I SSUE 2, N OVEMBER 2016

Transcription

1 COORDINATED BY THE ONEIDA COUNTY HEALTH DEPARTMENT I SSUE 2, N OVEMBER 2016 The is a broad partnership of community agencies and organizations that play a role in the health status of our community. A primary objective of the OCHC is to meet quarterly to prepare a Quarterly Health Report Card on various community health issues. Participants analyze county data, collect stakeholder feedback on perceptions and underlying causes, identify collaborative opportunities and evidence-based resources to address the issue, and compile the information into a Health Report Card. The topic of this Quarterly Health Report Card is: Issues Data Best practices Perceptions Trends Page 1 of 12

2 In , the prevalence of obesity was just over 36% in The medical costs for adults and 17% in youth (CDC). Obesity-related diseases people who are obese include heart disease, stroke, diabetes some types of cancer. were $1,429 higher than those of normal weight Obesity is a complex health issue to address and there are US Dept. of Health & Human many factors that have contributed to the national epidemic. Services Obesity is a serious public health concern because it is associated with poorer mental health outcomes, reduced quality of life, and the leading causes of death in the U.S. BREASTFEEDING** RATIO OF MEDICAID BIRTHS TO NON-MEDICAID BIRTHS FOR PERCENTAGE OF INFANTS EXCLUSIVELY BREASTFED IN THE HOSPITAL, (DISPARITY DATA***) Data Source: Vital Records data as of April 2016 Page 2 of 12

3 PERCENTAGE OF CHILDREN & ADOLESCENTS WHO ARE OBESE, SCHOOL YEARS Data Source: Counties outside NYC: Student Weight Status Category Reporting System (SWSCRS) data as of July 2015; NYC: NYC Fitnessgram data as of November The percentage of students attending public schools, with weight status information in the SWSCRS, with a body mass index (BMI) at or above the 95th percentile. Counties outside NYC: Grades Pre-K, K, 2nd, 4th, 7th and 10th. County estimates are based on students' school county, not their county of residence. SCHOOL DISTRICT NAME NUMBER OF OBESE STUDENTS PERCENTAGE Holland Patent Central School District % New Hartford Central School District % Camden Central School District % New York Mills Union Free School District % Whitesboro Central School District % Clinton Central School District % Remsen Central School District % Sherrill City School District % Oriskany Central School District % Sauquoit Valley Central School District % Waterville Central School District % Westmoreland Central School District % Utica City School District % Rome City School District % Adirondack Central School District % Page 3 of 12

4 WHAT TEENS BY GENDER ARE TRYING TO DO ABOUT THEIR WEIGHT Source: Oneida County 2015 TAP Survey 80% 70% 60% 50% 46% 57% All Female Male 40% 35% 30% 20% 10% 14% 6% 22% 23% 20% 18% 21% 17% 18% 0% Lose Weight Gain Weight Stay The Same Weight Not Trying to Do Anything 60% 50% 55% 57% 53% All Female Male 40% 30% 29% 25% 22% 20% 12% 14% 11% 10% 4% 3% 4% 5% 5% 4% 0% Very Underweight Slightly Underweight About Right Slightly Overweight Very Overweight TEEN PERCEPTIONS OF THEIR WEIGHT BY GENDER According to the Oneida County 2015 Teen Assessment Project (TAP) Survey (administered to 12 participating school districts, plus Notre Dame), among 7th, 9th and 11th grade students in school (5,700 students): Fifty-seven percent (57%) of females and 46% of males are trying to lose weight. Fifty-seven percent (57%) of boys and 53% of females perceive their weight to be About Right. Page 4 of 12

