February 28, 2018 Community Presentation Ottawa County Fillmore Complex

Transcription

1 2017 February 28, 2018 Cmmunity Presentatin Ottawa Cunty Fillmre Cmplex

2 Tday s Agenda Welcme Study Findings 2015 CHIP Prgress 2018 CHIP Launch 2.0

3 Backgrund & Methds

4 What is a CHNA? A cmmunity health needs assessment is a systematic examinatin f the health status indicatrs fr Ottawa Cunty used t identify key prblems and assets t develp strategies t address ur health needs and identified issues essential ingredients: cmmunity engagement and cllabrative participatin Public Health Accreditatin Bard (PHAB)

5 What is a CHNA? This study prduced 3 reprts Our Opprtunity Wrk tgether Dig deeper Ensure sustainability Mnitr change ver time Target limited resurces miottawa.rg/healthdata

6 Wh we heard frm in ,318

7 Data Cllectin Area

8 The Assessment Prcess Ppulatin data YAS Key infrmant surveys synthesize the data Key stakehlder interviews Rankings BRFS Underserved feedback learn the data tell the stry Husehld Survey CHNA COMMUNITY ASSESSMENT

9 Health Landscape

10 Our health, ur stry Ottawa ranks #1 in MI Ottawa ranks #1 in MI Ottawa ranks #1 in MI Ecnmy is a cncern Ecnmy still a cncern MI ranks 35 ut f 50 Lack health insurance Mre are insured Impact f new ACA Single female-headed families in pverty Alzheimer s disease Alchl use high Obesity and F/V impact all grups Health utcmes and incme/educatin Mental health Health care cst, cmplexity & lack f crdinatin Alzheimer s disease Alchl use high Obesity and F/V impact all grups Disparities persist Mental health & suicide

11 Our health, ur stry With 3 hspitals, several lw t n fee health clinics and hundreds f prviders, health care is accessible t mst Caring, giving and philanthrpic with a strng cllabrative spirit amng peple and rganizatins Cmmunity f faith with strng schls Slid ecnmy and safe neighbrhds Offers utdr spaces that invite activity In sum, Ottawa Cunty pssesses all f the scial and cmmunity characteristics that distinguish a cmmunity as healthy. - Ottawa Cunty CHNA 2017

12 Hw We Cmpare t Others Health Status Indicatrs Ottawa MI US General Health Fair/Pr 12.6% 17.7% 16.4% Pr Physical Health (14+ days) 10.0% 13.0% -- Pr Mental Health (14+ days) 8.8% 11.9% -- Activity Limitatin (14+ days) 7.6% 8.8% -- Disability 20.9% 25.1% -- Obese 29.9% 31.2% 29.9% Overweight 33.3% 34.9% 35.3% Healthy Weight 35.9% 32.4% 32.9% N Health Care Cverage (18-64) 9.2% 12.0% 12.3% N Leisure Time Physical Activity Adequate Fruit and Vegetable Cnsumptin (5 r mre/day) Risk Behavir Indicatrs Ottawa MI US 23.4% 25.5% % 14.9% -- Cnsumes Fruits <1 time/day 31.5% 39.7% 39.7% Cnsumes Vegetables <1 time/day 21.4% 24.7% 22.1% Current Cigarette Smking 17.6% 20.7% 17.1% Frmer Cigarette Smking 19.5% 26.7% 25.3% Binge Drinking 14.1% 18.5% 16.9% Heavy Drinking 5.7% 6.5% 6.5% N Persnal Health Care Prvider N Health Care Access Due t Cst 12.4% 14.8% 21.6% 7.4% 12.7% 12.0% = Ottawa Cunty is best = Ottawa Cunty is wrst 14

