Community Health Assessment Indicators Pitt County

Question:

 

  1. Have you matched each of your indicators to the data available in the Appendix? If not, explain how and where you got the data needed for your proposed indicator.

 

 

 

 

·   STEP THREE:  SETTING HEALTH PRIORITIES

 

Using the information gathered in the first two steps, please answer the following questions.

Note: Keep in mind that in order to plan an effective intervention program in real life, you must communicate with other constituents and stakeholders and see what they perceive to be priority health issues. Collaboration with community stakeholders in program design is critical to the success of an intervention plan. For this purposes of this assignment, however, you are reviewing the data on your own, without the input from other stakeholders.

 

Questions:

 

  1. Looking at this data only, what would you conclude are three priority health issues for this population? (Can be picked by how the indicator compares)

 

 

 

  1. Choose three of your indicators. Compare them to the Healthy People 2020 Standards (or 2010 if appropriate) and provide URL(s) for the relevant Web page from Healthy People to the specific indicator.

 

 

  1. How do you explain the health disparities of these indicators? (i.e., as shown by this comparison with HP?]

 

 

You have completed this Application on assessment. Submit this completed form in the Dropbox following the submission instructions in the Week 5 Application area.

 

 

 

 

 

 APPENDIX 1: DATA TABLES

Community Health Assessment Indicators Pitt County (NC),

North Carolina, and the United States

 

 

 

Domain: Maternal and Child Health (2004) 
Indicator Pitt County North Carolina United States
Infant mortality rate per 1,000 live births(2004)   7.1     8.8     6.9
      Black infant mortality per 1,000 live births   8.1  15.6   14.1
      White infant mortality per 1,000 live births   7.0    6.2   5.8
Neonatal infant mortality rate per 1,000 live births(<28 days of age) (2000-2004) 5.7 6.0 4.6
      Black neonatal infant mortality rate   8.9 11.2   7.3
      White neonatal infant mortality rate   3.3   4.1   3.8
Low birth weight (<2,500 g) per 100 births(2004) 11.6     9.1   7.9
      Minority births <2500 g 15.9 13.4  13.0
      White births <2500 g   8.3   7.4   6.5
Very low birth weight (<1500 g) per 100 births(2000-2004) 2.8 1.9 1.4
      Minority births <1500 g   3.3   3.6   3.0
      White births <1500 g   2.4   1.0
Teen pregnancy rate per 1,000 teens(ages 15-19)(2000-2004) 39.8 64.1(11.9%)  83.6
      Minority pregnancies 54.5 87.3 153.3
      White pregnancies 27.0 53.6  71.4
Smoked during pregnancy   8.9  12.5  11.4
Postneonatal infant mortality per 1,000 live births (>28 days <1 year) (2000-2004) 1.4 2.8 2.3
      Black postneonatal rate   1.1   4.5   4.8
      White postneonatal rate   1.7   2.1   1.9
Immunization status at 2 years of age NA 82%
Immunization status at school entry NA 99%

 

 

 

 

 

 

 

BRFSS for 2004Age adjusted rates Pitt County North Carolina
Adult disability   28.3   25.0
Current asthma    7.1     6.4
Smoking: women of childbearing age    30.4   24.4
Smoking everyday: men    32.9   37.6
Obesity    26.1   22.7
Binge drinking (childbearing age)      9.5    6.8
Binge Drinking (all)    12.0    8.4
       Men    19.8
       Women      3.1
No leisure time physical activity    26.4   26.3
Are any firearms kept in your home    39.6   40.9

 

 

 

Domain: Access to Care
Indicator Pitt County North Carolina United States
% No medical insurance   20.8   17.5   16.5
% Children with no health insurance   14.3   12.5     9.8
% Children enrolled in  Medicaid   36.7   32.6   26.0
% Children enrolled in NC Health Choice     5.2     5.9   NA
Primary Care Physicians/100,000 population  149   83.5
Dentists/100,000 population   37.8   40.5   58.4
Kindergarten Tooth Decay Rates   27.7%    22%   26% whites36% A-A

