1. BERNALILLO COUNTY COMMUNITY HEALTH COUNCIL Snapshot of Data for Community Health Profile . Presentation at monthly meeting on December 15, 2015 Marsha McMurray-Avila & Tracy McDaniel

2. HEALTH COUNCIL VISION A community that supports the ability of everyone to meet his or her full potential . HEALTH COUNCIL MISSION . To improve the health and quality of life in Bernalillo County through coalition building, health assessment and planning, and convening community action  

3. Strategies & Activities
Maintaining a Community Health Profile
Supporting county-wide comprehensive planning process
Convening community members from multiple sectors
Working collectively with other local coalitions and collaboratives
Creating action plans, policy recommendations, strategies and activities to achieve health equity
We work toward our mission and vision by:
Maintaining a Community Health Profile to assess the health status of county residents, and to identify and map our community's resources, needs, and conditions that affect health.
Supporting a county-wide comprehensive planning process that promotes the concept of primary prevention and assures that the voice of the community is represented to Bernalillo County decision-makers and is included in all planning and program development affecting the health of the county.
Convening community members, leaders, organizations, public agencies, policy-makers and advocates to identify and prioritize issues related to improving individual and community health through primary prevention and promotion of health in all policies.
Joining with other local coalitions/collaboratives to work collectively on issues aligned with our priorities.
Creating action plans, policy recommendations, strategies and activities to achieve the systemic changes, program coordination and policies needed to improve the health status of all Bernalillo County residents and achieve health equity.
IT’S IMPORTANT TO POINT OUT THAT THIS CONVERSATION ON DATA IS PART OF THE RENEWAL OF THIS ROUND OF ASSESSMENT AND PLANNING. Something new this time is that we are aligning our process with Presbyterian Healthcare Services as part of their requirement to provide a Community Health Needs Assessment that will drive how they spend their community benefit dollars. So the results of these conversations will not end up in lifeless plans on the shelf, but rather will be actively used to help inform the Pres process, as well as reporting to DOH.

4. BCCHC Priority Areas
The Health Council currently focuses on the following desired results:
Healthy and sustainable communities where all families and individuals have their basic needs met and prosper.
Improved health and education outcomes for children/youth from pregnancy to age 25.
Improved healthcare access and quality of service for uninsured and indigent populations for both physical and behavioral health.
From the last round of assessment and planning we ended up with these 3 broad priority areas, under which you can see almost everything can fit….

5. Priorities & Partners - 2015
In the spirit of collective impact, BCCHC supports and aligns with the strategic plans and initiatives developed by other community-based entities that convene multiple partners from throughout the county, listed under the issue areas of each priority.
Initiatives in BOLD represent activities with direct BCCHC involvement and/or leadership.
Improved health & education outcomes for children/youth from pregnancy to age 25
Improved healthcare access &
quality of service for uninsured & indigent populations
BEHAVIORAL HEALTH Opioid Accountability Initiative – Treatment & Prevention Teams
PHYSICAL HEALTH Healthy Here: Communities Leading Healthy Change (clinical/community linkages)
EARLY CHILDHOOD Early Childhood Accountability Partnership (ECAP)
YOUTH ABC Community Schools Partnership
YOUNG ADULT Mission: Graduate
HEALTHY COMMUNITIES
This is a picture of more or less how those priorities play out in our activities in the community. We currently have several projects where we are directly involved and/or provide leadership – two notable activities are the Opioid Accountability Initiative and Healthy Here: Communities Leading Healthy Change. In other areas, when we are made aware of other groups that are leading initiatives, we try to support and/or inform ourselves about their activities, rather than duplicating the effort.
POVERTY/ INCOME
IDHCC – Co-op Project
Pathways to a Healthy Bernalillo County
HOUSING/ HOMELESSNESS
NMCEH – ABQ Strategy
Healthy & sustainable communities where all families & individuals have their basic needs met & prosper
LAND USE & ENVIRONMENTAL JUSTICE Bernalillo County PLACE MATTERS
PUBLIC SAFETY
Opioid Accountability Initiative – Law Enforcement/ Criminal Justice Team
BUILT ENVIRONMENT
Healthy Here: Communities Leading Healthy Change
FOOD ACCESS POLICY
Healthy Here: Communities Leading Healthy Change

