Clermont County Community Health Assessment · e-cigarette- or vaping product use–associated lung injury (EVALI). As of December 19, 2019, state and local public health officials

2020

Clermont County Community Health Assessment

Clermont County Community Health Assessment 2020

i

Report Published

October 2020

Questions about this report may be addressed to:

Tara Jimison, BSN, RN

Director of Nursing

Clermont County Public Health

2275 Bauer Rd., Suite 300

Batavia, OH 45103

Phone: (513) 732-7749

Email: [email protected]

Website: ccphohio.org

mailto:[email protected]

http://www.ccphohio.org/


ii

Table of Contents Table of Figures ...................................................................................................................................................................... iv

Introduction ............................................................................................................................................................................ 1

Purpose ............................................................................................................................................................................... 1

Mobilizing for Action through Planning and Partnerships (MAPP) ..................................................................................... 1

Data and Information Sources Contributing to the Assessment ........................................................................................ 1

Collaborative Process for Sharing and Analyzing Data ....................................................................................................... 1

Vision and Values Statements ............................................................................................................................................. 1

Definition of the Community Served .................................................................................................................................. 2

Tools for Understanding This Report ...................................................................................................................................... 4

Report Layout ...................................................................................................................................................................... 4

Focus Groups ....................................................................................................................................................................... 4

Primary Data ....................................................................................................................................................................... 4

Secondary Data ................................................................................................................................................................... 4

Statistical Significance ......................................................................................................................................................... 4

Rates.................................................................................................................................................................................... 4

Key Findings/Significant Health Needs of the Community ................................................................................................. 4

Healthy People 2020 ........................................................................................................................................................... 5

Health Disparities and Health Equity .................................................................................................................................. 5

Social Determinants of Health ............................................................................................................................................ 5

Protective and Risk Factors ................................................................................................................................................. 5

Chapter 1: Key Findings/Significant Health Needs of the Community ................................................................................... 7

Community Meeting Focus Groups .................................................................................................................................... 7

Maternal and Infant .......................................................................................................................................................... 10

Youth ................................................................................................................................................................................. 11

Conditions and Diseases ................................................................................................................................................... 13

Health Behaviors ............................................................................................................................................................... 15

Tobacco Use .................................................................................................................................................................. 16

Alcohol Use ................................................................................................................................................................... 17

Mental Health ................................................................................................................................................................... 18

Injury and Violence ........................................................................................................................................................... 19

Access to Care ................................................................................................................................................................... 20

Chapter 2: Demographics of the Population and Social Determinants of Health ................................................................ 22

Demographic Determinants of the Population ................................................................................................................. 22

Social Determinants of Health .......................................................................................................................................... 24


iii

Neighborhood and the Built Environment .................................................................................................................... 24

Health and Health Care ................................................................................................................................................. 31

Social and Community Context ..................................................................................................................................... 33

Education ...................................................................................................................................................................... 33

Economic Stability ......................................................................................................................................................... 34

Chapter 3: Population Health ............................................................................................................................................... 38

Maternal, Infant, and Child Health Issues ......................................................................................................................... 38

Youth ................................................................................................................................................................................. 39

Health and Well-being .................................................................................................................................................. 39

Behavioral Health .......................................................................................................................................................... 41

Tobacco, Alcohol, and Illicit Drugs ................................................................................................................................ 45

Conditions and Diseases ................................................................................................................................................... 49

Infectious Diseases ........................................................................................................................................................ 49

Chronic Diseases ........................................................................................................................................................... 51

Health Behaviors ............................................................................................................................................................... 52

Mental Health ................................................................................................................................................................... 54

Injury and Violence ........................................................................................................................................................... 55

Chapter 4: Resource Distribution and Community Assets .................................................................................................... 58

Access to Health Care ....................................................................................................................................................... 58

Health Care Utilization .................................................................................................................................................. 59

Health Insurance ........................................................................................................................................................... 59

Health Care Facilities and Professionals ........................................................................................................................... 61

Chapter 5: Description of Health Disparities and High-risk Populations .............................................................................. 66

Factors that contribute to Poorer Health Outcomes ........................................................................................................ 66

Maternal, Infant, and Child Trends ............................................................................................................................... 66

Youth Trends ................................................................................................................................................................. 67

Conditions and Disease Trends ..................................................................................................................................... 70

Health Behavior Trends ................................................................................................................................................. 71

Mental Health Trends ................................................................................................................................................... 73

Injury and Violence Trends ........................................................................................................................................... 74

Food Access Trends ....................................................................................................................................................... 75

Access to Health Care Trends........................................................................................................................................ 76

Appendix ............................................................................................................................................................................... 78

References ............................................................................................................................................................................ 85


iv

Table of Figures Figure 1: Low Birth Weight, 2014-2018 ................................................................................................................................ 10

Figure 2: Low Birth Weight, 5-year Average (2014-2018) .................................................................................................... 11

Figure 5: Clermont County Youth (9th-12th Grade) Mental Health and Gender Comparison ............................................. 12

Figure 6: Top 3 Leading Causes of Death in Clermont County .............................................................................................. 13

Figure 7: Communicable Disease Reports ............................................................................................................................ 14

Figure 8: Identifying Health Disparities with Top 3 Leading Causes of Adult Death in Clermont County ............................ 14

Figure 9: Cancer Incidence in Clermont County Residents ................................................................................................... 15

Figure 10: Clermont County Adult Nutrition ......................................................................................................................... 15

Figure 11: Obesity and Physical Activity ............................................................................................................................... 16

Figure 12: Tobacco Use, Identifying Health Disparities ........................................................................................................ 16

Figure 13: Percentage of Adults that Currently Smoke Tobacco .......................................................................................... 17

Figure 14: Alcohol Use, Identifying Health Disparities .......................................................................................................... 17

Figure 15: Adult Mental Health Survey Results .................................................................................................................... 18

Figure 16: Clermont County Percentage of Suicide by Mechanism...................................................................................... 19

Figure 17: Accidental Deaths and Overdose Fatalities in Clermont County 2014-2018 ....................................................... 19

Figure 18: Unintentional Drug Overdose, Adults 20 Years of Age or Older, 10-year Age-Adjusted Rate (2009-2018) ........ 20

Figure 19: Clermont County Access to Care Responses ........................................................................................................ 20

Figure 20: Clermont County Population Trends, 2010-2040 ................................................................................................ 22

Figure 21: Clermont County Youth Population Projections, 2010-2050............................................................................... 22

Figure 22: Clermont County Senior Population Projections, 2010-2050 .............................................................................. 23

Figure 23: Clermont County Race ......................................................................................................................................... 23

Figure 24: Clermont County Ethnicity ................................................................................................................................... 23

Figure 25: Clermont County Household type ....................................................................................................................... 23

Figure 26: Clermont County Marital Status (15 years and older) ......................................................................................... 23

Figure 27: Clermont County Disability Characteristics ......................................................................................................... 24

Figure 28: Clermont County Resident Transportation for Work .......................................................................................... 25

Figure 29: Clermont County Neighborhood Safety ............................................................................................................... 25

Figure 30: 2019 Narcotics Unit Drug Related Arrests ........................................................................................................... 25

Figure 31: Clermont County Air Quality Index ...................................................................................................................... 26

Figure 32: Clermont County Land Use/Land Cover ............................................................................................................... 26

Figure 33: Clermont County Housing Problems Overview ................................................................................................... 27

Figure 34: Clermont County Severe Housing Problems Overview ........................................................................................ 27

Figure 35: Clermont County Recreational Opportunities ..................................................................................................... 28

Figure 36: Williamsburg-Batavia Bike Trail ........................................................................................................................... 28

Figure 37: Access to Exercise Opportunities ......................................................................................................................... 29

Figure 38: Health Insurance Coverage by Age ...................................................................................................................... 31

Figure 39: Comparison of Those with Health Insurance Coverage ....................................................................................... 31

Figure 40: Clermont County Caregivers ................................................................................................................................ 32

Figure 41: Clermont County Caregiver Duration .................................................................................................................. 32

Figure 42: Educational Attainment for the Population 25 Years of Age or Older ................................................................ 33

Figure 43: Annual Unemployment, 2014-2018..................................................................................................................... 34

Figure 44: Per Capita and Median Household Income ......................................................................................................... 34

Figure 45: Persons below the Poverty Level by Age ............................................................................................................. 35

Figure 46: Family Poverty ...................................................................................................................................................... 35

Figure 47: Clermont County Residents Qualifying for Most Public Assistance Programs .................................................... 35


v

Figure 48: Clermont County Households Qualifying for Most Public Assistance Programs ................................................. 35

Figure 49: Homeless Point in Time Count ............................................................................................................................. 36

Figure 50: First Trimester Care .............................................................................................................................................. 38

Figure 51: Low Birth Weight ................................................................................................................................................. 38

Figure 52: Pregnancy and Tobacco Use ................................................................................................................................ 38

Figure 53: Breastfeeding at Hospital Discharge, 2014-2018 ................................................................................................. 39

Figure 54: Youth Dietary and Physical Activity Related Behaviors ....................................................................................... 40

Figure 55: Comparison of Physical Activity Related Behaviors ............................................................................................. 41

Figure 56: School Immunization Completion ........................................................................................................................ 41

Figure 57: Behavioral Health ................................................................................................................................................. 42

Figure 58: Protective Factors ................................................................................................................................................ 42

Figure 59: Risk Factors .......................................................................................................................................................... 43

Figure 60 a, b and c: Cross Tabulations of Protective Factors and Illicit Drug Use ............................................................... 43

Figure 61: Distracted Driving from Clermont County Youth ................................................................................................. 44

Figure 62: Seat Belt Use from Clermont County Youth ........................................................................................................ 45

Figure 63: Substance Use-Related Behaviors ....................................................................................................................... 45

Figure 64: Youth Smokeless (Chew) Tobacco ....................................................................................................................... 46

Figure 65: Youth Cigarette Use ............................................................................................................................................. 46

Figure 66: Youth E. Cigarette Use ......................................................................................................................................... 46

Figure 67: Youth Perception of Harm Comparison between Cigarettes and E. Cigarettes .................................................. 46

Figure 68: Youth Current Alcohol Use ................................................................................................................................... 47

Figure 69: Youth Alcohol Initiation ....................................................................................................................................... 47

Figure 70: Clermont County Youth Frequency of Illicit Drug Use by Grade ......................................................................... 47

Figure 71: Clermont County Youth Age at First Illicit Drug Use by Grade ............................................................................ 48

Figure 72: Clermont County Youth Marijuana Use by Grade ............................................................................................... 48

Figure 73: Clermont County Youth Prescription Drug Use by Grade .................................................................................... 48

Figure 74: Clermont County Sexually Transmitted Disease (rate per 100,000), 2014- 2018 ............................................... 49

Figure 75: Hepatitis A Outbreak Cases, 2018-2020 .............................................................................................................. 50

Figure 76: HIV Surveillance ................................................................................................................................................... 51

Figure 77: Clermont County Adult Chronic Disease .............................................................................................................. 51

Figure 78: Comparison of the Top Three Chronic Conditions ............................................................................................... 51

Figure 79: Clermont County Adult Behavioral Risk Factors .................................................................................................. 52

Figure 80: Comparison of Adult Health Risk Behaviors ........................................................................................................ 53

Figure 81: Adult Alcohol Use ................................................................................................................................................. 53

Figure 82: Percentage of Adults that Currently Chew Tobacco ............................................................................................ 54

Figure 83: Percentage of Adults that Currently Smoke Tobacco .......................................................................................... 54

Figure 84: Percentage of Adults that Currently use E. Cigarettes ........................................................................................ 54

Figure 85: Adult Mental Health ............................................................................................................................................. 55

Figure 86: Accidental Drug Overdose, Adults 20 Years of Age or Older, 2014-2018 ............................................................ 56

Figure 87: Age-Adjusted Suicide Rate by County of Residence, Ohio, 2014-2018 ............................................................... 56

Figure 88: Clermont County Health Care Practitioners per 100,000 Population ................................................................. 58

Figure 89: Health Care Utilization, 2018 ............................................................................................................................... 59

Figure 90: Health Insurance Coverage by Age, 2017 ............................................................................................................ 59

Figure 91: Health Insurance Coverage under Age of 19, 2017 ............................................................................................. 60

Figure 92: Health Insurance Coverage 19 Years & Older, 2017 ............................................................................................ 60

Figure 93: Access to Health Care Professionals, 2018 .......................................................................................................... 61


vi

Figure 94: Clermont County Health Care Providers, 2019 .................................................................................................... 62

Figure 95: Clermont County Licensed Mental Health and Addiction Recovery Service Providers, 2019 ............................. 63

Figure 96: Clermont County Urgent Cares and Hospital, 2019 ............................................................................................. 64

Figure 97: Preterm Live Births (<37 weeks gestation), identifying health disparities, 5-year Average (2014-2018) ........... 66

Figure 98: Clermont County Youth 9th-12th Grade Gender and Nutrition Crosstab for Past 7 Days .................................. 67

Figure 99: Clermont County Youth 9th-12th Grade Weight Status and Behavior Crosstab Results ....................................... 67

Figure 100: Distracted Driving by Grade ............................................................................................................................... 68

Figure 101: Clermont County Youth (9th-12th) Grade Mental Health and Age Comparison ................................................ 68

Figure 102: Clermont County Youth (9th-12th Grade) Mental Health and Gender Comparison ......................................... 69

Figure 103: Clermont County Youth 9th-12th Grade, Mental Health and Nutrition Association ........................................ 69

Figure 104: Top 3 Adult Cancers by Site for Clermont County Residents ............................................................................. 70

Figure 105: Clermont County Leading Causes of Adult Death .............................................................................................. 70

Figure 106: Health Status Less Than Good ........................................................................................................................... 71

Figure 107: Sleep Less Than Eight Hours .............................................................................................................................. 71

Figure 108: Current Tobacco Use .......................................................................................................................................... 71

Figure 109: Adults Ever Smoked ........................................................................................................................................... 72

Figure 110: Adults Alcohol Use ............................................................................................................................................. 72

Figure 111: Adult Reported Not Good Mental Health Days ................................................................................................. 73

Figure 112: Adult Reported Depressive Disorder ................................................................................................................. 73

Figure 113: Clermont County Unintentional Drug Overdose Deaths of Ohio Residents and Average Crude and Age-

Adjusted Death Rates per 100,000 Population ..................................................................................................................... 74

Figure 115: Health Care Coverage, Identifying Health Disparities, 2019 .............................................................................. 76

Figure 116: Delayed Medical Care Because of the Cost, Identifying Health Disparities, 2019 ............................................. 76

Figure 117: Did Not Take Prescribed Medications Because of the Cost, Identifying Health Disparities, 2019 .................... 76

Figure 118: Health Care Bills Being Paid Off over Time, Identifying Health Disparities, 2019 ............................................. 77

Figure 119: Has a Personal Doctor or Health Care Provider, Identifying Health Disparities, 2019 ...................................... 77

Figure 120: Saw a Doctor for a Routine Checkup in the Past 12 Months, Identifying Health Disparities, 2019 .................. 77

Figure 121: Satisfied with the Health Received, Identifying Health Disparities, 2019 ......................................................... 77


1

Introduction

Purpose The purpose of the Clermont County Community Health Assessment (CHA) is to learn about the health of the

population, identify contributing factors to higher health risks or poorer health outcomes, and determine what assets

and resources are available to improve the population health status.

Mobilizing for Action through Planning and Partnerships (MAPP) More than the absence of illness, health is a dynamic state of complete physical, mental, and social well-being. Such a

broad definition of health requires a collective effort. MAPP is a community-wide strategic planning tool for improving

public health. Following the MAPP method helps communities prioritize public health issues, identify resources for

addressing them, and take action. The ultimate goal of MAPP is reaching toward optimal community health, a

community where residents are healthy, safe, and have a high quality of life. The Community Health Assessment is one

of four assessments conducted within the MAPP process that collectively lead to an understanding of the health status

of the community.

Data and Information Sources Contributing to the Assessment

The Clermont County Community Health Assessment contains both primary and secondary data elements which

contribute to a robust view of the community. Clermont County Public Health, in collaboration with Wright State

University, conducted primary data collection from youth (specifically high school students) and adults throughout the

county via electronic and phone surveys. Sources of secondary data for this report include the Ohio Department of

Health, Ohio Department of Job and Family Services, the Center for Disease Control and Prevention, the Bureau of the

Census’ American Community Survey, the Ohio Department of Public Safety, the Ohio Development Services Agency, the

Ohio Mental Health and Addiction Services, the Institute for Health Metrics and Evaluation, the Health Resources and

Services Association, the USDA Economic Research Service, and the Robert Wood Johnson Foundation. The inclusion of

data from a variety of sources provides a snapshot of the health of those in our community, and allows the opportunity

to track health trends over time and make comparisons between county, state and national data. Additionally, the

Clermont County Community Health Assessment includes health-related benchmarks such as the Healthy People 2020

goals against which our data can be measured.

