How Healthy Are We?

COBB COUNTY 2014 ANNUAL REPORT CARD

IntroductionEstablished in 1920, Cobb and Douglas Public Health (CDPH) is a health district (District 3-1) serving two metropolitan counties in Georgia and a population of nearly 900,000. The core functions of public health are to inform, prevent and protect in order to assure the well-being of our community and our residents.

With more than 30 distinct programs, we remain committed to our mission, which is:

Cobb & Douglas Public Health, with our partners, promotes and protects the health and safety of the residents of Cobb and Douglas counties.

We work to achieve healthy people in healthy communities by: Preventing epidemics and spread of disease

Protecting against environmental hazards

Preventing injuries

Promoting and encouraging healthy behaviors

Responding to disasters and assisting in community recovery

Assuring the quality and accessibility of health care

By excelling at our core responsibilities, we will achieve healthier lives and a healthier community.

By 2020, Cobb & Douglas Public Health will be an acknowledged leader among health departments in the United States.

In order to continuously improve our effectiveness and the health of our people and communities, we will work internally and with our community partners to:

In order to continuously improve our effectiveness and the health of our people and communities, we will work internally and with our community partners to:

• Demonstrate significant improvement on key health and safety indicators• Achieve operational excellence by exceeding local public health system performance expectations• Champion workforce enhancement

To achieve these ambitious goals, we will engage, respect and value our staff and partners, thereby creating healthier lives and a healthier community.

Cobb and Douglas Public Health (CDPH) staff designed the How Healthy Are We? Annual Report Card, Cobb County 2014 as a brief update to several more thorough Cobb County Community Health Assessments completed from 2010-2012. Please visit www.cobb2020.com for more information.

This health report card outlines the leading causes of death and infectious diseases. It presents trend and comparison data for Cobb County residents, including leading causes of death, children’s health issues, infectious and chronic diseases, and access to quality healthcare. The contents of this report represent information we use to assess our community’s current and future health needs. We hope it provides you with valuable information regarding the health of the community in which we live, work and play.

Below are highlights from the report:

Highlights

POPULATIONThe population of Cobb County continues to

moderately grow (4.5% from 2009-2013) and has a large percentage of youth.

Sixty-two percent of the population is under the age of 45.

ACCESS TO CARE Residents must have access to healthcare

(facilities and providers) in order to be healthy.

It is estimated that 18.6% of residents in Cobb County lack health insurance. This is higher than

the U.S. rates.

Cobb County has approximately 181 physicians per 100,000 residents. This is lower than the

Georgia rate, creating an access to health care issue in the county.

LEADING CAUSES These are the specific leading causes of illness, hospitalization and death in the county:

Heart and vascular disease is the leading cause of death in Cobb County, followed by other mental and behavioral disorders and lung cancers.

Infant Mortality is decreasing in Cobb County reflecting a national trend and due to the work of many. Georgia has moved from 44th highest in the nation to 34th reflecting important improvements. There is a disparity in infant mortality, however. Among the black population infant mortality is triple that of the white population.

Obesity due to poor nutritional habits and lack of physical activity are a major factor in the leading causes of illness and death in Cobb County. In 2012, 58% of Cobb County adults reported being either overweight or obese. It is a significant public health concern for our community.

Georgia, like the rest of the Southeast, has some of the highest rates of Sexually Transmitted Diseases (STDs) in the country. According to the CDC, in 2012 Georgia was ranked 8th in the U.S. for Chlamydia, 5th in the U.S. for Gonorrhea, and 1st in the U.S. for Primary and Secondary Syphilis. This is also an issue that needs critical attention and solutions.

This document contains the most current verifiable information availablefrom federal, state and local sources. The data is prior to 2014 due tocollection and verification processes. This document contains the most current verifiable information available and verification processes.

Population by Age Cobb County, 2012

Douglas County’s population has

increased by 3.4% between 2008 and

2012. Within the same time period

there was an 11% increase in

black/African Americans and an 18%

29%

26%

10% 24%

0-17 YEARS OF AGE

9%

18-24 YEARS OF AGE25-44 YEARS OF AGE45-64 YEARS OF AGE65+ YEARS OF AGE

Approximately 62% of Cobb County’s population is under the age of 45 years.

Population, by Race and Ethnicity, Cobb County, 2009 and 2013

The total population of Cobb County has grown since 2009. Cobb County’s population increased by 4.5% between 2009 and 2013. The racial and ethnic makeup of Cobb County has remained the same since 2008.

