TRI-COUNTY HEALTH NETWORK REPORT

Transcription

1 TRI-COUNTY HEALTH NETWORK REPORT Transforming the Health of Bamberg, Calhoun and Orangeburg Counties. This report was a collective effort of local Partners working together to improve Community Health.

2 1 Tri-County Health Network Report Tri-County Care Connect Partner Acknowledgements Regional Medical Center Department of Health and Environmental Control Low Country Region Eat Smart, Move More Orangeburg County Family Health Centers, Inc. Orangeburg County First Steps Orangeburg Calhoun Technical College South Carolina State University Claflin University Singleton Health Center Low Country Healthy Start Orangeburg Calhoun Ways to Wellness YMCA 1

3 2 Tri-County Health Network Report Executive Summary The Tri-County Health Network Report is designed to provide an overview of key health indicators for local communities and to encourage dialogue about actions that can be taken to improve a community s health. This report was designed not only for public health professionals but also for members of the community who are interested in the health of their community. The goal is to use this report to promote discussion with individuals and groups with an interest in making our counties a healthier place to live. While our report will probably not come as a surprise to those in the trenches of health care delivery, policy development, and community health it may be an impetus for stepping back and reflecting on accomplishments and taking a hard look at areas that need improvement. The Health Network plans to put this report in the hands of local board members, city council, county government, health care professionals and business leaders. The partners encourage health care professionals and community advocates working in private practices, schools, clinics, hospitals, and public health to review the report and assist with community-wide distribution. The report is designed to fit into existing public health planning resources used by local public health organizations. This report can be integrated into other planning activities and used to develop strategic issues and a work plan to improve community health. Data on the Federal Healthy People 2020 targets for the Nation are also included in our report. We will use these targets to set goals for the community. Our data provides a baseline for marking our progress towards Healthy People Identified Community Issues: Obesity and Chronic conditions Heart Disease, Stroke, High Blood Pressure, Cancer and Kidney Disease Access to healthy foods / Safe places to be active Community conditions education, employment, income, poverty, etc. The Health Network Report will be used to initiate further dialogue and identify strategic issues and community priorities in order to: Improve health care quality and access. Increase the efficiency of public health service delivery. Improve the health information infrastructure. Facilitate healthy consumer decision-making. Build health skills and knowledge. 2

4 3 Tri-County Health Network Report Introduction Improving health is a shared responsibility of health care providers and public health, as well as a variety of organizations and individuals who contribute to the well being of our community. No single entity can make a community healthy. So much more can be accomplished by working together with a common vision to improve health. We wanted to take a collaborative approach to learning more about our community so partners came together to collect data and understand what is impacting the health of our community. This report summarizes our findings and provides a framework for communty health planning. Through this process we gained a better understanding of community perceptions about health and quality of life; to provide useful information for local programmatic and fiscal decisionmaking; and to inform the development of a strategic community health improvement plan. We know that underlying factors besides biologic and behavioral aspects can greatly influence the health of communities. Such factors include population size, income level, educational attainment, and racial and ethnic characteristics. These factors, among others, are presented in our Health Partners Report. In 2012 we recruited key partners from all sectors of the community, local organizations, government officials, local businesses, schools, churches, universities and other partners. These partners were action oriented and formed our steering committee and oversee the assessment process. This assessment process used the Healthy South Carolina Initiative Community Engagement Toolkit to understand: 1. What are the strengths in our community? 2. What health concerns do county residents have? 3. What are the emerging health issues in the community? 4. What other resources are needed in the county to address these concerns? A subcommittee was formed using the Health Department Community Health Educator and students from Claflin University to conduct surveys, focus groups and key informant interviews. This information is highlighted in this report and will be used to provide insight into issues of concern, as well as local assets and resources related to health and quality of life. This report meets the Affordable Care Act / IRS Community Health Needs Assessment requirements for the Regional Medical Center and its partners. 3

