Improving Community Health through Planning and Partnerships Greene

Improving Community Health through Planning and Partnerships Greene Community Health Council

Things to keep in mind… • Feel free to ask questions as we go along • We are presenting the most recent data we have • (From the past 4 – 5 years) • This is the last part of Section 3 data

Today • Updates/Highlights from Section 3, Part 2 covered at last meeting • Section 3, Part 2 • Unintentional Injury Deaths • Violent Deaths • Ambulatory Care Sensitive Conditions / Prevention Quality Indicator Hospitalizations

Updates Maternal & Child Health

Infant Mortality by Race The rate is nearly twice as high for blacks in Greene than it is for whites, though it had been decreasing Infant Deaths Per 1, 000 Live Births By Race and Place of Residence, 5 -Year Rolling Averages 2004 -2014 50 50, 0 40 37, 6 30 20 13 09 20 08 20 Greene White 20 12 20 11 20 10 07 20 Greene Black 20 06 - 05 20 04 20 20 09 0, 0 20 08 0 Nelson Black 10 - 10, 7 10 7, 1 20 20 20 14 Healthy People 2020 12, 5 Goal 6, 0 7, 1 6, 4 Nelson White Source: Virginia Department of Health. Division of Health Statistics

Neonatal Death The percentage is slightly higher in Greene than the state-wide average and much lower than in Nelson. Neonatal Mortality Rate (Death within 28 days of life) per 1, 000 Live Births, 5 Year Rolling Averages, 20032013 12 10 8 6 4 2 0 7, 9 5, 0 4, 6 Greene Nelson Virginia 20 14 10 20 20 13 09 20 20 12 08 20 20 11 07 20 20 10 06 20 20 09 05 20 20 08 5, 2 Healthy People 2020 4, 1 04 20 8, 7 4, 4 Healthy People 2020 Source: Virginia Department of Health. Division of Health Statistics

SIDS Deaths There were fewer deaths from SIDS from ’ 09 -’ 14 then there were from ‘ 04 -’ 08. There were none in 2012. Number of SIDS Deaths in TJHD by Year, 200114 6 5 5 4 3 2 1 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Source: Virginia Department of Health. Division of Health Statistics

Pregnant Women with Prenatal Care A lower percentage of newborns were given prenatal care within the first 13 -weeks in Greene than in Nelson, but both are higher than the Healthy People 2020 goal Percent of Live Births with Prenatal Care Beginning in the first 13 Weeks, 3 Year Rolling 88% averages, 2004 -14 84, 3% 78, 1% 73% 20 13 11 - 20 12 10 - 20 Virginia 20 09 - 20 11 20 10 20 09 08 - 20 Nelson 20 20 07 - 20 08 20 Greene 06 - 20 07 05 - 20 20 04 - 20 06 68% 12 - 78% 20 14 82, 9% 80, 0% Healthy People 2020 Target 77, 9% 78, 5% 20 83% 84, 3% Healthy People 2020 Target Source: Virginia Department of Health. Division of Health Statistics

Ten or More Prenatal Care Visits Fewer mothers in Greene get at least 10 prenatal care visits than in Nelson or the state as a whole Percentage of Mothers Who Had 10 or More Prenatal Care Visits, 3 -Year Rolling Averages 2004 -2014 80, 0% 80, 4% 78, 6% 80% 72, 8% 60% 70, 7% 77, 8% 68, 7% 40% 20% 14 20 12 - 13 12 20 11 - Nelson 20 10 - 11 20 09 - 10 09 20 08 - Greene 20 07 - 08 20 06 - 07 20 05 - 20 04 - 06 0% Virginia Source: Virginia Department of Health. Division of Health Statistics

