Demographic and Health Profile Val Verde County 2001 Texas Department of State Health Services...

Demographic and Health ProfileVal Verde County

2001

Texas Department of State Health Services

Office of Border Health

Val Verde County

In population, Val Verde County ranked 7th (out of 32 counties) in the Border region and 64th (out of 254 counties) in Texas

There were 45,494 inhabitants in Val Verde County, compared to 2,176,117 in the Border region, and 21,325,018 in Texas

2.1% of the Border region population lived in Val Verde County

The area in square miles was 3,170.4

The number of people per one square mile was 14.3

Val Verde County2001

Source: TDH, Selected Fact Sheets - 2001


Age and Ethnicity2001

Population Val Verde County Border Texas Total 45,494 2,176,117 21,325,018

Ethnicity

White 9,973 (21.9%) 296,543 (13.6%) 11,175,226 (52.4%)

Black 668 (1.5%) 26,845 (1.2%) 2,465,400 (11.6%)

Hispanic 34,403 (75.6%) 1,832,436 (84.2%) 6,957,213 (32.6%)

Other 450 (1.0%) 20,293 (0.9%) 727,179 (3.4%)

Age

0-4 4,071 (8.9%) 239,252 (11.4%) 1,653,780 (8.5%)

5-14 8,078 (17.8%) 394,250 (18.8%) 3,326,002 (15.8%)

15-44 19,355 (42.5%) 925,092 (44.1%) 9,843,365 (46.0%)

45-64 8,962 (19.7%) 342,072 (16.3%) 3,949,887 (19.7%)

65 & up 5,028 (11.1%) 196,825 (9.4%) 2,006,768 (10.0%)

Gender

Male 22,401 (49.2%) 1,023,912 (48.8%) 9,941,407 (49.6%)

Female 23,093 (50.8%) 1,073,579 (51.2%) 10,102,734 (50.4%)

Note: Percent totals may not equal 100 due to rounding


8.911.4

8.5

17.8 18.815.8

42.544.1

46.0

19.716.3

19.7

11.19.4 10.0

0

5

10

15

20

25

30

35

40

45

50

Val Verde County Border Texas

Pe

rce

nt

0 - 4 5 - 14 15 - 44 45 - 64 65 & up

Population by Age2001

Population by Ethnicity2001


21.9

13.6

52.4

1.5 1.2

11.6

75.6

84.2

32.6

1.0 0.9 3.4

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0


Per

cen

t

White Black Hispanic Other

Socio-Economics2001


6.2

24.3

2.4

14.5

24.9

8.3

28.5

4.4

19.2

28.4

4.8

14.6

1.6

6.5

12.6

0 5 10 15 20 25 30

Unemployment Rate

Living Below Poverty

Temporary Assistancefor Needy Families

Food Stamps

Medicaid Eligibles

Percent

TexasBorderVal Verde County

Natality

There were 859 babies born in Val Verde County in 2001The percentage of adolescent mothers (<18) was 6.4% which was slightly lower than in the Border region (6.8%) but higher than in Texas (5.4%)The percentage of babies that were born with low birth weight (9.0%) was higher than in the Border region (6.9%) and Texas (7.6%)The percentage of pregnant women that received late or no prenatal care (14.9%) was lower than in the Border region (28.2%) and in Texas (19.7%)The fertility rate (88.8) was lower than in the Border region (104.1) but higher than in Texas (75.4) *

In 2001, the natality data of Val Verde County revealed the following:

Source: TDH, Selected Fact Sheets - 2001 * Fertility rates are per 1,000 women ages 15-44

Natality2001


6.4 6.85.4

9.06.9 7.6

14.9

28.2

19.7

0.0

5.0

10.0

15.0

20.0

25.0

30.0


Pe

rce

nt

Teen Moms (<18) Low Birth Weight Late/No Prenatal Care

Mortality

Cardiovascular Disease accounted for 36.8% of all deaths in Val Verde CountyThe rate of people that died of Cardiovascular Disease (318.2) was higher than in the Border (272.8) but lower than in Texas (344.2)

