2014 McHenry County Community Health Needs Assessment
Overview • • • • • • • • •
Purpose Data Collection Methods Demographics General Health Status Behavioral Risk Factors Maternal & Child Health Mental Health Health Care Utilization Next Steps
Purpose • To collect and analyze data regarding the health care priorities of McHenry County residents • To gather community feedback about perceived health needs • Community Health Needs Assessments are now a requirement by healthcare reform legislation – All hospitals must include an action plan based on a community health needs assessment with the IRS Form 990 by 2013.
Data Collection • Primary Research – Mailed Survey • Sample size = 1245 • Random sample of McHenry County residents • Response rate: 10.04%
• Secondary Research – – – – –
County Health Rankings Illinois Department of Public Health U.S. Census Data Kaiser Family Foundation State Health Facts Others
Community Perception Important Factors for a "Healthy Community" Goods Jobs, Healthy… Good Schools Access to Health Care Low Crime, Safe… Good Place to Raise… Healthy Behaviors &… Clean Environment Affordable Housing Strong Family Life Religious or Spiritual Values Parks & Recreation Emergency Preparedness Arts & Cultural Events Low Level of Child Abuse Low Adult Death &… Excellent Race / Ethic… Low Infant Deaths Other 0
Source:
75 80 72
4 4 4
18 22 8 7
34 33 35 29
106
52 60
12 20
McHenry County Community Health Needs Assessment Survey, 2014
40 60 80 Number of Times Selected
100
120
Demographics
Population of Harvard, Illinois 1990 – 2014(P) 10,000
9,447
9,000
8,961
7,996
8,000 7,000
6,000
5,975
5,000
4,000 3,000 2,000 1,000 0 1990
2000
2010
Sources: U.S. Census Bureau, 1990 American Community Survey, Summary of General Characteristics of Persons, Harvard, IL U.S. Census Bureau, 2000 American Community Survey, Profile of General Demographic Characteristics, Harvard, IL U.S. Census Bureau, 2010 American Community Survey, Profile of General Population and Housing Characteristics, Harvard, IL CLRsearch.com, Harvard, IL
2014(P)
Age Distribution of Harvard, IL: 2000,2010 & 2012 Under 18
2012
36.0%
2010
35.3%
2000
10%
20%
25 - 44
7.2%
40%
65+
16.8%
29.6%
9.4%
30%
45 - 64
31.8%
7.6%
33.4%
0%
18 - 24
31.3%
50%
60%
70%
Source: U.S. Census Bureau, American FactFinder, State and County QuickFacts: Harvard, Illinois 2010.. U.S. Census Bureau, American Community Survey, Profile of General Demographic Characteristics: Harvard, Illinois 2000.
8.1%
19.2%
8.3%
16.8%
9.1%
80%
90%
100%
Race & Ethnicity Race Distribution - Harvard, IL 2000 White 76.3% Black or African American 0.9% American Indian and Alaska Native 0.4% Asian 1.4% Other 18.8% Two or more races 2.3%
2010 71.5% 0.9% 0.8% 0.7% 22.9% 3.0%
Source: U.S. Census Bureau, American FactFinder, State and County QuickFacts: Harvard, Illinois 2012. U.S. Census Bureau, American FactFinder, State and County QuickFacts: Harvard, Illinois 2010. U.S. Census Bureau, American Community Survey, Profile of General Demographic Characteristics: Harvard, Illinois 2000.
2012 73.0% 0.1% 0.0% 1.8% 23.0% 2.0%
Employment Status (Population Age 16 and over)
Harvard
McHenry County
Illinois
80% 70% 60%
67% 67% 61%
50% 40%
33% 26% 27%
30%
20% 7%
10%
6%
6%
0% Employed
Unemployed
Not in Labor Force
Source: U.S. Census Bureau, American Community Survey, Profile of General Demographic Characteristics: Harvard, Illinois 2006-2010.
Employment Status - Harvard 2000
2010
80% 70%
67%
67%
60% 50% 40%
29%
30%
26%
20% 10%
5%
7%
0% Employed
Unemployed
Source: U.S. Census Bureau, American Community Survey, Profile of General Demographic Characteristics: Harvard, Illinois 2006-2010.
