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Sheboygan County Health Needs Assessment: A Few Pieces of the Healthy Community Puzzle

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Title: Sheboygan County Health Needs Assessment: A Few Pieces of the Healthy Community Puzzle


1
Sheboygan County Health Needs Assessment A Few
Pieces of the Healthy Community Puzzle
  • Presented on behalf of the Sheboygan County
    Division of Public Health and Healthy Sheboygan
    County 2020 June 22, 2011

2
As a Nation We Can Do Better.
  • United States spends more on medical care and
    medical research than any other nation in the
    world.
  • Average life expectancy in United States in 2008
    was 78.1 years ranking 34th among other nations.
  • If current trends in obesity and inactivity
    continue it is projected that life expectancy may
    decrease.

3
Factors Contributing to Premature Death
Source New England Journal Of Medicine, Sept
2007
4
Primary Source of Data used in this
Presentation 2009 Sheboygan County Community
Health Needs Assessment. Sources are noted when
more recent data is provided.
5
Underlying Social Determinants of Health
  • Sheboygan County Population 115,507
  • Growth of 2.5 since 2000 Census
  • Compares to 6.0 State Growth and 9.7 National
    Growth
  • Source 2010 US Census

6
Underlying Social Determinants of Health
  • 95 of Sheboygan County Residents born in US
  • 78 born in Wisconsin
  • 9 of persons over age five speak a language
    other than English in their home
  • 84.4 of adults 25 years are High School
    graduates (WI 85.1, US 80.4) Source US
    Census Bureau Quick Facts Nov. 2010
  • 17.9 of adults 25 years have Bachelor Degree or
    higher (WI 22.4, US 24.4)

7
2010 Census Demonstrates Increasing Racial/Ethnic
Diversity
2000 2010 Percent Change
White 104,438 103,861 -0.5
Hispanic/Latino 3,789 6,329 67
Asian 3,698 5,279 43
Black/African 1,224 1,605 31
Source US Census
8
Underlying Social Determinants of Health
  • 7.7 of population at or below poverty level
  • Percent of children at or below poverty level
    11.0
  • 2009 Median Household Income 52,848 now above
    State and National levels

9
Underlying Social Determinants of Health
  • 2008 25,427 have incomes below 200 FPL
  • Average Monthly Unemployment 2010 8.7
    (Jan-Mar 11 - 8.36)
  • 71.4 own their home (US 66.2)
  • 541 Home Foreclosures in 2009
  • 531 Home Foreclosures in 2010
  • Sources United Way and US Census,
    http//dwd.wisconsin.gov/oea/unemployment_rates_an
    d_labor_force_estimates

10
2010 Age Distribution Local, State, National
Levels
Sheboygan Co. Wisconsin United States
Less than 5 years, percent 6.4 6.4 6.9
Less than 18 years, percent 23.5 23.2 24.3
65 years and older, percent 14.3 13.5 12.9
Source US Census
11
Adequate, Appropriate, Safe Food and Nutrition
  • Two of three adults residing in Sheboygan County
    are overweight/obese
  • 64 of Aurora Community Survey respondents in
    2003 and 2008 consumed 2 or more servings of
    fruit per day and 23 consumed three or more
    servings of vegetables per day. No statistical
    improvements noted between 2003 and 2008

12
Adequate, Appropriate, Safe Food and Nutrition
  • WIC enrollment increased by 25.6 between 2004
    and 2010 slight decrease in enrollment from 2009
    to 2011
  • 80.3 of women enrolled in WIC try breastfeeding
    their infants 32.5 of babies enrolled in WIC
    are exclusively breastfed for the first six
    months of life (2007 62.7, 5.7)
  • 1 of 4 Sheboygan County students received
    free/reduced hot lunch in the 2009-2010 school
    year
  • 12,389 Food Stamp Enrollees in March 2011
  • Sources Sheboygan County WIC Project Data and
    WI DHS and DCF websites

13
Chronic Disease Prevention and Management
  • Local heart disease rates exceeded State rates
    each year from 2004-2008
  • 27 of deaths in 2008 were due to heart disease
  • Cancer incidence higher in Sheboygan County than
    Wisconsin for the following cancers colon,
    rectal, esophagus, leukemia, melanoma of skin,
    ovary, prostate, and bladder
  • 23 of deaths in 2008 were due to cancer
  • Sources 2008 Public Health Profile, DHS website

