summit county community health assessment

Transcription

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SUMMIT COUNTY PUBLIC HEALTH
MISSION STATEMENT
The mission of Summit County Public Health is to protect and promote
the health of the entire community through programs and activities designed to address the safety, health and well-being of the people who live
in Summit County. Through its programs and activities, the Health District seeks to create a healthful environment and ensure the accessibility
of health services to all.
Acknowledgments
We would like to thank the many government agencies, health, social service, and faith-based organizations, businesses, and people who work together on a daily basis to improve the community’s health and quality of life on
behalf of all the citizens of Summit County. These include the several hundred community volunteers who commit their time and talent to the Summit 2020: A Quality of Life project, as well as County Executive Russell M.
Pry and Summit County Council for their continued commitment to advancing public health.
Special thanks are also due to Akron Children’s Hospital, Akron General Health System, Summa Health Systems,
and Round River Consulting, LLC.
_________________________________________________________________________
Richard A. Marountas, Summit County Public Health, was the author of this report.
Donna Skoda, Summit County Public Health Deputy Health Commissioner, assisted with data gathering, analysis, and review of
findings. Heather Beaird, Ph.D. and Dimitre Stefanov, Ph.D., Summit County Public Health, were the primary authors of two
critical source documents utilized for this assessment, the 2008 Ohio Family Health Survey (Dr. Beaird) and the 2008 Behavioral Risk
Factor Surveillance Survey (Dr. Stefanov).
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Table of Contents
1. Structure of the Community Health Assessment
5
2. Community Input 7
2a. Attitudes of Community Leaders 8
2b. Attitudes of Community Residents 10
3. Community Health Outcomes and Indicators
13
Community Health Outcome 1: Years of Potential Life Lost 14
Community Health Outcome 2: Percent In Fair or Poor Health
15
Health Behaviors 17
1.
2.
3.
4.
5.
Estimated tobacco use (BRFSS)
Percent who exercise regularly (BRFSS)
Percent of population who abuse alcohol (BRFSS)
Number of STD cases per 100,000 population (Chlamydia / Gonorrhea)
African-American Teen Birth Rate per 1,000
18
19
20
21
Clinical Care 23
6. Percent of Persons Age 18-64 Who Had Health Insurance
7. Ambulatory-Sensitive Care Conditions per 1,000 Medicare enrollees
8. Percent of Population Living In Health Professional Shortage Areas
9. Percent of Children Receiving Immunizations by Their Second Birthdays
10. Percent of Pregnant Women Receiving First Trimester Prenatal Care
24
25
26
27
28
Social and Economic Factors 29
11. Percent of Persons Age 25+ With A 2-Year or Higher Degree
12. Percent rating proficient or better on 4th grade reading proficiency test
13. Graduation rate
14. Unemployment Rate
15. Poverty Rate
16. African-American Poverty Rate (overall)
17. Percent of female-headed households in poverty
18. Childhood poverty (all races)
19. Percent with an Ohio Direction Card
20. Percent of Households Paying More than 30 percent of Income on Housing
21. Percent of adults without adequate social / emotional support (BRFSS)
22. Number of substantiated / indicated incidents for Assessment of Child Abuse or
Neglect per 1,000 children
23. Number of violent crime arrests per 1,000 population
24. Elder Abuse, Neglect, Self-Neglect, or Exploitation Referrals per 1,000
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31
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34
35
36
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Physical Environment 44
25. Mobile and Major Sources of toxic air emissions (millions of tons)
26. Gallons of Water Used Per Person, 2010
27. Age and condition of residential structures, 2010
28. Percent of zip codes in a county with a healthy food outlet
29. Recreational facilities per 100,000
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45
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47
48
49
4. Discussion and Findings By Health Factor 50
Appendix A: Demographic Profile of Summit County, Ohio
51
Appendix B: Community Partners of the Summit 2020: A Quality of Life Project
60
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1. Structure of the Community Health Assessment
There are two major sections in the Community Health Assessment, Community Input and Community Health Indicators. The Community Input section, which directly follows this section, discusses two major recent efforts at involving the
community at large in the process of improving community health. One of these efforts involves a systematic, decade-long
project to involve the community in the process of improving the county’s economic, health, and social conditions. The
other involves a comprehensive study of the attitudes, perceptions, and behaviors of the people of Summit County with
respect to community health. Each is discussed in some detail in the pages that immediately follow this section.
The Community Health Indicators are modeled after the Wisconsin County Health Rankings project developed jointly by
the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. This model, outlined
below in a graphic reproduced from the County Health Rankings website, provides a comprehensive methodology for
understanding how a community’s collective efforts to improve health and social conditions interacts with prevailing socioeconomic and health conditions to
produce desirable (or undesirable)
outcomes in a community’s health and
quality of life.
Summit County’s Community Health
Indicators contain 29 indicators in
all, which are presented in the pages
that follow in the “County Health
Rankings” structure outlined at right.
Some of the indicators are reproduced
directly from County Health Rankings; most have been included because
they have been identified as a priority
indicator by the county’s Quality of
Life project.
Indicators are presented in three sections corresponding to the “flow” of
the Health Rankings model (and found
on the left side of the graphic at right).
Policies and programs combine with
health factors to produce health outcomes. In turn, those health outcomes
are measured in terms of morality, or
length of life, and morbidity, or quality
of life. These concepts are measured
by Years of Potential Life Lost and the
percent of the population which says it
is in fair or poor health, respectively.
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Beneath the two outcome indicators lie the bulk of the indicators in this assessment. They are organized into four major
sections, Health Behaviors, Clinical Care, Social and Economic Factors, and Physical Environment.
Community Health Indicators:
The 29 community health indicators each have four sections to them. The first, Why Is This Indicator Important? gives
the rationale for why the indicator was chosen. The Definitions section clearly defines each indicator and includes the data
source from which it was drawn. The third section, entitled How [The Indicator] Has Changed, presents the current data
and any trend data which is available. Finally, the fourth section, What Factors May Be Contributing To The Change
presents some possible explanations for why we are seeing the results that we are.
A Note on the American Community Survey
One final word needs to be included about the structure of the report. Much of the data for this report comes from the U.S.
Census Bureau’s American Community Survey (ACS). According to the Census Bureau own description, the ACS replaces
“...the long form in future censuses and is a critical element in the Census Bureau’s reengineered 2010 Census Plan.”
The ACS now presents annual data in three forms, five-year estimates which allow users to drill down to census tracts or
block groups, three-year estimates, which allow users to access data for geographic areas larger than 20,000, and one-year
estimates, which are generally most useful for geographic areas like large counties and central cities (like Summit County
and the City of Akron). Despite the increase in sample size, the ACS still uses a much smaller sample size than the fullcount decennial census (most recently conducted in 2010). The ACS data presented here are one-year estimates from 2010
and, therefore, have margins of error that should be taken into account, especially when assessing change over time. When
interpreting ACS data we can be 90 percent confident that if all persons in a given population were surveyed, the responses
would fall within the identified margins of error. This concept is called the 90 percent confidence interval.
We indicate in the discussion which differences are statistically significant through the use of these confidence intervals.
In the figures, we show the 90 percent confidence intervals by including error bars on each figure containing ACS-derived
data, so it is easy to see whether the intervals do or do not overlap. The columns in each figure show the estimated data
(called the point estimate), while the error bars show the range of possible values above and below the point estimate.
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2. Community Input
Community input for this assessment came from two major sources. The first of these is the Summit 2020: A Quality of
Life Project. The Quality of Life project began in 2003 as an initiative out of the Summit County Executive’s Office with
two goals: to improve the county’s economic competitiveness and its quality of life. Though an initiative of the Executive
Office, the project was (and still is) a broad-based community collaboration. Under the guidance of the Social Services
Advisory Board, the body charged with the oversight of the project by the County Executive, the Quality of Life project
brought together a diverse array of organizations and community leaders from government agencies, non-profit social services organizations, educational institutions (both K-12 and university), area businesses, neighborhood groups, individual
citizens, and faith-based groups; several hundred volunteers in all. This coalition worked with project staff to create a
comprehensive environmental scan and developed a set of priority indicators of the community’s socioeconomic health to
be monitored over time. Committees were then formed to create and implement plans to improve these priority indicators.
The initial goals for the project had a time line of 2010 for completion; targets for improvement were set for the project’s 20
priority indicators and progress monitored in the intervening years. In 2009, a report to the community was released which
charted progress on the indicators and goals. Now that the first decade has been completed, a second round of targets for
achievement have been set for 2020 and work continues. The project currently is organized into five major initiative areas:
Economic Stability and Prosperity
First Things First (the project’s early childhood initiative)
Older Adults
Health and Health Disparities
Government Efficiency and Effectiveness
While not primarily a community health-oriented initiative, the Quality of Life project nevertheless touches on issues of
community health in a number of areas, and has incorporated a social determinants of health model into its work regarding
health and health disparities. This orientation makes the Quality of Life project an ideal source for both socioeconomic
data as well as for community input; sources that we have drawn upon when creating this community health assessment.
Community input from the Quality of Life project takes two forms. The first is that many of the indicators chosen for this
community health assessment were chosen because community consensus around those indicators has already been built
through the Quality of Life project. One of the primary accomplishments of the Quality of Life project has been the acceptance by the wider community of specific indicators of progress and their associated targets for improvement. Since
most of those indicators are also a good fit with the social determinants of health model we’ve adopted for this community
health assessment, their inclusion made sense. The second source of community input from the Quality of Life project also
comes from the project’s 2009 progress report on its priority indicators. Included in that analysis was a small-scale survey
of community leaders, which asked them to identify the strengths, weaknesses, opportunities, and threats that they saw as
the community moved into the next decade. The results of that survey are included in the following pages and shed some
light on some of the issues facing the community, helping us to understand the context in which our efforts to improve
community health are taking place.
The second major source of community input comes from a series of focus groups, on-line, and paper surveys conducted in
2009 and 2010 by a collaboration of the county’s three major hospital systems, Akron Children’s Hospital, Akron General
Health System, and Summa Health Systems. This series of community input surveys was coordinated by a local company,
Round River Consulting, LLC. A summary of the results is also included in the pages that follow.
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2a. Attitudes of Community Leaders:
In preparation for the 2009 Quality of Life project report, project staff conducted a limited survey drawn from a variety
of community leaders from the non-profit, philanthropic, governmental, faith-based, and private sectors who have been
involved in the Summit 2010 project. The goal was to find out what leaders and citizens saw as the major strengths, weakness, opportunities, and threats facing Summit County as the community moved forward into the second decade of the
2000s. Below, the views of the respondents are reproduced in summary form:
Strengths
A couple of common themes arose from the comments about Summit County’s strengths:
•
Summit County’s culture of collaboration: As in the original 2003 environmental scan, the ability and willingness of the people and institutions of Summit County to join forces to find solutions to the county’s problems
was the most frequently cited strength.
•
People in Summit County are creative, caring, and resilient: Comments here included the willingness of
people to devote their own resources to help fight community problems, the existence of strong neighborhood
ties, and the ability of both people and organizations to overcome the immense economic upheavals of the last
three decades.
•
The county’s solution-oriented organizational leadership: Responses here included the county’s ability to
make the BioInnovations Institute and the Center for Outreach to the Medically Underserved happen, as well as
the strong leadership of the County Executive and Mayor of Akron.
Weaknesses
There were also a couple of common themes that arose when thinking about Summit County’s weaknesses:
•
Negative attitudes and perceptions: Comments here addressed the negative attitudes of some within the
county (a “glass half-empty” philosophy) and the perception of the county to many outsiders (in the words of
one respondent, Akron’s perception elsewhere is that of “a decaying city that went bust” after the demise of the
tire industry). In the opinion of some respondents, these kind of attitudes can lead to a persistence of parochial
thinking and an unwillingness to try new approaches to solve old problems.
•
The high and rising level of need within the community: Comments here centered around the growing hardships imposed by the poor economy, such as unusually high unemployment and growing limitations in funding
for health and social services. These limitations, in the view of some respondents, have forced many city and
county government agencies to seriously reduce staffing levels, and significantly eroded their ability to address priorities beyond their strict core scope of services. Other comments mentioned the fast-rising number of
people needing basic services like food and shelter.
•
A limited awareness of the depth of the problems that face us: Responses here included a lack of effective
communications and education that prevent many in our community from either recognizing existence of problems at all, or, as one respondent put it, “the general lack of awareness and concern about the degree of poverty
and deprivation that exists in this community.”
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Opportunities
Within the discussion of opportunities, there was one dominant theme:
•
The opportunity to try new approaches: Comments here included the idea of mobilizing the growing number
of retirees to use their increased free time to help improve the quality of life; the opportunity to mobilize people
in one or more Summit 2010 initiatives; the opportunity to redesign, streamline and align major systems, and
share employees in order to improve efficiency and promote even more effective collaboration. Other comments mentioned the opportunity to form more partnerships with organizations like Akron Public Schools, local
hospital systems, and major private sector employers. Others mentioned the opportunity to more aggressively
market the county’s assets such as the University of Akron, Cuyahoga Valley National Park, the Cuyahoga
River and the old canal system, and a revitalized downtown, as well as the opportunity to consider solutions
which may be new to Summit County but have been proven successful elsewhere.
Threats
There were also a couple of common themes that arose when thinking about threats facing Summit County:
•
The magnitude of the economic problems that face us: Comments here were related not only to the depth of
our current economic problems, but the perception that recovery will probably be very slow. This includes the
likelihood that job losses and negative demographic changes will continue, as will the current environment of
scarce resources available for government agencies and non profit groups to cope with growing problems (and
the competition for those resources among service providers). One respondent mentioned the need for the community to balance its investments in charity care with investment in economic growth and education.
•
Apathy and self-interest: Comments here included the apathetic attitude of some leaders within the community
towards problems that we know exist or are looming in the near future, and the hesitancy of some within the
community to give up anything that currently benefits themselves to help improve the overall quality of life for
all citizens. One respondent cited the threat of allowing the crisis at hand to “commandeer all resources, attention, and leadership.”
From its inception, Summit 2010 has focused on strengthening Summit County’s already-strong culture of collaboration
and on finding new, innovative solutions to long-standing problems the community faces. Lying beneath these two foundational strategies is a firm belief that, whatever the current state of our priority indicators, this community’s strengths far
outweigh its weaknesses, and that the opportunities to improve our quality of life far outweigh the things that threaten to
further undermine it. That sentiment is more than mere wishful thinking. As proof, we offer the collective experience of
the more than 300 volunteers working on one or more of Summit 2010’s 15 project committees. If we continue to work
together, and continue to “dream big,” than today’s tough times and past ways of thinking will ultimately give way to a
better future for all Summit County residents.
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2b. Attitudes of Community Residents:
As noted earlier, a series of series of surveys and focus groups were coordinated by a local company, Round River Consulting, LLC, in 2009 and 2010. Below, the top ten “key findings” from that research is reproduced in summary form:
Top Ten Key Findings
1. Responses to Questions Related to Key Health Indicators
On-line and paper survey respondents indicate whether they or a family member have ever been told by a doctor that they
have particular conditions, diseases, or health challenges. Nearly forty-percent (39.9%) of all assessment participants
indicate that mental/emotional problems and conditions have been diagnosed. Over twenty-seven percent (26.7%) of all
respondents say physicians have raised overweight/obesity concerns. Asthma or other respiratory conditions, heart disease/
attack or stroke, and diabetes rates range from 19.3% to 16.5% respectively. Cancer is mentioned by one-tenth (10.4%) of
all participants. Residents identify lack of financial resources for insurance and doctor visits as the most significant barrier
in managing chronic health conditions.
2. Residents Are Keenly Aware of Healthy Lifestyle Choices
A majority of residents express a balance of physical, emotional, mental, and spiritual wellbeing as critical to maintaining
health. Independence and freedom from pain, disability, illness, major disease and stress is at the center of their descriptions
of health. Being proactive about one’s health including understanding and dealing with chronic health conditions, eating a
healthy diet, engaging in physical activity/exercise, and knowing your own body are identified as priorities.