Cancer accounted for 21.0% of all deaths in Val Verde CountyThe rate of people that died of Cancer (169.1) was higher than in the Border (159.3) but lower than in Texas (192.7)

Source: TDH, Selected Fact Sheets - 2001 Note: Rates are per 100,000 population and adjusted for age

In 2001, the mortality data for Val Verde County revealed the following:

Mortality(continued)

Chronic Lower Respiratory Disease accounted for 4.4% of all deaths in Val Verde County

The number of deaths from Chronic Lower Respiratory Disease were too small to calculate a meaningful rate for comparison with the Border and Texas

Diabetes accounted for 7.6% of all deaths in Val Verde County

The rate of people that died of Diabetes (61.5) was higher than in the Border (43.6) and in Texas (46.7)

Source: TDH, Selected Fact Sheets - 2001 Note: Rates are per 100,000 population and adjusted for age

Causes of Death2001


318.2

272.8

344.2

169.1 159.3

192.7

33.447.4

61.443.6 46.7

0

50

100

150

200

250

300

350

400


Ra

tes

Cardiovascular Cancer Lower Respiratory Diabetes

Note: Rates are per 100,000 population and adjusted for age

?

Morbidity2001

* Rates are per 100,000 population


Val Verde County

Border Texas Disease

Cases Rate* Cases Rate* Cases Rate*

Tuberculosis 9 19.8 277 12.7 1,643 7.7 P & S Syphilis 0 -- 28 1.3 479 2.2 Gonorrhea 9 19.8 618 28.4 30,116 141.2 Chlamydia 99 217.6 6,363 292.4 69,934 327.9 AIDS 1 2.2 242 11.1 2,981 14.0 HIV 0 -- 235 10.8 4241 19.9 Hepatitis A 0 -- 80 3.7 1,154 5.4 Hepatitis B 1 2.2 32 1.5 714 3.3 Varicella (chickenpox) 14 30.8 353 16.2 5,741 26.9

Source: TDH, BRFSS 2001

Chronic Disease Val Verde

County Border Texas

Diabetes Prevalence (estimate for ages 18+)

7.5% 7.5% 6.2%

Morbidity2001

Healthy Border / Frontera Saludable

Healthy Border 2010 aims to improve health in the United States-Mexico border region, an area defined as 100 kilometers (62 miles) north and south of the United States-Mexico border and close to 2000 miles in length. The Healthy Border 2010 program was established by the U.S.-Mexico Border Health Commission as its binational agenda of health promotion and disease prevention. The Healthy Border 2010 agenda establishes 10-year objectives for binational health promotion and disease prevention in the border region. The program also serves as a basis for the development of bilateral, border-wide and community health improvement plans.

Healthy Border / Frontera Saludable Objectives

1. Reduce by 25 percent the proportion of persons lacking access to a primary care provider in underserved areas.

2. Reduce the breast cancer death rate for women by 20 percent.

3. Reduce the cervical cancer death rate for women by 30 percent.

4a. Reduce the diabetes death rate by 10 percent.

4b. Reduce diabetes hospital admissions by 25 percent.

5. Reduce to zero the population residing in counties exceeding EPA air quality standards.


6. Reduce to zero the proportion of households not connected to either compliant public sewage systems or septic tanks.

7. Reduce by 25 percent the number of persons hospitalized for acute pesticide poisoning.

8. Reduce the incidence of diagnosed HIV infection cases among adolescents and adults by 50 percent.

9a. Reduce the incidence of hepatitis A by 50 percent.

9b. Reduce the incidence of hepatitis B by 50 percent.

10. Reduce the incidence of tuberculosis by 50 percent.


11. Achieve and maintain an immunization coverage rate of 90 percent for children 19-35 months.

12. Reduce the motor vehicle crash death rate by 25 percent.

13. Reduce the childhood (under 5 years of age) death rate due to unintentional injuries by 30 percent.

14. Reduce the infant mortality rate by 15 percent.

15. Reduce the infant mortality rate due to birth defects by 30 percent.


16. Increase the proportion of women receiving prenatal care in the first trimester to 85 percent.

17. Reduce the pregnancy rate among 15 to 17 year old women by 33 percent.

18. Reduce the suicide death rate by 15 percent.

19. Reduce the proportion of adults who are obese by 15 percent.

20. Increase to at least 75 percent the proportion of the population served by community water systems with optimally fluoridated water.


