Transcript 2011 PRC Community Health Assessment

2011 PRC Community Health Assessment
A Data-Driven Approach to Identifying Community Health Needs
Lee County, Florida
Community Health Findings
Prepared for
COMMUNITY HEALTH
2011 PRC Community Health Assessment
The 2011 PRC
Community Health
Assessment
consists of both
primary and
secondary data.
Customized Local
PRC Community Health Survey
Identical to the
approach used in
2007.
PRC Community Health Assessment
Secondary
Data
Key Informant
Focus Groups
2011 PRC Community Health Assessment
Telephone Survey
BENCHMARKING
 State BRFSS
data (CDC)
– Stratified random sample of 1,000 adults
o 250 interviews in each of four Market Areas
 US Survey Data
(PRC National
Health Survey)
– 153 survey items; 20-25 minute interview
 Healthy People
2020 targets
– Each percentage
of the total sample
represents roughly
5,355 residents
 State and
national vital
statistics
– Lee County: ±3.1% maximum error
2011 PRC Community Health Assessment
Population & Sample Characteristics
(Lee County, 2011)
100%
Actual Population
Weighted Survey Sample
80%
68.2% 69.6%
60%
49.6% 49.5%
50.4% 50.5%
38.2% 38.9%
40%
31.6% 31.0%
30.2% 30.1%
26.1% 25.6%
20.7% 19.5%
20%
0%
Men
Sources:
Women
18 to 39
40 to 64
 Census 2000, Summary File 3 (SF 3). US Census Bureau.
 PRC Community Health Survey, Professional Research Consultants, Inc.
65+
White
Hispanic
<200% FPL
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Self-Reported Health Status
(Lee County, 2011)
Good 30.2%
Very Good 29.5%
52.2%
Excellent/
Very Good
Fair 12.4%
Excellent 22.7%
Poor 5.2%
Sources:
Notes:
 Professional Research Consultants, Inc. PRC Community Health Survey. [Item 6]
 Asked of all respondents.
17.6%
Fair/Poor
2011 PRC Community Health Assessment
Experience “Fair” or “Poor” Physical Health
100%
80%
60%
40%
23.9%
20%
16.7%
14.7%
14.8%
Market
Area 3
Market
Area 4
17.6%
16.5%
16.8%
Lee
County
Florida
United
States
17.9
%
17.6
%
0%
Market
Area 1
Market
Area 2
Lee County 2007 Lee County 2011
Sources: ● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 6]
● Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey. Atlanta, Georgia: US Department of Health and Human
Services,
Centers for Disease Control and Prevention, 2009 Florida Data.
● Professional Research Consultants. PRC National Health Survey. 2011.
Notes:
● Asked of all respondents.
2011 PRC Community Health Assessment
Experience “Fair” or “Poor” Physical Health
(Lee County, 2011)
100%
80%
60%
40%
31.4%
29.1%
23.4%
20%
17.7%
17.6%
Men
Women
13.5%
17.1%
13.7%
15.9%
200%+
FPL
White
18.1%
17.6%
Hispanic
LEE
COUNTY
0%
18 to 39
40 to 64
65+
<200%
FPL
Black
Sources: ● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 6]
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.
2011 PRC Community Health Assessment
Limited in Activities in Some Way
Due to a Physical, Mental or Emotional Problem
100%
80%
60%
40%
21.9%
23.9%
18.0%
20%
22.6%
22.0%
20.9%
21.3
%
22.0
%
Lee County 2007
Lee County 2011
17.0%
0%
Market
Area 1
Market
Area 2
Market
Area 3
Market
Area 4
Lee
County
Florida
United
States
Sources: ● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 128]
● Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey. Atlanta, Georgia: US Department of Health and Human
Services,
Centers for Disease Control and Prevention, 2009 Florida Data.
● Professional Research Consultants. PRC National Health Survey. 2011.
Notes:
● Asked of all respondents.
Predominantly age-related: most often attributed to musculoskeletal
issues — back/neck problems, arthritis/ rheumatism, fractures or
bone/joint injuries, or problems walking.
