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Public Health: Prevent-Promote-Protect Frederick County’s Health

Public Health: Prevent-Promote-Protect Frederick County’s Health. Barbara Brookmyer, MD, MPH Frederick County Health Officer Frederick County Health Department February 22, 2012. Objectives. Review Key Indicators of Health Status and later … Describe State Health Improvement Process

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Public Health: Prevent-Promote-Protect Frederick County’s Health

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  1. Public Health:Prevent-Promote-ProtectFrederick County’s Health Barbara Brookmyer, MD, MPH Frederick County Health Officer Frederick County Health Department February 22, 2012

  2. Objectives • Review Key Indicators of Health Status and later … • Describe State Health Improvement Process • Describe FC’s Local Health Improvement Process • Identify opportunities for you to become engaged 

  3. What is Public Health? Definition: • Protect and improve health of communities and populations through education, promoting healthy lifestyles, and research for disease and injury prevention • How: • Population or community level focus • Surveillance and data gathering • Develop plans, programs, and policies • Implement plans, programs, and policies • Evaluate performance and outcomes Reference:http://www.whatispublichealth.org/what/index.html

  4. Demographics of Frederick County Demographics Frederick Maryland • Total Population* 233,385 5,773,552 Age*, % • Under 5 Years 6.4% 6.3% • Under 18 Years 25.3% 23.4% • 65 Years and Older 11.1% 12.3% Race/Ethnicity*, % • White 81.5% 58.2% • Black 8.6% 29.4% • Native American 0.3% 0.4% • Asian 3.8% 5.5% • Hispanic or Latino origin 7.3% 8.2% Median Household Income**$81,436 $70,017 Households in Poverty**, % 5.5% 8.6% Pop. 25+ W/O H.S. Diploma** 8.4% 12.1% Pop. 25+ With Bachelor's Degree or Above**, % 36.2% 35.6% Sources: *U.S. Census (2010), **American Community Survey (2008-2010)

  5. County Health Rankings • All counties in the US • 3rd year in a row rankings to be released April • Frederick County ranked 3rd overall in health outcomes 2 years in a row! • Frederick County Health Factors rank was 4th • Frederick’s physical environment ranked 16th Reference:http://www.whatispublichealth.org/what/index.html

  6. 2007 Community Health Assessment Areas of Opportunity • Access to Healthcare Services • Routine Medical Care • Availability (Inconvenient Office Hours) • Health Disparities (Low-Income, Minorities) • Death, Disease & Disability • Heart Disease & Stroke • Cancer • Colorectal Cancer (Deaths) • Prostate Cancer (Screening) • Respiratory Disease • Asthma • Chronic Lower Respiratory Disease • Maternal & Infant Health • Prenatal Care • Mental & Emotional Health • Alzheimer’s Disease • Emotional Wellness • Stress • Suicide • Modifiable Health Risks • Overweight & Obesity • Alcohol Abuse • Tobacco Use

  7. 10 Leading Causes of Death in Frederick County, 2010 • Malignant Neoplasms (332 down from 385) • Diseases of the Heart (316 down from 380) • Chronic Lower Respiratory Diseases (92 up from 69) • Cerebrovascular Diseases (88 up from 71) • Accidents (62 up from 50) • Influenza and Pneumonia (46 up from 39) • Alzheimer’s (37 up from 23) • Kidney Disease (31 up from 30) • Diabetes Mellitus (23 down from 27) • Septicemia (23 down from 33) • Intentional Self-Harm (Suicide) (21 down from 32) Reference: http://dhmh.maryland.gov/vsa/Documents/deaths/Frederick.pdf

  8. Incidence Rates for All Cancers 1997-2007: Frederick County, Maryland, and U.S. All Rates are per 100,000. 1997 and 1998 rates are age-adjusted to the 1970 U.S. population, all other years are age-adjusted to the 2000 U.S. standard population Source: Maryland Department of Health and Mental Hygiene CRF Annual Reports 2000-2010.

