Sarpy/Cass Department of Health and Wellness

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This 2012 Community Health Report Card is the product of many community surveys and agency recordkeeping. The staff at the Sarpy/ Department of Health and Wellness finds value in all of this community health data. This 2012 Community Health Report Card is intended to briefly summarize the health status of our communities.

Population 2011 Sarpy County County Nebraska 162,561 25,188 1,842,641 Leading Causes of Death 2005-2009 Sarpy County County Nebraska 1 2 3 Cancer Cancer Heart Disease Heart Disease Heart Disease Cancer Stroke Unintentional Injuries Stroke Economics Sarpy NE Home Ownership Rate (Source: U.S. Census Bureau, American Community Survey) 72.4 % 2006-2010 82.6 % 2006-2010 68.6 % 2006-2010 Unemployment Rate (Source: Bureau of Labor Statistics) 4.1 % 11/11-10/12 4.6 % 11/11-10/12 4.0 % 11/11-10/12 Poverty Rate (Source: U.S. Census Bureau, American Community Survey) 5.9 % 2009-2011 6.2 % 2009-2011 12.7 % 2009-2011 Median Household Income (Source: U.S. Census Bureau, American Community Survey) $64,043 2011 $62,217 2008-2010 $50,296 2011 Adults Aged 18-24 Reporting Having No Insurance Coverage for Healthcare (Source: 2011 PRC Community Health Assessment) 5.7 % 2011 10.0 % 2011 16.5 % 2011

Body Mass Index (BMI) Makeup (%) 2011 PRC Community Health Needs Assessment 80 70 60 50 40 30 20 10 0 Normal Healthy Weight Overweight Obese Sarpy County 31.50 67.10 31.50 County 26.30 73.30 26.30 Children (Ages 5-17) Overweight Sarpy/ County 23.5 Nebraska 69.9 27.5 US 31.7 66.9 28.5 30.7 Physical Well Being (%) 2011 PRC Community Health Needs Assessment 70.00 60.00 50.00 40.00 30.00 20.00 10.00 0.00 Meets Physical Activity Recommendations 5 or More Servings of Fruit/Vegetables Sarpy County 51.90 39.00 County 62.20 42.40 Nebraska 51.1 US 42.7 48.8 Key s in Sarpy/ County pation in physical activity, and diet are linked to several of the largest health issues within Sarpy and County, including heart disease, stroke, and diabetes. The key to decreasing the number of people affected by such health Body Mass Index, Physical Activity Level, Consumption of Fruits and Vegetables, Smoking, and Drinking are five modifiable risk factors that greatly impact the health of a community. Being overweight or obese, low particiissues is in creating an environment that supports healthy lifestyles: opportunities to participate in exercise, eat more fruits and vegetables, and to cease smoking and heavy drinking.

Adult Drinking (%) 2011 PRC Community Health Needs Assessment 25.00 20.00 15.00 10.00 5.00 0.00 Chronic Drinkers Binge Drinkers Sarpy/ County 5.10 20.50 Nebraska 5.50 19.40 US 5.60 16.70 (Chronic: average of 2+ drinks per day. Binge: single occasion of 5+ drinks per man or 4+ drinks per woman.) Adult Smoking (%) 2011 PRC Community Health Needs Assessment 20 18 16 14 12 10 8 6 4 2 0 Adults Currently Smoking Smoking in Household Smoking in Household with Children Sarpy County 10.40 7.50 County 10.70 8.00 Sarpy/ County 16.9 Nebraska 17.2 US 16.6 13.60 12.10

