umatilla-morrow-union counties community health partnership child final report.pdfforeword . on...
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Umatilla-Morrow-Union CountiesCommunity Health Partnership
WorkingTogether fora Healthier Tomorrow
Umatilla-Morrow-Union Counties Children's Health Assessment Report 2016
FOREWORD On behalf of Umatilla, Morrow, and Union counties, we are pleased to present the 2016 Children Health Assessment. The data collected is the result of the strong commitment from community partners from across each county who believe that by working together with the residents of our communities we can bring about a healthier tomorrow. Umatilla, Morrow, and Union counties have strong partnerships like the Blue Mountain Early Learning Hub that are working to assure that children in our counties get the best possible start in life, that their families are able to support the health and well-being of their children, and that children enter school ready to learn and succeed throughout their lives. The Hospital Council of Northwest Ohio (HCNO) and public health researchers at The University of Toledo, who have conducted assessments for counties in Ohio for a number of years, were our collaborating partners and evaluated the surveys provided. The quality of their work has drawn the attention of the American Hospital Association, the Association of Community Health Institute and the Center for Disease Control. They have worked with us since 2011 when they conducted the first health assessment for Umatilla County. They are now helping with assessments for northeast Oregon (Umatilla, Morrow, and Union counties). Additional efforts have been made to reach out to the Hispanic population. This data was collected through online surveys that were publicized through local media, as well as by partners including Yellowhawk Tribal Health Center, Good Shepherd Health System, Oregon Child Development Coalition, Stanfield School District, Umatilla School District, and Center for Human Development. Thanks to their hard work, we are able to have a more concise view of the health of all residents in Umatilla, Morrow, and Union counties. Every effort has been made to assure that this report contains valid and reliable data. We recognize there is always room for improvement, however we believe this health assessment provides a clear, and comprehensive view of children’s health status. It can serve as a strategic planning source for organizations and individuals who are striving to improve the health of the residents of Umatilla, Morrow, and Union counties. Although some comparisons can be made related to other assessments, we are urged by the researchers to be cautious in comparing other assessment reports that do not hold to the same assessment process. This report provides us with a comprehensive picture of our counties, as well as our state and nation and in turn helps us identify our community’s unmet needs. This is only the first step. The Partnership will then prioritize these needs and work collaboratively in the development and implementation of a strategic plan to support quality programs that will improve the lives of children in Umatilla, Morrow, and Union counties. Sincerely,
Umatilla, Morrow, and Union Community Partners
This report has been funded and commissioned by:
Blue Mountain Early Learning Hub
Center for Human Development, Inc.
Greater Oregon Behavioral Health Inc.
InterMountain Educational Service District
Morrow County Health Department
Oregon Community Foundation Grant
Oregon Child Development Coalition (OCDC)
Umatilla County Public Health
The 2016 Umatilla/Union/Morrow County Children Health Assessment is available on the Hospital Council of Northwest Ohio’s website:
http://www.hcno.org/community/reports.html
Contact Information
Sarah Williams, RN, BAN Health Promotion & Prevention
Supervisor Umatilla County Health
200 SE 3rd Street Pendleton OR 97801
(541) 278-5432 [email protected]
Carrie Brogoitti, MPH Public Health Administrator
Center for Health Development, Inc.
2301 Cove Ave. La Grande, OR 97850
(541) 962-8800 [email protected]
Sheree Smith, RN Public Health Administrator
Morrow County Public Health 120 S. Main Street
PO Box 799 Heppner, OR 97836
(541) 676-5421 [email protected]
AC
KNO
WLED
GEM
ENTS
Project Management, Secondary Data, Data Collection, and Report Development
Hospital Council of Northwest Ohio Britney L. Ward, MPH Director of Community Health Improvement
Margaret Wielinski, MPH Assistant Director of Community Health Improvement
Selena Coley, MPH Community Health Improvement Coordinator
Emily Golias, MPH, CHES Community Health Improvement Coordinator
Tessa Elliott, MPH, CHES Community Health Improvement Coordinator
Emily Stearns, MPH, CHES Community Health Improvement Coordinator
Ellie Roselle Graduate Assistant
Derick Sekyere, MPH Graduate Assistant
Data Collection & Analysis
James H. Price, Ph.D., MPH Emeritus Professor of Health Education University of Toledo
Joseph A. Dake, Ph.D., MPH Professor and Chair of Health Education University of Toledo
Timothy R. Jordan, Ph.D., M.Ed. Professor of Health Education University of Toledo
TABLE OF CONTENTS
EXECUTIVE SUMMARY PAGES 5-7
TREND SUMMARY PAGE 8
Child Health (Ages 0-11)
HEALTH AND FUNCTIONAL STATUS PAGES 9-13
HEALTH INSURANCE, ACCESS, UTILIZATION, AND MEDICAL HOME PAGES 14-17
EARLY CHILDHOOD (0-5 YEARS) PAGES 18-21
MIDDLE CHILDHOOD (6-11 YEARS) PAGES 22-23
FAMILY FUNCTIONING, NEIGHBORHOOD & COMMUNITY CHARACTERISTICS PAGES 24-28
PARENT HEALTH PAGES 29-30
Appendices
HEALTH ASSESSMENT INFORMATION SOURCES APPENDIX I PAGE 31
LIST OF ACRONYMS AND TERMS APPENDIX II PAGES 32
DEMOGRAPHICS AND HOUSEHOLD INFORMATION APPENDIX III PAGES 33-38
5
EXECUTIV
E SUMM
ARY
EXECUTIVE SUMMARY
This executive summary provides an overview of health-related data for children (ages 0-11) in Umatilla, Morrow, and Union county, Oregon who participated in a three county regional health assessment survey during January 2016 through May 2016. The findings are based on self-administered surveys using a structured questionnaire. The questions were modeled after the survey instruments used by the Centers for Disease Control and Prevention for their national and state Behavioral Risk Factor Surveillance System (BRFSS) and the National Survey of Children’s Health (NSCH) developed by the Child and Adolescent Health Measurement Initiative. The Hospital Council of Northwest Ohio collected the data, guided the health assessment process and integrated sources of primary and secondary data into the final report.
Primary Data Collection Methods
DESIGN
This community health assessment was cross-sectional in nature and included a written
survey of parents within Umatilla, Morrow, and Union county, Oregon. From the beginning, community leaders were actively engaged in the planning process and helped define the content, scope, and sequence of the study. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid needs assessment.
INSTRUMENT DEVELOPMENT
One survey instrument was designed and pilot tested for this study for parents of children ages 0-11. As a first step in the design process, health education researchers from the University of Toledo and staff members from the Hospital Council of NW Ohio met to discuss potential sources of valid and reliable survey items that would be appropriate for assessing the health status and health needs of children ages 0-11 years old. The majority of the survey items for the parents of children 0-11 were derived from the NSCH. This decision was based on being able to compare local data with state and national data.
The Project Coordinator from the Hospital Council of NW Ohio conducted a series of
meetings with the planning committee from Umatilla, Morrow, and Union county. During these meetings, banks of potential survey questions from the BRFSS and NSCH surveys were reviewed and discussed. Based on input from the Umatilla, Morrow, and Union county planning committee, the Project Coordinator composed drafts of surveys containing 78 items for the 0-11 survey. The drafts were reviewed and approved by health education researchers at the University of Toledo.
SAMPLING | 0-11 Survey Children ages 0-11 residing in Umatilla, Morrow, and Union counties were the sampling frames for the surveys. Using U.S. Census Bureau data, it was determined that 19,425 children ages 0-11 reside in Umatilla, Morrow, and Union counties. The investigators conducted a power analysis based on a post-hoc distribution of variation in responses (70/30 split) to determine what sample size was needed to ensure a 95% confidence level with corresponding confidence interval of 5% (i.e., we can be 95% sure that the “true” population responses are within a 5% margin of error). Because many of the items were identical between the 0-5 and 6-11 surveys, the responses were combined to analyze data for children 0-11. The sample size required to generalize to children ages 0-11 was 377. The random sample of mailing addresses of parents of children 0-11 from Umatilla, Morrow, and Union counties were obtained from Allegra Marketing Services in Louisville, KY.
