Child Well Being Profile

Butler County, Ohio

December 2006

Prepared by

John Besl Mary Ann Hamilton

Child Policy Research Center

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2000 Census Data Analysis: Butler County, Ohio The following charts display 2000 Census data for Butler County, Ohio and 17 county subareas. The Census measures include a number of child well-being indicators presented in “State Profiles of Child Well-Being: Results from the 2000 Census,” a report issued by the Annie E. Casey Foundation and the Population Reference Bureau (March 2003). Each chart presents the Butler County total and ranks each of the 17 subareas on the relevant measure. For further information on Census 2000 measures, see technical documentation at http://www.census.gov/prod/cen2000/doc/sf3.pdf and http://www.census.gov/prod/cen2000/doc/sf1.pdf or contact John Besl at the Child Policy Research Center at Cincinnati Children’s Hospital Medical Center – (513) 636-0174. Key Findings Children in Butler County’s two major urban centers, Hamilton and Middletown, fare worse on many socio-economic measures compared to children in the rest of the county. For instance, about one of five children in both Hamilton and Middletown live in poverty. A family of four with a household income of about $17,000 or less was classified as poor in census tabulations. Three times as many children in West Chester Township (16%) have limited English-speaking ability compared to the county (5%) as a whole.

Percent of children (0 to 17) in poverty

0% 5% 10% 15% 20% 25%

Reily township

Hanover township

Liberty township

Milford township

West Chester township

Fairfield township

Ross township

Trenton city

Morgan township

Fairfield city

Wayne township

Lemon township

Madison township

St. Clair township

Oxford township

Hamilton city

Middletown city

Butler County Total

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Percent of children (0 to 17) in extreme poverty (below 50% of poverty level)

0% 1% 2% 3% 4% 5% 6% 7% 8% 9% 10%

Hanover township

Milford township

Reily township

West Chester township

Liberty township

Ross township

Morgan township

Wayne township

Fairfield township

Trenton city

Fairfield city

Lemon township

St. Clair township

Madison township

Oxford township

Middletown city

Hamilton city

Butler County Total

Percent of children (0 to 17) in low-income families (below 200% of poverty level)

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Reily township

Liberty township

Wayne township

Fairfield township

Hanover township

Trenton city

Fairfield city

Morgan township

Ross township

Lemon township

Madison township

Milford township

West Chester township

Oxford township

St. Clair township

Hamilton city

Middletown city

Butler County Total

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Percent of children (0 to 17) in single-parent families

0% 5% 10% 15% 20% 25% 30% 35%

Wayne township

Liberty township

Fairfield township

Hanover township

Reily township

Morgan township

West Chester township

Milford township

Madison township

Ross township

Trenton city

Lemon township

Fairfield city

St. Clair township

Oxford township

Hamilton city

Middletown city

Butler County Total

Percent of women, with a child under 6 years, who are employed

0% 10% 20% 30% 40% 50% 60% 70% 80%

St. Clair township

Hamilton city

Ross township

Liberty township

Fairfield township

Middletown city

West Chester township

Lemon township

Morgan township

Trenton city

Milford township

Reily township

Madison township

Hanover township

Fairfield city

Oxford township

Wayne township

Butler County Total

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Percent of children (0 to 17) with no parent in the labor force

0% 2% 4% 6% 8% 10% 12% 14%

Milford township

Liberty township

Wayne township

Ross township

Trenton city

West Chester township

Oxford township

Morgan township

Fairfield city

Reily township

Fairfield township

Hanover township

Madison township

Lemon township

St. Clair township

Middletown city

Hamilton city

Butler County Total

Percent of children (5 to 15) with a long-lasting disability

0% 1% 2% 3% 4% 5% 6%

Ross township

Morgan township

Hanover township

St. Clair township

Lemon township

Madison township

Oxford township

Wayne township

Reily township

Fairfield city

Liberty township

Milford township

West Chester township

Fairfield township

Trenton city

Middletown city

Hamilton city

Butler County Total

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Percent of teens (16 to 19) who are not enrolled in school and not working

0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

Milford township

Reily township

Oxford township

West Chester township

Hanover township

Wayne township

Ross township

Liberty township

Morgan township

Madison township

Fairfield city

Trenton city

Fairfield township

Middletown city

Hamilton city

St. Clair township

Lemon township

Butler County Total

Percent of teens (16 to 19) not enrolled in school and not a high school graduate