3. Residents Wish to be Inspired, Motivated and Supported To Make Behavior Changes
A desire to create a community culture of health promotion and disease prevention is broadly expressed. Building strong
trusting relationships with health care providers focused on keeping residents healthy instead of treating symptoms with
medications and medical procedures is preferred. Many assessment participants have heard the directive from their physicians to eat healthier foods and increase physical exercise; however, they often need support to implement actions that
would be impactful. Addictions to salt, sugar, and fat are acknowledged as major challenges in making changes in behavior.
Addiction to nicotine is identified as the top reason residents who smoke continue to do so. Receiving information and
training on nutrition, how to prepare healthy foods and managing chronic health conditions are identified as important supports. Residents also say they would benefit from learning, sharing and acting together with others to support them in their
own efforts to lose weight, eat healthier foods, and take responsibility for their own health. Residents want resources to
be embedded within their own communities. Transportation and time challenges are often significant barriers to accessing
exercise opportunities, classes, family-centered recreational activities, and health care providers. Physician office hours and
locations can make it difficult to access necessary care. Extended hours to include evenings and weekends are recommended.
Frustration with the complexity of the health care system and insurance policies is expressed. As a result, residents request
assistance to navigate the insurance and health care system. Many focus group participants express a deep desire to empower
families, educate and support parents to help their children transform their diets, increase physical activity and manage
behavioral and developmental challenges. They feel family cultures and traditions that favor unhealthy foods and little physical activity must be transformed and depression and other behavioral health and substance abuse issues must be addressed.
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4. Income, Race and Culture Impact Access
The Review of Published Data reveals a relationship between household income and chronic conditions such as obesity and
diabetes. Trends in the State of Ohio hold true in the 5-county area that show increases in prevalence as income decreases.
In addition, the Review of Published Data also suggests higher prevalence among African Americans in several of the
chronic conditions highlighted in this assessment. Samples in existing data for other racial groups are too low to suggest
higher prevalence rates in other racial groups.
Most focus group participants acknowledge the existence of disparities in the delivery of health care services and opportunities to improve personal health status. Availability of a comprehensive array of health care providers including dental,
optical, behavioral health and substance abuse treatment is needed. Access to fresh affordable healthy foods, safe affordable
places to exercise throughout the year, environmentally safe housing and neighborhoods, health education and information are critical resources that often are not available to many urban and rural communities. Every immigrant focus group
participant expresses frustration with the medical community’s capacity to demonstrate cultural sensitivity that leads to
effective health care for those who do not speak English and who embrace cultures and norms that are different from this
community’s mainstream. They also observe increasing levels of obesity and diabetes due to the inability of immigrants
to read nutritional labels, have access to affordable traditional fresh foods, and maintain the same level of physical activity
common in their countries of origin. The introduction of American fast food is also a major influence among all ages. The
African American community expresses a desire to generate a more racially and culturally diverse corps of health care
providers, particularly in the areas of behavioral health and substance abuse treatment. Additionally, a more effective referral process to navigate the system for children with developmental challenges is identified as a priority, particularly in the
African American community where support to advocate for families and their children with special needs is also desired.
5. Residents Expressed the Need for Economic Security
Employment is ranked high in most questions related to issues that impact the health of our region’s residents. Good-paying
jobs frequently offer health insurance and/or the ability to pay for health care, the capability to purchase fresh healthy
foods and provide transportation, and access to exercise and recreational facilities. Health insurance premiums, co-pays,
and deductibles are often barriers in accessing necessary preventative care and treatment. Many participants say that they
and family members often become depressed, lacking hope and motivation when they are unemployed or underemployed.
Many residents express deep concern regarding increasing numbers of family members who are struggling with substance
abuse and mental health issues as a result of stress.
6. Behavioral Health/Substance Abuse Concerns Residents
Residents recognize the importance of having behavioral health services available for adults of every age and children
throughout the region. They indicate there are not enough providers and facilities outside the City of Akron, expressing a
desire to be able to visit providers within their own communities. Some share challenges in dealing with health insurance
companies to pay for services.
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7. Residents are Deeply Concerned About Our Children’s Health
Residents express significant concern regarding the deteriorating physical and behavioral health status of our community’s
children. Extremely unhealthy diets rich in sugar, salt and fat coupled with very little physical activity are top concerns.
Parents, schools, health care providers and community institutions are all identified as key components of the change that is
necessary to help our children lose weight, improve self-esteem, and address other behavioral challenges. Parent education
and support to impact children’s behaviors and habits, a comprehensive school health curriculum, healthy school lunches,
availability of safe places to play and participate in recreational sports, and opportunities for family-based activities are
recommended.
8. Residents Want Better Information
Primary data shows a concern that information on existing sources of assistance is not always communicated through means
that reach the intended audience. Information shared through faith-based institutions and other trusted community-based
organizations is preferred over on-line communication, newspaper articles and public listings. Some residents observe that
too many agencies and organizations operate in isolation from another, creating a silo effect and increased confusion within
an already complex health care system.
9. Residents See the Need for Economic Development, Zoning & Safety for All
Attracting full-service grocery stores and encouraging smaller businesses to offer affordable fresh natural foods is desired.
In urban neighborhoods, residents also express a need to reduce concentrations of alcohol and tobacco sales and increase
businesses that offer other crucial amenities that build vibrant communities. Deploying resources and developing community initiatives that increase safety for every resident in the region is identified as an essential component in creating a safe
and attractive environment for outdoor activity and exercise. Assessment participants also make the point that affordable
indoor facilities are necessary in this climate.
10. Residents Propose Programs
Residents offer recommendations in the assessment for health care, health education or public health programs and services
they feel would be most helpful in supporting their efforts to be healthy. Top priorities are:
•
•
•
•
•
Health Prevention, Education and Wellness Resources and Programs
Free/Low Cost Indoor Community-Based Recreation and Exercise Programs
Healthy Nutrition/Cooking Classes for Adults and Children
Affordable Health Care
Behavioral Health/Substance Abuse Services
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3. Community Health Outcomes and Indicators
The terms “morbidity” and “mortality” summarize what are, arguably, the most important ultimate outcomes in public
health, how well we live and how long we live. The collective outcomes of the indicators included in this assessment,
as well as many indicators that were not included, all combine to shape how healthy we are as a population. Though
there are many indicators for morbidity and mortality that could have been included, we choose the two discussed below
because they most directly measure the twin ideas of how well we live and how long we live
Outcomes in this section:
Morbidity:
Community Health Outcome 1: Years of Potential Life Lost
Mortality:
Community Health Outcome 2: Percent in Fair or Poor Health
Indicators in this section:
Health Behaviors (see page 17)
Clinical Care (see page 23)
Social and Economic Factors (see page 29)
Physical Environment (see page 44)
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Community Health Outcome 1:
Years of Potential Life Lost
1999-2001, 2004-2006
Why This Indicator Is Important -- Years of potential life lost (YPLL) measures premature mortality. It represents the
number of years people would have lived if they did not die from heart disease, cancer, motor vehicle accidents, etc. YPLL
is presented for persons under 75 years of age since that age is roughly equivalent to the average life expectancy for all
Americans.
Definition -- Years of potential life lost (YPLL) is calculated by subtracting the age at death from 75 years of age. For
example, the death of an infant less than one year old counts as 74 years of potential life lost, whereas the death of a 70-yearold person counts as five years of potential life lost. YPLL per 1,000 population is calculated by dividing the total years of
potential life lost by the total population in a given geography, and then multiplying by 1,000.
How Years of Potential Life Lost Has Changed -- Years of potential life lost has remained essentially unchanged, declining slightly from 6.9 years lost during the 1999-2001 period to 6.4 years lost from the 2004-2006 period.
Factors That May Be Contributing to the
Change -- As noted above, years of potential life
lost is a measure of premature deaths among the
general population. Therefore, it can be impacted
by a wide variety of factors that impact health and
lead to premature death. Addressing controllable
lifestyle factors such as smoking, obesity, lack of
exercise, and stress are perhaps the best way to
decrease the years of potential life lost.
Due to the nature of the indicator, younger premature deaths (particularly infant mortality) have
a greater impact on the indicator than premature
deaths at older ages. Therefore, factors such as low
birth weight and lack of prenatal care can significantly impact the infant mortality rate, which, in
turn, impacts the years of potential life lost. In fact,
according to the U.S. Department of Health and Human Services’ Maternal and Child Health Bureau,
babies born to mothers receiving no prenatal care
are three times more likely to be low birth weight
and five times more likely to die than those whose
mothers received prenatal care.
Years of Potential Life Lost,
Sum m it County, 1999-2001 to 2004-2006
10.0
5.0
-
14
6.9
6.4
1999-2001
2004-2006
Community Health Outcome 2:
Percent of Population Saying They Are In Fair or Poor Health (Health Status), 2008
Why This Indicator Is Important -- Self-reported health status is a key factor in people’s quality of life. As noted by
the American Academy of Pediatrics, self-reported health status “...has consistently been shown to be a reliable and valid
measure of general physical well-being among adults that is highly correlated with objective measures of physical health,
including mortality risk and functional limitation, among others.”
Definition -- This indicator is defined as the number of respondents who rated their own health as either fair or poor in the
2008 Behavioral Risk Factor Surveillance Survey.
How Health Status Has Changed -- In the 2008 BRFSS, just over 13 percent of the adult population said they were in
fair or poor health. The Summit County figure was no statistically significantly different than comparable figures for the
state of Ohio (13.4 percent and 15.6 percent, respectively).
Factors That May Be Contributing to the Change -- Since the 2008 survey was the first for Summit County in which
data on health status was available, there is no trend data to compare 2008 results to.
Despite the lack of trend data, an analysis of 2008
data for Summit County examined several demographic factors for any potential relationship to
fair or poor health, including health plan coverage,
employment, age, race, education, income, and
marital status. Of these, three factors were identified that reduced the likelihood of having poor or
fair health, being in the highest income category,
being employed, and having a college education.
Percent of Adult Population Who Say They Are
In Fair or Poor Health
Sum m it County, 2008
20%
15%
10%
5%
13.4%
0%
2008
15
This Page Intentionally Left Blank
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Health Behaviors
Many factors can influence a person’s health. For example, genetic predispositions to various diseases can impact
health, as well as a whole host of environmental conditions. And, as recent research shows, there are many social
determinants of health as well. One critical factor that must not be left off of the list of factors is personal health
behaviors. Many health problems are caused by personal health behaviors such as substance abuse, the decision to
exercise (or not exercise), and practicing unsafe sex. Developing strategies to help improve people’s ability and willingness to make healthy personal choices is a key component in improving the health of all Summit County residents.
Tobacco Use:
1. Percent of Adults Using Tobacco
Diet and Exercise:
2. Percent of Adults Engaging In Regular Exercise
Alcohol Use:
3. Percent of Adults Who Abuse Alcohol
Unsafe / Unprotected Sex:
4. STD cases per 100,000
5. African-American Teen Birth Rate per 1,000
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Community Health Indicator 1:
Estimated Tobacco Use, 2008
Why This Indicator Is Important -- Smoking is the most important single preventable cause of death in the United States.
It is a major risk factor for several diseases, including heart and cerebrovascular diseases, chronic bronchitis and cancer. In
addition, secondhand smoke causes long-term adverse health effects in nonsmoking adults and children. For these reasons,
reducing or stopping tobacco use is critical to advancing the long-term health of the population.
Definition -- This indicator is defined as the number of respondents who said that they were a current smoker in the 2008
Behavioral Risk Factor Surveillance Survey.
How Tobacco Use Has Changed -- Since the 2008 survey was the first for Summit County in which data on tobacco use
was available, there is no trend data to compare 2008 results to. As of that year, approximately one-in-five Summit County
residents used one or more forms of tobacco. The Summit County figure was no statistically significantly different than
comparable figures for the state of Ohio (19.2 percent and 20.1 percent, respectively).
Factors That May Be Contributing to the Change -- There are a wide variety of potential causes of tobacco use, psychological, social, and pharmacological. A 2004 article
in the British Medical Journal entitled “Why People
Percent of Adult Population Who Are Current
Smoke” summarized the causes: “Experimenting
Sm okers, Sum m it County, 2008
with smoking usually occurs in the early teenage
years and is driven predominantly by psychoso- 50%
cial motives…The desired image [of perceived
adulthood or rebelliousness] is sufficient for the
novice smoker to tolerate the aversion of the first
few cigarettes, after which pharmacological factors assume much greater importance.” The article
goes on to highlight another facet of smoking, that
it tends to be more prevalent among people from
lower socioeconomic backgrounds. Analysis of
25%
BRFSS data for Summit County seems to support
this idea. Current smokers in the 2008 Summit
County BRFSS are more likely to lack a high school
diploma, be unmarried, and have incomes below
$25,000 per year. Current smokers are also more
likely to be African-American.
19.2%
0%
2008
18
Physical Activity, 2008
Why This Indicator Is Important -- The health benefits of regular physical activities for overall physical and mental
health are well documented. Therefore, regular physical activity is considered an essential part of good individual and
population health.
Definition -- This indicator is defined as the number of respondents who said that they exercised during the past month in
the 2008 Behavioral Risk Factor Surveillance Survey.
How Physical Activity Has Changed -- Since the 2008 survey was the first for Summit County in which data on physical
activity was available, there is no trend data to compare 2008 results to. Just over three-quarters say that they have exercised within the past month. The Summit County figure was statistically significantly higher than comparable figures for
the state of Ohio (77.9 percent and 74.0 percent, respectively).
Factors That May Be Contributing to the Change -- There are certain demographic factors which are more often associated with not exercising regularly. According to the HealthyPeople.gov website, “Factors negatively associated with
adult physical activity include: advancing age, low income, lack of time, low motivation, rural residency, perception of
great effort needed for exercise, overweight or obesity, perception of poor health, being disabled... Older adults may have
additional factors that keep them from being physically active, including lack of social support, lack of transportation to
facilities, fear of injury, and cost of programs.”
Demographic analysis of 2008 Summit County
BRFSS data shows that levels of physical activity
tended to be higher among whites and males, and
also among those who were younger. As with other
factors, higher incomes and educations tended to be
more physically active than others.
Percent of Adult Population Who Say They
Exercised Within the Past Month,
100%
75%
50%
25%
77.9%
0%
2008
19
Alcohol Abuse, 2008
Why This Indicator Is Important -- Alcohol drinking is a risk factor for numerous adverse health and social outcomes.
The effects of heavy and binge (“episodic heavy drinking”) drinking as well as the difficulties for overcoming it is a well
recognized public health problem..
Definition -- Heavy drinkers were defined as males who admitted having more than two drinks per day, or females who
admitted having more than one drink per day on the 2008 Behavioral Risk Factor Surveillance Survey.
How Physical Activity Has Changed -- Since the 2008 survey was the first for Summit County in which data on physical
activity was available, there is no trend data to compare 2008 results to. Just over three-quarters say that they have exercised
within the past month. The Summit County figure was no statistically significantly different than comparable figures for
the state of Ohio (4.7 percent and 5.8 percent, respectively).
Factors That May Be Contributing to the Change -- The HealthyPeople.gov website also summarized several factors
which are associated with alcohol abuse, “Several biological, social, environmental, psychological, and genetic factors are
associated with substance abuse. These factors can
include gender, race and ethnicity, age, income levPercent of Adult Population Who Say They
el, educational attainment, and sexual orientation.
Drink Heavily, Sum m it County, 2008
Substance abuse is also strongly influenced by interpersonal, household, and community dynamics. 10%
Results from the 2008 Summit County BRFSS
show that heavy drinking was more prevalent
among men and whites, and also decreased with
age. Rates of heavy drinking were lower for college graduates.
8%
6%
4%
2%
4.7%
0%
2008
20
Sexually-Transmitted Disease Rate Per 100,000 Population, 2009 and 2010
Why This Indicator Is Important -- Sexually-transmitted diseases STDs are an ongoing, serious public health problem.
Undiagnosed STDs such as Chlamydia, can lead to serious and often symptomless health complications including infertility,
Pelvic Inflammatory Disease, and an increased risk of contracting HIV. STDs are especially dangerous because of their
widespread communicability in cases of unprotected sexual activity.