6
MAIL PROCEDURE | Children 0-5 and 6-11
Prior to mailing the survey to parents of 0-11 year olds, an advance letter was mailed to 2,400 parents in Umatilla, Morrow, and Union counties. This advance letter was personalized and printed on county specific stationery. Umatilla County Public Health stationary was used for the letters and they were signed by George Murdock, Chair of the Board of Commissioners of Umatilla County and Meghan DeBolt, Director of the Umatilla County Public Health. Morrow County’s letters were on Morrow County Court stationary and signed by County Judge, Terry Tallman and Public Health Director of the Morrow County Health Department, Sheree Smith. The letters for Union County were on the Center for Human Development, Inc.’s stationary and signed by Carrie Brogoitti, Public Health Administrator. The letter introduced the county health assessment project and informed the readers that they may be randomly selected to receive the survey. The letter also explained that the respondents’ confidentiality would be protected and encouraged the readers to complete and return the survey promptly if they were selected. Three weeks following the advance letter, a three-wave mailing procedure was implemented to maximize the survey return rate. The initial mailing included a personalized hand signed cover letter for each county describing the purpose of the study; a questionnaire printed on colored paper; a self-addressed stamped return envelope; and a $2 incentive. Approximately three weeks after the first mailing, a second wave mailing included another personalized cover letter encouraging them to reply, another copy of the questionnaire on colored paper, and another reply envelope. A third wave postcard was sent three weeks after the second wave mailing. Surveys returned as undeliverable were not replaced with another potential respondent. The response rate for the mailed survey was 20% (n=389: CI=± 4.92). ONLINE SURVEY PROCEDURE | Children 0-5 and 6-11
An electronic version of the survey was created on Survey Monkey for distribution of the
survey to schools at parent teacher conferences and other events. There were 134 total responses from this method. These responses were added to the mailed survey responses for a total analysis. DATA ANALYSIS
Individual responses were anonymous and confidential. Only group data are available. All data was analyzed by health education researchers at the University of Toledo using SPSS 17.0. Crosstabs were used to calculate descriptive statistics for the data presented in this report.
LIMITATIONS
As with all county assessments, it is important to consider the findings in light of all possible limitations. First, the Umatilla, Morrow, and Union counties child assessment had a high response rate. However, if any important differences existed between the respondents and the non-respondents regarding the questions asked, this would represent a threat to the external validity of the results (the generalizability of the results to the population of Umatilla, Morrow, and Union counties). If there were little to no differences between respondents and non-respondents, then this would not be a limitation.
Second, it is important to note that, although several questions were asked using the same
wording as the NSCH questionnaire, the parent data collection method differed. NSCH child data were collected using a set of questions from the total question bank and parents were asked the questions over the telephone rather than as a mail survey.
Finally, this survey asked parents questions regarding their young children. Should enough
parents feel compelled to respond in a socially desirable manner which is not consistent with reality, this would represent a threat to the internal validity of the results.
7
EXECUTIV
E SUMM
ARY
Data Summary
CHILD HEALTH AND FUNCTIONAL STATUS In 2016, 19% of children were classified as obese by Body Mass Index (BMI) calculations. 76% of Umatilla, Morrow, and Union county parents had taken their child ages 0-11 to the dentist in the past year. 8% of Umatilla, Morrow, and Union county parents reported their child ages 0-11 had been diagnosed with asthma. 5% of parents reported their child had been diagnosed with ADD/ADHD. CHILD HEALTH INSURANCE, ACCESS & UTILIZATION In 2016, 2% of Umatilla, Morrow, and Union county parents reported their 0-11 year old did not have health insurance. 29% of parents reported they had taken their child to the hospital emergency room in the past year. 76% of parents had taken their child to the doctor for preventive care in the past year. EARLY CHILDHOOD (0-5 YEARS OLD) The following information was reported by parents of 0-5 year olds. 87% of mothers got prenatal care within the first three months during their last pregnancy. 4% of mothers smoked during their last pregnancy. 10% of mothers never breastfed their child. 17% of mothers experienced depression during or after pregnancy. MIDDLE CHILDHOOD (6-11 YEARS OLD) The following information was reported by Umatilla, Morrow, and Union county parents of 6-11 year olds. In 2016, 67% of Umatilla, Morrow, and Union county parents reported their child always feels safe at school. 48% of parents reported their child was bullied at some time in the past year. 79% of parents reported their child participated in extracurricular activities. 21% of parents reported their child had an email or a social network account. FAMILY FUNCTIONING, NEIGHBORHOOD AND COMMUNITY CHARACTERISTICS In 2016, Umatilla, Morrow, and Union county parents reported their 0-11 year old child slept an average of 10.1 hours per night. 49% of parents reported that every family member who lived in their household ate a meal together every day of the week. 74% of parents reported their child always rode in a car seat when a passenger in a car. 13% of parents reported they received benefits from the SNAP/food stamps program. 78% of Umatilla, Morrow, and Union county parents reported no one is allowed to smoke inside their home at any time. PARENT HEALTH In 2016, 11% of Umatilla, Morrow, and Union county parents were uninsured. 35% of parents were overweight and 32% were obese. 70% of parents rated their health as excellent or very good, decreasing to 44% of parents with incomes less than $25,000.
8
Child І TREND SUMMARY
Child Comparisons
Umatilla/ Morrow/
Union Counties
2016 0-5
Years
Oregon 2011/12
0-5 Years
U.S. 2011/12
0-5 Years
Umatilla/ Morrow/
Union Counties
2016 0-5
Years
Oregon 2011/12
6-11 Years
U.S. 2011/12
6-11 Years
Health and Functional Status
Rated health as excellent or very good 93% 87% 86% 85% 80% 83%
Dental care visit in past year 60% 52% 54% 87% 89% 88% Diagnosed with asthma 3% 4% 6% 10% 8% 10%
Diagnosed with ADHD/ADD 3% N/A 2%* 7% 8% 9%
Diagnosed with behavioral or conduct problems 0% N/A 2%* 5% 8% 4%
Diagnosed with vision problems that cannot be corrected 2% N/A <1% 5% N/A 2%
Diagnosed with bone, joint, or muscle problems 0% N/A 1% 5% N/A 2%
Diagnosed with epilepsy 0% N/A <1% <1% N/A 1% Diagnosed with a head injury 2% N/A <1% 4% N/A <1%
Diagnosed with diabetes 0% N/A N/A <1% N/A <1% Diagnosed with depression 1% N/A <1%* 4% 3% 2%
Health Insurance, Access, Utilization and Medical Home
Been to doctor for preventive care in past year 84% 87% 90% 75% 76% 82%
Family Functioning Never breastfed their child 10% 8% 21% N/A N/A N/A
Child did not miss any days of school because of illness or injury N/A N/A N/A 22% 20% 23%
Child missed school 11 days or more because of illness or injury N/A N/A N/A 6% 8% 6%
Parent felt child was usually/always safe at school N/A N/A N/A 94% 96% 94%
Family eats a meal together every day of the week 59% 65% 61% 45% 52% 47%
Parent Health
Mother’s mental or emotional health is fair/poor 8% 6% 7% 8% 9% 8%
Father’s mental or emotional health is fair/poor 8% 6% 3% 1% 12% 5%
N/A – Not available *2007 National Survey of Children’s Health The Oregon and U.S. comparisons are from the National Survey of Children’s Health.
9
HEALTH &
FUNC
TION
AL STA
TUS Child І HEALTH & FUNCTIONAL STATUS
Key Findings
In 2016, 19% of children were classified as obese by Body Mass Index (BMI) calculations. 76% of Umatilla, Morrow, and Union county parents had taken their child ages 0-11 to the dentist in the past year. 8% of Umatilla, Morrow, and Union county parents reported their child ages 0-11 had been diagnosed with asthma. 5% of parents reported their child had been diagnosed with ADD/ADHD.
Health of Children Ages 0-11 In 2016, over four-fifths (85%) of Umatilla, Morrow, and Union county parents of 0-11 year olds
rated their child’s health as excellent or very good. 1% of parents rated their child’s health as fair or poor.
