2015 PRC Community Health Needs Assessment

2015 PRC Community Health Needs Assessment
Clinton County, Ohio Prepared for: HealthFirst for Clinton County By Professional Research Consultants, Inc.

PRC Community Health Needs Assessment
Customized Local PRC Community Health Survey Random-sample survey among 400 adults in Clinton County 137 survey items; minute interview ±4.9% max error overall BENCHMARKING Prior Local Survey Data (1996, 2001) PRC National Health Survey Ohio BRFSS data Healthy People targets National vital statistics data PRC Community Health Needs Assessment Secondary Data Online Key Informant Survey Online Key Informant Survey among 88 community stakeholders: Public health, physicians & other health providers Social services & other community leaders

Population & Survey Sample Characteristics (Clinton County, 2015)
Sources: ● Census 2010, Summary File 3 (SF 3). US Census Bureau. ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc.

Dementias, Including Alzheimer’s Disease Diabetes
General Health Status Areas of Opportunity Access to Healthcare Cancer Dementias, Including Alzheimer’s Disease Diabetes Heart Disease & Stroke Infant Health & Family Planning Injury & Violence Mental Health Nutrition, Physical Activity & Weight Oral Health Potentially Disabling Conditions Respiratory Diseases Substance Abuse Tobacco Prioritization Results 14 Identified Needs

General Health Status Areas of Opportunity Access to Healthcare Cancer Dementias, Including Alzheimer’s Disease Diabetes Heart Disease & Stroke Infant Health & Family Planning Injury & Violence Mental Health Nutrition, Physical Activity & Weight Oral Health Potentially Disabling Conditions Respiratory Diseases Substance Abuse Tobacco Prioritization Results

Self-Reported Health Status (Clinton County, 2015)
“Fair/Poor” = 17.1% “Excellent/ Very Good” = 45.2% % "Fair/Poor" Physical Health Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 5] Notes: ● Asked of all respondents.

Experience “Fair” or “Poor” Overall Health
Clinton County Statistically similar to previous findings Statistically similar to OH & US % "Fair/Poor" Physical Health Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 5] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 Ohio data. ● PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Experience “Fair” or “Poor” Overall Health (Clinton County, 2015)
% "Fair/Poor" Physical Health Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 5] Notes: ● Asked of all 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.

Healthcare Insurance Coverage (Among Adults Age 18-64; Clinton County, 2015)
% [Age 18-64] Lack Health Insurance Private insurance = 60.4% Gov’t insurance = 28.5% No insurance = 11.1% Men are much more likely to be uninsured (19.2%). No significant change since 1996. Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 165] Notes: ● Reflects respondents age 18 to 64.

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 Significantly worse than US (11.0%). Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 7-12] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● 1996 data not available for cost of prescription, inconvenient office hours, or difficulty finding a doctor.

Experienced Difficulties or Delays of Some Kind in Receiving Needed Healthcare in the Past Year (Clinton County, 2015) % Difficulty Accessing Healthcare in Past Year (Composite) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 169] Notes: ● Asked of all respondents. ● Represents the percentage of respondents experiencing one or more barriers to accessing healthcare in the past 12 months. ● 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.

ER usage appears similar to US.
Have a Specific Source of Ongoing Medical Care Healthy People 2020 Target = 95.0% or Higher [All Ages] Also: 66.8% of adults (and 92.8% of children) have had a routine checkup in the past year (similar to and better than US, respectively). The Clinton County ratio of primary care physicians to population is similar to state and national ratios. ER usage appears similar to US. 20.7% of respondents perceive local healthcare as “fair” or “poor,” significantly higher than in 1996 (7.6%). Similar to US (76.3%) % [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 Clinton County Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 166] ● PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services. Healthy People December [Objective AHS-5.1] Notes: ● Asked of all respondents.