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Selected Lee County Indicators Better Than the US:
 Death rates due to: heart disease, cancer, chronic lower respiratory
disease, stroke, diabetes, Alzheimer’s disease, cirrhosis/liver
disease, pneumonia/influenza and kidney disease
 Vaccine-preventable conditions
 STD incidence
 Osteoporosis
 Seatbelt usage
 Firearm prevalence
 Physical activity
 Routine vision care
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Community Health Visioning 2017 Priority Areas
PRIORITY AREAS
ADDRESSED IN
DATA
• Behavioral Health
• Primary Care
Alternatives
• Preventive
Health Care
Behavioral Health
•
Depression indicators are similar to the US, but the
suicide rate is quite high compared to both the state
and US.
•
While most reported high-risk alcohol and drug
behaviors are close to national findings, the druginduced death rate is worse than both the state and
nation.
•
Behavioral health was the #1 ranked health priority
among participants in the key informant focus groups.
• Chronic Disease
2011 PRC Community Health Assessment
Community Health Visioning 2017 Priority Areas
PRIORITY AREAS
ADDRESSED IN
DATA
• Behavioral Health
• Primary Care
Alternatives
• Preventive
Health Care
Primary Care Alternatives
•
A relatively low proportion of residents have a “medical
home,” and fewer than found in 2007.
•
Receipt of routine medical care has likewise declined
since 2007.
•
A high proportion of parents report trouble accessing
healthcare for their child.
•
Access to healthcare services, especially for low-income
and uninsured populations, was the second top-ranked
priority among key informant focus group participants.
• Chronic Disease
2011 PRC Community Health Assessment
Community Health Visioning 2017 Priority Areas
PRIORITY AREAS
ADDRESSED IN
DATA
• Behavioral Health
• Primary Care
Alternatives
Preventive Health Care
•
Three out of 10 school-aged children are overweight or
obese, similar to what is found nationally.
•
Diabetes death rates are favorable, however, the
prevalence of diabetes (those living with diabetes) is
high.
•
More than one out four births in Lee County does not
receive timely prenatal care. This is similar to the
statewide proportion.
• Preventive
Health Care
• Chronic Disease
2011 PRC Community Health Assessment
Community Health Visioning 2017 Priority Areas
PRIORITY AREAS
ADDRESSED IN
DATA
• Behavioral Health
• Primary Care
Alternatives
• Preventive
Health Care
• Chronic Disease
Chronic Disease
•
Two-thirds of Lee County adults are overweight or
obese, close to the national proportion. However,
obesity has increased since 2007.
•
Prevalence levels for diabetes and high blood pressure
are both relatively high.
•
Nearly 10% of adults and children have asthma, similar
to national findings, although adult asthma has
increased since 2007.
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Healthcare Insurance Coverage
(Among Adults Age 18 to 64; Lee County, 2011)
Insured, EmployerBased 50.1%
No Insurance 20.5%
Other Gov't Coverage
0.8%
VA/Military 6.3%
Insured, Self-Purchase
10.1%
Medicare 5.1%
Medicaid 6.3%
Insured, Unknown Type
0.8%
Sources:
Notes:
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 206]
● Reflects respondents aged 18 to 64.
Private Insurance
61.0%
Gov’t Insurance
18.5%
No Insurance
20.5%
2011 PRC Community Health Assessment
Lack of Healthcare Insurance Coverage
(Among Lee County Adults Under 65, 2011)
100%
Healthy People 2020 Target = 0.0% (Universal Coverage)
80%
60%
40%
25.0%
20%
15.9%
19.6%
20.8%
Market
Area 3
Market
Area 4
20.5%
24.1%
23.5%
20.5%
14.9%
0%
Market
Area 1
Sources:
Notes:
Market
Area 2
Lee
County
Florida
United
States
Lee County 2007
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 206]
● Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey. Atlanta, Georgia: US Department of Health and Human Services,
Centers for Disease Control and Prevention, 2009 Florida Data.
● Professional Research Consultants. PRC National Health Survey. 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective AHS-1]
● Asked of all respondents under the age of 65.
Lee County 2011
2011 PRC Community Health Assessment
Lack of Healthcare Insurance Coverage
(Lee County Adults Under 65, 2011)
100%
Healthy People 2020 Target = 0.0% (Universal Coverage)
80%
60%
37.3%
40%
27.1%
20.6%
25.0%
20.4%
15.3%
20%
17.7%
19.5%
White
Black
20.5%
10.9%
0%
Men
Sources:
●
Notes:
Women
18 to 39
40 to 64
<200%
FPL
200%+
FPL
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 206]
US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective AHS-1]
● Asked of all respondents under the age of 65.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size.
