Community Health Needs Assessment 2013 · County is home to over 75,000 migrant and seasonal...
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Community Health Needs Assessment 2013
Transcript of Community Health Needs Assessment 2013 · County is home to over 75,000 migrant and seasonal...
Community Health Needs Assessment 2013
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Dear Community,
Improving Health Will Transform Yakima—This is our simple, yet profound, belief.
For decades, the Boards of Trustees of Memorial Hospital and The Memorial Foundation
have focused upon this belief. It has set in place various programs, services, and facilities
beyond acute care to promote improved health.
This assessment document is a map. With it, our community can PLAN; providers of
healthcare can PARTNER; programs can be DESIGNED and approaches can be
IMPLEMENTED—all directed toward improved HEALTH OUTCOMES.
It is a document filled with challenges. Its pages are abundant with opportunities. We
have it within us to face those challenges and to seize the opportunities to TRANSFORM
our community. We cannot view what lies ahead of us as a “spectator sport”. There is an
active role for all of us.
Health to you.
RWL
A Letter from Our CEO
3
Introduction 4
Demographics 6
Access to Health Services 8
Chronic Disease Profile 12
Clinical Preventive Services 14
Mortality 17
Environmental Quality 18
Injury and Violence 20
Maternal, Infant and Child Health 22
Mental Health 28
Nutrition, Physical Activity and Obesity 30
Reproductive and Sexual Health 32
Social Determinates 34
Substance Use 38
References 39
Table of Contents
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Yakima Valley Memorial Hospital Family of Services (Memorial) opened its doors in 1950
in response to a community need. We believe improving health will transform Yakima and
over our history we’ve committed to meeting the changing needs of our community by
reinforcing a legacy of collaboration and partnership that strengthens Yakima. It is more
than treating the sick; it is about creating and supporting healthy families—physically,
socially and economically. It is in this spirit of collaboration and dedication to the needs
of the Yakima Valley that Memorial puts forth this inaugural Community Health Needs
Assessment (CHNA).
In partnership with Yakima County Health District, YC Life, the Washington State
Department of Health and The Memorial Foundation, this CHNA serves as an
instrument to:
• Plan: Identify priorities for services and community health improvement processes
• Partner: Identify those who can work together to best meet community needs
• Do: Design programs and approaches to improve access to high quality health
care services
• Improve: Improve the health outcomes of Yakima County
Introduction
This CHNA is based on the Healthy People 2020 objec-tives. Released by the U.S. Department of Health and Human Services each decade, Healthy People provides objectives and science-based benchmarks to track and moni-tor progress towards a society in which all people live long, healthy lives. Yakima Valley Memorial Hospital Family of Services is committed to ensuring a healthier Yakima. We believe this summary information, in part-nership with our community, will serve as a critical step in achieving that goal.
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Healthy People 2020A society in which all people live long, healthy lives
Overarching Goals:• Attain high quality, longer lives free of preventable disease,
disability, injury, and premature death.
• Achieve health equity, eliminate disparities, and improve the health of all groups.
• Create social and physical environments that promote good health for all.
• Promote quality of life, healthy development and healthy behaviors across all life stages.
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Demographics
Yakima county is composed of primarily rural communities (14 cities and towns) in Central
Washington, spanning 4,296 square miles, with a 65% Medicare/Medicaid payer mix. The
Primary Service Area (PSA) of Yakima Valley Memorial Hospital is comprised of Yakima
County. Secondary Service Areas (SSA) includes Kittitas and Klickitat counties. Yakima
County is home to over 75,000 migrant and seasonal farmworkers and their dependents.
Located within Yakima County is the Yakama Nation Reservation which is over 1.3 million
acres and reaches across the cascades.
KittitasEllensburg
Yakima
Walla Walla
Seattle
Bellingham
Tacoma
Olympia
Richland
PascoKennewick
Spokane
Wenatchee
Yakima
Klickitat
Primary Service Area (PSA) of Yakima Valley Memorial Hospital
and its Family of Servicesby county
7
The 2011 population of Yakima
County is 247,141. The
majority of the population
is Hispanic/Latino and
Caucasian. The American
Indian/Alaska Native
population is about three
times the state average
and the Yakama Nation
Reservation is located
within Yakima County.
