Vermilion County IPLAN 2012 - 2017 Community Needs Assessment

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IPLAN 2012-2017 The Illinois Project for Local Assessment of Needs (IPLAN) is a Community health assessment and planning process that is conducted every five years by local health jurisdictions in Illinois. The essential elements of IPLAN are: An organizational capacity assessment; A community health needs assessment; and A community health plan, focusing on a minimum of three priority health problems.

IPLAN Team Shirley Hicks, BS, CPHA Jenny Trimmell, BSN, PHN VCHD Public Health Administrator Jenny Trimmell, BSN, PHN VCHD Director of Community Health Services Melissa Rome, MBA, CERC, CHES VCHD Emergency Planning and Response Coordinator Dr. Krista Jones UIC School of Nursing Instructor IPLAN Consultant

Health Problem Health problem: a situation or condition of people which is considered undesirable, is likely to exist in the future, and is measured as death, disease, or disability. Source: Assessment Protocol for Excellence in Public Health

Vermilion County Demographic Changes 2000 vs 2010 Population 83919 81625 Median Age 38 39.8 65 and older 16.0% 16.3% White (%) 85.8 % 82.5% Black (%) 10.6% 13.0% Hispanic 3.0% 4.2% Housing Units 36349 36318 Owner Occupied 71.0% 69.9% Renter Occupied 28.3% 30.1% Vacant Units 8.1% 10.1% Population age 25+ 66.0% 67.5% Population age 25-44 27.2% 23.7% 2.7% overall decrease in population since 2000 Decrease in white population/ increases in black & hispanic populations from 2000 to 2010 Increase in renter occupied/ decrease in owner occupied housing. Vacant housing units increased by 2% 24.9% of population (age 18-24) had less than a H.S. diploma Median Household Income: $37,167 (2009 data) Persons below poverty level 21.7% (2009 data)

Poverty Some data shows that numbers are higher, but these are the data sets we are going by. Overall Poverty Rate: US Census Bureau 2006-2010 Child Poverty Rate: County Health Rankings 2011

Poverty Vermilion County child abuse and neglect rate rose from 14.8 (per 1,000) in 2003 to a rate of 20.1 (per 1,000) in 2010, however have seen a decrease in the last 2 years. The Illinois rate was 7.5 and 8.3 respectively. Vermilion County children receiving medical assistance (KidCare and Medicaid) rose 29.0% from 9,990 children (2005) to 12,892 children (2011). There were 5,483 children under the age of 5 (2010 census data) in Vermilion County; 36.7% of these children live in households below poverty rates. 16.4% of children ages 5-17 live below poverty (2010 data). Source: Kids Count 2012 US Census Between 2000 and 2010 (children 5-17 who are in poverty in schools) District #118 – 21.78 to 35.03 = 60.87% increase Catlin – 2.83 to 11.39 = 302.92% increase Armstrong HS – 14.46 to 10.75 = 25.63% decrease Hoopeston 13.48 to 31.55 = 134% increase Source: U.S. Census via News Gazette

Child Poverty Rates Source: Voices for Illinois Children 2012 Report

County Rankings 2011 Out of 102 Counties Rank Health Outcomes Rank Health Factors (Mortality/ Morbidity) (Health Behaviors, Clinical Care, Social & Economic Factors, Physical Environment) 98 Vermilion 96 Vermilion Out of 102 Counties

County Rankings 2011 Rank: 98 / 102 V C Illinois 75% 80% 49% 64% 11.5% Social & Economic Factors Rank: 98 / 102 V C Illinois HS Graduation Rate 75% 80% Some College 49% 64% Unemployment 11.5% 10.1% Children in Poverty (per 100,000 population) 23% 17% Inadequate Social Support 25% 21% Single Parent Households 42% 31% Violent Crime Rate 700 550

