Contents, 2008 Marion County Community Health Assessment

Tables and Figures

Table 1‑6: Selected Age-Adjusted* Rates of Cancer Deaths per 100,000 Persons for Marion County, Indiana, Comparable Counties, and Healthy People 2010 Objectives. 1-10

Table 1‑7: Marion County All Cancers Deaths per 100,000 Persons by Age, Race, and Sex, 2005 1-11

Figure 1‑1: Age-Adjusted* Rates of Stroke Deaths per 100,000 Persons for Marion County and Comparison Populations. 1-12

Table 1‑8: Marion County Stroke Deaths per 100,000 Persons by Age, Race, and Sex, 2005. 1-12

Figure 1‑2: Age-Adjusted Rates of Homicide Rate per 100,000 Persons for Marion County and Comparison Populations 1-14

Table 1‑9: Marion County Chronic Liver Disease and Cirrhosis Deaths per 100,000 Persons by Age, Race, and Sex, 2005. 1-15

Table 1‑10: Marion County Diabetes Mellitus Deaths per 100,000 Persons by Age, Race, and Sex, 2005 1-15

Table 1‑11: Marion County Pneumonia/Influenza Deaths per 100,000 Persons by Age, Race, and Sex, 2005 1-16

Table 1‑12: Marion County AIDS Deaths per 100,000 Persons by Age, Race, and Sex, 2005 1-16

Table 1‑13: Marion County Accident (Unintentional Injury) Deaths per 100,000 Persons by Age, Race, and Sex, 2005 1-17

Figure 1‑3: Contribution of Various Factors to Preventable Deaths. 1-20

3. Summary Tables. 3-1

Table 3‑1: Population Demographics. 3-3

Table 3‑2: Access to Care. 3-4

Table 3‑3: Health Risk Factors and Prevention. 3-5

Table 3‑4: Children’s Health. 3-6

Table 3‑5: Communicable Diseases. 3-6

Table 3‑6: Social and Mental Health. 3-7

Table 3‑7: Morbidity and Hospitalizations. 3-8

Table 3‑8: Health Screenings for Early Detection. 3-9

Table 3‑9: Causes of Death. 3-10

5. Population Demographics. 5-1

Table 5‑1: Population Demographics Summary Table. 5-1

Table 5‑2: Age Distribution of Marion County Residents, 2000 and 2005. 5-4

Figure 5‑1: 2005 Marion County Residents’ Age Distribution by Gender and Race or Ethnicity 5-5

Table 5‑3: Population Totals for Marion County by Age, Race, and Sex, 2005. 5-6

Table 5‑4: Percent of the Total Population in Marion County by Age, Race, and Sex, 2005. 5-7

Figure 5‑2: 2005 Marion County Residents by Race/Ethnicity. 5-8

Table 5‑5: Marion County, Indiana, and U.S. Population Distribution by Race\Ethnicity, 2005. 5-9

Figure 5‑3: Percent of Marion County Residents of Latino or Hispanic Origin, by Census Block Group, 2000 5-11

Figure 5‑4: Marion County 2000 Population per Square Mile, by Census Block. 5-13

Table 5‑6: Estimates of Percent Unemployment Based on Self-reported Status, by Race, Marion County, American Community Survey, 2005. 5-14

Table 5‑7: Estimates of Percent Unemployment Based on Unemployment Insurance Claims:* Marion County, U.S. and Comparison Counties, 2002-2005. 5-15

Table 5‑8: Percent of Population in Poverty or in Selected Government Support Programs, 2005, U.S., Indiana, and Marion County. 5-17

Figure 5‑5: Percentage of the Marion County Population with a College Education by Gender, Race, and Age, 2005 5-18

Table 5‑9: General Health Status: Marion County Adults, by Gender, Race, and Age, 2005. 5-19

Table 5‑10: Self-reported General Health Status: Marion County, Indiana and U.S. Adults, 2005 5-19

Figure 5‑6: Marion County, Indiana, and U.S. 2005: Reported Health Status. 5-20

Figure 5‑7: Marion County Self-Reported Health Status, 2000 and 2005. 5-20

6. Access to Care. 6-1

Table 6‑1: Access to Care Summary Table. 6-1

Figure 6‑1: Indiana Residents Without Health Insurance by Race 2005 (N =716)6-3

Figure 6‑2: Marion County Households Without Health Insurance, 2001-05. 6-4

Table 6‑2: Marion County Adults Without Health Insurance, 2001, by Age. 6-4

Table 6‑3: Percent of Total Population with Medicaid or Self-Pay Status, 2006. 6-4

