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 Clay County, 17.9% 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 26.3%, compared to the Nebraska average of 25.5% in 2004.
· Racial and ethnic minority residents made up 4.9% of the population of Clay County, compared to 14.3% statewide in 2004. Hispanic Americans account for 4.1% of the total population of the county.
· The proportion of single-parent families in this county has increased since 1990, as it has statewide. In 2000, 8.2% of Clay County households were single-parent families, compared to an average of 12.4% for Nebraska.
· Among Hispanic American households, the proportion of single-parent families is larger (11.5% for Clay County and 17.9% for Nebraska).
· Overall, 13.3% of Clay County residents aged 25 years or older have less than a high school education, compared to 13.4% statewide.
· Among Hispanic Americans in Clay County, more than two-thirds (68.5%) had not completed high school. Statewide, 53.4% of Hispanic Americans had less than a high school education.
· In Clay County, 10.7% of residents lived in households with incomes below 100% of the federally-defined poverty level in 2002, compared to an average of 10.0% for Nebraska.
· The proportion of seventh- to twelfth-graders in Clay County who dropped out of school during the 2003-2004 school year was 1.1%, compared to 1.9% statewide.
· About one of every 12 first births in this county (8.1%) occurred to unmarried women under age 20 with less than a high school education. This rate of “new families at risk” is slightly lower than the Nebraska average of 9.0% of first births in 2000-2004.
· The arrest rate for all crime in Clay County in 2004 (13.4 arrests per 1,000 population) was much less than the overall rate for Nebraska (54.2).
· In an average month in 2004, 22 Clay 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 Clay County handled 1,633 crisis calls and served 906 new contacts in FY2000.
· The overall death rate in Clay County (812.8 deaths per 100,000 people) was larger than the Nebraska rate for 2000-2004 (789.1).
· The heart disease death rate for the county (235.6 deaths per 100,000 population) was also larger than the Nebraska rate (205.1).
· The cancer death rate for Clay County (168.8) was lower than the Nebraska rate of 182.0. The county rate was 14.8% higher than 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 Clay County (46.3) was 14.3% lower than the statewide rate (54.0) and met Nebraska’s 2010 objective for reducing deaths due to stroke (47.4).
· The unintentional injury death rate in Clay County (83.0) was more than double the statewide rate (37.6) and was 4.3 times as high as the Nebraska 2010 objective for reducing deaths due to this cause (19.4).
· The diabetes-related death rate in Clay County (70.7) was a little lower than the state rate (72.6), but was 2.8 times as high as the Nebraska 2010 objective of no more than 25.0 of these deaths per 100,000 population.
· There were 66 tobacco-related deaths in Clay County during the five-year period 2000-2004 (136.5 per 100,000 people vs. a statewide rate of 137.2).
· There were 212 new cases of cancer reported in Clay County during the five-year period 1999-2003, resulting in a rate (474.5 cases per 100,000 population) that nearly matched the statewide rate of 474.2.
· The hospitalization rate for Clay County residents (12,154 hospital discharges per 100,000 population) was 23.6% higher than the Nebraska rate (9,837). Clay County residents were 66.5% more likely than people in Nebraska overall to be hospitalized for heart disease in 2003-2004.
· Compared to the state overall (36.5%), Medicare was the expected payer for a much larger share of hospitalizations of county residents (50.6%) in 2003-2004. Medicaid accounted for a smaller share of the total (11.1% vs. 14.1% statewide).
· Incidence of sexually transmitted diseases (STDs) in Clay County (116.0 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 232 persons aged 65 and older in Clay County had senile dementia in 2004.
MATERNAL AND CHILD HEALTH AND WELL-BEING
· There was one death of an infant under one year of age in Clay County during the five-year period 2000-2004.
· The rate of low weight births (babies weighing less than 2,500 grams at birth) in Clay County (42.4 per 1,000 live births) was 64% lower than the Nebraska rate of 69.4. The county rate has reached the Nebraska 2010 target of no more than 50.0 low weight births per 1,000.
· An average of 13.8% of Clay 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%. The Nebraska 2010 objective is to reduce this proportion to 2.0% or less.
· Pregnant women in this county were more likely than Nebraska women overall to begin receiving prenatal care in the first three months of pregnancy (85.9% vs. 83.2% statewide) in 2000-2004. Hispanic women in Clay County were less likely (75.0%) than white women (86.0%) to receive first trimester prenatal care. 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-two percent of adults in the South Heartland Health District (which includes Clay County) 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 24.7% in the district and 25.0% statewide. These rates are much larger than the state’s 2010 target rate of no more than 15% of adults who are physically inactive.
· Adults in the district (19.9%) were somewhat less 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 12.6% in the district and 11.9% statewide.
· In 2000-2004, 6.7% 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 somewhat higher in the district than it was in the state overall. Eight out of ten women aged 40 and older in this district (82.1%) and 75.5% statewide reported having a mammogram in the past two years in 2000-2004.
· About three-fourths of the adults aged 65 and older in the district (75.6%) and 71.5% statewide had a flu shot in the past 12 months. A smaller proportion of these adults reported ever having been vaccinated for pneumonia (64.8% 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 14 municipal water systems or rural water districts in Clay County, 4.2% received water containing excessive levels of nitrate (>10 ppm) in 2000-2004.
· None of the county’s 9 community water systems sampled supplied adequate levels of fluoride in the drinking water in 2004.
· Of all children under age 6 years whose blood lead levels were tested, 10 (6.0%) were found to have elevated levels of lead in 2003-2004 vs. 3.3% statewide (1,846 tests elevated).
AVAILABILITY OF SERVICES
· Only 1 primary care physician (1 GP/FP) was in practice in Clay County in 2003. There were no psychiatrists, nurse practitioners or physician assistants practicing in the county. There were 3 dentists in practice in Clay County in 2003.
· As of 2003, all of Clay County was federally-designated as a Medically Underserved Area or Population.
· Public transportation is currently available in Clay County.
SERVICE UTILIZATION DATA
· Children made up the greatest share of the Medicaid eligible population in Clay County (64.9%) in FY 2003. In comparison to the state, aged persons in this county comprise a somewhat larger share of the Medicaid eligible population (11.8% vs. 9.0% for Nebraska).
· Medicaid expenditures for aged persons comprise 36.5% of the total in Clay County, compared to 29.4% statewide. ADC recipients (both children and adults) account for 31.7% of all Medicaid expenditures in the county, while blind and disabled recipients accounted for the remaining 31.7% of total expenditures in FY 2003.
· Medicaid fee-for-service expenditures accounted for the greatest share of the total, both in Clay County (87.3%) and the state (75.8%) in FY2003. Capitated and other Medicaid payments comprised a much smaller percentage of the total. Fee-for-service payments to nursing facilities made up 30.4% of total Medicaid expenditures in Clay County. Prescribed drugs comprised 14.7% of total expenditures in this county.
· In FY 2004, a monthly average of 33 families received Aid to Dependent Children benefits and 391 persons participated in the Food Stamp Program in Clay County.
· In 2004, 242 women, infants and children from this county participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
· A total of 116 beds in nursing homes and hospital long-term care facilities were licensed in Clay County in 2004, with an occupancy rate of 84.3%.
· In Clay County in 2004, 6.7% of residents aged 65 and older lived in nursing homes, compared to 5.5% for the state.