Health Assessment Part Ii (data Mining By Center For Small Towns)

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Health Assessment Part II (Data mining by Center for Small Towns) A community health assessment provides an overview of a region's population characteristics, social and economic factors, and health outcomes. The purpose of this community health assessment is to collect and analyze data in a way that educates and mobilizes communities to identify health priorities, enabling them to leverage resources and create a plan of action to improve the community's health. This report was accomplished through collection and analysis of data from a range of sources available at a community and county level. This portion of the community health assessment identifies areas where there is a lack of health, in the form of rate of death and disability from disease and injury. Leading Causes of Death and Mortality in Minnesota In the line chart shown below, the age adjusted death rate per 100,000 individuals is tracked from 1991 to 2010. The Horizon Community Health Region has remained lower in cancer death rate compared to Minnesota as a whole, and the rates for both Minnesota and the Horizon Community Health Region has declined throughout the years. Likewise, there has been a decrease in death due to heart disease in both Minnesota and the Horizon Community Health Region throughout the years. The difference between the Horizon Community Health Region and Minnesota has been decreasing; in 1991-1995 there was an age-adjusted death rate difference of 22 deaths between the region and Minnesota, and in 2006-2010 the difference in age-adjusted death rate declined to nine deaths. The death rate for strokes has also slightly declined throughout the years and the Horizon Community Health Region rate of death caused by strokes has remained lower than the state of Minnesota throughout the past few decades by an average of 5 deaths per 100,000 residents. Leading Causes of Death in Minnesota Age Adjusted Death Rate 300.0 MN - Cancer 250.0 Horizon - Cancer 200.0 MN - Heart Disease 150.0 Horizon - Hearth Disease MN - Stroke 100.0 50.0 Horizon - Stroke 0.0 1991-1995 1996-2000 2001-2005 2006-2010 Source: Minnesota Department of Heath, Center for Heath Statistics 1 The following tables describe the leading causes of death by age group from 2003 – 2010. Cancer, heart disease, and stroke are the leading causes of death in Minnesota through the years 2003 to 2010. This trend is similar for the Horizon Community Health Region –heart disease, cancer and stroke top the list of the leading causes of death through the years 2003 and 2010. Leading causes of death by age group: 2003-2010 Source: Minnesota Department of Health, Center for Health Statistics Age Groups Minnesota Cause AIDS/HIV Alzheimer's Disease Atherosclerosis Cancer Cirrhosis Congenital Anomalies Chronic Lower Respiratory Disease Diabetes Heart Disease Homicide Hypertension Nephritis Perinatal Conditions Pneumonia and Influenza Septicemia SIDS Stroke Suicide Unintentional Injury Other Total 0-4 1 0 0 64 1 833 10 2 61 64 0 13 1,238 41 18 272 26 0 315 427 3,386 5-14 0 0 0 121 0 51 13 6 24 24 0 5 10 8 3 0 10 53 256 162 746 15-24 4 1 0 215 7 53 19 15 109 303 2 7 6 10 9 1 31 687 1,527 389 3,395 45-64 198 133 46 18,231 1,545 257 1,489 1,666 8,277 175 390 472 3 368 426 0 1,466 1,582 3,430 7,921 48,075 65-74 26 453 60 17,423 512 65 3,095 1,639 7,364 27 514 700 1 395 388 0 1,919 233 1,097 7,400 43,311 75+ 2 9,854 588 35,882 509 114 10,472 5,456 43,761 23 2,849 4,705 3 4,698 1,477 0 14,316 317 6,276 49,505 190,807 All Ages 400 10,426 697 73,937 2,884 1,508 15,193 9,043 60,863 977 3,789 5,972 1,264 5,609 2,399 273 18,027 4,457 15,776 67,757 301,251 Age Groups Horizon Comm. Health Region Cause AIDS/HIV Alzheimer's Disease Atherosclerosis Cancer Cirrhosis Congenital Anomalies Chronic Lower Respiratory Disease Diabetes Heart Disease Homicide Hypertension