Definition -- This indicator is defined as the number of confirmed, probable, or suspected cases of Chlamydia and Gonorrhea reported to the Ohio Disease Reporting System per 100,000 population.
How STD Rates Have Changed -- STD rates in Summit County rose from 431.9 cases per 100,000 in 2009 to 580.1 per
100,000 in 2010.
Factors That May Be Contributing to the Change -- As with other behavioral factors, rates of sexually-transmitted
diseases are impacted by a variety of factors. To again quote Healthy People, “The spread of STDs is directly affected by
social, economic, and behavioral factors. Such factors may cause serious obstacles to STD prevention due to their influence
on social and sexual networks, access to and provision of care, willingness to seek care, and social norms regarding sex
and sexuality. Among certain vulnerable populations,
historical experience with segregation and discrimiReported Cases of Sexually-Transm itted
nation exacerbates the influence of these factors.”
Disease (Chlam ydia & Gonorrhea) per 100,000,
Sum m it County, 2009 and 2010
Healthy People goes on to identify several specific
700.0
social and demographic factors that are most associated with STD rates, including: “Racial and ethnic
disparities; poverty and marginalization; access to
health care; substance abuse; secrecy; and sexual
networks (groups of people who can be considered
“linked” by sequential or concurrent sexual partners.
A person may have only 1 sex partner, but if that
partner is a member of a risky sexual network, then
350.0
the person is at higher risk for STDs than a similar
individual from a non-risky network.)”
-
21
431.9
580.1
2009
2010
African-American Teen Birth Rate (Ages 15-17), 1999-2002, 2003-2005 Averages
Why This Indicator Is Important -- Infants born to mothers under the age of 18 are more likely to have low birth weights
and an increased risk of death. Additionally, children born to teenagers are more likely to be poor and have fewer educational opportunities, hence they are more likely to drop out of school and become teen parents themselves. For most teen
mothers, parenting will shorten their time in school and increase the likelihood that, as young adults, they will be poor and
dependent and place greater burdens on their families.
Definition -- Births to teens are calculated as the number of births to females ages 15 through 17 divided by the total estimated population of females in that age cohort. The rate is expressed as births per 1,000.
How Teen Births Have Changed -- The African-American teen birth rate has shown continued to improve, declining from
60.1 per 1,000 in the 1999-2002 period to 43.0 per 1,000 in the 2003-2005 period.
Factors That May Be Contributing to the Change -- There are a wide variety of possible factors which can influence
teen birth rates, making it difficult to say with any precision which factors may have driven the decline in birth rates in
Summit County.
Factors that have been associated with changes in
teen birth rates can be broken down into two main
themes - those that prevent or delay the beginning of
sexual activity by teens, and those that prevent pregnancy once teens become sexually active. Two of
the most strongly associated factors in delaying or
preventing sexual activity are parental influence and
religiosity. According to the National Campaign to
Prevent Teen Pregnancy, nearly half of teens say
that parents influence their sexual choices far more
than friends, teachers, or the media. Also, teens who
participate in religious activities with their families
are less likely to have sex before age 18.
When considering factors affecting teen pregnancy
once sexual activity has begun, contraception is
clearly critical. According to the Alan Guttmacher
Institute, teen girls who have sex without contraception have a 90 percent chance of becoming pregnant
within one year.
African-American Teen Birth Rate (Ages 1517) Per 1,000 African-American Females
Ages 15-17, Summit County, 1999-02, 200305 Averages
80.0
70.0
60.0
50.0
40.0
30.0
22
57.8
48.2
1999-2002 avg.
2003-2005 avg.
Clinical Care
As noted in the previous section, though other factors matter, in many instances, access to essential clinical care services is the biggest barrier to good health. Providing people with appropriate access to necessary health care services,
helping them to manage chronic diseases on their own. It is also important to promote the participation of pregnant
women and parents in preventative care opportunities such as immunizing children and ensuring that pregnant women
receive early and regular prenatal care.
Access To Care:
6. Percent Who Have Health Insurance
7. Preventable Medical Conditions
8. Population In Health Professional Shortage Areas
Quality of Care:
9. Childhood Immunizations
10. First Trimester Prenatal Care
23
Percent of Persons Age 18-64 Who Had No Health Insurance
1998, 2003-2004, and 2008
Why This Indicator Is Important -- Health insurance coverage, whether provided by employers in the private sector for
employees and their families or by government for the poor or disabled, enables people to have access to a basic level of
health care. The uninsured population is more likely to have low incomes and is more often unemployed. People who have
no health insurance coverage are less likely to have a regular source of care or receive preventive care, thereby worsening
their health status. People who lack coverage often delay seeking care until their illnesses become more serious, necessitating complex and expensive treatment. These people frequently seek medical care at hospital emergency departments.
Definition -- This indicator presents the estimated numbers and rates of the uninsured for adults ages 18 to 64 from the
1998, 2003-2004, and 2008 Ohio Family Health Survey (OFHS). Persons age 65 and older were excluded because they are
eligible for Medicare, which offers coverage for most of this population. The same can be said of children under age 18,
many of whom are covered by the State Children’s Health Insurance Program (SCHIP).
How Uninsured Rates Have Changed -- The point estimate for the percentage of adults who were uninsured rose from
12.0 percent in 1998 to 15.1 percent in 2003-2004. The percentage rose again between 2003-04 and 2008, from 15.5 percent in 2003-04 to 19.6 percent in 2008. The differences between the 2003-04 and 2008 OFHS for Summit County are
statistically significant.
Change -- The most likely drivers of increasing
rates of uninsured adults are the two recessions
we’ve experienced this decade, and the rising cost of
medical care. As companies cut jobs, workers who
were previously covered may have lost coverage.
Other companies, seeking to cut costs to cope with
declining economic conditions, may have reduced
the benefits offered to employees.
With regard to medical care, data from the Bureau
of Labor Statistics shows that the average annual medical care inflation rate for the ClevelandAkron metropolitan area was 5.6% from 2000 to
2008. With medical care costs growing at more
than 2.5 times the overall inflation rate (which
averaged 2.2% from 2000 to 2008), health insurance is becoming harder and harder to afford.
Percent of Persons Age 18-64 Who Had No
Health Insurance,
Sum m it County, 1998, 2003-2004, and 2008
24.0%
12.0%
0.0%
24
12.0%
15.5%
19.6%
1998
2003-04
2008
Preventable Medical Conditions, 2006-2007
Why This Indicator Is Important -- This indicator is a measure of access to and effectiveness of primary health care.
As noted by the National Quality Measures Clearinghouse, “While not all admissions for these conditions are avoidable,
it is assumed that appropriate ambulatory care could prevent the onset of this type of illness or condition, control an acute
episodic illness or condition, or manage a chronic disease or condition. A disproportionately high rate is presumed to reflect
problems in obtaining access to appropriate primary care.”
Definition -- This indicator presents the number of Ambulatory Care Sensitive Conditions per 1,000 Medicare Enrollees
as presented in the University of Wisconsin’s Wisconsin County Health Rankings. According to County Health Rankings,
“Estimates of preventable hospital stays were calculated for the County Health Rankings by the authors of the Dartmouth
Atlas of Health Care using Medicare claims data.”
How Preventable Medical Conditions Have Changed -- As presented in the chart below, there were approximately 80
Ambulatory Care Sensitive Conditions per 1,000 Medicare Enrollees in 2006-2007, the most recent time period available.
Change -- Unfortunately, trend data from this
source is not available at this time. That said, there
are certain factors that would likely impact this
indicator. Perhaps the most likely of these would
be increasing access to health care. By helping
people without access to health care to receive
routine checkups and to properly manage chronic
conditions they may have it is possible to reduce
the numbers of people whose conditions deteriorate
to the point where they need emergency room care.
It is also much more cost effective to treat most
health conditions in their early stages than when
left untreated for long periods.
Num ber of Am bulatory Care Sensitive Care
Conditions per 1,000 Medicare Enrollees,
Sum m it County, 2006-2007
100.0
80.0
60.0
40.0
In Summit County, this strategy is being pursued by
the Access To Care program, which has been working since 2006 to provide critical health services to
eligible uninsured low income adults.
20.0
-
80.0
2010
25
Percent of Persons Living in Health Professional Shortage Areas, 2003 and 2010
Why This Indicator Is Important -- Access to health care providers is an essential component of receiving necessary
medical care. When people are geographically isolated from an adequate supply of care providers, receiving necessary
care becomes both harder to accomplish and more costly in time and money than it is for those who have ready access to
the care they need.
Definition -- This indicator shows the number of people who live in census tracts labeled as “health professional shortage areas” by the US Department of HHS Health Resources and Services Administration as a percent of the county’s total
population. The 2003 HPSA calculation uses 2000 Census population counts, while the 2010 HPSA calculation uses 2010
Census population counts.
How Health Care Shortage Rates Have Changed -- In 2003, just under 4 percent of the county’s population lived in
Health Professional Shortage Areas (3.8 percent). By 2010 that figure had risen to just under 5 percent (4.7 percent).
Factors That May Be Contributing to the Change -- The most likely drivers of increasing numbers of people living in
HPSAs are population growth within already-designated HPSAs or the designation of new areas which meet the criteria
for being a HPSA.
Percent of Persons Living in Health
Professional Shortage Areas,
In Summit County, it appears that the designation
of new HPSA areas are responsible for the increase.
10.0%
The 2010 population of the 6 census tracts which
were designated HPSAs in 2003 declined by 7
percent. Since that time, however, three additional
census tracts were designated as HPSAs, adding
more than 6,600 people to the total number living
in HPSAs.
5.0%
0.0%
26
3.8%
4.7%
2003
2010
Percent of Children Receiving Immunizations by Their Second Birthday,
2004 and 2008
Why This Indicator Is Important -- Immunizations are a fundamental element in both public health and the health of
families and children. Vaccine-preventable diseases which once devastated tens of thousands of children each year have
been largely eradicated in the United States because of mass immunizations.
Definition -- Immunization data was obtained by the implementation of a retrospective immunization survey conducted
in 2005. The number of immunizations is defined as the number of children who received the complete series of so-called
“4:3:1” vaccinations by 24 months of age as a percentage of all children in the retrospective survey. The 4:3:1 series includes
four doses of diphtheria, pertussis, and tetanus; 3 doses of polio; and 1 dose of measles, mumps, and rubella vaccinations.
Notes: The 2008 retrospective survey does not include three elementary schools from the Copley-Fairlawn school district,
as well as five private schools in the city of Akron which were included in the 2004 survey. Therefore, data for 2008 should
be viewed with caution.
How Immunization Rates Have Changed -- Assuming that the results from the two surveys are,
in fact, comparable, the 2004 rate of 68.1 percent
experienced a statistically significant decline from
73.4 percent in 2004.
Factors That May Be Contributing to the Change
-- Immunization rates are impacted by a number of
factors, such as the availability of opportunities to
receive immunizations, the willingness of parents
to immunize their children, and the effectiveness
of strategies employed by health care providers to
promote increased immunizations.
Percent of Children Receiving 4:3:1
Im m unizations by their Second Birthday,
100%
75%
50%
25%
0%
27
73.4%
68.1%
2004
2008
Percent of Pregnant Women Receiving First Trimester Prenatal Care
1995-1998, 1999-2002 and 2003-2005 averages
Why This Indicator Is Important -- The link between the use of prenatal care services and birth outcomes is well-established. Late initiation of prenatal care has been associated with low birth weights, premature births, and infant and maternal
mortality. The benefits of early prenatal care are often the strongest among economically disadvantaged women who may
be the least likely to receive timely care.
Definition -- This indicator is calculated by dividing the number of pregnant women who receive care during the first three
months of their pregnancy by the total number of pregnant women.
How Prenatal Care Rates Have Changed -- The percentage of pregnant women who receive first trimester prenatal care
rose from 88.0 percent during the period 1995-1998 to 92.3 percent in 2003-2005.
Factors That May Be Contributing to the Change -- There are a couple of possible factors which may account for the
increase in first trimester prenatal care. One potential reason may be that more women have health insurance, making it more
likely that they would be able to seek prenatal care.
However, given that there was a probably a decline
Percent of Pregnant Wom en Receiving 1st
in adult health insurance coverage (discussed in the
Trim ester Prenatal Care,
Sum
m
it County, 1995-98 to 2003-05
previous Priority Indicator), this explanation may
100.0%
not be the most likely.
Perhaps the most likely explanation is that there has
been a concerted effort by a variety of organizations
within Summit County to increase first trimester
prenatal care. An extensive outreach program has
been conducted by the Child Family Health Services
consortium (CFHS), the Healthy Start and Help Me
Grow programs; by East Akron Community House
(EACH) through their OIMRI Program, LifeLink,
and In Due Time programs, by Summa’s program
for pregnant adolescents; and by various Medicaid
HMOs. In addition to direct outreach, a marketing
campaign has been underway to encourage prenatal
care, using a variety of approaches such as ads on
public transit vehicles.
75.0%
50.0%
25.0%
0.0%
28
88.0%
92.3%
92.3%
1995-98 avg.
1999-02 avg.
2003-05
Social and Economic Factors
Personal and medical conditions are two of the factors that impact people’s health. Another critical, and, until recently,
an often overlooked component of good health is the socioeconomic conditions that people live and work in. A large
and growing body of research is building a compelling case for the importance of these social determinants of health.
Education:
11. Percent With A College Degree
12. Percent of 4th Graders Reading At Grade Level
13. Graduation Rate
Employment:
14. Unemployment Rate
Income:
15. Poverty rate
16. African-American poverty rate
17. Female-headed household poverty rate
18. Childhood poverty rate
19. Percent receiving Ohio Direction Card
20. Housing affordability
Family and Social Support:
21. Percent of Adults Without Adequate Social Supports
Community Safety:
22. Child Abuse and Neglect
23. Violent Crime Arrests
24. Elder Abuse and Neglect
29
Percent of Persons Age 25 or Older With a 2-Year Degree of Higher, 1990-2010
Why This Indicator Is Important -- This indicator is important because primary and secondary education are the cornerstones of social and economic success throughout life. As the educational level of the population rises, so too does the
employment and income potential of the population. Those with no high school diploma are generally the least employable
and trainable, while those with at least an associate’s degree are generally the most viable in the labor market and are the
most important to economic innovation and growth for the region.
Definition -- This indicator measures the percent of the population age 25 or older who have attained a 2-year, 4-year, or
advanced degree as a percentage of all persons age 25 or older.
How Educational Attainment Has Changed -- Continuing the trend between 1990 and 2000, the percent of the age 25 and
over population without a high school diploma declined from 14.3 percent in 2000 to 10.4 percent in the 2006-08 period.
The improvement seen over this period confirms the findings from the original Mid-Decade report released in 2007 that
the percent of persons without a high school diploma has surpassed the Summit 2010 goal for this indicator and continues
to improve.
Factors That May Be Contributing to the Change
-- A number of demographic factors combine to help
explain the improvement in educational attainment
seen between 2000 and 2010. These factors are:
40.0%
Percent of Persons Age 25+
With A 2-Year Degree or Higher
1. A decline in older Summit County residents
(age 45+) without a diploma or GED;
2. A growth in older residents with a diploma
or GED;
3. A decline in younger Summit County residents (age 18-24) without a diploma or GED
30.0%
20.0%
4. An increase of younger residents with a
diploma or GED.
10.0%
0.0%
30
24.7%
30.4%
37.8%
1990 census
2000 census
2010 ACS
Percent of 4th Graders Scoring Proficient or Better on the 4th Grade Reading Proficiency Test,
1999-2000 to 2009-2010 School Years
Why This Indicator Is Important -- The ability to read at grade level in the fourth grade is considered a vital benchmark
for future academic performance. Students who can read at grade level by the fourth grade perform far better in all academic subjects than those who do not
Definition -- This indicator measures the percentage of fourth graders who passed the reading portion of the Ohio Proficiency
Test. Because the actual numbers of students taking the test are unavailable, it is impossible to calculate an overall passage
rate for the county as a whole. Therefore, the percentages shown in these figures are medians of all districts. Median
values, indicating that 50 percent are higher and 50 percent are lower, are preferred over average values since averages may
reflect one or a few individual values that are extreme.
