2016 Collier County Florida Health Assessment Executive Summary

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1 2016 Florida Health Assessment Executive Summary Prepared by: The Health Planning Council of Southwest Florida, Inc.

2 Executive Summary To access the report in its entirety, visit Population Demographics has a population just over 340,000. The county has a lower population density than the Florida average; the county has a population density of about 161 persons per square mile compared to a state average of 351 persons per square mile. The largest proportion of the population of the county is between the ages of 45 and 64, which is the same for the State. However, has a larger elder population, aged 65 and older, than the state as a whole (27.1% Collier vs. 18.4% State). The median age for residents is higher than that for the state as a whole (47.6 Collier vs State in 2013). The median age has also been rising in ; it was 44.1 in 2000 and 45.2 in percent of the residents of are female while 49.1 percent are male; statewide the percentages are 51.1 percent female and 48.9 percent male percent of the population of is non-white. About 26.4 percent of the residents of identify as Hispanic; this is higher than the state average of 21.9%. The vast majority of the people in who identify as Hispanic identify as white. Socioeconomic Indicators Like the rest of Florida, was affected by the economic downturn. The unemployment rate jumped from 3.7 percent in 2000 to 8.4 percent in It has since reduced to 5.7 percent; that is slightly lower than the state rate of 6.1 percent. The percent of people living under the poverty level in is lower than the state as a whole (14.4% Collier vs. 16.7% State). Fewer residents of have received a high school diploma than the state average (85.7% Collier vs. 87.2% State). A larger percentage of people in have received a Bachelor s degree than the percentage of residents of Florida who have done the same (32.3% vs. 27.3% State). The percentage of families with children under 18 who are below the poverty level has been rising in. The current rate of 25.4 percent is above the State rate of 23.8 percent. Among working adults in the most common areas of employment are education and healthcare services, hospitality and service industry, professional and management services, retail trade, and construction. Health Ranking County Health Rankings & Roadmaps has currently ranked the 2 nd healthiest out of 67 counties in Florida for Health Outcomes. is ranked 5 th healthiest for Health Factors. 2

3 Leading Causes of Death The death rate for residents has been consistently lower than the state average (487.2 Collier three-year rate vs State). The death rate for has been on the decline for the past twenty years, and has leveled off since The most frequent causes of death for people in are cancer and heart disease. Together they accounted for 46.9 percent of the deaths in Death rates for heart disease are lower than the state average (98 per 100,000 Collier vs State). Among the types of cancer, lung cancer causes the highest number of deaths in. Cancer and heart disease are the leading causes of death for both whites and blacks. The rate for heart disease is higher among blacks than whites (97.2 white vs black), the opposite holds true for the rate of death from cancer (123.6 white vs black). Deaths rates for diabetes in are much lower than those for cancer and heart disease, but are still a health concern. has a significantly lower rate of adults diagnosed with diabetes than the state (7.6% Collier vs. 11.2% State). Residents with incomes lower than $25,000 annually reported a 12.7% rate of diagnosed diabetes in 2013, while those with incomes $25,000-$ reported a rate of 4.8% and those who earned $50,000 or more reported a 6.5% rate. In, women are less overweight and obese than the state average (39.1 Collier vs State). Communicable Diseases ranks below the state average rate for all sexually transmitted diseases and many vaccine preventable diseases. Chlamydia is the most prevalent sexually transmitted disease in with an average of 807 cases per year between 2012 and That works out to a rate per 100,000 of 241; much lower than the state average of This number has been increasing rapidly. An average of 26 persons per year were diagnosed with AIDS in between 2012 and The rate per 100,000 in is 7.7 compared to a rate of 14.8 for the state as a whole. Maternal and Child Health On average, 3,197.0 babies were born per year in between 2012 and Infant deaths in have declined consistently since the most recent peak in 2009 (7.4 per 1,000 births). There were fifteen infant deaths in 2014 (4.6 per 1,000 births, vs state rate of 6.1 per 1,000). The percent of infants born with a low birth weight is lower than that of the state (1.3 Collier vs. 1.6). For 2014, had a rate of 3.0 births per 1,000 to mothers who smoked during pregnancy, as compared to the state average of 6.5 births per 1,000. Senior Citizen Health Over the past twenty years, the elderly population (those 65 and older) in has seen an increase of 82% compared to a 71% growth for the county overall. The population in age 65 and over tends to have a higher median income than residents of the same age across the state of Florida as well as throughout the United States ($57,191, $38,425 State, $39,186 Country). 3

