Professional Research Consultants, Inc. 2014 PRC Community Health Needs Assessment Prepared for Lee...

Professional Research Consultants, Inc.

2014 PRC Community Health Needs Assessment

Prepared for Lee Memorial Health System

June 12, 2014

Lee County, Florida

2Professional Research Consultants, Inc.

PRC Community Health Needs AssessmentLee County, Florida

PRC Community Health Needs Assessment

Customized Local PRC Community Health Survey

Customized Local PRC Community Health Survey

Key InformantFocus Groups

Key InformantFocus Groups

Secondary Data

Secondary Data

Random-sample survey among 1,000 adults in Lee County• By geography:o 250 in each of four

Market Areas • 149 survey items;

25-30 minute interview

• ±3.1% max error overall

Four Key Informant Focus Groups, comprised of 53 community stakeholders:o Public health,

Medical Society members & other health providers

o Social services & other community leaders

BENCHMARKING

Prior Local Survey Data (2007& 2011)

PRC National Health Survey

Florida BRFSS data

Healthy People 2020 targets

National vital statistics data



Population & Survey Sample Characteristics(Lee County, 2014)

Sources: ● Census 2010, Summary File 3 (SF 3). U.S. Census Bureau.● 2014 PRC Community Health Survey, Professional Research Consultants, Inc.

Men Women 18 to 39 40 to 64 65+ White Black Hispanic <200% FPL0%

20%

40%

60%

80%

100%

48.5

%

51.5

%

29.7

% 41.2

%

29.1

%

75.8

%

15.3

%

8.9

%

38.4

%48.6

%

51.4

%

29.8

% 41.0

%

29.2

%

75.6

%

15.1

%

9.3

%

37.6

%

Actual Population Weighted Survey Sample

Total Sample Maximum Error = ±3.1% at the 95 percent confidence level



PRC Assessment Findings

General Observations

General Findings

Overall Health Status

Activity Limitations

Positive Findings vs. US

Positive Trends in Lee County



15.9% Fair/Poor

56.3% Excellent/Very Good

Self-Reported Health Status(Lee County, 2014)

Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 6]Notes: ● Asked of all respondents.

Excellent 23.2%

Very Good 33.1%

Good 27.8%

Fair 10.4%

Poor 5.5%



Experience “Fair” or “Poor” Overall Health

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 6]● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human

Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data.● 2013 PRC National Health Survey, Professional Research Consultants, Inc.

Notes: ● Asked of all respondents.

2007 2011 2014

17.9% 17.6% 15.9%

LeeCounty

FL US0%

20%

40%

60%

80%

100%

15.9%19.9%

15.3%

trend: statistically similar

Lee County At-Risk

Less favorable health status is found among:

• Market Area 2 residents = 25.1%

• Low-income residents (<200% FPL) = 29.0%

• Less age-related than typically found



Limited in Activities in Some Way Due to a Physical, Mental or Emotional

Problem




LeeCounty

FL US0%

20%

40%

60%

80%

100%

24.0% 22.4% 21.5%

2007 2011 2014

21.3% 22.0%24.9%

Lee County Trend

trend: statistically similarsimilar to FL/US

Lee County At-Risk

Greater activity limitations found among:

• Adults age 40+ ≈ 30%


• Non-Hispanic White respondents = 27.6%

• Most favorable in Market Area 3 (16.7%)



Selected Lee County Indicators Better Than the US: Age-adjusted death rates: cancer (including lung, prostate, breast

and colorectal); heart disease; stroke; CLRD; diabetes; Alzheimer’s disease; kidney disease; pneumonia/influenza; homicide; HIV/AIDS

Access barriers: physician office hours, transportation

Routine medical care (adults and children) and regular vision care

• Blood pressure and cholesterol screening/management, diabetes screening

Injury and safety: seat belt use, firearms in home (including homes with children), drinking and driving, violent crime

Infant mortality

STD incidence

Obesity and medical advice on nutrition

Cigarette smoking in homes



Selected Favorable Trends in Lee County Indicators: Age-adjusted death rates: cancer; heart disease; stroke;

