Healthy - Tampa Bay Partnership

Transcription

Established in 1996, the Tampa Bay Partnership Regional Research & Education Foundation conducts research on
issues of regional economic significance and educates the public by serving as a source of data-driven information and
conducting informational leadership programs, conferences and seminars.
In 2006, the Foundation began an effort to develop a shared regional vision for the eight-county Tampa Bay region
to answer the question: how can the overall region prosper from a position of strength, diversity, opportunity, and
economic vitality over the long-term as we continue to grow?
The regional visioning process, now known as ONE BAY, explores the issues that are most critical to the region’s future
– not only the most urgent or pressing, but those issues that can only be successfully addressed with a long-term view
and commitment in mind.
For each ONE BAY initiative, the Foundation will:
• Create a strong and diverse coalition within the region to achieve better
coordination of services and resources and a higher appreciation and awareness
among partners with less duplication of services.
• Engage the community by implementing a participatory and highly-publicized
process to increase awareness and knowledge.
• Increase visibility so community residents may gain a better awareness of their own potential for improving their
quality of life.
• Create community ownership. Community-driven processes also lead to collective thinking, a sense of community
ownership in initiatives, and ultimately, may produce more innovative, effective and sustainable solutions to
complex problems.
There are currently three active ONE BAY initiatives.
Livable Communities. Started in 2007, the ONE BAY: Livable
Communities initiative has drawn upon
thousands of citizens to create a shared
regional vision to plan for where future
population and employment growth shall
go through responsible land use, mobility,
and environmental sustainability. This
initiative is now in the implementation
stages working collaboratively with the
public and private sectors to support the
Vision’s recommendations.
Healthy Communities. Started in 2010, the ONE BAY: Healthy
Communities initiative researched the overall health status of the
region with the goal of one day achieving more positive health
outcomes throughout our community. The next step will be to engage
the public in the highly visible process to answer the question –
How healthy do we want to be in 2050?
Lifelong Learning. The Foundation recognizes that the quality of a
region’s educational system is a critical factor in the site selection
process for relocating and expanding companies; is a catalyst for
research & commercialization; influences the skills of the region’s
workforce and quantity of available knowledge workers; and can
contribute to increasing the income of the region’s residents. In
2011, the Foundation will begin exploring how a long-term vision can
engage the community towards an improved educational system
for all its citizens.
FULFILLING LIFE’S POSSIBILITIES
Tampa Bay Partnership
Regional Research & Education
Foundation Directors:
Dan Mahurin, Chairman
SunTrust Bank
Lee Arnold
Colliers Arnold
David Fischer
Community Foundation of Tampa Bay
Stephen Mason
BayCare Health System
Stuart Rogel
Tampa Bay Partnership
Visit www.myonebay.com
for more information.
1
Table of Contents
About The Tampa Bay Partnership Regional Research & Education Foundation
2
Welcome
3
Introduction
4-9
Next Steps
10
About the Tampa Bay Region
11
Economy/Demographics
12-13
Health Outcomes
14-19
Health-Related Behaviors
20-23
Health Systems
24-26
Health Access
Environmental Health
28-31
Community Assessment
32-37
Goals & Methodology
Health Indicators
38
39-44
Organizations
45
Steering Committee
46
References
Acknowledgements
2
27
47-48
49
ONE BAY: Healthy Communities
As the nation begins a new era in health care, the country is also focusing on improving
individual health. Americans are living longer, yet the number of healthy productive years is
approximately 10% less than the average life expectancy. In addition, many individuals are
unnecessarily dying too young. Investing in one’s health is a smart play for people who want
to live healthier, longer, and happier lives. Communities investing in health will create a more
attractive, safe, and opportunistic place for current and future generations.
The Tampa Bay Partnership Regional Research & Education Foundation, through its regional
visioning process known as ONE BAY, is committed to exploring the issues most critical to the
region’s future which can only be successfully addressed with a long-term view and commitment.
In 2010, the ONE BAY: Healthy Communities initiative convened a diverse group of
stakeholders from the public, private and non-profit sectors and challenged them to find
ways for us to become more pro-active, gain a better understanding of our unique health and
community issues, and commit to working together to remove barriers and promote a healthy
lifestyle for all residents.
Stephen R. Mason
President & CEO,
BayCare Health
System
With Florida’s health rankings landing at the middle to bottom of national rankings, according to various surveys,
our first goal was to establish baseline data to help our region understand how healthy the Tampa Bay region is
compared to the state and nation.
This assessment of the Tampa Bay region highlights areas where we excel, but also where we need improvement.
While the state has various programs in place to address the challenges and opportunities Florida faces, we in
the Tampa Bay region need to raise awareness of the issues and create compelling reasons why business and
community leaders should commit to building cultures of health.
• The Tampa Bay region, in some cases, mirrors the health of the nation (i.e., obesity); yet we have found that some
Tampa Bay figures far exceed the U.S. rates and Healthy People 2010 targets (i.e., motor vehicle deaths).
• Our most difficult challenges are in the areas of suicide, infant deaths, low birth weight babies, obesity, smoking,
and motor vehicle deaths.
• Although the entire nation is experiencing the aging of the baby boomer generation, a higher proportion of the
Tampa Bay population is age 55 or older when compared to most other regions. We need to recognize the special
needs and abilities of this rising demographic.
We look forward to working closely with a variety of key stakeholders to improve the health of our current population
and attract new residents and businesses to further our economic prosperity and competitiveness.
Sincerely,
Stephen R. Mason
Chair, Steering Committee
3
Introduction
How healthy is the Tampa Bay community? How does it compare to Florida as a whole and to national
benchmarks? What community health improvement activities are occurring in the region? This report stems from a new
long-term regional visioning initiative called ONE BAY: Healthy Communities, aimed at improving the health of the eight
county region. The assessment on the following pages will give a basis for where we stand today, and help the region
prioritize and collaborate toward common goals.
What is a Healthy Community?
A healthy community encompasses
the physical, psychological, economic,
environmental and social well-being
of its citizens. These health domains
are interrelated, each impacting the
other. An unsafe neighborhood inhibits
outdoor physical activity; a poor
economy increases unemployment
and simultaneously decreases the
likelihood of families being able to
afford prescription medicines and
preventive care; and health disparities
have been correlated with race and
socioeconomic status.
In the broadest sense, a healthy
community is one in which all sectors of
the community (individuals, employers,
governments, educators, faithbased organizations and health care
providers), work together to remove
barriers and promote a healthy lifestyle
for all residents.
Living Longer
Americans are living longer than we
did 100 years ago. Living longer does
not always mean living “healthy”
longer. According to a recent study
4
U.S. Life
Expectancy
The number of
“healthy” years that
one can expect to live
without illness or injury
is 10% less than the
average life expectancy.
Women
80
72
Total Years
“Healthy” Years
Men
75
68
Total Years
“Healthy” Years
by the Organisation for Economic
Co-operation and Development (OECD),
the number of years that one could
expect to live healthy, that is, not limited
by disease or injury, is 10% less than
the average life expectancy.
In the U.S., based upon an average
life expectancy in 2006 of 80 years
for women and 75 years for men, the
“healthy” life expectancy is only 72
years for women and 68 years for men.1
Rather than dying at an early age from
heart disease, stroke or cancer, we are
more often living and coping with these
and other chronic diseases, such as
diabetes, arthritis, hypertension and
respiratory diseases. Nearly 25% of
those with chronic disease have one or
more limitations in their daily activities.2
Not only is chronic disease shortening
lives, the cost of treating chronic
disease continues to increase. Roughly
75% of all health care dollars are spent
treating chronic disease.3 Total health
care spending in 2009 was nearly $2.5
trillion and is expected to reach $4.3
trillion in 2017, or 20% of the U.S.
Gross Domestic Product.4,5
A Social Awakening
Evaluating Community Health
Improved health, whether through
disease prevention, increased access,
elimination of disparities, or reduction
of chronic disease, has become a
greater part of the public dialogue in
the last decade. The message being
communicated, and increasingly heard,
is that the majority of the American
populace is not healthy.
In an effort to determine whether Tampa
Bay is a healthy community, data for
60 indicators was collected in five
areas: Economy/Demographics, Health
Outcomes, Health-Related Behavior,
Health Systems and Access, and
Environmental Health for each of the
eight counties in the Tampa Bay region.
Analysis of health, economic and social
indicators reveal that Tampa Bay, as far
as health is concerned, is an average
community. It is neither a shining
example of health to be emulated
by other communities, nor a region
plagued by disease and unhealthy
behavior to such a degree that it
impacts economic growth of the region.
Highly popular network television reality
shows like “The Biggest Loser” and
“Jaime Oliver’s Food Revolution” have
reinstated a national discussion. In
addition, First Lady Michelle Obama has
launched the “Let’s Move” initiative to
combat childhood obesity and raise a
healthier generation of children.
Since the 1979 Surgeon General’s
Healthy People report laid out a
national public health agenda, research
advances and proactive efforts of the
public and private sector have made an
impact. We have experienced:
• Scientific and pharmaceutical
advances on both the prevention and
treatment of disease
• Employers paying for preventive
services and providing in-house health
clinics for employees and families
• Employers providing incentives for
employees to take responsibility for
their personal health and expenditures
• An increase in the number of walking
trails, marathons and triathlons
• Places of employment and public
places, including outdoor community
venues (i.e., sports stadiums),
becoming smoke-free zones
• Comprehensive reforms through the
Affordable Care Act of 2010 intended
to lower health care costs, guarantee
more choices, and enhance the
quality care for all Americans
• Requirements by the U.S. Department
of Agriculture for school districts to
have a wellness policy
One of the most visible examples of
societal change initiated by scientific
findings, citizen action and legislative
policy changes, is the transformation
from a smoking culture to one where
residents now expect a nearly smokefree community.
Poor
Good
How healthy is
Tampa Bay?
For many of the health indicators
measured, Tampa Bay statistics
are similar to state or national rates.
However, state and national figures may
not be the best benchmark, as they may
also fall short of the national Healthy
People 2010 goals as well as Healthy
People 2020 targets. Of 16 indicators
collected with corresponding Healthy
People 2010 targets, only four met or
exceeded the target in the Tampa
Bay region with 12 trailing the
2010 benchmarks.
Spotlight: Healthy People 2010/2020
Healthy People 2010 was designed to be
a guide for state and local governments,
professional associations and other
organizations to assist in setting local
goals and taking action. The primary
goals for Healthy People 2010 were:6
• Increase Quality and Years
of Healthy Life
• Eliminate Health Disparities
The Healthy People objectives include
over 450 measures that either affect
health and well-being or demonstrate
our progress, or lack thereof, in addressing a condition or illness.
Measures of injury, violence, and environmental quality are also
included as safe neighborhoods and clean air impact health.
Healthy People 2020 was launched in December 2010 and includes
a redesigned website, new topic areas and evidence-based
interventions.
www.healthypeople.gov
5
Introduction (cont.)
Those meeting the goals include
rates of colon cancer screenings and
deaths caused by breast cancer,
stroke and coronary heart disease. Of
the targets where we are lagging, the
more alarming statistics include suicide
deaths, infant deaths, low birth weight
babies, obesity, smoking, and motor
vehicle deaths.
We should note that some of these
challenges are not just a Tampa Bay
phenomenon. The percentage of adults
in Tampa Bay who are overweight or
obese mirrors that of the state and
nation. With two-thirds of our adult
population either overweight or obese,
our nation is suffering the consequences
in terms of increased costs, lower
quality of life, and premature death. As
the nation grapples with this challenge,
Tampa Bay should be prepared to work
in concert with state and national efforts
so as to not fall behind.
On the other hand, motor vehicle
deaths in Tampa Bay (and Florida) far
exceeded the Healthy People target
while the U.S. numbers were below the
target and trending downwards. In this
area, we should work closely with state
and local officials to increase the safety
of our citizens.
This report highlights notable indicators
with more detailed information in
subsequent sections.
Three out of four high school students
in Tampa Bay graduate within four
years of beginning high school, which
is only marginally lower than state and
national averages. Employers seeking
a skilled and educated labor force may
be concerned that only slightly over one
in five Tampa Bay adults (age 25 and
older) have a Bachelor’s degree or
higher compared to nearly one in
four nationally.
Health Outcomes
When thinking about the health of a
population, it is customary to consider
the number of residents who die from
a disease or condition, or who are
living with a disabling condition.
Prevalence of
smoking in U.S.
declined from
42%
in 1965 to
20%
in 2007
A Growing and Diverse Region
The Tampa Bay region is densely
populated with over four million
residents, of whom 60% are working
age (18-64) and 20% are age 18-34, a
desirable employment and consumer
pool. The population is primarily white
with African Americans comprising 11%
of the total population. The Hispanic
population is the fastest growing ethnic
group with a 75% increase in the
number of residents of Hispanic origin
between 2000 and 2009.
The region’s median annual household
income and annual per capita personal
income lag behind national numbers.
However, when other factors such as
6
cost of living and the absence
of income tax are considered,
the purchasing power of those
lower regional incomes begins
to align more closely with other
communities.
The percentage of families
living below the poverty level
in Tampa Bay approximates
the rest of the nation at 13%.
The region’s unemployment
rate was two percentage points
higher than the nation in 2009,
but historically, the Tampa Bay
unemployment rate has trended
less than national rates.7
Data on the health outcomes for
thirteen diseases and conditions
was collected for this report. The
good news is that for the three
conditions that cause the most deaths,
coronary heart disease, stroke and
cancer, there has been a downward
trend in the number of deaths caused
by these conditions. This is a national
and state trend, as well as one seen
in Tampa Bay.
Of these three major causes of death,
stroke and lung cancer stand out,
but for opposite reasons. The Tampa
Bay region has a substantially lower
death rate from stroke, 34.6 deaths
per 100,000 residents, compared to
the national rate of 43.6 per 100,000
residents. The Healthy People 2010
target was 50, which Tampa Bay
successfully met, even in 2002.
Lung cancer deaths in Tampa Bay,
unfortunately, exceed state and
national figures. In 2006, there were
55.7 lung cancer deaths per every
100,000 residents in Tampa Bay
compared to 51.2 in the state of
Florida, and 51.5 nationally. Unlike
other cancers, the correlation between
lung cancer and smoking, is proven.
Efforts to reduce the number of lung
cancer deaths in Tampa Bay require
successful behavioral intervention.
Also trending down throughout the
nation, state and region are deaths
caused by pneumonia and influenza.
These rates are generally reported
together because pneumonia is often
caused by influenza. In the U.S.,
pneumonia/influenza is the eighth
leading cause of death with 17.8 deaths
per 100,000 (2006). Deaths caused by
pneumonia/influenza in Tampa Bay and
in Florida are less than half of that, 8.8
and 8.9, respectively.
have declined over the last five years,
the number of those immunized against
pneumonia and influenza has increased,
and those being screened for colon
cancer have increased.
The condition with the most notable
trend in the wrong direction is diabetes.
According to the American Diabetes
Association, 1.6 million new cases of
diabetes are diagnosed in people age
20 and older each year, and the total
costs for diagnosed diabetes in the U.S.
in 2007 was $174 billion; $116 billion
for direct medical costs and $58 billion
for indirect costs (disability, work loss,
premature mortality).8 In 2007, the ageadjusted percentage of adults who have
ever been diagnosed with diabetes in
the U.S. was 5.7%; in Tampa Bay it
was 8.0%. Given the costs attributed
to diabetes, both in terms of dollars
and premature death, this is a condition
demanding intervention.
The percentage of people throughout
the region, state and nation, who
are overweight, defined as having
a body mass index (BMI) between
25.0 and 29.9, remained fairly
stable between 2002 and 2007.
Unfortunately, the rates of adult
and childhood obesity (BMI greater
than 30.0) have substantially increased.
The percentage of adults in Tampa
Bay who were obese in 2002 was
21.8. In 2007, it was 25.4%. Nearly
40% of Tampa Bay residents in 2007
reported that they did not regularly
exercise and 26% reported being
completely sedentary.
Another troubling statistic is the number
of suicide deaths in Tampa Bay. In
2006, our region had 14.9 deaths per
100,000, a slight uptick from 14.7 in
2002. In Florida, there were 12.6 suicide
deaths per 100,000 (2006) and 10.8
nationally. The Healthy People 2010
target was 4.8.
The region’s infant mortality is slightly
higher than state and national averages.
Infant deaths are most often caused
by birth defects, pre-term delivery,
low birth weight, sudden infant death
syndrome and maternal complications
during pregnancy. Tampa Bay’s number
of low birth weight babies is similar
to state and national averages, which
were all three to four percent above the
Healthy People 2010 target of 5.0%.
Tampa Bay’s birth rate to teenage girls
less than 15 was 0.7 births per 1,000
which was only slightly higher than
the state average of 0.6. However,
the range throughout the region
varies greatly.
Childhood immunizations have
remained consistent over time yet there
is room for improvement. In Tampa Bay,
77.4% of children age 2 had received
their immunizations compared to the
state rate of 83.2% and a Healthy
People 2010 goal of 90%.
62%
of Tampa Bay
residents are
overweight
or obese
Behaviors Affect Health
Most Americans are able to
choose whether to smoke,
overeat, be active, binge
on alcohol, prevent disease
through immunizations or
detect diseases early through
screening tests. Others,
unfortunately, have financial or
psychological limitations that
influence their ability to freely
choose healthy behaviors.
For those Tampa Bay residents
with access and choice, they
are generally making the same
choices as residents throughout
the country. Smoking rates
Good Access to Care
Availability of health care services
is generally good as the Tampa Bay
region supports 50 acute care hospitals
and physicians in all specialties. The
region, as a whole, is not suffering
from a physician shortage although
some counties have fewer primary care
providers than the average.
The strength of a community’s
outpatient care can be evaluated,
to a certain extent, by examining
the Agency for Healthcare Research
and Quality (AHRQ) Prevention
Quality Indicators or PQIs. The
PQIs are used in conjunction with
hospital inpatient discharge data to
identify quality of care for “ambulatory
care-sensitive conditions.”9 Where
the PQIs are low, the residents have
access to primary care, chronic
conditions like diabetes are managed
using evidence-based guidelines, and
care is coordinated. Consequently,
hospital admission rates for these
conditions are low.
7
Introduction (cont.)
The Tampa Bay community is having
some success assisting patients with
their management of diabetes, as
the PQIs for long-term complication
for diabetes and lower-extremity
amputation are below those for
the state and nation. The PQIs for
congestive heart failure and bacterial
pneumonia are also much lower
compared to state and national rates.
