Community Health Report: Health Status and Access in Northwest Ohio
This community health report, commissioned by various organizations in Northwest Ohio, covers a wide range of health topics including cardiovascular health, cancer, diabetes, mental health, and more. The report aims to provide insights into health status, perceptions, access to care, and utilization of health services in the region.
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Community Release December 14, 2016 Britney Ward, MPH Hospital Council of Northwest Ohio
Commissioned by: Four County ADAMhs Board Fulton County Auditor s Office Fulton County Board of Developmental Disabilities Fulton County Commissioners Office Fulton County Family & Children First Council Fulton County Health Center Fulton County Health Department Fulton County Job & Family Services Fulton County Schools Fulton County Sheriff s Office Four County Family Center/ Comprehensive Crisis Care Healthy Choices Caring Communities Northwestern Ohio Community Action Ohio State University Extension Sauder Woodworking Company United Way of Fulton County Village of Delta Police Department Wauseon Police Department Recovery Services of Northwest Ohio
Funders Four County ADAMhs Board Fulton County Board of Developmental Disabilities Fulton County Health Center Fulton County Health Department Fulton County Family & Children First Council Healthy Choices Caring Communities Fulton County Job & Family Services United Way of Fulton County
Acknowledgements Project Management, Secondary Data, Data Collection, & Report Development Hospital Council of Northwest Ohio Britney L. Ward, MPH, Director of Community Health Improvement Margaret Wielinski, MPH, Assistant Director of Community Health Improvement Selena Coley, MPH, Community Health Improvement Coordinator Emily A. Golias, MPH, CHES, Community Health Improvement Coordinator Tessa Elliott, MPH, Community Health Improvement Coordinator Emily Stearns, MPH, CHES, Community Health Improvement Coordinator Derick Sekyere, MPH, Graduate Assistant, University of Toledo Ellison Roselle, Graduate Assistant, University of Toledo Samantha Schroeder, Consultant Data Collection & Analysis James H. Price, Ph.D., MPH, Professor Emeritus of Health Education, University of Toledo Joseph A. Dake, Ph.D., MPH, Professor of Health Education, University of Toledo Timothy R. Jordan, Ph.D., M.Ed., Professor of Health Education, University of Toledo
Overview Health Status Perceptions Health Care Coverage Health Care Access and Utilization Cardiovascular Health Cancer Diabetes Arthritis Asthma and Other Respiratory Disease Adult and Youth Weight Status Adult and Youth Tobacco Use Adult and Youth Alcohol Consumption Adult and Youth Drug Use Women s Health Men s Health Preventive Medicine and Health Screenings Adult and Youth Sexual Behavior Quality of Life Social Determinants of Health Adult and Youth Mental Health and Suicide Oral Health Youth Safety Youth Violence Issues Child Health and Functional Status Child Health Insurance, Access, Utilization, and Medical Home Early Childhood Middle Childhood Family Functioning, Neighborhood, and Community Characteristics
Methodology Design Written surveys Instrument Development Majority of questions from BRFSS, YRBSS and NSCH (CDC) Procedure Adults: 4-wave mailing campaign, $2 bills Youth: schools & grades randomly selected, surveys administered in classrooms, passive permission slips Children: Collected by community partners at various venues, Fulton County Health Department facilitated collection efforts and entered the data
Methodology Adult 1,200 adults ages 18 and over Response Rates 47% (n=531: CI= 4.22) Power analysis #: 379 Youth Response Rates 90% (n=460: CI= + 4.3) Power analysis #: 355 Child 304 completed surveys
Methodology Data Analysis Analyzed using SPSS 23.0 Data weighted to reflect population statistics Limitations Adult data collection: CDC-telephone surveys Self-reported Data IRB Approval Chesapeake Research Review Inc., Columbia, Maryland Review methodology, surveys, and letters
Keep in Mind Each graph Secondary Data Portion of report Regional comparisons
Comparisons Visit The Hospital Council of Northwest Ohio website at http://www.hcno.org to view individual health assessments and compare indicators through Data Link.