Collaborative Process for Sharing and Analyzing Data This CHA was developed through a collaborative process of collecting and analyzing data, involving many sectors of the

community (local government, for-profits, non-profits, community foundations, and healthcare providers), ensuring

representation of populations that are at higher health risk or have poorer health outcomes. All of these partners have

committed to using the assessment, in which they have highlighted areas for improvement, identified resources, set the

stage to adopt priorities and policies, and develop plans to address community health outcomes. This CHA was

developed alongside the regional CHNA (Community Health Needs Assessment) completed by the regional hospitals

through The Health Collaborative and some information is shared between documents.

Vision and Values Statements Community members and stakeholders play a key role in the improvement of the health of Clermont County. Having a

shared vision helps to set expectations and steer efforts for the health and wellbeing of the county as a whole.

Supporting that vision are the values we hold and strive to employ for the ongoing betterment of the community. Input

from community members and stakeholders included the following values as important with regard to the guiding vision


2

of health in Clermont County: collaboration, equity, compassion, inclusion and respect. These values, along with the

data contained within this document will be reflected in the next step in the MAPP process – development of the

Clermont County Community Health Improvement Plan (CHIP). Goals, objectives and strategies developed for the CHIP

will help steer us toward our collective vision for Clermont County:

A thriving, vibrant, healthy community to live, play, work, learn, and grow!

Definition of the Community Served Covering 452 square miles, Clermont County is the 42nd largest county in Ohio by area. Located in the southwest

portion of the state along the Ohio River, Clermont County is bordered by Brown, Clinton, Hamilton and Warren

counties in Ohio, and Bracken, Campbell and Pendleton counties in Kentucky. Clermont County is the western-most

designated Appalachian county in Ohio and is comprised of 14 townships and nine villages. The most densely populated

areas are largely suburban neighborhoods on the western side of the county bordering Hamilton County - which

contains the City of Cincinnati. Agricultural and small residential areas are located in the eastern and southern portions

of the county.

Source: United States Census QuickFacts, Clermont County, Ohio

Clermont County Ohio

Quick Facts


3

Acknowledgments

Clermont County Community Health Assessment Steering Committee:

CareSource

Child Focus, Inc.

Clermont County Board of Commissioners

Clermont County Board of Developmental Disabilities

Clermont County Board of Health

Clermont County Community Services

Clermont County Coroner’s Office

Clermont County Department of Job and Family Services

Clermont County Educational Service Center

Clermont County Emergency Management Agency

Clermont County Fire/Emergency Medical Services Association

Clermont County Mayor’s Association

Clermont County Mental Health and Recovery Board

Clermont County Office of Environmental Quality

Clermont County Park District


Clermont County Senior Services

Clermont County Sheriff’s Office

Clermont County Township Association

Clermont County YMCA

Clermont Transportation Connection

Dr. Erik Powell, UC Health

Greater Cincinnati Behavioral Health Services

HealthSource of Ohio

Mercy Hospital Clermont

Ms. Marty Lambert

Ohio State University Extension Office

United Healthcare

United Way of Greater Cincinnati

University of Cincinnati


4

Tools for Understanding This Report

Report Layout This report illustrates the key health issues faced by County residents along with relevant health disparities affecting

community health. Data in this report are organized into topical areas, which can be located by referring to the table of

contents. The structure of this report includes this introduction and description of the process; a demographic discussion

of the population; an analysis of the Social Determinants of Health; a community health status report based on the

Foundational Public Health Areas; information gathered from focus group sessions; and a summary of the key findings.

Focus Groups Focus groups were held in three areas of the county - north, central, and south- in collaboration with the regional CHNA

process. CCPH assisted in conducting these assessments to collect information to inform the CHA. Focus groups were

comprised of community members and stakeholders, providing valuable insites into the status and needs of the

community.

Primary Data CCPH worked with Wright State University to administer surveys to adults and children in Clermont County for the CHA.

Questions were modeled after the CDC Behavioral Risk Factor Surveillance System (BRFSS) and the Youth Risk Behavioral

Surveillance System (YRBSS). The adult survey was administered via a random phone survey. The youth survey was

administered to high school students in public schools in Clermont County. The youth survey questions did not repeat

any questions that are used in the Pride Survey. The Pride Survey is administered to students in 7th- 12th grade in

Clermont County and evaluates their perceptions and behaviors, as well as risk and protective factors.

Secondary Data Secondary data sources are used to collect some data measures including demographics and data for state and national

comparison. Secondary data sources are cited throughout the document.

Statistical Significance Some data in the report was measured to determine statistical significance between categories. Statistical significance is

the likelihood that a relationship between two or more variables is caused by something other than chance. It is

intended to test how likely it is that an observed distribution is due to chance. A Chi-square test is designed to analyze

categorical data.

Rates Rates are used in some figures throughout the document. Rates are frequently used to do comparisons among different

population sizes. Rates take into account the number of cases or deaths and the population size. For example, if a cancer

incidence rate is 500 per 100,000, it means that 500 new cases of cancer were diagnosed for every 100,000 people.

Rates allow comparison of local Clermont County data to state and national data.

Key Findings/Significant Health Needs of the Community This chapter contains highlights and key findings and significant health needs of the community as identified throughout

the 2020 Clermont County Community Health Assessment and the CHNA process. Categorized by topic area (Maternal

and Infant, Youth, Conditions and Diseases, Health Behaviors, Mental Health, Injury and Violence, and Access to Care)

these data elements spotlight the findings contributing to the overall health of residents within Clermont County.


5

Healthy People 2020 The U.S. Department of Health and Human Services Healthy People

Initiative was developed to establish science-based objectives for

promoting and improving the health of all Americans. Healthy People 2020

(HP2020) is a 10-year agenda comprised of national goals and objectives

for health promotion and disease prevention. The Healthy People initiative

is committed to improving the quality of our nation’s health. In 2020, The

Healthy People goal was established to “achieve health equity, eliminate

disparities, and improve the health of all groups” (HealthyPeople.gov,

2020). In this chapter and throughout the document, the Healthy People

2020 (HP2020) benchmarks are included for many data points to frame health status and allow for a mechanism of the

measurement of health within the community. Consideration of the HP2020 benchmarks will assist in the establishment

of goals for future improvement for Clermont County.

Health Disparities and Health Equity Health disparities are differences in health outcomes, quality, access, or utilization of health care in groups, commonly

associated with social, economic, and/or environmental disadvantage. These groups may be defined by several factors,

including race or ethnicity, age, gender, geographic location, disability, or socioeconomic status. Where available, the

CHA will provide data that includes these factors to highlight areas of disparity. Striving to eliminate disparities where

they occur will lead to health equity, defined as “the attainment of the highest level of health for all people”

(HealthyPeople.gov, 2020).

Consideration of the key findings, HP2020 benchmarks and areas of health disparity,

along with the remaining data provided throughout this document, and future

completion of the additional MAPP assessments (Forces of Change and Community

Themes and Strengths), will help steer the selection of the Clermont County

Community Health Improvement Plan (CHIP) priority areas. Goals, objectives and

activities to improve health and achieve health equity within these priority areas

will be developed and monitored so progress can be tracked and measured over

time.

Social Determinants of Health “Social determinants of health are conditions in the environments in which people

are born, live, learn, work, play, worship, and age that affect a wide range of health

functioning, and quality-of-life outcomes and risks” (Healthy People 2020). Divided

into five categories (Neighborhood and Built Environment, Health and Health Care,

Social and Community Context, Education, and Economic Stability) the social

determinants include elements regarding access to health care, transportation

options, literacy, housing quality, incarceration and poverty. Improvements in these

areas provide the opportunity for better health outcomes.

Protective and Risk Factors Risk factors are characteristics at the biological, psychological, family, community, or cultural levels that precede and are

associated with a higher likelihood of negative outcomes. Protective factors are characteristics associated with a lower

likelihood of negative outcomes or that reduce a risk factor’s impact. Protective factors may be seen as positive

countering events. (Substance Abuse and Mental Health Services Administration (SAMHSA), 2020).

Image: Adobe Stock

Image: Healthy People 2020


6

Chapter 1: Key Findings/Significant Health

Needs of the Community


7

Chapter 1: Key Findings/Significant Health Needs of the Community

Community Meeting Focus Groups Focus groups were held in three areas of the county - north, central and south in collaboration with the regional CHNA

process. Information was collected and collated from these groups into the information provided below. Questions were

asked of community members and of agencies that provide services within the communities. This information was used

to assist in informing data collection for the CHA.

*ACEs (Adverse Childhood Experiences) ** STIs (Sexually Transmitted Infections)

What are the most serious health issues facing your community?

Co

mm

un

ity

Res

po

nse Access to Care

Addiction

Childhood Trauma/ACEs*

Communicable Diseases/STIs**

Cost of Health Care

Obesity

Oral Health

Tobacco Use

Age

ncy

Res

po

nse Access to Care

Addiction

Childhood Trauma/ACEs

Cost of Health Care

Obesity

Oral Health

STIs

Tobacco Use

Which important health issues are being handled well in your community? C

om

mu

nit

y R

esp

on

se Access to Care

Addiction Treatment

Crime

Mental Health

Outdoor Recreation

School Based Health CentersA

gen

cy R

esp

on

se Access to Care

Addiction Treatment

Cancer Resources

Chronic Disease Managent

Food Access

Infant/Child Health

Mental Health

Oral Health

Which important health issues are not being addressed enough in your community? What more could

be done?

Co

mm

un

ity

Res

po

nse Addiction

Child Health

Communicable Diseases/STIs

Food Insecurity/Nutrition

Geriatric Care

Health Education

Housing

Tobacco Use

Age

ncy

Res

po

nse Addiction

Chronic Care

Communicable Diseases/STIs

Mental Health

Nutrition/Food Deserts

Obesity

Poverty

What would you say is the most important child health issue in your community? C

om

mu

nit

y R

esp

on

se Acces to Care

Activities & Exercise

Addiction

Food Insecurity

Immunizations

Kinship Care

Mental Health

Parental Knowledge

Age

ncy

Res

po

nse Abuse/ACEs

Dental Care

Exercise

Nutrition

Obesity

Parental Knowledge/Skill

Poverty

Preventive Care


8

What would you say is the most important thing that can be done to improve child health in your community?

Co

mm

un

ity

Res

po

nse Access to Care

Education

Food Access

Funding

Mental Health/Suicide Prevention

Parental Knowledge/Skills

Age

ncy

Res

po

nse Access to Care

Activities/Programs

Addiction Prevention

Education

Financial Support

Nutrition/Exercise

Support

What is the biggest barrier to child wellness in your community?

Co

mm

un

ity

Res

po

nse ACEs/Mental Health

Education

Food Deserts

Insurance

Lifestyle


Technology

Transportation

Age

ncy

Res

po

nse Access to Care

Financial

Knowledge


Transportation

What do you/ your clients do to improve your/ their health?

Co

mm

un

ity

Res

po

nse Addiction Recovery

Exercise

Healthy Diet/Nutrition

Preventive Care

Religious/Spiritual Wellness

Sleep

Tobacco Cessation

Age

ncy

Res

po

nse Addiction Treatment

Education

Nutrition/Activity

Preventive Care

Tobacco Cessation

Where are some of the places you know that can help with health-related issues in your community? C

om

mu

nit

y R

esp

on

se Community Service Providers

County Agencies

Health Care Facilities

Internet

Religious/Spiritual Affiliations

Treatment Facilities

Age

ncy

Res

po

nse Community Service Providers

County Agencies

Health Care Facilities

Recreational Centers

Religious/Spiritual Affiliations

Treatment Facilities


9

What are some of the financial barriers to receiving health care in your community? C

om

mu

nit

y R

esp

on

se Co-pays

Insurance Premiums

Missed Work

Prescription Cost

Transportation Age

ncy

Res

po

nse Co-pays

Insurance Premiums

Missed Work

Poverty

Prescriptions Cost

Transportation

What are some of the non-financial barriers?

Co

mm

un

ity

Res

po

nse Access to Care

Access to Public Transportation

Health Knowledge

Housing

Knowledge of Available Resources

No Sidewalks

Time/Availability

Age

ncy

Res

po

nse Access to Care

Access to Public Transportation

Addiction

Knowledge

Stigma

What is your perception of the overall health status of your community?

Co

mm

un

ity

Res

po

nse

Age

ncy

Res

po

nse

Given the health issues facing the community, which ones would be your top priority?

Co

mm

un

ity

Res

po

nse Addiction

Communicable Disease/STIs

Nutrition

Access to Care

Mental Health

Exercise

Health Education

Age

ncy

Res

po

nse Obesity

Addiction

Nutrition/Activity

Poverty

Education

Abuse/ACEs

Chronic Disease

Mental Health

2.1%

33.3%

47.9%

16.7%

Excellent

Good

Fair

Poor

23.1%

23.1%42.3%

11.5%

Excellent

Good

Fair

Poor


10

The Healthy People 2020 goal for maternal and child health is to

improve the health and well-being of women, infants, children,

and families. Maternal and infant health includes infant and

maternal mortality, birth outcomes and related risk factors

affecting preconception, pregnancy and infancy. This includes

teen pregnancy.

Image: Adobe Stock

According to the Ohio Department of Health (ODH), Clermont County has a lower percentage of low birth weight babies (defined as infants weighing less than 2,500 grams, or 5 lbs. 8 oz., at birth) than the overall percentage for the state of Ohio – a trend that has persisted over the past five years. Additionally, Clermont County is below the HP2020 target of 7.8%. Low birth weight can be attributed to some factors including:

Smoking and/or drinking alcohol during pregnancy

Lack of weight gain during pregnancy

Age of the mother at the time of pregnancy (younger than 15 or more than 35 years)

Social and economic factors (i.e., low income, low educational level, stress or abuse, being unmarried)

Higher use of infertility therapies that result in more multiple births.

(Source: CDC.gov, 2020, HealthyPeople.gov, 2020)

Figure 1: Low Birth Weight, 2014-2018

Source: Ohio Department of Health, 2014-2018

7.5%

6.3%

7.5% 7.2% 7.5%

8.5% 8.5% 8.7% 8.7% 8.5%

4.0%

6.0%

8.0%

10.0%

2014 2015 2016 2017 2018

Low Birth Weight, 2014-2018HP2020 Target 7.8%

Clermont County Ohio HP2020

The risk of maternal and infant mortality and

pregnancy-related complications can be

reduced by increasing access to quality

preconception (before pregnancy), prenatal

(during pregnancy), and interconception

(between pregnancies) care. Centers for Disease Control and Prevention

Maternal and Infant

Image: Adobe Stock

https://stock.adobe.com/images/pregnant-mother-playing-with-little-daughter-in-park/163143668


11

Figure 2: Low Birth Weight, 5-year Average (2014-2018)


Compared to the state percentage, youth in Clermont County use E-Cigarettes more and have the perception that they

are less harmful than cigarettes.

Figure 3: Clermont County Youth E-Cigarette Use Figure 4: Youth Perception of Harm Comparison between Cigarettes and E-Cigarettes

County Source: Clermont County Pride Survey 7th-12th grade, 2017-2018 County Source: Clermont County Pride Survey 7th-12th grade, 2017-2018 State Source: ODH, 2017 US Source: CDC, 2018

7.1

%

13

.6%

5.8

%

6.1

%

9.3

%

9.7

%

7.1

%

7.8

%

12

.6%

6.8

%

7.3

%

13

.9%

8.1

%

6.7

%

11

.0%

10

.2%

8.4

%

11

.5%

11

.1%

8.1

%

0%

2%

4%

6%

8%

10%

12%

14%

0%

2%

4%

6%

8%

10%

12%

14%

White,Non-Hisp

Black,Non-Hisp

Hispanic Married Unmarried <20 20-39 40+ < H.S. H.S. +

Race Marital Status Age Education

Low Birth Weight, 5-year Average (2014-2018)

Clermont County Ohio HP2020 - 7.8%

Youth

16.4%

10.5%

20.8%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

ClermontCounty

Ohio US

Percentage of Youth with Current E-Cigarette Use

6.3

%

5.3

%

22

.4%

66

.0%

22

.3% 32

.7%

17

.9% 27

.1%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

No Harm Some Harm Harmful Very Harmful

Perception of Harm

Cigarettes Electronic Cigarettes


12

Figure 3: Clermont County Youth (9th-12th Grade) Mental Health and Gender Comparison

Source: Clermont County Community Health Assessment Survey, 2019

25.0%

12.1%10.1%

4.9%

32.5%

46.4%

22.3%

15.8%

8.8%

27%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

During the past 12months, did you ever feelso sad or hopeless almostevery day for two weeks

or more in a row that youstopped doing some usual

activities?

During the past 12months, did you ever

seriously considerattempting suicide?

During the past 12months, did you make a

plan about how youwould attempt suicide?

During the past 12months, how many timesdid you actually attempt

suicide?