Leading Causes of Death (Clinton County, 2011-2013)
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 September 2015. 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 Cancer Death Rates by Site (2004-2013 Annual Average Deaths per 100,000 Population)
Clinton County OH US HP2020 ALL CANCERS #1 Leading Cause of Death 222.1 181.7 166.2 161.4 Lung Cancer 69.4 56.4 48.6 45.5 Prostate Cancer 29.7 23.2 22.4 21.8 Female Breast Cancer 23.1 24.8 22.6 20.7 Colorectal Cancer 20.0 17.9 16.3 14.5 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 Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. ● US Department of Health and Human Services. Healthy People December

Cancer Incidence Rates by Site (Annual Average Age-Adjusted Incidence per 100,000 Population, ) CHNA.ORG > HEALTH OUTCOMES > PROSTATE CANCER INCIDENCE > Prostate Cancer Incidence CHNA.ORG > HEALTH OUTCOMES > BREAST CANCER INCIDENCE > Breast Cancer Incidence CHNA.ORG > HEALTH OUTCOMES > LUNG CANCER INCIDENCE > Lung Cancer Incidence CHNA.ORG > HEALTH OUTCOMES > COLON AND RECTUM CANCER INCIDENCE > Colon and Rectum Cancer Incidence CHNA.ORG > HEALTH OUTCOMES > CERVICAL CANCER INCIDENCE > Cervical Cancer Incidence SECONDARY DATA Prostate Cancer Incidence per 100,000 Female Breast Cancer Incidence per 100,000 Lung Cancer Incidence per 100,000 Colorectal Cancer Incidence per 100,000 Cervical Cancer Incidence per 100,000 Sources: ● State Cancer Profiles: ● Retrieved September 2015 from Community Commons at Notes: ● This indicator reports the age adjusted incidence rate (cases per 100,000 population per year) of cancers, adjusted to 2000 US standard population age groups (under age 1, 1-4, 5-9, ..., 80-84, 85 and older). This indicator is relevant because cancer is a leading cause of death and it is important to identify cancers separately to better target interventions. Survey data also reveal an increase in skin cancer prevalence from 2.7% to 9.0% between 1996 and 2015.

Alzheimer's Disease: Age-Adjusted Mortality (2011-2013 Annual Average Deaths per 100,000 Population)
Alzheimer's Disease (Age-Adjusted Death Rate) SECONDARY DATA 20.3% of Clinton County residents age 45+ report more/worsening confusion or memory loss in the past year. Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. 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.

Diabetes: Age-Adjusted Mortality ( Annual Average Deaths per 100,000 Population) Healthy People 2020 Target = 20.5 or Lower (Adjusted) 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 September 2015. ● US Department of Health and Human Services. Healthy People December [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 US Standard Population. ● The Healthy People 2020 target for Diabetes is adjusted to account for only diabetes mellitus coded deaths.

Prevalence of Diabetes
Clinton County Another 7.0% of adults report that they have been diagnosed with “pre-diabetes” or “borderline” diabetes (vs. 5.1% nationwide) % Diabetes/High Blood Sugar % Borderline/Pre-Diabetes Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 136] ● 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): 2013 Ohio data. Notes: ● Asked of all respondents. ● Local and national data exclude gestation diabetes (occurring only during pregnancy).

Prevalence of Diabetes (Clinton County, 2015)
% Diabetes/High Blood Sugar Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 136] Notes: ● Asked of all 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).

Diabetes Key Informants: Diabetes ranked as the #4 top health issue in the Online Key Informant Survey. Key informants’ concern regarding diabetes reflected issues with: Lack of Education/Awareness Lack of Providers/Resources Availability/Affordability of Medications Lifestyle Prevalence/Incidence Almost half of the respondents ranked this as a "major problem" for the community.

Leading Causes of Death (Clinton County, 2011-2013)
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 September 2015. 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.

