Stark County Indicators Report 2014

Stark County Indicators Report 214

Table of Contents Acknowledgements... 5 Introduction... 6 Stark County Demographics Population Estimates... 9 Population Estimates by Race... 1 Population Estimates by Hispanic Origin... 1 Population Estimates by Age... 11 Population Estimates by Gender... 11 Educational Attainment... 12 Population With A College Degree... 12 Marital Status... 13 Population Below Poverty... 13 Employment Status... 14 Employment Status 212... 14 Household Income... 15 Household Income 212... 15 Physical Health Stark County Women of Childbearing Age... 18 Live Birth Rate.. 18 Stark County Birth Rate by Maternal Age... 19 Adolescent Birth Rate... 19 Birth Weight... 2 Stark County Very Low Birth Weight by Race... 21 Low Birth Weight by Race... 21 Very Low Birth Weight by Maternal Age... 22 Low Birth Weight by Maternal Age... 22 Gestational Age... 23 Stark County Gestational Age... 23 Gestational Age by Race... 24 Gestational Age by Hispanic Origin... 24 Trimester of Entry into Prenatal Care... 25 Stark County Trimester of Entry into Prenatal Care... 25 Trimester of Entry into Prenatal Care by Race... 26 Trimester of Entry into Prenatal Care by Hispanic Origin... 26 Cesarean Sections... 27 1

Table of Contents Physical Health (continued) Infant Mortality Rate... 28 Stark County Infant Mortality Rate... 28 Infant Mortality Rate by Race... 29 Infant Deaths by Race... 29 Stark County Resident Induced Abortions... 3 Resident Induced Abortion by Race... 31 Resident Induced Abortion by Age... 31 Stark County Resident Deaths... 32 Resident Death by Race... 33 Resident Death by Hispanic Origin... 33 Resident Death by Gender... 34 Resident Death by Age Group... 34 Leading Causes of Death... 35 Stark County Leading Causes of Death... 36 Leading Causes of Death 212... 36 Gonorrhea Rate... 37 Chlamydia Rate... 37 Stark County Sexually Transmitted Infections... 38 Gonorrhea Rate by Race... 39 Gonorrhea Rate by Hispanic Origin... 39 Gonorrhea Rate by Age... 4 Gonorrhea Rate by Gender... 4 Chlamydia Rate by Race... 41 Chlamydia Rate by Hispanic Origin... 41 Chlamydia Rate by Age... 42 Chlamydia Rate by Gender... 42 Syphilis Rate... 43 Stark County Syphilis Rate by Race... 43 HIV Diagnosed Cases... 44 AIDS Diagnosed Cases... 44 Stark County HIV/AIDS Diagnosed Cases... 45 HIV Diagnosed Cases by Race 212... 45 HIV Diagnosed Cases by Gender 212... 46 HIV Diagnosed Cases by Age 212... 46 Diagnosed Diabetes... 47 Adult BMI Overweight... 48 Adult BMI Obese... 48 2

Table of Contents Physical Health (continued) Third Grade BMI... 49 Stark County Children Treated For Injury... 5 Children Treated For Injury by Age Group... 5 Behavioral Health Completed Suicide Rate... 51 Stark County Completed Suicide Rate by Race... 52 Completed Suicide Rate by Gender... 52 Unintentional Drug Death Rate... 53 Heroin Poisoning Death Rate... 54 Opioid Related Poisoning Death Rate... 54 Chronic Disease Risk Factors 28-21... 55 Stark County Chronic Disease Risk Factors... 55 Stark County Tobacco Use 211... 56 Tobacco Use by Race 211... 56 Tobacco Use by Age 211... 57 Tobacco Use by Gender 211... 57 Stark County Top Ten Diagnostic Groups 212... 58 Total Behavioral Health Clients... 59 Adult/Children Behavioral Health Clients... 59 Behavioral Health Clients by Race 212... 6 Behavioral Health Clients by Gender 212... 6 Behavioral Health Clients by Age... 61 Access To HealthCare Stark County Medicaid Recipients... 62 Medicaid Expenditures... 62 Medicaid by Race... 63 Medicaid by Hispanic Origin... 63 Medicaid by Age... 64 Medicaid by Gender... 64 Stark County Health Insurance Coverage... 65 Uninsured by Race... 66 Uninsured by Gender... 66 Uninsured by Age Group... 67 Uninsured by Employment Status... 67 Stark County Oral Health... 68 3

Table of Contents Environmental Health Asthma - Adults Current/Lifetime 28-21... 69 Asthma - Children Current/Lifetime 28-21... 69 Stark County Air Quality Index Levels... 7 Monthly Air Quality Index Levels 212....7 Air Pollutants... 71 Ozone Levels... 71 Carbon Monoxide Levels... 72 Particulate Matter 2.5 Levels... 72 Public Safety Traffic Crashes... 73 Stark County Traffic Crashes... 73 Alcohol-Related Traffic Crashes... 74 Stark County Alcohol-Related Traffic Crashes... 74 4

Acknowledgements The Stark County Indicators Report is a result of the past efforts of COMPASS (United Way), as well as, the 21 Patient Protection and Affordable Care Act that required charitable hospitals to conduct a Community Health Needs Assessment. The Indicators Report is only part of the needs assessment process, but would not be possible without the dedication of the Health Advisory Committee. The Advisory Committee is composed of 19 agencies and several community advocates. Through several discussions the Data Sub-Committee provided oversight, direction and recommendations for The Stark County Indicators Report. Special thanks is extended to the Data Sub-Committee for compiling, updating and formatting the secondary data for The Indicators Report. We would also like to thank those who took the time to review and edit The Stark County Indicators Report. Data Sub-Committee Members: Anne M. Baker, CPA Aultman Health Foundation Kay Conley, MPA, CHES Stark County Health Department Kimberly Douce, LSW United Way of Greater Stark County Christine Henning, RS, MPH Canton City Health Department Cindy Hickey Mercy Medical Center Janice Houchins, LISW-S Family Council Mark Juenemann, MBA Mercy Medical Center Julia Wagner, MPH Stark County Health Department Audra Martin, LISW, ABD Mental Health and Recovery Services Board of Stark County Kelly Potkay, BSAS, CHES Stark County Health Department Kara Witting Stark County Job & Family Services Carla Wright Stark County Community Action Agency William James, MBA Alliance Community Hospital Funded in part by the Ohio Department of Health/Federal Government Bureau of Child and Family Health Services Child and Family Health Services Program 5

Introduction Format Each segment of The Stark County Indicators Report is made up of the following sections: Narrative - qualitative context surrounding the data Related Data - additional data related to the indicator Data - indicator in question Sources, Definitions, Caveats and Notes - source citation, meaning of word term or phase and additional explanatory information Purpose The Health Advisory Committee is composed of over 2 agencies and several community advocates knowledgeable in the area of health and social services. An indicator is a set of data which reflects the current status of a segment of the community and can be used as a predictor of future conditions. The Data Sub-Committee made the initial selection of the indicators. Each of the indicators has been selected for accuracy, availability, consistency, timeliness, history and reporting. The indicators illustrate trends at the county level. Indicators have been added and subtracted through committee discussion, based on availability of data to monitor over time and the usefulness of the data to the community. How To Use This Report This report consists of narratives and selected indicators that are intended as a starting point in the exploration of the issues. Although indicators cannot be used to establish causal relationships between specific interventions and outcomes, they can be used to monitor progress toward outcomes over time. The indicators presented in this report can play a critical role in documenting whether changes are occurring in the desired direction. The brevity of the narratives is intentional. The content of the narratives is condensed and open to multiple interpretations. The narratives are intended to provide a context within which to interpret the data and to start discussions. The 214 Indicators Report includes the most current and up-to-date data available. To review older data not included in this Report please reference the 211 Indicators Report. Please note that this document is best viewed/printed in color. 6

Stark County Demographics Population The overall population in Stark County has been slightly decreasing since 2. Population growth or decline is positively correlated with the economic health of an area. Racial Stark County is racially and ethnically homogenous. Minority populations represent approximately 1 percent of the total population. While minority groups have increased in number, they still represent a very small, but increasing, portion of the population. Stark County is also racially and ethnically segregated. Minorities live in pockets within the county. The urban areas of Stark County (Canton, Massillon and Alliance) have a much higher percentage of minorities than the suburban areas of the county. Age The population in Stark County, like that of the state and the nation, is aging. The median age in Stark County is 41.6 years old which is 2.3 years older than the state median age and 4.2 years older than the national median age. This trend has been accelerating with specific trends contributing to the aging of Stark County: a decreasing birth rate and a stable consistency in the population of all ages. Dependent age groups, to19 and 65 years and older, represented 41.8 percent of the population in 212. Educational Attainment There is a developing consensus that education and training beyond a high school diploma is seen as critical to the economic growth within Stark County. A college degree is not the only postsecondary educational option available in Stark County. Approximately 22 percent of Stark County adults 25 years and older have some college experience but no degree. These post educational opportunities can include skilled training, certifications and stackable certificates resulting in a degree. On average, there is a direct correlation between educational attainment, earnings and employment. Higher educational attainment is directly related to higher individual earnings and to lower rates of unemployment. Educational attainment is higher among younger population groups than in the older population. 7