0% 2% 4% 6% 8% 10% 12% 14% 16%

Milford township

Reily township

Oxford township

West Chester township

Liberty township

Fairfield township

Fairfield city

Ross township

Wayne township

Trenton city

Madison township

Hanover township

Morgan township

St. Clair township

Middletown city

Hamilton city

Lemon township

Butler County Total

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Percent population change (estimated): April 1, 2000 to July 1, 2005

-5% 0% 5% 10% 15% 20% 25% 30% 35%

Middletown city

Fairfield city

Hamilton city

Oxford township

West Chester township

St. Clair township

Fairfield township

Morgan township

Wayne township

Hanover township

Madison township

Reily township

Ross township

Liberty township

Trenton city

Milford township

Lemon township

Butler County

Percent of children (5 to 17) with limited English proficiency

0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

Milford township

St. Clair township

Fairfield city

Liberty township

Hanover township

Trenton city

Middletown city

Fairfield township

Madison township

Oxford township

Hamilton city

Lemon township

Wayne township

Morgan township

Reily township

Ross township

West Chester township

Butler County Total

According to the U.S. Census Bureau’s latest estimates, the population of Butler County increased 5% between 2000 and 2005. Ten of the 17 subareas grew by 10% or more. Lemon Township experienced dramatic growth in the five-year period (+33%).

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2003 Maternal and Child Health: Butler County, Ohio The following charts display 2003 Ohio birth certificate data for Butler County and 17 county subareas. Each chart presents the Butler County total and ranks each of the 17 subareas on the particular health measure. Key Findings Butler County’s low birthweight rate stood at 7% in 2003. The rate in Wayne Township was nearly twice as high. A similar pattern is apparent with premature births. One in 10 county births were premature in 2003, while the comparable Wayne Township figure was nearly one in seven. Furthermore, 10% of Wayne Township births were to women under 18, compared to 3% countywide. Ten of 17 subareas exceeded the county’s percentage of mothers receiving prenatal care that is considered less than adequate. St. Clair Township stands out, with one in three mothers receiving insufficient prenatal care. An alarming proportion (19%) of women in Butler County smoked while pregnant. In Madison Township and St. Clair Township, the figure was nearly twice as high.

Percent of births at low birthweight (< 2500 grams): 2003

0% 2% 4% 6% 8% 10% 12% 14% 16%

Ross township

Morgan township

Lemon township

Hanover township

Milford township

Reily township

St. Clair township

Madison township

Fairfield city

Fairfield township

Oxford township

Trenton city

Hamilton city

Liberty township

West Chester township

Middletown city

Wayne township

Butler County

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Percent of births at very low birthweight (< 1500 grams): 2003

0% 1% 2% 3% 4% 5% 6% 7% 8%

Lemon township

Milford township

Morgan township

Reily township

Ross township

St. Clair township

Fairfield city

Madison township

Hanover township

Liberty township

Hamilton city

Fairfield township

Middletown city

West Chester township

Trenton city

Oxford township

Wayne township

Butler County

Percent of births that are premature (< 37 weeks gestation): 2003

0% 2% 4% 6% 8% 10% 12% 14% 16%

Milford township

Ross township

Reily township

Morgan township

Fairfield township

Lemon township

Madison township

Hanover township

Fairfield city

Middletown city

West Chester township

Trenton city

Hamilton city

St. Clair township

Oxford township

Liberty township

Wayne township

Butler County

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Percent of births that are very premature (< 32 weeks gestation): 2003

0% 1% 2% 3% 4% 5% 6% 7% 8%

Milford township

Reily township

Ross township

Lemon township

Fairfield city

St. Clair township

Madison township

Hanover township

Liberty township

Hamilton city

Morgan township

West Chester township

Fairfield township

Middletown city

Trenton city

Oxford township

Wayne township

Butler County

Mean age of mothers with a live birth in 2003

10 15 20 25 30 35

St. Clair township

Middletown city

Hamilton city

Madison township

Trenton city

Hanover township

Ross township

Milford township

Wayne township

Oxford township

Fairfield city

Lemon township

Reily township

Morgan township

Fairfield township

Liberty township

West Chester township

Butler County

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Mean years of school completed by mothers with a live birth in 2003

