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2018 Community Health Assessment of Cape Girardeau County

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2018 Community Health Assessment of Cape Girardeau County Cape Girardeau County Public Health Center Community Health Assessment 2018 0 Cape Girardeau County Public Health Center Community Health Assessment 2019 Table of Contents Introduction 4 Vision-Mission-Core Values 4 Section I: Demographic, Education, and Socioeconomic Indicators 6 Demographic Characteristics 7 Population 7 Age and Gender 9 Racial/Ethnic Diversity 11 Population with a Disability 12 Household Characteristics 15 Marital Status 16 Education 16 Educational Attainment 16 Graduation Rates 19 High School Dropout Rates 20 Basic Prose Literacy Skills 22 Limited English Proficiency 23 Children with Disabilities Receiving Special Education Services 23 Socioeconomic Indicators 23 Median Income Level 23 Wages 24 Child Care Costs 26 Housing 26 Employment 27 Employment by Type 32 Temporary Assistance for Needy Families (TANF) 33 Students Enrolled in Free and Reduced Lunch 34 Supplemental Nutrition Assistance Program (SNAP) 34 Social Security Administration Benefits 35 Unemployment 35 Poverty 37 Children in Poverty 41 Seniors in Poverty 43 45 Section II: Environmental Health Risk Factors Climate 46 Outdoor Air Quality 46 Indoor Air Quality 48 Occupational Health Risks 50 Water 52 Childhood Lead Poisonings 53 Housing Related to Blood Lead 54 Solid Waste Management 56 Hazardous Waste 56 Built Environment 56 1 Cape Girardeau County Public Health Center Community Health Assessment 2019 Section III: Public Safety and Domestic Violence 62 Crime Index 63 Juvenile Crime and Court Referrals 64 Domestic Violence 65 Child Abuse and Neglect 65 Section IV: Alcohol Tobacco and Substance Abuse 67 Alcohol Use and Abuse 68 Substance Use / Abuse 71 Tobacco Use 74 Smoking-Attributable Hospitalizations and Leading Causes of Death 77 Section V: Injury 81 Injury by Age 82 Injury by Cause 83 Leading Causes of Injury 86 Unintentional Injuries 86 Unintentional Injuries in Children 88 Section VI: Maternal and Child Health Indicators 89 Prenatal Care 90 Smoking During Pregnancy 92 Births 94 Gestation 95 Education Status of Mothers 97 Birth Weight 97 Teen Births 99 Birth Defects 101 WIC Participation 102 Section VII: Infectious, Communicable, and Vaccine Preventable Diseases 104 Infectious Disease 105 Sexually Transmitted Diseases 107 Communicable Diseases 109 Vaccine Preventable Diseases 116 Section VIII: Chronic Disease 119 Chronic Disease Background 120 Physical Inactivity 121 Unhealthy Diet 122 Adult Tobacco Use 123 High Blood Pressure 123 High Cholesterol 124 Overweight or Obese 125 Chronic Disease Risk Factor Summary 128 2 Cape Girardeau County Public Health Center Community Health Assessment 2019 Chronic Respiratory Disease 131 Diabetes 133 Cancer Incidence 136 Section IX: Leading Causes of Mortality 139 Causes of Death Overview 140 Death Related to Cancer 142 Deaths Related to Heart Disease 143 Chronic Lower Respiratory Disease Deaths 144 Diabetes Deaths 145 Infant Mortality 146 Child Deaths 148 Violent Deaths 149 Deaths by Race and Cause 150 Section X: Health Care System Indicators 152 Access to Care 153 Health Care Providers 156 Mental Health 159 Dental Health 162 Emergency Services 163 Long-Term Care Facilities 165 Transportation 165 Public Transportation 167 Section XI: Community Health Assessment Summary of Findings 169 Community Health Assessment Population Survey 170 Cape Girardeau County Public Health Priorities 172 3 Cape Girardeau County Public Health Center Community Health Assessment 2019 INTRODUCTION The Cape Girardeau County Public Health Center and its governing Board of Trustees have collaborated with community partners and residents to complete the 2018 Community Health Assessment of Cape Girardeau County. The 2018 Community Health Assessment contains baseline and trended data from a variety of sources including the Missouri Department of Health and Senior Services, Missouri Department of Social Services, Missouri Department of Elementary and Secondary Education, Missouri Kids Count, Office of Social and Economic Data Analysis, Missouri Department of Mental Health, Missouri Department of Natural Resources, U.S. Census Bureau Data Center, County Health Rankings, and other state and local data reports. This report examines rates and occurrences between Local, State, and National for key health status indicators as well as year to year comparisons for Cape Girardeau County. In instances where indicators reveal Cape Girardeau County is faring worse than the Region and the State, particular attention is paid to the importance of that health indicator being a public health priority issue. When indicators show that the rate for Cape Girardeau County is similar or slightly better than State rates, but when compared to the U.S. as a whole is