2018 Union County Health Status Assessment Report

Transcription

1 2018 County Health Status Assessment Report Community Release Event October 29 th, 2018 Presented by: Tessa Elliott, MPH Hospital Council of Northwest Ohio

2 Funders Bridges Community Action Partnership Mental Health & Recovery Board of County Memorial Hospital County Health Department County Senior Services United Way of County

3 Commissioned by: Memorial Hospital Logan--Champaign Regional Planning Commission Marysville Area Ministerial Association Mental Health & Recovery Board of County Council for Families County Health Department County Board of Developmental Disabilities County Emergency Management Agency County Health Department Salvation Army Maryhaven Mental Health & Recovery Board of County Bridges Community Action Partnership United Way of County County Health Department County Job and Family Services/ Human Services Memorial Hospital County Commissioners Wings Support and Recovery City of Marysville, Division of Police County YMCA

4 Acknowledgements Project Management, Secondary Data, Data Collection, and Report Development Hospital Council of Northwest Ohio Britney L. Ward, MPH, Director of Community Health Improvement Margaret Wielinski, MPH, Assistant Director of Community Health Improvement Tessa Elliott, MPH, Community Health Improvement Coordinator Emily A. Golias, MPH, CHES, Community Health Improvement Coordinator Emily Stearns, MPH, CHES, Community Health Improvement Coordinator Carolynn McCartney, Undergraduate Assistant, University of Toledo Alyssa Miller, Graduate Assistant, University of Toledo Erin Rauschenberg, Graduate Assistant, University of Toledo Emily Soles, Graduate Assistant, University of Toledo Data Collection & Analysis Joseph A. Dake, Ph.D., MPH, Professor and Chair, School of Population Health, University of Toledo Aaron J. Diehr, PhD, CHES, Consultant

5 Overview Health Care Coverage Health Care Access and Utilization Preventive Health Women s Health Men s Health Oral Health Health Status Perceptions Weight Status Tobacco Use Alcohol Consumption Drug Use Sexual Behavior Mental Health Cardiovascular Health Cancer Arthritis Asthma Diabetes Quality of Life Social Determinants of Health Environmental Conditions Parenting

6 Methodology Design Written surveys Instrument Development Majority of questions from BRFSS (CDC) Procedure Adults: 4-wave mailing campaign, $2 bills

7 Methodology Adult 1,200 adults ages 19 and over Response Rates 35% (n=496: CI= ± 4.90) Power analysis #: 380

8 Methodology Data Analysis Analyzed using SPSS 23.0 Data weighted to reflect population statistics Limitations Adult data collection: CDC-telephone survey Self-reported Data Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey IRB Approval Chesapeake Research Review Inc., Columbia, Maryland Review methodology, surveys, and letters

9 Comparisons Visit The Hospital Council of Northwest Ohio website at to view individual health assessments and compare indicators through Data Link. Michigan Shiawassee Lenawee Monroe Morrow Umatilla Oregon Hillsdale Lenawee Monroe Lake Ashtabula Williams Fulton Lucas Ottawa Geauga Defiance Henry Wood Sandusky Erie Cuyahoga Lorain Portage Trumbull Paulding Seneca Huron Medina Summit Putnam Hancock Mahoning Van Wert Crawford Ashland Wyandot Wayne Allen Stark Richland Columbiana Hardin Mercer Auglaize Marion Morrow Holmes Carroll Shelby Logan Knox Tuscarawas Jefferson Delaware Coshocton Harrison Darke Champaign Licking Miami Guernsey Franklin Muskingum Clark Madison Belmont Montgomery Fairfield Perry Noble Preble Greene Monroe Pickaway Morgan Fayette Hocking Butler Warren Clinton Washington Ross Athens Hamilton Highland Vinton Clermont Pike Jackson Meigs Brown Adams Scioto Gallia Lawrence

10 Demographics of Survey Population Race/Ethnicity White 92% Asian 2% Other 5% African American <1% Hispanic <1% American Indian/Alaska Native 1% Note: Percentages may not add to 100% due to missing data (non-responses).

11 Demographics of Survey Population Marital Status Married 63% Never Married/ Unmarried Couple 12% Divorced/ Separated 15% Widowed 9% Note: Percentages may not add to 100% due to missing data (non-responses).

