2010 Saint - Paul, MN Metro Adult Health Survey for Ramsey County

1. 2010 Saint - Paul, MN Metro Adult Health Survey for Ramsey County

2. In this Talk • What is SHIP? • What is MAHS? • Results from the survey • 1. General Health • 2. Infrastructure & Environment • 3. Health provider – patient interaction • 4. Health behaviors • Recommendations • Next steps

3. What is the Statewide Health Improvement Program (SHIP)? • Part of Minnesota’s health care reform initiative that was signed into law in May 2008 • In 2009, Saint Paul - Ramsey County Public Health received a two-year SHIP grant from the Minnesota Department of Health to create opportunities for healthier choices through policy, systems and environmental change to: • Encourage healthy eating • Encourage physical activity • Reduce tobacco use & exposure

4. Purpose of the Metro Adult Health Survey (MAHS) • Identify opportunities for new and on-going initiatives to support health in Ramsey County. • Provide evidence to support policy recommendations and positive environmental and system changes to enable physical activity and healthy eating and to reduce tobacco use and exposure. • Increase public awareness of ways communities, organizations and employers can be involved in supporting healthy lifestyles of adults.

5. MAHS – Domains and Topics • Six county* survey on : • General health & chronic disease conditions • Eating habits • Physical activity • Tobacco Use • Neighborhood and Community perceptions • Provider health behavior counseling • *Ramsey, Dakota, Washington, Anoka, Carver, Scott

6. Methodology • Use of addresses through random sample of households • Response to survey either through mail or telephone • “Most recent birthday” method used to select one adult respondent within each selected household • 144 questions asked • Total respondents: 3150 adult residents of six counties

7. Survey Respondents

8. Results

9. Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors

10. Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors

11. Health Status – Metro Area (6 Counties) % self reported 9.5 %

12. Percent reporting fair/poor health by county

13. Percent reporting fair/poor health by gender and age (ramsey county) Gender Age

14. Percent reporting fair/poor health by education and household income (ramsey county) aEducational attainment Poverty status

15. Calculated BMI (overweight/obese) by county

16. Perceptions of Weight for Ramsey County Average for all counties= 41.4% % self reported

17. Perceptions of Weight for Ramsey County Ramsey county : 36% All counties: 39% Average for all counties= 41.4% % self reported

18. Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors

19. Infrastructure & Environment for.. Infrastructure for Healthy Food choices Smoke free air Physical Activity Community Resources Reducing Tobacco use and exposure

20. Infrastructure & Environment for.. Healthy Food choices Smoke free air Physical Activity Community Resources Reducing Tobacco use and exposure

21. Access & Barriers to Healthy Food choices

22. Places for purchase of food

23. Places for purchase of food during the growing season

24. Infrastructure & Environment for.. Infrastructure for Healthy Food choices Smoke free air Physical Activity Community Resources Reducing Tobacco use and exposure

25. Availability & use of Community Resources for exercise My community has this and I do not use it My community has this and I use it

26. Awarenessof Community Resources for exercise I don’t know if my community has this

27. Infrastructure & Environment for.. Infrastructure for Healthy Food choices Smoke free air Physical Activity Community Resources Reducing Tobacco use and exposure

28. Perceptions of barriers to smoke free air • Around 48% indicated that they had been near someone, in Minnesota, who was smoking in the past 7 days, not including home, workplace or car. • Sidewalks, building entrances, & restaurants/bars were the most common places that someone was seen smoking. • Among renters(16%), more than half indicated that people in their building smoke in apartments, patios & balconies • 16% have been in a vehicle with someone who was smoking in the past week; 26% of those have a college degree

29. Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors

30. Self report visit • 78.2% had seen a doctor, nurse or other health professional about their health during the past 12 months

31. Health behavior counseling • Among the 78% who visited a health professional, • 56% were asked about their weight • 56% were asked about their diet or nutrition • 56% were asked about smoking or tobacco use • 67 % were asked about their physical activity

32. Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors

33. Food consumption • 38% ate > 5 servings of fruits and vegetables on day prior to the survey • 75% ate > 3 servings of fruits and vegetables on day prior to the survey • 60% eat breakfast everyday in an average week • 50% did not consume milk the day prior to the survey • 75% did not consume pop/soda prior to the survey • 50% ate a meal with their family for > 5 days in an average week • 76% ate a home cooked meal > 5 times in an average week; while 11% ate at a fast food place at least 3 times per week