Stark County Demographics Income Stark County is a low-income and low cost-of-living county. While Stark County s economic base has been deteriorating and discretionary income has been decreasing, most Stark County families have incomes that are sufficient for basic needs. Standard measures of income (per capita, median family and median household) are below that of the state and nation. Additionally, there are income disparities. On average, males earn more than females and whites earn more than people of color. The total percent of the population living below poverty for 212 was 14.5, with female headed households more likely to live in poverty. Employment Unemployment has decreased to 6 percent of the workforce during 212. Population estimates from the Census Bureau show that Stark County s population between 2 and 54 years of age has remained consistent. 8

Number of Individuals Stark County Demographics 4, 395, 39, 385, Stark County Population Estimates 38, 375, 37, 365, 36, 355, 35, 26 27 28 29 21 211 212 Population 38,575 378,664 379,214 379,466 375,321 375,87 374,868 U.S. Census Bureau - American Community Survey (ACS) Caveat: Estimates are based on statistical regression and not on actual counts. Note: The Population Estimates Program annually produces population estimates based upon the last decennial census. Each year, the estimates are re-calculated using the most up-to-date demographic components of change and legal boundaries available. 9

Number of Individuals Number of Individuals Stark County Demographics Stark County Population Estimates by Race 37, 33, 29, 25, 21, 17, 13, 9, 5, 1, 26 27 28 29 21 211 212 Caucasian 347,119 346,1 347,165 344,423 333,361 333,838 333,169 African-American 31,986 32,26 32,29 33,2 28,29 26,53 23,989 Stark County Population by Hispanic Origin 7, 6,5 6, 5,5 5, 4,5 4, 3,5 3, 2,5 2, 26 27 28 29 21 211 212 Hispanic 4,24 4,161 4,557 4,88 6,36 6,236 6,54 U.S. Census Bureau - American Community Survey Caveat: Estimates are based on statistical regression and not on actual counts. Native Americans and Asian/Pacific Islanders are not reported due to small population size. Changes in small populations can result in a large percent change. Note: Although the ACS produces population, demographic and housing unit estimates, it is the Census Bureau s Population Estimates Program that produces and disseminates the official estimates of the population. 1

Number of Individuals Number of Individuals Stark County Demographics 12, Stark County Population Estimates by Age Group 1, 8, 6, 4, 2, 26 27 28 29 21 211 212 to 9 45,343 45,64 46,787 45,3 45,882 44,167 42,269 1 to 19 52,755 52,114 48,755 52,429 5,41 5,373 51,129 2 to 34 67,637 66,849 67,67 65,469 63,346 65,458 65,997 35 to 54 11,6 18,682 18,864 16,573 13,518 1,535 98,595 55 to 64 45,837 46,638 47,839 49,481 51,885 83,66 52,885 65 to 84 5,387 5,43 5,59 5,758 52,285 52,524 52,693 85 and Over 8,16 8,311 8,853 9,726 8,364 9,513 11,3 2, 198, 196, 194, 192, 19, 188, 186, 184, 182, 18, 178, Stark County Population Estimates by Gender 26 27 28 29 21 211 212 Male 182,851 182,449 182,266 183,457 182,67 182,857 181,565 Female 197,724 196,215 196,948 196,9 192,651 192,23 193,33 U.S. Census Bureau - American Community Survey Caveat: Estimates are based on statistical regression and not on actual counts. Note: Although the ACS produces population, demographic and housing unit estimates, it is the Census Bureau s Population Estimates Program that produces and disseminates the official estimates of the population. 11

Number of Individuals 25 Years and Over Number of Individuals 25 Over Stark County Demographics Stark County Educational Attainment 12, 1, 8, 6, 4, 2, 26 27 28 29 21 211 212 Less than 9th Grade 8,242 6,889 9,331 9,127 6,377 6,631 7,79 9th to 12th Grade, No Diploma 28,646 23,195 21,646 25,429 2,265 2,366 18,64 High School Graduate 19,67 16,48 17,67 12,65 11,691 11,955 97,647 Some College, No Degree 48,412 46,698 54,535 51,429 54,561 53,569 56,671 Associate Degree 15,739 18,646 16,245 17,931 21,524 21,268 21,784 Bachelor's Degree 32,681 37,556 34,232 35,573 34,464 37,159 36,758 Graduate or Professional Degree 15,839 19,467 16,866 17,292 18,298 15,985 17,932 Stark County Population With A College Degree 4, 35, 3, 25, 2, 15, 1, 5, 26 27 28 29 21 211 212 Associate Degree 15,739 18,646 16,245 17,931 21,524 21,268 21,784 Bachelor's Degree 32,681 37,556 34,232 35,573 34,464 37,159 36,758 Graduate or Professional Degree 15,839 19,467 16,866 17,292 18,298 15,985 17,932 U.S. Census Bureau - American Community Survey Caveat: Estimates are based on statistical regression and not on actual counts. Note: Data are limited to the household population and exclude the population living in institutions, college dormitories and other group quarters. 12

Percent of Population Number of Individuals Stark County Demographics Stark County Marital Status 18, 16, 14, 12, 1, 8, 6, 4, 2, 22 23 24 25 26 27 28 29 21 211 212 Never Married 63,317 7,878 75,63 76,636 81,736 83,423 82,247 87,22 87,544 88,721 87,311 Now Married 167,458 161,752 16,483 166,147 16,283 16,48 157,28 158,325 151,913 152,15 152,461 Separated 5,777 4,98 4,948 3,42 3,894 4,5 4,718 6,131 6,536 4,838 4,67 Widowed 17,93 21,661 22,661 19,889 23,71 22,727 27,828 2,688 23,26 21,991 2,38 Divorced 35,86 33,2 36,193 33,725 39,981 36,981 41,447 36,589 36,219 38,287 41,54 Stark County Population Below Poverty 18% 16% 14% 12% 1% 8% 6% 4% 2% % 26 27 28 29 21 211 212 Population Below Poverty 12.3% 1.7% 12.3% 14.9% 14.3% 16.3% 14.5% U.S. Census Bureau - American Community Survey Caveat: Estimates are based on statistical regression and not on actual counts. Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The values shown here equal a 9% margin of error. Note: Data are limited to the household population and exclude the population living in institutions, college dormitories and other group quarters. Although the ACS produces population, demographic and housing unit estimates, it is the Census Bureau s Population Estimates Program that produce sand disseminated the official estimates of the population. 13

Number of Individuals Stark County Demographics Stark County Employment Status 2, 18, 16, 14, 12, 1, 8, 6, 4, 2, 22 23 24 25 26 27 28 29 21 211 212 Employed 18,254 178,24 175,343 177,55 183,48 182,188 184,147 169,859 168,249 169,956 171,144 Unemployed 11,639 14,949 17,297 13,763 14,684 13,831 14,388 21,894 23,591 2,977 18,689 Retired 93,25 95,87 12,492 12,969 15,855 17,397 15,414 112,64 19,248 19,675 112,45 Stark County Employment Status 212 Retired 37% Employed 57% Unemployed 6% U.S. Census Bureau - American Community Survey Caveat: Estimates are based on statistical regression and not on actual counts. Employment and unemployment estimates may vary from the official labor force data released by the Bureau of Labor Statistics because of differences in survey design and data collection. Note: Although the ACS produces population, demographic and housing unit estimates, it is the Census Bureau s Population Estimates Program that produces and disseminates the official estimates of the population. 14

Number of Households Stark County Demographics Stark County Household Income 16, 14, 12, 1, 8, 6, 4, 2, 22 23 24 25 26 27 28 29 21 211 212 $2, or more 1,212 634 1,348 1,786 3,86 2,364 3,6 2,825 3,63 2,887 2,662 $15 to $199,999 2,736 2,987 2,151 1,726 2,64 4,237 4,157 3,186 3,32 3,771 3,464 $1 to $149,999 9,522 9,489 7,163 12,768 11,614 13,386 12,25 12,447 13,122 13,546 14,791 $75 to $99,999 13,52 11,74 14,71 14,314 16,35 17,218 17,621 18,411 15,639 16,981 16,796 $5 to $74,999 27,613 28,86 29,543 31,185 3,16 31,248 29,644 28,562 26,565 26,524 3,826 $35 to $49,999 28,64 27,48 26,787 24,867 24,21 23,142 23,96 25,61 26,981 22,4 24,59 $25 to $34,999 27,94 23,57 21,569 19,24 19,317 17,449 19,142 18,388 2,694 18,795 18,478 $15 to $24,999 19,796 21,744 24,43 2,139 21,358 2,287 2,166 19,43 2,424 2,752 18,168 $1 to $14,999 8,258 11,91 12,269 1,413 11,178 9,872 9,184 8,286 9,9 9,697 8,495 Less than $1, 8,81 1,47 9,77 11,259 11,71 11,479 11,223 13,654 1,323 13,647 12,2 Stark County Household Income 212 $15 to $199,999 2% $1 to $149,999 1% $75 to $99,999 11% $2, or more 2% Less than $1, 8% $1 to $14,999 6% $15 to $24,999 12% $5 to $74,999 21% $35 to $49,999 16% $25 to $34,999 12% U.S. Census Bureau - American Community Survey Caveat: Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The values shown here equal a 9 percent margin of error. Note: Although the ACS produces population, demographic and housing unit estimates, it is the Census Bureau s Population Estimates Program that produces and disseminates the official estimates of the population. 15

