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State of Health in Nevada County. Nevada County Community Leadership Institute February 24, 2012 Jeff Brown, Director Nevada County Health and Human Services Agency. Health & Human Services Agency. Behavioral Health

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State of health in nevada county

State of Health in Nevada County

Nevada County Community Leadership Institute

February 24, 2012

Jeff Brown, Director

Nevada County Health and Human Services Agency


Health human services agency
Health & Human Services Agency

  • Behavioral Health

    • Children’s and adults mental health focused on mentally ill adults and emotionally disturbed children – Medi-Cal is priority

    • Crisis response

    • AOD Treatment

    • Odyssey House & Catherine Lane


Health human services agency1
Health & Human Services Agency

  • Public Health

    • Communicable disease control

    • Emergency preparedness

    • Nursing home visitation

    • Health and Wellness

    • Vital Records

    • Clinic services

    • WIC Nutrition


Health human services agency2
Health & Human Services Agency

  • Social Services

    • Adult and Child Protective Services

    • CalWORKS & Employment Services

    • Safety net programs – Food Stamps, GA, Medi-Cal and CMSP

    • Veteran’s Services


Health human services agency3
Health & Human Services Agency

  • Child Support and Collections

    • Paternity establishment

    • Child support order establishment/enforcement

    • Child & spousal support collection/distribution

    • Medical support establishment/enforcement


Other elements of safety net
Other Elements of Safety Net

  • Clinical medical & behavior health services – hospitals, clinics and private medical providers and therapists

  • Foster families and group homes

  • Family resource centers

  • Non-profit service providers (e.g. hospice, domestic violence, homeless, housing, AOD treatment, child development, etc.)



Nevada county health status
Nevada County Health Status the average Californian?

  • Recent survey using 2003-09 data lists Nevada County overall health outcomes ranking as 11th best of 56 California counties rated!


Health is most dependent on
Health is most dependent on? the average Californian?

  • Access to quality health care

  • Social factors --- education, housing, employment, income, neighborhood, etc.

  • Genetics


Determinants of health
Determinants of Health the average Californian?

  • Access to quality medical care only determines 15-20% of a person’s health.

  • Up to 75% of a person’s health is dependent on the social determinants of health --- housing, education, employment, income, neighborhood, social support


Children and adolescent indicators

Children and Adolescent Indicators the average Californian?


Persons under 18 in poverty
% Persons Under 18 in Poverty the average Californian?

California County Health Status Profiles 2011


Vital statistics 2004 2011
Vital Statistics the average Californian?2004-2011


Vital statistics
Vital Statistics the average Californian?

2011 – 875 births

  • 464 Sierra Nevada Memorial Hospital (SNMH); 354 Tahoe Forest Hospital (TFH); 57 home births

    2010 – 900 births

  • 457 SNMH; 394 (TFH); 49 home births

    2009 – 916 births

  • 465 SNMH; 417 TFH; 34 home births

    2008 - 1,047 births

    - 542 SNMH; 472 TFH; 33 home births

    2007 - 1,040 births

    - 477 SNMH; 516 TFH; 47 home births

    2006 – 965 births

    - 480 SNMH; 446 TFH; 39 home births


Estimate of child vaccination rates
Estimate of Child Vaccination Rates the average Californian?

  • 55%

  • 75%

  • 90%


Immunizations
Immunizations the average Californian?

73.0% of Kindergarteners have obtained all required immunizations

17.7% of Kindergarteners have Personal Belief Exemptions (PBE)

California Department of Public Health 2011


Immunizations1
Immunizations the average Californian?

Percentage of Nevada County Children

2 - 4 years of age with all recommended

vaccinations in licensed childcare

2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10

California 93.4% 93.7% 93.3% 93.6% 93.5% 92.9% 91.9%

Nevada Co. 81.7% 76.5% 77.6% 76.1% 74.4% 71.7% 71.9%

Vaccine Preventable Diseases and Immunization Coverage in California, SIRE, Immunization Branch California Department of Public Health (CDPH)


Children s dental insurance 2007
% Children’s Dental Insurance 2007 the average Californian?

CHIS 2007


Children s health insurance 2007 2009
% Children’s Health Insurance 2007 & 2009 the average Californian?

