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Community Assessment Report Knox/Sullivan Communities That Care Project

Funding was provided by the SAPT Block Grant through

FSSA/Division of Mental Health and Addiction

June 2013

United Way of Knox County

Prepared by: Tina Hidde

Terry Cohen

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Contents EXECUTIVE SUMMARY .................................................................................................................................. 3

INTRODUCTION ............................................................................................................................................. 4

Key Accomplishments ............................................................................................................................... 4

RISK AND PROTECTIVE FACTOR ASSESSMENT .............................................................................................. 5

Data Collection .............................................................................................................................................. 6

Limitations: ............................................................................................................................................... 6

Identified Risk and Protective Factors ...................................................................................................... 6

Prioritized Risk and Protective Factors ..................................................................................................... 8

PREDICTIVE BEHAVIORS ................................................................................................................................ 9

Risk Factors-High Risk: .............................................................................................................................. 9

Protective Factor-Low Protection: .......................................................................................................... 10

LOGIC MODEL ............................................................................................................................................. 11

KNOX AND SULLIVAN COUNTIES................................................................................................................. 12

Community Profile: ................................................................................................................................. 12

Overall Health: ........................................................................................................................................ 13

RISK FACTOR: PARENTAL ATTITUDES FAVORIABLE TOWARD ANTI-SOCIAL BEHAVIORS ........................... 14

Problem Behavior: Substance Abuse-Smoking ....................................................................................... 14

RISK FACTOR: PARENT ATTITUDES FAVORABLE TOWARD ANTI-SOCIAL BEHAVIOR and PEER REWARDS for ANTI-SOCIAL BEHAVIOR .............................................................................................................................. 19

Problem Behavior/Substance Abuse-Alcohol ......................................................................................... 19

RISK FACTOR: FAMILY CONFLICT................................................................................................................. 28

Problem Behavior: Mental Health-Depression and Anxiety: .................................................................. 31

Problem Behavior: Teen Pregnancy ........................................................................................................ 32

LOW PROTECTION: STUDENTS BENEFITTING FROM REWARDS FOR PRO-SOCIAL INVOLVEMENT IN SCHOOL ....................................................................................................................................................... 33

STRENGTHS: ................................................................................................................................................ 36

CONCLUSION ............................................................................................................................................... 37

NEXT STEPS ................................................................................................................................................. 37

ATTACHMENTS ............................................................................................................................................ 38

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EXECUTIVE SUMMARY The Knox County United Way was awarded a Communities That Care (CTC) development grant. This award allowed for the development of a Community Board that use the CTC system along with the Strategic Prevention Framework (SPF) to guide the communities of Knox and Sullivan counties through the process of identifying the community’s risk and protective factors. The CTC System was developed by Dr. David Hawkins and Dr. Richard Catalano. This system, based on years of prevention research, allows a community to identify risk and protective factors that are causing problem behaviors in youth. After identifying risk and protective factors in the community, the Community Board will also identify evidence-based resources being used in the community to reduce risk factors and increase protection factors. The process of identifying the risk and protective factors and evidence-based resources in the community allows the Community Board to find the gaps in evidence-based prevention services in the community. The Community Board will then provide a Community Action Plan that will address the risk and protective factors with a plan of evidence-based programs, policies and practices that will reduce the risk factors and increase protective factors that are causing the problem behaviors of substance abuse, delinquency, teen pregnancy, depression, school drop-out and violence. This report is the result of a comprehensive assessment of the risk and protective factors in the communities of Knox and Sullivan Counties. It was based on information gathered from the Indiana Prevention Resource Center’s Alcohol, Tobacco and Other Drugs used by Indiana Children and Adolescents Survey during the 2012 school year. Extensive data was also gathered from relevant pubic archives that indicate that risk and low protective factors are contributing to the negative behaviors in youth. The following risk and protective factors were identified and prioritized by the Risk Assessment Workgroup of the Community Board:

• Peer/Individual Rewards for Anti-Social Behavior • Family Conflict • Parental Attitudes Favorable Toward Anti-social Behavior and Drugs • Rewards for Pro-Social Involvement in School

These risk and protective factors were identified as a priority because survey and archival data both indicated that they were influencing considerable behavioral problems in youth. The problem behaviors of the youth lead to very negative consequences. Arrests, poor health, addictions, school failure and poverty are the consequences to the community at large. The Knox/Sullivan CTC Project Community Board believes that the community’s strength is its willingness to come together, share information and develop evidenced based programs, policies and practices that will decrease the risk factors and elevate the protective factors found in our community. The Community Board is dedicated to finding ways to decrease the problem behaviors of substance abuse, depression, teen pregnancy, school delinquency and school drop-outs so that youth can grow into healthy productive citizens, thereby making our community a healthier and more productive place to live.

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INTRODUCTION

KNOX/SULLIVAN CTC PROJECT

The Sullivan and Knox County Local Coordinating Councils (LCC) applied for a “Communities that Care” (CTC) grant in July of 2012. CTC is a coalition-based community prevention operating system that uses a public health approach to prevent youth problem behaviors including underage drinking, tobacco use, violence, delinquency, school dropout and substance abuse. This is a two-year development grant from the Indiana Family and Social Services Administration Division of Mental Health and Addiction. The CTC is a national, evidenced based drug and alcohol abuse prevention process under which communities evaluate the risks that negatively affect healthy development of youth and implement research-based programs to diminish those risks. The goal is to prevent substance abuse, teen pregnancy, school drop-outs, delinquency, and violence. The CTC system is a community action model developed by Dr. David Hawkins and Dr. Richard Catalano. The action model is based on years of research. The model allows for comprehensive community-wide prevention planning. The process incorporates the Strategic Prevention Framework (SPF) which builds an infrastructure consisting of Assessment, Capacity Building, Planning, Implementation, and Evaluation. This process ensures that communities use their own data-based community profile and existing resources to effectively and efficiently target their unique prevention needs and to positively impact youth development. The Knox/Sullivan CTC project was awarded to the Knox County United Way and is a combined effort from concerned community members from the each county’s Local Coordinating Councils. These community members saw a need in their communities and decided that the CTC process was a researched-based comprehensive way to address the destructive behavioral issues demonstrated by the youth in Knox and Sullivan counties.

Key Accomplishments After being awarded the development grant, the five phases of the CTC process began. The phases are 1) Getting Started, 2) Organizing, Introducing and Involving, 3) Developing a Community Profile, 4) Creating a Community Action Plan, and 5) Implementing and Evaluation of the Community Action Plan. Phases one and two began as Key Leaders in both communities were identified and agreed to be the catalyst in developing the CTC Community Board. The Key Leaders are a group of community leaders who will oversee the CTC process. The Key Leaders attended the Key Leader Orientation on December 2012. (See Attachment 1) These Key Leaders helped to

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identify important stakeholders of both communities who would become members of the Community Board. The Knox/Sullivan CTC Project Board (Board) attended the Community Board Orientation in January 2013. Members of the Board include a wide cross-section of the community organizations. The Board members include government officials, law enforcement, treatment professionals, school professionals, members from the probation department and prosecutor’s office, as well as many other community based service providers and concerned citizens. (See Attachment 2) The Board was trained to use a Risk and Protective Factor Framework. This framework supports a public health model using a theoretical framework of risk reduction and protection enhancement. Developments in prevention and intervention science have shown that there are characteristics, risk factors, of individuals and their families, environment, community, neighborhood and school that affect the likelihood of problem behaviors including substance abuse, delinquency, violence, and school drop-out. Other characteristics, protective factors, serve to protect or provide a buffer to moderate the influence of the problem behaviors. These characteristics are identified as risk factors and protective factors. (Arthur, Hawkins, et al., 1994, Hawkins, Catalano, Miller, 1992). The Board immediately began work with an organizational meeting. The Board developed workgroups to begin the work of completing the Community Action Plan. The Workgroups consist of:

• Risk/Protective Factor Assessment • Community Outreach and Public Relations • Youth Involvement • Resources Assessment and Evaluation • Funding

Each Workgroup elected a chair person to sit on the Executive Committee. (See Attachment 3) The Executive Committee reports to the Key Leader Board on the progress of the Community Board.