Yakima County has a higher percent of people ages 0-20 years when compared to the
Washington State average. Persons under 18 years of age make up 30% of the 2011 Yakima
County population, compared to 23% for Washington State.
0%
1%
2%
3%
4%
5%
80-8470-7460-6450-5440-4430-3420-2410-140-4
Yakima Female
WA Male
WA Female
Yakima Male
2010 Yakima County/WA State Age Structure 2
47%
Caucasian
46%
Hispanic or Latino
3%
Two or more races
6%
American Indian or Alaska Native
1%
African American
1%
Asian
2011 Yakima County Race/Ethnicity Profile 2
8
Access to Health Services
Over the years, Yakima County has exceeded the state averages of those who are medically
uninsured. At 24% and 33% respectively, Yakima County has the 3rd highest ranking in
Washington State for the medically uninsured and percent of the population on public
insurance. Public insurance is defined as Medicaid, Medicare and Veterans Assistance.
In Yakima County, 57% of the population has public or no insurance.
Access to comprehensive, quality health care services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone. Disparities in access to health services affect individuals and society. Limited access to health care impacts people’s ability to reach their full potential, negatively affecting their quality of life. Access to health care services in the United States is regarded as unreliable; many people do not receive the appropriate and timely care they need. The U.S. health care system, which is already strained, will face an influx of patients in 2014, when 32 million Americans will have health insurance for the first time.
— Healthy People 2020 1 Private
Public
None
2011 Type of Health Care Coverage 2
24%
53%
33%
Note: In some cases individuals may have dual insurance coverage of both private and public.
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During 2008–2010, the percent of medically uninsured in Yakima County rose by 8% while
the state only increased by 2% creating a disparity gap. It is estimated that 16% of adults have
had unmet medical needs in the last 12 months.2
In Yakima County, from 2010-2011 the percent of medically uninsured Caucasians decreased
by 6% and Hispanics/Latinos by 4%, while American Indians/Alaska Natives increased by 1%.
There is a notable disparity gap of the medically uninsured between races.
2008 2010 2011 2012
Yakima
WA
2008-2012 Health Coverage—Uninsured 2, 4
20%
12% 14% 14%15%
28%
24%25%
Caucasian Hispanic/LatinoAmerican Indian/Alaska Native
26%
20%
41% 41%37%
42%Yakima, 2010
Yakima, 2011
2010-2011 Yakima: Percent of Medically Uninsured by Race 1
Limited access to health care impacts people’s ability to reach their full potential, negatively affecting their quality of life.
10
In 2010, 18% of all documented children in Yakima were medically uninsured. From 2010-2011,
this percentage declined by 8%, thus narrowing a large disparity gap.
18%
2010
6% 6%10%
2011
Yakima
WA State
2010-2011 Children Under 18 Medically Uninsured 2
Access to Health Services
continued
11
The National Benchmark for the number of patients per primary care provider is 631:1.
The ratio in Washington State ranges from 10,862:1 to 682:13. The most current data from
2009 showed that Yakima County has 1,277 patients per provider, which indicates less
access to primary care than Washington State’s average.
Of those adults who are uninsured, 51% have less than a high school education.
As people obtain more education the uninsured percentages decline.
Less than High School
High SchoolGraduate or GED
Some collegeor AA
BA or higher
51%
26%
16%6%
2011 Yakima Percent Uninsured within Educational Attainment 2
2009 Yakima Primary Care Patient-to-Provider Ratio 1:1 1
Yakima WA State National
1,277
1,040
631
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Chronic Disease Profile
Obesity
31%
26%
High BloodPressure
26% 26%
HighCholesterol
43%
38%Yakima
WA State
2010 Adult Disease Prevalance 11
Asthma Diabetes Heart Diseaseand Stroke
8% 9% 9%7% 7% 6%
High Cholesterol, high blood pressure and obesity are the top three leading diseases
present in Yakima County. Yakima County asthma rate is 1% lower than the state average
and high blood pressure is the same as the state average. Yakima has higher rates in all
other diseases listed.
