The URL can be used to link to this page

Home My WebLink AboutAgenda - 03-16-2010 - 8bORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: March 16, 2010 Action Agenda Item No. SUBJECT: County Health Rankings: Mobilizing Action Toward Community Health Report DEPARTMENT: Health PUBLIC HEARING: (Y/N) No ATTACHMENT(S): PowerPoint Presentation County Health Rankings: Mobilizing Action Toward Community Health Report INFORMATION CONTACT: Rosemary Summers, 245-2411 PURPOSE: To provide the Board of Commissioners with the results of the County Health Rankings Report for Orange County. BACKGROUND: The Robert Wood Johnson Foundation funded the University of Wisconsin Population Health Institute to develop a ranking system for all local counties across the country - approximately 3,000 counties. The ranking only compares counties to each other within a state. The rankings are intended to help counties compare the multiple factors that influence health so that people can see where they are doing well and where they need to improve. The rankings show that Orange County is second overall in North Carolina. The County ranks first in health factors and second in health outcomes. These rankings were determined by examining data sets from certain points in time. North Carolina continually examines and updates some of the same data points contained in this report through its four year cycle of community assessment. Most of the achievements in Orange County's health rankings can be attributed to the strong partnerships that exist between both school systems, UNC Health Care System, UNC, non- profit agencies, the business community and governments. One place all of these partners come together is through Healthy Carolinians of Orange County. These partners collaborate to address high priority health issues for County residents. The focus issues are mental health services, prevention of child abuse and neglect, reducing obesity in children, and improving access to health services. Despite being higher in rankings overall, there are areas for improvement. The lowest scores for Orange County were in physical environment factors that contribute to health. These measures were ozone and particular matter days in 2005 and access to healthy foods and the density of liquor stores. Work has already occurred in these areas and this is an indicator that more work is needed. The availability of multiple farmers' markets across the County and the growing movement to start and foster community gardens has already started to improve access to healthy foods. This also may provide new opportunities for economic development of full service groceries in areas of the County that have limited access to fresh fruits and vegetables. The Health Department through Healthy Carolinians will work with partners to examine these results and use them to further improve the health of County residents and ensure that the County and residents do not become complacent by these achievements. FINANCIAL IMPACT: There is no financial impact with receiving the results of the Report. RECOMMENDATION(S): The Manager recommends that the Board receive the Report. 3 NC County Health Rankings 2010 Rankings by University of Wisconsin Project Description Robert Wood Johnson Foundation funded the project to look at a standard way to measure how healthy a county is and where they can improve • Each state had rankings published for all of its jurisdictions /counties • Rankings are a snapshot in time 4 The Model Used Health Outcomes ~.