12 Demographics of Survey Population Education Some College/College Graduate 71% High School Diploma 24% Less than High School Diploma 4% Note: Percentages may not add to 100% due to missing data (non-responses).

13 Demographics of Survey Population Income $50,000-$74,999 14% $75,000 plus 44% $25,000-$49,999 21% $15,000-$24,999 8% $14,999 and less 6% Note: Percentages may not add to 100% due to missing data (non-responses).

14 Healthcare Access Healthcare Coverage Healthcare Access and Utilization Preventive Medicine Women s Health Men s Health Oral Health

15 Healthcare Coverage 97% of adults had health care coverage 3% were without coverage Compared to 7% for Ohio and 10% for the U.S. (2016 BRFSS) 4% of adults with children did not have healthcare coverage, compared to 3% of those who did not have children living in their household

16 Healthcare Coverage Source of Health Coverage for County Adults Employer 58% Medicare 11% Medicaid 3% Self-purchased 3% Someone else's employer 15% Multiplegovernmenal sources 1% Multiple-private sources 3% Military 2% Health Insurance Marketplace 4%

17 Healthcare Coverage 15% Uninsured County Adults 10% 9% 10% 11% 5% 3% 3% 4% 2% 4% 3% 0% Total Males Females Under Years 65 & Over Income <$25K Income $25K Plus County 2015 Adult Comparisons County 2015 County 2018 Ohio 2016 U.S Uninsured 11% 3% 7% 10%

18 Healthcare Access and Utilization 75% of County adults visited a doctor for a routine checkup in the past year Increasing to 86% of those over the age of 65 59% of adults went outside of County for the following health care services in the past year: Specialty care (29%) Counseling services (5%) Primary care (18%) Cancer care (4%) Dental services (16%) Mental health care (3%) Obstetrics/gynecology/NICU (12%) Pediatric therapies (2%) Orthopedic care (7%) Developmental disability (1%) Pediatric care (6%) Addiction services (1%) Female health services (6%) Skilled nursing (<1%) Cardiac care (6%) Other services (9%)

19 Healthcare Access and Utilization The following might prevent County adults from seeing a doctor if they were sick, injured, or needed some kind of health care: Cost (30%) Doctor would not take their insurance (18%) Hours not convenient (13%) Difficult to get an appointment (13%) Could not get time off work (8%) Worried they might find something wrong (7%) Could not find child care (5%) Frightened of the procedure or doctor (4%) Do not trust or believe doctors (4%) Difficult to find/no transportation (2%) Discrimination (1%) Some other reason (3%)

20 Healthcare Access and Utilization Adults visited the following places for health care services or advice: Doctor s office (61%) Multiple places, including a doctor s office (15%) Urgent care center (10%) Internet (6%) In-store health clinic (2%) Family and friends (2%) Hospital emergency room (1%) Hospital outpatient department (1%) Department of Veteran s Affairs (VA) (1%) Multiple places, not including a doctor s office (1%) Etc. 2% of adults indicated they had no usual place for health care services

21 Healthcare Access and Utilization 100% County Adults with a Routine Check-up in the Past Year 86% 85% 80% 75% 74% 76% 71% 75% 75% 70% 60% 40% 20% 0% Total Male Female Under Years 65 & Over Income <$25K Income $25K Plus County 2015 Adult Comparisons Visited a doctor for a routine checkup in the past year Had at least one person they thought of as their personal doctor or health care provider County 2015 County 2018 Ohio 2016 U.S % 75% 75% 71% 89% 92% 83% 77%

22 Preventive Medicine 60% of adults had a flu vaccine in the past 12 months County adults had the following vaccines: MMR in their lifetime (81%) Tetanus booster (including Tdap) in the past 10 years (75%) Chicken pox vaccine in their lifetime (48%) Hepatitis B vaccine in their lifetime (47%) Hepatitis A vaccine in their lifetime (35%) Pertussis vaccine in the past 10 years (34%) Zoster (shingles) vaccine in their lifetime (19%) Human papillomavirus (HPV) vaccine in their lifetime (14%)