Nephritis Perinatal Conditions Pneumonia and Influenza Septicemia SIDS Stroke Suicide Unintentional Injury Other Total 25-44 167 1 2 2,006 311 137 99 262 1,275 361 36 65 2 91 80 0 253 1,592 2,872 1,919 11,531 0-4 0 0 0 1 0 6 1 0 1 2 0 0 12 0 0 7 0 0 1 3 34 5-14 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5 3 10 15-24 0 0 0 8 0 0 0 0 1 1 0 0 0 0 0 0 0 5 26 9 50 25-44 0 0 0 21 3 2 1 3 13 1 0 1 0 0 2 0 3 22 45 21 138 45-64 4 1 2 259 13 3 19 10 118 2 4 3 0 6 6 0 24 12 38 84 608 65-74 1 10 2 294 6 1 46 18 150 0 9 10 0 7 9 0 34 3 12 104 716 75+ 0 218 17 745 9 3 193 114 1,138 1 49 82 0 132 34 0 318 4 103 888 4,048 All Ages 5 229 21 1,326 32 15 259 146 1,421 8 62 95 12 145 51 7 379 47 232 1,111 5,603 2 Cancer As of 2010, cancer was the leading cause of death in Minnesota and the second leading cause of death in the Horizon Community Health Region. Cancer can be caused by both external factors (tobacco, infectious organisms, chemicals, and radiation) and internal factors (inherited mutations, hormones, immune conditions, and mutations that occur from metabolism). It can be caused from a single factor or a variety of factors mentioned above. The American Cancer Society estimates there will be 28,000 new cases of selected cancers and 10,000 deaths from selected cancers in the year 2013 within Minnesota.1 The Minnesota Department of Health states within its Statewide Health Assessment, "According to the American Cancer Society, the risk of death from cancer is influenced by poverty more than by race. People in poverty are more likely to smoke and to be obese, two major risk factors for cancer. In addition, poverty may expose people to unhealthy environments, limit awareness of health promotion messages and lead to seeking medical care at a later stage of illness, when treatment options are limited and the potential for death is much higher."2 Breast cancer is the most common cancer found in women. According to the National Breast Cancer Foundation, 1 out of 8 women will be diagnosed with breast cancer within their lifetime.3 Luckily, with early detection and treatment, most people will continue a normal life. Graphs shown below identify 15 percent of cancer deaths were due to breast cancer within Minnesota from 2000 to 2008. The Horizon Community Health Region averaged 13 percent of cancer deaths that were attributed to breast cancer. In Stevens County, six percent of cancer deaths were attributed to breast cancer in 2000 to 2002;thatincreased to seven percent in 2003 to 2005 and jumped to 27 percent in 2006 to 2008. The apparent sudden increase represents an increase in the total number of women who died due to breast cancer – from two in 2000-2002 to seven in 2006-2008. . Traverse County on the other hand has seen a decrease in the percent of deaths due to breast cancer with zero deaths in the years 2006-2008. Colon and rectal cancer have remained at a steady 10 percent of cancer deaths for Minnesota and the Horizon Community Health Region. Traverse County has the highest range of colon and rectal cancer deaths, ranging from five percent in 2003 to 2005 to 25 percent in 2006 to 2008. Once again, while looking at the actual number of deaths for men and women combined, in 2000-2002 there were 10 deaths due to colon and rectal cancer. In 2003-2005 there were two deaths, and in 2006-2008 there were 9 deaths. These numbers are small leaving the percentages to appear to be more drastic than in actuality. The percent of lung cancer deaths among men and women have remained pretty much constant; around 25 percent or one fourth of the total deaths by a certain type of cancer. According to the Center for Disease Control, prostate cancer is the most common cancer among men, regardless of race or ethnicity.4 Twelve percent of cancer deaths are attributed to prostate cancer in men in Minnesota and the Horizon Community Health Region as a whole. Overall, the percentage of deaths due to prostate cancer among men has declined. 