CCB Healthcare Access Committee 1 COORDINATING COUNCIL OF BROWARD HEALTH CARE ACCESS COMMITTEE NOVEMBER 24, 2008 Health Benchmarks Briefing CCB Healthcare Access CommitteeLast Updated 11/26/08

CCB Healthcare Access Committee 2 Critical Benchmarks 4.1 Births to Teenagers 4.3 Infant Mortality 4.6 Health Care Access Uninsured 4.8 Deaths (Unintentional Death Rate) 4.9 Communicable Diseases 4.16 Check ups/ Preventative Health CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 3 Major Initiatives Teen Birthrate Prenatal and Infant Screening Uninsured (Minority Population) Unintentional Death by Poisoning (Drug Overdose) and Drowning Chlamydia Immunizations of two year olds Primary Care CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 4 New Additions to Benchmarks Unintentional Death Rate by:  Motor Vehicle Deaths  Poisoning Noxious Substances (Drug Overdose)  Falls Prevention Quality Indicator  Adults (18+)  Children (Under 18) Estimated Avoidable ER Visits  Adults (18+)  Children (Under 18) CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 5 Births to Teenagers Children born to teenage parents are more likely to have health problems, live in poverty, and receive poor parenting. Also, teen parents often lack the education and economic means needed to raise their children. Percentage of babies born to teenage mothers has been fairly constant over the past three years. The highest percentage of births to teens is in the non-white teenage mothers and lowest percentage in white teenage mothers. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: Florida Charts Action: The Teen Collaborative continues to provide services in Broward County. CSC provides funding for Youth Development Programs which have shown outcomes of lower percentages of babies born to teenage mothers.

CCB Healthcare Access Committee 6 Birth to Teenagers Graph represents the percentage of teenage mothers (ages 15-19) giving birth who already had a child. Teen- age mothers with repeat births are most at-risk of not completing their high school education. The number of repeat births has increased over the past year. Broward County has a lower percentage then the state. Although Broward County has seen a slight increase in the percentage of repeat births to teenage mothers, there is still a need to keep it a focal point and to develop intervention programs in the future. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

7 Infant Mortality This graph represents the rate of infants (per 1,000 births) who died before their first birthday. The infant mortality rate is a worldwide health indicator. In Florida, non- white babies are twice as likely to die in the first year of life as white babies. The number of deaths in Broward County still remains below the state average, however, we still continue to see disparity’s between white and non-white babies. Action: Black Infant Health Initiative CCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 8 Low Birth Weight One of the most important factors influencing infant mortality is low birth weight (less than 2,500 grams). The best way to decrease the number of low birth weight babies, which is primarily the result of premature births, is through timely and effective prenatal care. Reduction of drug and alcohol abuse, poor nutrition, cigarette smoking and stress in pregnancy will also decrease this rate. Low birth weight is highly correlated with neonatal and infant mortality, long term illness and disability, developmental deficits and psychosocial problems. For the past three years the trend of low birth weight babies has been consistent. Action: Black Infant Health Initiative, WIC (Women, Infants, & Children), and Healthy Start CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 9 Prenatal Screening and Infant Screening The Infant Risk Screen is used to identify risk factors such as medical problems or adverse conditions in the infant's home or living environment. Babies are less likely to die or develop lifelong disabilities if problems are identified and treated at birth. Infant screens are conducted at the birth of the baby. Infant screenings have increased over the past three years. The universal prenatal risk screen is used to identify women at risk for poor birth outcomes. The Universal risk screen allows for factors to be addressed early in pregnancy. The prenatal screening rate has increased from the previous year. Action: As of March 2008, Healthy Families of Broward County has begun to serve prenatal women through universal screening. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: Florida Charts