For the other commonly measured
PQIs, the regional numbers are
generally in line with state and national
figures. However, the pediatric urinary
tract infection admission rate, both
regionally and statewide, is more than
50% higher than the national rate.
average but residents generally have
access to healthy foods.
Access to care for those without health
insurance (private or public assistance)
is limited to free clinics, community
health centers and hospital emergency
departments. In 2009, 28% of Tampa
Bay’s residents ages 18-64 did not have
health insurance which greatly exceeds
the national rate of 22%.
Community Assessment Findings
The region’s not-for-profit hospitals,
which provide the bulk of the
charity care rendered to the un- and
underinsured, have been feeling
the effects of this large unfunded
population for decades. Changes are
looming with state legislation in addition
to the expanded coverage provisions
within the Patient Protection and
Affordable Care Act.
Where We Live Affects
How We Live
The natural and built environment
influence the health of a community.
As communities understand and
confront the impact of their growth and
development patterns on residents’
health, the land use planning process
offers a unique opportunity to bring
together diverse partners and
advance strategies to improve
community health.
Air pollution and unsafe drinking water
lead to respiratory and gastrointestinal
ailments. Fortunately, for Tampa Bay,
the air and water quality are good.
8
The region’s crime rate of 688.9
violent crimes per 100,000 residents
was much higher than the national
rate of 454.5 and even higher than
the state rate of 622.0. The presence
of community violence influences
where people live, work, shop, and
learn. Violence jeopardizes health and
safety by causing injuries, death, and
emotional trauma. We need to broaden
the understanding of the relationship
between violence, chronic disease,
and community vitality and highlight
strategies to address the intersection.
The community assessment
supplements the health indicator data
and builds awareness about the many
valuable programs and numerous
organizations working to improve
community health in the region. Of the
nearly 100 organizations identified, the
most prevalent programs include:
• weight loss with an emphasis on
nutrition, healthy eating, and exercise
Motor Vehicle and
Pedestrian Deaths
in Tampa Bay
far exceed
national average
Commuting and vehicle miles
travelled per day within the
Tampa Bay region is on par with
other locales, yet the transit
ridership is low. However,
deaths from motor vehicles in
the region were unnecessarily
high with 14.4 deaths per
100,000 in 2006 compared to
7.4 nationally and the Healthy
People 2010 target of 8.0.
The number of grocery stores
per capita in Tampa Bay is
slightly less than the national
• smoking cessation
• diabetes management
Significant programming is aimed at
children, some of which is the result
of federal and state legislation. School
districts are creating healthier menu
options, adjusting curriculum schedules
to incorporate 150 minutes of physical
education per week for K-5 students,
and requiring physical activity as a
component of after school programs.
There are also programs aimed at
teenagers and parents of teens to learn
the signs of depression or despondence
that lead to suicide. The region’s
suicide rate is 35% higher than the
national average.
While this report did not encompass
data subsets of gender, race and
ethnicity, health disparities amongst
different populations are clearly
prevalent. Many of the programs
identified in the region have developed
programming geared towards lowincome or minority populations. Other
trends identified in this report include:
Broad Public Outreach
The region has classes for nutrition,
cooking, exercise, smoking cessation,
diabetes management, stroke
prevention and prenatal care to
name a few. In addition to classroom
education, online education is now
mainstream and becoming more
personalized.
Word Cloud: ONE BAY: Healthy Communities
Below is a “Wordle,” a computer generated “word cloud,” from text
in the ONE BAY: Healthy Communities assessment report. The clouds
give greater prominence to words that appear more frequently in the
text. To create your own wordle, go to www.wordle.net.
Individual and Family Connections
Although educational classes can
reach a greater number of residents,
many organizations – from the health
departments and hospitals to the
YMCAs and employers – are actively
working to establish a relationship
between the resident and an
individual educator. They are
devoting more resources to
facilitate one-on-one interactions
and develop trusting relationships.
When appropriate, organizations are
increasingly including the entire family
in their educational and behavior
modification efforts.
Increased Employer Involvement
Employers are beginning to consider
health as part of their corporate
culture and 75% of employers
surveyed believe they have a
responsibility to foster improvement
in their employees’ health. Emphasis
on prevention, healthy lifestyles and
disease management has increased
as employers have seen their health
care costs consume more and more
of their budgets in the last decade.
Recent developments include onsite
physical fitness centers and the
nearly universal prohibition of
smoking on worksite property,
including hospital campuses.
9
Next Steps
The Tampa Bay region’s public and private sector leaders are committed to developing
a long-term vision for healthy communities which is crucial to achieving regional prosperity. A regional
effort focused on health opens doors for improved collaboration, synergizes resources and creates a powerful voice for
a healthier Tampa Bay.
Next Steps
With information available to us from a variety of sources, ONE BAY has taken the first
step to collect and summarize the region’s health. In the coming year, we will utilize
new tools and resources to keep this information updated, publicly available on the
web, and begin connecting the community’s resources and convening stakeholders
to further facilitate improvement. In partnership with Healthy Communities Institute
(www.healthycommunitiesinstitute.com), we will:
• Understand what is working and not working in the community
• Efficiently participate in Best Practice sharing of successful community programs around the nation
• Easily connect people to their local resources
• Expand collaboration among organizations and key stakeholders
• Engage the community as part of the solution to improve public health
• Gather key stakeholders from the departments of public health, hospitals, economic development, public
safety, transportation, education, and environmental services in order to drive multi-stakeholder collaboration
to improve local public health
• Educate local and state political leaders around the value of public health
The next phase of this initiative will be to embark on a community input
process. Together, we will prioritize the issues, set goals for the vision,
and engage stakeholders towards leveraging resources for collective and
targeted improvement.
If we want a healthier Tampa Bay by 2050, what are we going to do now
to get there? Please join us as we embark on this endeavor towards better
health and longer, healthier, happier lives.
10
About the
Tampa Bay Region
Geography
The Tampa Bay region located in
west-central Florida, consists of three
contiguous metropolitan areas – TampaSt. Petersburg-Clearwater, BradentonSarasota-Venice and Lakeland-Winter
Haven and the micropolitan area of
Homosassa Springs.
The eight counties making up a
6,515-square-mile area include Citrus,
Hernando, Hillsborough, Manatee,
Pasco, Pinellas, Polk and Sarasota.
Population
The Tampa Bay region’s population is
projected to increase from 4.1 million in
2009, to just below 4.5 million in 2014,
which translates to nearly 400,000
new residents.
Tampa Bay’s expanding population
has grown more than 16% in the past
eight years and is projected to grow an
additional 10% by 2014.
Regional Assets
While the recent economic recession
has impacted the region, since 2001
Tampa Bay has seen both its labor force
and employment grow. Between 2001
and 2009, the region has generated a
net increase of 17,500 new jobs and
added 100,000 workers to the labor force.
Tampa Bay is home to the headquarters
of more than 15 billion-dollar companies,
eight of which are in the Fortune 1000.
Opportunities for post-secondary
education are numerous and
widespread throughout the region.
The region has 79 universities, colleges,
community colleges, technical and
trade schools and seminaries.
The University of South Florida (USF) is
the largest university in the region and
is the third largest in the Southeast,
serving more than 47,000 students
across four campuses located in
Tampa, St. Petersburg, SarasotaManatee and Lakeland.
USF has a $1.8 billion annual budget
and an annual economic impact of
$32.2 billion. USF is one of the nation’s
top 63 public research universities and
was awarded $394.1 million in research
contracts and grants in FY 2009/2010.
The communities of Tampa Bay enjoy
an average annual temperature of 73
degrees and an annual average coastal
water temperature of 75 degrees. The
beaches and climate provide yearround swimming, sailing, water-skiing,
jet skiing, windsurfing, parasailing,
diving and shelling.
It’s no secret anymore that along
with our sunshine, our sciences and
services have become a way of life
in our region. Our science clusters
include bioengineering, cancer
research, neuroscience, and marine.
Our service clusters include corporate
shared services, financial, critical
information processing and professional
services. Notably, the region continues
to develop the requisite talent and
supply chain for successful growth.
11
Economy/Demographics
The average age of the U.S. population is increasing as the Baby Boomers move up the
age spectrum, while at the same time, the Hispanic population is growing rapidly. These population
shifts are likely the two most influential demographic trends for the next thirty years. According to the
Brookings Institution’s new report, “State of Metropolitan America,” our nation faces “new realities” that are redefining
who we are, where and with whom we live, and how we provide for our own welfare.10 These changing demographics will
have an impact on how we grow and provide for ourselves in the future including how we tailor our health programs and
community infrastructure to help all populations prosper.
Population
Age
Florida has long been known as the
retiree state and the Tampa Bay
region is no exception. Estimates for
2009 indicate that the percentage
of Tampa Bay’s population 65 years
and over is nearly 20% while the
national average is nearly 13%.11 Our
region’s experience with its senior
population has generated some of
the most comprehensive “Aging in
Place” strategies in the country. This
population accesses the health care
system more frequently than other
age groups and has created greater
demand for health care services and
end of life care.12
Tampa Bay residents under 18 years
old comprise 21% of our population
compared to 25% nationally. A little over
20% of our population are in the 18-34
age bracket, an important demographic
among employers and retailers.13
12
Spotlight:
SCOPE:
Institute for
the Ages
SCOPE (Sarasota
County Openly Plans for
Excellence) has been
working to create the
Institute for the Ages.
With nearly 30% of the
population age 65 or
older, Sarasota County is
uniquely poised to be at
the leading edge of creative
thinking, policy changes
and the emergence of new
products and services that
a community can draw
upon in response to an
aging population.
www.scopexcel.org
Race and Ethnicity
About 80% of the Tampa Bay region
is white and about 11% are African
American. The percentage of residents
of Hispanic or Latino origin is increasing
nationally. In 1970, those of Hispanic
heritage comprised less than 5% of the
U.S. population. In 2050, that number is
projected to be over 30%.14
The percentage of Tampa Bay residents
of Hispanic origin has increased from
9.4% of the population in 2000 to over
14% in 2009.
Economy
Median Household Income
Median household income in Tampa
Bay dropped 1% from 2007 to 2008,
and has consistently lagged behind
state and national figures. Hillsborough
County leads the region with median
household income of $49,762 but is
below the $52,209 U.S. average.
Per Capita Personal Income
Per capita personal income is the
total of all income, including wages,
proprietor income and transfer
payments, such as Social Security,
coming into a region divided by the
region’s population.15
Per capita personal income in Tampa
Bay has increased 15% since 2004,
yet it still trails state and national
figures. Sarasota County leads the
region with a per capita personal
income of $55,856.
Unemployment
At the midpoint of the previous
decade, when touted as the champion
job-generating region, Tampa Bay
enjoyed an unemployment rate of
4.5%, lower than the state and
nation which recorded rates of 4.7%
and 5.5% respectively. At the close
of that decade however, Tampa
Bay bore the brunt of the near
shut-down in the housing market
cluster (construction, retail sales,
mortgage transaction processing),
and regional unemployment rate of
11.2% soared beyond the rates
of the state and nation, 10.5% and
9.3% respectively.
15%
growth in
personal income
between 2004-2008
in Tampa Bay
2009 regional
unemployment
rate was
11.2%
In 2008, the percentage of families
living in the Tampa Bay region with
incomes below the poverty rate stood
at its highest rate in the last five years
at 12.9%, yet below the state (13.3%)
and national (13.2%) figures.
High School Graduation Rates
For the 2008-2009 school year
in Tampa Bay, the percentage of
students who graduated within four
years of their first enrollment in 9th
grade was 78.5%. In the last five
years, regional and state graduation
rates have gradually increased. It
is difficult to compare to national
averages as many states calculate
graduation rates differently. The
U.S. Department of Education has
mandated that states implement a
“uniform, comparable graduation
rate” by the 2010-2011 school year.16
Individuals who do not finish high
school may lack the basic skills
required to function in an increasingly
complicated job market and society.
College Graduates
Attainment of a higher level of
education is associated with higher
income, better working conditions,
and more opportunities for promotion.
Specifically, those who have a
Bachelor’s degree average almost
twice the earnings of those with only
a high school education.17
Families Living Below
Poverty Level
Federal poverty thresholds are set
every year by the Census Bureau and
vary by size of family and ages of
family members. A high poverty rate
is both a cause and a consequence
of poor economic conditions.
A high poverty rate indicates that
local employment opportunities are
not sufficient to provide for the
local community.
Education
78.5%
students graduate
high school within
four years
in Tampa Bay
1/5
of Tampa Bay
residents
25 years and older
have a Bachelor’s
degree
According to the Brookings
Institution, more than one-third of
U.S. adults had a post-secondary
degree in 2008, up from one-quarter
in 1990.18 But younger adults,
especially in large metro areas,
are not registering the same high
levels of degree attainment as
their predecessors.
In Tampa Bay, 21.4% of the region’s
population age 25 and above has
a Bachelor’s degree. Among the
counties, there is great variability in
the percentage of residents who
have completed a Bachelor’s degree
or above, from a low of 13% to a
high of 26%.
Some communities have identified
an education gap and developed
training programs to meet the needs
of both its residents and employers.
(CareerEdge pg. 35)
13
Health Outcomes
Health outcome indicators reveal how medical conditions impact a community and are
useful in assessing community health when compared to benchmarks or outcomes in other regions.
There are numerous health outcome
indicators, yet there is not a uniformly
accepted data set. Indicator selection
may be influenced by areas of perceived
concern, anecdotal evidence or an
attempt by a community to determine
the general health of the population.
There are various ways to track health
status and utilization of each depends
on the specific information sought. The
mortality rate depicts how many people
per population die from the disease or
condition in a given year. Prevalence is
how many people at any one time have
a disease and incidence is the number
of new cases of a disease. Most of our
health status indicators are reported as
age-adjusted mortality rates but where
that does not apply, it is noted.
The most commonly accepted health
outcome indicators include prevalence
of chronic disease. In the U.S., 70%
of deaths each year are related to
chronic disease such as diabetes,
cardiovascular and respiratory diseases
and cancer.19 Other health status
measures, although not among the
primary causes of death in the U.S.,
often lead to chronic disease and are
14
70%
of American deaths
result from chronic
disease
also indicative of the health of
the community. As is the case
nationwide, chronic disease is
the leading cause of death in
the Tampa Bay region.
Chronic Disease Indicators
The number of people dying
from chronic disease in
the last decade has fallen
at the regional, state and
national levels while the
number of people living
with chronic disease has
increased. Chronic disease
is widespread and impacts
everyone, either directly or
indirectly. A review of the
data confirms that chronic
disease is a primary cause of
our overall decline in health
status. The National Center
for Chronic Disease Prevention
and Health Promotion (CDC) noted
in its 2009 report, The Power of
Prevention Chronic disease…the
public health challenge of the 21st
century, that:
• In 2005, 133 million Americans –
almost one out of every two adults
had at least one chronic illness
Approximately a quarter of those
with chronic conditions have
one or more limitations on their
daily activity
•
•
Health disparities in chronic
disease incidence and mortality
are widespread among members
of racial and ethnic minority
populations
•
Mental illnesses and chronic
diseases are closely related
In addition to the vast number of
Americans suffering from a chronic
disease, the cost to society for
treating these conditions is enormous
and continues to grow. In 2009,
the direct medical expenditures for
cardiovascular disease and stroke
alone reached $313.8 billion.20
•
Cardiovascular Disease
Cardiovascular disease kills more
Americans each year than any other
disease. Cardiovascular disease
refers to a variety of heart and blood
vessel diseases, including coronary
heart disease, hypertension and
stroke. Risk factors include high
cholesterol, high blood pressure,
tobacco use, physical inactivity,
diabetes, excess weight and obesity.
This indicator is measured by the
death rate per 100,000 people due to
coronary heart disease, one type of
cardiovascular disease. The Healthy
People 2010 target was 162 deaths
per 100,000 people. The U.S. figure
in 2006 was 144.3 deaths for every
100,000 people, 138.5 cardiovascular
disease deaths per 100,000 people in
Florida, and 147.3 per 100,000 people
in Tampa Bay.
Stroke ranks
Coronary Heart Disease
Stroke
Deaths per 100,000 (age-adjusted)
180
170
160
150
140
130
120
110
100
90
80
70
60
50
40
30
20
10
0
180.0
177.3
180.7
162
Healthy
People
2010
144.3
147.5
138.5
2002
2006
U.S. Florida Tampa
Bay
180
170
160
150
140
130
120
110
100
90
80
70
60
50
40
30
20
10
0
2002
2006
50
Healthy
People
2010
56.2
43.6 45.5
35.3
42.7
34.6
U.S. Florida Tampa
Bay
3rd
among the leading
causes of death
and disability in the U.S.
Stroke
Each year, approximately 795,000
people in the U.S. will suffer a new
or recurrent stroke. Although people
of all ages may have strokes, the risk
more than doubles with each decade
of life after age 55.21
This indicator is the death rate per
100,000 population due to stroke.
The Healthy People 2010 national
health target was to reduce the stroke
death rate to 50 deaths per 100,000
population. In 2006, the U.S. rate was
43.6 deaths per 100,000 people, a
reduction from 56.2 in 2002. Florida’s
stroke mortality rate of 35.3 was also
lower than its 2002 rate of 45.5. The
stroke mortality rate in Tampa Bay
declined from 42.7 deaths per 100,000
in 2002, to 34.6 deaths in 2006, lower
than both the U.S. and Florida rates
for the same year.
Spotlight: American Heart
Association: Go Red For Women
Cardiovascular disease claims
the lives of nearly 500,000
American women each year.
To dispel the myths and raise
awareness of heart disease as
the number one killer of women,
the American Heart Association
created Go Red For Women, a
passionate, emotional, social
initiative designed to empower
women to take charge of their
heart health. It challenges them
to know their risk for heart disease and take action to reduce their
personal risk. It also gives them the tools they need to lead a hearthealthy life.
In a 2008 survey, Lakeland/Polk County was the second LEAST
heart-friendly city of its size in the nation. The AHA of Tampa Bay is
determined to improve those numbers by changing behavior. Since
July 2009, they have registered 3,600 women in their Go Red for
Women campaign and documented that 86% have made at least
one change in behavior since signing on.
www.goredforwomen.org
15
Health Outcomes (cont.)
Cancer
Cancer Deaths
Nationally, death rates from all
cancers and from the four leading
causes of cancer deaths (lung,
colorectal, female breast, and
prostate) declined.
This indicator measures the death
rate per 100,000 due to cancer. While
less than the U.S. rate, 180.7 in 2006,
and trending downward, the Tampa
Bay mortality rate of 177.0 was higher
than the state of Florida rate of 171.9.