Stark County Narrative Physical Health Physical health concerns the body and its proper functioning and condition. Environment, nutrition, accidents, illness and age are factors affecting physical health. There are several significant negative trends emerging locally regarding an increase in the percentage of very low birth weight infants, a higher infant mortality rate in the African-American population and an increase in sexually transmitted infections (STIs). Stark County s population aged 6 and older has been increasing and mortality rates confirm that our residents are living longer. The issues of heart disease, blood pressure, diabetes, kidney disease and injuries related to falls in our aging population will continue to have an impact on health delivery systems and capacity. Health disparities are differences that can be seen in specific populations of a community in relation to diseases, health outcomes or quality of health care received. Several variables impacting disparities are health behaviors, status before care, access to healthcare and health care delivery. In Stark County there are significant disparities between the Caucasian and African-American populations including prenatal care, infant mortality rates, leading causes of death, STIs and insurance coverage. Behavioral Health Behavioral health includes mental health, substance abuse treatment and prevention services. Using national prevalence rates for mental health services, it is estimated that less than one-third of Stark County residents affected with mental illness receive treatment each year. Barriers to accessing treatment include stigma, lack of or inadequate insurance coverage and limited program capacity. The highest rates of mental illness are among adults aged twenty-five to thirty-four years old. Depression, bipolar disorders, anxiety disorders, alcohol abuse and schizophrenia are the most frequent diagnoses among adults. The leading diagnoses for children are adjustment, conduct, attention deficit, anxiety and bipolar disorders. There is concern that antidepressants are frequently being used without the associated mental health treatment. Illicit use of prescription drugs, heroin and opioids is an emerging concern due to the high incidents of drug overdose among teens and young adults. While unintended interactions are a cause of death, most poisonings seem to be linked to recreational use. Access to HealthCare Driven by a decline in the economy, demand for free/sliding fee healthcare services has been increasing. However, safety net providers in Stark County are at or beyond capacity. The use of the emergency room for non-emergency healthcare continues to be a concern for the hospitals in Stark County. 16

Stark County Narrative Access to HealthCare (continued) More than forty thousand or about one out of every nine Stark County residents are without health insurance and there is an increasing number of individuals who are underinsured. It is often difficult for adults to qualify for Medicaid due to income requirements. Of concern are individuals between the age of thirty and sixty-four with chronic medical problems who have difficulty maintaining employment but are not medically disabled. Even if an individual is Medicaid eligible, few healthcare providers, especially specialists, are willing to accept new Medicaid patients. Medicaid data and the number of uninsured will change due to the enactment of the Affordable Care Act (ACA) and will be referenced in future reports. Having insurance does not guarantee easy access to affordable, quality care. Even among those with medical insurance, one out of every three Stark County residents lack dental, vision and mental health services coverage. Businesses that offer health insurance have increased the employee premium contribution and/or increased the deductible paid by the employee, often making medical coverage more difficult to afford. Environmental Health On average 98 percent of days in Stark County have been between good to moderate range for the air quality index (AQI). Air quality is measured by ozone, carbon monoxide and particulate matter. As air quality degrades, the air becomes unhealthy for adults and children with respiratory ailments such as asthma or heart disease. Two pollutants of concern are ozone and particulate matter. In the Earth's lower atmosphere, near ground level, ozone is formed when pollutants emitted by cars, power plants, industrial boilers, refineries, chemical plants, and other sources react chemically in the presence of sunlight. Particulate matter less than 2.5 micrometers in diameter are called "fine" particles. These fine particles can lodge deep within the respiratory system causing potential problems for sensitive groups. Sources of fine particles include all types of combustion, including motor vehicles, power plants, residential wood burning, forest fires, agricultural burning, and some industrial processes. 17

Pate Per 1, Women 15 to 44 Years of Age Number of Women 15 to 44 Years Old Physical Health Women of Childbearing Age 76, 74, 72, 7, 68, 66, 64, 62, 26 27 28 29 21 211 212 213 Stark 73,751 72,6 71,689 7,367 67,43 67,665 68,429 68,429 Ohio 2,331,21 2,33,947 2,289,61 2,275,513 2,231,844 2,219,687 2,213,97 2,213,97 2,34, 2,32, 2,3, 2,28, 2,26, 2,24, 2,22, 2,2, 2,18, 2,16, 2,14, Live Birth Rate 66 65 64 63 62 61 6 59 58 57 26 27 28 29 21 211 212 213 Stark 61.2 62.8 61.6 6.8 6.8 6. 59.8 61.6 Ohio 64.6 65.4 64.9 63.5 62.3 62.2 62.4 61.6 Ohio Department of Health Data Warehouse Secure Site Definition: Birth Rate: Number of births per 1, women of childbearing age (15 to 44 years of age) Caveat: Due to incomplete 213 data, 212 information is used 18

Rate Per 1, Women 15 to 19 Years Old Rate Per 1, Women 15 to 44 Years Old Physical Health Stark County Live Birth Rate by Maternal Age 14 12 1 8 6 4 2 26 27 28 29 21 211 212 213 15-19 34.5 34.9 39.6 38.1 3.9 3.2 28.6 3.3 2-24 13.7 11.3 14.6 96.1 97.8 9.4 94.3 91.6 25-29 112. 115. 18.3 118.5 119.2 117.3 126.1 129.3 3-34 87.1 88.3 87. 83.9 87.6 87.6 78.9 86. 35-39 38. 38. 31.9 34.4 29.1 37.4 35.2 37.1 4-44 6.3 5.4 6.9 4.9 5.8 6.3 4.7 5.5 Adolescent Birth Rate 8 7 6 5 4 3 2 1 26 27 28 29 21 211 212 213 Stark 15-17 14.1 17.6 18.9 14.3 14.5 14.6 14.3 11.9 Ohio 15-17 19.8 19.9 19.6 18.7 15.7 14.1 12.8 11.1 Stark 18-19 71.2 61.6 74. 59.4 59.6 52. 49.2 56.8 Ohio 18-19 68.8 72.9 7.9 68. 59.4 55.2 52.5 46.9 Ohio Department of Health Data Warehouse Secure Site Definition: Birth Rate: Number of births per 1, women of childbearing age (15 to 44 years of age) Caveat: Due to incomplete 213 data, 212 information is used 19

Percent of Births Physical Health Birth Weight 9.% 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% 26 27 28 29 21 211 212 213 Stark Very Low Birth Weight 1.5% 2.% 2.2% 1.2% 1.7% 1.4% 1.7% 1.7% Ohio Very Low Birth Weight 1.6% 1.7% 1.6% 1.6% 1.7% 1.7% 1.7% 1.6% Stark Low Birth Weight 7.9% 8.% 7.1% 7.2% 6.7% 6.4% 7.2% 7.% Ohio Low Birth Weight 7.2% 7.% 7.% 6.9% 6.8% 6.9% 6.8% 6.9% Ohio Department of Health Data Warehouse Secure Site Definition: Birth Weight - The percent of births with known weight. Very Low Birth Weight (VLBW) - Births of weight less than 1,5 grams (approximately 3 pounds, 3 ounces). Low Birth Weight (LBW) - Births of weight less than 2,5 grams approximately 5 pounds, 8 ounces). 2

Percent of Births Percent of Births Physical Health 5.% 4.5% 4.% Stark County Very Low Birth Weight by Race 3.5% 3.% 2.5% 2.% 1.5% 1.%.5%.% 26 27 28 29 21 211 212 213 Caucasian 1.2% 1.7% 2.% 1.% 1.5% 1.1% 1.4% 1.5% African-American 3.3% 4.3% 3.4% 3.2% 2.6% 3.5% 3.1% 2.6% 16.% 14.% Stark County Low Birth Weight by Race 12.% 1.% 8.% 6.% 4.% 2.%.% 26 27 28 29 21 211 212 213 Caucasian 6.8% 7.2% 6.3% 6.8% 6.4% 6.% 6.5% 6.4% African-American 14.1% 14.2% 12.5% 1.7% 8.8% 9.8% 11.6% 11.6% Ohio Department of Health Data Warehouse Secure Site Definition: Birth Weight - The percent of births with known weight. Very Low Birth Weight (VLBW) - Births of weight less than 1,5 grams (approximately 3 pounds, 3 ounces). Low Birth Weight (LBW) - Births of weight less than 2,5 grams approximately 5 pounds, 8 ounces). Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. 21

Percent of Births Percent of Births Physical Health 7.% 6.% 5.% Stark County Very Low Birth Weight by Maternal Age 4.% 3.% 2.% 1.%.% 26 27 28 29 21 211 212 213 15 to 19 21.2% 14.2% 16.7% 15.1% 17.4% 12.1% 13.2% 1.% 2 to 29 45.5% 6.9% 6.4% 54.8% 46.3% 51.7% 6.3% 54.3% 3 to 44 33.3% 25.% 22.5% 3.2% 36.1% 36.2% 26.5% 35.7% 7.% 6.% 5.% Stark County Low Birth Weight by Maternal Age 4.% 3.% 2.% 1.%.% 26 27 28 29 21 211 212 213 15 to 19 13.7% 11.8% 12.5% 14.8% 7.7% 1.4% 7.8% 11.4% 2 to 29 57.5% 6.8% 59.1% 51.6% 58.6% 56.5% 59.9% 57.4% 33 to 44 28.4% 26.8% 28.1% 33.5% 33.3% 33.1% 32.3% 31.2% Ohio Department of Health Data Warehouse Secure Site Definition: Birth Weight - The percent of births with known weight. Very Low Birth Weight (VLBW) - Births of weight less than 1,5 grams (approximately 3 pounds, 3 ounces). Low Birth Weight (LBW) - Births of weight less than 2,5 grams approximately 5 pounds, 8 ounces). 22

