2014 PRC Community Health Needs Assessment Lee County, Florida Prepared for Lee Memorial Health System

Methodology

PRC Community Health Needs Assessment Customized Local PRC Community Health Survey BENCHMARKING Prior Local Survey Data PRC National Health Survey Florida BRFSS data Healthy People 2020 targets National vital statistics data Random-sample survey among 1,000 adults in Lee County By geography: 250 in each of four Market Areas 149 survey items; 25-30 minute interview ±3.1% max error overall PRC Community Health Needs Assessment Secondary Data Key Informant Focus Groups Four Key Informant Focus Groups, comprised of ### community stakeholders: Public health, physicians & other health providers Social services & other community leaders

Expected Error Ranges for a Sample of 1,000 Respondents at the 95 Percent Level of Confidence Note: ● The "response rate" (the percentage of a population giving a particular response) determines the error rate associated with that response. A "95 percent level of confidence" indicates that responses would fall within the expected error range on 95 out of 100 trials. Examples: ● If 10% of the sample of 1,000 respondents answered a certain question with a "yes," it can be asserted that between 8.1% and 11.9% (10% ± 1.9%) of the total population would offer this response. ● If 50% of respondents said "yes," one could be certain with a 95 percent level of confidence that between 46.9% and 53.1% (50% ± 3.1%) of the total population would respond "yes" if asked this question.

Population & Survey Sample Characteristics (Lee County, 2014) Sources: ● Census 2010, Summary File 3 (SF 3). U.S. Census Bureau. ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc.

General Health Status

Overall Health Status

Self-Reported Health Status (Lee County, 2014) % "Fair/Poor" Physical Health Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 6] Notes: ● Asked of all respondents.

Experience “Fair” or “Poor” Overall Health % "Fair/Poor" Physical Health Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 6] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Experience “Fair” or “Poor” Overall Health (Lee County, 2014) % "Fair/Poor" Physical Health Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 6] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Limited in Activities in Some Way Due to a Physical, Mental or Emotional Problem Lee County Trend % Activity Limitations Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 123] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Limited in Activities in Some Way Due to a Physical, Mental or Emotional Problem (Lee County, 2014) % Activity Limitations Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 123] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Type of Problem That Limits Activities (Among Those Reporting Activity Limitations; Lee County, 2014) % Activity Limitations Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 124] Notes: ● Asked of those respondents reporting activity limitations.

Number of Falls in the Past 3 Months (Lee County Residents Age 45+, 2014) 2011=14.1% % [Age 45+] Have Fallen in the Past 3 Months 2011=40.9% Number of Falls Fall Caused Injury Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 125-126] Notes: ● Asked of all respondents age 45 and older.

Mental Health & Mental Disorders

Self-Reported Mental Health Status (Lee County, 2014) % "Fair/Poor" Mental Health Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 118] Notes: ● Asked of all respondents.

Experience “Fair” or “Poor” Mental Health % "Fair/Poor" Mental Health Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 118] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Experience “Fair” or “Poor” Mental Health (Lee County, 2014) % "Fair/Poor" Mental Health Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 118] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Have Been Diagnosed With a Depressive Disorder % Diagnosed Depression Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 121] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Depressive disorders include depression, major depression, dysthymia, or minor depression.

Have Been Diagnosed With a Depressive Disorder (Lee County, 2014) % Diagnosed Depression Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 121] Notes: ● Asked of all respondents. ● Depressive disorders include depression, major depression, dysthymia, or minor depression. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Have Experienced Symptoms of Chronic Depression % Symptoms of Chronic Depression (2+ Years) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 119] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Chronic depression includes periods of two or more years during which the respondent felt depressed or sad on most days, even if (s)he felt okay sometimes.

Have Experienced Symptoms of Chronic Depression (Lee County, 2014) % Symptoms of Chronic Depression (2+ Years) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 119] Notes: ● Asked of all respondents. ● Chronic depression includes periods of two or more years during which the respondent felt depressed or sad on most days, even if (s)he felt okay sometimes. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Perceived Level of Stress On a Typical Day (Lee County, 2014) % Typical Day Is "Extremely/Very" Stressful Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 120] Notes: ● Asked of all respondents.

Perceive Most Days As “Extremely” or “Very” Stressful % Typical Day Is "Extremely/Very" Stressful Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 120] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Perceive Most Days as “Extremely” or “Very” Stressful (Lee County, 2014) % Typical Day Is "Extremely/Very" Stressful Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 120] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Suicide: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Suicide (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MHMD-1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Suicide: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Suicide (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MHMD-1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Suicide: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Suicide (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MHMD-1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Adults With Diagnosed Depression Who Have Ever Sought Professional Help for a Mental or Emotional Problem (Among Adults With Diagnosed Depressive Disorder) % [Those With Diagnosed Depression] Seeking Help % Have Ever Sought Help for Mental Health Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 150] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Reflects those respondents with a depressive disorder diagnosed by a physician (such as depression, major depression, dysthymia, or minor depression).

Member of Household Sought Mental Health Services % Member of HH Sought Mental Health Svcs Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 26-27] Notes: ● Asked of all respondents.

Child Takes Medication for ADD/ADHD (Among Parents of Children 5-17) % Child [Age 5-17] Takes Prescription for ADD/ADHD Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 140] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents with children age 5 to 17.

Death, Disease & Chronic Conditions

Leading Causes of Death

Leading Causes of Death (Lee County, 2010) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● CLRD is chronic lower respiratory disease.

Age-Adjusted Death Rates for Selected Causes (2008-2010 Deaths per 100,000) Lee County Florida US HP2020 Malignant Neoplasms (Cancers) 146.6 166.4 174.2 160.6 Diseases of the Heart 146.4 146.7 171.7 158.9* Unintentional Injuries 48.6 43.9 38.1 36.0 Chronic Lower Respiratory Disease (CLRD) 35.2 39.4 43.2 n/a Cerebrovascular Disease (Stroke) 26.3 32.1 39.7 33.8 Drug-Induced 18.1 17.2 12.6 11.3 Intentional Self-Harm (Suicide) 16.1 14.2 11.7 10.2 Diabetes Mellitus 15.9 20.3 21.3 Motor Vehicle Deaths 14.3 14.8 12.2 12.4 Firearm-Related 12.8 12.1 9.2 Alzheimer’s Disease 12.3 16.5 24.3 20.5* Cirrhosis/Liver Disease 11.1 10.5 8.2 Kidney Diseases 7.6 11.8 15.0 Pneumonia/Influenza 7.2 9.1 Homicide/Legal Intervention 5.4 6.9 5.7 5.5 HIV/AIDS 2.5 6.4 3.0 3.3 Drug-Induced Deaths (Age-Adjusted Death Rate) Cirrhosis/Liver Disease (Age-Adjusted Death Rate) Kidney Disease (Age-Adjusted Death Rate) Alzheimer’s Disease (Age-Adjusted Death Rate) Diabetes Mellitus (Age-Adjusted Death Rate) Homicide (Age-Adjusted Death Rate) Firearm-Related Deaths (Age-Adjusted Death Rate) Motor Vehicle Crashes (Age-Adjusted Death Rate) Unintentional Injury (Age-Adjusted Death Rate) Pneumonia/Influenza (Age-Adjusted Death Rate) CLRD (Age-Adjusted Death Rate) Cancer (Age-Adjusted Death Rate) Stroke (Age-Adjusted Death Rate) Diseases of the Heart (Age-Adjusted Death Rate) Suicide (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov. Note: ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population and coded using ICD-10 codes. ● *The Healthy People 2020 Heart Disease target is adjusted to account for all diseases of the heart; the Diabetes target is adjusted to reflect only diabetes mellitus-coded deaths. ● Local, state and national data are simple three-year averages.