How Reading Proficiency Has Changed -- In the 1999-2000 school year, the median percentage passing the reading
portion of the proficiency test was less than 59 percent. By the 2005-2006 school year that had risen to nearly 79 percent,
and rose again to more than 81 percent by the 2009-2010 school year.
Change -- Perhaps the most likely reasons that
scores have risen as they did (a phenomenon seen
in many districts around the state) is the increased
emphasis that is now placed on reading proficiency by public school districts, and the growing
body of literature showing the importance of 4th
grade reading proficiency to academic achievement in higher grades.
This increased emphasis can lead to long-term
payoffs. A 2005 analysis of Ohio Department
of Education data by the Center for Community Solutions shows that Ohio school districts
that performed well on the fourth grade reading
proficiency test in the 1998-1999 school year also
tended to perform well on the Ohio Graduation
Test (OGT) six years later (the 2004-2005 school
year). Conversely, districts that had lower fourthgrade reading proficiency scores in 1998-1999
also tended to have lower scores when that same
age cohort took the 10th grade OGT six years
later.
Percent of Students Passing the 4th Grade
Reading Test, Sum m it County,
1999-2000, 2005-06, and 2008-2009
100.0%
80.0%
60.0%
40.0%
20.0%
0.0%
31
58.5%
78.9%
81.1%
1999-2000
2005-2006
2009-2010
Public School Longitudinal Graduation Rate, 2008-2009 School Year
Why This Indicator Is Important -- This indicator is a fundamental measure of quality of education, and, in the modern
economy, is considered to be the absolute minimum level of education necessary to obtain employment leading to selfsufficiency.
Definition -- According to the Ohio Department of Education, this indicator measures “...the 4-year longitudinal graduation
rate for school districts. The LGR places students into a cohort when they enter 9th grade. Each student is then tracked to
identify whether they graduate within four years or are a non-graduate.”
How Longitudinal Graduation Rates Have Changed -- The longitudinal graduation rate is a new indicator calculated
by the Ohio Department of Education. Since the 2009-2010 school year is the first for which there is data on this indicator,
comparable data from past years is not possible.
the state as a whole (78.0 percent).
Summit County’s longitudinal graduation rate was well above that for
Factors That May Be Contributing to the Change -- As noted above, discussing change in this indicator is not possible
at this time. That said, the increased emphasis that has been placed on 4th grade reading scores has also been placed on
graduation rates. With increased emphasis on accountability both by the state and by federal initiatives such as No Child
Left Behind, school districts around the state have
Median Longitudinal Graduation Rate, Sum m it
focused additional energy and attention on all
County, 2009-2010 School Year
aspects of improving education. If successful,
100.0%
these efforts should lead to increasing longitudinal
graduation rates in the future.
98.0%
96.0%
94.0%
92.0%
90.0%
88.0%
86.0%
84.0%
82.0%
80.0%
92.2%
2009-2010
32
Unemployment Rate, 1990-2010
Why This Indicator Is Important -- This indicator is a basic measure of economic strength, the ability of a regional
economy to provide steady employment to its workforce, and the preparedness of that workforce. Low rates of unemployment translate to both personal and regional economic vitality. High rates indicate a need for improved workforce preparedness, more jobs, educational services to improve the employment prospects of the unemployed, and social services for the
unemployed and their families.
Definition -- This indicator measures the number of persons in the civilian labor force who are unemployed as a percent of
the total civilian labor force (age 16 and older). According to the 2010 ACS, “All civilians 16 years old and over are classified as unemployed if they (1) were neither “at work” nor “with a job but not at work” during the reference week, and (2)
were actively looking for work during the last 4 weeks, and (3) were available to start a job. Also included as unemployed
are civilians who did not work at all during the reference week, were waiting to be called back to a job from which they
had been laid off, and were available for work except for temporary illness.”
How Unemployment Has Changed -- Unemployment more than doubled over the decade, rising from 5.0 percent in 2000
to 11.6 percent in 2010.
Change -- The main factor driving the increase in
unemployment rates were the recessions of 2001
and 2007. Regional, state, and national unemployment rates also rose during this period. However,
unlike the 2001 recession, when the size of the labor
force trended upward during the recession, Summit
County’s labor force began getting smaller early in
the 2007 recession and kept trending downward for
the two and a half years that followed. The county’s
labor force finally began growing again early in
2011. A period of rising unemployment coinciding
with declining labor force participation can be seen
as a warning sign that long-term unemployment
and discouraged workers are becoming an issue.
Unem ploym ent Rate,
14.0%
7.0%
0.0%
33
6.6%
5.0%
11.6%
1990 census
2000 census
2010 ACS
Poverty Rate, 1990-2010
Why This Indicator Is Important -- The percentage of the population who live in poverty is a basic measure of the
economic and social health of the population. In addition to the lack of economic opportunity inherent in the definition of
poverty, high poverty rates have been associated with many social problems, including crime, low educational attainment,
and certain behavioral health disorders.
Definition -- “Poverty” is defined as the percent of individuals who live below the federal poverty level. The poverty level
is determined using household or family size, number of related children under 18 years old, and income. The threshold
increases with increasing family size. The weighted income threshold for a family of four in 2010 was 22,050. Data for
this indicator is from the U.S. Census and the ACS.
How Poverty Has Changed -- After a sharp decline between 1990 and 2000, poverty in Summit County as a whole rose
from 2000’s figure of 9.9 percent to an estimated 15.3 percent in 2010; a statistically significant increase. The poverty rate
has now surpassed the 12 percent seen in 1990, meaning that the gains made during the prosperity of the previous decade
have been effectively erased.
Change -- The main factors driving the increase in
poverty rates were the recessions of 2001 and 2007
At least two key factors may help shed light on how
these recessions may have impacted poverty rates:
• Two sharp rises in unemployment - Unemployment rates in the early part of the decade
rose sharply due to the 2001 recession, then
leveled off and mildly recovered between
mid-2003 and mid-2007. Beginning around
the time the recession was officially declared
in December 2007, unemployment in Summit
County began to rise sharply once again, from
5.6% in December 2007 to 7.4% in December
2008.
• Wage declines - Overall, average weekly
wages per private sector job in Summit County
between 2007 and 2009 declined by six tenths
of one percent. Seven of the 19 NAICS industrial sectors saw average weekly wages
decline from 2007 to 2009, impacting more
than one-third of the workforce (35.5%).
Poverty Rate,
17.5%
15.0%
12.5%
10.0%
7.5%
5.0%
34
12.1%
9.9%
15.3%
1990 census
2000 census
2010 ACS
African-American Poverty Rate, 1990-2010
and certain behavioral health disorders.
Definition -- “African-American Poverty” is defined as the percent of African-American individuals who live below the
federal poverty level. The poverty level is determined using household or family size, number of related children under 18
years old, and income. The threshold increases with increasing family size. The weighted income threshold for a family of
four in 2010 was $22,050. Data for this indicator is from the U.S. Census and the ACS.
How African-American Poverty Has Changed -- As the figure below shows, the poverty rate for African-Americans in
Summit County was estimated to be approximately 31% in 2010. This estimate is higher than the rate of 27.3% cited by
the 2000 U.S. Census; a difference which is statistically significant.
Change -- As was the case for overall poverty,
the main factors driving the increase in AfricanAmerican poverty rates were related to the recessions of 2001 and 2007:
• Two sharp rises in unemployment - Unemployment rates in the early part of the decade
2008.
42.0%
African-Am erican Poverty Rate,
35.0%
28.0%
21.0%
14.0%
7.0%
0.0%
35
33.4%
27.3%
31.0%
1990 census
2000 census
2010 ACS
Female-Headed Household Poverty Rate, 1990-2010
and certain behavioral health disorders. These problems are magnified for female-headed households; poverty rates among
such households are far above poverty rates for other family types.
Definition -- “Female-Headed Household Poverty” is defined as the percent of households with a female head and no
husband present who live below the federal poverty level. The poverty level is determined using household or family size,
number of related children under 18 years old, and income. The threshold increases with increasing family size. The weighted
income threshold for a family of four in 2010 was $22,050. Data for this indicator is from the U.S. Census and the ACS.
How Female-Headed Poverty Has Changed -- As the figure below shows, the poverty rate for female-headed households
in Summit County was estimated to be approximately 41% in 2010. While not statistically significantly higher than in
2000, poverty rates among female-headed households remain at a very high level relative to poverty among other types of
households.
Change -- As was the case for overall poverty, the
main factors impacting female-headed household
poverty rates were related to the recessions of 2001
and 2007:
60%
• Two sharp rises in unemployment - Unem-
50%
40%
Poverty Rate
ployment rates in the early part of the decade
2008.
Poverty Rate, Fem ale-Headed Households,
30%
20%
10%
0%
36
49.7%
38.0%
41.2%
1900 Census
2000 Census
2010 ACS
Child Poverty Rate, 1990-2010
and certain behavioral health disorders. These problems particularly impact children, whose development can be significantly hampered by poverty. As is the case with female-headed families, poverty rates among children are consistently
higher than poverty rates for the general population.
Definition -- “Child Poverty” is defined as the percent of individuals under age 18 who live below the federal poverty
level. The poverty level is determined using household or family size, number of related children under 18 years old, and
income. The threshold increases with increasing family size. The weighted income threshold for a family of four in 2010
was $22,050. Data for this indicator is from the U.S. Census and the ACS.
How African-American Child Poverty Has Changed -- As the figure below shows, the poverty rate for children in Summit County rose an estimated 53 percent; the highest growth rate in poverty levels among any of the poverty indicators
examined. As of 2010, more than one-in-five children in Summit County lived in poverty.
Change -- As noted in the previous discussions of
poverty, childhood poverty is impacted by the same
prevailing economic conditions that impact their
parents (or other caregivers).
Poverty Rate Under Age 18,
30.0%
20.0%
10.0%
0.0%
37
18.1%
14.4%
21.9%
1990 census
2000 census
2010 ACS
Percent of Households Receiving the Ohio Direction Card (ODC),
2005-2007 to 2010
Why This Indicator Is Important -- This indicator is a basic measure of economic self-sufficiency. Large percentages
of people receiving the ODC are indicative of widespread socioeconomic distress, while small percentages of such people
may be indicative of improving conditions for economically marginal households.
Definition -- This indicator measures the percent of all residents who receive food assistance through the Ohio Direction Card.
Data for this measure comes from the Public Children Services Association of Ohio (PCSAO), which reports the number
of ODC recipients in January of each year, and from the 2000 and 2010 US Census, which reports total population figures.
How Reliance on ODC Changed -- In 2000, just before the first of the nation’s two recessions in the past decade, ODC
was serving approximately 6% of Summit County residents. By 2010, that figure had more than doubled, to 14.4%.
Factors That May Be Contributing to the Change -- Clearly, the impact of the 2007 recession and the accompanying
rise in unemployment and other financial pressures has contributed to the increased reliance on this and other forms of
public assistance.
Data for these other forms of assistance are also
provided by the Public Children Services Association of Ohio. They note that between January 2005
and January 2010, Ohio Works First (OWF) / TANF
case loads rose by 30 percent, subsidized child care
rose by 24 percent, and children’s Medicaid coverage also increased, by 5%.
Percent of Households Receiving Ohio
Direction Card, Sum m it County, 2000 & 2010
20.0%
15.0%
10.0%
5.0%
0.0%
38
6.2%
14.4%
2000
2010
Percent of Households Paying More than 30 Percent of Income on Housing, 1990-2010
Why This Indicator Is Important -- This indicator is a fundamental measure of affordable housing, and, indirectly, of
financial self-sufficiency. According to the U.S. Department of Housing and Urban Development (HUD), “Families who
pay more than 30 percent of their income for housing are considered cost burdened and may have difficulty affording necessities such as food, clothing, transportation and medical care...The lack of affordable housing is a significant hardship for
low-income households preventing them from meeting their other basic needs, such as nutrition and health care, or saving
for their future and that of their families.”
Definition -- This indicator measures the percent of owner-occupied households which pay more than 30 percent of their
income on housing. According to the ACS, housing costs include “...everything paid to the lender including principal and
interest payments, real estate taxes, fire, hazard, and flood insurance payments, and mortgage insurance premiums.” The
definition also includes other housing-related costs such as utility and fuel costs, and other costs specific to individual types
of housing such as condominium association fees (for condos), and/or registration/licence fees for mobile homes.
How Housing Affordability Has Changed -- More than one-quarter of households were paying more than 30 percent of
their household income on housing in 2010 (27.0 percent). While the 2010 1-year estimate is not statistically significantly
different than 2000, the reason may be small sample size in the ACS rather than a lack of change in housing affordability.
In fact, the same data drawn from the 2005-2009 5-year average ACS, which has a much larger sample size than the 1 year
estimates, shows that housing affordability has statistically significantly worsened since 2000. This is true even though
2005, 2006, and 2007 were before the recession,
Percent of Households Spending
and before the full impact of the subprime mortgage
More than 30% of Incom e on Housing,
crisis became apparent.
32.0%
Change -- Assuming that housing affordability has
worsened since 2000, as argued above, the two most
likely reasons include the recession (and the rise in
poverty and unemployment it caused), and the subprime mortgage / foreclosure crisis. With regard to
the foreclosure crisis, evidence of the link between
subprime loans and foreclosure rates can be found
in a report published by the Ohio Community Reinvestment Project entitled, “The Expanding Role
of Subprime Lending in Ohio’s Burgeoning Foreclosure Problem,” Mortgage Bankers Association
data and court records for Lorain, Montgomery, and
Summit Counties were analyzed. According to the
report, court records for the three counties showed
that, “Loan for loan, subprime lending generated
more than three times as many home foreclosure
filings as conforming, prime loans...”
24.0%
16.0%
8.0%
0.0%
39
22.7%
25.2%
27.0%
1990 census
2000 census
2010 ACS
Percent of Adults Without Adequate Social / Emotional Support (BRFSS),
2005-2009
Why This Indicator Is Important -- According to Wisconsin County Health Rankings, “Poor family support, minimal
contact with others, and limited involvement in community life are associated with increased morbidity and early mortality. Furthermore social support networks have been identified as powerful predictors of health behaviors, suggesting that
individuals without a strong social network are less likely to participate in healthy lifestyle choices.”
Definition -- According to Wisconsin County Health Rankings, “The social and emotional support measure is based on
responses to the question: “How often do you get the social and emotional support you need?” The County Health Rankings
reports the percent of the adult population that responds that they “never,” “rarely,” or “sometimes” get the support they
need ...This measure was calculated by the National Center for Health Statistics using data obtained from the Centers for
Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS).”
How Social / Emotional Support Has Changed -- In the 2005-2009 period, approximately one-in-five adults in Summit County lived without adequate social or emotional support. Note: Data is unavailable prior to the 2005-2009 period.
Therefore, no analysis of change is possible at this time.
Change -- As noted in the first section of this indicator, the Wisconsin County Health Rankings cite
poor family support, minimal contact with others,
and limited involvement in community life as factors in determining social and emotional support.
These factors can be even more of a problem for
those with special needs or the elderly if their age
and/or conditions exaggerate social isolation.
Percent of Adults Without Adequate Social /
Em otional Support, Sum m it County, 2011
40%
30%
20%
10%
18.0%
0%
2005-2009
40
Referrals for Assessment of Child Abuse or Neglect, 2005 to 2010
Why This Indicator Is Important -- The occurrence of abuse and neglect are two of the most damaging things that can
happen to a child. Children suffering abuse experience both physical and emotional trauma that can cause long-term, even
life-long, damage. Reducing child abuse and neglect, therefore, is vital to protect the quality of life for all of Summit
County’s children.
Definition -- This indicator is defined as the number of substantiated and indicated allegations investigated by Summit
County Children Services (SCCS) per 1,000 children. Children Services uses a reporting system for abuse and neglect
based on five sub-classifications: Neglect, Physical Abuse, Sexual Abuse, Dependency, and Emotional Maltreatment. It is
important to note that the number of referrals does not necessarily equal the number of children; an allegation could either
refer to one child or all children in a family. The same is true for substantiated / indicated allegations. Data for the number
of children comes from the annual American Community Survey (ACS).