13
Cigarette smoking, physical inactivity and unhealthy diets are the main contributors to
heart disease, which is the leading cause of death. Yakima County has higher rates in adult
inadequate physical activity, inadequate food consumption and food insecurity than the
state. Yakima County and Washington State have the same rate of smoking, which is 15%.
Food Insecurity
16%9%
Cigarette Smoking
15% 15%
InadequatePhysical Activity
41%38%
InadequateFood
Consumption
78%74%
Yakima
WA State
2010-2011 Health Risk Factors Among Adults 9, 11
14
Clinical Preventive Services
51%
Child Immunizations
42% 38%39%
Adult Influenza
Yakima
WA State
2011 Child Immunizations and Adult Influenza Vaccine 5
2009 Age-Adjusted Cancer Incidence Rate 6
Yakima
WA State
All Stages of CancerRate per 100,000 resident population
443.5 534.3
Clinical preventive services, such as routine disease screening and scheduled immunizations, are key to reducing death and disability and improving the Nation’s health. These services both prevent and detect illnesses and diseases—from flu to cancer—in their earlier, more treatable stages, significantly reducing the risk of illness, disability, early death, and medical care costs. Yet, despite the fact that these services are covered by Medicare, Medicaid, and many private insurance plans under the Affordable Care Act, millions of children, adolescents, and adults go without clinical preventive ser-vices that could protect them from developing a number of serious diseases or help them treat certain health conditions before they worsen1.
— Healthy People 2020 1
Yakima County has
lower cancer incidence
rates when compared
to the state. Cancer
incidence is defined
by new cases during a
period of time, such as
the current year.
Yakima County
exceeds the state in
immunizations for
children by 9% and
is similar to the state
in adult influenza
vaccines.
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2011 Common Health Indicators 5
WA State
Yakima
Adult Dental Care(% in past year)
69% 72%
Cervical CancerScreening
(women over 21 with pap smear in last 3 years)
76% 76%
Colorectal CancerScreening
(Age 50 and overundergoing screening)
64%72%
2010-2012 Yakima Diabetic Screening Among Medicare Enrollees 3
WA State
Yakima 85%
80%
86%
85%
90%
86%
2010 2011 2012
Yakima parallels the state in cervical cancer screenings but has a lower percent of
colorectal cancer screenings.Adult dental care is 3% less than the state averages.
In 2010, Yakima exceeded Washington State averages in diabetic screenings by5%,
however, over the past year the overall rate of Medicare enrollees receiving screenings
has declined by 4%.
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Clinical Preventive Services
continuedMammography percent is reported as those who are Medicaid enrollees ages 67-69 who have
received at least one mammogram over a two-year period. The mammography screening rate
in Yakima for Medicaid enrollees ages 67-69 years of age is 7% less than the state.
According to the 2011
Yakima Health District
indicators report, women
50 years and older who have
received a mammogram in
the past 2 years is estimated
at 78%, congruent with
the state average.
2011-2012 Mammography Among Medicaid Enrollees 3
Age 67–69
Yakima
WA State
2011
68%63% 71%64%
2012
2011 Women 50 Years & OlderReceiving Mammogram in the Past Two Years 5
78% 78% 79%Yakima WA State National
2011 Women 50 Years & OlderReceiving Mammogram in the Past Two Years 5
78%Yakima
78%WA State
79%National
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Mortality
In 2010, the most concerning preventable cause of death in Yakima County was Major
Cardiovascular disease. The rate is much higher than Washington State’s.
