2016 Crawford County & Galion City Community Health Status Assessment Commissioned by: Released May 16, 2016 FOREWORD Dear Community Member, Thank you for your concern for the health and well-being of Crawford County and the City of Galion. The data presented in this publication is the result of the 2015 health and needs status assessment of Crawford County and City of Galion adults. The data collected from Crawford County and Galion residents is reported along with health information from the Ohio Department of Health and relevant national, state, and local data sources. FOREWO Monitoring the health status of local residents to identify community health problems is an essential public health service. This health and needs status assessment is invaluable because it serves as a guide for strategic planning and decision-making. It can help our community identify new health concerns, measure the impact of current community health improvement efforts, and guide the judicious use of local resources. However, this is only one planning tool. A true plan of action for community health improvement will require taking a closer look at these survey results; seeking additional information from community residents, service providers, and others; identifying population(s) at risk for specific health conditions; and choosing effective strategies that will truly improve the health of Crawford County and Galion residents when put into action. This report would not exist without the financial support of community organizations and assistance of community leaders who all care about your health. The project was supported financially by the following organizations: Avita Health System, City of Bucyrus, Crawford County Education & Economic Development Partnership, Community Foundation for Crawford County, Crawford County Public Health, Crawford-Marion ADAMH Board, and Galion City Health Department. In addition, the following agencies worked on the planning committee: Avita Health System, City of Bucyrus, Community Counseling Services, Community Foundation for Crawford County, Crawford County Education & Economic Development Partnership, Crawford County Family & Children First Council, Crawford County Public Health, Crawford-Marion ADAMH Board, Galion City Health Department, and Wesley Chapel/Restore Ministries. Special thanks are given to Britney Ward from the Healthy Communities Foundation of the RD Hospital Council of Northwest Ohio for guiding this process. While data is useful, it is how people utilize this information that ultimately benefits the community. Please join the Crawford County Health Partners as we work together to improve the health and well-being of all Crawford County residents. We encourage you to be open to new ideas and collaborations. We also encourage you to remain optimistic and positive about the excellent work this community can do together. Sincerely, Kate Siefert, RS Trish Factor, MPH, MCHES, CHEP Administrator Health Commissioner Crawford County Public Health Galion City Health Department Nathan P. Benich, Co-Chairperson Stephanie Zmuda, RS, Co-Chairperson Emergency Planner/SIT Environmental Health Director Crawford County Public Health Galion City Health Department Cinda M. Kropka , MHA Compliance/ Ethics & Privacy Director Avita Health System This report has been funded by: Avita Health System City of Bucyrus Crawford County Education & Economic Development Partnership Community Foundation for Crawford County Crawford County Public Health Crawford-Marion ADAMH Board Galion City Health Department This report has been commissioned by the Crawford County Health Partners: Avita Health System City of Bucyrus Community Counseling Services Community Foundation for Crawford County Crawford County Education & Economic Development Partnership Crawford County Family & Children First Council Crawford County Public Health Crawford-Marion ADAMH Board Galion City Health Department Wesley Chapel/Restore Ministries The 2015 Crawford County Health Assessment is available on the following websites: Avita Health System - http://www.avitahealth.org Crawford County Public Health - http://crawfordhealth.com/ Galion City Health Department - http://galionhealth.org/ Hospital Council of Northwest Ohio - http://www.hcno.org/community/reports.html To see Crawford County data compared to other counties, please visit the Hospital Council of Northwest Ohio’s Data Link website at http://www.hcno.org/community/data-indicator.html. Project Management, Secondary Data, Data Collection, and Report Development ACKNOWLEDGEMENTS Hospital Council of Northwest Ohio Britney L. Ward, MPH Margaret Wielinski, MPH Director of Community Health Assistant Director of Community Improvement Health Improvement