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Adair County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H ADAIR County A Look Back To Move Forward Teen Pregnancy Physical Activity, Wellness & Diabetes 4 5 County Health Department Usage 6 Health Care Costs Summary 7 Turning Point 7 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Adair County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Tobacco Use 4 4 Poverty 5 OK By One - State Immunization Date 8 million a year in medical costs in Adair County. Alzheimer’s disease and the complications associ-ated has increased from the 16th ranked cause of death (1983-1993) to the 11th leading cause of death in persons 65 and older accounting for a 233% increase in deaths. same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 31.3% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the (6,750) of people in Adair County were considered obese which accounted for an addi-tional $2,666,250 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Top 10 Leading Causes of Death Demographics Nutrition and Obesity killed 786 people in Adair County and is still the leading cause of death among all age groups. Ac-cording the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 67 deaths a year, heart disease accounts for almost $25 The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Adair County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease Heart disease accounts for almost $25 million a year in medical costs in Adair County. STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Vital Statistics, Health Care Information Systems, OSDH & * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 14% increase 1990 to 2000 (18,421 to 21,038) o state increase = 10% o 3.1% increase from 2000 to 2004 o Ranked 16th for growth in state 2000 Census • Hispanic/Latino ethnicity = 3% • Race o Whites = 48.5% o Native Americans = 42.5% o Blacks = 0.2% o Other/Multiple = 8.8% • Age o Under 5 = 7.5% o Over 64 = 12.0% o Median age = 33.2 years • Housing units o Occupied = 7,471 (89.5%) o Vacant = 877 (10.5%) • Disability (ages 21 to 64) = 26.6% state = 21.5% national = 19.2% • Families below poverty = 19.4% state = 11.2% national = 9.2% Adair County Population Growth with Projections 0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.00% 0.10% 0.20% 0.30% 0.40% 0.50% 0.60% 0.70% 0.80% 0.90% 1.00% Percent of State Population Adair % OF STATE Top 10 Causes of Death by Age Group Adair County 1993-2003 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages 1 CONGENITAL ANOMALIES UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY CANCER CANCER CANCER HEART DISEASE HEART DISEASE 13 5 32 16 24 55 108 585 738 2 PERINATAL PERIOD HEART DISEASE HOMICIDE/ LEGAL HOMICIDE/ LEGAL UNINTENT. INJURY HEART DISEASE HEART DISEASE CANCER CANCER 11 1 5 8 18 37 92 323 517 3 UNINTENT. INJURY HOMICIDE/ LEGAL CANCER SUICIDE HEART DISEASE UNINTENT. INJURY DIABETES MELLITUS STROKE STROKE 5 1 4 7 17 18 26 155 188 4 SIDS HYPERTENSION SUICIDE HEART DISEASE HOMICIDE/ LEGAL DIABETES MELLITUS STROKE INFLUENZA/ PNEUMONIA UNINTENT. INJURY 3 1 3 3 7 11 19 81 148 5 STROKE SUICIDE HEART DISEASE DIABETES MELLITUS STROKE LIVER DISEASE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA DIABETES MELLITUS 2 1 2 2 6 11 16 76 109 6 HEART DISEASE OTHER OTHER HIV LIVER DISEASE STROKE UNINTENT. INJURY DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA 1 1 5 2 6 5 12 67 95 7 CANCER CANCER SUICIDE SUICIDE LIVER DISEASE UNINTENT. INJURY INFLUENZA/ PNEUMONIA 1 2 6 5 5 42 88 8 OTHER CONGENITAL ANOMALIES DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA KIDNEY DISEASE KIDNEY DISEASE SEPTICEMIA (BLOOD POISONING) 8 1 3 3 4 26 33 9 LIVER DISEASE HIV HOMICIDE/ LEGAL SEPTICEMIA (BLOOD POISONING) SEPTICEMIA (BLOOD POISONING) LIVER DISEASE 1 3 3 4 26 31 10 OTHER INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA TWO CAUSES TIED ATHERO-SCLEROSIS KIDNEY DISEASE 7 2 3 3 25 30 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, Oklahoma State Department of Health July 2005 problem of the individual but also the community as a whole. With health care costs on the rise, target-ing areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Behavioral Risk Factor Surveillance System, it is estimated that 22.8% (4,917) of people in Adair County use tobacco of some sort. Medical costs accu-mulated by those per-sons are over $16 million a year for Adair County. According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Adair County. Unintentional injuries are the leading cause of death from ages 5 to 34 and the 2nd cause of death in ages 35 to 44 in Adair County. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Adair County which has an average of 9.4 motor vehicle-related deaths a year, that translates to over $10 million a year. Violence-related injuries (homicide and suicide) in Adair County are ranked in the top 10 in five of the eight age groups (see Top 10 list on page 3). (9,533) of people in Adair County had no leisure ac-tivity in the past month at the time they were sur-veyed. The BRFSS also indicated that 10.4% (2,243) of Adair County citizens have been diagnosed by a health professional as having dia- The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 44.2% betes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $29,704,049 in one year for Adair County. Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes “Medical costs accumulated by those persons are over $16 million a year for Adair County” STATE OF THE COUNTY’S HEALTH REPORT Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Adair County, 1999-2003 0 2 4 6 8 10 12 14 16 1999 2000 2001 2002 2003 Year of Death Number of Deaths Drowning Falls Fires/Burns Homicide MVC Poisonings Suicide * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control ADAIR COUNTY Rate of Live Births to Teen Mothers,Ages 15-19, Adair County, 1993 to 2003 0 20 40 60 80 100 120 140 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Adair Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 23.2% of persons in Adair County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Adair County is 58% above the state (14.7%) and 87% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Adair County had a teen birth rate of 101.7 in 2003 which was a 14% increase from 2002 (88.9) and a 9% increase since 1993 (93.6). With an average of 85 births per year, teen pregnancy costs the citizens of Adair County $272,000.00 a year. Note: 13 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 20,552 1,762 3,008 3,479 3,012 9,291 Cumulative Population 1,762 4,770 8,249 11,261 20,552 % of Total 100.0% 8.6% 14.6% 16.9% 14.7% 45.2% Cumulative % 8.6% 23.2% 40.1% 54.8% 100.0% Income to Poverty Ratio, Adair County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. ADAIR COUNTY Motor Vehicle-Related Injury Death • Average 9.4 deaths per year • $1,120,000.00 in economic costs per death • Total—$10,528,000.00 a year Tobacco Use • 22.8% of population (4,928) • $3,300.00 in health care costs • Total—$16,262,400.00 a year Diabetes • 10.4% of population (2,248 ) • $13,243.00 in healthcare costs a year • Total—$29,770,264.00 a year Teen Pregnancy • Average of 85 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $272,000.00 a year Cardiovascular Disease (Heart Disease) • Average 67 deaths a year • $369,476.69 per death • Total— $24,754,938.23 a year Obesity • 31.3% of population ( 6,765 ) • $395.00 in additional medical costs per person • Total—$2,672,175.00 Page 7 County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Adair County: $84,259,777.23 Health Care Costs Summary Attended Appointments for Adair County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning STD Communicable Disease Take Charge! Dysplasia Children First Adult Services Child Health Guidance Tuberculosis Early Intervention The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the department of health, local communities, and policy-makers. The Oklahoma Turning point engine is fueled by a community-based decision making process whereby local communities tap into the capacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the public health system, and the public’s health. ADAIR COUNTY Page 8 Looking Back to Move Forward OKLAHOMA STATE DEPARTMENT OF HEALTH Phone: 405-271-6127 Fax: 405-271-1225 Email: neil@health.ok.gov Community Development Service 1000 NE 10th St, Rm 508 Oklahoma City, OK 73117 Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH Oklahoma Community Partners in Public Health Innovation Alfalfa County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Alfalfa County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Al-falfa County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control costs are reflecting this downward spi-ral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2001-2005, 3% (103) of people in Alfalfa County were considered obese which accounted for an additional in medical costs for the county. These costs are underestimated because they With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the same rate as the nation, and health care do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity still the leading cause of death among all age groups. According to the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 30.1 deaths a year, heart disease accounts for over $11 million a year in medical costs in The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Alfalfa County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 432 people in Alfalfa County and is STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 5% decrease from 1990 to 2000 (6,416 to 6,105) o 5% decrease from 2000 to 2004 o Ranked 68th for growth in state 2000 Census • Hispanic/Latino ethnicity = 3% • Race o Whites = 89% o Native Americans =3% o Blacks =4% o Other/Multiple = 4% • Age o Under 5 = 5% o Over 64 = 20% o Median age = 42.3 years • Housing units o Occupied = 2,199 (78%) o Vacant = 633 (22%) • Disability (ages 21 to 64) = 18.2% national = 19.2% state = 21.5% • Individuals below poverty = 13.7% national = 12.4% state = 14.7% Alfalfa County Population Growth with Projections 5,400 5,500 5,600 5,700 5,800 5,900 6,000 6,100 6,200 6,300 6,400 6,500 1990 1991992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.00% 0.05% 0.10% 0.15% 0.20% 0.25% Percent of State Population Alfalfa Percent of Population Alfalfa County. Alzheimer’s disease and the complications associated with it have decreased from the 11th ranked cause of death (1983-1993) to the 14th ranked cause of death in persons 65 and older ac-counting for a 57% decrease in deaths. Heart disease accounts for over $11 million a year in medical costs in Alfalfa County. No Data Available At This Time ALFALFA COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY SUICIDE CANCER HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE 4 2 5 4 3 10 31 287 332 HEART DISEASE HEART DISEASE HEART DISEASE HIV SUICIDE CANCER CANCER CANCER CANCER 1 1 1 2 2 8 17 136 164 PERINATAL PERIOD SUICIDE CONGENITAL ANOMALIES UNINTENT. INJURY UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE 1 1 1 2 5 6 71 74 OTHER UNINTENT. INJURY DIABETES MELLITUS DIABETES MELLITUS UNINTENT. INJURY INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA 1 1 1 2 5 58 60 OTHER INFLUENZA/ PNEUMONIA VIRAL HEPATITIS STROKE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA 1 1 2 2 35 41 OTHER STROKE DIABETES MELLITUS DIABETES MELLITUS UNINTENT. INJURY 1 1 2 20 40 LIVER DISEASE SEPTICEMIA (BLOOD POISONING) KIDNEY DISEASE DIABETES MELLITUS 1 2 17 25 OTHER INFLUENZA/ PNEUMONIA UNINTENT. INJURY KIDNEY DISEASE 2 1 16 18 LIVER DISEASE ATHERO-SCLEROSIS ATHERO-SCLEROSIS 1 12 12 OTHER PNEUMONITIS TWO CAUSES TIED 7 12 12 Data source: Vital Statistics , Health Care Information Division, O klahoma State Department of Health Produced by: Community Development Service, Community Health Services, O klahoma State Department of Health Top 10 Causes of Death by Age Group Alfalfa County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Alfalfa County are ranked in the top 10 in three of the eight age groups (see Top 10 list on page 3). the community as a whole. With health care costs on the rise, targeting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a per-son that used tobacco accrued over $3,300 in health care costs per year. According to the Behavioral Risk Fac-tor Surveillance System, it is estimated that n/a% ( ) of people in Alfalfa County use tobacco of some sort. Medical costs accumulated by those persons are According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the problem of the individual but also Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Alfalfa County. Unintentional injuries are the leading cause of death from ages 5 to 24. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Alfalfa County which has an average of 1.2 motor vehicle-related deaths a year, that translates to over $1 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that n/a% (#VALUE!) of people in Alfalfa County Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri- #VALUE! $ million a year for Alfalfa County. “Medical costs accumulated by those persons are #VALUE! $ million a year for Alfalfa County” had no leisure activity in the past falfa County. month at the time they were surveyed. The BRFSS also indicated that n/a% ( ) of Alfalfa County citizens have been diagnosed by a health professional as having diabetes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumulated health care costs of in one year for Al- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Alfalfa County, 1999 - 2003 0 0.5 1 1.5 2 2.5 1999 2000 2001 2002 2003 Year of Death Number of Deaths FIRES/BURNS MVC POISONINGS SUICIDE No Data Available At This Time No Data Available At This Time *No homicides/legal intervention or poisoning deaths occurred during this time period While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control ALFALFA COUNTY Rate of Live Births to Teen Mothers, Ages 15-19, Alfalfa County, 1993 to 2003 0 10 20 30 40 50 60 70 80 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Alfalfa Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 13.7% of persons in Alfalfa County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Alfalfa County is 7% below the state (14.7%) and 11% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Alfalfa County had a teen birth rate of 42.6 in 2003 which was a 20% increase from 2002 (35.5) and a 82% increase since 1993 (23.4). With an average of 6 births per year, teen pregnancy costs the citizens of Alfalfa County $19,200.00 a year. Note: births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 5,028 178 512 722 696 2,920 Cumulative Population 178 690 1,412 2,108 5,028 % of Total 100.0% 3.5% 10.2% 14.4% 13.8% 58.1% Cumulative % 3.5% 13.7% 28.1% 41.9% 100.0% Income to Poverty Ratio, Alfalfa County, 2000 Census Unstable Rate Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. ALFALFA COUNTY Motor Vehicle-Related Injury Death • Average 1.2 deaths per year • $1,120,000.00 in economic costs per death • Total—$1,344,000.00 a year Tobacco Use • Data Not Available At This Time Diabetes • Data Not Available At This Time Teen Pregnancy • Average of 6 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $19,200.00 a year Cardiovascular Disease (Heart Disease) • Average 30 deaths a year • $369,476.69 per death • Total— $11,084,300.70 a year Obesity • Data Not Available At This Time Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Alfalfa County: $12,447,500.70 Health Departments Services Received by Alfalfa County Residents by County Health Department, State Fiscal Year 05 0% 20% 40% 60% 80% 100% Adult Services Child Health Early Intervention Family Planning STD