23 Preventive Medicine Adult Comparisons County 2015 County 2018 Ohio 2016 U.S Had a pneumonia vaccination (age 65 and over) 64% 79% 75% 73% Had a flu vaccine in the past year (age 65 and over) 82% 81% 57% 58% Had the human papillomavirus (HPV) vaccine (in their lifetime) 3% 14% N/A N/A N/A-Not Available

24 Women s Health 57% of women ages 40 and over had a mammogram in the past year 88% of women had a Pap smear at some time in their life and 34% had one in the past year During their last pregnancy within the past 5 years, County women Had a prenatal appointment in the first 3 months (76%) Took a multi-vitamin with folic acid pre-pregnancy (74%) Took a multi-vitamin with folic acid during pregnancy (70%) Had a dental exam (67%) Took folic acid/prenatal vitamins (59%) Took folic acid during pregnancy (46%) Etc.

25 Women s Health Adult Comparisons Had a clinical breast exam in the past two years (age 40 and over) Had a mammogram in the past two years (age 40 and over) Had a Pap smear in the past three years (age 21 to 65) County 2015 County 2018 Ohio 2016 U.S % 74% N/A N/A 78% 71% 74% 72% 84% 81% 82% 80% N/A Not Available In 2015, Pap smear was reported for women ages 19 and over

26 Men s Health 66% of males age 40 and over had a PSA test at some time in their life 58% had one in the past two years 50% of men had a digital rectal exam in their lifetime 18% had one in the past year Adult Comparisons Had a PSA test in within the past two years (age 40 and over) County 2015 County 2018 Ohio 2016 U.S N/A 58% 39% 40% Ever had a digital rectal exam 55% 50% N/A N/A N/A Not Available

27 Oral Health 74% of County adults had visited a dentist or dental clinic in the past year Decreasing to 48% of adults with incomes less than $25,000 Compared to 66% for the U.S. and 68% for Ohio (2016 BRFSS) When asked the main reason for not visiting a dentist in the last year, County adults gave the following responses: Cost (32%) Fear, apprehension, nervousness, pain, and dislike going (22%) No reason to go/had not thought of it (14%) Had dentures (11%) Did not have or know a dentist (2%) Dentist did not accept their medical coverage (1%) Could not get into a dentist (1%)

28 Oral Health 100% 80% 60% 40% 20% County Adults Who Visited a Dentist or Dental Clinic in the Past Year 74% 75% 73% 71% 76% 62% 48% 80% 73% 0% Total Males Females Under Years Adult Comparisons Adults who had visited a dentist or dental clinic in the past year Adults who had one or more permanent teeth removed Adults 65 years and older who had all their permanent teeth removed County & Over Income <$25K County 2018 Income $25K Plus Ohio 2016 County 2015 U.S % 74% 68% 66% 34% 29% 45% 43% 20% 15% 17% 14%

29 Health Behaviors Health Status Perceptions Weight Status Tobacco Use Alcohol Consumption Drug Use Sexual Behavior Mental Health

30 Health Status Perceptions General Health Status 57% of County adults rated their health as excellent or very good 13% as fair or poor County adults were most likely to rate their health as fair or poor if they: Had been diagnosed with high blood pressure (61%) Had been diagnosed with igh blood cholesterol (55%) Had an annual household income under $25,000 (33%) Were 65 years of age or older (23%) Had been diagnosed with diabetes (22%) Were widowed (8%)

31 Health Status Perceptions 100% 80% 60% County Adult Health Perceptions* 13% 14% 11% 12% 12% 23% 30% 30% 30% 38% 29% 31% 33% 9% 10% 29% 31% 35% 40% 20% 57% 56% 59% 50% 59% 46% 32% 62% 59% 0% Total Males Females Under years 65 & Over Income <$25K Income $25K Plus 2015 Excellent/Very Good Good Fair/Poor *Respondents were asked: Would you say that in general your health is excellent, very good, good, fair or poor?

