2016 Community Health Status Assessment _2016 HP... · 2017. 12. 6. · MD Vital Statistics Data US Census Bureau CRISP - Tableau Dashboards Maryland Youth Risk Behavior Survey (YRBS)

Worcester County Health Department, MD

2016 – Community Health Status

Assessment

DATA USED REPORT INCLUDES

Behavioral Risk Factor SurveillanceSystem (BRFSS)

MD Vital Statistics Data

US Census Bureau

CRISP - Tableau Dashboards

Maryland Youth Risk Behavior Survey(YRBS)

Center for Sexually TransmittedInfection Prevention, DHMH

State Health Improvement Process(SHIP)

Primary Care Office

County Health Ranking

Demographic & Social EconomicFactors

Health Care System Access to Health Care Health Care Utilization

Mortality

Chronic Health Conditions

Health Risk Behaviors

2

Worcester County Demographics

50,678

51,049

51,196

51,313

51,454

51,425

51,567

51,620

51,675

51,540

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

Worcester County Population, 2006-2015

10

15

20

25

30

35

2006 2007 2008 2009 2010 2011 2012 2013 2014

Perc

ent

Worcester County Population By Age Group, 2006-2014

Under 20 20-44 45-64 65+

Source: US Census

3


2015 Census

Total Population 65 + Population

Worcester MD Worcester MD

Total Population 51,540 6,006,401 25.3% 14.1%

Non-Hispanic White 79.9% 52.0% 28.9% 18.3%

Non-Hispanic Black

13.4% 29.4% 16.3% 11.2%

Hispanic 3.4% 9.5% 6.9% 4.6%

Others 3.3% 9.0% 12.9% 9.6%

Poverty & Income (2014)

Worcester MD

Median household income $55,691 $73,851

All age in poverty 11.9% 10.4%

Under age 18 in poverty 20.5% 13.8%

Ages 5-7 in families in poverty 20.1% 13.2%

Source: US Census 4


10.5

12

10.6

13

11.1

13.1

11.9

8.2

9.2

9.9 10.2 10.4 10.2 10.4

2008 2009 2010 2011 2012 2013 2014

Perc

ent

All Ages In Poverty, Worcester and MD, 2008-2014

Worcester MD

Source: US Census

5

Access to Care Health Professional Shortage Areas (HPSAs):

Worcester has 100 percent of its resident population residing in primary care and mental health HPSAs

Medically Underserved Areas (MUAs)100 percent of Worcester county population reside in MUA

2016 PC - FTE PC provider to Population

ratio

MH - FTE MH provider to Population

ratio

Worcester 30.6 1:1,667 3.0 1:16,833

MD 3771.2 1:1,534 574.4 1:10,086

Source: Source: MD DHMH, Primary Care Office 6

Access to Care

9.6

7.0

14.5

15.9

10.2

5.6

11.3 11.7 12.1 11.5

13.0

11.7

2005-2007 2006-2008 2007-2009 2008-2010 2011-2013 2012-2014

Perc

ent

Percentage of Adults with No Health Insurance, (3-year moving average)

Worcester and MD, 2005-2014

Worcester MD

Source: BRFSS Due to the changes in BRFSS methodology, results after 2011 cannot be compared with previous years

7

Access to Care

87.0

93.4

83.8

85.9

2011-2013 2012-2014

Perc

ent

Percentage of Adults 18-64 yr old with any Type of Health Insurance,

2011-2014

Worcester MD

10.3

9.5

12.6

11.5

2011-2013 2012-2014

Perc

ent

Percent of Adults Reporting Not Seeing a Doctor in the Past 12 Months Because

of Cost, 2011-2014

Worcester MD

Source: BRFSS 8

Health Care Utilization

18.8

16

14.1 13.6 12.6

7.6

19.6

17.1 15.8 15.7 15.2

11.4

2009 2010 2012 2013 2014

Perc

ent

Uninsured Emergency Department Visit, Worcester and MD, 2009-2014

2011

Worcester MD MD 2017 Goal

Source: MD SHIP 9

Mortality

865.3

691.4

883.6

701.1

Rat

e pe

r 10

0,00

0 Po

pula

tion

Age-Adjusted Mortality Rates (Three-year moving average) for All Causes of Death Worcester and Maryland, 2000-2014

