Seneca County

2013 Project Assessment Health Seneca County

COMMUNITY

community. our and look forward to new members bringing new ideas and resources toAlliance the We encourage new membership into the Seneca County Health Alliance and and strive to initiate quality programs to improve the healt community, our in needs unmet identify resources, coordinate to collaboratively work to continue will we assessment, this of results the As review we member. This assessment will prove invaluabl cautious comparing in previous data to this current assessment. comparisons can be made related to previous health assessments, one must be assessment throughAlthoughThis is counted reliable scientificmethod. well and health of areas in the structure our community into insight additional provide will It strategies that focus on wellness, access to care, and unmet community needs. d The residents of Seneca County. and weaknesses order in to take action to improve the health and well our strengths analyze and compare to nation and state community, our into community Health Assessment is the result of astrong commitment by dedicated Community comprehensive This community. Assessment our of Health 2013 The members of the Seneca County Health Alliance are pleased to present the FOREWORD ata presented thisin report will provide valuable information to develop partners. This health assessment gives usthe opportunity to glance - being. being.

e to you as an agency or a community community a or agency asan you to e h of our residents. residents. our of h - being of

FirstCall for Help FostoriaCommunity Hospital – Fostoria City Schools Services Recovery and Counseling Firelands Program Coordinator Christine Schools City Tiffin Superintendent Don Coletta Director Executive Cochran Nancy Salvation Army Martha Cobb Commission OnAging Director Project Carper Brenda Seneca County General Health District CommunityHealth Nurse Laura Bogard Director of Nursing Jenifer Bayer by: Commissioned Schools City Tiffin SenecaCounty Department of JobFamily and Services Seneca County General Health District Council First Children and Family County Seneca Community Hospice Care Seneca forFunding the A OSU Extension Educatorfor Youth Development Golden Ann Council First Children & Family County Seneca Director Executive George Sharon Fo Wel Bev Funkhouser Seneca County Sheriff Sheriff Bill Eckelberry Fostoria Ministerial Pastor Bernie Dickson Seneca UnitedWay Director DeMonte Pat Schools City Tiffin Director of Operations Scott Daniel of Seneca, Sandusky and Wyandot Counties Mental Health and Recovery Services Board Seneca County General Health District Printing of the report made possible by the Mental Health and Recovery Merc Mental Health and Recovery Services Board of Seneca, Sandusky and Wyandot Counties

storia Communitystoria Hospital – lness Specialist CKNOWLEDGEMENTS yHospital of Tiffin

Courtney

Fostoria

Seneca County Health Alliance Health County Seneca

County Health Assessment Provided by: Provided Assessment Health County

ProMedica Pro

Medica

Board of Seneca, Sandusky and Wyandot Counties Heidelberg University Heidelberg Director Assistant Becky Gosche Ment Director Deputy Handru Mircea Allen Eiry Senior Center Director Executive Hampshire Sue MercyHospital of Tiffin PK PK Social Services Coordinator Angel Torrez WSOS Advocate Health Todd Angi Fostoria City Schools Nurse School Sheryl St. Clair, RN, BSN Community Hospice Care Director Executive Rebecca Shank Services Recovery and Counseling Firelands Site Robin Reaves SenecaCounty Department of JobFamily and Services Director Oliver Kathy ManagerOutpatient of Lori Myers Fostoria MayorOffice Dir Murray Allyson Tiffin of City Mayor MontzAaron School of Opportunity Superintendent Hurst Lewis . Of Public Safety and Service and Safety Public Of .

Management Director alHealth and RecoveryServices

Services levy

Services and Specialty Clinics Specialty and Services

funds.

419- Phone: 44883 Ohio Tiffin, 600 North River Road of Seneca, Sandusky, and Wyandot Counties Recovery & Health Services Mental Board Cochran A. Nancy Information Contact James H. Price, Ph.D., MPH Data &Collection Analysis Margaret Wielinski, MPH Ohio Northwest of Council Hospital Foundation Communities Healthy Development Report and Collection, Data Data, Secondary Management, Project Email: [email protected] Emeritus Professor Specialist Data Improvement Health Universityof Toledo G Nagl Amy Universityof Toledo Professor of Health Education M.Ed. Jordan, Ph.D., R. Timothy raduate Assistant e

448- 0640

Education Health of

Assistant Director of Health Planning Ward, Britney L. MPH Joseph A. Dake, Ph.D., MPH MichelleLehmden Von Professor and Chair of Health Education Universityof Toledo Health Assessment Coordinator Assessment Health

INFORMATION AND HOUSEHOLD DEMOGRAPHICS PROFILE DEMOGRAPHIC PARTICIPATION SCHOOL METHODS WEIGHTING AND TERMS LIST ACRONYMS OF SOURCES INFORMATION ASSESSMENT HEALTH ISSUES VIOLENCE YOUTH SAFETY YOUTH SUICIDE AND HEALTH MENTAL SEXUAL BEHAVIORAND TEEN PREGNANCY OUTCOMES USE DRUG OTHER AND MARIJUANA CONSUMPTION ALCOHOL USE TOBACCO CONTROL WEIGHT PARENTING ORAL SUICIDE AND HEALTH MENTAL AND SAFETY CONTEXT SOCIAL LIFE OF QUALITY SEXUAL BEHAVIORAND PREGNANCY OUTCOMES EMERGENCY PREPAREDNESS PREVENTIVE MEDICINEAND HEALTH SCREENINGS HEALTH MEN’S HEALTH WOMEN’S USE DRUG OTHER AND MARIJUANA CONSUMPTION ALCOHOL USE TOBACCO WEIGHT STATUS AN ASTHMA ARTHRITIS DIABETES CANCER CARDIOVASCULAR HEALTH AND ACCESS UTILIZATION CARE HEALTH COVERAGE CARE HEALTH PERCEPTIONS STATUS HEALTH SUMMARY TREND EX ECUTIVE SUMMARY ECUTIVE Appendices

Youth Health HEALTH Adult Health TABLE OFCONTENTS

D OTHER RESPIRATORY DISEASE DISEASE RESPIRATORY OTHER D

(Ages 12 (Ages Over) 19and (Ages

- 18)

APPENDIX VI PAGES 140 PAGES VI APPENDIX APPENDIX III III APPENDIX

APPENDIX II APPENDIX APPENDIX I APPENDIX I APPENDIX APPENDIX V V APPENDIX

PAGES 125 PAGES 122 PAGES 119 PAGES 115 PAGES PAGES 108 PAGES 105 PAGES 101 PAGES PAGES 128 PAGES PAGES 135 133 PAGES PAGES 99 PAGES PAGES 71 PAGES 65 PAGES 57 PAGES 52 PAGES 49 PAGES 46 PAGES 43 PAGES 35 PAGES 30 PAGES 28 PAGES 21 PAGES 17 PAGES PAGES 93 PAGES 90 PAGES 88 PAGES 81 PAGES 76 PAGES PAGES 62 PAGES 40 PAGES 24 PAGES PAGES 96 PAGES 79 PAGES V PAGES 5 PAGES

PAGE 139 PAGE 138 PAGE 112 ------127 124 121 118 114 111 107 104 100 147 137 132 134 ------95 92 89 87 78 75 70 61 56 51 48 45 39 34 29 23 20 16 98 80 64 42 27

primary and secondarydata into thefinal report. Ohio collected the data, guided thehealth assessment process and integrated sources of and Youth Risk Behavior Surveillance System(YRBSS). The Hospital Council of Northwest Prevention for their national and state Behavioral Risk Factor Surveillance System(BRFSS) and Control Disease for Centers usedthe by instruments survey the after modeled based on self needs assessment. assessment. needs throughout theplanning processregarded is an important as step in completing a valid conte community leaders were actively engaged in the planning process and helped define the written survey of adults adolescents and within Seneca County. From the beginning, participated in a county County adults(19years of age and older)(ages and youth through 12 18), who EXECUTIVE SUMMARY INSTRUMENT DEVELOPMENT INSTRUMENT DESI Primary DataCollectionMethods

fromSeneca County was obtained fromAmerican Clearinghouse in Louisville, KY. representative of theentire county.The random sample of mailing addresses of adults sampleand size meansthe responses that in thehealth assessment should be level of confidence.The response rate for themailing was 49%(n=467). This return rate errorof the survey findings.)A sample size least of at 381 adults was needed to ensure this sur 95% be can (i.e., we needed to ensureconfidence a 95% level with a corresponding confidence interval of 5% County. The investigators conducted a power analysis to determine what sample size was over living in Seneca County. Th to this age parameter, the investigators calculated thepopulation of those 18 years and exactly correspond do not categories age Bureau U.S.Census Since survey. adult for the SAMPLING education researchers theUniversity at of Toledo. items for theadolescent survey.The drafts were reviewed and approved by health drafts composed Coordinator discussed. Basedon from input theSeneca County planning committee, the Project banks of potential survey questions from theBRFSS and YRBSS surveysreviewed were and of meetings with the p based on being able to compare local datawith state and national data. surve from BRFSS.The survey items majority ofadult the derive to the decided the assessing thehealth status and health needs of adults and adolescents.The investigators sourc potential discuss to from theUniversity of Toledo and staff members from theHospital Council of NW Ohiomet and one for adolescents.As a first step in thedesign process, health education researchers GN y items for theadolescent survey were derived from theYRBSS. This decision was nt, scope, and sequence of thestudy.Active engagement of community members T and were pilot designed tested instruments survey Two for this study:one for adults This community health assessment was cross Adults ages frame 19 and sampling used overwere as the living County in Seneca The Project Coordinator from theHospital Councilof Ohio NW conducteda series his executive summaryprovides an overview ofhealth

| Adult Survey Adult - a dministered surveysusing a structured questionnaire. The questions were

lanning committee from Seneca County. During these meetings, e that thee “true” population responses are within a 5% margin of - es ofvalid and reliable survey items that wouldappropriate be for wide health assessment survey during 2013.The findings are

of surveys containing 115 items for the adult survey and 76 76 survey and adult for the 115items containing of surveys ere were 43,377 persons ages 18 and over living in Seneca Seneca in over living 18and ages persons 43,377 were ere

- sectional in nature and included a - related data for Seneca data related

procedure for adults took place from January throughApril 2013. as undeliverable replaced were not with another potential respondent. The entire mailing third wave postcard was sent two weeks after the second wave mailing. returned Surveys reply, another copyof thequestionnaire on colored paper, and another reply envelope.A second wave mailing included another personalized cover letter encouraging them to return envelope; and incentive. a $2 Approximately weeks two after the fir then t non and respondents little between no differences to were there County). If validity of theresults(the generalizability of theresults to thepo respondents regarding the questions asked, this would represent a threat to theexternal However, if any important differences existed between therespondents and thenon possible limitations. First, theSeneca County adult assessment rate. had a good response LIMITATIONS ANALYSIS DATA | PROCEDURE | SAMPLING Appendix iii. analyses. For more informatio weightings were created based on this information to account for different types of was weighted by age, gender,race, and income using 2010 census data.Multiple presented in this report. To be representative of Seneca County, theadult datacollected Toledo using SPSS 17.0.Crosstabs were used to calculate descriptive statistics for thedata available.All datawere analyzed by health education researchers the at University of and had a multiple choice response format. Thestudents were surveyed February in 2013. any student whose classwas selected to participate. The survey contained 76 questions chosen by theschool principal. Passive permission slips were mailed home to parents of the class that was selected,such a general as English or health class. Classrooms were randomly selected. student Each in that grade had to have an equal chance of being in purpose of thestudy; a questionnaire printed on colored paper;self a hand signed cover letter (onSenecaCounty Alliance Health stationery) describingthe implemented to maximize the survey return rate.The initial mailing included a person selected. were they if survey promptly the return and complete readers to the also explained that the respondents’ confidentiality would be protected survey. The letter the receive to selected they randomly may be readers that the informed General Health District. The letter introduced thecounty health assessment project and Alliance stationery and was signed by Jenifer Bayer and Laura Bogard, Seneca C Seneca County.This advance letter was personalized, printed on SenecaCounty Health | PROCEDURE of confidence.The response rate was 90%(n=436). survey findings.)Asample size least of at 353 adolescents was needed to ensure this level can be 95% sure the that “true” population responses area 5% within margin of errorof the ensure a 95% confidence level with a corresponding confidence interval of 5%(i.e., we investigators conducted a power analysis to determine what sample size was needed to his would not be a limitation. As all with county assessments, is it important to consider thefindings in light of all Individual responses were anonymous and confidential. Only group dataare Superintendents reviewed and approved thesurvey. Two weeks following the advance letter, a three Prior to mailing thesurvey to adults, an advance letter was mailed to 1,000 adults in Youth in grades 6

Adolescent Survey Adolescent Adolescent Survey Adolescent Adult Sur

vey - 12 were used as thesampling frame for theyouth survey.The

n on how the weightings were created and applied, see

- wave mailing procedure was Schools and grades were were grades and Schools pulation of Seneca

- addressed stamped and encouraged st mailing, a - respondents,

ounty ounty alized -

2011) assessment. CDCth surveyyou was administered in schools in a similar fashion as this county health adults were asked thequestions over the telephone rather than as a mail survey.The CDC adult datawere collected using a set of questions from thetotalquestion bank and wording same the as the CDC questionnaires, theadult datacollection method differed.

live below the poverty level. 30 and those an with income levelunder $25,000. Seneca In County, 15.4% of residents without health care coverage. Those most likely The 2013Assessment Health data has identified that 15% ofSeneca County adults were HEALTH poor?” *Respondents described their health as fair or poor. of 65, age the over those 17% of to adults,increasing the of 13% Conversely, very good. 2013,In (50%) half of theSeneca County adults rated their health statusexcellent as or PERCEPTIONS HEALTH Data Summary 100% 20% 40% 60% 80% 0% 10% 20% 30% 40%

S CARE COVERAGE CARE econd, is it important to note that, although several questions were askedusing

Total Total 13% 50% 37% were asked: “Would you say that in general your health is excellent, very good, good, fair or

15%

Males Males 12% 44% 44% 15%

Females

32% Excellent/Very Good Excellent/Very Seneca County Adult Health Perceptions* 14% 54% 16% (Source U.S. Census, American Community Survey 3 Year Estimates, 2009 Uninsured Seneca County Adults Seneca CountyUninsured

Under 30 Under Under 30 Under 24% 20% 16% 64%

years 30-64 Years 30-64 12% 16% 40% 48%

Good

to be uninsured were adults under age adults were to uninsured be 65 & Over 65 Over 65 & 17% 6% 34% 49%

Fair/Poor

Income Income <$25K <$25K 29% 27% 29% 44%

Income Income $25K $25K Plus Plus 9% 55% 36% 9%

Seneca

Seneca 2005 2005 10% 51% 14% 35%

Seneca Seneca 2009 2009 11% 12% 55% 33%

- asthma. According to theSeneca County survey data,16% of adults had been diagnosed with ASTHMA were told they have arthritis. Ohio adults and 24% ofU.S. adults of 29% 2011BRFSS, the to According diagnosed were adults arthritis. with County Seneca of 31% survey data, According to theSeneca County ARTHRITIS had been diagnosed with diabetes. adults County Seneca 2013,of 9% In DIABETES detection may reduceoverall cancer deaths. limiting alcoholic beverages and early eating more fruits and vegetables, adopting a physically active lifestyle, maintaining a healthy weight, not using toba American CancerSociety advises that causeof death in thecounty. The from cancer, the second leading died County residents of Seneca 1,123 from 2000- that indicate Department of Health statistics some time in their life. Ohio had been diagnosed with cancer at adults County Seneca 2013,of 9% In CANCER (Source: ODH Information Warehouse). 2006- from deaths adult County accounted forof 34% Seneca all Heart disease (28%) and stroke (6%) CARDIOVASCULAR routine checkup. with incomes less $25,000. than thepast In year,5 a hospital emergency room as their usual place of health care, increasing to 17% of those The 2013Assessment Health project identified that 8% of Seneca County adults were using ACCESS CARE HEALTH stroke. and disease heart for factors risk known four smokers, 17% were and obese, were 36% cholesterol, blood high blood pressure,have 36% high adults have been diagnosed with one stroke some at time in their life. Nearly had aheart attack and 2% had a Assessment found 7% that of adults Health County 2013 Seneca - third (30%) of Seneca Co

cco products,

HEALTH

2008, a total total a 2008,

unty unty The The 2008

5. 4. 3. 2. (Source: ODH Information ODH Warehouse,(Source: updated 4 . . . ODH, Information Warehouse) (Source: Cancer Ohio Incidence Surveillance System, County. Seneca in deaths 134cancer were 2010, there In . . . . Information ODH Warehouse,(Source: updated 4 1.

Diabetes (5%) Diabetes (6%) Stroke Chronic Lower Respiratory Diseases(8%) (21%) Cancers Heart Disease(28% deaths) of all

females (24.3 40.6 Ohio) and (34.4 for males 51.6 deaths was diabetes for per 100,000 rate mortality adjusted - From 2006 death in Ohio from 2006 Diabetes was the 7th leading cause of death in Seneca Countyfrom 2006 Diabetes was the 5th leading cause (12%) cases 38 Rectum: and Colon Breast: 43 cases Lung and Bronchus:(14%) cases 44 (15%) 46cases Prostate: Incidence of Cancer, 2005 Cancer, of Incidence 7% of adults had visited a doctor for a a for doctor a visited had adults of 7% Leading Types Death of .

All Types: 308cases All Types: Total Deaths: 1,747 2008, the Seneca County age County Seneca the 2008,

Seneca County Seneca County Seneca Diabetes Facts Diabetes

2006

(14%) -

2008

Ohio) deathsfor

- 2008.

- 2009

- 2008. of of - - 15- 15- 10) 10)

100%

20% 40% 60% 80% 100% number is expected to increase to 8 million tobacco use is responsible for almost 6 million premature deaths, and 2030, by this obese.Over (51%) half of adults were trying to lose weight. 28% of U.S. adults were obese by BMI. Over one Over obeseby BMI. were of adults U.S. 28% or obese basedon BodyMass Index (BMI).The 2011 BRFSS indicates that 30% ofOhio and The 2013Assessment Health identified that 71% of Seneca County adults were overweight ADULT responsible for thedeaths of approximately long half of that tobacco use was the most preventable cause of death worldwide, and is (ACS) stated Society Cancer American 2013, the In smokers. former considered were 25% smokers and current were adults County Seneca 2013, of 17% In ADULT Cancer Society, 2013). Society, Cancer

0% 20% 40% 60% 80% 0% (Percentages may not equal 100% due to the exclusion of data for those who were classified as

WEIGHT STATUS WEIGHT TOBACCO USE TOBACCO Total

28% 35% Total 36% 58% 25%

17%

Male 43% 15% 41% Male

29% 58% 13% If yes, do you now smoke cigarettes every day, some days or not at all?”

Female “Haveyousmoked atleast 100 cigarettesyour in entire life? Female 30% 39% 31% 58% 21% 21% Current smoker Current Seneca County Adult BMI Classifications Seneca County Adult Smoking Behaviors

Under 30 Under Normal Under 30 Under 21% 49% 26% 68% 14% 18% underweight) Respondentswere asked:

Years 30-64

Years Overweight

30-64 40% 25% 35% (Source: Cancer Facts & Figures, American 27% Former smoker Former 53% 20%

third (36%) of Sene (36%)of third Over 65 & 36% Over 43% 21% 65 & 38% 9% 53%

term users. Each year, year, users. Each term Obese

Income < Income

$25K Income <$25K

45% 28% 27% Never smoked Never 26% 21% 53%

Income ca County adultsca were $25K Plus Income 37% 28% $25K 34% Plus 59% 27% 14%

Seneca 2005 Seneca 38% 31%

30% 2005 49% 27% 24%

Seneca 2009 Seneca 31% 41% 27% 2009 26% 55% 19%

10% 15% 0% 5%

good or high and/or more active or alert or active more and/or high or good adults had used medication not prescribed for them or took more prescribed than to feel 2013,In 5%ofSenecaCounty adults had used marijuana during thepast 6 months.of 4% USE DRUG OTHER AND MARIJUANA ADULT beverages. alcoholic 5or more drinking drove after adults dri guidelines).of 39% adults who drank had five or more drinks(for males) and 4 or more CDC per week, per ordays more three of (drank average an drinkers frequent considered 2013,In theHealth Assessment indicated that 10%of SenecaCounty adults were CONSUMPTION ALCOHOL ADULT drinks (for males) or four or more drinks (for females) on an occasion at least once in the previous month (for males) or four or more drinks (for females) on an occasion. Adults must have reported drinking five or more *

Based on adults who have drunk alcohol in the past month. Binge drinking is 20% 40% 60% 80% 0% nks (fornks females)on one occasion(binge drinking) in thepast month. Five percent of Total 5%

Total 39%

Seneca County Adult Drinkers Who Binge Drank in Past Month* Past in Drank Binge Who AdultDrinkers CountySeneca

Males 7% Males 50%

Seneca County Adult UseMarijuana in 6 Past Months

Females Females 4% 29%

Under 30 Under Under 46% 30 8%

Years 30-64 Years 30-64 37% 6% during the past 6 months.

Over 65 & 24% Over 65 & 1%

Income <$25K 28% Income <$25K 7%

Income $25K Plus 42% defined as havingfivemoreor drinks Income $25K Plus

Seneca

2005 39% Seneca 2005

4% Seneca

2009 40% Seneca 2009

5% .

1 1

100% smokers, w smokers, pressure, 31% had high blood cholesterol, 31% were obese,21% and were identified as and 2% had a stroke some at time in their life. Over one attack heart a 3% had of that women determined Assessment the past year. The Health had aclinical breast exam and 49%smear cancer to haddetect aPap of cervix the in having a mammogram thepast year. in 50% ofSeneca County women ages 19over and 2013,In more half than (51%) ofSenecaCounty women over theage of reported 40 HEALTH WOMEN’S

cardiovascular diseases. 13% were identified as smokers, which, along wit men had been diagnosed with high blood pressure, 41% had high blood cholesterol, and a heart attack and 3% had survived a stroke some at time in their life. One 2006 from County stroke) accounted for33% and cancers accounted forof Seneca 24%in male all deaths digital rectal exam the in year. past Major cardiovascular diseases(heart disease and (PSA) test in thepast year. Moreone than In 2013, 48% of Seneca County males over the age of 50 had a Prostate a of 50had age over the males County Seneca 2013, of 48% In HEALTH MEN’S 25% 50% 75% 20% 40% 60% 0% 0% 30% 30%

Total Total hich are all known risk factors for cardiovascular diseases. 50%

22%

49%

Seneca County Men's Health Exams Within Year Past the Within Exams Men's Health CountySeneca

- Seneca County Women's Health Exams Within Year Past the Within Exams Women's Health CountySeneca 2008.AssessmentThe Health determin

3% Under 40 Under Under 50 Under 10%

51%

56%

Prostate-Specific Antigen Prostate-Specific

Mammogram 40 & Older 40 51% 50 & Older 50 48%

51%

37% 40%

- third (37%) of third

22% Breast Exam Breast Income <$25K 23% Income <$25K

50% h obesity (43%), are known risk factors for risk (43%), known are obesity h

15%

48%

- 34% males over the age of 50 had a a of 50had age the over males quarter(27%) high blood had ed that 11% of men had survived had 11% of men that ed Income >$25K Income Digital Rectal Digital 35% >$25K

50% Pap Smear Pap

27%

49%

Seneca 2005 Seneca 29%

Seneca 2005 Seneca 34%

57% - Specific Antigen

- 30% third (33%) of of (33%) third

59%

42% Seneca 2009 Seneca Seneca 2009 Seneca 21%

58%

14%

54%

STDs STDs represent only 25% of thesexually experienced population, they acquire nearly half o stopped doing usual activities. period of or two more weeks they when felt so sad or hopeless nearly every day that they 2013,In 4%ofSenecaCounty adults considered attempting suicide.of adults 13% had a M firearm in or around their home. Sene 2013,of 9% In CONTEXT SOCIAL mental or emotional problem. 2013,In 29% ofSenecaCounty adults were limited in some way becauseof a physical, LIFE OF QUALITY percent of adults had more one than partner. though Even young aged people 15 2013, three nearly In OUTCOMES & PREGNANCY BEHAVIOR SEXUAL ADULT would evacuate if authorities announced amandatory evacuation. prepared to handle a large 2013,In 67% ofSenecaCounty residents indicated their household was somewhat or well PREPAREDNESS EMERGENCY screening within the past 24 months. in their life.Almost Almost(46%) half of adults ages 65over and a pneumonia had vaccination some at time SCREENINGS HEALTH AND MEDICINE PREVENTIVE 25% 50% 75% ENTAL HEALTH AND SUICIDE AND HEALTH ENTAL 0% (Source: STDsCDC, in Adolescents and Young Adults, 2011 STD Surveillance). Total 51%

Male

58% one ca Countyca adults were abusedin thepast year.51%of adults kepta Home the in Firearm a With AdultsCounty Seneca - fourths(72%) of SenecaCounty adults had sexual intercourse. Five

- third (29%) third of ages adults and over 50 cancer had acolorectal Female 45% - scale disast scale

Under 30 Under

45%

er or emergency. 65% of adults reported they they reported adults of 65% er or emergency. Years 30-64 55%

Over 65 & 47%

Income <$25K 33%

Income $25K Plus 56%

Seneca 2005 45%

Seneca 2009 43% - 24

f all 1 2

1 3

past year. had visited the dentist for a check PARENTING in theprevious twelve months.Almost three reported 70% that of U.S.adults and 72%of Ohio adults had visited a dentist or dental clinic County adults had visited a dentist or dental clinic in thepast year.The 2010 BRFSS 2013Health The HEALTH ORAL have enoughfood. reported they went to bed hungryon least at one day per week because they did not youth of 15% week. per more days or on3 minutes for 60 exercising were youth of 65% weight, 34%ofSenecaCounty youth reported that they were slightly or very overweight. according to Body MassIndex(BMI) by age. asked When how they would describe their The 2013Assessment Health identified that 17% of Seneca County youth were obese, STATUS WEIGHT YOUTH identified they were concerned with their child and bullying. of 30% week. parents everyof the together day meal a ate household their in member The 2013Assessment Health project identified that 28% of parents reported everyfamily

100% 20% 40% 60% 80% 0%

Total 17% 14%

62% 8% - three nearly that determined has project Assessment

Obese Male 11% 55% 24% 11% Classifications BMI Youth County Seneca

Female Overweight - up, exam, cleaning, teeth or other dental work in the 70% 18% 8% 4%

- younger fourths(74%) of Senecayouth in grades 6 13 or 14% 16% 59% 12% Normal

14 to 16 to 14 18% 12% 64% 6%

Underweight

17 & Older 17 62% 13% 21% 4% fifths (59%) of Seneca

Seneca 2009 Seneca 14% 13% 70% 3%

- 12

had been drinking alcohol. of binge drinking. 8% of high school all youth had driven a car in thepast month after they 6th over theage of least17 one had at drink in thepast 30 days. Morehalf than (57%) of the 6th County Seneca all of 20% younger. or old years 6th of older. 40% those and seventeen grades 6 2013,In theHealth Assessment results indicated that 50% ofSeneca County youth in CONSUMPTION ALCOHOL YOUTH Of County youth in grades 6 Seneca of 6% Overall, 17. of age the over were who those of 19% to increasing smokers, The 2013Assessment Health identified that 9% ofSeneca County youth in grades 6 USE TOBACCO YOUTH

10% 20% 30% 100% those 6th 0% - 20% 40% 60% 80% 12th grade youth who reported drinking in the past 30 days one episode least had at 0% *Based on all current drinkers. Binge drinking is defined as having five or more drinks on an - 12 had drank least at one drink of alcohol in their life, increasing to 75%ofyouth Total Total 9% - 57% Current smokers are those who have smoked at any time during the past 30 days. 12th grade youth who currently smoked, 70% had tried to quit. Seneca County Youth Current Drinkers Binge Drinking Past in Drinking Binge Current Drinkers Youth CountySeneca

Smokers Current Are Who Youth CountySeneca Male 10% Male

62%

12 indicated they had used chewing tobacco in the past month.

Female Female 9% 53%

12 to 13 to 12 - 12th graders who drank, took their first their took drank, graders who 12th 12 to 13 to 12 4% 18%

Month*

14 to 16 to 14 10% 14 to 16 to 14 - 53%

12th grade youth and 45% of those of those 45% and youth grade 12th

17 & Older 17 17 & Older 17 19% 76%

Seneca 2005 17% Seneca 2005 69%

Seneca

2009 11% drink at 12 at drink occasion.