How Abuse and Neglect Has Changed -- The number of substantiated and indicated allegations per 1,000 has been declining since 2006, from 14.7 cases per 1,000 in that year to 8.1 per 1,000 in 2010.
Change -- One major factor in the decline is the
increased emphasis around the nation on programs
to reduce child abuse and neglect. In fact, the most
recent report from the US Department of Health and
Human Services, Child Maltreatment, 2010, identifies a national trend of declining child abuse and
neglect rates. As noted by the National Children’s
Advocacy Center, “Child Advocacy Centers and
countless other initiatives to address and prevent
child abuse in all forms were implemented all over
the country and made significant progress. Communities put programs in place, governments provided
funding, and concerned people got involved. And
the needle began to move.”
Substantiated and Indicated Allegations of Child
Abuse or Neglect Per 1,000 Children, Sum m it
County, 2005-2010
20.0
15.0
10.0
5.0
-
41
14.6
14.7
10.6
10.2
9.4
8.1
2005
2006
2007
2008
2009
2010
Violent Crime Arrest Rate,
2000 and 2009
Why This Indicator Is Important -- This indicator is a fundamental measure of public safety and community stability.
Definition -- This indicator measures the number of arrests for violent crimes in Summit County per 1,000 population.
“Violent Crimes” for purposes of this indicator is defined as one of four FBI so-called “index crimes,” which include
murder, forcible rape, robbery, or aggravated assault. Data for the City of Akron comes from the Akron Police Department’s
annual report for 2000 and 2009. The remainder of the data comes from the Ohio Department of Public Safety’s Office of
Criminal Justice Services. Note: Data for this indicator is only available for selected communities, not by Summit 2010
cluster.
How Violent Crime Has Changed -- Since data is not available for all police departments, it is not possible to calculate a
county-wide rate at this time. Of the four communities which saw violent crime increase, the City of Akron saw the biggest
increase, from 6.34 per 1,000 persons in 2000 to 9.76 per 1,000 persons in 2009.
Violent Crim es Per 1,000 Population, Sum m it
County by Police Departm ent, 2000 and 2009
Change -- It is difficult to identify specific causes
of the rise in violent crime rates (in the communiAkron
ties where it indeed rose) when data for all comFairlaw n
munities is not available. That said, increasing
economic stress has traditionally been cited as a
Barberton
factor in rising crime rates. However, national
Springfield
data from the FBI’s Uniform Crime Index report
for 2009 points out that violent crime nationally
Tallmadge
has actually declined during the past 10 years,
noting that “In 2009, an estimated 1,318,398 Cuyahoga Falls
violent crimes occurred nationwide, a decrease of
Stow
5.3 percent from the 2008 estimate. When considering 5- and 10-year trends, the 2009 estimated violent
Munroe Falls
crime total was 5.2 percent below the 2005 level
Norton
and 7.5 percent below the 2000 level.”
Tw insburg
Richfield
2009
2000
Hudson
0.0
42
2.0
4.0
6.0
8.0
10.0
12.0
Elder Abuse, Neglect, Self-Neglect, or Exploitation Referrals
Where An Assessment Is Completed, 2001 to 2010
Why This Indicator Is Important -- Elder abuse and neglect is a basic indicator of quality of life for seniors.
Definition -- This indicator is defined as the number of referrals (where an assessment is completed) of elder abuse, neglect,
self-neglect, and exploitation per 1,000 seniors age 65 or older. Data for elder abuse, neglect, self-neglect, and exploitation come from Adult Protective Services (APS) at the Summit County Department of Job and Family Services. Senior
population estimates come from the 2000 and 2010 Census. Note: The reporting system for referrals used in 2001 differs
somewhat from the current reporting system and may not yield directly comparable definitions of referrals where an assessment is completed. Therefore, caution should be exercised when comparing these figures.
How Elder Abuse and Neglect Has Changed -- Referrals for elder abuse declined from 8.0 per 1,000 in 2001 to 7.6 per
1,000 in 2010.
Factors That May Be Contributing to the Change -- As with some of the other indicators, it is difficult to empirically tie
specific factors to the rise in elder abuse, neglect, or exploitation. However, organizations which study abuse, neglect, or
exploitation do suggest some possible factors which may help explain changes in rates of abuse and/or neglect.
Outright abuse of seniors is most often perpetrated
by a family member, according to the National
Center on Elder Abuse (NCEA). Neglect can take
two forms - neglect of an older adult by a caregiver,
or self-neglect by seniors themselves. Exploitation
is defined by NCEA as the “illegal taking, misuse,
or concealment of funds, property, or assets of a
vulnerable elder” and can be perpetrated either by
a family member or someone outside the family.
The NCEA also points out that social isolation and
mental impairment are the two factors which leave
seniors most at risk for suffering abuse, neglect, or
exploitation.
Abuse, neglect, and exploitation rates can also be
impacted by the effectiveness of law enforcement
and of other agencies in a position to serve elderly
populations. It can also be impacted by the willingness of witnesses to come forward and report
incidents of abuse or neglect, and the ability and
willingness of victims to do the same.
Rate of Referrals
of Elder Abuse and Neglect,
Sum m it County, 2000-01, 2009-10
10.0
5.0
-
43
8.0
7.6
2001
2009-10
Physical Environment
Along with personal behavior, access to health care services, and social determinants of health, the physical environment
that people live and work in is an important factor in their level of overall health. Factors that reduce environmental
quality such as air and water pollution and toxic releases can have significant impacts on health. The conditions of a
community’s homes and apartments, the built environment, is also an important factor in overall health; unsafe and/
or unsanitary conditions at home can lead to a whole host of health problems. In addition, living in a geographic area
where healthy food choices are scarce and opportunities for regular exercise are limited or non-existent can also significantly impact health. For people living in such areas, personal behavior choices are negatively impacted by lack of
access to the healthy choices they would like to make.
Environmental Quality:
25. Toxic Air Emissions
26. Water Use Per Capita
Built Environment:
27. Condition of Housing
28. Access To Healthy Food
29. Access To Recreational Opportunities
44
Mobile and Major Sources of Toxic Air Emissions, 2008
Why This Indicator Is Important -- Poor air quality is linked to premature death, cancer, and long-term damage to respiratory and cardiovascular systems, making this indicator a key social determinant of health. Reducing the level of toxic
emissions will help improve the overall health of the population.
Definition -- According to the U.S. EPA, mobile sources of toxic air emissions are “...compounds emitted from highway
vehicles and nonroad equipment which are known or suspected to cause cancer or other serious health and environmental effects.” Major sources of toxic air emissions are defined as “sources that emit 10 tons per year of any of the listed
toxic air pollutants, or 25 tons per year of a mixture of air toxics. These sources may release air toxics from equipment
leaks, when materials are transferred from one location to another, or during discharge through emission stacks or vents.”
How Air Emissions Have Changed -- Trend data for this indicator is not currently available. In 2008, mobile sources
accounted for 3.5 million tons of emissions, while major sources accounted for another 0.9 tons.
Factors That May Be Contributing to the Change -- The levels of pollution in a community are impacted by a variety
of factors such as the number and type of industrial facilities, and the number of vehicles in a given area and the number of
miles those vehicles travel. With regard to vehicles
miles traveled, the Akron Metropolitan Area TransMobile and Major Sources Toxic Air
portation Study Annual Report for 2010 shows that
Em issions (in m illions of tons),
traffic counts within the Akron metropolitan area
10.0
(Summit and Portage Counties) has been declining
for six straight years.
5.0
-
45
3.5
0.9
Mobile
Major
Water Use Per Capita, 2010
Why This Indicator Is Important -- Using water efficiently helps maintain water quality while reducing the cost of providing high-quality water.
Definition -- This indicator is defined as the number of gallons os water used within Summit County per person per day.
How Water Use Has Changed -- Water use per capita dropped from 133.7 gallons per person per day in 2000 to 108.0
gallons per person per day in 2010.
Factors That May Be Contributing to the Change -- Any number of factors could contribute to a decline in water
use, such as increased water efficiency, or conservation efforts. It is also possible that water use could be impacted by a
significant decline in business establishments, the number of households and the number of housing units, the size of the
population, rising cost of water, or some combination of the above. While Summit County’s population and its number of
households grew modestly over the last decade, the county had nearly 1,300 fewer business establishments in 2009 than in
2000, caused at least in part by the two recessions this decade. These figures include 234 fewer manufacturing establishments, and nearly 40 fewer large business establishments (employing 250 or more people). Manufacturing and other large
establishments would be much more likely to be heavy users of water supplies; having a meaningful decline could impact
the amount of water used.
It is also plausible that factories and other businesses
that didn’t leave or go out of business altogether experienced a slowdown in business operations. This
slowdown and the large number of layoffs that came
with it may have reduced operations sufficiently to
put a meaningful dent in the amount of water used
by businesses, especially manufacturing. One possible indicator of this is that the Akron metro area’s
Gross Domestic Product declined between 2008 and
2009 to levels not seen since 2002.
In addition, the American Water Works Association,
in an article entitled “Declining Demand Likely to
Continue Beyond Recession,” notes that “utility
managers generally acknowledge that economic
conditions are among the factors affecting reduced
demand.” They also note, however, that it is difficult to isolate the impact that economic conditions
have on water use.
Gallons of Water Used Per Person Per Day,
150.0
100.0
50.0
-
46
133.7
108.0
2000
2010
Condition of Residential Structures, 2010
Why This Indicator Is Important -- High quality housing is a key “social determinant” of health. As noted by the Robert
Wood Johnson’s Commission to Build A Healthier America, “Good physical and mental health depends on having homes that
are safe and free from physical hazards. When adequate housing protects individuals and families from harmful exposures
and provides them with a sense of privacy, security, stability, and control, it can make important contributions to health.
In contrast, poor quality and inadequate housing contributes to health problems such as infectious and chronic diseases,
injuries, and poor childhood development.”
Definition -- This indicator presents the number of residential structures in the Summit County Fiscal Office’s parcel
database given a condition rating of above average (which includes the Fiscal Office designations of “excellent,” “good,”
and “very good”) average (which includes the Fiscal Office designation of “average”), and below average (which includes
the Fiscal Office designations of “fair,” “poor,” “very poor,” or “unsound”). These figures are shown as a percent of all
residential structures. For our purposes, “Residential structures” includes apartment buildings and condominiums as well
as single- and multi-family housing units.
How Condition of Residential Structures Have Changed -- As of 2010, about 39 percent of all residential structures
in Summit County were in above average condition, while more than half (about 55 percent) were in average condition.
Another 6 percent were in below average condition. These figures show higher percentages of above average and lower
percentages of average and below average residential structures than in 2000. All told, 11,553 residential parcels have a
rating of below average. Of those, 836 fall into the
poor, very poor, or unsound categories.
Condition of Residential Parcels, Sum m it
Change -- Housing quality is impacted by a wide
variety of factors, including the ability of homeowners to maintain properties, the strength of the housing market, and the quality of initial construction.
The overall quality of housing is also impacted by
the combination of construction of new homes and
the demolition of old ones.
It is possible that the overall condition of residential
structures in Summit County will suffer as a result
of the magnitude of the foreclosure crisis. However,
the data do not yet show any such impact. Any
general decline in the quality of housing stock will
take some time to become apparent. What can be
shown is that the number of newly-built residential
parcels in the Fiscal Office database has declined
sharply each year since 2004, cutting off the influx
of high-quality homes that helps improve the overall
quality of the county’s housing stock over time.
75.0%
County, Residential Structures Built Before
2000 & All Residential Structures To Date
50.0%
25.0%
0.0%
47
34.1% 38.7%
59.3% 55.2%
Above average
Average
6.6%
6.1%
Below average
Access to Healthy Foods, 2010
Why This Indicator Is Important -- As noted in the Wisconsin County Health Rankings, “Studies have linked the food
environment to consumption of healthy food and overall health outcomes.”
Definition -- According to Wisconsin County Health Rankings, “In 2011, the measure was based on the percent of residential
Zip codes in a county with a healthy food outlet, defined as grocery stores or produce stands/farmers’ markets.” Data was
published by Wisconsin County Health Rankings based on the Census Bureau’s Zip Code Business Patterns data
How Condition of Residential Structures Have Changed -- Approximately 74% of Summit County zip codes contain
a healthy food outlet.
Factors That May Be Contributing to the Change -- At this time, data is only available for the current year, making
analysis of trends impossible. However, there a couple of identifiable factors that impact access to healthy food. Access is
often market-driven, with private sector investments being made where investors see the biggest potential for return on their
investment. Such market-driven decisions can, and often do, leave lower-income neighborhoods under served. Access can
be improved for lower-income neighborhoods and other areas through targeted investment by government, philanthropic,
and non-profit initiatives and/or partnerships between such groups and private sector providers.
Availability and ease of transportation is another
major factor in access to healthy foods. Even when
stores aren’t close, neighborhoods with high rates
of automobile ownership and/or access to effective
public transportation service can reach healthy food
outlets at greater distances than neighborhoods with
lower rates of automobile ownership or marginal
public transportation service.
Percent of Residential Zip Codes With Access
to A Healthy Food Outlet, Sum m it County, 2011
100%
75%
50%
25%
74.0%
0%
2011
48
Recreational Facilities Per 100,000 Population, 2010
Why This Indicator Is Important -- As noted in the Wisconsin County Health Rankings, “The availability of recreational
facilities can influence individuals’ and communities’ choices to engage in physical activity. Proximity to places with
recreational opportunities is associated with higher physical activity levels, which in turn is associated with lower rates of
adverse health outcomes associated with poor diet, lack of physical activity, and obesity.”
Definition -- According to Wisconsin County Health Rankings, “This measure is based on a measure from United States
Department of Agriculture (USDA) Food Environment Atlas, and is calculated using the most current County Business
Patterns data set. Recreational facilities are identified by North American Industrial Classification System (NAICS) code
713940, and include such amenities as fitness facilities, tennis courts, swimming pools, and ice skating rinks.
How Condition of Residential Structures Have Changed -- There are approximately 56 recreational facilities per 100.000
population in Summit County.
Factors That May Be Contributing to the Change -- Like access to the healthy food indicator, data is only available for
the current year, making analysis of trends impossible. However, here, too, there are a couple of identifiable factors that
impact the availability of recreational facilities. As is the case with access to healthy food, access to recreational facilities
is also frequently market-driven, with private sector investments being made where investors see the biggest potential for
return on their investment. These decisions often leave lower-income neighborhoods under served.
Unlike the previous indicator, however, local governments often build and operate recreational facilities
on behalf of their citizens, financed through tax levies. However, the availability and quality of such
amenities is impacted by the cost of operations and
the ability of local governments to bear these costs.
That ability often declines during economic downturns, especially for cash-strapped central cities.
Transportation access is also a factor in the ability
of people to reach and utilize recreational assets.
Num ber of Recreational Facilities Per 100,000
Population, Sum m it County, 2010
100.0
75.0
50.0
25.0
-
56.0
2010
49
4. Discussion and Findings By Health Factor:
Health Behaviors -- Findings for the health behavior indicators is mixed. On the substance abuse
indicators (tobacco and alcohol), Summit County was no different than the state averages. On the STD
rates, the county has seen a clear increase in rates. On the issues of African-American teen births and
regular exercise, Summit County has seen improvement in teen births and has a higher rate of adults
who say they exercise regularly than the state.
Clinical Care -- On most clinical care indicators, the county has seen conditions decline. The percent
with health insurance and childhood immunization rates have both worsened over time, as has the percent of the population living in health professional shortage areas. Only first trimester prenatal care
showed improvement.
Social and Economic Factors -- Largely due to the two recessions of this decade, most of Summit
County’s social and economic factors have gotten worse over time. Employment and income indicators including unemployment rate, several measures of poverty, reliance on the Ohio Direction Card,
and housing affordability have all worsened over the course of the decade. The one area in which
some positive news can be found is in education. On two key education indicators, conditions have
improved (percent with a 2-year college degree or higher and 4th grade reading test scores). While the
short-term economic news is undeniably negative, the improvement in education is a bright spot and
offers some opportunities to help improve health conditions in the future.
Physical Environment -- Like health behaviors, indicators of physical environment tell a mixed story.
