2015 United Way Tarrant County Community Assessment

Transcription

2015 United Way Tarrant County Community Assessment
2015 United Way Tarrant County Community Assessment
www.unitedwaytarrant.org
1500 N. Main Street, P.O. Box 4448, Fort Worth, TX 76164-0448
2015 UNITED WAY TARRANT COUNTY COMMUNITY ASSESSMENT
TABLE OF CONTENTS
ACKNOWLEDGMENTS ................................................................................................................................................ 3
EXECUTIVE SUMMARY ............................................................................................................................................... 5
DEMOGRAPHICS......................................................................................................................................................... 9
Population Growth................................................................................................................................................. 9
Age Distribution ................................................................................................................................................... 12
Income and Poverty ............................................................................................................................................. 13
Race and Ethnicity................................................................................................................................................ 16
Foreign Born Persons and Language Other than English Spoken at Home ......................................................... 17
Educational Attainment ....................................................................................................................................... 19
County Health Rankings ....................................................................................................................................... 21
EDUCATION .............................................................................................................................................................. 23
Academic Achievement ....................................................................................................................................... 23
Early Childhood Education ................................................................................................................................... 29
Juvenile Crime/Gangs .......................................................................................................................................... 33
Out of School Time............................................................................................................................................... 38
School dropouts/Truancy..................................................................................................................................... 40
INCOME .................................................................................................................................................................... 44
Adult Literacy and Adult Basic Education ............................................................................................................ 44
Asset poverty ....................................................................................................................................................... 47
Crime .................................................................................................................................................................... 50
Crime: Family violence ........................................................................................................................................ 52
Crime: Inmate Re-entry....................................................................................................................................... 54
Crime: Sexual Assault .......................................................................................................................................... 57
Disaster ................................................................................................................................................................ 60
Food Insecurity..................................................................................................................................................... 62
Homelessness ...................................................................................................................................................... 66
Housing/Home Ownership................................................................................................................................... 68
Transportation ..................................................................................................................................................... 70
Unemployment .................................................................................................................................................... 72
HEALTH..................................................................................................................................................................... 74
Adult Abuse .......................................................................................................................................................... 74
Alzheimer’s Disease (AD) ..................................................................................................................................... 75
Child Abuse/Neglect ............................................................................................................................................ 78
Chronic and disabling conditions: Asthma ......................................................................................................... 81
Chronic and disabling conditions: Cancer .......................................................................................................... 83
Chronic and disabling conditions: Cardiovascular (Heart) Disease .................................................................... 87
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Chronic and disabling conditions: Diabetes ....................................................................................................... 90
Chronic and disabling conditions: Disabilities ................................................................................................... 92
Chronic and disabling conditions: Multiple Sclerosis ......................................................................................... 97
Chronic and disabling conditions:
Preventable Hospitalizations ..................................................................... 99
Chronic and disabling conditions: Sickle Cell Anemia ...................................................................................... 100
Chronic and Disabling Conditions: Veterans .................................................................................................... 102
Communicable Diseases .................................................................................................................................... 106
Health Care Access ............................................................................................................................................. 108
Health Disparities ............................................................................................................................................... 113
Injury and Mortality ........................................................................................................................................... 114
Isolation ............................................................................................................................................................. 118
Maternal and Child Health ................................................................................................................................. 120
Mental Health and Mental Disorders ................................................................................................................ 123
Oral Health Care................................................................................................................................................. 127
Substance Use Disorder ..................................................................................................................................... 129
Teen Pregnancy and Parenting .......................................................................................................................... 131
Wellness and Healthy Lifestyles: Overweight and Obesity ............................................................................... 134
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ACKNOWLEDGMENTS
The research on secondary data for this 2015 Community Assessment was conducted by Patricia F.
Cheong, M.S.S.W., Vice President, Community Development, United Way of Tarrant County.
Much appreciation goes to local agencies and organizations that provided information upon request.
Credit also goes to Leila Vazquez, as well as to Lisa Fisher and Rachel Burgos, who assisted in gathering
data and editing profiles for this report as part of the requirements for their Master’s degree in Social
Work from the University of Texas at Arlington. Thanks to United Way staff who proofread and
suggested edits to selected profiles.
The “issue profiles” framework for this document is built upon the format created for our 2012
Community Assessment Update, which brought 2010 Census data to bear on research originally
compiled by our 2009 Community Assessment research partner, James Burdine, Dr.PH. and Associates,
at Texas A&M University Center for Community Health Development.
This document relied upon myriad reliable sources of national state and local facts and statistics. A
partial list of sources follows.
2-1-1 Texas at United Way
AARP
Afterschool Alliance
Alzheimer’s Association
American Cancer Society
American Community Survey
American Public Transit Association
Annie E. Casey Foundation
Arlington Police Department
Assets and Opportunity Scorecard
Center for Disease Control & Prevention (CDC)
Center for Public Policy Priorities
Challenge of Tarrant County
Children’s Safety Network
Clayton YES!
Community-wide Children’s Health Assessment and Planning Survey
Cook Children’s
Corporation for Enterprise Development (CFED)
Countyhealthrankings.org
Fort Worth SPARC
Fort Worth After School
Healthyntexas.org
Healthy People 2020
Healthy Tarrant County Collaborative
Hobby Center for the Study of Texas, Rice University
Internal Revenue Service (IRS)
JP Morgan Chase
JPS Health Network
Kids Count 2015
MHMR/Tarrant County
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National Association for the Education of Young Children
National Council on Aging
National Multiple Sclerosis Society
National Summer Learning Association
North Central Texas Council of Governments
North Texas Community Health Collaborative
North Texas Regional P-16 Council
Nurse Family Partnership
Office of the State Demographer
Raise Your Hand Texas
Star-Telegram
Tarrant County Behavioral Risk Factor Surveillance Survey
Tarrant County Drug Impact Index
Texas A&M University
Tarrantcares.org
Tarrant County Criminal Justice Plan
Tarrant County Homeless Coalition
Tarrant Literacy Coalition
Tarrant County Public Health
Texas Council on Family Violence
Texas state agencies
Texas Food Bank Network
Texas Tribune
TexProtects
United Way-Arlington
United Way Program Partners
United Way Worldwide
U.S. Census 2010 and subsequent updates
U.S. Chamber of Commerce
U.S. federal government agencies
ERRATA and UPDATES
This report is posted online at www.unitedwaytarrant.org
To report errors or to provide updated information, please contact:
Patricia F. Cheong, Vice President
United Way of Tarrant County
1500 N. Main Street, Suite 200
P.O. Box 4448
Fort Worth, TX 76164-0448
Pat.cheong@unitedwaytarrant.org
817-258-8052
December, 2015
2015 United Way Tarrant County Community Assessment
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2015 UNITED WAY OF TARRANT COUNTY COMMUNITY ASSESSMENT
EXECUTIVE SUMMARY
CONTEXT
United Way of Tarrant County has historically undertaken a county-wide Community Assessment focused on
health and human service issues affecting residents every 4 or 5 years since the early 1980s. This 2015
Community Assessment updates secondary data (statistics) from reliable national, state and local sources to
illustrate 47 health and human service “issue profiles” that were originally published in the 2012 Update. The
2012 Update captured new 2010 Census data to provide a decade-long perspective. The last full Community
Assessment, which included not only secondary data but also a leadership survey and focus groups, was
conducted in 2009.
The purpose of this 2015 Community Assessment is to provide information about changes in our community
since the 2012 assessment that will inform United Way program partners, other nonprofits, policymakers and
funders about issues that merit focus for community action, policy changes and resources. If available, local
data is compared with state and national information.
DEMOGRAPHICS
In a state that had the greatest population growth of all the states over the decade 2000-2010, Tarrant County
has continued to be one of the fastest growing counties in the country. During the decade 2000 to 2010,
Tarrant County grew by 25% and in the last four years continued to grow by 7.5%, reaching a population of 1.9
million residents in 2014.
Although about two-thirds of the growth in the first ten years of the decade was in Fort Worth, some smaller
suburban communities (specifically Mansfield) doubled in size. Since 2010, Fort Worth has added over 70,000
people for a 7.5% increase while Mansfield and Keller grew by 10.4%, adding over 5,800 and 4,200 new
residents, respectively.
About half of the growth in Tarrant County over the past 4 years has been due to more babies being born than
people dying. Almost one-third of the growth has been due to people moving in from other parts of the country
and about 18% has been due to immigration from other countries. Historically, immigration to Texas has been
predominantly from Mexico. But, during the recession in 2007-2008, immigration from Mexico declined sharply
and by 2013 the share of immigrants from Asian had risen to 40%. The Texas State Demographer suggests “a
new kind of 21st century immigration will lead to an increasingly diverse Texas population”.
About one in six Tarrant County residents was born in another country. In Texas, almost two-thirds of
immigrants are either naturalized citizens or lawful permanent residents. The longer an immigrant is in the
country and the higher their education, the more likely they are to speak English. According to the Center for
Public Policy Priorities, Texas immigrants at every education level (except a bachelor’s degree) have a higher
participation in the labor force than native workers. Texas immigrant-owned small businesses contributed
almost 20% of the small business earnings in the state (2012).
Tarrant County residents and Texans (median age 33) are younger than the country overall (median age 37).
More than half a million county residents (27%) are under the age of 18; and, although fewer than 10% are over
65, the older population has grown by 16% between 2010 and 2014.
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Tarrant County ranked second among 5 urban counties in Texas in health rankings. County residents are also
better off financially than others in Texas and the U.S. However, while half the county population makes over
$56,000, about one in five Tarrant County children lives in a family experiencing poverty. African-Americans and
Hispanics are about three times as likely as Caucasians to be poor. Education is directly linked to income. In
Tarrant County, although 85% of adults over 25 have a high school diploma, some college or a college degree,
40% of adults have no more than a high school diploma (or less).
EDUCATION
Tarrant County students fared similarly to the state in terms of high school graduates and reading and math test
scores in 2014. However, disparities continue to exist among the Tarrant County school districts on a variety of
indicators. School districts in the more affluent northeastern suburbs (such as Grapevine-Colleyville and
Southlake) had the highest attendance and graduation rates, along with the lowest percentage of economically
disadvantaged students. Districts in lower socio-economic municipalities, such as Fort Worth, White Settlement
and Lake Worth, had the lowest graduation and attendance rates and lowest number college-ready graduates,
respectively.
Across Tarrant County school districts, there continue to be disparities in both the dropout rate and completion
rates both by district and by ethnic/racial groups. In 2014, the percentage of students from a class of 9th graders
not enrolled in 12th grade four years later (attrition) is higher in Tarrant County (27%) than statewide (24%). And
the percentage of students who dropped out between 9th grade and graduation was 7.3% for Tarrant County
compared to 6.6% statewide.
Between 2011 and 2014, the percentage of young Tarrant County children enrolled in subsidized child care, in
public Pre-K, and in Head Start continued to be lower than statewide.
Children of working parents also need care during out-of-school times: before/after school, summer and
holidays. Summer care, in particular, can focus on preventing “summer slide” – a decline in reading and other
skills. In Fort Worth and Arlington, the number of children participating in after school on-campus programs has
decreased since 2011, but number served in summer programs is increasing. Recent efforts in the greater Fort
Worth area, have resulted in coordinated data collection among a variety of providers; longstanding efforts to
collect data in Arlington will continue.
In 2014, Tarrant County had higher dropout and attrition rates than for the state. Meanwhile, the Texas
legislature has recently passed legislation that no longer makes truancy a criminal offense. Lack of a high school
diploma is an important indicator of future engagement in the criminal justice system. But, recent research has
found that young people do better when they are held accountable in their own communities and efforts are
being made to reduce referrals to the state system. Minority youth continue to have been disproportionately
represented in arrests and referrals to the state system.
INCOME
One in seven Tarrant County adults (14%) is unable to do simple math or read a story and is considered illiterate.
Although almost one in four local adults lacks a high school diploma, only 5,500 people are registered in adult
education classes in Tarrant County. That number has increased, primarily due to enrollment in English as a
Second Language classes. With a change in the GED test in 2014, the number of passers in Texas plummeted to
half the previous rate. Access to obtaining a high school equivalency certificate is expected to improve since the
State Board of Education voted to consider alternative tests to the GED, plagued with complaints that it is too
costly, too advanced, and must be completed on computer. Although the percentage of Spanish test-takers in
Texas is twice the percentage as nationally, test site locations for Spanish are very limited.
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Despite the improvement in the economy since 2011 and a steep drop in unemployment from 8.5% to 4.1%,
Texas ranks 37 out of 50 among states in “asset poverty” – the ability of households to have enough assets to
subsist for up to 3 months at the poverty level without income. One in four Tarrant County residents lacks
assets that could sustain them for 3 months in case of loss of income and this rate is twice as high for
households of color. Asset poverty is higher in lower-income cities of the county. Food insecurity continues to
be an issue, as indicated by the 12% increase in Supplemental Nutrition Assistance Program (SNAP – formerly
Food Stamps) cases and 18% increase in calls to 2-1-1 about food. The proportion of homeowners to renters
(2/3 to 1/3) remained the same and about half the renters continue to be “cost-burdened”, paying more than
30% of their income in rent. Overall, crime (incidents and arrests and victims served in Arlington) has continued
to decline throughout the county since 2010, even though arrests increased in Fort Worth, along with reports of
rape (a separate crime from sexual assault). Reporting is a positive phenomenon. Renewed federal, state and
local efforts to move people who have been chronically homeless into housing has resulted in an almost 10%
decrease in the number of people reported as homeless.
The lack of county-wide public transportation affects not only low-income workers and older people but also
public health. In 2014, 83% of county residents drove alone to work, while about 10% carpooled. The number
of calls to 2-1-1 for medical transportation increased in 2014. Meanwhile, in the health arena, parents of North
Texas children reported in 2008 that almost one in five children under 14 suffered from asthma.
HEALTH
The leading edge of the Baby Boomers (born in 1946) will turn 70 in 2016. Although Texas has a smaller
proportion of older adults than nationally, with the fast growing older adult population has come an increase
(12%) in adult abuse cases taken by Adult Protective Services and a 40% increase since 2010 in facility
investigations. The number of people age 65+ with Alzheimer’s disease in Tarrant County and Texas is
projected to increase by 44% by 2025. That means caregivers will continue to need support to keep older people
safe at home.
Older people are also affected by child abuse. Although the rate of child abuse in Tarrant County (11.5 per 1,000
children – or 6,000 children in 2014) and the number of children in substitute care (close to 2,000) has stayed
steady since 2010, the 2010 Census estimated that close to 20,000 local grandparents are caring for children. In
light of conservative state budgets in recent years, authorities are increasingly turning to relatives to keep
children out of the system.
Statistics related to the leading causes of death and hospitalizations due to injury have not been updated since
2009. Leading causes of death remain heart disease and cancer, followed by accidents, Alzheimer’s disease,
and diabetes. The very high rate of hospitalizations due to injuries from falls among older adults continues to
cause the overall statistics for hospitalizations for all ages to be higher from falls than from motor vehicle
crashes, assaults, self-inflicted injuries or poison.
There is no single cause of infant mortality, but the health of a mother before she becomes pregnant is highly
correlated with birth outcome. Tarrant County’s rate of death of infants in their first year of life (7 per 1,000
live births) continues to exceed the rate for Texas. The infant mortality rate is significantly higher for AfricanAmerican and Hispanic babies than for whites. Meanwhile, the number of births to women receiving late or no
prenatal care has declined to 42% of births in 2013 and the number of teen births has declined. Tarrant
County’s high rate of communicable disease, notably chlamydia and gonorrhea, may also be a factor in a birth
mother’s health.
The advent of the Affordable Care Act and the addition of Community Health Centers in Tarrant County has
improved insurance coverage and access to care, especially for individuals without insurance. Enrollment in
Children’s Medicaid and Children’s Health Insurance Program (CHIP) increased 7-9% between 2010 and 2013.
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However, access to health care continues to be an issue for Tarrant County. In 2013, one in five people lacked
health insurance and one in 10 children lived in a household without health insurance.
In the area of mental health, Texas has a serious shortage of psychiatrists and other behavioral health
professionals. Although Tarrant County is not designated a Health Professional Shortage Area (HPSA), improving
access to behavioral health services continues to be important. Under terms of the 1115 Waiver issued by the
state, county institutions such as MHMR and JPS are working closely to transform the system and increase
access to care through a mobile crisis unit and outpatient services/clinics that are “trauma-informed” and
culturally sensitive. A 2015 update to the Children’s Community Health Assessment and Planning Survey (by
Cook), indicates that North Parents increasingly report a child in their household that has experienced a
traumatic event or had behavioral problems at school. A June 2015 study called “The Other Nine” by Challenge
of Tarrant County revealed that only 10% of the 134,000 county residents who need treatment for substance
use disorder will receive it. Many will not even perceive the need for care. Substance use disorder is an issue
for parents in the child welfare system, emergency rooms, jail inmates and youth in the juvenile system.
Tarrant County is home to over 118,000 veterans, 15% of whom have served since 9/11/2001. The veterans are
more likely than non-vets to be older than 35, white males, with higher education, and more likely to be
employed. More than one in five (22%) local veterans has some kind of disability rating.
With two-thirds of county residents either overweight or obese, children are also affected. Among 4th -11th
graders in Tarrant County, more than one in three was overweight or obese. More than 27% of Texas adults and
17% of Texas youth reported in 2014 that they participate in no physical activity. Overweight and obesity is
directly related to chronic disease, including diabetes, which is linked to heart disease. Through 2008-13,
congestive heart failure continues to be the leading cause of preventable hospitalizations, with hospital charges
of over $814 million. This condition is preventable!
For more information about the 2015 Community Assessment, please contact:
Pat Cheong, Vice President, Community Development
United Way of Tarrant County
Pat.cheong@unitedwaytarrant.org
817-258-8052
www.unitedwaytarrant.org
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DEMOGRAPHICS
INDICATOR:
Population Growth
ABOUT THE
INDICATOR:
Population growth is an indicator of migration (both domestic and international), natural increase
(excess of births over deaths), and other factors.
IMPORTANCE:
Population growth affects infrastructure, such as housing, roads and transportation, demand for
natural resources (such as water), goods and services, such as education and health, and manpower
for jobs.
WHAT THE
DATA TELLS US:
Between 2000 and 2013, Texas experienced the highest numeric increase of all the states (an increase
of 5.6 million people). Beginning in 2005, Texas has outpaced all other states in population growth.
About half the state’s growth (2000-13) was from people migrating to Texas, either from other states
(domestic migration) or from other countries (international migration). According to the Star
Telegram, many people move to Texas for economic opportunities: low cost of living and job
opportunities available.
Texas has 7 of the 10 counties that gained the most from people moving in from other parts of the
country from April 1, 2010, to July 1, 2013, with Tarrant County listed as number 10.
Tarrant County also ranks 8th in population increase in the United States.
In 2013, the three largest immigrant-receiving states - California, Texas and Florida - had different
patterns of immigrant origins. Texas had roughly equal numbers of Latin American and Asian
immigrants. California’s immigration was predominantly Asian; Florida’s were mainly from Latin
America.
Nearly one in three Texas international migrants is naturalized, eligible to vote. In 2010, immigrants
accounted for one in five people in the Texas’ workforce. Immigrants, both legal and undocumented,
contribute to the economy in state and local taxes.
Much of Tarrant County’s growth was in the city of Fort Worth, but 10 cities experienced a higher
percentage growth than the county.
According to the Texas State Demographer (2015), recent Census data suggest a new pattern of
immigration is emerging in Texas. Traditionally, Texas immigration has been dominated by people
originating in Latin America, particularly Mexico. Following the 2007-2009 recession, immigration
from Mexico has declined sharply. Although in 2005, 56.8 percent of all non-citizen immigrants
originated in Mexico, by 2013, Mexican-origin immigrants made up only 27.1 percent of all non-citizen
immigrants. This decline is being offset by non-Latin American immigrants, especially those of Asian
origin. In 2005, Asian-origin immigrants comprised 17.3 percent of all non-citizen immigrants. By
2013, the Asian-origin share had risen to 40.4 percent. With this shift in immigrant origins, the
immigration stream to Texas has become much more diverse than in the past. Using a standard
measure of diversity where 1.00 represents maximum diversity, we find that immigrant diversity in
Texas has risen from 0.67 in 2005 to 0.90 in 2013. With this rise, Texas’ immigrant diversity has
become similar to that of legacy immigration destinations such as California (0.93) and New York
(0.95). These recent patterns suggest a new kind of 21st century immigration which will lead to an
increasingly diverse Texas population. (See also profile on Foreign-Born).
Three largest states in the U.S. ranked by population increase, 2000-2010 and 2010-2014*
2000-2010
2000
2010
2014
2010-2014
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# change
U.S.
281,421,906
33,871,648
308,745,538
37,253,956
%
change
27,423,632
3,382,308
9.7%
10%
318,857,056
38,802,500
# change
% change
10,111,518
1,548,544
3.3%
4.2%
California
20,851,820
25,145,561 4,293,741
20.6%
26,956,958
1,811,397
7.2%
Texas
15,982,378
18,801,310
2,818,932
17.6%
19,893,297
1,091,987
5.8%
Florida
*July 1, 2014 (Source: Steve Murdock presentation, 2015 United Way Economic Summit, U.S. Census Bureau)
Components of Change, U.S., Texas, and Tarrant County, 2010-2014
U.S.
Total Change
Natural Increase
Net Domestic Migration
Net International Migration
Numeric
Change
10,098,951
6,035,640
-4,063,311
% of total
change
100%
59%
--
Texas
Numeric
% of total
Change
change
1,811,397
100%
893,134
49.3%
562,661
31.1%
343,093
18.9%
Tarrant County
Numeric
% of total
change
change
136,326
100%
59,396
51%
42,130
30.9%
23,676
17.4%
(Source: Real Estate Center, Texas A&M University)
Trend: Population Growth, U.S., Texas, and Tarrant County, 2000-2014
Population
2000
2010
U.S.
281,421,906 311,591,917
Texas
20,841,820
25,145,561
Tarrant Co.
1,446,219
1,809,934
(Source: Hobby Center, Rice University)
2000-2010
# change
%
change
27,323,632
9.7%
4,293,741
20.6%
382,815
25.1%
2014
318,857,056
26,956,958
1,945,360
2010-2014
# change
%
change
7,265,139
2.3%
1,811,397
7.2%
136,326
7.5%
Trend: Tarrant County’s 6 largest cities (over 50,000) in 2014, compared with 2000-2010
2000-2010
2010-2014
#
%
change
change
# change
%
change
Population
2014
1,809,034
362,815
25.1%
1,945,360
534,694
741,206
206,512
38.6%
812,238
71,032
9.6%
332,969
365,438
32,469
9.8%
383,204
17,766
4.9%
Grand Prairie
127,427
175,396
47,959
37.6%
185,483
10,097
5.7%
North Richland Hills
55,635
63,343
7,708
13.9%
68,529
5,186
8.2%
Mansfield
28,031
56,368
27,337
101.1%
62,246
5,878
10.4%
Euless
46,005
51,277
4,272
11.5%
53,640
2,353
4.6%
County
Population
2000
Population
2010
Tarrant
1,446,219
Fort Worth
Arlington
36,326
7.5%
City:
Source: Hobby Center, Rice University, May 20, 2015
Tarrant County cities with greatest numerical population change, 2000-2010, compared with 20102014
2000-2010
County
Population
2000
Population
2010
# change
% change
Tarrant
1,446,219
1,809,034
362,815
25.1%
Fort Worth
534,694
741,206
206,512
Grand Prairie
127,427
175,396
Arlington
332,969
365,438
Mansfield
28,031
56,368
Population
2014
2010-2014
#
change
%
change
1,945,360
102,507
5.7%
38.6%
812,238
71,032
9.6%
47,969
37.6%
185,453
10,057
5.7%
32,469
9.8%
383,204
17,766
4.9%
28,337
101.1%
62,246
5,878
10.4%
City:
2015 United Way Tarrant County Community Assessment
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SOURCES:
North Richland
Hills
68,529
5,186
8.2%
Grapevine
50,844
4,510
9.7%
Keller
43,924
4,297
10.8%
Growth of Asian population: Office of the Texas State Demographer,
http://osd.texas.gov/Publications, May 2015
The Hobby Center for the Study of Texas at Rice University
http://www.hobbycenter.rice.edu
Population Distribution & Change: 2000 to 2010; 2010 Census Briefs, March 2011, U.S. Census Bureau
(Narrative) http://www.census.gov/prod/cen2010briefs/c1010br-01.pdf)
http://www.americanprogress.org/issues/2012/05/top10_texas.html/
http://www.star-telegram.com/2014/03/27/5684010/dallas-fort-worth-arlington-adds.html
http://recenter.tamu.edu/data/pop/pops/st48.asp
The Top 10 Things You Should Know about Texas’s Demographic Changes and Immigration Politics,
Center for American Progress, May 2012
https://www.americanprogress.org/issues/race/news/2012/05/25/11595/the-top-10-things-youshould-know-about-texass-demographic-changes-and-immigration-politics/
2015 United Way Tarrant County Community Assessment
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DEMOGRAPHICS
INDICATOR:
Age Distribution
ABOUT THE
INDICATOR:
Age demographics can be a reflection of birth rates, immigration and longevity.
IMPORTANCE
OF THIS
INDICATOR:
WHAT THE
DATA TELLS US:
Age demographics and projections have implications for education and health care, among other
issues.
Two major phenomena are occurring: the aging of the baby boomers following World War II and the
immigration and growth of the Hispanic population with a higher birth rate than other ethnicities. In
2006, the first of the post-war (1946-1964) babies turned 60; in 2016, they will turn 70. The number
of people over 60 and the longevity of that group have implications for isolation, chronic disease, and
end-of-life care.
Both Tarrant County and Texas have a younger median age than the U.S.
Although older adults make up a smaller percentage of the population, the 65+ age group continues
to be the fastest growing age group, with 22% growth between 2010 and 2014.
Age Distribution, Tarrant County, Texas, U.S., 2014 estimates
Tarrant County
Texas
U.S.
Total Population
100%
1,945,360
26,956,958
316,857,056
Median Age
34.2
34.3
37.7
% of total
Number
% of total
%
Under 5 years
7.3%
142,011
7.2%
6.2%
Under 18 years
19.8%
385,181
19.2%
16.9%
25 years+*
63.3%
1,231,412
63.3%
67%
60+ years
14.8%
287,913
16.5%
20.4%
62+ years
12.8%
249,006
14.4%
17.9%
65+ years
10.2%
198,426
11.5%
14.5%
75+ years
4.1%
79,759
4.7%
6.2%
Source: Census, American Community Survey 2014 one-year estimates
http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?fpt=table
*Population of adults 25+ is used in literacy and educational achievement data
Trend: Selected age groups as a percentage of population, Tarrant County, 2014 compared to 2010
2014
Total Pop.
Median Age
Selected Age Groups:
Under 5
Under 18
60+
62+
65+
75+
100%
2010
1,911,541
34.2
100%
1,817,658
33.3
2010-14
# change
% change
93,883
5.2%
% of total
7.3%
19.8%
#
142,011
385,181
% of total
7.9%
20.1%
#
143,594
365,349
# change
(1,583)
19,832
% change
(1%)
5%
14.8%
12.8%
10.2%
4.1%
287,913
249,006
198,426
79,759
13.5%
11.5%
8.9%
3.9%
245,383
209.030
161,771
70,888
42,530
39,976
36,655
8,871
17%
19%
22%
12%
Source: American Community Survey: 2014 and 2010 – One year estimates
SOURCES:
American Community Survey: 2014 and 2010 – One Year Estimates
Census 2010 2013, Quick Facts; Census 2000 DP-1; Summary File 1 – 100% data
http://quickfacts.census.gov/qfd/states.48000.html
Texas Association of Counties: http://www.txcip.org/tac/census/profile.php?FIPS=48439
2015 United Way Tarrant County Community Assessment
12
DEMOGRAPHICS
INDICATOR:
Income and Poverty
ABOUT THE
INDICATOR:
Poverty has historically been tracked in three primary ways:
(a) the official U.S. poverty rate is published annually by the Census Bureau every September;
(The U.S. Census Bureau establishes annual income thresholds to measure poverty and estimate the
number of poor people, i.e., those in families with income below the federal poverty thresholds.
The U.S. Department of Health and Human Services (HHS) uses the federal poverty thresholds to set
income guidelines, which vary by family size and are referred to as the “federal poverty level” (FPL).
(b) the official U.S. unemployment rate is published monthly by the U.S. Department of Labor’s
Bureau of Labor Statistics;
(c) the federal Supplemental Nutritional Assistance Program (SNAP), formerly Food Stamps, reports
usage monthly, with a three-month lag.
In fall 2015, The Salvation Army and the Indiana University Lilly Family School of Philanthropy developed
a complementary tool, the Human Needs Index (HNI), a multi-dimensional measure of human needs
based on objective data from The Salvation Army, which provides social services.
Median income refers to a dollar level at which half the population has more and half has less income.
(It is not an average.)
IMPORTANCE
OF THIS
INDICATOR:
Federal poverty guidelines are used to determine eligibility for many government programs.
WHAT THE
DATA TELLS
US:
The national HNI mirrors overall economic trends over time. Not shown on the chart, but at the start of
the Great Recession in 2008, the HNI score began a gradual increase, climbing to its highest peak in
2012. In the past year (2014), HNI scores have begun to decline, reflecting an overall decrease povertyrelated need. Also not reflected on the chart below, the Southern region HNI scores by year displays the
most variability (among the four regions) over time. The index increased from 2006 through 2012,
reflecting Hurricane Katrina and other large-scale regional disasters, and then declined after 2012. The
effects of the Great Recession appear less pronounced in the Southern region, perhaps due to the
abundance of natural disasters during this time.
The Human Needs Index (HNI) includes seven types of services representing basic human needs: meals
provided, groceries, clothing, housing, furniture, medical assistance and help with energy bills. The HIN
provides national and state metrics on a quarterly (real-time) basis. The scale begins at 0, which
indicates a minimum level of need.
The median income (2009-2013) for Tarrant County ($56,850) is higher than that of Texas and the U.S.
The cost of living from 2010-2014 in the Dallas-Fort Worth area not risen as high (8.6%) as for the U.S.
(10%).
The 2015 poverty level for a family of four- $24,250-equates to a wage of $11.66/hour based on a fulltime job (40 hours/week x 52 weeks/year =2080 hours/year). The CPPP’s Family Budget Estimator
shows that a family of four in the Fort Worth-Arlington metroplex area, in which the employer pays
health insurance and the family is saving for emergencies, needs $4,012/month ($48,144/year) to make
ends meet.
The percentage of residents in poverty in the DFW-Arlington area (15.9%) has increased since 2008, but
is lower than for Texas (17.4%) and the U.S. Older adults have a lower percentage of individuals in
poverty by 9.1% in 2012.
There are disparities in poverty by age and race. Although 14.5% of the overall population is poor, one
in five children (20.8%) lives in a poor family, while one in 12 older adults is poor(8.3%). The percentage
of African-Americans (29%) and Hispanics (33%) with income at or below poverty is more than double
2015 United Way Tarrant County Community Assessment
13
that of Anglos (12%).
HNI Scores: National and State Human Need Index (HNI) December Scores (Salvation Army data), 2014
and 2013
National HNI Scores Region-South-HNI Scores Texas HNI Scores
2014
101.65*
101.89*
102.21
2013
103.76*
104.21*
102.51
*December
HNI Indicators: National and South Region Human Need Index (HNI) Indicators (Salvation Army data),
2014
Housing
Medical
Meals
Grocery
Energy
Clothing Furniture
orders
orders
provided
orders
orders
orders
orders
National
-0.39
-.37
-0.57
0.20
-0.24
0.24
0.38
South Region
0.15
0.68
0.83
-0.43
.74
-0.07
0.11
(incl Texas)
Trend: Median Household Income, Tarrant County, Texas, and U.S., 2009-2013
United States
Texas
Tarrant County
$53,046
$51,900
$56,853
Source: http://quickfacts.census.gov/qfd/states/48/48439.html
2015 Federal Poverty Guidelines, 48 Contiguous United States and D.C.
Federally facilitated marketplaces will use the 2015 guidelines to determine eligibility for Medicaid and
CHIP.
Household
100%
133%
150%
200%
250%
300%
400%
Size
1
$11,770
$15,654
$17,655
$23,540
$29,425
$35,310
$47,080
2
15,930
21,187
23,895
31,860
39,825
47,790
63,720
3
20,090
26,720
30,135
40,180
50,225
60,270
80,360
4
24,250
32,253
36,375
48,500
60,625
72,750
97,000
5
28,410
37,785
42,615
56,820
71,025
85,230
113,640
6
32,570
43,318
48,855
65,140
81,425
97,710
130,280
7
36,730
48,851
55,095
73,460
91,825
110,190
146,920
8
40,890
54,384
61,335
81,780
102,225
122,670
163,560
Source: Families USA. http://familiesusa.org/product/federal-povertyguidelines#sthash.wxg303sN.dpuf
For families/households with more than 8 persons, add $4,160 for each additional person
Trend: Cost of living, Dallas-Fort Worth and U.S., 2008-14
(Consumer Price Index – CPI - Base is 1982-84=100)
Historical annual
Dallas-Fort
U.S.
averages
Worth*
2008
201.791
215.3
2011
207.933
224.939
% change 2008-2011
+2.95%
+4.29%
2014
218,392
236.736
% change 2011-2014
+5.0%
+5.4%
Poverty, U.S., Texas, and Tarrant County, 2013
U.S.
Individuals under FPL
14.5%
Source: Census.gov/Quickfacts
2015 United Way Tarrant County Community Assessment
Texas
17.5%
Tarrant County
15.2%
14
Poverty, selected age groups, U.S., Texas, and Tarrant County, 2010
U.S.
Texas
Tarrant County
Under age 18 below FPL
21.6%
25.7%
20.8%
Age 65+ below FPL
9%
10.7%
8.3%
Poverty by Race/Ethnicity, DFW-Arlington, Texas, U.S., 2011-2012
DFWTexas
Arlington
White
7.3%
12%
African-American
23.7%
29%
Hispanic
23.7%
33%
Asian
11.0%
12.1%
U.S.
13%
28.1%
25.4%
13.0%
Trend: Poverty, Tarrant County*, Texas, and U.S., 2007-2012
Indicator
Persons at or
below FPL
Children at or
below FPL
Tarrant
2007
12.2%
Tarrant
2010*
14.5%
Texas
2007
16.3%
Texas
2012
16.8%
U.S.
2007
13%
U.S.
2012
13.8%
17.5%
20.8%
23.2%
25.7%
18%
14%
**No updated information had been found on those living below the FPL; 2012 is the latest (source:
Center for Public Policy Priorities)**
2-1-1 Top 5 Needs related to Income Support, All Calls and Callers 60+, 2014
Income Support, Total Calls

Medicaid

Free Tax Prep (VITA, AARP)

Medicare Savings Programs

Children’s Health Insurance Program (CHIP)

Child Care Subsidies

Social Security Disability Insurance (SSDI)

