1. Virginia’s Planning District 10 (Thomas Jefferson Health District) Community Health Assessment 2012

2. Source: Centers for Disease Control and Prevention; National Association of County and City Health Officials MAPP Model

3. 1.Locality CHA Councils Review, discuss and determine need for additional quantitative and qualitative data Prioritize health issues Charlottesville-AlbemarleFluvannaGreeneLouisaNelson 2.TJHD MAPP 2 Health Leadership Council Decide health questions for TJHD phone survey Complete Community Health Improvement Plan for TJHD 1-2 reps per CHA locality council District-wide agencies serving TJHD Local government Schools Colleges Community agencies Healthcare organizations Non-profits Source: Thomas Jefferson Health District MAPP 2 Health 2011-12

4. M2H Organizational Partners 2012 Source: TJHD

5. Community Health Assessment Data

6. Demographics Socioeconomics Health Resource Availability Section One: Who are we and what do we bring to the table?

7. Demographics

8. Population Growth TJHD by Locality, 1990-2010 Source: Weldon Cooper Center

9. Percent Change in Population TJHD by Locality, TJHD, and Virginia 1990-2010 Source: Weldon Cooper Center and the Thomas Jefferson District Planning Commission 199020002010 % Change 1990-2000 %Change 2000-2010 Albemarle68,17284,18698,97023%18% Charlottesville40,47540,09943,475-1%8% Fluvanna12,42920,04725,69161%28% Greene10,29715,24418,40348%21% Louisa 20,23525,62733,15326%29% Nelson12,77814,44515,02013%4% TJHD164,476199,648234,71221%18% Virginia6,189,3177,079,0308,001,02414%13%

10. Age and Sex Distribution TJHD, 2010 Source: U.S. Census Bureau

11. Age Distribution TJHD, 2000,2010 Source: U.S. Census Bureau

12. Racial Composition TJHD, 2010 Source: U.S. Census Bureau Other includes: American Indian, Alaska Native, Native Hawaiian, Pacific Islander, and some other race

13. Percent of Population by Race TJHD by Locality, 1980-2010 Percent of Population 1980199020002010 Albemarle County Black 11%10% White 87%86%85%81% City of Charlottesville Black 18%21%22%19% White 81%76%70%69% Fluvanna County Black 29%23%18%15% White 70%77%79%81% Greene County Black 8%6% White 92%93%91%88% Louisa County Black 33%26%22%18% White 67%74%77%78% Nelson County Black 24%19%15%13% White 76%80%83% Source: U.S. Census Bureau

14. Percent Change in Hispanic Population TJHD by Locality and Virginia, 2000,2010 Source: U.S. Census Bureau

15. Limited English Proficient Student Enrollment TJHD and Virginia, 2002-2012 Source: Virginia Department of Education

16. Limited English Proficient Student Enrollment TJHD by Locality, 2002-2012 Source: Virginia Department of Education *Note: For locality graphs such as this one, only the localities that start or end as the lowest and highest points are labeled

17. SSI and Disabled OASDI Beneficiaries TJHD by Locality and Virginia, 2011 Source: U.S. Social Security Administration; U.S. Census Bureau Residents who received SSI (Supplemental Security Income) benefits, excluding those who also received OASDI (Old-Age, Survivors, and Disability Insurance) benefits to avoid duplication, PLUS persons classified as “Disabled” who received OASDI benefits.

18. Greene County 1.3% Albemarle County 0.9% Charlottesville 2.0% Fluvanna County 1.0% Nelson County 2.4% Louisa County 1.9% Source: Weldon Cooper Center: County Health Rankings; U.S. Social Security Administration Percent of Supplemental Security Income (SSI) Recipients, TJHD by Locality, 2010 *Measured as December 2010 recipients of SSI benefits divided by the total population

19. Percent of Students Receiving Special Education TJHD by Locality, 2006-2010 Source: Virginia Department of Education; U.S. Census Bureau, Small Area Health Insurance Estimates

20. On-time* Graduation Rate: All Students TJHD by Locality and Virginia, 2008-2011 Source: Virginia Department of Education *The percentage of students in a cohort who earn a diploma within 4 years of entering high school **Cohort: Students who entered the ninth grade for the first time together and were scheduled to graduate 4 years later

21. On-time* Graduation Rate: Economically Disadvantaged Students TJHD by Locality and Virginia, 2008-2011 Source: Virginia Department of Education *The percentage of students in a cohort who earn a diploma within 4 years of entering high school **Cohort: Students who entered the ninth grade for the first time together and were scheduled to graduate 4 years later

22. Educational Attainment Charlottesville Metro Area, and Virginia, 2011 Source: American Community Survey

23. Socioeconomics

24. Median Household Income Virginia and U.S., 2000-2011 Source: U.S. Census Bureau, Small Area Income and Poverty Estimates

25. Median Household Income TJHD by Locality, 2000-2011 Source: U.S. Census Bureau, Small Area Income and Poverty Estimates

26. Greene County 9.7% Albemarle County 9.1% Charlottesville 20.2% Fluvanna County 7.3% Nelson County 13.1% Louisa County 9.9% Source: Weldon Cooper Center: County Health Rankings; US Census Bureau, Small Area Income and Poverty Estimates 2010 Percent of Persons in Poverty TJHD by Locality, 2010