2010 Top 12 Leading Causes of Death in Yakima 6
0 55 110 165 220 275
Yakima
WA State
Major CardiovascularDiseases
Chronic Lower Respiratory Disease
Infectious and ParasiticDisease
Intentional Self-Harm(Suicide)
Chronic Liver Diseaseand Cirrhosis
Nephritis Nephrotic Syndromeand Nephrosis
Influenza andPneumonia
Malignant Neoplasms
Accidents
Alzheimer’s Disease
Diabetes Mellitus
Assault (Homicide)
202.42256.33
37.348.82
40.2942.72
43.5731.18
21.5525.24
15.8517.3
13.7814.18
10.4412.83
7.8911.32
8.3110.33
2.6510.16
169.98168.79
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Environmental Quality
The environment directly affects health status and plays a major role in quality of life, years
of healthy life lived, and health disparities. Poor air quality is linked to premature death,
cancer, and long-term damage to respiratory and cardiovascular systems. Secondhand smoke
containing toxic and cancer-causing chemicals contributes to heart disease and lung cancer
in nonsmoking adults. Globally, nearly 25% of all deaths and the total disease burden can
be attributed to environmental factors. Poor environmental quality has its greatest impact
on people whose health status is already at risk.
— Healthy People 2020 1
Photo by Karl Corpron
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Air quality indices (AQI) are
figures used by government
agencies to characterize the
quality of the air in a given
location. As the AQI increases,
a larger percentage of the
population is likely to
experience increasingly
severe adverse health effects.
Air quality index values are
divided into ranges, and each
range is assigned a descriptor
and a color code. National,
State, and Yakima County
Averages are all in the
“Green Range” which is
defined as “Good” on
level of health concern.
Quality Index (AQI) Values
Levels of Health Concern Colors
0 to 50 Good Green
51 to 100 Moderate Yellow
101 to 150 Unhealthy for Sensitive Groups
Orange
151 to 200 Unhealthy Red
201 to 300 Very Unhealthy Purple
301 to 500 Hazardous Maroon
AQI National State Yakima County
1999 45 32 31
2000 42 34 32
2001 43 33 40
2002 43 34 41
2003 42 38 43
2004 40 34 39
2005 43 33 34
2006 42 34 37
2007 42 32 39
2008 41 31 32
2009 38 34 32
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Injury and Violence
Yakima
WA State
2010 Yakima Fatal Injury Rates 1
Motor
All Accident
Poisoning
Suicide
Drowning
Fire
Homicide
Rate
per
100
,00
0 p
opul
atio
n
24
3.9
10.3
11.7
13.6
15
48.8
0
1.6
2.6
11.2
14.1
7.4
37.3
Injuries are the leading cause of death for Americans ages 1 to 44, and a leading cause of disability for all ages, regardless of sex, race/ethnicity, or socioeconomic status. More than 180,000 people die from injuries each year, and approximately 1 in 10 sustains a nonfatal injury serious enough to be treated in a hospital emergency department. Beyond their immediate health consequences, injuries and violence have a significant impact on the well-being of Americans by contributing to: premature death, disability, poor mental health, high medical costs, and lost productivity. The effects of injuries and violence extend beyond the injured person or victim of violence to family members, friends, coworkers, employers, and communities.
— Healthy People 2020 1
In 2010, fatal accidents accounted for the deaths of approximately 173 people in Yakima,
exceeding the Washington State rates. Of the fatal Injuries, the top five leading causes are
motor vehicle/traffic, suicide, poisoning, homicide and falls.
2011 Top 5 Types of Contribution to Fatal Injuries 1
2.
19%Suicide
1.
20%All Motor
Vehicle Traffic
3.
16%Poisoning
4.
15%Homicide
5.