Heart Disease: Age-Adjusted Mortality ( Annual Average Deaths per 100,000 Population) Healthy People 2020 Target = or Lower (Adjusted) Stroke: Age-Adjusted Mortality ( Annual Average Deaths per 100,000 Population) Healthy People 2020 Target = 34.8 or Lower Prevalence of heart disease (9.3%) is also higher than the US (6.1%). Prevalence of stroke has increased since 1996 (1.8% to 4.2%).

High Blood Cholesterol Healthy People 2020 Target = 13.5% or Lower
Prevalence of High Blood Pressure Healthy People 2020 Target = 26.9% or Lower Prevalence of High Blood Cholesterol Healthy People 2020 Target = 13.5% or Lower Clinton County Clinton County % Told Have High Blood Pressure (Ever) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 43, 125] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 Ohio data. ● PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services. Healthy People December [Objective HDS-5.1] Notes: ● Asked of all respondents. Each is similar to national prevalence levels. 87.8% of residents have one or more cardiovascular risk factors (higher than US).

Teen Birth Rate (Births to Women Age 15-19 Per 1,000 Female Population Age 15-19, 2006-2012)
CHNA.ORG > SOCIAL & ECONOMIC FACTORS > TEEN BIRTHS > Teen Births SECONDARY DATA Teen Births per 1,000 (Age 15-19) Sources: ● Centers for Disease Control and Prevention, National Vital Statistics System: Accessed using CDC WONDER. ● Retrieved September 2015 from Community Commons at Notes: ● This indicator reports the rate of total births to women under the age of per 1,000 female population age This indicator is relevant because in many cases, teen parents have unique social, economic, and health support services. Additionally, high rates of teen pregnancy may indicate the prevalence of unsafe sex practices.

Unintentional Injuries: Age-Adjusted Mortality ( Annual Average Deaths per 100,000 Population) Healthy People 2020 Target = 36.4 or Lower Leading Causes of Accidental Deaths: Poisoning/Noxious Substances Motor Vehicle Accidents Falls 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 September 2015. ● US Department of Health and Human Services. Healthy People December [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 US Standard Population.

Motor Vehicle Crashes: Age-Adjusted Mortality ( Annual Average Deaths per 100,000 Population) Healthy People 2020 Target = 12.4 or Lower 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 September 2015. ● US Department of Health and Human Services. Healthy People December [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 US Standard Population. 85.4% of resident report “always” wearing a seat belt; this indicator has improved significantly since 1996 (70.1%).

Have a Firearm Kept in or Around the Home
Clinton County Households With Children: 41.5% (vs. 37.4% nationwide) % Firearm in Home % [Homes With Children] Firearm in Home Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 52, 137] ● 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. Men and middle/high income residents more likely to have a firearm in the home.

Experience “Fair” or “Poor” Mental Health (Clinton County, 2015)
% "Fair/Poor" Mental Health Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 100] Notes: ● Asked of all 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. Excellent/Very Good = 46.7% Good = 35.2% Fair/Poor = 18.1%

Have Experienced Symptoms of Chronic Depression
Clinton County % Symptoms of Chronic Depression (2+ Years) 26.8% of residents report being diagnosed with depression, significantly higher than OH (20.2%) and the US (20.4%). Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 101] ● 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.

Mental Health Key Informants: Mental Health ranked as the #2 top health issue in the Online Key Informant Survey. Key informants’ concern regarding mental health reflected issues with: Lack of Providers/Resources Access to Care Affordability Wait lists Prevalence/Incidence Stigma Over half of key informants ranked this as a "major problem" for the community.

Prevalence of Total Overweight (Percent of Adults With a Body Mass Index of 25.0 or Higher)
Clinton County Included in this is 34.8% of Clinton County adults who are obese. % Overweight (BMI 25+) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 151] ● 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): 2013 Ohio 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. Only 32.2% of overweight or obese residents are trying to lose weight.