27. Percent of Persons in Poverty Virginia and U.S., 2000-2011 Source: U.S. Census Bureau, Small Area Income and Poverty Estimates

28. Percent of Persons in Poverty TJHD by Locality, 2000-2011 Source: U.S. Census Bureau, Small Area Income and Poverty Estimates

29. Percent of Children in Poverty Virginia and U.S., 2000-2011 Source: U.S. Census Bureau, Small Area Income and Poverty Estimates

30. Percent of Children in Poverty TJHD by Locality, 2000-2011 Source: U.S. Census Bureau, Small Area Income and Poverty Estimates

31. Source: Virginia Department of Education, School Nutrition Program Percent of Students Eligible for Free/Reduced Lunch TJHD and Virginia, 2005-2012

32. Source: Virginia Department of Education, School Nutrition Program Percent of Students Eligible for Free/Reduced Lunch TJHD by Locality, 2005-2012

33. Number of Households Receiving Supplemental Nutrition Assistance TJHD by Locality, 2001-2011 Percent Increase Albemarle: 313% Charlottesville: 120% Fluvanna: 387% Greene: 269% Louisa: 247% Nelson: 168% Source: Virginia Department of Social Services, SNAP Participation Report.

34. Greene County 10.4% Albemarle County 5.8% Charlottesville 12.6% Fluvanna County 6.0% Nelson County 13.7% Louisa County 11.8% Source: Weldon Cooper Center: County Health Rankings; Virginia Department of Social Services Percent of Supplemental Nutrition Assistance Program (SNAP) Participants TJHD by Locality, 2010 *Measured as average monthly persons on SNAP divided by the total population

35. Number of Homeless Persons TJHD, 2004-2011 Source: Thomas Jefferson Area Coalition for the Homeless (TJACH)

36. Unemployment Rate TJHD, Virginia, & U.S., 2000-2011 Source: Virginia Workforce Connection

37. Unemployment Rate TJHD by Locality, 2000-2011 Source: Virginia Workforce Connection

38. Health Resource Availability

39. Sources of Health Insurance Virginia and U.S., 2010 Source: Kaiser Family Foundation VirginiaUnited States Percentages may not sum to 100% due to rounding effects

40. Health Insurance Coverage by Age Virginia, 2010-2011 Source: U.S. Census Bureau, Annual Social and Economic Supplement

41. Estimated Uninsured Persons, 18-64 TJHD and Virginia, 2005-2010 Source: U.S. Census Bureau, Small Area Health Insurance Estimates

42. Estimated Uninsured Persons, 18-64 TJHD by Locality, 2005-2010 Source: U.S. Census Bureau, Small Area Health Insurance Estimates

43. Estimated Uninsured Persons <19 Years TJHD and Virginia, 2006-2010 Source: U.S. Census Bureau, Small Area Health Insurance Estimates

44. Estimated Uninsured Persons <19 Years TJHD by Locality, 2006-2010 Source: U.S. Census Bureau, Small Area Health Insurance Estimates

45. Medicaid Enrollment and Spending by Recipient Group Virginia and U.S., FY 2009 Source: Kaiser Family Foundation United StatesVirginia

46. Number of Primary Care Providers TJHD by Locality, 2011 Source: UVA Physician Directory; Martha Jefferson Hospital Physician Directory

47. Number of Charlottesville Free Clinic Medical Patients TJHD by Locality, FY2012 Source: Charlottesville Free Clinic

48. Number of Dental Service Providers TJHD by Locality, 2012 Source: Community Dental Center; DentaQuest; yellow pages

49. Number of Charlottesville Free Clinic Dental Patients, TJHD by Locality, FY2012 Source: Charlottesville Free Clinic

50. Average Number of Community Dental Center Patients Served Per Month, FY2010-2012 Source: Community Dental Center

51. Medicaid/FAMIS Enrollees <19 Years Receiving Dental Services TJHD by Locality, FY 2007-FY 2010 Source: Virginia Smiles for Children

52. Number of Licensed Mental Health Providers TJHD by Locality, 2011 Source: Mental Health America

53. Number of Region Ten Community Services Board Direct Service Staff TJHD by Locality, 2012 Source: Region Ten All mental health direct service staff at Region Ten – anyone who provides mental health services, whether licensed or not

54. Number of Public Health Staff by Specialty TJHD by Locality, 2012 Source: Thomas Jefferson Health District

55. Section Two: What are the strengths and risks in our community that contribute to health? Community Resources Community Safety Environmental Quality Health Behaviors

56. Community Resources

57. CAT Bus Route Alignments Monday-Saturday Service, Charlottesville, 2012 Source: Charlottesville Area Transit, Transit Development Plan: Fiscal Years 2012-2017

58. CAT Top Trip Origin and Destination Locations CAT Survey Responses, Charlottesville, 2012 Source: Charlottesville Area Transit, Transit Development Plan: Fiscal Years 2012-2017

59. JAUNT Passengers TJHD by Locality, FY2008-FY2012 Source: Jaunt Ridership Report *Passengers are counted by trip and may be duplicated