Lung Cancer
More people die from lung cancer
than any other type of cancer. In
2002, lung cancer accounted for more
deaths than breast cancer, prostate
cancer and colon cancer combined.
health target was to reduce the lung
cancer death rate to 43.3 deaths per
100,000 population. For the last year
data is available, in 2006, the national
rate was 51.5. Florida’s lung cancer
mortality rate was 51.2 and Tampa
Bay’s rate was 55.7 per 100,000
population.
Breast Cancer
Breast cancer is the most common
type of cancer among women in the
U.S. other than skin cancer. Based on
rates from 2005-2007, one in eight
female babies born today will be
diagnosed with breast cancer at some
time during their lifetime.22
This indicator shows the death rate
per 100,000 females due to breast
cancer. The Healthy People 2010
national health target was to reduce
the breast cancer death rate to 22.3
deaths per 100,000 females. By 2006,
the nation, the state and Tampa Bay
had all met the Healthy People 2010
goal with 21.5 deaths per 100,000
females in the U.S. and Florida and
21.6 in Tampa Bay.
Lung Cancer
2002
2006
60
55.1
54.9
51.5
51.2
50
59.0
55.7
43.3
40 Healthy
People
2010
30
20
Asthma is a condition where a
person’s air passages become
inflamed and the narrowing of the
respiratory passages makes it difficult
to breathe. Asthma is often brought
on by exposure to inhaled allergens
(like dust, pollen, cigarette smoke,
pollution and animal dander) or by
exertion and stress. There is no cure
for asthma but, for most people, the
symptoms can be managed through
prevention strategies including
minimizing exposure to allergens
and other triggers, and a combination
of quick-relief and long-term
controller medications.
In Tampa Bay in 2007, 7.6% of adults
were told by a health care provider
that they had asthma compared to
8.2% in the U.S. and 6.2% in Florida.
10
0
U.S. Florida Tampa
Bay
Cancer is the
2nd leading
cause of death in
the U.S.
60
2002
2006
50
40
30
22.3
23.7
21.5
23.7
21.5
24.5
Spotlight: Tampa
Bay Community
Cancer Network
The Tampa Bay Community
Cancer Network is a collaborative
network of academic and
community-based organizations
and is one of 25 Community
Networks Programs across the
country funded by the National
Cancer Institute’s Center to
Reduce Cancer Health Disparities.
Breast Cancer
21.6
20 Healthy
People
2010
10
The network is made of local
community-based health centers,
nonprofit organizations, faithbased groups, adult education
and literacy groups, and the
Moffitt Cancer Center, as an
NCI designated Cancer Center.
Together, the goal is to create
and implement sustainable and
effective community-based
interventions to impact cancer
disparities in the Tampa Bay area.
www.tbccn.org
0
16
Asthma Prevalence
U.S. Florida Tampa
Bay
Diabetes Prevalence
In 2007, the American Diabetes
Association reported that 17.9 million
Americans have been diagnosed
with diabetes, 5.7 million Americans
have diabetes but have not yet been
diagnosed, and 57 million Americans
are pre-diabetic, meaning their
blood glucose levels are higher than
normal and they are at increased
risk for developing type 2 diabetes.23
Diabetes disproportionately affects
minority populations and the elderly.
Its incidence is likely to increase as
minority populations grow and the
U.S. population becomes older.
This indicator shows the age-adjusted
percentage of adults that have ever
been diagnosed with diabetes. Even
while adjusting for age, the Tampa
Bay and Florida percentage, 8.0% and
7.9% respectively, was significantly
higher than the national rate of 5.7%.
Diabetes Prevalence
Pneumonia/Influenza
2007 - % of adults ≥ 20 yrs old
U.S. 5.7
5.7
U.S.
FL
7.0
Tampa Bay
8.0
Citrus
8.4
Hernando
9
Hillsborough
8.4
Manatee
7.3
Pasco
8.4
Pinellas
million Americans are
pre-diabetic
Non-chronic Disease Indicators
Pneumonia/Influenza
In 2006, influenza and pneumonia
ranked eighth among the leading
causes of death in the United States.
The two diseases are traditionally
reported together, as pneumonia is
frequently a complication of influenza.
Influenza is a contagious disease
caused by a virus. Pneumonia is a
serious infection of the lungs that
develops when the immune system
is weakened. Persons most at risk
include the elderly, the very young,
and the immunocompromised.
The death rate has decreased
significantly since 2002 in the U.S.,
Florida and Tampa Bay. In 2006,
Tampa Bay had 8.8 deaths per
100,000, well under the national
average of 17.8.
10
7.2
Polk
U.S.
8.7
Sarasota
Florida
Tampa Bay
6.6
0
0
57
20
2
4
6
8
10
2002 2003 2004 2005 2006
Spotlight: FAB Families
Fit, Active, Black (FAB) Families
is funded by the Department
of Health and Human Services
Community Partnership to
Eliminate Health Disparities. FAB
Families is a coalition of seven
community partners that address
disparities with diabetes and
childhood/adolescent overweight/obesity among African Americans
in St. Petersburg.
One unique program, administered by the Midtown Health Council,
is the Under the Tree Project. According to Gwendolyn Reese, part
of the African-American culture is to “meet under the tree.” On the
south side of St. Petersburg, a number of African-American men
and women meet under trees in the area. In an effort to reach out
to these individuals, some of who do not seek routine medical care,
a health care professional regularly goes to these trees and checks
their blood pressure, blood sugar and cholesterol. The health care
volunteer (typically a nurse or pharmacist) seeing the individuals often
leaves behind decks of cards and leaflet information containing health
information about diabetes, stroke and other chronic illnesses. The
health care team also visits other areas throughout the Mid-Town
community such as restaurants, beauty and barber shops.
www.stpetefabfamilies.com
17
Behavioral Health
Spotlight:
The National Alliance for Mental Illness
(NAMI) recently released its 2009 report
card of states and Florida received
an overall “D” grade. According
to the report, Floridians living with
mental illness face uphill battles to
get appropriate services due to a lack
of funding and a shortage of mental
health providers. The report’s authors
noted concern with Florida’s insufficient
efforts to address cultural competence
and the inadequate supply of mental
health professionals.24
American
Foundation for
Suicide Prevention
Suicide Deaths
Suicide is a major, preventable public
health problem. In 2006, suicide was
the 11th leading cause of death in the
United States.25
death rate per 100,000 people due
to suicide. In Tampa Bay, 14.9
deaths occur per 100,000 people
compared to 12.6 in Florida and 10.9
in the U.S. The Healthy People 2010
national health target was to reduce
the suicide rate to 4.8 deaths per
100,000 population.
Between 2002 and 2006, the suicide
rate increased in Tampa Bay while
decreasing both nationally and
in Florida. The rate of suicide in
Tampa Bay in 2006 was more than
three times greater than the Healthy
People 2010 target.
Although there are a number of
inpatient and outpatient settings
in the region for behavioral health
issues such as depression, cognitive
disorders, suicidal tendencies and
substance abuse and addiction,
the region’s high rate of suicide is
alarming and deserves attention.
D
Grade given to
Florida for care
of adults with
mental illness
2002
2006
14.7 14.9
13.3
11.0
12.6
10.8
10
4.8
Healthy
People
2010
0
18
Healthy
People
2010
www.afsp.org
Spotlight:
Operation PAR
Suicide Deaths
20
The Sarasota Chapter of the
American Foundation for
Suicide Prevention (AFSP)
serves the following counties in
Southwest Florida: Charlotte,
Collier, DeSoto, Glades, Hendry,
Hillsborough, Lee, Manatee,
Pasco, Pinellas and Sarasota.
AFSP is the leading national notfor-profit organization exclusively
dedicated to understanding
and preventing suicide through
research, education and
advocacy, and to reaching out
to people with mental disorders
and those impacted by suicide.
Combining local and national
efforts, this chapter promotes
educating the community toward
suicide prevention, intervention
and postvention.
U.S. Florida Tampa
Bay
Operation PAR cares for families
and individuals impacted by
substance abuse and mental
illness and serves Pinellas, Pasco
and Manatee counties. More than
13,000 individuals a year receive
intervention and treatment
services and another 40,000
participants are impacted
annually by the agency’s messages
of substance abuse awareness,
education, prevention, research
and information and referral.
Despite this volume, the number
of facilities/programs does not
meet the need and many go
without treatment.
www.operationpar.org
Maternal, Fetal and Infant Health
Infant deaths
The leading causes of death among
infants are birth defects, pre-term
delivery, low birth weight, Sudden Infant
Death Syndrome (SIDS) and maternal
complications during pregnancy.
This indicator measures the mortality
rate in deaths per 1,000 live births for
infants within their first year of life.
health target was to reduce the infant
mortality rate to 4.5 deaths per 1,000
live births. Tampa Bay and Florida
had higher death rates with 7.5 and
7.2 deaths respectively.
8.5%
of Tampa Bay
newborns weighed less
than 5 lbs. 8 oz.
Low Birth Weight
Low birth weight is most often
associated with a baby being born too
soon (prior to 37 weeks gestation) and/
or being too small for gestational age.
Babies born with a low birth weight
are more likely than babies of normal
weight to have underdeveloped
lungs and other organs that require
specialized medical care. A common
cause of low birth weight is poor
nutritional status of mother prior to
and during pregnancy.26
This indicator is the percentage of
births in which the newborn weighed
less than 2,500 grams (5 lbs., 8 oz.).
health target was to reduce the
proportion of infants born with low
birth weight to 5.0%. Between 2004
and 2008, Tampa Bay, Florida and the
U.S. consistently ranged between 8.0
and 9.0%.
Births to Female Teens <15 yrs old
Babies born to this population are
more likely to be born prematurely, be
of low birth weight and more likely
to die in their first year of life than babies
of women in their twenties and thirties.27
This indicator shows the
number of births per 1,000 to
female teens who were less
than 15 years old when they
delivered a baby. The state of
Florida registered 0.6 births
per 1,000 teen mothers and
Tampa Bay at 0.7, though this
rate varied widely within our
region from 0-0.2 in Citrus,
Hernando and Pasco; 0.5 in
Pinellas and Sarasota; 0.8 in
Hillsborough and Polk; and
1.3 in Manatee County.
Sexually Transmitted
Diseases
Despite the burdens,
costs, complications, and
preventable nature of STDs,
they remain a significant
public health problem.
STDs can cause harmful,
often irreversible, and costly
clinical complications such as
reproductive health problems,
fetal and perinatal health
problems, and cancer.
This indicator is the reported
number of cases for three
sexually transmitted diseases,
chlamydia, gonorrhea, syphilis
(STDs). Florida and Tampa Bay
are slightly lower than the U.S.
at 514 cases per 100,000, yet
the growth rate of the disease
is greater in Tampa Bay than
the national average. There
is also a significant variation
between counties from a low
of 207 cases in Pasco County
to a high of 717 cases in
Hillsborough County.
Spotlight: Healthy
Start Coalition
Infant Mortality
Campaign
Florida law requires
that every pregnant
woman and
every newborn
is screened by a
health professional
to identify those at risk
of poor birth, health and
developmental outcomes. There
are 30 Healthy Start Coalitions
throughout the state. Each coalition
receives funding from the state.
Services can include prenatal
counseling, perinatal counseling,
education on birthing and
breastfeeding classes, visiting home
nurses, referrals for the Women,
Infant and Children program,
Medicaid applications, mental health
services, and housing needs.
The Pinellas County Healthy Start
Coalition, as part of a statewide
campaign, has studied fetal/infant
mortality and determined that the
main cause of death for Pinellas
County babies is prematurity
(babies born before 37 weeks).
Prematurity has been linked to
conditions related to the mother’s
health such as:
• Infections
• Chronic Disease
• Obesity
• Smoking
Spotlight: Text4baby
The Florida Department of Health and the National
Healthy Mothers and Healthy Babies Coalition will
soon launch “Text4baby”, an integrated mobile phone
technology with timely health information for pregnant
women and new moms. Women who sign up for the
service will receive free text messages each week,
timed to their due date or baby’s date of birth. The
messages focus on a variety of topics critical to maternal and child
health, including birth defects prevention, immunization, nutrition,
seasonal flu, mental health, oral health and safe sleep. Text4baby
messages also connect women to prenatal and infant care.
19
An individual’s health-related behavior can impact the likelihood of developing
chronic disease or suffering from other poor health outcomes. Although genetic composition plays a part
in the prevalence of some of these diseases, for the vast majority of cases behavior modification would greatly reduce the
mortality rate for these conditions. Poor nutrition and diet, lack of physical activity, smoking, substance abuse, drug use and
unsafe sex are all health-related behaviors that can be modified provided there is awareness, opportunity and motivation.
In the last decade, public health
practitioners have been moderately
successful in increasing awareness
of the consequences of unhealthy
behaviors.
For example, diets high in sodium
can cause high blood pressure28 and
high blood pressure increases the
likelihood of having a stroke by four
to six times.29
Likewise, cigarette smokers are two
to four times more likely to develop
cardiovascular heart disease than
nonsmokers.30 Physical inactivity is
responsible for 12.2% of the global
burden of heart attacks after accounting
for other cardiovascular risk factors.31
Someone attempting to reduce his or
her risk of heart disease should stop
smoking and exercise regularly.
Despite increased sensitivities to the
impact of risky or unhealthy habits,
there has been limited success driving
lasting behavior change. For the last
20 years, people have known that
eating in excess and limited physical
activity results in weight gain. Yet men
20
Cigarette
smokers are
2-4
times
more likely
to develop
cardiovascular
heart disease than
nonsmokers
Nearly
40%
of Tampa Bay
residents do not
exercise 150
minutes per week
in Florida have gained an average of
18.2 pounds, and women 10.6 pounds
in this time period. If this rate continues,
by 2018, the rate of obesity in Florida is
forecasted to be 44%.
Although behavior change is an
individual effort, education about the
need for the change can be a systemic
or institutional driver of that change.
Communities that come together to
support individual behavior modification
will likely be rewarded with improved
population health.
A Heavier America
Since 1960, the percentage of
overweight Americans (age 20-74) has
remained relatively steady at approximately one third of the population.
However, the percent of Americans who
are obese has increased from 13% to
34% and the percent who are extremely
obese has increased from 1% to 6%
of the population.32 In 2007, almost
63% of Americans, 62% of Floridians,
and 62% of Tampa Bay residents were
overweight or obese.
150 minutes of physical education per
Overweight/Obesity
The percentage of overweight and
obese adults is an indicator of the
overall health and lifestyle of a
community. Obesity increases the
risk of many diseases and health
conditions including heart disease,
type 2 diabetes, cancer, hypertension,
stroke, liver and gallbladder
disease, respiratory problems and
osteoarthritis. The Healthy People
2010 national health target was to
reduce the proportion of adults who
are obese to 15%.
In Tampa Bay in 2007, 36.8%
of residents were overweight
with a Body Mass Index (BMI)
between 20 and 30. A BMI >=30
is considered obese while a BMI
>=40 is categorized as extremely
obese. Between 2002 and 2007, the
percentage of adults who were obese
in Tampa Bay increased from 21.8%
to 25.4%.
Childhood Obesity
Over the past three decades, obesity
rates have doubled among children
age 2-5 and tripled among 6-11
year-olds.33 Childhood obesity rates
in Tampa Bay have declined slightly
since 2006 when the percentage of
first, third and sixth graders whose
BMI was at or above the 95th
percentile was 20.6%. In 2008, the
percentage had dropped to 18.1,
marginally better than the state
percentage of 18.5.
Physical Activity
In 2008, the U.S. Department of
Health and Human Services issued
the first-ever Physical Activity
Guidelines which offer recommended
amounts of exercise for people in
different age groups.
Adults
• 2.5 hours/wk of moderate-intensity
exercise or
• 1.25 hours/wk of vigorous
physical activity
week required for Florida K-5 students.
Percentage of Adults who
are Obese (BMI >30)
2002
2007
30
26.3
24.1
25
21.9
20
20.4
• 1 hour/day of exercise
• 3 hours/wk of vigorous intensity
25.4
21.8
20
15
Healthy
People
10 2010
15
5
0
Children/Adolescents
U.S. Florida Tampa
Bay
• 3 hours/wk of muscle-strengthening
activity
• 3 hours/wk of vigorous activity
In that same year, 35% of
American adults did not meet these
recommendations.34 In Florida and
in Tampa Bay in 2007, 39.4% of the
population did not regularly engage in
moderate or vigorous physical activity.
Most adults have numerous options to
participate in physical activity and learn
about a healthy diet. County health
departments offer resources for weight
loss and the Healthy Start programs
educate mothers about the importance
of their own health and nutrition in
addition to that of their infant.
Spotlight: Kidz Bite Back
This campaign educates students about “Big Fat
Industries” and “Couch Potato Companies” that
promote excessive consumption and sedentary
lifestyles. The students spread the word to other
students and promote improved nutrition and
increased physical activity. The campaign, developed by 180-Change,
a Tampa Bay not-for-profit focused on youth health and safety, is
active in selected Hillsborough and Pinellas County schools.
www.kidzbiteback.com
Spotlight: The “Y” – YMCA
The Tampa Bay region is home to over 40 YMCA
branches. YMCA has exercise classes and sports
leagues for children and is actively engaging entire
families to exercise together. For example, the
Sarasota YMCA developed Family TIME (Together
It’s More Exciting), an initiative which emphasizes
being more active, a healthier diet and spending time together. As
part of this family focus, the Y recently launched Thank Goodness It’s
Family Friday (TGIFF), where group exercise classes such as yoga,
Zumba and kick-boxing have been designed for parents and children
and are shortened to 40 minutes. The region’s YMCA branches also
sponsor Healthy Kids Day in the Spring, a day of physical activities for
kids and information for parents on family health. www.ymca.net
21
Health Behaviors (cont.)
Tobacco and Alcohol Use
Smoking
Tobacco is the agent most directly
responsible for avoidable illness and
death in America today. Tobacco use
brings premature death to almost half
a million Americans each year, and it
contributes to profound disability and
pain in many others. Approximately
one-third of all tobacco users in this
country will die prematurely because
of their dependence on tobacco.
Areas with a high smoking prevalence
will also have greater exposure to
secondhand smoke for non-smokers,
which can cause or exacerbate
a wide range of adverse health
effects including cancer, respiratory
infections and asthma.
The percentage of adults who have
smoked more than 100 cigarettes in
their lifetime and who currently smoke
some days or everyday has declined
at the regional, state and national
level, but not sufficiently to meet the
Healthy People 2010 target of 12%.