Two of the three community safety indicators improved, child and elder abuse, while violent crime for
the county’s largest city, Akron, got worse (running against national trends showing declining rates of
violent crime). Water use is down, but that decline was more likely the result of a recession-induced
decrease in demand than by any cumulative impact of conservation or improvements in efficiency. Also,
while the condition of housing got slightly better, the first decade of the 2000s also saw new construction decline sharply. This seriously reduces the influx of new, high-quality homes even as waves of
foreclosed and abandoned homes reduces the quality of existing housing stock. While the data do not
yet show evidence of a decline, it is likely that a decline in quality will begin to manifest itself over the
next few years unless the housing market recovers sufficiently to prevent it.
50
Appendix A: Demographic Profile of Summit County, Ohio
1. Selected Variables from the 2010 U.S. Census
Population Pyramid -- The population
pyramid at right shows the age and gender
breakdown of Summit County’s residents.
The group represented by the shaded borders is the Baby Boom generation. The
oldest of this generation is now turning 65
years old. Due to the size and increasing
life expectancy of this group, the Baby
Boomers are expected to present a serious challenge to the health care and social
services systems in Summit County and
throughout the country.
Population Pyram id, Sum m it County, 2010 (in thousands)
(3.8)
Female
8.4
(5.0)
Male
7.8
(6.1)
8.4
(7.6)
9.7
(10.2)
11.9
(15.7)
17.1
(18.8)
20.0
(21.1)
22.4
21.1
(19.8)
(17.9)
18.4
(16.2)
16.8
(15.4)
16.0
(16.3)
16.9
(17.3)
16.8
(19.5)
18.8
(18.4)
17.4
(16.9)
16.3
(16.0)
(30)
(20)
(10)
15.5
-
10
20
Population in each age group (shading indicates Baby Boom generation)
Gender -- Summit County has slightly
more female residents than male, as the
figure at right shows.
Gender Distribution -- Sum m it County, 2010 US Census
100%
80%
60%
40%
20%
0%
51
48%
52%
Male
Female
30
Race -- Summit County is over 80% white,
with African-Americans making up the
second largest racial group with nearly
15% of the population.
Racial Distribution -- Sum m it County, 2010 US Census
100%
80%
60%
40%
20%
0%
Family Composition -- More than one-infive families in Summit County is femaleheaded, with another 7% male-headed.
81.0%
14.5%
2.2%
2.1%
0.2%
White
African
American
Asian
Other
American
Indian /
Alaska
Native
Com position of Fam ily Households -Sum m it County, 2010 US Census
100%
80%
60%
40%
20%
Husband-w ife family
Housing Occupancy -- More than 90%
of Summit County’s housing units are
occupied. Of the approximately 9% that
aren’t, about 1% have valid reasons for
being vacant, such as being sold but not
occupied. The remainder, about 20,000
units, are either vacant and for sale or rent,
or for some other reason.
7.1%
71%
0%
21.5%
Male householder, no
w ife present
Female householder,
no husband present
Housing Occupancy -- Sum m it County, 2010 US Census
100%
80%
60%
40%
20%
0%
91%
3.2%
0.2%
1.6%
Occupied Vacant, for Vacant, Vacant, for
rent
rented, not sale only
occupied
52
0.3%
0.5%
3.4%
Vacant,
sold, not
occupied
Vacant,
seasonal
use
All other
vacancies
2. 2008 Behavioral Risk Factor Surveillance Survey
Executive Summary
If there is one finding from the BRFSS which stands out from the others, it is the impact of socioeconomic status on people’s health. In nearly every subject area studied in the survey, statistically significant differences were found between those with higher levels of education and/or higher incomes
and those with lower levels of education and/or lower incomes. The pattern seen in these findings is
very difficult to ignore (see “Summary of Findings by Subject Area” below).
These findings are consistent with an already-robust and growing body of research which links socioeconomic status and health outcomes nationwide. As Dr. Dennis Raphael, an internationally-recognized expert on social determinants of health, points out in a 2006 article entitled, Social Determinants of Health: Present Status, Unanswered Questions, and Future Directions, “Behavioral factors
were weak predictors of health status as compared with sociodemographic measures. While obesity
rate predicted 1 percent of unique variation and smoking rate 8 percent of unique variation among
communities in life expectancy, sociodemographic factors predicted 56 percent of variation in life
expectancy. Concerning self-reports of fair or poor health, obesity predicted 10 percent and smoking
rate predicted 4 percent of variation among communities. But sociodemographic factors predicted 25
percent of differences among communities.”
Viewed in the light of the growing body of knowledge about social determinants of health, the findings in this report related to the impact of income and education on health make it clear that poor
health is far more than an individual person’s problem. It is certainly true that an individual’s ability to avoid obvious behavioral risk factors such as smoking, weight gain, and lack of exercise does
have a direct impact on their own health. However, it is equally true that factors out of the direct
control of individual people (like employment opportunities, income potential, and educational opportunities) also play a critical part. As the discussion guide to the documentary series, Unnatural
Causes, states, “People who are middle to lower on the class pyramid are exposed to more health
threats (material deprivation to chronic stressors) and have less access to the opportunities and resources needed to control their destinies. People middle to higher on the class pyramid have access
to more power and resources and in general live longer, healthier lives. This is true not only for the
bottom and top but at every level.”
The discussion above suggests an active role for the community in improving the health of people at
every socioeconomic level. By working to improve the quality of life of all members of the Summit County community, we can not only improve our socioeconomic status, but our health as well.
Fortunately, the county’s Summit 2010: A Quality of Life Project, is continuing its eight-year effort
to improve the health status, income, educational attainment, and overall quality of life of all Summit County citizens. Hopefully, the community can use the findings of this report to make the point
that everyone can have an impact, not just on their own health and wellbeing, but on the health and
wellbeing of all our citizens as well.
53
Methodology:
Data from the 2008 Ohio BRFSS was used to compare health risk factors for different subpopulations. The analysis was performed at both the state and county level. The sample size for state-wide
data analysis was larger (n=12,962) compared to the county (n=2,080), and therefore has a greater
ability to detect differences between groups. Statistical comparisons were made between demographic groups and different years using the t-test, at 5% significance level. Logistic regression was used
in several analyses to adjust for different factors. Statistical comparison between the state and county
was not considered as the county level data was a subset of the state sample.
Summary of Findings by Subject Area:
• Obesity – About one-quarter of Summit County residents were obese in 2008. Obesity affects
African-Americans and low income groups disproportionately. The estimates of obesity rates
were lower for the county than the rate for the state, but remain very high compared to national
standards.
• Tobacco Use – About one-fifth of Summit County residents were smokers in 2008. Smokers are
more likely to be without a high school diploma, unmarried, have incomes below $25,000 per
year, and be African-American.
• Binge and Heavy Drinking – About one in six Summit County residents engaged in binge
drinking, while nearly 5% engaged in heavy drinking. Binge drinking was more prevalent
among men, whites and residents with higher income, and tended to decrease with age. Heavy
drinking was also higher among men and whites and also decreased with age. Rates of heavy
drinking were lower for college graduates.
• Diabetes – About one-tenth of Summit County residents had diabetes in 2008. Rates of diabetes were higher among African-Americans than others. The prevalence of diabetes tended to be
lower among those with college educations and who had higher incomes than others.
• Asthma – About one-tenth of Summit County residents had asthma in 2008. Asthma occurred
disproportionately among women and African-Americans. Asthma prevalence tended to decline
as income rose, and was highest among those who earned less than $25,000 per year.
• Disability – About one-in-five Summit County residents suffered from some form of disability in
2008. Disability tended to occur more frequently among females than males, and were lower for
those with higher income and educational attainment. Disabilities also tend to increase with age.
• Oral Health – About three quarters of Summit County residents say they visited a dentist within
the past year in 2008. Visits to a dentist were highest among those with college educations and
with incomes over $50,000. The percentage of those who visited a dentist within the past year
were also higher among those who were married than those who were not.
54
• Health Care Access / Coverage – About 85% of adults (age 18-64) in Summit County say they
had health coverage in 2008. As with several other risk factors discussed earlier, rates of health
coverage were higher among those with higher income and education than others.
• Coronary Heart Disease (CHD) / Heart Attack – About 5% of Summit County residents had
coronary heart disease in 2008, while just under 4% suffered a heart attack. Age-adjusted rates
of CHD tended to be lower for those with college educations and those with higher incomes than
others. Men were significantly more likely to suffer from a heart attack than women.
• Influenza and Pneumonia Vaccination Coverage – About three-quarters of Summit County
residents say they received influenza and pneumonia vaccinations in 2008. Whites and women
tended to receive influenza vaccinations more frequently than African-Americans or men. Influenza vaccination rates tended to rise with age, with those 65 or older being the most likely to say
they were vaccinated. Pneumonia vaccinations were higher among women than men, and among
those who were unmarried.
• Physical Activity – About one-in-five Summit County residents suffered from some form of disability in 2008. Physical activity tended to be higher among whites and males, and also among
those who were younger. As with other factors, higher incomes and educations tended to be
more physically active than others.
• Women’s Health – About three-quarters of women in Summit County say they had a mammogram sometime during the past two years. Factors making women more likely to get a mammogram include having a personal doctor, health coverage, marital status and education. Nearly
eight-in-ten women had a pap test with the past three years. Younger women (age 18-44) were
more likely than older women to have had a pap test, as were married women. Higher levels of
education and income also made having a pap test more likely.
• Men’s Health – Nearly two-thirds of men over age 40 in Summit County say they had a Prostate-Specific Antigen (PSA) test sometime during the past two years. Factors making men more
likely to get a PSA include being older and being married.
• Colorectal Cancer Screening – Nearly two-thirds of residents in Summit County say they had
either a sigmoidoscopy or colonoscopy sometime in their lives. Older residents were more likely
than younger residents to say they’ve had colorectal cancer screening, and both higher levels of
education and income were also more likely to say they’ve had a screening. Those who are married were also more likely to have received a screening.
• HIV Testing – Nearly one-third of Summit County residents say they’ve been tested for HIV.
The percentage of people having had a test were higher among African-Americans, women, and
those age 18-44. Higher income persons and those with a high school diploma or college degree
were less likely to have had an HIV test than others.
• Seat Belt Usage / Drinking While Driving – About eight-in-ten residents of Summit County
say they always wear a seat belt. Factors making people more likely to wear a seat belt include
women and white residents, as well as those with higher levels of education and income. Nearly
five percent of Summit County residents said that during the past 30 days they drove home at
55
least once when they’ve had too much to drink. Women, older residents, and married residents
were all significantly less likely to say they have driven drunk than others.
• Health Status – Nearly 14% of Summit County residents say they are in fair or poor health.
African-Americans were more likely than others to say they are in fair or poor health. The percentage of those in fair or poor health also tends to rise as age rises, and to be higher for married
people than unmarried ones. Percentages of those in fair or poor health tend to fall as educational attainment and income rises, and is higher for those who report dissatisfaction with life than
others. A detailed regression analysis concluded that the most important factors associated with
reducing the likelihood of fair or poor health include having higher income, being employed, and
having a college education.
56
3. 2008 Ohio Family Health Survey
Executive Summary
The results presented in this report lead to the conclusion that several longstanding flaws in the nation’s health care system continue to threaten the health and/or financial condition of many Ohioans
and their families. More than one-in-six Ohioans is without health insurance at any given time.
Unacceptable disparities in health insurance coverage persist with regard to race, educational attainment, age, and especially income; specifically, income as a percentage of the federal poverty level
(FPL). Approximately one-third of those near poverty (between 101% and 200% of the FPL) are
uninsured, as are about one-quarter of those between 200% and 300% of the FPL. For those earning
more than 300% of the FPL, uninsured rates decline dramatically, to approximately 5%.
This disparity highlights a very serious problem facing thousands of Ohio families – health insurance is simply too expensive for a large percentage of the population. To reach 300% of the FPL, a
family of four would need to earn approximately $65,000 per year. To put that figure into perspective, the median family income for the state of Ohio in 2008 (according to the American Community
Survey) was approximately $60,000. Nearly all who earn more than 300% of the federal poverty
level are apparently able and willing to absorb the cost of health insurance. Only three out of every
four Ohioans – at best – who earn less than this amount can say the same. That figure declines the
further down the income scale one moves, until approaching the poverty level, when health insurance through Medicaid becomes an option. Clearly, the difficulties in maintaining adequate health
insurance continue to mount for those who live their lives caught between prosperity and poverty.
Financial hardship isn’t the only problem associated with being uninsured. As the findings in this
report indicate, those who were uninsured were more likely to have been in poor or fair health, to
have had no usual source of health care, and to have had unmet health care and prescription needs,
than those with health insurance.
On the plus side, the number of children who have health insurance grew between 2004 and 2008,
despite the weak recovery from the 2001 recession and the onset of the 2007 recession. This is
likely due, in large part, to the State Children’s Health Insurance Program (SCHIP). While troubling
disparities still exist in rates of insured children by adult educational attainment and income, it is
interesting to note that rates of insured children by race (at least between African-Americans and
Whites) showed no significant differences.
These results and conclusions extend to northeast Ohio and to Summit County in particular. We hope
that the analyses contribute to the growing recognition that national, state, and local policies and actions are needed to address very significant unmet health care needs among the population.
57
Data Highlights for Summit County Adults:
• An estimated 67,000 working-age adults were without health insurance in 2008. The rate of
uninsured adults rose from 15.5% in 2004 to 19.6% in 2008; a significant increase of 26% in four
years.
• Several socio-demographic groups were significantly more likely to have been uninsured in
2008; specifically: younger adults, Blacks and African Americans, Asians, unmarried individuals, less-educated persons, unemployed adults and those employed part time, persons living in
poverty or near-poverty, and adults in poor or fair health.
• Adults without health insurance coverage did not have a usual source of care 4.7 times more
than their insured counterparts, were more likely to have utilized a hospital emergency room as
their usual source of care, and were over four times less likely to have had a personal health care
provider.
• Over 22,000 residents had a problem seeing a specialist in the year prior to the survey and, of
those that were uninsured, 65% stated that the reason was because it was too expensive.
• Over 100,000 adults reported that they had at least one unmet health care need in the previous
year. Those that were uninsured were four times more likely to have had unmet dentals needs,
2.7 times more likely to have had unmet prescription needs, and 4.5 times more likely to have
had other unmet health care needs as compared to those with health insurance coverage.
• More than 57% of uninsured residents found it harder to obtain medical care than in the previous
three years and approximately 60% had problems paying for medical bills in the previous year.
• Uninsured adults were twice as likely as those that were insured to have reported that their health
status was poor or fair. However, they were less likely to have reported that they had special
health care needs and reported that they were diagnosed with hypertension and diabetes at about
the same rate as their insured counterparts.
• Nearly 62% of adults were considered overweight or obese and almost 30% smoked cigarettes at
the time of the survey.
• Adults without health insurance were 1.4 times less likely to have had a non-emergency health
care visit and two times less likely to have had a routine check-up as compared to those with
health insurance.
• Approximately 176,000 residents had vision coverage in 2008 and, of those, only 66% had
an eye exam in the previous year, compared to 42% of those without vision coverage. Nearly
210,000 residents had dental coverage in 2008 and 82% had a dental visit, while only 52% of
those without dental coverage visited a dentist.
• One in four adults had at least one emergency room visit in the year prior to the survey and
almost 10% visited an urgent care center. Insurance status was not associated with emergency
health care visits or overnight hospital stays.
58
• Uninsured adults were 2.4 times more likely than the insured to have reported that they were dissatisfied with the overall quality of the health care that they received in the previous year.
Data Highlights for Summit County Children:
• An estimated 3,800 children were without health insurance in 2008. The rate of uninsured children decreased from 5.3% in 2004 to 3.0% in 2008; a decrease of 77% in four years.
• Only one socio-demographic group was significantly more likely to have been uninsured in
2008; specifically, non-Hispanics. Although the differences were not significant, other groups
that appeared to have been more likely to have been uninsured included: older children, children
of less-educated adults, children of unemployed adults, and children living in near-poverty.
• Children without health insurance coverage did not have a usual source of care 15 times more
than their insured counterparts and were about three times less likely to have had a personal
health care provider.
