Dallas County Community Health Dashboard Parkland Health & Hospital System

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1 Dallas County Community Health Dashboard Parkland Health & Hospital System 1

2 Mortality Years of Potential Life Lost Model for Determining Community Health Dashboard Health Outcomes Infant Mortality Very Low Birth Weight Births Morbidity Mental Health Status Cancer Screening Mammogram Pap Test Colon Cancer Screening Vaccinations Flu Shots for Adults 65+ Child ages months Health Risk Behaviors Violence and Injury Prevention Mortality Ed Visits for Injury High Risk Sexual Behavior Tobacco Use HIV/STD Rates Teen Birth Rate Alcohol Use Health Factors Diet and Exercise Over Weight and Obese Percent Uninsured Access to Clinical Care Quality of Clinical Care Percent with Personal Physician Physician-to-Population Ratio Non-Emergent Emergency Department Use Prevention Quality Indicators 2

3 Mortality Years of Potential Life Lost Model for Determining Community Health Dashboard Health Outcomes Infant Mortality Very Low Birth Weight Births Mammogram Health Factors Morbidity Mental Health Status Health Risk Behaviors Access to Clinical Care Quality of Clinical Care Cancer Screening Vaccinations Violence and Injury Prevention High Risk Sexual Behavior Tobacco Use Alcohol Use Diet and Exercise Over Weight and Obese Percent Uninsured Percent with Personal Physician Physician-to-Population Ratio Non-Emergent Emergency Department Use Prevention Quality Indicators Pap Test Colon Cancer Screening Flu Shots for Adults 65+ Child ages months Mortality ED Visits for Injury HIV/STD Rates Teen Birth Rate 3

4 Access to care Doing better than the benchmark Same as/not significantly different from the benchmark Worse than the benchmark Dallas County Compared to Healthy People 2020 Goal Dallas County Compared to 8 Peer Counties (Quartiles) Dallas County Compared to Past Years Data (CI) Percent Uninsured Access to Clinical Care Percent with Personal Physician Physician-to- Population Ratio N/A Non-emergent Emergency Department Use N/A N/A 4

5 40.0% Other Peer Counties Range, Percent Access: Percent Without Health Insurance age 0-64, to Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook Healthy People 2020 goal is to decrease the portion of persons without health insurance to 0% (target based on total coverage ) Dallas County Trend, Percent Uninsured, Ages 0-64,,, and Percent 35.0% 30.0% 32.9% 33.2% 30.8% 25.0% 18.8% % 29.1% 20.0% 0.0% 10.0% 20.0% 30.0% 40.0% 15.0% 10.0% Percent with no health insurance trend, City of Dallas, all ages 36.1% Percent 5.0% 0.0% 17.2% 23.0% 29.1% 25.0% 26.3% 17.9% 24.6% 33.4% 25.9% % Uninsured under 65 % Uninsured under % 34.0% 42.5% 39.9% U.S. Bexar County Harris County Tarrant County Dallas County Texas 31.0% and data is from: US Census American Community Survey, and and data is from: US Census Small Area Health Insurance Estimates -6, accessed from the following web site Healthy People 2020 Objective AHS City of Dallas, EBRI, Special run by Ken McDonnell, EBRI and ASEC Program Director, , data is from : US Census American Community Survey, 28.7% 0.0% 20.0% 40.0% 60.0% City of Dallas 5

6 90.0% 80.0% Percent Healthy People 2020 goal is to increase the proportion of persons with a usual primary care provider. (target based on 10% improvement) 83.9% 83.9% Access: Percent of Adults With A Personal Doctor, This indicator shows the percentage of adults that report that they do have someone they think of as their personal doctor or health care provider. Dallas County Trend to % 60.0% 50.0% 40.0% 30.0% 20.0% % 68.5% 73.6% 76.4% 69.4% Percent 10.0% 0.0% 81.8% 78.5% 74.3% 82.9% 73.8% 76.8% 79.6% 72.1% 72.3% 72.1% % 72.5% 69.2% 69.3% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 BRFSS Survey Question: Do you have one person you think of as your personal doctor or health care provider? (response includes: Yes one or yes more than one) Source: BRFSS, Texas, -2010, personal from TX Dept of State Health Services Healthy People Objective AHS

