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2015 PRC Community Health Needs Assessment

2015 PRC Community Health Needs Assessment. Clinton County, Ohio. Prepared for: HealthFirst for Clinton County By Professional Research Consultants, Inc. Customized Local PRC Community Health Survey. BENCHMARKING Prior Local Survey Data (1996, 2001) PRC National Health Survey

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2015 PRC Community Health Needs Assessment

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  1. 2015 PRC Community Health Needs Assessment • Clinton County, Ohio Prepared for: HealthFirst for Clinton County By Professional Research Consultants, Inc.

  2. Customized LocalPRC Community Health Survey BENCHMARKING Prior Local Survey Data (1996, 2001) PRC National Health Survey Ohio BRFSS data Healthy People 2020 targets National vital statistics data PRC Community Health Needs Assessment • Random-sample survey among 400 adults in Clinton County • 137 survey items; 25-30 minute interview • ±4.9% max error overall Secondary Data Online Key Informant Survey • Online Key Informant Survey among 88 community stakeholders: • Public health, physicians & other health providers • Social services & other community leaders

  3. Population & Survey Sample Characteristics(Clinton County, 2015) Sources: ● Census 2010, Summary File 3 (SF 3). US Census Bureau. ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc.

  4. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results 14 Identified Needs

  5. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  6. Self-Reported Health Status(Clinton County, 2015) “Fair/Poor” = 17.1% “Excellent/Very Good” = 45.2% Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 5] Notes: ● Asked of all respondents.

  7. Experience “Fair” or “Poor” Overall Health Clinton County Statistically similar to previous findings Statistically similar to OH & US Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 5] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 Ohio data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

  8. Experience “Fair” or “Poor” Overall Health(Clinton County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 5] Notes: ● Asked of all respondents. ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

  9. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  10. Healthcare Insurance Coverage(Among Adults Age 18-64; Clinton County, 2015) • Private insurance = 60.4% • Gov’t insurance = 28.5% • No insurance = 11.1% • Men are much more likely to be uninsured (19.2%). • No significant change since 1996. Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 165] Notes: ● Reflects respondents age 18 to 64.

  11. Barriers to Access Have Prevented Medical Care in the Past Year Significantly worse than US (11.0%). Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 7-12] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● 1996 data not available for cost of prescription, inconvenient office hours, or difficulty finding a doctor.

  12. Experienced Difficulties or Delays of Some Kindin Receiving Needed Healthcare in the Past Year(Clinton County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 169] Notes: ● Asked of all respondents. ● Represents the percentage of respondents experiencing one or more barriers to accessing healthcare in the past 12 months. ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

  13. Have a Specific Source of Ongoing Medical CareHealthy People 2020 Target = 95.0% or Higher [All Ages] • Also: • 66.8% of adults (and 92.8% of children) have had a routine checkup in the past year (similar to and better than US, respectively). • The Clinton County ratio of primary care physicians to population is similar to state and national ratios. • ER usage appears similar to US. • 20.7% of respondents perceive local healthcare as “fair” or “poor,” significantly higher than in 1996 (7.6%). Similar to US (76.3%) Clinton County Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 166] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AHS-5.1] Notes: ● Asked of all respondents.

  14. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  15. Leading Causes of Death(Clinton County, 2011-2013) Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● CLRD is chronic lower respiratory disease.

  16. Age-Adjusted Cancer Death Rates by Site(2004-2013 Annual Average Deaths per 100,000 Population) Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov

  17. Cancer Incidence Rates by Site(Annual Average Age-Adjusted Incidence per 100,000 Population,2007-2011) Sources: ● State Cancer Profiles: 2007-11. ● Retrieved September 2015 from Community Commons at http://www.chna.org. Notes: ● This indicator reports the age adjusted incidence rate (cases per 100,000 population per year) of cancers, adjusted to 2000 US standard population age groups (under age 1, 1-4, 5-9, ..., 80-84, 85 and older). This indicator is relevant because cancer is a leading cause of death and it is important to identify cancers separately to better target interventions. Survey data also reveal an increase in skin cancer prevalence from 2.7% to 9.0% between 1996 and 2015.