Seneca 2009 64%

- 12 were 12 were

1 4

1 5

100% behavior questions. were sexually active, were and 4% had participated in anal sex. 16% of youth participated in sexting.Of those who increasing to 72% of those ages 17over. and 20% ofyouth had participated in oral sex to get high at some time in their life, increasing to 19%of thoseover theage of 17. used youth the past 30 days, increasing to 29% of those ages 17 and older. 7% of 6th 7% older. 17 and ages those 29% of to 30days, increasing past the In 2013, 9% of Seneca County 6th County Seneca 2013,of 9% In USE DRUG OTHER AND MARIJUANA YOUTH In 2013, one In OUTCOMES PREGNANCY & BEHAVIOR SEXUAL YOUTH 25% 50% 75%

0% 10% 20% 30% 40% 0%

Total 25% 2% medications that were not prescribed for them or took more prescribed than Cocaine - quarter quarter 1%

Male

24% Seneca County Youth Who Had Sexual Intercourse Intercourse Sexual Had Who Youth CountySeneca (25%) of SenecaCountyyouth have had sexual

58% had 58% multiple

1% Heroin

1% Total Female Seneca County Youth Lifetime UseDrug Lifetime Youth CountySeneca <1%

27% 1%

12th grade youth had used marijuana least at once in

Male Medications 7% Younger sexual partners. 2 school districts did not ask sexual 13 or 7%

10%

Female 14 to 16 to 14

27% 1%

Meth

17 & Older 17 2%

Seneca 2009 Seneca 72%

2% Steroids

2% Seneca intercourse, 2005 1%

31% 1%

- 12th grade grade 12th

5% Seneca Inhalants 2009

25% 3%

100% YOUTH VIOLENCE YOUTH they met online. riding in a car driven by someone else.ofyouth 12% had been asked to meet someone youth had been bullied in thepast year and 33%had been bullied on school property. been threatened or injured with a SenecaIn County,ofyouth 7% had carried a weapon in thepast month. 5% ofyouth had self youth County Seneca 2013, of 39% In SAFETY YOUTH actually attempting suicide in the past year. had seriouslyyouth considered attempting suicide in thepast year and 4% admitted 2013,In theHealth Assessment results indicated that 10% ofSeneca County 6th SUICIDE AND HEALTH MENTAL YOUTH 20% 40% 60% 80% 10% 15% 0% 0% 5% Total Total 12% 39% 50% 10%

Male Male 13% Month Past the in Use Seatbelt Youth CountySeneca 37% 50% 8% Seneca County Youth Who Had Seriously Considered

Always 12Months Past the in Suicide Attempting Female Female 41% 49% 10% 12% weapon on school property in thepast year.of 51%

younger Most/Sometimes 12 to 13 to 12 13 or - 51% 13% 36% reported that they always wore a seatbelt when 9%

14 to 16 to 14 14 to 16 to 14 41% 50% 12% 9%

Rarely/Never 17 & Older 17 17 & Older 17 39% 45% 16% 7%

Seneca Seneca 2005 2005 12% 10% 40% 52%

- 12th grade grade 12th Seneca Seneca

2009 2009 10% 10% 42% 48%

1 6

Described themselves as slightly or very Y Ever been electronically/cyber bullied Bullied on school property in past year past in property school on Bullied Felt sadFelt or hopeless almost everyday Threatenedor injured awith weapon calories,or foods fewer food, less Ate Suicideattempt resulted an in injury, Physically active at least 60 minutes Physically active at least 60 minutes Been aphysical in fight past in year Seriouslyconsidered suicide past in Went without eating for 24 hours or Did not go to to go not Did Hit, slapped, or physically hurt on on hurt physically or slapped, Hit, Carried a weapon past in month Took dietpills, powders, or liquids *Comparative YRBSS for data Ohio 2007is and U.S. is 2009 N/A poisoning, or overdose that had to Did not participate in at least 60 60 least at in participate not Did per dayper onlessthan5 days dayper onlessthan7 days past in minutes of physical activity on any on any activity physical of minutes outh Rarely or never wore never or Rarely Attempted suicide in past year past in suicide Attempted Ate 1 to 4 servings of fruits and be treatedbe doctor a by nurse or on schoolon propertyyear past in purposetheir by boyfriendor for 2 or more weeks in a rowa in more 2 or weeks for Vomited or took laxatives took or Vomited Exercisedto lose weight - without a doctor’s advice Always wore aseatbelt lower in fatlowerto in lose weight

not available

Trying toloseTrying weight girlfriend in past year past in girlfriend vegetables per day Youth Variables Youth day past in week (of youth) all Overweight in past year overweight Obese school becausefelt unsafe week week more year І

TREND

a seatbelt a

in past past in

Unintentional andViolenceInjuries Unintentional

SUMMARY Seneca County grade) (6 2005 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 50% 30% 22% 12% 33% 10% 12% 36% 1% 1% 3% 8% 6% 4% 6% 5% - 12 12

Weight Control Weight

Seneca County grade) (6 2009 N/A N/A 27% 46% 71% 10% 52% 50% 14% 13% 25% 10% 48% 29% 21% 10% 11% 2% 8% 1% 5% 2% 3% 6% 4% 7% - 12 12

Seneca County grade) (6 2013 84% 28% 57% 79% 16% 13% 42% 48% 14% 17% 33% 24% 12% 39% 34% 23% 10% 1% 2% 4% 2% 8% 4% 5% 5% 7% - 12 12

Seneca County County grade) (9 2013 86% 33% 57% 80% 16% 15% 45% 44% 14% 20% 27% 19% 12% 40% 35% 27% 11% 1% 2% 4% 4% 9% 7% 4% 3% 7% - 12 12

grade) (9 Ohio 85%* 43%* 61%* 2011 N/A N/A N/A 55% 75% 16% 15% 15% 23% 31% 17% 13% 15% 30% 27% 14% 16% 8%* 4% 6% 9% 6% 6% - 12 12

grade) (9 78%* 39%* 61%* 2011 N/A N/A 51% 71% 14% 20% 33% 15% 13% 12% 16% 29% 29% 16% 17% U.S. 9% 2% 8% 8% 4% 5% 7% 6% - 12 12

Used cigarettes on one or more days Binged duringpastmonth (5 or more Drank forDrank the first time before 13 age ‡ 2 school districts did not ask sexual behavior questions **2005 YRBS Data *Comparative YRBSS for data Ohio 2007is and U.S. is 2009 N/A Used inhalants in order to get high in in high get to order in inhalants Used Obtained the alcohol they drank by by drank they alcohol the Obtained Ever been offered, sold, or given an Used a a Used Used marijuana in the past month past the in marijuana Used Used chewing tobacco or snuff in Smoked cigarettes on 20 or more Used methamphetamines in their Had four or more sexual partners Lifetime cigarette use (ever tried illegal drug by someone on school school on someone by drug illegal Used alcohol during past month Used prescription medication in in medication prescription Used days days drinks in a couple of hours on an an on hours of couple a in drinks order to get high or feel good in Rode with someone who was was who someone with Rode Ever had at least one drinkof Used cocaineUsed their in lifetime Usedsteroids intheir lifetime cigarette smoking, even 1 or 2 - sexual intercourse had Ever heroin Used

Ever usedecstasy/MDMA not available someone givingthemto it property in the past year past the in property duringthe past month(of all during theduring past month Tried to quit smoking drinking in past month condom at last intercourse Drank and drove and Drank Youth Variables Youth alcohol in lifetime in alcohol (of youth) all their lifetime their lifetime past month occasion) lifetime youth) puffs) in theirin lifetime

Marijuana andOther DrugUse Seneca County County grade) (6 2005 N/A N/A N/A 16% 12% 11% 66% 31% 64% 17% 43% 21% 28% 30% 24% 35% 65% 2% 3% 1% 5% 6% 7% 4% - Alcohol Consumption 12 12

Sexual Behavior ⱡ

Tobacco Use Seneca County grade) (6 2009 N/A 40% 10% 10% 70% 25% 53% 11% 32% 19% 25% 18% 29% 60% 7% 1% 2% 1% 3% 4% 6% 1% 9% 4%

- 12 12

Seneca County grade)

(6 2013 28% 61% 25% 70% 27% 21% 17% 11% 20% 50% 2% 5% 2% 1% 1% 2% 6% 6% 2% 5% 5% 7% 9% 9% - 12 12

Seneca County County grade) (9 2013 13% 10% 30% 12% 14% 15% 65% 47% 54% 38% 22% 14% 21% 32% 68% 4% 4% 1% 1% 1% 2% 4% 7% 8% - 12 12

grade) 12%** (9 Ohio 60%* 45%* 2011 N/A N/A N/A 18% 12% 10% 24% 24% 21% 56% 52% 21% 18% 24% 38% 71% 6%* 4% 3% 7% 7% - 12 12

grade) (9 2011 N/A 11% 40% 15% 26% 23% 18% 50% 45% 24% 21% 22% 39% 71% 60% 47% U.S. 8% 4% 8% 4% 3% 7% 6% 8% - 12 12

dult Adult

Rated their mental health as not good on four or Has been diagnosed with high high with diagnosed been Has Former smoker (smoked 100 cigarettes inlifetime 100 smoker (smokedFormer Adults usedwho marijuana in the past 6 months Had blood cholesterol checked within the past past the within checked cholesterol blood Had Averagedays that physical healthgood not in Has been diagnosed with high blood pressure blood high with diagnosed been Has Average days that mental health not good in *2010 BRFSS Data N/A Had at least one alcoholic beverage in past Adults misusedwho prescription drugs in the Current smoker (currently smoke some or all Average days that poor physical or mental Bingedpast inmonth (5 or more drinks a in

Rated health as excellent or very good Has everHas been diagnosed with asthma health kept them from doing their usual - Rated general health as fair or poor Has been

not available arthritis with diagnosed been Has couple of hours on an occasion) Has health care coverage І activities in

Had a heart attack & now do not smoke) not do now & TREND Adult Variables Adult diagnosed with diabetes with diagnosed past 6 months Had a stroke Had angina Overweight past month past month

more days 5 years

Obese days) month past month

blood cholesterol blood

SUMMARY

Arthritis, Asthma & Diabetes Asthma & Arthritis,

Health Care Coverage Health Cardiovascular Health Cardiovascular

Alcohol Consumption

Weight Status Weight Tobacco Use Health Status Health

Drug Use Seneca County County 2005 N/A N/A N/A N/A N/A 11% 17% 29% 90% 26% 14% 51% 27% 24% 17% 43% 31% 38% 35% 34% 7% 4% 4% 7%

Seneca County County

2009

N/A N/A N/A N/A N/A 11% 13% 28% 89% 16% 26% 19% 17% 56% 27% 41% 31% 33% 12% 55%

2% 5% 3% 5%

Seneca County 2013 16% 31% 85% 23% 25% 17% 19% 47% 36% 35% 79% 36% 30% 13% 50% 2.3 4.6 3.7 9% 4% 5% 2% 7% 6%

Ohio 2011 N/A N/A N/A 25% 25% 20% 56% 30% 36% 76% 39% 33% 11% 14% 29% 86% 18% 51% 2.3* 3.9* 3.9* 3% 5% 5%

2011 N/A N/A N/A 25% 21% 18% 57% 28% 36% 76% 38% 31% 10% 14% 24% 82% 17% 51% 2.4* 3.5* 3.7* U.S. 3% 4% 4%

Adults hadwho one or more of their permanent Had a clinical breast exam in the past two years Had a PSA test in within the past two years (age (age years two past the within in PSA test a Had Had a mammogram thein past two years (age Considered attempting suicide in the past year digital rectal exam within the past year past the within exam rectal Had a digital Adults who have visited the dentist in the past past the in the dentist visited have who Adults Had a pneumonia vaccine in lifetime (age 65 Adults ages65and over had of all theirwho *2010 BRFSS Data N/A Limited in some way because of physical, physical, of because way some in Limited Had a pap smear in the past three years -

not available mental or emotional problem permanent teeth removed (age 40 and older) and 40 (age Adult Adult 40 and older) 40 and older) 40 teeth removed

and older) and

Variables

year

Preventive Medicine

Mental Health Quality of Life Oral Oral Seneca County County 2005 N/A N/A N/A N/A N/A N/A N/A N/A 67% 15% 5% Health

Seneca County County

2009 N/A N/A N/A N/A N/A N/A N/A 14% 62% 22% 4%

Seneca County 2013 52% 72% 68% 65% 46% 13% 43% 59% 22% 29% 4%

Ohio 54%* 82%* 74%* 75%* 20%* 45%* 72%* 2011 N/A N/A 70% 24%

17%* 44%* 70%* 53%* 81%* 75%* 77%* 2011 N/A N/A 70% 24% U.S.

Adult . . Physical HealthStatus . . . General HealthStatus or poor. fair as health described their 65, of age the over those of 17% to increasing adults, the of 13% Conversely, or very good. excellent adults rated their health status as County Seneca (50%) the of half 2013, In Key Findings . . Mental HealthStatus . 2010 BRFSS). good on an average of 3.9 3.7of and days days,re goodon average an 3.7 days in the previousmonth. OhioU.S. and adults reported their physical health as not daysor more in the previous month. of Ohio17% andofU.S. adults self $25,000. health as excellent or very good, compared to 29% of those with incomes less than good.SenecaCounty adults with higher incomes(55%) were most likely to rate their on an average of 3.9 days and 3.5 days, respectively in theprevious month days in theprevious month. Ohio and U.S. adults reported their mental health as not good daysor more in theprevious month. BRFSS).

Seneca County adults reported their physical health as not good on an average of 2013,In 20% ofSenecaCounty adults rated their physical health as not good on four     Seneca County adults were most likely to rate their health as fair or poor if they: of 13% 2013, ha In Seneca County adults reported their mental health as not goodon an average of 4.6 2013,In 23% ofSenecaCounty adults rated their mental health as not good on four    Seneca County adults were most likely to rate their physical health as not good if they:

Were Were 65 years of or(17%) older age Had high blood pressure(21%) Had an annual household income under$25,000(27%) Had been dia Were less than 30 years old (22%) old 30years than less Were (23%) female Were Had an annual household income under$25,000(31%)

adults rated their health as fair or poor. The 2011 BRFSS has identified that 18%

І lf (50%) of Seneca County adults rated their health as excellent as excellent or very health rated their County adults (50%) Seneca of lf HEALTH STATUSPERCEPTIONS gnosed with diabetes (42%)

- reported their health as fair or poor.

(Source: BRFSS 2011 for Ohio and U.S.) . . .

Adults Who Rated General Health Status Status Health Rated General Who Adults

spectively in theprevious month

U.S. 51% (2011) U.S. 51% (2011) 51% Ohio (2013) 50% County Seneca Excellent or Excellent Very Good Very

(Source:

(Source: (Source:

2010

100% 20% 40% 60% 80% 0%

. . . days. 30 the in past health mental and physical poor with adults of percentage the shows table The good. very or excellent as health their rated older and 65 ages those of 34% and 30, age under those of 64% adults, County Seneca all of 50% include: the information interpret to of how Examples fair/poor. and good, good, excellent/very as status health personal T

he following graph shows the percentage of Seneca County adults who described their their described who adults County Seneca of percentage the shows graph following he

month, increasing to 33% of those incomes with less $25,000. than them from doingusual activities such as self month usual activities on anaverage of 2.4days and 2.3days, respectively theprevious in U.S. adults reported that poor physical or mental health kept them from doing their doing their usual activities on an averageof 2.3 days in theprevious month. Ohio and Seneca County adults reported that poor physical or mental health ke Nearly one Seneca County adults were most likely to rate their mental health as not good if they: Total 13%

50% 37%

  

(Source: 2010BRFSS). Had an annual household income under$25,000(26%) (30%) female Were (31%) old 30years than less Were Males 12% 44% 44% - fourth (23%) of adults reported that reported of(23%) adults fourth

Females 32% 14% 54% Excellent/Very Good Excellent/Very Seneca County Adult Health Perceptions*

Under 30 Under

20% 16% 64%

years 30-64 12% 40% 48%

Over 65 & 17% - 34% 49% Good care, work, or recreation in the past past the in or recreation work, care, poor or mental physical health kept

Income <$25K 27% 29% 44%

Fair/Poor Income $25K Plus 55% 36% 9%

Seneca 2005 51% 14% 35% pt them from from them pt

Seneca 2009 12% 55% 33%

2 2

2 3

*Totalsmaynot equal 100% assomerespondents answered “Don’t know/Notsure”.

Average days mental that health was Health Status N/A N/A *2010 BRFSS data mental health kept them from doing Average days poor that physical or 2005/2009/2013Adult Comparisons that physical that Average days health their usual activities in past month good on four or more days in the the in days more or four on good Rated health as excellent or very as excellent health Rated Rated their mental health as not – was not good in past month

Rated health as fair or poor Not available available Not Females Females

not good in past month Males Males Total Total previous month

good

No Days

66% 62% 56% 69% 60% 56%

Physical Health Not Good in Past 30 Days* Past in Good Not Health Physical Mental Health Not Good in Past 30 Days* 30 Past in Good Not Health Mental

- 3 Days 3 11% 12% 12% 9% 9% 7%

Seneca County

2005 N/A N/A N/A 51% 26% 14% 4

- 5 Days 5

4% 4% 5% 6% 7% 4%

Seneca Seneca County County

2009 N/A N/A N/A 12% 55% 16%

6 - Seneca Seneca County County 7 Days 7 1% 2% 1% 2% 2% 1% 2013 13% 50% 23% 2.3 4.6 3.7

Ohio Ohio 2011 8 or More Days More 8 or N/A 18% 51% 2.3* 3.9* 3.9*

16% 22% 12% 13% 9% 9%

2011 N/A 17% 51% 2.4* 3.5* 3.7* U.S. U.S.

Adult І HEALTH CARE COVERAGE

Key Findings

The 2013 Health Assessment data has identified that 15% of Seneca County adults were without health care coverage. Those most likely to be uninsured were adults under age 30 and those with an income level under $25,000. In Seneca County, 15.4% of residents live below the poverty level. (Source U.S. Census, American Community Survey 3 Year Estimates, 2009-2011)

General Health Seneca County and Ohio Medicaid Statistics

Coverage Seneca Ohio County Residents . In 2013, 85% of Seneca Calendar Year 2010 Residents Enrolled in County adults had Enrolled in Medicaid health care coverage, Medicaid

leaving 15% who were uninsured. The 2011 Average Members 5,818 1,159,095 BRFSS reports uninsured per Year Ages 0-18 (56%) (55%) prevalence rates for Ohio (14%) and the U.S. Average Members 3,896 787,749 (18%). per Year Ages 19-64 (37%) (38%)

. In the past year, 15% of Average Members 744 155,896 adults were uninsured, per Year Ages 65 (7%) (7%) increasing to 24% of and Over those under the age of *(Percent of Members Enrolled = Total Enrollment/Population per 30 and 29% of those U.S. Census Bureau) with incomes less than $25,000. (Source: Ohio Department of Job & Family Services, Seneca County 2008-2011 Profile, http://jfs.ohio.gov/county/cntypro/pdf11/Seneca.pdf) . Of those who had health insurance, 6% reported there was a time in the past year that they did not have health insurance or coverage.

. 19% of adults with children did not have healthcare coverage, compared to 13% of those who did not have children living in their household.

15% of Seneca County adults were uninsured.

. The following types of health care coverage were used: employer (47%), someone else’s employer (18%), Medicare (10%), multiple-including private sources (10%), self-paid plan (5%), Medicaid or medical assistance (4%), multiple-including

government sources (2%), military, CHAMPUS, TriCare, or VA (2%), and other (2%).

. Seneca County adult health care coverage included the following: medical (100%), prescription coverage (96%), preventive care (70%), immunizations (70%), dental (68%), their spouse (67%), vision (62%), mental health (61%), their children (55%), county physicians (38%), alcohol and drug treatment (31%), home care (27%), skilled nursing (25%), and hospice (22%). 24

2 5

coverage care health adults’ County Seneca of sources shows chart pie The coverage. care health lacked 30 bei reported $25,000 than less income an with of adults 29% uninsured, were adults County Seneca of all 15% include: graph first the in information the interpret to of how Examples characteristics. demographic by uninsured were who adults County Seneca of percentages the shows graph following The (Percentages do not equal 100% because respondents could select more than one reason) . 10% 20% 30% 40%

0% 2005/2009/2013Adult Comparisons 5. 4. 1. The top reasons uninsured adults gave for being without health care coverage were: 2. 3. 19% of adults with children did not have healthcare coverage. The became apart Their employer did not/stopped offering coverage(12%) T They could afford not pay to the insurance premiums They Medicaid lost eligibility (23%) Total hey their lost job or changed employers(35%) 15%

Uninsured Males 15%

Females

16% - time or temporary employee (11%) employee or temporary time Uninsured Seneca County Adults Seneca CountyUninsured

Under 30 Under 24%

Years 30-64

Seneca 16% County 2005 10%

ng uninsured and 24% of those under age age under those of 24% and uninsured ng 65 & Over 65

6% Seneca Seneca County County

2009 11%

Income <$25K

29%

(35%) Seneca Seneca

County County

2013 $25K Plus 15%

Income 9%

Seneca Ohio Ohio 2011 14% 2005

10%

Seneca 2009 11% 2011

18% U.S. U.S.

Hospice Skilled Nursing Home Care Alcohol and Drug Treatment County Physicians Their Children Health Mental Vision Their Spouse Dental Immunizations Health Preventive Coverage Prescription Medical coverage Seneca in included what is shows chart The following

Health Coverage Includes: Coverage Health

Sourceof Health Coverage for SenecaCounty Adults

Employer

47%

Medicare 10%

100% 96% 22% 25% 27% 31% 38% 55% 61% 62% 67% 68% 70% 70% Yes

Multiple sources Medicaid County adults’ insurance County 2% 4% -govt.

Someone Else's

18% 18% 18% 14% 12% 39% 12% 36% 28% 30% 10% No 4% 9% 0% Employer

18%

-purchasedSelf

Multiple Don’t Know

sources <1% 60% 57% 55% 55% 50% 27% 20% 21% 0% 6% 2% 5% 2% 10% Other

Military 2% -private

2 6

care insurance years health with of 65 age under AHS 2010& Oh https://ckm.osu.edu/sitetool/sites/omaspublic/documents/OMASStatewideRolloutPresentationSildes.pdf (      Source: Ohio Medicaid Assessment Survey, 2012 Presentation Slides, -

1.1: Persons Persons 1.1: Objective unmet needs, and paying for care theinsured. than Ohio,In uninsuredcare, to access individuals reported with greater issues 2010,In uninsured children h 2008. 4% in and 17% to respectively 2010, compared Ohio,In 19%of adults 18 children). 139,884 and adults (1,229,587 uninsured were Ohioans 2012,million 1.36 In More 2.3 than million Ohioans are enrolled in Medicaid. higher rate of not source of care insured than children. Uninsured children had an almost 3 times io Family Health Survey Results, 03

Seneca County Seneca - 55 81% age 88% age - 35 83% age - 25 76% age - 20 77% age having a usual sourceof coverage uninsured than adults. Access to Quality Health Services Ohio Medicaid Assessment Survey Assessment Medicaid Ohio 2013 - 64 years old and 5% of children were uninsured in

Healthy People2020 45 not of not rate higher 11.7 an times ad - 64 54 44 34 24 - 08-

2011)

- 55 87% age - 45 83% age - 35 84% age - 25 81% age - 18 80% age

Ohio Ohio 2011

64 54 44 34 24

- 55 87% age - 45 84% age - 35 80% age - 25 73% age - 18 75% age

2011 U.S. U.S.

havingusual a

64 54 44 34 24

Healthy Healthy People People Target 100% 2020 2020

...... Health CareAccess routine checku adults had visited adoctor for a of year, 57% past the In $25,000. of thosewith incomes less than health care, increasing to 17% room usual as their place of using a hospital emergency were adults County Seneca project8%of identified that Assessment 2013Health The Key Findings AND UTILIZATION Adult

needs, but were unable to for some reason. some for to unable were needs, but County adults wanted to see Seneca of a specific doctor19% for their health care (2%). issues/expenses no public transportation before 8 a.m. and after 4:30 p.m.(<1%), and other car insurance(1%), disabled(1%), public no transportation available or accessible (<1%), not work (2%), limited public transport care:health could not afford(7%), gas no driver’s(5%),license (3%), car no car did Seneca County adults had thefollowing transportation problems they when needed (13%). pl no (4%), go to where know not did (4%), (22%), previous doctor unavailable/moved(10%), did not like/trust/believe doctors not afford insurance(34%), needed(25%), had not adoctor orusual two more places Reasons for not having a usual sourc health care, increasing to 17% of those with incomes less $25,000. than 8% of SenecaCounty adults used a hospital emergency room their as usual place of outpatient department (1%), and some(2%). other place (2%), publichealth clinic/community health center(2%), store(2%), clinic h (8%),usual (7%), no place chiropractor(5%), theinternet (3%), alternative therapies following: a doctor’s office(81%), hospital emergency room(8%), urgent care center When adults were sick or needed advice about their health, they usually to went the and 11% did not have all. one at particular doctor or healthcare professional they went to for routine medical care, professional they went 53%of Seneca County adults reported they had one particular doctor orhealthcare in thepast year, increasing to 79% of those over theage of 65. More half than (57%) ofSeneca County adults visited a doctor for a routine checkup

І HEALTHCAREACCESS p.

to for routine medical care.of 35% adults had more onethan (Source: Healthy People 2020 and CDC) they: if care Adults are more to likely have access to medical

...... e ofe medicalcare included: insurance/could no

ation available or accessible(1%), car no Work for alarge company Have acollege education Utilize preventive services in a clinic setting Have health insurance provider care primary regular a Have Earn a higher income Predictors of Access to Health Care Health to Access of Predictors ace close(2%), enough other reasons and

ospital

2 8

2 9

there was no generic equivalent of what was prescribed(5% they did not think they needed(11%), it side effects (6%), they had no insurance(6%), premiums were too(1%), high opted they ou were too high (2%),had they a high health savings account(HSA) (1%), deductible their (3%),stretched they their prescription by taking less prescribed than (3%), their deductibles the past year due to cost, increasing to 37% of those with reported having all of their prescriptions filled. could not afford(1%), it and they were taking too many medications(1%). of 73% adults . Availability ofServices . . . doctor filled because: they could not afford to pay theout hospice(<1%), care addiction services(<1%), other services and (10%). (3%),mental health care (3%), care pediatric (2%), developmental disability services(1%), obstetrics/gynecology/NICU(15%), cardiac(7%), care orthoped pastyear:the specialty(22%), care primary(18%), care services dental (17%), cessation(8%), alcohol(3%), abuse and drug(3%). abuse themselves or a loved one: depression or anxiety(14%), problem a weight (13%), smoking

usual primary care provider AHS (% of all adults who looked for the the for looked who adults all of (% Seneca County adults reported they had looked for During thepast year,Seneca County adults did not get a prescription from their 61%of adults went outside ofSeneca County for following the health care services in Nearly one (Sources: Health (Sources: * U.S.baseline is age- - 3: Increase theproportion of persons a with (13% of all adults looked) (14% of all adults (3% of all adults looked) (3% of all adults looked) (8% of all adults looked)

Anxiety or Depression Smoking Cessation Smoking Seneca County Adults Able to Access Assistance Programs/Services Assistance Access to Able Adults County Seneca Types of Programs of Types Weight Control Weight Alcohol Abuse Alcohol Drug AbuseDrug - programs) fifth (19%)ofadults could not seedoctor needed when a some at time in y

People 2020 Objectives, 2013 Seneca County Health Assessment) adjusted to the 2000 population standard Objective looked)

Access to Quality Health Services Health Quality to Access

Healthy People 2020 People Healthy Seneca County adults adults County Seneca who have looked but but looked have who have have specific program specific t oft prescription coverage because they

NOT 25% 25% 58% 40% 20%

found a found a

thefollowing programs for Seneca Seneca

incomes less $25,000. than - of ), their co their ),

2013 pocket expenses (11%), expenses pocket 53% ic care (5%), careic cancer care County

who have looked and and looked have who adults County Seneca have found a specific specific a found have -

pays were too high

program Healthy People People Healthy 2020 Target 75% 75% 42% 60% 80%

84%

stroke. factors for heart disease and fo smokers, were 17% and wereobese, 36% cholesterol, pressure, 36% blood had high diagnosedwith high blood County adults had been

Nearly one life. their in time some at stroke a survived 2% had and attack heart that 7% of a survived adultshad County Health Assessment found Warehouse).

. . . High BloodPressure(Hypertension) ...... Heart DiseaseandStroke 2006- Seneca County adult deaths from all of 34% for accounted (6%) Heart disease (28%)stroke and Key Findings Adult

31% for the U.S. U.S. the 31% for pressure. The2011 BRFSS reports hypertension prevalence rates of 33%forOhio and 86%of adults had their blood pressure checked within the past year. pre they were told were 9% adults of Nearly one 2011 in disease 5% of Ohioof and 4% U.S. adults reported having had angina or coronary heart 6% of adults reported they ha 3% of OhioU.S. and adults reported having survived a stroke in 2011 65. of age over the those 2% of SenecaCounty adults reported having survived a stroke, increasing to 6%of myocardial infarction in 2011 or attack heart a survived had they reported adults of U.S. 4% and Ohio 5% of 65. of age over the those infarction, increasing to 19% of heart attack or myocardial a survived they reported adults 2013,In County 7% of Seneca 2008

(Source: ODH Information The 2013 Seneca 2013Seneca The - third (30%) of Seneca Seneca of (30%) third І - third (30%)ofSeneca County adults had been diagnosed with high blood CARDIOVASCULAR (Source: 2011BRFSS)

ur known risk risk ur known

(Source: 2011BRFSS) d angina, increasing to 15%of thoseover theage of 65. .

5. 4. 3. 5. 4. 3. 2. (Source: ODH Information Warehouse, updated 4 2. 1. (Source: ODH Information 1. - hypertensive/borderline high. Accidents,Unintentional Injuries(5%) Stroke (5%) Stroke Chronic Lower Respiratory Diseases(6%) (5%) Diabetes (6%) Stroke Chronic Lower Respiratory Diseases(8%) (21%) Cancers Cancers (23%) Cancers Heart Disease(25% deaths) of all Heart Disease(28% deaths) of all

Leading Types Death of Leading Types Death of Total Deaths: 322,264

Seneca County Seneca Total Deaths: 1,747

2006 2006 Ohio Warehouse, updated 4

- -

2008 2008 HEALTH

(Source:2011 BRFSS)

- -

15- 15-

10) 10)

Symptoms_UCM_308528_SubHomePage.jsp) correctly? repeated sentence the go away, go 9 call

. Being prompt can make a remarkable difference in their recovery. F.A.S.T is: because thesooner a stroke victim gets to the hospital, thesooner they can spot thesigns, you'll know quickly that you needto call 9 F.A.S.T. an easy is way to remember thesudden signs and symptoms of a stroke. When you Stroke WarningSignsandSymptoms major risk factors for developing cardiovascular disease (CVD). had who adults County Seneca of percentage the demonstrates graph following The http://strokeassociation.org/STROKEORG/WarningSigns/Stroke (Source: American Heart Association, Stroke Warning Signs and Symptoms, Beyond F.A.S.T-OtherSymptomstoKnow

downward? one armdrift Does Health Assessment)

   Seneca County adults diagnosed high with blood pressure were more likely to: . . .  ...... 25% 50%

understand?Ask person the to repeat a simple senten Index Mass Body obese by as classified been Have 6 age been Have Have rated their overall health as poor(75%) Speech Difficulty: Speech Weakness: Arm smile. Drooping: Face Have an annual household income less $25,000 than (37%) Sudden trouble walking, dizziness, lossof balance or coordination. Sudden trouble seeingone in or eyes. both cause. no known with headache severe Sudden Sudden numbness or weakness of theleg. Sudden confusionor trouble understanding. 911: call Time to Obesity

36%

Does one side of the face droop or is numb? it Ask theperson droop to face the of side one Does - Is one Is or weak arm Ask numb? theperson to raise arms. both If the person shows any of these of any shows person the If 1- Cholesterol High Blood Is speech Is slurred, to areor hard speak, they are unabl theyeto 5 years or (56%) older 1 and get them to thehospital immediately. SenecaCounty Adults with CVDRisk Factors 36%

High Blood Pressure

30%

Sedentary Warning

28%

symptoms, even if thesymptoms -

Signs - BMI (42%) BMI

2013, - - ce, and 1- Smoking 1 for help.This is important

(Source: 2013 Seneca County Seneca (Source: 2013 like “they sky is blue.” Is -

17%

'll get treatment.

Diabetes

20% 40% 60% 80% 20% 40% 60% 80% 0% 0% 5 females, and

been diagnosed with high blood pressure, 3 pressure, blood high with diagnosed been . . . race/ethnicity. and gender by stroke and disease heart for population 100,000 age Ohio and County Seneca the show graphs following The *Does not 30 include: graph first on the the information interpret to how of Examples cholesterol. blood high or pressure blood high with diagnosed of number show the The graphs following

Total Total Disparities exist for heart disease mortality rates gender by in Seneca County. state, theU.S. figure, but higher than the Healthy People 2020 target objective. - County age The Seneca the U.S. figure and theHealthy People 2020 target. Seneca County heart disease mortality rate was higher than the figure for thestate, When age differences accounted are for, thestatistics indicate that the 2010 30% 36% include respondents who indicated high blood pressure during pregnancy only.

Male Male 6 41% 33% % of those 65 years and older. and years 65 of those %

Female Female 31% 27% Diagnosed with Cholesterol Blood High with Diagnosed

Under 30 Under Under 30 Under Diagnosed with Pressure* Blood High with Diagnosed

adjusted stroke mortality rate for 2010 was lower than the the than lower for 2010was rate mortality stroke adjusted 4% 8%

Years Years 30-64 30-64 42% 30% Seneca 3

% of all Seneca all of % 65 & Over 65 65 & Over 65

65% 56%

County adults who have been whoCounty have adults

% of all Seneca all of % Income Income <$25K <$25K 26% 37%

County males, 2 males, County adjusted mortality rates per per rates mortality adjusted $25K Plus $25K Plus Income Income 38% 31%

County adults have have adults County

Seneca Seneca

2005 2005 35% 34%

% of all % all of Seneca Seneca 2009 2009 31% 33%

3 3

*The Healthy People 2020 Target for objective Coronary Heart Disease is reported for heart attack mortality. 10% 0% 5% Rate per 100,000 Rate per 100,000 population 100 150 200 250 300 350

population 50 0 100 200 300 400 500 0

(Source: ODH Information Warehouse 6% Angina Seneca CountyAge - (Source: 2013Seneca County Health Assessment and 2011 BRFSS)

200 Age (Source: ODH Information Warehouse 2000-2002 Seneca 2010 321 273 374

5% Heart Disease - Adjusted Heart Disease and Stroke Mortality Rates Mortality Stroke and Disease Heart Adjusted Seneca Total

192 Cardiovascular Disease Prevalence Disease Cardiovascular 180 Seneca 2013 Ohio 2010 Adjusted Heart Disease Mortality Rates by Rates Mortality Disease Heart Adjusted 101 Heart Attack Heart , updated, 5

7% Seneca Males 2003-2005

Gender Gender 297 247 354 Ohio 2011 , updated 4 updated , 5% - 23- U.S. 2009

, Healthy 2020) People 36 - 15- 10 ) Seneca Females

42 Stroke HP 2020 Target*

2% 2006-2008 Stroke

192 302 240 3% 34

Healthy People2020Objectives

N/A N/A (Source: 2020, HealthyPeople 2011 BRFSS, Had blood cholesterol checked within *All U.S. figures age figures U.S. *All cholesterol checked within the (Source: 2020, HealthyPeople 2011 BRFSS, 2013 Seneca County Health Assessment) *All U.S. figures age HDS 2005/2009/2013Adult Comparisons HDS HDS adults with high total blood adults –

adults with hypertension Not available Not - Had high blood cholesterol - 7: Decrease proportion of of proportion 7: Decrease - 6: Increase proportion of of proportion 6: Increase 5: Reduce proportion of of proportion Reduce 5: Had high blood pressure preceding 5years preceding cholesterol (TBC) cholesterol who had their blood Had aheart attack Objective Objective Had astroke Had angina past 5years past

- adjusted to 2000 population standard. - adjusted to 2000 population standard.