0 2 4 6 8 10 12 14 16

Hamilton city

St. Clair township

Middletown city

Madison township

Ross township

Hanover township

Wayne township

Trenton city

Reily township

Milford township

Fairfield city

Lemon township

Morgan township

Fairfield township

Oxford township

West Chester township

Liberty township

Butler County

Percent of mothers receiving less than adequate prenatal care: 2003

0% 5% 10% 15% 20% 25% 30% 35% 40%

Morgan township

Liberty township

West Chester township

Wayne township

Oxford township

Ross township

Fairfield city

Fairfield township

Lemon township

Trenton city

Milford township

Reily township

Middletown city

Hamilton city

Hanover township

Madison township

St. Clair township

Butler County

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Percent of mothers with less than 2 prenatal care visits: 2003

0.0% 0.2% 0.4% 0.6% 0.8% 1.0% 1.2% 1.4% 1.6% 1.8% 2.0%

Hanover township

Madison township

Milford township

Oxford township

Reily township

Trenton city

Wayne township

Liberty township

Fairfield city

West Chester township

Lemon township

Fairfield township

St. Clair township

Hamilton city

Middletown city

Ross township

Morgan township

Butler County

Multiple births as percent of live births: 2003

0% 1% 2% 3% 4% 5% 6% 7% 8%

Hanover township

Milford township

Reily township

Ross township

Middletown city

Madison township

Hamilton city

Trenton city

Wayne township

Fairfield township

Morgan township

Fairfield city

Lemon township

West Chester township

Oxford township

St. Clair township

Liberty township

Butler County

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Percent of births to mothers under age 18: 2003

0% 2% 4% 6% 8% 10% 12%

Milford township

Morgan township

Liberty township

Hanover township

Trenton city

Lemon township

Fairfield township

West Chester township

Fairfield city

St. Clair township

Ross township

Madison township

Oxford township

Middletown city

Hamilton city

Reily township

Wayne township

Butler County

Percent of mothers who are married: 2003

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Middletown city

Hamilton city

St. Clair township

Ross township

Hanover township

Wayne township

Madison township

Fairfield city

Oxford township

Reily township

Trenton city

Lemon township

Morgan township

West Chester township

Fairfield township

Milford township

Liberty township

Butler County

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Percent of mothers completing fewer years of school than expected for age: 2003

0% 5% 10% 15% 20% 25% 30%

Wayne township

Liberty township

Morgan township

Lemon township

West Chester township

Fairfield township

Oxford township

Fairfield city

Reily township

Milford township

Trenton city

Hanover township

Madison township

Ross township

St. Clair township

Middletown city

Hamilton city

Butler County

Percent of mothers who smoked during pregnancy: 2003

0% 5% 10% 15% 20% 25% 30% 35% 40%

Liberty township

West Chester township

Fairfield township

Fairfield city

Lemon township

Milford township

Morgan township

Oxford township

Hanover township

Trenton city

Wayne township

Reily township

Ross township

Hamilton city

Middletown city

St. Clair township

Madison township

Butler County

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Percent of mothers who drank alcohol during pregnancy: 2003

0.0% 0.5% 1.0% 1.5% 2.0% 2.5%

Lemon township

Liberty township

Madison township

Milford township

Morgan township

Oxford township

Reily township

West Chester township

Wayne township

Fairfield city

Trenton city

Middletown city

Fairfield township

Hamilton city

Hanover township

Ross township

St. Clair township

Butler County

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Child Well Being Survey, 2005 The Child Well Being Survey (CWB) is a project of the Child Policy Research Center (CPRC) at Cincinnati Children’s Hospital Medical Center, the Health Foundation of Greater Cincinnati and the United Way of Greater Cincinnati. It was conducted by the University of Cincinnati’s Institute for Policy Research (IPR). The IPR administered the random telephone survey of caregivers of children in a 22-county area in Ohio, Kentucky, and Indiana in October through December 2005. The purpose of the survey is to provide policy-makers, decision-makers, public agencies, and academicians with population-based information to describe and monitor the well being of children in the tri-state area. A random sample of parents with children less than age 18 in the aggregated region of Butler, Warren and Clermont counties was conducted between October and December, 2005. The survey results have a + 5.7 % margin of error.

RESULTS o Children in Butler, Warren, and Clermont counties have optimal health overall.

