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

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. As a Nation We Can Do Better….

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

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  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 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_and_labor_force_estimates

  10. 2010 Age Distribution: Local, State, National Levels 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 Source WI DHS Website

  16. Communicable Disease Control and Prevention Significant Increase in Sexually Transmitted Disease Rates between 2001 and 2010 *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 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 < 90% of Pregnant Women Receive First Trimester Care

  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/portals/0/staticContent/Member/caseloads/481-caseload.htm 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)

  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 can’t or won’t go in for it, in malls and other places Stop thinking of health as something obtained in hospitals and doctor’s 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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