6. What determines how healthy we are?
MEDICAL CARE
GENETICS
20%
10%
Before we start this conversation, there are just a few key concepts that will help us all be on the same page. One is this idea of what determines how healthy we are as individuals and as a community. The percentages can vary, depending on the particular study, but this gives you an idea especially of the lesser role that medical care plays – much less than most people would guess. Genetics tends to be reported as anywhere from 5% to 20%. Individual Behaviors is a big piece. But you’ll notice this doesn’t add up to 100%. That’s because those individual behaviors are impacted by several other factors…
INDIVIDUAL BEHAVIORS
30%

7. What (really) determines how healthy we are?
So what really determines how healthy we are? Many of you are familiar with various forms of this depiction of what we call Social and Economic Determinants of Health and Equity. All of these things listed on the right side determine whether we can actually engage in healthy behaviors. And the determinants of equity are those social factors – among others – that can determine what kind of access we have to all the determinants of health. This is all important because we’ll be looking at all the data through what’s called an equity lens whenever possible.

8. Socioeconomic Determinants of Health
Poverty/Income Housing Transportation Food Insecurity/Food Access High School Graduation Early Childhood Experiences Healthcare Coverage & Access
So what’s the landscape for socioeconomic factors in Bernalillo County that determine how healthy we are? Before going into the actual health status indicators in our county, we want to share several slides that provide an overview of some of the most significant determinants of health status. We are particularly interested in identifying those factors that represent inequities in access to resources and opportunities to keep ourselves healthy.

9. Population Below 100% Poverty
Although we definitely have higher rates of poverty in Bernalillo County than the national rate, compared to other counties in NM we appear to be doing better. However, here’s where we begin our journey into the inequities that are hidden by deceptive averages…
Source: CHNA.org – ACS

10. Population Below 100% Poverty
Bernalillo County
When we look at the number of dark-colored census tracts (from the American Community Survey a common data source that will be referred to frequently) with poverty over 20%, the overall state rate, we can see that the average is in no way evenly distributed. You will notice this general pattern repeating itself in the following slides.
Source: CHNA.org - ACS

11. Per Capita Income Source: CHNA.org – ACS 2009-2013
So now looking at average per capita income, we once again see Bernalillo County under the US average, but compared to other counties in NM, we’re looking pretty good.
Source: CHNA.org – ACS

12. Per Capita Income Bernalillo County Source: CHNA.org - ACS
But here’s per capita income by census tract where we can once again see that the average is in no way evenly distributed. In this slide the darkest areas are good, i.e., higher income, and the lighter areas are lower income, pretty much the reverse of the previous slide.
Source: CHNA.org - ACS

13. Per Capita Income by Race
Another way per capita income is not evenly distributed is by race…
Source: CHNA.org – ACS

14. Per Capita Income by Ethnicity
…and definitely not evenly distributed by ethnicity when considering the Hispanic/Latino population.
Source: CHNA.org – ACS

15. Median Family Income Bernalillo County Source: NMCDC - ACS 2013
This slide shows income by family, rather than by individual (per capita). Once again the dark areas are the highest income, so you can clearly see the pockets of wealth. Ranges here are from ~$20,500 in the International District to ~$150,000 in the far NE Heights.
Source: NMCDC - ACS 2013

16. Children in Poverty Source: CHNA.org – ACS 2009-2013
Another way to look at poverty is to look at those who are most affected by it in terms of their future health – the children. Pretty much everyone is aware of the appalling place we continually occupy at the bottom of the lists rating child well-being in the country. As reflected here, NM is much worse than the US as a whole, but again Bernalillo County doesn’t look like it’s the worst in NM.
Source: CHNA.org – ACS

17. Children under 18 in Poverty
Bernalillo County
Yet as we can see here, that Bernalillo County average of about 26% of children under 18 in poverty (the county average) is surpassed in numerous census tracts that exceed 30%. One extreme example is from (South San Pedro) to 4.13 (Parkland Hills) to 0 in the foothills.
Source: CHNA.org – ACS

18. Children under 5 in Poverty
And here we can see when looking at the most vulnerable – children under 5 – there are areas where the percentage exceeds 50%. (Percentage of children under 5 who are living below poverty in Bernalillo County (by Department of Health Small Area))