13 Hw We Cmpare t Others N Rutine Checkup in Past Year Clinical Preventive Practices Ottawa MI US 18.7% 28.0% 29.1% N Dental Visit in Past Year 18.4% % Had Flu Vaccine in Past Year (65+ Only) Ever Had Pneumnia Vaccine (65+ Only) 70.8% 57.7% 58.6% 72.9% 72.8% 73.4% Chrnic Cnditins Ottawa MI US Arthritis 19.4% 30.0% 25.8% Depressin 17.1% 19.7% 17.4% Lifetime Asthma 12.7% 15.7% 14.0% Diabetes 9.8% 10.7% 10.8% Current Asthma 8.7% 10.2% 9.3% Skin Cancer 6.3% 6.1% 5.9% Other Cancer 4.8% 7.0% 6.7% COPD 4.0% 7.7% 6.3% Heart Attack 3.7% 4.7% 4.4% Angina/CHD 3.3% 4.6% 4.1% Strke 1.7% 3.3% 3.1% = Ottawa Cunty is best = Ottawa Cunty is wrst 15

14 Hw We Cmpare t Ourselves Health Status Indicatrs General Health Fair/Pr 9.9%% 10.5% 12.6% Pr Physical Health (14+ days) Pr Mental Health (14+ days) Activity Limitatin (14+ days) 8.1% 6.1% 10.0% 8.6% 8.6% 8.8% 5.1% 5.7% 7.6% Disability 22.2% % Obese 25.8% 23.9% 29.9% Overweight 36.7% 35.3% 33.3% Healthy Weight 36.3% 37.7% 35.9% N Health Care Cverage (18-64) N Persnal Health Care Prvider N Health Care Access Due t Cst Cnfidence in Navigating the Health Care System Medicatin/Treatment fr Mild t Severe Psychlgical Distress 12.6% 9.3% 9.2% 12.0% 11.4% 12.4% % 7.4% % 84.4% % 53.5% N Leisure Time Physical Activity Adequate Fruit and Vegetable Cnsumptin (5 r mre/day) Cnsumes Fruits <1 time/day Cnsumes Vegetables <1 time/day Risk Behavir Indicatrs % 20.5% 23.4% % 17.6% % 31.5% % 21.4% Current Cigarette Smking 17.2% 18.6% 17.6% Frmer Cigarette Smking 24.5% 22.6% 19.5% Binge Drinking 20.3% 19.3% 14.1% Heavy Drinking 7.5% 6.5% 5.7% = better/imprved = wrse 16

15 Hw We Cmpare t Ourselves Clinical Preventive Practices N Rutine Checkup in Past Year % 19.9% 18.7% N Dental Visit in Past Year 21.6% 21.2% 18.4% Had Flu Vaccine in Past Year (65+ Only) 67.9% 72.1% 70.8% Chrnic Cnditins Arthritis 23.2% 18.3% 19.4% Depressin 18.8% % Anxiety 14.8% % Lifetime Asthma 13.5% 11.9% 12.7% Ever Had Pneumnia Vaccine (65+ Only) 70.9% 66.9% 72.9% Diabetes 7.3% 7.8% 9.8% Current Asthma 8.4% 6.5% 8.7% Skin Cancer 7.3% 4.7% 6.3% Other Cancer 5.3% 5.4% 4.8% COPD % 4.0% Heart Attack 2.1% 2.1% 3.7% Angina/CHD 3.0% 2.9% 3.3% Strke 1.2% 2.1% 1.7% = better/imprved = wrse 17

16 Tp Reprted Health Cncerns The mst imprtant health prblem in the cmmunity is: 1. Depressin & Anxiety 2. Obesity 3. Drug abuse Obesity 1 in 5 We need better resurces and supprt fr difficult issues Cancer Health care csts/lack f affrdable health care 1 in 8 1 in 9 91 Alchl/drugs/ substance abuse Lifestyle chices (diet, smking, lack f exercise) Mental health 1 in 11 1 in 11 1 in Mental health 2. Substance Use/Opiids 3. Obesity Behaviral health is still very underserved Surce: BRFS Q1.1: What d yu feel is the mst imprtant health prblem in yur cmmunity tday? (n=1,221) 18

17 New fr 2017

18 New t this CHNA Adverse Childhd Experiences study Maternal and Child Health Reprt Adult suicidal thinking and attempts Chrnic pain & use f Rx pain meds Vaping (adults and yuth) Fd insufficiency Health literacy Weight cntrl 11 questins wmen children in 20 1 in 4 6% vs 14% 1 in 13 1 in 5 nt cnfident 50% f bese received n advice