Percent of Births Percent of Births Physical Health 1.% 9.% 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% Gestational Age 26 27 28 29 21 211 212 213 Stark Very Pre-Term 1.9% 2.2% 2.4% 1.2% 2.% 1.5% 1.7% 1.7% Ohio Very Pre-Term 1.8% 1.9% 1.8% 1.9% 2.4% 1.9% 2.5% 1.8% Stark Pre-Term 9.4% 8.9% 8.9% 8.2% 8.4% 7.7% 8.1% 7.4% Ohio Pre-Term 9.3% 9.% 8.9% 8.5% 7.9% 8.3% 7.9% 8.4% Stark Term 88.6% 88.8% 88.9% 9.4% 89.5% 9.7% 88.5% 84.3% Ohio Term 88.5% 88.7% 89.% 89.3% 89.3% 89.2% 89.3% 89.3% 1.% 9.% 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% Stark County Gestational Age 26 27 28 29 21 211 212 213 Very Pre-Term 1.9% 2.2% 2.4% 1.2% 2.% 1.5% 1.7% 1.7% Pre-Term 9.4% 8.9% 8.9% 8.2% 8.4% 7.7% 8.1% 7.4% Term 88.6% 88.8% 88.9% 9.4% 89.5% 9.7% 88.5% 84.3% Ohio Department of Health Data Warehouse Secure Site Definition: Gestational Age - is a clinical estimation. Very Pre-Term - <32 Weeks Pre-Term - 32 to 36 Weeks Term - 37 to 42 Weeks Post-Term - >42 Weeks Note: Due to small numbers post-term and unknown are not included. 23

Percent of Births Physical Health Percent of Births Born Prematurily Stark County Gestational Age by Race 14.% 12.% 1.% 8.% 6.% 4.% 2.%.% 26 27 28 29 21 211 212 213 Caucasian Very Pre -Term 1.7% 1.9% 2.2% 1.% 1.8% 1.1% 1.5% 1.5% African-American Very Pre-Term 3.9% 4.3% 4.2% 3.% 3.2% 4.% 2.6% 2.4% Caucasian Pre-Term 9.2% 8.3% 8.4% 8.2% 8.2% 7.4% 8.1% 6.9% African-American Pre-Term 1.3% 12.6% 1.9% 8.1% 8.6% 9.6% 9.6% 1.5% Stark County Gestational Age by Hispanic Origin 1.% 9.% 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% 26 27 28 29 21 211 212 213 Pre-Term 12.5% 9.4% 4.9% 2.8% 14.3% 6.% 5.% 6.9% Term 85.% 9.6% 89.% 94.3% 85.7% 94.% 91.3% 84.2% Ohio Department of Health Data Warehouse Secure Site Definition: Very Pre-Term - <32 Weeks Pre-Term - 32 to 36 Weeks Term - 37 to 42 Weeks Post-Term - >42 Weeks Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. 24

Percent of Females Percent of Females Physical Health 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% Trimester of Entry into Prenatal Care 26 27 28 29 21 211 212 Stark First Trimester 76.1% 74.1% 72.8% 71.8% 75.4% 73.% 71.2% Ohio First Trimester 74.5% 72.8% 71.8% 71.8% 74.4% 74.4% 73.8% Stark Second Trimester 21.3% 22.7% 24.6% 25.3% 21.9% 23.5% 25.1% Ohio Second Trimester 21.5% 22.8% 23.6% 23.7% 21.5% 21.3% 21.6% Stark Third Trimester 2.7% 3.2% 2.6% 2.9% 2.7% 3.5% 3.7% Ohio Third Trimester 3.9% 4.4% 4.6% 4.5% 4.1% 4.3% 4.6% 8.% 7.% 6.% Stark County Trimester of Entry into Prenatal Care 5.% 4.% 3.% 2.% 1.%.% 26 27 28 29 21 211 212 First Trimester 76.1% 74.1% 72.8% 71.8% 75.4% 73.% 71.2% Second Trimester 21.3% 22.7% 24.6% 25.3% 21.9% 23.5% 25.1% Third Trimester 2.7% 3.2% 2.6% 2.9% 2.7% 3.5% 3.7% Ohio Department of Health Data Warehouse Secure Site Definition: First Trimester - Time period extending from the first day of the last menstrual period through 12 weeks of gestation. Second Trimester - Time period extending from the 13th to the 27th week of gestation. Third Trimester - Time period extending from the 28th week of gestation until delivery. Note: 212 data is preliminary data that may change. 25

Number of Females Percent of Females Physical Health Stark County Trimester of Entry into Prenatal Care by Race 9.% 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% 26 27 28 29 21 211 212 Caucasian 1st Trimester 77.7% 76.1% 74.8% 73.6% 76.8% 74.5% 72.6% African-American 1st Trimester 63.4% 58.6% 58.3% 59.3% 67.1% 66.3% 61.9% Caucasian 2nd Trimester 19.8% 21.1% 23.% 23.8% 21.% 22.7% 24.3% African-American 2nd Trimester 32.4% 34.6% 36.1% 35.3% 27.6% 27.4% 3.8% Caucasian 3rd Trimester 2.5% 2.8% 2.2% 2.6% 2.2% 2.8% 3.2% African-American 3rd Trimester 4.1% 6.8% 5.6% 5.4% 5.3% 6.4% 7.3% Stark County Trimester of Entry into Prenatal Care by Hispanic Origin 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% 26 27 28 29 21 211 212 First Trimester 5.9% 46.6% 5.7% 49.2% 64.5% 44.8% 56.8% Second Trimester 42.1% 42.2% 42.5% 37.7% 32.3% 41.4% 35.1% Third Trimester 7.% 11.1% 6.8% 13.1% 3.2% 13.8% 8.1% Ohio Department of Health Data Warehouse Secure Site Definition: First Trimester - Time period extending from the first day of the last menstrual period through 12 weeks of gestation. Second Trimester - Time period extending from the 13th to the 27th week of gestation. Third Trimester - Time period extending from the 28th week of gestation until delivery. Caveat Native Americans and Asian/Pacific Islanders are not reported due to small population size. 26

Percent of Cesarean Sections Physical Health Cesarean Section 35% 3% 25% 2% 15% 1% 5% % 28 29 21 211 212 Stark 24.9% 22.9% 26.3% 3.9% 25.9% Ohio 27.1% 27.4% 26.9% 26.8% 26.3% ODH Hospital Performance Measure Reporting Note: Number of cesarean section births only include moms having their first baby with no complications (baby was not breech, delivery was at full-term and mom was not having twins or multiples). 27

Rate Per 1, Live Births Rate Per 1, Live Births Physical Health Infant Mortality Rate 12 1 8 6 4 2 26 27 28 29 21 211 212 Stark 6.4 7.7 8.6 7.5 9.1 8.1 9.8 Ohio 7.8 7.7 7.7 7.7 7.7 7.9 7.6 12 Stark County Infant Mortality Rate 1 8 6 4 2 26 27 28 29 21 211 212 Stark 6.4 7.7 8.6 7.5 9.1 8.1 9.8 Ohio Department of Health for all CityMatCH Partners Definition: Infant Mortality - Number of infant deaths per 1, live births 28

Number of Deaths Rate per 1, Live Births Physical Health Stark County Infant Mortality Rate by Race 3 25 2 15 1 5 26 27 28 29 21 211 212 Caucasian 5.3 6. 7.3 4.9 6.6 7.1 8.5 African-American 14.7 2.6 18.9 28.2 28. 16.3 19.7 35 3 25 Stark County Infant Deaths by Race 2 15 1 5 27 28 29 21 211 212 Caucasian 24 28 18 23 25 3 African-American 11 1 14 13 7 9 Ohio Department of Health for all CityMatCH Partners Definition: Infant Mortality - Number of infant deaths per 1, live births 29

Number of Induced Abortions Physical Health Stark County Resident Induced Abortions 1 9 8 7 6 5 4 3 2 1 24 25 26 27 28 29 21 211 212 Stark 795 859 831 84 752 771 745 634 636 Ohio Department of Health - Induced Abortions in Ohio Table 3: Resident Induced Abortions by County of Residence, 24-212 Definition: Induced Abortions - Pregnancy terminated by a physician. 3

Number of Induced Abortions Number of Induced Abortions Physical Health Stark County Resident Induced Abortions by Race 7 6 5 4 3 2 1 24 25 26 27 28 29 21 211 212 Caucasian 635 654 648 641 55 587 535 453 431 African-American 143 169 156 154 115 132 169 143 15 Stark County Resident Induced Abortions by Age 6 5 4 3 2 1 24 25 26 27 28 29 21 211 212 1 to 19 148 154 16 167 134 129 147 12 1 2 to 29 441 47 478 467 446 416 43 359 349 3 to 39 167 197 164 179 136 189 151 125 154 4 to 49 28 31 24 19 26 33 31 23 24 Ohio Department of Health - Induced Abortions in Ohio Table 5a: Resident Induced Abortions 24-212 Definition: Induced Abortions - Pregnancy terminated by a physician. Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. No data was available for age 5 and over. 31

Number of Individuals Physical Health 4,1 Stark County Resident Deaths 4,5 4, 3,95 3,9 3,85 3,8 3,75 3,7 3,65 27 28 29 21 211 212 Stark 3,922 4,2 3,88 3,927 4,48 4,3 Ohio Department of Health - Vital Statistics Note: 212 data is preliminary. Preliminary means the data is strong enough to show a certain result, but has not been thoroughly analyzed. 32