19. Households with Public Assistance
Percent of Households with Public Assistance (TANF, GA)
Given this, how much assistance are these families receiving? We can see here that even though the arrow is green – which is supposed to be a good thing – what that means is that with all the poverty we have, NM families and Bernalillo County families are actually receiving less in TANF and GA assistance.
Source: CHNA.org – ACS

20. Households with Public Assistance
Bernalillo County
And again, it’s not evenly distributed across the county.
Source: CHNA.org – ACS

21. Average Public Assistance Received
$3,386
$3,304
$3,807
And when we look at what that average public assistance amount is annually, it looks pretty pitiful across the board.
Source: CHNA.org – ACS

22. Unemployment – October 2015
The unemployment rate has gone up and down since the economic downturn in The Bureau of Labor Statistics actually has monthly data that they keep. Here’s what it looked like in October of this year with Bernalillo County pretty close to the overall US rate.
Source: CHNA.org – Bureau of Labor Statistics

23. Unemployment, 2013 Bernalillo County Source: NMCDC - ACS 2013
Although we don’t have a map for what it looked like in October, this map from two years ago is still likely reflecting the patterns of unemployment we would see across the county and clearly there are areas that are twice the average rate.
Source: NMCDC - ACS 2013

24. Poverty/Income
What strikes you as most significant about this information? Share thoughts with your neighbors.
Write any questions on post-it notes: Additional data needed Questions about data presented
Post the notes in the QUESTIONS section of Poverty/Income poster board

25. Housing Burden Source: CHNA.org – ACS 2009-2013
Now we’re going to go into some of the other social determinants that are obviously linked to poverty and income. The area of housing and the burden of housing costs is an issue across the whole country. In this regard it looks like NM overall isn’t doing as bad as Bernalillo County.
Source: CHNA.org – ACS

26. Housing Burden Source: CHNA 2015
When we look at the distribution of housing cost burden across the county, it literally looks pretty dark.
Source: CHNA 2015

27. Households with No Motor Vehicle
Another issue that’s frequently raised - in relation especially to access to goods, services and opportunities – is transportation. Although it might be seen as a negative thing, we can see by looking at the US percentage of households with no motor vehicle the impact of areas – particularly large urban areas with excellent public transportation where a private vehicle is not as necessary. In Bernalillo County where we do not have excellent public transit, this becomes more of an issue.
Source: CHNA.org – ACS

28. Households with No Motor Vehicle
Bernalillo County
Especially when we see those areas with over 8% of households with no vehicle that are spread across the metropolitan area.
Source: CHNA .org

29. Households with No Motor Vehicle Homeowners vs. Renters
( )
And here we can see the disparity between those who own a home and those who rent. It is clearly the renters that are having to deal with the transportation issue even more.
Source: CHNA.org

30. Food Insecurity Source: CHNA.org – Feeding America, 2013
Moving into another area, let’s look at food insecurity – defined as “The percentage of persons living in households where there was not enough food, healthy food, or money to buy food.”
Here once again we see that Bernalillo County looks like it’s doing better than NM overall.
Source: CHNA.org – Feeding America, 2013

31. Households with SNAP NMCDC 2013
But let’s look at some of the indications of food insecurity – in this case SNAP or food stamp benefits. The high percentage of households with SNAP is reflective of those same areas of poverty in previous maps.
NMCDC 2013

32. Students Eligible for Free or Reduced-Price Lunch
Bernalillo County
Another indication of food insecurity is to look at the students who are eligible for free or reduced-price lunch, which is clearly huge in APS as you can see from the dark circles which are schools where over 80% of the students qualify.
Source: CHNA.org

33. Food Access Source: CHNA .org – USDA 2010
Another way to look at food is through the issue of access. Here Bernalillo County looks much better than NM overall and we know that this is a huge issue in the rural areas in particular.
Source: CHNA .org – USDA 2010

34. Limited Food Access Bernalillo County Source: CHNA .org – USDA 2010
However, that average rate of 22% with low food access is once again shown to be poorly distributed. Limited food access is defined in several different ways. Used to be ½ mi to 1 mi to a grocery store, but they’re changing some of the ways they define it so the patterns are slightly different depending on proximity to grocery stores and definitions.
Source: CHNA .org – USDA 2010