Cardiovascular Disease

Heart Disease: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Diseases of the Heart (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-2] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages. ● The Healthy People 2020 Heart Disease target is adjusted to account for all diseases of the heart.

Heart Disease: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Diseases of the Heart (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-2] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages. ● The Healthy People 2020 Heart Disease target is adjusted to account for all diseases of the heart.

Heart Disease: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Diseases of the Heart (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-2] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages. ● The Healthy People 2020 Heart Disease target is adjusted to account for all diseases of the heart.

Stroke: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Stroke (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-3] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Stroke: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Stroke (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-3] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Stroke: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Stroke (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-3] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Prevalence of Heart Disease % Heart Disease (Heart Attack, Angina, Coronary Disease) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 151] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Includes diagnoses of heart attack, angina or coronary heart disease.

Prevalence of Heart Disease (Lee County, 2014) % Heart Disease (Heart Attack, Angina, Coronary Disease) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 151] Notes: ● Asked of all respondents. ● Includes diagnoses of heart attack, angina or coronary heart disease. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Prevalence of Stroke % Stroke Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 45] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. Notes: ● Asked of all respondents.

Prevalence of Stroke (Lee County, 2014) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 45] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Have Had Blood Pressure Checked in the Past Two Years % Blood Pressure Checked in Past 2 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 54] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-4] Notes: ● Asked of all respondents.

Prevalence of High Blood Pressure 75.8% of these respondents have been told more than once that their blood pressure was high % Told Have High Blood Pressure (Ever) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 52, 152] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2011 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-5.1] Notes: ● Asked of all respondents.

Prevalence of High Blood Pressure (Lee County, 2014) % Told Have High Blood Pressure (Ever) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 152] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-5.1] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Taking Action to Control Hypertension (Among Adults With High Blood Pressure) % [HBP] Taking Action to Control High Blood Pressure Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 53] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents who have been diagnosed with high blood pressure. ● In this case, the term “action” refers to medication, change in diet, and/or exercise.

Have Had Blood Cholesterol Levels Checked in the Past Five Years % Cholesterol Checked in Past 5 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 57] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2011 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-6] Notes: ● Asked of all respondents.

Have Had Blood Cholesterol Levels Checked in the Past Five Years (Lee County, 2014) % Cholesterol Checked in Past 5 Years Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 57] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-6] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Prevalence of High Blood Cholesterol % Told Have High Cholesterol (Ever) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 153] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2011 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-7] Notes: ● Asked of all respondents. ● *The Florida data reflects those adults who have been tested for high cholesterol and who have been diagnosed with it.

Prevalence of High Blood Cholesterol (Lee County, 2014) % Told Have High Cholesterol (Ever) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 153] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-7] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Taking Action to Control High Blood Cholesterol Levels (Among Adults With High Cholesterol) % [HBC] Taking Action to Control High Blood Cholesterol Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 56] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents who have been diagnosed with high blood cholesterol levels. ● In this case, the term “action” refers to medication, change in diet, and/or exercise.

Present One or More Cardiovascular Risks or Behaviors % 1+ Cardiovascular Risk Factor Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 154] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Cardiovascular risk is defined as exhibiting one or more of the following: 1) no leisure-time physical activity; 2) regular/occasional cigarette smoking; 3) hypertension; 4) high blood cholesterol; and/or 5) being overweight/obese.

Present One or More Cardiovascular Risks or Behaviors (Lee County, 2014) % 1+ Cardiovascular Risk Factor Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 154] Notes: ● Asked of all respondents. ● Cardiovascular risk is defined as exhibiting one or more of the following: 1) no leisure-time physical activity; 2) regular/occasional cigarette smoking; 3) hypertension; 4) high blood cholesterol; and/or 5) being overweight/obese. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Cancer

Cancer: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Cancer (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective C-1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Cancer: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Cancer (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective C-1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Cancer: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Cancer (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective C-1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● State and national data are simple three-year averages.

Age-Adjusted Cancer Death Rates by Site (2008-2010 Annual Average Deaths per 100,000 Population) Lee County Florida US HP2020 Lung Cancer 42.0 48.2 48.5 45.5 Prostate Cancer 15.3 19.5 22.3 21.2 Female Breast Cancer 17.5 21.4 20.6 Colorectal Cancer 12.1 15.1 16.1 14.5 Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov Lung Cancer (Age-Adjusted Death Rate) Prostate Cancer (Age-Adjusted Death Rate) Female Breast Cancer (Age-Adjusted Death Rate) Colorectal Cancer (Age-Adjusted Death Rate) SECONDARY DATA

Prevalence of Skin Cancer Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 40] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Prevalence of Cancer (Other Than Skin Cancer) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 39] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Have Had a Prostate Screening in the Past Two Years (Among Men Ages 50 and Older) % [Men 50+] Prostate Exam in Past 2 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 208] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all male respondents age 50 and older.

Have Had a Mammogram in the Past Two Years (Among Women Ages 50-74) % [Women 40+] Mammogram in Past 2 Years % [Women 50-74] Mammogram in Past 2 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 155-156] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective C-17] Notes: ● Reflects female respondents 50-74. ● *Note that state data reflects all women 50 and older (vs. women 50-74 in local, US and Healthy People data).

Have Had a Pap Smear in the Past Three Years (Among Women Ages 21-65) % [Women 21-65] Pap Smear in Past 3 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 157] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective C-15] Notes: ● Reflects female respondents age 21 to 65; *note that the Florida percentage represents all women age 18 and older.

Have Had a Colorectal Cancer Screening (Among Adults Age 50-75) % [Age 50-75] Colorectal Cancer Screening Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 160] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective C-16] Notes: ● Asked of all respondents age 50 through 75. ● In this case, the term “colorectal screening” refers to adults age 50-75 receiving a FOBT (fecal occult blood test) in the past year and/or a lower endoscopy (sigmoidoscopy/colonoscopy) in the past 10 years.