If you attempted suicideduring the past 12

months, did any attemptresult in an injury,

poisoning, or overdosethat had to be treated by

a doctor or nurse?

Youth Mental Health Questions by Gender Comparison

Male Female

The Chi-square statistic is significant at the .05 level for this data

Clermont Youth (9th-12th grade) Behavioral Health

35.7% Felt sad or hopeless everyday for 2 weeks or more

17.3% Considered suicide in the past year 6.9% Attempted suicide one or more times in the past year

Source: Clermont County Community Health

Assessment Survey, 2019

According to the CDC, risk factors for suicide include: Family history of suicide Family history of child maltreatment Previous suicide attempt(s) History of mental disorders, particularly clinical depression History of alcohol and substance abuse Feelings of hopelessness Impulsive or aggressive tendencies Cultural and religious beliefs (e.g., belief that suicide is noble resolution

of a personal dilemma) Local epidemics of suicide Isolation, a feeling of being cut off from other people Barriers to accessing mental health treatment Loss (relational, social, work, or financial) Physical illness Easy access to lethal methods Unwillingness to seek help because of the stigma attached to mental

health and substance abuse disorders or to suicidal thoughts

During the past 12

months, did you

attempt suicide one or

more times?

Among all schools surveyed through the Pride Survey, 77.3% of youth in

grades 7th – 12th experience stress daily.


13

According to the CDC, children and adolescents ages 6 through 17 years should get 60 minutes or more of moderate-to-vigorous intensity physical activity each day, including daily aerobic – and activities that strengthen bones – 3 days each week, and that build muscles – 3 days each week.

The USDA recommends:

Healthy food and beverage choices from all five food groups including fruits, vegetables, grains, protein, and dairy to get the nutrients you need.

Eating the right amount of calories for your age, sex, height, weight, and physical activity level.

Healthy eating can help you avoid being overweight or obese.

Clermont Youth (9th-12th grade) BMI and Nutrition


The Centers for Disease Control and Prevention (CDC) broadly defines a chronic disease as a condition that lasts for one year or longer. It also requires ongoing medical attention and/or limits activities related to daily living. Some examples of chronic disease include stroke, diabetes, asthma, chronic obstructive pulmonary disease, and arthritis. The CDC explains that about half of all adults in the United States have one or more chronic health conditions and four in ten adults have two or more chronic health conditions. Behaviors such as tobacco use, lack of physical activity, and poor nutrition are health risks that can cause chronic diseases. Related clinical risk factors such as obesity, hypertension, and high cholesterol can also contribute to developing a chronic disease. Heart disease and cancer are two chronic diseases included in the top ten causes of death. These two conditions account for almost half of all deaths in the United States. You can reduce your likelihood of developing a chronic disease by maintaining a healthy lifestyle and avoiding key risk behaviors.

Figure 4: Top 3 Leading Causes of Death in Clermont County


Chronic diseases including obesity,

cardiovascular disease, diabetes and

cancer, as well as related risk factors

such as tobacco use and poor

nutrition, stand out as concerns for

Ohio and its communities. Obesity

and hypertension, for example, are

highly-prevalent conditions reported

by nearly one-third of Ohio’s adult

population.

2014 2015 2016 2017 2018

Malignant neoplasms 177.3 169.0 168.6 174.5 160.9

Diseases of heart 150.3 161.3 165.4 168.8 170.3

Accidents 72.0 81.4 79.0 67.6 62.7

0.0

50.0

100.0

150.0

200.0

Age

-Ad

just

ed R

ate

per

10

0,0

00

Top 3 Leading Causes of Death, 2014-2018Age-Adj Rate/100,000 Adults 20 Years of Age or Older

2.5% Underweight

63.6% Normal BMI

16.9% Overweight

17.2% Obese (equal to or greater than

95th percentile)

34% Drank milk > 1 time/day

51.7% Consumed fruit/fruit juice milk > 1

time/day

56.8 Consumed vegetables >1 time/day

Conditions and Diseases


14

Figure 5: Communicable Disease Reports

Source: Clermont County Public Health, 2019

Figure 6: Identifying Health Disparities with Top 3 Leading Causes of Adult Death in Clermont County


14

8.0

19

8.7

17

1.8

10

2.5

1.9

18

.1

14

9.9

32

.7

13

5.9

12

8.4

20

8.0

16

5.6

11

3.7

2.9

16

.7

14

3.8

40

.7

12

1.3

47

.5

98

.2

75

.5

*

27

.4

28

.9

16

.3

16

.4

55

.6

0

50

100

150

200

250

Female Male White Minorities 20-34 35-54 55+ <H.S. H.S.+

Gender Race Age Education

Age

-Ad

just

ed R

ate

per

10

0,0

00

Top 3 Leading Causes of Adult Death, 5-year Rate (2014-18)

Malignant neoplasms Diseases of heart Accidents

* - Indicates rates have been suppressed for counts < 10 or where population counts are not available, rates based on counts < 20 are considered unreliable


15

Figure 7: Cancer Incidence in Clermont County Residents


Health behaviors are decisions individuals make that can have an impact on their overall health and can be related to

chronic diseases. They include things like choosing to use tobacco products, getting enough regular physical activity,

consuming alcohol, maintaining normal body weight, and obtaining daily sufficient sleep.

Figure 8: Clermont County Adult Nutrition


17

9.7

2.2

95

.9

57

.5

49

.5

47

.8

20

8.8

10

4.0

11

8.0

10

9.7

83

.4

*

17

.9

32

6.5

N/A

11

6.4

86

.5 85

.0

* 13

.6

35

6.8

0

50

100

150

200

250

300

350

400

Female Male White,Non-Hisp

Minorities,Non-Hisp

Hispanic <55 55+

Gender Race Age

Age

-Ad

just

ed R

ate

per

10

0,0

00

Top 3 Adult Cancers by Site, 5-year Rate (2012-2016)Breast Lung and Bronchus Prostate

* Indicates rates have been suppressed for counts < 10 or where population counts are not available, rates based on counts < 20 are considered unreliable

Health Behaviors

26.1%

38.0%

21.4%

14.5%

Servings of Vegetables per Day

< 1 serving 1 serving2 servings 3 or more servings

40.7%

28.0%

22.1%

9.2%

Servings of Fruit or Fruit Juice per Day

< 1 serving 1 serving2 servings 3 or more servings


16

Figure 9: Obesity and Physical Activity

County Source: Clermont County Community Health Assessment Survey, 2019

State & US Source: Behavioral Risk Factor Surveillance System (BRFSS), 2017

Tobacco Use

E-cigarette, or Vaping, Product Use–Associated Lung Injury (EVALI)

The Centers for Disease Control and Prevention (CDC) and multiple states continue to investigate the occurrence of

severe pulmonary disease among people who report vaping. This severe pulmonary disease may be referred to as

e-cigarette- or vaping product use–associated lung injury (EVALI). As of December 19, 2019, state and local public health

officials in Ohio have confirmed 91 cases of EVALI (Ohio Department of Health). Three of these confirmed cases are

Clermont County residents. Additional information about the investigations can be found on the CDC and ODH websites.

Figure 10: Tobacco Use, Identifying Health Disparities


Ohio Source: Behavioral Risk Factor Surveillance System (BRFSS), 2017

69.5%

49.9%

66.8%

52.2%

66.6%

49.4%

0%

20%

40%

60%

80%

Overweight or obese <150 min aerobic activity

Comparison of Obesity and Physical Activity Clermont County Ohio United States

22.9%

17.4%

21.2%

18.2%

36.7%

18.1%

43.2%

16.0% 14.5%

25.3%

19.9%

22.4%20.3%

23.4% 23.5%

13.8%

42.5%

16.2%

41.1%

16.2%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Male Female <55 yearsof age

55+yearsof age

No HSDip

or GED

HSDip/GEDor higher

<$15k $15k+ Suburban Rural

Gender Age Education Income Region

Adult Current SmokersClermont County, 2019 Ohio, 2017


17

Figure 11: Percentage of Adults that Currently Smoke Tobacco

Sources: Clermont County Community Health Assessment Survey, 2019 and CDC BRFSS Prevalence and Trends

Alcohol Use

Figure 12: Alcohol Use, Identifying Health Disparities


15.9%

11.7%

18.9%

* *

14.9%

*

19.1%15.9%

11.7%

0%

5%

10%

15%

20%

25%


55+yearsof age

No HSDip

or GED

HSDip/GEDor higher


Gender Age Education Income Region

Clermont County Adult Binge Drinking in the Past 30 Days

*Indicates rates have been suppressed for counts < 10 or where population counts are not available

Smoking is linked to almost half a million deaths

each year in the United States. Smoking can cause

cancer almost anywhere in the body, and

increases the risk of developing heart disease and

stroke. Women who smoke while pregnant are at

an increased risk for having a preterm baby,

stillbirth, and infant death.

Centers for Disease Control and Prevention

Excessive alcohol consumption is associated with numerous health problems. Unintentional injuries, such as

motor vehicle crashes, falls, burns, and drownings are often tied to alcohol use. Intentional injuries associated

with alcohol use include firearm injuries, sexual assults, and domestic violence. Long-term health risks include

liver disease, depression, anxiety, high blood pressure, stroke, heart attack, cancer, and uncontrollable diabetes.

Pregnant women who drink risk having a child born with fetal alcohol spectrum disorders.

19.6%21.1%

14.1%HP2020 Target, 12.0%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

Clermont County,2019

Ohio, 2017 US, 2017

Adult Current Smoker

Image: Adobe Stock

Image: Adobe Stock


18

Mental health is part of several factors that contribute to a person’s well-being. The World Health Organization says that

health is complete physical, mental, and social well-being. Mental health maintenance is important from childhood

through adolescence and adulthood. While Ohio and its counties face many behavioral health challenges, including poor

access to care and a high prevalence of depression, the rise in opiate-related drug overdose deaths stands out as an

immediate threat to the wellbeing of Ohioans.

Figure 13: Adult Mental Health in Clermont County Survey Results


44.8%

42.9%

24.6%

22.7%

22.9%

31.3%

0% 10% 20% 30% 40% 50%

One or more days during the past 30 days whenmental health was not good

Felt stressed within the past 30 days

Had little interest or pleasure in doing things

Bothered by feeling down, depressed or hopeless

Bothered by not being able to stop or controlworrying

Bothered by feeling nervous, anxious or on edge

Mental Health Survey Results

Mental Health

Mental health, which is linked to physical health,

can affect work productivity, quality of life, social

interaction, diseases, treatments, and outcomes.

People who maintain positive mental health are

more likely to succeed in life, and more likely to

increase their chances of living longer, healthier

lives.

domestic violence. Long-term health risks

include liver disease, depression, anxiety, high

blood pressure, stroke, heart attack, cancer, and

uncontrollable diabetes. Pregnant women who

drink risk having a child born with fetal alcohol

spectrum disorders.

Image: Adobe Stock


19

Unintentional injuries are the leading cause of death for Ohioans ages 1 through 44 and the third leading cause of death for all Ohioans (Ohio Department of Health, 2020). According to the CDC, both unintentional injuries and those caused by acts of violence are among the top 15 killers for Americans of all ages.

Figure 14: Clermont County Percentage of Suicide by Mechanism

Source: Ohio Department of Health, 2017

Figure 15: Accidental Deaths and Overdose Fatalities in Clermont County 2014-2018


2014 2015 2016 2017 2018

Accidents 72 81.4 79 67.6 62.7

Accidental Drug OverdoseFatality

42.5 55.9 50.3 46.5 40

Fentanyl related OverdoseDeath

11.9 30.4 27.6 35.3 30.9

Prescription Opiate relatedOverdose Death

11.8 9.3 6.4 4.9 5

0102030405060708090

Accidental Deaths and Overdose Fatalities, 2014-2018

Injury and Violence


20

Image: Adobe Stock

Figure 16: Unintentional Drug Overdose, Adults 20 Years of Age or Older, 10-year Age-Adjusted Rate (2009-2018)


Immunization provider density, including health care

providers, urgent cares facilities and pharmacies, is

higher in suburban areas which are located in the

northwestern portion of the county (Miami and Union

townships). Areas in the southern and eastern portions

of the county have a limited number of providers, and

some areas (Felicity, Washington, Jackson, Stonelick

and Wayne townships) have no providers. (CCPH, Get

Vaccinates Ohio Disparity Report, 2019)

23.2

49.8

37.3

* *

28.5

39.0

4.1

9.4

26.4

16.9

34.4

27.9

20.8

14.5

9.7

2.5 5.7

19.5

0

10

20

30

40

50

60

Female Male White Black Hispanic 20-34 35-54 55+ <H.S. H.S.+

Age

-Ad

just

ed R

ate

per

10

0,0

00

Adult Accidental Drug Overdose, 10-year Rate (2009-18)


* Indicates rates have been suppressed for counts < 10 or where population counts are not available, rates based on counts < 20 are considered unreliable

Non-Hispanic

Figure 17: Clermont County Access to Care Responses Source: Clermont

County Community Health Assessment

Survey, 2019

Access to Care

Drug use and misuse continue to create

public health challenges in the United States,

leading to overdose deaths, HIV and hepatitis

C infections, and other chronic health

conditions. APHA Policy Statement

https://stock.adobe.com/images/rehabilitation-concept-wooden-signboards-pointing-different-directions-to-recovery-and-addiction-on-landscape-background/156304304


21

Chapter 2: Demographics of the Population

and Social Determinants of Health


22

Chapter 2: Demographics of the Population and Social Determinants of Health Population projections are important for community development planning. This population growth prediction can help

facilitate discussions for employment opportunity, available resources, and community development. According to the

U.S. Census, the 2010 population of Clermont County was 197,363. By 2020, the population is estimated to be 208,330,

demonstrating a 5.6% increase. Notably, individuals aged 65 years and older are anticipated to demonstrate a

population increase of 44.3% within that same timeframe.

Figure 18: Clermont County Population Trends, 2010-2040

Source: American Community Survey, 2013-2017

Ohio Development Services Agency

Figure 19: Clermont County Youth Population Projections, 2010-2050



Image: Adobe Stock

197,363

202,166

208,330

214,090216,180 215,610

185,000

190,000

195,000

200,000

205,000

210,000

215,000

220,000

2010 2017 2020 2030 2040 2050

Population Trends, 2010-2050

13

,52

8

11

,92

9

13

,61

0

14

,45

0

15

,02

0

15

,22

0

14

,43

8

13

,67

3

13

,74

0

14

,17

0

14

,82

0

14

,68

0

14

,19

9

14

,30

1

13

,88

0

13

,81

0

14

,56

0

14

,42

0

13

,18

5

12

,78

2

13

,95

0

13

,45

0

13

,98

0

14

,04

0

28%26% 26% 26% 27% 27%

0%

5%

10%

15%

20%

25%

30%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2010 2017 2020 2030 2040 2050

Youth Population Trends, 2010-2050

0-4 5-9 10-14 15-19 YOUTH, % POPULATION

“A large and growing body of evidence

shows that sociodemographic factors - age,

race, ethnicity,… and socioeconomic status

(SES), such as income and education, can

influence health outcomes.” America’s Essential Hospitals, 2020

Demographic Determinants of the Population

https://stock.adobe.com/images/wooden-house-with-a-man-inside-concept-of-high-demand-for-real-estate-property-increase-energy-efficiency-of-housing-rise-in-house-prices-population-growth/223498477


23

Figure 20: Clermont County Senior Population Projections, 2010-2050

Source: American Community Survey, 2013-2017 and the Ohio Development Services Agency

Figure 21: Clermont County Race


Figure 22: Clermont County Ethnicity


Figure 23: Clermont County Household type


Figure 24: Clermont County Marital Status (15 years and older)


8,0

08

10

,64

2

11

,99

0

13

,40

0

10

,90

0

10

,88

0

5,5

88

7,3

71

8,9

90

11

,77

0

10

,47

0

9,3

60

4,1

09

4,6

91

5,8

20

8,4

10

9,3

30

7,6

30

3,0

18

3,7

17

3,4

70

5,3

10

6,8

50

5,7

00

2,5

21

3,1

69

3,2

70

4,3

40

6,2

10

7,1

80

12%

15%16%

20% 20%19%

0%

5%

10%

15%

20%

25%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2010 2017 2020 2030 2040 2050

Senior Adult Population Trends, 2010-205065-69 70-74 75-79 80-84 85+ SENIORS, % POPULATION

White, 95.4%

African American, 1.4%

Amer Indian/Alaska Native, 0.2%

Asian, 1.2%

Native Hawaiian/Oth Pacific Islander, 0.0%

Some other race, 0.3%

Two or more races, 1.5%

Race

Not Hispanic,

98.2%

Hispanic or Latino,

1.8%

Hispanic or Latino Origin

Married with child(ren),

23.6%

Single with child(ren),

9.1%

Non-family Single

Adult with child(ren),

0.3%

Households with no child(ren), 67.0%

Household Type

Married, 54.0%

Separated/spouse absent,

3.2%

Divorced11.1%

Widowed, 5.5%

Never Married,

26.3%

Marital Status

Image: Adobe Stock


24

Figure 25: Clermont County Disability Characteristics


There are six core questions included in the U.S. Census survey intended to capture disability characteristics of the

population. In addition to difficulty hearing or deafness and visual difficulty or blindness, these questions also cover

cognitive (difficulty concentrating, remembering or making decisions), ambulatory (serious difficulty walking or climbing

stairs), self-care (difficulty dressing or bathing), and independent living (difficulty doing errands alone, such as visiting a

doctor’s office or shopping) disabilities (U.S. Census Bureau, 2017). Among residents of Clermont County, children

under 18 years are most likely to have a cognitive disability, whereas those aged 65 years and older report disability

characteristics related to hearing, ambulation and independent living. These findings mirror those of the nation, in which

older Americans are more likely to have a disability than younger Americans, and disabilities involving walking and

independent living are those most commonly experienced (Pew Research Center, 2017).