35. Food Access Source: NMCDC - 2015
And since there has been a lot of attention paid to access to locally-grown fresh fruits and vegetables, here’s a look at where the growers and farmers markets were located in the summer of This number is growing however and we’re seeing more of these popping up, including the Mobile Market that was piloted this year as part of Healthy Here in the International District and the South Valley.
Source: NMCDC

36. Food Access Source: CHNA.org – US Census/CBP 2013
One more way to look at the food access question is just to compare the overall rate of access to fast food restaurants – we’ve got lots of access! – to access to grocery stores, which doesn’t look as good.
Grocery stores are defined as supermarkets and smaller grocery stores primarily engaged in retailing a general line of food, such as canned and frozen foods; fresh fruits and vegetables; and fresh and prepared meats, fish, and poultry. Included are delicatessen-type establishments. Convenience stores and large general merchandise stores that also retail food, such as supercenters and warehouse club stores are excluded.
Source: CHNA.org – US Census/CBP 2013

37. Housing, Transportation, Food
What strikes you as most significant about this information? Share thoughts with your neighbors.
Write any questions on post-it notes: Additional data needed Questions about data presented
Post the notes in the QUESTIONS section of appropriate poster board

38. High School Graduation Rates
We’ve heard plenty in the last few years about the connection between education and health. One of the most commonly cited statistics is that of high school graduation rates – where we all know we’re not doing well. In this one, Bernalillo County falls below both the US average and NM average rate.
Source: CHNA.org - EDFacts

39. High School Graduation Rates
If we look at the distribution of those schools, we see a mix of graduation rates. This includes charter schools as well. All of the “very low” are all charter schools with special populations. The APS high schools tend to be average to high.
Source: NMCDC

40. Population Age 25+ with No High School Diploma
Another way of looking at this is the population over age 25 that has no high school diploma. Once again, although we don’t look as bad as NM or the US…
Source: CHNA .org – ACS

41. Population Age 25+ with No High School Diploma
Bernalillo County
…the distribution of those rates shows a very familiar pattern.
Source: CHNA .org – ACS

42. Early Childhood Experiences
Social supports by maternal education
Source: NMDOH PRAMS

43. Stress events during pregnancy
Source: NMDOH PRAMS

44. Substantiated Child Abuse Cases

45. Uninsured Source: CHNA .org – ACS 2009-2013
Moving to another area related to healthcare coverage, let’s look at the uninsured population data. Here for the period , it looks like Bernalillo County is doing worse that the US, but better than NM overall.
Source: CHNA .org – ACS

46. Percent Uninsured Bernalillo County Source: CHNA .org - ACS
Although this is how the uninsured rate was distributed during that same period, we know that it has changed since then with the ACA, but don’t have the most recent data to show how much it has changed.
Source: CHNA .org - ACS

47. Medicaid Coverage Source: CHNA .org – ACS 2009-2013
Within those who are insured we do know that Medicaid makes up a sizable portion – showing here that in Bernalillo County it’s about 25%.
Source: CHNA .org – ACS

48. Medicaid Coverage Bernalillo County Source: CHNA .org - ACS
Again – the distribution shows the areas where the rate is over 25%. And again – since this only goes through 2013, it has changed and we need to get the new data.
Source: CHNA .org - ACS

49. Medicaid Coverage by Age
This slide shows the preponderance of Medicaid in the under 18 age category. The expansion of Medicaid to adults has changed that and we look forward to what the new data will show us.
Source: CHNA .org – ACS

50. Access to Healthcare Services
Primary care
Specialty care
Hospitalization
Behavioral health services
Mental health
Substance use disorders
We do not have slides to show the kinds of questions that we all have about actual access to care, including time needed to get appointments, waiting lists for services, and people who have simply been unable to access care.
We do know that Bernalillo County is doing better than the rest of NM with access to primary care and other healthcare services. However, we all know the stories of difficulties getting an appointment with a primary care physician or getting in to see specialists. And the question of behavioral health treatment services is a big one being discussed right now with the new opportunities for funding being presented by the GRT and other sources. This is an area that requires more data and more time to discuss than we have today. But please include your specific questions on the post-it notes.