Worcester MD

Source: MD Vital Statistics Administration (VSA) 10

Mortality

Diseases of the heart, 27.2%

Malignant neoplasms, 26.3%

Chronic lower respiratory diseases,

Cerebro-vascular disease, 4.3%

Accidents, 2.7%

Alzheimer's disease, 2.4%

Diabetes mellitus, 2.2%

Influenza and pneumonia, 2.1%

Nephritis, nephrosis and neprotic syndrome,

1.9%

All other causes, 22.3%

Percent Distribution of the 10 Leading Causes of Death in Worcester County, 2012-2014

53.5%

6.2%


Septicemia, 23%

Mortality

49.4 45.9 40.0 34.4 31.0 34.5 32.7 31.0 33.1 30.9 29.7 27.1 29.0

271.7 260.7

215.3 199.2 196.1 202.2

210.9 197.5

212.6

183.6 179.3 183.4 183.1

Rat

e pe

r 10

0,00

0 Po

pula

tion

Age-Adjusted Death Rate (Three-year moving average) from Heart & Cerebro-Vascular Diseases, Worcester County, MD, 2000-2014

CEREBRO-VASCULAR DISEASE DISEASES OF THE HEART


Chronic Conditions

32.6

41 42.3

34.9 36.7

26.3 25.9

28.2 30

32.8

2001/2003 2003/2005 2005/2007 2007/2009

Perc

ent

Prevalence of High Blood Pressure (Two-year average) among Adults,


Worcester MD

2011/2013

HP 2020 (26.9)

37.7

41.9

47 46.6 44.5

32.5 33.5

35.1 37.2

36.2

10

15

20

25

30

35

40

45

50

2001/2003 2003/2005 2005/2007 2007/2009

Percentage of Adults with High Cholesterol Level (Two-year average),


Worcester MD

2011/2013

HP 2020 (13.5)

Source: BRFSS 13

Chronic Conditions

65.6

58.9

29.5

28.0

25.7

15.4

12.9

12.4

10.4

9.8

9.1

6.8

4.5

4.5

3.9

2.17

59.5

49.3

28.5

29.1

28.6

16.3

13.7

13.9

10.0

8.8

7.9

10.0

4.4

6.5

4.9

3.36

Hypertension

Hyperlipidemia

Ischemic Heart Disease

Arthritis

Diabetes Chronic

Kidney Disease

Heart Failure

Depression

COPD

Cancer

Atrial Fibrillation

Alzheimer's Disease/Dementia

Stroke

Osteoporosis

Asthma

Chronic Condition Prevalence among Medicare FFS Beneficiaries* in Worcester and MD

Worcester MD

14

Schizophrenia and Other Psychotic …

Source: CRISP - Tableau Dashboards

Chronic Conditions

18.3

16.7

7.7 7.5

2011-2013 2012-2014

Perc

ent

Prevalence of Cardiovascular Disease (heart attack, angina/CHD, stroke) among Adults, Worcester County

and MD, 2011-2014

Worcester MD

10.5 9.4 9.4

8.3

9.8 10.8

14.4

16.7

7.2 7.5 7.9 8.4

8.9 9.2 10.0 10.2

Perc

ent

Prevalence of Diabetes among Adults (Three-year moving average), Worcester County and

MD, 2002-2014

Worcester MD

15 Source: BRFSS. Due to the changes in BRFSS methodology, results after 2011 cannot be compared with previous years


Prevention Quality Indicator

2014 County

Rank out of 24

(1 being the best)

Uncontrolled Diabetes Without

Complications 1

Diabetes with Long-term

Complications

4

Lower Extremity Amputations

Among Admissions for Diabetes

12

Emergency Department Visit Rate Due To

Diabetes*

14

220.9

241.8 246.8 240.3 229.9

177.3 180.9 194.8 192.1

204.1

2010 2011 2012 2013 2014

Rat

e pe

r 10

0,00

0 Po

pula

tion

Emergency Department Visit Rate Due To Diabetes, Worcester County and MD, 2014

Worcester MD MD 2017 Goal (186.3)

Source: MD SHIP Source: MD PCO 16

Chronic Conditions

22.2 24.4 25.1

27.1 26.4 28.9

27.1 26.3 28.5

31 31.7

20.0 20.6 21.7 23.4 24.4 25.2 26.0 26.6 27.1 28.1 28.5

2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-2010 2011-2013 2012-2014

Perc

ent

Prevalence of Self Reported Obesity Among Adults (Three-year moving average), Worcester and MD, 2000-2014