About one-fifth (19%) of children were classified as obese by Body Mass Index (BMI) calculations. 14% of children were classified as overweight, 58% were normal weight, and 9% were underweight.
8% of Umatilla, Morrow, and Union county parents reported their child ages 0-11 had been
diagnosed with asthma. Of those children with asthma, 6% of parents reported that asthma caused their child severe health difficulties. An additional 28% suffered moderate difficulties due to asthma.
Umatilla, Morrow, and Union county children ate the following for breakfast: cereal (65%), milk
(59%), toast (38%), eggs (37%), yogurt (35%), fruit/fruit juice (32%), oatmeal (26%), bacon/ham/sausage (21%), Pop Tart/donut/pastry (11%), pizza (1%), and other (11%). 18% of children ate at the school breakfast program. 1% of parents reported their child did not usually eat anything for breakfast.
62% of Umatilla, Morrow, and Union county children ate fruit at least once per day in the past week. Over half (59%) of Umatilla, Morrow, and Union county children ate vegetables at least once per day in the past week.
76% of children had been to the dentist in the past year, increasing to 87% of 6-11 year olds.
Almost two-fifths (38%) of parents reported problems with their child’s teeth. The top problems
were: cavities (23%), crooked teeth/teeth that need braces (11%), hygiene (5%), and family history of dental problems (5%).
Of those children who had not been to the dentist in the past year, parents gave the following reasons for not getting dental care for their child: child was not old enough to go to the dentist (35%), inconvenient times/could not get an appointment (7%), no insurance (5%), cost (4%), did not know where to go for treatment (3%), no referral (3%), child refused to go (2%), treatment was ongoing (2%), dentist would not see child yet because of their age (2%), child has a disability and could not find a place that accepts them (2%), not available in area/transportation problems (2%), could not find a dentist who accepted their insurance (1%), health plan problems (1%), dentist did not know how to provide treatment (1%), and other (24%). No one reported they missed an appointment and was not allowed to go back to clinic or dissatisfaction with dentist.
National Survey of Children’s Health 2011/12
4% of Oregon children ages 0-5 were diagnosed with asthma, increasing to 8% of 6-11 year olds.
8% of Oregon children ages 6-11 were diagnosed with ADD/ADHD.
(Source: National Survey of Children’s Health,
2011/12, http://nschdata.org)
10
Parents reported their child had the following allergies: Pollen (9%) Mold (2%) Soy (1%) Grasses (8%) Wheat (2%) Red dye (1%) Peanuts (5%) Gluten (2%) Strawberries (<1%) Cats (5%) House dust mites (1%) Shellfish (<1%) Milk (5%) Bees (1%) Fish (<1%) Ragweed (4%) Eggs (1%) Watermelon (<1%) Dogs (3%) Fungi (1%) Other (7%) Horses (2%) Tree nuts (1%)
1% of children had an epi-pen for their allergy.
Umatilla, Morrow, and Union county children ages 0-11 years old had the following health
conditions:
7% of parents reported their child had been tested for lead poisoning, and the results were
within normal limits. <1% reported the levels were elevated and medical follow-up was needed. 78% of parents had not had their child tested for lead poisoning and 7% of parents did not know if their child had been tested for lead.
Almost one in five (19%) of Umatilla, Morrow, and Union county children ages 0-11 had difficulties in at least one of the following areas: emotions (11%), concentration (11%), behavior (5%), and being able to get along with people (2%).
6% of Umatilla, Morrow, and Union county children ages 0-11 had emotional, developmental,
or behavioral problems for which they needed treatment or counseling.
Umatilla, Morrow, and Union county children spent an average of 1.84 hours watching TV, 1.33 hours reading, 0.84 hours on the computer, and 0.84 hours playing video games on an average day of the week.
Dental problems (12%) Pneumonia (3%) Asthma (8%) Head injury (3%) Speech and language problems (7%) Autism (2%) Hearing problems (6%) Digestive tract infections (1%) ADD/ADHD (5%) Urinary tract infection (5%)
Intellectual disability/ mental retardation (1%)
Anxiety problems (4%) Other life threatening illness (1%) Learning disability (4%) Appendicitis (1%) Vision problems that cannot be
corrected with glasses (4%) Birth defect (1%) Cerebral palsy (<1%)
Behavioral/conduct problems (3%) Bone/joint/muscle problems (3%)
Genetic disease (<1%) Cancer (<1%)
Developmental delay or physical impairment (3%)
Diabetes (<1%) Epilepsy (<1%)
Depression problems (3%)
11
HEALTH &
FUNC
TION
AL STA
TUS Umatilla, Morrow, and Union county parents reported they were concerned a lot with the
following issues with their child: having enough time with their child (13%), their child’s self-esteem (8%), their relationship with their child (7%), how their child copes with stressful things (7%), cell phone and technology use (7%), internet use (6%), their child’s anxiety (5%), learning difficulties with their child (4%), their child being bullied by their classmates(4%), their child’s depression (2%), their child talking (2%), their child walking or running (2%), eating disorders (2%), their child getting along with others (3%), violence in the home, school or neighborhood (1%), risky behaviors (1%), and substance abuse (<1%). No parents reported they were concerned a lot with their child’s academic achievement.
N/A – Not available ** - Ages 2-5
Child Comparisons
Umatilla/ Morrow/
Union Counties
2016 Ages 0-5
Oregon 2011/12
Ages 0-5
U.S. 2011/12
Ages 0-5
Umatilla/ Morrow/
Union Counties
2016 Ages 6-11
Oregon 2011/12
Ages 6-11
U.S. 2011/12
Ages 6-11
Rated health as excellent or very good 93% 87% 86% 85% 80% 83%
Dental care visit in past year 60% 52% 54% 87% 89% 88% Diagnosed with asthma 3% 4% 6% 10% 8% 10%
Diagnosed with ADHD/ADD 3% N/A 2%** 7% 8% 9% Diagnosed with behavioral or
conduct problems 0% N/A 2%** 5% 8% 4%
Diagnosed with vision problems that cannot be corrected 2% N/A <1% 5% N/A 2%
Diagnosed with bone, joint, or muscle problems 0% N/A 1% 5% N/A 2%
Diagnosed with epilepsy 0% N/A <1% <1% N/A 1% Diagnosed with a head injury 2% N/A <1% 4% N/A <1%
Diagnosed with diabetes 0% N/A N/A <1% N/A <1% Diagnosed with depression 1% N/A <1%* 4% 3% 2%
12
Asthma The following graph shows that Umatilla, Morrow, and Union County has a lower percentage of children ages 0-5 who are diagnosed with asthma than both Oregon and the U.S. However, the percentage of children ages 6-11 with asthma surpassed Oregon and was equal to the U.S. percentage.
0%
5%
10%
15%
20%
25%
30%
Ages 0-5 Ages 6-11
3%
10%
4%
8% 6%
10%
Children Diagnosed with Asthma
Umatilla/Morrow/Union 2016 Oregon 2011/12 U.S. 2011/12
Attention-Deficit / Hyperactivity Disorder (ADHD)
5% of school-aged children have ADHD. However, studies have estimated higher rates in community samples.
Parents report that approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with ADHD as of 2011.
Rates of ADHD diagnosis increased an average of 3% per year from 1997 to 2006 and an average of 5% per year from 2003 to 2007.
Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with ADHD.
Rates of ADHD diagnosis increased at a greater rate among older teens as compared to younger children.
The average age of ADHD diagnosis was 7 years of age, but children reported by their parents as having more severe ADHD were diagnosed earlier.
The highest rates of parent-reported ADHD diagnosis were noted among children covered by Medicaid and multiracial children.
(Source: CDC, Attention-Deficit / Hyperactivity Disorder (ADHD), 5/4/2016, from: http://www.cdc.gov/ncbddd/adhd/data.html)
13
HEALTH &
FUNC
TION
AL STA
TUS Promoting Healthy Weight and Development in Early Childhood
• Many children are already overweight at a very young age. Nearly 15 percent of children aged 2-5 years who participate in the Women, Infants and Children Program in Oregon, are obese.
• Children who are overweight or obese are at risk of becoming overweight or obese adults.