Mothers with < 12 th Grade Education th The percent of births to mothers with less than a 12 grade education is decreasing in Greene and lower in Greene than in Nelson and VA Percentage of Live Births to Mothers With Less Than a 12 th Grade Education in TJHD, 3 -Year Rolling Averages, 2004 -14 20% 15% 13% 10% 12% 14% 10% 8% 9% 5% Greene Nelson 20 14 20 12 - 20 13 20 11 - 20 12 10 - 20 11 20 20 09 - 20 10 08 - 20 09 20 20 07 - 20 08 20 06 - 20 07 05 20 20 04 - 20 06 0% Virginia Source: Virginia Department of Health. Division of Health Statistics

Smoking During Pregnancy The percent of mothers smoking while pregnant in Greene is higher than the state-wide average and higher than the Healthy People 2020 target Percent of Live Births to Mothers Who Reported Smoking During Pregnancy, 3 -Year Rolling Averages, 2004 -2014 14, 5% 11, 7% 9, 1% 20 12 - 13 12 20 11 - Nelson 20 10 - 11 10 20 09 - Greene 20 08 - 20 06 - 07 20 05 - 20 04 - 06 0% 12, 9% 8, 0% 7, 0% 4, 8% 4, 3% Healthy People 2020 1, 4% 6, 7% 09 5% 20 07 - 10% 08 15% 14 20% Virginia Source: Virginia Department of Health. Division of Health Statistics

Updates Mental Health-More details about MH emergency services

Mental Health Outcomes Mental Health Emergency Services by Type in Consumers Served by Region 10 in 2015 Emergency Custody Order Evaluations, 20. 1%, (n = 511) Wellness Recovery Center Referrals, 14. 9% (n=379) 2, 543 Total MH Emergency Service Evaluations in 2015 Hospital Admissions, 35. 0% (n = 891) Temporary Detention Orders Issued, 26. 6% (n =676) Source: Region 10

Mental Health Outcomes 891 of the 1, 836 pre-screened for hospitalization by Region in 2015 went on to a hospitalization (were admitted to hospital) More Detailed Breakdown: Type Number TDO’s 676 Recommitments 133 Voluntary Admissions 220 WRC 337 Safety Plan 290 Released 116 Referred 152 Other 152 Yes, there can be some duplication in these types, such as someone who was released and referred is counted for both of those Source: Region 10

Section 3: What is Our Health Status? • Unintentional Injury Deaths • Violent Deaths • Ambulatory Care Sensitive Conditions / Prevention Quality Indicator Hospitalizations

Unintentional Injury Deaths

Unintentional Injury Deaths The rate of unintentional injury deaths is lower in Greene than Nelson but above VA and the Healthy People 2020 goal Unintentional Injury Mortality, Rate per 100, 000 Population (Age-Adjusted), 3 -Year Rolling Averages, 1999 -2013 59 45 34 HP 2020 Goal = 36. 4 19 99 - 0 20 1 00 -0 20 2 01 -0 20 3 02 -0 20 4 03 -0 20 5 04 -0 20 6 05 -0 20 7 06 -0 20 8 07 -0 20 9 08 -1 20 0 09 -1 20 1 10 -1 20 2 11 -1 3 80 70 61 60 50 46 40 30 34 20 10 0 Greene Nelson Virginia Healthy People 2020 Goal Source: Virginia Department of Health, Division of Health Statistics

Unintentional Injury Deaths by Race There are racial disparities in with the rate currently being higher for white Virginians than black Virginians Unintentional Injury Mortality Rate per 100, 000, 4 Year Rolling Averages, 2000 -2013 37, 3 35, 9 33, 4 VA White 13 20 10 - 12 20 09 - 11 20 08 - 10 20 07 - 09 20 06 - 08 20 05 - 07 20 04 - 06 03 - 20 05 20 02 - 04 27, 3 20 01 - 20 00 - 03 60 50 40 30 20 10 0 VA Black Source: Virginia Department of Health, Division of Health Statistics for years 2000 -2012. Centers for Disease Control and Prevention, National Center for Health Statistics. CDC Online WONDER database for years 2013.