County Rankings 2011 Clinical Care Rank: 35 / 102 V C Illinois 12% 17% Uninsured Adults (under age 65) 12% 17% Primary Care Providers 1,298:1 778:1 Preventable Hosp. Stays 101 83 Diabetic Screening (Medicare enrollees that receive HbA1c screening) 80% Mammography Screening (Medicare enrollees) 64% 63%

County Rankings 2011 Physical Environment Rank: 38 / 102 V C Illinois Air Pollution-particulate matter days (annual # days) 3 Air pollution-ozone days (annual # days) 4 Access to Healthy foods (health food outlets: grocery stores & produces stands/farmers markets) 38% 53% Access to recreational facilities (per 100,000 population) 9 10

Leading Causes of Death in Vermilion County Leading Causes of death (2006 data) in Vermilion County are as follows: Diseases of the Heart Cancer Chronic Lower Respiratory Disease Cerebrovascular Diseases (Stroke) Accidents Diabetes Mellitus Nephritis, etc. (Kidney Disease) (IPLAN Data System Report 2006, app. idph.state.il.us)

Leading Causes of Death in Vermilion County (#1) Diseases of the heart remains the leading cause of death in Vermilion County. In 2008 24% of all deaths were due to diseases of the heart (226 deaths). The majority of those deaths were due to Coronary Heart Disease specifically. There has been a gradual decline in deaths due to diseases of the heart since 2003 with an overall decrease of 7% According to the BRFSS 2007-09, Vermilion County had a 2.8% decrease in smokers but a 2.9% increase in those who report being obese and a 12.3% decrease in those report they meet the recommended amount of physical activity

RISK FACTORS THAT MAY CONTRIBUTE TO HEART DISEASE BRFSS Comparison Data Vermilion County 2004-06 2007-09 % changed Smoker 30.60% 27.7% 2.8% ↓ Told have high blood pressure 30.4% 33.8% 3.4% ↑ Take meds for blood pressure 87.8% 77.3% 10.5% ↓ Told cholesterol high 35.8% 43.2% 7.4% ↑ Normal weight/ underweight 35.75% 32.5% 3.2% ↓ Overweight 37.2% 37.5% .3% ↑ Obese 27.1% 30.0% 2.9% ↑ Meets recommended physical activity 46.8% 43.1% 12.3% ↓ Insufficient activity 37.3% 41.8% 4.5% ↑ Inactive 15.9% 15.2% .7% ↓ 0-2 servings fruit/veggies/day 58.6% 64.5% 5.9% ↑ 3-4 servings fruit/veggies/day 26.9% 28.8% 1.9% ↑ 5+ servings fruit/veggies/day 14.5% 7.2% 7.3% ↓

Leading Causes of Death in Vermilion County (#2) Cancer (all types) is the 2nd leading cause of death in Vermilion County V.C. rate for all cancers is 522.1 compared to the state rate of 490.4 (HP 2020 target is 160.6/100,000) There were 224 deaths in 2006 due to all cancers; 70 of those deaths were due to Lung Cancer specifically In gender specific data for highest number of deaths from cancer were prostate cancer for men and breast cancer for women

OBESITY Obesity and physical inactivity has been linked to a range of chronic diseases including diabetes and hypertension. 20 years ago 12.1% of Illinois residents were obese; currently (2008-2010) 27.7% are obese (F as in Fat Report, www.healthamericans.org; RWJF) 20 years ago 5.2% of Illinois residents had diabetes; currently (2008-2010) 8.4% have diabetes 20 years ago 21.9% of Illinois residents had hypertension; currently (2008-2010) 27.5% have hypertension 30.0% of Vermilion County adult residents report fitting the criteria for obesity (2007-09 BRFSS)

OBESITY & CHILDREN Almost 1/3 of U.S. children and adolescents between the ages of 2 and 19 are overweight or obese Children who are obese are more than twice as likely to die before the age of 55 as children whose BMI is in the normal range. Children who are obese after the age of 6 are 50% more likely to be obese adults. Those who did not graduate high school have the highest rates of obesity. (32.8% obesity rate) Vermilion County has a 75% graduation rate (F as in Fat 2011 Report; www.healthyamericans.org, RWJF)