Sarpy Sarpy/ NE US Heart Disease Deaths Stroke Deaths Number of Adults Ever Told That Their Blood Pressure Was High Number of Adults Ever Told That Their Cholesterol Level Was High Adults Report Being Diagnosed With Diabetes 153.9 170.1 140.0 179.8 per 100,000 population, 2005-2009 39.3 42.4 40.3 38.9 per 100,000 population, 2005-2009 21.0% 27.1% 34.3% 33.6% 37.4% 35.1% 9.1% 8.4% 7.7% 10.1% Heart Disease and Stroke in Sarpy and County In Sarpy County, Heart Disease and Stroke were the number 2 and number 3 killers (from 2005-2009), respectively, with cancer the top cause of mortality. In County, heart disease was the second leading cause of death. While great improvement has been made in the prevention of heart disease and stroke deaths, there is still work to be done both at the national and local level. This should come in programs working to improve outcomes in the five key indicators, as those five indicators are directly linked to heart disease and stroke outcomes. It is important to note that while heart disease is one of the leading causes of death, it is also the second leading cause of hospitalization in Sarpy and Coun- ties, and accounted for $93 million in hospital charges in 2010, according to the Nebraska Heart Disease and Stroke Prevention Program. Work towards healthier citizens would not only pay off in longevity of life, but also in a decrease in health care spending.

All Cancer Deaths Adults 50 Years and Older Who Have Had a Fecal Occult Blood Test (FOBT) within Two Years Adults 50 Years and Older Who Have Had a Sigmoidoscopy or Colonoscopy at Some Point in Their Lives Sarpy NE US 161.1 186.5 167.7 173.6 per 100,000 population, 2005-2009 33.2% 30.4% 15.3% 28.3% 77.4% 77.0% 61.8% 72.0% Cancer in Sarpy and County Between 2005-2009, Cancer was the leading cause of death in both Sarpy and County. Proper and regular screenings are one of the best ways to prevent cancer deaths. This is very evident when talking about Colon Cancer. According to the Centers for Disease Control and Prevention, 60% of deaths from colon cancer could be prevented if everyone aged 50 years or older had regular screening tests. The Sarpy/ Department of Health and Wellness has acknowledged this important data, and participates in the Dress in Blue Day, delivering colon cancer prevention fact sheets, posters, and paycheck inserts to local businesses and public buildings, including setting up a booth at the Sarpy County courthouse and local grocery stores. A nurse and health educator use this day to speak with passersby about the importance of screening and educating about colon cancer. This is an education effort that will continue for years to come.

Deaths from Unintentional Injuries Deaths from Motor Vehicles (Source: NDHHS Vital Statistics) Child Always Wears a Seatbelt or Appropriate Restraint when Riding in a Vehicle Ages 0-17 Child Always Wears a Helmet when Riding a Bicycle Ages 5-16 Sarpy Sarpy/ NE US 24.7 47.3 35.7 37.0 per 100,000 population, 2005-2009 8.78 12.4 per 100,000 population, 2004-2008 96.9% 91.6% 52.7% 35.3% Injuries in Sarpy and County Unintentional injuries are the third leading cause of death in County. Injuries are also the number one cause of death nationwide for people up to age 44. In Sarpy and County, the leading cause of injury death is due to motor vehicle accidents. For this reason, efforts to increase the number of adults wearing seatbelts, and the number of children either in seatbelts or proper child passenger safety seats, is vitally important. At the Sarpy/ Department of Health and Wellness, the Safe Kids Sarpy/ County Coordinator regularly gives presentations in the community about a variety of topics to prevent injuries, including Spot the Tot, Child Passenger Safety, Fall Prevention, Anti Texting and Driving, and Bike Helmets. The health department also has child passenger safety technicians who regu- larly educate families on how to properly install a car seat through community events and regularly scheduled fitting stations at the SCDHW office.

Adults Who Have Been Diagnosed with Chronic Lung Disease Adults Who Currently Have Asthma Children Who Currently Have Asthma Ages 0-17 Sarpy Sarpy/ NE US 8.6% 6.0% 8.4% 8.6% 5.3% 7.8% 7.5% 13.5% 6.2% 11.8% Adults Who Currently Smoke 16.9% 17.2% 16.6% Respiratory Disease in Sarpy and County With the passing of the Clean Indoor Air Act, it has become increasingly difficult for smokers to smoke in public places. With such a change in environment, the hope is that the number of smokers in communities will also decrease, and, in effect, such health issues as chronic lung disease will also decrease. The Environmental Health Coordinator at the Sarpy/ Department of Health and Wellness regu- larly responds to Clean Indoor Air Act complaints by visiting businesses, restaurants and bars to ensure they are compliant with the law. There is a proven link between children s exposure to secondhand smoke and the onset and severity of asthma. For this reason, it is healthiest for adults with children to either smoke outside or to cease smoking altogether. Staff at the health department regularly partner with the local tobacco prevention coalitions to educate the public about the effects of smoking on adults, children, and unborn babies.