2013 High Blood Pressure Blood High Seneca Seneca Seneca Survey Survey Seneca Blood Cholesterol Blood

Seneca Population Population Population Population Baseline Baseline Baseline Baseline Seneca County 2013 2013 79% 36% 30% 2005 N/A N/A 35% 34% 7% 4%

CountyHealth Assessment) Survey Survey

Seneca Seneca

County County

2009 N/A N/A 31% 33% 3% 5%

Adults age 18 & & 18 age Adults Adults age 2 age Adults TBC>240 mg/dl TBC>240

Adults age 18 age Adults U.S. Baseline* U.S. U.S. Baseline* U.S.

up with and up and (2011) (2011) (2011) 76% 38% 31% up Seneca Seneca County County 2013 79% 36% 30% 6% 2% 7%

Ohio Ohio 2011 39% 33% 76% 5% Healthy People People Healthy 3% 5% Healthy People People Healthy 2020 Target 2020 Target

82% 14% 27% 2011

38% 31% 76% U.S. U.S. 4% 3% 4%

3 4

Adult І CANCER

Key Findings Seneca County Incidence of Cancer, 2005-2009 In 2013, 9% of Seneca County adults had been diagnosed with cancer at All Types: 308 cases

some time in their life. Ohio Department . Prostate: 46 cases (15%) of Health statistics indicate that from . Lung and Bronchus: 44 cases (14%) 2000-2008, a total of 1,123 Seneca . Breast: 43 cases (14%) County residents died from cancer, the . Colon and Rectum: 38 cases (12%) second leading cause of death in the county. The American Cancer Society In 2010, there were 134 cancer deaths in advises that not using tobacco Seneca County.

products, maintaining a healthy weight, (Source: Ohio Cancer Incidence Surveillance System, adopting a physically active lifestyle, ODH Information Warehouse) eating more fruits and vegetables, limiting alcoholic beverages and early detection may reduce overall cancer deaths.

9% of Seneca County adults had been diagnosed with cancer at some time in their life.

Adult Cancer

. 9% of Seneca County adults were diagnosed with cancer at some point in their lives.

. Of those diagnosed with cancer, they reported the following types: cervical (19%), other skin cancer (16%), prostate (14%), endometrial (7%), breast (7%), colon (5%), melanoma (3%), leukemia (3%), non-Hodgkin’s lymphoma (3%), lung (3%), head and neck (3%), thyroid (3%), rectal (3%), renal (3%), and other types of cancer (8%). 19% of adults have been diagnosed with multiple types of cancer.

Cancer Facts

. The Ohio Department of Health (ODH) vital statistics indicate that from 2000-2008, cancers caused 22% (1,123 of 5,099 total deaths) of all Seneca County resident deaths. The largest percent (29%) of cancer deaths were from lung and bronchus cancer (Source: ODH Information Warehouse).

. The American Cancer Society reports that smoking tobacco is associated with cancers of the mouth, lips, nasal cavity (nose) and sinuses, larynx (voice box), pharynx

(throat), and esophagus (swallowing tube). Also, smoking has been associated with cancers of the lung, colorectum, stomach, pancreas, kidney, bladder, uterine cervix, ovary (mucinous) and acute myeloid leukemia. The 2013 health assessment has determined that 17% of Seneca County adults were current smokers and many more were exposed to environmental tobacco smoke, also a cause of heart attacks and cancer. 35

. . . . Breast Cancer . . . . . Lung Cancer

A current smoker is defined as

21% of21% Seneca County female adults and of 13% male adults were Over half (5 half Over rectum(n=47) cancers.

age 40 age recommendation. increased risk(e.g., family history, past breast cancer) and physician upon based 20s 30s are and their in for women Mammograms 3 years. every For women in their 20s and 30s, a clinical breast exam should be d early, 5 detected the If year. past the mammogram a in of had 40 over age the females County Seneca of 51% examination in the past year. 2013,In 50% ofSenecaCounty females reported had having a clinical breast Facts & Fig Cancer Society, American (Source: smokers and 13 times higher in female smokers, compared to lifelong nonsmokers deaths in the U.S. The risk of developing lung cancer is about 23 times higher in male AccordingAmerican to the Cance trying to quit had stopped smoking for one ormoredays in the past 12 months becausethey were Approximately 21% offemale adults in thecounty were current smokers1and 56% (n=111)Seneca in County from 2000 ODH reports lung that cancer was theleadin (Source: 2013 Seneca County Health Assessment). smoking foroneor days more in thepast 12 months because they were trying to quit SenecaIn County,of male 13% adults were current smokers1 and 55%stopped had period. same time caused male 63 deaths and prostate cancer caused49 male deaths during the causeof male cancerfrom deaths 2000 The Ohio Department ofHealth reports that lung cancer(n=216) was theleading Cancer Society, Facts & Facts Figures 2013). Society, Cancer cigarettes in lifetime and currently smokes some or days.all

(Source: (Source: 1 (Source: 2013 Seneca County Health Assessment).

%) of Seneca County females over the ofage 40 had a American Cancer Society, Facts & Figures 2013). Otherwise, annual mammography is recommended, beginning at mammogramthein past year. - year survival rate for breast cancer is 98% is cancer for breast rate survival year

current smokers.

r Society,smoking causes of 87% lung cancer someone haswho smoked over 100 - 2008 followed by breast(n=84) and colon & ures 2013).

- 2008 Seneca in County.Colorectal cancer g causeof femalecancer deaths

(Source: American one at least once once least one at

3 6

Colon and Rectum Cancer

. The American Cancer Society recognizes any cancer involving the esophagus, stomach, small intestine, colon, rectum, anus (anal canal & anorectum), liver, gallbladder or pancreas as a digestive cancer. Digestive cancers accounted for 23% of all cancer deaths in Seneca County from 2000-2008 (Source: ODH Information Warehouse).

. The American Cancer Society reports several risk factors for colorectal cancer including: age; personal or family history of colorectal cancer, polyps, or inflammatory bowel disease; obesity; physical inactivity; a diet high in red or processed meat; alcohol use; long-term smoking; and possibly very low intake of fruits and vegetables.

. In the U.S., 90% of colon cancers are diagnosed in individuals over the age of 50. Because of this, the American Cancer Society suggests that every person over the age of 50 have regular colon cancer screenings.

The leading types of cancer diagnoses for Seneca County adults were: cervical (19%), other skin cancer (16%), prostate (14%), endometrial (7%), and breast (7%).

Prostate Cancer

. In 2013, 48% of Seneca County males over the age of 50 had a PSA test in the past year.

. The Ohio Department of Health statistics indicate that prostate cancer deaths accounted for 8% of all male cancer deaths from 2000-2008 in Seneca County.

. Incidence rates for prostate cancer are 70% higher in African Americans than in whites and are twice as likely to die of prostate cancer. In addition, about 60% of prostate cancers occur in men over the age of 65, and 97% occur in men 50 and older. Other risk factors include strong familial predisposition, diet high in processed meat or dairy foods, and obesity. Prostate cancer is more common in North America and Northwestern Europe than in Asia and South America (Source: American Cancer Society, Facts & Figures 2013).

In 2013, 48% of Seneca County males over the age of 50 had a PSA test in the past year.

The following graph following The Disease Hodgkins Larynx Uteri Cervix of Cancer Uteri Corpus of Cancer Skin of Melanoma Lip,Oral Cavity & Pharynx Multiple Myeloma Stomach and Liver Bladder Kidney and Renal Pelvis Ovary Esophagus Brain and CNS Non Prostate Leukemia Pancreas Breast Anus & Rectum Colon, Other/Unspecified Trachea,Lung and Bronchus Rate per 100,000 population gr The gender. by County Seneca in deaths total of percentage a as cancer and objective, 2020 People Healthy the rates (per 100,000 population,2000 standard) forall types of cancercomparison in to 100 150 200 250 50 0 . - Hodgkins Lymphoma

lower rate than the U.S. mortality rate Ohio,than and theHealthy People2020 target objective, a but When age differences accounted are for, Seneca County had ahigher cancer

Type of Cancer of Type

Bile Ducts

(Source: ODH Information Warehouse, 5 Warehouse, updated ODH Information (Source: Total

Seneca 2010

and Age- show (Source: ODH(Source: Information Warehouse, updated 4

194 s

the Seneca County, Ohio and U.S. age U.S. and Ohio County, Seneca the Seneca County Cancer Deaths Deaths Cancer County Seneca

Cancers Allfor Rates Mortality Adjusted 2020Objective People Healthy

aphs indicate:aphs Ohio 2010 Number of Cancer Deaths of Cancer Number 2000 187 - 23- - ; Healthy People 2020, 2013 Seneca County Health Assessment Health County 2013Seneca 2020, People Healthy 12; 2008 1,123 110 136 327 14 14 15 17 22 25 27 28 30 30 44 49 50 74 84 10 4 6 7

U.S. 2010

206

- 15- HP 2020 Target 10) - adjusted mortality adjusted Percent of Total of Percent

Cancer Deaths Cancer 161 100% <1% 10% 12% 29% 1% 1% 1% 2% 2% 2% 2% 2% 3% 3% 4% 4% 4% 7% 7% 1% 1% 1%

)

3 8

3 9

gender. indicate: graphs The graph following The

than the percentage of Seneca County femaleswho died from all cancers.

036845.pdf) http://www.cancer.org/acs/groups/ 2013, Facts Figures and Cancer Society, American (Source: .

10% 15% 20% 25% 30% 0% 5%          The percentage of Seneca County of Seneca malesThe percentage who from died all cancers is higher

thus could be prevented. related to overweight or obesity, physical inactivit third of thenew cancer cases expected to occur in theU.S. in 2013 be will bronchus cancers. About 15%of cancer all new cases in Ohio are expected to be from lung& 9,060. be to expected cases are cancer breast new The Ohio female expected. are Ohio,In 66,610 cases new of cancerexpected, are and 25,130 cancer deaths use. by tobacco caused be will deaths 174,100cancer 2013, about In 2013. in cancer of die to expected are Americans 580,350 About The WorldCancer Research Fund estimates that about one diagnosed. be to expected cases are cancer new 1,660,290 2013, about In The Ohio male, new prostate cancer cases are expected to be 8,530 be (13%). to expected cases are cancer prostate new The Ohio male, colon & rectum cancers. 5, About

890 (9%)890 of cancer all new cases in Ohio are expected to be from

show (Source: ODH Information Warehouse, updated 4 Cancer As Percent of Total Deaths in Seneca County Seneca in Deaths Total of Percent AsCancer s

cancer as a percentage of total deaths in Seneca County by by County Seneca in deaths total of percentage a as cancer Male

25% content/@epidemiologysurveilance/documents/document/acspc 2013 Cancer Estimations

by Gender, 2000- Gender, by

2008

y, and poor nutrition, and - 15- Female 10) 19%

- quarter to one to quarter

10% 20% 30% 0% . . . . Diabetes diabetes. adults had been diagnosedwith County Seneca 9% of 2013, In Key Findings Adult

following characteristics or conditions: Seneca County adults diagnosed diabetes with also had oneor of more the adults with diabetes rated their health as fair or poor. More two than borderline diabetic. diagnosed pre with 6% of adults had been U.S. the for 10% 11% and reports an Ohio prevalence of 2011 BRFSS of 65.The age the over those of 17% to increasing been diagnosed diabetes, with of SenecaCounty adultshad project has identified that 9% 2013health The Total 9%

o o o

Males І DIABETES 69% had been diagnosed with high blood cholesterol 70% had been diagnosed with high blood pressure 92% were obese o obese 92% were 13% -

fifths (42%) of of (42%) fifths assessment assessment Females Seneca County Adults Diagnosed with Seneca CountyAdults with Diagnosed Diabetes -

6% diabetes or

Under 30 Under 2% r overweight

Years 30-64 hiosdiabetesfactsheet.ashx) TS/Files/hprr/diabetes%20prevention%20and%20control/o http://www.healthyohioprogram.org/~/media/ODH/ASSE o o o o o 12% (Source: Ohio ODH, Diabetes 2010 F

stroke then those without diabetes. times more likely to havea heart Adults in Ohio diabetes with are 2 to 4 amputations among adults. failure and non cardiovascu related complications such as Diabetes can lead to serious health 10 - those with diabetes will lose an average of diabetes sometime in their lifetime, and nationally,Ohioans 1 in 3 will develop trends current If 2009 has considerably grown (37%). diagnosed diabetes in Ohio from 2000 of prevalence adult The estimated has continued to increase in Ohio. Diabetes is a serious health condition that

65 & Over 65

15 years of potential life. 17%

Diabetes Facts Income

<$25K lar disease,blindness, kidney

15%

- traumatic lower extremity continue as they have

Income $25K Plus

acet Sheet,acet

Seneca

2005 11%

ttack or

Seneca 2009 - 11%

poundsor birth more at Those atGreaterRiskforType2Diabetes basics/symptoms/) (Source: American Diabetes Association, Diabetes Basics, Symptoms, http://www.diabetes.org/diabetes Diabetes Symptoms DIABETES 1 TYPE are: symptoms caused by blood high sugar. The most commonsymptoms of type 2 diabetes Many people with type 2 diabetes never show any signs, some but do people show TYPE 2 DIABETES

http://www.diabetes.org/diabetes (Source: American Diabetes Association, Diabetes Basics, Your Risk: Who is at Greater Risk for Type 2 Diabetes, ...... Diagnosed diabetes with

2005/2009/2013 Adult Adult 2005/2009/2013 (IFG) People impaired with glucose tolerance(IGT) and/or impaired fasting glucose Frequent infections heal to slow are that Cuts/bruises Recurring skin,or gum, bladder infections Tingling/numbness in hands or feet vision Blurred symptoms 1 type the of Any Extreme fatigue and irritability Unusual loss weight hunger Extreme Unusual thirst Frequent urination Women who Certain racial and ethnic groups(e.g. Non People low with HDL cholest regularly exercise do not People who or obese overweight are People who People a family with history of diabetes 45 age People over Americans,Asian Americans and Pacific Islanders,American and Indians and Alaska Natives) Comparisons

had gestational diabetes, or

- basics/pre

erol or high triglycerides, high blood pressure Seneca County

vention/risk 2005 11%

factors) Seneca Seneca County County

2009 11% who had have a baby weighing 9 - H ispanic Blacks, Hispanic/Latino

Seneca Seneca County 2013 9%

Ohio 2011 11%

2011

10% U.S. -

. . show age The graphs following objective. target 2020 People Healthy the to comparison with residents Ohio and County

Rate per 100,000 Population Rate per 100,000 population 10 20 30 40 50 60 objective. mortality rates were less thenational than rate and theHealthy People 2020 target From 2006 to 2008, both Seneca County and Ohio’s age 2008. Seneca County’s age 20 40 60 80 0 0 (Source: ODH Information Warehouse, updated 4

Healthy People 2020 Objectives and Age and 2020Objectives People Healthy-

2000-2002 Seneca 2006-2008 45 (Source: ODH Information Warehouse, updated 4 31 - 45 adjusted diabetes mortality rate fluctuated from fluctuated mortality to rate 2000 diabetes adjusted Diabetes AgeDiabetes - - adjusted mortality rates from diabetes for Seneca Seneca for diabetes from rates mortality adjusted Ohio 2006-2008 29 Seneca 2003-2005 48 Diabetes for Rates Mortality Adjusted

- 15- 30 Ohio U.S. 2007 10 and Healthy 2020, People CDC) 73 adjusted Mortality Rates Rates Mortality adjusted - adjusted diabetes adjusted diabetes - 15- HP 2020 Target 10) 2006-2008 66

45 29

4 2

4 3

65. of age over the of those 61% to that they increasing had arthritis,

Key Findings Adult . (Source: CDC at Arthritis Glancea 2012). . . . Arthritis adultswere told they have arthritis. U.S. of 24% and adults Ohio of 29% BRFSS, 2011 the to According arthritis. with diagnosed According Seneca to the County survey 31% data, of Seneca

are overweight or obese, and/or have injuries joint or infections associated with certain typesof arthritis, have an occupation associatedwith arthritis, i 1 About arthritis. have 10% 20% 30% 40% 50% 60% 70%

31% they they had some form of arthritis, increasing to 61 Adults are higher at risk of developing arthritis if they are female, have genes An estimated 50 million U.S. adults(about 1 in 5) doctor have diagnosed arthritis. they told were of adults U.S. 24% and adults Ohio of 29% 2011BRFSS, the to According Nearly one (Source for graph:

n 3 of working age adults (aged18 3 adults n ofage working of Seneca Healthy Weight І - third (31%)ofSeneca County adults were told by a health professional Arthritis ARTHRITIS

Arthritis Arthritis Glanceat a 2011, 35% County adults were told healthby a professional that

- Attributable Activity Limitations Increase with Weight with Increase Limitations Activity Attributable

Overweight BMI 25-29.9 age of 65. age

Morbidity and Mortality Weekly Report 2010; 59(39):999 - - 65) reported that arthritis limited their work

35%

County adults were were adults County % of those over the (Source CDC). (Source ObeseBMI >30 45%

1003.)

10% 20% 30% 40% 50% 0%

(Source for graph: at Arthritis a 2011,Glance Morbidity and Mortality Weekly Report 2010; 59(39):1261- Diagnosed with arthritis with Diagnosed o o o o http://www.ncbi.nlm.nih.gov/pubmed/22550055) Murphy, LB. 2012. “Anxiety and depression among US adults with arthritis: Prevalence http://www.cdc.gov/arthritis/data_statistics.htm 2011, Statistics, and Data Arthritis CDC, (Source: o 2005/2009/2013 Adult

depression. should providers care Anxiety and depression can develop in people with diagnosed arthritis. Health blood pressure and obesity. Arthritis is a co developing arthritis. indicatesData that lack of exercisemarked are and risk age factors for year 2030. by the arthritis 67 million(25%) adults aged 18 yearsor older have will doctor States, osteoarthritis with (OA) being themost common type. Arthritis is themost frequent cause of disability among adults in theUnited Comparisons Healthy Weight Arthritis Prevalence Increases With Body Weight in the U.S. the in Weight Body With Increases Prevalence Arthritis

17%

- morbidity of diabetes, heart disease, high cholesterol, high

screen all people with arthritis, for anxiety both and

The Impact of Arthritis of Impact The Overweight BMI 25-29.9

Seneca County 2005 29%

19%

Seneca County County

2009 29%

Seneca County 2013 31% ObeseBMI >30

- diagnosed Ohio 2011 29% 30% and correlates,”

2011

& 24% U.S. 1265.)

4 4

osteoarthritis. bending have more osteoarthritis.Avoid injury joint to reduce your risk of developing sports oroccupational injuriesor have repetitive jobs with motions like repeated knee | JOINTS YOUR PROTECT management of your condition. arthritis. you If symptoms have of arthritis, seeyour doctor and begin appropriate For example, early use of disease of use early example, For and appropriate management is important, especially for inflammatory types of WEIGHT YOUR WATCH least 5at days aweek. You activity canget 10 in and | BE ACTIVE a day to day basis. Program | DOCTOR YOUR SEE reduce pain and disability. occurrence (incidence) o the decrease can pounds 11 just of A loss progression. disease decrease may and arthritis Research suggests that maintaining a healthy weight reduces the risk ofdeveloping the Arthritisthe Self limitations can be beneficial to people with arthritis.Self | STRATEGIES MANAGEMENT ARTHRITIS LEARN Key self pain, improve function, and stay productive. www.cdc.gov/arthritis/basics/key.htm, updated September 2011) (Source: for Centers Disease Control and Prevention, Arthritis: Key Public Health Messages, Early diagnosis of arthritis and self Arthritis: KeyPublicHealthMessages

delays disability. Make sureyou least at 30 get minutes of moderate physical activity - management activities include thefollowing:

(CDSMP) help you develop theskills and confidence to manage your arthritis on Research shown has that physical activity decreases pain, improvesfunction, - Program Management Program

Although there is no curemost for types of arthritis, early diagnosis | The Joint injuryJoint can lead f knee new osteoarthritis and a modest weight loss can help

prevalence of arthritis increases with increasing weight.

- - management activities can help people decrease their decreasetheir help people can activities management modifying drugscan affect the course ofrheumatoid Chronic Disease Self Disease Chronic the or (ASMP), to osteoarthritis. People who experience

Learning techniques to reduce pain and - minute intervals.

- management education, such as - Management Management arthritis.

. . . . Asthma andOtherRespiratoryDisease asthma. 1 data, survey County Seneca the to According Key Findings Adult

10% 20% 30% 2005/2009/2013Adult Comparisons Had been diagnosed with 0%

Information Warehouse) Chronic lower respiratory disease was the3 viruses respiratory and colds, allergens, pets, mold, smoke from burning woodor grass, infections linked to theflu, smoke,outdoo mites, are secondhandtriggers dust There are several importantfactors may that trigger anasthma attack. Someof these 14%of OhioU.S. and adults have ever been diagnosed asthma with had been diagnosed adults County asthma. with Seneca 2013, of 16% In County an County

Total 16%

І d the 3 the d

Males ASTHMA ANDOTHER RESPIRATORY DISEASE 10%

leading causeof death in Ohio, from 2006 Seneca County Adults Diagnosed with Seneca CountyAdults with Diagnosed Asthma .

Females

22% asthma

Under 30 Under (Source: 2012). CDC, 20%

Years 30-64 Seneca County 11% 2005 17%

65 & Over 65

6% of adults had been diagnosedwith leading causeof death in Seneca

23% Seneca Seneca County County

2009 13% r air pollution, cockroach Income <$25K

22%

Seneca Seneca County County $25K Plus 2013 Income 16% - 2008 16%

(Source: ODH, ODH, (Source:

( Source: 2011BRFSS Seneca 2005 Ohio Ohio 17% 2011 14%

Seneca 2009 13% 2011 14% U.S. U.S.

). ).

4 6

4 7

residents U.S. and Ohio for gender by ofasthma rates prevalence current and lifetime the demonstrate graphs following The Chronic RespiratoryConditions (Source: National Heart, Lung, Blood Institute, 2011) causeof chronic bronchitis. a low fever,shortness ofbreath and a cough that brings up mucus.Smoking is themain y to recurring periodsof wheezing, tightness, chest shortness of and coughing. breath breath, chest tightness, other and symptoms.Smoking is themain cause ofCOPD. harderit to breathe. COPD can cause large amounts of mucus, wheezing, shortness of Percentage Self-Reported

Percentage Self-Reported 10% 15% 20% . . . our lungs) become inflamed. Bronchitis can cause wheezing, chest pain or discomfort, 0% 5% 10% 15%

0% 5%

Chronic Obstructive Pulmonary Disorder(COPD)is a d Chronic bronchitis is a condition where thebronchial tubes (the tubes that carry air Asthma is a chronic lungdisease inflames that and narrows airways. can It cause Adult Current Asthma Prevalence Rates By Gender Current AsthmaPrevalenceAdultRates By 11.5% Adult Lifetime Adult Lifetime Asthma Prevalence Rates By Gender 7.2% Males Males

. 6.7%

11.6% Ohio Current Ohio Lifetime

U.S. Current U.S. U.S. Lifetime U.S. 12.3% isease that over makes time isease that Females 15.6% Females

11.6% 15.6%

        http://www.cdc.gov/asthma/faqs.htm) (Source: Centers for Disease Control, Vital Signs, Asthma, updated April 30, 2013,

burning wood in your home. too muchof thissmoke cause can anasthma attack. you If can, avoid plants is made up of of a mix harmful gases particles.small and Breathing in breathing in some chemicals, and acid refluxalso can trigger attacks. syncytial virus(RSV) can trigger an asthma attack. Sinus infections, allergies, Other Triggers: Grass: or Wood Burning from Smoke your home to help control your attacks. Mold: causing attacks, you may want to find thepet another home. Pets: can trigger anasthma attack. many and food water sources you can. as Cockroaches and theirdroppings Allergens: Cockroach airwhen pollution levels will be low. and other sources. Pay attention to air quality forecasts to plan activit Pollution: Air Outdoor barrier between dust mites and yourself. attacks,ent prev usemattress covers and pillowcase covers to make a Mites Dust car,or wherever you may spend a lot of time if you have asthma. Smoke: Tobacco Furry pets cantrigger anasthma attack. you If afurry think maybe pet Breathing in mold can trigger an asthma attack. Get rid of mold in : you have If asthma, dust mites cantrigger anasthma attack. To Infections linked to influenza (flu), Peopleshould never smoke you, near in your home, in your What Causes an Asthma Attack? This pollution can come from factories, automobiles, Get rid of cockroaches in your home by removing as as removing by home your in cockroaches of rid Get

Smok

e from burning wood or other other or wood burning from e colds, and respiratory

ies ies

4 8

4 9

(<1%), and vomitedor laxatives took (<1%). participated in a prescribed dietary or fitness program(<1%), took prescribed medications liquids without a doctor’s advice(3%), went without eating 24 or more(1%), hours (9%),used loss a weight program(4%), smoked cigarettes (3%), took diet pills, powdersor low a ate (45%), exercised (50%), fat in low foods or calories, fewer food, less ate

. . Physical Activity . . . Adult WeightStatus weight. lose to were trying adults of (51%) Over half obese. one Over by BMI. were obese U.S.of adults 28% and Ohio of 30% that indicates BRFSS 2011 The (BMI). Index Mass Body on based obese or were overweight adults County 71% Seneca of that identified Assessment The 2013 Health Key Findings Adult

week week m week. Whether participating in moderate or vigorous exercise,CDC also recommends every 15minutes 1hour and least at for exercise or vigorous week every 30minutes and exercise. participating in any physical activity in thepast week, including 5% who were unable to one than More week. per 5 days or more exercising were adults of 25% week. days per 3 or 30 minutes more least at or for exercise activity current weight or keep from gaining weight, and 4% were trying to gain weight. puts elevated them at risk for developing a variety of diseases. (BMI) Index (36%) Mass Body (35%)or by obese overweight either were County adults

physical activity or exercise for at least 30 minutes or 3 more days per

uscle The CDC recommends adults that participate in moderate exercise for least at 2 hours SenecaIn County,(50%) half of adults were engaging in some type of physical County Seneca Over(51%) half of adults were trying to lose weight, 29% were trying to maintain their 2013,In thehealth assessment indicated that almost three I (Source: Physical CDC, Activity for Everyone). n Seneca - strengthening activities that work all major muscle groups onor 2 more days per

І WEIGHT STATUS

County, 5 County, adults did thefollowing to lose or weight keep from gaining weight: 36% of36% Seneca County adults

0 % of adults were engaging in some type of week.

- third (36%)third of SenecaCounty adults

- quarter (28%) of adults were not not were (28%)of adults quarter

are obese. - fourths (71%) of Seneca Seneca (71%) of fourths

- carb diet

were . This 100% and 36% were obese. were 36% and 35% weight, normal as classified were adults County Seneca of all 28%

(BMI) Index Mass Body by obese or show The graph following . . . . . Nutrition (Percentages may not equal 100% due to the exclusion of data for those who were classified as underweight) 20% 40% 60% 80%

0% week. per Over half (51%) of Seneca County adults trying were to lose Adults ateout in a restaurant or brought home take juice(8%), and other sources(11%). products dairy other (30%), yogurt Seneca County adults consumed thefollowing sources of calcium daily:milk (59%), 45%of adults never usedcalorie information to help them decide what to order. what to order the when info 8% of SenecaCounty adults always used calorie information to help them decide carehealth provider’s(4%), advice (1%). and other content (23%), their what spouse preferred(22%), what their child preferred(15%), preparation (36%), availability(31%), (31%), time food they were used(29% to (48%), of ease of(52%), food (55%), healthiness cost (71%), enjoyment ate: taste they Seneca County adults reported thefollowing reasons they chose thetypes of food of servings offruits and veg only 21% of Ohio adults and 23% nationwide were eating the recommended number reduce therisk of cancer and to maintain good health. The 2009 BRFSS reported that adults that at recommends eat least 2 ½ cups offruits and vegetables per day to 87% were eating between 1 and 4 servings perAmerican day. The Cancer Society day. per vegetables and of fruits servings 5or more eating were 2013,of adults 6% In

Total 28% 35% 36%

Male 43% 15% 41%

Female s 30% 39% 31%

the percentage of Seneca County adults who are overweight overweight are who adults County Seneca of percentage the Seneca County Adult BMI Classifications

etables. Under 30 Under Normal rmation available was afast at food orrestaurant. chain 21% 49% 26% .

Examples of how to interpret the information include: include: information the interpret to how of Examples

(29%),supplements calcium(20%), calcium

Years 30-64 Overweight 35% 40% 25%

Over 65 & 36% 43% 21%

Obese - Income < Income

out food an average of 2.2 times 2.2times of average an out food $25K 45% 28% 27%

Income $25K Plus 34% 37% 28%

were overweight, overweight, were Seneca 2005 31% 30% 38% weight.

Seneca ), calorie - 2009 fortified fortified 31% 41% 27%

U.S. and Ohio to compared show The graph following

20% 40% 60% 0% 2005/2009/2013 Adult Adult 2005/2009/2013 o o o http://www.cdc.gov/obesity/data/adult.html) 2012, 13, August updated Facts, Obesity Adult CDC, (Source: o Comparisons

Overweight Seneca County 2013 County Seneca those who are normal weight. Persons who are obese medical have costs are that $1,429 higher than No No preventable death. diabetes and certain types of cancer,some of theleading causesof Obesity More one than Obese state has an obesity rate less 15%, than thenational goal.

(Source: 2013Seneca County Health Assessment and 2011 BRFSS)

36% - related conditions include heart disease,stroke, 2 type Obesity in Seneca County, Ohio, Adultsand U.S. Ohio, Seneca County,in Obesity

the percentage of Seneca County adults who are obese obese are who adults County Seneca of percentage the

- third of U.S. adults (35.7%) are obese. obese. are (35.7%) of adults U.S. third

Seneca County 2005 38% 31% Obesity Facts

Ohio 2011

30% Seneca Seneca County County 2009 41% 27%

Seneca Seneca County 2013 35% 36%

U.S. 2011

Ohio 2011 36% 30% 28%

2011 36% 28% U.S.

million. almost 6 million premature deaths, and by 2030, this number expeis . . . . . Adult TobaccoUseBehaviors of approximately half of long worldwide, death of cause preventable most and was the responsibleis for thedeaths former smokers. In 2013, the American Cancer Society (ACS) that stated tobacco use considered were 25% and smokers were current adults County Seneca 17% of 2013, In Key Findings Adult

one day in thepast yearbecause they were trying to quit smoking. 55%of thecurrent smokers responded that they had stopped smoking leastat for e (2%), (3%),snuff(3%), cigarillos(2%), cigars little (2%), swishers(2%), flavored cigarettes cigarettes(24%), (6%), cigars tobacco chewing (4%),(3%), hookah and Black Milds Seneca County adults u to: likely more were smokers adult County Seneca O for of 25% rates smoker prevalence cigarettes in their lifetime and now do not smoke). The 2011 BRFSS reportedformer One smoker current reported 2011 BRFSS The days). or all some currently smoke and lifetime their adults were current smokers(those who indicated smoking least at 100 cigarettes in The 2013 health assessment identified that about one(17%) in six Seneca County

2005/2009/2013 Adult Adult 2005/2009/2013

One in six (17%) Seneca County adults currentwere smokers. (Source: Cancer Facts & Facts (Source: Cancer - Current smoker Current Former smoker Former quarter (25%) of adults indicated that they were former smokers (smoked 100 (smoked smokers former were they that indicated (25%) adults of quarter Comparisons - prevalence rates of 25% for Ohio and 21% for the U.S. for the 21% and Ohio for of 25% rates prevalence o o cigarettes (1%),( snus o o

І (21%) female Be (26%) $25,000 than less incomes Have Have been a memberof an unmarried couple(33%) or divorced(27%) Have rated their overall health as poor(43%)

TOBACCO

Figures, American Cancer Society, 2013) sed thefollowing tobacco products in thepast year: - term users. Each year, tobacco use is responsible for for responsible is use tobacco year, Each users. term

1%), and(1%). pipes Seneca County 2005 27% 24%

hioU.S. and the

USE Seneca Seneca County County 2009 26% 19%

Seneca Seneca County County 2013 25% 17%

cted to increase to 8 to to increase cted Ohio Ohio 2011 25% 25%

2011 25% 21% U.S. U.S.

5 3

100% Assessment) http://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf and 2013 Seneca County Health . or $2,190/year. $168/month, . . Costs ofTobaccoUse smoked. werecurrent smokers, 25% of all adultswere former smokers, 58% and never had adults County Seneca of all 17% include: information the interpret to how of Examples tobacco. used who adults County Seneca of percentage the shows graph following The (Source: Campaign for Tobacco S . 7,038 adults. .

20% 40% 60% 80% eneca County. eneca

0% There are 41,399 adults 18 years old and older living in Seneca County. apack If The average pricepack forof a cigarettes in the United States is $5.98. If 7,038 adults spent $2,190/year, then $15,413,220 is spent a year on cigarettes in in year oncigarettes a spent is $15,413,220 then $2,190/year, spent 7,038 adults If 17%of Seneca County adults indicated they were smokers. That is approximately Total

58% 25%

17% smoking for leastat one day in the past year because they were 55% of the current smokers responded that they had stopped -

day smoker approximately spent $6/pack, they wouldspend:$42/week, If yes, do you now smoke cigarettes every day, some days or not

Male 29% 58% 13% “Haveyousmoked atleast 100 cigarettesyour in entire life?

