2012 Community Health Status Assessment Sullivan County, Tennessee 2012 Community Health Status Assessment Acknowledgements: Sullivan County Regional Health Department Gary Mayes Barry Honeycutt Andrew Stephen May, MD, FAAFP Director Director of Operations Regional Medical Director Special Thanks To: Heather Mullins, MPH Regional Epidemiologist, Sullivan County Regional Health Department Christian L. Williams, MPH DrPH Candidate, ETSU College of Public Health Academic Health Department Coordinator, Sullivan County Regional Health Department East Tennessee State University, College of Public Health Students David Blackley, DrPH Billy Brooks, MPH Amber Hall, MPH Knox County Health Department Sullivan County Regional Health Department|ETSU College of Public Health 2 2012 Community Health Status Assessment Sullivan County Community Members, Improving the health of people in Sullivan County begins with a thorough understanding of the population’s health status as well as the underlying causes of those conditions that adversely affect our health. As such, the Sullivan County Regional Health Department in coordination with ETSU College of Public Health is pleased to present the 2012 Community Health Status Assessment (CHSA) for Sullivan County, Tennessee. The CHSA is one of four assessments that will be conducted over the next year as part of the Mobilizing for Action through Planning and Partnerships (MAPP) process to improve community health. This document serves as a snapshot of our community’s health and provides data for over 150 health indicators covered in ten sections. Those sections are: • Community description (including • Social and mental health demographics) • Maternal and child health • Access to health care and coverage • Death, illness and injury • Quality of life • Communicable disease • Behavioral risk factors • County health rankings • Environmental health indicators Each section provides a brief overview of the topic area, relevant morbidity and mortality data, and when applicable comparisons between county, state, and national data. This document addresses four main questions: 1) How healthy are our residents? 2) What does the health status of our community look like? 3) What health resources are available to Sullivan County Residents? and 4) In what areas do we excel and in what areas do we need to improve? This document should be used to identify priority health issues in Sullivan County, guide program planning, provide baseline data for programs/services, inform decision makers about Sullivan County residents’ health status, and help the community gain a better understanding of health disparities as they relate to health status. It is our sincerest hope that you will find this document useful and refer to it often when planning your own programs to help improve our county’s health. Sincerely, Andrew Stephen May, M.D., FAAFP Regional Medical Director Sullivan County Regional Health Department|ETSU College of Public Health 3 2012 Community Health Status Assessment Executive Summary The purpose of the Community Health Status Assessment (CHSA) is to develop a comprehensive health profile of Sullivan County in an effort to determine the health of its residents and their respective overall health status. The following table highlights the core health indicators included in the CHSA, providing a brief overview of Sullivan County’s strengths as well as challenging areas in need of improvement. Core Health Indicator Strengths Areas for Improvement/Challenges Employment: The unemployment Population: Since 2000, estimates rate in Sullivan County was 8.4% in indicate that the population of 60-69 2010, below the national and state year olds has increased by 24.89% unemployment rates 9.7% and while the population of 30-39 year olds 9.6% respectively. has decreased by 18.50%. Community Description Poverty: In 2010, approximately 18.4% of all people in Sullivan County were living below the poverty level (compared to 15.8% in 2005). Healthcare: Sullivan County’s Insurance: Only 74.8% of adults aged ration of physicians and dentists 18-44 reported having some kind of per 100,000 population exceeds health insurance in 2010. This is slightly those for the state. Sullivan County lower than the state at 78.4% for this has 289.5 physicians per 100,000 age group. population and 61.2 dentists per 100,000 population compared to Sullivan County has one of the highest Access to the state’s ratios of 246.1 and 52.2 rates of dental related emergency respectively. room visits. This reveals that while Health Care individuals may have access to health and Coverage insurance they may not have adequate coverage. *It should be noted that effects from Accountable Care Organization’s and the Affordable Care Act are not known at this time. Sullivan County Regional Health Department|ETSU College of Public Health 4 2012 Community Health Status Assessment Recreation: Sullivan County Recreation: Although Sullivan County residents have access to 17 boasts multiple options/venues for greenways and trails, 5 