19 ACEs Overview ACEs are adverse childhd experiences r traumatic events such as abuse, neglect r family dysfunctin. The 1 st ACE study was cnducted with 17,000 adults between ACEs are cmmn acrss all ppulatins ACEs cluster ACEs have a dse-respnse relatinship with many health, scial & behaviral utcmes ACEs help us t understand hw Ottawa Cunty residents are impacted by things that happen in childhd ACEs can be prevented Ottawa Cunty ACE Study Ottawa MI US Emtinal abuse 29.6% Physical abuse 14.6% Sexual abuse 7.8% Separated r divrced parents 22.0% Husehld substance abuse 19.5% Husehld mental illness 17.5% Intimate partner vilence 12.8% Incarcerated husehld member 7.9%

20 Hw Cmmn are ACEs? 14% 15% 14% 47% 38% 41% OTTAWA MICHIGAN UNITED STATES 39% 47% 45% ZERO ONE t THREE FOUR r mre

21 Prevalence f 4+ ACEs 14% Age Educatin % < High Schl 18.2% % High Schl Grad 14.4% 47% OTTAWA % 13.9% Sme Cllege Cllege Grad 19.5% 7.8% % HH Incme 39% % 3.4% <$20,000 $20,000-$34, % 23.7% Gender $35,000-$49, % Male Female 11.3% 16.8% $50,000-$74,999 $75, % 7.2% Race/Ethnicity White Nn-White Pverty Level Belw Pverty Line Abve Pverty Line 14.0% 15.0% 24.7% 13.5% Sectin Nrthwest Nrtheast Central Suthwest Sutheast 16.9% 15.5% 16.2% 12.5% 12.3% N=1,157. *Amng all adults, the prprtin wh reprted ever experiencing fur r mre f the eleven adverse childhd experiences by age 18.

22 0 ACEs 1-3 ACEs 4+ ACEs Impact f ACEs 41% Obesity 26% Chrnic pain Disability Smker Depressin Heavy drinker Suicide attempt

23 0 ACEs 1-3 ACEs 4+ ACEs Impact f ACEs 49% Obesity Chrnic pain 19% Disability Smker Depressin Heavy drinker Suicide attempt

24 0 ACEs 1-3 ACEs 4+ ACEs Impact f ACEs 41% Obesity Chrnic pain Disability 15% Smker Depressin Heavy drinker Suicide attempt

25 0 ACEs 1-3 ACEs 4+ ACEs Impact f ACEs 33% Obesity Chrnic pain Disability Smker Depressin 10% Heavy drinker Suicide attempt

26 0 ACEs 1-3 ACEs 4+ ACEs Impact f ACEs 49% Obesity Chrnic pain Disability Smker Depressin 7% Heavy drinker Suicide attempt

27 0 ACEs 1-3 ACEs 4+ ACEs Impact f ACEs Obesity Chrnic pain Disability Smker Depressin 11% Heavy drinker 3% Suicide attempt

28 Impact f ACEs 50% Obesity Chrnic pain Disability Smker Depressin Heavy drinker Suicide attempt 0% 0 ACEs 1-3 ACEs 4+ ACEs

29 Impact f ACEs 50% 49% 41% 33% Obesity 26% Chrnic pain Disability Smker Depressin Heavy drinker 19% 15% 10% 7% 3% 11% Suicide attempt 0% 0 ACEs 1-3 ACEs 4+ ACEs

30 ACEs affect ur lives Implicatins & Slutins It is easier t build strng children than t repair brken men. Frederick Duglass American ablitinist, authr & ratr 33

31 Key Findings

32 9 Key Findings Mental Health Substance Abuse Obesity Access t Care Chrnic Diseases Health Disparities Specific Risk Behavirs Bipsychscial Apprach Negative Scial & Ecnmic Factrs

33 Key Themes fr Maternal & Child Health Yuth & Maternal Depressin / Yuth Suicide Substance Abuse Obesity Access t Care Hispanic Disparities Specific Risk Behavirs Access t Transprtatin Lack f Cnsistent Develpmental Screening Value, Belief, & Pririty f Persnal Health

