Some college. Native American/ Other. 4-year degree 13% Grad work

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Access to Affordable Health Care Access to affordable care improves quality of life and health outcomes. Without affordable access to a doctor, residents are more likely to end up in expensive emergency room care with problems that could have been prevented. Howard County has the lowest rate of uninsured residents in the state.1 Yet there are differences in access to care when you compare by income, race and education. What are the most common barriers in Howard County? Do you have a doctor you regularly see? None 1 More than one Yes, only one 1 in 9 residents with incomes less than $50k have ended up in the 77% ER because they could not get a timely appointment with a doctor. 1 More can be done about uninsured residents Uninsured in Maryland1 17,965 Uninsured residents () Residents who could not see a doctor because of cost in the last 12 months, by race/ethnicity Uninsured* by education 37% <HS 1 HS/GED Some college White Hispanic African American 1 Asian 1 Native American/ Other 1 4-year degree Grad work 1 County Health Rankings, Behavioral Risk Factor Surveillance System Learn more: *Includes those unsure of insurance status

Access to Affordable Health Care Income plays a big role in the decision on where Howard County residents go for medical care. Total 77% Doctor s office Community health center Hospital emergency room 60% No usual place Other <HS 5 7 77% 8 8 HS/GED Some college 4-year degree Grad work Urgent care center Some other place <$50k Percentage of respondents who saw a dentist in the last year, by education level 1 1 Most residents spend $100 to $200 Monthly medical costs But 1 in 10 spend much more Ellicott City Percentage of those who would have liked to see a dentist in the past year but didn t 1 7% 1 $300 to $2,000 Visit Healthy Howard s Door to HealthCare (www.healthyhowardmd.org) to connect with local, affordable care options. For information on providers and the affordable care act, visit Maryland s Health Benefit Exchange (www.marylandhealthconnection.org) and HealthCare.gov. Why didn t they see a dentist? Lack of transportation Cost 5 Time 1

Mental Health and Addictions People may turn to drugs, tobacco and alcohol to cope with stress and mental health problems, yet these habits can have a detrimental effect on overall wellbeing. How are Howard County residents doing in terms of stress, drinking, tobacco use and mental health? TOBACCO PRODUCTS Chewing tobacco, snus or snuff Ellicott City Smoking by gender Smoke cigarettes every day or some days 7% BINGE DRINKING Those who report binge drinking* at least once in a month *More than five drinks for men, four drinks for women by age 20% by income 17% 1 1 18-34 35-49 Need a reason to quit? Smoking harms nearly every organ of your body, causing diseases and affecting overall health. Quitting has immediate as well as long-term benefits for you and loved ones. <$50k $50-99k 20% 1 $100-149k $150-199k How many drinks are okay? The National Institutes of Health recommends no more than one drink per day for women and no more than two for men. Learn more: 1 $200k

Mental Health and Addictions STRESS MENTAL HEALTH Residents stressed about money for vital expenses, such as rent, mortgage, food* White Africian American Asian Native American/Other Hispanic 1 in 5 1 in 3 1 in 4 1 in 2 1 in 3 Taking medicine or receiving treatment from a doctor or other health professional for any type of mental health condition or emotional problem White *Those who were sometimes, usually or always stressed about being able to pay for vital expenses (rent, mortgage or food) in the last year. 1 Always or Usually Ellicott City 1 1 Sometimes 1 Ellicott City 1 1 2 African American Asian 1 3 5 Below average About the same Above average 1 How do residents of Howard County compare to the nation in terms of mental health? Hispanic Healthy ways to cope with stress Exercise regularly, connect socially and ask for support from friends, family or a counselor.

Chronic Diseases In many ways, Howard County residents are in better health than in other areas of the state. Yet chronic diseases are still common in the county and a leading cause of premature death. A chronic disease is a long lasting condition that can be controlled but not cured. Unhealthy choices increase the odds of high blood pressure, heart disease, diabetes and cancer. Maintaining a healthy diet and weight are important lifestyle choices in reducing the risk of chronic diseases. At least some college2 Have high blood pressure, by age group Howard National 8 70% Households with an income under $50k3 Howard 2 National 50% Age 5 5 of deaths in the county are due to heart disease, stroke, diabetes or cancer the same as the national average.1 Considering the higher levels of education and income, it is surprising that health outcomes are not better. Reducing alcohol 3 3 How residents with high blood pressure try to lower it 35-49 Exercising 7 Changing eating habits or cutting down on salt 18-34 17% 80% Keeping blood pressure in the normal range reduces risk of cardiovascular disease, congestive heart failure and kidney disease (Dietary Guidelines for Americans). 1 DHMH, Vital Statistics; 2 County Health Rankings; 3 American Community Survey 2011 Learn more:

Chronic Diseases Percentage of residents who have been told they have diabetes... Asian Years old White Ellicott City by age 18-34 by race/ethnicity by location Native American/Other 7% Hispanic 35-49 African Americans are four times less likely to have been diagnosed with diabetes than white residents and are three times more likely to make an ER visit for diabetes1 African American 20% Physical health compared to general U.S. population 1 Below average 30% About the same 5 Above average Diabetes rate2 8. 1 Maryland SHIP Howard Baseline Data; 2 Behavioral Risk Factor Surveillance System, 2010 Reduce your risk of Type 2 diabetes by choosing healthy foods, maintaining a healthy weight and exercising regularly.