60. JAUNT Passengers by Type TJHD, FY2008–FY2012 Source: Jaunt Ridership Report

61. Greene Transit Authority Greene County, January – August 2011 Source: Greene County Transit, Inc.

62. Recreational Facilities TJHD by Locality and Virginia, 2009 Source: County Health Rankings

63. Food Stores by Type TJHD, 2009 Source: U.S. Department of Agriculture

64. Food Stores by Type TJHD by Locality, 2009 Source: U.S. Department of Agriculture

65. Food Stores by Type TJHD by Locality, 2009 Source: U.S. Department of Agriculture

66. Source: Virginia Department of Social Services Licensed Child Care Facilities TJHD by Locality, 2012 Fluvanna Greene Louisa Nelson Charlottesville & Albemarle

67. Community Safety

68. Reported Crime Incidence Rate TJHD, 2000-2011 *Reported Group A Offenses; arson, assault, bribery, burglary, counterfeiting/forgery, destruction/damage/vandalism of property; drug/narcotic; embezzlement; extortion/blackmail; fraud; gambling; homicide; kidnapping/abduction; larceny/theft; motor vehicle theft; pornography/obscene material; prostitution; robbery; sex, forcible and non-forcible; stolen property; weapon law violations Source: Department of State Police, Virginia Uniform Crime Reporting Program

69. Reported Crime Incidence Rates TJHD by Locality, 2000-2011 *Reported Group A Offenses; arson, assault, bribery, burglary, counterfeiting/forgery, destruction/damage/vandalism of property; drug/narcotic; embezzlement; extortion/blackmail; fraud; gambling; homicide; kidnapping/abduction; larceny/theft; motor vehicle theft; pornography/obscene material; prostitution; robbery; sex, forcible and non-forcible; stolen property; weapon law violations Source: Department of State Police, Virginia Uniform Crime Reporting Program

70. Domestic Violence Arrest Rates Albemarle and Charlottesville, 2001-2010 Source: Commission for Children and Families, Stepping Stones

71. Domestic Violence Arrest Rate Louisa County, 2009-2011 Source: Louisa County Sheriff’s Office

72. Violence Incidence Rates in Schools TJHD and Virginia, 2007-2011 Source: Virginia Department of Education

73. Violence Incidence Rates in Schools TJHD by Locality, 2007-2011 Source: Virginia Department of Education

74. Founded Child Abuse and Neglect Rates TJHD and Virginia, 2000-2011 Source: Virginia Department of Social Services *Five-year rolling averages of Rate of Abuse and Neglect per 1,000 Children (Founded Investigations and Duplicated)

75. Founded Child Abuse and Neglect Rates TJHD by Locality, 2000-2011 Source: Virginia Department of Social Services *Five-year rolling averages of Rate of Abuse and Neglect per 1,000 Children (Founded Investigations and Duplicated)

76. Reported Adult Abuse and Neglect Rates, TJHD and Virginia, 2008-2011 Source: Virginia Department of Social Services

77. Reported Adult Abuse and Neglect Rates, TJHD by Locality, 2008-2011 Source: Virginia Department of Social Services

78. Drug/Narcotic Arrest Rates TJHD and Virginia, 2000-2011 Source: Department of State Police, Virginia Uniform Crime Reporting Program

79. Drug/Narcotic Arrest Rates TJHD by Locality, 2000-2011 Source: Department of State Police, Virginia Uniform Crime Reporting Program

80. Driving Under the Influence (DUI) Arrest Rates, TJHD and Virginia, 2000-2011 Source: Department of State Police, Virginia Uniform Crime Reporting Program

81. Driving Under the Influence (DUI) Arrest Rates, TJHD by Locality, 2000-2011 Source: Department of State Police, Virginia Uniform Crime Reporting Program

82. Environmental Quality

83. Air Quality Index Report Charlottesville CBSA, Fairfax CBSA, Richmond CBSA, and Virginia Beach CBSA, 2011 Source: Environmental Protection Agency

84. Good and Impaired Streams in Watersheds TJHD, 2008 Source: Environmental Protection Agency – Surf Your Watershed

85. Watersheds That Drain Into TJHD Source: Environmental Protection Agency Rivanna Pamunkey South Fork Shenandoah Middle James - Buffalo Rapidan – Upper Rappahannock Maury Middle James - Willis

86. Impaired Steams TJHD, 2010 Source: Thomas Jefferson District Planning Commission

87. Rivanna: Biological Health Scores TJHD, 2006-2009 Source: StreamWatch Samples are scored per an index that reflects the composition and diversity of the array of captured organisms. Site health is assessed based on all scores generated during the assessment window

88. Lead Exposure: At-Risk Zip Codes* TJHD by Locality, 2011 Source: Virginia Department of Health, Lead Safe Virginia *VDH identifies areas in Virginia at risk for lead exposure as those with more than 27% of homes built before 1950 and/or those with an increased prevalence of children with elevated blood lead levels (EBLL)

89. Elevated Blood Lead Level Tests in Children <72 Months of Age TJHD by Locality, 2004-2011 Source: Virginia Department of Health, Lead Safe Virginia

90. Elevated Blood Lead Level Test Results in Children <72 Months of Age TJHD by Locality, 2004-2011 Source: Virginia Department of Health, Lead Safe Virginia