32 Health Status Perceptions Adult Comparisons County 2015 County 2018 Ohio 2016 U.S Rated health as good, very good, or excellent 90% 87% 82% 83% Rated health as excellent or very good 59% 57% 51% 52% Rated health as fair or poor 10% 13% 18% 17% Rated physical health as not good on four or more days (in the past 30 days) 25% 20% 22% 22% Rated their mental health as not good on four or more days (in the past 30 days) 24% 30% 24% 23% Average days that physical health not good (in the past 30 days) Average days that mental health not good (in the past 30 days) Poor physical or mental health kept them from doing usual activities, such as self-care, work, or recreation (on at least one day during the past 30 days) 25% 26% 22% 22% 2016 BRFSS data as compiled by 2018 County Health Rankings N/A Not Available

33 Weight Status 67% of all County adults were either overweight or obese by Body Mass Index (BMI) 38% of adults were obese Compared to 32% for Ohio and 30% for the U.S. (2016 BRFSS) 50% of adults were trying to lose weight 33% were trying to maintain their current weight or keep from gaining weight 2% were trying to gain weight Adult Comparisons County 2015 County 2018 Ohio 2016 U.S Obese 33% 38% 32% 30% Overweight 35% 29% 35% 35%

34 Weight Status 30% of adults ate between 1 to 2 servings of fruits and/or vegetables per day 46% ate 3 to 4 servings per day 24% ate 5 or more servings per day 1% of adults ate 0 servings per day 62% of adults engaged in some type of physical activity at least 30 minutes on 3 or more days per week 14% of adults did not participate in any physical activity in the past week

35 Weight Status 100% County Adult BMI Classifications* 80% 38% 42% 36% 37% 42% 31% 39% 39% 33% 60% 40% 29% 36% 23% 23% 30% 37% 26% 29% 35% 20% 0% 30% 21% 38% 34% 27% 27% 26% Total Male Female Under Years 65 & Over Income <$25K Normal Overweight Obese 31% 32% Income $25K Plus County 2015 *Percentages may not equal 100% due to the exclusion of data for those who were classified as underweight

36 Tobacco Use 11% of all County adults were current smokers Compared to 23% for Ohio and 17% for U.S. (2016 BRFSS) 23% were former smokers 24% for Ohio and 25% for the U.S. (2016 BRFSS) County adults used the following tobacco products in the past year: Cigarettes (17%) Chewing tobacco, snuff, dip, Betel quid (5%) E-cigarettes (4%) Cigars (Black and Milds) (2%) Little cigars (2%) Pouch (snus) (1%) Pipes (1%) Cigarillos (Swisher Sweets) (1%)

37 Tobacco Use 100% County Adult Smoking Behaviors* 80% 60% 66% 59% 72% 75% 62% 58% 62% 67% 66% 40% 20% 23% 32% 15% 11% 25% 34% 26% 21% 23% 0% 11% 9% 13% 14% 13% Total Male Female Under Years 65 & Over Income <$25K 8% 12% 12% 11% Income $25K Plus County 2015 Current smoker Former smoker Never smoked Respondents were asked: Have you smoked at least 100 cigarettes in your entire life? If yes, do you now smoke cigarettes every day, some days or not at all?

38 Tobacco Use N/A Not Available Adult Comparisons Current smoker (currently smoke some or all days) Former smoker (smoked 100 cigarettes in lifetime & now do not smoke) County 2015 County 2018 Ohio 2016 U.S % 11% 23% 17% 23% 23% 24% 25% Tried to quit smoking 45% 48% N/A N/A

39 Alcohol Consumption 66% of County adults had at least one alcoholic drink in the past month Compared to 53% for Ohio and 54% for the U.S. (2016 BRFSS) 22% of all adults were binge drinkers Compared to 18% for Ohio and 17% for U.S. (2016 BRFSS) 36% of current drinkers were binge drinkers County adult drinkers consumed 2.4 drinks on average

40 Alcohol Consumption 100% County Average Number of Days Drinking Alcohol in the Past Month* 90% 80% 70% 60% 43% 52% 36% 51% 46% 23% 23% 18% 38% 47% 40% 50% 40% 30% 23% 16% 30% 26% 23% 58% 22% 17% 20% 10% 33% 30% 35% 23% 31% 40% 30% 41% 0% Total Male Female Under Years 65 & Over Income <$25K Income $25K Plus 2015 Did not drink any 1-2 days 3 or more days *Percentages may not equal 100% as some respondents answered don t know

