Statewide Health Improvement Program Community Health Indicators: Roseau County

1
Statewide Health Improvement ProgramCommunity
Health Indicators Roseau County

• Prepared by Garth Kruger, Ph.D.
• Dmitri Poltavski, Ph.D.
• EvaluationGroup, LLC

2
Introduction

• EvaluationGroup,LLC
• Dmitri Poltavski, Ph.D.
• Garth Kruger Ph.D.
• Jacque Gray, Ph.D.
• OUR SERVICES INCLUDE
• PROGRAM EVALUATION DESIGN
• WRITING LOGIC MODELS
• NEEDS ASSESSMENTS
• SURVEY CONSTRUCTION
• DATA ANALYSIS
• POLICY ANALYSIS
• WEB PAGE DESIGN

3
Purpose of Presentation

• To review county and state health risk indicators
• Select interventions that provide maximum impact.

4
(No Transcript)
5
What are the results?

• Adults in Roseau County and the NW MN Region are
  overweight/obese.
• Increase physical activity and improve nutrition.
  
• Roseau County youth need tobacco
  prevention/intervention
• Use tobacco products significantly more often.
• Most likely to smoke cigarettes
• Smokeless tobacco use is twice the state average.
• Physical activity and nutritional issues
  important but secondary.

6
The End
7
Overview

• Behavioral Risk Statistics
• Indexes of Obesity and Tobacco Use Adults (18)
• Indexes of Obesity and Tobacco Use for High
  School Students (grade 12)
• Overweight and Obesity
• Exercise and Physical Activity
• Fruit and Vegetable Consumption
• Tobacco Use, Access, Smoking Policy
• Interviews with County Residents
• Review of Interventions and Recommendations

8
Behavioral Risk Statistics

• Indexes of Obesity and Tobacco Use
• Adults (18)

9
Risk Statistics (Adults)

• Data Used
• Behavioral Risk Factor Surveillance Survey
  (BRFSS) databases 2004, 2007 and 2008.
• There are only synthetic estimates of behavioral
  adult risk statistics for the 8-county SHIP
  region.
• There are currently no recent BRFSS data
  available on smokeless tobacco use in Minnesota.

10
MN Risk Statistics (Adults)

• General Health and Obesity
• Over 60 of all Minnesotans are overweight or
  obese (mean BMI of 27.5 1 ).
• 37.5 of all Minnesotans were overweight.
• 26.5 were classified obese.

1 BMI between 25.00 and 29.99 corresponds to
the category overweight BMI of 30.00 and above
corresponds to the category obese.
11
MN Risk Statistics (Adults)
2007 Minnesota Physical Activity (PA) Categories
().

• 45.5 of Minnesotans met physical activity
  recommendations.
• 40.4 reported insufficient levels of physical
  activity.
• 12.9 had none at all.

12
Roseau County Risk Statistics (Adults)
Health risk category Roseau County () SHIP Counties ()1 MN State ()
Overweight (not obese) 36.4 36.4 37.5
Obese 26.2 25.9 26.5
Current smokers 16.4 15.6 15.7
No Exercise 16.6 17.8 12.9
Fair or Poor Overall Health 11.4 12.5 14.2

1 Aggregate data for Kittson, Mahnomen,
Marshall, Norman, Pennington, Polk, Red Lake
Roseau Counties.
13
MN Risk Statistics (Adults)

• Fruit and Vegetable Consumption
• 21.3 of Minnesotans reported consuming 5 or more
  servings of fruits and vegetables per day.

14
MN Risk Statistics (Adults)

• Tobacco Use and Smoking Policy
• 15.7 of Minnesotans in 2008 reported currently
  smoking at least on some days.
• 11.1 percent were regular smokers (smoke every
  day).
• 53 of smokers reported trying to quit at least
  once in the past 12 months.

15
Summary

• Data suggest
• Over half the adult population is overweight or
  obese.
• Only slightly more than 20 of adults eat the
  recommended guidelines of fruits and vegetables.
• Roseau county adults are much less physically
  active (no exercise) than other adults statewide.

16
Behavioral Risk Statistics

• Indexes of Obesity and Tobacco Use
• High School Students (grade 12)

17
Risk Statistics (High School Students)

• Datasets Used
• Minnesota Student Survey 2007
• Information used for only students in grade 12.
• Good proxy for needs given SHIP parameters.
• They show the greatest prevalence of health risk
  behaviors compared to grades 6 and 9.
• 80.8 response rate
• 72 response rate for SHIP region

18
Risk Statistics (High School Students)

• Datasets Used
• MN Student survey administrators provided raw
  data sets in order for us to make statistical
  comparisons.
• Confidence intervals used to assess statistical
  differences.

14.0
9.9
95 Confidence Interval
19.3
19
Risk Statistics (High School Students)

• Overweight and Obesity See Table 2, pg. 7
• 14.0 of 12th-graders in Roseau County were
  classified at risk for becoming overweight

• 8.8 of 12th-graders in Roseau County were
  considered overweight.
• Adult population at 60

• 29.1 of Roseau county students thought they were
  overweight.