34 Mental Health Mental health cntinues t be a critical issue with little change since & Indicate this is a tp cncern, mentining 4 main themes: 1 lack f prgrams & services 3 lack f therapists/psychiatrists 2 lack f funding fr services 4 stigma attached t mental illness Age Educatin < High Schl 16% mild t severe High Schl Grad Sme Cllege 3% 13% Cllege Grad HH Incme <$20, $20,000-$34,999 Psychlgical DISTRESS Gender Male $35,000-$49,999 $50,000-$74,999 Female $75,000+ Race/Ethnicity Sectin 84% Well Mild t Mderate Severe White Nn-White Pverty Level Belw Pverty Line Abve Pverty Line Nrthwest Nrtheast Central Suthwest Sutheast 75.6%

35 Mental Health Many f thse wh culd benefit the mst frm medicatin/treatment are nt getting it. If 90% f Ottawa adults agree that treatment can help peple with mental illness lead nrmal lives WHY are many nt seeking treatment that wuld benefit them? are nt getting treated 1/2 wh reprt pr mental health 92% 1/3 wh reprt 50% anxiety/depressin 1/4 wh reprt 24% severe distress Peple are Generally Caring and Sympathetic t Peple with Mental Illness Agree Neither Disagree 11% 36% 53% Agree by Psychlgical Distress Categry Well 56% Mild t Mderate 41% Severe 14% STIGMA may prevent sme peple frm seeking & receiving needed treatment

36 Mental Health Thught f taking wn life in past 12 mnths Attempted taking wn life in past 12 mnths We are finding that suicides amng yuth are ccurring at yunger ages. 91 Adults 5.0% 20.0% 10 In ur schls, with the amunt f suicides r attempted suicides in ur area it s just heartbreaking. Schls are very, very wrried. Teens 15.0% 39.8% Taking ne s wn life 13 t 16 years ld Surce: BRFS Q20.1: Has there been a time in the past 12 mnths when yu thught f taking yur wn life? (n=1,265); Ottawa Cunty Yuth Assessment Survey, (n=4913); BRFS Q20.2: During the past 12 mnths, did yu attempt t cmmit suicide (take yur wn life)? Wuld yu say (n=43); Ottawa Cunty Yuth Assessment Survey, (n=736)

37 Mental Health Sme critical cncerns Experiencing 4+ ACEs greatly increases reprted mental illness & suicide attempts Females are disprprtinately affected by mental health cncerns 1 in 4 teens reprt depressin in past year, higher than adults Self-reprted mental health issues cntinue t increase amng adults and yuth Sme bright spts Adults wh reprt receiving treatment fr a mental health cnditin imprved cmpared t 2014 Cmmunity members reprt prgress in addressing mental health Discussin f mental health acrss all surveyed grups may indicate increasing awareness Increase in belief that treatment helps peple lead nrmal lives

38 Substance Abuse Substance abuse, particularly piid addictin, has becme mre cncerning since It is ften c-mrbid with mental illness. 10 & 91 Identified as secnd mst cncerning issue, mentining: 1 Rx & Illicit piid addictin 2 lack f treatment ptins 3 increase in verdses and deaths frm piids Substance use fr us has caused an increase in child abuse and neglect. 9 in 10 f all verdse deaths in Ottawa invlved an piid Adult alchl use in Ottawa is nw lwer than MI & U.S. Engaged in binge drinking in the past 30 days (amng thse wh drink) Adults 29% Teens 52%

39 Substance Abuse Substance use amng Ottawa Cunty yuth has been ging dwn. 30% Used in past 30 days % 10% 0% Alchl Alchl - Binge Vapr Prducts Cigarettes Marijuana Prescriptin drugs OTC drugs Things t nte 91 Teen vaping is as prevalent as teen alchl use Teen perceptin f risk fr many substances headed in wrng directin Teen use f alchl/cigarettes is lwer than adults, but use f vapr prducts is higher Overdses are becming cmmnplace in the ER addictin is affecting teens thrugh adults.

