Community Helth Profile 2015 Crter County Public Helth nd Sfety Division
Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl Risk Fctors 14
Methods Methods for ll dt nlyses re in seprte document, Helth Profile Methodology. Demogrphic Informtion Crter County Montn Popultion, Census, April 1, 2010 1,160 989,415 Popultion estimte, July 1, 2014 1,169 1,023,579 Popultion, percent chnge April 1, 2010 July 1, 2014 0.8% 3.5% Persons under 5 yers, July 1, 2013 5.6% 6.0% Persons under 18 yers, July 1, 2013 17.1% 22.1% Persons 65 yers nd older, July 1, 2013 24.4% 16.2% Femle persons, July 1, 2013 48.9% 49.8% White lone, July 1, 2013 98.4% 89.5% Blck or Africn Americn lone, July 1, 2013 Americn Indin nd Alsk Ntive lone, July 1, 2013 0.1% 0.6% 0.9% 6.5% Asin lone, July 1, 2013 0.1% 0.8% Ntive Hwiin nd other Pcific Islnder lone, July 1, 2013 0.0% 0.1% Two or more rces, July 1, 2013 0.5% 2.5% Hispnic or Ltino, July 1, 2013 0.8% 3.3% White, not Hispnic or Ltino, July 1, 2013 97.7% 87.0% Foreign born persons, 2009 2013 0.2% 2.0% Lnguge other thn English spoken t 2.4% 4.4% home, percent of persons ge 5+, 2009 2013 Z Vlue greter thn zero but less thn hlf unit of mesure shown. Dt from http://quickfcts.census.gov/ 1
Demogrphic Informtion High school grdute or higher, percent of persons ge 25 yers+, 2009 2013 Bchelor s degree or higher, percent of persons ge 25 yers+, 2009 2013 Crter County Montn 92.8% 92.1% 16.4% 28.7% Veterns, 2009 2013 75 94,404 With disbility, under ge 65, 2009 2013 Men trvel time to work (minutes), workers ge 16 yers+, 2009 2013 6.1% 9.0% 13 minutes 18 minutes Medin gross rent, 2009 2013 $423 $682 Owneroccupied housing unit rte, 2009 2013 80.4% 68.3% Persons per household, 2009 2013 2.46 2.39 Medin household income, 2009 2013 $39,659 $46,230 Persons without helth insurnce, under ge 65 yers 29.2% 19.5% Persons in poverty 15.5% 16.5% Popultion per squre mile, 2010 0.3 6.8 Z Vlue greter thn zero but less thn hlf unit of mesure shown. Dt from http://quickfcts.census.gov/ 2
Communicble Disese Tble 1. Number nd rte of selected communicble diseses Montn, 2011 2013. Crter County Frontier County Dt Montn Rte per Rte per Rte per 100,000 Number per 100,000 100,000 Helth Indictor Number (95% CI) County (95% CI) (95% CI) Chlmydi 2 57.39 140.12 366.24 154 (6.7, 207.2) (119.7, 164.0) (359.5, 373.1) Heptitis C 0 45.49 122.95 50 (34.4, 60.1) (119.1, 127.0) Pertussis 0 17.29 44.60 19 (10.9, 27.2) (42.3, 47.0) Cmpylobcteriosis 0 45.49 22.23 50 (34.4, 60.1) (20.6, 24.0) Deprtment of Corrections popultion included in county rte where pplicble. Dt provided by the Communicble Disese Epidemiology Section. Tble 2. Uptodte (UTD) on childhood vccintions for 24 35 month old children s of Mrch 1st of the yer of ssessment bsed on immtrx dt reviewed during Vccines for Children Progrm Clinic Reviews conducted every other yer Montn, 2011 nd 2014. Helth Indictor Crter County Frontier County Dt Montn Number ssessed 2011 b 2,249 Number UTD 2011 1,305 Percent UTD 2011 c 58.7 Number ssessed 2014 d 206 4,042 Number UTD 2014 162 2,651 Percent UTD 2014 78.6 65.6 (95% CI) (72.4, 84.0) (64.1, 67.1) UTD = 4 DTP, 3 Polio, 1 MMR, 3/4 HIB, 3 Hep B, 1 Vr, 4 PCV by 24 months. b In 2011, chrt reviews occurred. Clinics with fewer 50 chrt, the review included ll vilble chrts. Clinics with more thn 50 chrts, smple of chrts were reviewed nd vlidted. c Confidence intervl cnnot be clculted becuse the totl number of records reviewed is unknown. d In 2014, ll immuniztion records were reviewed electroniclly in the Montn Immuniztion Informtion System (immtrx). The precision of ech estimte ws quntified using 95% confidence intervls. Dt provided by the Immuniztion Section of the Communicble Disese Bureu. 3
