DISTRICT PROFILE HIGHLIGHTS--2005
Douglas County Health District
· 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 the district, 10.7% of 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 district residents who were under age 18 was 26.2%, near the Nebraska average of 25.5% in 2004.
· Racial and ethnic minority residents made up 24.0% of the population of the district, compared to 14.3% statewide in 2004. African Americans account for 11.7% of the total population of the district, while Hispanic Americans account for 8.5%. Asian Americans comprise 2.2% of the population of the district.
· The proportion of single-parent families in this district has increased since 1990, as it has statewide. In 2000, 15.7% of district households were single-parent families, compared to an average of 12.4% for Nebraska.
· In the district, the proportion of single-parent families was higher among African Americans (30.8%), Native Americans (26.9%), and Hispanic Americans (17.2%) than it was among whites (7.6%) and Asian Americans (5.4%).
· Overall, 12.7% of district residents aged 25 years or older have less than a high school education, compared to 13.4% statewide.
· The proportion of district residents in this age group that had not completed high school was higher among Hispanic Americans (51.7%), Native Americans (24.6%), and African Americans (23.5%) than it was among Asian Americans (12.0%) and whites (10.0%).
· The proportion of district residents living in households with incomes below 100% of the federally-defined poverty level was 10.1% in 2002, nearly matching the average of 10.0% for Nebraska.
· The proportion of residents living in poverty was higher for racial/ethnic minority groups than it was for whites (6.2%) in the district, with Native Americans (30.6%) and African Americans (29.6%) experiencing the highest poverty rates, according to the 2000 U.S. Census.
· The proportion of seventh- to twelfth-graders in the district who dropped out of school during the 2003-2004 school year was 2.9%, compared to 1.9% statewide.
· In 2000-2004, 10.5% of first births in this district occurred to unmarried women under age 20 with less than a high school education. This rate of “new families at risk” is higher than the Nebraska average of 9.0% of first births.
· The proportion of new families at risk in the district was highest among Native Americans (30.2%), African Americans (26.5%), and Hispanic Americans (19.0%) in 2000-2004.
· The arrest rate for all crime in the district in 2004 (64.1 arrests per 1,000 population) was 18.3% higher than the overall rate for Nebraska (54.2). The arrest rate for juveniles under age 18 (30.1) was 9.6% lower than the statewide rate (33.3).
· In an average month in 2004, 2,509 district children were in out-of-home care (that is, foster care, group homes or other residential care facilities).
· The agencies serving domestic violence victims in the district handled 17,765 crisis calls and served 6,882 new contacts in FY2000.
· The overall death rate in the district (845.8 deaths per 100,000 population) was 7% higher than the state average (789.1) in 2000-2004.
· The heart disease death rate for the district (204.3 deaths per 100,000 population) was very near the Nebraska rate (205.1).
· The cancer death rate for the district (201.9) was 11% above the Nebraska rate (182.0) and was 37% 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 the district (56.1) was 4% higher than the statewide rate (54.0) and was 18% higher than Nebraska’s 2010 objective for reducing deaths due to stroke (47.4).
· The unintentional injury death rate in the district (29.6) was 21% lower than the statewide rate (37.6), but was 53% higher than the Nebraska 2010 objective for reducing deaths due to this cause (19.4).
· The motor vehicle death rate (9.9) was much lower than the Nebraska rate (16.6) and reached the state’s Healthy People 2010 target for reducing these deaths (12).
· The rate of deaths due to chronic lung disease in the district (46.8) was 19% higher than the Nebraska rate (39.4).
· The suicide death rate in the district (10.4) was near the state rate (10.7), but was 27% higher than Nebraska’s target rate for 2010 (8.2).
· The rate of deaths due to homicide in the district (5.9) was nearly double the rate for Nebraska overall (3.0). The district rate was nearly triple the Nebraska 2010 objective of no more than 2.0 homicides per 100,000 population.
· In 2000-2004 the diabetes-related death rate in the district (77.6) was 7% above the state rate (72.6), but was more than triple the Nebraska 2010 objective for these deaths (25.0).
· There were 10,499 new cases of cancer reported in the district during the five-year period 1999-2003, resulting in a rate (496.9 cases per 100,000 population) that was 5% higher than the statewide rate (474.2).
· The hospitalization rate for district residents (10,050 hospital discharges per 100,000 population) was 2.2% higher than the Nebraska rate (9,837) in 2003-2004. District residents were at least 69% more likely than people in Nebraska overall to be hospitalized for assault or other unintentional injury. District residents were 16.1% less likely than statewide to be hospitalized for MV accidents or overexertion.
· Compared to the state overall (36.5%), Medicare was the expected payer for a smaller share of hospitalizations of district residents (21.0%) in 2003-2004. Medicaid accounted for a somewhat larger share of the total (15.2% vs. 14.1% statewide).