RISK AND PROTECTIVE FACTOR ASSESSMENT The Knox/Sullivan CTC Community Board is committed to getting a complete picture of the community. The Risk and Protective Factor Assessment Workgroup (Workgroup) began work on phase three of the CTC process. The Workgroup was very intentional about using the youth survey and obtaining archival data from a multitude of public records allowing them additional measures of the risk and protective factors in the community. The information gathered will allow the Board to identify and implement evidence-based programs that will address the communities identified high risk and low protective factors.

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Data Collection

All five public schools in both Knox and Sullivan counties signed data agreement documents committing to participating in the Indiana Prevention Resource Center’s Alcohol Tobacco and Other Drug Use by Indiana children and Adolescents (ATOD) so that Workgroup will be able to review the risk and protective factors relevant to our community. The survey will allow the Workgroup to identify the problem behaviors of our youth that are most elevated as well as protective factors that are most depressed.

Limitations: Data for this report was gathered from Knox/Sullivan schools participating in the Indiana Prevention Resource Center’s Alcohol Tobacco and Other Drug Use by Indiana children and Adolescents (ATOD) Survey during the 2012 school year. Knox County had two of three school corporations participate in 2012. Sullivan had one of three school corporations participate in 2012. The data reviewed for this report comes from those three schools. Archival data from both counties supports the understanding that the counties and their youth are very similar. The community board agreed to determine the risk and protective factors from the available surveys.

Identified Risk and Protective Factors

The youth in Knox and Sullivan counties participated in the ATOD Survey which is coordinated by the Indiana Prevention Resource Center. The answers from the youth identified that there are characteristics in the community that are highly predictive of problem behaviors. These characteristics are known as Risk Factors. The survey also identified areas of low protection, or Protective Factors, that would help to buffer areas of risk. The Risk and Protective Factors are divided into four domains; Peer/Individual, Family, School and Community. A cut-point method was used to identify elevated risk and depressed protective factors. Survey respondents were divided into two categories – low risk and high risk – based upon national data. Students from around the country were asked the same questions and the median (or middle most) response was identified for each risk factor. These medians were used to determine a cut-point for low and high risk. Those areas where more than 50% of youth in the community are high risk are areas where youth in Knox and Sullivan counties are not faring as well as youth nationally. The following high risk and low protective factors were identified in Knox and Sullivan youth.

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RISK/PROTECTIVE FACTORS

Peer/Individual Domain • The ATOD survey indicated that both communities were at higher

risk for Peer/Individual Rewards for Anti-Social Behavior. The number of 12th grade students in Knox/Sullivan County at risk for Peer/Individual Rewards for Anti-Social Behavior is greater than that of other communities in the nation.

• The ATOD survey indicated that both communities had lower protection in the area of Individual Interaction with Pro-Social Peers. The number of 8th, 10th and 12th graders Benefitting from Interaction with Pro-Social Peers is less than that of other communities in the nation.

Family Domain • The ATOD survey indicated that both communities were at higher

risk in the area of Family Conflict. The combined report indicated that 8th graders in the communities report risk for Family Conflict greater than that of other communities in the nation.

• The ATOD surveys indicated that both communities were at higher risk for Parental Attitudes Favoring Anti-Social Behavior. The Combined report indicated that the 8th Graders in both communities report Risk for Parental Attitudes Favoring Anti-Social Behavior greater than that of other communities in the nation.

School Domain

• The ATOD survey indicated that both communities had lower protection in the area of school involvement. Students Benefitting from School Rewards for involvement are less than that of other communities in the nation.

Community Domain • The ATOD survey indicated that both communities had lower

protection in the area of Community Involvement. The number of 8th, 10th, and 12th Graders Benefitting from Community Rewards is less than that of other communities in the nation.

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Prioritized Risk and Protective Factors The Workgroup gathered and studied the ATOD survey information and archival data and prioritized the Risk and Protective factors as follows: RISK FACTORS

Peer/Individual Rewards for Anti-Social Behavior (Peer/Individual Domain) • -The ATOD survey indicated that both communities were at higher

risk for Peer/Individual Rewards for Anti-Social Behavior. The number of 12th grade students in Knox/Sullivan County at risk for Peer/Individual Rewards for Anti-Social Behavior is greater than that of other communities in the nation.

Family Conflict (Family Domain) • -The ATOD survey indicated that both communities were at higher

risk in the area of Family Conflict. The combined report indicated that 8th graders in the communities report risk for Family Conflict greater than that of other communities in the nation.

Parental Attitudes Favorable Toward Anti-social Behavior and Drugs (Family Domain)

• -The ATOD surveys indicated that both communities were at higher risk for Parental Attitudes Favoring Anti-Social Behavior and Drugs. The Combined report indicated that the 8th Graders in the communities report Risk for Parental Attitudes Favoring Anti-Social Behavior greater than that of other communities in the nation.

PROTECTIVE FACTORS Rewards for Pro-Social Involvement in School (School Domain)

• The ATOD survey indicated that both communities had lower protection in the area of school involvement. Students Benefitting from School Rewards for Involvement are less than that of other communities in the nation.

The Workgroup chose the three higher risk factors in the Individual and Family domain because they reasoned that the Peer Rewards for Anti-social Behavior, Parental Attitudes for Anti-social Behavior and Family Conflict were closely related. The Workgroup concluded that programs, policies and practices can be developed to address these Risks. The Workgroup also chose an area of low protection: Students Benefitting from School Rewards for Involvement, because they believe that it is an area that the community has the best ability to address and increase protection. The Workgroup analyzed the available data to determine what risk factors were most elevated and what protective factors were most depressed. The Workgroup looked at the priorities and discussed the ability of the community to address and make an impact on the identified factors. By consensus, the board chose the risk and protective factors that they determined to be the highest priority as well as the factors they determined that the community would be able to

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impact. *There were two other areas of low protection that were identified in the Knox/Sullivan ATOD Survey: The Knox/Sullivan 8th, 10th, and 12th graders benefitting from Community Rewards for Involvement is less than that of other communities in the nation and Knox/Sullivan 10th and 12th graders Benefitting From Interaction with Pro-social Peers is less than that of other communities in the nation. Although this information indicated low levels of protection in the identified areas, the Assessment Workgroup chose to begin our efforts focusing on the four prioritized risk and protective factors. We will continue to monitor all areas of risk and low protection. The Workgroup believes that if progress is made on lowering the risk factors and increasing the protection of our four priorities, the community will also see an increase in the protection level of two areas where we will not concentrate our efforts. The identified priorities were presented to the Executive Committee for review and endorsement. The full Knox/Sullivan Community Board voted and approved the Executive Committee’s recommendation. The findings were communicated to the Key Leader Board. After final approval, the Workgroup proceeded with a recommendation for future prevention action to take place to address the identified risk and protective factors.