  18. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  19. Alzheimer's Disease: Age-Adjusted Mortality(2011-2013 Annual Average Deaths per 100,000 Population) 20.3% of Clinton County residents age 45+ report more/worsening confusion or memory loss in the past year. Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population.

  20. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  21. Diabetes: Age-Adjusted Mortality(2011-2013 Annual Average Deaths per 100,000 Population)Healthy People 2020 Target = 20.5 or Lower (Adjusted) Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective D-3] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population. ● The Healthy People 2020 target for Diabetes is adjusted to account for only diabetes mellitus coded deaths.

  22. Prevalence of Diabetes Clinton County Another 7.0% of adults report that they have been diagnosed with “pre-diabetes” or “borderline” diabetes (vs. 5.1% nationwide) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 136] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 Ohio data. Notes: ● Asked of all respondents. ● Local and national data exclude gestation diabetes (occurring only during pregnancy).

  23. Prevalence of Diabetes(Clinton County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 136] Notes: ● Asked of all respondents. ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● Excludes gestation diabetes (occurring only during pregnancy).

  24. Diabetes Key Informants: Diabetes ranked as the #4 top health issue in the Online Key Informant Survey. • Key informants’ concern regarding diabetes reflected issues with: • Lack of Education/Awareness • Lack of Providers/Resources • Availability/Affordability of Medications • Lifestyle • Prevalence/Incidence Almost half of the respondents ranked this as a "major problem" for the community.

  25. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  26. Leading Causes of Death(Clinton County, 2011-2013) Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● CLRD is chronic lower respiratory disease.

  27. Heart Disease: Age-Adjusted Mortality(2011-2013 Annual Average Deaths per 100,000 Population)Healthy People 2020 Target = 156.9 or Lower (Adjusted) Stroke: Age-Adjusted Mortality(2011-2013 Annual Average Deaths per 100,000 Population)Healthy People 2020 Target = 34.8 or Lower Prevalence of heart disease (9.3%) is also higher than the US (6.1%). Prevalence of stroke has increased since 1996 (1.8% to 4.2%).

  28. Prevalence of High Blood PressureHealthy People 2020 Target = 26.9% or Lower Prevalence of High Blood CholesterolHealthy People 2020 Target = 13.5% or Lower Clinton County Clinton County Each is similar to national prevalence levels. 87.8% of residents have one or more cardiovascular risk factors (higher than US). Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 43, 125] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 Ohio data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-5.1] Notes: ● Asked of all respondents.

  29. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  30. Teen Birth Rate(Births to Women Age 15-19 Per 1,000 Female Population Age 15-19, 2006-2012) Sources: ● Centers for Disease Control and Prevention, National Vital Statistics System: 2006-2012. Accessed using CDC WONDER. ● Retrieved September 2015 from Community Commons at http://www.chna.org. Notes: ● This indicator reports the rate of total births to women under the age of 15 - 19 per 1,000 female population age 15 - 19. This indicator is relevant because in many cases, teen parents have unique social, economic, and health support services. Additionally, high rates of teen pregnancy may indicate the prevalence of unsafe sex practices.

  31. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  32. Unintentional Injuries: Age-Adjusted Mortality(2011-2013 Annual Average Deaths per 100,000 Population)Healthy People 2020 Target = 36.4 or Lower Leading Causes of Accidental Deaths: Poisoning/Noxious Substances Motor Vehicle Accidents Falls Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-11] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population.

  33. Motor Vehicle Crashes: Age-Adjusted Mortality(2009-2013 Annual Average Deaths per 100,000 Population)Healthy People 2020 Target = 12.4 or Lower 85.4% of resident report “always” wearing a seat belt; this indicator has improved significantly since 1996 (70.1%). Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-13.1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population.

  34. Have a Firearm Kept in or Around the Home Clinton County Households With Children: 41.5% (vs. 37.4% nationwide) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 52, 137] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● In this case, firearms include pistols, shotguns, rifles, and other types of guns; this does not include starter pistols, BB guns, or guns that cannot fire. Men and middle/high income residents more likely to have a firearm in the home.

