montgomery county, ohio - phdmc

Community Health Assessment 2014

Executive Summary

Montgomery County, Ohio

Executive Summary

Public Health - Dayton & Montgomery County (PHDMC) conducted this collaborative community health assessment (CHA) to summarize Montgomery County’s population health status and needs. The findings of this CHA will inform community decision-makers, help identify priority public health issues, and guide health improvement strategies. PHDMC will use the data to engage stakeholders in the development and implementation of a community health improvement plan for Montgomery County. The data presented in this CHA is from multiple sources, including secondary quantitative data from the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS), Ohio Department of Health Vital Statistics, U.S. Census Bureau, Greater Dayton Area Hospital Association emergency department and hospitalization records, Dayton Children’s Hospital’s Community Health Needs Assessment, CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS), and the Ohio Disease Reporting System (ODRS). Information from these sources is summarized into seven sections: Overall Health, About Montgomery County, Health Risks, Health Outcomes, Special Interest (drug overdose and infant mortality), Built Environment, and Access to Care. Additionally, primary qualitative data was collected from focus groups representing four underserved communities; African Americans, Asians, Latinos, and Senior Citizens. These groups shared their views on issues that impact the health of their respective communities.

Overall HealthThis assessment measured overall health as an individual’s perceived physical and mental health over time, also referred to as their health-related quality of life (HRQOL). Women more than men and Blacks more than Whites perceive their health to be fair-to-poor health and have more unhealthy days per month. The same is true for adults whose annual household income is below $15,000.

About Montgomery CountyMontgomery County’s population of 534,325 is comprised of 72% White, 21% Black, 2% Asian, 2.5% Native American or two or more races, and 2% Hispanic. Children less than 18 years of age make up 22% of the population while 16% of the population is 65 years and older. The composition of the family household differs significantly between Whites and Blacks. Among Whites, 44% of households are married couples compared to 21% of Black households, and 12% of White households are headed by an unmarried female compared to 27% of Black households. Sixty percent of the Black female, head of household families with children under the age of 5 live below poverty level.

Health RisksParticipating in regular exercise, eating a balanced diet, maintaining a healthy weight, limiting alcohol use, and quitting smoking are all part of a healthy lifestyle. In the county, less than half of adults meet the recommended physical activity guidelines. Most children spend one hour participating in physical activity, but have two or more hours of screen time a day. Many adults eat take-out, delivery, or fast food more than 10 times a month. Not surprisingly, obesity is a problem for both adults and children. Among 12 to 17 year olds, 12% drink alcohol and 10% use tobacco.

Health OutcomesMany of the poor health outcomes are directly related to inactivity, poor nutrition, obesity, and tobacco and excessive alcohol use. Thirteen percent of women smoke during their pregnancy and almost 10% of babies are born with low birth weight. Two times as many low birth weight babies are born to Black women than to White women.

At birth, the estimated life expectancy of a Montgomery County resident is 76.6 years. There is almost a 10 year difference between the life expectancy of a White woman and a Black man. Cancer and heart disease are the two leading causes of death. The rate of new cancers is highest for breast, prostate, and lung and bronchus cancers, and the cancers with the highest mortality rate are lung and bronchus, breast, and prostate cancers. Lung and bronchus cancers have the highest percent of late stage diagnosis. Two of the risk factors for heart disease, high blood pressure and high cholesterol, are diagnosed more often in men than women. The mortality rate for heart disease is one and half times greater in men than women, and black men have the highest mortality rate for heart disease. Diabetes also disproportionately affects Black men as they have the highest diabetes mortality rate. The third leading cause of death is accidents. Among individuals 65 and older, the leading cause of injury-related deaths due to accidents is from falls. Sexually transmitted diseases such as HIV, chlamydia, gonorrhea, and syphilis remain a serious public health problem. Since 2009, the rate of new syphilis cases has increased 114%. The rate of chlamydia is 10 times higher and the rate of gonorrhea is 16 times higher in Blacks than it is in Whites. Hepatitis C and influenza-associated hospitalizations were the most commonly reported communicable diseases in 2013. Among children, pertussis accounted for more than 50% of diseases reported to Public Health; a 481% increase in one year. Four out of every 1,000 children under the age of one were diagnosed with pertussis.

Special Interest From 2010 to 2013, the number of drug overdose deaths increased 78% in Montgomery County. These deaths were most often associated with heroin use, but deaths from prescription drugs are also on the rise. The populations most impacted by drug overdoses are Whites, males, and individuals between 35 and 44 years old. Infant mortality is an important indicator of the overall health of a community. In 2012, eight infants died for every 1,000 live births in Montgomery County. The Black infant mortality rate was over 2 times higher than the White infant mortality rate. Actions that can change the negative birth outcomes of our infants can take place before conception, during pregnancy, and after the infant’s birth.