91. Health Behaviors

92. Deaths (in thousands) Source: Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, et al. (2009) The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors. PLoS Med 6(4): Heron, M., Tejada-Vera, B. (2009). Deaths: Leading Causes for 2005. National Vital Statistics Reports. 58(8) Leading Causes of DeathDeaths Attributable to Individual Risk Factors Leading vs. Actual Causes of Death

93. Self-Reported Adult Smokers TJHD and Virginia, 2000-2010 Source: Virginia Department of Health, Virginia Behavioral Risk Factor Surveillance Survey

94. Tobacco Facts Virginia, 2012 VirginiaUnited States Adult Smoking Rank (1 st = low smoking rates) 31stN/A Cigarette Tax (per pack) $0.30 ($0.35 local tax for Cville) $1.46 Cigarette Tax Rank (1 st = high taxes) 50thN/A FY 2012 Funding for State TC Programs (millions) $8.4$456.7 Tobacco Prevention Spending % of CDC Target 8.1%12.5% Tobacco Prevention Spending Rank (1 st =high spending rates) 30thN/A Source: Campaign for Tobacco-Free Kids; City of Charlottesville City Treasurer Website

95. Physical Inactivity TJHD by Locality and Virginia, 2009 Source: Behavioral Risk Factor Surveillance System; County Health Rankings*Numbers are self-reported

96. Percent of Obese Adults by State U.S., 1990 and 2010 Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System

97. Percentage of Adults Who Are Obese TJHD by Locality, 2009 Greene County 30.5% Albemarle County 27.1% Charlottesville 26.9% Fluvanna County 29.6% Nelson County 26.4% Louisa County 31.7% Source: Centers for Disease Control and Prevention: National Diabetes Surveillance System **Body mass was derived from self-report of height and weight from adults 20 and Over. *Obese = Body Mass Index (BMI) ≥30, or ~ 30 lbs. overweight for 5’ 4” person

98. Percentage of Adults Who Are Obese TJHD and Virginia, 2000-2010 Source: Virginia Department of Health, Virginia Behavioral Risk Factor Surveillance Survey

99. Percentage of 5 th Graders Who Are Overweight or Obese Albemarle and Charlottesville Public Schools, 1998-2011 Source: Community Action on Obesity

100. Percentage of 5 th &10 th Graders Who Are Overweight or Obese Nelson County Public Schools, 2009-2011 Source: Blue Ridge Medical Center

101. Seat Belt Usage Virginia, 1987-2011 Source: Virginia Department of Motor Vehicles, Highway Safety Office

102. Three Year Rolling Average Number of Hospitalizations from Motor/Other Vehicle Accidents With and Without Safety Device Usage, TJHD, 2007-2011 Source: Virginia Department of Health, Office of Emergency Medical Services *Safety Devices include air bags, child safety seats, helmets, and safety belts; note that the presence of a safety device does not necessarily imply that it was used (properly or otherwise). Similarly, "none" does not necessarily mean that safety device was not used

103. Three Year Rolling Average Number of Hospitalizations from Motor/Other Vehicle Accidents With and Without Safety Device Usage, TJHD by Locality, 2007-2011 Source: Virginia Department of Health, Division of Health Statistics

104. Source: Virginia Department of Health, Division of Immunization Percentage of Adequately Immunized Kindergarteners TJHD, 2008-2011 *Includes schools that submit student immunization survey results in the Fall of each year – approximately 30 public schools and 6 private schools (only 2 private schools reported in 2008)

105. Percentage of Adequately Immunized Sixth Graders TJHD, 2008-2011 *Includes schools that submit student immunization survey results in the Fall of each school year – approximately 10 public schools and approximately 8 private schools (only 2 private schools reported in 2008) Source: Virginia Department of Health, Division of Immunization

106. Section Three: What is our health status? Maternal and Child Health Leading Causes of Death Cancer Unintentional Injury Infectious Diseases Ambulatory Care Sensitive Conditions Mental Health

107. Maternal and Child Health

108. Live Birth Rates TJHD and Virginia, 1998-2011 *Live Births Counted by Place of Residence Source: Virginia Department of Health. Division of Health Statistics

109. Live Birth Rates TJHD by Locality, 1998-2011 Source: Virginia Department of Health. Division of Health Statistics *Live Births Counted by Place of Residence

110. Infant Mortality Rates* TJHD and Virginia,1999-2011 Source: Virginia Department of Health, Division of Health Statistics *Deaths among infants <1year of age

111. Infant Mortality Rates* by Race TJHD, Virginia, and U.S., 1999-2011 Source: Virginia Department of Health, Division of Health Statistics *Deaths among infants <1year of age

112. Neonatal Death Rate* TJHD and Virginia, 1999-2011 Source: Virginia Department of Health, Division of Health Statistics *Deaths among infants <28 days of age

113. Percentage of Preterm* Births TJHD, West Central Perinatal Region and Virginia, 2001-2010 Source: Virginia Department of Health *Percent of live births born less than 37 weeks gestation Healthy People 2020

114. Percentage of Preterm* Births TJHD by Locality, 2001-2010 Source: Virginia Department of Health *Percent of live births born less than 37 weeks gestation