Worcester MD

39.0

34.1

30.7 31.4 31.9 32.2 33.1 35.4 35.3

30.3 31.1

42.8 42.0 41.5 40.4 39.9 38.5 37.8 37.0 35.9

34.1 34.0

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

2008-2010

2011-2013

2012-2014

Percentage of Adults who are at Healthy Weight (Three-year moving average), Worcester and MD, 2000-2014

Worcester MD MD 2017 Goal (36.6) HP 2020 (33.9)

Source:BRFSS 17

Perc

ent

Chronic Conditions

10.9

13.5

11.0 11.5

2013 2014

Perc

ent

Percentage of High School Students who were Obese, Worcester and MD,

2013-2014 YRBS


13.5 17.3

9.6 14.5 13.8 13.9

11.5

22.5

10.5

Perc

ent

Percentage of High School Students who were Obese by Sex and Race,

Worcester, 2014 YRBS

Source: YRBS 18

Health Behaviors

24.6 24.4

26.6

24.4

27.1 26.5

25.5

27.4

22.0 22.6 23.0 23.3 23.6 23.6

24.8

23.2

Perc

ent

Percentage of Adults in Worcester County and MD who engaged in

No Leisure Time Physical Activity, (Three-year moving average), 2003-2014

Worcester MD

24.5

98.9

37.5

86.4

High School Middle School

Perc

ent

Percentage of High and Middle School students who attended PE classes on one or more days in an average school week,

2014

Worcester

MD

Source: BRFSS Source: YRBS 19

Mortality

33.6 32.5 33.5

25.3 23.9 23.6

28.2

35.3

44.8 42.2

37.8 37.9 39.7

Rat

e pe

r 10

0,00

0 Po

pula

tion

Age-Adjusted Death Rates (Thee-year moving average) from Chronic Lower Respiratory Disease, Worcester County, MD, 2000-2014

CHRONIC LOWER RESPIRATORY DISEASES


Chronic Conditions

7.5

5.7 5.6 5.5

2011-2013 2012-2014

Perc

ent

Percentage of Adults with COPD, Worcester County and MD,

2011-2014

Worcester MD

5.2

7.8

8.5 8.1

5.9

6.7 6.8

8.3 8.5

8.9 9.0 9.0 9.0 9.0

Adults Current Asthma Prevalence in Worcester County and MD, (Three-

year moving average), 2004-2014

Worcester MD

Source: BRFSS 21

Health Behaviors

21.3

14.7

6.5 6.9

11.9

8.7

7.0

5.4

2013-HS

2014-HS

2013-MS

2014-MS

Prevalence of Current Smoking among High School

and Middle School Students in Worcester County and MD,

2013 -2014

Worcester MD

24 25.2 25.7

21.2

19.5

21.1 21.2 19.8

15.6 17.1

15.2

21.1 21.1 20.5 19.5

18.7 17.9

16.5 15.7 15.1

17.2 15.7 Pe

rcen

t

Prevalence of Current Smoking among Adults in Worcester County and MD, (Three-year

moving average), 2000-2014

MD Worcester MD 2017 Goal HP 2020


Mortality

218.3 214.1

205.8 206.8 199.2

195.1 192.1 196.4

204.7

189.4 185.8 180.7

175.7

Rat

e pe

r 10

0,00

0 Po

pula

tion

Age–adjusted Death Rates (Thee-year moving average) from Malignant Neoplasms, Worcester County, MD, 2000-2014

