DISTRICT PROFILE HIGHLIGHTS--2005
Lancaster County Health District
· Please note that some of the data discussed in the “Highlights” are either not available by district 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-tenth (10.3%) of district 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 are under age 18 is 22.8%, lower than the Nebraska average of 25.5% in 2004.
· Racial and ethnic minority residents made up 12.2% of the population of the district, compared to 14.3% statewide in 2004. This proportion represents an increase from 8.7% for the district in 1998.
· Hispanic Americans account for 4.1%, Asian Americans account for 3.3%, African Americans account for 3.0%, and Native Americans account for 0.7% of the district’s total population.
· The proportion of single-parent families in this district has increased since 1990, as it has statewide. In 2000, 12.4% of district households were single-parent families, matching the average for Nebraska (12.4%).
· Among racial/ethnic minority households, the proportion of single-parent families is higher (17.2% for district and 21.8% for Nebraska).
· Overall, 9.5% of district residents aged 25 years or older have less than a high school education, compared to 13.4% statewide.
· Among racial/ethnic minority residents, the proportion that had not completed high school was much higher--26.6% in the district and 34.2% in Nebraska.
· The proportion of district residents living in households with incomes below 100% of the federally-defined poverty level was 9.4% in 2000, below the average of 10.0% for Nebraska.
· Among racial/ethnic minority residents of this district, the proportion living in poverty was much greater—particularly among African Americans (27.1%) and Native Americans (25.6%).
· The proportion of seventh- to twelfth-graders in the district who dropped out of school during the 2003-2004 school year was 3.1%, compared to 1.9% statewide.
· About one of every 16 first births in this district (6.3%) 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.
· Rates of new families at risk were higher for African Americans (23.6%), Native Americans (40.5%), and Hispanic Americans (15.4%) than for whites (5.5%) or Asian Americans (3.2%).
· The arrest rate for all crime in the district in 2004 (74.2 arrests per 1,000 population) was 36.9% higher than the overall rate for Nebraska (54.2). The arrest rate for juveniles under age 18 (48.1) was 44.4% higher than the statewide rate (33.3).
· In an average month in 2004, 1,273 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 47,504 crisis calls and served 4,504 new contacts in FY2000.
· The overall death rate in Lancaster County (752.0) was 5% lower than the state average for 2000-2004 (789.1).
· The heart disease death rate for the county (175.6 deaths per 100,000 population) was 14% lower than the Nebraska rate (205.1).
· Cancer death rates for Lancaster County (185.2) and for Nebraska (182.0) were similar. The Lancaster County rate was 26% 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 Lancaster County (47.4) was 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 Lancaster County (35.1) was lower than the statewide rate (37.6), but was 81% higher than the Nebraska 2010 objective for reducing deaths due to this cause (19.4).
· The motor vehicle death rate (11.8) was lower than the Nebraska rate (16.6) and reached the state’s Healthy People 2010 target for reducing these deaths (12.0).
· The suicide death rate in Lancaster County (11.4) was slightly higher than the state rate (10.7) and 39% higher than Nebraska’s target rate for 2010 (8.2).
· The homicide death rate for Lancaster County (1.6) was lower than the Nebraska rate (3.0) and achieved the 2010 objective for these deaths (2.0).
· The diabetes-related death rate in Lancaster County (73.1) was very near the state rate (72.6), but was 2.9 times as high as the Nebraska 2010 objective for these deaths (25.0).
· There were 5,304 new cases of cancer reported in Lancaster County during the five-year period 1999-2003, resulting in a rate (483.6 cases per 100,000 population) that was slightly higher than the statewide rate (474.2).
· The hospitalization rate for district residents (10,560 hospital discharges per 100,000 population) was 7.3% higher than the Nebraska rate (9,837) in 2003-2004. District residents were at least 41.8% more likely than people in Nebraska overall to be hospitalized for psychosis/mental illness or alcohol related diseases. Rates of hospitalization resulting from pneumonia or other unintentional injury were at least 18.4% lower than Nebraska rates.
· Compared to the state overall (36.5%), Medicare was the expected payer for a slightly smaller share of hospitalizations of district residents (35.0%) in 2003-2004. Medicaid also accounted for a slightly smaller share of the total (13.6% vs. 14.0% for Nebraska).
· Incidence of sexually transmitted diseases (STDs) in the district (541.0 reported cases per 100,000 population) was 27.5% higher than the rate for the state (424.4) in 2004.
