McIntosh County - Community Health Needs Assessment
Transcription
McIntosh County - Community Health Needs Assessment
by preventing illness and injury, promoting healthy behaviors, and protecting from harm. of those who live, work, and play in McIntosh County, and To improve the health Community Health Needs Assessment Coastal Health District McIntosh County, Georgia Prepared by College of Coastal Georgia Faculty and Students Mary Eleanor Wickersham, D.P.A., Assistant Professor of Public Affairs, and Student Interns: Stephanie Basey, Suncica Beba, Jannronn Bradford, April Davis, Jennifer Dougherty, John Lander, Maurice Mason, Jay Moreno, Maurey Moss, and Corliss Wade 2013 McIntosh County Community Health Needs Assessment October 31, 2013 Diane Z. Weems, M.D. District Health Director, Coastal Health District 24 Oglethorpe Professional Boulevard Savannah, Georgia 31406 Dear Dr. Weems, Following this letter of transmittal, you will find the Community Health Needs Assessment for McIntosh County, Georgia. The document includes four sections: public data, survey data and focus group responses, and data analysis. It has been a tremendous learning experience for the students who have volunteered to work on this project. Thank you for this opportunity. Yours truly, Mary Eleanor Wickersham, D.P.A., Assistant Professor of Public Affairs and Students in the Public Affairs and Health Informatics Programs, Stephanie Basey, Suncica Beba, Jannronn Bradford, April Davis, Jennifer Dougherty, John Lander, Maurice Mason, Jay Moreno, Maurey Moss, and Corliss Wade 2 2013 McIntosh County Community Health Needs Assessment Executive Summary As part of its responsibility to better meet the needs of the communities it serves, Coastal Health District authorized a Community Health Needs Assessment for three of its southern counties in late August 2013. The College of Coastal Georgia Foundation received a small grant in return for work on the survey by students in the College of Coastal Georgia Public Affairs and Health Informatics Programs. Following approval by the college’s Institutional Review Board, faculty and students worked together to devise, distribute, and collect surveys, host focus groups to discuss survey data, and analyze data that will be useful for program planning for the Coastal Health District. This Assessment is provided to readers in three sections: 1. Public Data - This section includes county-level data derived from public sources, including the Georgia Department of Public Health. Data used are the most recent available and trending was conducted whenever data were available. 2. Survey Data - A 36-question survey was prepared and approved by the Coastal Health District and the college’s IRB. It was distributed online and as a paper survey. There were 251 respondents in McIntosh County. Although each question varied slightly in the number of respondents, overall the survey results have a 95% confidence level with a margin of error of plus or minus six. Once survey results were in, highlights of the survey were shared with focus groups, who commented on the validity of the information provided by respondents and made other suggestions about community needs. These comments follow the appropriate survey data. 3. The final phase of the project was data analysis, in which trends are identified and relationships between findings are identified. There is much more that could be learned from this information, however, a focus was placed on areas that could be impacted by Public Health. 3 2013 McIntosh County Community Health Needs Assessment Table of Contents Public Data ....................................................................................................................... 7 Demographic Data ...................................................................................................................8 Race, Age, Gender Data ..................................................................................................................8 Income ......................................................................................................................................... 10 Poverty Indicators ........................................................................................................................ 11 Employment ................................................................................................................................. 13 Housing Characteristics ............................................................................................................. 18 Special Populations ...................................................................................................................... 22 Pregnancy and Birth Rates by County .......................................................................................... 24 Mortality Data ....................................................................................................................... 25 Non-Injury Mortality Rates Per 100,000 ...................................................................................... 25 Compressed Mortality Rates per 100,000 from Injuries ............................................................. 26 Suicides ........................................................................................................................................ 26 Top Hospital Discharge Diagnoses ............................................................................................... 31 Discharge Rate per 100,000 for Colon Cancer by Race................................................................ 32 Discharge Rate per 100,000 for Breast Cancer by Race............................................................... 33 Discharge Rate per 100,000 for Lung Cancer by Race ................................................................. 34 Discharge Rate per 100,000 for Prostate Cancer......................................................................... 35 Discharge Rate per 100,000 for High Blood Pressure by Race .................................................... 36 Discharge Rate per 100,000 for Kidney Disease by Race ............................................................. 37 Discharge Rate per 100,000 for Obstructive Heart Disease by Race ..................................... 38 Discharge Rate per 100,000 for Diabetes by Race and Gender ................................................... 39 Discharge Rate per 100,000 for Bone and Muscle Diseases by Race and Gender ...................... 40 Discharge Rate per 100,000 for Pneumonia by Race and Gender............................................... 41 Discharge Rate per 100,000 for Nervous System Diseases by Race and Gender ........................ 42 Communicable/Infectious Disease Counts, McIntosh County..................................................... 43 Data Provided by Georgia Department of Public Health, Coastal Health District ....................... 43 Sexually Transmitted Diseases ..................................................................................................... 44 Percentage of Persons Who Did Not See a Doctor in the Past 12 Months, Due to Cost ............. 45 Uninsured Population .................................................................................................................. 45 Medicare Enrollees Who Had a Mammogram ............................................................................ 45 Medicare Spending Per Enrollee.................................................................................................. 46 Preventable Hospital Stays for Medicare Enrollees ..................................................................... 46 Diabetic Screening and Prevalence of Diabetes .......................................................................... 47 Emergency Room (ER) Visits by County ....................................................................................... 47 4 2013 McIntosh County Community Health Needs Assessment Age-Adjusted Emergency Room Visit Rate, McIntosh County, 2006 – 2010 Aggregate ............. 48 Mental and Physical Health Status .............................................................................................. 49 Obesity Rates ............................................................................................................................... 50 Index Crimes ................................................................................................................................ 50 Family Violence, McIntosh County 2012 (GBI)............................................................................ 50 Auto Injuries ................................................................................................................................. 51 Alcohol and Drug Abuse/Use ....................................................................................................... 52 Controlled Substance Prescriptions by County ............................................................................ 53 Georgia Department of Juvenile Justice (DJJ), McIntosh Statistics, 2009 – 2011........................ 55 Environmental Risks ..................................................................................................................... 56 Healthcare Resources ............................................................................................................. 60 McIntosh County Greenway Trails ............................................................................................... 62 Access to Healthy Foods .............................................................................................................. 63 Public Transportation Opportunities ........................................................................................... 64 McIntosh County Survey Data......................................................................................... 65 Survey Respondent Demographics .......................................................................................... 66 Age, Race, Gender, and Marital Status ........................................................................................ 66 Educational Attainment ............................................................................................................... 67 Employment Status ...................................................................................................................... 68 Income ......................................................................................................................................... 68 Health Insurance Status ............................................................................................................... 69 Survey Respondent Morbidity ................................................................................................ 70 Self-Reported Health Status and Need for Supports ................................................................... 70 Self-Reported Health Problems ................................................................................................... 