MALIGNANT NEOPLASMS

Source: MD VSA 23

Cancer Incidence and Mortality

507.9

72.8

141.4

158.7

37.5

36.6

447

58.7

128.1

138.3

20.9

38.1

All Cancer Sites

Lung and Bronchus Cancer

Female Breast Cancer*

Prostate Cancer**

Melanoma of the Skin

Colon and Rectum Cancer

Rat

e pe

r 10

0,00

0 Po

pula

tion

Age-Adjusted Cancer Incidence Rates, Worcester County and MD, 2008-2012

Worcester

MD

187.7

59.1

28.9

22.9

14.6

171.8

46.3

23.8

22.5

15.4

All Cancer Sites

Lung and Bronchus Cancer

Female Breast Cancer*

Prostate Cancer**

Colon and Rectum Cancer

Rat

e pe

r 10

0,00

0 Po

pula

tion

Age-Adjusted Cancer Mortality Rate, Worcester and MD, 2008-2012

Worcester

MD

Source: DHMH-MD Cancer Registry 24

Mortality

12

10 9

10

6 7

6

14

16

2007 2008 2009 2010 2011 2012 2013 2014 2015

Num

ber

of D

eath

s

Drug and Alcohol Intoxication Deaths, Worcester County, 2007-2015

Total Heroin Fentanyl

Source MD Vital Statistics Administration (VSA) 25

Health Behaviors

14.8

13.6 14.1

16.2

15.1

13.4 13

13.7

16.2

15.4

2006-2008

2007-2009

2008-2010

2011-2013

2012-2014

Perc

ent

Prevalence of Binge Drinking among Adults

in Worcester County and MD, (Three-year moving average), 2006-2014

Worcester MD

20 20.1

13.1

17.3

Binge drinking Drank alcohol before age 13

Alcohol Use among High School Students in Worcester County

and MD, 2014

Worcester MD


Youth Risk Behaviors

43.1

37.5

16.6

10.0 8.8 7.7 4.8 5.6 5.3

37.6

32.5

14.2

8.5 6.4 5.4

4.2 4.3 4.2

Perc

ent

Percentage of Worcester County and MD High School Students who Ever Used Drugs and E-Vapor, One or More Times, 2014 YRBS

Worcester MD

Source: YRBS 27


1442.4

1663.2

1904.8 1891.4

2296.8

1122.4 1237.5

1398.2 1474.6

1591.3

2010 2011 2012 2013 2014

Emergency Department Visits for Addictions-Related Conditions, Worcester County and MD, 2014


Source: MD SHIP 28

Youth Risk Behaviors

Texted or emailed while driving

Drank alcohol or used drugs at lastsexual intercourse

Bullied on school property

Currently used marijuana

Did not attend PE classes at leastonce a week

Currently smoked cigarette

Rode in a car with a driver who hadbeen drinking alcohol

Rode in a car driven by someone whowas texting while they were driving

Were bullied on school property

Were electronically bullied

Ever drank alcohol

Had sexual intercourse with three ormore people during their life

High School Middle School

In 2014, Worcester County Students Ranks in the top-three with highest percentage of students who:

Source: YRBS 29

Health Status

14.1

17.8

16.0 17.3

21.2

13.0 13.1 12.8

15 14.9

2006-2008

2007-2009

2008-2010

2011-2013

2012-2014

Percent of Adults who Reported their Health as Fair/Poor

(Three-year moving average), Worcester County and MD, 2006-2014

Worcester MD

21.6 22.8 22.1 21.5

20.7

18.5 18.4 18.7 18.1 16.9

2006-2008

2007-2009

2008-2010

2011-2013

2012-2014

Percent of Adults who Reported Limited Activity due to Physical, Mental or Emotional Problems (Three-year moving average),


Worcester MD

Source: BRFSS 30

Mortality

13.9

10.3 10.1

8.0 8.0 9.2

12.4

15.0

13.6 14.3 14.2

13.6

11.6

8.7 8.6 8.8 8.7 8.6 8.6 8.8 9.1 9.0 9.2 9.2 9.4 9.6

Rat

e pe

r 10

0,00

0 Po

pula

tion

Suicide Rates (Three-year moving average), Worcester County and MD, 2000-2014

Worcester MD


Maternal and Child Health

31.1 33.5

35.6

38.7

34.5

31.2

26.2

24.2

17.1

32.6 33.3 33.6

32.8

30.4

27.7

24.7

22.0 19.7

Rat

e pe

r 1,

000 Po

pula

tion

Teen Birth Rate (Three-year moving average), Worcester and MD, 2004-2014

Worcester

MD

MD 2017 Goal (17.8) 5.1

5.6 5.3

8.3

8.8 9.1

2010-2012 2011-2013 2012-2014

Perc

ent

Percentage of Pregnant Women with Late or No Prenatal Care (Three-year moving

average), Worcester and MD, 2010-2014

Worcester MD



6.6 6.6 6.3

8.8 8.7 8.6

2010-2012 2011-2013 2012-2014

Perc

ent

Low Birth Weight Rate (Three-year moving average), Worcester County and

MD, 2010-2014

Worcester

MD 2017 Goal (8.0)