Not in Labor Force
Unemployment 12.00%
10.00%
8.00%
6.00%
McHenry County
Illinois United States
4.00%
2.00%
0.00%
Source:
2007
2008
2009
2010
2011
2012
McHenry County
4.30%
5.80%
9.60%
10.00%
9.40%
8.40%
Illinois
5.10%
6.40%
10.00%
10.40%
9.70%
8.90%
United States
4.60%
5.80%
9.30%
9.60%
8.10%
8.10%
U.S. Bureau of Labor Statistics, Economy at a Glance – Crystal Lake, Illinois, December 2011 State Health Facts, Kaiser Family Foundation, http://www.statehealthfacts.org
Median Income $90,000 $80,000 $70,000 $60,000 $50,000 $40,000 $30,000 $20,000 $10,000 $0 2000 2010
Harvard $44,363 $45,991
McHenry Co. $64,826 $76,482
Source: U.S. Census Bureau, American Community Survey, Profile of General Demographic Characteristics, 2006-2010.
Illinois $46,590 $55,735
Income & Benefits $200,000 +
Harvard McHenry Co.
$150,000 to $199,999
Illinois
$100,000 to $149,999 $75,000 to $99,999 $50,000 to $74,999 $35,000 to $49,999 $25,000 to $34,999 $15,000 to $24,999 $10,000 to $14,999 Less than $10,000 0%
5%
10%
Source: U.S. Census Bureau, American Community Survey, Profile of General Demographic Characteristics, 2006-2010.
15%
20%
25%
Education Harvard
McHenry County
Illinois
High School Graduation Rate
69.2%
91.1%
83.8%
High School Graduation Rate for Low Income Students
63.5%
83.7%
75.1%
Percent Meeting or Exceeding Standards Statistics for the 2010 – 2011 Academic Year of ISAT
71.3%
87.5%
82.4%
Source: Harvard Community Unit School District 50, District Report Card, 2011. < http://www.cusd50.org/index.php/cusd50-report-card> Social Impact Research Center, 2011 Report on Wellbeing – McHenry County, <http://www.ilpovertyreport.org/county/mchenry-county>
Educational Attainment (25+) 2012 Harvard
McHenry County
Illinois
United States
35.0%
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
Less than 9th Grade Some High School, No High School Graduate Diploma
Some College, No Degree
Source: U.S. Census Bureau, American Community Survey, Educational Attainment, 2012.
Associate's Degree
Bachelor's Degree
Graduate or Professional Degree
Marital Status 60% 50%
50%
40% 31% 30% 20% 13% 10%
4%
2%
0% Married
Never Married
Divorced
Source: U.S. Census Bureau, American Community Survey, Profile of General Demographic Characteristics, 2006-2010.
Widowed
Separated
General Health Status
Community Perception: Health Problems Cancers Heart Disease & Stroke Obesity Aging Problems Mental Health Problems Diabetes Domestic Violence Child Abuse / Neglect Teenage Pregnancy High Blood Pressure Respiratory / Lung Disease Motor Vehicle Crash Injuries Dental Problems STDs Suicide Infectious Diseases Firearm-Related Injuries Rape / Sexual Assault Homicide HIV/AIDS Other Terrorist Activities Infant Death
61 60 16 19
6
3 3 2 1 0
3
11
65
50
8 9
8
0
Source:
22 20
26
52
76 73
McHenry County Community Health Needs Assessment Survey, 2012
20
40 60 Number of Times Selected
80
Chronic Conditions Prevalence of Selected Chronic Conditions 2006-2010 14.00% 12.00% 10.00% 8.00% 6.00%
4.00% 2.00% 0.00%
Asthma Diabetes Heart Disease Source:
McHenry County 13.29% 6.90% 3.10%
Illinois Department of Public Health, Illinois Behavioral Risk Factor Surveillance System.