PREDICTIVE BEHAVIORS Many years of research found that risk factors were highly predictive of problem behaviors. The high risk factors in the Family Domain of Family Conflict and Parental Attitudes Favoring Anti-social Behaviors are predictive of problem behaviors in Knox and Sullivan counties. The high risk of Knox and Sullivan Youth Rewards for Anti-social Behavior in the Individual Domain also have shown to predict harmful behaviors.

Risk Factors-High Risk:

1) Parental Attitudes Favorable Toward Anti-social Behavior and Drugs: In families with parental attitudes favorable to anti-social behavior, children are at higher risk for drug use, delinquency and violence. In families where parents use illegal drugs, are heavy users of alcohol, or are tolerant of children’s use, children are more likely to become drug abusers during adolescence. The risk is further increased if parents involve children in their own drug (or alcohol) using behavior, for example, asking the child to light the parent’s cigarette or get the parent a beer from the refrigerator.

2) Peer/Individual Rewards for Anti-Social Behavior: Young people who receive rewards antisocial behavior are at higher risk of engaging in a variety of problem behaviors, including drug use, delinquency, teen pregnancy and school drop-out and violence.

3) Family Conflict: Children raised in families high in conflict, whether or not the child is

directly involved in the conflict, appear at higher risk for all problem behaviors; drug use, delinquency, depression, teen pregnancy, school drop-out and violence.

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In the school domain, the ATOD Survey indicated that Knox and Sullivan youth reported areas of lower protection. While risk factors increase the likelihood of problem behaviors, increasing protective factors are a way to buffer against risk factors.

Protective Factor-Low Protection: Rewards for Pro-Social Involvement in School: When young people are recognized and rewarded for their contributions at school, they are less likely to be involved in substance use, delinquency, teen pregnancy, and school drop-out.

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LOGIC MODEL

The Knox Sullivan CTC Community Board uses a logic model as a tool to connect determinants, behaviors and consequences. The research behind this logic model demonstrates that determinants, or risk factors, will predict problem behaviors and problem behaviors result in negative consequences for the community. These logic theories suggests that if a community can decrease its risk factors, there should be a corresponding decrease in the problem behaviors in the youth and thereby decrease the negative consequences in the community.

It should be noted that each risk factor may predict more than one problem behavior. For example, all three of the identified risk factors for Knox and Sullivan counties are highly predictive of the problem behavior of substance abuse which leads to the consequences of arrests, addiction, poor health and even death. This logic model indicates that decreasing the level of one risk factor can have an impact on all its predictive problem behaviors.

Results of Problem Behaviors Behaviors Influenced by high risk Identified Risk and Protective Factors

Consequences Problem Behaviors Determinants-Risk/Protective Factors

Legal

Individual

Arrests Substance Abuse Peer Rewards for anti-social behavior

Death Health

Family

Poor Health Depression/Anxiety Family Conflict

Addiction Teen Pregnancy Parental Attitudes favoring anti-social behavior

Social

School

School Failure Drop Out Rewards for Pro-Social Involvement

Poverty Delinquency/school suspension and expulsion

Problem behaviors, predicted by risk factors, result in negative

consequences Risk factors predict problem

behaviors in youth

Negative consequences are avoided or reduced by affecting decreasing

risk factors

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KNOX AND SULLIVAN COUNTIES

Community Profile: Knox and Sullivan counties are contiguous counties in Southern Indiana. The counties run along the Wabash River/ Illinois border. According to the US census, the population of the counties is 38,500 and 21,356 respectively. The counties are located in a very rural area and according to the US Census, suffer from a higher rate of poverty than other counties in the state of Indiana.

Source: http://www.census.gov/did/www/saipe/

US Census (SAIPE) 2011

% All Age in Poverty % Under 18 years of age in Poverty

% 5-17 years of age in Poverty

US 15.9 22.5 20.8 Indiana 15.8 22.6 20.6 Knox 19.7 27 24.3 Sullivan 18 22.6 19.8

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Overall Health: The “County Health Rankings and Roadmaps,” (http://www.countyhealthrankings.org/app/home), is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute where the County Health Rankings measure the health of nearly all counties in the nation and rank them within states. The Rankings are compiled using county-level measures from a variety of national and state data sources. These measures are standardized and combined using scientifically-informed weights. Knox and Sullivan counties ranked at the bottom 25% of all 92 Indiana counties in almost all areas that were measured. Their rankings measure the overall health of a county. Their ranking suggests that Knox and Sullivan counties problem behaviors have negatively affected the overall health of the counties. There are 92 counties in the state of Indiana. The following chart shows where Knox and Sullivan rank in the State as compared to the other counties. A ranking of 1st is the highest and the rank of 92nd is the lowest. Knox and Sullivan counties rank in the lower third of almost all categories. This information suggests that the behaviors of the residents of Knox and Sullivan counties are having a negative impact on their overall health.

County Health Rankings and Roadmaps 2012 **1st is the highest rank-92nd is the lowest rank.

Category

Knox Rank

Sullivan Rank

Health Outcomes 80 89 Mortality 82 90 Morbidity 65 89 Health Factors 69 79 Health Behaviors 83 74 Clinical Care 92 91 Social/Economic Factors 24 45 Physical Environment 56 82

Source: http://www.countyhealthrankings.org/app/home

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The Board took a comprehensive look at the data in the community. The Board looked at the ATOD survey as well as current public archival data. The Board looked specifically at the communities’ identified risk factors and the problem behaviors that were not only predicted by those behaviors, but in fact are documented behaviors. The community is suffering the consequences of those problem behaviors. Knox and Sullivan youth are reacting to the high risk factors just as the logic model on page 11 predicts. This assessment documents the identified risk factors and the behaviors predicted by them.

RISK FACTOR: PARENTAL ATTITUDES FAVORIABLE TOWARD ANTI-SOCIAL BEHAVIORS Knox and Sullivan counties youth are at high risk for Parental Attitudes Favorable Toward Anti-social Behavior. This risk factor is highly predictive of substance abuse, and delinquency. In families where parents use illegal drugs, are heavy users of alcohol, or are tolerant of children’s use or other problem behaviors, children are more likely to become drug abusers during adolescence. Adolescents that begin using alcohol or drugs are more likely to continue to use these substances as adults and are at higher risk for becoming addicted. One of the problem behaviors predicted by this risk factor is smoking.

Problem Behavior: Substance Abuse-Smoking The following chart came from the 2012 Alcohol Tobacco and Other Drug (ATOD) survey provided by the Indiana Prevention Resource Center (all values represented indicate rates of use higher than the State). The Survey indicated that Knox and Sullivan youth in the 8th, 10th, and 11th grades use cigarettes at a rate of 9.8-11% higher than the state rates. Positive values indicate that local rates are higher than state rates.