Temporary Aid for Needy Families (TANF)
(Source: 2-1-1 Texas at United Way, 2014 Annual Report)
SOURCES:
All Calls
70,851
49,521
6,388
5,855
4,688
4,399
60+ calls
11,283
6,563
801
3,715
-114
90
Human Needs Index, The Salvation Army and Lilly Family Foundation, 2015 https://philanthropy.iupui.edu/newsevents/news-item.html?id=177
Census 2014 Quick Facts http://quickfacts.census.gov/qfd/states/48/48439.html
Bureau of Labor Statistics, CPI Program; Bimonthly Report compiled by Texas Labor Market & Career Information
Department http://www.tracer2.com/admin/uploadedPublications/958_CPI.pdf
Federal Poverty Guidelines: U.S. Department of Health & Human Services
http://aspe.hhs.gov/poverty/12poverty.shtml
Family Budget Estimator, Center for Public Policy Priorities, http://www.familybudgets.org
2015 United Way Tarrant County Community Assessment
15
DEMOGRAPHICS
INDICATOR:
Race and Ethnicity
ABOUT THE
INDICATOR:
The 2010 Census provides reports on the diversity of the population, including people of Hispanic
origin and race, as well as information on the population reporting more than one race, and detailed
race combinations. Hispanic is considered an ethnicity. Hispanic or Latino people may be White,
Black or other races. Hispanic or Latino refers to people of Cuban, Mexican, Puerto Rican, South or
Central American or other Spanish culture or origin, regardless of race. Asian refers to a person
having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the
Philippine Islands, Thailand, and Vietnam.
IMPORTANCE
OF THIS
INDICATOR:
WHAT THE
DATA TELLS US:
The increasing diversity of the community has implications for culturally sensitive services,
particularly related to language, education, financial stability and health.
In 2013, people who identify themselves as Black, Hispanic, Asian and other races/ethnicities now
account for slightly more than half (50.9%) of the Tarrant County population. The percentage of
those who identify themselves as White, not Hispanic, has decreased as a percentage of the whole,
from 2010-2012, largely due to the growth in the Hispanic population.
Trend: Race & Ethnicity, Tarrant County 2000-2013, and Texas, U.S., 2013
Tarrant County
Texas
U.S.
2000
2010
2013
2013
2013
Total pop.
1,446,219
1,800,034
1,911,541
26,448,193
316,128,839
White, not Hispanic
61.9%
51.8%
50.1%
44%
62.6%
Black
12.8%
14.9%
15.9%
12.4%
13.2%
Hispanic
19.7%
26.7%
27.6%
38.4%
17.1%
Asian
3.6%
4.7%
5.0%
4.3%
5.3%
Other
0.8%
0.9%
0.2%
0.1%
0.2%
2 or more races
2.2%
1.8%
2.4%
Source: Census 2000 SF1, 100-Percent Data; Quick Facts 2014;
Trend: Increase in Population by Race & Ethnicity, Tarrant County, 2000-2013
2000
2010
2013
2000-10
% chg
Total Population
1,446,219
1,800,034
1,911,541
24.5%
White, not Hispanic
895,253
937,135
957,682
4.7%
Black
185,116
268,205
303,935
45.1%
Hispanic
285,290
482,977
527,585
69.3%
Asian
52,594
84,561
95,577
60.7%
Other
11,570
16,200
3,823
40%
2 or more races
--42,053
N/A
Source: Quick Facts, 2014
SOURCE:
2010-13
% chg
6.2%
0.3%
13.3%
9.2%
13%
Census 2010, 2013, 2014 Quick Facts http://quickfacts.sensus.gov/qfd/states.48000.html
2015 United Way Tarrant County Community Assessment
16
DEMOGRAPHICS
INDICATOR:
Foreign Born Persons and Language Other than English Spoken at Home
ABOUT THE
INDICATOR:
The U.S. Census uses the term “foreign born” to refer to anyone who is not a U.S. citizen at birth. This
includes naturalized citizens, lawful permanent residents (immigrants), temporary migrants (such as
foreign students), humanitarian migrants (such as refugees and asylees), and persons illegally present in
the United States. “Natives” or “native born” are those born in the U.S., Puerto Rico, or a U.S. Island
Area (e.g., Guam) or born abroad of a U.S. citizen parent(s). Place of birth cannot be used alone to
determine foreign-born.
Census information on place of birth, etc., provides data used to allocate funds to public and private
nonprofits that provide employment resources aimed at making foreign-born residents self-sufficient.
IMPORTANCE OF
THIS
INDICATOR:
WHAT THE
DATA TELLS
US:
By 2013, more than one of every 10 foreign-born persons in the United States resided in Texas. Currently
(October 2015), about one out of six Tarrant County residents was born in a foreign country.
For the period 2009-2013 in Texas, immigration from Mexico has slowed dramatically and immigration
from Asia has increased.
Higher levels of education and length of time in the U.S. are correlated with a high English-speaking
ability. A longer period of residence in the U.S. is associated with a higher proportion speaking only
English at home and greater English-speaking ability for those speaking a non-English language at home.
Many foreign born persons who are over the age of 5 come from English-speaking countries such as
Canada, Germany, Jamaica, and the United Kingdom and countries which use English as an official
language, notably India, Nigeria and the Philippines.
Currently (2015), about three-quarters of Tarrant County residents speak only English at home. Of those
who speak another language at home, 76% speak Spanish, and half of the remainder (12%) speak Asian
languages. More than half of those who speak a language other than English at home speak English very
well. In Tarrant County, more than 125 different languages were reported.
Trend: Foreign-born persons, Tarrant County, Texas, and U.S., 2009-13 compared with 2000
2009-2013
2000
Tarrant County
Texas
U.S.
Tarrant County Texas
U.S.
15.6%
16.3%
12.9%
12.7%
13.9 11.1%
%
Changes in country of origin of foreign-born in Texas, Hispanic and Asian, 2013 compared with 2005
2013
2005
Foreign-born originating from Mexico
27.1%
56.8%
Foreign-born originating from Asia
40.3%
17.3%
Source: Office of the Texas State Demographer, Publications, May 2015
Trend: Language other than English spoken at home (over age 5), Tarrant County, Texas, and the U.S.,
2008-2012 compared with 2000.
Tarrant County
Texas
U.S.
2000
2008-2012
2000
2008-2012
2000
2008-2012
21.9%
27.6%
31.2%
34.6%
18%
20.5%
2015 United Way Tarrant County Community Assessment
17
Languages other than English spoken at home (over age 5), Tarrant County, 2009-13
Percentage of
those who
speak a
language
Speaks
other than
English less
English at
than "very
home
well"
Percent
speaks
English
less than
“very
well”
Population age 5 years +
Speaks only English at home
Percentage that speaks only English at home
1,705,872
1,233,882
72%
210,263
12%
SPEAKS A LANGUAGE OTHER THAN ENGLISH
AT HOME
Percentage speaks other language at home
471,990
28%
210,263
45%
SPANISH
OTHER INDO-EUROPEAN LANGUAGES
358,580
39,353
76%
8%
165,808
11,305
46%
29%
54,951
12%
27,399
50%
ALL OTHER LANGUAGES (e.g., African
languages, Arabic)
19,106
4%
Source: American Community Survey, 2009-13, Released October 2015
5,751
30%
(e.g., French, German, Persian, Urdu & Indic
languages, Slavic languages)
ASIAN and PACIFIC ISLAND LANGUAGES
(e.g., Vietnamese, Chinese, Korean, Tagalog,
and other Asian languages)
SOURCES:
Office of the Texas State Demographer, Publications, May 2015 http://osd.texas.gov/Publications
“Asia now sending most new Texans”, Bud Kennedy, In My Opinion, Star-Telegram, October 16, 2015
American Community Survey, Detailed Languages Spoken at Home and Ability to Speak English, 2009-13
for counties (released October 2015) http://www.census.gov/data/tables/2013/demo/2009-2013-langtables.html?eml=gd&utm_medium=email&utm_source=govdelivery
“Immigrants Drive the Texas Economy”, Center for Public Policy Priorities, September 17, 2014.
http://forabettertexas.org/images/EO_2014_09_PP_Immigration.pdf
Census 2010; 2012 Quick Facts http://quickfacts.census.gov/qfd/states/48/48439.html
English-speaking Ability of the Foreign Born Population in the U.S., 2012.
http://www.census.gov/library/publications/2014/acs/acs-26.html
2015 United Way Tarrant County Community Assessment
18
DEMOGRAPHICS
INDICATOR:
Educational Attainment
ABOUT THE
INDICATOR:
The highest level of education attained has implications not only for job skills but is linked directly to
income and poverty. Changing demographics have resulted in changes in school district
demographics.
IMPORTANCE
OF THIS
INDICATOR:
The rate of poverty is highest among those with less than a high school diploma and the rate
decreases dramatically among those with a college degree.
WHAT THE
DATA TELLS US:
Although Tarrant County exceeds Texas and compares favorably to the U.S. with respect to percent of
the population with a high school diploma or greater or bachelor’s degree or higher, still 16% have
less than a high school diploma and almost one in four (24.2%) have some college but no degree.
Fort Worth lags behind Arlington and Tarrant County on percentage of adults 25+ who are high school
graduates or higher.
Highest Level of Education Attained (% of population 25+), U.S., Texas, and Tarrant County, 20102014 American Community Survey 5-year Estimates
U.S.
209,056,129
13.6%
28%
21.2%
Texas
16,426,730
18.5%
25.2%
22.7%
Tarrant County
1,184,855
15.3%
23.8%
24.3%
Associate’s degree
7.8%
6.6%
6.9%
Bachelor’s degree
18.3%
17.9%
20.4%
Population 25 years+
Less than high school graduate
High school graduate (includes GED)
Some college, no degree
Graduate or professional degree
11.0%
9.1%
9.3%
% H.S. graduate or higher
86.3%
81.6%
84.7%
% bachelor’s degree or higher
29.3%
27.1%
29.7%
Source: American FactFinder, 2010-14 American Community Survey, 5 Year Estimates, S1501
Educational Attainment (percent of adults age 25+), Fort Worth, Arlington, 2010-2014 compared
with 2006-2010
2010-2014
2006-2010
Fort Worth
Arlington
Fort Worth
Arlington
H.S. Graduate or higher
80.4%
84.6%
78.6%
84.6%
Bachelor’s degree or higher, 2006-2010
26.7%
28.9%
25.7%
28.7%
Source: American FactFinder, 2010-14 American Community Survey, 5 Year Estimates, S1501
Trend: Fort Worth ISD, Demographics, 2013-14
STUDENT POPULATION
SCHOOL DISTRICT
2010
2013-14
% chg
% MINORITY
2010
2014
% ECONOMICALLY
DISADVANTAGED
2O1O
2014
Fort Worth
88103
84,360
(4%)
87%
89%
75%
(Source: Texas Education Agency, 2013-14 Texas Academic Performance Reports, District Profiles)
77%
Trend: Northeast Tarrant County School Districts, Demographics, 2010 compared with 2013-2014
STUDENT POPULATION
SCHOOL DISTRICT
Birdville
Carroll
Grapevine-Colleyville
2010
2013-14
% chg
2010
2014
% ECONOMICALLY
DISADVANTAGED
2O1O
2014
23,441
7,642
13,614
24,252
7,791
13,469
3%
2%
-1%
52%
19%
36%
55%
25%
41%
55%
2%
20%
2015 United Way Tarrant County Community Assessment
% MINORITY
57%
2%
22%
19
Hurst-Euless-Bedford
21,000
22,129
5%
54%
58%
51%
Keller
32,613
33,685
3%
37%
41%
20%
(Source: Texas Education Agency, 2013-14 Texas Academic Performance Reports, District Profiles)
53%
24%
Trend: Southeast Tarrant County School Districts, Demographics, 2010 compared with 2013-2014
STUDENT POPULATION
SCHOOL DISTRICT
% MINORITY
% ECONOMICALLY
DISADVANTAGED
2010
2013-14
% chg
2010
2013-14
2O1O
2013-14
Arlington
63,385
64,629
2%
71%
77%
60%
68%
Everman
5,046
5507
9%
94%
94%
83%
86%
Kennedale
3,155
1%
41%
49%
36%
42%
Mansfield
31,614
36%
38%
3181
56%
32735
4%
63%
(Source: Texas Education Agency, 2013-14 Texas Academic Performance Reports, District Profiles)
SOURCE:
American FactFinder – 2010-2014 American Community Survey 5-Year Estimates, 2014
http://factfinder.census.gov/rest/dnldController/deliver?_ts=467567973902
2014 Census Quick Facts
Texas Education Agency, Texas Academic Performance Reports, 2013-14.
http://ritter.tea.state.tx.us/perfreport/tapr/2014/index.html
2015 United Way Tarrant County Community Assessment
20
DEMOGRAPHICS
INDICATOR:
County Health Rankings
ABOUT THE
INDICATOR:
This website – www.countyhealthrankings.org - enables a county to see its health ranking within a
state and compare its ranking with counties within the same state. It is not intended to rank states or
compare counties across the nation. The purpose is to enable a county to identify issues around which
to collaborate and develop community action. The site also includes best practices/programs and
resources.
IMPORTANCE
OF THIS
INDICATOR:
The county rankings are based on scores primarily on Health Outcomes but also on Health Factors.
(Note: Over the years, some of the subcategories have changed.)
For 2015, Health Outcomes includes 2 subcategories:
 mortality – premature death;
 morbidity – poor/fair health, poor physical health days, poor mental health days, and low
birth weight;
Health Factors includes 4 subcategories:
 health behaviors – smoking, obesity, food environment index, physical inactivity, access to
exercise, excessive drinking, alcohol-impaired driving deaths, sexually transmitted infections,
and teen births
 clinical factors – uninsured adults, primary care providers, dentists, mental health providers,
preventable hospital stays, diabetes screening, mammography screening
 socio-economic factors – high school graduation, some college, unemployment rate, children
in poverty, income inequality, children in single parent households, social associations, violent
crime, and injury deaths
 physical environment - air pollution/particulate matter, drinking water violations, severe
housing problems, driving alone to work, long commute-driving alone
WHAT THE
DATA TELLS
US:
Between 2012 and 2015, Tarrant County Health Factors ranking improved but Health Outcomes
ranking declined related to mortality (premature deaths).
Note: In the following rankings, a lower number indicates a higher rank.
Trend: Health Ranking (among 253 counties), Tarrant County, 2015 compared with 2012
2012
2015
Change in Rank
HEALTH OUTCOMES
24
33
Worsened by 9
Mortality
29
53
Worsened by 24
Morbidity
46
31
Improved by 15
HEALTH FACTORS
Health behaviors
Clinical
Socio-economic
Physical environment
65
31
38
104
217
49
24
32
104
204
Improved by 16
Improved by 7
Improved by 6
Same
Improved by 13
Tarrant County Ranking (of 253 counties) compared with 4 other urban Texas counties, 2015
HEALTH OUTCOMES

Mortality

Morbidity
2015 United Way Tarrant County Community Assessment
TARRANT
TRAVIS
HARRIS
DALLAS
BEXAR
33
53
9
9
50
48
57
68
74
66
31
15
100
77
125
21
HEALTH FACTORS
49
9
94
122
50

Health Behaviors
24
5
27
57
63


Clinical
Socio-economic
32
104
9
75
50
171
37
191
15
128

Physical
204
50
130
217
45
Environment
Note: the lower
the number the higher the rank.
SOURCE:
Countyhealthrankings.org
2015 United Way Tarrant County Community Assessment
22
EDUCATION
INDICATOR:
Academic Achievement
ABOUT THE
INDICATOR:
Since 2013 the Texas Education Agency (TEA) requires school districts to report annual performance
through the Texas Academic Performance Reports (TAPR), known from 1990-2012 as the Academic
Excellence Indicators System (AEIS), which provides information about students in each school and each
district in Texas.
In spring 2012, the State of Texas Assessments of Academic Readiness (STAAR™) replaced the Texas
Assessment of Knowledge and Skills (TAKS) tests, which had been administered annually beginning in
Grade 3 and used to measure the extent to which a student had learned and was able to apply the defined
knowledge and skills at each tested grade level. The STAAR program at grades 3–8 assesses the same
subjects and grades that previously assessed on TAKS. At high school, however, grade-specific
assessments were replaced with twelve end-of-course (EOC) assessments: algebra I, geometry, algebra II,
biology, chemistry, physics, English I, English II, English III, world geography, world history, and U.S.
history. In the first year of its implementation (2012-13), the STAAR passing rates across Texas were
significantly lower than the TAKS passing rates of previous years.
In 2013, Texas was granted a waiver from the federal government to waive specific provisions of the
Elementary and Secondary Education Act (ESEA), as amended by P.L. 107-110 No Child Left Behind (NCLB)
Act of 2001. The waiver gives TEA and more than 1,200 local education agencies (LEAs) additional
flexibility while reducing duplication. Previously, the federal government’s accountability system,
Adequate Yearly Progress (AYP), measured how districts were doing in preparing students to be proficient
in math and reading. The passing rate needed to achieve the standard increases each year towards the
No Child Left Behind goal of 100% of students proficient in reading and math by 2014. For 2012, the
passing rate needed is 87% for reading and 83% for math. In August 2012, TEA announced 56% of Texas
campuses (including at least one campus in each Tarrant County ISD) failed to meet AYP this year
(compared with 34% that failed to meet the federal benchmark in 2011).
The North Texas Regional P-16 Council, a collaboration since 2000 between schools, post-secondary
educational institutions, families, businesses, faith-based groups, local, state and federal agencies, and
community organizations, fosters a more integrated education system while addressing college/career
readiness, college access and college/career success. The P-16 Council reports annually on data and
trends on key indicators for TEA’s Education Service Council Regions 10-11 (which includes Arlington ISD
and Fort Worth ISD, respectively) or the Region 3-Metropolex (of the Texas Higher Education Regions).
The 2014 annual U.S. Chamber of Commerce report, “Leaders and Laggards”, which rates states on
educational effectiveness and innovation, added new metrics, including measures of parental choice,
international competitiveness, technology policy, and fiscal responsibility. For the first time, the 2014
Leaders and Laggards report showed change over time in student scores between the first Leaders &
Laggards report in 2007 and this edition. Although every state showed improvement since 2007, the
report concludes we have a long way to go.
In November 2015, the Center for Public Policy Priorities published a Texas Education Scorecard, which
assigns letter grades using five key indicators of “leaks” in the education pipeline that signal challenges in
student preparation or transitions between educational stages. A letter grade of “C” indicate te county is
close to the statewide and county average. (Source: Texas Education Scorecard http://texaseducationscorecard.org/county/tarrant)
IMPORTANCE OF
THIS INDICATOR:
The data enables districts and regions to identify areas of excellence and areas at risk or needing academic
improvement, including subjects, outcomes, and population groups.
2015 United Way Tarrant County Community Assessment
23
WHAT THE DATA
TELLS US:
There are disparities among Tarrant County’s 20 school districts and among ethnic/racial groups on
academic indicators.
Findings from the North Texas P-16 Council Gap Analysis for 2013:
 Despite rapid change in the region’s ethnic diversity, whites are expected to remain the largest ethnic
group among the young adult population in the region through 2020 in a state with a Hispanic
majority for this age group.
 Longitudinal data going back to 2006 for college readiness indicators related to high school graduates
through the 2011-12 school year showed patterns of progress similar for the state and region.
 Student scores on the state assessments have increased over time; but gaps in the achievement of
ethnic, gender and socioeconomic subgroups continued despite subgroup gains.
 Advanced Placement (AP)/International Baccalaureate (IB) participation has been consistently high for
this region compared to the state as are regional percentages of students who take the AP/IB tests
and those who achieve the criterion scores.
 The percentages of students meeting or exceeding the Scholastic Aptitude Test (SAT)/national college
admissions test (ACT) test passing criteria tends to be higher for students in the region (30%/32% in
2012) than for the state (25% in 2012).
 Percentages of high school students enrolled in advanced courses have increased by about 10% in the
region and state since 2003. Breaking out dual credit enrollment since 2009 shows the region lagged
behind the state on this college readiness measure; instead AP/IB courses were more likely to be
taken by students in the region.
 Since 1996, the number of students enrolled in higher education in Dallas, Denton, Collin and Tarrant
Counties has doubled. Despite increasing college enrollment for all subgroups, there were gaps for
African-American and Hispanic compared to White students, for males compared to females, and for
socioeconomically disadvantaged students.
 Students who entered college not requiring developmental education were more likely to graduate or
persist in their programs than those requiring developmental education. More than 50% of regional
students who entered 2-year colleges required developmental education. Students in the region who
entered 4-year colleges not requiring developmental education were less likely than those statewide
to graduate. Of high school graduates who entered postsecondary education in the region, 26%
completed a degree or certificate within 6 years, which is similar to the state.
 From 2009-2012, the employment rate for graduates of 2-year colleges in the region was about 69%
and for 4-year colleges in the region about 74% . The employment picture for the region’s graduates
was slightly better than for the state.
Source: P-16 North Texas Council, Gap Analysis Report 2013 http://ntrp16.org/gap-analysis-report2013
Findings and Recommendations from the Texas Education Scorecard for Tarrant County, November
2015
5 Key Indicators
Grade
All
EconomiLatino
Black
White
Students
cally DisadStu/AfricanStudents
vantaged
dents
American
Students
Students
School Readiness: Do not meet
B60%
73%
69%
75%
45%
3rd grade reading standards
Transition to High School:
C11.5%
15.7%
15%
15.4%
6.5%
th
Must repeat the 9 grade
High School Success: Drop out
C7.3%
9.5%
9.8%
11.1%
4.1%
of high school
Transition to College:
C
50.9%
44.9%
45%
48.8%
54%
Percentage of high school
students who don’t enroll in
2015 United Way Tarrant County Community Assessment
24
Texas Colleges
College Success: Percentage of
C
53%
Texas College Students who
don’t graduate
Source: Texas Education Scorecard, Tarrant County 2015
63.8%
62.9%
67.8%
46.5%
Policies and practices to help:
 Set up the youngest and neediest students for success
Pre-K participation rates
Texas
Tarrant
74.5%

70.8%
Top 25
counties
97.7%
Bottom 25
counties
40.2%
Adequately and equitably fund schools
Average Funding per Student
Texas
Tarrant
$5,462
$5,436
Top 25
counties
$7,372
Bottom 25
counties
$4,875
Range of Per-Student Funding within Tarrant County
Highest
Lowest
Carroll ISD
Eagle Mt-Saginaw
$5,810
$5,068

Prepare students for successful transitions to college
th
Advanced Placement/International Baccalaureate Enrollment Rate: Percentage of 9-12
graders enrolled in AP or IB courses
Texas
Tarrant
Top 25
counties
22.1%
27.7%
36.5%
th
Dual Credit Enrollment Rate: Percentage of 9-12 graders enrolled in courses offering
both high school and college credit
Texas
Tarrant
Top 25
Bottom 25
counties
counties
7.5%
4.9%
36.5%
2.1%
th
FAFSA Completion Rate: Percentage of 12 graders completing the Free Application for
Federal Student Aid (application for college financial aid) by June of their senior year
Texas
Tarrant
40.3%
42.6%
College Readiness Rate: Percentage of students entering post-secondary education
deemed “college-ready”
Texas
Tarrant
N/Al
73.4%

Help adult students advance in their education goals with financial security
GED Testing Rate
Tarrant
County
GED test takers
Adults under 25 without a high school diploma
2015 United Way Tarrant County Community Assessment
Top
county
rate
Texas
overall
rate
1,537
186,000
25
Testing rate
0.8%
Share of community college students who
take out loans they are unable to repay
3.2%
Tarrant
County
College
District
20.4%
FWISD
N/A
Texas
overall
rate
Average
top 6
colleges
Average
bottom 6
colleges
20.1%
12%
26.1%
Average
of top 6
grant
recipient
s
77%
Average
of
bottom 6
recipient
s
33%
Texas
Share of students in Adult Basic Education
32.3%
72%
programs making educational gains
Number of students enrolled in Career
15
25,000
Pathways Programs (integrated education
and job training)
Source: Texas Education Scorecard, CPPP, 2015 http://texaseducationscorecard.org/county/tarrant
Educational Effectiveness and Innovation - Texas Report Card, Texas compared to the U.S.,
2014
2014
D
B
B
DC
CC
A
BC
C
Academic Achievement
Academic achievement for low-income and minority students
Return on investment
Truth in Advertising: Student proficiency
Postsecondary and Workforce Readiness
st
21 Century Teaching Force
Parental Options
Data Quality
Technology
International Competitiveness
Fiscal Responsibility
2007
F
D
Source: Leaders & Laggards 2014, U.S. Chamber of Commerce Foundation and U.S. Chamber
Selected Characteristics, Highest and Lowest Rates, Tarrant County Independent School
Districts, 2013-2014
Indicator
ISD with highest
rate/number
Rate/
Number
ISD with lowest
rate/number
Rate/
Number
Total schools
Fort Worth
142
Kennedale
5
Total students
Fort Worth
84,360
Kennedale
3,181
Everman
40.5%
Azle
0.8%
African-American
Hispanic
Castleberry
76.6%
Carroll
8.3%
White
Azle
77%
Birdville
0.7%
Other
Carroll
10.4%
Castleberry/Birdville
0.3%
Castleberry
86.9%
Carroll
2.1%
Castleberry/Fort Worth
30.6%
Carroll
1.2%
White Settlement
9.8%
Castleberry
7.1%
Fort Worth
29.2%
Carroll
1.2%
Economically Disadvantaged
English Language Learners (ELL)
Special Education
Bilingual/ESL
2015 United Way Tarrant County Community Assessment
26
Career Tech
Lake Worth
32%
Castleberry
17.1%
Carroll
23%
White Settlement
4.9%
Carroll, GrapevineColleyville, Hurst-EulessBedford, Mansfield
96.7%
White Settlement
94.6%
Arlington
Carroll
3,760
98.8%
Lake Worth
Fort Worth
131
82.1%
Carroll
99.3%
Fort Worth
83.7%
Carroll
95.9%
Castleberry
42%
Gifted/Talented
Attendance Rate (2012-13)
Annual Graduate Count, Class 2013
4 year Longitudinal Graduation
Rate, Class of 2013
5 year Longitudinal Graduation
Rate, Class of 2012
College Ready Graduates
Texas Education Agency (TEA) Snapshot, 2014
Various Education Indicators, Tarrant County ISDs compared to Texas, 2014
2013-14
Tarrant Co
Texas
Students in Bilingual/ESL Programs
Special Education Students
18%
8.2%
17.1%
8.6%
High School Graduates
th
(class of 2006-08; % of class of 9 graders who graduated four years later)
88%
88%
High school – Continuing
(% of students continuing in HS beyond the standard graduation period;
cohort graduating year 2010)
4%
5%
Received GED
th
th
% of students from class of 9 graders who received GED between 9
Grade and standard graduation date 4 years later; class graduating year
2010)
8%
7%
Source: Center for Public Policy Priorities, Kids Count Data Center
Reading & Math Test Scores at 3rd, 7th and High School grades, Tarrant County ISDs compared
to Texas, 2014
2012-13
Tarrant County
Texas
41%
41%
67%
40%
38%
63%
Students Passing STAAR – 3 grade Math
th
Students Passing STAAR – 7th grade Math
Students Passing STAAR – High School Algebra I
31%
29%
37%
32%
31%
36%
Economically Disadvantaged – passing STAAR reading
Non-economically Disadvantaged – passing STAAR reading
29%
59%
28%
58%
Economically Disadvantaged – passing STAAR Math
Non-economically disadvantaged – passing STAAR Math
24%
48%
25%
49%
rd
Students passing STAAR – 3 grade Reading
th
Students passing STAAR – 7 grade Reading
Students passing STAAR – High School English II
rd
Source: Center for Public Policy Priorities, Kids Count Data Center
2015 United Way Tarrant County Community Assessment
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SOURCES:
Texas Education Agency www.tea.state.tx.us
North Texas Regional P-16: Gap Analysis Report 2013 http://ntrp16.org/gap-analysis-report-2013
Kids Count 2015, Annie E. Casey Foundation http://www.aecf.org/resources/the-2015-kids-count-databook/
Leaders and Laggards 2014, U. S. Chamber of Commerce http://www.leadersandlaggards.org/reportcard/texas
Texas Education Scorecard, Center for Public Policy Priorities, November 2015
http://texaseducationscorecard.org/county/tarrant
2015 United Way Tarrant County Community Assessment
28
EDUCATION
INDICATOR:
Early Childhood Education
ABOUT THE
INDICATOR:
Early childhood education includes child care as well as education such as Head Start, PreKindergarten, and Kindergarten. Brain development research indicates that the brain develops
fastest during the early years and relationships with a caregiver during those years are paramount to
a child’s cognitive, social and emotional development.
The Texas Department of Family & Protective Services (DFPS) regulates all child-care operations and
child-placing agencies to protect the health, safety, and well-being of children in care, largely by
reducing the risk of injury, abuse, and communicable disease.
The Texas Workforce Commission’s Child Care Management Services (CCMS) helps with the cost of
child care at licensed centers, registered family day homes or through relative care for low-income or
otherwise eligible parents who are working, attending school, or participating in job training. Texas
Rising Star Provider certification is a process for improving the quality of child care services provided
in Texas. A Texas Rising Star Provider has an agreement with a Workforce Board's Child Care
Contractor to serve Texas Workforce Commission (TWC) subsidized children and voluntarily meets
requirements that exceed the State's Minimum Licensing Standards for child care facilities. Head
Start is a federal program that promotes the school readiness of children ages birth to 5 from lowincome families by enhancing their cognitive, social and emotional development.
In Texas, state funding is available to school districts to provide a public half-day Pre-K program if
there are at least fifteen 3 year olds at greatest risk: limited English speaking, economically
disadvantaged, homeless, military, or foster care. Once the basic criteria are met, the program may
be expanded and funded with other sources.
Texas school districts are required to provide either a half-day or full-day public Kindergarten for
children who are at least 5 years old as of September 1. There is no required state assessment of
Kindergarten students - the State of Texas Assessments of Academic Readiness (STAAR) begins at
Grade 3 - but a reading instrument is administered for children in Kindergarten, Grades 1 and 2.
IMPORTANCE
OF THIS
INDICATOR:
“Minimum” state child care licensing standards focus on safety and minimizing risk. “Quality” child
care standards emphasize factors important to a child’s development such as parents as first
teachers, developmentally appropriate practices, growth in the preschool years, children as
individuals, and children’s best learning patterns being through enjoyable interaction. Quality child
care is expensive, because it is labor/training-intensive.
WHAT THE
DATA TELLS US:
Between 2010 and 2014, the number of children in Tarrant County age 0-13 grew by 8.3%, but the
number of centers and licensed/listed/registered homes decreased. The number of residential care
homes also decreased.
The percentage of Tarrant County children enrolled in subsidized child care, Pre-K and Head Start
continued to lag behind participation rates for the state.
The Raise Your Hand Texas report cited below says that “Because Texas programs are not required to
report assessment data or demographic data at the Pre-K level in a statewide system, it is difficult to
evaluate impacts during the Pre-K or kindergarten year. Thus, the effect of Texas Pre-K has been
measured by various academic and non-profit organizations rather than by the state. … The results
from two studies show that public Pre-K attendance was related to better academic outcomes for
children. Results for retention and special education were sizeable in one study, while the effect of
public Pre-K attendance on third grade standardized test scores is modest in both studies, especially
compared to the 20% reductions in the achievement gap that effective programs have shown. …In
2011, the organization Education Equals Economics (E3) surveyed central Texas kindergarten teachers
to investigate whether children were ready for kindergarten. Children who attended any type of
preschool program (54% ready) were more likely to be ready for kindergarten than children who had
2015 United Way Tarrant County Community Assessment
29
not attended kindergarten (38% ready). … Analyses suggested that students who had attended fullday Pre-K were more ready in the domain of language and literacy than half-day students. And
students who attended Pre-K in a district with a full-day Pre-K and a low student-teacher ratio were
more ready than students in a half-day program, a program with high student-teacher ratios, or
both.” The report adds the political landscape in Texas is such that “Texas has a think funding source
for its programs and early learning funds have been significantly reduced since 2011. There are also
very few statewide requirements for programs, making it difficult to efficiently lead and make
changes at a systems-level.” (Source: Pre-Kindergarten for the Modern Age)
In 2012, the Community Assessment reported that public Pre-K enrollment in the North Texas
regional council increased much slower than for the state and in 2008-09, 90% of the public Pre-K
enrollees were from African-American or Hispanic or Economically Disadvantaged households.
2012 information from Fort Worth Early Childhood Collaborative (which focuses on Fort Worth ISD)
revealed a gap between the number of children in Pre-K and the number who show up for
kindergarten without having been enrolled in Pre-K. Reports indicate that children who enroll in Prerd
K perform much more successfully in math and reading in both Kindergarten and 3 grade.
Trend: Child Day Care Licensing Statistics, Tarrant County, August 31, 2014 compared with August
31, 2010
Child
Population Age
0-13
Licensed child care
centers
#
centers
capacity
Licensed child care
homes
# homes
Capacity
Listed
Family
Homes
2014
410,804
650
74,107
118
1,412
447
2010
379,261
664
72,214
94
1,088
558
% change
8.3%
(2.1%)
(1.2%)
(25.5%) (29.7%)
(19%)
Source: Texas Department of Family and Protective Services Annual Databooks
Registered
Child Care
Homes
619
807
(23.3%)
Trend: Residential Child Care Licensing Statistics, Tarrant County, August 31, 2014 compared with
August 31, 2010
Child Pop
Age 0-17
Child Placing
Agencies (CPAs)
# CPAs
General
residential
operations
Residential
treatment
centers*
Total
Residential
Total
residential
capacity
# homes
verified by
CPAs
2014
2010
529,400
31
686
5
1
723
2158
482,819
34
721
5
0
761
2,472
% change
8.3%
(8.8%)
(4.9%)
100%
(5%)
(12.7%)
*Residential treatment centers are a care type of General Residential Operations. Total= sum.
Source: Texas Department of Family and Protective Services Annual Databooks
Accredited or certified early childhood programs in the Child Care Management System (CCMS),
Tarrant County, 2015
Number of
National
National
National
Texas School Texas Rising
centers on list Association for the
Early
Accreditation Ready Grant
Star
Education of
Childhood
Commission
(only for
Young Children
Program
(NAC)
Pre-K
(NAEYC)
Accreditaclassrooms)
tion (NECPA)
85
3
3
19
22
66
Note: Some centers have more than one accreditation.
Source: Tarrant County CCMS https://tarrantcountyccms.org/am-site/media/accreditation-list110315.pdf
2015 United Way Tarrant County Community Assessment
30
Accredited or certified early childhood programs, Tarrant County, 2015 compared with 2012
2015
2012
Child care centers accredited by NAEYC
3
13
Learning centers* certified as Texas School Ready
22
26
*denotes separate Head Starts, school districts, private and nonprofit child care centers
Children’s Participation in Early Care and Education, Tarrant County and Texas, 2011-14
Tarrant
Texas
County
Children in state-subsidized child care, 2013
3.1%
3.8%
Children (3-4) in public Pre-Kindergarten, 2013-14
24.2%
29.7%
Children (3-4) in Head Start, 2011-12
4.2%
9.2%
Source: Center for Public Policy Priorities: Kids Count 2015
Children in subsidized child care, Tarrant County, 2014
Number of children in subsidized child care
2014
11,361
2012
12,526
Sources: Kids Count 2015
Enrollment in Early Childhood Education, Pre-Kindergarten, and Kindergarten, Tarrant County ISDs,
2013-14
District
Arlington
Azle
Birdville
Carroll
Castleberry
Crowley
Eagle Mt/Saginaw
Everman
Fort Worth
Grapevine/Colleyville
Hurst-Euless-Bedford
Keller
Kennedale
Lake Worth
Mansfield
White Settlement
ECE
216
35
62
8
4
31
39
19
184
37
85
127
4
4
93
26
Pre-K
4208
96
943
82
186
479
369
314
4,387
167
643
363
54
135
717
204
Kindergarten
4,788
452
1,928
457
322
1,115
1,413
434
6,982
861
1,742
2,373
245
287
2,166
530
Total
9,212
583
2,933
547
512
1,625
1,821
767
11,553
1,065
2,470
2,863
303
426
2,976
760
Totals:
974
13,347
26,095
40,416
Source: TEA, Texas Academic Performance Reports, Districts in Tarrant County, 2013-14
How does Texas stack up?
Elements of Effective Pre-K Programs
Focus on Quality: Teacher/student interactions
Curriculum and Standards
Professional Development
Full-day Enrollment
Adult-child Ratios
2015 United Way Tarrant County Community Assessment
An evaluation of Public School
pre-K Statewide Requirements
and Funding
No
Partial*
No
No
No
31
Credentials and Wages
Using Data and Measurement to Drive Instruction
Political Leadership and Support
Partial **
No
Partial ***
*While Texas has pre-K guidelines, they are voluntary, with little uniformity with respect to the quality across the
state; ** Texas requires a BA and regular PK-6 credentialing; no Early Learning Credential required. Wages are
on same local pay scale as K-6 teachers. *** The Texas Legislature initially supported the creation and growth of
Pre-K, but defunded the Pre-K grant in 2011 and has not focused on quality or increased funding in recent years.
Source: Pre-Kindergarten for the Modern Age, Raise Your Hand Texas and University of Virginia, 2014
Impact of Pre-K on School Readiness, Fort Worth ISD, 2012
Kindergarten Reading - Percent Met Standard
With Pre-K
Without Pre-K
Difference
TPRI (reading assessment)
45.4%
18.3%
27.1%
Tejas LEE (Spanish assessment)
25.7%
5.0%
20.7%
Kindergarten Math - Percent Met Standard
SAT 10
83.7%
74.8%
8.9%
rd
3 Grade – Percent Met Standard
Reading TAKS
86.3%
76.1%
10.2%
Math TAKS
83.9%
71.7%
12.3%
Source: Fort Worth Early Childhood Collaborative, June, 2012 Note: In 2015, this organization no
longer exists.
SOURCE:
Texas Department of Family & Protective Services Annual Databooks;
http://www.dfps.state.tx.us/about/data_books_and_annual_reports/2006/databook/ and 2011
Center for Public Policy Priorities: The State of Texas Children 2015 and 2012
http://www.cppp.org/sotc/county_profile.php?fipse=48439
National Association for the Education of Young Children
http://www.naeyc.org/academy/accreditation/search
Texas School Ready – Children’s Learning Institute http://www.childrenslearninginstitute.org/ourprograms/program-overview/tx-school-ready/
Child Care Management System (CCMS), Child Care Associates of Tarrant County Tarrant County
CCMS https://tarrantcountyccms.org/am-site/media/accreditation-list-110315.pdf
Pre-Kindergarten for the Modern Age: A Scalable, Affordable High Quality Plan for Texas, Raise Your
Hand Texas and the University of Virginia, November 2014 http://www.raiseyourhandtexas.org/wpcontent/uploads/2014/11/RaiseYourHandTexas_PreK_ResearchReport1.pdf
2015 United Way Tarrant County Community Assessment
32
EDUCATION
INDICATOR:
Juvenile Crime/Gangs
ABOUT THE
INDICATOR:
Texas law defines an adult as one who is 17 and older, making it one of only 9 states that does not
classify youths under the age of 18 as juveniles. As a result, 17 year olds charged with a crime can be
punished in adult prisons rather than being sent to facilities designed to rehabilitate juveniles.
Rulings by the U.S. Supreme Court in 2012 deemed it unconstitutional to sentence a teen under 18
to a mandatory life sentence without the possibility of parole.
th
Texas’ truancy law changed in the 84 legislative session (2015). According to the Texas Tribune,
“For years, Texas was one of two states that made truancy a criminal violation. Public school
students who had at least 10 unexcused absences in a six-month period found their truancy cases
heard by justices of the peace or municipal judges. Schools also had the option of sending students
with three unexcused absences within a four-week period to adult courts. …Those 17 and older who
failed to pay school fines (for truancy) could be charged with contempt, and in some cases, wound
up in adult jails.” Under the new law, schools must notify parents, set up meetings and the student
must enroll in a truancy prevention program. (See also the profile on School Dropouts/Truancy in
this 2015 Community Assessment.)
nd
During the 82 Legislature (2011), SB653 abolished both the Texas Juvenile Probation Commission
and the Texas Youth Commission, transferring their operations to the new Texas Juvenile Justice
Department.
Youth age 10-17 who commit crimes in Tarrant County are referred to Tarrant County Juvenile
Services (TCJS). Law enforcement refers reports defined as delinquent conduct (misdemeanor or
felony) or conduct indicating a need for supervision, such as public intoxication, truancy, running
away, inhalant abuse, and violation of school disciplinary codes that result in expulsion. Youth who
are first offenders and others may be referred by local police departments to a first offender
program.
Although Congress passed the Prison Rape Elimination Act in 2003, it was not implemented until a
decade later, in 2013. Its requirement that 17-year-olds be separated from older inmates (by sight
and sound) to prevent sexual assault added more expense for county jails, according to the StarTelegram. The LBB’s fiscal analysis of HB 1205 points out there were 514 new admissions to adult
correctional institutions for juveniles age 17 and 7,587 convicted of crimes at age 17 were placed on
adult supervision. It costs more ($437.11/day) to house a teen in juvenile residential facilities than
the $54.89/day to house a person in TDCJ, (Source: Star-Telegram Editorial: “17-year-olds shouldn’t
go to prison”, April 3, 2015.)
IMPORTANCE OF
THIS INDICATOR:
A 2015 report, “Closer to Home”, found Texas youth have better outcomes when they are held
accountable in their own community rather than in facilities farther from home. Teen offenders
kept close to home were 21% less likely to commit additional crimes compared with similar teens
locked up in state facilities. Going into the juvenile justice system rather than the adult system
results in fewer repeat offenses for teens.
The Tarrant County Criminal Justice Community Plan 2015 identifies six “problem contributors” to
juvenile crime: discriminatory minority contact (DMC), lack of education, family instability, gangs,
mental illness, and substance abuse.
“Disproportionate Minority Contact” (DMC): Through an analysis of Tarrant County data over a 5
year period (2009-2013) which examined contact points with the juvenile justice system, including
arrest, referral, diversion, detention, petitioned, delinquent/violated findings, probation,
confinement in secure correctional facilities, and referral to the Juvenile Justice Alternative
Education Program (JJAEP), the 2015 Plan reported these findings:
2015 United Way Tarrant County Community Assessment
33