115. Percentage of Low-Weight* Births TJHD, Virginia, and U.S.,1999-2011 Source: Virginia Department of Health, Division of Health Statistics *Low Birth Weight = Live Births Weighing <2500 grams

116. Percentage of Low-Weight* Births TJHD by Locality,1999-2011 Source: Virginia Department of Health, Division of Health Statistics *Low Birth Weight = Live Births Weighing <2500 grams

117. Percentage of Low-Weight Births* by Race, TJHD and Virginia, 1999-2011 Source: Virginia Department of Health, Division of Health Statistics *Low Birth Weight = Live Births Weighing <2500 grams

118. Percentage of Low-Weight Births* by Race, TJHD by Locality, 2005-2011 Source: Virginia Department of Health, Division of Health Statistics *Low Birth Weight = Live Births Weighing <2500 grams

119. Teen Pregnancy Rates: Ages 10-19 TJHD and Virginia, 2000-2011 Source: Virginia Department of Health, Division of Health Statistics

120. Teen Pregnancy Rates: Ages 10-19 TJHD by Locality, 2000-2011 Source: Virginia Department of Health, Division of Health Statistics

121. Teen Pregnancy Rates: Ages 15-17 TJHD and Virginia, 2000-2011 Source: Virginia Department of Health, Division of Health Statistics

122. Teen Pregnancy Rates: Ages 15-17 TJHD by Locality, 2000-2011 Source: Virginia Department of Health, Division of Health Statistics

123. Teen Pregnancy Rates by Race, Ages 10-19, TJHD and Virginia, 2000-2011

124. Teen Pregnancy Rates by Race, Ages 10-19, TJHD by Locality, 2005-2011 Source: Virginia Department of Health, Division of Health Statistics

125. Induced Termination Rates TJHD and Virginia, 2003-2011 Source: Virginia Department of Health, Division of Health Statistics

126. Induced Termination Rates TJHD by Locality, 2003-2011 Source: Virginia Department of Health, Division of Health Statistics

127. Percentage of Mothers Entering Prenatal Care in the 1 st Trimester TJHD and Virginia, 2000-2010 Source: Virginia Department of Health, Division of Health Statistics *Percentage of Total Live Births to mothers with Prenatal Care Beginning in the First 13 Weeks

128. Percentage of Mothers Entering Prenatal Care in the 1 st Trimester TJHD by Locality, 2000-2010 Source: Virginia Department of Health, Division of Health Statistics *Percentage of Total Live Births to mothers with Prenatal Care Beginning in the First 13 Weeks

129. Percentage of Mothers Who had 10 or More Prenatal Care Visits TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

130. Percentage of Mothers Who had 10 or More Prenatal Care Visits TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

131. Percentage of Mothers With <12 th Grade Education TJHD by Locality and Virginia, 2002-2010 Source: Virginia Department of Health, Division of Health Statistics

132. Percentage of Mothers Who Report Smoking during Pregnancy TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

133. Percentage of Mothers Who Report Smoking during Pregnancy TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

134. Reported Substance Exposed Infants* TJHD, FY1999-2011 Source: Virginia Department of Social Services *Newborn infants that may have been exposed to controlled substances prior to birth (as indicated by a positive drug toxicology of the mother with presence of a controlled substance or by the child being born dependent on a controlled substance and demonstrating withdrawal symptoms) or have a diagnosis of fetal alcohol syndrome

135. Leading Causes of Death

136. Mortality Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

137. Mortality Rates TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

138. Mortality Rates by Race TJHD and Virginia, 2002-2011 Source: Virginia Department of Health, Division of Health Statistics

139. Mortality Rates by Race TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

140. Five Leading Causes of Death TJHD and Virginia, 2010 1. Cancer 2. Heart Disease 3. Stroke 4. Chronic Respiratory Disease (Chronic Obstructive Pulmonary Disease (COPD) and Asthma) 5. Unintentional Injuries Source: Virginia Department of Health, Division of Health Statistics

141. Leading Causes of Death By Age Virginia, 2010 Youth/Teens Source: Virginia Department of Health, Division of Health Statistics

142. Leading Causes of Death By Age Virginia, 2010 Adults Source: Virginia Department of Health, Division of Health Statistics

143. Leading Causes of Death By Age Virginia, 2010 65 and over Source: Virginia Department of Health, Division of Health Statistics

144. Heart Disease Death Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

145. Heart Disease Death Rates TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

146. Heart Disease Death Rates by Race TJHD and Virginia, 2000-2009 Source: Virginia Department of Health, Division of Health Statistics

147. Heart Disease Death Rates by Race TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

148. Stroke-Related Death Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

149. Stroke-Related Death Rates TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

150. Stroke-Related Death Rates by Race TJHD and Virginia, 2000-2009 Source: Virginia Department of Health, Division of Health Statistics

151. Cancer-Related Death Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

152. Cancer-Related Death Rates TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

153. Cancer-Related Death Rates by Race TJHD and Virginia, 2000-2009 Source: Virginia Department of Health, Division of Health Statistics

154. Cancer-Related Death Rates by Race TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics

155. COPD-Related Death Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics Four-year rolling averages

156. COPD-Related Death Rates TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics Four-year rolling averages

157. COPD-Related Death Rates by Race TJHD and Virginia, 2000-2009 Source: Virginia Department of Health, Division of Health Statistics