Table 6‑4: Marion County June 2006 Medicaid Enrollment6-5

Table 6‑5: Indiana Adults Over 18 Without a Personal Health Care Provider, 2005. 6-8

Table 6‑6: HP 2010 Objectives for Usual Source of Care by Age Group. 6-9

Table 6‑7: Primary Care Physicians, OB/GYN Physicians, and Dentists, Marion County, Indiana, and U.S., 2001, 2005 6-10

Figure 6‑3: Marion County Dental Professional Shortage Areas; HRSA 2005. 6-12

Table 6‑8: Marion County State Licensed Hospitals, by Type and Beds, 2006. 6-12

Table 6‑9: Health Advantage Participants: 2000-2005. 6-13

Figure 6‑4: 2005 Marion County HRSA-Designated Medically Underserved Area and Professional Shortage Area Census Tracts. 6-16

Figure 6‑5: Federally Qualified Health Centers (FQHCs) and Medically Underserved Populations/Professional Shortage Areas in Marion County: 2005. 6-17

Table 6‑10: Self Pay as a Percent of All Discharges from Marion County Hospitals: Marion County Residents Coded as Self-pay Patients, by Age, Race, and Gender, 2005. 6-19

Table 6‑11: Medicaid as a Percent of All Discharges from Marion County Hospitals: Marion County Residents Coded as Medicaid Insured, by Age, Race, and Gender, 2005. 6-19

7. Health Risk Factors and Prevention. 7-1

Table 7‑1: Health Risk Factors and Prevention Summary Table. 7-1

Figure 7‑1: Current Smoking Among Adults, U.S., Indiana, and Marion County, 2000-2006. 7-4

Table 7‑2: Prevalence of Smoking in Marion County by Age, Race, and Gender Groups, 2005 7-5

Figure 7‑2: Smoking Prevalence in Marion County Adults Over 18, by Race and Gender, 2001 and 2005 7-5

Figure 7‑3: Marion County Smoking by Education Level7-6

Table 7‑3: Marion County Prevalence of Smoking in Adults, by Race, Gender and Educational Achievement, 2005 7-7

Figure 7‑4: Marion County: Smoking Status, 2002 and 2005. 7-8

Figure 7‑5: Adults with Cholesterol Screening, Past 5 Years: Marion County, Indiana, and U.S., 2001-2005 7-9

Table 7‑4: Percentage of Screened Marion County Adults Told They Have Elevated Cholesterol, by Race and Gender, 2005. 7-10

Figure 7‑6: Percentage of Screened Adults Told Their Cholesterol Was High, Marion County, Indiana, and U.S., 1999-2005. 7-10

Table 7‑5: Percentage of Marion County, Indiana and U.S. Adults Told by a Health Professional That They Had High Blood Pressure, by Race and Gender, 2005. 7-12

Figure 7‑7: Marion County Adults Reporting Multiple Cardiovascular and Respiratory Conditions, 2005 7-12

Figure 7‑8: Frequency of Walking for Exercise, by Gender and Race, Marion County Adults, 2005 7-14

Figure 7‑9: Percent of Non-Pregnant Marion County Residents, Age 18 Years or Older, by BMI Category, 2005 7-16

Table 7‑6: Prevalence of BMI Categories, Marion County Adults, 2005. 7-16

Figure 7‑10: Obese Adults as Percentage of All Adults, United States, Indiana, and Marion County, 1990-2005 7-17

Figure 7‑11: Percent of Marion County Adult Males in Each BMI Category, by Race and Ethnicity, 2005 7-18

Figure 7‑12: Percent of Marion County Adult Females in Each BMI Category, by Race and Ethnicity, 2005 7-19

Figure 7‑13: Marion County Adults Trying to Lose Weight in Past 12 Months, 2005. 7-20

Table 7‑7: Percent of Marion County Adults Who Tried to Lose Weight in Past 12 Months, by Gender, Age, and Race, 2005. 7-20

Figure 7‑14: 2005 Obesity Prevalence by Geographic Area, Marion County 2005. 7-21

8. Children’s Health. 8-1

Table 8‑1: Children's Health Summary Table. 8-1

Table 8‑2: Number of Births, Infant Deaths, and Infant Mortality Rates* by Race, Marion County Residents, 2001-2005 8-4

Figure 8‑1: Total Infant Mortality Rates Marion County (MC) and Comparison Populations, 2000-2005 8-5