Tuberculosis Health Department Service Percent of Visits Garfield Grant Major Woods Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Oklahoma Community Partners in P ublic H ealth In novation Page 8 STATE OF THE COUNTY’S HEALTH REPORT 1000 NE 10th St, Room 508 Oklahoma City, OK 73117 Phone: 405-271-6127 Fax: 405-271-1225 Email: miriamm@health.ok.gov Atoka County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Atoka County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Atoka County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 20.1% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 2,843 ) of people in Atoka County were considered obese which accounted for an addi-tional $1,122,985 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity still the leading cause of death among all age groups. According the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 56.4 deaths a year, heart disease accounts for almost $21 million a year in medical costs The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Atoka County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 694 people in Atoka County and is STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 9% increase from 1990 to 2000 (12,778 to 13,879) o 3% increase from 2000 to 2004 o Ranked 17th for growth in state 2000 Census • Hispanic/Latino ethnicity = 1% • Race o Whites = 76% o Native Americans =11% o Blacks =6% o Other/Multiple = 7% • Age o Under 5 = 6% o Over 64 = 15% o Median age = 38.3 years • Housing units o Occupied = 4,964 (88%) o Vacant = 709 (12%) • Disability (ages 21 to 64) = 25.8% national = 19.2% state = 21.5% • Individuals below poverty = 19.8% national = 12.4% state = 14.7% Atoka County Population Growth with Projections 0 5,000 10,000 15,000 20,000 25,000 1990 1991992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.37% 0.38% 0.39% 0.40% 0.41% 0.42% 0.43% 0.44% 0.45% 0.46% 0.47% Percent of State Population Atoka Percent of Population in Atoka County. Alzheimer’s disease and the complications associ-ated with it have increased from the 18th ranked cause of death (1983-1993) to the 10th ranked cause of death in persons 65 and older accounting for a 900% increase in deaths. Heart disease accounts for almost $21 million a year in medical costs in Atoka County. ATOKA COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages CONGENITAL ANOMALIES UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE 5 4 15 14 15 28 66 514 620 PERINATAL PERIOD BRONCHITIS/ EMPHYSEMA/ ASTHMA HEART DISEASE SUICIDE HEART DISEASE CANCER CANCER CANCER CANCER 5 1 1 6 7 15 61 235 321 SIDS PERINATAL PERIOD HOMICIDE/ LEGAL HEART DISEASE CANCER UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA INFLUENZA/ PNEUMONIA STROKE 3 1 1 4 7 8 12 78 90 UNINTENT. INJURY SUICIDE CANCER SUICIDE LIVER DISEASE STROKE STROKE UNINTENT. INJURY 1 1 3 5 7 12 75 87 OTHER LIVER DISEASE LIVER DISEASE SUICIDE UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA INFLUENZA/ PNEUMONIA 6 2 3 5 10 53 83 HOMICIDE/ LEGAL HOMICIDE/ LEGAL STROKE LIVER DISEASE DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA 1 2 3 4 30 67 INFLUENZA/ PNEUMONIA DIABETES MELLITUS DIABETES MELLITUS KIDNEY DISEASE KIDNEY DISEASE DIABETES MELLITUS 1 1 3 4 30 35 OTHER INFLUENZA/ PNEUMONIA BRONCHITIS/ EMPHYSEMA/ ASTHMA SUICIDE SEPTICEMIA (BLOOD POISONING) KIDNEY DISEASE 5 1 1 3 20 35 OTHER HIV INFLUENZA/ PNEUMONIA UNINTENT. INJURY LIVER DISEASE 8 1 2 20 26 FOUR CAUSES TIED THREE CAUSES TIED ALZHEIMER'S DISEASE SUICIDE 1 1 10 23 Data source: Vital Statistics , Health Care Information Division, O klahoma State Department of Health Produced by: Community Development Service, Community Health Services, O klahoma State Department of Health Top 10 Causes of Death by Age Group Atoka County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Atoka County are ranked in the top 10 in five of the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Atoka County. Unintentional injuries are the leading cause of death from ages 5 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Atoka County which has an average of 4.4 motor vehicle-related deaths a year, that translates to almost $5 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 33.8% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 31.6% (4,469) of people in Atoka County use tobacco of some sort. Medical costs accumulated by those persons are al-most $15 million a year for Atoka County. “Medical costs accumulated by those persons are almost $15 million a year for Atoka County” tes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $14,421,627.00 in one year for Atoka County. (4,780 ) of people in Atoka County had no leisure ac-tivity in the past month at the time they were sur-veyed. The BRFSS also indicated that 7.7% (1,089 ) of Atoka County citizens have been diagnosed by a health pro-fessional as having diabe- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Atoka County, 1999 - 2003 0 1 2 3 4 5 6 7 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS HOMICIDE MVC POISONINGS SUICIDE While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control ATOKA COUNTY Rate of Live Births to Teen Mothers, Ages 15-19, Atoka County, 1993 to 2003 0 20 40 60 80 100 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Atoka Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 19.8% of persons in Atoka County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Atoka County is 34% above the state (14.7%) and 59% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Atoka County had a teen birth rate of 50.1 in 2003 which was a 41% decrease from 2002 (84.4) and a 33% decrease since 1993 (74.4). With an average of 29 births per year, teen pregnancy costs the citizens of Atoka County $92,800.00 a year. Note: 4 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 12,282 1,018 1,408 2,147 1,534 6,175 Cumulative Population 1,018 2,426 4,573 6,107 12,282 % of Total 100.0% 8.3% 11.5% 17.5% 12.5% 50.3% Cumulative % 8.3% 19.8% 37.2% 49.7% 100.0% Income to Poverty Ratio, Atoka County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. ATOKA COUNTY Motor Vehicle-Related Injury Death • Average 4.4 deaths per year • $1,120,000.00 in economic costs per death • Total—$4,928,000.00 a year Tobacco Use • 31.6% of population (4,469) • $3,300.00 in health care costs • Total—$14,747,700.00 a year Diabetes • 7.7% of population (1,089 ) • $13,243.00 in healthcare costs a year • Total—$14,421,627.00 a year Teen Pregnancy • Average of 29 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $92,800.00 a year Cardiovascular Disease (Heart Disease) • Average 56 deaths a year • $369,476.69 per death • Total— $20,690,694.64 a year Obesity • 20.1% of population ( 2,843 ) • $395.00 in additional medical costs per person • Total—$1,122,985.00 Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Atoka County: $56,003,806.64 Attended Appointments for Atoka County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning General Child Health Children First Dysplasia Tuberculosis STD Communicable Disease Chronic Disease Take Charge! Adult Services The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Oklahoma Community Partners in Public Health Innovation Page 8 STATE OF THE COUNTY’S HEALTH REPORT Atoka County Health Department 1006 W 13th St Atoka, OK 74525 580-889-2116 Atoka & Coal Counties Partnership For Change Community Coalition We want to thank all the people and organizations that make the Partnership for Change Community Coalition successful. Thank you! • American Cancer Society • Atoka & Coalgate Chamber of Commerce • Atoka Community Chest • Atoka First Baptist Church • Atoka/Coalgate Hospital • Big Five Community Action Agency/Sorts Transit • Choctaw Nation CORE Capacity/Healthy Life-styles/ Project CHILD • Coal and Atoka County Health Departments • Coal and Atoka County Public Schools • Coalgate Register • COALition • Community members at large • County Commissioners • Department of Human Services • Girl Scouts 1000 NE 10th St, Room 508 Oklahoma City, OK 73117 405-271-6127 Email: neilh@health.ok.gov • Head Start • INCA Community Action Agency/Jamm Transit • Kiamichi Technology Center • Oklahoma State Department of Health Turning Point • Oklahoma State University Cooperative Extension Service • School Based Social Workers • Senior Nutrition Center • Southeast Oklahoma Division on Aging (SODA) • Tri-County Indian Nations Community Development Corporation • USDA • Women, Infants and Children (WIC) • Youth Beaver County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Beaver County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Bea-ver County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 33.7% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 1,881 ) of people in Beaver County were considered obese which accounted for an addi-tional $742,995 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity still the leading cause of death among all age groups. According the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 17.6 deaths a year, heart disease accounts for almost $7 million a year in medical costs in The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Beaver County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 239 people in Beaver County and is STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 3% decrease from 1990 to 2000 (6,023 to 5,857) o 6% decrease from 2000 to 2004 o Ranked 75th for growth in state 2000 Census • Hispanic/Latino ethnicity = 11% • Race o Whites = 93% o Native Americans =1% o Blacks =0% o Other/Multiple = 6% • Age o Under 5 = 6% o Over 64 = 17% o Median age = 39.3 years • Housing units o Occupied = 2,245 (83%) o Vacant = 474 (17%) • Disability (ages 21 to 64) = 15.1% national = 19.2% state = 21.5% • Individuals below poverty = 11.7% national = 12.4% state = 14.7% Beaver County Population Growth with Projections 5,200 5,300 5,400 5,500 5,600 5,700 5,800 5,900 6,000 6,100 6,200 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.00% 0.05% 0.10% 0.15% 0.20% 0.25% Percent of State Population Beaver Percent of Population Beaver County. Alzheimer’s disease and the complications associ-ated with it have increased from the 14th ranked cause of death (1983-1993) to the 9th ranked cause of death in persons 65 and older accounting for a 300% increase in deaths. Heart disease accounts for almost $7 million a year in medical costs in Beaver County. BEAVER COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages PERINATAL PERIOD SUICIDE UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY CANCER HEART DISEASE HEART DISEASE HEART DISEASE 3 2 8 3 5 10 17 167 195 CONGENITAL ANOMALIES OTHER STROKE SUICIDE HEART DISEASE UNINTENT. INJURY CANCER CANCER CANCER 1 1 2 2 2 10 12 112 137 CANCER OTHER CANCER HEART DISEASE NON-CANCEROUS TUMOR ATHERO-SCLEROSIS UNINTENT. INJURY 1 1 2 8 3 35 42 BRONCHITIS/ EMPHYSEMA/ ASTHMA DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE 1 2 3 32 36 LIVER DISEASE NON-CANCEROUS TUMOR DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA ATHERO-SCLEROSIS 1 1 3 24 35 NUTRITIONAL DEFICIENCY BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA 1 1 2 20 29 OTHER LIVER DISEASE INFLUENZA/ PNEUMONIA UNINTENT. INJURY DIABETES MELLITUS 1 1 2 14 25 NUTRITIONAL DEFICIENCY UNINTENT. INJURY INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA 1 2 13 15 SUICIDE HYPERTENSION ALZHEIMER'S DISEASE ALZHEIMER'S DISEASE 1 1 12 12 OTHER OTHER TWO CAUSES TIED SUICIDE 3 3 5 10 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, Oklahoma State Department of Health Top 10 Causes of Death by Age Group Beaver County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Beaver County are ranked in the top 10 in three of the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Beaver County. Unintentional injuries are the leading cause of death from ages 15 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Beaver County which has an average of 1.6 motor vehicle-related deaths a year, that translates to almost $2 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 28.1% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 22.3% (1,245) of people in Beaver County use tobacco of some sort. Medical costs accumulated by those persons are over $4 million a year for Beaver County. “Medical costs accumulated by those persons are over $4 million a year for Beaver County” tes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $1,178,627.00 in one year for Beaver County. (1,569 ) of people in Beaver County had no leisure ac-tivity in the past month at the time they were sur-veyed. The BRFSS also indicated that 1.6% (89 ) of Beaver County citizens have been diagnosed by a health pro-fessional as having diabe- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Beaver County, 1999 - 2003 0 0.5 1 1.5 2 2.5 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS MVC SUICIDE While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control BEAVER COUNTY Rate of Live Births to Teen Mothers,Ages 15-19, Beaver County, 1993 to 2003 0 10 20 30 40 50 60 70 80 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Beaver Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 11.7% of persons in Beaver County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Beaver County is 20% below the state (14.7%) and 6% below the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Beaver County had a teen birth rate of 41.2 in 2003 which was a 8% decrease from 2002 (44.8) and a 19% increase since 1993 (34.5). With an average of 9 births per year, teen pregnancy costs the citizens of Beaver County $28,800.00 a year. Note: 1 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 5,748 226 447 606 574 3,895 Cumulative Population 226 673 1,279 1,853 5,748 % of Total 100.0% 3.9% 7.8% 10.5% 10.0% 67.8% Cumulative % 3.9% 11.7% 22.3% 32.2% 100.0% Income to Poverty Ratio, Beaver County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. BEAVER COUNTY Motor Vehicle-Related Injury Death • Average 1.6 deaths per year • $1,120,000.00 in economic costs per death • Total—$1,792,000.00 a year Tobacco Use • 22.3% of population (1,245) • $3,300.00 in health care costs • Total—$4,108,500.00 a year Diabetes • 1.6% of population (89 ) • $13,243.00 in healthcare costs a year • Total—$1,178,627.00 a year Teen Pregnancy • Average of 9 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $28,800.00 a year Cardiovascular Disease (Heart Disease) • Average 18 deaths a year • $369,476.69 per death • Total— $6,650,580.42 a year Obesity • 33.7% of population ( 1,881 ) • $395.00 in additional medical costs per person • Total—$742,995.00 Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Beaver County: $14,501,502.42 Attended Appointments for Beaver County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning Children First Guidance Maternity General Child Health Adult Services Communicable Disease Chronic Disease STD Tuberculosis Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Oklahoma Community Partners in Public Health Innovation Page 8 STATE OF THE COUNTY’S HEALTH REPORT Beaver County Health Department PO Box 520 Beaver, OK 73932 580-625-3693 Beaver County Health Department PO Box 520 Beaver, OK 73932 580-625-3693 Beaver Health Awareness Partnership We want to thank all the people and organizations that make the Beaver Health Awareness Partnership such a huge success. With successes such as helping to recruit a physician and conducting a community health assessment and future plans of developing a wellness/fitness center, you are paving the way to a healthier future for all residents of Beaver County. Thank you! Beaver County Health Department First Security Bank Bank of Beaver City Beaver County Memorial Hospital Nutrition Site OSU Extension Herald Democrat City of Beaver Howard Drilling