40 Obesity A sizeable majrity f adults are either verweight r bese and this prprtin is higher than in bth 2011 and Obesity is mentined by all grups as a tp cncern and increased in adults frm 23.9% t 29.9% 91 Adult besity 29.9% Obesity is fairly universal acrss all demgraphics. That said, besity is slightly mre cmmn amng wmen than men cllege grads slightly less cmmn amng & highest incmes 27% 23% Teen besity 11.8% Obesity is at the cre f multiple preventable chrnic cnditins. If we culd reverse this trend we wuld, withut dubt, lwer the incidence f disease

41 Obesity Many verweight r bese adults & teens see themselves in a mre favrable light. ADULTS Self-Described Weight Healthy Weight BMI Categry Overweight Obese Underweight 8% 0.6% 0% Abut the right weight 71% 40% 10% Slightly Overweight 20% 57% 54% Very Overweight 1% 3% 36% Advice n Weight frm a Health Care Prfessinal Overweight 23% Obese 50% TEENS Self-Described Weight Healthy Weight BMI Categry Overweight Obese Underweight 21% 3% 1% Abut the right weight 68% 39% 16% Slightly Overweight 10.5% 54% 63% Very Overweight 0.5% 4% 20% Amng teens cnsidered bese per their BMI 21% vs. 8% f males f females think their weight is abut right Surce f teen data: 2015 Ottawa Cunty Yuth Assessment Survey

42 Access t Care Can be summed up as a case f thse wh have and thse wh have nt Underserved residents reprt services mst lacking are: 1 Affrdable mental health treatment ptins 2 Assistance in finding ecnmical health cverage and medicatin 3 Free r reduced-cst exercise and fitness ptins fr all ages 4 Teaching lw incme families hw t stretch fd dllars & prepare healthy fd Fr the issue f access, it s abut cst. We have sme prgrams that really supprt peple, but it s the numbers f peple that need it the need utweighs the resurces. 10 N Well-Child Physical (past year) N Adult Physical (past year) Ottawa 1.2% 5.7% 6.1% 28.0% 29.1% 18.7% N Adult Dental 18.4% (past year) 33.6% 42% MI US 1,318 34% amng thse earning < $20,000

43 Access t Care 85.7% f Key Infrmants believe access t care is a critical issue fr sme OC residents 91 1 Ottawa Cunty cnsistently has fewer primary care prviders 62.1 vs 80.6 per 100,000 peple than Michigan 1, Lack healthcare cverage 9% 17% 3 Lack cnfidence navigating healthcare system 16% 22% 4 Delayed medicatin due t cst 8% 35% 5 Delayed health care due t cst 7% 42% 6 Difficulty understanding medical infrmatin 12% 33%

44 Chrnic Disease Chrnic disease rates are relatively lw, but sme cnditins merit watching. 1,318 Arthritis (including rheumatid, gut, lupus, fibrmyalgia) 19.4% Skin Cancer 6.3% Depressive Disrder 17.1% Cancer (Nn-Skin) 4.8% Anxiety Disrder 15.0% COPD (including emphysema, chrnic brnchitis) 4.0% Lifetime Asthma 12.7% Heart Attack 3.7% Pre-Diabetes r Brderline Diabetes* 10.9% Angina/Crnary Heart Disease 3.3% Diabetes Current Asthma 9.8% 8.7% Strke 1.7% Plus 1 in 4 suffer frm chrnic pain deaths due t Alzheimer s disease

45 Health Disparities Differences in health utcmes persist acrss several demgraphic grups. When we talk abut cmmunity health needs we have t talk abut disparities, because that s ur stry. In the verall picture, we re a healthy cmmunity, but if we re ging t cntinue t imprve, we need t address the areas at risk Cmmunity Health Needs Assessment 1 There cntinues t be a direct relatinship between health utcmes and bth educatin and incme 4+ ACEs General health status Smetimes r ften insufficient fd Fair/pr physical health, disability and chrnic pain Mental health, psychlgical distress, anxiety/depressin Health risk behavirs: nutritin, smking, physical activity Preventive health care: dentist r dctr visit, vaccinatin Health care access: having a PCP, cverage, lack meds due t $$ and being health literate Thse ccupying the very bttm incme and educatin grups are mst likely t experience the wrst health utcmes