Childhood Obesity in Illinois (F as in Fat 2011 Report; www.healthyamericans.org, RWJF) Illinois ranked 4th highest in the U.S. for obesity in children ages 10-17 yrs old Illinois tied with Louisiana for 4th, Mississippi, Georgia and Kentucky were 1-3 respectively Obesity is correlated with income Households that make less than $15,000 have a 33.8% obesity rate Households making between $15,000 & $25,000; obesity rate is 31.8% Households making between $25,000 & $35,000; obesity rate is 29.7% Households making between $35,000 & $50,000; obesity rate is 29.5% Median Income for V.C. residents $37,167 (2009 data) In Vermilion County 16.4% of children ages 5-17 live below poverty (2010census data) There were 5483 children under the age of 5 (2010 census data) in Vermilion County; 36.7% of these children live in households below poverty rates

Teen Pregnancy Vermilion County Teen Births Live Births Mother < 20 % of births to teens VC % of births to teens Illinois Infant mortality cases rate 2004 1079 177 16.4% 9.9% 6 ** 2005 1112 180 16.2% 9.7% 11 2006 1176 166 14.1% 10.0% 7 2007 1117 151 13.5% 10.1% 8 2008 1094 164 15.0% 9 2009 1100 172 15.6% 9.6% Not avail The 13.5% teen birth rate in 2007 was the lowest % of teen births since we began keeping records in 1970; this was still above State rate of 10.1%. VC students who have had sexual intercourse sometime in their life reached the highest percent since data was first collected in 2002 (ISBE 2010 data). The 2010 number (55.7%) represents an increase of 4.5% from 2002 and an even greater increase of 6.5% from 2008.

TEEN BIRTHS Health Concerns Approximately 400,000 teens aged 5-19 yrs give birth every year in the U.S. The U.S. teen birth rate remains the highest in the developed world Teen mothers are more likely to experience negative social outcomes, including school dropout. Infants of teen mothers are more likely to be low birth weight & have lower academic achievement Daughters of teen mothers are more likely to become teen mothers themselves. (CDC: MMWR Jan 20, 2012 / 61(02);25-29)

TEEN BIRTHS Additional Statistics Data from the Pregnancy Risk Assessment Monitoring System (PRAMS) collected in 19 states (Illinois participates in PRAMS), during 2004-2008, for teens aged 15-19, who became pregnant unintentionally & gave birth to a live infant indicated: 50.1% reported doing nothing to prevent pregnancy Of these teens, 31.4% thought they could not get pregnant at the time 23.6% did not use contraception because their partner did not want to use it 22.1% did not mind getting pregnant (CDC: MMWR Jan 20, 2012 / 61(02);25-29)

Reported Chlamydia Cases in Vermilion County 2007-2011 Source IDPH STD SECTION Provider Type 2007/cases total VCHD separate 2008/cases 2009/cases 2010/cases 2011/cases Health Dept STD & FP 207 STD 136 FP 71 224 140 84 191 86 105 99 91 8 13 Private Physician 174 167 137 225 294 Hospital 65 52 70 175 Aunt Martha’s 1 25 Adult Corrections 17 19 12 JDC 4 14 15 Top 6 Providers listed; other Provider categories not included on this chart*** TOTALS 491 496 413 438 587

STD DATA: Chlamydia

STD TRENDS: Chlamydia Chlamydia case reports have been steadily increasing over the past 20 years in the U.S. In 2010, 1.3 million Chlamydia cases were reported in the U.S. While some of the increase is due to expanded screening efforts, a majority of infections go undiagnosed. (per: CDC 2010 STD Surveillance) In Illinois: (Per 2009 IDPH STD Section Data; Ill HIV/AIDS/STD Monthly Surveillance Update) Majority of Chlamydia cases are seen in the age ranges of 15-19 (36.3%) & 20-24 (36.0%). Ages 25-29 (18.5%) More females than male By race: Highest in African Americans, White, Unknown By Ethnicity: Highest in Non-hispanic (73.9%); Hispanic (10.3%)