CCB Healthcare Access Committee 10 Adult Health Percentage of adults who rated their health as excellent, very good, or good. There is an increase from the previous two years of how adults perceive their health. However, the percentage perceiving overall general good health has decreased slightly from Action: The Nutrition and Fitness Task Force continues to plan for adult health activities to increase wellness. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 11 Adult Health CCB Healthcare Access Committee Action: Increase access to health care through public clinics, with the collaboration of Broward County Health Department, Federally Qualified Health Center, Memorial Health Care System and Broward Health. CCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 12 Health Care Access The greatest number of persons with no health insurance in Broward County are adults Broward County has twice as many non- white persons with no health insurance in comparison to white. Although survey data shows a decrease in the number of children under 18 without insurance, Florida now has the second highest rate of uninsured children in the nation. Almost one in five Florida children have no health insurance, and the number has grown 10 percent in the past three years despite efforts to cover them. Action: Increase access to insurance options. Also includes Outreach Programs for Florida Healthy Kids. CCB Healthcare Access CommitteeCCB Healthcare Access Committee Source: PRC Survey

CCB Healthcare Access Committee 13 Health Care Satisfaction Patient satisfaction with Primary Care Services continues to increase. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: Memorial Healthcare System, Broward Health, and Broward County Government

CCB Healthcare Access Committee 14 Health Care Satisfaction Over eight times as many people evaluated the quality of their health care as excellent or very good as compared to those rating their quality of health care as poor. Break down of 2008 evaluation of how people evaluate the health care they receive in Broward County. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 15 Check-Ups / Preventative Health The percentage of adults who had visited a physician for a routine checkup within the past year is 8% higher than the state and almost 17% higher than the US. There continues to be a steady increase. Action: Continue increase in wellness campaigns. Broward County Government has provided new funding initiatives which will increase access to health care and prenatal care. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 16 Check-Ups / Preventative Health Percentage of women over 50 who had a mammogram within the past year has increased almost 12% since Data shows that women with lower household income are more likely to have had a mammogram within the past year. Cost does not seem to be an issue. Action: Continue working with area agencies on providing mammograms in the community. BCCI Program, MHS, and BH provide free or reduced diagnostic and mammogram screening to Broward County residents. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: PRC Survey

CCB Healthcare Access Committee 17 Check-Ups / Preventative Health CCB Healthcare Access Committee Since 2000 there has been a 6% decrease in those receiving a digital rectal exam. CCB Healthcare Access Committeewww.brhpc.org Action: It is important to continue awareness of preventative health checkups. Source: PRC Survey

CCB Healthcare Access Committee 18 Dental Check-Ups / Preventative Health Ten percent more people in Broward County have received a dental check- up within the past year than in the US. This percent continues to increase. Action: Broward Regional Health Planning Council has convened an Oral Health Task Force to develop an Oral Health Plan for Broward County. The Health Foundation of South Florida is funding Oral Health initiatives in Broward County. In conjunction with Broward County Schools Broward County Health Department provides free oral health screening to children in the Head Start program CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: PRC Survey

CCB Healthcare Access Committee 19 Dental Check-Ups / Preventative Health Though the percentage of children in Broward County who have visited a dentist within the past year is lower than the US, this trend is increasing. Action: Broward Regional Health Planning Council has convened an Oral Health Task Force to develop an Oral Health Plan for Broward County. The Health Foundation of South Florida is funding Oral Health initiatives in Broward County. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: PRC Survey

CCB Healthcare Access Committee 20 Deaths There continues to be an overall decrease in the death rate per 100,000 residents for both the county and state over the past four years. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: Florida Charts

CCB Healthcare Access Committee 21 Deaths This chart depicts the death rate per 100,000 residents for the top four causes of death. Death rates indicate whether progress is being made in reducing the most serious effects of disease, accidents and crime. Number of deaths for Heart Disease, Cancer and Stroke have all had a steady decrease over the past 4 years for both Broward County and the State. However the number of deaths due to Chronic lower respiratory has increased over the past year for both Broward County and the state. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: Florida Charts

Deaths CCB Healthcare Access Committee 22 Heart Disease Cancer Stroke Chronic Lower Respiratory Source: Florida Charts YPLL is an estimate of premature mortality that has been defined as the number of years of life lost among persons who die before a predetermined age. As depicted by the chart, the YPLL continues to increase for Heart Disease, Cancer, and Stroke.