CHIS 2007 & 2009


3 rd graders with cavities
3 the average Californian?rd Graders with Cavities

HP 2010 Goal – 42%

Nevada County PHD Healthy Smiles 2007 Survey


3 rd graders with untreated dental decay
3 the average Californian?rd Graders with Untreated Dental Decay

Nevada County PHD Healthy Smiles 2007 Survey


7 th grade school fitness zone results not passing
7 the average Californian?th Grade School Fitness Zone Results - % Not Passing

California Dept of Education 2010-11 Physical Fitness Report



Children with entries into foster care
Children with Entries into Foster Care Week

Center for Social Services Research, UC Berkeley, 7/2011


Prevalence of children in foster care
Prevalence of Children in WeekFoster Care

Center for Social Services Research, UC Berkeley 2/2011


Ozone of days above state 8 hr standard
Ozone - # of Days Above State Week8 hr Standard

California Air Resources Board, 2011


Asthma
Asthma Week

  • Approximately 1.7 million children in California have been diagnosed with asthma.

    The Burden of Asthma in California, A Surveillance Report June 2007, California Department of Health Services.

  • Nevada County’s age adjusted rate (per 10,000) for asthma hospitalizations for the years 2000-2005 is 6.0 (368 cases) compared with the state of California 10.5 (220,777 cases)

    The Burden of Asthma in California, A Surveillance Report June 2007, California Department of Health Services


Of teens diagnosed with asthma
% of Teens Diagnosed with Asthma Week

CHIS 2007 & 2009


Nevada county teens substance of choice
Nevada County Teens’ Substance of Choice Week

  • Methamphetamine

  • Marijuana

  • Alcohol

  • Prescription Pain Killers



Students using prescription painkillers 4 or more times

12 Week

10

8

Percent

6

4

2

0

NJUHSD 9th Graders

NJUHSD 11th Graders

TTUSD 9th Graders

TTUSD 11th Graders

2007-08

2009-10

% Students Using Prescription Painkillers 4 or More Times


Teen birthrates ages 15 19
Teen Birthrates Ages 15-19 Week

California County Health Status Profiles 2011



Vital statistics leading causes of death for 2010
Vital Statistics WeekLeading Causes of Death for 2010

  • Male

    • Heart Disease

    • Prostate Cancer

    • Chronic Obstructive Pulmonary Disease (COPD)

    • Pneumonia

    • Lung Cancer

  • Female

    • Heart Disease

    • Pneumonia

    • Lung Cancer

    • Breast Cancer

    • COPD

    • Alzheimer’s Disease/Dementia

Nevada County PHD 2010




Communicable diseases incidence rates per 100 000
Communicable Diseases – Incidence Rates per 100,000 Week

California County Health Status Profiles 2011



Adults with chronic diseases
% Adults with Chronic Diseases Week

CHIS 2009

*Data from CHIS 2005

^Data from CHIS 2007


State of health in nevada county

2008 County-level Estimates Diabetes Adults Weekaged ≥ 20 years

Age-adjusted percent

www.cdc.gov/diabetes


Health dental insurance
Health & Dental Insurance Week

*Dental is CHIS 2007 data

CHIS 2009


Mental health
Mental Health Week

  • 4.7% of county adults likely had psychological distress within the last year

  • 13.7% of residents needed help for emotional/mental health problems or alcohol/substance abuse issues

  • 11.5% had thoughts of committing suicide

CHIS 2009


Group with greatest suicides
Group with Greatest Suicides Week

  • 0-17 years of age

  • 18-39 years of age

  • 40-64 years of age

  • 65+ years of age


Of suicides by age group 2011
% of Suicides by Age Group 2011 Week

Sheriff/Coroner 2011


Suicide deaths 1991 2011
Suicide deaths 1991-2011 Week

California County Health Status Profiles, CDPH, & Nevada County Chief Deputy Coroner/NC Sheriff’s Office


State of health in nevada county

AOD Related WeekArrests 2001-2009

1,600

1,400

Controlled Substances

1,200

Marijuana Possession

Meth Possession

1,000

DUI

Drunk in Public

Number of Arrests

800

600

400

200

-

2001

2002

2003

2004

2005

2006

2007

2008

2009

Year


Drug induced deaths 2002 09
Drug Induced Deaths, 2002-09 Week

Nevada County Sheriff’s Department Coroner Report


Adult current smoker
Adult Current Smoker Week

CHIS 2009




State of health in nevada county

Obesity Trends Among U.S. Adults Weekbetween 1985 and 2010

  • Definitions:

  • Obesity: Body Mass Index (BMI) of 30 or higher.

  • Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, specifically the adult’s weight in kilograms divided by the square of his or her height in meters.