Table 8‑3: Neonatal Mortality Rates per 1,000 by Race. 8-6

Table 8‑4: Post-neonatal Mortality Rates per 1,000, by Race. 8-7

Figure 8‑2: Infant Mortality Rates by Death Period, Marion County, 1992-2006. 8-7

Table 8‑5: Perinatal Mortality Rates per 1,000 Live Births. 8-8

Figure 8‑3: Non-Hispanic White Infant Mortality Rates, Marion County (MC) and Comparison Populations, 2000-2005 8-9

Figure 8‑4: White Infant Mortality Rates by Death Period, Marion County, 2001-2006. 8-10

Figure 8‑5: Non-Hispanic Black Infant Mortality Rates*, Marion County (MC) and Comparison Populations, 2000-2005. 8-11

Figure 8‑6: Disparity Between Non-Hispanic Black and Non-Hispanic White Infant Mortality Rates, Marion County, 2000-2005. 8-12

Table 8‑6: Non-Hispanic Black Infant Mortality Rates by County Linked Birth/Infant Death Records, 1999-2002 8-13

Figure 8‑7: Hispanic Infant Mortality Rates, Marion County (MC) and Comparison Populations, 2000-2005 8-14

Table 8‑7: Percent of Babies Born to Married Women, Marion County Resident Births by Race, 2000-2005 8-15

Table 8‑8: Percent of Low Birth Weight Babies, Marion County Resident Births by Race, 2000-2005 8-16

Table 8‑9: Percent of Babies Born with no Prenatal Care, Marion County Resident Births by Race, 2000-2005 8-16

Table 8‑10: Percent of Mothers Entering Prenatal Care in the First Trimester, Marion County Residents, by Race, 2000-2005. 8-17

Table 8‑11: Percent of Births to Mothers Under Age 19, Marion County Residents by Race, 2000-2005 8-18

Table 8‑12: Percent of Mothers Smoking During Pregnancy, Marion County Residents by Race, 2000-2005 8-19

Table 8‑13: Percent of Marion County Mothers Smoking During Pregnancy by Age and Race, 2005 8-20

Table 8‑14: Mortality Rates per 100,000 for Youth Age 1-14, by Race. 8-20

Table 8‑15: Leading Causes of Child Mortality, Ages 1 Through 14 Years, 2001-2006. 8-21

Table 8‑16: Youth (<18 Years) Lifetime Cigarette Use. 8-22

Table 8‑17: Youth Current Cigarette Use. 8-23

Table 8‑18: Youth Reporting Binge Drinking. 8-24

Figure 8‑8: Percentage of Marion County^a Public School Students Who Were Overweight or At Risk of Becoming Overweight, by Sex, Race/Ethnicity, and Age, 2005. 8-25

Table 8‑19: Percentage of Marion County^a students who were overweight or at risk of becoming overweight, 2005, by age group, race, and gender8-26

Table 8‑20: Percent of School Population by BMI Category. 8-27

Table 8‑21: Percent of High School Population by BMI Category. 8-27

Table 8‑22: Rarely or Never Wore Seat Belt8-28

Table 8‑23: Rarely or Never Wore Bicycle Helmets. 8-29

Table 8‑24: Condom Use During Last Sexual Intercourse. 8-30

Figure 8‑9: 2007 Child Immunization Schedule. 8-31

Table 8‑25: Percentage of 2 year olds with age-appropriate immunizations. 8-32

9. Communicable Diseases. 9-1

Table 9‑1: Communicable Diseases Summary Table. 9-1

Table 9‑2: Incidence of Primary and Secondary Syphilis Infection per 100,000 Persons, Marion County, Indiana, and U.S., 2002-2005. 9-3

Table 9‑3: Incidence of AIDS Cases per 100,000 Persons, Marion County, Indiana, and U.S., 2000-2005 9-4

Figure 9‑1: HIV (Not AIDS) Cases by Report Year, Marion County, 2000-2005. 9-4

Table 9‑4: Incidence of Gonorrhea infections per 100,000 Persons, Marion County, Indiana, and U.S. 2002-2006 9-7

Table 9‑5: Incidence of Gonorrhea Infections per 100,000 Persons, Marion County 2006. 9-7

Table 9‑6: Incidence of Chlamydia Infections per 100,000 Persons, Marion County, Indiana, and U.S. 2002-2006 9-9

Table 9‑7: Incidence of Chlamydia Infections per 100,000 Persons, Marion County, 2006. 9-9