Hispanic
LEE
COUNTY
2011 PRC Community Health Assessment
Experienced Difficulties or Delays of Some Kind
in Receiving Needed Healthcare in the Past Year
(Lee County, 2011)
Barriers
Tested:
100%
• Cost of Doctor Visits
• Cost of Prescriptions
• Appointment
Availability
80%
• Trouble Finding a Doctor
• Inconvenient Office Hours
• Lack
60% of Transportation
Overall,
similar to US
63.5%
48.9%
47.3%
42.1%
41.6%
40%
43.5%
32.5%
30.0%
37.1%
32.9%
20.5%
20%
0%
Men
Sources:
Notes:
Women
18 to 39
40 to 64
65+
<200%
FPL
200%+
FPL
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 210]
● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size.
White
Black
Hispanic
LEE
COUNTY
19.0% of adults did not see a doctor
in the past year because of the cost
(higher than US, an increase since 2007).
2011 PRC Community Health Assessment
Had Trouble Obtaining Medical Care for Child in the Past Year
(Lee County Parents of Children <18, 2011)
50%
40%
Parents with trouble obtaining medical care for their child
reported barriers due to cost or lack of insurance coverage,
limited insurance acceptance, and lack of accessibility.
30%
20%
12.9%
10.0%
10%
7.7%
6.2%
6.2%
4.7%
2.0%
1.9%
0%
Market
Area 1
Sources:
Notes:
Market
Area 2
Market
Area 3
Market
Area 4
● Professional Research Consultants, Inc. PRC Community Health Survey. [Items 138-139]
● Professional Research Consultants. PRC National Health Survey. 2011.
● Asked of all respondents with children under 18 at home.
Lee
County
United
States
Lee County 2007
Lee County 2011
2011 PRC Community Health Assessment
Have a Specific Source of Ongoing Medical Care
(Lee County, 2011)
Lower than US (76.3%),
lower than in 2007 (76.5%)
100%
80%
74.3%
73.9%
77.5%
77.2%
74.8%
70.3%
66.3%
63.7%
58.5%
60%
60.4%
61.8%
Black
Hispanic
40%
20%
0%
Men
Sources:
Notes:
●
●
●
●
Women
18 to 39
40 to 64
65+
<200%
FPL
200%+
FPL
White
Professional Research Consultants, Inc. PRC Community Health Survey. [Item 207]
US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objectives AHS-5.3, 5.4]
Asked of all respondents.
Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size.
LEE
COUNTY
Again, access to healthcare services, especially for
low-income and uninsured populations, was the #2
priority identified in the key informant focus groups.
2011 PRC Community Health Assessment
Rating of Overall Healthcare
Services Available in the Community
(Lee County, 2011)
Very Good 32.5%
Good 26.6%
54.2%
Excellent/
Very Good
Excellent 21.7%
Fair 11.7%
Poor 7.5%
Sources:
Notes:
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 7]
● Asked of all respondents.
19.2%
Fair/Poor
2011 PRC Community Health Assessment
Perceive Local Healthcare Services as “Fair” or “Poor”
100%
80%
60%
40%
23.9%
20%
18.9%
21.3%
Market
Area 2
Market
Area 3
14.7%
19.2%
15.3%
17.4%
19.2%
0%
Market
Area 1
Sources:
Notes:
Market
Area 4
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 7]
● Professional Research Consultants. PRC National Health Survey. 2011.
● Asked of all respondents.
Lee
County
United
States
Lee County 2007 Lee County 2011
2011 PRC Community Health Assessment
Perceive Local Healthcare Services as “Fair” or “Poor”
(Lee County, 2011)
100%
80%
60%
16.0% of residents left Lee County for healthcare in the past year.
• Predominantly for specialty care
• Predominantly because of a perceived lack of services,
physician referral, or perceived better quality elsewhere
50.2%
40%
20%
38.2%
34.6%
17.1%
21.2%
23.8%
22.1%
11.4%
14.2%
16.3%
200%+
FPL
White
19.9%
19.2%
14.3%
0%
Men
Sources:
Notes:
Women
18 to 39
40 to 64
65+
<200%
FPL
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 7]
● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size.
Black
Hispanic
Insured
Uninsured
LEE
COUNTY
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Prevalence of Heart Disease & Stroke
50%
Lee County
Florida
United States
40%
30%
20%
10.6%
10%
6.1%
5.0%
3.0%
2.7%
0%
Heart Disease
Sources:
Notes:
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 155]
● Professional Research Consultants. PRC National Health Survey. 2011.