Illinois 13.17% 8.60% 4.04%
United States 13.20% 8.95% 4.33%
Cancer Incidence Males TYPE
Females CASES RATE*
TYPE
CASES RATE*
1. Prostate
913
148.2
1. Breast (invasive)
891
116.2
2. Lung & Bronchus
432
75.3
2. Lung & Bronchus
418
58.8
3. Colon & Rectum
313
53.5
3. Colon & Rectum
338
46.5
4. Bladder
219
39.3
4. Uterus
238
30.7
5. Kidney & Renal Pelvis
157
24.2
5. Breast in situ
177
22.5
3,205
526.3
TOTAL
3,223
432.7
TOTAL
*Age-adjusted incidence rate per 100,000 population
Source:
Illinois Department of Public Health, Illinois Cancer Registry, 2010.. K. Harrison, 2010 Health Community Study, Community Analysis, 2010.
Communicable Diseases DISEASE1 Cryptosporidiosis Giardiasis Hepatitis A, Acute Hepatitis B, Chronic & Acute Hepatitis C, Chronic or Resolved Legionellosis Lyme Disease Non-Bacterial Aseptic Meningitis Pertussis Rabies, Potential Human Exposure Salmonellosis Shiga Toxin-Producing E. coli O157:H7 Shigellosis Streptococcal Disease, Invasive Group A Varicella (Chicken Pox)
2004 2005 2006 2007 2008 2009 2 6 4 0 2
3 9 3 17 94
6 29 170 27 30 4 12 4 0
7 44 28 8 47 0 7 6 4
1 Excludes Sexually Transmitted Diseases
Source:
Illinois Department of Public Health, Illinois Notifiable Disease Surveillance System, 2004 â&#x20AC;&#x201C; 2009.
4 12 2 22 97 3 8 25 11 24 35 3 8 8 1
7 16 4 23 99 5 6 52 8 57 44 4 6 2 5
7 10 3 15 60 4 3 3 23 92 34 3 8 6 68
7 8 5 12 86 2 6 0 51 26 47 5 9 7 53
Sexually Transmitted Infections Rate per 100,000 population
MCHENRY COUNTY
ILLINOIS
Chlamydia
92.4
417.6
Gonorrhea
14.7
157.3
-
3.4
Syphilis
Source:
Illinois Department of Public Health, Illinois Notifiable Disease Surveillance System, 2004 â&#x20AC;&#x201C; 2009.
Deaths McHenry County Rate
Illinois Rate
U.S. Rate 10.0
1,800
9.0
1,600
8.0
1,400
7.0
1,200
6.0
1,000
5.0
800
4.0
600
3.0
400
2.0
Source:
Centers for Disease Control and Prevention, National Center for Health Statistics, CDC WONDER Online Database. <http://wonder.cdc.gov/ucd-icd10.html>.
2006
2004
2002
2000
1998
1996
1994
1992
1990
1988
1986
1984
1980
0
1982
200
1,035 1,077 1,110 1,102 1,148 1,137 1,255 1,178 1,190 1,175 1,170 1,309 1,237 1,337 1,377 1,387 1,449 1,448 1,487 1,548 1,521 1,507 1,625 1,706 1,662 1,709 1,794 1,820
2,000
1.0
0.0
Deaths Per 1,000 Population
Deaths
McHenry County Deaths
Deaths by Age Group in McHenry County, IL 2006
2007
2008
2009
2010
700
600
500
400
300
200
100
0
< 1 year Source:
1-4 years
5-14 years
15-24 years
25-34 years
35-44 years
45-54 years
55-64 years
Centers for Disease Control and Prevention, National Center for Health Statistics, CDC WONDER Online Database. <http://wonder.cdc.gov/ucd-icd10.html>.
65-74 years
75-84 years
85+ years
Leading Causes of Death McHenry County
Illinois
CAUSE
RATE
CAUSE
Lung or Bronchus Cancer
46.7
Atherosclerosis
53.2
Atherosclerosis
35.8
Lung or Bronchus Cancer
51.3
COPD
26.5
Heart Attack (AMI)
44.6
Dementia
19.3
Dementia
28.1
Heart Attack (AMI)
18.4
COPD
26.8
Congestive Heart Failure
16.2
Alzheimer's
22.2
Alzheimer's
15.9
Stroke
21.9
Stroke
15.0
Congestive Heart Failure
19.9
Pneumonia
11.5
Pneumonia
16.9
Source:
Centers for Disease Control and Prevention, National Center for Health Statistics, CDC WONDER Online Database. <http://wonder.cdc.gov/ucd-icd10.html>.
