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 the county, 12.5%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 county residents who were under age 18 was 36.9%, much higher than the Nebraska average of 25.5% in 2004.
· Racial and ethnic minority residents made up 55.5% of the population of Thurston County, compared to 14.3% statewide in 2004. Native Americans account for more than one-half (52.0%) of the total population of the county, while Hispanic Americans account for 2.9%.
· The proportion of single-parent families in this county has increased since 1990, as it has statewide. In 2000, 25.9% of the county households were single-parent families, compared to an average of 12.4% for Nebraska.
· In Thurston County, the proportion of single-parent families was higher among Native Americans (43.2%) and Hispanic Americans (18.5%) than it was among whites (5.5%).
· Overall, 19.7% of county residents aged 25 years or older have less than a high school education, compared to 13.4% statewide.
· The proportion of county residents in this age group that had not completed high school was higher among Hispanic Americans (50.0%) and Native Americans (23.6%) than it was among whites (15.5%).
· The proportion of county residents living in households with incomes below 100% of the federally-defined poverty level was 22.3% in 2002, more than double the average of 10.0% for Nebraska.
· The proportion of residents living in poverty was generally higher for racial/ethnic minority groups than it was for whites (10.6%) in the county, with 38.4% of Native Americans and 36.4% of Hispanic Americans living in poverty, according to the 2000 U.S. Census.
· The proportion of seventh- to twelfth-graders in the county who dropped out of school during the 2003-2004 school year was 7.0%, compared to 1.9% statewide.
· Overall, 38.6% of first births in this county occurred to unmarried women under age 20 with less than a high school education. This rate of “new families at risk” is 4.3 times as high as the Nebraska average of 9.0% of first births in 2000-2004.
· The proportion of new families at risk in the county was highest among Native Americans (49.4%) in 2000-2004.
· The arrest rate for all crime in the county in 2004 (11.6 arrests per 1,000 population) was 78.6% lower than the overall rate for Nebraska (54.2).
· In an average month in 2004, 54 Thurston County 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 multi-county area handled 1,229 crisis calls and served 482 new contacts in FY 2000.
· The overall death rate in Thurston County (1,089.0 deaths per 100,000 population) was 38% higher than the state average (789.1) for 2000-2004.
· The heart disease death rate for the county (291.5 deaths per 100,000 population) was 42% above the Nebraska rate (205.1).
· The cancer death rate for the county (222.5) was 22% higher than the Nebraska rate (182.0) and 51% 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 the county (87.4) was 62% above the statewide rate (54.0) and 84% higher than Nebraska’s 2010 objective for reducing deaths due to stroke (47.4).
· The unintentional injury death rate in the county (86.2) was 2.3 times the statewide rate (37.6) and was 4.4 times the Nebraska 2010 objective for reducing deaths due to this cause (19.4).
· The motor vehicle death rate (35.0) was 2.1 times as high as the Nebraska rate (16.6) and 2.9 times as high as the state’s Healthy People 2010 target for reducing these deaths (12.0).
· The diabetes-related death rate in this county (159.1) was 2.2 times the state rate (72.6) and was 6.4 times as high as the Nebraska 2010 objective for these deaths (25.0).
· There were 64 tobacco-related deaths and 30 alcohol-related deaths recorded in the county in 2000-2004.
· There were 155 new cases of cancer reported in the county during the five-year period 1999-2003, resulting in a rate (464.6 cases per 100,000 population) that was slightly lower than the statewide rate (474.2).
· The hospitalization rate for the county residents (4,778 hospital discharges per 100,000 population) was only about one-half the Nebraska rate (9,837) in 2003-2004. The Thurston County rate may be low due to hospitalizations that occur in Indian Health Service facilities and are not picked up in Nebraska hospital discharge data. Nevertheless, the pneumonia discharge rate was 23.8% higher than statewide.