21. Increase to at least 75 percent the proportion of children and adults who use the oral health care system each year.

22. Reduce the asthma hospitalization rate by 40 percent.

23. Reduce the rate of alcohol-related motor vehicle crash deaths by 50 percent.

24. Increase to 89 percent the proportions of adolescents not using alcohol or any illicit drug during the past 30 days.

25. Reduce by 33 percent the proportion of adults and adolescents currently using tobacco.

Access to Care

Access to quality health care is essential to improving the health of Texas-Mexico border residents. Access to care is required for individuals to obtain preventive health services such as immunizations, regular Pap tests, or early prenatal care. Effective primary care can also educate people about modifiable risk factors such as smoking. Residents with chronic diseases require health care access for effective management of conditions such as diabetes and hypertension.

1. Reduce by 25 percent the proportion of persons lacking access to a primary care provider in underserved areas.

In 2001, “Access to Care” data for Val Verde County revealed the following:

23% did not have health care coverage which was the same percentage as in Texas *

17% of the population was unable to see a doctor due to cost which was higher than in Texas at 15% *

There was a significant difference among men and women as 24% of the women and 9% of the men could not see a doctor due to cost *

24.9% of the population is eligible for Medicaid compared to 12.6% of the Texas population **

Source: * TDH, BRFSS - 2001 and ** TDH, Selected Fact Sheets - 2001

Access to Care

Access to Care2001

Ratio of Population to Health Professional


Physicians 1,569:1 851:1 661:1

Registered Nurses

292:1 244:1 156:1

Dentists 4,549:1 6,535:1 2,820:1


Access to Care2001

Health Facilities Val Verde County

Border Texas

Acute Care Hospitals 1 40 470

Licensed Beds 93 7,735 73,993

Staffed Beds 81 5,026 56,898

Nursing Homes 3 63 1,143

Licensed Beds 268 6,813 125,864

Certified Mammography Locations 1 45 554

Health Professionals

Direct Patient Care Physicians 29 2,556 32,281

Registered Nurses 156 8,929 136,353

Dentists 10 333 7,561

Emergency Vehicles Permitted 5 417 3,489

Certified EMS Personnel 64 3,833 49,562


Cancer

2. Reduce the breast cancer death rate for women by 20 percent.

3. Reduce the cervical cancer death rate for women by 30 percent.

Cancer

Smoking cessation

Eating more fruits and vegetables

More physical activity

Weight control

Several types of cancer can be prevented by changes in behaviors or dietary habits. As many as 50 percent of all cancers could be prevented by:

Cancer

Equally vital in the fight against cancer is screening for early detection and treatment. In the Texas-Mexico border region, both breast cancer and cervical cancer are often diagnosed at later stages of development. Detection can be improved through mammograms and breast self-examinations for breast cancer, and through Pap smears for cervical cancer. Enhancing the access of border residents to routine health care services is a key element in reducing cancer mortality.

Prevention and early detection of cancer require various types of resources. First is the need to provide culturally and linguistically appropriate information on prevention, early detection, and treatment to the public and to health care professionals. Second, the public must have access to preventive and diagnostic services as well as treatment.

Cancer

In 2001, “Breast & Cervical Cancer” data for Val Verde County revealed the following:

43% of women ages 18 and above had never had a mammogram, compared to 19% of the women the same age in Texas *

47% of women 40 and older did not have a clinical breast exam and a mammogram in the past 2 years which was significantly higher than the 20% in Texas *

The number of deaths from female breast cancer were too small to calculate a meaningful rate for comparison with the Border and Texas **

In Texas there were 18,846 mammograms performed through the Texas Breast and Cervical Cancer Control Program of which 3 (0.02%) were performed in Val Verde County **


Cancer


Diabetes

The growing prevalence of diabetes is a result of a number of trends, including improper nutrition, obesity, and the aging of population groups with a predisposition to develop diabetes. Despite the growing number of diabetes cases identified annually, it is believed that a large proportion of persons with diabetes remains undiagnosed.