CCB Healthcare Access Committee 23 Deaths Unintentional Death rates include deaths by suicide, homicide, drowning, falls, fires, poisonings, firearms discharges, violent crimes, medical and surgical care complications all motor vehicle traffic crashes, and alcohol related motor vehicle traffic crashes Death rates for unintentional deaths has been fluctuating over the past four years. There is an increase in the number of unintentional deaths for the state of Florida from 2006 to The unintentional death rate in Broward County has decreased over the past three years and did not change between 2006 and Action: Focus on drowning, poisoning (drug overdose) and falls as they can be prevented. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: Florida Charts

CCB Healthcare Access Committee 24 Suicide Suicides indicate that people are having difficulty coping with personal crisis, serious health problems, or other life stresses. There has been an increase in the number of deaths from suicide from 2005 thru 2007 for both Broward County and the state. Action: Florida Initiative for Suicide Prevention (FISP) works with the community to reduce suicides. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: Florida Charts

CCB Healthcare Access Committee 25 Communicable Diseases This graph represents the rate of new cases reported per 100,000 residents of top three communicable diseases. As can be seen, there is an increase in the number of cases of Chlamydia. Sexually transmitted diseases account for the greatest number of reported cases. Action: Provide awareness of sexually transmitted diseases to the community without isolating the problem to AIDS. Broward county currently is second in the nation for AIDS cases. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: Florida Charts

CCB Healthcare Access Committee 26 Immunizations The percentage of two year olds who were adequately immunized has decreased over the past three years. Broward County continues to be below the percentage for the State. This trend leads to the possibility of future outbreaks of vaccine preventable diseases. The National goal is 90%. Action: Broward County Health Department has convened an Immunization Task Force to work on increasing the immunization rate. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 27 Physical Fitness Obesity is on the rise. Broward County sees a five percent increase in the number of adults who are more than 20% overweight. Action: The Broward County Health Department convened a Nutrition and Fitness Task Force to develop a Strategic Plan to address obesity in Broward County. Though obesity is on the rise, there is an increase in the number of adults who exercise for 20 minutes at least three times a week. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: PRC Survey

CCB Healthcare Access Committee 28 Mental Health In 2007 the number one perceived barrier that people face with mental illness who need treatment is access, followed by cost. Action: With the passing of the Mental Health Parity Bill, barriers to access and cost should decrease. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 29 Mental Health Provides a gauge on how the general public views individuals with mental illness. Action: Broward County is trying to reduce the stigma mental illness carries. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 30 Youth Alcohol, Drug, and Cigarette Use Alcohol and drug use can lead to poor health, crime, and employment problems. The younger a person starts using drugs, the greater the chance of serious drug problems and addiction in later life. In most instances, drug use among youth begins with either alcohol or marijuana. Though the use of marijuana and cocaine has decreased, youths are still drinking alcohol and smoking cigarettes more than the previous year. This graph depicts that alcohol and cigarette use among youth is increasing while drug use (marijuana and cocaine) is decreasing. Although not been reflected in this graph, the use of prescription drugs among youth is increasing. Action: The United Way Commission on Substance Abuse Under Age Drinking Task Force, Prescription Drug Task Force, and the CSC Youth Development program are examining this issue. CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org

CCB Healthcare Access Committee 31 Adult Cigarette Smoking As can be seen from this graph, the percentage of adults (18 and older) who smoked is decreasing. Action: Broward County Health Department has developed an Adult Tobacco Cessation Program CCB Healthcare Access CommitteeCCB Healthcare Access Committeewww.brhpc.org Source: PRC Survey

End Notes The sample design used for the 2008 PRC Survey consisted of a random sample of 1,009 individuals aged 18 and older in the defined community of Broward County. Once these data were collected, the sample was weighted in proportion to the actual population distribution at the ZIP Code level. Florida CHARTS contains data from a wide variety of sources. These include: the Florida Department of Health, the Florida Agency for Health Care Administration (AHCA), and the Florida Department of Law Enforcement (FDLE). The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors and the prevalence of obesity and asthma among youth and young adults. The YRBSS includes a national school-based survey conducted by the Centers for Disease Control and Prevention (CDC) and state, territorial, tribal, and local surveys conducted by state, territorial, and local education and health agencies and tribal governments. Patient satisfaction with Primary Care Services information comes from Memorial Healthcare System, Broward Health, and Broward County Govt. CCB Healthcare Access Committee 32