5 4 Tri-County Health Network Report Demographic Data (2011) Bamberg County: The largest portion (32%) of the population in Bamberg County are between the ages of The elderly population (16%) is slightly higher than the state (15%). There were more females (52%) than males (48%) in Bamberg County; and its minority population (63%) is also higher than the state (31%). Calhoun County: The largest portion (32%) of the population in Calhoun county are between the ages of The elderly population (17%) is slightly higher than the state (15%). There are more females (51%) than males (49%). Calhoun's minority population (45%) is higher than the state (31%). Orangeburg County: The largest portion (34%) of the population in Orangeburg county are between the ages of which is slightly lower that the state (36%). There are more females (53%) than males (47%). Orangeburg County has a much higher minority population (65%) than the state (31%). County Population Percent Below Poverty Bamberg 15, % $26,697 Calhoun 15, % $37,318 Orangeburg 91, % $33,162 Median Household Income In the year 2011 the leading causes of death among South Carolinians were cancer, heart disease, chronic lower respiratory disease, stroke, accidents, Alzheimer s disease, diabetes, nephritis, nephritic syndrome and nephrosis, septicemia, and influenza and pneumonia. Leading Causes of Death (2011) Bamberg Calhoun Orangeburg 1 Cancer (39 deaths) Diseases of the Heart Cancer (204 deaths) (38 deaths) 2 Diseases of the Heart (38 deaths) Cancer (38 deaths) Diseases of the Heart (176 deaths) 3 Cerebrovascular Diseaes (12 deaths) Alzheimer s Disease (16 deaths) Cerebrovascular Diseaes (75 deaths) In spite of the overall reports of good health given by the citizens of the Palmetto State, chronic conditions are still making an impact on the health of many South Carolinians. 4

6 5 Tri-County Health Network Report Risk Factors(2011) Through primary and secondary prevention we hope to reduce the risk factors that contribute to the major chronic diseases and leading causes of death among South Carolinians. The charts below contain the risk factors for premature death. These risk factors are related to the major causes of morbidity and mortality among South Carolinians. Some common behavioral risk factors that contribute to the leading causes of death are smoking, sedentary lifestyle, obesity, high blood pressure, diabetes and low consumption of fruits and vegetables. Bamberg, Calhoun and Orangeburg County communities also collected data for some of these measures to monitor at local level in the community assessment process. The data charts below are provided by the Behavioral Risk Factor Surveillance System (BRFSS), a survey conducted jointly by States and the Centers for Disease Control and Prevention provides information on the prevalence of adult risk characteristics associated with the leading causes of death. County-level BRFSS survey data from 2000 to The charts capture the following information: Diabetes The percentage of adults who responded yes to the question, Have you ever been told by a doctor that you have diabetes? Smoker The percentage of adults who responded yes to the question, Do you smoke cigarettes now? High Blood Pressure The percentage of adults who responded yes to the question, Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure? Obesity The calculated percentage of adults at risk for health problems related to being overweight, based on body mass index (BMI). A BMI of 30.0 or greater is considered obese. To calculate BMI, multiply weight in pounds by 703 and divide the result by height (in inches) squared. Few Fruits/Vegetables The percentage of adults reporting an average fruit and vegetable consumption of less than 5 servings per day. No Exercise The percentage of adults reporting of no participation in any leisure-time physical activities or exercises in the past month. 5

7 6 Tri-County Health Network Report Calhoun County Bamberg County *nrf No report, survey sample size fewer than 50. *nrf No report, survey sample size fewer than 50. Orangeburg County Note: Confidence intervals are available as tooltips for the Adult Preventive Services Use (%). To view the confidence intervals, however your mouse over any bar on the graph. 6