4b. Reduce diabetes hospital admissions by 25 percent.

4a. Reduce the diabetes death rate by 10 percent.

Improving nutrition and increasing physical activity (thereby reducing the prevalence of overweight and obesity) has been shown to reduce the number of persons who develop Type 2 diabetes.

Diabetes

26% were told that they had high blood pressure, which was slightly higher than the 24% in Texas *

27% were told that they had high cholesterol which was slightly lower than the 30% in Texas *13% were told that they had diabetes, which was higher than the 6% in Texas *The diabetes mortality rate for Val Verde County (61.4) was higher than in Texas (31.9) *

In 2001, “Diabetes” data for Val Verde County revealed the following:


Diabetes


Environmental Health

5. Reduce to zero the population residing in counties exceeding EPA air quality standards.

6. Reduce to zero the proportion of households not connected to either compliant public sewage systems or septic tanks.

7. Reduce by 25 percent the number of persons hospitalized for acute pesticide poisoning.

Human exposures to hazardous agents in the air, water, soil and food, and physical hazards in the environment are major contributions to illness, disability and death worldwide. Pollutants and contaminants that arise on one side of the border can easily affect the air, water, and soil of the other side, as well as affect the health of persons living along the opposite border.

In 2001, no air quality data was available for Val Verde County.

Environmental Health

8. Reduce the incidence of diagnosed HIV infection cases among adolescents and adults by 50 percent.

HIV/AIDS is no longer restricted to specific population groups: HIV infection and AIDS have been reported in almost every age and socio-economic group, and in all large cities in the Texas-Mexico border. As with all other communicable diseases, HIV/AIDS transmission is not restrained by political boundaries.

HIV / AIDS

HIV prevention requires a broad range of medical and counseling services, accompanied by information, education and other activities. Many strategies have been developed to reduce the spread of HIV infection, including the promotion of safer sex practices and the reduction of needle sharing. In addition, HIV counseling, education and information should be appropriate for local cultures and languages.

An important issue, however, is access to care, as knowledge of HIV status is a key part of halting the transmission of HIV. On of the major barriers to care is the lack of HIV trained providers on both sides of the border.

HIV / AIDS

The HIV rate for Val Verde County (0.0) was lower than in the Border (10.8) and in Texas (14.3) *

The AIDS rate for Val Verde County (2.2) was lower than the rate in the Border (11.1) and in Texas (14.0) *

In 2001, “HIV/AIDS” data for Val Verde County revealed the following:


HIV / AIDS

Note: Rates are per 100,000 population

9a. Reduce the incidence of Hepatitis A by 50 percent.

9b. Reduce the incidence of Hepatitis B by 50 percent.

10. Reduce the incidence of Tuberculosis by 50 percent.

11. Achieve and maintain an immunization coverage rate of 90 percent for children 19-35 months.

Immunizations and Infectious Diseases

Increased vaccination coverage has produced dramatic declines in the incidence of some infectious diseases. For example, measles and mumps cases have decreased significantly in the past decade. The strategy is to detect, control and prevent infectious diseases, and then to maximize the vaccination coverage rate in the “at-risk” population.


For diseases that are not preventable or only partially preventable by vaccine, a different approach is required. Reducing tuberculosis rates requires active surveillance, including testing of “at-risk” populations, providing curative therapy to tuberculosis patients, ensuring that therapy is completed and investigating close contacts of tuberculosis patients. Lack of access to care can delay the detection of tuberculosis cases, and limit direct observation of therapy by health care providers.