Built EnvironmentAmong the bike paths, hiking trails, and parks within Montgomery County, residents have multiple outdoor physical activity options. Almost a third of the population has low access to a grocery store, and more than half of the low income population has low access to a grocery store. There are federal, state, and local programs that are available to assist families who are unable to afford or have insufficient access to food.

Access to CareAccessing medical and dental care remains a challenge for many residents of Montgomery County. Due to a lack of insurance, cost prohibits some adults from visiting a doctor. Many adults and children have unmet dental needs that could lead to serious health problems if left untreated.

key community health indicators

Birth Outcomes

Mortality

Indicator Montgomery County Ohio

Life Expectancy (2011-2012) 76.7 years 77.4 years

Infant Mortality Rate (2012) 8.0 per 1,000 births 7.6 per 1,000 births

Fetal Mortality Rate (2011-2012) 8.0 per 1,000 births and fetal deaths

6.6 per 1,000 births and fetal deaths

Drug Overdose Death Rate (2011) 24.9 per 100,000 16.6 per 100,000

Leading Causes of Death

2011-2012

Rate per 100,000

Cancer 188.8 187.0

Heart Disease 174.1 193.1

Accidents 61.1 46.7

Chronic Lower Respiratory Disease 51.8 52.5

Alzheimer's Disease 38.3 28.5 Cancer

Indicator

Montgomery County Ohio

2010-2011

Rate per 100,000

All Sites/Types 441.4 448.0

Breast (female) 123.9 117.7

Prostate 111.6 123.5

Lung and Bronchus 75.8 69.5 Health Risks


Met Aerobic Recommendations (2011 & 2013) 43.1% 44.4%

Overweight (2011-2013) 35.9% 35.4%

Obese (2011-2013) 30.8% 30.0%

Food Insecurity (2012) 18.0% 17.2%

Current Smoker (2011-2013) 22.7% 23.3% Access to Care


Percent Uninsured (2012) 12.7% 11.5%

Could not see a doctor because of cost (2011-2013) 17.1% 14.5%

Have not seen the dentist in 5 or more years (2012) 14.7% 11.9%


2012

Low Birth Weight ( < 2500g) 9.7% 8.5%

Women Who Smoked During Pregnancy 13.1% 13.7%

Preterm Births (< 37 weeks gestation) 14.0% 12.3%

Based on the population health data presented in this assessment and the documented disparities in health status among racial groups, Public Health - Dayton & Montgomery County offers the following crucial calls to action.

1. We challenge Montgomery County adults to serve daily as role models for healthy lifestyles. Serving as a role model is a duty incumbent on all adults, but particularly on parents and individuals in positions of leadership.

2. We challenge all individuals to adopt a healthy diet; exercise more; avoid tobacco, alcohol, drugs, and unsafe sexual practices; and serve as mentors to help the next generation do the same. We must make significant improvements in our collective behaviors and lifestyle choices because they are directly related to our health outcomes.

3. We urge all individuals to establish a relationship with a primary care provider. We believe this linkage is essential to early disease detection and treatment.

4. We encourage local public health system partners to continue promoting health equity to eliminate disparities in health outcomes.

5. We challenge local public health system partners to explore policy, systems, and environmental changes to prevent chronic disease development.

Calls to Action

ction hanges hings

AC T

Your health is determined not only by your own genetics and personal choices, but also by the environment around you. We all strive to live long, healthy lives and where we live, work and play affects our health. If you care about your health, the quality of your life, and the health and lives of others, then you should take the time to look through the Community Health Assessment 2014.

Jim Gross, MPHMontgomery County Health Commissioner

Our mission is to lead and innovate by working with our community to achieve the goals of public health: prevention, promotion, and protection.

Our Mission

Our vision is to be an innovative leader in achieving the highest possible health and well-being for Dayton and Montgomery County residents and visitors. To that end, we provide vital, cost-effective and culturally competent health services that protect and promote people’s health and support and create healthy environments and communities.

Through our services, we:

• Prevent the spread of disease • Protect against health threats in air, food and water • Promote healthy behaviors • Reach out to vulnerable populations, linking or providing direct services • Mobilize community action through partnerships • Prepare for and respond to public health emergencies • Serve as a public health information resource

Our Vision

This report was produced byPublic Health - Dayton & Montgomery County

Reibold Building • 117 South Main Street Dayton, OH 45422-1280.

For more information, call (937) 225-5700.To download or view the complete report online,

visit www.phdmc.org. Search for: Community Health Assessment 2014

November 2014

montgomery county, ohio - phdmc

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