~ =~~ ._ Health Factors ~; . Programs and Policies Health Outcomes • Mortality Measures - Years of potential life lost prior to age 75 (5,730) • Morbidity Measures - Self-reported fair or poor health (12%) - Self-reported poor physical health days (avg. 2.6 days in past 30 daps) - Self-reported poor mental health days (avg. 2.9 days in past 30 days) - % of births with low birth weight (<2500 grams) (8 per 1,000 births) 5 Health Factors • Health Behaviors (30%) of score - Tobacco (13% adults smoke) - Diet and Exercise • Physical activity (48% adults meet guidelines) • adult obesity (22% with BMI>30) - Alcohol use • Binge drinking (14% have had more than 5 drinks in same day last month) • Motor vehicle death rate (14 per 100,000 population) - High risk sexual behavior • Teen births (13 per 1,000 under 19) • Chlamydia rate (194 per 100,000 population) Health Factors • Clinical Care (20% of score) - Access to Care • Uninsured adults (23% under 65) • Primary care providers (387 per 100,000 population) - Quality of Care • Preventable hospital stays (47 per 100,000 population) • Diabetic screening (87% received HbA1c test) • Hospice use (35% Medicare patients used in last 6 months of life) 6 Health Factors • Socioeconomic Factors (40% of score) - Education • High school graduation (83%) • College graduates (54% of adult population) - Employment • Unemployment rate (4%) [2008) - Income • Children in poverty (12% under 18) [2007] • Income inequality (53%) Health Factors - Family & Social Support • Social/emotional support (16% adults without support) • Single-parent households (7%) - Community Safety • Violent crime (4 homicides per 100,000 population) 7 Health Factors • Physical environment (10% of score) - Air quality • Unhealthy air due to ozone (0) • Unhealthy air due to particulate matter (9 average annual number) [2005] - Built environment • Access to healthy foods (56% zip codes with grocery stores or farmer's markets) • Liquor stores (.7 per 100,000 density) Overall Orange Rank: Second • First - Health Behaviors - Clinical Care - Social and Economic Factors • Second - Mortality • Fourth - Morbidity • 32nd - Physical environment 8 Celebrating Success! • Strong long established partnerships • Collaboration between public and private sector • Healthy Carolinians structure that fosters and encourages collaboration • Excellent health care system • Excellent schools Orange County Acts • Health Department through Healthy Carolinians examines local data every four years • More than 45 community agencies involved • Last Community Health Assessment in 2007 • Four priority areas were selected by the community - Obesity/health prevention and promotion - Adolescent health with emphasis on reducing drug and alcohol use - Mental health and substance abuse (adults) - Child health especially preventing child abuse and neglect • Committees plan and carry out projects in each area 9 Orange County Acts- Examples • Farmer's markets have grown in past two years • Orange County Partnership for Young Children has strong community garden program to increase access to healthy foods • Both school systems have new programs in physical activity and nutrition • Pro Bono counseling network developed What's Next • Monitor statistics through NC CATCH • Room to improve, especially in disparity health • High uninsured adult rates at 23% of adults under 65 • Continual examination of best practice programs to improve the health of our community 10 iqj. t. ~ ~ ~£ ~- ~~~n~ ~~ath ~an~~n s ~:y ~ _ ~~ Mok~i~i'zir~g Action Toward Community -[~alth 2010 North Carolina Robert. Wood Johnson Foundation UNIVERSITY CAF WISCQI~~SIN Papua~on Heal~-h Insti~te II' ~ -- ?'ranslntinp Research into Policy and Practice County Health Rankings: 2010 North Carolina Introduction Where we live matters to our health. The health of a community depends on many different factors, including quality of heath care, individual behavior, education and jobs, and the environment. We can improve a community's health through programs and policies. For example, people who live in communities with ample park and recreation space are more likely to exercise, which reduces heart disease risk. People who live in communities with smoke-free laws are less likely to smoke or to be exposed to second-hand smoke, which reduces lung cancer risk. The problem is that there are big differences in health across communities, with some places being much healthier than others. And up to now, it has been hard to get a standard way to measure how healthy a county is and see where~they can improve. The Robert Wood Johnson Foundation and the University of W isconsin Population Health Institute are pleased to present the 2010 County Health Rankings, a collection of 50 reports that reflect the overall health of counties in every state across the country. For the first time, counties can get a snapshot of how healthy their residents are by comparing their overall health and the factors that influence their health, with other counties in their state. This will allow them to see county-to-county where they are doing well and where they need to improve. Everyone has a stake in community health. We all need to work together to find solutions. The County Health Rankings serve as both a call to action and a needed tool in this effort. All of the County Heatth Rankings are based upon this model of population health improvement: In this model, health outcomes are measures that describe the current health status of a county. These health outcomes are influenced by a set of health factors. These health factors and their outcomes may also be affected by community-based programs and policies designed to alter their distribution in the community. Counties can improve health outcomes by addressing all health factors with effective, evidence-based programs and policies. To compile the Rankings, we built on our prior work in Wisconsin, worked closely with staff from the Centers for Disease Control and Prevention and Dartmouth College, and obtained input from a team of expert advisors. Together we selected a number of population health measures based on scientific relevance, importance, and availability of data at the county level. For a more detailed explanation of the choice of measures, see www. countyhealthrankings. org. www.countyhealthrankings.org/north-Carolina 1 11 Institute of Medicine, 2002 County Health Rankings: 2010 North Carolina The Rankings This report ranks North Carolina counties according to their summary measures of health outcomes and health factors, as well as the components used to create each summary measure. The figure below depicts the structure of the Rankings model. Counties receive a rank for each population health component; those having high ranks (e.g., 1 or 2) are estimated to be the "healthiest." Our summary health outcomes rankings are based on an equal weighting of mortality and morbidity measures. The summary health factors rankings are based on weighted scores of four types of factors: behavioral, clinical, social and economic, and environmental. The weights for the factors (shown in parentheses in the figure) are based upon a review of the literature and expert input, but represent just one way of combining these factors. Mortality (length of life) 5D°% Morbidity (quality of life] 50°ib Tobacco use ~Iet 8ceXBfGISe z t-leatth behaviors i Hlcohol use-. Unsafe sex `` Access to care ~ . Clinical care t ~ZIl°~~ °'"~ uality of care • Education • Employment Social and . ' ' Bf.C1ilOmIC~'dCtOtS c -- IRCOtTte Family & social suppo Gomrrtunity safety Physical: ` ~ ("° Environmental quality IIII • N' : ~N . _ environment . .. j._._......y.~....~ • `* ~ Built eRtirironment County Health Bookings model X2010 t3WPHl I 12 2 www.countyhealthrankings.org/north-Carolina County Health Rankings: 2010 North Carolina The maps on this page display North Carolina's counties Maps help locate the healthiest and least healthy divided into groups by health rank. The lighter colors counties in the state. The health factors map appears indicate better performance in the respective summary similar to the health outcomes map, showing how health rankings. The green map shows the distribution of factors and health outcomes are closely related. summary health outcomes. The blue displays the distribution of the summary rank for health factors. HEALTH OUTCOMES HEALTH FACTORS K CO CM CY. 13 www.countyhealthrankings.org/north-Carolina ;~ v ~ Rank. 1-25 Rank 26-SO $ Rank 51-75 • Rank 76-100. Rank 1-ZS Rank 26-SO e Rank 51-75 ^ Rank 76-1i?0 County Health Rankings: 2010 North Carolina Summary Health Outcomes & Health Factors Rankings Counties receive two summary ranks: • Health Outcomes • Health Factors Each of these ranks represents a weighted summary of a number of measures. Health outcomes represent how healthy a county is while health factors are what influences the health of the county. ~ x b~.: .d. 3 '~. 1~t~an)~ -;~,allEft"~itt~ouireri. Rank Heal#h Factors 1 Wake 1 Orange. ,_ Oranaa ~ Wake Union 3 Buncombe 4 Chatham 4 Polk S Mecklenburg 5 Henderson ti New Hanover 6 Transylvania 7 Darr 7 New"Hanover---- 8 Watauga 8 Durham 9 l:abarrus 9 Moore 14 GuilR~id 10 Union 11 Durham 11 Chatham 1 ~ ,lack~cn 12 Catawba 1 Randolph 13 Yancey 1 Madison 14 Mecklenburg 15 ~(~nslvw 15 ~ Macon 5E Yancey 1~S Watauga W Transylvania 1'`' Guilford 18 Catawba 18 Madison 19 Clay 19 Haywood ~0 Forsyth 20 Forsyth 21 Iredell 21 Clay _~ Lineoln 22 Cabarrus 23 Polk 23 Davie 34 Craven 24 Carteret 25 buncombe 25 ~ Dare 26 Alamancc ~~6 Craven 27 Carteret 27 Mitchell ~~ PasquotanF: 28 Alamance 29 Ashe 29 -> Iredell 30 Camden 30 Yadkin 31 Moore 31 ' Jackson v~ Johnston 32 Brunswick, 33 Henderson 33 iincdn ~4 HydP 34 Alexander 5 HarnE~tt ~5 Pamlico ~6 Franklin ~6 Stanly 37 Davie .,. Ashe ~- Fender ~N~ Camden 3° Pamlico 39 ~ Pitt 40 Currituck 40 Fender 14 4 www.countyhealthrankings.org/north-Carolina County Health Rankings: 2010 North Carolina 3 ,~ ~~ ~. ~:.., .: Rat~~~ ~'Hsi'I~i~t3uCCA1rIAB8 Rank Health Factors 41 Davidson 41 Randolph`. 42 Yadkin 42 Rutherford 43 Brunswick 43 ~ Onslow 44 Mason 44 Franklin 45 Pitt 45 .. Caldwell 46 Lee 46 Avery . 47 Person 47 Gates 4~ Suny 48 Allegheny 49 Gram~lle 49 Gaston ~~ Chan-an 50 Johnston 51 McDowell b1 Cumtuck __ Avery 52 McDowell 53 Stokes 53 ~ Stokes 54 Cumberland 54 Cumberland S5 Caswell 55. Cherokee `6 Haywcxxi 56 Burke 57 Hoke 57 Wayne c Caldwzll 58 Davidson 59 Montgomery 59 Lee SO Alexander 60 Suny u1 Nash f,t-' Nash 62 Bowan G2 Wilkes 63 Wayne h3. Hameti 04 WilF.es 64 Rowan 65 Wa~.ington 65 Cleveland r-5 Gates 66 Pasquotank 57 ;,ampson 67_ Beaufort 6' Stanly 68 Jones G4 ,;reeve 69 Ghowan 0 Gaston 70 Granville 71 Rockingham 71 Caswell Burke 72 Perouimans 3 Duplin 73 Greene 74 All~ahany 74 Per".on 75 Perquimans 75 .Hoke 76 Graham 76 Wilson 77 Tyrrell 77 Bladen ?" Swain -!-' Hertford 79 Cleveland 79 .Montgomery 80 Beaufort 80 Washington 81 Wlson 81 Hyde: ~~ Janes 82 Sampson ~~ Cherokee 83 '; Duplin' 8~ Mitchzll 84 Lenoir 85 Rutherford 85 Rockingham __ Scotland 86 Graham d7 Anson 87 Martin ~= I encrr 88 Tyrrell 89 Northampton 89__: Berne 90 Richmond 90 Richmond 15 www.countyhealthrankings.org/north-Carolina 6 County Health Rankings: 2010 North Carolina ~ ,i,. _.. v ~x ~ ~ ..~ :Rank .:I~a1Yh.O~tcoilles"• Rank Health Factors 91 Vance 91 Swan ` 52 Warrel~ 92 Anson 93 Hertford 43 Halifax 94 Edq~ombe G4 Northampton 95 Martin SS Scotland 56 Halifax 96 Vance 97 Bladen 97 Columbus ~~ 9b Robc--son 98 Warren ~~ gg Bertie 99 Edgecombe 100 Columbus 100 Robeson ~6 & www.countyhealthrankings.org/north-Carolina Ccunty Health Rankings: 2010 North Carolina Health Outcomes Rankings The summary health outcomes ranking is based on measures of mortality and morbidity. Each county's ranks for mortality and morbidity are displayed here. The mortality rank, representing length of I'rfe, is based on a measure of premature death: the years of potential life lost prior to age 75. The morbidity rank is based on measures that represent health-related quality of life and birth outcomes. We' combine four morbidity measures: self-reported fair or poor health, poor physical health days, poor mental health days, and the percent of births with low birthweight. Vii`: stank' 1~4' ::•. . ~iVlosbidity ~: 1 ` 4'Vake !Wake Orange Chatham 3 Union Polk 4 New Hanover Orange 5 Mecklenburg Union 5 '/Vatauga Jackson -,7 Madison Dare Durham Clay J Chatham Mecklenburg 10 i_amden Moors 11 Guilford Crave 12 Cabarrus i;abarnis 13 Dare TransyP~ania 14 Onslaw Guilford 15 Randolph; New Hanover 1V D:3 Jle LInC 7n 17 Pasquotank Macon 13 Johnston Carteret 19 Alamance Yancey ~0 Catawba Randolph 21 Yancey Onslow ~~ Forsyth Pamlico 23 Currituck Catawba 24 I rc,~ el I I red el I 25 Buncombe Durham 26 ,`she Forsyth 27 Jackson Harnett ~S Transylvania Watauga 29 McDowell Lee „_ Lincoln Buncombe P.1 Hyde Person ~._ Henderson Henderson 33 Ponder Nash 34 Ua)~ BrunswicF: 35 Franklin Granville 36 Da'.id;cx~ Cv/ain 37 Craven Yadkin . ~ Carvell Hvde 9 Carteret Ashe 40 Suny Franklin 17 www.countyhealthrankings.org/north-Carolina 7 County Health Rankings: 2010 North Carolina 1 8 ~~ ~ ~ ... g d1 SioF;es \111ayne a2 Rowan Alarnance 43 Harnett `Madison 4a Pitt Montgomery 45 Gates Pender 46 YadEin Sampson 47 Chowan Pasquotark- 4y Pr~l~ Pitt 49 Allegheny Hoke 50 Mry~re Davidson 51 Tyrrell Avery 52 Cumberland Johr,s(on 53 Wilkes Cumberland 54 6runs:~icF. Green? 55 Avery Haywood 56 Pamlico Chowan 57 Caldwel! A1erandcr 58 Haywood Gaston 59 Granville Sorry b0 Ale=antler Caldwell 61 Person Camden 1~~2 Jtanly r herGhre 63 EurN:e Washingta~ f4 Lee D:3via 85 VJashington Gurrituck G5 Jones Ra-hinuhani 67 Ho~.e Duplin 6~ Montgcxn~y `stokes 69 Macon Stanly 70 Perquimans Wilson "r'1 Rockingham Ruther#6rd D~~pPn ~Nilkas 73 Mitchell Beaufort 74 Gaston Caswell 75 Cleveland Graham . _ r;~eane hurt e 77 Wayne Anson 78 Graham Perquimans 79 Nash McDowell En Sanips,nn Gates 81 Eeaufat Martin 82 Lenoir Raven ~~ Wrl~n Scotland b4 Warren Cleveland 85 Northam pion Allegheny F6 CheroF.ee Edq Er:Om he 87 Richmond ..Robeson 8q R.utherford Vance 89 Srotland 'Mitchell 90 Hertford Jones $ www.countyhealthrankings.org/north-Carolina County Health Rankings: 2010 North Carolina ~` _ " ~y ~ ~~: ii;.}~&l1y,:.. `:.IINV~LiARX.C.w S'~:'1nQ~{iit Y•~~~':.l 31 Swain Tyrrell +' Anson Richmond 93 Vance Northampton H4 Edgecombe Hertford 95 Halifax Bladen P6 Bladen Columbus 9; Bertie Halifax 58 Columbus Lenoir 99 Robeson Bertie t00 Martin Warm www.countyhealthrankings.org/north-Carolina 9 19 County Health Rankings: 2010 NoRh Carolina Health Factors Rankings The summary health factors ranking is based on four factors: health behaviors, clinical care, social and economic, and physical environment factors. In turn, each of these factors is based on several measures. Health behaviors include measures of smoking, diet and exercise, ak:ohol use, and risky sex behavior. Clinical care includes measures of access to care and quality of care. Social and economic factors include measures of education, employment, income, family and social support, and community safety. The physical environment includes measures of environmental quality and the built environment. Rank Health Behaviors Clinical Care Social & Economic Factors .Physical Environment 1 Orange Orange' Orange HoF:e 2 Yancey Durham Wake Yadkin 3 Poik Buncombe ' Curntuck Madison 4 MeckleJ,burg Transylvania Transylvania Clay 5' Wake _NewHanover Union. Onslow 6 Buncombe Pitt Watauoa Halifax 7 New Hanover Forsyth Camden Tyrrell 8 Henderson Catawba Chatham Polk 9 Moore: Rutherford Pdk Ashe ` 10 Clay Henderson Dare Craven 11 Avery Haywood Henderson Brunswick 12 Macon Guilford Buncombe Moore 13 Watauga Wake Davie Buncombe 14 Union Macon Carteret Swain i5 Catawba Mecklenburg Cabarrus Nasty 16 Chatham Moore Haywood Mitchell 17 Transylvania Madison Neav Hanover ~ Richmond 18 Forsyth Cleveland Madison Jones 19 Durham Cumberland Jackson Robeson 20 Guilford Mitchell Iredell Rutherford 21 Mitchell Ghcrovan Mecklenburg Fri3riklin 22 Cabarn,s Yancey Yadkin Montg ,m e: ~, 23 Gates Bfaden ' Jofinston Chao.~an 24 Alleghany Alamance Druham Dare' 25 Ashe : Burke Moore Scotland 26 Lincoln Nash Onslcnv Pasquotar~i. 27 Alexander Scotland Guilford ` Cleveland 2E~ Greene Vance Pamlico Duplin 2G Cherokee Cabarrus Stokes 8laden" 30 Brunswick Caldwell Forsyth Henderson 31 Rutherford Pamlico raven Cherokee 32 Stanly Polk C,at nvba Orange 33 Carteret Hertford Macon ' Randoph 34 Alaman~.e Craven Pender Davie 35 Haywood Edgecombe Lincoln Jackson 36 Iredell Gaston Clay Alexander 37 Davie Wayne Alamance Suny 38 Graham McDowell Franklin Vance 39 Jackson Stanly Stanly Perquimans 40 Pitt Randolph Avery Graham 20 10 www.countyhealthrankings.org/north-Carolina County Health Rankings: 2010 North Carolina Rank Health Behaviors Clinical Care Social & Economic Factors :Physical Environment 41 Washington - Pasquotahk ' Brunswick Alamance 42 Wilkes Rowan Alexander Harnett 43 Pender :Wilson Granville. Wayne'` 44 Craven Lee Rowan Yancey 45 Caldwell Union Ashe Sampson 46 Madison Bertre Gates Washington 4"7 Randolph Halifax Randolph Gaston 46 Dare Chatham Harnett Rockingham 49 Suny ` Beaufort McDowell Chatham 50 Yadkin Caswell Wayne Carteret 51 Cleveland Clay Yancey Macon 52 Camden Brunswick Davidson Catawba 53 Lee `Lincoln 'Hoke ' Warren.- 54 McDowell Alexander Cumberland Stokes 55 Davidson Davie :.Person Iertford 56 Jones Person Gaston Pamlico 57 Tyrrell Columbus Caldwell Pender 58 Gaston Surry Alleghany Johnston 59 Harnett Iredell Mitchell Lenorr 60 Wilson Cherokee Burke Anson &1 Duplin Hoke Beaufort Lee 62 Franklin Carteret Casvrell Pitt 63 Chowan Davidson _ Wilkes Caldwell 64 Bladen Richmond Perquimans Bertie 65 Pamlico Lenoir Pitt Edgecombe 66 Burke Robeson Lee Durham 67 Johnston Granvrlle._ Suny Cumberland ` 68 Nash Anson Pasquotank New Hanover 69 Hyde Washington Rockingham Burke 70 Perquimans Franklin Duplin Wilson 71 Rowan Hyde Cherokee Aileghany 72 Montgomer~~ Northampton Sampson Haywood 73 Stokes Ashe Nash Beauforf 74 Hertford Graham Greene Wilkes 75 :Halifax Jones Jones Hyde 76 Lenrrr WilNss Rutherford Union 77 Wayne Onslow Montgomery Davidson 78 Cumberland Montgcuriery Martin Guilford 79 Martin Pender Swain Transylvania 80 Onslow Stokes Hyde McDowell 81 Richmond Wan'en Lenoir Camderi 82 Beaufort Alleghany Hertford Caswell 83 Pasquotank 'Rockingham Wilson Northampton 84 Anson Perquimans Chowan Iredell 85 Caswell Watauga Cleveland Greene 86 Sampson Jackson Bladen Avery B7 `Person Dare Northampton. Stanly 88 Currituck Tyrrell Washington Gates 89 Bertie Yadkin Bertie Currituck 90 Granville Gates Anson Watauga 21 www.counfyhealthrankings.org/north-Carolina 1~ County Health Rankings: 2010 ~•!orth Carolina 2 2 •~- - - 91 Cdumtws Sampson ! Tyrrell Person 92 Rockingham Martin Richmond Lincoln 93 Warren Swan 'Warren Martin 94 Scotland Greena Columbus Columbus 95 Northamptcm 'Harnett Graham Cabarrus 96 Vance Johnston Vance Granville 97 Swain Currituck _ Scotland Forsyth 98 Hoke Camden Halifax Wake 99 Robeson Avery Edgecombe' Rowan 100 Edgecombe Duplin Robeson Mecklenburg 12 www.countyhealthrankings.org/north-Carolina County Health Rankings: 2010 North Carolina 2010 County Health Rankings: Measures, Data Sources, and Years of Data Measure Data Source Years of Data • ~ Mortality Premature death National Center for Health Statistics 2004-2006 Morbidity Poor or fair health Behavioral Risk Factor Surveillance System 2002-2008 Poor physical health days Behavioral Risk Factor Surveillance System 2002-2008 Poor mental health days Behavioral Risk Factor Surveillance System 2002-2008 Low birthweight National Center for Health Statistics 2000-2006 •~ HEALTH BEHAVIORS Tobacco Adult smoking Behavioral Risk Factor Surveillance System 2002/2008 Diet and Exercise Adult obesity National Center for Chronic Disease 2006-2008 ~ Prevention and Health Promotion Alcohol Use Binge drinking^~ Behavioral Risk Factor Surveillance System ~~~ 2002-2008 ~ ( Motor vehicle crash death rate National Center for Health Statistics 2000-2006 High Risk Sexual Chlamydia rate National Center for Health Statistics 2006 Behavior Teen birth rate National Center for Health Statistics - -. _.___ 2000-2006 CLINICAL CARE Access to Care Uninsured adults Small Area Health Insurance Estimates, 2005 U.S. Census Primary care provider rate Health Resources 8 Services 2006 Administration I Quality of Care Preventable hospital stays Medicare/Dartmouth Institute 2005-2006 Diabetic screening Medicare/Dartmouth Institute 2003-2006 Hospice use Medicare/Dartmouth Institute 2001-2005 SOCIOECONOMIC FACTORS Education High school graduation National Center for Education Statistics' 2005-2006 College degrees U.S. Census/American Community Survey 2000/2005-2007 Employment Unemployment ~ Bureau of Labor Statistics _ 2008 __ A _~___ Children in poverty Income __ Small Area Income and Poverty Estimates, _ _ 2007 U.S. Census Income inequality ~ ~ U.S. Census/American Communty SurveyZ ~ 2000/2005-2007 ~~ Family and Social Inadequate social support Behavioral Risk Factor Surveillance System 2005-2008 Support Single-parent households U.S. Census/American Community Survey 2000/2005-2007 Community Safety ~ Violent crime' _.