5 Source: HealtheCNY Green = the top 50 th percentile; Yellow = the 25 th to 50 th percentile; Red = the worst quartile. OBESITY PERCENT LOW-INCOME PRESCHOOL OBESITY ( ) For children aged 2-4 years, obesity is defined as BMI-for-age above 95th percentile PERCENT YOUTH WHO ARE OBESE ( ) Using body mass index reference data by age and sex, obese is categorized as >=95th percentile PERCENT ELEMENTARY SCHOOL STUDENTS WHO ARE OVERWEIGHT OR OBESE ( ) Using body mass index reference data by age and sex, overweight/obese is categorized as >=85th percentile. PERCENT MIDDLE AND HIGH SCHOOL STUDENTS WHO ARE OVERWEIGHT OR OBESE ( ) Using body mass index reference data by age and sex, overweight/obese is categorized as >=85th percentile. PERCENT ADULTS WHO ARE OBESE (2014) A BMI >=30 is considered obese. ADULTS WHO ARE OVERWEIGHT OR OBESE (2014) A BMI between 25 and 29.9 is considered overweight and a BMI >=30 is considered obese. AGE-ADJUSTED ER RATE DUE TO HYPERTENSION (ER VISITS/10,000 POPULATION 18+ YRS.) (2014) AGE-ADJUSTED HOSPITALIZATION RATE DUE TO HYPERTENSION (HOSPITALIZATIONS PER 10,000 POPULATION 18+ YRS.) ( ) HYPERTENSION % (MEDIAN CNY REGION)+ 17.3% (EXC. NYC) 33.1% 35.2% 24.6% 60.5% 25.5% 63 PERCENT HIGH BLOOD PRESSURE PREVALENCE (2014) 27.3% PHYSICAL ACTIVITY PERCENT ADULTS WHO ARE SEDENTARY (2014) 27.1% PERCENT ACCESS TO EXERCISE OPPORTUNITIES (2016) 90.7% NUTRITION PERCENT ADULT FRUIT AND VEGETABLE CONSUMPTION (2009) 27.1% FOOD ENVIRONMENT INDEX (2016) 7.9% 7.6 PERCENT LOW-INCOME AND LOW ACCESS TO A GROCERY STORE (2010) PERCENT PEOPLE 65+ WITH LOW ACCESS TO A GROCERY STORE (2010) PERCENT HOUSEHOLDS WITH NO CAR AND LOW ACCESS TO A GROCERY STORE (2010) % (MEDIAN CNY REGION)+ 1.85% (MEDIAN CNY REGION)+ 2.45% (MEDIAN CNY REGION)+ PERCENT FOOD INSECURITY RATE (2014) 13.5% PERCENT INFANTS EXCLUSIVELY BREASTFEED IN THE HOSPITAL (2014)** 59.8% Middle or Median Value for CNY Region: Onondaga, Cayuga, Cortland, Oneida, Madison and Oswego Counties Page 5 of (MEDIAN CNY REGION)+

6 HYPERTENSION BY RACE/ETHNICITY (DISPARITY DATA***) OUTCOMES: CENTRAL NEW YORK DIABETES EDUCATION PROGRAM (CNY DIABETES) REFERRALS- PREDIABETES Source: Mohawk Valley Health System REFERRALS National Diabetes Education Program (NDPP) YEAR : 1/1-9/ NUMBER OF REFERRALS RECEIVED 95 OVER 18 YRS OF AGE (27% increase since 2013) TOTAL One (1) year post program: participants reach and maintain % weight reduction CDC estimates 86 million people have diabetes in the US. Currently working on initiatives to scale this program up in our community. Medicare has approved coverage for the National Diabetes Prevention Program in 2018 Page 6 of 12

7 The following represents a summary of feedback received from participants in the September 29 th OCHC brainstorming session and follow up survey on Obesity; participants reviewed quantitative data and discussed issues, trends (i.e., social, economic, and political), challenges and opportunities for improvement: Food insecurity - food prices and lack of access to affordable, nutritious foods Poor education on what is healthy, how to keep foods fresh, plan for, and prepare fresh produce and healthy meals Inaccurate, mixed and changing messages on what is healthy Limited access to grocery stores and farmers markets Difficulty for seniors to prepare their own meals Poverty can make accessing fresh foods and healthy behaviors a low priority Inexpensive food options are often unhealthy and easily accessible Increasing social norms of eating out and not cooking and eating family-style sit-down meals. Lack of time to shop and prepare home-cooked meals (a factor that spans across all income groups) Generational obesity The deceptive marketing of poorer food options as healthy options (i.e., including addictive ingredients) Large media push for high sugar, carbs and fat content foods and snacks Body shame is a stressor that can contribute to having an unhealthy relationship with food Poor stress management and coping skills Stressful environments make it a challenge for people to want to take the time to purchase and prepare fresh foods even when they can afford and access them Poor mental health status (depression, adverse childhood experiences) Page 7 of 12

8 Cycling between dieting and overeating Taste buds become conditioned to choose unhealthy options Perceptions of safety and security can prevent parents from allowing their children to be active outside Children being home alone after school and thus needing to be inside rather than being active outdoors A culture that is increasingly sedentary (i.e., work that does not involve physical labor, spending leisure time on screens, car-dependent for transportation versus walking/biking or using public transportation) High use of electronic devices that don't promote activity. Weather and perceptions about limited physical activity options Lack of resources and programs that support middle class poor Need resources to address adverse childhood experiences, which contribute to obesity. Need access to nutritious foods, especially in the rural areas Resources to teach people about how to shop, plan and prepare nutritional food Resources to provide transportation to farmers markets or grocery stores with healthier food options Need a consistent, continual program that can address healthy living starting as early as possible and followed through in preschool to grade 12 and in college and work environments Need for support in making long-term changes that are supported by the environment Year-round public recreation opportunities that are available, affordable and interesting Lack of incentives/discounts to purchase healthier foods to make the healthy choice the easy choice Lack of access to free and mobile programs Rural populations Children, adults and seniors living in poverty or with limited incomes Individuals with limited education and economic resources (inner city neighborhoods and rural areas without transportation options). Women Page 8 of 12