71 Persons Who Report Need for Assistance with Activities of Daily Living .................................... 72 Social and Emotional Support Needs ........................................................................................... 72 Social Issues that Affect the Health and Safety of McIntosh Residents ...................................... 73 Survey Respondent Health Resource Utilization ...................................................................... 74 Primary Source of Health Care..................................................................................................... 74 Barriers to Health Care ................................................................................................................ 75 Physician and Dentist Visits in the Last Two Years ...................................................................... 76 Gaps in Health Care in McIntosh ................................................................................................. 76 Respondent Health Risks/Behaviors ....................................................................................... 77 Tobacco Use ................................................................................................................................. 77 Binge Drinking .............................................................................................................................. 77 Weight, Exercise, and Diet Findings ............................................................................................. 78 Self-Reported Experience with Risks ........................................................................................... 79 Emergency Planning and Ability to Evacuate............................................................................... 80 Top Environmental Problems ...................................................................................................... 80 Primary Source of Health Information ......................................................................................... 81 5 2013 McIntosh County Community Health Needs Assessment Access to Computer and Internet ................................................................................................ 81 Public Health Services Accessed by Respondents ....................................................................... 82 Challenges to Good Health Experienced by McIntosh Families .................................................. 83 Resources that Could be Leveraged to Improve Health .............................................................. 84 McIntosh County Open-Ended Responses by Age and Gender ................................................... 85 Analysis.......................................................................................................................... 87 Select Trends in Public Data .................................................................................................... 88 Survey Demographics and Health Status ................................................................................. 89 Education and Health Status ........................................................................................................ 89 Smoking by Race, Gender, Income, and Health Status ................................................................ 90 Household Income, Education, and Healthy Diets ...................................................................... 91 Overweight by Race ..................................................................................................................... 92 Age and Exercise Habits ............................................................................................................... 93 Exercise Habits and Weight ......................................................................................................... 93 Exercise and Healthy Diets ........................................................................................................... 94 Access to Computer and Internet for Health Education .............................................................. 95 Need for Emotional and Social Supports by Age ......................................................................... 96 Evacuation in the Event of a Natural Disaster ............................................................................. 97 Health Services Utilization ...................................................................................................... 98 Primary Source of Care for Insured, Uninsured ........................................................................... 99 Dental Visits and Income ........................................................................................................... 100 6 2013 McIntosh County Community Health Needs Assessment Public Data 7 2013 McIntosh County Community Health Needs Assessment Demographic Data Race, Age, Gender Data Census Details Census Details 2010 Census Counts Percentages 2000 Census Counts 14,333 100.00% 10,847 100.00% 53 45 5,149 10 0.37% 0.31% 35.92% 0.07% 41 32 3,993 4 0.38% 0.30% 36.81% 0.04% 88 177 8,811 0.61% 1.23% 61.47% 29 94 6,654 0.27% 0.87% 61.34% Population by Hispanic or Latino Origin (of any race) Persons of Hispanic or Latino Origin 227 Persons Not of Hispanic or Latino Origin 14,106 1.58% 98.42% 99 10,748 0.91% 99.09% Population by Gender Male Female 48.76% 51.24% 5,369 5,478 49.50% 50.50% 5.48% 16.00% 61.24% 17.29% 715 2,327 6,525 1,280 6.59% 21.45% 60.15% 11.80% McIntosh County, Total Population Population by Race American Indian and Alaska native alone Asian alone Black or African American alone Native Hawaiian and Other Pacific native alone Some other race alone Two or more races White alone 6,989 7,344 Population by Age Persons 0 to 4 years 785 Persons 5 to 17 years 2,293 Persons 18 to 64 years 8,777 Persons 65 years and over 2,478 Source: http://censusviewer.com/county/GA/McIntosh 8 Percentages 2013 McIntosh County Community Health Needs Assessment Population Trends Population Trends 11,878 2003 12,408 12,182 2004 2005 12,950 2006 13,623 2007 13,973 2008 14,268 2009 14,271 2010 14,170 13,839 2011 2012 Data from U.S. Census Population by Race McIntosh County Population by Race 0.37% 0.31% American Indian and Alaska native alone Asian alone Black or African American alone 35.92% Native Hawaiian and Other Pacific native alone Some other race alone 61.47% 0.07% 0.61% 1.23% Data from U.S. Census 9 Two or more races White alone 2013 McIntosh County Community Health Needs Assessment Income McIntosh County Income, U.S. Census Data McIntosh County, Georgia Households Families Marriedcouple families Nonfamily households Estimate Estimate Estimate Estimate Total 5,583 3,638 2,590 1,945 Less than $10,000 11% 2% 0% 27% $10,000 to $14,999 8% 4% 2% 15% $15,000 to $24,999 16% 15% 8% 19% $25,000 to $34,999 14% 13% 12% 16% $35,000 to $49,999 12% 13% 14% 8% $50,000 to $74,999 20% 28% 32% 5% $75,000 to $99,999 10% 12% 14% 6% $100,000 to $149,999 8% 11% 15% 3% $150,000 to $199,999 1% 2% 3% 0% $200,000 or more 1% 0% 0% 1% Median income ($) 37,194 53,812 62,778 17,997 Mean income ($) 49,407 57,901 31,946 Household Income McIntosh County 2% 19% 32% 19% 29% $0-14,999 $15,000-$34,999 $75,000-$149,999 $150,000-more $35,000-$74,999 All Data on page from U.S. Census 10 2013 McIntosh County Community Health Needs Assessment Poverty Indicators Gini Index* Comparison County ( 2006-2010) Gini Index* Camden Glynn McIntosh U.S. .402 - .421 .461- .645 .439 - .460 .467 *GINI Index defined: The Gini index varies between zero and one. A value of one indicates perfect inequality where only one household has any income. A value of zero indicates perfect equality, where all households have equal income.” (Bee, Adam. 2012. “Household Income Inequality within U.S. Counties: 2006 – 2010.”) Data from American Community Survey Briefs, U.S. Census. McIntosh County Residents Receiving Food Stamps SNAP Recipients (Food Stamps) Percentage of Population on SNAP Percentage Increase Since 2000 *2009 2,591 17% -- **2011 2,591 17% 199% *Data from “County-by-County Review of SNAP/Food Stamp Participation,” http://frac.org/wp-content/uploads/2010/07/ny_times_snap_poverty_formatted.pdf; **2013 from Slate: Kirk, Chris. “How Many People Around You Receive Food Stamps?” Slate. April 30, 2013. Percentage of Population in Poverty by County Percent of Residents in Poverty, 2011 All Persons Children 0 - 17 26.6 19.2 Georgia 35.5 31.1 20.4 14.7 Camden 21.7 19.6 Glynn McIntosh USDA Economic Research Service, http://www.ers.usda.gov/data-products/county-level-datasets/poverty.aspx#.UjYSXMZeaSo 11 2013 McIntosh County Community Health Needs Assessment Families with children with annual incomes of less than 150% of the federal poverty threshold Location Georgia Camden Glynn McIntosh Data Type 2005 - 2009 2006 - 2010 2007 - 2011 Number 340,003 359,789 374,251 Percent 27.30% 28.50% 29.60% Number 1,809 1,995 2,020 Percent 25.30% 27.90% 27.60% Number 2,552 2,999 3,144 Percent 28.10% 30.60% 32.60% Number 447 591 607 Percent 33.80% 37.60% 43.50% Data from Kids Count Database, http://datacenter.kidscount.org/data/tables/698-families-with-children-withannual-incomes-of-less-than-150-of-the-federal-povertythreshold?loc=12&loct=5#detailed/5/1946,1989,2024/true/1067,1000,939/any/8886,8887 Eligible children, birth through 4, enrolled in the Women, Infants, and Children (WIC) program Location 2007 2008 2009 2010 2011 Camden 2,509 2,645 2,718 2,635 2,743 Glynn 3,316 3,444 3,599 3,590 3,447 McIntosh 504 519 541 533 523 Georgia 340,589 361,291 379,071 377,186 373,572 Data from Kids Count Database, http://datacenter.kidscount.org/data/tables/698-families-with-children-withannual-incomes-of-less-than-150-of-the-federal-povertythreshold?loc=12&loct=5#detailed/5/1946,1989,2024/true/1067,1000,939/any/8886,8887 12 2013 McIntosh County Community Health Needs Assessment Employment Employment Characteristics by Family All data from U.S. Census, American Community Survey Georgia Glynn County, Georgia Total Estimate McIntosh County, Georgia Total Estimate Families 2,389,321 13,419 EMPLOYMENT STATUS CHARACTERISTICS Married-couple families 1,701,625 10,566 Both husband and wife in 54.50% 52.60% labor force Husband in labor force, 23.80% 26.90% wife not in labor force Wife in labor force, 7.20% 7.40% husband not in labor force Both husband and wife 14.60% 13.00% not in labor force 20,756 3,638 15,105 49.00% 2,590 42.90% 21.60% 24.00% 7.20% 6.00% 22.20% 27.20% Other families Female householder, no husband present In labor force Not in labor force Male householder, no wife present In labor force Not in labor force Total Estimate Camden County, Georgia Total Estimate 687,696 76.90% 2,853 78.80% 5,651 81.40% 1,048 81.70% 55.80% 21.10% 23.10% 57.00% 21.80% 21.20% 57.20% 24.20% 18.60% 55.20% 26.50% 18.30% 18.40% 4.70% 12.00% 9.30% 14.10% 4.40% 15.90% 2.40% 13 2013 McIntosh County Community Health Needs Assessment Employment Characteristics by Family Georgia Camden County, Georgia Total Estimate Glynn County, Georgia Total Estimate McIntosh County, Georgia Total Estimate 13,419 12.10% 20,756 17.70% 3,638 19.90% 35.50% 34.40% 38.90% 52.40% 47.90% 41.20% 1,701,625 10,566 57.20% 58.40% 15,105 52.90% 2,590 46.50% 29.30% 30.30% 28.00% 24.50% 18.70% 18.10% 16.50% 15.30% 5.30% 4.50% 4.60% 2.30% 24.10% 23.50% 30.50% 38.20% 13.30% 11.50% 20.20% 25.40% Total Estimate WORK STATUS CHARACTERISTICS Families 2,389,321 No workers in the past 12 13.10% months 1 worker in the past 12 35.40% months 2 + workers in the past 12 51.60% months Married-couple families Householder worked fulltime, year-round in the past 12 months Spouse worked full-time, year-round in the past 12 months Householder worked part-time or part-year in the past 12 months Spouse worked part-time or part-year in the past 12 months Householder did not work in the past 12 months Spouse did not work in the past 12 months All data from U.S. Census, American Community Survey 14 2013 McIntosh County Community Health Needs Assessment Work Status Work Status Georgia Population 16 to 64 years WEEKS WORKED Worked 50 to 52 weeks Worked 40 to 49 weeks Worked 27 to 39 weeks Worked 14 to 26 weeks Worked 1 to 13 weeks Did not work USUAL HOURS WORKED Usually worked 35 or more hours per week Usually worked 15 to 34 hours per week Usually worked 1 to 14 hours per week Did not work Mean usual hours worked for workers Camden County, Georgia Glynn County, Georgia McIntosh County, Georgia Estimate Estimate Estimate Estimate 6,396,436 33,596 50,036 9,100 53.80% 6.10% 4.70% 4.00% 5.30% 26.10% 58.50% 4.80% 4.90% 3.70% 4.50% 23.60% 58.60% 5.40% 3.50% 3.40% 5.40% 23.60% 50.40% 2.80% 4.90% 4.30% 4.50% 33.20% 58.30% 60.60% 59.80% 49.60% 12.60% 13.00% 14.00% 12.50% 2.90% 2.80% 2.60% 4.60% 26.10% 23.60% 23.60% 33.20% 39.3 40.6 39 38.3 Data from U.S. Census Bureau, American Community Survey Quarter Wages and Employment Census, McIntosh Quarterly Wages and Employment Census, McIntosh County, 2003 - 2012 2458 2348 2222 2312 2351 2225 2056 1905 1709 1775 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Bureau of Labor Statistics, http://www.bls.gov/cew/ 15 2013 McIntosh County Community Health Needs Assessment Employment Status of Residents All data from U.S. Census, American Community Survey Camden County Glynn County McIntosh County EMPLOYMENT STATUS Population 16 years and over 38,083 61,777 11,440 In labor force 25,678 39,675 6,638 Civilian labor force 21,969 39,636 6,638 Employed 19,928 36,014 6,031 Unemployed 2,041 3,622 607 Armed Forces 3,709 39 0 Not in labor force 12,405 22,102 4,802 Civilian employed population 16 years and over 19,928 36,014 6,031 Management, business, science, and arts occupations 6,197 11,291 1,628 Service occupations 4,003 8,684 1,232 Sales and office occupations 5,325 8,921 1,264 Natural resources, construction, and maintenance occupations Production, transportation, and material moving occupations INDUSTRY 2,244 3,618 1,101 2,159 3,500 806 Civilian employed population 16 years and over 19,928 36,014 6,031 Agriculture, forestry, fishing and hunting, and mining 97 279 311 Construction 1,240 2,782 879 Manufacturing 1,655 2,446 409 Wholesale trade 566 877 61 Retail trade 2,678 4,119 671 Transportation and warehousing, and utilities 1,041 1,555 276 Information 247 660 144 Finance and insurance, and real estate and rental and leasing Professional, scientific, and management, and administrative and waste management services Educational services, and health care and social assistance Arts, entertainment, and recreation, and accommodation and food services Other services, except public administration 807 1,631 209 1,867 3,717 380 3,684 7,196 1,293 2,085 5,801 623 920 2,279 202 3,041 2,672 573 OCCUPATION Public administration CLASS OF WORKER 19,928 36,014 6,031 Private wage and salary workers Civilian employed population 16 years and over 13,519 27,127 4,059 Government workers 5,553 6,186 1,427 825 2,603 545 31 98 0 Self-employed in own not incorporated business workers Unpaid family workers 16 2013 McIntosh County Community Health Needs Assessment Unemployment Rate Unemployment Rate, 2005 - 2012 12 Percentage 10 8 6 4 2 0 2005 Camden 2006 2007 Glynn 2008 2009 McIntosh 2010 2011 Georgia 2012 U.S. *Data from Bureau of Labor Statistics, http://www.bls.gov/lau/ and http://data.bls.gov/timeseries/LNS14000000 McIntosh continues to fall behind its neighbors, the state, and the U.S. in employment. This trend makes clear that there has not been a full recovery since the economic downturn that began in 2009. 17 2013 McIntosh County Community Health Needs Assessment Housing Characteristics Housing Characteristics Georgia Percent Camden County, Georgia Percent Glynn County, Georgia Percent McIntosh County, Georgia Percent Total housing units 4,063,024 20,945 40,332 8,966 Occupied housing units 85.90% 86.00% 76.80% 62.30% Vacant housing units 14.10% 14.00% 23.20% 37.70% Occupied housing units 3,490,754 18,015 30,980 5,583 Owner-occupied 66.80% 69.30% 63.90% 78.60% Renter-occupied 33.20% 30.70% 36.10% 21.40% Occupied housing units 3,490,754 18,015 30,980 5,583 Utility gas 42.70% 6.10% 14.20% 6.00% Bottled, tank, or LP gas 6.30% 2.20% 3.10% 16.10% Electricity 49.50% 90.40% 81.50% 75.70% Fuel oil, kerosene, etc. 0.30% 0.10% 0.40% 0.00% Coal or coke 0.00% 0.00% 0.00% 0.00% Wood 1.00% 0.50% 0.40% 2.10% Solar energy 0.00% 0.00% 0.00% 0.00% Other fuel 0.10% 0.20% 0.00% 0.00% No fuel used 0.30% 0.40% 0.40% 0.00% Occupied housing units 3,490,754 18,015 30,980 5,583 Lacking complete plumbing facilities Lacking complete kitchen facilities 0.50% 0.90% 1.30% 1.80% 0.70% 1.00% 1.40% 1.30% No telephone service available 4.10% 2.70% 4.20% 7.00% HOUSING OCCUPANCY HOUSING TENURE HOUSE HEATING FUEL SELECTED CHARACTERISTICS Data from U.S. Census, American Community Survey 18 2013 McIntosh County Community Health Needs Assessment Georgia Camden Glynn McIntosh VALUE Owner-occupied units 2,332,685 12,486 19,800 4,388 Less than $50,000 9.10% 10.20% 10.80% 22.30% $50,000 to $99,999 15.80% 10.70% 16.10% 28.60% $100,000 to $149,999 20.40% 21.30% 14.20% 7.80% $150,000 to $199,999 19.10% 23.80% 13.00% 12.90% $200,000 to $299,999 17.80% 20.20% 16.10% 8.70% $300,000 to $499,999 11.90% 9.20% 17.60% 16.10% $500,000 to $999,999 4.80% 3.60% 9.50% 2.40% $1,000,000 or more 1.10% 1.10% 2.60% 1.20% Owner-occupied units 2,332,685 12,486 19,800 4,388 Housing units with a mortgage 71.40% 73.20% 66.70% 52.30% Housing units without a mortgage 28.60% 26.80% 33.30% 47.70% Occupied units paying rent 1,084,745 5,107 10,574 868 Less than $200 1.90% 0.30% 3.10% 12.30% $200 to $299 3.20% 2.40% 3.00% 9.80% $300 to $499 9.10% 7.70% 12.00% 23.70% $500 to $749 25.30% 26.20% 26.30% 42.70% $750 to $999 29.90% 34.10% 29.50% 9.70% $1,000 to $1,499 24.70% 24.50% 20.80% 1.70% $1,500 or more 6.00% 4.80% 5.20% 0.00% MORTGAGE STATUS GROSS RENT Source: U.S. Census Bureau, 2007-2011 American Community Survey 19 2013 McIntosh County Community Health Needs Assessment Educational Attainment Educational Attainment Estimate 969,452 21.00% 32.00% Camden County, Georgia Estimate 6,509 16.00% 42.30% Glynn County, Georgia Estimate 6,662 22.60% 40.50% McIntosh County, Georgia Estimate 1,459 17.30% 49.60% 39.60% 35.00% 32.20% 26.80% 7.40% 6.70% 4.70% 6.30% Population 25 years and over Less than 9th grade 9th to 12th grade, no diploma High school graduate (or GED) Some college, no degree Associate's degree Bachelor's degree Graduate or professional degree 6,152,481 5.90% 10.10% 29.40% 20.50% 6.60% 17.70% 9.80% 29,965 2.40% 8.30% 31.20% 28.90% 8.90% 12.20% 8.10% 52,973 3.90% 10.00% 30.10% 22.90% 7.30% 16.10% 9.70% 9,486 9.10% 13.50% 38.10% 18.70% 5.50% 9.60% 5.60% Population 25 to 34 years High school graduate or higher Bachelor's degree or higher 1,327,582 84.90% 28.90% 7,132 93.20% 19.20% 9,523 84.50% 24.50% 1,030 91.10% 21.60% Population 35 to 44 years High school graduate or higher Bachelor's degree or higher 1,413,864 87.70% 31.40% 6,695 92.40% 19.40% 10,056 90.10% 25.50% 1,664 74.00% 15.40% Population 45 to 64 years High school graduate or higher Bachelor's degree or higher 2,404,926 86.10% 28.00% 11,651 89.60% 21.60% 21,653 88.20% 24.80% 4,452 79.00% 12.80% Population 65 years and over High school graduate or higher Bachelor's degree or higher 1,006,109 72.60% 19.00% 4,487 77.50% 19.60% 11,741 80.10% 29.20% 2,340 71.10% 16.90% Population 18 to 24 years Less than high school graduate High school graduate (includes equivalency) Some college or associate's degree Bachelor's degree or higher Georgia Data Source: U.S. Census Bureau, 2007-2011, American Community Survey According to the National Center for Education Statistics, National Assessment of Adult Literacy, in 2003 (the most recent year for which statistics are available), 19.8% of adults lacked basic literacy skills. 20 2013 McIntosh County Community Health Needs Assessment Graduation Rates and Educational Attainment by Age Group McIntosh County Graduation Rate Graduation Rate 100% 94% 92% 90% 88% 86% 84% 82% 80% 78% 76% 80% 60% 40% 20% 0% 2010 2010 2011 Camden 2012 2011 Glynn 2012 McIntosh Data from Georgia Department of Education Education Attainment for Population 25 Years and Older 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Georgia Camden Glynn McIntosh Less than 9th grade 9th to 12th grade, no diploma High school graduate (or GED) Some college, no degree Associate's degree Bachelor's degree Graduate or professional degree U.S. Census Bureau, American Community Survey, 2007 – 2011 According to the National Center for Education Statistics, in 2003, (the most recent data available by county), 19.8% of the McIntosh population did not have basic literacy skills. 