7 Rate Per 100,000 Population Other Peer Counties Range, Access: Primary care physician to population ratio (rate per 100,000), September 2010 Other Peer Counties include: Maricopa, Los Angeles, Miami-Dade, Cook This indicator shows the number of primary care physicians per 100,000 population 2010 Dallas County Trend to 2010 Rate Per 100,000 Population to Sources: Texas Bureau of Primary Care, for Texas counties for Texas and Other Peer Counties U.S. Comparison is base year Center for Health System Change, State Variation in Primary Care Physician Supply: Implications for Health Reform Medicaid Expansions. Research Brief No. 19 March 2011 (U.S. comparison for most recent comparison year is ) U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas * 68.1 Includes: Active primary care physicians with Texas practice addresses and a practice type of direct patient care. Primary Care Physicians are those physicians that indicate a primary specialty of: Family Practice/Medicine, General Practice, Internal Medicine, Pediatrics, Obstetrics and/or Gynecology, or Geriatrics (Geriatrics was included for the first time in ). The data on primary care providers for peer counties are obtained from the Health Resources and Services Administration s Area Resource File (ARF) for. The ARF data on practicing physicians come from the AMA Master File (), and the population estimates are from the U.S. Census Bureau s population estimates. From the County Health Rankings website. 7

8 Access: Non-Emergent Use of Emergency Departments, Percent of ED Visits 40.0% 35.0% Dallas County Trend in Emergency Department Visits for Non-Emergent Conditions, Percent of ED Visits 30.0% 25.0% 20.0% 15.0% % 33.1% 33.4% 33.9% 34.7% 10.0% 5.0% 0.0% 34.1% 34.1% Sources: DFW Hospital Council, Outpatient Data System. NYU Algorithm for determining appropriate Emergency Dept. use 33.1% 2010 Tarrant Co. 34.7% 0.0% 10.0% 20.0% 30.0% 40.0% The Dallas Fort Worth Hospital Council has established an Emergency Department data set from more than 44 hospitals in the region. The data repository has over 3.6 million emergency department visits as of Analysis of this data was based on the New York University s Emergency Department Algorithm. The NYU Algorithm defines a non-emergent ED visit as the patient s initial complaint, presenting symptoms, vital signs, medical history and age indicated that immediate medical care was not required within 12 hours. 8

9 Health Outcomes Mortality Years of Potential Life Lost Infant Mortality Very Low Birth Weight Births Morbidity Mental Health Status Model for Determining Community Health Dashboard Cancer Screening Mammogram Pap Test Colon Cancer Screening Vaccinations Flu Shots for Adults 65+ Child ages months Health Risk Behaviors Violence and Injury Prevention Mortality ED Visits for Injury High Risk Sexual Behavior Tobacco Use Alcohol Use HIV/STD Rates Teen Birth Rate Health Factors Access to Clinical Care Quality of Clinical Care Diet and Exercise Over Weight and Obese Percent Uninsured Percent with Personal Physician Physician-to-Population Ratio Non-Emergent Emergency Department Use Prevention Quality Indicators 9

10 Quality of care Doing better than the benchmark Same as/not significantly different from the benchmark Worse than the benchmark Diabetes Short Term Comp Dallas County Compared to Four Peer Counties (Quartiles) Dallas County Compared to Past Years Data Preventable Hospitalizations Diabetes PQIs Diabetes Long Term Comp Diabetes Lower Extremity Amputations Uncontrolled Diabetes Hypertension Quality of Clinical Care Prevention Quality Indicators Preventable Hospitalizations Cardiovascular PQIs Preventable Hospitalizations Chronic Pulmonary PQIs Congestive Heart Failure Angina w/o Procedure Adult Asthma COPD Urinary Tract Infection Preventable Hospitalizations Acute/Infectious Disease PQIs Bacterial Pneumonia Dehydration Perforated Appendix 10

11 Potentially Preventable Hospitalizations, Adult Asthma, Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided Bexar Co. Harris Co. Tarrant Co. Texas The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 11

12 Potentially Preventable Hospitalizations, Angina W/O Procedure, Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 12

13 Potentially Preventable Hospitalizations, Bacterial Pneumonia, Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 13

14 Potentially Preventable Hospitalizations, Chronic Obstructive Pulmonary Disease (COPD), Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 14