Monthly Use by 6th -12th graders

DRUG 6th 7th 8th 9th 10th 11th 12th

Cigarettes -- -- 11.1 -- 9.8 10.7 -- Source: 2012 ATOD Youth Survey Information was gathered from Vincennes University’s assessment tool “the Core Alcohol and Drug survey” in the spring of 2008. Two notes of concern from this survey were 1) the percentage of students using tobacco in the previous 30 days was for Vincennes University Students at 39% versus the Indiana rate at 19% and 2) that according to the surveyed students, 22% of them use tobacco on a daily basis.

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The “County Rankings and Roadmaps” shows that Knox and Sullivan adults also have higher rates of smoking than the average in the state of Indiana.

Indiana Knox Sullivan

Adult smoking 24% 31% 29%

Source: http://www.countyhealthrankings.org/ The ATOD survey information indicates that the youth of Knox and Sullivan counties report abuse of tobacco, inhalants, ecstasy, prescription drugs and alcohol at higher rates than the State. The Risk Assessment Workgroup focused on Cigarettes and Alcohol because archival data gathered by the Risk/Protective Factor Workgroup found additional problem behaviors associated with their use. Information gathered by INdicators website developed by the Indiana State Department of Health and the Indiana Hospital Association shows adult problem behaviors connected to tobacco use by adults in Knox and Sullivan counties. http://indianaindicators.org/ Adult women in Knox and Sullivan County show a significantly higher percentage of smoking during pregnancy. Prenatal Smoking: Births (%) where mother smoked during pregnancy

Knox Co. IN

28.3 Indiana Goal 17.1 1

Sullivan Co. IN

24.7 Indiana Goal 17.1 1

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Information gathered from the Indiana Youth Institute also indicates that women in Knox and Sullivan counties smoke during pregnancy at a significantly higher rate than the rest of the State.

% of Mothers who smoked while pregnant:

Community DATA Indiana Youth Institute 2009 2010

Knox 30.7% 28.3% Sullivan 26.6% 24.7% State 18.2% 17.1%

Source: www.iyi.org

According to the CDC, research has shown that smoking during pregnancy causes health problems for both mothers and babies, such as pregnancy complications, premature birth, low birth weight infants, stillbirth and sudden infant death syndrome. http://www.cdc.gov/tobacco/basic_information/health_effects/heart_disease/index.htm

Information gathered by INdicators website developed by the Indiana State Department of Health and the Indiana Hospital Association illustrates other adult problem behaviors connected to tobacco use by adults in Knox and Sullivan counties. INdicators show that Knox and Sullivan adults have higher rates of Heart Disease, Stroke Mortality and Chronic Lower Respiratory Disease Mortality than others in the State of Indiana. According to the CDC, these problem behaviors are related to smoking. The CDC reports cigarette smoking causes coronary heart disease, the leading cause of death in the United States. Cigarette smokers are 2–4 times more likely to develop coronary heart disease than nonsmokers. The CDC also has found that cigarette smoking approximately doubles a person’s risk for stroke. They also report that about 90% of all deaths from chronic obstructive lung diseases are attributed to cigarette smoking. http://www.cdc.gov/tobacco/basic_information/health_effects/heart_disease/index.htm

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Heart Disease Hospitalization: Heart disease hospital admissions per 10,000 population (age-adjusted)

Stroke Mortality: Stroke deaths per 100,000 populations (age-adjusted)

Knox Co. IN

100.1 Indiana Goal 89.4 N/A

Sullivan Co. IN

109.7 Indiana Goal 89.4 N/A

Knox Co. IN

101.9 Indiana Goal 45.2 34

Sullivan Co. IN

55.7 Indiana Goal 45.2 34

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Chronic Lower Respiratory Disease Mortality: Chronic lower respiratory disease deaths per 100,000 populations (age-adjusted)

From the data gathered concerning the problem behavior of cigarette smoking by youth in Knox and Sullivan counties, it is logical to predict that youth who smoke will continue to smoke into adulthood and suffer the negative consequences of the significant health problems associated with smoking. Significant consequences can be seen in the area of health due to the smoking of cigarettes. Logic Model-Smoking Consequences Behaviors Determinants-Risk Factors Health Problems: Heart Disease Hospitalization, Stroke Mortality and Chronic Upper Respiratory Disease Mortality are higher in Knox and Sullivan counties when compared to other counties in the State.

Substance Abuse: The Monthly rates of smoking for Knox and Sullivan 8th, 10th, and 11th graders were higher than the State rate.

Parental Attitudes favoring anti-social behavior: the ATOD indicated that the 8th Graders in both communities report Risk for Parental Attitudes Favoring Anti-Social Behavior greater than that of other communities in the nation.

Knox Co. IN

60.3 Indiana Goal 53.6 N/A

Sullivan Co. IN

62.7 Indiana Goal 53.6 N/A

Problem behaviors, predicted by risk factors, result in negative consequences

Risk factors predict problem behaviors in youth

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RISK FACTOR: PARENT ATTITUDES FAVORABLE TOWARD ANTI-SOCIAL BEHAVIOR and PEER REWARDS for ANTI-SOCIAL BEHAVIOR Another risk factor, along with Parental Attitudes Favorable Towards Anti-Social Behavior, that predicts the problem behavior of substance abuse is Peer/Individual Rewards for Anti-Social Behaviors. The first use of any substance is usually preceded by attitudes that are favorable to its use. The middle school years are often a time of first use of alcohol and other drugs. As youth are rewarded for anti-social behavior they become at higher risk for further alcohol and drug use. Young people who engage in anti-social behavior are more likely to engage in a variety of problem behaviors, including drug use, delinquency, teen pregnancy and school drop-out. One of the problem behaviors predicted by these risk factors is alcohol abuse.

Problem Behavior/Substance Abuse-Alcohol In the 2012 ATOD Youth Survey, Knox and Sullivan 10th graders report monthly use of alcohol at a higher rate than the State rate. Knox and Sullivan 10th and 11th graders also report binge drinking at a higher rate that the State. Positive values indicate that local rates are higher than state rates.

Monthly Alcohol use by 6th-12th graders

DRUG 6th 7th 8th 9th 10th 11th 12th

Alcohol -- -- -- -- 9.3 -- --

Binge drinking* -- -- -- -- 7.0 7.1 --

Source: 2012 ATOD Youth Survey The high risk factors of Knox and Sullivan counties predict that the youth will exhibit the problem behavior of substance abuse. As predicted, Knox and Sullivan youth are documented as abusing alcohol. There are numerous consequences that are the result of the use of alcohol by youth. The Risk Assessment Workgroup found archival data that supports that fact.

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The Law Enforcement Data shows that Knox County youth exhibit problem behaviors caused by substance abuse, in particular, alcohol. Data shows an increase in the percentage of Knox County juveniles arrested for violation of liquor laws (underage drinking) in the past three years. Illegal alcohol use is shown to be an increasing problem for law enforcement. (The information from the Chart below was gathered from the Vincennes Police Department.)