Female

Current smoker Current - 58% 21% 21% Free Kids, State Cigarette Excise Tax Rates & Rankings, accessed from: Seneca CountyAdultSmoking Behaviors

Under 30 Under Respondentswere asked: 68% 14% 18% trying to quit smoking.

Years 30-64 27% Former smoker 53% 20%

65 & Over 65 38% 9% 53%

Income <$25K 26% 21% 53% Never smoked

$25K Plus Income at all?” at 59% 27% 14%

Seneca

2005 24% 49% 27%

Seneca 2009 19% 26% 55%

developing heart disease and COPD. cigar smoke and whosmoke multiple cigars adayare also increased at risk for can include cancers of thelung, larynx, oral cavity, and esophagus. Thosewho inhale are not asafe alternative to cigarettes. consequences Health of regular cigar smoking Cigars same contain the toxic and cancer

2010 National TobaccoAdult Survey,” published August 27, 2012) (Source: Nicotine & Tobacco Research, “Flavored Cigar Smoking Among U.S. Adults: Findings From the 2009 . . . . . Flavored CigarSmokingamongU.S.Adults

Transgendered (LGBT) cig Transgendered female cigar smokers(61%); and higher among Lesbian, Gay, Bisexual, Flavoreduse cigar was higher among Hispanic cigar smokers(62%); higheramong $20,000 (52%). Equivalenc Flavored morewas cigar smoking those common aGraduate among with cigars. flavored 18- the in smokers 57% of cigar than More Nearlyof 43% all adult cigar smokers in theU.S. report using flavored cigars. cigars. - From 2009 http://www.cdc.gov/VitalSigns/AdultSmoking/#LatestFindings) (Source: CDC, Vital Signs, Tobacco Use: Smoking & Secondhand Smoke, September 2011,      

One quarter of Seneca County adults indicated that they were Smoking rates are higheramong people a lower with education level. adults living at or abovepoverty level(18%). Adults living below poverty level(29%) are more likely to smoke than smoke. 17%) (about women than 22%) (about men More each year. 443,000Americans of smoking die orexposure secondhand to smoke About(46.6 1 in 5 million) adults still smoke. 2010. (19.3%) in 2005to in (20.9%) from smoke decreased who adults American of The percentage

2010, 6.6% of adults in the U.S. smoke cigars and 2.8% smoke flavored flavored smoke 2.8% and U.S.smoke cigars the in adults of 6.6% 2010, y Degree(GED) (65%), and those with annual household income under

ar smokers (67%). smokers ar

U.S. Adult Smoking Facts

for

mer smokers. - causing chemicals found in cigarettes; they 24 year-

old group, age smoke they say

5 4

5 5

rates in both cases. - 2006 The rates. mortality cancer age and age rates smoking cigarette adult U.S. and Ohio, County, Seneca show graphs following The higher than the Ohio rate. Seneca(about County one objective. 2020target People Healthy Respiratory Diseasehigher was than the Ohio rate, lower but than the U.S. rate and the rates, but rates,

Rate per 100,000 population adults 18older. These years show: and graphs w U.S. the and Ohio for shown rates BRFSS The objectives. 2020 People Healthy the diseases (formerly with and trachea,and lungin comparison cancers COPD) bronchus 100 150 200 . . . . 50

0 10% 20% 30% 40% 0% Disparities existed by gender forSenecaCounty trachea, bronchus, a - From 2006 - From 2006 Seneca County adult smoking cigarette rate lowerwas t * Healthy People 2020’s target rate and the U.S. rate is for adults aged 45 years and older. - (Source: 2013Seneca County Health higher the than Healthy People 2020Goal. adjusted mortality rates per 100,000 population for chronic lower respiratory respiratory lower chronic for population 100,000 per rates mortality adjusted - adjusted mortality rates, as as well chronic lower respiratory disease Seneca County Seneca 2006-2008 72 2013 Total 2010 thepercentage of mothers who smoked during pregnancy in County’s age Seneca 2008, (Source: ODH Information Warehouse and Healthy People 2020) 51

Chronic Lower COPD) (Formerly Diseases Lower Respiratory Chronic 17% different goals by gender. by goals **HP2020 not does report different 112 2008 Seneca male rates were higher than the Seneca female female theSeneca than higher were rates male 2008 Seneca

- fourth) fluctuated slightly from year alwaysyear, was to but 99 Healthy People 2020 Objectives & 2020Objectives People Healthy Age Ohio 2011 Ohio 2006-2008 Rates Smoking Cigarette - Adjusted Mortality Rates for for Rates Mortality Adjusted

25% 96 Assessment, 2011 BRFSS and Healthy 2020) People

Male 60

adjustedmortality rate for Chronic 134 U.S. 2011 U.S. 2007

21%

HP 2020 Target 56 han the Ohio and U.S. HP 2020 Target*

Female

12% 98

nd lung

Lower Lower ere for for ere Rate per 100,000 population 100 Rate per 100,000 population 10% 20% 30% 40% 50% 20 40 60 80 0% 100 0 20 40 60 80 0 26% (Source: Healthy People 2020, ODH 2006 Seneca County and Ohio Births to Mothers Who Smoked During During Smoked Who Mothers to Births and Ohio CountySeneca (Source: ODH Births, Vital Statistics Annual Birth Summaries by Year, 2006 *Healthy 2020 People Target and U.S. 2007 data are for cancerlung only

Seneca 2006-2008 19%

(Source: ODH Information Warehouse, updated 4 (Source: ODH Information Warehouse, updated 4 Seneca Males 2006-2008 Age 57 24% 2007 Trachea, Bronchus & Lung Cancer &Bronchus Trachea, Age -

Trachea, Bronchus & Lung Cancer &Bronchus Trachea, Adjusted Mortality Rates by Gender Gender for by Rates Mortality Adjusted 20% Seneca Mothers - Adjusted Mortality Rates for for Rates Mortality Adjusted Ohio 2006-2008

81 58

Information Warehouse, updated 4 Pregnancy 26% 2008

19%

Ohio Mothers Seneca Females 2006-2008 U.S. 2007*

51 27% 39 2009 - 15-

- 15- 19% 10) 10) HP 2020 Target*

46 - 15- - 2010) 10)

23%

2010

18%

5 6

5 7

...... Adult AlcoholConsumption beverages. alcoholic 5or more drinking drove after adults drinks (for females) on one occasion (binge drinking) thepast in month. Five percent of 4or more and males) (for drinks or more five had who drank adults of 39% guidelines). CDC per week, per or days more three of average an drinkers (drank frequent considered were County adults Seneca of 10% that Assessment indicated Health the 2013, In Key Findings Adult more alcoholic beverages, increasing to 8%of males. drink, increasing to 9%ofmales. considered binge drinkers by definition(See box above). (for fe drinks or more or 4 5.3 drinks for males and 5.5 drinks for thoseunder theage of 30. The 2011 BRFSS reportedbinge drinking rates of 20% for Ohio and 18% for theU.S. week). or per morethree days U.S. for the 57% and Ohio for of 56% rates prevalence drinker current reported BRFSS 2011 The of 30. age the under of those 53% to increasing month, Drank alcohol least once at past in

drinks for males and 4 or more for more for or 4 and for males drinks Binge drinker (drank 5 or more or (drank 5 drinker Binge 47% of47% Seneca County adults had at least one alc In In the past month, 5%ofadults reported driving within a couple hourshaving after 5 or In the past month, 6%ofadults reported driving after having perhaps toomuch to 25%of adults reported driving after having any alcoholic beverages in thepast month. (for males) drinks alcoholic or more five had they reported drinkers current of those 39% Nearlyone in five(19%) of a Of those who drank, Seneca County adults drank 4.0 drinks on average, increasing to One in ten(10%) adults were considere 2013, of 47% In femalesoccasion) on an Adult 2005/2009/2013 Comparisons І month ALCOHOL

SenecaCounty adults had least at one alcoholic drink in the past

males)on an occasion thelast month in and would be

ll Seneca County adults were considered binge drinkers.

past month.past Seneca County 2005 17% 43% CONSUMPTION d frequentd drinkers(drank on an average of

Seneca Seneca County County 2009 21% 56%

Seneca Seneca County County 2013 19% 47%

oholic drink in the

Ohio Ohio 2011 20% 56%

2011 18% 57% U.S. U.S.

0 1 2 3 4 5 6 100% 10% 20% 30% 40% 50% 60% 70% 80% 90% One in ten (10%) adults were considered frequent drinkers drink. not females39%Seneca reported theyof53% adultdid didof not County males drink,and alcoho drink not did adults County Seneca all of 47% include: graph first the on shown information the interpret to of how Examples average. on consumed amount the and alcohol consuming adults County Seneca of percentage the show graphs following The 0% Total 4.0

Total 13% 47% 34% Occasion Drinking Per Consumed Drinks of Number AverageAdults

Males

Percentages may not equal 100% as some respondents answered “don’t know” 5.3

Male AverageNumber of Days Drinking Alcoholin the Past Month

42% 10% 39% average of three or more days per week). Females

Did not drink any 3.0 Female

53% 29% 15% Under 30 Under

Under 30 Under 5.5 41% 12% 35%

Years 30-64 Years 30-64 4.0 13% 40% 43% 1-2 days 1-2

65 & Over 65 Over 65 & 3.7 28% 10% 58%

3 or more days Income Income <$25K <$25K 15% 3.5 60% 20%

$25K Plus Income Income $25K Plus 14% 38% 42% 4.1

Seneca 2005 Seneca (drank on an an on (drank 18% 16% 66% 2005 3.1

Seneca 2009 Seneca 39% 18% 40% 2009 3.5

l, l,

5 8

5 9

10% 20% 30% 40% more drinks (for males) or four or more drinks (for females) on an occasion at least once in the previous month. drinks (for males) or four or more drinks (for females) on an occasion. Adults must have reported drinking five or *Based on adults who have drunk alcohol in the past month. Binge drinking is defined as having five or more with Ohio and U.S. U.S. and with Ohio drinkers binge County Seneca comparison of the monthand past a who binge drinkers drank in County Seneca of percentage the show graphs following The

20% 40% 60% 80%

*Based on all adults. Binge drinking is defined as males having five or more drinks on an occasion, females 0% 6 % of % of

Total

39% Seneca Seneca 2013

Seneca County Adult Drinkers Who Binge Drank in Past Month* Past in Drank Binge Who AdultDrinkers CountySeneca Males 50% 19% (Source: 2011BRFSS, 2013 Seneca County Health Assessment) County adults reported driving after having perhaps too

Females 29% having four or more drinks on one occasion.

Under 30 Under 46% AdultBinge Drinkers* much to drink.

Years 30-64 Ohio 2011 37%

20%

65 & Over 65

24%

Income <$25K

28%

$25K Plus Income 42%

U.S. 2011

Seneca 2005 18% 39%

Seneca 2009

40%

http://www.cdc.gov/alcohol/fact (Source: CDC, Alcohol and Public Health, Fact Sheets, Caffeinated Alcoholic Beverages, July 2010, Caffeinated AlcoholicBeverages N/A . shows: Thetable statistics. vehicle accident select shows table following The (Source: Ohio Department of Public Safety, Crash Reports, Updated 7/23/2013, Traffic Crash Facts) Crash Traffic 7/23/2013, Updated Reports, Crash Safety, Public of Department Ohio (Source: Alcohol . . .

Alcohol Impaired Drivers in Crashes – Ohio. 50%of crashes fatal all in Seneca County were alcohol

Not available available Not alcohol outlets, stores. including convenience Currently, morebrands 25 than of caffeinated alcoholic beveragessold are in retail who was report taking who dodrinkers not report mixing to report being taken a Drinkers who consume alcohol energy with drinks are about as likely twice as binge drink drinkersthan who do not report mixing alcohol with energy drinks. Drinkers who consume alcohol mixed energy with dr Alcohol Alcohol Alcohol - Alcohol

Alcohol Related Property Damage Only Property DamageOnly Total Non Total - - - Related Injury Crashes Injury Related Injury Crashes Injury Related FatalCrashes Fatal Crashes Related Total Crashes Total Related Total Crashes Total under the influence of alcohol.

- - Related Deaths Related Deaths Related InjuriesRelated advantage of someone elsesexually, and to report riding with driver a - Fatal Injuries

sheets/cab.htm)

cities in Seneca County, Seneca County, and Ohio motor motor Ohio and County, Seneca County, Seneca in cities

Fostoria Fostoria City of of City 2012

N/A 151 201 49 11 71 7 3 3 1 1 1 1

City of of City inks are 3 times more likely to 2012 Tiffin - 200 241 40 49 related compared to 42% in 42% in to compared related 6 5 3 1 0 6 1 0 1

dvantage Seneca Seneca County 1,258 2012 291 398 959 63 33 43 26 63 10 4 4 8 of sexually, to to sexually, of

104,964 213,452 286,448 12,370 71,972 12,518 6,775 7,576 5,312 1,122 1,024 Ohio 2012 431 470

Healthy People 2020objective. deaths per 100,000 population was greater than the state rate, thenational rate, and the Seneca County femalesdied of motor vehicle accidents during thesame period. The graphs show: The graphs objectives. 2020 People Healthy to comparison with population 100,000 per rates mortality age Ohio and County show Seneca The graphs following Motor VehicleAccidents . . . higher than the female rate

32 SenecaCounty males died of motor vehicle accidents from 2006 - County age The Seneca - From 2006 No. of reported deaths Rate per 100,000 population 10 10 20 30 40 50 0 2 4 6 8 0 (Source: ODH Information Warehouse, updated 4 Healthy People 2020 Objective and Age and 2020Objective People Healthy- 2008, the Seneca County motor vehicle age vehicle motor County Seneca the 2008, 0-14*

1 26.1

Seneca 2006-2008 0

11.4 Total Seneca County Number of Motor Vehicle Deaths Deaths Vehicle Motor of Number County Seneca 13.8 (Source: ODH Information Warehouse, updated 4 2008. from 2006to 15-24 adjusted motor mortality accident vehicle rate for males was 8

12.4

Females=12 Males=20 N=32 2 By Age and Gender, 2006-

Seneca Males Motor Vehicle Accidents Vehicle Motor Ohio 2006-2008 25-34 3

38.5 3

16.6 N= 45 N= Male Seneca Females 19.9 - 35-44 15- 6

10 1 - and and Adjusted Mortality Rates for for Rates Mortality Adjusted adjusted motor vehicle accident accident vehicle motor adjusted

U.S. 2007 - ortality rate of 26.1 rate adjusted mortality Healthy 2020) People 2008 45-64 7

14.4 - 15- 4

10) Female 6.6 - HP 2020 Target

2008 while 13 while 2008

65 and > 65 7.9

affects from: http://www.drugabuse.gov/related from: (Source: National Institute on Drug Abuse, Abuse of Prescription (Rx) Drugs AffectsYoung Adults Most, June 2013, admissions andemergency 66 room visits. 17 treatment were there due overdose, Rx to drug everyfor death young adults, Among This wa 2010,In almost 3,000 young adults died from prescription drug(mainly opioid)overdoses. good friends. time with dealing with problems, weight, losing feeling better, increasing alertness, and having a Reasons for abusing these drugs include: get relievers,ADHD, stimulants, and- anti Young adults(age 1825) to are thebiggest abusers of prescription(Rx) opioid pain Abuse ofPrescription(Rx)Drugs ...... Adult DrugUse 6months. past the during or alert active more and/or or high good adults had used not prescribed medication for them or took more prescribed than to feel In 2013, 5% of SenecaCounty adults had used marijuana during thepast 6 months. 4% of Key Findings Adult

away (1%),away some other and destruction(5%). method down thetoilet it medication: took as prescribed(43%), in it threw the trash (23%), (22%), keptit flushed Seneca County adults indicated they did thefollowing with their unusedprescription so less once than a month. useddi drugs who these County adults of Seneca When asked about their frequencyof medication misuse in thepast six months, 44% 65. of age the over those of 7% to increasing prescr 4% of adults used medication not prescribed for them or they took more than day, and 41% did so less oncethan a month. the past six months,of 36% SenecaCounty adults who used drugsso did almost every When asked about their frequencyof marijuana and other recreational drug use in cocaine and methamphetamines. <1%ofSeneca County adults reported usingother recreational drugsas such 30. of age underthose the 5% of SenecaCounty adults usedmarijuana in the past 6 months, increasing to 8% of - young s a 250% increase from 1999. from 1999. 250%s a increase ibed to feel goodor high and/or more active or alert during thepast 6 months, - adults І MARIJUANAANDOTHER -

most) DRUG USE (18%), to took theMedication it Collection program(8%), gave it

- topics/trends

anxiety drugs. anxiety

- ting ting high, relieving pain, studying better, statistics/infographics/abuse

d so almost every day, and 28% every day,d sodid and almost

- prescription - rx- drugs - 6 2

6 3

incomes lessthan $25,000were current users. past six months,of 8% adults under the age of 30were current users,7% and of ad the in marijuana used County adults Seneca all 5% of include: the information interpret to of how Examples misuse. medication and months six past the in use marijuana adult indicating Assessment Health County Seneca 2013 the from data are graphs following The 10% 15% 10% 15%

0% 5% 0% 5% Total Total 5%

Males Males 7% 5% Months 6 Past in Misuse Medication AdultCounty Seneca Seneca CountyAdult UseMarijuana in 6 Past Months

Females Females 3% 4%

Under 30 Under Under 30 Under 4% 8%

Years 30-64 Years 30-64 4% 6%

65 & Over 65 7% Over 65 & 1%

Income <$25K Income <$25K 6% 7%

Income $25K Plus Income 3% $25K Plus 4%

Seneca 2005 Seneca 7% 2005 4%

Seneca ults with ults 2009 2% Seneca 2009 5%

Adults who used marijuana in the Adults who misused prescription Long problems such as bronchitis, emphysema, and bronchial asthma. blood pressure. Like tobacco smokers, marijuana smokers experienceserious health increased heart rate, coughing from lung irritation, increased appetite, and decreased Short disorders, especially for teens have that a genetic predisposition. of depression; an increased risk and earlier onset of schizophrenia and other psychotic ha Researchers cancer of head, the neck, lungs and respiratory track. Marijuana contains toxins and carcinogens,marijuana smokers increase their risk of hallucinations. High dosesof marijuanacan result in mental confusion, panic reactions and of motivation, ambition and interest in the pursuit of personal goals. characterized by apathy, impairment of judgment, memory and concentration, and loss (Source: U.S. U.S. (Source: perception, difficulty in thinking and problem short The Marijuana contains over 400 chemicals. Marijuana is a mind Marijuana N/A http://www.justice.gov/dea/druginfo/factsheets.shtml recreational drugs in thepast 6 drugs in thepast 6 months –

Adults who used other Not available Not - - 2005/2009/2013 Adult Adult 2005/2009/2013 term chronic marijuana use is associatedAmotivational with Syndrome, term physical effects from marijuanause may include sedation, shot blood eyes, - past 6 months Comparisons term effects ofmarijuana include problems memory with and learning, distorted Department months

ve alsofound an association between marijuana use increased and an risk

- altering(psychoactive) drug,produced theCannabis by sativa plant.

of Justice of

: DEA Briefs : DEA

Seneca County

2005 & Background, & Background, 7% 4% 4%

)

- solving, and loss of coordination. Seneca Seneca County County 2009 2% 0% 5% Drug Fact Sheets,June 2012, from:

Seneca Seneca County County 2013 <1% 4% 5%

Ohio Ohio 2011 N/A N/A N/A

2011 N/A N/A N/A U.S. U.S.

6 4

6 5

Adult Adult ...... Women’s HealthScreenings factors for cardiovascular diseases. are which all known risk smokers, obese, and 21% were identified as high blood cholesterol, 31% w had high blood pressure, 31% had Over one life. their in time some at stroke a survived survived aheart attackand 2% had determined that 3%women of had Assessment year. The Health past can detect and 49%exam had aPap smear to and over breast had aclinical 19 ages women County Seneca of year. 50% past the in mammogram a having 40reported of age women over the County Seneca Key Findings had this screening in the past year. women had a pap smear in thepast three years. of Ohio 82% 81% of and U.S. that indicated BRFSS years. 2010 The three past the in smear smear and 49% reportedhaving had theexam in the past year.72% of had women a pap 75% in Ohio, had a clinical breast exam in the past two years. U.S. and the over in 40and of women 77% that BRFSS reported 2010 years. The two past life and 50% had one within the past year. and over in theU.S.74% and in Ohio, had a mammogram in thepast two years. 40 of women 75% that BRFSS reported 2010 years. The two past the in one 68% had and In 2013, more than half (51%) of half than more 2013, In

47%of Seneca County women had doneself a This assessment has identified that most(95%) Seneca County womenhad have a Pap two Nearly County women have Seneca hadof a clinical breast 86% exam some at time in their More half than (51%) ofwomen ages 40over and had a mammogram in thepast year nearly and one time 2013, some mammogram a at had In of 62% women cer of the cervix in the the cervix in the of cer І - thirds (65%) women of ages 40over and had a clinical breast exam in the WOMEN’S HEALTH - quarter (27%) quarter ere

Information ODH Warehouse,(Source: updated 4 5. 4. 3. 2. 1. 5. 4. 3. 2. 1. (Source: ODH Information

Alzheimer’s Disease (7%) Disease Alzheimer’s Chronic Lower Respiratory Diseases(8%) (8%) Stroke (18%) Cancers Heart Diseases(27% of deaths) all Alzheimer’s disease (5%) (5%) disease Alzheimer’s Chronic Lower Respiratory Diseases(6%) (6%) Stroke (22%) Cancers Heart Diseases(25% of deaths) all Leading2006 Types Death, of – Leading2006 Types Death, of –

- breast exam in thepast year. Seneca County Female County Seneca

Ohio Female Female Ohio

Warehouse, updated 4

2008 - 2008

third (30%) third

- - 15- 15-

10) 10)

100% 25% 50% 75% 0% year, 50% had a clinical breast exam, and 49% had a Pap smear. aPap breast exam,49%year,50% had aclinical and had within had amammogram past on Countythe thefemales 30%Seneca of include: graph shown information the interpret to how of Examples year. past the in exams health various had that adults female County Seneca of percentage the shows graph following The N/ . . . Women’s HealthConcerns *2010 BRFSS Data Had a mammogram in the past two past the mammogram a in Had 2005/2009/2013Adult Comparisons Had a pap smear in the past three

Had a clinical breast exam in the A past two years – the 2013Assessment Health has identif cholesterol, high blood pressure, physical inactivity, and diabetes. Seneca County In Major risk factors for cardiovascular disease include smoking, obesity, high blood 2% had a stroke sometime in at their life. 2013,In thehealth assessment determined that 3% of had women a heart attack and for 35% of all female in deaths Seneca County - From 2006

30%

Not Available Not Total years (age 40 & over) & (age 40 years     

50%

6% had been diagnosed with diabetes (11% U.S., 10% Ohio, 2011 BRFSS) Ohio, 10% (11%U.S., diabetes with diagnosed been 6% had curre were women of all 21% 27% were diagnosed with h BRFSS) 31% were diagnosed with high blood cholesterol(37% U.S.,Ohio, 37% 2011 BRFSS) 2011 Ohio, 58%U.S., (57% or obese overweight 61% were

49%

2008, major cardiovascular diseases(heart disease and stroke)accounted Seneca County Women's Health Exams Within Year Past the Within Exams Women's Health CountySeneca years

Under 40 Under

(age 40 & over) (age 40&

51%

56% Mammogram

40 & Older 40 51%

51%

40%

igh blood pressure (30% U.S., pressure blood igh Seneca County Income <$25K Income nt smokers (19% U.S., 24% Ohio, 2011 BRFSS) BRFSS) 2011 24% Ohio, (19%U.S., smokers nt

2005 N/A N/A N/A 22% Breast Exam Breast ied that:

50%

48%

Seneca Seneca Co

(Source: ODH Information Warehouse) 2009 N/A N/A N/A Income >$25K Income

unty 34%

50% Pap Smear Pap Seneca Seneca County

49% 2013 72% 68% 65%

Seneca 2005 Seneca 29%

32% Ohio, 2011 BRFSS) 2011 Ohio, 32%

57% Ohio 82%* 74%* 75%* 2011

59%

Seneca 2009 Seneca 42%

58%

81%* 75%* 77%*

2011

U.S.

54%

6 6

6 7

100,000 population forcardiovascular diseases. The graphs show: age Ohio and County Seneca the show graphs following The . . 2008. to from 2006 lower than the male rate for heart disease.

Rate per 100,000 population - From 2006 Rate per 100,000 population The SenecaCounty female stroke mortality rate was higher than the Ohio female rate 100 150 200 250 300 50 0 100 150 200 250 300 350 400 50 0 Ohio AgeOhio - 2008, the Seneca County the 2008, and Ohio age female

(Source for graphs: ODH Information Warehouse, updated 4 Heart Disease Seneca CountyAge - 264 Heart Disease Adjusted Heart Disease and Stroke Mortality Rates By Rates Mortality andStroke Disease Heart Adjusted 302 Mortality Rates By Gender, 2006- Gender, By Rates Mortality 168 192 Gender, 2006- Gender, Adjusted Heart Disease and Stroke Stroke and Disease Heart Adjusted

2008 45 Stroke 54 Stroke - adjusted mortality rates per per rates mortality adjusted - adjusted mortality rate was was rate adjusted mortality

2008 43 - 15 55 - 10)

Female Male Female Male Rate per 100,000 Rate per 100,000 . . . available. The show: graphs population age County Seneca the show graphs following The

population population *Note: Healthy People 2020 target rates are not gender specific; Healthy People 2020 Targets may not be be not may Targets 2020 People Healthy specific; gender not are rates target 2020 People Healthy *Note: - County age The Seneca less theOhio than rate and theHealthy People 2020 target objective. - From 2006 cancer was less than the Ohio rate. - From 2006 cancer and ovarian cancer rates were lower than state the rates. higher than the state rate and theHealthy Uterine People objective. 2020 target 10 20 30 40 50 60 10 12 14 0 0 2 4 6 8

for women’s health with comparison to Healthy People 2020 objectives when when objectives 2020 People Healthy to comparison with health women’s for (Source: ODH Information Warehouse, updated 4 2008, the Seneca County age County Seneca the 2008, age County Seneca the 2008, Cervical Cancer 39.1 2.9 Lung Cancer Seneca County Female AgeFemale County- Seneca Seneca County Female AgeFemale County- Seneca

44.7 Seneca 2006-2008 2.7 Seneca 2006-2008

2.2 adjusted cervical cancer mortality rate for 2006- rate mortality cancer cervical adjusted

available for all for all available Colon/Rectum Cancer

14.9 Uterine Cancer Uterine 2.9 Ohio 2006-2008 - - Ohio 2006-2008

adjusted breast cancer mortality rate was for rate femalelung mortality adjusted

16.1 Adjusted Cancer Mortality Rates Rates Mortality Cancer Adjusted Adjusted Cancer Mortality Rates Rates Mortality Cancer Adjusted 4.8 diseases. -

adjusted mortality rates per 100,000 - 15- 10, and Healthy 2020) People

HP 2020 Target* HP 2020 Target* 20.3 Breast Cancer Ovarian Cancer 1.7

25.6

7.9 2008 was was 2008

20.6

6 8

6 9

(12.6%). (19.8%) in 2009.Following African were American (13.3%)women and Hispanicwomen 2010. warts. 26y through 9 for recommended also vaccinated. The vaccine protects females against HPV types 6, 11,18. 16,and Gardasil is - 12year 11 and 25. 10through ages female’s for recommended is vaccine 2009. This

disease from this die of them 4,000 almost and cancer cervical with diagnosed are 11,000 women The Centers for DiseaseControl and Prevention report that every year in the U.S., about almost cervical all cancers are related to infections by HPV. of can infect which the genitals. Most HPV infections are benign and transient; however, becoming newly infected annually. There more are 100 than types of more HPV, 40 than HPV is themost common sexually transmitted infection in the U.S., 6.2 with million people Human PapillomaVirus(HPVandVaccine Cancer Society. Cancer Prevention & Early Detection Facts & 2012; Figures p. 40- updated January 24, 2013, from http://www.cdc.gov/vaccinesafety/vaccines/HPV/Index.html and American (Sources: Centers for Disease Cont from 10.5% in 2008 to 17.1% in 2009. in 17.1% to 2008 in from 10.5% 2010. in 48.7% to 2007 in from 25.1% showed Teens of Survey Immunization National the from data Recent underinsured oreligible for Medicaid. and teens who do not have insuranc through theVaccine forChildren (VFC) program, coverswhich vaccine costs for children subtypesof cause HPV that cervical cancers. These vaccinations include: human papillomavirus(HPV).

Society; 2012)

......

32% or about one about or 32% AmongU.S. girls agesto 17, 13 uptake of theHPV vaccine initiation increased HPV Vaccines are approximately $130 per dose are and available in all 50 states   There are HPV two vaccines available to protect against types 16, 18, and other  Most cases of cancer cervical andcases all ofwarts genital are causedby Catch-

Gardasil Cervarix 70%of cervical cancersare caused HPV types16 by and 18. 

up vaccine uptake improved for women between t Non old girls as well as females ages through 13 26, who were not previously - : The FDA licensed Gardasil in 2006.This vaccine is recommended for :The Federal Food andAdministration Drug (FDA) licensedCervarix in Hispanic women had thehighest catch - third of girls had thecomplete three rol and Prevention, Vaccine Safety, Human Papillomavirus (HPV) Vaccine,

e and for somechildren and teens who are ear

- old males to protect against some genital - up HPV vaccine uptake

- shot vaccine seriesby 41. he ages of 13 and 26; of ages 13and he

Atlanta: American Cancer :

http://www.cdc.gov/vitalsigns/BingeDrinkingFemale/index.html) (Sources: Centers for Disease Control and Prevention, Binge Drinking, January 2013, ...... A Serious,UnderRecognizedProblemamongWomenandGirls Binge Drinking:

6 drinks per binge. Women who binge drink do so frequently – About 1 in 8 women aged 18 years and older 1 in 5 and high school girls binge drink. alcohol spectrum disorders. Drinking during pregnancy can lead to sudden infant death syndrome and fetal alcohol use levels of alcohol, increasing thechances the baby be harmed will by the mother’s If women binge drink while pregnant, they risk exposing their developing baby to high transmitted diseases,unintended pregnancy, many and other health problems. Binge drinking increases thechances of breast cancer, heart disease,sexually Drinking toomuch health problem. Binge drinking is a dangerous behavior is but not widely recognizedwomen’s as a wine, or liquor)on an occasion. Binge drinking for women is defined as consuming4 or more alcohol drinks(beer, .

resultsin about 23,000 deaths in women and girls each year.

about 3 times a month

– and have about

(43%), are known factors risk for cardiovascular diseases. smokers,which, alongwith obesity as were identified 13% and cholesterol, blood pressure, 41%high blood had hadof men been diagnosedwith high (PSA) some test at time in their life and 30% had one in thepast year. Key Findings Adult . . . Men’s HealthScreeningsandConcerns . . . some time in their life. One heart attack and 3% had ast determined that 11% ofhad men a Assessment Health 2008. The 2006- from County Seneca in deaths cancers accounted for 24% male of all and stroke) accounted for 33% and cardiovascular diseases (heart disease in exam rectal males over theage of 50 had a digital one More than year. Specific Antigen (PSA) test in the past over the age of 50 had a Prostate a 50had of age over the one in thepast year. 3% had astroke some at for 33% of all male deaths in Seneca County and 37% had one in the past year. one in thepast year. test in the past two years. PSA a had Ohio, 54% U.S. in the and over in and 40 of men 53% that reported 2010 BRFSS

In 2013, 48% of Seneca County males males County Seneca 48% of 2013, In .

More half than (54%) ofmen had a digital rectal exam in their lifetime and 22% had More half than (52%) ofmen ages 40over and a PSA had in thepa More two than 2013,In thehealth assessment determined that 11% ofmen had a heart attack and - From 2006 79%of males50 over age and had a digital rectal exam some at time in their life, 50 over age and had a PSAsome males test at of 69% time in their life, 48% and had І

2008, major cardiovascular major 2008, diseases(heart disease and stroke)accounted the past year.Major past the MEN’S HEALTH - fifths (43%) of SenecaCounty had males aProstate -

third (37%) of of (37%) third time in their life.

- third (33%) third roke at -

ODH(Source: Information Warehouse, updated 4 5. 4. 3. 2. 1. 2. 1. 5. 4. 3.