CLRD; unintentional injury (including motor vehicle crashes); Alzheimer’s disease; pneumonia/influenza; HIV/AIDS

Insurance coverage for prescriptions

Routine children’s medical care, ease of getting children’s healthcare

HIV/AIDS incidence

Teen births

Infant mortality

Seat belt usage, violent crime

Children’s obesity

Physical activity levels

Cigarette smoking cessation, smoking in homes




Healthy Lifestyles

Healthy Lifestyles

Overweight & Obesity

Nutrition

Physical ActivityInjury & Safety

Tobacco Use



Prevalence of Total Overweight(Percent of Adults With a Body Mass Index of 25.0 or Higher)

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 181]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for

Disease Control and Prevention (CDC): 2012 Florida data.

Notes: ● Based on reported heights and weights, asked of all respondents.● The definition of overweight is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater

than or equal to 25.0, regardless of gender. The definition for obesity is a BMI greater than or equal to 30.0.

2007 2011 2014

64.0% 65.2% 65.0%

Lee County Trend

MarketArea 1

MarketArea 2

MarketArea 3

MarketArea 4

LeeCounty

FL US0%

20%

40%

60%

80%

100%

60.3%

67.5%71.3%

62.6% 65.0%62.1% 63.1%



Prevalence of Obesity(Percent of Adults With a Body Mass Index of 30.0 or

Higher)

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 181]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-9]● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data.

Notes: ● Based on reported heights and weights, asked of all respondents.● The definition of obesity is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or

equal to 30.0, regardless of gender.

2007 2011 2014

23.0%29.3%

24.8%

Lee County Trend

LeeCounty

FL US0%

20%

40%

60%

80%

100%

24.8% 25.2%29.0%

Healthy People 2020 Target = 30.5% or Lower Lee County At-Risk

Higher prevalence of obesity:



• Adults age 40-64 = 30.5%



Relationship of Overweight With Other Health Issues

(By Weight Classification; Lee County, 2014)

0%

20%

40%

60%

80%

100%

30

.2%

30

.4%

29

.0%

18

.1% 25

.9%

5.9

%

37

.2%

33

.6%

33

.3%

18

.6% 26

.9%

11

.0%

52

.8%

42

.6%

37

.7%

37

.4%

32

.5%

21

.1%

Healthy Weight Overweight/Not ObeseObese

69.9% of overweight/obese adults have not been advised

about weight by a health professional in the past year.

61.2% of overweight/obese adults are not trying to lose

weight by modifying both diet and exercise.



Child Obesity Prevalence(Percent of Children 5-17 Who Are Obese;

Body Mass Index in the 95th Percentile or Higher)

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 185]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov

[Objective NWS-10.4]Notes: ● Asked of all respondents with children age 5-17 at home.

● Obesity among children is determined by children’s Body Mass Index status equal to or above the 95 th percentile of US growth charts by gender and age.

2007 2011 2014

31.6%

21.4% 20.7%

Lee County US0%

20%

40%

60%

80%

100%

20.7%14.8%

Healthy People 2020 Target = 14.5... Lee County Trend

35.9% are overweight

or obese

Lee County At-Risk

• Childhood obesity is higher among younger children, age 5-12 = 29.1%



Consume Five or More Servings of Fruits/Vegetables Per Day

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 173]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.

Notes: ● Asked of all respondents.● For this issue, respondents were asked to recall their food intake on the previous day.

LeeCounty

US0%

20%

40%

60%

80%

100%

34.2%39.5%

2007 2011 2014

41.4% 42.9%

34.2%

Lee County Trend Lee County At-Risk

Lower consumption among:


• African American (23.0%) or Hispanic (27.2%) residents

• Residents of Market Area 2 (28.6%) or Market Area 3 (28.8%)

• Men = 30.3%



Find It “Very” or “Somewhat” Difficult to Buy Affordable Fresh

Produce

Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 108]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.