3 Breast cancer deaths for women Colon and Rectal deaths for men and women 30.0% 25.0% 25.0% 20.0% 20.0% 15.0% 15.0% 10.0% 10.0% 5.0% 5.0% 0.0% 0.0% 2000-2002 2003-2005 2000-2002 2006-2008 2003-2005 2006-2008 2003-2005 2006-2008 Minnesota Horizon Douglas Grant Pope Stevens Traverse Lung cancer in men and women Prostate cancer in men 35.0% 25.0% 30.0% 20.0% 25.0% 15.0% 20.0% 15.0% 10.0% 10.0% 5.0% 5.0% 0.0% 0.0% 2000-2002 2003-2005 2006-2008 2000-2002 Source: Minnesota Department of Health, Minnesota Cancer Surveillance System *Percent = # diagnosed for county (or state) / total cancer cases for county (or state) 4 Obesity Obesity places people at a higher risk for a variety of chronic diseases and health conditions. The Minnesota Department of Health lists hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, depression, osteoarthritis, sleep apnea and respiratory problems, and even some cancers (endometrial, breast, and colon) as a few of the chronic diseases and health conditions one can obtain while being overweight or obese.5 Along with health effects, obesity can have social and emotional impacts as well. Children and teenagers can be teased or ostracized at school or among social groups. Adults can be discriminated in the workplace or in public. The charts below show that the percent of Minnesotans overweight or obese has risen throughout the years. Starting in 1995 50.6 percent of its total population was overweight or obese and it has risen to 63.1 percent in 2010 – a 12.5 percent increase. Based on Minnesota's population in 2010, an additional 662,000 individuals became overweight or obese within that 15 year span. Within the Horizon Community Health Region, the percentage of individuals overweight or obese is comparable to that of the state of Minnesota. Based on the population size of the Horizon Community Health Region in 2010, approximately 8,300 individuals became overweight or obese within the 15 year span. The chart showing the percent of Horizon residents overweight depicts a dramatic decrease since 2003. However, this is misleading due to the fact that between 2003 to 2005 overweight and obesity percentages were combined while in 2006 the two categories were separated. If the two charts were added together the percentages would show a similar increase as what was found for Minnesota as a whole. Stevens County has the smallest percentage of individuals overweight or obese when compared to Minnesota and the other neighboring counties. This could be due to the University of Minnesota, Morris being located within the county. The students of the University are counted as residents and many are athletes for the school or participate in intramurals or various sports related clubs. This is a factor that potentially explain the decreasing percentage of the individuals overweight or obese within Stevens County. The increase in the percentage of individuals becoming overweight or obese is partially due to the increase in the percentage of Minnesotans and Horizon Community Health Region members that report a lack of physical activity. In 2004, the average percentage of individuals not exercising was 16 percent or roughly 10,500 residents in the Horizon Community Health Region. Throughout the years, the percentage has risen slightly by one or two percent, and in 2010, the Horizon Community Health Region had a higher percentage of individuals not exercising than Minnesota as a whole. 