Demographics of Survey Population Race/Ethnicity White 90% African American 0% American Indian/Alaska Native 1% Other 3% Hispanic 4%
Demographics of Survey Population Marital Status Never Married/ Unmarried Couple, 20% Married,61% Divorced/ Separated, 12% Widowed, 6% * Percentages may not add to 100% due to missing data (non-responses).
Demographics of Survey Population Education High School Diploma, 39% Some College/College Graduate, 56% Less than High School Diploma, 3% * Percentages may not add to 100% due to missing data (non-responses).
Demographics of Survey Population Income $50,000-$74,999, 22% $25,000-$49,999, 28% $75,000 plus, 19% $15,000-$24,999, 8% $14,999 and less, 8% * Percentages may not add to 100% due to missing data (non-responses).
HEALTH STATUS PERCEPTIONS
Adult Health Status Perceptions General Health Status 50% of Fulton County adults rated their health as excellent or very good 12% as fair or poor 21% rated their mental health as not good on 4 or more days in the previous month 17% reported their physical health was not good on 4 or more days in the previous month 19% of adults reported that poor mental or physical health kept them from doing usual activities such as self-care, work, or recreation
Adult Health Status Perceptions Fulton County Adult Health Perceptions* 3% 100% 11% 10% 11% 10% 12% 9% 13% 15% 14% 29% 80% 35% 38% 42% 36% 39% 37% 38% 42% 60% 56% 40% 68% 52% 50% 55% 50% 51% 52% 49% 44% 20% 29% 0% Total Males Females Under 30 30-64 years 65 & Over Income <$25K Income $25K Plus Fulton 2005 Fulton 2012 Excellent/Very Good Good Fair/Poor *Respondents were asked: Would you say that in general your health is excellent, very good, good, fair or poor?
Adult Health Status Perceptions Fulton County 2005 Fulton County 2012 Fulton County 2016 Ohio 2014 U.S. 2014 Adult Comparisons Rated health as excellent or very good Rated health as fair or poor Rated their mental health as not good on four or more days in the previous month Average days that physical health not good in past month Average days that mental health not good in past month Average days that poor physical or mental health kept them from doing their usual activities in past month 51% 49% 50% 51% 53% 13% 9% 12% 18% 17% 20% 17% 21% N/A N/A N/A 3.1 3.2 3.9* 3.7* N/A 2.6 3.2 3.9* 3.5* N/A 1.6 2.1 2.3* 2.4* ***2010 BRFSS Data
Health Care Coverage 95% of adults had health care coverage 5% were without coverage Increasing to 14% of those with incomes less than $25,000 Compared to 10% for Ohio and 13% for the U.S. (2014 BRFSS) 2% of adults with children did not have healthcare coverage, compared to 7% of those who did not have children living in their household
Health Care Coverage Fulton County adult health care coverage includes the following: Medical (99%) Prescription coverage (93%) Fulton County physicians (88%) Fulton County facilities (77%) Immunizations (76%) Preventive health (73%) Outpatient therapy (66%) Dental (62%) Vision (62%) Their spouse (59%) Mental health (56%) Their children (51%) Mental health counseling (48%) Home care (31%) Alcohol and drug treatment (29%) Skilled nursing (29%) Hospice (23%) Long term care (22%) Their partner (19%) Transportation (11%) Assisted living (6%)
Health Care Coverage The top reasons uninsured adults gave for being without health care coverage were: They lost their job or changed employers (35%) They could not afford to pay the premiums (21%) Their employer did not/stopped offering coverage (11%) (Percentages do not equal 100% because respondents could select more than one reason)