4 has seen a dramatic increase in recent years in the rate of deaths attributed to Alzheimer s disease, the most common form of dementia. The rate is higher than the state average for (25.1 Collier vs State). Oral Health According to the Behavioral Risk Factor Surveillance System 2010 Data Report (these questions were not asked in 2013), a larger percentage of adults in reported that they had visited a dentist or dental clinic in the past year than the same for the state (73.3% Collier vs. 64.7% State). residents reported lower rates of having a permanent tooth removed because of tooth decay or gum disease than adults across the state (48.4% Collier vs. 53.0% State). Overall 69.2 percent of adult residents had their teeth cleaned compared to 60.9 percent of adults across the state of Florida. As of 2012 (the latest year of available data), 22.6 percent of low income persons in Collier County had access to dental care. That is below the state average of 24.9 percent. Social and Mental Health The rates of people who have ever been told that they have a depressive disorder are a little lower in than the average for the state (13.7 percent Collier vs percent State). Fewer people in than in the State report that they have had fourteen or more days of poor mental health in the past thirty days (7.3 Collier vs State). ranks below the state average for all categories of crime and domestic violence, and ranks in the 1 st Quartile for burglary, aggravated assault and forcible sex offenses. Domestic violence offenses in have been on the decline in recent years, and are currently lower than the state rate from (456.0 domestic violence offenses per 100,000 population, compared to the state average of 557.7). The suicide rate for is consistently a little lower than the state average. The threeyear age adjusted rate for for is 11.2 percent compared to a state-rate of 14.0 percent. Florida Youth Substance Abuse Survey Alcohol use in the past 30 days was 20.2 percent for students, which was similar to the state average of 20.5 percent. The percentage of students reporting cigarette use over the past 30 days in in 2014 was similar to the Florida average (4.7% Collier vs. 4.9% State). Past-30-day marijuana use for students in 2014 was lower than students across the state as a whole (11.0% Collier vs. 12.4% State). Hospitalizations Congestive heart failure, bacterial pneumonia, urinary infections, and chronic obstructive pulmonary disease (this category includes chronic bronchitis and emphysema) are the most common preventable causes of hospitalizations for residents. Hypertension is the number one cause of hospitalization for a chronic condition; the number of hypertension-related hospitalizations was rising but seems to be falling again. The hospitalization rates for AIDS have begun to fall over the last few years. 4

5 Emergency Room Visits by Residents Residents made 93,411 visits to hospitals in 2014 that did not result in an inpatient admission. The largest number of visits was made to Naples Community Hospital. The next largest numbers of visits were made to Physicians Regional Medical Center Collier Blvd., and Physicians Regional Medical Center Pine Ridge and Lehigh Regional Medical Center. Health Resources Medicaid enrollment rates in are lower than the State rates. Rates in Collier County and across the State have been climbing in recent years even though the eligibility rules have not changed. As of 2014, approximately 13,143 out of every 100,000 people in were enrolled in Medicaid; the state rate is approximately 19,000 per 100, percent of adults in reported in 2013 that they were unable to see a doctor at least once in the previous year due to cost. This is better than the state average of 20.8 percent. Older residents had more difficulty seeing a doctor than their younger counterparts. 84.5% adults 65 and older reported they could not see a doctor at least once in the past year due to cost. As of 2014, was estimated as having approximately 30 percent of adults without health insurance. This is higher than the State average. People in with incomes below 138% of the Federal Poverty Level (FPL) are the most likely to be uninsured at 55.9 percent compared to 30.9 percent of those at all incomes. Children who are below 400% of the poverty level are more likely to be uninsured than those of all incomes. Physicians and Facilities As of 2014, there were 884 licensed physicians in. That works out to doctors for every 100,000 residents. That is a very similar to the state average of doctors for every 100,000 residents. There are a significantly lower number of skilled nursing home beds per 100,000 residents in than across the state (266.9 Collier vs State). The Health Department spent $11,744,029 dollars in 2014; that places the rate of expenditure per 100,000 residents at a little lower than the state average. Federal Health Professional Shortage Designations The Immokalee/Everglades service area has been designated as a Health Professional Shortage Area (HPSA) for primary care. is also designated as a shortage area for dental care for the low income and migrant farmworker population. 5