Neighborhood and the Built Environment The population is directly affected by the state of the environment. Housing conditions, Air quality, and water quality,

are examples of environmental factors that could negatively impact our quality of life.

0.6% 0.5%

4.0%

0.1% 0.6%2.7%

1.9%

5.4% 6.2%

2.7%

5.0%

14.6%

6.1%7.9%

20.2%

6.7%

13.3%

0%

5%

10%

15%

20%

25%

Hea

rin

g

Vis

ion

Co

gnit

ive

Am

bu

lato

ry

Self

-car

e

Hea

rin

g

Vis

ion

Co

gnit

ive

Am

bu

lato

ry

Self

-car

e

Ind

epen

den

t liv

ing

Hea

rin

g

Vis

ion

Co

gnit

ive

Am

bu

lato

ry

Self

-car

e

Ind

epen

den

t liv

ing

Under 18 18 to 64 years 65 years and over

Disability Characteristics by Age

Social Determinants of Health


25

Figure 26: Clermont County Resident Transportation for Work


When asked, only 2.9% of adults in Clermont County reported they considered their neighborhood to be unsafe (Figure

27). Conditions within neighborhoods, such as a lack of safety, can have a negative impact on overall health status and

health behaviors (Robert Wood Johnson Foundation, 2008).

The Clermont County Narcotics Unit is

a multijurisdictional unit with

employees from the Sheriff’s Office,

Miami Township, Union Township,

and Pierce Township Police

Departments and is overseen by the

Sheriff and managed by a lieutenant

from the Sheriff’s Office. The

Narcotics Unit targets mid to upper-

level narcotics traffickers in all areas

of Clermont County. In 2019,

Narcotics Agents made 241 criminal

arrests.

Figure 27: Clermont County Neighborhood Safety

Source: Clermont County Community Health

Assessment Survey, 2019

Figure 28: 2019 Narcotics Unit Drug Related Arrests

DRUG # OF

ARRESTS

Meth 56

Marijuana 20

Fentanyl 13

Hashish 12

Heroin 10

LSD 7

Cocaine 3

Mushrooms 2

Adderall 2

Clonazepam 2

Oxycontin 1

Xanax 1

Psilocybin 1

Crack 1

Total Drug Arrests 131 Source: Clermont County Sheriff’s Office

40.6%

56.5%

2.9%

Public Health Importance: The built

environment includes all of the

physical aspects of where we live

and influences on a person’s level of

physical activity. Access to healthy

foods, quality of housing,

environmental conditions, and crime

and violence comprise the HP2020

list for this determinant.

Healthy People 2020

Car, truck, or van92.0%

Public transportation

0.6%

Other7.4%

Means of Transportation to Work for Workers 16+

Car, truck, or van Public transportation Other

Extremely Safe

Safe

Unsafe


26

The Air Quality Index (AQI) is a tool used to report how clean or polluted the air is and how it may affect your health.

“Good” air quality is determined when the air is satisfactory and there is little to no risk associated with air pollution.

“Moderate” air quality is determined when the air is acceptable but may be of concern for groups who are typically

sensitive to air pollution. In 2018, Clermont County experienced 287 days when the air quality was considered “good”

according to the Air Quality Index (Figure 31). During the same year, 67 days were classified as having “moderate” air

quality (Figure 31).

Source: U.S. EPA AirData

Clermont County utilizes the land across the

county in various ways. It can provide economic

benefits, recreational outlets, or be maintained in

order to preserve wildlife habitats. Over 50% of

the county is covered by forests (Figure 32). The

forests that occupy our county create a dynamic

ecosystem that can be beneficial for both humans

and wildlife. Land cover and utilization influences

the county’s water quality, climate, generation of

waste and ultimately the population’s health

(Environmental Protection Agency, 2018). As the

population continues the increase, there will also

be an increase in urbanization.

Figure 30: Clermont County Land Use/Land Cover

Source: Ohio Development Services Agency, Office of Research, Ohio County Profiles, 2019

Developed, Lower

Intensity, 14.6%

Forest, 50.1%

Pasture, 14.6%

Cultivated Crops, 15.4%

Other, 5.4%

Land Use/Land Cover

Figure 29: Clermont County Air Quality Index

2014 2015 2016 2017 2018

Good 188 240 242 272 287

Moderate 165 114 119 91 67

-35

65

165

265

365

Air Quality Index, Healthy and Moderate Days, 2014-2018 Public Health Importance: Poor environmental

quality has its greatest impact on people whose

health status is already at risk. According to the

World Health Organization, almost a quarter of

all deaths are attributable to preventable

environmental factors.

Healthy People 2020


27

Housing quality is an important environmental factor when determining health status. The majority of one’s time is

spent at home when they are not at work or school. The U.S. Department of Housing and Urban Development (HUD)

uses the American Community Survey (ACS) data, also known as “CHAS” data, to explain the housing problems and

housing needs of communities. There are four problems that are examined among households: incomplete kitchen

facilities, incomplete plumbing facilities, more than one person per room, and cost-burdened families. Cost-burdened

families are those that pay more than 30% of their income for housing (HUD, 2019). The housing problems are

considered severe if there are incomplete kitchen and plumbing facilities, along with 1.5 persons per room and the cost

burden is greater than 50%. Between 2012 and 2016, 19.1% of Clermont County homeowners and 42.4% of Clermont

County renters experienced one or more housing problems, which is similar to the state of Ohio. Data for severe housing

problems was also similar between Clermont County and the state.

Image: Adobe Stock

Figure 31: Clermont County Housing Problems Overview

Source: U.S. Department of Housing and Urban Development (HUD) Office of Policy Development and American Community Survey (ACS) Comprehensive

Housing Affordability Strategy data for the 2012-2016 period

Figure 32: Clermont County Severe Housing Problems Overview

Source: U.S. Department of Housing and Urban Development (HUD) Office of Policy Development and American Community Survey (ACS) Comprehensive

Housing Affordability Strategy data for the 2012-2016 period

19

.1%

19

.9% 4

2.4

%

44

.5%

80

.3%

79

.5%

55

.7%

52

.9%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

ClermontCounty

Ohio ClermontCounty

Ohio

Owner Renter

Housing Problems Overview

Household has at least 1 of 4 Housing Problems

Household has none of 4 Housing Problems

8.0

%

8.4

% 21

.4%

25

.1%

91

.5%

91

.0%

76

.6%

72

.2%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

ClermontCounty

Ohio ClermontCounty

Ohio

Owner Renter

Severe Housing Problems Overview

Household has at least 1 of 4 Severe Housing Problems

Household has none of 4 Severe Housing Problems

https://stock.adobe.com/images/residential-neighborhood/123842055


28

The Clermont Coalition for Activity and Nutrition creates the Places and Spaces brochure that identifies 66 locations

throughout the county that offer opportunities for fitness and fun. These include three state parks (East Fork, Stonelick

Lake, and the Little Miami Scenic Bike Trail), the Cincinnati Nature Center, and several township and village parks (Figure

35). These locations offer multiple recreational activities, including nature preserves, playgrounds, fishing, canoeing,

beach access for swimming, walking, bicycling, basketball courts, hiking trails, and soccer and baseball fields.

Figure 33: Clermont County Recreational Opportunities

Source: Clermont County Places and Spaces, 2019

The Clermont County

Park District,

operates six parks,

three nature

preserves, and eight

greenspaces

encompassing nearly

800 acres throughout

the county. The

Williamsburg to Batavia Hike Bike Trail is a 13.5-mile route

connecting the villages of Williamsburg and Batavia. Six miles of the

proposed 13.5-mile trail are completed, beginning at the end of Old

Broadway Road in Williamsburg and ending at Zagar Road in

Batavia Township (Figure 36). The mixed-use trail shares roadways

with vehicles in some places and uses abandoned roadways in other

places, winding along the edge of William Harsha Lake and the

campground area of East Fork State Park, providing a scenic trek for

hikers, runners walkers and bicyclists (Clermont County Park

District, 2019).

Figure 34: Williamsburg-Batavia Bike Trail

Image: Clermont County Park District, 2019

Image: Clermont County Public Health


29

According to County Health Rankings & Roadmaps, the percentage of the population with adequate access to locations

for physical activity in Clermont County, Ohio is 83%. Overall, Ohio has 84% of the population with access to exercise

opportunities. (Figure 37).

Figure 35: Access to Exercise Opportunities

Source: County Health Rankings & Roadmaps, 2019

Public Health Importance: There is strong evidence that improving access to places for physical activity increases

physical activity and improves physical fitness in urban, rural, and suburban areas. Access itself is also strongly

associated with high levels of physical activity. Among adolescents, access is associated with increased time spent in

vigorous physical activity (Nicosia 2018), and lower obesity rates. County Health Rankings & Roadmaps, 2019


30

The public waters of Clermont County are used for both recreation and as a source of drinking water. Water

contamination has the potential to cause a number of adverse health effects and to limit the recreational use of public

water. The Ohio Environmental Protection Agency (OEPA) regulates and monitors public drinking water. Routine

sampling is performed to check for contamination in both raw and treated drinking water. Drinking water advisories are

communicated to the public by the water provider and the Ohio EPA. The advisories can be found on Ohio EPA’s drinking

water advisory webpage.

Clermont County Public Health performs a bacteriological sampling of recreational waters at five locations. If the

bacteria levels are considered too high, an advisory will be issued on the Ohio Department of Health’s Beachguard

website. During an advisory, people are asked to stay out of the water and to be aware of the health effects if they do

swim. In 2018, CCPH issued twelve contamination advisories for recreational waters. In 2019, eight advisories were

issued.

Another source of water contamination is algal blooms. Algal blooms commonly occur in all bodies of water. Although

most blooms are comprised of green algae and not harmful to humans, certain cyanobacteria, known as blue-green

algae, can cause harmful algal blooms (HABs), which can produce liver, skin, and neurotoxins (cyanotoxins). These toxins

can result in health problems (including rashes, difficulty breathing, gastrointestinal problems, neurological symptoms,

and even death) for humans and animals that ingest, inhale or have skin contact with them. Factors that contribute to

harmful algal blooms include sunlight, low-water or low-flow conditions, calm water, warmer temperatures, and excess

phosphorus or nitrogen (Ohio Department of Health). CCPH partners with Ohio Department of Natural Resources

(ODNR), OEPA, Ohio Department of Health (ODH) and the Ohio River Valley Water Sanitation Commission (ORSANCO) to

monitor waters in Clermont County for algal blooms. When an algal bloom is detected, a Recreational Public Health

Advisory is issued. When high levels of cyanotoxins are detected, an Elevated Public Health Advisory is issued. If the HAB

is located in a drinking water source, a drinking water advisory may be issued by OEPA. (Ohio Department of Health,

Harmful Algal Blooms in Ohio, 2019).

Harmful algal blooms (HABS) can

appear as scum or mats on the

surface of the water. The blooms

can vary in color from bluish green,

bright green, and red.

Ohio Department of Health

Image: Clermont County Public Health


31

Health and Health Care The number of residents within Clermont County with health insurance coverage exceeds 90% across all age groups,

meeting or exceeding rates across the state and nation. Individuals 65 years and older have the highest rates of

coverage, followed by children under 19 years of age (Figure 38).

Figure 36: Health Insurance Coverage by Age


Figure 37: Comparison of Those with Health Insurance Coverage


96.8%90.8% 91.7%

99.6%

95.4%87.2% 90.1%

99.5%

94.3% 81.9% 85.8% 99.1%

100% 100%

0%

20%

40%

60%

80%

100%

With health insurance coverage With health insurance coverage With health insurance coverage With health insurance coverage

Under 19 years 19 to 25 years 26 to 64 years 65+ and over

Health Insurance Coverage by Age

Clermont County Ohio United States HP2020

Public Health Importance: Uninsured people receive less medical care and less timely care, they have worse

health outcomes, and lack of insurance is a financial burden for them and their families (urban.org). Urban Institute

96

.8%

3.2

%

90

.8%

9.2

%

91

.7%

8.3

%

99

.6%

0.4

%

100%

0%

20%

40%

60%

80%

100%

With healthinsurancecoverage

No healthinsurancecoverage








Health Insurance Coverage by AgeClermont County HP2020


32

In Clermont County, 17.7% of adults serve as a caregiver to a friend or family member. The majority of respondents

report caring for their mother (23.7%), followed by caring for their child (16.7%). Over 40% (40.6%) of caregivers have

been providing care or assistance for more than five years. The highest reported reasons for caring for a friend or family

member were “other” (undefined) or “developmental disabilities”, which include autism, spina bifida and Down

syndrome. When asked about support services (i.e., support groups, individual counseling to cope with caregiving, and

access to services) needed most that are not currently being received, 16.2% of caregivers reported needing help getting

access to services; however, 79.3% denied needing any of these services (Clermont County Community Health

Assessment Survey, 2019).

Figure 38: Clermont County Caregivers


Figure 39: Clermont County Caregiver Duration


13.90%

1.30%

18.30%25.80%

40.60%

0%10%20%30%40%50%

Less than 30days

1 month toless than 6

months

6 months toless than 2

years

2 years toless than 5

years

More than 5years

Per

cen

t

Time

Length of time providing care

17.7%

82.3%

Caregiver Status

Yes No

Public Health Importance: Caregiving can affect the caregiver’s

life in a myriad of ways including his/her ability to work,

engage in social interactions and relationships, and maintain

good physical and mental health. Centers for Disease Control and Prevention

Image: Adobe Stock

Image: Adobe Stock


33

Social and Community Context

Education

Figure 40: Educational Attainment for the Population 25 Years of Age or Older


10.1% 10.2% 12.7%

32.5% 33.6% 27.3%

19.4% 20.5%20.8%

9.6% 8.5%8.3%

18.6% 17.0%19.1%

9.7% 10.2% 11.8%Graduate/prof degree

Bachelor's degree

Associate's degree

Some college, no degree

High school graduate, GED, or alternative

No diploma, GED, or alternative

Clermont County Ohio United States

Public Health Importance: “Social isolation predicts morbidity and mortality from cancer, cardiovascular disease,

and a host of other causes.” Civic participation, incarceration, and social cohesion are the main elements for this

determinant. US Department of Health and Human Services, Administration for Children and Families, 2010

Public Health Importance:

Level of education is one of

the greatest predictors of

individual health. Early

childhood education

provides a foundation for

children’s academic

success, health, and

general well-being. Higher

educational attainment

allows for better paying

jobs with resources like

health benefits, paid leave,

retirement accounts, easier

access to healthy foods and

services, and more time for

exercise.

Clermont County's 2015 incarceration rate was 121.3 per

100,000 residents for ages 15-64. (Vera

Institute)

There were 1,247 domestic violence

incidents in 2018 in Clermont County.

None of the incidents resulted in fatal

injuries. (Ohio Attorney General Domestic Violence

Report)

There were a total of 1,348 reports of child

abuse and neglect involving children under 18 in 2016.

(Public Children Services Association of Ohio, 2018)

Many children in custody (70%) are in temporary custody. The greatest reason

for displacement was dependency (50%).

The majority of children were 12-17

years old (40%), followed by 0-5 (35%).

(Public Children Services Association of Ohio, 2018)


34

Economic Stability

Figure 41: Annual Unemployment, 2014-2018

Source: Ohio Dept. of Job & Family Services, Local Area Unemployment Statistics (LAUS) Program

Figure 42: Per Capita and Median Household Income


2014 2015 2016 2017 2018

Clermont County 5.5 4.5 4.2 4.4 4.1

Ohio 5.8 4.9 5.0 5.0 4.6

United States 6.2 5.3 5.0 4.4 3.9

3.0

4.0

5.0

6.0

7.0

Un

emp

loym

ent

Rat

e

$31,812

$64,183

$29,011

$52,407

$31,177

$57,652

Per Capita Income Median Income


Public Health Importance: A person’s health is

linked to their economic and educational status.

Economic stability is influenced by employment,

food insecurity, housing instability, and poverty.