Chronic Disese Tble 3. Inptient dmissions for selected chronic conditions Montn, 2011 2013. Crter County Frontier County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) Asthm <5 2.2 26.9 (18.1, 39.5) 47.7 (45.2, 50.3) Chronic Obstructive Pulmonry Disese (COPD) b 20 320.3 (194.4, 616.6) 55.8 470.2 (438.6, 504.6) 716.8 (708.1, 725.6) Crdiovsculr Disese 12 67.4 577.9 (541.9, 616.9) 746.7 (737.7, 755.8) Dibetes (types 1 nd 2) 24 359.9 (229.2, 657.3) 57.9 545.3 (507.7, 586.0) 822.5 (812.8, 832.3) Rtes re ge stndrdized to the 2000 Projected US Popultion using Distribution #1 s described in Klein nd Schoenborn 2001 nd given per 100,000 person yers. b Chronic obstructive pulmonry disese (COPD), includes chronic bronchitis, emphysem, bronchiectsis, nd chronic irwy obstruction. Does not meet stndrds of relibility or precision. Inptient dmission nd ED visit dt provided courtesy of prticipting MHA members, collected through the Montn Hospitl Dischrge Dt System (MHDDS). 4
Tble 4. Inptient dmissions for injury by type nd mechnism of injury Montn, 2011 2013. Crter County Frontier County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) All Unintentionl Injury 17 36.8 416.5 (379.1, 457.4) 538.6 (530.6, 546.8) Flls 5 18.6 162.6 (143.0, 185.3) 268.7 (263.2, 274.3) Struck by/ginst <5 1.3 21.1 (12.5, 34.1) 18.0 (16.5, 19.6) Motor Vehicle <5 4.1 62.6 (47.0, 82.5) 60.6 (57.8, 63.6) Poisoning <5 1.1 36.3 (34.2, 38.5) Intentionl SelfHrm <5 2.3 42.9 (29.8, 60.3) 106.5 (102.6, 110.5) Trumtic Brin Injury <5 Rtes re ge stndrdized to the 2000 Projected US Popultion using Distribution #1 s described in Klein nd Schoenborn 2001 nd given per 100,000 person yers. Does not meet stndrds of relibility or precision. Inptient dmission nd ED visit dt provided courtesy of prticipting MHA members, collected through the Montn Hospitl Dischrge Dt System (MHDDS). 6.3 81.8 (64.8, 102.5) 91.3 (87.9, 94.8) 5
Tble 5. Emergency Deprtment visits for selected chronic conditions Montn, 2011 2013. Crter County Frontier County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) Asthm <5 9.3 156.6 (131.3, 186.0) 260.0 (254.0, 266.2) Chronic Obstructive Pulmonry Disese (COPD) b 14 43.2 407.0 (374.3, 442.9) 804.9 (795.2, 814.8) Crdiovsculr Disese 7 37.8 333.0 (305.0, 364.0) 372.7 (366.2, 379.3) Dibetes (types 1 nd 2) 18 57.9 585.4 (544.1, 630.1) 1,235.6 (1223.3, 1248.0) Rtes re ge stndrdized to the 2000 Projected US Popultion using Distribution #1 s described in Klein nd Schoenborn 2001 nd given per 100,000 person yers. b Chronic obstructive pulmonry disese (COPD), includes chronic bronchitis, emphysem, bronchiectsis, nd chronic irwy obstruction. Does not meet stndrds of relibility or precision. Inptient dmission nd ED visit dt provided courtesy of prticipting MHA members, collected through the Montn Hospitl Dischrge Dt System (MHDDS). 6
Tble 6. Emergency deprtment visits for injury by type nd mechnism of injury Montn, 2011 2013. Crter County Frontier County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) All Unintentionl Injury 69 2,197.4 (1638.8, 2926.0) 257.9 4,046.6 (3914.1, 4182.9) 5,901.8 (5873.1, 5930.4) Flls 21 638.0 (357.2, 1103.2) 96.4 1,290.7 (1220.2, 1364.9) 2,020.0 (2003.7, 2036.5) Struck by/ginst 12 34.6 606.0 (554.4, 661.6) 820.2 (809.4, 831.1) Motor Vehicle <5 18.3 321.3 (283.3, 363.4) 520.0 (511.5, 528.6) Poisoning <5 2.5 38.8 (27.0, 54.8) 95.4 (91.8, 99.1) Intentionl SelfHrm <5 2.5 50.3 (35.5, 69.6) 104.5 (100.6, 108.4) Trumtic Brin Injury 6 Rtes re ge stndrdized to the 2000 Projected US Popultion using Distribution #1 s described in Klein nd Schoenborn 2001 nd given per 100,000 person yers. Does not meet stndrds of relibility or precision. Inptient dmission nd ED visit dt provided courtesy of prticipting MHA members, collected through the Montn Hospitl Dischrge Dt System (MHDDS). 22.6 359.8 (321.0, 402.6) 649.9 (640.5, 659.5) 7