Knox Juveniles Vincennes Police Department

JUVENILE ARRESTS 2010 2011 2012 Theft 19 14 9 Other Assault 7 5 5 Drug 6 1 3 Liquor Laws** 22 26 27 Disorderly conduct 14 3 8 Runaways 11 15 10 TOTAL ARRESTS 83 72 67

** Liquor Laws for juveniles is underage drinking. Knox and Sullivan Probation Departments also indicate that there are consequences caused by substance abuse in juveniles on probation. Alcohol and drug issues are around 30% of the juvenile probations cases in both Knox and Sullivan counties. Juvenile Probation:

Knox Juvenile Probation 2010 2011 2012 Youth Referred by Probation 150 183 154 Alcohol/drug Related 51 58 39 % Alcohol/drug Related 34% 32% 25%

Total Youth Probation (Formal and Informal) 74 66 54

Sullivan Juvenile Probation 2011 2012 Alcohol 28 24 other Drug 5 15 % Alcohol/drug related 27% 27%

Total Youth 124 145

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The Knox County Teen Court is a diversionary program for first time, non-violent juvenile offenders. The data received from the Knox County Teen Court indicates that this program also shows that minor consumption of alcohol is a problem behavior for Knox County Youth. Consequences caused by substance abuse continue into adulthood for Knox and Sullivan counties. The following information was gathered from the Vincennes Police Department in Knox County and Sullivan County Law Enforcement and Probation. LAW ENFORCEMENT

Vincennes Police (Knox Co) Sullivan 2010 2011 2012 2010 2011 2012

ADULTS 18+

Gambling 0 0 0 0 0 0 Drug Violations 78 113 110 154 148 141 DUI 43 38 44 136 112 143 Liquor Laws 48 212 85 35 67 29 Drunkenness 49 2 3 35 44 34 Domestic Violence 5 8 8 35 24 18 Battery/Assault 57 82 62 34 42 42 TOTAL Arrests 513 637 701 897 896 731 % Drug/Alcohol related arrests 43% 57% 35% 40% 41% 47% **Liquor Laws for adults include contributing to minor, alcohol transportation violation, public intox, etc.

Knox County Teen Court 2010 2011 2012

Total # Teen Court 29 34 41 Minor Consumption/Drug 20 24 24 % Minor Consumption/Drug 69% 70% 59%

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The information from law enforcement in Knox and Sullivan counties shows that during the years 2010-2012, drug and alcohol infractions were between 35% and 57% of the arrests. The charts below show Knox and Sullivan County Adult Probation statistics. Over 50% of adults on probation because of alcohol or drug related issues. Knox Co Probation Adult 2010 2011 2012

Felony Substance Use 113 186 144 Misdemeanor Substance Use 404 481 456

Total Substance %Total 53% 54% 59%

Total Misdemeanor 770 921 756 Total Felony 212 320 266

Total Adult Probation 982 1241 1022

Sullivan Adult Probation 2012

OVWI/Operating vehicle while intoxicated 165 Public Intox 16 Other Drug 122 % Drug/Alcohol Related 58%

Total Adult 521

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Data gathered from the Uniform Crime Report also shows adult consequences caused by substance abuse. Below is the Uniform Crime Report from 2009. The highlighted portion in red shows that between 76 and 81% of the crimes reported in 2009 were alcohol or drug related. Table 6.13a FBI Uniform Crime Report Data -- All Arrests (FBI UCR, 2012)

Knox Sullivan Indiana FSSA Region 7 4 Total Population-Agencies report arrests 37,996 21,318 Number of Agencies 4 3 Multi-county jurisdictional flag One county One county Coverage Indicator (%) 87.8 86.0 Driving Under the Influence 151 108 30,817 Liquor Law Violations 276 15 16,188 Drunkenness 77 52 20,938 Drug Possession Subtotal 220 47 22,901 Opium/Cocaine 22 7 2,624 Marijuana 121 38 14,436 Synthetic Narcotics 47 2 1,830 Other Drug Possession 30 0 3,998 Drug Abuse-Sale/Manufacturing 121 22 6,451 Opium/Cocaine 14 0 2,431 Marijuana 69 21 2,292 Synthetic Drug 31 0 786 Other Sale: Dangerous Non-narcotics 7 1 937 Gambling 0 0 35 Offenses against Family/Child 26 0 2,243 Prostitution 0 0 1,214 Sex offenses 5 4 1,823 Disorderly conduct 104 6 9,350 Vagrancy 1 0 119 All Other Off Except Traffic 218 63 69,912 Curfew, Loitering Viol: Juv 1 0 978 Runaway Juveniles 17 0 3,632 Weapons Violations 6 0 2,266 Total 1564 313 % Substance Abuse Related 76% 81% Year of Data: 2009 Primary Source: FBI UCR, 2012

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Additional data showing consequences stemming from substance abuse were gathered from treatment facilities in Knox and Sullivan County. The Hamilton Center in Sullivan and the Samaritan Center in Knox County provided the following data: TREATMENT

Total Clients

Substance Abuse Adults

% Substance Abuse

Substance Abuse Under 18

Alcohol Abuse

Alcohol Dependence

Poly-Substance Dependence

Knox Samaritan Center

2010 2043 1206 59% 29 231 175 91 2011 2392 1223 51% 37 207 220 127 2012 3340 1232 36% 72 168 133 95

Sullivan

Hamilton Center 2010 622 74 12% 0 0 0 0

2011 655 99 15% 1 19 0 21 2012 668 141 21% 8 0 27 39

The information gathered from the treatment centers in both counties show an increasing number of both juveniles and adults in treatment for substance abuse. Addiction was not the worst complication due to substance abuse issues. The deaths noted below were strictly alcohol or drug related. Other deaths may have had alcohol or drugs as a contributing factor, but those were not counted here. The Knox County Health Department provided the following information:

Knox County Health Department Death due to Drug/Alcohol

2010 2011 2012

Adult Drug 8 2 6 Adult Alcohol 1

1

Adult Drug/Alcohol 1 1

Total 10 3 7

Juveniles

1 newborn

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Knox and Sullivan counties struggle with a Methamphetamine problem. This is particularly true for Knox County. According to the website www.Meth.in.gov, Knox County was in the top 10 counties for Meth labs in 2012.

# OF METH LABS

2010 2011 2012

Knox 33 25 53 Sullivan 14 8 9

The Knox County community recognized the serious Methamphetamine problem in 2007 and developed the LAM (Life After Meth) program. LAM is made up of a group of people who have been incarcerated and choose to follow an evidence-based program of recovery and re-entry into the community. Of the 30 active members of LAM in August of 2013, 56.6% of their substance abuse started with alcohol. LAM provided the following information from 2012:

Knox County LAM Statistics 2012

LAM MALES LAM FEMALES

Total in Program 54 22 Average Age 32 35 Average number of Children 2 2 Average Age Onset Use 15 15 Drug of Choice: Methamphetamine 40% 56% Marijuana 2% 0 Alcohol 6% 4% Prescription pills 11% 4% Poly-Substance 40% 37%

* Note: All women listed methamphetamine in with their poly-substance drugs so actually 93% of these women used meth. The members of the LAM program had an average of 2 children. This information is important as it shows us that the adults abusing methamphetamine in Knox County have children and supports the finding of the risk factor of Parents having Favorable Attitudes Toward Anti-social Behaviors. This risk factor influences the problem of substance use by youth. Another archival piece of data that supports the Knox and Sullivan Youth are at higher risk for Parents with Favorable Attitudes Toward Anti-social Behaviors and Peer Rewards for Anti-

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Social Behavior is information on the number of alcohol licenses per capita that was gathered from Indiana State Excise Police.