• About one in 20 children had a problem seeing a specialist in the year prior to the survey, including 19% of those that were uninsured and only 4% of that with health insurance coverage.
• Over 11,000 children had at least one unmet health care need in the previous year. Those that
were uninsured were three times more likely to have had unmet dentals needs, nine times more
likely to have had unmet prescription needs, and 21.3 times more likely to have had other unmet
health care needs as compared to those with health insurance coverage.
• The responding adults of nearly 68% of uninsured children found it harder to obtain medical care
for the child than in the previous three years.
• Uninsured children were slightly more likely than those that were insured to have been diagnosed with asthma. However, they were less likely to have had special health care needs and
were in poor or fair health at about the same rate as their insured counterparts.
• More than 23,000 children were considered overweight or obese, including 54% of the uninsured
and 40% of the insured.
• Children without health insurance were 1.4 times less likely to have had a non-emergency health
care visit and 1.3 times less likely to have had a well-child check-up as compared to those with
health insurance.
• One in six children had at least one emergency room visit in the year prior to the survey. Insurance status was not associated with emergency health care visits or overnight hospital stays.
• Almost 33% of responding adults of uninsured children reported that they were dissatisfied with
the overall quality of the health care that the child received in the previous year, as compared to
12% of those with insured children.
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Appendix B: Community Partners of the
Summit 2020: A Quality of Life Project, 2003 - 2011
The following individuals have either served in the past or are currently collaborating with the ongoing implementation of the Quality of Life project. The people on this list (more than 600) have
served in a number of capacities; many have and continue to serve in multiple roles. People have
served: as members of one or more of the project’s 15 standing volunteer committees or as members of several different planning committees; as members of the Social Service Advisory Board; as
subject matter experts that assist in the development of the project’s infrastructure; as representatives
of their government agency, non-profit group, faith-based organization, business, as neighborhood
residents, or as concerned citizens. Combined, these committee citizens put in literally thousands of
hours of volunteer time every year.
It is the involvement of these community partners that makes the Quality of Life project as successful as it has been during the past decade. These same partners stand ready to assist in the improvement of community health.
Roberta Aber, Planned Parenthood of Summit , Portage & Medina Co.
Dottie Achmoody, OPEN-M
Val Adams, SSAM, Summit County Developmental Disabilities Board
Ismail Al-Amin, M.P.A., University of Akron
Sheriff Drew Alexander, Summit County Jail
Sandra L. Alexander, Faith in Action- Interfaith Caregivers
William Alford, Akron Summit Community Action
BRENDA ALLEN, Care Source
Dennis Allen, Hattie Larlham
Tom Allio, Catholic Commission
JANARIS ALSTON, VIOLET’S CUPBOARD
Conrad L. Ames II, Ohio Department of Youth Services
Karey Anderson,
Sally Antonucci, Tallmadge High School
Beth Apanasiewicz, Oriana House, Inc.
Paula Apynys, TH Design
Byron Arledge, Pastoral Counseling Services
Thomas Armstrong, Summit County Developmental Disabilities Board
Joanne Arndt, Summit County ADM Board
Adrienne Ash, Access, Inc.
Ann Askew,
Louise Askew,
Ophellia Averitt, NAACP
Angela Avery, Summit County Children’s Services Board
Lindsay Bachman, MRDD
Jody Bacon, Akron Community Foundation
David C. Bailey, County of Summit Juvenile Court
George Baker, Summit County Veterans Service Commission
Rose Baker, R.N., St. Bernard’s Church Health Ministry
Traci Balint, Rankin Elementary
Tracy Barnett, Summit County Public Health
Derek Barnett, Kaiser Permanente
Elizabeth Bartz, State and Federal Communications, Inc.
Andrew J. Bauer, County of Summit Common Pleas Court
Dr. Kristin Baughman, NEOUCOM
Jerry Bauman, Visiting Nurse Service & Affiliates
Heather Beaird, Summit County Public Health
Leanne Beavers, Summit County Public Health
Toni Beckley Payne, Northeast Ohio African American Health Network
Linda Berger, Summit County Public Health
Sherri Bevan Walsh,
Gail Bialek, Fifth Third Bank
Bob Bickett, Summit County Juvenile Court
Payne Bill, MRDD
Lillian Bishop,
Mary Bishop, Head Start/Akron Summit Community Action, Inc.
JANET BLACK,
Tonya Block, Summit County Family & Children First Council
Ron Bobner, Interval Brotherhood Home
James Boex, Northeastern Ohio Universities College of Medicine
Nichole Booker, Akron Summit Community Action, Inc.
Ray Borom,
Janice Bourda Mercier Wade, PhD, UMADAOP of Akron
Jill Boxler, Summit County Developmental Disabilities Board
Darryl Brake, Community Partnership
Chandra Bramlett, MPA, Akron Urban League
Mort Braunstein, Akron Children’s Hospital
Evis Brinson, PRAC
Rebecca Brittain, ADM
Becky Brittain, LISW, Summit County ADM Board
Officer R. Brock,
Angela Brooks, Akron Metropolitan Housing Authority
Margaret Brown, Akron Community Service Center & Urban League
RONALD BROWN, Brother to Brother Project
Margaret Brown, Akron Urban League
Ann Brown,
Bessie Brown,
Shawne Buckner, Summit County Office of Consumer Affairs
Lynn Budnick, Access, Inc. Shelter
Kim Buehler, U.L. Light Middle School
Ron Burkhard, Barberton Community Foundation
Bernice Bush,
Chuck Byrd, Summit County Workforce Policy Board
Evaughn Cagle, Urban Ounce of Prevention
Robert Calderone, City of Green
Byron Calhoun, Stewart & Calhoun Funeral Home
Judge Lynne Callahan, Akron Municipal Court
Terri Campanelli,
Judith Campbell, Akron-Summit Public Library
Kim Carlson, Tallmadge High School/Family & Consumer Sciences
University of Akron
Police Chief Greg Carris, City of Norton Police Department
Theresa Carter, The OMNOVA Solutions Foundation
Tracy Carter, Summa Health System
Gerald Carter , Juneteenth Celebration
Pastor Jason D. Carthen, MA, MST, The House of the Lord
Ethel Chambers, Community Member
60
Ken Cheatham, Barberton Police Dept., Juvenile Division
May Chen, Asia, Inc.
Jane Christy, Akron Urban League
Bonnie Church, Summit County Public Health
Stephanie Churn, Schumacher
Nakia Clark, MRDD
Capt. Brian Clark, The Salvation Army
BRENDA CLARK, Summit County Public Health
Yolanda Clay, Akron Urban League
Arthur Coates, Sr,
John Codrea,
Capt. Misty Coffelt,
Charles Coffelt,
Lola Coker, Akron Summit Community Action Agency
Trill Cole, Charisma Community Connection
Jim & Gerri Coleman,
Joseph Coleman, 3AERC
Michele Colopy, OMCDC/SCHN/KDP
William Considine, Akron Children’s Hospital
Bill Considine, Akron Children’s Hospital
Georgette Constantinou, PhD, Akron Children’s Hospital
Gary Cook, Area Agency on Aging, Inc.
Marjorie Cook, Peer Parent for Mental Health America
Angela T. Cooper, Mental Health America of Summit County
Patrick Corbett, Summit County Schools
Judge Patricia Cosgrove, County of Summit Common Pleas Court
Malcolm Costa, Akron Summit Community Action, Inc.
Cathy Cotrufu, Westside Neighborhood Development Corporation
Brian Cowan,
Brenda Cox, United Way of Summit County
Thom Craig, The Margaret Clark Morgan Foundation
Jerry Craig, ADM
Tim Crawford, Summit County Council
Kelly Crosby, Akron Summit Community Action Agency
Nathaniel Crosby,
Wendy Cross,
Laurie Curfman, Project GRAD Akron
Deon L. Curry, 994 Hartford Ave.
John Custer,
Terry Dalton, Community Support Services, Inc.
Corinne Dameron, Summit Psychological Associates Inc.
James David, Akron Public Schools
Arian Davis, County of Summit Court of Common Pleas
Jan Davis, African American Health Task Force
ANNA DAVIS, EAST AKRON COMMUNITY HOUSE
KLISHA R. DAVIS, EAST AKRON COMMUNITY HOUSE
Angelina Davis,
“Arian Davis, Offender Services Director
Summit County Adult Probation”
John Davis, Akron Commercial Color Lab
Goran Debelnogich, International Institute of Akron
Flora Dees, Project GRAD Akron
Robert DeJournett, Summa Health Systems
Nancy Delnay, Children’s Services Board
Andrea Denton, Summit County Suicide Prevention Coalition
Doug Denton, OPEN-M
Samuel DeShazior, Greater Akron Chamber
Lisa Di Sabato-Moore, MJA, Juvenile Court Crossroads Program
Clair Dickinson, County of Summit Council
Pat Divoky, Summit County Department of Job and Family Services
Pat Dobbins, Summit County Department of Job and Family Services
Vicki Doepker, Mental Health America Summit County
Dr. Therese Dowd, The University of Akron
James Dowdell, Ohio Department of Rehabilitation and Correction
Michael Dowdell, National City Bank
Robert Dowdell, Akron Summit Community Action
Kathleen Downing, Mobile Meals
Grace Duncan, Summit County Public Health
Ray Dunkle, Brockman, Coats, Gedelian & Company
Gerard Dusa, Tarry House Board of Directors
Donna Dye, Summit County Developmental Disabilities Board
Jackie Easley,
Meghann M. Eberhart,
Donae Eckert, United Way
Jerry Egan, Akron Department of Planning & Urban Development
Lorraine Ellithorp, Greenleaf Family Center
Linda Emore, Children’s Hospital of Akron
Marilyn Espe-Sherwindt, Ph.D., Family & Child Learning Center
Laurie Estep, Summit County Children’s Services
Dietrich Evege, Akron Urban League
DIETRICH EVEGE, Akron Urban League
LISA FAZENBAKER, OPEN M
Virginia Felder, Akron Summit Community Action, Inc.
Evelyn Fennell,
Bob Fenner, Wesley Temple/A M E Zion Church
BETH FERGUSON, BLICK CLINIC
Penny Ferguson,
Benjamin T. Ferguson,
MELVIN FIELDS, HAVEN OF REST
Steve Finical, County of Summit Sheriff’s Office
Donald P. Finn, CYO & Community Services
Cathie Finn, AMHA
Shirley Finney, ASCA Inc.
Maxine Floreani, International Institute
Ruby Flowers,
Teresa Ford, Summit County Children Services
Lois Foster, United Way of Summit County
Phyllis Foster, Akron Metropolitan Housing Authority
Greg Franklin, Oriana House, Inc.
Robin Freedman, Summit Co. Children’s Services
Karen Freeman, First Glance Teen Mom’s Program
Drs. Fred and Penny Frese, Summit County ADM Board
Stuart Friedman, Catholic Charities Housing Corporation
Heather Fry, AMHA
Linda Fuline, Summit County Educational Service Center
Tom Fuller, Alpha Phi Alpha Homes
Don Fuzer, Barberton City Schools
Marge Gaffney, Summit County Public Health/ FCFC
Christine Gardner Marshall, Summit County Department of Job and
Family Services
Stacey Garske, Summit County Public Health/ FCFC
Justin Gates, Principal, UL Light Middle School
Tami Gaugler, TriCounty Independent Living
Robert Genet, Mayor, City of Barberton
Jerilyn George, MRDD
Dr. Susan S. Gerberich, R.N., Healthy Connections Network
Barbara Gercken, Barberton Public Library
Christine Gilley, Summit County Office of Consumer Affairs
Larry Givens, Summit County Sheriffs Office
Sam Glen,
Julie Goldberg, Akron General Medical Center, Social Work Office
Jimmy Gooden,
Tom Grande, ADM
Barbara A. Greene, CommonGood Consulting, Inc.
Renee Greene, Akron City Council
Pastor William Greene, Galilee Baptist Church
Robert F. Greene, Sr.,
Judy Griggs, Akron Children’s Hospital
Marty Harbin, Summit County Department of Job and Family Services
Elaine Harlen, Child Guidance & Family Solutions
Thomas Harnden, The Barberton Community Foundation
Brenda Harrell,
Daneen Harrison, WENDCO
DORIAN HARRISTON, Ohio KePRO
Ted Haughawout, TH Design
Pam Hawkins, Akron Metropolitan Housing Authority
Terri Heckman, Battered Women’s Shelter
Paul Heilman,
Jeffrey Heintz, Brouse McDowell
William Henderson,
Lucinda Henderson,
Judy Hendrick, Summit County Department Job & Family Services
61
Rob Hermanowski, MD, Community Support Services, Inc.
Jessica L. Heropulos, Crossroads Probation Officer
Laura Higgins, FCFC Family Committee
Skip Hill, Nazareth Housing
Valerie Hill-Austin, Summit County Department of Job and Family
Services
Sylvia Hines, Access, Inc.
Suzzanne Hobson, Akron General Development Foundation
SUE HOBSON, AKRON GENERAL MEDICAL CENTER
Paul Holm, Rebuilding Together with Christmas in April
Peggy Holmes, Weed & Seed
Candace Hooks,
Pete Hoose, County of Summit Common Pleas Court
Judge Kim Hoover, Cuyahoga Falls Municipal Court
Darla K. Hopkins, OPEN M
Robert N. Howard, Director of Planning
Michael Ho-Yong Byun, Asia Services in Action
Michael Ho-Yong Byun, Asia Services in Action
Courtney Hudson, Summit County Public Health
Hank Hudson, St. Sebastian Catholic Church
Gwendolyn Hughes Wilson, Community Partnership
Judy Hummel, Summit Education Initiative
Danielle Hupp, Habitat for Humanity of Summit County
Kim Ickes, Better Business Bureau
Nan Ingol,
Anthony Ingram, Akron Municipal Court Probation Department
Michael Irby,
Mike Irby, Summit County Public Health
Dr. Todd Ivan, Center for Akron Psychiatry, Inc.
Timothy C. Ivey, Roetzel & Andress
ROLAND JACKSON, JAMARI’S DRUM PROJECT
Dylanna Jackson, International Institute
Mike Jacobs, Summit County Developmental Disabilities Board
Martha Jamison,
Don Jankura, Summit County Developmental Disabilities Board
David L Jenkins, Zoning Inspector Village of Lakemore
David Jennings, Akron-Summit County Public Library
Lori Johnsen, Ohio Department of Health
Devoe Johnson, United Way
Christine Johnson, Summit County Public Health
CATHY JOHNSON, THE HOUSE OF THE LORD
Charles & Glennie Johnson,
Christine Johnson R.N., Division of Nursing
Bettie Jones,
Crystal Jones,
Dawonna Jones,
Cherrian L. Jones,
Judy Joyce, Greenleaf Family Center
Sean Joyce, Good will Industries of Akron
William Judge, City Council Ward 2
Rick Justice,
Ingrid Kanics, Hattie Larlham
McDay Karla, Summit County Children Services
Joelyn Karlson,
Ed Kaufmann, Mature Services, Inc.
Patty Kaufmann, Parent Coalition for Persons with Disabilities
Rick Kavenagh, Brockman, Coats, Gedelian & Co.
C. William Keck, M.D., M.P.H., Division of Community Health Sciences
Rick Kellar, The Margaret Clark Morgan Foundation
Lt. Gerald Kelley, Akron Police Department
Lynn Kelley, Akron Community Health Resources
Don Kelley, Community AIDS Network
Calvin Kennedy, Third Federal
Jennifer Kephart, Info Line, Inc.
Kerry Kernen, Summit County Public Health
Brian King, Akron Children’s Hospital
David King, Open M
Barbara Kirbawy, Barberton Public Library
Sarah Kisner, Summit County Department of Job and Family Services
Paulette Kline, Summit County Public Health
MARGARET KNOX, EAST AKRON COMMUNITY HOUSE
Gary Knuth, United Disability Service
Mike Kolomichuk, Lakemore Mayor/ American Wings Flight Academy
Steve Korane, Parent Rep
KATHLEEN KOROSI, OHIO KE PRO
Kelly Kortvejesi, Goodwill Industries
Jerry Kraker, Portage Path Behavioral Health
Connie L. Krauss, Greater Akron Chamber
Robert A. Kulinski, United Way of Summit County
Rocky Kurchak, Family Resource Center, Summit County Juvenile
Court
RICK LANGE, HIV/AIDS EDUCATION & PREVENTION CONSULTANT
Linda Lanier, The Black Pages
Kate Lanza, Summit County Public Health
Amanda Large,
James Lawrence, Oriana House, Inc.