Healthy Weight, Exercise & Nutrition Every day we make choices about what to eat and how often to move our bodies. Inactivity and unhealthy foods and drinks may lead to being overweight or obese. How are Howard County residents eating and exercise habits measuring up? 1 Weight by gender Overweight/ obese by race Obese Overweight 2 Total 3 2 Men African American 2 Ellicott City 5 5 6 Native American/ Other 5 White 3 2 6 70% 4 Women Maryland Asian 3 Hispanic The CDC recommends that children and adolescents get an hour or more of exercise each day. Adults need at least 2 hours and 30 minutes of weekly medium-intensity exercise (such as water aerobics or light gardening) OR 1 hour and 15 minutes of weekly high-intensity exercise (such as jogging or jumping rope). 5 60% Percentage of residents who are overweight or obese, according to their BMI 60% Body Mass Index (BMI) is calculated using a person's weight and height. For most, BMI is a reliable indicator of body fatness. 3 Trying to lose weight Advised to lose weight Women Parents who have been told their child should lose weight by a doctor Men 47% 37% 8 Got exercise such as walking, running or swimming in the last month Days of exercise in a week 4-7 2-3 times Once or less 1 Behavioral Risk Factor Surveillance System, 2010 Learn more: 40% 3 2

Healthy Weight, Exercise & Nutrition How often each day do Howard County residents eat How many residents drink at least one non-diet soda, flavored water with added sugar or sugary beverage per week? 5+ 1 3-4 CDC recommends 2 or more a day fruit? Flavored water with added sugar 5 1-2 Soda 3 <1 vegetables that aren t fried? 5+ 3-4 Adults 1 Sugary beverages* 40% 3 Sugary *Flavored teas, fruit and sports drinks CDC recommends 3 or more a day 6 1-2 2 <1 17% How many times a week do residents drink non-diet soda? 1 1 2-4 1 5-6 7-10 11+ What parents think their children drink* 5 3 *Other studies indicate kids drink more than parents think they do. Who isn t getting enough fruits and vegetables? 5 of those earning less than $50,000 are getting less than one serving of fruit/day and 3 are eating less than one serving of vegetables daily. African Americans, Asians and Native American/ Other residents are more likely to report eating less than one serving of fruits and vegetables daily. Sugary drinks are the largest source of added sugar in the American diet today. They are also the source of many extra calories that cause weight gain. Choosing healthier beverage options can help you achieve and maintain a healthy weight. See www.betterbevfinder.org for a list of healthy beverage choices for you and your family.

Tobacco Usage Smoking is the single most preventable cause of disease and premature death, according to the CDC. How common is smoking and exposure to secondhand smoke in Howard County? Smoking frequency by Every day Some days Age 18-34 35-49 7% Adults who smoke Howard County 1 in 13 Maryland1 1 in 6 17% HS/GED 17% Some college 4-yr degree Graduate work Smoking by gender Residents exposed to secondhand smoke from others 1 in 33 Vehicle 1 in 20 Chewing tobacco, snus or snuff Secondhand smoke exposes children and other nonsmokers to harmful toxins. Home 7% 7% 7% Education <HS Smoke cigarettes every day or some days Ellicott City Residents in apartments or condos who smell tobacco smoke coming from other units or outside. Ellicott City 2 1 2 1 Behavioral Risk Factor Surveillance System The Howard County Health Department offers free classes for those interested in quitting smoking. Call 410-313-6265 for more information.

Health and Aging in Howard County The population of older adults is growing, and this group is at high risk for developing chronic disease. How are older adults in Howard County doing in terms of access to care, chronic diseases and healthy lifestyles? Have Health Care Coverage ACCESS TO AFFORDABLE HEALTH CARE LEGEND Ages: Could not see a doctor in the past year due to cost 9 9 Yes No Goes to doctor s office when in need of medical attention 8 8 CHRONIC DISEASES Have high blood pressure 3 6 5 3 Had a stroke Have high cholesterol 47% 50% 5 4 Had cancer 1 2 Have angina or coronary heart disease 1 9 8 Have COPD or other breathing condition Ages: LIFESTYLE Do not smoke Smoke some days Smoke every day 7 9 1 97% 9 Have Diabetes Type II, excludes gestational 7 20% 6 8 7 Overweight BMI between 25.0-29.99 3 3 9 9 Obese BMI 30.0+ 2 2 Have a health problem requiring the use of special equipment 1 The Association (www.columbia association.org) offers programs and classes for older adults, with discounted membership rates for seniors () Note: Numbers may not equal 100 percent because of rounding