Parents of only 11% of children in this area report their child’s health as neither “excellent” nor “very good.”

o Similar rates of chronic conditions, such as asthma, ADHD, and learning disabilities, exist among children in Butler, Warren and Clermont counties compared to children in greater Cincinnati.

o Nearly all children (95.9%) in Butler, Warren and Clermont counties have a usual source of care they visit when sick.

o Children in these Ohio counties are less likely to be publicly insured or have no insurance compared to all children in the CWB area. A large percentage of children in these counties are covered by private insurance (85.6%).

o Food security in the household (i.e. skipping meals because of lack of money) is a problem for 7.6% of families residing in Butler, Warren and Clermont counties.

o Children in the Ohio counties and greater Cincinnati suffer from comparable rates of have high problem level behavioral/emotional health (13.0% and 12.2%).

o One-third of parents in Butler, Warren and Clermont counties report their health as neither “excellent” nor “very good.”

o About one in five parents are current smokers in these counties.

o Families in Butler, Warren and Clermont counties are less likely to be poor or near poor. About three out of four families live on a household income that is greater than 200% of the Federal Poverty Level. Two out of three families in greater Cincinnati live on this income.

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Child Well Being Survey Item

Butler, Warren,

Clermont

All CWB Children

1. Parents’ perception of their child’s overall health: a. My child’s overall health is neither “excellent” nor “very good”

11.4%

13.1%

2. My child has been diagnosed with asthma

11.0%

13.9%

3. My child has not been diagnosed with asthma, but has asthma- like symptoms

5.6%

6.2%

4. My child has been diagnosed with ADHD

8.3%

8.7%

5. My child has been diagnosed with a learning disability

5.4%

7.2%

6. My child does not have a personal doctor or nurse

8.5%

13.5%

7. My child has not made a visit to a health provider in the last year

9.0%

10.4%

8. My child has had an injury requiring medical attention in the last year

22.3%

19.1%

9. When my child is sick, his/her usual source of care is: a. Doctor b. Clinic c. Other

95.9% 1.0% 3.0%

87.2% 6.5% 6.0%

10. My child’s health insurance is: a. Private b. Medicaid/SCHIP c. None

85.6% 12.6% 1.1%

78.9% 16.8% 3.5%

11. My family often runs our of food and doesn’t have money to buy more

3.7%

5.3%

12. My family has skipped meals in the last 12 months because of lack of money

7.6%

10.2%

13. I use child care for my child

28.0%

29.4%

14. My child, age 6-17, has had “no” or “little” physical activity in the past week

18.1%

25.9%

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Child Well Being Survey Item

Butler, Warren,

Clermont

All CWB Children

15. My child, age 6-17, is not involved in community service activities

38.3%

43.5%

16. My child has a “high level” of behavioral/emotional problems [Scale from the National Survey of American Families]

13.0%

12.2%

17. I talked with my child, age 6-17, in the last month about drugs and alcohol

75.0%

76.8%

18. My child, age 6-17, has used alcohol, in the last 30 days

1.9%

0.8%

19. I read to my child, age less than 6, less than once a week

11.9%

11.3%

20. My health (parent) is neither “excellent” nor “very good”

33.0%

37.5%

21. I (parent) smoked more than 100 cigarettes in my life

38.7%

44.4%

22. I (parent) am currently a smoker

21.0% 26.7%

23. Our family income is: a. Less than 100% of the Federal Poverty Level (FDL) b. 100-200% FDL c. Greater than 200% FDL [The current FDL for a family of four is $20,000]

8.7% 14.5% 76.9%

15.0% 18.8% 66.2%

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Butler County Health and Wellness Indicators The following tables present data on child safety, obesity, insurance status, and child mortality for Butler County as a whole. The various sources of data are listed at the end of each table. Child Abuse and Neglect (2005) Incidents Reported: Emotional maltreatment 95 Neglect 1,309 Physical Abuse 1,171 Sexual Abuse 374 Total 2,949 Source: Statistics provided by personal correspondence with L. Peters at Butler County Children Services Board, December 19, 2006. Growth Indicators Children 2 years of age and older Overweight (% ≥ 95th percentile) 10.5% Underweight (% < 5th percentile) 4.5% Children less than 2 years of age Overweight (% ≥ 95th percentile) 14.1% Source: Ohio Department of Health, Pediatric Nutrition Surveillance Survey, 2002 Child Insurance Status Butler County Children (0-17 yrs) Estimated % Total #Insured 94.43% 80,336Uninsured 5.57% 4,739 Source: Ohio Family Health Survey, 2004