• Being overweight or obese increases the risk for chronic diseases, including coronary
heart disease, stroke, diabetes and some cancers, as well as decreasing social and emotional wellbeing and increasing the risk for depression.
• Today’s children are projected to have shorter life expectancies than their parents or
grandparents due to overweight and obesity.
What Influences Childhood Obesity?
Obesity is a complex health issue, influenced by our genes, the social and physical environment, in which we live, work, learn and play, and early life influences during the critical periods of preconception, pregnancy and early childhood.
What Supports Healthy Weight and Development in Childhood?
Obesity prevention must start very early in life, even during preconception, using a lifecourse approach. Factors that support healthy weight and development in childhood and prevent obesity:
Not using tobacco during pregnancy
Control of diabetes during pregnancy
A healthy pre-pregnancy weight Healthy weight gain during
pregnancy Healthy birth weight (not too low
and not too high) Breastfeeding Appropriate introduction of foods
complementary to breastfeeding Parenting and feeding practices
that promote healthy behaviors
Healthy diet, including a variety of fruits, vegetables and no sugar-sweetened beverages
Sufficient sleep Daily physical activity, including
active play Limited or no screen time Health-promoting practices in
places where children spend time, such as early child care and education
(Source: OHA, Promoting Healthy Weight and Development in Early Childhood)
14
National Survey of Children’s Health 2011/12
5% of 0-5 year old and 3% of 6-11 year old Oregon children were without insurance at some time in the past year.
43% of 0-5 year old and 37% of 6-11 year old Oregon children had public insurance.
88% of 0-5 year old and 76% of 6-11 year old Oregon children had been to the doctor for preventive care in the past year.
(Source: National Survey of Children’s Health, 2011/12 http://nschdata.org)
Child І HEALTH INSURANCE, ACCESS, UTILIZATION AND MEDICAL HOME
Key Findings
In 2016, 2% of Umatilla, Morrow, and Union county parents reported their 0-11 year old did not have health insurance. About three-quarters (76%) of parents had taken their child to the doctor for preventive care in the past year. Health Insurance
2% of parents reported that their child did not
have health insurance, and 5% reported their child was not covered by any health insurance within the past year.
Umatilla, Morrow, and Union county children had the following types of health insurance: the parent who filled out the survey’s employer (52%), Medicaid, OHP or State Children’s Health Insurance Program (S-CHIP) (21%), someone else’s employer (11%), multiple-including private sources (6%), multiple-including government sources (4%), self-paid (3%), military, CHAMPUS, TriCare, CHAMPVA or the VA (1%), Insurance Marketplace (1%), Medicare (<1%), or some other source of insurance (<1%).
Parents reported their child’s health insurance covered the following: doctor visits (98%), well visits (97%), prescription coverage (96%), immunizations (96%), dental (95%), hospital stays (93%), vision (87%), mental health (76%), and therapies (58%).
12% of parents reported they had problems paying or were unable to pay for any of their
child’s medical bills.
More than one-third (37%) of Umatilla, Morrow, and Union counties children have ever been enrolled in OHP/Medicaid. Of those who had been enrolled in OHP/Medicaid, 56% were enrolled in the past year.
Employer 52%
Medicaid 21%
Someone Else's Employer
11%
Multiple-Private Sources
6% Multiple-
Govt. Sources
4% Self-Purchased
3% Military 1%
Health Insurance
Marketplace 1%
Medicare <1%
Other <1%
Source of Health Coverage for Umatilla, Morrow, and Union Counties Children
15
CHILD
HEALTH IN
SURAN
CE
The following chart shows what is included in Umatilla, Morrow, and Union county children’s insurance coverage.
Access and Utilization 9% of parents reported their child did not get all of the prescription medications they needed
in the past year. Of those whose child did not get all of the needed prescription medications, they gave the following reasons: their child did not need prescription medication (71%), cost (22%), no insurance (7%), health plan problem (7%), no referral (5%), dissatisfaction with doctor (2%), or specialist was not available (2%). No one reported they could not find a doctor to accept child’s insurance, transportation problems, they could not get an appointment, religious preference, ongoing treatment, doctor did not know how to treat or provide care or did not know where to go for treatment.
Parents reported the following reasons their child did not get all of the mental health or addiction care they needed in the past year: no referral (30%), treatment is ongoing (10%), deductibles/copays were too high (6%), did not like doctor (6%), did not know where to go for treatment (5%), not available in area/transportation problems (5%), could not find a doctor who accepted child’s insurance (5%), cost (4%), care was not timely (4%), doctor did not know how to treat or provide care (4%), inconvenient times/could not get an appointment (3%), child refused to go (3%), no insurance (1%), language barriers (1%), and other reasons (11%).
10% of Umatilla, Morrow, and Union county children received mental health care or counseling in the past year, increasing to 21% of those with incomes less than $25,000.
Over one-quarter (29%) of parents took their child to the hospital emergency room for health care in the past year, increasing to 36% of parents with incomes less than $25,000.
44% of children had a seasonal flu vaccine (65% received a shot and 35% received nasal
spray).
Health Coverage Includes: Yes No Don’t Know
Doctor visits 98% 1% <1%
Well child visits 97% 1% 2%
Prescriptions 96% 2% 2%
Immunizations 96% 2% 2%
Dental 95% 4% 1%
Hospital stays 93% 3% 4%
Vision 87% 8% 5%
Mental Health 76% 4% 20%
Therapies 58% 5% 37%
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Reasons for Emergency Visit
None One visits Two visits Three or more visits
Fever/cold/flu 89% 8% 2% 1% Accidents, injury or poisonings 90% 8% 1% <1% Other sick visits 91% 7% 1% 1% Ear infections 93% 6% <1% <1% Dental issue 96% 3% 1% <1% Doctor’s office told parent to go 97% 2% 1% 0% Broken bones 98% 1% 0% <1% Asthma 98% 1% 1% <1% Mental health 99% <1% 0% <1%
Medical Home
79% of parents reported they had one or more people they think of as their child’s personal
doctor or nurse, decreasing to 13% of those with incomes less than $25,000.
76% of children had visited their health care provider for preventive care in the past year, increasing to 84% of 0-5 year olds.
98% of Umatilla, Morrow, and Union county parents reported that their child had one particular place they usually went if they were sick or needed advice about their health. They reported the following places: a private doctor’s office (60%), an urgent care center (11%), Family Medicine (11%), Mirasol Family Health Center (3%), Columbia River Community Health Services (3%), a hospital emergency room (1%), Tribal Health Center (1%), health department (<1%), and some other kind of place (9%).
68% of parents reported that their child’s personal doctor or nurse always explained things in a
way that they and their child could understand.
More than three-quarter (77%) of parents called their child’s personal doctor or nurse for help or advice about their child’s health. Of those parents who called, 45% of parents indicated that they were always able to get the help or advice they needed when they called their child’s personal doctor or nurse for advice. 3% were never able to get the help or advice they needed.
One in 9 (11%) of Umatilla, Morrow, and Union county parents reported that they received a
home visit from a nurse, healthcare worker, social worker or other professional to help them prepare for a new baby or take care of the baby or mother, either during the pregnancy or until present.
Child Comparisons
Umatilla/ Morrow/
Union Counties
2016 Ages 0-5
Oregon 2011/12
Ages 0-5
U.S. 2011/12
Ages 0-5
Umatilla/ Morrow/
Union Counties
2016 Ages 6-11
Oregon 2011/12
Ages 6-11
U.S. 2011/12
Ages 6-11
Been to doctor for preventive care in past year 84% 87% 90% 75% 76% 82%
17
CHILD
HEALTH IN
SURAN
CE
Uninsured Children, Ages 0-18, Percent by County, Small Area Health Insurance Estimates, 2013
(Source: Small Area Health Insurance Estimates, 2013, as compiled by Community Commons)
18
Child І EARLY CHILDHOOD (0-5 YEAR OLDS)
Key Findings
The following information was reported by parents of 0-5 year olds. 87% of mothers got prenatal care within the first three months during their last pregnancy. 4% of mothers smoked during their last pregnancy.
Early Childhood The following information was reported by Umatilla, Morrow, and Union county parents of 0-5
year olds.