12%Falls
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Non-fatal hospitalizations are defined by patients who were admitted to the hospital for
care, excluding emergency department visits. Washington State rates have remained stable
over time, while Yakima County rates have increased. Ra
te p
er 10
0,0
00
resi
dent
pop
ulat
ion
2006-2010 Non-Fatal Hospitalizations 6
0
200
400
600
800
1000
1200
2006 2007 2008 2009 2010
771.8 718.9813
704.9
916.1
720.5
885.9
713.4
1002.9
705.7
Yakima WA State
Unintentional Falls Unintentional Motor VehicleTransportation (occupant)
Unintentional Poisoning
0
90
180
270
360
450
2006 2008 2009 20102007
2006-10 Types of Unintentional Non-Fatal Hospitalizations Yakima County 6
Rate
per
100
,00
0 re
side
nt p
opul
atio
n
53.5
39.7 41.4 59.8 67.5
73.259.8 58.5 63.8
57.3
283321.5
354.4
340.6
404.9Unintentional falls have
continuously increased in
Yakima County, with 968
reported falls in 2010. Rates
include hospitalizations
and exclude emergency
department visits.
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Maternal, Infant and Child Health
The fertility rate for Yakima County is the highest in the state of Washington. General
fertility rate is the live births per 1,000 women ages 15-44 years 7.
Since 1997, there has been
a slow downward trend in
teens giving birth. In Yakima
County, however, teen
birth rates consistently
remain more than double
Washington State’s rates.
Yakima County WA State
1997-2009 Yakima County Fertility Rates 1
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
89.6
61.5
92.7
62.2
91.5
61.9
92.5
62.7
90.7
61.2
88.1
60.8
97.8
62
90.5
62.8
92.1
63.1
91.4
65.6
94.9
66.4
97.9
66.9
96.2
65.9
Rate
per
1,0
00
live
bir
ths
Age–Specific Birth Rate Teens 17 Years and Younger 1
2000 2003 2005 2010
Yakima
WA State
Rate
per
1,0
00
live
bir
ths
51.4
20.4
40.8
15.3
38.7
14.9 17.918.78
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2008-2011 Yakima Infant Mortality Rates by Race 6, 7
Hispanic
Caucsian
American Indian/Alaska Native
Rate per 1,000 live births
2008
2009
2010
2011
8.837.14
5.91
8.81
3.71
3.13
10.58
6.05
8.81
2.84
4.17
12.85
The Yakima County infant mortality rates mirror Washington State rates except in 2008,
when there was a spike. Overall, rates in Yakima County and Washington State remain stable.
Washington State leads the nation for low infant mortality, however, racial disparity gaps
exist. In Yakima County, the rates among American Indians/Alaska Natives are increasing
and exceed all other races. Caucasian and Hispanic rates have declined over time. Since
2011, the Caucasian rate is increasing and exceeding the Hispanic rate.
2008-2010 Average Percent Premature Births 6
Yakima
13%
WA State
10%
Yakima County has the 2nd highest premature birth rate in Washington State. Yakima County has 3% more pre-term births than the Washington State average. Premature births are infants born before the 37th week.
Yakima
WA State
2007–2011 Infant Mortality Rates 6, 7
Rate per 1,000 live births
2007 2008 2009 2010 2011
5.984.8
5.754.91 5.26 4.5 4.274.45
9.69
5.44
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Maternal, Infant and Child Health
continuedAdverse Childhood Experiences (ACE) is tracked by the Department of Social and
Health Services (DSHS). One ACE point includes one of the following: parental death,
parental domestic violence arrests, parental mental illness or alcohol/drug treatment,
parental arrest, conviction or incarceration, a homeless spell for the child or either birth
parent, a CPS referral for abuse or neglect for any child of either parent, or any other
child welfare services for any child of either birth parent.
Children with 3 or more ACE are highly likely to be at risk throughout their entire life
for disease, drug and alcohol addiction, domestic violence, and many other risky behaviors.
In Yakima, 50,213 children under the age of 18 were receiving DSHS support enforcement
services in 2009. Compared to Washington State, Yakima County has more children with
one or more ACE scores and less children with no ACE scores. The number of Yakima
County children experiencing one to two ACE was 18,698 and 11,703 children experienced
three or more. These alarming numbers of children are now at risk for poor health
outcomes and risky behaviors.