In 2007 in Tampa Bay, 21.6% of the
population smoked compared to
19.3% in the state and 19.8% in the
U.S. For all three populations, there
was a decrease in the number of
smokers from 2002 but Tampa Bay’s
decline was the most modest.
Immunizations – Prevention
% of Adult Smokers
25
Childhood Immunizations
2002
2007
24.0
23.2
22.2
19.9
20
21.6
19.3
Immunization rates for 2-year-olds
have remained steady in our region
for the last five years at 77.4% and
were comparable to national figures
but trailed the state rate of 83.2%.
Both lagged the Healthy People 2010
goal of 90%.
15
12
Healthy
10 People
2010
5
0
Influenza Immunizations
U.S. Florida Tampa
Bay
1/3
of all
tobacco users
will die
prematurely
Consumption of Alcohol
Male binge drinking is defined as
five or more drinks on one occasion,
and female binge drinking is four or
more drinks on one occasion. Among
adults who engage in heavy or binge
drinking, the Tampa Bay region is
equivalent to the national average
of 15.8% (2007) and represents a
marginal decrease from 2002. This
indicator measures the percentage of
adults who reported binge drinking
at least once during the 30 days
prior to the survey. The prevalence of
binge drinking among men is twice
that of women. In addition, it was
found that binge drinkers are 14 times
more likely to report alcohol-impaired
driving than non-binge drinkers.35
22
Immunizations protect children
from contracting and spreading
communicable diseases such as
measles, mumps, and whooping
cough. These diseases can result
in extended school absences,
hospitalizations, and death.
Influenza is a contagious disease
caused by viruses. It can lead to
pneumonia and can be dangerous
for people with heart or breathing
conditions. Infection with influenza
can cause high fever, diarrhea and
seizures in children. The seasonal
influenza vaccine, recommended
annually by the CDC, can prevent
serious illness and death.
This indicator measures the
percentage of adults over 65 who
have had a flu vaccine within the last
year. The immunization rate is going
up in the Tampa Bay region, state and
nation but at 64%, we trailed the
Healthy People 2010 objective of 90%.
Spotlight: Tobacco Free Florida
Unveiled in 2008 under the direction of the
Florida Department of Health, the Tobacco
Free Florida campaign seeks to decrease
the number of tobacco users in the state
of Florida through efforts aimed at both
preventing nonusers from starting to use tobacco and encouraging
current users to quit. These efforts are funded by money derived from
court settlements against major tobacco companies, and include
initiatives in the realm of advertising, public relations, interactive,
guerilla media, event media, sponsored promotions and more. It is
our hope that one day every Floridian might be free of the hazards of
tobacco and that we all may eventually live in the paradise that our
name implies - a truly Tobacco Free Florida.
www.tobaccofreeflorida.com
Pneumonia Immunizations
Pneumococcal pneumonia is a
serious condition characterized by
high fever, cough and shortness
of breath. It is the leading cause of
vaccine-preventable death and illness
in the United States. Pneumococcal
pneumonia kills about one out of
every 20 people who come down with
the disease. It is a contagious disease
and can be spread by respiratory
secretions from coughing or sneezing.
The pneumococcal vaccine is very
effective at preventing severe disease,
hospitalization and death.
This indicator measures the
percentage of adults over 65 who
have ever received the pneumonia
immunization. In the Tampa Bay
region, the rate was 65.8% which
slightly exceeded our rate for
influenza vaccines. This rate is
comparable to the state and national
rates but again trailed the Healthy
People 2010 benchmark of 90%.
Health Screenings
Breast Cancer Screening
Breast cancer is the second
leading cause of cancer death for
women36 and early detection through
mammograms has proven effective in
reducing the death rate.
In 2007, 65% of women age 40 and
over in Tampa Bay and in the state of
Florida have received a mammogram
in the past year. Although this
approaches the Healthy People 2010
target of 70%, this number has not
increased in the last five years.
Cervical Cancer Screening
The Pap test checks for changes in
the cells of the cervix that can be
early signs of cervical cancer. Cervical
cancer is a common cancer that has a
very high cure rate when caught early.
In 2003, the American College of
Obstetricians and Gynecologists
altered their recommendation for
Pap tests from every year to every
three years if no abnormal tests had
occurred. Women under 30 should
have a Pap test every two years. This
indicator measures women, age 18
% of Immunizations
2007
Healthy People
U.S.
Florida
Tampa Bay
100
90% Healthy People 2010
80
83.4
77.4
Colon Cancer Screening
76.1
72.0
67.3 63.0
65.8
64.6 64.1
60
40
20
0
and older, who have received a Pap
test in the last year. Both the region
and state values have decreased
between 2002 and 2007 which
may be a result of a change in the
guidelines. In Florida, the percentage
of women, in 2007, who had received
a Pap test in the last year was 64.8%.
Childhood Influenza Pneumonia
In 2007
63.1%
of Tampa Bay
women had
a Pap test
Colorectal cancer is second only to
lung cancer in the number of deaths
it causes annually in the U.S. If adults
age 50 or older had regular screening
tests, as many as 60% of deaths from
colorectal cancer could be prevented.
Sigmoidoscopy and colonoscopy
are both effective screening methods
for detecting colon cancer before
symptoms develop. If detected
early, treatment for colon cancer is
more successful.
The indicator is the percentage
of adults 50 years old and older
who received a sigmoidoscopy or
colonoscopy in the past five years.
health target was to increase the
proportion of adults aged 50 years
and older who received a colorectal
cancer screening exam to 50%.
Between 2002 and 2007, screening
rates increased in the Tampa Bay
region from 44.2% to 54.9% and in
the state from 44.6% to 53.7%.
Spotlight: National Breast & Cervical
Cancer Early Detection Program
The Centers for Disease
Control administers and
funds states for the National
Breast and Cervical Cancer
Early Detection Program
(NBCCEDP). The Florida program is available statewide through the
lead of 16 county health departments including four in Tampa Bay:
Hillsborough, Manatee, Pasco and Pinellas.
Females between 50 and 64 years of age, have household income
at or below 200% of the Federal Poverty Level, and are uninsured or
have no insurance that covers screenings are eligible. As of the end
of 2009, over 1,500 women screened through this program have been
diagnosed with breast cancer, over 50 with invasive cervical cancer
and 470 with pre-cancerous lesions or conditions.
23
Health Systems
Hospitals in the United States provide the setting for some of life’s most pivotal
events—the birth of a child, major surgery and treatment for otherwise fatal illnesses. These hospitals
house the most sophisticated medical technology in the world and provide state-of-the-art diagnostic and therapeutic
services. But access to these services comes with certain costs. In 2008, nearly 37% of personal health care expenditures
in the United States were for hospital care.37 Policymakers, employers, and consumers have made the quality of care in
U.S. hospitals a top priority and have voiced the need to assess, monitor, track and improve the quality of inpatient care.
The Agency for Healthcare Research
and Quality (AHRQ) is the lead Federal
agency charged with improving
the quality, safety, efficiency and
effectiveness of health care for all
Americans. As one of 12 agencies
within the Department of Health and
Human Services, AHRQ supports health
services research that will improve
the quality of health care and promote
evidence-based decision-making.
AHRQ has developed measures for
assessing health care quality.
Prevention Quality Indicators
Prevention Quality Indicators (PQIs)
are a set of measures that can be used
with hospital inpatient discharge data
to identify quality of care. Even though
these indicators are based on hospital
inpatient data, they provide insight into
the community health care system or
services outside the hospital setting.
These are conditions for which good
outpatient care can potentially prevent
the need for hospitalization or for
which early intervention can prevent
24
complications or more severe disease.
The PQIs represent hospital admission
rates for ambulatory care-sensitive
conditions. (Note that the national data
presented here is for 2007 while the
state and regional data is for 2009.)
37%
of personal
health care
expenditures
in the
United States
go toward
hospital care
Hypertension
Hypertension is the term used to
describe high blood pressure. Dietary
and lifestyle changes can improve
blood pressure control and decrease
the risk of complications, although
drug treatment may prove necessary
in patients for whom lifestyle changes
prove ineffective or insufficient.38
This indicator is the annual ageadjusted hospitalization rate due to
hypertension per 100,000 residents,
age 18 years and older. In Tampa
Bay, the hospitalization rate rose
from 55.3 in 2008 to 64.7 in 2009 per
100,000. Florida rates were much
higher at 74.1 and 84.7 in 2008 and
2009, respectively.
Congestive Heart Failure
Congestive heart failure is a condition
in which the heart can’t pump enough
blood to the body’s other organs.
This can result from coronary artery
disease, diabetes, past heart attack,
hypertension, heart infections,
diseases of the heart valves or
muscle, and congenital heart defects.
In heart failure, symptoms are usually
related to reduced blood flow and
accumulation of fluids in body tissues.
This indicator is the average annual
age-adjusted hospitalization rate
due to non-hypertensive congestive
heart failure, including rheumatic
heart failure, per 100,000 people age
18 and older. While nationally the
rate was 415.5 per 100,000, Florida
and Tampa Bay were substantially
lower at 333.2 and 274.3 respectively
in 2009.
Chronic Obstructive
Pulmonary Disease
Chronic obstructive pulmonary
disease, or COPD, refers to a group
of diseases that cause airflow
blockage and breathing-related
problems. According to the American
Lung Association, COPD includes
chronic bronchitis, emphysema and
bronchiectasis. COPD is often related
to tobacco use but can also be
caused by air pollutants in the home
and workplace, genetic factors and
respiratory infections.
age-adjusted hospitalization rate due
to COPD per 100,000 people age 18
and older. Nationally, the rate was
193 while Florida and Tampa Bay
rates were slightly higher at 214.4 and
207.9 respectively.
Uncontrolled Diabetes
Uncontrolled diabetes indicates that
the patient’s blood sugar level is
not kept within acceptable levels by
his or her current treatment routine.
Diabetes risk factors such as obesity
and physical inactivity have played a
major role in this dramatic increase.
to uncontrolled diabetes per 100,000
Diabetes Hospitalization
Rates
(per 100,000)
Uncontrolled Diabetes
Short-term Complications
Long-term Complications
Lower Extremity Amputations
125
123.8
116.2
106.2
100
75
59.9
55.7
54.8
50
33.6
31.0
25
0
21.1
U.S.
30.2
24.7
Florida
diabetes per 100,000 people ages
18 and older. Nationally, the rate per
100,000 was 59.9. In Florida, the rate
was 54.8 and in Tampa Bay, 55.7.
Diabetes Long-term Complication
Long-term complications of diabetes
may include heart disease, stroke,
blindness, amputations, kidney
disease and nerve damage. This
indicator was the average annual ageadjusted hospitalization rate due to
long-term complications of diabetes
per 100,000 people age 18 and older.
Nationally, the rate per 100,000 was
123.8. In Florida, the rate was 116.2
and in Tampa Bay, 106.2.
Lower-extremity Amputation in
Patients with Diabetes
26.6
Tampa Bay
Complications from
diabetes include:
heart disease
stroke
blindness
amputation
kidney disease
nerve damage
people ages 18 and older.
Nationally, the rate was 21.1.
In Florida the rate was 31.0
and in Tampa Bay, 24.7.
Diabetes Short-term
Complication
Short-term complications
of diabetes can include
hyper- or hypoglycemia,
diabetic ketoacidosis and
hyperosmolar nonketotic
coma. This indicator was the
average annual age-adjusted
hospitalization rate due to
short-term complications of
This indicator measures the average
annual age-adjusted hospitalization
rate for lower-extremity amputation
among patients with diabetes per
100,000, age 18 and older. Nationally,
the rate was 33.6. In Florida the rate
was 30.2 and in Tampa Bay, 26.6.
Diabetes is a major risk factor
for lower-extremity amputation,
which can be caused by infection,
neuropathy, and microvascular
disease. Proper and continued
treatment and glucose control may
reduce the incidence of lowerextremity amputation.
Bacterial Pneumonia
Pneumonia is an inflammation of
the lungs that’s usually caused by
infection with bacteria, viruses, fungi
or other organisms. Pneumonia is a
particular concern for older adults
and people with chronic illnesses or
impaired immune systems but it can
also strike young, healthy people.
Some forms of bacterial pneumonia
are treatable with antibiotics but
antibiotic-resistant strains are a
growing problem.
due to bacterial pneumonia per
100,000 people ages 18 and older.
In the U.S. approximately 374.8 per
100,000 people were hospitalized
compared to 234.1 in Florida and
205.2 in Tampa Bay.
25
Health Systems (cont.)
Asthma
Diabetes Short-term Complication
Asthma is a condition in which a
person’s air passages become
inflamed, and the narrowing of
the respiratory passages makes it
difficult to breathe. There is no cure
for asthma but, for most people,
the symptoms can be managed
through a combination of long-term
medication prevention strategies and
short-term quick relievers. In some
cases, however, asthma symptoms
are severe enough to warrant
hospitalization and can result in death.
The CDC reports that diabetes is
ranked as one of the leading chronic
illnesses for younger children and
teens.40 Over 186,000 youths 20
years of age and younger have
the disease.41
due to short-term complications of
diabetes per 100,000 children ages
6 years to 17 years. While the U.S.
average was 29.7, Tampa Bay rates
were 25.3 and Florida 24.8.
to asthma per 100,000 people ages 18
and older. Again, Florida and Tampa
Bay ranked higher than the national
rate of 117.9 with Florida in at 136.7
and Tampa Bay at 133.3 per 100,000.
Pediatric Asthma
Nearly five million asthma sufferers
are under age 18. Among children
ages 5 to 17, asthma is the leading
cause of school absences from a
chronic illness. It accounts for an
annual loss of more than 14 million
school days per year and more
hospitalizations than any other
childhood disease.
Urinary Tract Infection
Urinary tract infections (UTI) are a
serious health problem affecting
millions of people each year.
According to the National Kidney
and Urologic Diseases Information
Clearinghouse (NKUDIC), infections
of the urinary tract are the second
most common type of infection in the
body, accounting for about 8.3 million
doctor visits each year.
to urinary tract infections per 100,000
people age 18 and older. Tampa Bay
rates (182.1) were consistent with
Florida (185.3) and U.S. rates (185.4).
Perforated Appendix
Perforated appendix results from
delay in surgery, potentially reflecting
problems in access to ambulatory
care or misdiagnosis. Timely
diagnosis and treatment may reduce
the incidence of perforated appendix.
This indicator measures admissions
for perforated appendix per 1,000
adults age 18 and older. The U.S.
benchmark is approximately 280.2
while Tampa Bay admissions were
slightly lower at 273.1 and Florida
even lower at 253.6.
26
Diabetes is ranked
as one of the
leading chronic
illnesses for young
children and teens
Pediatric Quality
Indicators:
The Pediatric Quality Indicators
(PDIs) are a set of measures that
focus on children’s health care
quality using routinely collected
hospital discharge data as the
basis for indicator specification.
In 2000, children accounted
for 18% or 6.3 million of the
hospitalizations in the U.S. The
vast majority of these stays were
for newborn infants, with children
and adolescents (1 to 17 years
old) accounting for 1.8 million of
the hospital stays (5%).39
due to asthma per 100,000 children
ages 2-17 years. The U.S. rate
averages 134.8. From 2008 to 2009,
the rate in Florida rose from 120.3 to
137.9 and in Tampa Bay from 122.7
to 140.6.
Pediatric Urinary Tract Infection
Urinary tract infections (UTIs) occur
in about 3% of children every year.
The risk throughout childhood of
having a UTI is 8% for girls and 2%
for boys. Treatment is oral antibiotics
or, in extreme cases, intravenous
antibiotics.42
due to UTIs per 100,000 people
age 18 and older and in children
3 months to 17 years. While the
U.S. average was 41.7, Florida and
Tampa Bay ranked higher with 63.9
and 64.1, respectively, increasing
since 2008.
Health Access
Access refers to actual proximity of health care as well as the ability to afford it. In order for a
community to be healthy, the citizens need to be able to access high-quality care at all levels of the health care delivery
system. Our eight-county region has 50 acute care hospitals, two children’s hospitals and a world-renowned cancer
center. Given this depth of service capacity, residents generally do not have to travel unreasonable distances to access
quality health services.
Uninsured Population
The ranks of the uninsured keep
growing. Nationally, for those
between ages 18 and 64, 22.3%
were uninsured in 2009 and in the
state of Florida, nearly 30% were
uninsured.43 America’s Health
Rankings in 2009 placed Florida 48
out of 50 states because of the high
percentage of residents who lack
insurance coverage. In Tampa Bay
in 2008, 24.6% of the population
between ages 18-64 was uninsured
and it is estimated that 28% of Tampa
Bay residents were uninsured in
2009.44 For those residents who are
uninsured, their financial hardship
has been well documented by the
media and was one of the driving
forces behind passage of the Patient
Protection and Affordable Care Act.
For those in our region who are
uninsured or underinsured, the
region’s community health centers
provide primary care services to
these populations on a sliding fee
scale basis. Access to primary care
for those who are uninsured and
28%
of Tampa Bay
population between
ages 18-64 were
uninsured in 2009
60-80
primary care
physicians
per 100,000
recommended
ineligible for Medicaid or Medicare
varies from county to county with
each county making every effort to
serve this population despite enduring
budget reductions in recent years.
Hillsborough and Polk Counties offer
the most comprehensive services,
as their funding comes from ¼
and ½ cent sales tax surcharges,
respectively, yet they still are
challenged to meet the health care
needs of their residents.
Access to Primary Care Providers
The Department of Health and Human
Services’ Council on Graduate
Medical Education recommends
60 to 80 primary care physicians
per 100,000 people. As a region,
we slightly exceed this range but
individual counties vary widely.
Hillsborough, Pinellas and Sarasota
counties all had more than 90
primary care providers per 100,000
population in 2008 but Citrus, Pasco
and Polk counties were at or below
the minimum recommendation of 60.
Hernando and Manatee counties were
just above 60.
27
The air we breathe, the water we drink, crossing the street, driving
our car and the food we eat are all examples of how our built and natural environments can
influence our health, reduce risk factors and encourage people to make healthy choices that promote healthy lifestyles and
prevent disease and injury. Research shows a connection between our environment and our health, but we have a long way
to go to in understanding what links the two.