  35. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  36. Experience “Fair” or “Poor” Mental Health(Clinton County, 2015) Excellent/Very Good = 46.7% Good = 35.2% Fair/Poor = 18.1% Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 100] Notes: ● Asked of all respondents. ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

  37. Have Experienced Symptoms of Chronic Depression Clinton County 26.8% of residents report being diagnosed with depression, significantly higher than OH (20.2%) and the US (20.4%). Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 101] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Chronic depression includes periods of two or more years during which the respondent felt depressed or sad on most days, even if (s)he felt okay sometimes.

  38. Mental Health Key Informants: Mental Health ranked as the #2 top health issue in the Online Key Informant Survey. • Key informants’ concern regarding mental health reflected issues with: • Lack of Providers/Resources • Access to Care • Affordability • Wait lists • Prevalence/Incidence • Stigma Over half of key informants ranked this as a "major problem" for the community.

  39. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  40. Prevalence of Total Overweight(Percent of Adults With a Body Mass Index of 25.0 or Higher) Clinton County Included in this is 34.8% of Clinton County adults who are obese. Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 151] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 Ohio data. Notes: ● Based on reported heights and weights, asked of all respondents. ● The definition of overweight is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 25.0, regardless of gender. The definition for obesity is a BMI greater than or equal to 30.0. Only 32.2% of overweight or obese residents are trying to lose weight.

  41. Prevalence of Obesity(Percent of Adults With a BMI of 30.0 or Higher; Clinton County, 2015)Healthy People 2020 Target = 30.5% or Lower In Clinton County, only 34.0% of obese residents have received advice from a health professional about their weight, significantly below US findings (48.3%). Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 151] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-9] Notes: ● Based on reported heights and weights, asked of all respondents. ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● The definition of obesity is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 30.0, regardless of gender.

  42. Consume Five or More Servings of Fruits/Vegetables Per Day(Clinton County, 2015) Note that 41.0% of low-income residents find it "very/somewhat difficult" to access fresh fruits/vegetables. Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 146] Notes: ● Asked of all respondents. ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● For this issue, respondents were asked to recall their food intake on the previous day.

  43. Meets Physical Activity Recommendations(Clinton County, 2015) • Also: • 20.4% of adults engage in no leisure-time physical activity (similar to US). • Participation in vigorous physical activity appears to be below US averages. • A relatively low percentage (37.3%) of adults have received advice about exercise from a health professional in the past year. Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 147] Notes: ● Asked of all respondents. ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● In this case the term “meets physical activity recommendations” refers to participation in moderate physical activity (exercise that produces only light sweating or a slight to moderate increase in breathing or heart rate ) at least 5 times a week for 30 minutes at a time, and/or vigorous physical activity (activities that cause heavy sweating or large increases in breathing or heart rate) at least 3 times a week for 20 minutes at a time.

  44. Nutrition, Physical Activity & Weight Key Informants: Nutrition, Physical Activity, & Weight ranked as the #3 top health issue in the Online Key Informant Survey. • Key informants’ concern regarding nutrition, physical activity, & weight reflected issues with: • Lack of Infrastructure for Healthy and Active Living • Poor Diet/Nutrition, Low Physical Activity • Obesity • Lack of Nutrition Education Over half of respondents ranked this as a "major problem" for the community.

  45. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  46. Have Visited a Dentist orDental Clinic Within the Past Year(Clinton County, 2015)Healthy People 2020 Target = 49.0% or Higher Significantly below OH (67.6%) and US (65.9%). Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 21] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective OH-7] Notes: ● Asked of all respondents. ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

  47. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  48. Prevalence of Potentially Disabling Conditions Additionally, 26.0% of adults are limited in activities due to a health problem; these are predominantly musculoskeletal issues. Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 139] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Reflects respondents age 50 and older.

  49. General Health Status Areas of Opportunity • Access to Healthcare • Cancer • Dementias, Including Alzheimer’s Disease • Diabetes • Heart Disease & Stroke • Infant Health & Family Planning • Injury & Violence • Mental Health • Nutrition, Physical Activity & Weight • Oral Health • Potentially Disabling Conditions • Respiratory Diseases • Substance Abuse • Tobacco Prioritization Results

  50. CLRD: Age-Adjusted Mortality(2011-2013 Annual Average Deaths per 100,000 Population) Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population. ● CLRD is chronic lower respiratory disease.

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