Company Community Clinic Downing’s Market Beaver Senior Citizens Area Agency on Aging Hardberger & Smylie OEDA Department of Human Services XCEL Energy EMT Howard Auto Supply Assembly of God Church O’Laughlin Center, Spearman TX Chamber of Commerce Trippett and Kee Law Office SW Kansas Technical School M & M Consultants Beckham County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Beckham County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Beckham County. We will take a look back to discover what has been affecting the health of the citizens in order to move forward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2001-2005, 24.5% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 4,874 ) of people in Beckham County were considered obese which accounted for an addi-tional $1,925,230 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity and is still the leading cause of death among all age groups. Accord-ing to the Centers for Disease Control, al-most $400,000 is spent on each heart disease-related death. With an average of 94.7 deaths a year, heart disease accounts for almost $35 million a year in medical costs The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Beckham County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 1,032 people in Beckham County STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 5% increase from 1990 to 2000 (18,812 to 19,799) o 3% decrease from 2000 to 2004 o Ranked 58th for growth in state 2000 Census • Hispanic/Latino ethnicity = 5% • Race o Whites = 87% o Native Americans =3% o Blacks =6% o Other/Multiple = 5% • Age o Under 5 = 6% o Over 64 = 15% o Median age = 36.6 years • Housing units o Occupied = 7,356 (84%) o Vacant = 1,440 (16%) • Disability (ages 21 to 64) = 24.8% national = 19.2% state = 21.5% • Individuals below poverty = 18.2% national = 12.4% state = 14.7% Beckham County Population Growth with Projections 0 5,000 10,000 15,000 20,000 25,000 30,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.51% 0.52% 0.53% 0.54% 0.55% 0.56% 0.57% 0.58% 0.59% 0.60% 0.61% Percent of State Population Beckham Percent of Population in Beckham County. Alzheimer’s disease and the complications associated with it have increased from the 16th ranked cause of death (1983-1993) to the 10th ranked cause of death in persons 65 and older ac-counting for a 380% in-crease in deaths. Heart disease accounts for almost $35 million a year in medical costs in Beckham County. BECKHAM COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages PERINATAL PERIOD UNINTENT. IN JURY UNINTENT. IN JURY UNINTENT. IN JURY UNINTENT. IN JURY HEART DISEASE CANCER HEART DISEASE HEART DISEASE 9 6 25 14 20 37 98 909 1042 UNINTENT. IN JURY AORTIC ANEURYSM SUICIDE SUICIDE CANCER CANCER HEART DISEASE CANCER CANCER 6 1 8 6 13 35 79 336 486 SIDS HEART DISEASE CANCER HEART DISEASE HEART DISEASE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE 4 1 2 4 10 8 18 276 297 CONGENITAL ANOMALIES INFLUENZA/ PNEUMONIA ANEMIA HIV SUICIDE UNINTENT. IN JURY UNINTENT. IN JURY BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA 3 1 1 2 8 8 11 159 186 HOMICIDE/ LEGAL CANCER BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE STROKE STROKE INFLUENZA/ PNEUMONIA UNINTENT. IN JURY 2 1 1 1 5 7 7 83 123 ATHERO-SCLEROSIS OTHER STROKE HOMICIDE/ LEGAL HOMICIDE/ LEGAL LIVER DISEASE DIABETES MELLITUS DIABETES MELLITUS INFLUENZA/ PNEUMONIA 1 1 1 1 2 7 6 41 93 HEART DISEASE HEART DISEASE CANCER INFLUENZA/ PNEUMONIA DIABETES MELLITUS SEPTICEMIA (BLOOD POISOINING) KIDNEY DISEASE DIABETES MELLITUS 1 1 1 2 6 5 38 53 HERNIA HIV OTHER LIVER DISEASE SUICIDE SUICIDE SEPTICEMIA (BLOOD POISOINING) SEPTICEMIA (BLOOD POISOINING) 1 1 8 2 5 5 37 43 OTHER HOMICIDE/ LEGAL CONGENITAL ANOMALIES INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA UNINTENT. IN JURY KIDNEY DISEASE 6 1 1 3 3 33 40 INFLUENZA/ PNEUMONIA TWO CAUSES TIED CONGENITAL ANOMALIES LIVER DISEASE ALZHEIMER'S DISEASE SUIC IDE 1 1 2 3 24 38 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, Oklahoma State Departm ent of Health 9 10 7 8 Top 10 Causes of Death by Age Group Beckham County 1993-2003 5 6 1 2 3 4 and suicide) in Beckham County are ranked in the top 10 in six of the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Beckham County. Unintentional inju-ries are the leading cause of death from ages 5 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Beckham County which has an average of 4.4 motor vehicle-related deaths a year, that translates to almost $5 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 38.8% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 32.3% (6,426) of people in Beckham County use tobacco of some sort. Medical costs accumulated by those persons are over $21 million a year for Beckham County. “Medical costs accumulated by those persons are over $21 million a year for Beckham County” ing diabetes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $30,299,984.00 in one year for Beckham County. (7,719 ) of people in Beckham County had no leisure activity in the past month at the time they were surveyed. The BRFSS also indicated that 11.5% (2,288 ) of Beckham County citizens have been diagnosed by a health professional as hav- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Beckham County, 1999 - 2003 0 1 2 3 4 5 6 7 8 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS HOMICIDE MVC POISONINGS SUICIDE *No homicides/legal intervention or poisoning deaths occurred during this time period While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control BECKHAM COUNTY Rate of Live Births to Teen Mothers, Ages 15-19, Beckham County, 1993 to 2003 0 10 20 30 40 50 60 70 80 90 100 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Beckham Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 18.2% of persons in Beckham County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Beckham County is 24% above the state (14.7%) and 46% above the na-tion (12.4%) for persons with in-comes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Beckham County had a teen birth rate of 76.3 in 2003 which was a 0% decrease from 2002 (76.5) and a 6% decrease since 1993 (81.5). With an average of 52 births per year, teen pregnancy costs the citizens of Beckham County $166,400.00 a year. Note: 7 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 17,884 1,224 2,023 2,387 2,277 9,973 Cumulative Population 1,224 3,247 5,634 7,911 17,884 % of Total 100.0% 6.8% 11.3% 13.3% 12.7% 55.8% Cumulative % 6.8% 18.2% 31.5% 44.2% 100.0% Income to Poverty Ratio, Beckham County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. BECKHAM COUNTY Motor Vehicle-Related Injury Death • Average 4.4 deaths per year • $1,120,000.00 in economic costs per death • Total—$4,928,000.00 a year Tobacco Use • 32.3% of population (6,426) • $3,300.00 in health care costs • Total - $21,205,800.00 a year Diabetes • 11.5% of population (2,288 ) • $13,243.00 in healthcare costs a year • Total—$30,299,984.00 a year Teen Pregnancy • Average of 52 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $166,400.00 a year Cardiovascular Disease (Heart Disease) • Average 95 deaths a year • $369,476.69 per death • Total— $35,100,285.55 a year Obesity • 24.5% of population ( 4,874 ) • $395.00 in additional medical costs per person • Total—$1,925,230.00 Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Beckham County: $93,625,699.55 Attended Appointments for Beckham County Health Department, State Fiscal Year 05 Immunizations STD Child Health Family Planning Chronic Disease Children First Tuberculosis Communicable Disease Adult Services WIC Dysplasia Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Oklahoma Community Partners in P ublic H ealth In novation Page 8 STATE OF THE COUNTY’S HEALTH REPORT 1000 NE 10th St, Room 508 Oklahoma City, OK 73117 Phone: 405-271-6127 Fax: 405-271-1225 Email: miriamm@health.ok.gov Beckham County Health Department 400 East Third St Elk City, OK 73644 580-225-1173 Blaine County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Blaine County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Blaine County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 36.6% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 4,274 ) of people in Blaine County were considered obese which accounted for an addi-tional $1,688,230 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity still the leading cause of death among all age groups. According to the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 61.9 deaths a year, heart disease accounts for almost $23 million a year in medical costs The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Blaine County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 767 people in Blaine County and is STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 4% increase from 1990 to 2000 (11,470 to 11,976) o 6% decrease from 2000 to 2004 o Ranked 73rd for growth in state 2000 Census • Hispanic/Latino ethnicity = 7% • Race o Whites = 76% o Native Americans =9% o Blacks =7% o Other/Multiple = 8% • Age o Under 5 = 6% o Over 64 = 17% o Median age = 37.6 years • Housing units o Occupied = 4,159 (80%) o Vacant = 1,049 (20%) • Disability (ages 21 to 64) = 20.7% national = 19.2% state = 21.5% • Individuals below poverty = 16.9% national = 12.4% state = 14.7% Blaine County Population Growth with Projections 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.29% 0.30% 0.31% 0.32% 0.33% 0.34% 0.35% 0.36% 0.37% 0.38% Percent of State Population Blaine Percent of Population in Blaine County. Alzheimer’s disease and the complications associ-ated with it have increased from the 18th ranked cause of death (1983-1993) to the 11th ranked cause of death in persons 65 and older accounting for a 250% increase in deaths. Heart disease accounts for almost $23 million a year in medical costs in Blaine County. BLAINE COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages CONGENITAL ANOMALIES UNINTENT. IN JURY UNINTENT. IN JURY UNINTENT. IN JURY UNINTENT. IN JURY HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE 5 5 9 15 15 23 51 594 681 PERINATAL PERIOD SUIC IDE HOMICIDE/ LEGAL HEART DISEASE CANCER CANCER CANCER CANCER 4 5 3 11 15 48 275 345 HOMICIDE/ LEGAL HOMICIDE/ LEGAL SUIC IDE CANCER UNINTENT. IN JURY STROKE STROKE STROKE 2 2 3 6 11 8 102 116 SIDS HERNIA STROKE INFLUENZA/ PNEUMONIA STROKE UNINTENT. IN JURY INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA 2 1 2 2 4 7 96 100 UNINTENT. IN JURY HEART DISEASE LIVER DISEASE LIVER DISEASE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA UNINTENT. IN JURY 2 2 2 4 6 68 98 OTHER HIV GALLBLADDER DISORDER DIABETES MELLITUS DIABETES MELLITUS DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA 5 1 1 3 4 41 74 CANCER HIV SUICIDE HYPERTENSION UNINTENT. IN JURY DIABETES MELLITUS 1 1 3 2 34 48 KIDNEY DISEASE MENINGITIS KIDNEY DISEASE LIVER DISEASE KIDNEY DISEASE KIDNEY DISEASE 1 1 2 2 31 34 OTHER SUICIDE VIRAL HEPATITIS SUIC IDE PNUEMONITIS SUIC IDE 5 1 2 2 17 20 OTHER THREE CAUSES TIED SIX CAUSES TIED SEPTICEMIA (BLOOD POISOINING) PNUEMONITIS 10 1 1 15 18 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, Oklahoma State Departm ent of Health Top 10 Causes of Death by Age Group Blaine County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Blaine County are ranked in the top 10 in sixof the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Blaine County. Unintentional injuries are the leading cause of death from ages 5 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Blaine County which has an average of 4.8 motor vehicle-related deaths a year, that translates to over $5 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 34.8% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 32.4% (3,784) of people in Blaine County use tobacco of some sort. Medical costs accumulated by those persons are over $12 million a year for Blaine County. “Medical costs accumulated by those persons are over $12 million a year for Blaine County” tes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $12,527,878.00 in one year for Blaine County. (4,064 ) of people in Blaine County had no leisure ac-tivity in the past month at the time they were sur-veyed. The BRFSS also indicated that 8.1% (946 ) of Blaine County citizens have been diagnosed by a health pro-fessional as having diabe- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Blaine County, 1999 - 2003 0 1 2 3 4 5 6 7 8 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS HOMICIDE MVC POISONINGS SUICIDE While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control BLAINE COUNTY Rate of Live Births to Teen Mothers,Ages 15-19, Blaine County, 1993 to 2003 0 10 20 30 40 50 60 70 80 90 100 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Blaine Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 16.9% of persons in Blaine County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Blaine County is 15% above the state (14.7%) and 36% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Blaine County had a teen birth rate of 76.1 in 2003 which was a 111% increase from 2002 (36.1) but a 8% decrease since 1993 (82.7). With an average of 29 births per year, teen pregnancy costs the citizens of Blaine County $92,800.00 a year. Note: 4 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 10,378 549 1,202 1,408 1,322 5,897 Cumulative Population 549 1,751 3,159 4,481 10,378 % of Total 100.0% 5.3% 11.6% 13.6% 12.7% 56.8% Cumulative % 5.3% 16.9% 30.4% 43.2% 100.0% Income to Poverty Ratio, Blaine County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. BLAINE COUNTY Motor Vehicle-Related Injury Death • Average 4.8 deaths per year • $1,120,000.00 in economic costs per death • Total—$5,376,000.00 a year Tobacco Use • 32.4% of population (3,784) • $3,300.00 in health care costs • Total—$12,487,200.00 a year Diabetes • 8.1% of population (946 ) • $13,243.00 in healthcare costs a year • Total—$12,527,878.00 a year Teen Pregnancy • Average of 29 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $92,800.00 a year Cardiovascular Disease (Heart Disease) • Average 62 deaths a year • $369,476.69 per death • Total— $22,907,554.78 a year Obesity • 36.6% of population ( 4,274 ) • $395.00 in additional medical costs per person • Total—$1,688,230.00 Page 7 County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Blaine County: $55,079,662.78 Attended Appointments for Blaine County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning Children First Tuberculosis Child Health Take Charge! Dysplasia Maternity Adult Services Adolescent Health Chronic Disease General STD Guidance Communicable Disease Health Care Costs Summary Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Page 8 STATE OF THE COUNTY’S HEALTH REPORT 1000 NE 10th St, Rm 508 Oklahoma City, OK 73117 Phone: 405-271-6127 Fax: 405-271-1225 Email: neil@health.ok.gov Blaine County Health Department 521 W 4th Watonga, OK 73772 580-623-7977 Oklahoma Community Partners in Public Health Innovation Blaine County Community Health Action Team & Geary Community Health Care We want to say thank you to all the members of the Blaine County Community Health Action Team and Geary Community Health Care. Blaine County Community Health Action Team • Blaine County Health Department • Roman Nose State Park • Department of Human Services • Oklahoma Commission for Children and Youth • YWCA • Business Owners • Preventionworks • Watonga Police Department • Faith Community • County Judge Geary Community Health Care • Geary Schools • Parkview Hospital • Chamber of Commerce • Emergency Medical Services • Nursing Home Board • Local Physicians • Local Pharmacist • Concerned Citizens • Local Business • Blaine County Health Department Bryan County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Bryan