(Source: ODH Information Warehouse, updated 4 (Source: ODH Information Warehouse) Stroke (5%) and Diabetes (5%) Diabetes and (5%) Stroke Accidents,Unintentional Injuries(7%) Chronic Lower Respiratory Diseases(9%) (24%) Cancers Heart Diseases(28% of deaths) all Stroke (4%) Stroke Accidents,Unintentional Injuries(6%) Chronic Lower Respiratory Diseases(6%) (25%) Cancers Heart Diseases(26% of deaths) all Leading2006 Types Death, of – Leading2006 Types Death, of –

Seneca

Ohio Male Ohio

County Male County

- st two years. The The years. two st Specific Antigen

2008 2008

15-

- 15- 10) 10)

20% 40% 60% N/A N/A exam. rectal digital a 22% had and year past within the PSAa test had males County Seneca of include:30% graph on the information shown the interpret to how of year. Examples past testhad aPSA rectal the andin digital exam have that surveyed males County Seneca of percentage the shows graph following The . . *2010 BRFSS Data 0% 2005/2009/2013Adult Comparisons

43 Had a PSA test in within the past – males were both lung, prostate, colorectal, pancreas, and esophageal - From 2006 the 2013 health assessment has identified that: cholesterol, high blood pressure, physical inactivity, and diabetes. Seneca County In Major risk factors for cardiovascular disease include smoking, obesity, high blood Information Warehouse)

Not Available Not % of % of 30% Total (age 40 and older) (age 40 and

o o o o o Seneca 22%

two years years two

2008, the leading cancer deaths for Seneca County malesOhio and 2011 BRFSS) (10% Ohio, 10% U.S., diabetes with diagnosed been 13% have 2011 BRFSS) Ohio, 26% (24% U.S., smokers current were men of all 13% BRFSS) 2011 Ohio, 34% (32% U.S., pressure blood high with diagnosed 33% were 2011 BRFSS) 41% were diagnosed with high blood cholesterol(40% U.S.,Ohio, 41% BRFSS) 2011 Ohio, 74%U.S., (70% or obese overweight 84% were

Seneca County Men's Health Exams Within Year Past the Within Exams Men's Health CountySeneca

Under 50 Under 10%

County males had Prostate a

5% test at some time in their life.

Prostate-Specific AntigenProstate-Specific

50 & Older 48%

37% Seneca Seneca County

2005 N/A Income

<$25K 23%

15%

Seneca Seneca County County

2009

N/A Digital Rectal Income >$25K

35%

- Specific Antigen (PSA)

27% Seneca Seneca County County 2013

52%

Seneca 34%

2005

30% Ohio Ohio 2010 54%

(Source: OD (Source:

Seneca

21% 2009 2010 53% U.S. U.S.

14%

7 2

7 3

. 100,000 population formen’s cardiovascular diseases. The graphs show: age Ohio and County Seneca the show graphs following The .

Rate per 100,000 population higher the than - From 2006 higher than the Ohio male rate. - age County male The Seneca

100 150 200 250 300 350 400 50

Rate per 100,000 population 0 100 150 200 250 300

0 2008, the Seneca County and Ohio age male (Source for graphs: ODH Information Warehouse, updated 4 Seneca CountyAge - Heart Disease female rate for heart disease. rate forfemale heart 302 Heart Disease Ohio AgeOhio - 264 Mortality Rates By Gender, 2006- Gender, By Rates Mortality Mortality Rates By Gender, 2006- Gender, By Rates Mortality 192 168 Adjusted Heart Disease and Stroke andStroke Disease Heart Adjusted adjusted heart disease and stroke mortality rate was

Adjusted Heart Disease and Stroke Stroke and Disease Heart Adjusted

54 45 Stroke Stroke - - adjusted mortality rate was was rate adjusted mortality 2008 2008 adjusted mortality rates per per rates mortality adjusted - 15 43 55 - 10)

Female Male Female Male . . shows:graph The objectives. 2020 People Healthy to comparison with health men’s for population age County Seneca the shows graph following The

Rate per 100,000 http://www.cdc.gov/nchs/fastats/men from 1/11/2013 Stats, Fast Health, Men’s Statistics, Health for Center National CDC, (Source:        100

population lower than the Ohio rate but higher than theHealthy People 2020objective. age The cancer was higher than the Ohio rate. - From 2006

20 40 60 80 0 cancer and accidents (unintentional injuries). The leading causes for of death males in theUnited States are heart disease, coverage. care health of age 65 without the under of males There 19% are obese. over are and years 20 of men 34% guidelines for aerobic activity t Only 52% of adult males in theU.S.met the2008 federal physical activity in thepast year. Of theadult males in the U.S.,31% 5 or had more drinks in 1 day least at once 22%of males adult in the U.S. currently smoke. health. or poor fair or reported older 18years aged males of adult 13% Approximately

- adjusted prostate cancer mortality rate in Seneca County for2006

*Note: Healthy the People 2020 target rates are not gender specific. 80.6 2008, the Seneca County age County Seneca the 2008, Lung Cancer (Source: ODH Information Warehouse and Healthy People 2020) 77.4

Seneca County Male AgeMale - County Seneca Seneca 2006-2008 Men’s HealthData s_health.htm Colon/Rectum Cancer hrough leisure 19.6 Mortality Rates Rates Mortality

) -

22.6 adjusted mortality rate for mortality adjusted male lung

- Ohio 2006-2008 - adjusted mortality ratesper 100,000 time aerobictime activity. Adjusted Cancer

Prostate Cancer 23.9

24.7

21.2 - 2008 was 2008 was

7 4

7 5

http://www.cdc.gov/features/cancerandmen/) (Source: Center for Disease Control and Prevention, National Cancer Institute, June 18, 2012, ...... Cancer andMen

regularly, starting at age 50. before they turn into cancer. Everyone should tested be for colorectal cancer men. Screening tests can find precancerous polyps so they can be removed all men are at risk for prostate cancer, some factors increase risk. These include: skin cancer. is theIt second most common cause of cancer death in men.While pancreas. stomach), your to throat your connects that colorectal cancer, esophageal adenocarcinoma(a type of cancer of the tube thro smoke. you if quit to or smoking, notto start is cancer lung to do prevent can you thing important most The

at, kidney, bladder, pancreas, stomach, and acute myeloid leukemia. Every year, cancer claims the lives of nearly 300,000 men America. in Colorectal cancer is the third leading cause of cancer deaths America in counting U.S., not the in men in cancer common the most is cancer Prostate men, are associated cancers overweight: following In the being with box), mouth, (voice larynx esophagus, the of cancers causes Smoking More men the in U.S. die from lung cancer than any other type of cancer. o o o

being African American family age older

history of prostate cancer prostate of history

and cancer of the kidney and

. . . . Preventive HealthScreeningsandExams ...... Preventive Medicine within the past 24 months. colorectal cancer screening adults agesover 50had a and one Almost life. vaccination at some time their in pneumonia a over had 65 and Almost half (46%)of adults ages Key Findings AND HEALTHSCREENINGS Adult

over. 65and ages of those 46% mammogram. of year,51% past the In 9% of SenecaCounty females were tested for osteoporosis in thepast 24 months. months, increasing to 28% of those ages and 65 older. 10%of Seneca County adults received preventive testing for skin cancer in thepast 24 screening in thepast 24 months, increasing to 29% of those ages and 50 over. About one seven in (15%) of SenecaCounty adultshad acolorectal cancer vaccine in their lifetime (5%), and human papillomavirus vaccine in their lifetime (3%). Tdap) in thepast 10 years(45%), pertussis in thepast 10 years(7%), Zoster(shingles) C Seneca pneumonia shot in their life. a had over 65and ages adults Ohio 70% of and U.S. that reported 2011BRFSS The Nearly one hadyear. a flu vaccine past in the over and 65 ages adults Ohio and U.S. 61% of that reported 2011BRFSS The months. 63%of Seneca County adultsagesover 65 aflu and had vaccine past the in 12 thoseOf who had a flu vaccine, 99% had theshot and 1% had the nasal spray. 12 months. flu vaccine during thepast Seneca County adults had a More two than o І - unty adults have had thefollowing vaccines: tetanus booster(including - fifth (19%)ofadults have had a pneumonia shot in their life, increasing to third (29%) of of (29%) third

PREVENTIVE MEDICINE

- fifths (44%) of of (44%) fifths

Seneca County women ages 40 and over have had a a over had have 40 and ages County women Seneca

http://www.cdc.gov/flu/protect/habits/index.htm) 2012, (Source: CDC, Seasonal Influenza (Flu), updated November 8, . . . . rest of their lives.Generally this they received as children will protect them for the Some adults incorrectly assume that the vaccines

(such as flu and pneumococcus). infec common by caused serious disease to more susceptible become we age, As we Immunity can begin to fade over time. some adults were children. Newer vaccines available were not when children. as vaccinated never were Some adults Reasons Some Adults Still Need Vaccines Need Still Adults Some Reasons

is true, except that:

tions

test. . .

breast exam, and Pap

N/A Diagnosed a Stroke with Diagnosed aHeart with Attack Diagnosed Diabetes with Diagnosed High with Blood Pressure Diagnosed High with Blood Cholesterol RESULTS SCREENING GENERAL Had apneumonia vaccination Had a flu shot in thepast year 2005/2009/2013 Comparisons See theWomen and Men’s Health Sections for further prostate, mammogram, clinical Prostate a over had 50and ages men of year,48% past the In against 65 years and olderare vaccinated who non IID –

Not available - 13.1: Increase the percentage of percentage the 13.1: Increase (ages 65 and over) 65 and (ages over) 65 and (ages (Sources: Health (Sources: - institutionalized high pneumococcal disease

Objective y *U.S.baseline is age Seneca County Adult Health Screening Results Screening Health Adult County Seneca

People 2020People Objectives, 2011 BRFSS, 2013 Seneca County Health Assessment) smear screening test information for SenecaCounty adults ( Percents based on all

- risk adults aged risk aged adults

Pneumonia VaccinationPneumonia Healthy People2020

- Seneca County adjusted to the 2000 population standard

2005 N/A N/A

Seneca Seneca

Seneca Seneca Seneca County County County County adults surveyed) 2009 2013 N/A N/A 46%

Seneca Seneca County County Ohio Ohio 2013 2011 70% 46% 63% -

SpecificAntigen (PSA)

Ohio Ohio 2011 2011 70% 70% 61% U.S. U.S. Total Sample

30% 36% 2% 7% 9%

Healthy Healthy

People People Target 2011 2020 2020 90% 70% 61% U.S. U.S.

http://www.cdc.gov/cancer/skin/basic_info/prevention.htm) http://www.cdc.gov/mmwr/pdf/wk/mm6118.pdf CDC, & Skin Cancer Preventio Adults Aged18 (Sources:The CDC’s, Morbidity and Mortality Weekly Report, “Sunburn and Sun Protective Behaviors Among ...... Skin Cancer,Sunburn&Sun-ProtectiveBehaviors radiation: UV from protection for options easy recommends CDC The

(3.8%) and wearing a long Avoid indoor tanning. protection. wit sunscreen Use possible. as rays Wear sunglasses wrap around that and block as closeof to 100% both UVAand UVB Wear with ahat awide brim to shade face, the head, ears, and neck. Wearclothingprotect to exposed skin. esp shade, Seek time.” the of most or “always use behaviors, use remainedlow, only with 37.1% of women and 15.6%ofreporting men Even though sun blacks (10.9%). 2010,In sunburn prevalence was highest among whites (65.6%) and among lowest (15.6%). sunscreen behavior reported in 2010,(32.9%), followed by staying in theshade (25.6%)using and Amongmen, wearing long clothing to theankles was themost common protective most common protective behaviors reported in 2010. Among women, using sunscreen(37.1%) and staying in theshade (34.9%)were the months. 18 aged whites 2010,In prevalence ofsunburn was high 5 at days, as well as bright and sunny days. summer or beach. the UV at raysfrom sun the canreach youon cloudy hazy and Protection from ultraviolet (UV) radiation is important all year round, not just during the o

29 Years

less likely to report sunscreen use. White women were less likely to report shade use,while black women were

- —

29 years,of 65.6% which reported leastat one sunburn in the past 12 ecially during midday hours. screen was reported as one of the most common protective protective common most the asone of reported was screen United States, 2000 States, United h sun protective factor(SPF) or 15higher, and both UVA UVB and

- sleeved shirt (5.3%) were the least common. least (5.3%) the sleeved shirt were - 2010”, vol. 61, 18,no. May 2012, 11,

0.1%,with even higher prevalence for

Wearing awide

n, Updated 2/15/2013,

brimmed hat brimmed hat

disaster preparedness supplies. communication plan (25%),disaster and a plan (8%).95% of households multiple had the household(1 gallonof per water personday per each person who takes prescribed medicines(51%), 3 ...... Emergency Preparedness evacuation. announced amandatory they would evacuate if authorities reported of adults 65% emergency. handle a large was somewhat or prepared well to residents indicated their household County Seneca 2013, of 67% In Key Findings Adult radios (2%), 2- radios (31%), internet (20%), (17%), email regular home phones(16%), Tracfone (6%), two operated radio and working batteries (56%), 3 problems (2%), and other reasons (6%). about traffic jams and inability to get out(12%), of lack transportation (4%), health (26%), concern about personal safety(21%), lack of trust in public offic property(41%), behind concern about familysafety(28%), concern about leaving pets know. did not they 28% reported evacuation. mandatory not have any reliable sources of communication. did 1% and communication, of source one than more had 79% (2%). sources other and communication:(94%), cell phone internet (62%), landline phone (58%),Tracfone with relativ information from authorities in a large 3- phone(89%), working flashlight and working batteries(87%), cell phone with texting (74%), reported their householdwa 25% or emergency. disaster scale preparedwell to handle a large household wouldsomewhat be or residents thought that their methods (3%). (57%), internet (37%), neighbors(22%), social media(17%), newspaper(17%), other and prepared all. at reported they didreported not know what would be their main method of communicating.

day supply of nonperishable food for everyonein thehous Reasons for not evacuating if asked to do so included: concern about leaving 65%of adults reported they would evacuate if publicauthorities announced a S Seneca County residents reported thefollowing method or way of communicating Seneca County adults indicated the following as their main method or way of getting Seneca County households had thefollowing disaster preparedness supplies: cell County Seneca of 67% eneca County adults indicated they had thefollowing reliable sourcesof es and family in a large

1- І EMERGENCYPREPAREDNESS

- scale disaster or 1 (<1%), senior emergency alert (<1%), and other methods (1%). 5% 5% (1%). methods (<1%), other and alert emergency (<1%), senior 1 s not not s

- - scale disaster or emergency: cell phones (93%), text (93%), phones text cell or emergency: disaster scale - scale disaster or emergency: television (74%), radio television or emergency: disaster scale

2012, 2012, (Source: CDC, Seasonal Influenza (Flu), updated November 8, ...... following recommended items: Abasic emergency supply could kit include the

Manual can opener for food ties for personal sanitation Moist towelettes, garbage bags and plast to help filter mask contaminatedDust air Whistle to signal for help kit aid First Flashlight and extra batteries batteries A workingbattery opera food At least a three day three least One at for gallon day of per person per water http://www.cdc.gov/flu/protect/habits/index.htm) - day supplyday of prescription medication for

Basic Disaster Supplies Kit Supplies Disaster Basic

) (39%), generator (27%), (39%), (27%), ) generator

- day supplyof for water everyone in

s, for drinking and sanitation - day ehold (62%), working battery supply of non of supply

ted radio and working working radio and ted

ials (18%),ials concern

- perishable

- (9%), (9%), way way

ic ic

- http://www.ready.gov/sites/default/files/documents/files/checklist_1.pdf) (Source: Federal Emergency Management Agency (FEMA, Emergency Supply List, Obtained from: ...... Additional ItemstoConsiderAddingEmergencyKit

Cell phone chargers, with inverter orsolar charger. Mess kits, paper cups, plates and plastic utensils,paper towels. Sleeping bag or warm blanket for eac Additional clothing including a long sleeved shirt,pants and sturdy shoes. bank account recordsa waterproof, in portable container. Important family documents such as copiesof insurance policies, identification and Prescription medications and glasses.

h person.

Adult І SEXUAL BEHAVIOR AND PREGNANCY OUTCOMES

Key Findings 2011 STD Trends in the United States

The CDC estimates that 19 million new STD In 2013, nearly three-fourths (72%) of infections occur every year in the United Seneca County adults had sexual States, nearly half among young people ages intercourse. Five percent of adults had 15-24. STDs are a potential threat to an more than one partner. Even though individual’s immediate and long-term health young people aged 15-24 represent and well-being. STDs cost the nation about only 25% of the sexually experienced $17 billion in health care costs every year. population, they acquire nearly half of Below are the reported STD cases and rates in all STDs (Source: CDC, STDs in Adolescents and 2011. Young Adults, 2011 STD Surveillance).  Chlamydia cases: 1,412,791

Adult Sexual Behavior  Chlamydia rates per 100,000 people: 457.6; increase in 8% since 2010 . Nearly three-fourths (72%) of  Gonorrhea cases: 321,849 Seneca County adults had sexual intercourse in the past year.  Gonorrhea rate per 100,000 people: 104.2; increase in 4% since 2010 . 5% of adults reported they had  Syphilis (primary and secondary) intercourse with more than one cases: 13,970 partner in the past year, increasing to 18% of those under the age of 30.  Syphilis rate per 100,000 people: 4.5; unchanged from 2010 . Seneca County adults used the  Syphilis (congenital) cases: 360 following methods of birth control: vasectomy (21%), they or their partner  Syphilis rate per 100,000 live births: 8.5; are too old (20%), hysterectomy (16%), decrease in 7% since 2010

tubes tied (14%), birth control pill (12%), (Source: CDC, Sexually Transmitted Diseases, Sexually condoms (12%), withdrawal (6%), IUD Transmitted Diseases Surveillance, 2011, (4%), abstinence (3%), rhythm method http://www.cdc.gov/std/stats/) (2%), shots (2%), and contraceptive patch (<1%).

. 8% of Seneca County adults were not using any method of birth control.

. Seneca County adults did not use birth control for the following reasons:  They or their partner had a hysterectomy/vasectomy/tubes tied (34%)  They or their partner were too old (19%)  They wanted to get pregnant (6%)

 They did not think they or their partner could get pregnant (5%)  They did not care if they or their partner got pregnant (4%)

 They or their partner did not like birth control/had a fear of side effects (3%)  They or their partner were currently pregnant (2%)  Religious preferences (2%)  They could not pay for birth control (1%)  They did not want to use birth control (1%)  Their partner did not want to use birth control (1%) 81  They or their partner were breastfeeding (1%)  They had a same-sex partner (1%)  No regular partner (1%)

. The following situations applied to Seneca County adults in the past year: were tested for an STD (5%), had anal sex without a condom (3%), had sex with someone they did not know (1%), thought they may have had an STD (<1%), and were treated for an STD (<1%).

. Seneca County adults had been diagnosed with the following STDs in the past 5 years: HPV (1%), genital herpes (1%), and gonorrhea (<1%).

8% of Seneca County adults were not using any method of birth control.

The following graph shows the sexual activity of Seneca County adults. Examples of how to interpret the information in the graph include: 67% of all Seneca County adults had one sexual partner in the last 12 months and 5% had more than one, and 66% of males had one partner in the past year.

Number of Sexual Partners in the Past Year 100% 23% 22% 24% 28% 28% 28% 28% 31% 80% 43% 4% 3% 60% 5% 6% 5% 18% 6% 6% 60% 12% 40% 0% 73% 66% 67% 66% 67% 74% 59% 63%

45% 20% 40%

0% Total Male Female Under 30 30-64 65 & Over Income Income Seneca Seneca Years <$25K $25K Plus 2005 2009

One More than one None

Respondents were asked: “During the past 12 months, with how many different people have you had sexual intercourse?”

Seneca Seneca Seneca Ohio U.S. 2005/2009/2013 Adult County County County 2011 2011 Comparisons 2005 2009 2013 Had more than one sexual 6% 6% 5% N/A N/A partner in past year

N/A – Not available

The following graphs show Seneca County chlamydia disease rates per 100,000 population and annualitzed count updated April 18, 2012 by the Ohio Department of Health. The graphs show:

. Seneca County chlamydia rates increased overall from 2007 to 2011.

. Seneca County rates remained below the Ohio rates.

. In 2011, the U.S. rate for new chlamydia cases was 457.6 per 100,000 population. (Source: CDC, STD Trends in the U.S., 2013)

Chlamydia Annualized Disease Rates for Seneca County and Ohio 500 456.5 400 443.7 420.2 399.6 406.8 300

200 227.3 203.0 204.4

100 142.9 97.4 Rate per Population 100,000 0 2007 2008 2009 2010 2011

Seneca Ohio

Annualized Count of Chlamydia Cases for Seneca County 150

125 129 100 114 116 75 81 50 55

Number of Number reported cases 0 2007 2008 2009 2010 2011

(Source for graphs: ODH, STD Surveillance, data reported through 4-18-12)

The following graphs show Seneca County gonorrhea disease rates per 100,000 population updated April 18, 2012 by the Ohio Department of Health. The graphs show:

. The Seneca County gonorrhea rate drastically increased to 52.9 in 2010, and then decreased in 2011.

. The Ohio gonorrhea rate fluctuated from 2007 to 2011.

. In 2011, the U.S. rate for new gonorrhea cases for the total population was 104.2 per 100,000 population (Source: CDC, STD Trends in the U.S., 2013)

. The Healthy People 2020 Objective for gonorrhea is 257 new female and 198 new male cases per 100,000 population.

Gonorrhea Annualized Disease Rates for Seneca County and Ohio 250

200 174.5 143.7 139.3 143.2 145.1 150

100 52.9 50 19.4 19.6 19.4 Rate Rate per population 100,000 10.6

0 2007 2008 2009 2010 2011

Seneca Ohio

Annualized Count of Gonorrhea Cases for Seneca County 40

35 30 30

15 11 11 11 10 6 5

Number of Number reported cases 0

2007 2008 2009 2010 2011

(Source for graphs: ODH, STD Surveillance, data reported through 4-18-12)

Pregnancy Outcomes *Please note that the pregnancy outcomes data includes all births to adults and adolescents.

The following graphs show Seneca County and Ohio fertility rates per 1,000 population and total number of live births updated April 12, 2012 by the Ohio Department of Health. The graphs show:

. From 2006-2010, there was an average of 681 live births per year in Seneca County.

. In 2010, the U.S. fertility rate was 64.1 per 1,000 women ages 15-44 (Source: National Vital Statistics Report 2012).

Seneca County and Ohio Fertility Rates

100

80 67 65 65 65 65 65 64 64 62 57 60

20 Rate per Population 1,000

0 2006 2007 2008 2009 2010

Seneca Ohio

Seneca County Total Live Births

716 712 731 800 660

700 585

600 500

400

300

Number of Live Births Live of Number 200

100 2006 2007 2008 2009 2010

(Source for graphs: ODH Information Warehouse Updated 4-12-12)

The following graphs show Seneca County total number of live births by race/ethnicity and Seneca County and Ohio percentage of unwed births updated January 13, 2012 by the Ohio Department of Health. The graphs show:

. The percentage of births to unwed mothers in Seneca was equal to the Ohio percentage in 2006, but above the Ohio percentage from 2007 to 2010.

. In 2010, 41% of U.S. births were to unwed mothers. (Source: National Vital Statistics Report 2012)

Seneca County Total Live Births By Race/Ethnicity 2008

800 703

600

400

200

Births Live of Number 48 21 1 6 0 White African Native Asian/Pacific Hispanic American American Islander

Seneca County and Ohio Unwed Births

60% 50%

45% 46% 46% 42% 43% 44% 44% 40% 40% 40%

20%

Percent of Births Live

0% 2006 2007 2008 2009 2010

Seneca Ohio

(Source for graphs: ODH Information Warehouse Updated 1-13-12)

The following graphs show Seneca County and Ohio percentage of births with first trimester prenatal care and low birth weight rates updated January 13, 2012 by the Ohio Department of Health. The graphs show:

. In 2010, 82% of Seneca County mothers received prenatal care during the first trimester. (ODH, Birth Statistics, 2010)

. In 2010, 8.2% of all U.S. live births were low birth weight births. (Source: National Vital Statistics Report 2012)

Seneca County and Ohio Births with First Trimester Prenatal Care

100% 80% 79% 79% 80% 82% 73% 71% 70% 70% 73% 80%

60%

40%

20% Percent of Births Live 0% 2006 2007 2008 2009 2010

Seneca Ohio

Seneca County and Ohio Low Birth Weight Births*

14%

12% 10% 8.8% 8.7% 8.6% 8.5% 8.6% 7.7% 8.1% 7.4% 7.3% 7.0% 8%

6% 4%

Percent of Births Live 2%

0% 2006 2007 2008 2009 2010 Seneca Ohio

*Low Birth Weight is defined as weighing less than 2,500 grams or 5 pounds, 8 ounces. (Source for graphs: ODH Information Warehouse Updated 1-13-12)

arthritis or joint symptoms diagnosed arthritis who experience a limitation in activity due to AOCBC . . . . . Problems Impairments andHealth problem. physical, mental a way of some because in were limited adults County Seneca 29% of 2013, In Key Findings Adult

problems(2%), and a developmental disability (2%). $25,000. 3.1 days in the past month, increasing to 5.7 days for those wit Pain made hard it for Seneca County adults to dotheir usual activities an average of communication aids or(<1%). devices spe (1%), equipment (2%), help with personal care needs(2%), oxygen or respiratorysupport hearing aids or devices(4%), special telephone(3%), (3%), a cane durable medical vis Seneca County adults needed thefollowing services in thepast year: eyeglassesor (8%),(6%), dependency tobacco alearning disability(6%), (4%), cancer stroke bone/joint injuries(10%), eye/vision problems(10%), diabet walking problems(22%), heart problems (15%), hearing problems(12%), fractures, depression, anxiety,or emotional problems(25%), lung/breathing problems(23%), impairments were reported:or back neck problem Among those who were limited in some way, thefollowing most limiting problems or physical problems(27%), emotional problems(6%), and mental problems(5%). limited in the following ways: were adults County Seneca older. and 65 ages those 43% of to increasing BRFSS), U.S., 2011 and emotional problem (24% Ohio becauseof a physical, or mental adults were limited in some way County Seneca 2013, of 29% In ion(26%), care routine help with needs(9%), medical supplies(5%), walker(4%), - 2: Reduce the proportion of adults with doctor with adults of proportion the Reduce 2:

cial bed (1%),cial bed mobility aids or devices(1%), (<1%), wheelchair and І QUALITY OFLIFE or emotional emotional or

Objective

Healthy People2020

Arthritis

kpain.htm) http://www.ninds.nih.gov/disorders/backpain/detail_bac Diseases, Skin and Musculoskeletal and Arthritis Institute National (Source: pain are: The best things youdo can to prevent back

   

and keep your straight. back lift something heavy, your bend legs heavy lifting when you can. you If do Trystand toup straight and avoid is very important to keep bones strong. calcium and vitamin D everyThis day. sureyou getting are Make weight if you weigh toomuch. Maintain a healthy weight or lose strong. muscles Exercise often and keep your back

s (46%), arthritis (31%), stress, (46%), arthritis s

Back Pain Prevention Pain Back -

es(9%), high blood pressure s of Health, National Institute of of Institute National of Health, s

h incomes less than Seneca Seneca County 2013 31%

enough

Healthy Healthy

People People Target 2020 2020

36% - related related

8 8

8 9

older. and 65 those of 43% and females, of 32% way, in some arelimited adults County Seneca of include:29% graph on the information shown most the and way some in limited were that adults County Seneca of percentage the show graphs following The 10% 20% 30% 40% 50% 60% Limited in some way becauseof a 0% 10% 20% 30% 40% 50% physical, mental,or emotional 0% 2005/2009/2013 Adult Adult 2005/2009/2013 Total Back, Neck Back, Problems

29% Comparisons problem 46%

Male 26%

Seneca County Adults Limited Way Some in AdultsLimited CountySeneca Seneca County Most Limiting Health Problems Limiting Most CountySeneca

limiting health problems. Examples of how to interpret the interpret to how of Examples problems. health limiting Female 32% Arthritis

31% Under 30 Under

18% Seneca County

2005 15% Stress, Depression, Stress, Anxiety, Emotional Anxiety, Years 30-64 26%

Problems

25% Seneca Seneca County County Over 65 & 43% 2009 22%

Income <$25K 44% Lung, Breathing Seneca Seneca County County Problems

2013 29% 23% Income $25K Plus

26%

Seneca Ohio Ohio 2011 24% 2005 15% Walking Problems Walking

Seneca 22% 2009 22% 2011 24% U.S. U.S.

. Safety . . . . . Social Context home. or aroundtheir in firearm a kept adults of year. 51% past the in were abused adults County Seneca 9% of 2013, In Key Findings Adult

74% of Seneca Countyadults reported always wearing theirseatbelt 4% of adults reported they were unlocked and loaded. and unlocked were they reported 4% adults of half over Just and suicide completion(<1%). ab (3%),marital problems (3%), major health problems due to injury(3%), substance/drug medical(4%), care access tohealth mental treatment (4%), could not find/keep ajob fol served in themilitary.Those family with members themilitary in reported that the 48%of Seneca County adults reported someone that in their immediate family had $25,000. than food, clothing, shelter orpaying utility bills, increasing to 31% of those incomes with less 13%of Seneca County adults needed help meeting their general needs, such as affordable transportation(5%), and other(12%). concerns affordable healthcare (35%), of lack affordable housing(11%), (8%), traffic of lack unemployment(75%), school funding(41%), alcohol and druguse Seneca County adults had thefollowing concerns for their community: (<1%). credit counseling(2%), clothing (1%), legal aid services(1%), and emergency shelter (2%), preparation free tax (2%), repair (3%), home (3%), transportation rent/mortgage healthcare (8%), prescription assistance (6%), utilities(5%), employment(4%), Seneca County adults sought assistance for thefollowing in thepast year: food(9%), (16%), another family(8%), member a child following: a spouse or (39%), partner another person outside thehome(34%), a parent 9% of SenecaCounty adults were abused in thepast year. They were abused by the lowing issues had their affected family as a result of military service: access to use (2%), housing issues (1%), access to substance abuse/drug use treatment (<1%), (<1%), treatment use abuse/drug substance to access (1%), issues housing (2%), use 9% of Seneca County adults were abused in the past year.

І SOCIALCONTEXTANDSAFETY (51%) of Seneca County adults kepta firearm in or around their home. while driving or riding car in a

(5%), and someone else (24%). else someone and (5%),

(40%), of lack

shaving, etc.)(3%). being under theinfluence of drugs(1%), and other activities (such as applying makeup, influence of alcohol (5%), checking facebooktheir on cell phone(3%), (1%), readi ng hands ...... (1%). afford seat for their child indicated they did not think their child needed (8%), it could and not not using orparents Those booster seat. or acar seat used seat child booster car a their (7%). other and homelessness(15%),(11%), speed (10%), usage seat belt bicycle safety(6%), (2%), falls (16%), sexting (17%), prevention suicide (20%), abuse drug (23%), care senior/elder (24%), preparedness(30%), teen pregnancy(30%), dr following: prescription misuse(40%), distracted driving(35%), bullying(35%), disaster not safe all. at safe. slig quite reported 15% was it reported safe. 61% extremely Approximately 5%reported having no smoke detectors in their Seneca County home. the past year, and 14% of adults had tested their s (90%), talking on hand additional 14% reported wearing their seatbelt most of thetime. reason. other some for them work,had 6% and

90%of parents with a child under the age of8 or less 4 than feet, 9 inches reported Adults indicated that Seneca County residents needmoreeducation about the One in five(20%) Seneca County adults considered their neighborhood to be 73%of Seneca County adults deliberately tested the smoke detectors in their home in Seneca County adults reported doing thefollowing driving: while wearing a s 74%of adults reported always wearing their seatbelt drivingwhile or riding in a car.An Of those firearms, with 100% had them for protection, 59% had them for hunting, 11% 13% of Sene of 13% - Prescription Assistance free cell phone(13%), using internet on their cell phone (6%),under being the Free tax Free tax

Emergency shelter Emergency Legal aid services aid Legal Credit counseling needs, such food, as clothing, shelter or paying utility bills. Rent/mortgage Transportation Employment Home repair

Seneca County Adults Who Had Sought Assistance in the Past Year Past the in Assistance Sought Had Who Adults County Seneca Healthcare Clothing Utilities

Food preparation

ca County adults needed help meeting their general

- held cell phone(52%), eating (44%), texting (16%), talking on

(Source: 2013 Seneca County Health Assessment)

Assistance Received Received <1% <1% 1% 2% 2% 2% 3% 3% 4% 5% 6% 8% 9%

iving under theinfluence(26%), violence

moke detector in thepast month. Where to Look to Where Did Did Not Know Know Not 4% 1% 2% 2% 7% 7% 5% 5% 5% 7% 7% 7% 4%

htly safe,and 2% reported

Did Not Need Need Not Did Assistance

96% 99% 97% 96% 91% 91% 95% 91% 91% 88% 87% 85% 87% eatbelt eatbelt

N/A home. their in firearm a kept 30 under those of 45% and males, of 58% home, their in firearm a kept adults County Seneca of all 51% include: graph first the on shown information the interpret to of how Examples home. the in firearm a had that adults County Seneca of percentage the shows graph following The http://www.cdc.gov/motorvehiclesafety/distracted_driving/index.html) (Source: Distracted CDC, Driving, updated September 20, 2012,    Firearms keptin or around their 25% 50% 75%

0% – once in thelast 30 days. - 18 ages of drivers U.S. 52% injuries included cell phone use themajor as distraction Among those killed or injured in these crashes, nearly 1,000 deaths and 24,000 in crashes that were reported to involve a distracted driver. day,Each 15 more than

Not available Not 2005/2009/2013 Adult Adult 2005/2009/2013 Total 51% Comparisons

home

Male 58%

Home the in Firearm a With AdultsCounty Seneca

Female 45%

people are killed and more 1,200 than peopleinjured are

29 reported texting or e texting 29 reported Under 30 Under 45% Distracted Driving Distracted Seneca County

2005 45% Years 30-64 55%

Seneca Seneca County County Over 2009 65 & 43% 47%

- mailing while driving at least Income <$25K

33% Seneca Seneca County County .