21 2013 McIntosh County Community Health Needs Assessment Special Populations Older Residents as a Percentage of Population Percentage of Older Persons in Population 20 15 % 65+ 10 % 85+ 5 0 2003 2010 Data from Georgia Statistics System, http://www.georgiastats.uga.edu SSI* and SSI + OASDI** Recipients by County and Total Payments by County, December 2012 Georgia Camden Glynn McIntosh Total Aged Blind and Disabled Under 18 18-64 65 or older SSI recipients also receiving OASDI Total payments in thousands of dollars* 247,951 846 1,924 464 24,722 51 134 43 223,229 795 1,790 421 45,271 197 370 49 151,984 520 1,251 305 50,696 129 303 110 82,568 277 713 211 135,864 433 1,009 205 *SSI stands for Supplemental Security Income; **OASDI stands for Old Age, Survivors, and Disability Insurance or what we know as Social Security. According to the Social Security Administration, “SSI targets eligible persons who have limited income and resources and who are disabled, blind, or aged 65 or older. Blind or disabled children, as well as adults, are also eligible to receive SSI benefits.” SOURCES: Social Security Administration, Master Beneficiary Record and Supplemental Security Record, 100 percent data. *The state payment total does not equal the sum of the rounded county totals. http://www.ssa.gov/policy/docs/statcomps/ssi_sc/2005/index.html 22 2013 McIntosh County Community Health Needs Assessment Persons with Disabilities in the Civil Non-Institutionalized Population, 2000 (2010 Disability Data Not Available) Georgia Total disabilities tallied Total disabilities tallied for people 5 to 15 years Sensory disability 2,638,739 Camden County 10,656 Glynn County 24,738 McIntosh County 5,053 99,511 644 931 143 12,885 67 154 10 Physical disability 13,471 48 204 27 Mental disability 60,819 466 508 97 Self-care disability 12,336 63 65 9 Total disabilities tallied for people 16 to 64 years Sensory disability 1,784,544 7,992 14,637 3,610 122,519 641 1,275 350 Physical disability 336,687 1,802 2,942 778 Mental disability 190,182 887 1,977 372 Self-care disability 93,199 487 775 264 Go-outside-home disability Employment disability Total disabilities tallied for people 65 years and over Sensory disability 375,962 1,154 2,603 644 665,995 3,021 5,065 1,202 754,684 2,020 9,170 1,300 119,668 384 1,618 228 Physical disability 256,057 767 3,051 456 Mental disability 107,051 236 1,329 187 Self-care disability 89,319 240 1,177 142 Go-outside-home 182,589 393 1,995 287 disability Data from U.S. Census, Fact Finder, http://factfinder2.census.gov/faces/tableservices/jsf/pages/ productview.xhtml?pid=DEC_00_SF3_P041&prodType=table 23 2013 McIntosh County Community Health Needs Assessment Pregnancy and Birth Rates by County Birth Rates by County, 2000-2010 Pregnancy Rate, age 20+ 60 60 50 50 40 40 30 30 20 20 10 10 0 2000 2005 Camden Glynn 0 2010 McIntosh 2000 2005 2010 Camden Glynn McIntosh First Births to Mothers Age 20 or Older with 12 Years of Education 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% 2003 2004 Georgia 2005 2006 Camden 2007 2008 Glynn All data on page from Georgia Family Connection Partnership 24 2009 2010 McIntosh 2011 2013 McIntosh County Community Health Needs Assessment Mortality Data Non-Injury Mortality Rates Per 100,000 Compressed Mortality, Non-Injury, 1999 - 2010, McIntosh County All other diseases Diseases indicated by abnornal labs Perinatal conditions Kidney disease Chronic liver disease/ cirrhosis Other respiratory diseases Chronic respiratory disease Flu and pneumonia Circulatory system diseases Atherosclerosis Cerebrovascular diseases/stroke Hypertension Diseases of Heart Alzheimers disease Diabetes mellitus Malignant neoplasms (Cancers) HIV Septicemia 0 50 100 150 200 250 Centers for Disease Control, Wonder Database, http://wonder.cdc.gov/controller/datarequest/D91;jsessionid=1123EB164D7EBF83302C63A85AD0E C85 25 2013 McIntosh County Community Health Needs Assessment Compressed Mortality Rates per 100,000 from Injuries Compressed Mortality, Injuries, 1999 - 2010, McIntosh County 30 25 20 15 10 5 0 Drowning Firearm Motor Vehicle Traffic Centers for Disease Control, Wonder Database, http://wonder.cdc.gov/controller/datarequest/D91;jsessionid=1123EB164D7EBF83302C63A85AD0E C85 Suicides Suicides by County 25 20 15 10 5 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Camden Glynn McIntosh Data from Georgia Statistics System, http://www.georgiastats.uga.edu 26 2013 McIntosh County Community Health Needs Assessment Top Ten Causes of Death in McIntosh, 2007 - 2011 County Comparison with Georgia Cause McIntosh Rank Georgia Rank Ischemic Heart and Vascular Disease 1 1 Malignant Neoplasms of the Trachea, Bronchus and Lung All COPD Except Asthma 2 2 3 4 Cerebrovascular Disease 4 3 Alzheimer’s Disease 5 7 Nephritis, Nephrotic Syndrome and Nephrosis Malignant Neoplasms of Colon, Rectum and Anus Motor Vehicle Crashes 6 9 7 12 8 13 Malignant Neoplasm of the Breast 9 14 All Other Mental and Behavioral Disorders 10 5 Data from Georgia Department of Public Health Years of Potential Life Lost Years Years of Potential Life Lost Before Age 75 Per 100,000 Population (Age-adjusted) 14000 12000 10000 8000 6000 4000 2000 0 Camden Glynn McIntosh Georgia 2010 2011 2012 2013 Data from County Health Rankings, http://www.countyhealthrankings.org/our-approach/healthoutcomes/premature-death Years of Potential Life Lost provides a measure of the overall population health. According to County Health Rankings, “Premature deaths are deaths that occur before a person reaches an expected age, for instance, age 75. Many of these deaths are considered to be preventable.” 27 2013 McIntosh County Community Health Needs Assessment Infant Mortality Infant Deaths by County, 2005 – 2011 2005 2006 2007 2008 2009 2010 2011 Georgia 1,196 1,241 1,292 1,157 1,192 1,070 1,165 Camden 1 3 3 4 3 4 4 Glynn 6 10 7 5 6 8 7 McIntosh 3 1 1 1 3 0 3 Data from OASIS, Georgia Public Health Online Statistical Information System, http://oasis.state.ga.us/oasis/oasis/qryMCH.aspx Leading Causes of Infant Deaths, by Crude Death Rate, 2000 – 2007 McIntosh County Certain Conditions Originating in the Perinatal Period Suffocation Data from OASIS, Georgia Public Health Online Statistical Information System, http://oasis.state.ga.us/oasis/oasis/qryMCH.aspx Infant Deaths, 2000 - 2011 Numbe of Infant Deaths 20 15 Camden 10 Glynn McIntosh 5 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Data from OASIS, Georgia Public Health Online Statistical Information System, http://oasis.state.ga.us/oasis/oasis/qryMCH.aspx 28 2013 McIntosh County Community Health Needs Assessment Induced Terminations by County Induced Termination of Pregnancy Camden Glynn McIntosh 51 25 18 11 9 2 1 2000 5 1 2005 2010 Data from Georgia Statistics System, http://www.georgiastats.uga.edu Number of Early Childhood Deaths by County Early Childhood Deaths (Ages 1-4) by County Camden Glynn McIntosh 44 3 2 2 11 0 0 1 1 0 2 22 1 2 1 1 0 22 2 11 00 0 0 0 11 0 0 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Data from Georgia Public Health, OASIS 29 2013 McIntosh County Community Health Needs Assessment Morbidity Data Health Risks Related to Pregnancy Pregnancy Rate, age 10-19 60 50 40 30 20 10 0 2000 2005 Camden Glynn 2010 McIntosh Low Birthweight Rate 2000-2010 14 12 10 8 6 4 2 0 2000 2005 Camden Glynn 2010 McIntosh Very Low Birthweight Rate 2000-2010 5 4 3 2 1 0 2000 2005 Camden Glynn 2010 McIntosh 30 All data on this page from Georgia Department of Public Health, OASIS Statistical System 2013 McIntosh County Community Health Needs Assessment Inadequate Prenatal Care 2000 Births Camden 48 Glynn 109 McIntosh 17 % Inadequate Prenatal Care Utilization 7.5 11 10.6 2005 Births % Inadequate Prenatal Care Utilization 125 81 6 19.5 8 4.8 Data from Georgia Department of Public Health, OASIS Top Hospital Discharge Diagnoses McIntosh/Georgia Age-Adjusted Hospital Discharge Rate, 2006- 2010 Cause McIntosh County Rank 1 Georgia Rank 1 Diseases of the Musculoskeletal System and Connective Tissue 2 3 All Other Mental and Behavioral Disorders 3 4 Ischemic Heart and Vascular Disease 4 2 Pneumonia 5 5 All Other Diseases of the Genitourinary System 6 6 Cerebrovascular Disease 7 7 Essential (Primary) Hypertension and Hypertensive Renal, and Heart Disease All Other Endocrine, Nutritional and Metabolic Diseases 8 17 9 8 All COPD Except Asthma 10 10 Pregnancy, Childbirth and the Puerperium Data provided by Georgia Department of Public Health 31 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Colon Cancer by Race Discharge Rates for Colon Cancer Among Whites by County 120 100 80 60 40 20 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Camden Glynn McIntosh Discharge Rates for Colon Cancer Among Blacks by County 70 60 50 40 30 20 10 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Camden Glynn McIntosh Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 32 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Breast Cancer by Race 70.0 Discharge Rates for Breast Cancer Among Whites by County 60.0 50.0 40.0 Camden 30.0 Glynn 20.0 McIntosh 10.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Discharge Rates for Breast Cancer Among Blacks by County 40.0 30.0 Camden 20.0 Glynn McIntosh 10.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 33 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Lung Cancer by Race Discharge Rates for Lung Cancer among Whites by County 120.0 100.0 80.0 Camden 60.0 Glynn 40.0 McIntosh 20.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Discharge Rates for Lung Cancer among Blacks by County 70 60 50 40 Camden 30 Glynn McIntosh 20 10 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 34 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Prostate Cancer Discharge Rates for Prostate Cancer Among Whites by County 35.0 30.0 25.0 20.0 Camden 15.0 Glynn McIntosh 10.0 5.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Discharge Rates for Prostate Cancer Among Blacks by County 45.0 40.0 35.0 30.0 25.0 Camden 20.0 Glynn 15.0 McIntosh 10.0 5.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 35 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for High Blood Pressure by Race Discharge Rates for High Blood Pressure Among Whites by County 70 60 50 40 Camden 30 Glynn McIntosh 20 10 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Discharge Rates for High Blood Pressure Among Blacks by County 250.0 200.0 150.0 Camden Glynn 100.0 McIntosh 50.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 36 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Kidney Disease by Race Discharge Rates for Kidney Disease Among Whites by County 200 180 160 140 120 100 80 60 40 20 0 Camden Glynn McIntosh 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Discharge Rates for Kidney Disease Among Blacks by County 300.0 250.0 200.0 Camden 150.0 Glynn 100.0 McIntosh 50.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 37 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Obstructive Heart Disease, Including Heart Attack, by Race Discharge Rates for Heart Disease Among Whites by County 1000 900 800 700 600 500 400 300 200 100 0 Camden Glynn McIntosh 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Discharge Rates for Heart Disease Among Blacks by County 450 400 350 300 Camden 250 Glynn 200 McIntosh 150 100 50 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 38 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Diabetes by Race and Gender Discharge Rates for Diabetes Among Whites McIntosh County, 2000-2010 300 250 200 150 White Male McIntosh 100 White Female McIntosh 50 0 Discharge Rates for Diabetes Among Blacks McIntosh County, 2000-2010 350 300 250 200 Black Male McIntosh 150 Black Female McIntosh 100 50 0 Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown According to the Centers for Disease Control, in 2009, 11.4% of McIntosh residents had been diagnosed with diabetes, and 31.3% percent were obese. Almost 29% were physically inactive. This data from http://apps.nccd.cdc.gov/DDT_STRS2/CountyPrevalenceData.aspx?mode=OBS. 39 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Bone and Muscle Diseases by Race and Gender Discharge Rates for Bone and Muscle Diseases Among Whites, McIntosh,County, 2000-2010 700 600 500 400 White Male McIntosh 300 White Female McIntosh 200 100 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 0 Discharge Rates for Bone and Muscle Diseases Among Blacks, McIntosh County, 2000-2010 700 600 500 400 Black Male McIntosh 300 Black Female McIntosh 200 100 0 Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 40 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Pneumonia by Race and Gender Discharge Rates for Pneumonia Among Whites McIntosh County, 2000-2010 700 600 500 400 White Male McIntosh 300 White