RATE
Unnatural Causes of Death in McHenry County, IL 2009 - 2012
2009
45
2010
2011
2012
40
40
38
37
35
30
32 29
31
29 26
25
20
18
20 14 14
15
21 18
13
9
10
6
3
5
2
2
0
Suicides Source:
Motor Vehicle Related
McHenry County Coronerâ&#x20AC;&#x2122;s Statistical Report 2012.
Accidental
Homicides
Drug Overdose
Behavioral Risk Factors
Community Perception: “Risky” Behaviors Most Concerning "Risky Behaviors" Drug Abuse Alcohol Abuse Being Overweight Not Receiving Needed… Poor Eating Habits Tobacco Use Lack of Exercise Dropping Out of School Not Using Birth Control Unsafe Sex Unsecured Firearms Not Using Seat Belts / Child… Not Getting "Shots" to… Racism Lack of Maternity Care Other
81
89 81 41 61 45
53 33 16 13 21 15 25 12 3 5
0 Source:
McHenry County Community Health Needs Assessment Survey, 2012
20
40 60 80 Number of Times Selected
100
Alcohol Use McHenry County
Illinois
AT RISK FOR CHRONIC DRINKING At Risk
-
5.1%
Not At Risk
-
94.9%
At Risk
20.7%
18.3%
Not At Risk
79.3%
81.7%
AT RISK FOR ACUTE / BINGE DRINKING
Source:
Illinois Department of Public Health, Illinois Behavioral Risk Factor Surveillance System.
U.S. Substance Use By Any Mental Illness 2012 Had Mental Illness in the Past Year
Did Not Have Mental Illness in the Past Year 30.0%
26.7%
Percent Using Substance
25.0%
19.5%
20.0%
15.0% 13.3%
13.2%
10.3%
10.0%
4.8%
5.0%
4.0% 2.8% 1.4%
1.0%
1.3% 0.3%
Illicit Drugs
Marijuana
Psychotherapeutics
Cocaine
Hallucinogens
Inhalants
Source: Substance Abuse and Mental Health Administration [SAMHSA], Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health: Mental Health Findings, 2010.
0.9% 0.1% Heroin
0.0%
Tobacco Use McHenry County
19.8%
47.4%
Illinois Current Smoker Former Smoker Non-Smoker
32.9%
Source:
Illinois Department of Public Health, Illinois Behavioral Risk Factor Surveillance System.
16.9%
60.0%
23.1%
Obesity McHenry County
23.5% 40.8% 35.7%
Source:
Illinois
Underweight / Normal
27.6%
Overweight Obese
Illinois Department of Public Health, Illinois Behavioral Risk Factor Surveillance System.
33.9%
38.5%
Preventive Health McHenry County
Illinois
Ever had a prostate exam (men age 40+)
57.4%
54.1%
Had a Colon/Sigmoidoscopy (adults age 50+)
60.0%
64.1%
Diabetic HbA1c screening at physician office visit (Medicare enrollees) Mammogram within the past 12 months (women age 40+)
84.0%
82.0%
69.5%
61.2%
Pap Test within the past 12 months (women only)
82.8%
70.0%
Flu Shot within the past 12 months
26.0%
32.6%
Ever had a Pneumonia shot
20.6%
28.3%
Teeth Cleaned within the past 12 months
74.2%
65.8%
Dental Visit within the past 12 months
76.9%
66.9%
Source:
Illinois Department of Public Health, Illinois Behavioral Risk Factor Surveillance System. University of Wisconsin Population Health Institute. County Health Rankings 2011.
Frequency of Regular Check-Ups At Least Annually 41.6%
Every 2 Years 31.2%
Every 3 or More Years 12.0%
Family Doctor
75.8%
9.5%
Dentist
80.2%
Gynecologist Chiropractor
Eye Doctor
Source:
Never
No Answer
13.6%
1.6%
7.9%
3.8%
3%
6.3%
6.6%
2.6%
4.4%
40.1%
11.2%
16.2%
18.3%
14.2%
22.4%
3.7%
9.0%
45.4%
19.5%
Rock County Community Health Needs Assessment Survey, 2011
Activity & Nutrition McHenry County
Illinois
12
10
Percent of Restaurants that are “Fast Food”
48%
51%
Percent of the Population who are Low-Income and Do Not Live Close to a Grocery Store
7%
4%
Recreational Facilities per 100,000 population
Source:
University of Wisconsin Population Health Institute, County Health Rankings, 2011.