8 7 Tri-County Health Network Report Obesity As a result of these behaviors, the Nation has experienced a dramatic increase in obesity. Today, approximately 1 in 3 adults (34.0%) and 1 in 6 children and adolescents (16.2%) are obese. Obesity-related conditions include heart disease, stroke, and type 2-diabetes, which are among the leading causes of death. In addition to grave health consequences, overweight and obesity significantly increase medical costs and pose a staggering burden on the U.S. medical care delivery system. We know that obesity is impacting our preschool children at the local level and that access to healthy foods can reduce the intake of high fat and sugar foods. County Percent Overweight / Obese (Adults) Bamberg 77% Calhoun Orangeburg Obesity is a problem throughout the population. However, among adults, the prevalence is highest for middle-aged people and for non-hispanic black and Mexican American women. Among children and adolescents, the prevalence of obesity is highest among older and Mexican American children and non-hispanic black girls. The association of income with obesity varies by age, gender, and race/ethnicity. Obesity Bamberg Calhoun Orangeburg Low Income Preschool Obesity Rate 12.9% 15.6% 12.9% (2009) Number of Farmers Markets (2012) Number of Farm to School Access to and availability of healthier foods can help people follow healthful diets and reduce obesity. For example, better access to retail venues that sell healthier options may have a positive impact on a person s diet; these venues may be less available in low-income or rural neighborhoods. The places where people eat appear to influence their diet. For example, foods eaten away from home often have more calories and are of lower nutritional quality than foods prepared at home. Local Markets: Family Health Center Farmer s Market / Orangeburg Famer s Market Sprinkle Avenue (Saturday Only) /Santee Farmer s Market Highway 301 Nutrition / Physical Activity: Good nutrition, physical activity, and a healthy body weight are essential parts of a person s overall health and well-being. Together, these can help decrease a person s risk of developing serious health conditions, such as high blood pressure, high cholesterol, diabetes, heart disease, stroke, and cancer. A healthful diet, regular physical 7

9 8 Tri-County Health Network Report activity, and achieving and maintaining a healthy weight also are paramount to managing health conditions so they do not worsen over time. Average daily intake for fruits and vegetables for Bamberg, Calhoun and Orangeburg Counties Total Black White Male Female SC Median daily servings of fruits Median daily servings of vegetables *Coordinated Chronic Disease Fact Sheet /2011 DHEC Report Our partners are using the Healthy People 2020 objectives to better understand the health status of our communities. The Healthy People 2020 Food and Nutrition Consumption recommendation is to increase the contribution of fruits to the diets of the population aged 2 years and older. Baseline: 0.5 cup equivalent of fruits per 1,000 calories was the mean daily intake by persons aged 2 years and older in (age adjusted to the year 2000 standard population) Target: 0.9 cup equivalent per 1,000 calories The Healthy People 2020 Food and Nutrition Consumption recommendation is to increase the variety and contribution of vegetables to the diets of the population aged 2 years and older. Baseline: 0.8 cup equivalent of total vegetables per 1,000 calories was the mean daily intake by persons aged 2 years and older in (age adjusted to the year 2000 standard population) Target: 1.1 cup equivalent per 1,000 calories To promote fruit and vegetable consumption locally partners have: Work with schools to start on-site gardens, Promote local farmers markets to increase access and availability of fresh foods Work with local work places to promote healthy choices. South Carolina Adult Physical Activity (2009) More than 80 percent of adults do not meet the Healthy People 2020 guidelines for both aerobic and muscle-strengthening activities. Similarly, more than 80 percent of adolescents do not do enough aerobic physical activity to meet the guidelines for youth. Factors impacting physical activity: advancing age, low income, lack of time, low motivation, rural residency, overweight or obesity and being disabled. 8