Natural Environment
Water Quality
Air Quality Index
34.3
The Environmental Protection Agency
(EPA) estimates that reducing air
pollution to levels required by the 1990
Clean Air Act Amendments will prevent
more than 1.7 million asthma attacks.45
0
Established by the EPA, the Air Quality
Index (AQI) is an index for reporting
daily air quality. AQI describes how
clean or polluted the air is and what
associated health effects may be of
concern. The EPA calculates the AQI
for five major air pollutants regulated
by the Clean Air Act.46
Measurements for air pollutants are
converted into AQI values using
standard formulas developed by the
EPA. AQI is measured on the spectrum
0-500 with less than 50 being good
and over three hundred as hazardous.47
The higher the AQI value, the greater
the level of air pollution and the greater
the health concern. In Tampa Bay,
the median AQI value of 34.3 in 2008
represents good air quality with little
potential to affect public health.
28
500
34.3
median
AQI value in
Tampa Bay
99.6%
compliance of
Tampa Bay
community water
systems
These measures are based on
violations reported by states to the
EPA Safe Drinking Water Information
System. All federal agencies must set
performance standards for community
water systems, which are public water
systems that supply water to the same
population year-round.
By 2011, the EPA’s target is for
community water systems to
provide drinking water that meets
all applicable health-based drinking
water standards 96% of the time.
The measure tracks the duration of a
population’s exposure to violations.
For example, some systems may
receive a violation for an incident
that lasts only one day (e.g. turbidity
increase due to storm event). The
measure is intended to give a more
accurate picture of exposure of the
population to contamination.
In 2009, community water systems in
the Tampa Bay area were in compliance
99.6% of the time compared to 96.3%
in the U.S. and 98.9% in Florida.
Transportation
Today, the U.S. transportation system
is designed to move people and goods
efficiently, however, there is a growing
awareness across communities that
transportation systems impact quality
of life and health. Expanding the
availability of, safety for, and access
to a variety of transportation options
and integrating health-enhancing
choices into transportation policy
has the potential to save lives by
preventing chronic diseases, reducing
and preventing deaths, and improving
environmental health.48
Daily Vehicle Miles Traveled
Per Capita
Vehicle miles traveled (VMT) indicates
the demand on county roads and
freeways. Areas with higher numbers
of vehicle miles traveled tend to
have higher rates of motor vehicle
and pedestrian accidents, injuries
and fatalities. Vehicle miles traveled
lead to increased air pollution and
greenhouse gas emission which
contribute to cardiovascular mortality
rates and respiratory disease. On
average, Americans spend 443 hours
in a car each year. Increased numbers
of VMT have been tied to obesity and
impact general well-being.49
This indicator shows the average
weekday daily VMT per capita
as measured by total number of
vehicle miles divided by the county’s
population. In 2008, the weekday
daily VMT per capita for the U.S. was
26.8, for Florida it was 29.6 and for
Tampa Bay it was 27.8.
Motor Vehicles Deaths
Motor vehicle-related injuries kill
more children and young adults
than any other single cause in the
United States. More than 33,000
people in the United States died
in motor vehicle crashes in 2009,
the lowest number of deaths since
1950.50 Crash injuries result in about
500,000 hospitalizations and four
million emergency department visits
annually.51 Increased use of safety
belts and reductions in driving while
Motor Vehicle Fatalities
2002
2006
20
15
13.3 13.6
10 9.2%
5
0
Healthy
People
2010
8.2
14.7 14.4
7.4
impaired are two of the most effective
means to reduce the risk of death and
serious injury of occupants in motor
vehicle crashes.52
death rate per 100,000 people due
to motor vehicle crashes. In 2006,
Florida and Tampa Bay far exceeded
the number of deaths at 13.6 and 14.4
deaths per 100,000 compared to 7.4
in the U.S. The Healthy People 2010
target was 8.0.
Pedestrian Fatalities
U.S. Florida Tampa
Bay
27.8
average weekday
daily vehicle miles
travelled per capita
in Tampa Bay
in 2008
In 2009, 4,092 pedestrians were killed
in traffic crashes in the United States.
With 2.51 deaths per 100,000 people,
Florida had the highest pedestrian
fatality rate of all 50 states in 2009.
California, the most populated state,
ranked 15th.53
This indicator shows the number of
pedestrians killed in traffic collisions
per 100,000 population. The Healthy
People 2010 national health target
was to reduce the pedestrian death
rate on public roads to 1.0 death per
100,000 population. In Tampa Bay,
the pedestrian fatality rate declined
from 3.2 persons per 100,000 in 2006
compared to 4.1 in 2003.
Spotlight: Charlotte
Area Transit System
Research shows a correlation
between weight loss and ridership on
the Charlotte Rail Line. The Journal
of Preventative Medicine recently
published a study on Charlotte’s Lynx
Light Rail. Their research found riding the blue line led to an average
weight loss of around 6.5 pounds and that Light Rail users are 81%
less likely to be obese over time. Researchers say that’s because
walking to and from your stop is part of a more physically active
lifestyle. The built environment can constrain or facilitate physical
activity. While the results are impressive, most studies of the health
consequences of the built environment face problems of selection
bias associated with confounding effects of residential choice
and transportation decisions. Nonetheless, the authors of this
study state that the findings suggest that improving neighborhood
environments and increasing the public’s use of light rail transit
systems could provide improvements in health outcomes for millions
of individuals.54
29
Environmental (cont.)
Travel to work
Lengthy commutes cut into workers’
free time and can contribute to health
problems such as headache, anxiety,
and increased blood pressure. More
time spent in transit also translates
to increased consumption of fossil
fuels used for transportation, which is
costly for workers as well as for
the environment.
Tampa Bay
commuters spent
25.1
minutes traveling
to work in 2008
Spotlight: Safe Routes to School
The Safe Routes to School
Program (SRTS) was authorized
in August 2005 by Section 1404
of the federal transportation
act, SAFETEA-LU (the Safe,
Accountable, Flexible, Efficient
Transportation Equity Act: A
Legacy for Users). This program
provided a total of $612 million
in Federal-aid highway funds
to State Departments of
Transportation (DOTs) over five
Federal fiscal years (FY2005-2009), to make it safer, easier and more
fun for children in grades K through 8, to walk or bicycle to and
from school.
The Florida Department of Transportation received approximately
$29.1 million for use on SRTS projects through Federal Fiscal year
2009. The purposes of the Safe Routes to School Program are:
• To enable and encourage children, including those with
disabilities, to walk and bicycle to school
• To make bicycling and walking to school a safer and more
appealing transportation alternative, thereby encouraging a
healthy and active lifestyle from an early age
• To facilitate the planning, development, and implementation of
projects and activities that will improve safety and reduce traffic,
fuel consumption and air pollution in the vicinity of schools
The Alliance for Bicycling and Walking in its 2010 Benchmarking
report measured the potential impact of bicycling and walking levels
on public health. They found a correlation between obesity and
overweight levels, physical activity levels, high blood pressure
and diabetes.
States with higher levels of bicycling and walking
• average lower obesity levels
• have higher levels of physical activity
• have lower rates of diabetes
• average lower levels of high blood pressure
30
This indicator shows the average
daily commuting travel time to work
in minutes for workers 16 years of
age and older. In 2008, Tampa Bay
commuters spent an average of 25.1
minutes traveling to work, whereas
commuters in Pasco and Hernando
spent the most time in their cars at
about 30.1 minutes.
Transit Ridership
Public transportation offers mobility
for U.S. residents, particularly people
without cars. Transit can help bridge
the spatial divide between people
and jobs, services, and training
opportunities. Public transportation is
also beneficial because it reduces fuel
consumption, minimizes air pollution,
and relieves traffic congestion.
This indicator is the daily average
number of unlinked transit trips as a
percentage of population. In the past
five years, transit ridership as a percent
of the population has been steadily
increasing in Tampa Bay from 1.86%
to 2.27% but in 2008, still lagged the
Healthy People 2010 target of 3.6%.
Built Environment
Population Density
Persons per square mile is the average
number of inhabitants per square mile
of land area. Population density is
one indicator of how land is used in a
given area. Higher population density
signifies more urban areas.
According to the Brookings
Institution, our nation’s large metro
areas remain at the cutting edge
of the nation’s continued growth.
Growth of primary city populations
of the nation’s 100 metropolitan
areas accelerated from 2006 to 2008,
at the same time that suburban
population growth slowed. Some of
this resurgence of big cities is due
to inherent strengths, such as broad
economic diversity. But much is
attributable to a “windfall” of residents
attracted to and retained in cities who
might – in the absence of the housing
crisis and deepening recession – have
moved to the suburbs.55
Between 2004 and 2008, the
population of the Tampa Bay region
grew at an average of 6.9% with the
outlying areas in Pasco and Hernando
counties growing at a much faster
rate of 15.2% and 16.4% respectively
compared to Pinellas County which
had a negative growth rate of 1.5%.
alcohol that is available for immediate
consumption than do taverns and
restaurants serving alcohol.
This indicator measures liquor stores
per 100,000 residents. In Tampa
Bay, there are an average of 6.9
establishments per 100,000 people
compared to 10.1 in the U.S. It
should be noted that Florida
law permits the sale of alcohol
in establishments other than
liquor stores, such as grocery
and convenience stores. If those
vendors were included in the density
calculation, the region and state
rates would likely be closer to the
national average.
Access to Healthy Foods
Studies have linked the food
environment to consumption of
healthy food and overall health
outcomes. Grocery stores include
establishments generally known as
supermarkets, smaller grocery stores
and delicatessen-type establishments
primarily engaged in retailing a
general line of food, such as canned
and frozen foods, fresh fruits and
vegetables, and fresh and prepared
meats, fish and poultry. (Convenience
stores, large general merchandise
stores that also retail food, such as
supercenters and warehouse club
stores are excluded.)
This indicator measures grocery
stores per 100,000 residents.
In Tampa Bay, there were 19.2
establishments per 100,000 people
compared to 21.3 in the U.S.
A “food desert” is an area without
a grocery store within a reasonable
walking distance or near public
transportation.56 Residents in a food
desert do not have access to healthy
foods. Tampa Bay is not a food desert
as communities within the region
have made strides in increasing the
availability of healthy foods; from
the addition of grocery stores in
neighborhoods which previously
lacked one, to the expansion in the
number of farmer’s markets selling
locally grown fresh produce.57
Liquor Store Density
Researchers have documented a
variety of problems associated with
the physical availability of alcohol
including assaultive violence, motor
vehicle accidents, drinking and driving,
riding with a drinking driver, high
mortality rates due to liver cirrhosis,
and binge drinking. Furthermore,
liquor stores sell larger quantities of
Public Safety
Violent Crime Rate
19.2
grocery
establishments per
100,000 people in
Tampa Bay
A violent crime is a crime in which
the offender uses or threatens to
use violent force upon the victim. In
the FBI’s Uniform Crime Reporting
Program, violent crime is composed
of four offenses: murder and
nonnegligent manslaughter, forcible
rape, robbery and aggravated assault.
Over 1.3 million violent crimes
occurred nationwide in 2009, showing
a decrease of 6.1% from the
2008 estimate.58
This indicator is the rate per 100,000
population of total violent crimes.
There were an estimated 454.5 violent
crimes per 100,000 inhabitants in
2008 in the U.S. compared to 688.9 in
Florida and 622.0 in Tampa Bay.
Spotlight: Women Infant and
Children (WIC)
WIC is a food program for women,
infants and children funded by the
U.S. Department of Agriculture and
administered through the county health
departments. The program provides
vouchers for the purchase of WIC foods
to supplement the nutritional needs of
a pregnant woman, a breastfeeding
mother, a new mother, an infant or a
child up to 5 years old.
www.doh.state.fl.us/family/wic
31
Community Assessment
The community assessment
that follows was an opportunity for ONE BAY: Healthy Communities
to supplement the health indicator data and learn about the many valuable programs and organizations working to affect
community health in the Tampa Bay region. As we move through this visioning process, it will become very important to
gain the feedback and participation of these organizations towards a common vision and goal setting for the region.
As a starting point, a comprehensive,
though not conclusive, list of public,
private, and non-profit organizations
from the eight-county region was
compiled based on their involvement
with any one aspect of creating a
healthy community. While not every
single organization that has an impact
could be identified, a broad effort
was made to find programs targeting
specific conditions for populations at
risk for disparities, low-income residents
and larger employee populations.
Direct health care providers (physicians,
clinics, nursing homes, hospices) were
excluded because their contribution
to community health generally occurs
at the individual level. Hospitals were
included not for their direct patient
care activities, but for their admirable
community outreach programs.
In an effort to reach our community
of employers, an online survey of
employers was conducted through
the Maddux Business Wire and
Tampa Bay Partnership from August
19 - September 10, 2010. The survey
focused on employee benefits at nearly
32
Over
100
organizations
in Tampa Bay
region focused
on improving
community health
150 organizations, of all sizes,
responded. Employers, as
the primary funders of health
insurance benefits for working
age adults, serve an important
role for employee access to
health care, disease
prevention and health and
wellness programs.
Our independent research
and outreach regarding
community health programming
identified a list of nearly 140
organizations. Three-fourths of these
140 organizations were contacted for
additional information and most were
interviewed. This process provided
substantial insight into the numerous
community health activities being
conducted in the region. Throughout
this report, you will find examples of
unique programs and organizations
spotlighted. While there was not
sufficient time to interview every entity,
we continue to encourage organizations
to submit additional information about
their efforts to this process.
In total, the community assessment
process got information from nearly 280
organizations in the Tampa Bay region
(including the 150 employer responses).
The organizations have been grouped
into the following sectors:
• Governmental agencies
• Hospitals
• Not-for-profit organizations
• Alliances/partnerships
• Employers
Governmental Agencies
Federal Programs
The U.S. Department of Health and
Human Services (HHS), the Centers
for Disease Control and Prevention
(CDC), the Health Resources Services
Administration (HRSA), the Substance
Abuse and Mental Health Services
Administration (SAMSHA), the U.S.
Department of Agriculture (USDA), and
the U.S. Department of Transportation
(USDT) are the primary Federal funding
agencies for health improvement
programs and typically provide the
funds to state or local agencies for
administration of programs such as
Women, Infants and Children (WIC, pg.
31), Healthy Start/Head Start (pg. 19),
and National Breast & Cervical Cancer
Early Detection Program (pg. 23).
For many programs, like Safe Routes
to School (pg. 30), federal funding must
be supplemented by state, local and
often private funds in order to meet the
community needs. Other programs are
fully-funded federal grants, such as the
nearly $5 million grant awarded to the
Pinellas County Health Department to
implement policy changes in all sectors
of the community to combat obesity.
The grant is from the Prevention and
Public Health Fund, a component of the
Affordable Care Act/Health and Human
Services Communities Putting Prevention
to Work Program. The CDC administers
this prevention and wellness initiative.
State of Florida
Florida Department of Health
The largest state agency focused
on improving public health is the
Florida Department of Health. The
Florida Department of Health funds
and oversees the 67 county health
departments in the state and is
charged to “promote, protect and
improve” the health of the “public”
or residents. Despite their moniker
of county health departments, they
are not within the county government
structure but are divisions of the state
health department.
The physical and behavioral services
provided or coordinated by county
health departments varies slightly,
depending on the demographics and
8
state county health
departments
4
regional health
councils
2
children’s services
councils
needs of the county, yet
all provide the following
services or direct residents
to another resource for care
or education:
• Immunizations/vaccinations
• Smoking cessation
• Weight loss/nutrition
education
• Diabetes management
• Illicit and prescription
medication and alcohol
addiction
• Suicide prevention
• Sexually transmitted disease
testing and treatment
• Pregnancy prevention
• Pre-natal care aimed at reducing
low birth weight and infant mortality
Health departments also oversee vital
statistics, environmental health and
preparedness, and programs addressing
the health needs of the community.
Regional Health Councils
The Florida legislature has established
a network of agencies called Health
Councils with 11 districts throughout the
state. The Health Councils are mandated
by state law to conduct regional health
planning and implementation. The
Councils collect and analyze health care
data, describe community health status,
identify health care needs and resources,
and work with community partners to
design strategies to improve access
to affordable and quality of health care
services at the local level. The Tampa
Bay region has four Health Councils that
encompass counties beyond our region.
Region 3
WellFlorida Council
Region 5
Suncoast Health Council
Region 6
Health Council of West
Central Florida
9
Region 8
Health Planning Council of
Southwest Florida
Spotlight: Suncoast Health Council:
MedNet Prescription Assistance
The Suncoast Health Council in Pinellas County started the MedNet
Prescription Assistance Program in 1999 in response to a finding that
access to prescription medications was identified as the top health issue
in the county. The program expands access to prescription medicines
for low-income uninsured and underinsured adults with chronic health
conditions. The program expanded to 19 sites in five counties and in
2009 obtained $5.2 million in free prescription medications, returning
$9.93 for every dollar spent to provide the services. Funding is provided
by private foundations and public entities.
www.healthcouncils.org
33
Community (cont.)
Children’s Services Councils
Eleven counties within Florida have
children’s services councils which focus
on serving the needs of all children
within the county. Eight of these counties
have passed referendums authorizing
an ad valorem tax for the sole purpose
of funding programs and services for
children. In the Tampa Bay region,
Pinellas and Hillsborough counties each
have a children’s services council.
Juvenile Welfare Board of
Pinellas County
The Juvenile Welfare Board (JWB)
funds programs in three priority
areas: Ending Child Maltreatment,
School Readiness and Ensuring
School Success. The fourth area
for funding is a conglomeration
of programs that do not directly
fall within these priorities but have
been deemed necessary, such as
residential programs, behavioral
health counseling and coordinated
child care.
Children’s Board of
Hillsborough County
The Children’s Board of Hillsborough
County funds numerous programs
throughout Hillsborough County with
an emphasis on: Promoting Healthy
Births, Improving School Readiness,
Advancing School Achievement and
Helping Families Succeed.
County Government
Funding for community health programs
at the county level is dependent on
prioritization of needs and budget
dollars available. Most of the region’s
counties have an established health and
human or social services agency that
is completely separate from the county
health department. The county health
or social service agency is typically
charged with addressing medical and
social service needs of the county and
often assists residents in need with
access to health care.
County governments also have
departments whose functions are
complementary to the foundations
34
67
Hospitals in
Tampa Bay region
for a healthy community. For
example, county sheriff’s
departments and local
police departments work
to keep our region safe.
Public works, transportation,
economic development,
education, and parks and
recreation departments are all
collaborating to improve the
quality and “livability” of
our communities.
Hospitals
The Tampa Bay region is home
to 67 hospitals including
acute care, long-term
care, rehabilitation, cancer,
psychiatric, addiction and
children’s hospitals. Of the
50 acute care hospitals, 23
are tax-exempt not-for-profit
and 27 are for-profit. All of
the region’s hospitals offer
community health programming
for local residents but the
not-for-profit hospitals tend
to provide greater financial
contribution to the community.