DATA CURRENT AS OF 2.6.2013

COUNTY ACTIVE LICENSES

POPULATION AS OF 7.1.2011

# OF LICENSES PER 10,000 RANK PERCENTILE

Sullivan 48 21,356 22.48 64 30 Knox 106 38,500 27.53 85 8 NOTES ON HOW TO READ SHEET: RANK lists counties from the lowest (best) per 10,000 population number of active licenses. For example, Wells County's rank is 4. This means Wells County has the 4th lowest number of licenses per 10,000 population.

PERCENTILE shows the percent of the counties that scored below the specified per 10,000 population number of licenses. A higher percentile is superior to a lower percentile.

Knox and Sullivan counties rank in the top 30th percentile for the number of active alcohol licenses per capita in the state of Indiana with Knox being in the top 10. Information was also taken from the Alcohol and Tobacco Commission concerning the Alcohol Compliance rates for Knox and Sullivan counties. This information shows the number of businesses with alcohol licenses selling alcohol to minors.

ATC Compliance Rates

2012

2011

2010

County Cited Passed Total % Failed County Cited Passed Total %

Failed County Cited Passed Total %

Failed

Knox 5 42 47 10.638% Knox 0 116 116 0.000% Knox 15 207 222 6.757% Sullivan 1 31 32 3.125% Sullivan 2 66 68 2.941% Sullivan 0 74 74 0.000%

Although both Knox and Sullivan counties have a high percentage of alcohol outlets, with Knox having one of the highest in the State, the counties also seem to have businesses compliant by not selling alcohol to minors. For the past three years, both counties have had a 10% or less failure rate. The Failure rate is the percentage of the outlets who were cited for selling alcohol to minors. Both counties have had a least one year in the past three years with a 0% failure rate. This information suggests that the youth in Knox and Sullivan counties are not getting alcohol from the community outlets illegally. If the youth are not getting the alcohol from the community outlets, then they are most likely getting alcohol from family or friends. This information supports Knox and Sullivan youth are at higher risk from Parental Attitudes Favoring Anti-social Behavior and Peer Rewards for Anti-social Behavior.

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Archival data suggests that consequences from problem behaviors due to the influence of the identified risk factors of Parents with Favorable Attitudes Toward Anti-social Behaviors and Peer Rewards for Anti-Social Behavior and Family Conflict continue to influence these problem behaviors into adulthood in Knox and Sullivan counties. The Youth of Knox and Sullivan counties continue to use alcohol and other drugs into adulthood with increasing consequences. Logic Model- Alcohol Abuse Consequences Behaviors Determinants-Risk Factors Arrests: Alcohol and drug issues are around 30% of the juvenile probations cases in both Knox and Sullivan counties. Death: 21 Deaths due to alcohol and drugs in last three years in Knox County

Substance Abuse: The Monthly rates for alcohol use of 10th graders and for binge drinking by 10th and 11th graders in Knox and Sullivan County are higher that the rates of the State.

Parental attitudes favoring anti-social behavior Peer rewards for anti-social behaviors: The ATOD indicated that the number of 12th grade students in Knox/Sullivan County at risk for Peer/Individual Rewards for Anti-Social Behavior is greater than that of other communities in the nation.

Risk factors predict problem behaviors in youth

Problem behaviors, predicted by risk factors, result in negative consequences

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RISK FACTOR: FAMILY CONFLICT Knox and Sullivan County youth are at higher risk for Family Conflict as compared to other counties in the State. Children raised in families high in conflict such as the children raised in Knox and Sullivan counties, whether or not the child is directly involved in the conflict, appear at risk for the following problem behaviors: Depression/Anxiety, Teen Pregnancy, Alcohol use, Delinquency (School Suspension and Expulsions), and School drop-out. The Indiana Youth Institute provides county level data in various areas:

Community DATA Indiana Youth Institute 2010 2011

Knox CHINS * see definition CHINS 169 195 Sullivan CHINS 51 48

Knox Rate Child Abuse 28.9 27.8 Sullivan Rate Child Abuse 17.7 18 State Rate Child Abuse 14.5 12.2

Knox # neglect/abuse 178 190 Sullivan # neglect/abuse 52 60

Knox Termination of Parental Rights 34 36 Sullivan Termination of Parental Rights 6 7

**The State of Indiana Department of Child Services: “The State of Indiana defines a child in need of services (CHINS) as a child prior to his/her 18th

birthday who is experiencing one or

more of the conditions outlined below AND the situation is unlikely to be remedied without the coercive intervention of the court.

CHINS 1: Neglect The child's physical or mental condition is seriously impaired or seriously endangered as a result of the parent/guardian/custodian being unable, refusing, or

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neglecting to supply the child with necessary food, clothing, shelter, medical care, education, or supervision.

CHINS 2: Abuse

a. The child's physical or mental condition is seriously impaired or seriously endangered due to an injury as a result of the parent/guardian/custodian’s act or omission, or

b. There is evidence that Illegal manufacture of a drug or controlled substance is occurring on property where a child resides.

1

Note: According to IC 31-34-12-4, a rebuttable presumption is raised that the child is a CHINS because of an act or omission of the child’s parent/ guardian/custodian if the state introduces competent evidence of probative value that: 1) The child has been injured, 2) at the time the child was injured, the parent/guardian/custodian had the

care, custody or control of the child OR the legal responsibility for the care, custody or control of the child, and

3) the injury would not ordinarily be sustained except for the act or omission of a parent/guardian/custodian.

Note: There is a rebuttable presumption that the child is a CHINS when there is evidence of manufacture of an illegal or controlled substance.” *

Knox and Sullivan counties have increasing number of Children In Need of Services or CHINS and the rate of Child Abuse is significantly higher than the rate of Indiana and the Termination of Parental Rights (TRP) is increasing. This information supports that there is significant evidence of Family Conflict in Knox and Sullivan counties.

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The following chart shows more evidence of Family Conflict. Domestic Violence, Battery and other Assaults are notable in the number of arrests from both counties. Of note: Knox County dispatch received 414 calls concerning Domestic Violence and Family Fights into the central dispatch during the year of 2010-2011.

LAW ENFORCEMENT

Knox-Vincennes Police Department

Sullivan Police Department

2010 2011 2012 2010 2011 2012 ADULT ARRESTS 18+

Gambling 0 0 0 0 0 0 Drug Violations 78 113 110 154 148 141 Driving Under Influence 43 38 44 136 112 143

Liquor Laws 48 212 85 35 67 29 Drunkenness 49 2 3 35 44 34 Domestic Violence 5 8 8 35 24 18

Battery/Assault 57 82 62 34 42 42 TOTAL Arrests 513 637 701 897 896 731

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Problem Behavior: Mental Health-Depression and Anxiety: According to the ATOD youth survey there are some concerning statistics related to the mental health of the youth of the Knox and Sullivan communities. The 8th, 10th and 11th graders in Knox and Sullivan counties felt sad or hopeless at a higher rate compared to the State. When asked, “During the past 12 months, did you ever feel so sad or hopeless almost every day or more in a row that you stopped doing usual activities,” nearly 30% answered “yes”. Knox and Sullivan County 8th through 12th graders also reported that they had considered suicide at a higher rate compared to the State. Below is a chart showing the comparison. The Centers for Disease Control (CDC) states that feelings of sadness, hopelessness and thoughts of suicide are indicators of persons suffering from depression. The CDC states that persons suffering from depression are at higher risk for suicidal thoughts and suicide attempts. http://www.cdc.gov/Features/Depression/

According to the Mayo Clinic, adolescents with depression often experience other consequences in their lives such as alcohol and drug abuse, academic failure, or they might be involved with the juvenile justice system. http://www.cdc.gov/Features/Depression/ The research done by Hawkins and Catalano suggests that the Risk Factor of Family Conflict is a strong predictor of depression and anxiety. The Risk Factor Assessment Workgroup found that Knox and Sullivan youth have suffered the consequences of school failure, substance abuse, addiction and arrests. These consequences have been documented and are demonstrated throughout this assessment.