· Compared to the state overall (36.5%), Medicare was the expected payer for a much larger share of hospitalizations of county residents (50.5%) in 2003-2004. Medicaid accounted for a larger share of the total (16.3% vs. 14.1% statewide).
· Incidence of sexually transmitted diseases (STDs) in the county (1,288.2 reported cases per 100,000 population) was about triple the rate for the state (424.4) in 2004.
· Based on prevalence estimates supplied by the Alzheimer’s Association, it is estimated that 159 persons aged 65 and older in Thurston County had senile dementia in 2004.
MATERNAL AND CHILD HEALTH AND WELL-BEING
· There were 10 deaths of infants under one year of age in the county during the five-year period 2000-2004, resulting in an infant mortality rate of 12.8 per 1,000 live births. This rate is 1.9 times higher than the Nebraska rate (6.6) and is 2.8 times as high as the Nebraska 2010 objective of 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 the county (44.9 per 1,000 live births) was 54.6% lower than the Nebraska rate of 69.4 in 2000-2004. The Thurston County rate meets the Nebraska 2010 target rate of no more than 50.0 low weight births per 1,000.
· In this county, births to adolescent girls aged 10 to 17 accounted for 8.5% of all births in 2000-2004. This was more than double the statewide average of 2.9%. In the county, 9.9% of all Native American births occurred to girls under age 18.
· Nearly one-fourth (23.9%) of Thurston 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 less likely than Nebraska women overall to begin receiving prenatal care in the first three months of pregnancy (80.0% vs. 83.2% statewide) in 2000-2004. Native American women (78.0%) and Hispanic American women (82.4%) were less likely than white women (87.0%) in the county to receive first trimester care. The Nebraska objective for the year 2010 is to have 90% 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
· One-fourth (25.4%) of adults in the Northeast Nebraska Public Health district (which includes Thurston 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 28.5% 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 (23.7%) 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 14.1% in the district and 11.9% statewide.
· 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 slightly lower in the district than it was in the state overall. Seventy-three percent of women aged 40 and older in this district reported having a mammogram in the past two years, compared to 75.5% statewide.
· About two-thirds of the adults aged 65 and older in the district (68.3%) 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 (59.8% vs. 63.2% statewide) in 2000-2004. 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 8 municipal water systems or rural water districts in the county, none received water containing excessive levels of nitrate (>10 ppm) from results sampled in 2000-2004.
· Of the 9 community water systems sampled, 2 supplied an adequate level of fluoride in the drinking water in 2004. These systems supply water to 30.5% of the people who are served by community water systems.
· Of all county children under age 6 years whose blood lead levels were tested, 20 (5.3%) 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 6 primary care physicians (5 GP/FP’s and 1 Internist) were in practice in the county in 2003. Six physician assistants and 1 dentist were also in practice in the county in 2003.
· All of Thurston County has been federally-designated as a Medically Underserved Area or Population.
SERVICE UTILIZATION DATA
· Children make up the greatest share of the Medicaid eligible population in the county (72.1%).
· Medicaid expenditures for aged persons comprise 15.9% of the total in this county, compared to 29.4% statewide. ADC recipients (both children and adults) account for 52.0% of all Medicaid expenditures in the county, while blind and disabled recipients account for the remaining 32.1% of total expenditures.
· Medicaid fee-for-service expenditures (91.6%) comprised the greatest share of the total in the county, as they did statewide (75.8%) in FY 2003.
· Fee-for-service payments to nursing facilities made up 17.8% of total Medicaid expenditures in the county. Hospital services accounted for 46.2% and prescribed drugs comprised 7.2% of the total.
· In FY 2004, a monthly average of 205 families received Aid to Dependent Children benefits and 1,543 persons participated in the Food Stamp Program in the county.
· In 2004, 69 women, infants and children from this county participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
· A total of 71 beds in nursing homes and hospital long-term care facilities were licensed in the county in 2004, with an occupancy rate of 80.5%.
· In this county in 2004, 3.8% of residents aged 65 and older lived in nursing homes, compared to 5.5% for the state.