Table 1: Percentage of Clermont County Students Eligible for Free and Reduced Price Meals, 2018-2019

School District Percent of Students Eligible for Free and Reduced Price Meals

Felicity-Franklin 54.7%

Batavia 51.9%

Goshen 50.0%

Williamsburg 41.5%

Bethel-Tate 39.3%

New Richmond 36.2%

Clermont Northeastern 33.9%

West Clermont 26.5%

Milford 19.0%

Loveland 13.2% Source: Ohio Department of Education, 2019


35

Figure 43: Persons below the Poverty Level by Age


Figure 44: Family Poverty


Public assistance is defined as the government benefits

provided to the needy. This assistance includes aid in the

form of money or food. Programs are available at the local,

state, and federal levels to provide a safety net for

disadvantaged individuals who lack the resources to provide

basic necessities for themselves and their families.

Figure 45: Clermont County Residents Qualifying for Most Public Assistance Programs


Figure 46: Clermont County Households Qualifying for Most Public Assistance Programs


9.8

%

12

.8%

9.4

%

6.8

%

14

.9%

21

.3%

14

.3%

8.0

%14

.6% 2

0.3

%

13

.7%

9.3

%

Below povertylevel

Below povertylevel

Below povertylevel

Below povertylevel

All people <18 Years 18 to 64 65+ Years

Percentage of the Population below the Poverty Level


11

.1%

3.6

%

18

.2%

4.7

%

16

.7%

5.2

%

-1.0%

1.0%

3.0%

5.0%

7.0%

9.0%

11.0%

13.0%

15.0%

17.0%

19.0%

Families with Children Families with No Children

Percentage of Familes below the Poverty


9.8%15.4%

11.6%9.4%

6.8%

3.6%

3.3%

4.4%3.4%

3.8%

8.6%

11.1%

9.6%

7.7% 10.2%

0%

5%

10%

15%

20%

25%

30%

Allindividuals

Under 6 6 to 17 18 to 64 65 orolder

Percentage of Individuals Qualifying for Most Public Assistance Programs

by Income to Poverty Level & Age

Below the poverty level 100%-124% 125%-184%

10.6% 8.0% 4.3%

38.0%

14.3%

6.3%6.1%

4.4%

13.4%

7.0%

0%

10%

20%

30%

40%

50%

60%

Allhouseholds

Married,with

children

Married,no

children

Single,with

children

Single,no

children

Percentage of Households Qualifying for Most Public

Assistance Programs by Type

Below 130%of the poverty level 130%-184%

Image: Adobe Stock

Image: Adobe Stock


36

Figure 47: Homeless Point in Time Count

Source: Ohio Balance of State

Continuum of Care, 2019

Source: Ohio Balance of State

CoC, 2019

According to the Ohio Balance of State Continuum of Care (CoC) 2019 Point in Time Count, Clermont County homeless client count was 44 individuals. The Point in Time Count indicates that 15.9% were reported with mental illness and 4.5% were diagnosed with Substance Use Disorder. There were 27 homeless households counted with an average max-age of 40 and an average household size of 1.7. In 2018, of those exiting the homeless shelter in Clermont County, 81% exited into permanent housing.

*Data not available for counties in white

0 298


37

Chapter 2: Population Health


38

Chapter 3: Population Health

Population health is defined as the health outcomes of a group of individuals, including the distribution of such

outcomes within the group. This section of the report will present health outcomes for groups of individuals in Clermont

County including the distribution within groups.

Maternal, infant, and child health can be affected by environmental and social factors. It is important to address

disparities among this population to reduce the risk of adverse health outcomes. The Office of Disease Prevention and

Health Promotion explains that education, family income, and breastfeeding are factors that can significantly influence

the health of infants and children. Healthy People 2020 aims to increase the proportion of mothers who receive prenatal

care in the beginning of the first trimester from 70.8% to 77.9% nationally. In 2018, 69.3% of Clermont County mothers

who gave birth received care in the first trimester compared to 67.9% of mothers for the state of Ohio. Healthy People

has also set a target to increase the proportion of infants who are breastfed to 81.9% by the year 2020. Clermont

County’s proportion of infants who were breastfeeding at the time of discharge increased from 68.6% in 2017 to 72.6%

in 2018.

Figure 48: First Trimester Care


Figure 49: Low Birth Weight

Source: Ohio Public Health Information Warehouse, 2014-2018

Figure 50: Pregnancy and Tobacco Use

Source: Ohio Women, Infants, and Children Program, 2018-2019

70.6%72.4%

70.1%72.6%

69.3%

63.0%64.8%

66.1% 66.5%67.9%

60.0%

65.0%

70.0%

75.0%

80.0%

2014 2015 2016 2017 2018

Births to Mothers Who Received First Trimester Care, 2014-2018

HP2020 Target 77.9%


7.5%6.3%

7.5% 7.2% 7.5%

8.5% 8.5% 8.7% 8.7% 8.5%

0.0%

5.0%

10.0%

2014 2015 2016 2017 2018

Low Birth Weight, 2014-2018HP2020 Target 7.8%

Clermont County Ohio HP202041.1%

27.9% 35.4%26.1%29.1%

16.7% 21.8% 15.1%

0.0%

20.0%

40.0%

60.0%

Clermont Ohio Clermont Ohio

2018 2019

Pregnancy and Tobacco Use

Smoking rate (3 months before pregnancy)

Smoking rate (last 3 months of pregnancy)

Public Health Importance: Maternal and

infant health includes infant and

maternal mortality, birth outcomes and

related risk factors impacting

preconception, pregnancy and infancy.


Maternal, Infant, and Child Health Issues


39

Figure 51: Breastfeeding at Hospital Discharge, 2014-2018


Image: Adobe Stock

Health and Well-being Figure 52 highlights notable findings from the 2019 Clermont County Youth Health Assessment Survey about health

behaviors and status among students in 9th through 12 grade.

Sleep: The American Academy of Pediatrics endorses the recommendation

of the American Academy of Sleep Medicine that teens 13-18 years old

should sleep 8-10 hours per 24 hours regularly to promote optimal health,

adequate sleep benefits (improved attention, behavior, learning, memory,

emotional regulation, quality of life, and mental and physical health).

Clermont County youth report that 81.4% receive less than eight hours of

sleep each night.

Image: Adobe Stock

Physical Activity: To promote child and adolescent health and fitness, the

U.S. Department of Health and Human Services recommends that they

participate in at least one hour of physical activity every day. Some of the

benefits of daily physical activity include lower body fat, improved brain

function, and reduced symptoms of depression. The 2019 Clermont County

Youth Survey asked respondents how many days they were physically

active for at least 60 minutes in the past seven days and 76.8% of youth

reported six or fewer days of physical activity. Additionally, of all the

students surveyed, 34.1% were classified as having an overweight or obese

weight status based on their body mass index (BMI)-for-age calculation.

72.0%

67.3% 68.4% 68.6%72.6%71.1%

71.5% 72.8% 73.0% 74.2%

40.0%

60.0%

80.0%

2014 2015 2016 2017 2018

Breastfeeding at Discharge, 2014-2018HP2020 Target 81.9%


Youth

Image: Adobe Stock

https://stock.adobe.com/images/serious-calm-careful-young-black-mom-sitting-on-sofa-bed-and-breastfeeding-baby-while-holding-son-in-arms/269996841


40

Nutrition: According to the 2015-2020 Dietary Guidelines for Americans (March

2016), a healthy diet begins with the development of healthy eating patterns

throughout the life span, which includes: focusing on the consumption of

nutrient-dense foods (such as a variety of fresh fruits and vegetables, whole

grains, fat-free or low-fat dairy products, lean proteins, and healthy fats) while

limiting added sugars, saturated fats, and excess calories. In Clermont County,

more than 48% of teens report consuming fruit/fruit juice less than one time per

day, more than 43% consume vegetables less than one time per day, and more

than 65% drink milk less than once per day.

Screen Time: The Kaiser Family Foundation states that children 8-18 years of

age spend an average of 7.5 hours per day in front of a screen for

entertainment, with 4.5 of those hours being spent watching television

(CDC.gov, 2018). When asked about screen time, 50.4% of Clermont County

9th – 12th graders reported using video games or computers for over three

hours per day, and 22% reported watching three or more hours of television

per day. Time spent in front of screens is primarily sedentary and can reduce

the time available for physical activity, social interaction, and adequate sleep,

among other things. To help families determine appropriate screen time

amounts for children, the American Academy of Pediatrics has developed a Family Media Plan and Media Calculator

which factors in the time needed for activities such as sleep, school, meal and family time, chores, homework and more,

thus quantifying time remaining for screen-related activities (American Academy of Pediatrics, 2020).

Figure 52: Youth Dietary and Physical Activity Related Behaviors


81.4%

34.1%

76.8%

50.4%

22.0%

65.3%

48.3%

43.2%

22.3%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

< 8 hours of sleep on average school night

Overweight or Obese

< 60 minutes/day or physicalactivity in the past 7 days

Played video/comp games or used a comp for other than schoolwork 3+ hours/day on an avg school day

Watched 3 or more hours per day of TV on an average school day

Drank milk <1 time/day

Fruit/fruitjuice <1 time/day

Vegetables <1 time/day

Drink a soda or pop 1+ times/day

Clermont County Youth (9th-12th Grade) Helath and Well-being Related Behaviors, 2019

Data may not be generalizable to the entire county, region, or state,and are representative only of the students that participated

Image: Adobe Stock

Image: Adobe Stock


41

Figure 53: Comparison of Physical Activity Related Behaviors

County Source: Clermont County Community Health Assessment Survey, 2019 State Source: OHYES! Ohio Healthy Youth Environments Survey Data, 2019

Figure 54: School Immunization Completion


Behavioral Health Adolescence is a time of great physical, social and emotional change, which for some can lead to mental health

challenges, including increased risk of suicide. The Clermont County Youth Health Assessment Survey (2019) found that

among students in 9th-12th grade, 35.7% had experienced feeling sad of hopeless for two weeks or more in a row, and

17.3% had seriously considered suicide in the past year (Figure 55). These figures are similar to the nation, wherein

31.5% of high school students reported feelings of hopelessness for two weeks or more, and 17.2% had seriously

contemplated suicide (CDC Youth Risk Behavior Survey Data Summary and Trends Report, 2007-2017).

The 2017-2018 Clermont County Pride Survey identified several factors that can mitigate or eliminate the risks

associated with youth health and well-being. Students who make good grades (78%) had the highest protective effect

and their likelihood of participating in risky behaviors or activities. Students who reported conversations with their

parents about drugs (42.6%) or participation in school activities (31.6%) also indicated a protective effect.

81.4%

31.7%

50.4%64.6%

46.0%40.0%

0%

20%

40%

60%

80%

100%

< 8 hours of sleep on average school night Not physically active for a minimum 60minutes/day on 5+ days of past 7

Played video/comp games or used a comp.for other than school work 3+ hours/day on

an avg. school day

Comparison of the Top 3 Youth (Ages 12-17) Health and Well-being Related Behaviors


Data may not be generalizable to the entire county, region, or state,and are representative only of the students that participated

94.56%96.46%

90.42%89.53%88.11%

82.15%

70.00%

75.00%

80.00%

85.00%

90.00%

95.00%

100.00%

Kindergarten 7th Grade 12th Grade

Percentage of Students with All Required Immunizations, 2017-2018



42

Figure 55: Behavioral Health

Source: Clermont County Community Health Assessment Survey, 2019 and *Clermont County Pride Survey 7th-12th grade, 2017-2018

Figure 56: Protective Factors

Source: Clermont County Pride Survey 7th-12th grade, 2017-2018

6.9%

17.3%

35.7%

77.3%

0% 20% 40% 60% 80% 100%

Attempted suicide one or more time in the past year

Seriously considerd suicide in the past year

In the past year felt sad or hopeless almost every day for two weeks ormore in a row

Experience Stress Daily*

Clermont Youth (9th-12th grade) Behavioral Health, 2019

Data may not be generalizable to the entire county, region, or state, and are representative only of the students that participated.

24.0%

30.4%

30.9%

31.6%

42.6%

78.0%

0% 20% 40% 60% 80% 100%

Take Part in Community Activities

Teachers Talk About the Dangers of Drugs

Attend Church or Synagogue

Take Part in School Activities

Parents Talk About the Dangers of Drugs

Make Good Grades

Clermont County Youth (7th-12th grade) Protective Factors, 2018


Public Health Importance: The presence or absence and various combinations of protective and risk factors

contribute to the mental health of youth. Identifying protective and risk factors in youth may guide the

prevention and intervention strategies to pursue with them. Youth.gov


43

Figure 57: Risk Factors

Source: Clermont County Pride Survey 7th-12th grade 2017-2018 and * Clermont County Community Health Assessment Survey, 2019

Figure 58 a, b and c: Cross Tabulations of Protective Factors and Illicit Drug Use


2.5%

1.9%

18.2%

16.4%

18.1%

18.3%

1.2%

17.9%

0.5%

13.6%

5.8%

27.8%

1.2%

16.7%

37.8%

11.3%

0% 10% 20% 30% 40%

Carrying a Gun to School

Involvement in Gangs

Threatening/ Harmful Behaviors

Trouble with Police

Afraid Another Student will Hurt Them at School

Get in Trouble at School

Threaten a Student with a Gun, Knife, or Club

Threaten to Hurt A Student By Hitting, Slapping or Kicking

Hurt a Student with a Gun, Knife, or Club

Hurt a Student by Hitting, Slapping or Kicking

Been Threatened With a Gun, Knife or Club

Had a Student Threaten to Hit, Slap or Kick

Been Hurt By a Student with a Gun, Knife or Club

Been Hurt By a Student By Hitting, Slapping or Kicking

Participated in gambling

Sometimes, Rarely, or Never wear a seat belt*

Clermont County Youth Risk Factors


Image: Adobe Stock

56.4%

37.8%

28.9%

18.7%

11.6%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

Never Seldom Sometimes Often A Lot

Makes Good Grades

Percent of Annual Use of Any Illicit Drug


44



Figure 59: Distracted Driving from Clermont County Youth


27.1%

22.5%

17.5%

13.2%10.4%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%


Teachers Talk About Dangers of Drugs


22.7%

17.2%16.0%

13.1% 12.5%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%


Takes Part in Community Activities


Assessment of protective factors in conjunction with

illicit drug use among Clermont County youth

demonstrated that factors such as making good

grades, talking with teachers about the dangers of

drugs, and youth participation in community

activities all have a protective effect, reducing the

likelihood of illicit drug use (Figure 60).

Image: Adobe Stock

60.3%19.0%

9.0%11.7%

Number of Days Youth Reported Texting or Emailing While Driving, in the past 30 days

0 1-5 days 6-19 days 20+ days


45

Figure 60: Seat Belt Use from Clermont County Youth


Tobacco, Alcohol, and Illicit Drugs During the 2017-2018 school year, the following substance-use related behaviors were reported by Clermont County 7th-

12th grade students: using an illicit drug within the past year (18.3%); using an electronic vapor product in the past 30

days (16.4%); rode in car with a driver who was drunk (13.1%), and consumed at least one drink of alcohol on one or

more days in the past 30 days (13.1%).

Figure 61: Substance Use-Related Behaviors


61.3% 60.3%65.8%

74.1% 72.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

14 years old or younger 15 years old 16 years old 17 years old 18 years old

Per

cen

t o

f R

esp

on

den

ts

Percent of Clermont County Youth Reporting Always Wearing a Seat Belt

1.8%

3.3%

3.4%

3.7%

4.1%

4.9%

5.3%

8.0%

12.2%

12.5%

13.1%

13.1%

16.4%

18.3%

0% 5% 10% 15% 20%

Within the past year driven a car while drunk

Within the past year used pain medication not prescribed to them

Within the past year driven a car while high

Tried marijuana for the first time before age 13

Used chewing tobacco, snuff, or dip, on one or more of the past…

Smoked cigars, cigarillos, or little cigars in the past year

Smoked cigarettes on one or more of the past 30 days

Used marijuana or hashish during the past 30 days

First drank more than few sips alcohol before age 13

Within the past year rode a car with a driver that was high

Consumed at least one drink of alcohol on one or more of the past…

Within the past year rode in a car with a driver who was drunk

Used an electronic vapor product one or more of the past 30 days

Within the past year used any illicit drug


Clermont County Youth (7th-12th grade) Substance Use-Related Behaviors, 2019


46

Tobacco

The 2017-2018 Clermont County Pride Survey identified 5.3% of Clermont County youth were current smokers.

However, 16.4% of Clermont County youth are current electronic cigarette users and 4.1% of youth are current tobacco

chewers (Figures 62, 63, and 64). Electronic cigarettes are perceived by students as being less harmful than cigarettes

(27.1% versus 66%, Figure 65).