In exchange for tax-exempt status,
not-for-profit hospitals are obligated
to provide benefit to the community.
These hospitals fulfill this obligation
by providing charity care, financial
assistance to low-income patients,
subsidized health care, research,
health professions education and
sponsoring community education and
health-related activities.59 According to
an IRS study of hospitals completed in
February 2009, uncompensated care
was the largest category of community
benefit expenditures at 56% followed
by medical education and training
(23%), research (15%) and community
programs (6%).60
Charitable activities of hospitals in
the Tampa Bay region, particularly
those with tax-exempt status, mirror
those of the IRS study with the largest
community benefit provided in the form
of charity care. Our regional hospitals
provide programs to local residents,
generally at no cost including disease
management programs, heart risk
assessments, cholesterol, glucose,
breast and cervical screenings, health
fairs, and educational workshops on
numerous health topics. In addition
to these programs provided directly
by the hospitals, many hospitals also
financially support community activities
such as walks, runs and triathlons.
Not-for-Profit Organizations
A not-for-profit organization (NPO) is
mission-driven, exempt from federal
corporate income taxes and classified
Spotlight: BayCare Health System:
Faith Community Nursing
The Faith Community Nursing Program, available through BayCare
Health System, trains nurses who establish health ministries within
their home faith-based congregation. Over 200 nurse volunteers
work in underserved communities and homeless shelters. Their
mission is health promotion and disease prevention. Nurses
arrange for health screenings or presentations by community health
centers. In 2009, there were 14,000 hours served with 36,000 direct
and indirect contacts.
www.stanthonys.com
according to the U.S. Internal Revenue
Code. NPOs include professional
associations, charities, foundations,
religious organizations, social clubs,
fraternal organizations, private schools,
and colleges and museums and cultural
organizations.
The Tampa Bay region is home to
hundreds of NPOs, a small portion
of which is focused on health-related
issues. Many of the NPOs with a health
mission or emphasis are affiliates of
national organizations such as:
• American Heart Association
• American Cancer Society
• American Lung Association
• American Diabetes Association
• Susan G. Komen for the Cure
• Alzheimer’s Association
• American Association of Retired
Persons
Funding Organizations
Other national NPOs are primarily
funding organizations. These organizations raise money from the community
and re-distribute it in the form of
grants to fund programs designed
by the local NPOs. The programs
must be aligned with the strategic
objectives of the funding organization
in order to receive grant funding.
In 2009, the United Way began a
process to identify the most promising
evidence-based community strategies
to improve health, education and
financial stability. The United Way has a
strong presence in Tampa Bay with an
affiliate in each of our eight counties.
Our region also has several community
foundations that raise money from
the community for the community.
Residents participate in prioritysetting processes and award grants
based on these priorities. Our region’s
community foundations include:
• Community Foundation of
Tampa Bay
• Pinellas County Community
Foundation
• Sarasota/Manatee Community
Foundation
• Gulf Coast Community Foundation
Allegany Franciscan Ministries
is a Catholic organization
with three regions in Florida,
including Tampa Bay. Local
grants include Healthy Start,
the Tampa Bay Healthcare
Collaborative, Kidz Bite Back,
James B. Sanderlin Family
Center, the Sulphur Springs
Resource Center and Faith
Community Nursing.
Alliances
Corporate Philanthropy
• Polk County Health Alliance
Many publicly owned
companies have formed
separate foundations that give
back to their communities.
Large corporations such
as Blue Cross/Blue Shield,
Publix, AT&T, Bank of America
and UnitedHealthcare all
have foundations that have
supported regional programs.
• Health and Human Services
Coordinating Council of Pinellas
County
Our region supports other
private foundations that are
not focused on health but are
currently funding programs for
children, the homeless and the
disabled in addition to funding
for the arts and humanities.
Combined, all of these efforts
serve to improve the quality of
life for our Tampa Bay region.
Recognizing the overlapping needs of
certain populations, health alliances
or collaborations have formed in each
of the eight counties. All of the county
coalitions include the health department
but diverge from there. The focus of the
alliances varies slightly but all are working
together to improve the health of the
residents. Alliances identified include:
• Hernando County Health Care
Advisory Board
• Citrus Partnerships in Health
• Shared Services Alliance of Citrus
County
• Community Alliance of Sarasota
County
• Manatee County Substance Abuse
Coalition
• Health Equity Coalition of
Hillsborough County
• HillsboroughHATS (Health and
Transition Services)
• Manatee Healthcare Alliance
Spotlight: Non-profit Programs
Gulf Coast Community Foundation of Venice: CareerEdge (www.
gulfcoastcf.org) is a collaborative program aimed at transitioning
low-wage earners into higher-paying positions in an effort to provide
trained employees for the Manatee-Sarasota businesses focusing on
the health care industry first.
Healthy Together: Prime Time Sister Circles (www.healthy-together.
org), developed by the Gaston & Porter Health Improvement Center,
is designed for 40-70-year-old African American women. According
to their research, African American women are dying prematurely at
a rate higher than any other population in America. Using esteembuilding support groups, the program motivates participants to make
changes in their lifestyle and create lifelong wellness plans. Healthy
Together enrolled 60 women with more than 50% of the participants
reducing their blood pressure, BMI and abdominal circumference.
Sarasota County’s Community Health Improvement Partnership (CHIP)
(www.chip4health.org): Housed within the Department of Health, CHIP
hosted a Community Health Interactive, which convened and engaged
a diverse group of citizens in changing the status quo, prioritizing
health challenges and generating solutions and action steps.
35
Community (cont.)
Employers
An online survey was conducted
through the Maddux Business Wire and
Tampa Bay Partnership from August 19
- September 10, 2010, in which nearly
150 organizations responded. The
purpose of the survey was to assess
an employer’s cost in providing health
care, their view on their role in affecting
employee health, and their direct
involvement with employee
health and wellness initiatives and in
the community. The survey is not
representative of the entire labor force
in the region, but supports that Tampa
Bay employers, as a whole, are in line
with national benefits trends.
Of the survey respondents, over
60% of companies have less than
100 employees. According to the
2008 County Business Patterns,
98% of Tampa Bay establishments
had fewer than 100 employees. As
a result, it should be noted that a
higher percentage of large employers
responded to the employer
survey than is represented in the
business community.
The Cost of Medical Care
The cost of medical care continues
to rise and both employers and
employees are paying more. As has
been the case nationally, medical
expenses for Tampa Bay employers
have increased at a rate outpacing
inflation. Survey results demonstrate
that between 2008 and 2009 health
care expenses for half of the region’s
employers increased between 1-15%.
For 16% of the employers, costs
increased 16-30%.
For employees, personal medical
expenditures have increased either
because they have moved into a
high deductible consumer-directed
health plan or their share of the
premium contribution expected by the
employer has increased. According to
our employer survey, between 20082009, 42% of employees saw their
medical expenses increase between
1-15%. Another 10% of employees
saw increases of 16-30%.
36
Nearly
75%
of employers
surveyed believe
they have a
responsibility to
play an active role
in their employee’s
health
50
Employer Expense
Employee Expense
41.5
40
• Health education seminars
• Weight loss programs
• Healthy meal options in building/
on campus
• Preventive counseling/
support groups
• Wellness clinic
30
• Workplace violence awareness
programs
20
16.3
9.8
10
0
An overwhelming majority of our local
employers are committed to their
employees’ health. Nearly 75% of
survey respondents believe that they
have a responsibility to take an active
role in improving the health status of
their employees. For the employers
that benefit from economies of scale
because of their large employee base,
their offerings include one or more of
the following:
• Free or discounted health club
memberships/on-site fitness center
2008-09 Increase in
Medical Expenses
49.1
The Employer’s Role in
Employee Health
1-15%
Increase
16-30%
Increase
Behaviors/Diseases
Targeted by Employer
Programs
Smoking
Cessation
Weight Loss
High Blood
Pressure
Of the 100 organizations that
answered the question asking
what behaviors or diseases they
were hoping to impact with their
employee health programs, 48% were
addressing smoking and 46% were
addressing weight loss. High blood
pressure, diabetes, high cholesterol,
coronary heart disease, substance
abuse, depression and stroke
prevention were also risk factors that
employers are monitoring and hope
to impact. The larger employers also
tend to cover cancer screenings for
their employees at no charge.
Over 55% of employers responding to
the survey indicated that they offer an
Employee Assistance Program (EAP).
EAPs provide counseling and other
resources for employees and family
members with behavioral health
concerns such as substance abuse
and depression.
Diabetes
High Cholesterol
Coronary Heart
Disease
Substance Abuse
Depression
Stroke Prevention
Healthy Lifestyle
Asthma
0% 10% 20% 30% 40% 50%
For smaller employers who do not
have the resources to track specific
behaviors or risk factors or offer
EAPs, they have begun emphasizing
prevention and general health and
wellness in an effort to get employees
more engaged in an active lifestyle.
Spotlight:
USF Health
Regardless of whether a healthy
lifestyle program was offered or not,
41% of employers indicated that in
the last two years, their company has
spent either more staff time, more
budget dollars, or both, in an effort to
improve employee health.
USF Health’s mission is to enhance
life by improving health through
research, education and healthcare
to improve the full spectrum of
health, from the environment, to
the community, to the individual.
Together, through talent and
innovation,
USF Health
is developing
real-world
solutions to
reach our
shared value
– making life
better.
In terms of outcomes for these
wellness programs, there is not much
objective evidence of their success.
For the few largest employers
who are self-insured and have
trend data, they have documented
that prevention activities such as
wellness visits and health screenings
have increased. Benefits managers
report that if the CEO and senior
management embrace the wellness
and healthy living initiatives, and it
is part of the corporate culture, then
employees seem more engaged
with their personal wellness. These
companies are leveraging their
healthy culture into an effective
employee recruitment tool.
Community Support
Tampa Bay employers are actively
engaged in supporting health
activities for our entire community.
Seventy-four percent of respondents
financially sponsor walks, marathons,
triathlons, children’s athletics and
health fairs while 44% financially
sponsor infrastructure improvements
such as walking trails, bike paths,
parks, playground equipment and
athletic complexes/community
recreation centers. Of those who
financially sponsor community health
improvement activities or infrastructure
improvements, 75% of that sponsorship was $10,000 or less.
PaperFree Florida is helping
doctors across the state convert
to electronic medical records as a
national model for bringing health
care into the digital age.
75%
of employers
spent up to
$10,000
on community
health
sponsorships
USF Health’s Center for Advanced
Medical Learning and Simulation,
a $30 million project in downtown
Tampa, will use leading USF
faculty surgeons to train surgeons
from around the world on how
to perform robotic, computerassisted, and image-guided
surgeries. In the simulation
center’s Virtual Hospital, doctors,
nurses and other healthcare
providers will train side-by-side,
perfecting the teamwork and
communication skills vital to topquality medicine.
www.health.usf.edu
Leadership in the Community
Spotlight: Hernando County
Worksite Wellness Toolkit
The survey asked respondents
whom they perceive to be taking
a leadership role in improving
community health. Hospitals and
hospital systems received the most
responses, followed by national nonprofit organizations with local presence
like the American Cancer Society,
American Heart Association and the
United Way.
Hernando County has very few large employers and many small
employers. To assist the county employers who cannot afford to
offer wellness programs, the Hernando County Health Department,
supported by a grant from The United Way of Hernando County,
developed a free Worksite Wellness Toolkit that is designed to be a
quick and flexible resource for promoting positive lifestyle choices
among employees. The toolkit includes health facts, tips posters,
newsletter and paycheck inserts on topics such as physical activity,
nutrition, smoking cessation, stress management and habit formation.
37
Goals & Methodology
ONE BAY: Healthy Communities has measured the health
of the region using a two-fold approach:
• Using a core set of indicators in the areas of
Economy/Demographics; Health Outcomes; Health
Related Behaviors; Health Systems/Access; and
• Initiating an inventory of existing community health
improvement programs within the region as a start for
community support and collaboration.
Methodology
Indicator Selection
The Healthy Communities Data
Committee, comprised of public health
researchers, providers and insurance
organization leaders developed the
following criteria for the selection of
the indicators:
• Must reflect the care delivered in the
community
• Must be established measures
• Must be an area of concern to public
health or reflect the Tampa Bay region’s
unique qualities
• Must be publicly available data with
measurement reported at the national,
state and county level, where possible
The indicators selected provide a
comprehensive view of community
health, wellness and disease. They
include measures of mortality, disease
prevalence, hospitalization rates,
health-related behaviors, and
environmental factors.
Sources
Public data sources include the Center for
Disease Control and Prevention, Florida
Department of Health, U.S. Census
Bureau, Florida Bureau of Immunization,
Federal Bureau of Investigations,
Environmental Protection Agency,
Kaiser Family Foundation, U.S. Bureau
of Economic Analysis, and U.S. Health
Resources and Services Administration.
38
Regionalization
Age Adjustments
County-level measures for
the Citrus, Hernando, Pasco,
Pinellas, Hillsborough, Polk,
Manatee and Sarasota counties
were aggregated into a Tampa
Bay region score. This composite
score allows for comparisons
with the Tampa Bay region
(county vs. region, region vs.
state, etc.). To create Tampa
Bay region-level scores,
population ratios calculated
from appropriate county-level
weighing factors were used.
Regional figures were compared
to state and national figures
and to Healthy People 2010
when available.
Measures were adjusted to account for
the differences related to age, where
applicable. For example, Florida has
an older population than the rest of the
United States, on average. Therefore, the
health-related measures were statistically
adjusted to reveal differences in
community health not related to aging.
Trends
Whenever possible, five year
trend data were collected
to provide perspective on
the relative direction of the
community health indicators.
Some measures, such as
the Florida Department of
Health Behavioral Risk Factor
Surveillance System (BRFSS),
are conducted every two years.
A compilation of the county,
regional, and state data is
included in the Appendices.
Detailed Operational Definition
of Measures and Data Sources
are available at the following
website: www.myonebay.com
Data Limitations
Many measures were collected using
surveys conducted from randomly
selected individuals, such as the state
and federal Behavioral Risk Factor
Surveillance System (BRFSS). As such,
the numbers listed for each measure
represent a point estimate within a
range of possible numbers, called the
confidence intervals (not reported). This
means that the scores may give the
impression of exactness, but may actually
contain various levels of imprecision
depending on the sample size. In these
instances, direct comparisons between
national, state, and county measures
should be performed with caution.
Some of the data collected for measures
may not be from the same source at all
levels. For example, national surveys
on immunizations for two year olds
conducted by the CDC were performed
on 19 to 35 month olds during a six month
period. On the other hand, Florida countylevel immunization surveys conducted by
the Florida Department of Health were
completed for children that were two in
the first week in January. These slightly
different approaches result in indicators
that are not directly comparable.
Health Indicators
Population
U.S.
Florida
TB Region
Citrus
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
4,159,158
140,357
171,233
1,195,317
318,361
471,709
909,013
583,403
369,765
100%
3.4%
4.1% 28.7%
7.6%
11.3%
21.9%
14.0%
8.9%
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
$39,552
$49,762
$46,573
$42,407
2009 Census Population
Source: U.S. Census Bureau
307,006,550 18,537,969
% of Region Economy/Demographics
U.S.
Florida
TB Region
Citrus
2008 Median Household Annual Income
Source: U.S. Census Small Area Income and Poverty Estimates
$52,029 $47,802
$46,199
$38,476
$45,899 $44,350
$49,001
$43,064 $32,572
$55,856
2008 Annual Per Capita Personal Income
Source: Bureau of Economic Analysis Regional Economic Accounts - Personal income, population, per capita personal income (Table CA1-3 3.0)
$40,166 $39,064
$38,427
$30,170
$29,148
$37,778
$40,353
$29,113
10.7%
11.5%
11.9%
10.8%
11.4%
11.2%
13.9%
12.2%
13.2%
10.9%
15.3%
9.9%
78.7%
73.7%
67.3%
70.6%
83.5%
2009 Unemployment
Source: Bureau of Labor Statistics, CPS (National), LAUS (Regional and Local)
9.3%
10.5%
11.2%
12.3%
13.2%
2008 Families Living Below Poverty Level (%)
Source: U.S. Census Small Area Income and Poverty Estimates Data
13.2%
13.3%
12.9%
15.8%
12.4%
2007 High School Graduation Rates (Within 4 Years of 9th Grade Enrollment)
Source: Florida Department of Education, FSIR
73.9%
75.4%
78.5%
76.1%
75.1%
79.1%
2009 College Graduates (% Age 25+ with Bachelor’s Degree or higher)
Source: Nielsen Claritas, 2009
24.6%
22.6%
21.4%
13.4%
12.7%
26.0%
22.4%
14.7%
23.2%
15.0%
26.5%
Citrus
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
175.4
148.6
149.9
137.4
169.0
109.1
41.7
29.1
32.7
34.9
41.2
28.6
188.2
162.1
187.5
174.4
177.8
153.6
Health Outcomes
U.S.
Florida
TB Region
2006 Coronary Heart Disease (Age-Adjusted Deaths per 100,000)
Source: CDC Wonder Compressed Mortality, 1999-2006 Request
144.3
138.5
147.3
158.2
153.8
2006 Stroke (Age-Adjusted Deaths per 100,000)
43.6
35.3
34.6
31.0
30.5
2006 Cancer (Age-Adjusted Deaths per 100,000)
180.7
171.9
177.0
212.3
204.0
39
Health Indicators (cont.)
U.S.