Table 9‑8: Newly Reported Cases of Selected Communicable Diseases, Marion County Residents, 2002-2005 Report Years. 9-11

10. Social and Mental Health. 10-1

Table 10‑1: Social and Mental Health Summary Table. 10-1

Figure 10‑1: Marion County Adults Reporting Days with Depression Symptoms in the Past 30 Days, 2005 10-4

Figure 10‑2: Mean Depression Days in Past 30 Days, by Gender, Age Group, and Race, Marion County Adults 2005 10-5

Table 10‑2: DMHA Estimated Marion County Adult Population with Serious Mental Illness and Co-Occurring Disorder, 2006. 10-6

Table 10‑3: Indiana DMHA Estimated Marion County Youths 9-17 Years Old with Serious Emotional Disturbance, 2006. 10-7

Figure 10‑3: Percent of Indiana and Marion County Adults Seeking Alcohol or Drug Treatment When Needed: 2003 IN FSSA, DMHA.. 10-8

Table 10‑4: Substantiated Child Abuse and Neglect Rates: Marion County, Indiana and U.S., 2000 and 2005 10-11

Table 10‑5: Percent Mental Illness Diagnoses Among Marion County Discharges (2005) and of Total U.S. Hospital Discharges (2004), by Age. 10-13

Table 10‑6: Frequency and Rate of Psychoses Admissions per 100,000 Marion County Resident, 2000 and 2005 10-13

Table 10‑7: Inpatient Psychiatric Care Providers in Marion County. 10-14

Table 10‑8: Marion County Drug Induced Death Rates per 100,000 Persons by Age, 2005. 10-15

Table 10‑9: Drug Induced Deaths per 100,000 Persons, by Gender and Race, Marion County 2005 and U.S. 2003-2004. 10-15

Table 10‑10: Age-Adjusted Suicide Rate per 100,000: Marion County, Indiana, U.S., and Comparison Counties 10-17

11. Environmental Health. 11-1

Table 11‑1: Environmental Health Summary Table. 11-1

Table 11‑2: MCHD Septic system Violations and Actions: 2004-2006. 11-1

Table 11‑3: Reason for Impairment, Marion County Assessed Water Segments, 2006. 11-2

Table 11‑4: KnoZone Air Quality Action Days by Year for Marion County. 11-3

Table 11‑5: Prevalence of Lead Hazards Among All Homes, and Among Homes of Young Children, United States, 1999 11-5

Table 11‑6: Percent of Homes by Year Built, within Township, Marion County, 2000. 11-5

12. Morbidity and Hospitalizations. 12-1

Table 12‑1: Morbidity and Hospitalizations Summary Table. 12-1

Table 12‑2: Morbidity and Hospitalizations Summary Table - Health Screenings. 12-3

Figure 12‑1: Lifetime Prevalence of Diabetes, Marion County, Indiana, and the U.S., 2000-2005 12-5

Table 12‑3: Diabetes Prevalence In the U.S., Indiana, and Marion County by Age group, Race and Gender, 2005 12-5

Table 12‑4: Black and White Adult Disparity in Self Reported Diabetes Prevalence: Marion County, Indiana and U.S., 2005. 12-5

Table 12‑5: Prevalence of Diabetes, Gestational Diabetes, and Pre-Diabetes, Marion County: BRFSS 2005 12-6

Figure 12‑2: All-Diabetes Prevalence, Indiana and National Population, by Age group 2005. 12-7

Table 12‑6: Marion County with Physician recognized Diabetes, 2005. 12-8

Table 12‑7: Rates of Diabetes-related Mortality, Admissions, and Amputations, Marion County Residents by Age, 2004-2005. 12-9

Figure 12‑3: Prevalence of Asthma, Marion County, Indiana, and the U.S.12-10

Table 12‑8: Asthma-related Hospitalization Rates per 100,000 Persons by Age, Race, and Gender, 2005 Marion County Residents. 12-11

Table 12‑9: Ratios of Rates of Hospital Admissions Due To Asthma by Race and Sex, Marion County Residents, 2005 12-11

Table 12‑10: Marion County, Indiana and U.S. Leading Cancers’ Incidence per 100,000 for All Ages: 2000-2002 12-12

Table 12‑11: Women 40+ years having Screening Mammogram in Past 2 Years, 2005: Marion County, Indiana and U.S.12-13

Figure 12‑4: Percentage of Marion County Women Older than 40 Having A Mammogram in Past 2 Years 12-14