2013 51%

Income

$25K Plus 56%

Ohio Ohio 2011 N/A Seneca 2005 45%

Seneca 2009 43% 2011 N/A U.S. U.S.

. . . . Adult MentalHealth usual doing stopped activities. they that day so every nearly or sad hopeless when felt they weeks two of or more period a had adults 13% of suicide. attempting considered adults County Seneca 4% of 2013, In Key Findings Adult

the past year. past the activities, increasing to 25% of thoseunder theage of when they felt so sadhopeless or nearlyevery day that they stopped doing usual 10% 20% 30%

0% Two or more weeks in a row felt felt row a in weeks more or Two Considered attempting suicide In past the N/A <1%of adults reported attempting suicide in thepast year. 2% of SenecaCounty adults made a plan about how they would attempt suicide in 4% of SenecaCounty adults considered attempting suicide in thepast year. In the past year,13% ofSeneca County adults had a period of ormore two weeks more weeks when they felt sad, blue depressedor nearly every day. – 2005/2009/2013 Adult Adult 2005/2009/2013

Not Total 13% sad or hopeless or sad

Comparisons available

MENTAL HEALTHANDSUICIDE year, 13% of Seneca County adults had perioda of two or Male

Seneca County Adults Feeling Sad or Hopeless for for Hopeless Sad or AdultsFeeling CountySeneca Female

16%

Under 30 Under Two or More Weeks in a Row a in More Weeks or Two

25% Seneca County 2005

16% 5%

Years

30-64

11%

Seneca Seneca County County 65 & Over 65 2009 13% 4%

8% 30. 30.

<$25,000 Income Seneca Seneca County County 20% 2013 13% 4%

>$25,000 Income

9% Ohio Ohio 2011

N/A N/A

Seneca

2005

16%

2011 N/A N/A U.S. U.S. Seneca 2009

13%

. . . show: county. The graphs rates per 100,000 for of group the population number andage the deaths suicide by age County Seneca and Ohio the show graphs following The

Rate per 100,000 population 35- 34 and - From 2006 2008. from 2000to rate - age County male The Seneca - County age The Seneca Rate per 100,000 population 10 15 20 0 5 10 20 30 0 44 years old, combined. 2008, 50% of all Seneca County suicide deaths occurred to those ages 25- ages those to occurred deaths suicide County Seneca of all 50% 2008, Seneca County and Ohio AgeOhio and - County Seneca Seneca CountyAge - (Source 2000-2002 10.8 2000-2002 21.9

for graphs

10.4 1.1 adjusted suicide mortality rate decreased rate mortality suicide adjusted

: ODH Information Warehouse, updated 4 updated Warehouse, Information : ODH Seneca Males adjusted suicide rate consistently exceeded the female female the exceeded consistently rate suicide adjusted

Adjusted Suicide Mortality Rates by Gender byRates Mortality Suicide Adjusted Seneca 2003-2005 2003-2005 18.4 9.6

Rates Mortality Suicide Adjusted Seneca Females 10.8 2.0 Ohio

- adjusted suicide mortality mortality suicide adjusted - 15 - 2006-2008 10) 13.2 2006-2008 from 2000 8.5

4.0 11.3

- 2008.

9 4

9 5

agitation, restlessness

...... psychiatric disorders, in particular: More 90 than percent of people who kill themselves are sufferingone fromor more Warning SignsforSuicide https://www.afsp.org/) (Source: American Foundation for . . . . Dangers Imminent the Recognize member. Fifty to 75%of all suicidesgive some warning of their intentions to a friend or family Prevention: TakeitSeriously

weight patterns dependence as: well as weeks, or a loss of interest or pleasure in activities that were previously enjoyed leastat for two day the of most mood depressed or “down” a are depression major of symptoms core The

Number of Deaths Has made plans or preparations for a potentially serious attempt Looking for ways to kill oneself(weapons, pills, or other means) Talking or writing about death, dying, or suicide Threatening to hurt or kill oneself 10 0 2 4 6 8 Intense anxiety, Change in appetite or Changes in sleeping Personality disorders Drug and abuse Bipolar depression depression Major 15-24

Group Age ByDeaths Suicide of Number County Seneca

25-34

Suicide Prevention, When You Fear Someone MayTake Their Life, 3

35-44 ......

4 Total Deaths = 14 = Deaths Total

Recurrent thoughts of suicide reproach self worthlessness, hopelessness, of Feelings poorer memory Decreased concentration, indecisivenessor energy of loss or Fatigue Eating disordersEating Post Schizophrenia Alcohol abuse and dependence : 2006- - Traumatic Stress Disorder (PTSD) Disorder Stress Traumatic 2008 45-54

or excessiveorinappropriate guilt 2

55-64

65+ 2

Adult and Youth І ORAL HEALTH

Key Findings Seneca County Dental Care Resources – 2011 The 2013 Health Assessment project has determined that nearly o Number of licensed dentists- 18 three-fifths (59%) of Seneca o Number of primary care dentists- 14 County adults had visited a dentist o Ratio of population per dentist- 3,120:1 or dental clinic in the past year. o Number of dentists who treat Medicaid The 2010 BRFSS reported that 70% patients- 7 of U.S. adults and 72% of Ohio o Ratio of Medicaid population per dentist who treats Medicaid patients- 1,726:1 adults had visited a dentist or dental clinic in the previous twelve (Source: ODH Ohio Oral Health Surveillance System, 2011) months. Almost three-fourths (74%) of Seneca youth in grades 6-12 had visited the dentist for a check-up, exam, teeth cleaning, or other dental work in the past year.

Access to Dental Care

. In the past year, 59% of Seneca County adults had visited a dentist or dental clinic, decreasing to 42% of adults with annual household incomes less than $25,000.

. The 2010 BRFSS reported that 70% of U.S. adults and 72% of Ohio adults had visited a dentist or dental clinic in the previous twelve months.

. When asked how long it had been since their last visit to a dentist or dental clinic, 12% of Seneca County adults reported that it had been more than one year but less than two years, 13% reported that it had been more than two years but less than five years, and 13% responded it had been five or more years ago.

. Nearly three-fourths (72%) of Seneca County adults with dental insurance had been to the dentist in the past year, compared to 62% of those without dental insurance.

. When asked the main reason for not visiting a dentist in the last year, 42% said cost, 28% had no reason to go, 10% said fear, apprehension, nervousness, pain, and dislike going, 8% did not have/know a dentist, 7% said their dentist did not accept their medical coverage, 3% had other priorities, 3% had not thought of it, 1% could not find a dentist who took Medicaid, and 1% could not get to the office/clinic.

. More than two-fifths (43%) of adults had one or more of their permanent teeth removed. The 2010 BRFSS reported that 44% of U.S. adults and 45% of Ohio adults had one or more permanent teeth removed.

. The 2013 Health Assessment reports that 13% of Seneca County adults ages 65 and over had all of their permanent teeth removed. The 2010 BRFSS reported that 17% of U.S. adults and 20% of Ohio adults ages 65 and over had all of their permanent teeth removed.

. In the past year, 74% of Seneca County youth had visited the dentist for a check-up, exam, teeth cleaning, or other dental work. 11% responded more than one year but less than 2 years, and 4% responded more than 2 years ago. 96

The following graphs provide information about the frequency of Seneca County adult and youth dental visits. Examples of how to interpret the information on the first graph include: 59% of all Seneca County adults had been to the dentist in the past year, 49% of those under the age of 30, and 42% of those with incomes less than $25,000.

Seneca County Adults Visiting a Dentist in the Past Year 100%

80% 67% 63% 63% 63% 62% 59% 59% 59% 60% 49% 42% 40%

20%

0% Total Males Females Under 30 30-64 65 & Income Income Seneca Seneca Years Over <$25K $25K 2005 2009 Plus

Seneca County Youth Visiting a Dentist in the Past Year 100%

79% 75% 74% 80% 74% 73% 71% 68% 65%

60%

40%

20%

0% Total Males Females 13 or 14-16 17 or older Seneca Seneca younger 2005 2009

Within Within Within 5 or More Adult Oral Health the Past the Past the Past Never years Year 2 Years 5 Years Time Since Last Visit to Dentist/Dental Clinic Males 59% 10% 13% 14% 2% Females 59% 14% 13% 13% <1% Total 59% 12% 13% 13% 1%

Seneca Seneca Seneca 2005/2009/2013 Adult Ohio U.S. County County County Comparisons 2011 2011 2005 2009 2013

Adults who have visited the 67% 62% 59% 72%* 70%* dentist in the past year Adults who had one or more of N/A N/A 43% 45%* 44%* their permanent teeth removed Adults ages 65 and over who had all of their permanent N/A N/A 13% 20%* 17%* teeth removed N/A – Not Available *2010 BRFSS Data

Key Findings Adult their child: . da 5.4 of average an together meal a ate Families every week. of together the day meal a ate . 3 and average school day:unsupe no . to. able not were but doctor, needs byspecific a type of child to be seen for health care County parents wanted their . Parenting child being bullied. they were concerned with their week. 30% of parents identified everyof the day together meal member in their household atea every family reported parents project identified that 28% of Assessment 2013Health The

o Parents believed there was a reason to be concerned about thefollowing issues with 28%of Seneca County parents reported that every family member in their household Parents reported their child spent the following unsupervised time after school on an One in s o o o o o o o o o o o o o o o o

- ys per week. per ys (3%). 4 hours Bullying (30%) N D D W Academic performance(17%) Having a poor(17%) diet Facebook or ot or Facebook Using tobacco (8%) tobacco Using Using alcohol(8%) Texting (7%)Texting Communication/speech (8%) T (7%) drugs Using Getting alcohol (4%) D Hearing (2%) Hearing een pregnan een getting enough exercise (19%) enough exercise getting ot eve epressio rinkin atching TV even (14%) Seneca (14%)even Seneca loping a weight problem(19%) g and driving (3%) driving g and І PARENTING n/anxiety/mental health (18%)

(17%)

cy (5%) cy her social network sites(9%)

rvised(52%), time less one than hour(36%), 1

ent/safesex.html) http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/adolesc G (Source: American Academy of Pediatrics (AAP), Safer Sex     uidelines,

different formsof sexuality, and date rape. peer pressure to have sex, birth control, discussion may include: STDs and prevention, Topics are appropriate that for asafe sex questions honestly. Listen to your adolescent and answer his/her adult before approaching your adolescent. Practice talking about safe sex another with Talk calmly and honestly about safe sex.

How to Talk to your Teen about Safe Sex Safe about Teen your to Talk to How

- 2 hours (8%), 2 hours

31, 2011) October http://www.cdc.gov/healthyweight/children/index.html, (Source: CDC, Healthy Weight, “Tips for Parents ...... Tips forParents–IdeastoHelpChildrenMaintainaHealthyWeight

  (Source: U.S. Department of Education, Facebook, MySpace) 

should be placed not on a diet without consulting a doctor. teens while still accounting for normal and growth development.Children and teens The goal is to reduce therate of gain weight in overweight and obese children and o orvideo games Encourage fun activities to reduce theamount ofsedentary time watching TV, playing playing tag, jumping rope, playing soccer,swimming and dancing. habit. Some examples ofmoderate intensity physical activity include brisk walking, Adding physical activity into thefamily’s routine lead will for it to become healthy a home. Limit or reduce theconsumption of calorie Find ways to make yourfamily’s favorite dishes in a healthier way. non or Encourage healthy eating habits by providing fruits,vegetables, whole grains, low ages, and 18% had posted pictures of themselves. addresses, or thenamesof their schools. 45%posted had their date of birth or with social profiles, 34% posted their real names, telephone numbers, home 55%of teens have profiles on a social networking are under 13.” under are the Terms ofUse, under which section 4 states “You not use will Facebook you if youwhen click “sign up”you are agreeing you that it will come up and say “Sorry,you are ineligible to sign upFacebook.” for Also Facebook also will asks for your date of birth, if you are not over theage of 13 beli we may be deleted and your Membership may be terminated without warning, if Yourprofile older… or age of years you 13 … that are warrant and represent Use, under which thefirst section states “By using theMySpace Services,you MySpace.”Also, you when “signup click free” you are agr information you have submitted to us, you are ineligible to register on not over theage of will it come 13 up and say “We’re sorry. Basedon the When signing up forace,you MySp your are for asked of date birth,youare if - fat dairy products, and lean meats and proteins for your family.

eve that you are under 13 years of youyears age…” under 13eve that are

n thecomputer. MySpace and Facebook –

Ideas to Help Children Maintain a Healthy Weight”, - rich, sugary and/or saturated fat in your in fat saturated and/or sugary rich,

website. Of 10 website.

have read and agreeto

eeing to the Terms of Terms the to eeing

- 17 years old 17 years old

- fat fat

100

101

and 4% for the U.S.) obese. and they grow. children In and teens, is used BMI to assess underweight, normal, overweight, which is gender and age specific as children’s body fatness changesover theyears as 13% for Ohio and 12% for the U.S.) the 12% for and Ohio for 13% . . . . . Youth WeightStatus have enough food. reportedwent they to bed hungryon least at one dayweek per because they not did youth of week. 15% days per more on3or 60minutes for were exercising youth of 65% weight, 34% of SenecaCounty youth or very reported overweight. were that they slightly according to BodyMass Index (BMI)When age.asked by howwould theydescribe their were obese, youth County 17% Seneca of that identified Assessment The 2013 Health Key Findings Y gaining weight in the past 30 days: County(compared femaleyouth to 35%of males). U.S.). the for 29% and Ohio for 30% reported YRBS underweight. 8% were and weight, 62% were U.S.). the 15% for and Ohio 15% for (2011 reported YRBS overweight as classified were youth of U.S.). 14% for the 13% for and Ohio 15% reported YRBS (2011

outh o o o o o o Seneca County youth reported doing the following to lose or weight keep from Almost(48%) half of all youth were trying to lose weight, increasing to 62% of Seneca 34%ofyouth described themselves as being either slightly or veryoverweight (2011 2013,In 17% ofyouth were classified as obese by Body MassIndex (BMI) calculations for BMI

48% of48% all youth were trying to lose weight, increasing to 61% of 2% vomited or took laxatives to lose weight (2011 YRBS reported 6% for Ohio for 6% reported YRBS (2011 weight lose to laxatives took or vomited 2% (2 2% reported taking diet pills, powders,or liquids without a doctor’s advice 3% reported smoking to lose weight YRB (2011 more for or 24hours eating without going 8% reported i lower foods or calories, fewer food, less ate youth of 28% 45% of youth exercised 011 YRBS reported 6% for Ohio and 5% for the U.S.) the for 5% and Ohio 6% for reported YRBS 011 Seneca County female youth (compared to of 35% males). children is calculated differently from adults. TheCDC uses BMI

І WEIGHT STATUS

n fat n

S reported - for normal - age, age,

. . . . Physical Activity . . . . . Nutrition

Seneca County 6 County Seneca

organized activities, week. 1.4 of and the hours day average on an doing homework screen(TV, time video games, and computer/tablet), 2.1 hours participating in Seneca County youth an average spent of 3.3 hourson their cell phone, 3.1 hours of should participate in each of these t physical activity that children should engage in, appropriate to their age.Children activity, muscle strengthening, and bone strengthening are three distinct types of minutes of physical activity per The CDC recommends children that and adolescents participate in at least 60 U.S.). the 51% for and Ohio 55% for reported were physically active at least 60 minutes per day on less 5 than days(2011 YRBS 71% fo and Ohio for 75% reported YRBS (2011 7days, than less 79%of Seneca Countyyouth were physically active least at 60 minutes per day on U.S.). the for 14% and Ohio 16% for 60 least and 27% did so every day in thepast week. 16% of youth did not participate in at on 3 ormoredays in the past week. 43%on did so 5 or more days in the past week 65%of Seneca Countyyouth participated in at least 60 minutes of physical activity week. food least at one nightper week. 1% of youth went to bed hungryevery nightof the 15%ofyouth reported they to bed went hungry because they have did not enough (Percentages may be fast food (6%), school (6%), restaurant (3%), and convenience store (1%). Seneca County youth atemost of their food the at following places:(93%), home (9%),practice to mixalcohol(7%), with other and some reason (44%). (56%), to get pumped(24%),up to help them perform(11%), before ga 39%ofyouth reported drinking energy drinks for thefollowing reasons: to stay awake supplements(6%), and other calcium sources(46%). yog (31%), products dairy other Seneca County youth consumed thefollowing sourcesof calcium daily: (88%), milk day. per vegetables and fruits of 4servings 1to 84% ate day. per vegetables and of fruits servings 5or more ate youth County of Seneca 10%

Took diet pills, powders,or liquids without a doctor’s advice

minutes of physical activity on any day in the past week (2011 YRBSreports Ate Ate less food, fewer calories, or foods lower in fat in lower foods or calories, fewer food, less th Went without eating for 24 hours - greater than 100% due to the ability to check more than one.) than more check to ability the to due 100% than greater 12 Vomited or took laxatives took or Vomited th

Grade Youth did the following to lose weight to lose following the did Youth Grade in the past 30in the days: past Smoked cigarettes Exercised day. As day. part of their 60 minutes per day; aerobic urt (26%), urt calcium ypes of activity on at least three days week. per three least on at ypes activity of

fortified juice(14%), calcium

r the U.S.) and 57% U.S.) and r the

mes or or mes Percent 28% 45% 2% 2% 3% 8%

102

103

60, obtainedfrom: (Source: Dairy National 2010; Council, Newsweek Back goal. that meet of mere8% adolescents a 11 and ages6 to of children according to a study published in Medicine and Science Sportsin and Exercise Current guidelines call for kids to least get at 60 minutes of exerciseYet, a day. cope socially and peer deal with pressure. behavior, and regular physical activity has psychological benefits that can help kids Exercise breaks during theday havesh been English. vigorous physical activity did about 10% better in core classes like math, science and school students by researchers from Michigan State University, those who participated in Getting active canalso improve academic performance. Exercise leads to better cardiovascular fitness, reduced body fat and stronger bones. Learning ToGetFit;StrongerBodies,SharperMinds

gender. and age their for underweight be to calculated were 8% and overweight, were 14% obese, were 17% weight, normal as classified were youth County Seneca all of 62% include: graph first the in information the interpret to how (BMI). Index Mass Body by underweight or normal, overweight, obese, as The following graph shows the percentage of Seneca County youth who were classified classified were who youth County Seneca of percentage the shows graph following The 100% 20% 40% 60% 80% 0% In 2013,In 1

Total 17% 14% 62% 8% www.nationaldairycouncil.org/childnutrition

7 % of Obese Male Body Mass Index (BMI) calculations. 11% 11% 55% 24%

Classifications BMI Youth County Seneca Seneca

Female Overweight County youth were classified obese as by 70% 18% 8% 4%

13 or younger - To own to improve learning and classroom

- School Guidebook: In Association with Fuel up to Play 14% 16% 59% 12% )

Normal

14 to 16 to 14 In a studyof a middle 214 In 18% 12% 64% 6%

Underweight 17 & Older 17

13% 62%

21% 4%

Examples of of Examples

Seneca 2009 Seneca , only 42% 42% , only 14% 13% 70% - 3%

Seneca Seneca Seneca Seneca Ohio U.S. 2005/2009/2013 County County County County 2011 2011 Youth 2005 2009 2013 2013 (9th-12th) (9th-12th) Comparisons (6th-12th) (6th-12th) (6th-12th) (9th-12th)

Obese N/A 13% 17% 20% 15% 13%

Overweight N/A 14% 14% 14% 15% 15% Described themselves as 30% 29% 34% 35% 30% 29% slightly or very overweight Trying to lose 50% 50% 48% 44% N/A N/A weight Exercised to lose N/A 52% 42% 45% 61%* 61%* weight Ate less food, fewer calories, or N/A 27% 28% 33% 43%* 39%* foods lower in fat to lose weight

Went without eating for 24 hours 3% 3% 8% 9% 13% 12% or more Took diet pills, powders, or liquids 1% 2% 2% 4% 6% 5% without a doctor’s advice

Vomited or took 1% 1% 2% 2% 6% 4% laxatives Ate 1 to 4 servings of fruits and N/A N/A 84% 86% 85%* 78%* vegetables per day Physically active at least 60 minutes per day on less N/A 71% 79% 80% 75% 71% than 7 days in past week Physically active at least 60 minutes per day on less N/A 46% 57% 57% 55% 51% than 5 days in past week

Did not participate

in at least 60 minutes of physical N/A 8% 16% 16% 16% 14% activity on any day in past week

N/A – Not available * Comparative YRBSS data for Ohio is 2007 and U.S. is 2009 110400

1 05

...... Youth TobaccoUseBehaviors Key Findings Y (2%),e and cigars(6%), flavored (4%), cigarettes cigarillos(4%), (3%), hookah (2%), snus littlecigars cigarettes(14%), and Black Milds (11%), tobacco chewing orsnuff(8%), swishers(6%) , way. other some them got 18% and from them got afrommember, vending 4% machine, family a 2% took them fromstore, a station, 18% said a person 18 years orolder gavethem thecigarettes, took 18% them else to buy them cigarettes, 25% indicated they bought cigarettes from a store or gas days during thepast month and 6% for theU.S). 20or more on cigarettes smoked Ohio in 10% of youth that reported (2011 YRBS month 12- one Almost U.S). the for 18% and Ohio for 21% (2011 reported YRBS 30days past in the time U.S. the for 10% reported YRBS 2011 13 and age before time first for the cigarette the age of 13. The2011 YRBS reported 14% that of youth in Ohio had smoked a whole Seneca County youth had done thesame.) 27% of that indicated assessment 2013health the and youth U.S. of 45% reports YRBS were also current drinkers, defined as having had a drink of alcohol in thepast 30 days. old. years 13.3 was smoking for onset of age average The old. 12years by so done 23% had and month.past Of those 6th Seneca County youth in grades 6 6% of Overall, 17. of age overwhowere the those of 19% to increasing smokers, were The 2013 Health Assessment identified that 9% of Seneca County youth in grades 6

outh year olds and 10% of 14 of 10% and olds 13 year Seneca County youth used thefollowing forms oftobacco themost in the past year: c borrowed smokers youth of 43% More two than 2% of all Seneca County youth smoked cigarettes on 20 or more days during the past 15%of current smokerssmoked cigarettes daily. some at smoked having smokers, current were youth County Seneca 2013,ofIn 9% 7% of all Seneca County youth had smoked a whole cigarette for thefirst time before d cigarette whole a smoked have who those of 13% (2011 smoking cigarette tried had Ohio in youth 52% of that reports 2011YRBS The - In 2013, 9% of Seneca County youth were current smokers, having fifth (19%) of those ages 17 year and older were current smokers, compared to 4% of 4% of to compared smokers, current were older year and 17 ages of (19%) those fifth

- cigarette (1%).cigarette

І TOBACCO USE - thirds (69%)of theSenecaCounty youth identified as current smokers smoked some at time in the past 30 days.

- 12th grade youth who currently smoked, 70% had tried to quit. quit. to tried 70% had who smoked, youth currently grade 12th

- 16 year olds. - 12 indicated theyused had chewing tobacco in the

igarettes from someone else, 43% asked someone someone asked 43% from else, someone igarettes

id so at 10 years old or younger, younger, or old years 10 soid at

- 12

7% Seneca of all County youth had smoked whole a cigarette for the first

smokers. current were females of 9% and smoked, males of 10% smokers, current were youth County Seneca all of 9% include: information the interpret to how of Examples cigarettes. The f . .

10% 20% 30%

Misused prescription medication at 0% Current smokers are those youth surveyed who have self U.S). U.S). to quit smoking in thepast year(2011 YRBS reported 56%forOhio andfor 50% the Almost three older. and 17 ages those of 10% and of males 11% to U.S.) increasing the for 8% and Ohio for 12% reported YRBS In the past 30 days,of Seneca 6% County youth used chewing tobacco orsnuff (2011 ollowing graph shows the percentage of Seneca County youth who smoke smoke who youth County Seneca of percentage the shows graph ollowing

Total Have used marijuana past30 the in days Attempted suicide in the past 12 months

9% Had drank alcohol the in past 30 days

Were depressed in the past year past the in depressed Were Were bullied in thepast year Have had sexual intercourse - fourths (70%) of Seneca County 6 County Seneca of (70%) fourths Male 10% Youth Behaviors Youth Current Smokers vs. Non vs. Smokers Current

SenecaCounty Youth Who AreCurrent Smokers Behaviors of Behaviors time time before the age of 13. Female

some time in their life

12 to 13 Seneca County Youth County Seneca 4% days.

- - Current Smokers Current reported smoking at any time during the past 30 30 past the during time any at smoking reported 14 to 16

10% - 12 th

grade youth smokers had tried tried had youth smokers grade 17 & Older

19%

Smoker Current Current

28% 41% 49% 59% 62% 67% 74% Seneca

2005 17%

Smoker Current Non Seneca 20% 12% 45% 19% 6% 4% 3% 2009 11%

1 06

1 07

Ever tried cigarettes tried Ever Youth Comparisons Youth first time before the before the time first days days more on 20or tobacco or snuff in in snuff or tobacco Smoked cigarettes Smoked cigarettes Smoked a whole whole a Smoked cigarette for the for the cigarette Current smokers Current 2005/2009/2013 during thepast Used chewing (of all youth) (of all youth) Tried to quit past month    (Source: http://www.cdc.gov/healthyyouth/tobacco/facts.htm, retrieved 11  age of 13 of age smoking

month special appeal to these young people. and Children and teenagers constitute the majority new of all smokers, products. their promote Cigarette companies spent more than $15.2 billion 2003 in to before the survey. cigarettes by buying them astore in or gasstation during the 30 days own their obtained usually they reported cigarettes smoke currently under the age of 18, yet 14% of students under the age of 18 who All states have laws making illegalit to sell cigarettes to anyone advertised brands. (aged 12 smokers young of 83%

the industry’s advertising and promotion campaigns often have often campaigns promotion and advertising industry’s the

Tobacco SalesandPromotingtoYouth (6 Seneca Seneca County 2005 th 64% 17% 43% 16% 7% 4% - 12

)

(6 Seneca Seneca County

2009 th 53% 11% 32% 6% 1% 8% - 12

th )

- 17) choose the three most heavily heavily most three the 17) choose (6

Seneca Seneca County 2013 th 70% 27% 6% 2% 7% 9% - 12

)

(9 Seneca County th 2013 10% 15% 54% 38% 4% 8% – 12

th )

- 3 (9 -

11) Ohio 2011 th 10% 14% 12% 21% 56% 52% -

)

(9 th 2011 10% 18% 50% 45% U.S. 6% 8% – 12

th )

...... Youth AlcoholConsumption they had been drinking alcohol. of binge drinking. 8% of all high school youth had driven a car in the past aftermonth 6th over theage of least 17 one had at drink in thepast 30 days.More half than (57%) of the 6th County Seneca all of 20% younger. or old years 6th those of older. 40% and seventeen grades 6 In 2013, theHealth Assessment results indicated that 50% of Seneca County youth in Key Findings Y

In Seneca County, 20% of youth had least at one drink in the past 30 outh - (16%). convenience store/gas station (1%), took from it store(1%), a other and some way them (8%), bought at it a restaurant/bar/club(2%), bought in a liquor it store/ forit them (20%), took from it a family for theU.S.),older an friend or sibling bought for it them (28%), someoneolder bought 40% reports YRBS (2011 (28%), them to it gave (33%), someone them to it gave parent Seneca County youth drinkers reported th U.S.). for the 21% of 13and age the before time first the for alcohol drank youth Ohio of 18% reports YRBS (2011 13. of Of all Seneca County youth, 17% had drank alcohol for thefirst time before theage Two least 10 or more days themonth. during 1% of SenecaCounty youth who reported drinking in thepast 30 days on drank at U.S.). the for 22% and Ohio 24% for reports YRBS (2011 older 17and ages those Based on all youth surveyed,11% were definedbinge as drinke older. ages17 and those month and would be considered binge drinkers by definition, increasing to 76%of Of those who drank,had 57%five or more alcoholic drinks on an occasion thelast in U.S.). for the 39% and for Ohio 38% (2011 reports YRBS older 17and ages of those One U.S.). the for 71% and Ohio for 71% reports (2011 YRBS older 17and ages of those 75% youth(ages 12 to 18) had have least at one drink of alcohol in their life, increasing to 2013,In theHealth Assessment results indicate that(50%) half of all SenecaCounty old. years 12.9 was onset of age The average 18. 15 and the agesof between drank 34% 14, and 13 and ofages life had their first drink at 12 years oldoryounger; 26% took their first drink between the 12th grade youthwho reported drinking in the past 30 days one episode least had at - - fifths (40%) of Seneca Cou of Seneca (40%) fifths - fifth (20%) of youth had least at one drink in the past 30 days, increasing to 45% 12 had drank least at one of drink alcohol theirin life, increasing to 75%of youth

І ALCOHOL CONSUMPTION

nty youth who reported drinking some at time - 12th graders who drank, took their first their took who graders drank, 12th member (10%), member friend’s a parent gave it to days.

ey got their alcohol from the following: a

- 12th grade youth and 45% of those those of 45% and youth grade 12th rs, increasing to 34% of 34% to rs, increasing drink at 12 at drink in their

108

10 9

. . . and 54%females. of life: their in time some at drank have youth County Seneca all of 50% include: information the interpret to ofhow Examples drinkers. current are who those and lifetime their in drank have who youth County Seneca of percentage the show graphs following The alcohol least at once during thepast month. U.S.). the 8% for and Ohio 7% for reports (2011 YRBS older drinking 17and those alcohol12% of to , increasing U.S.). for the 24% reports someone who had drinking been alcohol (2011 YRBS reports 21%forOhio and 2011 YRBS

100% 20% 40% 60% 20% 40% 60% 80% 0% <1%ofSeneca County youth reported being on school propertyunder theinfluence of 8% of all high school youth had driven a car in the past month after they had been During thepast month, 21% of all Senec 0%

Of Seneca all County youth, had17% drank alcohol for first the time

Total Total 20% 50% Seneca County Youth Having At Least One Drink In Their Lifetime TheirLifetime In Drink One Least At HavingYouth County Seneca

Male

Male 18% 46% Drinkers Current Youth County Seneca

Female Female 22% 54% before the age of 13.

