $25,001 $35,000 reported having their last routine checkup 5 or more years ago. 18

20 Seventy-three percent (73%) or above of respondents who are self-employed (73%), employed (73%), not in the workforce (8), retired (93%), or a student (10) reported their last routine checkup be within the past year. More females (84%) than males (73%) reported having their last routine checkup within the past year. Nine percent (9%) of males reported their last routine checkup be 5 or more years ago while only 3% of females reported 5 or more years ago. Please see Table 7 below. Table 7 Gender by Last Routine Checkup Length of Time Male Female Within past year (1-12 months) 73% 84% Within past 2 years (1-2 years) 9 9 Within past 5 years (2-5 years) or more years ago 9 3 Never 0 0 Reasons Other than Cost for Delay of Medical Care Other than cost, there are many other reasons why people may delay getting the medical care they need. When asked, a large percentage (84%) reported they did NOT delay getting medical care or did not need medical care in the past 12 months. However, 5% reported a delay because they couldn t get an appointment soon enough, each reported that once they got there, they had wait o long see the docr, they couldn t get through on the telephone, or they didn t have transportation, and 8% said other various reasons. Please see Figure 13 below. 19

21 5% 8% 8% 5% 4% 9% 3% 4% 4% 84% 8 79% 8 Figure 13 Have you delayed getting medical care for any of the following reasons in the past 12 months? You couldn't get through on the telephone You couldn't get an appointment soon enough Once you got there, you had wait o long see the docr The (clinic/docr's) office wasn't open when you got there You didn't have transportation Other No, I did not delay getting medical care/did not need medical care 2015 Tri-County Area Wisconsin The majority of all respondents in all age categories reported not delaying getting medical care or did not need medical care in the past 12 months. As age increased, so did the number of respondents who reported that they didn t delay getting the medical care they needed. This went from 64% of respondents who are age % age 65 and over. Twelve percent (1) of respondents age and 1 age reported a delay because they couldn t get an appointment soon enough. All other age categories and response options garnered 3% or less (other category garnered 18% or less). Respondents with an annual household income of $75,001 or more had the highest percentage (93%) in terms of not delaying medical care. Eleven percent (1) of respondents who earn $35,001 $50,000 reported a delay because they couldn t get an appointment soon enough. Half (5) of respondents who are students reported a delay in getting medical care because they couldn t get an appointment soon enough. Eleven percent (1) of respondents who are not in the workforce also reported a delay in getting the medical care they need because they couldn t get an appointment soon enough. The majority of respondents from all employment categories (5-94%) reported that they didn t delay getting medical care for any reason in the past 12 months. 20

22 5% 8% 1 13% 9% 1 83% Medication Cost Five percent (5%) of respondents reported not taking their medication in the past 12 months as prescribed because of cost. Ninety-five percent (95%) of respondents had no issues or did not need medication during the past 12 months. Please see Figure 14 below. Figure 14 Was there a time in the last 12 months when you did not take your medication as prescribed because of cost? Yes No No one in the household takes prescription meds Tri- County Area Wisconsin The majority of respondents age 18 or older have not delayed taking their medication as prescribed because of cost (7 9). Of those who did not take their medication as prescribed because of cost, were age 25-34, each were or age 65 and over, 5% were age 45-54, and 4% were years old. A response rate of 1 or below was observed for all household income levels who reported not taking their medication as prescribed because of cost with those making $10,001 $15,000 reporting the highest percentage at 1. Twelve percent (1) of respondents who are not in the workforce, 5% each who are retired or self-employed, and 3% who are employed reported not taking their medication as prescribed because of cost. 21

23 24% 2 23% % 7 8 Health Care Bills Being Paid Off Over Time Twenty-four percent (24%) of respondents reported they currently have health care bills being paid off over time while 7 said they do not. Please see Figure 15 below. Figure 15 Do you currently have any health care bills that are being paid off over time? 10 Yes No Tri-County Area Wisconsin Forty percent (4) of respondents age 18-24, 4 age 25-34, , , and currently have health care bills being paid off over time. Only of respondents 65 and over reported having health care bills being paid off over time. Sixteen percent (1) of respondents with a college degree currently have bills being paid off over time. This is less than those with some college or tech school (2) and those with a high school diploma or less (29%). Fifty-nine percent (59%) of respondents who make less than $10,000 annually and 7 who make $10,001 $15,000 said they currently have health care bills being paid off over time. Only between 1 and 3 of respondents making $15,001 or more reported currently having health care bills being paid off over time. Over half (5) of respondents who are not in the workforce reported they have health care bills being paid off over time. This then jumps down 24% who are employed, 1 for those who are retired, and 9% for respondents who are selfemployed. 22

