1. APEXPH Summary Assessment Protocol for Excellence In Public Health Community Health Planner Panayiota Agamemnonos Three River District Health Department

2. National Center for Health Statistics, U.S. Census Bureau, 2002 Vital Statistics

3. District Demographic Profile  2006 Population – 45,436  21,963 (50%) males*  21,873 (50%) female*  44,069 (97.6%) white (  44,069 (97.6%) white (2005)  549 (1.3%) black (2005)  1,126 (2.8%) Hispanic or Latino origin (2005) National Center for Health Statistics, U.S. Census Bureau, *2002 Vital Statistics

4. 2002 Race Distribution by Sex MaleFemale White 21,176 (50%)21,333 (50%) Black 306 (59%)207 (41%) Other 481 (58%)333 (42%) 2002 Kentucky Vital Statistics

5. Population Distribution by Age in 2002 DistrictKentucky Under 1 year 603 (1.4%) 54,312 (1.3%) 1 – 4 years 2,433 (5.6%) 216,039 (5.3%) 5 – 14 years 6,837 (15.7%) 558,077(13.6%) 15 – 24 years 5,796 (13.2%) 584,864(14.3%) 25 – 34 years 5,788 (13.2%) 554,891(13.6%) 35 – 44 years 7,020 (16.0%) 631,173(15.4%) 45 – 54 years 5,961 (13.7%) 582,643(14.2%) 55 – 64 years 4,741 (10.0%) 402,450 (9.8%) 65 – 74 years 2,744 (6.2%) 273,875 (6.7%) 75 – 84 years 1,696 (3.8%) 176,282 (4.3%) 85 + 611 (1.4%) 58,402 (1.5%) Total 43,8364,093,008 2002 Kentucky Vital Statistics

6. 2010 Population Projections 2000 Census

7. Socioeconomic Profile  In 2004, the percentage of people below the poverty level in District was 15.3% compared to 16.3% statewide.  Per capita income in 2004 was $22,033 compared to the state average of $27,265.  Median family income in 2004 was $37,529– Kentucky was $37,046.  In 2005, unemployment rates were 5.9% compared to 6.1% statewide. National Center for Health Statistics, U.S. Census Bureau

8. National Center for Health Statistics, U.S. Census Bureau

9. National Center for Health Statistics, U.S. Census Bureau

10. National Center for Health Statistics, U.S. Census Bureau

11. 2002 Socioeconomic Profile, cont. 2002 County Health Profile

12. Birth Indicators DistrictKentucky Birth rate 13.7 per 1000 pop. 13.4 per 1000 pop. Infant death rate 6.7 per 1000 births 6.8 per 1000 births Mothers under 15 0.6 per 1000 births 0.8 per 1000 births Mothers 15 – 17 25.5 per 1000 births 24.8 per 1000 births Birthweights < 2500 grams 9.5 per 100 births 8.8 per 100 births No care in first trimester 14.1%13.0% Maternal Smoking 38% * 26%* 2003 Kentucky Vital Statistics, *2006 KIDS COUNT

13. 2003 Kentucky Vital Statistics

14. 2003 Kentucky Vital Statistics,

15. 2003 Kentucky Vital Statistics

17. *2006 KIDS COUNT

18. Child Well-being Indicators  In 2003, 19% of pop. <18 lived in poverty.  Only 64% of obligated child support payments were collected in 2006.  In 2005, there were 87 reports cases of physical abuse, 44 reports of sexual abuse and 311 reports of neglect and/or dependency. 2006 KIDS Count Data Book

21. Child Well-being Indicators  Average daily attendance for students in District. - 94%. KY's average was 94%. (2005)  85% completed high school with the state average 83% in 2005. 8.5% completed 4 or more years of college – Kentucky’s average is 17.1% in 2000.  School drop-out rate in District was 2.5% with Kentucky’s being 2.6% (2000-2001). 2006 KIDS Count Data Book

24. District High School 2004-2005 KCCT TestProficient/DistinguishedAcademic Index DistrictStateDistrictState Reading 10th32%39%73.477.5 PL/VS 10th52%54%77.079.1 Mathematics 11th28%34%6166.3 Science 11th32%37%67.669.4 Social Studies 11th30%41%69.378.1 Arts & Humanities 11th32%39%65.770.7 Writing 12th31%33%67.768.4 KY Department of Education

25. District High School 2004-2005 National Norm Referenced Test (CTBS/5) DistrictStateNation 9th Grade Reading 46%ile56%ile50%ile 9th Grade Language Arts 40%ile51%ile50%ile 9th Grade Mathematics 46%ile52%ile50%ile KY Department of Education