46% of people 65 and older not get a flu shot during the past 12 months, compared to 59% in Texas *45% of people aged 65 and older had never had a pneumonia vaccine, compared to 44% for the same age group in Texas *The Hepatitis A rate (0.0) was lower than in the Border (3.7) and in Texas (5.4) **The Hepatitis B rate (2.2) was higher than in the Border (1.5) but lower than in Texas (3.3) **The Tuberculosis rate (19.8) was higher than in the Border (12.7) and in Texas (7.7) **

In 2001, “Immunizations and Infectious Diseases” data for Val Verde County revealed the following:



Note: Rates are per 100,000 population


Service Provided Val Verde

County Border Texas

Persons evaluated for TB disease after contact with a TB case 71 3,039 23,762

12. Reduce the motor vehicle crash death rate by 25 percent.

Injury and Violence Prevention

13. Reduce the childhood (under 5 years of age) death rate due to unintentional injuries by 30 percent.

The risk of death due to a motor vehicle crash is greatest among adolescents and young adults (15 to 24 years of age) and the elderly population (75 or more years of age). Motor vehicle deaths can be prevented by increasing the use of automobile seat belts, reducing the consumption of alcohol by automobile drivers, enhancing the enforcement of traffic laws (particularly maximum speed limits), and improving the quality of roads, lighting and other safety enhancements.


Unintentional injuries are an important cause of death among young children, but particularly so for those 1 to 4 years of age. Important causes of injury deaths include motor vehicle crashes, drowning, poisonings, and fires. Important preventive measures would be restricting unsupervised access to swimming pools or other bodies of water, and improved safeguards against access to household toxic substances by young children.


9% of the people (age 18 and over) did not always use a seat belt when they drove or rode in a car *

The number of deaths resulting from motor vehicle crashes were too small to calculate a meaningful rate for comparison with the Border and Texas **

In 2001, “Unintentional Death” data for Val Verde County revealed the following:




14. Reduce the infant mortality rate by 15 percent.

Maternal, Infant and Child Health

15. Reduce the infant mortality rate due to birth defects by 30 percent.

17. Reduce the pregnancy rate among 15 to 17 year old women by 33 percent.

16. Increase the proportion of women receiving prenatal care in the first trimester to 85 percent.

Screening of pregnant women and young children is essential to prevent or mitigate many serious health problems. Screenings, as part of prenatal care, can identify many important maternal health conditions or risk factors for poor infant outcome, including pregnancy-related hypertension and diabetes, cigarette smoking and others.


The use of alcohol, tobacco and illegal substances during pregnancies is associated with many developmental problems in infancy and childhood, partly as the result of very low birth weight and premature delivery. The use of alcohol during pregnancy can cause fetal alcohol syndrome, a leading cause of mental retardation.

Most neural tube defects are preventable, but the intervention requires nutritional supplements prior to conception.


66% of childbearing aged women (18-44) did not take supplements containing folic acid, compared to 46% of the women the same age in Texas *The number of infant deaths were too small to calculate a meaningful rate for comparison with the Border and Texas **85.1% of pregnant women in Val Verde County received prenatal care during the first trimester, which was higher than the 80.3% in Texas **

In 2001, “Maternal, Infant, and Child Health” data for Val Verde County revealed the following:




18. Reduce the suicide death rate by 15 percent.

Mental Health

Mental disorders are health conditions characterized by altered thinking, mood, or behavior that are associated with distress or impaired functioning. These conditions can lead to a variety of problems including disability, pain, or death. The prevalence of mental illness in the border population is unknown, but annually, about 22 percent of the U.S. population is affected by a mental disorder.

Of the principal mental disorders, major depression is thought to be one of the most important. Suicide, a major public health problem, occurs most frequently as a consequence of a mental disorder, usually due to major depression and bipolar disorder (manic-depression).

Mental Health

There is no available mental health data for Val Verde County

The number of deaths due to suicide were too small to calculate a meaningful rate for comparison with the Border and Texas ** **

In 2001, “Mental Health” data for Val Verde County revealed the following:


Mental Health


19. Reduce the proportion of adults who are obese by 15 percent.

Nutrition and Overweight

In June 1998, the federal government announced guidelines which created a new definition of a healthy weight – a BMI of 24 or less. Thus, a BMI of 25 to 29.9 is now considered overweight. Individuals who fall into the BMI range of 25 to 34.9, and have a waist size of over 40 inches for men and 35 inches for women, are considered to be at especially high risk for health problems.