● Asked of all respondents.
Stroke
Although death rates are comparatively low,
prevalence levels are high.
2011 PRC Community Health Assessment
Prevalence of High Blood Pressure
100%
Healthy People 2020 Target = 26.9% or Lower
Number of Times Diagnosed:
Once = 24.9%
More Than Once = 75.1%
80%
60%
39.9%
41.1%
40%
37.7%
39.2%
39.6%
32.1%
34.3%
Florida
United
States
36.4%
39.6%
20%
0%
Market
Area 1
Sources:
Notes:
Market
Area 2
Market
Area 3
Market
Area 4
Lee
County
Lee County
2007
● Professional Research Consultants, Inc. PRC Community Health Survey. [Items 52-53, 156]
● Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey. Atlanta, Georgia: US Department of Health and Human Services,
Centers for Disease Control and Prevention, 2009 Florida Data.
● Professional Research Consultants. PRC National Health Survey. 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective HDS-5.1]
● Asked of all respondents.
Lee County
2011
2011 PRC Community Health Assessment
Prevalence of High Blood Cholesterol
100%
Healthy People 2020 Target = 13.5% or Lower
80%
60%
44.2%
40%
35.1%
34.7%
Market
Area 1
Market
Area 2
38.9%
38.5%
39.7%
38.5%
38.5%
Lee County 2007
Lee County 2011
31.4%
20%
0%
Sources:
Notes:
Market
Area 3
Market
Area 4
Lee
County
Florida*
United
States
● Professional Research Consultants, Inc. PRC Community Health Survey. [Items157]
● Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey. Atlanta, Georgia: US Department of Health and Human Services,
Centers for Disease Control and Prevention, 2009 Florida Data.
● Professional Research Consultants. PRC National Health Survey. 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective HDS-7]
● Asked of all respondents.
● *The Florida data reflects those adults who have been tested for high cholesterol and who have been diagnosed with it.
2011 PRC Community Health Assessment
Prevalence of Skin Cancer
100%
80%
60%
40%
20%
13.5%
13.9%
18.3%
10.6%
14.6%
Sources:
Notes:
Market
Area 2
Market
Area 3
14.6%
Lee County 2007
Lee County 2011
8.1%
0%
Market
Area 1
14.6%
Market
Area 4
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 39]
● Professional Research Consultants. PRC National Health Survey. 2011.
● Asked of all respondents.
Lee
County
United
States
2011 PRC Community Health Assessment
Prevalence of Cancer (Other Than Skin Cancer)
100%
80%
60%
40%
20%
8.6%
8.1%
Market
Area 1
Market
Area 2
6.5%
7.9%
7.9%
5.5%
Market
Area 3
Market
Area 4
Lee
County
United
States
0%
Sources:
Notes:
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 38]
● Professional Research Consultants, Inc. PRC National Health Survey. 2011.
● Asked of all respondents.
9.8%
7.9%
Lee County 2007
Lee County 2011
2011 PRC Community Health Assessment
Diabetes: Age-Adjusted Mortality by Race
(2005-2007 Annual Average Deaths per 100,000 Population)
100
Healthy People 2020 Target = 19.6 or Lower (Adjusted)
80
66.6
60
Overall, death
rate is below FL
& US, but is
increasing
40
22.7
20
18.9
17.2
0
Lee County
Non-Hispanic White
Sources:
Notes:
Lee County
Hispanic
Lee County
Non-Hispanic Black
Lee County
All Races/Ethnicities
● Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. CDC WONDER Online Query System.
Data extracted May 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective D-3]
● 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.
● County, state and national data are simple three-year averages.
● The Healthy People 2010 target for Diabetes is adjusted to account for only diabetes mellitus coded deaths.
● The Hispanic and Non-Hispanic Other death rates are unreliable due to the low number of deaths within each population.
2011 PRC Community Health Assessment
Prevalence of Diabetes
(Lee County, 2011)
100%
80%
Overall,
higher than
FL (10.7%)
& US (10.1%)
60%
40%
26.4%
24.8%
20%
18.7%
16.0%
13.7%
11.1%
12.0%
12.6%
200%+
FPL
White
11.7%
13.5%
Hispanic
LEE
COUNTY
3.2%
0%
Men
Sources:
Notes:
Women
18 to 39
40 to 64
65+
<200%
FPL
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 50]
● Asked of all respondents.
● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size.
Black
2011 PRC Community Health Assessment
Currently Have Asthma
100%
80%
60%
40%
20%
9.5%
9.4%
9.1%
8.6%
9.1%
6.9%
7.5%
6.1%
Market
Area 1
Market
Area 2
Market
Area 3
Market
Area 4
Lee
County
Florida
United
States
Lee County 2007
9.1%
0%
Sources:
Notes:
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 166]
● Professional Research Consultants. PRC National Health Survey. 2011.
● Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey. Atlanta, Georgia: US Department of Health and Human Services,
Centers for Disease Control and Prevention, 2009 Florida Data.
● Asked of all respondents.
Lee County 2011
15.6% of adults with asthma report a
related trip to the ER or urgent care
center in the past year
2011 PRC Community Health Assessment
HIV/AIDS: Age-Adjusted Mortality by Race
(1999-2007 Annual Average Deaths per 100,000 Population)
50
48.1
Healthy People 2020 Target = 3.3 or Lower
40
Overall, death rate
is better than FL,
worse than US
30
20
10
2.8
6.0
5.2
0
Lee County
Non-Hispanic White
Sources:
Notes:
Lee County
Hispanic
Lee County
Non-Hispanic Black
Lee County
All Races/Ethnicities
● Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. CDC WONDER Online Query System.
Data extracted May 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective HIV-12]
● 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.
● HIV death rates represent deaths between 1999 and 2007.
2011 PRC Community Health Assessment
Unintentional Injuries: Age-Adjusted Mortality Trends
(Annual Average Deaths per 100,000 Population)
100
80
60
40
20
0
Healthy People 2020
Lee County
Florida
United States
Sources:
Notes:
1999-2001
36.0
51.4
37.8
35.3
2000-2002
36.0
53.3
39.8
35.8
2001-2003
36.0
56.7
42.1
36.7
2002-2004
36.0
57.4
43.4
37.4
2003-2005
36.0
62.9
45.1
38.1
2004-2006
36.0
64.9
45.9
39.0
● Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. CDC WONDER Online Query System.
Data extracted May 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective IVP-11]
● 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.
● State and national data are simple three-year averages.
2005-2007
36.0
64.3
46.6
39.7
2011 PRC Community Health Assessment
Motor Vehicle Crashes: Age-Adjusted Mortality
(2005-2007 Annual Average Deaths per 100,000 Population)
50
40
Healthy People 2020 Target = 12.4 or Lower
Notably higher
for Hispanics
30
24.7
18.3
20
14.3
10
0
Lee County
Sources:
Notes:
Florida
United States
● Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. CDC WONDER Online Query System.
Data extracted May 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective IVP-13.1]
● 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.
● County, state and national data are simple three-year averages.
2011 PRC Community Health Assessment
Firearm-Related Deaths: Age-Adjusted Mortality
(2005-2007 Annual Average Deaths per 100,000 Population)
50
Healthy People 2020 Target = 9.2 or Lower
40
Notably higher
for Blacks
30
20
14.0
11.2
10.3
Florida
United States
10
0
Lee County
Sources:
Notes:
● Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. CDC WONDER Online Query System.
Data extracted May 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective IVP-30]
● 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.
● County, state and national data are simple three-year averages.
2011 PRC Community Health Assessment
Homicide: Age-Adjusted Mortality by Race
(2005-2007 Annual Average Deaths per 100,000 Population)
50
Healthy People 2020 Target = 5.5 or Lower
40
30
23.4
Higher than
FL & US
20
12.6
10
8.2
5.6
0
Lee County
Non-Hispanic White
Sources:
Notes:
Lee County
Hispanic
Lee County
Non-Hispanic Black
Lee County
All Races/Ethnicities
● Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. CDC WONDER Online Query System.
Data extracted May 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective IPV-29]
● 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.
● County, state and national data are simple three-year averages.
● All Lee County homicide death rates are unreliable due to the low number of deaths in the county.
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Immunization & Infectious Disease
Influenza
•
Flu vaccination coverage for seniors 65+ is generally
good (although low in Market Area 3), but coverage for
other high-risk adults is below US levels.
Tuberculosis
•
Tuberculosis incidence is higher than FL and US rates,
and has increased in recent years.
Hepatitis B
•
Self-reported hepatitis B vaccination is lower than found
nationally.