2008 Children’s ACEs Scores
Yakima
WA State40%
47%
37%34%
23%19%
No ACEs 1–2 ACEs 3 or More ACEs
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Many Yakima County children are at risk. As the number of ACE increases, the risk for
health problems later is strongly correlated, including:
• Alcoholism and alcohol abuse
• Chronic obstructive pulmonary disease (COPD)
• Depression
• Fetal death
• Illicit drug use
• Ischemic heart disease (IHD)
• Liver disease
• Intimate partner violence
• STD’s
• Smoking
• Early initiation of smoking
• Unintended pregnancies
• Health-related quality of life
• Suicide attempts
• Early initiation of sexual activity
• Adolescent pregnancy
26
Maternal, Infant and Child Health
continuedChildren with Special Health Care Needs
On average 12-19 out of every 100 children have a special health care need. Children with
SpecialHealth Care Needs are defined as having at least one of the following conditions,
regardless of diagnosis, lasting longer than 12 months;
1 ) Elevated medical service use relative to children their age
2) Regular use of prescription drugs
3) Use of special therapy
4) Activity limitation
5) Emotional, behavioral or developmental problems
There are an estimated 11,270 children in Yakima County who have special health care
needs. Of these children 2,799 are receiving coordinated care and services through
Children’s Village. There is a substantially higher percent of children in Yakima County
who are receiving coordinated services through the Children with Special Health Care
Needs Program (CSHCN) than the statewide average. Children’s Village in Yakima County
monitors an estimated 2,799 children with various chronic condtions.
The estimated number of children with Autism Spectrum Disorders (ASD) is increasing.
The CDC estimates that one out of every 88 children is impacted by ASD.
27
24.8% 44.9%% Yakima County
WA State
Percent of Children Receiving Coordinated Care2
Number of Children Under 18 Years of Age
Estimated Number of Children with Special Health Care Needs
Number of Children in CSHCN Program
Yakima County 75,131 11,270 2,799
Washington State 1,570,909 235,636 11,628
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Mental Health
Mental disorders are among the most common causes of disability. The resulting disease
burden of mental illness is among the highest of all diseases. According to the National
Institute of Mental Health (NIMH), in any given year, an estimated 13 million American adults
(approximately 1 in 17) have a seriously debilitating mental illness. Mental health disorders are
the leading cause of disability in the United States and Canada, accounting for 25 percent
of all years of life lost to disability and premature mortality. Mental health plays a major role
in people’s ability to maintain good physical health. Mental illnesses, such as depression and
anxiety, affect people’s ability to participate in health-promoting behaviors. In turn, problems
with physical health, such as chronic diseases, can have a serious impact on mental health and
decrease a person’s ability to participate in treatment and recovery.
— Healthy People 2020
2007-2010 Suicide Rates 6
Rate
per
100
,00
0 re
side
nt p
opul
atio
n
Yakima
WA State
2007 2008 2009 2010
13.213.614.113.4
13.7
14.7
10.6
In 2010, Yakima County’s
average suicide rate
mirrored Washington
State’s rate. There are
sub-populations which
tend to have higher
suicide rates.
Suicide is the 11th leading cause of death in the United States, accounting for the deaths of approximately 30,000 Americans each year. Mental health and physical health are closely connected.
— Healthy People 2020 1
29
2010 Depression Among Youth per Grade 9
Grade 8 Grade 10 Grade 12
29%25%
30%34%
28%35%
Yakima WA State
2010 Youth Considering Suicide9
Grade 8 Grade 10 Grade 12
18%19%14%17%18%
Yakima WA State
Youth depression, as reported by the Washington State Healthy Youth Survey, measures
the feeling of sadness or hopelessness for 2 weeks or more, causing the child to stop doing
their usual activities. Depression averages among youth in Yakima County are higher than
Washington State in all grades. In addition, Yakima County youth contemplating suicide
exceeds Washington State averages for grades 8, 10 and 12.