10 9 Tri-County Health Network Report County Percent Physically Inactive (Adults) (2009) Bamberg 25.1% Calhoun 23.8% Orangeburg 30.0% Our counties show that many citizens are physically inactive and do not meet the Healthy People 2020 targets. Our partners are working to increase awareness regarding the health benfits of exercise. Key partners are engaging local organzations to create safe environments and increase availability of sidewalks, bike lanes, trails, and parks in local communities. The Health Network partners are working hard to engage key stakeholders, such as that of education, health care, transportation, city planning, recreation to improve access opportunities to be physically active and reduce the percentage of citizens that are inactive. Hospital Inpatient Discharges and Charges (2011) Hospital discharge data provide critical information for a variety of public health such as disease surveillance and chronic disease prevention. Data provided by the South Carolina Hospital Association. Bamberg County Residents 20 of 137 inpatient discharges (14.6%) were for ambulatory care sensitive conditions (ACSC) The ACSC diagnoses with the most inpatient discharges were: Diabetes (5 discharges) Bacterial pneumonia (4 discharges Grand mal status (2 discharges) Kidney/urinary infection (2 discharges) The ACSC inpatient diagnoses with the most inpatient charges were: Grand mal status ($437,998) Diabetes ($81,372) Pelvic Inflammatory Disease ($44,595) Bacterial pneumonia ($28,505) 308 of the 1,775 emergency department discharges (17.35%) were for ACSC The ACSC diagnoses with the most emergency department discharges were: Severe ENT infections (89) Dental conditions (46) Kidney/urinary infection (30) Cellulitis (21) Hypertension (21) The ACSC diagnoses with the most emergency department charges were: Severe ENT ($57,507) Kidney/urinary infection ($55,483) Grand mal status ($38,056) Bacterial pneumonia ($34,243) Diabetes ($31,887) 9

11 10 Tri-County Health Network Report Calhoun County Residents 28 of 129 inpatient discharges (21.7%) were for ambulatory care sensitive conditions (ACSC) The ACSC diagnoses with the most inpatient discharges were: Diabetes (11 discharges) Congestive Heart Failure (6 discharges) COPD (4 discharges Hypertension (3 discharges) The ACSC inpatient diagnoses with the most inpatient charges were: Skin grafts with cellulitis ($180,537) Congestive Heart Failure ($176,038) Diabetes ($145,145) Hypertension ($99,066) COPD ($70,082) 230 of the 1376 emergency department discharges (16.7%) were for ACSC The ACSC diagnoses with the most emergency department discharges were: Severe ENT infections (51) Dental conditions (42) Kidney/urinary infection (28) Cellulitis (22) Grand mal status (19) The ACSC diagnoses with the most emergency department charges were: Severe ENT ($69,714) Gastroenteritis ($66,596) Grand mal status ($62,674) Kidney/urinary infection ($59,052) Dental conditions ($51,315) Orangeburg County Residents 219 of 1099 inpatient discharges (19.9%) were for ambulatory care sensitive conditions (ACSC)The ACSC diagnoses with the most inpatient discharges were: Diabetes (53 discharges) Asthma (35) Congestive Heart Failure (31) COPD (21) Hypertension and Bacterial Pneumonia (19 each) The ACSC inpatient diagnoses with the most inpatient charges were: Diabetes ($1,044,654) Congestive Heart Failure ($619,893) Bacterial Pneumonia ($580,753) COPD ($514,211) Asthma ($403,606) 10

12 11 Tri-County Health Network Report 2310 of the 12,953 emergency department discharges (17.8%) were for ACSC The ACSC diagnoses with the most emergency department discharges were: Severe ENT (500) Dental Conditions (402) Kidney/urinary infections (329) Asthma (223) Gastroenteritis (179) The ACSC diagnoses with the most emergency department charges were: Kidney/urinary infections ($748,058) Severe ENT ($604,755) Gastroenteritis ($473,513) Dental conditions ($449,036 Asthma ($462,273) Access to Care A person s ability to access health services has a profound effect on every aspect of his or her health, yet at the start of the decade, almost 1 in 4 Americans do not have a primary care provider (PCP) or health center where they can receive regular medical services. Approximately 1 in 5 Americans (children and adults under age 65) do not have medical insurance. People without medical insurance are more likely to lack a usual source of medical care, such as a PCP, and are more likely to skip routine medical care due to costs, increasing their risk for serious and disabling health conditions. When they do access health services, they are often burdened with large medical bills and out-of-pocket expenses. Access to health services affects a person s health and well-being. Regular and reliable access to health services can: Prevent disease and disability Detect and treat illnesses or other health conditions Increase quality of life Reduce the likelihood of premature (early) death Increase life expectancy Primary care providers (PCPs) play an important role in protecting the health and safety of the communities they serve. PCPs can develop meaningful and sustained relationships with patients and provide integrated services while practicing in the context of family and community. 11