15 Potentially Preventable Hospitalizations, Congestive Heart Failure (CHF), Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 15

16 Potentially Preventable Hospitalizations, Dehydration, Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 16

17 Potentially Preventable Hospitalizations, Diabetes Longterm Complications, Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 17

18 Potentially Preventable Hospitalizations, Diabetes Shortterm Complications, Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 18

19 Potentially Preventable Hospitalizations, Lower Extremity Amputations for Patients with Diabetes, Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 19

20 Potentially Preventable Hospitalizations, Uncontrolled Diabetes, Dallas County Trend 2000 to Risk Adjusted Rate per 100, Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 20

21 Potentially Preventable Hospitalizations, Hypertension, Dallas County Trend 2000 to Risk Adjusted Rate per 100,000 Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 21

22 Potentially Preventable Hospitalizations, Urinary Tract Infections, Risk Adjusted Rate per 100, Dallas County Trend 2000 to Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 22

23 Potentially Preventable Hospitalizations, Perforated Appendix, Dallas County Trend 2000 to Risk Adjusted Rate per 100,000 Total risk adjusted rate per 100,000 population Bexar Co. Harris Co. Tarrant Co. Texas Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided The Prevention Quality Indicator (PQI) is a product of the Agency for Health Research and Quality (AHRQ). AHRQ has defined 13 adult PQIs that measure rates of inappropriate hospital admissions for illnesses that can be effectively managed with high-quality, communitybased primary care. 23

24 Mortality Years of Potential Life Lost Model for Determining Community Health Dashboard Health Outcomes Infant Mortality Very Low Birth Weight Births Morbidity Mental Health Status Cancer Screening Mammogram Pap Test Colon Cancer Screening Vaccinations Flu Shots for Adults 65+ Child ages months Health Risk Behaviors Violence and Injury Prevention Mortality ED Visits for Injury High Risk Sexual Behavior Tobacco Use HIV/STD Rates Teen Birth Rate Alcohol Use Health Factors Diet and Exercise Over Weight and Obese Percent Uninsured Access to Clinical Care Quality of Clinical Care Percent with Personal Physician Physician-to-Population Ratio Non-Emergent Emergency Department Use Prevention Quality Indicators 24

25 Doing better than the benchmark Same as/not significantly different from the benchmark Worse than the benchmark Health Risk Behaviors Cancer Screening Dallas County Compared to Healthy People 2020 Goal Dallas County Compared to 8 Peer Counties (Quartiles) Dallas County Compared to Past Years Data (CI) Mammogram Cancer Screening Pap Test Colon Cancer Screening 25

26 Other Peer Counties Range Percent 100.0% Other Peer Counties include: Maricopa, Los Angeles, Miami-Dade, Cook 93.0% 93.0% Screenings: Percent of women aged 18 and over who have had a Pap test within the past three years, Dallas County Trend to % Percent 80.0% 74.5% 82.8% 85.6% 60.0% 91.4% 40.0% 86.5% 65.0% 70.0% 75.0% 80.0% 85.0% 90.0% 95.0% 20.0% 0.0% 81.1% 78.2% 77.2% 84.5% 76.7% 79.4% Source: CDC BRFSS, , Texas 2010 data provided by Anna Vincent, Research Specialist, Texas Dept. of State Health Services, via Healthy People 2020 Objective C % 83.0% 83.1% 87.5% 2010 U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People % 82.2% Healthy People 2020 goal is to increase the proportion of women who receive a cervical cancer screening based on the most recent guidelines. Baseline for the United States for this measure is 84.5% of women aged 21 to 65 years received a cervical cancer screening based on the most recent guidelines in. (target based on 10% improvement or an increase to in screening rates to 93.0%) 26

27 Percent 90.0% Other Peer Counties Range Screenings: Percent of women aged 40+ who have had a mammogram within the past two years, 2010 Other Peer Counties include: Maricopa, Los Angeles, Miami-Dade, Cook Dallas County Trend to % 74.3% 81.3% 81.1% % 70.0% 60.0% 77.3% 50.0% 78.3% 40.0% 30.0% 20.0% 10.0% 0.0% 75.6% 71.9% 70.9% 76.9% 75.4% 70.1% 74.9% 73.5% 69.8% 74.6% 2010 U.S. Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: CDC BRFSS, , Texas 2010 data provided by Anna Vincent, Research Specialist, Texas Dept. of State Health Services, via Healthy People 2020 Objective C % 67.8% 64.3% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% Dallas County Healthy People 2020 goal is to increase the proportion of women who receive breast cancer screening based on the most recent guidelines. Baseline for the United States for this measure is 73.7% of females 50 to 74 years of age received a breast cancer screening based on the most recent guidelines in. (target based on 10% improvement to a target of 81.1%) 27

