FOREWORD Thank you for your interest in the data presented in this publication. It is the result of the 2014 Youth Health Assessment of Fulton County. The data collected is reported along with health information from the Ohio Department of Health and relevant national, state, and local data FOREWO sources. The health assessment is vital as it serves as a guide for strategic planning and decision-making. This process assists the community in identifying new health concerns, measuring the impact of the current efforts, and guiding the wise stewardship of local resources. This assessment is but one tool to be used in the development of a planning process. Community health improvement requires examining, in depth, the data contained in the publication, pursing additional information from service providers and others, identifying the target population at risk and choosing effective strategies that will work to create a heathier Fulton County. This assessment would not have been possible without the collaboration of community leaders and organizations. We thank them for their time and support. Special thanks to the Fulton County Superintendents, Healthy Choices Caring Communities, and the Hospital Council of Northwest Ohio for guiding the health assessment process. The information contained in this assessment can be paramount to improving our community. It is up to us, as individual organizations, to use the information in a way that is beneficial. We are happy to assist you in your efforts to improve the health and well-being of the Fulton County residents. We encourage you to be open to new ideas and collaborations. I am confident that with effective collaboration, we can create a more healthy community for the residents of Fulton County. Sincerely, Kathy Helmke, LISW-S RD Fulton County Family and Children First Chairperson Fulton County Family & Children First Council Members Larry Brown, Wauseon Schools Judge Michael Bumb, Fulton County Juvenile Court Carmen Coy, NOCAC Maurine Clymer, Fulton County Commissioners’ Office Art Eli, Department of Youth Services Beth Friess, Fulton County Board of DD Kerri Gearhart, NWOESC Kathy Helmke, Four County Family Center Kristie Humbert, Help Me Grow Meg Murphy, City of Wauseon Mayor’s Office Les McCaslin, ADAMhs Board Rhonda Lamb-Moore, Family Representative Mike Oricko, Fulton County Health Department Becky Rupp, Family Representative Michelle Schweinhagen, Family Representative Amy Metz-Simon, Fulton County Job & Family Services Funding for the Fulton County Health Assessment Provided by: Healthy Choices Caring Communities (HC3), a committee of The Fulton County Family & Children First Council Commissioned by Healthy Choices Caring Communities: Bart Ankney, AJA Behavioral Associates Mary Apodaca, Fulton County Health Department Ken Bond, Recovery Services of NW Ohio Tim Churchill, Swanton Elks Club Dora Cortes Pathstone Jim Currier, Fulton County Health Center Kerri Gearhart, NOESC Jessica Gerig, Wauseon Schools Jill Gilliland, NOESC Vond Hall, Fulton County Commissioners Nathan Hartsock, Delta Police Department Jodi Hybart, Recovery Services of Northwest Ohio Antonia Jensen, AJA Behavioral Associates, Inc Rachel Kinsman, Fulton County Health Department Norris Ledyard, Fulton County Expositor Colleen Leu, Delta Police Department Tante Lovins, Four County Family Center Les McCaslin, Four County ADAMhs Board Amy Metz-Simon, Fulton County JFS Mat McDonough, School Resource Officer Sharon Morr, Fulton County Health Center Mike Oricko, Fulton County Health Department Karen Pennington, Coordinator, Fulton County FCFC Jodi Rabquer, Parent Representative Ray Rodriguez, Ohio Investigative Unit Gina Saaf, United Way of Fulton County Jane Sauder, Fiscal Officer for HC3 Toni Schindler, Fulton County Commissioners Phyllis Smith, United Way of Fulton County Matt Strader, Crossroads Evangelical Church Beth Thomas, Program Director for HC3 Keith Torbet, Wauseon Police Department Britney Ward, Hospital Council of Northwest Ohio Steve Waxler, Fulton County Sheriff Department Barb Zimmerman, Marathon Continental Plaza Question Selection Committee: Mary Apodoca, Fulton County Health Department Larry Brown, Wauseon Schools Joe Friess, Wauseon Schools Rachel Kinsman, Fulton County Health Department Keith Leatherman, Wauseon Schools Tonie Long, Four County Family Center Sharon Morr, Fulton