13 12 Tri-County Health Network Report Community Health Status Indicators (CHSI) Report (2011) The data used to construct the Community Health Status Indicators (CHSI) were obtained from a variety of federal agencies including the Department of Health and Human Services, Environmental Protection Agency, Census Bureau, and Department of Labor. The data reported are publicly available data. CHSI data is reported at the county-level, representing several areas of responsibility for public health such as access to and utilization of healthcare services, birth and death measures, vulnerable populations, risk-factors for premature deaths, communicable diseases, and environmental health. The estimates presented in the report rely on various data sources, methods, and calculations. The estimates are consistent across the CHSI reports, but the calculations may not correlate with other established methods for analyses of the same data. Bamberg County Uninsured individuals (age under 65) 1 2,286 Medicare beneficiaries 2 Elderly (Age 65+) 2,198 Disabled 601 Medicaid beneficiaries 2 5,978 Primary care physicians per 100,000 pop Dentists per 100,000 pop Community/Migrant Health Centers 3 Health Professional Shortage Area 3 Yes Yes Vulnerable Populations Have no high school diploma (among adults age 25 and older) 3,519 Are unemployed 739 Are severely work disabled 761 Have major depression 892 Are recent drug users (within past month)

14 13 Tri-County Health Network Report Calhoun County Uninsured individuals (age under 65) 1 2,867 Medicare beneficiaries 2 Elderly (Age 65+) 2,026 Disabled 541 Medicaid beneficiaries 2 4,243 Primary care physicians per 100,000 pop Dentists per 100,000 pop Community/Migrant Health Centers 3 Yes Health Professional Shortage Area 3 No Vulnerable Populations Have no high school diploma (among adults age 25 and older) 2,775 Are unemployed 537 Are severely work disabled 485 Have major depression 864 Are recent drug users (within past month) 791 Orangeburg County Uninsured individuals (age under 65) 1 13,332 Medicare beneficiaries 2 Elderly (Age 65+) 12,313 Disabled 3,453 Medicaid beneficiaries 2 31,906 Primary care physicians per 100,000 pop Dentists per 100,000 pop Community/Migrant Health Centers 3 Yes Health Professional Shortage Area 3 No Vulnerable Populations Have no high school diploma (among adults age 25 and older) 16,467 Are unemployed 4,278 Are severely work disabled 3,713 13

15 14 Tri-County Health Network Report Have major depression 5,164 Are recent drug users (within past month) 5,213 Footnotes The most current estimates of prevalence, obtained from various sources (see the Data Sources, Definitions, and Notes for details), were applied to 2008 mid-year county population figures. 1 The Census Bureau. Small Area Health Insurance Estimates Program, HRSA. Area Resource File, HRSA. Geospatial Data Warehouse, BAMBERG COUNTY AVERAGE NUMBER OF UNHEALTHY DAYS IN PAST MONTH 3 CALHOUN COUNTY AVERAGE NUMBER OF UNHEALTHY DAYS IN PAST MONTH 3 ORANGEBURG COUNTY AVERAGE NUMBER OF UNHEALTHY DAYS IN PAST MONTH 3 14