28 Other Peer Counties Range Per cent 80.0% Screenings: Percent of adults age 50 and over who have ever had a sigmoidoscopy or colonoscopy, 2010 Other Peer Counties include: Maricopa, Los Angeles, Miami-Dade, Cook Dallas County Trend 2002 to 2010 Percent 70.0% 60.0% 56.3% 71.4% 70.5% % 56.0% 50.0% 60.4% 40.0% 47.6% 30.0% % 20.0% 10.0% 0.0% 65.3% 70.5% 60.2% 69.5% 60.8% 61.6% 53.5% 59.6% 48.8% 48.2% 2010 U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: CDC BRFSS, , Texas 2010 data provided by Anna Vincent, Research Specialist, Texas Dept. of State Health Services, via Healthy People 2020 Objective C-16 * 47.6% 48.4% 0.0% 20.0% 40.0% 60.0% 80.0% Healthy People 2020 goal is to increase the proportion of adults aged who receive colorectal cancer screening based on the most recent guidelines. Baseline for the United States for this measure is 54.2% of adults 50 to 74 years of age received a colonoscopy or sigmoidoscopy based on the most recent guidelines in. (target based modeling/projection) 28

29 Doing better than the benchmark Same as/not significantly different from the benchmark Worse than the benchmark Health Risk Behaviors Vaccinations Dallas County Compared to Healthy People 2020 Goal Dallas County Compared to 8 Peer Counties (Quartiles) Dallas County Compared to Past Years Data (CI) Adult Vaccinations Child age months 29

30 Percent 90.0% 80.0% Healthy People 2020 goal is to increase the proportion of children aged 19 to 35 months who receive the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella and PCV vaccines. (Target based on consistency with national programs) 80.0% 80.0% Immunization: Vaccinations for children ages 19 to 35 months Dallas County Trend for percent of children receiving the appropriate vaccinations for ages 19 to 35 months, Percent 70.0% 60.0% 50.0% 73.5% 74.2% 71.9% 40.0% 30.0% 20.0% 10.0% 0.0% 69.9% 70.6% 73.5% 73.9% 73.7% 71.4% % U.S. Median Bexar Co. Texas Healthy People 2020 Source: Centers for Disease Control and Prevention, National Immunization Survey, 2001, 2002,,,,,,. Beyond ABC: Growing Up in Dallas County, Children s Medical Center Healthy People 2020 Objective IID % % The only Peer County available in Los Angeles for at 78.1% immunized in this age group. 72.8% 67.1% 73.3% 68.0% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% Vaccine recommendations based on the 4:3:1:3:3:1 schedule and at the appropriate age. 30

31 Other Peer Counties Range Percent 100.0% 90.0% 80.0% 70.0% 60.0% Healthy People 2020 goal is to increase the proportion of adults who are vaccinated annually against influenza. (Target based on better than best, retention of Healthy People 2010 target) 49.3% % 90.0% 90.0% Immunization: Adults aged 65+ who have had a flu shot within the past year, 2010 Dallas County Trend for Adults aged 65+ who have had a flu shot within the past 12 months Percent % 70.3% 68.9% 50.0% 72.8% 40.0% /6 63.6% 30.0% 20.0% 10.0% 0.0% 67.5% 68.7% 65.3% 74.0% 65.1% 67.2% 67.3% 65.5% 58.2% 60.5% 59.7% / % 2003/4 71.4% 2001/2 59.7% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% Dallas County US Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: CDC BRFSS, 2001/2002 combined, 2003/ combined, / combined, and. Years were combined to ensure a sufficient sample size. Data for Other Peer Counties is Texas 2010 data provided by Anna Vincent, Research Specialist, Texas Dept. of State Health Services, via Healthy People 2020 Objective IID Other Peer Counties include: Maricopa, Los Angeles, Cook, Miami/Dade 31