46 Older Yunger Health Disparities 2 There is a relatinship between health utcmes and age Pr mental health, psychlgical distress, anxiety and depressin, 4+ ACEs Smetimes r ften insufficient fd N health cverage, persnal health prvider r rutine physical Health risk behavirs: smking & binge drinking Fair r pr health, pr physical health & activity limitatin Lack f muscle strengthening activities Chrnic diseases Chrnic pain 3 There is a relatinship between health utcmes and gender Pr mental health, psychlgical distress, anxiety and depressin, 4+ ACEs Chrnic arthritis & chrnic pain Fair r pr physical health Obesity & n muscle strengthening activities Health risk behavirs: smking, binge drinking, fewer fruits & vegetables Resist preventive practices like visiting a dentist r dctr N health cverage r persnal health prvider

47 Specific Risk Behavirs Certain risk behavirs are nt imprving and remain issues wrth addressing. Mre than 8 in 10 adults and 2 in 3 yuth cnsume fewer than 5 servings f fruits and vegetables per day Age Educatin < High Schl High Schl Grad Sme Cllege 18% Cllege Grad HH Incme <$20,000 Fruits and Vegetables per Day 8% 75+ Gender Male $20,000-$34,999 $35,000-$49,999 $50,000-$74,999 74% Female Race/Ethnicity White $75,000+ Sectin Nrthwest 5 r mre F/V 1 t less than 5 less than 1 Nn-White Pverty Level Belw Pverty Line Abve Pverty Line Nrtheast Central Suthwest Sutheast

48 Specific Risk Behavirs Certain risk behavirs are nt imprving and remain issues wrth addressing. Abut 1 in 4 adults d n leisure time physical activity and 1 in 2 teens d nt meet daily physical activity guidelines. 77% Physical Activity 23% Physical activity utside f wrk Nne Age Gender Male Female Race/Ethnicity White Nn-White Pverty Level Belw Pverty Line Abve Pverty Line Educatin < High Schl High Schl Grad Sme Cllege Cllege Grad HH Incme <$20,000 $20,000-$34,999 $35,000-$49,999 $50,000-$74,999 $75,000+ Sectin Nrthwest Nrtheast Central Suthwest Sutheast

49 Negative Scial Indicatrs Addressing certain scial indicatrs will imprve the verall health and health care climate f the cmmunity. 10 I think yu wuld have mre f a true cmmunity if peple culd live and wrk in the same place. Scial factrs putting ur health at risk: 1 Lack f affrdable husing 2 Lack f affrdable healthy fd & hw t prepare it 3 Adverse childhd experiences 4 Pverty f single mthers with children under 5 5 Transprtatin cntinues t be a barrier fr sme Sme things t nte Thugh cmparatively lwer than MI & U.S., cnfirmed reprts f child abuse & neglect are increasing Preliminary analysis indicates that many 2017 teen measures headed in the wrng directin Decreasing teen births; increasing STD rates Althugh emplyment is high and pverty levels are relatively lw, pverty and lack f educatin cntinue t adversely impact the health f Ottawa residents Infant mrtality is similar t MI & U.S.

50 Bipsychscial Apprach The mst apprpriate and effective way t address health and health care issues is frm an integrated, whle persn perspective. the gd news 85% f ur health is NOT related t genes & bilgy Health is a state f physical, mental and scial well-being and nt merely the absence f disease r infirmity. -Wrld Health Organizatin

51 What s Next

52 Digging Deeper What mtivated lng-term change? want t live lnger 27% want t feel better 25% a health crisis 20% my family 18% Surce: 2015 UW Husehld Survey Q32: In the past, what has caused yu r mtivated yu t make lng-term changes fr imprved health? Select all that apply.

53 Digging Deeper Mst imprtant health message? eating healthy 39% exercise 35% preventin & wellness 27% my respnsibility 23% Surce: 2015 UW Husehld Survey Q33: When it cmes t health, what message shuld all health related agencies prmte? Multiple respnses pssible.

54 A Healthy Future cllabrate t maximize effrts Ottawa Cunty is blessed t have a lt f resurces and peple behind them making a lt f headway. 10 A multi-discipline apprach is needed in view f limited prfessinal and ecnmic resurces. 91 Having lcal cmmunity champins like Jeff Elhart helps t make struggles mre real and accessible.

55 Thank Yu! Fr questins, cntact: Marcia Mansaray, M.Sc., Epidemilgist Ottawa Cunty Department f Public Health (616) r mmansaray@mittawa.rg Advisry Cuncil Research Partner