Number of Chlamydia Cases Ages 15-19 (Source: Nebraska DHHS, Epidemiology) 321 cases (Sarpy/) per 10,000 people, 2009-2011 Number of Chlamydia Cases Ages 20-24 (Source: Nebraska DHHS, Epidemiology) 523 cases (Sarpy/) per 10,000 people, 2009-2011 Number of Gonorrhea Cases Ages 15-19 (Source: Nebraska DHHS, Epidemiology) 45 cases (Sarpy/) per 10,000 people, 2009-2011 Number of Gonorrhea Cases Ages 20-24 (Source: Nebraska DHHS, Epidemiology) 77 cases (Sarpy/) per 10,000 people, 2009-2011 STD in Sarpy and County Sexually transmitted diseases are a public health concern throughout the country. In Sarpy and County, the highest gonorrhea and chlamydia rates are in young people ages 15-19. Sexually transmitted disease prevention and education can be a challenge, as these age groups are often hard to reach. It is important that the community make a concerted effort to teach young people to make healthy and responsible choices to prevent STD s, including getting tested regularly if at highrisk for infection. Parents are the most important support group for this age group.

Alzheimer s Disease Deaths Adults 50 years and Older with Arthritis/ Rheumatism Sarpy NE US 18.6 26.6 25.4 23.4 per 100,000 population, 2005-2009 32.9% 41.8% 35.4% Adults 65 years and Older with Medicare Supplemental Insurance 80.8% 74.5% 75.5% Senior Health in Sarpy and County As our technology in healthcare has improved, seniors are living longer. This means that public health will have to adjust to accommodate an aging population, covering new health issues. Falls are the number one cause of death and injury in people over the age of 65. Fall prevention programs and education outreach will be needed for prevention. Resources for those taking care of their elderly relatives will also need to become more readily available within communities. As a way to address the needs of our elder citizens, the SCDHW will be adding a geriatric educator to our staff.

Infant Mortality Rate Low Weight Births Number of Infants Who Are Ever Breastfed (Source: CDC, Breastfeeding Report Card, 2012) Sarpy NE US 4.4 5.2 5.4 6.4 per 1,000 live births, 2005-2009 6.9% 6.7% 7.1% 8.2% 2001-2007 82.2% 2009 Number of New Mothers Who Breastfed for 6 Months (Source: CDC, Breastfeeding Report Card, 2012) 53.4% 2009 Infant Health in Sarpy and County Infant Health data is often the most telling sign of a community s health. Prenatal care is one of the largest factors in having a healthy pregnancy and baby. Outreach to ensure that soon-to -be mothers are getting healthcare is especially important. At the Sarpy/ Department of Health and Wellness, a Maternal Child Health Outreach Coordinator conducts regular home visits for those who have requested it. She specializes in teaching mothers, often young, about the benefits of breastfeeding, and assists them in troubleshooting life factors that could negatively affect their pregnancy or newly born baby.

Sarpy Sarpy/ US Children Taking Prescriptions for ADD/ADHD Ages 5-17 Adults with Symptoms of Chronic Depression Lasting 2+ Years 8.1% 6.5% 19.8% 18.6% 26.5% Adults with Major Depression Seeking Help 100% 81.8% 82.0% Mental Health in Sarpy and County In Sarpy and County, the second leading cause of death for those aged 15-24 is suicide. This is a major public health concern. Within these communities, mental health care will have to become more proactive to identify and assist youth who are experiencing depression, one of the leading causes of suicide. Parents and peers should be taught to recognize signs of a person thinking about harming themselves, and how to get them proper help. This will come with community partnerships between the mental health, medical, public health, educational, and faith-based communities. Resources about suicide prevention should be made readily available for people within the Sarpy and County communities. The SCDHW has established a workgroup to support local school efforts in behavioral health education.