32 Doing better than the benchmark Same as/not significantly different from the benchmark Worse than the benchmark Health Risk Behaviors Violence and Injury Prevention All Unintentional Injuries Death Rate Dallas County Compared to Healthy People 2020 Goal Dallas County Compared to 8 Peer Counties Dallas County Compared to Past Years Data (CI) Motor Vehicle Crash Death Rate Falls Death Rate Violence Mortality and ED Visits for Injury Falls Death Rate Age 65+ Unintentional Poisoning Death Rate Suicide Death Rate Homicide Death Rate ED Visits for Injuries N/A N/A 32

33 Injuries: Age-Adjusted Unintentional Injury Death Rate, per 100,000 population Other Peer Counties Range Rate Per 100, Healthy People 2020 goal is to reduce deaths caused by unintentional injuries (Target based on 10 percent improvement) Dallas County Trend in Unintentional Injury Death Rates, 2001 to Rate Per 100, U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File CDC WONDER On-line Database, compiled from Compressed Mortality File Series 20 No. 2M, Accessed at on Jul 15, :32:01 PM Healthy People 2020 Objective IVP-11 U.S. data source: National Vital Statists Reports, Deaths: Preliminary data for, March 2011 Vol. 59., No.4. pp Other Peer Counties include: Maricopa, Los Angeles, Miami-Dade, Cook ( data) Includes all unintentional injuries, including motor vehicle accidents, falls, poisoning, drowning/submersion, and others. Does not include homicide and suicide. ICD10 codes for unintentional injury deaths include: (V01-X59, Y85-Y86). 33

34 Rate Per 100, Other Peer Counties Range Injuries: Age-Adjusted Motor Vehicle Crash Death Rate, per 100,000 population Healthy People 2020 goal is to reduce deaths caused by motor vehicle crashes (Target based on 10% improvement) U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File CDC WONDER On-line Database, compiled from Compressed Mortality File Series 20 No. 2M, Accessed at on Jul 15, :32:01 PM Healthy People 2020 Objective IIVP U.S. data source: National Vital Statists Reports, Deaths: Preliminary data for, March 2011 Vol. 59., No.4. pp Dallas County Trend in Motor Vehicle Crash Death Rates, Rate Per 100, Other Peer Counties include: ( data) Maricopa, Los Angeles, Miami- Dade, Cook ICD10 Codes for Motor Vehicle Crashes Includes V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6, V20-V79, V80.3- V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V

35 Injuries: Age-Adjusted Falls Death Rate, per 100,000 population Rate Per 100, Other Peer Counties Range Healthy People 2020 goal prevent an increase in the rate of fall-related deaths (Target is to maintain the baseline rate) Dallas County Falls Death Rates, Rate Per 100, U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File CDC WONDER On-line Database, compiled from Compressed Mortality File Series 20 No. 2M, Accessed at on Jul 15, :32:01 PM Healthy People 2020 Objective IIVP U.S. data source: National Vital Statists Reports, Deaths: Preliminary data for, March 2011 Vol. 59., No.4. pp Other Peer Counties include: Maricopa, Los Angeles, Miami-Dade, Cook ( data) Includes falls deaths. ICD 10 W00 W19 35

36 Rate per 100,000 population age 65 and over 140 Other Peer Counties Range Injuries: Age Specific Fall Death Rates, per 100,000 population for age 65 Healthy People 2020 to prevent an increase in the rate of fallrelated deaths (Target is to maintain the baseline rate) Dallas County Trend in Age- Specific Falls Death Rates, 2001-, age 65 and over U.S. Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File CDC WONDER On-line Database, compiled from Compressed Mortality File Series 20 No. 2M, Accessed at on Jul 15, :32:01 PM Healthy People 2020 Objective IVP U.S. data source: National Vital Statists Reports, Deaths: Preliminary data for, March 2011 Vol. 59., No.4. pp Includes falls deaths. ICD 10 W00-W19 Other Peer Counties include: Maricopa, Los Angeles, Miami-Dade, Cook ( data) 36