During their last pregnancy, mothers did the following: got prenatal care within the first 3 months (87%), took a multi-vitamin (83%), received a dental exam during pregnancy (56%), took folic acid during pregnancy (54%), took folic acid pre-pregnancy (43%), received WIC services (35%), experienced depression during or after pregnancy (17%), smoked cigarettes (4%), received services at a pregnancy resource/crisis intervention center (2%), used alcohol (1%), used marijuana (1%), experienced domestic violence (1%), used other tobacco products (1%), had an abortion (1%).
Mothers breastfed their child: more than 9 months (36%), 4 to 9 months (20%), 7 weeks to 3
months (14%), 3 to 6 weeks (8%), 2 weeks or less (6%), still breastfeeding (6%), and never breastfed (10%).
Parents reported the following reasons for not breastfeeding their child for more than 1 year:
did not produce enough milk (50%), did not want to (11%), did not have workplace support (7%), inconvenient (7%), medical issue with baby (4%), did not have time (3%), did not have adequate support (2%), did not have adequate education (1%), and other reasons (32%).
Children 0-5 years old were more likely than children 6-11 years old to:
Have visited a doctor for preventive care in the past year (84% compared to 75% of 6-11). Have health rated as excellent or very good (93% compared to 85% of 6-11).
Child Comparisons
Umatilla/ Morrow/
Union Counties
2016 0-5 years
Oregon 2011/12
0-5 years
U.S. 2011/12
0-5 years
Never breastfed their child 10% 8% 21%
19
EARLY C
HILDHO
OD
0%
20%
40%
60%
80%
100%
Never Breastfed Breastfed
10%
90%
8%
92%
21%
79%
Children Breastfed
Umatilla/Morrow/Union Oregon 2011/12 U.S. 2011/12
Children Breastfed The following graph shows the percent of infants who have been breastfed or given breast milk from Umatilla, Morrow, and Union counties, Oregon, and U.S. Oregon has a larger percent of children who have been breastfed for any length of time,
compared to the U.S. and Umatilla, Morrow, and Union counties.
(Source: National Survey of Children’s Health, Data Resource Center, and 2016 Umatilla, Morrow, and Union counties
Health Assessment)
Duration of Breastfeeding The following graph shows the duration of time that mothers breastfed their child from Umatilla, Morrow, and Union counties.
More than one third of mothers breastfed their child for more than nine months.
10% of mothers never breasted their child.
9 months or more 36%
4-9 months 20%
7 weeks-3 months 14% 3-6 weeks
8%
2 weeks or less 6%
Still Breastfeeding 6%
Never breastfed 10%
Duration of Breastfeeding for Umatilla, Morrow, and Union County Children
20
0%
5%
10%
15%
20%
25%
Umatilla County Union County Morrow County Oregon
14.2% 14.2%
10.1% 10.2% 12.1%
17.7%
11.4% 10.4%
Perc
ent o
f Liv
e B
irths
Tobacco Use During Pregnancy
2013 2014
Health Effects of Smoking and Secondhand Smoke on Babies
Mothers who smoke have a higher chance of delivering a premature baby. Preterm delivery is a leading cause of death, disability, and disease among newborns.
1 in every 5 babies born to mothers who smoke during pregnancy are born with a low birth weight.
Mothers who are exposed to secondhand smoke while pregnant are also more likely to have lower birth weight babies. Babies that are born too early or are too small are not as healthy.
Babies who are exposed to secondhand smoke after birth have a higher likelihood of dying from sudden infant death syndrome (SIDS) than babies who are not exposed to secondhand smoke.
Newborns who are exposed to cigarette smoke or whose mothers smoked while pregnant have weaker lungs than other babies, which increases the risk for additional health complications.
(Source: CDC, Smoking During Pregnancy, March 16, 2016, from:
(https://www.cdc.gov/tobacco/basic_information/health_effects/pregnancy/)
Tobacco Use During Pregnancy The following graph shows the percent of mothers who smoked during pregnancy in Umatilla, Morrow, and Union counties and Oregon, according to the birth certificates.
(Source: OHA, Vital Statistics, County Data, Table 7: Reported Use of Tobacco by Mother’s Age and County of Residence, 2013 & 2014).
21
EARLY C
HILDHO
OD
Impact of Folic Acid
Folic acid is a B vitamin. Our bodies use it to make new cells. The U.S. Public Health Service and CDC recommend that all women of childbearing age
consume 0.4 mg of folic acid daily to prevent common and severe birth defects of the brain and spine.
All women between 15 and 45 years of age should consume folic acid daily because half of U.S. pregnancies are unplanned and because these birth defects occur very early in pregnancy before most women know they are pregnant.
The CDC estimates that most of these birth defects could be prevented if this recommendation were followed before and during early pregnancy.
A single serving of many breakfast cereals, for example, Raisin Bran, has the amount of folic acid that a woman needs each day.
(Source: CDC, Facts about folic acid, December 24, 2014, from: https://www.cdc.gov/ncbddd/folicacid/about.html)
0%
20%
40%
60%
80%
100%
First Trimester Prenatal Care Inadequate Prenatal Care
74.6%
7.6%
67.1%
7.4%
82.4%
5.5%
77.5%
6.0%
Timeliness of Prenatal Care, 2014
Umatilla Morrow Union Oregon
Prenatal Care The following graph shows the percent of mothers who received prenatal care in the first trimester and inadequate prenatal care from Umatilla, Morrow, and Union counties, Oregon, and U.S. Inadequate prenatal care is defined as less than five prenatal visits or prenatal care began in the third trimester. Oregon has a larger percent of children who have been breastfed for any length of time,
compared to the U.S. and Umatilla, Morrow, and Union counties.
(Source: OHA, Vital Statistics, County Data, Table 8: Prenatal Care by Mother’s County of Residence, 2014).
22
National Survey of Children’s Health 2011/12
8% of Oregon and 9% of U.S. parents of 6-11 year olds reported their child watched 4 or more hours of TV or played video games each day.
79% of Oregon and 79% of U.S. parents of 6-11 year olds reported their child participated in one or more organized activities outside of school
89% of Oregon and 86% of U.S. parents of 6-11 year olds reported they felt their child was usually or always safe at school.
(Source: National Survey of Children’s Health, 2011/12, accessed from: http://nschdata.org)
Child І MIDDLE CHILDHOOD (6-11 YEARS OLD)
Key Findings
The following information was reported by Umatilla, Morrow, and Union county parents of 6-11 year olds. In 2016, 67% of Umatilla, Morrow, and Union county parents reported their child always feels at school. 48% of parents reported their child was bullied at some time in the past year. 79% of parents reported their child participated in extracurricular activities. 21% of parents reported their child had an email or a social network account. Middle Childhood
The following information was reported by
Umatilla, Morrow, and Union county parents of 6-11 year olds.
79% of parents reported their 6-11 year old child participated in extracurricular activities in the
past year. Their child participated in the following: a sports team or sports lessons (74%), a religious group (44%), a club or organization such as Scouts (19%), Boys/Girls Club (1%), and some other organized activity (37%).
Children missed school an average of 3.9 days per year because of illness or injury.
Umatilla, Morrow, and Union county children 6-11 years old were enrolled in the following types
of schools: public (88%), private (4%), charter (4%), and home-schooled (3%). 67% of parents reported they felt their child was always safe at school. 28% reported usually,
3% reported sometimes, and 1% reported they felt their child was never safe at school.
Parents reported they did not feel their child was safe at school for the following reasons: fear of bullying (23%), afraid of other kids who show unusual behavior (12%), buildings are not secure (5%), drug/alcohol activity (5%), gangs (2%), bomb threats (1%), and other reasons (5%).
48% of parents reported their 6-11 year old child was bullied in the past year. The following types of bullying were reported: 38% were verbally bullied (teased, taunted or called harmful names) 15% were indirectly bullied (spread mean rumors about or kept out of a “group”) 14% were physically bullied (they were hit, kicked, punched or people took their
belongings) 1% were sexually bullied <1% were cyber bullied (teased, taunted or threatened by e-mail or cell phone)
3% of parents reported they did not know if their child was bullied.