41 Alcohol Consumption Adult Comparisons County 2015 County 2018 Ohio 2016 U.S Current drinker (drank alcohol at least once in the past month) 57% 66% 53% 54% Binge drinker (defined as consuming more than four [women] or five [men] alcoholic beverages 19% 22% 18% 17% on a single occasion in the past 30 days) Drove after having too much alcohol to drink 4% 3% 4% 4%

42 Drug Use 3% of County adults had used recreational marijuana or hashish in the past 6 months 3% of adults reported using other recreational drugs in the past 6 months such as cocaine, synthetic marijuana/k2, heroin, LSD, inhalants, Ecstasy, bath salts, and methamphetamines 5% of adults had used medication not prescribed for them or they took more than prescribed to feel good or high and/or more active or alert during the past 6 months

43 Drug Use County adults indicated they did the following with their unused prescription medication: Took all medication as prescribed (25%) Kept it (17%) Threw it in the trash (16%) Took it to the Medication Collection program (16%) Flushed it down the toilet (12%) Took it in on Drug Take Back Days (12%) Took it to the sheriff s office (8%) Kept in a locked cabinet (5%) Disposed in a RedMed box or Yellow Jug (2%) Used a mailer to ship it back to the pharmacy (1%) Gave them away (1%) Used a prescription dissolvable bag or tablet (<1%) Traded it (<1%)

44 Drug Use 20% County Adult Prescription Medication Misuse in Past 6 Months 15% 14% 10% 5% 5% 3% 6% 3% 5% 7% 2% 5% 0% Total Males Females Under Years 65 & Over Income <$25K Income $25K Plus County 2015 Adult Comparisons County 2015 County 2018 Ohio 2016 U.S Adults who used recreational marijuana or hashish in the past 6 months 5% 3% N/A N/A Adults who used recreational drugs in the past 6 months <1% 3% N/A N/A Adults who misused prescription medications in the past 6 months 14% 5% N/A N/A N/A Not Available

45 Sexual Behavior 6% of adults reported they had intercourse with more than one partner in the past year County adults used the following methods of birth control: Vasectomy (21%) Ovaries/testicles removed (4%) Birth control pills (13%) Infertility (3%) Too old (12%) Rhythm method (2%) Tubes tied (12%) Gay or lesbian (2%) Condoms (12%) Contraceptive implants (2%) Hysterectomy (10%) Diaphragm, cervical ring, cap (<1%) IUD (8%) Emergency contraception (<1%) Withdrawal (6%)

46 Sexual Behavior The following situations applied to County adults: Had sex without a condom in the past year (34%) Had anal sex without a condom in the past year (5%) Tested for an STD in the past year (4%) Had sexual activity with someone of the same gender (2%) Had sex with someone they did not know (1%) Thought they may have an STD (1%) Treated for an STD in the past year (1%) Tested positive for HPV (1%) Had sex with someone they met on social media (2%) Know someone involved in sex trafficking (1%) Tested positive for Hepatitis C (1%) Had four or more sexual partners in the past year (1%) Were forced to have sex (<1%)

47 Sexual Behavior 100% 80% 60% County Number of Sexual Partners in the Past Year* 12% 21% 17% 19% 19% 23% 26% 5% 12% 3% 4% 6% 44% 5% 6% 58% 40% 73% 78% 69% 76% 78% 1% 16% 77% 71% 20% 37% 40% 0% Total Male Female Under Years 65 & Over Income <$25K One More than one None Income $25K Plus County 2015 *Respondents were asked: During the past 12 months, with how many different people have you had sexual intercourse?

48 Mental Health 11% of County adults had a period of two or more weeks when they felt so sad or hopeless nearly every day that they stopped doing usual activities Increasing to 29% those with incomes less than $25,000 1% of adults made a plan about how they would attempt suicide in the past year <1% of adults reported attempting suicide in the past year

49 Mental Health County adults reported they or a family member were diagnosed with or treated for the following mental health issues in the past year: Anxiety or emotional problems (28%) Depression (24%) An anxiety disorder (panic attacks, phobia, obsessive compulsive disorder) (19%) Attention Deficit Disorder (ADD/ADHD) (11%) Post-traumatic stress disorder (PTSD) (6%) Other trauma (4%) Autism spectrum (4%) Bipolar Disorder (4%) Alcohol and illicit drug abuse (3%) Etc.

