COUNTY PROFILE HIGHLIGHTS--2005
· Please note that some of the data discussed in the “Highlights” are either not available by county or the number of cases or respondents is too small to permit meaningful analysis. For these data elements, Service Area or other multi-county data have been presented and noted in the Profile. Further details are available in the “2005 County Profiles Definitions and Data Sources” document.
· In Cass County, 12.3% of the residents are aged 65 or older, according to the 2004 U.S. Census Estimates. Statewide, 13.3% of the population are 65 or older.
· The proportion of county residents who were under age 18 was 26.9%, higher than the Nebraska average of 25.5% in 2004.
· Racial and ethnic minority residents made up 3.5% of the population of Cass County, compared to 14.3% statewide in 2004. Hispanic Americans account for 1.5% of the county’s total population.
· The proportion of single-parent families in this county has increased since 1990, as it has statewide. In 2000, 11.0% of Cass County households were single-parent families, compared to an average of 12.4% for Nebraska.
· Overall, 10.6% of Cass County residents aged 25 years or older have less than a high school education, compared to 13.4% statewide.
· Among Hispanic Americans, the proportion that had not completed high school was higher—20.0% in Cass County and 53.4% in Nebraska.
· The proportion of Cass County residents living in households with incomes below 100% of the federally-defined poverty level was 6.7% in 2002, lower than the average of 10% for Nebraska.
· The proportion of seventh- to twelfth-graders in Cass County who dropped out of school during the 2003-2004 school year was 0.2%, compared to 1.9% statewide.
· About one of every 11 first births in this county (9.1%) occurred to unmarried women under age 20 with less than a high school education. This rate of “new families at risk” nearly matches the Nebraska average of 9.0% of first births in 2000-2004.
· The arrest rate for all crime in Cass County in 2004 (15.9 arrests per 1,000 population) was much lower than the overall rate for Nebraska (54.2). The arrest rate for juveniles under age 18 (1.5) was also much lower than the statewide rate (33.3).
· In an average month in 2004, 92 Cass County children were in out-of-home care (that is, foster care, group homes or other residential care facilities).
· The agencies serving dometic violence victims in Cass County handled 7,228 crisis calls and served 1,613 new contacts in FY2000.
· The overall death rate in Cass County (861.9) was 9.2% higher than the state average (789.1) for 2000-2004.
· The heart disease death rate for the county (243.1 deaths per 100,000 population) was higher than the Nebraska rate (205.1).
· The cancer death rate for Cass County (178.5) was slightly lower than the rate for Nebraska (182.0). The county rate was 21.4% higher than the state’s Healthy People 2010 objective of no more than 147.0 deaths per 100,000 population.
· The rate of deaths due to cerebrovascular disease (stroke) in Cass County (60.4) was 11.9% higher than the statewide rate (54.0) and was 27.4% higher than Nebraska’s 2010 objective for reducing deaths due to stroke (47.4).
· The unintentional injury death rate in Cass County (42.6) was 13.3% higher than the statewide rate (37.6) and 2.2 times as high as the Nebraska 2010 objective for reducing deaths due to this cause (19.4).
· The motor vehicle death rate (21.4) was also higher than the Nebraska rate (16.6) and was almost double the state’s Healthy People 2010 target rate for reducing these deaths (12.0).
· The diabetes-related death rate in Cass County (69.3) was 4.5% lower than the state rate (72.6) and was 2.8 times as high as the Nebraska 2010 objective rate for these deaths (25.0).
· There were 202 tobacco-related deaths in Cass County in 2000-2004 (162.5 deaths per 100,000 population vs. a statewide rate of 137.2. A total of 48 alcohol-related deaths were recorded for the county during the five-year period (39.3 per 100,000) vs. a statewide rate of 35.5.
· There were 558 new cases of cancer reported in Cass County during the five-year period 1999-2003, resulting in a rate (450.5 cases per 100,000 population) that was 5% lower than the statewide rate (474.2).