23
MID
DLE C
HILDHO
OD
About one-fifth (21%) of parents of 6-11 year olds reported their child had an email, Facebook, Twitter, Instagram or other social network account. Of those who had an account, they reported the following: they had their child’s password (80%), they knew all of the people in their child’s “my friends” (51%), their child’s account was checked private (51%), and their child had a problem as a result of their account (3%). 2% of parents reported they did not know if their child had a social network account. No one reported their child’s friends had their passwords.
Parents reported their 6-11 year old child read: almost every day (81%), a few times a week (12%), a few times a month (2%), a few times a year (<1%), almost never-child cannot read (2%), and almost never-child has no interest (2%).
Parents reported in the past month, their 6-11 year old child did the following: showed interest and curiosity in learning new things (90%), finished tasks and followed through with what they said they would (71%), and stayed calm and in control when they faced a challenge (49%).
Children 6-11 years old were more likely than children 0-5 years old to:
Have been diagnosed with asthma (10% compared to 3% of 0-5). Have ADD or ADHD (7% compared to 3% of 0-5). Have been diagnosed with behavioral or conduct problems (5% compared to 0% of 0-5). Have gone to the dentist in the past year (87% compared to 60% of 0-5).
Child Comparisons
Umatilla/ Morrow/
Union Counties
2016 6-11 Years
Oregon 2011/12
6-11 Years
U.S. 2011/12
6-11 Years
Child did not miss any days of school because of illness or injury 22% 20% 23%
Child missed school 11 days or more because of illness or injury 6% 8% 6%
Parent felt child was usually/always safe at school 94% 96% 94%
24
Child І FAMILY FUNCTIONING, NEIGHBORHOOD AND COMMUNITY CHARACTERISTICS
Key Findings
13% of parents reported they received benefits from the SNAP/food stamps program. 2% of Umatilla, Morrow, and Union County parents reported their child went to bed hungry at least one day per week because they could not afford food.
Family Functioning
Umatilla, Morrow, and Union county children
slept an average of 10.1 hours per night. The average time children woke up was 6:40 a.m. and went to bed at 8:34 p.m.
2% of parents reported their child went to bed hungry at least one day per week because
they could not afford food.
49% of parents reported that every family member who lived in their household ate a meal together every day of the week. Families ate a meal together an average of 5.6 times per week.
Parents reported their child regularly attended the following: elementary school (59%), child
care outside of their home provided by a relative (26%), child care in their home provided by a relative other than a parent/guardian (25%), nursery school, pre-school, or kindergarten (20%), family-based child care outside of home (18%), child care in their home provided by a baby sitter (12%), child care center (11%), and Head Start or Early Start program (4%).
Parents reported the following forms of discipline they used for their child: take away privileges (76%), time out (58%), spanking (36%), grounding (28%), yelling (19%), wash mouth out (2%) and other method (8%). 3% of parents had not disciplined their child.
Parents missed work an average of 2.2 days per year due to their child being ill or injured, 0.9 days per year due to their child’s medical appointments, 0.7 days due unreliable child care, 0.2 days due to child’s asthma, and 0.1 days due to behavioral or emotional problems.
94% of parents reported the primary language spoken in their home was English. 5% reported
Spanish. <1% reported multiple languages were spoken in their home.
Child Comparisons
Umatilla/Morrow/
Union Counties
2016 0-5
Years
Oregon 2011/12
0-5 Years
U.S. 2011/12
0-5 Years
Umatilla/Morrow/
Union Counties
2016 6-11
Years
Oregon 2011/12
6-11 Years
U.S. 2011/12
6-11 Years
Family eats a meal together every day of the week 59% 65% 61% 45% 52% 47%
National Survey of Children’s Health 2011/12
65% of Oregon and 61% of U.S. parents of 0-5 year olds reported their family ate a meal together every night of the week.
17% of 0-5 year old and 23% of 6-11 year old Oregon children lived in a household with someone who smokes.
(Source: National Survey of Children’s Health, 2011/12)
25
FAM
ILY FUNC
TION
ING
Child Passenger Safety Facts
In the United States during 2013, more than 638 children ages 12 years and younger died as occupants in motor vehicle crashes, and approximately 127,250 were injured.
One CDC study found that, in one year, more than 618,000 children ages 0-12 rode in vehicles without the use of a child safety seat or booster seat or a seat belt at least some of the time.
More than two-thirds of fatally injured children were killed while riding with a drinking driver.
Restraint use among young children often depends upon the driver’s seat belt use. Almost 40% of children riding with unbelted drivers were themselves unrestrained.
Booster seats reduce the risk for serious injury by 45% for children ages 4 to 8 years. Child safety seats reduce the risk of death in passenger cars by 71% for infants, and by
54% for toddler’s ages 1 to 4 years. Child restraint systems are often used incorrectly. One study found that 72% of nearly
3,500 observed car and booster seats were misused in a way that could be expected to increase a child’s risk of injury during a crash.
(Sources: CDC, Injury Prevention & Control: Motor Vehicle Safety, Updated: February 8, 2016, from: http://www.cdc.gov/motorvehiclesafety/child_passenger_safety/cps-factsheet.html)
Family Dinners The following graph shows the percent of Umatilla, Morrow, and Union county families that eat a meal together every day of the week along with the percent of Oregon families and the percent of U.S. families.
U.S. families eat a meal together every day of the week more frequently than Oregon and
Umatilla, Morrow, and Union county families.
(Source: National Survey of Children’s Health & 2016 Umatilla, Morrow, and Union counties Health Assessment)
Child Safety Characteristics
74% of parents reported their child always rode in a car seat when a passenger in a car.
More than half (57%) of parents reported their child always used a booster seat. 16% of
parents reported their child was too small for a booster seat and 22% reported their child was over 4’9” and 80 pounds.
Of the children eligible by height and weight requirements, 71% always wore a seatbelt
without a booster seat and 19% seldom or rarely wore a seatbelt without a booster seat.
0%
20%
40%
60%
80%
100%
49% 50% 53%
Families that Eat Together Everyday of the Week
Umatilla/Morrow/Union 2016 Oregon 2011/12 U.S. 2011/12
26
Neighborhood and Community Characteristics
Umatilla, Morrow, and Union county parents had the following rules about smoking in their home: no one is allowed to smoke inside their home at any time (78%), smoking is not allowed when children are present (9%), smoking is allowed in some rooms only (2%), and smoking is allowed anywhere (2%).
Umatilla, Morrow, and Union county parents had the following rules about smoking in their car: no one is allowed to smoke inside their car at any time (84%), smoking is not allowed when children are present (6%), smoking is allowed as long as a window is open (1%), and smoking is allowed anywhere (1%).
In the past year, parents reported that someone in the household received the following: free
or reduced cost breakfast or lunches at school (20%), SNAP/food stamps (13%), benefits from WIC program (9%), mental health treatment (6%), Head Start/Early Head Start (3%), cash assistance from a welfare program (1%), and subsidized childcare through Job and Family Services (1%).
0%
5%
10%
15%
20%
25%
Free/ReducedMeals atSchool
SNAP WIC Benefits Mental HealthTreatment
HeadStart/EarlyHead Start
Welfare CashAssistance
SubsidizedChildcarefrom JFS
20%
13%
9% 6%
3% 1% 1%
Household Program Involvement in the Past Year
27
FAM
ILY FUNC
TION
ING
Food Insecure Children Ineligible for Assistance by SNAP-Authorized Retailers
(Sources: Feeding America: 2013 and U.S. Department of Agriculture, Food and Nutrition Service, USDA-SNAP Retailer Locator: May 2016, as compiled by Community Commons)
28
Household with Children Receiving SNAP Benefits by SNAP-Authorized Retailers
(Source: Feeding America: 2013 and U.S. Department of Agriculture, Food and Nutrition Service, USDA-SNAP Retailer Locator: May 2016, as compiled by Community Commons)
29
PAREN
T HEALTH
Child І PARENT HEALTH
Key Findings
In 2016, 11% of Umatilla, Morrow, and Union county parents were uninsured. 35% of parents were overweight and 32% were obese. Parent Health
Those filling out the survey had the
following relationship to the child: mother (66%), father (26%), grandparent (2%), aunt/uncle (<1%) and other family member (<1%).