Figure 62: Youth Smokeless (Chew) Tobacco

County Source: Clermont County Pride Survey 7th-12th grade, 2017-2018

State Source: ODH, 2017 US Source: CDC, 2018

Figure 63: Youth Cigarette Use



Figure 64: Youth E. Cigarette Use



Figure 65: Youth Perception of Harm Comparison between Cigarettes and E-Cigarettes


4.1% 4.6%5.9%HP2020 Target, 6.9%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

Clermont County Ohio US

Current Youth SmokelessTobacco Use

Data may not be generalizable to the entire county, and are representative only of the students that participated.

5.3%8.4% 8.1%

HP2020 Target, 16.0%

0.0%

5.0%

10.0%

15.0%

20.0%


Current Youth Cigarette Use


16.4%

10.5%

20.8%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%


Current Youth E-Cigarette Use


Youth who use multiple tobacco products are

at higher risk for developing nicotine

dependence and are more likely to continue

using tobacco into adulthood. Youth use of

tobacco products in any form is unsafe.


6.3% 5.3%

22.4%

66.0%

22.3%32.7%

17.9%27.1%

0.0%

20.0%

40.0%

60.0%

80.0%

No Harm Some Harm Harmful Very Harmful

Perception of Harm

Cigarettes

ElectronicCigarettes


47

Alcohol

The 2017-2018 Clermont County Pride Survey results indicated that 13.1% of Clermont County youth had at least one

drink within the past 30 days. Of the youth who reported drinking alcohol, 13.8% reported having their first drink before

the age of 13 (Figures 66 and 67).

Figure 66: Youth Current Alcohol Use


State Source: OHYES! Ohio Healthy Youth Environments Survey Data 2019 US Source: CDC YRBS, 2017

Figure 67: Youth Alcohol Initiation


State Source: OHYES! Ohio Healthy Youth Environments Survey Data 2019 US Source: CDC YRBS, 2017

Illicit Drugs

Figure 68: Clermont County Youth Frequency of Illicit Drug Use by Grade


13.1%10.0%

29.8%

0%

10%

20%

30%

40%


Youth - Drank in the Past 30 Days

HP2020 Target


13.8%11.0%

15.5%

0%2%4%6%8%

10%12%14%16%


Youth - Alcohol (more than a few sips) initiation before age 13


5.7

%

2.6

%

2.0

%

2.3

%

1.4

%

2.3

% 2.9

%

6.8

%

3.7

%

1.4

% 2.2

%

1.9

%

1.8

%

5.1

%

6.3

%

5.9

%

1.9

% 2.7

%

2.5

%

1.5

%

3.6

%

7.6

%

5.1

%

3.9

%

3.0

%

2.7

%

3.7

%

7.2

%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

Once/year 6 times/ year Once/month Twice/ month Once/ Week 3 times/Week Every day

Frequency of Illicit Drug Use During the Past Year

9th grade 10th grade 11th grade 12th grade

Thirteen to fifteen-year-olds are at high risk to begin drinking. While drinking may be a singular problem behavior for

some, research suggests that for others it may be an expression of general adolescent turmoil that includes other

problem behaviors and these behaviors are linked to unconventionality, impulsiveness, and sensation seeking. National Institute on Alcohol Abused Alcoholism


48

Figure 69: Clermont County Youth Age at First Illicit Drug Use by Grade


Figure 70: Clermont County Youth Marijuana Use by Grade


Figure 71: Clermont County Youth Prescription Drug Use by Grade


2.9

%

3.6

%

8.5

%

1.6

%

2.2

%

3.4

%

11

.3%

7.3

%

2.0

%

3.1

%

6.7

%

15

.8%

2.4

%

2.5

%

7.9

%

20

.3%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

10 and under 11 or 12 13 or 14 15 or older

Age (years)

Age at First Illicit Drug Use


9.0%

11.8% 11.8%

20.4%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%


Marijuana Use in the Past 30 Days

3.30%3.0%

1.6%

4.4%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%


Use of Perscription Drugs Prescribed to Someone Else In

the Past 30 days


49

Infectious Diseases

Infectious diseases are caused by microorganisms (viruses, bacteria, parasites or fungi) that have the ability to cause illness. Many of these infectious diseases are required by law to be reported for the purpose of investigation, mitigation, prevention and surveillance.

Disease surveillance allows for monitoring of disease trends over time. Clermont County, like the state of Ohio, has

experienced a rising number of sexually transmitted infections in recent years, as evidenced in the case rates presented

in Figure 65. (Additional reportable disease information for Clermont County is located in the Appendix).

Figure 72: Clermont County Sexually Transmitted Disease (rate per 100,000), 2014- 2018


Table 2: STI Disease Rate Data Comparison 2014 2015 2016 2017 2018

Chlamydia Clermont County 237.9 285.2 281.7 287.9 291.9

Ohio 468.4 489.9 521.8 526.8 543.4

Gonorrhea Clermont County 32.3 36.6 61.1 55.8 70.5

Ohio 138.3 143.1 176.8 205.8 216.3

Syphilis Clermont County 4.0 4.0 0.5 5.4 5.4

Ohio 10.5 11.7 13.9 16.4 16.4

Source: Ohio Department of Health

23

7.9

46

8.4

32

.3

13

8.3

4.0

10

.5

28

5.2

48

9.9

36

.6

14

3.1

4.0

11

.7

28

1.7

52

1.8

61

.1

17

6.8

0.5

13

.9

28

7.9

52

6.8

55

.8

20

5.8

5.4

16

.4

29

1.9

54

3.4

70

.5

21

6.3

5.4

16

.4

-

100.0

200.0

300.0

400.0

500.0

600.0

Clermont County Ohio Clermont County Ohio Clermont County Ohio

Chlamydia Gonorrhea Syphilis

Sexually Transmitted Infections, 2014-2018

2014 2015 2016 2017 2018

Public Health Importance: “Infectious disease surveillance has long been a critical aspect of public health…..

Surveillance efforts contribute to rapid recognition of public health issues, control of outbreaks and prevention of

disease at local, state and national levels.” American Academy of Pediatrics, 2020

Conditions and Diseases


50

In June 2018, the Ohio Department of Health declared a statewide community outbreak of hepatitis A, a vaccine-

preventable disease of the liver that is spread when a person ingests a small amount of fecal matter from an infected

person. Hepatitis A can be spread through contaminated objects, food, water, or (as was the case with this outbreak)

from person-to-person. Risk factors during this outbreak included illicit drug use (injection and non-injection), recent or

current incarceration, unstable housing or homelessness, having liver disease (including hepatitis B or C), and men who

have sex with men (MSM). Clermont County had a total of 111 cases of hepatitis A associated with the statewide

outbreak, with 3,462 cases reported statewide (current as of January 13, 2020). Mitigation efforts included community

wide education on prevention measures, and provision of hepatitis A vaccine to those at high risk.

Figure 73: Hepatitis A Outbreak Cases, 2018-2020



51

Figure 74: HIV Surveillance


Image: Adobe Stock

Chronic Diseases Chronic diseases are conditions that last a year or longer, requiring ongoing medical attention and/or that interfere with

activities of daily living, and include a number of conditions such as heart disease, stroke, diabetes, cancer, chronic

obstructive pulmonary disease/chronic lower respiratory disease, asthma, and arthritis (CDC.gov, 2020).

Clermont County Rate:

78.4

Ohio Rate: 206.4

Rate of Individuals Living with

HIV Infection,

2018

Clermont County Rate:

5.8

Ohio Rate: 8.5

Rate of New Diagnoses of

HIV Infection,

2018

Figure 75: Clermont County Adult Chronic Disease


Figure 76: Comparison of the Top Three Chronic Conditions

Sources: Clermont County Community Health Assessment Survey, 2019 and CDC BRFSS Prevalence and Trends

1.7%

3.0%

4.2%

4.9%

6.4%

7.4%

8.6%

15.8%

16.5%

20.6%

30.0%

0% 10% 20% 30% 40%

Kidney disease

Heart attack

Stroke

Heart disease

Skin Cancer

COPD, emphysema, chronic bronchitis

Cancer (Exc. Skin Cancer)

Diabetes

Asthma

Depression

Arthritis

Chronic Disease

20.6%16.5% 15.8%

22.6%

13.7%11.3%

20.5%

14.2%10.5%

0%

10%

20%

30%

Depression Asthma Diabetes

Comparison of the Top 3 Chronic Conditions to Ohio & US



“Chronic diseases such as heart

disease, cancer, and diabetes

are the leading causes of death

and disability in the United

States. They are also leading

drivers of the nation’s $3.5

trillion in annual health care

costs.”



52

Health behaviors are those activities and practices that serve to contribute to, or

take away from, good health and the prevention of illness. Maintaining a healthy

weight and getting regular exercise are health behaviors that promote wellness;

whereas, practices such as tobacco use, excessive alcohol consumption, and

obesity can contribute to poorer health. The top three adult behavioral risk factors

for Clermont County residents are overweight and obese weight status, less than 8

hours of sleep in 24 hours, and less than 150 minutes of aerobic activity per week

(Figure 77). Image: Adobe Stock

Figure 77: Clermont County Adult Behavioral Risk Factors


5.7%

6.4%

7.4%

12.6%

19.6%

26.1%

29.2%

40.7%

47.5%

49.9%

65.3%

69.5%

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

Current tobacco chewer

Current E-cigarette smoker

Heavy drinking

Binge drinking

Current cigarette smoker

Veggies <1 time per day

No physical activities

Fruit <1 time per day

Drank in the past month

<150 min aerobic activity

<8 hours of sleep

Overweight or obese

Adult Risky Behavior, 2019

Health Behaviors


53

Figure 79: Adult Alcohol Use


State & US Source: CDC BRFSS Prevalence and Trends

12.6%

19.0%17.4%

HP2020 Target, 24.2%

0%

5%

10%

15%

20%

25%


Adult Binge Drinker, 2019

Figure 78: Comparison of Adult Health Risk Behaviors


State & US Source: CDC BRFSS Prevalence and Trends

69.5%

49.9%

66.8%

52.2%

66.6%

49.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Overweight or obese <150 min aerobic activity

Comparison of Obesity and Physical Activity



Behavioral risk factors

include any particular

behavior or behavior

pattern, which strongly yet

adversely affects health. It

increases the chances of

developing a disease,

disability, or syndrome.


Binge drinking is defined as

adult males having 5 or

more drinks on one

occasion and adult females

having 4 or more drinks on

one occasion. According to

CDC, “One in six US adults

binge drinks about four

times a month, consuming

about seven drinks per

binge.”



54

Of adults who participated in the 2019 Clermont County Community Health Assessment Survey who indicated they have

smoked at least 100 cigarettes in their life, 19.6% of the total number of Clermont County residents surveyed currently

smoke. This percentage is lower than Ohio (21.1%) and higher than the nation (14.1%).

Figure 80: Percentage of Adults that Currently Chew Tobacco

Sources: Clermont County Community Health Assessment Survey, 2019 and CDC

BRFSS Prevalence and Trends

Figure 81: Percentage of Adults that Currently Smoke Tobacco

Sources: Clermont County Community Health Assessment Survey, 2019 and

CDC BRFSS Prevalence and Trends

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also

helps determine how we handle stress, relate to others, and make choices.

5.7%5.1%

4.0%

HP2020 Target, 0.2%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%


Ohio, 2017 US, 2017

Adult Current Tobacco Chewer

19.6%21.1%

14.1%HP2020 Target, 12.0%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%


Ohio, 2017 US, 2017

Adult Current Smoker

Figure 82: Percentage of Adults that Currently use E. Cigarettes

Sources: Clermont County Community Health Assessment Survey, 2019 and

CDC BRFSS Prevalence and Trends

6.4%5.3%

4.6%

0.0%

2.0%

4.0%

6.0%

8.0%


Ohio, 2017 US, 2017

Current Adult E-cigarette User

Mental Health

Public Health Importance: Linked to physical health, mental health can affect work productivity, quality of life, social interaction, diseases, treatments, and outcomes. People who maintain positive mental health are more likely to succeed in life, and more likely to increase their chances of living longer, healthier lives.

U.S. Department of Health & Human Services

Image: Adobe Stock


55

Figure 83: Adult Mental Health


The number of unintentional drug overdose fatalities among Clermont County residents declined in 2018 for the third

year in a row. While the number of overdose deaths continues to decline, the state monitors a six year rolling age

adjusted rate which remains one of the highest in Ohio. The age-adjusted death rate from 2013-2018 was 44.8 deaths

per 100,000 population, ranking eighth in the state (Ohio Department of Health, 2018 Ohio Drug Overdose Data). The

decrease in the number of unintentional overdose deaths shows we are moving in a positive direction; however, there is

still work to be done in Clermont County.

There was a 10.5% decrease in overdose fatalities between 2017 and 2018. Unmarried, 18-54 year old individuals

remain the most at-risk population among Clermont County residents with 82% of 2018 cases being single, divorced, or

widowed and 81% falling between the ages of 25-54. Opioids (including prescription drugs, heroin, and fentanyl and

related drugs) were present in 89% of 2018 cases’ toxicology results. Fentanyl and related analogues were found in 78%

of cases’ toxicology results, making it the most common category of all substances present in cases' toxicology results.

Another notable point was the increase in the presence of naltrexone among cases (n=11).

Public Health Importance: Injuries result in more deaths than all other causes for people aged 1 to 44 years. Injuries are an enormous threat to our communities, a threat for which we have an array of effective prevention strategies.


Injury and Violence

44.8%

42.9%

24.6%

22.7%

22.9%

31.3%

0% 10% 20% 30% 40% 50%

One or more days during the past 30 days when mental health wasnot good

Felt stressed within the past 30 days

Had little interest or pleasure in doing things

Bothered by feeling down, depressed or hopeless

Bothered by not being able to stop or control worrying

Bothered by feeling nervous, anxious or on edge

Mental Health Survey Results


56

Figure 84: Accidental Drug Overdose, Adults 20 Years of Age or Older, 2014-2018


In Ohio, five people die by suicide every day. One youth dies by suicide every 33 hours in Ohio. The Clermont County age

adjusted suicide rate is 12.9 – 14.2 (Figure 85).

Figure 85: Age-Adjusted Suicide Rate by County of Residence, Ohio, 2014-2018

Source: Ohio Department of Health Vital Statistics

2014 2015 2016 2017 2018

Accidents 72 81.4 79 67.6 62.7

Accidental Drug OverdoseFatality

42.5 55.9 50.3 46.5 40

Fentanyl related OverdoseDeath

11.9 30.4 27.6 35.3 30.9

Prescription Opiate relatedOverdose Death

11.8 9.3 6.4 4.9 5

0

10

20

30

40

50

60

70

80

90

Age

-Ad

just

ed R

ate

per

10

0,0

00

Clermont County Accidental Deaths and Overdose Fatalities, 2014-2018**

*

*

*


57

Chapter 4: Resource Distribution and

Community Assets


58

Chapter 4: Resource Distribution and Community Assets

Access to quality medical professionals and facilities is crucial in maintaining and promoting good health, preventing and

managing various disease states, reducing avoidable and preventable sickness and death, and providing equality in

health care for all. Perceived and true barriers to accessing providers and care may include geographic location,

socioeconomic status, insurance coverage status, high cost of treatment, lack of service availability, sex, race, ethnicity,

disability status, sexual orientation, and lack of cultural competence in care. These barriers enable unmet health needs

to continue, further contributing to future health complications.

Figure 86: Clermont County Health Care Practitioners per 100,000 Population

Health Professional Shortage Areas 2

Family Medicine 27.1

General Practice 3.5

Internal Medicine 26.6

Ob-Gyn 5.9

Pediatrician 16.8

Primary Care Physician 67.5

Resident Primary Care 5.4

Nurse Practitioner 30.1

Source: HRSA.gov

Dental Health Professional Shortage Areas 2

Dental Practitioners/Dentist 36.0

Source: HRSA.gov

Mental Health Professional Shortage Areas 2

Mental Health Practitioners 0.9

Access to Health Care

Images: Adobe Stock


59

Health Care Utilization

Figure 87: Health Care Utilization, 2018


Health Insurance The increasing size and prevalence of high deductibles and copayments in private health plans, including employer-

based plans, are leading many people with low and moderate incomes to avoid or delay needed health care. According

to the American Community Survey, between 2013 and 2017 more than 90% of Clermont County residents ages 19 and

older have health insurance coverage. When compared to Ohio and the United States, Clermont County has a higher

percentage of coverage across all four age groups. Individuals 65 and older have the most individuals covered (99.6%),

followed by residents under 19 years old (96.8%).