Mental Health Knox/Sullivan Schools 6th-12th Graders: ATOD Youth

Survey (Values expresses as percentages)

Grade level 6th 7th 8th 9th 10th 11th 12th Felt sad or hopeless: Knox/Sullivan 14.7 20.8 28.1 24.3 29.9 29.2 23.9 Felt sad or hopeless: State of Indiana

16.2 20.3 25 27 27.4 24.7 22.2

Considered attempting Suicide: Knox/Sullivan

6.3 11.2 17.8 16 18.3 16.9 12.4

Considered attempting Suicide: State of Indiana

7.4 11 15.2 15.4 14.6 13.1 10.5

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The following logic model shows how Hawkins and Catalano’s research holds true in Knox and Sullivan County Youth. Logic Model-Depression Consequences Behaviors Determinants-Risk/Protective Factors

Addiction: both counties show an increasing number of both juveniles and adults in treatment for substance abuse.

Depression/Anxiety: Knox and Sullivan 8th, 10th and 11th graders report feeling sad or hopeless at higher rates than the State.

Family Conflict: The ATOD indicated that 8th graders in the communities report risk for Family Conflict greater than that of other communities in the nation.

Problem Behavior: Teen Pregnancy Another problem behavior attributed to the high risk of youth due to Family Conflict is the high teen birth rate in Knox and Sullivan counties. The teen birth rate is significantly higher than that of the State.

Community DATA Indiana Youth Institute 2010

Knox Teen Birth Rate 21.9% Sullivan teen Birth Rate 28.9% State Teen Birth Rate 18.5%

According to the Centers for Disease Control and Prevention (CDC), there are numerous negative consequences due to teen pregnancy. Teens that become pregnant have an 80% likelihood of being on government assistance at some point in their lives and they drop out of high school at a rate of 50%. http://www.cdc.gov/teenpregnancy Logic Model-Teen Pregnancy Consequences Behaviors Determinants-Risk/Protective Factors School Failure: Knox and Sullivan counties have lower rates of graduation or higher rate of drop outs than the State. Pregnant Teen Drop out at a rate is 50% nationally Poverty: nationally, 80% of pregnant teens require government assistance

Teen Pregnancy: Knox 21.9 % Teen Pregnancy Rate Sullivan 28.9% Pregnancy Rate

Family Conflict: The ATOD indicated that 8th graders in the communities report risk for Family Conflict greater than that of other communities in the nation

Risk factors predict problem behaviors in youth

Problem behaviors, predicted by risk factors, result in negative consequences

Risk factors predict problem behaviors in youth

Problem behaviors, predicted by risk factors, result in negative consequences

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LOW PROTECTION: STUDENTS BENEFITTING FROM REWARDS FOR PRO-SOCIAL INVOLVEMENT IN SCHOOL The 2012 ATOD Youth Survey identified not only that Knox and Sullivan County youth have high risk factors it also indicated the Knox and Sullivan Students Benefitting from School Rewards for Involvement was less than that of other communities. This was an area of low protection for Knox and Sullivan youth. Areas of low protection need to be increased to buffer the influence of high risk factors. The following information was gathered from the Indiana Department of Education. Both communities suffer with high poverty levels, and that fact is evident from the higher than the State rate of Free/Reduced Lunch. Poverty is a contributing factor to the problem behaviors of substance abuse, delinquency, teen pregnancy, school drop-out, and violence. Both Knox and Sullivan counties also have lower rates of graduation or higher rate of drop outs than the State. These statistics support the research finding that Knox and Sullivan students are at higher risk for being Rewarded by Peers for Anti-Social behavior, and that that they have lower protection for Rewards for Pro-social Involvement in School.

School Attendance Department of Education www.doe.in.gov

Grade 2009-10

2010-11

2011-12

Graduation rate Knox

80.7 82.6 82.8 Graduation rate Sullivan

85.4 85.8 83.4

State Graduation Rate

81.4 84.1 85.7

School Free/ Reduced lunch

Knox

53 55.5 56.4 Sullivan

44.6 48.6 48.4

State

41.8 45.3 46.8 Another indication of students showing that Knox and Sullivan County youth receive Rewards for Anti-social Behavior and the they have lower protection for Student Rewards for Pro-Social Involvement in School are the suspension and expulsions at the schools. The information from

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the chart below came from the Indiana Department of Education. All of the schools except one show an increase in the number of suspensions and expulsions from 2011 to 2012.

Total Total

CORP SCHOOL NAME Expulsions &

Suspensions 2011 Expulsions &

Suspensions 2012

4315 3537 North Knox Jr-Sr High School 53 160

4325 3490 South Knox Middle-High School 65 32

4335 3553 Lincoln High School 150 176 7645 7909 Union High School 31 33

7645 7917 North Central High School 164 197

7715 7957 Sullivan High School 30 47 Source: Indiana Department of Education The following chart gives more information about the number of students leaving the school environment. Although the students leaving school to “home school” are not considered drop-outs, they are no longer enrolled in the schools and their graduation status is unclear. Since these students are no longer in a school environment, they would clearly be affected by lower protection from Rewards for Pro-social Involvement in School.

2010 2011 2012

CORP SCHOOL NAME

Total Students who Dropped out

to be Home Schooled

Total Students who Dropped out

to be Home Schooled

Total Students who Dropped out

to be Home Schooled

4315 3537 North Knox Jr-Sr High School 5 4 11

4325 3490

South Knox Middle-High School 12 12 9

4335 3553 Lincoln High School NO info 3 3

7645 7909 Union High School 8 15 9

7645 7917 North Central High School 27 21 28

7715 7957 Sullivan High School 11 17 5

Source: Indiana Department of Education

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One of the consequences of dropping out of school is living in poverty. The Department of Education reports that young adults who drop out of high school are 30% more likely to live in poverty. Those consequences are evident in the Free and Reduced lunch rates and the poverty rates noted in the Community Profile (page 11) in Knox and Sullivan counties.

Logic Model-School Drop-out, Suspension/Expulsion

Consequences Behaviors Determinants-Risk Factors/Protective Factor Poverty: Knox and Sullivan County School have Free and Reduced lunch rates that are higher than the State

School Drop-out: Knox and Sullivan Students Drop-out of school at a higher rate than other students in the State. School Expulsions/ Suspensions: Knox and Sullivan School have an increasing number of School expulsions and suspensions.

Peer Rewards for anti-social behaviors Students Benefitting from rewards for pro-social involvement in school: The ATOD indicated that Students Benefitting from School Rewards for Involvement is less than that of other communities in the nation.

