Public Health2

Spartanburg Community Indicators Project : 

Spartanburg Community Indicators Project It is a collaboration of The Spartanburg County Foundation, United Way of the Piedmont, Spartanburg County Government, and The University of South Carolina Upstate. It reports on progress of key issues that are the clearest indicators of quality of life in the County of Spartanburg, South Carolina. Its goal is to report on data and community initiatives to inspire dialogue and strategy within the community which hopefully leads to change.

Slide 3: 

History

Slide 4: 

2000

Slide 5: 

2003-2006

Slide 6: 

2008-2009

Ten Goals : 

Ten Goals Academic Success Education and Training Elderly Independence Stable & Nurturing Families Healthy Families Economic Means Economic Viability Community Safety Civic Engagement Management of Natural Resources

Six Indicator Areas : 

Six Indicator Areas Education Economy Public Health Natural Environment Social Environment Community Engagement

Slide 9: 

Dashboards

Slide 10: 

Stakeholders

Moving Data to Action : 

Moving Data to Action 40/30 Challenge Joint Funders on Teen Pregnancy Road to Better Health

Slide 12: 

Dr. Kathleen Brady Director Metropolitan Studies Institute

Slide 13: 

SPARTANBURG’S SIGNIFICANT INDICATORS

Access to Care : 

Access to Care

Access to Care : 

Access to Care Approximately 75,000 residents of Spartanburg County are uninsured 17.1% of Spartanburg County residents were unable to see a doctor because they could not afford to (SC BRFSS 2008-2009) SRHS provided: care to 42,118 self-pay / indigent patients in the ED who were not admitted to inpatient treatment ($63.3 million) Care to an additional 2,092 self-pay indigent patients who were admitted ($75.7 million) $116 million in indigent care in 2009

Access to Care : 

AccessHealth Spartanburg Uninsured age 19 – 64 Living at or below 150% of FPL Three “safety net” providers for primary care: ReGenesis FQHC (4 week wait) SRMC Family Medicine Clinic (6 month wait) St. Luke’s Free Medical Clinic (1,100 on waiting list - currently suspended) Access to Care

Access to Care : 

Access to Care Access to Care includes Primary health care for low income Specialty health care for low income Dental care for low income Behavior health care for low income Health Inequities The burden of chronic disease is inequitably distributed across the population (health inequities) Socioeconomic status = strong and consistent predictor of morbidity and mortality Education!

Slide 19: 

Chronic Disease : 

Responsible for 7 of every 10 U.S. deaths Cause major limitations in daily activities for 1 in 10 Americans Account for approximately 75% of U.S. medical costs Related risk factors: tobacco, poor diet, physical inactivity (highly preventable!) Chronic Disease

Chronic Disease : 

Chronic Disease

Leading Causes of Death (per 100,000 adults), 2005U.S. and S.C. Comparison : 

Leading Causes of Death (per 100,000 adults), 2005U.S. and S.C. Comparison

Obesity Trends* Among U.S. AdultsBRFSS, 1985 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1986 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1986 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1987 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1987 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1988 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1988 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1989 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1989 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1990 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1991 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1992 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1993 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1994 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1995 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1996 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1997 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 1998 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 1999 : 

Obesity Trends* Among U.S. AdultsBRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2000 : 

Obesity Trends* Among U.S. AdultsBRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2001 : 

Obesity Trends* Among U.S. AdultsBRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Slide 40: 

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) Obesity Trends* Among U.S. AdultsBRFSS, 2002 No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2003 : 

Obesity Trends* Among U.S. AdultsBRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2004 : 

Obesity Trends* Among U.S. AdultsBRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2005 : 

Obesity Trends* Among U.S. AdultsBRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2006 : 

Obesity Trends* Among U.S. AdultsBRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2007 : 

Obesity Trends* Among U.S. AdultsBRFSS, 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2008 : 

Obesity Trends* Among U.S. AdultsBRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2009 : 

Obesity Trends* Among U.S. AdultsBRFSS, 2009 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Slide 48: 

1999 Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1999, 2009 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 2009 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Chronic Disease: Obesity : 

64% of Spartanburg adults are overweight or obese 34% of Spartanburg children are overweight or obese Medical expenditures related to obesity in SC >$1 billion 30% - 50% more chronic medical problems Chronic Disease: Obesity

Chronic Disease: Tobacco Use : 

The leading preventable cause of disease and death in S.C. 30.1% of adult residents in Spartanburg County smoke every day (2008-2009 BRFSS) In FY 2010, 6,664 patients were seen at the SRHS Emergency Department with smoking-related diagnosis codes (8,239 visits) Total charges for patients with smoking-related diagnosis codes was $22,025,105 ($2,673 per visit – nearly $1,300 more than the average charge for nonsmokers) 74.6% of Spartanburg 9th and 11th graders said they would “absolutely not” smoke tobacco when they are adults (Communities that Care Youth Survey, 2010) Chronic Disease: Tobacco Use

Slide 51: 

Behavioral Health : 

Lack of sufficient behavioral health care 37% of county residents miss work or other usual activities at least once a month due to mental / emotional condition (BRFSS, 2008) SCDMH statewide “penetration rate” has decreased and service priorities have shifted SC spends $68 per capita vs. US spends $100 per capita In 2009, there were 4,308 visits to Spartanburg County EDs for behavioral health issues – total charges = $21,036,512 Of these visits, 1,587 were by self-pay / indigent patients – total charges = $5,142,007 Medicaid or Medicare visits accounted for $10,702,854 of total charges Behavioral Health

Behavioral Health : 

U.S. Population Lifetime Prevalence Rates: 22.5% of all people will be diagnosed with a non-substance abuse mental disorder 13.5% will be diagnosed with alcohol dependence-abuse 6.1% will be diagnosed with other drug dependence-abuse 37% of persons with alcohol disorder have a comorbid mental disorder 53% of persons with drug disorders have a comorbid mental disorder Behavioral Health

Slide 54: 

Infant Mortality : 

Measure of the overall health status of a population Infant mortality in Spartanburg = 7.5 per 1,000 (2008) SC = 8.3 Spartanburg whites = 4.9, blacks = 11.2 Spartanburg = 29th highest of 46 counties (2005-2007) Spartanburg = 7.8 Richland = 7.5 Greenville = 6.6 Charleston = 11.7 SC = 8.9 Infant Mortality

Infant Mortality : 

Infant Mortality

Slide 57: 

Slide 58: 

Questions and Comments www.strategicspartanburg.org