24 Having children under the age of 18 in the household was also statistically significant with currently having health care bills being paid off over time. More respondents with children under the age of 18 years old living with them (3) reported having health care bills that are being paid off over time compared those who don t have children living with them under the age of 18 (2). Weight/Diet/Exercise Summary Finding #3 Respondent s BMI (body mass index) was calculated by using weight (rounding up for fractions) and height (in feet and inches) without shoes. According the CDC categories, 29% were neither overweight or obese, 3 were overweight, and 35% were obese. Additionally, the plurality of respondents said they eat one serving of vegetables per day and two servings of fruit per day. Seventy-four percent (74%) said they participated in physical activities or exercises during the past month; 84% reported they do moderate exercise in a typical week and 4 reported they do vigorous exercise in a typical week. Weight - BMI Body Mass Index The Body Mass Index (BMI) is calculated by the Centers for Disease Control (CDC) as an indicar of body fat. The CDC calculation for BMI is: BMI = Weight in Pounds x 703 (Height in inches)(height in inches) We asked respondents their weight (rounding up for fractions) and their height (in feet and inches) without shoes on. We then calculated their BMIs. According the CDC categories, respondents fell in the following categories according Figure 16 and Table 8 below. 23

25 2 29% 3 35% 3 34% 3 44% % 3 33% % 29% Figure 16 BMI is calculated as {weight in pounds/(height in inches)(height in inches)} X Neither overweight or obese Overweight Obese Tri- County Area Wisconsin Table 8 Respondent s BMI BMI range Percentage of respondents Underweight (Below 18.5) Normal ( ) 27 Overweight ( ) 36 Obese (30.0 +) 35 The BMI range for respondents went from a low of a high of The weight range was from pounds. The mean BMI was 28.4 and median was 27.4 with a standard deviation of Those in the age category were the most likely be obese and those in the or age categories were the most likely be overweight according CDC definitions. The youngest adults, age 18-24, were most likely be normal weight. Note: the underweight category was rolled in neither overweight or obese because there were so few people that when broken down further in demographic categories, the percentages look very large for a single respondent. Please see Figure 17 below. 24

26 1 23% 2 29% 29% % % 35% 43% 4 29% 33% 38% Figure 17 BMI is calculated as {weight in pounds/(height in inches)(height in inches)} X Neither overweight or obese Overweight Obese More females (4) than males (1) are considered normal weight and more males are considered overweight (45%) or obese (38%) than females (2 and 3 respectively). Interesting results were found when analyzing BMI and overall rating of general health. The majority or plurality of respondents who are normal (3) and overweight (5) rated their general health as very good while the plurality of respondent who are obese reported their general health as only good (4). Please see Table 9 below. Table 9 BMI by General Health General Health Normal Overweight Obese Excellent 3 1 4% Very Good Good Fair Poor When comparing BMI respondents who participated in physical activities or exercises in the past month other than their regular job, the majority of respondents who are normal weight (8), overweight (79%), and obese (64%) reported some type of physical activity or exercise in the past month. This shows there is a real interest in staying active combat this issue. 25

27 When looking at high blood pressure, although the majority of respondents from each BMI category had never been ld they had high blood pressure by a docr, nurse, or other health professional, those who are normal weight had the lowest percentage (18%) of having high blood pressure while those who are obese had the highest percentage (38%). In terms of high blood cholesterol, fewer respondents who are normal weight (2) and overweight (3) had been ld they have high blood cholesterol while just under half (44%) of respondents who are obese were ld they have high blood cholesterol. The majority or plurality of respondents from all BMI categories reported drinking regular soda or pop that contains sugar during the past 30 days (between 5 and 6). Interestingly, on the days in which respondents did drink these sugary drinks, 14% of respondents who are normal weight drank an average of 5 or more drinks, which is higher than respondents who are overweight (8%) or obese (). The plurality of respondents who are normal weight (45%) or overweight (4) reported eating an average of 2 servings of fruit per day while the plurality of respondents who are obese (38%) reported eating an average of only 1 serving per day. Respondents who are obese had the highest percentage in terms of not eating any fruits per day (13%). Please see Table 10 below. Table 10 BMI by Servings of Fruit Number of Neither overweight Servings or obese Overweight Obese 1 serving 2 33% 38% 2 servings servings servings or more servings None Vegetables On average, 3 of respondents eat one serving of vegetables a day, 29% eat two, 2 eat three, eat four, five or more, and 5% do not eat vegetables. Please see Figure 18 below. 26

28 8% 5% 5% 8% 4% 8% 3 29% 2 19% 1 18% 38% 3 34% 35% % Figure 18 On an average day, how many servings of vegetables do you eat? Would you say One Two Three Four Five or More Not at all Tri-County Area * 2001 ON AVERAGE, HOW MANY TIMES A DAY DO YOU EAT VEGETABLES? ONE SERVING IS A ½ CUP OF COOKED OR RAW VEGETABLES, 1 CUP OF LEAFY GREENS. *NO 2014 STATE OR NATIONAL DATA. When looking at age, the majority or plurality of respondents age (53%), 65 and over (48%), and (35%) reported eating an average of one serving of vegetables per day. The plurality of those age (33%) reported an average of two servings and the plurality of respondents age (4) and (3) reported an average of three servings. Please see Table 11 below. Table 11 Age by Servings of Vegetables Number of Servings and over 1 serving 53% 1 23% 3 35% 48% 2 servings servings servings or more servings None Fifty percent (5) of respondents with a high school diploma or less reported eating an average of one serving of vegetables per day. Thirty-five percent (35%) of respondents with some college or tech school reported eating an average of three servings and 33% with a college degree reported an average of two servings of vegetables per day. Eighty-one percent (8) of respondents with an annual household income of less than $10,000 reported eating an average of one serving of vegetables per day. In general, almost all respondents in all income categories reported eating an average of between one and three servings of vegetables per day. A small 27