golf recreational activities, there is a need courses, and approximately 30 for additional marketing of these parks including sports complexes, activities within the community. soccer parks, skate parks, dog Furthermore, many residents feel they parks, and other facilities. cannot afford to take part in some of Sullivan County also boasts 4 these activities due to costs. community centers that offer Additionally, Sullivan County does not Quality of Life indoor games such as billiards, have many pedestrian friendly areas ping pong, and foosball. that allow residents to walk to their destinations safely. Health Perception: 78.6% of Sullivan County adults compared to 80.5% of Tennessee adults considered in general, that their health was excellent, very good, or good. Alcohol Use: In 2010, 22.7% of Cigarette Use: In 2010, 22.0% of adults Sullivan County adults reported in Sullivan County reported being current alcohol use compared to current smokers compared to 20.0% in 28.2% in TN and 54.6% in the US. TN and 17.01% in the US. Overweight/Obese: In 2010, 36.4% of adults in Sullivan County reported being obese and 36.5% reported being overweight based on their reported Behavioral height and weight. This is higher than Risk Factors the overall percentage for both Tennessee (31.7% and 36.1%) and the U.S (27.6% and 36.2%). In addition, approximately 41% of elementary students, 46% of middle school students, and 41% of high school students in Sullivan County are considered overweight or obese. Sullivan County Regional Health Department|ETSU College of Public Health 5 2012 Community Health Status Assessment Sullivan County meets current None at this time. standards for regulation of Ozone and Particulate Matter. Environmental Furthermore, Sullivan County has a Health communication and action plan in Indicators place that enables officials to respond to ozone action days in an appropriate manner. Homicide: The homicide rates in Social Support: In 2010, 11% of males Sullivan County have remained and 6% of females in Sullivan County consistently lower than those for reported that they rarely or never get Social and the state at 4.2 per 100,000 and all the social and/or emotional support Mental Health 7.89 per 100,000 respectively in that they need compared to 8% of 2007-2009. males and 5.8% of females in Tennessee. Child Mortality: Child mortality Infant Mortality: In 2009, the infant rates have consistently remained mortality rate for Sullivan County was below the state level and saw a 5% 9.38 per 1,000 live births. This rate was decrease in 2009. higher than the national and state rates at 6.39 and 7.98 respectively. The Adolescent Pregnancy Rates: The majority of infant deaths in Sullivan adolescent pregnancy rates for 15- County are due to sleep related causes 17 year olds for 2006-2010 and prematurity. In response, the consistently remained below the health department has increased Maternal and state level. education efforts through initiatives Child Health such as Project ABC. Tobacco Use during Pregnancy: In 2009, 29.0% of mothers reported smoking during pregnancy in Sullivan County. This is much higher than the national and state percentages of 18.4% and 10.4% respectively. Sullivan County Regional Health Department|ETSU College of Public Health 6 2012 Community Health Status Assessment Motor Vehicle Accidents: From Diabetes: In 2010, 8.7% of U.S. adults, 2007-2009, Sullivan County had 11.3% of adults in Tennessee, and 13.31 deaths per 100,000 due to 12.1% of adults in Sullivan County motor vehicle accidents. This was reported being told they had below the state rate of 19.23. Diabetes. Diseases of the Heart: In 2010, in Sullivan County 8.9% of adults reported suffering from a heart attack, 5.7% reported having angina or coronary heart disease, and 39.8% reported having high blood pressure. That same year, in Tennessee 5.2% of Death, Illness, adults reported suffering from a heart attack, 4.8% reported having angina or and Injury coronary heart disease, and 35.4% reported having high blood pressure. Malignant Neoplasms (Cancer): In Sullivan County the second leading cause of death is malignant neoplasm. Many lifestyle behaviors such as excessive drinking, tobacco use, and obesity can cause cancer. Unintentional Injury: In Sullivan County, the number one cause of death due to unintentional injury is poisoning followed by falls. Influenza Vaccine: In 2010, 46.2% Influenza Vaccine: In 2012, 9.26% of of Sullivan County adults reported reproductive women (between the receiving the flu vaccine compared ages of 10 and 50) received a flu shot to only 40.6% in Tennessee. from Sullivan County Regional Health Department. Furthermore, only 1.6% Pneumonia Vaccine: of pregnant women received their Approximately, 29.8% of Sullivan influenza vaccine. County adults reported receiving Communicable the pneumonia vaccine compared STDs: In Sullivan County, incidence Disease to only 25.8% in Tennessee. rates for Chlamydia and Gonorrhea continue to rise in the 15-24 age Childhood Immunizations: In 2012, group.