37 Rate Per 100, Other Peer Counties Range Injuries: Age-Adjusted Unintentional Poisoning Death Rate, per 100,000 population Healthy People 2020 goal is to Prevent an increase in the rate of poisoning deaths ((Target is to maintain the baseline rate) Dallas County Trend in Poisoning Death Rates, Rate Per 100, U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People Other Peer Counties include: Maricopa, Los Angeles, Miami-Dade, Cook Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File CDC WONDER On-line Database, compiled from Compressed Mortality File Series 20 No. 2M, Accessed at on Jul 15, :32:01 PM Healthy People 2020 Objective IVP U.S. data source: National Vital Statists Reports, Deaths: Preliminary data for, March 2011 Vol. 59., No.4. pp Includes all unintentional poisoning deaths. ICD 10 X40- X49 37

38 Other Peer Counties Rate per 100,000 Range Injuries: Age-Adjusted Suicide Death Rate, per 100,000 population Healthy People 2020 goal is to reduce deaths the suicide rate (Target based on 10 percent improvement) Dallas County Trend in Suicide Death Rates, Rate per 100, U.S. Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File CDC WONDER On-line Database, compiled from Compressed Mortality File Series 20 No. 2M, Accessed at on Jul 15, :32:01 PM Healthy People 2020 Objective MHMD-1 U.S. data source: National Vital Statists Reports, Deaths: Preliminary data for, March 2011 Vol. 59., No.4. pp Includes all Suicides deaths. ICD 10 X60-x84, Y87.0 Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook

39 Other Peer Counties Rate per 100,000 Range Injuries: Age-Adjusted Homicide Death Rate, per 100,000 population Healthy People 2020 goal is to reduce homicides (Target based on 10 percent improvement) Dallas County Trend in Homicide Death Rates, Rate per 100, U.S. Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File CDC WONDER On-line Database, compiled from Compressed Mortality File Series 20 No. 2M, Accessed at on Jul 15, :32:01 PM Healthy People 2020 Objective IVP 29 U.S. data source: National Vital Statists Reports, Deaths: Preliminary data for, March 2011 Vol. 59., No.4. pp Includes all homicide deaths. ICD 10 X85-Y09, Y87.1 Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook

40 Injuries: Emergency Department Visits for Injuries, Injury-Related ED Visits per 1,000 population Dallas County Trend in Emergency Department Visits for Injuries, Rate per 1,000 population Tarrant Co. Sources: DFW Hospital Council, Outpatient Data System. NYU Algorithm for determining appropriate Emergency Dept. use The Dallas Fort Worth Hospital Council has established an Emergency Department data set from more than 44 hospitals in the region. The data repository has over 3.6 million emergency department visits as of

41 Doing better than the benchmark Same as/not significantly different from the benchmark Worse than the benchmark Health Risk Behaviors High Risk Sexual Behaviors Dallas County Compared to Healthy People 2020 Goal Dallas County Compared to 8 Peer Counties (Quartiles) Dallas County Compared to Past Years Data (CI) HIV Incidence N/A Chlamydia Incidence N/A High Risk Sexual Behavior HIV/STD Rates Gonorrhea Incidence Primary/ Secondary Syphilis N/A N/A Teen Birth Rates N/A 41

42 STD/HIV: Annual HIV Cases and Rates, Number of New Cases 5,000 4,500 4,000 3,500 3,000 Dallas County Trend for Rate of New HIV Cases, 2003 to Cases per 100, , , ,500 1, , , , ,081 4, ,300 new cases of HIV in in the U.S. Bexar Co. Harris Co. Tarrant Co. Texas from Ed Weckerly Epidemiologist TB/HIV/STD Epidemiology and Surveillance, MC /20/11 The Texas HIV Surveillance Report 2010, Texas Department of State Health Services, Ed Weckerly, Epidemiologist, TB/ HIV/STD Epi and Surveillance, MC 1873, Texas Department of State Health Services Tel

43 Cases per 100, Other Peer Counties Range STD/HIV: Chlamydia Cases per 100,000 population Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook ( data) Dallas County Trend 2003 to 2010 Cases per 100, U.S. Median () Bexar Co. Harris Co. Tarrant Co. Texas Source: Sexually Transmitted Diseases Surveillance The Texas STD Surveillance Report 2010, Texas Department of State Health Services, Healthy People 2020, STD-3.1 to 4.2. No overall target is available, all targets are age- and gender-specific. Ed Weckerly, Epidemiologist, TB/ HIV/STD Epi and Surveillance, MC 1873, Texas Department of State Health Services Tel