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; Clinton County, 2015) Healthy People 2020 Target = 30.5% or Lower % Obese (BMI 30+) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 151] ● US Department of Health and Human Services. Healthy People December [Objective NWS-9] Notes: ● Based on reported heights and weights, asked of all 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. In Clinton County, only 34.0% of obese residents have received advice from a health professional about their weight, significantly below US findings (48.3%).

Consume Five or More Servings of Fruits/Vegetables Per Day (Clinton County, 2015)
% Eat 5+ Servings of Fruit or Vegetables per Day Note that 41.0% of low-income residents find it "very/somewhat difficult" to access fresh fruits/vegetables. Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 146] Notes: ● Asked of all 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.

Meets Physical Activity Recommendations (Clinton County, 2015)
Also: 20.4% of adults engage in no leisure-time physical activity (similar to US). Participation in vigorous physical activity appears to be below US averages. A relatively low percentage (37.3%) of adults have received advice about exercise from a health professional in the past year. % Meeting Physical Activity Guidelines Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 147] Notes: ● Asked of all 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.

Nutrition, Physical Activity & Weight
Key Informants: Nutrition, Physical Activity, & Weight ranked as the #3 top health issue in the Online Key Informant Survey. Key informants’ concern regarding nutrition, physical activity, & weight reflected issues with: Lack of Infrastructure for Healthy and Active Living Poor Diet/Nutrition, Low Physical Activity Obesity Lack of Nutrition Education Over half of respondents ranked this as a "major problem" for the community.

Significantly below OH (67.6%) and US (65.9%).
Have Visited a Dentist or Dental Clinic Within the Past Year (Clinton County, 2015) Healthy People 2020 Target = 49.0% or Higher Significantly below OH (67.6%) and US (65.9%). % [Age 18+] Dental Visit in Past Year Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 21] ● US Department of Health and Human Services. Healthy People December [Objective OH-7] Notes: ● Asked of all 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 Potentially Disabling Conditions
CHNA.ORG > HEALTH OUTCOMES > PROSTATE CANCER INCIDENCE > Prostate Cancer Incidence CHNA.ORG > HEALTH OUTCOMES > BREAST CANCER INCIDENCE > Breast Cancer Incidence CHNA.ORG > HEALTH OUTCOMES > LUNG CANCER INCIDENCE > Lung Cancer Incidence CHNA.ORG > HEALTH OUTCOMES > COLON AND RECTUM CANCER INCIDENCE > Colon and Rectum Cancer Incidence CHNA.ORG > HEALTH OUTCOMES > CERVICAL CANCER INCIDENCE > Cervical Cancer Incidence SECONDARY DATA Prostate Cancer Incidence per 100,000 Female Breast Cancer Incidence per 100,000 Lung Cancer Incidence per 100,000 Colorectal Cancer Incidence per 100,000 Cervical Cancer Incidence per 100,000 Additionally, 26.0% of adults are limited in activities due to a health problem; these are predominantly musculoskeletal issues. Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 139] ● PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Reflects respondents age 50 and older.

CLRD: Age-Adjusted Mortality (2011-2013 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 September 2015. 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. ● CLRD is chronic lower respiratory disease.

Prevalence of Chronic Obstructive Pulmonary Disease (COPD)
Clinton County % COPD (Lung Disease) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 25] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 Ohio data. ● 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.

Adults Ever Diagnosed With Asthma
Adults age and low income residents are more likely to report having asthma. Also: 6.3% of children have ever been diagnosed with asthma (similar to prior findings, better than US). Clinton County % [Adult] Currently Has Asthma Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 37, 134] ● 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): 2013 Ohio data. Notes: ● Asked of all respondents. ● “Currently have asthma” includes those who have ever been diagnosed with asthma, and who report that they still have asthma.

