Presentation on theme: "Public Health: Prevent-Promote-Protect Frederick County’s Health"— Presentation transcript:
1 Public Health: Prevent-Promote-Protect Frederick County’s Health Barbara Brookmyer, MD, MPHFrederick County Health OfficerFrederick County Health DepartmentFebruary 22, 2012
2 Objectives Review Key Indicators of Health Status and later … Describe State Health Improvement ProcessDescribe FC’s Local Health Improvement ProcessIdentify opportunities for you to become engaged
3 What is Public Health? Definition: Protect and improve health of communities and populations through education, promoting healthy lifestyles, and research for disease and injury preventionHow:Population or community level focusSurveillance and data gatheringDevelop plans, programs, and policiesImplement plans, programs, and policiesEvaluate performance and outcomesReference:
4 Demographics of Frederick County Demographics Frederick MarylandTotal Population* 233,385 5,773,552Age*, %Under 5 Years 6.4% 6.3%Under 18 Years % 23.4%65 Years and Older % 12.3%Race/Ethnicity*, %White % 58.2%Black % 29.4%Native American 0.3% 0.4%Asian % 5.5%Hispanic or Latino origin 7.3% 8.2%Median Household Income**$81,436 $70,017Households in Poverty**, % 5.5% 8.6%Pop. 25+ W/O H.S. Diploma** 8.4% 12.1%Pop. 25+ With Bachelor'sDegree or Above**, % 36.2% 35.6%Sources: *U.S. Census (2010), **American Community Survey ( )
5 County Health Rankings All counties in the US3rd year in a row rankings to be released AprilFrederick County ranked 3rd overall in health outcomes 2 years in a row!Frederick County Health Factors rank was 4thFrederick’s physical environment ranked 16thReference:
6 2007 Community Health Assessment Areas of Opportunity Access to Healthcare ServicesRoutine Medical CareAvailability (Inconvenient Office Hours)Health Disparities (Low-Income, Minorities)Death, Disease & DisabilityHeart Disease & StrokeCancerColorectal Cancer (Deaths)Prostate Cancer (Screening)Respiratory DiseaseAsthmaChronic Lower Respiratory DiseaseMaternal & Infant HealthPrenatal CareMental & Emotional HealthAlzheimer’s DiseaseEmotional WellnessStressSuicideModifiable Health RisksOverweight & ObesityAlcohol AbuseTobacco Use
7 10 Leading Causes of Death in Frederick County, 2010 Malignant Neoplasms (332 down from 385)Diseases of the Heart (316 down from 380)Chronic Lower Respiratory Diseases (92 up from 69)Cerebrovascular Diseases (88 up from 71)Accidents (62 up from 50)Influenza and Pneumonia (46 up from 39)Alzheimer’s (37 up from 23)Kidney Disease (31 up from 30)Diabetes Mellitus (23 down from 27)Septicemia (23 down from 33)Intentional Self-Harm (Suicide) (21 down from 32)The leading causes of death in Frederick County and the State of Maryland are very similar. It is public health’s role to work to prevent many chronic diseases. Many of these deaths are preventable through lifestyle changes such as healthy diet and increased physical activity and/ or screeningReference:
8 Incidence Rates for All Cancers 1997-2007: Frederick County, Maryland, and U.S. All Rates are per 100, and 1998 rates are age-adjusted to the 1970 U.S. population, all other years are age-adjusted to the 2000 U.S. standard populationSource: Maryland Department of Health and Mental Hygiene CRF Annual Reports
10 African American vs. Caucasian Mortality Data for the Top 15 Causes of Death, Maryland 2009 Ratio Disparity RankExcess Rate of Disparity RankFrederick Cause of DeathStatewide Cause of DeathDiseaseAge-Adjusted Mortality per 100,000 Black WhiteRatioAge-Adjusted Difference per 100,000712Heart Disease238.3184.31.295494Cancer193176.61.0916.483Stroke48.338.31.2610Chronic Lung Disease27.840.40.69-12.65Diabetes34.417.12.0117.36Accidents22.924.70.93-1.8Flu and Pneumonia17.517.21.020.3Septicemia184.108.40.2068.711Alzheimer's Disease15.617.60.89-219HIV1.214.5816.3Nephritis, Nephrotic Syndrome, and Nephrosis220.127.116.1110.31512Homicide18.104.22.16816.713Chronic Liver Disease22.214.171.124-114Suicide126.96.36.199-6.218Certain conditions originating in the perinatal period2.64.388.8Source: Maryland Vital Statistics Annual Report 2009
11 Frederick County Data: Heart Disease and Related Risk Factors Heart disease and cancer are the leading causes of death in Frederick County followed by stroke (Maryland VSA , Table 50). Among chronic disease risk factors, 15% of adults smoke, 25% report having high blood pressure and well over a third report having high cholesterol (Maryland BRFSS, 2009). 25% of adults are classified as obese; 40% are classified as overweight, which is 5th worst in the State (Maryland BRFSS, 2010). 72% of adults, 4th highest in the State, describe their activity level at work as “mostly sitting/standing” (Maryland BRFSS, 2010). With regards to chronic disease disparities, the rate (per 100,000) of diabetes-related ED visits is 536 for Blacks vs. 197 for Whites (2.7 times greater), and hypertension-related ED visits is for Blacks vs for Whites (3 times greater) (HSCRC, 2010). Age-adjusted mortality data for Frederick County also shows that Blacks, when compared to Whites, suffer a higher rate of death from stroke (1.26 times greater), heart disease (1.29 times greater), and diabetes (2 times greater) (Maryland Vital Statistics Annual Report 2009).