43% Hispanic

BRFSS 2001 Eastern NC North Carolina
Cost as barrier to health insurance   16.5   11.5
No usual place of care   24.0   22.1
No dental insurance   52.7   45.3
Domain: Communicable Diseases
Indicator Pitt County North Carolina United States
TB rate per 100,000 population (2004)  5.0  4.5  4.9
Hepatitis A rate per 100,000 population2004: 17 cases 12.1(2004)  3.65(2003)  2.6(2003)
Hepatitis B rate per 100,000 population2004: 11 cases   7.0(2004)  1.9  2.6
Hepatitis C rate per 100,000 population2004: 4 cases  2.9  0.2  0.4

 

 

Domain:Sexually Transmitted Diseases
Indicator Pitt County  North Carolina United States
Gonorrhea rate per 100,000 population   347.8 181.3   113.5
      Black rate   848.3 673.8   629.6
      White rate     52.6   38.4     33.3
Chlamydia rate per 100,000 population   645.9 313.3   319.6
      Black rate 1206.4 929.7 1209.4
      White rate   216.2 116.3   143.6
Syphilis rate per 100,000 population       3.2    8.9       2.7
      Black rate       8.0  15.3       9.0
      White rate       1.3    1.1       1.6
HIV rate per 100,000 population     18.0  25.2      20.7
      Black  rate     38.8  76.6      76.3
      White rate       7.2    9.6        9.0

 

Domain: Cancer (2000)
Indicator Pitt County North Carolina United States
Lung Cancer
      Mortality rate per 100,000 population   68.7   61.6    54.2
      Incidence rate per 100,000   78.8   69.7    67.5
Breast Cancer (Female)
      Mortality rate per 100,000 females   27.7   26.5   14.4
      Female incidence per 100,000 females 167.5 149.5  132.2
Colon/Rectum Cancer
       Mortality rate per 100,000 population   22.7   20.0   19.1
        Incidence rate per 100,000 males   64.7   48.4   52.0
Prostate Cancer
      Mortality rate per 100,000 males   36.7   36.9    31.5
      Incidence rate per 100,000 males  154.5 152.5  166.7
Incidence All Cancer  494.3 445.3

 

 

 

 

 

 

Domain: Chronic Diseases
Indicator Pitt County N.C.(1999-2002) United States(2003)
Heart disease
      Mortality rate per 100,000 population 248.5  246.6 235.4
Stroke
      Mortality rate per 100,000 population   82.1   72.0  54.3
Diabetes
      Mortality rate per 100,000 population   34.3   27.4  25.4
COPD
      Mortality rate per 100,000 population   38.4   46.5  43.4
Youth death rates (Ages 0-17)/100,000  100.6   79.9

 

 

 

 

Domain: Environmental Health
Indicator Pitt County North Carolina United States
Lead (2004)     2.8 1.3 >1100 infants56% tested
Have you had an illness in the past 12 months that you think was caused by outdoor air pollutants?     9.1      12.0
Have you had an illness in the past 12 months that you think was caused by poor indoor air quality?    15.0      16.4

 

 

 

 

 

Domain: Injury and Violence
Indicator Pitt County North Carolina1999–2002 United States2003
Motor vehicle accidents
      Mortality rate per 100,000 population  19.6  19.2  15.2
Mortality
      Homicide rate per 100,000 population  11.2   7.6   5.9
      Suicide rate per 100,000 population(10-24 yr) 10.82 11.36  10.5
Violent Crime rate per 100,000 population (2004) 617.2 446.9
Accidents Unintentional injuries
      Mortality rate per 100,000 population   40.0  42.7  36.3
Child Maltreatment substantiated   18.1  14.5 12.3
Admissions to Juvenile Justice  38.6  34.1

 

 

 

Domain: Economic and Education
Indicator Pitt County North Carolina United States
Premature mortality rate per 100,000 populationunder 75 956 years 903 years 799 years
Percent below poverty level   17.5    15.2    12.4
Percent of children below poverty level   21.8    21.9    16.9
Unemployment rate     5.2      5.0      4.7
Percent children receiving food stamps   24.9    18.2 10.6 million(14%)
Percent children receiving free or reduced lunch   48.4    44.3    41.9
Public school dropout rate (9-12thgrade)2004-5      6.95        4.86    10.3%
High School completion (%)    56      86.1    85%
Percent >25 years of age with <9th grade education      7.6      7.8     7.5
Median Household income $ 33,734 46,335 50,046
Median per capita income $ 18,243 26,882 32,937
Migrant and seasonal workers number 6,606 (5.4%) 155,888(2.1%) 13 million(4.4%)

 

 

 

 

APPENDIX 2: Healthy People 2020

 

What Is Healthy People?