14
Chronic Disease Prevention and Management
  • 20.8 of Sheboygan County women 18 years of older
    had no Pap Tests in the past three years
  • 33 of Sheboygan County adults have high
    cholesterol levels
  • 22 of Sheboygan County adults have hypertension
  • 9.2 of Sheboygan County adults have diabetes
    which includes an estimated 2,460 undiagnosed
    adults.
  • Estimated 22,190 persons over age 20 and older
    are pre-diabetic.
  • Sources 2008 Public Health Profile, 2008
    Wisconsin Burden of Diabetes Report

15
Sheboygan County Leading Causes of Death - 2008
Heart Disease (274) Cancer (233)
Cerebrovascular Disease (53) Chronic Lung Disease (52)
Pneumonia and Influenza (30) Diabetes (28)
Accidents (27) Suicide (21)
Source WI DHS Website
16
Communicable Disease Control and Prevention
  • Significant Increase in Sexually Transmitted
    Disease Rates between 2001 and 2010

Year Sheboygan County Wisconsin
2001 188 cases/100,000 462 cases/100,000
2010 296 cases/100,000 500 cases/100,000
2001 data included reports of Genital Herpes
these cases are no longer reported. National
Benchmark is 83 cases per 100,000 Source WI DHS
Website
17
Communicable Disease Control and Prevention
  • 71 Cases of HIV/AIDS have been reported in
    Sheboygan County between 1983 and 2011
  • First local case of multi-drug resistant TB
    reported in 2008. Individual remained infectious
    and in court ordered isolation until death from
    TB in 2010
  • 2009 vaccination coverage levels of children
    19-35 months

Sheboygan County Wisconsin United States
88 75.9 70.5
Sources WI DHS Website, CDC, Local Health
Department Data, and Wisconsin Immunization
Registry
18
Environmental/Occupational Health
  • Childhood lead poisoning remains above
    State/National Average despite marked progress
    (Tested children with elevated results 1995
    15.9, 2010 1.3)
  • Recently released American Lung Association
    Report indicates an F grade related to county
    ozone levels
  • 2011 County Rankings Report indicates Sheboygan
    County with 71 of 72 ranking for air
    pollution-particulate matter days

19
Healthy Growth and Development
  • lt 90 of Pregnant Women Receive First Trimester
    Care

1997 2006 2007 2008
Sheboygan County 89.5 83.9 81.2 85.7
Wisconsin 84.4 83.8 82.4 82.2
20
Healthy Growth and Development
  • 11 of Sheboygan County adults are uninsured
  • Hispanics/Latinos residing in Wisconsin have
    highest rate uninsured rate 23
  • 18,565 enrolled in Medical Assistance in March
    2011
  • 56.7 increase in enrollment in Medical
    Assistance between March 2006 and March 2011
  • (Sources www.forwardhealth.wi.gov/WIPortal/portal
    s/0/staticContent/Member/caseloads/481-caseload.ht
    m and 2011 County Health Rankings)

21
Healthy Growth and Development
  • Aurora Sheboygan and St. Nicholas Hospital
    reported providing over 20 million of
    uncompensated/charity care in 2009
  • Sources Sheboygan Area Community Clinic Grant
    Application 12/2010

22
Mental Health
  • Access to psychiatric care challenging for
    children, those with Medical Assistance, those
    without insurance and those who are underinsured
  • Local suicide rates exceed regional and state
    levels
  • 301 suicides from 1988 to 2009
  • 13 reported suicides in 2010 concern re
    ethnic/racial disparity 4 among minority groups
  • Data Sources County Health Rankings, DHS
    Website/Public Health Profiles, HSC 2020 Mental
    Health Workgroup

23
Mental Health
Greater than 30 increase in crisis calls from
2009 to 2010.
24
Mental Health
25
Oral Health
  • Forward Health/Medicaid billing records
    demonstrate that only 19.5 of persons enrolled
    in Medicaid received dental services in FFY 2008
  • No dental providers in Sheboygan County accept
    new patients if their source of payment is
    Medicaid
  • 379 persons sought ER care at local hospitals for
    dental problems in 2008

Data Sources Dental Access Committee, Forward
Health Website
26
Physical Activity
  • Sheboygan County residents engaging in physical
    activity increased from 2003 to 2008. Percentage
    of those exercising remains below state and
    national levels
  • Percent of residents exercising at CDC
    recommended level (2008)