MarketArea 1

MarketArea 2

MarketArea 3

MarketArea 4

LeeCounty

United States

0%

20%

40%

60%

80%

100%

28.4% 26.5%19.7%

12.8%

21.1%24.4%

49.8% report that this is “not at all difficult,” 29.1% “not too difficult.”

Lee County At-Risk

Greater difficulty among:


• Women = 26.4%



No Leisure-Time Physical Activity in the Past Month

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 110]● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of

Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data.● 2013 PRC National Health Survey, Professional Research Consultants, Inc.● US Department of Health and Human Services. Healthy People 2020. December 2010.

http://www.healthypeople.gov [Objective PA-1]Notes: ● Asked of all respondents.

LeeCounty

FL US0%

20%

40%

60%

80%

100%

20.0%23.3% 20.7%

Healthy People 2020 Target = 32.6% o...

2007 2011 2014

26.7%22.3% 20.0%


Higher among:

• Hispanic residents = 30.3%

• Women = 26.3%



Indicators of frequency, intensity and duration are similar to

national findings, and similar among areas of the county.



Child Is Physically Active for One or More Hours per Day

(Among Children Ages 2-17)

Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 142]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.

Notes: ● Asked of all respondents with children age 2-17 at home.● Includes children reported to have one or more hours of physical activity on each of the seven days preceding the survey.

Lee County US0%

20%

40%

60%

80%

100%

54.0%48.6%

Children With Three or More Hours per School Day of Total

Screen Time (Among Parents of Children 5-17)

Lee County0%

20%

40%

60%

80%

100%

28.7%

Highest in teens.

Lowest in teens.



Lee County At-Risk

Seat belt usage is lower among:

• Adults age 18-39= 86.6%


• Men = 87.5%


“Always” Wear a Seat BeltWhen Driving or Riding in a Vehicle


Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data.● 2013 PRC National Health Survey, Professional Research Consultants, Inc.● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov

[Objective IPV-15]Notes: ● Asked of all respondents.

LeeCounty

FL US0%

20%

40%

60%

80%

100%90.5%

94.3%

84.8%

Healthy People 2020 Target = 92.0% or Higher

2007 2011 2014

83.6%90.0% 90.5%

Lee County Trend



Texted While Driving One or More Times in the Past Month

(Lee County, 2014)


● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents).

● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes households

with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level.

Men Women 18 to 39 40 to 64 65+ LowIncome

Mid/HighIncome

White Black Hispanic Lee County

0%

20%

40%

60%

80%

100%

23.0%

14.4%

39.4%

15.6%

2.7%

11.9%

26.1%

17.4%

25.6% 24.4%18.6%

13.2% said 3+ times



Lee County At-Risk

Higher smoking rates among:


• Adults age 40-64 = 17.5%

• No significant difference by geography

Current Smokers

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 186]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data.● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov

[Objective TU-1.1]Notes: ● Asked of all respondents.

● Includes regular and occasional smokers (those who smoke cigarettes everyday or on some days).

LeeCounty

FL US0%

10%

20%

30%

40%

50%

13.5%

17.7%14.9%

Healthy People 2020 Target = 12.0% or Lower

2007 2011 2014

15.6%17.9%

13.5%

Lee County Trend

Smoking cessation attempts have increased significantly since 2007.



Lee County At-Risk

Higher exposure among:

• Low-income households (<200% FPL) = 16.5%

• African American households = 17.6%

• Market Area 2 households = 13.5%

Member of Household Smokes at Home

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 72, 188]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.

Notes: ● Asked of all respondents.● “Smokes at home” refers to someone smoking cigarettes, cigars, or a pipe in the home an average of four or more times per

week in the past month.