Number of Individuals Number of Individuals Physical Health Stark County Resident Death by Race 4, 3,5 3, 2,5 2, 1,5 1, 5 27 28 29 21 211 212 Caucasian 3,653 3,74 3,549 3,664 3,751 3,76 African-American 261 25 249 253 277 262 25 Stark County Resident Death by Hispanic Origin 2 15 1 5 27 28 29 21 211 212 Hispanic 13 2 18 17 11 9 Ohio Department of Health - Vital Statistics Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. Note: 212 data is preliminary. Preliminary means the data is strong enough to show a certain result, but has not been thoroughly analyzed. 33

Number of Individuals Number of Individuals Physical Health Stark County Resident Death by Gender 2,2 2,15 2,1 2,5 2, 1,95 1,9 1,85 1,8 1,75 1,7 1,65 27 28 29 21 211 212 Male 1,84 1,872 1,842 1,928 1,927 1,888 Female 2,82 2,13 1,966 1,999 2,11 2,142 Stark County Resident Deaths by Age Group 3 25 2 15 1 5 27 28 29 21 211 212 213 <1 Year to 14 53 51 46 46 4 56 36 15 to 34 52 57 75 82 72 66 75 35 to 54 32 355 31 291 339 318 297 55 to 74 1,2 1,35 1,8 1,8 1,112 1,119 1,156 75 to 85+ 2,495 2,54 2,369 2,428 2,485 2,471 2,438 Ohio Department of Health - Vital Statistics Note: 212 data is preliminary. Preliminary means the data is strong enough to show a certain result, but has not been thoroughly analyzed. 34

Rate per 1, Individuals Physical Health Leading Causes of Death 25 2 15 1 5 Stark 28 Ohio 28 Stark 29 Ohio 29 Stark 21 Ohio 21 Stark 211 Ohio 211 Stark 212 Ohio 212 Heart Disease 186 27 169 193 171 192 183 192 177 187 Cancer 178 194 189 19 18 187 176 187 169 184 Stroke 47 45 37 42 4 42 35 42 41 41 CLRD 53 53 44 5 5 5 46 53 51 52 Unintentional Injury 39 42 35 39 45 42 42 43 36 42 Alzheimer's Disease 36 35 31 28 26 3 3 29 33 28 Ohio Department of Health, Office of Vital Statistics Definition: Age-Adjusted Death Rate - Rate per 1, population age standardized to average out differences due to changes in the overall age of the population. CLRD - Chronic Lower Respiratory Diseases - Diseases of the lungs 35

Rate Per 1, Individuals Physical Health 2 18 16 14 12 1 8 6 4 2 Stark County Leading Causes of Death Heart Disease Cancer CLRD Stroke Unintentional Injury Alzheimer's Disease 28 186 178 53 47 39 36 29 169 189 44 37 35 31 21 171 18 5 4 45 26 211 183 176 46 35 42 3 212 177 169 51 41 36 33 Stark County Leading Causes of Death 212 Alzheimer's Disease 7% Unintentional Injury 7% CLRD 1% Heart Disease 35% Stroke 8% Cancer 33% Ohio Department of Health, Office of Vital Statistics Definition: Age-Adjusted Death Rate - Rate per 1, population age standardized to average out differences due to changes in the overall age of the population. CLRD - Chronic Lower Respiratory Diseases - Diseases of the lungs 36

Rate Per 1, Individuals Rate Per 1, Individuals Physical Health Gonorrhea Rate 2 18 16 14 12 1 8 6 4 2 24 25 26 27 28 29 21 211 212 Stark 155.8 139.9 167.2 172.3 132.1 116.5 16 164.5 169.3 Ohio 177.7 178.9 175.2 174.5 143.7 139.3 143.2 145.1 143.5 Chlamydia Rate 5 45 4 35 3 25 2 15 1 5 24 25 26 27 28 29 21 211 212 Stark 257.8 34.5 322.5 328.2 317.5 323.6 342.4 381.8 44.2 Ohio 342 374 362.9 398.6 46.8 42.2 443.7 456.6 462 Ohio Department of Health - STD Surveillance Notes: Rates are shown per 1, persons and were calculated using census estimates for that year. Provisional data. Numbers subject to change when additional information is gained. 37

Rate Per 1, Individuals Physical Health Stark County Sexually Transmitted Infections 45 4 35 3 25 2 15 1 5 23 24 25 26 27 28 29 21 211 212 Gonorrhea 186.2 155.8 139.9 167.2 172.3 132.1 116.5 16 164.5 169.3 Chlamydia 266.3 257.8 34.5 322.5 328.2 317.5 323.6 342.4 381.8 44.2 Ohio Department of Health - STD Surveillance Notes: Rates are shown per 1, persons and were calculated using census estimates for that year. Syphilis diagnoses are not a good indicator of sexually transmitted diseases due to the small numbers of diagnoses. Small numbers are unstable and should be interpreted with caution. Provisional data. Numbers subject to change when additional information is gained. 38

Rate per 1, Individuals Rate per 1, Individuals Physical Health Stark County Gonorrhea Rate by Race 12 1 8 6 4 2 24 25 26 27 28 29 21 211 212 Caucasian 63.5 57.5 69.8 78.3 55.9 41 48.1 73.6 75.9 African-American 963. 849.7 1,38.6 1,52.1 861.1 783.8 539.3 844.5 921.5 2 175 Stark County Gonorrhea Rate by Hispanic Origin 15 125 1 75 5 25 24 25 26 27 28 29 21 211 212 Hispanic 79.1 13. 172.8 96.1 72.1 143.4 67.1 1.6 67.1 Ohio Department of Health - STD Surveillance Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. Notes: In this presentation, date of diagnosis is defined as the date the specimen was collected by the provider. Rates are shown per 1, persons and were calculated using census estimates for that year. Provisional data. Numbers subject to change when additional information is gained. Small numbers are unstable and should be interpreted with caution. 39

Rate per 1, Individuals Rate per 1, Individuals Physical Health Stark County Gonorrhea Rate by Age 1 9 8 7 6 5 4 3 2 1 24 25 26 27 28 29 21 211 212 15 to 19 63.1 564.2 585.4 731.4 58.5 217.1 183.7 231.2 247.6 2 to 24 643. 79.7 719.69 828.6 644.5 464.4 484.7 91.2 874.7 25 to 29 525.2 418.4 52.8 422.6 434.9 379.9 319.8 513.5 486.5 3 to 34 242.4 187.3 264.4 264.9 147.1 17.2 166.8 276.4 347.9 35 to 39 131.4 18.6 184. 27.1 15.7 127.6 117.3 132 25.3 Stark County Gonorrhea Rate by Gender 25 2 15 1 5 24 25 26 27 28 29 21 211 212 Male 13.4 111.9 15.3 148.5 1.3 87.4 7.4 123.3 14.3 Female 178.3 158.3 181.9 194.7 161.6 143.6 139.3 23.3 196.5 Ohio Department of Health - STD Surveillance Notes: In this presentation, date of diagnosis is defined as the date the specimen was collected by the provider. Rates are shown per 1, persons and were calculated using census estimates for that year. Provisional data. Numbers subject to change when additional information is gained. Small numbers are unstable and should be interpreted with caution. 4

Rate per 1, Individuals Rate per 1, Individuals Physical Health Stark County Chlamydia Rate by Race 18. 16. 14. 12. 1. 8. 6. 4. 2.. 24 25 26 27 28 29 21 211 212 Caucasian 144. 191.4 169.5 168.5 149. 149.2 161.3 181.4 225.4 African-American 1,11.5 1,555. 1,469.7 1,54.9 1,589.4 1,359.7 1,288.3 1,442.4 1,399.2 Stark County Chlamydia Rate by Hispanic Origin 5 45 4 35 3 25 2 15 1 5 24 25 26 27 28 29 21 211 212 Hispanic 263.6 463.7 444.2 456.6 48.6 225.4 268.2 352.1 42.3 Ohio Department of Health - STD Surveillance Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. Notes: In this presentation, date of diagnosis is defined as the date the specimen was collected by the provider. Rates are shown per 1, persons and were calculated using census estimates for that year. Provisional data. Numbers subject to change when additional information is gained. Small numbers are unstable and should be interpreted with caution. 41

Rate per 1, Individuals Rate per 1, Individuals Physical Health Stark County Chlamydia Rate by Age 2,5. 2,. 1,5. 1,. 5.. 24 25 26 27 28 29 21 211 212 15 to 19 1,523.3 1,98.4 1,697.6 1,87.2 1,787.9 772.9 831.4 844.6 865.9 2 to 24 1,422.9 1,953.7 2,22.1 1,876.5 1,872.1 1,718.1 1,836.6 2,135.7 2,37.5 25 to 29 582.5 8.1 79. 832.9 722.1 729.2 81.8 837.8 1, 3 to 34 229.2 26.3 37.1 358.1 299.2 282.2 35 433.7 381.2 35 to 39 73.9 112.8 75.3 122.6 19.9 127.6 112.5 176 141.8 7 6 Stark County Chlamydia Rate by Gender 5 4 3 2 1 24 25 26 27 28 29 21 211 212 Male 87.1 123.4 118.5 129.3 131. 124 135.9 167.8 26.9 Female 416.1 54.1 59.1 513.8 491.4 58.8 536 582.4 589.6 Ohio Department of Health - STD Surveillance Notes: In this presentation, date of diagnosis is defined as the date the specimen was collected by the provider. Rates are shown per 1, persons and were calculated using census estimates for that year. Small numbers are unstable and should be interpreted with caution. Provisional data. Numbers subject to change when additional information is gained. 42