STD TRENDS: Chlamydia con’t In 2010, Vermilion County was #10 in top 10 highest counties for Chlamydia. (Jackson, Peoria, Alexander, St. Clair, Pope, Macon, Pulaski, Champaign, Sangamon were 1-9 respectively)

Reported Gonorrhea in Vermilion County By Provider Type 2007-2011 2007/cases total VCHD separate 2008/cases 2009/cases 2010/cases 2011/cases Health Dept STD & FP 122 STD 107 FP 15 91 71 20 67 48 19 18 17 1 3 Private Physician 61 40 43 29 51 Hospital 100 69 37 22 83 Aunt Martha’s 4 Adult Corrections 13 8 2 JDC 6 5 Top 6 Providers listed; other Provider categories not included on this chart*** TOTALS 300 218 158 82 162

STD DATA: Gonorrhea

STD TRENDS: Gonorrhea Gonorrhea rates are at historically low levels in the U.S. Cases increased slightly from 2009 to 2010 (300,000 cases in 2010 in U.S.) In the last 10 years (2000-2010) the Gonorrhea rate decreased from 128.7/100,000 to 100.8/100,000. per CDC 2010 STD Surveillance CDC surveillance systems indicate that Gonorrhea may become resistant to the only available treatment option. In the U.S., African Americans are most affected by Gonorrhea. (Black rate 512.2; Hispanic rate 63.2; White rate 26.0 (per 100,000) Gonorrhea in Illinois (per IDPH STD section report 1/30/2012) (*Note: Illinois reporting is “cases” vs CDC “rates” above) 61.0% of all positive cases were in ages 10-29; with highest prevalence in age group 15-19 yr old, 10.6% is highest in prevalence in Black population, 8.9%; followed by Other 2.3%, then White 2.2%. is prevalent in Non-Hispanic population 6.9%; Hispanic 2.3% More males, 7.8% have Gonorrhea than females, 4.3% Vermilion County ranked 15th in top counties with STD’s in 2010.

STD TRENDS: Syphilis The overall Syphilis rate decreased for the first time in a decade in the U.S. and is down 1.6% since 2009 per CDC 2010 STD Surveillance Early Syphilis Data for Illinois (Per IDPH STD Section 2009; Ill HIV/AIDS/STD Monthly Surveillance Update) : Highest in 20-49 yr old population: 20-24 yr olds (17.9%); 25-29 (17.2%); 30-34 (13.2%) 35-39 (12.2%); 40-44 (12.1%) 45-49 (12.0%) By gender: More males than females By Race: African Americans (55.9%); Unknown (20.1%); White (19.0%) By Ethnicity: More Non-Hispanic (84.1%) than Hispanic (13.4%) In Vermilion County: 0 cases of Early Syphilis in 2008; 6 cases in 2009; 2 cases in 2010 (as of Oct 2010)

STD Trends: HIV/AIDS Per: Ill. HIV/AIDS/STD Monthly Surveillance Update (October 2011) for Vermilion County 6 cases of HIV diagnosed 40 cumulative cases of HIV diagnosed since 2005*; total of 52 people living with HIV in VC 1 case of AIDS diagnosed 25 cumulative cases of AIDS diagnosed since 2005*; total of 60 people living with AIDS in VC *2005—named reporting began in Illinois

STD Trends: HIV/AIDS In Illinois HIV/AIDS*: Highest in Black population (51.5%); White (26.0%; Hispanic 15.5%) Age at diagnosis; highest in 20-39 yr ages Mode of exposure MSM (46.0%); Other (17.7%); Heterosexual (13.2%); Undetermined (12.9%); IDU (7.1%) *Per: Ill. HIV/AIDS/STD Monthly Surveillance Update October 2011 (Not full year data)