· The hospitalization rate for Cass County residents (9,017 hospital discharges per 100,000 population) was lower than the Nebraska rate (9,837) in 2003-2004. Cass County residents were 26% more likely than people in Nebraska overall to be hospitalized for motor vehicle accident injuries. On the other hand, rates of hospitalization resulting from pneumonia and other respiratory diseases were at least 18% lower than Nebraska rates for corresponding causes.
· Compared to the state overall (36.5%), Medicare was the expected payer for a slightly smaller share of hospitalizations of county residents (33.8%) in 2003-2004. Medicaid accounted for a smaller share of the total (11.7% vs. 14.1% for Nebraska).
· Incidence of sexually transmitted diseases (STDs) in Cass County (229.8 reported cases per 100,000 population) was considerably lower than the rate for the state (424.4) in 2004.
· Based on prevalence estimates supplied by the Alzheimer’s Association, it is estimated that 567 persons aged 65 and older in Cass County had senile dementia in 2004.
MATERNAL AND CHILD HEALTH AND WELL-BEING
· There were 12 deaths of infants under one year of age in Cass County during the five-year period 2000-2004, resulting in an infant mortality rate of 7.5 per 1,000 live births. This is higher than the statewide rate of 6.6 infant deaths per 1,000 live births. The Nebraska 2010 objective is to reduce this rate to no more than 4.5 infant deaths per 1,000 live births.
· The rate of low weight births (babies weighing less than 2,500 grams at birth) in Cass County (65.3 per 1,000 live births) was 6% below the Nebraska rate of 69.4 in 2000-2004. The Cass County rate was 31% higher than the Nebraska 2010 target rate of 50.0 low weight births per 1,000.
· In Cass County, births to adolescent girls aged 10 to 17 accounted for 2.1% of all births for 2000-2004, compared to a statewide average of 2.9%.
· An average of 21.2% of Cass County women giving birth during the five-year period 2000-2004 reported smoking cigarettes during this pregnancy, compared to the state average of 14.1% of women giving birth. The Nebraska 2010 objective is to reduce this proportion to 2.0% or less.
· Pregnant women in this county were somewhat more likely than women throughout Nebraska to begin receiving prenatal care in the first three months of pregnancy (85.7% vs. 83.2% statewide). The Nebraska objective for the year 2010 is to have 90.0% of all pregnant women begin receiving prenatal care in their first trimester.
· Results of an immunization survey conducted by the Centers for Disease Control and Prevention showed that 82.4% of Nebraska children aged 19 to 35 months were up-to-date on immunizations with all five recommended vaccines in 2004. The current Nebraska objective is to have at least 90% of all children in this age group appropriately immunized.
RISK FACTOR PREVALENCE
· More than one-fifth (23.7%) of adults in the Sarpy Cass Health District (of which Cass County is a part) reported heights and weights that placed them in the obese category (Body Mass Index = 30 or higher). The Nebraska 2010 objective is to reduce this proportion to no more than 15%.
· The proportion of adults who said they had not participated in any leisure-time physical activity in the previous month was 22.1% in the district and 25% statewide. These rates are largre than the state’s 2010 target rate of no more than 15% of adults who are physically inactive.
· Adults in the district (21.2%) were about as likely as Nebraska adults overall (21.1%) to state that they are current smokers. The Nebraska 2010 objective is to reduce the proportion of adults currently smoking cigarettes to no more than 12%.
· The proportion of adults reporting they have no health insurance was smaller in the district (7.8%) than it was statewide (11.9%).
· In 2000-2004, 8.3 percent of adults in the district and 8.4% statewide reported that there had been a time in the past 12 months when they were unable to see a doctor for needed care due to the potential cost of services. The Nebraska 2010 target is to reduce this proportion to no more than 4% of adults.
· Prevalence of screening for breast cancer was higher in the district than in the state overall. Eight of every 10 women aged 40 and older in this district (81.5%) reported having a mammogram in the past two years, compared to 75.5% statewide.