50 Mental Health County adults dealt with stress in the following ways: Talked to someone they trust (55%) Exercised (36%) Prayer/meditation (35%) Slept (33%) Listened to music (32%) Worked on a hobby (27%) Ate more than normal (25%) Worked (18%) Drank alcohol (15%) Ate less than normal or not at all (8%) Talked to a professional (8%) Smoked tobacco (6%) Took it out on others (6%) Etc.

51 Mental Health Adult Comparisons Felt sad or hopeless for two or more weeks in a row Made a plan about attempting suicide in the past year Attempted suicide in the past year County 2015 County 2018 Ohio 2016 U.S % 11% N/A N/A 2% 1% N/A N/A <1% <1% N/A N/A N/A Not available

52 Chronic Disease Cardiovascular Health Cancer Arthritis Asthma Diabetes Quality of Life

53 Cardiovascular Health 4% of County adults reported they had survived a heart attack Increasing to 15% of those over the age of 65 Compared to 5% for Ohio and 4% for the U.S. (2016 BRFSS) 2% of adults reported they had survived a stroke Increasing to 6% of those over the age of 65 Compared to 4% for Ohio and 3% for U.S. (2016 BRFSS) 3% of adults reported they had angina or coronary heart disease Increasing to 7% of those over the age of 65 Compared to 5% for Ohio and 4% for U.S. (2016 BRFSS)

54 Cardiovascular Health 28% were diagnosed with high blood pressure Compared to 34% for Ohio and 31% for the U.S. (2015 BRFSS) 95% of adults had their blood pressure checked within the past year 38% were diagnosed with high blood cholesterol Compared to 37% for Ohio and 36% for U.S. (2015 BRFSS) 90% of adults had their blood cholesterol checked in the past five years Compared to 78% for Ohio and U.S. (2015 BRFSS)

55 Cardiovascular Health 50% County Adults with CVD Risk Factors 38% 38% 28% 25% 14% 11% 7% 0% Obesity High Blood Cholesterol High Blood Pressure Sedentary Smoking Diabetes

56 Cardiovascular Health *2015 BRFSS Data Adult Comparisons County 2015 County 2018 Ohio 2016 Had angina or coronary heart disease 3% 3% 5% 4% Had a heart attack 3% 4% 5% 4% Had a stroke 2% 2% 4% 3% U.S Had high blood pressure 28% 28% 34%* 31%* Had high blood cholesterol 34% 38% 37%* 36%* Had blood cholesterol checked within past 5 years 83% 90% 78%* 78%*

57 Cancer 10% County adults were diagnosed with cancer at some point in their lives Increasing to 25% of those over the age of 65. Of those diagnosed with cancer, they reported the following types: Cervical (25%) Renal (kidney) (5%) Breast (19%) Pharyngeal (throat) (5%) Other skin cancer (16%) Head and neck (5%) Melanoma (16%) Non-Hodgkin s Lymphoma (3%) Testicular (11%) Lung (3%) Prostate (11%) Liver (3%) Ovarian (6%) Other types of cancer (8%)

58 Cancer Adult Comparisons County 2015 County 2018 Ohio 2016 U.S Diagnosed with skin cancer 6%* 3%* 6% 6% Diagnosed with any type of cancer, other than skin cancer Diagnosed with cancer at some point in their lives 7% 6% 7% 7% 13% 10% N/A N/A N/A-Not Available *Melanoma and other skin cancers are included for diagnosed with skin cancer

59 Arthritis 30% of County adults were told by a health professional that they had some form of arthritis Increasing to 60% of those over the age of 65 Compared to 31% for Ohio and 26% for the U.S. (2016 BRFSS) 75% of adults diagnosed with arthritis were overweight or obese Adult Comparisons County 2015 County 2018 Ohio 2016 U.S Had been diagnosed with arthritis 36% 30% 31% 26%