VIOLENCE Vermilion County Data Year/2008 % change from 2007 to 2008 % change from 2004 to 2008 Total Crime Index Offense 4167 0.7% (4136) 14.0% (3646) Murder 2 -66.7% (6) -75.0% (8) Criminal Sexual Assault 54 -39.3% (89) -32.5% (80) Robbery 97 -32.2% (143) 32.9% (73) Aggravated Assault/ Battery 349 -7.7% (378) -15.2% (412) Burglary 1040 6.4% (977) 24.6% (835) Theft 2460 5.6% (2330) 16.7% (2121) Motor Vehicle Theft 133 -27.7% (184) 30.4% (102) Arson 32 10.3% (29) 113.0% (15) Total Crime Index for Vermilion County increased 0.7% from 2007 to 2008; but increased 14.0% from 2004 to 2008 Robbery, Burglary, Theft, Motor Vehicle Theft and Arson all increased from 2004 to 2008 Murder, Criminal Sexual Assault and Aggravated Assault/Battery all decreased from 2004 to 2008 In 2008 there were 389 drug arrests (-13.4% decrease from 2007--449 arrests) Per Illinois State Police Crime Report 2007/2008

VIOLENCE and V.C.YOUTH (I Sing the Body Electric 2010 data) Nearly 41.0% of Vermilion County teens have been the target of bullying on school property during the past 12 months 34.7% of students said someone had spread a rumor about them online, in a chat room, through a social networking site in emails or through text messaging 47.7% of VC students report being sent a threatening or aggressive e-mail, instant message or text message 7.0% of VC youth stayed home from school because they felt unsafe at school or on the way to or home from school 11.1% of VC youth report being threatened or injured by someone with a weapon at school in the past year

VIOLENCE and V.C. YOUTH (I Sing the Body Electric 2010 data) con’t At least once, females in 9th grade (27.6% and males in 11th grade (27.5%) report the highest percentage of those saying that someone had stolen or deliberately damaged their property while at school One in 5 female (19.1%) and one in 5 male (20.5%) students report being hit, slapped or physically hurt by a boyfriend or girlfriend. This is an increase in two year’s time of 32.6% of females and 19.2% of males being abused by their partners In their lifetime, 17.1% of 2010 VC high school females and 8.7% of high school males report being “physically forced to have sex when they did not want to”

Health Risk Concerns of Youth in Vermilion County I Sing the Body Electric Data 2010: 3,164 out of 4,106 (77.1%) students in grades 9-12 in our local schools participated in survey & ranked their top concerns as: #1 Drinking & Driving, Alcohol Use (unchanged from 2008 survey) #2 Sexual Behaviors (AIDS, STDs, teen pregnancy) (unchanged from 2008 survey) #3 Drug Use (has been in top 3 or 4 since 2002) #4 Body Image (weight) Eating Disorders, Use of Steroids (has been in top 3 or 4 since 2002) #5 Carrying Weapons, Threats, Bullying, Physical Fighting (ranked #8 in 2002; moved to #5 in 2010)

2007-2012 IPLAN Data Reduce the incidence of premature deaths (<age 65) due to diseases of the heart in Vermilion County. Met this overall priority. Deaths from heart disease decreased from 259 in 2006 to 226 in 2008. (2009-2011 data not yet available) There was a reduction in the percentage of VC adults who smoke There was an increase in the percentage of adults who report being at risk for health problems related to being overweight Percent of adults reporting cholesterol increased but unknown whether number increase due to more people being tested or more people having higher cholesterol** Percent of adults with high blood pressure increased but unknown whether due to increased testing or more people having higher blood pressures.** Unknown whether adults under 65 had their blood sugar checked** **VCHD had planned to enhance testing opportunities to adults under 65 but program was terminated.