Have Ever Had a Lower Endoscopy (Among Adults Age 50 and Older) % [Age 50+] Sigmoid/Colonoscopy Ever % [Age 50+] Blood Stool Test in Past 2 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 158] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. Notes: ● Asked of respondents age 50 and older. ● Lower endoscopy includes either sigmoidoscopy or colonoscopy.

Have Had a Blood Stool Test in the Past 2 Years (Among Adults Age 50 and Older) % [Age 50+] Sigmoid/Colonoscopy Ever % [Age 50+] Blood Stool Test in Past 2 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 159] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. Notes: ● Asked of respondents age 50 and older.

Respiratory Disease

CLRD: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) CLRD (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages. ● CLRD is chronic lower respiratory disease.

CLRD: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) CLRD (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages. ● CLRD is chronic lower respiratory disease.

CLRD: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) CLRD (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● State and national data are simple three-year averages. ● CLRD is chronic lower respiratory disease.

Pneumonia/Influenza: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Pneumonia/Influenza (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Pneumonia/Influenza: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Pneumonia/Influenza (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● State and national data are simple three-year averages.

Prevalence of Chronic Obstructive Pulmonary Disease (COPD) % COPD (Lung Disease) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 34] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Includes those having ever suffered from or been diagnosed with COPD or chronic obstructive pulmonary disease, including bronchitis or emphysema. ● *In prior data, the term “chronic lung disease” was used, which also included bronchitis or emphysema.

Adult Asthma: Current Prevalence % [Adult] Currently Has Asthma Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 161] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. Notes: ● Asked of all respondents. ● Includes those who have ever been diagnosed with asthma, and who report that they still have asthma.

Currently Have Asthma (Lee County, 2014) % [Adult] Currently Has Asthma Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 161] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Childhood Asthma: Current Prevalence (Among Parents of Children Age 0-17) % [Child 0-17] Currently Has Asthma Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 162] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents with children 0 to 17 in the household. ● Includes children who have ever been diagnosed with asthma, and whom are reported to still have asthma.

Injury & Violence

Leading Causes of Accidental Death (Lee County, 2008-2010) Unintentional Injury (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).

Unintentional Injuries: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Unintentional Injury (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-11] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Unintentional Injuries: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Unintentional Injury (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-11] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Unintentional Injuries: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Unintentional Injury (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-11] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Motor Vehicle Crashes: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Motor Vehicle Crashes (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-13.1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Motor Vehicle Crashes: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Motor Vehicle Crashes (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-13.1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Motor Vehicle Crashes: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Motor Vehicle Crashes (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-13.1] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

“Always” Wear a Seat Belt When Driving or Riding in a Vehicle % "Always" Wear Seat Belt Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 58] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IPV-15] Notes: ● Asked of all respondents.

“Always” Wear a Seat Belt When Driving or Riding in a Vehicle (Lee County, 2014) % "Always" Wear Seat Belt Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 58] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IPV-15] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Frequency of Texting While Driving in the Past Month Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 67] Notes: ● Asked of all respondents.

Texted While Driving in the Past Month (Lee County, 2014) % Texting While Driving in the Past Month Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 67] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Child “Always” Wears a Seat Belt or Appropriate Restraint When Riding in a Vehicle (Among Parents of Children Age 0-17) Lee County Trend % Child [Age 0-17] "Always" Uses Seat Belt/Car Seat Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 149] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents with children 0 to 17 in the household.

Child “Always” Wears a Helmet When Riding a Bicycle (Among Parents of Children Age 5-17) % Child [Age 5-17] "Always" Wears Bicycle Helmet Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 148] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents with children age 5 to 17 at home. ● *2007 data reflects children age 5 to 16 at home.

Have a Swimming Pool at Home or Apartment % Have a Swimming Pool at Home/Apartment Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 65] Notes: ● Asked of all respondents.

Have Safety Features for the Pool (Among Lee County Adults w/Home or Apartment Pools) % Have a Swimming Pool at Home/Apartment Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 6] Notes: ● Asked of all respondents.

Firearms-Related Deaths: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Firearm-Related Deaths (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-30] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population. ● Local, state and national data are simple three-year averages.

Firearms-Related Deaths: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Firearm-Related Deaths (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-30] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population. ● Local, state and national data are simple three-year averages.

Firearms-Related Deaths: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Firearm-Related Deaths (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-30] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population. ● Local, state and national data are simple three-year averages.

Have a Firearm Kept in or Around the Home Lee County Trend HH w/Kids: 2007: 23.9% 2011: 30.5% 2014: 27.9% % Firearm in Home % [Homes With Children] Firearm in Home Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 62, 163] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● In this case, firearms include pistols, shotguns, rifles, and other types of guns; this does not include starter pistols, BB guns, or guns that cannot fire.

Have a Firearm Kept in or Around the House (Lee County, 2014) % Firearm in Home Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 62] Notes: ● Asked of all respondents. ● In this case, firearms include pistols, shotguns, rifles, and other types of guns; this does not include starter pistols, BB guns, or guns that cannot fire. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Household Has an Unlocked, Loaded Firearm (Among Respondents Reporting a Firearm in or Around the Home) Lee County Trend % [Homes With Firearms] Weapon(s) Unlocked & Loaded % Firearm in Home % [Homes With Children] Firearm in Home Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 164] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● In this case, firearms include pistols, shotguns, rifles, and other types of guns; this does not include starter pistols, BB guns, or guns that cannot fire.

Homicide: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Homicide (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-29] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Homicide: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Homicide (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-29] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Homicide: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Homicide (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IVP-29] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Violent Crime Rates (2008-2010 Annual Average Offenses per 100,000 Population) Violent Crime per 100,000 SECONDARY DATA Sources: ● Florida Department of Law Enforcement. ● US Department of Justice, Federal Bureau of Investigation Notes: ● Rates are offenses per 100,000 population among agencies reporting.

Violent Crime Rates (Annual Average Offenses per 100,000 Population) Violent Crime per 100,000 SECONDARY DATA Sources: ● Florida Department of Law Enforcement. ● US Department of Justice, Federal Bureau of Investigation Notes: ● Rates are offenses per 100,000 population among agencies reporting.

Victim of a Violent Crime in the Past Five Years Lee County Trend % Victim of Violent Crime in Past 5 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 59] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Victim of a Violent Crime in the Past Five Years (Lee County, 2014) % Victim of Violent Crime in Past 5 Years Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 59] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Domestic Violence Rates (2010-2012 Annual Average Offenses per 100,000 Population) Domestic Violence Offenses per 100,000 SECONDARY DATA Sources: ● Florida Department of Law Enforcement. Notes: ● Rates are domestic calls for assistance per 100,000 population.

Domestic Violence Rates (Annual Average Offenses per 100,000 Population) Domestic Violence Offenses per 100,000 SECONDARY DATA Sources: ● Florida Department of Law Enforcement. Notes: ● Rates are domestic calls for assistance per 100,000 population.