5 % Horizon Residents Overweight % Horizon Residents Obese 26.0 65.0 25.5 60.0 25.0 55.0 24.5 50.0 24.0 45.0 23.5 40.0 23.0 35.0 22.5 30.0 22.0 2003 2004 2005 2006 2007 2008 2009 2006 2007 2008 2009 Minnesota Horizon Douglas Grant Pope Stevens Traverse % Horizon Residents Reporting No Exercise 20.0 19.0 18.0 17.0 16.0 15.0 14.0 2004 2005 2006 2007 2008 2009 Source: MN Department of Health, Behavioral Risk Factor Surveillance System 6 Obesity and overweight children are becoming a large issue across the country and the Federal Government has recently approved new regulations for healthy school lunches. As seen in the charts below, the Horizon Community Health Region compares similarly to Minnesota for the percentage of ninth and twelfth graders overweight, obese or feels overweight. However, there are some disparities when broken down by county. Based on the Minnesota Student Survey, Douglas County consistently has the lowest percentage of ninth and twelfth graders who are overweight, obese, or feel overweight. Pope and Grant counties have some of the highest percentages, while Stevens and Traverse counties fall between 10-15% of ninth and twelfth graders overweight, 6-10% of ninth and twelfth graders obese, and 20-25% of ninth and twelfth graders who feel overweight. 7 Percent 9th Graders Overweight (BMI)* 2007 2010 25 20 15 10 5 0 Minnesota Horizon Douglas Grant Pope Stevens Traverse Douglas Grant Pope Stevens Traverse Douglas Grant Pope Stevens Traverse Percent 9th Graders Obese (BMI)* 16 14 12 10 8 6 4 2 0 Minnesota Horizon Percent 9th Graders who Feel Overweight 35 30 25 20 15 10 5 0 Minnesota Horizon *(BMI) – According to their Body Mass IndexSource: MN Department of Health, Center for Health Statistics 8 Percent 12th graders Overweight (BMI)* 2007 2010 30 25 20 15 10 5 0 Minnesota Horizon Douglas Grant Pope Stevens Traverse Douglas Grant Pope Stevens Traverse Grant Pope Stevens Traverse Percent 12th Graders Obese (BMI)* 18 16 14 12 10 8 6 4 2 0 Minnesota Horizon Percent 12th Graders Who Feel Overweight 40 35 30 25 20 15 10 5 0 Minnesota Horizon Douglas *(BMI) – According to their Body Mass Index Source: MN Department of Health, Center for Health Statistics 9 The following table describes the breakdown of overweight and obesity among WIC participants in the state and the five counties within the Horizon Community Health region. Grant County had the highest percentage of overweight children aged two to five years receiving WIC with 20.2% while Traverse County had the highest percentage of obese children aged two to five years receiving WIC with 17.1% . Grant County also had the highest percentage of overweight or obese women (prepregnancy) receiving WIC with 60.6%. . However, the other counties were below the state percentage of 13.1%. Minnesota children aged two to five enrolled in WIC who are overweight or obese: 2010 2008-2010 Pediatric and Pregnancy Nutrition Surveillance 2 Infant and Child Health Children 2-5 years Maternal Health 2010 WIC Participants Unduplicated Counts1 Overweight3 Obese3 Ever Breastfed Women (Prepregnancy) - Overweight or Obese4 230,110 16.7 13.1 73.7 54.2 1,558 14.6 10.1 73.5 53.4 Grant 372 20.1 9.1 73.6 60.6 Pope 594 16.5 8.4 76.2 58.8 Stevens 506 14.3 11.2 81.9 57.4 Traverse 149 11.9 17.1 * * State of Minnesota Douglas 1 WIC Participants - Unduplicated Counts: The total number of pregnant, post-partum and nursing women, infants and children less than 5 years of age who received WIC vouchers. County level data are determined by combining unduplicated participants of all clinics within a county's boundaries. State total does not equal the sum of the counties because participants may move counties during the year. 2 Reporting period is January 1 through December 31. Excludes records with unknown data or errors Data in this report were prepared by the Centers for Disease Control and Prevention’s (CDC’s) Pediatric Nutrition Surveillance System and the Pregnancy Nutrition Surveillance System. The Minnesota-specific data depicted in this table represent the status of children participating in the MN WIC Program in 2008-2010. Trend data do not necessarily include the same children from one year to the next, and so should not be interpreted to reflect changes in individual children’s health status. Rather the changes reflect health status of the population over time. Infants and children participating in WIC come from