LeeCounty

US0%

10%

20%

30%

40%

50%

9.2%12.7%

2007 2011 2014

13.3%10.8%

9.2%

Lee County Trend

same trend is seen in households with kids




Primary Care Alternatives

Primary Care Alternatives

Health Insurance

Difficulty Accessing Healthcare

ER Utilization

Specific Source of Ongoing Care



Lee County At-Risk

Higher uninsured:



• African American residents = 34.7%


• Adults age 18-39 = 28.9%

• Best coverage found in Market Area 4Lee

CountyFL US

0%

20%

40%

60%

80%

100%

20.3%27.6%

15.1%

Healthy People 2020 Target = 0.0% (Universal Coverage)

Lack of Healthcare Insurance Coverage

(Among Adults Age 18-64)

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 194]● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States

Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data.● 2013 PRC National Health Survey, Professional Research Consultants, Inc.● US Department of Health and Human Services. Healthy People 2020. December 2010.

http://www.healthypeople.gov [Objective AHS-1]Notes: ● Asked of all respondents under the age of 65.

2007 2011 2014

24.1%20.5% 20.3%

Lee County Trend

not statistically significant

Another 8.3% of insured adults went without coverage at some point in the past year.



Experienced Difficulties or Delays of Some Kind in Receiving Needed

Healthcare in the Past Year

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 198] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc.Notes: ● Asked of all respondents.

● Represents the percentage of respondents experiencing one or more barriers to accessing healthcare in the past 12 months.

LeeCounty

US0%

20%

40%

60%

80%

100%

41.6% 39.9%

2007 2011 2014

37.9% 37.1%41.6%


Greater difficulty:



• Market Areas 1 (47.3%) and 2 (46.3%)

• Adults age 18-39 (54.0%) or 40-64 (43.8%)



Barriers to Access Have Prevented Medical Care in the Past Year

Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Items 8-12, 16]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.


Cost(Doctor Visit)

Cost(Prescriptions)

Getting aDr Appointment

InconvenientOffice Hours

Findinga Doctor

Lack ofTransportation

0%

10%

20%

30%

40%

50%

20.3%

15.6% 15.2%12.5%

10.5%

4.0%

18.2%15.8% 17.0%

15.4%

11.0%9.4%

Lee County United States

This indicator increased significantly between

2007 and 2011 and has since held steady.



Lack or Type of Insurance CoveragePrevented Medical Care at Some Point in the Past

Year

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 18-19]Notes: ● Asked of all respondents.

MarketArea 1

MarketArea 2

MarketArea 3

MarketArea 4

LeeCounty

0%

20%

40%

60%

80%

100%

20.7%25.1%

16.1%11.9%

17.8%

2007 2011 2014

15.4%18.8% 17.8%

Lee County Trend

Reasons given:• No health insurance coverage (38.5%)• Problems with coverage limits (20.8%)• Cost of services (16.8%)• Insurance not accepted (9.6%)• Problem with type of insurance (3.5%)



Lack or Type of Insurance Coverage Prevented Medical Care at Some Point

in the Past Year(Lee County, 2014)





Private Insurance

Medicare Medicaid Uninsured Lee County0%

20%

40%

60%

80%

100%

11.7%

25.5%

51.1%55.0%

17.8%

Lee County At-Risk

Other segments with high impact:



• Adults age 18-39 = 29.8%



Have a Specific Source of Ongoing Medical Care


● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AHS-5.1]Notes: ● Asked of all respondents.

LeeCounty

US0%

20%

40%

60%

80%

100%

76.1% 76.3%

[All Ages] Healthy People 2020 Target = 95.0% or Higher

2007 2011 2014

76.5%70.3%

76.1%

Lee County Trend

Lee County At-Risk

Lower among:




• Adults age 18-39 = 64.7%


• Men = 71.2%



Have Visited a Physician for a Checkup in the Past Year



LeeCounty

US0%

20%

40%

60%

80%

100%

76.6%

65.0%

2007 2011 2014

75.7%69.6%

76.6%

Lee County Trend

Lee County At-Risk

Lower among:


• Adults age 18-39 = 65.2%


• Men = 73.6%

Routine checkups for children are higher than for

adults and have improved consistently since 2007.



Have Used a Hospital Emergency Room

More Than Once in the Past Year

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 32-33]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.