Suicide & Homicide

*Note: 2014 data is preliminary and subject to change Violent Deaths The rate of violent deaths in our health district are very close to the state-side average Violent Deaths by Type and Overall, 2014* 20 17, 6 17, 9 13, 5 13, 6 15 10 5 4, 1 4, 2 0 0 Homicides Suicides TJHD 0, 1 Unintentional Firearms Violent Deaths VA Source: Virginia Violent Death Reporting System, Office of the Chief Medical Examiner, Virginia Department of Health

Suicide The suicide rate in Greene has reached the Healthy People 2020 goal Suicide Rate per 100, 000 Population (Ageadjusted), 3 -Year Rolling Averages, 1999 -2013 30 25, 0 25 20 20, 5 15 10 12, 0 5 0 24, 8 12, 6 10, 2 19 99 - 0 20 1 00 -0 20 2 01 -0 20 3 02 -0 20 4 03 -0 20 5 04 -0 20 6 05 -0 20 7 06 -0 20 8 07 -0 20 9 08 -1 20 0 09 -1 20 1 10 -1 20 2 10 -1 3 HP 2020 Goal = 10. 2 Greene Nelson Virginia HP 2020 Goal Source: Virginia Department of Health, Division of Health Statistics

Youth Suicide The youth suicide rate in our district is lower than the state-wide average Suicide Rate per 100, 000 in Youth aged 10 -24 Years, 10 Year Average, 2003 -13 8 7 6 5 4 3 2 1 0 7, 16 5, 01 TJHD VA Source: Virginia Department of Health, Virginia Online Injury Reporting System

Youth Suicide The suicide rate among Virginian youths has increased since 1999 Suicide Rate in Youth Aged 10 -24 Years in Virginia, 5 -Year Averages, 1999 -2013 8 7 6 5 4 3 2 1 0 6, 54 6, 86 1999 -2003 2004 -2008 7, 50 2009 -2013 Source: Virginia Department of Health, Virginia Online Injury Reporting System

Youth Suicide The suicide rate among white youths is nearly double the rate of black youths Suicide Rate per 100, 000 in Youth Age 10 -24 Years by Race, 10 Year Average, 2003 -13 10 8 8, 22 6 4, 81 4 2 0 2003 -2013 VA White VA Black Source: Virginia Department of Health, Virginia Online Injury Reporting System

Homicide Greene has not had any homicides recently. The homicide rates in Nelson and Virginia as a whole fall just under Healthy People 2020 goals. Homicide Rate per 100, 000 Population (Ageadjusted), 3 -Year Rolling Averages, 1999 -2013 HP 2020 Goal = 5. 5 6, 8 5, 4 4, 0 6, 1 0, 0 19 99 -0 20 1 00 20 02 01 20 03 02 -0 20 4 03 20 05 04 20 06 05 -0 20 7 06 20 08 07 20 09 08 -1 20 0 09 20 11 10 20 12 10 -1 3 14 12 10 8 6 4 2 0 Greene Nelson Virginia Healthy People 2020 Source: Virginia Department of Health, Virginia Online Injury Reporting System

Ambulatory Care Sensitive / Prevention Quality Indicator Hospital Discharges

Prevention Quality Indicator (PQI) Hospital Discharges Greene’s rate is lower than Nelson’s and the state-wide average, all of which are lower than the national standard Total PQI Hospitalizaton Discharge Rate per 100, 000 (Age-Adjusted), 2012 1600 1400 1200 1000 800 600 400 200 0 1 457, 5 996, 2 Greene 1 124, 1 Nelson 1 040, 9 VA AHRQ National Benchmark Source: Virginia Atlas of Community Health. Behavioral Health Hospital Discharge Profile (January 1 -December 21, 2012). Accessed at www. Atlas. VA. org.

Prevention Quality Indicator (PQI) Hospital Discharges The rate in Greene is almost identical to the state-wide average and slightly lower than in Nelson, all of which are under the national standard Bacterial Pneumonia PQI Hospitalization Discharge Rates per 100, 000 (Age-Adjusted), 2012 300 250 200 150 100 50 0 248, 19 187, 3 194, 8 186, 7 Greene Nelson VA AHRQ National Benchmark Source: Virginia Atlas of Community Health. Behavioral Health Hospital Discharge Profile (January 1 -December 21, 2012). Accessed at www. Atlas. VA. org.

Prevention Quality Indicator (PQI) Hospital Discharges The rates in Nelson and Virginia are both well below the national standard COPD or Asthma in Older Adults PQI Hospitalization Discharge Rates per 100, 000 (Age-Adjusted), 2012 350 300 250 200 150 100 50 0 321, 4 169, 0 181, 8 Nelson VA Data suppressed Greene AHRQ National Benchmark Source: Virginia Atlas of Community Health. Behavioral Health Hospital Discharge Profile (January 1 -December 21, 2012). Accessed at www. Atlas. VA. org.

Prevention Quality Indicator (PQI) Hospital Discharges Greene’s rate is slightly higher than the state-wide average, lower than Nelson’s, and below the national standard Congestive Heart Failute PQI Hospitalization Discharge Rates per 100, 000 (Age-Adjusted), 2012 350 300 250 200 150 100 50 0 321, 38 241, 4 Greene 273, 9 Nelson 237, 5 VA AHRQ National Benchmark Source: Virginia Atlas of Community Health. Behavioral Health Hospital Discharge Profile (January 1 -December 21, 2012). Accessed at www. Atlas. VA. org.

Prevention Quality Indicator (PQI) Hospital Discharges The district and state discharge rates are both well below the national standard Dehydration PQI Hospitalization Discharge Rates per 100, 000 (Age-Adjusted), 2012 160 140 120 100 80 60 40 20 0 135, 7 87, 7 68 TJHD VA AHRQ National Benchmark Source: Virginia Atlas of Community Health. Behavioral Health Hospital Discharge Profile (January 1 -December 21, 2012). Accessed at www. Atlas. VA. org.

Prevention Quality Indicator (PQI) Hospital Discharges The rate in Greene is higher than in Nelson and both are higher than the state-wide average Diabetes PQI Hospitalization Discharge Rates per 100, 000 (Age-Adjusted) by Type, 2012 200 170, 6 159, 7 150 141, 5 100 50 0 Greene Nelson VA Source: Virginia Atlas of Community Health. Behavioral Health Hospital Discharge Profile (January 1 -December 21, 2012). Accessed at www. Atlas. VA. org.

Prevention Quality Indicator (PQI) Hospital Discharges Virginia’s rate is much lower than the nationwide standard, and the district’s average is lower than the state’s Hypertension PQI Hospitalization Discharge Rates per 100, 000 (Age-Adjusted), 2012 60 54, 27 50 40 36, 7 38, 6 TJHD VA 30 20 10 0 AHRQ National Benchmark Source: Virginia Atlas of Community Health. Behavioral Health Hospital Discharge Profile (January 1 -December 21, 2012). Accessed at www. Atlas. VA. org.

Prevention Quality Indicator (PQI) Hospital Discharges Virginia’s rate is much lower than the nationwide standard Asthma in Younger Adults PQI Hospitalization Discharge Rates per 100, 000 (Age-Adjusted), 2012 46, 0 50 40 30 20 14, 6 10 0 VA AHRQ National Benchmark Source: Virginia Atlas of Community Health. Behavioral Health Hospital Discharge Profile (January 1 -December 21, 2012). Accessed at www. Atlas. VA. org.

