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2011 ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT December 2011 HEALTHY CAROLINIANS OF ORANGE COUNTY.

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Presentation on theme: "2011 ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT December 2011 HEALTHY CAROLINIANS OF ORANGE COUNTY."— Presentation transcript:

1 2011 ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT December 2011 HEALTHY CAROLINIANS OF ORANGE COUNTY

2 PARTNERING FOR A HEALTHY COMMUNITY December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 2

3 A network of community members and service providers partnering to promote health and wellness in Orange County Members are representatives from schools, human service agencies, churches, civic groups, businesses, local government, UNC Chapel Hill, health care organizations including UNC Healthcare, and concerned citizens. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 3

4 Mission is to advocate, guide and assist Orange County in planning and implementing health care strategies to promote healthy lifestyles, improve health status and prevent premature death and injury for ALL residents in the county regardless of age, race, income, or educational level. Overall goal of the partnership is to reduce health disparities 2011 COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY December HEALTHY CAROLINIANS OF ORANGE COUNTY

5 What We Do  Build and promote collaborative partnerships  Guide local planning efforts to improve health  Support innovative health programs  Advocate for health-promoting policies  Identify critical health needs in the community December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 5

6 December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT

7 ACKNOWLEDGMENTS Thanks to the residents of Orange County, Community Health Assessment Team members, and all Healthy Carolinians partners and member agencies who helped to guide and make the assessment a true community process. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 7

8 COMMUNITY HEALTH ASSESSMENT: OVERVIEW Required of all NC Health Departments every 4 years Collaborative process with multiple stages  Over 50 Leadership Team members  Nearly 150 community survey volunteers  30+ document writers  Close to 200 forum participants December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 8

9 COMMUNITY HEALTH ASSESSMENT: GOALS Enable local public health officials/community groups to  Monitor trends in health status  Identify priorities among health issues  Determine the availability of resources Document  Useful, relevant, actionable, reflective, forward-looking Information gathered lays the foundation for effective, strategic community health planning December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 9

10 HEALTH ASSESSMENT PROCESS: PHASES Phase 1: Establish Community Assessment Team Phase 2: Collect Community Data Phase 3: Collect and Analyze Community Health Statistics Phase 4: Combine County Statistics and Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create Community Health Assessment Document Phase 7: Disseminate CHA Document to the Community Phase 8: Develop the Community Health Action Plans December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 10

11 DATA SOURCES AND COMMUNITY INVOLVEMENT Both primary and secondary data sources Community Involvement  Various roles  Involvement at every stage  Planning  Data collection  Identification of health issues, community strengths  Development of strategies to address problems December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 11

12 Community Health Opinion Survey Survey households sampled from census blocks with high poverty percentage Administered in multiple languages Covered various topics December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 12 QUANTITATIVE: HEALTH OPINION SURVEY

13 QUALITATIVE: FOCUS GROUPS AND FORUMS Nine focus groups  Gain well-rounded understanding of health concerns  Nearly 70 community voices Five community forums  Almost 200 participants  Presented and discussed main data findings  Selected initial priorities December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 13

14 Available online /healthycarolinians December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 14 COMMUNITY HEALTH ASSESSMENT: FULL REPORT

15 ORANGE COUNTY COMMUNITY PROFILE December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 15

16 COMMUNITY PROFILE: DEMOGRAPHICS Population has more than doubled in past four decades  Total: 57,567 (1970) to 133,801 (2010)  About a 5.8% rate of increase every ten years Age  Median: 33 years old December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 16

17 COMMUNITY PROFILE: DEMOGRAPHICS Gender  52.2% female / 47.8% male Rural/Urban  57% of residents live in southern “urban” areas of Chapel Hill and Carrboro  43% live throughout rural areas Diversity  Race and ethnicity  Country of origin  Languages December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 17

18 COMMUNITY PROFILE: DEMOGRAPHICS December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 18

19 PROFILE: LEADING CAUSES OF DEATH December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 19

20 PROFILE: DEATH RATES, AGE ADJUSTED December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 20

21 PROFILE: LEADING CAUSES OF DEATH December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 21

22 PROFILE: LEADING CAUSES OF HOSPITALIZATION December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 22

23 SOCIAL, ECONOMIC, AND ENVIRONMENTAL DETERMINANTS OF HEALTH HEALTH DISPARITIES December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 23

24 HEALTH DISPARITIES Health depends largely on  Economic status, income  Race/ethnicity  Where someone lives (Place, geography) Rates of disease and health outcomes significantly worse among economically disadvantaged, particular racial and ethnic minorities, and rural populations. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 24

25 DETERMINANTS OF HEALTH Built Environment Child Care Crime and Safety Education Housing and Homelessness Hunger and Food Insecurity Income and Poverty* Labor and Employment* Parks and Recreation Transportation December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 25

26 DETERMINANTS OF HEALTH: INCOME, POVERTY Median household income: $51,944 (2009) December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 26