County Health Center, Karen Pennington, Fulton County FCFC Jodi Rabquer, Parent Representative Gina Saaf, United Way of Fulton County Amy Metz-Simon, Fulton County Job & Family Svcs. Beth Thomas, Healthy Choices Caring Communities Britney Ward, Hospital Council of Northwest Ohio Jim Wyse, Evergreen Schools Hospital Council of Northwest Ohio: Project Management, Secondary Data, Data Collection, and Report Development Britney L. Ward, MPH Amy Nagle Director of Community Health Improvement Graduate Assistant Margaret Wielinski, MPH Tessa Elliot Health Improvement Data Specialist Undergraduate Assistant Michelle Von Lehmden Health Assessment Coordinator Data Collection & Analysis James H. Price, Ph.D., MPH Joseph A. Dake, Ph.D., MPH Professor Emeritus of Health Education Professor and Chair of Health Education University of Toledo University of Toledo Timothy R. Jordan, Ph.D., M.Ed. Professor of Health Education University of Toledo Contact Information Michael Oricko Fulton County Health Commissioner 606 S. Shoop Avenue Wauseon, OH 43567 (419) 337-0915 This report was developed under grant number 5H79SP015851 from the Office of National Drug Control Policy and Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services. The views, policies and opinions expressed are those of the authors and do not necessarily reflect those of ONDCP, SAMHSA, or HHS. TABLE TABLE OF CONTENTS EXECUTIVE SUMMARY PAGES 4-8 TREND SUMMARY PAGES 9-10 Youth Health (Ages 12-18) WEIGHT CONTROL PAGES 11-14 TOBACCO USE PAGES 15-17 ALCOHOL CONSUMPTION PAGES 18-21 OF DRUG USE PAGES 22-26 SEXUAL BEHAVIOR AND TEEN PREGNANCY OUTCOMES PAGES 27-29 MENTAL HEALTH AND SUICIDE PAGES 30-32 YOUTH SAFETY PAGES 33-34 YOUTH VIOLENCE ISSUES PAGES 35-37 YOUTH PERCEPTIONS PAGES 38-40 CONTENTS Appendices HEALTH ASSESSMENT INFORMATION SOURCES APPENDIX I PAGE 41 LIST OF ACRONYMS AND TERMS APPENDIX II PAGE 42 SCHOOL PARTICIPATION APPENDIX III PAGE 43 EXECUTIVE SUMMARY This executive summary provides an overview of health-related data for Fulton County youth (ages 12 through 18) who participated in a county-wide health assessment survey during 2014. The findings are based on self-administered surveys using a structured questionnaire. The questions were modeled after the survey instrument used by the Centers for Disease Control and Prevention for their national and state Youth Risk Behavior Surveillance Survey (YRBSS). 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 adolescents within Fulton County. 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 was regarded as an important step in completing a valid needs assessment. INSTRUMENT DEVELOPMENT A survey instrument was designed and pilot tested for this study. 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 adolescents. The investigators decided to derive the majority of the survey items from the Youth Risk Behavior Surveillance System survey. This was important because it provided for a more valid comparison of the findings with the state and national YRBS data. The Project Coordinator from the Hospital Council of NW Ohio conducted a series of meetings with a committee of Family and Children First Council from Fulton County. During these meetings, banks of potential survey questions from the YRBSS survey were reviewed and discussed. Based on input from the Fulton County planning committee, the Project Coordinator composed a draft of a survey containing 83 items. This draft was reviewed and approved by health education researchers at the University of Toledo. PROCEDURE | Adolescent Survey Superintendents reviewed and approved the survey. Schools and grades were randomly selected. Each student in that grade had to have an equal chance of being in the class that was selected, such as a general English or health class. Classrooms were chosen by the school principal. Passive permission slips were mailed home to parents of any student whose class was selected to participate. The response rate was 90% (n=456). The number needed to have adequate power was 365. Adequate power means that the results are more likely to be representative of all of the students of a similar age in the county DATA ANALYSIS Individual responses were anonymous and confidential. Only group data were available. All data were 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. 4 Data Summary EXECUTIVE YOUTH WEIGHT STATUS The 2014