Rate per 1, Individuals Rate Per 1, Individuals Physical Health Syphilis Rates 4 3.5 3 2.5 2 1.5 1.5 29 21 211 212 Stark 2.4 2.7 3.5 2.9 Ohio.8.8 1.3.5 12 Stark County Syphilis Rate by Race 1 8 6 4 2 29 21 211 212 Caucasian.6.6.3 African-American 9.6 3.1 9.2 3.1 Ohio Department of Health - STD Surveillance Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. Notes: Syphilis rate includes primary and secondary cases. Rates are shown per 1, persons and were calculated using census estimates for that year. Provisional data. Numbers subject to change when additional information is gained. Syphilis diagnoses are not a good indicator of sexually transmitted diseases due to the small numbers of diagnoses. Small numbers are unstable and should be interpreted with caution. 43

Rate Per 1, Individuals Rate Per 1, Individuals Physical Health HIV Diagnosed Cases 1 9 8 7 6 5 4 3 2 1 24 25 26 27 28 29 21 211 212 Stark 4.7 4.2 5.5 3.5 6.1 6.9 7.5 7.7 4 Ohio 8.6 8.6 9.4 8.8 9.3 9.2 8.4 9.1 9.5 AIDS Diagnosed Cases 6 5 4 3 2 1 24 25 26 27 28 29 21 211 212 Stark 2.6 2.9 2.1 2.1 3.2 3.1 2.9 3.7.5 Ohio 5.3 5. 5.2 4.6 5. 5.4 4.7 4.7 4.2 Ohio Department of Health - HIV/AIDS Surveillance Program Notes: Diagnoses of HIV infection include persons with a diagnosis of HIV infection (not AIDS), a diagnosis of HIV infection and a later AIDS diagnosis and concurrent diagnoses of HIV infection and AIDS. Diagnoses of HIV infection by year (24-212) represent all reported cases diagnosed in each year. AIDS diagnoses by year (24-212) represent all reported AIDS cases diagnosed in each year. County reflects county of residence at time of earliest diagnosis. Rate per 1, population. The rate is based on the U.S. Census Bureau s population estimates. 44

Number of Reported Diagnosed Cases Physical Health Stark County HIV/AIDS Diagnosed Cases 35 3 25 2 15 1 5 24 25 26 27 28 29 21 211 212 HIV 18 16 21 8 23 26 28 29 16 AIDS 1 11 8 8 12 13 11 14 2 Stark County HIV Diagnosed Cases by Race 212 African-American 21% Caucasian 79% Ohio Department of Health - HIV/AIDS Surveillance Program Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. Notes: Diagnoses of HIV infection include persons with a diagnosis of HIV infection (not AIDS), a diagnosis of HIV infection and a later AIDS diagnosis and concurrent diagnoses of HIV infection and AIDS. Diagnoses of HIV/AIDS by year (24-212) represent all reported cases diagnosed in each year. County reflects county of residence at time of earliest diagnosis or AIDS diagnosis. 45

Physical Health Stark County HIV Diagnosed Cases by Gender 212 Female 14% Male 86% Stark County HIV Diagnosed Cases by Age 212 5-54 14% 55-64 % 15-19 7% 2-24 % 45-49 14% 25-29 21% 4-44 3% 35-39 % 3-34 14% Ohio Department of Health - HIV/AIDS Surveillance Program Notes: Diagnoses of HIV infection include persons with a diagnosis of HIV infection (not AIDS), a diagnosis of HIV infection and a later AIDS diagnosis and concurrent diagnoses of HIV infection and AIDS. Diagnoses of HIV infection by year (24-212) represent all reported cases diagnosed in each year. County reflects county of residence at time of earliest diagnosis or AIDS diagnosis. 46

Percent of Adults Physical Health Diagnosed Diabetes 12% 1% 8% 6% 4% 2% % 24 25 26 27 28 29 Stark 8.% 7.7% 8.9% 9.6% 1.1% 9.8% Ohio 7.8% 7.1% 7.5% 8.2% 9.2% 9.4% Centers for Disease Control and Prevention - Behavioral Risk Factor Surveillance System National Diabetes Surveillance System Definition: Age-Adjusted Percentage - Artificial estimate that minimizes the effects of different age distributions and allows comparisons between different populations. Notes: Data computed by personnel of the CDC s Division of Diabetes Translation 47

Percent of Adults Percent of Adults Physical Health Adult BMI - Overweight 4% 35% 3% 25% 2% 15% 1% 5% % 27 28 29 21 211 Stark 35.8% 36.8% 36.8% 35.7% 34.3% Ohio 35.4% 34.1% 37.% 36.% 36.2% Adult BMI - Obese 4% 35% 3% 25% 2% 15% 1% 5% % 27 28 29 21 211 Stark 28.5% 34.1% 32.7% 29.6% 3.7% Ohio 28.1% 29.3% 29.8% 29.7% 29.7% Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology and Laboratory Services, Behavioral Risk Factor Surveillance System Definition: BMI - Body Mass Index - a weight classification. BMI is a measure that compares weight and height. Neither Overweight/Obese - BMI 24.9 and under. Overweight - BMI between 25.-29.9. Obese - BMI over 3.. Notes: Percentages are weighted to population characteristics. 48

Percent of Third Graders Physical Health Third Grade BMI 4% 35% 3% 25% 2% 15% 1% 5% % 24-25 29-21 Stark - Overweight/Obese 33.5% 34.1% Ohio - Overweight/Obese 35.6% 34.6% Ohio Department of Health Division of Family and Community Health Services - School and Adolescent Health Section. A Report on Body Mass Index of Ohio's Third Graders - 24-25. Definitions: Overweight - BMI-for-age 85th percentile to <95th percentile. Obese- BMI-for-age 95th percentile and greater. BMI - Body Mass Index used to screen for obesity. BMI is a measure that compares weight to height. Notes: BMI is interpreted differently for adults. 49

Number of Children Number of Children Physical Health 16, 14, 12, Stark County Children Treated For Injury 1, 8, 6, 4, 2, 23 24 25 26 27 28 29 21 211 212 Children Treated For Injury 7,627 8,913 8,144 7,781 7,791 7,467 9,262 11,712 14,326 11,413 6 5 Stark County Children Treated for Injury by Age Group 4 3 2 1 23 2,4 25 26 27 28 29 21 211 212 Under Age 1 173 279 187 32 17 33 287 336 253 257 1 to 5 281 3248 2959 2877 277 2636 263 3141 36 338 6 to 12 3376 3921 3679 333 3426 3265 341 4113 5373 4187 13 to 17 1277 1465 1319 1272 1425 1263 3296 4122 51 3931 Stark County Health Department, Stark County Child Injury Report: 23-212 Note: 22-29 Reports did not include Immediate Care Facilitates, only Hospitals. 29 Stark County Child Injury Report - First year to include adolescents age 15-17. 5

Rate Per 1, Individuals Behavioral Health Completed Suicide Rate 18 16 14 12 1 8 6 4 2 26 27 28 29 21 211 Stark 11.9 8.7 12.7 11.1 15.7 11.9 Ohio 11.1 1.8 12. 11.6 12. 12.3 Ohio Department of Health - Vital Statistics Definition: Age-Adjusted Suicide Rate -Rate of completed suicides per 1, population age standardized to average out differences due to age. 51

Rate Per 1, Individuals Rate Per 1, Individuals Behavioral Health Stark County Competed Suicide Rate by Race 2 18 16 14 12 1 8 6 4 2 26 27 28 29 21 211 Caucasian 11.7 8.5 13.2 11.2 17.2 12.3 African-American 4.6 9.7 6.9 7.4 8.6 Stark County Completed Suicide Rate by Gender 3 25 2 15 1 5 26 27 28 29 21 211 Male 17.5 14.1 22 18.9 27.6 2.6 Female 5.3 8.8 4.2 3.7 5. 3.9 Ohio Department of Health - Vital Statistics Definition: Age-Adjusted Suicide Rate -Rate of completed suicides per 1, population age standardized to average out differences due to age. Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. 52

Rate per 1, Individuals Behavioral Health 18 16 14 Unintentional Drug Death Rate 12 1 8 6 4 2 23 24 25 26 27 28 29 21 211 Stark 2.6 4. 4.2 6.6 6.6 7.9 5.5 1.4 1.7 Ohio 5.8 7.9 8.9 11. 11.8 12.8 12.3 13.4 15.3 Ohio Department of Health and World Health Organization Definition: Includes accidental poisoning by and exposure to the following: analgesics, antipyretics and antirheumatics; antiepileptic, sedative-hypnotic, medications for Parkinson s disease and psychotropic medications; narcotics and hallucinogens; drugs acting upon the autonomic nervous system and other, unspecified drugs or medications. Note: Deaths directly attributable to prescription drug use include drug psychoses, drug dependence, nondependent abuse of drugs and polyneuropathy due to drug use. Indicator only includes deaths; illicit drug-related morbidity is not reflected. Deaths in which drugs may have been a contributing but not primary cause are not included. 53