12 Based on expanded coverage though employer-sponsored health plans # Marylanders Estimated to be Receiving Expanded Preventive Services Under the ACATotal 1,153,000Children 297,000Women 448,000Men 408,000Based on expanded coverage though employer-sponsored health plansSource = February 2012 ASPE Issue Briefavailable on the Internet at: eServices/ib.shtml accessed February 21, 2012
13 BMI-For-Age 2 to 18: >=95th Percentile Frederick County / Maryland vs. Healthy People 2020 Target HP Objective NWS-10: Reduce the proportion of children and adolescents who areconsidered obese (target for ages 2-19).Note: BRFSS data & HP objective- similar but not exact.Maryland Behavioral Risk Factor Surveillance System, BRFSS , Retrieved from:
14 Adults ever told they had high cholesterol HP Objective HDS-7: Reduce the proportion of adults with high total blood cholesterol levelsMaryland Behavioral Risk Factor Surveillance System, BRFSS , Retrieved from:
15 Ever Had Sigmoidoscopy or Colonscopy Exam - Age 50+ Frederick County / Maryland vs. Healthy People 2020 TargetHP Objective C-16: Increase the proportion of adults who receive a colorectal cancer screening based on the most recent guidelinesMaryland Behavioral Risk Factor Surveillance System, BRFSS , Retrieved from:
16 Last Mammogram Less than 2 years ago - Women 40+ Frederick County / Maryland vs. Healthy People 2020 TargetHP Objective C-17: Increase the proportion of women who receive a breast cancer screening based on the most recent guidelinesMaryland Behavioral Risk Factor Surveillance System, BRFSS , Retrieved from:
17 Pap Smear Within Past Two Years - Women 18+ Frederick County / Maryland vs. Healthy People 2020 TargetHP Objective C-15: Increase the proportion of women who receive a cervical cancer screening based on the most recent guidelinesMaryland Behavioral Risk Factor Surveillance System, BRFSS , Retrieved from:
18 Tobacco Use in Frederick County Cigar use among youth is more than twice the State average.
19 Frederick County Drunk Driving Fatalities Maryland State Health Improvement Plan: Frederick CountyMD SHIP Objective: Decrease the rate of alcohol impaired driving fatalities.Objective Description: Rate of deaths associated with fatal crashes where driver had alcohol involvement (SHA 2009).National baseline: per 100,000 vehicle miles traveledMaryland baseline: per 100,000 vehicle miles traveledHP 2020 Goal: per 100,000 vehicle miles traveledMD 2014 Target: per100,000 vehicle miles traveled
20 Coverage Source for Overall Mental Health Related ER Visits While percent of emergency department patients are admitted, almost one-third of allpsychiatric patients seen in the emergency department are subsequently hospitalized. Althoughthe number of emergency department visits for patients with diagnoses of mental health disordershas increased in recent years, there have been declines in the number of inpatient beds forpsychiatric patients across all settings—acute care hospitals, private psychiatric hospitals, andState psychiatric hospitals.
21 Dental Care - Adults Calls seeking care received by FCHD >10/wk Religious Coalition for Emergency Human Needs – # served limited by funding for vouchers:2010 = 1222011 = 2382012 = ?>350Mission of Mercy free dental services2011 = 338OthersDentists – charity care in officeSeton CenterFCAA
22 Frederick County Health Department Is Your Health Department Thank You!Frederick County Health DepartmentIsYour Health Department