Healthy People 2020 provides science-based, 10-year national objectives for improving the health of all Americans.. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to:

  • Encourage collaborations across communities and sectors.
  • Empower individuals toward making informed health decisions.
  • Measure the impact of prevention activities

It can be used by many different people, states, communities, professional organizations, and others to help them develop programs to improve health.

Healthy People 2020 continues in this tradition with the launch on December 2, 2010 of its ambitious, yet achievable, 10-year agenda for improving the Nation’s health. Healthy People 2020 is the result of a multiyear process that reflects input from a diverse group of individuals and organizations.

 

What Are the Leading Health Indicators?

 

Healthy People 2020 provides a comprehensive set of 10-year, national goals and objectives for improving the health of all Americans. Healthy People 2020 contains 42 topic areas with nearly 600 objectives (with others still evolving), which encompass 1,200 measures. A smaller set of Healthy People 2020 objectives, called Leading Health Indicators, has been selected to communicate high-priority health issues and actions that can be taken to address them

. The Leading Health Indicators are composed of 26 indicators organized under 12 topics. The Healthy People 2020 Leading Health Indicators are:

  1. Access to Health Services                                  7.  Nutrition, Physical Activity, and Obesity

 

  1. Clinical Preventive Services                                  8.  Oral Health

 

 

  1. Environmental Quality                                           9.  Reproductive and Sexual Health

 

  1. Injury and Violence                                                10.  Social Determinants

 

  1. Maternal, Infant, and Child Health                       11. Substance Abuse

 

  1. Mental Health                                             .      12. Tobacco

 

 

 

 

http://www.healthypeople.gov/2020/about/default.aspx

 

 

 

 

 

 

 

 

 

 

 

Pitt County Municipalities Data:

 

Municipality Child<5 yrs Pop. Persons/square mile WhiteNon-Hispanic% African-America% Amer.Indian% Hispanic (#) % Asian%
Ayden   282   4,622   1992 47.6 49.5 0.2   (102)  2.2 0.2
Bethel   116   1,681   1618 40.2 58.1 0.0    (13)   0.8 0.1
Falkland     11      112  <112 68.8 30.4 0.0    (11)   9.8 0.0
Farmville   252   4,302   1431 47.4 50.1 0.1    (91)   2.1 0.2
Fountain     38     533     515 49.0 50.5 0.2      (3)   0.6 0.0
Greenville 3,361 60,476   2298 61.4 34.1 (181) 0.3 (1,244) 2.1 (1,098)1.8
Grifton   122   2,073   1188 63.2 33.2 0.0     (98)  4.7 0.2
Grimesland     19      440     850 62 29.1 0.0    (39)  8.9 0.2
Simpson     32      464   1125 56 42.5 0.0    (13)  2.8 0.0
Winterville    399   4,791   1877 58.7 38.4 0.5     (49) 1.0 0.1
Total 4,603  75,624 (1573)
Pitt County 8,653 133,798     216 62.1 33.6 (357)0.3 (4,216) 3.2 (1,443)1.1
North Carolina 72.1 21.6 1.2   4.7 1.4
U.S. 75.1 12.3 0.9 12.5 3.6

 

MunicipalitiesCounty/State MedianFamily

Income

% < HSEducation Families below poverty In labor force>16 years of age Median travel to work(min) %  nowmarried

(>15 yrs of age)

Ayden 34,808 30% 21% 53.1% X 45%
Bethel 35,278 40% 18.5% 49.2% 25 42.5%
Falkland 43,750 40%  5.0 57.4% 18 36%
Farmville 38,918 27.4% 14.6 57.5% 18.7 44.6%
Fountain 26,042 41% 35.6 51.6% 20.4 48%
Greenville 44,491 14%  9.0 66.3% 17.9 35.9%
Grifton 40,875 27% 12.2 55.9% 23.4 58.3%
Grimesland 36,250 40% 12.3 58.3% 22.9 53.5%
Simpson 47,500 23.6% 14.2 63.6% 17 56.6%
Winterville 47,167 16.6% 10.3 71.2% 25.5 56.7%
Pitt County 43,971 20% 13.5 65.8% X 47%
North Carolina 46,335 22%  9.0 65.7% X 56.3
U.S. 50,046 19.6%  9.2 63.9% 25.5 54.4

 

http://factfinder.census.gov               http://www.city-data.com/city

 

 

 

Disclaimer regarding interpretation of data in this Community Assessment:

 

Various sources of data have been used in the development of this teaching case  including but not limited to vital statistics, the 2004 BRFSS survey, N.C. Communicable Disease Control Branch reports, N.C. County Health Data Book, U.S. Census  American Fact Finder, N.C. Child Advocacy Institute, N.C. Child Fatality Task Force.