Drug-Induced Deaths: Age-Adjusted Mortality ( Annual Average Deaths per 100,000 Population) Healthy People 2020 Target = 11.3 or Lower Drug-Induced Deaths (Age-Adjusted Death Rate) SECONDARY DATA 4.9% of Clinton County adults report having ever sought professional help for an alcohol/drug-related problem, a significant increase from 1996 (1.7%). 8.0% dealing with a drug-related problem in their immediate family in the past 3 years. Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics. Data extracted September 2015. ● US Department of Health and Human Services. Healthy People December [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.

Substance Abuse Key Informants: Substance Abuse ranked as the # 1 top health issue in the Online Key Informant Survey. Key informants’ concern regarding substance abuse reflected issues with: Lack of Centers/Facilities Lack of Motivation to Change Cost of Care/Services Lack of Awareness of Services Specific substances of concern included: 1) heroin; 2) alcohol; and 3) prescription medications. Nearly three in four respondents ranked this as a "major problem" for the community.

Current Smokers (Clinton County, 2015) Healthy People 2020 Target = 12
Current Smokers (Clinton County, 2015) Healthy People 2020 Target = 12.0% or Lower % Current Smoker Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 156] ● US Department of Health and Human Services. Healthy People December [Objective TU-1.1] Notes: ● Asked of all 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). 15.7% of adults have ever used an e-cigarette, increasing to 35.8% among low-income populations.

Use of Smokeless Tobacco Healthy People 2020 Target = 0.3% or Lower
Clinton County % Use Smokeless Tobacco Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 60] ● 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): 2013 Ohio data. ● US Department of Health and Human Services. Healthy People December [Objective TU-1.2] Notes: ● Asked of all respondents. ● Smokeless tobacco includes chewing tobacco or snuff.

Tobacco Use Key Informants: Tobacco Use ranked as the #5 top health issue in the Online Key Informant Survey. Key informants’ concern regarding substance abuse reflected issues with: Prevalence/Incidence Culture Habits/Lack of Motivation to Quit Comorbidities Roughly 40% of key informants ranked this as a "major problem" for the community.

Criteria for Prioritizing Health Needs
Scope & Severity Rate how much of a problem each issue is for our community. (i.e., How big is the problem?) Ability to Impact Rate how much we are able to have a positive impact, either alone or with community partners. (i.e., Can we make a difference?) 20 community stakeholders attended a presentation on November 16, 2015 and engaged in a prioritization exercise.

Scope & Severity Ranking Results
9.40 Substance Abuse 8.45 Mental Health 8.25 Cancer 8.05 Diabetes 7.90 Tobacco Use 7.90 Heart Disease & Stroke 7.45 Nutrition, Physical Activity & Weight 6.95 Access to Healthcare Services 6.95 Respiratory Diseases 6.70 Oral Health 6.35 Dementias, Including Alzheimer's Disease 6.15 Injury & Violence 6.05 Infant Health & Family Planning 5.74 Potentially Disabling Conditions

Ability to Impact Ranking Results
7.75 Substance Abuse 7.40 Mental Health 7.10 Infant Health & Family Planning 7.00 Access to Healthcare Services 6.85 Oral Health 6.80 Tobacco Use 6.80 Diabetes 6.75 Nutrition, Physical Activity & Weight 6.35 Heart Disease & Stroke 5.89 Cancer 5.85 Injury & Violence 5.35 Respiratory Diseases 4.80 Potentially Disabling Conditions 4.35 Dementias, Including Alzheimer's Disease

Prioritization of Community Issues
10 1 10

Identified Areas of Opportunity for Clinton County
Access to Healthcare Services Cancer Dementias, Alzheimer’s Disease Diabetes Heart Disease & Stroke Infant Health & Family Planning Injury & Violence Mental Health Nutrition, Physical Activity & Weight Oral Health Potentially Disabling Conditions Respiratory Diseases Substance Abuse Tobacco Use

Professional Research Consultants, Inc.
Thank You Professional Research Consultants, Inc.

2015 PRC Community Health Needs Assessment

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