6 Behavioral Risk Factor Surveillance Survey Behavioral Risk Factors Telephone Survey,, and State, 2013 Collier Trend County Quartile Florida Percent who Smoke 13.9% Positive % Percent who Drink Heavily 18.1% Steady % Percent with High Blood Pressure 34.6% Negative % Percent with High Cholesterol 33.3% Positive % Percent with Diabetes 7.6% Positive % Percent Overweight 33.0% Positive % Percent Obese 20.8% Positive % Healthy People 2020 Objectives Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. Healthy People 2020 is managed by the Office of Disease Prevention and Health Promotion within the US Department of Health and Human Services. Below is s data with relation to selected objectives (comparing 2010 Behavioral Risk Factor Surveillance Survey data with 2013 data). has shown progress in the following areas Percentage of adults with diabetes who had an annual foot exam. Percentage of adults with diabetes who had two A1C tests in the past year. Percentage of adults with diabetes who self-monitor blood glucose at least once a day on average. Percentage of adults with diabetes who ever had diabetes self-management education. Percentage of adults with diagnosed hypertension. Percentage of adults less than 65 years of age who have ever been tested for HIV. Percentage of adults who have ever received a pneumonia vaccination. Percentage of adults who have a healthy weight (BMI from 18.5 to 24.9). needs improvement in the following areas Percentage of women 18 years of age and older who received a Pap test in the past year. Percentage of adults 50 years of age and older who received a sigmoidoscopy or colonoscopy in the past five years. Percentage of women 40 years of age and older who received a mammogram in the past year. Percentage of women 18 years of age and older who had a clinical breast exam in the past year. Percentage of adults with diabetes who had an annual eye exam. Percentage of adults age 65 and over who received a flu shot in the past year. Percentage of adults age 65 and over who have ever received a pneumonia vaccination. Percentage of adult current smokers who tried to quit smoking at least once in the past year. Percentage of adults who are obese. Percentage of adults who engage in heavy or binge drinking. 6

7 Community Input Survey on Health and Healthcare in Sixty-nine surveys were completed on paper and online over a two month period in the summer of The findings of the surveys are as follows: When asked, How would you rate the general health of residents? 24 percent of survey respondents said Excellent, 53 percent said Good, 19 percent said Fair, and 4 percent said Poor. When asked, How would you rate the quality of healthcare in? 32 percent said Excellent, 51 percent said Good, 15 percent said Fair, and 2 percent said Poor. Respondents were asked to select what they felt to be the three most important health concerns for residents of. Access to primary care topped the list, with 23 responses. Respondents were then asked to select the three most important risky behaviors in Collier County. Substance abuse was listed most frequently, with 29 responses. Respondents were asked to identify the main reason that keeps residents from seeking medical treatment. A lack of health insurance and/or lack of ability to pay was cited most frequently (28 responses). Interviews with Community Leaders The Health Planning Council of Southwest Florida conducted twenty-two key informant interviews in A more complete summary of the interviews can be found at: According to community leaders: Most pressing healthcare needs Mental health for adults and children Obesity Other common answers Dental care Preventative care Substance abuse Most Important Health Issue Access to Mental Healthcare Other common answers Preventative and Primary Care, Access to dental care (for adults), Geriatric Care Healthcare affordability Obesity Substance Abuse 7