families with limited resources. Only families with incomes at or below 185% of federal poverty (or eligible to receive benefits from another program with comparable income guidelines), are eligible for WIC services. All children participating in WIC are considered at nutritional risk. 3 Based on 2000 CDC growth chart percentiles for BMI-for-age for children 2 years of age and older. Overweight children are in the 85th to less than 95th percentile category and obese children are in the equal to or greater than 95th percentile category 4 Prepregnancy overweight - Based on 2009 IOM report "Weight Gain During Pregnancy": underweight (BMI <18.5), normal weight (BMI 18.5 to 24.9), overweight (BMI 25.0 to 29.0) Obese (BMI >30.0) For more data on WIC got to: www.health.state.mn.us/divs/fh/wic/localagency/infosystem/pednss/index.html 10 Sexually Transmitted Infections (STIs) Sexually transmitted infections (STIs), commonly referred to as sexually transmitted disease, are the most frequent reported communicable diseases in Minnesotavi. Three of the most common STIs have been charted below: chlamydia, gonorrhea, syphilis (All Stages). For Minnesota, the number of cases of chlamydia has increased by one half, with 10,000 cases in 2003 to 15,000 in 2010 as seen on the charts below. For the Horizon Community Health Region there also has been an increase in the number of reported cases of chlamydia. In 2003, there were 43 cases reported. Until 2010, the number of cases reported within the Horizon Community Health Region was always below 50 counts; however, in 2010 the number of reported cases of chlamydia increased to 72. Douglas County has the highest number of reported cases of chlamydia. In 2003, there were 20 cases reported and in 2010 there were 36 cases reported – an 80 percent increase in the last seven years. The second STI graphed was gonorrhea. In Minnesota, the number of reported cases of gonorrhea has declined. There has also been a decline of reported gonorrhea cases in the Horizon Community Health Region since a sudden increase in 2006 where there were seven counts. The county with the highest number of reported gonorrhea cases is Douglas County. It is also responsible for the sudden increase in the Horizon Community Health Region. The final STI graphed is syphilis. The number of cases includes all stages of the STI – neurosyphilis, primary, secondary, early latent, late latent, congenital and other. Syphilis, similar to chlamydia, is also rising in Minnesota. In 2003, the number of syphilis cases reported totaled 195; by 2010, the number of cases reported increase by roughly 200 percent to 347 cases. There are few syphilis cases reported with the Horizon Community Health Region. In fact, the only reports of syphilis were two cases in 2005 located in Pope County, and one case in 2009 in Douglas County. Source: Minnesota Department of Health, Acute Disease Epidemiology STIs in Minnesota 15,294 16,000 14,350 14,000 Number of Cases 12,000 11,601 12,187 12,935 14,186 13,412 10,714 10,000 Chlamydia 8,000 Gonorrhea 6,000 Syphilis - All Stages 4,000 3,202 2,957 3,481 3,303 3,459 3,036 2,302 2,119 2,000 0 2002 195 145 207 190 186 263 214 347 2003 2004 2005 2006 2007 2008 2009 2010 2011 11 STIs - Chlamydia in Horizon Area 90 80 70 60 50 40 30 20 10 0 Horizon Douglas 2003 2004 Grant 2005 2006 Pope 2007 2008 Stevens 2009 2010 Traverse 2011 STIs – Gonorrhea in Horizon Area 7 6 5 4 3 2 1 0 Horizon Douglas Grant Pope Stevens Traverse 12 Tick & Mosquito Transmitted Disease Minnesota, the land of 10,000 lakes, takes pride in the large number of lakes, rivers, and streams it possesses within its boundaries. It is also great for people who love the outdoors and the number of activities available to do recreational activities. Yet, these outdoor activities place people in danger and risk of diseases carried by insects. Most common are tick and mosquito-borne diseases. The number of cases of tick-borne