Metro ACEs Data 2018 Community Health Needs Assessment Douglas, Sarpy, Cass and Pottawattamie Counties

Sample Douglas, Sarpy, Cass, and Pottawattamie Counties Total= 2,527 individuals Douglas – 1,527 Sarpy – 500 Cass – 100 Pottawattamie - 400 Quadrants in Douglas County (NE, SE, SW, NW) were split by 72nd and Dodge Streets The sample design used for this effort consisted of a total of 2,527 individuals age 18 and older in the Metro Area. This random sampling of residents reflects 1,527 adults in Douglas County, 500 in Sarpy County, 100 in Cass County, and 400 in Pottawattamie County. The higher sample within Douglas County reflects targets set to achieve 50 surveys per ZIP Code within the county. Once all of the interviews were completed, these were weighted in proportion to the actual population distribution so as to appropriately represent the individual counties and the Metro Area as a whole. All administration of the surveys, data collection, and data analysis was conducted by PRC.

Survey Participants Sample Characteristics To accurately represent the population studied, PRC strives to minimize bias through application of a proven telephone methodology and random-selection techniques. While this random sampling of the population produces a highly representative sample, it is a common and preferred practice to “weight” the raw data to improve this representativeness even further. This is accomplished by adjusting the results of a random sample to match the geographic distribution and demographic characteristics of the population surveyed (poststratification), so as to eliminate any naturally occurring bias. Specifically, once the raw data are gathered, respondents are examined by key demographic characteristics (namely sex, age, race, ethnicity, and poverty status), and a statistical application package applies weighting variables that produce a sample which more closely matches the population for these characteristics. Thus, while the integrity of each individual’s responses is maintained, one respondent’s responses may contribute to the whole the same weight as, for example, 1.1 respondents. Another respondent, whose demographic characteristics may have been slightly oversampled, may contribute the same weight as 0.9 respondents. The following chart outlines the characteristics of the Metro Area sample for key demographic variables, compared to actual population characteristics revealed in census data. [Note that the sample consisted solely of area residents age 18 and older; data on children were given by proxy by the person most responsible for that child’s healthcare needs, and these children are not represented demographically in this char

Adverse Childhood Experiences (ACEs) This included surveys conducted via telephone (landline and cell phone), as well as through online questionnaires.

Prevalence by Category Original ACE research findings: Emotional Abuse – 11%, Emotional Neglect – 15% Household Substance Abuse – 27% Parental Separation/Divorce – 23% Physical Abuse – 28%, Physical Neglect – 10% Household Mental Illness – 19% Mother Treated Violently – 13% Sexual abuse -21% Incarcerated Household member – 5%

Prevalence by Area

Prevalence by County

Prevalence of High Ace Scores Original ACE research findings: Four or more – 12.5% Zero – 36% One to three – 51.5% High ACE score =4 or more

Prevalence of High Ace Scores Original ACE research findings: Four or more – 12.5% Zero – 36% One to three – 51.5% High ACE score =4 or more

Relationship of ACEs with Other Issues Relationship of ACEs with Other Health Issues As a person’s ACE score increases, so does their risk for disease, social issues, and emotional problems. Note the following strong correlations of various health indicators in the Metro Area, comparing those reporting no ACEs with those with low (1-3) and high (4+) ACE risk. Low ACEs = 1-3 High ACEs= 4+

Find the Report: www.douglascountymetro.healthforecast.net/ or www.livewellomaha.org/data