Threatened With Domestic Violence: 10.8% Have Ever Been Hit, Slapped, Pushed, Kicked, or Hurt in Any Way by an Intimate Partner Threatened With Domestic Violence: 10.8% (vs. 14.1% nationwide) % Victim of Domestic Violence (Ever) % Ever Threatened With Violence by Intimate Partner Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 60, 61] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Have Ever Been Hit, Slapped, Pushed, Kicked, or Hurt in Any Way by an Intimate Partner (Lee County, 2014) % Victim of Domestic Violence (Ever) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 61] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Diabetes

Diabetes: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Diabetes Mellitus (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective D-3] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages. ● The Healthy People 2020 target for Diabetes is adjusted to account for only diabetes mellitus coded deaths.

Diabetes: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Diabetes Mellitus (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective D-3] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● The Healthy People 2020 target for Diabetes is adjusted to account for only diabetes mellitus coded deaths.

Diabetes: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Diabetes Mellitus (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective D-3] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages. ● The Healthy People 2020 target for Diabetes is adjusted to account for only diabetes mellitus coded deaths.

Prevalence of Diabetes % Diabetes/High Blood Sugar % Borderline/Pre-Diabetes Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 207] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. Notes: ● Asked of all respondents. ● Local and national data exclude gestation diabetes (occurring only during pregnancy).

Prevalence of Diabetes (Lee County, 2014) % Diabetes/High Blood Sugar Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 207] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● Excludes gestation diabetes (occurring only during pregnancy).

Have Had Blood Sugar Tested in the Past Three Years (Among Non-Diabetics) % [Non-Diabetes] Blood Sugar Tested in Past 3 Years Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 49] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of respondents who have not been diagnosed with diabetes.

Alzheimer’s Disease

Alzheimer’s Disease: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Alzheimer's Disease (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Alzheimer’s Disease: Age-Adjusted Mortality by Race (2008-2010 Annual Average Deaths per 100,000 Population) Alzheimer's Disease (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Alzheimer’s Disease: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Alzheimer's Disease (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population.

Kidney Disease

Kidney Disease: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Kidney Disease (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Kidney Disease: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Kidney Disease (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● State and national data are simple three-year averages.

Prevalence of Kidney Disease Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 42] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Prevalence of Kidney Disease (Lee County, 2014) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 42] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Potentially Disabling Conditions

Prevalence of Arthritis/Rheumatism (Among Adults Age 50 and Older) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 165] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Reflects respondents age 50 and older.

Prevalence of Osteoporosis (Among Adults Age 50 and Older) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 166] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AOCBC-10] Notes: ● Reflects respondents age 50 and older.

Prevalence of Sciatica/Chronic Back Pain Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 38] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Prevalence of Blindness/Trouble Seeing Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 35] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Prevalence of Deafness/Trouble Hearing Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 36] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Infectious Disease

Vaccine-Preventable Conditions

For report text: there was one case of mumps in Lee County between 2010-2012 (no measles or rubella). Measles per 100,000 Mumps per 100,000 Rubella per 100,000 Pertussis per 100,000 SECONDARY DATA

Pertussis Incidence (Annual Average Cases per 100,000 Population) Pertussis per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Center for Health Statistics. Notes: ● Rates are annual average new cases per 100,000 population.

Hepatitis C (Acute) Incidence (2009-2011 Annual Average Cases per 100,000 Population) Hepatitis C, non-A non-B Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IID-26] Notes: ● Rates are annual average new cases per 100,000 population.

Hepatitis C (Acute) Incidence (Annual Average Cases per 100,000 Population) Hepatitis C, non-A non-B Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IID-26] Notes: ● Rates are annual average new cases per 100,000 population.

Older Adults: Have Had a Flu Vaccination in the Past Year (Among Adults Age 65+) % [Age 65+] Flu Vaccine in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 167] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IID-12.7] Notes: ● Reflects respondents 65 and older. ● Includes FluMist as a form of vaccination.

High-Risk Adults: Have Had a Flu Vaccination in the Past Year (Among High-Risk Adults Age 18-64) % [High-Risk 18-64] Flu Vaccine in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 168] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IID-12.6] Notes: ● Reflects high-risk respondents age 18-64. ● “High-Risk” includes adults age 18 to 64 who have been diagnosed with heart disease, diabetes or respiratory disease. ● Includes FluMist as a form of vaccination.

Older Adults: Have Ever Had a Pneumonia Vaccine (Among Adults Age 65+) % [Age 65+] Pneumonia Vaccine Ever Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 169] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IID-13.1] Notes: ● Reflects respondents 65 and older.

High-Risk Adults: Have Ever Had a Pneumonia Vaccine (Among High-Risk Adults Age 18-64) % [High-Risk 18-64] Pneumonia Vaccine Ever Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 170] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IID-13.2] Notes: ● Asked of all high-risk respondents under 65. ● “High-Risk” includes adults age 18 to 64 who have been diagnosed with heart disease, diabetes or respiratory disease.

Tuberculosis

Tuberculosis Incidence (2009-2011 Annual Average Cases per 100,000 Population) Tuberculosis Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IID-29] ● Centers for Disease Control and Prevention, Division of Public Health Surveillance and Informatics. Epidemiology Program Office. Notes: ● Rates are annual average new cases per 100,000 population.

Tuberculosis Incidence (Annual Average Cases per 100,000 Population) Tuberculosis Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective IID-29] ● Centers for Disease Control and Prevention, Division of Public Health Surveillance and Informatics. Epidemiology Program Office. Notes: ● Rates are annual average new cases per 100,000 population.

HIV

HIV/AIDS: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) HIV/AIDS (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HIV-12] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population.

HIV/AIDS: Age-Adjusted Mortality (Annual Average Deaths per 100,000 Population) HIV/AIDS (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● Centers for Disease Control and Prevention, National Center for Health Statistics. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HIV-12] ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population.

HIV/AIDS Incidence (2010-2012 Annual Average Cases per 100,000 Population) HIV/AIDS Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. Notes: ● Rates are annual average new cases per 100,000 population.

HIV/AIDS Incidence (Annual Average Cases per 100,000 Population) HIV/AIDS Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HIV-4] Notes: ● Rates are annual average new cases per 100,000 population.

Tested for HIV in the Past Year (Among Adults Age 18-44) % [Age 18-44] HIV Test in the Past Year % [Age 18-64] Ever Tested for HIV Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 171] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HIV-14.1] Notes: ● Reflects respondents age 18 to 44. ● Note that the Healthy People 2020 objective is for ages 15-44.

Sexually Transmitted Diseases

Gonorrhea Incidence (2010-2012 Annual Average Cases per 100,000 Population) Gonorrhea Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Center for Health Statistics. Notes: ● Rates are annual average new cases per 100,000 population.

Gonorrhea Incidence (Annual Average Cases per 100,000 Population) Gonorrhea Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Center for Health Statistics. Notes: ● Rates are annual average new cases per 100,000 population.