County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Bryan County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 17.1% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 6,379 ) of people in Bryan County were considered obese which accounted for an addi-tional $2,519,705 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity is still the leading cause of death among all age groups. According the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 136.2 deaths a year, heart disease accounts for over $50 million a year in medical costs in The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Bryan County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 1,529 people in Bryan County and STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 14% increase from 1990 to 2000 (32,089 to 36,534) o 3% increase from 2000 to 2004 o Ranked 13th for growth in state 2000 Census • Hispanic/Latino ethnicity = 3% • Race o Whites = 80% o Native Americans =«Indian %» o Blacks =1% o Other/Multiple = 6% • Age o Under 5 = 6% o Over 64 = 15% o Median age = 35.8 years • Housing units o Occupied = 14,422 (86%) o Vacant = 2,293 (14%) • Disability (ages 21 to 64) = 26.3% national = 19.2% state = 21.5% • Individuals below poverty = 18.4% national = 12.4% state = 14.7% Bryan County Population Growth with Projections 0 10,000 20,000 30,000 40,000 50,000 60,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.90% 0.95% 1.00% 1.05% 1.10% 1.15% 1.20% Percent of State Population Bryan Percent of Population Bryan County. Alzheimer’s disease and the complications associ-ated with it have increased from the 16th ranked cause of death (1983-1993) to the 10th ranked cause of death in persons 65 and older accounting for a 173% increase in deaths. Heart disease accounts for over $50 million a year in medical costs in BryanCounty. BRYAN COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages PERINATAL PERIOD UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY CANCER CANCER HEART DISEASE HEART DISEASE 15 11 23 28 31 69 166 1261 1499 CONGENITAL ANOMALIES BRONCHITIS/ EMPHYSEMA/ ASTHMA SUICIDE HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE CANCER CANCER 4 1 13 7 25 53 148 689 943 UNINTENT. INJURY HEART DISEASE HOMICIDE/ LEGAL SUICIDE CANCER UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE 3 1 3 6 13 14 20 202 229 HOMICIDE/ LEGAL HOMICIDE/ LEGAL HEART DISEASE HOMICIDE/ LEGAL SUICIDE LIVER DISEASE STROKE INFLUENZA/ PNEUMONIA BRONCHITIS/ EMPHYSEMA/ ASTHMA 2 1 2 5 12 12 16 182 202 SEPTICEMIA (BLOOD POISOINING) CANCER INFLUENZA/ PNEUMONIA CANCER HIV DIABETES MELLITUS UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA UNINTENT. INJURY 2 1 1 4 5 10 14 174 202 SIDS OTHER OTHER STROKE VIRAL HEPATITIS SUICIDE DIABETES MELLITUS DIABETES MELLITUS INFLUENZA/ PNEUMONIA 2 2 6 2 5 9 13 97 199 HEART DISEASE HIV STROKE STROKE INFLUENZA/ PNEUMONIA KIDNEY DISEASE DIABETES MELLITUS 1 2 4 5 11 81 125 INFLUENZA/ PNEUMONIA DIABETES MELLITUS DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA LIVER DISEASE SEPTICEMIA (BLOOD POISOINING) SEPTICEMIA (BLOOD POISOINING) 1 1 4 4 7 78 85 CANCER OTHER BRONCHITIS/ EMPHYSEMA/ ASTHMA HOMICIDE/ LEGAL SUICIDE UNINTENT. INJURY KIDNEY DISEASE 1 15 3 4 7 78 83 OTHER HOMICIDE/ LEGAL THREE CAUSES TIED HYPERTENSION ALZHEIMER'S DISEASE SUICIDE 8 3 2 4 30 60 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, OK State Dept. of Health July-05 Top 10 Causes of Death by Age Group Bryan County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Bryan County are ranked in the top 10 in Seven of the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Bryan County. Unintentional injuries are the leading cause of death from ages 5 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Bryan County which has an average of 9.4 motor vehicle-related deaths a year, that translates to almost $11 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 30.7% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 35.6% (13,281) of people in Bryan County use tobacco of some sort. Medical costs accumulated by those persons are al-most $44 million a year for Bryan County. “Medical costs accumulated by those persons are almost $44 million a year for Bryan County” tes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $36,060,689.00 in one year for Bryan County. (11,453 ) of people in Bryan County had no lei-sure activity in the past month at the time they were surveyed. The BRFSS also indicated that 7.3% (2,723 ) of Bryan County citizens have been diagnosed by a health pro-fessional as having diabe- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Bryan County, 1999 - 2003 0 2 4 6 8 10 12 14 16 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS HOMICIDE MVC POISONINGS SUICIDE While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control BRYAN COUNTY Rate of Live Births to Teen Mothers,Ages 15-19, Bryan County, 1993 to 2003 0 10 20 30 40 50 60 70 80 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Bryan Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 18.4% of persons in Bryan County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Bryan County is 25% above the state (14.7%) and 48% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Bryan County had a teen birth rate of 63.2 in 2003 which was a 8% decrease from 2002 (68.4) and a 14% decrease since 1993 (73.9). With an average of 89 births per year, teen pregnancy costs the citizens of Bryan County $284,800.00 a year. Note: 15 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 35,521 2,503 4,026 4,653 4,679 19,660 Cumulative Population 2,503 6,529 11,182 15,861 35,521 % of Total 100.0% 7.0% 11.3% 13.1% 13.2% 55.3% Cumulative % 7.0% 18.4% 31.5% 44.7% 100.0% Income to Poverty Ratio, Bryan County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. Attended Appointments for Bryan County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning Early Intervention Children First Communicable Disease Guidance Take Charge! Adolescent Health General Dysplasia Chronic Disease Adult Services STD Child Health Tuberculosis BRYAN COUNTY Motor Vehicle-Related Injury Death • Average 9.4 deaths per year • $1,120,000.00 in economic costs per death • Total—$10,528,000.00 a year Tobacco Use • 35.6% of population (13,281) • $3,300.00 in health care costs • Total—$43,827,300.00 a year Diabetes • 7.3% of population (2,723 ) • $13,243.00 in healthcare costs a year • Total—$36,060,689.00 a year Teen Pregnancy • Average of 89 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $284,800.00 a year Cardiovascular Disease (Heart Disease) • Average 136 deaths a year • $369,476.69 per death • Total— $50,248,829.84 a year Obesity • 17.1% of population ( 6,379 ) • $395.00 in additional medical costs per person • Total—$2,519,705.00 Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Bryan County: $143,469,323.84 1000 NE 10th St, Rm 508 Oklahoma City, OK 73117 Phone: 405-271-6127 Fax: 405-271-1225 Email: neil@health.ok.gov Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH Bryan County Turning Point Coalition The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Bryan County Health Department 1524 W Chuckwa PO Box 598 Durant, Oklahoma 74702-0598 580-924-4285 Oklahoma Community Partners in Public Health Innovation Page 8 STATE OF THE COUNTY’S HEALTH REPORT We want to say Thank You to all the people that make the Bryan County Turning Point Coa-lition such a huge success. • Bryan County Health Department • Bryan County Coalition • Bryan County Community Council • Turning Point Coalition • Durant Public Schools • Choctaw Nation Community Health Programs/ Health Services • Durant Chamber of Commerce • Durant Kiwanis Club • Durant Lions Club • OSU Extension Service • Medical Center of Southeastern Oklahoma • Success by Six Initiative • City of Durant—Parks & Recreation Department • Southeast Oklahoma Division on Aging ( SODA) • Chickasaw Nation Health Services Caddo County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Caddo County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Caddo County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 32.8% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 9,863 ) of people in Caddo County were considered obese which accounted for an addi-tional $3,895,885 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity is still the leading cause of death among all age groups. According to the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 127.5 deaths a year, heart disease accounts for over $47 million a year in medical costs in The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Caddo County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 1,452 people in Caddo County and STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 2% increase from 1990 to 2000 (29,550 to 30,150) o 0% increase from 2000 to 2004 o Ranked 40th for growth in state 2000 Census • Hispanic/Latino ethnicity = 6% • Race o Whites = 66% o Native Americans =24% o Blacks =3% o Other/Multiple = 7% • Age o Under 5 = 7% o Over 64 = 15% o Median age = 36.0 years • Housing units o Occupied = 10,957 (84%) o Vacant = 2,139 (16%) • Disability (ages 21 to 64) = 22.5% national = 19.2% state = 21.5% • Individuals below poverty = 21.7% national = 12.4% state = 14.7% Caddo County Population Growth with Projections 27,000 28,000 29,000 30,000 31,000 32,000 33,000 34,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.70% 0.75% 0.80% 0.85% 0.90% 0.95% 1.00% Percent of State Population Caddo Percent of Population Caddo County. Alzheimer’s disease and the complications associ-ated with it have increased from the 12th ranked cause of death (1983-1993) to the 9th ranked cause of death in persons 65 and older accounting for a 231% increase in deaths. Heart disease accounts for over $47 million a year in medical costs in Caddo County. CADDO COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages PERINATAL PERIOD UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE 15 8 52 31 34 65 135 1167 1402 CONGENITAL ANOMALIES HEART DISEASE SUICIDE HOMICIDE/ LEGAL HEART DISEASE CANCER CANCER CANCER CANCER 13 3 7 9 24 54 117 547 742 SIDS CONGENITAL ANOMALIES HOMICIDE/ LEGAL SUICIDE CANCER UNINTENT. INJURY STROKE STROKE STROKE 4 1 5 6 18 23 28 244 287 HEART DISEASE OTHER COMPLICATED PREGNANCY CANCER LIVER DISEASE LIVER DISEASE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA UNINTENT. INJURY 3 2 2 5 11 19 26 162 239 INFLUENZA/ PNEUMONIA HEART DISEASE DIABETES MELLITUS HOMICIDE/ LEGAL DIABETES MELLITUS DIABETES MELLITUS INFLUENZA/ PNEUMONIA BRONCHITIS/ EMPHYSEMA/ ASTHMA 3 2 4 10 11 25 141 193 SEPTICEMIA (BLOOD POISONING) NON-CANCEROUS TUMOR STROKE DIABETES MELLITUS SUICIDE UNINTENT. INJURY DIABETES MELLITUS DIABETES MELLITUS 2 1 3 6 10 21 114 160 STROKE STROKE HEART DISEASE HIV STROKE LIVER DISEASE UNINTENT. INJURY INFLUENZA/ PNEUMONIA 1 1 3 5 6 16 69 158 HOMICIDE/ LEGAL CONGENITAL ANOMALIES INFLUENZA/ PNEUMONIA SUICIDE SEPTICEMIA (BLOOD POISONING) SEPTICEMIA (BLOOD POISONING) KIDNEY DISEASE KIDNEY DISEASE 1 1 3 5 5 9 68 79 KIDNEY
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Okla State Agency | Health, Oklahoma State Department of |
Okla Agency Code | '340' |
Title | State of the county health reports, 2005 |
Alternative title | 2005 county health profiles |
Authors |
Oklahoma. State Department of Health. McGaugh, Miriam Jane, 1975- Baker, Kelly (Kelly M.) |
Publisher | Oklahoma State Department of Health |
Publication Date | 2006 |
Subject | Public health--Oklahoma. |
Purpose | Individual county reports bear series title State of the county's health report; The following reports focus on health factors for the citizens of each county in Oklahoma.; Topics covered are demographics, leading causes of death, nutrition & obesity, injury & violence, tobacco use, physical activity & diabetes, teen pregnancy, poverty, health care costs and Turning Point. |
Contents | 77 county reports; County Demographics; Top 10 Leading Causes of Death; Nutrition & Obesity; Top 10 Leading Causes of Death Table; Injury & Violence; Tobacco use; Physical Activity, Wellness & Diabetes; Teen Pregnancy; Poverty; OK by One-State Immunization Data; County Health Department; Health Care Costs Summary; Turning Point |
Notes | as of 4/1/10 URL on agency website is www.ok.gov/health/Community_Health/Community_Development_Service/Community_Epidemiology/County_Health_Profiles/ |
OkDocs Class# | H850.3 S797c 2006 |
Digital Format | PDF, Adobe Reader required; compiled by Oklahoma Publications Clearinghouse from webpage using Adobe Professional |
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Full text | Adair County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H ADAIR County A Look Back To Move Forward Teen Pregnancy Physical Activity, Wellness & Diabetes 4 5 County Health Department Usage 6 Health Care Costs Summary 7 Turning Point 7 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Adair County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Tobacco Use 4 4 Poverty 5 OK By One - State Immunization Date 8 million a year in medical costs in Adair County. Alzheimer’s disease and the complications associ-ated has increased from the 16th ranked cause of death (1983-1993) to the 11th leading cause of death in persons 65 and older accounting for a 233% increase in deaths. same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 31.3% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the (6,750) of people in Adair County were considered obese which accounted for an addi-tional $2,666,250 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Top 10 Leading Causes of Death Demographics Nutrition and Obesity killed 786 people in Adair County and is still the leading cause of death among all age groups. Ac-cording the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 67 deaths a year, heart disease accounts for almost $25 The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Adair County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease Heart disease accounts for almost $25 million a year in medical costs in Adair County. STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Vital Statistics, Health Care Information Systems, OSDH & * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 14% increase 1990 to 2000 (18,421 to 21,038) o state increase = 10% o 3.1% increase from 2000 to 2004 o Ranked 16th for growth in state 2000 Census • Hispanic/Latino ethnicity = 3% • Race o Whites = 48.5% o Native Americans = 42.5% o Blacks = 0.2% o Other/Multiple = 8.8% • Age o Under 5 = 7.5% o Over 64 = 12.0% o Median age = 33.2 years • Housing units o Occupied = 7,471 (89.5%) o Vacant = 877 (10.5%) • Disability (ages 21 to 64) = 26.6% state = 21.5% national = 19.2% • Families below poverty = 19.4% state = 11.2% national = 9.2% Adair County Population Growth with Projections 0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.00% 0.10% 0.20% 0.30% 0.40% 0.50% 0.60% 0.70% 0.80% 0.90% 1.00% Percent of State Population Adair % OF STATE Top 10 Causes of Death by Age Group Adair County 1993-2003 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages 1 CONGENITAL ANOMALIES UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY CANCER CANCER CANCER HEART DISEASE HEART DISEASE 13 5 32 16 24 55 108 585 738 2 PERINATAL PERIOD HEART DISEASE HOMICIDE/ LEGAL HOMICIDE/ LEGAL UNINTENT. INJURY HEART DISEASE HEART DISEASE CANCER CANCER 11 1 5 8 18 37 92 323 517 3 UNINTENT. INJURY HOMICIDE/ LEGAL CANCER SUICIDE HEART DISEASE UNINTENT. INJURY DIABETES MELLITUS STROKE STROKE 5 1 4 7 17 18 26 155 188 4 SIDS HYPERTENSION SUICIDE HEART DISEASE HOMICIDE/ LEGAL DIABETES MELLITUS STROKE INFLUENZA/ PNEUMONIA UNINTENT. INJURY 3 1 3 3 7 11 19 81 148 5 STROKE SUICIDE HEART DISEASE DIABETES MELLITUS STROKE LIVER DISEASE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA DIABETES MELLITUS 2 1 2 2 6 11 16 76 109 6 HEART DISEASE OTHER OTHER HIV LIVER DISEASE STROKE UNINTENT. INJURY DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA 1 1 5 2 6 5 12 67 95 7 CANCER CANCER SUICIDE SUICIDE LIVER DISEASE UNINTENT. INJURY INFLUENZA/ PNEUMONIA 1 2 6 5 5 42 88 8 OTHER CONGENITAL ANOMALIES DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA KIDNEY DISEASE KIDNEY DISEASE SEPTICEMIA (BLOOD POISONING) 8 1 3 3 4 26 33 9 LIVER DISEASE HIV HOMICIDE/ LEGAL SEPTICEMIA (BLOOD POISONING) SEPTICEMIA (BLOOD POISONING) LIVER DISEASE 1 3 3 4 26 31 10 OTHER INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA TWO CAUSES TIED ATHERO-SCLEROSIS KIDNEY DISEASE 7 2 3 3 25 30 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, Oklahoma State Department of Health July 2005 problem of the individual but also the community as a whole. With health care costs on the rise, target-ing areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Behavioral Risk Factor Surveillance System, it is estimated that 22.8% (4,917) of people in Adair County use tobacco of some sort. Medical costs accu-mulated by those per-sons are over $16 million a year for Adair County. According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Adair County. Unintentional injuries are the leading cause of death from ages 5 to 34 and the 2nd cause of death in ages 35 to 44 in Adair County. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Adair County which has an average of 9.4 motor vehicle-related deaths a year, that translates to over $10 million a year. Violence-related injuries (homicide and suicide) in Adair County are ranked in the top 10 in five of the eight age groups (see Top 10 list on page 3). (9,533) of people in Adair County had no leisure ac-tivity in the past month at the time they were sur-veyed. The BRFSS also indicated that 10.4% (2,243) of Adair County citizens have been diagnosed by a health professional as having dia- The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 44.2% betes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $29,704,049 in one year for Adair County. Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes “Medical costs accumulated by those persons are over $16 million a year for Adair County” STATE OF THE COUNTY’S HEALTH REPORT Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Adair County, 1999-2003 0 2 4 6 8 10 12 14 16 1999 2000 2001 2002 2003 Year of Death Number of Deaths Drowning Falls Fires/Burns Homicide MVC Poisonings Suicide * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control ADAIR COUNTY Rate of Live Births to Teen Mothers,Ages 15-19, Adair County, 1993 to 2003 0 20 40 60 80 100 120 140 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Adair Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 23.2% of persons in Adair County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Adair County is 58% above the state (14.7%) and 87% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Adair County had a teen birth rate of 101.7 in 2003 which was a 14% increase from 2002 (88.9) and a 9% increase since 1993 (93.6). With an average of 85 births per year, teen pregnancy costs the citizens of Adair County $272,000.00 a year. Note: 13 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 20,552 1,762 3,008 3,479 3,012 9,291 Cumulative Population 1,762 4,770 8,249 11,261 20,552 % of Total 100.0% 8.6% 14.6% 16.9% 14.7% 45.2% Cumulative % 8.6% 23.2% 40.1% 54.8% 100.0% Income to Poverty Ratio, Adair County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. ADAIR COUNTY Motor Vehicle-Related Injury Death • Average 9.4 deaths per year • $1,120,000.00 in economic costs per death • Total—$10,528,000.00 a year Tobacco Use • 22.8% of population (4,928) • $3,300.00 in health care costs • Total—$16,262,400.00 a year Diabetes • 10.4% of population (2,248 ) • $13,243.00 in healthcare costs a year • Total—$29,770,264.00 a year Teen Pregnancy • Average of 85 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $272,000.00 a year Cardiovascular Disease (Heart Disease) • Average 67 deaths a year • $369,476.69 per death • Total— $24,754,938.23 a year Obesity • 31.3% of population ( 6,765 ) • $395.00 in additional medical costs per person • Total—$2,672,175.00 Page 7 County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Adair County: $84,259,777.23 Health Care Costs Summary Attended Appointments for Adair County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning STD Communicable Disease Take Charge! Dysplasia Children First Adult Services Child Health Guidance Tuberculosis Early Intervention The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the department of health, local communities, and policy-makers. The Oklahoma Turning point engine is fueled by a community-based decision making process whereby local communities tap into the capacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the public health system, and the public’s health. ADAIR COUNTY Page 8 Looking Back to Move Forward OKLAHOMA STATE DEPARTMENT OF HEALTH Phone: 405-271-6127 Fax: 405-271-1225 Email: neil@health.ok.gov Community Development Service 1000 NE 10th St, Rm 508 Oklahoma City, OK 73117 Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH Oklahoma Community Partners in Public Health Innovation Alfalfa County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Alfalfa County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Al-falfa County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control costs are reflecting this downward spi-ral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2001-2005, 3% (103) of people in Alfalfa County were considered obese which accounted for an additional in medical costs for the county. These costs are underestimated because they With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the same rate as the nation, and health care do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity still the leading cause of death among all age groups. According to the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 30.1 deaths a year, heart disease accounts for over $11 million a year in medical costs in The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Alfalfa County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 432 people in Alfalfa County and is STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 5% decrease from 1990 to 2000 (6,416 to 6,105) o 5% decrease from 2000 to 2004 o Ranked 68th for growth in state 2000 Census • Hispanic/Latino ethnicity = 3% • Race o Whites = 89% o Native Americans =3% o Blacks =4% o Other/Multiple = 4% • Age o Under 5 = 5% o Over 64 = 20% o Median age = 42.3 years • Housing units o Occupied = 2,199 (78%) o Vacant = 633 (22%) • Disability (ages 21 to 64) = 18.2% national = 19.2% state = 21.5% • Individuals below poverty = 13.7% national = 12.4% state = 14.7% Alfalfa County Population Growth with Projections 5,400 5,500 5,600 5,700 5,800 5,900 6,000 6,100 6,200 6,300 6,400 6,500 1990 1991992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.00% 0.05% 0.10% 0.15% 0.20% 0.25% Percent of State Population Alfalfa Percent of Population Alfalfa County. Alzheimer’s disease and the complications associated with it have decreased from the 11th ranked cause of death (1983-1993) to the 14th ranked cause of death in persons 65 and older ac-counting for a 57% decrease in deaths. Heart disease accounts for over $11 million a year in medical costs in Alfalfa County. No Data Available At This Time ALFALFA COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY SUICIDE CANCER HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE 4 2 5 4 3 10 31 287 332 HEART DISEASE HEART DISEASE HEART DISEASE HIV SUICIDE CANCER CANCER CANCER CANCER 1 1 1 2 2 8 17 136 164 PERINATAL PERIOD SUICIDE CONGENITAL ANOMALIES UNINTENT. INJURY UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE 1 1 1 2 5 6 71 74 OTHER UNINTENT. INJURY DIABETES MELLITUS DIABETES MELLITUS UNINTENT. INJURY INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA 1 1 1 2 5 58 60 OTHER INFLUENZA/ PNEUMONIA VIRAL HEPATITIS STROKE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA 1 1 2 2 35 41 OTHER STROKE DIABETES MELLITUS DIABETES MELLITUS UNINTENT. INJURY 1 1 2 20 40 LIVER DISEASE SEPTICEMIA (BLOOD POISONING) KIDNEY DISEASE DIABETES MELLITUS 1 2 17 25 OTHER INFLUENZA/ PNEUMONIA UNINTENT. INJURY KIDNEY DISEASE 2 1 16 18 LIVER DISEASE ATHERO-SCLEROSIS ATHERO-SCLEROSIS 1 12 12 OTHER PNEUMONITIS TWO CAUSES TIED 7 12 12 Data source: Vital Statistics , Health Care Information Division, O klahoma State Department of Health Produced by: Community Development Service, Community Health Services, O klahoma State Department of Health Top 10 Causes of Death by Age Group Alfalfa County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Alfalfa County are ranked in the top 10 in three of the eight age groups (see Top 10 list on page 3). the community as a whole. With health care costs on the rise, targeting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a per-son that used tobacco accrued over $3,300 in health care costs per year. According to the Behavioral Risk Fac-tor Surveillance System, it is estimated that n/a% ( ) of people in Alfalfa County use tobacco of some sort. Medical costs accumulated by those persons are According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the problem of the individual but also Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Alfalfa County. Unintentional injuries are the leading cause of death from ages 5 to 24. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Alfalfa County which has an average of 1.2 motor vehicle-related deaths a year, that translates to over $1 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that n/a% (#VALUE!) of people in Alfalfa County Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri- #VALUE! $ million a year for Alfalfa County. “Medical costs accumulated by those persons are #VALUE! $ million a year for Alfalfa County” had no leisure activity in the past falfa County. month at the time they were surveyed. The BRFSS also indicated that n/a% ( ) of Alfalfa County citizens have been diagnosed by a health professional as having diabetes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumulated health care costs of in one year for Al- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Alfalfa County, 1999 - 2003 0 0.5 1 1.5 2 2.5 1999 2000 2001 2002 2003 Year of Death Number of Deaths FIRES/BURNS MVC POISONINGS SUICIDE No Data Available At This Time No Data Available At This Time *No homicides/legal intervention or poisoning deaths occurred during this time period While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control ALFALFA COUNTY Rate of Live Births to Teen Mothers, Ages 15-19, Alfalfa County, 1993 to 2003 0 10 20 30 40 50 60 70 80 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Alfalfa Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 13.7% of persons in Alfalfa County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Alfalfa County is 7% below the state (14.7%) and 11% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Alfalfa County had a teen birth rate of 42.6 in 2003 which was a 20% increase from 2002 (35.5) and a 82% increase since 1993 (23.4). With an average of 6 births per year, teen pregnancy costs the citizens of Alfalfa County $19,200.00 a year. Note: births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 5,028 178 512 722 696 2,920 Cumulative Population 178 690 1,412 2,108 5,028 % of Total 100.0% 3.5% 10.2% 14.4% 13.8% 58.1% Cumulative % 3.5% 13.7% 28.1% 41.9% 100.0% Income to Poverty Ratio, Alfalfa County, 2000 Census Unstable Rate Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. ALFALFA COUNTY Motor Vehicle-Related Injury Death • Average 1.2 deaths per year • $1,120,000.00 in economic costs per death • Total—$1,344,000.00 a year Tobacco Use • Data Not Available At This Time Diabetes • Data Not Available At This Time Teen Pregnancy • Average of 6 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $19,200.00 a year Cardiovascular Disease (Heart Disease) • Average 30 deaths a year • $369,476.69 per death • Total— $11,084,300.70 a year Obesity • Data Not Available At This Time Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Alfalfa County: $12,447,500.70 Health Departments Services Received by Alfalfa County Residents by County Health Department, State Fiscal Year 05 0% 20% 40% 60% 80% 100% Adult Services Child Health Early Intervention Family Planning STD Tuberculosis Health Department Service Percent of Visits Garfield Grant Major Woods Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Oklahoma Community Partners in P ublic H ealth In novation Page 8 STATE OF THE COUNTY’S HEALTH REPORT 1000 NE 10th St, Room 508 Oklahoma City, OK 73117 Phone: 405-271-6127 Fax: 405-271-1225 Email: miriamm@health.ok.gov Atoka County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Atoka County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Atoka County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 20.1% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 2,843 ) of people in Atoka County were considered obese which accounted for an addi-tional $1,122,985 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity still the leading cause of death among all age groups. According the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 56.4 deaths a year, heart disease accounts for almost $21 million a year in medical costs The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Atoka County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 694 people in Atoka County and is STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 9% increase from 1990 to 2000 (12,778 to 13,879) o 3% increase from 2000 to 2004 o Ranked 17th for growth in state 2000 Census • Hispanic/Latino ethnicity = 1% • Race o Whites = 76% o Native Americans =11% o Blacks =6% o Other/Multiple = 7% • Age o Under 5 = 6% o Over 64 = 15% o Median age = 38.3 years • Housing units o Occupied = 4,964 (88%) o Vacant = 709 (12%) • Disability (ages 21 to 64) = 25.8% national = 19.2% state = 21.5% • Individuals below poverty = 19.8% national = 12.4% state = 14.7% Atoka County Population Growth with Projections 0 5,000 10,000 15,000 20,000 25,000 1990 1991992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.37% 0.38% 0.39% 0.40% 0.41% 0.42% 0.43% 0.44% 0.45% 0.46% 0.47% Percent of State Population Atoka Percent of Population in Atoka County. Alzheimer’s disease and the complications associ-ated with it have increased from the 18th ranked cause of death (1983-1993) to the 10th ranked cause of death in persons 65 and older accounting for a 900% increase in deaths. Heart disease accounts for almost $21 million a year in medical costs in Atoka County. ATOKA COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages CONGENITAL ANOMALIES UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE 5 4 15 14 15 28 66 514 620 PERINATAL PERIOD BRONCHITIS/ EMPHYSEMA/ ASTHMA HEART DISEASE SUICIDE HEART DISEASE CANCER CANCER CANCER CANCER 5 1 1 6 7 15 61 235 321 SIDS PERINATAL PERIOD HOMICIDE/ LEGAL HEART DISEASE CANCER UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA INFLUENZA/ PNEUMONIA STROKE 3 1 1 4 7 8 12 78 90 UNINTENT. INJURY SUICIDE CANCER SUICIDE LIVER DISEASE STROKE STROKE UNINTENT. INJURY 1 1 3 5 7 12 75 87 OTHER LIVER DISEASE LIVER DISEASE SUICIDE UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA INFLUENZA/ PNEUMONIA 6 2 3 5 10 53 83 HOMICIDE/ LEGAL HOMICIDE/ LEGAL STROKE LIVER DISEASE DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA 1 2 3 4 30 67 INFLUENZA/ PNEUMONIA DIABETES MELLITUS DIABETES MELLITUS KIDNEY DISEASE KIDNEY DISEASE DIABETES MELLITUS 1 1 3 4 30 35 