Rate per 1, Individuals Rate per 1, Individuals Behavioral Health Heroin Poisoning Death Rate 4. 3.5 3. 2.5 2. 1.5 1..5. 23 24 25 26 27 28 29 21 211 Stark..3..5. 1.6.5 2.1 3.5 Ohio.8 1. 1.1 1. 1.3 2. 2.5 2.9 3.7 12 1 Opioid Related Poisoning Death Rate 8 6 4 2 23 24 25 26 27 28 29 21 211 Stark 1.3 2.4 2.4 1.9 1.3 2.6 1.6 7. 8.5 Ohio 2.6 3.8 4.3 4.8 5.5 6.4 6.8 8.5 1 Ohio Department of Health, National Drug Intelligence Center and Ohio Department of Alcohol and Drug Addiction Services Ohio Department of Health and World Health Organization Definition: ICD1 Poison codes/cause of Death Codes included T4.1 Out-of-state deaths are only included for 27 and 28. Indicators include poisonings which involve opioids, methadone and other synthetic narcotics. Deaths are recorded by county of residence. Note: According to the National Drug Intelligence center (29), the amount of black tar heroin within Ohio has increases significantly in recent years. The Ohio Substance Abuse Monitoring (OSAM) Network reports that prescription drug misuse, which has seen a significant increase in Ohio, is a gateway substance to heroin. Unintentional drug overdose has accounted for the highest percentage of death in Ohio since 27. Deaths directly attributable to prescription drug use include drug psychoses, drug dependence, nondependent abuse of drugs and polyneuropathy due to drug use. Indicators only include deaths; illicit drug-related morbidity is not reflected. Deaths in which drugs may have been a contributing but not primary cause are not included. 54

Percent of Adults Percent of Adults Behavioral Health 9% 8% 7% 6% 5% 4% 3% 2% 1% % Chronic Disease Risk Factors 28-21 Heavy Drinking Current Cigarette Smoker Lack of Physical Activity Consuming <5 Fruits/Vegetables Per Day Stark 3.7% 2.6% 25.5% 8.1% Ohio 5.5% 21.% 26.2% 79.% 9% 8% 7% 6% 5% 4% 3% 2% 1% % Stark County Chronic Disease Risk Factors Heavy Drinking Current Cigarette Smoker Lack of Physical Activity Consuming <5 Fruits/Vegetables Per Day Stark 24-27 4.1% 25.1% 23.8% 77.1% Stark 28-21 3.7% 2.6% 25.5% 8.1% Ohio Behavioral Risk Factor Surveillance System, Chronic Disease and Behavioral Epidemiology, Center for Public Health Statistics and Informatics, Ohio Department of Health Definitions: Heavy Drinking - Men having more than 2 drinks/day, Women having more than 1 drink/day. Current Cigarette Smoking - Persons who reported smoking at least 1 cigarettes in their lifetime and currently smoke everyday or some days. Lack of Physical Activity - Persons who failed to participate in moderate physical activity for 3 or more minutes per day on five or more days per week; or vigorous physical activity for 2 or more minutes per day on three or more days per week. Note: Question regarding consumption of fruit/vegetables was only asked on the 29 Behavioral risk factor Surveillance System. 55

Percent of Respondents Behavioral Health Stark County Tobacco Use 211 Use Tobacco 28% Do Not Use Tobacco 72% 8% 7% 6% Stark County Tobacco Use by Race 211 5% 4% 3% 2% 1% % Use Tobacco Do Not Use Tobacco Caucasian 28% 72% African-American 29% 71% Center for Marketing and Opinion Research, L.L.C. - 211 Stark Poll Caveat: The Stark Poll is a statistically representative telephone survey of Stark County residents. Note: Tobacco use includes cigarettes and other tobacco products. 56

Percent of Respondents Percent of Respondents Behavioral Health 9% 8% 7% 6% 5% 4% 3% 2% 1% % Stark County Tobacco Use by Age 211 Use Tobacco Do Not Use Tobacco 18-24 35% 65% 25-34 35% 65% 35-44 28% 72% 45-54 38% 62% 55-64 21% 79% 65 and over 16% 84% 8% 7% Stark County Tobacco Use by Gender 211 6% 5% 4% 3% 2% 1% % Use Tobacco Do Not Use Tobacco Male 31% 69% Female 25% 75% Center for Marketing and Opinion Research, L.L.C. - 211 Stark Poll Caveat: The Stark Poll is a statistically representative telephone survey of Stark County residents. Note: Tobacco use includes cigarettes and other tobacco products. 57

Behavioral Health Top Ten Diagnostic Groups 212 Adults Depressive Disorders 3,16 Bipolar Disorders 2,567 Anxiety Disorders 1,64 Alcohol Use Disorders 1,487 Schizophrenia/Other Psychotic Disorders 1,28 Adjustment Disorders 1,197 V Codes 873 Opioid Use Disorders 75 Cannabis Use Disorders 696 Post-Traumatic Stress Disorders 558 Total 14,136 Top Ten Diagnostic Groups 212 Children Adjustment Disorders 1,185 Conduct Disorders 1,179 Attention-Deficit/Disruptive Disorders 782 Anxiety Disorders 476 Bipolar Disorders 4 Depressive Disorders 4 Post-Traumatic Stress Disorders 323 Cannabis Use Disorders 198 Pervasive Developmental Disorders 133 Other Childhood Disorders 122 Total 5,198 Mental Health and Recovery Board of Stark County - Heartland East Reporting Services 58

Number of Clients Number of Clients Behavioral Health Stark County Behavioral Health Clients 15,8 15,6 15,4 15,2 15, 14,8 14,6 SFY 21 SFY 211 SFY 212 Total Clients 15,133 15,442 15,615 14, Stark County Behavioral Health Clients 12, 1, 8, 6, 4, 2, - Adults Children Clients SFY 21 11,372 3,761 Clients SFY 211 11,519 3,923 Clients SFY 212 11,517 4,98 Mental Health and Recovery Board of Stark County - Heartland East Reporting Services Definition: Behavioral health includes mental health, substance abuse treatment and prevention services. Caveat: Native Americans and Asian/Pacific Islander are not reported due to small population size. Note: State Fiscal Year (SFY) July 1st through June 3th. 59

Behavioral Health Stark County Behavioral Health Clients by Race 212 Other 5% African-American 17% Caucasian 78% Stark County Behavioral Health Clients by Gender 212 Female 5% Male 5% Mental Health and Recovery Board of Stark County - Heartland East Reporting Services Definition: Behavioral health includes mental health, substance abuse treatment and prevention services. Caveat: Native Americans and Asian/Pacific Islander are not reported due to small population size. Note: State Fiscal Year (SFY) July 1st through June 3th. 6

Number of Clients Behavioral Health Stark County Behavioral Health Clients by Age 3,5 3, 2,5 2, 1,5 1, 5 - to 9 1 to 13 14 to 17 18 to 24 Clients SFY 21 1,125 1,83 1,371 2,245 3,18 2,45 2,368 1,147 236 Clients SFY 211 1,234 1,91 1,41 2,212 3,247 2,414 2,37 1,229 244 Clients SFY 212 1,29 1,127 1,377 2,188 3,264 2,548 2,328 1,462 292 25 to 34 35 to 44 45 to 54 55 to 64 65+ Mental Health and Recovery Board of Stark County - Heartland East Reporting Services Definition: Behavioral health includes mental health, substance abuse treatment and prevention services. Note: State Fiscal Year (SFY) July 1st through June 3th. 61

Expenditures (In Millions) Number of Recipients Access to HealthCare 7, 68, 66, Stark County Medicaid Recipients 64, 62, 6, 58, 56, 54, 52, SFY 28 SFY 29 SFY 21 SFY 211 SFY 212 Recipients 57,693 63,245 65,682 66,571 67,549 6,, Stark County Medicaid Expenditures 5,, 4,, 3,, 2,, 1,, SFY 28 SFY 29 SFY 21 SFY 211 SFY 212 Expenditures 38,441,725 428,747,32 452,85,46 487,879,849 59,573,232 Ohio Department of Job and Family Services - BIC (Business Intelligence Channel) Definition: State Fiscal Year (SFY) - The fiscal year for the State of Ohio is July 1st through June 3th. Caveat: Expenditures not adjusted for inflation. Note: Average for the year. 62

Number of Individuals Number of Individuals Access to HealthCare Stark County Medicaid by Race 6, 5, 4, 3, 2, 1, SFY 28 SFY 29 SFY 21 SFY 211 SFY 212 Caucasian 44,784 49,563 52,62 52,758 53,765 African-American 13,148 14,35 14,61 14,833 15,115 7 6 5 Stark County Medicaid by Hispanic Origin 4 3 2 1 SFY 28 SFY 29 SFY 21 SFY 211 SFY 212 Hispanic 48 564 65 488 633 Ohio Department of Job and Family Services - BIC (Business Intelligence Channel) Definition: State Fiscal Year (SFY) - The fiscal year for the State of Ohio is July 1st through June 3th. Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. Expenditures not adjusted for inflation. Note: Average for the year. 63

Number of Individual Number of Individuals Access to HealthCare 25, Stark County Medicaid by Age 2, 15, 1, 5, Under 1 1 to 5 6 to 14 15 to 18 19 to 2 21 to 44 45 to 64 65 to 74 75 to 84 85 and Older SFY 28 2,551 9,864 15,159 5,816 1,563 13,832 6,553 2,5 1,836 1,54 SFY 29 2,576 1,737 16,47 6,464 1,914 15,635 7,84 2,188 1,83 1,574 SFY 21 2,568 11,136 16,863 6,422 2,23 16,851 7,614 2,278 1,836 1,633 SFY 211 2,43 11,189 16,966 6,368 2,95 17,614 8,164 2,274 1,279 1,132 SFY 212 2,353 1,175 15,745 5,832 2,144 2,311 9,3 2,216 1,531 1,317 Stark County Medicaid by Gender 45, 4, 35, 3, 25, 2, 15, 1, 5, SFY 28 SFY 29 SFY 21 SFY 211 SFY 212 Male 25,622 28,32 29,537 3,172 3,614 Female 35,111 38,146 39,676 4,293 4,314 Ohio Department of Job and Family Services - BIC (Business Intelligence Channel) Definition: State Fiscal Year (SFY) - The fiscal year for the State of Ohio is July 1st through June 3th. Caveat: Expenditures not adjusted for inflation. Note: Average for the year. 64