Exercise at CDC recommended levels Exercise, but less than CDC recommended levels Inactive Do not Exercise
44 38 18
27
Reproductive and Sexual Health
  • Number Births by Year
  • 2000 1437
  • 2010 1324
  • 2009 Teen Birth Rate (Ages 15-19 per 1000 )
  • Sheboygan County 27.45
  • Wisconsin 29.57
  • US Benchmark 22
  • Total Births to Teens 1999-2009 1359
  • Sources WI DHS Website and 2011 County Health
    Rankings

28
Reproductive and Sexual Health
  • Percent of infants born below 5.5 - 7.0
  • Percent of infants born prematurely 11.1
  • 2004-2008 Infant Mortality Rate 5.64/1000 Births
    (WI 6.48/1000)
  • Number of reported induced terminations of
    pregnancy decreased by 46 from 2004-2008
  • (152 to 82)
  • Number enrolled in Family Planning Waiver Medical
    Assistance, March 2010 877 (Source
    https//www.forwardhealth.wi.gov/WIPortal/portals/
    0/staticContent/Member/caseloads/481-caseload.htm)

29
Tobacco Use and Exposure
  • Estimated 20,000 Sheboygan County residents smoke
  • Local adult smoking rates exceed State and
    National rates
  • 17.5 of Sheboygan County High School youth smoke
  • 14 of Sheboygan County deaths smoking related
    estimated 148/year
  • 14.7 of Sheboygan County women smoke during
    pregnancySource Burden of Tobacco Report March
    2010

30
Unhealthy Alcohol and Drug Use
  • County Health Rankings 29 Sheboygan County
    Adults report excessive/binge drinking (Wisconsin
    average 25)
  • National benchmark 8
  • OWI arrest rates higher than Wisconsin average
  • Moderate percentage of alcohol-related motor
    vehicle accident deaths
  • Increase incidence of alcohol and drug related
    hospitalizations
  • 2009 Coroner reports show 7 of 8 undetermined
    deaths (undetermined to be accidental or suicide)
    were related to drug overdose
  • Additional Data Source 2011 County Health
    Rankings 2009 Coroner reports

31
Violence and Injury Prevention
  • 1286 Reports of Child Abuse/Neglect received at
    Sheboygan County DSS in 2008 13 of reports
    substantiated
  • Violent Crime Rate
  • Sheboygan County 116/100,000
  • Wisconsin 283/100,000
  • National Benchmark 100/100,000
  • Motor Vehicle Death Rate
  • Sheboygan 15/100,000
  • Wisconsin 15/100,000
  • National Benchmark 12/100,000
  • Additional Data Source 2011 County Health
    Rankings

32
Violence and Injury Prevention
  • Domestic abuse increased from 2002 through 2009
    576 reports of domestic abuse in 2009
  • 87 of Sheboygan County residents report
    always/nearly always use seat belts (WI 82)
  • Low percentage of adults who use helmets (32)
  • Local Rate of Fall-Related Hospitalizations
    exceeds State Rate (Local Rate 391/100,000)
    (State Rate 376/100,000)

33
Examples of Local Initiatives
  • Dental Access Coalition
  • Healthy Sheboygan 2020
  • Alcohol and Drug Abuse Committee
  • Mental Health Committee
  • Activity and Nutrition Committee
  • Lead Task Force
  • Prevention Policy Committee
  • Team Blue Ribbon
  • Safe Kids Coalition
  • Lakeshore Community Health Clinic
  • Sheboygan County Immunization Coalition
  • Tobacco Free Council

34
Robert Wood J Three Steps to Improve Health
  • Ensure access to care
  • Build preventive care like screening for cancer
    and heart disease into every health care plan and
    make it available to people who otherwise cant
    or wont go in for it, in malls and other places
  • Stop thinking of health as something obtained in
    hospitals and doctors offices but instead as
    something that starts in families, schools,
    workplaces, playgrounds and parks, and in the air
    we breathe and the water we drink.
  • It s time we expand the way we think about
    health to include how to keep it, not just how to
    get it back.

35
2009 Sheboygan County Community Health Needs
Assessment
  • To Review Full Report visit
  • www.healthysheboygancounty.org
  • To Review County Health Rankings visit
  • www.countyhealthrankings.org
  • Other Resources
  • www.informedcaring.org
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