16 15 Tri-County Health Network Report How Healthy are Our Communities? A range of personal, social, economic, and environmental factors contribute to individual and population health. For example, people with a quality education, stable employment, safe homes and neighborhoods, and access to preventive services tend to be healthier throughout their lives. Conversely, poor health outcomes are often made worse by the interaction between individuals and their social and physical environment. Disparities in access to health information, services, and technology can also impact health status. Our key informant interviews conducted in June 2013 provided a good snapshot about local health concerns as well as local assets and barriers for Bamberg, Calhoun and Orangeburg counties. Information noted in this section also captured key data from the community surveys. Identified Health Issues Heart Disease, Diabetes, High Blood Pressure, Cancer, Aging, and Obesity, Stroke, Kidney Disease Local Assets Local coalitions addressing health, places to be active, farmer's market, community access to school walking tracks, local health events, YMCA, Regional Medical Center, Health Department, Family Health Centers, Singleton Health Center, South Carolina State Univerity, Clafflin University, OC Tech, OCAB Orangeburg /Calhoun/Allendale/ Bamberg, First Steps, Eat Smart Move More Orangeburg County, Ways to Wellness, Community Education Programs - Diabetes, Heart Disease, etc, worksite wellness, school health policies. Barriers to Change Local culture /traditions, limited resources, awareness of assets, no connectivity between local groups addressing health, economic factors impacting health, healthcare costs, access to affordable healthy foods in rural areas, safe places to be active, lack of good jobs, limited transportation in rural areas, lack of trust in system. 15

17 16 Tri-County Health Network Report Bamberg County Bamberg County is working to improve health however 50 percent of the 232 participants surveyed felt that Bamberg County was somewhat healthy, 19.6 percent reported that their community was unhealthy and 7.0 percent reported it was very unhealthy. How would you rate the overall health of the community? 4.3% 7.0% 19.1% 19.6% Very Unhealthy Unhealthy Somewhat healthy Healthy Very Healthy 50.0% The stakeholder interviews conducted in Bamberg County with key leaders reinforced the data captured in our surveys. Many felt that Bamberg County was somewhat unhealthy and that limited access to affordable healthcare and lack of jobs had a significant impact on the health status of citizens Drug Abuse 52.6 Alcohol abuse Most common "risky behaviors" or "bad habits" 58.4 Unsafe Sex Being overweight Lack of Exercise 44.8 Poor Eating Habits 38.5 Top 3 "risky behaviors" perceived in your community? Top 3 "risky behaviors" you take part in? Alcohol abuse scored highest at 58.4 percent followed closely by drug abuse and unsafe sex as the perceived risky behaviors for Bamberg County. The number one personal risky behavior was 16

18 17 Tri-County Health Network Report lack of exercise at 44.8 percent, second was poor eating habits (38.5%) and third being overweight (36.4%). Citizens in Bamberg felt it was extremely important to eat fruits and vegetables and that consuming fresh foods was best however individuals eating 5 or more was only 18.3 percent. The South Carolina Behavioral Risk Factor Surveillance Data showed that 82.5% of adults consumed less than 5 servings of fruit and vegetables a day in Bamberg County None 1 to 2 3 to 4 5 or more It is not that important Fruits and Vegetables It is important It is extremely important Fresh Frozen Canned Can't afford to buy 2.6 In the last 2 days, how many fruits and vegatables have you eaten? How do you feel about fruits and vegetables? In the last 30 days, when buying fruits and vegetables how were they packaged? The South Carolina Behavioral Risk Factor Surveillance Data showed that 23.8% of adults are physically inactive in Bamberg County. Our survey showed that 56.5 percent felt it was extremely important to be physically active however 38.7 percent reported only being active 1-2 days per week None 1 to 2 3 to 4 5 or more It is not very important 4.2 Physical Activity 39.3 It is important It is extremely important 56.5 None, I didn't own this... Thirty minutes to 2 hours hours More than 5 hours 16.5 In the last week how many times were you physically active? How do you feel about being physically active? How many hours a day do you watch television, surf the internet, or play video games? 17