LeeCounty

US0%

10%

20%

30%

40%

50%

9.4% 8.9%

Used the ER because:Emergency Situation = 64.9%Weekend/After Hours = 19.7%Access Problems = 10.4%

2007 2011 2014

7.4% 6.5%9.4%

Lee County TrendLee County At-Risk

Higher among:

• Residents of Market Area 1 (16.5%) or Market Area 2 (14.2%)


• Adults age 18-39 = 14.2%



Have Visited a Dentist orDental Clinic Within the Past Year

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 30]

● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services. Healthy People 2020. December 2010.

http://www.healthypeople.gov [Objective OH-7]● Behavioral Risk Factor Surveillance System Survey Data.

Atlanta, Georgia. United States Department of Health and Human Services, Centers for

Disease Control and Prevention (CDC): 2012 Florida data.


MarketArea 1

MarketArea 2

MarketArea 3

MarketArea 4

LeeCounty

FL US0%

20%

40%

60%

80%

100%

66.7%

47.3%

56.7%

81.9%

65.3%59.8%

65.9%

Healthy People 2020 Target = 49.0%...

2007 2011 2014

65.2% 66.7% 65.3%

Lee County Trend

Dental insurance coverage is low (54.6% vs. 65.6% nationally), although

it has improved since 2007.



Have Visited a Dentist orDental Clinic Within the Past Year

(Lee County, 2014)

Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 30]

● US Department of Health and Human Services. Healthy People 2020. December 2010.

http://www.healthypeople.gov [Objective OH-7]Notes: ● Asked of all respondents.

● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g.,

“White” reflects non-Hispanic White respondents).● Income categories reflect respondent's household

income as a ratio to the federal poverty level (FPL) for their household size. “Low Income”

includes households with incomes up to 200% of the federal poverty level; “Mid/High Income”

includes households with incomes at 200% or more of the federal poverty level.

0%

20%

40%

60%

80%

100%

64.1% 66.5%

58.4%

66.2%70.1%

42.4%

75.6%70.0%

36.8%

55.2%

78.2%

51.5%

65.3%

Healthy People 2020 Target = 49.0%...

Among kids, utilization is low (72.1% have had dental care in the

past year, versus 81.5% nationally).




Chronic Disease Management

Chronic Disease

Diabetes

Respiratory Disease

Cancer

Heart Disease & Stroke



Prevalence of Diabetes

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 207]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human

Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data.

Notes: ● Asked of all respondents. ● Local and national data exclude gestation diabetes (occurring only during pregnancy).

MarketArea 1

MarketArea 2

MarketArea 3

MarketArea 4

LeeCounty

FL US0%

10%

20%

30%

40%

50%

11.2%

14.9%

10.7% 11.7% 12.0% 11.4% 11.7%

Another 7.6% of adults report that they have been diagnosed with “pre-diabetes” or “borderline”

diabetes( higher than the 5.1% found

nationwide)

2007 2011 2014

12.5% 13.5%12.0%

Lee County Trend



Prevalence of Diabetes(Lee County, 2014)


● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents).● Income categories reflect respondent's household income as a ratio to the federal poverty level (FPL) for their household size. “Low Income” includes

households with incomes up to 200% of the federal poverty level; “Mid/High Income” includes households with incomes at 200% or more of the federal poverty level. ● Excludes gestation diabetes (occurring only during pregnancy).


Mid/HighIncome


0%

10%

20%

30%

40%

50%

13.3%10.8%

3.8%

13.0%

18.9%

13.4%10.4%

12.3%

21.4%

5.9%

12.0%

Of those who are not diabetic, 60.9% have had their blood sugar level tested

in the past 3 years (better than US, 49.2%).



Adult Asthma

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 161]● 2013 PRC National Health Survey, Professional Research Consultants, Inc.● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department

of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2012 Florida data.Notes: ● Asked of all respondents.

● Includes those who have ever been diagnosed with asthma, and who report that they still have asthma.

LeeCounty

FL US0%

10%

20%

30%

40%

50%

7.9% 8.2% 9.4%

Childhood Asthma(Among Parents of Children Age

0-17)

Lee County US0%

10%

20%

30%

40%

50%

4.1%7.1%

statistically similar to FL/US; no significant trend statistically similar to US; no significant trend

Lee County At-Risk

Statistically higher among:


• Favorably low in Market Area 4

10.2% of county residents have COPD, just above statewide prevalence, similar to US.