Figure 88: Health Insurance Coverage by Age, 2017


18.6%

6.0%

6.6%

96.0%

5.1%

94.8%

0.0% 50.0% 100.0%

Has health care bills being paid off overtime

Did not take medication as prescribedbecause of cost

Could not see a doctor because of thecost

Satisfied with the health care received

Did not have coverage at some point inthe past 12 months

Has health care coverage

Health Care Access/Coverage

96.8%90.8% 91.7%

99.6%95.4%87.2% 90.1%

99.5%94.3%

81.9% 85.8%

99.1%

0%

20%

40%

60%

80%

100%

With health insurancecoverage





Health Insurance Coverage by Age

Clermont County Ohio United States HP2020

Public Health Importance: Health insurance is important for several reasons. Uninsured people

receive less medical care and less timely care, they have worse health outcomes, and lack of

insurance is a financial burden for them and their families. Urban Institute


People use health care for

many reasons including

preventing and curing health

problems, promoting

maintenance of health and

well-being, or obtaining

information about their

health status and prognosis. Encyclopedia of Behavioral Medicine


60

Figure 89: Health Insurance Coverage under Age of 19, 2017


Figure 90: Health Insurance Coverage 19 Years & Older, 2017


Employer-based or TRICARE health

insurance, 38,115,766


insurance, 66.4%Employer-based or

TRICARE health insurance, 53.9%


insurance, 48.9%

Direct-purchase, 4,321,204

Direct-purchase, 3.5%

Direct-purchase, 3.9%Direct-purchase, 5.5%

Medicare &/or Medicaid coverage, 26,691,507

Medicare &/or Medicaid coverage, 22.4%



Other coverage, 4,321,199

Other coverage, 4.5%Other coverage, 6.0% Other coverage, 5.5%

No coverage, 4,434,876 No coverage, 3.2% No coverage, 4.6% No coverage, 5.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

United States Clermont County, Ohio Ohio United States

Medical Insurance Coverage for the Population under the Age of 19

Employer-based or TRICARE health insurance

111,807,278

Employer-based or TRICARE health insurance

54.8%


insurance, 49.8%


insurance, 46.9%

Direct purchase, 16,250,017

Direct purchase, 4.9%

Direct-purchase, 5.0% Direct-purchase, 6.8%

Medicare &/or Medicaid coverage

41,127,788

Medicare &/or Medicaid coverage

17.3%Medicare &/or Medicaid

coverage, 19.1%Medicare &/or Medicaid

coverage, 17.3%

Other coverage, 40,215,736

Other coverage, 16.1%Other coverage, 17.8%

Other coverage, 16.9%

No coverage, 28,742,270No coverage, 6.9% No coverage, 8.3% No coverage, 12.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

United States Clermont County, Ohio Ohio United States

Medical Insurance Coverage for the Population 19 Years of Age or Older


61

Figure 91: Access to Health Care Professionals, 2018


6.6%

96.0%

93.2%

77.4%

73.6%

0.0% 50.0% 100.0%

Could not see a doctorbecause of the cost

Satisfied with the health carereceived

Saw health care professional1 or more times in the past…

Saw a doctor for a routinecheckup in the past 12…

Has personal doctor or healthcare provider

Access to Health Care ProfessionalsHealth professionals play a central and critical

role in improving quality health care for the

population. They provide essential services that

promote health, prevent diseases, and deliver

health care services to individuals, families and

communities. Health care facilities should

reflect the needs and values of the communities

in and around them. Effective hospitals are

designed for their users, with attention to the

needs of special populations, such as children

and the elderly.

Encyclopedia of Behavioral Medicine

Health Care Facilities and Professionals

Image: Adobe Stock

Image: Adobe Stock


62

Figure 92: Clermont County Health Care Providers, 2019



63

Figure 93: Clermont County Licensed Mental Health and Addiction Recovery Service Providers, 2019



64

Figure 94: Clermont County Urgent Cares and Hospital, 2019



65

Chapter 5: Description of Health Disparities

and High-risk Populations


66

Chapter 5: Description of Health Disparities and High-risk Populations Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations (CDC, 2008). Populations can be defined by factors such as race or ethnicity, gender, education or income, disability, geographic location (e.g., rural or urban), or sexual orientation. Health disparities are inequitable and are directly related to the historical and current unequal distribution of social, political, economic, and environmental resources. Several protective factors that have registered substantial average increases (e.g., physical activity among adults, high blood pressure control, and human papillomavirus vaccination among adolescent females) have stalled in recent years. Many protective factors, even those with impressive relative gains, still represent only a minority of the U.S. population (e.g., control of high cholesterol at 29.5%) (CDC, 2014).

Maternal, Infant, and Child Trends

Figure 95: Preterm Live Births (<37 weeks gestation), identifying health disparities, 5-year Average (2014-2018)


8.9%

12.6%

5.8%

8.1%

10.3%11.0%

8.7%

13.6% 13.1%

8.6%9.5%

14.1%

10.4%9.0%

12.1%10.8% 10.2%

14.5%

11.7%10.1%

0%

5%

10%

15%

20%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

White,Non-Hisp

Black,Non-Hisp

Hispanic MarriedUnmarried <20 20-39 40+ < H.S. H.S. +

Preterm Live Births (<37 weeks gestation), 5-year Average (2014-2018)


Factors that contribute to Poorer Health Outcomes

Factors that Contribute to Poorer Health

Outcomes: Babies born prematurely can suffer

from many lifelong medical conditions that

affect their heart, lungs, intestines, kidneys, and

eyes. As these babies mature, developmental

delays and learning disabilities often appear. March of Dimes

Image: Adobe Stock


67

Youth Trends

Figure 96: Clermont County Youth 9th-12th Grade Gender and Nutrition Crosstab for Past 7 Days


Figure 97: Clermont County Youth 9th-12th Grade Weight Status and Behavior Crosstab Results


16.0%

37.2%

55.0%

22.9% 23.1%

17.1% 15.5%12.8%

37.8%

53.3%

18.7%

32.1% 32.8%

19.1%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

Fruit Potatoes Carrots Other Vegetables Soda or Pop Milk BreakfastPer

cen

tage

of

Res

po

nd

ents

th

at D

id

No

t C

on

sum

e in

Pas

t 7

Day

s

Youth Gender and Nutrition Association

Male Female

Nutrition consumption by gender identified above have a Chi-square statistic that is significant at the .05 level

16.0%

13.7%

25.3%

53.4%

74.8%

81.0%

1.0%

23.7%

19.7%

48.7%

74.4%

81.6%

0% 20% 40% 60% 80% 100%

Overweight Perception

Not Trying to Do Anything About Weight

Watch TV >2 hours per Day

Playing Video Games >2 hours per Day

Physically Active for 60min/day < Everyday

<8 hours of Sleep per Night

Clermont Youth (9th-12th grade) Weight Crosstabulations, 2019

Not Obese Obese


Behaviors identified above have a Chi-square statistic that is significant at the .05 level


68

Figure 98: Distracted Driving by Grade


Figure 99: Clermont County Youth (9th-12th) Grade Mental Health and Age Comparison


1.9%8.0%

26.7%

39.8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

9th Grade 10th Grade 11th Grade 12th Grade

Per

cen

t o

f R

esp

on

den

ts Percent of Clermont County Youth Reporting Distracted Driving by Grade


33

.8%

17

.5%

14

.4%

7.8

%

29

.9%

36

.4%

17

.7%

13

.2%

7.2

%

30

%

37

.4%

17

.8%

13

.3%

7.5

%

31

.5%

36

.8%

17

.7%

12

.6%

6.1

%

25

.4%2

8.9

%

12

.3%

9.1

%

4.0

%

21

.4%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%


or more in a row that youstopped doing some usual

activities?




plan about how you wouldattempt suicide?

During the past 12months, how many timesdid you actually attempt

suicide?




a doctor or nurse?

Youth Mental Health Questions by Age Comparison

14 years old or younger 15 years old 16 years old 17 years old 18 years old or older


69

Figure 100: Clermont County Youth (9th-12th Grade) Mental Health and Gender Comparison


Figure 101: Clermont County Youth 9th-12th Grade, Mental Health and Nutrition Association


25.0%

12.1%10.1%

4.9%

32.5%

46.4%

22.3%

15.8%

8.8%

27%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%


or more in a row that youstopped doing some

usual activities?




plan about how youwould attempt suicide?

During the past 12months, did you actuallyattempt suicide one or

more times?




a doctor or nurse?

Youth Mental Health Questions by Gender Comparison

Male Female

The Chi-square statistic is significant at the .05 level for this data

41.5%

35.8%32.9%

40.0%

35.3% 34.2%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

none <2 Servings >2 Servings

Youth Feeling Sad or Hopeless for >2 Weeks Compared to Nutrition

Servings of Fruit per Day Servings of Vegetables per Day

Pattern signifies that the Chi-square statistic is significant at the .05 level


70

Conditions and Disease Trends

Figure 102: Top 3 Adult Cancers by Site for Clermont County Residents


Figure 103: Clermont County Leading Causes of Adult Death


17

9.7

2.2

95

.9

57

.5

49

.5

47

.8

20

8.8

10

4.0

11

8.0

10

9.7

83

.4

*

17

.9

32

6.5

N/A

11

6.4

86

.5 85

.0

* 13

.6

35

6.8

0

50

100

150

200

250

300

350

400

Female Male White,Non-Hisp

Minorities,Non-Hisp

Hispanic <55 55+Age

-Ad

just

ed R

ate

per

10

0,0

00

Top 3 Adult Cancers by Site, 5-year Rate (2012-2016)

Breast Lung and Bronchus Prostate

*Indicates rates have been suppressed for counts < 10 or where population counts are not available, rates based on counts < 20 are considered unreliable

14

8.0

19

8.7

17

1.8

10

2.5

1.9

18

.1

14

9.9

32

.7

13

5.9

12

8.4

20

8.0

16

5.6

11

3.7

2.9

16

.7

14

3.8

40

.7

12

1.3

47

.5

98

.2

75

.5

*

27

.4

28

.9

16

.3

16

.4 55

.6

0

50

100

150

200

250

Female Male White Minorities 20-34 35-54 55+ <H.S. H.S.+Age

-Ad

just

ed R

ate

per

10

0,0

00

Top 3 Leading Causes of Adult Death, 5-year Rate (2014-18)

Malignant neoplasms Diseases of heart Accidents

Factors that Contribute to Poorer Health Outcomes: Age-adjusted rates for most of the leading causes of death are

declining, but in some cases, the number of deaths is increasing ... heart disease, cancer, or accidents are the

leading causes of premature death. Gardner JW, et al. Epidemiology

Factors that Contribute to Poorer Health Outcomes: Daily habits like smoking, poor diet, and little physical activity

increase the risk for cancer. Education, housing, income and occupation are factors that can contribute to cancer.

For example, stomach and cervical cancers are higher in lower socioeconomic groups, as is lung cancer. American Cancer Society


71

Health Behavior Trends

Figure 104: Health Status Less Than Good


Figure 105: Sleep Less Than Eight Hours


Figure 106: Current Tobacco Use


17.9% 18.5% 16.0%21.9%

57.2%

14.0%

45.9%

11.6% 13.0%

23.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Male Female 18-54years

55+ years <H.S. H.S.+ <$15,000 $15,000+ Suburban Rural

Per

cen

t o

f R

esp

on

den

ts

Clermont County Adults Reporting that Their General Health Status is <Good (2019)


64.8% 65.9%70.7%

56.4%

46.7%

67.5%

43.4%

72.3%63.4%

67.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



Per

cen

t o

f R

esp

on

den

ts

Percent of Clermont County Adults Reporting <8 Hours Sleep in 24-hour Period (2019)


22.9%17.4%

21.2%18.2%

36.7%

18.1%

43.2%

16.0% 14.5%

25.3%

0%

10%

20%

30%

40%

50%


55+yearsof age

No HSDip

or GED

HSDip/GEDor higher


Clermont County Adult Current Smokers

Due to the manner this data was collected, statiscal significance could not be determined.


72

Figure 107: Adults Ever Smoked


Figure 108: Adults Alcohol Use


55.0%

40.4% 42.0%

56.6%

66.5%

45.4%

67.8%

44.7% 43.7%51.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



Per

cen

t o

f R

esp

on

den

ts

Percent of Clermont County Adults Reporting Smoking at least 100 cigarettes(2019)


46.0%

58.6%

48.0%

59.8%

96.8%

47.5%

83.5%

44.3% 42.0%

61.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



Per

cen

t o

f R

esp

on

den

ts

Percent of Clermont County Adults Reporting Drinking Alcohol (2019)



73

Mental Health Trends

Figure 109: Adult Reported Not Good Mental Health Days


Figure 110: Adult Reported Depressive Disorder


31.3%

52.8% 50.4%

28.7%

67.1%

39.3%

73.3%

43.0%36.3%

48.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



Per

cen

t o

f R

esp

on

den

ts

Percent of Clermont County Adults Reporting 1 or More Days of Not Good Mental Health in Past 30 Days (2019)


14.1%

27.7%22.7%

18.7%

39.9%

19.0%

56.5%

20.1%16.4%

25.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



Per

cen

t o

f R

esp

on

den

ts

Percent of Clermont County Adults Reporting having a Depressive Disorder (2019)



74

Injury and Violence Trends

Figure 111: Clermont County Unintentional Drug Overdose Deaths of Ohio Residents and Average Crude and Age-Adjusted Death Rates per 100,000 Population

Source: Ohio Department of Health

49.8

23.2

28.5

39.0

4.1

9.4

26.4

0

10

20

30

40

50

60

Male Female 20-34 35-54 55+ <H.S. H.S.+

Age

-Ad

just

ed R

ate

per

10

0,0

00

Adult Accidental Drug Overdose, 10-year Rate (2009-18)


75

Food Access Trends

Factors that Contribute to Poorer Health Outcomes: Neighborhoods without access to quality, healthy food

frequently rely on what is available at local convenience stores. Many of the foods provided in convenience

stores are high in calories and low in nutrition, contributing to future health complications such as obesity,

diabetes, heart disease, and hypertension.

Healthy People 2020


76

Access to Health Care Trends

Figure 112: Health Care Coverage, Identifying Health Disparities, 2019


Figure 113: Delayed Medical Care Because of the Cost, Identifying Health Disparities, 2019


Figure 114: Did Not Take Prescribed Medications Because of the Cost, Identifying Health Disparities, 2019


96.9% 92.9% 94.6% 95.2%89.1%

95.5% 93.3% 94.5% 95.5% 94.2%

0%

50%

100%

Male Female <55 55+ <HS HS+ <$15k $15k Suburban Rural

Has health care coverageHP2020 Target - 100%

4.4%

8.8%7.6%

5.0%

8.6%6.4%

18.8%

5.9% 5.9%7.3%

0%

5%

10%

15%

20%


Delayed medical care because of the costHP2020 Target - 4.2%

3.4%

8.6%

6.1% 5.9%

13.5%

5.3%

1.3%

5.0% 4.9%

7.1%

0%

2%

4%

6%

8%

10%

12%

14%


Did not take medication as prescribed because of cost

HP2020 Target - 2.8%


77

Figure 115: Health Care Bills Being Paid Off over Time, Identifying Health Disparities, 2019


Figure 116: Has a Personal Doctor or Health Care Provider, Identifying Health Disparities, 2019


Figure 117: Saw a Doctor for a Routine Checkup in the Past 12 Months, Identifying Health Disparities, 2019


Figure 118: Satisfied with the Health Received, Identifying Health Disparities, 2019


15.8%

21.3% 22.0%

13.8% 14.5%

19.0%

26.9%

18.0%19.4%

17.9%

0%

5%

10%

15%

20%

25%

30%


Paying Health Care Bills over Time

71.1%76.1%

70.0%79.5%

59.6%

75.1% 76.5% 73.5% 73.1% 74.1%

0%

20%

40%

60%

80%


Has personal doctor or health care provider

75.9% 78.8%70.4%

89.0%83.8%

76.7% 80.9%75.3% 75.5% 79.2%

0%

50%


Saw a doctor for a routine checkup in the past 12 monthsHP2020 Target - 83.9%

95.4% 96.5% 95.7% 96.3%88.5%

96.8% 95.2% 95.8% 97.9% 94.3%

0%

50%

100%


Satisfied with the health care received


78

Appendix

Demographics Comparison Clermont County

Ohio United States

Population. American Community Survey 5-Year Estimates, 2017 202,166 11,658,609 325,719,178

Median Household Income. American Community Survey 5-Year Estimates, 2017

$64,183 $54,021 $60,336

Poverty Rate. American Community Survey 5-Year Estimates, 2017 9.8% 14% 13.4%

Employment Rate. American Community Survey 5-Year Estimates, 2017 62.9% 59.6% 59.50%

Foreign Born. Percentage of foreign born residents. American Community Survey 5-Year Estimates, 2017

2.3% 4.5% 13.4%

Veterans. Percentage of veterans. American Community Survey 5-Year Estimates, 2017

8.8% 7.9% 7.7%

Grandparents as Caregivers. Number of grandparents living with own grandchildren (under 18 years old) American Community Survey 5-Year Estimates, 2017

4,423 216,559 7,269,685

Grandparents as Caregivers. Percent of grandparents responsible for grandchildren (under 18 years old) American Community Survey 5-Year Estimates, 2017

44.6% 44.0% 35.5%

English Language Spoken at Home. Percent of the population (5 years and over) that speak only English. American Community Survey 5-Year Estimates, 2017