44 Cases per 100, Other Peer Counties Range STD/HIV: Gonorrhea Rate per 100,000 population Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook ( data) Dallas County Trend 2003 to 2010 Cases per 100, to U.S. Rate () Bexar Co. Harris Co. Tarrant Co. Texas Source: Sexually Transmitted Diseases Surveillance The Texas STD Surveillance Report 2010, Texas Department of State Health Services, Healthy People 2020, STD-3.1 to 4.2. No overall target is available, all targets are age- and gender-specific Ed Weckerly, Epidemiologist, TB/ HIV/STD Epi and Surveillance, MC 1873, Texas Department of State Health Services Tel

45 Other Peer Counties Range Cases per 100, STD/HIV: Syphilis Primary and Secondary Rate per 100,000 population, Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook ( data) Dallas County Trend for Syphilis Rate, 2003 to 2010 Cases per 100, U.S. Rate () Bexar Co. Harris Co. Tarrant Co. Texas Source: Sexually Transmitted Diseases Surveillance The Texas STD Surveillance Report 2010, Texas Department of State Health Services, Healthy People 2020, STD-3.1 to 4.2. No overall target is available, all targets are age- and gender-specific Ed Weckerly, Epidemiologist, TB/ HIV/STD Epi and Surveillance, MC 1873, Texas Department of State Health Services Tel

46 Other Peer Counties Range) Cases per 1,000 women 90 Teen Births: Teen Birth Rate, 2003 to (Number of births per 1,000 women ages 15 to 19) Other Peer Counties include: ( data) Maricopa, Los Angeles, Miami-Dade, Cook Dallas County Trend for Teen Birth Rate, 2003 to Cases per 1, U.S. Rate Bexar Co. Harris Co. Tarrant Co. Texas Source: CDC Wonder 2003 American Community Survey Population Estimates 2003-, Females 15 to 19 Texas Department of State Health Services Query Tool and correspondence from Lyudmila Baskin, Ph.D. Research Specialist Peer County Data Source: National Center for Vital Statistics System, Beyond 2020 tables, data The Healthy People 2020 national health target is to reduce pregnancies among adolescent females ages from 40.2 per 1,000 in to 36.2 per 1,000 in 2020 Healthy People 2020, FP

47 Doing better than the benchmark Same as/not significantly different from the benchmark Worse than the benchmark Health Risk Behaviors Other High Risk Behaviors Dallas County Compared to Healthy People 2020 Goal Dallas County Compared to 8 Peer Counties (Quartiles) Dallas County Compared to Past Years Data (CI) Health Risks Tobacco Use Alcohol Use Diet and Exercise Current Smokers Binge Drinking Overweight and Obese Recommended Physical Activity Frequency of Five Fruits/ Vegetables per Day N/A 47

48 Diet and Exercise: Adults* with 30+ minutes of moderate physical activity five or more days per week, or vigorous physical activity for 20+ minutes three or more days per week Other Peer Counties Range Percent 60% 50% Healthy People 2020 goal is to increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity for at least 150 minutes/week or 75 minutes/week of vigorous intensity, or an equivalent combination (Target set at 10 percent improvement) 47.9% % Dallas County Trend for Physical Activity, 2003 to Percent 42.6% 44.7% 40% 30% 20% % 44.2% 0% 10% 20% 30% 40% 50% 10% 0% 51.0% 49.2% 44.3% 54.6% 42.6% 48.1% 49.1% 48.7% 43.0% 48.8% U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People % 46.7% Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook Source: CDC BRFSS, 2003,, and Healthy People 2020 Objective PA *Adults are described as 18 and over 48

49 Overweight and Obese: Adults* with a BMI Greater Than 25 and Greater Than 30, to 2010 Percent 80% 70% Other Peer Counties Range 66.1% Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook 66.1% Dallas County Trend for Overweight or Obese, Percent 60% 61.3% 66.4% % 50% 60.3% 40% 71.3% 30% 57.3% 20% 63.0% 10% 0% 63.1% 65.7% 64.3% 68.1% 59.3% 66.5% 61.6% 68.3% 52.7% % U.S. Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 Source: CDC BRFSS, 2003,, and Healthy People 2020 Objective NWS % 62.4% *Adults are defined as ages 18 and over 0% 20% 40% 60% 80% Healthy People 2020 goal is to increase the proportion of adults who are at a healthy weight. Baseline and target are for adults over the age of 20. The data source available here is for adults over the age of 18. (Target is a 10% increase. Baseline is at 30.8% of adults 20 and over at a healthy weight. The target is to increase to 33.9% of adults 20 and over at a healthy weight.) 49