27 DETERMINANTS OF HEALTH: POVERTY December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 27

28 DETERMINANTS OF HEALTH: LABOR, EMPLOYMENT December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 28

29 TOP 10 ISSUE AREAS (ALPHABETICAL) December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 29

30 ACCESS TO HEALTH CARE, INSURANCE, AND INFORMATION Includes the availability and affordability of health care services and insurance, ability to navigate and understand the health system, access and transportation to services, and information about health care. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 30

31 BUILT ENVIRONMENT Includes human-made structures such as sidewalks, streets, housing, businesses, schools, parks, and, more broadly, land use patterns. The built environment impacts safety and the ability to get exercise, to access good nutrition, and health care services. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 31

32 CANCER The leading cause of death in Orange County in 2010 and has been ranked as #1 in 9 of the past 10 years. It is estimated that nearly 80% of cancers are due to factors that can be prevented: tobacco use, poor nutrition, lack of physical activity, and exposure to radiation. Many cancers are highly treatable with advanced screening. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 32

33 CHRONIC DISEASE: EXERCISE & NUTRITION Regular exercise and proper nutrition significantly contribute to physical and mental health; and can help prevent chronic diseases like diabetes, heart disease, stroke and cancer. Physical activity and good nutrition are important in maintaining a healthy body weight. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 33

34 ENVIRONMENTAL HEALTH Includes air quality; drinking, and ground water quality; and lead hazards. Environmental health issues local to neighborhoods may exist in addition to these key factors. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 34

35 INJURY Addresses unintentional injuries like motor vehicle crashes, falls, poisonings, drowning, etc., and intentional injuries, or violence, which includes sexual assault, child abuse, domestic violence, homicide, and suicide. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 35

36 MENTAL HEALTH Refers to a wide range of conditions that affect one’s mood, thinking and behavior. Broad classes of illness include mood disorders (depression, bipolar disorder), anxiety disorders, psychotic disorders (schizophrenia), eating disorders, personality adaptations or disorders, and addictive behaviors/substance abuse disorders. Many factors contribute to its onset, including genetics, biological factors, life experiences, and brain chemistry, though everyday stress. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 36

37 ORAL HEALTH Not only includes tooth and gum health, but also has overall health impacts (gum disease contributes to heart disease; tobacco use contributes to tooth decay). Issues in oral health include availability of affordable dental insurance, access to regular and preventative care, and population specific issues. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 37

38 SUBSTANCE ABUSE Includes alcohol abuse and illegal drug use, but also includes underage drinking, traffic accidents, prescription drug abuse/misuse, and injury related to alcohol and drugs. It often connects with mental health needs. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 38

39 TRANSPORTATION Transportation systems impact quality of life and health. Expanding active transportation (walking and biking) options and safety can prevent disease, reduce and prevent motor- vehicle-related injury and deaths, improve environmental health, stimulate the economy and improve equal access to resources. Accessible and affordable transportation is particularly an issue in rural areas, for those with disabilities, older citizens and lower-income people. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 39

40 COMMUNITY PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 40

41 RANKED TOP 10 ORANGE COUNTY PRIORITIES 1. Access to Health Care, Insurance, and Information 2. Chronic Disease: Exercise, and Nutrition 3. Mental Health 4. Transportation 5. Built Environment 6. Cancer 7. Substance Abuse 8. Environmental Health 9. Oral Health 10. Injury  Write-ins: Teen Pregnancy/Youth Health, Sexual health, Socio-economic Development December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 41

42 TOP 5 HEALTHY CAROLINIANS PRIORITIES 1.Access to Health Care, Insurance, and Information 2.Chronic Disease: Exercise and Nutrition 3.Mental Health 4.Substance Abuse 5.Injury  Current Healthy Carolinians of Orange County Focus Areas December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 42

43 CURRENT FOCUS AREAS AND FINDINGS HEALTHY CAROLINIANS OF ORANGE COUNTY, December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 43

44 ACCESS TO HEALTH CARE Orange County has highest per capita number of physicians and dentists in NC  88.9 physicians, 10.4 dentists per 10,000 population 18.3% of Orange County residents do not have one or more persons that they considered a doctor or health care provider Close to 28% of residents did not visit a doctor for a routine (general physical exam) checkup within the past year 14.8% of county residents could not see a doctor due to cost December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 44

45 ACCESS TO HEALTH CARE In addition to medical insurance, factors contributing to a resident’s inability to access health care services include  Concentration of health care resources in the southern part of county  Inadequate transportation systems in the central and northern parts of Orange County  Language barriers; Recent relocation to the county from another country  Perceived disparities (or racism) within health care facilities December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 45

46 Medical facilities (hospitals, urgent care facilities, and health departments) in the county are all within city limits of Chapel Hill, Carrboro, or Hillsborough. This map does not include private physician or dentist offices. December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 46 ACCESS: ORANGE COUNTY MEDICAL FACILITIES