The largest age group in Cobb County is between 25 and 44 years old, with a population of 210,105 persons.

*Source: Georgia Department of Public Health, Online Analytical Statistical Information System (OASIS)

WHITE

BLACK/AFRICAN AMERICAN

ASIAN/PACIFIC ISLANDER

AMERICAN INDIAN/ALASKA NATIVE

NATIVE HAWAIIAN OR PACIFIC ISLANDER

MULTIRACIAL

HISPANIC

NON-HISPANIC

462,821

173,317

30,956

3,256

538

13,888

82,116

602,660

469,626

191,823

35,255

3,575

471

16,440

90,668

626,522

2009

2009

2013

2013

684,776 684,776717,190 717,190

RACE

ETHNICITY

TOTAL TOTAL

Leading Causes of Death, Cobb County, 2008-2012:

Diseases of the Heart: The Number One Leading Cause of Death in Cobb County, 2008 - 2012

*Source: Georgia Department of Public Health: Online Analytical Statistical Information System (OASIS)

Heart and Vascular Disease continues to be the number one leading cause of death in adults in Cobb County, the state of Georgia and the United States. All other mental and behavioral disor-ders (including Dementia, Schizophrenia and Bipolar disorder) was the second leading cause of death in Cobb County between 2008 and 2012, followed by lung and related cancers, cerebro-vascular disease and Chronic Obstructive Pulmonary Disease (COPD).

The dashboard arrow indicates where Cobb County ranks compared to the State of Georgia.

Ischemic Heart and Vascular Disease

(1,556)

All COPD Except Asthma

(820)

CerebrovascularDisease(876)

GA GAGA

All Other Mental and Behavioral Disorders

(1,184)

GA

Malignant Neoplasms of the Trachea,

Bronchus and Lung(1,089)

GA

Rate = Infant (

The results of the 2013 Georgia Immunization Study indicate that the District 3-1 immunization coverage estimates for the 4:3:1:3:3:1:4* vaccination series is 85%. As of 2013, Cobb and Douglas counties have a 6% lower vaccination rate among 2 year olds compared to the state of Georgia. The importance of immunizations does not stop at 2 years old. Cobb & Douglas Public Health continues to stress the importance of childhood and adult vaccinations. Please visit http://www.cdc.gov/vaccines/acip/ for further information.

*4:3:1:3:3:1:4 Immunizations coverage considered fully immunized (a child has received 4 DTaP, 3 Polio, 1 MMR, 3 Hib, 3 Hepatitis B, 1 Varicella, and 4 PCV vaccine doses), were based on the childhood immunization and catch-up schedules recommended by the Advisory Committee on Immunization Practices.

Source: Georgia Department of Public Health, Georgia.

Currently in America, one in three children is overweight or obese. These numbers have tripled over the last 30 years, and if this trend continues, one third of all children born in the year 2000 or later will suffer from a chronic obesity-related health problem.

The Georgia Student Health and Physical Education (S.H.A.P.E.) Act was passed in 2009. Beginning in the 2011-2012 school year, the law required each local school district to conduct an annual fitness assessment program (FitGrams) for all students in grades 1-12 enrolled in classes taught by certified physical education teachers.

Students who fell within the healthy fitness zone scored higher in math and reading, had fewer discipline referrals and had better attendance.

We are Facing a Youth Obesity Epidemic in Cobb County

*Source: Cobb2020 FitGrams data, 2012

YEAR COBB AND DOUGLAS GEORGIA201 3 2012201 12010

Percent of Children 2 Years of Age Fully Immunized, 2010-2013 Cobb and Douglas counties have a lower percentage of fully immunized children 2 years of age than Georgia.

79%83%86%78%

85%85%82%76%

Childhood Obesity

CHILDREN’S HEALTH ISSUES

Motor vehicle crashes continue to be the leading cause of death among youth in Cobb County and the state of Georgia. Between 2008 and 2012 motor vehicle crashes accounted for 28% of deaths among youth in Cobb County. Suicide was the second leading cause of death in youth in Cobb County followed by homicide.