Primary/Secondary Syphilis Incidence (2010-2012 Annual Average Cases per 100,000 Population) Primary & Secondary Syphilis Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Center for Health Statistics. Notes: ● Rates are annual average new cases per 100,000 population.

Primary/Secondary Syphilis Incidence (Annual Average Cases per 100,000 Population) Primary & Secondary Syphilis Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Center for Health Statistics. Notes: ● Rates are annual average new cases per 100,000 population.

Chlamydia Incidence (2010-2012 Annual Average Cases per 100,000 Population) Chlamydia Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Center for Health Statistics. Notes: ● Rates are annual average new cases per 100,000 population.

Chlamydia Incidence (Annual Average Cases per 100,000 Population) Chlamydia Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Center for Health Statistics. Notes: ● Rates are annual average new cases per 100,000 population.

Hepatitis B (Acute) Incidence (2010-2012 Annual Average Cases per 100,000 Population) Hepatitis B Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Center for Health Statistics. Notes: ● Rates are annual average new cases per 100,000 population. ● *US rate represents 2009-2011 data.

Hepatitis B (Acute) Incidence (Annual Average Cases per 100,000 Population) Hepatitis B Incidence per 100,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Center for Health Statistics. Notes: ● Rates are annual average new cases per 100,000 population.

Have Completed the Hepatitis B Vaccination Series % Have Completed Hepatitis B Vaccination Series Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 83] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Includes a series of three shots, usually administered at least one month between shots

Have Completed the Hepatitis B Vaccination Series (Lee County, 2014) % Have Completed Hepatitis B Vaccination Series Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 83] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Number of Sexual Partners in Past 12 Months (Among Unmarried Adults Age 18-64; Lee County, 2014) % [Unmarried 18-64] 3+ Sexual Partners in Past Year Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 103] Notes: ● Asked of all unmarried respondents under the age of 65.

Had Three or More Sexual Partners in the Past Year (Among Unmarried Adults Age 18-64) % [Unmarried 18-64] 3+ Sexual Partners in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 103] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all unmarried respondents under the age of 65.

Had Three or More Sexual Partners in the Past Year (Among Unmarried Adults Age 18-64; Lee County, 2014) % [Unmarried 18-64] 3+ Sexual Partners in Past Year Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 103] Notes: ● Asked of all unmarried respondents under the age of 65. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Condom Was Used During Last Sexual Intercourse (Among Unmarried Adults Age 18-64) % [Unmarried 18-64] Using Condoms Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 104] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all unmarried respondents under the age of 65.

Condom Was Used During Last Sexual Intercourse (Among Unmarried Adults Age 18-64; Lee County, 2014) % [Unmarried 18-64] Using Condoms Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 104] Notes: ● Asked of all unmarried respondents under the age of 65. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Births

Prenatal Care

Lack of Prenatal Care in the First Trimester (Percentage of Live Births, 2010-2012) No Prenatal Care in First Trimester (Percent) Less Than Adequate Prenatal Care (Percent) SECONDARY DATA Sources: ● Florida Department of Health. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MICH-10.1] Note: ● Numbers are a percentage of all live births within each population.

Lack of Prenatal Care in the First Trimester (Percentage of Live Births) No Prenatal Care in First Trimester (Percent) Less Than Adequate Prenatal Care (Percent) SECONDARY DATA Sources: ● Florida Department of Health. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MICH-10.1] Note: ● Numbers are a percentage of all live births within each population.

Birth Outcomes

Low-Weight Births (Percentage of Live Births, 2010-2012) Low Birthweight Births (Percent) SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Vital Statistics System. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MICH-8.1] Note: ● Numbers are a percentage of all live births within each population. ● Defined as an infant born weighing less than 5.5 pounds (2,500 grams) regardless of gestational age.

Low-Weight Births (Percentage of Live Births) Low Birthweight Births (Percent) SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Vital Statistics System. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MICH-8.1] Note: ● Numbers are a percentage of all live births within each population. ● Defined as an infant born weighing less than 5.5 pounds (2,500 grams) regardless of gestational age.

Infant Mortality Rate (2008-2010 Annual Average Infant Deaths per 1,000 Live Births) Infant Death Rate SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● Centers for Disease Control and Prevention, National Center for Health Statistics. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MICH-1.3] Notes: ● Rates are three-year averages of deaths of children under 1 year old per 1,000 live births.

Infant Mortality Rate (2008-2010 Annual Average Infant Deaths per 1,000 Live Births) Infant Death Rate SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MICH-1.3] Notes: ● Rates are three-year averages of deaths of children under 1 year old per 1,000 live births.

Infant Mortality Rate (Annual Average Infant Deaths per 1,000 Live Births) Infant Death Rate SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● Centers for Disease Control and Prevention, National Center for Health Statistics. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective MICH-1.3] Notes: ● Rates are three-year averages of deaths of children under 1 year old per 1,000 live births.

Family Planning

Births to Unwed Mothers (Percentage of Live Births, 2010-2012) SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Vital Statistics System. Note: ● Numbers are a percentage of all live births within each population. ● US percentage reflects 2004-2006 data.

Births to Unwed Mothers (Percentage of Live Births) SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Vital Statistics System. Note: ● Numbers are a percentage of all live births within each population.

Births to Teen Mothers (Percentage of Live Births, 2010-2012) Births to Teenagers (Percent) Teenage Birth Rate (15-19)/1,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Vital Statistics System. Note: ● Numbers are a percentage of all live births within each population. ● US percentage reflects 2004-2006 data.

Births to Teen Mothers (Percentage of Live Births) Births to Teenagers (Percent) Teenage Birth Rate (15-19)/1,000 SECONDARY DATA Sources: ● Florida Department of Health. ● Centers for Disease Control and Prevention, National Vital Statistics System. Note: ● Numbers are a percentage of all live births within each population.

Modifiable Health Risks

Nutrition

Consume Five or More Servings of Fruits/Vegetables Per Day % Eat 5+ Servings of Fruit or Vegetables per Day Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 173] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● For this issue, respondents were asked to recall their food intake on the previous day.

Consume Five or More Servings of Fruits/Vegetables Per Day (Lee County, 2014) % Eat 5+ Servings of Fruit or Vegetables per Day Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 173] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● For this issue, respondents were asked to recall their food intake on the previous day.

Generally Read Food Labels When Selecting Foods % Read Food Labels for Nutrition Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 109] Notes: ● Asked of all respondents.

Generally Read Food Labels When Selecting Foods (Lee County, 2014) % Read Food Labels for Nutrition Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 109] Notes: ● Asked of all respondents

Level of Difficulty Finding Fresh Produce at an Affordable Price (Lee County, 2014) % Eat 5+ Servings of Fruit or Vegetables per Day % "Very/Somewhat" Difficult to Buy Fresh Produce Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 108] Notes: ● Asked of all respondents.