Female McIntosh 200 100 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Discharge Rates for Pneumonia Among Blacks McIntosh County, 2000-2010 500 450 400 350 300 250 200 150 100 50 0 Black Male McIntosh Black Female McIntosh 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 41 2013 McIntosh County Community Health Needs Assessment Discharge Rate per 100,000 for Nervous System Diseases by Race and Gender Discharge Rates for Nervous system Diseases Among Whites. McIntosh County, 2000-2010 250 200 150 White Male McIntosh 100 White Female McIntosh 50 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 0 Discharge Rates for Nervous System Diseases Among Blacks, McIntosh County, 2000-2010 300 250 200 150 Black Male McIntosh 100 Black Female McIntosh 50 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 0 Source for data above and below: http://oasis.state.ga.us/oasis Age-Adjusted Discharges, Rates based on 1-4 events are not shown 42 2013 McIntosh County Community Health Needs Assessment Communicable/Infectious Disease Counts, McIntosh County Years with no reported cases are left blank. Disease 2008 2009 2010 2011 2012 3 1 13 3 1 4 2 Animal Bite Positive Rabid Animals 3 Lyme Disease 2 Influenza-Fatal 1 Hepatitis B (Acute) 1 Hepatitis B (Chronic) 1 1 2 2 Total Hepatitis B Reported 1 1 2 3 2 2 3 Hepatitis C (Chronic) Hepatitis C (Infected) 1 1 Total Hepatitis C Reported 1 1 1 2 Streptococcal Disease, Group A (Invasive) 2 4 1 Streptococcal Disease, Group B (Invasive) 2 Streptococcus Pneumoniae (Invasive) Total Invasive Pathogens 2 1 1 3 1 2 2 2 2 3 6 2 1 1 1 1 Aseptic Meningitis 1 Neisseria Meningitidis (Invasive) Meningitis (Cryptococcus) Total Meningitis 1 Mumps Legionelolsis Pertussis Varicella Shigatoxin Producing E. Coli (Stec) Vibrios-Other Yersinia Total Enteric Pathogens Reported Data Provided by Georgia Department of Public Health, Coastal Health District 43 2013 McIntosh County Community Health Needs Assessment Sexually Transmitted Diseases Sexually Transmitted Diseases, Counts, 2000 - 2010 700 600 500 400 300 200 100 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Camden Glynn McIntosh Data from Georgia Statistics System, www.georgiastats.uga.edu 44 2013 McIntosh County Community Health Needs Assessment Health Resource Utilization Percentage of Persons Who Did Not See a Doctor in the Past 12 Months, Due to Cost Year 2012 2013 Camden 14% 14% Glynn 12% 11% McIntosh 19% 18% Georgia 16% 16% Data from http://www.countyhealthrankings.org Uninsured Population Number Uninsured Camden Glynn McIntosh Percent Uninsured 2012 7664 13127 2182 2013 7689 15361 2728 2012 Camden 18% Glynn 21% McIntosh 23% Data from http://www.countyhealthrankings.org Medicare Enrollees Who Had a Mammogram Number of Female Medicare Enrollees Who Had Mammography Screening by County 1000 800 600 400 200 0 2011 2012 Camden Glynn 2013 McIntosh Data from County Health Rankings, http://www.countyhealthrankings.org 45 2013 17% 23% 23% 2013 McIntosh County Community Health Needs Assessment Percent of Female Medicare Enrollees Who Had Mammography Screening 80.00% 75.00% 70.00% 65.00% 2012 Camden 2013 Glynn McIntosh Data from http://www.countyhealthrankings.org Medicare Spending Per Enrollee Price-Adjusted Medicare Spending Per Enrollee $15,000.00 $10,000.00 $5,000.00 $0.00 Camden Glynn 2012 McIntosh Georgia 2013 Data from http://www.countyhealthrankings.org Preventable Hospital Stays for Medicare Enrollees Preventable Hospital Stays for Medicare Enrollees Axis Title Per 1000 Hospitalizations for Ambulatory Sensitive Conditions) 100 80 60 40 20 0 Camden Glynn McIntosh 2010 2011 2012 2013 All data on this page from County Health Rankings, http://www.countyhealthrankings.org 46 2013 McIntosh County Community Health Needs Assessment Diabetic Screening and Prevalence of Diabetes Percentage of Persons Having Diabetic Screenings 100% 80% Camden County 60% McIntosh County Glynn County 40% Georgia 20% USA 0% 2010 2011 2012 2013 Data from County Health Rankings, http://www.countyhealthrankings.org Emergency Room (ER) Visits by County 40000 3600000 35000 3500000 30000 3400000 25000 3300000 20000 3200000 15000 3100000 10000 5000 3000000 0 2900000 2005 2006 2007 2008 2009 2010 Data from Georgia Public Health OASIS Statistics System 47 ER Visits for State ER Visits by County ER Visits, 2005 - 2010 Georgia Camden Glynn McIntosh 2013 McIntosh County Community Health Needs Assessment Age-Adjusted Emergency Room Visit Rate, McIntosh County, 2006 – 2010 Aggregate Cause McIntosh County Rank Georgia Rank All Other Unintentional Injury 1 1 Diseases of the Musculoskeletal System and Connective Tissue 2 2 All Other Diseases of the Genitourinary System 3 4 Falls 4 3 Motor Vehicle Crashes 5 5 All Other Mental and Behavioral Disorders 6 7 Pregnancy, Childbirth and the Puerperium 7 6 All COPD Except Asthma 8 10 All Other Diseases of the Nervous System 9 8 Assault (Homicide) 10 12 Data from Georgia Department of Public Health According to the Georgia Department of Public Health: “The age-adjusted emergency room rate for the period described above was 3,597.9. The rate for the previous 4 year aggregate (2002 - 2005) was 4,458.5. This difference is statistically significant.” 48 2013 McIntosh County Community Health Needs Assessment Risk Factors/Health Behaviors Mental and Physical Health Status McIntosh County Self-Reported Health Status Number of Poor Physical Health Days Number of Poor Mental Health Days Percentage Who Describe Their Health as Poor or Fair 2010 4.5 6 25% 2011 4.2 5.1 N/A 2012 4.2 4.4 N/A 2013 3.9 4.2 N/A Georgia Self-Reported Health Status 2010 2011 2012 2013 Number of Poor Physical Health Days 3.6 3.5 3.6 3.5 Number of Poor Mental Health Days 3.5 3.4 3.4 3.4 Percentage Who Describe Their 17% 17% 16% 16% Health as Poor or Fair http://www.countyhealthrankings.org/app/georgia/2013/mcintosh/county/outcomes/overall/snapshot/byrank Physical Inactivity Years 2012 2013 Camden 24% 24% McIntosh 30% 30% Glynn 26% 26% Georgia 24% 24% USA 21% 21% Data from County Health Rankings 49 2013 McIntosh County Community Health Needs Assessment Obesity Rates Obesity Rates 35.00% 30.00% 25.00% Camden County 20.00% McIntosh County 15.00% Glynn County 10.00% Georgia USA 5.00% 0.00% 2010 2011 2012 2013 Data from County Health Rankings Index Crimes McIntosh County Index Crimes, 2008-2012 (GBI) 2008 2009 2010 2011 2012 Murder Rape Robbery Assault Burglary Larceny Vehicle Theft 1 0 2 2 1 0 2 2 1 0 6 7 11 2 4 50 58 33 17 20 95 162 167 118 146 279 269 260 256 231 18 34 39 26 23 Data in chart above and below from Georgia Bureau of Investigation, http://services.georgia.gov/gbi/crimestats Family Violence, McIntosh County 2012 (GBI) Abuse Type Fatal Injury Permanently Disabled Temporarily Disabled Broken Bones Gun/Knife Wounds Superficial Wounds Property Damage Threats Abusive Language Sexual Abuse Male 0 0 1 0 3 26 9 9 6 1 Female 0 0 0 0 0 9 2 2 1 0 Other Abuse 5 1 Total 60 15 50 2013 McIntosh County Community Health Needs Assessment Safety Seat/Restraint Use, 2006 Safety Restraint Use Crashes, Injuries and Fatalities, Occupants over Age 5 (Number and Percent, 2006) Crashes Injuries Fatalities Number Restrained Percent Restrained Total Occupants Number Restrained Percent Restrained Total Occupants Number Restrained Percent Restrained Camden Glynn McIntosh Georgia Total Occupants County 2,739 7,923 183 776,157 2,464 6,713 137 628,137 90.0% 84.7% 74.9% 80.9% 461 1,236 52 119,572 380 1,024 37 94,628 82.4% 82.8% 71.2% 79.1% 6 23 3 1,308 4 12 0 492 66.7% 52.2% 0.0% 37.6% http://www.gahighwaysafety.org/research/data-by-county/ Safety Restraint Use, Crashes Occupants under Age 6 (Number and Percent, 2006) Crashes County Total Occupants 167 421 10 38597 Camden Glynn McIntosh Georgia Number Restrained 102 225 8 25076 Percent Restrained 61.1% 53.4% 80.0% 65.0% Car Restraint Information from Governor’s Office of Highway Safety, http://www.gahighwaysafety.org/research/data-by-county/ Auto Injuries McIntosh Auto Crashes, Injuries, Fatalities 140 Crashes and Injuries 120 100 80 Fatalities 60 Injuries 40 Crashes 20 3 4 8 2007 2008 2009 2 5 2010 2011 0 Georgia Department of Highway Safety, http://www.gahighwaysafety.org/research/data-by-county/ 51 2013 McIntosh County Community Health Needs Assessment Crashes by Young Drivers, 2006, Number and Rate Per 100,000 Licensed Drivers Ages 15 – 17 Ages 18 – 20 Ages 21 – 24 Crashes Rate per 100,000 LD Licensed Drivers Crashes Rate per 100,000 LD Licensed Drivers Crashes Rate per 100,000 LD Camden Glynn McIntosh Totals Licensed Drivers County 1,530 1,958 352 233,888 147 315 12 474 9,607 16,087 3,409.1 202.7 2,242 2,818 413 328,158 213 519 9 741 9,500 18,417 2,179 225 3,320 3,871 559 462,825 224 580 15 819 6,747 14,983 2,683 177 All auto crash data from Governor’s Office of Highway Safety, www.georgiahighwaysafety.org According to the Governor’s Office of Highway Safety, traffic fatalities related to alcohol included 2 in 2007, 0 in 2008 and 2009, 2 in 2010, and 0 in 2011. In 2011, 80% of fatalities were not wearing seatbelts, and 20% were unknown. http://www.gahighwaysafety.org/fullpanel/uploads/files/mcintosh.pdf Alcohol and Drug Abuse/Use Binge Drinking 18.00% 16.00% 14.00% 12.00% Camden County 10.00% McIntosh County 8.00% Glynn County 6.00% Georgia 4.00% USA 2.00% 0.00% 2010 2011 2012 2013 Data from County Health Rankings 52 2013 McIntosh County Community Health Needs Assessment Controlled Substance Prescriptions by County Per Capita Prescriptions for Controlled Substances by County, January – August 2013 County Number of Prescriptions for Controlled Substances 2012 Census Population Estimate Prescriptions Per Capita Camden Glynn McIntosh Georgia 53465 104776 13978 10205243 51402 81022 13839 9919945 1.04 1.29 1.01 1.03 Data from Georgia Drug and Narcotics Agency, 2012 Census Estimates, State and County Quick Facts, http://www.quickfacts.census.gov Tobacco Use Adult Smoking Years Camden Glynn County McIntosh Georgia USA 2010 23% 24% 26% 21% N/A 2011 23% 21% 28% 20% 15% 2012 22% 19% N/A 19% 14% 2013 22% 17% N/A 19% 13% Data from County Health Rankings (2012, 2013 data not available for McIntosh) Births with Reported Tobacco Use 25 20 15 10 5 0 2000 2005 Camden Glynn 2010 McIntosh Data from Public Health, OASIS Statistics System 53 2013 McIntosh County Community Health Needs Assessment Child Welfare Children Leaving Foster Care Who are Reunified with Their Families or Placed with a Relative within 12 Months of Entering Foster Care Location Data Type 2007 2008 Camden Camden Number Percent 7 70% 10 66.7% Glynn Glynn Number Percent 45 70.3% 28 68.3% McIntosh McIntosh Number Percent 21 61.8% 6 54.5% Data from Georgia Family Connection Partnership Unduplicated Count of Children with a Substantiated Incident of Child Abuse and/or Neglect Location Camden Glynn McIntosh Data Type 2009 2010 2011 2012 Number 134 113 118 107 Rate per 1,000 9.9 8.2 8 7.3 Number 177 115 164 149 Rate per 1,000 9.2 6 7.7 7 Number 45 17 19 24 Rate per 1,000 13.9 5.6 5.8 7.4 Data from Georgia Family Connection Partnership 54 2013 McIntosh County Community Health Needs Assessment Georgia Department of Juvenile Justice (DJJ), McIntosh Statistics, 2009 – 2011 