Health Care Coverage Source of Health Coverage for Fulton County Adults Self-purchased 5% Medicare 13% Medicaid 7% Other 2% Someone Else's Employer 15% Employer 43% Military 1% Health Insurance Marketplace 2% Multiple-private sources 8% Multiple-govt. sources 4%
Health Care Coverage Uninsured Fulton County Adults 20% 14% 10% 9% 10% 7% 5% 5% 5% 4% 3% 1% 0% Total Males Females Under 30 30-64 Years 65 & Over Income <$25K Income $25K Plus Fulton 2005 Fulton 2012
Health Care Coverage Fulton County 2005 Fulton County 2012 Fulton County 2016 Ohio 2014 U.S. 2014 Adult Comparisons Uninsured 10% 9% 5% 10% 13%
Health Care Access 54% of Fulton County adults visited a doctor for a routine checkup in the past year Increasing to 71% of those over the age of 65 66% of adults went outside of Fulton County for the following health care services in the past year: Vision services (26%) Dental services (25%) Specialty care (22%) Primary care (20%) Obstetrics/ gynecology/NICU (10%),
Health Care Access Adults visited the following places for health care services or advice: Doctor s office (55%) Multiple places-including a doctor s office (19%) Family and friends (5%) Internet (4%) Multiple places-not including a doctor s office (4%) Chiropractor (2%) Urgent care center (2%) Department of Veteran s Affairs (VA) (1%) Hospital emergency room (1%) Walk-in health center (1%) Etc. 5% of adults indicated they had no usual place for health care services
Health Care Access Fulton County adults had the following issues regarding their healthcare coverage: Deductibles were too high (29%) Premiums were too high (20%) Co-pays were too high (18%) High HSA account deductible (13%) Opted out of certain coverage because they could not afford it (8%) Service not deemed medically necessary (6%) Limited visits (5%) Provider/facility no longer covered (5%) Opted out of certain coverage because they did not need it (5%) Could not understand their insurance plan (3%) Working with their insurance company (3%) Etc.
Cardiovascular Health 5% of Fulton County adults reported they had survived a heart attack Increasing to 10% of those over the age of 65 Compared to 5% for Ohio and 4% for the U.S. (2014 BRFSS) 1% of adults reported they had survived a stroke Increasing to 3% of those over the age of 65 Compared to 4% for Ohio and 3% for U.S. (2014 BRFSS) 4% of adults reported they had angina or coronary heart disease Increasing to 7% of those over the age of 65 Compared to 5% for Ohio and 4% for U.S. (2014 BRFSS)
Cardiovascular Health 37% were diagnosed with high blood pressure Compared to 34% for Ohio and 31% for the U.S. (2013 BRFSS) 75% of adults with high blood pressure were taking medication for their high blood pressure 32% were diagnosed with high blood cholesterol Compared to 38% for both Ohio and U.S. (2013 BRFSS) 81% of adults had their blood cholesterol checked in the past five years Compared to 78% for Ohio and 76% for U.S. (2013 BRFSS)
Cardiovascular Health Fulton County Adults with CVD Risk Factors 50% 43% 37% 32% 30% 25% 13% 11% 0% Obesity High Blood Pressure High Blood Cholesterol Sedentary Smoking Diabetes
Cardiovascular Health Fulton County 2005 N/A Fulton County 2012 1% Fulton County 2016 4% Ohio 2014 U.S. 2014 Adult Comparisons Had angina 5% 4% Had a heart attack 5% 2% 5% 5% 4% Had a stroke 2% 1% 4% 4% 3% Had high blood pressure 26% 32% 37% 34%* 31%* Had high blood cholesterol Had blood cholesterol checked within past 5 years 24% 29% 32% 38%* 38%* 61% 77% 81% 78%* 76%* N/A Not available *2013 BRFSS Data
Cancer 15% of Fulton County adults were diagnosed with cancer at some point in their lives.
