First District Health Unit Community Health Assessment September 2015 Serving Bottineau, Burke, McHenry, McLean, Renville, Sheridan and Ward Counties Mission: The mission of public health is to make a positive impact on the health & welfare of the community through service, education, prevention and collaborative activities. Vision: Healthy People in Health Communities 1 Table of Contents EXECUTIVE SUMMARY ....................................................................................................... 4 ACKNOWLEDGEMENTS ..................................................................................................... 4 INTRODUCTION .................................................................................................................. 5 METHODOLOGY................................................................................................................. 7 FIRST DISTRICT HEALTH UNIT HISTORY................................................................................ 7 COMMUNITY DATA ............................................................................................................ 8 Physical Environment ...................................................................................................................................... 9 Geography .......................................................................................................................................................... 9 National Wildlife Refuges ................................................................................................................................ 11 Climate ............................................................................................................................................................... 11 Economy ........................................................................................................................................................ 12 Industry ............................................................................................................................................................... 12 Income ............................................................................................................................................................... 15 Employment ...................................................................................................................................................... 17 Demographics ............................................................................................................................................... 25 Transportation ................................................................................................................................................ 34 Education ....................................................................................................................................................... 35 Crime .............................................................................................................................................................. 39 Politics ............................................................................................................................................................. 46 CHRONIC DISEASE & COMMUNICABLE DISEASE .......................................................... 47 Chronic Disease ............................................................................................................................................ 47 Communicable Disease .............................................................................................................................. 53 HEALTH RISK BEHAVIORS ................................................................................................. 61 Nutrition .......................................................................................................................................................... 62 Physical Activity ............................................................................................................................................ 62 Tobacco Use .................................................................................................................................................. 63 Alcohol & Drugs ............................................................................................................................................. 64 Intentional and Unintentional Injury ............................................................................................................ 67 2 PREVENTIVE CARE ............................................................................................................ 69 ACCESS TO HEALTH CARE ............................................................................................... 72 Access to Health care: Coverage .............................................................................................................. 72 Access to Health care: Services ................................................................................................................. 73 Ambulance Services .................................................................................................................................... 73 Access to Health care: Timeliness .............................................................................................................. 74 Access to Health care: Workforce .............................................................................................................. 74 MATERNAL HEALTH .......................................................................................................... 89 MENTAL HEALTH ............................................................................................................... 92 ENVIRONMENTAL HEALTH ............................................................................................... 94 CAUSES OF HOSPITALIZATION & DEATH ......................................................................... 95 Causes of Hospitalization ............................................................................................................................. 95 Causes of Death ............................................................................................................................................ 96 COUNTY HEALTH RANKINGS ........................................................................................... 98 WINDSHIELD ASSESSMENT ............................................................................................. 101 Bottineau County ........................................................................................................................................ 105 McHenry County ......................................................................................................................................... 120 McLean County ........................................................................................................................................... 128 Renville County ........................................................................................................................................... 136 Sheridan County ......................................................................................................................................... 142 Ward County ................................................................................................................................................ 148 SURVEY REPORT .............................................................................................................. 158 REFERENCES ................................................................................................................... 197 3 Executive Summary This document provides an in depth community health assessment for First District Health Unit in North Dakota, including the counties of Bottineau, Burke, McHenry, McLean, Renville, Sheridan and Ward. The purpose of this document is to provide policy makers, community members and public health staff the information needed to identify risk factors that impact the health of the community. The document is organized into eleven sections that include: Community Data, Chronic Disease and Communicable Disease, Health Risk Behaviors, Preventive Care, Access to Health Care, Maternal Health, Mental Health, Environmental Health, Causes of Hospitalization & Death, County Health Rankings and Windshield Assessment. The findings for each section will illustrate where the health needs of each county need improvement. The findings indicate that the counties served by First District Health Unit have similar strengths and challenges, consistent with the other counties of North Dakota. Of the 7 counties in First District Health Unit, 6 are classified as “Oil Producing Counties”. Those counties face additional rewards and challenges because of the oil boom. The 2011 flood impacted all counties in First District and the impact of that disaster can still be seen in this health assessment. This community assessment will be reviewed and updated as determined by the First District Health Unit Board of Health. Acknowledgements First District Health Unit gratefully acknowledges the work and commitment of several individuals who assisted in the development of the Community Health Assessment. This document could not have been completed without the leadership, guidance, and vision of the Assessment Task Force Members: