Howard County Health Assessment Survey Results Executive Summary

Transcription

1 Howard County Health Assessment Survey Results Executive Summary

2 This survey provides us with a useful roadmap to guide us so we can better direct our resources and target our energies. Ken Ulman Howard County Executive INTRODUCTION Public health officials and researchers have increasingly focused on health disparities between different groups as a way to determine program goals. Although Howard County s populations, on average, have been found to be healthier than those of other counties in Maryland, health challenges persist. When the county is broken into its component demographic parts, significant disparities were apparent among different groups. Furthermore, Howard County benefits from incomes higher than the national average, and residents on average have a higher level of educational attainment than much of the nation. It is therefore surprising that some groups in Howard County score just above the national average on a number of important health metrics. METHODOLOGY The 2012 Howard County Health Assessment Survey (HCHAS) was commissioned by the Horizon Foundation, the Howard County Health Department, Howard County General Hospital, and the Columbia Association. OpinionWorks, LLC provided the technical aspects of the survey, including recommendations on the precise wording of questions, population sampling, and telephone data collection. Healthy Howard, Inc. assisted with the evaluation and materials development of the survey results. The executive summary, fact sheets, and trainers guide, including GIS analysis and data visualization, were prepared by Simplicity Metrics. How many residents lack affordable health care? 13% Uninsured in Maryland 17,965 Uninsured residents (6%) Sources: Howard County Health Assessment Survey, Maryland Behavioral Risk Factor Surveillance System Selecting and Weighting Respondents More than 2,000 interviews were conducted between July 30 and October 3, In order to be compared geographically, the county was divided into five sampling areas, based on the seven regional planning areas, with the three westernmost planning areas combined into a single sampling area. Howard County households were dialed at random, and the first adult to answer the phone was asked to participate in the survey. Caregivers were not allowed to answer for others; answers for all study respondents reflected their own characteristics and experience.

3 Even though we are the healthiest county in the state, many of our neighbors do not have access to health care for even the most basic of needs: medical or dental. Dr. Maura Rossman Howard County Health Officer As is common with telephone surveys, some populations were underrepresented (including African-Americans and residents ages 18 to 34), while other groups were overrepresented (including Whites, women, and residents over age 65). To ensure the survey results reflected the characteristics of Howard County, a statistical procedure known as weighting, was used. The demographic profile of the survey was adjusted to be similar to the actual population, based on the most recent Census data. In short, the answers from those groups underrepresented in the sample count more when totaling up responses and calculating averages to accurately represent all residents. The Questions The survey s sponsors together determined the questions that were asked. As closely as possible, the survey approach, methodology, and questions were modeled after the Centers for Disease Control and Prevention s Behavioral Risk Factor Surveillance System (BRFSS). This means that residents across the country have been asked many of the same questions, and results from national studies may be effectively compared with Howard County results. Also included was the SF-12, a 12-question functional health survey that produced a composite physical health score, mental health score, and projected monthly medical expenditure. The SF-12 was used to predict a person s overall health. RESULTS Howard County is, on average, healthier than the rest of the country, but significant health challenges persist especially among those with lower levels of income and education, as well as health outcomes related to everyday choices about smoking, drinking, diet, and exercise. Visiting the ER rather than the doctor... 1 in 9 residents with incomes less than $50k have ended up in the ER because they could not get a timely appointment with a doctor. Source: Howard County Health Assessment Survey Access to Affordable Health Care The survey revealed that approximately 17,600 residents currently do not have health insurance coverage. Income and level of educational attainment were the demographic characteristics most often associated with health coverage and access to affordable health care.

4 While 93% of residents have some type of health care coverage, only 79% of households making less than $50,000 a year have coverage, and only 63% without a high school diploma or GED have coverage. Countywide, 87% of residents said that they have at least one person they think of as their doctor, while only 76% of those living in households making less than $50,000 said so. We have already put this data to work in a collaborative Community Health Needs Assessment exercise with more than 20 community partners to set hospital priorities for improving community health to build a better, healthier Howard County. Paul Gleichauf, Senior Vice President, Planning and Marketing, Howard County General Hospital Respondents who identified their race as African-American or Native American/ other were more likely to experience health access difficulties. 95% of White residents said they have health coverage, compared with 89% for African-Americans, 88% of Hispanics, and 87% of those in the Native American/other category. Employment status also affected access to health care. For example, while 95% of those employed say they have some type of health insurance, only 87% of those who were self-employed and 85% of those unemployed were insured. How many adult residents drink at least one non-diet soda, flavored water with added sugar or sugary, beverage per week? Adults Soda 39% Sugary Flavored water with added sugar 14% Sugary beverages* 40% Source: Howard County Health Assessment Survey Chronic Diseases The survey included questions about many chronic diseases, including cancer, high blood pressure, and diabetes. These medical conditions were more prevalent among residents with lower levels of educational attainment. 34% of residents with less than a high school diploma and 30% with a high school diploma reported high blood pressure, compared with 24% countywide. Tobacco and Alcohol Tobacco use and secondhand smoke exposure was reported more frequently among those with lower levels of educational attainment.

5 36% of residents without a high school diploma living in a condo or apartment said they smell neighbors smoke in their home every day, compared with only 5% of apartment/condo residents countywide. Binge drinking (defined as more than five drinks on one occasion for men, or four for women) in the last month was reported by 15% of county residents. Although residents identifying as White were most likely to report having at least one drink in the past month (69% vs. 62% countywide), binge drinking was highest among African-Americans (17%), Hispanics (17%), and participants who identified their race as Native American/other (18%). Men reported higher amounts of alcohol consumption in general. How often each day do Howard County residents eat % 11% fruit? CDC recommends 2 or more a day % <1 35% % 8% vegetables that aren t fried? CDC recommends 3 or more a day % <1 28% Sources: Howard County Health Assessment Survey, Centers for Disease Control and Prevention Seat Belts Seat belt use was reported by nearly every survey respondent. Ninety-six percent of residents said they always wear a seat belt when driving or riding in a car. Always wearing a seat belt was least common among unmarried couples (82%) and residents without a high school diploma (84%). Mental Health Women were more likely than men to report receiving medication or treatment from a doctor for a mental or emotional condition (11% vs. 7%), and residents ages 50 to 64 were more likely to receive such treatment than other age groups (12% vs. 9% countywide). The Mental Component Score (MCS), calculated from the answers to the questions from the SF-12, provides a glimpse at how a person s emotional and mental health affects his or her functioning. Countywide, 90% of men and 89% of women had an

6 MCS score at or above the national average, with a mean score of 54. Healthy Weight, Nutrition, and Exercise Twenty-two percent of Howard County respondents reported BMI scores in the obese range, compared with 28% of Marylanders. Although fewer Howard County residents were obese compared to the state, many survey participants reported behaviors that contribute to unhealthy weight, including lack of exercise and low consumption of fruits and vegetables. The groups most likely to report participation in some kind of cardiovascular exercise in the past month include those between the ages of 18 and 35 (94%), unmarried couples (97%), those who have never been married (92%), and those who were employed (90%). CONCLUSION The 2012 Howard County Health Assessment Survey offers the most in-depth data ever captured about how health behaviors and needs vary across different demographic groups in the area. It is clear that health disparities exist in some areas, especially nutrition, healthy weight, and access to health care. In other areas, such as the connection between race and chronic diseases, further research is required in order to fully understand these complicated dynamics. The Howard County Health Assessment Survey will be repeated again in 2014, 2016, and The Howard County Health Department and partners will continue to work together to update information, conduct studies, and ensure resources are focused where greatest need meets greatest opportunity to improve the health of all residents of Howard County. a collaboration with