Find It “Very” or “Somewhat” Difficult to Buy Affordable Fresh Produce % Eat 5+ Servings of Fruit or Vegetables per Day % "Very/Somewhat" Difficult to Buy Fresh Produce Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 108] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Find It “Very” or “Somewhat” Difficult to Buy Affordable Fresh Produce (Lee County, 2014) % Eat 5+ Servings of Fruit or Vegetables per Day % "Very/Somewhat" Difficult to Buy Fresh Produce Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 108] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Have Received Advice About Diet and Nutrition in the Past Year From a Physician, Nurse, or Other Health Professional (By Weight Classification) % Medical Advice on Nutrition in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 24] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Physical Activity

No Leisure-Time Physical Activity in the Past Month Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 110] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective PA-1] Notes: ● Asked of all respondents.

No Leisure-Time Physical Activity in the Past Month (Lee County, 2014) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 110] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective PA-1] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Meets Physical Activity Recommendations Lee County Trend % Meeting Physical Activity Guidelines Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 174] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● In this case the term “meets physical activity recommendations” refers to participation in moderate physical activity (exercise that produces only light sweating or a slight to moderate increase in breathing or heart rate ) at least 5 times a week for 30 minutes at a time, and/or vigorous physical activity (activities that cause heavy sweating or large increases in breathing or heart rate) at least 3 times a week for 20 minutes at a time.

Meets Physical Activity Recommendations (Lee County, 2014) % Meeting Physical Activity Guidelines Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 174] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● In this case the term “meets physical activity recommendations” refers to participation in moderate physical activity (exercise that produces only light sweating or a slight to moderate increase in breathing or heart rate ) at least 5 times a week for 30 minutes at a time, and/or vigorous physical activity (activities that cause heavy sweating or large increases in breathing or heart rate) at least 3 times a week for 20 minutes at a time.

Moderate & Vigorous Physical Activity (Lee County, 2014) % Moderate Physical Activity % Vigorous Physical Activity US=30.6% US=38.0% Moderate Physical Activity Vigorous Physical Activity Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 175-176] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Moderate Physical Activity: Takes part in exercise that produces only light sweating or a slight to moderate increase in breathing or heart rate at least 5 times per week for at least 30 minutes per time. ● Vigorous Physical Activity: Takes part in activities that cause heavy sweating or large increases in breathing or heart rate at least 3 times per week for at least 20 minutes per time.

Have Received Advice About Exercise in the Past Year From a Physician, Nurse, or Other Health Professional (By Weight Classification) % Medical Advice on Physical Activity in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 25] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Child Is Physically Active for One or More Hours per Day (Among Children Ages 2-17) % Child [Age 2-17] Physically Active 1+ Hours per Day Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 142] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents with children age 2-17 at home. ● Includes children reported to have one or more hours of physical activity on each of the seven days preceding the survey.

Children With Three or More Hours per School Day of Total Screen Time [TV, Computer, Video Games, Etc. for Entertainment] (Among Parents of Children 5-17) % Child [Age 5-17] 3+ Hours per Day of Total Screen Time Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 143] Notes: ● Asked of all respondents with children 5-17 at home. ● For this issue, respondents with children who are not in school were asked about “weekdays,” while parents of children in school were asked about typical “school days.” ● “Three or more hours” includes reported screen time of 180 minutes or more per day.

Weight Status

Healthy Weight (Percent of Adults With a Body Mass Index Between 18 Healthy Weight (Percent of Adults With a Body Mass Index Between 18.5 and 24.9) % Healthy Weight (BMI 18.5-24.9) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 181] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-8] Notes: ● Based on reported heights and weights, asked of all respondents. ● The definition of healthy weight is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), between 18.5 and 24.9.

Prevalence of Total Overweight (Percent of Adults With a Body Mass Index of 25.0 or Higher) % Overweight (BMI 25+) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 181] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. Notes: ● Based on reported heights and weights, asked of all respondents. ● The definition of overweight is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 25.0, regardless of gender. The definition for obesity is a BMI greater than or equal to 30.0.

Prevalence of Obesity (Percent of Adults With a Body Mass Index of 30 Prevalence of Obesity (Percent of Adults With a Body Mass Index of 30.0 or Higher) % Obese (BMI 30+) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 181] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-9] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. Notes: ● Based on reported heights and weights, asked of all respondents. ● The definition of obesity is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 30.0, regardless of gender.

Prevalence of Obesity (Percent of Adults With a BMI of 30 Prevalence of Obesity (Percent of Adults With a BMI of 30.0 or Higher; Lee County, 2014) % Obese (BMI 30+) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 181] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-9] Notes: ● Based on reported heights and weights, asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● The definition of obesity is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 30.0, regardless of gender.

Actual vs. Perceived Weight Status (Among Overweight/Obese Adults Based on BMI; Lee County, 2014) % [Overweights] Perceive Self "About the Right Weight" Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 117] Notes: ● BMI is based on reported heights and weights, asked of all respondents. ● The definition of overweight is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 25.0, regardless of gender. The definition for obesity is a BMI greater than or equal to 30.0.

Relationship of Overweight With Other Health Issues (By Weight Classification; Lee County, 2014) % Overweight (BMI 25+) % Obese (BMI 30+) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 37, 119, 123, 153, 185, 207] Notes: ● Based on reported heights and weights, asked of all respondents.

Have Received Advice About Weight in the Past Year From a Physician, Nurse, or Other Health Professional (By Weight Classification) % Medical Advice on Weight in Past Year % [Overweights] Counseled About Weight in Past Year % [Obese Adults] Counseled About Weight in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 116, 183-184] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Trying to Lose Weight by Both Modifying Diet and Increasing Physical Activity (By Weight Classification) % [Overweights] Trying to Lose Weight Both Diet/Exercise Sources:  PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 182]  2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes:  Based on reported heights and weights, asked of all respondents.

Child Total Overweight Prevalence (Percent of Children 5-17 Who Are Overweight/Obese; Body Mass Index in the 85th Percentile or Higher) % Children [Age 5-17] Overweight (85th Percentile) % Child [Age 5-17] Healthy Weight Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 185] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents with children age 5-17 at home. ● Overweight among children is determined by children’s Body Mass Index status at or above the 85th percentile of US growth charts by gender and age.

Child Obesity Prevalence (Percent of Children 5-17 Who Are Obese; Body Mass Index in the 95th Percentile or Higher) Lee County Trend % Children [Age 5-17] Obese (95th Percentile) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 185] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-10.4] Notes: ● Asked of all respondents with children age 5-17 at home. ● Obesity among children is determined by children’s Body Mass Index status equal to or above the 95th percentile of US growth charts by gender and age.

Substance Abuse

Cirrhosis/Liver Disease: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Cirrhosis/Liver Disease (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-11] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● Local, state and national data are simple three-year averages.

Cirrhosis/Liver Disease: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Cirrhosis/Liver Disease (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-11] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population. ● State and national data are simple three-year averages.

Current Drinkers % Current Drinker Lee County Trend Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 190] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Current drinkers had at least one alcoholic drink in the past month.