9 Single parent households African Americans Hispanics Lower education families Families that struggle with having enough time to cook at home on week nights. Oppression - judgment - assumptions about being people who are overweight. A lack of understanding between the connection of stress and obesity. The overwhelming perception is that obesity comes from eating too much only. Obesity is associated with laziness and other negative stereotypes The perception that people get that way by not caring about what they eat or how they take care of their body and the belief that people are just disregarding information about the benefit of diet and exercise There is a lot of personal/individual blame on people who are obese, and a misconception that the issue is solely one of self-control Families often say they re too busy to focus on healthy meals, snacks 100% of the time. Families are struggling to combat the use of their children's use of electronic devices. The word "obesity" is very stigmatizing for people. As a culture, people are judged on their weight and shamed for being fat. People struggle to have a healthy relationship with food, exercise, and their own bodies. Some that are obese only consider themselves to be overweight, and do not see it as a major health issue Perception that surgical interventions are the solution. Below is a summary of some of the suggested areas for improvement taken from the above qualitative analysis: Continue to improve the school lunch options Employers that provide food services should have healthy options Continue to improve the sidewalks and walkability throughout our communities including working street lights Infrastructure changes including increasing trail systems, bike lanes and racks, and other options that makes being active attractive Promote strategies and programs that are proven to work in the long-term (i.e., expansion of Complete Streets) Identifying or creating walking routes for people indoors that can be used year-round Increase transportation options Continue to support farmers markets and community gardens Page 9 of 12

10 More accessible grocery stores in the city and rural areas Better food choices and affordable options at restaurants Hands on support and education regarding how to plan and prepare nutritional meals Teach children healthy eating, nutrition and physical activity early in life and include parents in the nutrition classes (i.e., Saturday parent/child classes at libraries or community centers) Encourage elimination of junk food, prepared foods and soda or high sugar drinks as choices Incentivize and reward healthier food choices. More involvement from the medical profession including preventive programs to help patients struggling with obesity Livable wages so that people will have enough money to buy healthy food A more holistic and comprehensive community plan that takes into consideration all of the relevant factors contributing to obesity. We do a good job handling the individual factors contributing to obesity but we do not look at how those individual factors interrelate to other causal factors and therefore present interventions may only partially address the issue of obesity Page 10 of 12

11 Below is a listing of multi-agency partnerships or collaborative groups that are addressing obesity and related issues. It is not a listing of the host of individual agencies and provider resources in the community that provide obesity-related services****; it does, rather, identify some local coalitions or groups for which individual agencies and providers may want to collaborate with or support: (facilitated by United Way of the Valley and Greater Utica Area and Utica Safe Schools Healthy Students): A variety of community providers that convene to discuss issues facing youth and families, trends, concerns, resources, facilitate effective interagency communication and coordination of services, respond to professional development needs and advocate for needs. (facilitated by Oneida County Health Department): Public health partners meet quarterly to analyze county data on multiple health topics, provide feedback on perceptions and underlying causes, identify collaborative opportunities and evidence-based resources to address the issue, and compile the information into a Health Report Card. (facilitated by SUNY POLY): A group of individuals and organizations that are working collaboratively to develop and implement a community wide intervention plan to prevent the progression of negative physical and mental health implications of ACEs through increased public education and awareness and by strengthening the support systems that serve individuals affected by ACEs. (facilitated by Cornell Cooperative Extension): Engages the communities of Oneida County and the surrounding region to create a healthy and secure future based on a productive, resilient local food system where affordable, healthy and nutritious food is accessible to all. (lead by United Way of the Valley & Greater Utica Area) focuses on reaching children who fall through the cracks by increasing access to healthy foods, implementing fitness programs and activities that all children enjoy, and providing knowledge and information to families to lower the childhood obesity rate in the community. (facilitated by Oneida County Health Department, Mohawk Valley Health System and Rome Memorial Hospital) includes members from community organization seeking to increase the percentage of infants who breastfeed to improve the health of women, infants and children and is one of the focus areas in the OCHD and hospital collaborative Community Health Improvement Plan. is a non-profit organization whose mission is supporting the breastfeeding family, promoting breastfeeding in the region and serving as an educational resource for healthcare professionals. Members include local breastfeeding professionals and those who promote breastfeeding in the community. Page 11 of 12

12 Coalition for Evidence-Based Policy The Community Guide The Community Guide County Health Rankings: What Works for Health HealtheCNY Promising Practices NOTES *Data: This Report Card is only a summary of data related to the topic of focus in this report card; however, additional relevant data are available at the following sources: NYSDOH Data Sources HealtheCNY.org **Breastfeeding was not included in the qualitative discussion and will likely be included in future reports related to maternal and infant child health. However, breastfeeding is widely recognized as the single best way to feed infants and therefore merits attention in this data section because of the linkage between breastfeeding and other health-related issues including childhood obesity, and diabetes and high blood pressure risks for both the mother and child. Currently, the U.S. Surgeon General recommends that babies be fed exclusively with breast milk for the first 6 months of life ***Healthy People 2020 defines a health disparity as a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion ****Community Programs and Services: Comprehensive information regarding individual health and human services and programs in the community to support issues related to this and other report card issues can be found at the Mid-York website at or by dialing All OCHC Report Cards and other materials are available at: HealtheCNY.org/OneidaCountyHealthCoalition Page 12 of 12