51. Education, Early Childhood Experiences, Healthcare Coverage/Access
What strikes you as most significant about this information? Share thoughts with your neighbors.
Write any questions on post-it notes: Additional data needed Questions about data presented
Post the notes in the QUESTIONS section of appropriate poster board

52. County Health Rankings
Now we’re going to move into the actual health status indicators for Bernalillo County. Just as a reminder for how all of this fits together, this slide from the County Health Rankings – an RWJF funded project out of the University of Wisconsin – shows that our health outcomes in general – defined broadly as length of life and quality of life are impacted by health factors, some of which we’ve just looked at – physical environment, socioeconomic factors, clinical care and health behaviors – and that these factors are impacted and can be improved by policies and programs.

53. Life Expectancy,
83.7
81.7
82.9
75.7
73.1
76.6
76.6
82.4
So let’s take a look at length of life – life expectancy – in Bernalillo County. With just a quick look you can see that there is over a 10 year difference in how long you’re expected to live based on whether you live in the International District or the far NE Heights. This slide is just a simplified summary to make the point of… 76

54. Life Expectancy Bernalillo County Source: NMCDC – NM IBIS
…this slide which shows all of the small areas by life expectancy.
Since life expectancy relates directly to when and from what people die, i.e., cause of death, what are people dying from that drives the life expectancy rates?
Source: NMCDC – NM IBIS

55. 10 Leading Causes of Death by Age Group, NM 2010-2014
This chart shows how complicated this question can get, since the primary causes of death vary by age. Hard to see, but makes the point that it’s not the same for all ages. This chart is for all of NM.

56. So what are people in Bernalillo County dying from?
Here are the top 10 causes of death in Bernalillo County according to race/ethnicity. The final column gives the overall ranking based on numbers of deaths overall. Of the top 6, you can see that except for Unintentional Injury, the other 5 are all Chronic Diseases.
NM IBIS

57. Criteria for choosing indicators
County rate higher than state or national
Significant inequities within the county, geographically or by race/ethnicity, age, gender
Magnitude of impact on multiple health indicators (e.g., obesity leads to multiple issues)
Magnitude of impact on healthcare system costs
Preventable through policies, systems, environmental changes (i.e., not just healthcare services)
In the next part of our presentation we’re going specifically into many of the different health status indicators. There is not enough time, obviously, to cover everything that we see in these charts. So we established a quick criteria for what to focus on.

58. Health Status Indicators
CHRONIC DISEASE Cancer Heart Disease Asthma Stroke Diabetes/ Obesity
INJURY Drug Overdose Violent Crime - Homicide Child Maltreatment Suicide
MATERNAL/CHILD HEALTH Infant Mortality Low Birthweight Prenatal Care
These are the indicators we will now take a look at based on the previous criteria.

59. Cancer Heart Disease Asthma Stroke Diabetes/Obesity
Chronic Disease
Cancer Heart Disease Asthma Stroke Diabetes/Obesity
Chronic disease long ago replaced infectious disease as the top cause of death overall in the US as well as NM. We’ve chosen 5 chronic diseases to look at today, based on the criteria above. We’re going to race through a lot of this to just provide a quick snapshot.

60. Cancer Mortality Source: CHNA.org - CDC NVSS 2009-13
Cancer mortality – although a top cause of death at all levels – Bernalillo County not doing too much worse than state or national.
Source: CHNA.org - CDC NVSS

61. Cancer Mortality by Race/Ethnicity
Here’s the breakdown showing rates for all NM residents and then by race/ethnicity and gender. One thing we don’t have is the type of cancer. This is just to give a general idea.
Source: CHNA.org - CDC NVSS

62. Cancer Mortality Source: CHNA.org - CDC NVSS 2002-13
What we do know is that it’s getting somewhat better in NM and the US where the rates have been going down, although leveling off a bit.
Source: CHNA.org - CDC NVSS

63. Heart Disease Mortality
Here is heart disease mortality – comparing the county, state and US, with Bernalillo County looking pretty good.
Source: CHNA.org - CDC NVSS

64. Heart Disease by Race/Ethnicity
This time we can see that at least for race/ethnicity, for the most part the rate in Bernalillo County is actually better than both the state rate and the US rate. The exception here is that the rate for Hispanics/Latinos in Bernalillo County is higher than both the state and the US, but is fairly similar to both non-Hispanic White and non-Hispanic Black.
Source: CHNA.org - CDC NVSS

65. Heart Disease Mortality
This is probably the most positive slide, showing how both the rate in NM and the US have been going down, although leveling off a bit.
Source: CHNA.org - CDC NVSS