still faring worse; it is also viewed as a public health priority. The information contained in this Community Health Assessment will be utilized by the Cape Girardeau County Public Health Center as a resource for identifying and planning service delivery, program planning, and fiscal obligation. MISSION– VISION – CORE VALUES Mission: Cape Girardeau County Public Health Center promotes good health and protects the County’s public health through: • Assessment of health and environmental needs • Policy Development • Community Education • Prevention • Assurance • Evaluation Vision: Cape Girardeau County will be a community where the safety and health needs of all people are identified, addressed, and resolved. Core Values: Cape Girardeau County Public Health Center’s staff and Board of Trustees are a dedicated, professional, physical and environmental health care team committed to building and maintaining a relationship of trust and accountability to the community. We believe in promoting access to care, communicable disease prevention and control, disaster preparedness, and quality environmental health services for all residents of Cape Girardeau County. We believe community partnerships and collaborations are key factors in achieving our strategic goals. 4 Between October 2018 – February 2019, Community Stakeholders, Partner Agencies, and Board of Trustees members joined Cape Girardeau County Public Health Center staff to review the findings from the 2018 Community Health Assessment. This included a review of the compiled data for each identified indicator, a summary of the analysis of that data, and input from the attendees. For each Health Indicator, local data was reviewed as well as a comparison to state and national benchmarks. For some indicators the data was compared to adjacent and surrounding counties in Southeast Missouri. Following this review, attendees participated in the process of prioritizing these indicators for health improvement planning. Attendees were asked to complete the following task: • Identify and list the ten leading priority issues that the Health Center, and the community as a whole, should focus on over the next 3-5 years, utilizing the following selection process: • The impact of the problem • The urgency of solving the problem • The size of the problem The Nominal Group method was utilized for this group prioritization. This method, in particular, allowed for group and individual input and information exchange. Through this process the group identified the following as Public Health Priority Issues (in rank order) 1. Mental Health 2. Substance Abuse 3. Access to Healthcare 4. Overweight Children 5. Wellness and Prevention 6. Transportation 7. Overweight Adults 8. Dental Health 9. Smoking / Smoking Cessation 10. Chronic Disease Care This same selection method was utilized again by Community Partners, Health Center Staff, and Board of Trustees members at the conclusion of the Local Public Health System Assessment process. Mental Health Care, Dental Health Care, Smoking, Substance Abuse, Heart Disease, Obesity, Child Injury and Death, and Access to Care were all identified as priority areas. In an attempt to adequately acknowledge and address these concerns, the Priority Health Issues were further grouped into three main categories. Combining the ranking scores of both processes, the Public Health Priority Issues have been identified as follows: 1. MENTAL HEALTH 2. WELLNESS & PREVENTION a. Substance Abuse b. Obesity: Adult and Childhood c. Smoking d. Dental Health e. Chronic Disease Care 3. ACCESS TO CARE a. Transportation 5 SECTION I: Demographics, Education, and Socioeconomic Indicators 6 SECTION I: Demographics, Education, and Socioeconomic Indicators DEMOGRAPHICS Cape Girardeau County, organized on October 1, 1812, is located in the southeastern part of Missouri with the Mississippi River forming the eastern border of the county. The geography of Cape Girardeau County varies greatly with the southern areas to be considered as flood plains while western and northern areas are hilly and forested. Cape Girardeau County is considered a Metropolitan Statistical Area with the County Seat located in Jackson, Missouri. Cape Girardeau is the largest city in the county and is home to Southeast Missouri State University. There are 3 cities (Cape Girardeau, Delta, and Jackson), 6 villages (Allenville, Gordonville, Oak Ridge, Old Appleton, Pocahontas, and Whitewater) and 9 unincorporated communities (Burfordville, Daisy, Friedheim, Fruitland, Millersville, New Wells, Oriole, Egypt Mills, and Randles). The 2017 U.S. Census Bureau estimates, Cape Girardeau County had a population of 78,161 residents and covered a geographical area of 578.54 square miles. The population per square mile averages 130.8. Table 1.1 compares the general demographics of the County and State for 2017.
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