MD

HP 2020 (7.8)

8.9 8.9 8.7

10.3 10.1 10.0

11.4

2010-2012 2011-2013

Perc

ent

Preterm Birth Rate (Three-year moving average), Worcester County

and MD, 2010-2014

Worcester MD

2012-2014

HP 2020 (11.4)



5.9

5.0

6.5

7.7

6.6

7.7

8.6 7.9 7.7 7.6

7.3 7.0 6.7 6.6

Rat

e pe

r 1,

000 Li

ve B

irth

s

Infant Mortality Rate (Five-year moving average), Worcester County and MD, 2004-2014

Worcester MD MD 2017 Goal (6.3) HP 2020 (6.0)


Sexually Transmitted Disease (STDs)

119.7

80.0

60.8

88.5 79.7

69.7

133.1

52.1

82.9

119.7

130.5 120.5 118.3

112.2

128.4

110.8 96.6 101.0 102.2 114.2

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Rat

es p

er 1

00,0

00 P

opul

atio

n

Gonorrhea Rates, Worcester County and Maryland, 2006-2015

Worcester Maryland

355.0

305.7

372.8

331.7

388.7 422.2 420.5 430.4

412.6

361.0

389.2 412.0

437.9 416.7

453.7 466.9 450.9 450.7 458.9 457.0

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Rat

es p

er 1

00,0

00 P

opul

atio

n

Chlamydia Rates, Worcester County and Maryland, 2006-2015

Source: DHMH 35

Category County Rank

(out of 24) 2013 2014 2015 2016

Health Outcomes Overall Health Outcome 11 11 11 12

• Length of Life 13 13 11 14 • Quality of Life 8 8 8 11

Health Factors Overall Health Factors 14 15 14 15 • Health Behaviors 16 15 15 16 • Clinical Care 7 7 5 7 • Socio & Economic Factors 20 19 20 21 • Physical Environment 3 2 1 2

Worcester County Health Rankings

Source: County Health Ranking 36

1. COUNTY RATE COMPARED TO MARYLAND RATE 2. TREND IN ……

Worse Better

Poverty Rate Behaviors 1. Underage Drinking2. Physical Inactivity3. Drug Use among

Adolescents (HighSchool Students)

Chronic Conditions 1. High Blood pressure2. High Cholesterol3. COPD4. CVD5. Adult Diabetes6. Obesity7. Skin Cancer Incidence8. GonorrheaMortality 1. Infant Deaths2. Suicide3. Overall Cancer DeathsHealthcare1. ED visit due to DM2. Addictions related ED visit

1. AdultAsthma

2. Chlamydia3. Teen Birth

Rate4. Preterm

Birth5. Low

Birthweight6. Overall Age

AdjustedMortality

7. UninsuredED Visit

8. Uninsured

The wrong direction The right direction

1. PhysicalInactivity

2. Obesity3. High Blood

Pressure4. Diabetes5. Gonorrhea6. Infant Deaths7. Addiction Related

ED Visit8. Drug Related

Deaths

1. Uninsured2. Uninsured ED

Visit3. Current Smoking4. Binge Drinking5. Underage

Drinking6. Drug Use among

Adolescents (HighSchool Students)

7. COPD8. CVD9. ED Visit due to

DM10. Chlamydia11. Overall Age

AdjustedMortality

12. Suicide

37

Trends in the wrong direction

Areas where the county rates are higher than the states and trends are going in the wrong direction

1. Physical Inactivity2. High Blood Pressure3. High Cholesterol4. Adult Diabetes5. Obesity6. Gonorrhea7. Infant Deaths8. Drug Related Deaths9. Addictions Related ED Visit

38

For comments or questions about this data

Contact: Genet Burka, MD MPH

Planning and Quality Program at 410-632-1100, ext 1234

Worcester County Health Department, MD

Documents

2016 Community Health Status Assessment _2016 HP... · 2017. 12. 6. · MD Vital Statistics Data US Census Bureau CRISP - Tableau Dashboards Maryland Youth Risk Behavior Survey (YRBS)