· The proportion of adults aged 65 and older who had a flu shot in the past 12 months was higher in the district (75.4%) than in Nebraska overall (71.5%). A smaller proportion of these adults reported ever having been vaccinated for pneumonia (63.8% vs. 63.2% statewide). The Nebraska 2010 objectives for these adult immunizations have been set at 90%.
· Based on results of the 2000-2004 Nebraska Behavioral Risk Factor Surveillance System, African Americans report higher prevalence of obesity (34% vs. 23%), no leisure-time physical activity (34% vs. 25%), and cigarette smoking (27% vs. 23%) than white BRFSS respondents. African Americans were also more likely to say they have no health insurance (20% vs. 11%) or could not afford to see a physician at some time during the past 12 months (17% vs. 9%).
· Native Americans report a much higher prevalence of cigarette smoking (44% vs. 23%) than white persons in Nebraska do, and they were more likely to be physically inactive (29% vs. 25%) or obese (39% vs. 23%). They were more likely to report having no health insurance (27% vs. 11%) and to say there had been a time during the past 12 months when they could not afford to see to a doctor (21% vs. 9%).
· Asian Americans in Nebraska were less likely than white persons in the state to be obese (11% vs. 23%). Like other members of racial and ethnic minority groups, a greater proportion of Asian Americans reported having no health insurance (14% vs. 11%).
· Compared to non-Hispanic white persons in Nebraska, a greater proportion of Hispanic Americans stated they had not participated in any leisure-time physical activity in the previous month (44% vs. 25%). They were also more likely to have no health insurance (25% vs. 11%) and to be unable to afford to see a physician at least once in the past 12 months (17% vs. 9%).
· According to the 2003 Youth Risk Behavior Survey, Nebraska high school students are more likely than their counterparts nationwide to drink and drive and ride in a motor vehicle with a drinking driver. However, they were less likely to have ever used marijuana or to have used it, or tobacco, in the past 30 days.
· Of the persons receiving their drinking water from 36 municipal water systems or rural water districts in Cass County, 0.8% received water containing excessive levels of nitrate (>10 ppm).
· Three of the county’s 22 community water systems sampled supply adequate levels of fluoride in the drinking water. These systems supply water of adequate fluoride level to 39.7% of the people served by community water systems in Cass County.
· Of all children under age 6 years whose blood lead levels were tested, 7 (1.3%) were found to have elevated levels of lead in 2003-2004 vs. 3.3% statewide (1,846 tested).
AVAILABILITY OF SERVICES
· A total of 6 primary care physicians (2 GP/FP’s, 2 IM, 2 pediatricians) were in practice in Cass County in 2003. There was also 1 physician assistant, 2 nurse practitioners, and 6 dentists practicing in the county.
· As of 2003, part of Cass County was federally designated as a Health Professional Shortage Area and part was designated as a Medically Underserved Area.
· Public transportation is currently available in Cass County.
SERVICE UTILIZATION DATA
· Children made up the greatest share of the Medicaid eligible population in Cass County (68.8%) in FY 2003.
· Medicaid expenditures for aged persons comprise 37.4% of the total in Cass County, compared to 29.4% statewide. ADC recipients (both children and adults) account for 37.3% of all Medicaid expenditures in the county, while blind and disabled recipients account for the remaining 25.2% of total expenditures.
· Medicaid fee-for-service expenditures accounted for the greatest share of the total, both in Cass County (79.9%) and the state (75.8%) in FY2003. Capitated payments comprised a much smaller percentage of the total. Fee-for-service payments to nursing facilities made up 25.9% of total Medicaid expenditures in Cass County, while prescribed drugs comprised 15.5%.
· In FY 2004, a monthly average of 83 families received Aid to Dependent Children benefits and 1,102 persons participated in the Food Stamp Program in Cass County.
· In 2004, 623 women, infants and children from this county participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
· A total of 174 beds in nursing homes and hospital long-term care facilities are licensed in Cass County, with an occupancy rate of 85% in 2004.
· In Cass County, 4.7% of residents aged 65 and older live in nursing homes, compared to 5.5% for the state in 2004.