Motor Vehicle Crashes were the Number One Leading Cause of Death among Youth in Cobb County, 2008-2012

*Source: Georgia Department of Public Health, Online Analytical Statistical Information System (OASIS) Community Health Needs Assessment Dashboard

Leading Causes of Death in Youth

Rank 1-4 years 5-9 Years 10-14 Years 15-19 Years

2 Motor Vehicle Crashes Accidental All Other Diseases Intentional Self-Harm Drowning and of the Nervous System (Suicide) Submersion

1 Congenital Septicemia Leukemia Motor Vehicle Crashes Malformations, Deformations and Chromosomal Abnormalities

3 Leukemia All Other Diseases Congenital Malformations, Assault (Homicide) of the Nervous System Deformations and Chromosomal Abnormalities

4 All Other Diseases Motor Vehicle Crashes Intentional Self-Harm Accidental Poisoning of the Nervous System (Suicide) and Exposure to Noxious Substances

5 Accidental Malignant Neoplasms of Diabetes Mellitus All Other Diseases Drowning and Meninges, Brain and of the Nervous System Submersion Other Parts of the Cenral Nervous System

CHILDREN’S HEALTH ISSUES

In 2012, 58% of adults in Cobb County reported being either overweight or obese. The highest percentage of obesity in Cobb and Douglas counties is among the

black population at 45.8%. 22% of Cobb County adults reported being obese, 6% less than the 2011 average for the state of Georgia..

*Body Mass Index is a number calculated from a person’s weight and height. A BMI greater than 18.5 and less than 25 is considered healthy.

Approximately 12% of adults in Cobb County smoke, 9% below the 2011 state average for Georgia. Those that reported tobacco use in Cobb County tended to be male, have less education and have less income.

*Source: Douglas County MAPP Survey Report, A.L. Burruss Institute of Public Service and Research, 2011-2012; The Georgia Behavioral Risk Factor Surveillance Survey Report, 2012

*Source: Cobb County MAPP Survey Report, A.L. Burress Institute of Public Service and Research, 2011-2012; The Geor-gia Behavioral Risk Factor Surveillance Report, 2012.

Body Mass Index* of Adults, Cobb County, 2012

Smoking in Adults, Cobb County, 2012

Obesity

0.208

Underweight

Yes

Normal Weight

No

Overweight

Don’t Know/Refused

Obese

Tobacco

36.2%

35.1%28.5%

0.1%

87.10%

11.80%

1.10%

CHRONIC DISEASES

TOTAL MALE FEMALE WHITE BLACK 18-44 45-64 65+

COBB & 4.1% 3.2% 4.8% 4.7% 6.0% 3.2% 2.6% 12.2%DOUGLAS

GEORGIA 4.4% 5.2% 3.6% 5.2% 3.1% 0.9% 5.8% 13.8%

*Source: Georgia Department of Public Health, Online Analytical Statistical Information System (OASIS) Behavioral Risk Factor Surveillance System

Percent of Adults Who Have Had a Heart Attack, 2011

Heart Disease

CHRONIC DISEASES

In 2011, approximately 4.1% of adults suffered a heart attack in Cobb and Douglas counties. This rate is lower than the Georgia average; however, heart attacks are still a major concern in Cobb County. In Cobb and Douglas counties a higher percentage of the black population and 18-44 year old population reported having a heart attack compared to the Georgia average.

After adjusting for age in order to make Cobb County comparable to the state of Georgia, Cobb County had a lower death rate for cardiovascular disease. Cardiovascular disease, however, is the leading cause of death in Cobb County.

Age–Adjusted Death Rates* Due to Cardiovascular Disease, 2008-2012

Source: Georgia Department of Public Health, Online Analytical Statistical Information System (OASIS) Morbidity/Mortality Web Query Tool

*Rate = the number of cases per 100,000 population. Age adjusting rates is a way to make fairer comparisons between populations with different age distributions.

Georgia CobbCounty270

202.5

135

67.5

0

267.8 262.6 252.1242.5 233.3214.8 211.7 207.1

194.8176.8

2008 2009 2010 2011 2012

TOTAL MALE FEMALE WHITE BLACK 18-44 45-64 65+

COBB & 8.2% 7.8% 8.6% 8.6% 10.4% 3.9% 9.1% 23.5% DOUGLAS

GEORGIA 10.2% 9.8% 10.5% 10.1% 11.8% 2.8% 14.8% 25.9%

TOTAL MALE FEMALE WHITE BLACK 18-44 45-64 65+

COBB & 6.6% 2.6% 9.7% 7.1% 7.8% 7.7% 4.6% 7.4% DOUGLAS

GEORGIA 9.6% 7.5% 11.6% 9.8% 10.9% 10% 9.2% 9.3%

Adults Living with Diabetes, 2011

Prevalence of Adults Living with Asthma, 2011

Diabetes

Cobb and Douglas counties have a lower prevalence of asthma compared to the state of Georgia, which has a prevalence of 9.6%.