158. Diabetes-Related Death Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics Five-year rolling averages

159. Diabetes-Related Death Rates TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics Five-year rolling averages

160. Diabetes-Related Death Rates by Race TJHD and Virginia, 2000-2009 Source: Virginia Department of Health, Division of Health Statistics

161. Unintentional Injury Death Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics Four-year rolling averages

162. Unintentional Injury Death Rates TJHD by Locality, 1999-2010 Source: Virginia Department of Health, Division of Health Statistics Four-year rolling averages

163. Unintentional Injury Death Rates by Race TJHD and Virginia, 2000-2009 Source: Virginia Department of Health, Division of Health Statistics Four-year rolling averages

164. Suicide and Homicide Rates TJHD and Virginia, 1999-2009 Source: Virginia Department of Health, Virginia Online Injury Reporting System

165. Youth Suicide Rates TJHD and Virginia, 2004-2008 Suicide is the third leading cause of death for 10-24 year-olds. On average, two Virginia youths die each week from suicide. The suicide rate is higher in males than the rate of females. The White suicide rate is 2.4 times higher than the Black suicide rate. Source: Virginia Department of Health, Office of Family Health Services

166. Cancer

167. Lung Cancer Incidence Rates TJHD by Locality, TJHD and Virginia, 1999-2008 Source: Virginia Cancer Registry

168. Lung Cancer Incidence Rates by Race TJHD and Virginia, 1999-2008 Source: Virginia Cancer Registry

169. Lung Cancer Death Rates TJHD and Virginia, 1996-2007 Source: Virginia Department of Health, Division of Health Statistics

170. Breast Cancer Incidence Rates TJHD by Locality, TJHD and Virginia, 1999-2008 Source: Virginia Cancer Registry

171. Breast Cancer Incidence Rates by Race TJHD and Virginia, 1999-2008 Source: Virginia Cancer Registry

172. Breast Cancer Death Rates TJHD and Virginia, 1996-2007 Source: Virginia Department of Health, Division of Health Statistics

173. Prostate Cancer Incidence Rates TJHD by Locality, TJHD and Virginia, 1999-2008 Source: Virginia Cancer Registry

174. Prostate Cancer Incidence Rates by Race, TJHD and Virginia, 1999-2008 Source: Virginia Cancer Registry

175. Prostate Cancer Death Rates TJHD and Virginia, 1996-2007 Source: Virginia Department of Health, Division of Health Statistics

176. Colorectal Cancer Incidence Rates TJHD by Locality, TJHD and Virginia, 1999-2008 Source: Virginia Cancer Registry

177. Colorectal Cancer Incidence Rates by Race, TJHD and Virginia, 1999-2008 Source: Virginia Cancer Registry

178. Colorectal Cancer Death Rates TJHD and Virginia, 1996-2007 Source: Virginia Department of Health, Division of Health Statistics

179. Unintentional Injury

180. Percent of Hospitalizations due to Unintentional Injury by Cause TJHD and Virginia, 1999-2009 TJHDVirginia Source: Virginia Department of Health, Virginia Online Injury Reporting System

181. Percent of Hospitalizations due to Unintentional Injury by Cause TJHD by Locality, 1999-2009 Source: Virginia Department of Health, Virginia Online Injury Reporting System

182. Hospitalizations due to Unintentional Injury by Cause and Age Group, TJHD and Virginia, 1999-2009 0-1920-6465 and over Number% % % Falls TJHD 17419%126330%365379% Virginia 838423%4882133%12760378% Motor Vehicle/ Other Transport Crashes TJHD 39343%133332%2345% Virginia 1189933%3977827%79815% Struck by, against TJHD 768%1393%561% Virginia 27938%55464%18921% Poisoning TJHD 455%2306%1433% Virginia 27528%115128%46063% Bites, Stings TJHD 243%1173%471% Virginia 13144%39603%11581% Other/Unspecified TJHD 19922%105926%50611% Virginia 856624%3853026%2035212% Source: Virginia Department of Health, Virginia Online Injury Reporting System

183. Rates of Hospitalizations due to Falls among Persons Aged 65+, TJHD and Virginia, 1999-2009 Source: Virginia Department of Health, Virginia Online Injury Reporting System

184. Rates of Unintentional Injury Deaths by Cause, TJHD and Virginia,1999-2009 Source: Virginia Department of Health, Virginia Online Injury Reporting System

185. Rates of Unintentional Injury Deaths by Cause, TJHD by Locality,1999-2009 Source: Virginia Department of Health, Virginia Online Injury Reporting System

186. *Crashes are by place of occurrence Rates of Motor Vehicle Accidents TJHD and Virginia, 2000-2011 Source: Virginia Department of Motor Vehicles

187. *Crashes are by place of occurrence Rates of Motor Vehicle Accidents TJHD by Locality, 2000-2011 Source: Virginia Department of Motor Vehicles

188. Motor Vehicle Crash Fatality Rates TJHD and Virginia, 2000-2011 Source: Virginia Department of Motor Vehicles Five Year Averages

189. Percent of Alcohol-Related Motor Vehicle Crashes, TJHD and Virginia, 2000-2011 Source: Virginia Department of Motor Vehicles