60 Asthma 13% of County adults had been diagnosed with asthma Compared to 14% for Ohio and the U.S. (2016 BRFSS) 25% County Adults Diagnosed with Asthma 20% 15% 13% 17% 18% 14% 15% 12% 14% 10% 5% 8% 7% 0% Total Males Females Under Years 65 & Over Income <$25K Income $25K Plus County 2015

61 Diabetes 7% of County adults were diagnosed with diabetes Increasing to 23% of those over the age of 65 Compared to 11% for Ohio and U.S. (2015 BRFSS) 7% had been diagnosed with pre-diabetes or borderline diabetes County adults diagnosed with diabetes also had one or more of the following characteristics or conditions: 96% were obese or overweight 79% had been diagnosed with high blood cholesterol 71% had been diagnosed with high blood pressure

62 Diabetes 30% County Adults Diagnosed with Diabetes 23% 20% 17% 10% 7% 11% 4% 7% 6% 9% 0% 0% Total Males Females Under Years 65 & Over Income <$25K Income $25K Plus County 2015 Adult Comparisons County 2015 County 2018 Ohio 2016 U.S Had been diagnosed with diabetes 9% 7% 11% 11% Had been diagnosed with prediabetes or borderline diabetes 7% 7% 1% 2%

63 Quality of Life 24% of reported they were limited in some way because of a physical, mental or emotional problem Increasing to 39% of those with incomes less than $25,000 Compared to 21% for Ohio and U.S. (2015 BRFSS) Of those who were limited in some way, the following most limiting problems or impairments were: Back or neck problems (44%) Arthritis/rheumatism (41%) Stress, depression, anxiety, or emotional problems (37%) Walking problems (30%) Chronic pain (28%) Sleep problems (25%) Fitness level (24%) Etc.

64 Quality of Life 17% County adults had fallen in the past year Increasing to 33% of those ages 65 9% of adults had fallen two or more times Of those who fell, 46% resulted in an injury that caused them to limit their regular activities for at least one day or they had to see a doctor for their injury 12% of County adults reported they or a loved one were told by a health care professional they had Alzheimer s Disease and 11% were told by a health care professional they had some other form of dementia (but not Alzheimer s Disease)

65 Quality of Life 60% County Adult's Most Limiting Health Problems 40% 44% 41% 37% 30% 28% 20% 0% Back/Neck Problems Arthritis/Rheumatism Stress/Depression/ Anxiety/Emotional Problems Walking Problems Chronic Pain *2015 BRFSS Adult Comparisons Limited in some way because of a physical, mental, or emotional problems County 2015 County 2018 Ohio 2016 U.S % 24% 21%* 21%*

66 Social Conditions Social Determinants of Health Environmental Conditions Parenting

67 Social Determinants of Health 13% adults experienced at least one issue related to hunger/food insecurity in the past year. They experienced the following: Had to choose between paying bills and buying food (11%) Worried food might run out (7%) Did not eat because they did not have enough money for food (5%) Loss of income led to food insecurity issues (4%) Went hungry/ate less to provide more food for their family (4%) Their food assistance was cut (2%) 8% of adults experienced more than one issue related to hunger/food insecurity in the past year

68 Social Determinants of Health County adults received assistance for the following in the past year: Healthcare (9%) Transportation (2%) Mental illnesses (9%) Legal aid services (1%) Dental care (9%) Drug or alcohol addiction (1%) Medicare (8%) Affordable childcare (1%) Prescription assistance (6%) Clothing (1%) Food (5%) Credit counseling (1%) Free tax preparation (4%) Unplanned pregnancy (<1%) Home repair (4%) Diapers (<1%) Utilities (4%) Homelessness (<1%) Breastfeeding support (4%) Post-incarceration issues (<1%) Employment (2%) Rent/mortgage (2%)

69 Social Determinants of Health When County adults needed assistance, the following social service agencies were the first they reached out to: County Health Department (3%) A friend or family member (3%) Jobs and Family Services (JFS) (3%) Community Action Organization/Bridges (2%) Maryhaven (1%) Wings (1%) County Senior Services (1%) Welfare department (1%) Food pantries (1%) Etc. 6% of adults reached out to multiples places when they needed assistance