12 to 13 to 12 12 to 13 to 12 7% 29% a County youth had ridden in a car driven by

14 to 16 to 14 14 to 16 to 14 22% 59%

17 & Older 17 17 & Older 17

45% 75%

Seneca 2005 Seneca 2005 35% 65%

46% of males males of 46% Seneca 2009 Seneca 2009 29% 60%

100% 20% 40% 60% 80% Current drinkers are those youth surveyed who current drinkers. drink current between behaviors risk specific in differences shows table 53% femalesdrank. of month, had binge binge62% males, of and The drank past in the drinkers current of 57% include: information the interpret to how of Examples drinkers. who youth County Seneca of percentage the shows graph following The 0%

33% of Seneca County youth drinkers reported they got their alcohol Based on all on all Based Misused prescription medication at some time in their life *Based on all current drinkers. Binge drinking is defined as having five or more drinks on an occasion Total 57%

Seneca County Youth Current Drinkers Binge Drinking Past in Drinking Binge Current Drinkers Youth CountySeneca Have used marijuana past30 the in days Attempted suicide in the past 12 months Have smoked past the in 30 days

Were depressed in the past year past the in depressed Were Male Were bullied in thepast year Have had sexual intercourse 62% Seneca County youth surveyed, were 11% defined as Current Drinkers vs. Non vs. Drinkers Current

Youth Behaviors Youth from from Behaviors Senecaof County Youth Female 53% a parenta giving

binge drinkers. have self have 12 to 13 to 12 18%

Month*

reported drinking at any time during the past 30 days

14 to 16 to 14 -

Current Drinkers Current

53% it to it

them 17 & Older 17 76%

Current Current Drinker Seneca 25% 32% 33% 43% 52% 62% 2005 6% 69% ers and non and ers were binge binge were

Seneca Current Drinker 2009 Non 18% 51% 16% 64% 4% 2% 4% 2% -

1 10

1 11

N/A N/A Obtained the alcohol Drank for thefirst time someone giving to it Rode with someone someone with Rode Youth Comparisons Youth Ever tried alcohol tried Ever who who Drank and drove and Drank 2005/2009/2013 2005/2009/2013 – Current drinker before 13 age they drank by

Binge drinker (of all youth) Not available Not

was drinking

them http://www.udetc.org/factsheets/OH.pdf) 2011, September ofJuvenile Justice and Delinquency Prevention, Underage Drinking (Source: Pacific Institute for Research and Evaluation (PIRE)with funding from the Office o o o o o

associated with driving after underage drinking. 31traf 2009, about In in risky sex can be attributed to underage drinking in 2009. Approximately 1,253 teen pregnancies and 36,019 teens engaging abuse treatment admissions. an alcohol treatment program in Ohio, which was 11%of all alcohol 12- ages youth 4,178 were 2009, there In each youth in Ohio or $3.19 per drink consumedunderage. The figureof $2.9 billion translates to a cost of $2,596 per year for 2010. The price forunderage drinking on Ohio residents was $2.9 billion in

(6 Seneca Seneca County County 2005 th N/A 28% 30% 24% 35% 65% 6% - 12

th Underage DrinkingUnderage in Ohio )

fic fatalities and 1,872 nonfatal injuries were (6 Seneca Seneca County County 2009 th 18% 29% 60% 40% 19% 25% 4% - 12

)

(6 Seneca Seneca County County 2013 th 11% 20% 50% 28% 21% 17% 5% - 12

th e admitted to to admitted e wer 20 who )

(9 Seneca County County

2013 th 21% 32% 68% 30% 22% 14%

8% - 12

th in Ohio: The Facts, )

(9 Ohio Ohio th 2011 N/A 24% 38% 71% 21% 18% – 7%

)

(9 th 2011 22% 39% 71% 40% 24% 21% U.S. U.S. 8% – 12

)

. . . . Youth DrugUse 17. of age the over those of 19% some time in their life, increasing to more prescribed than to get high at took or them for prescribed not were that grade youthused medications 6th of 7% older. 17and ages 30 days, increasing to 29% of those marijuana least once at in past the used grade youthhad 12th 6th County Seneca 2013,of 9% In Key Findings DRUGUSE Y

outh             Seneca County youth have tried thefollowing in their life: time prescribed One in fourteen(7%) Seneca County youth usedmedications that were not 14.1 old. years was onset of age average The one Almost during thepast 30 days. marijuana one used had youth U.S. 23% for Ohio youth and a prevalence of for 24% of prevalence a found 2011 YRBS of 17.The age the over those of 29% to increasing least once in thepast 30 days, youth had used at marijuana County Seneca 2013,of all 9% In

GhB <1% <1%misused hand sanitizer salts bath used 1% 1% pharm party/skittles U.S.) 3% for and Ohio for 3% reports YRBS (2011 used heroin, 1% U.S.) the for 4% reports YRBS (2011 used methamphetamines, 1% 2% YRBS used(2011 reports 7% for a Ohio cocaine, U.S.) 4% for and Ohio 4% for reports (2011 YRBS steroids, used 2% U.S.) 8% for reports YRBS (2011 used ecstasy/MDMA, 2% over misused 3% us 5% 9%used K2/spice /posh/salvia/synthetic marijuana in their lives, increasing to 19% of those over theage of 17. ed inhalants, (2011 YRBS reports 11% for U.S.) for 11% reports YRBS (2011 inhalants, ed for them or took more prescribed than to feel good or get high some at - І quarter(22%) of youth who tried marijuana did so before of theage 12.

MARIJUANA ANDOTHER or more times times more or - the - - counter medications

12th 12th

andother influencer,www.drugfree.org, 2 Synthetic Drugs : Bath Salts, K2/Spice : Guide A for parents (Source:The Partnership At Drugfree.Org, Parents 360    

continue rising in 2012. to ontrack is 2011and 2010and between exposure to synthetic m Calls to poison control centers for conducted by the University of Michigan. the “Monitoring the Future” study, marijuana in theprior year according to high school seniors used synthetic parents, more one than American in 10 t “new” drugs these may be While uncontrolled/spastic body movements. pale skin, vomiting and increased agitation, profusesweating, marijuana are very troubling and include The physical signs of using synthetic marijuana. supposed to mimic theeffects of sprayed artificial with chemicals that are or other materials plant that have been synthetic marijuana. is It a mixture of herbs “K2” and “Spice”street arenames for

Synthetic Marijuana Synthetic

nd 7% for U.S.) 7% for nd

arijuana doubled

- 16- 12) o many many o

1 12

1 13

cocaine. cocaine them (4%). them family member(7%), gave a parent it to them (5%), and another family member gave to it them (68%), bought them from a friend or someone else(38%), took them from a friendor E in use the past marijuana use,youth drug lifetime Coun Seneca 2013 the from data are graphs following The U.S.). the 26% for and Ohio for 24% (2011 reports YRBS youth school high had offered,sold, or given them an illegal drug school on property, increasing to 7% of xamples of how to interpret the information include: include: the information interpret to how of xamples 10% 20% 30% 40% 10% 20% 30% 40% 0% 0% . .

Youth reported they usually g During thepast

2% in the in

Cocaine

Total (Percentages

1% 9% 3%

ir lifetime, 1% of male youth used cocaine and 3% of female youth used used youth female of 3% and cocaine used youth male of 1% lifetime, ir

Male

10% may be greater than 100% due to the ability to check more than one.) 1% 12 months,5%of all SenecaCounty youth reported that someone Month Past in Use Marijuana Youth CountySeneca Heroin Seneca County Youth Lifetime UseDrug Lifetime Youth CountySeneca

<1%

Total Female 1%

Medications 7% ot illegal drugs from thefollowing: a friend gave to it Male

7% younger 13 or 7%

2% 10%

Female

lifetime lifetime month and 1% 14 to 16 to 14 Meth 2 1%

6% % of all Seneca County youth County Seneca all of % 0% Seneca 2009

ty Health Assessment indicating indicating Assessment Health ty 2%

17 or older

29% 2% Steroids

2% medication misuse. misuse. medication 1%

Seneca 1%

2005 11%

5% Inhalants

3% Seneca 2009

used used 10%

10% 15% 20% 25% **2005 YRBS Data *2007YRBS Data N/A N/A sold, or given an illegal

0% 5% 2005/2009/2013 Youth Youth 2005/2009/2013 school property in the past marijuana in thepast drug by someone ondrug someone by methamphetamines Ever used used Ever Ever used cocaine Ever been offered, offered, been Ever Ever used steroids used Ever Ever used heroin used Ever Youth who used used who Youth - ecstasy/MDMA

Not available Not Comparisons Ever misused misused Ever medications Ever used used Ever used Ever past year Total month 7%

inhalants

Seneca County Youth Lifetime Prescription Medication Abuse Medication Prescription Lifetime Youth County Seneca

Male

(6 Seneca Seneca County County 2005 Female th N/A N/A 12% 11% 16% 2% 3% 1% 5% - 12 7%

)

(6 Seneca Seneca County County younger 2009 th 13 or N/A 10% 10% 2% 7% 1% 1% 3% 9% - 2% 12

th )

(6 14 to 16 to 14 Seneca Seneca County County 2013 th 6% 1% 5% 5% 2% 1% 2% 2% 7% 9% - 12

th )

17 or older (9 Seneca County County 19% th 2013 12% 14% 1% 7% 4% 4% 1% 1% 2% -

th )

Seneca (9 2005 12% 12%** th Ohio Ohio 2011 N/A N/A 24% 24% 6%* 4% 3% 7% -

)

Seneca 2009 (9 10%

th 2011 N/A 26% 11% 23% U.S. U.S. 4% 8% 4% 3% 7% -

th )

1 14

1 15

sexual behavior questions. were sexually 58% active, had multiple sexual partners. 2 school districts did not ask and 4% had participated anal in sex. 16% of youth participated sexting.in Of thosewho participated had youth of oral20% in over. sex 17and ages those 72% of to increasing Y ...... Youth SexualBehavior one 2013, In Key Findings . . . U.S.). the 15% for and Ohio for 18% reports (2011 YRBS more partners m 58% had and over. over over. sexual intercourse.) 17 ages those 72% of to (9%). else somewhere (4%), and (11%), church (14%), internet (23%), doctor friends high school(58%), (40%), home high school(35%), elementary or gradeschool (25%), and birth control, Seneca County youth reported thefollowing: middle school or junior U.S). the for 6% and Ohio age of years 15 by so done had 25%

outh outh Of thoseyouth who were sexually active in their lifetime, 42% had onesexual partner 16%ofyouth had viewed pornography, increasing to 24%of males. 16%ofyouth had participated in sexting, increasing to 38% of those17 ages and 4% of youth had participated in anal sex, increasing to 13% of those17 ages and 20%ofyouth had participated in oral sex, increasing to 59% of those17 ages and One Two school districts did not ask sexual behavior questions. When asked where they were taught about pregnancy prevention, STDs,AIDS/HIV, 6% for reports (2011 YRBS of 13 age the before active sexually were youth, 2% Of all Of thoseyouth who were sexually active, 7%done had so by theageAnother of 13. .

quarter(25%) of Seneca Countyyouth have had sexual intercourse, increasing - quarter (25%) of SenecaCounty youth have had sexual intercourse,

І ultiple partners. 13% of all SenecaCounty high school youth had 4 or 72% of72% Seneca SEXUAL BEHAVIORANDTEEN

PREGNANCY OUTCOMES

and over. (The 2011 YRBS reports 47% of U.S. youth have had had have youth U.S. of 47% reports 2011 YRBS (The over. and

have had sexual intercourse.

County youth ages 17 and over . The average age of onset was 14.9 years old. years 14.9 was onset of age . The average

. femal of 27% and males, of 24% intercourse, sexual had youth County Seneca of all 25% include: information the interpret to of how Examples sex. oral and intercourse sexual in participated who youth County Seneca of percentage the shows graph following The

100% 100%

25% 50% 75% 25% 50% 75% 0% 0% 14- intercourse without a reliable method of protection, increasing to 15%of those ages Depo used method, 7% withdrawal the used U.S), 11% the 18% for and Ohio for 23% reports (2011 YRBS pills control birth used 30% U.S); the 60% for (2011 reports YRBS pregnancy Almost two 10% of10% youth who were sexually es had sexual intercourse. intercourse. sexual had es U.S.). the 13% for and Ohio for 10% reports YRBS (2011 old 16 years

- Total and 5% used some other method. However, 10% were engaging in in engaging were 10% However, method. other some used 5% and Provera, Total 25% 20%

- thirds(61%) of youth who were sexually active used condoms to prevent

method of protection to prevent pregnancy. Male SenecaCounty Youth Who Had SexualIntercourse 24% Male SenecaCounty Youth ParticipatedWho Oralin Sex 21%

Female 27% Female

19% Younger

13 or 1% Younger

13 or

active were not using reliable a 1% 14 to 16 to 14

27%

14 to 16 to 14 17 & Older 17 21% 72%

17 & Older 17 Seneca 2005 59% 31%

Seneca 2009 Seneca Seneca 2009 25% 28%

1 16

1 17

in 2012. 2012. in County Seneca in hospitals and clinics doctors, from results tests positive with diagnosed been have that old) years 19 to (15 of teens percentage the show statistics following The females. of 4% and males, of 4% sex, anal in participated youth County Seneca all 4% of include: the information interpret to how of Examples sexting. sex and anal in participated who youth County Seneca of percentage the shows graph following The

25% 50% 25% 50% 0% 0% . .

Gonorrhea - Gonorrhea (36 Chlamydia -

County General Seneca (Source: HealthDistrict) Total

Total of 97 cases) total 16% 4%

28% of all reported cases were in this age group(5 of18 totalcases) 37% of all reported case reported all of 37% SenecaCounty Youth Who Participatedin Anal Sex SenecaCounty Youth Who Participatedin Sexting Male Male 14% 4%

Female Female 18% 4%

s were in this 15 to 19 year old age group group age old 19year 15 to this in s were 13 or Younger 13 or Younger

5% 1%

14 to 16 14 to 16 16% 2%

17 & Older 17 & Older 38% 13%

*2007YRBS data

Youth Comparisons Youth method to prevent prevent to method Used a condom at at condom a Used intercourse before before intercourse sexual partners(of pregnancy during Used birth control Had four or more more or four Had 2005/2009/2013 Ever had sexual sexual had Ever Did not use any last intercourse last (of all intercourse intercourse intercourse Had sexual last sexual sexual last pills at last all youth) age 13 age Rate per 1,000 Population youth)

10 20 30 40 0

(Source: Ohio Department of Health Information Warehouse Updated 4 16.9 2006

19.8 (6 Seneca Seneca County 2005 th 14% 21% 66% 31% 8% 6% - 12 Teen Birth RatesSenecaforCounty and Ohio*

th )

*Teen birth rates include women ages 15 (6 Seneca Seneca County 2007 19.7 18.2 2009 th 29% 70% 25% 1% 4% 8% - 12

th )

Seneca

Seneca Seneca County 2013 th 10% 30% 61% 25% 2% 6% - 12 19.7 2008 13.2

th )

(9 Ohio Seneca Seneca County th 2013 13% 12% 33% 65% 47% 1%

- 12

th 2009

) 19.9 18.7

- 17 (9

th Ohio Ohio 60%* 45%* 2011 18% 10% 23% 6%

- 12

)

- 12 (9 2010 - 16.8 12) 15.6 th 2011 15% 13% 60% 47% 18% U.S. U.S. 6%

th )

1 18

1 19

suicidal.ofyouth 54% reported they did not have thoughts ofdepression orsuicide. advisor(<1%), or other(4%). 14% ofyouth talked toone no feeling when depressedor (2%), pastor/priest/rel (3%), teacher girlfriend/boyfriend(12%), brother/sister(7%), professional counselor(4%), school counselor their concerns with the following: a best friend (24%), their parents(13%), depression. or stress, anxiety, harming someone else(1%), (1%). and gambling 23% of youth reported they did not have U.S.). for the 29% for and Ohio 27% reported YRBS (2011 every day for weeks two or more in a row that they stopped doing some usual activities admitted actually attempting suicide in the past year. grade youth had seriously considered attempting suicide thein past year and 4% Key Findings Y ...... Youth MentalHealth In 2013, the Health Assessment results indicated that 10% of Seneca County 6th . . professional(3%), vandalism/violent behavior(2%), using un (4%),using prescribed medication (4%), using illegal drugs(4%), talking to self (7%), m their family (29%), talking to a peer(28%), exercising(25%), (25%), eating using social depression:sleeping(44%), texting someone(34%), (30%), hobbies talking to someone in U.S.). for the 2% and Ohio 4% for reported (2011 YRBS attempt suicide a to due or overdose injury, poisoning related nurse. or doctor a by treated be to had youth. Ohio for rate 9% a and youth U.S. for 8% of rate prevalence attempt suicide a reported YRBS The 2011 one attempt. moremade than youth. Ohio 14% for and youth U.S. for of 16% rate 2011YRBS the to months.of 11% high school youth had seriously considered attempting suicide, compared having a place to(1%), live feeling and not safe in community(1%). parent/caregiver with a substance abuse(2%), problem sexual orientation (2%), not home(3%), family member in themilitary (3%), not having enough(3%), to eat parent (5%), parent lost their job(5%), not feeling safe home at (4%) alcohol or divorce/separation(14%), caring for younger siblings(12%), poverty/no(10%), money ill (19%), death of close family memberor friend(18%), breakup(16%), parent other stress home at (22%), dating relationship (19%), bullied being (19%), peer academic success(30%), sports(28%), fighting at home(28%), fighting with friends(27%),

(13%),edia praying(12%), breaking something(12%), (8%), shopping writing in a journal ІMENTALouth HEALTHANDSUICIDE Seneca CountySeneca youth reported thefollowing ways of dealing anxiety, with stress, or Of Seneca all County youth, 1%had to be treated by adoctoror nurse aresult as of a Of those who attempted suicide, 5% resulted in an injury, poisoning,oroverdose th In the past year,4%ofSeneca County you they had seriously reported youth of considered10% attempting suicide in the past 12 one 2013,In about Seneca County youth reported thefollowing causesof anxiety,stress depression: and When dealing with feelings of depress - (6%),harm smoking/using tobacco(5%), reading theBible (4%), drinking alcohol - quarter(23%) of youth reported they felt so sad or hopeless almost

igious leader (1%), coach (1%), scout master/club

ion orion suicide, SenecaCounty youthabout talk th hadth attempted suicide and 3% had

- prescribed (1%), medication

amedical pressure pressure drug use at at use drug - 12th 12th

at at

10% 15% 0% 5% 10% 15% males and 12% of females). of 8/% suicide, attempting considered seriously had youth all of 10% that shows graph first (i.e., the 12 months past the in suicide attempted and suicide attempting considered seriously had who youth County Seneca of percentage the show graphs following The 0% 5%

almost every day for two weeks or more in that row a they stopped 23% of23% Seneca County youth reported they felt so sad or hopeless 1 Total 4 10% Total % of % of 4%

Months 12 Past in Suicide Attempted Who Youth County Seneca Seneca Male Male 8% Seneca County Youth Who Had Seriously Considered 3%

County youth Female 12Months Past the in Suicide Attempting doing some usual activities.

Female 12%

5% depressed suicidal. or

12 to 13 to 12 12 to 13 to 12 9% 4% did not talk to anyone

14 to 16 to 14 14 to 16 to 14 12% 5%

17 & Older 17 17 & Older 17

when feeling Seneca Seneca 2005 2005 12% 8%

Seneca Seneca 2009 2009 10% 5%

1 20

1 21

Recognizing WarningSignsofSuicideinOthers N/A decision to commit suicide

(Source: CDC, National Depression and Manic Depression Association) . . . . .

overdose that had to to had that overdose Youth who felt sad or or sad felt who Youth attempting suicide in attempted suicide in more weeks in a row a in more weeks seriously considered resulted in an injury, Youth Comparisons Youth (28%), fighting at home (28%), fighting with friends (27%), and other - every day for 2 or 2 for every day

Shows signsof improvement, but in reality, relief comes from havingthe made Rehearsing suicide or seriously discussing specific suicide methods Drug or alcohol abuse Taking care of business Feelings of despair or hopelessness Not Suicide attempt be treated by a treated be hopeless almost 2005/2009/2013 Youth who had Youth who had doctor or nurse nurse or doctor

the past year past the year past the anxiety, stress and depression: academic success (30%), sports poisoning, or (of all youth)

Seneca County youth reported the following leading causes of available

(6 Seneca Seneca

County - preparing for thefamily’swelfare 2005 th N/A 22% 12% 8% -

stress homeat (22%).

)

(6 Seneca Seneca County 2009 th 21% 10% 5% 2% -

th )

(6 Seneca Seneca County 2013 th 23% 10% 4% 1% - 12

)

(9 Seneca Seneca County

th 2013 27% 11% 4% 1%

- 12

)

(9 th Ohio Ohio 2011 27% 14% 9% 4%

- 12

)

(9 th 2011 29% 16% U.S. U.S. 8% 2%

- 12

th )

online. met they someone when riding in a car driven by someoneelse. of youth 12% had been asked to meet

...... Personal Safety Key Findings Y In 2013, 39% of Seneca County youth self youth County Seneca 39% of 2013, In

8 outh outh 19% of19% Seneca County cleaningteeth or other dental work in the past year. past year. with someone theyonline met or through texts. 12% had been askedmeet someone, to had andparticipated 3% in sexual activity Of thoseyouth who ha social network account believed that sharing information online is dangerous. Almost(48%) half of the youth who had a Twitter, Facebook,online gaming,or other (5%). friends had their passw bullied through these accounts(9%), theypersonal shared information(8%), their online(15%), they had asked been to share personal information (9%), they were their pare allknew of “my friends”(59%), theiraccount currently was checked private(38%), network account.Of those who had an account,they reported thefollowing: they Over four around their home.of youth 4% reported they were unlocked and loaded. Almost two Almost three Over two U.S.). the 8% for and Ohio 7% for reported of high school youth had driven a car themselvesafter drinking alcohol(2011 YRBS been drinking alcohol,(2011 YRBS reported 21% Ohio for and 24% for the U.S.)8% and In the past 30 days,of 21% youth had ridden in a car driven by someonewho had U.S.). the 8% for and Ohio 17% for (2011 reported YRBS else 12%ofyouth rarely or never wore a seatbelt when by riding driven someone in a car else. someone Almost two % of % of Seneca County - - nts had their password(24%), all of they knew thepeople they played

thirds(68%) ofyouth had been to thedoctor for a routine check fifths(82%) ofyouth had a Twitter, Facebook,online gaming, orother social - -

І thirds(63%) of SenecaCounty youth reported there was a firearm in or fifths (39%) ofyouth always wore a seatbelt when riding in a car driven by - fourths for(74%) check a ofthedentist youth to had been SAFETY

ord(5%), and they had problems as a result of their account ve participated in chat rooms, Facebook,Twitter or texting, some time in their lives. high school youth had driven acar after drinking alcohol youth had purposefully hurt themselves at

- reported that they always wore a seatbelt woreseatbelt they a reported always that

themselves - up, exam, exam, up, -

up in the

1 22

1 23

. seatbelt their wear alwayswear aseatbelt that shows the graph (i.e., seatbelt a wear rarely/never and sometimes, show The graph following . . up to in thefollowing places: home(89%), school(74%), and their community (67%). . self the following ways:(10%), cutting scratching (9%),hitting (8%), (4%), biting (2%), burning their school(54%). meal together (63%), helpedwith school(58%), work to and meetings went or events at aboutthem school(64%), about askedthem (64%), homework made family the a eat high school(3%). no 1% had hope for their future. community collegeor technical/trade school(28%), join themilitary(10%), and not finish school(75%), a4 attend 100%

20% 40% 60% 80% 0% - 19%ofyouth had purposefully hurtthemselves some at time in their lives.They did so in Youth reported that their parent or guardian regularly does thefollowing: talked to Seneca County youth reported thefollowing plans for their future:graduate from Seneca County youth reported having least at one adult they could to talk and look embedding (1%),( other embedding and +Seat+Belt+Use) http://www.nhtsa.gov/Driving+Safety/Driver+Education/Teen+Drivers/Teen+Drivers+ (Source: National HighwayTraffic Safety Administration: Teen Drivers

Total    50% 39% 12%

fatal carfatal crashes were unbuckled. 2009,In themajority(56%) of young people 16 to years 20 old involved in 2008- 80% in at seat use belt among teens and young(16 adults years 24 to useobserved teens, among belt seat increasing at efforts aimed Despite Teens buckle up far less frequently adults than do.

Male Month Past the in Use Seatbelt Youth CountySeneca

13% 37% 50%

, - 50/% do so sometimes or most of the time and 12% rarely or rarely 12% and time the of most or sometimes so do 50/% year college(62%), their career follow (53%), path a attend

the percentage of Seneca County youth who always, who youth County Seneca of percentage the Always the lowest of any age group. of lowest any age the Female 41% 49% 10% 6%). 6%).

Teen Seat BeltTeen Seat Use Most/Sometimes younger 13 or 51% 13% 36%

14 to 16 to 14 41% 50% 9%

Rarely/Never

17 & Older 17 - 39% 45% Seat Belt Use, 16%

Seneca % of all youth 39% all of 2005 10% 40% 52% - old) stood stood old)

Seneca 2009 10% 42%

48%

never never high

. . . Understanding SelfHarm N/A Rarely or never wore a a wore or never Rarely Ridden in a car driven by someone who had been drinking alcohol Visited a doctor for a a for doctor a Visited Visited a dentist for a

check- within the past year Youth Comparisons Youth routine check after car Drove a drinking alcohol - 2005/2009/2013 2005/2009/2013 the to body damage injuring by permanent nerves. http://www.yspp.org/about_suicide/self_harm.htm) (Source:YouthSuicide Prevention Pr self assessed. be to suicide is trying to end all feelings, BUT of theintent thebehavior can varyand needs Typically teens who self by these: Self an immediate sense of relief, is it not but a long Self

Always wore a Not available Not in past month      past year - - - seatbelt seatbelt harm, the greater the risk of suicide. harm is correlated with the following behaviors and symptoms but is it NOT caused harm is often a behavior is used that to copewith difficult situations. may It bring

up within the Hypercritical parents Anxiety, self Impulsivity Hopelessness Depression

- up up

Self

- blaming

- harm can be a risk factor for suicide; thehigher thefrequencyof (6 Seneca Seneca County County - 2005 th harm are trying to feel better, a teen while who attempts 65% 60% 21% 28% 12% 36% - 12

th ogram, Understanding Self Harm, Self Understanding ogram, )

(6 Seneca Seneca County County 2009 th 74% 66% 19% 10% 48% 4% - 12

)

(6 Seneca Seneca      County County 2013

th 74% 68% 21% 12% 39% 5% - - term solution andcan cause it 12 Awareness of self of Awareness Low Impaired family communication Perfectionism Loneliness/isolation

)

self (9

Seneca County - esteem th 2013 74% 74% 22% 12% 40% 8%

- 12

)

- harm by peers by harm (9

th Ohio Ohio 2011 N/A N/A N/A 21% 17% 7%

- 12

)

(9 th 2011 N/A N/A N/A 24% U.S. U.S. 8% 8%

- 12

th )

1 24

1 25

belongings)

...... Violence-Related Behaviors property. 33% had been on bullied school had been bullied in thepast year and property youth in the past year.of 51% injured with a weapon on school 5% of youth had been threatened or carried aweapon pastmonth.the in In Seneca County, 7%of youth had Key Findings Y 8% for the U.S.). the 8% for unsafesexual(5%), way and sexual i U.S.). the for 33% and Ohio for 31% reported YRBS (2011 occasion one than U.S.). the 20% for and Ohio 23% for reported reported: U.S.). the for 6% and Ohio for 6% reported YRBS (2011 school from or to way their on or school at U.S.) the 7% for (2011 reported YRBS year. past the in property injured a with weapon on school U.S.). for the 17% and Ohio for 16% reported YRBS days, a gun, knife or club) in thepast 30 youth had carried aweapon(such as U.S.), or and anadult caregiver(12%). on purpose the following: by a boyfriendor girlfriend(4%) (2011 YRBS reported 9% for the

outh outh o o o Seneca County youth had been forced to engage in the following: touched in an In the past year,SenecaCounty youth reported being hit, slapped, or physically hu In the past year,24% ofyouth had been involved a physical in fight; 11%on more In the past year,33% ofyouth had been bullied school on property(2011 YRBS o 51%ofyouth had been bullied in thepast year.The following types of bullying were safe feel not did they because days more or one on school to go not did youth of 5% or threatened were youth 5% of 2013,In County 7% of Seneca

increasing to 11% of males (2011 males of 11% to increasing (2011 YRBS reported 15% for Ohio and 16% for the U.S.) for the 16% and Ohio for 15% reported YRBS (2011 atened by e- atened or(teased, thre taunted bullied cyber 13% were 14% were physically(you bullied were hit, kick “group”) a of out 25% were indirectly bullied(spread me bul verbally 40% were

VIOLENCE ISSUES

lied (teased,lied taunted or called you harmful names) ntercourse (3%) (2011 YRBS reported 9% for Ohio and and Ohio for 9% reported YRBS (2011 (3%) ntercourse

    http://www.respect2all.org/parents/bullying (Source: RESPECT, Bullying Definition

an rumors about you or kept you kept or you about rumors an messages, and cell phones. networking sites (suchFacebook), as text includes email, instantmessaging, social over any technological device.This Bullying: Cyber types of physical bullying. fighting, and destroying property all are possessions. Stealing, shoving, hitting, their damages or body someone's Physical Bullying: “group”. a of out someone keeping or someone involves mean rumors spread being about Bullying Indirect others are all formsof bullying. verbal threatening somebody,and making fun of by speaking.Calling names, teasing, Bullying: Verbal ed,punched or people tookyour

Types of Bullying of Types

Any bullying that happens : A form of of : A form Any bullying that is done

Any bullying that hurts mail or cell phone) s, obtained from:

bullying that

definitions)

rt rt

10% 20% 30% 0% females). of 3% weapon and youth30carried in11%males shows7%graph of the days, all of a that past first the (i.e., answer each giving segment each in youth of number shows the The graph days. 30 past the in weapon a carrying youth County Seneca shows graph following The Misused prescription medication at some time in Physically Bullied Indirectly Bullied Youth Behaviors Youth Contemplated suicide in thepast 12 months Verbally Bullied Had smoked Cyber Bullied Attempted suicide in the past 12 months Had usedmarijuana the in past30 days Total Had drank alcohol the in past 30 days 7% Were depressed in the past year past the in depressed Were Types of Bullying Seneca County Youth Experienced in Past Year

Male

cigarettes Youth Seneca County Youth Carrying aWeapon During 11%

their life Behaviors Behaviors Senecaof County Youth Female Total

13% 14% 25% 40% in thepast 30 days 3%

Bullied vs. Non vs. Bullied

the Past 30 Days 30 Past the 12 to 13 to 12 Male 14% 11% 30% 9% 7%

14 to 16 to 14

Female -

Bullied 19% 14% 40% 52% 5%

17 & Older 17 younger Bullied 13 or 22% 23% 44% 13% 14% 15% 16% 23% 24% 34% 8% 7%

Seneca 2005 Years 14 10% 16% 10% 25% 41% old

- Non 16

13% 12% - 6% 7% 1% 7% 4% Bullied Seneca 2009 17 and

older 11%

16% 29% 30% 6%

1 26

1 27

*2007 YRBS N/A school property in past 2005/2009/2013 Youth Youth 2005/2009/2013 Ever physically forced Threatened or injured Threatened boyfriendor girlfriend Carried a weapon in property in past year Did not go to school school to go not Did Electronically/cyber because felt unsafe because felt bullied in past year with a weapon on - Been in a physical physically hurt on

Bullied on school fight in past year Not available Not purpose by their Hit, slapped,or to have sexual have to Comparisons in past year past month intercourse

year

(6 Seneca Seneca County 2005 th N/A 33% 10% 6% 4% 6% 5% 8% - 12

th )

(6 Seneca Seneca County 2009 th N/A 10% 25% 11% 6% 4% 7% 3% - 12

th )

(6 Seneca Seneca County 2013 th 13% 33% 24% 4% 5% 5% 3% 7% - 12

th )

(9 Seneca County th 2013 15% 27% 19% 7% 4% 3% 3% 7%

- 12

)

(9 th Ohio 2011 N/A 16% 15% 23% 31% 8%* 6% 9%

- 12

th )

(9 th 2011 17% 16% 20% 33% U.S. 6% 8% 7% 9%

- 12

th )

Appendix I І

SENECA COUNTY HEALTH ASSESSMENT INFORMATION SOURCES

Source Data Used Website American Academy of Pediatrics . Safe Sex Guidelines http://www.lpch.or (AAP) g/DiseaseHealthInf o/HealthLibrary/ad olescent/safesex.h tml American Cancer Society, . 2013 Cancer Facts, Figures, www.cancer.org Cancer Facts and Figures 2013. and Estimates Atlanta: ACS, 2013 . Nutrition Recommendations American Diabetes Association . Type 1 and 2 Diabetes www.diabetes.org . Risk Factors for Diabetes American Foundation for Suicide . When You Fear Someone https://www.afsp. Prevention May Take Their Life org/ American Heart Association, . Stroke Warning Signs and http://www.heart. 2013 Symptoms org/HEARTORG/

Annals of Emergency Medicine, . Firearm Injury Prevention http://journals.ohio v. 57, issue 6, 2011, p. 691 link.edu/ejc/pdf.c gi/EJC_Article.pdf? issn=01960644&issu e=v57i0006&article =691_fip Arthritis at a Glance, 2012, . What Can Be Done to http://www.cdc.g Centers for Disease Control & Address Arthritis? ov/chronicdisease Prevention, Morbidity and . Arthritis Statistics /resources/publica Mortality Weekly Report 2010; tions/AAG/arthritis. 59(39):999-1003 & 59(39):1261- htm 1265 Behavioral Risk Factor . 2009 - 2011 Adult Ohio and www.cdc.gov Surveillance System, National U.S. Correlating Statistics Center for Chronic Disease Prevention and Health