Current Drinkers (Lee County, 2014) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 190] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● Current drinkers had at least one alcoholic drink in the past month.

Chronic Drinkers % Chronic Drinker (Average 2+ Drinks/Day) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 191] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2011 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Chronic drinkers are defined as having 60+ alcoholic drinks in the past month.

Chronic Drinkers (Lee County, 2014) % Chronic Drinker (Average 2+ Drinks/Day) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 191] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● Chronic drinkers are defined as those having 60+ alcoholic drinks in the past month.

Binge Drinkers % Binge Drinker (Single Occasion - 5+ Drinks Men, 4+ Women) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 192] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-14.3] Notes: ● Asked of all respondents. ● Binge drinkers are defined as men having 5+ alcoholic drinks on any one occasion or women consuming 4+ drinks on any one occasion.

Binge Drinkers (Lee County, 2014) % Binge Drinker (Single Occasion - 5+ Drinks Men, 4+ Women) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 192-193] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-14.3] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● Binge drinkers are defined as men having 5+ alcoholic drinks on any one occasion or women consuming 4+ drinks on any one occasion

Have Driven in the Past Month After Perhaps Having Too Much to Drink % Drinking & Driving in Past Month Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 78] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Drug-Induced Deaths: Age-Adjusted Mortality (2008-2010 Annual Average Deaths per 100,000 Population) Drug-Induced Deaths (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-12] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population. ● Local, state and national data are simple three-year averages.

Drug-Induced Deaths: Age-Adjusted Mortality Trends (Annual Average Deaths per 100,000 Population) Drug-Induced Deaths (Age-Adjusted Death Rate) SECONDARY DATA Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted March 2014. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-12] Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 US Standard Population. ● County, state and national data are simple three-year averages.

Illicit Drug Use in the Past Month % Illicit Drug Use in Past Month Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 79] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-13.3] Notes: ● Asked of all respondents.

Have Ever Sought Professional Help for an Alcohol/Drug-Related Problem % Ever Sought Help for Alcohol or Drug Problem Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 80] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Tobacco Use

Cigarette Smoking Prevalence (Lee County, 2014) % Current Smoker Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 186] Notes: ● Asked of all respondents.

Current Smokers % Current Smoker Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 186] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective TU-1.1] Notes: ● Asked of all respondents. ● Includes regular and occasional smokers (those who smoke cigarettes everyday or on some days).

Current Smokers (Lee County, 2014) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 186-187] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective TU-1.1] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● Includes regular and occasion smokers (everyday and some days).

Member of Household Smokes at Home Non-smokers exposed to smoke in the home: 3.7% (US = 6.3%) % Someone Smokes at Home % [Non-Smokers] Someone Smokes in the Home Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 72, 188] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● “Smokes at home” refers to someone smoking cigarettes, cigars, or a pipe in the home an average of four or more times per week in the past month.

Member of Household Smokes At Home (Lee County, 2014) % Someone Smokes at Home Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 72] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● “Smokes at home” refers to someone smoking cigarettes, cigars, or a pipe in the home an average of four or more times per week in the past month.

Percentage of Households With Children In Which Someone Smokes in the Home % [Household With Children] Someone Smokes in the Home Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 189] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● “Smokes at home” refers to someone smoking cigarettes, cigars, or a pipe in the home an average of four or more times per week in the past month.

Advised by a Healthcare Professional in the Past Year to Quit Smoking (Among Current Smokers) % [Smokers] Received Advice to Quit Smoking Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 71] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all current smokers.

Have Stopped Smoking for One Day or Longer in the Past Year in an Attempt to Quit Smoking (Among Everyday Smokers) % [Smokers] Have Quit Smoking 1+ Days in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 70] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective TU-4.1] Notes: ● Asked of respondents who smoke cigarettes every day.

Use of Cigars % Smoke Cigars Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 74] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective TU-1.3] Notes: ● Asked of all respondents.

Use of Smokeless Tobacco % Use Smokeless Tobacco Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 73] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective TU-1.2] Notes: ● Asked of all respondents. ● Smokeless tobacco includes chewing tobacco or snuff.

Access to Health Services

Health Insurance Coverage

Healthcare Insurance Coverage (Among Adults Age 18-64; Lee County, 2014) % [Age 18-64] Lack Health Insurance Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 194] Notes: ● Reflects respondents age 18 to 64.

Health Insurance Covers Prescriptions at Least in Part (Among Insured Respondents) % [Insured] Insurance Covers Prescriptions Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 93] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents with healthcare insurance coverage.

Lack of Healthcare Insurance Coverage (Among Adults Age 18-64) % [Age 18-64] Lack Health Insurance Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 194] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AHS-1] Notes: ● Asked of all respondents under the age of 65.

Lack of Healthcare Insurance Coverage (Among Adults Age 18-64; Lee County, 2014) % [Age 18-64] Lack Health Insurance Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 194] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AHS-1] Notes: ● Asked of all respondents under the age of 65. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Preventive Healthcare (By Insured Status; Lee County, 2014) % [Age 18-64] Lack Health Insurance Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 23, 54, 57, 195, 198] Notes: ● Asked of all respondents.

Went Without Healthcare Insurance Coverage At Some Point in the Past Year (Among Insured Adults) % [Insured] Went Without Coverage in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 94] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all insured respondents.

Went Without Healthcare Insurance Coverage At Some Point in the Past Year (Among Insured Adults; Lee County, 2014) % [Insured] Went Without Coverage in Past Year Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 94] Notes: ● Asked of all insured respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Difficulties Accessing Healthcare

Experienced Difficulties or Delays of Some Kind in Receiving Needed Healthcare in the Past Year % Difficulty Accessing Healthcare in Past Year (Composite) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 198] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Represents the percentage of respondents experiencing one or more barriers to accessing healthcare in the past 12 months.

Experienced Difficulties or Delays of Some Kind in Receiving Needed Healthcare in the Past Year (Lee County, 2014) % Difficulty Accessing Healthcare in Past Year (Composite) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 198] Notes: ● Asked of all respondents. ● Represents the percentage of respondents experiencing one or more barriers to accessing healthcare in the past 12 months. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Barriers to Access Have Prevented Medical Care in the Past Year % Difficulty Accessing Healthcare in Past Year (Composite) % Inconvenient Hrs Prevented Dr Visit in Past Year % Cost Prevented Getting Prescription in Past Year % Cost Prevented Physician Visit in Past Year % Difficulty Getting Appointment in Past Year % Difficulty Finding Physician in Past Year % Transportation Hindered Dr Visit in Past Year Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 8-12, 16] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Trend in Barriers to Access Have Prevented Medical Care in the Past Year % Difficulty Accessing Healthcare in Past Year (Composite) % Inconvenient Hrs Prevented Dr Visit in Past Year % Cost Prevented Getting Prescription in Past Year % Cost Prevented Physician Visit in Past Year % Difficulty Getting Appointment in Past Year % Difficulty Finding Physician in Past Year % Transportation Hindered Dr Visit in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 8-12, 16] Notes: ● Asked of all respondents.