Referrals: African-American youth were disproportionately referred to TCJS compared to
white youth in the most recent 2 years; Hispanic youth were overrepresented at the
referral level, a trend which should be monitored;
Arrests: Hispanic and African-American youth are consistently overrepresented in the
number of arrests (in-custody referrals) to TCJS.
Diversion: Although historically African-American youth were consistently
underrepresented in diversion programs offered by TCJS, this difference disappeared in the
most recent year and should be monitored.
Detention: Hispanic and African American youth are detained at significantly higher rates
and petitioned at higher rates than whites.
Delinquent/violated and Confinement: Youth from all races are found delinquent or in
violation at similar rates; there does not appear to be disproportionate minority contact in
number of youth receiving modification of an existing term or new term of court-ordered
probation; and youth of all races are being remanded to secure confinement facilities at
similar rates.
Alternative Education: Although there has historically been a consistent trend of minority
overrepresentation in Juvenile Justice Alternative Education Program (JJAEP) referrals, the
trend disappeared for Hispanic youth.
Lack of Education: Numerous studies indicate that failure to obtain a high school diploma is an
important indicator of future engagement with the criminal justice system. A dropout is 8 times
more likely to be incarcerated than a person with a high school diploma. The 2015 Tarrant County
Criminal Justice Plan reports that, in 2012, for all Tarrant County ISDs, the longitudinal dropout rate
th
th
was 8.4% and the attrition rate was 28% (calculated by subtracting 9 grade enrollment from 12
grade enrollment for a specific class).
WHAT THE DATA
TELLS US:
The 2014 report, Juvenile Offenders and Victims, reports that, based on the 2006-07 American
Community Survey, it was estimated that 1.4% of the nation’s 16-24 year-olds were institutionalized
with nearly 93% residing in correctional facilities. Dropouts are more likely than educated peers to
be institutionalized. “The incidence of institutionalization among high school dropouts was more
than 63 times higher than among four-year college graduates.”
A 2014 article “From Colors and Guns to Caps and Gowns? The Effects of Gang Membership on
Educational Attainment” reported there were disparities between gang and nongang youth in
educational attainment. In a matched study comparing youth from 1998 to 2009, youth who joined
gangs were 30% less likely to graduate from high school and 58% less likely to earn a four-year
degree than their matched counterparts. Although much research focuses narrowly on
consequences of gang membership related to crime and victimization, the “social forces associated
with gang membership will likely cascade into other significant noncriminal life domains, such as
education, family and employment. …Indeed, the majority of inmates in local, state and federal
correctional facilities lack a high school diploma.”
Based on formal referrals to Tarrant County Juvenile Services in 2012, approximately 16% (675) of
the juveniles referred (4,214) self-identified themselves as gang members. This trend has continued
since at least 2007. Gang members are typically ages 10-21, have not performed well in school or
have dropped out. The kinds of gangs typically found in Texas include Delinquent Youth Gangs (who
hang out but have not yet committed serious crimes); Turf-Based Gangs (identified by clothing or
hand signs and associated with a territory, commit offenses such as vandalism/graffiti, assault and
sometimes homicide); and Gain-Oriented Gangs (who repeatedly engage in criminal activities as a
group and individually for economic gain, such as robbery, theft, and distribution/sale of controlled
substances).
Fort Worth: In the 2015 Plan, Fort Worth Police Department (FWPD) identified 60 criminal street
gangs (down from 197 gangs in 2011) and 4,309 gang members, of whom about 3% (131) are
juveniles (down from 5,300 members of which 12% (23 gangs) were estimated to be youth gangs.
2015 United Way Tarrant County Community Assessment
34
Arlington: From 2011-2013, Arlington Police Department (APD) witnessed a 65% reduction in gang
violent crime. But there are 70 identified gangs in Arlington with over 1200 members (up from 47
gangs reported in the FY2011 Plan).
Mansfield: In the first half of 2014, Mansfield Police Department responded to 13 incidents. MPD
has identified 4 juvenile gangs with 15 members.
Juvenile Justice Profile, U.S. and Texas (retrieved December 2015)
Texas
U.S.
Population ages 0-17 (2014)
7,115,614
73,583,618
Black, percent of juvenile population
12.4%
15.2%
Hispanic, percent of juvenile population
49.1%
24.4%
Juvenile arrest rates (per 100,000 age 10-17):
Reporting coverage, 2012
Violent Crime Index arrest rate, 2012
Property Crime Index arrest rate, 2012
Drug Abuse arrest rate, 2012
Weapons arrest rate, 2012
97%
121
785
471
29
84%
187
914
417
72
Juveniles in Corrections:
Commitment rate (per 100,000 juveniles age
95
10-upper age), 2013
Detention rate (per 100,000 juveniles age 1065
upper age), 2013
Proportion of juveniles placed for non-person
61%
offenses, 2013
Ratio of minority to white rate of youth in
1.9
residential placement, 2013
Source: OJJDP Statistical Briefing Book, Texas Juvenile Justice Profile
114
57
63%
2.7
Trend: Juvenile Referrals to Tarrant County Juvenile Services, 2009-2013
Offenses
2013
2009
384
604
%
change
(36.3%)
554
904
(38.7%)
938
1508
(37.8%)
2017
3301
(38.9%)
818
401
104%
3373
5210
(35.3%)
165
470
(64.9%)
Total Referrals
3,938
5,680
(30.7%)
Total Juveniles
2,629
3,924
(33%)
Felonies:
Violent referrals
(homicide, sexual assault, aggravated assault,
robbery)
Non-violent referrals
(burglary, theft, motor vehicle theft, weapons
violations)
Total felony referrals
Class A&B Misdemeanors
(weapons, assault, theft, contempt of court)
Total violation of probation
Total Delinquent conduct Referrals
Conduct in Need of Supervision:
(truancy, runaway, theft, disorderly conduct, inhalant
abuse, DUID, liquor laws, expulsions, etc.)
(Source: Tarrant County Juvenile Services, 2013 Annual Report)
2015 United Way Tarrant County Community Assessment
35
Number of Tarrant County Youth committed to Texas Youth Commission, Tarrant 2010-2013
2013
2010
Tarrant County Commitments to Texas Youth Commission
54
74
Source: Tarrant County Juvenile Court (2010); Tarrant County Juvenile Services, 2013 Annual Report
Expected and Actual Re-arrest Rates for Youth under the Probation Supervision of the County
Juvenile Probation Departments (Texas)
Expected rearrest rate
Actual rearrest rate
36%
46%
Source: Closer to Home report, 2015
Trend: Arrests for Juvenile Violent Crime, Texas and Tarrant County, 2010-12
Rate per 100,000 children age 10-17
Source: Kids Count 2015
Texas
2010
2012
4,379
3,709
Tarrant County
2010
2012
375
298
Tarrant County Youth Served in the Juvenile Delinquency Prevention Programs FY 2014
STAR (services to AtCYD (Community Youth
SYSN (Statewide Youth
Risk Youth)
Development Programs)*
Services Network)
1,269
910
231
Source: Department of Family & Protective Services Databook, 2014
Total
2,410
Juvenile Justice Facilities: Student Academic Achievement and Outcomes, U.S.

Nearly half of all students (48%) enter residential juvenile justice facilities with an academic
achievement level that is below the grade level equivalent for their age

More than 20% of youth are not enrolled in school at all upon entering a facility despite having not
yet completed high school

Students participating in Part D –funded detention and corrections services and programs attain a
range of academic achievements and outcomes while in or soon after exiting the facilities. In SY200809

Over 2/3 of students showed improvements in reaching (68%) and math (69%)

40% of students earned high school course credits while in justice facilities

One-third of students enrolled in their local school district upon exiting a facility, and