* BMI is calculated as weight in pounds divided by the square of the height in inches and the resulting number then multiplied by 704.5. For example: a woman that is 5’5” and weighs 125 pounds would be considered normal in weight because her BMI would be 20.8. If she weighed 150 pounds she would be considered overweight because her BMI would then be 25; and, if she weighed 180 pounds, she would be considered obese because her BMI would then be 30.


40% of the people in Val Verde County reported engaging in more than 20 minutes of physical activity most days of the week, which was better than the 21% for Texas

45% of males and 35% of females exercised more than 20 minutes per day

Only 8% of people in Val Verde County reported eating 5 or more servings of fruits and/or vegetables each day, which was much lower than the 23% in Texas

In 2001, “Nutrition and Overweight” data for Val Verde County revealed the following:



20. Increase to at least 75 percent the proportion of the population served by community water systems with optimally fluoridated water.

Oral Health

21. Increase to at least 75 percent the proportion of children and adults who use the oral health care system each year.

Treatment of dental cavities

Preventive services such as dental sealants

Dental restorative treatments such as replacement of temporary teeth

Screening and diagnosis of oral and pharyngeal cancers

Identification and referral for treatment of oral birth defects such as cleft lip and cleft palate

Oral health is an essential component of health. Essential dental services include:

Oral Health

The level of dental caries in children has declined in recent decades, due to the increased use of toothpaste containing fluoride as well as community water fluoridation. Dental caries remain a significant problem for certain subgroups of the population, in particular for low-income groups.

A continued focus on oral health by governmental agencies and professional organizations will help to improve oral health. Increasing the number of dental personnel and community-based treatment programs will provide affordable access to dental care for the underserved population.

Oral Health

82% of the people reported brushing their teeth 2 or more times a day *

77% of the men and 86% of the women reported brushing their teeth 2 or more times a day *

35% reported using dental floss to clean between teeth at least once per day *

33% of the men and 38% of the women reported using dental floss at least once per day *

In 2001, “Oral Health” data for Val Verde County revealed the following:


Oral Health

22. Reduce the asthma hospitalization rate by 40 percent.

Respiratory Disease

Increases in asthmatic symptoms have been associated with a variety of pollutants. Illness and disability from asthma are related to air pollutants (e.g., ozone and particulate matter), allergens, and exposure to some pesticides.

For 2001, no data on asthma was available for Val Verde County.

23. Reduce the rate of alcohol-related motor vehicle crash deaths by 50 percent.

Substance Abuse

24. Increase to 89 percent the proportion of adolescents not using alcohol or any illicit drug during the past 30 days.

14% reported having 5 or more drinks in the past 30 days, compared to 18% in Texas

24% of the men and 6% of the women reported drinking at least 5 alcoholic beverages in the last 30 days

3% reported having 60 or more drinks in the past 30 days, compared to 8% in Texas

6% of the men and 1% of the women had at least 60 alcoholic beverages in the past 30 days

3% reported driving after “perhaps” too much to drink in the past 30 days, compared to 4% in Texas

In 2001, “Substance Abuse” data for Val Verde County revealed the following:


Substance Abuse

25. Reduce by 33 percent the proportion of adults and adolescents currently using tobacco.

Tobacco Use

52% of the men and 28% of the women reported having smoked at least 100 cigarettes in their lifetime

57% reported smoking every day or some days, which was much higher than the 22% in Texas

52% of the men and 64% of the women reported smoking every day or some days

19% of the men and none (0%) of the women reported using chew and/or snuff tobacco

In 2001, “Tobacco Use” data for Val Verde County revealed the following:


Tobacco Use

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Demographic and Health Profile Val Verde County 2001 Texas Department of State Health Services...

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