97.0% 93.1% 78.7%

Other Language Spoken at Home. Percent of the population (5 years and over) that speak language other than English. American Community Survey 5-Year Estimates, 2017

3.0% 6.9% 21.3%

Gender. Percent Female based on 2018 population estimates 50.7% 51.0% 50.8%

Gender. Percent Male based on 2018 population estimates 49.3% 49.0% 49.2%

Household Size. Average estimated household size. American Community Survey 5-Year Estimates, 2017

2.63 2.44 2.63

Family Size. Average estimated family size. American Community Survey 5-Year Estimates, 2017

3.11 3.04 3.24

Driving alone to work. Percentage of the workforce that drives alone to work. County Health Rankings, 2013-2017

86% 83% *

Long commute- driving alone. Among workers who commute in their car alone, the percentage that commute more than 30 minutes. County Health Rankings, 2013-2017

48% 30% *

*No data available


79

Maternal, Infant, and Child Health Issues Clermont

County Ohio

United States

Infant Mortality Rate. The ratio of infant deaths (babies who died during the first year of life) per 100,000 live births in a given year. ODH 2017

5.6* 7.2 579.3

Infant Mortality Rate. The ratio of infant deaths (babies who died during the first year of life) per 100,000 live births in a given year. Ohio 5-Year Average Infant Mortality Rate, by County (2013-2017)

6.2 7.2 *

Birth Rate. Births per 1,000 population 11.3 11.6 11.6

Teen Births. Number of teen females (ages 15 - 19yrs old) that gave birth, ODH 2018

107 7,045 *

Teen Birth Rate. Rate of teen females (ages 15 - 19yrs old) that gave birth per 1,000 teen females, ODH 2018

17.5 18.9 *

Smoking During Pregnancy. Percentage of mother's who smoked during the third trimester of pregnancy, ODH 2018

13.7 48.1 *

Oral Health. Percentage of third grade students that had untreated cavities reported from "Make Your Smile Count! Oral Health Screening Survey" (2013-2015)

14.1% 17.0% *

Oral Health. Percentage of third grade students that had history of tooth decay reported from "Make Your Smile Count! Oral Health Screening Survey" (2013-2015)

43.5% 51.0% *

Oral Health. Percentage of third grade students that had one or more sealants reported from "Make Your Smile Count! Oral Health Screening Survey" (2013-2015)

49.7% 49.0% *

Kindergarten Immunizations. Pupils with all required immunizations, ODH 2018

95.5% 89.1% *

7th Grade Immunizations. Pupils with all required immunizations, ODH 2018

93.6% 87.4% *

12th Grade Immunizations. Pupils with all required immunizations, ODH 2018

88.7% 84.0% *

*No data available


80

Maternal, Infant, and Child Health Issues 2014 2015 2016 2017 2018

Teen Births. Number of teen females (ages 15 - 19yrs old) that gave birth, 2018

141 156 125 129 107

Teen Birth Rate. Rate of teen females (ages 15 - 19yrs old) that gave birth per 1,000 teen females, 2018

22.7 25.3 20.5 21.0 17.5

Clermont County Conditions and Diseases 2014 2015 2016 2017 2018

Hepatitis B. Total case counts of Hepatitis B in Clermont County residents as reported by Ohio Department of Health (excluding cases diagnosed in state correctional facilities)

* 49 44 48 63

Hepatitis B. Rate of Hepatitis B cases per 100,000 in Clermont County residents as reported by Ohio Department of Health (excluding cases diagnosed in state correctional facilities)

* 24.3 21.7 23.5 30.8

Hepatitis C. Total case counts of Hepatitis C in Clermont County residents as reported by Ohio Department of Health (excluding cases diagnosed in state correctional facilities)

286 391 496 429 435

Hepatitis C. Rate of Hepatitis C cases per 100,000 in Clermont County residents as reported by Ohio Department of Health (excluding cases diagnosed in state correctional facilities)

194.2 193.7 244.3 210.1 213

*No data available

Conditions and Diseases Clermont County

Ohio United States

Hepatitis B. Total case counts of Hepatitis B in residents as reported by Ohio Department of Health (excluding cases diagnosed in state correctional facilities)

63 2,672

13,391 (chronic )

3,409 (acute)

Hepatitis B. Rate of Hepatitis B cases per 100,000 in residents as reported by Ohio Department of Health (excluding cases diagnosed in state correctional facilities)

30.8 23 1.1 (acute)

Hepatitis C. Total case counts of Hepatitis C in residents as reported by Ohio Department of Health (excluding cases diagnosed in state correctional facilities)

435 18,500

143, 286 (chronic)

3,216 (acute)

Hepatitis C. Rate of Hepatitis C cases per 100,000 in residents as reported by Ohio Department of Health (excluding cases diagnosed in state correctional facilities)

213 158.7 1 (acute)

HIV. Rate of reported new diagnoses of HIV infection, ODH 2018 & CDC 2018

5.8 8.5 11.6

HIV. Rate of reported persons living with diagnosed HIV infection, ODH 2018 & CDC 2016

78.4 206.4 369.4


81

Clermont County Overdose Fatalities 2014 2015 2016 2017 2018

Unintentional Drug Overdose Deaths. Number of deaths that occurred in Clermont County

68 93 83 76 68

Female Overdose Fatalities. Percentage of female fatalities with unintentional drug overdose as cause of death that occurred in Clermont County

25% 33% 29% 41% 35%

Male Overdose Fatalities. Percentage of male fatalities with unintentional drug overdose as cause of death that occurred in Clermont County

75% 67% 71% 59% 65%

Criminal History. Percent of cases with a criminal history in Hamilton County or Clermont County

62% 66% 66% 66% 66%

Toxicology Type. Percent of cases' toxicology results were polysubstance

65% 74% 94% 84% 91%

Clermont County Suicide by Mechanism 2013 2014 2015 2016 2017

Suffocation. Percentage of suicide deaths by this external injury mechanism group

22% 28% 22% 20% 31%

Firearm. Percentage of suicide deaths by this external injury mechanism group

50% 61% 78% 53% 34%

Poisoning. Percentage of suicide deaths by this external injury mechanism group

25% 6% 0% 20% 28%

Other. Percentage of suicide deaths by the remaining external injury mechanism groups

3% 5% 0% 7% 7%

Clermont County Water Quality Violations 2014 2015 2016 2017 2018

Health Based Violations. Violation count 0 0 0 1 1


82

2014

# Cases 2015

# Cases 2016

# Cases 2017

# Cases 2018

# Cases

General Infectious Diseases

Amebiasis 0 0 0 0 0

Botulism 0 0 0 0 0

Campylobacteriosis 17 19 26 20 26

Coccidioidomycosis 0 0 1 0 1

CP-CRE * * * * 0

Creutzfeldt-Jakob Disease (CJD) 0 0 0 0 0

Cryptosporidiosis 3 0 8 7 3

Cyclosporiasis 0 0 0 0 1

Escherichia coli, Shiga Toxin-Producing 4 10 13 1 15

Giardiasis 12 5 5 7 9

Haemophilus influenzae, Invasive Disease 2 2 5 8 7

Hemolytic Uremic Syndrome (HUS) 0 0 2 0 0

Legionellosis 1 2 3 3 3

Leprosy (Hansen Disease) 0 0 * * *

Listeriosis 0 0 1 0 0

Meningitis, Aseptic 10 16 14 10 18

Meningitis, Other Bacterial 1 1 1 2 4

Salmonellosis 16 25 13 28 25

Shigellosis 0 8 6 1 1

Staphylococcus aureus, Intermediate Resistance to Vancomycin (VISA) 0 0 1 0 0

Streptococcal Disease, Group A, Invasive 5 5 4 15 10

Streptococcal Disease, Group B, in Newborn 1 0 1 2 2

Streptococcal Toxic Shock Syndrome (STSS) 0 0 0 0 0

Streptocococcus pneumoniae, Invasive Disease 26 15 19 22 21

Toxic Shock Syndrome (TSS) 0 1 0 0 0

Typhoid Fever 0 0 0 0 0

Vibriosis 0 0 0 2 2

Yersiniosis 0 0 0 0 1

Outbreaks

Community 1 0 0 0 *

Foodborne 0 0 0 0 *

Healthcare-Associated 0 0 0 0 *

Institutional 0 0 3 2 *

Waterborne 0 0 0 0 *

Zoonotic 0 1 1 0 * *No data available


83

2014

# Cases 2015

# Cases 2016

# Cases 2017

# Cases 2018

# Cases

Vaccine Preventable

Diphtheria 0 * * * *

Influenza-Associated Hospitalization 152 41 54 178 276

Influenza-Associated Pediatric Mortality 0 0 0 0 0

Influenza A Virus, Novel Human Infection 0 0 0 0 0

Measles 0 0 * 0 *

Meningococcal Disease 0 0 0 0 0

Mumps 4 0 0 0 2

Pertussis 11 11 26 13 7

Rubella * * * * *

Tetanus 0 0 0 * 0

Varicella 8 10 7 4 12

Zoonoses

Babesiosis * 0 * 0 *

Brucellosis * 0 0 * 0

Chikungunya Virus Infection 1 1 0 0 0

Dengue 0 0 0 0 0

Ehrlichiosis/Anaplasmosis 0 0 0 0 1

La Crosse Virus Disease 0 0 0 0 0

Leptospirosis 0 * 0 0 0

Lyme Disease 0 1 4 2 1

Malaria 0 0 0 3 1

Q Fever 0 0 0 0 0

Rabies, Animal 0 0 1 1 *

Spotted Fever Rickettsiosis 0 1 0 2 3

Trichinellosis * * 0 * *

Tularemia 0 0 * 1 0

West Nile Virus Infection 1 0 2 2 1

Zika Virus Infection * * 0 0 *

Hepatitis

Hepatitis A 0 0 0 1 43

Hepatitis B (Total Acute & Chronic) 1* 51 44 48 63

Acute 1 6 3 2 9

Chronic * 45 41 46 54

Hepatitis B, Perinatal Infection 0 * 1 1 1

Hepatitis C (Total Acute & Chronic) 286 391 496 429 435

Acute 2 0 2 4 11

Chronic 284 391 494 425 424

Hepatitis E * 0 0 0 0 *No data available


84

2014 Rate

2015 Rate

2016 Rate

2017 Rate

2018 Rate

General Infectious Diseases

Amebiasis 0.0 0.0 0.0 0.0 *

Botulism 0.0 0.0 0.0 0.0 *

Campylobacteriosis 8.4 9.4 12.8 9.8 *

Coccidioidomycosis 0.0 0.0 0.5 0.0 *

CP-CRE * * * * *

Creutzfeldt-Jakob Disease (CJD) 0.0 0.0 0.0 0.0 *

Cryptosporidiosis 1.5 0.0 3.9 3.4 *

Cyclosporiasis 0.0 0.0 0.0 0.0 *

Escherichia coli, Shiga Toxin-Producing 2.0 5.0 6.4 0.5 *

Giardiasis 6.0 2.5 2.5 3.4 *

Haemophilus influenzae, Invasive Disease 1.0 1.0 2.5 3.9 *

Hemolytic Uremic Syndrome (HUS) 0.0 0.0 1.0 0.0 *

Legionellosis 0.5 1.0 1.5 1.5 *

Leprosy (Hansen Disease) 0.0 0.0 * * *

Listeriosis 0.0 0.0 0.5 0.0 *

Meningitis, Aseptic 5.0 7.9 6.9 4.9 *

Meningitis, Other Bacterial 0.5 0.5 0.5 1.0 *

Salmonellosis 7.9 12.4 6.4 13.7 *

Shigellosis 0.0 4.0 3.0 0.5 *

Staphylococcus aureus, Intermediate Resistance to Vancomycin (VISA) 0.0 0.0 0.5 0.0 *

Streptococcal Disease, Group A, Invasive 2.5 2.5 2.0 7.3 *

Streptococcal Disease, Group B, in Newborn ** ** ** ** *

Streptococcal Toxic Shock Syndrome (STSS) 0.0 0.0 0.0 0.0 *

Streptocococcus pneumoniae, Invasive Disease 12.9 7.4 9.4 10.8 *

Toxic Shock Syndrome (TSS) 0.0 0.5 0.0 0.0 *

Typhoid Fever 0.0 0.0 0.0 0.0 *

Vibriosis 0.0 0.0 0.0 1.0 *

Yersiniosis 0.0 0.0 0.0 0.0 * *No data available **See Ohio Deparment of Health Annual Summary of Infectious Diseases Technical Notes


85

2014 Rate

2015 Rate

2016 Rate

2017 Rate

2018 Rate

Vaccine Preventable

Diphtheria 0.0 * * * *

Influenza-Associated Hospitalization 75.4 20.3 26.6 87.2 *

Influenza-Associated Pediatric Mortality ** ** ** ** *

Influenza A Virus, Novel Human Infection 0.0 0.0 0.0 0.0 *

Measles 0.0 0.0 * 0.0 *

Meningococcal Disease 0.0 0.0 0.0 0.0 *

Mumps 2.0 0.0 0.0 0.0 *

Pertussis 5.5 5.4 12.8 6.4 *

Rubella * * * * *

Tetanus 0.0 0.0 0.0 * *

Varicella 4.0 5.0 3.4 2.0 *

Zoonoses

Babesiosis * 0.0 * 0.0 *

Brucellosis * 0.0 0.0 * *

Chikungunya Virus Infection 0.5 0.5 0.0 0.0 *

Dengue 0.0 0.0 0.0 0.0 *

Ehrlichiosis/Anaplasmosis 0.0 0.0 0.0 0.0 *

La Crosse Virus Disease 0.0 0.0 0.0 0.0 *

Leptospirosis 0.0 * 0.0 0.0 *

Lyme Disease 0.0 0.5 2.0 1.0 *

Malaria 0.0 0.0 0.0 1.5 *

Q Fever 0.0 0.0 0.0 0.0 *

Rabies, Animal n/a n/a n/a n/a *

Spotted Fever Rickettsiosis 0.0 0.5 0.0 1.0 *

Trichinellosis * * 0.0 * *

Tularemia 0.0 0.0 * 0.5 *

West Nile Virus Infection 0.5 0.0 1.0 1.0 *

Zika Virus Infection * * 0.0 0.0 *

Hepatitis

Hepatitis A 0.0 0.0 0.0 0.5 *

Hepatitis B (Total Acute & Chronic) 24.3 21.7 23.5 30.8

Acute 0.5 3.0 1.5 1.0 4.4

Chronic * 22.3 20.2 * *

Hepatitis B, Perinatal Infection ** * * ** *

Hepatitis C (Total Acute & Chronic) 194.2 193.7 244.3 210.1 213.0

Acute 1.0 0.0 1.0 2.0 5.4

Chronic * * * * *

Hepatitis E * 0.0 0.0 0.0 0.0 *No data available **See Ohio Deparment of Health Annual Summary of Infectious Diseases Technical Notes


86

References American Academy of Pediatrics

America’s Essential Hospitals, 2020

APHA Policy Statement

Behavioral Risk Factor Surveillance System (BRFSS), 2017

Clermont County Community Health Assessment Survey, 2019

Clermont County Park District

Clermont County Places and Spaces

Clermont County Pride Survey 7th-12th grade, 2017-2018


Clermont County Sheriff’s Office

CDC. Community Health and Program Services (CHAPS): Health Disparities Among Racial/Ethnic Populations. Atlanta:

U.S. Department of Health and Human Services; 2008

CDC National Health Report: Leading causes of morbidity and mortality and associated behavioral risk and protective

factors — United States, 2005–2013 (Published Date: October 31, 2014) MMWR. Morbidity and mortality

weekly report; v. 63, suppl. 4 https://stacks.cdc.gov/view/cdc/25809

County Health Rankings & Roadmaps, 2019

Dietary Guidelines for Americans, 2015-2020

Healthy People 2020

March of Dimes

Ohio Attorney General Domestic Violence Report

Ohio Balance of State Continuum of Care, 2019

Ohio Department of Education, 2019

Ohio Department of Health

Ohio Dept. of Job & Family Services, Local Area Unemployment Statistics (LAUS) Program

Ohio Department of Natural Resources


Ohio Women, Infants, and Children Program, 2018-2019

OHYES! Ohio Healthy Youth Environments Survey Data, 2019

Pew Research Center, 2017

https://stacks.cdc.gov/view/cdc/25809


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Public Children Services Association of Ohio Factbook, 14th Edition

Robert Wood Johnson Foundation, 2008

The Kaiser Family Foundation

United States Census

Urban Institute

US Department of Health and Human Services, Administration for Children and Families, 2010

U.S. Department of Housing and Urban Development (HUD) Office of Policy Development

U.S. EPA AirData

Vera Institute

Documents

Clermont County Community Health Assessment · e-cigarette- or vaping product use–associated lung injury (EVALI). As of December 19, 2019, state and local public health officials