OTHER INFLUENZA/ PNEUMONIA BRONCHITIS/ EMPHYSEMA/ ASTHMA SUICIDE SEPTICEMIA (BLOOD POISONING) KIDNEY DISEASE 5 1 1 3 20 35 OTHER HIV INFLUENZA/ PNEUMONIA UNINTENT. INJURY LIVER DISEASE 8 1 2 20 26 FOUR CAUSES TIED THREE CAUSES TIED ALZHEIMER'S DISEASE SUICIDE 1 1 10 23 Data source: Vital Statistics , Health Care Information Division, O klahoma State Department of Health Produced by: Community Development Service, Community Health Services, O klahoma State Department of Health Top 10 Causes of Death by Age Group Atoka County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Atoka County are ranked in the top 10 in five of the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Atoka County. Unintentional injuries are the leading cause of death from ages 5 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Atoka County which has an average of 4.4 motor vehicle-related deaths a year, that translates to almost $5 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 33.8% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 31.6% (4,469) of people in Atoka County use tobacco of some sort. Medical costs accumulated by those persons are al-most $15 million a year for Atoka County. “Medical costs accumulated by those persons are almost $15 million a year for Atoka County” tes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $14,421,627.00 in one year for Atoka County. (4,780 ) of people in Atoka County had no leisure ac-tivity in the past month at the time they were sur-veyed. The BRFSS also indicated that 7.7% (1,089 ) of Atoka County citizens have been diagnosed by a health pro-fessional as having diabe- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Atoka County, 1999 - 2003 0 1 2 3 4 5 6 7 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS HOMICIDE MVC POISONINGS SUICIDE While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control ATOKA COUNTY Rate of Live Births to Teen Mothers, Ages 15-19, Atoka County, 1993 to 2003 0 20 40 60 80 100 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Atoka Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 19.8% of persons in Atoka County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Atoka County is 34% above the state (14.7%) and 59% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Atoka County had a teen birth rate of 50.1 in 2003 which was a 41% decrease from 2002 (84.4) and a 33% decrease since 1993 (74.4). With an average of 29 births per year, teen pregnancy costs the citizens of Atoka County $92,800.00 a year. Note: 4 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 12,282 1,018 1,408 2,147 1,534 6,175 Cumulative Population 1,018 2,426 4,573 6,107 12,282 % of Total 100.0% 8.3% 11.5% 17.5% 12.5% 50.3% Cumulative % 8.3% 19.8% 37.2% 49.7% 100.0% Income to Poverty Ratio, Atoka County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. ATOKA COUNTY Motor Vehicle-Related Injury Death • Average 4.4 deaths per year • $1,120,000.00 in economic costs per death • Total—$4,928,000.00 a year Tobacco Use • 31.6% of population (4,469) • $3,300.00 in health care costs • Total—$14,747,700.00 a year Diabetes • 7.7% of population (1,089 ) • $13,243.00 in healthcare costs a year • Total—$14,421,627.00 a year Teen Pregnancy • Average of 29 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $92,800.00 a year Cardiovascular Disease (Heart Disease) • Average 56 deaths a year • $369,476.69 per death • Total— $20,690,694.64 a year Obesity • 20.1% of population ( 2,843 ) • $395.00 in additional medical costs per person • Total—$1,122,985.00 Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Atoka County: $56,003,806.64 Attended Appointments for Atoka County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning General Child Health Children First Dysplasia Tuberculosis STD Communicable Disease Chronic Disease Take Charge! Adult Services The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Oklahoma Community Partners in Public Health Innovation Page 8 STATE OF THE COUNTY’S HEALTH REPORT Atoka County Health Department 1006 W 13th St Atoka, OK 74525 580-889-2116 Atoka & Coal Counties Partnership For Change Community Coalition We want to thank all the people and organizations that make the Partnership for Change Community Coalition successful. Thank you! • American Cancer Society • Atoka & Coalgate Chamber of Commerce • Atoka Community Chest • Atoka First Baptist Church • Atoka/Coalgate Hospital • Big Five Community Action Agency/Sorts Transit • Choctaw Nation CORE Capacity/Healthy Life-styles/ Project CHILD • Coal and Atoka County Health Departments • Coal and Atoka County Public Schools • Coalgate Register • COALition • Community members at large • County Commissioners • Department of Human Services • Girl Scouts 1000 NE 10th St, Room 508 Oklahoma City, OK 73117 405-271-6127 Email: neilh@health.ok.gov • Head Start • INCA Community Action Agency/Jamm Transit • Kiamichi Technology Center • Oklahoma State Department of Health Turning Point • Oklahoma State University Cooperative Extension Service • School Based Social Workers • Senior Nutrition Center • Southeast Oklahoma Division on Aging (SODA) • Tri-County Indian Nations Community Development Corporation • USDA • Women, Infants and Children (WIC) • Youth Beaver County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Beaver County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Bea-ver County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 33.7% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 1,881 ) of people in Beaver County were considered obese which accounted for an addi-tional $742,995 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity still the leading cause of death among all age groups. According the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 17.6 deaths a year, heart disease accounts for almost $7 million a year in medical costs in The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Beaver County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 239 people in Beaver County and is STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 3% decrease from 1990 to 2000 (6,023 to 5,857) o 6% decrease from 2000 to 2004 o Ranked 75th for growth in state 2000 Census • Hispanic/Latino ethnicity = 11% • Race o Whites = 93% o Native Americans =1% o Blacks =0% o Other/Multiple = 6% • Age o Under 5 = 6% o Over 64 = 17% o Median age = 39.3 years • Housing units o Occupied = 2,245 (83%) o Vacant = 474 (17%) • Disability (ages 21 to 64) = 15.1% national = 19.2% state = 21.5% • Individuals below poverty = 11.7% national = 12.4% state = 14.7% Beaver County Population Growth with Projections 5,200 5,300 5,400 5,500 5,600 5,700 5,800 5,900 6,000 6,100 6,200 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.00% 0.05% 0.10% 0.15% 0.20% 0.25% Percent of State Population Beaver Percent of Population Beaver County. Alzheimer’s disease and the complications associ-ated with it have increased from the 14th ranked cause of death (1983-1993) to the 9th ranked cause of death in persons 65 and older accounting for a 300% increase in deaths. Heart disease accounts for almost $7 million a year in medical costs in Beaver County. BEAVER COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages PERINATAL PERIOD SUICIDE UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY CANCER HEART DISEASE HEART DISEASE HEART DISEASE 3 2 8 3 5 10 17 167 195 CONGENITAL ANOMALIES OTHER STROKE SUICIDE HEART DISEASE UNINTENT. INJURY CANCER CANCER CANCER 1 1 2 2 2 10 12 112 137 CANCER OTHER CANCER HEART DISEASE NON-CANCEROUS TUMOR ATHERO-SCLEROSIS UNINTENT. INJURY 1 1 2 8 3 35 42 BRONCHITIS/ EMPHYSEMA/ ASTHMA DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE 1 2 3 32 36 LIVER DISEASE NON-CANCEROUS TUMOR DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA ATHERO-SCLEROSIS 1 1 3 24 35 NUTRITIONAL DEFICIENCY BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA 1 1 2 20 29 OTHER LIVER DISEASE INFLUENZA/ PNEUMONIA UNINTENT. INJURY DIABETES MELLITUS 1 1 2 14 25 NUTRITIONAL DEFICIENCY UNINTENT. INJURY INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA 1 2 13 15 SUICIDE HYPERTENSION ALZHEIMER'S DISEASE ALZHEIMER'S DISEASE 1 1 12 12 OTHER OTHER TWO CAUSES TIED SUICIDE 3 3 5 10 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, Oklahoma State Department of Health Top 10 Causes of Death by Age Group Beaver County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Beaver County are ranked in the top 10 in three of the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Beaver County. Unintentional injuries are the leading cause of death from ages 15 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Beaver County which has an average of 1.6 motor vehicle-related deaths a year, that translates to almost $2 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 28.1% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 22.3% (1,245) of people in Beaver County use tobacco of some sort. Medical costs accumulated by those persons are over $4 million a year for Beaver County. “Medical costs accumulated by those persons are over $4 million a year for Beaver County” tes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $1,178,627.00 in one year for Beaver County. (1,569 ) of people in Beaver County had no leisure ac-tivity in the past month at the time they were sur-veyed. The BRFSS also indicated that 1.6% (89 ) of Beaver County citizens have been diagnosed by a health pro-fessional as having diabe- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Beaver County, 1999 - 2003 0 0.5 1 1.5 2 2.5 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS MVC SUICIDE While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control BEAVER COUNTY Rate of Live Births to Teen Mothers,Ages 15-19, Beaver County, 1993 to 2003 0 10 20 30 40 50 60 70 80 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Beaver Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 11.7% of persons in Beaver County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Beaver County is 20% below the state (14.7%) and 6% below the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Beaver County had a teen birth rate of 41.2 in 2003 which was a 8% decrease from 2002 (44.8) and a 19% increase since 1993 (34.5). With an average of 9 births per year, teen pregnancy costs the citizens of Beaver County $28,800.00 a year. Note: 1 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 5,748 226 447 606 574 3,895 Cumulative Population 226 673 1,279 1,853 5,748 % of Total 100.0% 3.9% 7.8% 10.5% 10.0% 67.8% Cumulative % 3.9% 11.7% 22.3% 32.2% 100.0% Income to Poverty Ratio, Beaver County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. BEAVER COUNTY Motor Vehicle-Related Injury Death • Average 1.6 deaths per year • $1,120,000.00 in economic costs per death • Total—$1,792,000.00 a year Tobacco Use • 22.3% of population (1,245) • $3,300.00 in health care costs • Total—$4,108,500.00 a year Diabetes • 1.6% of population (89 ) • $13,243.00 in healthcare costs a year • Total—$1,178,627.00 a year Teen Pregnancy • Average of 9 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $28,800.00 a year Cardiovascular Disease (Heart Disease) • Average 18 deaths a year • $369,476.69 per death • Total— $6,650,580.42 a year Obesity • 33.7% of population ( 1,881 ) • $395.00 in additional medical costs per person • Total—$742,995.00 Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Beaver County: $14,501,502.42 Attended Appointments for Beaver County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning Children First Guidance Maternity General Child Health Adult Services Communicable Disease Chronic Disease STD Tuberculosis Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Oklahoma Community Partners in Public Health Innovation Page 8 STATE OF THE COUNTY’S HEALTH REPORT Beaver County Health Department PO Box 520 Beaver, OK 73932 580-625-3693 Beaver County Health Department PO Box 520 Beaver, OK 73932 580-625-3693 Beaver Health Awareness Partnership We want to thank all the people and organizations that make the Beaver Health Awareness Partnership such a huge success. With successes such as helping to recruit a physician and conducting a community health assessment and future plans of developing a wellness/fitness center, you are paving the way to a healthier future for all residents of Beaver County. Thank you! Beaver County Health Department First Security Bank Bank of Beaver City Beaver County Memorial Hospital Nutrition Site OSU Extension Herald Democrat City of Beaver Howard Drilling Company Community Clinic Downing’s Market Beaver Senior Citizens Area Agency on Aging Hardberger & Smylie OEDA Department of Human Services XCEL Energy EMT Howard Auto Supply Assembly of God Church O’Laughlin Center, Spearman TX Chamber of Commerce Trippett and Kee Law Office SW Kansas Technical School M & M Consultants Beckham County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Beckham County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Beckham County. We will take a look back to discover what has been affecting the health of the citizens in order to move forward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2001-2005, 24.5% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 4,874 ) of people in Beckham County were considered obese which accounted for an addi-tional $1,925,230 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity and is still the leading cause of death among all age groups. Accord-ing to the Centers for Disease Control, al-most $400,000 is spent on each heart disease-related death. With an average of 94.7 deaths a year, heart disease accounts for almost $35 million a year in medical costs The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Beckham County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 1,032 people in Beckham County STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 5% increase from 1990 to 2000 (18,812 to 19,799) o 3% decrease from 2000 to 2004 o Ranked 58th for growth in state 2000 Census • Hispanic/Latino ethnicity = 5% • Race o Whites = 87% o Native Americans =3% o Blacks =6% o Other/Multiple = 5% • Age o Under 5 = 6% o Over 64 = 15% o Median age = 36.6 years • Housing units o Occupied = 7,356 (84%) o Vacant = 1,440 (16%) • Disability (ages 21 to 64) = 24.8% national = 19.2% state = 21.5% • Individuals below poverty = 18.2% national = 12.4% state = 14.7% Beckham County Population Growth with Projections 0 5,000 10,000 15,000 20,000 25,000 30,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.51% 0.52% 0.53% 0.54% 0.55% 0.56% 0.57% 0.58% 0.59% 0.60% 0.61% Percent of State Population Beckham Percent of Population in Beckham County. Alzheimer’s disease and the complications associated with it have increased from the 16th ranked cause of death (1983-1993) to the 10th ranked cause of death in persons 65 and older ac-counting for a 380% in-crease in deaths. Heart disease accounts for almost $35 million a year in medical costs in Beckham County. BECKHAM COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages PERINATAL PERIOD UNINTENT. IN JURY UNINTENT. IN JURY UNINTENT. IN JURY UNINTENT. IN JURY HEART DISEASE CANCER HEART DISEASE HEART DISEASE 9 6 25 14 20 37 98 909 1042 UNINTENT. IN JURY AORTIC ANEURYSM SUICIDE SUICIDE CANCER CANCER HEART DISEASE CANCER CANCER 6 1 8 6 13 35 79 336 486 SIDS HEART DISEASE CANCER HEART DISEASE HEART DISEASE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE 4 1 2 4 10 8 18 276 297 CONGENITAL ANOMALIES INFLUENZA/ PNEUMONIA ANEMIA HIV SUICIDE UNINTENT. IN JURY UNINTENT. IN JURY BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA 3 1 1 2 8 8 11 159 186 HOMICIDE/ LEGAL CANCER BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE STROKE STROKE INFLUENZA/ PNEUMONIA UNINTENT. IN