More than 4,000 student were accepted into postsecondary education while in a facility or within 30
days of exiting
Source: Fact Sheet: Juvenile Justice Education, 2011, NDTAC
SOURCES:
Tarrant County Criminal Justice Community Plan 2015
http://access.tarrantcounty.com/content/dam/main/administration/2015_CJ_Plan_.pdf
NCTCOG 2014 Criminal Justice Regional Strategic Plan – Executive Summary
http://www.nctcog.org/cs/cj/pdf/NCTCOG_Strategic_Plan_Executive_Summary.pdf
Tarrant County Juvenile Services, 2013 Annual Report
Sickmund, Melissa, and Puzzanchera, Charles (eds.). 2014. Juvenile Offenders and Victims: 2014
National Report, National Center for Juvenile Justice, Pittsburgh, PA
http://www.ojjdp.gov/ojstatbb/nr2014/
“From Colors and Guns to Caps and Gowns? The Effects of Gang Membership on Educational
Attainment”, David C. Pyrooz, Sam Houston State University, Huntsville, TX, Journal of Research in
Crime and Delinquency, 2014, Vol. 51(10) 56-87 http://jrc.sagepub.com/content/51/1/56.full.pdf
“Texas Among States Facing ‘Raise the Age’ Debate”, March 4, 2015, Texas Tribune,
2015 United Way Tarrant County Community Assessment
36
http://www.texastribune.org/2015/03/04/texas-among-states-facing-raise-age-debate/
Closer to Home: An Analysis of the State and Local Impact of the Texas Juvenile Justice Reforms, The
Council of State Governments Justice Center, January 2015
Fact Sheet: Juvenile Justice Education, The National Evaluation and Technical Assistance Center
(NDTAC) for the Education of Children and Youth who are Neglected, Delinquent, or At Risk, January
2011, Washington, D.C.
Office of Juvenile Justice and Delinquency Prevention (OJJDP) Statistical Briefing Book, “Texas
Juvenile Justice Profile”, U.S. Department of Justice
DFPS Databook, FY2014, Texas Department of Family & Protective Services
2015 United Way Tarrant County Community Assessment
37
EDUCATION
INDICATOR:
Out of School Time
ABOUT THE
INDICATOR:
Out of school time initiatives include before, afterschool and weekend programs; summer learning
opportunities; service learning; mentoring and internships. Most often, they are provided by schools,
community and faith-based groups, youth-serving organizations, cultural institutions, and city/state
agencies. Out-of-school time program goals and content can vary considerably.
Some summer programs focus on addressing summer learning loss that can affect children’s academic
performance. The National Summer Learning Association (NSLA) is the only national nonprofit
exclusively focused on closing the achievement gap through high-quality summer learning for all
children and youth.
In 2014, many afterschool programs offered Science, Technology, Engineering and Math (STEM)
opportunities.
The national After School Alliance publishes annual data from America After 3 PM, a nation-wide
survey.
The 21st Century Community Learning Centers (21st CCLC) initiative is the only federal funding source
dedicated exclusively to before-school, afterschool and summer learning programs. Each state
education agency receives funds based on its share of Title I funding for low-income students at highpoverty, low performing schools.
Since 2011, the City of Fort Worth’s Parks & Community Services Department has been leading the
Fort Worth SPARC afterschool initiative as part of a multiyear capacity-building grant from the Wallace
Foundation. At the end of the 2012-13 school year, a Data Task Team shared detailed data about
programs offered and number of children and youth served.
In Arlington, on-campus and off-campus out of school time care is coordinated through a partnership
among Arlington ISD, United Way-Arlington, and local nonprofit child-serving organizations.
IMPORTANCE
OF THIS
INDICAR:
Afterschool programs keep kids safe, improve academic performance and help working families across
America. Studies have shown that quality programs give students the academic, social and careerready skills they need to succeed. Students who regularly attend have better grades and behavior in
school; better peer relations and emotional well-being; and lower incidences of drug-use, violence and
unintended pregnancy. (Source: After School Alliance, Outcomes & Benefits, November 2015)
WHAT THE
DATA TELLS
US:
In 2014, America After 3PM reports that the most common afterschool providers in Texas were public
schools, YMCAs, and Boys & Girls Clubs. Between 2009 and 2014, the percentage of Texas K-12
children who participated in afterschool programs increased from 15% to 18%. The percentage of
Texas children who were unsupervised dropped from one in four in 2009 to 19% in 2014. The survey
results indicate that, among those who would participate if an after school program were available, the
percentage unserved in Texas declined from 51% in 2009 to 37% in 2014.
Trend: Survey Results, Texas and the U.S., 2014 compared with 2009
Texas
U.S.
2014
2009
2014
2009
Percentage of Children in Afterschool Programs
18%
15%
18%
15%
Percentage of Children Unsupervised After School (2009 –
“in Self Care”)
Percentage of Children in Sibling Care
19%
26%
20%
26%
N/A
15%
N/A
14%
Percentage of Parents Extremely/Somewhat Satisfied with
Afterschool Programs
2015 United Way Tarrant County Community Assessment
N/A
91%
N/A
89%
38
Percentage of Children Who Would Participate if an
Afterschool Program Were Available)
Source: Afterschool Alliance, U.S. and Texas, 2014 and 2009
37%
51%
41%
38%
Trend: Texas State Level Demand and Support for Summer Learning Programs, 2014 compared
with 2010
Does your child participate in a summer learning program?
If not, are you interested in enrolling your child in a summer learning
program?
Do you support public funding for summer learning programs?
2014
Yes
28%
\
(2013)
55%
2010
Yes
24%
80%
84%
62%
Sources: Afterschool Alliance, Texas, 2014 and 2010. TXPOST 2015.
Youth Served After School On-Campus, Fort Worth and Arlington, 2012-13 compared with 2011
Fort Worth
Number Youth
Served
Arlington
2012-13
2011
2012-13
2011
17,834
23,105*
1,826
3,814
Sources: *2011 data combines Fort Worth After School (which serves Fort Worth ISD) and Clayton YES! serving
Birdville ISD, Keller ISD, and private schools.
2012-13 data is derived from Fort Worth SPARC for Fort Worth ISD, which includes multiple providers.
Trend: Arlington Youth Served during Out of School Time, 2013-14 compared with 2010-11
School year School year
Change 2011-2014
2013-14*
2010-11
Sub-total: before school care, oncampus
#
%
229
271
(42)
(16%)
After school care, on-campus
1,922
3,814
(1,892)
(49.6%)
After school care, off-campus
4,891
3,566
1,325
37%
Sub-total: after school care
6,813
7,380
(567)
(8%)
Summer care*, on-campus
1,348*
364
984
270%
Summer care, off-campus
6,626
5,464
1,162
21%
Sub-total: summer care*
7,794*
5,828
1,966
34%
*2013-14 Includes both Summer and Holiday care
Source: Afterschool Alliance and United Way Arlington Out-of-School Time Annual Reports
SOURCES:
United Way-Arlington, Out of School Time Child Care Annual Reports, 2013-14 and 2010-2011
Afterschool Alliance, 2014 http://www.afterschoolalliance.org/AA3PM/
Afterschool Alliance Texas from Texas Partnership of Out-of-School Time, 2009;
Fort Worth SPARC, Youth Participation in Selected Afterschool Programs in the Greater Fort Worth
Area During School Year 2012-2013, revised March 2014, http://fortworthsparc.org/content/citywidedata-sharing-system
Out of school time annual report 2010-11, Clayton YES! , Fort Worth After School
United Way Worldwide Out-of-School Time (OST) Tool Kit http://www.outofschooltime.unitedway.org
National Summer Learning Association http://www.summerlearning.org/?page=know_the_facts
2015 United Way Tarrant County Community Assessment
39
EDUCATION
INDICATOR:
School dropouts/Truancy
ABOUT THE
INDICATOR
Texas uses the National Center for Education Statistics dropout definition: a student who is enrolled
in public school in Grades 7-12, does not return to public school the following fall, is not expelled,
and does not: graduate, receive a GED certificate, continue school outside the public school system,
begin college, or die. Definitions:
 The annual dropout rate is the percentage of students in a specified grade range who drop
out of school during one school year (Grades 7-12 and various student groups).
 The four-year longitudinal rate (previously referred to as completion rate) determines the
percentage of beginning ninth graders who graduate within four years. Dropouts are
calculated according to the definition in place the year they drop out. TEA also tracks fiveyear and six-year longitudinal rates.
 The attrition rate (not a dropout rate) is the percentage change in fall enrollment between
two grades across years. Aggregate enrollment counts (not student level data) are used to
estimate the percentage of Grade 9 students who are not enrolled in Grade 12 three years
later.
In 2009-10, the Texas Education Agency (TEA) began collecting data on student race and ethnicity in
compliance with a new federal standard. Earlier years’ reports used different categories and are not
comparable.
Truancy: Until 2015, Texas was one of two states that made truancy a criminal offense. In 2015,
the 84th Texas legislative session passed House Bill 2398, which significantly changes the laws and
procedures regarding students who are truant from school, including repealing the criminal offense
of Failure to Attend School that was in Section 25.094, Education Code. One of the more significant
provisions of HB 2398 is the requirement to expunge all information relating to a criminal complaint
or conviction for a truancy offense under former Section 25.094, Education Code, from the local
school records and information data systems upon receipt of a court order requiring the same. This
requirement does not apply to referrals to juvenile court or to a juvenile court order. According to
the Texas Tribune (August 2015), schools can no longer send students with three unexcused
absences within the four-week period to truancy courts but must notify parents of the absences and
warn them of the consequences, which could be a fine or a loss of driving privileges if the student
accumulates more absences or a criminal complaint against the parents. In addition, a face-to-face
meeting between the school officials and the parents will be set up, and the student must be
enrolled in a truancy prevention program. Starting Sept. 1, 2015, schools will have some kind of
truancy prevention program in place that will probably come in the form of mentoring and
counseling.
IMPORTANCE OF
THIS INDICATOR:
Dropout and completion rates allow comparison by school districts and by campus to identify
disparities and identify ways to improve performance. Disparities may be a reflection of student
diversity and socio-economic level, teacher effectiveness, and resources invested per student.
Truancy may be a symptom of more serious problems such as depression, drug/alcohol problems,
poor academic skills, and family and financial difficulties. According to a 2012 paper cited below,
chronic/ high absenteeism is the best single predictor of whether a student will drop out of school -a choice that can severely limit the individual's life earnings and career potential. Missing school
also affects performance on standardized tests.
2015 United Way Tarrant County Community Assessment
40
WHAT THE DATA
TELLS US:
From 2010 to 2014, Texas’ statewide graduation rates have improved and dropout rates have
declined. However, disparities continue to exist by ethnic/racial groups. Asian students (followed by
white students) continue to have the highest graduation rate (94.8%) and African-American students
(followed by Hispanic students) had the highest dropout rate (9.8%) among racial/ethnic groups.
However, the dropout rate was highest among English Language Learners (ELL) at 15.9%.
Across Tarrant County school districts, disparities in both the dropout and completion rates by
district are noted in the table. Tarrant County districts had higher attrition and dropout rates than
Texas in 2014.
Texas Public Schools, Grade 9 Longitudinal Graduation, Completion, and Dropout Rates (%), by
Race/Ethnicity and Economic Status, Class of 2014 compared with Class of 2010
Class of 2014
Class of 2010
Ethnic/racial
GradConRec’d
DropGradConRec’d
DropGroup or
uated
tinued GED
ped
uated
tinued GED
ped
Economic/Other
out
Out
Status
African American
84.2
5.3
0.6
9.8
78.8
8.4
1.0
11.8
American Indian
87.1
4.0
1.1
7.9
84.2
9.1
1.5
5.1
Asian*
94.8
2.7
0.1
2.4
93.8
3.5
0.3
2.3
Hispanic
85.5
5.6
0.8
8.2
78.8
10.3
1.3
9.6
Pacific Islander*
88.9
3.7
0.5
7.0
*
*
*
*
White
93.0
2.5
0.9
3.6
91.6
3.5
1.4
3.5
Multiracial
91.2
3.2
0.7
4.8
N/A
N/A
N/A
N/A
Economically
85.2
5.0
0.9
9.0
81.9
9.2
1.0
7.8
disadvantaged
English Language
71.5
12.3
0.3
15.9
N/A
N/A
N/A
N/A
Learners 9-12
Special education
77.5
10.8
0.5
11.2
N/A
N/A
N/A
N/A
State
88.3
4.3
0.8
6.6
84.3
7.2
1.3
7.3
*For Class of 2010, Asian/Pacific Islander were combined; English Language Learners and Special
Education were not reported on this table.
Source: TEA, Secondary School Completion and Dropouts in Texas Public Schools, 2013-14 and
2009-10.
Texas Public Schools, Annual Dropout Rate (%), Grades 7-8, and Grades 9-12, by Race/Ethnicity
and Economic Status, 2013-14
Ethnic/racial group
or Economic/other
status
African-American
American Indian
Asian
Hispanic
Pacific Islander
White
Multiracial
Economically
disadvantaged
English Language
Learners
Special education
2013-14
Grades 7-8
Grades 9-12
2009-10
Grades 7-8
Grades 9-12
0.4%
0.5
0.1
0.8
1.0
0.2
0.2
0.7
3.1%
2.3
0.7
2.7
3.0
1.1
1.5
2.6
0.4%
0.2
0.1
0.3
0.1
0.1
0.2
0.2
3.9%
2.6
0.8
3.1
2.5
1.1
1.3
2.1
2.2
4.8
N/A
N/A
0.4
3.0
N/A
N/A
State
0.5%
2.2%
0.2%
2.4%
Source: TEA, Secondary School Completion and Dropouts in Texas Public Schools, 2013-14
2015 United Way Tarrant County Community Assessment
41
Tarrant County School Districts, Annual Drop Out Rates by Grade Span and Longitudinal
Graduation Rates, 2013-2014
2013-14
2013-14
Annl DropOut
Annl DropOut
DISTRICT
Gr 7-8 (2013)
Gr 9-12 (2013)
Arlington
0.3
2.5
85.1
85.9
Azle
4 year Longitudinal Rate
Gr 9-12, Class of 2013
GRADUATED
GRAD & GED
0
0.4
91.4
91.4
Birdville
0.2
1.8
88.4
88.9
Carroll
0
0.1
98.8
99.3
0.2
1.6
87.6
88.6
Crowley
0
0.6
95.7
95.9
Eagle Mt/Saginaw
0
1
94.4
94.7
Everman
0
1.6
92.5
92.5
0.5
2.9
82.1
82.9
Castleberry
Fort Worth
Grapevine-Colleyville
HEB
Keller
Kennedale
Lake Worth
0
0.2
97.7
97.8
0.2
0.6
95.5
95.7
0
0.7
95.1
95.7
0.2
0.7
94.8
96.1
0
1.5
86.9
86.9
Mansfield
0.1
1.2
91.6
92.3
White Settlement
1.4
1.1
92.2
92.4
Pink – highest rate; green – lowest rate Source: TEA, Texas Academic Performance Report (TAPR),
2013-14
Annual Dropout Rate (%) Grades 7-8 and Grades 9-12 by Race/Ethnicity and Economic Status,
Texas Public Schools, 2013-14 compared with 2009-10
Grades 7-8
Gr 7-8
Gr 9-12
Gr 9-12
Ethnic/racial group or 2013-14
2009-10
Trend
2013-14
2009-10
Trend
Economic/other
status
African-American
0.4%
0.4%
3.1%
3.9%
American Indian
0.5
0.2
2.3
2.6
Asian
0.1
0.1
0.7
0.8
Hispanic
0.8
0.3
2.7
3.1
Pacific Islander
1.0
0.1
3.0
2.5
White
0.2
0.1
1.1
1.1
Multiracial
0.2
0.2
1.5
1.3
Economically
0.7
0.2
2.6
2.1
disadvantaged
English Language
2.2
N/A
4.8
N/A
Learners
Special education
0.4
N/A
3.0
N/A
State
0.5%
0.2%
2.2%
2.4%
Source: TEA, Secondary School Completion and Dropouts in Texas Public Schools, 2013-14
2015 United Way Tarrant County Community Assessment
42
Tarrant County ISDs, Attrition and Dropout rates, compared to Texas, 2014
Tarrant
County
th
Attrition in Public High Schools (% of students from a class of 9
th
graders not enrolled in 12 grade 4 years later)
th
High School Dropouts (% of students who dropped out between 9
grade and graduation; cohort graduating year 2014)
Source: Center for Public Policy Priorities, Kids Count Data Center, 2015
SOURCES:
Texas
27%
24%
7.3%
6.6%
Texas Education Agency (TEA), Secondary School Completion and Dropouts in Texas Public Schools,
2013-14 and 2009-10 http://tea.texas.gov/acctres/dropcomp_index.html
Texas Education Agency (TEA), Texas Academic Performance Report (TAPR), 2013-14
http://ritter.tea.state.tx.us/perfreport/tapr/index.html
Kids Count Data Center 2015, Center for Public Policy Priorities
http://datacenter.kidscount.org/data#USA/2/8/10,11,12,13,15,14,2719
New Truancy Law Set to put Pressure on Schools, Parents, Texas Tribune, August 8 2015
http://www.texastribune.org/2015/08/08/new-truancy-law-puts-pressure-schools/
Balfanz, Robert and Byrnes, Vaughan, The Importance of Being in School: A report on absenteeism in
the nation’s public schools, Johns Hopkins University, 2012
2015 United Way Tarrant County Community Assessment
43
INCOME
INDICATOR:
Adult Literacy and Adult Basic Education
ABOUT THE
INDICATOR:
Literacy is the ability to use printed and written information to function in society, to achieve one's goals,
and to develop one's knowledge and potential.
The Texas Education Agency (TEA) subcontracts funding for adult education to Texas LEARNS, the Harris
County Department of Education, which, in turn, contracts with Fort Worth ISD for Adult Basic Education
(ABE)/Literacy; Adult Secondary Education (ASE/GED); and English as a Second Language and English
Literacy and Civics (ESL/EL Civics) in Tarrant County. Through Fort Worth ISD, there are over 65 sites in
Tarrant County with approximately 30 ABE/ASE classes and 80 ESL classes. In addition, United Way
initiated and funds the Tarrant Literacy Coalition, which coordinates and supports literacy efforts and
works to grow literacy programs through community organizations to make this instruction more
accessible.
Central Connecticut State University began ranking of America’s Most Literate Cities among those with
populations of 250,000 or more, in 2005, based on several factors (listed in the table below).
In July 2015, Texas State Board of Education voted to explore offering alternatives to the General
Educational Development (GED) exam after the test was revamped in 2014, requiring it to be done on the
computer. The change resulted in fewer test takers and passers. Advocates claim that the GED is too
expensive ($135), too difficult (college-entry oriented), requires computer skills, and Spanish preparation
classes and the Spanish language version of the test are not offered in many locations. Test proponents
claim that there has historically been a decrease in test takers following a revamping.
IMPORTANCE
OF THIS
INDICATOR:
Adults who lack Basic Prose Literacy Skills (BPLS) range from being unable to read and understand any
written information to being able only to locate easily identifiable information. The percentage of those
who lack BPLS reflects the magnitude of the adult household population at the lowest level of English
Literacy. A functionally illiterate adult cannot fill out an employment application, follow written
instructions, or read the label on a prescription bottle.
WHAT THE
DATA TELLS
US:
One in seven Tarrant County adults (14%) is functionally illiterate, which is comparable to the U.S., but
th
better than Texas. One in five adults in Tarrant County cannot read well enough to succeed at the 4
grade level. Only about 5,500 Tarrant County residents are enrolled in any kind of adult literacy program.
Tarrant County adults age 25 and over without a high school diploma (24% in 2009-13) have the highest
rate of poverty, 36.6% for men and 36.5% for women. Among adults with a bachelor’s degree or higher,
poverty rates drop to 10.4% for men and 9.3% for women. (Source: Tarrant Literacy Coalition fact sheet)
In the 2014 ranking of America’s 75 most literate cities with pop. 250,000+, Fort Worth dropped to
53.5rd/75 and Arlington improved to 62nd/75 based on 6 key indicators of literacy.
In Texas in 2013, more than half (52.6%) of the GED test takers were Hispanic , which is more than double
the percentage of test takers who were Hispanic in the nation. When the GED test was changed
nationally in 2014, not only did the number of people taking the test decline, but the passing rate
dropped by half. In Tarrant County, the number of people taking Adult Basic Education has increased, but
primarily due to people taking English as a Second Language.
Illiteracy rate, Tarrant County, Texas, and the U.S., 2003
Indirect estimate of percent lacking basic prose
literacy skills, 2003
Direct estimate*
2015 United Way Tarrant
County Community Assessment
Tarrant County
14%
Texas
19%
U.S.*
14.5%
44
Trend: Fort Worth and Arlington’s Ranking among 75 of America’s Most Literate Cities
(over 250,000 pop), 2014 compared with 2010 (Note: The lower the number the higher the rank.)
Overall ranking
Booksellers
2014
Fort Worth
53.5
56.5
2010
Fort Worth
50.5
60
2014
Arlington
62
23
2010
Arlington
71
68.5
53.5
23.5
58
16.5
43
71
44
67
51
48.5
55
62
Education
Internet resources
Libraries
Newspapers
37
41
73.5
71.5
Periodicals/Magazines
58
53
57
69
Source: Central Connecticut State University, America’s Most Literate Cities 2014
Individuals Served through Fort Worth ISD Adult Basic Education, Adult Secondary Education, and
English as a Second Language classes, Fort Worth ISD, 2014-2015 compared to 2011-2012
2014-2015
2011-12
% change
1,697
1,873
(10.4%)
123
156
(21.2%)
3,738
2,960
26.3%
5,558
4,989
11.4%
Literacy/Adult Basic Education (ABE)
Adult Secondary Education (ASE/GED)
English as a Second Language and English
Literacy and Civics (ESL/EL Civics)
Total served
Fort Worth ISD, by request from the Adult Literacy Director
Decline in GED rates with new test, United States, 2001-02 compared to 2013-14
Number who took at least
one sub-test of the 4-part
GED
Of those, number who
completed the test battery
(4 sub-tests)
Number who received GED
New test introduced
in 2002
2001
2002
557,000
1,016,000
New test introduced
in 2014
2013
2014
848,763
248,000
928,000
467,000
743,143
(not
reported)
648,000
330,000
559,773
86,000
N/A
75%
Passing rate (of those who
N/A
completed all 4 parts)
Passing rate (of all who took
69%
at least one part of the test)
Source: www.highered.com. January 2015
70%
GED Test Passers by Ethnicity, Texas and the U.S., 2013
Hispanic
Am.Indian Asian
AfrAmerican
Texas
52.6%
0.9%
2%
13.6%
U.S.
23.2%
2.3%
2.1%
21.1%
2015 United Way Tarrant County Community Assessment
66%
N/A
35%
Pacific
Islander
0.3%
0.6%
White
Other
28.8%
50.6%
2.1%
0.2%
45
GED Test Version Taken, 2013
Number
English
Texas
58,735
52,881
U.S.
816,213
770,416
French
4
547
Spanish
5,550
45,250
Spanish version as % of Total
9.4%
5.5%
GED Test Candidates who Tested, Completed and Passed, Texas and the U.S., 2013
# w/out HS
Tested
Completed
Passed
diploma
Number Target Number Rate
Target Number Rate
Pop
Pop
Texas
3,571,240
58,235
1.6%
50,826
87.3%
1.4%
37,338
73.5%
U.S.
39,969,125 816,213
2.1%
713,960 87.5%
1.8%
540,535 75.7%
Target
Pop
1%
1.4%
GED Test Takers and Test Passers by Age, Texas, 2013
16-18
19-24
25-29
30-34
TX – takers
17.3%
29.8%
16%
12%
TX – passers
18.9%
31.8%
16.4%
12.1%
U.S. – takers
19.2%
34.5%
15.3%
11%
Mean
28.8
27.8
27.5
34-39
8.8%
7.8%
7%
40-49
10.8%
9%
8.5%
50-59
4.3%
3.3%
3.7%
GED Test Passers, Highest Grade Completed, Texas and the U.S., 2013
Gr 0-5
Gr 6
Gr 7
Gr 8
Gr 9
Gr 10
Texas
0.7%
1.3%
1.7%
8.9%
20.9%
25.5%
U.S.
0.9%
0.7%
1.4%
7.6%
17.6%
26.8%
Gr 11
27.8%
34.4%
GED Test Passers, Years out of School, Texas and the U.S., 2013
Less than 1
1 yr
2
3-5
6-10
yr
yrs
yrs
yrs
Texas
7.5%
9.5%
6.8% 15.3% 17.9%
U.S.
8.4%
12.4%
9%
17.2% 17.4%
11-20
yrs
24.6%
21.3%
60+
0.9%
0.7%
0.7%
Gr 12
13%
10.5%
21+
yrs
18.3%
14.3%
Mode
11
11
Mean
11.3
9.7
Source: GED Testing Service
SOURCES:
U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics
(NCES), 2003 National Assessment of Adult Literacy http://nces.ed.gov/naal/
And http://nces.ed.gov/naal/estimates/StateEstimates.aspx
Central Connecticut State University, America’s Most Literate Cities 2014
http://web.ccsu.edu/americasmostliteratecities/2014/default.asp?redirected
Tarrant Literacy Coalition http://www.tarrantliteracycoalition.org/
Fort Worth ISD Adult Literacy Program report, 2015
“State Education Board to seek GED Alternatives”, Texas Tribune, July 15, 2015
GED Testing Service, 2013 Annual Statistical Report on the GED Test (the close of the 2002 test)
http://www.gedtestingservice.com/uploads/files/5b49fc887db0c075da20a68b17d313cd.pdf
2015 United Way Tarrant County Community Assessment
46
INCOME
INDICATOR:
Asset Poverty
ABOUT THE
INDICATOR:
Asset poverty refers to the number of families without sufficient net worth (total assets minus total
liabilities) to subsist at the poverty level for three months in the absence of income, 2011. The Asset
and Opportunity Scorecard evaluates 135 different policy and outcome measures in five categories:
financial assets & income, businesses & jobs, housing & homeownership, health care, and education.
Liquid asset poverty measures the minimum amount of liquid savings (i.e., cash, retirement savings,
checking account, etc.) a household would need to get by at the poverty level in the event that an
emergency left them without income. The amount a household would need in liquid savings to avoid
falling below this conservative threshold varies by household size.
In tax year 2010, the Internal Revenue Service (IRS) began a grant-funded Volunteer Income Tax
Assistance (VITA) initiative in Tarrant County to increase the number of low-income tax filers applying
for the Earned Income Tax Credit (EITC).
2-1-1 Texas directs callers to volunteer tax preparation centers.
IMPORTANCE
OF THIS
INDICATOR:
The concept of asset poverty measures not only income but also vulnerability to financial shocks (e.g.,
income cut off for such reasons as unemployment, a medical emergency, divorce).
WHAT THE
DATA TELLS
US:
Nearly one in four Texas households (23.8%) lacks assets to enable them to live for 3 months without
income. Texas ranks among the lowest states in the nation with respect to unbanked and
underbanked households and consumers with poor credit.
Low-income working families who are citizens and earning $50,000 or less are eligible to apply for the
Earned Income Tax Credit (EITC) when filing their federal income tax. In 2008 and 2009, the IRS VITA
initiative had not yet begun and several volunteer projects were discontinued as a result of IRS
oversight. However, the number of EITC refunds, direct deposits and split refunds increased.
The number and percentage of low-income people filing for Earned Income Tax Credits (EITC) and
requesting direct deposit of their refunds and split refunds (with some going into savings) is increasing.
Assets & Opportunity Scorecard, Texas, 2015
Outcomes Rank
Texas – Overall Rank
37
Financial Assets & Income
41
Businesses & Jobs
34
Housing & Home ownership
14
Health care
50
Education
33
Policy Rank
44
47
38
13
22
34
Liquid Asset Poverty Rate and Threshold for a family of four, Tarrant County, Texas, and the U.S.,
2015
Tarrant County
Texas
U.S.
Liquid Asset Poverty Rate
41.9%
49.8%
43.5%
Savings amount below which
$5,963
family is “asset poor”
Source: Assets and Opportunity Scorecard, Calculator
2015 United Way Tarrant County Community Assessment
47
Asset Poverty Indicators, Tarrant County, Texas and U.S., 2015
Indicator
Tarrant
County
25.5%
Asset Poverty Rate
Asset poverty rate by race
23.8%
U.S.
25.4%
2.2 x as high for
households of
color
1.15 x as high for
single women
1.07 x as high for
single women
Asset poverty by family structure
1.9 x as high for 1parent households
41.9%
Liquid asset poverty by race
49.8%
2.2 x as high for
1-parent
households
43.5%
30
1.4 x as high for
households of color
Liquid asset poverty by gender
1.7 x as high for
households of
color
1.09 x as high for
single women
1.1 x as high for
single women
Liquid asset poverty by family structure
Net Worth
Texas
Rank
N/A
2.2 x as high for
households of color
Asset poverty rate by gender
Liquid Asset Poverty Rate
Texas
1.6 as high for 1parent households
N/A
Income inequality
$53,452
1.9 x as high for
1-parent
households
$70,359
N/A
5 x as high for top
20%
5 x as high for top
20%
Unbanked households *
8.6%
10.4%
41
7.7%
Underbanked Households **
19.9%
27.4%
50
20.0%
Households with Savings Accounts
N/A
63.9%
40
68.8%
Consumers with subprime credit***
N/A
64.3%
47
55.6%
Borrowers 90+ days overdue
N/A
3.98%
42
3.4%
Average Credit Card Debt
N/A
$6,646
7
$9,890
Bankruptcy Rate (per 1,000 pop)
N/A
1.4
6
3.3
*Unbanked – percentage of households with neither a checking nor savings account; **Underbanked –
household has checking or savings account and has used alternative financial services (non-bank money orders,
non-bank check-cashing services, non-bank remittances, payday loans, rent-to-own services, or pawn shops or
refund anticipation loans at least once in the past 12 months, 2013. ***Subprime credit - TransUnion TransRisk
Score at or below 700 (on a scale of 150-934), Quarter 3, 2011.
Source: Assets and Opportunity Scorecard – http://localdata.asssetsandopportunity.org/place/48439
Percentages of residents in Asset Poverty, Selected Tarrant County Cities, 2015
Asset Poverty
Liquid Asset
Unbanked
Underbanked
Rate
Poverty Rate
Fort Worth
30.9%
45%
10.6%
20.9%
White Settlement
34.1%
54.5%
11.5%
20.8%
Forest Hill
36.4%
55.6%
11.6%
27.7%
Asset Poverty
Rate
Arlington
Mansfield
Kennedale
Grand Prairie
28.6%
13.1%
17.6%
32%
2015 United Way Tarrant County Community Assessment
Liquid Asset
Poverty Rate
42.2%
18.8%
30.8%
47.3%
Unbanked
Underbanked
9.9%
4.2%
5.7%
10.6%
20.6%
16.2%
17.5%
22.7%
48
Hurst
Euless
Bedford
Grapevine
Haltom City
Keller
Southlake
21.7%
28.4%
20.8%
16.7%
33.9%
3.4%
<1%
35.4%
41.2%
32.2%
24.6%
53.4%
5.5%
<1%
7.9%
8.2%
5.2%
5.2%
11.2%
2.1%
1.0%
16.6%
19.6%
16.5%
15.5%
20.9%
11.8%
10.2%
Source: Assets & Opportunity Local Data Center, 2015
Trend: 2-1-1 Calls related to Income Tax Preparation Assistance, Tarrant County, 2014 compared to
2010
2014
2010
% change
2010-14
6,388
1,653
286%
Trend: Tax Returns, Tarrant County, 2014 compared with 2009
Tax year
Tax year
2014
2009
Total returns
Low-income returns % of total
880,900*
689,290
64.9%
Low-income returns with refunds
Not reported
449,859
65.3%
396,770
Low-income sum refunds
Not reported
65.3%
$1.09 billion
Low-income returns with EITC
% of low-income returns
VITA returns with refund
VITA – amount of refund
163,977
5,200
35.8%
58.4%
$10 Million
$6.9 million
44.9%
1,982
1.24%
305,539
67.5%
2,607
0.6%
24.8%
2,474
1.51%
270,768
62.4%
1,617
0.4%
Source: IRS, August 2012, 2013-2014; *2013
Trend
27.8%
159,232
35.3%
3,283
EITC volunteer returns
% of EITC - volunteer
Low-income direct deposit
returns
Low-income Split Refund
SOURCE:
% chg
2009-2014
3.0%
(11.4%)
(38%)
Assets and Opportunity Scorecard; Calculator
http://scorecard.assetsandopportunity.org/latest/calculator
Assets and Opportunity Local Data Center - http://localdata.assetsandopportunity.org/map
Internal Revenue Service (IRS) by request
2-1-1 Texas at United Way, Annual Report 2014
2015 United Way Tarrant County Community Assessment
49
INCOME
INDICATOR:
Crime
ABOUT THE
INDICATOR:
The federal Uniform Crime Reporting (UCR) system enables municipalities to report crime to the
Texas Department of Public Safety, using defined definitions of offenses. Of the seven “indexed
crimes”, four were considered “violent crime” (murder, rape, robbery, aggravated assault) and three
were considered “property crime” (burglary, larceny/theft, motor vehicle theft, arson). (Notes:
family violence and sexual assault are in separate data profiles. Although rape is reported among
indexed crimes (violent crime), sexual assault includes 6 separately defined offenses. )
IMPORTANCE
OF THIS
INDICATOR:
WHAT THE
DATA TELLS US:
UCR statistics ensure crimes are reported according to the same definition, which makes data
comparable from one city/jurisdiction or state to another.
Crime has decreased in all areas since 2011 with the exception of total arrests in Fort Worth. The
final numbers on rape have not been calculated due to the FBI’s revised definition. In the uniform
crime reporting addendum there were 11,466 reports of rape in 2014. This is a 54% increase since
2013. Of those cases, 4,170 individuals have been arrested. In Arlington there were 206 offenses,
with 100 arrests. In Fort Worth there were 545 offenses with 127 arrests.
Trend: Indexed Crime, all crime arrests, Texas and Tarrant County, 2014 compared to 2010
Texas
Tarrant County
2014
878,686
2010
1,144,178
2014
15,133
2010
15,387
Total incidences
indexed crime
Violent crime sub-total
901,937
1,065,271
69,114
83,914
97,382
113,300
6,709
7,913
Property crime subtotal
804,555
951,971
62,405
75,861
Total arrests all crime
Source: http://txdps.state.tx.us/administration/crime_records/pages/crimestatistics. htm
Changes in indexed crime, Fort Worth and Arlington, 2014 compared to 2010
Fort Worth PD
2014
2011
Trend
Fort
Worth
Arlington PD
2014
2011
Total Arrests
7,548
6,458
3,901
4,126
Total Incidents
35,757
39,577
15,122
19,082
Violent crime
sub-total
Property crime
sub-total
3,907
4,574
1,648
1,874
31,850
35,003
13,462
18,199
Trend
Arlington
Source: http://txdps.state.tx.us/administration/crime_records/pages/crimestatistics.htm
2015 United Way Tarrant County Community Assessment
50
Victims served, Arlington, 2014 compared with 2011
Type
Physical/sexual abuse of a child
DWI incidents
Domestic abuse (female victims)
Domestic abuse (other victims)
Arlington
2014
932
Arlington
2011
569
26
60
4,289
4,675
Incl.above
428
Sexual assault
138
220
Homicide
Attempted murder
22
12
19
6
1,431
587
1,681
496
Kidnapping
Failure to stop and render aid
17
297
11
234
Indecent exposure
Robbery
28
553
26
631
1,311
655
2,243
623
1,446
947
11,744
13,043
Assault (nonfamily)
Stalking/harassment
Home burglary
Other crimes, such as elder abuse, criminal mischief or
retaliation
Noncriminal incidents, such as injury to a person, suicide, missing
person or runaway
Total
Trend
Source: Arlington victim services
SOURCES:
Texas Department of Public Safety
http://txdps.state.tx.us/administration/crime_records/pages/crimestatistics.htm 2010, 2014
Arlington Police Department, Victim Services, by request.
2015 United Way Tarrant County Community Assessment
51
INCOME
INDICATOR:
Crime: Family Violence
ABOUT THE
INDICATOR:
Family violence is now part of the federal Uniform Crime Reporting system, which allows for comparison
among cities and states. The National Domestic Violence Hotline and the National Dating Abuse Hotline
release semiannual reports of national and Texas statistics related to calls received. Texas Department
of Family Violence, in concert with the Texas Department of State Health Services, collects consistent
data from the network of shelters in Texas.
IMPORTANCE
OF THIS
INDICATOR:
Family violence is a crime in which the abuser has emotional and financial power over the victim. The
cycle of abuse is such that the victim may leave the abuser and return home several times before
leaving for good. The survivor may be reluctant to press charges.
In 2014 in Tarrant County, SafeHaven answered over 34,000 crisis hotline calls. They protected 674
women and 862 children in emergency shelters. The agency also provides transitional housing for
women and their children who qualify for long-term assistance to help the survivor create a financial
independence plan. Requests for shelter increase during economic downturns.
Tarrant County has 20 adult criminal courts and 5 adult specialty courts, including a domestic violence
court. The Batterers Intervention Program (BIP) provides psychosocial counseling/education for
offenders in custody in Tarrant County Jail or on labor detail. BIP is mandatory for every family violence
offender sentenced to labor detail; those in custody in Tarrant County Jail may voluntarily participate in
group counseling.
WHAT THE
DATA TELLS
US:
Texas Council on Family Violence, Facts and Statistics, Texas, 2014 compared with 2010
2014
2010
% change
20102014
Women killed
132
114
15.7%
Family Violence incidents
Adults and children sheltered
Adults and children receiving
nonresidential services (counseling, legal
advocacy, etc.)
Adults denied shelter (due to lack of space)
Unmet requests for shelter
Hotline calls answered
185,817
23,311
61,119
188,992
26,528
52,525
(1.7%)
(12%)
16.4%
39%
14,801
185,373
26.2%
N/A
191,301
(3.1%)
Trend: Reports of Family Violence, Texas and Tarrant County, 2014 compared with 2010
Texas
Tarrant County
Family violence incidents
2014
2010
2014
2010
187,817
193,505
12,875
12,772
2015 United Way Tarrant County Community Assessment
52
Trend: Reports of Family Violence, Fort Worth and Arlington, 2014 compared with 2010
Fort Worth
Arlington Police
Police Dept.
Dept.
2014
2010
2014
2010
Family violence
6,269
5,724
3,288
3,370
incidents
Source: http://www.txdps.state.tx.us/administration/crime_records/pages/crimestatistics.htm
Trend: Tarrant County Domestic Violence Diversion Court, 2007-2013 compared with 2001-2009
Referred
Placed
Of placed, successful completion
Of placed, unsuccessful
completion
Of placed, removed/other
Note: Not accounted for
2007-2013
1278
719
548
170
%
100%
56.3%
42.9%
13.3%
2001-2009
2,058
1,150
751
232
%
100%
56%
65%
20%
11
1
.9%
N/A
30
137
3%
12%
Source: Tarrant County Criminal Justice Community Plan, FY2011, FY2015
Trend: In-Custody Batterers Intervention Program and Labor Detail Batterers Intervention Program,
County Criminal Court #5, 2013 compared with 2009
2013
2009
% change
20092013
In-Custody participants
254
463
(45%)
Labor detail participants*
110
419
(74%)
Total: both programs
364
882
(59%)
Note: Labor detail program began 2008. Source: Tarrant County Criminal Justice Community Plan FY2015
Trend: Protective orders (PO) served, Tarrant County, 2013 compared with 2009
%
change
2013
2009
2009-2013
Protective Orders Issued
344
223
54%
Source: Tarrant County District Attorney's Protective Order Unit, (In TC Criminal Justice Community Plan, FY2011),
SOURCES:
Texas Council on Family Violence http://www.tcfv.org/resources/facts-and-statistics/
Texas Department of Public Safety, UCR Data Collection: Crime in Texas, 2014
http://www.txdps.state.tx.us/administration/crime_records/pages/crimestatistics.htm
Tarrant County Criminal Justice Community Plan, FY 2011, 2015
http://www.nctcog.org/cs/cj/pdf/NCTCOG_Strategic_Plan.pdf
http://www.nctcog.org/cs/cj/pdf/plans/Tarrant_2015.pdf
2015 United Way Tarrant County Community Assessment
53
INCOME
INDICATOR:
Crime: Inmate Re-Entry
ABOUT THE
INDICATOR:
According to 2014 U.S. Department of Justice reports, Texas now has the largest prison population in the
United States and has steadily held that place over the last few years. Texas houses 166,043 inmates
followed by California with 136,088, and Florida with 102,870. The Texas Department of Criminal Justice
has 109 prison units throughout the state, which include prisons, state jails, private state jails, transfer
facilities, pre-release facilities, medical, geriatric, psychiatric and work programs. In addition, there are 3
parole confinement facilities.
Tarrant County has 20 adult criminal courts which include 10 felony courts and 10 misdemeanor courts. In
addition, there are 8 specialty programs/courts. These include Behavioral Intervention with Assault NonFamily, Youthful Offender Diversion program, Domestic Violence Diversion Program, First Offender Drug
Program, Felony Alcohol Intervention Program, mental health diversion court program, veterans court
diversion program, and reaching independence through self-empowerment (RISE), which is a prostitution
diversion effort.
In 2008, the Tarrant County Criminal Justice Office conducted a study of recidivism (re-arrests) among
individuals paroled to Tarrant County between 2000 and 2006. Almost two-thirds of those released were
re-arrested in 8 years. In 2014, the Council of State Governments was to begin a follow-up study
beginning with 2011 releases from local jails, probation, and those paroled from prison.
IMPORTANCE
OF THIS
INDICATOR:
Encouraged by a body of research that demonstrated certain programs and approaches to supervision can
help them succeed upon release from incarceration, Congress passed the Second Chance Act in 2008
which established grant programs to further stimulate innovation at the state and local level. Evidencebased practices to reduce recidivism include: using risk and needs assessments to inform case
management, establishing programs shown to reduce recidivism and ensuring they are implemented with
fidelity, and implementing community supervision policies and practices that promote successful reentry.
The Tarrant County Re-Entry Initiative (TCRI) facilitates collaboration among Tarrant County organizations
and institutions to develop, implement, and maintain a strategy for the effective integration of exoffenders, thereby reducing recidivism, supporting victims, and promoting public safety in Tarrant County.
While incarcerated, an individual’s Social Security benefits are terminated and must be reinstated after
release. Without identification, ex-offenders are unable to secure housing and, unless they have family,
they run the risk of becoming homeless.
WHAT THE
DATA TELLS US:
In 2012, 5,494 inmates, on average, were released to Tarrant County from penitentiary and state jail, of
whom 3,030 were released to supervision and 2,464 were released without supervision. After 1 year the
recidivism rate for Tarrant County was 36%. (Source: Tarrant County Criminal Justice Community Plan 2015).
The January 2013 Texas Legislative Budget Board 3-year recidivism rates show that re-arrest results for the
prison population analyzed from 2004-08 remained relatively the same at approximately 48% for the
prison population and 63% for state jail. (Source: Tarrant County Criminal Justice Community Plan 2015)
Inmates released to Tarrant County 2014 compared to 2011
Total
released
Supervised
after
release
Released to
community
Tarrant
Co Jail
37,330
Penitentiary
3,442
2014
State
Jail
1,795
22,106
2,795
15,224
647
42,824
Tarrant
Co Jail
22,371
Penitentiary
3,175
2011
State
Jail
1,733
233
25,136
0
2,501
24
17,688
22,371
674
SAFP*
Total
257
2
1,793
2015 United Way Tarrant County Community Assessment
SAFP*
Total
N/A
27,279
0
N/A
14,589
1,733
N/A
24,778
54
without
supervision
Source: Tarrant County Criminal Justice Plans 2015 and 2011; * SAFP=Substance Abuse Felony Punishment
Texas Department of Criminal Justice, Number Incarcerated, “Receives” from (convicted in) Tarrant
County, and Releases to Tarrant County, 2014 compared with 2011
2014
2011
Prison
State
SAFP
Total
Prison
State SAFP
Total
Jail
Jail
Texas: Total “On Hand”
(incarcerated)
Total “On Hand”
(incarcerated) from Tarrant
County
TDCJ “Total Receives”*by
county of conviction (i.e.,
Tarrant County)
Prison & State Jail “New
Receives”**by county of
conviction (i.e., Tarrant
County)
TDCJ Releases by county of
conviction (i.e., Tarrant
County)
TDCJ Releases to Community
Supervision by county of
conviction (i.e., Tarrant
County)
Prison and SAFP Releases to
Parole Supervision by county
of conviction (i.e., Tarrant
County)
136,560
10,524
3,377
150,361
141,315
11,919
3,288
156,522
9,553
758
199
10,510
9,888
818
144
10,850
2,877
1,837
344
5,058
3,013
1,783
264
5,060
2,579
1,837
N/A
4,416
2,602
1,783
N/A
4,385
2,982
1,879
329
5,190
3,067
1,627
282
4,976
11
0
312
323
24
0
253
277
2,490
N/A
17
2,507
2,333
N/A
29
2,362
*Total Receives include offenders arriving at TDCJ as a new offender or due to a revocation.
**New Receives include offenders admitted to TDCJ for the first time on an offense or repeat offenders
who were not under parole or mandatory supervision at the time of their new conviction.
Source: Texas Department of Criminal Justice, Statistical Report, 2014
Recidivism Study, Tarrant County, 2008
Total individuals paroled to Tarrant County
from 2000-2006
Total studied
2008 Tarrant County
Recidivism (re-arrest)
Study
14,851
1,850
Re-arrested after 3 years (released 2005)
51.4%
Re-arrested after 5 years (released 2003)
58.9%
Re-arrested after 8 years (released 2000)
63.7%
Source: Tarrant County Criminal Justice Community Plan 2015
SOURCES:
Tarrant County 2015 Criminal Justice Community Plan
http://www.nctcog.org/cs/cj/pdf/plans/Tarrant_2015.pdf
U.S. Department of Justice Reports
Texas Department of Criminal Justice, Statistical Report 2014
TDCJ Unit Directory, 2015
“Reducing Recidivism”, The National Reentry Resource Center, Center for State Governments Justice
2015 United Way Tarrant County Community Assessment
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Center, June 2014 https://csgjusticecenter.org/wpcontent/uploads/2014/06/ReducingRecidivism_StatesDeliverResults.pdf
“Ex-Offender Re-entry to Tarrant County”, Tarrant County Ex-Offender Re-Entry Initiative, 2007
http://www.directionshome.org/wp-content/uploads/2013/05/Appendix-E_Ex-Offender-Re-Entry-toTarrant-County.pdf
2015 United Way Tarrant County Community Assessment
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INCOME
INDICATOR:
Crime: Sexual Assault
ABOUT THE
INDICATOR:
Sexual assault can be defined as any type of sexual contact or behavior that occurs without explicit
consent. The recent 2015 Texas Statewide Sexual Assault Prevalence Study found only 9.2% of
sexual assaults are reported.
Under the Texas Penal Code, information about Sexual Assault is collected related to 6 offense
definitions: Continuous Sexual Abuse of Young Child; Indecency with a Child by Contact; Indecency
with a Child by Exposure; Sexual Assault; Aggravated Sexual Assault; and Sexual Performance by a
Child.
Since 2013 the FBI’s uniform crime reports have reflected an expanded definition of rape. This
allowed men to be counted as victims for the first time and dropped the requirement that victims
must have physically resisted their attackers. The revised definition covers any gender of victim or
attacker and includes instances in which the victim cannot give consent because of the influence of
drugs or alcohol or because of age.
https://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2013/crime-in-the-u.s.-2013/violentcrime/rape
IMPORTANCE OF
THIS INDICATOR:
The FBI uniform crime reports’ expanded definition of rape has increased the number of people
counted as rape victims in FBI statistics. The FBI’s expanded definition of rape is an important
shift because crime statistics are used to allocate money and other resources for prevention and
victim assistance.
WHAT THE DATA
TELLS US:
On September 24 , 2015, the Texas Observer published some startling findings from the Health
and Well-Being: Texas Statewide Sexual Assault Prevalence Study. It estimates that 6.3 million
Texans, which is over 33%, have experienced some form of sexual assault. More than 400,000
Texans were victimized over the past year alone.
th
The last study (A Health Survey of Texans in 2003) was done in 2003. The 2014 telephone survey
questions of a random sample of 1,203 adult Texans included 5 questions asked in 2003 and
additional questions reflecting a more inclusive definition of sexual violence that mirror the
expanded definition of the 2014 Penal Code. These questions included exposure of body parts,
wearing victims down, unwanted participation in sexual photos or movies, deception, repeated
requests, unwanted sexual touching and forced kissing and groping. Individuals who identify
themselves as LGBTQ were especially at risk of sexual assault. However, even with a more
inclusive definition of rape, the crime continues to be severely underreported due to fear of
retaliation, a belief that nothing will get done, or confusion about what constitutes assault.
Statewide findings:
 33.2% of adult Texans (6.3 million) have experienced some form of sexual assault in their
lifetime.
 2.3% of women and 2% of men (over 413,000 men and women) experienced sexual
assault within a year prior to this survey;
 65.2% of victims report multiple victimizations.
 Women (2 in 5) are twice as likely to be sexually assaulted as men (1 in 5) in their
lifetimes.
 Women are more likely to experience sexual assault when they are 18 or older (26.1%)
and men when they are ages 14-17 (10.6%).
 Sexual assault continues to be a severely underreported crime. Only 9.2% of victims
reported their experience to the police.
 Only 14.6% of victims report they were under the influence of alcohol or drugs at the time
of the assault; almost 24% reported their perpetrator was under the influence of alcohol
or drugs.
2015 United Way Tarrant County Community Assessment
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
Physical, mental and emotional problems that limit activities are nearly twice as prevalent
among sexual assault victims (41.3%) as among non-victims 26.5%).
 While most sexual assaults do not involve other physical violence (i.e., weapons), a
substantial minority (14.8% for women and 1.9% for men) does involve weapons.
 70% of sexual assaults are committed by a perpetrator known or related to the victim.
 10% of sexual assaults result in pregnancy.
(Source: Health and Wellbeing: The Texas Statewide Sexual Assault Prevalence Study August,
2015)
Trend: Victimization Rates for women and men, Texas, 2015 compared with 2003
2015
2003
Lifetime victimization rate for women
27.6%
20%
Lifetime victimization rate for men
8.6%
5%
Overall lifetime victimization rate
18.3%
13%
Sexual Assault, U.S., Texas, Tarrant County, and Cities, 2014 compared with 2010 (includes 6
offense definitions)
2014
2010
% change
United States
Texas
Tarrant County
Fort Worth PD
Arlington PD
284,350*
19,821
1,596
936
315
188,380*
19,007
1,414
846
226
50.9%
5.7%
12%
10.6%
39.4%
Note: Sexual assault was not part of the Uniform Crime Reporting system until 2010.
*U.S. numbers include rape/sexual assault.
Source: Tarrant County Criminal Justice Community Plan, FY2011
Source: U.S. data – “Criminal Victimization, 2014 and 2010”, U.S. Department of Justice
Rape incidents, U.S., Texas, Tarrant County and Cities, 2014 (new definition) compared with 2010
(1 definition)
2014
2010
%
(new
(Old
change
definition) Definition)
United States
116,645*
85,593
35%
Texas
11,293*
7,626
48%
Tarrant County
938
619
51%
Fort Worth Police Department
545
319
70.8%
Arlington Police Department
206
119
73%
Sources: Texas DPS, Uniform Crime Reports – Rape Reports by Jurisdiction, 2014 and 2010.
For U.S., FBI Unform Crime Reports 2014
* U.S. and Texas 2014 – expanded definition of rape
**Due to change in definition of rape, 2014 rape statistics for Texas are not available.
Service Statistics, Rape Crisis Program, The Women’s Center of Tarrant County, 2014
Number of calls to Rape Crisis and Victim
1,721
Services Hotline
Number of victims and significant others
544 victims and 403 significant others
counseled at local hospital rape exam sites
Number of abused and victimized children and 449
others who received received therapy
Number of adult victims of sexual assault and
364
other violent crimes and others who received
therapy
Number of children and adults accompanied
14
through the criminal justice process
2015 United Way Tarrant County Community Assessment
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Number of children and youth who
91,887 (of whom 142 children disclosed
participated in child abuse and sexual assault
current or past abuse)
prevention programs
Number of adults who received sexual assault
8,440
prevention training
Number of professionals trained in sexual
1,872
assault and victim assistance issues
Source: The Women’s Center Annual Report, 2014
SOURCES:
Health and Well-being: The Texas Statewide Prevalence Study on Sexual Assault, August 2015,
University of Texas at Austin http://www.texasobserver.org/new-data-new-questions-on-sexualviolence-as-a-texas-public-health-issue/
“Criminal Victimization, 2014 (and 2010)”, August 2015 (and September 2011), U.S. Department of
Justice, Bureau of Justice Statistics
http://www.bjs.gov/index.cfm?ty=pbdetail&iid=5366
FBI Uniform Crime Reports, 2014
https://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2014/crime-in-the-u.s.-2014/tables/table-1
Texas Department of Public Safety, Uniform Crime Reports, 2014, 2010
http://www.txdps.state.tx.us/administration/crime_records/pages/crimestatistics.htm
2015 United Way Tarrant County Community Assessment
59
INCOME
INDICATOR:
Disaster
ABOUT THE
INDICATOR:
In the US, the Federal Emergency Management Agency (FEMA) leads and coordinates response to
major disasters that are federally declared by the President. The majority of disasters across the
nation, and in Tarrant County, are not federally declared because they are classified as single or
multi-family residential structure fires. These home fire disasters, some 450 each year in Tarrant
County, are responded to by the volunteers at American Red Cross. (Note: In 2015, American
Red Cross did not track house fires as a separate category of disaster.)
The American Red Cross, founded in 1881, was chartered by Congress in 1900 and mandated to
render aid to those wounded during war, provide communication between family members and
members of the U.S. military, and administer relief to those affected by disasters during
peacetime. Although mandated by Congress, Red Cross is not a federally funded organization; it is
a non-profit, charitable organization that receives its funding from public donations. The
American Red Cross partners with disaster relief organizations from many religious
denominations, community service agencies, including Volunteer Organizations Active in Disaster
(VOAD), corporations and individuals to carry out or convene relief services. In addition to
responding immediately to assist families affected by house fires with safe shelter, the means to
buy new clothing, shoes and groceries, the Red Cross also supports first responders through their
“Canteen” service at emergency scenes, which includes providing bottled water, Gatorade, hot
coffee, snacks, towels, etc.
A national reorganization of the American Red Cross in the mid-2000’s resulted in the Red Cross
office located in Fort Worth joining forces with 10 additional chapters across the northern tier of
Texas to create the new North Texas Region, which now covers 121 counties in total.
The American Red Cross serving Dallas and Fort Worth includes approximately 22 counties, of
which Tarrant would account for the highest number in the statistics below. The changed
reporting system makes it difficult to compare with previous years.
The most recent natural disaster that the Red Cross responded to affecting North Texas was the
flooding caused by record high rainfalls in 2015. The Red Cross reports more than 2,100 Red Cross
workers worked around the clock serving more than 63,000 meals and snacks, distributing more
than 47,000 relief items and providing more than 2,000 overnight stays in shelters. Officials
estimate 8,000 residences were affected and 45 Red Cross emergency response vehicles traveled
through the impacted neighborhoods, distributing food, water and relief supplies. The Red Cross
has a new Digital Operations Center in Dallas powered by Dell. They gather data from multiple
social media sites during times of disaster and use it to route emergency vehicles to greater
emergencies.
2-1-1 Texas at United Way, a free help line answered 24 hours a day, seven days a week, is
connected to nearly every service in the state, including government agencies, food pantries, and
many other state and local resources. During any statewide disaster response, a special Option # 4
is activated to point callers directly to disaster-related information, which becomes the first option
the caller hears.
IMPORTANCE OF
THIS INDICATOR:
Crucial to saving lives is coordination of efforts by municipalities and volunteer organizations such
as American Red Cross and VOAD to ensure quick, efficient response in times of disaster. 2-1-1
Texas provides a central communication channel by which the community receives current,
accurate information in times of disaster.
2015 United Way Tarrant County Community Assessment
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WHAT THE DATA
TELLS US:
Although families affected by house fires in Tarrant County each year are in need of financial
assistance temporarily, American Red Cross was not able to provide information about different
categories of disaster for 2014.
House fires
and natural disasters for which the Red Cross provided assistance, Tarrant County,
2015 compared with 2012
Jul 2014Jun 2015
N/A
N/A
Jan-Jun 2012
(6 mos)
113
39
2012 - If
Annualized
N/A
N/A
Total: House fires - response
Families assisted in above fires
N/A
N/A
152
230
304
460
Individuals assisted in above fires
N/A
Fire-related: Financial assistance issued –
food & clothing
Fire-related: Financial assistance issued –
temp lodging
Total: financial assistance issued
N/A
Total disaster incidents where assistance
was provided
Adults/children (total disaster incidents)
House fires – single family structures
House fires – multi-family structures
Percent of families assisted that had
insurance
Total financial assistance for disasters
707
(236 adults;
471 children)
$64,474
1414
N/A
N/A
$24,742
N/A
N/A
$ 89,216**
$178,432
302***
N/A
N/A
1,098
593 adults;
505 children
28%
N/A
N/A
N/A
N/A
$227,917
N/A
N/A
*All figures are preliminary and unaudited. Total responses are higher. ** Does not include additional
medical items, such as glasses, etc. ***The Red Cross no longer breaks down the statistics into categories of
disasters. (Source: American Red Cross, by request)
2-1-1 Calls related to Disaster Services (top 5 Requested needs), Tarrant County, 2014
Special needs registries
2,243
Disaster Recovery Centers
153
Extreme Heat Cooling Centers
63
Mass Care Shelters
17
Disaster Donations Hotlines
16
Total Top 5
2,492
Source: 2-1-1 Texas at United Way, 2014 Annual Report
SOURCES:
American Red Cross by request
2-1-1 Texas at United Way, 2014 Annual Report
2015 United Way Tarrant County Community Assessment
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INCOME
INDICATOR:
Food Insecurity
ABOUT THE
INDICATOR:
2015 marks the fifth consecutive year that Feeding America has undertaken the “Map the Meal Gap”
project to continue learning about food insecurity at the local level. To create a food-insecurity model,
they use Current Population Survey data and data from the Bureau of Labor Statistics, specifically, the
unemployment rate, the poverty rate, median income, home ownership rate, the percent AfricanAmerican and percent Hispanic. Recognizing that children are particularly vulnerable to the economic
challenges facing families, Feeding America has replicated the model to reflect the need among children.
The U.S. Department of Agriculture (USDA) manages the federal food and nutrition assistance programs,
which are intended to provide children and low-income people access to food and a healthful diet. In the
2008 Farm Bill, the Food Stamps program was changed to The Supplemental Nutritional Assistance
Program (SNAP), the largest program in the domestic hunger safety net. SNAP benefits are 100% federally
funded, but the state covers administrative costs. Other federal nutrition programs are the School
Breakfast Program, the National School Lunch Program (which includes summer), the Child and Adult Care
Food Program (which provides After School food), Summer Nutrition Program, Women/Infants/Children
(WIC), and the Fresh Fruit and Vegetable Program. (Source: FRAC)
Recent policy changes: Beginning in school year 2014-15, schools and districts have the option to use the
Community Eligibility Provision to serve more Texas school children in the National School Lunch program.
The provision allows all students in high-poverty schools to eat school meals (both lunch and breakfast) at
no cost. Fewer than half (1,476) of eligible Texas schools (3,500) decided to take advantage of this option.
Also, with SB 376, beginning in the 2014-15 school year, schools in which 80% or more of students qualify
for free/reduced price meals will offer free breakfast to all students (at no additional cost to the state).
Communities also have a role. In Texas, a network of 21 regional food banks (now called “Feeding Texas”)
distributes food to charities.
In 2015 in Texas, a family of 4 earning up to $31,536/year ($2628/month) qualifies for SNAP. In Tarrant
County, the average benefit in July 2015 was $284/month, slightly higher than the statewide average
benefit of $274/family.
IMPORTANCE
OF THIS
INDICATOR:
Food security means a family can afford to put enough healthful food on the table each day. Food
insecurity refers to limited or uncertain availability of nutritionally adequate and safe foods or limited or
uncertain ability to acquire acceptable foods in socially acceptable ways. Food insecurity is related to
unemployment rates, poverty rates, homeownership rates, and median household income.
In 2013, Tarrant County Public Health undertook a study of food deserts in Tarrant County. A food desert
is defined as an urban neighborhood and rural town without ready access to fresh, healthy, affordable
food. They are usually found in impoverished areas that lack grocery stores, farmers’ markets, and healthy
food providers. Instead, they are heavy on convenience stores that provide mostly processed food that
are high in calories and low in nutrients.
WHAT THE
DATA TELLS
US:
th
In 2015, Tarrant County is 10 in the nation with the number of food-insecure individuals (341,210) and a
food insecurity rate of 18.5%, which is higher than for the U.S. which has remained unchanged at about
15.9% the past two years. (Source: Map the Meal Gap 2015)
The percentage of families receiving Supplemental Nutrition Assistance Program (SNAP) has increased
faster in Tarrant County and Texas between 2010 and 2015 than in the U.S. More than half the recipients
are children and youth under the age of 18; the percentage of people over 60 is growing.
Although SNAP is reaching more eligible participants, there are gaps, with benefits going unclaimed.
2015 United Way Tarrant County Community Assessment
62
According to the CPPP’s “Food and Nutrition in Texas”, in 2011, Texas had one of the lowest rates of
participation for eligible individuals in the country, with 71% of all eligible Texans enrolled in SNAP,
compared to 79% nationally. According to the USDA (August 2015), the SNAP program served 85% of all
eligible SNAP individuals in 2013, up from 83% in 2012. However, participation is higher for those eligible
for higher benefits, such as children and families in poverty. Participation was much lower for older
people and households with income above poverty (41% and 42%, respectively) and only 75% for
households with earnings. (source: USDA, “Trends in SNAP Participation Rates: FY2010 to FY2013Summary”) And, according to a July 2014 report from the Center for Rural Affairs, 86% of rural people
who are eligible participated for the period 2008-12, whereas only 73% of eligible people living in urban
areas participated.
Participation in Women Infants Children (WIC) has been declining in Texas and in Tarrant County. The
program is 100% federally funded. Texas Department of State Health Services (DSHS) has made policy
changes to improve program effectiveness and efficiency, including moving from paper vouchers to
electronic benefits transfer and expanding WIC clinic hours so that more eligible women and children can
receive screenings and reload their food benefits. A major state role is enrolling people in the program
and recertifying their eligibility every 6 or twelve months, depending on the age of the mother and
whether she is breastfeeding. It is estimated that only 2 out of every 3 eligible women, infants and
children are participating in WIC. Participation rates are highest for infants under age 1 and lowest for
children age 1-5. (Source: Food and Nutrition in Texas, CPPP)
2-1-1 is a portal to statewide services and benefits. The major increase in calls to 2-1-1 for food or meals
in Tarrant County may be attributable to confusion about the response message, which instructs the caller
to choose different buttons for state or local services.
The Tarrant County Food Desert Project identified 11 zip codes as food deserts. Fresh fruit and vegetables
were among the five least available foods. Zip code 76179 had the highest food availability with 42 of 134
items available and the highest percentage of grocery stores (30%) of all the food stores in the area. Zip
code 134 had the lowest food availability
Food Insecurity, U.S., Texas, and Tarrant County, 2013
U.S.
Texas
Tarrant
County
Overall food-insecurity rate
15.8%
17.6%
18.5%
Child food-insecurity rate
21.4%
27.4%
25.5%
Source: Map the Food Gap 2015
Trend: Number of SNAP cases, U.S., Texas, and Tarrant County, 2015 compared to 2012
U.S.
SNAP Cases
Texas
Tarrant County
FY2015
July 2012
% chg
July 2015
July 2012
%
chg
July
2015
July
2012
%
chg
22,533,541
22,541,831
(0.03%)
1,586,110
1,500,007
5.7%
98,266
88,773
9.5%
45,798,608
46,836,236
(2.2%)
3,798,182
3,634,308
4.5%
241,103
222,436
8.4%
(households)
SNAP
recipients
Source: U.S.D.A. http://www.fns.usda.gov/sites/default/files/pd/34SNAPmonthly.pdf
Number of SNAP cases, recipients, and benefits, Tarrant County, July 2015 compared to 2012 and 2010
July 2015
July 2012
% change
2012-2015
July 2010
Number of SNAP cases/families
98,266
89,773
9.5%
79,301
Number of SNAP recipients
241,103
222,436
8.4%
203,709
$286/case
$306/case
(6.5%)
$331
Average monthly Benefit
2015 United Way Tarrant County Community Assessment
63
136,364
56.5%
17,642
7.3%
126,364
56.8%
14,249
6.4%
$28,057,535
$27,484,730
Recipients under age 18
Recipients age 60+
Benefits
117,348
57.6%
11,830
5.8%
2.1%
$26,228,129
Source: Texas Health & Human Services Commission, Texas SNAP/TANF Enrollment Statistics
https://www.hhsc.state.tx.us/research/TANF-FS-results.asp
Trend: Children receiving free-reduced lunch, Tarrant County, 2014 compared with 2010-11
Children receiving free-reduced lunch
2014
2010-11
153,253
195,426
Trend: Children receiving WIC, Texas and Tarrant County, 2014 compared with 2012 and 2010
2014
2012
2010
Texas
673,473
841,583
769,505
Percent
Not available
43.6%
39.7%
Tarrant County
37,617
45,175
Percent
Not available
31.9%
(Source: Center for Public Policy Priorities, Kids Count 2015 and 2012)
50,737
35.5%
2-1-1 Requested Needs in Food/Meals, Tarrant County, 2011, 2014
Requests for:
2014
All calls
2011
All calls
Food stamps (SNAP)
Food pantries
72,650
16,101
10,135
13,645
%
change
All calls
163%
18%
2014
60+ Calls
2011
60+ calls
8,116
2,098
902
1,107
%
change
60+calls
800%
89%
243
2.8%
WIC
1,065
2,703
(60.6%)
11
Summer Food Service
345
569
(39.4%)
N/A
Prog
Home-delivered Meals
429
420
2%
250
Source: 211 Texas at United Way , Annual Reports, 2014 and 2011
Selected findings: Tarrant County Food Desert Project, September 2013
Highest-scoring
Lowest-scoring
Food availability (134 items)
Zip code 76179 (31% of the
Zip code 76134 (11% of 134 items
134 items)
available)
Grocery stores
76179 (30% of all food stores)
76134 (0 grocery stores)
Type of food available
Milk, canned vegetables,
Bulk section, frozen
grains, breads and cereals
fruits/vegetables, fresh vegetables
Source: Tarrant County Food Desert Project, Tarrant County Public Health
SOURCES:
USDA http://www.fns.usda.gov/sites/default/files/pd/34SNAPmonthly.pdf
USDA “Trends in Supplemental Nutrition Assistance Program Participation Rates: FY2010-FY2013Summary”
Texas Health and Human Services Commission – http://www.hhsc.state.tx.us/research/index/html
Center for Public Policy Priorities – Kids Count 2012, 2014
http://datacenter.kidscount.org/data/bystate/Default.aspx?state=TX
Center for Public Policy Priorities, “Food and Nutrition in Texas: What You Need to Know”
http://forabettertexas.org/images/HW_2015_01_NutritionReport_web.pdf
Texas Food Bank Network http://www.endhungerintex.org/hungerfacts.html
2015 United Way Tarrant County Community Assessment
64
Center for Rural Affairs, “Supplemental Nutrition Assistance Program and Rural Households”
http://files.cfra.org/pdf/snap-and-rural-households.pdf
2-1-1 Texas at United Way: 2014 Annual Report
Tarrant County Public Health, Tarrant County Food Desert Project, September 2013
http://www.tarrantcounty.com/ehealth/lib/ehealth/12-19-2013FOOD_DESERT_final_report.pdf
2015 United Way Tarrant County Community Assessment
65
INCOME
INDICATOR:
Homelessness
ABOUT THE
INDICATOR:
The Tarrant County Homeless Coalition (TCHC), using hundreds of volunteers and police, has
conducted a point-in-time census (PIT) of the unsheltered homeless each year since 2006. The 2015
survey and census reflect information from homeless people surveyed on January 22, 2015, as well as
data recorded within the Homeless Management Information System (HMIS). The Point-In-Time
Census (PIT) collects information on all of the people living in emergency shelters and in transitional
housing through the HMIS.
IMPORTANCE
OF THIS
INDICATOR:
Federal U.S. Department of Housing & Urban Development (HUD) policy requires cities receiving HUD
funds to develop comprehensive plans to end homelessness. The Homeless Emergency Assistance
and Rapid Transition to Housing (HEARTH) Act of 2009 reauthorized the McKinney-Vento
Homeless Assistance Act with substantial changes, including revised definitions of homelessness,
consolidated HUD programs, an increase in match required and a focus on performance. The
“housing first” philosophy prioritizes the most chronically homeless people for housing. These
policies, together with the collaborative efforts of cities, the county, nonprofit and faith-based
organizations to provide supportive services, has effectively moved formerly homeless adults and
children into permanent housing, thus reducing the number of unsheltered individuals in Tarrant
County.
The federal plan “Opening Doors” had set a goal to end veteran homelessness in 2015.
WHAT THE
DATA TELLS US:
Between 2012 and 2015, the number of Tarrant County residents experiencing homelessness
decreased overall by 10.8%, primarily due to the decrease in number in transitional housing. On any
given day in 2015, there were approximately 1,894 people considered homeless in Tarrant
County. The number of homeless veterans decreased by 41.9% from 2012-2015.
In the most recent (2013) survey of reasons for homelessness, unemployment was ranked as number
one, accounting for 40% of cases. There was also a significant number of individuals who claimed
release from prison as a reason for homelessness, so this category was added in 2013.
Trend: Point in Time (PIT) Count Highlights , Tarrant County, 2015 compared to 2012
2015
2012
#
%
change
change
Unsheltered
Sheltered:
Emergency shelters
Transitional housing
Safe Haven (Presbyterian Night Shelter)
Total
217
136*
81
59.6%
1,245
432
20
1,166
821
Not
reported
2,123
79
(389)
20
6.8%
(47.4%)
N/A
(209)
(9.8%)
1,914
*Assumes that 136 are unsheltered based on 2011 full census.
Trend: Homeless veterans, Tarrant County, 2015 compared with 2012
2015
2012
# change % change
Homeless veterans
136
193
(57)
(41.9%)
Chronically homeless in shelters, Tarrant County, 2014 compared with 2012
2014
2012
%
change
2015 United Way Tarrant County Community Assessment
66
Individuals - chronically homeless , sheltered
214
181
18.2%
Families - chronically homeless, sheltered
14
6
133%
“What were the reasons you became homeless?”, 2013 compared to 2012
Top 5 Reasons
Population: Unsheltered
Population: Emergency
Shelter
2013
2012
2013
2012
Unemployment
40%
77.6%
41%
59%
Unable to pay rent/mortgage
Addictions/Substance Abuse
Physical/Mental Disabilities
Divorce/Separation
17%
8%
8%
N/A
50%
30.3%
23.7%
21.1%
31%
10%
10%
N/A
45.7%
15.5%
20.40%
14.3%
Release from prison/Jail
11%
N/A*
9%
N/A
Domestic Violence
5%
N/A
16%
N/A
*These categories were not figured in for these years.
SOURCES:
Tarrant County Homeless Coalition, 2015 (and 2012) Point in Time Survey
http://www.ahomewithhope.org/wp-content/uploads/2015-PIT-TX601.pdf
2011 State of Homelessness Address
2015 United Way Tarrant County Community Assessment
67
INCOME
INDICATOR:
Housing/Home Ownership
ABOUT THE
INDICATOR:
Homeownership is one of the most important means by which low-income and minority households
can build wealth. For those that are not ready or able to buy a home, access to affordable high-quality
housing is essential. Whether owning or renting, having a safe, affordable place to live provides
physical and financial security.
IMPORTANCE
OF THIS
INDICATOR:
Owning a home provides financial equity and generates commitment to a neighborhood.
WHAT THE
DATA TELLS US:
According to the 2013 American Fact Finder, almost two-thirds of Tarrant County homes (61.7%) are
owner-occupied. The median value is higher than statewide.
Expenses such as mortgage payments, property taxes, utility costs and other fees take away money
that could be used for consumption or saved. When these expenses exceed 30% of household income,
the household is classified as “cost-burdened” and is at risk of foreclosure or homelessness if it suffers
a decline in income.
Although Texas ranks high (6th out of 50 states) in home affordability, it ranks 43rd out of 50 states in
rate of home ownership and 47th out of 50 in high cost mortgage loans.
In Tarrant County and Texas, almost half of renters pay more than 30% of their income for housing,
making them “housing cost-burdened”.
Percent of Housing Owned or Rented, Tarrant County and Texas, 2013 compared with 2010
Tarrant County
Texas
2013
2010
2013
2010
Home owner-occupied
61.7%
62%
63.3%
63.6%
Renter
38.3%
38%
36.7%
36.4%
$136,400
$137,100
$128,900
$128,000
Median value of owner-occupied housing
units
Source: Census 2010 , American Fact Finder (U.S. Census Bureau) 2013
Home Ownership/Rental and Housing Cost-Burden, U.S., Texas, and Tarrant County, 2015 compared
with 2010
Indicator
Tarrant County
Texas
Texas Rank
U.S.
2013^
2010
2015
2010
2015
2010
2015
2010
Homeownership Rate
(home occupied by owner)
Affordability of Homes*
61.7%
57.5%
61.8%
63.6%
43
42
63.5%
65.4%
N/A
N/A
2.6
6
4
N/A
N/A
8.0%
47
47
3.3 x
higher
than
median
income
3.35%
3.6
High cost mortgage loans*
2.6 x
higher
than
median
income
6.0%
5.2%
28.5%
32.6%
27.6%
32.6%
18
16
31.7%
38.0%
Housing cost Burden –
Homeowners
2015 United Way Tarrant County Community Assessment
68
Housing Cost Burden –
Renters***
49.3%
48.5%
47.7%
50.3%
16
18
51.5%
53.0%
^Note: County data not available in 2015.
*Ratio of median housing value divided by median family income
**percentage of first lien home purchase loans that are at least three percentage points and second lien loans that are at least
five percentage points above the yield on a comparable term treasury security, first three quarters of 2009).
*** Rent and utilities
Source: American Fact Finder U.S. Census Bureau; Asset and Opportunity Scorecard 2015
2-1-1 Top 5 Requested Needs for Housing/Shelter/Utilities, Tarrant County, 2014 compared with
2010
2014
2010
% chg Trend
 Electric Payment Assistance
 Rent payment assistance
 Housing Subsidies
 Gas bill payment assistance
 Water bill payment assistance
Total Top 5 – Housing/shelter/utilities
25,102
18,786
10,651
4,986
4,984
64,509
31,980
Not in top
5
3,858
5,767
52,794
(21.5%)
N/A
N/A
29.2%
(13.6%)
22.2%
Source: 2-1-1 Texas at United Way, 2014 Annual Report
SOURCE:
Corporation for Enterprise Development (CFED), Assets & Opportunity Scorecard 2012, 2013-2014
www.assetsandopportunity.org/scorecard
Census 2010; 2013 American FactFinder
2-1-1 Texas at United Way, 2014 Annual Report http://unitedwaytarrant.org/financials-reports/
2015 United Way Tarrant County Community Assessment
69
INCOME
INDICATOR:
Transportation
ABOUT THE
INDICATOR:
The U.S. Census Bureau collects information in between census years and posts it on American Fact
Finder. On here you can find current data collected on people’s commute to work.
The American Public Transit Association (APTA) calculates transit savings by ranking cities with the
highest transit ridership based on the cost of a monthly public transit pass and factoring in local gas
prices.
IMPORTANCE
OF THIS
INDICATOR:
Transportation is essential for getting to work, medical appointments, shopping, and socializing. Lack of
public transportation especially affects special populations, including those who cannot drive, and
particularly people who are aged, have disabilities, or lack the means to buy and maintain a car. Public
and regional transportation can also have a positive effect on air pollution, which is linked to asthma and
lung disease. In an area like North Texas, with multiple municipal and county jurisdictions, developing a
comprehensive regional transportation system has many challenges. Services have been pieced
together by nonprofits, cities and faith-based organization with funds from United Way, the Area Agency
on Aging, and local governments, including public-private partnerships. A recent effort is the Tarrant
Riders Network.
WHAT THE
DATA TELLS
US:
A higher percentage of Tarrant County workers commute to work and fewer used public transportation
or walked than for Texas and the U.S.
In 2013, Texas received the highest amount of federal funding for highways of the 50 states.
Individuals who ride public transportation can save on average $9,491 annually (or $791/month) based
on the June 2015 national average gas price and the national unreserved monthly parking rate.
Although total number of calls to 2-1-1 for transportation decreased from 2011 to 2014; the calls
relating to people age 60+ increased.
Commuting to Work (Workers age 16+), Tarrant County, Texas, and the U.S., 2014
Tarrant County
Texas
2014
2010
Drove alone
83%
82%
Carpooled
9.5%
10%
Public Transportation
.6%
1%
Walked
N/A
1%
Worked at home
N/A
4%
Mean travel time to
26.6
25
work
minutes
minutes
Source: U.S. Census. American FactFinder 2014
U.S.
2014
2010
2014
2010
80.4%
10.6%
1.6%
N/A
N/A
25.6
minutes
80%
11%
2%
2%
4%
25
minutes
76.5%
9.2%
5.2%
N/A
N/A
26
minutes
77%
10%
5%
3%
4%
26
minutes
Selected cities with transit savings, July 2015
City
1
5
10
15
20
New York
Seattle
Portland
Pittsburgh
Dallas
Monthly Savings
$1,349
$1,106
$1,004
$932
$884
2015 United Way Tarrant County Community Assessment
Annual
Savings
$16,185
$13,267
$12,050
$11,185
$10,609
70
Source: American Public Transportation Association, Press Releases 2015
Trend: 2-1-1 Calls related to Transportation, Tarrant County, 2014 compared to 2011.
All calls
Transportation – Total Calls