Maternal & Child Health
McHenry County Births • Total births (2009): 3,719 • Number of births has been decreasing since 2004 • Birth rate has been declining since 1995
Source:
McHenry County
Illinois
Birth Rate per 1,000 population
12.0
13.7
Teen Birth Rate per 1,000 population
21.0
40.0
Mothers married at time of birth
71.9%
59.2%
Mothers who smoke during pregnancy
6.9%
8.6%
Illinois Department of Public Health, 2012. K. Harrison, 2010 Health Community Study, Community Analysis, 2010.
Number of Births
McHenry County Number
K. Harrison, 2010 Health Community Study, Community Analysis, 2010.
McHenry County Illinois 20.0 18.0 16.0 14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 Births Per 1,000 Population
Source:
5,000 4,500 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 0 1980 2,435 2,358 1982 2,405 2,339 1984 2,406 2,512 1986 2,552 2,716 1988 2,841 3,041 1990 3,365 3,246 1992 3,385 3,453 1994 3,684 3,824 1996 3,894 3,836 1998 3,822 4,016 2000 4,056 4,125 2002 4,200 4,141 2004 4,364 4,229 2006 4,224 4,113 2008 3,816
Births U.S.
Births by Age of Mother: 2008 - 2011 35% 30% 25% 20%
15% 10% 5% 0% McHenry County Illinois Source:
<20 6% 10%
20-24 16% 21%
25-29 28% 28%
Illinois Department of Health, Health Statistics, http://www.idph.state.il.us/health/bdmd/birthchar_09.htm.
30-34 31% 26%
35-39 16% 13%
40+ 4% 3%
Births by Race / Ethnic Origin: 2008 - 2011 McHenry County
Illinois
90% 80% 70%
79% 62%
60% 50% 40% 30% 20%
14%
10%
16% 19% 3% 5%
1%
0% White Source:
Black
Hispanic
Illinois Department of Health, Health Statistics, http://www.idph.state.il.us/health/bdmd/birthchar_09.htm.
Other
Infant Mortality • Infant Deaths (2008): 22 • Infant Mortality Rate (2008): 5.8 per 1,000 live births
Infant Mortality 2000-2009
Deaths per 1,000 Live Births
ILLINOIS
MCHENRY
UNITED STATES
10.0
Source:
8.0 6.0 4.0 2.0
0.0 2000
2001
2002
2003
2004
Illinois Department of Public Health, 2012. Centers for Disease Control and Prevention, National Center for Health Statistics, 2012.
2005
2006
2007
2008
2009
Child Health McHenry County Immunized children, age 24-35 months (%)
U.S.
76.0
75.0
Overweight & Obese children (%)
-
29.9
31.6
High school students not meeting recommended physical activity level (%)
-
52.0
53.0
Received mental health care or counseling in the past 12 months(%)
-
53.0
60.0
Dental and medical preventive care visit in the past 12 months (%)
-
73.7
72.0
Children with one or more oral health problems, age 1 â&#x20AC;&#x201C; 17 years (%)
-
26.5
26.7
Children in single-parent households
18.0
31.0
20.0*
* 90th Percentile (i.e. only 10% are better)
Source:
Illinois
Annie E. Casey Foundation, Kids Count Data Center, Illinois. Kaiser Family Foundation, State Health Facts.
Mental Health
Percent of U.S. Population with Any Mental Illness in the Past Year - 2012 25.0%
22.0% 21.2% 19.6%
20.0%
18.6%
15.8% 14.9%
15.0%
10.0%
5.0%
0.0% 18 or Older Source:
18 to 25
26 to 49
50 or Older
SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2012.