190. Percent of Alcohol-Related Motor Vehicle Crashes, TJHD by Locality, 2000-2011 Source: Virginia Department of Motor Vehicles

191. Percent of Alcohol-Related Motor Vehicle Crash Fatalities, TJHD and Virginia, 2000-2011 Source: Virginia Department of Motor Vehicles

192. Infectious Diseases

193. Rates of Reportable Communicable Diseases, TJHD and Virginia, 2000-2010 Communicable Disease TJHDVirginia Average Number of Cases Average Rate Per 100,000* Average Number of Cases Average Rate Per 100,000* Chlamydia 559260.2 23,406306.7 Gonorrhea 13462.38,723119.3 Pertussis 5626.3 2463.3 Salmonellosis 3516.3 1,18615.8 Giardiasis 3315.5 4896.5 Chicken Pox 2511.7 1,07914.3 Campylobacteriosis 219.8 6879.2 Lyme Disease 209.1 5146.7 Source: Virginia Department of Health, Division of Surveillance and Investigation *Population data based on U.S. Census Data for TJHD and State of Virginia (2000-2010)

194. Chlamydia Incidence Rates TJHD and Virginia,1997-2010 Source: Virginia Department of Health, Division of Disease Prevention

195. Chlamydia Incidence Rates TJHD by Locality,1997-2010 Source: Virginia Department of Health, Division of Disease Prevention

196. Gonorrhea Incidence Rates TJHD and Virginia,1997-2010 Source: Virginia Department of Health, Division of Disease Prevention

197. Gonorrhea Incidence Rates TJHD by Locality,1997-2010 Source: Virginia Department of Health, Division of Disease Prevention

198. HIV and AIDS Incidence Rates TJHD and Virginia, 1997-2009 Source: Virginia Department of Health, Division of Disease Prevention

199. Syphilis (early) Incidence Rates TJHD and Virginia,1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation

200. Pertussis Incidence Rates TJHD, and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation

201. Chicken Pox Incidence Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation

202. Hepatitis B Incidence Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation

203. Salmonellosis Incidence Rates TJHD and Virginia,1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation

204. Campylobacteriosis Incidence Rates TJHD and Virginia,1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation

205. E. Coli O157:H7 Incidence Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation

206. Giardiasis Incidence Rates TJHD and Virginia,1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation

207. Legionellosis Incidence Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Disease Prevention

208. Lyme Disease Incidence Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation

209. Spotted Fever Rickettsiosis Incidence Rates, TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Surveillance and Investigation Reported Cases of Spotted Fever Rickettsiosis per 100,000 Persons Living in Locality

210. Tuberculosis Incidence Rates TJHD and Virginia, 1999-2010 Source: Virginia Department of Health, Division of Disease Prevention

211. Ambulatory Care-Sensitive Conditions

212. Source: Virginia Department of Health, Virginia Behavioral Risk Factor Surveillance System Percent of Adults Diagnosed with Diabetes (Self-Reported), TJHD and Virginia, 2000-2010

213. Hospital Discharge Rates for Diabetes TJHD and Virginia, 2000-2011 Source: VDH Data Warehouse; Virginia Hospital Information Systems

214. Hospital Discharge Rates for Diabetes TJHD by Locality, 2000-2010 Source: VDH Data Warehouse; Virginia Hospital Information Systems

215. Hospital Discharge Rates for Asthma TJHD and Virginia, 2000-2010 Source: VDH Data Warehouse; Virginia Hospital Information Systems

216. Hospital Discharge Rates for Asthma TJHD by Locality, 2000-2010 Source: VDH Data Warehouse; Virginia Hospital Information Systems

217. Hospital Discharge Rates for Hypertension, TJHD and Virginia, 2000-2011 Source: VDH Data Warehouse; Virginia Hospital Information Systems

218. Hospital Discharge Rates for COPD TJHD and Virginia, 2000-2010 Source: VDH Data Warehouse; Virginia Hospital Information Systems

219. Hospital Discharge Rates for COPD TJHD by Locality, 2000-2010 Source: VDH Data Warehouse; Virginia Hospital Information Systems

220. Mental Health

221. Average Number of Poor Physical/Mental Health in the Last 30 Days (Self-reported) TJHD by Locality, TJHD and Virginia, 2004-2010 Source: County Health Rankings *Numbers are self-reported

222. Region Ten Community Services Board’s Most Frequent Diagnosed Disorders, 2011 Source: Region Ten Community Services Board

223. Number of Emergency Services Delivered by Region 10 Community Services Board by Type of Service 1996-2009 Source: Region Ten Community Services Board

224. Source: Substance Abuse and Mental Health Services Administration Percent of Persons Served though State Mental Health Agencies with Co-Occurring Mental Health and Substance Abuse Disorders, Virginia and U.S., 2010 MH = Mental Health; AOD = Alcohol and Other Drug

225. Source: Substance Abuse and Mental Health Services Administration Percent of Persons Served though State Mental Health Agencies with Co-Occurring Severe Mental Health and Substance Abuse Disorder, Virginia and U.S., 2010 Adults with a serious mental illness (SMI) are Persons 18 years and Over who, “at any time during a given year, had a diagnosable mental, behavioral, or emotional disorder without the benefit of treatment or other support services … that has resulted in functional impairment which substantially interferes with or limits one or more major life activities.…"