26. District Middle School 2004-2005 KCCT TestProficient/DistinguishedAcademic Index DistrictStateDistrictState Reading 7th57%62%8587 Science 7th39%41%7074 Writing 7th19%21%5757.3 Mathematics 8th34%36%6771 Social Studies 8th36%39%7073.5 Arts & Humanities 8th43%53%7176.5 PL/VS 8th44%43%6574.3 KY Department of Education

27. District Middle School 2004-2005 National Norm Referenced Test (CTBS/5) DistrictStateNation 6th Grade Reading 51%ile58%ile50%ile 6th Grade Language Arts 47%ile54%ile50%ile 6th Grade Mathematics 52%ile57%ile50%ile KY Department of Education

28. District Primary/Elementary School 2004-2005 KCCT TestProficient/DistinguishedAcademic Index DistrictStateDistrictState Reading 4th56%68%78.187.1 Science 4th45%54%81.587.6 Writing 4th32%43%69.274.9 Mathematics 5th34%45%65.774.4 Social Studies 5th39%53%68.579.3 Arts & Humanities 5th29%32%58.262.8 PL/VS 5th57%63%78.884.9 KY Department of Education

29. District Primary/Elementary School 2004-2005 National Norm Referenced Test (CTBS/5) DistrictStateNation End of Primary (EOP) Reading 55%ile65%ile50%ile EOP Language Arts 55%ile62%ile50%ile EOP Mathematics 61%ile67%ile50%ile KY Department of Education

30. Access to Primary Health Care Profile  Primary care provider ratio is the population of a given area divided by the number of full- time primary care providers serving that area.  The Federal Government estimates that 1 primary care provider can provide care to 1500 individuals.  In 2007, District’s ratio is 1 to 4615, Kentucky’s ratio is 1917. KY Department of Public Health, Health Care Access Branch

31. 2005 Traffic Collisions  2005 saw a total of 1,229 collisions of those 20 involved fatalities, 345 non-fatal injuries, and 864 property damage. 21 people were killed and 494 people were injured. 21 people were killed and 494 people were injured.  Of the 1,229 collisions, 82 involved drinking drivers and 9 involved drivers under influence of drugs 2005 Traffic Collision Facts

32. 2005 Driving under the Influence  6 of the 82 collisions with drinking drivers involved fatal collisions, 38 non-fatal injury, and 38 property damage. 6 people were killed and 62 people were injured. 6 people were killed and 62 people were injured.  1of the 9 collisions under influence of drugs involved a fatality and 6 non-fatal injury with 1 person killed and 7 people injured. 2005 Traffic Collision Facts

33. DUI Convictions Trend 2006 Crime in Kentucky

34. 2005 Crime  In 2005, 384 DUI arrests with 367 adults and 12 juveniles (4 unknown).  There was a total of 2,708 arrest in 2005 with 395 arrests for narcotic drug laws at the highest.  Another 282 of the arrests were for drunkenness. 2006 Crime in Kentucky

35.  District’s cancer of all sites incidence age- adjusted rate for 2000-2004 was 471.65 compared to KY’s age-adjusted rate as 513.73 2007 Kentucky Cancer Registry

36.  District’s cancer of respiratory system incidence age-adjusted rate for 2000-2004 was 115.72 compared to KY’s age-adjusted rate as 108.12 2007 Kentucky Cancer Registry

37.  District’s cancer of breast incidence age- adjusted rate for 2000-2004 was 59.66 compared to KY’s age-adjusted rate as 66.90 2007 Kentucky Cancer Registry

38.  District’s cancer of all sites mortality age- adjusted rate for 2000-2004 was 237.02 compared to KY’s age-adjusted rate as 224.25 2007 Kentucky Cancer Registry

39.  District’s cancer of respiratory system mortality age-adjusted rate for 2000-2004 was 88.40 compared to KY’s age-adjusted rate as 81.85 2007 Kentucky Cancer Registry

40.  District’s cancer of breast mortality age-adjusted rate for 2000-2004 was 16.55 compared to KY’s age-adjusted rate as 14.99 2007 Kentucky Cancer Registry

41. Leading Causes of Mortality 2002 Under 1 year Perinatal conditions Age 1-14 Unintentional injury 15-24 25-34 35-44 45-54 Heart Disease 55-64 Malignant neoplasm 65 + Heart Disease 2002 Vital Statistics Report

42. Years of Potential Life Lost (YPLL)  Years of Potential Life Lost is a measure of causes of mortality that are responsible for taking the highest number of years of life based on life expectancy.  Years of potential life lost are calculated by multiplying the number of deaths per age group by years of life lost as determined by the difference in age at the time of death and life expectancy.