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Modifiable Health Risks
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Family Planning
Births to Teens
• 11.1% of Lee County births (2007-2009) were to teens.
o Lower than statewide (12.9%), higher than nationally (10.4%)
o By race, higher (16.4%) in births to Black women
Births to Unmarried Mothers
• 48.7% of Lee County births (2007-2009) were to
unmarried mothers.
o Similar to FL (46.9%), higher than US (39.6%)
o By race, highest (70.5%) in births to Black women
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Suicide: Age-Adjusted Mortality
(2005-2007 Annual Average Deaths per 100,000 Population)
50
Healthy People 2020 Target = 10.2 or Lower
40
Notably higher
for Whites,
trending upward
30
20
16.5
12.9
11.1
10
0
Lee County
Sources:
Notes:
Florida
United States
● Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. CDC WONDER Online Query System.
Data extracted May 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective MHMD-1]
● 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.
● County, state and national data are simple three-year averages.
Prevalence of chronic depression symptoms and diagnosed
major depression appear similar to national levels.
2011 PRC Community Health Assessment
Drug-Induced Deaths: Age-Adjusted Mortality Trends
(Annual Average Deaths per 100,000 Population)
25
20
15
10
5
0
Healthy People 2020
Lee County
Florida
United States
Sources:
Notes:
1999-2001
11.3
11.9
8.7
7.2
2000-2002
11.3
14.3
10.6
7.9
2001-2003
11.3
16.3
12.3
8.9
2002-2004
11.3
19.3
13.2
9.8
2003-2005
11.3
19.3
14.1
10.6
2004-2006
11.3
20.1
15.2
11.5
● Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. CDC WONDER Online Query System.
Data extracted May 2011.
● US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective SA-12]
● 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.
● State and national data are simple three-year averages.
2005-2007
11.3
18.8
15.9
12.2
Only 1.6% of adults acknowledge use of illicit
drugs in the past month (similar to US).
2011 PRC Community Health Assessment
Top-Ranked Priorities as Identified by Key Informants
#1. BEHAVIORAL HEALTH SERVICES
(mental health/substance abuse treatment)
Mentioned resources available to address this issue:
• Alcoholics Anonymous/Al-Anon/Alateen
• Churches
• ERs
• HOPE Clubhouse of Southwest Florida
• Jennings Behavioral Health
• Lee Memorial Health System
• Lee Mental Health Center
• National Alliance on Mental Illness of Lee County
• Police Departments
• Private Clinics
• Ruth Cooper Center/Lee Mental Health Center
• Senior Behavioral Center at Lee Memorial Hospital
• Southwest Florida Addiction Services
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Prevalence of Total Overweight
(Overweight or/Obese Adults; Body Mass Index of 25.0 or Higher)
100%
80%
64.3%
67.5%
62.7%
65.5%
65.2%
63.4%
Market
Area 4
Lee
County
Florida
66.9%
64.0%
65.2%
United
States
Lee County 2007
Lee County 2011
60%
40%
20%
0%
Market
Area 1
Sources:
Notes:
Market
Area 2
Market
Area 3
● Professional Research Consultants, Inc. PRC Community Health Survey. [Item 193]
● Professional Research Consultants. PRC National Health Survey. 2011.
● Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey. Atlanta, Georgia: US Department of Health and Human Services,
Centers for Disease Control and Prevention, 2009 Florida Data.
● 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.
2011 PRC Community Health Assessment
Prevalence of Obesity
(Body Mass Index of 30.0 or Higher)
100%
Healthy People 2020 Target = 30.6% or Lower
80%
60%
40%
28.7%
28.6%
27.6%
Market
Area 2
Market
Area 3
31.3%
29.3%
26.5%
28.5%
Florida
United
States
29.3%
23.0%
20%
0%
Market
Area 1
Sources:
Notes:
●
●
●
●
Market
Area 4
Lee
County
Lee County 2007
Professional Research Consultants, Inc. PRC Community Health Survey. [Item 193]
Professional Research Consultants. PRC National Health Survey. 2011.
US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective NWS-9]
Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey. Atlanta, Georgia: US Department of Health and Human Services,
Centers for Disease Control and Prevention, 2009 Florida Data.
● Based on reported heights and weights, asked of all respondents.
● 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.