___ Uniform Crime Reporting, Federal Bureau 2005-2007 of Investigation PHYSICAL ENVIRONMENT Air Quality4 Air polution-particulate matter U.S. Environmental Protection Agency / 2005 days Centers for Disease Control and Prevention Air pollution-ozone days U.S. Environmental Protection Agency / 2005 Centers for Disease Control and Prevention Built Environment Access to healthy foods Census Zip Code Business Patterns 2006 Liquor store density Census County Business Pattems 2006 State data sources for KY, NH, NC, PA, SC, and UT (2007-2008). Z Income inequality estimates for 2000 were calculated by Mark L. Burkey, North Carolina Agricultural 8~ Technical State University, www.ncat.edu/-burkeym/Gini.htm. a Homicide rate (2000-2006) from National Center for Health Statistics for AK, AZ, AR, CO, CT, GA, ID, IN, IA, KS, KY, LA, MN, MS, MT, NE, NH, NM, NC, ND, OH, SD, UT, and WV. State data source for IL. Not available for AK and HI. 23 www.countyhealthrankings.org/north-Carolina 53 County Heatth Rankings: 2010 North Carolina 24 CREDITS Report Editors University of Wisconsin-Madison School of Medicine and Public Health Population Health Institute Bridget Booske, PhD, MHSA Jessica Athens, MS Patrick Remington, MD, MPH This publication would not have been possible without the following contributions: Conceptual Development David Kindig, MD, PhD Paul Peppard, PhD Patrick Remington, MD, MPH Technical Advisors Amy Bernstein, ScD, Centers for Disease Control and Prevention Michele Bohm, MPH, Centers for Disease Control and Prevention Vickie Boothe, MPH, Centers for Disease Control and Prevention Ethan Burke, MD, MPH, Dartmouth Institute for Health Policy and Clinical Practice Research Assistance Clare O'Connor Karen Odegaard Hyojun Park Matthew Rodock Production and Editing Chuck Alexander Alex Field Joan Fischer Irene Golembiewski Jennifer Robinson Design Forum One, Alexandria, VA Media Solutions, UW School of Medicine and Public Health Metrics Advisory Group Yukiko Asada, PhD, Associate Professor, Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia Tom Eckstein, MBA, Principal, Arundel Street Consulting Inc, St. Paul, MN Elliott Fisher; MD, MPH, Director, Center for Population Health, Dartmouth Institute for Health Policy and Clinical Practice, and Professor of Medicine and Community and Family Medicine, Dartmouth Medical School, Lebanon, NH. Howard Frumkin, MD, MPH, Dr. PH, Director of the National Center for Environmental Health, ATSDR, CDC, Atlanta, GA Thomas Kottke, MD, MSPH, Medical Director for Evidence-Based Health, HealthPartners, Minneapolis, MN Ali Mokdad, PhD, Professor of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA. Roy Gibson Parrish, MD, Consultant in Population Health Information Systems, Peacham, VT Robert M. (Bobby) Pestronk, MPH, Executive Director, National Association of County and City Health Officials (NACCHO), Washington DC. Tom Ricketts, PhD, Professor of Health Policy and Administration, University of North Carolina Steven Teutsch, MD, MPH, Chief Science Officer, Los Angeles County Public Health, Los Angeles, CA. Julie Willems Van Dijk, PhD, RN, former Marathon County, WI Health Officer Suggested citation: University of Wisconsin Population Health Institute. County Health Rankings 2010. 14 www.countyheafthrankings.org/north-Carolina 25 '` Jaunty Healt}~ Rankings 141obitizi~9 Action Toward Community Health cc~ul-ttyhea[thrankn~s.org s~ ~ F~~~ n~a t F F. d kj' University of Wisconsin Population Health Institute 610 Walnut St, #524, Madison, WI 53726 (608) 265-63701 info@countyhealthrankings.org