Medicaid Coverage Total PopulationMedicaid Eligibles % Medicaid

0-4 years 23,328 8,693 37.3%5-18 years 69,774 15,359 22.0% Source: Ohio Job and Family Services, Ohio Medicaid Report (January 2005 update)

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Child Mortality Total # Rate

Child Deaths (rate per 100,000 population)Less than 1 year 32 684.5 1-4 years 4 21.6 5-14 years 7 14.6 15-24 years 29 51.1

Child Motor Vehicle Crash Deaths (# deaths per 100,000 children ages 1-14) 1 1.5 Source: Ohio Department of Health Information Warehouse, 2002 Infant Mortality

Total # Rate*All 32 7.0White 26 6.3African American 5 16.3Native American 0 0Asian/Pacific Islander 1 8.5 Source: Ohio Department of Health Information Warehouse, 2002

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Childhood Injury Mortality (rate per 100,000 population)

Total # Rate* Total # Rate*Motor Vehicle Accidents Other/Unspecified Non Transport Accidents

Less than 1 year 0 0 Less than 1 year 2 14.21-4 years 0 0 1-4 years 0 05-14 years 6 4.1 5-14 years 0 015-24 years 30 18.0 15-24 years 0 0

Other Land Transport Accidents Intentional Self-Harm (suicide) by FirearmsLess than 1 year 0 0 Less than 1 year 0 01-4 years 0 0 1-4 years 0 05-14 years 0 0 5-14 years 0 015-24 years 2 1.2 15-24 years 4 2.4

Accidental Discharge of Firearms Intentional Self-Harm (suicide) by Other/Unspecified MeansLess than 1 year 0 0 Less than 1 year 0 01-4 years 0 0 1-4 years 0 05-14 years 1 0.7 5-14 years 2 1.415-24 years 0 0 15-24 years 6 3.6

Accidental Drowning and Submersion Assault (homicide) by FirearmsLess than 1 year 0 0 Less than 1 year 0 01-4 years 0 0 1-4 years 0 05-14 years 1 0.7 5-14 years 0 015-24 years 1 0.7 15-24 years 1 0.6

Accidental Exposure to Smoke, Fire and Flames Assault (homicide) by Other/Unspecified MeansLess than 1 year 0 0 Less than 1 year 1 7.11-4 years 2 3.6 1-4 years 3 5.45-14 years 0 0 5-14 years 0 015-24 years 3 1.8 15-24 years 0 0

Accidental Poisoning Less than 1 year 0 01-4 years 1 1.85-14 years 0 015-24 years 4 2.4

Source: Ohio Department of Health, 2000-2002

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Leading Causes of Child Mortality (rate per 100,000 population)

Total # Rate* Total # Rate*Diseases of the Heart Accidents (Unintentional Injuries)

Less than 1 year 2 14.2 Less than 1 year 2 14.21-4 years 0 0 1-4 years 3 5.45-14 years 1 0.7 5-14 years 8 5.515-24 years 2 1.2 15-24 years 40 24.0

Malignant Neoplasms Influenza and PneumoniaLess than 1 year 0 0 Less than 1 year 1 7.11-4 years 3 5.4 1-4 years 0 05-14 years 0 0 5-14 years 0 015-24 years 5 3.0 15-24 years 0 0

Cerebrovascular Disease Nephritis, Nephrotic Syndrome and NephrosisLess than 1 year 1 7.1 Less than 1 year 1 7.11-4 years 0 0 1-4 years 0 05-14 years 0 1.4 5-14 years 0 015-24 years 0 0 15-24 years 0 0

Chronic Lower Respiratory Disease SepticemiaLess than 1 year 1 7.1 Less than 1 year 1 7.11-4 years 0 0 1-4 years 0 05-14 years 0 0 5-14 years 0 015-24 years 0 0 15-24 years 0 0

Diabetes MellitusLess than 1 year 0 01-4 years 0 05-14 years 0 015-24 years 2 1.2

Source: Ohio Department of Health, 2000-2002