Prevalence of Heart Disease


Notes: ● Asked of all respondents.● Includes diagnoses of heart attack, angina or coronary heart disease.

LeeCounty

US0%

10%

20%

30%

40%

50%

10.1%

6.1%

Prevalence of Stroke

LeeCounty

FL US0%

10%

20%

30%

40%

50%

3.9% 3.1% 3.9%

Lee County At-Risk

Statistically higher among:

• Residents age 65+ = 21.5%

• Market 4 residents = 14.8%



Prevalence of Skin Cancer




LeeCounty

FL US0%

10%

20%

30%

40%

50%

14.4%

8.3%6.7%

Lee County At-Risk

Statistically higher in:

• Market 4 = 20.1%

Prevalence of Cancer (Other Than Skin

Cancer)

LeeCounty

FL US0%

10%

20%

30%

40%

50%

9.2%7.2% 7.1%




Behavioral Health

Behavioral Health

Mental Health Status

Depression

Mental Health Treatment

Suicide

Alcohol/Drug Use

Alcohol/Drug Treatment



Experience “Fair” or “Poor” Mental Health



2007 2011 2014

9.2%10.8%

13.8%

Lee County Trend

LeeCounty

US0%

10%

20%

30%

40%

50%

13.8%11.9%

33.5% “Excellent”32.2% “Very Good” Lee County At-Risk

Higher among:


• Adults age 18-39 (17.4%) or age 40-64 (15.3%)

• Most favorable in Market Area 4



Have Experienced Symptoms of Chronic Depression

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 119] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc.Notes: ● Asked of all respondents.

● Chronic depression includes periods of two or more years during which therespondent felt depressed or sad on most days, even if (s)he felt okay sometimes.

2007 2011 2014

25.2% 27.3%32.4%

Lee County Trend

LeeCounty

US0%

20%

40%

60%

80%

100%

32.4% 30.4%

17.4% of Lee County adults have been diagnosed with a depressive disorder

by a physician.

Lee County At-Risk

Chronic depression affects:

• 51.9% of low-income residents (<200% FPL)

• ≈35% of adults <65

• Most favorable in Market Area 4



Suicide: Age-Adjusted Mortality(2008-2010 Annual Average Deaths per 100,000 Population)

Sources: ● CDC WONDER Online Query System. Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Public Health Surveillance and Informatics.

Data extracted March 2014.● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective

MHMD-1]Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).

● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population.● Local, state and national data are simple three-year averages.

Lee County Florida US0

10

20

30

40

50

16.114.2

11.7

Healthy People 2020 Target = 10.2...

higher in non-Hispanic Whites



Suicide: Age-Adjusted Mortality Trends(Annual Average Deaths per 100,000 Population)


Data extracted March 2014.● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective

MHMD-1]Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).

● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population.● Local, state and national data are simple three-year averages.

2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-2010 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-2010

Healthy People 2020

10.2 10.2 10.2 10.2 10.2 10.2 10.2 10.2

Lee County

14.1 14.9666666666667

15.7666666666667

16.7 16 15.6666666666667

15.1666666666667

16.1

Florida

13.2666666666667

13.1333333333333

12.8666666666667

12.7666666666667

12.8333333333333

13.3 13.9666666666667

14.2

US

10.8 10.8666666666667

10.8666666666667

10.9 11.0333333333333

11.2666666666667

11.5666666666667

11.7333333333333

3

8

13

18

23



Member of Household Sought Mental Health Services in the Past Year

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Items 26-27]


Lee County 2007

Lee County 2011

Lee County 2014

0%

20%

40%

60%

80%

100%

10.3% 11.6% 9.8%

Among All HouseholdsMember of Household Sought Care

Note that 76.5% of Lee County adults diagnosed with a depressive disorder have ever sought help

for mental health (US=76.6%).