66. Adults with Asthma Source: CHNA.org – BRFSS 2011-2012
Here we move into asthma, another chronic disease, but where our rates in Bernalillo County are worse than both the state and the US.
We unfortunately don’t have more recent data and/or childhood asthma rates at this point.
Source: CHNA.org – BRFSS

67. Permitted Air Toxics Bernalillo County, 2012
We weren’t able to share much in the socioeconomic/environmental factors about environmental pollution issues in Bernalillo County. However, this one slide gives some insight into the location of facilities that have air emission permits for toxic substances and the tendency to place those in lower-income neighborhoods.
Bernalillo County, 2012
Source: CABQ Environment Dept., Air Quality Division

68. Asthma Hospitalizations, 2008-2009
Although this map from the CINCH assessment is out-of-date, it brings up questions regarding the relationship of asthma to not only the toxic air permitting process, but also the possible link with multi-family housing, as seen in the International District. Multi-family housing that permits smoking creates second-hand smoke for everyone living in the building. Children are particularly susceptible. Also, low-income multi-family housing may have other issues related to mold or cockroaches which are also asthma triggers.
Source: CINCH Health Assessment for Bernalillo County – NMDOH data

69. Stroke Mortality Source: CHNA.org - CDC NVSS 2009-13
Here we see how rates for stroke are higher in Bernalillo County than in NM overall.
Source: CHNA.org - CDC NVSS

70. Stroke Mortality by Race/Ethnicity
Looking at the breakdown by race/ethnicity and gender, we notice that only for African Americans is the rate lower in Bernalillo County, which is significant because nationally they have the highest rate.

71. Stroke Mortality
However, once again we see the positive sign of rates that are decreasing both in NM and the US.

72. Adult Obesity & Overweight
One of the areas where Bernalillo County has looked pretty good nationally is overweight and obesity, as seen here based on BMI of over 30.
Source: CHNA.org – CDC/NCCDPHP 2012

73. APS Elementary Schools – Proportion Overweight or Obese
Although we don’t have a map to show how adult obesity varies across the county, looking at this map of childhood obesity and overweight for elementary school children gives us an idea of how much it varies – despite the low overall rate for adults - and what we have in store for our future adults.
Source: NMCDC

74. Overweight or Obese by selected risk factors
APS - Grades 9-12, 2013
Youth Risk & Resiliency Survey Overweight or obese by selected risk factors Grades 9-12, 2013
Here we wanted to add some interesting information from the YRRS for When looking at APS grades 9-12, the answers to these questions point toward some valuable directions for addressing the problem.

75. Adult Diabetes, 2012 Source: CHNA.org - CDC NCCDPHP 2012
Similar to the rates for obesity, both NM and especially Bernalillo County looked good relative to the national rate in 2012.
Source: CHNA.org - CDC NCCDPHP 2012

76. Diabetes Death Rate 27 1 7 Source: NMCDC - 2015
However, as with almost everything else, the rates are not evenly distributed and many of the same areas are the most heavily impacted. Please notice the two worst areas – 1 (International District) and 7 (South Valley) and the best at 27 (Far NE Heights). 7
Source: NMCDC

77. Diabetes Death Rates by Bernalillo County Small Area
This slide has the breakdown for those 2 worst areas and the 1 best for a better comparison.

78. Chronic Disease
What improvements in policy, systems or environmental factors discussed previously would impact these issues the most ? Share thoughts with your neighbors and write themes on post-it notes.
Does this data resonate with your own experience or understanding of the issue? Write any questions on post-it notes: Additional data needed Questions about data presented
Post all notes in the CHRONIC DISEASE section

79. Injury Intentional & Unintentional
Drug Overdose Violent Crime – Adult & Child Homicide Suicide Fall-Related Deaths
Unintentional injury is high on the list of causes of death - #1 for ages 1 to 44.

80. Drug Overdose Death Rates
Bernalillo County,
This slide shows the relationship of total OD to types of drugs – note 2001 when more was classified as unspecified, making it difficult to compare trends for heroin and Rx opioids. This was fixed the following year…

81. Drug Overdose Deaths Bernalillo County, 2007-2011 Source: NM IBIS
A large part of the county exceeds the county’s average rate (for this period it was 28.7).
Bernalillo County was #10 among all counties, with a rate of 28.9 in However, the number of deaths represented almost 40% of the overdose deaths in the whole state and as seen in more detail in the next slide … (Rates: Rio Arriba was 67.7 that year, Mora was 61 and Catron was 42.5.)
Source: NM IBIS

82. Narcotics Overdose
…the rates for the 4-year period from in several areas were over twice the county’s average rate of 11.2 during that period.