  9. Frederick County Data:  Heart Disease and Related Risk Factors • Heart disease and cancer are the leading causes of death in Frederick County followed by stroke (Maryland VSA 2007-2009, Table 50).  • Among chronic disease risk factors, 15% of adults smoke, 25% report having high blood pressure and well over a third report having high cholesterol (Maryland BRFSS, 2009).  • 25% of adults are classified as obese; 40% are classified as overweight, which is 5th worst in the State (Maryland BRFSS, 2010).  • 72% of adults, 4th highest in the State, describe their activity level at work as “mostly sitting/standing” (Maryland BRFSS, 2010).  • With regards to chronic disease disparities, the rate (per 100,000) of diabetes-related ED visits is 536 for Blacks vs. 197 for Whites (2.7 times greater), and hypertension-related ED visits is 426.8 for Blacks vs. 142.9 for Whites (3 times greater) (HSCRC, 2010).  • Age-adjusted mortality data for Frederick County also shows that Blacks, when compared to Whites, suffer a higher rate of death from stroke (1.26 times greater), heart disease (1.29 times greater), and diabetes (2 times greater) (Maryland Vital Statistics Annual Report 2009).

  10. # Marylanders Estimated to be Receiving Expanded Preventive Services Under the ACA • Total 1,153,000 • Children 297,000 • Women 448,000 • Men 408,000 • Based on expanded coverage though employer-sponsored health plans • Source = February 2012 ASPE Issue Brief • available on the Internet at:http://aspe.hhs.gov/health/reports/2012/PreventiveServices/ib.shtml accessed February 21, 2012

  11. BMI-For-Age 2 to 18: >=95th PercentileFrederick County / Maryland vs. Healthy People 2020 Target HP Objective NWS-10: Reduce the proportion of children and adolescents who are considered obese (target for ages 2-19). Note: BRFSS data & HP objective- similar but not exact. Maryland Behavioral Risk Factor Surveillance System, BRFSS-2006- 2010, Retrieved from: www.marylandbrfss.org

  12. Adults ever told they had high cholesterol HP Objective HDS-7: Reduce the proportion of adults with high total blood cholesterol levels Maryland Behavioral Risk Factor Surveillance System, BRFSS-2001- 2009, Retrieved from: www.marylandbrfss.org

  13. Ever Had Sigmoidoscopy or Colonscopy Exam - Age 50+ Frederick County / Maryland vs. Healthy People 2020 Target HP Objective C-16: Increase the proportion of adults who receive a colorectal cancer screening based on the most recent guidelines Maryland Behavioral Risk Factor Surveillance System, BRFSS-2002- 2010, Retrieved from: www.marylandbrfss.org

  14. Last Mammogram Less than 2 years ago - Women 40+ Frederick County / Maryland vs. Healthy People 2020 Target HP Objective C-17: Increase the proportion of women who receive a breast cancer screening based on the most recent guidelines Maryland Behavioral Risk Factor Surveillance System, BRFSS-2000- 2010, Retrieved from: www.marylandbrfss.org

  15. Pap Smear Within Past Two Years - Women 18+Frederick County / Maryland vs. Healthy People 2020 Target HP Objective C-15: Increase the proportion of women who receive a cervical cancer screening based on the most recent guidelines Maryland Behavioral Risk Factor Surveillance System, BRFSS-2000- 2010, Retrieved from: www.marylandbrfss.org

  16. Tobacco Use in Frederick County

  17. Frederick County Drunk Driving Fatalities

  18. Coverage Source for Overall Mental Health Related ER Visits

  19. Dental Care - Adults • Calls seeking care received by FCHD >10/wk • Religious Coalition for Emergency Human Needs – # served limited by funding for vouchers: • 2010 = 122 • 2011 = 238 • 2012 = ?>350 • Mission of Mercy free dental services • 2011 = 338 • Others • Dentists – charity care in office • Seton Center • FCAA

  20. Thank You! Frederick County Health Department Is Your Health Department

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