Diabetes 11% of Fulton County adults were diagnosed with diabetes Increasing to 20% of those over the age of 65 and 23% of those with incomes less than $25,000 Compared to Ohio 12% and U.S. 10% (2014 BRFSS) 6% of adults had been diagnosed with pre-diabetes Fulton County adults diagnosed with diabetes also had one or more of the following characteristics or conditions: 90% were obese or overweight 69% had been diagnosed with high blood cholesterol 62% had been diagnosed with high blood pressure
Diabetes Adults with diabetes saw a doctor, nurse, or other health professional for their diabetes an average of 3.2 times in the past year. Fulton County 2005 Fulton County 2012 Fulton County 2016 Ohio 2014 U.S. 2014 Adult Comparisons Diagnosed with diabetes 8% 9% 11% 12% 10%
Arthritis 39% of Fulton County adults were told by a health professional that they had some form of arthritis Increasing to 68% of those over the age of 65 Compared to 31% for Ohio and 26% for the U.S. (2014 BRFSS) Fulton County 2005 Fulton County 2012 Fulton County 2016 Ohio 2014 U.S. 2014 Adult Comparisons Diagnosed with arthritis 23% 27% 39% 31% 26%
Adult Weight Status 75% of all Fulton County adults were either overweight or obese by Body Mass Index (BMI) 43% of adults were obese Compared to Ohio 33% and U.S. 30% (2014 BRFSS) 50% of adults were trying to lose weight 30% were trying to maintain their current weight or keep from gaining weight 2% were trying to gain weight
Adult Weight Status Fulton County adults did the following to lose weight or keep from gaining weight: Ate less food, fewer calories, or foods low in fat (47%) Drank more water (44%) Exercised (41%) Ate a low-carb diet (10%) Used a weight loss program (3%) Bariatric surgery (2%) Health coaching (2%) Smoked cigarettes (2%) Etc.
Adult Weight Status 4% of adults ate 5+ servings of fruits and vegetables per day 29% ate 3-4 servings per day 63% of adults ate 1-2 servings of fruits and vegetables per day Fulton adults reported the following barriers in consuming fruits and vegetables: Too expensive (9%) Did not know how to prepare (3%) Did not like the taste (7%) Etc. 49% of adults engaged in some type of physical activity at least 30 minutes on 3 or more days per week 30% of adults did not participate in any physical activity in the past week
Adult Weight Status Fulton County adults reported the following reasons they chose the types of food they ate: Taste (60%) Time (30%) Enjoyment (53%) What their spouse prefers (28%) Cost (48%) Nutritional content (24%) Ease of preparation (44%) Calorie content (19%) Healthiness of food (44%) What their child prefers (15%) Food they re used to (32%) If it is organic (5%) Availability (31%) Etc. Adults ate out in a restaurant or brought home take-out food an average of 2.3 times per week
Adult Weight Status Fulton County Adult BMI Classifications 100% 34% 32% 36% 80% 43% 42% 42% 45% 42% 47% 53% 60% 32% 35% 35% 32% 32% 27% 40% 32% 37% 31% 22% 36% 20% 28% 31% 28% 26% 24% 25% 24% 22% 21% 0% Total Male Female Under 30 30-64 Years 65 & Over Income < Income $25K Plus Fulton 2005 Fulton 2012 $25K Normal Overweight Obese
Adult Weight Status Fulton County 2005 Fulton County 2012 Fulton County 2016 Ohio 2014 U.S. 2014 Adult Comparisons Obese 34% 36% 43% 33% 30% Overweight 35% 35% 32% 34% 35%
Adult Tobacco Use 13% of all Fulton County adults were current smokers Compared to Ohio 21% and U.S. 18% (2014 BRFSS) 26% were former smokers 25% for Ohio and the U.S. (2014 BRFSS) Fulton County adults used the following tobacco products in the past year: Cigarettes (20%) Snuff (2%) E-cigarettes (8%) Cigarillos (1%) Cigars (5%) Little cigars (1%) Chewing tobacco (4%) Pipes (1%) Black and Milds (2%) Swishers (1%) Roll-your-own (2%)
