1. County Health Rankings - 2013 Health Council, April 11, 2013 Presented by Haydee A. Dabritz, Ph,D. Yolo County Epidemiologist

2. Yolo County population growth - 20% in past 12 years

3. Yolo Co. has a diverse population Latest estimate of size (ACS 2011): 202,054

4. Disparities in household income Source: ACS 2011 3-yr estimate

5. Background Two different reports recently released:  RWJ Foundation (nationwide) – variety of health indicators: deaths before age 75, HS graduation, unemployment, access to parks/healthy foods, air quality  CDPH (California) – snapshop of CA’s 58 counties vs. state vs. HP2020 for chronic and infectious disease

6. Yolo County in the rankings RWJ weights the health indicators Yolo County is #5 in California Why?  Lower premature deaths & preventable hospital stays  Fewer people with poor/fair health  More people with health insurance  Fewer people smoking

7. Progress in maternal & infant health High breastfeeding rates C-section rates lower than state Fewer premature births (<37 wks) Fewer low birthweight infants Low teenage pregnancy rates

8. Health insurance and clinical care, 2010-2013

9. Preterm, low birthweight and teen births – percentage of live births

10. Yolo County teen birth rates, 2007-2012 California

11. But there are areas of concern… High unemployment Increasing poverty Disparities by city and race/ethnicity High prevalence of obesity in ALL age groups

12. Many of these factors are social determinants of health Education Household income Race/ethnicity Place/neighborhood

13. Unemployment and children (<18) in poverty

14. Childhood Poverty by City, 2008-2011

15. Health behaviors Smoking – trending downward, only 7% of adults in Yolo County vs. 14% in CA Binge drinking – trending downward but about 1 in 6 adults (17%) reported this behavior in the past month

16. Obesity – a major problem, affects many health outcomes 6 million Californians (about 16%) are obese – costs $28B annually Related to chronic conditions (diabetes, asthma, autoimmune disease, heart disease); 38% of Californians have one Increased risk maternal risk for C-section, gestational diabetes, pre-eclampsia Increased risk for breast cancer

17. The staggering cost of chronic disease Chronic conditions account for: 60% of CA’s healthcare costs ($51B) 80% of hospital admits 90% of prescriptions 75% of doctor visits Source: CDPH Center for Chronic Disease Prevention & Health Promotion, 2013 http://www.cdph.ca.gov/programs/Documents/Burden%20Report%20 Online%2003-20-13.pdf

18. Overweight/obese 9 th grade (Yolo) children by race/ethnicity, 2011-12

19. Obesity in women of childbearing age (15-44 years), 2001-2009 (CHIS)

20. Prevalence of diabetes in Yolo County mothers, 2009-2012

21. Live births by delivery type and pre- pregnancy BMI, Yolo County, 2012

22. We have work to do! Increase physical activity Increase servings of fruits/vegetables Reduce consumption of sugary drinks Improve access to full-service grocery stores in impoverished areas Make healthy behaviors a lifelong habit

23. Questions?