Barriers to Healthcare Access (By Insured Status; Lee County, 2014) % Difficulty Accessing Healthcare in Past Year (Composite) % Inconvenient Hrs Prevented Dr Visit in Past Year % Cost Prevented Getting Prescription in Past Year % Cost Prevented Physician Visit in Past Year % Difficulty Getting Appointment in Past Year % Difficulty Finding Physician in Past Year % Transportation Hindered Dr Visit in Past Year Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 8-12, 16] Notes: ● Asked of all respondents.

Lack or Type of Insurance Coverage Prevented Medical Care at Some Point in the Past Year Of these people, 38.5% lacked healthcare coverage, while 20.8% reported problems with coverage limits and 16.8% mentioned the cost of services. Another 9.6% report that their insurance was not accepted, and 3.5% mentioned a problem with their type of insurance. % Lack/Type of Insurance Prevented Care Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 18-19] Notes: ● Asked of all respondents.

Lack or Type of Insurance Coverage Prevented Medical Care at Some Point in the Past Year (Lee County, 2014) % Lack/Type of Insurance Prevented Care Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 18] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Skipped or Reduced Prescription Doses in Order to Stretch Prescriptions and Save Money % Skipped Prescription Doses to Save Costs Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 17] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Skipped or Reduced Prescription Doses in Order to Stretch Prescriptions and Save Money (Lee County, 2014) % Skipped Prescription Doses to Save Costs Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 17] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Had Trouble Obtaining Medical Care for Child in the Past Year (Among Parents of Children 0-17) % Difficulty Getting Child's Healthcare in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 135-136] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents with children 0 to 17 in the household.

Primary Care Services

Have a Specific Source of Ongoing Medical Care % [Age 18+] Have a Specific Source of Ongoing Care % [Age 18-64] Have a Specific Source of Ongoing Care % [Age 65+] Have a Specific Source of Ongoing Care Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 195] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AHS-5.1] Notes: ● Asked of all respondents.

Have a Specific Source of Ongoing Medical Care (Lee County, 2014) % [Age 18+] Have a Specific Source of Ongoing Care % [Age 18-64] Have a Specific Source of Ongoing Care % [Age 65+] Have a Specific Source of Ongoing Care Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 195-197] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objectives AHS-5.1, 5.3, 5.4] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Particular Place Utilized for Medical Care (Lee County, 2014) % [Age 18+] Have a Specific Source of Ongoing Care % [Age 18-64] Have a Specific Source of Ongoing Care % [Age 65+] Have a Specific Source of Ongoing Care Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 21-22] Notes: ● Asked of all respondents.

Have Visited a Physician for a Checkup in the Past Year % Have Had Routine Checkup in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 23] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Have Visited a Physician for a Checkup in the Past Year (Lee County, 2014) % Have Had Routine Checkup in Past Year Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 23] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Child Has Visited a Physician for a Routine Checkup in the Past Year (Among Parents of Children 0-17) % Child Has Had Checkup in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 137] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents with children 0 to 17 in the household.

Emergency Room Services

Have Used a Hospital Emergency Room More Than Once in the Past Year % Two or More ER Visits in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 32-33] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Have Used a Hospital Emergency Room More Than Once in the Past Year (Lee County, 2014) % Two or More ER Visits in Past Year Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 32] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Availability of Services

Member of Household Left Lee County for Medical Care in the Past Year % Outmigration for Care Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 13] Notes: ● Asked of all respondents.

Member of Household Left Lee County for Medical Care in the Past Year (Lee County, 2014) % Outmigration for Care Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 13] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Type of Medical Care Sought Outside Lee County (Among Adults Who Left Lee County for Medical Care in the Past Year, 2014) % Outmigration for Care Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 14] Notes: ● Asked of those residents who left Lee County in the past year for some type of medical care.

Reason for Seeking Medical Care Outside Lee County (Among Adults Who Left Lee County for Medical Care in the Past Year, 2014) % Outmigration for Care Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 15] Notes: ● Asked of those residents who left Lee County in the past year for some type of medical care.

Oral Health

Have Visited a Dentist or Dental Clinic Within the Past Year % [Age 18+] Dental Visit in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 30] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective OH-7] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data. Notes: ● Asked of all respondents.

Have Visited a Dentist or Dental Clinic Within the Past Year (Lee County, 2014) % [Age 18+] Dental Visit in Past Year Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 30] ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective OH-7] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Child Has Visited a Dentist or Dental Clinic Within the Past Year (Among Parents of Children 2-17) % Child [Age 2-17] Dental Visit in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 141] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective OH-7] Notes: ● Asked of all respondents with children age 2 through 17.

Have Insurance Coverage That Pays All or Part of Dental Care Costs % Have Dental Insurance Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 31] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Vision Care

Had an Eye Exam in the Past Two Years During Which the Pupils Were Dilated % Eye Exam in Past 2 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 29] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Had an Eye Exam in the Past Two Years During Which the Pupils Were Dilated (Lee County, 2014) % Eye Exam in Past 2 Years Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 29] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Health Education & Outreach

Participated in a Health Promotion Activity in the Past Year % Attended Health Event in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 127] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Participated in a Health Promotion Activity in the Past Year (Lee County, 2014) % Attended Health Event in Past Year Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 127] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Healthy Lee Community Initiatives

Have Heard of the Healthy Lee Community Initiatives (Lee County, 2014) % Heard of Healthy Lee Community Initiatives Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 128] Notes: ● Asked of all respondents.

Have Heard of Healthy Lee Community Initiatives (Lee County, 2014) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 128] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Have Heard the “Choose, Commit, Change!” Message (Lee County, 2014) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 129] Notes: ● Asked of all respondents.

Have Heard the “Choose, Commit, Change!” Message (Lee County, 2014) Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 129] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Healthy Lee Has Impacted Lifestyle Choices (Among Adults Who Have Heard of Healthy Lee Community Initiatives or the Healthy Lee “Choose, Commit, Change!” Message; Lee County, 2014) % Heard the “Choose, Commit ,Change!” Message % Heard of Healthy Lee Community Initiatives Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 194] Notes: ● Asked of respondents who have heard of either Healthy Lee Community Initiatives or the Healthy Lee “Choose, Commit, Change!” message.

Local Resources

Perceptions of Local Healthcare Services

Rating of Overall Healthcare Services Available in the Community (Lee County, 2014) % Rate Local Healthcare "Fair/Poor" Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 7] Notes: ● Asked of all respondents.

Perceive Local Healthcare Services as “Fair/Poor” % Rate Local Healthcare "Fair/Poor" Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 7] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Perceive Local Healthcare Services as “Fair/Poor” (Lee County, 2014) % Rate Local Healthcare "Fair/Poor" Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 7] Notes: ● Asked of all respondents. ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents). ● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.