19 18 Tri-County Health Network Report Calhoun County Calhoun County is working to improve health however over 53.4 percent of the 214 participants surveyed felt that Calhoun County was somewhat healthy, 21.4 percent reported that their community was unhealthy and 5.5 percent reported it was very unhealthy. Our survey identified the top three important health concerns for Calhoun County which are high blood pressure, diabetes and obesity. The three most important factors for a healthy community are good jobs, good schools and access to affordable healthcare. 18

20 19 Tri-County Health Network Report The following chart shows 43.1 percent of participants had been told by a physician they have high blood pressure, with 43.1 percent responding that they had not seen a dental care provider and 50.2 percent responding no for receiving a flu shot or mist in the past 12 months. 19

21 20 Tri-County Health Network Report Citizens in Calhoun County are not physically active because there are not enough places to be active, crime and stray dogs also impact how active and safe people feel while exercising outdoors. 20

22 21 Tri-County Health Network Report Orangeburg County Orangeburg County is working to improve health however over 49 percent of the 904 participants surveyed felt that Orangeburg County was somewhat healthy, 24 percent reported that their community was unhealthy and 10 percent reported it was very unhealthy. Orangeburg County overall health status How would you rate the overall health of the community? 13% 4% 10% 24% Very Unhealthy Unhealthy Somewhat healthy Healthy Very Healthy 49% The stakeholder interviews conducted with key leaders reinforced the data captured in our surveys. Many felt that Orangeburg County was somewhat unhealthy and that limited access to healthy choices was a contributing factor. They also felt that chronic conditions such as diabetes, high blood pressure and heart disease contributed to our unhealthy status. Most common "risky behaviors" or "bad habits" Percent Top 3 "risky behaviors" perceived in your community? Top 3 "risky behaviors" you take part in? 10 0 Drug Abuse Alcohol abuse Being overweight Lack of Exercise Poor Eating Habits Being overweight scored highest at 54.2 percent followed closely by alcohol and drug abuse as the perceived risky behaviors for Orangeburg County. The number one personal risky behavior was lack of exercise at 56.9 percent. 21

23 22 Tri-County Health Network Report Citizens in Orangeburg felt it was extremely important to eat fruits and vegetables and that consuming fresh foods was best however individuals eating 5 or more was only 24.7 percent. The South Carolina Behavioral Risk Factor Surveillance Data showed that 83.3% of adults consumed less than 5 servings of fruit and vegetables a day in Orangeburg County. Fruits and Vegetables Percent None 1 to 2 3 to 4 5 or more It is not that important It is important It is extremely important 61.8 Fresh Frozen Canned Can't afford to buy 2.5 In the last 2 days, how many fruits and vegatables have you eaten? How do you feel about fruits and vegetables? In the last 30 days, when buying fruits and vegetables how were they packaged? The South Carolina Behavioral Risk Factor Surveillance Data showed that 30.0% of adults are physically inactive in Orangeburg County. Our survey showed that 59.2 percent felt it was extremely important to be physically active however 34.4 percent reported only being active 1-2 days per week. Physical Activity Percent None 1 to 2 3 to 4 5 or more It is not very important It is important It is extremely important Thirty minutes to 2 hours None, I didn't own this technology hours More than 5 hours 12.5 In the last week how many times were you physically active? How do you feel about being physically active? How many hours a day do you watch television, surf the internet, or play video games? Healthy People 2020 identified factors positively associated with adult physical activity: postsecondary education, higher income, enjoyment of exercise, social support from peers, family, or spouse, access to and satisfaction with facilities and safe neighborhoods. 22

24 23 Tri-County Health Network Report Data Sources Healthy South Carolina Initiative Toolkit Survey 2012 Department of Health and Environmental Control Regional Medical Center, Data Reports Hilton Head Regional Healthcare, Directory of Physicians and Services, 05/12 South Carolina Hospital Association, Inpatient Discharges and Emergency Department Charges 2011 U.S. Department of Commerce, United States Census Bureau, State & County Quick Facts, retrieved from: U.S. Department of Health and Human Services, Community Health, Community Health Status Reports, Bamberg, Calhoun and Orangeburg Counties,