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2007 Community Health Assessment Lee County, Florida

This report provides a comprehensive assessment of the community health in Lee County, Florida in 2007. It includes data from surveys, secondary sources, and indicators related to health status, diseases, modifiable health risks, access to healthcare, and more.

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2007 Community Health Assessment Lee County, Florida

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  1. 2007 PRC Community Health AssessmentLee County, Florida

  2. 2 1 3 4 Data Input for the 2007 Community Health Assessment • 2007 Community Health Survey • Telephone survey of 1,000 adults • Stratified equally among four Market Areas • Administered in both English and Spanish • 148 survey items • 25-30 minute interview • Weighted to be geographically representative • ±3.1% maximum error • Wide benchmarking potential • Florida BRFSS data • U.S. (PRC National Health Survey) • Healthy People 2010 targets Market Area 1: Boca Grande, Bokeelia, Saint James City & Cape Coral Market Area 2: Fort Myers, North Fort Myers & Alva Market Area 3: Southeast Fort Myers & Lehigh Acres Market Area 4: Southwest Fort Myers, Fort Myers Beach, Sanibel, Captiva, Bonita Springs & Estero

  3. Data Input for the 2007 Community Health Assessment • 2007 Community Health Survey (continued) • Indicators Regarding: • Self-Reported Health Status • Disease Conditions • Modifiable Health Risks • Access to Healthcare Services • Health Education & Outreach • Secondary Data • Lee County Public Health & Other Data • Deaths • Reportable Diseases • Births • Violence Two distinct types of data input.

  4. 17.9% “Fair/Poor”

  5. similarly high in Fort Myers and North Fort Myers similar to both state and US

  6. FPL = $20,000 for a family of four 200% FPL = $40,000 for a family of four Note: Sample sizes for Blacks and <FPL were relatively small, but, where noted, differences are statistically significant.

  7. similar to US

  8. Additionally, 10.0% of adults have been diagnosed with major depression by a physician.

  9. Of those able to receive services, 86.0% received these in Lee County.

  10. the region fails to meet available Healthy People 2010 targets, except heart disease, stroke and diabetes

  11. Heart Disease & Stroke • Heart Disease Is the #1 Leading Cause of Death • Accounts for 31.9% of all area deaths (2004) • Death rates are below FL and US; have decreased consistently • Stroke Is the #5 Leading Cause of Death • Accounts for 5.7% of all area deaths (2004) • Death rates are below FL and US; generally declining • Cardiovascular Risk Factors • 36.4% of adults have high blood pressure (similar to US; worse than FL) • 38.5% of adults have high blood cholesterol (worse than US and FL) • 85.1% carry some level of modifiable risk (better than US) • overweight, physically inactive, smoking, high blood pressure/cholesterol

  12. Cancers • Cancers Are the #2 Leading Cause of Death • 24.1% of all area deaths (2004) • Death rates are below FL and US; have declined in recent years • Lung cancer is by far the leading cancer site, followed by breast (women), prostate (men), and colorectal cancers • Cancer Screenings • Colorectal cancer screening (adults 50+) – 74.1% sigmoidoscopy/colonoscopy 37.0% blood stool test • Both better than FL testing levels; sigmoid-/colonoscopy also better than US • Female breast cancer screening (women 40+) – 78.0% • Better than national average; meets Healthy People 2010 target • Prostate cancer screening (men 50+; DRE and/or PSA) – 88.2% • Similar to national testing levels

  13. Diabetes • Death Rates • Below state and US • Rates have fluctuated, but follow a general downward trend • More than 5 times higher among Blacks than among Whites • Prevalence • 12.5% of adults report a diabetes diagnosis • Better than FL, similar to US • Particularly high (17.1%) in Market Area 2 • Particularly high among: • Blacks (32.8%) • Adults 65+ (22.5%) • Households below 200% FPL (16.8%) • Men (15.7%)

  14. especially in Fort Myers similar to US Note: 13.5% of parents report that their child has been diagnosed with asthma (similar to US). Diagnoses are noticeably higher past age 5.

  15. considerably higher than both FL and US; increasing trend 33.0% of accidental deaths are due to motor vehicle crashes;MVC death rates are likewise high in Lee Co. Seat belt usage is better than the national average, except in Market Area 2. Lee County also has relatively high rates for falls and poisonings.

