Community Helth Profile 2015 Yellowstone 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 Yellowstone County Montn Popultion, Census, April 1, 2010 147,972 989,415 Popultion estimtes, July 1, 2014 155,634 1,023,579 Popultion, percent chnge April 1, 2010 July 1, 2014 5.2% 3.5% Persons under 5 yers, July 1, 2013 6.5% 6.0% Persons under 18 yers, July 1, 2013 23.6% 22.1% Persons 65 yers nd over, July 1, 2013 15.0% 16.2% Femle persons, July 1, 2013 51.0% 49.8% White lone, July 1, 2013 91.5% 89.5% Blck or Africn Americn lone, July 1, 2013 Americn Indin nd Alsk Ntive lone, July 1, 2013 0.8% 0.6% 4.3% 6.5% Asin lone, July 1, 2013 0.7% 0.8% Ntive Hwiin nd Other Pcific Islnder lone, July 1, 2013 0.1% 0.1% Two or more rces, July 1, 2013 2.7% 2.5% Hispnic or Ltino, July 1, 2013 5.1% 3.3% White lone, not Hispnic or Ltino, July 1, 2013 87.4% 87.0% Foreign born persons, 2009 2013 1.7% 2.0% Lnguge other thn English spoken t home, 4.0% 4.4% percent of persons ge 5 yers+, 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 Yellowstone County Montn 92.3% 92.1% 28.7% 28.7% Veterns, 2009 2013 13,513 94,404 With disbility, under ge 65 yers, 2009 2013 Men trvel time to work (minutes), workers ge 16 yers+, 2009 2013 9.3% 9.0% 19.0 minutes 18 minutes Medin gross rent, 2009 2013 $718 $682 Owner-occupied housing units, 2009 2013 68.8% 68.3% Persons per household, 2009 2013 2.40 2.39 Medin household income, 2009 2013 $51,342 $46,230 Persons without helth insurnce, under ge 65 yers 17.8% 19.5% Persons in poverty 12.9% 16.5% Popultion per squre mile, 2010 56.2 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. Yellowstone County Lrge 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 1,786 391.7 348.7 366.2 6,645 (374.0, 410.3) (340.4, 357.1) (359.5, 373.1) Heptitis C 682 149.6 107.4 123.0 2,047 (138.8, 161.2) (102.9, 112.2) (119.1, 127.0) Pertussis 122 26.8 48.4 44.6 922 (22.4, 32.0) (45.4, 51.6) (42.3, 47.0) Cmpylobcteriosis 69 15.1 20.9 22.2 399 (12.0, 19.2) (19.0, 23.1) (20.6, 24.0) Deprtment of Corrections popultion included in county rte where pplicble. Dt provided by the Communicble Disese Epidemiology Section. Tble 2. Up-to-dte (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 Yellowstone County Lrge County Dt Montn Number ssessed 2011 b 326 1,419 2,249 Number UTD 2011 198 797 1,305 Percent UTD 2011 c 60.0 56.2 58.7 Number ssessed 2014 d - 1,573 4,042 Number UTD 2014-1,061 2,651 Percent UTD 2014-67.5 65.6 (95% CI) - (65.1, 69.8) (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. Yellowstone County Lrge 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 255 55.1 (48.4, 62.5) 123.0 46.3 (43.2, 49.6) 47.7 (45.2, 50.3) Chronic Obstructive Pulmonry Disese (COPD) b 4,539 845.2 (820.3, 870.7) 2,220.6 707.9 (696.6, 719.4) 716.8 (708.1, 725.6) Crdiovsculr Disese 4,941 917.7 (891.7, 944.3) 2,330.4 747.4 (735.8, 759.3) 746.7 (737.7, 755.8) Dibetes (types 1 nd 2) 5,816 1,126.1 (1096.6, 1156.3) 2,382.6 781.2 (769.0, 793.5) 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. Yellowstone County Lrge 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 3,465 683.7 (660.5, 707.5) 1,488.1 500.4 (490.6, 510.4) 538.6 (530.6, 546.8) Flls 1,889 352.3 (336.2, 369.0) 810.3 263.4 (256.5, 270.5) 268.7 (263.2, 274.3) Struck by/ginst 97 21.2 (17.1, 26.0) 42.9 15.6 (13.8, 17.5) 18.0 (16.5, 19.6) Motor Vehicle 296 65.1 (57.7, 73.2) 132.0 46.8 (43.7, 50.0) 60.6 (57.8, 63.6) Poisoning 243 51.9 (45.5, 59.1) 107.1 37.7 (35.0, 40.6) 36.3 (34.2, 38.5) Intentionl Self-Hrm 974 230.6 (216.2, 245.9) 297.3 114.8 (109.9, 120) 106.5 (102.6, 110.5) Trumtic Brin Injury 561 115.3 (105.7, 125.6) 236.3 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. 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). 81.4 (77.4, 85.5) 91.3 (87.9, 94.8) 5