SOURCES:

Medical Appointments
Transportation
Gas Money

Disability-related Transportation

%
chg
2014
4,026
2011
5,808
2,082
1,932
(30)
6%)
7.8
60+Calls
% chg
2014
1,254
2011
1,142
707
560
9%
%
809
963
61
39
598
539
248
209
Travelers Assistance
Not in top
5
405

Local Transit Passes
321
381

Indigent Transportation
Not in top
5
N/A
38
74

Senior Ride Programs
216
N/A
200
39
2015 Urban Mobility Scorecard, Texas A&M Transportation Institute, http://mobility.tamu.edu/ums/
U.S. Department of Transportation, National Transportation Statistics, 2014
http://www.rita.dot.gov/bts/sites/rita.dot.gov.bts/files/publications/national_transportation_statistics/i
ndex.html
Highway Statistics, January 2015, U.S. Department of Transportation, Federal Highway Administration
http://www.fhwa.dot.gov/policyinformation/statistics/2013/fe221.cfm#foot1
Transit Savings Report, American Public Transportation Association (APTA)
http://www.publictransportation.org/tools/transitsavings/Pages/default.aspx;
http://www.apta.com/mediacenter/pressreleases/2015/Pages/1500730_Transit-Savings.aspx
2010 Census; 2014 American FactFinder
2-1-1 Texas at United Way, 2014 Annual Report http://unitedwaytarrant.org/financials-reports/
2015 United Way Tarrant County Community Assessment
71
INCOME
INDICATOR:
Unemployment
ABOUT THE
INDICATOR:
The unemployment rate is the percentage of the total labor force that is unemployed but actively
seeking employment and willing to work.
IMPORTANCE OF
THIS INDICATOR:
A severe global economic problem began in December 2007 and took a particularly sharp
downward turn in September 2008. The Great Recession resulted in the collapse of large financial
institutions, the bailout of banks by national governments and downturns in stock markets around
the world. In many areas, the housing market also suffered, resulting in numerous evictions,
foreclosures and prolonged unemployment. (Source: Wikipedia)
Unemployment Insurance Claims filed does not include people who have stopped seeking work or
whose claims have expired.
WHAT THE DATA
TELLS US:
According to the Harvard Business Review (2012), many employers still struggle to fill certain types
of vacancies, especially for so-called “middle-skills” jobs—in computer technology, nursing, highskill manufacturing, and other fields—that require postsecondary technical education and training
and, in some cases, college math courses or degrees. Currently in the U.S. about 69 million people
work in middle-skills jobs, representing roughly 48% of the labor force.
“Strengthening Dallas-Fort Worth” reports that with the DFW region being among the top three
U.S. metro areas for business expansions, relocations and employment growth, middle-skill jobs are
critical to the DFW economy. Currently, 960,000 middle-skill jobs in DFW represent 29% of all
positions and pay an average median hourly wage of $24.47, which is 35% higher than the region’s
living wage of $18.08. Nearly 42,000 middle-skill job openings are projected annually through
2018. High demand in middle-skill jobs is projected in Healthcare (5.5%) and Information
Technology (3.6%). The report recommends strategies for developing a demand-driven career
pathways system to connect more residents to middle-skill jobs, including:
 Strengthening the “first rung” of career pathway programming so more low-income, lowskilled adults can prepare for and earn middle-skill credentials;
 Investing in comprehensive student supports for low-income students;
 Promoting employer leadership in developing career pathways and expanding sectorbased strategies;
 Developing stronger connections between workforce development resources and the
region’s high need communities and populations; and
 Increasing public awareness of middle-skill job opportunities.
Over the last 5 years the unemployment rate has continued to drop in the U.S., Texas, and Tarrant
County. This decline in job seekers is reflected in the decline in employment-related calls to 2-1-1.
Unemployment Rate, Tarrant, Texas and US, 2015 compared with July 2011
July 2015 July 2011
Trend
Tarrant County
4.1%
8.5%
Texas
4.6%
8.3%
U.S.
5.6%
9.5%
Source: http://www.twc.state.tx.us/news/press-releases-year-2015
2015 United Way Tarrant County Community Assessment
72
Trend: Unemployment Insurance Claims Filed, Tarrant County, July 2011 – 2015
June 2015 June 2014 June 2012 July 2011
% change
2011-15
9,560
10,433
11,674
26,255
(63.6%)
Source: Texas Workforce Commission, Tracer2 reports
Trend: Unemployment Claims Filed, Tarrant County, 2008-2015
60,000
40,000
20,000
0
2008
2009
2010
2011
2012
2014
2015
Trend: 2-1-1 Calls related to Employment, 2014 compared to 2011
Employment, all calls

Job Search

Vocational
Assessment/Rehab
2014
2011
%
change
1,905
3,224
(40.9%)
1,631
2,724
(40.1%)
157
Not
reported
N/A
Source: 2-1-1 Texas at United Way, 2014 Annual Report
SOURCES:
“Strengthening Dallas-Fort Worth”: Building a Middle-Skill Pipeline to Sustain Economic Growth and
Expand Opportunity, New Skills at work, JP Morgan Chase & Co, 2015
https://www.jpmorganchase.com/corporate/Corporate-Responsibility/document/335911-jpmcgap-dallas-aw5-online-2.pdf
“Who can fix the middle-skills gap?”, Harvard Business Review, December 2012
https://hbr.org/2012/12/who-can-fix-the-middle-skills-gap
Texas Workforce Commission, Tracer2 http://www.tracer2.com
2-1-1 Texas at United Way, 2014 Annual Report http://unitedwaytarrant.org/financials-reports/
2015 United Way Tarrant County Community Assessment
73
HEALTH
INDICATOR:
ABOUT THE
INDICATOR:
IMPORTANCEO
F THE
INDICATOR:
WHAT THE
DATA TELLS
US:
Adult Abuse
Adult Protective Services (APS), a division of the Texas Department of Family and Protective Services,
investigates allegations of abuse, neglect or exploitation of adults over the age of 65 or adults age 18-64
with a disability.
People with disabilities and adults age 65+ are vulnerable to abuse, neglect or exploitation, particularly by
caregivers. In 2012, Tarrant County Adult Protective Services staff spearheaded a community effort to
establish an Adult Fatality Review Team.
In the In-Home Population, the 11.8% increase in Total APS Intakes between FY2010 and FY2014
correlated with the almost 10% increase in Target Population (mostly older adults). However, the
number of completed investigations increased by 26% and the percentage of cases validating
abuse/neglect climbed from just over half to close to two-thirds. In facilities, there was a 40% increase
in intakes but fewer confirmed cases of abuse.
Trend: APS In-Home Population and Case-Related Statistics, Tarrant County, FY2014 compared with
FY2010
FY2014
FY2010
% change
Target population
299,894
273,585
9.6%
110,438
127,030
(13.1%)
 Population with a disability

Population age 65+
Total APS intakes
Total APS completed investigations
Validated APS investigations
APS clients receiving services
Of completed, % validated
189,456
145,555
29.3%
5561
4421
2862
N/A
64.7%
4973
3509
1880
1679
53.6%
11.8%
26%
52.2%
N/A
Trend: APS Facilities Investigations, Tarrant County, FY2014 compared with FY2011
FY2014
FY2011
% change
Intakes
502
359
40%
Completed Investigations
447
322
38.8%
Confirmed Investigations
53
59
(10%)
Of completed, % confirmed
11.9%
18.3%
SOURCE:
Texas Department of Family & Protective Services Annual Databooks https://www.dfps.state.tx.us/documents/about/Data_Books_and_Annual_Reports/2014/10CountyTable
sAll.pdf
2015 United Way Tarrant County Community Assessment
74
HEALTH
INDICATOR:
Alzheimer’s Disease (AD)
ABOUT THE
INDICATOR:
Alzheimer’s Disease (AD) is the most common form of dementia, a condition caused by various
diseases and conditions that results in damaged brain cells or connections between brain cells.
For a diagnosis of dementia, the decline in cognitive abilities must be severe enough to interfere with
daily life and symptoms must include decline in memory and decline in at least one of the following
abilities: to generate coherent speech or understand spoken/written language; to recognize or
identify objects; to execute motor activities; and/or to think abstractly, make sound judgments, and
plan and carry out complex tasks. Some symptoms can be reversed if they are caused by treatable
conditions such as depression, delirium, drug interaction, thyroid problems, excess use of alcohol, or
certain vitamin deficiencies.
IMPORTANCE
OF THIS
INDICATOR:
In May 2012, the U.S. government launched a National Alzheimer’s Plan to find effective ways to
treat, or at least stall, the disease. (Source: www.alzheimers.gov) The Alzheimer’s Association
estimates that caring for people with Alzheimer’s will cost the U.S. $200 billion in 2012 and $1 trillion
by 2050. One of the most important determinants in the cost of care is the stage of the disease. As
the disease progresses and the individual’s care needs rise, the cost of care increases. It is projected
that by 2050, not only the number of people with Alzheimer’s will increase, but the proportion of
Americans in various stages – mild, moderate, severe – will change to almost half in the severe stage.
Alzheimer’s Disease is associated with aging and as more baby-boomers reach age 65 and the
proportion of older adults in the population increases, the incidence of the disease will increase. The
condition always results in death, but death certificates often list a more immediate reason for death,
leading to severe underreporting of the disease.
The Alzheimer’s Association reports that nearly two-thirds of Americans with Alzheimer’s are women.
Although people over 65 with AD live an average of 4-8 years after diagnosis, some live for as long as
20 years. On average, a person with AD will spend more years in the most severe stage of the
disease than any other stage. Nursing home admission by the age of 80 is expected for 75% of
people with AD, compared with only 4% for the general population.
Unpaid family caregivers provide 85% of care provided to older adults. Approximately two-thirds of
family caregivers are women and one-third are age 65+. Although two-thirds of caregivers are
Caucasian, Hispanic and African-American caregivers spend more time caregiving (20-30 hours/week)
and are more likely to experience high burden from caregiving. Unpaid caregivers may experience
high levels of emotional stress and depression, declining health, and experience a negative impact on
employment, income and financial security. Sandwich generation caregivers indicate lower quality
of life and poorer health behaviors. Individuals with dementia are more likely to rely on three or
more caregivers. About one-third of caregivers of people with dementia provide care for 5 years.
(Source: Alzheimer’s Association – Facts)
WHAT THE DATA
TELLS US:
th
Alzheimer’s is the 6 leading cause of death in the U.S. and Tarrant County. (See also the profile this
report on Injury and Mortality). Dementia increases dramatically by age and the number of new
cases is projected to double by 2050.
Incidence rate of dementia (new cases) by age, U.S., 2014
Age 65-74
Age 75-84
Age 85+
New cases
59,000
2015 United Way Tarrant County Community Assessment
172,000
238,000
Total new cases among
people 65+
469,000
75
Trend: Incidence (new cases) of dementia, U.S., 2010 and projected for 2025 and 2050
U.S.
2010
2015
454,000
473,000
2025
Projected
Projected
615,000
2050
Projected
% change
2015-2050
946,000
100%
Number of deaths and annual mortality rate due to Alzheimer’s Disease, U.S. and Texas, 2013
Number of deaths Mortality rate
(per 100,000)
U.S.
84,767
26.8
Texas
5,293
20
Prevalence (existing cases) of Alzheimer’s disease by age, U.S. , 2015
Among
Among
Among
Among
>65
people
age 75people
population age 6584
age 85+
74
Alzheimer’s disease
10.3%
15%
43%
38%
Source: https://www.alz.org/facts/downloads/facts_figures_2015.pdf
Trend: Projected number of people age 65+ with Alzheimer’s, Texas and Tarrant County, 20102025
2010
Texas
Tarrant County*
2025
340,000
16,730
490,000
24,100
% change
2010-2025
44.1%
44.1%
*Tarrant County estimate based on percentage of state figures
Proportion of Americans living with Alzheimer’s Disease by Disease Stage, U.S., 2015 and 2050
Severe
2050
Moderate
2015
Mild
0%
20%
40%
60%
Note: 2015 – 5.1 million people; 2050 – 13.5 million people
Source: Alzheimer’s Association – Changing the Trajectory of AD
Number of Alzheimer's disease (AD) and dementia caregivers, hours of unpaid care, economic
value of unpaid care and higher health care costs of caregivers, U.S. and Texas, 2014
U.S.
Texas
Number of
AD/dementia
caregivers
Hours of unpaid
care (avg. 21.9
hrs/week)
Value of unpaid care
(@$12.17/hr)
Higher Health Care
Costs of Caregivers
15,706,000
1,331,000
17,886,000,000
1,516,000,000
$21,670,000,000
$ 18,446,000,000
$9,733,000,000
$716,000,000
2015 United Way Tarrant County Community Assessment
76
Trend: Cognitive impairment in nursing home residents, U.S. and Texas, 2012 compared with 2008
2012
2008
% change 20082012
Total Nursing Home
Residents
U.S
1,409,749
Texas
98,195
Percent of residents at each level of impairment:
None to mild
37%
27%
Moderate
26%
29%
Severe
38%
43%
U.S.
3,261,183
32%
27%
41%
Texas
189,553
U.S.
(57%)
Texas
(48%)
24%
32%
45%
NOTE. Created from data from U.S. Department of Health and Human Services, Centers for Medicare and
Medicaid Services. Nursing home data compendium. 2013
SOURCES:
2015 Update – National Alzheimer’s Plan to Address Alzheimer’s Disease
http://aspe.hhs.gov/daltcp/napa/NatlPlan2015.shtml and www.Alzheimers.gov
Texas Department of State Health Services - http://www.dshs.state.tx.us/alzheimers/statistics.shtm
Alzheimer’s Association: https://www.alz.org/facts/downloads/facts_figures_2015.pdf
Alzheimer’s Association: Changing the Trajectory of Alzheimer’s Disease
https://www.alz.org/documents_custom/trajectory.pdf
CMS Data Compendium, 2013: https://www.cms.gov/Medicare/Provider-Enrollment-andCertification/CertificationandComplianc/downloads/nursinghomedatacompendium_508.pdf
2015 United Way Tarrant County Community Assessment
77
HEALTH
INDICATOR:
Child Abuse/Neglect
ABOUT THE
INDICATOR:
Texas Department of Family & Protective Services (DFPS) investigates allegations of child
abuse/neglect. Abuse/neglect may be confirmed, ruled out or unconfirmed. Children at risk may
be removed from the home to substitute care, which may include foster care, institutional care or
care of relatives. The Department also provides prevention services and supportive services to
families.
In 2014, TexProtects conducted a county risk assessment focused on child maltreatment to
determine where to focus prevention programs and compared its risk assessment with other risk
assessments, including county health rankings.
IMPORTANCE OF
THIS INDICATOR:
A poor economy may result in more cases of child abuse/neglect. Neglect accounts for
approximately 2/3 of cases. Adverse childhood experiences (such as abuse) have long-lasting
health consequences in childhood and adulthood.
WHAT THE DATA
TELLS US:
Even though the number of confirmed victims of child abuse/neglect in Tarrant County and the rate
per 1,000 children declined from 2010 to 2014, Tarrant County had the highest number of
confirmed child victims in the state in 2014. (That might be partly due to the increase in
population.) A high percent of confirmed investigations may indicate that community
reports/allegations are being made with greater accuracy.
Although the number of child deaths from abuse decreased from 2010-2014, the number is still
higher than in 2007. Neglectful supervision is the leading cause of child death from abuse.
According to Cook Children’s, young children 0-3 years old are at highest risk because they cannot
protect themselves or tell what is happening. Domestic violence and child abuse co-occur about 50
percent of the time. Adults’ untreated mental illness or drug use and the presence of an unrelated
male in the home add risk of child abuse in an environment.
Trend: Confirmed CPS Victims & Investigations, Tarrant County, FY 2014 compared with FY2010
Child
Population
Confirmed
Victims
Rate
per
1000
children
2014
529,400
6,097
2010
482,819
6,222
Trend: Rate
Total CPS
completed
investigations
Confirmed
CPS
investigations
Percent
investigations
confirmed
11.5
13,058
3,731
28.6%
12.9
13,046
3,608
27.7%
Trend: Child victims of abuse/neglect, Tarrant County compared with 4 other urban counties, FY
2014 and FY 2010
FY 2014
FY 2010
% change
FY 2010 –
2014
Tarrant County
6,097
6,222
(2%)
Harris County
6,070
6,535
(7.1%)
Dallas County
5,967
5.591
6.7%
Bexar County
5,434
5,999
(9.4%)
Travis County
2,157
1,735
24.3%
2015 United Way Tarrant County Community Assessment
78
Trend: Completed CPS Abuse/Neglect Investigations, FY 2014 compared with FY2010
Complete
d Investigations
Alleged
victims of
child
abuse/neg
lect
Alleged
Victims in
Unconfirmed Investigations
Alleged
victims in
Ruled Out*
investigations
Alleged
Victims
Provided
Services
Alleged
Victims
Not
provided
services
Children
removed
from
home*
**
595
740
2014
13,098
21,241
14,391
10,651
3,461
17,780
2010
13,046
22,161
15,233
10,812
4,786
17,375
*a subcategory of Unconfirmed Investigations
*** children removed from home as a result of completed investigation, a subset of number who entered
Substitute Care (see other table for total entering substitute care)
Trend: Child Abuse/Neglect Related Fatalities, Tarrant County and Texas, FY 2014 compared
with FY2010 and FY2007
FY 2014
11
151
Tarrant County
Texas
FY 2010
18
227
% change
(38.9%)
(33.4%)
2007
9
223
Child Abuse/Neglect-Related Fatalities, Tarrant County compared with 4 other urban counties, FY
2014 and FY2010
Harris County
Dallas County
Bexar County
Tarrant County
Travis County
Statewide
FY 2014
FY2010
FY2007
21
14
12
11
9
151
44
17
17
18
3
227
30
17
13
9
6
223
Trend: CPS Children in Care, Tarrant County FY2014 compared with FY2010
Child
Population
Children in
DFPS Legal
Responsibility
Point of
Prevalence
*
Trend:
prevalence
Children
entering
Substitute Care
2014
529,400
2,104
4.0
673
2010
482,819
2,135
4.4
824
Children in
Substitute Care
Relative
NonCare
Relative
Care
1,992
586
1,406
2,066
Children
in
Foster
Care
1,661
1,697
* Rate of the annual number of children in DFPS legal responsibility in FY per 1,000 children in the child
population
Annual Number of Families Receiving Preservation* Services, FY 2014
No. Families
No. Children
Children removed
from home
% of children
removed
2,070
5,599
136
2.4%
*Services are provided to the child and family, but caregiver retains legal custody.
2015 United Way Tarrant County Community Assessment
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Children Leaving DFPS Custody by Type, Tarrant County, FY 2014
Year
2014
Total
Family
Reunification
801
Custody
to
Relative
PCA*
Custody
to
Relative
Non-PCA
27
165
256
Adoption
Nonrelative
Children
Emancipated
Other
relative
276
69
231
45
*PCA-Permanency Care Assistance (aka Kinship Guardianship Assistance Payments)
9
Five-Year Outcome for Children Returned Home from Substitute Care or Served in Family-Based
Safety Services, Tarrant County, FY2014 compared with FY2010
Total Children Served 5 years earlier
FY 2014
(based on total
children served
FY 2009)
4,523
FY 2010
(based on total
children served
FY 2005)
2,105
965
491
21.3%
23.3%
Subsequent Confirmed Victims during 5
year period
% subsequent confirmed victims
Child Maltreatment County Risk Assessment, Tarrant County, 2014
Ranked (among 254 Texas counties) risk of:
Range:
Tarrant Co
Family
Violence
Substance
Abuse
9-254
252
1-254
123
Teen
Pregnancy
1-254
77
Child Abuse
Fatalities
past 5 years
Child
Poverty
55-254
143
0-253
86.5
Final Ranking of Health & Human County Health
Child
Services
Ranking
Maltreatment
Commission
Prevention
Ranking
Need
Range:
1-254
1-254
1-221
Tarrant County
146.5
190
64
Source: TexProtects, Texas Child Maltreatment Risk Assessment
SOURCES:
Averag
e Risk
Rankin
g
18-216
136.3
Final
Ranking of
Child
Maltreatme
nt
Prevention
Need
1-254
146.5
Average Risk
Ranking Across
3 Assessments
146
Texas Department of Family & Protective Services Annual Databooks (2014, 2010, 2007)
https://www.dfps.state.tx.us/About_DFPS/Data_Books_and_Annual_Reports/2014/default.asp
TexProtects: Texas Child Maltreatment Risk Assessment
http://texprotects.org/media/uploads/08_14_14_child_maltreatment_county_risk_assessment_final_(2).pdf
2015 United Way Tarrant County Community Assessment
80
HEALTH
INDICATOR:
Chronic and disabling conditions: Asthma
ABOUT THE
INDICATOR:
Asthma is a chronic condition involving inflammation of the airways.
IMPORTANCE OF
THIS INDICATOR:
In 2010, lower respiratory disease was ranked 4 leading cause of death in Tarrant County. (See also
the profile on Injury and Mortality in this report.) Asthma-related costs consist not only of
hospitalization and medication charges, but also lost work and school days due to illness. Children
with asthma are more likely to have health problems, behavior problems, and problems in school.
th
A 2012 study, Child and Asthma Burden in Tarrant County, Texas, 2004-2010 provides insight into
specific populations in Tarrant County which may be more heavily burdened by asthma.
The 2013 Tarrant County Community Health Assessment targeted asthma as one of the issues for
future discussion.
In May 2015, the University of North Texas Health Science Center (UNTHSC) School of Public Health
announced a new children’s asthma management program to be piloted in two East Fort Worth
schools in fall 2015 to help children and families decrease absences due to asthma.
WHAT THE DATA
TELLS US:
Asthma among Tarrant County adults and children is higher than for Texas and the U.S. According
to the 2012 study, the age groups with the highest prevalence of current asthma were children age
15-17 and adults 35-64. The prevalence of current asthma was higher among adults whose highest
education was high school (10.5%) compared to adults who were college graduates (6.2%). Its
prevalence was higher among adults who are morbidly obese (BMI>40) (18%) compared to those
who are normal, overweight or obese. The 2010 hospitalization rate was highest for adults over age
65 (21 per 10,000) compared to all other age groups and significantly higher for African-Americans
(16.3 per 10,000) compared to whites (7.8 per 10,000) and Hispanics (7.0 per 10,000). The mortality
(death) rate for asthma was highest for adults age 65+ (4.8 per 100,000 person-years) and higher for
African-Americans (2.5 per 100,000) compared to Whites (1.1 per 100,000 person-years).
The 2008 Community-Wide Children’s Health and Planning Survey (CCHAPS) study by Cook Children’s
Center for Children’s Health found the prevalence to be 18% for children under age 14 in a 6-county
North Texas area. Although adult females make up double the percentage than adult males, among
children, boys account for more than double the percentage of girls. A higher percentage of
asthma is found among boys and African-Americans.
Prevalence of “Current Asthma” among Children and Adults, Tarrant County and Texas, Texas
BRFSS 2007-2010
Children
Adults
Tarrant
Texas
Tarrant
Texas
County
County
Total
10%
8.5%
8%
7.3%
Gender: Male
13.7%
10.1%
5.3%
5.7%
Female
6.5%
7.0%
10.4%
9%
Ethnicity: White
7.6%
8.9%
8.6%
8.4%
Black
18.4%
14.3%
9.1%
9.9%
Hispanic
8.7%
7.0%
6.1%
4.9%
Age group 0-14
8.7%
8.5%
0 -4
7.2%
6.3%
5-9
8.8%
10.1%
10-14
11.6%
9.5%
2015 United Way Tarrant County Community Assessment
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15-17
12.8%
8.6%
18-34
7.2%
7.3%
35-64
8.5%
7.3%
65+
7.7%
7.6%
Education: Less than High
9.3%
6.3%
Reported only for adults
School
High School graduate
10.5%
8.0%
Some College
8.0%
8.5%
College Grad or more
6.2%
6.5%
Weight: Normal or
6.7%
6.9%
Underweight (BMI <24.9)
Overweight (BMI 25-29.9)
6.5%
6.3%
Obese (BMI 30-39.9)
7.3%
7.7%
Morbidly Obese (BMI>40)
18.0%
12.3%
Source: Child and Adult Asthma Burden in Tarrant County, Texas, 2004-2010, DSHS in Oct 2012
Age-adjusted* Hospitalization Rates per 10,000 person-years for Asthma and Mortality Rates per
100,000 for Asthma, Tarrant County and Texas, 2010
Hospitalization (admission)
Mortality (deaths) Rate per
rate per 10,000 person-years
100,000 person-years
Tarrant Co
Texas
Tarrant Co
Texas
Total
8.7
10.5
1.3
1.0
Gender: Male
5.8
7.9
0.9
0.8
Female
11.2
12.7
1.6
1.2
Ethnicity: White
7.8
9.1
1.1
1.0
Black
16.3
20.4
2.5
2.3
Hispanic
7.0
8.7
-0.7
Other, non-Hispanic
4.3
13.7
-1.3
Age: 0-14*
9.6
15.6
-0.2
15-17
3.1
3.4
-0.2
18-34
3.7
3.0
35-64
7.7
9.1
1.2
1.0
65+
21.0
22.2
4.8
4.2
Source: Child and Adult Asthma Burden in Tarrant County, Texas, 2004-2010. DSHS Oct 12, 2012
6-county (North Texas) profile of children age 0-14: Asthma, 2008
Percent of children 0-14 with asthma
18.1%
School absences 3 days+ due to asthma
27%
Children who missed 3+ days of school due to asthma
51%
Source: CCHAPS, 2008
SOURCES:
Child and Adult Asthma Burden in Tarrant County, Texas, 2004-2010, Department of State Health
Services, October 12, 2012.
New program targets children’s asthma, Posted May 26, 2015 https://www.unthsc.edu/school-ofpublic-health/new-program-targets-childrens-asthma/
2013 Tarrant County Community Health Assessment,
http://access.tarrantcounty.com/content/dam/main/public-health/PHTCVFH/Documents/2013_Tarrant_County_Community_Health_Assessment_Report_-_Final.pdf
Community-wide Children’s Health Assessment & Planning Survey (CCHAPS), 2008 www.cchaps.org
2015 United Way Tarrant County Community Assessment
82
HEALTH
INDICATOR:
Chronic and disabling conditions: Cancer
ABOUT THE
INDICATOR:
Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the
spread is not controlled, it can result in death. Cancer is caused by both external factors, such as tobacco,
infectious organisms, chemicals, and an unhealthy diet, and internal factors such as inherited genetic
mutations, hormones and immune conditions. These factors may act together or in sequence to cause
cancer. Ten or more years often pass between exposure to external factors and detectable cancer.
Treatments include surgery, radiation, chemotherapy, hormone therapy, immune therapy, and targeted
therapy (drugs that specifically interfere with cancer cell growth. (Source: American Cancer Society,
Cancer, Facts and Figures 2015)
IMPORTANCE
OF THIS
INDICATOR:
Many cancer deaths could be prevented, including all cancers caused by tobacco use and heavy alcohol
consumption. About one-third of cancer cases that occur in economically developed countries like the
U.S. are related to overweight or obesity, physical inactivity, or poor nutrition and could be prevented.
Certain cancers related to infectious agents, such as human papillomavirus (HPV), hepatitis B virus (HBV),
hepatitis C virus (HCV), human immunodeficiency virus (HIV), and helicobacter pylori (H. pylori) could be
avoided by preventing infection through behavioral changes or vaccination. Many skin cancer cases could
be prevented by protecting skin from excessive sun exposure and avoiding indoor tanning. Screening can
prevent colorectal and cervical cancers and is known to reduce mortality for cancers of the breast, colon,
rectum, cervix, and lung. (Source: American Cancer Society, Facts and Figures 2015)
At risk of developing cancer are older people. More than three-quarters of all cancer diagnoses are in
people age 55+. People who smoke, eat an unhealthy diet or are physically inactive also have a higher risk
of cancer. “Risk” can mean lifetime risk – the probability that an individual will develop or die from cancer
over the course of a lifetime (e.g., 1 in 2 men compared to 1 in 3 women) or relative risk, the measure of a
strength of the relationship between a risk factor and cancer. (e.g., people who smoke are about 25 times
more likely to develop cancer than nonsmokers). (Source: American Cancer Society, Facts and Figures
2015)
According to the CDC (Addressing the Cancer Burden), cancer does not affect all groups of people equally.
African-Americans are more likely to die of cancer than people of any other race or ethnicity. (199 per
100,000 people compared to 169 for whites, 118 for Hispanics).
In transitioning from Healthy People 2010 to Healthy People 2020 , the Cancer objectives were expanded
to include a broader range of measures, reflecting the latest trends in cancer prevention and diagnosis. In
addition to objectives on mortality, screening, counseling, survival, and cancer registries, the Healthy
People 2020 Cancer Topic Area includes new objectives on cancer incidence, quality of life for cancer
survivors, prevalence of sunburn, and use of artificial sources of ultraviolet light for tanning. (Source:
Healthy People 2010/Final Review).
The mission of the Texas Center for Health Disparities, established in 2005 at the University of North Texas
Health Science Center and designated as a Center of Excellence by the National Institutes of Health, is to
prevent, reduce and eliminate health disparities through research, education/training and outreach. One
of three current (2015) research projects is on breast cancer, known to be disproportionate in
premenopausal and African-American women. UNT/HSC also hosts the Tarrant County Cancer Disparities
Coalition, which emerged in 2012. (https://www.unthsc.edu/research/center-for-communityhealth/tarrant-county-cancer-disparities-coalition/)
WHAT THE
DATA TELLS
US:
Based on 2010 data, cancer is the second leading cause of death in the U.S. and in Tarrant County (22.4%).
(See profile on Injury and Mortality elsewhere in this report.). The incidence of cancer in Tarrant County
is 459.3/100,000 population (2005-08), according to www.tarrantcares.com
2015 United Way Tarrant County Community Assessment
83
Although the rates of new cancer cases and deaths are declining, the number of new cases and deaths are
increasing because our (Texas) population is aging and growing. (Source: 2014 Texas Selected Cancer
Facts)
For cancer screening, there are disparities by geographic area, gender, age, ethnicity, and employment
status in Tarrant County. A few key findings:

A lower proportion of residents age 50+ in central Tarrant County (51.8%) received a
sigmoidoscopy/colonoscopy in the past 5-10 years compared to Northeast Tarrant County
(67.6%)
 The proportion of women who obtained a mammogram within the past year was lower among
women aged 40-49 (50.4%) than older women. Women in age groups 18-24 (51.8%) or 65+
(59.9%) had a lower prevalence of obtaining a Pap test within the past three years than women in
all other age groups.
 The percentage of Hispanic males age 40+ (35.7%) who obtained a PSA (prostate-specific antigen)
test within the past two years was lower than among white males in the same age group (59%).
 Among adults 50+, a greater proportion of retired persons (71.6%) obtained either a
sigmoidoscopy within the past 5 years or a colonoscopy with in the past 10 years compared to
individuals employed for wages (50.9%), adults out of work less than one year (26.9%) and
persons unable to work (56.7%).
(Source: Behavioral Risk Factor Surveillance Survey (BRFSS) 2010, Tarrant County http://access.tarrantcounty.com/content/dam/main/publichealth/PH%20DOCUMENTS/Epi/BRFSS%20Reports/Tarrant_County_BRFSS_20092010.pdf
Estimated number of new cancer cases by primary site, Texas and Tarrant County, 2015
Estimated new cases
Texas
Tarrant County
All
109,053
7,842
Top 10 by primary site:
Breast
15,420
1,174
Lung/bronchus
13,619
962
Prostate
13,363
985
Colon/rectal
7,002
462
Kidney/renal
5,118
367
Non-Hodgkin Lymphoma
4,658
343
Urinary Bladder
3,789
293
Melanoma of the skin
3,593
284
Thyroid
3,578
266
Leukemia
3,396
236
Source: Texas Department of State Health Services, Cancer Epidemiology & Surveillance Branch, Dec.
2014
Estimated Cancer Deaths by Primary Site, Texas and Tarrant County, 2015
Texas
Tarrant County
All
42,255
2,775
Top 10 by primary site
Lung
10,985
741
Colon
3,217
210
Breast
2,975
206
Pancreas
2,676
174
Liver
2,205
135
Prostate
1,919
117
Leukemia
1,752
114
Non-Hodgkin Lymphoma
1.424
90
Kidney/renal
1,194
75
Brain/other nervous system
1,716
71
2015 United Way Tarrant County Community Assessment
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Source: Texas Department of State Health Services, Cancer Epidemiology & Surveillance Branch, Dec. 2014
Average annual number of new cancer cases and cancer deaths, 5 Leading Cancer Sites, Tarrant County,
2007-2011
New Cases
2007-2011
Deaths
2007-2011
Breast
1047
Lung
658
Prostate
913
Colorectal
236
Lung
906
Breast
177
Colorectal
628
Pancreas
145
Non-Hodgkins Lymphoma
295
Prostate
107
The average annual number of all
The average annual number
cancer cases
6,939
of all cancer deaths
2,404
Source: 2014 Texas Selected Cancer Facts, Department of State Health Services
Incidence and Mortality Rates for Cancer (per 100,000 population) by race, ethnicity and
gender, Tarrant County, 2007-2011
Incidence Rates (per
Mortality (deaths)
100,000 pop.)
(per 100,000 pop.)
White
Black
Hispanic
Asian
Male
556.9
646.9
392.4
301.1
Female
423.3
414.0
330.2
233.8
Male
215.1
285.7
155.2
110.8
Female
150.3
170.1
104.5
86.7
Age-adjusted death rate (per 100,000 population) due to cancer, Tarrant County, 2008-12 compared
with Healthy People 2020 Target
Tarrant County
Healthy People 2020 Target
All cancers
168.6
161.4
Lung
46.4
45.5
Prostate
21.7 (per 100,000 males)
21.8
Breast
21.1 (per 100,000 females)
20.7
Colorectal
15.9
14.5
Source: healthyntexas.org (2015)
Leading Child and Adolescent (ages 0-19 years) Cancers in Tarrant County, 2002-2011
Number
% of Total
All cancers combined
957
100%
Leukemia
245
25.6%
Brain/Central Nervous System (III)
222
23.2%
Lymphoma (II)
119
12.4%
All other groups
371
38.8%
Source: 2014 Texas Selected Cancer Facts, Department of State Health Services
Weighted Percentage of Risk Factors for U.S., Texas, and Tarrant County, compared with Healthy People
2010 Goal, 2009-10
Healthy
U.S.
Texas
Tarrant
People 2010
County
Goal
Women’s Health:
Mammogram within past 2 years
70%
76.8%
72.6%
73.5%
Pap test within past 3 years
90%
82.9%
81.5%
77.1%
Screening:
Ever had sigmoidoscopy or colonoscopy
50%
62.3%
56.2%
63.8%
2015 United Way Tarrant County Community Assessment
85
SOURCES:
American Cancer Society, Cancer Facts and Figures 2015
http://www.cancer.org/Research/CancerFactsFigures/Index
Center for Disease Control and Prevention (CDC) – Addressing the Cancer Burden http://www.cdc.gov/chronicdisease/resources/publications/aag/dcpc.htm
Healthy People 2020
https://www.healthypeople.gov/2020/topics-objectives/topic/cancer
Health People 2010 Final Review: Transitioning to Healthy People 2020
http://www.cdc.gov/nchs/data/hpdata2010/hp2010_final_review_focus_area_03.pdf
Healthy North Texas website –
http://www.healthyntexas.org/modules.php?op=modload&name=NSIndicator&file=index&topic1=County&topic2=Tarrant
Texas Department of State Health Services, Cancer Epidemiology and Research Branch
https://www.dshs.state.tx.us/tcr/default.shtm
Texas Center for Health Disparities, UNT/HSC https://www.dshs.state.tx.us/tcr/default.shtm
2014 Texas Selected Cancer Facts, Texas Department of State Health Services, Texas Cancer
Registry, published 8/14. http://dshs.state.tx.us/tcr/statisticalData/2014FactSheets/Texas.pdf
National Cancer Institute, State Cancer Profiles
http://statecancerprofiles.cancer.gov/map/map.withimage.php?48&001&001&00&0&01&0&2
&5&0#results
Tarrant County Behavioral Risk Factor Surveillance Survey (BRFSS), 2009/2010
http://www.tarrantcounty.com/ehealth/lib/ehealth/Tarrant_County_BRFSS_20092010.pdf
Tarrantcares.org
2015 United Way Tarrant County Community Assessment
86
HEALTH
INDICATOR:
Chronic and disabling conditions: Cardiovascular (Heart) Disease
ABOUT THE
INDICATOR:
Heart disease refers to a variety of diseases affecting the heart and blood vessels.
Atherosclerosis (plaque buildup in the artery walls) narrows the arteries and leads to blockage,
which, in turn, can lead to a heart attack. Congestive heart failure is a type of heart disease that
occurs when the heart cannot pump enough blood to the rest of the body, due to
atherosclerosis, high blood pressure, a heart defect or other conditions. Stroke (also known as
cerebrovascular disease) occurs when an artery becomes blocked or cuts off blood flow to part
of the brain or when an artery in the brain leaks or ruptures.
(Source: Texas Department of State Health Services, The Health Status of Texas)
The majority of cardiovascular disease (CVD) is caused by risk factors that can be controlled,
treated or modified, such as high blood pressure, cholesterol, overweight/obesity, tobacco use,
lack of physical activity and diabetes. Modifiable stroke risk factors include many of the same
conditions. However, there are some major risk factors that cannot be controlled, including age,
gender, and family history of CHD. Heart disease becomes increasingly common as a person
gets older; the heart muscle undergoes changes. A man is at greater risk of heart disease than a
pre-menopausal woman. Once past menopause, a woman’s risk is similar to a man’s. Risk of
stroke is similar for both men and women. If a first-degree blood relative has had coronary
heart disease or stroke before age 55 (male relative) or 65 (female relative), the risk increases.
In terms of attributable deaths, the leading risk factor is raised blood pressure, followed by
tobacco use, raised blood glucose, physical activities and overweight/obesity. (Source World
Heart Federation)
IMPORTANCE
OF THIS
INDICATOR:
Among Tarrant County adults in 2007, heart disease ranked as the leading cause of death for
both men and women and the condition accounting for the highest number of preventable
hospitalizations in Tarrant County in 2004.
WHAT THE
DATA TELLS
US:
Heart disease was the leading cause of death in the U.S. and Texas (2012) and in Tarrant County
in 2008 (with 2,490 deaths, representing 23% of deaths attributable to a specific cause and a
rate of 202/100,000). Congestive heart failure was ranked the number 1 preventable
hospitalization for Tarrant County (2004). Stroke is the third leading cause of death in Texas
and the fourth in the U.S.; it is also a leading cause of long-term disability. (Source: DSHS, The
Health of Texas 2014)
Cardiovascular disease is lower in Tarrant County than Texas or the U.S. However, these
conditions are disproportionately higher among certain age, ethnic, and employment groups, as
shown below.
Heart disease in Texas declined 28% from 2003-2012 but deaths from congestive heart failure
were higher in Texas than the overall U.S. rate over the past decade. (Source: DSHS, The Health
Status of Texas 2014).
2015 United Way Tarrant County Community Assessment
87
Age-adjusted death rates (per 100,000 pop. from Cerebrovascular Disease (Stroke) and
Cardiovascular (Heart) Disease, Tarrant County 2009-13 compared with Healthy People 2020
Target
Tarrant County
Healthy People 2020 Target
Cerebrovascular disease (stroke)
46.1
34.8
Cardiovascular (heart) disease
173.5
N/A
Source: healthyntexas.org
Cardiovascular disease, Tarrant County, Texas and the U.S., 2009/10
Tarrant County
Texas
U.S.
Heart disease among adults 18+
4.6%
5.1%
6.1%
Cardiovascular disease, selected characteristics, Tarrant County, 2009/2010
High BP
High
Heart
diagnosis
Cholesterol Disease
diagnosis Diagnosis
Overall (among adults 18+)
27.4%
37.7%
4.6%
By Age:
45-54
55-64
>65
By Ethnicity:
White
Black
Hispanic
Other
35.1%
51.8%
60.8%
43.6%
60%
55.8%
5.8%
10.7%
17.6%
28.5%
36.8%
20.3%
18.5%
41.1%
24.9%
36.2%
23.9%
5.4%
2.9%
2.8%
3.9%
By Employment status:
Retired
61.9%
Unable to work
59.2%
Source: Tarrant County BRFSS 2009/2010
58.4%
62.0%
17.7%
18.5%
Trend: Cardiovascular disease, Tarrant County, 2004-2009/10
Risk Factor
2009/10
2004
% change
2004-2009/10
High blood pressure
27.4%
23.1%
14.6%
High cholesterol
37.7%
36.4%
25.2%
Diagnosed heart disease
4.6%
5.5%
N/A
Source: BRFSS 2009/10
SOURCES:
National Heart Blood & Lung Institute http://www.nhlbi.nih.gov/health/health-topics/topics/hd
World Heart Federation http://www.world-heart-federation.org/heart-facts/fact-sheets/
Texas Department of State Health Services, The Health Status of Texas 2014
http://www.dshs.state.tx.us/chs/HealthStatusTexas2014.pdf
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Healthy North Texas, DFWHC Foundation healthyntexas.org
Tarrant County Behavioral Risk Factor Surveillance Survey (BRFSS), 2009/2010
http://www.tarrantcounty.com/ehealth/lib/ehealth/Tarrant_County_BRFSS_20092010.pdf
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HEALTH
INDICATOR:
Chronic and disabling conditions: Diabetes
ABOUT THE
INDICATOR:
Diabetes is a group of conditions involving impaired glucose regulation in the body, which, when left
untreated, results in serious disease and even death. There are two major types of diabetes: Type
1 is characterized by absolute insulin deficiency, a process that destroys the pancreas’ ability to
produce insulin. Onset occurs most often in childhood or adolescence but can occur any time. Type
2, much more common, is characterized by relative insulin deficiency, a progressive disease of
insulin resistance in combination with insulin deficiency. The body may produce some insulin but is
unable to use it properly. Previously called “adult onset”, Type 2 is now being diagnosed more
frequently in children and adolescents. A less common type is gestational diabetes, which occurs
during pregnancy but usually resolves thereafter. Non-modifiable risk factors of type 2 diabetes
include a family history of diabetes and age 45+. People of color have higher risks for diabetes.
Modifiable risk factors include being overweight and limited physical exercise. (Source:
Department of State Health Services, The Health Status of Texas 2014)
IMPORTANCE
OF THIS
INDICATOR:
Diabetes lowers life expectancy by up to 15 years, increases the risk of heart disease by 2 to 4 times,
and is the leading cause of kidney failure, lower limb amputations, and adult-onset blindness.
The rate of diabetes continues to increase in the U.S. and throughout the world. Concern is growing
about the possibility of substantial increases in diabetes-related complications, the possibility that
the increase in number of people with diabetes and the complexity of their care might overwhelm
existing health care systems, the need to take advantage of recent discoveries on the individual and
societal benefits of improved diabetes management and prevention by bringing life-saving
discoveries into wider practice; and the clear need to complement improved diabetes management
strategies with efforts in primary prevention among those at risk for developing diabetes.
Effective therapy can prevent or delay diabetic complications. However, almost 25 percent of
Americans with diabetes are undiagnosed and another 57 million Americans have blood glucose
levels that greatly increase their risk of developing diabetes in the next several years. Few people
receive effective preventive care, which makes diabetes an immense and complex public health
challenge.
Healthy Tarrant County Collaboration established a plan in 2012 which includes a multi-year
initiative, across sectors, to address diabetes and improve population health in Tarrant County. A
goal is to become the first county to implement recommendations in the North Texas Community
Health Collaborative Diabetes Strategic Plan 2012-2015. (Source: Healthy Tarrant County
Collaboration - http://www.healthytarrant.org/the-plan.html)
WHAT THE
DATA TELLS
US:
th
Diabetes is the 7 leading cause of death in the U.S. and Tarrant County. (See also the profile on
Injury and Mortality elsewhere in this Community Assessment.)
Several diabetes-related conditions put it near the top of the list of preventable hospitalizations in
Tarrant County. (See also the profile on Chronic & Disabling Conditions: Preventable
Hospitalizations elsewhere in this report.)
Although diabetes occurs in a lower percentage of Tarrant County residents than Texas and the U.S.,
older adults, African-Americans, and people who are retired/unable to work account for a higher
percentage of those with diabetes.
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Percentage of Population with Diabetes: Tarrant County, Texas, and the U.S., 2009/10
Diagnosed with Diabetes
(among adults 18+)
Tarrant County
8.5%
Texas
9.3%
U.S.
9.1%
By Age:
45-54
12.8%
55-64
20.3%
>65
23 %
By Ethnicity:
White
8.0%
Black
11.8%
Hispanic
8.6%
Other
7.6%
By Employment status:
Retired
23.1%
Unable to work
28%
Source: Tarrant County BRFSS 2009/2010
Trend: Diabetes, Tarrant County, 2012 compared with 2009/10
Risk Factor
2012
2009/10
Diabetes diagnosis
9.6%
8.5%
Sources: Healthyntexas.org (retrieved in 2015 for 2012 figure); Tarrant County BRFSS, 2009/10
SOURCES:
Healthy People 2020
http://www.healthypeople.gov/2020/topicsobjectives2020/ovrview.aspx?topicid=8
Department of State Health Services, The Health Status of Texas 2014
https://www.dshs.state.tx.us/chs/datalist.shtm
Tarrant County Behavioral Risk Factor Surveillance Survey (BRFSS), 2009/2010
http://www.tarrantcounty.com/ehealth/lib/ehealth/Tarrant_County_BRFSS_20092010.pdf
Healthy Tarrant County Collaborative – Plan 2012-15
http://www.healthytarrant.org/the-plan.html
North Texas Community Health Collaborative Diabetes Strategic Plan 2012-15
http://www.healthyntexas.org/index.php?module=InitiativeCenters&func=display&icid=1
Healthy North Texas website, DFWHC Foundation healthyntexas.org
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HEALTH
INDICATOR:
Chronic and disabling conditions: Disabilities
ABOUT THE
INDICATOR:
Disability, as defined by the Americans with Disabilities Act, is an individual’s physical or mental
impairment that substantially limits one or more major life activities of that individual. Studies
consistently find that disability rates rise with age. Beyond age 65, the oldest old (age 85+) are
at highest risk for disease and disability and, among them, disability prevalence increases
rapidly with age. In recent decades, the concept of disability has shifted from an individual,
medical perspective to a social model in which disability is viewed as the result of social and
physical barriers. The International Classification of Functioning, Disability and Health views
both models as valuable and views disability as arising from the interaction of health conditions
and environmental and personal factors. (Source: Older Americans with a Disability 2008-12,
U.S. Census Bureau)
In 2008, the U.S. Census American Community Survey (ACS) changed the way it asks people
about disabilities; therefore, data should not be compared with previous years. [From 20002005, the US Census -American Community Survey- disability estimates represented only the
civilian population age 5+ living in households; in 2006, the ACS expanded to include people
living in Group Quarters (GQ)].
The Survey of Income and Program Participation (SIPP), administered annually by the U.S.
Census, is a nationally representative survey that asks many questions about disabilities. The
percentages will vary from ACS because of the different questions asked. (Source: 2014
Disability Statistics Annual Report)
The Texas Department of Aging & Disability Services (DADS) is responsible for regulating longterm care facilities, agencies, programs and individual providers of long-term care services,
including Adult day care facilities (ADCs), Assisted living facilities (ALFs), Home and community
support services agencies (HCSSAs), Intermediate care facilities for individuals with an
intellectual disability or related conditions (ICFs/IID), Nursing facilities (NFs), Home and
Community-based Services waiver providers (HCS) [Certified, exempt from licensure], and Texas
Home Living waiver providers (TxHmL) [Certified, exempt from licensure].
IMPORTANCE
OF THIS
INDICATOR:
Disability is a multidimensional experience for the person involved, affecting organs or body
parts and participation in areas of life. Impairment might affect Activities of Daily Living (ADLs)–
including bathing, eating, toileting – or Instrumental Activities of Daily Living (IADLs) – including
doing errands, visiting a doctor’s office, etc.
The aging of the baby boomers and the fact that people are living longer means there will be
more people with disabilities in the future.
WHAT THE
DATA TELLS
US:
Quick facts, according to the SIPP (Source: 2014 Disability Statistics):
 About 18% of civilians living in the community reported at least one disabling condition
in 2010. Statistics from the American Community Survey are lower; about 12% in
2013.
 In 2013, of the U.S. population with disabilities, children and youth accounted for only
7.4% (age 5-17) and 0.4% (under age 5), over half (51.9%) were adults age 18-64, and
40% were age 65+.
 In 2013, 33.9% of US civilians with disabilities age 18-64 living in the community were
employed compared to 74.2% for people without disabilities. (Varies by state.)
Employment rates vary by type of disability. Rates are highest for people with hearing
(50.2%) and vision (39.6%) and lowest for people with limitations related to self-care
(15.2%) and independent living (15.3%).
 Almost 30% (28.7%) of Americans with disabilities of working age in 2013 were living in
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poverty compared to the national poverty rate of 13.6%.
American Community Survey figures reflect that, among civilians not living in institutions, the
prevalence of disability is highest among people age 65+ (36-40%). Among those living in group
quarters, the prevalence of disability is highest among those in nursing homes (97.3%), which
reflects the median age of nursing home residents at 83 years. In Tarrant County nursing
homes in 2010, 68% of residents were female, three-quarters were Caucasian, and two-thirds
were over age 75. Unlicensed board and care homes are populated predominantly by younger
adults and include more African-Americans. According to the Long-Term Care Ombudsman
program, younger people in facilities tend to have complex conditions that may be related to
strokes, uncontrolled diabetes, and/or substance abuse.
In the U.S., individual with disabilities were less likely to be employed than those without
disabilities and those who were employed typically held jobs with lower earnings and also
earned less than colleagues with no disability. 2013 calculations determined that, between
2008 and 2010, people with disabilities were only one-third as likely to be employed and people
with disabilities accounted for about 6% of the civilian work force. More than half the workers
with a disability were clustered in four general occupation groups: service workers, except
protective services (18%), administrative support (15%), sales workers (10.4%), and
management/business/finance (8.9%). More than half the workers with disabilities (52%)
earned less than $25,000 the previous year (about 75% of what non-disabled workers earned)
compared with only 38% of workers with no disabilities. (Source: Press release, March 2013.)
Among the older population, ambulatory difficulty (walking or climbing stairs) was the most
frequently reported disability (66.5%), followed by difficulty with independent living (e.g.,
visiting a doctor’s office or shopping) at 47.8% and serious hearing difficulty (40.4%). The order
of these top three types of disability was consistent across older adult age groups, except
among those age 65-74, where the prevalence of hearing difficulty (34.9%) was higher than
difficulty with independent living (34%). Older men stood out with a higher proportion
reporting serious hearing difficulty (52% compared with 32.3% for women). Older women with
disabilities were more likely than older men to have five of the six types of disability. (Source:
Older Americans with a Disability: 2008-12)
Civilian non-institutionalized population with disability, by age, U.S., Texas, and Tarrant
County, 2010
Tarrant
Texas
U.S.
County
Total civilian non-institutionalized
9.9%
11.6%
11.9%
population, % with a disability
Under age 5
0.3%
0.6%
0.8%
Age 5-17
5.0%
5.5%
5.2%
Age 18-64
9.1%
10.1%
10.0%
Age 65+
36.1%
40.6%
36.7%
Source: American Community Survey, 2010 - 1 year estimates.
Individuals with Disabilities and Labor force participants with Disabilities, Tarrant County,
2011
Population Individuals
Disabilities
with Disabilities
Vision
Hearing
AmbulaCognitive Self-care
Ind.
tory
Living
1,838,416
187,080*
37,678 50,199
98,620
70,889
40,129
63,892
Source: People with Disabilities: A Texas Profile, Texas Workforce Investment Council, 2013
*Labor Force participants with disabilities: 60,080
Civilian non-institutionalized population, Type of disability by Age, Tarrant County, Texas,
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and U.S., 2010
Tarrant
County
9.9%
Texas
Total civilian non-institutionalized
11.6%
population, % with a disability
Under age 5, % with disability
0.3%
0.6%
With hearing difficulty
0.2%
0.5%
With vision difficulty
0.3%
0.4%
Age 5-17
5.0%
5.5%
With hearing difficulty
0.6%
0.7%
With vision difficulty
0.7%
0.9%
With cognitive difficulty
3.6%
4.0%
With ambulatory difficulty
0.5%
0.7%
With self-care difficulty
0.7%
1.0%
Age 18-64
9.1%
10.1%
With hearing difficulty
1.9%
2.3%
With vision difficulty
2.2%
2.1%
With cognitive difficulty
3.4%
3.9%
With ambulatory difficulty
4.3%
5.2%
With self-care difficulty
1.5%
2.0%
With independent living difficulty
2.6%
3.3%
Age 65+
36.1%
40.6%
With hearing difficulty
13.8%
16.9%
With vision difficulty
6.7%
8.4%
With cognitive difficulty
8.9%
10.8%
With ambulatory difficulty
23.9%
27.4%
With self-care difficulty
8.5%
10.7%
With independent living difficulty
16.5%
18.1%
Source: American Community Survey, 2010 - 1 year estimates.
U.S.
11.9%
0.8%
0.5%
0.4%
5.2%
0.6%
0.7%
3.9%
0.6%
0.9%
10.0%
2.1%
1.7%
4.2%
5.2%
1.8%
3.5%
36.7%
15.1%
6.9%
9.5%
23.8%
8.8%
16.2%
Population in Group Quarters, Percent with a Disability by Type of Facility, 2006
U.S.
Median
Age
Of people living in group quarters,
49.4%
percentage with a disability
armed forces
4.4%
27.1
adult correctional institutions
28.8%
34.3
nursing facilities
97.3%
83.2
Source: American Community Survey, 2006
Trend: Snapshot* - Long-term care facilities and occupancy numbers by program type, Texas,
2014
Facilities
% of
Occupancy
% of all
facilities
occupants
Adult Day Care
478
11%
22,174
13.4%
Assisted Living Facilities (ALF)
1,771
40.8%
39,435
23.9%
ICF/IID
863
19.9%
8,803
5.3%
Nursing Homes
1,224
28.2%
94,591
57.3%
Total
4,336
165,003
*Snapshot – point in time - from most recent DADS visit
Source: DADS Regulatory Services FY2014, Annual Report
Trend: Long-term care facilities and occupancy numbers by program type*, Texas, 2014
compared to 2010
Adult Day Care
Assisted Living
ICF/IID
NH
Faciliti
OccuFacilitie Occup
FaciliOccupanc Facilitie Occup
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es
pancy
s
ties
2014
478
22,174
1,771
39,435
863
2010
471
20,730
1,615
33,204
858
% change
1.4%
6.9%
9.6%
18.7%
0.5%
*Snapshot from most recent DADS visit
Source: DADS Regulatory Services FY2014, Annual Report
y
s
8,803
10,552
(16.5%)
1,224
1,194
2.5%
94,591
88,432
6.9%
Number of long-term care facilities, Region 03 (19 metroplex counties including Tarrant
County), 2014
Adult Day Care
Assisted Living
ICF/IID
Nursing Home
Total Count
37
512
217
273
1,039
Source: DADS Regulatory Services FY2014, Annual Report
Medicaid beds Occupancy Report (No encumbered report), Tarrant County, August 2015
Occ Beds
Beds
% Full
Occ Days
Bed days
Tarrant County Pre1
1,495
1,833
81.6%
46,369
56,823
Tarrant County Pre2
817
1,174
69.7%
25,370
36,394
Tarrant County Pre3
1,186
1,451
81.8%
36,806
44,981
Tarrant County Pre4
1,580
2,005
78.8%
48,948
62,155
Source: DADS Statewide Occupancy, August 2015
Medicaid Occupancy Report, 6 months, Tarrant County, August 2015
August 2015
6 months Range
Tarrant County Pre1
80.5%
80.5% - 83.8%
Tarrant County Pre2
63.9%
63.0% - 73.6%
Tarrant County Pre3
75.6%
74.3% - 82.3%
Tarrant County Pre4
75.4%
70.0% - 75.4%
Source: DADS Statewide Occupancy, August 2015
Trend: Persons living in Nursing Homes, Assisted Living Facilities and Unlicensed Personal
Care Homes, Demographics, Tarrant County, 2008 compared with 2010
Nursing Homes
Assisted Living
Unlicensed Personal
Facilities
Care Homes
2008
2010
2008
2010
2008
2010
Facilities
68
70
79
81
97
76
Beds
8,687
8739
3,739
3,878
802
516
Residents
6,659
6745
2,818
3,085
573
348
SOURCES:
Female
Male
67%
33%
68%
32%
72%
28%
70%
30%
46%
54%
43%
57%
AfricanAmerican
Asian
Caucasian
Hispanic
15%
16%
6%
6%
36%
22%
1%
78%
6%
1%
76%
7%
0%
93%
1%
1%
90%
2%
1%
58%
5%
2%
71%
5%
Age 19-24
25-59
60-74
75-84
86+
0%
8%
15%
32%
33%
0
13%
23%
32%
32%
0%
4%
20%
33%
43%
0%
9%
16%
31%
44%
2%
78%
6%
5%
12%
2%
59%
16%
11%
12%
Older Americans With a Disability 2008-2012, American Community Survey Reports, U.S.,
Department of Health & Human Services, and U.S. Department of Commerce/Census Bureau,
December 2014.
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https://www.census.gov/content/dam/Census/library/publications/2014/acs/acs-29.pdf
2014 Disability Statistics Annual Report, University of New Hampshire
http://www.disabilitycompendium.org/docs/default-source/2014-compendium/annualreport.pdf
People with Disabilities: A Texas Profile, Texas Workforce Investment Council, April 2013
Texas Department of Aging and Disability Services (DADS) Regulatory Services
FY2014 Annual Report https://www.dads.state.tx.us/providers/reports/sb190/index.html
Statewide Occupancy, August 2015
https://www.dads.state.tx.us/providers/reports/occupancy/2015/Occupancy_August_15.pdf
Press release: Workers with a Disability Less Likely to be Employed, More Likely to Hold Jobs
with Lower Earnings, Census Bureau Reports. , March 14, 2013
http://www.census.gov/newsroom/press-releases/2013/cb13-47.html
Brault, Matthew, Disability Status and Characteristics of People in Group Quarters, American
Community Survey, February 2008.
http://factfinder2.census.gov/faces/tableserves/jsf/pages/productview.xhtml?pic=ACS_10_1YR
_S1810&prodType=table – and same S1811
Long-term Care Ombudsman Program, Mental Health America (Tarrant County), 2008 and 2010
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HEALTH
INDICATOR:
Chronic and disabling conditions: Multiple Sclerosis
ABOUT THE
INDICATOR:
Multiple sclerosis (MS) is an unpredictable, often disabling disease of the central nervous system that
disrupts the flow of information within the brain, and between the brain and body.
MS involves an immune-mediated process in which an abnormal response of the body’s immune system is
directed against the central nervous system (CNS), which is made up of the brain, spinal cord and optic
nerves. The exact antigen — or target that the immune cells are sensitized to attack — remains unknown,
which is why MS is considered by many experts to be "immune-mediated" rather than "autoimmune."
People with MS typically experience one of four courses of the disease – which may be mild, moderate or
severe;

Relapsing-remitting MS (RRMS) - the most common disease course — is characterized by clearly
defined attacks of worsening neurologic function. These attacks - also called relapses, flare-ups
or exacerbations - are followed by partial or complete recovery periods (remissions), during
which symptoms improve partially or completely and there is no apparent progression of disease.
Approximately 85 percent of people with MS are initially diagnosed with relapsing-remitting MS.

Secondary-progressive MS (SPMS) follows after the relapsing-remitting course. Most people who
are initially diagnosed with RRMS will eventually transition to SPMS, which means that the
disease will begin to progress more steadily (although not necessarily more quickly), with or
without relapses.

Primary-progressive MS (PPMS) is characterized by steadily worsening neurologic function from
the beginning. Although the rate of progression may vary over time with occasional plateaus and
temporary, minor improvements, there are no distinct relapses or remissions. About 10 percent
of people with MS are diagnosed with PPMS.

Progressive-relapsing MS (PRMS), the least common of the four disease courses, is characterized
by steadily progressing disease from the beginning and occasional exacerbations along the way.
People with this form of MS may or may not experience some recovery following these attacks;
the disease continues to progress without remissions.
Most of the available disease-modifying therapies used to treat MS are approved by the U.S. Food and
Drug Administration (FDA) to treat “relapsing forms” of MS, which include RRMS, SPMS, and PRMS in
those individuals who continue to experience relapses. People who have PPMS, SPMS, or PRMS without
relapses, have “progressive MS.” Scientists around the world are actively working to find effective
treatments for progressive forms of MS. And, addressing the challenges of progressive MS is a primary
target of the Society’s research strategy to stop MS, restore function and end MS forever.
IMPORTANCE
OF THIS
INDICATOR:
In 2004, in response to community concerns, Texas Department of State Health Services conducted a
multi-county Multiple Sclerosis Pilot Surveillance study of multiple sclerosis of 19 North Texas Counties, of
which Lubbock was the only urban area. It entailed reviewing 224 case records of neurologists practicing
in the area. Texas Medicine reports that the Texas Department of State Health Services extended a
prevalence study of multiple sclerosis (MS) in a 19-county area in North Texas to include 3 additional years
of data and included a new geographic area with a predominantly Hispanic population (El Paso County).
Patients in whom MS was diagnosed by a neurologist, who resided in the study areas, and who had an
office visit between 1998 and 2003 were included in the study.
WHAT THE
Selected results of the initial study:
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DATA TELLS US:
1. Texas has one of the lowest reported MS prevalences in the United States.
2. The results of this pilot project support an apparent regional difference in MS prevalence across the
United States.
3. The overall age distribution for age-specific prevalences in the 19-county study area is similar to that
reported in the NHIS data, although the Texas data indicate a substantially lower prevalence in each of the
age groups.
4. The difference in the sex-specific prevalences in Texas is higher than reported in the national studies:
four-fold versus two-fold.
5. There are no published national prevalence estimates for Hispanics that will allow comparison with the
pilot data.
Results of the 6 years of study:
The 6-year MS prevalence estimate for the North Texas counties was 71.5 per 100,000, and for El Paso
County it was 49.4 per 100,000. In both areas, prevalence estimates were higher for females, age groups
40 to 49 and 50 to 59, and for non-Hispanic whites. These estimates provide valuable information about
the epidemiology of MS in Texas and allow for a comparison with national estimates. The results also
provide much needed prevalence data for the Hispanic population.
SOURCES:
National Multiple Sclerosis Society
http://www.nationalmssociety.org/What-is-MS/Definition-of-MS
Texas Medicine, June 2009
http://www.texmed.org/Template.aspx?id=7660
Texas Department of State Health Services
2012; 2004
http://www.dshs.state.tx.us/Layouts/ContentPage.aspx?PageID=34558&id=5054&terms=multiple+scleros
is
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HEALTH
INDICATOR:
Chronic and disabling conditions: Preventable Hospitalizations
ABOUT THE
INDICATOR:
Hospitalizations for the conditions below are considered “potentially preventable”, because if the
individual had access to and cooperated with appropriate outpatient healthcare, the
hospitalization would likely not have occurred.
IMPORTANCE
OF THIS
INDICATOR:
Lack of access to healthcare continues to cost Tarrant County adults billions of dollars in
preventable hospitalizations.
WHAT THE
DATA TELLS
US:
Although the number of preventable hospitalizations increased by 22% (from 77,022 to 93,586)
between the two five year periods (2006-10 and 2008-13), the total hospital charges increased by
41% (from $2,196.8 million to $3,105.8 million).
Trend: Adult Potentially Preventable Hospitalizations, Tarrant County, 2008-13 compared with
2006-2010
Condition:
Average hospital
charge
2008-13
2006-10
Hospital charges
($ millions)
2008-13
2006-10
Congestive Heart
Failure
Bacterial
Pneumonia
Chronic
Obstructive
Pulmonary
Disease (COPD)
19,940
17,067
$40,835
$31,285
$814.2
$533.9
18,225
16,550
$35,654
$30,802
$649.8
$509.7
17,188
9,847
$31,532
$30,335
$541.9
$298.7
Urinary Tract
Infection
Diabetes (Longterm
complications)
Asthma
13,361
10,175
$24,544
$21,753
$327.9
$221.3
8,870
6,751
$42,928
$37,894
$380.7
$255.8
Not reported
4,950
5,174
$23,933
$18,697
Not reported
$105.1
$123.8
3.261
Not reported
$21,240
Diabetes (Shortterm
complications
Hypertension
5,519
5,519
$25,977
$24,328
$143.3
$92.5
4,637
3.416
$25,597
$22,732
$118.6
$77.7
Angina (without
Procedures)
Total
896
976
$26,703
$22,015
$ 23.9
$21.5
93,586
77,022
$33,187
$26,377
$3,105.8
$2, 195.8
Dehydration
% CHANGE
SOURCE:
Number of
hospitalizations
2008-13
2006-10
22%
26%
$60.9
44%
Texas Department of State Health Services
For 2008-13: http://www.dshs.state.tx.us/ph/county.shtm Per site update: 1/20/15.
For 2006-10, Tarrant County data by special request
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HEALTH
INDICATOR:
Chronic and disabling conditions: Sickle Cell Anemia
ABOUT THE
INDICATOR:
Sickle Cell is a group of inherited blood disorders that affect a person's red blood cells
caused by a change in the genes that make hemoglobin which helps the blood cells carry
oxygen to different parts of the body. Sickle Cell disease is a lifelong illness that can result
in serious health problems. Sickle cell anemia is most commonly found in persons of
African, Arabian, Asian Indian, Mediterranean origin and Hispanics from the Caribbean, and
Central and South America. People with sickle cell trait will not get sickle cell disease, but
they carry a gene that could affect their children. If both parents carry the sickle cell trait,
each child has a 1 in 4 (25%) chance of having sickle cell anemia. Individuals with sickle cell
trait may have problems with extreme exertion. (Source: Cook Children’s)
The sickle-shaped (C) cells can block veins, causing damage to organs, and can also cause
mild to severe and sometimes excruciating pain for the patient. Sickle cells also have a
shorter lifecycle, which results in anemia because the body cannot regenerate new cells fast
enough. Some common types of sickle cell disease include Sickle Cell Anemia, Sickle
Hemoglobin C disease, and Sickle Beta Thalassemia. Early treatment is essential.
Stroke among children with sickle cell disease is a major risk. Testing and diagnosis include
newborn screening, genetic testing, complete blood count and hemoglobin electrophoresis.
Treatment includes antibiotics, pain management, medication to improve the red blood
cells, blood transfusions, or surgery. The most advanced treatment is stem cell
transplantation, for which the best donors are full siblings. (Source: Cook Children’s)
Early treatment can prevent serious complications such as growth problems, developmental
delays, deafness or blindness, intellectual disability, seizures or even early death. (Source:
Department of State Health Services)
IMPORTANCE All newborn babies in the United States are tested for sickle cell disease, despite race or
ethnic background. Infection is the major cause of death in children with sickle cell anemia.
OF THIS
INDICATOR:
According to the American Sickle Cell Anemia Association, about 8% of the general AfricanAmerican population in the U.S. has the trait. Although newborns are tested, by the time
children reach high school, they may be unaware of their condition, so testing at that point
is important. When children turn 18, their access to health care changes and they might
begin using emergency rooms to treat pain. Without consistent care, their organs may be
damaged. Today, many patients with sickle cell disease live into their forties.
WHAT THE
DATA TELLS
US:
The Sickle Cell Anemia Association of America Fort Worth Chapter served an estimated 500
people in FY2013 (same as for 2011) and projected 400 for FY2014. Services included
education, testing for those of child-bearing years, financial assistance, and access to health
care through a JPS clinic specifically for patients managing sickle cell disease.
Cook Children’s serves approximately 300 children/year in its Sickle Cell programs (Source;
cookchildrens.org )
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Statistics pertaining to Sickle Cell Disease, Tarrant County, 2013 compared to 2009-10
2013
Number of births (for newborn screening)
Tarrant County total population
# African-American
Est. number of African-Americans with sickle cell trait (8%)
27,829
2010
1,911,541
29,060
(2009)
1,800,034
303,935
(15.9%)
24,314
268,205
(14.9%)
21,456
(Source: Births – DSHS; population – U.S. Census)
SOURCES:
Cook Children’s
http://www.cookchildrens.org/SpecialtyServices/HematologyOncology/HematologyPrograms/Pages/Sickle-cell.aspx
Texas Department of State Health Services
Newborn screening: https://www.dshs.state.tx.us/newborn/nbs.shtm
http://www.dshs.state.tx.us/layouts/contentpage.aspx?pageid=29480&id=2444&terms=sick
le
Births: https://www.dshs.state.tx.us/chs/vstat/vs13/data.aspx#birth
American Sickle Cell Anemia Association
http://www.ascaa.org/research.php - 2012
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HEALTH
INDICATOR:
Chronic and Disabling Conditions: Veterans
ABOUT THE
INDICATOR:
The U.S. developed an All-Volunteer Force (AVF) in 1973. There have been a number of campaigns.
Women are now given access to most professional jobs, including combat. Post-9/11 veterans now face
conditions such as post-traumatic stress disorder as well as physical injury and disability.
IMPORTANCE OF
THIS INDICATOR:
Veterans may be provided services through the Veterans Administration (VA), particularly if they have a
disability that has been linked to their service (called “service-connected”). Services may include health
care, disability compensation, home loans, education, dependents’ education, employment,
rehabilitation, vocational training, trauma counseling, insurance, burial, and others.
The VA works continuously to address the backlog of claims for disability and pension claims. The backlog
exploded in 2010 after the VA expanded the list of illnesses presumed to have been caused by Agent
Orange, which pumped more than a quarter million claims into the system. The bottleneck grew
exponentially when combined with other factors, such as veterans returning from Iraq and Afghanistan.
The VA has also been working to end veteran homelessness by getting the chronically homeless into
housing with vouchers that subsidize most or all of the rent and providing counseling, healthcare and
other benefits. (Source: “For VA, it’s two steps forward, one back”, Star-Telegram, November 11, 2015.)
WHAT THE DATA
TELLS US:
In 2014, Texas had the second highest population of veterans in the nation.
As of November 28, 2015, the Department of Veterans Affairs had 12,751 claims pending in the Waco
office with an average of almost a year - 322 days - pending. In addition there were 19,524 appeals
pending at that office.
The Department of Veterans Affairs’ annual survey of homelessness and formerly homeless veterans
th
shows that legal issues account for three of the top 10 unmet needs. Texas ranks 50 in access to Legal
Aid lawyers, with only 1 per 11,000 qualifying Texans. (Source: “Texas Vets deserve access to Justice
System”, Nathan Hecht & Thomas Palladino, November 6, 2014.)
According to the 2015 Veterans Civic Health Index (and the census data in the table below):