70% of parents rated their health as excellent or very good, decreasing to 44% of parents with incomes less than $25,000. 5% of parents had rated their health as fair or poor.
70% of parents rated their mental and emotional health as excellent or very good. 5% rated their mental and emotional health as fair or poor.
8% of mothers and 8% of fathers of 0-5 year olds rated their mental and emotional health as fair or poor. 8% of mothers and 1% of fathers of 6-11 year olds rated their mental or emotional health as fair or poor.
11% of parents were uninsured.
67% of parents were either overweight (35%) or obese (32%). 32% were normal weight, and 1% were underweight.
65% of Umatilla, Morrow, and Union county parents reported they were physically active for at
least 30 minutes on 3 or more days per week. 36% had done so on 5 or more days and 16% were physically active for at least 30 minutes every day per week. 9% reported no physical activity.
Child Comparisons
Umatilla/ Morrow/
Union Counties
2016 0-5
Years
Oregon 2011/12
0-5 Years
U.S. 2011/12
0-5 Years
Umatilla/ Morrow/
Union Counties
2016 6-11
Years
Oregon 2011/12
6-11 Years
U.S. 2011/12
6-11 Years
Mother’s mental or emotional health is
fair/poor 8% 6% 7% 8% 9% 8%
Father’s mental or emotional health is
fair/poor 8% 6% 3% 1% 12% 5%
National Survey of Children’s Health 2011/2012
74% of mothers of 0-5 year olds and 69% of mothers of 6-11 year olds in Oregon rated their mental and emotional health as excellent or very good.
74% of fathers of 0-5 year olds and 60% of fathers of 6-11 year olds in Oregon rated their mental and emotional health as excellent or very good.
6% of mothers of 0-5 year olds and 9% of mothers of 6-11 year olds in Oregon rated their mental and emotional health as fair or poor.
12% of fathers of 6-11 year olds in Oregon rated their mental and emotional health as fair or poor.
(Source: National Survey of Children’s Health, 2011/12, http://nschdata.org)
30
Parent Weight Status
• About two-thirds (67%) of Umatilla/Union/Morrow county parents were overweight or obese.
Maternal Mental Health
• Depression is the most common complication of childbirth. One in four Oregon women report symptoms of prenatal or postpartum depression.
• Perinatal mood and anxiety disorders can occur anytime during pregnancy or the first year postpartum.
• Most women (80%) experience emotional swings and weepiness, often called the “Baby
Blues,” in the first few weeks after delivery. This is normal and usually resolves in a few weeks without treatment.
• Perinatal mood disorders include: prenatal or postpartum depression or anxiety, postpartum obsessive-compulsive disorder, birth-related post-traumatic stress disorder, and a severe but rare condition called postpartum psychosis.
• Dads, partners, adoptive parents, and foster parents can also experience depression or
anxiety after the arrival of a new child. All parents need support and extra care during this transition.
• Untreated perinatal mood and anxiety disorders can impact a mother’s ability to care for herself, relate to others, bond with her infant, and parent her older children.
• Children of depressed mothers are at risk for serious health, developmental, emotional,
behavioral, and learning problems that can last for many years.
(Source: Oregon Health Authority, Maternal Mental Health)
Obese 32%
Overweight 35%
Normal Weight 32%
Underweight 1%
Parent Weight Status from Umatilla, Morrow, and Union Counties
31
APPEN
DIX
I Appendix I І REGIONAL CHILD HEALTH ASSESSMENT INFORMATION SOURCES
Source Data Used Website
Centers for Disease Control and Prevention (CDC)
Adverse Childhood Experiences
Breastfeeding Impact of Folic Acid Mental Health of Parents Motor Vehicle Safety Progress on Childhood Obesity Smoking during Pregnancy
www.cdc.gov
Community Commons
Food Insecure Children Households with Children Households with Children
Receiving SNAP Benefits Uninsured Children
www.communitycommons.org/maps-data/
Healthy Children Breastfeeding Benefits your Baby’s Immune System
www.healthychildren.org/
National Sleep Foundation Sudden Infant Death Syndrome and Sleep
http://sleepfoundation.org/sleep-disorders-problems/sudden-
infant-death-syndrome-and-sleep
National Survey of Children’s Health
Breastfed Children Child Asthma Child ADD/ADHD Health Insurance Meals Together Organized Activities Parent’s Health Status School Safety Smoking in the Home TV or Video Games Usage
http://nschdata.org
Oregon Health Authority (OHA)
Maternal Mental Health Promoting Healthy Weight and
Development in Early Childhood
Tobacco Use During Pregnancy
https://public.health.oregon.gov/PHD/Directory/Pages/program.as
px?pid=25
Safe Kids Oregon Preventing Unintentional Injuries to Oregon’s Kids
www.safekidsoregon.org/
32
Appendix II І REGIONAL COUNTIES CHILD ACRONYMS AND TERMS
ACS American Community Survey, a survey conducted by the U.S. Census Bureau
ADD Attention Deficit Disorder
ADHD Attention Deficit Hyperactivity Disorder
BMI Body Mass Index is defined as the contrasting measurement/relationship of weight to height.
CDC Centers for Disease Control and Prevention.
CY Calendar Year
FY Fiscal Year
HCNO Hospital Council of Northwest Ohio
HP 2020 Healthy People 2020, a comprehensive set of health objectives published by the Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services.
N/A Data is not available.
NSCH National Survey of Children’s Health
OHA Oregon Health Authority
Race/Ethnicity Census 2010: U.S. Census data consider race and Hispanic origin separately. Census 2010 adhered to the standards of the Office of Management and Budget (OMB), which define Hispanic or Latino as “a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.” Data are presented as “Hispanic or Latino” and “Not Hispanic or Latino.” Census 2010 reported five race categories including: White, Black or African American, American Indian & Alaska Native, Asian, Native Hawaiian and Other Pacific Islander. Data reported, “White alone” or “Black alone”, means the respondents reported only one race.