83. Narcotics Overdose Mortality
It’s significant that we see what’s called the income gradient no matter what race/ethnicity for narcotics overdose. This would indicate that poverty plays a huge role, compounding any differences in race/ethnicity as a risk factor.

84. Current painkiller use to get high by selected risk factors
APS – Grades 9-12, 2013
Similar to the other slide referring to the YRSS, we can see some of the resilience and risk factors leading to use of painkillers to get high.
Source: YRRS

85. Violent Crime, 2010-2012 Source: CHNA.org – FBI UCR
Violent crime is often cited by community members as one of the things they’re most concerned about and that most affect their ability to, for example, walk freely in their neighborhood. We don’t have the data on rapes or assaults at this time, only homicide.
Source: CHNA.org – FBI UCR

86. Intentional Injury - Homicide
This slide shows a clear disparity in African Americans and Native Americans as victims of homicide more than whites or Hispanics.

87. Child Homicide Deaths
This slide covers all child homicide for ages Not all homicide deaths are the result of child abuse. Some are a result of community violence or other issues.

88. Self-inflicted Injury - Suicide
Suicide was included here to show the differences between races/ethnicities, as well as male/female differences. Some areas of the state with higher Native American population have a much bigger problem than we do here, as shown by the chart. It also appears that the white population is at higher risk for suicide than people of color.

89. Fall-Related Deaths
One last area related to injury we included because it is one of the state’s priorities and both NM and Bernalillo County have much higher rates than the national rate. Other than this slide showing the race/ethnic difference, we don’t have any additional information on possible causes, except that this is primarily within the population over 65 or so.

90. Injury
What improvements in policy, systems or environmental factors discussed previously would impact these issues the most ? Share thoughts with your neighbors and write themes on post-it notes.
Does this data resonate with your own experience or understanding of the issue? Write any questions on post-it notes: Additional data needed Questions about data presented
Post all notes in the INJURY section

91. Maternal/Child Health
Infant Mortality
Low Birthweight Prenatal Care
(For maternal/child health, the presentation was turned over to Tracy McDaniel, coordinator for the Early Childhood Accountability Partnership (ECAP). Notes to be added soon…)

92. Infant Mortality

93. Low Birth Weight – Percent of Births

94. Adequate Prenatal Care

95. Adequate Prenatal Care by Maternal Education

96. Maternal/Child Health
What improvements in policy, systems or environmental factors discussed previously would impact these issues the most ? Share thoughts with your neighbors and write themes on post-it notes.
Does this data resonate with your own experience or understanding of the issue? Write any questions on post-it notes: Additional data needed Questions about data presented
Post all notes in the MATERNAL/CHILD HEALTH section

97. Questions to Consider
Are the BCCHC priority areas still the most significant areas to focus on? Is there data that show something else?
We know that more services are needed. But what policies are needed – or need to be changed – to be able to prevent these conditions in the first place?
What new opportunities or new challenges have emerged that affect our ability to prevent these conditions?
Overall questions to consider for today’s conversation…

98. THANK YOU! For more information contact:
Marsha McMurray-Avila, BCCHC Executive Director
Tracy McDaniel, ECAP Coordinator

99. PARKING LOT SLIDES
The following slides were not used in the BCCHC presentation on , due to time constraints. But may be of interest…

100. Motor Vehicle Traffic Fatalities

101. Pedestrian-Involved Crashes

102. Truancy Rate, APS K-5

103. Influenza/Pneumonia Death Rate

104. Healthy Eating Tobacco Use
Health Behaviors
Physical Activity
Healthy Eating Tobacco Use

105. Health Behaviors
Source: CHNA.org

106. Fruit/Vegetable Consumption
Source: CHNA.org – BRFSS

107. Soda Expenditures
Bernalillo County
Source: CHNA.org

108. 10 Leading Causes of Death by Race/Ethnicity, NM 2010-2014
Source: NM Death Data: BVRHS, NMDOH