Percent of Population Access to HealthCare 1.% Stark County Health Insurance Coverage 9.% 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% 29 21 211 212 Health Care Coverage 89.3% 87.6% 87.8% 88.5% No Health Care Coverage 1.7% 12.4% 12.2% 11.5% U.S. Census Bureau - American Community Survey Note: Although the ACS produces population, demographic and housing unit estimates, it is the Census Bureau s Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities and towns and estimates of housing units for states and counties. 65

Percent of Population Percent of Population Access to HealthCare 25.% Stark County Unisured by Race 2.% 15.% 1.% 5.%.% 29 21 211 212 Caucasian 1.1% 11.7% 11.8% 1.4% African-American 17.3% 21.% 18.% 21.9% 16.% 14.% 12.% Stark County Uninsured by Gender 1.% 8.% 6.% 4.% 2.%.% 29 21 211 212 Male 11.5% 13.4% 13.8% 12.7% Female 9.9% 11.5% 1.6% 1.3% U.S. Census Bureau American Community Survey Caveat: Native Americans and Asian/Pacific Islanders are not reported due to small population size. Note: Although the ACS produces population, demographic and housing unit estimates, it is the Census Bureau s Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities and towns and estimates of housing units for states and counties. 66

Percent of Population Percent of Population Access to HealthCare Stark County Uninsured by Age Group 2.% 18.% 16.% 14.% 12.% 1.% 8.% 6.% 4.% 2.%.% 29 21 211 212 Under 18 3.3% 5.7% 5.6% 6.9% 18 and Older 16.2% 18.3% 17.8% 16.3% Stark County Uninsured by Employment Status 5.% 45.% 4.% 35.% 3.% 25.% 2.% 15.% 1.% 5.%.% 29 21 211 212 Employed 11.8% 13.8% 13.5% 13.1% Unemployed 43.4% 42.3% 44.3% 38.8% U.S. Census Bureau American Community Survey Note: Although the ACS produces population, demographic and housing unit estimates, it is the Census Bureau s Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities and towns and estimates of housing units for states and counties. 67

Percent of Individuals Access to HealthCare 8% Stark County Oral Health Last Visited Dentist/Dental Clinic 7% 6% 5% 4% 3% 2% 1% % Within The Past Year Within The Past 2 Years Within The Past 5 Years 5 or More Years Ago Stark 28 68.9% 1.9% 9.2% 1.7% Stark 21 67.1% 1.7% 8.4% 13.3% Ohio Behavioral Risk Factor Surveillance System, Chronic Disease and Behavioral Epidemiology, Center for Public Health Statistics and Informatics, ODH 68

Percent of Children Percent of Adults Environmental Health Adults Current and Lifetime Asthma 28-21 16% 14% 12% 1% 8% 6% 4% 2% % Current Lifetime Stark 8.1% 11.8% Ohio 9.7% 14.3% Children Current and Lifetime Asthma 28-21 16% 14% 12% 1% 8% 6% 4% 2% % Current Lifetime Stark 1.9% 14.5% Ohio 9.% 12.9% 28-21 Ohio Behavioral Risk Factor Surveillance System, Chronic Disease and Behavioral Epidemiology, Center for Public Health Statistics and Informatics, Ohio Department of Health Caveat: Estimates are based on statistical regression and not on actual counts. Definition: Lifetime Asthma - Individuals who have reported ever having been diagnosed with asthma. Current Asthma - Individuals who reported having asthma at the time of the survey. 69

Percent of Days Environmental Health Stark County Air Quality Index Levels 9% 8% 7% 6% 5% 4% 3% 2% 1% % 25 26 27 28 29 21 211 212 Good 67.6% 69.6% 66.2% 77.5% 71.5% 59.5% 66.% 52.5% Moderate 27.7% 26.3% 25.6% 19.% 28.2% 37.5% 31.7% 45.9% Unhealthy - Sensitive Groups 4.4% 3.8% 7.6% 3.4%.2% 3.% 2.1% 1.3% Unhealthy.3%.3%.6%.%.%.%.%.2% Good (<=5 AQI) Moderate (51-1 AQI) Unhealthy for Sensitive Groups (SG) (11-15 AQI) Unhealthy (151-2 AQI) Very Unhealthy (>=21 AQI) US EPA - Air Data Air Quality Index Report www.epa.gov/airdata/ad_rep_aqi.html Notes: AirData reports are produced from an extract of EPA's air pollutions database. They represent the best information available to EPA from agencies on that date. However, some values may be absent due to incomplete reporting, and some values subsequently may be changed due to quality assurance activities. The AQS database is updated daily by organizations who own and submit the data. Air Quality Index (AQI) is a standardized value for reporting daily air quality based on the measured pollutant concentration that produces the highest AQI value. Generally, an AQI value of 1 equals the national air quality standard for the pollutant, which is the level set by EPA to protect public health and is considered satisfactory. Values above 1 are considered unhealthy. 7

Parts Per Million Environmental Health Carbon Monoxide Ozone Particle Matter 2.5 2nd Max 1hr Value 2nd Max 8hr Value 2nd Max 1hr Value 4th Max 8hr Value 98th Percentile Value Annual Mean Value 25 3.8 2.7.11.86 51. 18.24 26 3.3 2.2.91.79 33.1 14.82 27 2.1 1.7.18.87 33.4 16.24 28 2.9 2.5.9.77 38.5 13.12 29 2 1.8.66 32. 13.2 21 2 2.1.8 42. 15 211 2 2.9.81 28. 12.8 212 1.9 1.8.89.77 27. 12.3.14.12.1 Stark County Ozone Levels.8.6.4.2 25 26 27 28 29 21 211 212 1hr 2nd Max.11.91.18.9.8.1.9.89 1hr Standard.12.12.12.12.12.12.12.12 4th Max 8hr Value.86.79.87.77.66.8.81.77 8hr Standard.75.75.75.75.75.75.75.75 US EPA - Air Data County Air Quality Report www.epa.gov/airdata/ad_rep_aqi.html Notes: AirData reports are produced from an extract of EPA's air pollutions database. They represent the best information available to EPA from agencies on that date. However, some values may be absent due to incomplete reporting, and some values subsequently may be changed due to quality assurance activities. The database is updated daily by state and local organizations who own and submit the data. EPA National Ambient Air Quality Standards: Carbon Monoxide - 35 parts per million (1 hr average), 9 parts per million (8 hr average) Ozone -.12 parts per million (1 hr average),.75 parts per million (8 hr average) Particulate Matter (diameter <2.5 Micrometers) - 35 micrograms per cubic meter ( 24 hr average), 15. micrograms per cubic meter (annual mean) 71

Micrograms Per Cubic Meter Parts Per Million Environmental Health 1 9 8 7 6 5 4 3 2 1 Stark County Carbon Monoxide Levels 25 26 27 28 29 21 211 212 1hr 1st Max 4 4 2 3 2 2 2 1.9 8hr Values 3 3 2 3 1 2 2 1.6 8hr Standard 9 9 9 9 9 9 9 9 2 18 Stark County Particulate Matter 2.5 Levels 16 14 12 1 8 6 4 2 25 26 27 28 29 21 211 212 Annual Mean Value 18.24 14.82 16.24 13.12 13.2 15. 12.8 12.3 Annual Mean Standard 15. 15. 15. 15. 15. 15. 15. 15. US EPA - Air Data Monitor Values Report www.epa.gov/airdata/ad_rep_mon.html EPA National Ambient Air Quality Standards: Carbon Monoxide - 35 parts per million (1 hr average), 9 parts per million (8 hr average) Air Quality Standards: These levels may not be exceeded more than once per year: 1hr average concentration - 35ppm 8hr average concentration - 9ppm Definition: ppm - parts per million 72

Number of Traffic Crashes Number of Traffic Crashes Public Safety Traffic Crashes 45, 4, 35, 3, 25, 2, 15, 1, 5, 24 25 26 27 28 29 21 211 212 Stark 13,355 12,38 11,169 11,49 1,757 1,64 1,215 1,226 9,68 Ohio 381,639 358,127 334,26 328,742 32,876 298,646 3,164 292,163 287,5 16, 14, Stark County Traffic Crashes 12, 1, 8, 6, 4, 2, 24 25 26 27 28 29 21 211 212 Traffic Crashes 13,355 12,38 11,169 11,49 1,757 1,64 1,215 1,226 9,68 Ohio Department of Public Safety - Traffic Crash Facts - 24-212 73

Number of Traffic Crashes Number of Traffic Crashes Public Safety Alcohol-Related Traffic Crashes 2, 18, 16, 14, 12, 1, 8, 6, 4, 2, 24 25 26 27 28 29 21 211 212 Stark 639 59 619 517 515 478 532 526 481 Ohio 17,244 16,474 16,76 15,54 14,425 13,426 13,37 12,639 12,545 7 6 Stark County Alcohol-Related Traffic Crashes 5 4 3 2 1 24 25 26 27 28 29 21 211 212 Alcohol-Related Crashes 639 59 619 517 515 478 532 526 481 Ohio Department of Public Safety - Traffic Crash Facts - 24-212 74