· Based on prevalence estimates supplied by the Alzheimer’s Association, it is estimated that 5,111 persons aged 65 and older in the district had senile dementia in 2004.
MATERNAL AND CHILD HEALTH AND WELL-BEING
· There were 124 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 6.4 per 1,000 live births. This is lower than the Nebraska rate of 6.6, but is 42% 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 (21.5) is 3.8 times the rate for white babies in the district (5.7) and 4.8 times as high as the Nebraska 2010 objective for reducing infant deaths.
· The rate of low weight births (babies weighing less than 2,500 grams at birth) in the district (71.0 per 1,000 live births) was very near the Nebraska rate of 69.4 in 2000-2004. The district rate was 42% higher than the Nebraska 2010 target rate of no more than 50.0 low weight births per 1,000.
· The low birth weight rate for African Americans in this district (109.0) was 1.5 times as high as the rate for white babies in the district (70.4) and was 2.2 times the state’s 2010 objective for low weight births (50.0).
· In the district, births to adolescent girls aged 10 to 17 accounted for 2.5% of all births for 2000-2004, compared to a statewide average of 2.9%.
· Among African Americans (10.0%) and Native Americans (10.7%) in the district, the proportions of births occurring to teens were higher.
· An average of 13.9% of district women giving birth during the five-year period 2000-2004 reported smoking cigarettes during this pregnancy, matching 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 a little more likely than women throughout Nebraska to begin receiving prenatal care in the first three months of pregnancy (84.9% vs. 83.2% statewide). However, racial and ethnic minority women were less likely than white women in District to receive first trimester 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-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 24.2% in the district and 25% statewide. This rate is larger than the state’s 2010 target rate of no more than 15% of adults who are physically inactive.
· Adults in the district were about as likely as Nebraska adults overall (21.3%) 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 (10.7) as it was statewide (11.9%).
· Seven 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 greater in the district than in the state overall. More than three-fourths (81%) 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 greater in the district (72.5%) than in Nebraska overall (71.5%). A greater proportion of these adults also reported ever having been vaccinated for pneumonia (66.9% 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 92 municipal water systems or rural water districts in the district, none received water containing excessive levels of nitrate (>10 ppm) in 2000-2004.
· Three of the district’s 23 community water systems, sampled in 2004, supply adequate levels of fluoride in the drinking water. Of the people served by community water systems, 96.3% drank water with adequate fluoride levels.
· Of all district children under age 6 years whose blood lead levels were tested, 82 (2.5%) 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 182 primary care physicians (GP/FP’s, IM’s, PED’s, and OB/GYN’s) were in practice in the district in 2003. There were also 27 psychiatrists, 101 physician assistants, and 59 nurse practitioners practicing in the district. In addition, 236 dentists were in practice in the district in 2003.
· As of 2003, none of the district was a federally-designated Health Professional Shortage Area and part of the district was designated a Medically Underserved Area or a Medically Underserved Population.
· Public transportation is currently available in the district.
SERVICE UTILIZATION DATA
· Children make up the greatest share of the Medicaid eligible population in the district (64.3%). In comparison to the state, aged persons in this district comprise a slightly smaller share of the Medicaid eligible population (7.0% vs. 9.0% for Nebraska).
· Medicaid expenditures for aged persons comprise 25.4% of the total in the district, compared to 29.4% statewide. ADC recipients (both children and adults) account for 37.4% of all Medicaid expenditures in the district, while blind and disabled recipients account for the remaining 37.2% of total expenditures.
· Medicaid fee-for-service expenditures accounted for the greatest share of the total, both in the district and the state in FY2003. However, capitated payments comprised a larger percentage of the total in the district (28.3%) than they did statewide (24.2%). Fee-for-service payments to nursing facilities made up 18.3% of total Medicaid expenditures in the district, while prescribed drugs comprised 14.7%.
· In FY 2004, a monthly average of 1,476 families received Aid to Dependent Children benefits and 15,158 persons participated in the Food Stamp Program in the district.
· In 2004, 9,935 women, infants and children from this district participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
· A total of 1,388 beds in nursing homes and hospital long-term care facilities were licensed in the district in 2004, with an occupancy rate of 86.0%.
· In the district, 3.9% of residents aged 65 and older lived in nursing homes in 2004, compared to 5.5% for the state.