20
Risk Statistics (High School Students)
Exercise and Physical Activity

• 70.4 of students met recommendations for regular
  weekly physical activity.
• Higher than MN (68.7).
• 45 of MN Adults

• 14.6 of students reported insufficient physical
  activity.

• 15.0 reported no weekly physical activity.

21
Risk Statistics (High School Students)

• Fruit and Vegetable Consumption
• Only 14.6 of students reported adequate daily
  intake of fruits and vegetables.
• Far fewer than MN (16.1).
• 21.3 of adults met

22
Risk Statistics (High School Students)

• Tobacco Use and Access
• 43.8 of the 12th-grade students in Roseau County
  reported using tobacco products in the 30 days
  preceding the survey. (15.7 of adult Minnesotans
  smoke)
• Cigarette smoking was the most frequent form of
  tobacco use reported by 32.1 of students.

• 20.5 of 12th graders had used smokeless tobacco
  during the last 30 days compared to state average
  of 10.4.

23
Risk Statistics (High School Students)

• 71.1 of tobacco users purchased them at a gas
  station or a convenience store.
• Higher than MN average of 63.1 (but not stat
  sig).

24
Summary of Findings

• Compared to the statewide averages of MN youth,
  Roseau County youth
• Use tobacco products significantly more often
  than the statewide average..
• Most likely to smoke cigarettes
• Smokeless tobacco use is twice the state average.
• Meet PA guidelines about the same as state
  average.
• However, youth are more likely to get no physical
  activity at all. (Those uninvolved in sports?).
• Eat slightly less fruits/vegetables per day than
  state average.

25
What are the results again?

• Adults in Roseau County and the NW MN Region are
  overweight/obese.
• Increase physical activity and improve nutrition.
  
• Roseau County youth need tobacco
  prevention/intervention
• Use tobacco products significantly more often.
• Most likely to smoke cigarettes
• Smokeless tobacco use is twice the state average.
• Physical activity and nutritional issues
  important but secondary.

26
County Resident Interviews

• Most Pressing Issues and
• Extent of Problems

27
Interviews

• Primary and pressing healthcare issues facing
  their community
• Obesity
• Tobacco use both by adults and students

28
Interviews

• Confluence of factors negatively impacting
  healthy eating and physical activity in Roseau
  County
• Food costs
• cheap, fast, unhealthy food is what people want
• Food vendors offer poor choices
• Culture of inactivity
• Lack of supports for those seeking to become
  healthier
• Lack of parent time/interest in childrens
  weight and activity

29
Interviews

• One convenience store clerk respondent stated I
  feel bad when people come into the store and say,
  I need my fruit for the day when buying
  Starburst candy.

30
Recommendations

• Best Options for Addressing Overweight, Physical
  Activity and Tobacco Use in Adults and Youth

31
Intervention Settings
Community
Worksites
Schools
Tobacco Use and Obesity
Healthcare
32
Recommendation Increase Adult Physical
Activity

• COMMUNITY/WORKSITE SETTING INTERVENTIONS
• Policies and practices that create active
  communities
• Increase opportunities for non-motorized
  transportation (walking and biking)
• Increase access to community recreation
  facilities.
• Implement signage prompting use of stairs in
  community buildings.
• A comprehensive employee wellness initiative
• Provide health assessment with follow-up
  coaching,
• Provide ongoing health education,
• Provide policy and environmental supports that
  promotes healthy weight and behaviors.
• HEALTHCARE SETTING INTERVENTIONS
• Develop relationships among health care providers
  and community leaders to facilitate active
  referral of patients to resources that increase
  access to nutritious foods, physical activity,
  and tobacco use cessation.

33
Recommendation Decrease Tobacco use by Youth

• COMMUNITY SETTING INTERVENTIONS
• Tobacco-free policies for parks, playgrounds,
  beaches, zoos, fairs, and other recreational
  settings.
• Policies that restrict youth access to tobacco
  such as sales laws directed at tobacco retailers
  to reduce illegal sales to minors.
• HEALTH CARE SETTING INTERVENTIONS
• Better connect people with existing effective
  cessation services (such as the 5 As and fax
  referral).

34
Recommendation Nutrition Physical
Activities for Youth

• SCHOOL SETTING INTERVENTIONS
• Comprehensive nutrition policies
• Breakfast promotion
• Healthy lunch and snacks
• School gardens
• Farm-to-school initiatives.
• Creating more active schools through
• Supporting quality school-based physical activity
• Increasing opportunities for non-motorized
  transportation
• Increased access to school recreation facilities.
• COMMUNITY SETTING INTERVENTIONS
• Improving access to nutritious foods (e.g.
  fruits, vegetables) through
• Increased availability and affordability of
  nutritious foods in grocery stores, corner
  stores, concession facilities, and other food
  vendors.
• License and facilitate the development of new
  farmers markets and promote their use.

35
If you have further questions you can contact us
at

• www.evaluationgroupllc.com
• 29337 310th ave NW
• Warren, MN 56762
• Ph218-201-0375
• Fax [phone]