CHRONIC DISEASES

*Source: Georgia Department of Public Health, Online Analytical Statistical Information System (OASIS) Behavioral Risk Factor Sur-veillance System, The Georgia Behavioral Risk Factor Surveillance Report, 2012

*Prevalence = the number of cases of a disease/ condition in a population at a given time.*Source: Georgia Department of Public Health, Online Analytical Statistical Information System (OASIS) Behavioral Risk Factor Surveillance System, The Georgia Behavioral Risk factor Surveillance System Report, 2012

In 2011, 10.2% of adults in Georgia had ever been diagnosed with diabetes. This is slightly higher than the U.S. prevalence* of 9.5%. Cobb and Douglas counties have a combined prevalence slightly lower than the state prevalence.

Asthma

The occurrence of stroke within Cobb and Douglas counties was less than Georgia in 2011. Females and Whites, however, were more likely to have a stroke within Cobb and Douglas counties compared to other populations.

Percent of Adults Who have had a Stroke, 2011

*Source: Georgia Department of Public Health, Online Analytical Statistical Information System (OASIS) Behavioral Risk Factor Surveillance System, The Georgia Behavioral Risk Factor Surveillance Report, 2012

4

3

2

1

0

4

3

2

1

0

2.5%

3.4%

2.3%

2.8%

1.6%

3.5%3.3% 3.3%3.3%

3.9%

Stroke

COBB AND DOUGLAS GEORGIA

CHRONIC DISEASES

FEMALE FEMALEWHITE

WHITE

BLACK

BLACK

TOTAL

TOTAL

MALE

MALE

Georgia, like the rest of the Southeast, has some of the highest rates of Sexually Transmitted Diseases (STDs) in the country. According to the CDC, in 2012 Georgia was ranked:

8th Highest in the U.S. for chlamydia with a rate of 534 per 100,000

5th Highest in the U.S. for gonorrhea with a rate of 156.1 per 100,000

1stin the U.S. for primary and secondary syphiliswith a rate of 9.5 per 100,000

STD RANKINGS

Cobb County has averaged about 60 cases of primary and secondary syphilis per year since 2008.

*Rate = the number of cases per 100,000 population.**Source: Centers for Disease Control and Prevention, Sexually Transmitted Disease Surveillance 2011, Atlanta: U.S. Department of Health and Human Services, 2012

SYPHILLIS

COBB GEORGIA COBB GEORGIA CASES CASES RATES RATES

2008 74 912 10.9 9.6

2009 68 954 9.9 9.9

2010 50 778 7.2 8

201 1 53 860 7.6 8.8

2012 57 935 8.1 9.4

Sexually Transmitted DiseasesPrimary and Secondary Syphilis, 2008-2012

INFECTIOUS DISEASES

PERTUSSIS

2008 2009 2010 2011 2012

COBB 20 42 22 25 65 COUNTY

GEORGIA 116 230 247 180 330

Reported Pertussis Cases in Cobb County and Georgia, 2008-2012

*Rate = the number of cases per 100,000 population.

Source: Georgia Department of Public Health, Acute Disease Epidemiology Section

2008 2009 2010 2011 2012

10

7.5

5

2.5

0

Incidence Rates* of Pertussis are Increasing in Cobb County

COBBDOUGLASGEORGIA

Pertussis rates have increased significantly in Cobb County in recent years; nearly triple the rate for the state of Georgia in 2012. Pertussis is a vaccine preventable disease. Cobb & Douglas Public

Health recommends vaccinations to all age groups.

Percent of the Population without Insurance Coverage, 2013

Unintentional Injuries: Number One Reason for Emergency Room Visits, 2008 – 2012

Ratio of Persons to Physicians, 2010

Cobb County

Georgia

United States

Cobb County Georgia

18.6%

18.8%

489

14.6%

In the 2011-2012 Cobb County MAPP Survey Report, 15% of participants reported having to forgo a doctor’s visit in the past year due to cost. Those who reported having to delay care tended to be female, non-White, Hispanic, have less income and less education. The opposite was true for people who were 65 years old or older.

Cobb County has approximately the same percentage of uninsured individuals compared to the state of Georgia, but a higher percentage of uninsured individuals compared to the U.S. as a whole.

Unintentional injuries, not including falls, were the number one reason for emer-gency room visits in Cobb County between 2008 and 2012, with 95,084 cases total. The rate of emergency room visits for all other unintentional injuries in Cobb County falls below the rate for the state of Georgia..