Lee County 2007

Lee County 2011

Lee County 2014

0%

20%

40%

60%

80%

100%

85.0% 84.3% 86.1%86.0%81.7% 84.8%

Among Those Seeking Mental Health Services:Able to Receive Needed Svcs

Received Svcs in Lee County



Cirrhosis/Liver Disease: Age-Adjusted Mortality

(2008-2010 Annual Average Deaths per 100,000 Population)


Data extracted March 2014.● US Department of Health and Human Services. Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-11]

Notes: ● Deaths are coded using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). ● Rates are per 100,000 population, age-adjusted to the 2000 U.S. Standard Population.● Local, state and national data are simple three-year averages.


10

20

30

40

50

11.1 10.5 9.2

Healthy People 2020 Target = 8.2 or Lower

Drug-Induced Deaths: Age-Adjusted Mortality

(2008-2010 Annual Average Deaths per 100,000 Population)


10

20

30

40

50

18.1 17.2

12.6

Healthy People 2020 Target = 11.3 or Lower

Lee County Trend: Historically comparatively high, but not increasing

as sharply as FL/US rates.

Lee County Trend: Relatively stable over the past decade.



Binge Drinkers

Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 192]

● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States

Department of Health and Human Services, Centers for Disease Control and Prevention (CDC):

2012 Florida data.● 2013 PRC National Health Survey, Professional Research

Consultants, Inc.● US Department of Health and Human Services. Healthy

People 2020. December 2010. http://www.healthypeople.gov [Objective SA-14.3]

Notes: ● Asked of all respondents.● Binge drinkers are defined as men having 5+ alcoholic

drinks on any one occasion or women consuming 4+ drinks on any one occasion.

LeeCounty

FL US0%

20%

40%

60%

80%

100%

18.9% 16.5%19.5%

Healthy People 2020 Target = 24.4% or Lower

2007 2011 2014

12.5%17.5% 18.9%

Lee County TrendLee County At-Risk

Binge drinking is higher among:

• Adults age 18-39 = 29.3%


• Mid/High-income residents (200%+ FPL) = 23.8%

• Men = 23.6%

A total of 2.7% of county adults acknowledge using an illicit drug in the

past month (similar to US).



Have Ever Sought Professional Helpfor an Alcohol/Drug-Related Problem



2007 2011 2014

3.1% 3.4% 2.8%

Lee County Trend

MarketArea 1

MarketArea 2

MarketArea 3

MarketArea 4

LeeCounty

US0%

10%

20%

30%

40%

50%

1.7%3.4%

0.2%

5.3%2.8%

4.9%




Public Awareness of Services

Public Awareness of Services

Attendance at Health Events

Healthy Lee Initiatives

Choose, Commit, Change!



Participated in a HealthPromotion Activity in the Past Year



LeeCounty

US0%

20%

40%

60%

80%

100%

14.3%

23.8%

2007 2011 2014

13.2%17.2%

14.3%

Lee County Trend

Lower among:

• Adults age 65+ = 9.1%

• Men = 10.7%




Have Heard of Healthy Lee Community Initiatives(Lee County, 2014)






Mid/HighIncome


0%

10%

20%

30%

40%

50%

8.7%

13.0%

6.1%

14.1%10.8%

7.1%

12.2% 11.0%12.5%

7.9%10.9%

statistically similar by geography



Have Heard the “Choose, Commit, Change!” Message(Lee County, 2014)






Mid/HighIncome


0%

10%

20%

30%

40%

50%

6.1%

11.3%

5.2%

10.6%8.6% 8.2%

9.6% 8.9%

12.3%

6.6%8.8%

statistically similar by geography



Healthy Lee Has Impacted Lifestyle Choices(Among Adults Who Have Heard of Healthy Lee Community Initiatives or the

Healthy Lee “Choose, Commit, Change!” Message; Lee County, 2014)

Sources: ● 2014 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 194]Notes: ● Asked of respondents who have heard of either Healthy Lee Community Initiatives or the Healthy Lee “Choose, Commit, Change!” message.

Yes 28.8%

No 71.2%



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