A Compilation on Health Status
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A Compilation on Health Status Kentucky Department for Public Health Cabinet for Health and Family Services 275 East Main Street Frankfort, Kentucky 40621 TABLE OF CONTENTS Acknowledgements .......................................................................................................................... 3 Executive Summary .......................................................................................................................... 4 SECTION 1 Introduction ............................................................................................................................. 8 Demographics ........................................................................................................................ 12 Socioeconomic Factors .......................................................................................................... 15 Health Resource Availability .................................................................................................. 19 SECTION 2 Quality of Life ......................................................................................................................... 22 Lifestyle Behaviors ................................................................................................................. 25 Preventive Health Practices ................................................................................................... 31 Environmental Health ............................................................................................................ 38 Social and Mental Health ....................................................................................................... 43 Maternal and Child Health ..................................................................................................... 46 Mortality ................................................................................................................................ 54 Morbidity .............................................................................................................................. 64 Injuries ................................................................................................................................... 72 Violence ................................................................................................................................. 76 Infectious Disease .................................................................................................................. 78 Public Health System Assessment ........................................................................................ 93 SECTION 3 Futures Group Recommendations ......................................................................................... 94 Friedell Committee Recommendations ................................................................................. 96 Ten Winnable Battles (CDC Recommendations) ................................................................... 97 National Prevention Strategy .............................................................................................. 102 Healthy Kentuckians 2020 Plan ........................................................................................... 105 References ................................................................................................................................... 108 List of Figures and Tables ............................................................................................................. 111 2013 Kentucky State Health Assessment - Page 2 Acknowledgements The following individuals contributed to this compilation. Others not mentioned here include all those public health professionals who developed reports and compiled data for the source documents and referenced materials that were used to compile this assessment. Dr. Stephanie Mayfield, Commissioner Joy Hoskins Dr. William Hacker, Former Commissioner Kathy Fowler Dr. Steve Davis, Former Deputy Dr. Kraig Humbaugh Commissioner Laura Iwig Amanda Gatewood Linda Sims (Lincoln Trail DHD) Amanda Wilburn Liz Hoo April Harris (Three Rivers DHD) Mark Pyle (Christian CHD) Becky Gillis Matthew Hill Bonita Bobo Melissa Gibson Brandon Hurley Paul Hopkins (Pike CHD) Chang Lee Dr. Robert Brawley Charles Kendell Rona Dawson Chris Workman Rosie Miklavcic Dr. Christopher Stein, UK Prev. Med. Dr. Ruth Shepherd Resident Sandy Kelly David Smith Sara Robeson Dennis Chaney (Barren River DHD) Sarah Wilding Dennis Peyton Dr. Sarojini Kanotra Elaine Russell Shelley Adams Ellen Kershaw (Alzheimer’s Association Sigga Jagne of Greater Louisville) Sue Thomas-Cox Dr. Fontaine Sands Teresa Goins Fran Hawkins Dr. Teri Wood Dr. Georgia Heise (Three Rivers DHD) Dr. Terry Bunn (KIPRC) Gwen Cobb (KIPRC) T.J. Sugg James Tolley (Pennyrile DHD) Dr. Tony Lobianco, Univ. of Kentucky Jan Chamness (Montgomery CHD) Dr. Torrie Harris Janie Cambron Dr. Tisha Johnson, UK Prev. Med. Resident Jennye Grider Tracey Jewell Jim Rousey Tricia Okeson Jodi Smith Vivian Lasley-Bibbs Special acknowledgement is made to the Center for Performance Management, Kentucky Department for Public Health for compiling this document. 2013 Kentucky State Health Assessment - Page 3 EXECUTIVE SUMMARY DEMOGRAPHIC SUMMARY Kentucky’s population of 4,339,367 ranks 26th among the states. The population’s distribution by gender and age groups are representative of the distribution of the U.S. population. Kentucky has a lower percentage of African Americans and Hispanic/Latinos than the U.S. population; however, the Hispanic/Latino population doubled in the last decade. Kentucky’s population growth from 2000 to 2010 is lower than the U.S. population growth but exceeds the average growth among the seven states contiguous with Kentucky. SOCIOECONOMIC SUMMARY Health status is greatly influenced by income and education. Children living in poverty have greater risk for school failure, poor health and higher rates of teenage pregnancy and childbearing. Men and women with a 4-year college degree can expect to live longer than men and women having only a high school diploma or GED. HEALTH RESOURCE SUMMARY Less healthy counties have a higher percentage of citizens who are uninsured. Having insurance greatly improves access. Kentucky has a significant number of counties identified by Health Resources and Services Administration (HRSA) with shortage designations (health professional shortage areas and/or medically underserved areas). QUALITY OF LIFE SUMMARY Citizens in the least healthy counties report a poorer quality of life. Citizens in the healthiest counties report fewer “poor physical” and fewer “poor mental” days. Health influences the quality of life. LIFESTYLE BEHAVIORS SUMMARY Smoking, diet and physical inactivity account for one-third of all preventable deaths. Kentuckians still smoke too much, are too overweight or obese, and are too sedentary. Teen birth rates are lower in healthier counties and higher in less healthy counties. PREVENTIVE HEALTH PRACTICES SUMMARY More Kentuckians need to be screened for breast cancer, cervical cancer, and colorectal cancer at recommended intervals. More Kentuckians need to have annual flu and recommended pneumonia vaccinations. More Kentuckians need to visit their dentist on an annual basis. 2013 Kentucky State Health Assessment - Page 4 ENVIRONMENTAL HEALTH SUMMARY Air pollution is worse in large more urban areas. Education about infectious diseases is needed for staff who work at child care centers, swimming pools, confinement facilities, schools, and long term care facilities – places prone to have infectious disease outbreaks. Fast food restaurants and availability of healthy foods are noteworthy environmental issues. SOCIAL AND MENTAL HEALTH SUMMARY Kentuckians report a higher number of “poor mental health days” than 48 other states. Kentucky and Mississippi (least healthy state in U.S.) have almost twice the number of adults with serious psychological distress than Vermont (the healthiest state in U.S.). Less healthy counties in Kentucky have greater percentages of adults who lack an adequate social support network. MATERNAL AND CHILD HEALTH SUMMARY The percentage of pregnant women receiving early prenatal care appears to be decreasing. The percentage of women who report smoking during pregnancy ranges from 15 percent to 54 percent in Kentucky’s counties. Over the last 20 years, the percentages of preterm birth and low birthweight infants have been increasing. MORTALITY SUMMARY Kentuckians die from the same leading causes of death as most of the nation. Kentuckians die at higher rates for many of the Ten Leading Causes of Death. Kentuckians living in healthier counties live longer than citizens living in less healthy counties. Disparities of race and ethnicity greatly increase infant mortality. MORBIDITY SUMMARY Significant numbers of Kentuckians are burdened by serious chronic diseases. Kentucky has a higher percentage of adults with heart disease, diabetes, high blood pressure, asthma, disabilities and complete edentulism than most states. Kentucky has a higher rate of adults with risk factors for heart disease, including high blood pressure and high cholesterol. INJURY SUMMARY Unintended injuries are a leading cause of death. Too many Kentuckians are dying in motor vehicle crashes. Seatbelts and child restraints are vitally important to preventing death in motor vehicle crashes. Driving and texting on cell phones present new challenges. Suicides and self-harm