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.
· About one-fifth (19.8%) of Cedar County 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 27.8%, slightly higher than the Nebraska average of 25.5% in 2004.
· Racial and ethnic minority residents made up 1.2% of the population of Cedar County, compared to 14.3% statewide in 2004.
· Although the proportion of single-parent families in this county has increased somewhat since 1990, the percentage was smaller than the state average. In 2000, 7.1% of Cedar County households were single-parent families, compared to an average of 12.4% for Nebraska.
· Overall, 16.5% of Cedar County residents aged 25 years or older have less than a high school education, compared to 13.4% statewide.
· The proportion of Cedar County residents living in households with incomes below 100% of the federally-defined poverty level was 8.7% in 2002, slightly below the average of 10.0% for Nebraska.
· The proportion of seventh- to twelfth-graders in Cedar County who dropped out of school during the 2003-2004 school year was very small (0.2%, compared to 1.9% statewide).
· About one of every 21 first births in this county (3.9%) occurred to unmarried women under age 20 with less than a high school education. This rate of “new families at risk” is lower than the Nebraska average of 9% of first births in 2000-2004.
· The arrest rate for all crime in Cedar County in 2004 (1.9 arrests per 1,000 population) was much lower than the overall rate for Nebraska (54.2).
· In an average month in 2004, 21 Cedar County children were in out-of-home care (that is, foster care, group homes or other residential care facilities).
· The multi-county agency serving domestic violence victims in Cedar County handled 1,229 crisis calls and served 482 new contacts in FY2000.
· The overall death rate in Cedar County (683.8 per 100,000) was 13.3% lower than the state average for 2000-2004 (789.1).
· The heart disease death rate for the county (203.7 deaths per 100,000 population) was very near the Nebraska rate (205.1).
· The cancer death rate for Cedar County (147.6) was 18.9% lower than the Nebraska rate of 182.0. The Cedar County rate has almost reached the state’s Healthy People 2010 objective of no more than 147.0 cancer deaths per 100,000 population.
· The rate of deaths due to cerebrovascular disease (stroke) in Cedar County (75.1) was 39.1% higher than the statewide rate (54.0) and 58.4% higher than Nebraska’s 2010 objective for reducing deaths due to stroke (47.4).
· The unintentional injury death rate in Cedar County (53.7) was higher than the statewide rate (37.6) and 2.8 times more than the Nebraska 2010 objective for reducing deaths due to this cause (19.4).
· The diabetes-related death rate in Cedar County (68.3) was a little lower than the state rate (72.6), but was 2.7 times as high as the Nebraska 2010 objective for these deaths (25.0).
· There were 86 tobacco-related deaths (112.5 per 100,000 people) in Cedar County during the five-year period 2000-2004 vs. a statewide rate of 137.2.
· There were 285 new cases of cancer reported in Cedar County during the five-year period 1999-2003, resulting in a rate (435.8 cases per 100,000 population) that was 8.1% lower than the statewide rate (474.2).
· The hospitalization rate for Cedar County residents (3,802 hospital discharges per 100,000 population) was less than one-half the Nebraska rate (9,837) in 2003-2004. However, Cedar County residents may be receiving care at out-of-state hospitals, where admissions are not picked up in Nebraska hospital discharge data.
· Compared to the state overall (36.5%), Medicare was the expected payer for a much larger share of hospitalizations of Cedar County residents (55.2%) in 2003-2004. Medicaid accounted for a smaller share of the total (9.6% vs. 14.1% for Nebraska).
· Incidence of sexually transmitted diseases (STDs) in Cedar County (32.5 reported cases per 100,000 population) was much smaller than the rate for the state (424.5) in 2004.
· Based on prevalence estimates supplied by the Alzheimer’s Association, it is estimated that 372 persons aged 65 and older in Cedar County had senile dementia in 2004.
MATERNAL AND CHILD HEALTH AND WELL-BEING
· There were 2 deaths of infants under one year of age in Cedar County during the five-year period 2000-2004.
· The rate of low weight births (babies weighing less than 2,500 grams at birth) in Cedar County (37.3 per 1,000 live births) was 46% lower than the Nebraska rate of 69.4. The Cedar County rate already has met the Nebraska 2010 target rate of no more than 50.0 low weight births per 1,000.
· An average of 9.6% of Cedar 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 more likely than women throughout Nebraska to begin receiving prenatal care in the first three months of pregnancy (89.2% vs. 83.2% statewide) during 2000-2004. 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
· Twenty-five percent of adults in the Northeast Nebraska Public Health District (which includes Cedar County) reported heights and weights that placed them in the obese category (Body Mass Index = 30 or higher) in 2000-2004. 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 28.5% in the district and 25.0% statewide. These rates are much higher than the state’s 2010 target rate of no more than 15% of adults who are physically inactive.
· Adults in the district (23.7%) were somewhat more likely than 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 higher in the district (14.1%) than it was statewide (11.9%) in 2000-2004.
· Eleven 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 a little lower in the district than in the state overall. Seven of every 10 women aged 40 and older in this district (73.0%) 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 slightly lower in the district (68.3%) than in Nebraska overall (71.5%). A smaller proportion of these adults also reported ever having been vaccinated for pneumonia (59.8% 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 10 municipal water systems or rural water districts in Cedar County, 2.0% received water containing excessive levels of nitrate (>10 ppm).
· Five of the county’s 12 community water systems sampled supply adequate levels of fluoride in the drinking water. These systems supply water of adequate fluoride level to 75.2% of the people served by community water systems in Cedar County.
· Of all children under age 6 years whose blood lead levels were tested, 7 (3.9%) were found to have elevated levels of lead in 2003-2004 vs. 3.3% statewide (1,846 tests elevated).
AVAILABILITY OF SERVICES
· A total of 3 primary care physicians (2 GP/FP’s and 1 IM) were in practice in Cedar County in 2003. There were no psychiatrists or physician assistants, and only one nurse practitioner practicing in the county. In addition, there were 2 dentists in practice in Cedar County in 2003.
· As of 2003, part of Cedar County was a federally-designated Health Professional Shortage Area and all of the county was designated a Medically Underserved Area.
· Public transportation is currently available in Cedar County.
SERVICE UTILIZATION DATA
· Children make up the greatest share of the Medicaid eligible population in Cedar County (66.0%) in FY 2003. In comparison to the state, aged persons in this county comprise a larger share of the Medicaid eligible population (19.1% vs. 9.0% for Nebraska).
· Medicaid expenditures for aged persons comprise 65.3% of the total in Cedar County, compared to only 29.4% statewide. ADC recipients (both children and adults) account for 15.4% of all Medicaid expenditures in the county, while blind and disabled recipients account for the remaining 19.2% of total expenditures.
· Medicaid fee-for-service expenditures accounted for the greatest share of the total, both in Cedar County and the state in FY 2003. However, capitated and other Medicaid payments comprised a much smaller percentage of the total in Cedar County (12.5%) than they did statewide (24.2%). Fee-for-service payments to nursing facilities made up 45.5% of total Medicaid expenditures in Cedar County, compared to only 21.2% in Nebraska overall. Prescribed drugs comprised 12.2% of total expenditures in this county.
· In FY 2004, a monthly average of 8 families received Aid to Dependent Children benefits and 180 persons participated in the Food Stamp Program in Cedar County.
· In 2004, 214 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 Cedar County, with an occupancy rate of 83.9% in 2004.
· In Cedar County in 2004, 7.1% of residents aged 65 and older live in nursing homes, compared to 5.5% for the state.