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2010 Saint - Paul, MN Metro Adult Health Survey for Ramsey County. 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
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2010 Saint - Paul, MN Metro Adult Health Survey for Ramsey County
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
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
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.
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
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
Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors
Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors
Health Status – Metro Area (6 Counties) % self reported 9.5 %
Percent reporting fair/poor health by gender and age (ramsey county) Gender Age
Percent reporting fair/poor health by education and household income (ramsey county) aEducational attainment Poverty status
Perceptions of Weight for Ramsey County Average for all counties= 41.4% % self reported
Perceptions of Weight for Ramsey County Ramsey county : 36% All counties: 39% Average for all counties= 41.4% % self reported
Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors
Infrastructure & Environment for.. Infrastructure for Healthy Food choices Smoke free air Physical Activity Community Resources Reducing Tobacco use and exposure
Infrastructure & Environment for.. Healthy Food choices Smoke free air Physical Activity Community Resources Reducing Tobacco use and exposure
Infrastructure & Environment for.. Infrastructure for Healthy Food choices Smoke free air Physical Activity Community Resources Reducing Tobacco use and exposure
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
Awarenessof Community Resources for exercise I don’t know if my community has this
Infrastructure & Environment for.. Infrastructure for Healthy Food choices Smoke free air Physical Activity Community Resources Reducing Tobacco use and exposure
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
Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors
Self report visit • 78.2% had seen a doctor, nurse or other health professional about their health during the past 12 months
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
Results divided in to 4 sections.. 1. Health Status 2. Infrastructure & Environment 3. Health provider - patient interaction 4. Health behaviors
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
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
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%)
Smoking Status 16% are current smokers 16.3% - Minnesota, BRFSS 2009
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
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
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.
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
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
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%)
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
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
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
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
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