226. Hospital Discharge Rates for Psychoses TJHD and Virginia, 2000-2011 Source: VDH Data Warehouse; Virginia Hospital Information Systems

227. Hospital Discharge Rates for Neurotic Disorders, Personality Disorders, and other Nonpsychotic Mental Disorders TJHD and Virginia, 2000-20 11 Source: VDH Data Warehouse; Virginia Hospital Information Systems

228. Section Four: What are community members’ perceptions of health in their communities? Thomas Jefferson Area Community Survey MAPP 2 Health Focus Groups Louisa County Qualitative Data

229. Thomas Jefferson Area Community Survey

230. Thomas Jefferson Area Community Survey (TJACS) TJHD, 2012 Source: UVA Center for Survey Research Conducted by the UVA Center for Survey Research (CSR) in January 2012 Survey of 1,098 individuals living in Charlottesville City and Albemarle, Nelson, Fluvanna, Greene, and Louisa Counties Conducted through a Random Digit Dial (RDD) sample of landline and cell-phone numbers –Also included a random sample of directory-listed landline households

231. Question 1: Thinking about [your county], which of the following services is most difficult to get care from? Source: UVA Center for Survey Research

232. Question 2: Thinking about [your county], what is the biggest difficulty people have in getting health services? Source: UVA Center for Survey Research

233. Question 3: Which of the following public health concerns is the most important for [your county] to give more attention to? Source: UVA Center for Survey Research

234. MAPP 2 Health Focus Groups

235. Focus Group Demographics TJHD, 2012 NumberPercent Attendees 47100.0% Gender Male 1531.9% Female 3268.1% Race Black or African American 48.5% White 4085.1% Other 36.4% Ethnicity Hispanic or Latino 48.5% Not Hispanic or Latino 4391.5% Age 18-27 714.9% 28-37 36.4% 38-47 510.6% 48-57 817.0% 58-67 1327.7% >68 1021.3%

236. Focus Group Demographics TJHD, 2012 NumberPercent Marital Status Married 2757.4% Widowed 36.4% Divorced 612.8% Never Married 817.0% No Answer 36.4% Employment status Employed 2655.3% Homemaker 12.1% Student 24.3% Self-Employed 36.4% Retired 817.0% Unemployed 48.5% Disabled/ Unable to Work 12.1% No Answer 24.3%

237. Focus Group Demographics TJHD, 2012 NumberPercent Education Completed Less than eighth grade 1 2.1% High school diploma or GED 8 17.0% College degree (4 years or less of college) 2348.9% Advanced degree 1429.8% No Answer 12.1% Income < $15,000 1123.4% $15,000–$29,000 510.6% $30,000–$44,000 1021.3% $45,000–$59,000 510.6% $60,000–$74,000 48.5% $75,000–$89,000 12.1% >90,000 36.4% No answer 817.0%

238. Focus Group Health Care Characteristics TJHD, 2012 NumberPercent Medical Insurance None 48.5% Medicare 1123.4% Medicaid 612.8% Private 1327.7% Employment-based 2042.6% Other 48.5% No Answer 12.1% On average, how many times each month do you use health care services (doctor, dentist, hospital, etc)? 1- 4 3370.2% 5-9 36.4% 10-14 00.0% 15 or more 00.0% Other: 1-4/year 714.9% Never 36.4% No Answer 12.1%

239. Focus Group Health Care Characteristics TJHD, 2012 NumberPercent Do you have any of the following conditions? Check all that apply: Smoking 510.6% Diabetes 510.6% Heart Disease 24.3% Cancer 24.3% Asthma 612.8% High Blood Pressure 1429.8% Other 510.6%

240. TJHD Focus Group Results 2012 Weight and Obesity –Education about health and nutrition is important in combating weight and obesity issues –The cost of nutritious foods, the convenience of unhealthy foods, and a lack of activity are important contributing factors to obesity –Fluvanna, Greene, and Nelson participants reported a lack of walking trails and places to take part in physical activity This was not considered a problem by Charlottesville and Albemarle participants

241. TJHD Focus Group Results 2012 Transportation –Noted as an issue by Fluvanna, Greene and Nelson participants: Some citizens of these counties rely on public transportation to get healthcare from providers in Charlottesville/Albemarle –Current transportation system presents some barriers to community members, such as the cost and the schedule Urgent Care –Urgent care centers in Greene and Fluvanna would be a helpful, may reduce reliance on the rescue squad

242. TJHD Focus Group Results 2012 Mental Health and Substance Abuse Issues –Drug abuse is heavily tied to mental health issues Those who do not receive mental healthcare more likely to turn to drugs and alcohol in order to “self- medicate” –Barriers to receiving mental healthcare are stigma, cost, and availability of providers –Fluvanna and Nelson participants believed that drug use was affected by a lack of recreational activities

243. TJHD Focus Group Results 2012 Resources –Participants reported frustration over the lack of a central location to access information about resources Recommend disseminating information through the media (television, radio, newspaper) Recommend having people that assist community members in navigating services

244. Louisa County Qualitative Data

245. Louisa County Citizen Survey: Health-related questions Source: County of Louisa