34. Physical activity

35. Physical activity • 87 % reported participating in any form of physical activity or exercise in the past 30 days • Usual place for exercise • 70% - outdoors (parks, trails) • 68% - at home • 27% - at a health club • 10% - public recreation facility or community center • 47% have over 3 hours of TV and computer time per day (while not at work or school); 55 % of these are high school graduates or less • 67 % reported having sedentary jobs

36. Tops issuesconsidered “big problems” in preventing physical activity • Cost of fitness programs, gym memberships or admission fees (24.2%) • Lack of time (19.8%) • Lack of self-discipline or willpower (17.0%) • Long-term illness, injury or disability (10.3%) • Don’t like to exercise (9.1%) • Lack of athletic ability (8.1%) • Public facilities are not open or available at the times I want to use them (8.3%)

37. Smoking Status 16% are current smokers 16.3% - Minnesota, BRFSS 2009

38. Tobacco use • 27% of those below 200% FPL are current smokers • 24% of18-34 yr olds are current smokers • Among current smokers, half smoke a half pack or more per day

39. Resources to quit smoking

40. Other Tobacco issues • 14% report having used another tobacco product (such as cigars, pipes, snuff, chewing tobacco, bidis) • 31.7% of 18-24 yr olds • 20.2% of males vs. 8% of females • 88% indicated that smoking is NOT ALLOWED anywhere inside the house • 76% indicated that smoking is NEVER allowed any vehicle

41. Summary of Results for ramsey county

42. Good health is not shared equally across populations in Ramsey county. Disparities in health status exist across gender, different educational attainment , income levels and age groups.

43. Health Behaviors • About 30% have been told that they have high blood cholesterol or high blood pressure • 61% are considered overweight or obese according to BMI • 36% of those who considered themselves as ‘about the right weight’ are obese or overweight by BMI • 75% ate > 3 servings of fruits or vegetables on the day prior to the survey • 74% met CDC physical activity recommendations of 150 minutes or more of mod or vigorous activity per week • 16% are current smokers

44. Environment & systems (Food choices) • 43% indicated that although fresh fruits and vegetables were available in their neighborhood, they were too expensive • Only 22% had a farmer’s market or place to pick up CSA that was less than 1 miles from their home • 96% never purchased food / purchased food less than 1 time per month from a food shelf or pantry • Food grown at home/community garden was the most common place for purchase of fresh fruits and vegetables in the growing season

45. Environment & systems (physical activity) • More than 50% reported using walking trails or parks as places for exercising • Only 27% indicated using health clubs even though they were available in the community • Less than 30 % used public recreation centers, swimming pools or schools and colleges for physical activity. • 25% did not know if there existed school or colleges for exercising in the neighborhood, followed by public recreation centers (15%)

46. Environment & systems (tobacco use) • Around 48% indicated that they had been near someone, in Minnesota, who was smoking in the past 7 days, not including home, workplace or car. • Sidewalks, building entrances, & restaurants/bars were the most common places that someone was seen smoking. • More than half of those that rented apartments in multi-unit housing buildings indicated that people in their building smoke in apartments • Around 67% indicated that they did not seek help from professional sources to help them quit smoking • The most common treatment modality among those that sought help was nicotine replacement and prescription medication

47. Environment & systems (health system) • 44% indicated that their providers did not ask about their • weight, • diet or nutrition • smoking or tobacco use • 33 % indicated that their provider asked them about their physical activity level

48. Recommendations (Healthy food choices) • Build infrastructure to facilitate easy access to fresh fruits and vegetables for: • Farmers markets • Local food production • Build infrastructure to facilitate access to health food choices in small grocery stores • Make fresh fruits & vegetables more available & affordable • Future opportunities • Utilize the findings of the present study as a benchmark to measure progress

49. Recommendations (Physical Activity) • Create information hub of community resources to • increase awareness of places for physical activity • Provide affordable places for exercise • Collaborate with health professionals , communities • and organizations to encourage physical activity

50. Recommendations (contd.) • Reduce tobacco use and exposure • Implement smoke free Multi-unit housing policies • Reinforce laws that provide • Provide education and implement policies that reduce tobacco use across all age groups and socio-economic groups. • Patient – provider counseling • Implement clinical guidelines for • weight management • diet or nutrition counseling • tobacco use