Florida
TB Region
Citrus
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
54.7
49.3
61.5
57.9
55.6
46.3
18.0
24.4
19.7
26.7
18.9
7.9
6.0
2006 Lung Cancer (Age-Adjusted Deaths per 100,000)
51.5
51.2
55.7
68.7
63.9
2006 Female Breast Cancer (Age-Adjusted Deaths per 100,000)
21.5
21.5
21.6
23.2
26.4
21.7
2007 Asthma (Percentage of adults (18+) who currently have asthma)
Source: Florida CHARTS: Florida Department of Health, BRFSS County Questionnaire (2002 & 2007) / CDC BRFSS Nationwide (States and DC) Prevalence and Trend Data
8.2
6.2
7.6
11.8
7.3
6.9
7.1
7.2
8.8
2007 Diabetes (Percentage of adults ≥ 20 years old diagnosed with type 1 or type 2 diabetes)
Source: CDC Diabetes Data and Trends - County Level Estimates of Diagnosed Diabetes
5.7
7.9
8.0
8.4
9
8.4
7.3
8.4
7.2
8.7
6.6
7.8
7.2
4.4
9.1
15.4
9.5
15.0
16.1
18.8
16.1
10.9
13.5
6.0
9.3
7.5
4.6
8.0
8.2
8.9
8.1
7.3
1.3
0.2
0.5
0.8
0.5
2006 Pneumonia/Influenza (Age-Adjusted Deaths per 100,000)
17.8
8.9
8.8
7.3
9.8
2006 Suicide Deaths (Age-Adjusted Deaths per 100,000)
10.8
12.6
14.9
18.7
10.7
2008 Infant Deaths (Infant Deaths (under 1 year) per 1,000 live births all causes)
Source: Florida Vital Statistics (CHARTS)
6.7 (2006)
7.2
7.5
5.4
5.7
8.0
8.0
2008 Low Birth Weight (Low Birth Weight (<2500 grams) per 100 live births)
Source: Florida Vital Statistics
8.2 (2007)
8.8
8.5
7.2
7.7
9.3
2008 Birth to Female Teens (Births per 1,000 to females aged 10-14)
Source: Florida Vital Statistics/CDC
0.6 (2006)
0.6
0.6
0.0
0.0
0.8
2008 Sexually Transmitted Diseases (Reported Cases of STDs (Chlamydia/gonorrhea/syphilis per 100,000)
Source: Florida Department of Health Trends & Statistics / CDC Sexually Transmitted Diseases Surveillance
528.2
514.3
514.2
222.4
209.9
717.0
487.0
207.8
584.5
532.7
331.7
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
32.6
41.9
U.S.
Florida
TB Region
Citrus
2007 Overweight Adults (% of adults with BMI between 25.0-29.9)
36.6
40
38.0
36.8
38.2
36.8
39.4
33.2
35.9
35.5
Health-Related Behaviors (cont.)
U.S.
Florida
TB Region
Citrus
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
33.2
17.2
65.9
59.1
2007 Obesity (% of adults with BMI between 30.0-99.9)
26.3
24.1
25.4
25.0
25.1
24.8
21.5
21.8
27.7
2007 Overweight and Obese Adults (% of adults with BMI between >25.0)
63.0
62.1
62.2
65.9
61.9
64.2
54.7
57.6
63.2
2008-2009 Childhood Obesity (% of 1st, 3rd, 6th graders whose body mass index (BMI) at or above the 95th percentile)
Source: U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.
N/A
18.5
18.1
17.6
18.4
14.4
25.9
18.5
18.3
20.3
18.9
25.9
19.3
52.8
66.6
2007 Physical Activity (% of individuals who engage in no leisure-time physical activity)
22.6
25.4
23.9
28.7
25.9
25.3
24.4
22.3
22.1
Percentage of Adults Who Are Physically Active
64.5
60.6
60.6
53.6
59.6
62.3
62.4
62.3
63.3
2007 Smoking (% of adults who have smoked >100 cigarettes in lifetime and who smoke on some days or everyday)
Source: Florida CHARTS: Florida Department of Health, BR FSS County Questionnaire (2002 & 2007) / CDC BRFSS Nationwide (States and DC) Prevalence and Trend Data
19.8
19.3
21.6
26.8
27.0
22.1
14.9
30.4
18.0
19.0
22.6
2007 Consumption of Alcohol (% of adult males having five or more drinks, or adult females having four or more
drinks on one occasion, one or more times in the past 30 days)
15.8
16.2
15.8
14.8
13.9
19.6
13.9
15.7
12.8
16.3
13.4
83.5
81.9
82.1
89.4
69.8
2008 Childhood Immunizations (Immunization levels among 2-yr.-olds)
Source: The Florida Bureau of Immunization
76.1
83.4
77.4
N/A
N/A
87.2
2007 Influenza Immunizations (% of adults over 65 years old who received influenza immunizations in the last year)
72.0
64.6
64.1
65.5
65.4
56.6
74.0
62.5
68.5
62.1
72.2
2007 Pneumonia Immunizations (% of adults over 65 years old who have ever received the pneumonia immunization)
67.3
63.0
65.8
68.6
73.3
57.4
77.6
69.5
67.2
64.9
71.6
63.3
69.3
62.3
63.9
2007 Breast Cancer Screening (Women age 40 and over who received mammogram in past year)
N/A
64.9
65.0
62.8
66.2
66.0
67.0
63.9
63.0
2007 Cervical Cancer Screening (Women age 18 and older who received a Pap test in the past year)
N/A
64.8
63.1
52.5
55.6
64.4
63.0
66.2
63.2
41
Health-Related Behaviors (cont.)
U.S.
Florida
TB Region
Citrus
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
2007 Colon Cancer Screening (Adults 50-years-old and older who received a sigmoidoscopy or colonoscopy in the
past five years)
N/A
53.7
54.9
51.5
54.3
50.1
60.1
53.7
56.0
57.7
61.7
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
33.0
55.1
57.7
137.8
18.5
266.2
229.1
461.0
168.4
Health Systems/Access *(U.S. Data is for 2007)
U.S. *
Florida
TB Region
Citrus
Hernando
2009 Hypertension - Age-Adjusted hospitalization rate per 100,000
Source: BayCare Health System analysis of FL Agency for Health Care Administration with AHRQ PQI software
61.6
84.7
64.7
54.2
62.5
75.6
2009 Congestive Heart Failure - Age-Adjusted hospitalization rate per 100,000
415.5
333.2
274.3
277.6
276.4
321.0
228.6
2009 Chronic obstructive Pulmonary disease - Age-Adjusted hospitalization rate per 100,000
193.0
214.4
207.9
213.1
209.9
216.9
170.3
188.7
208.4
339.9
106.6
21.6
17.9
50.7
8.0
47.9
80.8
38.0
98.2
150.2
47.2
2009 Uncontrolled Diabetes - Age-Adjusted hospitalization rate per 100,000
21.1
31.0
24.7
11.0
15.9
35.4
9.8
2009 Diabetes Short-term complication - Age-Adjusted hospitalization rate per 100,000
59.9
54.8
55.7
57.5
45.6
62.8
32.5
55.9
2009 Diabetes Long-term complication - Age-Adjusted hospitalization rate per 100,000
123.8
116.2
106.2
75.9
108.6
138.4
65.8
112.6
2009 Low-extremity amputation among patients with Diabetes - Age-Adjusted hospitalization rate per 100,000
33.6
30.2
26.6
34.2
24.4
28.8
22.0
31.2
25.0
30.0
19.2
130.6
162.8
215.2
298.4
104.1
81.0
126.1
119.2
214.7
62.4
248.1
251.4
278.4
272.5
329.1
2009 Bacterial pneumonia - Age-Adjusted hospitalization rate per 100,000
374.8
234.1
205.2
156.5
197.9
278.5
2009 Adult asthma - Age-Adjusted hospitalization rate per 100,000
117.9
136.7
133.3
122.2
156.7
154.8
2009 Perforated Appendix - Age-Adjusted hospitalization rate per 1,000
280.2
42
253.6
273.1
284.9
171.3
282.0
Health Systems/Access (cont.) *(U.S. Data is for 2007)
U.S. *
Florida
TB Region
Citrus
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
2009 Pediatric Diabetes Short-term Complications Admission Rate - PDI 15 - Age-Adjusted hospitalization rate per 100,000
29.7
24.8
25.3
10.9
24.8
30.9
31.2
18.6
15.3
36.3
15.2
2009 Pediatric Asthma Admission Rate - PDI 14 - Age-Adjusted hospitalization rate per 100,000
134.8
137.9
140.6
91.4
160.6
144.2
114.4
98.6
142.3
192.6
99.7
153.6
194.5
288.3
79.4
2009 Urinary tract infection - Age-Adjusted hospitalization rate per 100,000
185.4
185.3
182.1
129.9
176.0
224.4
135.0
2009 Pediatric Urinary Tract Infection Admission Rate - PDI 18 - Age-Adjusted hospitalization rate per 100,000
41.7
63.9
64.1
74.9
113.1
75.4
71.6
62.0
37.6
73.6
31.3
23.2%
27.5%
28.3%
24.0%
23.4%
26.2%
2008 Rates of Uninsured
Source: U.S. Census American Community Survey, Health Insurance Coverage
19.7%
24.8%
24.6%
27.3%
27.3%
2008 Access to Primary Care Provider (Primary Care Physicians per 100,000)
Source: FL CHARTS: Health Resources Availability: Physicians
89.6
96.9
83.1
56.9
68.0
92.7
65.5
61.7
103.5
60.7
96.5
Citrus
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
N/A
40.0
36.0
36.0
36.0
36.0
35.0
10.0
8.7
N/A
9.6
9.5
8.9
U.S.
Florida
TB Region
2008 Clean Air (Median Air Quality Index)
Source: Environmental Protection Agency
N/A
00.0
34.3
N/A
2006 Air Pollution (Average Particulate Concentrations)
Source: FL Department of Health
N/A
0.0
8.8
9.27
N/A
2009 Drinking Water (% of population served by community water systems failing to meet standards for 96% of
person months)
Source: Environmental Protection Agency
3.7
1.0
0.4
5.2
0.0
0.1
0.0
0.1
0.6
0.0
0.0
29.1
29.5
28.9
23.2
25.5
28.8
30.9
14.9
12.1
13.9
18.6
10.7
23.1
9.2
2008 Daily Vehicle Miles Travelled per Capita
Source: FL Department of Transportation
26.8
29.4
27.8
29.2
2006 Motor Vehicle Deaths
7.4
13.6
14.4
20.5
43
Environmental Health (cont.)
U.S.
Florida
TB Region
Citrus
Hernando
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sarasota
0.6
3.3
1.6
4.9
2.9
4.5
1.4
30.2
25.6
23.0
30.1
23.1
25.6
21.4
3.2
1.3
0.6
3.9
1.1
1.9
1,123.6
426.1
632.4
3,251.9
309.8
651.0
22.5
20.1
13.9
21.9
16.4 18.1
5.6
10.2
2006 Pedestrian Fatalities
2.1
3.3
3.2
4.4
2008 Time Travel to Work
Source: U.S. Census American Community Survey 1-Yr Estimates
25.3
25.9
25.1
25.1
2008 Daily Transit Ridership (Daily trips as a % of population)
Source: National Transit Database
2.97
1.09
2.3
N/A
0.31
2008 Population Density (Avg # persons per sq. mile)
Source: U.S. Census Annual Population Estimates
86.0
339.9
1,218.9
242.2
358.9
2007 Grocery Stores in county per 100,000 people
Source: U.S. Census North American Industry Classification System County Business Patterns
21.3
20.2
19.2
13.6
13.0
2007 Liquor Store Density (does not include non-liquor stores such as grocery and gas stations)
Source: U.S. Census North American Industry Classification System County Business Patterns
10.1
6.9
6.9
4.3
7.1
6.4
8.3
6.3
7.1
2008 Violent Crime Rate (violent crimes per 100,000 residents)
Source: FBI Uniform Crime Reports
454.5
44
688.9
622.0
(not available by county)
Organizations
These organizations were identified as having a potential role in impacting community health. Organizations noted with an * were researched and most
subsequently interviewed.
AARP Florida*
All Children’s Hospital*
Allegany Franciscan Ministries*
American Cancer Society - Florida Division
American Heart Association*
Amerigroup*
Bartow Regional Medical Center*
BayCare Health System*
Bayfront Medical Center*
Blake Medical Center*
BlueCross/BlueShield of Florida*
Blue Foundation for a Healthier Florida
Bon Secours St Petersburg
Brandon Regional Hospital*
Brooksville Regional Hospital*
Children’s Advocacy Center - St. Joe’s Children’s Hospital*
Children’s Board of Hillsborough County*
Citrus County Health Department/FL Dept of Health
Citrus Memorial Health System
Coca-Cola Enterprises*
Community Foundation of Sarasota
Community Foundation of Tampa Bay (includes divisions for Hernando, Pasco, Greater St. Pete and Sun City Center)
Community Hospital
Conn Foundation*
Doctors Hospital of Sarasota
Early Learning Coalition of Pasco and
Hernando Counties
Edward White Hospital
Englewood Community Hospital
FAB Families*
Fit4AllKids*
Florida Hospital Zephyrhills
Good Samaritan Health Clinic
Gulf Coast Community Foundation of Venice*
H. Lee Moffit Cancer Center and Research Institute*
Health and Human Services Coordinating Council for Pinellas County*
Health Council of W. Central Florida*
Health Equity Coalition of Hillsborough County*
Health Planning Council of Southwest Florida
HealthSouth Rehab Hospital of Sarasota
HealthSouth Rehabilitation Hospital of Spring Hill
HealthSouth RidgeLake Hospital
Healthy Start Coalition of Pinellas County*
Healthy Together*
Heart of Florida Regional Medical Center
Helen Ellis Memorial Hospital
Hernando County Department of Health*
Hernando County School District
Hernando Youth Initiative*
Hillsborough County Department of Health*
Hillsborough County School District
Hillsborough Education Foundation
Hillsborough Health Department/FL Dept of Health*
James A Haley VA Medical Center
Juvenile Welfare Board of Pinellas County*
K Force*
Kidz Bite Back*
Kindred Hospital Tampa
Kindred Hospital Bay Area - St Petersburg
Kindred Hospital Central Tampa
Lake Wales Medical Center
Lakeland Regional Medical Center*
Lakewood Ranch Medical Center
Largo Medical Center*
Manatee Chamber of Commerce Healthcare Committee*
Manatee County Community Services Dept*
Manatee County Health Department/FL Dept of Health*
Manatee County Family YMCA*
Manatee County School District
Manatee Glens Hospital
Manatee Memorial Hospital
Manatee Palms Youth Services
Mease Countryside Hospital*
Mease Dunedin Hospital*
Memorial Hospital Tampa
Midtown Health Council*
MORE HEALTH - Tampa General/All Childrens/Hills. & Pinn. School Dist.*
Morton Plant Hospital*
Morton Plant North Bay Hospital*
National Council on Alcoholism and Drug Dependence Tampa Bay
Northside Hospital and Heart Institute
Oak Hill Hospital*
Operation PAR
Palms of Pasadena*
Pasco County Health Department/FL Dept of Health
Pasco Regional Medical Center*
Pinellas Community Foundation
Pinellas County Health Department/FL Dept of Health*
Pinellas County Health and Human Services*
Pinellas County Planning Department*
Pinellas County School District*
Pinellas Education Foundation
Polk County Health Department/FL Dept of Health*
Polk County School District
Polk Vision
Regional Medical Center Bayonet Point*
Sarasota Chapter of the American Foundation for Suicide Prevention
Sarasota County Community Health Improvement Partnership*
Sarasota County Health Department/FL Dept of Health*
Sarasota County School District (SRQKids4Health)*
Sarasota Family YMCA*
Sarasota Memorial Hospital*
Seven Rivers Regional Medical Center
Shriners Hospital for Children
South Bay Hospital
South County Family YMCA
South Florida Baptist Hospital
Spring Hill Regional Hospital*
Springbrook Hospital
St. Anthony’s Hospital*
St. Joseph’s Children’s Hospital *
St. Joseph’s Hospital*
St. Joseph’s Hospital North*
St. Joseph’s Women’s Hospital*
St. Petersburg General Hospital*
Sun Coast Hospital
Suncoast Center*
Suncoast Health Council*
Syniverse Technologies*
Tampa Bay Healthcare Collaborative*
Tampa General Hospital*
Tampa Metropolitan Area YMCA*
TechData*
TECO Energy*
Town and Country*
UnitedHealthcare of Florida
United Way of Central Florida*
United Way of Central Florida*
United Way of Hernando County*
United Way of Manatee County*
United Way of Pasco County*
United Way of Sarasota County*
United Way of Tampa Bay*
University Community Hospital - Medical Center*
University Community Hospital Carrollwood*
USF School of Public Health*
Venice Regional Medical Center*
WellFlorida Council
Windmoor Healthcare of Clearwater
YMCA of Greater St Petersburg*
YMCA of the Suncoast*
YMCA of West Central Florida*
45
Steering Committee
The following members of our community serve on the ONE BAY: Healthy Communities Steering Committee:
Steve Mason*
Chair, Healthy Communities Steering Committee
President & CEO, BayCare Health System
Jean Mayer
Senior Vice President, Strategic Services
Tampa General Hospital
Diana Baker
CEO-President, United Way of Tampa Bay
William (Bill) McHugh
CEO, Florida Region, AMERIGROUP Community Care
George Banks, MD
Medical Director, Manatee County Health Department
Suzy O’Malley
VP of Metro Tampa Bay, American Heart Association
Jennifer Bencie, M.D., M.S.A.
Administrator, Manatee County Health Department
Tom Pankey
Managing Director/Advisory Services, KPMG LLP
Alan Bomstein
President, Creative Contractors, Inc.
Donna Petersen, Sc.D.*
Dean, USF College of Public Health
Eileen Coogan Boyle
President & CEO, Allegany Franciscan Ministries
Celeste Philip, MD, MPH
Senior Physician, Polk County Health Department
Maureen “Moe” Freaney
Bureau Director, Health & Human Services,
Pinellas County
Leslene Gordon, PhD, RD, LD/N
Community Health Director, Hillsborough County
Health Department
G. Scott Goyer
Executive Director, YMCA of the Suncoast
Daniel Haight, MD
Director, Polk County Health Department
Ron Hytoff
President & CEO, Tampa General Hospital
William Johnson
Director of Shared Services
Coca-Cola Enterprises Bottling Companies
Richard Karl, M.D.
Surgeon, USF Health
Stephen Klasko, M.D.
Vice President, Health Sciences; Dean, College
of Medicine, USF Health Sciences Center
Jack Kolosky
EVP, Chief Operating Officer
H. Lee Moffitt Cancer Center & Research Institute
Barbara Langland Orban, Ph.D.
Associate Professor and Chair, Department of Health
Policy and Management, USF College of Public Health
Rick Lentz, LEED AP
Florida Regional Vice President, Cutler Associates, Inc.
T. David Lewis
CEO, UnitedHealthcare of Florida, Inc.
Gwen MacKenzie
President and CEO, Sarasota Memorial Hospital
Dan Mahurin*
Chair, TBP Regional Research & Education Foundation
Chairman, President & CEO, SunTrust Bank, Tampa Bay
Ernest Marquart
Managing Partner, Shumaker, Loop & Kendrick, LLP
46
David Pizzo*
Market President, BlueCross BlueShield of Florida
Michelle Robinson*
President - Southeast Region, Verizon
Stuart Rogel*
President & CEO, Tampa Bay Partnership
Jayme S. Rothberg, MS, RT
Dean, Health Occupations, Pasco-Hernando
Community College
The Honorable Karen Seel
Vice-Chair, Commissioner - District 5, Pinellas County
Mickey Smith
CEO, Oak Hill Hospital
Jim Vett
General Manager/VP, Vanguard Advanced
Pharmacy Systems
* denotes Executive Committee
Data Committee
Denise Remus, Ph.D., R.N.