Legal Status Intake Diversion / Informal Probation Short Term Program Commitment Placement FY 2009 FY 2010 FY 2011 At Home Awaiting Adjudication 67 61 52 Non-Secure Detention 5 3 3 Secure Detention RYDC 16 18 11 Intake Total 69 68 56 At Home 30 27 30 Non-secure Residential Treatment 0 0 0 Diversion / Informal Total 30 27 30 At Home 37 24 11 Non-secure Residential Treatment 6 3 2 Probation Total 38 25 12 Non-secure Residential Treatment 1 0 0 RYDC 9 3 3 YDC 7 0 0 Short Term Program Total 9 3 3 At Home 3 5 5 Non-secure Residential Treatment 1 3 5 RYDC Awaiting Placement 1 8 3 YDC 3 2 1 Commitment Total 5 9 6 93 91 75 MCINTOSH DJJ County Total Department of Juvenile Justice, http://www.djj.state.ga.us/ResourceLibrary/rptstatComparative.asp?type=County&County=20&Cou ntyName=GLYNN Availability of Fluoridated Water Of 47 water systems in McIntosh County, only the City of Darien adds fluoride to optimum levels to help reduce dental caries. http://apps.nccd.cdc.gov/MWF/PWSDetailV.asp?PWSID=0390002&State=GA&StartPg=1&EndPg=20&County= Camden&PWSName=&Filter=0&PWS_ID=&State_ID=GA&SortBy=1&StateName=Georgia 55 2013 McIntosh County Community Health Needs Assessment Environmental Risks Coastal Hurricane Flood Zones for Category 3 Storm Surge Data from http://www.gachd.org/extra/general_hurricane_information.php 56 2013 McIntosh County Community Health Needs Assessment Percentage of Homes Lacking Complete Plumbing Facilities Homes Lacking Complete Plumbing Facilities, 2007 - 2011 398 163 98 Camden Glynn McIntosh Data from American Fact Finder: http://www.factfinder2.census.gov Toxic/Hazardous Waste Sites County Camden Glynn McIntosh Hazardous Waste Sites Number, 2012 2 14 2 Toxic Chemical Releases # Facilities, 2011 2 6 1 Toxic Chemical Releases Pounds, 2011 62,792 1,335,967 37 Data from Georgia Statistics System, http://www.georgiastats.uga.edu 57 2013 McIntosh County Community Health Needs Assessment Air Quality Measures A B C D F A = Best/Cleanest in the US; F = Worst/Dirtiest in the US. Map from http://creativemethods.com/airquality/maps/georgia.htm Air Pollution-Particulate Matter Days 10 8 Camden County 6 McIntosh County 4 Glynn County Georgia 2 USA 0 2010 2011 2012 58 Data from County Health Rankings 2013 McIntosh County Community Health Needs Assessment Water Quality Measures Water quality measures change with conditions. Current data are available for beaches at http://waterwatch.usgs.gov/wqwatch/map?state=ga&pcode=00010. Beach advisories are available at http://www.coastalgadnr.org/node/2130. 59 2013 McIntosh County Community Health Needs Assessment Healthcare Resources Physician and Dentist Data McIntosh Physicians by Specialty, 2000, 2010 6 5 4 3 2000 2 2010 1 0 Family Practice Internal Pediatrics OB/GYN Medicine General Total, All Surgery Specialities Data from Georgia Board for Physician Workforce, http://gbpw.georgia.gov/sites/gbpw.georgia.gov/files/related_files/site_page/Physicians%20by%20County%2 0by%20Specialty%202010.pdf; http://gbpw.georgia.gov/sites/gbpw.georgia.gov/files/imported/GBPW/Files/PRIMARY.pdf Population to Primary Care Physician Ratio 14,000 12,000 10,000 Camden County 8,000 McIntosh County 6,000 Glynn County Georgia 4,000 USA 2,000 0 2011 2012 2013 Data from County Health Rankings 60 2013 McIntosh County Community Health Needs Assessment Population to Dentist Ratio 16000 14000 12000 10000 8000 6000 4000 2000 0 Camden Glynn McIntosh 2010-2011 Georgia 2011-2012 Data from County Health Rankings, http://www.countyhealthrankings.org 61 U.S. 2013 McIntosh County Community Health Needs Assessment Quality of Life/Non-Health Care Resources McIntosh County Greenway Trails Map courtesy of McIntosh County Chamber of Commerce 62 2013 McIntosh County Community Health Needs Assessment Access to Recreational Facilities 18 16 14 12 Camden County 10 McIntosh County 8 Glynn County 6 Georgia 4 USA 2 0 2011 2012 2013 Data from County Health Rankings Access to Healthy Foods Percent of Population Who Are Low-Income and Do Not Live Close to a Grocery Store Years 2012 2013 Camden McIntosh Glynn Georgia USA 1% 42% 17% 10% 0% 11% N/A 9% 8% 1% Data from County Health Rankings (McIntosh data not available for 2013) Percent of All Restaurants That Are Fast-Food Establishments Years 2012 2013 Camden McIntosh Glynn Georgia USA 50% 33% 43% 50% 25% 47% 30% 44% 50% 27% Data from County Health Rankings 63 2013 McIntosh County Community Health Needs Assessment Public Transportation Opportunities Coastal Regional Commission offers subsidized shuttle services within McIntosh, Glynn, Camden, Long, Chatham, Effingham, Bryan, Liberty and Screven Counties. Intra-county $3 each way, Inter-county $6 each way. Public Transit with no eligibility requirements. CRC can be used to go to/from anywhere (shopping, doctors’ offices, etc.) coaches run. (Information from Coastal Regional Commission) 64 2013 McIntosh County Community Health Needs Assessment McIntosh County Survey Data 65 2013 McIntosh County Community Health Needs Assessment Survey Respondent Demographics Age, Race, Gender, and Marital Status McIntosh County Respondents by Age 24% 12% McIntosh County Respondents by Gender 18 - 24 years 29% 25 - 44 years 28% 36% 45 - 64 years 65 years and over 71% Male Female Persons 65 and over make up a higher percentage of the population than in most Georgia counties. Older persons are somewhat overrepresented in this sample, as the census data indicates only about 17% of the population is 65 or older. The male/female population is close to 50/50 in McIntosh. Women are overrepresented in this survey sample. McIntosh County Respondents by Race/Ethnicity 0.39% 1.95% 1.17% Black or African American Non-Hispanic White 44.53% Two or more races 51.95% Asian Hispanic or Latino 66 The U.S. Census reports that McIntosh County is approximately 36% African-American. African-Americans are over-represented in this sample. 2013 McIntosh County Community Health Needs Assessment McIntosh County Respondents by Marital Status 5% Married 8% 3% Never Married Divorced 47% 18% Separated Unmarried Couple 19% Widowed Educational Attainment McIntosh Respondent Educational Attainment 10% No high school diploma 19% 19% High school diploma Some college or technical school 21% 31% College graduate Post graduate work 67 98% of respondents speak English at home. The other 2% speak Spanish at home. 2013 McIntosh County Community Health Needs Assessment Employment Status McIntosh County Respondents by Work Status Unemployed, but looking for work 13% Retired 25% Employed part-time 13% Employed full-time 36% Disabled and unable to work 13% 0% 5% In McIntosh County, according to the U.S. Census, about 43% of married couples both work. 10% 15% 20% 25% 30% 35% 40% Income Household Income of McIntosh County Respondents 9% Less than $10,000 6% 34% 7% $10,001 to $25,000 $25,001 to $40,000 $55,001 to $70,000 13% $70,001 to $85,000 More than $85,000 31% According to U.S. Census Data, 48% of McIntosh residents make less than $35,000. Although the economic downturn may have resulted in higher unemployment since that time (see above chart), the McIntosh sample represents a higher number of people in poverty than in the 2010 Census. 68 2013 McIntosh County Community Health Needs Assessment Health Insurance Status Health Insurance Status of McIntosh Respondents I don't have medical insurance Individual insurance 7% 4% 19% Insurance through employer 2% Medicaid 22% Medicare Medicare and Medicaid 14% 32% Tricare or other government insurance 69 The 19% of people who are uninsured in McIntosh mirrors state and federal data from recent polls. 2013 McIntosh County Community Health Needs Assessment Survey Respondent Morbidity Self-Reported Health Status and Need for Supports Self-Reported Health Status of Survey Respondents 6% 18% Excellent 20% Good Fair Poor 56% County Health Rankings survey data from 2012 indicated that 25% of McIntosh residents considered themselves to be in poor or fair health. 15% of survey respondents indicated that they need assistance with activities of daily living, including activities such as driving, housekeeping, and cooking. 70 2013 McIntosh County Community Health Needs Assessment Self-Reported Health Problems Do you currently have or have you been affected by any of the following health issues? Other Thyroid 2% 0% Stroke 2% STD 0% Septicemia 1% Seizures 0% Seasonal allergies Prostate cancer Polio Pneumonia 13% 1% 0% 1% Obesity 4% None of these 13% Mental health problems or behavioral disorders 2% Lung cancer 1% Liver disease 1% Kidney disease High Cholesterol 1% 0% High blood pressure 19% Heart Disease Drug addiction 4% 1% Diabetes 7% COPD (not including asthma) Colon cancer 3% 1% Asthma Breast Cancer 6% 1% Arthritis Any sort of muscular or bone disease 11% 2% Any disease of the nervous system 1% Alzheimer’s disease 1% Alcoholism 1% 71 2013 McIntosh County Community Health Needs Assessment The high percentage of self-reported arthritis may reflect the higher percentage of older adults participating in the survey and the relative age of the population. Diabetes may be underreported, since 2009 data from County Health Rankings reports that 11.4% of McIntosh residents have been diagnosed with diabetes. Persons Who Report Need for Assistance with Activities of Daily Living Do you need assistance with daily activities? 15% 85% No For example; driving, shopping, dressing, cooking or housekeeping Yes The relatively high proportion of elders in McIntosh and their over-representation in the sample may reflect the 15% who report needing assistance with activities of daily living. Social and Emotional Support Needs How often do you get all the social and emotional support you need? 50% 40% 30% 20% 10% 0% I don't need any social or emotional support Never Sometimes All the time Only 2% of respondents consider mental health services as a gap in care in McIntosh. 72 2013 McIntosh County Community Health Needs Assessment Social Issues that Affect the Health and Safety of McIntosh Residents What are the top social problems in McIntosh that affect the health of families? Sub-standard housing 3% Poverty 24% Low paying jobs with no benefits 18% Lack of personal responsibility 6% Lack of after-school activities 8% Lack of affordable housing 9% Lack of access for persons with disabilities 3% Violence/crime, inc. fear of crime 5% Hunger 7% Homelessness Gang activity Drug use Domestic violence Child abuse/child neglect 5% 2% 0% 3% 7% Focus group respondents strongly agreed with survey respondents that poverty and low-paying jobs with no benefits are the primary factors that limit the health and safety of McIntosh residents. According to the Georgia Statistics System, 19% of McIntosh residents lived in poverty in 2010. The economic downturn may have worsened those numbers. 