Community Health Assessment
Marion County · September 2008
A report of the Community Health Assessment Steering Committee
and the Marion County Health Department
Community Health Assessment
Marion County · September 2008
A report of the Community Health Assessment Steering Committee
and the Marion County Health Department
|
On behalf of the Marion County Health Department, I am pleased to present the Marion County Community Health Assessment.
The Community Health Assessment describes the health status of the residents of Marion County, as compared to that of other major cities in the United States, Indiana, and the nation as a whole. This assessment examines the trends and patterns in the health of the county, and provides useful data against which future trends can be continually assessed. This report will help to heighten awareness of important health trends; serve as a useful tool for improving the health of the county; and provide a record of community needs and disparities for decision- makers.
Over the past few years, Indianapolis has made dramatic progress in improving heart disease and stroke. Heart disease, the leading cause of death in the nation, has fallen to second, behind cancer, as a cause of death in Indianapolis. In addition, due to health promotion and disease prevention initiatives, combined with significant advances in the diagnosis and treatment of cancer, Indianapolis had the third lowest breast cancer mortality rate of any large city in the United States in 2004. In the area of sexually transmitted infections, after having the highest incidence of new syphilis cases among large U.S. cities, Indianapolis achieved the lowest syphilis incidence in 2003-2005.
March 2008 marked the second anniversary of the Indianapolis Smoke Free Ordinance, an evidence-based strategy for reducing exposure to secondhand tobacco smoke. According to Smoke Free Indy, the result of this initiative has been an 85 percent reduction in small-particle indoor pollution in all businesses and buildings covered by the ordinance. Small particulate pollution in indoor air is a major trigger for asthma and other respiratory conditions, making this development a welcome reprieve for people with respiratory conditions and their families.
The prevalence of obesity in Indianapolis is a condition that will have long-term negative effects on the health of our citizens and the economic integrity of the region. Obesity in Indiana has consistently been about three percentage points more prevalent than in the rest of the country. In 2005, one out of four adults in Marion County was obese and another 35 percent were overweight.
A child who is obese at age 12 has an 85 percent chance of remaining obese as an adult and increased risk for developing Type 2 diabetes. In 2005, 22 percent of Marion County schoolchildren were overweight and 18 percent were at risk of being overweight. Persons who are obese in early adulthood are more likely to develop diabetes, high blood pressure, heart disease, and have higher rates of knee arthritis, sleep apnea and other chronic conditions. Current trends, if unchanged, will have direct impact, as they do today, on healthcare costs and high rates of premature disability, lost productivity and life for everyone.
Local physical activity and child obesity coalitions, along with health department initiatives, such as Heart Alive and Indy in Motion, are underway, targeting adult diets, activity behaviors and cardiovascular risk factors. Both of these initiatives have strong community visibility and support.
Population-based efforts like the year-long development of the Health by Design coalition, a partnership of the Health Department, Alliance for Health Promotion, city and regional planners, other non-profit organizations, government entities, academia, private industries and environmental groups are united in reducing the environmental barriers to a more physically active population. Appropriate nutritional habits and caloric intake, integrating more physical activity into daily routines, and other evidence-based strategies will, in time, reduce the county’s high prevalence of obesity and associated health problems.
There are many financially vulnerable households in Marion County. This assessment revealed that access to healthcare in Indianapolis is a growing problem. In a 2005 survey, 17.5 percent of the Marion County population reported having no healthcare coverage at all. This group coupled with persons with government-subsidized healthcare account for half of the citizens of Marion County. More than one in ten of all Marion County families live in poverty. It will take an unprecedented collaborative effort to eliminate the effects of poverty and health inequities in our community.
Community partnerships are invaluable resources in making a difference in the health of the individual resident and the community as a whole. Businesses, local government, policy makers, healthcare providers, human service agencies, educators, civic, professional and faith based organizations, and individual efforts can provide and promote healthy behaviors to make Indianapolis the healthiest city in the nation. This report provides a road map for individual and community action.