43. Deaths from All Causes /YPLL Age# of Deaths Mean Age at Death 75 – Mean Age at Death YPLL < 1 20.574.5149 1-14 years 3867201 15-24 years 52055275 25-34 years 93045405 35-44 years 194035665 45-54 years 255025625 55-64 years 596015885 65+ years 2857051425 Total 407--4,630 2002 Kentucky Vital Statistics

44. Deaths from Unintentional Injuries /YPLL Age# of Deaths Mean Age at Death 75 – Mean Age at Death YPLL < 1 0000 1-14 years 1867 15-24 years 42055220 25-34 years 43045180 35-44 years 2403570 45-54 years 2502550 55-64 years 16015 65+ years 17055 Total 15--607 2002 Kentucky Vital Statistics

45. Malignant Neoplasm  Cancer tops the list for YPLL in District with 905 years of life lost.  Lung cancer is responsible for 405 of those years and breast cancer another 85. 2002 Kentucky Vital Statistics

46. Unintentional Injuries  Unintentional injuries are responsible for 605 years of life lost.  Motor vehicle accidents make 405 years of the total.  Drug-induced death is to blame for the loss of 105 years. 2002 Kentucky Vital Statistics

47. Heart Disease  Heart disease ranks 3rd for YPLL with 590 years of potential life lost.  Heart disease ranks 1 st as cause of mortality in those over the age of 65 and those between the ages of 45 and 54, 2 nd for those between the ages of 55 and 64, and 3 rd for those between the ages of 35 and 44. 2002 Kentucky Vital Statistics

48. Other contributors to YPLL  Suicide takes 280 years.  Chronic lower respiratory disease takes 235 years.  Diabetes takes another 125 years.  Chronic liver disease/cirrhosis is responsible for 65 years.  Cerebrovascular disease takes 15 years. 2002 Kentucky Vital Statistics

49. Next Steps  The next step in the APEXPH process is to gather input from community leaders regarding actions to be taken to address the preceding statistics.

50. Sources 1. National Center for Health Statistics; U.S. Census Bureau (2007) Fedstats. From http://www.fedstats.gov/qf/states/21000.html http://www.fedstats.gov/qf/states/21000.html 2. Cabinet for Health and Family Services; Kentucky Department for Public Health (2002) Kentucky Vital Statistics. From http://chfs.ky.gov/dph/vital/2002vitalreports.htm http://chfs.ky.gov/dph/vital/2002vitalreports.htm 3. Cabinet for Health and Family Services; Kentucky Department for Public Health (2002) KY County Health Profile. From http://chfs.ky.gov/dph/epi/cohealthprofiles.htm http://chfs.ky.gov/dph/epi/cohealthprofiles.htm 4. Kentucky Youth Advocates (2006) KIDS COUNT. From http://www.kyyouth.org/Publications/KIDS_COUNT_2006/2006+County+Data +Book+v3.pdf http://www.kyyouth.org/Publications/KIDS_COUNT_2006/2006+County+Data +Book+v3.pdf http://www.kyyouth.org/Publications/KIDS_COUNT_2006/2006+County+Data +Book+v3.pdf 5. KY Department of Education; School Report Card 2000-2005 (2004-2005) School Report Card. From http://apps.kde.state.ky.us/report_card/index.cfm?action=display_cards http://apps.kde.state.ky.us/report_card/index.cfm?action=display_cards 6. Kentucky State Police (2005) Traffic Collision Facts, From http://www.kentuckystatepolice.ky.gov/pdf/KY_Traffic_Collision_Facts_2005. pdf http://www.kentuckystatepolice.ky.gov/pdf/KY_Traffic_Collision_Facts_2005. pdf http://www.kentuckystatepolice.ky.gov/pdf/KY_Traffic_Collision_Facts_2005. pdf 7. Kentucky State Police (2006) Crime in Kentucky, From http://www.kentuckystatepolice.ky.gov/pdf/cik_2006.pdf http://www.kentuckystatepolice.ky.gov/pdf/cik_2006.pdf 8. Kentucky Cancer Registry (2003) From http://cancer-rates.info/ky/index.html http://cancer-rates.info/ky/index.html 9. Cabinet for Health and Family Services; Kentucky Department for Public Health (2003) Kentucky Vital Statistics. From http://chfs.ky.gov/dph/vital/2003vitalreports.htm http://chfs.ky.gov/dph/vital/2003vitalreports.htm