  16. Injury Control • Firearm Safety • 27.6% of homes have a firearm, below the national average (34%). • Higher in Market Area 2. • 29.7% of firearms are kept unlocked and loaded (worse than US = 19.1%). • Pool Safety • 43.1% of Lee County adults have a swimming pool at their house/apartment.(32.6% among households with children aged 1 to 17) • Of these, 37.1% either have no type of safety features for their pool (e.g., alarms, fence), or have safety features, but “never” use them. • 27.9% of households with pools and kids report that their child cannot swim/float • Bicycle Safety • 33.5% of parents of school-aged children say their child “always” wears a helmet when riding a bicycle (similar to US).

  17. Lee County homicide and suicide death rates exceed FL and US rates. Homicide death rates are nearly seven times higher among Blacks than among Whites. Suicide death rates are four times higher among Whites than Blacks.

  18. worse than US Additionally, 1.8% of respondents report being the victim of domestic violence in the past five years (similar to US).

  19. similarly high in Fort Myers and North Fort Myers similar to FL and US

  20. About 40% of these adults report joint or orthopedic problems (arthritis, back/neck, trouble walking, etc.).

  21. each is better than FL; similar to US each is better than US

  22. Infectious Disease • Measles, Mumps, Rubella, Pertussis • Zero cases of measles, mumps, rubella in Lee County between 2003-2005 • Pertussis case rates are very low • Tuberculosis • County rates have dropped and are well below FL and US • HIV/AIDS • HIV deaths are similar to US, but below FL rates • No clear trend • Reported HIV is dramatically higher in the African American community • 53.9% of area adults aged 18 to 64 have ever been tested for HIV • Similar to US, better than FL • Nearly 90% of Black respondents 18-64 have been tested • Sexually Transmitted Diseases • Rates are generally below FL and US rates. • Most are decreasing, although chlamydia is increasing

  23. Percentage has dropped in recent years. Black mothers less often receive timely prenatal care (66.1%).

  24. slightly better than FL; similar to US Despite a recent drop, low-weight births have been increasing in Lee County.

  25. better than both FL and US Rates are improving in Lee County.

  26. Lee County proportion is higher than FL and US proportions. 70.5% of African American births are to unmarried women.

  27. FL = 22.0% Overall teen birth rates are declining, as they are statewide and nationwide.

  28. MODIFIABLE HEALTH RISKS

  29. statistically similar similar to FL & US 64.0% of Lee County adults are overweight or obese. The survey showed strong relationships with many conditions.

  30. ? NOTE: 31.6% of children (aged 2-17) represented in the survey are overweight, much higher than the prevalence found nationwide.

  31. lower fruit consumption better than FL & US Lower among Blacks, lower-income adults.

  32. similar to FL & US

  33. Only 40.9% of adults meet physical activity recommendations (intensity/frequency/duration) - below FL and US. Particularly low in Market Area 2 and among Blacks, low-income adults.

  34. Tobacco • Cigarette Smoking • 15.6% of area adults currently smoke cigarettes • Better than FL and US, but fails to satisfy the Healthy People 2010 target (12%) • However, cessation attempts among current smokers (47.3%) are below US • Cigars & Smokeless Tobacco • Usage is lower than national prevalence levels (but do not meet Healthy People 2010 targets)

  35. Alcohol & Other Substances • Alcohol • Cirrhosis/liver disease deaths are similar to FL, but higher than US • 12.5% of adults are binge drinkers (5+ drinks/occasion) • Better than US,but twice the Healthy People 2010 target • 7.5% of adults are chronic drinkers (2+ drinks/day) • Worse than US • 3.0% of adults acknowledge drinking and driving in the past month • Similar to US • Other Drugs • 1.9% of adults acknowledge using an illicit drug in the past month (similar to US) • 3.1% of adults have ever sought help for an alcohol/drug problem (similar to US)

  36. similar to FL & US The relationship between insurance coverage and the receipt of preventive care was borne out in the survey findings (source of care, checkups, cancer screenings, etc.). In all, 15.4% of adults say they did not receive care in the past year because of a lack of health insurance, having the wrong insurance, or coverage limitations.

  37. Additionally, 8.3% of insured adults went without coverage at some point in the past year (higher among women, young adults, Hispanics, lower incomes)

  38. all similar to US

  39. similar to US

  40. 12.9% of parents report difficulty getting healthcare for a child in the past year (compared to 6.1% nationwide).

  41. Convenience (23.6%) was the top reason, followed by doctor referral (12.9%), cost (9.6%) and quality (9.1%).

  42. US=8.5% No difference among the four Market Areas.

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