The veteran unemployment rate has been below the non-veteran rate every year for the past
decade;
Veterans have consistently earned more than non-veterans from 2005-13;
Veterans comprise only 8.6% of the homeless population;
Only 11-20% of veterans experience Post-Traumatic Stress Disorder (PTSD). The vast majority of
veterans do not experience PTSD.
Four-year college completion rates are lower among veterans (28.1%) than non-veterans
(33.2%). However, veterans participating in the GI Bill are completing degree programs at a rate
(48%) similar to traditional beginning post-secondary students in the general population (49%).
A United Way of Tarrant County “2013 Veterans Fund: A Rapid Analysis of the Needs of Returning
Veterans” identified priorities for services to veterans returning from deployment in the years since
9/11/2001. Among those were the need to be able to identify and connect with returning veterans, to
assesses holistically their mental health and family needs, including employment skills and educational
aspirations, to assist them in learning or re-learning ways of behavior appropriate to a civilian
environment, to create a system of strong community supports as veterans acculturate into civilian life,
and to educate community service providers, educators and faith-based leaders about the needs of
service personnel and benefits available to equip them to offer practical solutions and support. Building
2015 United Way Tarrant County Community Assessment
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on the Peer-to-Peer concept to create mentors in the business, education and faith-based communities
seems to have great potential.
Veteran Population, Texas, as of 9/30/14
Veteran Population
Wartime Veterans
Gulf War
Vietnam Era
Korean Conflict
World War II
Peacetime
Benefits:
Number vets receiving Disability Compensation
Number vets receiving Pensions
Number of Dependency & Indemnity
Compensation Beneficiaries
Number of Death Pension Beneficiaries
Health Care
Enrollees in VA Health Care System
Unique Patients Treated
Source: VA.gov/vetdata/Veteran_Population.asp
1,680,418
1,309,440
655,430
541,730
116,959
59,694
370,978
Female
177,074
Over 65
663,000
367,020
22,880
35,161
15,019
708,430
446,227
Veterans compared to non-veterans, Texas and Tarrant County, 2009-2013 5-year Estimates (2015)
Texas
Tarrant County
Civilian population 18+
Vets as % of civilian pop
Period of Service:
Total
Veterans
Non-vets
Total
Veterans
Non-vets
18,612,749
1,583,272
17,029,477
1,333,730
118,263
1,215,467
Gulf War (9/2001 or later)
Gulf war (8/1990 to 8/2001)
Vietnam era
Korean War veterans
World War II veterans
8.5%
8.9%
14.9%
21.3%
35.1%
9.6%
6.6%
14.9%
11.4%
35.0%
8.3%
6.0%
Sex:
Male
Female
48.9%
51.1%
91.3%
8.7%
45%
55%
48.2%
51.8%
91.3%
8.7%
44.0%
56.0%
33.6%
37.2%
14.5%
8.4%
6.3%
11.0%
28.4%
22.7%
19.6%
18.3%
35.7%
38.0%
13.8%
7.4%
5.2%
33.5%
39.4%
14.2%
7.5%
5.4%
10.5%
32.1%
23.0%
18.6%
15.8%
35.8%
40.1%
13.3%
6.4%
4.4%
98.3%
98.3%
98.3%
98.2%
98.5%
87.2%
75.5%
11.6%
0.5%
4.1%
0.1%
81.5%
12.8%
0.6%
0.8%
0.1%
74.9%
11.5%
0.5%
4.4%
0.1%
72.1%
14.4%
0.5%
4.9%
0.2%
80.3%
14.8%
0.5%
1.3%
0.2%
71.3%
14.3%
0.6%
5.3%
0.2%
Age:
18-34
35-54
55-64
65-74
75+
Race, Hispanic Origin:
One race
White
Black/African-American
Am.Indian/Alaskan
Asian
Nat.Hawaiian/Pacific
Islander
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103
Some other race
6.5%
Two+ races
1.7%
Hispanic/Latino (any race)
34.1%
White alone, not Hisp
48.9%
Median Income past 12 months:
2.4%
1.7%
16.5%
68.2%
6.9%
1.7%
35.7%
47.2%
6.1%
1.8%
23.2%
55.9%
1.5%
1.5%
8.9%
73.4%
6.6%
1.8%
24.6%
54.1%
All
Male
Female
$26,190
$39,737
40,423
33,322
$25,113
30,909
20,701
$30,028
$45,011
45,885
36,372
$28,302
34,563
23,656
16,017,956
18.9%
25.4%
29.1%
26.6%
1,552,007
7.0%
24.3%
40.0%
28.7%
14,465,949
20.2%
25.5%
27.9%
26.4%
1,157,643
15.5%
23.9%
31.2%
29.5%
116,006
4.7%
22.1%
41.2%
32%
1,041,637
16.7%
24.1%
30.0%
29.2%
16,017,956
1,552,007
14,465,949
1,161,910
77,630
1,084,280
75.2%
77.3%
75.1%
79.1%
82.4%
78.9%
11,939,143
7.9%
759,788
7.3%
11,179,355
8.0%
919,363
8.2%
63,929
7.1%
855,434
8.2%
18,123,022
1,550,493
16,572,529
1,314,603
116,739
1,197,864
14.8%
6.8%
15.6%
12.5%
5.8%
13.2%
18,123,022
1,550,493
16,572,529
1,314,603
116,739
1,197,864
14.4%
26.5%
13.3%
12.5%
22.8%
11.5%
EDUCATIONAL ATTAINMENT
Civilian pop. age 25+
Less than HS graduate
HS graduate (incl equiv.)
Some college/assoc. degree
Bachelor degree or higher
EMPLOYMENT STATUS
Civilian population 18-64
years
Labor force participation
rate
Civilian labor force 18-64
Unemployment rate
POVERTY STATUS LAST 12 MO
Civilian population 18+ (for
whom poverty status is
determined)
Below poverty last 12 mo.
DISABILITY STATUS
Civilian population 18+ (for
whom poverty status is
determined)
With any disability
SERVICE-CONNECTED DISABILITY RATING STATUS
Total veterans 18 yrs+
No service-connected
disability rating
Has a service-connected
disability rating
0%
10% or 20%
30 or 40%
50 or 60%
70%+
Rating not reported
1,583,272
1,269,713
118,263
97,623
313,559
20,650
16,592
100,010
54,976
37,931
82,677
21,373
1,101
7,842
4,074
2,029
4,206
1,388
Source: U.S. Census, American FactFinder, 2009-2013 Estimates, 2015)
SOURCES:
“Texas Vets deserve access to Justice System”, Op-ed by Nathan Hecht and Thomas Palladino, StarTelegram, November 6, 2014.
“For VA, it’s two steps forward, one back”, Star-Telegram, November 11, 2015
U.S. Census, American FactFinder 2009-2013 Estimates
http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=CF
Texas Veteran Civic Index, 2015, http://ncoc.net/VetsCHI2015
Veterans Administration www.VA.gov/vetdata/Veteran_Population.asp
Veterans Administration – Claims Backlog, November 30, 2015 report -VBA Monday Morning Workload
Sheet, TA Regional Office
2015 United Way Tarrant County Community Assessment
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2013 Veterans Fund: A Rapid Analysis of the Needs of Returning Veterans, United Way of Tarrant County,
2013
2015 United Way Tarrant County Community Assessment
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HEALTH
INDICATOR:
Communicable Diseases
ABOUT THE
INDICATOR:
Public health entities are required to report incidences of certain communicable diseases.
IMPORTANC
E OF THIS
INDICATOR:
Chlamydia, syphilis (which includes primary, secondary and early latent phases) and
gonorrhea are all caused by bacterial infections during sexual contact and can also be
transmitted by a mother to her baby during pregnancy or delivery.
WHAT THE
DATA TELLS
US:
Sexually transmitted diseases, specifically chlamydia, gonorrhea, and early syphilis, continue
to be among the top communicable diseases in Tarrant County. The rate of chlamydia
increased from 2010 to 2012. Shigellosis, aseptic meningitis, and pertussis (whooping cough)
dropped in ranking. Campybacterioris (a diarrheal illness) and West Nile Fever moved up to
the top 10 list in 2012.
Vaccine has dramatically reduced some communicable diseases, such as varicella (chicken
pox).
HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). There is no cure
for AIDS. In Texas about three-quarters of persons with HIV are infected by sexual contact
with an infected person and about 22% acquire infection by sharing needles or syringes with
an infected person. With more people living longer, the number of people living with HIV in
Texas (76,621 in 2013) has been slowly increasing. The number of deaths in Texas resulting
from HIV infection has slowly decreased (to 693 in 2012) since its peak in the mid-nineties.
(Source: The Health Status of Texas 2014)
Top 10 Leading Communicable Diseases, Tarrant County, 2012 compared with 2007-10
2012
2010
Trend
# of cases
Rate per
Rate
100,000
2010
population
1
Chlamydia
8,515
443.3
435.2
2
Gonorrhea
2,176
113.3
138.4
3
Salmonellosis
340
17.7
19.9
4
Early syphilis
301
15.7
14.2
Shigellosis
Not listed
13.7
Aseptic Meningitis
Not listed
11.9
5
Varicella (chicken
208
10.8
11.1
pox)
6
Campylobacteriosis
204
10.6
Not listed
7
HIV
189
9.8
11.3
8
West Nile Fever
179
9.3
Not listed
9
Pertussis
162
8.4
15.5
10
S. pneumonia, inv
153
8.0
10.4
Source: Communicable Diseases 2012, Tarrant County Public Health
Trend: HIV and AIDS diagnoses by county of residence, Tarrant County, 2014 compared
with 2008
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2014
2008
HIV diagnoses
230
269
AIDS diagnoses
137
148
Source: Texas 2014 HIV Surveillance Report
Change
(14.5%)
(7.4%)
Trend
People living with HIV and Cumulative Diagnoses by County of Residence, Tarrant County,
through December 31, 2014
People living with HIV
Cumulative HIV
Diagnoses
Cases
Rate per
Cases
100,000 pop,
Tarrant County
4,806
247.1
7,514
Source: Texas 2014 HIV Surveillance Report
HIV and AIDS Diagnosis by City of Residence, Tarrant County, 2014
City of residence
HIV
AIDS
Fort Worth
122
83
Arlington
60
34
Euless
10
6
Texas
4,406
2,089
Selected communicable diseases, Number of cases and rate (per 100,000 population), Fort
Worth, Arlington, Euless, 2012 compared with 2010
Fort Worth
Arlington
Euless
2012
2010
2012
2010
2012
2010
Chlamydia
Rate
4,741
639.6
4,505
611.9
1,823
498.9
1,738
468.9
240
468
196
358.3
Gonorrhea
Rate
1,389
187.4
1,582
214.9
423
115.8
551
148.7
56
109.2
53
96.9
Salmonellosis
Rate
119
16.1
140
19
75
20.5
57
15.4
15
29.3
11
20.1
Early syphilis
180
173
55
47
12
7
Rate
24.3
23.5
15.1
12.7
23.4
12.8
Source: Communicable Disease Reports, 2012 and 2010, Tarrant County Public Health
SOURCES:
Tarrant County Public Health:
Communicable Diseases, Tarrant County, 2012
http://access.tarrantcounty.com/content/dam/main/publichealth/2013.08.10_2012_Comm_Dis_Full_Report_FINAL.pdf
Communicable Diseases, Tarrant County, 2010
http://access.tarrantcounty.com/content/dam/main/publichealth/2010_Communicable_Disease_Report.pdf
Texas HIV Surveillance Report, 2014 Annual Report, Texas State Health Services
Https://www.dshs.state.tx.us/hivstd/reports/
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HEALTH
INDICATOR:
Health Care Access
ABOUT THE
INDICATOR:
This indicator shows the percentage of adults age 18-64 and percentage of children 0-17
that have no type of health insurance.
IMPORTANCE OF
THIS INDICATOR:
Medical costs in the United States are extremely high, so people without health insurance
may not be able to afford medical treatment or prescription drugs. They are also less likely
to get routine checkups and screenings, so if they do become ill they will not seek
treatment until the condition is more advanced and therefore more difficult and costly to
treat. Many small businesses are unable to offer health insurance to employees due to
rising health insurance premiums. Children with health insurance are more likely to have
better health throughout their childhood and adolescence. They are more likely to receive
required immunizations, fall ill less frequently, obtain necessary treatment when they do
get sick, and perform better at school. Having health insurance lowers barriers to accessing
care, which is likely to prevent the development of more serious illnesses. This is not only of
benefit to the child but also helps lower overall family health costs. (Source:
healthyntexas.org)
The federal Bureau of Primary Health Care (BPHC) funds Health Centers in underserved
communities, providing access to high quality, family oriented, comprehensive primary and
preventive health care for people who are low-income, uninsured or face other obstacles to
getting health care. In Tarrant County, the North Texas Community Health Center, Inc.
(CHC), formerly known as the Albert Galvan Clinic, reports under this designation as a
federally-qualified health center (FQHC).
The federal Patient Protection and Affordable Care Act, signed into law in 2010, has two
parts: the Patient Protection and Affordable Care Act and the Health Care and Education
Reconciliation Act. The Act ensures that all Americans have access to quality, affordable
health care and will create the transformation within the health care system necessary to
contain costs. The Congressional Budget Office (CBO) has determined that the Patient
Protection and Affordable Care Act is fully paid for, will provide coverage to more than 94%
of Americans while staying under the $900 billion limit that President Obama established,
bending the health care cost curve, and reducing the deficit over the next ten years and
beyond. The Patient Protection and Affordable Care Act contains nine titles, each
addressing an essential component of reform:  Quality, affordable health care for all
Americans  The role of public programs  Improving the quality and efficiency of health
care  Prevention of chronic disease and improving public health  Health care workforce 
Transparency and program integrity  Improving access to innovative medical therapies 
Community living assistance services and supports  Revenue provisions (Source:
Democratic Policy Committee
http://www.dpc.senate.gov/healthreformbill/healthbill04.pdf)
WHAT THE DATA
TELLS US:
The percentage of adults and children without health insurance has decreased from
2010 to 2015, as more children have been enrolled in Medicaid and the Children’s
Health Insurance Plan (CHIP) and with the availability of the federal Affordable Care
Act. However, in 2015, Texas still has the highest uninsured rate in the nation
2015 United Way Tarrant County Community Assessment
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Marketplace Signups and Tax Credits in Texas:

85% of Texas consumers who were signed up qualified for an average tax credit of
$239/month through the Marketplace;
 68% of Texas Marketplace enrollees obtained coverage for $100 or less after any
applicable tax credits in 2015 and 92% had the option of doing so.
 469,797 Texas consumers under age 35 are signed up for Marketplace coverage
(39% of plan selections in the state)
 348,593 Texas consumers 18-34 (29% of all plan selections are signed up for
Marketplace coverage)
Source: HHS.gov /healthcare/facts-and-features/state-by-state/how –aca-is-working-fortexas/index.html
Consumers enrolled in coverage through the Marketplace, Texas and the U.S., 2015
Texas
U.S.
Consumers who selected or were
1,205,174
11.7 million
automatically enrolled in coverage through (through Feb 22/15)
(approx.)
the Marketplace
Source: HHS.gov – October 20, 2015
Trend: People without health insurance, Tarrant County and Texas, 2015 compared to
2010
Tarrant County
Texas
2013
2010
Change
2013
Adults & children (0-64) without
21%
27.6%
24.8%
health insurance
Children (0-18) without health
10.1%
13.5%
12.7%
insurance
Source: http://healthdata.dshs.texas.gov/HealthFactsProfiles
Trend: Enrollment Rate in Children’s Medicaid and CHIP, Tarrant County
2013 compared with 2010
2013
2010
Medicaid (Children 0-18)
Children’s Health Insurance Plan (CHIP) –(018)
Source: www.Kidscount .org, 2015
32.9%
8.4%
9.6%
7.2%
Health Coverage by Type, Tarrant County, 1-year estimates, 2014
Number Insured by
coverage type
Total population
1,929,342
Number insured, by coverage type
1,586,590
Private insurance
1,228,750
Employer-based health insurance
1,029,100
Direct-purchase health insurance
203,946
TRICARE Military health
51,814
Public coverage
2015 United Way Tarrant County Community Assessment
499,479
Percent insured
by coverage type
82.2%
63.7%
53.3%
10.6%
2.7%
25.9%
109
Medicare coverage
Medicaid means-tested public coverage
VA Health Care
218,824
300,422
36.179
11.3%
15.6%
1.9%
Uninsured
342,752
17.8%
Source: American Community Survey, 2014 – 1 year estimates
http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk
2-1-1 Top 5 Requested Health Care Needs, Tarrant County, 2014
Prescription expense assistance
729
Dental care
598
Aging & Disability Resource Centers
398
Eye care (glasses, contacts, exams)
203
Community/Public Clinics
198
Total Top 5 Needs
1,063
Source: 2-1-1 Texas at United Way, 2014 Annual Report
North Texas Community Health Center, 2014 compared with 2012
Patients by type of insurance, 2014 compared with 2012
2014
2012
Total patients
11,720 10,782
Medicaid/CHIP/other
11.8%
23.6%
public
Medicare
3.1%
3.1%
Private Insurance
54.3%
5.4%
No insurance
30.8%
67.9%
Patients served by age, North Texas Community Health Center, 2014
2014
2012
Age 0-17
10.4%
15.1%
Age 18-64
85%
79.6%
Age 65+
4.5%
5.2%
Total Patients
11,720 10,782
Patients by race/ethnicity, North Texas Community Health Center, 2014 compared to 2012
2014
2012
White, non-hispanic
5.9%
12.9%
Hispanic/Latino ethnicity
94.2% 87.1%
Black/African-American
4.1%
4.6%
Asian
0.2%
0.3%
More than 1 race
0.1%
5.7%
Patients served in language other than English, North Texas Community Health Center,
2014 compared with 2012
2014
2012
6,205
7,498
52.9%
69.5%
2015 United Way Tarrant County Community Assessment
110
Patients, special characteristics, North Texas Community Health Center, 2014 compared
with 2012
2014 2012
Agricultural workers or dependents
0.3% 0.3%
Total homeless
0.4% 1.7%
Total veterans
0.1% 0.2%
Total public housing patient
0.2% Patients, Income status, North Texas Community Health Center, 2014 compared with 2012
2014
2012
at or below 200% of poverty
98.2%
99.5%
At or below 100% of poverty
80.1%
95.9%
Selected diagnoses, North Texas Community Health Center, 2014 compared with 2012
Condition
% of Patients with
medical conditions
Hypertension
Diabetes
Asthma
HIV
2014
2012
19.0%
13.5%
1.5%
0
20.1%
11.6%
1.9%
0
Number
Number
Prenatal patients
263
371
Prenatal who delivered
152
176
Source: Bureau of Public Health Centers , North Texas Community Health Center
SOURCES
Detailed Summary, The Patient Protection and Affordable Care Act, Democratic Policy
Committee http://www.dpc.senate.gov/healthreformbill/healthbill04.pdf)
“5 Years Later: How the Affordable Care Act is Working for Texas”, HHS.gov
http://www.hhs.gov/healthcare/facts-and-features/state-by-state/how –aca-is-workingfor-texas/index.html
Uniform Data System Reports, North Texas Community Health Center, 2014 and 2012.
Available at http://bphc.hrsa.gov/uds/datacenter.aspx?q=d
Texas Department of State Health Services. Health Facts Profiles, Tarrant County, 2013
http://healthdata.dshs.texas.gov/HealthFactsProfiles
American Community Survey, 2014 1-year Estimates
http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk
2015 County Health Rankings (2012 data)
http://www.countyhealthrankings.org/app/texas/2015/measure/factors/85/data
2015 United Way Tarrant County Community Assessment
111
Center for Public Policy Priorities, “New Census Data show Texas’ Uninsured Rate Tops
Nation”, September 13, 2011.
www.cppp.org/files/091311_PovertyDay_policyPatge_HealthIns.pdf
Tarrant County Public Health www.healthyntexas.org
2015 United Way Tarrant County Community Assessment
112
HEALTH
INDICATOR:
Health Disparities
ABOUT THE
INDICATOR:
Disparity refers to differences that occur by gender, race or ethnicity, education or income,
disability, living in rural localities and sexual orientation (Dept. of Health and Human Services
Healthy People 2010, 2000) to the overall rate of disease incidence, prevalence, morbidity,
mortality or survival rates. (Minority Health and Health Disparities Research and Education Act
of 2000).
The Texas Health Disparities Task Force, 2008 found “. . . there is a significant disparity in the
overall rate of disease incidence, prevalence, morbidity, mortality, or survival rates in the
population as compared to the health status of the general population. ..Health disparities
primarily affect African Americans, Hispanics, those in geographically underserved regions, and
low‐income individuals and families. “
IMPORTANCE
OF THIS
INDICATOR:
There have been recent developments in this field.
In 2011, the Texas Legislature, through SB 501, created the Center for Elimination of
Disproportionality and Disparities and designated it as the Texas State Office of Minority
Health. The center's mission is to partner with health and human services agencies, external
stakeholders, other systems, and communities to identify and eliminate disproportionality and
disparities affecting children, families, and disparately impacted individuals. The Center works
to identify the systemic factors and practice improvements that address the disproportionate
representation and disparate outcomes for children, families, and disparately impacted
individuals in the state's health and human services programs. The center includes the State
Office of Minority Health and Health Equity, the Office of Border Affairs, and Equity and
Inclusion with regional equity specialists throughout Texas. The Center grounds its work in the
Texas Model, which comprises 5 components: advancing data-driven strategies, collaborating
across systems, engaging communities, promoting work defined by race equity principles, and
evaluation and transformation.
In 2005 The National Center on Health and Health Disparities (NCMHD) awarded the University
of North Texas Health Science Center a $7.25 million five year grant entitled “Texas Center for
Minority Health, Education, Research and Outreach” to establish and run a comprehensive
center of Excellence in Partnerships for Community Outreach, Research on Health Disparities
and Training (EXPORT). UNTHSC has been a leader among the health science centers in Texas
in training minority biomedical scientists and in developing innovative programs specifically
tailored to Texas minority populations. As part of its commitment to combat the problem of
health disparities and promote educational and training activities for underrepresented
minorities, the University of North Texas Health Science Center established the Texas Center on
Health Disparities (TCHD). In 2012, The National Institute on Minority Health and Health
Disparities awarded TCHD an additional $5.8 million five year grant to continue its work. The
TCHD’s mission is to prevent, reduce and eliminate health disparities in our communities
through research, education and community relations. Current research projects include HIV,
breast cancer, and obesity.
SOURCES:
Texas Department of State Health Services – Center for Elimination of Disproportionality and
Disparities: http://www.hhsc.state.tx.us/hhsc_projects/cedd/
UNT/HSC: https://www.unthsc.edu/research/texas-center-for-health-disparities/
2015 United Way Tarrant County Community Assessment
113
HEALTH
INDICATOR:
Injury and Mortality
ABOUT THE
INDICATOR:
Injury and mortality data provided by the Texas Department of State Health Services is derived from three
separate databases: Texas Vital Statistics Mortality Data, Texas Hospital Inpatient Discharge Data, and
Texas Hospital Trauma Registry Data. The data lags by several years.
IMPORTANCE
OF THIS
INDICATOR:
The Texas Vital Statistics Mortality Data, a subset of variables collected on the Texas Certificate of Death,
includes all Texas residents who died in the calendar year, including those who died while traveling
outside of Texas. Deaths of non-Texas residents who died in Texas is not included. The Texas Hospital
Inpatient Discharge Data is inpatient discharge billing data with a length of stay of 24+ hours. All hospitals
and ambulatory surgery centers in Texas are required to report. Texas Hospital Trauma Registry Data is
trauma patients that meet several criteria: patient was admitted for more than 48 hours OR patient was
seen, stabilized, and transferred to a higher level acute care hospital OR patient died after receiving any
evaluation/treatment OR was dead on arrival. All hospitals in Texas are required to report. Note: The
state does not collect emergency department data.
WHAT THE
DATA TELLS
US:
The 5 leading causes of all death in Tarrant County (2010) are heart disease, cancer, lung disease and
accidents.
In Trauma Service Area E (TSA E), which includes Tarrant County, the leading causes of deaths due to
injuries for all ages are motor vehicle crashes and suicide, poison, falls, and homicide (2009). Among TSA
E residents age 20-65, suicide was the leading cause of injury-related deaths. Among TSA E residents age
65+, falls were the leading cause of injury deaths.
Falls are the leading causes of hospitalizations due to injury in Trauma Service Area E (2009), followed by
motor vehicle crashes, poisoning, self-inflicted injuries, and assault. The National Council on Aging’s
National Falls Prevention Resource Center has implemented “Falls Free: 2015 National Falls Prevention
Action Plan” to achieve the Healthy People 2020 objective to reduce the rate of emergency department
visits due to falls among older adults by 10%.
In Texas (2009), the leading cause of death for children/youth (age 0-19) was unintentional injuries,
primarily motor vehicle traffic crashes. In Texas (2009), the leading cause of child hospitalizations due to
injuries was falls and motor vehicle crashes.
Deaths, Leading causes, U.S. and Texas, 2013 (Texas 2013 compared with 2009)
All causes
1. Heart disease
2. Cancer (Malignant neoplasms)
3. Chronic lower respiratory disease
4. Unintentional injuries (accidents)
5. Cerebrovascular disease (stroke)
6. Alzheimer’s Disease
7. Diabetes
Septicemia
8.
9.
Influenza/pneumonia
Kidney disease (nephritis)
Chronic liver disease/cirrhosis
2015 United Way Tarrant County Community Assessment
2013
U.S.
Texas
Rate (deaths per 100,000
pop)
731.9
674.9
169.8
151.8
163.2
144.8
42.1
37.0
39.4
35.3
36.2
34.9
23.5
20.0
21.2
19.9
Not listed
14.7
15.9
13.2
Not listed
not listed
14.1
12.9
2009
Texas
656.9
153.9
143.4
34.8
37.6
36.8
20.4
19.6
12.4
13.6
14.9
Not listed
114
10. Intentional self-harm (suicide)
12.6
Not listed
Source: Centers for Disease Control, Mortality in the United States;
Texas Department of State Health Services, Vital Statistics 2013 and 2009
Not listed
Deaths, Leading causes, Tarrant County, 2010
Number of
deaths
1
Heart disease
2,499
% of deaths
attributed to a
specific cause
22.8%
Rate *
2
Malignant neoplasms (Cancer)
2,480
22.6%
172.2
3
Cerebrovascular Disease
683
6.2%
51.3
4
Chronic Lower Respiratory Disease
640
5.8%
48.8
5
Accidents
471
4.3%
28.8
6
Alzheimer’s Disease
297
2.7%
24.2
7
Diabetes Mellitus
291
2.6%
20.5
8
Nephritis, etc.
232
2.1%
17.2
9
Chronic Liver Dis and Cir.
209
1.9%
12.3
10
Septicemia
189
1.7%
13.2
182.7
*Rate per 100,000 age-adjusted to 2000 standard population
Source: Tarrant County Public Health, 2015 http://access.tarrantcounty.com/content/dam/main/publichealth/2010_TC_Leading_Causes_of_Death_Summary.pdf
Injury Deaths: 5 Leading Causes of Injury Mortality (Deaths), Texas and Trauma Service Area E (TSA E),
which includes Tarrant County), 2009
Age
0-19
20-64
65+
Total
Motor Vehicle
Crash
Rate per 100,000
TX
TSA E
7.2
16.5
17.9
13.9
4.7
12.1
15.0
10.1
Suicide
Rate per
100,000
TX
TSA E
2.6
14.8
15.2
11.2
2.1
13.4
12.7
10.0
Falls
Rate per 100,000
TX
TSA E
0.2
2.2
50.9
6.4
0.1
2.0
51.2
5.6
Poison
Rate per
100,000
TX
TSA
E
1.2
1.7
12.7
10.6
4.9
4.8
8.5
7.5
Homicide
Rate per
100,000
TX
TSA E
3.4
7.7
3.4
6.0
2.7
6.5
2.8
5.1
Injury Hospitalizations: 5 Leading Causes of Injury Hospitalization by Age, Texas and Trauma Service
Area E, which includes Tarrant County, 2009
Age
Motor Vehicle
Crash
Rate per 100,000
TX
TSA E
Self-inflicted
Rate per
100,000
TX
TSA E
Poison
Falls
Rate per
Rate per
100,000
100,000
TX
TSA E
TX
TSA
TX
TSA E
E
0-19
39
35
23
21
16
14
16
14
55
48
20-64
85
79
64
55
38
37
48
51
134
142
65+
83
88
18
30
11
15
84
101
1,896
2,267
Total
71
67
47
43
29
28
42
44
286
292
How to read: 35 of every 100,000 children ages 0-19 in TSA E were hospitalized for a motor vehicle crash injury;
2,267 of every 100,000 adults age 65+ in TSA E were hospitalized for injuries sustained in a fall.
2015 United Way Tarrant County Community Assessment
Assault
Rate per 100,000
115
Injury Hospitalization: Leading Causes of Injury Hospitalization for Trauma Service Area E, 2009
Cause of Injury
Number
Rate per
100,000
Falls
19,747
292
Motor vehicle traffic
4,528
67
Accidental poisoning
2,993
44
Self-inflicted
2,920
43
Assault
1,909
28
Source: DSHS, 2009 Hospital Inpatient Discharge Data Public Use Data File
Child/Youth Deaths: Leading causes and total 5 year incidence of all child/youth deaths by age group,
Texas, 2004-2008
Rank
<1 year
1-4 yrs
5-9 yrs
10-14 yrs
15-19 yrs
1
2
3
Congenital
anomalies
2,716
Short gestation
1,694
SIDS
1,102
Unintentional
injury
892
Congenital
anomalies
234
Homicide
213
4
Unintentional
injury
509
Malignant
neoplasms
222
Congenital
anomalies
97
Homicide
61
Unintentional
injury
619
Malignant
neoplasms
206
Homicide
99
Unintentional
injury
2,728
Homicide
747
Suicide
666
Maternal
Malignant
Suicide
Malignant
pregnancy comp.
neoplasms
90
neoplasms
691
181
312
5
Placenta cord
Heart disease
Heart disease
Congenital
Heart disease
membranes
78
42
anomalies
152
466
66
Source: WISQARS Leading Causes of Death Reports, 2004-2008 - From Children’s Safety Network – Texas 2012 State
Fact Sheet
Child/Youth Injury deaths: Leading causes and total 5 year incidence of child/youth injury deaths by
age group, Texas, 2004-2008
Rank
<1 year
1-4 yrs
5-9 yrs
10-14 yrs
15-19 yrs
20-24 yrs
1
Suffocation
297
Homicide
130
MV traffic
85
Drowning
32
Fire/burn
***
MV traffic
MV traffic
MV traffic
MV traffic
MV traffic
315
289
395
1,958
2,614
2
Drowning
Drowning
Homicide
Homicide
Homicide
263
68
99
747
1,177
3
Homicide
Homicide
Suicide
Suicide
Suicide
213
61
90
666
1,070
4
Fire/burn
Fire/burn
Drowning
Poisoning
Poisoning
83
45
64
343
782
5
Pedestrian/ot Other land
Other land
Drowning
Drowning
her
transport 23
transport 28
128
148
77
Note: all mechanisms of suicide and homicide were combined according to intent. Each listed mechanism is
unintentional except as noted.
Source: National Center for Health Statistics, Multiple Causes of Death Data, 2004-2008 – From Children’s Safety
Network – Texas 2012 State Fact Sheet
2015 United Way Tarrant County Community Assessment
116
Child Hospitalization Injuries: Leading Causes and Annual Incidence of Child Hospital-Admitted Injuries
by Age Group, Texas residents, 2009
Rank
>1 year
1-4 yrs
5-9 yrs
10-14 yrs
15-19 yrs
1
2
3
4
Unintentional fall
319
Unintentional
other specified,
NEC 258
Unspecified
187
Assault
141
5
SOURCES:
Unintentional
Bites & Stings
63
Unintentional fall
892
Unintentional
Bites & Stings
394
Unintentional
Poisoning
316
Unintentional
Other specified,
NEC
294
Unspecified
292
Unintentional Fall
863
Unintentional
MVT
348
Unspecified
273
Unintentional
Bites & Stings
223
Unintentional
Struck By/against
153
Unintentional
Fall 636
Unspecified
473
Unintentional
MVT 1,594
Self-Inflicted
1,354
Unintentional
MVT
351
Unintentional
Struck By/Against
292
Unspecified
894
Self-Inflicted
281
Unintentional Fall
628
Assault
673
Centers for Disease Control, Mortality in the United States, 2013
http://www.cdc.gov/nchs/data/databriefs/db178.htm#fig3
Texas Department of State Health Services, The Health Status of Texas 2014
https://www.dshs.state.tx.us/chs/datalist.shtm
Texas Department of State Health Services, Vital Statistics Annual Report, 2013
https://www.dshs.state.tx.us/chs/vstat/vs13/t16.aspx
Texas Department of State Health Services; Children’s Safety Network-Texas 2012 Fact Sheet
http://www.childrenssafetynetwork.org
Texas Department of State Health Services –Morbidity & Mortality Data by TSA 2009
http://www.dshs.state.tx.us/injury/NewInjuryReports.aspx
Tarrant County Public Health Department, Leading Causes of Death
http://access.tarrantcounty.com/en/public-health/epidemiology-and-health-information/health-dataand-information/leading-causes-of-death.html
“Falls Free: 2015 National Falls Prevention Action Plan, National Falls Prevention Resource Center,
National Council on Aging https://www.ncoa.org/resources/2015-falls-free-national-falls-preventionaction-plan/
2015 United Way Tarrant County Community Assessment
117
HEALTH
INDICATOR:
Isolation
ABOUT THE
INDICATOR:
With the aging of the baby boomer population and subsequent growth in the number of older adults and
the issues that frequently accompany aging, there is growing concern about social isolation of older
adults as it contributes to declining health.
IMPORTANCE
OF THIS
INDICATOR:
Isolating conditions are thought to be related to lack of social connections, a trigger for higher deaths
related to breast cancer, high blood pressure, heart disease and other chronic diseases, living alone, lack
of close friends, lack of transportation, and also caregiving. (Source: AARP Foundation).
AARP International has developed an initiative to promote and create networks of age-friendly
communities. The availability and quantity of 8 domains of livability impact the well-being of older
adults: outdoor spaces and buildings, transportation, housing, social participation, respect and social
inclusion, work and civic engagement, communication and information, and community and health
services. (Source: AARP Livable Communities)
WHAT THE DATA According to the 2010 Census, in Tarrant County, 25% of households are occupied by someone living
alone. Of householders living alone, more than one-quarter are people over the age of 65. Women
TELLS US:
make up three-quarters of the older people living alone.
From 2011-2014, 2-1-1 Texas at United Way experienced a 51% increase in calls from or on behalf of
older adults 60+.
2-1-1 attributes the dramatic increase in 60+ calls related to Income Support (which includes Medicare,
Medicaid, Social Security and the Volunteer Income Tax Assistance program) and to Food to callers
intending to request “federal or state” programs but selecting the option for “local programs”.
Older adults living alone, Tarrant County, 2010
% of total
households
Total households, Tarrant Co.
Householders living alone
 People age 65+
o Females, age 65+
o Males, age 65+
(Source: 2010 Census, DP-1)
657,134
100%
163,559
43,374
30,010
11,364
24.9%
6.6%
% of all
householders
living alone
100%
26.5%
Trend: 2-1-1 calls related to persons 60+, Arlington and NE Tarrant County, 2014 compared with 2011
2014
2011
% change
Trend
2011 -14
2-1-1 calls from or on behalf of
38,702
25,811
51%
persons age 60+
Arlington
6,203
3,637
87%
Northeast Tarrant County
5,806
3,421
70%
2015 United Way Tarrant County Community Assessment
118
2-1-1 Calls, 60+, Most Requested Needs by Category, Tarrant County, 2014 compared to 2011
Category of Need:
2014
2011
Requests*
Requests
Income Support
11,283
2,351
Food/Meals
10,499
2,362
Housing, shelter and utilities
10,038
9,623
Health care
2,126
3,371
Individual, Family & Community Support
1,849
2,758
Transportation
1,254
1,142
Legal, Consumer & Public Safety
1,063
1,408
*For 2014, total requests = sum of top 5 requested needs.
SOURCES:
2010 Census – www.census.gov
AARP Livable Communities http://www.aarp.org/livable-communities/info-2014/slideshow-eightdomains-of-livability.html#slide1
2-1-1 Texas at United Way, 2014 and 2011 Annual Reports www.unitedwaytarrant.org
2015 United Way Tarrant County Community Assessment
119
HEALTH
INDICATOR:
Maternal and Child Health
ABOUT THE
INDICATOR:
This profile includes data about infant mortality and incorporates Teen Pregnancy and Parenting reported
as a separate profile in the 2012 Community Assessment.
Infant mortality is reported as a rate: the number of infant deaths per 1,000 live births. It includes deaths
before a child’s first birthday.
IMPORTANCE
OF THIS
INDICATOR:
The two most important determinants of infant survival are birthweight and length of gestation. The
health of the mother before she becomes pregnant is a factor in whether she carries the baby to term.
Prematurity is a cause of low birthweight, which is related to infant mortality. Although access to early
prenatal care is important, long-standing health conditions such as obesity, chronic illness (such as
diabetes or hypertension), as well as substance abuse and smoking contribute to infant mortality.
WHAT THE
DATA TELLS
US:
According to The National Campaign to Prevent Teen and Unplanned Pregnancy, half of all pregnancies are
described by the women themselves as unplanned. Among unmarried young women 20-29, nearly 70% of
pregnancies are unplanned.
In 2013, more than one in 10 Tarrant County babies was born too soon (less than 37 weeks gestation).
Babies born between 39-40 weeks have the best outcomes. Babies born earlier are at greater risk of death
or serious health issues.
The infant mortality rate in Tarrant County continues to be higher than for Texas and the U.S., although it
declined in recent years and has recently increased again. Disparities exist by race/ethnicity: the rate of
infant mortality is extremely high for African-American women compared to Hispanics and Anglos.
Ensuring that girls and women of child-bearing age have adequate nutrition and avoid poor health habits,
(such as smoking, drugs, alcohol) is a primary prevention strategy.
However, Infant mortality is a complex social problem. There is not one single cause of infant mortality or
one single solution. Economic, social, environmental and behavioral factors can influence poor birth
outcomes. A growing understanding of the role of social influences on health has broadened the
responsibility for creating healthy communities beyond simply individual responsibility. These social
influences include such factors as poverty, unemployment, racism, housing, transportation, social
support, crime and other neighborhood conditions that can directly influence health behaviors and/or
health outcomes. (Source: Tarrant County Infant Health Network –
http://www.tcinfanthealthnetwork.org)
A 2013 report of the Tarrant County Fetal Infant Mortality Review (FIMR) team’s sample of cases from
2008-2010 indicated the most prevalent maternal health risk observed within the cohort (134 cases
reviewed of 1,175 infant deaths which occurred) was unhealthy weight status of the mother: 4% began
their pregnancy underweight, while 61% were overweight (27%) or obese (34%). In 75% of deaths
reviewed, the baby was very pre-term (less than 32 weeks) and in 74% of cases, the baby’s birth weight
was very low (less than 3.3 lbs.) (Source: Tarrant County Public Health, 2013. Fetal Infant Mortality
Review 2008-10)
2015 United Way Tarrant County Community Assessment
120
Trend: Births to women receiving late or no prenatal care, Tarrant County, 2013 compared with 2009
2013
2009
Births to women receiving late or no prenatal care
11,717
13,767
42%
47%
Source: Kids Count 2015
Trend: Infant mortality, low birthweight and pre-term births, Tarrant County and Texas, 2013 compared
with 2009
Texas
Tarrant County
Change
Tarrant
County
2013
2013
2009
2009-2013
Total live births
387,110
27,829
29,060
Infant mortality rate (per 1,000 live
5.8
7.1
6.7
births)
Low birth weight *
8.3%
8.1%
8%
( % of all live births)
Pre-term Births -less than 37 wks
12.0%
11.6%
11.3%
gestation (% of all live births)
** Low birth weight=less than 5.5 lbs (or 2500 grams) at birth; Source: 2013 Kids Count
2015 United Way Tarrant County Community Assessment
121
Pre-pregnancy weight status, Tarrant County Fetal/Infant Mortality Review (FIMR) cases, 2008-10
Underweight (less
Normal (18.5-24.9 BMI) Overweight (25.0-29.9
Obese (30+ BMI)
than 18.5 BMI)
BMI)
4%
35%
27%
34%
SOURCES:
Tarrant County Infant Health Network – http://www.tcinfanthealthnetwork.org
Tarrant County Public Health, January 2013, Fetal Infant Mortality Review, Study of findings and
recommendations from the Tarrant County FIMR Case Review Team, 2008-2010
http://www.tarrantcounty.com/ehealth/lib/ehealth/2008-2010_FIMR_Report_FINAL.pdf
Kids Count 2013 http://datacenter.kidscount.org/data#TX/5/0
Star-Telegram “One in 10 Tarrant County babies born too soon”, November 18, 2014
The National Campaign to Prevent Teen and Unplanned Pregnancy, Washington, DC –
http://www.thenationalcampaign.org
2015 United Way Tarrant County Community Assessment
122
HEALTH
INDICATOR:
Mental Health and Mental Disorders
ABOUT THE
INDICATOR:
Mental Health Mental Retardation of Tarrant County reports number of people served and types of
services.
JPS Health Network reports psychiatric Emergency Room visits, admissions to both adult and
adolescent psychiatric units, and outpatient psychiatric visits.
The Tarrant County Behavioral Risk Factor Surveillance Survey (BRFSS), undertaken every five years,
provides individuals’ self-report of good/bad mental health days and limitations due to impairment.
The Children’s Community Health Assessment Survey (CCHAPS) periodically surveys North Texas
families about their perception of a particular child’s health and provides data that can be
compared from year to year.
The U.S. Department of Health and Human Services/Health Resources and Services Administration
(HRSA) designates over 4,000 (in 2015) Health Professional Shortage Areas (HPSAs) for Mental
Health (as well as primary care and dental services), based on specific criteria to determine whether
a geographic area, population or facility is underserved.
In December, 2011, Texas received federal approval of an 1115 Waiver that would preserve Upper
Payment Limit (UPL) funding to hospitals under a new methodology but allow for managed care
expansion to additional areas of the state. MHMR/TC, along with JPS Health Network, health care
providers, the Texas Health & Human Services Commission and the federal Centers for
Medicare/Medicaid Services (CMS) is participating in the 1115 Waiver designed to transform health
care and improved access to quality affordable care. MHMR’s 2016 waiver goals include increasing
number served, expanding by adding a clinic and increasing hours; integrating primary and
behavioral health care, providing 24/7 crisis response to people with various conditions, and
providing trauma-informed, culturally sensitive care to children. (Source:
http://www.mhmrtarrant.org/Media/Health-Care-Transformation-Initiatives)
IMPORTANCE
OF THIS
INDICATOR:
These indicators provide a sense of the state of mental health conditions and resources in Tarrant
County. (Note: Data was not collected from other not-for-profit and private behavioral health
facilities in Tarrant County. )
WHAT THE
DATA TELLS US:
According to the State Health Services report cited below, nationally 46.4% of adults experience
mental illness at least once in their lifetime and 26.2% experience it annually. In Texas, over 25% of
surveyed adolescents reported negative emotional states within the previous 12 months and over
20% of adults reported poor mental health in the 30 days preceding the survey. Despite this need,
a mental health workforce shortage exists nationwide.
Texas continues to lead the nation among states with number of Health Professional Shortage Areas
(HPSAs) for Mental Health. In 2015, 200 of Texas’ 254 counties are designated HPSAs for mental
health, with a ratio of only 1 psychiatrist to more than 30,000 population. The Texas Medical
Association estimates it would take 1,100 more psychiatrists and 200 more child psychiatrists to
bring Texas up to the national per capital workforce totals. (Sources: Texas Tribune and Texas
Medical Association articles cited below.)
Between 2011 and 2015, the number of MHMR/Tarrant County screenings, assessments and crisis
calls increased 28%. The implementation of a mobile crisis unit some years ago may account for a
portion of the increase in volume. At JPS Health Network, although the number of Psychiatric
Emergency Center (PEC) visits decreased almost 6% and admissions to both adult and adolescent
inpatient units decreased by 13% and 35%, respectively, between 2011 and 2014, the number of
outpatient behavioral health visits increased substantially -by almost 20%.
2015 United Way Tarrant County Community Assessment
123
Trend: Mental Health Mental Retardation of Tarrant County Services, 2015 compared to 2011
Number of unduplicated clients
Screening, assessment and crisis calls
Clients served by division:
Addictions
Mental Health
Early Childhood Intervention
Individual and Developmental Disabilities
2015
42,697
82,071
2011
33,131
83,236
13%
58%
19%
10%
10%
58%
22%
10%
% change
28%
(1.4%)
Source: MHMRTC Annual Reports, 2015 and 2011
Trend: Tarrant County Behavioral Risk Factor Surveillance Survey (BRFSS), 2009-10 compared
with 2007
At least 1 day of poor mental health in last 30 days
Physical, mental or emotional health limited their
regular activities
2009-10
18.8%
10.8%
2007
33%
15%
Note: BRFSS results are reported every 5 years.
Trend: JPS Psychiatric Emergency Center Visits/Inpatient Admissions, Tarrant County, 2015
compared to 2011
Psychiatric Emergency Center (PEC) visits
Psychiatric Observation Days
Adult inpatient admissions
Adolescent inpatient admissions
Crisis Stabilization Unit (CSU)
Local Commitment Alternative (LCA)
Outpatient Behavioral Health Visits
Psychiatric Partial Hospitalization Days
2015
2011
20,007
3,491
2,890
529
N/A
318
24,989
1,512
21,248
N/A
3,324
810
780
N/A
20,855
N/A
%
Change
(5.8%)
(13.1%)
(34.7%)
19.6%
Source: JPS Health Network, by request, November 2015
2-1-1 Calls related to Mental Health/Addiction, 2014