All Other Unintentional Injury

(95,084)

All Other Diseases of the Genitourinary System

(52,462)

Motor Vehicle Crashes(28,770)

Diseases of the Musculoskeletal System and Connective Tissue

(52,685)

In Cobb County, the ratio of residents to physicians was 551 to 1, 13% worse than theGeorgia ratio (489 to 1).This contributes to the access to health care issue in the county.

*Source: Cobb County MAPP Survey Report, A.L. Burruss Institute of Public Service and Research, 2011-2012 Source: American Community Survey, 2013

*Source: Georgia Department of Public Health, Online Analytical Statistical Information System (OASIS) Community Health Needs Assessment Dashboard

*Source: UGA Georgia County Guide

Physicians to Population Ratio

Insurance Coverage

Emergency Room Visits, Cobb County 2008-2012

GAGA

GAGA

ACCESS TO HEALTH SERVICES

551

Falls(57,900)

GA

CDPH facilitated the 2011 launch of Cobb2020 - a partnership of community organizations and individuals dedicated to promoting healthy lifestyles and the delivery of essential health services in Cobb County. Together, through a strategic process called Mobilizing Action through Planning and Partnerships (MAPP), Cobb2020 has assessed the current health status of the County and is developing a Health Improvement Plan that will help create significant changes in building a healthier community.

The overall goal of Cobb2020 is to implement strategic changes throughout Cobb County over the next five years that build a foundation for reducing and preventing chronic disease such as diabetes, stroke, heart disease and cancer by promoting healthy lifestyles and better access to health and prevention services for the community.

Cobb 2020 has identified the following focus areas:

• Improving Access to Primary Health Care

• Improving Healthy Lifestyles – Through Proper Nutrition – Access to Physical Activity – Reducing the Use Of Alcohol and Other Drugs

Please visit Cobb2020.come or CobbandDouglasPublicHealth.org for more information on our health status, community improvement plan and current partnership activities.

Seeking a Solution

Important Websites and NumbersCobb & Douglas Public Health: http://www.cobbanddouglaspublichealth.org/

Cobb 2020:http://cobb2020.com/

Georgia Department of Public Health: http://dph.georgia.gov/

Centers for Disease Control & Prevention: http://www.cdc.gov/

Georgia Poison Center: 404-616-9000 (inside metro Atlanta) or 1-800-222-1222 (outside metro Atlanta)

Acworth Public Health Center 4489 Acworth Industrial DriveAcworth, Ga. 30101Phone: (770) 974-3330Fax (770) 966-9192

East Cobb Public Health Center4938 Lower Roswell RoadMarietta, Ga. 30068Phone: (678) 784-2180Fax: (678) 784-2198

Marietta Public Health Center 1650 County Services Pkwy.Marietta, Ga. 30008Phone: (770) 514-2300Fax: (770) 514-2363

Smyrna Public Health Center3830 South Cobb Drive, Suite 200Smyrna, Ga. 30080Phone: (770) 438-5105Fax: (770) 319-8245

South Cobb Public Health Center875 Six Flags DriveAustell, Ga. 30168Phone: (678) 385-1360Fax: (678) 385-1376

Lake Park Public Health Center1955 Lake Park Drive, Suite 300Smyrna, GA 30080-8855Phone: (770) 514-2357Fax: (770) 432-1774

Cobb County Environmental Health3830 South Cobb Drive, Suite 102Smyrna, Ga. 30080Phone: (770) 435-7815Fax: (770) 431-7410

The Cobb Health Futures Foundation is a 501(c)3 philanthropic arm of public health in Cobb County.

Incorporated in 1994, the foundation’s purpose is to support the mission it shares with Cobb & Douglas

Public Health, which is, with our partners, to promote and protect the health and safety of the residents of our county. Cobb Health Futures has selected to focus its 2014 fundraising efforts on:

Cobb Public Health

For more information about the foundation or any of the programs it supports, call (770) 514-2325, email jan.heidrich-rice@dph.ga.gov, or visit www.cobbhealthfutures.org.

Cobb Health Futures Foundation

Board of Health Members

Dr. Dan Stephens, Chairman

Dr. W. Wyman Pilcher, III, Vice-Chair

Dr. Emily Lembeck

Mr. Tim Lee

Mr. Chris Ragsdale

Ms. Judi Snelson

Dr. James M. Tallman

Babies Can’t Wait

Perinatal Case Management

Children’s Medical Services

CDPH-CHR_121214