Chair, Data Committee
Chief Quality Officer, BayCare Health System
Bob Costello
Director of Strategic Planning, BayCare Health System
Linda Leon, R.N., MBA/HCM
Director Clinical Outcomes, BayCare Health System
Barbara Langland Orban, Ph.D.
Associate Professor and Chair, Department of Health
Policy and Management, USF College of Public Health
Michael Manocchia, Ph.D.
Sr. Research Scientist, Medical Informatics, BlueCross
BlueShield of Florida
Michael Newman
Vice President, Medical Informatics, BlueCross BlueShield
of Florida
Etienne Pracht, Ph.D.
Associate Professor, Department of Health Policy and
Management, USF College of Public Health
References
Introduction (pages 4-9)
Organisation for Economic Co-Operation and Development, Women
and Men in OECD Countries, 27, accessed Oct. 13, 2010, http://www.
oecd.org/dataoecd/44/52/37962502.pdf
1
National Center for Chronic Disease Prevention and Health Promotion,
The Power of Prevention, Chronic disease…the public health challenge
of the 21st century (2009), 1, last modified Jan. 11, 2010, http://www.cdc.
gov/chronicdisease/overview/pop.htm
2
National Center for Chronic Disease Prevention and Health Promotion
3
Anne Martin, David Lassman, Lekha Whittle, Aaron Catlin, and the
National Health Expenditure Accounts Team, “Annual Spending Update:
Recession Contributes To Slowest Annual Rate Of Increase In Health
Spending In Five Decades”, Health Affairs, Jan. 2011 30:111-22,
doi:10.1377/hlthaff.2010.1032.
4
Sean Keehan, Andrea Sisko, Christopher Truffer, Sheila Smith, Cathy
Cowan, John Poisal, M. Kent Clemens the National Health Expenditure
Accounts Projections Team, “Health Spending Projections Through
2017: The Baby-Boom Generation Is Coming To Medicare”, Health
Affairs, 27, no. 2 (2008): w145-w155 (Published online ), doi:10.1377/
hlthaff.27.2.w145.
5
U.S. Department of Health and Human Services, “Healthy People 2010:
Understanding and Improving Health, (second edition)” A Systematic
Approach to Health Improvement, last modified Jan. 20, 2001, http://
www.healthypeople.gov/2010/Document/html/uih/uih_2.htm
6
U.S. Department of Labor, Bureau of Labor Statistics, “Overview of BLS
Statistics on Unemployment”, last modified June 4, 2010, http://www.
bls.gov/bls/unemployment.htm
7
American Diabetes Association, Diabetes Basics, Diabetes Statistics,
“Data from the 2007 National Diabetes Fact Sheet”, http://www.
diabetes.org/diabetes-basics/diabetes-statistics/
8
Agency for Healthcare Research and Quality, “Prevention Quality
Indicators Overview”, AHRQ Quality Indicators, July 2004, Rockville, MD.
http://www.qualityindicators.ahrq.gov/pqi_overview.htm
9
Economy/Demographics (pages 12-13)
Brookings Institution, The State of Metropolitan America, On the Front
Lines of Demographic Transformation, Executive Summary, 1, 2010,
http://www.brookings.edu/~/media/Files/Programs/Metro/state_of_
metro_america/metro_america_execsum2.pdf
10
U.S. Census Bureau, “ACS Demographic and Housing Estimates:
2009. Data Set: 2009 American Community Survey 1-Year Estimates
Survey: American Community Survey”, American FactFinder http://
factfinder.census.gov
11
The percentage of Medicare expenditures for post-acute settings such
as nursing homes, hospice and home health has increased substantially
in the last decade. National Center for Health Statistics. Health, United
States, 2009: With Special Feature on Medical Technology, Hyattsville,
MD, 2010, Table 142, http://www.cdc.gov/nchs/data/hus/hus09.
pdf#listtables
12
U.S. Census Bureau, “ACS Demographic and Housing Estimates:
2009. Data Set: 2009 American Community Survey 1-Year Estimates
Survey: American Community Survey”, American FactFinder http://
factfinder.census.gov
13
U.S. Census Bureau, Population Division, Table 5, “Percent
Distribution of the Projected Population by Net International Migration
Series, Race, and Hispanic Origin for the United States: 2010 to 2050”
(NP2009-T5), Release Date: December 16, 2009. The federal government
treats Hispanic origin and race as separate and distinct concepts. In
surveys and censuses, separate questions are asked on Hispanic origin
and race. The question on Hispanic origin asks respondents if they are
Spanish, Hispanic or Latino. Starting with Census 2000, the question
on race asked respondents to report the race or races they consider
14
themselves to be. Thus, Hispanics may be of any race. U.S. Census
Bureau, Population Division, Social & Demographic Statistics, U.S.
Census Bureau Guidance on the Presentation and Comparison of Race
and Hispanic Origin Data, 2003, http://www.census.gov/population/
www/socdemo/compraceho.html
U.S. Census Bureau, State and County QuickFacts, “Household
Income and Persons Below Poverty”, http://quickfacts.census.gov/qfd/
meta/long_IPE010204.htm
15
Florida Department of Education, Office of Education Information
and Accountability Services, Data Report, Florida Public High School
Graduation Rates, 2008-09, Series 2010-09D, Nov. 2009.
16
National Education Association, Office of Higher Education, Update,
“Higher Education: Who Benefits?”, Vol 9, Number 3, May 2003, http://
www.nea.org/assets/docs/HE/vol9no3.pdf
17
18
Health Outcomes (pages 14-19)
Centers for Disease Control and Prevention, A-Z Index, Chronic
Disease Prevention and Health Promotion, last modified Jan. 5, 2011,
http://www.cdc.gov/chronicdisease/; Council of State Governments
Trends Alert, “Using Sound Science to Prevent Chronic Disease: State
Policy Implications”, 2, www.healthystates.csg.org
19
National Center for Chronic Disease Prevention and Health Promotion
20
American Heart Association, “Risk Factors and Coronary Heart Disease
and Stroke”, last modified Jan. 20, 2008, http://www.americanheart.org/
presenter.jhtml?identifier=539
21
Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron
W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP,
Lewis DR, Cronin K, Chen HS, Feuer EJ, Stinchcomb DG, Edwards BK
(eds). “SEER Cancer Statistics Review, 1975-2007”, (National Cancer
Institute. Bethesda, MD, 2010) http://seer.cancer.gov/csr/1975_2007/
22
American Diabetes Association, Diabetes Statistics, “Data from
the 2007 National Diabetes Fact Sheet”, http://www.diabetes.org/
diabetes-basics/diabetes-statistics/?utm_source=WWW&utm_
medium=DropDownDB&utm_content=Statistics&utm_campaign=CON
23
National Alliance for Mental Illness, “Grading the States 2009
Report Card: Florida”, http://www.nami.org/gtsTemplate09.
cfm?Section=Florida_Grades09&template=/contentmanagement/
contentdisplay.cfm&contentID=74682
24
Centers for Disease Control and Prevention, A-Z Index, “Injury
Prevention & Control: Data Statistics (WISQARSTM)”, last modified Mar.
4, 2010, http://www.cdc.gov/injury/wisqars/index.html
25
UNICEF, Child info, “Monitoring the Situation of Children and Women,
Statistics by Area/Child Nutrition”, last modified Nov. 2009, http://www.
childinfo.org/low_birthweight.html 26
March of Dimes, Professionals, Medical Resources, last modified Nov.
2009, http://www.marchofdimes.com/Professionals/medicalresources_
teenpregnancy.html
27
Health-Related Behaviors (pages 23-24)
American Heart Association, “Understand Your Risk for
High Blood Pressure”, last modified July 30, 2010, http://
www.heart.org/HEARTORG/Conditions/HighBloodPressure/
UnderstandYourRiskforHighBloodPressure/Understand-Your-Risk-forHigh-Blood-Pressure_UCM_002052_Article.jsp
28
WedMD, “Hypertension/High Blood Pressure Guide”, http://www.
webmd.com/hypertension-high-blood-pressure/guide/hypertensionhigh-blood-pressure-stroke
29
47
References (cont.)
Health-Related Behaviors (pages 23-24)
Environmental Health (pages 28-31)
Centers for Disease Control and Prevention, A-Z Index, “Smoking
and Tobacco Use”, last modified Sept. 15, 2010, http://www.cdc.gov/
tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/
45
30
Prof Salim Yusuf DPhil a, Steven Hawken MSc a, Stephanie Ôunpuu
PhD a, Tony Dans MD a, Alvaro Avezum MD a, Fernando Lanas MD a,
Matthew McQueen FRCP a, Andrzej Budaj MD a, Prem Pais MD a,
John Varigos BSc a, Liu Lisheng MD a, on behalf of the INTERHEART
Study Investigators, Effect of potentially modifiable risk factors
associated with myocardial infarction in 52 countries (the INTERHEART
study): case-control study, The Lancet, Volume 364, Issue 943B,
937-52, Published online Sept. 3, 2004 http://image.thelancet.com/
extras/04art8001web.pdf
31
Centers for Disease Control and Prevention, A-Z Index, Publications
and Information Products, NCHS Health E-Stat, “Prevalence of
Overweight, Obesity, and Extreme Obesity Among Adults: United States,
Trends 1976-1980 Through 2008-2008”, June 2010, http://www.cdc.
gov/nchs/products/hestats.htm
32
Centers for Disease Control and Prevention, A-Z Index, “Childhood
Overweight and Obesity”, last modified Mar. 31, 2010, http://www.cdc.
gov/obesity/childhood/index.html
33
Pleis JR, Lucas JW, Ward BW. Summary health statistics for U.S.
adults: National Health Interview Survey, 2008. National Center for
Health Statistics. Vital Health Stat 10(242), 2009.
34
Centers for Disease Control and Prevention, A-Z Index, “Alcohol and
Public Health Fact Sheets”, last modified Dec. 17, 2010, http://www.cdc.
gov/alcohol/fact-sheets/binge-drinking.htm
35
Centers for Disease Control and Prevention, A-Z Index, “Breast
Cancer: Rates of New Cases and Deaths”, last modified Oct. 20, 2010,
http://www.cdc.gov/Features/dsBreastCancerTrends/
36
Environmental Protection Agency, “New Report Shows Benefits
of 1990 Clear Air Act Amendments Outweigh Costs by Four-to-One
Margin”, last modified Sept. 10, 2009, http://www.epa.gov/history/
topics/caa90/10.htm
U.S. Environmental Protection Agency, Air Quality Index - A Guide
to Air Quality and Your Health, Aug. 2009, http://www.epa.gov/airnow/
aqi_brochure_08-09.pdf
46
U.S. Environmental Protection Agency, Air Quality Index - A Guide
to Air Quality and Your Health, Aug. 2009, http://www.epa.gov/airnow/
aqi_brochure_08-09.pdf
47
Centers for Disease Control and Prevention, “CDC Recommendations
for Improving Health through Transportation Policy”, Apr. 28, 2010,
http://www.cdc.gov/transportation/docs/FINAL%20CDC%20
Transportation%20Recommendations-4-28-2010.pdf
48
The Sierra Club, “Clearing the Air with Transit Spending”, Nov.
2001, http://www.sierraclub.org/sprawl/report01/SierraClub_
SprawlReport2001_low-res.pdf
49
U.S. Department of Transportation, National Highway Traffic Safety
Administration, Traffic Safety Facts, “Highlights of 2009 Motor Vehicle
Crashes”, Aug. 2010, http://www-nrd.nhtsa.dot.gov/Pubs/811363.pdf
50
Website: Miami-Dade Matters: Better health through community,
“Age-Adjusted Death Rate due to Motor Vehicle Collisions”, 2008, http://
www.miamidadematters.org/modules.php?op=modload&name=NSIndicator&file=indicator&iid=48
51
Website: Miami-Dade Matters: Better health through community,
“Age-Adjusted Death Rate due to Motor Vehicle Collisions”, 2008, http://
www.miamidadematters.org/modules.php?op=modload&name=NSIndicator&file=indicator&iid=48
52
National Highway Traffic Safety Administration, “2009 Ranking of
STATE Pedestrian Fatality Rates – State: USA”, http://www-fars.nhtsa.
dot.gov/States/StatesPedestrians.aspx
53
Health Systems (pages 24-27)
U.S. Centers for Medicare and Medicaid Services, Office of the
Actuary, “Personal Health Care Expenditures by Object and Source of
Payment: 2008”, Internet release date: Dec. 15, 2010, http://www.hhsstat.net/scripts/orgurl.cfm?orgabb=CMS-OA
37
Nelson, Mark. “Drug treatment of elevated blood pressure”, Australian
Prescriber (33): 108–112, August, 2010, http://www.australianprescriber.
com/magazine/33/4/108/12
38
Agency for Healthcare Research and Quality, Care of Children
and Adolescents in U.S. Hospitals. HCUP Fact Book No. 4. AHRQ
Publication No. 04-0004, (AHRQ: Rockville, MD, 2003). http://www.ahrq.
gov/data/hcup/factbk4/
39
Centers for Disease Control and Prevention, A-Z Index, Diabetes
Public Health Resource, “Children and Diabetes SEARCH for Diabetes
in Youth”, last modified Oct. 20, 2010, http://www.cdc.gov/diabetes/
projects/diab_children.htm
40
John M. MacDonald, PhD, Robert J. Stokes, PhD, Deborah A. Cohen,
MD, MPH, Aaron Kofner, MS, Greg K. Ridgeway, PhD, “The Effect of
Light Rail Transit on Body Mass Index and Physical Activity”, Am J Prev
Med 2010; 39(2):105-112, http://download.journals.elsevierhealth.com/
pdfs/journals/0749-3797/PIIS0749379710002977.pdf
54
55
Centers for Disease Control and Prevention, CDC Features, “Food
Deserts”, last modified July 5, 2010, www.cdc.gov/Features/FoodDeserts
56
U.S. Department of Agriculture, Food Environment Atlas, http://maps.
ers.usda.gov/FoodAtlas/foodenv5.aspx
57
Centers for Disease Control and Prevention, A-Z Index, Diabetes Public
Health Resource, “2007 National Diabetes Fact Sheet”, last modified Mar.
12, 2010, http://www.cdc.gov/diabetes/pubs/estimates07.htm#3
U.S. Department of Justice, Federal Bureau of Investigation, “Crime
in the United States, 2009, National Data”, Table 1 and 1A, released
Sept. 2010, http://www2.fbi.gov/ucr/cius2009/offenses/standard_links/
national_estimates.html
National Kidney and Urologic Diseases Information Clearinghouse,
“Urinary Tract Infections in Children”, NIH Publication No. 07-4246, Dec.
2005, http://kidney.niddk.nih.gov/kudiseases/pubs/utichildren/
Community Assessment (pages 32-37)
41
58
42
State Health Access Data Assistance Center, “Health Insurance
Coverage Estimates, CPS, All Ages, All Poverty Levels, United States:
Calendar Year 2009”, http://www.shadac.org/datacenter/tables/tables/
id/e7162673-6f5d-4cf3-851e-628cffb34054
43
American Hospital Association,” AHA Guidance on Reporting of
Community Benefit”, Nov. 27, 2006.
59
Internal Revenue Service, “IRS Exempt Organizations Hospital
Compliance Project”, Executive Summary, Feb. 2009, http://www.irs.
gov/pub/irs-tege/execsum_hospprojrept.pdf
60
Estimation based on 3.5% increase in Florida rates of uninsured. State
Health Access Data Assistance Center, “Health Insurance Coverage
Estimates Tables”, last modified Sept 20, 2010, http://www.shadac.org/
datacenter/tables/filters/id/f4906958-164b-4875-a562-0bf1fc2030d1
44
48
Acknowledgements
The Tampa Bay Partnership Regional Research & Education Foundation thanks the following organizations and
individuals whose efforts, insights, and support were critical to the completion of this report.
First and foremost, we thank BayCare Health System, Blue Cross Blue Shield of Florida, United Way of
Tampa Bay, and the Allegheny Franciscan Foundation for their generous financial and intellectual support
of this project. BayCare and Blue Cross Blue Shield have provided long-standing support to the Tampa Bay
Partnership for many years, and we welcome the participation of our community partners from the United Way
and Allegheny Franciscan Foundation who provide valuable insights and expertise from our community.
The Steering Committee greatly informed the overall approach to the Initiative, the methodology and scope of
this report. The Data Committee spent countless hours developing criteria, reviewing data, and co-authoring
the Health Outcomes, Health Behaviors, Infrastructure, and Health Access chapters of this report. Special
recognition goes to Denise Remus, PhD, RN, who not only chaired the Data Committee, but also provided wise
counsel and insight into the numerous report drafts.
Lynda Leedy, J.D., provided day-to-day management of the initiative including conducting a comprehensive
community survey assessment, research assistance, and convening leadership and committees to guide the
overall scope of this project.
Zac Pruitt, Data Intern, Doctoral Student, at the University of South Florida for compiling the data sources for
the indicators reflected in this report. Mr. Pruitt provided much needed, timely assistance to the Foundation in
navigating and analyzing data from the various data sources. The project would not have been possible without
his tireless effort.
Healthy Communities Institute gave permission for us to utilize the descriptor language they have developed
for their Healthy Communities Network system for our indicators in this report.
Amy Lovett Dunn, BayCare, Laurel St. Clair, BayCare, Erica Rogers Maxwell, American Heart Association and
Michael Manocchia, PhD, Blue Cross Blue Shield of Florida, gave generously of their time to critique, proof and
edit drafts of this report.
Stuart Rogel, President & CEO of the Tampa Bay Partnership, provided invaluable guidance and vision for this project.
Other Tampa Bay Partnership staff members also contributed to data analysis, co-authoring, editing and design
for this report including Elisa DeGregorio, Dave Sobush, Chris Steinocher, Betty Carlin and Kasey Smith.
Laurie Beyer Weinberg, Beyer Design, provided the layout and design for the report.
Funding Partners
Initial funding for the ONE BAY: Healthy Communities initiative to fund the research and development of this report
comes from:
49
an initiative of
4300 West Cypress Street • Suite 250 • Tampa, Florida 33607
www.myonebay.com

Healthy - Tampa Bay Partnership

Transcription

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