A copy of the full report is available at www.mchd.com by clicking on the Community Health Assessment link.
Sincerely,
Virginia A. Caine, M.D.
Director
Marion County Health Department
A DIVISION OF THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
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Frederick C. Bagg, Kimberly L. Curry Don R. Deutsch, MBA Katherine Humphreys, MBA Steven Ivy, PhD |
Jon Lewis, PhD Cathie M. McKinley, MSN Roger A. Brandon, MSW, MBA Mark Smith, MS Gregory Steele, DrPH, MPH Bernice Ulrich |
Project Director
P. Joseph Gibson, PhD, MPH, Director of Epidemiology
Community Health Assessment
Writers and Analysts
Marion County Health Department/Health & Hospital Corporation of Marion County
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Millicent Fleming-Moran, PhD Nathan Van Andel Shandy Dearth, MPH P. Joseph Gibson, PhD, MPH Jutieh Lincoln, MPH |
Catherine R Lesko, MPH Mary McKee, MSW, LCSW Jamesey Thomas Gary Weir, MS |
Suggested Citation: Gibson PJ, ed. Marion County Community Health Assessment. September 2008. Marion County Health Department, Indianapolis, IN.
Acknowledgments
The Marion County Community Health Assessment project represents the contributions of many working groups, representing literally hundreds of individuals. Their contributions guided and enabled the tasks performed as the basis of this report.
The project would not have been possible without the technical support, active participation and leadership of the participating hospitals: Clarian Health Partners, Community Health Network, St. Francis Hospital & Health Centers, St. Vincent Health, Westview Hospital and Wishard Health Services. In addition to the hospitals, other participating organizations included the Indiana Hospital Association, Indiana State Department of Health and Indiana University School of Medicine. Overall guidance for the project was provided by Virginia A. Caine, MD, Director of the Marion County Health Department who envisioned this project. P. Joseph Gibson, PhD, MPH, Director of Epidemiology served as the Project Director to ensure all data analysis tasks were coordinated. In addition, he directed the components and actively participated in the formation of this report to meet the needs of the community stakeholders. Mary McKee, MSW, LCSW, Director of Public Health Practice provided significant editorial contribution.
The Marion County Health Assessment Steering Committee provided guidance and commentary on the assessment process, as well as Marion County Health Department (MCHD) and Health and Hospital Corporation of Marion County (HHC) reviews. This Steering Committee was comprised of representatives from major hospitals and other health related organizations: Frederick C. Bagg, ABC, APR, FELLOW, PRSA (St. Francis Hospital and Health Centers; Kimberly L. Curry (Wishard Health Services); Don R. Deutsch, MBA (Clarian Health Partners); Katherine Humphreys, MBA (St. Vincent Health); Steven Ivy, PhD (Clarian Health Partners); Jon Lewis, PHD (Indiana State Department of Health); Cathie M. McKinley (Westview Hospital); Roger A. Brandon, MSW, MBA (Community Health Network); Mark Smith, MS (St. Vincent Health); Gregory Steele, DrPH, MPH (Indiana University School of Medicine) and Bernice Ulrich, (Indiana Hospital Association).The expertise of the Steering Committee was critical in producing a fair and accurate representation of the study results.
A particular note of appreciation goes to Bernice Ulrich and the Indiana Hospital Association members for their generous support in supplying data on hospitalizations and procedures in Marion County. The initial organization and framework for this report was drawn from a report created by the Steering Committee’s Gregory Steele, DrPH, (Indiana University School of Medicine) in 2002, during his tenure at MCHD. This report was assembled by the MCHD Epidemiology Department, led by P. Joseph Gibson, PhD, MPH, with significant interpretation and writing contributions by Millicent Fleming-Moran, PhD, Gary Weir, MS, Catherine Lesko, MPH, and Shandy Dearth, MPH, and data gathering and analysis contributions by Nathan Van Andel, Jamesey Thomas, MPH, and Jutieh Lincoln, MPH.