47 ACCESS TO HEALTH INSURANCE county-level estimates of uninsured  18.9% (21,854) of Orange County residents, 0-64 years of age Due to economic recession, rise in unemployment rates consistent with rise in uninsured residents December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 47

48 ACCESS TO HEALTH INFORMATION December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 48 Health Literacy  “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”  Extends beyond a person’s reading and writing skills  Ability to comprehend spoken words  Use numeracy and math skills for calculations  Navigate the health care system  Transcends income and education levels

49 CHRONIC DISEASE: CANCER Cancer  Leading cause of death in Orange County (2010)  Ranked as leading cause of death in 9 of past 10 years  Among all cancers, death rate per 100,000 population was (2008)  Lower cancer death rates than NC (2008)  Responsible for 859 deaths ( )  Total number of cancer deaths decreased slightly in comparison with previous time periods  Difference in cancer deaths between racial groups is dramatic  For all common cancers, African Americans had higher death rate than whites December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 49

50 CHRONIC DISEASE: DIABETES Diabetes  , age-adjusted diabetes death rates for Orange County was 17.8 per 100,000 (NC rate was 27.6 per 100,000)  Percentage county residents with diabetes varied in recent years December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 50

51 CHRONIC DISEASE: HEART DISEASE AND STROKE Heart Disease and Stroke  Second leading cause of death  137 deaths due to heart disease; 29 due to cerebrovascular disease (2009)  Heart disease and cerebrovascular disease leading causes of hospitalizations, hospital expenses  Heart disease: $31,730,269  Cerebrovascular disease: $7,290,187  Age-adjusted death rate for heart disease decreasing  : per 100,000  2009: per 100,000  Age-adjusted death rate for cerebrovascular disease is 39.0 per 100,000 (2009) December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 51

52 CHRONIC DISEASE: OBESITY, OVERWEIGHT Obesity and Overweight  Contributes to the burden of cancer, heart disease, stroke  Rate of overweight or obese among residents 18 and older  Overall rate dropped from 56% to 48.1% ( )  However, recent increase to 53.2% (2010)  Rate of overweight among 2-4 year olds has decreased December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 52

53 CHRONIC DISEASE: EXERCISE AND NUTRITION Physical activity and proper nutrition  Important to reach a healthy body weight  Meeting recommendations can help prevent cardio- metabolic conditions  Healthy eating in childhood and adolescence important for proper growth and development 31.1% of residents consume five or more servings of fruits or vegetables per day (2009) December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 53

54 MENTAL HEALTH AND SUBSTANCE ABUSE Suicide  Among top 10 leading causes of death  Rates fluctuated ( ), ranging from a low of 5.8/100,000 to a high of 18.5/100,000 High stress/Poor mental health Substance abuse  Increasing prevalence of prescription drug abuse/misuse  Underage drinking  Driving under the influence December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 54

55 MENTAL HEALTH AND SUBSTANCE ABUSE Contributing factors  System instability  Family and community violence  Barriers to access  Stigma  Lack of knowledge about existing services  Lack of adequate insurance or co-pays  Lack of specific service/needing more options COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY December 2011

56 TOBACCO Tobacco use remains leading preventable cause of death 11.5% of county residents report smoking some days or every day, compared to 20.3% in NC (2009) 14.5% of high school students report using tobacco (cigarettes, cigars, smokeless tobacco) in the past 30 days (2011) 8.1% of people exposed to secondhand smoke in workplace (2008) Educational attainment, employment correlated with secondhand smoke exposure Percentage of mothers who smoked during pregnancy has been decreasing since 1994 December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 56

57 INJURY AND VIOLENCE Broad topic: Injury-related health issues including  Unintentional injuries: Motor vehicle crashes, falls, poisonings, drowning, etc.  Intentional injuries/violence: Sexual assault, child abuse, domestic violence, suicide, human trafficking, etc. Unintentional injuries a leading cause of death for ages 1-44 Intentional injuries (or violence) likewise pervasive and a leading cause of death/hospitalization, especially for ages December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 57

58 TAKING ACTION, TOGETHER Many efforts underway to address priority areas; new initiatives needed to respond to identified gaps Progress requires total community involvement to improve the quality of life for people living in Orange County December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 58

59 TAKING ACTION, TOGETHER Join the more than 125 other individuals and 80 county agencies and organizations who are partnering with Healthy Carolinians of Orange County to find creative solutions so that all Orange County residents can choose health as their first priority To find out how to become involved with work groups addressing the top health concerns in the county, please contact the Healthy Carolinians Coordinator December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 59

60 CONTACT INFORMATION Nidhi Sachdeva MPH, CHES Healthy Carolinians Coordinator Orange County Health Department 300 West Tryon Street | Hillsborough, NC Phone: Website, Full Report, Membership Information: December COMMUNITY HEALTH ASSESSMENT HEALTHY CAROLINIANS OF ORANGE COUNTY 60


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