disease has increased dramatically over the last ten years. Three main tick-borne diseases were tracked; Lyme disease, anaplasmosis, and babesiosis. With the large amount of water located within the state, Mosquitoes are a critical carrier of diseases. There were no cases of mosquito-borne disease reported until 2002. There was a sudden spike in the number of cases in 2002 and 2003. The following year the number of cases dropped but began to rise and peak again in 2007. Since 2007, the number of mosquito-borne disease in Minnesota and west central Minnesota has decreased and appears to be under control again. The number of Lyme disease cases in Minnesota has tripled within the last ten years from 465 cases to 1293 cases as shown in the charts below. The number of cases in west central Minnesota, where Horizon Community Health Region is located, has increased significantly over the last ten years. In 2000, two cases were reported and by 2010 there were 46 cases reported. Similar to Lyme disease, anaplasmosis has increased significantly. In west central Minnesota, there was one case reported in 2003 and by 2010 there were 34 cases reported. For babesiosis, it has remained fairly constant ranging from zero to 3 cases each year. However, in the state of Minnesota the case numbers have started to increase and have nearly tripled over the last four years. Source: Minnesota Department of Health - Infectious Disease Epidemiology, Prevention and Control Division Mosquito-borne disease in Minnesota: 1997-2010 148 140 Minnesota West Nile Number of Cases 120 West Central West Nile 101 100 80 65 60 48 45 32 40 1998 1999 2000 2001 2002 15 4 1 1997 32 14 10 20 34 2003 2004 2005 2006 2007 10 4 3 2 2008 2009 8 2010 13 Tick-borne disease in Minnesota 1400 1293 1239 1200 1065 Number of Cases 1023 918 1000 913 1050 867 800 720 473 600 465 461 400 322 139 200 0 2000 186 2002 2003 2004 2005 317 176 78 2001 278 18 24 29 31 56 2006 2007 2008 2009 2010 Lyme Disease Anaplasmosis Babesiosis Tick-borne disease in West Central Minnesota 50 46 45 38 Number of Cases 40 40 34 35 29 30 29 27 25 18 20 15 10 10 5 2 0 2000 5 2 2001 2002 5 10 5 5 1 2 0 1 1 0 3 2 2003 2004 2005 2006 2007 2008 2009 2010 14 Unintentional Deaths The Minnesota Department of Health states, "Injury is the leading cause of death for children and young adults in Minnesota, but deaths are a small proportion of the impact of injury. For every one injury death, there are three severe traumas (including brain and spinal cord injuries), ten other hospitalized injuries, and 100 injuries that result in emergency department treatment only."2 In the Horizon Community Health Region there were steadily eight to ten deaths per year due to unintentional injuries for people 20 years of age or older, as can be seen on the chart below. For those under 20 years of age, there were zero to 3 deaths per year. The number of fatal falls in the Horizon Community Health Region has increased over the last few years. However, in 2009 the increased number of fatal falls peaked and declined in 2010. Douglas County has the highest number of fatal falls compared to the other four counties. Source: Minnesota Department of Health, Center for Health Statistics Number of Unintentional Injury Deaths in Horizon Community Health Region 40 35 30 25 Over 20 Years Old 20 Under 20 Years Old 15 10 5 0 2003 2004 2005 2006 2007 2008 2009 2010 Number of Fatal Falls 14 12 10 8 6 4 2 0 Horizon Douglas 2003 2004 Grant 2005 2006 Pope 2007 2008 Steven 2009 Traverse 2010 15 Motor Vehicle Injury Motor Vehicle Injury rates are declining in Minnesota, yet within the Horizon Community Health Region they have remained fairly constant as shown in the charts below. Douglas and Stevens County have declined in the motor vehicle fatalities per 100,000 residents in 2011 by one third of their initial rate in 2007. Douglas has had the most significant decline from nine fatalities in 2007 to one fatality per 