MH assessment/Treatment (inpatient/outpatient)
Counseling
Substance abuse assessment/treatment
(inpatient/outpatient)
Mental health hotlines
Domestic Violence
Total: top 5 types of calls
2014
986
840
631
203
202
2,862
Note: Need categories have changed since 2011.
2015 United Way Tarrant County Community Assessment
124
Trend: Cook Children’s Health Network, Psychiatric Emergency Room Visits, Tarrant County, 2014
compared with 2011
2014
2011
% chg
2011-14
Preadolescents
Not avail1,177
able
Adolescents
361
Adults
Total
8
1,968
1,546
27.3%
Source: Cook Children’s, by request
Trend: Cook Children’s Health Network psychiatric inpatient admissions, Tarrant County, 2014
compared with 2011
CY 2014*
2011**
% change
Total admissions to CCMC Inpatient
Psychiatry
Transferred to another Inpatient
Psychiatry Unit
Total
470
361
458
189
928
550
Possibly not
comparable
*2014: Age range not available; **2011: Preadolescents age 0-12;
Source: Cook Children’s, by request
Trend: Children’s Community Health Assessment & Planning Survey, Selected questions related
to children’s mental health, North Texas, 2015 compared to 2009
Has this child ever experienced something traumatic, such as
a natural disaster, accident, violence, neglect or abuse?
Has this child ever had negative obsessive thoughts?
Has this child ever received assistance for a mental illness or
a behavioral, emotional or developmental problem?
Has this child ever needed mental healthcare but not
received it?
Has this child ever had academic problems in school?
Has this child ever had behavioral problems at school?
Has this child ever been suspended from daycare, school, or
a program of activities due to reported behavioral problems?
Have you ever been told by a doctor or health professional
that this child has a mental illness or disorder
Have you ever been told by a doctor or healthcare
professional that this child has a developmental delay:
Does this child regularly exhibit problematic social
behaviors?
Source: CCHAPS 2015
2015
“Yes”
2009
“Yes”
7.3%
6.5%
6.3%
14.4%
5.3%
12%
1.6%
1.8%
12.1%
10.8%
3.6%
7.2%
6.1%
2.1%
8.5%
8.8%
4%
3%
5.9%
N/A
Trend
Age-adjusted Death Rate (per 100,000) due to Suicide, Tarrant County 2009-13 compared to
Healthy People 2020 Target
Tarrant County
Healthy People 2020 Target
10.6
10.2
Source: Healthyntexas.org
SOURCES:
Mental Health Mental Retardation of Tarrant County, Annual Reports 2015, 2011
www.mhmrtc.org
2015 United Way Tarrant County Community Assessment
125
JPS Health Network (by request)
Children’s Community Assessment & Planning Survey (CCHAPS) Results 2015 www.cchaps.org
rd
The Mental Health Workforce Shortage in Texas, as required by HB1023, 83 Legislature,
Department of State Health Services, September 2014.
“Texas Hopes to Attract More Mental Health Workers”, Texas Tribune, July 4, 2015.
http://www.texastribune.org/2015/07/04/texas-struggles-attract-mental-health-care-workers/
“No Quick Fix for Texas’ Shortage of Psychiatrists”, commentary by Clifford Moy, M.D., in Texas
Medicine, published by Texas Medical Association, February 2015
http://www.texmed.org/Template.aspx?id=32763
Healthy North Texas, DFWHC Foundation healthyntexas.org
2015 United Way Tarrant County Community Assessment
126
HEALTH
INDICATOR:
Oral Health Care
ABOUT THE
INDICATOR:
Oral health affects more than just the health of the mouth. Poor oral health can compromise a
person’s general health, quality of life and life expectancy.
The Center for Disease Control and Prevention/Oral Health Division’s goal extends the use of proven
strategies to prevent oral disease by encouraging the effective use of fluoride products and
community water fluoridation; and promoting greater use of school-based and –linked dental
sealant programs. The Surgeon General's report on oral health indicates that sealants can reduce
decay in school children by more than 70 percent. (Source: Center for Disease Control and
Prevention/Oral Health Division)
IMPORTANCE
OF THIS
INDICATOR:
The young, sick, poor and elderly are falling through the cracks when it comes to dental care, due to
economic, structural, and cultural barriers that prevent some Texans from getting proper care.
According to “Dental Crisis in America: The Need to Expand Access”, a 2012 report of the U.S.
Senate Committee on Health, Education, Labor and Pensions, dental caries are the most common
chronic disease of childhood, affecting almost 60% of children ages 5-17.
One in four adults ages 65+ in the U.S. has lost all of his/her teeth. Low-income Americans of any
age are more likely to have oral health problems due to lack of access to a dental provider and the
high cost of dental services. Dentists tend to be concentrated in the suburbs rather than the inner
city. More than one-third of Americans do not have dental coverage. Traditional Medicare does
not cover dental benefits and many veterans do not qualify for dental benefits through the Veterans
Administration. Although Medicaid and the Children’s Health Insurance Program (CHIP) provide
dental coverage through the Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
program, and under the Affordable Care Act, over 5 million more children were projected to have
dental coverage by 2014, that coverage alone, especially Medicaid, in no way guarantees access to a
dentist. (Source: U.S. Department of Health & Human Services, Bureau of Health Workforce http://bhpr.hrsa.gov/healthworkforce/supplydemand/dentistry/nationalstatelevelprojectionsdentis
ts.pdf
Texas is designated as a Health Professional Shortage Area (HPSA) for dentists. According to a
national and state projection for dentists, in 2012, Texas had 13,087 dentists, a shortage of 354.
The shortage is expected to increase to 490 by 2025. (Source: National and State-Level Projections
of Dentists and Dental Hygienists in the U.S., 2012-2025, U.S. Department of Health and Human
Services, Bureau of Health Workforce, published February 2015)
WHAT THE
DATA TELLS US:
State Oral Health Profile: Texas, 2013-14, 2012-13, 2012 and 2010 compared with 2009
Adults
2010
2009
Percent of adults who had a dental visit in last
year
Percent of adults who’d had teeth cleaning by
dentist or dental hygienist
Percent of 65+ population who have lost all
their teeth
Percent of 65+ population who have lost 6 or
more teeth
Children
Percent of Head Start students with caries
(cavities) experience, treated or untreated
2015 United Way Tarrant County Community Assessment
59.7%
59%
59.9%
60.2%
14.1%
17.5%
39.4%
39.5%
2013-14
42.9%
N/A
127
2012-13
2009
rd
51.2%
34.4%
rd
66.8%
73.3%
25.2%
42.7%
2012
2009
79.5%
78.1%
Percent of 3 grade students with one or more
sealants on permanent teeth
Percent of 3 grad students with treated or
untreated cavities, 2012-13
rd
Percent of 3 grade students with untreated
tooth decay
Percent of population on public water systems
receiving fluoridated water
Source: Center for Disease Control, National Oral Health Surveillance System
SOURCES:
Dental Crisis in America: The Need to Expand Access, A report from Chairman Bernard Sanders,
Subcommittee on Primary Health and Aging, U.S. Senate Committee on Health, Education, Labor
and Pensions, February 29, 2012.
U.S. Department of Health and Human Services Health Resources and Services Administration
Bureau of Health Workforce National Center for Health Workforce Analysis, 2015
Center for Disease Control, National Oral Health Surveillance System
http://nccd.cdc.gov/OralHealthData/
2009 data: http://apps.nccd.cdc.gov/nohss/bystate.asp?stateid=48
2015 United Way Tarrant County Community Assessment
128
HEALTH
INDICATOR:
Substance Use Disorder
ABOUT THE
INDICATOR:
Substance use disorder (SUD) encompasses the misuse of alcohol as well as legal and illegal drugs.
Substance use disorders can refer to substance use or substance dependence. Symptoms may include
behavioral changes (such as drop in attendance and performance at work or school, frequently getting
into fights, accidents, illegal activities); physical changes (such as bloodshot eyes and abnormally sized
pupils, sudden weight loss or weight gain, deterioration of physical appearance, or impaired
coordination); or social changes (such as sudden change in friends, favorite hangouts, and hobbies; legal
problems related to substance use; unexplained need for money or financial problems; using substances
even though it causes problems in relationships).
Mental health problems and substance use disorders sometimes occur together. This is because certain
illegal drugs can cause people with an addiction to experience one or more symptoms of a mental health
problem; mental health problems can sometimes lead to alcohol or drug use, as some people with a
mental health problem may misuse these substances as a form of self-medication; and mental and
substance use disorders share some underlying causes, including changes in brain composition, genetic
vulnerabilities, and early exposure to stress or trauma. Someone with a mental health problem and
substance use disorder must treat both issues. Treatment for both mental health problems and
substance use disorders may include rehabilitation, medications, support groups, and talk therapy.
(Source: U.S. Department of Health and Human Services
http://www.mentalhealth.gov/what-to-look-for/substance-abuse/)
In July 2015, Challenge of Tarrant County presented “The Other Nine”, a community needs assessment
on substance use disorder in Tarrant County. Only 1 in 10 Americans receives help.
The Tarrant County Drug Impact Index 2014 (aka S.A.I.D Report – Substance Abuse Information
Databank) profiles the pervasiveness of substance use in Tarrant County.
IMPORTANCE
OF THIS
INDICATOR:
“The Other Nine” community assessment on substance use disorder in Tarrant County highlighted the
need for community engagement in ensuring individuals access and receive treatment.
WHAT THE
DATA TELLS
US:
Findings of “The Other Nine”, a Tarrant County substance use disorder needs assessment:
The Tarrant County Drug Impact Index reports data annually on 19 indicators.








134,000 Tarrant County individuals need behavioral health services for substance use disorders;
only 13,400 will receive the care they need.
95% of those dealing with a substance use disorder will not perceive a need for care;
Of the 1,897 on the waiting list for SUD health care, only 52% received care.
In 766 child welfare cases in which children were removed from their home, 65% of parents had
an SUD.
23% of accidental deaths were due to SUD
Patients with SUD are seen at a rate of 2.97 visits to the emergency room compared to 1.35
visits for patients without SUDs.
Of the 40,102 Tarrant County jail inmates booked in 2014, it is estimated 25,000 may have SUD.
The Forensic Mental Health program served 8,315 in the Tarrant County Jail.
Of the 2,927 youth referred to Tarrant County Juvenile Services in 2014, 40% reported currently
using alcohol/drugs. If the 685 youth detailed or on supervision who received a drug test, 78%
tested positive for drug metabolites.
2015 United Way Tarrant County Community Assessment
129
Selected findings from the Tarrant County Drug Impact Index 2014/S.A.I.D. Report
2015:
Reported youth use of alcohol and drugs, Tarrant County and Texas, 2013 compared with 2011
2014
Texas
Youth who reported using
alcohol in month prior to
survey
Youth who reported using
marijuana during month
prior to survey
25%
Arlington
25%
11%
13.5%
2011
Fort
Worth
23%
10%
Texas
29%
Arlington
28%
Fort
Worth
31%
11.4%
13.9%
11.2%
2013
2010
Adult admissions to county DSHS-funded treatment
4,862
5,433
Detox/rehab clients served at Billy Gregory (detox) and Pine
Street (rehab) centers
Adult admissions – primary drug (highest %) at time of
admission to DSHS-funded facilities
1709
1,358
Opiates
1,382
28%
Marijuana
885
94%
73%
Alcohol
1,525
28%
Marijuana
868
86%
71%
Adolescent admissions – primary drug (highest %) at time of
admission to DSHS-funded facilities
Percentage of HIV tests in which drug use was a reported risk
factor
Source: Tarrant County Drug Impact Index, 2014/S.A.I.D. Report 2015
United Way/Arlington’s Youth Issues Survey (2012) of young people ranked alcohol/drug abuse
as the highest priority problem, whereas it did not rank among committee members’ top four
youth issues.
Reported youth use of alcohol and drugs, Tarrant County and Texas, 2011
Texas
Arlington
Fort
Worth
Youth who reported using alcohol in
29%
28%
31%
month prior to survey
youth who reported using marijuana
11.4%
13.9%
11.2%
during month prior to survey
SOURCES:
U.S. Department of Health and Human Services – http://www.mentalhealth.gov/what-to-lookfor/substance-abuse/
“The Other Nine”, Challenge of Tarrant County, 2015
Tarrant County Drug Impact Index 2014/S.A.I.D. Book 2015
http://challengetc.org/assets/challenge_said_2015.pdf
2015 United Way Tarrant County Community Assessment
130
HEALTH
INDICATOR:
Teen Pregnancy and Parenting
ABOUT THE
INDICATOR:
The teen birth rate is measured in different ways by different sources – as a percentage of all live births,
as a rate per 1,000 births to teens within a specific age group, or as a rate per 1,000 population of female
teens within an age group, making comparisons challenging. The age ranges of “teens” vary from
“under 20” to “13-17” to “15-19”, depending on the data source. Note that the teen pregnancy rate and
teen birth rate are different. It should be noted that not all teen parents are single; some are married.
IMPORTANCE OF
THIS INDICATOR:
According to the federal Office of Adolescent Health, children born to adolescents face particular
challenges—they are more likely to have poorer educational, behavioral, and health outcomes
throughout their lives, as compared to children born to older parents.
WHAT THE DATA
TELLS US:
The federal Office of Adolescent Health reports that the U.S. teen pregnancy and birth rates are at the
lowest levels in years, due primarily to two factors: the percentage of adolescents having sex at earlier
ages has decreased since 1988 and contraceptive use has increased since the 1990s. Still, almost half of
all high school students reported they had had sexual intercourse in 2013 and one in 8 adolescent
females will become pregnant before turning 20.
Texas rose from 5th to 4th between 2010 and 2012 among 51 states (including DC) in state rankings of
teen birth rates among females age 15-19 (where 1 is the highest rate of teen births).
The Nurse-Family Partnership Program in Texas pairs university-degreed registered nurses with lowincome, first-time mothers to improve prenatal care and provide one-on-one education and counseling,
focusing on child development. As of June 30, 2014, statewide results included 89% of babies were
born full-term and 91% were born at a healthy weight (5.5 lbs or more).
Of the 318 first-time mothers served by the Tarrant County Nurse-Family Partnership Program between
2008 and 2011, nearly one-third (approximately 100) were under 18.
The Arlington ISD Pregnancy, Education and Parenting Program served 491 pregnant and parenting girls
and boys in 2010-11. (Source: United Way/Arlington Youth Issues Study, 2012)
Teen pregnancy rate (pregnancies per 1,000 females age 15-19), U.S. and Texas, 2010
Texas
U.S.
Females aged 15-19
73
57
Females aged 15-17
Females aged 18-19
% change in the teen
pregnancy rate (females aged
15-19) 1988-2010
40
122
(38%)
30
96
(51%)
Source: U.S. Department of Health & Human Services, Office of Adolescent Health (from website last
updated September 2015).
Teen birth rate (births per 1,000 females aged 15-19), 2013
Texas
U.S.
Females aged 15-19
41
26.5
Females aged 15-17
Females aged 18-19
% change in the teen
pregnancy rate (females aged
15-19) 1991-2013)
2015 United Way Tarrant County Community Assessment
21.1
72
(48%)
12.3
47.1
(57%)
131
2012-13
(8%)
(10%)
Source: U.S. Department of Health & Human Services, Office of Adolescent Health (from website last
updated September 2015).
Births, Texas and Tarrant County, 2013 compared with 2012 and 2010
Texas
2013
2012
2010
Tarrant County
2013
Total live births
387,110
382,43
385,74 27,819
8
Births to All Teens (under 19)
38,030
40,968
48,4246
2,299
age 19)
Teen
births as a percent of all
9.8%
10.7%
12.6%
8.3%
live births
Births to teens under age 14
N/A
544
705
N/A
Births to teens 15-17
12,932
16,015
Births to teens 18-19
27,492
31,704
Births to Unmarried Teens
35,256
40,625
Source: For 2012 data, Center for Public Policy Priorities, Kids Count 2015
2012
2010
27,67
2,5061
9.1%
27,885
3,026
10.9%
30
805
1,671
2,213
50
957
2,019
2,683
Repeat births to teens, Texas and Tarrant County, 2008 and 2009
Texas
Tarrant County
2009
2008
2009
2008
Births to teens already
53,419 12,313
3,436
802
mothers
Percent of all teen births
22%
22.4%
20.9%
22%
Source: Center for Public Policy Priorities, Kids Count 2015 (no recent data)
Teen birth rate, US, Texas, and Tarrant County , 2012
U.S.
Texas
Tarrant
County
Teen birth rate per 1,000
29.4
44.4
35.9
females age 15-19
Births to Mothers 17 years or younger by ethnicity, Tarrant County, 2013
Tarrant County
White
Black
Hispanic
Number
794
170
154
420
% of all births
2.7%
1.3%
3.4%
4.2%
Source: Texas Department of State Health Services, 2013
https://www.dshs.state.tx.us/chs/vstat/vs13/t11.aspx
Reported youth sexual activity, Tarrant County, Texas, and U.S., 2011
Had sexual intercourse with at least 1 person
during prior 3 months
*2007
SOURCES:
Tarrant
County
38.7%*
Texas
U.S.
36.2%
33.7%
Source: Youth Risk Factor Surveillance Survey
U.S. Department of Health & Human Services, Office of Adolescent Health
http://www.hhs.gov/ash/oah/adolescent-health-topics/reproductive-health/home.html
2015 United Way Tarrant County Community Assessment
132
Texas Department of State Health Services, Office of Adolescent Health
http://www.dshs.state.tx.us/Layouts/ContentPageNoNav.aspx?pageid=36131
The National Campaign to Prevent Teen and Unplanned Pregnancy
http://www.thenationalcampaign.org/national/default.aspx
Kids Count 2015 http://www.datacenter.kidscount.org/data/bystate/stateprofile.aspx?state=TX
Nurse Family Partnership – State profiles
http://www.nursefamilypartnership.org/assets/PDF/Communities/State-profiles/TX_State.aspx
Youth Risk Behavior Surveillance Survey, Center for Disease Control, and Texas Department of State
Health Services http://www.cdc.gov/healthyyouth/sexualbehaviors/index.htm
United Way/Arlington Youth Issues Study, 2012 http://unitedwaytarrant.org/about-us/uwarlington/youth-issues-report
2015 United Way Tarrant County Community Assessment
133
HEALTH
INDICATOR:
Wellness and Healthy Lifestyles: Overweight and Obesity
ABOUT THE
INDICATOR:
Overweight and obesity are measured by body mass index (BMI), which compares weight to height.
Standard groupings include: BMI of 18.5-24.9 = healthy weight; BMI below 18.5 = underweight; BMI
25-29.9 = overweight; BMI 30+ = obese.
IMPORTANCE OF
THIS INDICATOR:
Although BMI may overestimate body fat in people who are muscular, the measurement is a useful way
to compare obesity in populations. Overweight and obesity contribute to numerous adverse conditions
including coronary heart disease, type II diabetes, cancer, stroke, and hypertension. Various physical,
environmental, social and genetic factors all contribute to overweight and obesity in different
populations.
The national epidemic of obesity is a major factor in rising health care costs and skyrocketing health
insurance premiums. Overweight/obese children have a greater than two-thirds chance of remaining
obese at age 35 and will suffer lifelong health and productivity consequences. Strategies to reduce
childhood obesity include addressing away-from-school food, strengthening in-school physical activity,
and capitalizing on the promise of Coordinated School Health Programs (CSHPs), which push schools to
consider the big picture of child health.
WHAT THE DATA
TELLS US:
In 2015, according to State of Obesity.org, a project of the Trust for America’s Health and the Robert
th
Wood Johnson Foundation, Texas now has the 11 highest adult obesity rate in the U.S. The adult
obesity rate for Texas is now 31.9%, up from 21.7% in 2000.
Based on the 2012 Community Assessment profile, the prevalence of adult obesity in Tarrant County is
similar to that of Texas and the U.S. Approximately 2/3 of the adult population is overweight or obese.
More than three-quarters of Hispanics, people with less than high school education, and those earning
less than $15,000 are overweight or obese. The percentage has stayed about the same from 2004 to
2009/10.
According to a 2011 study, Texas ranked among the top 10 states with the highest rate of childhood
obesity in the U.S. In 2004-05, the prevalence of childhood obesity was greater in Texas than for the U.S.
The percentage of obese students in Texas was much higher among minorities, with the highest
th
th
prevalence of obesity in Hispanic boys in 4 and 11 grades.
In a 2008 local survey (CCHAPS, 2008) 13% of Tarrant County parents were concerned about a child being
overweight, but the percentage increased to 18% among undocumented parents.
Adult Obesity, Tarrant County, 2015 compared with 2009-10
2015
2009-10
29%
28.2%
Sources: County Health Rankings, 2015; BRFSS, Tarrant County, 2009-10
Overweight and obesity among adults 18+, Tarrant County, Texas and the U.S., 2009/10
Tarrant County
Texas
U.S.
Overweight/obesity
65.7%
66.8%
63.8%
(BMI =/> 25.0)
By gender:
Male
Female
74.0%
57.1%
By age:
45-54
55-64
72.9%
71.7%
2015 United Way Tarrant County Community Assessment
134
By race/ethnicity:
White
Black
Hispanic
63.5%
71.4%
77.3%
By education:
< High school
77.5%
By annual income:
< $15,000
79.3%
By employment:
Out of work for <1 yr
Source: BRFSS, 2009/10
77.4%
Obesity, Texas rank, 2014 compared with 2009
2014
2009
Rank in U.S.
11th
14th
% obese
31.9%
27.9%
Year
2014
(2006-08)
Source: State of Obesity.org, 2015; Texas Overweight and Obesity Statistics, May 2010
Adult Obesity in Texas, by age, gender, ethnicity, 2014
Overall adults
31.9%
Race/Ethnicity
Age: 18-25
19.1%
White
26.7%
26-55
30.9%
Black
40.7%
45-64
38.9%
Latino
35.8%
65+
30.7%
Source: State of Obesity.org, 2015
Childhood Obesity in Texas, by age, 2014
Age
Percent obese
Age 2-4 from low income
No data
families
10-17 year olds
19.1% (2011)
High school students
15.7% (2013)
Source: State of Obesity.org, 2015
Male
Female
Gender
28.5%
30%
Rank among states
10/51 states (2011)
5/43 states (2013)
Physical Activity /Behavioral indicators, Adults and Children, Texas, 2014
ADULTS
YOUTH
No leisure
Met both 150
Usually biked No physical
Met aerobic
time physical
minute aerobic
or walked to
activity
activity
activity
and musclework
guideline
strengthening
guidelines
27.2%
19.0%
1.9%
16.6%
30%
Source: 2014 State Indicator Report on Physical Activity, CDC
th
Daily
physical
education
38.3%
th
Childhood Obesity among 4 - 11 Graders, Texas, 2009-11 compared with 2004-05
th
4 Graders, Texas, 2009-11 compared with 2004-05
2009-11
2004-05
Overweight
Obese
Overweight
Obese
19%
23.8%
19%
23%
42.8%
42%
2015 United Way Tarrant County Community Assessment
135
th
8 Graders, Texas, 2009-11 compared with 2004-05
2009-11
2004-05
Overweight
Obese
Overweight
Obese
17.4%
23%
19%
20%
40.4%
39%
th
11 Graders, Texas, 2009-11 compared with 2004-05
2009-11
2004-05
Overweight
Obese
Overweight
Obese
13.7%
21.6%
17%
19%
35.3%
36%
th
th
th
4 , 8 , and 11 Graders, Region 2/3 (which includes Tarrant County), 2009-11
th
th
th
4 Graders
8 Graders
11 Graders
Overweight
Obese
Overweight
Obese
Overweight
Obese
19.4%
17.6%
10.8%
21.2%
14.9%
17.2%
37%
32.0%
32.1%
Source: Texas Department of State Health Services – Obesity Data
https://www.dshs.state.tx.us/ObesityData2015/
Childhood obesity, Texas, 2011
2009 YRBS*
% of
obese HS
students
% of
overweight
HS students
13.6%
15.6%
% of HS
students
who were
physically
active at
least 60 min
on all 7 days
27.2%
2009
PedNSS**
% of obese
low-income
children age 25
16%
2007 National Survey of Children’s
Health***
% of
Ranking
%
obese
participating
children
in vigorous
ages 10Physical
17
activity every
day
Ages 6-17
20.4%
7
28.9%
Combined 29.2%
Sources:
*YRBS – Youth Risk Behavior Survey (YRBS) 2009, CDC (collected every 2 years)
**PedNSS – Pediatric Nutrition Surveillance 2009 Report, Table 2.
www.cdc.gov/pednss/pdfs/PedNSS_2009.pdf
*** National Survey of Children’s Health, 2007. Overweight and Physical Activity among Children: A
Portrait of States and the Nation 2009, Health Resources & Services Administration (HRSA), Maternal and
Child Health Bureau.
SOURCES:
State of Obesity - http://stateofobesity.org/states/tx/, 2015
2014 State Indicator Report on Physical Activity
http://www.cdc.gov/physicalactivity/downloads/pa_state_indicator_report_2014.pdf
https://sph.uth.edu/research/centers/dell/resources/SPAN-Survey-Results_All-Grades-and-Regions.pdf
2015 County Health Rankings
http://www.countyhealthrankings.org/app/texas/2015/measure/factors/11/data
Tarrant County Behavioral Risk Factor Surveillance Survey (BRFSS), 2009/2010
http://www.tarrantcounty.com/ehealth/lib/ehealth/Tarrant_County_BRFSS_20092010.pdf
Trust for America’s Health (Childhood Obesity) – www.healthyamericans.org
Department of State Health Services Obesity Data Sheet, Nov. 2008 http://dshs.state.tx.us
2015 United Way Tarrant County Community Assessment
136
Community-wide Children’s Health Assessment & Planning Survey (CCHAPS), 2008 – www.CCHAPS.org
Childhood Obesity in Texas: The Costs, the Policies, and a Framework for the Future, Abigail Arons,
Prepared for the Children’s Hospital Association of Texas (CHAT), January 2011
2015 United Way Tarrant County Community Assessment
137