30
Nutrition, Physical Activity and
Obesity Good nutrition, physical activity, and a healthy body weight are essential parts of a
person’s overall health and well-being. Together, these can help decrease a person’s risk
of developing serious health conditions, such as high blood pressure, high cholesterol,
diabetes, heart disease, stroke, and cancer. A healthful diet, regular physical activity,
and achieving and maintaining a healthy weight also are paramount to managing health
conditions so they do not worsen over time. Fewer than 1 in 3 adults and an even lower
proportion of adolescents eat the recommended amount of vegetables each day.
Compounding this is the fact that a majority of adults (81.6%) and adolescents (81.8%)
do not get the recommended amount of physical activity.
— Healthy People 2020
About 1 in every 3 adults in Yakima County are obese. Yakima County has consistently
exceeded Washington State rates in adult obesity. In 2012, the rate was 5% higher.
2010 2011 2012
2010-2012 Adults Who are Obese 2
Yakima
WA State
29% 32%
26% 27%
31
The data presented on youth obesity is from the Washington State Healthy Youth Survey,
which is self-reported and administered during school hours. From 2004-2010, Yakima County
consistently exceeded Washington State youth obesity percentages in grades 8, 10 and 12.
2004–2010 Percent of 8th Graders Who Are Obese 9
2004 2006 2008 2010
Yakima WA
14% 13%15% 14%
10% 10% 11% 11%
2004–2010 Percent of 10th Grad-ers Who Are Obese 9
2004 2006 2008 2010
Yakima WA
12%14% 13% 14%
10% 11% 11% 10%
2004–2010 Percent of 12th Graders Who Are Obese 9
2004 2006 2008 2010
Yakima WA
14% 14% 15% 15%
10% 11% 11% 11%
2010 2011 2012
2010-2012 Adults Who are Obese 2
Yakima
WA State
29% 32%
26% 27%
Today, approximately 1 in 3 adults (34.0%) and 1 in 6 children and adolescents (16.2%) are obese. Obesity- related conditions include heart disease, stroke, and type 2 diabetes, which are among the leading causes of death.
— Healthy People 2020 1
32
Reproductive and Sexual Health
There is a decline of HIV in Yakima County and the rate is more than twice as low when
compared to Washington State.
Gonorrhea rates have increased since 2010.
0
5
10
2007 2008 2009 2010 2011
2007–2011 HIV 10
5.1
9
5
8.2
7
8.2
6.6
8.3
3.3
7.6
Yakima WA StateRa
te p
er 10
0,0
00
resi
dent
pop
ulat
ion
0
20
40
60
2007 2008 2009 2010 2011
2007–2011 Gonorrhea 10
47.7
55.9
35.5
47.2
15.7
34
14
42.6
40.5
40.3
Yakima WA State
Rate
per
100
,00
0 re
side
nt p
opul
atio
n
33
0
200
400
600
2007 2008 2009 2010 2011
2007–2011 Chlamydia Trachomatis 10
293.1
498.9
322.7
496
317.4
488.2
318.3
456.4
343.3
500.2
Yakima WA State
Rate
per
100
,00
0 re
side
nt p
opul
atio
n
Chlamydia rates have consistently remained high and have exceeded Washington State
rates since 2007. Yakima County currently has the highest Chlamydia rate in the State
of Washington. Chlamydia is most likely to infect youth who are 14–24 years old. Women
who have it are at risk for infertility.
34
Social Determinates
2011 Families and Individuals in Poverty 2
Families in Poverty All People
9%
17%
23%
14%
WA State Yakima
A range of personal, social, economic, and environmental factors contribute to individual and population health. For example, people with a quality education, stable employment, safe homes and neighborhoods, and access to preventive services tend to be healthier throughout their lives. Conversely, poor health outcomes are often made worse by the interaction between individuals and their social and physical environment. Social determinants are in part responsible for the unequal and avoidable differences in health status within and between communities. The selection of Social Determinants as a Leading Health Topic recognizes the critical role of home, school, workplace, neighborhood, and community in improving health.