JURY 2 1 1 1 5 7 7 83 123 ATHERO-SCLEROSIS OTHER STROKE HOMICIDE/ LEGAL HOMICIDE/ LEGAL LIVER DISEASE DIABETES MELLITUS DIABETES MELLITUS INFLUENZA/ PNEUMONIA 1 1 1 1 2 7 6 41 93 HEART DISEASE HEART DISEASE CANCER INFLUENZA/ PNEUMONIA DIABETES MELLITUS SEPTICEMIA (BLOOD POISOINING) KIDNEY DISEASE DIABETES MELLITUS 1 1 1 2 6 5 38 53 HERNIA HIV OTHER LIVER DISEASE SUICIDE SUICIDE SEPTICEMIA (BLOOD POISOINING) SEPTICEMIA (BLOOD POISOINING) 1 1 8 2 5 5 37 43 OTHER HOMICIDE/ LEGAL CONGENITAL ANOMALIES INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA UNINTENT. IN JURY KIDNEY DISEASE 6 1 1 3 3 33 40 INFLUENZA/ PNEUMONIA TWO CAUSES TIED CONGENITAL ANOMALIES LIVER DISEASE ALZHEIMER'S DISEASE SUIC IDE 1 1 2 3 24 38 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, Oklahoma State Departm ent of Health 9 10 7 8 Top 10 Causes of Death by Age Group Beckham County 1993-2003 5 6 1 2 3 4 and suicide) in Beckham County are ranked in the top 10 in six of the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Beckham County. Unintentional inju-ries are the leading cause of death from ages 5 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Beckham County which has an average of 4.4 motor vehicle-related deaths a year, that translates to almost $5 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 38.8% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 32.3% (6,426) of people in Beckham County use tobacco of some sort. Medical costs accumulated by those persons are over $21 million a year for Beckham County. “Medical costs accumulated by those persons are over $21 million a year for Beckham County” ing diabetes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $30,299,984.00 in one year for Beckham County. (7,719 ) of people in Beckham County had no leisure activity in the past month at the time they were surveyed. The BRFSS also indicated that 11.5% (2,288 ) of Beckham County citizens have been diagnosed by a health professional as hav- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Beckham County, 1999 - 2003 0 1 2 3 4 5 6 7 8 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS HOMICIDE MVC POISONINGS SUICIDE *No homicides/legal intervention or poisoning deaths occurred during this time period While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control BECKHAM COUNTY Rate of Live Births to Teen Mothers, Ages 15-19, Beckham County, 1993 to 2003 0 10 20 30 40 50 60 70 80 90 100 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Beckham Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 18.2% of persons in Beckham County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Beckham County is 24% above the state (14.7%) and 46% above the na-tion (12.4%) for persons with in-comes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Beckham County had a teen birth rate of 76.3 in 2003 which was a 0% decrease from 2002 (76.5) and a 6% decrease since 1993 (81.5). With an average of 52 births per year, teen pregnancy costs the citizens of Beckham County $166,400.00 a year. Note: 7 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 17,884 1,224 2,023 2,387 2,277 9,973 Cumulative Population 1,224 3,247 5,634 7,911 17,884 % of Total 100.0% 6.8% 11.3% 13.3% 12.7% 55.8% Cumulative % 6.8% 18.2% 31.5% 44.2% 100.0% Income to Poverty Ratio, Beckham County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. BECKHAM COUNTY Motor Vehicle-Related Injury Death • Average 4.4 deaths per year • $1,120,000.00 in economic costs per death • Total—$4,928,000.00 a year Tobacco Use • 32.3% of population (6,426) • $3,300.00 in health care costs • Total - $21,205,800.00 a year Diabetes • 11.5% of population (2,288 ) • $13,243.00 in healthcare costs a year • Total—$30,299,984.00 a year Teen Pregnancy • Average of 52 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $166,400.00 a year Cardiovascular Disease (Heart Disease) • Average 95 deaths a year • $369,476.69 per death • Total— $35,100,285.55 a year Obesity • 24.5% of population ( 4,874 ) • $395.00 in additional medical costs per person • Total—$1,925,230.00 Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Beckham County: $93,625,699.55 Attended Appointments for Beckham County Health Department, State Fiscal Year 05 Immunizations STD Child Health Family Planning Chronic Disease Children First Tuberculosis Communicable Disease Adult Services WIC Dysplasia Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Oklahoma Community Partners in P ublic H ealth In novation Page 8 STATE OF THE COUNTY’S HEALTH REPORT 1000 NE 10th St, Room 508 Oklahoma City, OK 73117 Phone: 405-271-6127 Fax: 405-271-1225 Email: miriamm@health.ok.gov Beckham County Health Department 400 East Third St Elk City, OK 73644 580-225-1173 Blaine County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Blaine County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Blaine County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 36.6% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 4,274 ) of people in Blaine County were considered obese which accounted for an addi-tional $1,688,230 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity still the leading cause of death among all age groups. According to the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 61.9 deaths a year, heart disease accounts for almost $23 million a year in medical costs The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Blaine County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 767 people in Blaine County and is STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 4% increase from 1990 to 2000 (11,470 to 11,976) o 6% decrease from 2000 to 2004 o Ranked 73rd for growth in state 2000 Census • Hispanic/Latino ethnicity = 7% • Race o Whites = 76% o Native Americans =9% o Blacks =7% o Other/Multiple = 8% • Age o Under 5 = 6% o Over 64 = 17% o Median age = 37.6 years • Housing units o Occupied = 4,159 (80%) o Vacant = 1,049 (20%) • Disability (ages 21 to 64) = 20.7% national = 19.2% state = 21.5% • Individuals below poverty = 16.9% national = 12.4% state = 14.7% Blaine County Population Growth with Projections 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.29% 0.30% 0.31% 0.32% 0.33% 0.34% 0.35% 0.36% 0.37% 0.38% Percent of State Population Blaine Percent of Population in Blaine County. Alzheimer’s disease and the complications associ-ated with it have increased from the 18th ranked cause of death (1983-1993) to the 11th ranked cause of death in persons 65 and older accounting for a 250% increase in deaths. Heart disease accounts for almost $23 million a year in medical costs in Blaine County. BLAINE COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages CONGENITAL ANOMALIES UNINTENT. IN JURY UNINTENT. IN JURY UNINTENT. IN JURY UNINTENT. IN JURY HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE 5 5 9 15 15 23 51 594 681 PERINATAL PERIOD SUIC IDE HOMICIDE/ LEGAL HEART DISEASE CANCER CANCER CANCER CANCER 4 5 3 11 15 48 275 345 HOMICIDE/ LEGAL HOMICIDE/ LEGAL SUIC IDE CANCER UNINTENT. IN JURY STROKE STROKE STROKE 2 2 3 6 11 8 102 116 SIDS HERNIA STROKE INFLUENZA/ PNEUMONIA STROKE UNINTENT. IN JURY INFLUENZA/ PNEUMONIA INFLUENZA/ PNEUMONIA 2 1 2 2 4 7 96 100 UNINTENT. IN JURY HEART DISEASE LIVER DISEASE LIVER DISEASE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA UNINTENT. IN JURY 2 2 2 4 6 68 98 OTHER HIV GALLBLADDER DISORDER DIABETES MELLITUS DIABETES MELLITUS DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA 5 1 1 3 4 41 74 CANCER HIV SUICIDE HYPERTENSION UNINTENT. IN JURY DIABETES MELLITUS 1 1 3 2 34 48 KIDNEY DISEASE MENINGITIS KIDNEY DISEASE LIVER DISEASE KIDNEY DISEASE KIDNEY DISEASE 1 1 2 2 31 34 OTHER SUICIDE VIRAL HEPATITIS SUIC IDE PNUEMONITIS SUIC IDE 5 1 2 2 17 20 OTHER THREE CAUSES TIED SIX CAUSES TIED SEPTICEMIA (BLOOD POISOINING) PNUEMONITIS 10 1 1 15 18 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, Oklahoma State Departm ent of Health Top 10 Causes of Death by Age Group Blaine County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Blaine County are ranked in the top 10 in sixof the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Blaine County. Unintentional injuries are the leading cause of death from ages 5 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Blaine County which has an average of 4.8 motor vehicle-related deaths a year, that translates to over $5 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 34.8% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 32.4% (3,784) of people in Blaine County use tobacco of some sort. Medical costs accumulated by those persons are over $12 million a year for Blaine County. “Medical costs accumulated by those persons are over $12 million a year for Blaine County” tes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $12,527,878.00 in one year for Blaine County. (4,064 ) of people in Blaine County had no leisure ac-tivity in the past month at the time they were sur-veyed. The BRFSS also indicated that 8.1% (946 ) of Blaine County citizens have been diagnosed by a health pro-fessional as having diabe- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Blaine County, 1999 - 2003 0 1 2 3 4 5 6 7 8 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS HOMICIDE MVC POISONINGS SUICIDE While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control BLAINE COUNTY Rate of Live Births to Teen Mothers,Ages 15-19, Blaine County, 1993 to 2003 0 10 20 30 40 50 60 70 80 90 100 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Blaine Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 16.9% of persons in Blaine County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Blaine County is 15% above the state (14.7%) and 36% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Blaine County had a teen birth rate of 76.1 in 2003 which was a 111% increase from 2002 (36.1) but a 8% decrease since 1993 (82.7). With an average of 29 births per year, teen pregnancy costs the citizens of Blaine County $92,800.00 a year. Note: 4 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 10,378 549 1,202 1,408 1,322 5,897 Cumulative Population 549 1,751 3,159 4,481 10,378 % of Total 100.0% 5.3% 11.6% 13.6% 12.7% 56.8% Cumulative % 5.3% 16.9% 30.4% 43.2% 100.0% Income to Poverty Ratio, Blaine County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. BLAINE COUNTY Motor Vehicle-Related Injury Death • Average 4.8 deaths per year • $1,120,000.00 in economic costs per death • Total—$5,376,000.00 a year Tobacco Use • 32.4% of population (3,784) • $3,300.00 in health care costs • Total—$12,487,200.00 a year Diabetes • 8.1% of population (946 ) • $13,243.00 in healthcare costs a year • Total—$12,527,878.00 a year Teen Pregnancy • Average of 29 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $92,800.00 a year Cardiovascular Disease (Heart Disease) • Average 62 deaths a year • $369,476.69 per death • Total— $22,907,554.78 a year Obesity • 36.6% of population ( 4,274 ) • $395.00 in additional medical costs per person • Total—$1,688,230.00 Page 7 County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Blaine County: $55,079,662.78 Attended Appointments for Blaine County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning Children First Tuberculosis Child Health Take Charge! Dysplasia Maternity Adult Services Adolescent Health Chronic Disease General STD Guidance Communicable Disease Health Care Costs Summary Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Page 8 STATE OF THE COUNTY’S HEALTH REPORT 1000 NE 10th St, Rm 508 Oklahoma City, OK 73117 Phone: 405-271-6127 Fax: 405-271-1225 Email: neil@health.ok.gov Blaine County Health Department 521 W 4th Watonga, OK 73772 580-623-7977 Oklahoma Community Partners in Public Health Innovation Blaine County Community Health Action Team & Geary Community Health Care We want to say thank you to all the members of the Blaine County Community Health Action Team and Geary Community Health Care. Blaine County Community Health Action Team • Blaine County Health Department • Roman Nose State Park • Department of Human Services • Oklahoma Commission for Children and Youth • YWCA • Business Owners • Preventionworks • Watonga Police Department • Faith Community • County Judge Geary Community Health Care • Geary Schools • Parkview Hospital • Chamber of Commerce • Emergency Medical Services • Nursing Home Board • Local Physicians • Local Pharmacist • Concerned Citizens • Local Business • Blaine County Health Department Bryan County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Bryan County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Bryan County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 17.1% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 6,379 ) of people in Bryan County were considered obese which accounted for an addi-tional $2,519,705 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity is still the leading cause of death among all age groups. According the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 136.2 deaths a year, heart disease accounts for over $50 million a year in medical costs in The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Bryan County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 1,529 people in Bryan County and STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 14% increase from 1990 to 2000 (32,089 to 36,534) o 3% increase from 2000 to 2004 o Ranked 13th for growth in state 2000 Census • Hispanic/Latino ethnicity = 3% • Race o Whites = 80% o Native Americans =«Indian %» o Blacks =1% o Other/Multiple = 6% • Age o Under 5 = 6% o Over 64 = 15% o Median age = 35.8 years • Housing units o Occupied = 14,422 (86%) o Vacant = 2,293 (14%) • Disability (ages 21 to 64) = 26.3% national = 19.2% state = 21.5% • Individuals below poverty = 18.4% national = 12.4% state = 14.7% Bryan County Population Growth with Projections 0 10,000 20,000 30,000 40,000 50,000 60,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.90% 0.95% 1.00% 1.05% 1.10% 1.15% 1.20% Percent of State Population Bryan Percent of Population Bryan County. Alzheimer’s disease and the complications associ-ated with it have increased from the 16th ranked cause of death (1983-1993) to the 10th ranked cause of death in persons 65 and older accounting for a 173% increase in deaths. Heart disease accounts for over $50 million a year in medical costs in BryanCounty. BRYAN COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages PERINATAL PERIOD UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY CANCER CANCER HEART DISEASE HEART DISEASE 15 11 23 28 31 69 166 1261 1499 CONGENITAL ANOMALIES BRONCHITIS/ EMPHYSEMA/ ASTHMA SUICIDE HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE CANCER CANCER 4 1 13 7 25 53 148 689 943 UNINTENT. INJURY HEART DISEASE HOMICIDE/ LEGAL SUICIDE CANCER UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA STROKE STROKE 3 1 3 6 13 14 20 202 229 HOMICIDE/ LEGAL HOMICIDE/ LEGAL HEART DISEASE HOMICIDE/ LEGAL SUICIDE LIVER DISEASE STROKE INFLUENZA/ PNEUMONIA BRONCHITIS/ EMPHYSEMA/ ASTHMA 2 1 2 5 12 12 16 182 202 SEPTICEMIA (BLOOD POISOINING) CANCER INFLUENZA/ PNEUMONIA CANCER HIV DIABETES MELLITUS UNINTENT. INJURY BRONCHITIS/ EMPHYSEMA/ ASTHMA UNINTENT. INJURY 2 1 1 4 5 10 14 174 202 SIDS OTHER OTHER STROKE VIRAL HEPATITIS SUICIDE DIABETES MELLITUS DIABETES MELLITUS INFLUENZA/ PNEUMONIA 2 2 6 2 5 9 13 97 199 HEART DISEASE HIV STROKE STROKE INFLUENZA/ PNEUMONIA KIDNEY DISEASE DIABETES MELLITUS 1 2 4 5 11 81 125 INFLUENZA/ PNEUMONIA DIABETES MELLITUS DIABETES MELLITUS BRONCHITIS/ EMPHYSEMA/ ASTHMA LIVER DISEASE SEPTICEMIA (BLOOD POISOINING) SEPTICEMIA (BLOOD POISOINING) 1 1 4 4 7 78 85 CANCER OTHER BRONCHITIS/ EMPHYSEMA/ ASTHMA HOMICIDE/ LEGAL SUICIDE UNINTENT. INJURY KIDNEY DISEASE 1 15 3 4 7 78 83 OTHER HOMICIDE/ LEGAL THREE CAUSES TIED