100,000 residents in 2011. Stevens declined from three to one fatality. Pope County has declined from 2 to 1 deaths every year and Grant County rate has remained the same rate of 16 (estimated one death per year). Traverse County had zero motor vehicle fatalities from 2007 to 2011. Source: MN Department of Health, Center for Health Statistics Minnesotans Aged Under 20 Horizon Residents Age Under 20 Minnesotans Aged 20+ 600 12 500 10 400 8 300 6 200 4 100 2 0 Horizon Residents Age 20+ 0 2003 2004 2005 2006 2007 2008 2009 2010 2003 2004 2005 2006 2007 2008 2009 2010 Number of motor vehicle fatalities in Horizon Community Health Region Horizons Douglas Grant Pope Stevens Traverse 14 12 10 8 6 4 2 0 2003 2004 2005 2006 2007 2008 2009 2010 16 Suicide In 2010, 11 out of every 100,000 Minnesota residents committed suicide. Among the Horizon Community Health Region there were six suicides in 2010 – 9 per 100,000 population. These facts can be seen on the charts below. From 2003 to 2010, Grant County had the highest rate of suicides – 10 per 10,000 residents while the other counties rates of suicide were as follows: Stevens (9), Pope (6), Douglas (6), and Traverse (6) per 10,000 residents. Source: Minnesota County Health Tables, Minnesota Student Survey Number of Suicides in Minnesota MN - Under 20 Number of Suicides in Horizon Comm. Health Region MN - 20+ Horizons - Under 20 Horizons - 20+ 10 600 9 500 8 7 400 6 5 300 4 200 3 2 100 1 0 0 2003 2004 2005 2006 2007 Horizons 2008 Douglas 2009 2003 2010 Grant Pope 2004 Stevens 2005 2006 2007 2008 2009 2010 Traverse 10 9 Number of Suicides 8 7 6 5 4 3 2 1 0 2003 2004 2005 2006 2007 2008 2009 2010 17 Among sixth, ninth and twelfth graders in Minnesota and the Horizon Community Health Region there has been a decline in the percent of students with suicidal thoughts within the last year as can been seen in the charts below. The Horizon Community Health Region has had a stronger decrease in the percentage of students who have attempted suicide within the last year compared to Minnesota. Percent of Minnesota 6th, 9th, and 12th graders with suicidal thoughts 6th Graders 9th Graders Percent of Horizon 6th, 9th, and 12th graders with suicidal thoughts 12th Graders 6th Graders 25 30 20 25 9th Graders 12th Graders 20 15 15 10 10 5 5 0 0 1998 2001 2004 2007 2010 Percent of Minnesota 6th, 9th, and 12th graders who attempted suicide within the last year 6th Graders 9th Graders 1998 2001 2004 2007 2010 Percent of Horizon 6th, 9th, and 12th graders who attempted suicide within the last year 12th Graders 6th Graders 10 10 9 9 8 8 7 7 6 6 5 5 4 4 3 3 2 2 1 1 9th Graders 12th Graders 0 0 1998 2001 2004 2007 2010 1998 2001 2004 2007 2010 18 1998 2001 2004 2007 2010 Percent 6th Graders with suicidal thoughts 20 15 10 5 0 Horizon Douglas Grant Pope Stevens Traverse Grant Pope Stevens Traverse Grant Pope Stevens Traverse Percent 9th with suicidal thoughts 35 30 25 20 15 10 5 0 Horizon Douglas Percent 12th Graders with suicidal thoughts 30 25 20 15 10 5 0 Horizon Douglas 1998 2001 2004 2007 2010 19 1998 2001 2004 2007 2010 Percent of 6th Graders Who Attempted Suicide Within The Last Year 8 7 6 5 4 3 2 1 0 Horizon Douglas Grant Pope Stevens Traverse Stevens Traverse Stevens Traverse Percent of 9th Graders Who Attempted Suicide Within the Last Year 14 12 10 8 6 4 2 0 Horizon Douglas Grant Pope Percent 12th Graders Who Attempted Suicide Within the Last Year 7 6 5 4 3 2 1 0 Horizon Douglas 1998 Grant 2001 Pope 2004 2007 2010 20 Mental Illness Serious mental illness, such as schizophrenia, schizoaffective disorder, and bipolar affective disorder, can significantly increase mortality. Individuals with serious mental illness die an average of 25 years earlier than those without.29 This holds true in Minnesota, as well: a study of Minnesotans receiving services through Minnesota Health Care Programs found that Minnesotans with serious mental illness do not live past an average