The data in this report is not to be relied on for actual assessment activities because of various limitations including: different time periods for data collections and a small number of events during the reported time period. These factors subject the results to chance variation. Longer time periods of data collection are required before inferences can be made. For a full discussion of the issues and up-to-date data, refer to the report of the North Carolina State Center of Health Statistics, http://www.schs.state.nc.us/SCHS/.

 

 

Resources for Community Assessment

 

Advocates for Youth

 

Cecil G. Sheps Center for Health Services Research – University of North Carolina,   Chapel Hill

http://www.shepscenter.unc.edu/Data.html

http://www.shepscenter.unc.edu/hp/prof04.htm

 

Center for Disease Control and Prevention – STD Surveillance 2004

http://www.cdc.gov/std/stats/toc2004.htm

 

Center for Health Services Research and Development, East Carolina University

http://www.chsrd.med.ecu.edu

 

CLIKS: community-Level Information for Kids

http://www.aecf.org/cgi-bin/cliks.cgi

 

Employment Security commission of North Carolina – Labor & Wage Unit, Labor Market Information Division

http://eslmi23.esc.state.nc.us/ew/

 

Environmental Defense Fund

http://www.scorecard.org/

 

Geographic.org

http://www.geographic.org

 

Guttmacher Institute

http://www.guttmacher.org/pubs/fb_teens.html

 

Institute of Research in Social Science at University of North Carolina, Chapel Hill

http://unc.edu/depts/irss/

 

Log into North Carolina (LINK)

http://data.osbm.state.nc.us/pis/linc/dyn_linc_main.show

 

North Carolina Child Advocacy Institute

Home

 

 

North Carolina Child Fatality Task Force

www.preventchildabusenc.org/publications/press_releases/cftf

 

North Carolina Communicable Disease Control

http://www.epi.state.nc.us/epi/gcdc.html

 

North Carolina Crime Statistics

http://sbi2.jus.state.nc.us/crp/public/default.htm

 

North Carolina Department of Agriculture

http://www.agr.state.nc.us/stats/

 

North Carolina Department of Commerce

http://www.commerce.state.nc.us

 

North Carolina Department of Health and Human Services – Division of Medical Assistance

http://www.dhhs.state.nc.us.dma/

 

North Carolina Department of Health and Human Services – HIV/STD Prevention & Care Branch

http://www.epi.state.nc.us.epi/hiv/surveillance.html

 

North Carolina Department of Public Instruction

http://www.dpi.state.nc.us

 

North Carolina Department of Transportation Public Transportation Division

http://www.dot.state.nc.us/transit/transitnet/

 

North Carolina Division of Public Health – Oral Health Section

http://www.communityhealth.dhhs.state.nc.us/dental/

 

North Carolina Division of Public Health – Women’s and Children’s Health Section

http://wch.dhhs.state.nc.us/

 

North Carolina Employment Security Commission

http://esc.state.nc.us

 

North Carolina Office of State Planning

http://www/ospi.state.nc.us

 

North Carolina State Bureau of Investigation

http://sbi.jus.state.nc.us

 

North Carolina State Center for Health Statistics (NC-SCHS)

http://www.schs.state.nc.us/SCHS/index.html

 

North Carolina Rural Data Bank (by county)

http://www.ncruralcenter.org/databank/profile

 

Public Schools of North Carolina

http://www.ncpublicschools.org/accountability/reporting/sat/2005

 

State of North Carolina

http://www.state.nc.us

 

University of North Carolina Highway Safety Research Center

Home

[*]This case study exercise adapted by Lloyd F. Novick, MD, MPH and Jorg Westermann, PhD, from Cibula, D. A, Novick, L. F., Morrow, C. B., & Sutphen, S. M. (2003). Community health assessment. American Journal of Preventive Medicine, 24(4S), 118–123.

 

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