Prevention Quality Indicator (PQI) Hospital Discharges Virginia’s rate is much lower than the nationwide standard Angina PQI Hospitalization Discharge Rates per 100, 000 (Age-Adjusted), 2012 16 14 12 10 8 6 4 2 0 13, 34 7, 5 VA AHRQ National Benchmark Source: Virginia Atlas of Community Health. Behavioral Health Hospital Discharge Profile (January 1 -December 21, 2012). Accessed at www. Atlas. VA. org.

Ambulatory Care Sensitive Hospitalizations

ACS Hospitalizations in Older Adults Greene has a higher rate than the district and the state, but it is lower than the nationwide average Ambulatory Care Sensitive Condition Hospital Discharge Rate of Medicare Part A Enrollees per 1, 000 Medicare Part A Enrollees 70 60 50 40 30 20 10 0 58, 4 50, 4 47, 4 59, 2 55, 2 2012 Greene Nelson TJHD VA US Source: Community Commons CHNA Report for TJHD Localities. Dartmouth College Institute for Health Policy & Clinical Practice, Dartmouth Atlas of Health Care. 2012. Source geography: County

ACS Hospitalizations Asthma Hospitalization Rate per 10, 000 Population, 2013 Source: Virginia Department of Health, Division of Population Health.

ACS Hospitalizations Asthma Greene’s rate has been dropping since 2010, and is lower than the state’s and district’s averages, which are lower than the rate in Nelson Asthma Hospitalization Rate per 10, 000 Population, 3 -Year Rolling Averages, 200413 19, 3 18, 8 16, 7 15, 2 12, 3 11, 2 10, 1 8, 1 7, 7 VA 13 TJHD 20 11 - 12 20 10 - 11 10 Nelson 20 09 - Greene 20 08 - 09 20 07 - 08 20 06 - 07 5, 4 20 05 - 20 04 - 06 25 17, 2 20 15 11, 3 10, 9 10 10, 4 5 0 Source: Virginia Department of Health, Division of Population Health.

ACS Hospitalizations Diabetes (Type 2) Hospitalization Rate per 10, 000 Population, 2013 Source: Virginia Department of Health, Division of Population Health.

ACS Hospitalizations Diabetes (Type 2) Greene’s rate has increased over the last few years while Nelson’s decreased. Greene has a higher rate than the district’s and the state’s averages Diabetes (Type 2) Hospitalization Rate per 10, 000 Population, 3 -Year Rolling Averages, 2004 -13 40 24, 8 20 21, 6 19, 5 19, 3 10 30 26, 4 14, 2 27, 8 27, 9 25, 4 22, 7 14, 7 16, 1 17, 8 20, 1 25, 7 21, 1 19, 8 20, 5 19, 7 18, 8 VA 13 TJHD 20 11 - 12 20 10 - 11 10 Nelson 20 09 - Greene 20 08 - 09 20 07 - 08 20 06 - 07 20 05 - 20 04 - 06 0 Source: Virginia Department of Health, Division of Population Health.

ACS Hospitalizations Hypertension Hospitalization Rate per 10, 000 Population, 2013 Source: Virginia Department of Health, Division of Population Health.

ACS Hospitalizations Hypertension Greene’s rate has risen since 2010, and is now higher than Nelson’s, but it is still lower than the district’s and state’s averages Hypertension Hospitalization Rate per 10, 000 Population, 3 -Year Rolling Averages, 2004 -13 20 Nelson 8, 3 7, 1 TJHD VA 13 9, 5 8, 4 7, 1 20 11 - 11 12 5, 9 5, 0 20 10 - Greene 8, 6 20 09 - 09 5, 7 20 07 - 08 20 04 - 06 0 6, 4 10, 6 10, 2 10 7, 2 6, 4 10, 6 9, 8 20 08 - 10, 8 20 06 - 5 9, 2 11, 3 07 10 12, 6 20 05 - 15 Source: Virginia Department of Health, Division of Population Health.

Questions ? Contact Info: Jillian Regan, MPH Jillian. Regan@vdh. virginia. gov