Risk factors predict problem behaviors in youth

Problem behaviors, predicted by risk factors, result in negative

consequences

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STRENGTHS:

Although most of this profile has focused on the problem behaviors evident in our communities, it must be noted that Knox and Sullivan counties have several strengths. Although data shows that substance abuse and addiction is a problem in Knox and Sullivan counties, it does not show that gambling is a significant problem in the area. The following chart with information gathered from the IPRC, Indiana Prevention Resource Center (IPRC, Prev-Stat). Gambling Behavior in Knox and Sullivan counties were not significantly higher that the State in any category. Playing Bingo and buying an Instant Game Lottery ticket were the two areas of note. Neither Law enforcement agency in Knox or Sullivan County noted a gambling arrest in three years. Table 6.11a Adult Gambling Behavior & Leisure Activities (ESRI, 2010 est., 2011)

Knox Sullivan Indiana USA Gambled at casino in last 12 months 15.3 12.2 14.9 16.1 Gambled in Atlantic City in last 12 months 1.6 1.2 2 2.7 Gambled in Las Vegas in last 12 months 2.4 1.7 3.3 4.6 Attended horse races in last 12 months 2.4 1.9 2.5 2.8 Played bingo in last 12 months 5 5.7 4.6 4.4 Bought lottery ticket in last 12 months 35.1 33.5 35.5 34.9 Bought lottery ticket in last 12 mo: Daily Drawing:Buyer 4.2 4.1 4.6 5 Bought lottery ticket in last 12 mo: Instant Game 19.9 19.3 18.8 16.5 Bought lottery ticket in last 12 mo: Lotto Drawing:Buyer 20.4 19.5 21.8 21.8 Played lottery: 10.9 10.9 11.5 11.8 Played lottery: 2-5 times in last 30 days 11.6 10.3 11.7 11.7 Played lottery: 6+ times in last 30 days 12.7 12.3 12.3 11.5 Year of Data: 2010

Primary Source: ESRI, 2010 est., 2011

The most important strength is evident in how quickly and willingly the two communities came together to develop the Knox/Sullivan CTC Project. A willing group of people from across sectors came together to look at the problems in our communities. This widespread collaboration and willingness to look at the facts and address them shows that the two communities are committed to helping the youth develop into healthy adults. Another strength is the willingness of the schools to not only participate in the ATOD survey, but their willingness to participate on the community board and their desire to implement changes that will help to lower the risks and increase the protection of our youth. The schools are the center of the community. The board believed that the best way to address the high risk and low protection in the community might be through the schools. Board members hope that

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information, education and training not only for students, but parents as well, might be funneled through the local community schools. In addition, Lincoln High School and North Knox High School have both instituted alternative schools to help students who do not function well in a regular school environment. Alice Academy at Lincoln High School has graduated an additional 26 students in 2011 and 21 students in 2012. The North Knox Alterative School graduated 9 students in 2011 and 12 students in 2012. The students in these programs were at a very high risk of dropping out of school. These alternatives should make a large impact on the graduation rate in the future.

CONCLUSION The Knox/Sullivan CTC Project Community Board has gathered a concerned and committed group of people who have identified and prioritized the specific risk factors that are influencing the problem behaviors of smoking, alcohol abuse, depression, teen pregnancy, school suspensions, expulsions and drop-outs in Knox and Sullivan County youth. They have also identified an area of protection that needs to be increased. An increase in this protective factor will help to buffer the identified risk factors.

NEXT STEPS Phase three continues as the Resources Assessment Workgroup meets and will take the priorities that have been identified by the Risk/Assessment Workgroup to develop a list of resources that are already available to address those identified risk and protective factors. The Resource Assessment Workgroup will then identify gaps in the prevention resources in the counties. Their work and this report will move the Knox/Sullivan CTC Project forward by completing the profile that will be used in phase four, developing a Community Action Plan. The Community Action plan will take the community profile and develop a plan that uses evidence-based programs, policies and practices that will reduce our identified risk and protective factors, thereby reducing problem behaviors in our youth.

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ATTACHMENTS Attachment 1

KNOX/SULLIVAN CTC PROJECT KEY LEADERS

Lisa Bishop Terry Johnson Vincennes University Vincennes Police Dept Lori Bouslog Clint Lamb Purdue Extension Office Sullivan Mayor Laura Carie Barb Lance Cardinal Liquor Sullivan Co. Probation Judge Tim Crowley Jesse Morin Knox County Juvenile Judge Sullivan Police Dept. Lacey Dabelow Angie Lange Hamilton Center PACE Shannon Dillon Bob Murawski Samaritan Center United Way Michelle Pitcher Kathy Ocampo Pace Hamilton Center Dave Haddix James Rees Sullivan County Sheriff Dept Knox Co. Probation Peter Haskins Lynne Rump Life After Meth Children and Family Services Mark Hill Michelle Sly-Smith Samaritan Center Sullivan Community Hospital Portia Hockman John Sievers PACE Knox Co. Prosecutor Pat Hutchison Marie Watson VU-ETS/VCSC Sullivan Co. Prosecutor’s Office Angie Jahn Joe Yochum Sullivan Co. Probation Vincennes Mayor Kreg Battles State Representative House District 45

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Attachment 2 Knox/Sullivan CTC Project Community Board Members

Jennifer Andrews Nancy Hazelman Vincennes University Counseling Center Children and Family Services Bill and Rosalie Bloebaum Holly Hillenbrand Community Members Children and Family Services Lori Bouslog John Hillenbrand Sullivan Co. Purdue Extension Office Vincennes Police Department Ellen Clark Portia Hockman Vincennes University Educational Talent Search Pace Community Action Bill Davis Nancy Hunt YMCA Community Member Mark Dillon Pat Hutchison North Knox High School Vincennes Community School Corp Michelle Ellerman Angie Jahn Community Member Sullivan County Probation Kathy Evans Christy Jarvis Vincennes University Counseling Center Vincennes School Corp Cara Gilmore Kyla Jones Knox County Probation Jobs for America’s Graduates Heidi Goss Ruth King Children and Family Services Community Member Sharon Goss Beth Lindsey Stair Steps to Success Clark Middle School Dave Haddix Jill Lopez Sullivan Co. Sheriff Dept. Clark Middle School Sarah Hannon Barb Martin Southwest School Corporation Sullivan Co 21st Century Scholars Peter Haskins Eva Martin Life After Meth Community Member

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Trina Noel Tania Willis Northeast School Corp of Sullivan Live After Meth Kathy Ocampo Jana Yochum Hamilton Center Children and Family Services Dale and Betty Phillips Community Members Danny Pierson Higher Bound James Rees Knox County Probation Greg Risley Knox Co Coordinating Council Liz Romani Knox Co Coordinating Council Karen Sandy Community Member Karen Schmeling Knox Co. Probation Karen Steele Community Member Gunnar Stiles Southwest Indiana Youth Village Amy Tolliver Lincoln High School Juli Tredway Samaritan Center Cindy Uhlik Community Member Marie Watson Sullivan Co. Prosecutors Office

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Attachment 3 Knox/Sullivan CTC Project

Executive Committee Lori Bouslog Board Maintenance Workgroup Michelle Ellerman Resource Assessment Workgroup Jill Lopez Risk/Protective Factor Workgroup Barb Martin Funding Workgroup Greg Risley Community Outreach/Public Relations Workgroup Gunnar Stiles Youth Involvement Workgroup