Tble 5. Emergency Deprtment visits for selected chronic conditions Montn, 2011 2013. Yellowstone County Lrge 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 1,535 358.1 (340.1, 376.8) 652.7 254.4 (247.0, 262.1) 260.0 (254.0, 266.2) Chronic Obstructive Pulmonry Disese (COPD) b 4,191 837.0 (811.1, 863.3) 2,016.4 673.8 (662.4, 685.3) 804.9 (795.2, 814.8) Crdiovsculr Disese 1,381 263.8 (249.7, 278.6) 877.3 285.0 (277.7, 292.4) 372.7 (366.2, 379.3) Dibetes (types 1 nd 2) 8,580 1,753.4 (1715.3, 1792.2) 3,365.7 1,152.0 (1136.9, 1167.4) 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. Yellowstone County Lrge 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 27,926 6,246.7 (6172.3, 6321.9) 14,697.0 5,520.6 (5486.1, 5555.2) 5,901.8 (5873.1, 5930.4) Flls 9,714 2,066.1 (2024.3, 2108.6) 5,266.0 1,926.7 (1906.6, 1946.9) 2,020.0 (2003.7, 2036.5) Struck by/ginst 3,700 864.7 (836.7, 893.4) 1,925.1 752.9 (740.0, 765.9) 820.2 (809.4, 831.1) Motor Vehicle 2,888 665.3 (640.8, 690.5) 1,398.7 520.7 (510.2, 531.3) 520.0 (511.5, 528.6) Poisoning 561 126.9 (116.4, 138.0) 241.1 93.2 (88.8, 97.9) 95.4 (91.8, 99.1) Intentionl Self-Hrm 387 93.5 (84.4, 103.5) 243.7 94.6 (90.1, 99.3) 104.5 (100.6, 108.4) Trumtic Brin Injury 4,415 987.5 (958.0, 1017.6) 1,776.9 669.9 (658.0, 682.1) 649.9 (640.5, 659.5) 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). 7
Tble 7. Cncer incidence Montn, 2011 2013. Yellowstone County Lrge 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) 458.2 444.5 439.8 All Cncer 2,456 1412.7 (439.8, 477.2) (435.6, 453.7) (432.9, 446.8) Prostte (mles) 337 124.6 (111.4, 139.3) 193.7 118.3 (111.9, 125.0) 112.8 (108.1, 117.8) Brest (femle) 322 114.8 (102.2, 128.8) 193.0 118.9 (112.4, 125.7) 115.7 (110.8, 120.9) Lung nd Bronchus 329 61.7 (55.1, 68.9) 175.7 55.5 (52.4, 58.8) 56.4 (54.0, 58.9) Colon nd Rectum 187 34.9 (29.9, 40.5) 109.4 34.7 (32.2, 37.3) 36.9 (35.0, 39.0) Corpus Uteri (femle) 78 26.6 (20.8, 33.7) 41.9 23.9 (21.2, 27.0) 25.4 (23.2, 27.9) Melnom 133 26.2 (21.8, 31.3) 82.3 Does not meet stndrds of relibility or precision. Cncer incidence dt re from the Montn Centrl Tumor Registry. 26.6 (24.4, 29.0) 24.9 (23.2, 26.7) 8
Figure 1: Age-djusted cncer incidence rtes by cncer site Montn, 2011 2013. 160 Age-Adjusted Cncer Incidence Rte by Cncer Site, Montn, 2011--2013 Rte per 100,000 people 140 120 100 80 60 40 20 Yellowstone Lrge 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 Yellowstone County Retiler Number 119 Retilers per 1,000 popultion 0.77 Dt from: http://dphhs.mt.gov/portls/85/documents/mtupppp/index.html 9
Mternl nd Child Helth Tble 9. Totl births occurring in Yellowstone County, 2011 2013. Helth Indictor Yellowstone County Montn Number of births 5,955 35,881 Dt bout births were tbulted from birth certifictes of infnts to Montn-resident 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 Yellowstone County Montn Teen birth rte per 1,000 34.7 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. Yellowstone Lrge County County Dt Montn Helth Indictor Percent Percent Percent Children (2 5 yers of ge) overweight or obese 26.8 25.1 27.9 Initite brestfeeding 85.1 89.7 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 Yellowstone County, 2011 2013. Yellowstone County Lrge County Dt Montn