— Healthy People 2020 1
Yakima County has a large percent of families and individuals living in poverty which is
a primary contributor to health outcomes. Yakima County has historically exceeded the
state in percentages of individuals living in poverty. The most recent data shows about one
in every four individuals in Yakima County are living in poverty.
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2011 Employment Status of Families 2
UnemployedLabor Force
All Parents inLabor Force
Unemployed CivilianLabor Force
Yakima
WA State
7% 6%
60% 62%
10% 10%
2011 Average Household Income2
Yakima WA State
$54,746
$74,186
Yakima County’s employment and unemployment rates are similar to State rates. However,
the average household income is about $20,000 less per year.
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Social Determinates
continued2011 Educational Attainment 2
Yakima
WA State
Graduate orProfessional
Some College,No Degree
High SchoolGraduate
Bachelors
Associates
9th–12th Grade
Less Than 9th Grade
12%6%
20%11%
10%7%
25%20%
24%27%
6%11%
4%18%
The distribution of
educational attainment
shows lower percentag-
es of the population in
Yakima County obtaining
a college education and
higher percentages not
completing high school.
When compared to
Washington State,
Yakima County has a
smaller percentage of
people graduating high
school and obtaining
a Bachelor’s degree
or higher.
2007–2011 Educational Attainmentof Person Age 25 and Older 2
Bachelors Degree or Higher High School Graduate or Higher
WA State
Yakima16%
32%
71%
90%
37
34%
2010
222%% 223%%31%
2011
Yakima
WA State
2010-2011 Dropout Rates 12
In 2010, Yakima County exceeded the state by 12% in student dropouts. Yakima County’s
dropout percentage declined by 3% in 2011, but still exceeded the state rate by 8%.
38
From 6th–10th grade, Yakima County alcohol and drug use averages among adolescents
exceeded state averages. In 12th grade, the Yakima County rate is 2% lower than Washington
State. The data collected is from the Washington State Healthy Youth Survey and does not
include those who are not attending school.
2010 Adolescents Using Alcohol or Illicit DrugsDuring the Past 30 Days, by Grade 9
Yakima
WA State
Grade 6 Grade 8 Grade 10 Grade 12
38% 40%
31%28%
20%
14%
5% 4%
Adolescents Smoking Cigarettes 9
12th Grade 8th Grade
WA StateYakima
14%20%
6% 7%
Substance Abuse
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From 2006-2010, Yakima County has a smaller percent of adult binge drinking than
Washington State.
2006–2010 Adults Engaging in Binge DrinkingDuring the Past 30 Days 11
10.8 12.5 13.5
14.2 15.1 15.4
2006 2008 2010
WA StateYakima
40
Preliminary Priorities
Yakima Valley Memorial Hospital Family of Services has identified the following priorities:
1) Access to care
2) Disparities in health outcomes – children with special healthcare needs, obesity,
infant mortality rate, coronary heart disease, and diabetes
3) Adverse Childhood Experiences (ACES) – community evaluation tool and education
4) Mental health
5) Unintentional non-fatal hospitalizations
6) Food insecurity
7) Maternal child health gap analysis priorities – pre-term birth, infant mortality rate,
teen birth, and children with special healthcare needs
Through a four-stage approach, we will make progress toward improved health and
TRANSFORMING Yakima.
• Plan: Identify priorities for services and community health improvement processes
• Partner: Identify those who can work together to best meet community needs
• Do: Design programs and approaches to improve access to high quality health
care services
• Improve: Improve the health outcomes of Yakima County
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1 Healthy People 20202 US Census Bureau American Community Survey3 County Health Rankings and Roadmaps 4 Washington State Insurance Commissioner 5 Yakima Health District Indicators Bulletin December 20116 Washington State Department of Health 7 Yakima Valley Memorial Hospital Maternal Child Health 2000-2010 Report8 YC Life Yakima County Annual Report 20129 Washington State Healthy Youth Survey 10 Washington State Department of Health Communicable Disease 2011 Report 11 Center for Disease Control Behavioral Risk Factor Surveillance System12 Office of Superintendent of Public Instruction
References