Table 12‑12: Occult Blood and Colonoscopy Screening in past 2 years, 2006: Indiana and U.S. adults 50+ years of age 12-15

Figure 12‑5: Percentage of Marion County Women Having A Pap Test12-16

Table 12‑13: Women 18+ Reporting Annual Pap in Past Year: Marion County, Indiana and U.S, 2004 and 2005 12-16

Table 12‑14: Marion County and U.S. Hospital Crude Admission Rates per 10,000 Population by Gender and Race, 2005. 12-18

Table 12‑15: Percentage of Marion County Residents’ (2005) and U.S. (2004) Hospitalizations by Age and Diagnostic Group. 12-20

Table 12‑16: Percent of Hospital Discharges by Payer-Source, Marion County Residents, 2005, by Age 12-21

Table 12‑17: Frequency of Potentially Preventable Hospitalizations Marion County Residents, 2000 and 2005 12-22

Table 12‑18: Percentage of ACS Conditions Admitted: Marion County 2000 & 2005, and U.S. 2004 12-23

Table 12‑19: Leading Causes for Admission Among Marion County Residents: Frequency and Rate per 100,000 Persons, 2000 and 2005. 12-24

Table 12‑20: Number and Percent of Inpatient Procedures by Age, Marion County Residents 2005, and U.S. 2004 12-25

Table 12‑21: Percentage of Hospital Inpatient Procedures, by Type, Marion County Residents (2005), and National Discharge Data (2004)12-26

Table 12‑22: Percent of Hospital Procedures In Marion County Residents by Age, 2005. 12-27

13. Causes of Death. 13-1

Table 13‑1: Causes of Death Summary Table. 13-1

Table 13‑2: Selected Age-Adjusted* Rates of Death per 100,000 Persons, Marion County, Indiana, and U.S.13-4

Table 13‑3: Rank of Ten Leading Causes of Death, Plus Homicide, Suicide, and AIDS Deaths by Race: Marion County, 2002-2005. 13-5

Table 13‑4: Marion County All Causes Death Rates by Age, Race, and Sex, 2005. 13-5

Table 13‑5: Marion County Heart Disease Death Rates by Age, Race, and Sex, 2005. 13-7

Table 13‑6: Selected Age-Adjusted* Rates of Cancer Deaths per 100,000 Persons for Marion County, Indiana, Comparable Counties, and Healthy People 2010 Objectives. 13-8

Table 13‑7: Marion County All Cancers Deaths per 100,000 Persons by Age, Race, and Sex, 2005 13-9

Figure 13‑1: Age-Adjusted* Rates of Stroke Deaths per 100,000 Persons for Marion County and Comparison Populations. 13-11

Table 13‑8: Marion County Stroke Deaths per 100,000 Persons by Age, Race, and Sex, 2005 13-12

Figure 13‑2: Age-Adjusted Rates of Homicide Rate per 100,000 Persons for Marion County and Comparison Populations. 13-14

Table 13‑9: Marion County Chronic Liver Disease and Cirrhosis Deaths per 100,000 Persons by Age, Race, and Sex, 2005. 13-15

Table 13‑10: Marion County Diabetes Mellitus Deaths per 100,000 Persons by Age, Race, and Sex, 2005 13-15

Table 13‑11: Marion County Pneumonia and Influenza Deaths per 100,000 Persons by Age, Race, and Sex, 2005 13-16

Table 13‑12: Marion County AIDS Deaths per 100,000 Persons by Age, Race, and Sex, 2005 13-16

Table 13‑13: Marion County Accident (Unintentional Injury) Deaths per 100,000 Persons by Age, Race, and Sex, 2005 13-17

Table 13‑14: Marion County Years of Potential Life Lost (YPLL) Under 75 Years of Age, 2005 13-18

Table 13‑15: Leading Causes of Death Having the Greatest^a Black versus White Mortality Disparities, Marion County, 2005. 13-19

14. Appendices. 14-1

Table 14‑1: Principal Diagnosis Codes. 14-16

Table 14‑2: Preventable Hospitalization Codes. 14-16

Table 14‑3: Diabetes Related Hospitalization Codes. 14-17

Table 14‑4: Leading Hospital Admissions - HCFA DRG Codes and Descriptions. 14-17

Table 14‑5: Mortality Codes. 14-30

Table 14‑6: Inpatient Hospital Procedures Codes. 14-31

Table 14‑7: Diabetes Related Hospital Procedures Codes. 14-31