age of 58, while those without mental illness live to an average age of 82.30 Serious mental illness has other important influences on health: individuals with serious mental illnesses are more likely to experience homelessness, uninsurance, and a lack of social support. The difficulty of changing behaviors such as smoking or alcohol use in persons with serious mental illnesses is compounded by their mental status and these life circumstances. Over 8 percent of Minnesota’s adult population—or about 350,000 Minnesotans—experienced significant depressive symptoms in 2011; and 3 percent (about 125,000) had symptoms of suggestive of serious psychological distress (although these groups are not mutually exclusive). 31 Vulnerable Adult Abuse Vulnerable adults include the elderly and adults of all ages with physical or mental disabilities, whether living at home or being cared for in a health facility. Abuse and maltreatment of vulnerable adults can include physical, emotional, or sexual abuse; caregiver neglect; self-neglect; and financial exploitation. Below are the number of total reports taken by Minnesota Department of Human Services for Adult Protection. Source: Minnesota Department of Human Services, Social Services Information System Vulnerable Adult Adult protection report victims in Minnesota: Douglas Grant Pope Stevens Traverse 30 Total Reports 25 20 15 10 5 0 2010 Q 1 Q2 Q3 Q4 2011 Q1 Q2 Q3 Q4 2012 Q1 Q2 Q3 Q4 21 Youth Violence There has been a decline in the number of students who have hit or beat up another person one or more times in the last year in Minnesota and the Horizon Community Health Region. Sixth and Ninth graders are more likely to hit or beat up another person compared to twelfth graders as shown in the charts below. Each county has seen a percentage decrease in the number of sixth and ninth graders who hit or beat up another person since 2004. Throughout all grades and years, Grant County consistently has the highest percentage. Minnesota 6th, 9th, and 12th Graders who have hit or beat up another person 6th Graders 9th Graders 12th Graders 40 35 Percent 30 25 20 15 10 5 0 1998 2001 2004 2007 2010 Horizon 6th, 9th, and 12th Graders who have hit or beat up another person 6th Graders 9th Graders 12th Graders 40 35 Percent 30 25 20 15 10 5 0 1998 2001 2004 2007 2010 22 2004 2007 6 Graders who have hit or beat up another person 2010 th 50 45 40 35 Percent 30 25 20 15 10 5 0 Horizon Douglas Grant Pope Stevens Traverse 9th Graders who have hit or beat up another person* 45 40 35 Percent 30 25 20 15 10 5 0 Horizon *No data for Traverse County Douglas Grant Pope Stevens Pope Stevens Percent 12th Graders who hit or beat up another person* 25 Percent 20 15 10 5 0 Horizon Douglas *No data for Traverse County and for Stevens County in 2010 2004 Grant 2007 2010 23 From the Text 1 American Cancer Society, Midwest Division. (2013). Minnesota cancer facts and figures: 2013. Retrieved from http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036845.pdf 2 Minnesota Department of Health. (2012). The Health of Minnesota, Statewide Health Assessment: Part Two. Retrieved from http://www.health.state.mn.us/healthymnpartnership/sha/docs/1205healthofminnesotasupp.pdf 3 National Breast Cancer Foundation, Inc. (2012). Breast Cancer Facts. Retrieved from http://www.nationalbreastcancer.org/breast-cancer-facts. 4 Centers for Disease Control and Prevention. (2010). Prostate Cancer. Retrieved from http://www.cdc.gov/cancer/prostate/basic_info/fast_facts.htm 5 Minnesota Department of Health, Heart Disease and Stroke Prevention Unit. Overweight and obesity prevention: The importance of a healthy weight. Retrieved March 12 2013 from http://www.health.state.mn.us/divs/pcd/chp/cdrr/obesity/heathyweights.html vi Minnesota Department of Health. Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). Retrieved March 12 2013 from http://www.health.state.umn.us/divs/idepc/disease/hiv/index.html 24