Michelle Von Lehmden Selena Coley, MPH Health Assessment Coordinator Community Health Improvement Coordinator Emily Golias, MPH Tessa Elliott Community Health Improvement Graduate Assistant Coordinator Ellie Roselle Derick Sekyere Graduate Assistant Graduate Assistant Data Collection & Analysis James H. Price, Ph.D., MPH Joseph A. Dake, Ph.D., MPH Emeritus Professor of Health Education Professor and Chair of Health Education University of Toledo University of Toledo Timothy R. Jordan, Ph.D., M.Ed. Professor of Health Education University of Toledo Contact Information Kate Siefert Stephanie Zmuda Crawford County Public Health Galion City Health Department 1520 Isaac Beal Road 113 Harding Way East Bucyrus, Ohio 44820 Galion, Ohio 44833 [email protected] [email protected] 419-562-5871 ext. 1213 419-468-1075 ext. 1265 TABLE OF CONTENTS EXECUTIVE SUMMARY PAGES 5-14 TREND SUMMARY PAGES 15-18 Adult Health (Ages 19 and Over) HEALTH STATUS PERCEPTIONS PAGES 19-20 HEALTH CARE COVERAGE PAGES 21-23 HEALTH CARE ACCESS AND UTILIZATION PAGES 24-26 CARDIOVASCULAR HEALTH PAGES 27-32 CANCER PAGES 33-37 DIABETES PAGES 38-41 ARTHRITIS PAGES 42-43 ASTHMA AND OTHER RESPIRATORY DISEASE PAGES 44-46 WEIGHT STATUS PAGES 47-49 TOBACCO USE PAGES 50-55 ALCOHOL CONSUMPTION PAGES 56-62 DRUG USE PAGES 63-69 WOMEN’S HEALTH PAGES 70-74 MEN’S HEALTH PAGES 75-79 PREVENTIVE MEDICINE AND HEALTH SCREENINGS PAGES 80-83 SEXUAL BEHAVIOR AND PREGNANCY OUTCOMES PAGES 84-88 QUALITY OF LIFE PAGES 89-90 SOCIAL CONTEXT AND SAFETY PAGES 91-98 MENTAL HEALTH AND SUICIDE PAGES 99-100 ORAL HEALTH PAGES 101-102 PARENTING PAGES 103-104 GALION CITY – HEALTHCARE ACCESS, COVERAGE AND UTILIZATION PAGES 105-106 GALION CITY – CHRONIC DISEASES AND RISKY BEHAVIORS PAGES 107-110 GALION CITY – SOCIAL CONTEXT AND SAFETY PAGE 111 Youth Health (Ages 12-18) TOBACCO USE PAGES 112-114 ALCOHOL CONSUMPTION PAGES 115-117 DRUG USE PAGES 118-121 YOUTH SAFETY AND VIOLENCE PAGE 122 YOUTH PERCEPTIONS PAGES 123-124 Appendices HEALTH ASSESSMENT INFORMATION SOURCES APPENDIX I PAGES 125-129 LIST OF ACRONYMS AND TERMS APPENDIX II PAGES 130-131 WEIGHTING METHODS APPENDIX III PAGES 132-134 SCHOOL PARTICIPATION APPENDIX IV PAGE 135 DEMOGRAPHIC PROFILE APPENDIX V PAGE 136 DEMOGRAPHICS AND HOUSEHOLD INFORMATION APPENDIX VI PAGES 137-144 COUNTY HEALTH RANKINGS APPENDIX VII PAGES 145-147 EXECUTIVE EXECUTIVE SUMMARY This executive summary provides an overview of health-related data for Crawford County adults (19 years of age and older) and youth (ages 12 through 18) who participated in a county- wide health assessment survey during 2015. The findings are based on self-administered surveys using a structured questionnaire. The questions were modeled after the survey instruments used by the Centers for Disease Control and Prevention for their national and state Behavioral Risk Factor Surveillance System (BRFSS) and Youth Risk Behavior Surveillance System (YRBSS). The Hospital Council of Northwest Ohio collected the data, guided the health assessment process and integrated sources of primary and secondary data into the final report. Primary Data Collection Methods DESIGN This community health assessment was cross-sectional in nature and included a written survey of adults and adolescents within Crawford County. From the beginning, community leaders were actively engaged in the planning process and helped define the content, scope, and sequence of the study. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid needs assessment. INSTRUMENT DEVELOPMENT One survey instrument was designed and pilot tested for adults for this study. As a first step in the design process, health education researchers from the University of Toledo and staff members from the Hospital Council of NW Ohio met to discuss potential sources of valid and reliable survey items that would be appropriate for assessing the health status and health needs of adults. The investigators decided to derive the majority of the adult survey items from the BRFSS. SUMMARY This decision was based on being able to compare local data with state and national data. The Project Coordinator from the Hospital Council of NW Ohio conducted a series of meetings with the planning committee from Crawford County. During these meetings, banks of potential survey questions from the BRFSS surveys were reviewed and discussed. Based on input from the Crawford County planning committee, the Project Coordinator composed drafts of the survey containing 115 items for the adult survey. The drafts were reviewed and approved by health education researchers at the University of Toledo. SAMPLING | Adult Survey Adults ages 19 and over living in Crawford County were used as the sampling frame for the adult survey. Since U.S. Census Bureau