73 2013 McIntosh County Community Health Needs Assessment Survey Respondent Health Resource Utilization Primary Source of Health Care Primary Source of Health Care VA Urgent care clinic (not at hospital) School/college Public health office none Mental health provider Free care clinic Emergency room Doctor’s office Community health center 0 20 40 60 80 100 120 140 160 180 Focus group discussants in McIntosh County pointed out that the disparate geographic location of facilities in McIntosh is a deterrent to care. One suggested that if there were a more centralized location for health services that health care would be more accessible. There is no Community Health Center (Federally Qualified Health Center) in McIntosh, nor a free care clinic, which implies that these services are being obtained outside of McIntosh County. One focus group participant commented that an orthopedic center with an urgent care service is expected to open in the near future. A relatively large number of residents use the Emergency Room (ER) and urgent care. One focus group member commented that this reflects lack of after-hours care in McIntosh. The 19% of the population of uninsured persons may also be a factor in ER use. 74 2013 McIntosh County Community Health Needs Assessment Barriers to Health Care Identify any barriers you and your family have to receiving health care. No childcare 1% Lack of transportation 5% Lack of information about medical resources 2% Lack of education 3% Lack of available appointments 1% Insurance doesn’t cover my health problems 2% Inability to pay 10% Have not experienced any barriers 14% Finding an office or clinic open during non-work hours 7% Finding a provider who will take Medicaid 4% Don’t have a regular medical provider 7% Cultural or language barriers 1% Cost of prescription medications 11% Co-payments and deductibles for insurance are too expensive 12% Ability to take off from work and not lose pay when self or family… Finding free or reduced-cost health care services 5% 15% The cost of health care figures into the greatest barriers to access: finding free or reduced-cost health care; co-payments and deductibles are too high, cost of prescription medications, and inability to pay were the top four barriers. This aligns with the focus group assertion that poverty is a major factor in access to health care in McIntosh. Focus group members also discussed access to transportation, lack of doctors who are willing to take new Medicaid patients, and the need for a Community Health Center (Federally Qualified Health Center) in McIntosh. 75 2013 McIntosh County Community Health Needs Assessment Physician and Dentist Visits in the Last Two Years Respondents to Have Send a Doctor or Dentist in the Last Two Years Yes No 85% 59% 41% 15% DOCTOR DENTIST 85% of respondents have seen a doctor in the last two years, but only 59% have seen a dentist in the last two years. County Health Rankings reports that 18% of residents have not seen a doctor in the last two years. McIntosh has a much higher population to doctor and population to dentist ratio than surrounding counties, which may reduce use. Gaps in Health Care in McIntosh Health Care Gaps Personal doctor or primary care doctor 10% Public health services 1% Physical therapy 1% Pediatric care (care for babies and children) 1% None of these 54% Mental health services 2% Hospital care 2% Home care services 1% Free care for people who can’t afford it Doctor who provides specialty services 15% 4% Dental care Assisted living 8% 1% 76 2013 McIntosh County Community Health Needs Assessment Respondent Health Risks/Behaviors Tobacco Use McIntosh Respondents Who Smoke or Use Tobacco 24% Nearly a quarter of McIntosh residents smoke or use tobacco. This is well above the national rate of 13% in 2013. No Yes 76% Binge Drinking The definition for binge drinking is the Centers for Disease Control’s definition. The questions were presented as follows: “If you are a woman, how often do you drink four or more alcoholic drinks in a two hour period? If you are a man, how often do you drink five or more alcoholic drinks in a two hour period?” Female Binge Drinking Never 67% Daily 1% Several times a week 2% Several times a month 4% Once a month 4% A few times a year 21% Male Binge Drinking Never Daily 56% 5% Several times a week 8% Several times a month 8% Once a month A few times a year 2% 23% 77 2013 McIntosh County Community Health Needs Assessment Weight, Exercise, and Diet Findings Are you overweight? These charts tell a story about the relationship between weight, exercise and diet. Nearly one-third of respondents never exercise and 60% report that they are overweight. 40% 60% No Yes Do you eat a healthy diet? 48% 52% No A healthy diet is one that is low in fat, with 5 or more servings of fuits and vegetables per day. Yes How often do you exercise? 35% 32% 29% 30% 24% 25% 20% 16% 15% 10% 5% 0% Seldom or never Once or twice a week Three to four times a week 78 More than 4 times a week 2013 McIntosh County Community Health Needs Assessment Self-Reported Experience with Risks In the past 5 years, has anyone in your household been negatively affected by any of the issues listed below? Sports injuries 6% Sexual assault 0% On the job injuries 3% None of the above 64% Motor vehicle accidents 5% Health care issues of elderly parents 0% Gun violence 0% Gang activity 0% Falls 5% Failure to use seat belts in a motor vehicle 1% Failure to use helmets when riding a bike or motorcycle 1% Drunk driving 2% Drug abuse 4% Domestic violence 4% Alcohol abuse 4% If the category of “none of the above” is removed, the data is more striking. The chart below illustrates the percentages of respondents whose families have been affected by these specific issues. Issues Affecting McIntosh Families Water safety accidents 2% Sports injuries Sexual assault 8% 2% On the job injuries 8% Motor vehicle accidents Gun violence Gang activity 13% 3% 2% Falls 15% Failure to use seat belts in a motor vehicle Failure to use helmets when riding a bike or… Failure to use child safety car seats 6% 3% 4% Drunk driving 8% Drug abuse Domestic violence 12% 3% Alcohol abuse 13% 79 2013 McIntosh County Community Health Needs Assessment Emergency Planning and Ability to Evacuate 250 No 216 Yes 200 142 150 113 100 36 50 0 Do You have evacuation plan? Could you evacuate? Top Environmental Problems Respondent Identified Environmental Problems in McIntosh Rodents and other pests Agricultural pesticides Septic system runoff 63 11 23 Mosquitos 198 Threat of hurricanes and flooding 71 Exposure to tobacco smoke 30 Water quality/pollution Hazardous waste sites Air quality/pollution 45 14 32 Survey participants were asked to list the top two environmental problems in McIntosh County. Focus group members felt strongly that air and water pollution are not a problem, though this may be a public perception. Focus group members agreed that mosquitos are a problem, due in part to heavy rains in summer 2013. Some respondents also blamed the mosquito population on the fact that Little St. Simons does not spray, although McIntosh does have a spraying program for mosquitos. 80 2013 McIntosh County Community Health Needs Assessment Health and Other Resources/Challenges Primary Source of Health Information Respondent Top Three Sources of Healthcare Information Note that WIC is a service of Public Health 6% WIC 18% Computer/internet 20% Friends/family 7% Churches 6% Bulletin Boards 12% Public Health 32% Healthcare providers Access to Computer and Internet Access to Computer and Internet for Looking up Health Information 32% 68% No Yes 81 2013 McIntosh County Community Health Needs Assessment Public Health Services Accessed by Respondents Public Health (PH) Services Accessed by Respondents Never accessed PH services 84 Health information 39 Blood tests Medical appointment Dental, hearing, health, vision screenings 34 30 25 Access to WIC benefits 42 Mother and baby care 25 Advice on a health condition 27 Family planning 34 Immunizations/vaccinations 107 32% of respondents had never accessed any Public Health Services. Some respondents accessed multiple services. 82 2013 McIntosh County Community Health Needs Assessment Challenges to Good Health Experienced by McIntosh Families In the past year, has anyone in your household been negatively affected by any of the issues listed below? Obese or overweight 13% Not enough physical activity 15% None of these 36% Lack of sidewalks 12% Lack of safe places to exercise 8% Lack of nutritional knowledge 3% Lack of meal planning 8% Junk food and sugary drinks at… 4% The chart below illustrates challenges to families, if the category “none of these” is removed. Junk food and sugary drinks at school Lack of meal planning 7% 20% 13% Lack of nutritional knowledge Lack of safe places to exercise Lack of sidewalks 5% 12% 23% Not enough physical activity Obese or overweight 20% 83 2013 McIntosh County Community Health Needs Assessment Resources that Could be Leveraged to Improve Health What are the three most important factors that make this county a good place to live? Strong family life 13% Religious or spiritual values 16% Parks and recreation 4% Low death and disease rates 2% Low crime rate/safe neighborhoods Healthy behaviors and lifestyles 12% 1% Good schools Good jobs and a healthy economy 9% 2% Community involvement 13% Clean environment Arts and cultural events 10% 3% Affordable housing Access to higher education Access to good health care Acceptance of diversity 5% 2% 3% 5% Respondents were asked about factors that make the community a good place to live. Some of these factors, such as church and community involvement, might be leveraged to engage others in working to improve the health status of McIntosh families. 84 2013 McIntosh County Community Health Needs Assessment McIntosh County Open-Ended Responses by Age and Gender Age Group/Gender Perceived Problems Recommendations for Health Department Action Women, 18 – 44 Alcohol addiction Cancer Crime Drugs DUI drivers Gangs Lack of access to healthy foods Lack of after-school programs Lack of awareness of diseases Lack of clinicians Lack of jobs Lack of public parks Lack of sidewalks Lack of walk-in clinics More health care resources for seniors Mosquitos Obesity Pests Pollution Poverty Speeding Threat of hurricanes Unintended pregnancy Violence Water quality Abandoned buildings Air quality Alcohol abuse Crime Dirty surroundings Drug use EMT qualifications Hunger Industrial pollution Lack of after school activities Lack of availability of doctors Lack of county water Education about health risks Have a program for abused children of parents with drug addictions Need more funding Offer affordable health care Offer free birth control Offer free or low cost health care/primary care Offer health checks to uninsured Offer swimming lessons for children Provide doctors Provide more health promotion programs Women, 45+ 85 Create public awareness of health issues and role of public health Encourage early parental involvement Increase awareness of public health More health fairs/health screenings Offer free clinics Organize citizen participation to work on problems Promote healthy lifestyles 2013 McIntosh County Community Health Needs Assessment Men, 18 - 44 Men, 45+ Lack of education/ignorance Lack of presence of Department of Family and Children Services Lack of septic systems Lack of sidewalks Lack of traffic lights Lack of transportation Mosquitos Obesity Poverty Smokers Storm water drainage issues Air pollution Drugs Hazardous wastes High cost of health care HIV Lack of health care services Poor road conditions Poverty Smoking Air Pollution Bugs Cancer Drugs Drugs Hazardous waste Homelessness Lack of a hospital Lack of a trauma center Lack of health care services Lack of physicians Lack of primary care Mosquitos Obesity Poverty Reckless drivers Smoking Teen pregnancy 86 Provide doctors Provide education on nutrition, exercise/disease prevention Provide flu shots Provide free services Provide outreach to low income families about children’s health Provide safety information Provide services to residents without insurance Work on mosquito problem Offer medical services More education on teen pregnancy Add staff Create community physician services Educate residents Free clinics Have a full time doctor on staff Lead food drives Offer primary care Provide drug screening Provide obesity counseling Support healthy lifestyle initiatives Work on mosquito control 2013 McIntosh County Community Health Needs Assessment Analysis 87 2013 McIntosh County Community Health Needs Assessment Select Trends in Public Data 46.5% of families had a member who worked full-time year round in the past 12 months, compared to the Georgia rate of 57.2%. Only 62.3% of total housing units are occupied in McIntosh County compared to 85.9% in Georgia. McIntosh has 1.8% of homes without complete plumbing, compared to 0.5% for the state. 7% of McIntosh residents do not have telephone service. Over 12% of houses in McIntosh rent for less than $200, compared to only 1.9% statewide. 42.7% of homes rent for between $500 and $749 compared to 25.3% statewide. 30% of McIntosh residents are inactive, compared to the Georgia rate of 24% and the U.S. rate of 21%. McIntosh has a relatively low binge drinking percentage at approximately 7%, a figure lower than Georgia’s and the U.S., but that figure has been increasing since 2010. McIntosh has fewer hazardous waste sites than nearby counties. McIntosh had a poverty rate of 21.7% in 2011, compared to the state’s poverty rate of 19.2%. The rate of children in poverty in McIntosh was 35.5%, compared to a state rate of 26.6%. The percentage of persons below the 150% of Federal Poverty Level has increased since 2005. The graduation rate has declined from 2010 to 2012. Public data describing the birth rates from 2000 – 2010 and pregnancy rate, age 20+ both show a sharp decline since 2005. McIntosh has a much higher rate of hospital discharges for hypertension and heart disease than Georgia as a whole. 88 2013 McIntosh County Community Health Needs Assessment Survey Demographics and Health Status Education and Health Status Self-Reported Health Status by Educational Attainment Fair/Poor College/Post-Grad Excellent 50% No HS Diploma HS/Some College Good 35% 26% 13% 15% 61% 59% 13% 29% This chart indicates that that survey respondents with college and post-graduate degrees are more likely to be in excellent health, and those with no high school diplomas are significantly more likely to be in fair or poor health. (P - <.0001, Cramer’s V = .23, a moderate association) 89 2013 McIntosh County Community Health Needs Assessment Smoking by Race, Gender, Income, and Health Status Smoking and Gender 100% 81% 80% 61% 60% Yes 39% 40% 19% 20% No 0% Female Male There was virtually no difference in rates of smoking by race, but there are distinct differences in smoking by gender. Smoking is much more prevalent among men in McIntosh. As noted in the survey data discussion, the rate of smoking among men in McIntosh is about three times the national average for all groups. In analysis of selfreported health status and smoking, there was not relationship. The chart below holds a somewhat surprising finding: the largest percentage per income group who smoke are those in the less than $25,000 income category. Those with incomes above $55,000 follow closely behind. Percentage of Smokers by Income Group 29% 26% 7% up to $25000 $25000 - $55000 > $55000 90 2013 McIntosh County Community Health Needs Assessment Tobacco Use and Self-Reported Health Status Yes No 21% Fair/Poor 79% 34% Good 66% Excellent 0% 100% None of the respondents who consider themselves in excellent health status smoke. Household Income, Education, and Healthy Diets Education and Healthy Diets 70% 50% 60% 58% 60% 51% 49% 42% 40% 58% 54% 46% 40% 42% 30% Yes 20% No 10% 0% No high school diploma High school Some college College diploma or technical graduate school Post graduate work The chart above appears to indicate that, in general and with the exception of those who have some college/technical school, that education is associated with healthy diets. 58% of those with no high school diploma indicated that they do not have healthy diets, compared to 46% of college graduates and 42% of those who have completed post graduate studies. The chart below illustrates the percentage of each income group that said their families ate a healthy diet, that is, a low-fat diet with five or more fruits or vegetables daily. There appears to be no association between income and healthy diets. 91 2013 McIntosh County Community Health Needs Assessment Household Income and Healthy Diets 70% 60% 50% 40% 30% 20% 10% 0% Less than $10,000 $10,001 to $25,001 to $40,001 to $55,001 to $70,001 to More than $25,000 $40,000 $55,000 $70,000 $85,000 $85,000 Yes No Overweight by Race Overweight and Race Yes No 63% 55% 45% 37% Black or African American Non-Hispanic White Fewer respondents who were black indicated that they were overweight. Whether this is factual or self-perception is not clear. 92 2013 McIntosh County Community Health Needs Assessment Age and Exercise Habits Age Group and Exercise 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 18 - 24 years 25 - 44 years More than 4 times a week 45 - 64 years Three to four times a week 65 years and over Once or twice a week Seldom or never The group least likely to exercise is the 25 – 44 age group, which may reflect pressures of work and family. Exercise Habits and Weight Exercise Habits by Self-Reported Overweight Status More than 4 times a week Once or twice a week Seldom or never Three to four times a week 71% 64% 63% 55% 45% 37% 36% 29% No Yes 93 2013 McIntosh County Community Health Needs Assessment Exercise and Healthy Diets Exercise and Healthy Diets 80% 60% 40% Yes 20% No 0% More than 4 times a week Three to four times a week Once or twice a week Seldom or never There is a direct relationship between increased exercise activity and healthy eating among respondents to the survey. Major Disease Processes by Race Self-Reported Major Diseases by Race 50% 40% 30% 20% 10% 0% Asthma High blood pressure Arthritis Black Diabetes White 94 Obesity 2013 McIntosh County Community Health Needs Assessment Access to Computer and Internet for Health Education Access to Computer and Internet for Health Information by Age Group 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 18-24 25-44 45-64 65+ Surprisingly, given the fact that most young people have grown up with the computers, the group least likely to have access to a computer and the internet is the 18-24 age group. 95 2013 McIntosh County Community Health Needs Assessment Need for Emotional and Social Supports by Age Emotional and Social Support Needs by Age Group All the time Sometimes Never I don’t need any social or emotional support 63% 48% 35% 36% 33% 35% 31% 25% 19% 19% 11% 7% 18 - 24 years 10% 8% 25 - 44 years 13% 45 - 64 years 7% 65 years and over This chart indicates that the oldest cohort is slightly less likely to be assured of social and emotional support all the time than other groups. 96 2013 McIntosh County Community Health Needs Assessment Evacuation in the Event of a Natural Disaster The chart below indicates that, while the majority of McIntosh residents do not have a disaster plan in place, nearly all would be able to evacuate if necessary. The following chart provides the percentage by age group who say that they have an evacuation plan. Evacuation Plan and Being Able to Evacuate in the Event of a Natural Disaster 120.00% 98.53% 100.00% 80.00% 68.87% Yes 60.00% No 31.13% 40.00% 20.00% 1.47% 0.00% No Yes Emergency Evacuation Plan by Age Group 40% 35% 30% 25% 20% No 15% Yes 10% 5% 0% 18 - 24 years 25 - 44 years 45 - 64 years 65 years and over 97 2013 McIntosh County Community Health Needs Assessment Health Services Utilization Insurance Status, Work Status, and Doctor Visits in the Last Two Years Insurance Status and Seen by a Doctor in the Last Two Years Tricare or other government insurance 0% 100% Medicare and Medicaid 6% Medicare 7% 94% 93% 10% Medicaid No 90% Yes 6% Insurance through employer Individual insurance 94% 0% 100% 51% 49% I don't have medical insurance 0% 20% 40% 60% 80% 100% 120% Having insurance clearly matters to McIntosh residents who need to see a physician. Just over half of McIntosh respondents without insurance had not seen a doctor in the last two years. 10% of Medicaid recipients also report that that they have not seen a doctor in the same timeframe, which may indicate problems with access to a provider who accepts Medicaid or transportation issues. The chart below illustrates that those who are unemployed and those who are employed part-time are least likely to have had a doctor visit. 98 2013 McIntosh County Community Health Needs Assessment Percentage by Category of Respondents Who Have Not Visited a Doctor in the Last Two Years Unemployed, not looking for work Unemployed, but looking for work Retired Employed part-time Employed full-time Disabled and unable to work 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% Primary Source of Care for Insured, Uninsured Primary Source of Care for Insured, Uninsured VA Urgent care clinic (not at hospital) School/college Public health office none Mental health provider Free care clinic Emergency room Doctor’s office Community health center 0% Insured 20% 40% 60% 80% 100% No Insurance Note that 83% of insured respondents use a doctor as their primary source of care, compared to only 4% of uninsured persons. 33% of uninsured respondents seek their primary care at a hospital emergency room, 20% depend on a free care clinic, and 12% use an urgent care center. 5% of insured respondents depend on the ER as their primary source of care. 99 2013 McIntosh County Community Health Needs Assessment Dental Visits by Age Group Respondents by Percentage of Age Category Who Have Visited a Dentist in the Past Two Years 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 18-24 25-44 45-64 65+ Younger survey respondents were less likely to have visited a dentist in the past two years than others. Dental Visits and Income Respondents Who Have Visited a Dentist in the Last Two Years by Income 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 94% 88% 94% 93% 69% 68% 54% 46% 32% Yes 31% No 12% 6% Less than $10,000 7% 6% $10,001 to $25,001 to $40,001 to $55,001 to $70,001 to More than $25,000 $40,000 $55,000 $70,000 $85,000 $85,000 There is a clear relationship between respondent dental visits and income. The lower the income of respondents, the less likely that a dental visit has taken place in the past two years. 100