Tanya R. Lawrence,
Dr. Peter Leahy, University of Akron
Allyson Lee, ASCA, Inc.
D’ Lareg Lee,
Yu-Ling Leh, ASCA, Inc.
Jim Lenahan, Vision Support Services
LATONYA LEWIS, AKRON CHILDRENS HOSPITAL
Myron Lewis, Juvenile Detention
Mark Lewis,
Gwen Lewis, Summit County Executive’s Office
MARY ANNE LOFTUS, AKRON GENERAL MEDICAL CENTER
Mary Ann Loftus , Summit County Public Health
Everett Logue, Summa Health Systems
EVERETT LOGUE, SUMMA HEALTH SYSTEM
Adrianne Lopp, UMADAOP
Karin Lopper-Orr, Blick Clinic
Marianne Lorini, Akron Regional Hospital Association
Courtney Luff, Summit Co. Executive Office of Public Safety and
Justice Affairs
ALICE LUSE, AMERICAN HEART ASSOCIATION
Bruce Lyman, Senior Pastor, Hope Alliance Church
JACK LYONS, NORTH AMERICAN INDIAN CULTURAL CENTER
Gregory Macko, City of Barberton
Greg Macko,
Joli Magnus, International Institute
Anita Maldonado-Moorer, ASCA, Inc.
Rev. Dr. Alicia J. Malone, Bondage Breakers, Inc.
Daryl Mangeri, Program Enrichment Coordinator, Summit County
Salvation Army
Megan Mannion, Principal, Rankin School of Technology
Debra Manteghi ,
Mike Marks, West Akron Kiwanis
Cathy Marrone, Summit County Public Health
Judge Elinore Marsh Stormer, Akron Municipal Court
Marlene Martin, Summit County Public Health
Ray Martin, Blick Clinic, Inc.
MARLENE MARTIN, Summit County Public Health
Chief Mike Matulavich, Akron Police Department
Fred Maurer, 3rd Ward Councilman
Brian McCalister, Charisma Community Connection
Janette McCarthy,
Sandra McClain,
Nan McClenaghan, The Goodwill Industries of Akron, Ohio, Inc.
Jon D. McCray,
Karla McDay, Summit County Children Services
Karla McDay, MSW, LSW, Summit County Children Services
Pat McGrath, Catholic Social Services of Summit County, Inc.
Patrick McGrath, Catholic Services of Summit County
Amy McLaughlin, InfoLine, Inc.
Kathleen McLaughlin, Mature Services
Yvette McMillan, Haven of Rest Ministries - Mission/Harvest Home
Darnella McNeil, Legacy III, Inc.
Linda McRay, Charisma Community Connection
Gene P. McWain,
62
Jessie Meadow,
Vince Mealy, YMCA Green
Barbara Medlock, R.N., Portage Path Behvioral Health, Psychiatric
Emergency Services
Terry Meese, University of Akron, School of Family and Consumer
Sciences
Deb Megyzs, Child Guidance and Family Solutions
Iris Meltzer, Akron Children’s Hospital.
Janice Mercier, UMADAOP
Pam Meredith, Greenleaf Family Center
Ann Mezger, Akron Beacon Journal
Natalie Michailides, Summit County Criminal Justice Affairs Division
Chief Michael Mier, Copley Police Department
Kim Miller, Fifth Third Bank
Julie D. Miller,
Tom Miller,
Julie Miller, Senior Center
Regina Mills, Akron Metropolitan Housing Authority
Jeff Mills, Key Bank
Nastacia Minor, Summit County Developmental Disabilities Board
Marquita Mitchell, Project LEARN of Summit County
Lauri Molnar, Larlham Community Network
Douglas Monhart,
Laura Moomaw, Summit County Public Health
DEBORAH MOORE, AMERICAN CANCER SOCIETY
Dr. Diane Moran, Reserve Psycological Consultants, Inc.
Alfred and Eleanor Morgan,
Richard Morris, Executive Director, Pleasant Pointe Assisted Living
“Sharon Morris, Harvest Home
Neighbor to Neighbor Women’s Campaign”
Michael Moser, M.D., M.P.H., Akron City Health Department
Mark Munetz, MD, Summit County ADM Board
Tiffany Munnerlyn, Rankin Elementary School- PTA President
Jo A. Murr, Summit County Department of Job and Family Services
Natalyn Mytareva, International Institute of Akron, Inc.
Le Joyce Naylor, Director of Public Relations, Summit County Childrens Services
Sandy Neal, Hattie Larlham Foundation
Russell Neal Jr., Grafitti Print Shop
Corliss Newsome, Ohio MultiCounty Development
Linda Nice, Akron General Medical Center
Hannah Nitz, OPEN-M
Gene Nixon, Summit County Board of Health
DeAndre’ Nixon, iN Education, Inc.
Gene Nixon, Summit County Public Health
Pastor Eugene Norris, Mountain of the Lord
Maxine O’ Mara, National College of Business and Technology
Mary Beth O’Donnell, North Coast Community Homes
Anthony O’Leary, Akron Metropolitan Housing Authority
Louwana Oliva, METRO
Linda Omobien, Community Support Services, Inc.
James A. Orlando, Ph D, Summit Psychological Associates Inc.
Bob Otterman, Summit County Senior Services
Mary B. Outley-Kelly, Akron Public Schools
Richard Owens, Summit County Department of Job and Family Services
Brian Owens,
Valerie Owens,
Rick Owens,
Candance Pallante, Portage Path Behavioral Health, Emergency Services
Katerina Papas, Summit County Children’s Services
Lynn Parmentier, Summit County Youth Employment for Success
Debra Parmer, Ex. Dir. NEO African American Health Network Amani
Health and Wellness Cnt.
CHRIS PARTIS, Summit County Public Health
Mohammed Parvez, Fair Housing Contact Service
Eric Paull,
ULONDA PAYNE, JANIE’S HEART
Linda Payne, Summit County Board of MRDD
Jerry Pecko,
Brian Pendleton, University of Akron Dept. Socio.
Fannie L. Perdue,
Nick Perez, State Treasurer’s Office
Kathy Perge, Community Health Center
Annette Petranic, Emergency Mangement Agency
Joe Petrucelli, Summit County Juvenile Court
Robert Pfaff, METRO Regional Transit Authority
Elizabeth Pfeiffer, AMHA
Ann M Phillips, Curriculum Director Springfield Local Schools
Sue Pierson, InfoLine, Inc.
Linda D. Pitman, Lakemore UM Church
RUSSELL PLATT, M.D.,
Glee Plough, American Medical Response
Mayor Donald Plusquellic, City Of Akron
Glorya Porter,
ADRIANNE PRICE, INFOLINE, INC.
Sheree Thomas Pritchard, International Institute of Akron, Inc.
Russ Pry, Summit County Executive
Tom Quade, Summit County Public Health
Richard Quay, Lakemore Village
Anita Rabaa, The Medical Society of Greater Akron
Paula Rabinowitz, ADM
Geneva Reddick,
Barbara Reiter, Access, Inc.
Ron Rett, NAMI/Mental Health Housing Leadership Institute
Fran Rice, United Way of Greater Stark County
Deanna Rice, Universal Nursing Service
Chris Richardson, Oriana Crisis Center
Julie Rittenhouse, GAR Foundation
Chris Ritter, NEOUCOM
Rita Rizzo, Rizzo and Associtates
Dani Robbins, Boys & Girls Clubs of Summit County
Carrie Roberts, Summit County Developmental Disabilities Board
Charlotte Robinson, Akron Summit Community Action, Inc.
Dorothy Robinson,
Tanya Robinson, PhD,
Rita Rocci, Akron Dental Society
Bernie Rochford, Oriana House
Jorge Rodrigues, IBM Corporation
Richard Rogen, Carnegie Consulting Group, LTD
Pastor Joseph Rogers, Abundant Life Christian Church
James R. Rogers, PhD, The University of Akron, Fir Hill Plaza, Department of Counseling
STEPHANIE ROLLINS, EAST AKRON COMMUNITY HOUSE
Eric Roper, Getting Ahead Graduate; no email
Pat Rossi, OSU Extension
CHANDRA RUDOLPH, SUMMIT PORTAGE AHEC
MUSTAPHA SAADIQ, FREELANCE CARTOONIST
Gregory R. (Attorney) Sain, Community Legal Aid
Jennifer Samardak, Summit County Juvenile Court Chuck Sandstrom, Salvation Army
Sloan Sanford, City of Summit County Public Health
John Saros, Summit County Children’s Services Board
Leeanne M. Sarro, The Arc
Gary Schaefele, County of Summit Alcohol, Drug Addiction & Mental
Health Services Board
Denice Schafer, Junior Achievement of Akron Area, Inc.
Lance Schmidt, FG Ayers Inc.
Marsha Schofield, Summit County Public Health
Kim Schontz, Community Support Services, Inc.
Brad Schroeder, YRC Worldwide Enterprise Services, Inc.
MacKenzie Scott,
Martha Scott,
E. Demond Scott, M.D., SUMMA HEALTH SYSTEM
Dr. Kathleen Scroggins, M.D.,
Robb Seders,
Julie Seeley, R.N., Summit County Department of Job and Family
Services
Sandra Selby, Furnace Street Mission
Nanci Self, Nazareth Housing
Pete Sell, ASCA Inc.
Pete Seminaroti, Seibert Keck Insurance Company
Quinita Sewell, Rankin Elementary School
Elaine Seyerle, Mobile Meals
Karla Shackelford, Springfield/Lakemore Community
63
Javan and Jessie Shaw,
Robert Shelton, and Vickie Gooden
Diane Sheridan, Barberton Planning Department
Tom Showalter, Pastor, Friends Church
Juliet Shreve, Barberton NAACP
Kimberly Shull, Lakemore United Methodist Church
Cynthia Sich, Summit County Office of Consumer Affairs
Courtney Siedlecki, County of Summit
Patricia Siefert, PhD, Akron Children’s Hospital- PIRC
Jackie Silas-Butler, Caring Communities of Summit County
Chris Silva, Barberton City Council
Shirley Simon,
Sheila Sims, Open M
Ralph Sinistro, Summit County Department of Job and Family Services
Tamala Skipper, Fair Housing Contact Service
John Skipper, Camp Quality Ohio
David James, Akron Public Schools
Elaine Small, Community/Concerned Connection
Stacy Smith, Akron Urban League
Cazzell Smith, Summit County Council
Michele Smith, Caring Communities of Summit Cty
Captain Roy Smith, Lakemore Village Police
Scotty Snowden,
Don Snyder, Brockman, Coats, Gedelian & Co.
Kelli Snyder, Common Pleas Adult Probation
Gillian Solem, R.N. , Summit County Public Health
Linda (Rev.) Somerville, Park United Methodist Church
Mary Alice Sonnhalter, County of Summit ADM Board
Mike Soyars ,
Shellie Sparhawk, Barberton Police Dept., Juvenile Division
Jim Spender,
Judge Mary Spicer, County of Summit Common Pleas Court
Karen Spinelli, Project GRAD Akron
Eric Spooney,
Ruth Squires, County of Summit Common Pleas Court
Richard Stahl, InfoLine, Inc.
William Stauffer, Springfield Local School District
Dimitre Stefanov, Summit County Public Health
Richard Steiner, University of Akron
Linda Stemple, Summit County Public Health
Natalie Stemple, R.N. , American Medical Response
Faith Stewart, The Goodyear Tire & Rubber Co.
Effie Stewart, USBC
Steve Stock, IBEW Local 306
Toree Stokes, Mustard Seed Development Center
Jim Stonkus, Barberton Citizens Hospital
Sarah Strattan, Community Legal Services
Sara Strattan, Community Legal Aid
Bill and Linda Strittmatter, Residents
Davidcia Stubbs, East Akron Community House
DAVIDCIA STUBBS, EAST AKRON COMMUNITY HOUSE
Judge Annalisa Stubbs Williams, Akron Municipal Court
Valerie (Rev.) Stultz, Canal District United Methodist Church
Paul Subotichi, Chairperson, Environmental Health and Social Services
Long Sue, Summit Education Initiative
Robert M. Sukel, Greenleaf Family Center
Bonnie Susko, ORSC
Maryanne Sweeney, Summit County Sheriff’s Office
Karen Talbott, Social Services Advisory Board
Joyce Tate, Akron Community Health Resources
Bessie Tate,
Thomas Tatum, City of Akron
Howard Taylor, United Disability Services
Pastor Jimmy Taylor, The House of the Lord
Robert Taylor, BOECO
Sarah Taylor,
Vera Thomas,
Curtis Thomas III, Haven of Rest Ministries
Richard Thompson,
Pastor Juan Thompson, New Bethlehem Full Gospel Baptist Church
Janice Thurman,
James Toles, Buckeye State Credit Union
Carmine Torio, Akron HBA
Kirstin S. Toth, GAR Foundation
Diane Touschner, Clinical Site Manager, Child Guidance Centers
Jon Trainor, President, Akron General Development Foundation
Judge Linda Tucci Teodosio, County of Summit Juvenile Court
Sue Tucker , Summit County Domestic Relations Court
Angela Tucker Cooper, Mental Health America Summit County
Ann Vainer, Barberton City Schools
Lynne Van Nostran, Summit Education Initiative
Diana Vanwinkle, Access, Inc.
Barbara Vassel, Pastoral Counseling Service of Summit County
Nick Veauthier , ADM Board IT Manager
Andrea Victor, Habitat for Humanity
SONI VYAS, ASIAN SERVICES IN ACTION INC.
Jonathan Wade,
Pastor Henry Wade, Jr., Frank Avenue Church of God
Jan Wagner, Community Health Center
Nabeeh Waheed, Tax Management Shelter
Warren Walfish, County of Summit Department of Development
Tanya Walkin, ASCA, Inc.
Terry Walton, Juvenile Court
Stephanie Warsmith, Akron Beacon Journal
Shirley Washington,
Yvette Watkins, Goodwill Industries
Mark Watson, Decker Family Center
Lisa Weaver, FCFC Family Committee
Dr. Anne Weiner, University of Akron,
Jill Weingart, Summit County Department of Job and Family Services
Sharon Weitzenhof, United Way
Jean Welch,
Tracy Wheeler, Beacon Journal
Shelley C. White, Seibert-Keck Insurance
Florastean White,
Marilyn White,
Michelle Wieland,
Andy Wildman,
Linda Wilkins, Kastner, Westman & Wilkins LLC
Alford William, Akron Summit Community Action
Bernett Williams, Akron Urban League
Lee Williams, International Institute of Akron, Inc.
Evelyn Williams, Bamco 4 Youth, Inc.
Michael Williams,
Dee Williams, NMCDC
Lisa Williams,
Reverand Dick Williams,
Dr. Jay C. Williamson, M.D., NEOUCOM
Jerrie Wilmington,
Gwen Wilson, Summit Co. Community Partnership, Inc.
John Wilson,
Dawson Wise, Lakemore PD Youth Officer Juvenile Court
Mike Wojno, Open M
Elaine Woloshyn, Center for Nonprofit Excellence
Richard Wood, Barberton Citizens Hospital
Renea A. Woods,
Lynn Wright, Portage Lakes Career Center
Elaine Yehle-Bowen, ASCA, Inc.
Sgt. Mike Yohe, Akron Police Department/ Mental Health Court
Debbie and Dan Yost,
Tracy Young,
Ann Young, Springfield School Board
Dean A. Young,
Diana Zaleski, County of Summit Clerk of Courts
Dodi Zbuka, Springfield Schools
Baomei Zhao, PhD, University of Akron
Theodore P. Ziegler, Community Health Center
Randy Zumbar, Summa Health System
Ron Zumpano, Summit County Public Health
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summit county community health assessment

Transcription

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