50 Other Peer Counties Range Percent 30% Diet and Exercise: Adults* who have consumed fruits or vegetables 5 or more times per day, Other Peer Counties include: Maricopa, Los Angeles, Miami-Dade, Cook Dallas County Trend for Fruit and Vegetable Consumption, 2003 to Percent 25% 22.1% 26.5% 23.3% 20% 25.5% 20.1% 15% % 10% 0% 20% 40% 5% 0% 23.4% 23.4% 22.7% 25.0% 23.3% 23.8% 23.2% 21.8% 23.6% 21.8% 20.1% 22.6% U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People 2020 goal is to increase contribution of total vegetables to the diets of the population aged 2 years and older. (Target is 1.1 cup equivalents per 1,000 calories) Source: CDC BRFSS, 2003,,, and *Adults are described as 18 and over 50

51 Alcohol Use: Binge Drinkers (Males over the age of 18 who have had 5 or more drinks on one occasion; females who have had 4 or more drinks on one occasion) Other Peer Counties Range Percent 30% Healthy People 2020 goal is to reduce the proportion of adults that engaged in binge drinking during past month (Target set at 10% improvement) Dallas County Trend for Binge Drinking, to 2010 Percent 25% 24.3% 24.3% % 10.9% 20% 15.0% 17.2% 15% 14.9% 10% 11.6%-18.8% 10.6% 16.5% 5% 0% 15.1% 19.7% 14.3% 15.3% 10.9% 14.7% 15.1% 17.5% 18.2% % U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People % 15.7% 0% 5% 10% 15% 20% Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook Source: CDC BRFSS, 2010 Healthy People 2020 Objective TU *Adults are described as 18 and over 51

52 Other Peer Counties Range Percent 25% Tobacco Use: Adults* who are Current Smokers (Do you now smoke cigarettes every day, Healthy People 2020 goal is to reduce tobacco use by adults (Target set at 2010 goal) some days, or not at all) Dallas County Trend for Rate of Current Smokers, to 2010 Percent 20% % 22.4% 15% 10% 10.2% % 12.0% 12.0% 18.6% 15.8% 12.5% 16.7% 5% 20.8% 0% 17.3% 17.5% 16.0% 14.5% 15.8% 15.8% 20.9% 19.0% 17.1% 19.7% 20.8% 2010 U.S. Median Bexar Co. Harris Co. Tarrant Co. Texas Healthy People % 0% 5% 10% 15% 20% 25% Other Peer Counties include: Maricopa, Los Angeles, Miami- Dade, Cook Source: CDC BRFSS, 2010 Healthy People 2020 Objective TU *Adults are described as 18 and over 52

53 Health Outcomes Mortality Years of Potential Life Lost Infant Mortality Very Low Birth Weight Births Morbidity Mental Health Status Model for Determining Community Health Dashboard Cancer Screening Mammogram Pap Test Colon Cancer Screening Health Factors Health Risk Behaviors Access to Clinical Care Quality of Clinical Care Vaccinations Violence and Injury Prevention High Risk Sexual Behavior Tobacco Use Alcohol Use Diet and Exercise Over Weight and Obese Percent Uninsured Percent with Personal Physician Physician-to-Population Ratio Non-Emergent Emergency Department Use Prevention Quality Indicators Flu Shots for Adults 65+ Child ages months Mortality ED Visits for Injury HIV/STD Rates Teen Birth Rate 53

54 Doing better than the benchmark Same as/not significantly different from the benchmark Worse than the benchmark Health Outcomes Mortality Dallas County Compared to Healthy People 2020 Goal Dallas County Compared to 8 Peer Counties (Quartiles) Dallas County Compared to Past Years Data (CI) Heart Disease Death Rate Cancer Death Rate Health Outcomes Mortality Stroke Death Rate COPD Death Rate Diabetes Death Rate N/A 54

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