Male
Female
Prevalence of Mental Disorders Disorder
Examples
Prevalence
Panic, OCD, PTSD, Phobias
18.5%
-
4.1%
Eating Disorders
Anorexia, Bulimia, Binge Eating
4.4%
Mood Disorders
Depression, Bipolar Disorder
9.5%
Antisocial, Avoidant, Borderline
9.1%
-
1.1%
Anxiety Disorders
Attention Deficit Hyperactivity Disorder
Personality Disorders Schizophrenia
Source: National Institute of Mental Health, Mental Health in America. < http://www.nimh.nih.gov/health/publications/the-numbers-countmental-disorders-in-america/index.shtml#ADHD >
Adults Who Did Not Receive Mental Health Care Could Not Afford Cost Could Handle Problem without Treatment Did Not Know Where to Go for Services Did Not Have Time Did Not Want Others to Find Out Might Cause Community to Have Negative Opinion Treatment Would Not Help
Did Not Feel Need for Treatment Health Insurance Did Not Cover Enough Treatment
Concerned about Confidentiality Might Have Negative Effect on Job Health Insurance Did Not Cover Any Treatment Fear of Being Committed / Having to Take Medicine
0% Source:
10%
20%
30%
SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health: Mental Health Findings, 2010.
40%
50%
Health Care Utilization
Hospitalizations Top Causes for McHenry County Hospitalizations - 2011
Rank
Cause of Hospitalization
Number of Hospitalizations
Percent
1
All Other Diag.
12,606
35.1%
2
Heart Disease
3,483
9.7%
3
Newborn
3,459
9.6%
4
Delivery
3,305
9.2%
5
Mental Disorders
2,845
7.9%
6
Cancer
1,278
3.6%
7
Injury
1,147
3.2%
8
Pneumonia/Influenza
1,033
2.9%
791
2.2%
732
2.0%
Stroke Rates for Adults Age 25+ 9 *Utilization NA = Data Not Available
10
Urinary Dis. - Other
Source: Illinois Department of Public Health, Emergency Medical Services (EMS) Data Reporting System.
Trauma Admissions Top Causes for Illinois EMS Region 9 Trauma Admissions - 2011
Cause Of Injury
Trauma Admissions
Percent
Falls (Unintentional)
5,586
65.1%
Motor Vehicle Crashes (Unintentional)
1,370
16.0%
All Other External Causes
1,270
14.8%
Intentional Injury/Inflicted by Others
169
2.0%
Intentional Injury/Self-Inflicted
88
1.0%
Firearm (All Intents)
45
0.5%
8,576
100%
Total Source: Illinois Department of Public Health, Health Statistics, EMS Data Reporting System, 2011.
Locations Where Health Care Received by McHenry County Residents 40% 35%
35%
30% 25%
22%
21%
20% 15%
10%
7%
6%
5%
4%
3%
1%
0% McHenry County Source:
Cook County
Lake County
Wisconsin
McHenry County Community Health Needs Assessment Survey, 2012.
Kane County
Other
Winnebago County
DuPage County
Summary of Key Findings • One in four Harvard families lives in poverty. • Compared to the rest of the state, McHenry County has a greater proportion of residents who use tobacco and engage in binge drinking. McHenry County residents are also at a greater risk for alcoholism. • McHenry County residents are less likely to have received certain preventive services, including colonoscopies and immunizations for both the flu and pneumonia. • Harvard, Illinois younger mothers tend to have less formal education and data shows that they are less likely to seek prenatal care in the first trimester.
Summary of Key Findings
• Infant mortality in McHenry County has decreased in the most recent year available stopping the increasing trend which started in 2005. • One in four residents has a mental illness. • Over 90% of McHenry County residents have some type of health insurance coverage; 14.4% are enrolled in Medicare. • McHenry County has a high ratio of residents to primary care physicians and dentists performing poorer than the state average in both areas.
Summary of Key Findings â&#x20AC;˘ Residents of McHenry County are more likely to be hospitalized, although the average length of stay per admission is shorter than the statewide rate. â&#x20AC;˘ Of McHenry County residents who receive health services outside of McHenry County, most receive care in Cook or Lake County.
Next Steps • Identify Priorities • Develop Action Plan • Submit Action Plan with 2012 Tax Forms