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Home My WebLink AboutAgenda - 04-19-2011 - 4bORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: April 19, 2011 Action Agenda b Item No. SUBJECT: County Health Rankings: Mobilizing Action Toward Community Health Report DEPARTMENT: Health PUBLIC HEARING: (YIN) No ATTACHMENT(S): County Health Rankings: Mobilizing Action Toward Community Health Report (Under Separate Cover) INFORMATION CONTACT: Rosemary Summers, 245-2411 PURPOSE: To receive the results of 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 first rankings and report was issued in 2010. 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 continues as second overall in the state. 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. Orange County is currently gathering data for a new community assessment that will be completed December 1, 2011. 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 current focus issues are mental health services, prevention of child abuse and neglect, reducing obesity in children, and improving access to health services. There will be an opportunity this summer for County residents to select new priorities for the next four years as a result of the community assessment data currently being gathered. 2 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 particulate matter days in 2006 and access to healthy foods and access to recreational areas (2008). 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 continued 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 Department will include the data from these rankings into the overall data collection for the community health assessment and work with partners to develop a community health improvement plan that will move Orange County toward meeting national standards for health. FINANCIAL IMPACT: There is no financial impact with receiving the results of the Report. RECOMMENDATION(S): The Manager recommends that the Board accept the Report and encourage residents to participate in the needs assessment and community improvement plan process. ~--F~-w~; y;;.: - .. w» :.Fxk ..». ~oun~ ~#~a~h ankn s Y ~ c~~ilzir~g ~~ican Tvwr~c arr~munt~r Ne~lt 2011 North Carolina .,^ Rert'c~g Jr~hsc~n ~~;undatc~l~ U'.`IIVERSITY C)F WISC;Q~SIN ~'C-~?U.~1.~1t3I1 HCa~~2 II2S~~'UtC 7"ranslaxraA Research auto Polacy and .Practice County Health Rankings 2011: North Carolina Introduction Where we live matters to our health. The health of a community depends on many different factors, including quality of health 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 Wisconsin Population Health Institute are pleased to present the 2011 County Health Rankings, a collection of 50 reports that reflect the overall health of counties in every state across the country. For the second year in a row, 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 allows communities 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. a~~~ t4`l`1~K TtY~~7`"iEs'~ Eval uaf e Asses ltcerts Eltprts ~ FdeBWt*f.'= C..n~ln+exrra E)trft:zaya fl~:Gx#E¢ai!h Ggmmunsty tfeeRhcxe bni:~., ~.r:~~:1 Plck .~iF'": CS t'~i3~Rl)E9 Ga•:srnmert LQ<:rwUas Finn Fr~gt+ama p4ti~t~~ T tea{ k~o-rk All of the County Health 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, obtained input from a team of expert advisors, and worked closely with staff from the National Center for Health Statistics. 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 our approach, the methods used to compile the Rankings, information on the action steps communities can take to improve their health, and examples of communities in action, see www. cou ntvhealthran ki ngs. org www.countyhealthrankings.org/north-Carolina 1 County Health Rankings 2011: 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) 509'0 Morbidity (quality of Life) 5t)°fo °°°" Tobacco use-~ ~ -- Dief & exercise Health behaviors {3C7°l } ' ~~~ Alcohol use t t ;Unsafe sex Clinical care Aacess to care (20%) ~ ~Quality of care Education ' -~ Employment Social and economic factors r - ~ Income (d0 ~~} Family & social support Community safety Physical environment (10°''x) CountyHeatth Rankings model X2010 UWPHI '~ Environmental quality Built environment 2 www.countyhealthrankings.orglnorth-Carolina County Health Rankings 2011: 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 pertormance 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 CO CM CK MI .-tom' ". o/ `~ ~i'~ Sp R ~ ~S 1~G i f ' ~" .. ~ i ~ ~ ~^~t ~~rG~ I ~ I..r i y-~. PR t `•. ~~ '~ ~ ~~r--j `r ~ , -'- AL Gk< GR _I FP „;: ( tt CL (.GCJ IF rCI ) PL5 ~'~~j-e, ~ ~MG~ ~ i i' R~-L,~V ~ CH _ '. ~ '~ ~_J DP ~ ~E ~Jp~~ HD P~~ I. C,i~ (~MK \ r SY ~ ~~1i P~1O L H _ \~ ) Jv'Y ~\- 3--• M4 f ._ `-- uH ~ E ''~~~ ' H ~ c.. PA r ~ ~ pig i""~."_\.~ ^~ ()PJ CR \~ g$ .. ...........NH Rank 1-25 Rank 26-SO =Rank 51 75 =Rank 75-l Op HEALTH FACTORS CO CM CK www.countyhealthrankings.org/north-Carolina 3 Rank 1-25 Rank 25-50 =Rank 51-75 e Rank 76-1OD County Health Rankings 2011: North Carolina Summary Health Outcomes & Health Factors Rankings Counties receive two summary ranks: Health outcomes represent how healthy a county is while s Health Outcomes health factors are what influences the health of the • Health Factors county. Each of these ranks represents a weighted summary of a number of measures. r-~, ~~ _. _; . A 1 ~ f d9 1 Wake 1 Orange 2 Orange 2 Wake 3 Union 3 Buncombe 4 Watauga 4 New Hanover 5 McGdentwrg 5 Watauga 6 Dare 6 Henderson 7 Cabarrus 7 Union 8 New Hanover 8 Polk 9 Durham 9 Durham 10 Guilford 10 Moore 11 Chatham 11 Transylvania 12 Onslow 12 Chatham 13 Carteret 13 Forsyth 14 Madison 14 Macon 15 Iredell 15 Mecklenburg 16 Yancey 16 Clay 17 Buncombe 17 Guilford 18 Catawba 18 Camden 19 Transylvania 19 Cabarrus 20 Alamance 20 Haywood 21 Lincoln 21 Carteret 22 Forsyth 22 Iredell 23 Randolph 23 Dare 24 Johnston 24 Yancey 25 Craven 25 Craven 26 Jackson 26 Davie 27 Polk 27 Catawba 28 Henderson 28 Stanly 29 Moore 29 Jackson 30 Pasquotank 30 Mitchell 31 Pender 31 Lincoln 32 Ashe 32 Onslow 33 Davie 33 Pamlico 34 Macon 34 Madison 35 Clay 35 Brunswick 36 Harnett 36 Cherokee 37 Camden 37 Pitt 38 Lee 38 Currituck 39 Davidson 39 Alamance 40 Pamlico 40 Yadkin 41 Perquimans 41 Alexander 42 Pitt 42 Gates 43 Currituck 43 Ashe 44 Montgomery 44 Granville 45 Avery 45 Avery 4 www.countyhealthrankings.org/north-Carolina County Health Rankings 2011: North Carolina .:~ 46 Hyde 46 Surry 47 Franklin 47 Randolph 48 Brunswick 48 Pasquotank 49 Hoke 49 Cumberland 50 Surry 50 Franklin 51 Duplin 51 Burke 52 Cumberland 52 Johnston 53 Wayne 53 Gaston 54 Caldwell 54 Pender 55 Tyrrell 55 Caldwell 56 Alexander 56 Wayne 57 Yadkin 57 Beaufort 58 Person 58 Hyde 59 McDowell 59 Lee 60 Beaufort 60 Perquimans 61 Nash 61 McDowell 62 Rowan 62 Davidson 63 Burke 63 Jones 64 Stanly 64 Rutherford 65 Haywood 65 Alleghany 66 Alleghany 66 Person 67 Caswell 67 Nash 68 Granville 68 Wilkes 69 Wilkes 69 Chowan 70 Greene 70 Hertford 71 Sampson 71 Harnett 72 Chowan 72 Stokes 73 Stokes 73 Rowan 74 Rockingham 74 Hoke 75 Gaston 75 Martin 76 Wilson 76 Lenoir 77 Cleveland 77 Washington 78 Washington 78 Cleveland 79 Cherokee 79 Wilson 80 Graham 80 Sampson 81 Gates 81 Caswell 82 Rutherford 82 Greene 83 Lenoir 83 Duplin 84 Mitchell 84 Bertie 85 Jones 85 Montgomery 86 Martin 86 Rockingham 87 Anson 87 Northampton 88 Richmond 88 Bladen 89 Scotland 89 Richmond 90 Swain 90 Graham 91 Hertford 91 Halifax 92 Bertie 92 Swain 93 Northampton 93 Tyrrell 94 Vance 94 Columbus 95 Edgecombe 95 Warren 96 Bladen 96 Scotland 97 Warren 97 Anson 98 Robeson 98 Vance 99 Halifax 99 Edgecombe 100 Columbus 100 Robeson www.countyhealthrankings.org/north-Carolina 5 County Health Rankings 2011: 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 life, 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. 1 Wake Wake 2 Orange Orange 3 Union Union 4 Watauga Polk 5 Mecklenburg Transylvania 6 New Hanover Macon 7 Dare Mecklenburg 8 Durham Jackson 9 Cabarrus Cabarrus 10 Chatham Craven 11 Guilford Watauga 12 Johnston Guilford 13 Pasquotank Person 14 Onslow Carteret 15 Buncombe Moore 16 Madison Dare 17 Davie Onslow 18 Alamance Clay 19 Yancey lredell 20 Carteret Durham 21 Catawba Chatham 22 Iredell Lincoln 23 Forsyth Madson 24 Henderson Randolph 25 Randolph New Hanover 26 Lincoln Nash 27 Alleghany Pamlico 28 Pender Catawba 29 Hamett Forsyth 30 Ashe Brunswick 31 Perquimans Yancey 32 Franklin Avery 33 Rowan Pender 34 McDowell Ashe 35 Moore Buncombe 36 Craven Alamance 37 Chowan Henderson 38 Davidson Wayne 39 Transylvania Lee 40 Jackson Camden 41 Pitt Duplin 42 Caldwell Cumtuck 43 Camden Hamett 44 Clay Johnston 45 Hyde Davidson 6 www.countyhealthrankings.org/north-Carolina County Health Rankings 2011: North Carolina 46 Suny Montgomery 47 Hoke Pitt 48 Lee Hyde 49 Montgomery Pasquotank 50 Stanly Graham 51 Burke Beaufort 52 Polk Davie 53 Cumberland Rockingham 54 Currituck Sampson 55 Caswell Hoke 56 Tyrrell Alexander 57 Macon Yadkin 58 Alexander Cumberland 59 Yadkin Perquimans 60 Gates Surry 61 Haywood Tyrrell 62 Pamlico Swain 63 Stokes Greene 64 Wilkes Franklin 65 Avery Haywood 66 Granville Granville 67 Beaufort Gaston 68 Duplin Caldwell 69 Brunswick Martin 70 Wayne Wilson 71 Greene Wilkes 72 Cleveland Rutherford 73 Sampson Washington 74 Gaston Caswell 75 Jones Burke 76 Wilson Cherokee 77 Lenoir Stanly 78 Cherokee McDowell 79 Nash Cleveland 80 Mitchell Scotland 81 Washington Rowan 82 Rockingham Stokes 83 Person Anson 84 Rutherford Bertie 85 Northampton Lenoir 86 Graham Alleghany 87 Richmond Robeson 88 Hertford Chowan 89 Anson Vance 90 Warren Richmond 91 Scotland Mitchell 92 Martin Edgecombe 93 Halifax Gates 94 Vance Hertford 95 Bertie Braden 96 Columbus Jones 97 Edgecombe Columbus 98 Braden Halifax 99 Swain Northampton 100 Robeson Warren www.countyhealthrankings.org/north-Carolina 7 County Health Rankings 2011: North 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, alcohol 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. :- - -_ ~ b~ 1 Orange 1 Orange 1 Orange 1 Lee 2 Yancey 2 Durham 2 Wake 2 Lenoir 3 Polk 3 Buncombe 3 Camden 3 Dare 4 Wake 4 New Hanover 4 Watauga 4 Pasquotank 5 Buncombe 5 Pitt 5 Currituck 5 Perquimans 6 Mecklenburg 6 Chowan 6 Union 6 Rutherford 7 Henderson 7 Haywood 7 Dare 7 Swain 8 Watauga 8 Guilford 8 Onslow 7 Washington 9 Union 9 Transylvania 9 Carteret 9 Hyde 10 Transylvania 10 Moore 10 Chatham 10 Franklin 11 Clay 11 Wake 11 New Hanover 11 New Hanover 12 Macon 12 Catawba 12 Henderson 12 Chatham 13 Mitchell 13 Forsyth 13 Buncombe 13 Caldwell 14 Ashe 14 Hertford 14 Cabarrus 14 Yadkin 15 New Hanover 15 Henderson 15 Polk 15 Stanly 16 Forsyth 16 Edgecombe 16 Transylvania 16 Person 17 Durham 17 Nash 17 Iredell 17 Polk 18 Guilford 18 Craven 18 Moore 18 Beaufort 19 Moore 19 Rutherford 19 Davie 19 Henderson 20 Avery 20 Macon 20 Mecklenburg 20 Cherokee 21 Lincoln 21 Halifax 21 Durham 21 Carteret 22 Greene 22 Caswell 22 Haywood 21 Pender 23 Chatham 23 Mecklenburg 23 Jackson 23 Clay 24 Catawba 24 McDowell 24 Johnston 23 Madison 25 Cherokee 25 Gaston 25 Clay 25 Alamance 26 Iredell 26 Beaufort 26 Guilford 26 Moore 27 Camden 27 Granville 27 Pamlico 27 Northampton 28 Alexander 28 Alamance 28 Forsyth 28 Halifax 29 Gates 29 Cabarrus 29 Gates 29 Brunswick 30 Cabarrus 30 Cleveland 30 Craven 29 Robeson 31 Alleghany 31 Stanly 31 Macon 31 Orange 32 Craven 32 Vance 32 Yadkin 32 Onslow 33 Haywood 33 Burke 33 Avery 33 Avery 34 Madison 34 Jackson 34 Cumberland 33 Tyrrell 35 Davie 35 Caldwell 35 Granville 35 Burke 36 Lee 36 Cherokee 36 Pender 36 Craven 37 Graham 37 Madison 37 Franklin 37 Macon 38 Martin 38 Pamlico 38 Pasquotank 38 Randolph 39 Brunswick 39 Rowan 39 Stokes 39 Watauga 40 Stanly 40 Bladen 40 Stanly 40 Duplin 41 Randolph 41 Brunswick 41 Hamett 41 Buncombe 42 Wilson 42 Cumberland 42 Lincoln 42 Alexander 43 Alamance 43 Carteret 43 Brunswick 43 Hoke 44 Gaston 44 Surry 44 Surry 44 Wayne 45 Duplin 45 Columbus 45 Yancey 45 Hamett 8 www.countyhealthrankings.org/north-Carolina County Health Rankings 2011: North Carolina 46 Davidson 46 Pasquotank 46 Madison 46 Warren 47 Pitt 47 Union 47 Randolph 47 Rockingham 48 Jackson 48 Chatham 48 Catawba 48 Cleveland 49 Burke 49 Scotland 49 Wayne 49 Johnston 50 Rutherford 50 Polk 50 Alamance 50 Cabarrus 51 Carteret 51 Wilson 51 Hoke 51 Surry 52 Yadkin 52 Mitchell 52 Perquimans 52 Sampson 53 Wilkes 53 Alexander 53 Pitt 53 Iredell 54 Surry 54 Bertie 54 Rowan 54 Mitchell 55 Jones 55 Northampton 55 Mitchell 55 Davie 56 McDowell 56 Clay 56 Person 56 Davidson 57 Caldwell 57 Randolph 57 Jones 57 Union 58 Hyde 58 Iredell 58 Alleghany 58 Forsyth 59 Cleveland 59 Lincoln 59 Hyde 59 Granville 60 Pamlico 60 Yancey 60 Alexander 60 Durham 61 Tyrrell 61 Person 61 Beaufort 61 Pamlico 62 Richmond 62 Wayne 62 Swain 62 Hertford 63 Anson 63 Davie 63 Burke 63 Caswell 64 Chowan 64 Wilkes 64 Davidson 64 Vance 65 Wayne 65 Washington 65 Ashe 65 Jones 66 Rowan 66 Dare 66 Gaston 66 Gaston 67 Nash 67 Lee 67 McDowell 67 Currituck 68 Montgomery 68 Lenoir 68 Cherokee 68 Transylvania 69 Washington 69 Watauga 69 Caldwell 69 Haywood 70 Perquimans 70 Anson 70 Nash 70 Bertie 71 Beaufort 71 Perquimans 71 Wilkes 71 Columbus 72 Lenoir 72 Ashe 72 Sampson 72 Cumberland 73 Franklin 73 Davidson 73 Rockingham 73 Pitt 74 Dare 74 Montgomery 74 Hertford 74 Martin 75 Hamett 75 Jones 75 Duplin 75 Ashe 76 Granville 76 Hyde 76 Lee 76 Wilkes 77 Person 77 Pender 77 Martin 77 Wilson 78 Johnston 78 Franklin 78 Caswell 78 Yancey 79 Cumberland 79 Martin 79 Greene 79 Bladen 80 Sampson 80 Graham 80 Lenoir 80 Stokes 81 Pender 81 Rockingham 81 Washington 81 Alleghany 82 Hoke 82 Sampson 82 Chowan 82 Chowan 83 Onslow 83 Robeson 83 Montgomery 83 Catawba 84 Hertford 84 Richmond 84 Bertie 84 Richmond 85 Bladen 85 Johnston 85 Rutherford 85 Montgomery 86 Pasquotank 86 Onslow 86 Cleveland 86 Nash 87 Bertie 87 Stokes 87 Wilson 87 Scotland 88 Northampton 88 Yadkin 88 Richmond 88 Lincoln 89 Stokes 89 Tyrrell 89 Northampton 89 McDowell 90 Caswell 90 Warren 90 Bladen 90 Camden 91 Scotland 91 Camden 91 Warren 90 Gates 92 Currituck 92 Hoke 92 Columbus 92 Wake 93 Warren 93 Cun-ituck 93 Graham 93 Jackson 94 Columbus 94 Gates 94 Halifax 94 Guilford 95 Halifax 95 Alleghany 95 Tyrrell 95 Graham 96 Rockingham 96 Hamett 96 Scotland 96 Anson 97 Vance 97 Duplin 97 Vance 97 Greene 98 Swain 98 Greene 98 Anson 98 Edgecombe 99 Edgecombe 99 Swain 99 Edgecombe 99 Mecklenburg 100 Robeson 100 Avery 100 Robeson 100 Rowan www.countyhealthrankings.orglnorth-Carolina 9 County Health Rankings 2011: North Carolina 2011 County Health Rankings: Measures, Data Sources, and Years of Data Measure Data Source Years of Data . . 'F dLrk ~ i ~ c i ~ i ti ~~~ ~ . . . ..... . ,....: . z .. .., rfrti,.. .. ...... . . A < C t iL . . , Mortality Premature death National Center for Health Statistics 2005-2007 € Morbidity Poor or fair health Behavioral Risk Factor Surveillance System 2003-2009 Poor physical health days Behavioral Risk Factor Surveillance System 2003-2009 Poor mental health days Behavioral Risk Factor Surveillance System 2003-2009 Low birthweight National Center for Health Statistics 2001-2007 HEALTH BEHAVIORS Tobacco Adult smoking Behavioral Risk Factor Surveillance System ___ Diet and Exercise Adult obesity National Center for Chronic Disease Prevention and Health Promotion Alcohol Use Excessive drinking Behavioral Risk Factor Surveillance System 2003-2009 Motor vehicle crash death rate National Center for Health Statistics 2001-2007 [ High Risk Sexual Sexually transmitted infections National Center for Hepatitis, HIV, STD and 2008 t Behavior i TB Prevention Teen birth rate National Center for Health Statistics _ 2001-2007 CLINICAL CARE _ Access to Care Uninsured adults Small Area Health Insurance Estimates, U.S. Census 2007 Primary care providers Health Resources & Services ~ 2008 _.... _ _ _ r ~....~.._~__.___ Administration ._,. ~ Quality of Care ~ _ _ ~ __._.._ _ _ _ _ _ ~~~~ _ __----._.~ Preventable hospital stays ..~..~~~_ _ _ ___W_______ ~_.._ ~ ~~---..~_.~~~~~~~__~ __~ Medicare/Dartmouth Institute _ _ _____ 2006-2007 E Diabetic screening Medicare/Dartmouth Institute 2006-2007 Mammography screening Medicare/Dartmouth Institute 1 2006-2007 SOCIOECONOMIC FACTORS Education High school graduation National Center for Education Statistics' 2006-2007 ~---- Some college American Community Survey 2005-2009 '. Employment ~ _ _ ._. ____ ~._.._ w Unemployment, ~ ~ ._.._._.__ ~ . _ ... Bureau of Labor Statistics ~ __._ ~ ......._._...._ _ ~ _ _ ...._ ~ 2009 __~~ ~ . Income Children rn poverty Small Area Income and Poverty Estimates, ~.,...., 2008 U.S. Census € Family and Social Inadequate social support Behavioral Risk Factor Surveillance System 2005-2009 Support t 2003-2009 2008 Single-parent households Community Safety _m__ Violent crime2 PHYSICAL ENVIRONMENT __. Air Quality' Air pollution-particulate matter days Air pollution-ozone days 2005-2009 2006-2008 2006 American Community Survey Uniform Crime Reporting, Federal Bureau of Investigation U.S. Environmental Protection Agency / Centers for Disease Control and Prevention U.S. Environmental Protection Agency / Centers for Disease Control and Prevention 2006 Built Environment Access to healthy foods Census Zip Code Business Pattems 2008 Access to recreational facilities Census County Business Pattems 2008 ___ ' State data sources for KY, NH, NC, PA, SC, and UT (2008-2009). z Homicide rate (2001-2007) 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 INV. State data source for IL. s Not available for AK and HI. 10 www.countyhealthrankings.org/north-Carolina County Health Rankings 2011: North Carolina CREDITS Report Authors University of Wisconsin-Madison School of Medicine and Public Health Department of Population Health Sciences 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: Technical Advisors Amy Bernstein, ScD, Centers for Disease Control and Prevention Michele Bohm, MPH, Centers for Disease Control and Prevention Research Assistance Jennifer Buechner Hyojun Park, MA Seth Prins, MPH Jennifer Robinson Matthew Rodock Anne Roubal Communications and Outreach Bumess Communications Ivan Cherniack Nathan Jones, PhD Kate Konkle, MPH Angela Russell Julie Willems Van Dijk, PhD, RN Design Forum One, Alexandria, VA Media Solutions, UW School of Medicine and Public Health Robert Wood Johnson Foundation Brenda L. Henry, PhD, MPH -Program Officer Michelle Larkin, JD, MS, RN -Team Director and Senior Program Officer James S. Marks, MD, MPH -Senior Vice President and Group Director, Health Group Joe Marx -Senior Communications Officer Suggested citation: University of Wisconsin Population Health Institute. County Health Rankings 2011. www.countyhealthrankings.org/north-Carolina 11 ....._.___. ~~~" County Health Rankings ~~_~ '.' ~k.- ping Actican Tc~vuard Corrrrnur~ity Health c~r~~h~aF~ r~ k;? rl.or University of Wisconsin Population Health Institute 610 Walnut St, #524, Madison; WI 53726 (608) 265-63701 info@countyhealthrankings.org