Tble 7. Cncer incidence Montn, 2011 2013. Crter County Frontier County Dt Montn Rte per 100,000 Averge Rte per 100,000 Rte per 100,000 Number per Helth Indictor Number (95% CI) County (95% CI) (95% CI) 187.4 409.9 439.8 All Cncer 10 45.2 (73.0, 495.6) (378.0, 444.8) (432.9, 446.8) Prostte (mles) <5 6.3 101.2 (82.1, 126.5) 112.8 (108.1, 117.8) Brest (femle) <5 5.1 95.7 (74.0, 124.6) 115.7 (110.8, 120.9) Lung nd Bronchus <5 7.1 59.6 (48.7, 73.7) 56.4 (54.0, 58.9) Colon nd Rectum <5 4.4 37.3 (28.7, 49.4) 36.9 (35.0, 39.0) Corpus Uteri (femle) <5 1.4 24.2 (15.1, 41.0) 25.4 (23.2, 27.9) Melnom <5 Does not meet stndrds of relibility or precision. Cncer incidence dt re from the Montn Centrl Tumor Registry. 1.8 19.7 (12.3, 31.1) 24.9 (23.2, 26.7) 8
Figure 1: Agedjusted cncer incidence rtes by cncer site Montn, 2011 2013. 140 AgeAdjusted Cncer Incidence Rte by Cncer Site, Montn, 20112013 Rte per 100,000 people 120 100 80 60 40 20 Frontier Counties All Montn 0 Prostte (mle) Brest (femle) Lung & Bronchus Colon & Rectum Corpus Uteri (femle) Melnom Tble 8. Tobcco retilers by county, Montn 2013. Helth Indictor Crter County Retiler Number 2 Retilers per 1,000 popultion 1.72 Dt from: http://dphhs.mt.gov/portls/85/documents/mtupppp/index.html 9
Mternl nd Child Helth Tble 9. Totl births occurring in Crter County, 2011 2013. Helth Indictor Crter County Montn Number of births 19 35,881 Dt bout births were tbulted from birth certifictes of infnts to Montnresident mothers who delivered in Montn, 2011 2013, covering more thn 95% of ll births. Tble 10. Teen birth rte per 1,000 femles ge 15 19 yers, 2009 2013.,b Helth Indictor Crter County Montn Teen birth rte per 1,000 32.0 Due to the smll number of events in some counties, five yer rtes hve been used to include more counties with t lest 20 events over the five yers. Not ll counties hd enough events to be included. b Full report cn be found t: http://dphhs.mt.gov/portls/85/publichelth/documents/wmh/2014%20teen%20birth%20 nd%20pregnncy%20report%20finl.pdf Denomintor less thn 20; rtes bsed on fewer thn 20 events re not sttisticlly relible. Tble 11. WIC dt by county Montn, 2011 2013. Frontier County Crter County Dt Montn Helth Indictor Percent Percent Percent Children (2 5 yers of ge) overweight or obese 30.4 27.9 Initite brestfeeding 78.7 84.7 Denomintor less thn 20; rtes bsed on fewer thn 20 events re not sttisticlly relible. Dt provided by the WIC Progrm in the Fmily nd Community Helth Bureu. 10
Tble 12. Births to Montn resident mothers occurring in Crter County, 2011 2013. Crter County Frontier County Dt Montn Percent Percent Percent Helth Indictor Number (95% CI) Number (95% CI) Number (95% CI) Born less thn 37 weeks 91 9.6 (7.8, 11.7) 3,265 9.1 (8.8, 9.4) Born weighing less thn 2,500 grms 77 8.2 (6.5, 10.1) 2,619 7.3 (7.0, 7.6) Women entering prentl cre fter first trimester 249 26.4 (23.6, 29.3) 9,580 26.7 (26.2, 27.2) Women whose Kotelchuk Index is 80% b 673 71.2 (68.2, 74.1) 26,911 75.0 (74.6, 75.5) Smoking during pregnncy 139 14.7 (12.5, 17.1) 5,849 16.3 (15.9, 16.7) Eduction less thn high school grdute 114 12.1 (10.1, 14.3) 4,281 12.0 (11.6, 12.3) Any insurnce 843 89.2 (87.1, 91.1) 33,118 92.3 (92.0, 92.6) Receiving WIC 247 26.1 (23.4, 29.1) 12,415 34.6 (34.1, 35.1) Brestfeeding t dischrge Dt bout births were tbulted from birth certifictes of infnts to Montnresident mothers who delivered in Montn, 2011 2013, covering more thn 95% of ll births. Demogrphic informtion on the birth certifictes is selfreported by prents; medicl informtion is bstrcted from medicl records. b Kotelchuk Index: computed index of dequcy of prentl cre, function of erly initition nd enough visits, 80% or greter is defined s dequte. Too few events to report or complimentry suppression of corresponding cell. Does not meet stndrds of relibility or precision. 836 88.5 (86.3, 90.4) 31,898 88.9 (88.6, 89.2) 11