70 Social Determinants of Health County adults experienced the following adverse childhood experiences (ACEs): Their parents became separated or were divorced (25%) Lived with someone who was a problem drinker or alcoholic (18%) A parent or adult in their home swore at, insulted, or put them down (17%) Lived with someone who was depressed, mentally ill, or suicidal (16%) Their parents or adults in their home slapped, hit, kicked, punched, or beat each other up (9%) Someone at least 5 years older than them or an adult touched them sexually (9%) 13% of County adults had four or more ACEs in their lifetime Increasing to 21% of those with incomes less than $25,000

71 Social Determinants of Health 30% County Adults Who Experienced 4 or more ACEs in their Lifetime 20% 13% 16% 24% 12% 21% 12% 14% 10% 8% 2% 0% Total Male Female Under Years 65 & Over Income <$25K Income $25K Plus *The 2015 County Health Assessment reported those adults who had experienced 3 or more ACEs in their lifetime. County 2015*

72 Social Determinants of Health Behaviors of County Adults Experienced 4 or More ACEs vs. Did Not Experience Any ACEs Adult Behaviors Experienced 4 or More ACEs Did Not Experience Any ACEs Current drinker (had at least one alcoholic beverage in the past month) 73% 61% Classified as overweight or obese by BMI 66% 62% Binge drinker (drank 5 or more drinks for males and 4 or more for females on an occasion) 35% 32% Felt sad or hopeless for two or more weeks in a row 25% 8% Had an income less than $25,000 21% 10% Current smoker (currently smoke on some or all days) 19% 5%

73 Social Determinants of Health 10% County adults had the following transportation issues: No public transportation available or accessible (3%) Did not feel safe to drive (3%) Disabled (2%) Could not afford gas (2%) Limited public transportation available or accessible (1%) No car (1%) Suspended/no driver s license (<1%) No car insurance (<1%) Other car issues/expenses (4%) 4% of adults reported they had more than transportation issue

74 Social Determinants of Health County adults reported doing the following while driving in the past 30 days: Talking on hand-held cell phone (47%) Eating (42%) Talking on hands-free cell phone (42%) Texting (27%) Not wearing a seatbelt (12%) Using internet on their cell phone (17%) Reading (8%) Etc. 52% of adults reported they had more than one distraction while driving

75 Environmental Conditions County adults thought the following threatened their health in the past year: Insects (mosquitos, ticks, flies) (18%) Air quality (7%) Mold (5%) Agricultural chemicals (5%) Temperature regulation (5%) Rodents (mice or rats) (4%) Bed bugs (3%) Radon (3%) Chemicals found in household products (3%) Unsafe water supply/wells (2%) Safety hazards (structural problems) (2%) Moisture issues (2%) Etc.

76 Environmental Conditions County households had the following disaster preparedness supplies: Cell phone (88%) Working smoke detector (87%) Cell phone with texting (85%) Working flashlight and working batteries (84%) Computer/tablet (83%) 3-day supply of nonperishable food for everyone in the household (50%) 3-day supply of prescription medication for each person who takes prescribed medicines (44%) Working battery-operated radio and working batteries (37%) 3-day supply of water for everyone in the household (one gallon of water per person per day) (34%) Home land-line telephone (24%) Generator (24%) Etc.

77 Parenting (Ages 0-17) Parents discussed the following health topics with their year old in the past year: Career plan/post-secondary education (50%) Social media issues (50%) Bullying (cyber/indirect/physical/verbal) (49%) Dating and relationships (48%) Negative effects of alcohol/tobacco/illegal drugs/misusing prescription drugs (44%) Volunteering (43%) Weight status (40%) Body image (36%) Refusal skills/peer pressure (36%) Stress and anxiety (36%) Etc.

78 Questions? You will now be given an opportunity to provide participant feedback. Tessa Elliott, MPH Hospital Council of Northwest Ohio

79 Participant Feedback 1. What surprised you the most? 2. What would you like to see covered in the report next time? 3. What will you or your organization do with this data? 4. Based on the community health assessment, what health topics do you see as the most important? Please list 2 or more choices. 5. Are there any groups or agencies you think would be valuable resources or partners to work towards the priority health issues? 6. What are some barriers people may face regarding the issues identified? 7. In your opinion, what is the best way to communicate the information from the community health assessment to the rest of public?