Percent Percent Percent Helth Indictor Number (95% CI) Number (95% CI) Number (95% CI) Born less thn 37 weeks 566 9.5 (8.8, 10.3) 2,036 8.8 (8.4, 9.2) 3,265 9.1 (8.8, 9.4) Born weighing less thn 2,500 grms 476 8.0 (7.3, 8.7) 1,642 7.1 (6.8, 7.4) 2,619 7.3 (7.0, 7.6) Women entering prentl cre fter first trimester 1405 23.6 (22.5, 24.7) 5,413 23.4 (22.9, 24.0) 9,580 26.7 (26.2, 27.2) Women whose Kotelchuk Index is 80% b 4818 80.9 (80.0, 81.9) 18,482 79.9 (79.4, 80.4) 26,911 75.0 (74.6, 75.5) Smoking during pregnncy 941 15.8 (14.9, 16.8) 3,238 14.0 (13.6, 14.5) 5,849 16.3 (15.9, 16.7) Eduction less thn high school grdute 652 10.9 (10.2, 11.8) 2,136 9.2 (8.9, 9.6) 4,281 12.0 (11.6, 12.3) Any insurnce 5705 95.8 (95.3, 96.3) 21,397 92.5 (92.2, 92.8) 33,118 92.3 (92.0, 92.6) Receiving WIC 1727 29.0 (27.9, 30.2) 7,240 31.1 (30.7, 31.9) 12,415 34.6 (34.1, 35.1) Brestfeeding t dischrge 5342 89.7 (88.9, 90.5) 21,281 Dt bout births were tbulted from birth certifictes of infnts to Montn-resident mothers who delivered in Montn, 2011 2013, covering more thn 95% of ll births. Demogrphic informtion on the birth certifictes is self-reported 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. 92.0 (91.6, 92.3) 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. Yellowstone County Lrge County Dt Montn Helth Indictor Mle Femle Mle Femle Mle Femle White 76.0 82.0 75.0 83.0 76.0 83.0 Americn Indin 59.5 55.0 59.0 60.0 62.5 63.5 Too few events to report or complimentry suppression of corresponding cell. Tble 14. Frequency nd ge-djusted rtes of selected cuses of deth by county ll cuse Montn residents, 2011 2013. Yellowstone County Lrge County Dt Montn Age-djusted Age-djusted Age-djusted 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 4,106 749.0 (725.8, 772.8) 15,555 713.6 (702.3, 725.1) 27,334 744.8 (735.8, 753.9) Homicide 43 80 Suicide 99 416 21.2 (19.1, 23.4) 688 22.3 (20.6, 24.1) All injuries 154 918 45.2 (42.2, 48.3) 1,726 53.3 (50.7, 56.0) Motor vehicle Accidents 57 277 14.2 (12.5, 16.0) 603 19.8 (18.2, 21.5) Confidence Intervls (95%) For The Age Adjusted Rte Are Computed Using the Fy-Feuer (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, single-yer 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 5-yer 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 ge-djusted rtes of selected cuses of deth by county ll cuse Montn residents, 2011 2013. Yellowstone County Lrge County Dt Montn Age-djusted Rte per 100,000 Age-djusted Rte per 100,000 Age-djusted Rte per 100,000 Helth Indictor Number (95% CI) Number (95% CI) Number (95% CI) Deths Attributed to Drugs 44 87 2.7 (2.2, 3.4) All Cncer 913 167.0 (156.2, 178.5) 3,440 154.9 (149.6, 160.2) 5,902 156.2 (152.1, 160.3) Cerebrovsculr 218 38.8 (33.7, 44.5) 779 35.7 (33.2, 38.3) 1,339 35.8 (33.9, 37.9) Hert Disese 840 149.2 (139.1, 159.9) 3,109 140.1 (135.2, 145.2) 5,757 152.4 (148.5, 156.5) All Liver 80 264 566 16.3 (14.9, 17.8) Alcohol-Relted Liver Disese 37 130 292 8.6 (7.6, 9.7) Dibetes 98 342 15.7 (14.0, 17.5) 729 19.8 (18.4, 21.4) Pneumoni nd Influenz 75 284 12.8 (11.3, 14.4) 517 13.8 (12.6, 15.1) Chronic Lower Respirtory Disese nd Asthm 300 54.9 (48.8, 61.7) 1,098 50.8 (47.8, 54.0) 1,881 50.6 (48.3, 53.0) Confidence Intervls (95%) For The Age Adjusted Rte Are Computed Using the Fy-Feuer (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, single-yer 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 5-yer 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. 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