Mortlity Tble 13. Medin ge t deth in yers by rce nd sex Montn, 2011 2013. Crter County Frontier County Dt Montn Helth Indictor Mle Femle Mle Femle Mle Femle White 77.5 78.0 85.0 76.0 83.0 Americn Indin 62.5 63.5 Too few events to report or complimentry suppression of corresponding cell. Tble 14. Frequency nd gedjusted rtes of selected cuses of deth by county ll cuse Montn residents, 2011 2013. Crter County Frontier County Dt Montn Agedjusted Agedjusted Agedjusted Rte per 100,000 Rte per 100,000 Rte per 100,000 Helth Indictor Number (95% CI) Number (95% CI) Number (95% CI) All Cuses 43 1,336 710.9 (670.2, 754.6) 27,334 744.8 (735.8, 753.9) Homicide 0 80 Suicide 0 21 688 22.3 (20.6, 24.1) All injuries 86 1,726 53.3 (50.7, 56.0 ) Motor vehicle Accidents 31 603 19.8 (18.2, 21.5) Confidence Intervls (95%) For The Age Adjusted Rte Are Computed Using the FyFeuer (1997) Method Ntionl Center for Helth Sttistics. Vintge 2013 postcensl estimtes of the resident popultion of the United Sttes (April 1, 2010, July 1, 2010 July 1, 2013), by yer, County, singleyer of ge (0, 1, 2,.., 85 yers nd over), bridged rce, Hispnic origin, nd sex. Prepred under collbortive rrngement with the U.S. Census Bureu. Avilble from: http://www.cdc.gov/nchs/nvss/bridged_rce.htm s of June 26, 2014, following relese by the U.S. Census Bureu of the unbridged Vintge 2013 postcensl estimtes by 5yer ge group on June 26, 2014. Too few events to report or complimentry suppression of corresponding cell. Does not meet stndrds of relibility or precision. Dt provided by the Office of Epidemiology nd Scientific Support. 12
Tble 15. Frequency nd gedjusted rtes of selected cuses of deth by county ll cuse Montn residents, 2011 2013. Crter County Frontier County Dt Montn Agedjusted Rte per 100,000 Agedjusted Rte per 100,000 Agedjusted Rte per 100,000 Helth Indictor Number (95% CI) Number (95% CI) Number (95% CI) Deths Attributed to Drugs 0 87 2.7 (2.2, 3.4) All Cncer 303 159.2 (140.9, 180.4) 5,902 156.2 (152.1, 160.3) Cerebrovsculr 63 1,339 35.8 (33.9, 37.9) Hert Disese 316 151.9 (135.1, 171.7) 5,757 152.4 (148.5, 156.5) All Liver 21 566 16.3 (14.9, 17.8) AlcoholRelted Liver Disese 292 8.6 (7.6, 9.7) Dibetes 63 729 19.8 (18.4, 21.4) Pneumoni nd Influenz 0 23 517 13.8 (12.6, 15.1) Chronic Lower Respirtory Disese nd Asthm 94 1,881 50.6 (48.3, 53.0) Confidence Intervls (95%) For The Age Adjusted Rte Are Computed Using the FyFeuer (1997) Method Ntionl Center for Helth Sttistics. Vintge 2013 postcensl estimtes of the resident popultion of the United Sttes (April 1, 2010, July 1, 2010 July 1, 2013), by yer, County, singleyer of ge (0, 1, 2,.., 85 yers nd over), bridged rce, Hispnic origin, nd sex. Prepred under collbortive rrngement with the U.S. Census Bureu. Avilble from: http://www.cdc.gov/nchs/nvss/bridged_rce.htm s of June 26, 2014, following relese by the U.S. Census Bureu of the unbridged Vintge 2013 postcensl estimtes by 5yer ge group on June 26, 2014. Too few events to report or complimentry suppression of corresponding cell. Figure does not meet stndrds of relibility or precision. Dt provided by the Office of Epidemiology nd Scientific Support. 13
Behviorl Risk Fctors Becuse of the smll numbers in Montn, behviorl risk fctor helth indictors re reported by Montn s Helth Plnning Regions s demonstrted below. Here is the link to the 2013 nnul report, regionl comprisons of 2013 helth indictors strt on pge 32: http://dphhs.mt.gov/portls/85/publichelth/documents/brfss/annul%20reports/2013%20 Annul/2013MTBRFSSAnnulReport.pdf 14