2007-2012 IPLAN Data Reduce the percentage of birth to teens in Vermilion County Partially met: Teen births decreased in 2006 (14.1%) and in 2007 (13.5%). 13.5% lowest percentage since recording keeping began in 1970. But teen births then climbed back to 15.6% in 2009. Did not meet goal to reduce the percentage of youths reporting sexual intercourse before age 17. (ISBE 2010 data shows 55.7% of youth reporting having had sexual intercourse; a 4.5% increase from 2002 and 6.5% increase from 2008)

2007-2012 IPLAN Data Reduce violent and abusive behaviors in Vermilion County Met? From 2007 to 2008 Total Crime Index Offense increased by 0.7% Increase in Burglary, Theft, and Arson Decrease in Murder, Criminal Sexual Assault, Robbery From 2004 to 2008 Total Crime Index Offense increased by 14.0% Increase in Robbery, Burglary, Theft, Motor Vehicle Theft and Arson Decrease in Murder, Criminal Sexual Assault, Aggravated Assault/Battery We (community) did expand and enhance community awareness on this issue: Youth Violence Prevention Coalition (2008) (BB/BS); Illinois Family Violence Prevention Coalition—Vermilion County; Illinois Health Cares Project (15 community partners)--Violence Video-2008; Violence Prevention:6 Best practices for healthcare providers)

2011-12 Community Survey Data Who filled out the survey? Over 1,000 surveys have been completed so far. We will conclude taking surveys at the end of March. Nursing students from U of I, Lakeview, and DACC passed out surveys to the residents of Vermilion County. Age Range for the surveys are 15-90 years of age. Gender for the surveys was 71% female, 28% male. Some of the locations were McDonalds, Town Center, St. James Food Pantry, DACC, Parish Nurse Churches, Vermilion House, Doctor’s Offices, YFRC, Fair Oaks, YMCA, etc.

2011-12 Community Survey Data Who filled out the survey? About 7% of the surveys were the Northern areas including Hoopeston, Rankin, Rossville, Alvin, Armstrong, and Bismarck. About 8 % of the surveys were from the Western areas including Catlin, Oakwood, Sidell, Fithian, and Fairmount. About 66% of the surveys were from the County Seat, Danville. About 15% of the surveys were from the Southern areas including Ridgefarm, Indianola, Westville, Tilton, and Georgetown. About 2% of the surveys were from areas outside Vermilion County including Milford, Urbana, champaign, Ogden, Rantoul, and Frankfurt, IN, Covington, IN, Kingman, IN, and Stateline, IN.

Demographics of Survey Data

Quality of Life Statements

Healthy Community

Personal Health

Quality of Environment

The Importance on Community Issues

“Your” Top 3 Health Concerns

Top 3 Community Health Problems

Top 3 Risky Behaviors

Comments from Survey Data Comments made in survey that were not part of the survey. Section 1: Quality of Life Statements Health care system: No health in Westville Health care system. Needs to be level 1 trauma Economic Opportunity – Not enough well paying jobs Faith based – Do Not Participate Section 2: Community and Environmental Issues No lights at Home Gardens (Rt1 between Lete Ln and Lyons Road) TURN THE LIGHTS BACK ON!!! Water impure Crime Patrols/Block Watches – lacking Crime Patrols/Block Watches – not working – break ins Quality of Life – Too many killing (sic) Mass Transportation – need to make the card assessable (sic) Adequate street lighting - sidewalks Other Comments Need a Health Department We need the Health Department for STD’s to open back up (2) Need more programs at the Health Department Inconsistencies: Some questions on hand written surveys had to be skipped for analysis due to multiple answers for a one answer question. A few people also put down more than 3 for their health problems/risky behaviors.

Additional Data and Powerpoint can be found on www.vchd.org 2012-2017 IPLAN Thank you! Questions???? Additional Data and Powerpoint can be found on www.vchd.org

2012-2017 IPLAN Shirley Hicks Jenny Trimmell Melissa Rome 217-431-2662 ext 267 shicks@vchd.org Jenny Trimmell 217-431-2662 ext. 229 jtrimmell@vchd.org Melissa Rome 217-431-2662 ext. 246 mrome@vchd.org Dr. Krista Jones kjones29@illinois.edu