Lee County 2011
2011 PRC Community Health Assessment
Prevalence of Obesity
(Body Mass Index of 30.0 or Higher; Lee County, 2011)
100%
Healthy People 2020 Target = 30.6% or Lower
80%
60%
51.9%
35.3%
40%
30.7%
27.9%
27.1%
Women
18 to 39
37.6%
35.2%
29.6%
29.3%
25.0%
24.3%
20%
0%
Men
Sources:
Notes:
●
●
●
●
●
●
40 to 64
65+
<200%
FPL
200%+
FPL
White
Black
Professional Research Consultants, Inc. PRC Community Health Survey. [Item 193]
US Department of Health and Human Services. Healthy People 2020. December 2010 http://www.healthypeople.gov. [Objective NWS-9]
Asked of all respondents.
Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size.
Based on reported heights and weights, asked of all respondents.
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.
Hispanic
LEE
COUNTY
2011 PRC Community Health Assessment
Nutrition
• 42.9% of Lee County adults have 5+ servings of
fruits/vegetables per day.
o Lower than found nationally (48.8%)
o Vegetable consumption, in particular, is low
• 71.5% of adults say they read nutrition labels when
deciding what foods to buy.
• Favorably, more adults report getting nutrition advice from
their physicians than in 2007.
Key Informant Focus Groups
• Obesity/weight management was the #3 top-ranked
priority.
• Health education (especially nutrition education) was the
#4 top-ranked priority.
2011 PRC Community Health Assessment
Physical Activity
Adults
• Physical activity indicators are generally better than or
similar to state and national findings.
Children
• 45.9% of school-aged children have 3+ hours/day of
screen time (TV, video games, computer), similar to what
is found nationally.
• However, 19.1% of children have 3+ hours per day of
computer/video game screen time. (US = 9.9%)
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH
2011 PRC Community Health Assessment
Income Disparity in
Selected Lee County Health Indicators
0.0%
10.0%
20.0%
Difficulty Accessing Healthcare in Past Year
30.0%
40.0%
43.5%
54.5%
26.8%
Lack Health Insurance Coverage (Ages 18-64)
37.3%
10.9%
Chronic Depression
47.3%
22.0%
Cost Prevented a Prescription in Past Year
34.1%
12.9%
Arthritis/Rheumatism (50+)
37.3%
Children 3+ Hours/Day of Screen Time
37.4%
Difficulty Getting Appt in Past Year
“Fair/Poor” Overall Health
70.0%
63.5%
12.4%
No Dental Visit in the Past Year
Skipped/Reduced Rx Doses to Save Money
60.0%
30.0%
Cost Prevented Doctor Visit in Past Year
Lack of Transportation Prevented Medical Care
50.0%
57.9%
54.5%
28.9%
12.2%
18.8%
2.6%
11.6%
13.7%
27.0%
29.1%
Low Income
Middle/High Income
2011 PRC Community Health Assessment
Preventive Healthcare
(By Insured Status; Lee County, 2011)
100%
Insured
96.3%
Uninsured
93.5%
83.4%
80%
75.9%
72.9%
67.7%
75.7%
71.3%
69.9%
60%
40.6%
40.2%
34.8%
40%
38.1%
36.1%
20%
0%
BP Test/
Past 2 Yrs
Cholesterol
Test/Past
5 Yrs
No Access
Difficulties/
Past Yr
Eye Exam/
Past 2 Yrs
Have a Source of
Ongoing Care
Dental Visit/
Past Yr
Checkup/
Past Yr
2011 PRC Community Health Assessment
Lee County Disparities
By Geography
• Where geographic differences exist, it is often
Market Area 2 (North/Northeast Lee County) that fares
worst.
By Race/Ethnicity
• Blacks have overall poorer health status, less dental
care, and greater problems associated with diabetes,
cardiovascular disease, cancer, kidney disease,
HIV/AIDS and violence.
• Hispanics and Blacks have greater access difficulties
and insurance instability, less often have a medical
home, and face more depression and higher rates of
obesity.
2011 PRC Community Health Assessment
Overall Health Status
Positive Health Findings
Overview of Community Health Visioning 2017 Priority Areas
Areas of Opportunity
• Access to Healthcare Services
• Chronic Disease & Injury
• Immunization & Infectious Disease
• Maternal, Infant & Child Health
• Mental Health & Substance Abuse
• Nutrition, Physical Activity & Overweight
Overarching Issues
Q&A
COMMUNITY HEALTH