HYPERTENSION ALZHEIMER'S DISEASE SUICIDE 8 3 2 4 30 60 Data source: Vital Statistics , Health Care Information Division, Oklahoma State Department of Health Produced by: Community Development Service, Community Health Services, OK State Dept. of Health July-05 Top 10 Causes of Death by Age Group Bryan County 1993-2003 5 6 1 2 3 4 9 10 7 8 and suicide) in Bryan County are ranked in the top 10 in Seven of the eight age groups (see Top 10 list on page 3). problem of the individual but also the community as a whole. With health care costs on the rise, tar-geting areas such as tobacco use is an effective way to control those costs. In 2002, the CDC estimated that a person that used to-bacco accrued over $3,300 in health care costs per year. According to the Be- According to the 2005 State of the State’s Health Report, tobacco use among Oklahomans has remained fairly stable from 1990 to 2002. Oklahoma has been consistently higher in its tobacco use than the nation and is 30% higher than the nation on the amount of tobacco consumed per capita (103 packs vs. 79 packs). Tobacco use is no longer just the Across the nation and the state of Oklahoma, unintentional and violence-related injuries are on the rise. Unin-tentional injuries account for the 4th leading cause of death in the United States and the 5th leading cause of death in Oklahoma from 1999-2002. For persons ages 1 to 44 in Oklahoma, unintentional injuries are the leading cause of death. This trend does not change much in Bryan County. Unintentional injuries are the leading cause of death from ages 5 to 44. It is estimated that for every motor ve-hicle- related death $1.1 million in eco-nomic costs are incurred. For Bryan County which has an average of 9.4 motor vehicle-related deaths a year, that translates to almost $11 million a year. Violence-related injuries (homicide The increasing inactivity of the U.S. population is contributing to an increase in numerous poor health-related out-comes. Physical inactivity robs the body of precious energy needed to function properly, in turn health declines and rates of various chronic diseases escalate. According to the 2002-2004 Behavioral Risk Factor Surveillance System (BRFSS), it is estimated that 30.7% Page 4 Tobacco Use Injury and Violence Physical Activity, Wellness and Diabetes STATE OF THE COUNTY’S HEALTH REPORT * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control * Vital Statistics, Health Care Information Systems, OSDH & National Safety Council * Behavioral Risk Factor Surveil-lance System, Health Care Infor-mation System, OSDH & Ameri-can Diabetes Association, 2002 havioral Risk Factor Surveillance Sys-tem, it is estimated that 35.6% (13,281) of people in Bryan County use tobacco of some sort. Medical costs accumulated by those persons are al-most $44 million a year for Bryan County. “Medical costs accumulated by those persons are almost $44 million a year for Bryan County” tes. In 2002, the per capita annual healthcare costs for people with diabetes was $13,243 compared to $2,560 for people without diabetes. Persons with diabetes accumu-lated health care costs of $36,060,689.00 in one year for Bryan County. (11,453 ) of people in Bryan County had no lei-sure activity in the past month at the time they were surveyed. The BRFSS also indicated that 7.3% (2,723 ) of Bryan County citizens have been diagnosed by a health pro-fessional as having diabe- Increase activity gradually. Moderate exercise for 30 minutes 5 days a week. Injury and Violence-Related Deaths in Bryan County, 1999 - 2003 0 2 4 6 8 10 12 14 16 1999 2000 2001 2002 2003 Year of Death Number of Deaths DROWNING FALLS FIRES/BURNS HOMICIDE MVC POISONINGS SUICIDE While births to teen mothers (age 15 to 19) are on the decline in both the U.S. and Oklahoma, Oklahoma has moved up in rank from 13th to 8th in the country. In 1993 the rate of teen births was 60.0 (per 1,000 15-19 year old females) in the U.S. and 66.6 in Oklahoma. In 2003, the rate de-creased to 41.7 in the U.S. and 55.8 in Oklahoma, a decrease of Page 5 Teen Pregnancy * Sawhill V., Policy Brief #8, The Brookings Institute; Vi-tal Statistics, Health Care Information Systems, OSDH & National Vital Statistics, Centers for Disease Control BRYAN COUNTY Rate of Live Births to Teen Mothers,Ages 15-19, Bryan County, 1993 to 2003 0 10 20 30 40 50 60 70 80 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year Rate per 1,000 15-19 year old females *2003 U.S. data is preliminary Bryan Oklahoma U.S.* As the nation advances in tech-nology and the ability to detect and prevent disease at an ear-lier stage, persons that are im-poverished carry a large burden of poor health outcomes. Higher incidences of un-planned or unwanted pregnan-cies, teen pregnancy, inade-quate prenatal care, higher rates of low-birth-weight babies, infant deaths and low immunization rates are all associated with poverty along with a myriad of other ad-verse health outcomes. According to the 2000 census, 18.4% of persons in Bryan County for whom poverty status was known had an income below what was needed to live at the federal poverty level. Bryan County is 25% above the state (14.7%) and 48% above the nation (12.4%) for persons with incomes below the federal poverty level. Poverty * U.S. Census Bureau 31% and 7%, respectively. Children of teen mothers are more likely to display poor health and social outcomes than those of older mothers, such as pre-mature birth, low birth weight, higher rates of abuse and neglect, and more likely to go to foster care or do poorly in school. Additionally, births to teen mothers accu-mulate $3,200 a year for each teenage birth, which is passed on to citizens. According to Oklahoma Vital Statistics, Bryan County had a teen birth rate of 63.2 in 2003 which was a 8% decrease from 2002 (68.4) and a 14% decrease since 1993 (73.9). With an average of 89 births per year, teen pregnancy costs the citizens of Bryan County $284,800.00 a year. Note: 15 births to a mother 10-14 years of age occurred during the 11 year period. Poverty level Total 50% below 51% to 99% below poverty level to 149% above 150% to 199% above 200% and above Population 35,521 2,503 4,026 4,653 4,679 19,660 Cumulative Population 2,503 6,529 11,182 15,861 35,521 % of Total 100.0% 7.0% 11.3% 13.1% 13.2% 55.3% Cumulative % 7.0% 18.4% 31.5% 44.7% 100.0% Income to Poverty Ratio, Bryan County, 2000 Census Page 6 STATE OF THE COUNTY HEALTH REPORT OK By One - State Immunization Data * 2 Year-old Immunization Sur-vey, Immunization Service, OSDH 4:3:1:3:3 Coverage by Location of Shots, Oklahoma, 2004 64.0 66.5 64.1 69.7 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 Provider Type Percent Health Dept Priv Dr. IHS/Tribal Other Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love McClain McCurtain MacIntosh Major Marshall Mayes Murray Muskogee Noble Nowata Oklahoma Okfuskee Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward 2003-04 Immunization Coverage Rates 80% 70-79% 66-69% 60-65% 50-59% <50% Oklahoma Children On Schedule by Antigen, 2004 0 20 40 60 80 100 2 Mth 4 Mth 6 Mth 12 Mth 15-18 Mth 24 Mth Age Percent DTaP IPV MMR Hib HepB **Note: County level data will be available soon. Attended Appointments for Bryan County Health Department, State Fiscal Year 05 Immunizations WIC Family Planning Early Intervention Children First Communicable Disease Guidance Take Charge! Adolescent Health General Dysplasia Chronic Disease Adult Services STD Child Health Tuberculosis BRYAN COUNTY Motor Vehicle-Related Injury Death • Average 9.4 deaths per year • $1,120,000.00 in economic costs per death • Total—$10,528,000.00 a year Tobacco Use • 35.6% of population (13,281) • $3,300.00 in health care costs • Total—$43,827,300.00 a year Diabetes • 7.3% of population (2,723 ) • $13,243.00 in healthcare costs a year • Total—$36,060,689.00 a year Teen Pregnancy • Average of 89 births to teen mothers per year • $3,200.00 in costs for each birth a year • Total— $284,800.00 a year Cardiovascular Disease (Heart Disease) • Average 136 deaths a year • $369,476.69 per death • Total— $50,248,829.84 a year Obesity • 17.1% of population ( 6,379 ) • $395.00 in additional medical costs per person • Total—$2,519,705.00 Page 7 Health Care Costs Summary County Health Department Usage * PHOCIS, Community Health Services, OSDH Grand Total for Bryan County: $143,469,323.84 1000 NE 10th St, Rm 508 Oklahoma City, OK 73117 Phone: 405-271-6127 Fax: 405-271-1225 Email: neil@health.ok.gov Community Health Services Community Development Service OKLAHOMA STATE DEPARTMENT OF HEALTH Looking Back to Move Forward Report compiled by: Miriam McGaugh, M.S. Community Development Service, OSDH Kelly Baker, MPH Health Care Information Systems, OSDH Bryan County Turning Point Coalition The Oklahoma Turning Point Initiative is public health improvement in action. The success of the Turning Point process involves a partnership between the state and county departments of health, local communities, and policy-makers. The Oklahoma Turning point en-gine is fueled by a community-based decision making process whereby local communities tap into the ca-pacities, strengths, and vision of their citizens to create and promote positive, sustainable changes in the pub-lic health system, and the public’s health. Bryan County Health Department 1524 W Chuckwa PO Box 598 Durant, Oklahoma 74702-0598 580-924-4285 Oklahoma Community Partners in Public Health Innovation Page 8 STATE OF THE COUNTY’S HEALTH REPORT We want to say Thank You to all the people that make the Bryan County Turning Point Coa-lition such a huge success. • Bryan County Health Department • Bryan County Coalition • Bryan County Community Council • Turning Point Coalition • Durant Public Schools • Choctaw Nation Community Health Programs/ Health Services • Durant Chamber of Commerce • Durant Kiwanis Club • Durant Lions Club • OSU Extension Service • Medical Center of Southeastern Oklahoma • Success by Six Initiative • City of Durant—Parks & Recreation Department • Southeast Oklahoma Division on Aging ( SODA) • Chickasaw Nation Health Services Caddo County County Demographics 2 Top 10 Leading Causes of Death 2 Nutrition & Obesity 2 Top 10 Leading Causes of Death Table 3 Injury & Violence 4 Tobacco use 4 Physical Activity, Wellness & Diabetes 4 Inside this issue: State of the County’s Health Report O K L A H O M A S T A T E D E P A R T M E N T O F H E A L T H Caddo County A Look Back To Move Forward Teen Pregnancy 5 Poverty 5 OK By One—State Immunization Data 6 County Health Department Usage 7 Health Care Costs Summary 7 Turning Point 8 The state of Oklahoma has been in a downward health trend since the 1990’s, until recently. Through the efforts of the state and county health departments, state and local governments and the individual communities the health of Oklahomans is looking up. However, we could do more to improve the health of the citizens of Oklahoma. This report focuses on the health factors for the citizens of Caddo County. We will take a look back to discover what has been affecting the health of the citizens in order to move for-ward and make healthy, effective and safe changes for all. Demographics Top 10 Leading Causes of Death * Vital Statistics, Health Care Information Systems, OSDH & Centers for Disease Control same rate as the nation, and health care costs are reflecting this downward spiral of health. For persons under the age of 65, on average, health care costs are $395 more for obese individuals and are even greater for persons over the age of 65. In 2002-2004, 32.8% With the United States coming in as the most obese country in the world, health care costs related to obesity and poor nutrition are on the rise. Of the 292 million people in the United States, 129 million are overweight or obese according to their body mass in-dex (BMI). The number of obese (BMI > 29) and overweight (BMI 25-29) Ok-lahomans has been increasing at the ( 9,863 ) of people in Caddo County were considered obese which accounted for an addi-tional $3,895,885 in medical costs for the county. These costs are underestimated because they do not take into account the percentage of obese or overweight persons who are over the age of 65. Page 2 Nutrition and Obesity is still the leading cause of death among all age groups. According to the Centers for Disease Control, almost $400,000 is spent on each heart disease-related death. With an average of 127.5 deaths a year, heart disease accounts for over $47 million a year in medical costs in The top 10 leading causes of death table on the next page displays a broad picture of the causes of death in Caddo County. Since many health-related issues are unique to specific ages, this table provides causes of death by age group at a glance. The causes of death that are present across almost every age group have been highlighted. From 1983 to 1993 heart disease killed 1,452 people in Caddo County and STATE OF THE COUNTY’S HEALTH REPORT Sensible Foods — Sensible Portions 5 to 9 Fruits & Vegetables a Day * Behavioral Risk Factor Surveillance Sys-tem, Health Care Information System, OSDH & Health Affairs Journal, R. Strum, 2002 * U.S. Census Bureau • Population estimates o 2% increase from 1990 to 2000 (29,550 to 30,150) o 0% increase from 2000 to 2004 o Ranked 40th for growth in state 2000 Census • Hispanic/Latino ethnicity = 6% • Race o Whites = 66% o Native Americans =24% o Blacks =3% o Other/Multiple = 7% • Age o Under 5 = 7% o Over 64 = 15% o Median age = 36.0 years • Housing units o Occupied = 10,957 (84%) o Vacant = 2,139 (16%) • Disability (ages 21 to 64) = 22.5% national = 19.2% state = 21.5% • Individuals below poverty = 21.7% national = 12.4% state = 14.7% Caddo County Population Growth with Projections 27,000 28,000 29,000 30,000 31,000 32,000 33,000 34,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2010 2015 2020 2025 2030 Year County Population 0.70% 0.75% 0.80% 0.85% 0.90% 0.95% 1.00% Percent of State Population Caddo Percent of Population Caddo County. Alzheimer’s disease and the complications associ-ated with it have increased from the 12th ranked cause of death (1983-1993) to the 9th ranked cause of death in persons 65 and older accounting for a 231% increase in deaths. Heart disease accounts for over $47 million a year in medical costs in Caddo County. CADDO COUNTY Page 3 Rank 0-4 05-14 15-24 25-34 35-44 45-54 55-64 65+ All Ages PERINATAL PERIOD UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY UNINTENT. INJURY HEART DISEASE HEART DISEASE HEART DISEASE HEART DISEASE 15 8 52 31 34 65 135 1167 1402 CONGENITAL ANOMALIES HEART DISEASE SUICIDE HOMICIDE/ LEGAL HEART DISEASE CANCER CANCER CANCER CANCER 13 3 7 9 24 54 117 547 742 SIDS CONGENITAL ANOMALIES HOMICIDE/ LEGAL SUICIDE CANCER UNINTENT. INJURY STROKE STROKE STROKE 4 1 5 6 18 23 28 244 287 HEART DISEASE OTHER COMPLICATED PREGNANCY CANCER LIVER DISEASE LIVER DISEASE BRONCHITIS/ EMPHYSEMA/ ASTHMA BRONCHITIS/ EMPHYSEMA/ ASTHMA UNINTENT. INJURY 3 2 2 5 11 19 26 162 239 INFLUENZA/ PNEUMONIA HEART DISEASE DIABETES MELLITUS HOMICIDE/ LEGAL DIABETES MELLITUS DIABETES MELLITUS INFLUENZA/ PNEUMONIA BRONCHITIS/ EMPHYSEMA/ ASTHMA 3 2 4 10 11 25 141 193 SEPTICEMIA (BLOOD POISONING) NON-CANCEROUS TUMOR STROKE DIABETES MELLITUS SUICIDE UNINTENT. INJURY DIABETES MELLITUS DIABETES MELLITUS 2 1 3 6 10 21 114 160 STROKE STROKE HEART DISEASE HIV STROKE LIVER DISEASE UNINTENT. INJURY INFLUENZA/ PNEUMONIA 1 1 3 5 6 16 69 158 HOMICIDE/ LEGAL CONGENITAL ANOMALIES INFLUENZA/ PNEUMONIA SUICIDE SEPTICEMIA (BLOOD POISONING) SEPTICEMIA (BLOOD POISONING) KIDNEY DISEASE KIDNEY DISEASE 1 1 3 5 5 9 68 79 KIDNEY |
Month/year uploaded | January 2008 |
Date created | 2008-01-24 |
Date modified | 2017-04-17 |
OCLC number | 192176118 |
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