Promotion, Behavioral Surveillance Branch, Centers for Disease Control Campaign for Tobacco Free . Costs of Tobacco http://www.tobac Kids, State Cigarette Excise Tax cofreekids.org/res Rates & Rankings, July 2012 earch/factsheets/ pdf/0097.pdf 128

Source Data Used Website www.cdc.gov/art CDC, Arthritis . Key Public Health Messages hritis/basics/key.ht

m CDC, Adolescent & http://www.cdc.g . Soft drinks & adolescent weight School Health ov/healthyyouth/

nutrition/facts.htm . Asthma Statistics . Binge Drinking . Binge Drinking Among Women . Caffeinated Alcoholic Beverages . Cancer and Men . Cancer and Women Center for Disease Control . Chlamydia Profile: U.S. & Ohio and Prevention www.cdc.gov . Distracted Driving

. Immunization Schedules . Human Papillomavirus (HPV) . Obesity Statistics . Skin Cancer Prevention . U.S. Adult Smoking Facts

http://www.cdc.g ov/healthyweight/ CDC, Healthy Weight . Tips for Parents children/index.ht ml . Leading Causes of Death in U.S. . Men’s Health CDC, National Center for http://www.cdc.g . U.S. Female Fertility Rate Health Statistics ov/nchs/fastats/ . U.S. Births to Unwed Mothers . U.S. Low Birth Weight, Live Births

CDC, National Depressive and Manic Depression . Warning Signs of Suicide N/A Association CDC, Morbidity and . Sunburn and Sun Protective http://www.cdc.g Mortality Weekly Report Behaviors Among Adults Aged 18- ov/mmwr/pdf/wk/ 2000-2010”, vol. 61, no. 18 29 Years mm6118.pdf http://www.cdc.g CDC, Physical Activity for ov/physicalactivit . Physical Activity Recommendations Everyone y/everyone/guidel ines/adults.html . U.S. Chlamydia and Gonorrhea CDC, Sexually Transmitted Rates http://www.cdc.g Diseases Surveillance, . STD’s in Adolescents and Young ov/std/stats/ 2011 Adults

. U.S. STD Surveillance Profile, 2011

CDC, Vaccine Safety, http://www.cdc.g Human Papillomavirus ov/vaccinesafety/ . Human Papillomavirus (HPV), updated January vaccines/HPV/Ind 129 24 2013 ex.html

Source Data Used Website Federal Emergency Management . Basic Disaster Supply Kit http://www.ready.g Agency (FEMA), Ready: Prepare. . Additional Items for ov/basic-disaster- Plan. Stay Informed., Emergency Emergency Supply Kit supplies-kit Supply List Healthy People 2020: U.S. . All Healthy People 2020 http://www.healthy Department of Health & Human Target Data Points people.gov/2020/t Services . Some U.S. Baseline Statistics opicsobjectives202 . Predictors of Access to 0 Health Care Healthy Youth: Tobacco, CDC . Tobacco Sales & Promoting http://www.cdc.go to Youth v/healthyyouth/tob acco/facts.htm National Campaign to Prevent Teen . Facts about “Sexting” www.thenationalca and Unplanned Pregnancy mpaign.org/sextec h/PDF/SexTech_Pres sReleaseFIN.pdf) National Center for Environmental . Asthma Trigger Factors http://www.cdc.go Health, CDC, 2012 v/nceh/ National Dairy Council, 2010; . Learning to get fit; stronger www.nationaldairy Newsweek Back-To-School bodies, sharper minds council.org/chil Guidebook dnutrition National Highway Traffic Safety . Teen drivers-seat belt use http://www.nhtsa.go Administration v/Driving+Safety/Dri ver+Education/Tee n+Drivers/Teen+Driv ers+- +Seat+Belt+Use National Institute on Drug Abuse . Abuse of Prescription (Rx) http://www.drugab Drugs use.gov/related- topics/trends- statistics/infographi cs/abuse- prescription-rx- drugs-affectsyoung-adults-most National Institute of Health, National . Back Pain Prevention http://www.ninds.ni Institute of Arthritis and h.gov/disorders/ba Musculoskeletal and Skin Diseases ckpain/detail_back pain.htm Nicotine & Tobacco Research, . Flavored Cigar Smoking http://ntr.oxfordjour “Flavored Cigar Smoking Among Among U.S. Adults nals.org/content/e U.S. Adults: Findings from the 2009- arly/2012/08/17/ntr. 2010 National Adult Tobacco nts178.abstract Survey,” 2012 National Vital Statistics Report . Live Birth Data http://www.cdc.go

v/nchs/data/nvsr/n vsr61/nvsr61_01.pdf

#table01 Ohio Association of Community . The State of Poverty in Ohio http://issuu.com/oa Action Agencies, 2012 caa/docs/state_of_ 130 poverty_2012_final? mode=window

Source Data Used Website Ohio Department of Health, . Diabetes Facts http://www.odh.ohi Information Warehouse . Seneca County and Ohio o.gov/ Mortality Statistics . Seneca County and Ohio Birth Statistics . Seneca County and Ohio Sexually Transmitted Diseases . HIV/AIDS Surveillance Program . Statistics: Access to Health Services Ohio Department of Health, Ohio . Seneca County and Ohio http://www.odh.ohi Cancer Incidence Surveillance Cancer Mortality o.gov/ System . Seneca County and Ohio Cancer Incidence Ohio Department of Health, Ohio . Seneca County Oral Health http://publicapps.o Oral Health Surveillance System Resources for Adults and dh.ohio.gov/oralhe Children alth/default.aspx Ohio Department of Job & Family . Poverty Statistics http://jfs.ohio.gov/c Services . Seneca County and Ohio ounty/cntypro/pdf1 Medicaid Statistics 1/Seneca.pdf . Seneca County Health Care Statistics Ohio Department of Public Safety . 2013 Seneca County and https://ext.dps.state Ohio Crash Facts .oh.us/crashstatistic s/CrashReports.asp x Ohio Family Health Survey Results, . Ohio Uninsured Rates http://grc.osu.edu/ 2010 omas/ Ohio Medicaid Assessment Survey, . Ohio Statistics https://ckm.osu.ed 2012 u/sitetool/sites/oma spublic/documents /OMASStatewideRo lloutPresentationSild es.pdf Pacific Institute for Research and . Underage drinking in Ohio http://www.udetc. Evaluation, “Underage Drinking in fact sheet org/factsheets/OH. Ohio: The Facts,” September 2011 pdf

The Partnership at Drugfree.org, . Synthetic Drugs: Bath Salts, www.drugfree.org Parents 360, 2012 K2/Spice A guide for parents and other influencers Respect2All . Types of Bullying www.respect2all.or g/ parents/bullying-

definitions Substance Abuse and Mental . Drug-Related Emergency http://www.samhsa Health Services Administration Department Visits Involving .gov/data/2k12/DA (SAMHSA) Synthetic Cannabinoids WN105/SR105- 131 synthetic- marijuana.pdf

Source Data Used Website U. S. Department of Commerce, . American Community www.census.gov Census Bureau; Bureau of Economic Survey 3 year estimates, Analysis 2009-2011 . Ohio and Seneca County 2010 Census Demographic Information . Ohio and U.S. Health Insurance Sources . Small Area Income and Poverty Estimates . Federal Poverty Thresholds U.S. Department of Health and . Mental Health Services in http://www.lsc.stat Human Services, Ohio Department Ohio e.oh.us/fiscal/ohiof of Mental Health acts/sept2012/healt h&humanservices.p df U.S Department of Justice . Drug Fact Sheet http://www.justice. gov/dea/druginfo/f actsheets.shtml Youth Risk Behavior Surveillance . 2005 - 2011 youth Ohio and www.cdc.gov System, National Center for Chronic U.S. correlating statistics Disease Prevention and Health Promotion, Division of Adolescent and School Health, Centers for Disease Control

132

1 33

Health Indicator Current Smoker Current drinking Binge Crude Mortality Rates Mortality Crude Mortality RatesMortality Age HP 2020 BMI occasion. one CY CDC BRFSS measurement/relationship of to weight height. (for females) beverages alcoholic or more four or males) AND TERMS Appendix ODH Adult N/A Pressure Blood High HCF FY Cholesterol Blood High

Adjusted

smoking. cigarette cancer mortality rates, rates of obesity,or incidenceof HumanServices. Health Promotion, and U.S. Departmen objectives published by t lifetime and now smokes daily oron some days.

100,000. conducte

Northwest Ohio.

A measure of the health of health of the A measure Healthy People 2020 distribution of thepopulation. Individual who has smoked a Adult consumption of five alcoholic beveragesor more Number of of Number Centers for DiseaseControl and Prevention. Death rate per 100,000 adjusted for the age for the 100,000adjusted per rate Death older. and ofyears age as 19 Defined Body Inde Mass Fiscal Year Calendar Year Behavior Risk FactorSurve Ohio Department of Health not available.Data Systolic > Systolic Healthy Communities Founda 240 mg/dL and above and 240 mg/dL І 140 and Diastolic > LIST OFACRONYMS d by the CDC. the by d

deaths/esti

x is defined as thecontrasting

, a comprehensive of set health - mid mated

he Office of Disease Prevention Officeofhe Disease illance System, ansurvey adult people in a community, such as

90 t leastt 100 cigarettes in their

tion of theHospital Council of

year population times

t oft Health and

(for

YRBSS

Classifications BMI Youth Youth Weapon Race/Ethnicity

percentile. club” Defined in the YRBSS weapon as such “a as a gun, knife,or percentile. percentile to < 95 conducted by the CDC Y Defined as 12 through 18 years 18 12through as Defined Underweight reported onlyone race. “White alone” or “Black alone”, means therespondents Nat AfricanAmerican,American Alaska Indian & Native,Asian, 2010 reported five race categories including: White, Black or “Hispanic or Latino” and “Not Hispanic or Latino.” Census as presented are Data race.” of regardless origin or culture Puerto Rican, South or Central American, or o define Hispanic or Latino as “a personofCuban, Mexican, the Office of and Management Budget (OMB), which origin separately.Census 2010 adhered to thestandards of Census 2010: outh R outh ive Hawaiian and Other Pacific Islander. reported, Data

isk B isk

Overweight Overweight ehavior ehavior is defined is BMI as U.S. consider data Census race and Hispanic th percentile. S urveillance S is definedis as BMI

- Obese Obese for

of age of - a youth survey survey youth a ystem, age < age

isas defined > 5 - for th

- age 85 age ther Spanish th

95 th

1 34

1 35

2013Seneca from the data the represents the sample within that same specific category.Using sex as an example, thefollowing percent of Seneca County within the specific category and dividing that by thepercent of The numerical valueof the weight for eac Non sex, race, and income. the surveyrespondents to reflect theactual distribution of SenecaCount 2013 SenecaCounty survey, a weighting was applied prior to theanalysis that weighted the sample accurately reflect the proportioned characteristics of thepopulation. In the purposefully, thedataneeds to be weighted so that the proportioned characterist weighting and the numbers from they which were calculated. their combination of age, race,sex, and income.See next page for each specific individual in the 2013 Seneca County sample has own individual their weighting based on often done for minority groups). Whether theover that subgroup for data appropriate analysis when investigating them separately(this is a segment of thepopulation in order to gain an appropriate number of responses fr 0.925855463. of factor by less a weighted responses females’ females]. for of 0.925855463 weighting [50.11511221/54.128440= females for done was same The males]. for of 1.087490554 weighting [49.88488779/45.871560= (45.871560%) sample County information calculated by taking the percent of males in Seneca County(based on Census sample compared to the actual portion in Seneca County. The weighting for males was 1.108171392 (weight for age 35- for age (weight 1.108171392 x for White) (weight 1.004163618 x for females) (weight [0.925855463 1.08446397 with a household income in the$50 above. For example, a respondent who possible characteristic that may alter how an individual responds to thesurvey items. (if females respond differently than males). Thissame phenomenon holds true for any being male and 75% being female, then thesample is biased towards the views of females p population may be represented more in thecompleted surveys they than are in the responsefor different segments of thepopulation. otherIn words,somesubgroups of the SENECA COUNTY METHODS FORWEIGHTINGTHE2013 Appendix

opulation from those which surveys are sampled. a sample If has 25% of respondents its - White), age (7 different age categories), and income (7 different income categories). income (7 different income categories),and age (7 different age White), Female Female Male Sex Weightings were created for each category within(male, sex (White, female), race

In someIn cases, theproceduresof thesurvey methods may purposefullyover fromData sample surveys have thepotential for bias if there are different rates of

In In this example, shows it that there was a slightly larger portion of females in the This same thingwas done forof each the18 specific categories as described Thus males’ responses are weighted heavier by a factor of 1.087490554and 1.087490554and of factor by a heavier weighted are responses males’ Thus

)(49.88488779%) and dividing that by thepercent found in the 2013 Seneca

2013 Seneca Survey Seneca 2013 Number 236 200

III

54.128440 45.871560 І Percent Percent 44) x 1 x 44)

- $75k category would have an individual weighting of .052593098 (weight for income $50- for income (weight .052593098

was female, White, in the age category 35 category age female, the was in White,

ASSESSMENT DATA

h category calculated was by the taking County Survey and the 2010 Census. Census. 2010 the Survey and County

28,516 28,385 Number Number - sampling is done inadvertently or 2010 Census

50.11511221 49.88488779 Percent Percent

y based ony age, $75k)].Thus, each

0.925855463 1.087490554 Weight

ics of of ics - - 44, and and 44, om om sample

Multiple sets of weightings were created and used in the statistical software package (SPSS 14.0) when calculating frequencies. For analyses done for the entire sample and analyses done based on subgroups other than age, race, sex, or income – the weightings that were calculated based on the product of the four weighting variables (age, race, sex, income) for each individual. When analyses were done comparing groups within one of the four weighting variables (e.g., smoking status by race/ethnicity), that specific variable was not used in the weighting score that was applied in the software package. In the example smoking status by race, the weighting score that was applied during analysis included only age, sex, and income. Thus a total of eight weighting scores for each individual were created and applied depending on the analysis conducted. The weight categories were as follows:

1) Total weight (product of 4 weights) – for all analyses that did not separate age, race, sex, or income. 2) Weight without sex (product of age, race, and income weights) – used when analyzing by sex. 3) Weight without age (product of sex, race, and income weights) – used when analyzing by age. 4) Weight without race (product of age, sex, and income weights) – used when analyzing by race. 5) Weight without income (product of age, race, and sex weights) – used when analyzing by income. 6) Weight without sex or age (product of race and income weights) – used when analyzing by sex and age. 7) Weight without sex or race (product of age and income weights) – used when analyzing by sex and race. 8) Weight without sex or income (product of age and race weights) – used when analyzing by sex and income.

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1 37

* Seneca County population figures taken from the 2010 Census. 2010 the from taken figures population County Seneca * category. same that for survey County Seneca the in sample the of proportion the by subcategory each in County Seneca of population of the the ratio by taking calculated are ratios weighting Note: The

$75k or$75k more Category Category Household Household Non $50k $25k $15k $10k Less than than Less $35k Income $10,000 Female - Race: White White 75 65 60 55 45 35 25 20 - - - - Male Male Age: Age: $75k $35k $25k $15k - Sex: 85+ $50 ------84 74 64 59 54 44 34 24

Seneca Seneca Sample

236 200 407 23 76 51 69 80 64 29 36 91 77 75 64 51 28 14 26 1

17.715618 11.888112 16.083916 18.648019 14.918415 54.128440 45.871560 22.750000 19.250000 18.750000 16.000000 12.750000 93.995381 0.233100 5.361305 6.759907 8.391608 7.000000 3.500000 6.004619 %

Census * Census

2010 2010 28,516 28,385 53,707 1,349 2,824 4,115 3,272 3,961 8,541 6,842 6,556 3,926 4,886 4,463 3,859 3,107 2,911 1,286 1,514 3,194

3.259556372 6.823563524 9.942975886 7.906055188 9.570869376 20.63741362 16.53216063 15.84110569 9.486299715 50.11511221 49.88488779 22.18287478 20.26241714 14.10605648 13.21619904 5.838554436 6.873694724 5.613258115 94.38674189

17.5202034 %

proportion of the the of proportion

13.98349683 1.272742936 0.561254823 1.106681305 1.108171392 2.343391152 1.130450716 0.925855463 1.087490554 Weighting Weighting 0.66503876 0.5950584 Value 0.975071 1.052593 0.934411 0.881629 1.036565 0.834079 1.963913 0.934823 1.004164

2013 Seneca County Health Assessment: The following schools were randomly chosen and agreed to participate in the IV Appendix

Hopewell Fostoria Intermediate Elementary School Fostoria Junior/Senior High School High Junior/Senior Fostoria HOPEWELL І Seneca High School East Seneca East Elementary East Seneca New Riegel High School Columbian High School Bettsville Middle School - Loudon JuniorHigh/High School

COUNTY SENECA Bettsville SENECA EAST LOCAL EAST SENECA SCHOOLS Old Fort High School Tiffin Middle School NEW RIEGEL LOCAL RIEGEL NEW BETTSVILLE LOCAL BETTSVILLE OLD FORT LOCAL FOSTORIA CITY FOSTORIA TIFFIN CITY TIFFIN - LOUDON LOCAL High School High

13 8

13 9

Appendix V Appendix years and older. older. and years survey. Marital status calculatedis for those individuals 15 years and older. Education is calculated for those 25 †The Ohio and Seneca County Census percentages are slightly different than the percent who responded to the **Percentages Percents may not add to 100% due to missing data (non- contained within the report however are based on weighted data (weighted by age, race, sex, and income). *The percents

Some college/ College graduate College Some college/ High School Diploma Less High than School Diploma Education Widowed Divorced/Separated unmarried couple of an married/member Never been Married Couple Status Marital Hispanic Origin (mayof be any race) Other Asian American and Indian Alaska Native Black or African American White Race/Ethnicity 60 plus 50 40 30 20- Age $75,000 or more $75,000 $74,999 $50,000 to $25,000 to $24,999 $15,000 to less $14,999 and (Families) Income - - - 59 49 39 29

reported are the actual percent within each category who responded to the survey. The data The data survey. the to responded who category each within percent the actual are reported exceed

†

$49,999

† **

100% because respondents could select more than one response. Variable

COUNTY SENECA PROFILE* SAMPLE DEMOGRAPHIC

2013 Survey 2013 respo Sample 90.6% 26.2% 20.4% 17.3% 14.3% 14.9% 18.8% 17.4% 31.6% 57.4% 31.4% 13.6% 19.6% 61.5% 0.3% 9.8% 9.2% 6.4% 6.6% 3.2% 3.3% 1.0% nses). 0%

Census 2011 Seneca Seneca County County 94.5% 20.9% 14.6% 13.5% 11.2% 12.7% 27.2% 22.8% 30.5% 11.0% 42.3% 45.9% 11.8% 11.8% 29.5% 52.1% 2.6% 8.5% 6.6% 4.4% 0.9% 0.4% 0.3%

Ohio Census Ohio Census 36.5% 21.3% 24.4% 53.5% 34.8% 11.7% 14.1% 31.2% 48.3% 12.1% 82.9% 20.4% 14.6% 13.7% 12.1% 12.9% 2011 8.5% 9.3% 6.5% 3.2% 0.9% 1.7% 0.2%

HOUSEHOLD VI Appendix

Total 19 years and over and years 19 Total Totalyears and 65 over and years 85 Total 110 years & over & 110 years Seneca County Seneca 105 100 15 10 95 90 85 80 75 70 65 60 55 50 45 40 35 30 25 20 18 15 12 13 10

Category 5 0 7 5 3 1 1 < 1 year 1 < Seneca County Population by Age Groups and Gender ------109 years 104 years 99 years 94 years 89 years 84 years 79 74 years 69 years 64 years 59 years 54 years 49 years 44 years 39 years 34 years 29 years 24 years 19 years 17 years 19 years 18 years 14 years 12 years 14 years years 9 years 4 9 years 6 years 4 years 2 years 4 years years

over

DEMOGRAPHICS AND DEMOGRAPHICS INFORMATION U.S. Census 2010 Census U.S. 56,745 42,388 8,425 1,334 4,432 3,739 3,767 3,553 1,359 1,590 1,802 2,340 3,321 4,083 4,454 4,021 3,320 3,225 3,305 3,114 3,986 2,123 2,309 5,505 1,461 2,278 2,245 1,522 1,471 1,437 2,908 Total 645 368 863 12 91 0 0

28,337 20,886 Males 1,950 1,852 3,551 2,288 1,943 1,526 1,118 1,650 2,062 2,235 2,032 1,704 1,641 1,719 1,601 2,109 1,112 1,176 2,870 1,164 1,128 822 784 742 326 412 106 288 528 663 830 779 17 0 0 1

Females 28,408 21,502

1,817 1,701 4,874 2,144 1,796 1,382 1,222 1,671 2,021 2,219 1,989 1,616 1,584 1,586 1,513 1,877 1,011 1,133 2,635 1,114 1,117

700 687 695 319 922 262 575 831 927 682 972 11 74 0 0

140

141

SENECA COUNTYPROFILE

Total Households Total Type By Household Median age (years) more and 65 years 64years 45 to 44years 25 to 24years 18 to 17years 5 to years 5 Under 2010 Age By Population Other races more or Two Asian American and Indian Alaska Native African American Hispanic or(of Latino race) any White Alone Population Total Race/Ethnicity By Population Population 2000 Total Population 2011 Total City Largest 2000 2011 Total Population Total Population Average Family Size Family Average Size Household Average Households Individuals With 65 years and > Households Individuals With

- family Households With ownWith children <18 years ownWith children <18 > and years 65 Householder ownWith children <18 years -

Tiffin Couple Family Households

living alone (Source: U.S. Census Bureau, Census 2011)

General Demographic Characteristics Demographic General

years

2.91 2.46 people

56,672 18,135 17,944 58,683 53,536 56,672 11,569 15,126 21,942 15,879 12,964 6,816 1,498 2,504 5,802 6,775 2,588 5,503 1,574 2,636 4,403 6,108 8,425 6,109 9,815 3,553 39.0 people 725 154 504 255

0.3% 2.6% 4.4% 94.5% 100% 100% 100% 26.4% 30.9% 11.8% 25.1% 31.1% 7.2% 12.0% 18.4% 52.7% 27.8% 68.9% 100% 14.8% 28.0% 22.8% 10.8% 17.3% 6.3% 0.9% 1.3% 0.4%

*(X) or Higher Degree Bachelor’s Percent Percent High Degree Professional Or Graduate Degree Bachelor’s Degree Associate Degree No College, Some High School Graduate(Includes Equivalency) 9 < 9 Population 25 YearsOver and Educational Attainment School Graduate or College High School(Grades 9 Elementary School(Grades 1 Kindergarten Nursery & Preschool Population 3 Years and Over Enrolled School In Enrollment School Lacking Complete Plumbing Lacking Complete Kitchen Facilities No Telephone Service Total HousingUnits Median Rooms Per Housing Unit Renter for Rent Gross Median Median Monthly Median Monthly Owner Costs(With Mortgage) Median Value ofOwner th

th to 12 to –

Not available Grade Education th

Grade,No Diploma

School Graduate or Higher or Graduate School General Demographic Characteristics, Continued Characteristics, Demographic General

Owner Costs (Not Costs Owner Mortgaged)

(Source: U.S. Census Bureau, Census 2011) (Source: U.S. Census Bureau, Census 2011)

12)

- Selected Social Characteristics Occupied Units

2011 ACS 3 ACS 2011 3 ACS 2011

- Facilities -

Occupied Units

- -

year estimates year estimates

$100,500

24,103 15,115 17,050 37,185

3,521 4,390 3,007 6,120 2,348 2,885 6,979 3,424 $607 $357 $991 *(X) *(X) *(X) 294 492 978 716 882 6.2 77

15.8% 88.2% 6.3% 9.5% 7.8% 18.8% 45.8% 9.2% 2.6% 100% 29.0% 19.9% 40.5% 4.7% 5.8% 100%

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143

All ParentsFamily In LaborIn Force Population Living Own Children With <6 Years Population 16 YearsOver and Status Employment Over and 65 Years 64years 18 to years 18 Under Total Civilian Noninstitutionalized Population Non Civilian the of Status Disability Civilian Veterans 18 years and over Status Veteran Grandparent Responsible forGrandchildren <18 years Grandparent Living in Household with 1 or moregrandchildren own Grandparents As Caregivers Divorced Widowed Separated Now Married, Excluding Separated Never Married Population 15 YearsOver and Status Marital Females 16 Years and Over and 16Females Years a DisabilityWith a With a DisabilityWith a DisabilityWith Female Female In Labor Force Labor In Force Labor In Not Force Labor In

Disability

Selected Social Characteristics, Continued (Source: U.S. Census Bureau, Census 2011) (Source: U.S. Census(Source: Bureau, 2011) Census

Selected Economic Characteristics

2011 ACS 3 ACS 2011 2011 ACS 3 ACS 2011

institutionalized Population institutionalized

- - year year year estimates

estimates

23,755 13,451 45,588 13,177 22,585 16,384 28,339 44,723 34,854 13,308 56,043 4,884 3,014 2,993 3,944 2,986 7,881 4,433 8,228 4,741 2,634 2,232 809 881 484 487

75.9% 100% 58.3% 100% 36.6% 63.4% 100% 37.9% 100% 12.7% 100% 6.1% 100% 14.7% 100% 10.9% 55.3% 100% 5.8% 10.7% 4.9% 6.6% 1.1% 52.1% 29.5% 100%

Selected Economic Characteristics, Continued (Source: U.S. Census Bureau, Census 2011)

2011 ACS 3-year estimates

Occupations Employed Civilian Population 16 Years and Over 24,645 100% Production, Transportation, and Material Moving 6,458 26.2% Occupations Management, business, science, and art occupations 6,022 24.4% Sales and Office Occupations 4,843 19.7% Service Occupations 4,736 19.2% Natural Resources, Construction, and Maintenance 2,586 10.5% Occupations

Leading Industries Employed Civilian Population 16 Years and Over 24,645 100% Manufacturing 5,953 24.2% Educational, health and social services 6,491 26.3% Trade (retail and wholesale) 3,237 13.1% Arts, entertainment, recreation, accommodation, and food 1,831 7.4% services Professional, scientific, management, administrative, and 956 3.9% waste management services Transportation and warehousing, and utilities 1,129 4.6% Finance, insurance, real estate and rental and leasing 838 3.4% Other services (except public administration) 1,439 5.8% Construction 1,427 5.8% Public administration 657 2.7% Information 277 1.1% Agriculture, forestry, fishing and hunting, and mining 410 1.7%

Class of Worker Employed Civilian Population 16 Years and Over 24,645 100% Private Wage and Salary Workers 20,378 82.7% Government Workers 2,737 11.1% Self-Employed Workers in Own Not Incorporated Business 1,450 5.9% Unpaid Family Workers 80 0.3%

Median Earnings Male, Full-time, Year-Round Workers $38,551 Female, Full-time, Year-Round Workers $30,939

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145

*(X) Individuals Families Poverty Status In 2011 Per Capita (families) Income Household Median or more $200,000 $199,999 $150,000 to $149,999 $100,000 to $99,999 $75,000 to $74,999 $50,000 to $49,999 $35,000 to $34,999 $25,000 to $24,999 $15,000 to $14,999 $10,000 to < $10,000 Families 2011 In Income Income Household Median or more $200,000 $199,999 $150,000 to $149,999 $100,000 to $99,999 $75,000 to $74,999 $50,000 to $49,999 $35,000 to $34,999 $25,000 to $24,999 $15,000 to $14,999 $10,000 to < $10,000 Households 2011 In Income

–

Not available

Income In 2011 In Income

Selected Economic Characteristics, Continued

(Source: U.S. Census Bureau, Census 2011)

2011 ACS 3 ACS 2011

- year estimates

Poverty Level Poverty Below Number $40,025 $49,956 $20,628 15,126 21,942 1,052 3,678 2,762 1,354 2,100 3,449 2,740 1,873 1,291 1,486 2,432 4,312 3,320 1,519 1,757

*(X) *(X) 613 314 362 308 346

4.1% 7.0% 100% 1.4% 1.6% 6.8% 11.1% 19.7% 16.8% 15.1% 12.6% 6.9% 8.0% 100% 15.4% 12.2% Level Poverty % Below 2.0% 2.3% 8.9% 13.9% 22.8% 18.1% 12.4% 8.5%

Selected Economic Characteristics, Continued (Source: U.S. Bureau of Economic Analysis)

Bureau of Economic Analysis (BEA) Per Capita Personal Income Figures

Income Rank of Ohio counties

BEA Per Capita Personal Income 2011 $31,506 55th of 88 counties BEA Per Capita Personal Income 2010 $29,722 54th of 88 counties BEA Per Capita Personal Income 2009 $29,214 53rd of 88 counties BEA Per Capita Personal Income 2008 $29,323 57th of 88 counties BEA Per Capita Personal Income 2001 $24,264 52nd of 88 counties BEA Per Capita Personal Income 2000 $23,596 54th of 88 counties

(BEA PCPI figures are greater than Census figures for comparable years due to deductions for retirement, Medicaid, Medicare payments, and the value of food stamps, among other things)

Poverty Rates, 5-year averages 2006 to 2010 Category Seneca Ohio

Overall (%) 11.9% 14.2%

Children under 18 (%) 17.9% 20.2%

Age 65 and over (%) 8.3% 8.3%

< 50% FPL, i.e. severe poverty (%) 5.3% 6.5%

< 200% FPL, i.e. below self-sufficiency (%) 34.3% 31.8% (Source: The State of Poverty in Ohio 2012, Ohio Association of Community Action Agencies, 2012 Annual Report, http://issuu.com/oacaa/docs/state_of_poverty_2012_final?mode=window)

Employment Statistics Category Seneca Ohio

Labor Force 27,800 5,696,700

Employed 25,800 5,315,700

Unemployed 1,900 381,100

Unemployment Rate* in April 2013 6.9 6.7

Unemployment Rate* in March 2013 7.8 7.3

Unemployment Rate* in April 2012 7.5 7.1 *Rate equals unemployment divided by labor force. 146 (Source: Ohio Department of Job and Family Services, April 2013, from: http://ohiolmi.com/laus/current.htm)

Estimated Poverty Status in 2011 90% 90% Age Groups Number Confidence Percent Confidence Interval Interval Seneca County All ages in poverty 8,928 7,678 to 10,178 16.6% 14.3 to 18.9 Ages 0-17 in poverty 2,818 2,296 to 3,340 22% 17.9 to 26.1 Ages 5-17 in families in 1,825 1,435 to 2,215 19.5% 15.3 to 23.7 poverty Median household 36,426 to $38,349 income 40,272 Ohio All ages in poverty 1,811,265 to 1,836,098 16.3% 16.1 to 16.5 1,860,931 Ages 0-17 in poverty 618,946 to 634,234 23.9% 23.3 to 24.5 649,522 Ages 5-17 in families in 404,352 to 417,165 21.5% 20.8 to 22.2 poverty 429,978 Median household 45,487 to $45,803 income 46,119 United States All ages in poverty 48,217,869 to 48,452,035 15.9% 15.8 to 16.0 48,686,201 Ages 0-17 in poverty 16,262,247 to 16,386,500 22.5% 22.3 to 22.7 16,510,753 Ages 5-17 in families in 10,882,675 to 10,976,987 20.8% 20.6 to 21.0 poverty 11,071,299 Median household 50,429 to $50,502 income 50,575 (Source: U.S. Census Bureau, Small Area Income and Poverty Estimates, http://www.census.gov/did/www/saipe/data/interactive/#)

Federal Poverty Thresholds in 2012 by Size of Family and Number of Related Children Under 18 Years of Age

Size of Family No One Two Three Four Five Unit Children Child Children Children Children Children 1 Person $11,945 <65 years 1 Person $11,011 65 and > 2 people Householder $15,374 $15,825 < 65 years 2 People Householder $13,878 $15,765

65 and > 3 People $17,959 $18,480 $18,498

4 People $23,681 $24,069 $23,283 $23,364 5 People $28,558 $28,974 $28,087 $27,400 $26,981 6 People $32,847 $32,978 $32,298 $31,647 $30,678 $30,104 7 People $37,795 $38,031 $37,217 $36,651 $35,594 $34,362 8 People $42,271 $42,644 $41,876 $41,204 $40,249 $39,038 147 9 People or > $50,849 $51,095 $50,416 $49,845 $48,908 $47,620

(Source: U. S. Census Bureau, Poverty Thresholds 2012, http://www.census.gov/hhes/www/poverty/data/threshld/index.html)