State of health in nevada county

Obesity Trends* Among U.S. Adults WeekBRFSS,1990, 2000, 2010

(*BMI 30, or about 30 lbs. overweight for 5’4” person)

2000

1990

2010

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Obesity trends among u s adults brfss 1985
Obesity Trends* Among U.S. Adults WeekBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%


Obesity trends among u s adults brfss 1986
Obesity Trends* Among U.S. Adults WeekBRFSS, 1986

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%


Obesity trends among u s adults brfss 1987
Obesity Trends* Among U.S. Adults WeekBRFSS, 1987

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%


Obesity trends among u s adults brfss 1988
Obesity Trends* Among U.S. Adults WeekBRFSS, 1988

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%


Obesity trends among u s adults brfss 1989
Obesity Trends* Among U.S. Adults WeekBRFSS, 1989

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%


Obesity trends among u s adults brfss 1990
Obesity Trends* Among U.S. Adults WeekBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%


Obesity trends among u s adults brfss 1991
Obesity Trends* Among U.S. Adults WeekBRFSS, 1991

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%


Obesity trends among u s adults brfss 1992
Obesity Trends* Among U.S. Adults WeekBRFSS, 1992

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%


Obesity trends among u s adults brfss 1993
Obesity Trends* Among U.S. Adults WeekBRFSS, 1993

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%


Obesity trends among u s adults brfss 1994
Obesity Trends* Among U.S. Adults WeekBRFSS, 1994

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%


Obesity trends among u s adults brfss 1995
Obesity Trends* Among U.S. Adults WeekBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%


Obesity trends among u s adults brfss 1996
Obesity Trends* Among U.S. Adults WeekBRFSS, 1996

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%


Obesity trends among u s adults brfss 1997
Obesity Trends* Among U.S. Adults WeekBRFSS, 1997

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%


Obesity trends among u s adults brfss 1998
Obesity Trends* Among U.S. Adults WeekBRFSS, 1998

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%


Obesity trends among u s adults brfss 1999
Obesity Trends* Among U.S. Adults WeekBRFSS, 1999

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%


Obesity trends among u s adults brfss 2000
Obesity Trends* Among U.S. Adults WeekBRFSS, 2000

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%


Obesity trends among u s adults brfss 2001
Obesity Trends* Among U.S. Adults WeekBRFSS, 2001

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


State of health in nevada county

Obesity Trends* Among U.S. Adults WeekBRFSS, 2002

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


Obesity trends among u s adults brfss 2003
Obesity Trends* Among U.S. Adults WeekBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


Obesity trends among u s adults brfss 2004
Obesity Trends* Among U.S. Adults WeekBRFSS, 2004

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


Obesity trends among u s adults brfss 2005
Obesity Trends* Among U.S. Adults WeekBRFSS, 2005

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Obesity trends among u s adults brfss 2006
Obesity Trends* Among U.S. Adults WeekBRFSS, 2006

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Obesity trends among u s adults brfss 2007
Obesity Trends* Among U.S. Adults WeekBRFSS, 2007

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Obesity trends among u s adults brfss 2008
Obesity Trends* Among U.S. Adults WeekBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Obesity trends among u s adults brfss 2009
Obesity Trends* Among U.S. Adults WeekBRFSS, 2009

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


Obesity trends among u s adults brfss 2010
Obesity Trends* Among U.S. Adults WeekBRFSS, 2010

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


2011 homeless count
2011 Homeless Count Week

190 individuals (vs 345 individuals 2009)

Chronically homeless – 21%

Veterans – 6%

Severely mentally ill - 25%

Chronic substance abuse – 26%

HIV/AIDS – 1%

Domestic violence victims – 15%


2009 homeless count
2009 Homeless Count Week

345 Individuals

Sex – 68% Male 32% Female

Transitional Aged Youth 18-24 years – 29%

Veterans – 13%


2009 homeless count race ethnicity
2009 Homeless Count - Race/Ethnicity Week

Caucasian – 89.9%

American Indian – 7.1%

Hispanic – 6.3%

African American – 2.6%

Other – 1.6%


2009 homeless count housing barriers
2009 Homeless Count Housing Barriers Week

Disabled – 55%

Chronic substance abuse – 40%

Physically Disabled – 31%

Mental Illness – 31%

Co-occurring disorder – 13%

Learning disabilities – 9%

HIV/AIDS – 1%

Past Foster Care – 43%

Domestic/family violence – 13%


References
References Week

  • mynevadacounty.com

  • www.chis.ucla.edu/

  • http://www.wested.org/chks/