· Incidence of sexually transmitted diseases (STDs) in the district (834.9 reported cases per 100,000 population) was almost double the rate for the state (424.4) in 2004.
· Based on prevalence estimates supplied by the Alzheimer’s Association, it is estimated that 9,641 persons aged 65 and older in the district had senile dementia in 2004.
MATERNAL AND CHILD HEALTH AND WELL-BEING
· There were 295 deaths of infants under one year of age in the district 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 Nebraska rate of 6.6 and 67% higher than the Nebraska 2010 objective of no more than 4.5 infant deaths per 1,000 live births.
· The infant mortality rate for African American babies (16.7) in the district is more than double the statewide rate and 3.7 times as high as the Nebraska 2010 objective for infant deaths (4.5).
· The rate of low weight births (babies weighing less than 2,500 grams at birth) in the district (77.5 per 1,000 live births) was 12% above the Nebraska rate of 69.4. The district rate was 55% higher than the Nebraska 2010 target rate of 50.0 low weight births per 1,000.
· The low weight birth rate for African Americans in the district (131.6) was nearly double the rate for white babies in the district (68.1) and was 2.6 times the state’s 2010 objective for low weight births (50).
· In the district, births to adolescent girls aged 10 to 17 accounted for 3.5% of all births for 2000-2004, compared to a statewide average of 2.9%. The proportion of births occurring to teenaged girls was greater than the overall district rate for Native Americans (9.3%), African Americans (9.4%), and Hispanic Americans (5.6%).
· An average of 12.7% of district 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 district were about as likely as women throughout Nebraska to begin receiving prenatal care in the first three months of pregnancy (82.5% vs. 83.2% statewide). However, racial and ethnic minority women were generally less likely than white women (85.1%) in the district to receive first trimester care: Native American mothers (62.1%), Hispanic American mothers (67.7%), and African American mothers (70.4%). 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-one percent of adults in the district 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, compared to 25.0% statewide. The district rate is higher than the state’s 2010 target rate of no more than 15% of adults who are physically inactive.
· Adults in the district (23.4%) were 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 about the same in the district (11.8%) as it was statewide (11.9%).
· In 2000-2004, 8.6% 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 greater in the district than in the state overall. Eight out of ten (81.0%) of women aged 40 and older 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 larger in the district (75.4%) than in Nebraska overall (71.5%). The proportion of these adults who reported ever having been vaccinated for pneumonia was higher in the district (65.9%) than it was statewide (63.2%). 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 34 municipal water systems or rural water districts in the district, none received water containing excessive levels of nitrate (>10 ppm) in 2000-2004.
· Two of the district’s 20 community water systems sampled supply adequate levels of fluoride in the drinking water. These systems supply water to all of the people living in the district, thus, 99% of district residents drink water of adequate fluoride level.
· Of all district children under age 6 years whose blood lead levels were tested, 1,036 (3.7%) were found to have elevated levels of lead in 2002-2004 vs. 3.3% statewide (1,846 elevated tests).
AVAILABILITY OF SERVICES
· A total of 429 primary care physicians (173 GP/FP’s, 103 IM’s, 83 pediatricians, and 70 OB/Gyn’s) were in practice in the district in 2003. There were also 78 psychiatrists, 126 physician assistants, and 161 nurse practitioners practicing in the district. In addition, 382 dentists were in practice in the district in 2003.
· As of 2003, part of the district was a federally-designated Medically Underserved Area or a Medically Underserved Population.
· Public transportation is currently available in the district.
SERVICE UTILIZATION DATA
· Children made up the greatest share of the Medicaid eligible population in the district (64.9%) in FY2003. In comparison to the state, aged persons in this district comprise a slightly smaller share of the Medicaid eligible population (6.2% vs. 9.0% for Nebraska).
· Medicaid expenditures for aged persons comprise 22.2% of the total in the district, compared to 29.4% statewide. ADC recipients (both children and adults) account for 38.7% of all Medicaid expenditures in the district, while blind and disabled recipients account for the remaining 39.2% of total expenditures in FY 2003.
· Medicaid fee-for-service expenditures (68.7%) comprised the greatest share of the total in the district, as they did statewide (75.8%) in FY 2003.
· Fee-for-service payments to nursing facilities made up 18.1% of total Medicaid expenditures in the district. Hospital services accounted for 26.8% and prescribed drugs comprised 14.2% of the total.
· In FY 2004, a monthly average of 6,056 families received Aid to Dependent Children benefits and 41,639 persons participated in the Food Stamp Program in the district.
· In 2004, 20,289 women, infants and children from this district participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
· A total of 3,175 beds in nursing homes and hospital long-term care facilities were licensed in the district in 2004, with an occupancy rate of 81.6%.
· In the district, 4.1% of residents aged 65 and older lived in nursing homes in 2004, compared to 5.5% for the state.