29 15% 4% 8% 1 5% 8% 5% 4% 8% 3% 3% 3% 8% % 34% 35% 3 33% 33% 4 percentage of respondents from all income categories reported eating 4 or more servings of vegetables. The highest percentage in the five or more category is from those with an annual household income of $10,001-$15,000 at 28%; the next highest is at 15% who earn $25,001 $35,000 annually. Most respondents who are retired (5), a student (5), or not in the workforce (34%) reported eating an average of one serving of vegetables a day. Thirty-one percent (3) of respondents who are employed reported eating an average of two servings of vegetables per day and 44% who are self-employed reported an average of three. Respondents who are self-employed had the highest percentage of eating five or more servings per day at 13%. More males than females eat an average of one (4) or two (3) servings of vegetables per day compared females (one 24%; two 2). Conversely, more females (45%) than males (25%) eat an average of three or more servings of vegetables per day. Fruits When asked about the average number of servings of fruit they eat per day, not counting juice, 3 reported one serving, 3 two, 15% three, reported four, 4% five or more, and 8% reported no servings of fruit per day on average. Please see Figure 19 below. Figure 19 On an average day, not counting juice, how many servings of fruit do you eat? One Two Three Four Five or More Not at all Tri-County Area * 2001 ON AVERAGE, HOW MANY TIMES A DAY DO YOU EAT FRUIT OR DRINK FRUIT JUICE? ONE SERVING IS ½ CUP OF CANNED OR COOKED FRUIT, 1 MEDIUM PIECE OF FRUIT, OR ¼ CUP OF DRIED FRUIT. *NO 2014 STATE OR NATIONAL DATA. Fifty-six percent (5) of respondents age and 59% age reported eating an average of two servings of fruit per day compared 29% age 35-44, 3 age 55-64, 43% age 65 and over, and 4 age who reported eating 28

30 only one serving of fruit per day. Respondents age had the highest percentage who reported eating 5 or more servings of fruit per day (13%). Please see Table 12 below. Table 12 Age by Servings of Fruit Number of Servings and over 1 serving 19% 29% % 2 servings servings servings or more servings None More respondents with a college degree (39%) or a high school diploma or less (4) reported eating an average of two servings of fruit per day while more respondents with some college or tech school (33%) reported only one serving. Four percent (4%) or less of respondents from all education categories reported eating 5 or more servings of fruit per day. The majority or plurality of respondents from all income categories (34% 53%) reported eating an average of one or two servings of fruit per day. Respondents making $50,001 or more had the highest percentages who reported eating 5 or more servings (3% 1); no other income category reported eating 5 or more servings. More respondents who are employed (33%), self-employed (55%), not in the workforce (5), or a student (10) reported eating an average of two servings of fruit per day while more respondents who are retired (49%) reported eating only one serving. More males (3) than females (2) reported eating only one serving of fruit per day, conversely more females (4) than males (33%) reported two servings. Also, slightly more males (4%) than females (3%) reported eating an average of five or more servings of fruit per day. Exercise Participation Outside of Regular Job During the past month, other than their regular job, 74% of respondents reported participating in any physical activities or exercises. This is down from Twenty-six percent (2) reported not doing any exercise during the past month. Please see Figure 20 below. 29

31 19% % 2 24% 74% 74% 75% 8 79% 7 Figure 20 During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise? * NO LOCAL COMPARISON AVAILABLE FOR Yes 2001 No 2015 Tri- County Area Wisconsin When looking at exercise participation and age, the general trend found was that as age increased, the amount of respondents participating in any physical activities or exercises outside their regular job decreased (88% participation age down 63% age 65 and over). Respondents did not follow this overall trend. Sixty-six percent (6) reported participating in exercise, which is lower than those age (7) and just slightly higher than those age 65 and over (63%). Respondents with a college degree had the highest percentage who reported exercising in the past month other than their regular job (8). This was followed by those with some college or tech school (74%) and those with a high school diploma or less (6). As can be seen, as education increased, so did the percentage of respondents exercising outside of their job. In general, as income increased, so did the number of respondents who reported exercising in the past month other than their regular job (59% 8). Those making $25,001 $35,000 did not follow this pattern; only 48% reported exercising outside of their regular job. More males (79%) than females (7) reported exercising outside of their regular job in the past month. 30