SNAP Supplemental Nutrition Assistance Program
33
APPEN
DIX
III Appendix III І DEMOGRAPHICS AND HOUSEHOLD INFORMATION
Umatilla, Morrow, and Union County
Populations by Age Groups and Gender U.S. Census 2010
Age Umatilla County Union County Morrow County
Total Males Females Total Males Females Total Males Females
75,889 39,528 36,361 25,748 12,678 13,070 11,173 5,749 5,424
0-4 years 5,645 2,916 2,729 1,630 834 796 794 415 379 1-4 years 4,576 2,367 2,209 1,317 675 642 630 333 297 < 1 year 1,069 549 520 313 159 154 164 82 82 1-2 years 2,275 1,179 1,096 659 331 328 303 161 142 3-4 years 2,301 1,188 1,113 658 344 314 327 172 155 5-9 years 5,599 2,799 2,800 1,619 842 777 853 437 416 5-6 years 2,299 1,160 1,139 629 337 292 358 185 173 7-9 years 3,300 1,639 1,661 990 505 485 495 252 243
10-14 years 5,554 2,853 2,701 1,540 766 774 963 490 473 10-12 years 3,387 1,749 1,638 897 436 304 574 296 278 13-14 years 2,167 1,104 1,063 643 330 313 389 194 195 12-18 years 7,851 4,058 3,793 2,337 1,226 1,111 1,307 669 638
34
General Demographic Characteristics (Source: U.S. Census Bureau, 2010-2014 ACS 5-year estimates)
Selected Social Characteristics
(Source: U.S. Census Bureau, 2010-2014 ACS 5-year estimates)
Umatilla County Union County Morrow County Total Population
2014 Total Population 76,645 25,736 11,217 2000 Total Population 70,548 24,530 10,995
Population By Age 2010 Under 5 years 5,645 7.4% 1,630 6.3% 794 7.1% 5 to 17 years 14,555 19.2% 4,167 16.2% 2,396 21.4% 18 to 24 years 7,050 9.3% 2,849 11.1% 889 8.0% 25 to 44 years 19,658 25.9% 5,543 21.5% 2,670 24.0% 45 to 64 years 19,324 25.5% 7,251 28.2% 3,003 26.9% 65 years and more 9,657 12.7% 4,308 16.7% 1,421 12.7% Median age (years) 35.7 39.9 39.5
Household By Type Total Households 26,901 100% 10,134 100% 3,714 100%
Family Households (families) 18,157 67.5% 6,491 64.1% 2,742 73.8% With own children <18 years 8,602 32.0% 2,608 25.7% 1,231 33.1%
Married-Couple Family Households 12,937 48.1% 5,328 52.6% 2,132 57.4% With own children <18 years 5,131 19.1% 1,871 18.5% 842 22.7%
Female Householder, No Husband Present 3,630 13.5% 733 7.2% 408 11.0%
With own children <18 years 2,534 9.4% 507 5.0% 237 6.4% Non-family Households 8,744 32.5% 3,643 35.9% 972 26.2%
Householder living alone 7,171 26.7% 2,749 27.1% 855 23.0% Householder 65 years and > 2,722 10.1% 1,035 10.2% 392 10.6%
Households With Individuals < 18 years 9,574 35.6% 2,880 28.4% 1,357 36.5%
Households With Individuals 65 years and > 7,079 26.3% 3,000 29.6% 1,031 27.8%
Average Household Size 2.69 people 2.46 people 3.01 people Average Family Size 3.25 people 2.96 people 3.50 people
Umatilla County
Morrow County
Union County
School Enrollment Population 3 Years and Over Enrolled In School 19,679 100% 2,963 100% 6,718 100%
Nursery & Preschool 1,023 5.2% 129 4.4% 329 4.9% Kindergarten 1,321 6.7% 250 8.4% 287 4.3% Elementary School (Grades 1-8) 8,829 44.9% 1,434 48.4% 2,709 40.3% High School (Grades 9-12) 4,626 23.5% 834 28.1% 1,167 17.4% College or Graduate School 3,880 19.7% 316 10.7% 2,226 33.1%
Grandparents As Caregivers Grandparent Living in Household with 1 or more own grandchildren <18 years
1,614 100% 341 100% 377 100%
Grandparent Responsible for Grandchildren 685 42.4% 159 46.6% 152 40.3%
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III Oregon Counties Households with Children,
American Community Survey, 5-Year Estimates, 2010-2014
(Source: American Community Survey, 5 Year Estimates, as compiled by Community Commons)
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Selected Economic Characteristics (Source: U.S. Census Bureau, 2010-2014 ACS 5-year estimates)
Employment Statistics Category Umatilla
County Union
County Morrow County Oregon
Labor Force 36,043 12,156 5,688 2,058,136
Employed 34,017 11,402 5,379 1,951,276
Unemployed 2,026 754 309 106,860
Unemployment Rate* in July 2016 5.6 6.2 5.4 5.2
Unemployment Rate* in June 2016 5.3 5.9 5.0 4.8
Unemployment Rate* in July 2015 6.5 6.4 5.9 5.8 *Rate equals unemployment divided by labor force. (Source: Oregon Labor Market, July 2016, https://www.qualityinfo.org/home)
Household Income In 2014 Households 26,901 100% 3,714 100% 10,134 100%
< $10,000 1,896 7.0% 198 5.3% 1,121 11.1% $10,000 to $14,999 1,851 6.9% 199 5.4% 632 6.2% $15,000 to $24,999 3,310 12.3% 401 10.8% 1,402 13.8% $25,000 to $34,999 2,905 10.8% 521 14.0% 1,050 10.4% $35,000 to $49,999 4,127 15.3% 504 13.6% 1,686 16.6% $50,000 to $74,999 5,529 20.6% 885 23.8% 1,822 18.0% $75,000 to $99,999 3,373 12.5% 412 11.1% 1,157 11.4% $100,000 to $149,999 2,919 10.9% 451 12.1% 799 7.9% $150,000 to $199,999 547 2.0% 93 2.5% 215 2.1% $200,000 or more 444 1.7% 50 1.3% 250 2.5%
Family Income In 2014 Families 18,157 100% 2,742 100% 6,491 100%
< $10,000 751 4.1% 155 5.7% 343 5.3% $10,000 to $14,999 1,081 6.0% 126 4.6% 186 2.9% $15,000 to $24,999 1,446 8.0% 207 7.5% 659 10.2% $25,000 to $34,999 1,748 9.6% 313 11.4% 727 11.2% $35,000 to $49,999 2,572 14.2% 356 13.0% 1,229 18.9% $50,000 to $74,999 4,1945 23.1% 697 25.4% 1,283 19.8% $75,000 to $99,999 2,869 15.8% 357 13.0% 948 14.6% $100,000 to $149,999 2,873 14.3% 423 15.4% 736 11.3% $150,000 to $199,999 515 2.8% 70 2.6% 194 3.0% $200,000 or more 378 2.1% 38 1.4% 186 2.9%
Median Household Income (families) $47,185 $50,443 $51,648
Per Capita Income In 2014 $20,887 $20,750 $22,857 Poverty Status In 2014
Families 13.2% 15.5% 11.2% Individuals 17.1% 19.3% 18.8%
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III Estimated Poverty Status in 2014
(Source: U.S. Census Bureau, Small Area Income and Poverty Estimates, http://www.census.gov/did/www/saipe/data/interactive/#)
Age Groups Number 90% Confidence Interval Percent
90% Confidence
Interval Umatilla County All ages in poverty 12,416 10,417 to 14,415 17.1% 14.3 to 19.9 Ages 0-17 in poverty 4,456 3,572 to 5,340 22.8% 18.3 to 27.3 Ages 5-17 in families in poverty 2,655 1,990 to 3,320 18.8% 14.1 to 23.5 Median household income $47,053 $44,161 to $49,945 Morrow County All ages in poverty 1,903 1,520 to 2,286 16.8% 13.4 to 20.2 Ages 0-17 in poverty 769 610 to 928 24.5% 19.4 to 29.6 Ages 5-17 in families in poverty 523 399 to 647 22.7% 17.3 to 28.1 Median household income $51,289 $47,500 to $55,078 Union County All ages in poverty 4,418 3,706 to 5,130 17.7% 14.8 to 20.6 Ages 0-17 in poverty 1,219 956 to 1,482 22.0% 17.3 to 26.7 Ages 5-17 in families in poverty 841 660 to 1,022 21.1% 16.6 to 25.6 Median household income $44,841 $41,885 to $47,797 Oregon All ages in poverty 637,156 621,361 to 652,951 16.4% 16.0 to 16.8 Ages 0-17 in poverty 179,110 171,930 to 186,290 21.3% 20.4 to 22.2 Ages 5-17 in families in poverty 117,394 111,176 to 123,612 19.3% 18.3 to 20.3 Median household income $51,088 $50,607 to $51,569 United States All ages in poverty 48,208,387 47,966,830 to 48,449,944 15.5% 15.4 to 15.6 Ages 0-17 in poverty 15,686,012 15,564,145 to 15,807,879 21.7% 21.5 to 21.9 Ages 5-17 in families in poverty 10,714,518 10,632,252 to 10,796,784 20.4% 20.2 to 20.6 Median household income $53,657 $53,564 to $53,750
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Federal Poverty Thresholds in 2015 by Size of Family and Number of Related Children Under 18 Years of Age
(Source: U. S. Census Bureau, Poverty Thresholds 2015, http://www.census.gov/hhes/www/poverty/data/threshld/index.html)
Size of Family Unit No Children
One Child
Two Children
Three Children
Four Children
Five Children
1 Person <65 years $12,331 1 Person 65 and > $11,367
2 people Householder < 65 years $15,871 $16,337
2 People Householder 65 and > $14,326 $16,275
3 People $18,540 $19,078 $19,096 4 People $24,447 $24,847 $24,036 $24,120 5 People $29,482 $29,911 $28,995 $28,286 $27,853 6 People $33,909 $34,044 $33,342 $32,670 $31,670 $31,078 7 People $39,017 $39,260 $38,421 $37,835 $36,745 $35,473 8 People $43,637 $44,023 $43,230 $42,536 $41,551 $40,300
9 People or > $52,493 $52,747 $52,046 $51,457 $50,490 $49,159